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?
Period of primary reactions
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.
Paralysis of inspiration center
Paralysis of respiratory muscles
Reflex respiratory standstill (pain shock)
Total paralysis of respiratory center *
3. Increase of body temperature up to 38.5oC, 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?
4. Elevation of arterial pressure, tachycardia, and increase in body temperature to 38,8oC developed in a patient during narcosis with myorelaxants. Which disturbance of heat exchange appeared in this patient?
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
6. During long hypothermia of the organism phase of decompensation developed. Its feature is:
Decrease in blood pressure *
Constriction of peripheral vessels
Increase in muscle tone
7. A man took electric wire with high tension by both hands. He died momentary in result of:
Cardiac fibrillation *
Tearing extremities off
8. The main link in pathogenesis of kinetosis under radial acceleration is:
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?
Bone marrow *
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?
Leucocytosis and lymphocytopenia
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 *
Fibrillation of atria
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?
Increased outcome of mature leukocytes from bone marrow
Development of autoimmune processes
Increase in migration of granulocytes to tissues
Elevated destruction of leukocytes
Oppression of leucopoiesis *
13. A patient has bone marrow form of radiation diseases. What lineages of hemopoiesis are affected in this case?
14. Symptoms of hemorrhage syndrome appeared in a patient with radiation sickness.
Which mechanism is leading one in pathogenesis of this syndrome?
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?
Right hand – head *
Left leg - right leg
Right leg - right hand
Left leg - right hand
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?
Decompression diseases *
High altitude diseases
Lowering of reactivity
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?
Modification of skin proteins due to action of nickel ions with immunopathological reaction development *
Irritant action of nickel compounds on skin
Vegetative disorders related to nickel compounds received by respiratory tract
Infection of skin due to microtraumas
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 *
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?
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?
Ultraviolet radiation *
Exogenous chemical carcinogens
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?
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?
Blood 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?
Explosive decompression syndrome
Decompression syndrome *
Toxic influence of gases dissolved in the blood
24. What is the reason for pneumonia development in children after cooling?
Decrease in reactivity due to previous diseases
Insufficiency of nutrition
All these factors
25. Which changes are connected to direct injurious action of ionizing radiation?
Inhibition of DNA-synthesis under the influence of radiotoxines
Radiolysis of water
Interaction between free radicals and enzymes
Injury of chromosomes *
26. What reasons does high radiosensitivity of cells and tissues depend on?
High mitotic activity *
Activation of glycolysis
Level of differentiation
Number of mitochondria
Decrease of DNA-synthesis
27. Which changes in blood are typical for the first period of bone marrow form of acute radiation diseases?
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?
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?
Burn shock *
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?
General cooling of organism
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 *
32. A 45-year-old man suffering from hematoporphyria 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?
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 37,8oC, 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?