Krok 1 - 2020 Booklet

Question 1

Which enzyme should be measured in the blood and urine to confirm pancreatitis?

Answer 1

Alpha amylase

Question 2

Albumin 20g/l, increased activity of lactate dehydrogenase isoenzyme 5 (ldh5) disorder of which enzyme?

Answer 2

Liver

Question 3

Dilated pupil, unresponsive to light. Which muscle disturbed?

Answer 3

Iris sphincter muscle, ciliary

Question 4

Castles extrinsic factor (transcorrin) is also known as:

Answer 4

Cobalamin

Question 5

Liver fibrosis results from chronic blood flow disturbance. Which direction does blood flow in these lobules?

Answer 5

From the periphery to the centre

Question 6

Blood typing neither anti-a and anti-b reagents cause agglutination what blood type?

Answer 6

Type o

Question 7

Which method is recommended for serum confirmation of HIV infection?

Answer 7

Western blot (immunoblotting)

Question 8

During anaesthesia patient’s body temperature reached 43 degrees c which pathology developed?

Answer 8

Hyperthermic syndrome

Question 9

During exercise patient’s respiration rate increased what’s the main cause?

Answer 9

Increased CO2 tension in the blood

Question 10

5th day after onset patient had jaundice, myalgia, chills and nasal bleeding. Laboratory diagnostics performed dark field microscopy of a blood drop. Name the causative agent?

Answer 10

Leptospira interrogans

Question 11

Child has significant decrease of immunoglobulin concentration and absence of b lymphocytes. Which immunodeficiency?

Answer 11

Broughton syndrome (x-linked agammaglobulinemia)

Question 12

Positive widal test. What does this indicate?

Answer 12

Typhoid fever

Question 13

Rapid fatigue ability weakness and palpitations. Blood test: erythrocytes 2.5 g per litre, colour index 0.6, Anisa cytosis with prevalence of microcytosis. Blood serum iron is 5.4 mmols. What is the pathology?

Answer 13

Iron deficiency anaemia

Question 14

Patient has limb amputated yet still feels pain in it. What type of pain development is this?

Answer 14

Phantom pain

Question 15

Chronic kidney failure with osteoporosis, pathologic calcification of the internal organs and arterial hypertension. Which hormone is increased in activity?

Answer 15

Parathyroid hormone

Question 16

Uterine contraction during labour is absent. Which hormonal drugs should be given to intensify labour activity?

Answer 16

Oxytocin

Question 17

Electrical impulses that irritate the sympathetic nerve that innervates blood vessels of the skin. What reaction will be seen in the blood vessels?

Answer 17

Arterial and venous constriction

Question 18

Tumours in the laryngeal area can spread to which regional lymph nodes?

Answer 18

Deep cervical lymph nodes

Question 19

Which blood protein is indicative of liver cancer if found in the blood serum?

Answer 19

Alpha fetoprotein

Question 20

10 days after antitoxic anti diphtheric serum a child with diphtheria developed skin rashes accompanied by severe itching, body temperature increased up to 38 degrees c, pain in the joints. What’s the cause?

Answer 20

Serum sickness

Question 21

People from India displays grey tint to the skin, loss of appetite, inertness, hepatosplenomegaly, lymph node enlargement. Which protozoan disease can be suspected?

Answer 21

Visceral leishmaniasis

Question 22

Increase duration of qrs complex. Cause?

Answer 22

Increased period of ventricular excitation

Question 23

Blood test shows: sodium 115 mmol/l, chlorides 85mmol/l, glucose 6mmol/l, total protein 65g/l. The first consequence of such changes will be the decrease of:

Answer 23

Osmotic blood pressure

Question 24

Frequent and excessive urination and thirst. Urinalysis reveals 24-hour diuresis of 19 l, specific gravity these values a characteristic of:

Answer 24

Diabetes insipidus

Question 25

16-year old girl has no hair on pubis or in the underarms, mammary glands underdeveloped, no menstruation. What is the condition?

Answer 25

Ovarian failure

Question 26

Patient has allergic response with itching, edemas and skin redness. In the tissues there is an increased concentration of a biogenic amine. Name the biogenic amine.

Answer 26

Histamine

Question 27

Hepatitis d can only reproduce in the presence of which other hepatitis virus?

Answer 27

Hepatitis b

Question 28

A disease present in both genders has a 50% chance of heritance in 1 heterozygous and 1 healthy parent. What type of disease inheritance is it?

Answer 28

Autosomal dominant

Question 29

A vitamin is a component of glutamic acid decarboxylase as a coenzyme, takes part in the formation of gamma-aminobutyric acid and it's deficiency manifests as convulsions. Name this vitamin.

Answer 29

Pyridoxine (B6)

Question 30

Histological specimen shows paraclimber of an organ that consists of lymphoid tissue that forms lymph nodules; the nodules are located diffusely and have a central artery. Which anatomical structure has this characteristic?

Answer 30

Spleen

Question 31

Patient suspected to have infectious mononucleosis. Which lab result can confirm the diagnosis immediately?

Answer 31

Immunoglobulin m antibodies to epstein-barr virus

Question 32

After a spinal trauma a patient lost proprioceptive sensitivity in the lower half of the body and in the lower limbs. Which sensory conduction pathway was damaged?

Answer 32

Fasciculus gracilis (goll column)

Question 33

Acute cholelithiasis. Examination of the patients faeces will show what?

Answer 33

A negative reaction to stercobilin

Question 34

Patient suffering from rheumatoid arthritis died of uremia, enlarged pale grey kidneys with a glossy surface on section. What is the pathology?

Answer 34

Renal amyloidosis

Question 35

Steatorrhea and hypocholic faeces. Cause?

Answer 35

Obturation of bile ducts

Question 36

Increased pulmonary ventilation due to exercise. what indicator of external respiration will be significantly increased compared to the resting state?

Answer 36

Respiratory volume

Question 37

Man is unconscious. History of syncopal episodes with convulsions. Deformed qrs complex with unconnected p waves. Atrial tachycardia ventricular bradycardia. What is the arrhythmia?

Answer 37

Complete atrioventricular block

Question 38

What is the main source of blood supply to the descending colon?

Answer 38

Inferior mesenteric artery

Question 39

Sick child produces specific sweet smelling urine. Disturbed metabolism of amino acids such as leucine, isoleucine, and valine. What is the disease?

Answer 39

Maple syrup urine disease

Question 40

Chronic suppurative inflammation of the bone. What is the disease?

Answer 40

Osteomyelitis

Question 41

Large wedge shaped patch of dense dark red tissue with clear margins in the upper lobe of the right lung. Histological examination shows necrosis of alveolar walls; alveolar tightly packed with erythrocytes. Name?

Answer 41

Hemorrhagic infarction

Question 42

Which medicine should be administered to bring a patient out of hypoglycemic coma?

Answer 42

Glucose

Question 43

Subcutaneous Mercury chloride 5 mg. 24-hours later plasma creatine concentration increased several times. Why?

Answer 43

Decreased glomerular filtration

Question 44

Patient suffering from chronic peptic ulcer disease. What type of anaemia is most likely?

Answer 44

Chronic posthemorrhagic anaemia

Question 45

24-hours after operation patients blood test shows neutrophilic leukocytosis with regenerative shift. Why?

Answer 45

Intensification of leukopoiesis

Question 46

Which cells are responsible for transplant rejection?

Answer 46

T lymphocytes

Question 47

Which amino acid replacement in haemoglobin causes sickle cell anaemia?

Answer 47

Glutamate replaced with valine

Question 48

Name the supramolecular multienzyme complex that is integrated into the lipid layer of inner mitochondrial membranes that creates conditions for redox reactions.

Answer 48

Respiratory chain

Question 49

Oxidation of organic compounds in synthesis of macroergic molecules happens in which organelle?

Answer 49

Mitochondria

Question 50

Patient with ischaemic heart disease has increased levels of triglycerides and low density lipoproteins in blood plasma. What medicine should be prescribed?

Answer 50

Fenofibrate

Question 51

Woman with enteritis has severe diarrhoea, loss of water in the extracellular space, increased water content in the cells and decreasing blood osmolarity. What type of water electrolyte imbalance is this?

Answer 51

Hypo osmolar hypohydration

Question 52

Where is the most common place to find embolisms?

Answer 52

The lungs or pulmonary system

Question 53

Which antihypertensive drug causes a cough?

Answer 53

Lisinopril

Question 54

Pterin derivatives - aminopterin and methotrexate – are competitive inhibitors of dihydrofolate reductase. As a result they suppressed the regeneration of tetrahydrofolic acid from dihydrofolate.these medicines lead to the inhibition of intermolecular transport of one-carbon groups full stop in the process the biosynthesis of the following polymer is suppressed:

Answer 54

DNA

Question 55

What genetic defect is the cause of Niemann-Pick disease?

Answer 55

Sphingomyelinase deficiency

Question 56

Smooth down nasolabial fold, dilated right palpebral fissures, difficulty during speaking and eating. Which nerve is damaged?

Answer 56

N. Facialis Dexter

Question 57

Which artery is on the medial surface of the right frontal lobe?

Answer 57

A. Cerebri anterior

Question 58

An experiment of frog neuromuscular preparation had been processed with a curare like substance, which lead the disappearance of muscle contractions in response to electrical stimulation. What function of the muscle cell membrane is disrupted by the curare like substance?

Answer 58

Reception of the mediators in the neuromuscular synapse

Question 59

Which drug should be used to reverse opiate poisoning?

Answer 59

Naloxone

Question 60

Patient has status epilepticus. What medicine should be used to stop the seizures?

Answer 60

Diazepam