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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 person has diabetes mellitus with fasting hyperglycemia of over 7.2 mmol/L. What blood plasma protein allows for retrospective assessment (4-8 weeks before the examination) of glycemia levels?
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During a surgery for spleen injury, the surgeon needs to isolate an artery that supplies the spleen with blood. What branch of the arterial vessel is it?
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During an intense workout, the number of trophic inclusions in the cells of the athlete’s liver and skeletal muscles decreases. What substance belongs to such trophic inclusions?
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A 49-year-old woman developed a leg edema after a long time spent standing. What is the likely cause of edema development?
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Autopsy of the body of a 40-year-old patient detected groups of enlarged follicles in the small intestine. Their surface has ridges and fissures arranged in a pattern that resembles gyri and sulci of the brain. The follicles protrude above the surface of the intestinal mucosa. On section they are gray red and juicy. Microscopy shows proliferation of monocytes, histiocytes and reticular cells, there are macrophage clusters that form granulomas, while lymphocytes are depleted. What disease can be characterized by these changes?
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General catabolism pathway of biological macromolecules includes besides tricarbonic acid cycle and mitochondrial respiratory chain, the process of pyruvate oxidative decarboxylation. What is the product of pyruvate oxidative decarboxylation?
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A mountain climber was climbing a mountain for several days. At the altitude of 5000 meters he developed tachypnea, tachycardia and bursting headache. What is the likely cause of these signs?
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A patient has heart rhythm disturbances. To restore the rhythm, the doctors prescribed the patient calcium antagonists. What effect do calcium ions have on the myocardium?
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Regional lymph nodes surrounding an infected wound are enlarged. Histological examination shows increased number of macrophages, lymphocytes and lymphatic follicles in the cortical layer of the lymph nodes, as well as large amount of plasma cells. What process in the lymph nodes is indicated by these histologic changes?
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Autopsy of the body of 6 month old child, who died of sepsis, revealed the absence of thymus and diminished size and weight of the spleen. Microscopy of the spleen detected the absence of periarterial T dependent zones of the follicles and red pulp depletion; In the lymph nodes there is no paracortical zone that is represented mainly by T lymphocytes. B zones in the peripheral immune organs are developed normally. What pathological process is it?
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A patient was hospitalized into an infectious diseases department. His skin is dry, with low turgor, stool resembles rice water. The patient was diagnosed with cholera. What water-electrolyte imbalance is likely to occur during this disease?
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In the enlarged cervical lymph node of a 14-year-old girl microscopy detected the following: tissue structure of the lymph node is disturbed, no lymphoid follicles, there are sclerotic areas and necrotic foci, cellular composition of the lymph node is polymorphous, there are lymphocytes, eosinophils, large atypical cells with multilobular nuclei (Berezovsky-Reed_sternberg cells) and large mononuclear cells. Make the diagnosis:
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A 7-year-old girl has signs of anemia. Laboratory testing determined the deficiency of pyruvate kinase in her erythrocytes. In this case the main role in anemia development belongs to the disturbance of a certain process. What process is disturbed in this girl?
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Biopsy material of a 67-year-old man, who for 17 years has been suffering from chronic bronchitis, shows cylindrical bronchiectasis, the mucous glands have cystic changes, there are patches, where cuboidal epithelium is replaced with stratified squamous epithelium. What pathological process was detected in the bronchial mucosa?
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A 59-year-old man is a severe condition was hospitalized into the cardiology department with the following diagnosis; acute myocardial infarction in the region of the posterior wall of the left ventricle and septum, initial pulmonary edema development is primary in this patient?
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A patient developed a purulent inflammatory process in the periodontal tissues. The process was caused by activation of the microorganisms inherent in the body, which are a part of oral mucosal microflora. What type of infection is it?
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A patient suffers from disturbed renal function. To check the filtration ability of the kidneys, he was referred for clearance measurement of the following substance:
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During emotional excitation the heart rate of a 30-year-old person reached 112/min. The increased heart rate was caused by a change that occurred in a certain structure of the cardiac conduction system. Name this structure:
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A 40-year-old man with pulmonary tuberculosis was prescribed isoniazid. Prolonged taking of this drug can result in the development of the following vitamin deficiency:
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A patient with suppurative bronchitis was hospitalized into the pulmonology department. As a part of complex therapy, he was prescribed a medicine that liquefies sputum and facilitates expectoration. Name this medicine:
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In an experiment on an isolated squid giant axon submerged in a salt solution, the extracellular potassium ions concentration was increased to the level of the intracellular potassium ions concentration. What changes in the membrane potential will occur in this case?
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A patient with essential hypertension was prescribed hydrochlorothiazide as a part of complex therapy. What mechanism of drug action facilitates a decrease in blood pressure in this case?
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A patient is diagnosed with glucocerebroside lipidosis (Gaucher’s disease) that manifests as splenomegaly, liver enlargement, affected bone tissue and neuropathies. What enzyme of complex lipid catabolism is deficient, causing this disease?
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A patient with Parkinson’s disease made an appointment with the doctor. The doctor prescribed him a medicine that is a dopamine precursor in the central nervous system. What medicine of those listed below has such mechanism of action?
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During gastric resection the patient received mixed anesthesia with tubocurarine chloride muscle relaxant. To restore unassisted respiration in the patient, the patient was given proserin. What pharmacological group does this drug belong to?
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A patient has a trauma of the knee joint with crushed patella. With such injury, it is likely that the tendon of a certain thigh muscle is damaged. Name this muscle:
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Mitochondrial destruction is observed in some hereditary diseases (for example, Kearns-Sayre syndrome). What processes can be disturbed, as a result, in the cell?
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A 36-year-old man developed angina pectoris attacks immediately after a past case of staphylococcal sepsis. Coronarography detected mural thrombosis without signs of atherosclerosis in the left coronary artery. Thrombus formation occurred in the result of damage to the vascular endothelium and release of:
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T lymphocytes were affected by HIV. In the process, viral enzyme reverse transcriptase (RNA-dependent DNA-polymerase) catalyzed the synthesis of:
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There is a large amount of glucose oxidation metabolites dissolved in the cytoplasm of myocytes. Name one such metabolite that converts directly into lactate:
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From the feces of a patient with acute gastroenteritis a pure culture of microorganisms was obtained. The microorganisms are small mobile slightly curved gram-negative bacilli that within 6 hours grow into a light blue film on the 1% alkaline peptone water. Such properties are characteristic of the following microorganisms:
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A bioterrorist mailed an envelope with a powder that is suspected to contain anthrax causative agent. This envelope can remain dangerous for a long time, because anthrax causative agent:
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A 65-year-old woman against the background of chronic heart failure developed secondary hyperaldosteronism. What medicine should be prescribed to increase the patient’s diuresis?
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When examining a biopsy material obtained from the thyroid gland, the pathologist discovered lymphocyte infiltration of the thyroid tissues and destruction of the parenchymal elements. Diffuse lymphocyte infiltration with lymphoid follicles was detected in the stroma. What is the most likely diagnosis?
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A patient used an indirect-acting adrenergic agonist to treat rhinitis. After the patient has been putting in the nose drops for several days, the casoconstrictive effect of the drug gradually diminished. Name this phenomenon:
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A 40-year-old woman on examination presents with intensified basal metabolic rate. What hormone present in excess leads to such condition?
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Among lymphocytes there is a population of cells that have membrane receptors to IgM, activate in response to certain antigens, reproduce mitotically, differentiate into plasma cells that product antibodies (immunoglobulins). Name these cells:
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The ophthalmologist noticed a purulent discharge from the conjunctiva of a newborn. Microscopy of the smear obtained from the conjunctiva found three a large number of leukocytes, as well as gram-negative bean-shaped diplococci located inside the leukocytes. What is the causative agent of this disease?
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A biopsy material was obtained from the arches of the patient’s soft palate due to a suspected tumor (Macroscopy detected an ulcer with the dense floor). In the biopsy material the following was detected: necrosis of the mucosa with infiltration of the submucosal layer by lymphocytes, epithelioid cells, plasma cells and single neutrophils. Notable is the presence of marked endovasculitis and perivasculitis. The described changes are characteristic of:
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When examining a child, the pediatrician noted that the child presents with delayed physical and mental development. Urinalysis showed an acute increase in the levels of a keto acid that produce qualitative color reaction with ferric chloride. What metabolic disturbance was detected in this case?
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