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6.0 Патологічна фізіологія
A married couple applied to the genetic consultation in order to consult about their child with
multiple abnormalities (microcephaly, idiocy etc). The woman has had an illnesses during her
pregnancy but she didn't take any teratogens or mutagens. The parents' and the child's
karyotype is normal. Anamnesis study revealed that the family kept a cat. What gravidic disease
caused the child's abnormalities?
A patient underwent a surgery for excision of a cyst on pancreas. After this he developed
haemorrhagic syndrome with apparent disorder of blood coagulation. Development of this
complication can be explained by:
A*Activation of fibrinolytic system
BInsufficient fibrin production
CReduced number of thrombocytes
DActivation of anticoagulation system
EActivation of Christmas factor
ECG of a 44-year-old patient shows signs of hypertrophy of both ventricles and the right atrium.
The patient was diagnosed with the tricuspid valve insufficiency. What pathogenetic variant of
cardiac dysfunction is usually observed in case of such insufficiency?
A*Heart overload by volume
BHeart overload by resistance
CPrimary myocardial insufficiency
A patient who takes a blocker of membrane cytoreceptors of efferent conductor synapses of
autonomic nervous system complains about dry mouth. What receptors are blocked?
Examination of a patient revealed enlargement of some body parts (jaw, nose, ears, feet,
hands), but body proportions were conserved. It might be caused by intensified secretion of the
A patient complains about attacks of laboured breathing, dizziness. He works at a chemical plant
producing hydrocyanic acid. The described symptoms might be associated with dysfunction of
the following enzyme:
As a result of improper feeding an infant got full-blown diarrhea. One of its main consequences
is excretion of large amount of sodium bicarbonate. What form of acid-base balance
disturbance is it?
EAcid-base balance won't be disturbed
After sprinting untrained people feel muscular pain as a result of lactate accumulation. I may be
connected with intensification of the following biochemical process:
Blood of patients ill with diabetes mellitus has high content of free fatty acids. It may be caused by:
A*High activity of triglyceride lipase of adipocytes
BAccumulation of palmitoyl-CoA in the cytosol
CActivation of ketone bodies utilization
DActivation of synthesis of apolipoproteins А-1, А-2, А-4
ELow activity of phosphatidylcholine-cholestein-acyltransferase of plasma
What vitamin deficiency leads to both disorder of reproductive function and distrophy of skeletal
Toxic pulmonary edema was reproduced on a laboratory rat by means of ammonium chloride
solution. What is the leading pathogenetic factor of this edema?
A*Increased permeability of capillars
BIncrease of venous outflow
CDecrease of colloid osmotic pressure
DDisorder of neural and humoral regulation
EIncrease of lymph outflow
An experimental rat got intra-abdominal injection of 10 ml of 40% glucose solution. 60 minutes
later the rat passed into a comatose state as a result of dehydratation. What is the mechanism
of development of this state?
A*Rise of osmotic pressure of extracellular fluid
BRise of oncotic pressure of extracellular fluid
CReduction of vasopressin secretion
DLoss of salts and water
15 minutes after a car accident examination of a 35 year old man revealed massive injury of
lower extremities without serious external loos of blood. The victim is in excited state. What
component of pathogenesis of traumatic shock is basic and requires urgent correction?
BAcute renal insufficience
DCardiac function disorder
EInternal loss of plasma
A 50-year-old patient has been examined by a dentist and found to have crimson smooth
tongue. Blood analysis revealed a decrease in RBC level and hemoglobin concentration, colour
index of 1,3, symptoms of megaloblastic hematopoiesis, degenerative changes in WBCs. What
blood disorder was found in this patient?
BIron deficiency anemia
A pregnant women developed severe toxemia with exhausting recurrent vomiting throughout a
day. By the end of the day she developed tetanic convulsions and bodily dehydration. The
described changes were caused by the following type of acid-base disbalance:
A*Nongaseous excretory alkalosis
DNongaseous metabolic acidosis
ENongaseous excretory acidosis
After a diver had dived to a depth of 60 meters he got the following symptoms of CNS
dysfunction: anxiety, euphoria, lack of attention, professional errors. These symptoms are
associated with neurons being under a toxic effect of:
A patient has disorder of airways patency at the level of small and middle bronchs. What
changes of acid-base balance may take place?
EAcid-base balance won't change
The body temperature of a patient with an infectious disease rises once in two days up to 39,5-40,5oС and stays so for about an hour and then drops to the initial level. What type of fever is it?
A 23 year patient was admitted to the hospital in grave condition with craniocerebral trauma. His
respiration is characterized by a spasmodic long inspiration interrupted by a short expiration.
What respiration type is it typical for?
Two days after myocardial infarction a patient had a sudden systolic pressure decrease up to
60 mm, tachycardia up to 140/min, dyspnea; the patient lost consciousness. What mechanism
is principal for the shock pathogenesis?
A*Decrease of cardiac volume
CDecrease of circulating blood volume
After a psychoemotional stress a 48 year old patient had a sudden attack of acute heart pain
with irradiation to the left hand. Nitroglycerine suppressed pain in 10 minutes. What
pathogenetic mechanism is principal for the pain development?
A*Spasm of coronary vessels
BDilatation of peripheral vessels
CCoronary vessel occlusion
DEmbarrassement of coronary vessels
EIncreased need of myocardium in oxygen
A 46-year-old patient suffering from the diffuse toxic goiter underwent resection of the thyroid
gland. After the surgery the patient presents with appetite loss, dyspepsia, increased
neuromuscular excitement. The body weight remained unchanged. Body temperature is normal.
Which of the following has caused such a condition in this patient?
A*Reduced production of parathormone
BIncreased production of thyroxin
CIncreased production of calcitonin
DIncreased production of thyroliberin
EReduced production of thyroxin
A patient with periodontitis has developed gingival edema. The gums are of dark red colour.
What local circulation disorder prevails in the gums of the patient?
An 18-year-old patient complains of general weakness, fatigue, low spirits. The patient is of the
asthenic constitution type. Ps- 68/min., AP- 90/60 mm Hg. She has been found to have primary
neurocirculatory hypotension. What is the leading factor of the arterial pressure drop in this patient?
A*Decreased tonus of resistive vessels
BDecreased minute blood volume
DDeposition of blood in the veins of the systemic circulation
EDecreased cardiac output
A 40 year old man who took part in disaster-management at a nuclear power plant fell sick with
paradontitis. What etiological agent is the most important for the development of this pathology?
DIncreased load of dentoalveolar apparatus
To prevent the transplant rejection after organ transplantation it is required to administer
hormonotherapy for the purpose of immunosuppression. What hormones are used for this purpose?
A woman after labor lost 20 kg of body weight, her hair and teeth fall out, she has muscle
atrophy (hypophysial cachexia). Synthesis of what hypophysis hormone is disturbed?
Climbing the mountains at a height of 5000 m climbers started complaining of breath shortness,
palpitation, vertigo, ring in the ears. What pathogenetic factor determines the development of
CDecreased oxygen capacity of blood
Damage of one of the reactors at a nuclear power plant resulted in runout of radioactive
products. People who were present in the high-radiation area got approximately 250-300 R.
They were urgently taken to the hospital. What blood changes will be typical for this period?
A year after subtotal stomach resection on account of ulcer of lesser curvature the following
blood changes were revealed: anemia, leukocytopenia and thrombocytopenia, color index - 1,3,
megaloblasts and megalocytes. What factor deficiency caused the development of thos pathology?
A patient with a craniocerebral injury presents with respiration characterized by progressively
deeper respiratory movements followed by a gradual decrease that results in a temporary stop
in breathing. What pattern of abnormal respiration are these features typical for?
A 45 year old patient was taken to the hospital by an emergency team with serious cranial
trauma in shock condition. Objectively: unconscious, skin is pale, body to- 35oС, low muscular tonus, reflexes are absent, pulse is rapid and weak, AP- 50/30 mm Hg. What clinical shock stage is it?
After the traumatic tooth extraction a patient is complaining of acute, dull, poorly-localized pain in
gingiva, body temperature rise up to 37,5oC. The patient has been diagnosed with alveolitis.
Specify the kind of pain in this patient:
After poisoning with an unknown drug a 37 year old patient has stereotypical face muscle contractions that imitate blinking and squinting. What form of motor function disorder of nervous
system is it?
A teenger had his tooth extracted under novocain anaesthesia. 10 minutes later he presented
with skin pallor, dyspnea, hypotension. When this reaction is developed and the allergen
achieves tissue basophils, it reacts with:
A 12 year old boy came home from school and started complaining of headache, sickness, chill,
periodical muscle pain, appetite loss, flabbiness. What period of illness are these symptoms typical for?
DHigh point of illness
EEnd of illness
Rabbits lived on food with addition of cholesterol. Five months later the atherosclerotic aorta
changes were revealed. Name the main cause of atherogenesis in this case:
A patient with primary nephrotic syndrome has the following content of whole protein: 40 g/l.
What factor caused hypoproteinemia?
BTransition of protein from vessels to tissues
CReduced protein synthesis in liver
EDisturbance of intestinal protein absorption
Examination of experimental rats that have been getting only carbohydrate feed for a long time
revealed accumulation of water in tissues. What is the leading pathogenetic mechanism of
A man who took part in disaster-management at a nuclear power plant had hemorrhagic
syndrome at the same time with acute radiation sickness. What is the most important thing for
the pathogenesis of this syndrome?
BDestructed structure of vessel walls
CHigh activity of fibrinolysis factors
DHigh activity of anticoagulative blood system
ELow activity of anticoagulative blood system
Four months ago a 43 year old patient had a traumatic amputation of his lower extrimity. Now he
complains of sensing the amputated extremity and having constantly grave, sometimes
unbearable pain in it. What type of pain does he have?
In crisis period a 14 year old child ill with diphtheria has AP- 70/50 mm Hg accompanied by
abrupt fall in temperature and tachycardia. What form of vascular tone disturbance is it?
DEssential arterial hypotension
After a long-lasting and grave illness the blood pressure of a patient fell up to 60/40 mm; he has
tachicardia, dyspnea, black-out. How can this state be defined?
A patient ill with jaundice has increased content of conjugated bilirubin and bile acids in blood, no
stercobilinogen in urine. What jaundice are these symptomps typical for?
A newborn child ill with pylorostenosis has frequent vomiting accompanied by apathy, weakness,
muscular hypertonia, sometimes convulsions. What form of acid-base balance disorder has
A 10-year-old child cut his leg with a piece of glass and was sent to a clinic for an anti-tetanus
serum injection. In order to prevent the development of anaphylactic shock the Besredka
desensitisation method was applied. What mechanism underlies this method?
A*Binding to IgE fixed to mast cells
BInhibited synthesis of mast cells mediators
CStimulation of the immunological antigen tolerance
DStimulation of antigen-specific IgG2 synthesis
EBinding of IgE receptors on mast cells
A 19 year old patient was diagnosed with chronic acquired hemolytic anemia. What is the
leading pathogenetic mechanism of this pathology's development?
DHyposmolarity of plasm
A 56 year old man was taken to the hospital with complaints of general weakness, pain and
burning in the region of tongue, extremity numbness. In the past he had resection of cardiac part
of ventricle. Blood test: Hb- 80 g/L; RBC- 2,0x1012/L; colour index of blood- 1,2; leukocytes -
3,5x109/L. What type of anemy is it?
After recovering from epidemic parotiditis a patient began to lose weight, he was permanently
thirsty, drank a lot of water, had frequent urination, voracious appetite. Now he has complaints
of skin itch, weakness, furunculosis. His blood contains: glucose - 16 mmole/L, ketone bodies -
100 mcmole/L; glucosuria. What disease has developed?
A patient dropped into an ice hole, froze in the wind and fell ill. Body temperature rose up to
39,7oC and varied from 39oC to 39,8oC. Name the type of the patient's temperature profile?
A patient has the following diagnosis: renal hypertension. What is the initial pathogenetic factor
of arterial hypertension development in this case?
DIntensified renin synthesis
EIntensified angiotensin synthesis
A diver who has been staying at the depth of 40 m for a long time fell ill with caisson disease as
a result of decompression. The main pathogenetic factor is the following embolism:
A woman with intractable vomiting was admitted to the infectious disease ward.What changes of
water-salt metabolism are likely to be observed?
A 65 year old patient suddenly died. She suffered from thrombophlebitis of deep veins of shin.
Autopsy revealed: trunk and bifurcation of pulmonary artery contain red loose masses with dull
corrugated surface. What pathological process did the morbid anatomist reveal in pulmonary artery?
DForeign body embolism
ECG of a patient shows such alterations: P-wave is normal, P-Q-interval is short, ventricular
QRST complex is wide, R-wave is double-peak or two-phase. What form of arrhythmia is it?
A*WPW syndrome (Wolff-Parkinson-White)
BFrederick's syndrome (atrial flutter)
Skin samples of a patient with bronchial asthma revealed allergen sensitization of poplar fuzz.
What factor of immune system plays the main part in development of this immunopathological state?
A patient with insulin-dependent diabetes had an insulin injection. Some time later he felt
weakness, irritability, excessive sweating. What is the main reason of these disorders?
A*Carbohydrate starvation of brain
For the purpose of disinfection of nonmetallic surgical instruments the formaldehyde solution
was used. What group does this anticeptic preparation belong to according to its chemical
A patient with an acute myocarditis has the clinic presentations of cardiogenic shock. What
pathogenetic mechanism plays the main part in shock development?
A*Disorder of pumping ability of heart
BDepositing of blood in veins
CDecrease of diastolic flow to the heart
DDecrease of vascular tone
EIncrease of vascular tone
A patient with inflammation of trigeminal nerve has been having progressive paradontitis for
some years. What factor is the most important for parodontitis development?
BLow activity of leukocytic elastase
CPoor formation of immunoglobulins
DIncreased tone of vagus nerve
ELow activity of kallikrein-kinin system
A patient with streptococcal infection of gums was prescribed a drug that contained beta-lactam
ring in its structure. Which drug relates to this group?
During a prophylactic medical examination a 7-year-old boy was diagnosed with daltonism. His
parents are healthy and have normal colour vision, but his grandfather on his mother’s side has
the same abnormality. What is the type of the abnormality inheritance?
Potassium cyanide that is a poison came into a patient's organism and caused death a few
minutes after it. The most probable cause of its toxic effect was abnormal activity of:
A 12-year-old teenager has significantly put off weight within 3 months; glucose concentration
rose up to 50 millimole\\l. He fell into a coma. What is the main mechanism of its development?
A patient was stung by a bee. Examination results: his left hand is hot, pink and edematic, there
is a big blister on the spot of the sting. What is the leading mechanism of edema development?
A*Increased vascular permeability
BReduced blood filling of vessels
CVascular damage caused by the sting
DReduction of oncotic pressure of tissue
EReduction of osmotic pressure of tissue
A surgeon used novocaine as an anaesthetic during surgical manipulations. 10 minutes after it
the patient became pale, he got dyspnea and hypotension. What type of allergic reaction is it?
After the exposure to ionizing radiation a person was found to have a decrease in blood
granulocyte level. What mechanism underlies these changes?
BIncreased passage of granulocytes into the tissues
CAutoimmune process development
DIncreased disintegration of leucocytes
EDisturbed release of mature leukocytes from the bone marrow
An unconscious patient had been delivered to a hospital by the ambulance. Objectively: absent
reflexes, occasional convulsions, irregular breathing. After a laboratory examination he was
diagnosed with hepatic coma. What metabolite accumulation is essential for the development of
the central nervous system disorders?
A patient was admitted to a hospital with poisoning with unsound food. His stomach was lavaged
with solution of potassium permanganate. What is its mechanism of action?
A*Release of atomic oxygen
BRelease of chlorine
CRelease of iodine
DDisturbance of synthesis of respiratory chain enzymes
EDestruction of bacteria membranes
Examination of a patient revealed glycosuria and hyperglycemia. He complains of dry mouth,
itchy skin, frequent urination, thirst. He has been diagnosed with diabetes mellitus. What is the
cause of polyuria in this patient?
A*Increased urine osmotic pressure
BDecreased plasma oncotic pressure
CIncreased filtration pressure
DDecreased cardiac output
EIncreased plasma oncotic pressure
Hydrocyanic acid and cyanides are the most violent poisons. According to the dose the death
follows after a few seconds or minutes. The death is caused by the inhibited activity of the
Treatment of many diseases involves use of cocarboxylase (thiamine pyrophosphate) for
supplying cells with energy. What metabolic process is activated in this case?
A*Oxidizing decarboxylation of pyruvate
CAmino acids decarboxylation
DDecarboxylation of biogenic amines
EDetoxication of harmful substances in liver
A typical symptom of cholera is great loss of water and sodium ions. What mechanism underlies
development of diarrhea in this case?
A*Activation of adenylate cyclase of enterocytes
BIncreased secretion of renin by the cells of renal arterioles
CAldosterone oxidation in adrenal cortex
DInhibition of vasopressin synthesis in hypothalamus
EIncreased corticotropin synthesis
A newborn has signs of dyspepsia after milk feeding. Symptoms of dyspepsia disappear when
milk is substituted for glucose solution. The newborn has low activity of the following enzyme:
A patient with enteritis accompanied with intense diarrhea has reduced quantity of water in the
extracellular space and increased quantity of water inside the cells as well as low blood
osmolarity. Name this disorder of water-electrolytic metabolism:
For the preparation of the burned skin surface of a patient a certain medication was applied. Its
antiseptic properties are provided by free oxygen released in presence of organic substances.
What medication is it?
DAlcoholic iodine solution
A 30 y.o. patient is diagnosed with amebic dysentery. This diagnosis was bacteriologically
confirmed. Name the preparation for its treatment:
It is known that patients with diabetes mellitus are more subject to inflammative processes, they
have low regeneration and slower wound healing. What is the reason for this?
A*Decrease in protheosynthesis
BIncrease in lipolysis
DDecrease in lipolysis
EIntensification of catabolism
For infection prevention a patient who underwent appendectomy was prescribed a
cephalosporin antibiotic. Antimicrobial activity of these antibiotics is called forth by the
disturbance of the following process:
A*Microbial wall formation
BNucleic acid synthesis
CRibosomal protein synthesis
It is required to disinfect equipment in a dental room. Choose a preparation without disagreeable
odour and colouring power:
BCarbolic acid solution
A patient was admitted to the infectious diseases department. His skin was dry, with low turgor;
he had rice-water stool. The patient was diagnosed with cholera. This disease is ordinarily
accompanied by the folowing disorder of water-electrolytic balance:
Prophylactic examination of a patient revealed hyperglycemia, ketonuria, polyuria, glycosuria.
What form of acid-base balance disorder is the case?
Injection of an anaesthetic before the tooth extraction resulted in development of anaphylactic
shock accompanied by oliguria. What pathogenetic mechanism caused a decrease in diuresis
in this case?
A*Decrease in hydrostatic pressure in the renal corpuscle capillaries
BIncrease in hydrostatic pressure in the Bowman's capsule
CDamage of glomerular filter
DIncrease in oncotic pressure of blood plasma
EIncrease in vasopressin secretion
A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood plasma
the total bilirubin is increased, stercobilin is increased in feces, urobilin is increased in urine.
What type of jaundice is it?
A group of researchers set an experiment and obtained anucleate mutant cells. In the first place
they will have disturbed synthesis of the following compounds:
As a result of a trauma a patient has developed traumatic shock that led to the following
disorders: AP is 140/90 mm Hg, Ps is 120 bpm. The patient is fussy, talkative, pale. Such state
relates to the following shock phase:
A patient consulted a dentis about a lesion of his oral mucosa. He was diagnosed with herpetic
stomatitis. Which of the following drugs will have an effect on etiotropic factor?
A patient consulted a dentist about itching and burning in the oral cavity; high temperature. The
patient was diagnosed with trichomonal gingivostomatitis. What drug should be chosen for his
A patient is ill with herpetic stomatitis provoked by immunosuppression. What preparation
introduced intravenously, internally and locally can provide antiviral and immunopotentiating effect?
A patient suffering form stomatitis was prescribed oral rinsing. Which antiseptic from the oxidant
group is the most suitable for this purpose?
CAlcoholic iodine solution
A patient suffers from the haemorrhagic syndrome that shows itself in frequent nasal bleedings,
posttraumatic and spontaneous intracutaneous and intra-articular haemorrhages. After a
laboratory study a patient was diagnosed with the type B haemophilia. This disease is provoked
by the deficit of the following factor of blood coagulation: