Topic 24. Pathophysiology of the nervous system 1. A 38-year-old man is going undertreatment in a hospital for schizophrenia. Blood contents of glucose, ketone bodies, and urea in him are norm. Shock therapy with regular injections of insulin was led to the development of insulin coma, after that the patient’s condition improved. What was the most possible reason for development of insulin coma?
Dehydration of tissues
2. Smell of apples is felt from the patient in comatose state. The content of glucose is 18 mmol/L. Which coma is more possible in this case?
3. A patient is drowsy, with cloudiness of consciousness, his reaction to the strong stimuli is slow. His skin is pale and dry. He has edemas, muscular fibrillar tremor, mydriasis, Cheyne-Stokes respiration with ammonium smell. Pericardial rub was revealed during auscultation. Which type of coma has been developed in this patient?
4. Increase of blood pressure and rapid pulse are noticed in a sportsman at the start before competitions. Influence of which part of the CNS can above-mentioned changes be explained?
Cortex of hemispheres*
5. The close clinical examination of the patient, admitted to the reanimation department in unconscious condition allowed to make a conclusion that the patient was in uremic comatose state. Which symptom is more characteristic for this type of coma?
Acetone smell from his mouth
6. The close clinical examination of the patient, admitted to the reanimation department in unconscious condition allowed to make a conclusion that the patient was in state of diabetic coma. Which symptom is more characteristic for this type of coma?
Smell of ammonium from the mouth
Decrease of content of nonprotein nitrogen in serum
7. Ptyalism, bradycardia (heart rate 45 beats per minute), miosis are observed in a man.
What is the most possible reason for such changes?
Increase of sympathetic influence
Increase of parasympathetic influence*
Decrease of sympathetic influence
Decrease of parasympathetic influence
Decrease of vegetative influence
8. The reactions, typical for stimulation of parasympathetic nerves, appeared after irritation of trophogenic zone of hypothalamus, including preoptic nucleus and anterior hypothalamic area. What appears in this case?
Decrease of BP*
9. After amputating the upper extremity a patient had a bad pain in it. Which mechanism of the pain feeling formation is more possible in this case?
Hyposecretion of endorphin
Hypersecretion of endorphin
Hyposecretion of enkephalin
10. A patient had hemiplegia after insult. What disorder is observed in this case?