Topic 11. Fever

1. A 52-year-old woman complains to bad pain around her abdomen and back. Acute appendicitis was diagnosed. There is suspicion of complication of pancreatitis by abscess. Which type of fever would corroborate appearance of abscess?

A. Hectica

B. Continuous

C. Remittent

D. Intermittent

E. Atypical

2. Polyuria developed in a patient with fever after period of olyguria. What is the leading factor of diuresis change at the end of the second period of fever?

A. Normalization of hormonogenesis by adrenal medulla

B. Normalization of hormonogenesis by reticular zone of adrenal cortex

C. Normalization of hormonogenesis by glomerular zone of adrenal cortex

D. Normalization of hormonogenesis by fascicular zone of adrenal cortex

E. Normalization of thyroid gland function

3. A patient has felt cold, chills, “goose flesh”, increase of body temperature. Which else changes characterize the first period of rapid elevation of body temperature?

A. Tachycardia

B. Equilibration between heat production and heat loss

C. Dilation of skin vessels

D. Decrease of arterial pressure

E. Increase of metabolism on 100-200%

4. Body temperature of patient becomes pyretic. Which substances have to act to neurons of thermoregulation for fever development?

A. Interferon

B. Kallidinum

C. Prostaglandins

D. Free radicals

E. Leucotriens

5. Fever in a patient develops in following succession of stages:

A. Incrementi; fastigii; decrementi

B. Incrementy; decrementy; fastigii

C. Fastigii; decrementi; incrementi

D. Fastigii; incrementi; decrementi

E. Decrementi; fastigii; incrementi

6. The temperature of a patient with infectious disease increased to 39.5-40.5 ⁰ C in a day and kept that level about 1 hour, but then it returned to the normal level. Which type of fever is described in that case?

A. Continuous

B. Intermittent

C. Remittent

D. Recurrent

E. Atypical

7. The body temperature of a patient with infectious disease increased to 39.5-40.5 ⁰ C in a day and kept this level about 1 hour, but then became normal again. Which disease is characterized by described type of fever?

A. Tuberculosis

B. Influenza

C. Peritonitis

D. Brucellosis

E. Malaria

8. A patient had fever after injection of pyrogenal. His skin has become pale, cold; chill appeared in him, oxygen consumption increased. How do the processes of thermoregulation change in described period of fever?

A. Increase of heat production and decrease of heat loss

B. Decrease of heat loss

C. Heat loss is equal heat production

D. Decrease of heat production and increase of heat loss

E. Decrease of heat production

9. Body temperature of the 8-year-old Sasha with meningitis was on the level 39-40 ⁰C for a week. After 8 days under the influence of antibiotics the temperature has decreased to 36.8 ⁰C in 1.5 hours. There were acute hyperemia of skin, profuse sweating, decrease of arterial pressure, and loss of consciousness in him. Which medicine is the pathogenetic remedy?

A. Vasoconstrictors

B. Antibiotics

C. Antipyretics

D. Pyrogenal

E. Sulfanilamide

10. After being in the room with air temperature 40 ⁰C and humidity 80% a patient has been brought to hospital in grave condition. He was unconscious; he had tachypnea, tachycardia, and body temperature 41 ⁰C. Reanimation was failed. The patient has died. What is the most possible direct reason of death in this case?

A. Paralysis of the breath center

B. Collapse

C. Coagulation of blood and decrease of volume of circulating blood

D. Dehydration

E. Heart failure

11. Fever of the patients with relapsing fever is characterized by several periods of pyretic temperature per day and several periods of normal temperature. Such type of temperature curve is called:

A. Febris hectica

B. Febris intermittens

C. Febris continua

D. Febris recurrens

E. Febris atypica

12. Sharp increase of the temperature to 38.7 ⁰C was marked in a patient with acute purulent periodontitis. His body temperature has decreased to normal level after opening the pulp cavity. Which type of fever was in the patient?

A. Efemeral

B. Septic

C. Recurrent

D. Remittent

E. Continua

13. A patient suffers from osteomyelitis of maxilla. His body temperature increases to 40 ⁰C and then sharply decreases to 35.6 ⁰C every day. Which type of fever curve is characterized by these changes?

A. Continua

B. Intermittent

C. Reccurens

D. Atypica

E. Hectica

14. Pallor of the skin, “goose flesh” and increase of oxygen consumption appeared in the patient’s skin after injection of pyrogenal. Which stage of fever is characterized by these changes?

A. Stadium incrementi

B. Stadium fastigii

C. The stage of falling temperature by crisis

D. The stage of falling temperature by lysis

15. Acute increase of body temperature, dyspnea, tachycardia, nausea, convulsions, and loss of conciousness developed in a worker, working in the thick uniform in summer. What was the most possible reason of development of those symptoms?

A. Equilibration between heat loss and heat production

B. Decrease of heat production

C. Decrease of heat loss

D. Increase of heat production

E. Increase of heat loss

16. A man in light clothes is staying in a room with air temperature +14 ⁰C. Windows and doors are closed. Which way of heat loss is the most considerable in this case?

A. Evaporation

B. Perspiration

C. Conduction

D. Radiation

E. Convection

17. Experimental mice were kept in a lodge with air temperature 4 ⁰C. Which adaptive reaction supplies its thermal homeostasis?

A. Limitation of heat loss

B. Decrease of oxygen consumption

C. Anabiosis

D. Increase of blood consumption

E. Decrease of oxidation enzyme activity

18. Inclination of the set point of thermoregulation to higher level due to action of IL-1 is in a patient. What is the name of this typical pathological process?

A. Fever

B. Hyperthermia

C. Hypothermia

D. Inflammation

E. Hypoxia

19. The body temperature of a patient with crupous pneumonia is 39 ⁰C. The difference between the morning and evening temperature of his body didn’t exceed 1 ⁰C during 9 days. Which type of the fever curves was that?

A. Continua

B. Hectica

C. Intermittent

D. Hyperpyretic

E. Reccurens

20. A patient has fever with following stages: incrementi, fastigii, decrementi. Which disease these features can characterize?

A. Acute pneumonia

B. Acromegaly

C. Diabetes mellitus

D. Hyperaldosteronism

E. Myocardial hypertrophy

21. Body temperature of patient is pyretic; his skin is hot and red. What was the correlation between processes of heat production and heat loss in described stage of fever?

A. Heat loss is equal heat production

B. Heat loss is more then heat production

C. Heat production is more then heat loss

D. Heat loss is less then heat production

E. Heat production is less then heat loss

22. The body temperature of a patient with pneumonia was keeping on the level 38.3-38.5 ⁰C all the first week of disease. Such fever is called:

A. Febrile

B. Hyperpyretic

C. Pyretic

D. Subfebrile

23. Increase of “acute phase” proteins level in blood such as ceruloplasmin, fibrinogen, C-reactive protein is typical for development of fever. Indicate the possible mechanism of this phenomenon.

A. Stimulative influence of IL-1 on hepatocytes

B. Destructive action of elevated temperature to the cells of the organism

C. Proliferate action of IL-2 to T-lymphocytes

D. Adaptive reaction of the organism to pyrogen

E. Degranulation of mast cells

24. Most infectious diseases are characterized by development of fever. It can be explained:

A. Formation of IL-1 during phagocytosis of microorganisms

B. Intoxication of the organism

C. Degranulation of mast cells

D. Activation of T- and B-lymphocytes

E. Processes of exudation

25. Attacks of fever in a patient occur periodically. During the attack the body temperature sharply increases, keeps pyretic level nearly 2 hours and then decreases to normal level. This type of fever is typical for:

A. Tertian fever

B. Sepsis

C. Brucellosis

D. Relapsing fever

E. Epidemic typhus

26. Body temperature of a patient is 39 ⁰C for several hours (stadium fastigii). Indicate which changes of physiological functions are the most typical for this stage of fever.

A. Bradycardia

B. Ingibition of phagocytosis

C. Increase of heat production

D. Increase of heat production

E. Heat production is equal heat loss

27. In a patient with pneumonia the increased body temperature was revealed. What sort of biological active substances play the most important role in development of fever?

A. Interleukin-1

B. Leukotriens

C. Serotonin

D. Histamine

E. Bradykinin

28. In a patient with prolonged fever after the course of treatment body temperature begins decreasing. What is the possible mechanism of temperature decrease?

A. Protective activation of immune system

B. Decrease of heat production due to reducing metabolic rate

C. Decrease of production of pyrogens

D. Increase of resistance of organism to action of the pyrogens

E. Increase of heat loss due to peripheral vasodilatation

29. What is the most efficient mechanism of heat loss in case of following environmental conditions: 80% air humidity and +35^oC (95 degree Fahrenheit) air temperature?

A. Hyperventilation

B. Sweating

C. Conduction

D. Convection

E. Irradiation

30. During the examination of the patient following symptoms were revealed: redness of skin, skin is hot and dry to touch, heart bit rate is 92 per minute, respiratory rate is 22 per minute, body temperature is 39,2^oC (102.5 degree Fahrenheit). What is the correlation between heat production and heat loss in described period of fever?

A. Heat production surpasses heat loss

B. Heat production equals to heat loss

C. Heat production is less than heat loss

D. Decreasing of heat production without changes of heat loss

E. Increasing of heat production without changes of heat loss

31. Animal was injected with pyrogen to reproduce fever. What mechanism starts process of temperature increasing?

A. Activation of non-shivering thermogenesis

B. Activation of shivering thermogenesis

C. Rise of set point of thermoregulation in hypothalamus

D. Reduction of heat loss

E. Dissociation of oxidation and oxidative phosphrilation in tissues

32. In a patient with third stage of fever reaction following manifestations observed: abundant sweating, tachypnea (increase in respiratory rate), decrease of body temperature. What is the mechanism of development of these symptoms?

A. Reduction of shivering thermogenesis

B. Secondary aldosteronism

C. Rise of set point of thermoregulation in hypothalamus

D. Predomination of heat production over the heat loss

E. Peripheral vasodilatation

33. Patient, who has been suffering from malaria, has weakness of heart activity and tachycardia during the stage of heart loss. What is the name of this complication?

A. Infectious-toxic collapse

B. Bacterial shock

C. Hemorrhage collapse

D. Ortostatic shock

E. Hemorrhage shock

34. Adaptation of organism disturbances to decrease of environmental temperature when using medicines alpha-adrenoblokators. Which mechanism is responsible for this?

A. Formation of primary heat

B. Constriction of skin vessels

C. Contractile thermogenesis

D. Sweating

35. After blood trasfusion patient complaints feeling of heat, rigor, increase of body temperature to +40⁰C. Its known the cause of elevation temperature is secretion of endogenous pyrogens. Which cells produce endopyrogens?

A. Erythrocytes

B. Platelets

C. Endotheliocytes

D. B-lymphocytes

E. Macrophages

36. The different types of temperature curve are reported on examination of the infected patients. What other pathological conditions can lead to the fever?

A. Isoosmotic hyperhydratation

B. Sistemic immune complex diseases

C. Excess production of glucocorticoids

D. Protein starvation

E. Hypohonadism

ANSWERS:

1.-С. 2.-D. З.-В. 4.-В. 5.-А. 6.-А. 7.-А. 8.-В. 9.-А. 10.-Е. 11.-С. 12.-В. 13.-А. 14.-С. 15.-А 16.-В. 17.-Е. 18.-А. 19.-А. 20.-А. 21.-D. 22.-A. 23.-Е. 24.-А. 25.-С. 26.-D 27.-А. 28.-А. 29.-А. ЗО.-А. 31.-А. 32.-А. ЗЗ.-А. 34.-А. 35.-А. 36.-Е.

Дата добавления: 2015-07-25