Topic 6. Disorders of microcirculation

1. A patient was admitted to the hospital with diagnosis of acute left-ventricle heart failure. Patient’s condition suddenly became worse and edema of lungs developed in him. What kind of disorders of peripheral blood circulation causes the lungs edema?

A. Arterial hyperemia neurotonic type

B. Arterial hyperemia neuroparalytic type

C. Arterial hyperemia metabolic type

D. Ischemia

E. Congestion (venous hyperemia)

2. Dependence of blood pressure upon level of peripheral vascular resistance was measured in animal under experimental conditions. Indicate vessels, which have the most resistance.

A. Capillaries

B. Arteries

C. Aorta

D. Arterioles

E. Veins

3. A patient has obstruction of right calf profound veins, which results in increasing in amount of blood in the impaired part of tissue. What is the name for increase in amount of blood resulted from impeded blood outflow?

A. Venous hyperemia (congestion)

B. Thrombosis

C. Ischemia

D. Stasis

E. Arterial (active) hyperemia

4. A patient with paradontitis has edema of gums. His gums are dark red. What kind of local blood flow disturbance takes place in patient’s gums?

A. Venous (passive) hyperemia

B. Arterial (active) hyperemia

C. Embolism

D. Thrombosis

E. Ischemia

5. Pain in leg at walking, cyanosis, and edema of calf appeared in a patient with varicosity. His foot is cold. What kind of disturbances of regional blood flow appeared in this patient?

A. Angiospastic ischemia

B. Ischemic stasis

C. Compressive ischemia

D. Venous (passive) hyperemia

E. Obstructive ischemia

6. Edema and cyanosis of low extremities appear in a food shop assistant at the end of workday. What is the main factor of edema development in this patient?

A. Dilatation of resistant vessels

B. Orthostatic increase of venous pressure

C. Increase of number of functional capillaries

D. Increase of collateral blood flow

E. Increase of tissue drainage

7. Redness and increase in volume of affected place of tissue, and increase in local temperature are observed in a patient with burn of thigh. What pathologic process do indicated symptoms correspond to?

A. Arterial hyperemia

B. Venous hyperemia

C. Thrombosis

D. Ischemia

E. Stasis

8. A 23-year-old woman had intense psycho-emotional excitement. Hyperemia of face skin, tachycardia and increase in BP were observed in her. What is the mechanism of redness of her face skin?

A. Congestive venous hyperemia

B. Neuroparalytic arterial hyperemia

C. Post-ischemic arterial hyperemia

D. Neurotonic arterial hyperemia

E. Stasis

9. Dyspnea, sharp pain in the chest, cyanosis, and jugular venous distention suddenly develop in a patient with thrombophlebitis of lower extremities. What is the most possible disorder of blood circulation developed in the patient?

A. Thromboembolism of coronary vessels

B. Thromboembolism of mesenteric vessels

C. Thromboembolism of cerebral vessels

D. Thromboembolism of portal vein

E. Thromboembolism of pulmonary artery

10. Burning in the mouth appears after taking of food with pungent dressings. At examination mucosa of oral cavity is edematous, hyperemic, and bright red. What major reasons underlie disorders of microcirculation?

A. Congestion

B. Neuroparalitic arterial hyperemia

C. Postischemic arterial hyperemia

D. Atonic hyperemia

E. Degranulation of tissue basophiles

11. A woman experienced a strong psycho-emotional excitement during dentist’s reception. Redness of her face skin and profuse salivation were noticed at that time. What is the mechanism of these phenomena?

A. Manifestation of sympathetonic effect

B. Stagnant venous hyperemia

C. Neuroparalitic arterial hyperemia

D. Postischemic arterial hyperemia

E. Neurotonic arterial hyperemia

12. Patient’s arm was put in plaster cast on account of simple fracture of humeral bone. Swelling, cyanosis, and decrease in temperature of the traumatized arm appear next day. What disorder of peripheral blood flow do these symptoms testify to?

A. Thrombosis

B. Venous hyperemia

C. Ischemia

D. Embolism

E. Arterial hyperemia

13. Injury of sympathetic fibers of the sciatic nerve developed in a patient due to trauma. What kind of peripheral blood flow disorder takes place in the patient?

A. Neurotonic arterial hyperemia

B. Venous hyperemia

C. Angiospastic ischemia

D. Neuroparalitic arterial hyperemia

E. Obturative ischemia

14. A 42-year-old woman, shop assistant by profession, complains of edema of the lower extremities at the end of a workday. Her legs are cyanotic, their temperature is decreased. Venous hyperemia of lower extremities was established, which is due to constitutional weakness of the elastic apparatus of veins and the occupation. What is the major pathogenic factor causing local changes in venous hyperemia?

A. Disorders of metabolism

B. Hypoxia

C. Atrophy

D. Dystrophy

E. Sclerosis

15. Puncture of abdominal cavity for the extraction of fluid was performed to a 45-year-old patient with diagnosis “cirrhosis of liver, ascites”. State of unconsciousness suddenly developed in the patient as a result of decrease in blood pressure after extraction of 5L of fluid. That was considered as a manifestation of brain blood circulation insufficiency. Which disorder of microcirculation occurs in this case?

A. Ischemia

B. Arterial hyperemia

C. Venous hyperemia

D. Thrombosis

E. Embolism

16. Signs of disorders of microcirculation in form of venous hyperemia were observed in a patient with gingivitis. This condition manifested by cyanosis and edema of mucosa and decrease in local temperature. What is the major mechanism of congestion development?

A. Blood factors

B. Perivascular changes

C. Disturbances of lymph outflow

D. Exudation from vessels

E. Increased permeability of vessel wall

17. C. Bernard observed increase in secretion of submandibular salivary gland and development of arterial hyperemia irritating chorda tympani (branch of nervus facialis) in an experiment. What sort of arterial hyperemia it is according to mechanism of its development?

A. Neuroparalytic

B. Neurotonic

C. Metabolic

D. Reactive

E. Working

18. Thrombosis of coronary artery results in myocardial infarction. Which mechanisms will be dominating ones in this disease?

A. Electrolytic-osmotic

B. Acidosis

C. Protein-dependent

D. Lipid-dependent

E. Calcium-dependent

19. One of the most dangerous points in myocardial infarction pathogenesis is enlargement of the zone of necrosis, dystrophy, and ischemia. Increase in myocardial oxygen consumption plays important role in development of indicated processes. What substances contribute to this process?

A. Chlorine ion

B. Cholesterol

C. Catecholamines

D. Acetylcholine

E. Adenosine

20. High level of arterial blood pressure is observed in a patient with renal disease accompanied by ischemia of renal parenchyma. What is the leading factor of increase in arterial blood pressure in this patient?

A. Excess of angiotensin II

B. Excess of antidiuretic hormone

C. Augmentation of cardiac output

D. Increase in tonus of sympathetic nervous system

E. Hypercatecholaminemia

21. Patient has acute retrosternal pain irradiating into left arm, which cannot be controlled by the nitroglycerine for 30 minutes. What kind of changes develop in the patient’s heart?

A. Myocardial ischemia

B. Pathological hypertrophy of myocardium

C. Sharp increase in coronary blood flow

D. Mitral valve insufficiency

E. Inflammation of pericardium

22. Severe stress was induced in an experimental animal. Under this condition, necrotic changes of myocardium developed in the animal. What is the leading reason for pathogenesis of this injury?

A. Increase in calcium content in cardiomyocytes

B. Decrease in mitochondrial ATP synthesis

C. Affection of Na-K pump functions

D. Coronary blood flow insufficiency

E. Increase in myosin ATP-activity

23. After fast surgical removing of coronary artery occlusion in a patient with ischemic heart disease, secondary injury of myocardium develop (reperfusion syndrome) characterized by necrobiotic changes in the focus of previous ischemia. This complication results from:

A. Accumulation of hydrogen ions

B. Deficiency of potassium ions

C. Deficiency of adenosine triphosphate

D. Excessive accumulation of calcium ions

E. Deficiency of creatine phosphate

24. Phlebothrombosis of the profound veins of lower extremities with subsequent pulmonary thromboembolism develop in a patient operated for chronic ulcer of duodenum at the postoperative period. Which functional disorder of those that develop in this case is the most important?

A. Abrupt drop of arterial blood pressure

B. Increase in central venous pressure

C. Increase in pressure in pulmonary artery

D. Acute right ventricular failure

E. Changes of ventilation-perfusion ratio in the lungs

25. A 57-year-old man complains of heart pain that has developed after prolonged negative emotions. An emergency doctor diagnosed ischemic heart disease manifesting by stenocardia. What kind of ischemia is the most probable?

A. Compressive

B. Obliterative

C. Angiospastic resulting from deficiency of vasodilators

D. --

E. Obturative

26. Condition of a patient with thrombophlebitis of lower extremities suddenly became worse. Weakness, giddiness, dyspnea, pain in the chest, and cyanosis developed in him. It was established that pulmonary thromboembolism results in acute cor pulmonale. What is the leading link in forming of this syndrome?

A. Increased blood pressure in pulmonary artery

B. Increase in central venous pressure

C. Abrupt arterial blood pressure drop in systemic circulation

D. Weakening of heart function resulting from myocardial hypoxia

E. Disorders of external respiration

27. Atophan, which leads to vessel sclerosis, was introduced to gastric arteries of an experimental animal with purpose of gastric ulcer modeling. Which mechanism of gastric mucosa injury is the leading one in this experiment?

A. Hypoxic

B. Neurodystrophic

C. Mechanical

D. Dysregulative

E. Nerohumoral

28. The theory exists that atherosclerosis plays an important role in periodontitis development, affecting vessels of gums. What kind of local blood circulation disorders develops under atherosclerosis of vessels?

A. Active hyperemia

B. Passive hyperemia

C. Embolism

D. Ischemia

E. Disorders of lymph outflow

29. Instantaneous death of pilots occurs under depressurization of airplane cabin at the altitude of 19 km. What is the reason for it?

A. Multiple gas embolisms

B. Hemorrhage to the brain

C. Gas embolism of cerebral vessels

D. Bleeding

E. Paralysis of respiratory center

30. A patient has acute pain in his chest, dyspnea, tachycardia, cyanosis, and decreased BP. Pulmonary infarction was diagnosed in this patient. Which factor is the most common cause of pulmonary infarction?

A. Embolism by thrombus from veins of lower extremities

B. Congestion in the pulmonary circulation

C. Increase in number of platelets

D. Activation of fibrinolytic system

E. Pneumothorax

31. A 50-year-old patient suffers from endarteritis. Which of the following symptoms is the most characteristic one for this pathology?

A. Decreased temperature of lower extremities

B. Cyanosis

C. Increased temperature of lower extremities

D. Edema

E. Enlargement of volume of extremities

32. Pulmonary embolism developed in a patient with coxal bone fracture. What kind of embolism does this patient have?

A. Fat

B. Thromboembolism

C. Tissue

D. Gas

E. Air

33. Gas embolism developed in a diver who was lifted to the surface very fast. It results from fast change:

A. From increased atmospheric pressure to normal

B. From normal atmospheric pressure to increased

C. From normal atmospheric pressure to decreased

D. From decreased atmospheric pressure to normal

E. --

34. Acute heart arrest develops in a patient with thrombophlebitis of calf profound veins. What is its reason?

A. Pulmonary thromboembolism

B. Left ventricle hypertrophy

C. Myocardial dystrophy

D. Endocarditis of mitral valve

E. Atherosclerosis

35. Convulsions and loss of consciousness develop in a diver during the emergency raising from the depth. What is the major pathogenic mechanism in these disorders development?

A. Gas embolism

B. Hypoxia

C. Toxic action of oxygen

D. Toxic action of nitrogen

E. Hypercapnia

36. Destruction of endothelial layer of vessel leads to vasoconstriction. Decreased secretion of endothelial-derived factor plays the leading role in this phenomena development. What is this factor?

A. Nitric oxide

B. Adenosine

C. Histamine

D. Bradykinin

E. Adenosine monophosphate

37. What changes develop in human organism in case of depressurization of airplane cabin at altitude of 19 km?

A. Gas embolism

B. Compensatory augmentation of biologic oxidation in tissues

C. Increase in body temperature

D. Compensatory augmentation of heart work

E. Disorders of muscular coordination

ANSWERS:

1-E, 2-D, 3-A, 4-A, 5-D, 6-B, 7-A, 8-D, 9-E, 10-E, 11-E, 12-B, 13-D, 14-B, 15-A, 16-E, 17-B, 18-E, 19-C, 20-A, 21-A, 22-A, 23-D, 24-D, 25-C, 26-A, 27-A, 28-D, 29-A, 30-А, 31-А, 32-А, 33-А, 34-А, 35-А, 36-А, 37-А.

Дата добавления: 2015-07-25