Variant 2 Pathophysiology

1. Definition of health by WHO. State of complete physical, and social well-being. State of complete physical, mental, and social well-being and not merely the absence of disease. c. Mental and social well-being and not merely the absence of disease.

The example of multifactorial disease is. tuberculosis. cancer. AIDS.

Dissolved oxygen molecules are registered as…. CaO2. PaO2. SaO2.

The main source of free radicals is... Oxygen. Hydrogen. Carbogen.

5. Coagulation of blood vessels and tissue proteins occurs. a. With intense heat. b. With biologic injury. c. With lead toxicity.

6. The tissue colloidal osmotic pressure…. a. pulls water out of the interstitial spaces into the capillary. b. pulls water out of the capillary into the interstitial spaces. c. pushes water out of the cell.

7. Edema due to a decrease in capillary colloidal pressure. a. tends to affect tissues in dependent parts of the body. b. tends to affect the face as well as the legs and feet. c. tends to affect lungs.

8. The mechanism protecting the ECF volume: a. alterations in potassium balance. b. alterations in sodium balance. c. alterations in glucose balance.

9. Metabolic alkalosis is a... a. Decrease in HCO3. b. Reduction in pH. c. Increased HCO3.

10. Plasma pH below 7.35 and an arterial PCO2 above 50 mm Hg refers to: a. Metabolic acidosis. b. Respiratory acidosis. c. Respiratory alkalosis.

11. The organization (tissue repair) of the acute inflammation reflects the processes, in which. a. lost tissues are replaced by proliferation of cells of the same type, which reconstruct the normal architecture. b. dead material are removed by phagocytosis and the tissues are left with their original architecture. с. lost tissues are replaced by a fibrous scar, which is produced from granulation tissues.

12. The acute-phase inflammatory proteins are synthesized in. a. liver. b. spleen. c. bone marrow.

13. Beneficial effects of inflammation include the following except. a. dilution of toxins. b. stimulation of immune response. c. swelling. d. fibrin formation.

14. The increased oncotic pressure in inflammatory site is a consequence of. a. activation of lyzosomal enzymes with proteolytic activities. b. increased vascular permeability. c. all are correct.

15. The term “allergy” was originally defined as “an altered capacity of the body to react to a foreign substances” by : a. Clemens Von Pirquet. b. Edward Jenner. c. Louis Paster. d. Robert Kox.

16. Patient with sneezing and itchy, watery eyes is diagnosed with allergic rhinitis. This hypersensitivity reaction is caused by: a. binding of an allergen to a specific IgE on the surface of a mast cells. b. binding of an allergen to a specific IgA on the surface of a basophil. c. binding of a histamine to an allergen. d. binding of a mast cells to histamine (a).

17. The sensitization phase is present in the following processes: a. passive sensitization. b. active sensitization. c. hypertension.

18. Substances required the additional transformation to be the complete allergen are termed as: a. exogenous allergens. b. primary endogenous allergens;. c. secondary endogenous allergen. d. gaptens;. e. All are correct.

19. Antipyretics are also known as a: a. NSAID’s (non-steroid anti-inflammatory drugs). b. SAID’s ( steroid anti-inflammatory drugs. c. hypotensive drugs. d. all are correct.

20. The ability of antipyretics to reduce increased body temperature is due to. a. inhibit shivering and rigors. b. inhibit peripheral vasoconstriction. c. inhibit cyclooxygenase. d. increase sweating and vasodilation.

21. Persons with Wiskott-Aldrich syndrome are susceptible to: a. recurrent bacterial infections. b. bleeding episodes or symptoms (low platelet counts). c. Varicella infection. d. development of malignancies of the mononuclear phagocytic system, including Hodgkin's lymphoma and leukemia. e. all are correct.

22. The first circulating immunoglobulin to appear in response to an antigen and the first antibody type made by a newborn is: a. IgG. b. IgD. c. IgM. d. IgA;. e. IgE.

23. Acute viral infections ( measles, cytomegalovirus) are able to induce. a. primary humoral immunodeficiency. b. primary cellular immunodeficiency. c. secondary humoral immunodeficiency. d. secondary cellular immunodeficiency. e. combined severe immunodeficiency.

24.High susceptibility to the diseases caused by extracellular pathogens can be a consequence of. a. humoral immunodeficiency disorders. b. cellular immunodeficiency disorders. c. all are correct.

25. The central defect of X-Linked Agammaglobulinemia is. a. an inability of T cells to signal B cells to undergo isotype switching to IgG and IgA; thus, they produce only IgM. b. embryonic defect resulting in the partial or complete failure of thymus and parathyroid glands development. c. block of differentiation of pre-B cells, creating an absence of mature circulating B cells and plasma cells. d. all are correct.

26. If the DNA damage is non-repairable, p53 protein: a. increases the proliferation to repair damaged DNA in the S-phase. b. induces a quiescence. c. induces a apoptosis.

27. The initiation step of carcinogenesis is: a. a reversible mutation of DNA. b. precedes the promotion step of carcinogenesis. c. do not alter DNA but make it susceptible to the following mutagenesis. d. second stage of carcinogenesis.

28. Arrange in correct sequence the phases of the anti-tumor defenses: a. anticarcinogeniс, antimutational, anticellular. b. antimutational, anticarcinogenic, anticellular. c. anticellular, antimutational, anticarcinogeniс. d. anticarcinogenic, anticellular, antimutational (a).

29.The anti-mutational step of anti-tumor resistance include: a. recognition of cancer cells by cytotoxiс lymphocytes and NK-killers. b. inhibition and inactivation of carcinogens (free oxygen radicals, hydroperoxides etc.). c. reparation of damaged DNA and activation of anti-oncogenes (onco-supressors).

30. Burkitt's lymphoma can be developed after the exposure to: a. Epstein-Barr virus;. b. hepatitis B virus. c. human T-cell leukaemia virus. ; d. human papilloma virus. e. all are correct.

31. Thrombocytopenia commonly is characterized by…. a. petechiae, purpura. b. deep tissue bleeding. c. both are correct.

32. Which statement is correct ?. a. in both iron deficiency and chronic disease anemia TIBC is increased. b. in both iron deficiency and chronic disease anemia ferritin is increased. c. in both iron deficiency and chronic disease anemia iron is decreased.

33. Acute nonlymphoid leukemia is: a. A bone marrow derived neoplasm composed of myeloblasts. b. A bone marrow derived neoplasm composed of myelocytes. c. A bone marrow derived neoplasm composed of lymphoblasts.

34. What cells can be found in the blood count in chronic myeloid leukemia?. a. lymphoblasts. b. pronormocytes. c. myelocytes.

35. Anisocytosis means: a. irregular shape. b. irregular size. c. increased size.

36. Sickle cell anemia results from: a. inherited disorder of the red cell membrane. b. a point mutation in the p chain of the hemoglobin molecule. c. drug induced disorder of red blood cells.

37. Secondary polycythemia results from: a. a physiologic increase in the level of erythropoietin. b. neoplastic proliferation. c. blood loss.

38. Which type of antibodies causes red cell destruction?. a. Ig E. b. Ig M. c. Ig A.

39. What is thalassemia?. a. inherited disorder of the red cell membrane. b. are a group of disorders of hemoglobin α or the β chains synthesis. c. a point mutation in the p chain of the hemoglobin molecule (b).

40.Which statement is wrong?. a. vitamin K deficiency can result from malnutrition. b. vitamin K deficiency can result from obstructive jaundice. c. vitamin K deficiency can result from anemia.

41. In descending order of frequency, the vessels commonly affected by atherosclerosis are. a abdominal aorta, coronary arteries, popliteal arteries. b. descending thoracic aorta, internal carotid arteries. c. circle of Willis, coronary arteries, popliteal arteries.

42. The early lesion, or fatty streak, is characterized by: a. proliferating plasma cells. b. foam cells within the vascular wall. c. basophile full of oxidized LDL cholesterol.

43. What cells are postulated as an important source of the TF in atheroma?. a. erythrocytes. b. mast cells. c. monocytes/macrophages.

44. AV nodal conduction abnormalities can occur because of: a. activation of sympathetic fibers. b. both. c. reflex activation of the vagus nerve.

45. The afterload is: a. . the volume work of the heart. b. the pressure work of the heart. c. the heart rate.

46. The increased work of breathing is the mechanism of: a. vomiting. b. shortness of breath. c. chest pain.

47. A customary division of hypertension into two categories: a. primary and secondary. b. active and passive. c. hereditary and acquired.

48. Adrenal disease can cause hypertension by: a. complement production. b. cystein production. c. cateholamine production.

49. Common mechanism for all shocks is: a. volume excess. b. multiple organ underperfusion. c. increased pump function of the heart b.

50. Vital organs fails in shock as a result of. a. hypoxia. b. inflammation. c. immunodeficiency.

51. Tidal volume (VT) is: a. the amount of air that can be forcibly expired at the end of normal expiration. b. the amount of gas remaining in the lungs at the end of a maximal exhalation. c. the amount of gas inhaled and exhaled with each resting breath. d. the amount of gas in the lungs at the end of a resting tidal breath.

52. Inspiratory reserve volume (IRV) is: a. the amount of air that can be forcibly expired at the end of normal expiration. b. the amount of gas inhaled and exhaled with each resting breath. c. the amount of gas remaining in the lungs at the end of a maximal exhalation. d. the total amount of gas that can be exhaled following a maximal inhalation. e. the amount of air that can be forcibly inspired at the end of normal inhalation (e).

53. The increase of the V/Q ratio represents the pathologic processes referred as a: a. alveolar dead space. b. shunt. c. both. d. all are wrong.

54. Technetium 99m, which is coupled with macroaggregated albumin (MAA) is used to assess: a. lung ventilation in a ventilation perfusion scanning. b. lung perfusion in a ventilation perfusion scanning. c. diffusion lung capacity. d. all are correct.

55. Cardiogenic pulmonary edema is typically a consequence of the following factors except: a. increased pulmonary venous pressure (causing increased capillary hydrostatic pressure). b. increased alveolar surface tension (thereby lowering interstitial hydrostatic pressure),. c. loss of integrity of the alveolar epithelium and vascular endothelium. d. decreased capillary colloid osmotic pressure.

56. Residual volume (IRV) is: a. the amount of air that can be forcibly expired at the end of normal expiration. b. the amount of air remaining in the lungs at the end of a maximal exhalation. c. the amount of gas in the lungs at the end of a resting tidal breath. d. all are correct.

57. Resting pulmonary artery blood flow is approximately: a. 2 L/min;. b. 3 L/min;. c. 4 L/min;. d. 5 L/min;. e. all are wrong.

58. The hyperventilation of resting respiratory units is able to compensat. a. rise in Pco2 (hypercapnia). b. fall in Po2 (hypoxemia). c. both. d. All are wrong.

59. Factors able to protect lung parenchyma against oxidant injury are the following except: a. superoxide dismutase. b. catalase. c. elastase. d. glutathione.

60. Centriacinar emphysema is most frequently associated with: a. α1-protease inhibitor deficiency. b. prolonged smoking. c. chronic bronchitis. d. interstitial pulmonary fibrosis. e. all are correct.

61. Hepatitis B virus is transmitted. a. by fecal-oral route. b. by sexual contact. c. by contact with infected food.

62. …. has both direct and indirect toxic effects on the liver: a. sodium. b. glucose. c. ethanol.

63. …. is believed to be related to γ-aminobutyric acid (GABA) not be metabolized, failure of detoxification of ammonia, cerebral edema: a. jaundice. b. encephalopathy. c. arthralgias.

64. Which statement is not correct?. a. an elevation in the level of serum alkaline phosphatase specifically indicates bile ducts disease. b. an elevation in the level of serum alkaline phosphatase can be seen in bile duct obstruction. c. an elevation in the level of serum alkaline phosphatase can be seen in primary biliary cirrhosis.

65. Bilirubin ↑; AST normal; ALT normal; reticulocytes ↑; urinary changes: bilirubin: absent, urobilinogen: increased, faecal changes: stercobilinogen: normal. Laboratory findings are due to…. a. pre-hepatic jaundice. b. hepatic jaundice. c. post-hepatic jaundice.

66. Which statement is not correct?. a. the fractional excretion of sodium is an indicator of progressed from prerenal azotemia to acute tubular necrosis. b. in simple prerenal azotemia, over 99% of filtered sodium will be reabsorbed. c. the fractional excretion of sodium is less than 1% when the Na reabsorbtion is impared.

67.Chronic renal failure is: a. is a reversible clinical syndrome, due to the long-standing renal impairment. b. an irreversible clinical syndrome, due to progressive renal impairment and its effects on many types of tissues. c. is a clinical syndrome characterized by azotemia.

68. The interplay of afferent and efferent arteriolar constriction and dilatation is known as. a. autoregulation. b. decompensation. c. disregulation.

69. Excess consumption of salt and water in GN are expressed by: a. edema and hypertension. b. hematuria. c. urea casts.

70. Loss of plasma proteins in nephrotic syndrome may present as: a. hypocoagulability due to hyperfibrinogenemia, and hyperlipidemia. b decreased susceptibility to infections due to defect in opsonization by IgG. c. vitamin D deficiency state and secondary hyporparathyroidism. d. hypercoagulability, due to antithrombin III, protein C and protein S deficiency.

71. Prostaglandins E1 and E2 production are able to prevent ulcer development due to their ability to: a. attenuate acid production. b. support the capillary blood flow to surface. c. all are correct.

72. pH required for H. Pylori propagation is between: a. 4.0-8.0;o. b. 1.0-6.0. c. 3.0-4.0;. d. 6.0-8.0. e. all are correct.

73. The most effective ulcer therapy is known as: a. 2 weeks of triple therapy. b. 5 weeks of triple therapy fall in Po2 (hypoxemia). c. 2 weeks of dual therapy. d. 4 weeks of quadruple therapy. e. all are wrong.

74. The invasive toxin-producing bacteria are generally known as a: a. colon pathogens. b. small bowel pathogens. c. all are correct.

75. Exopeptidases are known as a: a. amilase and lipase. b. chemotrypsin, trypsine and elastase. c. carboxypeptidase. d. phospholipase A2. e. all are correct.

76. The mechanism underlying in NSAID’s-induced gastric ulcer formation is due to: a. decreased bicarbonate production and secretion. b. decreased mucus production and secretion. c. inhibition of the capillary blood flow to surface. d. all are wrong (c).

77. COPD are known to be accompanying diseases to ulcer development due to the: a. common source of gastrointestinal and respiratory tracts in the early ontogenesis. b. inherited deficiency of α-antitripsin treatment. c. all are correct.

78. The therapeutic activity of proton pump inhibitors is related to ability to: a. decrease acid production. b. kill the bacteria. c. decrease gastrin secretion. d. protect the stomach lining.

79. Osmotic diarrhea is due to: a. decrease acid production. b. kill the bacteria. c. decrease gastrin secretion. d. protect the stomach lining.

80. The alcohol is involved is acute pancreatitis development due to: a. direct toxic effect on pancreatic acinar cells. b. decreased tone at the sphincter of Oddi (predisposing to reflux of bile or duodenal contents into the pancreatic duct). c. inflammation of the sphincter of Oddi (retention of hydrolytic enzymes in the pancreatic duct and acini). d. all correct.