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WorksheetsТерапия 4к англичане экзамен
Total questions: 90
Worksheet time: 1hrs 8mins
FOR PATIENTS WITH DIABETIC NEPHROPATHY AND PROTEINURIA IT IS REASONABLE TO REDUCE SYSTOLIC BLOOD PRESSURE UNDER THE CONTROL OF THE GFR DOWN TO THE LEVEL OF _______ MM HG.
below 140
below 130
below 120
below 150
THE MOST SPECIFIC METHOD IN DIFFERENTIAL DIAGNOSTICS OF HYPERTENSIVE DISEASE AND ITSENKO-CUSHING SYNDROME IS DETERMINATION OF:
renin
thyrotropin
17-oxycorticosteroid
creatinine
THE SIGN OF LEFT VENTRICULAR HYPERTROPHY ACCORDING TO SOKOLOW-LYON INDEX IS:
RI> 11 мм
SV1+RV5/V6 > 38 мм
RI + SIII>25 мм
R/S< 1 в V1
A MALE PATIENT OF 48 YEARS WITH A STABLE BP RISE UP TO 160/100 MM HG DURING 3 YEARS WITHOUT ANY CLINICAL MANIFESTATIONS SHOULD BE RECOMMENDED WITH:
lifestyle change and permanent antihypertensive therapy
course intake of antihypertensive drugs
taking short-acting drugs only in crises
only lifestyle change; after 6 months - follow-up examination
THE MAXIMUM FAST REDUCTION OF BLOOD PRESSURE IS INDICATED IF THE HYPERTENSION CRISIS IS COMPLICATED WITH:
ischemic stroke
dissecting aortic aneurysm
acute coronary syndrome
heart rhythm disorder
AN ASSOCIATED CONDITION IN ARTERIAL HYPERTENSION IS:
transient ischemic attack
pulse BP > 60 mm Hg (in the elderly and senile people)
left ventricular hypertrophy
CKD with eGFR 30-60 ml/min/1.73 sq.m
ARTERIAL HYPERTENSION IN PHEOCHROMOCYTOMA IS DETERMINED BY:
excessive secretion of mineralocorticoids
increased secretion of renin
increased secretion of catecholamines
increased formation of angiotensin
ASSOCIATED CARDIOVASCULAR OR RENAL DISEASES IN ARTERIAL HYPERTENSION INCLUDE:
angina pectoris and heart failure, including heart failure with remaining ejection fraction
a history of early cardiovascular diseases
microalbuminuria and the ratio of albumin to creatinine (30-300 mg/g; 3.4-34 mg/mmol)
speed of the carotid-femoral pulse wave > 10 m/sec and the ankle-brachial index < 0.9
A PATIENT WITH BP OF 150/90 MM HG AFTER CORONARY BYPASS SURGERY HAS HYPERTENSIVE DISEASE OF THE ___ STAGE.
IV
I
II
III
A 50-YEAR-OLD WOMAN WITH ARTERIAL HYPERTENSION HAS DEVELOPED THROAT IRRITATION AND A DRY COUGH WITHIN 3 MONTHS. COUGH IS RESISTANT TO EXPECTORANT THERAPY AND ANTIBIOTICS (THE PATIENT DOES NOT SMOKE, ALLERGIC ANAMNESIS IS NOT AGGRAVATED, X-RAY OF THE THORAX REVEALS NO CHANGES). THE MOST PROBABLE CAUSE OF COUGH IS THE INTAKE OF:
ACE inhibitors
angiotensin receptor blockers
diuretics
calcium channel blockers
THE LEVEL OF BLOOD PRESSURE CHARACTERISTIC OF III DEGREE ARTERIAL HYPERTENSION IS _________ MM HG.
170/115
175/105
165/95
170/100
IN A PATIENT WITH ARTERIAL HYPERTENSION WITH A 20 MM HG DIFFERENCE OF BP ON THE LEFT AND RIGHT ARMS WE SHOULD FIRST SUSPECT:
atherosclerotic lesion of the brachial artery
Cushing's disease
Takayasu’s disease
Addison's disease
ACCORDING TO THE DATA OF SELF-MONITORING (AT HOME), THE DIAGNOSIS OF ARTERIAL HYPERTENSION IS MADE IN THE AVERAGE VALUE OF BP OF MORE THAN _____ MM HG.
135/85
130/80
140/90
150/90
THE LEVEL OF BLOOD PRESSURE CHARACTERIC OF II DEGREE ARTERIAL HYPERTENSION IS _________ MM HG.
180/95
180/90
170/100
160/110
THE ELECTROCARDIOGRAM IN ARTERIAL HYPERTENSION IS CHARACTERIZED BY:
RV5, V6> RV4
RV4> RV5, V6
S1> R1
RIII> RI
ASSOCIATED CONDITIONS IN ARTERIAL HYPERTENSION INCLUDE:
speed of the carotid-femoral pulse wave >10 m/sec, ankle-brachial index <0.9
a history of early cardiovascular diseases
microalbuminuria and the ratio of albumin to creatinine (30-300 mg/g; 3.4-34 mg/mmol)
IHD: myocardial infarction, angina pectoris, coronary revascularization
ASYMPTOMATIC TARGET LESIONS IN ARTERIAL HYPERTENSION INCLUDE:
heart failure with remaining ejection fraction
cerebrovascular disease
left ventricular hypertrophy
clinically manifested lesion of the peripheral arteries
THE LEVEL OF ARTERIAL PRESSURE CHARACTERIC OF I DEGREE ARTERIAL HYPERTENSION IS _________ MM HG.
150/100
160/100
150/95
160/95
ASSOCIATED CLINICAL CONDITIONS IN ARTERIAL HYPERTENSION INCLUDE:
aortic stenosis
dissecting aortic aneurysm
aortic insufficiency
tricuspid insufficiency
IN A 5 YEAR-OLD BOY WITH ARTERIAL HYPERTENSION AND COMPLAINS OF PAINS IN THE LOWER LEG WHEN WALKING, ONE SHOULD FIRST RULE OUT:
coarctation of the aorta
Takayasu’s syndrome
pyelonephritis
obliterating endarteritis
POSTSYNAPTIC ALPHA-1-ADRENEOREPTECTOR BLOCKERS INCLUDE:
phentolamine
moxonidine
aliskiren
doxazosin
THE CAUSE OF ARTERIAL HYPERTENSION IN A LESION OF THE KIDNEY PARENCHYMA IS:
activation of the renin-angiotensin system
excessive secretion of mineralocorticoids
increased secretion of catecholamines
increased production of angiotensin
THE CRISIS COURSE OF ARTERIAL HYPERTENSION IS CHARACTERISTIC OF:
Cohn’s syndrome
pheochromocytoma
Itsenko-Cushing’s syndrome
acromegaly
ASSOCIATED CARDIOVASCULAR OR RENAL DISEASES IN ARTERIAL HYPERTENSION INCLUDE:
a history of early cardiovascular diseases
CKD with eGFR < 30ml/min/1.73 sq.m or proteinuria > 300 mg per day
microalbuminuria and the ratio of albumin to creatinine (30-300 mg/g; 3.4-34 mg/mmol)
speed of the carotid-femoral pulse wave > 10 m/sec and the ankle-brachial index <0.9
THE ELECTROCARDIOGRAM IN ARTERIAL HYPERTENSION REVEALS:
the transition zone shift in V4-V6
the transition zone shift in V1-V2
pathological Q wave
prolongation of PQ interval
NORMAL VALUE OF TOTAL BLOOD CHOLESTEROL IN PATIENTS WITHOUT THE RISK OF CARDIOVASCULAR DISEASES IS LESS THAN _______ MMOL/L:
5
3
2
1
IIA TYPE OF HYPERLIPIDEMIA BY THE WHO CLASSIFICATION IS CHARACTERIZED BY INCREASED_______ IN THE BLOOD PLASMA:
VLDL
LDL
LDL and VLDL
LP (a)
THE DIAGNOSTIC CRITERION OF THE HETEROZYGOUS FORM OF FAMILY HYPERCHOLESTEROLEMIA IS:
low density lipoprotein cholesterol more than 8.5 mmol/l
high density lipoprotein cholesterol more than 5.0 mmol/l
xanthomatosis of the upper eyelids
severe peripheral atherosclerosis
IIB TYPE OF HYPERLIPIDEMIA BY THE WHO CLASSIFICATION IS CHARACTERIZED BY INCREASED_______ IN THE BLOOD PLASMA:
LP (a)
LDL
VLDL
LDL and VLDL
THE TARGET VALUE OF LDL FOR PATIENTS WITH TYPE II DM IN COMBINATION WITH IHD IS THE LEVEL <_____ MMOL/L:
1.8
2.0
2.5
3.0
FOR STRATIFICATION OF RISK OF CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE THEY USE:
coronary angiography, echocardiography
stress myocardial perfusion tomoscintigraphy and treadmill test (with determination of the Duke index)
stress myocardial perfusion tomoscintigraphy and stress echocardiography
treadmill test (with determination of the Duke index), echocardiography, stress echocardiography, coronary angiography
CLINICAL FORMS OF STABLE ISCHEMIC HEART DISEASE INCLUDE:
stable exertional angina and angina at rest, microvascular angina
stable exertional angina and angina at rest
stable exertional angina and angina at rest, vasospastic angina, microvascular angina
stable exertional angina, microvascular angina
A 46-YEAR-OLD FEMALE PATIENT DEVELOPS ATTACKS OF RETROSTERNAL PAIN AT NIGHT, WHEN THE ECG REGISTERS TRANSIENT ELEVATION OF ST SEGMENT. MOST PROBABLE DIAGNOSIS IS
acute coronary syndrome with ST elevation
variant angina
acute pericarditis
pulmonary embolism
THE MAIN QUESTION SOLVED DURING A STRESS TEST IS:
presence of the previous myocardial infarction
verification of coronary heart disease
probability of coronary heart disease
presence of a valvular pathology
IF A PATIENT HAS EXPERIENCED GRIPPING RETROSTERNAL PAIN AT THE SMALLEST PHYSICAL ACTIVITY WITHIN THE PAST YEAR, AND SUCH PAIN CAN BE ARRESTED WITH NITROGLYCERINE, ONE SHOULD THINK ABOUT:
progressive angina
exertional angina class III
exertional angina class IV
variant angina
INCREASING TROPONIN CONCENTRATION IN PATIENTS WITH MYOCARDIAL INFARCTION IS DETERMINED DURING:
12-24 hours
3-5 days
7-14 days
2-3 months
WHAT COMPLICATION IS POSSIBLE IN ACUTE LEFT VENTRICULAR ANEURISM?
pulmonary embolism
thrombosis of the cavity of the left ventricle
Dressler syndrome
right ventricular failure
THE MAIN CRITERION FOR SUCCESSFUL REPERFUSION AFTER SYSTEMIC THROMBOLYSIS IS:
disappearance of signs of heart failure
pain syndrome arrest
decrease in the elevation of the ST segment by 50% or more from the initial
restoration of AV conduction
IT IS POSSIBLE TO SUSPECT POSTINFARCTION ANEURYSM IN THE ECG IN CASE OF THE PRESENCE OF:
deep negative T waves
“stable” ST segment elevation
complexes of QS type in 2 or more leads
high R waves in the right thoracic leads
A LOADING DOSE OF ACETYLSALICYLIC ACID IN ACUTE MYOCARDIAL INFARCTION IS _____ MG:
250-300
500
150
75
INFERIOR MYOCARDIAL INFARCTION IS CHARACTERIZED BY APPEARANCE OF THE FOLLOWING INFARCTION CHANGES:
I, aVL
V1-V4
I, aVL, V5,V6
II, III, aVF
THE MOST COMMON COMPLICATION IN THE FIRST HOURS OF ACUTE MYOCARDIAL INFARCTION IS:
rhythm disorder
pulmonary edema
acute cardiovascular failure
cardiogenic shock
THE DRUG OF CHOICE FOR PAIN SYNDROME ARREST IN CARDIOGENIC SHOCK IS:
fentanyl
morphine
metamizole sodium
ketorolac
IN PULMONARY EDEMA IN PATIENTS WITH MYOCARDIAL INFARCTION ALL THE LISTED DRUGS ARE INDICATED, EXCEPT:
prednisolone
morphine
nitroglycerin
furosemide
AN OBJECTIVE SIGN OF MYOCARDIAL INFARCTION IS:
there is no characteristic objective sign
cyanosis
cardiomegaly
swelling of the cervical veins
INCREASED HEIGHT AND WIDTH OF THE R WAVE IN V1-V2 LEADS IN COMBINATION WITH ST SEGMENT DEPRESSION AND POSITIVE T WAVE IS A SIGN OF:
posterior myocardial infarction (posterior basal)
antero-septal myocardial infarction
right ventricular myocardial infarction
small-focal myocardial infarction
THE ACUTE PERIOD OF MYOCARDIAL INFARCTION CONTINUES FOR:
up to 10-14 days
up to 2 hours
up to 1 month
up to 2 months
MYOCARDIAL INFARCTION OF THE LATERAL WALL OF THE LV IS CHARACTERIZED BY ST SEGMENT ELEVATION IN THE FOLLOWING LEADS:
I, aVL, V1-V4
I, aVL, V5-V6
VR3, VR4
II, III, aVF
DIFFERENTIAL DIAGNOSTICS IN THE PRESENCE OF ST SEGMENT ELEVATION IN THE ECG IS CARRIED OUT BETWEEN MYOCARDIAL INFARCTION AND:
pericarditis
pneumonia
syndrome X
esophagitis
ARRESTING OF ANGINOUS ATTACK BEGINS WITH PRESCRIPTION OF:
spasmolytics
nitrates intravenously by drop infusion
sublingual nitroglycerin
narcotic analgesics
MYOCARDIAL INFARCTION OF WHICH LOCALIZATION IS MORE OFTEN COMPLICATED BY THE PAPILLARY MUSCLE RUPTURE?
posterior diaphragmatic
anterior septal
right ventricular
left ventricular apical
THE MOST PROBABLE CAUSE OF ACUTE RIGHT VENTRICULAR FAILURE AND SUDDEN APPEARANCE OF ROUGH SISTOLIC MURMUR IN A PATIENT WITH ACUTE MYOCARDIAL INFARCTION IS:
interventricular septal rupture
rupture of the free wall of the left ventricle
rupture of the papillary muscle
pulmonary embolism
IN THE DEVELOPMENT OF MYOCARDIAL INFARCTION, NORMALIZATION OF THE CONTENT OF CPK-MB IN THE BLOOD IS OBSERVED AFTER:
2-3 days
1 day
5-6 days
14 days
A COMBINATION OF SIGNS OF LEFT ATRIAL AND RIGHT VENTRICULAR HYPERTROPHY IN THE ECG CAN SIGNIFY:
mitral stenosis
atrial septal defect
pulmonary stenosis
aortic insufficiency
IN PATIENTS WITH AORTIC VALVE INSUFFICIENCY:
systolic BP does not change, and diastolic BP increases
systolic BP decreases, and diastolic BP increases
systolic BP increases, and diastolic BP decreases
systolic and diastolic BP levels do not change
A CHARACTERISTIC AUSCULATIVE SYMPTOM OF MITRAL VALVE INSUFFICIENCY IS:
mesodiastolic murmur
flapping I sound
systolic murmur at the apex
systolic murmur at the base of the heart
INTENSIFIED PULSATION OF THE CAROTID ARTERIES IS CHARACTERISTIC OF:
aortic insufficiency
aortic stenosis
tricuspid insufficiency
mitral insufficiency
“MITRALIZATION” OF THE AORTIC DEFECT IS THE NAME FOR:
compensatory hyperfunction of the left atrium while reduced contractile function of the left ventricle
combination of aortic and mitral stenosis
coexistent mitral stenosis with an existing aortic defect due to repeated rheumatic fever
combination of aortic orifice stenosis and mitral valve prolapse
A DEPRESSOR NEUROHUMORAL MECHANISM IN DEVELOPMENT OF HEART FAILURE INCLUDES ACTIVATION OF:
ADH
SAS
RAAS
cerebral and atrial natriuretic peptides
A SIGN OF LEFT VENTRICULAR HEART FAILURE IS:
hepatomegaly
edema of the legs
cardiac asthma attacks
visible pulsation of cervical veins
RIGHT VENTRICULAR HEART FAILURE IS NOT MANIFESTED BY:
swelling of the cervical veins decreasing in the upright position
congestion of blood in the venous bed of the greater circulation
positive venous pulse
acrocyanosis, edema of the feet and legs, aggravating in the evening
DIETARY RECOMMENDATION FOR PATIENTS WITH CHF:
limited sugar intake
limited fluid intake
limited protein intake
increased salt intake
LOOP DIURETICS INCLUDE:
amiloride
chlortalidone
torasemide
spironolactone
THE CRITERION FOR TERMINATION OF ANTIBACTERIAL THERAPY FOR PNEUMONIA IS:
normalization of peripheral blood parameters
a period of 8-10 days after normalization of temperature
resorption of pneumonic infiltration
a period of 3-4 days after normalization of temperature
TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN A 77-YEAR-OLD PATIENT WITH ISCHEMIC HEART DISEASE, ARTERIAL HYPERTENSION, DIABETES MELLITUS, CHRONIC KIDNEY DISEASE IS CARRIED OUT IN:
outpatient conditions
general resuscitation unit
department of cardiology
general therapeutic hospital
TREATMENT OF PNEUMONIA CAUSED BY LEGIONELLA REQUIRES:
tetracycline
penicillin
cefazolin
azithromycin
THE PRESENCE OF WHICH SIGN IS COMPULSORY FOR VERIFICATION OF THE DIAGNOSIS OF PNEUMONIA?
leukocytosis or leukopenia in the complete blood count
febrile body temperature
auscultative detection of moist fine (small bubbling) rales or crepitation
focal-infiltrative changes revealed by the X-ray examination
THE CRITERION OF SEVERE COURSE OF PNEUMONIA IS:
heart rate ≥120 per minute
heart rate ≤ 22 per minute
diastolic BP > 100 mm Hg
systolic BP < 120 mm Hg
THE INITIAL ASSESSMENT OF THE EFFECTIVENESS OF ANTIBACTERIAL THERAPY FOR COMMUNITY-ACQUIRED PNEUMONIA SHOULD BE CARRIED OUT IN _____ HOURS AFTER THE BEGINNING OF TREATMENT.
96-120
12-24
72-96
48-72
IN CASE OF LOBAR PNEUMONIA CREPITATION IS BETTER HEARD:
at all stages
at the stage of red hepatization
at the stage of gray hepatization
at the stages of effusion and resolution
FOR PNEUMONIA CAUSED BY MYCOPLASMA THEY USE:
amoxicillin
ceftriaxone
azithromycin
gentamicin
BY “ATYPICAL PNEUMONIA” THEY MEAN:
viral bronchopneumonia
pneumococcal pneumonia of the upper lobe localization
pneumonia caused by legionella, chlamydia or mycoplasma
eosinophilic infiltrate
FORMATION OF CAVITIES OF DESTRUCTION IN THE LUNGS IS MOST CHARACTERISTIC OF PNEUMONIA CAUSED BY:
enterococcus
pneumococcus
chlamydia
staphylococcus
THE RECOMMENDED DURATION OF TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IS:
7-14 days
21-30 days
14-21 days
30-35 days
THE CRITERION OF HOSPITALIZATION OF A PATIENT WITH PNEUMONIA IS:
upper lobe localization of the lesion
detected leukocytosis of more than 10*109/l
unstable hemodynamics
febrile fever for 3 days
PULMONARY COMPLICATION OF PNEUMONIA IS:
infectious-toxic shock
distress syndrome
infectious and allergic myocarditis
meningitis, meningoencephalitis
A CHARACTERISTIC PERCUSSION SOUND IN LOBAR PNEUMONIA AT THE HEIGHT OF THE DISEASE IS:
dull
box-like
tympanic
metallic
THE MAIN GOAL OF ANTI-HELICOBACTER THERAPY FOR ULCER DISEASE IS:
reduction of the frequency of relapses
decrease in the severity of pain syndrome
acceleration of ulcer cicatrization
reduction of the risk of ulcer perforation
HUNGER AND/OR “NIGHT PAINS” DEVELOPING IN 2.5–4 HOURS AFTER EATING AND DISAPPEARING AFTER NEXT FOOD INTAKE ARE MOST LIKELY THE SIGNS OF AN ULCER OF THE:
lower esophagus
lesser curvature of the stomach
fundus of the stomach
duodenum
CONTAMINATION OF THE STOMACH MUCOSA BY HELICOBACTERIAL INFECTION IS ACCOMPANIED BY:
development of antral gastritis
decreased gastrin secretion
achlorhydria
incompetence of cardia
THE CONTROL OF EFFECTIVENESS OF ERADICATION THERAPY IS CARRIED OUT IN ____ AFTER THE END OF TREATMENT:
3-4 weeks
1-2 weeks
4-6 weeks
1 year
ALKALINE PHOSPHATASE AND GAMMA-GLUTAMIN-TRANSPEPTIDASE RISE SHARPLY IN:
chronic hepatitis with phenomena of cholestasis and biliary liver cirrhosis
hemachromatosis
Wilson-Konovalov disease
opisthorchiasis
DIETARY RESTRICTIONS FOR A PATIENT WITH LIVER CIRRHOSIS AND A THREAT OF HEPATIC COMA CONCERN:
common salt
fats
carbohydrates
proteins
THE INDICATOR CHARACTERIZING THE ACTIVITY OF CHRONIC HEPATITIS IS:
cholesterol
alkaline phosphatase
albumin
ALT
TREATMENT OF AUTOIMMUNE HEPATITIS IS CARRIED OUT WITH:
categorical refusal of alcohol
antiviral therapy
corticosteroids (sometimes in combination with cytostatics)
dynamic observation
WHEN DEVELOPING SEVERE HEPATIC ENCEPHALOPATHY, PROTEIN INTAKE IS LIMITED TO _______ G/day
20-30
31-40
41-50
51-60
THE DIAGNOSIS OF CHRONIC HEPATITIS C IS MADE ON THE BASIS OF:
detection of HCV DNA
detection of HCV RNA
increased level of alkaline phosphatase
increased level of AST
THE DETERMINING EXAMINATION IN DIAGNOSTICS OF LIVER CIRRHOSIS IS:
ultrasonic examination
elastometry
X-radiography
irrigoscopy
THE FOURTH STAGE OF CHRONIC KIDNEY DISEASE (CKD 4) COMPLIES WITH GFR OF ____________ ML/MIN/1.73 m2.
45-59
15-29
30-44
60-89
THE MOST IMPORTANT CRITERION IN THE DIAGNOSTICS OF NEPHROTIC SYNDROME IS THE DETECTION OF:
daily proteinuria of more than 3.5 g
edema
serum albumin level below 30 g/l
hypercoagulation
