Module 1. Anaesthesiology and intensive care Text test questions A

Module 1. Anaesthesiology and intensive care

Text test questions

1.

A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –

A.

*omplete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

2.

A local anesthetic that is ineffective topically is –

A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

3.

A successful stellate ganglion block can produce –

A.

Hypotension

B.

* Horner's syndrome

C.

Brachial plexus involvement

D.

Hemifacial anaesthesia

E.

Hypertension

4.

According to the Glasgow Coma Scale active movements to verbal commend correspond to:

A.

2 points

B.

5 points

C.

4 points

D.

3 points

E.

* 6 points

5.

According to the Glasgow Coma Scale active movements to verbal commend correspond to:

A.

2 points

B.

5 points

C.

4 points

D.

3 points

E.

* 6 points

6.

According to the Glasgow Coma Scale deep coma corresponds to:

A.

4-5 points

B.

13-14 points

C.

11-12 points

D.

* to 3 points

E.

8-9 points

7.


A.

4-5 points

B.

13-14 points

C.

11-12 points

D.

* to 3 points

E.

8-9 points

8.

According to the Glasgow Coma Scale deep sopor corresponds to:

A.

11-12 points

B.

13-14 points

C.

4-5 points

D.

3 points

E.

* 8-9 points

9.

According to the Glasgow Coma Scale stupor corresponds to:

A.

11-12 points

B.

13-14 points

C.

4-5 points

D.

3 points

E.

* 10-11 points

10.

According to the Glasgow Coma Scale eyes opening to pain corresponds to:

A.

4 points

B.

3 points

C.

* 2 points

D.

0

E.

1 point

11.


A.

4 points

B.

3 points

C.

* 2 points

D.

0

E.

1 point

12.

According to the Glasgow Coma Scale free verbal response corresponds to:

A.

2 points

B.

3 points

C.

1 point

D.

* 5 points

E.

4 points

13.

According to the Glasgow Coma Scale free verbal response corresponds to:

A.

2 points

B.

3 points

C.

1 point

D.

* 5 points

E.

4 points

14.

According to the Glasgow Coma Scale lack of eyes opening to any irritant corresponds to:

A.

2 points

B.

* 1 point

C.

4 points

D.

5 points

E.

3 points

15.

According to the Glasgow Coma Scale lack of eyes opening to any irritant corresponds to:

A.

2 points

B.

* 1 point

C.

4 points

D.

5 points

E.

3 points

16.

According to the Glasgow Coma Scale lack of verbal response corresponds to:

A.

2 points

B.

5 points

C.

3 points

D.

4 points

E.

* 1 point

17.

According to the Glasgow Coma Scale lack of verbal response corresponds to:

A.

2 points

B.

5 points

C.

3 points

D.

4 points

E.

* 1 point

18.

According to the Glasgow Coma Scale moderate torpor corresponds to:

A.

4-5 points

B.

6-7 points

C.

* 8-10 points

D.

11-12 points

E.

13-14 points

19.

According to the Glasgow Coma Scale moderate torpor corresponds to:

A.

4-5 points

B.

6-7 points

C.

* 8-10 points

D.

11-12 points

E.

13-14 points

20.

According to the Glasgow Coma Scale normal extensible movements correspond to:

A.

1 point

B.

2 points

C.

3 points

D.

5 points

E.

* 4 points

21.

According to the Glasgow Coma Scale normal extensible movements correspond to:

A.

1 point

B.

2 points

C.

3 points

D.

5 points

E.

* 4 points

22.

According to the Glasgow Coma Scale normal flexible movements correspond to:

A.

* 5 points

B.

3 points

C.

1 point

D.

D* 4 points

E.

2 points

23.

According to the Glasgow Coma Scale normal flexible movements correspond to:

A.

* 5 points

B.

3 points

C.

1 point

D.

D* 4 points

E.

2 points

24.

According to the Glasgow Coma Scale pathological flexion of limbs corresponds to:

A.

* 3 points

B.

4 points

C.

5 points

D.

1 point

E.

2 points

25.

According to the Glasgow Coma Scale pathological flexion of limbs corresponds to:

A.

* 3 points

B.

4 points

C.

5 points

D.

1 point

E.

2 points

26.

According to the Glasgow Coma Scale pronunciation of separated phrases corresponds to:

A.

* 4 points

B.

3 points

C.

5 points

D.

2 points

E.

1 point

27.

According to the Glasgow Coma Scale pronunciation of separated phrases corresponds to:

A.

* 4 points

B.

3 points

C.

5 points

D.

2 points

E.

1 point

28.

According to the Glasgow Coma Scale pronunciation of separated phrases to pain corresponds to:

A.

4 points

B.

* 3 points

C.

1 point

D.

5 points

E.

2 points

29.

According to the Glasgow Coma Scale pronunciation of separated phrases to pain corresponds to:

A.

4 points

B.

* 3 points

C.

1 point

D.

5 points

E.

2 points

30.

According to the Glasgow Coma Scale soporose state corresponds to:

A.

13-14 points

B.

* 6-7 points

C.

8-10 points

D.

3 points

E.

4-5 points

31.

According to the Glasgow Coma Scale soporose state corresponds to:

A.

13-14 points

B.

* 6-7 points

C.

8-10 points

D.

3 points

E.

4-5 points

32.

According to the Glasgow Coma Scale spontaneous eyes opening corresponds to:

A.

* 3 points

B.

4 points

C.

2 points

D.

1 point

E.

0

33.


A.

* 3 points

B.

4 points

C.

2 points

D.

1 point

E.

0

34.

According to the Glasgow Coma Scale terminal coma corresponds to:

A.

* 3 points

B.

8-10 points

C.

6-7 points

D.

4-5 points

E.

0

35.


A.

* 3 points

B.

8-10 points

C.

6-7 points

D.

4-5 points

E.

0

36.

Acute arise of not adequate behavior in patient is characteristic feature of:

A.

Uremia comma

B.

Insult of brain

C.

* Hyperglycemic comma

D.

Hypoglicemic comma

E.

Alcohol comma

37.

Acute increasing of intracranial pressure most probably can be caused:

A.

Lowering of AP

B.

Change the direction of the liquor circulation

C.

* Arterial hyperthensia , bradicardia

D.

Arterial hypertensia , tachycardia

E.

Any from listed

38.

All are surface anaesthetics except –

A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

39.

An increased dose of epidural anaesthetic is obligatory in a patient who has –

A.

Ascities

B.

* Increased height of the patient

C.

Pregnant

D.

Age after 50

E.

Obese

40.

Anisocoria is typical for:

A.

uremic coma

B.

broken neck

C.

* local injury of CNS

D.

subarachnoid hemorrhage

E.

hypoglycaemic coma

41.


A.

uremic coma

B.

broken neck

C.


D.


E.

hypoglycaemic coma

42.

Areflexia is observed in:

A.

Hypoglycemic comma

B.

* hyperglycemic ketoacidotic comma

C.

uremic comma

D.

Alcohol comma

E.

Insult of brain

43.

At anaerobic metabolic processes during hypoxia glucose converts to:

A.

Cationic radicals

B.

* Citric acid

C.

Molecule ATF and carbonic acid gas

D.

Milk acid

E.

Glucose is not converting

44.

Average arterial pressure is:

A.

* Diastolic+ 1/3 pulsed

B.

Systolic +diastolic /2

C.

Pressure in aorta

D.

Systolic + CVT/2

E.

Synonym of pulls pressure

45.

Average norm of glucose consuming by brain per a day is :

A.

105 g

B.

38 g

C.

78g

D.

42 g

E.

* 90 g

46.

Average time for persistence of post spinal headache is -

A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

47.

Blood providing of hepar is made of :

A.

80% - hepatic artery , 20% - portal vena

B.

40% - hepatic artery, 60% - portal vena

C.

* 20% - hepatic artery, 80% - portal vena

D.


E.


48.

Brain blood circulation increase in most cases at:

A.

Hypoxia

B.

* Hypercapnia

C.

increased averaged АP

D.

Injection of adrenalin

E.

E. E Injection of corticosteroids

49.

Brain is using oxygen witch come into the whole organism in quantity

A.

* 40%

B.

10%

C.

20%

D.

15%

E.

50%

50.

Breath by Chain- Stox characterized for:

A.

Alcohol comma

B.

Hypoglycemic comma

C.

Hyperglycemic comma

D.

Insult of brain

E.

* Uremic comma

51.

Breath of Kusmaul is founded when it is :

A.

Alcohol comma

B.

Uremic comma

C.

Insult of brain

D.

Hypocalcaemic comma

E.


52.

Cauda Equina syndrome can be caused by

A.

* Spinal anaesthesia

B.

Epidural anaesthesia

C.

Both

D.

D.None

E.

E.General anaesthesia

53.

Central perfusion pressure is :

A.

Difference between diastolic and intracranial pressure

B.

Difference between systolic and intracranial pressure

C.

* Difference between gydrostatic and arterial pressure

D.

Hydrostatic pressure of liquor

E.

Difference between average arterial and intracranial pressure .

54.

Cerebral vessels strongly became wider after :

A.

Nimodypinum

B.

Galotan

C.

Barbiturats

D.

Hypocxemia

E.

* Hypercapnia

55.

Chose wrong affirmation , during ALV of the patient with cranial trauma:

A.

A. РСО2 is necessary support on the level 25-30 mm..mercury

B.

* Optimal is position of patient on the back in horizontal position

C.

It is necessary prevent hypoxia

D.

It is necessary prevent hypocapnia

E.

It is necessary to provide myorelaxation

56.

Clinical sign of hypercapcania is:

A.

Express cyanosis

B.

Wetness , purple –cyanosis skin

C.

Bradicardia

D.

* Marble skin

E.

All appointed signs

57.

Clonico -tonical spasms founded during:

A.

Insult of brain

B.

* Alcohol comma

C.

Hyperglycemic comma

D.

Hypoglicemic comma

E.

Uremia coma

58.

Commonest Cranial nerve affected in spinal anaesthesia -

A.

* 2

B.

3

C.

4

D.

6

E.

10

59.

Complication of epidural anaesthesia is except-

A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

60.

Concerning Barbotage –

A.

* Fluid (spinal) is alternately withdrawn and reinjected under pressure

B.

Technique used Epidural Analgesia

C.

Technique popularized in caudal Analgesia

D.

Cannot be carried out under hypothermic condition

E.

All of the above

61.

Cranial nerve not involved in spinal anaesthesia -

A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

62.

Critical level of CNS blood circulation in patient with normal BP appropriate to?

A.

Reduce АТ on 50%

B.

* Reduce AP to the level of diastolic

C.

Reduce of system АP lower of diastolic

D.

Reduce АP on 25%

E.

Reduce АP on35%

63.

Death of the brain by the scale of Glasgow amount to :

A.

* 3 points

B.

7-9 points

C.

3-5 points

D.

12-13 points

E.

15 points

64.

Deep coma by scale of Glasgow amount to :

A.

* 4-5 points

B.

12-14 points

C.

5-7 points

D.

6-8 points

E.

9-11 points

65.

Dilatation of pupil of the eye characterized :

A.

Uremic comma

B.

Insult of brain

C.


D.

Alcohol comma

E.

Intoxication with opiates

66.

Discoordination is typical for:

A.

* Light coma

B.

Deep coma

C.

Sopor

D.

Expressive coma

E.

Terminal coma

67.

Dryness of skin and mucous membranes are characteristic feature of:

A.

Hyperosmolar ketoacidotic comma

B.

Brain comma

C.

Alcohol comma

D.

* Hyperglycemic ketoacidotic comma

E.

Hypoglycemic comma

68.

During systolic contraction encranial pressure :

A.

* Lower on 2 mm.mercury

B.

Increase on 2mm. mercury item

C.

Increase on 6 mm.mercury

D.

Lower on 6 mm.mercury.

69.

During operation haemotransfusion therapy is providing by:

A.

A. Anaesthesiologist which provide narcosis

B.

* Special chosen doctor

C.

Doctor from station of blood transfusion

D.

Only the chief of department

E.

Administrator

70.

Edema is characters sign of :

A.

Insult of brain

B.

Alcohol comma

C.

* Uremical comma

D.

hyperglicemic comma

E.

Hypoglicemic comma

71.

Endogenous hepatic coma may caused by:

A.

Haemorrhagia from esofageus vens

B.

Damaged cell of hepar

C.

* Inflectional-toxic chock

D.

Endocrine illness

E.

Acute poisoning of charcoal gas

72.

Enlargement or reduction of the liver is typical for:

A.

hyperglycaemic coma

B.

cerebral coma

C.

hypoglicemic coma

D.

uremic coma

E.

* hepatic coma

73.

Enlargement or reduction of the liver is typical for:

A.

hyperglycaemic coma

B.

cerebral coma

C.

hypoglicemic coma

D.

uremic coma

E.

* hepatic coma

74.

Epidural anesthesia is preferred to spinal anesthesia because –

A.

Hypotension is absent

B.

* Dura is not penetrated

C.

Low dose of anesthetic is used

D.

Level of block easily changed

E.

Hypertension is present

75.

Epidural blocks is indicated in all excpect-

A.

* Patients in hypovolemia

B.

Patients with asthma and bronchitis

C.

Post-operative pain relief

D.

Obstetric analgesia

E.

In urologic surgery

76.

Epidural morphine cause -

A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

77.

Epidural narcotic is preferred over epidural LA because it causes –

A.

Less respiratory depression

B.

Not causes retention of urine

C.

* No motor paralysis

D.

Less dose required

E.

Cardiac depression

78.

Estimation of coma level for scale of Glasgow is based on:

A.

* Movement activity, possibility contact with patient , opening the eyes

B.

Estimate patellar reflex

C.

Estimate of reaction pupil of the eye

D.

Estimate of adequate function of the external breath

E.

Estimate of geodynamics

79.

Fall back head position is typical for:

A.

cerebral coma

B.

hypoglycaemic coma

C.

* meningitis, tetanus

D.

hyperglycaemic ketoacidic coma

E.

alcoholic coma

80.

Fall back head position is typical for:

A.

cerebral coma

B.

hypoglycaemic coma

C.

* meningitides, tetanus

D.

hyperglycaemic ketoacidic coma

E.

alcoholic coma

81.

First Fibres to be blocked at spinal anaethesia is –

A.

Afferent motor nerve

B.

Efferent motor nerves

C.

* Sympathetic preganglonic

D.

Sensory fibres

E.

Parasympathetick nerve

82.

First wich is paralised after spinal anaesthesia is

A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

83.

For hyperglicemic ketoacidosiscoma is not typical :

A.

* Metabolic acidose

B.

Hyperhydratation

C.

Low CVP

D.

Respiratory alkalosis

E.

Acute pallidity of face

84.

For brachial plexus block needle is inserted –

A.

Medial to subclavian artery

B.

* Lateral to subclavian artery

C.

Medial to subclavian vein

D.

Lateral to subclavian vein

E.

Inferior to subclavian vein

85.

For hyperglicemic coma is typical :

A.

Reducing of arterial pressure to critical level

B.

Soft eyeballs

C.

Wet skin

D.

Often noisy breathing

E.

* Acute cardial insufficiency

86.

For hyperglycaemic ketoacidic coma is not typical:

A.

marked paleness of the skin

B.

respiratory alkalosis

C.

metabolic acidosis

D.

* hyperhydration

E.

low CVP

87.

For hyperglycaemic ketoacidic coma is not typical:

A.

marked paleness of the skin

B.


C.

metabolic acidosis

D.

* hyperhydration

E.

low CVP

88.

For hypoglycaemic coma is typical:

A.

* humid skin

B.

lowering of blood pressure to the critical level

C.

mild eyeballs

D.

acute cardiac failure

E.

frequent, noisy breathing

89.

For hypoglycaemic coma is typical:

A.

* humid skin

B.

lowering of blood pressure to the critical level

C.

mild eyeballs

D.


E.


90.

For hypoglycemic coma is not typical :

A.

Reduce of АP to the critical

B.

Soft eye bolls

C.

Acute cardial insufficiency

D.

* Wet skin

E.

Often noisy breathing

91.

For the activity of CNS neurons is necessary:

A.

adequate level of proteins and lipids

B.

24-25% of general circulation should get into the cerebral vessels every minute

C.

level of glucose should be not lower than 3 mmol/l

D.

osmolarity of plasma should be 180-210 mosm/l

E.

* not less than 20% of general oxygen for cerebral needs

92.

For the activity of CNS neurons is necessary:

A.


B.

24-25% of general circulation should get into the cerebral vessels every minute

C.


D.


E.

* not less than 20% of general oxygen for cerebral needs

93.

Grey colour of the skin is characteristic feature of:

A.

Alcohol coma

B.

Hyperglycemic coma

C.

* Hypoglycemic coma

D.

Uremic coma

E.

Insult of brain

94.

Higher normal level of glycemia consist :

A.

6,6 mol/l

B.

5,5 mol/l

C.

4,2 mol/l

D.

* 7,3 mol/l

E.

3,8 mol/l

95.

How many points the absence of any movement reaction by scale of Glasgow has:

A.

* 1 point

B.

3 points

C.

2 points

D.

4 points

E.

5 points

96.

Hyperemia of skin and mucous membrans is characteristic feature of :

A.

Uremic coma

B.

Hyperglycemic coma

C.

Hypoglycemic coma

D.

* Insult of brain

E.

Alcohol coma

97.

Hyperreflexia and twitch is typical for :

A.

Hypercritical coma

B.

Insult of brain

C.

Hypoclemical coma

D.

Uremia coma

E.

Brain coma

98.

Hyperventilation include the next level РСО2:

A.

30-35 mm. mercury item

B.

40-45. mm. mercury item

C.


D.

* 35-45 mm. mercury item

E.

45-55 . mm. mercury item

99.

In acute convulsions due to toxicity to local anaethetic most important step in immediate management is –

A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.

IV short acting barbiturate

E.

Diazepam IV

100.

100. In case of hypothalamic injury there are next sign of cardio-vascular system affection:

A.

Acute decrease of vascular tonus, hypotension, bradicardia, heart arrest

B.

Extrasystolia , atrioventrucular block, fibrillation of ventricle

C.

Ventricle asistoles , gliming arrhythmia

D.

Bradicardia , fool atrioventucular block

E.

* Extrasystolia, paroxismal tachycardia , acute hypotension

101.

In doing a phrenic nerve block, it is best to infiltrate

A.

Scalenus anterior

B.

Scalenus posterior

C.

* Posterior border of sternomastoid

D.

Anterior border of sternomastoid

E.

Scalenus lateralis

102.

In spinal anaesthesia the drug is deposited between-

A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.

Into the cord substance

E.

Dura and mild

103.

In spinal anaesthesia, the first nerve fibre to get blocked is -

A.

* Autonomic preganglionic fibres

B.

Temperature fibres

C.

Somatic motor fibres

D.

Vibratory and proprioceptive fibres

E.

Vegetates fibers

104.

In spinal anaesthesia, the last fibres affected is -

A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

105.

In the treatment of presistent ventricular arrhythmias, the recommended infusion rate of

A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

106.

In which space is intra cardiac adrenaline given –

A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

107.

Late medullary depression following epidural anesthesia may be caused by -

A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

108.

Lidocaine can be used in all except –

A.

Ventricular fibrillation

B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

109.

Lidocaine can cause -

A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.

Myocardium infarction

110.

Local anesthetics act by-

A.

Forming area of nerve block along a neuron

B.

Binding to calcium receptor on nerve membrane

C.

Blocking calcium chanels of nerve membrane

D.

* Inhibiting the sodium pump

E.

Blocking sodium chanels

111.

Longest acting local anaesthetic solution is-

A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

112.

Lumbar puncture is done in the following positions –

A.

Rt. Lateral

B.

Lt. Lateral

C.

Sitting with head below flexed knees

D.

* All of the above

E.

None of above

113.

Manitol can cause subdural haematoma in result :

A.

Progress of edema of brain

B.

Influence on process of blood coagulation

C.

* Increase the risk of cerebral cortex venues breaking

D.

Reduce of AP

114.

Minimal level of glycemia for normal activity of brain is:

A.

2,3 mol/l

B.

1,2 mol/l

C.

* 1,5 mol/l

D.

1,7 mol/l

E.

1,8 mol/l

115.

Most common complication of spinal anaesthesia is-

A.

Post spinal headache

B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

116.

Movement reaction by scale of Glasgow consist of

A.

3 grades

B.

1 grade

C.

* 6 grades

D.

4 grades

E.

2 grades

117.

Movement reaction on pain shock by scale of Glasgow consist of:

A.

2 grades

B.

3 grades

C.

4 grades

D.

* 6 grades

E.

1 grade

118.

Name the position with downed main end :

A.

A.Obraztcov

B.

Renalis

C.

Orthopaedic

D.

* Trendeleburg

E.

Fowler

119.

Name the position with the elevated upper part of body :

A.

* Fowler

B.

Trendeleburg

C.

Obraztcov

D.

Cardiovascular

E.

Pulmonological

120.

Narrow eye pupils (like papaverous seeds) are typical for:

A.

hypoxia

B.

* poisoning with opiates

C.

poisoning with narcoleptics

D.

poisoning with antihistamines

E.

local cerebral injury

121.

Narrow eye pupils (like papaverous seeds) are typical for:

A.

hypoxia

B.

* poisoning with opiates

C.

poisoning with narcoleptics

D.

poisoning with antihistamines

E.

local cerebral injury

122.

122. Normal intracranial pressure is:

A.

1-10 ml.mercury

B.

10-15 ml.mercury

C.

15-20 ml.mercury

D.

30-35 ml.mercury

E.

* 25-30 ml.mercury

123.

Normal level of intracranial pressure is:

A.


B.

10-30 mm.mercury

C.


D.

60-80. mm. mercury item

E.


124.

Opening of eyes on appeal by the scale of Glasgow consist of:

A.

* 4 grades

B.

5 grades

C.

3 grades

D.

1 grade

E.

2 grades

125.

Pathological reflex of Babinskiy direct indicate to:

A.

Insult ischemic

B.

Intoxication by opiate

C.

Infarct myocardial

D.

* Organically damage of brain

E.

Hypertonic illness

126.

Percentage of Xylocaine used in spinal anaesthesia-

A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

127.

Pericardial friction rub is typical for:

A.

hepatic coma

B.

hyperglicemic ketoacidic coma

C.

* uremic coma

D.

hypoglicemic coma

E.

cerebral coma

128.


A.

hepatic coma

B.

hyperglicemic ketoacidic coma

C.

* uremic coma

D.

hypoglicemic coma

E.

cerebral coma

129.

Pneumothorax is a complication of -

A.

* Brachial plexus block

B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

130.

Post spinal headache can be prevented by -

A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.

Decrease dose of local anaesthetic

E.

Induced hypertension

131.

Post spinal headache can last for-

A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

132.

Post spinal headache is due to -

A.

Injury to spinal cord

B.

* CSF leak from dura

C.

Meningitis

D.

Meningioma

E.

Neurinoma

133.

Reason of exogenic hepatic coma is:

A.

* Acute exogenic poisoning

B.

Exotoxical shock

C.

Illness of Botkin

D.

Hyperblirubinemia

E.

Cirosis

134.

Shortest acting local anaesthetic is –

A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

135.

Shortest acting local anesthetic -

A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

136.

Signs of respiratory insufficiency :

A.

Hypoxia , hypercapcania or their unification

B.

Hypoxia

C.

* Hypercapcania

D.

Hypoxia and compensorative hypercapnia

E.

All noticed states.

137.

Small dose of insulinum during hyperglicemic coma injects in a such way

A.

0,2 IU for 1 kg of body weight

B.

* 0,4 IU for 1 kg of weight

C.

0,1 IU for 1 kg of weight

D.


E.


138.

Smell of acetone from mouth is characterized f or:

A.

hypoglycemic comma

B.

* hyperglycemic ketoacidotic comma

C.

Intoxication of organs by phosphorous compounds

D.

Intoxication by acetones essention

E.

Іintoxication by ethanol

139.

Smell of ammonia in expired air is characteristic for:

A.

* Uremia comma

B.

Alcohol comma

C.

hyperglycemic comma

D.

hypoglycemic comma

E.

Insult of brain

140.

Speech reaction by scale of Glasgow consist of:

A.

2 grades

B.

4 grades

C.

3 grades

D.

* 5 grades

E.

1 grade

141.

Spinal anaesthesia is preferred in lower abdominal surgeries because-

A.

Gives deep analgesia

B.

Gives good relaxation of abdominal muscles

C.

Patient is conscious and co-operative

D.

* All of above

E.

Intestines so that other viscera are seen well

142.

Subarachnoid block as anesthesia is contraindicated at:

A.

Ischemic heart disease

B.

Burgers disease

C.

Atherosclerotic gangrene

D.

Full stomach

E.

* Hemophilia

143.

Symptom of „white spot” normally lasts :

A.

Up to 1 second

B.

3-5 second

C.

* Up to 3 second

D.

Depend of arterial pressure value (AP)

E.

Not existed

144.

The device suited for introducing epidural catheter is -

A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

145.

The duration of effect of spinal anaesthesia depends upon –

A.

The site of injection

B.

Quantity of drug injected

C.

Type of drug used

D.

* All the above

E.

None of above

146.

The effects of chiling in refrigeration analgesia includes –

A.

Interference with conduction of nerve impulse

B.

Reduction of metabolic rate and oxygen requirement

C.

Inhibition of bacterial growth and infection

D.

Retardation of healing

E.

* All of the above

147.

The following is not used when giving local anaesthesia in the fingers -

A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

148.

The lack of eye pupils’ reaction to the light is typical for:

A.

* deep coma

B.

sopor

C.

stupor

D.

disorders of consciousness

E.

coma of middle grave

149.

The lack of eye pupils’ reaction to the light is typical for:

A.

* deep coma

B.

sopor

C.

stupor

D.

disorders of consciousness

E.

coma of middle grave

150.

The most often reason of death during ethanol-alcoholic coma is :

A.

Acute hepatic insufficiency

B.

* Acute kidney insufficiency

C.

Acute cardial insufficiency,

D.

Collapse

E.

Acute respiratory insufficiency

151.

The normal index of brain perfusion is

A.

700-750 ml/min (15% MCV)

B.

* 350-400 ml/min. (7% MCV)

C.

450-500 ml/min. (10% MCV)

D.

800-850 ml/min. (18% MCV)

E.

500-550 ml/min. (12% MCV)

152.

The pathological types of the breath are :

A.

Chein -Stocks, Biot

B.

Chein -Stocks, Biot, Bi-Braun

C.

* Chein -Stocks, Biot, Embeden -Meuerhoff

D.

Chein -Stocks, Knope, Biot

E.

Chein -Stocks, Kussmaul, Biot

153.

The spinal cord terminates opposite-vertebra –

A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

154.

The whole volume of liquor in adults is about:

A.

200-220 ml

B.

* 120-140 ml

C.

90-100 ml

D.

70-80 ml

E.

50-60 ml

155.

To prevent regurgitation patient needs to:

A.

* Make position with elevated upper part of body

B.

Make position with downed upper part of body

C.

Make position on the side

D.

Inject a portion of atropine

E.

Inject a portion of “cerucal”

156.

VCB (ОЦК) normally is:

A.

12% from weight of body

B.


C.


D.


E.

* 7% from weight of body

157.

Vital capacity of the lung is very low in –

A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

158.

Vomiting, muscular defans of peritoneal wall is characteristic feature of:

A.

* Hyperglycemic coma

B.

Hypoglycemic coma

C.

Uremic coma

D.

Alcohol coma

E.

Insult of brain

159.

What amount of points in the scale of Glasgow characterise normal human condition :

A.

* 7-9 points

B.

4-5 points

C.

8-10 points

D.

15 points

E.

12-14 points

160.

What anesthesiological component doesn’t belong to suppliement of surgical operations.

A.

* Position of the patient on operation table

B.

Medicinal sleep

C.

Mioplegia

D.

Anesthezia

E.

Neurovegetative protection

161.

What concentration of alcohol is considered to be deathly :

A.

* 5-6 g/l

B.

0,5-1 g/l

C.

C2-3 g/l

D.

1,5-2 g/l

E.

E2,5-3 g/l

162.

What criteria appoints on necessity of ALV (ШВЛ):

A.

* РСО2 > 45 mm .mercury

B.

РСО2 > 65 mm. mercury item

C.

РСО2 > 55 mm .mercury

D.


E.


163.

163. What critical level of РО2 requires ALV (ШВЛ) :

A.

РО2 <85 mm. mercury item

B.

* РО2 <55 mm. mercury item

C.


D.


E.

РО2 is not landmark

164.

What is hyppercapnia:

A.

* Over norm formation of carbon dioxide in tissues

B.

State witch appear at metabolism intensification

C.

Increasing of carbon dioxide concentration in blood

D.

Hypoxia

E.

Respiratory insufficiency

165.

What is normal partial pressure of blood ?

A.


B.


C.


D.


E.


166.

What is the normal saturation of oxygen in venues blood ?

A.

* SаО2 about 80%

B.

SаО2 about 70%

C.

SаО2 about 50%

D.

SаО2 about 60%

E.

SаО2 about40%

167.

What pathology often causes vomiting?

A.

Coma ІІІ.

B.

Acute respiratory insufficiency

C.

* Hypertonic crisis

D.

Clinical death

E.

Coma II.

168.

What percent of destroyed gepatocytes lead to development

A.

of hepatic coma:

B.

* 50%

C.

70%

D.

60%

E.

40%

169.

What saturation of blood must be for ALV :

A.

* SаО2<80%

B.

SаО2<85%

C.

SаО2<90%

D.

SаО2<95%

E.

SаО2<75%

170.

What should be used in case of ineffective breathing of patient in coma state?

A.

conicotomy

B.

* ALV

C.

infuse euphillin

D.

cardiac massage

E.

inject corticosteroids

171.

What should be used in case of ineffective breathing of patient in coma state?

A.

conicotomy

B.

* ALV

C.

infuse euphillin

D.

cardiac massage

E.

inject corticosteroids

172.

Which of the following is used to produce epidural analgesia-

A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

173.

Wide eye pupil and arterial pressure reduction is typical for

A.

Terminal coma

B.

Sopor

C.

Light coma

D.

* Deep coma

E.

Midle coma

174.

Coordination disorders are typical for:

A.

Terminal coma

B.

Stupor

C.

Sopor

D.

Deep coma

E.

* Light coma

175.

How much glucose does CNS consume daily on average?

A.

* 90 g

B.

42 g

C.

78g

D.

38 g

E.

105 g

176.

What concentration of glucose in minimally enough for providing normal brain activity?

A.

<1,8 mol/l

B.

<1,7 mol/l

C.

<1,5 mol/l

D.

* <1,2 mol/l

E.

<2,3 mol/l

177.

Normal intracranial pressure is:

A.

* 25-30 mm of mercury

B.

30-35 mm of mercury

C.

15-20 mm of mercury

D.

10-15 mm of mercury

E.

1-10 mm of mercury

178.

What is central perfusion pressure?

A.

Difference between average arterial and intracranial pressure.

B.

Hydrostatic pressure of liquor

C.

* Difference between hydrostatic and arterial pressure

D.

Difference between systolic and intracranial pressure

E.

Difference between diastolic and intracranial pressure

179.

The normal index of brain perfusion is:

A.

500-550 ml/min. (12% MHV)

B.

800-850 ml/min. (18% MHV)

C.

450-500 ml/min. (10% MHV)

D.

* 350-400 ml/min. (7% MHV)

E.

700-750 ml/min (15% MHV)

180.

Skin and mucous membranes hyperemia are characteristic symptoms of:

A.

Alcohol coma

B.

Cerebral stroke

C.

Hypoglycemic coma

D.


E.

Uremic coma

181.

Vomiting, muscular resistance of peritoneal wall are characteristic symptoms of:

A.

Cerebral stroke

B.

Alcohol coma

C.

Uremic coma

D.

Hypoglycemic coma

E.


182.

Grey color of the skin is characteristic symptom of:

A.

Cerebral stroke

B.

* Uremic coma

C.

Hypoglycemic coma

D.

Hyperglycemic coma

E.

Alcohol coma

183.

According to the Glasgow coma scale corresponds to :

A.

9-11 points

B.

6-8 points

C.

5-7 points

D.

12-14 points

E.

* 4-5 points

184.

Motor response in Glasgow coma scale is evaluated with

A.

2 grades

B.

4 grades

C.

* 6 grades

D.

1 grade

E.

3 grades

185.

Verbal response in Glasgow coma scale is evaluated with

A.

1 grade

B.

* 5 grades

C.

3 grades

D.

4 grades

E.

2 grades

186.

L ack of any motor response according to GCS corresponds to:

A.

0 points

B.

4 points

C.

2 points

D.

3 points

E.

* 1 point

187.

Motor response to pain according to GCS is evaluated with:

A.

1 grade

B.

* 6 grades

C.

4 grades

D.

3 grades

E.

2 grades

188.

Eyes opening to speech according to GCS is evaluated with :

A.

2 grades

B.

1 grade

C.

3 grades

D.

5 grades

E.

* 4 grads

189.

Brain death according to GCS corresponds to:

A.

15 points

B.

12-13 points

C.

3-5 points

D.

7-9 points

E.

* 3 points

190.

Normal condition of conscience according to GCS corresponds to:

A.

12-14 points

B.

* 15 points

C.

8-10 points

D.

4-5 points

E.

7-9 points

191.

Hyperreflexia and twitching are typical for :

A.

Brain injury coma

B.

Uremia coma

C.

Hypoglycemic coma

D.

Cerebral stroke

E.


192.

What concentration of alcohol is considered lethal?

A.

2,5-3 g/l

B.

* 1,5-2 g/l

C.

2-3 g/l

D.

0,5-1 g/l

E.

5-6 g/l

193.

What pСО2 level is possible for hyperventilation:

A.

45-55 . mm of mercury

B.


C.

20-25 mm of mercury

D.

40-45. mm of mercury

E.

30-35 mm of mercury

194.

What amount of total delivered to the organism oxygen brain is using?

A.

50%

B.

.15%

C.

.20%

D.

.10%

E.

*40%

195.

During systolic contraction intracranial pressure :

A.

Reduces 7 mm of mercury.

B.

B. reduces 6 mm of mercury.

C.

Increases 6 mm of mercury

D.

Increases 2mm of mercury

E.

* Reduces 2 mm of mercury

196.

Acute onset of inadequate behavior is a symptom of:

A.

Alcohol coma

B.

Hypoglicemic coma

C.


D.

Cerebral stroke

E.

Uremic coma

197.

Tonoclonic spasms are possible in case of:

A.

Uremc coma

B.

Hypoglicemic coma

C.

Hypercalcemic coma

D.

* Alcohol coma

E.

Cerebral stroke

198.

Edema is a characteristic symptom of :

A.

Hypoglicemic coma

B.

hyperglicemic coma

C.

* Uremic coma

D.

Alcohol coma

E.

Cerebral stroke

199.

Kussmaul's respiration is typical for:

A.


B.

hypocalcaemic coma

C.

Cerebral stroke

D.

Uremic coma

E.

Alcohol coma

200.

Ammonia breath is typical for:

A.

Cerebral stroke

B.

hypoglycemic coma

C.

hyperglycemic coma

D.

Alcohol coma

E.

* Uremic coma

201.

Cheyne-Stokes respiration is typical for:

A.

* Uremic coma

B.

Insult of brain

C.

Hyperglycemic coma

D.

Hypoglycemic coma

E.

Alcohol coma

202.

Areflexia is a symptom of:

A.

Cerebral stroke

B.

Alcohol coma

C.

Uremic coma

D.

* hyperglycemic ketoacidotic coma

E.

Hypoglycemic coma

203.

Pupil dilatation is typical for :

A.

Opiates intoxication

B.

Alcohol coma

C.


D.

Cerebral stroke

E.

Uremic coma

204.

Dry skin and mucous membranes are typical for:

A.

Hypoglycemic coma

B.

* Hyperglycemic ketoacidotic coma

C.

Alcohol coma

D.

Brain coma

E.

Hyperosmolar ketoacidotic coma

205.

Acetone smell from mouth is typical for:

A.

Ethanol intoxication

B.

Acetous essence intoxication

C.

Organophosphorous compounds intoxication

D.

* hyperglycemic ketoacidotic coma

E.

hypoglycemic coma

206.

Babinski's reflex is typical for:

A.

Essential hypertension

B.

*Organic brain damage

C.

Myocardial infarction

D.

Opiates intoxication

E.

Ischemic stroke

207.

What way does hypothalamic damage influence cardiovascular system?

A.

*Extrasystole, paroxismal tachycardia , acute hypotension

B.

Bradycardia , full atrioventricular block

C.

Asistole , arrhythmia

D.

Extrasystole , atrioventricular block, ventricular fibrillation

E.

Acute reduction of vascular tone, hypotension, bradycardia, cardiac arrest

208.

Narrow eye pupils (like poppy seeds) are typical for:

A.

. local cerebral injury

B.

. poisoning with antihistamines

C.

. poisoning with narcoleptics

D.

*poisoning with opiates

E.

Hypoxia

209.

Lack of photoreaction is typical for:

A.

middle coma

B.

light disorders of consciousness

C.

stupor

D.

sopor

E.

*deep coma

210.


A.

hypoglycemic coma

B.


C.


D.

broken neck

E.

uremic coma

211.

Head titled back is typical for:

A.

alcoholic coma

B.

hyperglycemic ketoacidic coma

C.

* meningitis, tetanus

D.

hypoglycemic coma

E.

cerebral coma

212.

What is typical for hypoglycemic coma?

A.


B.


C.

soft eyeballs

D.

critical hypotension

E.

*humid skin

213.

What is typical for hyperglycemic ketoacidotic coma?

A.

low CVP

B.

hyperhydration

C.

* metabolic acidosis

D.


E.

pale skin

214.

What is necessary for neurons activity?

A.

*not less than 20% of general oxygen for cerebral needs

B.


C.


D.

24-25% of general circulation volume should get into the cerebral vessels every minute

E.


215.

Changes of liver size are typical for:

A.

* hepatic coma

B.

uremic coma

C.

hypoglicemic coma

D.

cerebral coma

E.

hyperglycemic coma

216.


A.

cerebral coma

B.

hypoglicemic coma

C.

*uremic coma

D.

hyperglicemic ketoacidotic coma

E.

hepatic coma

217.

What should be used in case of ineffective breathing of patient with coma?

A.

steroids i/v

B.

heart massage

C.

euphillin i/v

D.

* ALV

E.

Conicotomy

218.

According to the Glasgow Coma Scale deep sopor corresponds to:

A.

*8-9 points

B.

3 points

C.

4-5 points

D.

13-14 points

E.

11-12 points

219.


A.

points

B.

4-5 points

C.

6-7 points

D.

8-10 points

E.

* 3 points

220.

According to the Glasgow Coma Scale sopor corresponds to:

A.

. 13-14 points

B.

.11-12 points

C.

* 8-10 points

D.

6-7 points

E.

4-5 points

221.

. According to the Glasgow Coma Scale light coma corresponds to:

A.

4-5 points

B.

3 points

C.

8-10 points

D.

* 6-7 points

E.

13-14 points

222.

According to the Glasgow Coma Scale pronunciation of inappropriate words correspondes to:

A.

. 2 points

B.

5 points

C.

. 1 point

D.

. *3 points

E.

4 points

223.

. According to the Glasgow Coma Scale lack of verbal response corresponds to:

A.

*1 point

B.

4 points

C.

3 points

D.

5 points

E.

2 points

224.

. According to the Glasgow Coma Scale confused verbal response (phrases) corresponds to:

A.

1 point

B.

2 points

C.

5 points

D.

3 points

E.

* 4 points

225.

. According to the Glasgow Coma Scale oriented verbal response corresponds to:

A.

4 points

B.

*5 points

C.

1 point

D.

3 points

E.

2 points

226.

According to the Glasgow Coma Scale localization of pain corresponds to:

A.

* 4 points

B.

.5 points

C.

3 points

D.

2 points

E.

1 point

227.

. According to the Glasgow Coma Scale lack of eyes opening corresponds to:

A.

3 points

B.

5 points

C.

. 4 points

D.

.*1 point

E.

2 points

228.

. According to the Glasgow Coma Scale pathological flexion of limbs corresponds to:

A.

2 points

B.

. 1 point

C.

. 5 points

D.

4 points

E.

. *3 points

229.

. According to the Glasgow Coma Scale obeying comands (motor response) corresponds to:

A.

* 6 points

B.

3 points

C.

4 points

D.

5 points

E.

2 points

230.

According to the Glasgow Coma Scale withdraws to pain corresponds to:

A.

2 points

B.

*4 points

C.

1 point

D.

3 points

E.

5 points

231.


A.

1 point

B.

0

C.

2 points

D.

.*3 points

E.

.4 points

232.


A.

0

B.

. 1 point

C.

2 points

D.

.*4 points

E.

3 points

233.


A.

8-9 points

B.

* 3 points

C.

11-12 points

D.

13-14 points

E.

4-5 points

234.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

235.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

236.

A peritoneal dialysis is not rotined at poisoning:

A.

* by an amitryptylin

B.

by dichloro-ethane, karbofos

C.

by a methyl alcohol

D.

by etaminal sodium

E.

by ethylene glycol

237.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

238.

A total blood flow in the kidney is

A.

10% of minute volume of heart

B.

* 20% of minute volume of heart

C.


D.


E.

all answers are correct

239.


A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

240.

All narcotic facilities:

A.

* repress urination

B.

does not influence on urination

C.

strengthen urination

D.


E.

all answers are not correct

241.

Among the complications that often arise during nefrectomia caused large tumors of the kidney of the least likely

A.

violation of venous return from the lower hollow veins anastalsis

B.

massive blood loss

C.

pneumothorax due to damage to the diaphragm when removing the tumor

D.

adrenal insufficiency due to damage or removal of adrenal gland

E.

* hypertensive crisis

242.

An ethyl spirit is used as an antidote at poisonings by:

A.

insulin

B.

amitryptylin

C.

FOS

D.

* ethylenglycol, methyl alcohol

E.

heavy metals

243.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

244.

An oliguria occurred in 62-year-old patient during the second days after the resection of bowel. What sign is it possible to suspect development of sharp tubulary necrosis ?

A.

sodium in urine 10 mmol/l

B.

specific gravity of urine 1024

C.

high leucocytosis

D.

* potassium in plasma 6.4 mmol/l

E.

correlation of kreatinine in urine/plasma more than 40

245.

An optimal dose of barbiturates for induction of anesthesia in patients with acute renal failure is

A.

* 4-6 mg/kg

B.

8-10 mg/kg

C.

12-13 mg/kg

D.

not used

E.


246.

Antibiotics: aminoglycosides, gentamicin, kefzol, cefaloridin

A.

* can cause toxic lesions of kidneys

B.

not lead to nephrotoxicity defeat

C.

can cause moderate toxic effect on kidneys

D.


E.


247.

Antibiotics: benzilpeni cyllinum, ampicillin, karbeni cyllinum:

A.

* have moderate cumulative effect, but the lack of nephrotoxicity effect

B.

does not have a cumulative and nephrotoxicity

C.

have a pronounced cumulative effect and nephrotoxicity

D.


E.


248.

Antibiotics: levomi citinum, oxacillinum, erythromycinum

A.

* largely derived by kidneys

B.

in an insignificant degree derived by kidneys

C.

not derived by kidneys

D.


E.


249.

Antibiotics: levomi citinum, oxacillinum, erythromycinum:

A.

have a cumulative effect and nephrotoxicity

B.

* have a cumulative action, but at an overdose does not give a nephrotoxicity

C.

does not own neither cumulative nor nephrotoxicity

D.


E.


250.

At a kidney ischemia:

A.

volume of urine rises

B.

sodium of urine rises

C.

kreatinine of urine rises

D.

kidney “cerebral” layer is struck more than crust

E.

* dobutaminum improves the formulation of urine

251.

At poisoning with unknown poison you should to inject as an antidote

A.

* nothing

B.

unithiol

C.

atropine

D.

unitiol, chromosmon, atropine

E.

correctly B and С

252.

At the blockade of parasympathetic structures it is necessary after operation (a patient does not feel the repletion of urinary bladder here):

A.

diathermy

B.

* anticholinesterasis remedies

C.

sympathomimetics

D.

correctly only B and C

E.


253.

Atropin is used as an antidote at poisoning by:

A.

insulin

B.

amitryptylin

C.

* FOS

D.

ethyleneglycol, methyl alcohol

E.

heavy metals

254.

Autoregulation renal blood flow is stopped while lowering blood pressure systole:

A.

to 100 mm Hg

B.

to 80-90 mm Hg

C.

* to 60-70 mm Hg

D.

to 40-50 mm Hg

E.

to 30-20 mm Hg

255.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

256.


A.


B.


C.

Both

D.

D.None

E.


257.


A.

* 2

B.

3

C.

4

D.

6

E.

10

258.


A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

259.


A.


B.


C.


D.


E.

All of the above

260.

Contra-indication to the leadthrough of the forced diuresis is:

A.

* exotoxic shock

B.

hemolysis

C.

comatose state

D.

contra-indications are not

E.

correctly B and С

261.

Contraindications to one-stage adenomectomia can be considered:

A.

compensated stage of chronic renal insufficiency

B.

compensated diabetes

C.

bronchial asthma

D.

residual hemiplehia after encephalorrhagia

E.

* over 2 months ago myocardial infarction

262.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

263.

Depolarizing muscular relaxants permitted in patients with renal insufficiency in short transactions, during which the total dose of it

A.

* must not exceed 500 milligrams

B.

must not exceed 1000 milligrams

C.

a total dose does not influence on duration of neuromuscular block

D.


E.


264.

Dipiridoxin is used as an antidote at poisonings by:

A.

insulin

B.

amitryptylin

C.

* FOS

D.


E.

heavy metals

265.

Duration of phase of resorption at poisoning by nonorganic acids is:

A.

* 1-3 hours

B.

3-6 hours

C.

6-12 hours

D.

12-24 hours

E.

10-12 hours

266.

Duration of phase of resorption at poisoning by organic acids is:

A.

1-3 hours

B.

* 3-6 hours

C.

6-12 hours

D.

12-24 hours

E.

10-12 hours

267.

During epidural analgesia the following points suggests that needle is in the extradural space –

A.

Loss of resistance sign

B.

Negative pressure sign

C.

Mackintosh extradural space indicator

D.

* All of the above

E.

Only A and C is true

268.

During operations on the suprakidney adrenal gland the most efficient method of anesthesia is:

A.

* intratracheal anesthesia

B.

the combined intratracheal anesthesia with epidural anesthesia

C.

spinal anaesthesia

D.


E.


269.

Endogenous water that formed as a result of oxidative processes in the body is

A.

100 ml per day

B.

* 200 ml

C.

500 ml

D.

700 ml

E.

1000 ml

270.


A.


B.


C.


D.


E.


271.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

272.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

273.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

274.


A.


B.


C.


D.

Sensory fibres

E.


275.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

276.

Following right about chronic pyelonephritis:

A.

* speed-up urinations and disuriya - the most frequent symptoms

B.

massive proteinuria

C.

pirexia rare

D.

very rarely is reason of death as a result of kidney insufficiency

E.

contra-indication is to transplantation of bud

277.


A.


B.


C.


D.


E.


278.

For the determination of the state of glomerular filtration at acute renal failure in the stage of oliguria was performed test with a manitol in a 30-40% solution of glucose intravenously in dose 1-1.5 g/kg. If in 1-1.5 hours a diuresis will make less than 40 ml/hour :

A.

* subsequent introduction of manitol is not rotined

B.

dose is increased

C.

dose is repeated

D.


E.


279.

For transcutaneous puncture (nefroureterolytotomia the optimum variant of anaesthesia is:

A.

toponarcosis

B.

* epidural anaesthesia

C.

toponarcosis + sedative + narcotic preparations

D.

ketamine intravenously and intramuscular

E.

intratracheal method of SVL and intravenous anesthesia

280.

Forced diuresis, as a method of detoxication, rotined at poisoning:

A.

by a phenobarbital

B.

by an ethanol

C.

by a karbofos

D.

all answers are faithful

E.

* right only A and B

281.

Furosemide in the phase of renal damage in acute renal failure (ARF) apply:

A.

at a negative test with a manitol

B.

during an overhydratation

C.

at an interstitial pulmonary edema

D.

* at all of the above

E.


282.

Gematuria does not develop at:

A.

cystitis

B.

hypernephroma

C.

* prolapsus of kidney

D.

tuberculosis

E.

glomerulonephritis

283.

Glyukagon is used as an antidote at poisonings by:

A.

* insulin

B.

amitryptylin

C.

FOS

D.


E.

heavy metals, aniline

284.

Hemodialysis is not rotined at poisoning:

A.

* by an amitryptylin, aminazyn

B.

by a phenobarbital

C.

by ethylene glycol

D.

by a mercury, heavy metal compounds

E.

by a methyl alcohol

285.

If you should use antibiotics at kidney insufficiency, which eliminate not through kidneys and low-toxic at exceeding of therapeutic concentration in blood. These antibiotics are:

A.

* penicillin

B.

aminoglycosides

C.

cephalosporins

D.


E.

all answers are wrong

286.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

287.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

288.

In oligoanuric stage of acute renal failure develops

A.

metabolic alkalosis

B.


C.

mixed acidosis

D.

mixed alkalosis

E.


289.

In oligoanuric stage of acute renal failure penicillin group of antibiotics due to

A.

to their nephrotoxicity

B.

high degree of cumulation

C.

* high maintenance to potassium in plasma of patient

D.

correctly A and B

E.


290.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

291.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

292.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

293.

In the case of hypertrophy of prostate:

A.

difficulty of beginning of urination

B.

an increase of frequency of urination is a late symptom

C.

* a chronic delay does not need rapid decompression

D.

exkrectory pyelogram must be conducted at kidney insufficiency

E.

an episode of sharp delay is a testimony for planned prostatectomia

294.

In the case of long and traumatic operations (vascular operation, kidney autotransplant, plastic ureteral, bladder exterpation) the most rational use:

A.

* the combined intratracheal anesthesia with epidural anaesthesia

B.

spinal anaesthesia

C.

epidural anaesthesia

D.


E.


295.

In the case of performing of operation on perineum it would be batter use:

A.

* epidural and spinal anesthesia

B.

intravenous anesthesia is with the spontaneous breathing

C.

toponarcosis

D.


E.


296.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

297.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

298.

Indications for dialysis for patient with anuria and acute renal failure are all listed, except:

A.

hyperpotassemia

B.

hypernitrogenmia

C.

expressed overhydratation

D.

metabolic acidosis

E.

* expressed anemia

299.

Intraoperational oliguria is caused by:

A.

* the release of ADG

B.

the stimulation of release of aldosterone

C.

the effect of histamine

D.

specific effect to anesthesia on kidney channels

E.

hyperglycemias

300.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

301.


A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

302.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


303.


A.


B.


C.


D.


E.


304.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

305.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

306.

Maximum dose of Xylocaine for local anaesthesia -

A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

307.

Methylene blue is applied as an antidote at poisonings by:

A.

insulin

B.

amitryptylin

C.

FOS, heavy metals

D.


E.

* aniline

308.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

309.

Normalisation of kidney blood stream at prerenal (functional) oliguria is pathogenetically implemented:

A.

by injection of saluretics

B.

by injection of osmodiuretics

C.

* by normalisation of the system of hemodynamics, introduction of dobutaminum or dopaminium in “kidney” doses

D.

right A and in C

E.

right B and D

310.

Operation of detoxic hemosorbtion is not rotined at poisoning:

A.

by an amitryptylin

B.

by amital sodium, phenobarbital

C.

by dichloro-ethane, karbofos

D.

* by a methyl alcohol

E.

correctly B and С

311.

Osmotic diurethics (manitol, glucitol) operate at level:

A.

cerebral part of ascending knee of kidney loop

B.

* proximal channel and kidney loop

C.

distal channel

D.

correctly and

E.

correctly and

312.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

313.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

314.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


315.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

316.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

317.

Preparations of choice in the treatment of heart failure caused by hyperpotassemia after kidney transplantation is considered

A.

strophanthin

B.

digoxin

C.

* digitoxin

D.

gangliothics

E.


318.

Preparations of potassium-preserve action (veroshpiron, spironolakton, triamteren) operate at level:

A.

* distal part of channels

B.

proximal parts of channels and kidney loop

C.

loops of Genle

D.

correctly A and B

E.


319.

Prerenal insufficiency in the early stage is characterize by:

A.

oliguria

B.

specific density of urine higher 1020

C.

* concentration of sodium is in urine of less than 15 mekv/l

D.

increase of kreatinine in plasma

E.

рН urines is less than 4.0

320.

Proper therapy of bleeding which proceeds, after the transurethral resection of prostate caused by carcinoma includes:

A.

fibrinogen

B.

concentrate of platelets

C.

blood

D.


E.

* all answers are not faithful

321.

Prozerin, ezerin is used as antidotes at poisonings by:

A.

insulin

B.

* amitryptylin

C.

FOS

D.


E.

heavy metals

322.

Raising activity of transaminases should be viewed as contra-kidney transplantation, if a level is:

A.

less than 50 ME

B.

less than 100 ME

C.

* more than 100 ME

D.

more than 250 ME

E.


323.

Reasons of nephrotoxic form of acute renal failure are all listed, except:

A.

poisoning of heavy metals connections

B.

organic solvents (ethylene glycol, carbon tetrachlorid)

C.

sulfanilamidums

D.

* anaphylactic shock

E.


324.

Saluretics (furosemide, ethacrynic acid) operate at level:

A.

* cerebellar part of ascending knee of kidney loop

B.

crust part of ascending knee of kidney loop

C.

proximal parts of channels

D.

distal part of channels

E.

correctly C and D

325.

Sharp glomerulonephritis is not characterize by

A.

oliguria

B.

hypertension

C.

perorbital edema

D.

* early beginning of edemas

E.

gematuria

326.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

327.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

328.


A.


B.


C.


D.

* All of above

E.


329.

Subarachnoid block as anesthesia is contraindicated in-

A.

Ischemic heart disease

B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

330.

System tolerance to glucose is often observed at the terminal stage of chronic kidney insufficiency conduces to development of uremic pseudodiabetes due to:

A.

deficit of insulin

B.

* a decline of utilisation of glucose is on a background sufficient high maintenance of insulin

C.

decline of sensitiveness of cages is to exogenous and endogenous insulin

D.

correctly A and B

E.

correctly B and C

331.

Tactics infusion therapy during anesthesia in kidney transplantation include kidney blood flow in

A.

* consists in strict limitation of volume of infusion environments

B.

varies in wide limits

C.

varies depending on the function of transplant

D.


E.


332.

The clinical situation of heart failure after kidney transplantation are often similar to hypokinetic forms

A.

hypovolemic form

B.

* hyperkinetic form

C.

hypovolemic forms

D.


E.

all answers are incorrect

333.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

334.

The early sign of kidney insufficiency is:

A.

the presence of leukocytes in urine

B.

lowering in blood of nitrogen of urea

C.

* low specific gravity of urine

D.

the presence of erythrocytes in urine

E.

the presence of protein in urine

335.


A.


B.


C.


D.


E.

* All of the above

336.


A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

337.

The methods of anesthesia, which are used for patients with acute renal failure, include:

A.

regional anesthesia (blockades)

B.

infusion of diprivanum (propofol)

C.

spinal anesthesia

D.

myoneural blockade with infusion of atrakurium

E.

* all answers are faithful

338.

The most common method of anesthesia when planned adenomectomia is

A.

intravenous anesthesia

B.

combined endotracheal anesthesia

C.

epidural anesthesia

D.

spinal anesthesia

E.

* right C and D

339.

The most effective way to remove water in patients with acute renal failure in anuria stage include:

A.

diarrhea

B.

stimulation sweating

C.

flushing the stomach

D.

peritoneal dialysis

E.

* ultrahemofiltration

340.

The most reliable finds at chronic kidney insufficiency are:

A.

increase of hematocrit

B.

* increasing of creatinine

C.

increase of ammonia in blood

D.

metabolic acidosis

E.

decline of level of phosphate in plasma

341.

The most reliable method of withdrawal of patients from anesthesia in renal insufficiency in terms of residual curaresation after applying any relaxant is:

A.

decuraresation

B.

introduction of central analeptics

C.

* continued artificial ventilation of lungs

D.


E.


342.

The normal size of kidney blood stream averages for the adult:

A.

1600 ml/min

B.

* 1100 ml/min

C.

800 ml/min

D.

600 ml/min

E.

400 ml/min

343.

The patient with acute renal insufficiency under anuria has anesthetic problems listed below, except:

A.

violation of kidney function

B.

* comatose state

C.

violation of electrolyte exchange

D.

violation of acid balance (metabolic acidosis)

E.

violation of erytropoethis (anemia)

344.

The simplified method of determination of speed of glomerular filtration is taken to determination of concentration:

A.

* to the creatinine in plasma

B.

urea

C.

remaining nitrogen in blood

D.


E.

no right answer

345.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

346.

To calculate the allowable amount of hydration in oligoanuric phase of acute renal failure guided by the formula

A.

daily diuresis + 200 ml of fluid

B.

* daily diuresis + 400 ml of liquid

C.

daily diuresis + 600 ml of liquid

D.


E.


347.

To ensure the transport of oxygen to the tissue concentration of hemoglobin in the postoperative period should not be below:

A.

60 g/l

B.

* 80 g/l

C.

100 g/l

D.

120 g/l

E.

140 g/l

348.

To the complications of transurethral resection of prostate belong

A.

disorientation

B.

edema lights

C.

nausea

D.

hyposodiummia

E.

* all of the above

349.

Transport of oxygen to tissues in patients in terminal stage of chronic renal failure with anemia is provided by

A.

increase of minute volume of heart

B.

decline of cognation of oxygen is to haemoglobin

C.

general peripheral high-resistance

D.

* correctly A and B

E.


350.

Unithiol is used as an antidote at poisonings by:

A.

insulin

B.

amitryptylin

C.

FOS

D.


E.

* heavy metals

351.

Using drugs to neuroleptanalgesia in patients in stage oligoanuric acute renal failure is accompanied by all the following effects except:

A.

CNS depression and slowed exit from anesthesia

B.

relative stability of hemodynamics

C.

danger of postural reactions

D.

reduction of peripheral vascular tone

E.

* induced hyperthermia, hypermetabolism

352.

Using of epidural anesthesia during prostatectomia:

A.

an adequate method is for prevention of blood loss

B.

* possibly for patients older 65 years

C.

rarely causes a hypotension

D.

contra-indicated, if a patient takes an aspirin during the transient attacks of ischemia

E.

contra-indicated for patients with high blood pressure

353.

Very reliable reasons of diffuse abdominal pains which are accompanied by shock during the transurethral resection of prostate under spinal anesthesia include:

A.

intravascular haemolysis

B.

* extravasation of liquid

C.

dissaminated intravascular rolling up

D.

myocardial infarction

E.

pulmonary embolism

354.

Violation of hemodynamics at exotoxic shock at poisoning an acetic acid is characterized by:

A.

declining impact of heart, OTSK and TSVD

B.

high total peripheral vascular resistance

C.

low total peripheral vascular resistance

D.

* right A and B

E.

right A and С

355.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

356.

At operations on the external genital organs and the bladder (epicystotomia, cystolitomia) we use:

A.

* intravenous narcosis or epidural anesthesia

B.

intratracheal anesthesia

C.

spinal anaesthesia

D.

faithful only A and B

E.


357.

When poisoning poisons burning action flushing the stomach through a probe held in terms:

A.

* to 12 hour

B.

from 13 to 24 hours

C.

on 2nd day

D.

on 3rd day

E.

during the first 5 days

358.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

359.

Which of the following substances appropriate to conduct the blood transfusion when poisoning?

A.

aniline

B.

arsenic hydrogen

C.

vinegar essence with high hemolysis

D.

* faithful only A and B

E.

faithful only B and С

360.

With hyperpotassemia appropriate use for induction of anesthesia in patients with acute renal failure:

A.

kalipsol + seduxen

B.

diprivan + fentanyl

C.

N2О + ftorotan

D.


E.

* right A and B

361.

With increasing tone of the vegetatic nervous system it is better to use after operation (patients feel the repletion of urinary bladder):

A.

* sympatholythics

B.

anticholinesterases facilities

C.

warmly

D.

correctly only A and B

E.


362.

You should perform hemotransfusions for patients in terminal stage of chronic renal failure if content of haemoglobin is:

A.

* not below after 80 g/l

B.

not below after 90 g/l

C.


D.


E.


363.

Acute respiratory insufficiency of restrictive type develops as a result of:

A.

All answers are correct

B.

Thoracic injuries

C.

Diffusion disorders at the level of blood-air barrier

D.

Obstructions of respiratory tracts

E.

* Limitation of lungs respiratory surface

364.

Simultaneous reduction of partial pressure of oxygen and carbon dioxide in the arterial blood is possible in case of:

A.


B.

All answers are wrong

C.

* violation of ventilation-perfusion correlation

D.

apnoea

E.

Decrease of respiratory volume

365.

Choose the apnoea treatment method in case of central nervous system depression:

A.


B.


C.

* Artificial lung ventilation

D.

Intravenous introduction of sodium bicarbonate

E.

Intravenous introduction of adrenaline

366.

Hyperbaric oxygenation :

A.

* All answers are correct

B.

all answers are wrong.

C.

Increases partial pressure of oxygen in the arterial blood

D.

is an instrument of increasing oxygen solubility in liquid part of blood

E.

Increases level of hemoglobin in the blood

367.

What symptom is connected with hypercapnia:

A.


B.

There is no right answer.

C.

*skin hyperemia

D.

skin pallor

E.

skin cyanosis

368.

What rate of partial oxygen pressure in arterial blood is an indication artificial lung ventilation:

A.


B.

* 60 and less mm of mercury under inhalation of 100% oxygen

C.

60 - 70 mm mm of mercury

D.

70 - 80 mm mm of mercury

E.

80 - 90 mm mm. of mercury

369.

What is indicated in case of hypercapnia?

A.


B.

* Artificial lungs ventilation

C.

Mask ventilation

D.

Administration of sodium bicarbonate

E.

Insertion of sedative facilities

370.

Diffusion of what gas will diminish as a result of alveolar-capillary membrane compression in a greater degree:

A.


B.

The compression of membrane will not influence gas diffusion

C.

Diffusion of oxygen and carbon dioxide will diminish in equal degree

D.

Carbon dioxide

E.

* Oxygen

371.

What is the normal rate of oxygen partial pressure in the arterial blood?

A.

A.


B.

B.All answers are correct

C.

C.

110-130 mm of mercury

D.

D.

60 - 70 mm of mercury

E.


372.

Which statement is correct?

A.


B.


C.

Hypoxemia and hypercapnia are obligatory signs of acute respiratory failure

D.

Hypoxemia is a permanent syndrome in case of acute respiratory failure

E.

* Hypoxemia is a permanent syndrome in case of acute respiratory failure

373.

The thoracic-abdominal form of acute respiratory failure occurs in case of:

A.


B.

Bad ventilation of respiratory tracts

C.

Atelectasis

D.

Enteroparesis

E.

* Multiple rib fractures

374.

Neuromuscular acute respiratory failure is observed in case of:

A.


B.

* Poliomyelitis, botulism

C.

Foreign body

D.

Depression of respiratory center

E.

Micro atelectasis

375.

The obstructive form of acute respiratory failure occurs in case of:

A.


B.


C.

Disorder of neurosynaptic connection.

D.

* Disorder of airways potency

E.

Micro atelectasis

376.

Ventilation with 100% oxygen for a long time can cause:

A.


B.

*Micro atelectasis

C.

Hypoventilation of patients with hypoxic type of disorder

D.

Drying of respiratory tracts

E.

Does not have any harmful influence

377.

What symptoms are typical for acute respiratory failure?

A.

decrease of oxygen partial tension in the arterial blood

B.

cyanosis, acrocyanosis

C.

tachycardia, and then bradycardia

D.

rise, and then decline of arterial pressure

E.

* tachypnea, pathological rhythms of breathing (Cheyn-Stokse, Kussmaul, Biot).

378.

What are the methods of hypertension prophylactic during intubation?

A.


B.

correct answers A. and B.

C.

slow introduction of ketamin, which provides circulation stability

D.

intravenous introduction of lidocain during induction

E.

* usage of hypotensive drugs (per os) in premedication

379.

Traheostomy (choose the correct statement)

A.

must be executed with premedication consisting of sedative medicines and remedies for salivation depression

B.

removes the necessity of gases humidifying

C.

pressure in the cuff of tube must be more than 20

D.

tubes should be changed every day

E.

* can be performed with local anesthesia

380.

Surgical traheostomy (choose the correct statement)

A.

* all answers are correct

B.

correct B. and C.

C.

should be performed after cerebral stroke (brainstem)

D.

should be done for sanation of respiratory tracts

E.

usually done between 1st and 3d rings of trachea

381.

What does belong to the defects of high-frequency ventilation (in comparing with traditional artificial lung ventilation ) belong?

A.


B.

right A. and B.

C.

inadequate ventilation in the case of untight respiratory tracts (for example, at a bronchoplevral fistula)

D.

considerable change of respiratory volume

E.

promotion of middle pressure in the respiratory tracts

382.

High-frequency ventilation (choose the correct answer)

A.


B.

all answers are correct.

C.

to achieve normocapnia high-frequency ventilation requires respiratory volume about 5 ml/kg

D.

high-frequency respirators is a routine method of ventilation

E.

*in case of high-frequency ventilation exhalation is passive

383.

What is the reason of considerable blood saturation decline in case of one side pleura damage?

A.

pathological reflexes from the wound

B.

* bloodshunting in collapsed lung

C.

influence of anesthetic

D.

decline of partial oxygen pressure in the inhaled air

E.

forced position of the patient

384.

Patient has multiple ribs fractures and acute respiratory failure. After trachea intubation and beginning of artificial lung ventilation the increase of cyanosis and hypotension are marked. The most probable reason is:

A.

lungs injury

B.

aspiration of gastric contents

C.

* tension pneumothorax

D.

esophagus intubation

E.

thoracic aorta rupture

385.

A patient after severe car crash delivered to the ICU. He has the shallow breathing, paradoxal chest movements, thoracic deformation, pain during inhalation, pallor skin, low blood pressure. The most probable diagnosis is:

A.


B.

injuries of abdominal cavity organs

C.

hemopericardium

D.

traumatic break of main bronchus

E.

* hemothora x , multiple ribs fractures

386.

In case of severe chest trauma respiratory exchange is violated by all those reasons, except for one:

A.

*central respiratory regulation disorder

B.

fat embolism lungs vessels

C.

violation of thoracic framework

D.

violations of airway potency

E.

disorders of microcirculation

387.

The paradoxical respiration is most often observed in case of:

A.

artificial lung ventilation

B.

pneumonia

C.

* pneumothorax

D.

lungs emphysema

E.

laryngospasm

388.

The risk of aspiration pneumonia grows in case of gastric contents aspiration according to the following pH level:

A.

pH= 0.

B.

pH = 7.5 and anymore

C.

* pH less than 2.5

D.

pH more than 5

E.

pH = 7.4

389.

What are the symptoms of

"syncopal drowning"?

A.


B.

correct A. and B.

C.

color of skin is not

cyanotic

D.

cardiac arrest goes first

E.

mostly happens in case of females and patients with coronary insufficiency

390.

Oxygenation at patients with the chronic unspecific disease of lungs can cause:

A.

D and E correct

B.

Correct C and D

C.

hyp o capnia

D.

D.* bradypnoe and hypoventilation

E.

increase of breathing rate

391.

A 20-years-old patient has acute chest pain after the attack of cough; he has shallow short breathing and during auscultation over right lung there are no respiratory murmur and percussion gives - high tympanites. What does the patient need?

A.

aspiration of mucous from right main bronchus

B.

trachea intubation

C.

* pleural cavity draining

D.

breathing with positive pressure and 100% O2 inhalation

E.

tracheostomy

392.

A p atient with prolonged asthma attack gasometry shows such indexes: pH - 7.2;

BE - -8; pCO2 - 75 mm of mercury; pO2 - 50 mm of mercury. What does he need?

A.


B.

*all answers are correct

C.

HBO treatment

D.

beta blockers

E.

intravenous introduction of 0.5 ml adrenalin solution and large doses of steroids, urgent beginning of artificial lung ventilation

393.

What is an indication for ALV in case of a patient with status asthmaticus?

A.

correct D. and C.

B.

only A. and C.

C.

* the decline PaO2 less than 60 is mm of mercury

D.

lowering of partial CO2pressure

E.

obstruction of bronchial tubes and appearance of mute areas during auscultation

394.

The spasm of bronchioles during anesthesia turns out as:

A.

* short inhalation and prolonged exhalation

B.

weak inhalation and the long exhalation

C.

prolonged inhalation and prolonged forced exhalation

D.

prolonged inhalation

E.

prolonged forced exhalation

395.

B ronchial asthma attack is accompanied with:

A.

correct only C and E.

B.


C.

increased exhalation resistance

D.

increased remaining volume

E.

reduction of volume and speed of the forced exhalation

396.

A patient has bilateral pneumonia. His consciousness is confused, temperature is

39.2°C, respiratory rate is 50 per min; auscultation shows bilaterally diminished breath sounds; pulse is 125 per minute, AP - 90/60 mm of mercury; gasometry results are next: pH-7.24; BE- -10; pCO2 - 66 mm of mercury, pO2 - 55 mm of mercury. What will be the most effective method of acute respiratory failure treatment in this case?

A.

correct D and C.

B.

* correct A. and B.

C.

micro traheostomia

D.

intubation and AVL

E.

advanced antibiotics therapy

397.

What is not prescribed in case of acute respiratory failure caused by massive pneumonia?

A.

* A. sessions of HBO

B.

micro traheostomia with introduction of mucolytic enzymes and aerosol therapy

C.

ALV

D.

cardiac glycosides, antibiotics, bronchial spasmolytics

E.

artificial lung ventilation, oxygen therapy

398.

Here is the gasometry of a patient with massive pneumonia: pH-7.2, BE-0;pCO2-

70 mm of mercury; pO2-55 mm of mercury. How would you evaluate his condition?

A.

normal results

B.

metabolic alkalosis

C.

metabolic acidosis

D.

* respiratory acidosis

E.


399.

Urgent intensive care steps of pulmonary edema treatment include:

A.


B.

all answers correct

C.

intubation of trachea, artificial lung ventilation

D.

* oxygen therapy

E.

intravenous introduction of respiratory analeptic

400.

Why is spontaneous ventilation with PEEP useful in case of patients with acute respiratory failure caused by massive pneumonia?

A.

correct only A. and B.

B.


C.

ventilation diminishes a veinous shunting in lungs

D.

makes natural drainingof respiratory tracts easier

E.

it’s an instrument which helps to increase the respiratory surface of lungs

401.

What will help to increase the oncotic blood

pressure during treatment of pulmonary edema?

A.


B.


C.

infusion of crystalloids

D.

stimulation of diuresis by osmotic diuretics

E.

* stimulation of diure sis

by diuretics

402.

What is not an indication for ALV of a patient with acute respiratory failure?

A.

* pvO2 more than 50 mm of mercury

B.

breathing rate more than 40 per minute

C.

decline of AT below 90 mm of mercury, tachycardia more than 120 per minute

D.

pO2 below 60 mm of mercury, pCO2 higher 60 mm of mercury

E.

hypoxemic coma

403.

What is happening during pulmonary edema?

A.

correct only B. and C.

B.

correct only A. and C.

C.

increasing of vascular wall permeability

D.

decompression of greater

circulation vessels

E.

* disorders of air ventilation

404.

Positive pressure at the end of exhalation (PEEP) diminishes

A.

pulmonary capillary wedge pressure

B.

* intracranial pressure

C.

functional remaining capacity

D.

PaCO2

E.

intrathoracic volume of blood

405.

Reduction of cardiac output during ventilation with PEEP is caused through:

A.

correct B. and C.

B.

correct A. and C.

C.

delay of carbonic acid

D.

reduction of heart rate

E.

* increase of right ventricle afterload

406.

What are the complication of a ventilation with positive pressure?

A.


B.

*all answers are correct

C.

pneumothorax

D.

pneumoperitoneum

E.

emphysema, pulmonary interstitial emphysema and emphysema of mediastinum

407.

What statements are true about bronchial asthma?

A.

all answers correct

B.


C.

mechanical ventilation can be used for providing night rest of patients with asthma

D.

steroids must be included into treatment of severe asthma

E.

prognosis of disease depends on age of the asthma onset

408.

The alveolar hypoventilation often develops in case of:

A.


B.


C.

metabolic alkalosis

D.

emphysema and asthma

E.

raised intra-abdominal pressure

409.

What would be like gasometry of a 63-year old patient with chronic bronchitis exacerbation?

A.

all answers correct

B.


C.

pH-7.58, standard bicarbonat 18 mmol/l

D.

PaO2 -10.4 cPa(78 mm of mercury)

E.

PaO2- 5.6 cPa(42 mm of mercury)

410.

What is the reason which declines diffusive possibility of lungs?

A.


B.

correct only A. and C.

C.

hepatitis

D.

polycythemia

E.

*emphysema

411.

What are the indications for ALV of a patient with a syndrome of Guillain-Barre?

A.


B.


C.

loss of reflexes

D.

* general pulmonary capacity less than

2

litres

E.

the forced vital capacity less than 15 ml/kg

412.

Development of spontaneous pneumothorax is related with:

A.


B.


C.

arthritis

D.

* asthma

E.

MI

413.

Late complication of prolongated intubation is:

A.

dysphagia

B.

*bronchoplevral fistula

C.

damage of nervus laryngeus reccurens

D.

trachea stenosis

E.

granulomatosis

414.

What are the adventages of controlled ALV in case of mobile chest and multiple rib fractures?

A.


B.

acceleration of fractures consolidation

C.

prevention of pneumothorax

D.

elimination of pulmonary infection

E.

*decline of paradoxical ventilation and possibility of PEEP usage

415.

Choose true statements about pulmonary embolism:

A.

correct A. and B.

B.

correct B. and C.

C.

there is a possibility of icterus development

D.

*there are characteristic ECG signs

E.

level of LDG is normal

416.

What are clinical symptoms of chronic bronchitis complicated with acute respiratory failure?

A.


B.

edema optical nerve disk

C.

muscular twitches

D.

cold limbs

E.

* pulse of the promoted filling

417.

Accidental surgical pneumothorax is probable during

A.


B.


C.

thyroidectomia and traheostomia

D.

neck sympathectomy

E.

catheterisation of v. subclavia

418.

What would be the result of PEEP 10 mbar ventilation of a patient with lobar pneumonia?

A.

increase of physiological dead space

B.

reduction of functional remaining capacity

C.

system hypertension

D.

* increasing of PaCO2

E.

decline of PaO2

419.

The increase of PaCO2 can be expected in case of:

A.


B.

diabetic coma

C.

kidney insufficiency

D.

moderately severe asthma attack

E.

* massive pulmonary embolism

420.

In case of severe pneumonia caused by gastric contents aspiration what index will not grow?

A.

interstitial water in lungs

B.

* compliance of lungs

C.

pressure in the pulmonary artery

D.

V/Q correlation

E.

resistance of airways

421.

In case of acute respiratory distress syndrome of adults:

A.

* pulmonary arterial pressure decreases

B.

kidney insufficiency might be a reason

C.

hypoxemia is an answer to the rise of FiO2

D.

a functional remaining capacity is promoted

E.

general pulmonary water is diminished

422.

In case of acute respiratory distress syndrome of adults takes place:

A.

decline of airways resistance

B.

rise lungs compliance

C.

*decline of pulmonary surfactant a ctivity

D.

decline alveolar - arterial pO2 gradient

E.

rise of alveolar ventilation

423.

What are the receptors responsible for stimulation of the respiratory center in hypoxemia?

A.

* The respiratory center is not a reflex stimulated carotid chemoreceptors

B.

The oxygen tension in arterial blood is reduced to 60 mm Hg

C.

A person inhales a gas mixture with 15% of oxygen

D.

The man rises to a height of 4000 m

E.

Patient anemic

424.

Child's sharply breathing can be caused by the following factors exept:

A.

Epiglotitis

B.

foreign body of larynx

C.

stenosing laryngotracheitis

D.

* Acute bronhiolospasm

E.

Submucose edema

425.

Kussmaul breathing :

A.

Occurs when renal excretory alkalose

B.

Is the respiratory compensation of diabetic ketoacidosis

C.

* Often observed at coma

D.

It is a characteristic feature of hyperosmolar diabetic coma

E.

Reduces alveolar ventilation

426.

Possible iatrogenic causes of acute respiratory distress syndrome may be the following factors exept:

A.

artificial ventilation, the concentration of oxygen in the inspired gas is not higher than 40%

B.

artificial ventilation with oxygen concentration in the inspired gas is not higher than 70%

C.

Transfusion of blood incompatible

D.

Operations using the heart-lung machine

E.

* Severe hypovolemic shock

427.

Synchronous intermittent mandatory ventilation (SIMV) compared with controlled ventilation:

A.

Reduces blood pressure and cardiac output

B.

Reduces the work of respiratory muscles

C.

Reduces the energy cost of breathing

D.

* Allows you to reduce the pressure on the height of inspiration

E.

Lowers pH and raises the pCO2

428.

The patient during intubation anesthesia using mechanical ventilation suddenly emerged cyanosis on the background of normal hemodynamic indexes. Ungual phalanges cyanosis not decrease. All is the proper, exept:

A.

Check tightness of breathing system

B.

Remove the flow of nitrous oxide (if applicable)

C.

Increase the supply of oxygen

D.

Check patency and position of endotracheal tube

E.

* Change absorber of carbon dioxide

429.

The rapid drop of carbon dioxide tension in arterial blood from a high level to normal can lead to:

A.

Arterial hypertension

B.

* Arrhythmias

C.

Cephaledema

D.

Increase in coronary perfusion

E.

None of the above

430.

After 20 minutes of ventilation with pure oxygen arterial pO2 of patient was 60 mm Hg . What is the mechanism of respiratory disorders?

A.

alveolar hypoventilation

B.

Violation of diffusion through the alveolar-capillary membrane

C.

Violation of ventilation-perfusion ratios in lungs

D.

Intrapulmonary shunting up to 10%

E.

* Toxicity of oxygen

431.

After a 2-sided carotid endarterectomy in a patient:

A.

changes of the regulation of respiration

B.

No reaction of pCO2

C.

There is a shortness of breath in response to hypoxemia

D.

* The main impetus of the respiratory center is to increase the pH and pCO2 intracerebral interstitial fluid

E.

None of the above

432.

Airway resistance during turbulent flow of gas depends on the following factors exept:

A.

pipe radius

B.

gas viscosity

C.

The gas density

D.

Bit stream

E.

* Lung compliance

433.

All statements about spontaneous pneumothorax are true, exept:

A.

The most common among men 20-40 years

B.

* the trachea is mooving in the patient side

C.

Increased risk for women during menstruation

D.

Increased risk in smokers

E.

There are people with a genetic predisposition

434.

Alveolar hypoventilation leads to everything, exept:

A.

hypoxemia during air breathing

B.

* hypoxemia while breathing oxygen

C.

hypercapnia when breathing air

D.

Hypercapnia during oxygen breathing

E.

Anything with the above listed

435.

Anatomical dead space is increased by the action of the following factors exept:

A.

* pleurorrhea

B.

Atropine

C.

Inhalation of phtorotan

D.

Introduction aminophylline

E.

None of the above

436.

At the function cilliaris apparatus of the lower respiratory tract adversely affect the following factors exept:

A.

incense

B.

dehydration

C.

Hyperhydration

D.

Atropinisation

E.

* Introduction glucocorticoids

437.

Before all chemical substances, the most powerful regulator of alveolar ventilation in normal conditions is:

A.

Oxygen

B.

* Carbon dioxide

C.

Hydrogen ions

D.

Lactic acid

E.

Nitrogen

438.

Breathing of Biott is characterized by:

A.

Short and long breath exhalation

B.

Duration of breath and short breath

C.

* A frequent deep breathing, alternating with breathing pauses

D.

Smoothly varying amplitude of the respiratory volume

E.

Ensures adequate ventilation

439.

Carbon dioxide tension in alveolar air in normal conditions is:

A.

More when breathing air under a pressure of 2 atmosphere

B.

Less when breathing air under a pressure of 2 atmosphere

C.

* It depends only on the alveolar ventilation and CO2 production

D.

Less when breathing with pure oxygen

E.

More when breathing with pure oxygen

440.

Cheyne - Stokes respiration is characterized by:

A.


B.


C.

respiration pauses, before the frequent deep breathing

D.

* Smoothly varying amplitude of tidal volume with short pauses

E.

Provides breathing

441.

Choose the wrong answer. Respiratory distress syndrome of newborns:

A.

* The probability of its development is reduced by the use of corticosteroids in pregnant

B.

Linked to hypoplasia of bronchial tree

C.

It is characterized by an increase of the respiratory muscles

D.

Effective treatment with artificial surfactant

E.

Usually develops in preterm

442.

Choose the wrong answer. Lung surfactant:

A.

produced pneumocites of type 2

B.

It consists mainly of lipoproteins

C.

Not for respiratory distress syndrome of newborns

D.

* Increases the surface tension of fluid in the alveoli

E.

None of the above

443.

Compared with atmospheric air alveolar gas has:

A.

The lower total pressure

B.

Higher pO2

C.

Lower pCO2

D.

* Higher partial pressure of water vapor

E.

Higher partial pressure of nitrogen

444.

Cromolyn Na (INTAL) may be effective in the treatment of bronchial asthma because of the following steps:

A.

Blockade of histamine receptors

B.

Inhibition of phosphodiesterase

C.

Activation of beta 2-adrenoceptor

D.

* Blocks bronhokonstriktivnyh substances

E.

None of the above listed

445.

Cyanosis is not indicative of the presence of hypoxemia if a concentration of hemoglobin is equal to:

A.

70 g / l

B.

100 g / l

C.

140 g / l

D.

* 170 g / l

E.

In the absence of hypoxemia and congestive heart failure cyanosis will be present

446.

Cyanosis of the skin and visible mucose will be possible to detect with a decrease in oxygen saturation of arterial blood below:

A.

70%

B.

* 80%

C.

90%

D.

100%

E.

20%

447.

Dead space is reduced by all exept:

A.

In the supine position compared with the vertical position

B.

Intubation

C.

After the imposition of tracheostomy

D.

* After the upper laporotomia

E.

None of the above

448.

Direct reading of spirographic data can be used to measure the following volumes, exept:

A.

tidal volume

B.

* residual lung volume

C.

lung capacity

D.

Expiratory reserve volume

E.

Inspiratory reserve volume

449.

Each gram of hemoglobin can bind:

A.

0.03 ml of oxygen

B.

0.57 ml of oxygen

C.

* 1,34-1,39 ml of oxygen

D.

1 ,48-1, 56 ml of oxygen

E.

2.0 ml of oxygen

450.

Fit bronchoconstriction in atopic form of bronchial asthma can be docked using:

A.

Intal

B.

* Betta adrenostimulators

C.

Calcium

D.

Diphenhydramine

E.

Chloride

451.

For acute respiratory distress syndrome characterized by the following symptoms exept:

A.

Increases in intrapulmonary shunting

B.

Violations of the permeability of the alveolar-capillary membrane

C.

Increase the amount of free water in the lungs

D.

* Increases elasticity (compliance) of the lungs

E.

Education pneumosclerosis and hyaline membrane

452.

For which of the above indices was best to evaluate the adequacy of mechanical ventilation?

A.

Hemodynamics

B.

pH of arterial blood

C.

* arterial blood gas composition

D.

pH of venous blood

E.

Gas composition of venous blood

453.

Frequency of atelectasis is less:

A.

* For men compared with women

B.

For women compared with men

C.

In patients with low birth weight

D.

After laparoscopic surgery

E.

After low laporotomic cuts

454.

Functional dead space is increased by:

A.

Reducing the partial pressure of oxygen in the inspired gas

B.

Growth of intrapulmonary shunting

C.

* hypovolemia

D.

Anemia

E.

Trendelenburg position of patient

455.

Functional dead space is likely increase if the following drugs used exept:

A.

ganglion blocking

B.

Atropine

C.

Nitroglycerin

D.

Dehydrobensperidol

E.

* Neostigmine

456.

High-frequency ventilation:

A.

Considered as such if the tidal volume above the volume of anatomic dead space

B.

More effective in patients with low extensibility (compliance) of light compared to conventional mechanical ventilation

C.

Helps increase intrathoracic pressure compared with conventional mechanical ventilation

D.

Reduces the risk of pulmonary barotrauma compared with conventional mechanical ventilation

E.

* Safer than conventional mechanical ventilation in patients with bronhopleural fistulas

457.

Hyperventilation is developed under the following conditions, exept:

A.

Metabolic acidosis

B.

Hypovolemia

C.

* barbiturate poisoning

D.

Hyperthermia

E.

Nothing from the above listed

458.

Hypoxic hypoxia is characterized by the following symptoms exept:

A.

Violations of consciousness

B.

Cyanosis of the skin and visible mucous

C.

Reduction of alveolar pO2

D.

Reduction of arterial pO2

E.

* Increasing arteriovenous oxygen difference

459.

In the case of elevated methemoglobin in the blood and the development of tissue hypoxia is shown the application:

A.

Atropine

B.

Inhibitors of holinesterase

C.

* Methylene blue

D.

Glucose

E.

Diphenhydramine

460.

In what form of hypoxia is inefficient oxygen therapy:

A.

Hypoxic

B.

circulatory

C.

Hemical

D.

* Hystotoxic

E.

None of the above

461.

Increasing of alveolar-arterial oxygen difference did not depend from:

A.

Violations of the diffusion of gases through the alveolar-capillary membrane

B.

The increase in the shunting pulmonary

C.

ventilation with pure oxygen

D.

* Moderate anemia

E.

By increasing blood flow

462.

Indicators of pulse oximetry:

A.

* Depends on the state of tissue perfusion

B.

Do not respond with a decrease in arterial pO2 to 60 mm Hg

C.

No Avis of light effects in the determination

D.

Do not depend on the state of the external gas exchange

E.

None of the above

463.

Intermediate bronchus of the right lung holds air:

A.

In the upper part

B.

The average share

C.

In the lower part

D.

* In the middle and lower lobe

E.

In the upper and middle lobe

464.

It can be expected that the pO2 will be normal arterial in:

A.

Decrease in partial pressure of oxygen in inhaled air

B.

Violations of diffusion through the alveolar-capillary membrane

C.


D.

Smoke gas poisoning

E.

* Anemia

465.

It is known that a healthy young man:

A.

The lungs are easy to stretch more than the thorax

B.

The lungs are easy to stretch less than the thorax

C.

* Tensile elongation of lungs are equal to the thorax

D.

The total elongation more than elongation of one lung

E.

None of the above

466.

Low oxygen tension in the inspired gas leads to:

A.

Increasing of tension and oxygen saturation of arterial blood

B.

It shifts the oxyhemoglobin dissociation curve to the left

C.

It increases the pulmonary arteriols

D.

* With prolonged exposure leads to pulmonary hypertension

E.


467.

Lung diffusion capacity is probably not broken in the case of:

A.

* myasthenia

B.

interstitial pulmonary edema

C.

severe attack of bronchial asthma

D.

Acute respiratory distress syndrome

E.


468.

In which case will be the greatest stimulation of the respiratory center carotid chemoreceptors?

A.

Carbon Monoxide Poisoning

B.

methemoglobinemia

C.

Severe anemia

D.

* Increased intrapulmonary shunting

E.

Pronounced metabolic alkalosis

469.

Normally, the maximum concentration of hemoglobin in the erythrocyte is:

A.

10%

B.

21%

C.

27%

D.

* 34%

E.

50%

470.

Normally, the percentage of dead space on the tidal volume is:

A.

5%

B.

15%

C.

* 30%

D.

50%

E.

60%

471.

Oxygen and carbon dioxide tension markedly fluctuate during inspiration and expiration if it were not :

A.

The reserve volume inspiratory

B.

Respiratory volume

C.

* Residual lung capacity

D.

Vital lung capacity

E.

Minute volume of breathing

472.

Possible complications of tracheostomy are, exept:

A.

Infection of lower respiratory tract

B.

* The increase of the dynamic resistance to breathing

C.

Formation of a fistula

D.

Tracheal stenosis

E.

Bleeding from the respiratory tract

473.

Pulmonary vascular resistance drops:

A.

Alveolar Hypoxia

B.

Alveolar hypercapnia

C.

* prostacyclin

D.

Carbon dioxide

E.

Catecholamines

474.

Recurrent laryngeal nerve:

A.

* It is a branch of the vagus nerve

B.

Is only the sensory nerves

C.

As a rule, is not damaged during surgery in the neck

D.

With his injury is not observed speech disorders

E.


475.

Reduced of which muscle has the greatest significance for the creation of high pressure in the airway by coughing before the opening of the glottis?

A.

intercostal muscles of expiration

B.

Diaphragm

C.

trapesius

D.

bronchialis

E.

* None of the above

476.

Reduced production and function of pulmonary surfactant leads to the following effects exept:

A.

Increases in the elastic resistance of lungs

B.

* Increases in the dynamic resistance (bronchial tree)

C.

Atelektasation

D.

Increases in the work of respiratory muscles

E.

Interstitial pulmonary edema

477.

Reduced the forced expiratory volume will probably be observed in all states exept:

A.

Asthma

B.

Emphysema

C.

chronic bronchitis

D.

* Lung abscess

E.

None of the above

478.

Reducing the partial pressure of oxygen causes spasm:

A.

coronary

B.

* pulmonary vascular

C.

receptacles of splanhnic zone

D.

Vessels of striated muscles

E.


479.

Sensitive innervation of the larynx by branches:

A.

trigeminal

B.

facial nerve

C.

Vestibulokohlearnogo nerve

D.

Glossopharyngeal nerve

E.

* Vagus

480.

Shortness of breath may be caused directly by the following factors, exept:

A.

Decrease in arterial pO2

B.

* Enhancement of arterial pO2

C.

Reduction of Hb saturation of venous blood oxygen

D.

Increased blood pCO2

E.

Decrease in pH of arterial blood

481.

Stimulation of the Hering-Breuer reflex resulting from stimulation of stretch receptors in the lungs, can lead to:

A.

The increase in inspiratory and expiratory

B.

* Switching from inhalation to exhalation, when tidal volume is more than 1 liter

C.

Reduction of alveolar ventilation

D.

decreasing the alveolar ventilation

E.

Anything of the above

482.

Tachypnea is characterized by:

A.

The increase of minute volume of respiration

B.

* By increasing the frequency of breathing

C.

By increasing the depth of respiration

D.

Decrease paCO2 below 35 mm Hg

E.


483.

Tensile properties (compliance) of lungs is reduced when:

A.

The normal production of surfactant

B.

* Pulmonary edema

C.

Open pneumothorax

D.

Breathing the hypoxic mixture

E.

None of the above

484.

The best way to treat "oxygen apnea", developed due to increased oxygen tension in arterial blood of patients with hypoxic respiratory stimulation type is:

A.

Application of respiratory analeptics

B.

Cessation of oxygen supply

C.

* Increased content CO2 in the inspired gas

D.

ALV

E.

Introduction of alkalify solutions

485.

The concentration of COHb (carboxyhemoglobin) in the patient is 30%. When it will drop to 7.5% in the case of breathing with atmospheric air?

A.

1 hour

B.

5 hours

C.

* 10 hours

D.

24 hours

E.

48 hours

486.

The following factors lead to alveolar hypoventilation after curaresation in the postoperative period, exept:

A.

Hypothermia

B.

Applications of dalacin

C.

Applications of furosemide

D.

Hypokalemia

E.

* Applications of beta-blockers

487.

The following symptoms are characteristic of hypercapnia, hypoxia is not accompanied by:

A.


B.

Expression of peripheral spasm

C.

Bradycardia

D.

* Sweats

E.

Reduction of cerebral blood flow

488.

The long-existing pulmonary hypertension is characterized by the following symptoms exept:

A.

Increasing vascular resistance

B.

Increase pulmonary bypass

C.

Increase of the load of the right ventricle of the heart

D.

* Hypertrophy of the left ventricle

E.

polycythemia

489.

The main reasons of pulmonary respiratory failure are the following, exept:

A.

Increasing the concentration of oxygen in the inspired gas

B.

* Reduction of alveolar ventilation

C.


D.

Violations of ventilation-perfusion ratios in lungs

E.

Increased intrapulmonary shunting

490.

The most common pulmonary embolism develops in:

A.

* proven deep vein thrombosis

B.

prolonged immobilization

C.

recent orthopedic surgery

D.

Obesity

E.

Availability of ELA in history

491.

The partial pressure of water vapor in the alveolar gas depends on:

A.

Composition of inhaled gas

B.

The values of atmospheric pressure

C.

* The body temperature

D.

Alveolar pO2

E.

Alveolar pCO2

492.

The pharmacological effect of bronchial spasmolytic can be realized by all, exept:

A.

Preemption effect of acetylcholine

B.

* increase of GMPh

C.

Increase of AMPh

D.

Blockade of release of cell mediators for adhession

E.

Blockade of Ca-channels

493.

The poisoning is fatal if carbon monoxide is minimal links:

A.

20% of blood hemoglobin

B.


C.


D.

* 76% of blood hemoglobin

E.


494.

The pressure in the pulmonary artery is reduced in the case of :

A.

Acidosis

B.

exercise

C.

Introduction propranolol

D.

Hypoxia

E.

* All the answers are not true

495.

The therapeutic effect of sympathomimetics for relieving of bronchospasm is associated with:

A.

blockade of adenosine receptors of bronchial muscles

B.

blockade of calcium tubules of bronchial muscles

C.

C. blockade of histamine receptors of bronchs

D.

* By increasing the content of cAMP in the cells of bronchial muscles

E.

Oppression bronhospasticheskih reflexes

496.

To the respiratory muscles of expiration are all listed, exept:

A.

* Diaphragm

B.

Internal intercostal muscles

C.

External and internal oblique abdominal muscles

D.

Lateral and ventral abdominal muscles

E.

None of the above

497.

To the respiratory muscles of inhalation are all listed, exept:

A.

Diaphragm

B.

outdoor intercostal muscle

C.

* Internal intercostal muscles

D.

Scalenus

E.

None of the above

498.

What applies to the drugs 'first appointment' acute attack of asthma?

A.

aminophylline

B.

Crank

C.

Parenteral beta 2-adrenomimetics

D.

* Inhaled beta 2-adrenomimetics

E.

Cholineblocker

499.

What are the normal values of carbon dioxide tension in arterial blood?

A.

20-30 mm Hg

B.

30-40 mm Hg

C.

* 35-45 mm Hg

D.

45-55 mm Hg

E.

50-60 mm Hg

500.

What could be the immediate causes of circulatory hypoxia?

A.

Alveolar hypoventilation

B.


C.

Renal insufficiency

D.

* Violation of blood microcirculation

E.

Carbon monoxide

501.

What is the most characteristic radiological sign for pulmonary embolismrterii?

A.

Expanding the root of the lung

B.

Pulmonary infiltration

C.

The rise of the dome diaphragm

D.

Symptom Hampton (wedge-shaped infarct of the lung)

E.

* Chest radiograph remains normal

502.

What is the normal value of minute breathing volume in an adult?

A.

2-4 L / min

B.

* 5-10 l / min

C.

8-12 l / min

D.

10-15 l / min

E.

20 l / min

503.

What is the smallest of these lung volumes?

A.

* respiratory volume

B.

Vital lung capacity

C.

Residual lung volume

D.


E.

None of the above

504.

What percentage of CO2 directly or indirectly transferred by means of hemoglobin?

A.

5%

B.

10%

C.

50%

D.

* 90%

E.

20%

505.

What should be the minimum pressure at the peak of inspiration from a patient with healthy lungs with normal weight and normal extensibility of the chest that would provide the necessary injection of tidal volume?

A.

8-10 cm water station

B.

* 14-20 cm of water station

C.

20-30 cm of water station

D.


E.


506.

What's wrong? Anatomical characteristics of the trachea:

A.

The average length is 10-18 cm

B.

Bifurcation is located at 5 th thoracic vertebra

C.

Motionless, fixed to the surrounding tissue

D.

About half of is above sternum

E.

* Length varies with body position

507.

Which from these factors can reduce the excretion of carbon dioxide?

A.

Alveolar hyperventilation

B.

Climb up to the highlands

C.

Breathing with pure oxygen under atmospheric pressure

D.

* Breathing with pure oxygen under pressure of 3 atmosphere

E.


508.

Which of the factors plays the greatest role in creating the elastic resistance of normal lung:

A.

Elastic skeleton of light

B.

* Surface tension of alveolar fluid

C.

Intrapleural pressure

D.

Cross-sectional area of the bronchi and bronchioles

E.

None of the above

509.

Which of the following indicators may serve as one of the criteria for transfer of patient on mechanical ventilation?

A.

The respiratory rate in adults over 20/min

B.

Vital lung capacity, equal to 20 ml / kg

C.

inspiratory force greater than 25 cm water station

D.

Arterial pO2 in 65-year-old patient, equal to 60 mm Hg

E.

* Arterial pCO2 greater than 55 mm Hg

510.

Which of the following symptoms may be useful for differential diagnosis of hypoxic and circulatory hypoxia, exept?

A.

Nature cyanosis

B.

Alveolar pO2

C.

Arterial pO2

D.

* pH of arterial blood

E.

Arteriovenous oxygen difference

511.

Which of these factors are not causes shortness of breath?

A.

* The oxygen tension in arterial blood of 80 mm Hg

B.

Metabolic acidosis

C.

Hypercapnia

D.

Hyperthermia

E.

Nothing used above listed

512.

With the catheter of Swan-Gans it can be defined the following parameters, exept:

A.

Pressures in the right atrium

B.

Pressure in the right ventricle

C.

Pressure in the pulmonary artery

D.

Pressure occlusion (wedge), pulmonary artery

E.

* End-diastolic pressure in the left ventricle

513.

With the development of a massive pulmonary haemorrhage are shown the following activities, exept:

A.

* Urgent introduce calcium preparations

B.

Lay the patient in position Trendeleburga on the side of bleeding

C.

You must create a controlled hypotension

D.

Urgent call for a consultation thoracic surgeon

E.

When continuous bleeding translate to one-lung ventilator

514.

With the introduction of excessively deep endotracheal tube most of its end is located in:

A.

The right main bronchus

B.

Left main bronchus

C.

* Intermediate bronchus

D.

Right distal bronchus

E.

The left distal bronchus

515.

Intravenous pyelogram (IVP)

A.

2, 3, 1, 4, 5

B.

* 2, 1, 3, 5, 4

C.

3, 2, 1, 5, 4

D.

1, 4, 2, 3, 5

E.

2, 1, 5, 3, 4

516.

A 1-week-old cyanotic infant presents in shock. History is significant for feeding difficulties and worsening URI symptoms over the past 2 days. The baby is limp, minimally responsive to noxious stimuli, and has an O2 saturation of 72 percent on room air (with little change after oxygen administration). RR is 60, HR is 200, blood pressure is undetectable, and rectal temperature is 38.0°C. Chest auscultation shows rales but no murmur. What is the BEST course of action?

A.

Oxygen, prostaglandin E1 titrated to effect, and consultation with a tertiary pediatric institution for possible transfer

B.

Morphine, oxygen, and phenylephrine; place the infant in the knee-to-chest position

C.

A septic work-up and antibiotics; defer lumbar puncture until the baby is stabilized

D.

* A and C

E.

B and C

517.

A 1-year-old baby presents with signs of severe dehydration and shock during a severe bout of gastroenteritis. Which of the following is the most appropriate fluid therapy?

A.

* Isotonic crystalloid bolus of 20 mL/kg

B.

Isotonic crystalloid infusion at 20 mL/kg/h

C.

D5W 0.45 NS bolus of 20 mL/kg

D.

D5W 0.45 NS infusion at 20 mL/kg/h

E.

D5W 0.25 NS infusion at 20 mL/kg/h

518.

A 1-year-old boy presents to the ED with gastroenteritis that is unresponsive to oral rehydration attempts. After physical examination, your assessment is that this 10kg child has 5 percent dehydration. Which of the following represents the total 24-h fluid requirement?

A.

1100 mL

B.

1200 mL

C.

1300 mL

D.

1400 mL

E.

* 1500 mL

519.

A 10-year-old female presents to the ED with left upper extremity pain and swelling after a fall onto an outstretched arm 2 h before. She has a tense forearm, moderate swelling at the elbow, and tenderness to palpation of the distal humerus.

Passive extension of the fingers elicits pain, and she complains of tingling in the hand.

Radial and ulnar pulses are present. What are the most appropriate immediate actions?

A.

Splint the arm in flexion and send the patient to x-ray

B.

Splint the arm in flexion, consult orthopedics, and send the patient for x-ray

C.

Splint the arm in flexion, start an intravenous line, obtain immediate x-ray, consult orthopedics, and prepare to reduce the fracture

D.

Splint the arm in extension and send the patient for x-ray

E.

* Splint the arm in extension, start an intravenous line, obtain immediate x-ray, consult orthopedics, and prepare to reduce the fracture

520.

A 13-year-old female presents with the complaint that she cannot move her right leg. There are no other associated symptoms and no history of trauma, head-ache, or prior medical problems. The symptom began on the day she was to meet her father for the first time. Which of the following would be LEAST helpful in the management of this patient?

A.

Perform a Hoover test

B.

* Tell her that nothing is wrong

C.

Hypnosis

D.

Tell her that she can talk with her father on the telephone rather than in person

E.

Reassure the patient that she will walk again

521.

A 13-year-old male is brought in by his parents for right hip stiffness and groin discomfort after activity. He feels well otherwise and denies fevers or chills. On examination he is ambulatory with a slight limp and mild discomfort with internal rotation. Which of the following is the most likely diagnosis?

A.

Congenital hip dislocation

B.

Septic arthritis

C.

Transient synovitis

D.

Legg-Calvй-Perthes disease

E.

* Slipped capital femoral epiphysis

522.

A 14-month-old irritable but nontoxic toddler presents with several days of upper respiratory infection (URI) symptoms and a rectal temperature of 40.0°C. On examination you do not find a specific source for the fever but note a few urticarial and nonblanching tiny petechiae on the baby's lower abdomen. Which of the following is the most appropriate action?

A.

CBC, blood and urine cultures, oral antibiotics, and close outpatient follow-up

B.

CBC, blood and urine cultures, home without medications, and follow-up every

24 h pending culture results

C.

* Immediate respiratory isolation; CBC; blood, urine, and cerebrospinal fluid

(CSF) cultures; intravenous antibiotics; admission

D.

Diphenhydramine for the urticaria, home with follow-up in 24 h or sooner if worse

E.

immediate respiratory isolation; CBC, blood and urine cultures; intravenous antibiotics; admission

523.

A 14-year-old male presents with acute onset of inability to walk and severe pain in the left groin, thigh, and knee. He is afebrile and appears nontoxic but is obviously distressed. Examination shows an externally rotated thigh and apparent limb shortening. What is the most likely diagnosis?

A.

Legg-Calvй-Perthes disease (coxa plana)

B.

* Slipped capital femoral epiphysis (SCFE)

C.

Septic arthritis of the hip

D.

Toxic tenosynovitis of the hip

E.

Osgood-Schlatter's disease

524.

A 16-month-old child presents with seven watery, nonmucoid, nonbloody stools beginning that day. The mother is not sure when he had his last void because the diaper is always wet with stool. The mother inserted a trimethobenzamide (Tigan) rectal suppository 1 h before. The child seems thirsty but has occasional clear emesis when he takes fluids. Vital signs are remarkable for a rectal temperature of 38.0°C, RR of 30, and pulse of 160, all taken while the child is screaming in triage. He appears vigorous but has a dry mouth and no tears. Appropriate ED management for this child would include all of the following exept

A.

oral rehydration solution, 5 cc by mouth at a time, every 5 min

B.

intravenous rehydration with 20 to 40 cc/kg LR or NS

C.

* oral rehydration at home with clear liquids, followed by the BRATT diet in 24 h

D.

regular milk within the first 24 h

E.

discontinue and discourage use of antiemetic/antimotility agents

525.

A 2-week-old infant presents with congestion, mild wheezing, and a history of a

"feeling warm." Exept for wheezing and mildly increased respiratory effort, the baby has normal vital signs and a normal examination. All the following historical elements would place this child at increased risk for apnea exept

A.

sluggish feeding and progressive increase in constipation

B.

frequent paroxysms of cough, often followed by emesis, but no color change

C.

* 1-week duration of symptoms

D.

2-day duration of symptoms

E.

premature birth

526.

A 2-week-old vaginally delivered infant with an unremarkable perinatal course presents with a rectal temperature of 38.0°C and reluctance to feed for 1 day. There is no history of URI symptoms, vomiting, diarrhea, or rash. The baby's siblings (aged 13 months and 3 years) have colds, but no one else at home is ill. The infant's only medication is acetaminophen, administered by the mother 3 h before arrival at the ED.

What is the most appropriate course of action?

A.

Home after blood culture

B.

Home after blood culture, CBC with differential, catheterized urine and urine culture

C.

* Admit after blood, catheterized urine, CSF cultures, CBC, urinalysis, and intravenous ampicillin and gentamicin

D.

Admit after blood, urine, and CSF cultures for intravenous ampicillin and ceftriaxone

E.

Home with close follow-up on no medications

527.

A 2-year-old male is brought to the ED by his parents for refusing to use his right arm. He was well until 30 min before, when his cousin tried to lift him up a curb by that arm. He now holds the elbow slightly flexed and pronated and will not use the injured arm. Which is the most appropriate initial approach?

A.

Obtain emergent orthopedic consultation

B.

Order plain radiographs of the elbow

C.

Attempt to reduce the elbow by pronation and extension

D.

* Attempt to reduce the elbow by supination and flexion

E.

Prepare to reduce the elbow under conscious sedation

528.

A 2-year-old male presents to the ED with a 5-day history of a high fever, malaise, and irritability. Vital signs are a HR of 130, blood pressure of 84/44, RR of 24, and temperature of 40°C. Examination shows an alert, uncomfortable-appearing boy, with bilateral nonpurulent conjunctivitis, no nuchal rigidity, a strawberry tongue, bilateral enlarged cervical nodes, palmar and plantar erythema, and a polymorphous rash over the trunk. Chest x-ray is normal, as are a lumbar puncture and urinalysis.

Blood cultures are sent, and empiric antibiotics are started. Which of the following is the most appropriate treatment?

A.

Admit and start aspirin

B.

Admit and start glucocorticoids

C.

* Admit and start IVIG

D.

Start aspirin and discharge with next-day follow-up

E.

Start glucocorticoids and aspirin and discharge with next-day follow-up

529.

A 20-year-old female undergraduate student presents complaining of a gradual onset of right-sided headache. The headache is accompanied by nausea and photophobia and prevents her from studying for exams. Which of the following is

LEAST likely to be associated with her headache?

A.

Aura

B.

Birth control pills

C.

Family history of similar headaches

D.

Menstruation

E.

* Unilateral tearing with conjunctival injection

530.

A 24-year-old unhelmeted motorcycle rider is declared brain dead 2 days after hitting a truck at freeway speeds. Per his prior expressed wishes, his family wants him to be considered for organ donation. During your night shift, the ICU nurse calls you because he is concerned that the patient's blood pressure is falling. For this patient to be considered an organ donor, all of the following are true exept

A.

he should receive CMV-negative blood transfusions to maintain a hematocrit of at least 30 percent

B.

central venous pressure must be sustained at > 10 cm H2O

C.

pO2 must be > 80 mm Hg, pCO2 must be 35 to 45 mm Hg, and pH must remain between 7.30 and 7.45

D.

the patient must have a negative chest x-ray

E.

* HLA matching must be performed

531.

A 25-year-old female presents with right elbow pain after a fall while doing gymnastics. The elbow is deformed and flexed at 45 degrees. Plain radiographs show an elbow dislocation, with both radius and ulna displaced posteriorly. Which of the following neurovascular structures is most likely to be injured?

A.

Axillary nerve

B.

Radial nerve

C.

* Ulnar nerve

D.

Radial artery

E.

Brachial plexus

532.

A 25-year-old male is brought to the ED by ambulance on a psychiatric hold after wandering in a residential area looking for the source of the evil voices that he states are controlling his thoughts. Upon arrival, he is screaming and wildly agitated. Which

of the following represents an appropriate initial dose of intramuscular haloperidol for this patient?

A.

0.05 mg

B.

0.5 mg

C.

* 5.0 mg

D.

50 mg

E.

500 mg

533.

A 25-year-old male is brought to the ED by his sister who states that he started vomiting that morning after complaining of a severe headache. On examination, he is drowsy but arousable with mild nuchal rigidity and no focal neurologic deficit. Which of the following is LEAST likely to be needed for his work-up and treatment?

A.

CT of the head

B.

Blood glucose determination

C.

Antiemetic

D.

* Lumbar puncture

E.

Nimodipine

534.

A 26-year-old female is brought to the ED after three successive witnessed grand mal seizures without recovery of consciousness. Upon arrival, she is obtunded with no spontaneous eye opening and withdraws to pain only. Initial ED management could include all of the following exept

A.

endotracheal intubation

B.

* barbiturate coma

C.

phenytoin infusion

D.

determination of blood glucose

E.

gastric lavage

535.

A 26-year-old soccer player presents after a direct blow to the shoulder. On examination, she has tenderness over the acromioclavicular joint, but no step-off or deformity. X-rays show no fracture, subluxation, or dislocation. Which of the following is the most appropriate management?

A.

Arrange immediate orthopedic follow-up for possible operative repair

B.

Place the shoulder in a figure-of-eight brace, with orthopedic follow-up in 1 to 2 weeks

C.

* Place the shoulder in a simple sling, with instructions for early range of motion

D.

Place the shoulder in a shoulder immobilizer for 2 to 3 weeks

E.

Tell the patient that immobilization is not necessary but that she should apply ice and use analgesics as needed for pain control

536.

A 27-year-old male presents with left wrist pain after falling on an outstretched hand. He has an obvious deformity of the wrist but is neurovascularly intact. Xray shows a transverse distal radius fracture with dorsal angulation. On the lateral view, the ulna is displaced dorsally. Which of the following terms describes this fracture?

A.

* Galeazzi's fracture

B.

Monteggia's fracture

C.

Colles' fracture

D.

Smith's fracture

E.

Barton's fracture

537.

A 28-year-old female overdosed on her father's lithium. She presents with complaints of nausea, vomiting, and blurred vision. Initial lithium level is 2 mEq/L.

Which of the following would not be appropriate ED management?

A.

Intravenous hydration

B.

Correction of electrolyte imbalance

C.

Urine pregnancy test

D.

* Discharge to an inpatient psychiatric facility if asymptomatic after a 4-h observation period

E.

Alkalinization of the urine

538.

116. A 3-month-old male presents with a fever of 39.5°C for several days, occasional vomiting with a few loose watery stools, mild URI symptoms, and a decreased appetite. He is irritable but consolable and appears nontoxic. Which of the following tests would be most likely to show the source of this child's fever?

A.

CBC with differential

B.

Blood culture

C.

* Urine culture

D.

CSF culture

E.

Chest x-ray

539.

A 3-week-old infant with a 2-day duration of whitish eye drainage presents to the

ED. The child had a normal spontaneous vaginal delivery. The mother reports mild

URI symptoms for the past 3 days, but the older siblings (13 months and 3 years) also have colds. The child is eating and acting normally. Which of the following is most appropriate?

A.

* Fluorescein staining of the cornea; if no dendritic changes, Gram stain and culture of the eye drainage for gonorrhea; if the Gram stain is negative for gramnegative diplococci, obtain a culture of nasopharyngeal aspirate for chlamydia; prescribe oral antibiotics

B.

Fluorescein staining of the cornea; if no dendritic changes, Gram stain for gonorrhea, culture eye drainage for chlamydia and gonorrhea; prescribe topical eye drops

C.

Topical antibiotic eye drops

D.

Treat with hot packs and lacrimal duct massage for presumptive lacrimal duct stenosis

E.

Fluorescein staining of the cornea; if no dendritic changes, topical antibiotic eye drops

540.

A 3-year-old female with hemoglobin sickle cell (HbSS) disease presents with a fever of 38.5°C after several days of URI symptoms, lower leg pain, and abdominal pain in the usual locations of her pain crises. She has scleral icterus and a spleen tip palpable on abdominal examination. The mother is concerned that the patient looks pale. RR is 18, HR is 110, blood pressure is 100/62, and O2 saturation is at 90 percent.

She takes penicillin and folic acid daily. Work-up and treatment should include all of the following exept

A.

* normal saline infusion at twice maintenance levels

B.

CBC with differential, reticulocyte count, blood and urine cultures, CXR, blood for type and screen

C.

presumptive treatment with parenteral antibiotics, active against encapsulated organisms

D.

opioids in adequate doses, at frequent intervals to control the pain

E.

O2 for hypoxia

541.

A 3-year-old preschool male presents with a 3-day history of high fever accompanied by sore throat, mild abdominal pain, headache, and vague pain "all over."

Examination shows a diffuse erythematous rash, especially in the perianal area. He complains of itching in areas where the rash is peeling. You also note red oral mucosa, prominent papillae consistent with strawberry tongue, and cervical adenopathy.

Appropriate actions at this point could include all the following exept

A.

performing a culture of the throat to rule out group A hemolytic strep (GABHS)

B.

treating for presumptive GABHS with oral or intramuscular penicillin

C.

* giving intravenous gamma globulin

D.

delaying treatment until you have the results of a complete blood count (CBC) with differential, ESR, and LFTs

E.

administering oral diphenhydramine

542.

A 30-year-old pregnant female presents to the ED complaining of vaginal bleeding. All of the following statements are true concerning this patient exept

A.

most patients with bleeding in early pregnancy have normal pregnancy outcomes

B.

urinary tract infection can precipitate spontaneous abortion

C.

* lack of adnexal mass on bedside ultrasound makes ectopic unlikely

D.

she should have her Rh status checked

E.

the quantitative RhCG level should be monitored

543.

A 35-year-old female presents with posterior ankle pain, which occurred suddenly while playing volleyball. Thompson's test is positive. What is the most likely diagnosis?

A.

Posterior talofibular ligament injury

B.

Achilles tenosynovitis

C.

* Achilles tendon rupture

D.

Posterior talotibial dislocation

E.

Calcaneal fracture

544.

A 35-year-old female with a history of newly diagnosed myasthenia gravis presents to the ED with profound generalized muscle weakness for 2 days without a known precipitant. A test dose of 2 mg intravenous edrophonium results in visible muscle fasciculations and slowing of the patient's respiratory rate and depth. Which of the following actions is INAPPROPRIATE?

A.

* Administering neostigmine

B.

Preparing for intubation

C.

Consulting a neurologist

D.

Establishing aspiration precautions

E.

Admission to the ICU

545.

A 35-year-old male presents after a significant hyperextension injury to the right knee while playing soccer. On examination the knee is severely unstable in both anteroposterior and lateral directions. A palpable hematoma is present in the popliteal fossa. Plain films demonstrate no bony abnormality. Which of the following tests must be performed emergently?

A.

Magnetic resonance imaging of the knee

B.

* Arteriography

C.

Bone scan

D.

CT of the knee

E.

Electromyography

546.

A 37-year-old male intravenous drug user (IVDU) presents with the complaint of several days of general malaise, difficulty swallowing, occasional double vision, and subjective fever. On examination, the patient is noted to have grossly intact cranial nerves II to XII, a distended bladder, and a temperature of 99.1°F. What is the most appropriate next step?

A.

Admit to the ED observation unit

B.

Admit to the floor for observation

C.

* Admit to the ICU

D.

Discharge to home with reassurance

E.

Discharge to home with follow-up in several days

547.

A 4-month-old infant presents with a rectal temperature of 38.7°C, a respiration rate (RR) of 60, a heart rate (HR) of 160, and an SpO2 on room air of 92 percent. He is smiling, drooling, and taking his bottle well, despite prominent intercostal retractions.

On auscultation, he has diffuse coarse breath sounds with sibilant wheezes at both bases. All other household members have colds. There is no family history of atopy or asthma; no one smokes. ED therapy for this child could include all the following exept

A.

supplemental O2 (by blow-by or nasal cannula as tolerated by the child)

B.

a trial of nebulized albuterol

C.

a trial of nebulized racemic epinephrine

D.

* a dose of glucocorticoids

E.

admission

548.

A 45-year-old male presents with foot pain after an automobile accident. The examination shows tenderness, swelling, and ecchymosis over the midfoot. X-ray shows fracture of the base of the second metatarsal and lateral displacement of the second, third, fourth, and fifth metatarsals. What is the optimal management of this patient?

A.

Posterior splint, with orthopedic follow-up as needed

B.

* Urgent orthopedic consultation for possible open reduction and internal fixation

C.

Splint the patient in equinus and follow up with orthopedics in 2 to 3 days

D.

Cast the foot and follow up with orthopedics in 2 to 3 days

E.

Hard-sole shoe, weight bearing as tolerated, follow-up in orthopedics as needed

549.

A 58-year-old female is brought to the ED by her family. They state that her words do not make sense, the right side of her face is drooping, and she is weak on the right side. On examination you note that the patient is awake and alert, has an expressive aphasia, right-sided facial droop, three-fifths right arm strength, four-fifths right leg strength, and decreased sensation to pin-prick on the right side. Which stroke syndrome is most likely?

A.

Anterior cerebral artery infarction

B.

Basilar artery occlusion

C.

* Middle cerebral artery infarction

D.

Lacunar infarction

E.

Intracerebral hemorrhage

550.

A 60-year-old male presents complaining of a typical spring headache, 2 months after a femoral-popliteal bypass. He states that the pain is excruciating, began over the left eye, and is causing the eye to tear and throb. Which abortive therapy is the LEAST appropriate?

A.

* Ergotamine

B.

Ketorolac

C.

Prochlorperazine

D.

Oxygen inhalation

E.

Intranasal lidocaine

551.

A 62-year-old female with a history of TIA affecting the right side complains of 8 h of a dense right-sided paralysis and dysarthria. No previous studies have been completed. What is the most appropriate disposition?

A.

* Admit to the medical ward

B.

Admit to the rehabilitation ward

C.

Discharge to home and arrange follow-up with the primary care physician

D.

Transfer the patient to a skilled nursing facility

E.

Conduct a stroke work-up in the ED and then discharge to home

552.

A 7-year-old male presents to the ED 6 months status post revision of a CSF shunt. He complains of a persistent headache for 1 week, occasional nausea, and vomiting three to four times that day. Evaluation for shunt infection should include all of the following exept

A.

CT of the head

B.

shunt survey (plain films of the skull, chest, and abdomen)

C.

compression of the reservoir

D.

neurosurgical consult

E.

* lumbar tap

553.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

554.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

555.

A nontoxic, playful, 18-month-old toddler is febrile to 40.5°C but has no focus for fever on examination. A 24-h follow-up visit is arranged. Which of the following would be INAPPROPRIATE management?

A.

Blood and urine cultures; intramuscular ceftriaxone

B.

Blood and urine cultures, intramuscular ceftriaxone only if WBC > 15,000

C.

Intramuscular ceftriaxone, no cultures

D.

Blood and urine cultures, no antibiotics

E.

* B, C, and D are all inappropriate

556.

A previously healthy 9-month-old child presents with a soft, nontender abdomen and a history of vomiting at home. Which of the following strongly suggests a nonsurgical etiology for the emesis?

A.

No bile present in the emesis

B.

Negative blood in stool by guaiac

C.

Normal KUB and left lateral decubitus film

D.

Soft, nontender belly without masses

E.

* None of the above

557.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

558.

A woman in the third trimester of pregnancy presents to the ED complaining of abdominal pain without vaginal bleeding. Vital signs are remarkable for a systolic blood pressure of 160, heart rate of 105, and a respiratory rate of 18. Which one of the following statements is true concerning this patient?

A.

A normal ultrasound excludes the diagnosis of placental abruption

B.

Lack of vaginal bleeding excludes the diagnosis of placental abruption

C.

A pelvic examination should be avoided

D.

* A CBC, electrolytes, and renal and liver function tests (LFTs) should be obtained

E.

Immediate delivery is indicated

559.

All are surface anaesthetics exept –

A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

560.

All of following are true of asthma in pregnancy exept

A.

asthma worsens in about one-third of cases

B.

* oral steroids should not be prescribed

C.

agonists are the mainstay of therapy

D.

chest radiographs should be ordered for the same indications as for nonpregnant patients

E.

pulmonary function tests are not significantly changed during pregnancy

561.

All of the following are consistent with multiple sclerosis (MS) exept

A.

multiple discrete lesions of the white matter

B.

increase of immunoglobulin in the CSF

C.

worsening spasticity with urinary tract infection

D.

* diminution of symptoms with fever

E.

optic neuritis as first symptom

562.

All of the following are indications for maternal transport to a tertiary perinatal center exept

A.

placental bleeding

B.

* premature labor with cervical dilation to 6 cm

C.

blood pressure of 160/110 mm Hg and proteinuria

D.

premature rupture of membranes

E.

term labor in a insulin-dependent diabetic

563.

All of the following are risk factors for pelvic inflammatory disease (PID) exept

A.

multiple sexual partners

B.

adolescence

C.

history of gonococcal salpingitis

D.

use of intrauterine (IUD) contraceptive device

E.

* low socioeconomic status

564.

All of the following are symptoms of physician burnout exept

A.

* illicit drug use

B.

chronic fatigue

C.

excessive irritability

D.

feelings of helplessness

E.

negative attitudes toward work

565.

All of the following are true concerning vulvovaginitis exept

A.

bacterial vaginosis is the most common etiology

B.

alkaline cervical secretions predispose a woman to infection

C.

older women usually do not have symptoms until the vulvovaginitis is advanced

D.

pinworms (Enterobius vermicularis) can cause vaginal irritation

E.

* the classic "strawberry cervix" is commonly seen in patients with Trichomonas vaginalis

566.

All of the following are true of HELLP syndrome exept

A.

the majority of women complain of right upper quadrant or epigastric pain with nausea and vomiting

B.

platelet count is < 100,000/mL

C.

urinalysis is positive for protein

D.

* 10 percent calcium gluconate should be administered

E.

hypertension is key to the diagnosis

567.

All of the following are true of infections during pregnancy exept

A.

40 percent of Cytomegalovirus infections are transmitted to the fetus

B.

* to be effective, Varicella zoster immune globulin should be given to seronegative women within 24 h of chicken pox exposure

C.

erythema infectiosum exposure can cause SAB

D.

infection with rubella in the first trimester is associated with congenital rubella syndrome

E.

fetuses exposed to maternal toxoplasmosis have a 10 percent chance of contracting congenital toxoplasmosis

568.

All of the following are true of intraperitoneal blood and culdocentesis exept

A.

* the test is positive when clotting blood is aspirated

B.

cervical motion tenderness may be present in a patient with intraperitoneal blood

C.

a ruptured corpus luteum cyst can produce a positive test

D.

culdocentesis is positive in the majority of ectopic pregnancies, ruptured and unruptured

E.

aspiration of clear fluid denotes a negative test

569.

All of the following are true of premature rupture of membranes (PROM) exept

A.

the finding of a "ferning" pattern is diagnostic of amniotic fluid

B.

nitrazine paper changes to dark blue

C.

* the pH of amniotic fluid is 4.5 to 6.0

D.

90 percent of term patients with PROM will go into labor within 24 h

E.

infections can precipitate PROM

570.

All of the following are true of spontaneous abortion (SAB) exept

A.

more than 50 percent of the abortuses have chromosomal abnormalities

B.

most SABs occur before 8 or 9 weeks of gestation

C.

* maternal factors such as uterine adhesions and pelvic structural abnormalities may lead to SABs

D.

the incidence of SAB climbs with increasing maternal age

E.

the pain associated with SAB usually occurs after the bleeding has commenced

571.

All of the following are true of trauma in pregnancy exept

A.

rapid deceleration may cause uterine rupture

B.

* pelvic fractures preclude a woman from having a vaginal delivery

C.

life-threatening hemorrhage is most often localized to the retroperitoneum

D.

splenic rupture, kidney injury, and liver laceration are the most common intraabdominal injuries

E.

the Kleihauer-Betke assay is recommended

572.

All of the following are typical of a failure-to-thrive (FTT) baby exept

A.

alopecia over a flattened occiput

B.

* inappropriate wide-eyed, affectionate reaction to strangers

C.

increased muscle tone and scissoring

D.

a relatively larger deviation from the weight curve than predicted by length or head circumference

E.

poor hygiene

573.

All of the following characteristics are associated with an increased suicide risk exept

A.

psychosis

B.

unemployment

C.

chronic illness

D.

* first attempt

E.

readily available lethal weapon

574.

All of the following increase the likelihood of the need for hospital admission in an asthma patient exept

A.

multiple previous admissions

B.

a second ED visit within the preceding 3 days

C.

medication regimen includes systemic steroids at the time of ED presentation

D.

* third-trimester pregnancy

E.

history of previous intubation due to asthma

575.

All of the following may have a role in the acute management of severe asthma exept

A.

magnesium

B.

* salmeterol

C.

halothane

D.

helium

E.

ketamine

576.

All of the following physiologic changes take place during normal pregnancy exept

A.

* respiratory rate is increased

B.

blood volume increases

C.

systolic blood pressure decreases

D.

serum blood urea nitrogen (BUN) decreases

E.

leukocyte count increases

577.

All of the following regimens are recommended for the treatment of acute PID exept

A.

* ceftriaxone 125 mg intramuscularly plus doxycycline 100 mg orally twice a day for 10 to 14 days

B.

cefoxitin 2 g intravenously every 6 h plus doxycycline 100 mg intravenously twice a day or orally for 10 to 14 days

C.

cefoxitin 2 g intramuscularly plus probenecid 1 g orally and ofloxacin 400 mg orally twice a day for 14 days

D.

clindamycin 900 mg intravenously every 8 h plus gentamycin loading dose of 2 mg/kg intravenously followed by a maintenance dose of 1.5 mg/kg every 8 h

E.

cefotetan 2 g intravenously every 12 h plus doxycycline 100 mg intravenously twice a day or orally for 10 to 14 days

578.

All of the following statements about fractures of the proximal humerus are true exept

A.

* any fracture involving the surgical neck may result in compromised blood supply to the articular segment

B.

fracture of the lesser tuberosity suggests a potential posterior shoulder dislocation

C.

significant displacement of a greater tuberosity fragment implies a possible rotator cuff tear

D.

markedly angulated surgical neck fractures are at risk for neurovascular damage

E.

emergent orthopedic consultation is recommended for multipart fractures

579.

All of the following statements about hemorrhagic shock and encephalopathy syndrome are true exept

A.

the etiology is unknown

B.

the prodrome is usually a mild, nonspecific illness

C.

profuse, watery diarrhea progresses to bloody diarrhea

D.

hypoperfusion, seizures, metabolic acidosis, and DIC occur

E.

* laboratory abnormalities are limited to acid-base and hematologic dysfunction

580.

All of the following statements about Volkmann's ischemic contracture are true exept

A.

Volkmann's ischemic contracture is a complication of supracondylar fracture

B.

signs include refusal to open the hand in children, pain with passive extension of fingers, and forearm tenderness

C.

local edema causes decreased venous outflow and arterial inflow, resulting in local tissue ischemia

D.

muscle and nerve necrosis may occur, leading to permanent disability

E.

* absence of radial pulse is diagnostic

581.

All of the following statements are true about moderate dehydration in an infant exept

A.

the skin has decreased turgor

B.

mucous membranes are dry

C.

tears are diminished

D.

the child is irritable

E.

* oliguria, tachycardia, and profound shock are present

582.

All of the following statements are true of endometritis exept

A.

the incidence is greater in patients who have had a cesarean section than in those who have had a spontaneous vaginal delivery

B.

many infections are polymicrobial

C.

when patients present with endometritis 48 h to 6 weeks after delivery, chlamydia and mycoplasma should be considered as primary etiologies

D.

* the speculum examination always reveals a purulent discharge

E.

the clinical diagnosis is based on the symptoms of fever, malaise, lower abdominal pain, and foul-smelling lochia

583.

All of the following statements are true regarding aerosolized anticholinergic medications for asthma management exept

A.

the effect is additive when they are used in combination with adrenergic agonists

B.

they affect large central airways

C.

* they can cause clinically significant adverse mucous plugging and systemic toxicity

D.

results of studies comparing them with Я-adrenergic agonists are conflicting

E.

they may reduce symptoms in patients with chronic obstructive pulmonary disease (COPD)

584.

All of the following statements are true regarding dynamic CT of the chest exept

A.

a negative study does not rule out pulmonary embolism (PE)

B.

it can detect pneumonia and acute aortic dissection

C.

* its specificity is lower than that of a high-probability V./Q. scan

D.

it is most reliable for pulmonary emboli that extend up to the subsegmental level of the pulmonary vessels

E.

it requires the injection of contrast material

585.

All of the following statements concerning drugs in pregnancy are true exept

A.

with the exeption of large molecules, virtually all drugs cross the placenta

B.

category A drugs are safe during the first trimester of pregnancy

C.

diuretics are not generally recommended in pregnancy

D.

* erythromycin estolate can be safely prescribed in pregnancy

E.

cephalosporins can be used at any time during pregnancy

586.

All of the following statements regarding a child with hypernatremic dehydration are true exept

A.

there is at least a 10 percent fluid deficit

B.

the skin may appear dry or doughy

C.

muscle tone is increased

D.

the sensorium fluctuates between lethargy and hyperirritability

E.

* rapid rehydration is indicated

587.

All of the following statements regarding bone remodeling are true exept

A.

young children have a greater capacity for remodeling than adults

B.

remodeling is related to the degree of angulation

C.

angulation near the end of a long bone will remodel more satisfactorily than angulation near the midshaft

D.

angulation in the natural plane of the joint motion will remodel more successfully than angulation outside the plane of joint motion

E.

* injuries involving the epiphyseal plate are more likely to remodel successfully

588.

All of the following statements regarding hyponatremic dehydration in children are true exept

A.

serum sodium is less than 130 mEq/L

B.

sodium deficit exceeds water deficit

C.

* osmolar load is less in the intracellular fluid (ICF) than in the extracellular fluid

(ECF) compartment

D.

water shifts from the ECF compartment into the ICF compartment during equilibration

E.

possible sequelae include decreased circulatory volume, cerebral edema, seizures, and coma

589.

All of the following statements regarding isotonic dehydration in children are true exept

A.

it is the most common type of dehydration

B.

serum sodium remains within the normal range of 130 to 150 mEq/L

C.

sodium and water deficits are proportionate

D.

* calculated fluid deficit should be replaced at a uniform rate over 24 h

E.

initial fluid boluses should be subtracted from the calculated fluid deficit

590.

All of the following suggest that a child with asthma needs to be admitted exept

A.

persistent respiratory distress after albuterol and glucocorticoid treatments

B.

a peak flow of < 60 percent predicted in a cooperative child

C.

persistent vomiting of medications

D.

underlying bronchopulmonary dysplasia, congenital heart disease, or cystic fibrosis

E.

* SaO2 < 95 percent on room air upon arrival

591.

All the following are major side effects of immunosuppressant drugs used in lung transplant patients exept

A.

* hypokalemia

B.

hypertension

C.

bilirubinemia

D.

gastric dysmotility

E.

neurotoxicity

592.

Amaurosis fugax is caused by occlusion of which one of the following arteries?

A.

Anterior cerebral artery

B.

Basilar artery

C.

* Carotid artery

D.

Posterior cerebral artery

E.

Vertebral artery

593.

An 11-month-old patient with no primary care physician is called back to the ED for reevaluation because blood that was drawn the day before as part of a work-up of fever is positive for N. meningitidis. The clinical impression at discharge was otitis

media, and the patient was treated with amoxicillin and acetaminophen. The patient is now afebrile and playful. What is the most appropriate action?

A.

Repeat blood culture, intravenous ceftriaxone, admit

B.

* Repeat blood culture, perform lumbar puncture and CSF culture, start intravenous ceftriaxone, admit

C.

Repeat blood culture, intramuscular ceftriaxone, home with follow-up in 24 h

D.

Repeat blood culture, continue oral amoxicillin, follow up in 24 h or sooner if worse

E.

Home after thorough history and physical examination, with reassurance to the parents

594.

An 18-month-old male is brought to the ED for evaluation of a brief episode of tonic-clonic extremity movements immediately after a spanking in the grocery store.

The child reportedly screamed, became limp and pale, fell to the ground, and exhibited the unusual movements. The episode lasted about 1 min and occurred about 30 min before. The toddler is now interactive, appears healthy, and has normal vital signs.

What is the most likely diagnosis?

A.

* Breath-holding spell

B.

Head trauma

C.

Toxic ingestion

D.

Prolonged QT syndrome

E.

Idiopathic (afebrile) seizure of childhood

595.

An 8-month-old nontoxic infant is brought to the ED with a new rash. Physical examination shows numerous 0.5- to 1.0-cm bullae and red, round, denuded lesions of similar size scattered all over but primarily in the diaper area. Because the child has spent the weekend at the father's house, where many people smoke, the mother is concerned that these may represent cigarette burns. What is the most appropriate action?

A.

Apply neomycin ointment to the lesions and call social services

B.

Administer topical mupirocin and local wound care

C.

* Give oral cephalexin and local wound cleaning

D.

Admit for intravenous cephalosporin therapy

E.

Perform a Tzanck smear, invoke isolation precautions, and begin acyclovir

596.

An 8-year-old female is brought to the ED because of longstanding vague abdominal complaints, with new onset of dysuria. An extensive medical and social history and physical examination (including inspection of the genitourinary area) are unremarkable. The maternal grandmother, who is the patient's guardian, suspects that the child may have been a victim of sexual abuse. Which of the following statements is true?

A.

Because the genitourinary examination is normal, sexual abuse is unlikely

B.

A pelvic examination is necessary to rule out abuse and sexually transmitted diseases (STDs)

C.

Vaginal secretions should be sent for rapid antigens to detect STDs

D.

Syphilis and HIV serologies should be sent

E.

* Social service should be called and child protective services (CPS) involved even if the general physical and genitourinary examinations are normal

597.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

598.

An otherwise healthy 7-week-old baby presents with a rectal temperature of

40.0°C. Thorough physical examination does not show a source for the fever. Which of the following tests is most likely to show a source of infection?

A.

* Culture of a catheterized urine specimen

B.

Peripheral blood culture

C.

CBC and differential

D.

Culture of the CSF

E.

CXR

599.

An unimmunized 5-month-old infant presents with an indurated, red-violet quarter-sized area on the cheek and a fever of 39.5°C of 1 day's duration. He is irritable but consolable and has a supple neck. What is the most appropriate action?

A.

* Admit after blood cultures, catheterized urine, wound aspirate, lumbar puncture,

CBC, and intravenous ceftriaxone

B.

Admit after blood cultures, catheterized urine, wound aspirate, and intravenous ceftriaxone

C.

Home with close follow-up after wound-edge aspirate cultures, intramuscular ceftriaxone

D.

Home with close follow-up after blood cultures and oral amoxicillin

E.

Home with close follow-up after blood cultures and oral amoxicillin-clavulanic acid

600.

Any pregnant woman beyond 20 weeks of gestation who presents to the ED and appears to be actively contracting may need an emergent delivery. All of the following are true of emergency delivery exept

A.

inability to detect fetal heart tones does not rule out a viable pregnancy

B.

amniotomy may result in prolapse of the umbilical cord

C.

* once the mother feels an urge to push, she should be encouraged to proceed

D.

if the physician delivering the baby notices a "turtle sign," an assistant should apply suprapubic pressure

E.

once the head is delivered, it is imperative to check for a nuchal cord (present in

25 percent of deliveries)

601.

Aspirin therapy is used in all of the following conditions exept

A.

Kawasaki syndrome

B.

polyarticular juvenile rheumatoid arthritis

C.

acute rheumatic fever

D.

Henoch-Schцnlein purpura

E.

* Kohler disease

602.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

603.


A.


B.


C.

Both

D.

D.None

E.

General anaesthesia

604.

Clinical features consistent with acute rejection in a lung transplant patient include all of the following exept

A.

bilateral interstitial infiltrates

B.

cough, chest tightness, and fatigue

C.

a rise in temperature of 0.5°C over baseline

D.

a normal chest x-ray

E.

* FEV1 drop of at least 25 percent below baseline over 48 h

605.


A.

* 2

B.

3

C.

4

D.

6

E.

10

606.

Complication of epidural anaesthesia is exept-

A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

607.

Complications of Mycoplasma pneumonia infection include all of the following exept

A.

Guillain-Barrй syndrome

B.

aseptic meningitis and encephalitis

C.

hemolytic anemia

D.

pericarditis and myocarditis

E.

* septic arthritis

608.


A.


B.


C.


D.


E.

All of the above

609.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

610.

Cyclosporine levels are affected by all the following exept

A.

type of laboratory assay

B.

* use of nonsteroidal antiinflammatory drugs

C.

length of time since the transplant was performed

D.

use of macrolides and antiepileptics

E.

use of calcium channel blockers

611.


A.


B.


C.


D.

* All of the above

E.


612.

During initial evaluation of a 1-month-old distressed infant with URI symptoms, a heart murmur is detected. Which of the following would be LEAST helpful in providing evidence for congenital heart disease?

A.

CXR

B.

* Baseline CBC, blood gas, and blood chemistries

C.

Finding of a rounded liver edge 2 cm below the right costal margin

D.

Detecting a holosystolic murmur with radiation to the back

E.

EKG

613.


A.


B.


C.


D.


E.


614.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

615.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

616.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

617.


A.


B.


C.


D.

Sensory fibres

E.


618.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

619.


A.


B.


C.


D.


E.


620.

Hypercapnia can result from all of the following exept

A.

rapid, shallow breathing

B.

* increased CO2 production

C.

small tidal volume

D.

underventilation of the lung

E.

reduced respiratory drive

621.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

622.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

623.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

624.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

625.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

626.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

627.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

628.

Initial ED tests for a patient status post lung transplant could include all of the following exept

A.

chest x-ray

B.

arterial blood gas

C.

cyclosporine level

D.

* azathioprine level

E.

complete blood count (CBC) with differential

629.

Laparoscopy is being used more frequently to aid in the diagnosis of pelvic disease and to perform gynecologic surgeries. When a patient presents to the ED after one of these procedures, all of the following are true exept

A.

* free air under the diaphragm is a normal finding 1 week after surgery

B.

pelvic infections are uncommon after this procedure

C.

a traumatic bowel injury is less problematic than a thermal injury

D.

infection is an infrequent complication

E.

patients with increasing abdominal pain after the procedure have perforated bowel until proven otherwise

630.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

631.

Lidocaine can be used in all exept –

A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

632.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


633.


A.


B.


C.


D.


E.


634.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

635.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

636.


A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

637.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

638.

On chest x-ray, an increased anteroposterior diameter, flattened diaphragms, increased parenchymal lucency, and an attenuation of pulmonary vasculature are most consistent with which one of the following?

A.

Chronic bronchitic disease

B.

Bronchiectasis

C.

Dominant bronchitic disease in COPD

D.

* Emphysema

E.

Pneumonia

639.

One day after discharge from the normal newborn nursery, a jaundiced infant exhibits fleeting bicycling movements of the limbs, sucking of the lips, and occasional apneic episodes with color change. You interpret these as possible neonatal seizures.

Work-up and treatment should include all of the following exept

A.

evaluation for inborn errors of metabolism (including urine for reducing substances, organic amino acids, serum for lactate, pyruvate, and ammonia)

B.

correction of electrolyte, calcium, magnesium, glucose, and acid-base imbalances

C.

sepsis work-up

D.

* administration of diazepam as a first-line drug to control seizures

E.

loading with phenobarbital

640.

Parkinson's disease is characterized by all of the following exept

A.

akinesia or bradykinesia

B.

cogwheel rigidity

C.

* intention tremor

D.

Lewy bodies

E.

impairment in posture and equilibrium

641.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

642.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

643.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


644.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

645.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

646.

Reducing of oxygen transport function of preserved blood may occur as a result of the following reasons:

A.

Reduction of pH

B.

* Reduction of 2,3-diphosphoglycerate in erythrocytes

C.

Reduction of 2,3-diphosphoglycerate in the plasma

D.

Increasing the extracellular concentration of potassium ions

E.

Violations of the rheological properties

647.

Regarding supracondylar fractures, which of the following radiographic finding is

LEAST likely?

A.

Subtle or nonvisible fracture line

B.

Posterior fat pad sign

C.

Loss of angulation of the anterior capitellum

D.

Imaginary anterior humeral line bisects the anterior capitellum

E.

* Imaginary anterior humeral line bisects the posterior two-thirds of the capitellum

648.

Risk factors for SIDS include all of the following exept

A.

* sleeping in the supine position

B.

being born to a mother with a substance-abuse problem during pregnancy

C.

prematurity or low birth weight

D.

having a sibling with SIDS

E.

history of a previous apneic episode of life-threatening proportions (ALTE)

649.

Risk factors for spontaneous pneumothorax include all of the following exept

A.

smoking

B.

Marfan's syndrome

C.

* female sex

D.

sarcoidosis

E.

COPD

650.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

651.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

652.


A.


B.


C.


D.

* All of above

E.


653.

.Strategies for the management of uncomplicated COPD include all of the following exept

A.

broad-spectrum antibiotics

B.

* cromolyn sodium

C.

glucocorticoid therapy

D.

anticholinergics

E.

Я-adrenergic agonists

654.


A.

Ischemic heart disease ,

B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

655.

Symptoms heralding respiratory arrest during an asthma exacerbation include all of the following exept

A.

lethargy

B.

* severe respiratory alkalosis and the use of accessory muscles of respiration

C.

a normal pCO2 on arterial blood gas

D.

a silent chest on auscultation

E.

agitation

656.

Temporal arteritis is a vasculitis that affects women more frequently than men.

Which one of the following is not usually associated with temporal arteritis?

A.

Age > 50 years

B.

ESR > 50

C.

Ischemic papillitis

D.

* Tender, pulsatile temporal artery

E.

Polymyalgia

657.

The anterior drawer sign, Lachman's test, and the pivot shift are used to measure stability of which knee structure?

A.

Medial collateral ligament

B.

Lateral collateral ligament

C.

* Anterior cruciate ligament

D.

Posterior cruciate ligament

E.

Medial meniscus

658.


A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

659.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

660.


A.


B.


C.


D.


E.

* All of the above

661.

The following factors can cause damage to the lung surfactant, exept for:

A.

Aspiration of gastric contents

B.

* Durable ventilation with 30% oxygen

C.

Pulmonary embolism

D.

Extracorporeal oxygenation

E.

Inhalation of toxic gases

662.


A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

663.

The partial pressure of oxygen in alveolar gas depends on the whole, exept:

A.

Atmospheric pressure

B.

The concentrations of oxygen in the inspired gas

C.

The partial pressure of carbon dioxide in the alveoli

D.

* The values of cardiac output

E.

Temperatures

664.

The patient tidal volume is 500 ml, minute volume of breath is 5000 ml, dead space - 100 ml. What is alveolar ventilation?

A.

* 4000 ml

B.

3500 ml

C.

3000 ml

D.

2500 ml

E.

2000 ml

665.

The severity of pulmonary injury from aspiration is based on all of the following factors exept

A.

the presence of bacterial contamination

B.

the pH of the aspirate

C.

the volume of the aspirate

D.

the presence of particulate matter

E.

* the position of the patient at the time of aspiration

666.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

667.

To make the diagnosis of toxic shock syndrome, all of the following must be present exept

A.

hypotension

B.

temperature greater than 38.9°F

C.

rash with subsequent desquamation

D.

* negative serologic test for streptococcal infection

E.

involvement of three of the following organ systems: gastrointestinal, musculoskeletal, renal, mucosal, hepatic, hematologic, or central nervous system

668.

Treatment for atypical pneumonia includes all of the following exept

A.

erythromycin

B.

azithromycin

C.

tetracycline

D.

* penicillin and/or cephalosporins

E.

bronchodilators, expectorants, and cough suppressants

669.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

670.

What are the pathogenic factors of acute respiratory failure in an open pneumothorax?

A.

* Shutdown of ventilation on the affected side

B.

Expression of shunting blood to the lungs in a healthy side

C.

Free motion of gas from one lung to another

D.

Flotation of the mediastinal organs during respiration

E.

Severe disorders of blood circulation in the lungs

671.

What is the BEST position in which to place a patient with massive hemoptysis?

A.

Affected side up

B.

* Affected side down

C.

Trendelenburg

D.

Reverse Trendelenburg

E.

None of the above

672.

What is the drug of choice for the endemic fungal pneumonias (histoplasmosis,

Blastomycosis, and coccidioidomycosis)?

A.

Amikacin

B.

* Amphotericin B

C.

Rifampin

D.

Pentamidine

E.

Fluoroquinolones

673.

What is the drug of choice for treatment of uncomplicated lung abscess?

A.

* Clindamycin

B.

Ceftriaxone

C.

Gentamicin

D.

Erythromycin

E.

Tetracycline

674.

What is the first study you should order on this patient?

A.

Urinalysis

B.

Complete blood count (CBC)

C.

Quantitative RhCG

D.

* Qualitative RhCG

E.

Ultrasound

675.

What is the method of choice for diagnosing PCP?

A.

Gallium scan

B.

Cytologic sputum analysis

C.

* Fiberoptic bronchoscopy

D.

Direct fluorescence of sputum with monoclonal antibodies

E.

Fungal culture

676.

What is the most common cause of preload disorders in children?

A.

Distributive shock

B.

* Hypovolemic shock from vomiting and diarrhea

C.

Congestive heart failure

D.

Severe anemia

E.

Hypoxemia

677.

What is the most common chest x-ray finding seen in patients with Mycoplasma pneumonia?

A.

* Acute interstitial, patchy infiltrates

B.

Lung abscess

C.

Large pleural effusions

D.

Mediastinal lymphadenopathy

E.

Cavitary lesions

678.

What is the most common site for a compartment syndrome?

A.

* Anterior compartment of the lower leg

B.

Peroneal compartment of the lower leg

C.

Deep posterior compartment of the lower leg

D.

Volar compartment of the forearm

E.

Dorsal compartment of the forearm

679.

What is the optimal humidity of inhaled gas for the patient breathing through intubation tube?

A.

40%

B.

60%

C.

* 95-100%

D.

Humidity does not matter

E.

80%

680.

When a gravid female presents in cardiac arrest, all of the following statements are true exept

A.

the "human wedge" is useful in bystander CPR

B.

* ideally, a Cardiff wedge should be placed under the patient's left hip and flank

C.

manual displacement of the uterus off the inferior vena cava helps increase venous return

D.

pregnant women are in an edematous state that can make intubation difficult

E.

the use of a femoral line to deliver medications should be discouraged

681.

When evaluating for possible otitis media, which of the following is of the

LEAST diagnostic value?

A.

History of a new onset of ear pulling starting several days after URI

B.

* Presence of the light reflex

C.

Translucency of the tympanic membrane (TM)

D.

Mobility in response to pneumatoscopy

E.

Fluid level behind the TM

682.

Which of the following are complications of aspiration pneumonia?

A.

Lung abscess

B.

Pulmonary fibrosis

C.

Hemoptysis

D.

Empyema

E.

* All of the above

683.

Which of the following BEST characterizes the typical chest x-ray findings seen in PCP infection?

A.

Normal chest x-ray

B.

* Diffuse bilateral interstitial infiltrates

C.

Hilar lymphadenopathy

D.

Pneumothorax

E.

Pleural effusions

684.

Which of the following BEST describes the classic chest x-ray findings in primary tuberculosis?

A.

* Parenchymal infiltrates in any area of the lung with unilateral lymphadenopathy

B.

Infiltrate or nodule with calcification

C.

Infiltrates of the upper lobe or superior segment of the lower lobes

D.

Cavitary lesions

E.

Pleural effusion

685.

Which of the following chest x-ray findings favors lung abscess over empyema?

A.

An air-fluid level at the site of a previous pleural effusion

B.

A cavity with an air-fluid level that tapers at the pleural border

C.

An air-fluid level that crosses a fissure

D.

An air-fluid level that extends to the lateral chest wall

E.

* None of the above

686.

Which of the following chest x-ray findings is LEAST consistent with pneumococcal pneumonia?

A.

Single, lobar consolidation

B.

Pleural effusion

C.

Patchy, multilobar involvement

D.

* Pneumothorax

E.

Bulging fissure

687.

Which of the following distinguishes delirium from dementia?

A.

Global cognitive impairment

B.

Periods of acute worsening of symptoms

C.

* Clouded sensorium

D.

Reversibility

E.

Gradual onset of symptoms

688.

Which of the following drugs have a selective beta-2 adrenergic effect:

A.

Epinephrine

B.

Izadrin

C.

Euphyllin

D.

* Salbutamol

E.

Ephedrine

689.

Which of the following groups has a high prevalence of tuberculosis?

A.

Elderly and nursing home patients

B.

Immigrants

C.

HIV-infected patients

D.

Alcoholics and illicit drug users

E.

* All of the above

690.

Which of the following groups of pediatric patients are at increased risk for hypoglycemia?

A.

Patients with glycogen storage disease type I

B.

Children younger than 18 months, after a period of fasting

C.

Children who have ingested alcohol but have no clinical signs of intoxication

D.

Children with an abdominal mass

E.

* All of the above

691.

Which of the following hip fractures is most likely to disrupt perfusion of the femoral head?

A.

* Subcapital fracture

B.

Intertrochanteric fracture

C.

Subtrochanteric fracture

D.

Pubic ramus fracture

E.

Avulsion of the greater trochanter

692.

Which of the following immunocompromised patients are not at increased risk for contracting fungal pneumonia?

A.

Patients with acquired immunodeficiency syndrome (AIDS)

B.

Organ transplant patients

C.

Patients on chronic steroids

D.

Cancer patients

E.

* Patients with sickle cell disease or splenectomy

693.

Which of the following injuries is most likely to be associated with disruption of the cruciate ligaments?

A.

Patellar fracture

B.

Femoral condyle fracture

C.

Avulsion of the tibial tuberosity

D.

Tibial plateau fracture

E.

* Tibial spine fracture

694.

Which of the following is an appropriate initial treatment for pulmonary tuberculosis?

A.

INH

B.

INH plus rifampin

C.

INH, rifampin, and ethambutol

D.

* INH, rifampin, ethambutol, and pyrazinamide

E.

INH, rifampin, ethambutol, and streptomycin

695.

Which of the following is beneficial if pulmonary aspiration has occurred?

A.

Irrigation of the tracheobronchial tree with neutral or alkaline saline

B.

Steroids

C.

Prophylactic antibiotics

D.

* Bronchoscopy

E.

All of the above

696.

Which of the following is false regarding myasthenia gravis?

A.

* The clinical hallmark is nonfatigable muscle weakness

B.

Myasthenia gravis is often associated with other autoimmune diseases

C.

Confirmation of myasthenia is possible with the edrophonium test

D.

Overmedication can produce a clinical picture that mimicks myasthenic crisis

E.

Thymectomy is advocated for most myasthenic patients

697.

Which of the following is LEAST consistent with a panic attack?

A.

* Hallucinations

B.

Palpitations

C.

Chest tightness

D.

Dizziness

E.

Dyspnea

698.

Which of the following is LEAST consistent with Guillain-Barr syndrome?

A.

Ascending paralysis

B.

Preceded by exposure to toxins

C.

Sensory involvement

D.

* Intact reflexes

E.

Resolution of symptoms in months

699.

Which of the following is more consistent with bulimia than with anorexia nervosa?

A.

Hypoglycemia

B.

Tachydysrhythmia

C.

Stress fracture

D.

* Dysphagia

E.

Cathartic colon

700.

Which of the following is most impaired by REM sleep deprivation?

A.

Physical recuperation

B.

Intellectual tasks

C.

* Psychological well being

D.

Social life

E.

Manual tasks

701.

Which of the following is not a cause of peripheral cyanosis?

A.

Congestive heart failure

B.

Peripheral vascular disease

C.

Cold exposure

D.

* Intracardiac shunting

E.

Arterial or venous obstruction

702.

Which of the following is not a chlamydial organism that can cause pneumonia?

A.

C. trachomatis

B.

psittaci

C.

The TWAR agent

D.

* Mycoides

E.

All of the above are chlamydial agents that cause pnuemonia

703.

Which of the following is not a clinical characteristic of Legionella pneumonia?

A.

Toxic appearance

B.

* Lack of GI symptoms

C.

Pleuritic chest pain and hemoptysis

D.

Relative bradycardia

E.

Mental status changes

704.

Which of the following is not characteristic of Klebsiella pneumonia?

A.

Most frequently occurs in alcoholics and patients with diabetes and COPD

B.

Empyema and abscess formation are common complications

C.

Pleuritic chest pain is a common symptom

D.

Sputum is often brown and proteinaceous

E.

* Patients usually respond to outpatient antibiotics

705.

Which of the following is not characteristic of pneumococcal pneumonia?

A.

Acute onset, tachycardia, and tachypnea

B.

* Recurrent rigors

C.

Pleuritic chest pain

D.

Thick, rusty sputum

E.

Malaise, flank or back pain, and vomiting

706.

Which of the following is the BEST view to request when assessing for the presence of pneumothorax on chest x-ray?

A.

Supine anteroposterior

B.

Upright posteroanterior (PA)

C.

Inspiratory PA

D.

Lateral decubitus with the patient lying on the unaffected side

E.

* Expiratory PA

707.

Which of the following is the LEAST consistent with a clinical diagnosis of acute appendicitis?

A.

Normal temperature

B.

Normal white blood cell (WBC) count

C.

Presence of hunger

D.

* Vomiting preceding the onset of abdominal pain

E.

Recent gastroenteritis

708.

Which of the following is the most common effect of pregnancy on an asthma patient?

A.

An improvement in respiratory function

B.

An exacerbation of asthma symptoms

C.

A decrease in asthma symptoms

D.

A worsening in overall respiratory function

E.

* An increase in maternal complications and perinatal mortality

709.

Which of the following is the most common ligament injured during ankle sprain?

A.

* Anterior talofibular ligament

B.

Posterior talofibular ligament

C.

Calcaneofibular ligament

D.

Deltoid ligament

E.

Anterior tibiofibular ligament

710.

Which of the following is true regarding Legionella pneumonia?

A.

Accounts for less than 2 percent of bacterial pneumonias

B.

Has a higher incidence in the winter and spring

C.

Mode of transmission is through person-to-person contact

D.

Usually resolves without sequelae, even if not treated with antimicrobials

E.

* The organism is a gram-negative rod

711.

Which of the following is true regarding scapular fractures?

A.

Most are treated with open reduction and internal fixation

B.

Approximately 50 percent are associated with intrathoracic injuries

C.

They frequently result in long-term disability

D.

They account for approximately 8 percent of all fractures

E.

* The mechanism of injury is from direct blow, trauma to the shoulder, or fall on an outstretched arm

712.

Which of the following is true regarding treatment of a child with diabetic ketoacidosis (DKA)?

A.

Volume replacement is the mainstay of therapy and should be generous and rapid

B.

An initial bolus of 0.1 U/kg insulin must be given before beginning an insulin infusion

C.

The insulin infusion should be discontinued once the patient's glucose has fallen below 200 to 250 mg/dL

D.

* Cerebral edema may occur 6 to 8 h into therapy, after apparent clinical improvement

E.

Potassium supplementation is not needed in the child with DKA who is still acidotic, provided the serum potassium is normal

713.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

714.

Which of the following laboratory values is LEAST consistent with Pneumocystis carinii pneumonia (PCP) infection?

A.

* Elevated WBC count

B.

Low CD4 count

C.

Elevated LDH and ESR

D.

Marked hypoxia on arterial blood gas

E.

Increased A-a gradient on arterial blood gas

715.

Which of the following mechanisms is most likely to result in an anterior glenohumeral dislocation?

A.

* Abduction, extension, and external rotation

B.

Forceful internal rotation and adduction

C.

Electric shock

D.

Seizure

E.

Direct force to the anterior shoulder

716.

Which of the following mechanisms of hypoxia during general anesthesia is associated with a normal alveolar-arterial gradient of O2 and CO2 and is easily corrected by the addition of O2?

A.

Intracardiac shunt

B.

* Hypoventilation

C.

Violation of ventilation-perfusion ratio

D.

Pulmonary shunt

E.

Low cardiac

717.

Which of the following methods is most appropriate for collecting a urine specimen for culture?

A.

Bag specimen in a circumcised infant boy

B.

Suprapubic tap in an infant girl with labial fusion

C.

Catheterization in a circumcised, 3-year-old boy

D.

Catheterization in an uncircumcised, 5-year-old boy

E.

* Clean catch in an uncircumcised, 5-year-old boy

718.

Which of the following most likely represents vertigo of peripheral origin?

A.

Ataxia

B.

Diplopia

C.

Dysphagia

D.

Facial numbness

E.

* Unilateral hearing loss

719.

Which of the following must be monitored in a schizophrenic patient controlled with clozapine?

A.

Liver function tests

B.

Amylase

C.

Glucose

D.

* CBC

E.

Urinalysis

720.

Which of the following organisms is associated with multilobar involvement, large pleural effusions, a rapidly progressive course, and a high mortality?

A.

* Group A streptococcal pneumonia

B.

Staphylococcal pneumonia

C.

Haemophilus influenza pneumonia

D.

Mycoplasma pneumonia

E.

Pneumococcal pneumonia

721.

Which of the following patient groups is LEAST likely to require admission for pneumonia?

A.

Pregnant patients

B.

Immunocompromised or debilitated patients

C.

Patients toxic in appearance

D.

Patients unable to care for themselves at home

E.

* Patients with mild hypoxia on blood gas analysis

722.

Which of the following personality disorders is seen in a disproportionate number of ED patients?

A.

* Antisocial

B.

Borderline

C.

Obsessive-compulsive

D.

Dependent

E.

Paranoid

723.

Which of the following reflex findings would be pathologic in an adult?

A.

Bilateral patellar hyperreflexia

B.

Bilateral patellar hyporeflexia

C.

* Bilateral snout reflexes

D.

Bilateral plantar reflexes

E.

Superficial anal reflex

724.

Which of the following regarding viral pneumonia is false?

A.

Hantavirus has a high associated mortality

B.

* Influenza vaccine is generally ineffective in preventing influenza pneumonia

C.

Viral pneumonias often occur as epidemics, but sporadic cases may be seen

D.

Complications include bacterial superinfection, respiratory failure, and bronchiolitis obliterans-organizing pneumonia (BOOP)

E.

Supportive care is the mainstay of treatment

725.

Which of the following relations is LEAST likely to exist?

A.

Crime and substance abuse

B.

Trauma and alcohol abuse

C.

Mental illness and suicide gestures

D.

Cocaine and sexually transmitted diseases

E.

* Intravenous drug use and long life expectancy

726.

Which of the following represents INAPPROPRIATE management of fever in children?

A.

Unwrapping the bundled child and retaking the temperature after 15 min

B.

* Documenting the temperature accurately by using a tympanic thermometer, especially in infants

C.

Ibuprofen orally in a maximum dose of 40 mg/kg/day divided between 6 and 8 h

D.

Slow cooling by sponging with tepid water

E.

Administration of ibuprofen and acetaminophen simultaneously

727.

Which of the following seizure patients requires electroencephalographic (EEG) monitoring for optimal treatment?

A.

35-year-old status post a witnessed tonic-clonic seizure with resolution of the postictal period in 10 min

B.

40-year-old alcoholic status post two witnessed seizures in the ED, with lucid periods after each seizure

C.

20-year-old status post first seizure

D.

28-year-old with status epilepticus controlled with fosphenytoin

E.

* 30-year-old with refractory status epilepticus requiring vecuronium

728.

Which of the following statements about anterior shoulder dislocations is false?

A.

Nerve injury occurs in 10 to 25 percent of acute dislocations

B.

Most neural injuries involve the axillary nerve

C.

Successful reduction occurs in 70 to 90 percent of cases, regardless of technique

D.

Associated rotator cuff injuries occur in 80 percent of patients older than 60 years

E.

* Vascular injuries are rare but, when they occur, tend to involve the brachial artery

729.

Which of the following statements about lunate fractures is false?

A.

The most common mechanism is a fall on an outstretched hand

B.

Lunate fractures are the third most common type of carpal fracture

C.

The lunate occupies two thirds of the radial articular surface

D.

* X-rays reliably demonstrate the fracture

E.

This fracture may be associated with avascular necrosis of the lunate

730.

Which of the following statements about management of hemorrhage in pelvic fractures is false?

A.

Patients with double breaks in the ring require blood products more often than those with single breaks

B.

Aggressive fluid and blood replacement is a mainstay of therapy

C.

An external fixator may be useful to reduce bleeding in some pelvic fractures

D.

Angiography and embolization can be done to control small bleeding sites

E.

* Laparotomy provides definitive therapy

731.

Which of the following statements about sternoclavicular dislocations is false?

A.

The medial clavicular epiphysis is the last epiphysis of the body to close (at age

22-25 years)

B.

CT is the imaging modality of choice

C.

Anterior dislocations are more common than posterior dislocations

D.

* Closed reduction is frequently successful

E.

Posterior dislocations are associated with injuries to thoracic structures

732.

Which of the following statements is true concerning genital herpes?

A.

HSV-1 accounts for up to 50 percent of the cases of genital herpes

B.

Systemic acyclovir decreases the frequency of recurrences

C.

* Systemic symptoms are common with the initial presentation of genital herpes

D.

Tzanck smears are positive in the majority of cases

E.

Cultures of fluid obtained from herpes vesicles are positive only a third of the time

733.

Which of the following statements regarding bacterial meningitis is false?

A.

Some bacteria are able to spread directly into the CNS, whereas others depend on hematogenous seeding

B.

Brudzinski's sign is not pathognomonic for meningitis

C.

Dexamethasone can be given to adult patients suspected of having meningitis

D.

Oral antibiotics change the clinical course

E.

* Patients should receive prophylactic phenytoin to prevent seizures

734.

Which of the following statements regarding hip dislocations is false?

A.

The risk of avascular necrosis increases if reduction is delayed

B.

Traumatic hip dislocations in children are rare

C.

Reduction should be done as soon as possible and always within 6 h

D.

* In patients with anterior dislocations, the extremity is shortened and internally rotated

E.

Posterior dislocations are more common than anterior dislocations

735.

Which one of the following can cause pancreatitis?

A.

* Azathioprine

B.

Prednisone

C.

Cyclosporine

D.

Tacrolimus

E.

All of the above

736.

Which one of the following children with diarrhea requires antibiotics?

A.

* A 3-month-old infant whose rectal swab from three nights before grew

Salmonella

B.

A 10-year-old patient with stool culture positive for Salmonella whose bowel movements have decreased in frequency and volume

C.

A 4-year-old patient with sickle cell trait whose stool grew Salmonella

D.

A 12-month-old with mild dehydration whose rectal swab from a previous ED evaluation grew Salmonella

E.

A 5-year-old patient with moderate bloody diarrhea that began after completing a course of amoxicillin for otitis media

737.

Which one of the following has the highest sensitivity for pulmonary embolism?

A.

A high-probability ventilation-perfusion radionuclear scan

B.

A medium-probability ventilation-perfusion radionuclear scan

C.

A low-probability ventilation-perfusion radionuclear scan

D.

Transesophageal echocardiography (TEE)

E.

* Dynamic (spiral) computed tomography (CT)

738.

Which one of the following indicates severe asthma?

A.

Pulsus paradoxus < 20 mm Hg

B.


C.

* Pulsus paradoxus > 20 mm Hg

D.

Pulsus paradoxus > 10 mm Hg

E.


739.

Which one of the following is considered the hallmark of COPD?

A.

* Exertional dyspnea

B.

Chronic dry cough

C.

Chronic cough productive of yellow sputum accompanied by global diminution of breath sounds

D.

Increased anteroposterior diameter

E.

Pursed-lip exhalation

740.

Which one of the following is the LEAST consistent with a diagnosis of intussusception?

A.

Intermittent colicky abdominal pain, interspersed with symptom-free periods

B.

Grossly normal appearing stool

C.

Normal plain films of the abdomen

D.

* Previously healthy 9-year-old child

E.

Altered, lethargic appearance

741.

Which one of the following pulmonary function tests is the most useful at the bedside?

A.

* Peak expiratory flow rate (PEFR)

B.

Forced expiratory volume in 1 s (FEV1)

C.

Forced vital capacity (FVC)

D.

Total lung capacity

E.

Arterial blood gas

742.

Which one of the following V./Q. findings (coupled with the clinical description) is LEAST suggestive of pulmonary embolism?

A.

* Multiple matched defects between ventilation and perfusion scans with a low clinical index of suspicion

B.

One moderately sized mismatched defect between ventilation and perfusion scans with a low clinical index of suspicion

C.

Bilateral mismatched defects between ventilation and perfusion scans with a moderate clinical index of suspicion

D.

A low-probability scan with a high clinical index of suspicion

E.

An intermediate-probability scan with a low clinical index of suspicion

743.

. Which statement about antibiotic therapy is true for COPD patients?

A.

Broad-spectrum antibiotic therapy is indicated to treat tracheobronchitis only when it is mucopurulent

B.

In mild to moderate cases of bronchitis, antibiotic therapy should be started selectively only after sputum culture and sensitivities are available

C.

* In mild to moderate cases of bronchitis, broad-spectrum antibiotics can be started before the availability of results of sputum culture and sensitivities

D.

Antibiotic therapy is reserved for the treatment of coexistent pneumonia

E.

Antibiotics are reserved to treat pneumonia and severe cases of bronchitis

744.

Which type of pelvic fracture is most often associated with severe hemorrhage?

A.

Anterioposterior compression

B.

* Vertical shear

C.

Lateral compression

D.

Crush injuries

E.

Combination injuries

745.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

746.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

747.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

748.


A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

749.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

750.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

751.


A.


B.


C.

Both

D.

D.None

E.


752.


A.

* 2

B.

3

C.

4

D.

6

E.

10

753.


A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

754.


A.


B.


C.


D.


E.

All of the above

755.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

756.


A.


B.


C.


D.

* All of the above

E.


757.


A.


B.


C.


D.


E.


758.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

759.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

760.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

761.


A.


B.


C.


D.

Sensory fibres

E.


762.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

763.


A.


B.


C.


D.


E.


764.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

765.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

766.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

767.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

768.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

769.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

770.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

771.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

772.


A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

773.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


774.


A.


B.


C.


D.


E.


775.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

776.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

777.


A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

778.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

779.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

780.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

781.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


782.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

783.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

784.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

785.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

786.


A.


B.


C.


D.

* All of above

E.


787.


A.


B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

788.


A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

789.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

790.


A.


B.


C.


D.


E.

* All of the above

791.


A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

792.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

793.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

794.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

795.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

796.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

797.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

798.

Acute intestinal obstruction first of all causes such disorders of haemostasis:

A.

intoxicative syndrome

B.

violations of breathing

C.

* hypohydration, violations of electrolytic concentrations

D.

acute renal and liver failure

E.

sepsis as a consequence of translocation phenomena

799.


A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

800.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

801.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

802.


A.


B.


C.

Both

D.

D.None

E.


803.

Choose the best calorie amount for parenteral nutrition of a patient in postoperative period:

A.

40 kkal/kg

B.

10 kkal/kg

C.

20 kkal/kg

D.

* 30 kkal/kg

E.

50 kkal/kg

804.

Choose the list of necessary postoperative corrective therapy:

A.

narcotic analgesics, antibiotics, cardiovascular medicines, electrolytes, vitamins

B.

* correction of haemostasis, pain relief, parenteral nutrition, exercise therapy

C.

pain relief, correction of breathing and volume of hydremia, stimulation of intestinal peristalsis

D.

pain relief, usage of central respiratory stimulators, antibiotics, parenteral nutrition

E.

correction of haemostasis, pain relief, antibiotics, exercise therapy

805.


A.

* 2

B.

3

C.

4

D.

6

E.

10

806.


A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

807.


A.


B.


C.


D.


E.

All of the above

808.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

809.

During anaesthesia of the patient with peritonitis the risk of which complication will grow greatly?

A.

* inhibition of respiratory centre as a consequence of pulmonary oedema

B.

bronchiolospasm

C.

acute heart failure as a consequence of mediastinum displacement, caused by the elevated diaphragm

D.

regurgitation and aspiration

E.

hyperpotassemic cardiac arrest

810.


A.


B.


C.


D.

* All of the above

E.


811.

During the intestinal obstruction greatly growth the risk of:

A.

* regurgitation and aspiration

B.

sepsis

C.

multiple organ failure

D.

liver failure

E.

pain shock

812.

During the postoperative period it’s necessary to use infusion therapy at the level of:

A.

50 ml/kg

B.

10 ml/kg

C.

20 ml/kg

D.

* 40 ml/kg

E.

30 ml/kg

813.


A.


B.


C.


D.


E.


814.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

815.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

816.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

817.


A.


B.


C.


D.

Sensory fibres

E.


818.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

819.


A.


B.


C.


D.


E.


820.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

821.

In case of reactive peritonitis hemodynamics is usually characterised with:

A.

collapses

B.

hypodynamic regimen

C.

* hyperdynamic regimen

D.

hypovolemic shock

E.

dependence on the initial blood pressure

822.

In case of toxic peritonitis cardiac output:

A.

depends on the blood pressure

B.

growth

C.

doesn’t change much

D.

* lowers

E.

depends on the initial blood pressure

823.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

824.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

825.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

826.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

827.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

828.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

829.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

830.


A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

831.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


832.


A.


B.


C.


D.


E.


833.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

834.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

835.


A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

836.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

837.

Parenteral nutrition should be used for the patients, when:

A.

* when enteral is impossible

B.

all patients in intensive care department

C.

all patients in bad conditions

D.

when vital functions are disordered

E.

in postoperative period

838.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

839.

Peritonitis is classified next way:

A.

* reactive, toxic, terminal

B.

compensated, uncompensated, terminal

C.

stages I, II, III

D.

upper and lower parts of the abdomen

E.

early and late

840.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

841.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


842.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

843.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

844.

Right after the operation with aesthesia proserin is used for:

A.

renewal of respiratory centre activity

B.

removal of residual curaresation after usage of depolarizing muscle relaxant

C.

* removal of residual curaresation after usage of nondepolarizing muscle relaxant

D.

stimulation of intestinal peristalsis

E.

prevention of bronchiolospasm

845.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

846.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

847.


A.


B.


C.


D.

* All of above

E.


848.


A.


B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

849.

The best anaesthesia for the patients with peritonitis is:

A.

* I/v with myoplegia and ALV

B.

inhalation through the mask

C.

epidural anaesthesia

D.

spinal anaesthesia

E.

conduction and infiltrative anaesthesia

850.


A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

851.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

852.

The duration of preoperative preparing of patient with peritonitis is limited with:

A.

conduction of necessary examinations

B.

* stabilisation of haemostasis

C.

readiness of surgeons

D.

preparation to the anaesthesia

E.


853.


A.


B.


C.


D.


E.

* All of the above

854.


A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

855.

The most common disorder of haemostasis during peritonitis are:

A.


B.

respiratory acidosis

C.

thrombosis of deep veins of lower limbs, thromboembolism

D.


E.

metabolic alkalosis

856.

The most common reason of early complications of operations with arduanum usage is:

A.

* falling back of the root of the tongue

B.

inhibition of respiratory centre

C.

dehydration

D.

laryngospasm

E.

bronchiolospasm

857.

The most common reason of early complications of operations with central anaesthesia is:

A.

* depression of respiration

B.

bronchiolospasm

C.

hypotension

D.

cardiac arrest

E.

acute liver impairment

858.

The most common reason of early complications of operations with dithylinum usage is:

A.

laryngospasm

B.

inhibition of respiratory center

C.

collapses

D.

* falling back of the root of the tongue

E.

arrhythmia

859.

The most common reason of early complications of operations with ketamine usage is:

A.

laryngospasm

B.

rhythm disturbance

C.

collapses

D.

* hallucinosis, inadequate behaviour

E.

respiratory “anarchy”

860.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

861.

The vital functions of the body are:

A.

haemodynamics, conciseness

B.

breathing, activity of kidneys, liver, gastro-intestinal tract

C.

* breathing haemodynamics, somatic and vegetative nervous system activity of kidneys, liver, gastro-intestinal tract

D.

breathing, circulation, activity of liver

E.

breathing, haemodynamics

862.

To the parenteral nutrition belong next:

A.

poliglukin

B.

albumin

C.

plasma

D.

derivative of starch

E.

* lipofundin

863.


A.

* 10% solution of glucose

B.

albumin

C.

plasma

D.

derivative of starch

E.

carbicarb

864.


A.

plasma, solution of kasein-hydrolizate

B.

albumin

C.

solution of kasein-hydrolizate

D.

* protein

E.

polivinilpirolidon

865.

To the parenteral nutrition does not belong next:

A.

* dextrins

B.

protein hydrolisates

C.

10% solution of glucose

D.


E.

lipomays

866.

To the parenteral nutrition does not belong next:

A.

* hydroxyetylstarch

B.

hydrolysin

C.

kasein-hydrolizate

D.


E.

lipofundin

867.

Uncompensated pylorostenosis is dangerous first of all because of:

A.

intoxicative syndrome

B.

* hyponatremia and hypohydration

C.

respiratory alkalosis and metabolic acidosis

D.

hypokaliemia, hypochloremia, metabolic alkalosis

E.

acute suprarenal failure

868.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

What way do the indexes of hemoconcentration change in case of acute intestinal obstruction?

F.

* Hematocrit elevates because of the hemoconcentration, but the level of haemoglobin and protein lowers in connection with intoxication

G.

B. lower

H.

C. do not change greatly

I.

D. greatly lowers haemoglobin because of intoxication and electrolytic disorders

J.

E. grow

869.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

870.

What are the receptors responsible for stimulation of the respiratory center in hypoxemia?

A.

* The respiratory center is not a reflex stimulated carotid chemoreceptors

B.

The oxygen tension in arterial blood is reduced to 60 mm Hg

C.

A person inhales a gas mixture with 15% of oxygen

D.

The man rises to a height of 4000 m

E.

Patient anemic

871.

Child's sharply breathing can be caused by the following factors except:

A.

Epiglotitis

B.

foreign body of larynx

C.

stenosing laryngotracheitis

D.

* Acute bronhiolospasm

E.

Submucose edema

872.

Kussmaul breathing :

A.

Occurs when renal excretory alkalose

B.

Is the respiratory compensation of diabetic ketoacidosis

C.

* often observed at coma

D.

It is a characteristic feature of hyperosmolar diabetic coma

E.

Reduces alveolar ventilation

873.

Possible iatrogenic causes of acute respiratory distress syndrome may be the following factors except:

A.

artificial ventilation, the concentration of oxygen in the inspired gas is not higher than 40%

B.

artificial ventilation with oxygen concentration in the inspired gas is not higher than 70%

C.

Transfusion of blood incompatible

D.

Operations using the heart-lung machine

E.

* Severe hypovolemic shock

874.

Synchronous intermittent mandatory ventilation (SIMV) compared with controlled ventilation:

A.

Reduces blood pressure and cardiac output

B.

Reduces the work of respiratory muscles

C.

Reduces the energy cost of breathing

D.

* Allows you to reduce the pressure on the height of inspiration

E.

Lowers and raises the pH pCO2

875.

The patient during intubation anesthesia using mechanical ventilation suddenly emerged cyanosis on the background of normal hemodynamic indexes . In the case of massage ungual phalanges cyanos does not decrease. All that is the proper, except:

A.

Check tightness of breathing system

B.

Remove the flow of nitrous oxide (if applicable)

C.

Increase the supply of oxygen

D.

Check patency and position of endotracheal tube

E.

* Change absorber of carbon dioxide

876.

The rapid drop of carbon dioxide tension in arterial blood from a high level to normal can lead to:

A.

Arterial hypertension

B.

* Arrhythmias

C.

cephaledema

D.

Increase in coronary perfusion

E.

None of the above

877.

After 20 minutes of ventilation with pure oxygen arterial pO2 of patient was 60 mm Hg . What is the mechanism of respiratory disorders?

A.


B.

Violation of diffusion through the alveolar-capillary membrane

C.

Violation of ventilation-perfusion ratios in lungs

D.

Intrapulmonary shunting up to 10%

E.

* Toxicity of oxygen

878.

After a 2-sided carotid endarterectomy in a patient:

A.

did not disturb the regulation of respiration

B.

No reaction to the rise of paCO2

C.

There is a shortness of breath in response to hypoxemia

D.

* The main impetus of the respiratory center is to increase the pH and pCO2 intracerebral interstitial fluid

E.

None of the above

879.

Airway resistance during turbulent flow of gas depends on the following factors except:

A.

pipe radius

B.

gas viscosity

C.

The gas density

D.

Bit stream

E.

* Lung compliance

880.

All statements about spontaneous pneumothorax are true, except:

A.

The most common among men 20-40 years

B.

* the trachea is mooving in the patient side

C.

Increased risk for women during menstruation

D.

Increased risk in smokers

E.

There are people with a genetic predisposition

881.

Alveolar hypoventilation leads to everything, except:

A.

hypoxemia during air breathing

B.

* hypoxemia while breathing oxygen

C.

hypercapnia when breathing air

D.

Hypercapnia during oxygen breathing

E.

Anything with the above listed

882.

Anatomical dead space is increased by the action of the following factors except:

A.

* pleurorrhea

B.

Atropine

C.

Inhalation of phtorotan

D.

Introduction aminophylline

E.

None of the above

883.

At the function cilliaris apparatus of the lower respiratory tract adversely affect the following factors except:

A.

incense

B.

dehydration

C.

Hyperhydration

D.

Atropinisation

E.

* Introduction glucocorticoids

884.

Before all chemical substances, the most powerful regulator of alveolar ventilation in normal conditions is:

A.

Oxygen

B.

* Carbon dioxide

C.

Hydrogen ions

D.

Lactic acid

E.

Nitrogen

885.

Breathing of Biott is characterized by:

A.


B.


C.

* A frequent deep breathing, alternating with breathing pauses

D.

Smoothly varying amplitude of the respiratory volume

E.

Ensures adequate ventilation

886.

Carbon dioxide tension in alveolar air in normal conditions is:

A.

More when breathing air under a pressure of 2 atmosphere

B.

Less when breathing air under a pressure of 2 atmosphere

C.

* It depends only on the alveolar ventilation and CO2 production

D.

Less when breathing with pure oxygen

E.

More when breathing with pure oxygen

887.

Cheyne Stokes respiration is characterized by:

A.


B.


C.

respiration pauses, before the frequent deep breathing

D.

* Smoothly varying amplitude of tidal volume with short pauses

E.

Provides breathing

888.

Choose the wrong answer. Respiratory distress syndrome of newborns:

A.

* The probability of its development is reduced by the use of corticosteroids in pregnant

B.

Linked to hypoplasia of bronchial tree

C.

It is characterized by an increase of the respiratory muscles

D.

Effective treatment with artificial surfactant

E.

Usually develops in preterm

889.

Choose the wrong answer.Lung surfactant:

A.

produced pneumocites of type 2

B.

It consists mainly of lipoproteins

C.

Not for respiratory distress syndrome of newborns

D.

* Increases the surface tension of fluid in the alveoli

E.

None of the above

890.

Compared with atmospheric air alveolar gas has:

A.

The lower total pressure

B.

Higher pO2

C.

Lower pCO2

D.

* Higher partial pressure of water vapor

E.

Higher partial pressure of nitrogen

891.

Cromolyn Na (INTAL) may be effective in the treatment of bronchial asthma because of the following steps:

A.

Blockade of histamine receptors

B.

Inhibition of phosphodiesterase

C.

Activation of beta 2-adrenoceptor

D.

* Blocks education bronhokonstriktivnyh substances

E.

None of the above listed

892.

Cyanosis is not indicative of the presence of hypoxemia if a concentration of hemoglobin is equal to:

A.

70 g / l

B.

100 g / l

C.

140 g / l

D.

* 170 g / l

E.

In the absence of hypoxemia and congestive heart failure cyanosis will be present

893.

Cyanosis of the skin and visible mucose will be possible to detect with a decrease in oxygen saturation of arterial blood below:

A.

70%

B.

* 80%

C.

90%

D.

100%

E.

20%

894.

Dead space is reduced by all except:

A.

In the supine position compared with the vertical position

B.

Intubation

C.

After the imposition of tracheostomy

D.

* After the top laporotomi

E.

None of the above

895.

26. Direct reading of spirographic data can be used to measure the following volumes, except:

A.

tidal volume

B.

* residual lung volume

C.

lung capacity

D.


E.

Inspiratory reserve volume

896.

Each gram of hemoglobin can bind:

A.

0.03 ml of oxygen

B.

0.57 ml of oxygen

C.

* 1,34-1,39 ml of oxygen

D.

1 ,48-1, 56 ml of oxygen

E.

2.0 ml of oxygen

897.

Fit bronchoconstriction in atopic form of bronchial asthma can be docked using:

A.

Inta

B.

* Betta adrenostimulyatorov

C.

Calcium glyukanata

D.

Diphenhydramine

E.

Chloride

898.

For acute respiratory distress syndrome characterized by the following symptoms except:

A.

Increases in intrapulmonary shunting

B.

Violations of the permeability of the alveolar-capillary membrane

C.

Increase the amount of free water in the lungs

D.

* Increases elasticity (compliance) light

E.

Education pneumosclerosis and hyaline membrane

899.

For which of the above indices was best to evaluate the adequacy of mechanical ventilation?

A.

Hemodynamics

B.

pH of arterial blood

C.

* arterial blood gas composition

D.

pH of venous blood

E.

Gas composition of venous blood

900.

Frequency of atelectasis is less:

A.

* For men compared with women

B.

For women compared with men

C.

In patients with low birth weight

D.

After laparoscopic surgery

E.

After low laporotomic cuts

901.

Functional dead space is increased by:

A.

Reducing the partial pressure of oxygen in the inspired gas

B.

Growth of intrapulmonary shunting

C.

* hypovolemia

D.

Anemia

E.

Trendelenburg position of patient

902.

Functional dead space is likely increase if the following drugs used except:

A.

ganglion blocking

B.

Atropine

C.

Nitroglycerin

D.

Dehydrobensperidol

E.

* Neostigmine

903.

High-frequency ventilation:

A.

Considered as such if the tidal volume above the volume of anatomic dead space

B.

More effective in patients with low extensibility (compliance) of light compared to conventional mechanical ventilation

C.

Helps increase intrathoracic pressure compared with conventional mechanical ventilation

D.

Reduces the risk of pulmonary barotrauma compared with conventional mechanical ventilation

E.

* Safer than conventional mechanical ventilation in patients with fistulas bronhoplevralnymi

904.

Hyperventilation is developed under the following conditions, except:

A.

Metabolic acidosis

B.

Hypovolemia

C.

* barbiturate poisoning

D.

Hyperthermia

E.


905.

Hypoxic hypoxia is characterized by the following symptoms except:

A.

Violations of consciousness

B.


C.

Reduction of alveolar pO2

D.

Reduction of arterial pO2

E.

* Increasing arteriovenous oxygen difference

906.

In the case of elevated methemoglobin in the blood and the development of tissue hypoxia is shown the application:

A.

Atropine

B.

Inhibitors of holinesterase

C.

* Methylene blue

D.

Glucose

E.

Diphenhydramine

907.

In what form of hypoxia is inefficient oxygen therapy:

A.

Hypoxic

B.

circulatory

C.

Hemical

D.

* Hystotoxic

E.

None of the above

908.

Increasing of alveolar-arterial oxygen difference did not depend from:

A.


B.

The increase in the shunting pulmonary

C.

ventilation with pure oxygen

D.

* Moderate anemia

E.

By increasing blood flow

909.

Indicators of pulse oximetry:

A.

* Depends on the state of tissue perfusion

B.

Do not respond with a decrease in arterial pO2 to 60 mm Hg

C.

No Avis of light effects in the determination

D.

Do not depend on the state of the external gas exchange

E.

None of the above

910.

Intermediate bronchus of the right lung holds air:

A.

In the upper part

B.

The average share

C.

In the lower part

D.

* In the middle and lower lobe

E.

In the upper and middle lobe

911.

It can be expected that the pO2 will be normal arterial in:

A.

Decrease in partial pressure of oxygen in inhaled air

B.

Violations of diffusion through the alveolar-capillary membrane

C.


D.

Smoky gas poisoning

E.

* Anemia

912.

It is known that a healthy young man:

A.

The lungs are easy to stretch more than the thorax

B.

The lungs are easy to stretch less than the thorax

C.

* Tensile elongation of lungs are equal to the thorax

D.

The total elongation more than elongation of one lung

E.

None of the above

913.

Low oxygen tension in the inspired gas leads to:

A.

Increasing of tension and oxygen saturation of arterial blood

B.

It shifts the oxyhemoglobin dissociation curve to the left

C.

It increases the pulmonary arteriols

D.

* With prolonged exposure leads to pulmonary hypertension

E.


914.

Lung diffusion capacity is probably not broken in the case of:

A.

* myasthenia

B.

interstitial pulmonary edema

C.

severe attack of bronchial asthma

D.

Acute respiratory distress syndrome

E.


915.

In which case will be the greatest stimulation of the respiratory center carotid chemoreceptors?

A.

Carbon Monoxide Poisoning

B.

methemoglobinemia

C.

Severe anemia

D.

* Increased intrapulmonary shunting

E.

Pronounced metabolic alkalosis

916.

Normally, the maximum concentration of hemoglobin in the erythrocyte is:

A.

10%

B.

21%

C.

27%

D.

* 34%

E.

50%

917.

Normally, the percentage of dead space on the tidal volume is:

A.

5%

B.

15%

C.

* 30%

D.

50%

E.

60%

918.

Oxygen and carbon dioxide tension markedly fluctuate during inspiration and expiration if it were not :

A.

The reserve volume inspiratory

B.

Respiratory volume

C.

* Residual lung capacity

D.

Vital lung capacity

E.

Minute volume of breathing

919.

Possible complications of tracheostomy are, except:

A.

Infection of lower respiratory tract

B.

* The increase of the dynamic resistance to breathing

C.

Formation of a fistula

D.

Tracheal stenosis

E.

Bleeding from the respiratory tract

920.

Pulmonary vascular resistance drops:

A.

Alveolar Hypoxia

B.

Alveolar hypercapnia

C.

* prostacyclin

D.

Carbon dioxide

E.

Catecholamines

921.

Recurrent laryngeal nerve (laryngeal):

A.

* It is a branch of the vagus nerve

B.

Is only the sensory nerves

C.

As a rule, is not damaged during surgery in the neck

D.

With his injury is not observed speech disorders

E.


922.

Reduced of which muscle has the greatest significance for the creation of high pressure in the airway by coughing before the opening of the glottis?

A.

intercostal muscles of expiration

B.

Diaphragm

C.

trapesius

D.

* Abs

E.

None of the above

923.

Reduced production and function of pulmonary surfactant leads to the following effects except:

A.

Increases in the elastic resistance of lungs

B.

* Increases in the dynamic resistance (bronchial tree)

C.

Atelektasation

D.

Increases in the work of respiratory muscles

E.

Interstitial pulmonary edema

924.

Reduced the forced expiratory volume will probably be observed in all states except:

A.

Asthma

B.

Emphysema

C.

chronic bronchitis

D.

* Lung abscess

E.

None of the above

925.

Reducing the partial pressure of oxygen causes spasm:

A.

coronary

B.

* pulmonary vascular

C.

receptacles of splanhnic zone

D.

Vessels of striated muscles

E.


926.

Sensitive innervation of the larynx by branches:

A.

trigeminal

B.

facial nerve

C.

Vestibulokohlearnogo nerve

D.

Glossopharyngeal nerve

E.

* Vagus

927.

Shortness of breath may be caused directly by the following factors, except:

A.

Decrease in arterial pO2

B.

* Enhancement of arterial pO2

C.

Reduction of Hb saturation of venous blood oxygen

D.

Increased blood pCO2

E.

Decrease in pH of arterial blood

928.

Stimulation of the Hering-Breuer reflex resulting from stimulation of stretch receptors in the lungs, can lead to:

A.

The increase in inspiratory and expiratory

B.

* Switching from inhalation to exhalation, and vice versa when tidal volume is more than 1 liter

C.

Reduction of alveolar ventilation

D.

decreasing the alveolar ventilation

E.

Anything of the above

929.

Tachypnea is characterized by:

A.

The increase of minute volume of respiration

B.

* By increasing the frequency of breathing

C.

By increasing the depth of respiration

D.

Decrease paCO2 below 35 mm Hg

E.


930.

Tensile properties (compliance) of lungs is reduced when:

A.

The normal production of surfactant

B.

* Pulmonary edema

C.

Open pneumothorax

D.

Breathing the hypoxic mixture

E.

None of the above

931.

The best way to treat "oxygen apnea", developed due to increased oxygen tension in arterial blood of patients with hypoxic respiratory stimulation type is:

A.

Application of respiratory analeptics

B.

Cessation of oxygen supply

C.

* Increased content CO2 in the inspired gas

D.

ALV

E.

Introduction of alkalify solutions

932.

The concentration of COHb (carboxyhemoglobin) in the patient is 30%. When it will drop to 7.5% in the case of breathing with atmospheric air?

A.

1 hour

B.

5 hours

C.

* 10 hours

D.

24 hours

E.

48 hours

933.

The following factors lead to alveolar hypoventilation after curaresation in the postoperative period, except:

A.

Hypothermia

B.

Applications of dalatsin C

C.

Applications of furosemide

D.

Hypokalemia

E.

* Applications of beta-blockers

934.

The following symptoms are characteristic of hypercapnia, hypoxia is not accompanied by:

A.


B.

Expression of peripheral spasm

C.

Bradycardia

D.

* Sweats

E.

Reduction of cerebral blood flow

935.

The long-existing pulmonary hypertension is characterized by the following symptoms except:

A.

Increasing vascular resistance

B.

Increase pulmonary bypass

C.

Increase of the load of the right ventricle of the heart

D.

* Hypertrophy of the left ventricle

E.

polycythemia

936.

The main reasons of pulmonary respiratory failure are the following, except:

A.

Increasing the concentration of oxygen in the inspired gas

B.

* Reduction of alveolar ventilation

C.


D.

Violations of ventilation-perfusion ratios in lungs

E.


937.

The most common pulmonary embolism develops in:

A.

* AA proven deep vein thrombosis

B.

prolonged immobilization

C.

recent orthopedic surgery

D.

Obesity

E.

Availability of ELA in history

938.

The partial pressure of water vapor in the alveolar gas depends on:

A.

Composition of inhaled gas

B.

The values of atmospheric pressure

C.

* The body temperature

D.

Alveolar pO2

E.

Alveolar pCO2

939.

The pharmacological effect of bronchial spasmolytic can be realized by all, except:

A. Preemption effect of acetylcholine

* increase of GMPh

C. Increase of AMPh

D. Blockade of release of cell mediators for adhession

E. Blockade of Ca-channels

940.

The poisoning is fatal if carbon monoxide is minimal links:

A.


B.


C.


D.

* 76% of blood hemoglobin

E.


941.

The pressure in the pulmonary artery is reduced in the case of :

A.

Acidosis

B.

exercise

C.

Introduction propranolol

D.

Hypoxia

E.

* All the answers are not true

942.

The therapeutic effect of sympathomimetics for relieving of bronchospasm is associated with:

A.

blockade of adenosine receptors of bronchial muscles

B.

blockade of calcium tubules of bronchial muscles

C.

C. blockade of histamine receptors of bronchi

D.

* By increasing the content of cAMP in the cells of bronchial muscles

E.

Oppression bronhospasticheskih reflexes

943.

To the respiratory muscles of expiration are all listed, except:

A.

* Diaphragm

B.

Internal intercostal muscles

C.

External and internal oblique abdominal muscles

D.

Lateral and ventral abdominal muscles

E.

None of the above

944.

To the respiratory muscles of inhalation are all listed, except:

A.

Diaphragm

B.

outdoor intercostal muscle

C.

* Internal intercostal muscles

D.

Scalenus

E.

None of the above

945.

What applies to the drugs 'first appointment' acute attack of asthma?

A.

aminophylline

B.

Crank

C.

Parenteral beta 2-adrenomimetics

D.

* Inhaled beta 2-adrenomimetics

E.

Cholineblocker

946.

What are the normal values of carbon dioxide tension in arterial blood?

A.

20-30 mm Hg

B.

30-40 mm Hg

C.

* 35-45 mm Hg

D.

45-55 mm Hg

E.

50-60 mm Hg

947.

What could be the immediate causes of circulatory hypoxia?

A.

Alveolar hypoventilation

B.


C.

Renal insufficiency

D.

* Violation of blood microcirculation

E.

Carbon monoxide

948.

What is the most characteristic radiological sign for pulmonary embolismrterii?

A.

Expanding the root of the lung

B.

Pulmonary infiltration

C.

The rise of the dome diaphragm

D.

Symptom Hampton (wedge-shaped infarct of the lung)

E.

* Chest radiograph remains normal

949.

What is the normal value of minute breathing volume in an adult?

A.

2-4 L / min

B.

* 5-10 l / min

C.

8-12 l / min

D.

10-15 l / min

E.

20 l / min

950.

What is the smallest of these lung volumes?

A.

* respiratory volume

B.

Vital lung capacity

C.

Residual lung volume

D.


E.

None of the above

951.

What percentage of CO2 directly or indirectly transferred by means of hemoglobin?

A.

5%

B.

10%

C.

50%

D.

* 90%

E.

20%

952.

What should be the minimum pressure at the peak of inspiration from a patient with healthy lungs with normal weight and normal extensibility of the chest that would provide the necessary injection of tidal volume?

A.

8-10 cm water station

B.

* 14-20 cm of water station

C.

S.20-30 cm of water station

D.


E.


953.

What's wrong? Anatomical characteristics of the trachea:

A.

The average length is 10-18 cm

B.

Bifurcation is located at 5 th thoracic vertebra

C.

Motionless, fixed to the surrounding tissue

D.

About half of is above sternum

E.

* Length varies with body position

954.

Which from these factors can reduce the excretion of carbon dioxide?

A.

Alveolar hyperventilation

B.

Climb up to the highlands

C.

Breathing with pure oxygen under atmospheric pressure

D.

* Breathing with pure oxygen under pressure of 3 atmosphere

E.


955.

Which of the factors plays the greatest role in creating the elastic resistance of normal lung:

A.

Elastic skeleton of light

B.

* Surface tension of alveolar fluid

C.

Intrapleural pressure

D.

Cross-sectional area of the bronchi and bronchioles

E.

None of the above

956.

Which of the following indicators may serve as one of the criteria for transfer of patient on mechanical ventilation?

A.

The respiratory rate in adults over 20/min

B.

Vital lung capacity, equal to 20 ml / kg

C.

inspiratory force greater than 25 cm water station

D.

Arterial pO2 in 65-year-old patient, equal to 60 mm Hg

E.

* Arterial pCO2 greater than 55 mm Hg

957.

Which of the following symptoms may be useful for differential diagnosis of hypoxic and circulatory hypoxia, except?

A.

Nature cyanosis

B.

Alveolar pO2

C.

Arterial pO2

D.

* pH of arterial blood

E.

Arteriovenous oxygen difference

958.

Which of these factors are not causes shortness of breath?

A.

* The oxygen tension in arterial blood of 80 mm Hg

B.

Metabolic acidosis

C.

Hypercapnia

D.

Hyperthermia

E.

Nothing used above listed

959.

With the catheter of Swan-Gans it can be defined the following parameters, except:

A.

Pressures in the right atrium

B.

Pressure in the right ventricle

C.

Pressure in the pulmonary artery

D.

Pressure occlusion (wedge), pulmonary artery

E.

* End-diastolic pressure in the left ventricle

960.

With the development of a massive pulmonary haemorrhage are shown the following activities, except:

A.

* Urgent introduce calcium preparations

B.

Lay the patient in position Trendeleburga on the side of bleeding

C.

You must create a controlled hypotension

D.

Urgent call for a consultation thoracic surgeon

E.

When continuous bleeding translate to one-lung ventilator

961.

With the introduction of excessively deep endotracheal tube most of its end is located in:

A.

The right main bronchus

B.

Left main bronchus

C.

* Intermediate bronchus

D.

Right distal bronchus

E.

The left distal bronchus

962.

A 13-year-old female presents with the complaint that she cannot move her right leg. There are no other associated symptoms and no history of trauma, head-ache, or prior medical problems. The symptom began on the day she was to meet her father for the first time. Which of the following would be LEAST helpful in the management of this patient?

A.

Perform a Hoover test

B.

* Tell her that nothing is wrong

C.

Hypnosis

D.

Tell her that she can talk with her father on the telephone rather than in person

E.

Reassure the patient that she will walk again

963.

A 20-year-old female undergraduate student presents complaining of a gradual onset of right-sided headache. The headache is accompanied by nausea and photophobia and prevents her from studying for exams. Which of the following is

LEAST likely to be associated with her headache?

A.

Aura

B.

Birth control pills

C.

Family history of similar headaches

D.

Menstruation

E.

* Unilateral tearing with conjunctival injection

964.

A 25-year-old male is brought to the ED by ambulance on a psychiatric hold after wandering in a residential area looking for the source of the evil voices that he states are controlling his thoughts. Upon arrival, he is screaming and wildly agitated. Which of the following represents an appropriate initial dose of intramuscular haloperidol for this patient?

A.

0.05 mg

B.

0.5 mg

C.

* 5.0 mg

D.

50 mg

E.

500 mg

965.

A 25-year-old male is brought to the ED by his sister who states that he started vomiting that morning after complaining of a severe headache. On examination, he is drowsy but arousable with mild nuchal rigidity and no focal neurologic deficit. Which of the following is LEAST likely to be needed for his work-up and treatment?

A.

CT of the head

B.

Blood glucose determination

C.

Antiemetic

D.

* Lumbar puncture

E.

Nimodipine

966.

A 26-year-old female is brought to the ED after three successive witnessed grand mal seizures without recovery of consciousness. Upon arrival, she is obtunded with no spontaneous eye opening and withdraws to pain only. Initial ED management could include all of the following EXCEPT

A.

endotracheal intubation

B.

* barbiturate coma

C.

phenytoin infusion

D.

determination of blood glucose

E.

gastric lavage

967.

A 28-year-old female overdosed on her father's lithium. She presents with complaints of nausea, vomiting, and blurred vision. Initial lithium level is 2 mEq/L.

Which of the following would NOT be appropriate ED management?

A.

Intravenous hydration

B.

Correction of electrolyte imbalance

C.

Urine pregnancy test

D.

* Discharge to an inpatient psychiatric facility if asymptomatic after a 4-h observation period

E.

Alkalinization of the urine

968.

A 30-year-old pregnant female presents to the ED complaining of vaginal bleeding. All of the following statements are true concerning this patient EXCEPT

A.

most patients with bleeding in early pregnancy have normal pregnancy outcomes

B.

urinary tract infection can precipitate spontaneous abortion

C.

* lack of adnexal mass on bedside ultrasound makes ectopic unlikely

D.

she should have her Rh status checked

E.

the quantitative ЯhCG level should be monitored

969.

A 35-year-old female with a history of newly diagnosed myasthenia gravis presents to the ED with profound generalized muscle weakness for 2 days without a known precipitant. A test dose of 2 mg intravenous edrophonium results in visible

muscle fasciculations and slowing of the patient's respiratory rate and depth. Which of the following actions is INAPPROPRIATE?

A.

* Administering neostigmine

B.

Preparing for intubation

C.

Consulting a neurologist

D.

Establishing aspiration precautions

E.

Admission to the ICU

970.

A 37-year-old male intravenous drug user (IVDU) presents with the complaint of several days of general malaise, difficulty swallowing, occasional double vision, and subjective fever. On examination, the patient is noted to have grossly intact cranial nerves II to XII, a distended bladder, and a temperature of 99.1°F. What is the MOST appropriate next step?

A.

Admit to the ED observation unit

B.

Admit to the floor for observation

C.

* Admit to the ICU

D.

Discharge to home with reassurance

E.

Discharge to home with follow-up in several days

971.

A 58-year-old female is brought to the ED by her family. They state that her words do not make sense, the right side of her face is drooping, and she is weak on the right side. On examination you note that the patient is awake and alert, has an expressive aphasia, right-sided facial droop, three-fifths right arm strength, four-fifths right leg strength, and decreased sensation to pin-prick on the right side. Which stroke syndrome is MOST likely?

A.

Anterior cerebral artery infarct

B.

Basilar artery occlusion

C.

* Middle cerebral artery infarct

D.

Lacunar infarct

E.

Intracerebral hemorrhage

972.

A 60-year-old male presents complaining of a typical spring headache, 2 months after a femoral-popliteal bypass. He states that the pain is excruciating, began over the left eye, and is causing the eye to tear and throb. Which abortive therapy is the LEAST appropriate?

A.

* Ergotamine

B.

Ketorolac

C.

Prochlorperazine

D.

Oxygen inhalation

E.

Intranasal lidocaine

973.

A 62-year-old female with a history of TIA affecting the right side complains of 8 h of a dense right-sided paralysis and dysarthria. No previous studies have been completed. What is the MOST appropriate disposition?

A.

* Admit to the medical ward

B.

Admit to the rehabilitation ward

C.

Discharge to home and arrange follow-up with the primary care physician

D.

Transfer the patient to a skilled nursing facility

E.

Conduct a stroke work-up in the ED and then discharge to home

974.

A 7-year-old male presents to the ED 6 months status post revision of a CSF shunt. He complains of a persistent headache for 1 week, occasional nausea, and

vomiting three to four times that day. Evaluation for shunt infection should include all of the following EXCEPT

A.

CT of the head

B.

shunt survey (plain films of the skull, chest, and abdomen)

C.

compression of the reservoir

D.

neurosurgical consult

E.

* lumbar tap

975.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

976.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

977.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

978.


A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

979.

All of the following are consistent with multiple sclerosis (MS) EXCEPT

A.

multiple discrete lesions of the white matter

B.

increase of immunoglobulin in the CSF

C.

worsening spasticity with urinary tract infection

D.

* diminution of symptoms with fever

E.

optic neuritis as first symptom

980.

All of the following are risk factors for pelvic inflammatory disease (PID)

EXCEPT

A.

multiple sexual partners

B.

adolescence

C.

history of gonococcal salpingitis

D.

use of intrauterine (IUD) contraceptive device

E.

* low socioeconomic status

981.

All of the following are symptoms of physician burnout EXCEPT

A.

* illicit drug use

B.

chronic fatigue

C.

excessive irritability

D.

feelings of helplessness

E.

negative attitudes toward work

982.

All of the following are TRUE concerning vulvovaginitis EXCEPT

A.

bacterial vaginosis is the most common etiology

B.

alkaline cervical secretions predispose a woman to infection

C.

older women usually do not have symptoms until the vulvovaginitis is advanced

D.

pinworms (Enterobius vermicularis) can cause vaginal irritation

E.

* the classic "strawberry cervix" is commonly seen in patients with Trichomonas vaginalis

983.

All of the following are true of intraperitoneal blood and culdocentesis EXCEPT

A.

* the test is positive when clotting blood is aspirated

B.

cervical motion tenderness may be present in a patient with intraperitoneal blood

C.

a ruptured corpus luteum cyst can produce a positive test

D.

culdocentesis is positive in the majority of ectopic pregnancies, ruptured and unruptured

E.

aspiration of clear fluid denotes a negative test

984.

All of the following are TRUE of spontaneous abortion (SAB) EXCEPT

A.

more than 50 percent of the abortuses have chromosomal abnormalities

B.

most SABs occur before 8 or 9 weeks of gestation

C.

* maternal factors such as uterine adhesions and pelvic structural abnormalities may lead to SABs

D.

the incidence of SAB climbs with increasing maternal age

E.

the pain associated with SAB usually occurs after the bleeding has commenced

985.

All of the following characteristics are associated with an increased suicide risk

EXCEPT

A.

psychosis

B.

unemployment

C.

chronic illness

D.

* first attempt

E.

readily available lethal weapon

986.

All of the following physiologic changes take place during normal pregnancy

EXCEPT

A.

* respiratory rate is increased

B.

blood volume increases

C.

systolic blood pressure decreases

D.

serum blood urea nitrogen (BUN) decreases

E.

leukocyte count increases

987.

All of the following regimens are recommended for the treatment of acute PID

EXCEPT

A.

* ceftriaxone 125 mg intramuscularly plus doxycycline 100 mg orally twice a day for 10 to 14 days

B.

cefoxitin 2 g intravenously every 6 h plus doxycycline 100 mg intravenously twice a day or orally for 10 to 14 days

C.

cefoxitin 2 g intramuscularly plus probenecid 1 g orally and ofloxacin 400 mg orally twice a day for 14 days

D.

clindamycin 900 mg intravenously every 8 h plus gentamycin loading dose of 2 mg/kg intravenously followed by a maintenance dose of 1.5 mg/kg every 8 h

E.

cefotetan 2 g intravenously every 12 h plus doxycycline 100 mg intravenously twice a day or orally for 10 to 14 days

988.

Amaurosis fugax is caused by occlusion of which one of the following arteries?

A.

Anterior cerebral artery

B.

Basilar artery

C.

* Carotid artery

D.

Posterior cerebral artery

E.

Vertebral artery

989.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

990.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

991.


A.


B.


C.

Both

D.

D.None

E.


992.


A.

* 2

B.

3

C.

4

D.

D*6

E.

10

993.


A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

994.



B. Technique used Epidural Analgesia

C. Technique popularized in caudal Analgesia

D. Cannot be carried out under hypothermic condition

E. All of the above

995.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

996.


A.


B.


C.


D.

* All of the above

E.


997.


A.


B.


C.


D.


E.


998.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

999.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

1000.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

1001.

. First Fibres to be blocked at spinal anaethesia is –

A.


B.


C.


D.

Sensory fibres

E.


1002.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

1003.


A.


B.


C.


D.


E.


1004.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

1005.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

1006.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

1007.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

1008.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

1009.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

1010.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

1011.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

1012.


A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

1013.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


1014.


A.


B.


C.


D.


E.


1015.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

1016.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

1017.


A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

1018.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

1019.

Parkinson's disease i s characterized by all of the following EXCEPT

A.

akinesia or bradykinesia

B.

cogwheel rigidity

C.

* intention tremor

D.

Lewy bodies

E.

impairment in posture and equilibrium

1020.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

1021.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

1022.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


1023.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

1024.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

1025.

Reducing of oxygen transport function of preserved blood may occur as a result of the following reasons:

A.

Reduction of pH

B.

* Reduction of 2,3-diphosphoglycerate in erythrocytes

C.

Reduction of 2,3-diphosphoglycerate in the plasma

D.

Increasing the extracellular concentration of potassium ions

E.

Violations of the rheological properties

1026.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

1027.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

1028.


A.


B.


C.


D.

* All of above

E.


1029.


A.


B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

1030.

Temporal arteritis is a vasculitis that affects women more frequently than men.

Which one of the following is NOT usually associated with temporal arteritis?

A.

Age > 50 years

B.

ESR > 50

C.

Ischemic papillitis

D.

* Tender, pulsatile temporal artery

E.

Polymyalgia

1031.


A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

1032.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

1033.


A.


B.


C.


D.


E.

* All of the above

1034.

The following factors can cause damage to the lung surfactant, except for:

A.

Aspiration of gastric contents

B.

* Durable ventilation with 30% oxygen

C.

Pulmonary embolism

D.

Extracorporeal oxygenation

E.

Inhalation of toxic gases

1035.


A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

1036.

The partial pressure of oxygen in alveolar gas depends on the whole, except:

A.

Atmospheric pressure

B.

The concentrations of oxygen in the inspired gas

C.

The partial pressure of carbon dioxide in the alveoli

D.

* The values of cardiac output

E.

Temperatures

1037.

The patient tidal volume is 500 ml, minute volume of breath is 5000 ml, dead space - 100 ml. What is alveolar ventilation?

A.

* 4000 ml

B.

3500 ml

C.

3000 ml

D.

2500 ml

E.

2000 ml

1038.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

1039.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

1040.

What are the pathogenic factors of acute respiratory failure in an open pneumothorax?

A.

* Shutdown of ventilation on the affected side

B.

Expression of shunting blood to the lungs in a healthy side

C.

Free motion of gas from one lung to another

D.

Flotation of the mediastinal organs during respiration

E.

Severe disorders of blood circulation in the lungs

1041.

What is the first study you should order on this patient?

A.

Urinalysis

B.

Complete blood count (CBC)

C.

Quantitative ЯhCG

D.

* Qualitative ЯhCG

E.

Ultrasound

1042.

What is the optimal humidity of inhaled gas for the patient breathing through intubation tube?

A.

40%

B.

60%

C.

* 95-100%

D.

Humidity does not matter

E.

80%

1043.

Which of the following distinguishes delirium from dementia?

A.

Global cognitive impairment

B.

Periods of acute worsening of symptoms

C.

* Clouded sensorium

D.

Reversibility

E.

Gradual onset of symptoms

1044.

Which of the following drugs have a selective beta-2 adrenergic effect:

A.

Epinephrine

B.

Izadrin

C.

Euphyllin

D.

* Salbutamol

E.

Ephedrine

1045.

Which of the following is FALSE regarding myasthenia gravis?

A.

* The clinical hallmark is nonfatigable muscle weakness

B.

Myasthenia gravis is often associated with other autoimmune diseases

C.

Confirmation of myasthenia is possible with the edrophonium test

D.

Overmedication can produce a clinical picture that mimicks myasthenic crisis

E.

Thymectomy is advocated for most myasthenic patients

1046.

Which of the following is LEAST consistent with a panic attack?

A.

* Hallucinations

B.

Palpitations

C.

Chest tightness

D.

Dizziness

E.

Dyspnea

1047.

Which of the following is LEAST consistent with Guillain syndrome?

A.

Ascending paralysis

B.

Preceded by exposure to toxins

C.

Sensory involvement

D.

* Intact reflexes

E.

Resolution of symptoms in months

1048.

Which of the following is more consistent with bulimia than with anorexia nervosa?

A.

Hypoglycemia

B.

Tachydysrhythmia

C.

Stress fracture

D.

* Dysphagia

E.

Cathartic colon

1049.

Which of the following is MOST impaired by REM sleep deprivation?

A.

Physical recuperation

B.

Intellectual tasks

C.

* Psychological well being

D.

Social life

E.

Manual tasks

1050.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

1051.

Which of the following mechanisms of hypoxia during general anesthesia is associated with a normal alveolar-arterial gradient of O2 and CO2 and is easily corrected by the addition of O2?

A.

Intracardiac shunt

B.

* Hypoventilation

C.

Violation of ventilation-perfusion ratio

D.

Pulmonary shunt

E.

Low cardiac

1052.

Which of the following MOST likely represents vertigo of peripheral origin?

A.

Ataxia

B.

Diplopia

C.

Dysphagia

D.

Facial numbness

E.

* Unilateral hearing loss

1053.

Which of the following must be monitored in a schizophrenic patient controlled with clozapine?

A.

Liver function tests

B.

Amylase

C.

Glucose

D.

* CBC

E.

Urinalysis

1054.

Which of the following personality disorders is seen in a disproportionate number of ED patients?

A.

* Antisocial

B.

Borderline

C.

Obsessive-compulsive

D.

Dependent

E.

Paranoid

1055.

Which of the following reflex findings would be pathologic in an adult?

A.

Bilateral patellar hyperreflexia

B.

Bilateral patellar hyporeflexia

C.

* Bilateral snout reflexes

D.

Bilateral plantar reflexes

E.

Superficial anal reflex

1056.

Which of the following relations is LEAST likely to exist?

A.

Crime and substance abuse

B.

Trauma and alcohol abuse

C.

Mental illness and suicide gestures

D.

Cocaine and sexually transmitted diseases

E.

* Intravenous drug use and long life expectancy

1057.

Which of the following seizure patients requires electroencephalographic (EEG) monitoring for optimal treatment?

A.

35-year-old status post a witnessed tonic-clonic seizure with resolution of the postictal period in 10 min

B.

40-year-old alcoholic status post two witnessed seizures in the ED, with lucid periods after each seizure

C.

20-year-old status post first seizure

D.

28-year-old with status epilepticus controlled with fosphenytoin

E.

* 30-year-old with refractory status epilepticus requiring vecuronium

1058.

Which of the following statements regarding bacterial meningitis is FALSE?

A.

Some bacteria are able to spread directly into the CNS, whereas others depend on hematogenous seeding

B.

Brudzinski's sign is not pathognomonic for meningitis

C.

Dexamethasone can be given to adult patients suspected of having meningitis

D.

Oral antibiotics change the clinical course

E.

* Patients should receive prophylactic phenytoin to prevent seizures

1059.

With respect to the patient in question 369, which of the following is the LEAST likely etiology of the pain?

A.

Ectopic pregnancy

B.

* Mittelschmerz

C.

Ovarian torsion

D.

Endometriosis

E.

Appendicitis

1060.

.If Hb is 130 g/l, how much oxygen is in one litter of arterial blood?

A.

A.*nearly 180 ml

B.

B.nearly 130 ml

C.

C.nearly 140 ml

D.

D.nearly 160 ml

E.

nearly 220 ml

1061.

.What are the signs of acute respiratory failure ?

A.

. all answers are correct

B.

B.. hypoxia and compensatory hypocapnia

C.

hypercapnia

D.

hypoxia

E.

*hypoxia, hypercapnia or their combination

1062.

3. What blood saturation is a critical marker for beginning of ALV?

A.

SaO2 < 95%

B.

SaO2 < 75%

C.

*SaO2 < 90%

D.

SaO2 < 85%

E.

SaO2 < 80%

1063.

.What is the criterion of AVL necessity?

A.

pCO2 doesn’t matter, the main point is pO2

B.

pCO2 > 55 mm. of mercury

C.


D.

*pCO2 > 60 mm. of mercury

E.


1064.

.What is the clinical symptom of hypercapnia?

A.


B.

marblelike mottling of the skin

C.

bradycardia

D.

*hyperhydrosis of purple-cyanotic skin

E.

manifested cyanosis

1065.

.What is hypercapnia?

A.

ineffectiveness of the external breathing function

B.

tissue hypoxia

C.

state, which occurs during intensive metabolic reactions of the body

D.

excessive production of CO2 in tissues

E.

*increasing of CO2 concentration in the blood

1066.

What is the critical meaning of pO2, which requires artificial lung ventilation of the patient?

A.

pO2 is not being used as a AVL necessity criterion

B.

pO2 < 65 mm. of the mercury

C.

*pO2 < 75 mm. of the mercury

D.


E.


1067.

.What are the most typical sings of the terminal breathing disorders?

A.

. deep inhibition of the CNS

B.

hypotension

C.

. decreasing of venous blood saturation

D.

. decreasing of arterial blood saturation

E.

. *ll mentioned

1068.

.What is a clinical symptom of respiratory impairment on initial stages?:

A.

decreasing of the saturation of arterial blood

B.

arising of excitation, restlessness, probable euphoria

C.

decreasing of the saturation of venous blood

D.

increasing of the cardiac output

E.

*verything mentioned below

1069.

.Acute respiratory failure is a state of:

A.

*ll answers are correct

B.

inadequate lungs ventilation

C.

expiratory dyspnoea

D.

inspiratory dyspnoea

E.

inadequate saturation of the blood

1070.

. Who works at the department of anaesthesiology and intensive care:

A.

*naesthesiologists

B.

intensivive care workers

C.

other specialists

D.

resuscitation specialists

E.

all answers are correst

1071.

.What is the correct name of hospital department for severe patients?

A.


B.

wards of intensive care

C.

*partment of anaesthesiology and intensive care

D.

resuscitation department

E.

department of urgent states

1072.

.In what year did anesthesiology become a science?

A.

.1943

B.

.1772

C.

.*1846

D.

.1902

E.

.1886

1073.

. How do the indexes of hemoconcentration change in case of acute intestinal obstruction?

A.

grow

B.

hemoglobin lowers because of intoxication and electrolytic disorders

C.

almost do not change

D.

lower

E.

*Hematocrit elevates because of the hemoconcentration, but the level of haemoglobin and protein lowers due to intoxication

1074.

. During the intestinal obstruction greatly growth the risk of:

A.

pain shock

B.

liver failure

C.

multiple organ failure

D.

sepsis

E.

* regurgitation and aspiration

1075.

. Noncompensated pylorostenosis first of all is dangerous because of:

A.

. acute suprarenal failure

B.

* hypokaliemia, hypochloremia, metabolic alkalosis

C.

respiratory alkalosis and metabolic acidosis

D.

hyponatremia and hypohydration

E.

intoxication syndrome

1076.

. Primary hemostasis disorders in case of acute intestinal obstruction are:

A.

sepsis as a consequence of translocation phenomena

B.

acute renal and liver failure

C.

* hypohydration, violations of electrolytic concentrations

D.

respiratory violations

E.

intoxication syndrome

1077.

. What is the best anesthesia for the patients with peritonitis:

A.

. conduction and infiltrative aaesthesia

B.

. spinal anesthesia

C.

. epidural anesthesia

D.

. inhalational anesthesia

E.

* I/v anesthesia with myscle relaxation and ALV

1078.

The duration of preoperative care for patient with peritonitis is limited with:

A.


B.

. preparation to the anesthesia

C.

. readiness of surgeons

D.

* . stabilisation of haemostasis

E.

. necessary examinations and tests

1079.

In case of toxic peritonitis cardiac output:

A.

depends on the initial blood pressure

B.

* lowers

C.

doesn’t change much

D.

grows

E.


1080.

. In case of reactive peritonitis hemodynamics is usually characterised with?

A.

dependence on the initial blood pressure

B.

hypovolemic shock

C.

* hyperdynamic reaction

D.

hypodynamic reaction

E.

collapse

1081.

What is the most common haemostasis disorder during peritonitis?

A.

. metabolic alkalosis

B.

. respiratory alkalosis

C.

. thrombosis of lower limbs deep veins, thromboembolism

D.

respiratory acidosis

E.

* . metabolic acidosis

1082.

. What is the most probable anaesthesia complication in case of the patient with peritonitis ?

A.

hyperpotassemic cardiac arrest

B.

. regurgitation and aspiration

C.

* acute heart failure as a consequence of mediastinum displacement, caused by hypotension

D.

. bronchiolospasm

E.

inhibition of respiratory centre as a consequence of pulmonary oedema

1083.

. What stages of peritonitis do you know?

A.

. early and late

B.

. upper and lower parts of the abdomen

C.

. stages I, II, III

D.

compensated, uncompensated, terminal

E.

* reactive, toxic, terminal

1084.

. Choose components of postoperative correction:

A.

correction of haemostasis, pain relief, antibiotics, activation of the patient

B.

pain relief, usage of central respiratory stimulators, antibiotics, parenteral nutrition

C.

pain relief, correction of breathing and hemodynamics, stimulation of intestinal peristalsis

D.

* correction of haemostasis, pain relief, parenteral nutrition, activation of the patient

E.

pain killers, antibiotics, cardiovascular medicines, electrolytes, vitamins

1085.

. What is proserin used for right after the operation?

A.

prevention of bronchiolospasm

B.

stimulation of intestinal peristalsis

C.

* removal of residual muscle relaxation after usage of nondepolarizing muscle relaxant

D.

removal of residual muscle relaxation after usage of depolarizing muscle relaxant

E.

stimulation of respiratory centre

1086.

. The most common early complication with central anaesthesia is:

A.

acute liver impairment

B.

cardiac arrest

C.

hypotension

D.

bronchiolospasm

E.

* depression of respiration

1087.

. The most common early complications of ketamine anesthesia is:

A.

respiratory disorders

B.

* hallucination, inadequate behaviour

C.

collapse

D.

rhythm disorders

E.

laryngospasm

1088.

The most common early complication of anesthesia with arduanum usage is:

A.

.bronchiolospasm

B.

. laryngospasm

C.

. dehydration

D.

inhibition of respiratory centre

E.

* falling back of the tongue

1089.

The most common early complication after anesthesia with suxamethonium usage is:

A.

arrhythmia

B.

* disorders of airway potency (falling back of the tongue)

C.

collapse

D.

inhibition of respiratory center

E.

laryngospasm

31. . What is not a kind of parenteral nutrition?

F.

lipofundin

G.


H.

kasein-hydrolizate

I.

hydrolysin

J.

* colloid solutions

1090.

What is not a kind of parenteral nutrition?

A.

lipomays

B.


C.

. 10% solution of glucose

D.

protein hydrolisates

E.

* dextrins

1091.

. What is a kind of parenteral nutrition?

A.

polivinilpirolidon

B.

* protein

C.

solution of kasein-hydrolizate

D.

albumin

E. plasma, solution of kasein-hydrolizate

1092.

. What is a kind of parenteral nutrition?

A.

carbicarb

B.

. derivative of starch

C.

. plasma

D.

albumin

E.

* 10% solution of glucose

1093.

What is a kind of parenteral nutrition:

A.

* lipofundin

B.

. derivative of starch

C.

plasma

D.

albumin

E.

poliglukin

1094.

What are the indications for parenteral nutrition?

A.

postoperative period

B.

vital functions disorders

C.

difficult condition of a patient

D.

intensive care unit stay

E.

* impossibility of enteral nutrition

1095.

What is energetic demand of a patient after operation (parenteral nutrition)?

A.

50 kkal/kg

B.

* 30 kkal/kg

C.

20 kkal/kg

D.

10 kkal/kg

E.

40 kkal/kg

1096.

. The vital functions of the body are:

A.

breathing, haemodynamics

B.

breathing, circulation, activity of liver

C.

* breathing haemodynamics, somatic and vegetative activity of nervous system, functioning of kidneys, liver and gastro-intestinal tract

D.

breathing, activity of kidneys, liver, gastro-intestinal tract

E.

haemodynamics, conciseness

1097.

In postoperative period infusion therapy should be provided at the level of:

A.

30 ml/kg

B.

* 40 ml/kg

C.

20 ml/kg

D.

10 ml/kg

E.

50 ml/kg

1098.

Selik Method is:

A.


B.

usage of probe to decompress the stomach

C.

* pressure on cricoid cartilage during anesthesia induction

D.

extension of neck before trachea intubation

E.

pressure on an epygastrium

1099.

Percussion findings on the side of hemothorax will be:

A.


B.

normal resonant lung sound

C.

bell sound

D.

tympanic resonance

E.

* dullness of percussion sound

1100.

Usually on the side of pneumothorax you can hear:

A.


B.

dry rales

C.

harsh breathing

D.

bronchial breathing

E.

* diminished breath sounds

1101.

What respiration rate is an indication for ALV?

A.

<16 in 1 min.

B.

<10 in 1 min.

C.

> 25 in 1 min.

D.

<15 in 1 min.

E.

* > 40 in 1 min.

1102.

What anesthesia method is mostly used in thoracic surgery?

A.


B.

spinal anaesthesia

C.

regional anesthesia

D.

exploratory anesthesia

E.

* Multicomponent i/v anesthesia with trachea intubation and ALV

1103.

What is used to restore the volume of blood circulation after spinal anesthesia ?

A.


B.

10 % of glucose

C.

0.9% solution of sodium hydroxybutyrate

D.

0.9% solution of sodium bicarbonate

E.

* physiologic saline

1104.

What medicine is used to slow the anesthetic resorbtion during regional anesthesia?

A.

Histamin

B.

Atselizin

C.

Arkuron

D.

Atropin

E.

* Adrenalin

1105.

What is an immediate complication of supraclavicular blockade of brachial plexus?

A.

Hypothermia

B.

Hypocapnia

C.

Arthritis

D.

Bursitis

E.

* Pneumothorax

1106.

What is the most common complication of spinal anesthesia?

A.


B.

Vomiting

C.

Hypothermia

D.

Hypocapnia

E.

* Low blood pressure

1107.

What method should be recommended for elected surgery on lower extremities?

A.


B.

local anaesthesia

C.

surface anesthesia

D.

infiltration anesthesia

E.

* spinal anesthesia

1108.

What anesthesia method is recommended for nail phalanxes surgery of the hand:

A.


B.

I|/v anesthesia with ALV

C.

infiltration anesthesia

D.

surface anesthesia

E.

* conduction anesthesia

1109.

What anesthesia method is recommended for patients with ENT pathology (earnose-throat)?

A.


B.

Guided hypertension

C.

Guided hypoesthesia

D.

Guided hypothermia

E.

* Guided hypotension

1110.

What method do we use to eliminate cerebral edema?

A.


B.

All answers are right

C.

Ventilation with normal respiratory rate

D.

Ventilation in the mode of moderate hypoventilation

E.

* Ventilation in the mode of moderate hyperventilation

1111.

What concentration of lidocaine is used for block anesthesia?

A.

6% - solution

B.

5% - solution

C.

0.5%- solution

D.

2% - solution

E.

* 1% - solution

1112.

What medicine given before operation does suppress neurovegetative reactions?

A.

Recofolum

B.

Dythyllinum

C.

Arduan

D.

Adrenalin

E.

* Atropin

1113.

What anesthetic is most frequently used in neurosurgery?

A.

sodium hydroxybutyrate

B.

ketamine

C.

tiotriazolinum

D.

sodium thiosulfate

E.

* thiopental sodium

1114.

What anesthesia method should be used for the plastic operation of the hard palate

(cleft palate)?

A.

Local anesthesia

B.

Mask anesthesia

C.

Multicomponent i/v

D.

Multicomponent i/v with orotracheal intubation

E.

* Multicomponent i/v with nasotracheal ventilation

1115.

What is used in premedication to avoid neurovegetative reactions?

A.

histamine antagonists

B.

adrenoceptor antagonists

C.

adrenoreceptor agonists

D.

Cholinergic agonists

E.

* Cholinergic antagonists

1116.

What method of general anesthesia does provide airways protection from aspiration in case of oral cavity surgery?

A.


B.


C.

Mask anesthesia

D.

I/v without trachea intubation

E.

* I/vein with trachea intubation

1117.

What is used together with local anesthetic to minimize bleeding during face and jaw surgery?

A.

histamine antagonists

B.

bronchial spasmolytic

C.

adrenoceptor antagonists

D.

cholinergic agonists

E.

* adrenoreceptor agonists

1118.

What method of anesthesia is most frequently used during the extraction of the tooth?

A.


B.


C.

arterial anesthesia

D.

surface anesthesia

E.

* conduction anesthesia

1119.

45-an annual man in plenty of weight is in the chamber of intensive care after the planned operation (opened biopsy lungs). What methods you should provide like the best prevention of thrombosis of deep veins?

A.

- pneumatic tire

B.

- bandaging of feet by an elastic bandage

C.

- a heparin for 1ml through each 8 hours intravenously

D.

* - early mobilization

E.

- infusion of reopoglyukin during an operation

1120.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

1121.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

1122.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

1123.

Acute respiratory failure is defined with:

A.

inadequate saturation of the blood

B.

inspiratory dyspnoea

C.

expiratory dyspnoea

D.

inadequate ventilation of lungs

E.


1124.

Alcohol delirium develops after an operation more frequent all:

A.

- during 24 hours

B.

* – during 2-3 days

C.

– in 4-5 days

D.

– in 6-7 days

E.

– at once after awakening, as a result of provocative action of anesthetics

1125.


A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

1126.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

1127.

Antihypoxic dose of sodium oxybutirat:

A.

- 1-5 mg/kg

B.

* – 20-40 mg / kg

C.

– 80-100 mg / kg

D.

– 0,1-0,2 g

E.

– does not own antihypoxic properties

1128.

At the department of anaesthesiology and intensive care work:

A.

all named here doctors

B.

resuscitation specialist

C.

sub specialists

D.

reanimatologists

E.

* anaesthesiologists

1129.

At the initial stages of the ineffective external respiratory function is possible:

A.

* everything mentioned below

B.

increasing of the cardiac output

C.


D.

arising of excitation, restlessness, probable euphoria

E.


1130.

At what stage of ether anesthesia is contra-indicated to operative interferences?

A.

– I

B.

* – II

C.

– III

D.

– IV

E.

– V

1131.

At which rate of Hb patient will become cyanotic (SaO2 86%)?

A.

30 g/l

B.

60 g/l

C.

* 120 g/l

D.

in any case

E.

cyanosis will not appear

1132.

At which rate of Hb will patient become cyanotic ( function of external breathing is normal)?

A.

180 g/l

B.

140 g/l

C.

120 g/l

D.

in any case

E.

* cyanosis will not appear

1133.

Ataralgesia is anesthesia with the use:

A.

- to the ketamine and phentanyl

B.

- neuroleptics and narcotic analgetics

C.

– propofol, phentanyl, morelaxants

D.

– muscular relaxants and SHVL

E.

* – sedative remedies and narcotic analgetics

1134.

Average blood pressure is:

A.

* diastolic+1/3 of pulse pressure

B.

systolic + diastolic / 2

C.

blood at aorta

D.

systolic + central venous blood / 2

E.

synonym of pulse blood

1135.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

1136.


A.


B.


C.

Both

D.

D.None

E.


1137.

Central analgesia is arrived at by injection:

A.

- middles for stabilizing of TSNS

B.

- narcotic analgetics, miorelaxants of central action

C.

- large doses of barbiturates, neuroleptics, analgetics

D.

* - large doses of narcotic analgetics

E.

- middles for the leadthrough of neuro-surgical operations

1138.

Closed contour of anesthetisation:

A.

– patient breathes in air and anesthetic, breathes out him in adsorber

B.

– patient breathes in oxygen and anesthetic, fully breathes out in an atmosphere

C.

* – patient breathes in oxygen and anesthetic, fully breathes out him in adsorber

D.

– patient breathes in oxygen and anesthetic, partly breathes out him in adsorber

E.

– patient breathes in air and anesthetic, breathes out him in an atmosphere.

1139.


A.

* 2

B.

3

C.

4

D.

D*6

E.

10

1140.


A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

1141.

Complication of the anesthetisation with sodium of oxybutirat:

A.

* - primer language in an early postoperative period

B.

- sharp kidney insufficiency

C.

-sharp hepatic insufficiency

D.

- bronchoconstriction

E.

- hyperpotassemia

1142.


A.


B.


C.


D.


E.

All of the above

1143.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

1144.

Depolarising operates preparation:

A.

- traktium

B.

- arduan

C.

- tubocurarin

D.

* - sukcinilholin

E.

– norkuron

1145.

Dinitrogen oxide is kept:

A.

– in the fluidized state force-feed 150atm

B.

– in small bottles for 250ml

C.

– in the bulbs of white colour

D.

* – in the fluidised state force-feed 50atm

E.

– in rotametres for a deinitrogen oxide

1146.

Dinitrogen oxide:

A.

– it is let to apply with oxygen only in correlation 5:1

B.

– it is let to apply with oxygen in correlation 10:1

C.

– it is let to apply with oxygen in correlation 8:1

D.

* – in using without oxygen will cause a hypoxia

E.

– it is let to apply in mixture with oxygen only < 50 %

1147.

Dinitrogen oxide:

A.

– apply only in quality of monoanesthesia

B.

* – apply in combination with other anesthetics for strengthening of their action

C.

– it is possible to use in quality of azeotrope

D.

– it is possible to use only with ftorotanom

E.

– it is contra-indicated to apply with uninhalation anesthetics

1148.

Disorders of microcirculation in conditions of hypovolemia appear because of:

A.

* spasm of arterioles

B.

arteriospasm

C.

paresis of arterioles

D.

activation of the arterial-venous anastomoses

E.

peripheric vasodilatation caused with deficit of circulating blood volume

1149.

During anaerobic respiration in patient with hypoxia glucose is metabolised to:

A.

ketone bodies

B.

pyruvic acid

C.

molecules of ATP( in limited quantity), CO2 and H2O

D.

* lactic acid

E.

metabolism of glucose is impossible

1150.


A.


B.


C.


D.

* All of the above

E.


1151.

During the leadthrough of ambulatory operations under anesthesia which can be the most frequent reason of hospitalization of patients?

A.

- hypotension

B.

- complication from the side of breathing

C.

- impossibility to send patients home

D.

- postoperative pain

E.

* - nausea and vomit

1152.

Enflyuran:

A.

- weak anesthetic and strong analgetic

B.

- weak anesthetic and analgetic

C.

- strong anesthetic and analgetic

D.

* - expressed anesthetic, weak analgetic

E.

– at application only enfluran of patient it is impossible to enter in anesthesia

1153.


A.


B.


C.


D.


E.


1154.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

1155.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

1156.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

1157.

Ether – it is:

A.

- gas odourless

B.

- yellow liquid

C.

* - colourless volatile liquid

D.

- fluidized gas

E.

- fluidized gas of specific smell

1158.

Ether acts as:

A.

– as adrenolithyk

B.

– as symphatolithyk

C.

– as parasimphatomymethyk

D.

– as parasymphatolithyk

E.

* – as simphatomymethyk

1159.

Ether anesthesia is contra-indicated to the patients with such concomitant diseases:

A.

- is kidney insufficiency

B.

- an innate heart-disease

C.

* – diabetes mellitus

D.

- oblitering diseases of vessels

E.

– by the allergic states

1160.

Ether for anesthesia – it is:

A.

- local anesthetic

B.

- unnarcotic analgetic

C.

- muscular relaksant

D.

* - anesthetic

E.

- a narcotic analgetic

1161.


A.


B.


C.


D.

Sensory fibres

E.


1162.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

1163.


A.


B.


C.


D.


E.


1164.

For patients with easy or moderate system disorders propose the degree of anaesthetic risk:

A.

– 1

B.

* – 2

C.

– 3

D.

– 4

E.

– 5

1165.

For patients with heavy system disorders propose the degree of anaesthetic risk:

A.

– 1

B.

– 2

C.

* – 3

D.

– 4

E.

– 5

1166.

For patients with the extremely expressed system disorders propose the degree of anaesthetic risk:

A.

– 1

B.

– 2

C.

– 3

D.

* – 4

E.

– 5

1167.

For the purpose of prophylaxis of regurgitation it is necessary at introductory anesthesia:

A.

- to intubate patient on a side

B.

- to provide to the patient of position of Trendelenburga

C.

* - to provide to the patient position of Fovler

D.

- to intubate patient only after introduction of stomach-pump

E.

- to press on a front abdominal wall in a epigastrium area

1168.

Ftorotan for anesthesia more expedient to apply at:

A.

* – to bronchial asthma

B.

– hepatitis

C.

– traumatic shock

D.

– neuro-surgical operations

E.

– operations on a heart

1169.

Ftorotan is contra-indicated:

A.

* – at application of sympathomimetics

B.

– at bronchial asthma

C.

– for people years old

D.

– to the babies

E.

– for high blood pressures

1170.

Ftorotan:

A.

* – not explosive

B.

– burns well

C.

– supports burning in mixture with dinitrogen oxide

D.

– it is possible to apply only in mixture with ether

E.

– at a hit on a skin can cause burns

1171.

Grade of CNS injury is diagnosed basing on:

A.

Maastricht Scale

B.

Manheim index

C.

APACH-II

D.

* Scale of Glasgow

E.

classification of USA neurologists’ association

1172.

Half-closed contour of anesthetisation:

A.

* – patient breathes in oxygen and anesthetic, partly breathes out in adsorber

B.


C.

– patient breathes in air and anesthetic, breathes out in adsorber

D.

– patient breathes in oxygen and anesthetic, fully breathes out in adsorber

E.

– patient breathes in air and anesthetic, breathes out in an atmosphere.

1173.

Half-open contour of anesthetisation:

A.

* – patient breathes in oxygen and anesthetic, fully breathes out in an atmosphere

B.

– patient breathes in oxygen and anesthetic, fully breathes out him in adsorber

C.

– patient breathes in air and anesthetic, breathes out him in adsorber

D.

– patient breathes in oxygen and anesthetic, partly breathes out him in adsorber

E.

– patient breathes in air and anesthetic, breathes out him in an atmosphere.

1174.

Hexenalum – it is:

A.

- weak anesthetic

B.

- a powerful analgetic

C.

* - anesthetic with an insignificant anesthetic effect

D.

- drastic anesthetic and analgetic

E.

- average for stabilizing of neurovegetation functions

1175.

If Hb is 130 g/l and the main exchanges – normal, how much oxygen is there in one litter of venous blood?

A.

А – near 60 ml

B.

В – near 90 ml

C.

С – near 80 ml

D.

* D – near 130 ml

E.

E – near 150 ml

1176.

If Hb is 130 g/l, how much oxygen is there in one litter of arterial blood?

A.

nearly 220 ml

B.

nearly 160 ml

C.

nearly 140 ml

D.

nearly 130 ml

E.

* nearly 180 ml

1177.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

1178.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

1179.

In order to prevent aspiration of gastric contents during regurgitation it’s necessary to:

A.

gastric lavage

B.

immediately elevate the upper part of the body

C.

block airways

D.

* down the upper part of the body

E.

infuse muscle relaxants

1180.

In order to prevent regurgitation it’s necessary to:

A.

* attach to the patient position with elevated upper part of the body

B.

attach to the patient position with upper part of the body down

C.

infuse atropine

D.

attach to the patient side position

E.

infuse solution of cerucal

1181.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

1182.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

1183.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

1184.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

1185.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

1186.

In which state of the patient hyperhidrosis will not appear?

A.

hypoglycemic coma

B.

hypothermia

C.

* hypoxia II grade

D.

poisoning with PhOS

E.

hypercapnia of II grade

1187.

Inhalation anesthesia can not be conducted on such contour:

A.

– closed

B.

– opened

C.

– half-open

D.

– half-closed

E.

* – extracorporal

1188.

Is there what most frequent reason of hypoxia for patients in an early postoperative period ?

A.

- violation of correlation of ventilation/circulation

B.

* - hypoventilation

C.

- insufficient maintenance of oxygen in gas mixture

D.

– by passing of blood in lights

E.

- violation of diffusion of gases as a result of application of inhalation anesthetics

1189.

It is expedient to apply sodium oxybutirat as middle for anesthesia for patients:

A.

* - with decompensated pathology of parenhimatosus organs

B.

– in ambulatory practice

C.

– wherein the maximal anaesthetizing is needed

D.

– in ophthalmology

E.

– for children

1190.

It is produced tiopental:

A.

* – in powder, for 0,5 and 1g

B.

– in solution, 20%

C.

– in small bottles, for 10ml of solution

D.

– in ampoules, for 2ml 0,5% solution

E.

– in 5% solution

1191.

Izoflyuran:

A.

* – not explosive, does not burn

B.

– can entail an explosion

C.

– easily supports burning

D.

– burns in presence a nitrous oxide

E.

– bursts in application with Ftorotanom

1192.

Ketaminum causes:

A.

- hypotension

B.

- miorelaksatsiya

C.

- parasimpatomymhetyk effect

D.

* - dissociative anesthesia

E.

– depression of respiratory centre

1193.

Ketaminum is produced in a kind:

A.

* - 1 % but 5 % solution in small bottles

B.

- 0,5 % solution in ampoules

C.

- powder for a 1g, in small bottles

D.

– 20 % solution

E.

– in small bottles, for 0,4ml

1194.

Ketaminum is rotined for anesthesia for patients:

A.

* - with the deficit of OTSK

B.

- at hypertensive illness

C.

- at saccharine diabetes

D.

- in neurosurgery

E.

– at sharp kidney insufficiency

1195.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

1196.


A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

1197.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


1198.


A.


B.


C.


D.


E.


1199.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

1200.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

1201.


A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

1202.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

1203.

One of the manifestations of microcirculation disorders at shock condition is:

A.

* decreasing of the diuresis

B.

paresis of intestine

C.

apparent hypotonia

D.

gooseflesh

E.

petechia

1204.

Opened contour of anesthetisation:

A.

– patient breathes in air and anesthetic, breathes out in adsorber

B.

– patient breathes in oxygen and anesthetic, fully breathes out in adsorber

C.

* – patient breathes in air and anesthetic, breathes out in an atmosphere

D.

– patient breathes in oxygen and anesthetic, partly breathes out in adsorber

E.


1205.

Patient 67 years, with concomitant diabetes mellitus in the stage of compensation is prepared to operation depended a calculary cholecystitis. Specify the degree of operating risk by Gologorsky

A.

– 1В

B.

* – 2 B

C.

– 3 A

D.

– 4 С

E.

– 5 D

1206.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

1207.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

1208.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


1209.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

1210.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

1211.

Propofol operates:

A.

- insignificantly sedative, expressed – analgesic

B.

- expressed hypnotically and analgesic

C.

- myorelaxing

D.

- neurostabilising

E.

* – expressed hypnotically and sedative, insignificantly - analgesic

1212.

Propofol produce in a kind:

A.

- 0,1g of powder, in ampoules

B.

- 20 % solution in ampoules

C.

- 0,5 % to solution in ampoules

D.

* - lipophylic in ampoules for 20ml

E.

- for 1,0g of powder, in small bottles

1213.

Propofol using is not good :

A.

- in ambulatory practice

B.

- at laparoskopick operative interferences

C.

* - for patients with the deficit of VCB

D.

- for the exhausted patients

E.

- at concomitant hypertensive illness

1214.

Regurgitation might appear:

A.

in first hours after mushrooms poisoning

B.

* when patient is in coma state

C.

after stimulation of intestine peristaltic

D.

in case of hyperacid gastritis

E.

without any pathology

1215.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

1216.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

1217.

Specify the most right answer: ether anesthesia is the method of choice at operations:

A.

– at pathology of lights

B.

* – for patients in a state of shock

C.

– at saccharine diabetes

D.

– in neuro-surgery

E.

– in gerontology

1218.


A.


B.


C.


D.

* All of above

E.


1219.


A.


B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

1220.

Symptom of “white spot” normally lasts for:

A.

to 1 second

B.

3-5 seconds

C.

* to 3 seconds

D.


E.

normally doesn’t exist

1221.


A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

1222.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

1223.


A.


B.


C.


D.


E.

* All of the above

1224.


A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

1225.

The most common reason of anestesiologic complications is:

A.

aspiration pneumonia

B.

* hypoxemia and hypercapnia

C.

circulation insufficiency

D.

acute toxic hepatitis

E.

malignant hyperpyrexia

1226.

The most effective mean of liquidation of laringospasm is:

A.

- introduction of glucocorticoids

B.

- leadthrough of konikothomia

C.

- leadthrough of SHVL

D.

* - introduction of muscular relaxants, ALV

E.

- application of solution of atropine of sulfate

1227.

The phenomenon of recurisation is:

A.

* - repeated action of relaxants after proceeding in muscular tone

B.

- the repeated injection of depolarizing relaxants

C.

- the repeated injection of antidepolarizing relaxants

D.

- weakening of muscles after introduction “curare”

E.

- absence of breathing as a result of defeat of respiratory centre

1228.

The reception of Sellik is applied:

A.

* - for visualisation of glottis, warning of aspiration

B.

- for deleting of extraneous body from overhead respiratory tracts

C.

- for liquidation of remaining action of muscular relaxants

D.

- for the leadthrough of probe in a stomach

E.

- obligatory reception for the intubation of trachea

1229.

The sodium oxybutirat is produced:

A.

- in ampoules, 0,5 % solution

B.

- in powder, in small bottles

C.

* – in ampoules, 20 % solution

D.

– in small bottles, 5 % solution

E.

– in ampoules, for 0,4ml

1230.

The sodium oxybutirat is used for:

A.

* - sleep for weak patients

B.

- is anaesthetising during anesthesia

C.

– myoplegia

D.

- stabilizing of neurovegetation functions of organism

E.

- providing of optimum function of the external breathing

1231.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

1232.

The state of neurolepsia is characterised with:

A.

heightened reflex excitability

B.

* amnesia and analgesia

C.

mioplegia

D.

preservation of adequate reaction to the environment

E.

narcotic sleep

1233.

The temperature of boiling of ether is

A.

* – 37 °С

B.

– 50 °С

C.

– 100 °С

D.

– 75 °С

E.

– 150 °С

1234.

There are such pathologic types of breathing:

A.

breathing of Chain-Stocks, Biot

B.

* breathing of Chain-Stocks, Biot, Kussmaul

C.

breathing of Chain-Stocks, Biot, Bi-Braun

D.

breathing of Chain-Stocks, Biot, Embden-Meergof

E.

breathing of Chain-Stocks, Biot, Knoop

1235.

To measure general resistance of peripheric vessels you need to:

A.

catheterize peripheric vessel

B.

* take cardiac output and average blood pressure

C.

take average blood pressure and central venous pressure

D.

place cuff at the limb and measure the pressure, under which the peripheric pulsation will disappear

E.

call vascular surgeon

1236.

To sodium oxybutirat in a dose 70-120 mg / kg causes narcotic sleep duration:

A.

- 0,5 hours

B.

- 5 minutes

C.

* - 2-3 hours

D.

- 6-8 hours

E.

– this is an antihypoxic dose, a patient from it will not fall asleep

1237.

Transfusion therapy during an operation provides:

A.

* - specially selected doctor

B.

- anaesthetist which conducts anesthesia

C.

- doctor from the station of blood transfusion

D.

- administrator

E.

– only head to the separations

1238.

VCB normally is:

A.

12% of the body weight

B.


C.


D.

depends on the basal metabolism

E.

* 7% of the body weight

1239.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

1240.

What anesthetics do belong to inhalation ?

A.

* - ftorotan, foran, etran, trichloroethylene

B.

- ftorotan, dioxide of nitrogen, ketamine, ether

C.

- dioxide of nitrogen, ether, hexenalum, ftorotan

D.

– propofol, ftorotan, foran, ether, ftorotan

E.

- ether, GOMK, enfluran, isofluran

1241.

What anesthetics do belong to uninhalation?

A.

* – propofol, GOMK, ketamine, viadril

B.

- ftorotan, dioxide of nitrogen, ketamine, ether

C.

- dioxide of nitrogen, ether, hexenalum, ftorotan

D.

– propofol, ftorotan, foran, ether, ftorotan

E.

- ether, GOMK, enfluran, isofluran

1242.

What local anesthetic does not use for epidural anaesthesia ?

A.

* – dikain

B.

- lidocaine

C.

– bulivakain

D.

- trimecaine

E.

– ultakain

1243.

What blood saturation with oxygen is critical marker for ALV?

A.

SaO2 < 80%

B.

SaO2 < 85%

C.

* SaO2 < 90%

D.

SaO2 < 75%

E.

SaO2 < 95%

1244.

What components do not belong to the anaesthetic providing of operations?

A.

- anaesthetizing

B.

- medicinal sleep

C.

* - placing of patient on an operating table

D.

- neurovegetation defence

E.

– myoplegia

1245.

What features are most typical for the terminal disorders of the external respiratory function?

A.

* all mentioned

B.


C.


D.

hypotension

E.

deep inhibition of the CNS

1246.

What from middles does behave to myorelaxants with antidepolarising action?

A.

* - tubocurarin

B.

- ditilin

C.

- miorelaxin

D.

– sukcinilholin

E.

– listenon

1247.

What from the indicated is necessary during an anesthetisation?

A.

- anesthesia vehicle

B.

- electric pump

C.

– solution of atropine

D.

* - respirator

E.

- defibrillator

1248.

What is catheter of Svan-Gans used for?

A.

gastric intubation

B.

fluid therapy

C.

transfusion therapy

D.

catheterisation of great vessels

E.

* measuring of systemic haemodynamics’ characteristics

1249.

What is hypercapnia?

A.

* increasing of the CO2 concentration in blood

B.

excessive production of CO2 in tissues

C.

state, which arises during intensive metabolic reactions of the body

D.

tissue hypoxia

E.

ineffectiveness of the external breathing function

1250.

What is normal oxygen saturation of venous blood?

A.

SaO2 < 80%

B.

* SaO2 < 70%

C.

SaO2 < 60%

D.

SaO2 < 50%

E.

SaO2 < 40%

1251.

What is normal partial pressure of oxygen in venous blood?

A.

* 36-44 mm. of mercury column

B.

40-48 mm. of mercury column

C.


D.


E.


1252.

What is the clinical expression of hypercapnia?

A.

manifested cyanosis

B.

* hyperhydrosis of purple-cyanotic skin

C.

bradycardia

D.

marmoreal skin

E.


1253.

What is the criterion of AVL necessity?

A.

pCO2 > 45 mm. of mercury column

B.

* pCO2 > 60 mm. of mercury column

C.


D.


E.

pCO2 doesn’t matter, the main thing is pO2

1254.

What is the critical meaning of pO2, which need artificial lung ventilation of the patient?

A.

pO2 < 85 mm. of the mercury column

B.


C.

* pO2 < 75 mm. of the mercury column

D.


E.

pO2 is not useful at this case

1255.

What is the name of patient’s position in bed with elevated head end?

A.

* Fowler

B.

Trendelenburg

C.

Obrazcov

D.

cardio-vascular

E.

pulmonary

1256.

What is the name of patient’s position in bed with head end down?

A.

Fowler

B.

* Trendelenburg

C.

Obrazcov

D.

renal

E.

orthopaedic

1257.

What is the name of the hospital department for critical patients?

A.

department of urgent states

B.

reanimation department

C.

* department of anaesthesiology and intensive care

D.

wards of intensive care

E.


1258.

What is the probable surface area of the body normally?

A.

nearly 1,2 m3

B.

nearly 2,5 m3

C.

* nearly 1,7 m3

D.

nearly 1,0 m3

E.

nearly 2,0 m3

1259.

What kind of anesthesia does belong to uninhalation?

A.

– intramuscular

B.

– intravenous

C.

– intestinal

D.

– peroral

E.

* – intubation

1260.

What kind of anesthesia does not belonged to explorer anaesthesia:

A.

- spinal anaesthesia

B.

- infiltration anaesthesia

C.

- pleksusis anaesthesia

D.

- epidural anaesthesia

E.

* - superficial anaesthesia

1261.

What should be used for treating apnoea caused by dytylin?

A.

transfusion of the blood

B.

infusion of proseryn

C.

infusion of proseryn and atropine

D.

intravenous injection of anticholinesterase medicine

E.

* ALV

1262.

What stage of ether anesthesia is belonged to surgical?

A.

–I

B.

– II

C.

* – III

D.

– IV

E.

– V

1263.

What way does the acute respiratory failure exist ?

A.

* hypoxia, hypercapnia or their combination

B.

hypoxia

C.

hypercapnia

D.

hypoxia and compensatory hypocapnia

E.


1264.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

1265.

Which pathology will be the most probable reason of vomiting?

A.

coma of III grade

B.

acute respiratory failure

C.

* hypertonic crisis

D.

clinic death

E.

coma of II grade

1266.

Which statement is wrong: to avoid aspiration of gastric contents you need:

A.

gastric lavage with the help of gastric sound

B.

rising of gastric pH

C.

inhibit H1 receptors

D.

inhibit H2 receptors

E.

* use method of Sellik

1267.

Which year did become the beginning of “anesthesiology” as a science?

A.

1886

B.

1902

C.

* 1846

D.

1772

E.

1943

1268.

Youn man is ill 12 hours. His diagnosis is: sharp appendicitis. Concomitant pathology it is not discovered. Expose degree of operating risk after Gologorsky

A.

– 1 A

B.

– 2 B

C.

– 1 С

D.

* – 1 AE

E.

– 2 A

1269.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

1270.

A hypercapnia causes the spasm of vessels:

A.

- of brain

B.

- of myocardium

C.

* - of the small circle of circulation of blood

D.

- of uterus

E.

- all of answer correct

1271.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

1272.

A respirator alkalosis can draw the followings disorders, after an exception:

A.

- increase of excitability of myocardium

B.

- infringement of cardiac rhythm

C.

* - increase of cerebral blood stream

D.

- infringement of transporting of oxygen to fabrics

E.

- decrease of concentration of the ionized calcium of plasma

1273.

A respirator alkalosis can result in such violations, except:

A.

- increase of excitability of myocardium and violation of rhythm of heart

B.

* - of increase of cerebral blood stream

C.

- infringement of transport of oxygen to tissues

D.

- decrease of concentration of the ionized calcium of plasma of blood

E.

- all of answer correct.

1274.

A sharp respiratory alkalosis can not be investigated in the case of:

A.

- hemoragic shock

B.

- embolism of pulmonary artery

C.

- bakteriemia

D.

* - increase of рН of cerebrospinal liquid

E.


1275.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

1276.

About what does testify PH of plasma of blood 7, 3?

A.

* - subcompensated acidosis

B.

- Subcompensated alkalosis

C.

- decompensated alkalosis

D.

- decompensated acidosis

E.

- hypohydration

1277.

About what does testify PH of plasma of blood 7, 5?

A.

- subcompensated acidosis

B.

* -subcompensated alkalosis

C.

- decompensated acidosis

D.

- decompensated alkalosis

E.

- hypohydration

1278.


A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

1279.

An „anionic hole” is formed by all except for:

A.

- sulphates

B.

- phosphates

C.

- fibers of plasma of blood

D.

- organic acids

E.

* - urea

1280.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

1281.

Application of antiacid preparations can assist to development of acidosis at:

A.

- Ulcer

B.

- Long term of application

C.

* -chronic to kidney insufficiency

D.

- Carrying out of protracted ARF

E.

- No of faithful answer

1282.

At the increase of рН solution from 7,4 to a 8,4 concentration of hydrions:

A.

- increases in 2 times

B.

* - decreases in 10 times

C.

- decreases in 2 times

D.

- increases in 10 times

E.

- all of answer wrong

1283.

Average daily maintenance of K for adult human is:

A.

10 mmol

B.

* 90 mmol

C.

150 mmol

D.

300 mmol

E.

500 mmol

1284.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

1285.

By the result of the use of sodium hydrogene of carbonate for a correction lactat acidosis can be all is transferred after an exception:

A.

- hypernatriumia

B.

- hypersmolarity of plasma of blood

C.

- increase of рСО2

D.

- decrease of endocellular рН

E.

* - oligoanuria

1286.


A.


B.


C.

Both

D.

D.None

E.


1287.

Choose a wrong answer. For hypertensive dehydration the peculiar followings signs:

A.

-Thirst

B.

-Turgidity

C.

-Increase of VCB

D.

* -Decrease of VCB

E.

- Increase of concentration of sodium is in plasma of blood

1288.

Choose assertions which touch the buffer systems of organism:

A.

- hydrogen-carbonate system is contained only in plasma of blood

B.

* - Except for the hydrogen-carbonate system in plasma of blood there are protein and phosphatic buffer systems

C.

- hydrogen-carbonate system there is only the buffer system of protein in plasma of blood

D.

- in the intracellular liquid the main buffer system is hydrogen carbonate

E.


1289.

Choose incorrect statement considering potassium exchange:

A.

Cells of different organs contain the same quantity of potassium

B.

Cells of different organs contain different quantity of potassium

C.

Intracellular concentration of potassium is greater than extra cellular

D.

Correlation between intracellular and extra cellular potassium is 30

E.

* Brain and muscles have the greatest amounts of potassium

1290.

Choose wrong position which touches sodium lactat:

A.

- Near 25 % in a norm appears in red corpuscles

B.

* - Basic place of formation is a liver

C.

- In a liver and in a bark substance of kidneys turns to glucose

D.

- Formation diminishes in the case of acidosis

E.

- All of answer correct

1291.


A.

* 2

B.

3

C.

4

D.

D*6

E.

10

1292.


A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

1293.

Concentration of ionic Ca increases in case of:

A.

Acidosis

B.

Alkalosis

C.

Deficiency of Na

D.

* Dehydration

E.

Deficiency of K

1294.


A.


B.


C.


D.


E.

All of the above

1295.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

1296.

What is the normal loss of water with urine per day for a man with body weight

100 kg?

A.

B.

C.

1600 ml

1500 ml

1000 ml

D. 1200 ml

E.

*2400 ml

1297.

What is the water distribution in the body of a man with weight 100 kg

(general water - intracellular - extracellular)?

A.

B.

C.

55 – 30 – 25

40 – 20 – 20

50 – 30 – 20

D.

E.

70 – 40 – 30

* 60 – 40 - 20

1298.

рН of the patient is 7,3, VE - + 2, PaCO2 – 48. What is your diagnosis?

A.

B.

subcompensated respiratory alkalosis

* subcompensated respiratory acidosis with metabolic alkalosis

C.

D.

E.

subcompensated metabolic acidosis

decompensated metabolic alkalosis

subcompensated metabolic alkalosis

1299.

рН of the patient is 7,3, VE - - 2, PaCO2 – 48. What is your diagnosis?

A.

B.

subcompensated respiratory alkalosis

* mixed subcompensated acidosis

C.

D.

E. subcompensated metabolic acidosis decompensated metabolic alkalosis subcompensated metabolic alkalosis

1300.


A. subcompensated respiratory alkalosis

B.

C.

D.

E.

* subcompensated respiratory acidosis subcompensated metabolic acidosis decompensated metabolic alkalosis subcompensated metabolic alkalosis

B.

C.

D.

E.

1301.

рН of the patient is 7,3, VE - - 2, PaCO2 - 40. What is your diagnosis?


B. decompensated metabolic acidosis

C.

D.

E.

* subcompensated metabolic acidosis decompensated metabolic alkalosis subcompensated metabolic alkalosis

1302.


A.

B.

C. subcompensated respiratory alkalosis

* decompensated metabolic acidosis subcompensated metabolic acidosis decompensated metabolic alkalosis D.

E. subcompensated metabolic alkalosis

1303.



*subcompensated respirator alkalosis with metabolic acidosis subcompensated metabolic acidosis decompensated metabolic alkalosis subcompensated metabolic alkalosis

A.

B.

1304.

рН of the patient 7,5, VE - + 2, PaCO2 – 32. What is your diagnosis?

subcompensated respiratory alkalosis decompensated metabolic acidosis subcompensated metabolic acidosis C.

D.

A.

* mixed subcompensated alkalosis


1305.

рН of the patient is 7,5, VE - + 1,5, PaCO2 – 32. What is your diagnosis?

* subcompensated respiratory alkalosis

B.

C.

decompensated metabolic acidosis subcompensated metabolic acidosis

D. decompensated metabolic alkalosis


1306.


A.

B. subcompensated respiratory alkalosis decompensated metabolic acidosis

subcompensated metabolic acidosis C.

D.

A.

* decompensated metabolic alkalosis


1307.

рН of the patient is 7,5, VE - + 2, PaCO2 - 40. What is your diagnosis?

- subcompensated respiratory alkalosis

B.

C.

- decompensated metabolic acidosis

- subcompensated metabolic acidosis

D.

E.

- decompensated metabolic alkalosis

-* subcompensated metabolic alkalosis

1308.

What is not a sign of respiratory alkalosis?

A.

B. decreased concentration of the ionized plasma calcium disorders of oxygen transportation

* increased cerebral perfusion C.

D.

E.

A. violations of cardiac rhythm increased excitability of myocardium

1309.

When does administration of antiacids help in development of acidosis? all answers are wrong

B.

C. in case of myocardial infarction

* in case of chronic renal insufficiency in case of duodenal ulcer D.

E.

A. in case of gastric ulcer

1310.

When does metabolic acidosis develop? all answers are wrong

B.

C.

D. in case of diuretics (saluretics) administration

* in case of carbonic anhydrase inhibitors administration in case of antiacids administration

E. uncontrollable vomiting

1311.

The major buffer of the extracellular liquid is:

A. all answers are wrong

B.

C. hemoglobin protein

D.

E. phosphate buffer

* bicarbonate buffer

1312.

The strength of acid is determined with:

A.

B.

C. all answers are wrong base strength ability of giving electrons

D.

E.

* dissociation constant solubility

1313.

What does plasma pH 7, 3 state?

A.

B.

C.

hypohydration decompensated acidosis decompensated alkalosis

D.

E. subcompensated alkalosis

* subcompensated acidosis

1314.

What does plasma pH 7, 5state?

A.

B.

C.

hypohydration decompensated alkalosis

decompensated acidosis

D.

E.

* subcompensated alkalosis subcompensated acidosis

A.

1315.

Which answer does represent water distribution of a newborn? general liquid is 85% from the body weight

B.

C.

D.

E. general liquid is 95% from the body weight general liquid is 70% from the body weight

* general liquid is 80% from the body weight general liquid is 90% from the body weight

A.

1316.

What is not a sign of tetany? syndrome of pancreatic insufficiency

B. decreased levels of calcium in plasma and urine

C.

D.

E.

* reduced concentration of phosphates in plasma and urine

increased concentration of 1, 25-dihydroxycalciferol in plasma increased concentration of parathironine in plasma

1317.

What is not a sign of calciferol deficient tetany?

A. maintenance of 1,25-dihydroxycalciferol in plasma

B. * decreased concentration of parathironine

C.

D.

Increased concentration of alkaline phosphate in plasma

Normal concentration of phosphates in plasma and urine decreased concentration of calcium in plasma and urine E.

1318.

What is not a sign of gastric alkalosis tetany ?

A. increased PH and BE of blood

B.* decreased concentration of 1,25-dihydroxycalciferol in plasma

C.

increased concentration of parathironine in plasma

D.

E. hypochloremia normal concentration of plasma general calcium and declined concentration of ionized

calcium

1319.

A.

B.

What is not a sign of hypertonic dehydration? increased concentration of sodium in plasma

* decreased VCB

C. increased of VCB

D.


E. thirst

A.

1320.

What solution should be used in case of hypertonic dehydration first of all? all answers are wrong

B.

C.

Isotonic solutions of sorbitol, glucose

* Colloid solutions

D.

E.

A.

Hypertonic solution of NaCl

Hypertonic solution of glucose

1321.

What is a sign of hypertonic dehydration?


B.

C. normal plasma osmotic pressure normal Na level

decreased Na level D.

E. * increased Na level

1322.

What is not a reason of hypertonic dehydration?

A. hypo- and isostenuria of patients with kidney diseases

B.

C. osmotic diuresis massive infusion of hypertonic NaCl solution

D.

E.

A.

* inadequate control and thus infusion therapy of perspiration loss watery diarrhea of patients with cholera or dysentery

1323.

What is the best solution for isotonic dehydration correction?

Isotonic glucose solution

B.

C.

Hypertonic glucose solution

* Colloid and electrolytic solutions

Electrolytic solutions D.

E. Colloid solutions

1324.

In case of isotonic dehydration:

A. All answers are correct

B.

C.

D.

CVP is increased

* Osmotic pressure of plasma is normal

Osmotic pressure of plasma is decreased

E. Osmotic pressure of b plasma is increased.

1325.

What isn’t a reason of hypotonic dehydration?

A.

B.

C. renal diseases, which violate electrolytes absorption

* diarrhea with Na-poor stool diarrhea with hypertonic stool

D.

E. suprarenalism mineralocorticoid insufficiency of adrenal glands

1326.

When does concentration of ionic Ca increase?

A. Acid-base balance doesn’t influence level of Ca

B.

C.

D.

E.

* deficiency of Na

Hypohydration

Alkalosis

Acidosis

1327.

What is not a reason of isotonic dehydration?

A. wounds

B.

C. peritonitis bleeding

D.

E. intestinal obstruction

* massive Na-solutions infusion

1328.

Name the most common reason of hypocalcaemia of adults:

A. massive infusions of citrated blood

B.

C.

* surgical damage of parathyroid glands hepatocirrhosis, alkalosis, hypomagnesaemia

D.

E. destructive pancreatic inflammetion chronic renal insufficiency

1329.

Name the drug, which is not used in case of hypercalcemia crises:

A. sodium salt of EDTA

B.

C.

* calcium gluconate furosemid

D.

E. steroids isotonic solution of NaCl

1330.

The most common reason of hypercalcemia is:

A. decreased level of plasma aldosterone

B.

C. increased level of plasma aldosterone

Thyrotoxicosis

D.

E.

Primary and secondary hypoparathyroidism

* Primary and secondary hyperparathyroidism

1331.

Concentration of ionic Ca increases in case of:

A.

B. deficiency of K

* dehydration

C.

D.

E. deficiency of Na

Alkalosis

Acidosis

1332.

Daily maintenance of Ca for an adult is:

A.

B.

100 g

10 g

C.

D.

E.

5 g

1 mg

* 1 g

1333.

How will adrenal failure affect electrolytic balance?

A.


B.

will not affect it at all

C.

Increase the level of K in urine

D.

Increase the level of K in cells

E.

*Increase the level of Na in the body

1334.

Choose incorrect statement about potassium exchange:

A.

*Brain and muscles have the greatest amounts of potassium

B.

Correlation between intracellular and extracellular potassium is 30

C.

Intracellular concentration of potassium is greater than extracellular

D.

Cells of different organs contain different quantity of potassium

E.

Cells of different organs contain the same quantity of potassium

1335.

Normally the correlation of extra and intracellular potassium is:

A.

7:1

B.

2:1

C.

30:1

D.

*1:30

E.

1:5

1336.

Normally the water amount in the body depends on:

A.

climate conditions

B.

*quantity of consumed liquid

C.

level of base exchange

D.

development of lipid tissue (it contains more water, than other tissues)

E.

development of lipid tissue (it contains less water, than other tissues)

1337.

How does aging influence water amount in the body?

A.

stays constant and depends on sex

B.

stays constant and depends on the fat tissue content

C.

stays constant with small oscillations

D.

*decreases

E.

increases

1338.

Electrolytic compositions of interstitial and intravascular liquids mainly differ in amount of:

A.

Protein

B.

Ca

C.

Cl

D.

*Na

E.

K

1339.

Average daily maintenance of K for an adult is:

A.

A.500 mmol

B.

B.300 mmol

C.

C.150 mmol

D.

D.*90 mmol

E.

E.10 mmol

1340.

ECG-signs of hypokaliemia are:

A.


B.

B.*high, sharp T wave

C.

prolongation of P-Q

D.

Extensive (wide) QRS

E.

Ventricular tachycardia, extrasystolia

1341.

The main intracellular cations are:

A.

Mg and Cl

B.

Ca and Cl

C.

Ca and Mg

D.

Ca and Cl

E.

*Na and Ca

1342.

The concentration of potassium in serum:

A.

doesn’t depend on acid-base balance

B.

decreases in case of alkalosis

C.

* increases in case of acidosis

D.

decreases in case of acidosis

E.

increases in case of alkalosis

1343.

Which statement does correctly describe changes in water amount in the bodies of people with different amount of fat?

A.

B.

All answers are incorrect

Absolute water content is almost equal in all mentioned cases

C.

People with normal weight have lower related and absolute water amount than people with obesity

D.

People with normal or low weight have greater water content, than people with obesity

E.

*People with obesity have related content of water greater, than people with normal or low weight

1344.

What index from the listed below might be an evidence of low plasma osmotic molarity?

A.

Hypoglycemia

B.

Ketoacidosis

C.

* Hyperglycemia

D.

Hyponatremia

E.

Hypernatremia

1345.

What is normal molar concentration of plasma?

A.

150-170

B.

310-340

C.

* 285-310

D.

260-280

E.

240-260

1346.

What type of dehydration is accompanied with hypernatremia?

A.


B.


C.

Isotonic

D.

* Hypertonic

E.

Hypotonic

1347.

What is daily water maintenance for a healthy adult?

A.

1,2-1,5 ml/kg/hour

B.

2,7-2,9 ml/kg/hour

C.

*1,5-1,7 ml/kg/hour

D.

3-4 ml/kg/hour

E.

2-3 ml/kg/hour

1348.

How does the water loss of patients with hyperthermia change?

A.

Decreases on 0,25 ml/kg/hour for each extra degree of temperature

B.

Increases on 0,5 ml/kg/hour for each extra degree of temperature

C.

Doesn’t change

D.

Decreases on 0,25 ml/kg/hour for each extra degree of temperature

E.

*Increases on 0,25 ml/kg/hour for each extra degree of temperature

1349.

What is endogenous water?

A.


B.

Intracellular water

C.

*Water, which is generated during fat, protein and carbohydrates catabolism

D.

Water, which is generated during fat catabolism

E.

Water, which is generated during protein catabolism

1350.

What is normal perspiration water loss?

A.

* 0,5 ml/kg/hour

B.

1,5 ml/kg/hour

C.

0,8 ml/kg/hour

D.

2 ml/kg/hour

E.

1 ml/kg/hour

1351.

What is the amount of water loss with urine (normally)?

A.

0,8 ml/kg/hour

B.

1,5 ml/kg/hour

C.

0,5 ml/kg/hour

D.

2 ml/kg/hour

E.

* 1 ml/kg/hour

1352.

Which way does the hematocrit change in case of hyperhydration?

A.


B.

* Increases greatly

C.

Doesn’t change

D.

Decreases

E.

Increases insignificantly

1353.

The reason of hypohydration might be everything, except:

A.

* Ascites , hydrothorax

B.

Hyperthermia

C.

Bleedings

D.

Burn disease

E.

Diseases, which cause vomiting and diarrhea

1354.

What is the amount of extra cellular water in the body?

A.


B.


C.


D.


E.


1355.

What is the amount of intracellular water in the body?

A.


B.


C.


D.


E.


1356.

62. What is the amount of water in the body of adult human?

A.

75% of body weight

B.

85% of body weight

C.

55% of body weight

D.

80% of body weight

E.

* 60% of body weight

1357.

Daily maintenance of Ca for adult human is:

A.

* 1 g

B.

1 mg

C.

5 g

D.

10 g

E.

100 g

1358.

Development of alkalosis it is possible to expect in the case of uncommunicating a digestive channel in an area:

A.

* - duodenum

B.

- thin bowels

C.

- cross-section- rim bowels

D.

- sygma bowels

E.


1359.

Development of metabolic alkalosis can be expected in cases:

A.

* - of hyperaldosteronism, Kushing desease

B.

- diarrhea

C.

- noncompensated of saccharine diabetes

D.


E.


1360.

Distribute water on the water sectors of organism for a man with mass 100 kg

(general water - intracellular - extracellular):

A.

* -60 – 40 - 20

B.

-70 – 40 – 30

C.

-50 – 30 – 20

D.

-40 – 20 – 20

E.

-55 – 30 – 25

1361.

During aging relative amount of water in the body of human is:

A.

increasing

B.

* decreasing

C.

staying constant with small oscillations

D.

staying constant and depends on the fat tissue content

E.

staying constant and depends on sex

1362.

During aging the content of water in the human body:

A.

increases

B.

* decreases

C.

stays constant with small oscillations

D.

stays constant and depends on the fat tissue content

E.

stays constant and depends on sex

1363.


A.


B.


C.


D.

* All of the above

E.


1364.

During hospitalization of patient with intoxication by unknown poison in the state of coma of рН 7,02, PaCO2 – 75,5, VE - is a 14,5. Violation of Acid-base state predefined:

A.

- noncompensated by metabolic acidosis

B.

- noncompensated by respirator acidosis

C.

* - mixed respirator-metabolic by acidosis

D.

- metabolic by acidosis of middle degree

E.


1365.

ECG-signs of hypokaliemia are:

A.

Ventricular tachycardia, extrasystolia

B.

Extensive (wide) QRS

C.

prolongation of P-Q

D.

* high, sharp T

E.


1366.

Electrolytic compositions of interstitial and intravascular liquids mainly differ in amount of:

A.

K

B.

* Na

C.

Cl

D.

Ca

E.

Protein

1367.


A.


B.


C.


D.


E.


1368.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

1369.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

1370.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

1371.


A.


B.


C.


D.

Sensory fibres

E.


1372.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

1373.

For an overventilation at ALV such variant of violation of ABS is peculiar: (рН -,

PaCO2 –, VE -):

A.

- 7,35 -, 55 - +6

B.

- 7,55 -, 47 - + 10

C.

- 7,2 -, 29 -, - 13

D.

- 7,35 -, 28 -, - 8

E.

* - 7,48 -, 32 -, - 3

1374.


A.


B.


C.


D.


E.


1375.

For diabetic cetoacidosis such variant of violation of ABS is peculiar: (рН -,

PaCO2 –, VE -):

A.

-7,35 -, 55 - +6.

B.

-7,55 -, 47 - + 10.

C.

* - 7,2 -, 29 -, - 13.

D.

-7,35 -, 28 -, - 8.

E.

-7,48 -, 32 -, - 3.

1376.

For gastric alkalosis tetaniya such changes are peculiar by a, for exception:

A.

-normal to maintenance in plasma of blood of general calcium and decline ionized

B.

- hypochlorinemia

C.

- Increase of content of parathironine is in plasma of blood

D.

* - Decrease of content of 1,25-dihydroxycalciumferol is in plasma of blood

E.

- Increase of PH and BE of blood

1377.

For steathorenium tetaniya such changes are peculiar by a, for exception:

A.

- Increase of content of parathironine in plasma of blood

B.

- Increase of content of 1, 25-dihydroxycalciumferol is in plasma of blood

C.

* - The reduced content of phosphates in plasma of blood and urine

D.

- Decrease of content of calcium is in plasma of blood and urine

E.

- Presence of clinical syndrome of insufficiency of pancreas

1378.

For stenosis of pyloric department of stomach peculiar is such variant of violation of ABS (рН -, PaCO2 –, VE - ):

A.

- 7,35 -, 55 - +6

B.

* - 7,55 -, 47 - + 10

C.

- 7,2 -, 29 -, - 13

D.

- 7,35 -, 28 -, - 8

E.

- 7,48 -, 32 -, - 3

1379.

For tetaniya of, which develops as a result of deficit of calciferol peculiar changes, after an exception?

A.

- Decrease of content of calcium is in plasma of blood and urine

B.

- Normal content of phosphates in plasma of blood and urine

C.

- Increase of alkaline phosphate is in plasma of blood

D.

* Decrease of content of parathironine

E.

- Normal maintenance of 1,25-dihydroxycalciumferol in plasma of blood

1380.

For the correction of isotonic dehydration the best solutions are:

A.

Colloid solutions

B.

Electrolytic solutions

C.

* Colloid and electrolytic solutions

D.

Hypertonic glucose solution

E.

Isotonic glucose solution

1381.

Force of acid is determined:

A.

- Step of solubility

B.

* - Constant of dissociation

C.

- Ability to give electrons

D.

- acid by a remain

E.


1382.

From the resulted humoral factors most strengthens suction of calcium in bowels:

A.

- Parathiryn

B.

- calciumnothynum

C.

- somatostathynum

D.

* - 1,25-dehydroxycholecalciferon

E.

- All of answer correct

1383.

Hematokrit 0,3, Sodium – 155 mmol/l. Specify the type of violation of homoeostasis:

A.

- hypertensive hypohydration

B.

- hypotonic hypohydration

C.

- isotonic hypohydration

D.

* - hypertensive to the overhydratation

E.

- hypotonic overhydratation

1384.


A.

- hypertensive hypohydration

B.


C.

* - isotonic hypohydration

D.

- hypertensive overhydratation

E.


1385.


A.

* - hypertensive hypohydration

B.


C.

- isotonic hypohydration

D.

- hypertensive overhydratation

E.


1386.

How does the water loss of patients with hyperthermia change?

A.

* Increase on 0,25 ml/kg/hour for every extra degree of temperature

B.

Decrease on 0,25 ml/kg/hour for every extra degree of temperature

C.

Doesn’t change

D.

Increase on 0,5 ml/kg/hour for every extra degree of temperature

E.

Decrease on 0,25 ml/kg/hour for every extra degree of temperature

1387.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

1388.

In case of hypertonic dehydration first of all should be infused:

A.

Hypertonic solution of glucose

B.

Hypertonic solution of NaCl

C.

* Colloid solutions

D.

Isotonic solutions of sorbitol, glucose

E.


1389.

In case of hypertonic dehydration:

A.

* The level of Na is above normal

B.

The level of Na is below normal

C.

The level of Na is normal

D.

Osmotic pressure of blood plasma is normal

E.


1390.

In case of isotonic dehydration:

A.

* Osmotic pressure of blood plasma is increased.

B.

Osmotic pressure of blood plasma is decreased

C.

Osmotic pressure of blood plasma is normal

D.

CVP is increased

E.


1391.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

1392.

In patient with metabolic alkalosis BE may be:

A.

* - (–5)

B.

- 0

C.

- 1

D.

- 2

E.


1393.

In polarizing solution the best correlation of K and Mg for disorders correction should be:

A.

1:20

B.

20:1

C.

1:8

D.

* 8:1

E.


1394.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

1395.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

1396.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

1397.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

1398.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

1399.

Ketoatsidoz can develop in such states after an exception:

A.

- insulin-dependent of saccharine diabetes

B.

* - cirrhosis of liver

C.

- alcoholism

D.

- long application of corticosteroids

E.

- starvation

1400.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

1401.


A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

1402.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


1403.


A.


B.


C.


D.


E.


1404.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

1405.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

1406.


A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

1407.

Metabolic acidosis for a patient develops at:

A.

- Unruly to vomit

B.

- Reception of antiacid preparations

C.

* - use of diuretic (inhibitors of carbounhydrasium)

D.

- Use of diuretics (saluretics)

E.


1408.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

1409.

Name the drug, which is not used in case of hypercalcemia crises:

A.

isotonic solution of NaCl

B.

glucocorticoids

C.

furosemid

D.

* calcium gluconate

E.

sodium salt of EDTA

1410.

Name the most common reason of hypocalcaemia of adults:

A.

chronic renal insufficiency,

B.

destructive pancreatitis

C.

hepatocirrhosis, alkalosis, hypomagnesaemia

D.

* surgical damage of parathyroid glands

E.

massive infusions of citrated blood

1411.

Normally the correlation of extra and intracellular potassium is:

A.

1:5

B.

* 1:30

C.

30:1

D.

2:1

E.

7:1

1412.

Normally the water amount in the body depends on:

A.

the quantity of lipid tissue (it contains less water, than other tissues)

B.

the quantity of lipid tissue (it contains more water, than other tissues)

C.

level of Base Exchange

D.

* the quantity of coming (consumed) liquid

E.

climatic conditions

1413.

Patient PaCO2 makes 40 mm mercury, and standard hydrogen carbonate – 12, then рН makes:

A.

- 7,0

B.

- 7,1

C.

* - 7,2

D.

- 7,3

E.

- 7,4

1414.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

1415.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

1416.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


1417.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

1418.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

1419.

Respirator and mixed acidosis it is possible to correct:

A.

- sodium hydrohen of carbonate

B.

* - trisaminum, to sodium by a lactat

C.

- hydrochloric acid

D.


E.


1420.

Results of laboratory researches: рСО2 – 50, рН – 7,12, HCO3 – 13. Your diagnosis:

A.

- compensated respirator acidosis

B.

- noncompensated metabolic alkalosis

C.

- respiratory alkalosis, metabolic acidosis

D.

* - metabolic acidosis respiratory acidosis

E.

- all of answer faithful

1421.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

1422.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

1423.

Specify on the most frequent reason of development of hypocalciemia for adults:

A.

- chronick renal failure

B.

- destructive pancreatitis

C.

- cirrhosis of liver, alkalosis

D.

* - operating shock of shield-similar glands

E.

- massive transfusions of citrate blood

1424.

Specify what norm of loss of water with urine for days for a man with mass 100 kg:

A.

* - 2400 ml

B.

-1200 of ml

C.

-1000 of ml

D.

-1500 of ml

E.

-1600 of ml

1425.

Specify what norm of perspirations losses for a man with mass 100 kg:

A.

-2400 of ml

B.

* -1200 of ml

C.

-1000 of ml

D.

-1500 of ml

E.

-1600 of ml

1426.

Specify which from the transferred facilities it is impossible to use during a hypercalcium crisis:

A.

- isotonic soluble-sodium of chloride or glucose

B.

- glucocorticoids

C.

- furosemide

D.

* - calcium gluconate

E.

- hemodialysis

1427.


A.


B.


C.


D.

* All of above

E.


1428.


A.


B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

1429.

Surplus of bases appears in cases:

A.

* - of the incessant vomiting

B.

- expressed sweaty state

C.

- expressed overventilations

D.

- fever

E.


1430.

The concentration of ionic Ca increases in case of:

A.

Acidosis

B.

Alkalosis

C.

Hypohydration

D.

* deficiency of Na

E.

Acid-base balance doesn’t influence rate of Ca

1431.

The concentration of potassium in serum:

A.

increases in case of alkalosis

B.

decreases in case of acidosis

C.

* increases in case of acidosis

D.

decreases in case of alkalosis

E.

doesn’t depend on acid-base balance

1432.

The correction of acidosis is carried out buds by the all transferred ways except for:

A.

- deducing of hydroids with hydrophosphates

B.

- deducing of hydroids with salts to the ammonium

C.

* - deducing of hydroids with salts of coal acid

D.

- reabsorption of hydroxylic ions

E.

- A, B

1433.


A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

1434.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

1435.


A.


B.


C.


D.


E.

* All of the above

1436.


A. 2 % xylocaine

B. Rubber tourniquet

C. Ring block

* Adrenaline

E. Atropin

1437.

The main intracellular cat ions are:

A.

* Na and Ca

B.

Ca and Cl

C.

K and Mg

D.

K and Cl

E.

Mg and Cl

1438.

The major buffer of the extracellular liquid is:

A.

* - hydrocarbonate

B.

- phosphatic

C.

- Protein

D.

- haemoglobin

E.


1439.

The most common reason of hypercalcemia is:

A.

* Primary and secondary hyperparathyreosis

B.

Primary and secondary hypoparathyreosis

C.

Thyrotoxicosis

D.

Growth of blood plasma aldosterone rate

E.

Reduction of blood plasma aldosterone rate

1440.

The most common reasons of isotonic dehydration are all from the listed below except:

A.

* extra inflow of Na

B.

bowel obstruction

C.

bleeding

D.

peritonitis

E.

wound

1441.

The reason of hypohydration might be everything, from the named below, except:

A.

Diseases, which cause vomiting and diarrhea

B.

Burn disease

C.

Bleedings

D.

Hyperthermia

E.

* Ascite, hydrothorax

1442.

The reason of hypotonic dehydration might be everything from the listed below, except:

A.

insufficiencies of mineral corticoid function of adrenal glands

B.

hyper function of adrenal glands

C.

diarrhoea with hypertonic stool

D.

* diarrhoea with Na-poor stool

E.

diseases of kidneys, which damage electrolytes absorption

1443.

The reasons of hypertonic dehydration might be every, from the listed below, except:

A.

Watery stool of patients with cholera or salmonellas disease

B.

* Inadequate completing of perspiration loss

C.

Excessive infusion of hypertonic solution of NaCl

D.

Osmotic diuresis

E.

Hypo and isostenuria of patients with kidney diseases

1444.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

1445.

The use of antiacid preparations can assist to development of acidosis in case:

A.

- stomach ulcer

B.

- long use

C.

* - chronic nephritic insufficiency

D.

- carrying out of long ALV

E.


1446.

To a chlorine over of resistant form of metabolic alkalosis such states can bring after an exception:

A.

- hyperaldostenorismus

B.

* - vomiting

C.

-use of mineralcorticoids

D.

- use of glucocorticoids

E.


1447.

To a chlorine-sensitive form of metabolic alkalosis such states can bring after an exception:

A.

- hypovolemia

B.

- vomiting

C.

- use of saluretics

D.

* - of hyperaldosteronism

E.


1448.

To trisaminum peculiar all except for:

A.

- synthetic containing sodium solution which creates a basic environment

B.

* - sodium hydrogen of carbonate well adjusts the intracellular acidosis

C.

- in time of hit in pair a venous cellulose is caused by necrosis of fabric

D.

- with the rapid intravenous introduction represses breathing

E.

- contraindicated at the parafunction of buds

1449.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

1450.

What from the transferred violations of ABS are peculiar for myasthenia gravis:

A.

- respiratory alkalosis

B.

* - respiratory acidosis and metabolic acidosis

C.

- metabolic alkalosis

D.

- respiratory alkalosis, metabolic alkalosis

E.

- A,C

1451.

What from the variants of analyses peculiar for a metabolic alkalosis, partly compensated by a respirator component: рН – PaCO2– HCO3:

A.

- 7,1 – 27 – 8

B.

- 7,34 – 70 – 39

C.

- 7,56 – 26 – 23

D.

- 7,0 – 70 – 16

E.

* - 7,5 – 46 – 36

1452.

What index from the listed below might be an evidence of low osmotic molarity of blood plasma?

A.

Hypernatremia

B.

* Hyponatremia

C.

Hyperglikemia

D.

Ketoacidosis

E.

Hypoglycaemia

1453.

What is endogen water?

A.

Water, which is generated during protein catabolism

B.

Water, which is generated during fat catabolism

C.

* Water, which is generated during fat, protein and carbohydrates catabolism

D.

Intracellular water

E.


1454.

What is normal molar concentration of plasma?

A.

240-260

B.

260-280

C.

* 285-310

D.

310-340

E.

150-17

1455.

What is normal perspiration water loss?

A.

1 ml/kg/hour

B.

2 ml/kg/hour

C.

0,8 ml/kg/hour

D.

1,5 ml/kg/hour

E.

* 0,5 ml/kg/hour

1456.

What is perspiration water loss?

A.

Water loss with stool

B.

Water loss with urine

C.

* Water loss through skin and breathing passages

D.


E.


1457.

What is the amount of extra cellular water in the body?

A.


B.


C.


D.


E.


1458.

What is the amount of intracellular water in the body?

A.


B.


C.


D.


E.


1459.

What is the amount of water in the body of adult human?

A.

* 60% of body weight

B.

80% of body weight

C.

55% of body weight

D.

85% of body weight

E.

75% of body weight

1460.

What is the amount of water loss with urine (normally)?

A.

* 1 ml/kg/hour

B.

2 ml/kg/hour

C.

0,5 ml/kg/hour

D.

1,5 ml/kg/hour

E.

0,8 ml/kg/hour

1461.

What positions correctly represent distributing of water in new-born:

A.

- general liquid is 90% from mass of body

B.

* - general liquid is 80% from mass of body

C.


D.


E.


1462.

What quantity of liquid should normally come to the body of healthy human every day?

A.

2-3 ml/kg/hour

B.

3-4 ml/kg/hour

C.

* 1,5-1,7 ml/kg/hour

D.

2,7-2,9 ml/kg/hour

E.

1,2-1,5 ml/kg/hour

1463.

What type of dehydration is accompanied with hypernatremia?

A.

Hypotonic

B.

* Hypertonic

C.

Isotonic

D.


E.


1464.

What value of рН plasma of blood is answered by the concentration of hydrions of 40 nmol/l:

A.

- 7,0

B.

- 7,35

C.

* - 7,4

D.

- 7,44

E.

- 7,6

1465.

What violations of ABS are most peculiar for cardiogenick shock:

A.

- respiratory acidosis

B.

- metabolic alkalosis

C.

- respiratory acidosis, metabolic alkalosis

D.

- respiratory alkalosis

E.

* - respiratory alkalosis, metabolic acidosis

1466.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

1467.

Which statement does correctly describe changes in water amount in the bodies of people with different amount of fat?

A.

* People with obesity have related content of water greater, than people with normal or lowered nourishment

B.

People with normal or lowered nourishment have greater water content, than people with obesity

C.

People with normal nourishment have lower related and absolute water content than people with obesity

D.

Absolute water content is almost equal in all mentioned cases

E.


1468.

Which way does the hematocrit change in case of hyperhydration?

A.

Increases insignificantly

B.

Decreases

C.

Doesn’t change

D.

* Increases greatly

E.


1469.

Which way will the loss of adrenal glands function influent the electrolytic balance?

A.

* Increases the rate of Na in the body

B.

Increases the rate of K in cells

C.

Increases the rate of K in urine

D.

Doesn’t influent electrolytic exchange

E.


1470.

рН of patient 7,2, VE - - 2, PaCO2 – 40. Your diagnosis:

A.

- subcompensated metabolic alkalosis

B.


C.


D.

* - decompensated metabolic acidosis

E.

- subcompensated respirator alkalosis

1471.

рН of patient 7,3, VE - - 2, PaCO2 - 40. Your diagnosis:

A.


B.


C.

* - subcompensated metabolic acidosis

D.

- decompensated metabolic acidosis

E.


1472.


A.


B.


C.


D.

* - is mixed the subcompensated acidosis

E.


1473.

рН of patient 7,3, VE - + 1, PaCO2 – 48. Your diagnosis:

A.


B.


C.


D.

* - subcompensated respirator acidosis

E.


1474.


A.


B.


C.


D.

* - subcompensated respirator acidosis with a metabolic alkalosis

E.


1475.


A.


B.


C.


D.

* - subcompensated respirator alkalosis with metabolic acidosis

E.


1476.

рН of patient 7,5, VE - + 1,5, PaCO2 – 32. Your diagnosis:

A.


B.


C.


D.

- noncompensated metabolic acidosis

E.

* - subcompensated respirator alkalosis

1477.

рН of patient 7,5, VE - + 2, PaCO2 - 40. Your diagnosis:

A.

* - subcompensated metabolic alkalosis

B.


C.


D.


E.


1478.


A.


B.

* - is mixed the subcompensated alkalosis

C.


D.


E.


1479.


A.


B.

* - decompensated metabolic alkalosis

C.


D.


E.


1480.

If you suspect neck backbone injury, backwards head titling might lead to:

A.


B.


C.

*damage of spinal cord

D.

asphyxia

E.

damage of synocarotid sinuses

1481.

What should you do at the beginning of resuscitation action, if clinical death was caused by mechanical injury?

A.


B.

electrical defibrillation

C.

heart massage

D.

ALV

E.

*precordial thump

1482.

What kind of drawning guarantees the most favorable prognosis?

A.


B.


C.

syncopal drowning

D.

true drowning

E.

*dry drowning

1483.

What does develop in case of salt water true drowning?

A.


B.

B. hypotonic hyperhydration

C.

* hypertonic hypohydration

D.

hypertonic hyperhydration

E.

hypotonic hypohydration

1484.

What is used during third stage of resuscitation of patients with salt water true drowning?

A.


B.

solution of sodium bicarbonate

C.

*solution of hypotonic infusible ions

D.

solution of magnesia sulfate

E.

solution of sodium chlorides

1485.

During the third study of resuscitation patient with natural drawing in fresh water use infusion therapy

A.


B.

*solution of sodium bicarbonate

C.

hypotonic solutions

D.

solution of magnesium sulphate

E.

physiologic saline

1486.

What should be the first resuscitation action in case of true drowning?

A.


B.

external cardiac massage.

C.

*ALV

D.

turning of the patient face down

E.

pericordial thump

1487.

What should be done in order to prevent secondary drowning of patients with true drowning during first 24 hours after it?

A.

A.


B.


C.

ALV with normal respiratory rate

D.

ALV with NEEP

E.

*ALV with PEEP

1488.

. What is the reason of natural drowning?

A.

A.


B.

*respiratory movements.

C.

hypoxia

D.

damage of reflective areas

E.

regurgitation

1489.

What is the reason of dry drowning?:

A.


B.

respiratory movements

C.

*hypoxia

D.

damage of reflective areas

E.

regurgitation

1490.

What is not a type of drowning?

A.


B.

dry drawing.

C.

*artificial drawing

D.

syncopal drawing

E.

true drawing

1491.

Prognosis of resuscitation is more favorable in the case of:

A.


B.


C.

primary cardiac arrest

D.

primary death of brain

E.

*primary respiratory arrest

1492.

What is not a sing of brain death?

A.


B.

lack of conciseness.

C.

lack of electrical activity on electroencephalogram

D.

* livores mortis

E.

lack of spontaneous breathing, areflexia

1493.

What is the most common reason of primary cardiac arrest?

A.


B.


C.

advanced deficit of circulating blood volume

D.

advanced obstruction of great vessels

E.

advanced cardiac decompensation

1494.

What is the most common death reason after primary respiratory arrest?

A.


B.


C.

violation of respiratory biomechanics

D.

*damages of respiratory centre

E.

obstruction of airways

1495.

Why aren’t glucose solutions being used when glucose blood level is more than 8 mmol/l ?

A.


B.


C.

* because they might cause brain edema (hyperosmolar solutions).

D.

because they might overfill bloodstream

E.

because they are dangerous for diabetics;

1496.

What kind of heart massage is used in the operating room in case of cardiac tamponade?

A.


B.


C.

mixed

D.

*open heart massage

E.

closed cardiac massage

1497.

What is the aim of ICU specialist during unconsciousness period?

A.


B.


C.

*protection of brain from hypoxia

D.

providing of cardiac output

E.

normalization of skin colour

1498.

What medicine is “forbidden” in the case of ”ineffective heart”, caused by acute reduction of circulating blood volume?

A.


B.

*lipofundin

C.

hemodynamics medicine

D.

steroids

E.

crystalloids

1499.

What is ECG picture of asystolia?

A.


B.

ineffective heart

C.

atrial fibrillation

D.

ventricular fibrillation

E.

*flat line

1500.

Where should you place hands during CPR?

A.


B.

2 fingers to the left from xiphoid process.

C.

2 fingers to the right from xiphoid process.

D.

*2 fingers to the top of xiphoid process.

E.

2 fingers down from xiphoid process.

1501.

When is solution of calcium chloride used during CPR:

A.


B.

* in case of hyperkaliemia

C.

in case of electric injury;

D.

in case of ventricular fibrillation

E.

in case of asystolia;

1502.

. When is solution of lidocaine used during CPR?

A.


B.

*in case of ventricular fibrillation

C.

when it’s necessary to eliminate atropine influence on heart

D.

in case of central veins catheterization

E.

asystolia;

1503.

What way of medicine introduction is not used during CPR?

A.


B.

endotracheal

C.

*intramuscular;

D.

intra-arterial introduction;

E.

intravenous introduction

1504.

What part of triple Safar method is “forbidden” in case of trauma patients?

A.


B.

forward jaw movement

C.


D.

opening of the mouth ;

E.

*titling of the head backwords;

1505.

What is the third stage of CPR according to P. Safar?

A.


B.

medical therapy, electrocardiography

C.

external cardiac massage, defibrillation, ALV;

D.

* renewal of brain functioning, correction of all body systems and organs

E.

farmaceutical therapy , electrocardiography, defibrillation;

1506.

What is the second stage of CPR according to P. Safar?

A.


B.

external cardiac massage, defibrillation,

C.

trachea intubation, ALV.

D.

external cardiac massage, defibrillation, ALV;

E.

*farmaceutical therapy, electrocardiography, defibrillation ;

1507.

What condition does demand prolonged resuscitation?

A.


B.

young age of the patient

C.

electric trauma;

D.

drugs overdose;

E.

*hypothermia;

1508.

What is not a criterium of CPR cessation?

A.


B.


C.

ineffective resuscitation during 7 minutes .

D.

*ineffective resuscitation during 30 minutes;

E.

renewal of spontaneous circulation and breathing

1509.

What is the energy of first defibrillation in case of biphasic defibrillators?

A.

320 J

B.

350 J;

C.

100 J,

D.

220-230 J,

E.

*150-200 J;

1510.

What is the energy of first and subsequent defibrillations in case of monophasic defibrillators?

A.

220 J

B.

150 J;

C.

the first - 100 J, all next – 200 J.

D.

200 J, all next -400 J;

E.

*360 J;

1511.

What are the indications for defibrillation?

A.


B.

*ventricular fibrillation.

C.

electrical activity without pulse;

D.

asystole;

E.

cardiac arrest;

1512.

What ECG lead is used during CPR for evaluation of the rhythm?

A.

I standard lead

B.

III standard lead

C.

*II standard lead.

D.

leads by Neb

E.

all standard and chest leads;

1513.

What types of cardiac arrest do you know?

A.


B.

asystolia

C.

ineffective heart;

D.

ventricular fibrillation;

E.

* atrial fibrillation

1514.

When is used solution of sodium bicarbonate during CPR?

A.


B.

in case of

РН> 7,4

C.

* in case of

РН< 7,1

D.

in all cases ;

E.

all answers are correct;

1515.

When is 2% solution of euphylline used during CPR?

A.


B.

after shock;

C.

in case of atropine resistant bradycardia

D.

* in case of drowning

E.


1516.

When is cordarone used during CPR?

A.


B.

during PEA

C.

during asystole,.

D.

*during ventricular fibrillation;

E.

always;

1517.

What is the dose of Atropine sulphate 0,1% used during CPR?

A.


B.

1 mg every 1 min intravenously;

C.

10 mg every 3 – 5 min intravenously;

D.


E.

*3 mg once intravenously;

1518.

What is the dose of 0,1 % adrenalin solution used during CPR?

A.


B.


C.


D.


E.

*1 mg every 3 – 5 min intravenously;

1519.

How should be changed the dose of a medicine in case of endotracheal administration?

A.


B.

Increased by 4 times

C.

Increase by 3 times

D.

*Increase by two times;

E.

shouldn’t change in comparing with intravenous administration

1520.

What way of administration should not be used during CPR?

A.


B.

endotracheal way

C.

*subcutaneous introduction

D.

intraarterial administration;

E.

intravenous administration;

1521.

What is not an indication for external heart massage?

A.


B.

*cardiac infarction.

C.

suspicion of a clinical death ;

D.

massive pulmonary thromboembolism;

E.

absence of оpen chest during surgery;

1522.

What does prove effectiveness of cardiac massage?

A.


B.

return of consciousness

C.

*pulse on the main arteries

D.

spontaneous respiratory movements

E.

normalization of skin color;

1523.

What is the frequency of compressions during CPR?

A.

120 per min

B.

110 per min

C.

*100 per min’

D.

80 per min.;

E.

60 per min

1524.

What in the ration between compressions and rescue breaths during CPR?

A.

1:5

B.

2:1

C.

10:4

D.

5:1

E.

* 30:2

1525.

Where should be placed your hands during heart massage?

A.


B.

*between lower and middle thirds of the sternum.

C.

upper third of the chest;

D.

xiphoid process;

E.

in the heart area;

1526.

Choose the correct statement about ALV :

A.


B.

triple method of Safar is necessary.

C.

attempts of medical stimulation of breath should be performed;

D.

*without control of ALV air might get to the stomach;

E.

chest excursion sholdn’t be controlled;

1527.

Precordial thump is:

A.


B.

element of defibrillation

C.

sharp pressure on the side of the chest.

D.

*sharp thump to a specific location on the sternum (it’s middle part)

E.

sharp thump to a specific location on the sternum (cardiac apex);

1528.

What can cause mouth-to-mouth ventilation with exceed tidal volume?

A.


B.

intestine injury

C.

*air in stomach

D.

falling back of the tongue;

E.

lung injury;

1529.

During ALV tidal respiratory volume is:

A.

200-300 ml

B.

* tidal volume of person performing ALV

C.

500-600 ml.

D.

300-400 ml;

E.

100-200 ml

1530.

What is inspiration volume during artificial lung ventilation ?

A.

800-1000 ml

B.

* 500-600 ml

C.

400 ml.

D.

300 ml.

E.

all answers are wrong;

1531.

„Triple method„ of P. Safar includes:

A.


B.

evaluation of general condition, external cardiac massage , intubation, lung ventilation;

C.

trachea intubation, ALV, external cardiac massage .

D.

* titling the head backwords, opening of the mouth, thrusting the jaw forward

E.

evaluation of general condition, external cardiac massage , pulmonary ventilation;

1532.

The first stage of CPR includes:

A.


B.

trachea intubation, defibrillation, heart massage;

C.

*providing of airways potency, respiratory support, circulation support

D.

trachea intubation, defibrillation, external cardiac massage;

E.

defibrilation, external cardiac massage , pharmaceutical therapy;

1533.

Stages of CPR include:

A.


B.

artificial ventilation , external cardiac massage, after resuscitation care

C.

evaluation of general condition, external cardiac massage , pulmonary ventilation

(intubation);

D.

*emergency oxygenation

, basic life support, renewal of spontaneous circulation, cerebral resuscitation and post resuscitation actions

E.

artificial ventilation, external cardiac massage , defibrillation;

1534.

What is not a sign of biological death?

A.


B.

cadaveric rigidity

C.

*hypertonic muscles;

D.

dry cornea;

E.

livores mortis

1535.

What is a reason not to provide CPR?

A.


B.

total skin cyanosis

C.

all answers are correct;

D.

hard injuries of chest

E.

*if it is known, that from the moment of death passed more than 25 minuets.

1536.

What is an indication for CPR?

A.


B.

lack of pulse on peripheral arteries

C.

unconsciousness;

D.

biological death;

E.

*clinical death;

1537.

What is an additional sign of clinical death?

A.


B.


C.

*dilatation of pupils

D.

unconsciousness;

E.

lack of pulse on main arteries

1538.

What is the main singn of clinical death?

A.


B.

atonia, areflexia.

C.

*lack of pulse on main arteries

D.

lack of skin sensitivity

E.

unconsciousness .

1539.

Resuscitation is:

A.


B.

* process of main vital functions replacement

C.

process of dying

D.

science about mechanisms of vital functions replacement

E.


1540.

Main stages of dying are:

A.


B.

*preagoni, terminal pause, agony, clinical death.

C.

agony, , terminal state , biological death.

D.

death of brain, biological death.

E.

sh осk, terminal pause, clinical death, biological death.

1541.

Triple method„ of Safar includes:

A.

estimate of total state , external cardiac massage , pulmonary ventilation;

B.

* neck extending, opening of mouth, move outing of jow.

C.

incubation of trachea, APV, external cardiac massage .

D.

estimate of total state , external cardiac massage , intubation, pulmonary ventilation;

E.

all answers are false

1542.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

1543.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

1544.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

1545.

Additional sign of clinical death is:

A.

Absence of pulsation on the central artery .

B.

Absent of conciseness;

C.

* Stretching of pupils.

D.

All answers are false

E.

All answers are right

1546.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

1547.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

1548.


A.


B.


C.

Both

D.

D.None

E.


1549.


A.

* 2

B.

3

C.

4

D.

D*6

E.

10

1550.


A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

1551.


A.


B.


C.


D.


E.

All of the above

1552.

Conditions need prolongation of resuscitation are:

A.

cooling of organism;

B.

overdosing of drugs;

C.

electro trauma;

D.

* young age of patient

E.


1553.

Contraindication for reanimation is:

A.

* if it is known, that from moment of death past more than 25 minuets.

B.

massiv breaking of webbing

C.

presents of auricle trembling;

D.

total cyanosis of skin.

E.


1554.

Cordarone apply in scheme CPR in case :

A.

allways;

B.

* during ventrical [ventricular] fibrillation;

C.

during asystole,.

D.

during systole

E.


1555.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

1556.

Criteria’s of stopping of reanimation actions are all exept:

A.

renewal independent circulation and breath;

B.

not affectivity of reanimation during 30 minuits;

C.

* not affectivity of reanimation during 7 minuits .

D.


E.

all answers are true

1557.

Dosing solution of adrenalin 0,1% during reanimation:

A.

* 1 mg every 3 – 5 min intravenously;

B.


C.


D.


E.


1558.

Dosing solution of atropine sulphate 0,1% in CPR:

A.

* 3 mg only one time intravenously;

B.


C.


D.


E.


1559.

During APV are wrong all excepting :

A.

absent of control of excursion of chest ;

B.

absent of control hit air into the stomach ;

C.

attempt of medical stimulation of breath;

D.

* making triple steps by Safar.

E.


1560.

During APV respiratory volume must compound

A.

100-200 ml

B.

300-400 ml;

C.

500-600 ml.

D.

* volume of inspiration of person performed APV

E.

200-300 ml

1561.

During artificial pulmonary ventilation volume of inspiration is:

A.

volume of max forsation ;

B.

300 ml.

C.

400 ml.

D.

500-600 ml

E.

* 800-1000 ml

1562.

During endotracheal injection to patient in clinical death you should increase dose of drugs comparing with intravenous dose in

A.

* 2 once again

B.

3 once again

C.

4 once again

D.

5 once again

E.

once again

1563.


A.


B.


C.


D.

* All of the above

E.


1564.

During external cardiac massage frequency of compression must compound:

A.

60 in min

B.

80 in min.;

C.

* 100 in min’

D.

110 in min

E.

120 in min

1565.

During external cardiac massage pressing made on:

A.

projection tip of the heart ;

B.

processus xiphoideus;

C.

top third of the chest;

D.

* between second and third third of the sternum.

E.


1566.


A.


B.


C.


D.


E.


1567.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

1568.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

1569.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

1570.

Exceed allowed respiratory volume during APV „mouth to mouth ” can lead to

A.

break of pullmone;

B.

sink down of root of tongue;

C.

* presence air in stomach

D.

hit air in intestine

E.


1571.


A.


B.


C.


D.

Sensory fibres

E.


1572.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

1573.


A.


B.


C.


D.


E.


1574.

Forecast of reanimation is more favorable in the case of:

A.

* primary stop of breath

B.

primary death of brain

C.

stop circulation of blood

D.

d ) all written before variants

E.


1575.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

1576.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

1577.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

1578.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

1579.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

1580.

In the case of ”non effective heart”, predetermined sharp reduction of circulated blood volume you should use all remedies exept:

A.

crystalloids

B.

glucocortycoids

C.

hemodynamics remedies

D.

* lipofundin

E.


1581.

In the case of drawing there are such variants teratogenesis except:

A.

natural drawing

B.

syncopal drawing

C.

* artificial drawing

D.

d ) asphyctic drawing.

E.


1582.

In the case of intratracheal introduction of drugs their dose is :

A.

the same like during intravenous introductions ;

B.

* Increase in two times;

C.

Increase in 3 times

D.

Increase in 4 times

E.


1583.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

1584.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

1585.

Indication for external cardiac massage is all except:

A.

absence of оpened chest in conditions of surgical ;

B.

massive pulmonary thromboembolism;

C.

suspiction on period unnoticed clinical death ;

D.

* acute cardiac infarction.

E.

a, b

1586.

Indication for resuscitation is:

A.

* clinical death;

B.

biological death;

C.

Absent of concsesness;

D.

Absent of pulsation on peripheric arteri

E.


1587.

Indication for using of calcium chloride in scheme of CPR:

A.

asistolia;

B.

fibrillation of ventricle;

C.

during bliding;

D.

* during hypercaliemia

E.


1588.

Indication for using of lidocain in scheme CPR is:

A.

asistolia;

B.

catheterization central veins ;

C.

for elimination of influence on the cardio of atropin;

D.

* ventricle fibrillation

E.


1589.

Indications for defibrillation is:

A.

circulatory arrest;

B.

assistole;

C.

electrical activity without puls;

D.

* ventrical fibrillation.

E.


1590.

Introduction of drugs during CPR fobbiden:

A.

introvenously

B.

b )introarterialy;

C.

* intramuscularly;

D.

intratracheal

E.


1591.

Introduction of remedies in CPR forbidden:

A.

intravenously;

B.

intra-arterial;

C.

* under skin;

D.

intratracheal way .

E.


1592.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

1593.


A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

1594.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


1595.


A.


B.


C.


D.


E.


1596.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

1597.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

1598.

Main stages of organism’s living functions extinction are:

A.

shосk, terminal pouse,clinical death,biological death.

B.

death of brain, biological death.

C.

agoni, , terminal state , biological death.

D.

* preagoni, terminal pause, agony,clinical death.

E.


1599.


A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

1600.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

1601.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

1602.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

1603.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


1604.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

1605.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

1606.

Pre-cordial strike is:

A.

strike on chest in projection of top of heart;

B.

* strike on chest in projections of middle of sternum:

C.

sharp press on side surface of chest.

D.

element of defibrillation

E.


1607.

Proportion number of compression on the chest and number of breath during CPR must compound

A.

* 30:2

B.

5:1

C.

10:4

D.

2:1

E.

1:5

1608.

Reasons of asphyctic drawing is:

A.

regurgitation

B.

damaging of reflexogenic zones

C.

* hypoxia

D.

breath movements

E.


1609.

Reasons of natural drawing is:

A.

regurgitation

B.

damaging of reflexogenic zones

C.

hypoxia

D.

* breath movements.

E.


1610.

Reasons of syncopal drawing is:

A.

regurgitation

B.

* trauma of reflexogenic zones

C.

gipoxia

D.

breath movements

E.


1611.

Resuscitation is

A.

process of organism’s living functions extinction:

B.

science of mechanism of organism’s living functions extinction

C.

process of dying away of organism’s living functions

D.

* process reproduction of organism’s living functions

E.


1612.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

1613.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

1614.

Sign of biological death is not

A.

livores mortis

B.

drying of cornea;

C.

* hypertonus of muscls;

D.

corps numbness.

E.


1615.

Sign of correctness making external cardiac massage is:

A.

* bouing of the chest on 5-6 cm;

B.

presence of movement of air from respiratory waves ;

C.

presence of pulsation on the central arteries .

D.

presence of conscious

E.


1616.

Sign of intravital death of brain is all except:

A.

absent of spontal breath, areflexia

B.

* livores mortis

C.

absence of electrical activity on electroencephalogram

D.

absent of conciseness.

E.


1617.


A.


B.


C.


D.

* All of above

E.


1618.

Stages of CPR are:

A.

artificial breth, external cardiac massage , defibrilation;

B.

* emergency oxygenation и elementary support of life, renewal of spontan blood circulation cerebral reanimation and post reanimation actions

C.

estimation of total state of organism, intubation of trachea, [external cardiac] massage

D.

artificial breth , external cardiac massage, post reanimation

E.


1619.


A.


B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

1620.

Terminal conditions are

A.

* preagonia, terminal pause, agonia, clinikal death

B.

agonia, clinikal and biological death

C.

coma, agonia, clinikal death

D.

preagonia, terminal pause, agonia, clinikal and social death

E.

coma, clinikal death

1621.


A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

1622.

The dose of atropin 0,1% solution intravenously during resuscitation is

A.

1 ml

B.

2 ml

C.

* 3 ml

D.

4 ml

E.

5 ml

1623.

The duration of clinical death in condition of normothermia is

A.

7-12 min

B.

1-3 min

C.

* 4-5 min

D.

5-7 min

E.

till 10 min

1624.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

1625.


A.


B.


C.


D.


E.

* All of the above

1626.

The first charge during defibrilation should be

A.

* 200 J

B.

220 J

C.

250 J

D.

300 J

E.

350 J

1627.

The first stage CPR has such steps:

A.

defibrilation, external cardiac massage , medical therapy;

B.

trachea intubation, defibrillation, external cardiac massage;

C.

* renewal permeability of respiratory tract , support of breath , support of blood circulation.

D.

trachea intubation, defibrillation, external pulmonary massage;

E.


1628.


A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

1629.

The frequentsy of pressing on chest during hurt massage is

A.

* 100 pressing a min

B.

60 pressing a min

C.

80 pressing a min

D.

150 pressing a min

E.

180 pressing a min

1630.

The heart stops in sysole during clinical death in

A.

60 % of patients

B.

80 % of patients

C.

* 90 % of patients

D.

40 * of patients

E.

30 % of patients

1631.

The main sign of clinical death is

A.

absent of conciseness.

B.

painless of cutaneous covering

C.

* absent of pulsation on the central artery

D.

atonia, areflexia.

E.


1632.

The most often reason of death during primary respiratory failure:

A.

obstruction of respiratory ways

B.

* damages of activity of respiratory centre

C.

damaged of biomechanics of breath

D.

all written before variants.

E.


1633.

The most often reason of primary stop of the heart

A.

high cardiac decompensation

B.

high obstruction of magisterial vessels

C.

high deficit of volume of circulated blood

D.

* all written before variants

E.


1634.

The second stage of CPR by Safar consist of next steps:

A.

* medical therapy, electrocardiography, defibrillation ;

B.

external cardiac massage, defibrillation, APV;

C.

assessment of general conditions ,intubation of trachea , APV.

D.

external cardiac massage, defibrillation,

E.


1635.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

1636.

The third study CPR by Safar consist of next steps:

A.

medical therapy, electrocardiography, defibrillation;

B.

* external cardiac massage, defibrillation, APV;

C.

assessment of general conditions, renewal of mental work, correction of the function of all systems of organism;

D.

medical therapy, electrocardiography

E.


1637.

The volume of minute ventilation during artifitial lung ventilation should increase normal minute volume of ventilation on

A.

* 30-40 %

B.

10-20 %

C.

50 %

D.

15 %

E.

70 %

1638.

Tipes of circulatory arrest are all exist:

A.

* atrial fibrillation

B.

ventricle fibrillation;

C.

c ) non effective heart;

D.

asystolia

E.


1639.

Using of sodium bicarbonate in CPR?

A.

not indicated ;

B.

indicated in all cases ;

C.

* indicated if РН< 7,1

D.

indicated if РН> 7,4

E.


1640.

Using of solution of euphilline 2,0 % in CPR?

A.

not indicated ;

B.

* indicated after drawing;

C.

indicated during bradycardia wich is resisted to atropine.

D.

indicated after shock;

E.


1641.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

1642.

What action is first prioritized during natural drawing?

A.

pericardial push

B.

over turn patient

C.

* APV

D.

external cardiac massage.

E.


1643.

What energy of the first and next discharge must be used with employed monopolary defibrilator?

A.

* 360 J;

B.

200 J, all next -400 J;

C.

the first - 100 J, all next – 200 J.

D.

150 J;

E.

220 J

1644.

What energy of the first discharge must be used with employed bipolar defibrilator?

A.

* 150-200 J;

B.

220-230 J,

C.

100 J,

D.

350 J;

E.

320 J

1645.

What is registed electrocardiography during assistolia?

A.

* straight line

B.

ventricular complex

C.

atrial fibrillation

D.

not effective hart .

E.


1646.

What is the aim of reanimation workers during renewal of conciseness?

A.

on renewal of colors of skin covering

B.

on makings hart push

C.

* protection of brain from hypoxia

D.

no one from before written variants.

E.


1647.

What is the wright disposition of arms during CPR?

A.

2 fingers lower xiphoid process.

B.

* 2 fingers higher of xiphoid process.

C.

2 fingers to the right of xiphoid process.

D.

2fingers to the left of xiphoid process.

E.


1648.

What kind of massage of heart is used in operating room during cardiac tapenade?

A.

closed massage of heart

B.

* open massage of heart

C.

mixed

D.

no one from written before variants.

E.

a, b

1649.

What leads use in resuscitation practice for estimating of ECG:

A.

all standart and pectoral leads;

B.

leads by Neb

C.

* II standart lead.

D.

III standart lead

E.

I standart lead

1650.

What moment is forbidden to use during „tripled ” method injured in a road accident:

A.

* through backing of head;

B.

opening of mouth ;

C.

moving -out of lowing jaw.

D.

moving –in of lowing jaw

E.


1651.

What volume of air you should inbreath in patients during artificial lung ventilation

A.

1700-2000 ml

B.

500-700 ml

C.

1200-1600 ml

D.

* 800-1100 ml

E.

2000-2300 ml

1652.

Which of below signs is not sign of clinical death

A.

* absence of systolick blood pressure

B.

absence of breathing

C.

absence of photoreaction, midriasis

D.

absence of pulse under femoral artery

E.

absence of pulse under jugular artery

1653.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

1654.

Why solution of glucose is not used when glucose level in blood is more than 8 mmol/l ?

A.

dangerous appearance of diabetes;

B.

not to overfill volume of circulating blood

C.

* dangerous hyperosmolar damaged of cells of brain.

D.

all written before variants.

E.


1655.

You should increase the next each charge during defibrilation on

A.

* 500 W

B.

100J

C.

1000 W

D.

1500 W

E.

2000 W

1656.

A complete atrioventricular block is characterised

A.

* by absence of conducting of impulses from an autriums to ventricles

B.

by a idioventricoular rhythm

C.

by the attacks Morgani - Adamsa - Stocsa

D.


E.

all answers are right

1657.

A doctor decided to perform the defibrillation to patient with ciliary arrhythmia, using a synchronizer. The digit of defibrilyater must be synchronized:

A.

* with wave Q

B.

with the descending phase of R

C.

by an T

D.

consideration of phase of ECG-complex not important

E.

there is no right answer

1658.


A.

* Complete block

B.

Unstable block

C.

Hemi block

D.

All of the above

E.

None

1659.

A leading symptom for the diagnosis of stop of circulation of blood is:

A.

wide pupils, that are irresponsive on light

B.

absence of consciousness

C.

absence of breathing

D.

* absence of pulse on a carotid

E.

cyanosis

1660.


A.

* Cocaine

B.

Mepivacaine

C.

Hexylcaine

D.

Lidocaine

E.

Tetracaine

1661.

A main direct danger for a patient with acute bleeding is

A.

deficit of haemoglobin

B.

* Hypovolemiya

C.

Hypoproteinemiya

D.

coagoulopatiya

E.

deficit of fibrinogenou

1662.

A most threat for the life through possible transformation in ventricles fibrilation is presented by arrhythmia

A.

ventricle premature beats more than 20 in a minute

B.

* ventricle tahicardiya

C.

arrhythmias, that unite with lengthening of intraventricular conductivity blockade of the left leg of bunch of Gis

D.

blinking arrhythmia

E.


1663.


A.

Hypotension

B.

* Horner's syndrome

C.


D.


E.

Hypertension

1664.


A.

Lidocaine

B.

* Bupivacaine

C.

Procaine

D.

Cinchocaine

E.

None

1665.

All medicine have vasodilatational and lowering postload, belong:

A.

nitrates

B.

* ganglioblocers

C.

nitroprousid

D.

morfin

E.

faithful all answers

1666.


A.

Ascities

B.


C.

Pregnant

D.

Age after 50

E.

Obese

1667.

Anafilactic shock appeared at a patient. The state heavy and progressively gets worse. HBA – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the rescue of life of patient above all things?

A.

* Adrenalin.

B.

Chloride of calcium.

C.

Prednizolon.

D.

Dofamin.

E.

Suprastin.

1668.

At veritable cadiogenic shock obligatory medicine are:

A.

osmodiuretics

B.

salureticsi

C.

adrenalin

D.

* doboutamin

E.

analgetics

1669.

At a patient 20 years on a background the injection of vitamin B1 suddenly there was excitation, fear of death, falling of AP to 50 mm rt.st., hard breathing. Which of medicine it is necessary to inject firstly?

A.

* Adrenalin

B.

Prednizolon

C.

Calcium

D.

Dimedrol

E.

Eufilin

1670.

At a patient 22 years, which was delivered in the induction centre with heavy politrauma and hemorhagia, there is sucking of air in in a needle during punction and cateterization of v. Subclavia dextra.

A.

It is typical for:

B.

* Negative CVT

C.

Erroneous punction of artery

D.

Right-side pmeumothorax

E.

Edema of lungs

1671.

At a patient 60 years with the third day after an exterpation uterus acute insufficiency of breathing developed suddenly, a skin became at first cyanotic, and then ash-colored color. Tachypnoe, cough with bloody sputum, retrosternal pain. BP –

100/70 mm. mercury, HR – 120, BR – 32 in 1 min., CVP – 300 mm wt.col. What most reliable reason of worsening of the state of patient ?

A.

* Tromboemboliya of pulmonary artery

B.

Bleeding

C.

Pain shock

D.

Hypostatic pneumonia

E.

Heart attack of myocardium

1672.

At a patient in the ward of intensive therapy you marked appearance on the monitor of fibrillation of ventricules. Your first actions?

A.

* To conduct defibrillation three times

B.

B To inject adrenalin

C.

To inject a chloride

D.

D To begin the closed massage of heart

E.

To inject lidocain

1673.

At a patient with concomitant cardiac insufficiency acutely the expressed anaemia. Which from offered remedies for transfusion prevails?

A.

* erithromass

B.

fresh blood

C.

fresh-frozen plasma

D.

there are all right answers

E.


1674.

At a patient with the acute heart attack of myocardium best of all to warn relapsing fibrillation of ventricles with :

A.

cordaronum

B.

lidocainum

C.

ornidinum

D.

* electrocardiostimulation

E.


1675.

At anafilactic shock obligatory medicine are:

A.

* antihistaminic facilities

B.

adrenalin, ephedrine, mezaton

C.

dobutamin

D.

hormones

E.

calcium

1676.

At development of signs of toxic action digocsinum medical treatment includes intravenous injection

A.

verapamilum

B.

* lidocainum

C.

chlorid calcium

D.

right A) and C)

E.


1677.

At hypovolumic shock obligatory medicine are:

A.

osmodiuretics

B.

* infusion therapy (crystalloids +koloids)

C.

adrenalin

D.

doboutamin

E.

hormones

1678.

At medical treatment of atrioventricular block III, that developed after the heart attack of myocardium, is intravenously used:

A.

Lidocain

B.

Propranolol

C.

Novocainamid

D.

* Izuprel

E.

Metaraminol

1679.

At medical treatment of paroxysmal tachycardia it is not prescribed to apply

A.

antagonists of beta-adrenoretseption

B.

electric cardioversia

C.

pressure on a carotid sine

D.

* lidocain

E.

verapamil

1680.

At tamponade of heart is not observed

A.

rise of central vein pressure

B.

* noise of systole

C.

cyanosis

D.

paradoxical pulse

E.

rise of pulmonary capillary pressure of wedging (PCWP)

1681.

At the patient operated concerning the festering peritonitis coused by perforation of gastric ulcer, in a postoperation period appeared: high temperature, frequency of breathing 35/min., AP – 70/40 mm of merc. item, diuresis -20 ml/h temperature of body to 39C., leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of chlorous sodium and 0,8 of solution of reopoliglucin did not improve general condition. Central vein pressure – 130 mm wt.st. For stabilization of hemodinamics will be optimum infusion:

A.

* Dopamin

B.

Mezaton

C.

Adrenalin

D.

Noradrenalin

E.

Ephedrine

1682.

At the ventilated patient with the edema of lungs at low pressure and septic shock intravenous infusion 7,5 mcg/kg/min dopamini will increase

A.

RaO2, saturation of oxygen of the mixed vein blood, consumption of oxygen

B.

diuresis

C.

* cardiac systolic volume

D.

right A) and B)

E.


1683.

At traumatic shock tactic of doctor on a prehospital stage:

A.

providing of permeability of respiratory tracts and adequate ventilation of lungs

B.

imobilisation extremities

C.

infousion therapy

D.

* analgesia

E.

injection of vazopresors

1684.

. At which types of arrhythmia intravenous injection to potassium is effective?

A.

Ventricular tahycardia

B.

Nodular tahycardia

C.

Ventricular extrasystolia

D.

Supraventricular arrhythmia

E.

* At all of indicated types of arrhythmia

1685.


A.

4 hours

B.

24 hours

C.

* 3-4 days

D.

3-4 weeks

E.

1 year

1686.

Cardiotoxic properties of hypercalciemia is taken off by application:

A.

Adrenalin

B.

Coffeinum

C.

Ephedrine

D.

* Molar solution of lactat natrium

E.

10 % solution of glucose

1687.

Cardiotoxicity action of hypercalciumemia buys by application:

A.

adrenalin

B.

ephedrine

C.

* preparations of calcium

D.

a 10% solution of glucose

E.

corticosteroid

1688.


A.


B.


C.

Both

D.

D.None

E.


1689.

Characteristic signs for different types of shocks are:

A.

Oppression of consciousness

B.

* Lowering of arterial pressure

C.

Lowering of shock index Algovera

D.

Lowering TSVD

E.

Oppression of breathing

1690.


A.

* 2

B.

3

C.

4

D.

D*6

E.

10

1691.


A.

* Headache

B.

Nausea

C.

Hypotension

D.

Bladder distension

E.

Dizziness

1692.


A.


B.


C.


D.


E.

All of the above

1693.


A.

* 1 and 10

B.

3 and 6

C.

2 and 4

D.

7and 8

E.

9

1694.


A.


B.


C.


D.

* All of the above

E.


1695.

During the operation concerning strangular impassability of bowels, which conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac diyal-nosti happened 50 years in the moment of mesenretium streching by the surgeon.

What would prevent the stop of heart in this case?

A.

* i/v injection atropin

B.

i/v injection of cardiac glycozidis

C.

Deepening of general anaesthesia.

D.

Additional injection of relaxants

E.

Additional injection droperidol

1696.

ECG-sign of subendocardial myocardial ischemia is:

A.

* rise of segment S-T higher to the izoelectrichniy line more than on 2 mm

B.

decline of segment S-T below to the izoelectrichniy line more than on 2 mm

C.

inversion of indent T

D.

A, B, C

E.

A, B

1697.

Effects of noradrenalinum:

A.

Spasm of arteries and dilatation of veins

B.

Expansion of arteries and spasm of veins

C.

* Spasm of arteries and veins, except of coronal and cerebral vessels

D.

Spasm of all arteries and veins

E.

There is the no correct answer

1698.

Electrocardiostymulation is not prescribed at:

A.

to the complete atrioventricular block

B.

syndrome of weakness of sine knot with the attacks Morgani-Adams-Stocs

C.

ciliary arrhythmia with rare contraction of ventricles

D.

* bradiarhythmia, by the caused intoxication by cardiac glucoside

E.


1699.

Endotraheal it is possible to enter the following preparations, except for:

A.

* noradrenalin

B.

adrenalin

C.

lidocain

D.

atropine

E.

oxybutirat

1700.


A.


B.


C.


D.


E.


1701.


A.


B.


C.


D.

Obstetric analgesia

E.

In urologic surgery

1702.


A.

Miosis

B.

Retention of urine

C.

Abolishes pain

D.

* All

E.

None

1703.


A.


B.


C.


D.

Less dose required

E.

Cardiac depression

1704.


A.


B.


C.


D.

Sensory fibres

E.


1705.


A.

* Sympathetic

B.

Parasympathetic

C.

Motor

D.

Sensory

E.

Vision

1706.


A.


B.


C.


D.


E.


1707.

For the Hypovolemia is not characteristic:

A.

reduction of volume of circulatory blood

B.

decline of BP, tahicardiya

C.

reduction of shock volume and cardiac troop landing

D.

* rise CVP

E.

decline of pressure of filling of the left ventricle

1708.

For the prophylaxis of cardiogenick shock it does not use at the acute heart attack follow

A.

beta-adrenoblocers

B.

anaesthetizing, sedation

C.

inhalation O2

D.

beta-adrenostimulators

E.

* all answers are not complete

1709.

Geparin behaves to the group;

A.

* Direct anticoagoulyants

B.

Trombolitic facilities

C.

Vasoconstrictors

D.

Indirect anticoagoulyants

E.

There is no right answer

1710.

High vein pressure, hypotension and acute circulation insufficiency, are at:

A.

tense pneumathoracs

B.

embolisms of pulmonary artery

C.

to vein air embolism

D.

* correctly A) and B)

E.

right all answers

1711.

Hypotension at anaphylactic shock develops as a result of

A.

* increase of permeability of vessels and loss of volume of intravascular liquid

B.

losses of likable tone

C.

frees of prostaglandini

D.

bradicardia

E.

all are right

1712.

In 2 hours after renewal of cardial activity at a patient, that carried the sudden stop of heart on a background hemorhagic shock (blood lost near 2,5 l) and is found on

ALV, unstable hemorhagia (AP – 80/40 – 90/60 mm of merc. item, tahycardia)is marked, central vein pressure – 5 mm wt.st. It is related to:

A.

* By Hypovolume syndrome

B.

By cardia insufficiency

C.

By the inadequate interchange of gases

D.

Vasoplegia

E.

By the inadequate anaesthetizing

1713.

In a clinic a patient with the traumatic tearing of both lower extremities off at the level of knee-joints is delivered. A patient is extremly inert, languid, pale, pulse 140

bmin, threadlike, AP 500. On both lower extremities there are the imposed plaits.

Bleeding at the receipt is not present. From the words of doctor of first-aid, lost about

3 litres of blood in place of event. What principal reason of heavy of the state of patient?

A.

* acute hemorrhage.

B.

Pain shock.

C.

S. Ishemia of extremities as a result of application of tourniquet

D.

Fatty embolism

E.

acute kidney insufficiency

1714.


A.

* Secure airway

B.

Adrenaline

C.

Atropine

D.


E.

Diazepam IV

1715.


A.

Scalenus anterior

B.

Scalenus posterior

C.


D.


E.

Scalenus lateralis

1716.


A.

Dura and arachnoid

B.

* Pia and arachnoid

C.

Dura and vertebra

D.


E.

Dura and mild

1717.


A.


B.

Temperature fibres

C.


D.


E.

Vegetates fibers

1718.


A.

* Pressure

B.

Pain

C.

Temperature

D.

Touch

E.

Somatic

1719.

In the case of Hypovolemia you should use remedies except :

A.

preparates of plasma

B.

cardiac glicozides

C.

simpatomimetics

D.

* beta-blocers

E.

corticosteroids

1720.

In the origin of hypererdinamic type of circulation of blood at patients with a sepsis, acute bleeding the following reactions take part:

A.

* shunting of circulation

B.

centralization of circulation of blood

C.

violations of microcirculation, disorders of tissue exchange

D.


E.

right B,C

1721.


A.

lidocaineis-

B.

5.0 to 10.0 mg/min

C.

2.0 to 4.0 mg/min

D.

* 0 to 1.5mg/min

E.

0.5 to 1.0 mg/min

1722.


A.

Mid axillary line

B.

Xiphisternum

C.

2ICS leftside

D.

* 4ICS left side

E.

8ICS left side

1723.

Indicate the reason of ventricular extrasystolia:

A.

Alcalosis

B.

Hypocaliemia

C.

Overdosage of glycosides

D.

* The protracted prescribing of diuretics

E.

All answers are faithful

1724.

Intravenous injection of morfin at the cardiogenic edema of lungs can be attained the following positive effects:

A.

Venodilatation and decentralization of circulation of blood

B.

sedatsii, reduction of frequency of breathing

C.

unloading of small circle of circulation of blood

D.

* right all answers

E.


1725.


A.

Fentanyl

B.

Pentazocine

C.

* Morphine

D.

Buprenorphine

E.

Analgin

1726.

Lengthening of interval R-R more than 0,2 sec is observed at:

A.

Fibrillation of auricles

B.

Sine bradycardia

C.

Alternuous pulse

D.

* cardial block 1

E.

Bigemenia

1727.


A.


B.

Spinal anaesthesia

C.


D.

* Convulsions

E.

Local anaesthesia

1728.


A.

Cardiac arrest

B.

Syncope

C.

Convulsions

D.

* All of the above

E.


1729.


A.


B.


C.


D.


E.


1730.


A.

Lignocaine

B.

Chlorprocain

C.

Amethocaine

D.

* Bupivacine

E.

Novocaine

1731.


A.

Rt. Lateral

B.

Lt. Lateral

C.


D.

* All of the above

E.

None of above

1732.


A.

200 mg

B.

250mg

C.

300mg

D.

* 650mg

E.

all doses are wrong

1733.

Medical treatment of anafilactic shock includes the use

A.

adrenalin

B.

antihistaminic preparations

C.

neuroplegic

D.

* right A) and B)

E.


1734.

Medical treatment of patient with acute left side ventricular insufficiency includes

A.

ALV at the permanent promoted pressure

B.

infusion of nitroglycerinum

C.

ingibitor of fphosphodiesterase, furosemide

D.

* all answers are faithful

E.

right only A) and B)

1735.

Medicine of choice at paroxysmal supraventricular tachycardia is:

A.

digocsin

B.

lidocain

C.

* izoptin

D.

novocainamid

E.

polarized mixture

1736.


A.


B.

Arrythmias

C.

* Hypotension

D.

Meningitis

E.

Hypertension

1737.

On a 4 day after incompatible (on a group) blood transfusion at a patient acutely reduced diuresis, anuria developed, the common state became worse acutely, arterial pressure rose. At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma -

24 mmol/l. What illness and what stage of illness it follows to think about in the first place?

A.

* Acute kidney insufficiency, anuria

B.

Anaphylactic shock, acute kidney insufficiency, anuria

C.

Hemotransfusion shock, postrenal acute kidney insufficiency, anuria

D.

Posthemoragic acute kidney insufficiency, anuria

E.

acute interstitsial nephritis, postrenal anuria

1738.


A.

1%

B.

* 2%

C.

3%

D.

0,5%

E.

6 %

1739.

Pharmacological medicine, that diminish the (afterload) left ventricle at a patient with the acute heart attack of myocardium, are not included

A.

nitroglycerine

B.

fentolamin

C.

nitroproussid sodium

D.

* esmolol (brevibloc)

E.

nifedipinum

1740.


A.


B.

Epidural block

C.

Axillary block

D.

High spinal blook

E.

Low spinal block

1741.


A.

* Thinner needle

B.

Early ambulation

C.

Induced hypotension

D.


E.


1742.


A.

1 to 2 hour

B.

2 to 3 days-

C.

3 to 7 days

D.

* 2 to 3 weeks

E.

1 year

1743.


A.


B.


C.

Meningitis

D.

Meningioma

E.

Neurinoma

1744.

Properties of blood reology are fixed:

A.

By viscidity of blood

B.

By physical and chemical stability of suspenzion of uniform elements

C.

By the state of vessels wall

D.

* All answers are correct

E.


1745.

Reliable reason of sudden shortness of breath, growth of pressure in jugular veins, systolic and diastolic noise at a patient with an infectious endocarditis include

A.

acute tamponade of heart

B.

heart attack of myocarditis

C.

* turn of leaf of mitral valve or break of aortic valve

D.

aneurism of aorta, that rozsharovoue

E.


1746.

Removing a pain syndrome at the urgent call concerning the acute heart attack of myocardium is possible simpler than all:

A.

* by injection of narcotic and unnarcotic analgetic

B.

epidural analgesia

C.

by inhalation of nitrous oxide, xenon with O2(1:1)

D.


E.


1747.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

Amethocaine

E.

* Chlorprocaine

1748.


A.

Procaine

B.

Xylocaine

C.

Bupivacaine

D.

* Chlorprocaine

E.

Novocaine

1749.

Signs of local myocarditis recovering are represented best of all by the changes of wave

A.

P

B.

Q

C.

T

D.

* R

E.

S

1750.


A.


B.


C.


D.

* All of above

E.


1751.

Stretched neck veins in standing position are observed at

A.

* tamponade of heart

B.

tense pneumothorax

C.

to pulmonary embolism

D.


E.

right A) and B)

1752.


A.


B.

Burgers disease

C.


D.

Full stomach

E.

* Hemophilia

1753.

The acute cardiogenic edema of lungs is conditioned:

A.

by the rise of hydrostatical pressure in pulmonary capillaries

B.

by the promoted pulmonary capillary permeability

C.

by insufficiency of the left ventricle

D.

* A, B, C

E.


1754.

The basic sign of heart death is:

A.

agonalni complexes

B.

mechanical asistolia with saving of electric systole

C.

electric asistolia during 30 min, not looking on cordial - pulmonary reanimation and proper medical therapy

D.

* isoelectric line on ECG during 15 min

E.


1755.


A.

Mitchell needle

B.

Gordh needle

C.

* Tuohy needle

D.

Sise introducer

E.

Nick needle

1756.

The dosage of biocarbonate of sodium in case of stopping of heart makes:

A.

the first injection 1 mmol/Kg

B.

the first injection 2 mmol/Kg

C.

the repeated injections 0.5 mэcv/cg every 10 mines

D.

* approximatelly 100 ml for each min of clinical death

E.


1757.


A.


B.


C.

Type of drug used

D.

* All the above

E.

None of above

1758.


A.


B.


C.


D.


E.

* All of the above

1759.


A.

2 % xylocaine

B.

Rubber tourniquet

C.

Ring block

D.

* Adrenaline

E.

Atropin

1760.

The forcing function of heart is supported:

A.

By the normal level of energy exchange in myocardium

B.

By the sufficient vein turning to the heart

C.

By the compensate possibilities keeping

D.

By the normal rhythm of heart

E.

* All answers are faithful

1761.

The injection of the following medicing may prevent the attack of paroxysmal auricles tahycardia, except of :

A.

* Izoproterenol

B.

Mezatonum

C.

Digitalis and hinidinum

D.

Metocsaminum

E.

Morphynum

1762.

The insufficiency of left ventricule can be caused:

A.

* by insufficient flow of blood to the heart

B.

by the overload volume of blood

C.

by the decline of retractive power of myocardium

D.

right only B) and C)

E.


1763.

The most expressed positive inotropny effect at cardiogenic shock is observed at injection of:

A.

noradrenalinum

B.

* dopaminum

C.

digocsinum

D.

isadrinum

E.

ephedrinum

1764.

The most frequent reason of embolism is:

A.

Trauma

B.

Cardial insufficiency

C.

Aneurism

D.

Atherosclerosis

E.

* Fibrillation of auricle

1765.

The patient 60 years is delivered in the department of intensive therapy with a diagnosis: bite of bee, anafilactic shock.. Which medicine will be primary and most effective?

A.

* Adrenalin

B.

Calcium the chloride

C.

Prednizolon

D.

Dimedrol

E.

Suprastin

1766.

The permission to use lidocainum in the process of cardiac-pulmonary reanimation are:

A.

* fibrillation of ventricles

B.

electromechanics dissociation

C.

fibrillation of atriums

D.

right all answers

E.

correctly only A and B)

1767.

The satisfactory oxygen capacity of blood is provided by hematocrit, not below

A.

20-25%

B.

* 30%

C.

35%

D.

40%

E.

45%

1768.

The signs of acute heart attack of myocardium during anesthesia are:

A.

Hypotensia

B.

changes of ECG, arrhythmia

C.

increase of pulse pressure

D.

* right A) and B)

E.

right A) and C)

1769.


A.

* Lumbar 1

B.

Lumbar 2

C.

Sacral l

D.

Sacral 2

E.

Thoracal 12

1770.

The stop of heart during unsynchronous defibrillation is linked

A.

with direct damaging of myocardium

B.

with the hit of impulse on the P wave of ECG

C.

with the hit of impulse on ascending part of T wave

D.

* with the hit of impulse on descending part of T wave

E.


1771.

The unfavorable cardial effects of calcium are included

A.

* increase of irritating of myocardium

B.

decline of retractive power of myocardium

C.

spasm of coronal vessels

D.


E.

right all answers

1772.

To arrhythmias, that are accompanied by acute cardiac insufficiency, belong:

A.

fibrilyatsiya of ventricles

B.

complete atrioventricul block

C.

high-frequency trembling of atriums

D.


E.

* right all answers

1773.


A.

Prone

B.

* Lithotomy

C.

Trendelenberg

D.

Supine

E.

Back

1774.

What is represented on a picture ?

A.

* Punction of v. subclavia

B.

Anaesthesia by Coulencampf

C.

Punction of pleura for liquidation of hemothorax

D.

Applying of heart rhythm driver

E.

Punction of pleura for liquidation of pneumothorax

1775.

What medicine is using for medical treatment of atrio-ventricular block III?

A.

Lidocain

B.

Inderal

C.

Novocainamid

D.

* Izuprel

E.


1776.

What must be applied from following during haemotransfusion for saving of blood properties, that take part in coagulation?

A.

Warmed-up blood

B.

Calcium

C.

Oxygen

D.

Blood of two-week remoteness

E.

* Fresh blood

1777.

What type of hypoxia changes greatly oxygen satiation of arterial blood ?

A.

Circulatoric

B.

Anaemic

C.

* Hypoxic

D.

Tissue

E.


1778.

What type of imunoglobulins take part in the anafilactic reaction of immediate type:

* Imunoglobulin E

B. Imunoglobulin M

C. Imunoglobulin A

1779.

When fibrillation will not be effective?

A.

At wrong situation of electrodes

B.

At inadequate ventilation of lungs

C.

acidosis

D.

* When the previous massage of heart was uneffective

E.

All answers are faithful

1780.

Which of medicines are most contra-indicated at ventricular tahycardia

A.

Digitalis

B.

Hinidinum

C.

Novocainamid

D.

* Calcium

E.

Novocaine

1781.

Which of the following changes on ECG is typical for hypercaliemia?

A.

fibrillation of ventricules

B.

fibrillation of auricles

C.

* High and narrow indent T

D.

Decline of indent T and appearance of indent V

E.

Decline of segment S-T

1782.


A.

* Fentanyl

B.

Morphine

C.

Fortwin

D.

Piroxican

E.

Analgin

Situational tasks

1.

A patient on meningococcemia had signs of syndrome of Waterhouse-Fridrikson.

What method of therapy can be considered on pathogenetic ground?:

A.

*A. high dose of GKS (5-10 mg/kg of prednizon and more)

B.

piracetam

C.

Inhibitors of protease

D.

Heparinum

E.

Cardiac glycoside

2.

Ambulance was called to teenager. In his anamnesis is diabetes mellitus. It is observed weakness, pallor, loss of consciousness. Objectively: consciousness absents, a skin is pale, "marble", extremities are cyanochroic, cold, sweating. Periodically are convulsive tremor, breathings, superficial, frequent; takhikardiya, from a mouth is a smell of alcohol. Specify, what medicine it is necessary immediately to inject a patient intravenously:

A.

*A. 40% solution of glucose 40 ml

B.

Insulin of short action in a dose 0,1 ED/kg

C.

a 0,9% solution of chloride of sodium is in the dose of 20 ml/kg

D.

a 0,45% solution of chloride of sodium is in a 5% solution of glucose

E.

Naloxonum in a dose 0,1 mg/kg

3.

Ambulance was called to unconsious person. It was established absence of breathing.

Sign of effective artificial ventilation of lungs:

A.

*A. excursion of thorax;

B.

Narrowing of pupils

C.

Noise at insufflation of air ;

D.

Thrusting out of epigastral area is at insufflation;

E.

Dizziness” of anesthesiologist

4.

Ambulance was called to unconsious person. It was established clinical death. Sign of stop of cardiac activity:

A.

*A. Dilatation of pupils

B.

Sudden loss of consciousness

C.

Cyanosis of skin

D.

A pulse above a radial artery is arrithmical

E.

Absence of arteriotonus

5.

Ambulance was called to unconsious person. It was established clinical death. For endocardial injection of medications a needle is pricked:

A.

*A. In 4th intercostal spase, on 1-2 sm on the left of breastbone

B.

In 5th intercostal spase, in the point of projection of apex of heart

C.

In 3th intercostal spase, on the left of breastbone

D.

On the lower edge of 4th cost., on the left of breastbone

E.

In the place of projection of cardiac shove

6.

Ambulance was called to unconsious person. It was established clinical death. Each next charge of bipolar defibrilator should be increased on ?

A.

*A. 500 W

B.

250 W

C.

200W on 1 kg of mass of body

D.

1000 W

E.

Charge can not be promoted

7.

Ambulance was called to unconsious person. It was established clinical death. During

CPR soluble-sodium bicarbonate is used with with a purpose:

A.

*A. Decreasing of metabolic acidosis

B.

Warning of development of metabolic acidosis

C.

An increase of time of survival of cerebrum in the conditions of hypoxia

D.

Liquidations of hypoxia

E.

To influence on the curve of dissociation of oxyhemoglobin

8.

Ambulance was called to unconsious person. It was established clinical death. What is the most credible laboratorical index of blood for patients after the real sinking in fresh water?

A.

*A. hyperkaliemia

B.

High hemoconcentration indexes

C.

High level of transaminases

D.

High level of urea, creatine

E.

Hypernatremia

9.

For a patient observed increasing weakness, decline of appetite, pain in joints with appearance of icterus on 4th day. The temperature of body is normal. Liver is enlarged by 2,5 sm. After 3 days of therapy the state was worsened: there were anorexia, vomiting, somnolence, pain in right chest, petechial rash. Size of liver diminish, symptoms of irritation of peritoneum were not esteblished What complication we can think of?:

A.

*A. acute hepatic insufficiency

B.

Sharp cholecystitis

C.

Sharp holecistopancreatitis

D.

Sharp kidney insufficiency

E.

Rosacea

10.

In postpartum period of patient T.,conducted scraping of walls of uterus cavity concerning post-natal metroendometriasis on a background of necrosis of decidual layer, complication appeared with sudden decline of AP to 80/50 mmhg., Pulse of

110 min. Skin is pale, covered with sticky death-damp. The uterine bleeding absent.

What should we begin the first aid from ?

A.

*A. artificial ventilation of lungs

B.

infusion therapy

C.

Antibacterial therapy

D.

Support of cardiac

E.

Laparotomia with next extraction of uterus

11.

Patient , 30 years old, was transferred to the to the infection department with a diagnosis: food toxicoinfection. Nausea, vomit increased during the first day.

Conscious, skin covers are dry, rough by touch, col The lines of person are sharp, eyes hollow, eyeballs are soft. Breathing is noisy, as Kusmaull, strong smell of aceton in mid air. Tones of heart are deaf. Pulse is 93 for a minute, BP is 90/60 mm mer Er

5,2*1012/l, Hb – 131 g/l . Glukose of blood 22 mmol/l. Glucose, ketonic bodies are determined in urin Your most first actions?

A.

*A. Insulin 0,1 U/kg (aktrapid) on a 0,9% solution of NaCl

B.

Glibenclamidis

C.

0,1 U/kg of ultralong insulin on 0,9% Nacl

D.

Washing of stomach

E.

IV 1% - 1 ml solution of mezatoni

12.

Patient , 52 years old, hospitalized with the heavy form of viral hepatitis . The signs of flu appeared in permanent establishment. During a day the indexes of transamynases and bilirubinum rosed sharply. What complication of viral hepatitis can arise up for a patient?

A.


B.

Electrolyte comma

C.

Gastric bleeding

D.

Mechanical icterus

E.

Cerebral comma

13.

Patient L is hospitalised in gynecological department with the temperature of 39 degrees C, with complaints of pain in the bottom of stomach, vomit, diarrhea.

Criminal abortion have been done 4 days befor AP 80/60, breathing is difficult, psychosomatic excitation. Symptom of Schotkin-blumberg is positiv Uterus is enlarged as on 9 weeks of pregnancy, limitedly mobile, painless. Pus with blood appeare Your Diagnosis?

A.

*A. septic shock

B.

Perforation of uterus

C.

Pelvic peritonitis

D.

Acute appendicitis

E.

Acute adnexia inflammation

14.

Patient M, 44 years old, admited to the infectious isolation with a diagnosis:

Leptospirosis. On 7th day of treatment his state was sharply worsened, pain appeared in lumbar region, somnolence, sickliness, cramps, head pain, diuresis diminished to

100 ml/day.blood: RBC -2,6*10

12

/L, Creatinine - 438 mkmol/l, urea - 13,0 mmol/l.

What complication developedin patient?

A.

*A. acute kidney insufficiency

B.

Sharp hepatic insufficiency

C.

Chronic pyelonephritis

D.

Ischemic stroke

E.

MI

15.

Patient N., 28 years ol 6 day after the complicated births. The clinical hematological signs of subacute disseminate intravascular coagulation syndrome developed after skin hemorrhage and uterine bleeding. The state of patient is very ba blood: Er-2,7 of

T/l, Hb-78 of gm/l, CI - 0,93, L-4,7 of Gm/l, thrombocytes-88 of gm/l, time of blood cloating - 16 min, prothrombin time - 25 sec, ethanol test +, fibrinogen-1,4 gramme/l,

What preparations should be prescribed ?

A.

*A. plasma

B.

Heparinum

C.

Reopoliglycin

D.

Cryoprecipitate

E.

U-aminokapric acid

16.

The patient 20 years old, delivered to ambulance department on the 2nd day of illness in a grave condition: temperature of body 39°c, symptoms of intoxication are expresse On extremities, trunk, buttocks, present hemorrhagic rash as eczema with necrosis in the center. One day before cut his leg. Now has the wound in that plac In

2 hours the decline of AP is registered from 100/70 to 60/30 mm of Hg, diffused cyanosis. Application of prednisolon of 120 mg and reopoliglycin did not give any effect. What complication does it follow to think about?

A.

acute sub renal failure

B.

*B. Septic shock

C.

hipovolemic shock

D.

Hemorragic shock

E.

Respirator distress syndrom of adults

17.

To the terminal states belong:

A.

*A. pre-agony, terminal pause, agony, clinical death

B.

Agony, clinical and biological death

C.

Commas, agony, clinical death

D.

Pre-agony, agony, clinical, social death;

E.

Lowering of AT is to 80 mm of rt.st., comma, clinical death.

18.

. You should perform CPR to patient The best place of performing of closed massage of heart by hands:

A.

*A. over lower third of breastbone, fingers parallel to the ribs

B.

On breastbone, by fingers to the chin

C.

On middle third of breastbone

D.

In 4 subcostal space on the left of breastbone

E.

On a thorax, in the place of projection of apex of heart.

19.

You should perfrm CPR to patient During artificial respiration by method “mouth to the mouth” it is need to blow air in volume:

A.

*A. 800-1100 ml

B.

500-700 ml

C.

1200-1600 ml

D.

1700-2000 ml;

E.

To carry out maximal inhalations

20.

You should perfrm CPR to patient L. Clinical death lasts :

A.

*A. 4-5 minutes;

B.

1-3 minutes

C.

5-7 minutes

D.

To 10 minutes

E.

7-12 minutes

21.

You should perfrm CPR to patient N. All the below signs are the signs of of clinical death except:

A.

*A. arterial pressure is not determined

B.

Absence of pulsation above femoral artery

C.

Absence of breathing

D.

pupils are irresponsive to light;

E.

Absence of pulsation on carotid artery.

22.

A patient 25 years is hospitalized in the surgical department with a diagnosis: penetrable wound of abdominal region. Objectively: it is excited, skin covers and visible mucous shells are pale; peripheral pulse of the weak filling, frequent, AP –

110/60 mm mercury Positive symptom of ”desolation” of peripheral hypodermic veins. Diuresis is decreased. How to characterize this state?

A.

*A. The compensated shock

B.

Preagonia

C.

Circulating shock

D.

Agony

E.

Irreversible shock

23.

2. A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical department with complaints on vomiting by "coffee-grounds", diarhea, moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a

tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test: Er. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in medical treatment:

A.

*A. solutions with colloid

B.


C.

Whole blood

D.

Red corpuscles mass

E.

Colloid solutions with red corpuscles mass

24.

:A patient entered the department with a diagnosis: acute intestinal impassability.

Complaints: insignificant thirst, dizziness at an attempt to get up from a be at a review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with cracks. Pulse – 110 min., AP – 80 /60 mm of mer item, diuresis – 25 ml /h.

Electrolyte composition: Na+ - 142 mmol/l, C+ - 4 mmol/l, glucose – 6 mmol/l, urea

– 7 mmol/l. What variant of infusion is most expedient during operation?

A.

*A. Transfusion of crystalloids.

B.

Transfusion of solution of glucos

C.

Transfusion of albumen.

D.

Transfusion of native plasm

E.

Transfusion of poliglucin.

25.

A patient is in the intensive care unit during a week. 4 days ago a level of consciousness was on a Glasgow coma scale - 8 ball, now makes 3 ball. Verification of level of consciousness was conducted during 6 hours, a dynamics absents, death of cerebrum was diagnose. How correctly a leadthrough of establishment of such diagnosis was?

A.

*A. for establishment of diagnosis of death of cerebrum the presence of complex of clinical criteria is needed, duration of supervision must be no less than 12 hours for the primary defeat of brain and 24 for the second defeat;

B.

all was conducted right. A main criterion is a negative dynamics of level of consciousness, and depth of coma 3 ball on a Glasgow coma scale;

C.

no, For establishment of diagnosis the level of consciousness does not matter.

Basic are results of laboratory tests;

D.

all was conducted right. It was enough monitoring during 3 hours.

E.

no,. For establishment of diagnosis of death of cerebrum a presence is needed complex clinical criteria, duration of supervision must be no less than 48 hours for the primary defeat of brain and 72 for the second defeat.

26.

A patient, 28 years, 2 hours ago fell down from the ground floor of hous Sopor, pale, there are the plural scratches of face, the lacerated hemorhagic wounds on the left forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l,

Hb – 100, AP – 90/40 mm of rt. item In the blood test: red corpuscles – 3,5 g/l. What medicine for i/v injection does not need to be used for medical treatment of shock?

A.

*A. 5% solution of glucose

B.

Solution of crystalloids

C.

Solutions gelatin

D.

Solutions of calcium

E.

Solution of albumen

27.

Anafilactic shock appeared at a patient. The state heavy and progressively gets worse. HBA – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the rescue of life of patient above all things?

A.

*A. Adrenalin.

B.


C.

Prednizolon.

D.

Dofamin.

E.

Suprastin.

28.


A.

*A. Adrenalin

B.

Prednizolon

C.

Calcium

D.

Dimedrol

E.

Eufilin

29.


A.

*A. To conduct defibrillation three times

B.

To inject adrenalin

C.


D.

To begin the closed massage of heart

E.

To inject lidocain

30.

At a patient with the acute heart attack of myocardium in the region of partition on a

5th day after the brief episode of loss of consciousness there is reduction of frequency of pulse to 32 in a minut BP - 80/40 mm Consciousness at the level of sopor. He immediately needs :

A.

to put right a craniocerebral hypothermia, to enter lasics, prednisoloni, cerebrolizini

B.

an atropine, eufilin

C.

*C. to conduct urgent cardiostimoulation

D.


E.


31.


A.

cordaronum

B.

lidocainum

C.

ornidinum

D.

*D. electrocardiostimulation

E.


32.

At a patient, carried to a 2 year ago the heart attack of myocardium, the acute decline of cholecystyties planned cholecystectomy, signs of electric instability of myocardium . Actions of anaesthesiologist must include:

A.

injection of prednisoloni, lidocaini, hyperventilation, take the ECG

B.

*B. injection of dopamini, after stabilisation of BP - nitroglycerine + infusion therapy under the control CVP, conducting of neurovegetative defence, take the ECG

C.

injection of streptodecasol, stream infusion of reopoliglyocinum, injection of lidocainum, increase of dose of analgetics

D.

correctly A) and C)

E.


33.

At a patient, that is found on medical treatment in the therapeutic department, the sudden stopping of circulation of blood happene Medical personnel begun the reanimation measures. Define the most rational way of injection of adrenalin for renewal of heart abbreviations in default of vein access:

A.

*A. 3 ml solution of adrenalin in a trachea

B.

1 ml solution of adrenalin in muscl

C.

adrenalin in muscle, multiplying a dose in 3 times.

D.

intracardial injection.

E.

adrenalin could not be injected

34.

At a patient, that is found under the permanent electrocardioscopic supervision, microwave fibrillation of myocardium and diagnosed clinical death develope It is necessary to do:

A.

to inject the solution of calcium in cor

B.

*B. to conduct high-voltage electric defibrillation

C.

to inject solution of atropine in cor

D.

to inject solution of adrenalin in cor

E.


35.

At the patient operated concerning the festering peritonitis coused by perforation of gastric ulcer, in a postoperation period appeared: high temperature, frequency of breathing 35/min., AP – 70/40 mm of mer item, diuresis -20 ml/h temperature of body to 39 , leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of chlorous sodium and 0,8 of solution of reopoliglucin did not improve general condition. Central vein pressure – 130 mm wt.st. For stabilization of hemodinamics will be optimum infusion:

A.

*A. Dopamin

B.

Mesaton

C.

Adrenalin

D.

Noradrenalin

E.

Ephedrine

36.


A.


B.

diuresis

C.

*C. cardiac systolic volume

D.

right A) and B)

E.


37.

During the operation concerning strangular impassability of bowels, which conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac function happened 50 years in the moment of mesenretium streching by the surgeon.


A.

*A. i/v injection atropin

B.


C.

Deepening of general anaesthesia

D.


E.

Additional injection droperidoli

38.




A.


B.

infusion therapy

C.


D.

Support of cardiac extrass

E.

Laparotomia with next extraction of uterus

39.

It is typical for:

A.

*A. Negative CVT

B.


C.


D.

Edema of lungs

E.

Hypodermic emphysema

40.

On a 4 day after incompatible (on a group) blood transfusion at a patient acutely reduced diouresis, anuria developed, the common state became worse acutely. At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma - 24 mmol/l.

What illness and what stage of illness it follows to think about in the first place?

A.

*A. Acute kidney insufficiency, anuria

B.


C.


D.


E.


41.

On an enterprise with plenty of workers educational practical work is conducted on the leadthrough of cardiopulmonary reanimation. It is foremost needed to teach the workers of «chain of survival», which plugs in itself:

A.

forming from the people chain on which will be passed to instruction in relation to correct implementation of urgent measures;

B.

set of tools and medical preparations for a grant to the first aid at clinical death;

C.

the «chains of survival» study only in the specialized higher educational establishments with the receipt of the special diploma for its use;

D.

immediate informing of guidance of establishment and direct chief of victim, bringing in to the reanimation of the medical cabinet, deliveries of patient to the nearest medical establishment.

E.

*E. early activating of service to medical first-aid, early beginning of elementary sustentation, early defibrillation by automatic external defibrillator, early beginning of further sustentation.

42.

Patient 20 years for verification of the functional state of kidneys the X- ray examination with v/v injection of cardiotrast is conducte At the end of injection the state of patient acutely became worse, the shortness of breath, hyperemia of skin, AP

– 60/20 mm, HBA – 132/min. A similar research was conducted 3 months ago, such effects were not observed. What most reliable diagnosis?

A.

*A. Medicinal anafilactic shock

B.

Acute kidney insufficiency

C.

Tromboembolism of pulmonary artery

D.

Stress on the conducted manipulation

E.

Heart attack miocardium

43.

Patient 30 years after a road-transport failure complaints of the acute tahypnoe Obly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax, stomach, right side of the neck. Auscultative: breathing on the right side is not conducted; pulse

– 130/min., AP – 80/60 mm.mercury., CVP – 140 mm., FB – 30 /min., Ht – 0,27, Hb

– 90 g/l. Subsequent therapy must include above all things:

A.

*A. punction of pleura cavity.

B.

Urgent ALV

C.

Massive infusion therapy of the crystalloid solutions

D.

Infusion of dofamin, 2-5 mcg/cg/min

E.

100% oxygen

44.

Patient 38 years, native plasma was poure. At the end of infusion the state became worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36 on 1 min., AP – 70/40 mm of mer item, whistling dry wheezes. Which from the following mediceni must be injected firstly?

A.

*A. Adrenalin.

B.

Eufilin.

C.

Suprastin.

D.

Noradrenalin.

E.

Prednizolon.

45.

Patient, 40 years, with the trauma of both thighs is delivered from the scene of accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of the neck, tahypnoe, AP 60/40 mm mer st., HBA=120 /min, in lungs moist wheezes, diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses most reliable?

A.

*A. Fatty embolism

B.

Traumatic shock

C.

Hemorhagic shock

D.

Pain shock

E.

Tromboembolism

46.

The patient 32 years have infusion of native plasm At the end of infusion the state became worse: disorientation, cyanosys, excitation, appeared hypersalivation, tahypnoe, AP =70/40 mm mer st., in lungs – the dissipated dry wheezes. What medicine must be injected firstly?

A.

*A. Adrenalin.

B.

Suprastin.

C.

Gidrocortizon.

D.

Dopamin.

E.

Eufilin.

47.

The patient 60 years is delivered in the department of intensive therapy with a diagnosis: bite of bee, anaphylactic shock.. Which medicine will be primary and most effective?

A.

*A. Adrenalin

B.


C.

Prednizolon

D.

Dimedrol

E.

Suprastin

48.

The patient of 2 days carried the state of clinical death back. During the first days of postasystolic period the state was stabilized with a tendency to the improvement.

Now there is worsening of the state, hypoxemia of PaO2 65 mm Hg, shortness of breath to 30 per min., tachycardia, high blood pressur What conclusions can be done?

A.

postasystolic illness begins;

B.

cardiopulmonary reanimation conducted inadequately;

C.

*C. ІІІ stage of postasystolic illness;

D.

for a patient chronic pathology was intensifyed;

E.

the fever of lungs makes progress for a patient.

49.

To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was conducted. A doctor went out from a chamber after conducting of necessary tests before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient without consciousness. The cyanosys of upper body part. Irregular breathing with the selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on peripheries and arterial pressure are not determine Tones of heart are deaf, unrhythmical. An ampoule and transfusion system is empty. What complication arose up as a result of hemotransfusion?

A.

*A. Air embolism of pulmonary artery

B.


C.

Edema of lungs

D.


E.

Syndrome of massive hemotransfusion

50.

To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v was quickly injected. Tahycardiya, arterial hypotension, cyanosys, shortness of breath appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.st. acute insufficiency of what part of the cardial-vascular system is observed at a patient?

A.

Right ventricle of heart

B.

*B. The left ventricle of heart

C.

Both ventricles of heart

D.

Vessels

E.

Uneffective heart

51.

Patient 30 years after a road-transport failure complaints of the acute tahypnoe. Obly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax, stomach, right side of the neck. Auscultative: breathing on the right side is not conducted; pulse

– 130/min., AP – 80/60 mm.mercury., CVP – 140 mm wt., FB – 30 /min., Ht – 0,27,

Hb – 90 g/l. Subsequent therapy must include above all things:

A.


B.

Urgent ALV

C.


D.


E.

100% oxygen

52.


110/60 mm mercury. Positive symptom of ”desolation” of peripheral hypodermic veins. Diuresis is lowered. How to characterize this state?

A.


B.

Preagonia

C.

Circulating shock

D.

Agony

E.

Irreversible shock

53.


110/60 mm mercury Positive symptom of ”desolation” of peripheral hypodermic veins. Diuresis is lowered. How to characterize this state?

A.


B.

Preagonia

C.

Circulating shock

D.

Agony

E.

Irreversible shock

54.

A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical department with complaints on vomiting by "coffee-grounds", diarhea, moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a tongue is dry,

AP – 80/60 mm rt.st., HR – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test:

Er. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in medical treatment:

A.


B.


C.

Whole blood

D.

Red corpuscles mass

E.


55.

A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical department with complaints on vomiting by "coffee-grounds", diarhea, moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a tongue is dry,

AP – 80/60 mm rt.st., HR – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test:

Er. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in medical treatment:

A.

*A. colloid solutions

B.


C.

Whole blood

D.

Red corpuscles mass

E.


56.

A patient 48 years the second day in dpartment of intensive therapy concerning the acute front-partition heart attack of myocardium. During a review “wheezing” suddenly, non-permanent tonic constricting of muscles is marked, pupils are extended, pulse on a. carotis is absent. What doctor have to do in the first place?

A.

*A. Triple Safar method

B.

Record of ECG

C.

Cardial hit in the area of heart

D.

Artificial respiration by the method of Silvester

E.

Intracardial injection of adrenalin with an atropine

57.

A patient entered the department with a diagnosis: acute intestinal impassability.

Complaints: insignificant thirst, dizziness. At a review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with cracks. Pulse – 110 min., AP – 80 /60 mm of mer item, diuresis – 25 ml /h. Electrolyte composition: Na+ - 142 mmol/l, C+

- 4 mmol/l, glucose – 6 mmol/l, urea – 7 mmol/l. What variant of infusion is most expedient during operation?

A.


B.


C.


D.

Transfusion of native plasma.

E.


58.

A patient with a traumatic shock AP – 60/0 mm mercury, HR – 90 /1 min. Define a shock index:

A.

*A. 1,5

B.

2,5

C.

1,5

D.

0,5

E.

0,3

59.

A patient, 28 years, 2 hours ago fell down from the ground floor of hous Sopor, pale, there are the plural scratches of face, the lacerated hemorhagic wounds on the left forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l, Hb –

100, AP – 90/40 mm of rt. item In the blood test: red corpuscles – 3,5 g/l. What infouziyniy serednic does not need to be used for medical treatment of shock?

A.


B.


C.

Solutions gelatin

D.


E.

Solution of albumen

60.

Anafilactic shock appeared at a patient. The state heavy and progressively gets wors.

HR – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the rescue of life of patient above all things?

A.

*A. Adrenalin.

B.


C.

Prednizolon.

D.

Dofamin.

E.

Suprastin.

61.

At a patient, that is found on medical treatment in the therapeutic department, the sudden stopping of circulation of blood happened. Medical personnel begun the reanimation measures. Define the most rational way of injection of adrenalin for renewal of heart abbreviations in default of vein access:

A.

*A. To enter to a 3 ml solution of adrenalin in a trachea.

B.

To enter to a 1 ml solution of adrenalin in muscl

C.

To enter adrenalin in muscle, multiplying a dose in 3 times.

D.

The intracardial injection.

E.

Adrenalin can be not entered.

62.

In a clinic a patient with the traumatic tearing of both lower extremities off at the level of knee-joints is delivered. A patient is extremly inert, languid, pale, pulse 140

bmin, threadlike, AP 50/0. On both lower extremities there are the imposed plaits.

Bleeding at the receipt is not present. From the words of doctor of first-aid, lost about 3 litres of blood in place of event. What principal reason of this?

A.

*A. Acute hemorrhage

B.

Pain shock.

C.

Ishemia of extremities as a result of application of tourniquet

D.

Fatty embolism

E.


63.

. It is typical for:

A.

*A. Negative CVT

B.


C.


D.

Edema of lungs

E.


64.



A.


B.


C.


D.


E.


65.

On a 4 day after incompatible (on a group) blood transfusion at a patient acutely reduced diouresis, anuria developed, the common state became worse acutely, arterial pressure ros At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma -


A.


B.


C.


D.


E.


66.

Patient 20 years for verification of the functional state of kidneys the X- ray examination with v/v injection of cardiotrast is conducte At the end of injection the state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch appeare AP – 60/20 mm of mer item, HR – 132/min. A similar research was conducted 3 months ago, such effects were not observe. What most reliable diagnosis?

A.


B.


C.


D.


E.


67.

Patient 20 years for verification of the functional state of kidneys the X- ray examination with v/v injection of cardiotrast is conducted. At the end of injection the state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch

appeare AP – 60/20 mm of mer item, HR – 132/min. A similar research was conducted 3 months ago, such effects were not observe What most reliable diagnosis?

A.


B.


C.


D.


E.


68.

Patient 38 years, native plasma was poure At the end of infusion the state became worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36 on 1 min., AP – 70/40 mm of mer item, whistling dry wheezes. Which from the following mediceni must be injected firstly?

A.

*A. Adrenalin.

B.

Eufilin.

C.

Suprastin.

D.

Noradrenalin.

E.

Prednizolon.

69.

Patient 40 years with the acute gastro - intestinal bleeding a canned blood was poured in a volume 400 ml after conducting of all tests on compatibility. After hemotransfusion the state of patient became worse, appeared head pains and pains in muscles the temperature of body rose to 38,8 What can explaine the state of patient?

A.

Pirogenic reaction of middle heavy

B.

*B. By development of hemotransfusion shock

C.

Alergic reaction

D.

By development of bacterial-toxic shock

E.

By air embolism

70.

Patient 62 years the third day of presense in department of intensive therapy concerning the acute transmural heart attack of myocardium of front-partition localization. At night woked up from a suffocating cough, feeling of fear and trouble.

At a review: cyanosys, FB – 30 after 1 min., HR – 132/ min., a rhythm is correct, tones of heart are deaf, accent ІІ tone above a pulmonary artery, AP – 180/110 mm mercury. There is the loosened breathing above lungs with the far of moist wheezes in lower fates. What probably became the reason of worsening of the state?

A.

*A. Edema of lungs

B.

Embolism of pulmonary artery

C.

The repeated heart attack miocardium

D.

Hypertensive crisis

E.

Attack of bronchial asthma

71.

Patient N., 40 years, groom. In anamnesis there is an allergy to nonsteriidal antiinflammatory. After injection of antitetanus on a method Besredco concerning the hammered wound of right shin, through 20 min, there was a acute weakness, labouring breath, through 10 min, loss of consciousness. What mechanism of development of anafilactic form of illness?

A.

*A. Sensitization to the albumen of horse whey

B.

Low quality of horse whey

C.

Breach of the technique of PPS injection

D.

Presence in anamnesis of medical allergy

E.

Infection of whey

72.

Persons 48 years, patient by the heart attack of miocardium, suddenly lost consciousness, breathing and palpitation. On ECG of highwave fibrilation of ventricules. Conducted defibrilation. Did not pick up normal cardial activity. What medicine needs to be entered for the rise of sensuality to defibrillation?

A.

*A. Amiodaron

B.

Propranolon

C.

Lidocain

D.

Strofantin

E.

Atropini sulfati

73.


A.

*A. Adrenalin

B.


C.

Prednizolon

D.

Dimedrol

E.

Suprastin

74.


A.

*A. Adrenalin

B.


C.

Prednizolon

D.

Dimedrol

E.

Suprastin

75.

To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was conducte A doctor went out from a chamber after conducting of necessary tests before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient without consciousness. The cyanosys of upper body part. Irregular breathing with the selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on peripheries and arterial pressure were not determined. Tones of heart are deaf, unrhythmical. An ampoule and transfusion system is empty. What complication arose up as a result of hemotransfusion?

A.


B.


C.

Edema of lungs

D.


E.


76.

To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v is quickly injected. Tahycardiya, arterial hypotension, cyanosys, shortness of breath appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.c. acute insufficiency of what part of the cardial-vascular system is observed at a patient?

A.

*A. Right ventricle of heart

B.

The left ventricle of heart

C.


D.

Vessels

E.

Uneffective heart

77.

A patient 48 years the second day in department of intensive therapy concerning the acute front-partition heart attack of myocardium. During a review “wheezing” suddenly, non-permanent tonic constricting of muscles is marked, pupils are extended, pulse on carotis not palpitat. What doctor have to do in the first place?

A.


B.

Record of ECG

C.


D.


E.


78.


A.

*A. Adrenalin

B.

Prednizolon

C.

Calcium

D.

Dimedrol

E.

Eufilin

79.

At a patient 60 years with the third day after an exterpation uterus acute insufficiency of breathing developed suddenly, a skin became at first cyanotic, and then ashcolored color. Tachypnoe, cough with bloody sputum, retrosternal pain. BP – 100/70 mm. mercury, HR – 120, BR – 32 in 1 min., CVP – 300 mm wt.col. What most reliable reason of worsening of the state of patient ?

A.

*A. Tromboemboliya of pulmonary artery

B.

Bleeding

C.

Pain shock

D.


E.


80.


A.


B.

To inject adrenalin

C.


D.


E.

To inject lidocain

81.

At the patient operated concerning the festering peritonitis coused by perforation of gastric ulcer, in a postoperation period appeared: high temperature, frequency of breathing 35/min., AP – 70/40 mm of mer item, diuresis -20 ml/h temperature of body to 39 , leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of chlorous sodium and 0,8 of solution of reopoliglucin did not improve general condition. Central vein pressure – 130 mm wt.c. For stabilization of hemodinamics will be optimum infusion:

A.

*A. Dopamin

B.

Mezaton

C.

Adrenalin

D.

Noradrenalin

E.

Ephedrine

82.

During the operation concerning strangular impassability of bowels, which conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac activity happened 50 years in the moment of mesenretium streching by the surgeon.


A.


B.


C.

Deepening of general anaesthesi

D.


E.


83.

In 2 hours after renewal of cardial activity at a patient, that carried the sudden stop of heart on a background hemorhagic shock (blood lost near 2,5 l) and is found on ALV, unstable hemorhagia (AP – 80/40 – 90/60 mm of mer item, tahycardia) is marked, central vein pressure – 5 mm wt.c. It is related to:

A.

*A. By Hypovolume syndrome

B.


C.


D.

Vasoplegia

E.


84.

In a clinic a patient with the traumatic tearing of both lower extremities off at the level of knee-joints is delivere A patient is extremly inert, languid, pale, pulse 140 b/min, threadlike, AP 50/0. Bleeding at the receipt is not present. From the words of doctor of first-aid, lost about 3 litres of blood in place of event. What principal reason of heavy of the state of Patient?

A.

*A. acute hemorrhag

B.

Pain shock.

C.


D.

Fatty embolism

E.


85.

Patient 40 years with the acute gastro - intestinal bleeding a canned blood was poured in a volume 400 ml after conducting of all tests on compatibility. After hemotransfusion the state of patient became worse, appeared head pains and pains in muscles, the temperature of body rose to 38,8. What can explaine the state of patient?

A.


B.


C.

Alergic reaction

D.


E.

By air embolism

86.


At a review: cyanosys, FB – 30 in 1 min., HR – 132/ min., a rhythm is correct, tones of heart are deaf, accent ІІ tone above a pulmonary artery, AP – 180/110 mm mercury. There is the loosened breathing above lungs with the far of moist wheezes in lower fates. What probably became the reason of worsening of the state?

A.

*A. Edema of lungs

B.


C.


D.

Hypertensive crisis

E.


87.

Patient M. 25 years old, was transferred in intensive care department with a diagnosis: Poisoning of tubazidum. From the moment of reception is 5 hours. The condition is heavy. Unconscious. BP is 140/100 mm mer , pulse - 120 a min. It is necessary to conduct the followings medical measures:

A.

*A. Acute hemodialisis

B.

Unithiolum, plasmapheresis

C.

Atropin, forced diuresis

D.

Proserin

E.

Oxybutirate sodium

88.

Patient S. 41 years treated oneself in a therapeutic department with sharp poisoning by an ethanol. What is a reason of death at the sharp poisoning by an ethanol:

A.

*A. Acute respiratory insufficiency

B.


C.


D.

Sharp cardiac insufficiency

E.

Collapse

89.

Patient S. 43 years treated oneself in a therapeutic department with sharp poisoning by vinegar essenc A patient had drunk 60 ml of vinegar essence. He needs:

A.

*A. Sodium bicarbonate IV

B.

To wash a stomach Sodium bicarbonate solutions

C.

Unitiol IV

D.

Enterosorbents

E.

Cardial remedies

90.

Patient S. 46 years treated oneself in a therapeutic department with pneumonia of lower dole of right lung. Planned antibacterial therapy - amoxiklav. After 40 min after intramuscular injection of duty dose, the patients feeled dizziness, pain behind a breastbon AT 60/40 mm mer , pulse, - 120 a min., rhythmical. During examination of lungs: wheezes under both lungs. Temperature is 38,5 What is worsening of the condition related to?

A.

*A. Anaphylactic shock

B.

Infectious toxic shock

C.

Collapse

D.

Tromboembolia of pulmonary artery

E.

Infectious shock

91.

Patient S., 35 years old, was delivered in reception department of hospital with complaints on general weakness, tachycardi It was examined by duty doctor.

Conscious, skin covers are cyanochroic, dry. Strong smell of aceton. Tones of heart are muffled, pulse is 90 per min. BP is 85/55 mm mer Glukose of blood is 18 mmol/l. What is tactic of duty doctor?

A.

*A. Small doses of simple insulin with rehydratation IV

B.

Introduction of large doses of simple insulin

C.

Permanent IV infusion of 7,5% solution of KCl

D.

Permanent IV infusion of simple insulin is with glucose

E.

Combination of insulin is with preparations of sulphaniluria

92.

Patient with poisoning with barbiturates. You should use

A.

*A. Solution of reamberin

B.

Bemegridum

C.

Kordiamin

D.

Unithiolum

E.

Cytitonum

93.

Patient Yu., 22, delivered to the hospital the brigade of ambulans The condition is heavy. Consciousness is entangle Skin covers are dry. A smell of aceton Pulse 115 a min., rhythmi BP is 95/65 mm mer Breathing is noisy, as Kusmaull. The activity of heart is rhythmic, tones are muffle Liver + 2 sm. Is there the most informing method of inspection for clarification of genesis of comma ?

A.

*A. Determination of glucose in blood

B.

To define the level of ADG of blood

C.

To define the kreatinine of blood

D.

To define the level of bilirubinu of blood

E.

All answers are wrong.

94.

Patient, 40 years, with the trauma of both thighs is delivered from the scene of accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of the neck, tahypnoe, AP 60/40 mm mer it., HBA=120 /min, in lungs moist wheezes, diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses most reliable?

A.

*A. Fatty embolism

B.

Traumatic shock

C.

Hemorhagic shock

D.

Pain shock

E.

Tromboembolism

95.

Sick D., 67 years, long time suffers from hypertension, obesity of the III degree, uncontrolledly accepts diuretics. The state was worsened a few days ago: appeared strong thirst, dryness, general weakness, polyuria, somnolence. The lines of person are sharp, eyes are hollow, a turgor and elasticity is mionecti Stuffiness. Pulse is 98 a min. BP 90/50 mm mer Tones of heart are muffle Osmolarity of plasma is 400 mosm/l. Glukose of blood 15,5 mmol/l. Your tactic?

A.

*A. Injection of insulin of short action with injection of hypotonic solutions

B.

A correction with the peroral insulindecreasing remedies

C.

Dopamin

D.

Injection of of insulin of the protracted action

E.

Solution of Ringer-Lokk

96.


A.

*A. Adrenalin.

B.

Suprastin.

C.

Gidrocortizon.

D.

Dopamin.

E.

Eufilin.

97.

Woman had drunk 40 pills of ftivazidum with a suicidal purpose. Delivered to the therapeutic department with complaints on nausea, vomit, pain in a stomach, headache. Tremor of extremities. Your subsequent actions:

A.

*A. Injection of vitamin of V6

B.

Hemodialysis

C.

Injection of vitamin of V6

D.

Injection of vitamin of Vit. C

E.


98.

A girl , 12 years old, entered in hospital with dizziness, head pain, hallucinations, periodic cramps, hypersalivation, cough, permanent nausea and vomit, pain in stomach. Pulse is 120 per min.,increase of liver, icterical color of scin. Her mother uses psyhotropical medications. There were chlororganic substanses and phosphororganic substanses at home of girl. Your previous diagnosis:

A.

Poisoning with psyhotropical medications

B.

Poisoning with chlororganic substanses

C.

*C. Poisoning with phosphororganic substanses

D.

Poisoning with food

E.

Poisoning with acid

99.

A patient on meningococcemia had displays of syndrome of Waterhouse-Fridrikson.

What method of therapy can be considered on pathogenetic ground?:

A.

*A. high dose of GKS (5-10 mg/kg of prednizolon and more)

B.

piracetam

C.

Inhibitirs of protease

D.

Heparinum

E.

Cardiac glycoside

100.

Ambulance was called to teenager. In his anamnesis is diabetes mellitus. It is observed weakness, pallor, loss of consciousness. Objectively: consciousness absents, a skin is pale, "marble", extremities are cyanochroic, cold, sweating. Periodically are convulsive tremor, breathings, superficial, frequent; tahycardia, from a mouth is a smell of alcohol. Specify, what from medicine it is necessary immediately to inject a patient intravenously:

A.

*A. 40% solution of glucose 40 ml

B.

Insulin of short action in a dose 0,1 ODES/kg

C.

a 0,9% solution of chloride of sodium is in the dose of 20 ml/kg

D.

a 0,45% solution of chloride of sodium is in a 5% solution of glucose

E.

Naloxonum in a dose 0,1 mg/kg

101.

Ambulance was called to unconsious person. It was established absence of breathing. Sign of effective artificial ventilation of lungs:

A.

*A. excursion of thorax;

B.

Narrowing of pupils

C.

Noise at insufflation of air ;

D.

Thrusting out of epigastral area is at insufflation;

E.

Dizziness of anesthesiologist

102.

Ambulance was called to unconsious person. It was established clinical death.

Sign of stop of cardiac activity:

A.

*A. Dilatation of pupils

B.

Sudden loss of consciousness

C.

Cyanosys of skin

D.

A pulse above a radial artery is arrithmical

E.

Absence of arteriotonus

103.


For endocardial injection of medications a needle is pricked:

A.

*A. In 4th intercostal spase, on 1-2 sm on the left of breastbone

B.

In 5th intercostal spase, in the point of projection of apex of heart

C.

In 3th intercostal spase, on the left of breastbone

D.

On the lower edge of 4th rib, on the left of breastbone

E.

In the place of projection of cardiac shove

104.


Each next charge of bipolar defibrilator should be increased on ?

A.

*A. 500 W

B.

250 W

C.

200W on 1 kg of mass of body

D.

1000 W

E.

Charge can not be promoted

105.


During CPR soluble-sodium bicarbonate is used with with a purpose:

A.

*A. Decreasing of metabolic acidosis

B.

Warning of development of metabolic acidosis

C.

An increase of time of survival of cerebrum in the conditions of hypoxia

D.

Liquidations of hypoxia

E.

To influence on the curve of dissociation of oxyhemoglobin

106.


What is the most credible laboratorical indexe of blood for patients after the real sinking in fresh water?

A.

*A. hyperkaliemia

B.

High hemoconcentration indexes

C.

High level of transaminases

D.

High level of urea, creatine

E.

Hypernatremiy

107.

For a patient observed increasing weakness, decline of appetite, pain in joints with appearance of icterus on 4th day. The temperature of body is normal. Liver is enlarged by 2,5 sm. After 3 days of therapy the state was worsened: there were anorexia, vomiting, somnolence, pain in right chest, petechial rash. Size of liver diminish, symptoms of irritation of peritoneum were not esteblished What complication we can think of?:

A.


B.

Sharp cholecystitis

C.

Sharp cholecistopankreatitis

D.


E.

Appendicitis

108.

In postpartum period of patient T.,conducted scraping of walls of uterus cavity concerning post-natal metroendometriasis on a background of necrosis of decidual layer, complication appeared with sudden decline of AP to 80/50 mm hg., Pulse of



A.


B.

infusion therapy

C.


D.

Support of cardiac activity

E.

Laparotomii with next extraction of uterus

109.

Patient , 30 years old, was transferred to the to the infection department with a diagnosis: food toxicoinfection. Nausea, vomit increased during the first day.

Conscious, skin covers are dry, rough by touch, cold. The lines of person are sharp, eyes hollow, eyeballs are soft. Breathing is noisy, as Kusmaull, strong smell of aceton in mid air. Tones of heart are deaf. Pulse is 93 for a minute, BP is 90/60 mm mer Er

5,2*1012/l, Hb – 131 g/l . Glukose of blood 22 mmol/l. Glucose, ketonic bodies are determined in urin Your most first actions?

A.

*A. Insulin 0,1 U/kg (aktrapid) on a 0,9% solution of Nacl

B.

Glybenklamid

C.

0,1 U/kg of ultralong insulin on 0,9% Nacl

D.

Washing of stomach

E.

IV 1% - 1 ml solution of mezaton

110.

Patient, 52 years old, hospitalized with the heavy form of viral hepatitis . The signs of flu appeared in permanent establishment. During a day the indexes of

Transamynases and bilirubin rose sharply. What complication of viral hepatitis can arise up for a patient?

A.


B.

Electrolyte comma

C.

Gastric bleeding

D.

Mechanical icterus

E.

Cerebral comma

111.

Patient L. is hospitalized in gynecological department with the temperature of 39 degrees C, with complaints of pain in the bottom of stomach, vomit, diarrhea .

Criminal abortion have been done 4 days befor AP 80/60, breathing is difficult, psychosomatic excitation. Symptom of Schotkin-Blumberg is positive. Uterus is enlarged as on 9 weeks of pregnancy, limitedly mobile, painless. Pus with blood appeared. Your Diagnosis?

A.

*A. septic shock

B.

Perforation of uterus

C.

Pelvic peritonitis

D.

Acute appendicitis

E.

Acute adnexia inflammation

112.

Patient M, 44 years old, admited to the infectious isolation with a diagnosis:

Leptospirosis. On 7th day of treatment his state was sharply worsened, pain appeared in lumbar region, somnolence, sickliness, cramps, head pain, diuresis diminished to

100 ml/day, blood: RBC -2,6*1012/L, Creatinine - 438 mkmol'/l, urea - 13,0 mmol/l.

What complication developed in patient?

A.

*A. acute kidney insufficiency

B.


C.

Chronic pyelonephritis

D.

Ischemic stroke

E.

atroke of kidneys

113.

Patient N., 28 years ol 6 day after the complicated births. The clinical hematological signs of subacute disseminate intravascular coagulation syndrome developed after skin hemorrhage and uterine bleeding. The state of patient is very ba blood: Er-2,7 of T/l, Hb-78 of gm/l, CI - 0,93, L-4,7 of Gm/l, thrombocytes-88 of gm/l, time of blood cloating - 16 min, prothrombin time - 25 sec, ethanol test +, fibrinogen-1,4 gramme/l, What preparations should be prescribed ?

A.

*A. freezed plasma

B.

Heparinum

C.

Reopoliglycin

D.

Cryoprecipitate

E.

U-aminokapric acid

114.

The patient 20 years old, delivered to ambulance department on the 2nd day of illness in a grave condition: temperature of body 39°c, symptoms of intoxication are expressed. On extremities, trunk, buttocks, present hemorrhagic rash as eczema with necrosis in the center. One day before cut his leg. Now has the wound in that plac In

2 hours the decline of AP is registered from 100/70 to 60/30 mm of Hg, diffused cyanosis. Application of prednisolon of 120 mg and reopoliglycin did not give any effect. What complication does it follow to think about?

A.

acute sub renal failure

B.

*B. Septic shock

C.

hipovolemic shock

D.

Hemorragic shock

E.

Respirator distress syndrom of adults

115.

To the terminal states belong:

A.

*A. pre-agony, terminal pause, agony, clinical death

B.

Agony, clinical and biological death

C.

Commas, agony, clinical death

D.

Pre-agony, agony, clinical, social death;

E.

Lowering of AT is to 80 mm of rt.st., commas, clinical death.

116.

You should perform CPR to patient. The best place of performing of closed massage of heart by hands:

A.

*A. over lower third of breastbone, fingers parallel to the ribs

B.

On breastbone, by fingers to the chin

C.

On middle third of breastbone

D.

In 4 subcostal space on the left of breastbone

E.

On a thorax, in the place of projection of apex of heart.

117.

You should perform CPR to patient During artificial respiration by method

“mouth to the mouth” it is need to blow air in volume:

A.

*A. 800-1100 ml

B.

500-700 ml

C.

1200-1600 ml

D.

1700-2000 ml;

E.

To carry out maximal inhalations

118.

. You should perform CPR to patient L. Clinical death lasts :

A.

*A. 4-5 minutes;

B.

1-3 minutes

C.

5-7 minutes

D.

To 10 minutes

E.

7-12 minutes

119.

You should perform CPR to patient N. All the below signs are the signs of of clinical death except:

A.

*A. arterial pressure is not determined

B.

Absence of pulsation above femoral artery

C.

Absence of breathing

D.

pupils are irresponsive to light;

E.

Absence of pulsation on carotid artery.

120.


110/60 mm mercury.Positive symptom of ”desolation” of peripheral hypodermic veins. Diuresis is lowere. How to characterize this state?

A.


B.

Preagonia

C.

Circulating shock

D.

Agony

E.

Irreversible shock

121.

A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical department with complaints on vomiting by "coffee-grounds", diarhea, moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test: Eras. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in medical treatment:

A.


B.

5% solution of glucosee

C.

Whole blood

D.

Red corpuscles mass

E.


122.

:A patient entered the department with a diagnosis: acute intestinal impassability.

Complaints: insignificant thirst, dizziness at an attempt to get up from a be At a review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with cracks. Pulse – 110 min., AP – 80 /60 mm of mer item, diuresis – 25 ml /h.

Electrolyte composition: Na+ - 142 mmol/l, C+ - 4 mmol/l, glucosee – 6 mmol/l, urea


A.


B.

Transfusion of solution of glucose

C.


D.

Transfusion of native plasm

E.


123.

A patient is in the intensive care unit during a week. 4 days ago a level of consciousness was on a Glasgow coma scale - 8 ball, now makes 3 ball. Verification of level of consciousness was conducted during 6 hours, a dynamics absents, death of

cerebrum was diagnose How correctly a leadthrough of establishment of such diagnosis was?

A.

*A. no, For establishment of diagnosis of death of cerebrum the presence of complex of clinical criteria is needed, duration of supervision must be no less than 12 hours for the primary defeat of brain and 24 for the second defeat;

B.

all was conducted right. A main criterion is a negative dynamics of level of consciousness, and depth of coma 3 ball on a Glasgow coma scale;

C.

no, For establishment of diagnosis the level of consciousness does not matter.

Basic are results of laboratory tests;

D.

all was conducted right. It was enough monitoring during 3 hours.

E.

no,. For establishment of diagnosis of death of cerebrum a presence is needed complex clinical criteria, duration of supervision must be no less than 48 hours for the primary defeat of brain and 72 for the second defeat.

124.

A patient, 28 years, 2 hours ago fell down from the ground floor of hous. Sopor, pale, there are the plural scratches of face, the lacerated hemorhagic wounds on the left forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l,

Hb – 100, AP – 90/40 mm of rt. item. In the blood test: red corpuscles – 3,5 g/l. What liquid does not need to be used for medical treatment of shock?

A.

*A. 5% solution of glucosee

B.


C.

Solutions gelatin

D.


E.

Solution of albumen

125.

Anafilactic shock appeared at a patient. The state heavy and progressively gets wors HBA – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the rescue of life of patient above all things?

A.

*A. Adrenalin.

B.


C.

Prednizolon.

D.

Dofamin.

E.

Suprastin.

126.


A.

*A. Adrenalin

B.

Prednizolon

C.

Calcium

D.

Dimedrol

E.

Eufilin

127.

At a patient 60 years with the third day after an exterpation uterus acute insufficiency of breathing developed suddenly, a skin became at first cyanotic, and then ash-colored color. Tachypnoe, cough with bloody sputum, retrosternal pain. BP

– 100/70 mm. mercury, HR – 120, BR – 32 in 1 min., CVP – 300 mm wt.col. What most reliable reason of worsening of the state of patient ?

A.


B.

Bleeding

C.

Pain shock

D.


E.


128.


A.


B.

To inject adrenalin

C.


D.


E.

To inject lidocain

129.

At a patient with the acute heart attack of myocardium in the region of partition on a 5th day after the brief episode of loss of consciousness there is reduction of frequency of pulse to 32 in a minut . BP - 80/40 mm . Consciousness at the level of sopor. He immediately needs :

A.

to put right a craniotserebral hypothermia, to enter lasics, prednisoloni, tserebrolizin

B.

to enter an atropine, eoufilin, to begin injection of aloupenta

C.


D.


E.


130.


A.

cordaronum

B.

lidocainum

C.

ornidinum

D.

*D. electrocardiostimulation

E.


131.


A.


B.


C.


D.

correctly A) and C)

E.


132.


A.

*A. To enter to a 3 ml solution of adrenalin in a trache

B.


C.


D.


E.


133.


A.


B.


C.


D.


E.


134.


A.

*A. Dopamin

B.

Mezaton

C.

Adrenalin

D.

Noradrenalin

E.

Ephedrine

135.


A.


B.

diuresis

C.


D.

right A) and B)

E.


136.

During the operation concerning strangular impassability of bowels, which conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac activity happened 50 years in the moment of mesenretium streching by the surgeon.


A.


B.


C.


D.


E.


137.

In 2 hours after renewal of cardial activity at a patient, that carried the sudden stop of heart on a background hemorhagic shock (blood lost near 2,5 l) and is found on ALV, unstable hemorhagia (AP – 80/40 – 90/60 mm of mer item, tahycardia)is marked, central vein pressure – 5 mm wt.st. It is related to:

A.


B.


C.


D.

Vasoplegia

E.


138.

In postpartum period of patient T.,conducted scraping of walls of uterus cavity concerning post-natal metroendometriasis on a background of necrosis of decidual

layer, complication appeared with sudden decline of AP to 80/50 mmhg., Pulse of



A.


B.

infusion therapy

C.


D.


E.


139.

It is typical for:

A.

*A. Negative CVT

B.


C.


D.

Edema of lungs

E.


140.

On a 4 day after incompatible (on a group) blood transfusion at a patient acutely reduced diouresis, anuria developed, the common state became worse acutely, arterial pressure ros At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma -


A.


B.


C.


D.


E.


141.


A.


B.


C.


D.

immediate informing of guidance of establishment and direct chief of victim, bringing in to the reanimation of the medical cabinet, deliveries of пострадавшего on an official machine to the nearest medical establishment.

E.


142.

Patient 20 years for verification of the functional state of kidneys the X- ray examination with v/v injection of cardiotrast is conducte At the end of injection the state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch appeare AP – 60/20 mm of mer item, HBA – 132/min. A similar research was conducted 3 months ago, such effects were not observe. What most reliable diagnosis?

A.


B.


C.


D.


E.


143.

Patient 30 years after a road-transport failure complaints of the acute tahypno

Ob-ly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax, stomach, right side of the neck. Auscultative: breathing on the right side is not conducted; pulse – 130/min., AP – 80/60 mm.mercury., CVP – 140 mm wt., FB – 30

/min., Ht – 0,27, Hb – 90 g/l. Subsequent therapy must include above all things:

A.


B.

Urgent ALV

C.


D.


E.

100% oxygen

144.

Patient 38 years, native plasma was poure At the end of infusion the state became worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36 on 1 min., AP – 70/40 mm of mer item, whistling dry wheezes. Which from the following mediceni must be injected firstly?

A.

*A. Adrenalin.

B.

Eufilin.

C.

Suprastin.

D.

Noradrenalin.

E.

Prednizolon.

145.


A.

*A. Fatty embolism

B.

Traumatic shock

C.

Hemorhagic shock

D.

Pain shock

E.

Tromboembolism

146.


A.

*A. Adrenalin.

B.

Suprastin.

C.

Gidrocortizon.

D.

Dopamin.

E.

Eufilin.

147.


A.

*A. Adrenalin

B.


C.

Prednizolon

D.

Dimedrol

E.

Suprastin

148.


Now there is worsening of the state, hypoxemia of PaO2 65 mm Hg, shortness of breath to 30 per min., tachycardia, high blood pressur What conclusions can be done?

A.


B.


C.


D.


E.


149.

To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was conducte A doctor went out from a chamber after conducting of necessary tests before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient without consciousness. The cyanosys of upper body part. Irregular breathing with the selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on peripheries and arterial pressure are not determine Tones of heart are deaf, unrhythmical. An ampoule and transfusion system is empty. What complication arose up as a result of hemotransfusion?

A.


B.


C.

Edema of lungs

D.


E.


150.

To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v is quickly injecte Tahycardiya, arterial hypotension, cyanosys, shortness of breath appeared, acute swelling of veins /of neck, extension of liver, CVT to 200 mm wt.st. acute insufficiency of what part of the cardial-vascular system is observed at a patient?

A.


B.


C.


D.

Vessels

E.

Uneffective heart

151.

Patient 30 years after a road-transport failure complaints of the acute tahypnoe.



A.


B.

Urgent ALV

C.


D.


E.

100% oxygen

152.


110/60 mm mercury. Positive symptom of ”desolation” of peripheral hypodermic veins. Diuresis is lowere. How to characterize this state?

A.


B.

Preagonia

C.

Circulating shock

D.

Agony

E.

Irreversible shock

153.


110/60 mm mercury Positive symptom of ”desolation” of peripheral hypodermic veins. Diuresis is lowere How to characterize this state?

A.


B.

Preagonia

C.

Circulating shock

D.

Agony

E.

Irreversible shock

154.

A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical department with complaints on vomiting by "coffee-grounds", diarhea, moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test: Eras. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in medical treat

A.


B.


C.

Whole blood

D.

Red corpuscles mass

E.


155.

A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical department with complaints on vomiting by "coffee-grounds", diarhea, moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test: Eras. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in

A.


B.


C.

Whole blood

D.

Red corpuscles mass

E.


156.

A patient 48 years the second day in department of intensive therapy concerning the acute front-partition heart attack of myocardium. During a review “wheezing” suddenly, non-permanent tonic constricting of muscles is marked, pupils are extended, pulse on a. carotis not palpitat. What doctor have to do in the first place?

A.


B.

Record of ECG

C.


D.


E.


157.


Complaints: insignificant thirst, dizziness at an attempt to get up from a be At a review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with cracks. Pulse – 110 min., AP – 80 /60 mm of mer item, diuresis – 25 ml /h.



A.


B.


C.


D.


E.


158.

A patient with a traumatic shock AP – 60/0 mm rt.st., HBA – 90 /1 min. Define a shock index:

A.

*A. 1,5

B.

2,5

C.

1,5

D.

0,5

E.

0,3

159.

A patient, 28 years, 2 hours ago fell down from the ground floor.Sopor, pale, there are the plural scratches of face, the lacerated hemorhagic wounds on the left forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l, Hb –

100, AP – 90/40 mm of rt. item In the blood test: red corpuscles – 3,5 g/l. What fluid does not need to be used for medical treatment of shock?

A.


B.


C.

Solutions gelatin

D.


E.

Solution of albumen

160.


A.

*A. Adrenalin.

B.


C.

Prednizolon.

D.

Dofamin.

E.

Suprastin.

161.


A.


B.


C.


D.


E.


162.

In a clinic a patient with the traumatic tearing of both lower extremities off at the level of knee-joints is delivere A patient is extremly inert, languid, pale, pulse 140 bmin, threadlike, AP 500. On both lower extremities there are the imposed plaits.

Bleeding at the receipt is not present. From the words of doctor of first-aid, lost about 3 litres of blood in place of event. What principal reason of heavy of the state of Patient?

A.

*A. Acute hemorrhag

B.

Pain shock.

C.


D.

Fatty embolism

E.


163.

It is typical for:

A.

*A. Negative CVT

B.


C.


D.

Edema of lungs

E.


164.

On a 4 day after incompatible (on a group) blood transfusion at a patient acutely reduced diuresis, anuria developed, the common state became worse acutely, arterial pressure ros At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma -


A.


B.


C.


D.


E.


165.



A.


B.


C.


D.


E.


166.

Patient 20 years for verification of the functional state of kidneys the X- ray examination with i/v injection of cardiotrast is conducte At the end of injection the state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch appeare AP – 60/20 mm of mer item, HBA – 132/min. A similar research was conducted 3 months ago, such effects were not observe. What most reliable diagnosis?

A.


B.


C.


D.


E.


167.

Patient 20 years for verification of the functional state of kidneys the X- ray examination with i/v injection of cardiotrast is conducte. At the end of injection the state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch appeare AP – 60/20 mm of mer item, HBA – 132/min. A similar research was conducted 3 months ago, such effects were not observe. What most reliable diagnosis?

A.


B.


C.


D.


E.


168.

Patient 38 years, native plasma was poure At the end of infusion the state became worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36 on 1 min., AP – 70/40 mm of mer item, whistling dry wheezes. Which from the following medicine must be injected firstly?

A.

*A. Adrenalin.

B.

Eufilin.

C.

Suprastin.

D.

Noradrenalin.

E.

Prednizolon.

169.

Patient 40 years with the acute gastro - intestinal bleeding a canned blood was poured in a volume 400 ml after conducting of all tests on compatibility. After hemotransfusion the state of patient became worse, appeared head pains and pains in muscles ,the temperature of body rose to 38,8 . What can explaine the state of patient?

A.


B.


C.

Alergic reaction

D.


E.

By air embolism

170.

Patient 62 years the third day of presense in department of intensive therapy concerning the acute transmural heart attack of myocardium of front-partition localization. At night woked up from a suffocating cough, feeling of fear and troubl

At a review: cyanosys, FB – 30 after 1 min., HBA – 132/ min., a rhythm is correct, tones of heart are deaf, accent ІІ tone above a pulmonary artery, AP – 180/110 mm mercury. There is the loosened breathing above lungs with the far of moist wheezes in lower fates. What probably became the reason of worsening of the state?

A.

*A. Edema of lungs

B.


C.


D.

Hypertensive crisis

E.


171.

Patient N., 40 years, groom. In anamnesis there is an allergy to nonsteriidal antiinflammatory. After injection of antitetanus on a method Besredco concerning the hammered wound of right shin, through 20 mines, there was a acute weakness, labouring breath, through 10 minutes, loss of consciousness. What way of development of anafilactic form of illness?

A.


B.


C.


D.


E.

Infection of whey

172.


A.

*A. Amidaron

B.

Propranolon

C.

Lidocain

D.

Strofantin

E.

Atropini sulfati

173.


A.

*A. Adrenalin

B.


C.

Prednizolon

D.

Dimedrol

E.

Suprastin

174.


A.

*A. Adrenalin

B.


C.

Prednizolon

D.

Dimedrol

E.

Suprastin

175.

To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was conducte. A doctor went out from a chamber after conducting of necessary tests before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient without consciousness. The cyanosys of upper body part. Irregular breathing with the selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on peripheries and arterial pressure are not determine Tones of heart are deaf, unrhythmical. An ampoule and transfusion system is empty. What complication a rose up as a result of hemotransfusion?

A.


B.


C.

Edema of lungs

D.


E.


176.

To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v is quickly injecte Tahycardiya, arterial hypotension, cyanosys, shortness of breath appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.st.

Acute insufficiency of what part of the cardial-vascular system is observed at a patient?

A.


B.


C.


D.

Vessels

E.

Uneffective heart

177.

A patient 48 years the second day in dpartment of intensive therapy concerning the acute front-partition heart attack of myocardium. During a review “wheezing” suddenly, non-permanent tonic constricting of muscles is marked, pupils are extended,it isnt pulse on arteria carotis . What doctor have to do in the first place?

A.


B.

Record of ECG

C.


D.


E.


178.


A.

*A. Adrenalin

B.

Prednizolon

C.

Calcium

D.

Dimedrol

E.

Eufilin

179.



A.


B.

Bleeding

C.

Pain shock

D.


E.


180.


A.


B.

To inject adrenalin

C.


D.


E.

To inject lidocain

181.

At the patient operated concerning the festering peritonitis coused by perforation of gastric ulcer, in a postoperation period appeared: high temperature, frequency of breathing 35/min., AP – 70/40 mm of mer item, diuresis -20 ml/h temperature of body to 39 , leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of chlorous sodium and 0,8 of solution of reopoliglucin did not improve general

condition. Central vein pressure – 130 mm wt.st. For stabilization of hemodinamics will be optimum infusion:

A.

*A. Dopamin

B.

Mezaton

C.

Adrenalin

D.

Noradrenalin

E.

Ephedrine

182.

During the operation concerning strangular impassability of bowels, which conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac diyal-nosti happened 50 years in the moment of mesenretium streching by the surgeon. What would prevent the stop of heart in this case?

A.


B.


C.


D.


E.


183.


A.


B.


C.


D.

Vasoplegia

E.


184.

In a clinic a patient with the traumatic tearing of both lower extremities off at the level of knee-joints is delivere A patient is extremly inert, languid, pale, pulse 140 bmin, threadlike, AP 500. On both lower extremities there are the imposed plaLits.

Bleeding at the receipt is not present. From the words of doctor of first-aid, lost about 3 litres of blood in place of event. What is a principal reason of heavy of the state of patient?

A.

*A. acute hemorrhag

B.

Pain shock.

C.


D.

Fatty embolism

E.


185.

Patient 40 years with the acute gastro - intestinal bleeding a canned blood was poured in a volume 400 ml after conducting of all tests on compatibility. After hemotransfusion the state of patient became worse, appeared head pains and pains in muscles ,the temperature of body rose to 38,8 . What can explaine the state of patient?

A.


B.


C.

Alergic reaction

D.


E.

By air embolism

186.

Patient 62 years the third day of presense in department of intensive therapy concerning the acute transmural heart attack of myocardium of front-partition localization. At night woked up from a suffocating cough, feeling of fear and troubl


A.

*A. Edema of lungs

B.


C.


D.

Hypertensive crisis

E.


187.

Patient M. 25 years old, was transferred in intensive care department with a diagnosis: Poisoning of tubazidum. From the moment of reception is 5 hours. The condition is heavy. Unconscious. BP is 140/100 mm mer , pulse - 120 a min. It is necessary to conduct the followings medical measures:

A.

*A. Acute hemodialisis

B.

Unithiolum, plasmapheresis

C.

Atropin, forced diuresis

D.

Proserin

E.

Oxybutirate sodium

188.

Patient S. 41 years treated oneself in a therapeutic department with sharp poisoning by an ethanol. What is a reason of death at the sharp poisoning by an ethanol:

A.

*A. Acute respiratory insufficiency

B.


C.


D.

Sharp cardiac insufficiency

E.

Collapse

189.

Patient S. 43 years treated oneself in a therapeutic department with sharp poisoning by vinegar essenc A patient had drunk 60 ml of vinegar essence. He needs:

A.

*A. Sodium bicarbonate IV

B.

To wash a stomach Sodium bicarbonate solutions

C.

Unitiol IV

D.

Enterosorbents

E.

Cardial remedies

190.

Patient S. 46 years treated oneself in a therapeutic department with pneumonia of lower dole of right lung. Planned antibacterial therapy - amoxiklav. After 40 min after intramuscular injection of duty dose, the patients feeled dizziness, pain behind a breastbon AT 60/40 mm mer , pulse, - 120 a min., rhythmical. During examination of lungs: wheezes under both lungs. Temperature is 38,5 What is worsening of the condition related to?

A.

*A. Anaphylactic shock

B.

Infectious toxic shock

C.

Collapse

D.

Tromboembolia of pulmonary artery

E.

Infectious shock

191.

Patient S., 35 years old, was delivered in reception department of hospital with complaints on general weakness, tachycardia. It was examined by duty doctor.

Conscious, skin covers are cyanochroic, dry. Strong smell of aceton. Tones of heart are muffled, pulse is 90 per min. BP is 85/55 mm mer Glukose of blood is 18 mmol/l. What is tactic of duty doctor?

A.

*A. Small doses of simple insulin with rehydratation IV

B.

Introduction of large doses of simple insulin

C.

Permanent IV infusion of 7,5% solution of KCl

D.

Permanent IV infusion of simple insulin is with glucose

E.

Combination of insulin is with preparations of sulphaniluria

192.

Patient with poisoning with barbiturates. You should use

A.

*A. Solution of reamberin

B.

Bemegridum

C.

Kordiamin

D.

Unithiolum

E.

Cytitonum

193.

Patient Yu., 22, delivered to the hospital the brigade of ambulans. The condition is heavy. Consciousness is entangle. Skin covers are dry. A smell of aceton. Pulse

115 a min., BP is 95/65 mm mer. Breathing is noisy, as Kusmaull. The activity of heart is rhythmic, tones are muffle. Liver + 2 sm. Is there the most informing method of inspection for clarification of genesis of comma ?

A.

*A. Determination of glucose in blood

B.

To define the level of ADG of blood

C.

To define the kreatinine of blood

D.

To define the level of bilirubinu of blood

E.

All answers are wrong.

194.


A.

*A. Fatty embolism

B.

Traumatic shock

C.

Hemorhagic shock

D.

Pain shock

E.

Tromboembolism

195.

Sick D., 67 years, long time suffers from hypertension, obesity of the III degree, uncontrolledly accepts diuretics. The state was worsened a few days ago: appeared strong thirst, dryness, general weakness, polyuria, somnolenc The lines of person are sharp, eyes are hollow, a turgor and elasticity is mionecti Stuffiness. Pulse is 98 a min. BP 90/50 mm mer Tones of heart are muffle Osmolarity of plasma is 400 mosm/l. Glukose of blood 15,5 mmol/l. Your tactic?

A.

*A. Injection of insulin of short action with injection of hypotonic solutions

B.

A correction with the peroral insulindecreasing remedies

C.

Dopamin

D.

Injection of of insulin of the protracted action

E.

Solution of Ringer-Lokk

196.

The patient 32 years have infusion of native plasm. At the end of infusion the state became worse: disorientation, cyanosys, excitation, appeared hypersalivation, tahypnoe, AP =70/40 mm mer st., in lungs – the dissipated dry wheezes. What medicine must be injected firstly?

A.

*A. Adrenalin.

B.

Suprastin.

C.

Gidrocortizon.

D.

Dopamin.

E.

Eufilin.

197.

Woman had drunk 40 pills of ftivazidum with a suicidal purpos. Delivered to the therapeutic department with complaints on nausea, vomit, pain in a stomach, headache. Tremor of extremities. At a receipt a stomach was your subsequent actions:

A.

*A. Injection of vitamin of V6

B.

Hemodialysis

C.

Injection of vitamin of V6

D.

Injection of vitamin of Vit. C

E.


198.


A.

*A. Adrenalin.

B.


C.

Prednizolon.

D.

Dofamin.

E.

Suprastin.

199.


A.

*A. Adrenalin

B.

Prednizolon

C.

Calcium

D.

Dimedrol

E.

Eufilin

200.



A.


B.

Bleeding

C.

Pain shock

D.


E.


201.

At a patient with the acute heart attack of myocardium in the region of partition on a 5th day after the brief episode of loss of consciousness there is reduction of

frequency of pulse to 32 in a minut BP - 80/40 mm Consciousness at the level of sopor. He immediately needs :

A.


B.

to enter an atropine, eoufilin, to begin infusion of aloupenta

C.


D.


E.


202.


A.


B.


C.


D.

correctly A) and C)

E.


203.


A.

*A. To enter to a 3 ml solution of adrenalin in a trache

B.


C.


D.


E.


204.


A.


B.


C.


D.


E.


205.


A.

*A. Dopamin

B.

Mezaton

C.

Adrenalin

D.

Noradrenalin

E.

Ephedrine

206.


A.


B.

diuresis

C.


D.

right A) and B)

E.


207.

During the operation concerning strangular impassability of bowels, which conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac happened 50 years in the moment of mesenretium streching by the surgeon. What would prevent the stop of heart in this case?

A.


B.


C.


D.


E.


208.


A.


B.


C.


D.

Vasoplegia

E.


209.




A.


B.

infusion therapy

C.


D.


E.


210.

It is typical for:

A.

*A. Negative CVT

B.


C.


D.

Edema of lungs

E.


211.

On a 4 day after incompatible (on a group) blood transfusion at a patient acutely reduced diuresis, anuria developed, the common state became worse acutely. At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma - 24 mmol/l.


A.


B.


C.


D.


E.


212.


A.


B.


C.


D.

immediate informing of guidance of establishment and direct chief of victim, bringing in to the reanimation of the medical cabinet, deliveries on an official machine to the nearest medical establishment.

E.


213.

Patient 20 years for verification of the functional state of kidneys the X- ray examination with v/v injection of cardiotrast is conducte At the end of injection the state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch appeare AP – 60/20 mm of mer item, HBA – 132/min. A similar research was conducted 3 months ago, such effects were not observe What most reliable diagnosis?

A.


B.


C.


D.


E.


214.




A.


B.

Urgent ALV

C.


D.


E.

100% oxygen

215.

Patient, 40 years, with the trauma of both thighs is delivered from the scene of accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of the neck, tahypnoe, AP 60/40 mm mer st., HBA=120 /min, in lungs moist wheezes, diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses is most reliable?

A.

*A. Fatty embolism

B.

Traumatic shock

C.

Hemorhagic shock

D.

Pain shock

E.

Tromboembolism

216.


A.

*A. Adrenalin.

B.

Suprastin.

C.

Gidrocortizon.

D.

Dopamin.

E.

Eufilin.

217.


A.

*A. Adrenalin

B.


C.

Prednizolon

D.

Dimedrol

E.

Suprastin

218.


Now there is worsening of the state, hypoxemia of PaO2 65 mm Hg, shortness of breath to 30 per min., tachycardia, high blood pressure. What conclusions can be done?

A.


B.


C.


D.


E.


219.

To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was conducte A doctor went out from a chamber after conducting of necessary tests before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient without consciousness. The cyanosys of upper body part. Irregular breathing with the selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on peripheries and arterial pressure are not determine Tones of heart are deaf, unrhythmical. An ampoule and transfusion system is empty. What complication arose up as a result of hemotransfusion?

A.


B.


C.

Edema of lungs

D.


E.


220.

To the patient 45 years with suspicion on holecystitis the rentgen contrast i/v is quickly injecte Tahycardiya, arterial hypotension, cyanosys, shortness of breath appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.st. acute insufficiency of what part of the cardial-vascular system is observed at a patient?

A.


B.


C.


D.

Vessels

E.

Uneffective heart

221.

The patient 32 years have infusion of native plasma. At the end of infusion the state became worse: disorientation, cyanosys, excitation, appeared hypersalivation, tahypnoe, AP =70/40 mm merc.st., in lungs – the dissipated dry wheezes. What medicine must be injected firstly?

A.

*A. Adrenalin.

B.

Suprastin.

C.

Gidrocortizon.

D.

Dopamin.

E.

Eufilin.

222.


110/60 mm mercury Positive symptom of ”desolation” of peripheral hypodermic veins. Diuresis is lowered. How to characterize this state?

A.


B.

Preagonia

C.

Circulating shock

D.

Agony

E.

Irreversible shock

223.

A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical department with complaints on vomiting by "coffee-grounds", diarhea, moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test: Eras. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in medical treatment:?

A.


B.


C.

Whole blood

D.

Red corpuscles mass

E.


224.

A patient 48 years the second day in dpartment of intensive therapy concerning the acute front-partition heart attack of myocardium. During a review “wheezing” suddenly, non-permanent tonic constricting of muscles is marked, pupils are extended, pulse on a. carotis not palpitate. What doctor have to do in the first place?

A.


B.

Record of ECG

C.


D.


E.


225.


Complaints: insignificant thirst, dizziness at an attempt to get up from a bed. At a review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with cracks. Pulse – 110 min., AP – 80 /60 mm of merc. item, diuresis – 25 ml /h.



A.


B.

Transfusion of solution of glucose.

C.


D.


E.


226.

A patient with a traumatic shock AP – 50/0 mm rt.st., HBA – 160 /1 min. Define a shock index:

A.

*A. 3,2

B.

2,5

C.

1,5

D.

0,5

E.

0,3

227.

A patient, 28 years, 2 hours ago fell down from the ground floor of house. Sopor, pale, there are the plural scratches of face, the lacerated hemorhagic wounds on the left forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l,

Hb – 100, AP – 90/40 mm of rt. item. In the blood test: red corpuscles – 3,5 g/l. What infusion fluid does not need to be used for medical treatment of shock?

A.


B.


C.

Solutions gelatin

D.


E.

Solution of albumen

228.

At a patient with the acute heart attack of myocardium in the region of partition on a 5th day after the brief episode of loss of consciousness there is reduction of frequency of pulse to 32 in a minute. BP - 80/40 mm Consciousness at the level of sopor. He immediately needs :

A.


B.

to enter an atropine, eoufilin, to begin infouziyo of aloupenta

C.


D.


E.


229.


A.


B.


C.


D.

correctly A) and C)

E.


230.

At a patient, that is found on medical treatment in the therapeutic department, the sudden stopping of circulation of blood happened. Medical personnel begun the

reanimation measures. Define the most rational way of injection of adrenalin for renewal of heart abbreviations in default of vein access:

A.


B.

To enter to a 1 ml solution of adrenalin in muscle.

C.


D.


E.


231.

At a patient, that is found under the permanent electrocardioscopic supervision, microwave fibrillation of myocardium and diagnosed clinical death developed. It is necessary to do:

A.

to inject the solution of calcium in heart

B.


C.

to inject solution of atropine in heart

D.

to inject solution of adrenalin in heart

E.


232.

Patient 20 years for verification of the functional state of kidneys the X- ray examination with intravenously injection of cardiotrast is conducted. At the end of injection the state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch appeared. AP – 60/20 mm of merc. item, HBA – 132/min. A similar research was conducted 3 months ago, such effects were not observed. What most reliable diagnosis?

A.


B.


C.


D.


E.


233.




A.


B.

Urgent ALV

C.


D.


E.

100% oxygen

234.

Patient 38 years, native plasma was poured. At the end of infusion the state became worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36 on 1 min., AP – 70/40 mm of merc. item, whistling dry wheezes.

Which from the following medicine must be injected firstly?

A.

*A. Adrenalin.

B.

Eufilin.

C.

Suprastin.

D.

Noradrenalin.

E.

Prednizolon.

235.

Patient 40 years with the acute gastro - intestinal bleeding a canned blood was poured in a volume 400 ml after conducting of all tests on compatibility. After

hemotransfusion the state of patient became worse, appeared head pains and pains in muscles ,the temperature of body rose to 38,8 C. What can explaine the state of patient?

A.


B.


C.

Alergic reaction

D.


E.

By air embolism

236.



A.

*A. Edema of lungs

B.


C.


D.

Hypertensive crisis

E.


237.

Patient N., 40 years, groom. In anamnesis there is an allergy to nonsteriidal antiinflammatory. After injection of antitetanus on a method Besredco concerning the hammered wound of right shin, through 20 mines, there was a acute weakness, labouring breath, through 10 mines, loss of consciousness. What way of development of anafilactic form of illness?

A.


B.


C.


D.


E.

Infection of whey

238.

Patient, 40 years, with the trauma of both thighs is delivered from the scene of accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of the neck, tahypnoe, AP 60/40 mm merc.st., HBA=120 /min, in lungs moist wheezes, diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses most reliable?

A.

*A. Fatty embolism

B.

Traumatic shock

C.

Hemorhagic shock

D.

Pain shock

E.

Tromboembolism

239.


A.

*A. Amiodaron

B.

Propranolon

C.

Lidocain

D.

Strofantin

E.

Atropini sulfati

240.

To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was conducted. A doctor went out from a chamber after conducting of necessary tests before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient without consciousness. The cyanosys of upper body part. Irregular breathing with the selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on peripheries and arterial pressure are not determined. Tones of heart are deaf, unrhythmical. An ampoule and transfusion system is empty. What complication arose up as a result of hemotransfusion?

A.


B.


C.

Edema of lungs

D.


E.


241.

To the patient 45 years with suspicion on holecystitis the rentgen contrast i/v is quickly injected. Tahycardiya, arterial hypotension, cyanosys, shortness of breath appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.st. acute insufficiency of what part of the cardial-vascular system is observed at a patient?

A.


B.


C.


D.

Vessels

E.

Uneffective heart

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