Topic 2. Pathogenic action of environmental factors

1. A worker of radiological department was exposed to radiation once as result of violation of the rules of safety appliances. Ulcerogangrenous stomatitis developed in him in 8 days. Patient’s blood test showed: RBC – 3.2 x 10¹²/L, reticulocytes – 0.01 %, Hb – 60 g/L, WBC – 2.3 x 10⁹/L, and platelets – 50 x 10⁹/L. Which period of radiation sickness are described changes typical for?

A. Period of primary reactions

B. Period of manifestation

C. Latent period

D. Pretended well-being period

E. Outcomes

2. Respiratory standstill developed in a man as a result of action of electric current from town mains for 0.1 seconds with position of electrodes “right hand – head”. Indicate the most probable reason for this complication.

A. Paralysis of inspiration center

B. Emotional stress

C. Paralysis of respiratory muscles

D. Reflex respiratory standstill (pain shock)

E. Total paralysis of respiratory center

3. Increase of body temperature up to 38.5^oC, tachycardia, and BP of 160/85 mmHg were noticed in a worker after prolonged work in conditions of “warming” microclimate. Disturbances of heart rhythm were revealed in the patient at auscultation. Which electrolyte primary loss affects adversely the heart work?

A. Potassium

B. Calcium

C. Magnesium

D. Sodium

E. Phosphate

4. Elevation of arterial pressure, tachycardia, and increase in body temperature to 38,8^oC developed in a patient during narcosis with myorelaxants. Which disturbance of heat exchange appeared in this patient?

A. Fever

B. Physical hyperemia

C. Hit heat

D. Hypothermia

E. Hyperthermia

5. At violation of the rules of safety appliances an electric welder took electric wire by unprotected and wet hand. Tonic contractions of muscles and involuntary urination developed in him. Which effect of electric current becomes apparent in this case?

A. Electrochemical

B. Biological

C. Heat

D. Mechanical

E. --

6. During long hypothermia of the organism phase of decompensation developed. Its feature is:

A. Decrease in blood pressure

B. Constriction of peripheral vessels

C. Rare respiration

D. Increase in muscle tone

E. Rigor

7. A man took electric wire with high tension by both hands. He died momentary in result of:

A. Intracerebral bleeding

B. Respiratory standstill

C. Cardiac fibrillation

D. Burns

E. Tearing extremities off

8. The main link in pathogenesis of kinetosis under radial acceleration is:

A. Excitation of motor nuclei of vagus nerve

B. Irritation of tactile receptors

C. Increase in muscular tone

D. Irritation of nuclei of vestibular nerve

E. Bradycardia

9. A worker, taking part in nuclear power plant breakdown elimination, was exposed to whole-body irradiation. Which organ or which tissue will tumor develop in?

A. Lung

B. Bone marrow

C. Stomach

D. Skin

E. Bone tissue

10. A worker, taking part in nuclear power plant breakdown elimination, was exposed to ionizing radiation in dose of 6Gr. What changes in the blood will happen after 10 days?

A. Agranulocytosis

B. Limpocytosis

C. Leucocytosis and limphocytopenia

D. Basophilia

E. Eosiniphilia

11. A man had electric trauma. Current went through the myocardium. What dangerous disorders in heart work needing emergency correction can appear in such situation?

A. Fibrillation of ventricles

B. Fibrillation of atria

C. Bradycardia

D. Tachycardia

E. Extrasystolia

12. A worker was exposed to ionizing radiation in dose of 5Gr after accident at nuclear power plant. Agranulocytosis was revealed in him in a week. What is the basic pathogenic mechanism in this case?

A. Increased outcome of mature leukocytes from bone marrow

B. Development of autoimmune processes

C. Increase in migration of granulocytes to tissues

D. Elevated destruction of leukocytes

E. Oppression of leucopoiesis

13. A patient has bone marrow form of radiation diseases. What lineages of hemopoiesis are affected in this case?

A. All

B. Erythrocytic

C. Megakariocytic

D. Granulocytic

E. Agranulocytic

14. Symptoms of hemorrhage syndrome appeared in a patient with radiation sickness. Which mechanism is leading one in pathogenesis of this syndrome?

A. Thrombocytopenia

B. Lymphopenia

C. Erythropenia

D. Eosinopenia

E. Neutropenia

15. A doctor revealed in a patient affected by electric current respiratory arrest and disturbances of heart functions. What pathway did electric current go in this case?

A. Right hand - head

B. Left leg - right leg

C. Right leg - right hand

D. Left leg - right hand

E. Abdomen - right leg

16. Diver, working at depth of 60 m, was raised very quickly on surface after an accident. After a time pain in the joints, skin itching appeared in him. What happened to diver?

A. Decompression diseases

B. High altitude diseases

C. Hyperbaric oxygenation

D. Lowering of reactivity

E. Compensatory adaptation

17. A galvanizer addressed to a doctor because of appearing of pink itching spots and vesicles on his arms skin. He worked a lot with nickel compounds recently. What is the mechanism of these lesions development?

A. Modification of skin proteins due to action of nickel ions with immunopathological reaction development

B. Irritant action of nickel compounds on skin

C. Vegetative disorders related to nickel compounds received by respiratory tract

D. Infection of skin due to microtraumas

E. Nickel is a complete antigen

18. In consequence of accident in laboratory man was exposed to radiation in dose of 6Gr. Which symptom is the most typical for latent period of acute radiation diseases?

A. Leukocytopenia

B. Headache

C. Depression

D. Vomiting

E. Diarrhea

19. A patient was admitted to the hospital with extensive burns of the body surface. Which pathogenic factor of burn disease has to be liquidated in the first turn?

A. Intoxication of decay products

B. Plasma loss

C. Pain

D. Infection through the injured skin

E. Autoallergy

20. During running parallel experiments rats were exposed to prolonged direct solar radiation in open chambers and in ones covered by glass. Tumor development at hair uncovered places of skin was marked in animals residing in open chambers. Which factor influence does this phenomena connected to?

A. Sun heat

B. Ultraviolet radiation

C. Biologic carcinogens

D. Exogenous chemical carcinogens

E. Infrared radiation

21. In consequence of accident at nuclear power plant radio-active products escape occurred. Peoples, who were in zone of increased radiation, got dose of radiation about 250 – 300 Gr. What symptom would be the leading one in these people?

A. Lymphocytosis

B. Anemia

C. Thrombocytopenia

D. Neutropenia

E. Leukocytosis

22. A man was admitted to the hospital after exposure to radiation in dose of 3Gr. Which physiological system develops changes in the first turn in this patient?

A. Blood system

B. Cardiovascular system

C. Immune system

D. Alimentary system

E. Endocrine system

23. Headache, pain in ears, nasal hemorrhages appeared in the passengers during flight by balloon. What serves the pathogenic base for these changes development?

A. Explosive decompression syndrome

B. Decompression syndrome

C. Hypoxia

D. Gas embolism

E. Toxic influence of gases dissolved in the blood

24. What is the reason for pneumonia development in children after cooling?

A. Microorganisms

B. General cooling

C. Decrease in reactivity due to previous diseases

D. Insufficiency of nutrition

E. All these factors

25. Which changes are connected to direct injurious action of ionizing radiation?

A. Inhibition of DNA-synthesis under the influence of radiotoxines

B. Radiolysis of water

C. Edema

D. Interaction between free radicals and enzymes

E. Injury of chromosomes

26. What reasons does high radiosensitivity of cells and tissues depend on?

A. High mitotic activity

B. Activation of glycolysis

C. Level of differentiation

D. Number of mitochondrias

E. Decrease of DNA-synthesis

27. Which changes in blood are typical for the first period of bone marrow form of acute radiation diseases?

A. Leukocytosis

B. Agranulocytosis

C. Thrombocytopenia

D. Erithrocytopenia

E. Leukocytopenia

28. Among many factors determining severity of electrical injury the first place belongs to injury of internal organs localized at the way which electric current passes through the body. Which organ injury is the most dangerous?

A. Heart

B. Cerebrum

C. Lungs

D. Liver

E. Kidneys

29. A patient with III – IV degree burns of 50% of the body surface was admitted to the hospital. He has depressed consciousness, bradycardia, and reduced blood pressure. What is the most possible diagnosis?

A. Burn shock

B. Intoxication

C. Preagony

D. Collapse

E. Coma

30. A patient very often has diseases of nasopharynx, which appear under the influence of different factors and in the most cases manifest by inflammation. Which of listed factors is the most probable reason for these diseases?

A. Microorganisms

B. General cooling of organism

C. Overstrain

D. Immunodeficiency

E. Insufficiency of nutrition

31. A woman, who took part in liquidation of accident at Chernobyl nuclear power plant, was admitted to the hospital with complaints of headache, pain in the heart, and worsening of general condition. Changes of subcellular structures were found out in her, except:

A. Proteins

B. Nucleus

C. Lisosomes

D. Mitochondrion

E. Endoplasmic reticulum

32. A 45-year-old man suffering from hematoporphiria complains of burns of skin, appeared after short-time (no more than 10 to 20 minutes) exposure to the sun, headache, nausea, and dizziness. Explain the reason for this pathology?

A. Photoallergy

B. Sun stroke

C. Heat stroke

D. Photochemical burn

E. Hyperthermia

33. A liquidator of accident at Chernobyl nuclear power plant after carrying out works addressed to a doctor with complaints of abrupt worsening of general state, significant weakness, increase in body temperature up to 37,8^oC, multiple punctate hemorrhages on skin and mucous membranes, diarrhea. In the patient’s blood analysis ESR – 25 mm/h, RBC – 2,4x10¹²/L, WBC - 2,2x10⁹/L, platelets – 70x10⁹/L. What period of radiation disease does this picture typical for?

A. Manifestation

B. First reaction

C. Pretended well-being period

D. Recovery

E. Outcome

ANSWERS:

1.-B, 2.-E, 3.-A, 4.-E, 5.-B, 6.-A, 7-C, 8.-D, 9.-B, 10.-A, 11.-A, 12.-E, 13.-A, 14.-A, 15.-A, 16.-A, 17.-A, 18.-A, 19.-C, 20.-B, 21.-D. 22.-A, 23.-B, 24.-A, 25.-E, 26.-A, 27.-A, 28.-A, 29.-A, 30.-A, 31.-A, 32.-A, 33.-A.

Дата добавления: 2015-07-25