A 9-year-old girl was referred to a rheumatologist with complaints of low-grade fever, aching pain in the heart area, and arthralgia. Deterioration of the condition occurred within 2 weeks after a sore throat. Heart rate: 96 beats per minute, regular rhythm. Blood pressure: 90/60 mmHg. The first heart sound at the apex is weakened. Blood test results: leukocytes 9.6 * 10^9/L, ESR 25 mm/hour, elevated CRP. What type of heart failure according to pathogenesis did the patient develop?

An 11-year-old patient presents with dizziness, chest pain, and shortness of breath upon exertion. The patient experienced a rheumatic attack 5 years ago. He exhibits pale skin, weak pulse, bradycardia, and blood pressure of 120/80 mmHg. An elevated apical impulse is palpated in the VI intercostal space 2 cm lateral to the left midclavicular line. Upon auscultation of the heart, a systolic murmur is heard. What pathogenetic mechanism underlies the development of heart failure in this patient?

Patient K. has been suffering from rheumatism since childhood, for 18 years. He was admitted with complaints of recurrent episodes of suffocation, dry cough, and hemoptysis occurring twice. There is weakened vesicular breathing above the lungs, and fine moist rales in the lower parts. On the ECG: prolonged P wave in standard leads I and II. Echocardiogram shows signs of mitral valve stenosis. What pathogenetic factor underlies the changes in the patient’s lungs?

Patient K., 9 years old, was admitted with complaints of cardiac arrhythmia, palpitations, and shortness of breath. Upon auscultation of the heart, a systolic murmur is heard at the apex, and the lungs show no pathology. On the ECG: single extrasystoles. Echocardiogram shows signs of regurgitation in the left atrium. What is the cause of the patient’s heart pathology?

A 30-year-old patient has a heart defect. The condition worsened 2 weeks ago after a sore throat. Pulse: 96 per minute, irregular. Heart rate: 130 beats per minute. Blood pressure: 90/60 mm Hg. The first heart sound at the apex is weakened, followed by a diminishing systolic murmur. In the blood, leukocytes are 9.6 × 10^9/l, ESR 25 mm/hour, C-reactive protein highly elevated. The ECG shows frequent supraventricular extrasystoles. What is the leading pathogenetic factor underlying the development of arrhythmia in the patient?

Patient M., suffering from rheumatism, combined mitral disease, and atrial fibrillation, was hospitalized with complaints of shortness of breath at rest, severe edema of the lower extremities, and ascites. Heart sounds are muffled, heart rate is 96/min, with a gallop rhythm. The liver protrudes from under the edge of the costal arch by 2.5 cm. What type of arrhythmia developed in the patient with this heart pathology?

An ambulance team delivered a 35-year-old patient with blood loss, who injured the soft tissues of his thigh while working with a chainsaw. Objectively: the patient is restless, the skin is cold and clammy to the touch; Respiratory rate 26 breaths/min, heart rate - 110 beats/min. Blood pressure 80/50 mm Hg. Indicate which pathological condition of the cardiovascular system has developed in the patient?

A 57-year-old woman suffers from severe headaches, dizziness, and blurred vision. She has been ill for 8 years; her father suffers from hypertension. Pulse: 86/min, rhythmic, tense. Blood pressure: 180/100 mm Hg. The left border of the heart is 2 cm lateral to the left midclavicular line, with accentuation of the 2nd tone above the aorta. What is the leading pathogenetic mechanism underlying the development of arterial hypertension in the patient?

The patient was prescribed a drug with pronounced lipophilic properties. What mechanism of absorption is typical for this drug?

A patient was admitted to the therapeutic department, he was administered the drug by mouth, and the effect quickly developed. In which dosage form is the substance absorbed more quickly and completely when taken orally?

A 39-year-old patient with epilepsy was prescribed valproic acid as monotherapy. What pharmacokinetic indicator can be used to determine the degree of absorption of a drug when administered orally?

With the simultaneous use of antibiotics from the tetracycline group with antacids, the absorption of antibiotics is reduced. What type of incompatibility is observed in this situation?

Patient with acute rhinitis drip xylometazoline solution into his nose every 10-15 minutes. After some time, despite the continued administration of the drug, the effect of the drug stopped, swelling of the mucous membrane and difficulty in nasal breathing reappeared. What is this phenomenon called?

Patient P., 45 years old, suffers from bronchial asthma and uses salbutamol to eliminate bronchospasm. One day he experienced interruptions in his heart function and, on the advice of a pharmacist, took propranolol. Heart function returned to normal, but bronchospasm occurred, which was not eliminated by inhalation of salbutamol. What is the cause of this complication?

The doctor prescribed diclofenac sodium to a patient who has been taking carbamazepine for a long time. However, the anti-inflammatory effect of diclofenac was weaker than expected due to the pharmacokinetic interaction of these drugs. What processes could result in such drug interactions?

When analyzing meta-analysis data, it was found that very often adverse effects occur in people over 60 years of age. What is the reason for this phenomenon in this age category?

After the drug wears off, drug addicts develop severe mental, neurological and somatic disorders. What is this symptom complex called?

The woman continued her previously started antitumor treatment with methotrexate, completing it by the 8th week of pregnancy. The child was born full-term with anencephaly and esophageal atresia. What is the negative effect of the drug called?

A patient with infectious mononucleosis took prednisolone for 2 weeks. There was a remission, however, he experienced an exacerbation of chronic tonsillitis. What effect of glucocorticoids resulted in this complication?

A patient with intolerance to antibiotics is prescribed co-trimaxozole for the treatment of meningitis. A few days later, the patient developed hemolysis of red blood cells. What enzyme deficiency in the body is responsible for this side effect?

A 12-year-old child was prescribed a drug that affects hemostasis according to indications. A few days later, control blood tests revealed a progressive decrease in the platelet count. What drug could cause this effect?

A patient suffering from scleroderma was prescribed an immunosuppressant. How long did it take for him to develop anemia, thrombocytopenia, leukopenia, neutropenia, agranulocytosis, eosinophilia, nausea, vomiting, cystitis. What drug caused these side effects?

A patient with meningitis was prescribed antibacterial therapy. After some time, a general blood test revealed reticulocytopenia and granulocytopenia , and there was a slight decrease in the number of red blood cells. When prescribing which antibiotic is such a change in the blood picture most likely?

The patient is receiving treatment for pulmonary tuberculosis. After some time, his vision deteriorated and his color perception changed, associated with retrobulbar neuritis. What drug caused these changes?

After long-term treatment with an anti-tuberculosis drug, a patient developed symptoms of peripheral neuritis, accompanied ­by paresthesia, a burning sensation and pain along the nerves­. What drug did the patient take?

A 19-year-old female patient lost her hearing after antibiotic treatment. What antibiotic could lead to such consequences?

A 35-year-old patient suffering from drug addiction cannot wake up after taking the drug. On examination, breathing is shallow, bradycardia, hypotension, pupil constriction, hypothermia. Naloxone was administered and the patient regained consciousness. What drug causes these symptoms?

A 20-year-old patient was admitted to a drug treatment clinic for treatment of a painful addiction to a psychoactive drug. Objectively: low nutrition, pale skin with an earthy tint, multiple traces of intravenous injections in the forearms, myosis. Complaints about sleep disturbances, constipation, urinary retention, inappropriate behavior - periods of excitement are replaced by depression. What drug could have caused these symptoms?

A patient with epilepsy was prescribed a drug. The epilepsy attacks stopped. But skin pigmentation disorders, purpura, acne, sweating, and alopecia appeared. What drug caused these changes?

A young woman with a urinary tract infection was prescribed the drug. While taking the drug, she continued to visit the solarium. Unexpectedly, she developed a burn, which forced her to stop insolation. What drug could cause this side effect?

Patient with rheumatoid arthritis was prescribed an anti-inflammatory drug for a long term as basic therapy. After some time, the patient began to complain of bone pain (there were fractures twice), frequent colds, swelling, and slow wound healing. What drug could cause such phenomena?

To prevent rickets, the doctor recommended an oil solution of ergocalciferol for a 2-month-old child, 1 drop every other day for a month. Mom, violating the recommendations, decided to give 5 drops every day. After 2 weeks, the child developed the following symptoms: loss of appetite, sleep disturbances, capriciousness, positive Sulkovich test, an x-ray shows osteoporosis of the shinbones and tibia. What is the cause of the child’s problems?

A patient suffering from a stable form of angina is prescribed metoprolol and, if necessary, sublingual nitroglycerin not more than 0.5 mg per dose. One day he felt severe pain in the heart area and began taking the recommended dose of nitroglycerin every 10 minutes. As a result, his condition deteriorated sharply and he was hospitalized in a hospital. What happened after taking a large dose of nitroglycerin?

To eliminate an attack of bronchial asthma, a drug was administered to the patient. The bronchospasm was relieved, but tachycardia, pain in the heart area, and tremor appeared. What adrenergic agonist was prescribed to the patient?

A 56-year-old man with a history of extrasystole complains of cough for the last 5 days. X-ray examination revealed infiltration in the lower lobe on the right. Sputum analysis revealed gram-positive cocci. The patient was prescribed an antibiotic, but a few days later he developed pirouette-type arrhythmia. What antibiotic could cause this complication?

A 23-year-old woman has increased sensitivity to aspirin and, as a result, severe bronchospasm upon administration of even small doses of the drug. What mechanism leads to the development of bronchospasm?

A patient diagnosed with heart failure, stage 1 hypertension and hyperlipidemia receives furosemide, captopril and simvastatin, amlodipine, trimetazidine. For a month, as prescribed by the doctor, the patient took these medications, but he began to complain of a frequent dry cough. There were no other complaints and his physical condition was consistent with his illness. What drug causes this side effect?

After long-term use of selective β2 - adrenomimetics, an increase in the number of deaths in patients with bronchial asthma is possible. Which of the following phenomena explains this fatal side effect?

A patient suffering from coronary heart disease and bronchial asthma consulted his doctor with complaints of asthma attacks that appeared after he began taking a drug to prevent cardialgia. Prescription of what drug could provoke the occurrence of asthma attacks?

A patient with rheumatoid arthritis was prescribed diclofenac sodium. After some time, he developed signs of gastropathy. What is the mechanism of development of this complication?

A 52-year-old woman with coronary heart disease, arterial hypertension, and tachycardia developed constipation while taking cardiac medications. What drug is this side effect associated with?

A patient suffering from gastric ulcer took an antacid for a long time. Due to this, the patient began to notice nausea, abdominal pain, and loss of appetite. The examination revealed a violation of the acid-base balance (alkalosis). What drug could cause this side effect?

A 3-year-old child with bilateral community-acquired pneumonia received amoxicillin for 10 days. The positive dynamics of pneumonia were complicated by complaints of frequent loose stools, abdominal pain and blood in the stool (on the 15th day). What adverse drug reaction did the patient develop?

The patient received hospital treatment for a mycotic infection. The drug was administered intravenously. After 3 weeks, the patient’s condition improved somewhat, but an increase in the activity of liver transaminases and hyperbilirubinemia appeared in the blood. What drug could cause these complications?

The patient receives treatment with an antibacterial agent in the nephrology department of the hospital. During treatment, the following symptoms appeared: increased levels of creatinine and urea in the blood, decreased hearing, dizziness, phlebitis, thrombocytopenia, “red neck” syndrome. Which antibiotic is characterized by these side effects?

A patient with interstitial nephritis was prescribed an antibacterial agent. After 7 days of treatment, the patient's condition began to improve. But soon he began to complain of pain in the lower back and difficulty urinating. Urine analysis revealed: crystalluria, cylindruria, albuminuria and macroscopic hematuria.

A 48-year-old man who had suffered a myocardial infarction was prescribed monotherapy with an antianginal drug due to mild hypertension. He is currently complaining of erectile dysfunction. What drug caused this side effect?

A 65-year-old man with coronary heart disease and heart failure complained of slight swelling in his ankles. During treatment, he began to notice gynecomastia, erectile dysfunction, and electrolyte imbalance. What drug caused these symptoms?

Patient was prescribed doxycycline to treat an infection of the skin and subcutaneous tissue. In the antenatal clinic, after the diagnosis of pregnancy, the appointment was canceled. Why was the drug discontinued?

A 28-year-old woman is receiving treatment for essential hypertension. She suddenly became pregnant. Which group of drugs is not recommended for the patient because it can cause fetal development disorders?

A woman took an oral semisynthetic vitamin preparation for a skin disease. During this therapy, she became pregnant, which ended in delivery at term. The following anomalies were immediately noticed in the newborn: atrophy of the muscles of the right half of the face, microotia, atresia of the external auditory canal. What vitamin preparation was used in this situation?

A patient with a systemic connective tissue disease is prescribed basic therapy with anti-inflammatory drugs. After some time, he was diagnosed with hyperglycemia. What group of drugs can cause this side effect?

A 57-year-old female patient is receiving antiarrhythmic drug therapy. The rhythm disturbance was stopped, but she developed symptoms of thyroid disease. What antiarrhythmic drug is characterized by these changes?

A 24-year-old woman regularly took a hormonal contraceptive (estrogen - progestogen complex). History of autoimmune thyroiditis. Over time, she developed hypertension, skin lesions, hemolytic anemia, and an increased risk of thrombosis. Which component of the drug caused these multisystem disorders?

A 9-year-old patient was admitted to the clinic with complaints of severe headaches and vomiting. He became ill one day ago. On examination, the patient's condition is serious; he lies on his side, with his head thrown back, legs bent at the knees, and pulled up to the stomach. There is a petechial rash on the thighs and buttocks. Temperature: 38.6°There is rigidity of the neck, with positive Kernig's and Brudzinski's signs on both sides. There are no focal neurological symptoms. What pathological process is likely irritating the patient’s vomiting center?

A 52-year-old man complains of intense headache, vomiting, and periodic seizures. Focal neurological symptoms are positive. An MRI revealed a 1.5 by 2.0 cm formation in the area of the precentral gyrus of the cerebral cortex. What is the mechanism of development of the brain disease in the patient?

A 32-year-old man was admitted to the clinic two years after a spinal cord injury. Complains of spasticity of the leg muscles. On examination: lower spastic paraplegia. Moderate muscle wasting. Bilateral Babinski's sign. What pathogenetic factor underlies the formation of spasticity in the patient’s leg muscles?

A 78-year-old woman was admitted to the hospital emergency room with complaints of weakness in her left limbs and headache. On examination: blood pressure - 180/90 mmHg, tendon reflexes are animated on the right. The muscle tone on the left is increased. Positive Babinski signs on the left. What pathogenetic factor underlies the damage to neurons in the cerebral cortex and the development of neurological symptoms in the patient?

Patient S., 32 years old, came to the clinic to see an ophthalmologist with complaints of severe pain in the eye, photophobia, lacrimation, and decreased vision. According to the patient, the day before he accidentally scratched the cornea of his left eye with a branch. What is the main reason for the development of pain in the patient's left eye?

A woman with a child A., 1.5 years old, came to the clinic to see an otolaryngologist with complaints of pain and purulent discharge from the right ear. Body temperature: 38.2°On examination, hyperemia, swelling, and suppuration are noted in the auditory canal of the right ear. What pathogenetic factor causes swelling of the auditory canal in the patient's right ear?

At an appointment with a psychiatrist, patient N., 33 years old, complained of increased anxiety, sleep disturbances, and dyspepsic disorders, for which she was treated by a gastroenterologist to no avail. Over the past six months, she has lost five kilograms. What is the leading pathogenetic factor underlying this mental health disorder in the patient?

Patient M., 20 years old, was admitted to the clinic with complaints of weakness, shortness of breath during exercise, and a feeling of paresthesia in the extremities. Upon examination, it was discovered that the patient had a helminthic infestation. Blood test: hemoglobin level 100 g/l, blood smear reveals red blood cells with a diameter of 12 microns, large hypersegmented neutrophils. What type of anemia does this patient have?

A child of 3 years old has been experiencing extensive hematomas and nosebleeds since early childhood after traumas. Admitted to the hospital with complaints of pain in the right knee joint after falling onto asphalt. The joint is enlarged, sharply painful, and the range of motion is significantly limited. What is the mechanism of hemostasis disorder in the child?

Patient I, 36 years old, has been suffering from inflammation of the mucous membranes of the maxillary sinuses for over a year. Over the past two weeks, the general condition has worsened: body temperature has fluctuated between 37.5°C and 38.5°C, headaches have intensified, and nasal breathing has become difficult. The mucous membrane of the nasal passages is markedly hyperemic and swollen. Blood analysis shows neutrophilic leukocytosis and an increase in ESR. What is the development of nasal passage edema in the patient due to?

During an eye examination by an ophthalmologist, a patient's eye revealed a pronounced inflammatory reaction: redness of the conjunctiva, dilation and hyperemia of the mucosal capillaries, swelling. The patient's visual function is impaired, with decreased vision and the presence of 'veils before the eyes'. What contributes to the process of exudation in the patient?

Patient M., 36 years old, complains of pain when swallowing, weakness, sweating, and headache. Body temperature is 38.8°The palatal mucosa is hyperemic, swollen, and covered with a grayish coating. White blood cell count is 15*10^9/L, leukocyte formula: Basophils-0, Eosinophils-2, Young neutrophils-4, Band neutrophils-10, Segmented neutrophils-68, Monocytes-2, ESR -20 mm/hour. Pulse 98/min, Respiratory rate 26/min. What is the cause of the development of arterial hyperemia in the inflamed tissue?

Patient R., 37 years old, suffering from Crohn's disease (a chronic nonspecific inflammatory bowel disease) for 3 years, complains of pain along the course of the large intestine, general weakness, stool with mucus, weight loss, and a body temperature increase to 37.2°Complete blood count: erythrocytes - 4.0×10^12/L, Hemoglobin - 120 g/L, Hematocrit - 0.85, leukocytes - 10.8 ×10^9/L, ESR - 29 mm/hour. What is the cause of the pain along the course of the large intestine?

Child N., 4 years old, has been suffering from atopic dermatitis since the age of 3 months. A year ago, the child started attending a preschool institution, which exacerbated the rashes and skin itching. Upon objective examination, a rash of vesiculopapular nature, hyperemia, and excoriations are detected on the skin of the shins, back, and wrists. What is the cause of the development of arterial hyperemia in inflammation?

Patient K., 65 years old, visited the outpatient clinic complaining of pain and morning stiffness in the symmetrical joints of the hands. From the medical history, it is known that the patient has been suffering from rheumatoid arthritis for 7 years. Upon examination, swelling and local increase in temperature in the area of the wrist joints are detected. What is the pathogenetic factor of local temperature elevation in the inflammatory reaction?