Which of the following is an enzyme abnormality associated with hyperuricaemia?
A. Glucose-6-phosphatase deficiency
B. Phenylalanine hydroxylase deficiency
C. Uridyl transferase deficiency
D. Galactose-1-phosphate deficiency
Urate handling by the kidney involves the following processes EXCEPT:
A. Tubular secretion
B. Tubular degradation
C. Tubular reabsorption
D. Glomerular filtration
A 40-year-old man presented with lassitude, weakness and weight loss. His skin was noticeably bronzed, although it was winter and he had not been out of the country. On examination, he was found to have hepatosplenomegaly, rather sparse body hair and small testes. On further questioning, he admitted that he had lost his libido and become impotent. Investigations showed: fasting blood glucose – 10 mmol/l, serum iron – 70 umol/l, iron-binding capacity – 67 umol/l, ferritin – 5000 ug/l, LH – 2 U/l. Which of the following conditions best describes the patient’s condition?
A. Severe haemochromatosis
B. Iron deficiency
C. Microcytic anaemia
D. Rheumatoid disease
In which biological material we can determine myoglobin?
A. In liquor
B. In urine
C. In red blood cells
D. In renal tissue
All complications cause appearance of myoglobin in urine, EXCEPT:
A. Cystitis
B. Acute renal Failure
C. Muscular necrosis
D. Paresis
All tests are possible to distinguish myoglobinuria from hemoglobinuria, EXCEPT:
A. After coloring of blood serum
B. At times appearances of Mb in urine
C. On activity of CK in blood
D. On concentration of hemosiderine in urine
To which form of porphyrias it is possible to take such symptoms: child΄s age, enlarged spleen, hemolytic anemia, ulcer, scars, erythema of skin covers, hyper sensitiveness to the sun radiation, leucocytosis, increased temperature. Urine is colored due to the presence of uroporphyrine I:
A. Uroporphyria (Gyunter΄s illness)
B. Hepatic porphyria
C. Erythropoetic porphyria
D. Coproprotoporphyria
All precursors of porphyrines have a diagnostic value, EXCEPT:
A. δ-ALA
B. Succinate
C. PBG
D. Porphobilin
A patient presented with severe unexplained abdominal pain, vomiting and constipation. He had muscle stiffness as well as occasional bouts of ceasures and sinus tachycardia. Excessive porphyrin precursors (ALA and PBG) were seen in the urine during an attack. Other examinations further confirmed that the patient suffers from:
A. Erythropoetic protoporphyria
B. Cutaneous hepatic porphyria
C. Congenital erythropoetic porphyria
D. Acute intermittent porphyria
Which of the following is not a clinical feature shown on the central nervous system in acute attacks of porphyrias:
A. Hysteria
B. Depression
C. Schizophrenia
D. Psychosis
A patient was admitted in the regional hospital with severe attacks of pain in the abdominal region, constipation and neurological disturbances like psychosis and occasional depression. After the detection of porphyrin precursors in the urine, a diagnosis of acute intermittent porphyria was made. Deficiency of which enzyme can be said to be responsible for this condition?
A. ALA dehydratase
B. PBG deaminase
C. Ferrochelatase
D. Uroporphyrinogen oxidase
An abnormal derivative of haemoglobin released from haemoglobin when red blood cells containing this pigment are haemolyzed but can be formed from free haem in severe intravascular haemolysis and also combines with albumin in the blood stream to form methaemalbumin is:
A. Carboxyhaemoglobin
B. Haematin
C. Sulphaemoglobin
D. Methaemoglobin
The best non-invasive test for iron deficiency is the measurement of:
A. Red cell indices
B. Porphyrin level
C. Plasma ferritin
D. Osteocytes in bone marrow
Measurement of the iron-binding capacity is a functional measurement of:
A. Plasma ferritin
B. Haemoglobin
C. Red cell indices
D. Transferrin
The sources of purine nucleotides are the following EXCEPT:
A. Diet
B. De novo synthesis
C. Renal uptake
D. Tissue breakdown
One important parameter that is associated with the pathogenesis of gout is:
A. Hyperacidemia
B. Hypocystinuria
C. Hyperuricaemia
D. Hyponatraemia
The following are associated causes of hyperuricaemia EXCEPT:
A. Chronic renal disease
B. Increased purine synthesis
C. Tissue hypoxia
D. Increased renal excretion
Purine nucleotides are degraded into uric acid pool and excreted by which of the following mechanisms:
A. Tubular secretion
B. Renal excretion
C. Tissue breakdown
D. Liver enzyme catabolism
The patient has tissue edema, hypernatraemia. Which hormone secretion imbalance is the cause of water-salt disturbance?
A. Aldosterone.
B. Cortisol.
C. Corticosteron.
D. Adrenaline.
E. Glucagon.
Choose the correct answer. How the concentration of potassium in blood serum will change under disorders of acid-base balance?
A. Increases under alkalosis.
B. Reduced under acidosis.
C. Increases under acidosis and decreases under alkalosis.
D. Decreases under acidosis and increases under alkalosis.
E. No changes under acidosis and alkalosis.
All below listed mechanisms are used to compensate of metabolic acidosis, except:
A. Reabsorption of bicarbonate.
B. Excretion of free acids.
C. Excretion of ammonium salts.
D. Excretion of alkaline phosphate.
E. Hyperventilation.
Compensation for metabolic alkalosis is due to all mechanisms, except:
A. Increased of sodium hydrocarbon excretion with urine.
B. Increase the volume of lung ventilation.
C. Exchange of chlorine and bicarbonate between cells and plasma.
D. Increasing partial pressure of carbon dioxide.
E. Reduction of respiratory center sensitivity to carbon dioxide.
Patient I. has 39 years old, miner. Diagnosis: chronic bronchitis. Exacerbation of emphysema in the stage of decompensation. Pulmonary heart. Circulatory failure the third degree. Broncho-pneumonia.
Parameters of acid-base balance:pH = 7,18; ρCO2 = 101 mm Hg; SB = 22 mmol/l; AB = 34,1 mmol/l; BB = 51 mmol/ l; BE = -2,8 mmol/l.
What form of acid-base balance disturbance patient has?
A. Decompensated respiratory acidosis.
B. Decompensated respiratory alkalosis.
C. Decompensated metabolic acidosis.
D. Decompensated metabolic alkalosis.
E. Subcompensated respiratory alkalosis.
*What type of disturbance of acid-base balance will be observed in the patient with the following parameters Sigurd-Andersen's nomogram:pH = 7,29; ρCO2 = 54,4 mm Hg; SB = 22 mmol/l; AB = 25,2 mmol/l; BB = 47 mmol/ l; BE = -2,4 mmol/l?
A. Compensated metabolic acidosis.
B. Decompensated respiratory acidosis.
C. Decompensated metabolic acidosis.
D. Decompensated respiratory alkalosis.
E. Compensated respiratory alkalosis.
*What type of disturbance of acid-base balance will be observed in the patient with the following parameters Sigurd-Andersen's nomogram:pH = 7,33; ρCO2 = 31,5 mm Hg; SB = 18 mmol/l; AB = 16,0 mmol/l; BB = 46 mmol/ l; BE = -8,0 mmol/l?
A. Decompensated metabolic acidosis.
B. Decompensated respiratory acidosis.
C. Subcompensated metabolic acidosis.
D. Decompensated respiratory alkalosis.
E. Subcompensated metabolic alkalosis.
What type of disturbance of acid-base balance will be observed in the patient with the following parameters Sigurd-Andersen's nomogram:pH = 7,55; ρCO2 = 60 mm Hg; SB = 43 mmol/l; AB = 49,4 mmol/l; BB = 74 mmol/ l; BE = +19,2 mmol/l?
A. Decompensated metabolic acidosis.
B. Decompensated respiratory acidosis.
C. Compensated respiratory alkalosis.
D. Decompensated respiratory alkalosis.
E. Decompensated metabolic alkalosis.
When hypokalemia will develop?
A. Systemic acidosis.
B. Deficiency of mineralocorticoids.
C. Diuretic phase of acute renal failure.
D. Potassium release from damaged cells.
E. Chronic renal failure.