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KROK 1 Medicine 2020 Questions | KROKEXAM
Browse 2020 KROK 1 Medicine exam questions with answers and explanations.
Exam questions
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A patient with essential hypertension developed a cough during the systematic treatment with a hypotensive drug. What drug of those listed below can cause such a side effect?
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Pterin derivatives – aminopterin and methotrexate – are competitive inhibitors of dihydrofolate reductase. As a result, they suppress the regeneration of tetrahydrofolic acid from dihydrofolate. These medicines lead to the inhibition of intermolecular transport of one-carbon groups. In the process, the biosynthesis of the following polymer is suppressed:
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A 2-year-old child presents with marked delay in psychomotor development, vision and hearing deterioration, marked enlargement of the liver and spleen. The child is diagnosed with hereditary Neimann-Pick disease. What genetic defect is the cause of this disease?
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The patient presents with smoothed out nasolabial fold, dilated right palpebral fissures (It cannot be closed when squinting, because of eyelids would not close), there are difficulties during speaking and eating (Food gets stuck between the cheek and teeth). What nerve is damaged in this case?
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A woman was hospitalized in a severe condition with the following diagnosis; hemorrhagic stroke in the region of the medial surface of the right frontal lobe. What artery is likely to be damaged, causing this condition in the patient?
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In an experiment, a frog neuromuscular preparation had been processed with a curare-like substance, which led to the disappearance of muscle contractions in response to electrical stimulation. What function of the muscle cell membrane is disrupted by curare-like substance?
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An unconscious patient was brough into the admission room. He presents with cold skin, constricted pupils, difficult respiration with Cheyne-Stokes pattern, low blood pressure, overfilled urinary bladder. He was diagnosed with morphine poisoning. What drug should the patient be given as an antagonist in this case?
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A patient has developed status epilepticus. What medicine should be used in this case to stop the seizures?
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In the process of acetylcholine interaction with muscarinic acetylcholine receptors of contractile cardiomyocytes, a bioactive substance is being produced. This bioactive substance leads to inactivation of calcium channels, decrease of calcium ions entry into the cardiomyocytes and development of negative inotropic effect. Name this substance:
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Examination showed that total leukocyte count in the patient’s blood is 11 x 109/L, with 80% neutrophils, among which 9% are band neutrophils. Characterize the changes in the cell composition of ‘white’ blood in this case:
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Blood smear analysis of a blood sample obtained from a patient with inflammatory process shows a large number of round cells with segmented nucleus (three or more segments) and fine pink-violet granulation in the cytoplasm. Name the blood cells:
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A newborn boy has dolichocephalic skull, microcephaly and defects of heart, kidneys and digestive system. The child’s karyotype is 47, XY + 18. Make the diagnosis:
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A histological specimen demonstrates a vessel with the wall that consists of endothelium, basement membrane and loose connective tissue. What type of vessel is it?
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Arterial blood pH is 7.4; Primary urine pH is 7.4; final urine pH is 5.8. Decreased pH of the final urine results from the secretion of a certain substance in the nephron tubules. Name the substance:
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A patient came to the hospital complaining of abdominal distension, diarrhea and meteorism that occur after eating protein-rich food, which indicated disturbed protein metabolism and intensified protein putrefaction. What substance is the product of this process in the intestine?
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A patient complains of acute increase in diuresis (upto 5-7 liters of urine per 24 hours). Examination of vasopressin in this patient. What cells have insufficient secretory activity in this case?
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A 35-year-old man complains of a severe rhinitis and a loss of sense of smell for a week. Examination detected in the nasal cavity a large amount of mucus that covered the mucosa and blocked the olfactory receptors. Where is the nasal cavity are these receptors located?
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A 50-year-old man experienced a severe stress. His blood levels of adrenaline and noradrenaline sharply increased. What enzyme catalyze the process of noradrenaline inactivation?
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Due to a case of diphtheria, preventive immunization of the whole contact group of students is necessary. What preparation should be used to produce artificial active immunity?
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A woman who works as a shop assistant and suffers from phlebitis, developed a thrombus in the area of the varicose veins in her leg. What pathogenetic factor was primary in the process of thrombus formation in this case?
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Section shows a significantly enlargement of the patient’s right kidney. There is a nephrolith at the place of the incision. Renal pelvic lumen is distended with accumulating urine. The renal parenchyma is substantially thinned out. What is the most correct diagnosis?
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A 46-year-old man was brought to the hospital specializing in nervous system disease. The man was provisionally diagnosed with cerebral hemorrhage. The patient presents with frequent spontaneous limb movements intermittent with the state of limb muscle hypertonia. These signs can be explained by the damage to the following brain structures:
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After a boy cell from a tree, the arm abduction to the horizontal position is difficult for him. What muscle is likely to be damaged in this case?
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A 7-year-old child developed sore throat and high body temperature. On the 2nd day after the onset of the disease, there appeared dense red rashes that look like small spots that size of a poppy seed. They cover the whole body, except the nasolabial triangle. Examination of the oral cavity revealed bright red pharynx, enlarged tonsils and raspberry-red tongue. Make the diagnosis:
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For the relief of intestinal colic a patient was prescribed atropine sulfate. What disease can be contraindication for administration of this medicine?
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Puncture biopsy of a transplanted kidney detected there a diffuse stromal infiltration by lymphocytes, plasma cells, lymphoblasts and plasmablasts as well as necrotizing arteritis. What pathological process developed in the transplant?
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A young woman suddenly developed cough and bronchial spasm, when she entered into a room with high concentration of tobacco smoke. What receptors activated this defensive reflex?
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A patient has peptic ulcer of the stomach. What medicine can decrease the secretion of hydrochloric acid and pepsin by blocking the H2 receptors?
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A 40-year-old woman was diagnosed with bronchial asthma that manifests as periodical asphyxia attacks. What type of ventilatory insufficiency can be observed in patient during an attack?
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A patient with an injury of the greater psoas muscle was delivered to the traumatology center. The patient has lost the ability to extend the lower leg at the knee joint. What nerve is damaged in this case?
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A patient complains of pain in the upper umbilical region. On palpation there is a mobile painful intestine. What intestine is being palpated by the doctor?
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A 5-year-old child is diagnosed with Bruton’s disease (X-linked agammaglobulinemia) that manifests itself in severe clinical course of bacterial infections and absence of B lymphocytes and plasma cells. What changes in the immunoglobulin content can be observed in the blood serum of the child with immunodeficiency?
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In a hypothetical experiment, the action of a toxic substance disrupts the mechanism of nerve impulse transmission between neurons. What structure enables this function?
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A 45-year-old woman has breast cancer. Metastases can spread in this case to the following regional lymph nodes:
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Due to a cerebral hemorrhage, the patient developed a disturbed speech perception (sensory aphasia). What brain structure is likely to be damaged in this case?
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Acute herpetic gingivostomatitis is the most common primary infection caused by herpes simplex virus type. What material should be obtained by a dentist for the laboratory testing that will confirm the diagnosis?
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The mountain climbers, who without oxygen equipment were climbing a mountain, at the altitude of 5000 meters above the sea level developed tachycardia, low blood pressure, fast respiration rate. What type of hypoxia did they develop?
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A 9-year-old child developed a severe case of purulent destructive pneumonia, for which the child received a massive antibacterial therapy. The disease was rapidly progressing. Against the background of marked intoxication, a sharp drop in blood pressure was registered, the patient went into the state of shock, which resulted in the death of the patient. What erippathogeneitic type of shock developed in the child?
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A patient suffers from the eye muscle paralysis, there are pupillary disturbances and pain along the trigeminal nerve. Aneurysm(dilation) of a certain venous sinus can be suspected. Name this venous sinus:
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A patient has cardiac rhythm disturbance. ECG shows heart rate of 60/min, prolongation of PQ interval, periodical loss of QRS complex. What cardiac rhythm disturbances is it?
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