You will be asked to complete 40 tasks, including
Anatomy and Morphology
The groove of the ulnar nerve of the humerus is located:
a) in front of the medial epicondyle. b) in front of the lateral epicondyle. c) behind the medial epicondyle. d) behind the lateral epicondyle. Entry level (1 point)
Which region originates at the pectoralis major?
a) Head b) Clavicular c) Cervical d) Scapular Entry level (1 point)
Where is the pineal gland located?
a) In the metathalamus region of the diencephalon b) Near the crossing of the optic nerves c) In the groove between the upper tubercles of the midbrain d) In the epithalamus of the diencephalon Entry level (1 point)
Which cranial nerves are responsible for gustatory sensitivity?
a) Trigeminal nerve (V) b) Facial nerve (VII) c) Glossopharyngeal nerve (IX) d) Vagus nerve (X) Intermediate level (3 points)
Physiology
Which of the following is NOT included in biological motivation?
a) Professional ambitions b) Hunger c) Fear d) Thirst Entry level (1 point)
Hypercapnia primarily affects respiration by stimulating which of the following?
a) Carotid and aortic bodies receptors b) Central (medullary) chemoreceptors c) Arterial baroreceptors d) Hypoglossal nerve Entry level (1 point)
Which of the following is a mediator in a synaptic contact between a somatic nerve and a skeletal muscle?
a) Noradrenaline b) Acetylcholine c) Serotonin d) Glycine Entry level (1 point)
Which of the following are caused by norepinephrine’s interaction with alpha1-adrenergic receptors?
a) Vasoconstriction b) Pupil dilation c) Bronchial dilation d) Pupil narrowing Intermediate level (3 points)
Pathology
Which of the following is caused by cell swelling?
a) Increased inflow of Na+ b) Increased inflow of K+ c) Accumulation of lactic acid d) Accumulation of albumin Entry level (1 point)
Which of the following is NOT a characteristic pathologic feature of apoptosis?
a) Nuclear chromatin condensation b) Nuclear fragmentation c) Cytoplasmic budding d) Swelling of organelles Entry level (1 point)
Which of the following are secondary pyrogens?
a) Interleukin-1 b) Thromboxane a2 c) Lipopolysaccharide d) Interleukin-6 Intermediate level (3 points)
Which of the following are found in a tuberculous granuloma?
a) Plasma cells b) A focus of caseous necrosis c) Epithelioid cells d) Langhans giant cells Intermediate level (3 points)
Pharmacology
Which of the following is a non-opioid analgesic that has analgesic and antipyretic effects but virtually no anti-inflammatory properties?
a) Ketamine b) Paracetamol c) Amitriptyline d) Carbamazepine Entry level (1 point)
Which of the following statements is correct?
a) M-cholinoblockers cause arterial hypertension. b) M-anticholinergics reduce the secretion of exocrine glands by blocking parasympathetic influences on the glands. c) M-cholinoblockers cause relaxation of the radial muscle of the iris. d) M-anticholinergics increase intraocular pressure by increasing the production of intraocular fluid. Entry level (1 point)
Which of the following does the concept of “pharmacokinetics” include?
a) Mechanisms of drug action b) Distribution of drugs in the body c) Pharmacological effects d) Drug metabolism Intermediate level (3 points)
Which of the following are contraindications for the use of cardiac glycosides?
a) Heart failure b) Tachyarrhythmic forms of atrial fibrillation c) Atrioventricular block d) Bradycardia Intermediate level (3 points)
General and Internal Medicine
Which of the following is a manifestation of pneumonia in elderly and senile patients?
a) Unexplained falls b) Hectic fever c) An acute beginning d) Abundant purulent sputum Entry level (1 point)
In the NYHA classification, which distance covered in a 6-minute walk corresponds to Class II chronic heart failure?
a) 301–425 meters b) 151–300 meters c) Less than 150 meters d) 426–550 meters Entry level (1 point)
Which of the following characterizes chronic hepatitis C?
a) Predominance of ALT over AST b) Predominance of AST over ALT c) Isolated increase in ALT d) Isolated increase in AST Entry level (1 point)
Which of the following are recommended for the prevention of bleeding from varicose veins?
a) Prescription of non-selective beta-blockers b) Endoscopic ligation of varicose veins esophagus c) Prescription of super-selective beta-blockers d) Ligation of hemorrhoidal veins Intermediate level (4 points)
A 20-year-old patient reported weakness, reduced physical and mental performance, unpleasant sensations in the muscles, and episodic pain in both small and large joints during movement. Past medical history: the patient reported being ill for two weeks, with the first symptoms appearing after work-related stress. The symptoms have been progressively worsening. Despite taking multivitamins to alleviate the symptoms, there was no improvement, which led her to seek medical help. Life history: the patient is single and lives in an apartment. She works in an office with an “irregular” schedule and describes her work as “stressful.” The patient does not smoke, drink alcohol, or use substances. She occasionally takes multivitamins. Two months ago, she underwent a medical examination that included visits to a general practitioner, gynecologist, neurologist, and otorhinolaryngologist, as well as fluorography, general blood and urine tests, and biochemical blood tests. No pathology was detected. The patient is physically active and exercises regularly. There is no history of hereditary or chronic illnesses, and no epidemiological history of diseases. She has been vaccinated according to the recommended schedule for her age. Examination: The patient's condition is relatively satisfactory. She has an asthenic physique, with a height of 178 cm and a weight of 62 kg. The skin and mucous membranes are of normal color. The joints are normal, and there are no pathologies in the respiratory or circulatory systems. The abdomen is of normal size, soft to palpation, and painless throughout. The liver and spleen are not enlarged, and there is no dysuria. Laboratory examination: A general blood test showed an increase in ESR up to 30 mm / h; HBsAg, HCV Ab, and HIV 1 and 2 antibodies, as well as the HIV 1 and 2 antigen (HIV Ag/Ab Combo), are negative. Biochemical blood test: ALT was within the upper limit of normal (ULN); AST-15 ULN; total and direct bilirubin levels were normal; ALP-1.5 ULN; GGT: 2 ULN; INR-1.30 (norm 0.8-1.2); total protein-88 g / l (the norm up to 83); albumin-30 g/l (the norm of 35–52); alpha 1 and 2 levels, beta globulins were normal; gamma globulin level was 22 g/l (ULN is 15.2); M-gradient was not detected on electrophoresis when assessing immunoglobulin levels; a slight increase in IgA, IgM levels and an increase in IgG levels up to 2 ULN were noted.
Questions and tasks:
What is the most probable diagnosis? Explain your answer.
Create a plan for an additional patient examination and explain your choices.
What therapy would you prescribe for this patient, including regimen, diet, and medication?
Advanced level (9 points)
Surgery
Within which method is a polypropylene mesh prosthesis used in hernioplasty?
a) Lichtenstein b) Shouldice c) Bossini d) Marcy Entry level (1 point)
Which of the following is Murphy's ultrasound symptom in acute cholecystitis?
a) Pain on probe pressure in the right subcostal region b) Thickening of the gallbladder wall c) Increase in the size of the gallbladder d) Sludge in the gallbladder lumen Entry level (1 point)
Abdominal effusion in colon perforation is:
a) Fecal b) Hemorrhagic c) Fibrinous d) Chylous Entry level (1 point)
Which of the following is acute cholecystitis characterized by?
a) Nausea and vomiting b) Pain in the RUQ c) Leukocytosis d) Irradiation of pain to the perineum Intermediate level (4 points)
A 38-year-old woman was brought to the emergency department with recurrent episodes of severe, sharp abdominal pain in the right upper quadrant with repeated nausea and vomiting. The patient’s height was 170 cm, weight 72 kg, BMI 24.9 kg/m². Her temperature was 38.0 °C (100.4 °F), pulse 99 beats per minute, blood pressure 120/80 mmHg, respiratory rate 22/min. On palpation, the abdomen was moderately tense in the right subcostal region. Peristalsis was audible. ECG discovered sinus tachycardia. According to the abdominal ultrasound, the pancreas and liver show no abnormalities, the common bile duct measures 6 mm, the gallbladder is enlarged and contains multiple concrements, having a layered wall up to 8 mm thick, and there is perivesical fluid with gas bubbles.
Questions and tasks:
List the syndromes seen in the patient.
What is the most likely diagnosis?
Propose a treatment algorithm.
Advanced level (9 points)
Dentistry and Oral Surgery
Which of the following is an oral manifestation of chronic poisoning by heavy metals?
a) Black line along the gingival margin b) Periodontal pockets c) Overgrowth of gingival papilla d) Oral candidiasis Entry level (1 point)
In chronic odontogenic sinusitis, which wall of the maxillary sinus is primarily affected?
a) Medial b) Lower c) Back d) Top Entry level (1 point)
Which of the following are pathological processes in oral leukoplakia?
a) Hyperkeratosis b) Acantosis c) Acantholysis d) Necrosis Intermediate level (4 points)
Which of the following are facial lymph nodes?
a) Buccal b) Molar c) Submandibular d) Mastoid Intermediate level (4 points)
Infectious Diseases
Which of the following is the ability of a population to resist the damaging effects of a disease pathogen?
a) immunity b) Incidence c) Susceptibility d) Contagiousness Entry level (1 point)
Which of the following describes the advantage of live vaccines over inactivated vaccines?
a) More robust immunity b) Fewer adverse effects c) Do not require maintaining the cold chain d) Do not cause allergic reactions Entry level (1 point)
Seasonal rises of morbidity are characteristic of:
a) The majority of infectious diseases. b) Some noncommunicable diseases. c) All noncommunicable diseases. d) All diseases, regardless of their origin. Entry level (1 point)
Which natural factors influence the intensity of an epidemic process?
a) Living and working conditions b) Migration c) Climate d) Virulence of the pathogen Intermediate level (3 points)
What epidemiological indicators should be calculated to compare the incidence in these populations?
Advanced level (9 points)
What social factors could explain the observed features of the epidemic process? Please provide examples.
Advanced level (9 points)
What natural factors could explain the observed features of the epidemic process? Please provide examples.
Advanced level (9 points)
Public Health
A study was conducted to assess the self-reported quality of life and associated social factors among residents of city K with the view to developing social programs for health protection.
Questions and tasks:
What are the objectives of the research?
What are the research program elements (observation unit, studied characteristics with their types specified)?
Outline the research plan (research object, place of study, type of study by period, type of study by scope).
Advanced level (9 points)
