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Topic 19. Pathophysiology of cardiovascular system

Дата конвертації25.01.2021
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Topic 19. Pathophysiology of cardiovascular system.
1. Thrombosis of coronary artery caused the development of myocardial infarction. What mechanism of the impairment will be dominating in this disease?

  1. Electrolyte-osmotic;

  2. Acidotic;

  3. Protein;

  4. Lipid;

  5. Calcic.*

2. Acute cardiac insufficiency appeared in a patient with arterial hypertension due to hypertensive crisis. What mechanism of cardiac insufficiency is the main in this case?

  1. Overload of heart by resistance;*

  2. Absolute coronary insufficiency;

  3. Relative incompetence;

  4. Overload of heart by rush of blood;

  5. Myocardial impairment.

3. A patient aged 59 was hospitalized at cardiological department in a severe state with the diagnosis of acute myocardial infarction of the posterior wall of the left ventricle and septum, and starting pulmonary edema. What is primary mechanism which causes the development of pulmonary edema in the patient?

  1. Pulmonary arterial hypertension;

  2. Left ventricular failure;*

  3. Pulmonary venous hypertension;

  4. Hypoxemia;

  5. Decrease of alveolocapillary diffusion of oxygen.

4. A female patient aged 18, complains of general weakness, quick fatigability, depressed mood. She has asthenic type of constitution. Pulse 68 per min., BP-90/60mm Hg. Primary neurocirculatory arterial hypertension was diagnosed. What is the main factor of decreasing of arterial pressure in a patient?

  1. Decrease of minute volume of the blood;

  2. Decrease of cardiac output;

  3. Decrease of the tension of resistant vessels;*

  4. Hypovolemia;

  5. Deposition of the blood in the vines of systemic circulation.

5. A patient has stable and marked increase of arterial pressure, increased extracellular fluid volume, increased content of Na+ and decrease of K+ in the blood, positive effect of saluretic treatment. What is the mechanism of development of hypertension in the patient?

  1. Mineralocorticoid*

  2. Renin-angiotensin

  3. Renovascular

  4. Reflexogenic

  5. Centroischemic

6. While climbing upstairs on the 5th floor a patient has got an increased arterial pressure. The cause is the increase of: A. Minute volume of the blood*

  1. The number of functioning capillaries

  2. Content of ions in blood plasma D. Viscosity of the blood

E. Circulating volume of the blood
7. On the diagnosis of myocardial infarction the main role belongs to enzymodiagnosis. The definition of content level in the blood of what enzyme is the most important during the first 2-4 hours after infarction?

  1. Aldolase

  2. Lipoprotein lipase

  3. Alanine aminotransferase

  4. Creatine phosphokinase*

  5. Acetylcholinesterase

8. On analysis ECG it was determined: sinus rhythm, correct, interval RR is 0.58 sec, location and duration of other intervals, waves and segments are not changed. Call the type of arrhythmia: A. Sinus tachycardia*

  1. Sinus bradycardia

  2. Idioventricular rhythm

  3. Sinus arrhythmia

  4. Ciliary arrhythmia

9. One of the most dangerous moments in pathogenesis of myocardial necrosis is the further increase of the zones of necrosis, dystrophy and ischemia. The important role in this belongs to the increase of the use of the oxygen by myocardium. What substance contributes to this process?

  1. Chlorine ion

  2. Cholesterol

  3. Catecholamine*

  4. Acetylcholine

  5. Adenosine

10. The functioning of certain structures is stopped on the isolated heart by means of cooling. What structure is cooled if due to this the contractions stopped at first, but then they began with a rate 2 times slower than initial one?

  1. Sinoatrial node*

  2. Purkinje's fibers

  3. Limbs of His’ bundle

  4. Atrioventricular node

  5. His’ bundle

11. A patient with chronic glomerulonephritis has edema, BP is 210/100 mmHg; the rate of heartbeat is 85 per minute; the borders of the heart are dilated. What is the leading mechanism in the development of arterial hypertension?

  1. Increase of the activity of sympathetic adrenal system

  2. Hyperfunction of the heart

  3. Activation of renin-angiotensin-aldosterone system*

  4. Increase of circulating volume of the blood

  5. Increase of vasopressin output

12. The patient’s ECG shows that interval RR=1.5 sec, heart rate - 40 per min. What is the pacemaker of the heart?

  1. Left limb of His’ bundle

  2. Sinus node*

  3. His’ bundle

  4. Right limb of the His bundle

  5. Atrioventricular node

13. Pulmonary edema developed in a patient with hypertonic crisis. What is the main factor in the pathogenesis of his state?

  1. Increase of arterial pressure

  2. Permeability increase of the vessels of pulmonary circulation

  3. Increase of hydrostatic pressure in the capillary of the lungs.*

  4. Resistibility increase of the lung vessels E. Decrease of oncotic pressure of blood plasma.

14. During the examination of blood for activity of AST and ALT in the patient who complained of pain in the chest and in upper part of the abdomen, the following results were received: activity of AST 2 times higher than ALT activity. What disease does the patient have? A. Acute infectious hepatitis

  1. Acute pancreatitis

  2. Myocardial infarction*

  3. Chronic hepatitis

  4. Cirrhosis of the liver

15. Redistribution of organ blood supply took place in a young man, aged 20 during the load. What organ did the blood flow increase in most of all?

  1. Brain

  2. Kidneys

  3. Liver

  4. Skeletal muscles*

  5. Heart

16. Clinical signs of developing pulmonary edema appeared in a patient with cardiac insufficiency of left ventricular type. Which of the pointed pathogenic mechanism is the primary in such pathology?

  1. Hydrodynamic

  2. Congestive*

  3. Colloid-osmotic

  4. Lymphogenous

  5. Membranogenic

17. A patient has cyanosis, increase of the liver, edema of the lower extremities due to the right ventricular insufficiency. What is the cause of the development of right ventricular failure?

  1. Cardiogenic cirrhosis of the liver.

  2. Functional shunting in lungs

  3. Hypercatecholaminemia

  4. Increase of venous pressure

  5. Hypotension of pulmonary circulation*

18. A woman, aged 25, complains of constant pain in the heart area, breathlessness on movement, and general malaise. She has pale and cold skin, acrocyanosis. Her pulse is 96/min and her BP is 105/70 mmHg. Heart border in her shifted 2 cm left. The first sound is weakened over the apex of heart; there is systolic murmur over the apex. Diagnosis is insufficiency of the mitral valve of the heart. What is the cause of the blood circulation failure?

  1. Myocardial overload by the increased blood volume*

  2. Myocardial overload by the increased of resistance of blood outflow

  3. Myocardial failure

  4. Volume decreased of circulating blood

  5. Volume increased of vascular bed

19. A patient with acute myocardial infarction was being given 1500ml of different solutions intravenously during 8 hours, oxygen intranasally. Death occurs due to pulmonary edema. What was the cause of the pulmonary edema?

  1. Overload of the left ventricle by the volume*

  2. Decrease of oncotic pressure due to hemodilution

  3. Allergic reaction

  4. Neurogenic reaction

  5. Oxygen inhalation

20. Functional hypertrophy of the left ventricle of the heart developed in a sportsman, aged 20, due to constant physical load. What morphofunctional process do these changes result from?

  1. Increase of cell size and number of contractile organelles*

  2. Increase of fibroblast number

  3. Increase of the number of conductive cardiomyocytes

  4. Increase of the amount of connective tissue

  5. Increase of the amount of fat tissue

21. A patient with renal disease accompanied by parenchyma ischemia has a high arterial pressure. What leading factor is the cause of the increase of BP in this patient?

  1. Excess of angiotensin II*

  2. Excess of antidiuretic hormone

  3. Increase of heart output

  4. Increase of sympathetic nervous system tonus

  5. Hypercatecholaminemia

22. During the operation reflex increased of vagus nerve influence on the heart happened. What may occur in this case?

  1. Cardiac arrest*

  2. Increase of atrioventricular node conduction

  3. Increase of myocardium conduction

  4. Intensification of myocardium contractions

  5. Increase of heart rate

23. Decrease of R-R interval was revealed on ECG of a man. What changes in the heart work are observed in this case?

  1. Increase of heart rate*

  2. Decrease of heart rate

  3. Increase of force of contractions

  4. Decrease of force contraction

  5. Decrease of force and rate of contractions

24. Large amount of isoenzymes of creatine kinase of MV-form was revealed in the blood of the patient with destructive changes in the muscular tissue. What is the most possible diagnosis? A. Myocardial infarction*

  1. Muscular atrophy

  2. Muscular dystrophy

  3. Polymyositis

  4. Myopathy

25. Patient’s attack of tachycardia was stopped by pressing on the eyeballs (DagniniAschner oculocardiac reflex). In the decrease of the heart rate there is intensification of the influence on the sinoatrial node of:

  1. Vagus nerves*

  2. Sympathetic nerves

  3. Autonomic nervous system

  4. Sympathoadrenal system

  5. Catecholamines

26. Considerable increase of PQ interval was found out on ECG. It means that conduction of stimulation is delayed by:

  1. AV node *

  2. Atria

  3. His’ bundle

  4. Purkinje’s fibers

  5. Ventricles

27. Sharp marked pains in the substernal area that radiate to the left arm cannot be controlled by nitro-glycerine for 30 minutes. What changes developed in the patient’s hearts?

  1. Myocardial ischemia*

  2. Pathological myocardial hypertrophy

  3. Sharp increase of coronary blood flow

  4. Mitral incompetence

  5. Inflammation of pericardium

28. The activity of what enzymes is it necessary to determine in pathology of cardiac muscle with diagnostic and prognostic aim?

  1. Arginase, peptidase, phosphatase

  2. Decarboxylase, decanidase, lactate dehydrogenase

  3. Creatine kinase, transaminase, lactate dehydrogenase* D. Lysozyme, citrate synthetase, succinate dehydrogenase

E. Neuroaminidase, aldolase, hexokinase.
29. A severe stress was caused in an experimental animal. Necrotic injuries of myocardium developed in this stage. What is the main cause in the pathogenesis of these injuries?

  1. Increase of calcium content in cardiomyocytes

  2. Decrease of adenosine triphosphoric acid synthesis in mitochondria

  3. Changes in the work of Na+-K+ pump

  4. Insufficiency of coronary circulation*

  5. Decrease of adenosine triphosphoric acid activity of myosin

30. A patient male has had a chronic disease of kidneys for 12 years. BP - 200/130mmHg. Pulse –75 beats per min. The main factor that causes the increase of pressure in this case is the increase of:

  1. Minute volume of the heart

  2. Heart rate

  3. Circulating volume of the blood D. Systemic peripheral resistance*

E. Venous recurrence.
31. During the attack of heartbeat a patient with thyrotoxicosis has an irregular pulse of different filling, pulse deficiency is observed. Waves P are absent; small in amplitude, disorderly undulations (P waves), and irregular ventricular complexes of ordinary configuration are noted. What kind of rhythm impairment is observed in a patient?

  1. Sinus tachycardia

  2. Sinoatrial block

  3. Ciliary arrhythmia*

  4. Paroxysmal tachycardia

  5. Ventricular extrasystole

32. At examination of a patient strengthening of a second pulmonic sound, hypertrophy of the right ventricle wall are determined. What changes of hemodynamic take place in pulmonary circulation? A. Hyperperfusion of the lungs

  1. Hypoperfusion of the lungs

  2. Manifestation of Hering-Breuer reflex

  3. Development of broncho-alveolar vascular anastomosis

  4. Spasm of resistant vessels in the lungs.*

33. A patient with mitral failure has an enlargement of the liver, edema of lower limbs.

What is the leading mechanism of the development of cardiac edema?

  1. Increase of venous recurrence

  2. Increase of tissue drainage

  3. Participation of renin-angiotensin-aldosterone system* D. Decrease of oncotic pressure

E. Decrease of transudation.

34. At examination a patient’s arterial pressure is 190/100 hg. What factors leads to increase of arterial pressure? A. Spasm of resistance vessels*

  1. Increase of venous recurrence

  2. Toxigenic dilation of cardiac muscle

  3. Aler-Lilestrand reflex E. Kitaev’s reflex.

35. A patient with myocardial infarction has a mark paleness of skin, oliguria, BP 100/90 mm Hg, and pulse 100 beats/min. What compensatory mechanism maintains relative high level of BP?

  1. Hypokalemia

  2. Hypoperfusion of the lungs

  3. Centralization of blood circulation*

  4. Increase of the level of vasodilators in blood

  5. Secondary aldosteronism

36. Marked frequency of the patients pulse was determined during the examination, what is sinus tachycardia due to?

  1. Hypothyrosis

  2. Hypokalemia

  3. Tonus increase of vagus nerve

  4. Increase of speed of slow diastolic depolarization*

  5. Excess of acetylcholine

37. Considerably slow pulse was determined in a patient at examination. What is sinus bradycardia due to?

  1. Decrease of speed of slow diastolic depolarization*

  2. Hypercatecholaminemia

  3. Decrease of circulating blood volume

  4. Hyperkalemia

  5. Hemic hypoxia

38. In cardiac pathology homeometric mechanism of compensation in the work of the left ventricle takes place in:

  1. Stenosis of atrioventricular foramen

  2. Mitral incompetence

  3. Aortic incompetence

  4. Hypertension of pulmonary circulation

  5. Hypertension of systemic circulation.*

39. In cardiac pathology heterometric mechanism of compensation connected with overloading of left ventricle volume takes place in:

  1. Mitral stenosis

  2. Aortic stenosis

  3. Aortic incompetence*

  4. Hypertension of pulmonary circulation

  5. Hypertension of systemic circulation.

40. Acute increase of AST activity was determined in the blood serum of a patient 12 hrs later after an acute attack of pain in the substernal area. Which of the pathogenesis is the most possible? A. Collagenosis

  1. Diabetes mellitus

  2. Myocardial infarction*

  3. Virus hepatitis

  4. Diabetes insipidus

41. Pressing pain in the heart area with irradiation to the left arm, neck and under the left shoulder blade suddenly appeared in a male patient aged 45, after considerable psycho-emotional exertion. His face became pale and covered with cold perspiration. Nitro-glycerin relieved the attack of pain. What process in the patient?

  1. Angina pectoris*

  2. Perforation of stomach ulcer

  3. Psychogenetic shock

  4. Myocardial infarction

  5. Insult

42. In recreation of the arterial hypertension in a dog a thickness in the left ventricle wall increased 1.7 times in a month, but the circulating blood volume was not changed in comparison with the initial data. What stage of myocardial hypertrophy is observed in the animal?

  1. Initial

  2. Repair

  3. Complete hypertrophy*

  4. Decompensation

  5. Progressive cardiosclerosis

43. The rate of spread of pulse wave turned out to be considerably higher in a man aged 70, than in a man aged 25. The cause of this is decrease of:

  1. Arterial pressure

  2. Cardiac output

  3. Elasticity of vascular wall*

  4. Rate of cardiac contractions

  5. Circulation rate

44. On recording ECG of a patient with hyperfunction of the thyroid gland increase of rate of cardiac contractions was registered. Shortening of what ECG element indicates this?

  1. Interval R-R*

  2. Interval P-Q

  3. Interval P-T

  4. Segment P-Q

  5. Complex QRS

45. A patient excretes water from the organism less than he uses it for 24 hours. What disease may lead to this state?

  1. Cardiac insufficiency*

  2. Pancreatitis

  3. Cystitis

  4. Hepatitis

  5. Infectious diseases

46. A man has got an electro trauma. Current went through the cardiac muscle. What dangerous impairment in the work of the heart demanding urgent measures may appear in this situation? A. Bradycardia B. Extrasystole

  1. Atrial fibrillation

  2. Ventricular fibrillation*

  3. Tachycardia

47. A patient who underwent myocardial infarction a month and a half ago had

Dressler’s syndrome with typical triad: pericarditis, pleurisy, and pneumonia. The cause of its development is:

  1. Sensibilization of the organism by myocardial antigens*

  2. Decrease of resistance to infectious agents

  3. Activation of saprophytic micro flora

  4. Intoxication of the organism by necrotic products

  5. Injection of myocardial enzymes in the blood.

48 A patient with rheumatism had incompetence of the left atrioventricular foramen and decompensation of cardiac activity. The characteristic hemodynamic index of this state is:

  1. Decrease of cardiac output*

  2. Slowing down of blood flow

  3. Decrease of arterial pressure

  4. Increase of venous pressure

  5. Widening of microcirculatory bed

49. A patient with rheumatic myocarditis began to feel intermissions in the work of heart. By means of auscultation of the heart, feeling the pulse and ECG investigation it was determined that this was connected with the appearance of ventricular extra systoles the characteristic feature of which is compensatory pause. Its appearance is due to:

  1. Refractivity of ventricular myocardium to the next impulse*

  2. Retention of stimulation in atrioventricular node

  3. Retrograde conduction of stimulation to atria

  4. Inhibition of function of sinoatrial node

  5. Impairment of contraction of ventricular myocardium

50. Considerable increase of myocardial mass of left ventricle was determined in a patient with hypertension. It was due to: A. Increase of cardiomyocyte volume*

  1. Increase in amount of cardiomyocytes

  2. Enlargement of connective tissue

  3. Retention of water in myocardium

  4. Fat infiltration of myocardium

51. A patient with aortic atherosclerosis has left ventricular hypertrophy as a compensatory phenomenon. Compensatory role of hypertrophy comes to:

  1. Normalization of load on each cardiomyocyte*

  2. Improvement of delivery of oxygen to myocardium

  3. Activation of synthesis of macroergs in myocardium

  4. Economical use of energy by cardiomyocytes

  5. Increase of stroke volume of the blood

52. A patient who is treated for myocardial infarction at the in-patient department has lost suddenly his consciousness several times a day. During the attack pulse is absent, heart sounds are not heard, face is cyanotic, and convulsions appear, arterial pressure is not determined. The diagnosis is Morgagni-Adams-Stokes syndrome. It appears due to:

  1. Development of full atrioventricular blockade*

  2. Weakness of sinoatrial node

  3. Attack of ventricular paroxysmal tachycardia

  4. Impairment of excitability of ventricular myocardium

  5. Cardiosclerotic changes in the heart

53. Electrocardiography examination of a patient with hypertension showed such results: right sinus rhythm, rate of cardiac constrictions is 92 per min; duration of PQ - 0.2 sec, QRS without change, a patient has disturbance of:

  1. Refractivity

  2. Conduction

  3. Automatism*

  4. Stimulation

  5. Contractility

54. By electrocardiogram investigation the following data were determined in a patient who had suffered the grippe; the rate of heart is 140 beats per min, sinus rhythm, the range of R-R is not more than 0.15 c; duration of PQ-0.2 c; QRS is not changed. These indicate of the development of:

  1. Sinus tachyarrhythmia

  2. Sinus tachycardia*

  3. Nonparoxysmal tachycardia

  4. Paroxysmal tachycardia

  5. Ventricular fibrillation

55. The signs of heart failure appeared in a man aged 56, during carrying out hard work, feelings of air shortage, heart beating, and general weakness. Objectively heart borders are dilated, the heart rate is 92 beats per min and arterial pressure is 180/110 mm hg. These signs are due to: A. Increase of peripheral resistance*

  1. General hypoxia of an organism

  2. Insufficiency of coronary circulation

  3. Increase of diastolic filling

  4. Neurotrophic disturbances

56. A patient aged 47 with mitral incompetence has the symptoms of cardiac insufficiency: breathlessness, cyanosis, edema of lower limbs. Objectively: the borders of the heart are dilated, the heart rate is 104 beats per min, and arterial pressure is 125/85 mm hg. These symptoms are due to:

  1. Increase of peripheral resistance

  2. Autoallergic changes of myocardium

  3. Increase of diastolic filling*

  4. Insufficiency of coronary circulation

  5. Neurotrophic disturbances

57. Dilation of the heart, BP-155/100 mm hg, the heart rate 95 beats per min, was revealed in a patient aged 63 with hypertension during the examination. The most effective mechanism, which will contribute to the normalization of BP, is:

  1. Inhibition of aldosterone synthesis

  2. Blocking of angiotensin synthesis

  3. Inhibition of catecholamine action*

  4. Blocking of vasopressin action

  5. Administration of salt low diet

58. After suffered rheumatism a patient had aortic stenosis. Point out what mechanism of compensation takes place in the left ventricle:

  1. Homeometric*

  2. Heterometric

  3. Systolic

  4. Diastolic

  5. Coronary

59. After suffered rheumatism a patient had aortic incompetence. Indicate what mechanism of compensation takes place in the left ventricle in this case:

  1. Homeometric

  2. Heterometric*

  3. Systolic

  4. Diastolic

  5. Coronary

60. Acute myocardial infarction of a patient includes three areas: zone of necrosis, dystrophy and ischemia. The changes of what ECG wave characterizes the place of necrosis in this case?

  1. R

  2. S

  3. Q*

  4. T

  5. P

61. A patient with acute myocardial infarction, which was caused by thrombosis of coronary arteries, was treated with fibrinolytic preparation urokinase that led to the development of reperfusion syndrome. Which of the mentioned syndromes is associated with reperfusion?

  1. Dressler’s

  2. Chediak-Higashi

  3. Morgagni-Adams-Stokes

  4. No-reflow*

  5. Wolff-Parkinson-White

62. Which of the factors is the most frequent cause of formation of acquired valvular heart disease? A. Septic endocarditis

  1. Syphilis

  2. Atherosclerosis

  3. Mechanical factor

  4. Rheumatism*

63. Acute pain in the heart area, marked skin paleness and loss of consciousness developed in a patient after short intensive physical excretion. What heart failure may be suspected in this patient?

  1. Mitral incompetence

  2. Aortic stenosis*

  3. Mitral stenosis

  4. Aortic incompetence

  5. Tricuspid stenosis

64. A patient aged 40, complains of increased fatigue, appearance of pain in the heart area on physical exertion. Objectively: cyanotic skin (especially on the fingers of the hands and legs, lobule of the ear), pulse rate 96 beats/min, BP-110/85 mm of hg. There are edemas in the lower and middle third of the cruses. The edge of the liver projects 3 cm from under the costal arch. Which form of circulatory insufficiency may be suspected in this patient? A. Acute left ventricular failure

  1. Acute vascular insufficiency

  2. Chronic left ventricular failure

  3. Chronic right ventricular failure*

  4. Acute right ventricular failure

65. A patient complains of breathlessness that appears even on slight physical exertion, cough with sputum, which recently has obtained bloody character. Objectively: the skin of the face and mucous membrane of the lips particularly are cyanotic. Which impairment of the heart work may be suspected in this patient?

  1. Mitral stenosis *

  2. Mitral incompetence

  3. Aortic stenosis

  4. Aortic incompetence

  5. Tricuspid stenosis

66. A patient has constant high arterial pressure - 160/110 mm of hg.

Periodically it may rise up to 220-240/120-130 mm of hg. What type of hypertension has this patient?

  1. Psycho emotional

  2. Cerebral

  3. Renal

  4. Adrenal*

  5. Essential

67. A patient, female, aged 48 complains of breathlessness on slight physical exertion, pains of pressing character in substernal area, appearance of syncope on exertion. According to a case history the patient suffered rheumatism. Heart failure was diagnosed - aortic stenosis, myocardial hypertrophy. What is the main mechanism of the development of myocardial hypertrophy?

  1. Hypertrophy of myocardiocytes

  2. Diffuse edema of interstice

  3. Synthesis increase of contractile proteins in myocardium*

  4. Hyperplasia of intermediate tissue of myocardium

  5. Accumulation of water and electrolytes in myocardiocytes

68. A patient 45 complains of breathlessness on slight physical exertion, edema of the legs, frequent tonsillitis are pointed out in case history, she is being ill for 2 years. Rheumocarditis, combined mitral incompetence, insufficiency of blood circulation were diagnosed. What is hemodynamic mechanism of decompensation?

  1. Decrease of circulating blood volume

  2. Decrease of venous pressure

  3. Increase of arterial pressure

  4. Decrease of minute volume of the heart*

  5. Tachycardia

69. A patient with ischemic heart disease had a sudden severe attack of angina pectoris: the face is pale, cold, damp skin, BP-70/50 mm Hg, extrasystole. Myocardial infarction and cardiogenic shock were diagnosed. Name the leading link of pathogenesis?

  1. Hypotension

  2. Pain syndrome

  3. Toxemia

  4. Extrasystole

  5. Decrease of minute blood volume*

70. Mitral incompetence without impairment of blood circulation was revealed in a patient aged 25. What mechanism provided the state of the heart compensation?

  1. Heterometric mechanism*

  2. Homeometric mechanism

  3. Inotropic action of catecholamines

  4. Increase of the heart mass

  5. Strengthening of protein synthesis

71. Aortic stenosis was revealed in a girl aged 15, but without impairments of blood circulation. What the mechanism provided the condition of heart compensation?

  1. Homeometric mechanism*

  2. Inotropic action of catecholamines

  3. Heterometric mechanism

  4. Decrease of heart mass

  5. Strengthening of protein synthesis

72. ECG of a child aged 5 shows the impairment of action of cardiac rhythm. On holding breathing the cardiac rhythm becomes normal. What kind of impairment was found out on ECG? A. Sinus extrasystole

  1. Ciliary arrhythmia

  2. Respiratory arrhythmia*

  3. Atrial extrasystole

  4. Transversal heart block

73. Strong palpitation, pain in the heart, sharp weakness, increase of BP, irregular pulse with deficiency developed suddenly in a man aged 50. ECG showed absence of wave P and different R-R intervals. What impairment of cardiac rhythm has a patient?

  1. Transversal heart block

  2. Paroxysmal tachycardia

  3. Respiratory arrhythmia

  4. Ciliary arrhythmia*

  5. Sinus extrasystole

74. ECG show that wave P overlaps the wave T what is observed in case of atrial obstruction. At what rate of the heart contractions will it occur?

  1. 150 beats per minute

  2. 160 beats per minute

  3. 170 beats pr minute*

  4. 140 beats per minute

  5. 130 beats per minute

75. During the experiment a white rat was given intraperitoneal injection of 0.1% adrenalin solution at 1 mg/100g of body mass. 30 minutes later respiration become hurried and shallow, then sharp and convulsive, foamy fluid appeared from the nasal cavity, there was acrocyanosis. The animal died when acute pulmonary edema developed. What pathogenetic mechanism is the leading in this case?

  1. Toxic

  2. Membranogenic

  3. Lymphogenous

  4. Hydrodynamic*

  5. Colloid-osmotic

76. Patient V., aged 67 suffers from atherosclerosis of heart vessels and brain vessels. Hyperlipidemia was revealed on examination. What class of lipoproteins of blood serum is of greatest importance in the pathogenesis of atherosclerosis?

  1. Lipoproteins of low density*

  2. Chylomicrons

  3. Beta lipoproteins

  4. Lipoproteins of high density

  5. Complex of fat acids with albumins

77. The planned investigation of cardiohemodynamics readings of patient M. with chronic cardiac insufficiency was carried out. Which of the named readings is the main sign of the development of cardiac decompensation?

  1. Development of tachycardia

  2. Decrease of stroke volume*

  3. Tonogenic dilatation

  4. Increase of peripheral vascular resistance

  5. Increase of central venous pressure

78. While analyzing the ECG of the patient with myocardial infarction attention was paid to absence of wave P, presence of wavy isoelectric line with plenty of small waves, frequent and irregular location of QRS complex. What impairment of rhythm does the described picture of ECG correspond to?

  1. Ventricular fibrillation

  2. Idioventricular fibrillation

  3. Atrial fibrillation*

  4. Paroxysmal tachycardia

  5. Ventricular extrasystole

79. Periodical appearance of ventricular extrasystole was revealed during ECG investigation of patient P. It was determined that wave P was absent before extrasystole. What is the cause of its disappearance?

  1. Appearance if refractory period in atria

  2. Impulse block in sinus node

  3. Appearance of refractory period in ventricles

  4. Block of impulse conduction round the atria

  5. Impossibility of retrograde conduction through A-V node*

80. During ultra-sound investigation dilation of heart cavities was revealed in patient S. who suffered from hypertension. Which of the below mentioned signs are evidence of development of tonogenic dilation?

  1. Dilation of heart cavities with increase if stroke volume*

  2. Dilation of cavities without change if stroke volume

  3. Dilation of cavities with change of stroke volume

  4. Uniform dilations of heart borders

  5. Irregular dilations of heart borders

81. Quick fatigue, breathlessness on physical exertion, feeling of “sink” and momentary cardiac arrest appeared in a patient D, aged 13, 2 weeks later after secondary suffered tonsillitis. ECG showed decrease of voltage of waves periodical prolapse of some cardiac cycles PQRST, RCC-55 beats/minute. What is the most possible mechanism of the impairment of heart functions?

  1. Toxic impairment of sinus node

  2. Impairment of sinus node by immune complexes*

  3. Sclerotic changes in sinus node

  4. Ischemic impairment of sinus node

  5. Parasympathetic irritation of sinus node

82. During ECG investigation irregular atrioventricular extrasystoles were determined in a patient aged 38. The impairment of what properties of myocardium composes the base of extra systole pathogenesis?

  1. Excitability*

  2. Automatism

  3. Conduction

  4. Contractility

  5. Tonicity

83. Patient Y, aged 40, is treated for pulmonary tuberculosis, acrocyanosis, breathlessness, extension of heart borders, increase of BP and number of erythrocytes, pachyemia, neutrophilic leukocytosis are marked on examination. Which of the below mentioned symptoms of chronic hypoxia are regarded as lasting compensatory mechanisms of organism.

  1. Pachyemia*

  2. Dilation of the cavities and myocardial hypertrophy

  3. Leucocytosis

  4. Increase of BP

  5. Increase of respiratory rate.

84. Increase of blood viscosity was revealed in a patient with chronic cardiac insufficiency, the damage of the walls of vessels of microcirculatory channel was found out on capillaroscopy. Which of the impairments of peripheral circulation are possible in this case?

  1. Sludge phenomenon*

  2. Thrombosis

  3. Arterial hyperemia

  4. Embolism

  5. Venous hyperemia.

85. Changes that testify to the impairment of cardiomyocytes were recorded on the ECG of an experimental animal after the injection of ouabain (substance which blockades K+/Na+-depending ATP). What molecular mechanisms had decisive significance in this case? A. Electrono-osmotic*

  1. Lipid

  2. Acidotic

  3. Calcic

  4. Protein

86. Patient, aged 44, complains of strangulation, palpitation, pains in the right costal interspace, and edemas on the legs. Pulsation of cervical veins, enlargement of the liver, edemas of the lower extremities were found out on examination. ECG shows the signs of hypertrophy of both ventricles and right auricle. Tricuspid incompetence was diagnosed. What is pathophysiological variant of this incompetence?

  1. Overloading of the heart by exertion

  2. Primary myocardial insufficiency

  3. Overloading of the heart by volume* D. Coronary insufficiency

E. Cardiac tamponade.
87. Acceleration of the heartbeat during breathing in and deceleration during breathing out were revealed in a youth, aged 16, on examination. ESG showed shortening of RR interval during inspiration and its lengthening during expiration. Name the kind of arrhythmia.

  1. Ciliary arrhythmia

  2. Sinus tachycardia

  3. Idioventricular rhythm

  4. Sinus arrhythmia*

  5. Sinus bradycardia

88. Choose in what form below mentioned states that cause of cardiac insufficiency heterometric mechanism of compensation (Frank-Starling) takes place:

  1. Hypertension of systemic circulation

  2. Hypertension of pulmonary circulation

  3. Mitral stenosis

  4. Aortic stenosis

  5. Aortic incompetence*

89. A patient, aged 58, was hospitalized with complaints of unpleasant feelings in the heart area; there was myocardial infarction in anamnesis. ECG shows registration of fibrillation waves (F) instead of P-waves; QRST complexes are widened and deformed. Ventricular rhythm is right; the rate of contractions of ventricles is 48 per minute. What is the most possible impairment of the rhythm in this case?

  1. Frederick’s syndrome*

  2. Morgagni-Adams-Stokes syndrome

  3. Wolf-Parkinson-White syndrome

  4. Mobitz type I of atrioventricular block

  5. Mobitz type II of atrioventricular block

90. Name the condition, which accompanied by pressure overload of left ventricle.

  1. Stenosis of mitral orifice

  2. Stenosis of aortic orifice*

  3. Incompetence of mitral valve

  4. Incompetence of aortic valve

  5. Pulmonary hypertension

91. A 24-year-old female patient was admitted to the hospital with complaints of headache, pain in kidney area, and general weakness. She was suffered from tonsillitis one month before. At examination patient has BP of 180/110 mmHg; in patient’s blood analysis erythrocytes – 3.1x10^12/L, leukocytes – 12.6x10^9/L, ESR – 28 mm/hour; in

patient’s urinalysis – marked proteinuria, hematuria, leukocyturia. What is the mechanism of hypertension development?

  1. Renovascular

  2. Reflexogenic

  3. Aldosterone-induced

  4. Renal*

  5. Mineralocorticoid-induced

92. In a patient with hypertension the pulse rate dropped from 72 to 52 bpm during hypertonic crisis and maintained at this level for 10 days. Intramuscular injection of 1 mg of atropine led to increasing of pulse rate at 16 bpm. What group of arrhythmias does described disorder of cardiac rhythm belong to?

  1. Ventricular fibrillation

  2. Atrial palpitation

  3. Disturbance of rhythm formation

  4. Disturbance of rhythm conduction

  5. Disturbance of automatism*

93. Decrease in pulse rate down to 50 bpm was observed in a patient with cerebral hemorrhage. His pulse was rhythmic. What is the mechanism of this disorder of cardiac rhythm?

  1. Irritation of nervus vagus*

  2. Reduction of rate of free diastolic repolarization

  3. Influence of sympathetic mediator

  4. Extension of site of sinoatrial node

  5. Elevation of rate of free diastolic repolarization

94. A patient died from myocardial infarction, which was proved by data of clinical and ECG examinations. No changes of coronary vessels were found at autopsy of this patient. What evokes myocardial infarction in this patient?

  1. Increase in tonus of sympathetic nervous system

  2. Enhanced secretion of catecholamines*

  3. Obstruction of vessel with embolus

  4. Thrombosis of coronary vessels

  5. Rheumatic coronaritis

95. A patient with neuro-circulatory dystonia has heartbeat rate increased up to 130 bpm. Clinical symptoms of organic heart injury were not found in this patient. At pressing on carotid sinus heart rate decreased, but after returned to previous frequency. What is the origin of this disorder of heart rhythm?

  1. Fluctuations of parasympathetic tonus

  2. Inflammatory lesion of myocardium

  3. Enhanced influence of sympathetic nervous system*

  4. Ischemic injury of myocardium

  5. Toxic injury of myocardium

96. Thrombosis of anterior intraventricular coronary artery developed after coronarography in a patient with ischemic heart disease and atherosclerosis of coronary arteries. What mechanism is the most significant for development of this complication?

  1. Slowing of blood flow

  2. Injury of endothelium of vessel wall*

  3. Increase in blood coagulant concentrations

  4. Decrease in blood anticoagulant concentrations

  5. Reduction of fibrinolytic system activity

97. Under hypertrophy of myocardium mass of heart increases due to:

  1. Enlargement of each muscular fiber*

  2. Growth of connective tissue

  3. Increase in number of myocardiocytes

  4. Growth of adipose tissue

  5. Enhancement of blood supply of heart muscle

98. Changes in ECG was shown at first by lengthening of P-Q interval, after that by falling out of single QRS complexes, later by increasing in number of fallen out ventricle complexes, and at last atriums constrict with frequency of 70 bpm and ventricles constrict with frequency of 35 bpm. Described changes are characteristic for: A. Intraatrial block

  1. Cross-sectional block*

  2. Intraventricular block

  3. Arrhythmia due to disturbances of automatism

  4. Arrhythmia due to disturbances of conduction

99. The first link in atherosclerosis development is:

  1. Slowing of blood flow

  2. Degenerative-proliferative changes of internal layer of arteries

  3. Excessive depositions of blood plasma lipoproteins in internal layer of arteries

  4. Formation of fibrous plaque on internal layer of arteries

  5. Disorders of intactness of arterial wall*

100. A patient suddenly lost consciousness and develop cramps. At his ECG followings were revealed: 2 to 3 P cogs related to 1 QRST complex. What property of heart conductive system is impaired?

  1. Automatism

  2. Excitability

  3. Conduction*

  4. Constriction

  5. Reproduction of frequency of excitement

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