База тестів крок-1 з патофізіології (пмк-1)



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Test 183

A 33-year old woman suffering from infectious myocarditis complains of a strong pain behind the sternum and breathlessness. On her examination: the respiratory rate is 23 per minute, the stroke volume is decreased, the BP- 70/40 mmHg. Cardiogenic shock is diagnosed. What is the leading mechanism of shock in the patient?



  1. Decreased venous return

  2. Loss of vessel tone

  3. Obstruction to blood flow to the heart

  4. Hypovolemia

  5. Decrease of myocardial contractility


Test 184

Patient with crush syndrome develops vomiting, bradycardia, hypotension, oliguria, laky-red color of the urine. Which of the following mechanisms is responsible for damage to the kidney in the patient?



  1. Hypotension

  2. Release of tissue decay products into the blood

  3. Dehydration

  4. Hemolysis of erythrocytes

  5. Acidosis


Test 185

An 18- year old man is admitted to a hospital. On his examination: the patient is in a soporous state, adynamic, his skin is dry; Kussmaul’s respiration and acetonic smell from his mouth are revealed. The blood glucose is 15,1 mmol/L. Which of the following kinds of coma does the patient develop?



  1. Hypoglycemic

  2. Lactacidemic

  3. Uremic

  4. Hypergosmolar

  5. Ketonemic

Test 186

A 50 –year old woman is hospitalized to clinic in unconsciousness state. Relatives said that she suffers from diabetes mellitus. During last week she complained of weakness, somnolence and thirst. Objectively: the skin is dry, the respiration is deep and noisy, the BP- 90/50 mmHg. Results of the tests: plasma glucose- 15, 0 mmol/L, urine glucose- 5%. Which of the following blood indexes are necessary to determine so to start with treatment?



  1. LDH, alkaline phosphatase

  2. Bilirubin, cholesterol

  3. Urea, creatinine

  4. Acide-base balance

  5. Total protein, hemoglobin

Test 187

In the refractory stage of shock a correction of hypotension by means of blood substitutes transfusion does not cause an increase in blood pressure. This phenomenon can be explained by which of the following:



  1. Increase capillary permeability

  2. Depression of the CNS

  3. Hypoproteinemia

  4. Hemodilution

  5. Spasm of resistive vessels


Test 188

A 48-year old man is unconsciousness. The reflexes are absent. The skin is pale and edematous. Muscle fibrillation, mydriasis, Cheyne-Stokes respiration, and smell of ammonium from the mouth are observed. Which of the following kinds of coma develops in the patient?



  1. Hepatic

  2. Ketoacetonemic

  3. Uremic

  4. Hyperosmolar

  5. Hypoglycemic


Test 189

A 25- year old woman is admitted to a hospital. On the examination: her skin is pale, moist with a normal turgor; her pulse - 90 per min, BP -135/85 mmHg; her respiration rate -18 per min. The patient is extremely excited. There is neither acetonic nor alcohol breath. Her neighbor said that she suffers from diabetes mellitus since her childhood and uses insulin for a treatment. Which of the following is likely the cause of the patient’s state?



  1. Alcohol intoxication

  2. Hyperketonemia

  3. Hypoglycemia

  4. Hyperlactacidemia

  5. Hyperosmolar dehydration


Test 190

A 13-year old boy in unconsciousness state is admitted to reanimation department. On his examinatiom: plasma glucose- 17,3 mmol/L; acetone smell from the mouth. An increase in which of the following substances is likely to be the cause of patient’s unconsciousness?



  1. Keton bodies

  2. Lactic acid

  3. Fatty acid

  4. Glucose

  5. Urine


Test 191

A 10-year old girl is admitted to clinic. Her respiration is noisy and deep. There is fruit smell from her mouth. On her examination: blood glucose - 15, 2 mmol/L, ketone bodies -100 mkmol/L. Which of the following kinds of coma is moslikely she developing?



  1. Hypoglycemic

  2. Hyperosmolar

  3. Tyrotoxic

  4. Hepatic

  5. Ketonemic



Test 192

Diabetic coma develops in a patient suffering from diabetes mellitus. It is characterized by a loss of consciousness, an absence of reflexes, hypotension, a decrease in body temperature, and a great, loud respiration. Which of the following kinds of respiration does she develop?



  1. Kussmaul’s

  2. Cheyne-Stokes

  3. Biot’s

  4. Apneustic

  5. Gasping


Test 193

A 43- year- old man is admitted to hospital in an unconscious state. Objectively: the skin is dry, the breathing is frequent and superficial, the smell of acetone is absent, and the pulse- 126 per min., BP - 70/40 mm Hg. The blood glucose level is 48 mmol/L, acetone is absent in the urine. Which of following states are these symptoms typical of?



  1. Toxic coma

  2. Hyperketonemic coma

  3. Lactatacidemic coma

  4. Collapse

  5. Hyperosmolar coma


Test 194

A 22 year- old man with coma is admitted to hospital. On his examination: decreased skin turgor, acetone smell from his mouth, Kussmaul’s respiration, pulse of 130 per minute, BP - 95/60 mmHg, blood glucose - 21.7mmol/L are revealed. Which of the following pathological conditions are these symptoms characteristic of?



  1. Prolonged starvation

  2. Ketonemic coma

  3. Hyperosmolar coma

  4. Lactatacidemic coma

  5. Alcoholic intoxication




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