База тестів крок-1 з патофізіології (пмк-1)

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. Topic. 17. Pathophysiology of blood and hemopoietic organs.

2. 
   Gastrin
   
3. 
   Pepsin
   
4. 
   Chlorine hydrate
   
5. 
   Mucin
   

2. Amino acids replacement in alpha and beta chains of hemoglobin takes place in a number of hemoglobinopathies. Which of them is typical for HbS (sickle-cell anemia)? A. Glycine to serine

2. 
   Aspartate to lysine
   
3. 
   Methionine to histidine
   
4. 
   Glutamate to valine*
   
5. 
   Alanine to serine
   

3. Hereditary microspherocytosis (Minkowski-Chauffard disease) was diagnosed in a woman aged 34. What mechanism caused hemolysis of erythrocytes in the patient?

1. 
   Enzymopathy
   
2. 
   Hemoglobinopathy
   
3. 
   Autoimmune impairment
   
4. 
   Membranopathy*
   
5. 
   Hypoplasia of bone marrow
   

1. 
   Cyanocobalamin*
   
2. 
   Cholecalciferol
   
3. 
   Magnesium
   
4. 
   Glycine
   
5. 
   Copper
   

5. Three years ago a man aged 45 was operated on for stomach resection. After the operation the content of erythrocytes in the blood is 2.0x10¹², Hb 85 g/L, color index1.27. What vitamin absorption is impaired that causes the change of erythropoiesis? A. C

2. 
   P
   
3. 
   A
   
4. 
   B₆
   
5. 
   B₁₂ *
   

6. A patient, carrier of hereditary sickle-cell erythrocytes anomaly, had pneumonia accompanied by hemolytic crisis and development of anemia. What is the main cause of hemolytic crisis in this case?

1. 
   Hyperoxia
   
2. 
   Heterozygosis HbS
   
3. 
   Mutation of structural gene
   
4. 
   Hypoxia caused by pneumonia*
   
5. 
   Blood osmolarity change
   

7. Examining the oral cavity of a patient, a dentist paid attention to the presence of inflammatory-dystrophy process in the mucous membrane (atrophic Hunter's glossitis, atrophic stomatitis). Blood analysis revealed hyperchromic anemia. What factor is a cause of this disease? A. Hypovitaminosis B₆

2. 
   Hypovitaminosis A
   
3. 
   Increase of stomach juice acidity
   
4. 
   Hypovitaminosis B₁
   
5. 
   Hypovitaminosis B₁₂ *
   

8. A female patient complains of malaise, weakness, breathlessness, rapid fatigability, and dizziness. Her blood test data: erythrocytes-1.8x10¹²/L, Hb-80 g/L, leukocytes3.2x10⁹/L, color index-1.5. Anisocytosis, poikilocytosis, megaloblasts, megalocytes were found in smear. What is the possible diagnosis?

1. 
   B₁₂-deficiency anemia*
   
2. 
   Posthemorrhagic anemia
   
3. 
   Acute leukemia
   
4. 
   Iron deficiency anemia
   
5. 
   Immunohemolytic anemia
   

1. 
   Pepsin
   
2. 
   Renin
   
3. 
   Secretin
   
4. 
   HCL
   
5. 
   Castle’s factor*
   

10. Funicular myelosis and hyperchromic anemia developed in a man 7 years later after the stomach resection due to ulcer. What pathogenic mechanism of changes in spinal cord is the most possible one? A. Hypoxia impairment in anemia

2. 
   Accumulation of methylmalonic acid in cyanocobalamin deficiency*
   
3. 
   Impairment of DNA in cyanocobalamin deficiency
   
4. 
   Deficiency of folic acid
   
5. 
   Deficiency of iron containing enzyme
   

11. On the seventh day after hemorrhage caused by a trauma, the following was revealed in a patient’s blood: erythrocytes - 2.8x10¹²/l, Hb - 3.9mmol/l, reticulocytes - 15%, acidophilic and polychromatophilic normoblasts were found in smear. What is the mechanism of appearance of regenerative forms of blood erythrocytes?

1. 
   Going out of blood deposition
   
2. 
   Increase permeability of erythrocyte sprout of bone marrow
   
3. 
   Intensification of regeneration of erythroid cells in bone marrow*
   
4. 
   Inhibition of maturation of erythroid cells in bone marrow E. Inhibition of synthesis of erythropoietin inhibitor
   

12. When treating a patient for malaria with primaquine, hemolysis occurs in him. At examination deficiency of Glucose-6-phosphate Dehydrogenase in patient’s erythrocytes was revealed. What metabolic process is impaired in this patient?

1. 
   Aerobic carbohydrate oxidation
   
2. 
   Glycogenesis
   
3. 
   Glycolysis
   
4. 
   Gluconeogenesis
   
5. 
   Pentose-phosphate pathway*
   

13. B₁₂-folate deficient anemia was diagnosed in a patient aged 55. What hematological index will be the most sensitive for pathogenetic treatment?

1. 
   Increase of number of erythrocytes
   
2. 
   Increase of number of reticulocytes
   
3. 
   Reduction of anisocytosis*
   
4. 
   Decrease of ESC
   
5. 
   Decrease of amount of hemoglobin
   

1. 
   Thalassemia
   
2. 
   B₁₂-deficiency anemia*
   
3. 
   Post-hemorrhagic anemia
   
4. 
   Iron-deficiency anemia
   
5. 
   Hemolytic anemia
   

15. In an infant, who is under an artificial nutrition with cow milk, severe anemia has developed. At the blood count of the infant: number of erythrocytes is 4x10¹²/L, content of hemoglobin is 68 g/L, reticulocytes of 0%. What kind of anemia developed in the infant? A. Sickle-cell anemia

2. 
   Inborn hemolytic anemia
   
3. 
   B₁₂-deficiency anemia
   
4. 
   Hypoplastic anemia
   
5. 
   Iron-deficiency anemia*
   

16. Predomination of erythroblasts, normoblasts and megaloblasts was revealed in blood analysis of a patient with anemia. The same cells were found in bone marrow. What type of anemia do these changes characteristic for?

1. 
   Post-hemorrhagic
   
2. 
   Hemolytic
   
3. 
   Aplastic
   
4. 
   B₁₂-folate deficiency anemia*
   
5. 
   Iron-deficiency anemia
   

17. Two years ago a patient was operated on for resection of pyloric portion of the stomach. There is weakness, periodical appearance of dark circles under eyes, breathlessness in this patient. In the blood analysis: HB-70g/L, erythrocytes-

3.3x10¹²/L, color index-0.7. What erythrocyte changes in the blood smear are the most typical for the given state?

1. 
   Microcytes*
   
2. 
   Megalocytes
   
3. 
   Schizocytes
   
4. 
   Ovalocytes
   
5. 
   Macrocytes
   

18. Singular oxyphilic normoblasts appeared in the blood of a patient after acute posttraumatic hemorrhage composing 15% of blood volume. On supravital staining 25% of reticulocytes were found. What is the patient anemia according to its ability of regeneration? A. Hyperregenerative*

2. 
   Regenerative
   
3. 
   Hyporegenerative
   
4. 
   Aregenerative
   
5. 
   Hypo- and aregenerative
   

19. What index of blood analysis is the most typical for beta-thalassemia?

1. 
   Considerable decrease of erythrocytes and hemoglobin
   
2. 
   Erythrocytes with basophilic stippling
   
3. 
   Increase of fetal hemoglobin*
   
4. 
   Target-like erythrocytes
   
5. 
   Increase of met-hemoglobin
   

20. A patient had anemia due to profuse blood loss. What blood changes are typical at the beginning of development of acute post-hemorrhagic anemia?

1. 
   Presence of megalocytes in the blood
   
2. 
   Absence of reticulocytes
   
3. 
   Poikilocytosis, anisocytosis
   
4. 
   Hyperchromia
   
5. 
   Normochromia*
   

21. Erythropenia, hyperchromia, normocytes, macrocytes, megalocytes, poikilocytosis were found out in a patient’s blood at examination. What is the cause of this pathology? A. Ascariasis

2. 
   Deficiency of gastromucoprotein*
   
3. 
   Iron deficiency in food
   
4. 
   Trichocephaliasis
   
5. 
   Frequent loss of blood
   

22. While studying a blood smear different forms of erythrocytes were found. Which of them are regenerative?

1. 
   Anisocytoses
   
2. 
   Poikilocytes
   
3. 
   Polychromatophils*
   
4. 
   Ovalocytes
   
5. 
   Megalocytes
   

23. The presence of agranulocytosis was determined in the blood analysis of a liquidator of accident at Chernobyl atomic power station who had got 5 Gr dose of irradiation. What pathogenetic mechanism is the leading one in its appearance?

1. 
   Inhibition of leucopoiesis*
   
2. 
   Increased penetration of granulocytes into tissues
   
3. 
   Increase of leukocytes destruction
   
4. 
   Impairment of going out of mature leukocytes from bone marrow
   
5. 
   Development of autoimmune process.
   

24. During the development of acute pulpitis a patient complained of paroxysm of pain in the upper jaw, which is increasing at night, fever. At examination leucocytosis was established in the blood. What kind of leucocytosis is possible in this case?

1. 
   Basophilic leucocytosis
   
2. 
   Lymphocytosis
   
3. 
   Eosinophilic leucocytosis
   
4. 
   Monocytosis
   
5. 
   Neutrophilic leucocytosis.*
   

25. Considerable increase of the number of eosinophils in a unit of blood volume was determined during the examination of a 5 years old boy. What may cause eosinophilia in this patient?

1. 
   Helminthic invasion*
   
2. 
   Obesity
   
3. 
   Hypodynamia
   
4. 
   Hypothermia
   
5. 
   Physical exertion
   

26. In the patient’s blood analysis the number of leukocytes is 250*10⁹/L. What syndrome does this patient have?

1. 
   Leukemia*
   
2. 
   Leucocytosis
   
3. 
   Leukopenia D. Leukemoid reaction
   

1. 
   Physical load*
   
2. 
   Mental work
   
3. 
   Rest at a health resort
   
4. 
   Considerable use of water
   
5. 
   Usage of alcohol
   

28. Lymphocytosis was revealed in a patient. What diseases may be accompanied by lymphocytosis?

1. 
   Sepsis
   
2. 
   Helminthic invasion
   
3. 
   Somatotropin insufficiency
   
4. 
   Pertussis, chicken pox*
   
5. 
   Bronchial asthma
   

29. Neutropenia is found out in a patient who has the manifestations of immunodeficiency. What diseases may neutropenia be determined in?

1. 
   After profuse hemorrhage
   
2. 
   Fusarium fungus poisoning*
   
3. 
   Myeloleukemia
   
4. 
   Insufficiency of sexual gland function
   
5. 
   Septic process
   

30. Increase of the number of eosinophils was determined in a patient with endocrine pathology during examination. Which of the named diseases may be accompanied by eosinophilia?

1. 
   Pheochromocytoma
   
2. 
   Conn’s disease
   
3. 
   Acromegaly
   
4. 
   Cushing disease
   
5. 
   Addison’s disease*
   

31. Functional insufficiency of monocytes is accompanied by immunodeficiency. What BAS produced by monocytes stimulate specific response?

1. 
   Interleukin-2
   
2. 
   Lysozyme
   
3. 
   Interleukin-1*
   
4. 
   Fibronectin
   
5. 
   Myeloperoxidase
   

32. Relative neutropenia with degenerative shift was revealed in the blood of a patient with TB during examination. What change of differential blood count corresponds to this state?

1. 
   Decrease of the number of segmented forms and increase of band forms of neutrophils*
   
2. 
   Decrease of lymphocyte number
   
3. 
   Increase of monocyte number
   
4. 
   Increase of basophil number
   
5. 
   Decrease of eosinophil number
   

33. Neutrophil leukocytosis was revealed in worker during examination. What pathologic condition may neutrophil leukocytosis result from?

1. 
   Chronic loss of blood
   
2. 
   Septic condition*
   
3. 
   Viral infection
   
4. 
   Radiation sickness
   
5. 
   Benzene poisoning
   

34. A patient aged 32 with massive hemorrhage due to car accident trauma was admitted to the hospital. Pluse-100 beats per min, respiratory rate-22 per 2 min, BP100/60 mmHg. What blood change will be the most characteristic in an hour after hemorrhage? A. Erythropenia

2. 
   Hypoproteinemia
   
3. 
   Hypovolemia*
   
4. 
   Leukopenia
   
5. 
   Erythrocyte hypochromia
   

35. During the examination of peripheral blood of a patient aged 42, it was revealed: Hb-80g/L, erythrocytes-3.2 x 10¹²/L, leukocytes-25 x 10⁹/L, leukocytic formula: basophils-5%, eosinophils- 9%, myeloblasts- 3 %, promyelocytes-8%, neutrophils17%, segmented- 19%, lymphocytes- 3 %, monocytes- 3%. What blood pathology is the most possible in this patient?

1. 
   Panmyelophthisis
   
2. 
   Erythroleukemia
   
3. 
   Acute myeloblast leukemia
   
4. 
   Chronic myelogenous leukemia*
   
5. 
   Promyelocytic leukemia
   

36. The experiment was carried out on a rabbit. The increase of the number of erythrocytes and hemoglobin in the blood due to the stimulation of erythropoiesis by erythropoietin was determined 2 weeks later after the narrowing of renal artery. What increases the formation of erythropoietin?

1. 
   Hypo-osmia
   
2. 
   Hypercapnia
   
3. 
   Hypoxemia*
   
4. 
   Hyperosmia
   
5. 
   Hypovolemia
   

37. Hemolytic anemia with decrease of osmotic erythrocyte resistance that averaged

0.6-0.5 was revealed in a smear of venous blood during microscopic examination. What substance accumulation in the blood plasma may also indicate the development oh hemolytic anemia?

1. 
   Creatinine
   
2. 
   Urea
   
3. 
   Indirect bilirubin*
   
4. 
   Lactic acid
   
5. 
   Inorganic phosphate
   

1. 
   Serum chlorine
   
2. 
   Serum phosphorous
   
3. 
   Serum magnesium
   
4. 
   Serum calcium
   
5. 
   Serum iron*
   

1. 
   1.30*
   
2. 
   1.15
   
3. 
   1.0
   
4. 
   0.85
   
5. 
   0.70
   

40. A victim of a car accident has lost much blood. What impairment of general blood volume takes place? A. Simple hypovolemia

2. 
   Polycythemic normovolemia
   
3. 
   Oligocythemic normovolemia
   
4. 
   Polycythemic hypovolemia
   
5. 
   Oligocythemic hypovolemia*
   

41. Excessive flow of estrogens into the blood due to follicle persistence (a state when follicle does not reach complete maturation and ovulation does not take place) often cause uterine bleeding. What anemia may develop in this case?

1. 
   Iron deficiency*
   
2. 
   Sideroachrestic
   
3. 
   Sickle cell
   
4. 
   Hypoplastic
   
5. 
   Metaplastic.
   

42. Which of the below named anemias relevant to hemoglobinopathies?

1. 
   Minkowski-Chauffard disease
   
2. 
   Iron deficiency anemia
   
3. 
   B₁₂ deficiency
   
4. 
   Thalassemia*
   
5. 
   Iron refractory anemia
   

1. 
   Minkowski-Chauffard disease
   
2. 
   Iron deficiency anemia
   
3. 
   B₁₂ deficiency
   
4. 
   Sickle cell anemia
   
5. 
   Iron refractory anemia*
   

1. 
   Purulent inflammation*
   
2. 
   Tuberculosis
   
3. 
   Infections mononucleosis
   
4. 
   Agranulocytosis
   
5. 
   Alimentary leukocytosis
   

1. 
   Acute myelogenous leukemia
   
2. 
   Chronic myelogenous leukemia*
   
3. 
   Hodgkin’s disease
   
4. 
   Burkitt's lymphoma
   
5. 
   Chronic lymphocyte leukemia
   

46. Patient M, aged 20 was admitted to the hospital complaining of high temperature, pain in the bones, and hemorrhage from his gums. Blood analysis of this patient shows: erythrocytes-2.5x10¹²/L; Hb-80g/L; leucocytes-2.0x10⁹/L; thrombocytes-6.0x10⁹/L; differential count: eosinophils-1%; stab neutrophils-1%; segmented neutrophils-10%; lymphocytes-10%; monocytes-3%; blast cells-75%. What pathology is this blood analysis typical for? A. Hodgkin’s disease

2. 
   Burkitt’s lymphoma
   
3. 
   Acute leukemia*
   
4. 
   Infections mononucleosis
   
5. 
   Chronic leukemia
   

47. General amount of leucocytes is 90x10⁹/l. In differential count: eosinophils-1%; basophils-0%; juvenile neutrophils-0%; stab neutrophils-2%; segmented neutrophils20%; prolymphocytes-2%; lymphocytes-70%; Botkin-Gumprecht cells. Cervical, submandibular lymph nodes are enlarged. What pathology is such blood picture typical for?

1. 
   Acute lymphoblastic leukemia
   
2. 
   Hodgkin’s disease
   
3. 
   Infectious mononucleosis
   
4. 
   Chronic lymphocytic leukemia*
   
5. 
   Chronic myelogenous leukemia
   

48. Hypochromic anemia was found out in a patient aged 54, who had a prolonged contact with lead at his work. Treatment with iron preparations for a month didn’t give any effect. The increased amount of iron was determined in blood serum. What is this anemia due to?

1. 
   Vitamin B₁₂ deficiency
   
2. 
   Porphyrin synthesis impairment
   
3. 
   Folic acid deficiency
   
4. 
   Hypoplasia of red bone marrow*
   
5. 
   Erythrocyte hemolysis
   

49. A patient aged 20, has periodically yellowness of sclera and skin that is accompanied by weakness. Minkowski-Chauffard disease is diagnosed. What is the most typical for blood picture in this disease?

1. 
   Reticulocytosis
   
2. 
   Agranulocytosis
   
3. 
   Macrocytosis
   
4. 
   Microspherocytosis*
   
5. 
   Thrombocytosis
   

50. Posthemorrhagic anemia has developed in a patient with periodical bleeding due to uterus fibromyoma. What type of chronic post hemorrhagic anemia takes place in this case?

1. 
   Megaloblastic, hyperchromic, hyperegenerative.
   
2. 
   Megaloblastic, hypochromic, hyporegenerative.
   
3. 
   Erythroblastic, hyperchromic, hyporegenerative.
   
4. 
   Erythroblastic, hypochromic, hyperregenerative.
   
5. 
   Erythroblastic, hypochromic, hyporegenerative.*
   

51. A female patient with impairment of menstrual cycle accompanied by prolonged bleeding the blood analysis was made which revealed hypochromia, decrease of reticulocytes, microcytosis. What group does this anemia belong to according to pathogenesis?

1. 
   B₁₂ folic deficiency anemia
   
2. 
   Iron deficiency anemia*
   
3. 
   Hypoplastic anemia
   
4. 
   Hemolytic anemia
   
5. 
   Metaplastic anemia
   

52. Patient R. aged 12 was operated on for acute phlegmonous appendicitis. At the examination of his blood, the amount of leukocytes is 12.10⁹/L. On the blood smear there are: basophils – 0%; eosinophils – 2%; monocytes – 2%; juvenile neutrophils – 0%; stab neutrophils – 30%; segmented neutrophils – 43%; lymphocytes – 23%; monocytes – 0%. Stab (immature) neutrophils have pyknosis of nuclei. There is anisocytosis of neutrophils; some of them have toxic granulation. What form of change of leukocyte blood composition takes place in this case? A. Neutrophilia with degenerative shift to the left.

2. 
   Neutrophilia with regenerative shift to the left.
   
3. 
   Neutrophilia with hyperegenerative shift to the left. D. Leukemoid reaction of neutrophil type.*
   

1. 
   Hyperregenerative, hypochromic with erythroblasts type of bleeding.
   
2. 
   Regenerative, hypochromic with erythroblasts type of bleeding.
   
3. 
   Hyporegenerative, hypochromic with megaloblasts type of bleeding.
   
4. 
   Hyporegenerative, hypochromic with erythroblasts type of bleeding.*
   
5. 
   Hyporegenarative, hyperchromic with megaloblasts type of bleeding.
   

54. A female patient, aged 25, was admitted to the hematological department with complains of the appearance of hemorrhages of different sizes on the body; during menstruation there are uterine bleedings. She has been ill for ten years. Paleness of skin and mucous membranes were determined on examination; there are hemorrhages of different size and color on the upper and lower extremities. Pulse = 100 beats/minute, BP 110/70 mmHg. Blood analysis shows: erythrocytes 3.3*10¹² /L, Hb 80g/L, thrombocytes 33*10⁹/L; time of blood coagulation: beginning is at 2nd minute, end is at 6th minute; time of bleeding (according to Duke) - 15 minutes. What is the possible diagnosis? A. Marchiafava-Micheli disease.

B. Thrombocytopenic purpura.* C. Glanzmann's thrombasthenia.

4. 
   von Willebrand thrombocytopathia
   
5. 
   Chronic myelogenous leukemia.
   

55. Neutrophil leukocytosis is determined in a patient with chronic myelogenous leukemia. Which variant of nuclear shift of differential count to the left is the most typical for chronic myelogenous leukemia?

A. Regenerative B. Degenerative.

3. 
   Hyper regenerative.*
   
4. 
   Regenerative and degenerative.
   
5. 
   Hyporegenerative.
   

56. A patient with atrophic gastritis has vitamin B₁₂ deficiency. What variant of nuclear shift of differential count is most typical for B₁₂ hypovitaminosis? A. Hyper regenerative to the left

2. 
   Degenerative to the left.
   
3. 
   Regenerative and degenerative to the left.
   
4. 
   To the right*
   
5. 
   Regenerative to the left
   

57. Hypochromic anemia was diagnosed in a patient on the 7th day after acute hemorrhage. What mechanism is the leading one in its development?

1. 
   Increase of iron excretion from the organism;
   
2. 
   Impairment of globin synthesis;
   
3. 
   Increased erythrocyte destruction in the spleen;
   
4. 
   Impairment of iron absorption in the intestine;
   
5. 
   Increased pen0etration of immature erythrocytes from bone marrow.*
   

1. 
   Intoxication by leukemic cells decay products;
   
2. 
   Formation of leukemic infiltrates;*
   
3. 
   Impairment of disintoxicational function of the liver;
   
4. 
   Cachexia;
   
5. 
   Increase of thrombogenesis.
   

1. 
   Neutrophilic leukocytosis;*
   
2. 
   Leukopenia;
   
3. 
   Monocytosis;
   
4. 
   Anemia;
   
5. 
   Eosinophilia.
   

60. A patient aged 43 has stomatitis, glossitis, the tongue is crimson color, smooth. Blood analysis revealed: Hb 100 g/l; erythrocytes 2.3x10¹⁹/l; color index 1.30. What is the patient’s state due to?

1. 
   Erythrocytes hemolysis
   
2. 
   Hypoplasia of red bone marrow
   
3. 
   Impairment of porphyrin synthesis
   
4. 
   Iron deficiency
   
5. 
   Vitamin B₁₂ deficiency*
   

61. After resection of small intestine a patient complained of increased fatigability, infringement of taste, fragility of nails, quick decay of dental enamel, and appearance of breathlessness on physical exertion. Which of the below given substances is the source of impairments in the patient’s organism?

1. 
   B₁₂-folic deficiency anemia
   
2. 
   Hypocalcemia
   
3. 
   Vitamin D deficiency
   
4. 
   Hyponatremia
   
5. 
   Iron deficiency anemia*
   

62. A female patient took analgin because of toothache. Dark urine, icteric sclera, weakness appeared in her two days later. Which of the causes given below is the most possible one?

1. 
   Immune hemolytic anemia*
   
2. 
   Hypoplastic anemia
   
3. 
   Thrombocytopenia
   
4. 
   Thrombocytopathy
   
5. 
   Agranulocytosis
   

63. A patient with acute pulpitis has an increased body temperature and a number of leukocytes up to 14.10⁹/L, differential count represents: basophils-0%; eosinophils-2%; megakaryocytes-0%; juvenile neutrophils-2%; stab neutrophils-8%; segmented neutrophils-58%; lymphocytes-26%; monocytes-4%. How can you evaluate such changes in blood?

A. Neutrophilic leukocytosis with regenerative shift to the left* B. Neutrophilic leukocytosis degenerative shift to the left

3. 
   Neutrophilic leukocytosis with hyperregenerative shift to the left
   
4. 
   Lymphocytosis
   
5. 
   Neutrophilic leukocytosis with shift to the right
   

64. A patient aged 30 took sulfaethidole for infectious process of mucous membrane in the mouth locally (as powder). Preparation has hemotoxic action and the treatment was complicated by the development of agranulocytosis. At examination it was revealed:

1. 
   Increase of agranulocytes in the blood;
   
2. 
   Decrease of the number of granulocytes in the blood on the background of leukocytosis;
   
3. 
   Decrease of the number of granulocytes in the blood on the background of leukopenia;*
   
4. 
   Decrease of the number of neutrophilic granules with their simultaneous increase;
   
5. 
   Loss of their granules by granulocytes.
   

65. A women fell ill with purulent stomatitis. What index of complete blood count is characteristic for this disease?

1. 
   Lymphocytosis
   
2. 
   Thrombocytosis
   
3. 
   Leukocytosis*
   
4. 
   Anemia
   
5. 
   Monocytosis
   

66. It is recommended to perform a clinical examination of blood in an empty stomach.

What compounds of peripheral blood may be changed after taking food?

1. 
   Decrease in number of platelets
   
2. 
   Elevation of number of leukocytes*
   
3. 
   Elevation of number of erythrocytes
   
4. 
   Increase in content of plasma proteins
   
5. 
   Reduction of number of erythrocytes
   

67. Acute inflammatory disease of upper airways and eyes appears in 45-years-old woman at the period of blossom of grass. Symptoms of this disease are hyperemia, edema, and mucous secretions. What kind of leukocytosis is the most characteristic one for this disease? A. Neutrophilia

2. 
   Monocytosis
   
3. 
   Eosinophilia*
   
4. 
   Basophilia
   
5. 
   Lymphocytosis
   

68. Enlargement of liver and spleen, anemia, and myeloblasts in peripheral blood were revealed in a patient with acute leukemia. What is the main trait, which allows to distinguish acute myelogenous leukemia from chronic one?

1. 
   Pancytopenia
   
2. 
   Blast cells in peripheral blood
   
3. 
   Anemia
   
4. 
   Leukemic gap*
   
5. 
   Thrombocytopenia
   

69. Extraction of a tooth, in a patient with chronic lymphocytic leukemia, was complicated by prolonged bleeding. What may cause the hemorrhagic syndrome in this patient?

1. 
   Anemia
   
2. 
   Lymphocytosis
   
3. 
   Eosinopenia
   
4. 
   Neutropenia
   
5. 
   Thrombocytopenia*
   

70. In blood analysis of 37-years-old woman following data were revealed: content of hemoglobin is 60 g/L, number of erythrocytes is 3.0x10¹²/L, and color index of 0.6; differential count of leukocytes without any changes; number of platelets is 200x10⁹/L; reticulocytes count of 0.3%; ESR of 18 mm/hour; microcytosis and poikilocytosis of erythrocytes. Indicate the most probable type of anemia according to mechanisms of its development.

1. 
   Hypoplastic anemia
   
2. 
   Hemolytic anemia
   
3. 
   Acute post-hemorrhagic anemia
   
4. 
   Iron deficiency anemia*
   
5. 
   B₁₂-folate deficiency anemia
   

71. In a patient aged 35 autoimmune hemolytic anemia developed. What index of blood serum is the most increased in this case?

1. 
   Mesobilinogen
   
2. 
   Stercobilinogen
   
3. 
   Direct bilirubin
   
4. 
   Indirect bilirubin*
   
5. 
   Protoporphyrin
   

72. A patient addressed a dentist with complaints of affections of mucous membrane of his mouth. During the examination of the patient ulcerous stomatitis with necrosis in center was revealed at him in area of his palate. In the history of disease of the patient recently endued pneumonia and taking of medicines (sulfonamides) were present. After administering treatment the doctor pointed the patient for blood analysis. What pathology from below mentioned does doctor suppose?

1. 
   Immune agranulocytosis*
   
2. 
   Iron deficiency anemia
   
3. 
   Thrombocytopenia
   
4. 
   Infectious mononucleosis
   
5. 
   Infectious lymphocytosis
   

1. 
   In vessels*
   
2. 
   In hepatic cells
   
3. 
   In the spleen
   
4. 
   In the bone marrow
   
5. 
   In renal parenchyma
   

74. Myocardial infarction was diagnosed in 65-years-old man. Neutrophilic leukocytosis with left shift is present in the blood of this patient. What factors underlie this phenomenon?

1. 
   Products of tissue decay*
   
2. 
   Elevation of mass of muscular fibers
   
3. 
   Disorders of alveolar ventilation
   
4. 
   Decrease in glycogen content in the myocardium
   
5. 
   Increase of arterial pressure
   

75. B₁₂ deficiency anemia was diagnosed in a man aged 57 after examination of him. Treatment was administered to this patient. Control blood test in this patient was performed in 3 years. What is the most adequate criterion for enhancement of erythropoiesis?

1. 
   Increase in number of reticulocytes*
   
2. 
   Increase in hemoglobin content
   
3. 
   Decrease in color index
   
4. 
   Normoblastic hematopoiesis
   
5. 
   Increase in number of leukocytes
   

76. Patient with chronic subacid gastritis has hypochromic anemia. In the blood smear of this patient agranulocytes, micro- and anisocytosis, and poikilocytosis are revealed. Name this anemia.

1. 
   Iron deficiency anemia*
   
2. 
   Acute post-hemorrhagic anemia
   
3. 
   Thalassemia
   
4. 
   Sickle-cell anemia
   
5. 
   Pernicious anemia
   

1. 
   Neutrophilic*
   
2. 
   Basophilic
   
3. 
   Eosinophilic
   
4. 
   Lymphocytosis
   
5. 
   Monocytosis
   

1. 
   Leukopenia*
   
2. 
   Eosinophilia
   
3. 
   Basophilia
   
4. 
   Hemophilia
   
5. 
   Hyperemia
   

79. A patient, who was exposed to ionizing radiation, has panmyelophthisis and secondary infections. What changes occur in blood analysis in this case?

1. 
   Agranulocytosis*
   
2. 
   Leucocytosis
   
3. 
   Eosinophilia
   
4. 
   Basophilia
   
5. 
   Hyperemia
   

80. A patient with leukemia has general number of leukocytes of 120.0x10⁹/L. What kind of leukemia does this patient have?

1. 
   Leukemic*
   
2. 
   Leukopenic
   
3. 
   Subleukemic
   
4. 
   Aleukemic
   
5. 
   Erythremia
   

81. In a woman hypochromic anemia was diagnosed after delivery accompanied by marked bleeding. What pathologic forms of erythrocytes are characteristic ones for this type of anemia?

1. 
   Anisocytes*
   
2. 
   Target-like erythrocytes
   
3. 
   Sickle-cell anemia
   
4. 
   Spherocytes
   
5. 
   Microcytes
   

82. Patient with chronic leukemia has sharply increased temperature, breathlessness, marked muscular weakness at insignificant physical exertion, increased sweating, cough. What mechanism of leukemia influence upon organism underlies complications in this patient?

1. 
   Immunodeficiency due to functional inability of leukocytes*
   
2. 
   Internal bleeding because metastases into vessel wall
   
3. 
   Anemia
   
4. 
   Tumor progression
   
5. 
   Airway obstruction because of development of metastases
   

83. When examining a blood in a patient, who endued bleeding three days ago, following data was revealed: number of leukocytes is 12x10⁹/L, basophils count is 0%, eosinophils count is 3%, myelocytes count 0%, juvenile neutrophils count is 3%, stab neutrophils count is 12%, segmented neutrophils count is 62%, lymphocytes count 16%, and monocytes count is 4%. What kind of changes of leukocyte differential count takes place in this case?

1. 
   Neutrophilia with regenerative shift to the left*
   
2. 
   Neutrophilia with degenerative shift to the left
   
3. 
   Neutrophilia with shift to the right
   
4. 
   Absolute lymphopenia
   
5. 
   Absolute monocytopenia
   

84. A 40-years-old patient, who was admitted to the surgical department with diagnosis of phlegmona of thigh, had high temperature, tachycardia, and breathlessness. On the blood test of this patient: number of leukocytes is 25x10⁹/L; eosinophils count is 1%, myelocytes count is 1%, juvenile neutrophils count is 15%, band neutrophils count is 25%, segmented neutrophils count is 40%, lymphocytes count 14%, monocytes count is 4%. What kind of shift in differential count is present in this case?

1. 
   Regenerative*
   
2. 
   Hyperregenerative
   
3. 
   Degenerative
   
4. 
   Regenerative-degenerative
   
5. 
   Leukemoid
   

85. What is the cause of intracellular hemolysis?

1. 
   Genetic infringements of erythrocytes*
   
2. 
   Malaria
   
3. 
   Action of hemolytic poison
   
4. 
   Infection with hemolytic streptococcus
   
5. 
   Transfusion of incompatible blood
   

86. What kind of disorders of total blood volume appears in case of absolute erythrocytosis?

1. 
   Polycythemic hypervolemia*
   
2. 
   Oligocythemic hypervolemia
   
3. 
   Oligocythemic hypovolemia
   
4. 
   Simple hypervolemia
   
5. 
   Simple hypovolemia
   

87. Beta-thalassemia was revealed in a patient, who came from Tunis. The disease was accompanied by hemolysis and jaundice. The disease was diagnosed on the base of presence in blood:

1. 
   Target-like erythrocytes*
   
2. 
   Grained erythrocytes
   
3. 
   Polychromatophil erythrocytes
   
4. 
   Normocytes
   
5. 
   Reticulocytes
   

88. During the examination of adolescents that reside in mounting region increase in level of erythrocytes and hemoglobin in peripheral blood was found out. What is the reason for indicated erythrocytosis?

1. 
   Exogenous hypoxia*
   
2. 
   Diseases of lungs
   
3. 
   Congenital heart disease
   
4. 
   Condensation of blood due to large loss of water
   
5. 
   Vaquez disease
   

89. Content of hemoglobin and number of erythrocytes significantly decreases in a patient’s blood from time to time. It was found out that such attacks appear after taking some horse beans. What kind of anemia takes place in this case?

1. 
   Enzymopathy*
   
2. 
   Membranopathy
   
3. 
   Iron deficiency anemia
   
4. 
   Hemoglobinopathy
   
5. 
   Acquired hemolytic anemia