1. The study of the skin epithelium shows that it consists of several layers of cells. The epithelial cells in the outer layer have no nuclei. What type of epithelium is it?

A. Stratified cuboidal epithelium
B. Non-keratinized stratified squamous epithelium
C. Pseudostratified ciliated epithelium
D. Transitional epithelium
E. Keratinized stratified squamous epithelium

Correct Answer: C. Pseudostratified ciliated epithelium

2. A patient has been hospitalized with complaints of periodic attacks of palpitations that start spontaneously and pass on their own. ECG detected an episode of contractions at the rate of 200/min with the following characteristics: regular rhythm, no P wave, unchanged QRS complex, deformed T wave. What type of arrhythmia is it?

A. Complete AV block
B. First-degree AV block
C. Paroxysmal tachycardia
D. Ventricular extrasystole
E. Atrial extrasystole

Correct Answer: C. Paroxysmal tachycardia

3. Microscopy and immunohistochemistry of the liver tumor cells obtained from a 65-year-old patient show a reduced number of spherical membrane bodies 0.3–0.5 mcm in size with reduced catalase activity. What organelle has been detected in this case?

A. –
B. Peroxisome
C. Lysosome
D. Centrosome
E. Ribosome

Correct Answer: C. Lysosome

4. Biopsy of the endometrium of a healthy woman, performed in the secretory phase of her menstrual cycle, detects polygonal cells rich in lipids and glycogen in the lamina propria of the mucosa. What are these cells?

A. Myofibroblasts
B. Smooth myocytes
C. Endothelial cells of damaged vessels
D. Fibroblasts
E. Decidual cells

Correct Answer: E. Decidual cells

5. Traumatic spinal cord injuries often result in damage to the dorsal roots of the spinal cord. What structures make up the dorsal roots of the spinal cord?

A. Root neurons
B. Bundle neurons
C. Association neurons
D. Pseudounipolar neurons
E. Interneurons

Correct Answer: D. Pseudounipolar neurons

6. A 35-year-old patient came to a doctor with complaints of periodic episodes of headache, palpitations, sweating, and an increased blood pressure. The episodes occur suddenly, last several minutes, and are accompanied by anxiety. Examination detects a tumor-like formation in the area of the abdominal aortic bifurcation. Biochemical testing shows increased levels of catecholamines in the blood plasma. What dysfunction of the paraganglia most likely caused the clinical picture in the patient?

A. Decreased adrenaline secretion
B. Impaired dopamine synthesis
C. Decreased receptor sensitivity to catecholamines
D. No catecholamine secretion
E. Excessive secretion of noradrenaline

Correct Answer: C. Decreased receptor sensitivity to catecholamines

7. A 49-year-old patient presents with increased levels of uric acid in the blood. The doctor prescribed the patient allopurinol to reduce the levels of uric acid. Allopurinol is a competitive inhibitor of a certain enzyme. Name this enzyme.

A. –
B. Adenosine deaminase
C. Guanine deaminase
D. Xanthine oxidase
E. Adenine phosphoribosyltransferase

Correct Answer: D. Xanthine oxidase

8. A patient has sensory aphasia and does not understand speech when spoken to. Where in the nervous system is the damage localized in this case?

A. Superior temporal gyrus
B. Superior frontal gyrus
C. Inferior frontal gyrus
D. Middle temporal gyrus
E. Middle frontal gyrus

Correct Answer:A. Superior temporal gyrus

9. A doctor has prescribed an anticholinesterase drug that lowers the intraocular pressure to a patient diagnosed with glaucoma. Select this drug from the list.

A. Noradrenaline hydrotartrate
B. Neostigmine methylsulfate
C. Atropine sulfate
D. Naloxone hydrochloride
E. Lidocaine hydrochloride

Correct Answer:B. Neostigmine methylsulfate

10. A patient presents with tachycardia, increased basal metabolic rate and body temperature, weight loss, and increased excitability. These disorders are caused by the increased secretion of hormones in the:

A. Parathyroid glands
B. Neurohypophysis
C. Thyroid gland
D. Gonads
E. Adrenal glands

Correct Answer:C. Thyroid gland

11. Mineralocorticoids regulate the body’s water-salt balance. What primary mechanism stimulates aldosterone secretion?

A. Hypothalamic-pituitary-adrenal system
B. Renin-angiotensin system
C. Nervous regulation of the adrenal glands
D. Concentration of calcium ions in blood plasma
E. Insufficient secretion of vasopressin

Correct Answer:B. Renin-angiotensin system C. Nervous regulation of the adrenal glands

12. Submicroscopy of a cell shows that its cytoplasm contains many lysosomes, phagosomes, and pinocytotic vesicles. Other organelles are moderately developed. What function can such a cell perform?

A. Synthesis of lipids
B. Deposition of calcium ions
C. Phagocytosis
D. Synthesis of polysaccharides
E. Reabsorption of sodium ions

Correct Answer:C. Phagocytosis

13. A 52-year-old overweight patient with hypercholesterolemia develops constricting chest pain during physical exertion. Objectively, the patient presents with increased blood pressure and obesity. Laboratory testing detects increased levels of low-density lipoproteins and decreased levels of high-density lipoproteins. What disease has developed in this patient?

A. Hypolipoproteinemia
B. Atherosclerosis of the coronary arteries
C. Diabetes mellitus
D. Niemann-Pick disease
E. Lesch-Nyhan syndrome

Correct Answer:C. Diabetes mellitus

14. As a result of an injury, the integrity of the anterior root of the spinal cord has been impaired. What processes in what neurons are damaged in this case?

A. Dendrites of sensory neurons
B. Axons of sensory neurons
C. Dendrites of motor neurons
D. Dendrites of interneurons
E. Axons of motor neurons

Correct Answer:E. Axons of motor neurons

15. A tricuspid valve defect has been detected in a patient. Where is this valve located?

A. Opening of the pulmonary trunk
B. Opening of the coronary sinus
C. Aortic opening
D. Between the right atrium and right ventricle
E. Between the left atrium and left ventricle

Correct Answer:D. Between the right atrium and right ventricle

16. After prolonged fasting, the patient developed tissue edema. What is the cause of this phenomenon?

A. Increased oncotic blood pressure
B. Decreased hydrostatic blood pressure
C. Decreased osmotic pressure of blood plasma
D. Decreased oncotic pressure of blood plasma
E. Increased osmotic pressure of blood plasma

Correct Answer:D. Decreased oncotic pressure of blood plasma

17. During the autopsy of the body of a 34-year-old man, who died of chronic kidney disease due to renal amyloidosis, the pathologist reveals multiple diffuse dilatations of the bronchi with purulent content in their lumina, observed mainly in the lower lobes. The surface of the lung section has small hollow cells and resembles a honeycomb. Histologically, there is chronic inflammation in the bronchial wall, muscle fibers are replaced by connective tissue. What changes have been detected in the lungs by the pathologist?

A. Chronic pneumonia
B. Bronchiectasis
C. Bronchopneumonia
D. Chronic bronchitis
E. Lung abscesses

Correct Answer:B. Bronchiectasis

18. A 62-year-old patient complains of weakness, shortness of breath, and nausea. There was no pain behind the sternum. Blood pressure 150/95 mm Hg. ECG shows signs of posterior ischemia. Eight days after the hospitalization, the increased activity of one of the enzymes persists, indicating a past myocardial infarction. What laboratory value remains elevated in this case?

A. Aspartate aminotransferase
B. Lactate dehydrogenase
C. Myoglobin
D. Alanine aminotransferase
E. Creatine phosphokinase

Correct Answer:E. Creatine phosphokinase

19. A patient with chronic kidney disease presents with elevated blood levels of phenyl sulfate — a uremic toxin. This compound forms in the process of phenol detoxification by sulfotransferase in the liver. The source of phenol is the bacterial decomposition of a certain amino acid in the large intestine. Name this amino acid.

A. Phenylalanine
B. Tryptophan
C. Serine
D. Tyrosine
E. Histidine

Correct Answer:D. Tyrosine

20. The disease symptoms have started abating in a 34-year-old patient recovering from a case of an intestinal infection caused by Salmonella. What class of immunoglobulins will be detected in the patient’s blood during the convalescence period?

A. IgE
B. IgA
C. IgG
D. IgD
E. IgM

Correct Answer:C. IgG

21. A patient with a urinary tract infection was taking a synthetic broad-spectrum antimicrobial drug. This drug acts by inhibiting DNA gyrase and disrupting DNA replication in microorganisms as a result. What drug was the patient taking in this case?

A. Metronidazole
B. Ceftriaxone
C. Azithromycin
D. Amoxicillin
E. Ciprofloxacin

Correct Answer:E. Ciprofloxacin

22. A woman was diagnosed with hypochromic anemia one month after a complicated delivery accompanied by significant blood loss. What pathological forms of erythrocytes are most characteristic of this type of anemia?

A. Annulocytes
B. Drepanocytes
C. Spherocytes
D. Acanthocytes
E. Target cells (codocytes)

Correct Answer:E. Target cells (codocytes)

23. Surfactant synthesis is impaired in premature newborns. What is its function in the lungs?

A. Impairs the O₂ diffusion through the aerogematic barrier
B. Facilitates diaphragmatic excursion
C. Increases the surface tension of the alveolar walls
D. Reduces the surface tension of the alveolar walls
E. Increases the airway resistance

Correct Answer:C. Increases the surface tension of the alveolar walls

24. An 8-year-old child with a genetic disorder has an abnormal collagen structure that causes loose skin and increased joint mobility. Laboratory testing confirms the collagen structure disorder, resulting from a defect in the formation of the triple helix. What amino acid is essential for the formation of the tropocollagen structure?

A. Cysteine
B. Alanine
C. Serine
D. Glycine
E. Glutamate

Correct Answer:B. Alanine

25. A 67-year-old patient with a hypertensive crisis was intravenously administered a drug that quickly lowered his blood pressure. When taken orally, this drug has choleretic and laxative effects. What drug is it?

A. Sodium thiosulfate
B. –
C. Drotaverine hydrochloride
D. Furosemide
E. Magnesium sulfate

Correct Answer:D. Furosemide

26. A 32-year-old man was involved in a car accident. He has multiple abrasions on his skin and a fracture of the bones in the forearm. The patient is in a state of emotional agitation. Despite the severe damage, he reports that he feels almost no pain, although objectively the movements of his limb are extremely limited. What mechanism has caused the decreased pain sensitivity in this patient?

A. Destruction of pain receptors as a result of the injury
B. Increased conduction in pain fibers
C. Increased levels of catecholamines in the blood
D. Activation of the sympathetic nervous system
E. Release of endogenous opioid peptides

Correct Answer:C. Increased levels of catecholamines in the blood

27. A 45-year-old woman presents with signs of depression, irritability, insomnia, increased anxiety, and fear. Biochemical testing detects decreased serotonin levels in her central nervous system. What vitamin is most likely to be deficient in this case, disrupting the synthesis of this neurotransmitter?

A. B₂
B. B₁
C. B₁₂
D. B₆
E. C

Correct Answer:A. B₂ C. B₁₂ D. B₆

28. A man developed signs of parkinsonism after a long course of treatment for schizophrenia. What drug could have caused this complication?

A. Chlorpromazine hydrochloride
B. Carbamazepine
C. Diazepam
D. Sodium valproate
E. Fluoxetine hydrochloride

Correct Answer:A. Chlorpromazine hydrochloride

29. A man presents with progressive muscular dystrophy. What metabolic urinary nitrogen parameter is characteristic of this health condition?

A. Creatinine
B. Ammonium salts
C. Urea
D. Uric acid
E. Creatine

Correct Answer:D. Uric acid

30. What is the etiological factor of type 1 diabetes mellitus?

A. High insulinase activity
B. Damage to the pituitary gland
C. Strong bond between insulin and protein
D. Absence of insulin receptors
E. Autoimmune damage to β-cells

Correct Answer : E. Autoimmune damage to β-cells

31. What is the main function of the pentose-phosphate pathway in adipose tissue?

A. Generation of NADPH₂
B. Production of ribose phosphates
C. Energy generation
D. Neutralization of xenobiotics
E. Oxidation of glucose to end products

Correct Answer :A. Generation of NADPH₂

32. A patient with megaloblastic anemia has been prescribed cyanocobalamin. Additionally, the doctor added to the treatment regimen a certain drug that takes part in the synthesis of purine and pyrimidine bases necessary for the formation of RNA and DNA. What drug is it?

A. Folic acid
B. Riboflavin
C. Tocopherol acetate
D. Pyridoxine hydrochloride
E. Ascorbic acid

Correct Answer :E. Ascorbic acid

33. Total hyperacidity was detected during pH-metry of gastric juice in a 56-year-old woman. What cells of gastric glands are dysfunctional in this case, causing this condition?

A. Parietal exocrine cells
B. Endocrine cells
C. Mucous neck cells
D. Gastric chief exocrine cells
E. Surface mucous cells

Correct Answer :D. Gastric chief exocrine cells

34. A 55-year-old woman has been hospitalized to the neurological unit of a hospital with complaints of impaired ability to determine the spatial position of her limbs when her eyes are closed. During the Romberg test, the patient staggers and loses her balance. Her thermal and pain sensitivity are not impaired, her muscle strength is preserved. Examination detects damage to the proprioceptive pathway to the cortex in the area of the decussation of the medial lemnisci. Where in the central nervous system has the damage occurred?

A. Dorsal funiculi of the spinal cord
B. Mesencephalon
C. Medulla oblongata
D. Cerebellum
E. Pons

Correct Answer :D. Cerebellum

35. A woman with Rh-negative blood of the II group gave birth to a baby with Rh-positive blood of the IV group. The baby has been diagnosed with hemolytic disease caused by the Rh incompatibility. What blood group is possible in the baby’s father?

A. I (O), Rh-positive
B. II (A), Rh-positive
C. IV (AB), Rh-negative
D. III (B), Rh-positive
E. III (B), Rh-negative

Correct Answer :D. III (B), Rh-positive

36. Patient’s stool test for helminth eggs reveals Ascaris and Taenia solium eggs. What drug should be prescribed for the treatment of the patient with mixed helminthiasis?

A. Levamisole
B. Albendazole
C. Piperazine
D. Praziquantel
E. Metronidazole

Correct Answer :B. Albendazole E. Metronidazole

37. A patient with alkaptonuria has signs of arthritis and ochronosis. What substance accumulates in the joints in this case, causing pain?

A. Oxalates
B. Homogentisates
C. Phosphates
D. Urates
E. Carbonates

Correct Answer :C. Phosphates

38. After experimental irradiation, the examination of a human cell culture detects in the cells 2–4 spherical fluid-filled double-membrane bodies, each containing nucleoprotein complexes and chromatin. What cell structure has been detected in this case?

A. Nucleus
B. Lysosome
C. Ribosome
D. Peroxisome
E. Mitochondria

Correct Answer :E. Mitochondria

39. A 25-year-old patient has been hospitalized with intense headache and nuchal rigidity. To confirm the diagnosis of enteroviral meningitis, a method was used, where the viral RNA is converted into complementary DNA for further identification. What enzyme is essential for this initial stage of the test?

A. DNA-dependent RNA polymerase
B. DNA gyrase
C. DNA-dependent DNA polymerase
D. Reverse transcriptase
E. Topoisomerase

Correct Answer :A. DNA-dependent RNA polymerase D. Reverse transcriptase

40. A man presents with acne and inflammatory changes in the skin of his face. Microscopy of the material obtained from the lesion foci reveals live elongated arthropods with 4 pairs of reduced limbs. Make the provisional diagnosis.

A. Allergy
B. Flea infestation on the skin
C. Demodicosis
D. Pediculosis
E. Sarcoptes scabiei infestation on the skin

Correct Answer :C. Demodicosis

41. Autopsy of the body of a 48-year-old man, who died 10 days after massive aspiration of gastric contents, reveals a cavity approximately 5 cm in diameter in the upper lobe of the right lung. The cavity is filled with thick yellow-green masses that have a sharp unpleasant odor. The wall of the cavity is uneven, edematous, and covered in necrotic masses. Microscopically, its wall is abundantly infiltrated with neutrophils and macrophages. What is the most likely diagnosis in this case?

A. Lung gangrene
B. Bronchiectasis
C. Acute lung abscess
D. Pneumonia
E. Acute cavitary tuberculosis

Correct Answer :B. Bronchiectasis E. Acute cavitary tuberculosis

42. What enzyme due to its bactericidal effect prevents inflammation of the oral mucosa, if it becomes damaged?
A. Mucin
B. Nuclease
C. Amylase
D. Lysozyme
E. Lingual lipase

Correct Answer :D. Lysozyme

43. A 40-year-old patient presents with glossitis, diarrhea, and dermatitis. The doctor suspects pellagra. What compound can be a precursor for the synthesis of the missing vitamin in the body?
A. Tryptophan
B. Tyrosine
C. Glycine
D. Valine
E. Glutamic acid

Correct Answer :B. Tyrosine

44. An electron micrograph of the wall of a pulmonary alveolus shows a large cell with many mitochondria in its cytoplasm, a developed Golgi complex, and osmiophilic lamellar bodies. What is the main function of this cell?

A. Being a component of the air-blood barrier
B. Air warming
C. Air purification
D. Microorganism absorption
E. Surfactant production

Correct Answer :C. Air purification

45. The parents of a 5-year-old girl with an acute respiratory viral infection have brought her to a hospital. After taking acetylsalicylic acid, the girl developed jaundice, general weakness, and dark-colored urine. Her complete blood count shows decreased hemoglobin levels, increased levels of free (unconjugated) bilirubin, and increased reticulocyte count. What is the most likely cause of this health condition?

A. Aplastic anemia
B. Glucose-6-phosphate dehydrogenase deficiency
C. Transketolase deficiency
D. Iron deficiency anemia
E. Hemoglobinopathy

Correct Answer :B. Glucose-6-phosphate dehydrogenase deficiency

46. A patient developed pneumothorax and later atelectasis after a chest injury. What is the cause of atelectasis in this case?

A. Increased pressure in the pleural cavity
B. Decreased elasticity of the lung tissue
C. Connective tissue hyperplasia
D. Obstruction of the bronchus with blood
E. Decreased surfactant production

Correct Answer :A. Increased pressure in the pleural cavity

47. In the process of blood transfusion, the patient developed signs of hemolysis of erythrocytes that were breaking down in the cells of the reticuloendothelial system. The breakdown of hemoglobin begins due to the effect of heme oxygenase enzyme. What coenzyme is a component of this enzyme?

A. Coenzyme QH₂
B. FADH₂
C. FMNH₂
D. NADPH
E. NADH

Correct Answer :D. NADPH

48. The patient’s karyotype has 47 chromosomes and a Barr body has been detected in the nucleus of a somatic cell. Additional testing reveals endocrine insufficiency: testicular hypoplasia and absence of spermatogenesis. What syndrome is indicated by this phenotype?

A. Klinefelter syndrome
B. Edwards syndrome
C. Patau syndrome
D. Turner syndrome
E. Down syndrome

Correct Answer :A. Klinefelter syndrome

49. When providing surgical care for a patient with a post-injection abscess, the doctor took a sample of the biological material (pus) and sent it to a bacteriological laboratory. What agar should be used to isolate a pure culture of staphylococci?
A. Meat-peptone agar
B. Tellurite-blood agar
C. Egg yolk-salt agar
D. Blood agar
E. Alkaline agar

Correct Answer :D. Blood agar

50. A 43-year-old woman complains of weight gain, weakness in her proximal muscles, and menstrual irregularities. Examination detects a round “moon-shaped” face, hypertension, red striae on the abdomen, and osteopenia. Blood testing reveals hyperglycemia and elevated cortisol levels. What disease is most likely in this patient?

A. Hypocorticism
B. Acromegaly
C. Primary hyperparathyroidism
D. Hypothyroidism
E. Cushing syndrome

Correct Answer :E. Cushing syndrome