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96 physio

Total questions: 118

Worksheet time: 59mins

Name
Class
Date
1.

Through the nerve conductors, the nervous system receives

a)

influenza A virus

b)

streptococcal exotoxin

c)

herpes viruses

d)

pneumococci

e)

adenovirus

2.

The consequence of disinhibition syndrome can be

a)

development of dystrophic changes in neurons and innervated structures

b)

development of organ atrophy

c)

development of deafferentation syndrome

d)

development of denervation syndrome

e)

formation of the GPUK (pathologically enhanced excitation generator)

3.

The importance of the formation of the GPUV

a)

promotes the formation of diffuse inhibition

b)

promotes the formation of a pathological system

c)

promotes the formation of the physiological system

d)

increases the trophic effect of the neuron on the innervated structures

e)

inhibits the development of neuropathological processes

4.

Involuntary, slow, “worm-like” movements localized in the upper limbs, especially in the fingers, are designated by the term

a)

convulsions

b)

athetosis

c)

ticks

d)

chorea

e)

tremor

5.

The most common cause of hemorrhagic stroke is

a)

arterial hypertension

b)

stenotic atherosclerosis of cerebral vessels

c)

thrombosis and embolism of cerebral vessels

d)

angiospasm of cerebral vessels

e)

increased hematocrit

6.

The main causes of meningitis in newborns are

a)

Neisseria meningitidis

b)

pneumococci (Streptococcus pneumoniae)

c)

Haemophilis influenzae

d)

staphylococci, pseudomonas aeruginosa, mycobacterium tuberculosis

e)

Ischerichia coli, beta-hemolytic streptococcus

7.

The cause of meningitis in adults is mainly

a)

Neisseria meningitidis

b)

pneumococci (Streptococcus pneumoniae)

c)

Haemophilis influenzae

d)

staphylococci, pseudomonas aeruginosa, mycobacterium tuberculosis

e)

Ischerichia coli, beta-hemolytic streptococcus

8.

A neurological examination of a 30-year-old man revealed a decrease in the strength and amplitude of voluntary movements of the left arm and left leg. What term is used to describe this condition?

a)

tetraplegia

b)

paraparesis

c)

hemiparesis

d)

paraplegia

e)

atony

9.

A neurological examination of a 35-year-old woman revealed a complete lack of voluntary movements due to a disruption of the innervation of the corresponding muscles. What term is used to describe this condition?

a)

paralysis

b)

athetosis

c)

paresis

d)

chorea

e)

akinesia

10.

Central paralysis is described

a)

preservation of voluntary movements

b)

weakening of contractile reflexes

c)

increased contractile reflexes

d)

absence of pathological reflexes

e)

decreased muscle tone

11.

Peripheral paralysis occurs when

a)

partial damage to the trunk of the peripheral nerve (sensory fibers)

b)

lesion of neurons of the anterior horns of the spinal cord

c)

lesion of neurons of the posterior horns of the spinal cord

d)

lesion of the first neuron of the pyramidal tract

e)

lesions of the basal ganglia of the extrapyramidal system

12.

Central paralysis occurs when

a)

partial damage to the trunk of the peripheral nerve (sensory fibers)

b)

lesion of neurons of the anterior horns of the spinal cord

c)

lesion of neurons of the posterior horns of the spinal cord

d)

lesion of the first neuron of the pyramidal tract

e)

in case of damage to the basal ganglia of the extrapyramidal system

13.

Brown-Sequard syndrome occurs when

a)

damage to the anterior horns of the spinal cord

b)

complete transverse spinal cord injury

c)

half lateral spinal cord injury

d)

damage to the midbrain

e)

damage to the pituitary gland

14.

Causalgia develops when

a)

amputations of limbs

b)

complete transection of nerve trunks

c)

incomplete transection of nerve trunks

d)

decreased excitability of the cerebral cortex

e)

increased excitability of the cerebral cortex

15.

A 73-year-old woman presented with muscle weakness and paresthesia in her arms and legs. Neurological examination revealed weakness of the flexors and extensors of the lower extremities, increased knee reflexes, and decreased vibration sensitivity. The patient most likely has a vitamin deficiency.

a)

RR

b)

D

c)

B12

d)

C

e)

A

16.

In a 60-year-old man, in the early period after an acute cerebrovascular accident, the severity of neurological symptoms continued to increase, despite the restoration of blood flow in the damaged cerebral vessel. The cause of the worsening of neurological symptoms in the patient is

a)

decrease in neuronal osmolarity

b)

shrinkage of neurons

c)

neuronal reperfusion

d)

calcium release from neurons

e)

inhibition of glutamate receptors

17.

A 28-year-old man has clonic seizures, twitching of the neck, face and trunk muscles with a short period of apnea, and foamy saliva coming out of the mouth. After the seizure, which lasts 2 minutes, the muscles relax. This typical form of pathology is based on

a)

decreased neuronal excitability

b)

suppression of neuronal discharge generation

c)

destruction of dopamine neurons in the area blue spot

d)

increased neural activity with hypersynchronous discharges

e)

predominance of cholinergic system activity in the striatum

18.

A young man of 18 years old was admitted to the clinic with complaints of headache, vomiting that did not bring relief, and elevated body temperature. Examination revealed rigidity of the occipital muscles. The patient is in a characteristic pose: head thrown back, back arched, stomach drawn in, legs bent and brought to the stomach. In the pathogenesis of this disease, of great importance is

a)

intracranial hypertension

b)

hypohydration of neurons

c)

narrowing of cerebrospinal fluid spaces

d)

reduction in the formation of cerebrospinal fluid

e)

decrease in the permeability of the blood-brain barrier

19.

A 60-year-old man, 10 years after being diagnosed with Syphilis, was found to have decreased tendon reflexes, a feeling of numbness and crawling "ants", and a tingling sensation. What typical form of neurogenic sensitivity disorders is observed in the patient?

a)

athetosis

b)

myasthenia

c)

paresthesia

d)

allodynia

e)

hyperpathy

20.

A 40-year-old man has been diagnosed with damage to the motor neurons of the lumbar spine. What will a neurological examination of the lower extremities reveal?

a)

increased spinal reflexes

b)

appearance of pathological reflexes

c)

muscle hypertrophy

d)

muscle hypotonia

e)

muscle hypertonicity

21.

A 40-year-old man has been diagnosed with damage to the motor neurons of the cervical spine. What will a neurological examination of the lower extremities reveal?

a)

preservation of voluntary movements

b)

weakening of tendon reflexes

c)

increased tendon reflexes

d)

absence of pathological reflexes

e)

decreased muscle tone

22.

A 17-year-old boy developed pain in the big toe of his right foot after surgical amputation of the same foot. What is the mechanism of pain?

a)

ectopic impulses from neuromas in the severed nerve of the stump causing central sensitization

b)

decreased nociceptor density in the stump reducing afferent input

c)

ischemia of the amputated limb tissues

d)

inflammation of the toe joint

e)

activation of vestibular pathways

23.

The reduction in pain sensitivity during massage is due to

a)

decreased sensitivity of nociceptors

b)

blockade of nerve conductors

c)

decreased excitability of neurons in the reticular formation

d)

suppression of excitability of thalamic neurons

e)

activation of inhibitory neurons of the gelatinous substance of the spinal cord

24.

A 25-year-old woman developed double vision and respiratory muscle dysfunction. Botulism was diagnosed. What is the most likely mechanism for the muscle dysfunction?

a)

inhibition of glycine secretion into the synaptic cleft

b)

inhibition of acetylcholine secretion into the synaptic cleft

c)

inhibition of norepinephrine secretion into the synaptic cleft

d)

blocking of glycine-sensitive receptors on the postsynaptic membrane

e)

blocking of acetylcholine-sensitive receptors on the postsynaptic membrane

25.

An 18-year-old young man was admitted to the clinic complaining of headache, vomiting that did not bring relief, and elevated body temperature. Examination revealed rigidity of the occipital muscles. The patient is in a characteristic pose: head thrown back, back arched, stomach pulled in, legs bent and brought to the stomach. The pathogenesis of headache in this disease is due to

a)

irritation of the endings of the trigeminal nerve that innervate the membranes of the brain

b)

irritation of the vagus nerve receptors located at the bottom of the fourth ventricle

c)

irritation of the vomiting center in the reticular formation of the medulla oblongata

d)

irritation of the posterior roots and cells of the spinal ganglia

e)

reflex tonic contraction of muscles

26.

A young man of 18 years old was admitted to the clinic with complaints of headache, vomiting that did not bring relief, and elevated body temperature. Examination revealed rigidity of the occipital muscles. The patient is in a characteristic pose: head thrown back, back arched, stomach drawn in, legs bent and brought to the stomach. The pathogenesis of the characteristic posture in this disease is due to

a)

irritation of the endings of the trigeminal nerve

b)

increased tone of parasympathetic and sympathetic fibers

c)

irritation of the vagus nerve receptors located at the bottom of the fourth ventricle

d)

irritation of the posterior roots and cells of the spinal ganglia

e)

reflex tonic contraction of muscles, rigidity of the occipital muscles

27.

Cerebellar ataxia, memory disorders for current events, nystagmus, dysarthria, dysphagia, hiccups, dizziness are characteristic of cerebrovascular accidents due to damage to

a)

vertebral artery

b)

anterior cerebral artery

c)

middle cerebral artery

d)

internal carotid artery

e)

pial arteries

28.

Paresis or spastic paralysis of the limbs (proximal arm and distal leg), loss of sensitivity on the side opposite the lesion, most likely observed with damage to

a)

vertebral artery

b)

anterior cerebral artery

c)

middle cerebral artery

d)

posterior cerebral artery

e)

pial arteries

29.

A 64-year-old man was diagnosed with ischemic stroke, revealed: decreased sensitivity and paresis of the muscles of the left leg, positive Babinsky reflex on the left. Which artery embolism caused these changes?

a)

left vertebral artery

b)

left anterior cerebral artery

c)

left middle cerebral artery

d)

right posterior cerebral artery

e)

right anterior cerebral artery

30.

A 50-year-old man with a history of atrial fibrillation suddenly felt weakness in the muscles of the left half of his body and lost his sight. The symptoms persisted for several weeks. Most likely the patient

a)

brain tumor

b)

hematoma

c)

stroke due to cerebral embolism

d)

stroke due to rupture of blood vessels in the brain

e)

transient ischemic attack

31.

During the examination of a 65-year-old homeless man, the following was revealed: multiple cuts on the feet and a bilateral decrease in pain and temperature sensitivity of the stocking and glove type, a pronounced smell of alcohol from the mouth. Most likely, the man

a)

polyneuritis

b)

syringomyelia

c)

amyotrophic lateral sclerosis

d)

stroke

e)

parkinsonism

32.

During examination of a 35-year-old woman, the following was revealed: paresis of the right arm, reflexes on the right arm are reduced. Reflexes of the right leg are increased and the Babinski reflex is determined. Reflexes of the left half of the body are normal. What brain structures are damaged?

a)

peripheral nerves

b)

anterior roots of the spinal cord

c)

spinal cord

d)

brain stem

e)

alpha motor neurons

33.

An 18-year-old boy was diagnosed with pharyngitis. A few days later, he developed a severe headache and a fever of 38.8°C. Revealed: stiff neck, positive Kernig and Brudzinski reflexes. Cerebrospinal fluid analysis: high protein, low glucose, high neutrophil count. What causes this disease?

a)

Neisseria meningitidis

b)

Cryptococcus neoformans

c)

Mycobacterium tuberculosis

d)

Toxoplasma gondii

e)

Poliovirus

34.

A 26-year-old female student presented with a history of increasing weakness and headaches over several weeks. Neurological examination revealed no significant changes. Cerebrospinal fluid analysis: colorless fluid with a slight increase in protein, normal glucose content, lymphocytes present, no neutrophils. Antibodies to which pathogens would a serological examination most likely reveal?

a)

Toxoplasma gondii

b)

Listeria monocytogenes

c)

Cryptococcus neoformans

d)

Neisseria meningitidis

e)

Echovirus

35.

A 15-year-old boy was admitted to the clinic with complaints of headache, fever, muscle weakness. Muscle hypotonia and hyporeflexia were detected. The diagnosis was poliomyelitis. What is the basis for the damaging effects of the polio virus?

a)

demyelination of axons of motor neurons of the anterior horns of the spinal cord

b)

demyelination of axons of cortical motor neurons

c)

myocyte damage

d)

damage to neuromuscular synapses

e)

destruction of motor neurons of the anterior horns of the spinal cord

36.

After a stroke, a 67-year-old man developed episodes of severe, difficult to bear polytopic pain, combined with vegetative and motor disorders. Most likely, the pathogenesis of these pains is due to

a)

suppression of brainstem excitability

b)

formation of the GPUV in the thalamus

c)

increased conductivity of nerve trunks

d)

decreased excitability of the cerebral cortex

e)

formation of the GPUC in the spinal cord

37.

The correct statement is

a)

hemorrhagic stroke is most often the result of arterial hypertension

b)

the cause of cerebral embolism is deep vein thrombosis of the lower extremities

c)

the most common route of infection to the central nervous system is through nerve conductors

d)

causalgia is a decrease in pain sensitivity

e)

pain mediator – GABA

38.

A 50-year-old patient consulted a doctor complaining of limited voluntary movement in his left arm and leg. A year ago, he suffered a cerebral hemorrhage. During examination, the left arm was sharply bent and brought to the body, the left leg was sharply straightened. Muscle tone and periosteal reflexes of the indicated extremities were increased. There were pathological tendon reflexes. Are these disorders based on damage?

a)

corticospinal pyramidal tract, disinhibition of α-motor neurons of the spinal cord

b)

corticospinal pyramidal tract, disinhibition of spinal cord gamma motor neurons

c)

corticospinal pyramidal tract, destruction of alpha-motor neurons of the spinal cord

d)

corticospinal pyramidal tract, destruction of gamma motor neurons of the spinal cord

e)

precentral gyrus

39.

A 50-year-old patient consulted a doctor complaining that after an injury to the back of the right thigh, active movements in this limb became sharply limited, and atrophy of the calf muscles appeared. During the examination, along with muscle atrophy, a lack of reflex from the Achilles tendon was noted. Name the form of nervous system dysfunction

a)

peripheral paresis of the right lower limb

b)

peripheral paralysis of the right lower limb

c)

central paresis of the right lower limb

d)

central paralysis of the right lower limb

e)

amyotrophic lateral sclerosis

40.

After a cerebrovascular accident, the patient developed spastic contraction of the muscles of the right arm and right leg. Muscle tone in these limbs is increased. Voluntary movements of these limbs are impossible, tendon and periosteal reflexes are increased. Muscle atrophy is not observed. Determine the form of akinesia in this patient

a)

right-sided hemiplegia, central paralysis

b)

right-sided hemiparesis

c)

right-sided hemiplegia, peripheral paralysis

d)

Parkinson's disease

e)

parkinsonism

41.

The reason for the heart being overloaded with blood volume is

a)

coarctation of the aorta

b)

arterial hypertension

c)

arterial hypotension

d)

valvular stenosis

e)

heart valve insufficiency

42.

The reason for the overload of the heart by resistance is

a)

aortic valve insufficiency

b)

hypervolemia

c)

arterial hypertension

d)

physical activity

e)

overhydration

43.

The cause of absolute coronary insufficiency is

a)

atherothrombosis of coronary arteries

b)

paroxysmal tachycardia

c)

hypercatecholaminemia

d)

metabolic disorders in the myocardium

e)

activation of b-adrenergic receptors of coronary vessels

44.

The cause of relative coronary insufficiency is

a)

stenotic coronary sclerosis

b)

paroxysmal tachycardia

c)

coronary artery spasm

d)

metabolic disorders in the myocardium

e)

coronary artery thromboembolism

45.

Prevents the restoration of microcirculation after myocardial reperfusion

a)

formation of active oxygen species

b)

negative charge of endothelial cells

c)

increased collateral blood flow

d)

accumulation of adenosine at the site of ischemia

46.

In pathogenesis secondary arterial hypertension is important

a)

persistent increase in excitability of sympathetic nerve centers

b)

chronic excitation of emotional centers

c)

reduction of the inhibitory effect of the cerebral cortex on the vasomotor center

d)

hereditary defect of membrane ion pumps of vascular myocytes

e)

excessive production of aldosterone

47.

A genetic defect in the cell membranes of vascular myocytes leads to hypertension due to

a)

increase in calcium content in the cytoplasm of vascular smooth muscle cells

b)

increase in the electrical potential of the cell membrane

c)

increasing the rate of reuptake of mediators by nerve endings

d)

suppression of ATPase activity of myosin

e)

reducing the time of action of mediators on the vascular wall

48.

In the pathogenesis of renovascular renal hypertension is important

a)

activation of the renin-angiotensin-aldosterone system

b)

reduction of renal parenchyma

c)

reduction in the production of depressant substances in the kidneys

d)

increased secretion of renal kinins

e)

decreased sodium reabsorption in the kidneys

49.

In the pathogenesis of renoparenchymatous arterial hypertension is important

a)

activation of the renin-angiotensin-aldosterone system

b)

decreased secretion of erythropoietin

c)

increased reabsorption of water in the kidneys

d)

decrease in secretion of renal kinins, prostaglandins

e)

increased sodium reabsorption in the kidneys

50.

Pathogenetic treatment of arterial hypertension includes the appointment of

a)

painkillers

b)

cardioprotectors

c)

ACE inhibitors

d)

antibacterial

e)

bronchodilators

51.

The clinical sign of right ventricular failure is

a)

hemoptysis

b)

pulmonary hypertension

c)

expiratory dyspnea

d)

ascites

e)

pulmonary edema

52.

Right ventricular failure is characterized by

a)

pulmonary edema

b)

hepatomegaly

c)

hemoptysis

d)

cardiac asthma

e)

hypertension of the pulmonary circulation

53.

A manifestation of left ventricular heart failure is

a)

venous congestion of blood in the systemic circulation

b)

swelling of the jugular veins

c)

pulmonary edema

d)

ascites

e)

hepatomegaly

54.

The emergency stage of cardiac hyperfunction is characterized by

a)

cardiomyocyte hypertrophy

b)

proliferation of connective tissue

c)

myogenic dilation

d)

hyperfunction of non-hypertrophic myocardium

e)

normalization of oxygen consumption, energy production, protein biosynthesis per unit of myocardial mass

55.

The cause of the myocardial form of heart failure is

a)

streptococcal infection

b)

hypertension

c)

hypervolemia

d)

stenosis of the heart valves

e)

tricuspid valve insufficiency

56.

The cause of myocardial insufficiency of non-coronary origin is

a)

coronary thrombosis

b)

hypercatecholaminemia

c)

coronary atherosclerosis

d)

tricuspid valve insufficiency

e)

primary metabolic disorder in the heart muscle

57.

The compensation stage of heart failure is characterized by

a)

tonogenic dilatation

b)

shortness of breath at rest

c)

decrease in stroke volume

d)

increase in residual blood volume in the heart cavities

e)

myogenic dilatation

58.

The method of pathogenetic therapy for ventricular fibrillation is

a)

defibrillation of the heart

b)

prescription of cardiac glycosides

c)

use of antihypertensive drugs

d)

use of sedatives

e)

prescription of central analeptics

59.

The leading link in the pathogenesis of decreased blood pressure in cardiogenic shock

a)

decreased contractility of the myocardium

b)

decreased tone of resistive vessels

c)

pathological deposition of blood

d)

hypoxia and metabolic acidosis

e)

pathological vasoconstriction

60.

The cause of right ventricular failure is

a)

arterial hypertension of the large circle of blood circulation

b)

non-closure of the interventricular septum

c)

infarction of the anterior wall of the left ventricle of the heart

d)

mitral valve insufficiency

e)

myocarditis

61.

Congenital heart defect accompanied by severe cyanosis

a)

narrowing of the pulmonary artery orifice

b)

low ventricular septal defect

c)

patent ductus arteriosus

d)

tetralogy of Fallot

e)

aortic coarctation

62.

Leads to right ventricular failure

a)

arterial hypertension of the large circle of blood circulation

b)

pneumosclerosis

c)

infarction of the anterior wall of the left ventricle of the heart

d)

mitral valve insufficiency

e)

myocarditis

63.

Specific markers for myocardial infarction are

a)

myoglobin

b)

troponins TnT and TnI

c)

ALT, AST

d)

LDH-1/LDH-2 ratio

e)

alkaline phosphatase

64.

In the pathogenesis of an increase in blood deoxyhemoglobin in heart failure, it is important

a)

acceleration of blood flow

b)

increased oxygenation of blood in the lungs

c)

increased oxygen utilization by tissues

d)

increase in oxygen capacity of blood

e)

decreased oxygen utilization by tissues

65.

In the pathogenesis of sinus bradycardia is important

a)

slowing of spontaneous diastolic depolarization of the sinus node

b)

increased sympathoadrenal effects on the heart

c)

the appearance of fault currents

66.

In the pathogenesis of sinus (respiratory) arrhythmia is important.

a)

Formation of an ectopic impulse focus

b)

Fluctuations in vagal tone

c)

Impaired conduction of excitation from the atria to the ventricles

d)

Re-entry mechanism

e)

Decrease in the threshold potential of pacemaker cells

67.

The overload form of heart failure occurs when.

a)

Myocardial infarction

b)

Myocarditis

c)

Heart valve insufficiency

d)

Atherosclerosis of the coronary arteries

e)

Coronary artery thromboembolism

68.

The consequence of the mechanism of re-entry of the excitation wave is.

a)

Atrial fibrillation

b)

Sinus bradycardia

c)

Sinus tachycardia

d)

Atrioventricular block

e)

Sinus arrhythmia

69.

Characterize complete transverse heart block.

a)

Tachycardia attacks

b)

Asynchronous contractions of the atria and ventricles

c)

Alternating periods of increased and decreased heart rate

d)

"Interruptions" in the heart

e)

Nomotopic heart rhythms

70.

Manifestation of left ventricular failure.

a)

Venous congestion of blood in the systemic circulation

b)

Cardiac asthma

c)

Swelling of the jugular veins

d)

Ascites

e)

Splenomegaly

71.

After the drug was prescribed, the patient's blood pressure increased and the total peripheral resistance to blood flow decreased. The drug caused.

a)

Vasoconstriction and decrease in cardiac output

b)

Vasodilation and increase in cardiac output

c)

Vasoconstriction and increase in cardiac output

d)

Vasodilation and decrease in cardiac output

e)

Vasoconstriction and cardiac output did not change

72.

Stress → increased corticosteroids → increased synthesis of angiotensinogen and angiotensin-converting enzyme → ? → vasospasm → increased total peripheral vascular resistance → arterial hypertension. The missing link in the pathogenesis of arterial hypertension.

a)

Increased water reabsorption in the kidneys

b)

Increased sensitivity of vascular myocytes to catecholamines

c)

Increased formation of angiotensin II

d)

Decrease in total peripheral vascular resistance

e)

Disorder of aldosterone secretion

73.

A common feature of chronic renal failure, pheochromocytoma, Conn's syndrome, coarctation of the aorta and acromegaly is.

a)

Arterial hypotension

b)

Systemic vasculitis

c)

Venous thrombosis

d)

Arterial hypertension

e)

Obliterating endarteritis

74.

Patient B., 56 years old, complains of dyspnea at rest, swelling of the legs, and attacks of suffocation at night. Objectively: the liver is significantly enlarged. Free fluid is detected in the abdominal cavity. The left border of the heart is displaced by 2.5 cm from the midclavicular line to the left, and the right border is displaced by 2.5 cm to the right from the right edge of the sternum. What form of heart failure does the patient have?

a)

Myocarditis

b)

Angina pectoris

c)

Myocardial infarction

d)

Acute heart failure

e)

Chronic heart failure

75.

Patient K., 66 years old, complains of shortness of breath at rest, swelling of the legs. Objectively: The liver is significantly enlarged. Free fluid is detected in the abdominal cavity. What form of heart failure by localization does the patient have?

a)

Overload

b)

Myocardial

c)

Left ventricular

d)

Right ventricular

e)

Chronic

76.

Patient I., 52 years old, was admitted to the therapeutic department complaining of severe pain in the heart area that did not subside after taking nitroglycerin. Blood tests revealed neutrophilic leukocytosis, increased AST and CPK-MB activity, increased troponins T and I. ECG: sinus rhythm, deepened Q wave and ST segment elevation in lead I with a mirror image in lead III. What form of heart failure does the patient have?

a)

Myocarditis

b)

Angina pectoris

c)

Myocardial infarction

d)

Idiopathic cardiomyopathy

e)

Chronic heart failure

77.

A female student, attending a surgical operation for the first time, suddenly experienced a feeling of "faintness", which was accompanied by tinnitus, dizziness, nausea and led to loss of consciousness. Objectively: the skin and mucous membranes are very pale, the extremities are cold to the touch. BP 70/3070/30 mm Hg. Breathing is rare. Spraying her face with cold water and inhaling ammonia vapors quickly brought the patient to consciousness. What type of circulatory failure does the patient have?

a)

Acute cardiac

b)

Chronic heart disease

c)

Cardiovascular

d)

Acute vascular

e)

Chronic vascular

78.

Patient K., 34 years old, was admitted to the clinic with a fracture of the right femur. The following day, sharp pains in the chest appeared, the skin became cyanotic, the respiratory rate was 36, the pulse was 120, blood pressure was 85/6085/60 mm Hg, and the heart rate was within normal limits. There was a sharp swelling of the jugular veins. The liver was enlarged. What type of heart failure does the patient have based on location?

a)

Overload

b)

Myocardial

c)

Left ventricular

d)

Right ventricular

e)

Chronic

79.

A 38-year-old woman was admitted to the hospital with a fracture of the right femur. The following day, sharp chest pains appeared, the skin became cyanotic, the respiratory rate was 36, the pulse was 120, blood pressure was 85/6085/60 mm Hg, and the heart rate was within normal limits. There was a sharp swelling of the jugular veins. The liver was enlarged. What type of heart failure does the patient have?

a)

Right ventricular

b)

Myocardial

c)

Left ventricular

d)

Sharp

e)

Chronic

80.

Patient A., 63 years old, complains of shortness of breath with minor physical exertion, attacks of suffocation at night, accompanied by a cough with a small amount of liquid transparent sputum. Objectively: skin with a cyanotic tint. Pronounced edema in the legs. Blood pressure 100/70100/70 mm Hg. What type of heart failure does the patient have?

a)

Right ventricular

b)

Myocardial

c)

Left ventricular

d)

Sharp

e)

Chronic

81.

A 46-year-old woman, irritable, a low-level manager, often has conflicts with the staff. Over the past 2–3 years, after stress and conflicts, she has begun to notice an increase in blood pressure. She was brought to the emergency department of the hospital with complaints of headache, anxiety, tremors throughout the body, stabbing pain in the heart area, palpitations, and interruptions. Blood pressure 170/105170/105 mm Hg. After the introduction of a tranquilizer and a β-blocker, blood pressure returned to normal and her health improved. What form of arterial hypertension does the patient have?

a)

Endocrine

b)

Renal

c)

Essential

d)

Neurogenic reflex

e)

Hemodynamic

82.

Patient N., 26 years old, has a constant increase in blood pressure to 170170180/90180/90110110 mmHg, detected by chance 7–8 years ago; there are changes in the general urine analysis (low specific gravity, proteinuria, erythrocyturia). At the age of 12, after suffering from tonsillitis, swelling of the face and shins was noted, and changes in the urine were detected. Which form of arterial hypertension is the patient’s?

a)

Secondary vasorenal

b)

Secondary renoprivate

c)

Endocrine

d)

Essential

e)

Neurogenic reflex

83.

Patient P., 32 years old, suffers from suddenly beginning and suddenly ending attacks of severe headache with a sharp increase in blood pressure (up to 280280300300 mmHg), sweating, anxiety, fear, rapid heartbeat, nausea, vomiting. During an attack, the face is red, tremor, hands and feet are cold, heart rate is 100100140140 per minute. Additional research revealed a tumor of the right adrenal gland. Which form of arterial hypertension is the patient’s?

a)

Secondary vasorenal

b)

Secondary renoprivate

c)

Endocrine

d)

Essential

e)

Neurogenic reflex

84.

A 32-year-old woman suffers from sudden onset and sudden end of severe headache attacks with a sharp increase in blood pressure (up to 280280300300 mmHg), sweating, anxiety, fear, rapid heartbeat, nausea, vomiting. During an attack, the face is red, tremor, hands and feet are cold, heart rate is 100100140140 per minute. Additional research revealed a tumor of the right adrenal gland. What hormones are the cause and what mechanism forms the arterial hypertension?

a)

Aldosterone causing sodium and water retention with increased plasma volume

b)

Glucocorticoids causing increased vascular sensitivity to catecholamines

c)

Catecholamines (adrenaline and noradrenaline) causing widespread vasoconstriction and increased cardiac output

d)

Renin causing activation of the renin–angiotensin system with increased angiotensin II

85.

Patient M., 63 years old, suffering from bronchial asthma, had been taking glucocorticoids for several years. During these years, his body weight gradually increased, diabetes mellitus and arterial hypertension developed. What form of arterial hypertension does the patient have?

a)

endocrine

b)

renal

c)

essential

d)

primary

e)

hemodynamic

86.

Patient D., 46 years old, after subtotal resection of the thyroid gland performed for a hormonally active tumor, was prescribed thyroid hormone replacement therapy. Six months later, at an endocrinology appointment, blood pressure was recorded as 140/70 mm Hg. What causes the development of arterial hypertension?

a)

excessive dose of the drug

b)

insufficient dose of the drug

c)

hyperthyroidism

d)

hypofunction of the thyroid gland

e)

inflammation of the thyroid gland

87.

Patient D., 35 years old, who has been observed for 15 years for glomerulonephritis, has had an increase in blood pressure up to 170/120 mm Hg over all these years. What form of arterial hypertension does the patient have?

a)

endocrine

b)

renal

c)

essential

d)

neurogenic reflex

e)

hemodynamic

88.

Patient S., 47 years old, trolleybus driver, complains of headaches, dizziness, nausea. Over the past year, increased blood pressure of 160/95 mm Hg has been observed repeatedly. What form of arterial hypertension does the patient have?

a)

endocrine

b)

renal

c)

essential

d)

neurogenic reflex

e)

hemodynamic

89.

Patient G., 30 years old, complains of significant weight gain. On examination, attention is drawn to a moon‑shaped face, fat deposits mainly on the abdomen and neck, and swelling in the legs. The examination revealed: blood pressure 160/100 mm Hg, hyperglycemia, hypokalemia, increased glucocorticoids in the blood and urine, and an adrenal tumor on ultrasound. What form of arterial hypertension does the patient have?

a)

endocrine

b)

renal

c)

essential

d)

neurogenic reflex

e)

hemodynamic

90.

Patient E., 45 years old, who has been observed for 15 years for glomerulonephritis, has had an increase in blood pressure up to 180/130 mm Hg over all these years. What form of arterial hypertension does the patient have?

a)

endocrine

b)

renal renopriv

c)

essential

d)

neurogenic reflex

e)

renal renovascular

91.

Patient S., 54 years old, suffering from alcoholic liver cirrhosis, underwent paracentesis with evacuation of about five liters of ascitic fluid. Immediately after the intervention, the patient felt sharp weakness, nausea, and darkening of the eyes. Systolic blood pressure was about 60 mm Hg, diastolic was not determined. What pathological process developed in the patient?

a)

traumatic shock

b)

collapse

c)

coma

d)

pain shock

e)

precoma

92.

Patient K., 38 years old, complained of shortness of breath during a routine medical examination during significant physical exertion. He suffers from a congenital heart defect. Objectively: the borders of the heart are expanded to the left and downwards, the cardiac impulse is well expressed. During auscultation, a systolic murmur is heard on the sternum, spreading throughout the chest. Palpation reveals the symptom of "cat purring". The second sound on the aorta is weakened. Blood pressure 110/85 mm Hg, pulse 60 min⁻¹. No significant changes were found in other organs. What type of circulatory failure does the patient have?

a)

acute cardiac

b)

chronic heart disease

c)

cardiovascular

d)

acute vascular

e)

chronic vascular

93.

Patient K., aged 38, complained of shortness of breath during a routine medical examination during significant physical exertion. He suffers from a congenital heart defect. Objectively: the borders of the heart are expanded to the left and downwards, the cardiac impulse is well expressed. During auscultation, a systolic murmur is heard on the sternum, spreading throughout the chest. Palpation reveals the symptom of "cat purring". The second sound on the aorta is weakened. Blood pressure 110/85 mm Hg, pulse 60 min⁻¹. No significant changes were found in other organs. What stage of pathological hyperfunction and myocardial hypertrophy does the patient have according to F.Z. Meerson?

a)

emergency with increased energy production

b)

activation of the genetic apparatus of cardiomyocytes

c)

hyperfunction of nothypertrophied cardiomyocytes

d)

completed hypertrophy and relatively stable hyperfunction

e)

progressive cardiosclerosis and myocardial function depletion

94.

Patient A., 20 years old, has had high blood pressure since childhood, currently 180–200/110–120 mm Hg. There is no influence of psychoemotional factors and practically no fluctuations in blood pressure. There is no headache. It is not possible to normalize blood pressure with antihypertensive drugs. A systolic murmur is heard to the left and right of the navel. General urine analysis is normal. What form of arterial hypertension does the patient have?

a)

endocrine

b)

renal renopriv

c)

essential

d)

neurogenic reflex

e)

renal renovascular

95.

Patient M., 46 years old, developed severe chest pain during intense physical work in the garden, which was relieved by nitroglycerin. In the evening, the pain resumed and was not relieved by nitroglycerin. Shortness of breath and cough with abundant liquid sputum developed. The patient was hospitalized. Objectively: the skin and visible mucous membranes are pale with a cyanotic tint. Respiration 42 min⁻¹, pulse 120 min⁻¹. On auscultation, moist rales of various sizes are heard over the entire surface of the right and left lungs. Cardiac output per minute is 2.8 l, blood pressure 90/60 mm Hg. The oxyhemoglobin content in arterial blood is 81%, and in venous blood 45%. What type of heart failure does the patient have according to pathogenesis?

a)

overload resistance

b)

coronary myocardial

c)

non‑coronary myocardial

d)

overload by volume

e)

pericardial dysfunction

96.

Patient M., 46 years old, developed severe chest pain during intense physical work in the garden, which was relieved by nitroglycerin. In the evening, the pain resumed and was not relieved by nitroglycerin. Shortness of breath and cough with abundant liquid sputum developed. The patient was hospitalized. Objectively: the skin and visible mucous membranes are pale with a cyanotic tint. Respiration 42 min⁻¹, pulse 120 min⁻¹. On auscultation, moist rales of various sizes are heard over the entire surface of the right and left lungs. Cardiac output per minute is 2.8 l, blood pressure 90/60 mm Hg. The oxyhemoglobin content in arterial blood is 81%, and in venous blood 45%. What type of heart failure does the patient have based on localization?

a)

right ventricular

b)

myocardial

c)

left ventricular

d)

sharp

e)

chronic

97.

Patient M., 46 years old, developed severe chest pain during intense physical work in the garden, which was relieved by nitroglycerin. In the evening, the pain resumed and was not relieved by nitroglycerin. Shortness of breath and cough with abundant liquid sputum developed. The patient was hospitalized. Objectively: the skin and visible mucous membranes are pale with a cyanotic tint. Respiration 42 min⁻¹, pulse 120 min⁻¹. On auscultation, moist rales of various sizes are heard over the entire surface of the right and left lungs. Cardiac output per minute is 2.8 l, blood pressure 90/60 mm Hg. The oxyhemoglobin content in arterial blood is 81%, and in venous blood 45%. The content of erythrocytes in peripheral blood is 5.0 × 10¹²/l, leukocytes 19.0 × 10⁹/l. What type of heart failure does the patient have?

a)

right ventricular

b)

myocardial

c)

left ventricular

d)

sharp

e)

chronic

98.

Patient R., 42 years old, has persistent headaches, general weakness, muscle weakness, a crawling sensation, polyuria, and nocturia. Relative urine density is 1001–1002. Blood pressure is 230/120 mm Hg. The blood has an elevated sodium level and a reduced potassium level. Ultrasound examination revealed a tumor of the right adrenal gland. What form of arterial hypertension does the patient have?

a)

endocrine

b)

renal renopriv

c)

essential

d)

neurogenic reflex

e)

renal renovascular

99.

Patient R., 42 years old, has persistent headaches, general weakness, muscle weakness, a crawling sensation, polyuria, and nocturia. The relative density of urine is 1001–1002. Blood pressure is 230/120 mm Hg. The blood has an elevated sodium content and a reduced potassium content. An ultrasound examination revealed a tumor of the right adrenal gland. What hormone does the tumor produce?

a)

aldosterone

b)

adrenalin

c)

thyroxine

d)

cortisol

e)

norepinephrine

100.

Patient T., 54 years old, suffering from arterial hypertension, came to the clinic complaining of periodic dyspnea with difficult and unsatisfied inhalation, especially pronounced during physical exertion. Several days ago, he had an attack of severe inspiratory dyspnea ("suffocation") with fear of death at night; the doctor diagnosed "cardiac asthma". During examination: blood pressure 155/120 mm Hg, X‑ray shows left ventricular dilation. What type of heart failure does the patient have according to pathogenesis?

a)

overload (afterload)

b)

coronary myocardial

c)

non‑coronary myocardial

101.

Restrictive type hypoventilation of the lungs arises at

a)

Edema of the larynx

b)

Hypersecretion of mucus in the bronchi

c)

Bronchiolospasm

d)

Strangulation

e)

Pleurisy

102.

Restrictive respiratory failure is developing as a result of

a)

Edema of the respiratory paths

b)

Blockages of the respiratory paths

c)

Spasm of smooth muscles of the bronchi

d)

Removals easy

e)

Compression of the respiratory paths

103.

Restrictive ventilation disorders may result from

a)

Bronchus tumor

b)

Pulmonary emphysema

c)

Bronchospasm

d)

Hydrothorax

e)

Laryngospasm

104.

For obstruction of the top respiratory paths, it is characteristic to have

a)

Stenotic breathing

b)

Infrequent superficial breathing

c)

Periodic breathing

d)

Difficulty with exhalation

e)

Apneustic breathing

105.

Terminal type breathing refers to

a)

Biot’s breathing

b)

Cheyne–Stokes breathing

c)

Tachypnea

d)

Bradypnea

e)

Gasping breathing

106.

Insufficiency of external respiration with impaired ventilation of the lungs is accompanied by

a)

Increase in the partial pressure of oxygen (pO2) and carbon dioxide (pCO2) in arterial blood

b)

Decrease in pO2 and pCO2 in arterial blood

c)

Decrease in pO2 and pCO2 in venous blood

d)

Increased pO2 and normal pCO2 in the blood

e)

Decrease in pO2 and increase in pCO2 in arterial blood

107.

Obstructive hypoventilation of the lungs occurs when

a)

Impaired respiratory muscle function

b)

Pulmonary atelectasis

c)

Bronchial asthma

d)

Pneumonia

e)

Barbiturate poisoning

108.

The intrapulmonary cause of restrictive hypoventilation of the lungs is

a)

Changes in the pleura and mediastinum

b)

Chest deformity

c)

Ossification of costal cartilages

d)

Ascites

e)

Surfactant deficiency

109.

Surfactant deficiency in newborns is caused by dysfunction of

a)

Pulmonary capillary endothelial cells

b)

Bronchial mucosa cells

c)

Epithelial cells of the respiratory bronchioles

d)

Type I alveolocytes

e)

Alveolar cells type II

110.

A valve mechanism of bronchial obstruction can occur when

a)

Pneumonia

b)

Surfactant deficiency

c)

Lung lobe resections

d)

Pulmonary emphysema

e)

Pulmonary edema

111.

Lower airway obstruction is accompanied by

a)

Reduction of the Tiffeneau index

b)

Difficulty in the inhalation phase

c)

Stenotic breathing

d)

Increase in the Tiffeneau index

e)

Decrease in OOL

112.

Precapillary pulmonary hypertension can develop with

a)

Left ventricular failure

b)

Impaired blood flow from the pulmonary vessels to the left atrium

c)

Thromboembolism of pulmonary arterioles

d)

Compression of the pulmonary veins

e)

Stenosis of the mitral valve orifice

113.

Postcapillary pulmonary hypertension can develop with

a)

Compression of pulmonary arterioles

b)

Obstruction of pulmonary arterioles

c)

Spasm of pulmonary arterioles

d)

Mitral valve defects

e)

Acute decrease in partial pressure of oxygen in inhaled air

114.

Alpha‑1 antitrypsin deficiency is characteristic of

a)

Pulmonary emphysema

b)

Pleural empyema

c)

Pneumonia

d)

Tuberculosis

e)

Exudative pleurisy

115.

Violation of respiratory regulation associated with a lack of excitatory afferentation occurs when

a)

Inhalation of irritating substances (ammonia)

b)

Inhaling hot or cold air

c)

Diaphragmatic paralysis

d)

Drug addiction

e)

Neurotic conditions

116.

Violation of the diffusion properties of alveolar‑capillary membranes is observed in

a)

Tracheitis

b)

Bronchial asthma

c)

Laryngeal edema

d)

Bronchitis

e)

Silicosis

117.

Periodic breathing in which the amplitude and frequency of breathing increases in a wave‑like manner and then decreases is

a)

Biot’s

b)

Cheyne–Stokes

c)

Apneustic

d)

Kussmaul

e)

Gasping

118.

The leading pathogenetic factor of cardiogenic pulmonary edema is

a)

Increased permeability of pulmonary capillaries

b)

Decreased lymph flow

c)

Increased blood oncotic pressure

d)

Decreased aldosterone

e)

Increased hydrostatic pressure in the pulmonary capillaries