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Worksheetspathphysio 1 61-75
Total questions: 15
Worksheet time: 8mins
Patient A., 17 years old, has increased blood pressure since childhood, the level of which is currently 200/120 mm Hg. Art. There is no influence of psychoemotional factors. It is not possible to normalize blood pressure with antihypertensive drugs. To the left and right of the navel, a systolic murmur is heard. General urine analysis without pathology. What is the most probable mechanism of arterial hypertension formation?
activation of renin-angiotensin-aldosterone system
reduction of renal parenchyma
decrease in the production of depressants in the kidneys
increased secretion of renal kinins
reduction of sodium reabsorption in the kidneys
A 42-year-old woman suffers from sudden onset and sudden end of severe headaches with a sharp rise in BP (up to 280-300 mm Hg), sweating, anxiety, a feeling of fear, palpitations, nausea, vomiting, abdominal pain. Examination revealed a right adrenal tumor. What are the mechanisms of arterial hypertension formation in this pathology?
increase in systemic vascular resistance and cardiac output
increased systemic vascular resistance and decreased cardiac output
decrease in systemic vascular resistance and cardiac output
increase in systemic vascular resistance
decreased cardiac output
A man, 55 years old, has been observed for 20 years for chronic glomerulonephritis, notes an increase in blood pressure up to 190/130 mm Hg. What is the form of arterial hypertension in the patient?
secondary vasorenal
secondary renoprivative
endocrine
essential
neurogenic reflex
Stress->increase in corticosteroid->increase in the synthesis of ? and angiotensinogen-> increase in the formation of angiotensin II ->vasospasm->increase in TPVR->hypertension. The missing link in the pathogenesis of hypertension.
increase water reabsorption in the kidneys
increased sensitivity to catecholamines vascular myocytes
increase in the synthesis of angiotensin converting enzyme
an increase in total peripheral vascular resistance
increased secretion of aldosterone
A man, 39 years old, 12 years ago was exposed to chronic glomerulonephritis. He notes swelling of the face, legs and an increase in blood pressure up to 200/140 mm Hg. Art. In the general analysis of urine - proteinuria and microhematuria. What is the mechanism of arterial hypertension formation?
activation of the renin-angiotensin-aldosterone system
decrease in the secretion of erythropoietin
increased reabsorption of water in the kidneys
decrease in the secretion of renal kinins, prostaglandins
increased sodium reabsorption in the kidneys
A 55-year-old man, resident of the big city, a taxi driver, complains of headaches, dizziness, nausea. Has been a smoker for about 20 years. During the last year, an increase in blood pressure of 160/90 mm Hg was repeatedly observed. What is the form of arterial hypertension in the patient?
endocrine
renal
essential
neurogenic reflex
hemodynamic
Stress-> ? ->increase in the synthesis of angiotensin converting enzyme and angiotensinogen-> increase in the formation of angiotensin II ->vasospasm->increase in TPVR->hypertension. The missing link in the pathogenesis of hypertension.
increase water reabsorption in the kidneys
increased sensitivity to catecholamines vascular myocytes
increase in corticosteroid
an increase in total peripheral vascular resistance
increased secretion of aldosterone
Patient P., 36 years old, has a constant increase in blood pressure to 180/110 mmHg, detected accidentally 7-8 years ago. In the general analysis of urine (proteinuria, hematuria). At the age of 12, after suffering from angina, swelling of the face and shins was noted, changes in urine were detected. What is the form of arterial hypertension in the patient?
secondary vasorenal
secondary renoprivative
endocrine
essential
neurogenic reflex
Patient B., 30 years old, suffers from congenital heart disease. She notes dyspnea on physical exertion. Objectively, the heart borders are dilated to the left and downward. On auscultation, a systolic murmur is heard on the sternum, which spreads throughout the chest. Palpation reveals a 'cat's purr' symptom. The second tone on the aorta is attenuated. BP 110/85 mm Hg, pulse 60 per min. What underlies the pathogenesis of heart failure in this defect?
resistance overload
volume overload
increase in total peripheral vascular resistance
primary damage to cardiomyocytes
hypervolemia
Patient K., 38 years old, during a medical examination revealed shortness of breath during exercise. From the anamnesis it was established that she suffers from congenital heart disease. Objectively: the borders of the heart are expanded to the left and downward. On auscultation, a systolic murmur is heard on the sternum, which spreads throughout the chest. Palpation reveals a symptom of 'cat's purr'. The second tone on the aorta is weakened. BP 110/85 mm Hg. Art., pulse 60 per min. What is the stage of pathological hyperfunction and myocardial hypertrophy in the patient according to F.Z. Meerson?
emergency with an increase in energy production
activation of the genetic apparatus of cardiomyocytes
hyperfunction of non-hypertrophied cardiomyocytes
completed hypertrophy and relatively stable hyperfunction
progressive cardiosclerosis and depletion of myocardial function
A 56-year-old woman complains of severe pain behind the sternum, which appeared during physical activity during the day and was treated with nitroglycerin. In the evening the pains resumed and became more severe. Dyspnea and cough with abundant liquid sputum appeared. Objectively: skin and visible mucous membranes were pale with cyanotic tint. On auscultation, over the entire surface of the right and left lungs, damp multifaceted rales were heard. BP is 90/60 mmHg. What form of heart failure does the patient have according to pathogenesis?
overload resistance
coronary myocardial
non-coronary myocardial
overload by volume
pericardial disorder
Patient R, 56 years old, complains of dyspnea on slight physical exertion, episodes of dyspnea at night. Objectively: skin with cyanotic hue, over the entire surface of the right and left lungs there were humid multifaceted rales. There were pronounced edemas on the legs. Arterial pressure 100/70 mm Hg. The following plays an important role in the development of edema.
increased oncotic pressure
increase in hydrostatic pressure
decrease in hydrostatic pressure
decrease in total peripheral vascular resistance
increase in minute blood volume
Patient T., 54 years old, suffering from arterial hypertension, went to the clinic with complaints of intermittent shortness of breath with difficulty and unsatisfied inhalation, especially pronounced during physical exertion. A few days ago, he had an attack of severe inspiratory dyspnea ('suffocation') at night with the fear of death. On this occasion, an ambulance was called, the doctor diagnosed 'cardiac asthma'. During the examination of the patient in the clinic, it was found: blood pressure 180/130 mmHg, during X-ray examination - dilation of the left ventricle. What is the form of heart failure according to the pathogenesis of the patient?
reloading (post-loading)
coronarogenic myocardial
non-coronary myocardial
reloading (preloading)
pericardial
A 49-year-old woman was admitted to the therapeutic department with complaints of severe pain in the region of the heart, which did not subside from taking nitroglycerin. A blood test revealed neutrophilic leukocytosis, increased activity of AST and CPK-MB, increased troponins T and I. On the ECG: sinus rhythm, deepened Q wave and ST segment elevation in the first lead with a mirror image in lead III. As evidenced by the increased activity of AST and CPK-MB, troponins T and I.
respiratory acidosis
activation of endonucleases
mitochondrial dysfunction
violation of the integrity of cardiomyocyte membranes
reduction of membrane potential
A woman, 46 years old, irritable, a lower-level manager, often conflicts with staff. Over the past 6 years, there has been an increase in blood pressure. She was taken to the emergency department of the hospital with complaints of headache, anxiety, trembling throughout the body, stabbing pain in the heart, palpitations, interruptions, blood pressure 180/110 mmHg. After the introduction of a tranquilizer and a beta-blocker, blood pressure normalized and well-being improved. What is the mechanism of arterial hypertension formation?
1.reduction of angiotensin and aldosterone production
2.increase of thyroid-stimulating hormone
3.activation of vascular RAAS and SAS against the background of endothelial dysfunction
4.reduction of total peripheral vascular resistance and cardiac output
5.increased total peripheral vascular resistance and decreased cardiac output
