Download Module 1. Anaesthesiology and intensive care Text test questions A

Module 1. Anaesthesiology and intensive care
Text test questions
1. A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
A. *omplete block
B. Unstable block
C. Hemi block
D. All of the above
E. None
2. A local anesthetic that is ineffective topically is –
A. * Cocaine
B. Mepivacaine
C. Hexylcaine
D. Lidocaine
E. Tetracaine
3. A successful stellate ganglion block can produce –
A. Hypotension
B. * Horner's syndrome
C. Brachial plexus involvement
D. Hemifacial anaesthesia
E. Hypertension
4. According to the Glasgow Coma Scale active movements to verbal commend
correspond to:
A. 2 points
B. 5 points
C. 4 points
D. 3 points
E. * 6 points
5. According to the Glasgow Coma Scale active movements to verbal commend
correspond to:
A. 2 points
B. 5 points
C. 4 points
D. 3 points
E. * 6 points
6. According to the Glasgow Coma Scale deep coma corresponds to:
A. 4-5 points
B. 13-14 points
C. 11-12 points
D. * to 3 points
E. 8-9 points
7. According to the Glasgow Coma Scale deep coma corresponds to:
A. 4-5 points
B. 13-14 points
C. 11-12 points
D. * to 3 points
E. 8-9 points
8. According to the Glasgow Coma Scale deep sopor corresponds to:
A. 11-12 points
B. 13-14 points
C. 4-5 points
D. 3 points
E. * 8-9 points
9. According to the Glasgow Coma Scale stupor corresponds to:
A. 11-12 points
B. 13-14 points
C. 4-5 points
D. 3 points
E. * 10-11 points
10. According to the Glasgow Coma Scale eyes opening to pain corresponds to:
A. 4 points
B. 3 points
C. * 2 points
D. 0
E. 1 point
11. According to the Glasgow Coma Scale eyes opening to pain corresponds to:
A. 4 points
B. 3 points
C. * 2 points
D. 0
E. 1 point
12. According to the Glasgow Coma Scale free verbal response corresponds to:
A. 2 points
B. 3 points
C. 1 point
D. * 5 points
E. 4 points
13. According to the Glasgow Coma Scale free verbal response corresponds to:
A. 2 points
B. 3 points
C. 1 point
D. * 5 points
E. 4 points
14. According to the Glasgow Coma Scale lack of eyes opening to any irritant corresponds
to:
A. 2 points
B. * 1 point
C. 4 points
D. 5 points
E. 3 points
15. According to the Glasgow Coma Scale lack of eyes opening to any irritant corresponds
to:
A. 2 points
B. * 1 point
C. 4 points
D. 5 points
E. 3 points
16. According to the Glasgow Coma Scale lack of verbal response corresponds to:
A. 2 points
B. 5 points
C. 3 points
D. 4 points
E. * 1 point
17. According to the Glasgow Coma Scale lack of verbal response corresponds to:
A. 2 points
B. 5 points
C. 3 points
D. 4 points
E. * 1 point
18. According to the Glasgow Coma Scale moderate torpor corresponds to:
A. 4-5 points
B. 6-7 points
C. * 8-10 points
D. 11-12 points
E. 13-14 points
19. According to the Glasgow Coma Scale moderate torpor corresponds to:
A. 4-5 points
B. 6-7 points
C. * 8-10 points
D. 11-12 points
E. 13-14 points
20. According to the Glasgow Coma Scale normal extensible movements correspond to:
A. 1 point
B. 2 points
C. 3 points
D. 5 points
E. * 4 points
21. According to the Glasgow Coma Scale normal extensible movements correspond to:
A. 1 point
B. 2 points
C. 3 points
D. 5 points
E. * 4 points
22. According to the Glasgow Coma Scale normal flexible movements correspond to:
A. * 5 points
B. 3 points
C. 1 point
D. D* 4 points
E. 2 points
23. According to the Glasgow Coma Scale normal flexible movements correspond to:
A. * 5 points
B. 3 points
C. 1 point
D. D* 4 points
E. 2 points
24. According to the Glasgow Coma Scale pathological flexion of limbs corresponds to:
A. * 3 points
B. 4 points
C. 5 points
D. 1 point
E. 2 points
25. According to the Glasgow Coma Scale pathological flexion of limbs corresponds to:
A. * 3 points
B. 4 points
C. 5 points
D. 1 point
E. 2 points
26. According to the Glasgow Coma Scale pronunciation of separated phrases corresponds
to:
A. * 4 points
B. 3 points
C. 5 points
D. 2 points
E. 1 point
27. According to the Glasgow Coma Scale pronunciation of separated phrases corresponds
to:
A. * 4 points
B. 3 points
C. 5 points
D. 2 points
E. 1 point
28. According to the Glasgow Coma Scale pronunciation of separated phrases to pain
corresponds to:
A. 4 points
B. * 3 points
C. 1 point
D. 5 points
E. 2 points
29. According to the Glasgow Coma Scale pronunciation of separated phrases to pain
corresponds to:
A. 4 points
B. * 3 points
C. 1 point
D. 5 points
E. 2 points
30. According to the Glasgow Coma Scale soporose state corresponds to:
A. 13-14 points
B. * 6-7 points
C. 8-10 points
D. 3 points
E. 4-5 points
31. According to the Glasgow Coma Scale soporose state corresponds to:
A. 13-14 points
B. * 6-7 points
C. 8-10 points
D. 3 points
E. 4-5 points
32. According to the Glasgow Coma Scale spontaneous eyes opening corresponds to:
A. * 3 points
B. 4 points
C. 2 points
D. 1 point
E. 0
33. According to the Glasgow Coma Scale spontaneous eyes opening corresponds to:
A. * 3 points
B. 4 points
C. 2 points
D. 1 point
E. 0
34. According to the Glasgow Coma Scale terminal coma corresponds to:
A. * 3 points
B. 8-10 points
C. 6-7 points
D. 4-5 points
E. 0
35. According to the Glasgow Coma Scale terminal coma corresponds to:
A. * 3 points
B. 8-10 points
C. 6-7 points
D. 4-5 points
E. 0
36. Acute arise of not adequate behavior in patient is characteristic feature of:
A. Uremia comma
B.
C.
D.
E.
Insult of brain
* Hyperglycemic comma
Hypoglicemic comma
Alcohol comma
37. Acute increasing of intracranial pressure most probably can be caused:
A. Lowering of AP
B. Change the direction of the liquor circulation
C. * Arterial hyperthensia , bradicardia
D. Arterial hypertensia , tachycardia
E. Any from listed
38. All are surface anaesthetics except –
A. Lidocaine
B. * Bupivacaine
C. Procaine
D. Cinchocaine
E. None
39. An increased dose of epidural anaesthetic is obligatory in a patient who has –
A. Ascities
B. * Increased height of the patient
C. Pregnant
D. Age after 50
E. Obese
40. Anisocoria is typical for:
A. uremic coma
B. broken neck
C. * local injury of CNS
D. subarachnoid hemorrhage
E. hypoglycaemic coma
41. Anisocoria is typical for:
A. uremic coma
B. broken neck
C. * local injury of CNS
D. subarachnoid hemorrhage
E. hypoglycaemic coma
42. Areflexia is observed in:
A. Hypoglycemic comma
B. * hyperglycemic ketoacidotic comma
C. uremic comma
D. Alcohol comma
E. Insult of brain
43. At anaerobic metabolic processes during hypoxia glucose converts to:
A. Cationic radicals
B. * Citric acid
C. Molecule ATF and carbonic acid gas
D. Milk acid
E. Glucose is not converting
44. Average arterial pressure is:
A. * Diastolic+ 1/3 pulsed
B. Systolic +diastolic /2
C. Pressure in aorta
D. Systolic + CVT/2
E. Synonym of pulls pressure
45. Average norm of glucose consuming by brain per a day is :
A. 105 g
B. 38 g
C. 78g
D. 42 g
E. * 90 g
46. Average time for persistence of post spinal headache is A. 4 hours
B. 24 hours
C. * 3-4 days
D. 3-4 weeks
E. 1 year
47. Blood providing of hepar is made of :
A. 80% - hepatic artery , 20% - portal vena
B. 40% - hepatic artery, 60% - portal vena
C. * 20% - hepatic artery, 80% - portal vena
D. 50% - hepatic artery, 50% - portal vena
E. 30% - hepatic artery, 70% - portal vena
48. Brain blood circulation increase in most cases at:
A. Hypoxia
B. * Hypercapnia
C. increased averaged АP
D. Injection of adrenalin
E. E. E Injection of corticosteroids
49. Brain is using oxygen witch come into the whole organism in quantity
A. * 40%
B. 10%
C. 20%
D. 15%
E. 50%
50. Breath by Chain- Stox characterized for:
A. Alcohol comma
B. Hypoglycemic comma
C. Hyperglycemic comma
D. Insult of brain
E. * Uremic comma
51. Breath of Kusmaul is founded when it is :
A.
B.
C.
D.
E.
Alcohol comma
Uremic comma
Insult of brain
Hypocalcaemic comma
* Hyperglycemic comma
52. Cauda Equina syndrome can be caused by
A. * Spinal anaesthesia
B. Epidural anaesthesia
C. Both
D. D.None
E. E.General anaesthesia
53. Central perfusion pressure is :
A. Difference between diastolic and intracranial pressure
B. Difference between systolic and intracranial pressure
C. * Difference between gydrostatic and arterial pressure
D. Hydrostatic pressure of liquor
E. Difference between average arterial and intracranial pressure .
54. Cerebral vessels strongly became wider after :
A. Nimodypinum
B. Galotan
C. Barbiturats
D. Hypocxemia
E. * Hypercapnia
55. Chose wrong affirmation , during ALV of the patient with cranial trauma:
A. A. РСО2 is necessary support on the level 25-30 mm..mercury
B. * Optimal is position of patient on the back in horizontal position
C. It is necessary prevent hypoxia
D. It is necessary prevent hypocapnia
E. It is necessary to provide myorelaxation
56. Clinical sign of hypercapcania is:
A. Express cyanosis
B. Wetness , purple –cyanosis skin
C. Bradicardia
D. * Marble skin
E. All appointed signs
57. Clonico -tonical spasms founded during:
A. Insult of brain
B. * Alcohol comma
C. Hyperglycemic comma
D. Hypoglicemic comma
E. Uremia coma
58. Commonest Cranial nerve affected in spinal anaesthesia A. * 2
B. 3
C. 4
D. 6
E. 10
59. Complication of epidural anaesthesia is exceptA. * Headache
B. Nausea
C. Hypotension
D. Bladder distension
E. Dizziness
60. Concerning Barbotage –
A. * Fluid (spinal) is alternately withdrawn and reinjected under pressure
B. Technique used Epidural Analgesia
C. Technique popularized in caudal Analgesia
D. Cannot be carried out under hypothermic condition
E. All of the above
61. Cranial nerve not involved in spinal anaesthesia A. * 1 and 10
B. 3 and 6
C. 2 and 4
D. 7and 8
E. 9
62. Critical level of CNS blood circulation in patient with normal BP appropriate to?
A. Reduce АТ on 50%
B. * Reduce AP to the level of diastolic
C. Reduce of system АP lower of diastolic
D. Reduce АP on 25%
E. Reduce АP on35%
63. Death of the brain by the scale of Glasgow amount to :
A. * 3 points
B. 7-9 points
C. 3-5 points
D. 12-13 points
E. 15 points
64. Deep coma by scale of Glasgow amount to :
A. * 4-5 points
B. 12-14 points
C. 5-7 points
D. 6-8 points
E. 9-11 points
65. Dilatation of pupil of the eye characterized :
A. Uremic comma
B. Insult of brain
C. * Hyperglycemic comma
D. Alcohol comma
E. Intoxication with opiates
66. Discoordination is typical for:
A. * Light coma
B. Deep coma
C. Sopor
D. Expressive coma
E. Terminal coma
67. Dryness of skin and mucous membranes are characteristic feature of:
A. Hyperosmolar ketoacidotic comma
B. Brain comma
C. Alcohol comma
D. * Hyperglycemic ketoacidotic comma
E. Hypoglycemic comma
68. During systolic contraction encranial pressure :
A. * Lower on 2 mm.mercury
B. Increase on 2mm. mercury item
C. Increase on 6 mm.mercury
D. Lower on 6 mm.mercury.
69. During operation haemotransfusion therapy is providing by:
A. A. Anaesthesiologist which provide narcosis
B. * Special chosen doctor
C. Doctor from station of blood transfusion
D. Only the chief of department
E. Administrator
70. Edema is characters sign of :
A. Insult of brain
B. Alcohol comma
C. * Uremical comma
D. hyperglicemic comma
E. Hypoglicemic comma
71. Endogenous hepatic coma may caused by:
A. Haemorrhagia from esofageus vens
B. Damaged cell of hepar
C. * Inflectional-toxic chock
D. Endocrine illness
E. Acute poisoning of charcoal gas
72. Enlargement or reduction of the liver is typical for:
A. hyperglycaemic coma
B. cerebral coma
C. hypoglicemic coma
D. uremic coma
E. * hepatic coma
73. Enlargement or reduction of the liver is typical for:
A. hyperglycaemic coma
B. cerebral coma
C. hypoglicemic coma
D. uremic coma
E. * hepatic coma
74. Epidural anesthesia is preferred to spinal anesthesia because –
A. Hypotension is absent
B. * Dura is not penetrated
C. Low dose of anesthetic is used
D. Level of block easily changed
E. Hypertension is present
75. Epidural blocks is indicated in all excpectA. * Patients in hypovolemia
B. Patients with asthma and bronchitis
C. Post-operative pain relief
D. Obstetric analgesia
E. In urologic surgery
76. Epidural morphine cause A. Miosis
B. Retention of urine
C. Abolishes pain
D. * All
E. None
77. Epidural narcotic is preferred over epidural LA because it causes –
A. Less respiratory depression
B. Not causes retention of urine
C. * No motor paralysis
D. Less dose required
E. Cardiac depression
78. Estimation of coma level for scale of Glasgow is based on:
A. * Movement activity, possibility contact with patient , opening the eyes
B. Estimate patellar reflex
C. Estimate of reaction pupil of the eye
D. Estimate of adequate function of the external breath
E. Estimate of geodynamics
79. Fall back head position is typical for:
A. cerebral coma
B. hypoglycaemic coma
C. * meningitis, tetanus
D. hyperglycaemic ketoacidic coma
E. alcoholic coma
80. Fall back head position is typical for:
A. cerebral coma
B. hypoglycaemic coma
C. * meningitides, tetanus
D. hyperglycaemic ketoacidic coma
E. alcoholic coma
81. First Fibres to be blocked at spinal anaethesia is –
A. Afferent motor nerve
B. Efferent motor nerves
C. * Sympathetic preganglonic
D. Sensory fibres
E. Parasympathetick nerve
82. First wich is paralised after spinal anaesthesia is
A. * Sympathetic
B. Parasympathetic
C. Motor
D. Sensory
E. Vision
83. For hyperglicemic ketoacidosiscoma is not typical :
A. * Metabolic acidose
B. Hyperhydratation
C. Low CVP
D. Respiratory alkalosis
E. Acute pallidity of face
84. For brachial plexus block needle is inserted –
A. Medial to subclavian artery
B. * Lateral to subclavian artery
C. Medial to subclavian vein
D. Lateral to subclavian vein
E. Inferior to subclavian vein
85. For hyperglicemic coma is typical :
A. Reducing of arterial pressure to critical level
B. Soft eyeballs
C. Wet skin
D. Often noisy breathing
E. * Acute cardial insufficiency
86. For hyperglycaemic ketoacidic coma is not typical:
A. marked paleness of the skin
B. respiratory alkalosis
C. metabolic acidosis
D. * hyperhydration
E. low CVP
87. For hyperglycaemic ketoacidic coma is not typical:
A. marked paleness of the skin
B. respiratory alkalosis
C. metabolic acidosis
D. * hyperhydration
E. low CVP
88. For hypoglycaemic coma is typical:
A. * humid skin
B. lowering of blood pressure to the critical level
C. mild eyeballs
D. acute cardiac failure
E. frequent, noisy breathing
89. For hypoglycaemic coma is typical:
A. * humid skin
B. lowering of blood pressure to the critical level
C. mild eyeballs
D. acute cardiac failure
E. frequent, noisy breathing
90. For hypoglycemic coma is not typical :
A. Reduce of АP to the critical
B. Soft eye bolls
C. Acute cardial insufficiency
D. * Wet skin
E. Often noisy breathing
91. For the activity of CNS neurons is necessary:
A. adequate level of proteins and lipids
B. 24-25% of general circulation should get into the cerebral vessels every minute
C. level of glucose should be not lower than 3 mmol/l
D. osmolarity of plasma should be 180-210 mosm/l
E. * not less than 20% of general oxygen for cerebral needs
92. For the activity of CNS neurons is necessary:
A. adequate level of proteins and lipids
B. 24-25% of general circulation should get into the cerebral vessels every minute
C. level of glucose should be not lower than 3 mmol/l
D. osmolarity of plasma should be 180-210 mosm/l
E. * not less than 20% of general oxygen for cerebral needs
93. Grey colour of the skin is characteristic feature of:
A. Alcohol coma
B. Hyperglycemic coma
C. * Hypoglycemic coma
D. Uremic coma
E. Insult of brain
94. Higher normal level of glycemia consist :
A. 6,6 mol/l
B. 5,5 mol/l
C. 4,2 mol/l
D. * 7,3 mol/l
E. 3,8 mol/l
95. How many points the absence of any movement reaction by scale of Glasgow has:
A. * 1 point
B. 3 points
C. 2 points
D. 4 points
E. 5 points
96. Hyperemia of skin and mucous membrans is characteristic feature of :
A. Uremic coma
B. Hyperglycemic coma
C. Hypoglycemic coma
D. * Insult of brain
E. Alcohol coma
97. Hyperreflexia and twitch is typical for :
A. Hypercritical coma
B. Insult of brain
C. Hypoclemical coma
D. Uremia coma
E. Brain coma
98. Hyperventilation include the next level РСО2:
A. 30-35 mm. mercury item
B. 40-45. mm. mercury item
C. 20-25 mm. mercury item
D. * 35-45 mm. mercury item
E. 45-55 . mm. mercury item
99. In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
100.
100. In case of hypothalamic injury there are next sign of cardio-vascular system
affection:
A. Acute decrease of vascular tonus, hypotension, bradicardia, heart arrest
B. Extrasystolia , atrioventrucular block, fibrillation of ventricle
C. Ventricle asistoles , gliming arrhythmia
D. Bradicardia , fool atrioventucular block
E. * Extrasystolia, paroxismal tachycardia , acute hypotension
101.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
A.
B.
C.
D.
E.
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
102.
103.
A.
B.
C.
D.
E.
In spinal anaesthesia, the first nerve fibre to get blocked is * Autonomic preganglionic fibres
Temperature fibres
Somatic motor fibres
Vibratory and proprioceptive fibres
Vegetates fibers
A.
B.
C.
D.
E.
In spinal anaesthesia, the last fibres affected is * Pressure
Pain
Temperature
Touch
Somatic
104.
105.
In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
A.
B.
C.
D.
E.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
A.
B.
C.
D.
E.
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
A.
B.
C.
D.
E.
Lidocaine can be used in all except –
Ventricular fibrillation
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
A.
B.
C.
D.
E.
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
106.
107.
108.
109.
110.
Local anesthetics act byA. Forming area of nerve block along a neuron
B.
C.
D.
E.
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
A.
B.
C.
D.
E.
Longest acting local anaesthetic solution isLignocaine
Chlorprocain
Amethocaine
* Bupivacine
Novocaine
A.
B.
C.
D.
E.
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
A.
B.
C.
D.
Manitol can cause subdural haematoma in result :
Progress of edema of brain
Influence on process of blood coagulation
* Increase the risk of cerebral cortex venues breaking
Reduce of AP
A.
B.
C.
D.
E.
Minimal level of glycemia for normal activity of brain is:
2,3 mol/l
1,2 mol/l
* 1,5 mol/l
1,7 mol/l
1,8 mol/l
A.
B.
C.
D.
E.
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
A.
B.
C.
D.
E.
Movement reaction by scale of Glasgow consist of
3 grades
1 grade
* 6 grades
4 grades
2 grades
A.
B.
C.
D.
E.
Movement reaction on pain shock by scale of Glasgow consist of:
2 grades
3 grades
4 grades
* 6 grades
1 grade
111.
112.
113.
114.
115.
116.
117.
118.
A.
B.
C.
D.
E.
Name the position with downed main end :
A.Obraztcov
Renalis
Orthopaedic
* Trendeleburg
Fowler
A.
B.
C.
D.
E.
Name the position with the elevated upper part of body :
* Fowler
Trendeleburg
Obraztcov
Cardiovascular
Pulmonological
A.
B.
C.
D.
E.
Narrow eye pupils (like papaverous seeds) are typical for:
hypoxia
* poisoning with opiates
poisoning with narcoleptics
poisoning with antihistamines
local cerebral injury
A.
B.
C.
D.
E.
Narrow eye pupils (like papaverous seeds) are typical for:
hypoxia
* poisoning with opiates
poisoning with narcoleptics
poisoning with antihistamines
local cerebral injury
A.
B.
C.
D.
E.
122. Normal intracranial pressure is:
1-10 ml.mercury
10-15 ml.mercury
15-20 ml.mercury
30-35 ml.mercury
* 25-30 ml.mercury
A.
B.
C.
D.
E.
Normal level of intracranial pressure is:
* 1-10 mm. mercury item
10-30 mm.mercury
40-60 mm. mercury item
60-80. mm. mercury item
20-40 mm. mercury item
A.
B.
C.
D.
E.
Opening of eyes on appeal by the scale of Glasgow consist of:
* 4 grades
5 grades
3 grades
1 grade
2 grades
119.
120.
121.
122.
123.
124.
125.
Pathological reflex of Babinskiy direct indicate to:
A. Insult ischemic
B.
C.
D.
E.
Intoxication by opiate
Infarct myocardial
* Organically damage of brain
Hypertonic illness
A.
B.
C.
D.
E.
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
A.
B.
C.
D.
E.
Pericardial friction rub is typical for:
hepatic coma
hyperglicemic ketoacidic coma
* uremic coma
hypoglicemic coma
cerebral coma
A.
B.
C.
D.
E.
Pericardial friction rub is typical for:
hepatic coma
hyperglicemic ketoacidic coma
* uremic coma
hypoglicemic coma
cerebral coma
A.
B.
C.
D.
E.
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
A.
B.
C.
D.
E.
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
A.
B.
C.
D.
E.
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
A.
B.
C.
D.
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
126.
127.
128.
129.
130.
131.
132.
E. Neurinoma
133.
A.
B.
C.
D.
E.
Reason of exogenic hepatic coma is:
* Acute exogenic poisoning
Exotoxical shock
Illness of Botkin
Hyperblirubinemia
Cirosis
A.
B.
C.
D.
E.
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
A.
B.
C.
D.
E.
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
A.
B.
C.
D.
E.
Signs of respiratory insufficiency :
Hypoxia , hypercapcania or their unification
Hypoxia
* Hypercapcania
Hypoxia and compensorative hypercapnia
All noticed states.
A.
B.
C.
D.
E.
Small dose of insulinum during hyperglicemic coma injects in a such way
0,2 IU for 1 kg of body weight
* 0,4 IU for 1 kg of weight
0,1 IU for 1 kg of weight
0,5 IU for 1 kg of weight
0,3 IU for 1 kg of weight
A.
B.
C.
D.
E.
Smell of acetone from mouth is characterized f or:
hypoglycemic comma
* hyperglycemic ketoacidotic comma
Intoxication of organs by phosphorous compounds
Intoxication by acetones essention
Іintoxication by ethanol
A.
B.
C.
D.
E.
Smell of ammonia in expired air is characteristic for:
* Uremia comma
Alcohol comma
hyperglycemic comma
hypoglycemic comma
Insult of brain
134.
135.
136.
137.
138.
139.
140.
Speech reaction by scale of Glasgow consist of:
A.
B.
C.
D.
E.
2 grades
4 grades
3 grades
* 5 grades
1 grade
A.
B.
C.
D.
E.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseGives deep analgesia
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
A.
B.
C.
D.
E.
Subarachnoid block as anesthesia is contraindicated at:
Ischemic heart disease
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
A.
B.
C.
D.
E.
Symptom of „white spot” normally lasts :
Up to 1 second
3-5 second
* Up to 3 second
Depend of arterial pressure value (AP)
Not existed
A.
B.
C.
D.
E.
The device suited for introducing epidural catheter is Mitchell needle
Gordh needle
* Tuohy needle
Sise introducer
Nick needle
A.
B.
C.
D.
E.
The duration of effect of spinal anaesthesia depends upon –
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
A.
B.
C.
D.
E.
The effects of chiling in refrigeration analgesia includes –
Interference with conduction of nerve impulse
Reduction of metabolic rate and oxygen requirement
Inhibition of bacterial growth and infection
Retardation of healing
* All of the above
141.
142.
143.
144.
145.
146.
147.
The following is not used when giving local anaesthesia in the fingers A. 2 % xylocaine
B. Rubber tourniquet
C. Ring block
D. * Adrenaline
E. Atropin
A.
B.
C.
D.
E.
The lack of eye pupils’ reaction to the light is typical for:
* deep coma
sopor
stupor
disorders of consciousness
coma of middle grave
A.
B.
C.
D.
E.
The lack of eye pupils’ reaction to the light is typical for:
* deep coma
sopor
stupor
disorders of consciousness
coma of middle grave
A.
B.
C.
D.
E.
The most often reason of death during ethanol-alcoholic coma is :
Acute hepatic insufficiency
* Acute kidney insufficiency
Acute cardial insufficiency,
Collapse
Acute respiratory insufficiency
A.
B.
C.
D.
E.
The normal index of brain perfusion is
700-750 ml/min (15% MCV)
* 350-400 ml/min. (7% MCV)
450-500 ml/min. (10% MCV)
800-850 ml/min. (18% MCV)
500-550 ml/min. (12% MCV)
A.
B.
C.
D.
E.
The pathological types of the breath are :
Chein -Stocks, Biot
Chein -Stocks, Biot, Bi-Braun
* Chein -Stocks, Biot, Embeden -Meuerhoff
Chein -Stocks, Knope, Biot
Chein -Stocks, Kussmaul, Biot
A.
B.
C.
D.
E.
The spinal cord terminates opposite-vertebra –
* Lumbar 1
Lumbar 2
Sacral l
Sacral 2
Thoracal 12
A.
B.
C.
D.
E.
The whole volume of liquor in adults is about:
200-220 ml
* 120-140 ml
90-100 ml
70-80 ml
50-60 ml
148.
149.
150.
151.
152.
153.
154.
155.
A.
B.
C.
D.
E.
To prevent regurgitation patient needs to:
* Make position with elevated upper part of body
Make position with downed upper part of body
Make position on the side
Inject a portion of atropine
Inject a portion of “cerucal”
A.
B.
C.
D.
E.
VCB (ОЦК) normally is:
12% from weight of body
10% from weight of body
5% from weight of body
18% from weight of body
* 7% from weight of body
A.
B.
C.
D.
E.
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
A.
B.
C.
D.
E.
Vomiting, muscular defans of peritoneal wall is characteristic feature of:
* Hyperglycemic coma
Hypoglycemic coma
Uremic coma
Alcohol coma
Insult of brain
156.
157.
158.
159.
What amount of points in the scale of Glasgow characterise normal human
condition :
A. * 7-9 points
B. 4-5 points
C. 8-10 points
D. 15 points
E. 12-14 points
160.
What anesthesiological component doesn’t belong to suppliement of surgical
operations.
A. * Position of the patient on operation table
B. Medicinal sleep
C. Mioplegia
D. Anesthezia
E. Neurovegetative protection
161.
A.
B.
C.
D.
E.
162.
What concentration of alcohol is considered to be deathly :
* 5-6 g/l
0,5-1 g/l
C2-3 g/l
1,5-2 g/l
E2,5-3 g/l
What criteria appoints on necessity of ALV (ШВЛ):
A.
B.
C.
D.
E.
* РСО2 > 45 mm .mercury
РСО2 > 65 mm. mercury item
РСО2 > 55 mm .mercury
РСО2 > 75 mm .mercury
РСО2 > 35 mm .mercury
A.
B.
C.
D.
E.
163. What critical level of РО2 requires ALV (ШВЛ) :
РО2 <85 mm. mercury item
* РО2 <55 mm. mercury item
РО2 <65 mm. mercury item
РО2 <75 mm. mercury item
РО2 is not landmark
A.
B.
C.
D.
E.
What is hyppercapnia:
* Over norm formation of carbon dioxide in tissues
State witch appear at metabolism intensification
Increasing of carbon dioxide concentration in blood
Hypoxia
Respiratory insufficiency
A.
B.
C.
D.
E.
What is normal partial pressure of blood ?
34-44 mm. mercury item
40-48 mm. mercury item
46-54 mm. mercury item
* 50-56 mm. mercury item
56-60 mm. mercury item
A.
B.
C.
D.
E.
What is the normal saturation of oxygen in venues blood ?
* SаО2 about 80%
SаО2 about 70%
SаО2 about 50%
SаО2 about 60%
SаО2 about40%
A.
B.
C.
D.
E.
What pathology often causes vomiting?
Coma ІІІ.
Acute respiratory insufficiency
* Hypertonic crisis
Clinical death
Coma II.
A.
B.
C.
D.
E.
What percent of destroyed gepatocytes lead to development
of hepatic coma:
* 50%
70%
60%
40%
163.
164.
165.
166.
167.
168.
169.
What saturation of blood must be for ALV :
A. * SаО2<80%
B. SаО2<85%
C. SаО2<90%
D. SаО2<95%
E. SаО2<75%
170.
A.
B.
C.
D.
E.
What should be used in case of ineffective breathing of patient in coma state?
conicotomy
* ALV
infuse euphillin
cardiac massage
inject corticosteroids
A.
B.
C.
D.
E.
What should be used in case of ineffective breathing of patient in coma state?
conicotomy
* ALV
infuse euphillin
cardiac massage
inject corticosteroids
A.
B.
C.
D.
E.
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
A.
B.
C.
D.
E.
Wide eye pupil and arterial pressure reduction is typical for
Terminal coma
Sopor
Light coma
* Deep coma
Midle coma
A.
B.
C.
D.
E.
Coordination disorders are typical for:
Terminal coma
Stupor
Sopor
Deep coma
*Light coma
A.
B.
C.
D.
E.
How much glucose does CNS consume daily on average?
*90 g
42 g
78g
38 g
105 g
171.
172.
173.
174.
175.
176.
What concentration of glucose in minimally enough for providing normal brain
activity?
A. <1,8 mol/l
B. <1,7 mol/l
C. <1,5 mol/l
D. *<1,2 mol/l
E. <2,3 mol/l
177.
Normal intracranial pressure is:
A.
B.
C.
D.
E.
178.
What is central perfusion pressure?
Difference between average arterial and intracranial pressure.
Hydrostatic pressure of liquor
*Difference between hydrostatic and arterial pressure
Difference between systolic and intracranial pressure
Difference between diastolic and intracranial pressure
A.
B.
C.
D.
E.
The normal index of brain perfusion is:
500-550 ml/min. (12% MHV)
800-850 ml/min. (18% MHV)
450-500 ml/min. (10% MHV)
*350-400 ml/min. (7% MHV)
700-750 ml/min (15% MHV)
Skin and mucous membranes hyperemia are characteristic symptoms of:
A. Alcohol coma
B. Cerebral stroke
C. Hypoglycemic coma
D. *Hyperglycemic coma
E. Uremic coma
181.
Vomiting, muscular resistance of peritoneal wall are characteristic symptoms of:
A.
B.
C.
D.
E.
182.
Cerebral stroke
Alcohol coma
Uremic coma
Hypoglycemic coma
*Hyperglycemic coma
Grey color of the skin is characteristic symptom of:
A.
B.
C.
D.
E.
183.
A.
B.
C.
D.
E.
184.
30-35 mm of mercury
15-20 mm of mercury
10-15 mm of mercury
1-10 mm of mercury
A.
B.
C.
D.
E.
179.
180.
*25-30 mm of mercury
Cerebral stroke
*Uremic coma
Hypoglycemic coma
Hyperglycemic coma
Alcohol coma
According to the Glasgow coma scale corresponds to :
9-11 points
6-8 points
5-7 points
12-14 points
*4-5 points
Motor response in Glasgow coma scale is evaluated with
A. 2 grades
B.
C.
D.
E.
4 grades
*6 grades
1 grade
3 grades
A.
B.
C.
D.
E.
Verbal response in Glasgow coma scale is evaluated with
1 grade
*5 grades
3 grades
4 grades
2 grades
185.
186.
Lack of any motor response according to GCS corresponds to:
A.
B.
C.
D.
E.
0 points
4 points
2 points
3 points
*1 point
A.
B.
C.
D.
E.
Motor response to pain according to GCS is evaluated with:
1 grade
*6 grades
4 grades
3 grades
2 grades
A.
B.
C.
D.
E.
Eyes opening to speech according to GCS is evaluated with :
2 grades
1 grade
3 grades
5 grades
*4 grads
A.
B.
C.
D.
E.
Brain death according to GCS corresponds to:
15 points
12-13 points
3-5 points
7-9 points
*3 points
187.
188.
189.
190.
Normal condition of conscience according to GCS corresponds to:
A.
B.
C.
D.
E.
12-14 points
*15 points
8-10 points
4-5 points
7-9 points
A.
B.
C.
D.
Hyperreflexia and twitching are typical for :
Brain injury coma
Uremia coma
Hypoglycemic coma
Cerebral stroke
191.
E. *Hyperglycemic coma
192.
A.
B.
C.
D.
E.
What concentration of alcohol is considered lethal?
2,5-3 g/l
*1,5-2 g/l
2-3 g/l
0,5-1 g/l
5-6 g/l
A.
B.
C.
D.
E.
What pСО2 level is possible for hyperventilation:
45-55 . mm of mercury
*35-45 mm of mercury
20-25 mm of mercury
40-45. mm of mercury
30-35 mm of mercury
A.
B.
C.
D.
E.
What amount of total delivered to the organism oxygen brain is using?
50%
.15%
.20%
.10%
*40%
A.
B.
C.
D.
E.
During systolic contraction intracranial pressure :
Reduces 7 mm of mercury.
B.
reduces 6 mm of mercury.
Increases 6 mm of mercury
Increases 2mm of mercury
*Reduces 2 mm of mercury
193.
194.
195.
196.
A.
B.
C.
D.
E.
197.
Cerebral stroke
Uremic coma
A.
B.
C.
D.
E.
Tonoclonic spasms are possible in case of:
Uremc coma
Hypoglicemic coma
Hypercalcemic coma
*Alcohol coma
Cerebral stroke
A.
B.
C.
D.
E.
Edema is a characteristic symptom of :
Hypoglicemic coma
hyperglicemic coma
*Uremic coma
Alcohol coma
Cerebral stroke
198.
199.
Acute onset of inadequate behavior is a symptom of:
Alcohol coma
Hypoglicemic coma
*Hyperglycemic coma
Kussmaul's respiration is typical for:
A.
B.
C.
D.
E.
200.
Cerebral stroke
Uremic coma
Alcohol coma
Cerebral stroke
hypoglycemic coma
hyperglycemic coma
Alcohol coma
*Uremic coma
Cheyne-Stokes respiration is typical for:
A. * Uremic coma
B.
C.
D.
E.
Insult of brain
Hyperglycemic coma
Hypoglycemic coma
Alcohol coma
A.
B.
C.
D.
E.
Areflexia is a symptom of:
Cerebral stroke
Alcohol coma
Uremic coma
*hyperglycemic ketoacidotic coma
Hypoglycemic coma
202.
203.
Pupil dilatation is typical for :
A.
B.
C.
D.
E.
Opiates intoxication
Alcohol coma
*Hyperglycemic coma
Cerebral stroke
Uremic coma
A.
B.
C.
D.
E.
Dry skin and mucous membranes are typical for:
Hypoglycemic coma
*Hyperglycemic ketoacidotic coma
Alcohol coma
Brain coma
Hyperosmolar ketoacidotic coma
A.
B.
C.
D.
E.
Acetone smell from mouth is typical for:
Ethanol intoxication
Acetous essence intoxication
Organophosphorous compounds intoxication
*hyperglycemic ketoacidotic coma
hypoglycemic coma
204.
205.
206.
hypocalcaemic coma
Ammonia breath is typical for:
A.
B.
C.
D.
E.
201.
*Hyperglycemic coma
Babinski's reflex is typical for:
A. Essential hypertension
B. *Organic brain damage
C. Myocardial infarction
D. Opiates intoxication
E. Ischemic stroke
207.
A.
B.
C.
D.
E.
What way does hypothalamic damage influence cardiovascular system?
*Extrasystole, paroxismal tachycardia , acute hypotension
Bradycardia , full atrioventricular block
Asistole , arrhythmia
Extrasystole , atrioventricular block, ventricular fibrillation
Acute reduction of vascular tone, hypotension, bradycardia, cardiac arrest
A.
B.
C.
D.
E.
Narrow eye pupils (like poppy seeds) are typical for:
. local cerebral injury
. poisoning with antihistamines
. poisoning with narcoleptics
*poisoning with opiates
Hypoxia
208.
209.
A.
B.
C.
D.
E.
210.
A.
B.
C.
D.
E.
211.
Lack of photoreaction is typical for:
middle coma
light disorders of consciousness
stupor
sopor
*deep coma
Anisocoria is typical for:
hypoglycemic coma
subarachnoid hemorrhage
*local injury of CNS
broken neck
uremic coma
Head titled back is typical for:
A.
B.
C.
D.
E.
212.
alcoholic coma
hyperglycemic ketoacidic coma
*meningitis, tetanus
hypoglycemic coma
cerebral coma
What is typical for hypoglycemic coma?
A.
B.
C.
D.
E.
213.
A.
B.
C.
D.
E.
frequent, noisy breathing
acute cardiac failure
soft eyeballs
critical hypotension
*humid skin
What is typical for hyperglycemic ketoacidotic coma?
low CVP
hyperhydration
*metabolic acidosis
respiratory alkalosis
pale skin
214.
A.
B.
C.
D.
E.
215.
A.
B.
C.
D.
E.
216.
Changes of liver size are typical for:
*hepatic coma
uremic coma
hypoglicemic coma
cerebral coma
hyperglycemic coma
A.
B.
C.
D.
E.
Pericardial friction rub is typical for:
cerebral coma
hypoglicemic coma
*uremic coma
hyperglicemic ketoacidotic coma
hepatic coma
A.
B.
C.
D.
E.
What should be used in case of ineffective breathing of patient with coma?
steroids i/v
heart massage
euphillin i/v
*ALV
Conicotomy
A.
B.
C.
D.
E.
According to the Glasgow Coma Scale deep sopor corresponds to:
*8-9 points
3 points
4-5 points
13-14 points
11-12 points
A.
B.
C.
D.
E.
According to the Glasgow Coma Scale terminal coma corresponds to:
points
4-5 points
6-7 points
8-10 points
*3 points
A.
B.
C.
D.
E.
According to the Glasgow Coma Scale sopor corresponds to:
. 13-14 points
.11-12 points
*8-10 points
6-7 points
4-5 points
217.
218.
219.
220.
221.
What is necessary for neurons activity?
*not less than 20% of general oxygen for cerebral needs
osmolarity of plasma should be 180-210 mosm/l
level of glucose should be not lower than 3 mmol/l
24-25% of general circulation volume should get into the cerebral vessels every
minute
adequate level of proteins and lipids
. According to the Glasgow Coma Scale light coma corresponds to:
A. 4-5 points
B.
C.
D.
E.
3 points
8-10 points
*6-7 points
13-14 points
222.
According to the Glasgow Coma Scale pronunciation of inappropriate words
correspondes to:
A. . 2 points
B. 5 points
C. . 1 point
D. . *3 points
E. 4 points
223.
A.
B.
C.
D.
E.
. According to the Glasgow Coma Scale lack of verbal response corresponds to:
*1 point
4 points
3 points
5 points
2 points
224.
. According to the Glasgow Coma Scale confused verbal response (phrases)
corresponds to:
A. 1 point
B. 2 points
C. 5 points
D. 3 points
E. *4 points
225.
A.
B.
C.
D.
E.
. According to the Glasgow Coma Scale oriented verbal response corresponds to:
4 points
*5 points
1 point
3 points
2 points
A.
B.
C.
D.
E.
According to the Glasgow Coma Scale localization of pain corresponds to:
*4 points
.5 points
3 points
2 points
1 point
A.
B.
C.
D.
E.
. According to the Glasgow Coma Scale lack of eyes opening corresponds to:
3 points
5 points
. 4 points
.*1 point
2 points
226.
227.
228.
. According to the Glasgow Coma Scale pathological flexion of limbs corresponds
to:
A. 2 points
B.
C.
D.
E.
. 1 point
. 5 points
4 points
. *3 points
229.
. According to the Glasgow Coma Scale obeying comands (motor response)
corresponds to:
A. *6 points
B. 3 points
C. 4 points
D. 5 points
E. 2 points
230.
A.
B.
C.
D.
E.
According to the Glasgow Coma Scale withdraws to pain corresponds to:
2 points
*4 points
1 point
3 points
5 points
A.
B.
C.
D.
E.
According to the Glasgow Coma Scale eyes opening to pain corresponds to:
1 point
0
2 points
.*3 points
.4 points
A.
B.
C.
D.
E.
According to the Glasgow Coma Scale spontaneous eyes opening corresponds to:
0
. 1 point
2 points
.*4 points
3 points
A.
B.
C.
D.
E.
According to the Glasgow Coma Scale deep coma corresponds to:
8-9 points
* 3 points
11-12 points
13-14 points
4-5 points
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
231.
232.
233.
234.
235.
A local anesthetic that is ineffective topically is –
A. * Cocaine
B. Mepivacaine
C. Hexylcaine
D. Lidocaine
E. Tetracaine
236.
A.
B.
C.
D.
E.
A peritoneal dialysis is not rotined at poisoning:
* by an amitryptylin
by dichloro-ethane, karbofos
by a methyl alcohol
by etaminal sodium
by ethylene glycol
A.
B.
C.
D.
E.
A successful stellate ganglion block can produce –
Hypotension
* Horner's syndrome
Brachial plexus involvement
Hemifacial anaesthesia
Hypertension
A.
B.
C.
D.
E.
A total blood flow in the kidney is
10% of minute volume of heart
* 20% of minute volume of heart
30% of minute volume of heart
40% of minute volume of heart
all answers are correct
A.
B.
C.
D.
E.
All are surface anaesthetics except –
Lidocaine
* Bupivacaine
Procaine
Cinchocaine
None
A.
B.
C.
D.
E.
All narcotic facilities:
* repress urination
does not influence on urination
strengthen urination
all answers are correct
all answers are not correct
237.
238.
239.
240.
241.
Among the complications that often arise during nefrectomia caused large
tumors of the kidney of the least likely
A. violation of venous return from the lower hollow veins anastalsis
B. massive blood loss
C. pneumothorax due to damage to the diaphragm when removing the tumor
D. adrenal insufficiency due to damage or removal of adrenal gland
E. * hypertensive crisis
242.
A.
B.
C.
D.
An ethyl spirit is used as an antidote at poisonings by:
insulin
amitryptylin
FOS
* ethylenglycol, methyl alcohol
E. heavy metals
243.
A.
B.
C.
D.
E.
An increased dose of epidural anaesthetic is obligatory in a patient who has –
Ascities
* Increased height of the patient
Pregnant
Age after 50
Obese
244.
An oliguria occurred in 62-year-old patient during the second days after the
resection of bowel. What sign is it possible to suspect development of sharp tubulary
necrosis ?
A. sodium in urine 10 mmol/l
B. specific gravity of urine 1024
C. high leucocytosis
D. * potassium in plasma 6.4 mmol/l
E. correlation of kreatinine in urine/plasma more than 40
245.
An optimal dose of barbiturates for induction of anesthesia in patients with acute
renal failure is
A. * 4-6 mg/kg
B. 8-10 mg/kg
C. 12-13 mg/kg
D. not used
E. all answers are correct
246.
A.
B.
C.
D.
E.
Antibiotics: aminoglycosides, gentamicin, kefzol, cefaloridin
* can cause toxic lesions of kidneys
not lead to nephrotoxicity defeat
can cause moderate toxic effect on kidneys
all answers are correct
all answers are not correct
A.
B.
C.
D.
E.
Antibiotics: benzilpeni cyllinum, ampicillin, karbeni cyllinum:
* have moderate cumulative effect, but the lack of nephrotoxicity effect
does not have a cumulative and nephrotoxicity
have a pronounced cumulative effect and nephrotoxicity
all answers are correct
all answers are not correct
A.
B.
C.
D.
E.
Antibiotics: levomi citinum, oxacillinum, erythromycinum
* largely derived by kidneys
in an insignificant degree derived by kidneys
not derived by kidneys
all answers are not correct
all answers are correct
A.
B.
C.
D.
Antibiotics: levomi citinum, oxacillinum, erythromycinum:
have a cumulative effect and nephrotoxicity
* have a cumulative action, but at an overdose does not give a nephrotoxicity
does not own neither cumulative nor nephrotoxicity
all answers are correct
247.
248.
249.
E. all answers are not correct
250.
A.
B.
C.
D.
E.
At a kidney ischemia:
volume of urine rises
sodium of urine rises
kreatinine of urine rises
kidney “cerebral” layer is struck more than crust
* dobutaminum improves the formulation of urine
A.
B.
C.
D.
E.
At poisoning with unknown poison you should to inject as an antidote
* nothing
unithiol
atropine
unitiol, chromosmon, atropine
correctly B and С
251.
252.
At the blockade of parasympathetic structures it is necessary after operation (a
patient does not feel the repletion of urinary bladder here):
A. diathermy
B. * anticholinesterasis remedies
C. sympathomimetics
D. correctly only B and C
E. all answers are correct
253.
A.
B.
C.
D.
E.
Atropin is used as an antidote at poisoning by:
insulin
amitryptylin
* FOS
ethyleneglycol, methyl alcohol
heavy metals
A.
B.
C.
D.
E.
Autoregulation renal blood flow is stopped while lowering blood pressure systole:
to 100 mm Hg
to 80-90 mm Hg
* to 60-70 mm Hg
to 40-50 mm Hg
to 30-20 mm Hg
A.
B.
C.
D.
E.
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
1 year
A.
B.
C.
D.
E.
Cauda Equina syndrome can be caused by
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
E.General anaesthesia
254.
255.
256.
257.
A.
B.
C.
D.
E.
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
6
10
A.
B.
C.
D.
E.
Complication of epidural anaesthesia is except* Headache
Nausea
Hypotension
Bladder distension
Dizziness
A.
B.
C.
D.
E.
Concerning Barbotage –
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
Technique used Epidural Analgesia
Technique popularized in caudal Analgesia
Cannot be carried out under hypothermic condition
All of the above
A.
B.
C.
D.
E.
Contra-indication to the leadthrough of the forced diuresis is:
* exotoxic shock
hemolysis
comatose state
contra-indications are not
correctly B and С
A.
B.
C.
D.
E.
Contraindications to one-stage adenomectomia can be considered:
compensated stage of chronic renal insufficiency
compensated diabetes
bronchial asthma
residual hemiplehia after encephalorrhagia
* over 2 months ago myocardial infarction
A.
B.
C.
D.
E.
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
258.
259.
260.
261.
262.
263.
Depolarizing muscular relaxants permitted in patients with renal insufficiency in
short transactions, during which the total dose of it
A. * must not exceed 500 milligrams
B. must not exceed 1000 milligrams
C. a total dose does not influence on duration of neuromuscular block
D. all answers are correct
E. all answers are not correct
264.
Dipiridoxin is used as an antidote at poisonings by:
A. insulin
B.
C.
D.
E.
amitryptylin
* FOS
ethyleneglycol, methyl alcohol
heavy metals
A.
B.
C.
D.
E.
Duration of phase of resorption at poisoning by nonorganic acids is:
* 1-3 hours
3-6 hours
6-12 hours
12-24 hours
10-12 hours
A.
B.
C.
D.
E.
Duration of phase of resorption at poisoning by organic acids is:
1-3 hours
* 3-6 hours
6-12 hours
12-24 hours
10-12 hours
265.
266.
267.
During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
268.
During operations on the suprakidney adrenal gland the most efficient method of
anesthesia is:
A. * intratracheal anesthesia
B. the combined intratracheal anesthesia with epidural anesthesia
C. spinal anaesthesia
D. all answers are correct
E. all answers are not correct
269.
A.
B.
C.
D.
E.
Endogenous water that formed as a result of oxidative processes in the body is
100 ml per day
* 200 ml
500 ml
700 ml
1000 ml
A.
B.
C.
D.
E.
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
270.
271.
Epidural blocks is indicated in all excpectA. * Patients in hypovolemia
B. Patients with asthma and bronchitis
C. Post-operative pain relief
D. Obstetric analgesia
E. In urologic surgery
272.
A.
B.
C.
D.
E.
Epidural morphine cause Miosis
Retention of urine
Abolishes pain
* All
None
A.
B.
C.
D.
E.
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
A.
B.
C.
D.
E.
First Fibres to be blocked at spinal anaethesia is –
Afferent motor nerve
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
A.
B.
C.
D.
E.
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
A.
B.
C.
D.
E.
Following right about chronic pyelonephritis:
* speed-up urinations and disuriya - the most frequent symptoms
massive proteinuria
pirexia rare
very rarely is reason of death as a result of kidney insufficiency
contra-indication is to transplantation of bud
A.
B.
C.
D.
E.
For brachial plexus block needle is inserted –
Medial to subclavian artery
* Lateral to subclavian artery
Medial to subclavian vein
Lateral to subclavian vein
Inferior to subclavian vein
273.
274.
275.
276.
277.
278.
For the determination of the state of glomerular filtration at acute renal failure in
the stage of oliguria was performed test with a manitol in a 30-40% solution of glucose
intravenously in dose 1-1.5 g/kg. If in 1-1.5 hours a diuresis will make less than 40
ml/hour :
A. * subsequent introduction of manitol is not rotined
B. dose is increased
C. dose is repeated
D. all answers are correct
E. all answers are not correct
279.
For transcutaneous puncture (nefroureterolytotomia the optimum variant of
anaesthesia is:
A. toponarcosis
B. * epidural anaesthesia
C. toponarcosis + sedative + narcotic preparations
D. ketamine intravenously and intramuscular
E. intratracheal method of SVL and intravenous anesthesia
280.
A.
B.
C.
D.
E.
Forced diuresis, as a method of detoxication, rotined at poisoning:
by a phenobarbital
by an ethanol
by a karbofos
all answers are faithful
* right only A and B
A.
B.
C.
D.
E.
Furosemide in the phase of renal damage in acute renal failure (ARF) apply:
at a negative test with a manitol
during an overhydratation
at an interstitial pulmonary edema
* at all of the above
all answers are not correct
A.
B.
C.
D.
E.
Gematuria does not develop at:
cystitis
hypernephroma
* prolapsus of kidney
tuberculosis
glomerulonephritis
A.
B.
C.
D.
E.
Glyukagon is used as an antidote at poisonings by:
* insulin
amitryptylin
FOS
ethyleneglycol, methyl alcohol
heavy metals, aniline
A.
B.
C.
D.
E.
Hemodialysis is not rotined at poisoning:
* by an amitryptylin, aminazyn
by a phenobarbital
by ethylene glycol
by a mercury, heavy metal compounds
by a methyl alcohol
281.
282.
283.
284.
285.
If you should use antibiotics at kidney insufficiency, which eliminate not through
kidneys and low-toxic at exceeding of therapeutic concentration in blood. These
antibiotics are:
A. * penicillin
B. aminoglycosides
C. cephalosporins
D. all answers are correct
E. all answers are wrong
286.
In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
287.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
A.
B.
C.
D.
E.
In oligoanuric stage of acute renal failure develops
metabolic alkalosis
* metabolic acidosis
mixed acidosis
mixed alkalosis
all answers are correct
A.
B.
C.
D.
E.
In oligoanuric stage of acute renal failure penicillin group of antibiotics due to
to their nephrotoxicity
high degree of cumulation
* high maintenance to potassium in plasma of patient
correctly A and B
all answers are correct
A.
B.
C.
D.
E.
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
A.
B.
C.
D.
E.
In spinal anaesthesia, the first nerve fibre to get blocked is * Autonomic preganglionic fibres
Temperature fibres
Somatic motor fibres
Vibratory and proprioceptive fibres
Vegetates fibers
A.
B.
C.
D.
In spinal anaesthesia, the last fibres affected is * Pressure
Pain
Temperature
Touch
288.
289.
290.
291.
292.
E. Somatic
293.
A.
B.
C.
D.
E.
In the case of hypertrophy of prostate:
difficulty of beginning of urination
an increase of frequency of urination is a late symptom
* a chronic delay does not need rapid decompression
exkrectory pyelogram must be conducted at kidney insufficiency
an episode of sharp delay is a testimony for planned prostatectomia
294.
In the case of long and traumatic operations (vascular operation, kidney
autotransplant, plastic ureteral, bladder exterpation) the most rational use:
A. * the combined intratracheal anesthesia with epidural anaesthesia
B. spinal anaesthesia
C. epidural anaesthesia
D. all answers are correct
E. all answers are not correct
295.
A.
B.
C.
D.
E.
In the case of performing of operation on perineum it would be batter use:
* epidural and spinal anesthesia
intravenous anesthesia is with the spontaneous breathing
toponarcosis
all answers are correct
all answers are not correct
296.
In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
297.
A.
B.
C.
D.
E.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
298.
Indications for dialysis for patient with anuria and acute renal failure are all
listed, except:
A. hyperpotassemia
B. hypernitrogenmia
C. expressed overhydratation
D. metabolic acidosis
E. * expressed anemia
299.
A.
B.
C.
D.
Intraoperational oliguria is caused by:
* the release of ADG
the stimulation of release of aldosterone
the effect of histamine
specific effect to anesthesia on kidney channels
E. hyperglycemias
300.
A.
B.
C.
D.
E.
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
A.
B.
C.
D.
E.
Lidocaine can be used in all except –
Ventricular fibrillation
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
A.
B.
C.
D.
E.
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
A.
B.
C.
D.
E.
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
A.
B.
C.
D.
E.
Longest acting local anaesthetic solution isLignocaine
Chlorprocain
Amethocaine
* Bupivacine
Novocaine
A.
B.
C.
D.
E.
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
A.
B.
C.
D.
E.
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
301.
302.
303.
304.
305.
306.
307.
Methylene blue is applied as an antidote at poisonings by:
A.
B.
C.
D.
E.
insulin
amitryptylin
FOS, heavy metals
ethyleneglycol, methyl alcohol
* aniline
A.
B.
C.
D.
E.
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
308.
309.
Normalisation of kidney blood stream at prerenal (functional) oliguria is
pathogenetically implemented:
A. by injection of saluretics
B. by injection of osmodiuretics
C. * by normalisation of the system of hemodynamics, introduction of
dobutaminum or dopaminium in “kidney” doses
D. right A and in C
E. right B and D
310.
A.
B.
C.
D.
E.
Operation of detoxic hemosorbtion is not rotined at poisoning:
by an amitryptylin
by amital sodium, phenobarbital
by dichloro-ethane, karbofos
* by a methyl alcohol
correctly B and С
A.
B.
C.
D.
E.
Osmotic diurethics (manitol, glucitol) operate at level:
cerebral part of ascending knee of kidney loop
* proximal channel and kidney loop
distal channel
correctly and
correctly and
A.
B.
C.
D.
E.
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
A.
B.
C.
D.
E.
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
311.
312.
313.
314.
Post spinal headache can be prevented by A. * Thinner needle
B.
C.
D.
E.
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
A.
B.
C.
D.
E.
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
A.
B.
C.
D.
E.
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
315.
316.
317.
Preparations of choice in the treatment of heart failure caused by
hyperpotassemia after kidney transplantation is considered
A. strophanthin
B. digoxin
C. * digitoxin
D. gangliothics
E. all answers are correct
318.
Preparations of potassium-preserve action (veroshpiron, spironolakton,
triamteren) operate at level:
A. * distal part of channels
B. proximal parts of channels and kidney loop
C. loops of Genle
D. correctly A and B
E. all answers are correct
319.
A.
B.
C.
D.
E.
Prerenal insufficiency in the early stage is characterize by:
oliguria
specific density of urine higher 1020
* concentration of sodium is in urine of less than 15 mekv/l
increase of kreatinine in plasma
рН urines is less than 4.0
320.
Proper therapy of bleeding which proceeds, after the transurethral resection of
prostate caused by carcinoma includes:
A. fibrinogen
B. concentrate of platelets
C. blood
D. all answers are faithful
E. * all answers are not faithful
321.
Prozerin, ezerin is used as antidotes at poisonings by:
A. insulin
B.
C.
D.
E.
* amitryptylin
FOS
ethyleneglycol, methyl alcohol
heavy metals
322.
Raising activity of transaminases should be viewed as contra-kidney
transplantation, if a level is:
A. less than 50 ME
B. less than 100 ME
C. * more than 100 ME
D. more than 250 ME
E. all answers are correct
323.
A.
B.
C.
D.
E.
Reasons of nephrotoxic form of acute renal failure are all listed, except:
poisoning of heavy metals connections
organic solvents (ethylene glycol, carbon tetrachlorid)
sulfanilamidums
* anaphylactic shock
all answers are correct
A.
B.
C.
D.
E.
Saluretics (furosemide, ethacrynic acid) operate at level:
* cerebellar part of ascending knee of kidney loop
crust part of ascending knee of kidney loop
proximal parts of channels
distal part of channels
correctly C and D
A.
B.
C.
D.
E.
Sharp glomerulonephritis is not characterize by
oliguria
hypertension
perorbital edema
* early beginning of edemas
gematuria
A.
B.
C.
D.
E.
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
A.
B.
C.
D.
E.
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
324.
325.
326.
327.
328.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseA. Gives deep analgesia
B. Gives good relaxation of abdominal muscles
C. Patient is conscious and co-operative
D. * All of above
E. Intestines so that other viscera are seen well
329.
A.
B.
C.
D.
E.
Subarachnoid block as anesthesia is contraindicated inIschemic heart disease
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
330.
System tolerance to glucose is often observed at the terminal stage of chronic
kidney insufficiency conduces to development of uremic pseudodiabetes due to:
A. deficit of insulin
B. * a decline of utilisation of glucose is on a background sufficient high
maintenance of insulin
C. decline of sensitiveness of cages is to exogenous and endogenous insulin
D. correctly A and B
E. correctly B and C
331.
Tactics infusion therapy during anesthesia in kidney transplantation include
kidney blood flow in
A. * consists in strict limitation of volume of infusion environments
B. varies in wide limits
C. varies depending on the function of transplant
D. all answers are correct
E. all answers are not correct
332.
The clinical situation of heart failure after kidney transplantation are often similar
to hypokinetic forms
A. hypovolemic form
B. * hyperkinetic form
C. hypovolemic forms
D. all answers are correct
E. all answers are incorrect
A.
B.
C.
D.
E.
The duration of effect of spinal anaesthesia depends upon –
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
A.
B.
C.
D.
E.
The early sign of kidney insufficiency is:
the presence of leukocytes in urine
lowering in blood of nitrogen of urea
* low specific gravity of urine
the presence of erythrocytes in urine
the presence of protein in urine
333.
334.
335.
The effects of chiling in refrigeration analgesia includes –
A. Interference with conduction of nerve impulse
B. Reduction of metabolic rate and oxygen requirement
C. Inhibition of bacterial growth and infection
D. Retardation of healing
E. * All of the above
336.
A.
B.
C.
D.
E.
The following is not used when giving local anaesthesia in the fingers 2 % xylocaine
Rubber tourniquet
Ring block
* Adrenaline
Atropin
337.
The methods of anesthesia, which are used for patients with acute renal failure,
include:
A. regional anesthesia (blockades)
B. infusion of diprivanum (propofol)
C. spinal anesthesia
D. myoneural blockade with infusion of atrakurium
E. * all answers are faithful
338.
A.
B.
C.
D.
E.
The most common method of anesthesia when planned adenomectomia is
intravenous anesthesia
combined endotracheal anesthesia
epidural anesthesia
spinal anesthesia
* right C and D
339.
The most effective way to remove water in patients with acute renal failure in
anuria stage include:
A. diarrhea
B. stimulation sweating
C. flushing the stomach
D. peritoneal dialysis
E. * ultrahemofiltration
340.
A.
B.
C.
D.
E.
The most reliable finds at chronic kidney insufficiency are:
increase of hematocrit
* increasing of creatinine
increase of ammonia in blood
metabolic acidosis
decline of level of phosphate in plasma
341.
The most reliable method of withdrawal of patients from anesthesia in renal
insufficiency in terms of residual curaresation after applying any relaxant is:
A. decuraresation
B. introduction of central analeptics
C. * continued artificial ventilation of lungs
D. all answers are correct
E. all answers are not correct
342.
The normal size of kidney blood stream averages for the adult:
A. 1600 ml/min
B. * 1100 ml/min
C. 800 ml/min
D. 600 ml/min
E. 400 ml/min
343.
The patient with acute renal insufficiency under anuria has anesthetic problems
listed below, except:
A. violation of kidney function
B. * comatose state
C. violation of electrolyte exchange
D. violation of acid balance (metabolic acidosis)
E. violation of erytropoethis (anemia)
344.
The simplified method of determination of speed of glomerular filtration is taken
to determination of concentration:
A. * to the creatinine in plasma
B. urea
C. remaining nitrogen in blood
D. all answers are correct
E. no right answer
345.
A.
B.
C.
D.
E.
The spinal cord terminates opposite-vertebra –
* Lumbar 1
Lumbar 2
Sacral l
Sacral 2
Thoracal 12
346.
To calculate the allowable amount of hydration in oligoanuric phase of acute
renal failure guided by the formula
A. daily diuresis + 200 ml of fluid
B. * daily diuresis + 400 ml of liquid
C. daily diuresis + 600 ml of liquid
D. daily diuresis + 800 ml of liquid
E. daily diuresis + 1000 ml of liquid
347.
To ensure the transport of oxygen to the tissue concentration of hemoglobin in
the postoperative period should not be below:
A. 60 g/l
B. * 80 g/l
C. 100 g/l
D. 120 g/l
E. 140 g/l
348.
A.
B.
C.
D.
E.
To the complications of transurethral resection of prostate belong
disorientation
edema lights
nausea
hyposodiummia
* all of the above
349.
Transport of oxygen to tissues in patients in terminal stage of chronic renal
failure with anemia is provided by
A.
B.
C.
D.
E.
increase of minute volume of heart
decline of cognation of oxygen is to haemoglobin
general peripheral high-resistance
* correctly A and B
all answers are correct
A.
B.
C.
D.
E.
Unithiol is used as an antidote at poisonings by:
insulin
amitryptylin
FOS
ethyleneglycol, methyl alcohol
* heavy metals
350.
351.
Using drugs to neuroleptanalgesia in patients in stage oligoanuric acute renal
failure is accompanied by all the following effects except:
A. CNS depression and slowed exit from anesthesia
B. relative stability of hemodynamics
C. danger of postural reactions
D. reduction of peripheral vascular tone
E. * induced hyperthermia, hypermetabolism
352.
Using of epidural anesthesia during prostatectomia:
an adequate method is for prevention of blood loss
* possibly for patients older 65 years
rarely causes a hypotension
contra-indicated, if a patient takes an aspirin during the transient attacks of
ischemia
E. contra-indicated for patients with high blood pressure
A.
B.
C.
D.
353.
Very reliable reasons of diffuse abdominal pains which are accompanied by
shock during the transurethral resection of prostate under spinal anesthesia include:
A. intravascular haemolysis
B. * extravasation of liquid
C. dissaminated intravascular rolling up
D. myocardial infarction
E. pulmonary embolism
354.
Violation of hemodynamics at exotoxic shock at poisoning an acetic acid is
characterized by:
A. declining impact of heart, OTSK and TSVD
B. high total peripheral vascular resistance
C. low total peripheral vascular resistance
D. * right A and B
E. right A and С
355.
A.
B.
C.
D.
E.
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
356.
At operations on the external genital organs and the bladder (epicystotomia,
cystolitomia) we use:
A. * intravenous narcosis or epidural anesthesia
B. intratracheal anesthesia
C. spinal anaesthesia
D. faithful only A and B
E. all answers are faithful
357.
When poisoning poisons burning action flushing the stomach through a probe
held in terms:
A. * to 12 hour
B. from 13 to 24 hours
C. on 2nd day
D. on 3rd day
E. during the first 5 days
358.
A.
B.
C.
D.
E.
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
359.
Which of the following substances appropriate to conduct the blood transfusion
when poisoning?
A. aniline
B. arsenic hydrogen
C. vinegar essence with high hemolysis
D. * faithful only A and B
E. faithful only B and С
360.
With hyperpotassemia appropriate use for induction of anesthesia in patients with
acute renal failure:
A. kalipsol + seduxen
B. diprivan + fentanyl
C. N2О + ftorotan
D. all answers are faithful
E. * right A and B
361.
With increasing tone of the vegetatic nervous system it is better to use after
operation (patients feel the repletion of urinary bladder):
A. * sympatholythics
B. anticholinesterases facilities
C. warmly
D. correctly only A and B
E. all answers are correct
362.
You should perform hemotransfusions for patients in terminal stage of chronic
renal failure if content of haemoglobin is:
A. * not below after 80 g/l
B. not below after 90 g/l
C. not below after 100 g/l
D. not below after 110 g/l
E. all answers are correct
363.
A.
B.
C.
D.
E.
Acute respiratory insufficiency of restrictive type develops as a result of:
All answers are correct
Thoracic injuries
Diffusion disorders at the level of blood-air barrier
Obstructions of respiratory tracts
*Limitation of lungs respiratory surface
364.
Simultaneous reduction of partial pressure of oxygen and carbon dioxide in the
arterial blood is possible in case of:
A. All answers are correct
B. All answers are wrong
C. *violation of ventilation-perfusion correlation
D. apnoea
E. Decrease of respiratory volume
365.
Choose the apnoea treatment method in case of central nervous system
depression:
A. all answers are correct
B. all answers are wrong
C. *Artificial lung ventilation
D. Intravenous introduction of sodium bicarbonate
E. Intravenous introduction of adrenaline
366.
A.
B.
C.
D.
E.
Hyperbaric oxygenation :
*All answers are correct
all answers are wrong.
Increases partial pressure of oxygen in the arterial blood
is an instrument of increasing oxygen solubility in liquid part of blood
Increases level of hemoglobin in the blood
A.
B.
C.
D.
E.
What symptom is connected with hypercapnia:
All answers are correct
There is no right answer.
*skin hyperemia
skin pallor
skin cyanosis
367.
368.
What rate of partial oxygen pressure in arterial blood is an indication artificial
lung ventilation:
A. All answers are correct
B. *60 and less mm of mercury under inhalation of 100% oxygen
C. 60 - 70 mm mm of mercury
D. 70 - 80 mm mm of mercury
E. 80 - 90 mm mm. of mercury
369.
What is indicated in case of hypercapnia?
A. All answers are correct
B. *Artificial lungs ventilation
C. Mask ventilation
D. Administration of sodium bicarbonate
E. Insertion of sedative facilities
370.
Diffusion of what gas will diminish as a result of alveolar-capillary membrane
compression in a greater degree:
A.
B.
C.
D.
E.
All answers are wrong
The compression of membrane will not influence gas diffusion
Diffusion of oxygen and carbon dioxide will diminish in equal degree
Carbon dioxide
*Oxygen
A.
B.
C.
D.
E.
What is the normal rate of oxygen partial pressure in the arterial blood?
A.All answers are wrong
B.All answers are correct
C.110-130 mm of mercury
D.60 - 70 mm of mercury
*93-98 mm of mercury
A.
B.
C.
D.
E.
Which statement is correct?
All answers are wrong
All answers are correct
Hypoxemia and hypercapnia are obligatory signs of acute respiratory failure
Hypoxemia is a permanent syndrome in case of acute respiratory failure
*Hypoxemia is a permanent syndrome in case of acute respiratory failure
A.
B.
C.
D.
E.
The thoracic-abdominal form of acute respiratory failure occurs in case of:
All answers are wrong
Bad ventilation of respiratory tracts
Atelectasis
Enteroparesis
* Multiple rib fractures
A.
B.
C.
D.
E.
Neuromuscular acute respiratory failure is observed in case of:
All answers are wrong
*Poliomyelitis, botulism
Foreign body
Depression of respiratory center
Micro atelectasis
A.
B.
C.
D.
E.
The obstructive form of acute respiratory failure occurs in case of:
All answers are wrong
All answers are correct
Disorder of neurosynaptic connection.
*Disorder of airways potency
Micro atelectasis
A.
B.
C.
D.
E.
Ventilation with 100% oxygen for a long time can cause:
All answers are correct
*Micro atelectasis
Hypoventilation of patients with hypoxic type of disorder
Drying of respiratory tracts
Does not have any harmful influence
371.
372.
373.
374.
375.
376.
377.
A.
B.
C.
D.
E.
What symptoms are typical for acute respiratory failure?
decrease of oxygen partial tension in the arterial blood
cyanosis, acrocyanosis
tachycardia, and then bradycardia
rise, and then decline of arterial pressure
*tachypnea, pathological rhythms of breathing (Cheyn-Stokse, Kussmaul, Biot).
A.
B.
C.
D.
E.
What are the methods of hypertension prophylactic during intubation?
all answers are correct
correct answers A. and B.
slow introduction of ketamin, which provides circulation stability
intravenous introduction of lidocain during induction
*usage of hypotensive drugs (per os) in premedication
378.
379.
Traheostomy (choose the correct statement)
A. must be executed with premedication consisting of sedative medicines and
remedies for salivation depression
B. removes the necessity of gases humidifying
C. pressure in the cuff of tube must be more than 20
D. tubes should be changed every day
E. *can be performed with local anesthesia
380.
A.
B.
C.
D.
E.
Surgical traheostomy (choose the correct statement)
*all answers are correct
correct B. and C.
should be performed after cerebral stroke (brainstem)
should be done for sanation of respiratory tracts
usually done between 1st and 3d rings of trachea
381.
What does belong to the defects of high-frequency ventilation (in comparing with
traditional artificial lung ventilation ) belong?
A. *all answers are correct
B. right A. and B.
C. inadequate ventilation in the case of untight respiratory tracts (for example, at a
bronchoplevral fistula)
D. considerable change of respiratory volume
E. promotion of middle pressure in the respiratory tracts
382.
A.
B.
C.
D.
E.
High-frequency ventilation (choose the correct answer)
all answers are wrong.
all answers are correct.
to achieve normocapnia high-frequency ventilation requires respiratory volume
about 5 ml/kg
high-frequency respirators is a routine method of ventilation
*in case of high-frequency ventilation exhalation is passive
383.
What is the reason of considerable blood saturation decline in case of one side pleura
damage?
A.
B.
C.
D.
pathological reflexes from the wound
*bloodshunting in collapsed lung
influence of anesthetic
decline of partial oxygen pressure in the inhaled air
E. forced position of the patient
384.
Patient has multiple ribs fractures and acute respiratory failure. After trachea
intubation and beginning of artificial lung ventilation the increase of cyanosis and
hypotension are marked. The most probable reason is:
A. lungs injury
B. aspiration of gastric contents
C. *tension pneumothorax
D. esophagus intubation
E. thoracic aorta rupture
385.
A patient after severe car crash delivered to the ICU. He has the shallow
breathing, paradoxal chest movements, thoracic deformation, pain during inhalation,
pallor skin, low blood pressure. The most probable diagnosis is:
A. all answers are correct
B. injuries of abdominal cavity organs
C. hemopericardium
D. traumatic break of main bronchus
E. *hemothorax, multiple ribs fractures
386.
In case of severe chest trauma respiratory exchange is violated by all those
reasons, except for one:
A. *central respiratory regulation disorder
B. fat embolism lungs vessels
C. violation of thoracic framework
D. violations of airway potency
E. disorders of microcirculation
387.
A.
B.
C.
D.
E.
The paradoxical respiration is most often observed in case of:
artificial lung ventilation
pneumonia
*pneumothorax
lungs emphysema
laryngospasm
388.
The risk of aspiration pneumonia grows in case of gastric contents aspiration
according to the following pH level:
A. pH= 0.
B. pH = 7.5 and anymore
C. *pH less than 2.5
D. pH more than 5
E. pH = 7.4
389.
A.
B.
C.
D.
E.
390.
What are the symptoms of "syncopal drowning"?
*all answers are correct
correct A. and B.
color of skin is not cyanotic
cardiac arrest goes first
mostly happens in case of females and patients with coronary insufficiency
Oxygenation at patients with the chronic unspecific disease of lungs can cause:
A. D and E correct
B.
C.
D.
E.
Correct C and D
hypocapnia
D.*bradypnoe and hypoventilation
increase of breathing rate
391.
A 20-years-old patient has acute chest pain after the attack of cough; he has
shallow short breathing and during auscultation over right lung there are no respiratory
murmur and percussion gives - high tympanites. What does the patient need?
A. aspiration of mucous from right main bronchus
B. trachea intubation
C. *pleural cavity draining
D. breathing with positive pressure and 100% O2 inhalation
E. tracheostomy
392.
A patient with prolonged asthma attack gasometry shows such indexes: pH - 7.2;
BE - -8; pCO2 - 75 mm of mercury; pO2 - 50 mm of mercury. What does he need?
A. all answers are wrong
B. *all answers are correct
C. HBO treatment
D. beta blockers
E. intravenous introduction of 0.5 ml adrenalin solution and large doses of steroids,
urgent beginning of artificial lung ventilation
393.
What is an indication for ALV in case of a patient with status asthmaticus?
A. correct D. and C.
B. only A. and C.
C. *the decline PaO2 less than 60 is mm of mercury
D. lowering of partial CO2pressure
E. obstruction of bronchial tubes and appearance of mute areas during auscultation
394.
A.
B.
C.
D.
E.
395.
The spasm of bronchioles during anesthesia turns out as:
*short inhalation and prolonged exhalation
weak inhalation and the long exhalation
prolonged inhalation and prolonged forced exhalation
prolonged inhalation
prolonged forced exhalation
Bronchial asthma attack is accompanied with:
A.
B.
C.
D.
E.
correct only C and E.
*all answers are correct
increased exhalation resistance
increased remaining volume
reduction of volume and speed of the forced exhalation
396.
A patient has bilateral pneumonia. His consciousness is confused, temperature is
39.2°C, respiratory rate is 50 per min; auscultation shows bilaterally diminished breath
sounds; pulse is 125 per minute, AP - 90/60 mm of mercury; gasometry results are
next: pH-7.24; BE- -10; pCO2 - 66 mm of mercury, pO2 - 55 mm of mercury. What
will be the most effective method of acute respiratory failure treatment in this case?
A. correct D and C.
B. *correct A. and B.
C. micro traheostomia
D. intubation and AVL
E. advanced antibiotics therapy
397.
What is not prescribed in case of acute respiratory failure caused by massive
pneumonia?
A. *A.
sessions of HBO
B. micro traheostomia with introduction of mucolytic enzymes and aerosol therapy
C. ALV
D. cardiac glycosides, antibiotics, bronchial spasmolytics
E. artificial lung ventilation, oxygen therapy
398.
Here is the gasometry of a patient with massive pneumonia: pH-7.2, BE-0;pCO270 mm of mercury; pO2-55 mm of mercury. How would you evaluate his condition?
A. normal results
B. metabolic alkalosis
C. metabolic acidosis
D. *respiratory acidosis
E. respiratory alkalosis
399.
A.
B.
C.
D.
E.
Urgent intensive care steps of pulmonary edema treatment include:
all answers are wrong
all answers correct
intubation of trachea, artificial lung ventilation
*oxygen therapy
intravenous introduction of respiratory analeptic
400.
Why is spontaneous ventilation with PEEP useful in case of patients with acute
respiratory failure caused by massive pneumonia?
A. correct only A. and B.
B. *all answers are correct
C. ventilation diminishes a veinous shunting in lungs
D. makes natural drainingof respiratory tracts easier
E. it’s an instrument which helps to increase the respiratory surface of lungs
401.
What will help to increase the oncotic blood pressure during treatment of pulmonary
edema?
A. all answers are correct
B. all answers are wrong
C. infusion of crystalloids
D. stimulation of diuresis by osmotic diuretics
E. *stimulation of diuresis by diuretics
402.
A.
B.
C.
D.
E.
403.
What is not an indication for ALV of a patient with acute respiratory failure?
*pvO2 more than 50 mm of mercury
breathing rate more than 40 per minute
decline of AT below 90 mm of mercury, tachycardia more than 120 per minute
pO2 below 60 mm of mercury, pCO2 higher 60 mm of mercury
hypoxemic coma
What is happening during pulmonary edema?
A. correct only B. and C.
B. correct only A. and C.
C. increasing of vascular wall permeability
D. decompression of greater circulation vessels
E. *disorders of air ventilation
404.
A.
B.
C.
D.
E.
Positive pressure at the end of exhalation (PEEP) diminishes
pulmonary capillary wedge pressure
*intracranial pressure
functional remaining capacity
PaCO2
intrathoracic volume of blood
A.
B.
C.
D.
E.
Reduction of cardiac output during ventilation with PEEP is caused through:
correct B. and C.
correct A. and C.
delay of carbonic acid
reduction of heart rate
*increase of right ventricle afterload
A.
B.
C.
D.
E.
What are the complication of a ventilation with positive pressure?
correct only A. and B.
*all answers are correct
pneumothorax
pneumoperitoneum
emphysema, pulmonary interstitial emphysema and emphysema of mediastinum
405.
406.
407.
What statements are true about bronchial asthma?
A. all answers correct
B. correct only A. and B.
C. mechanical ventilation can be used for providing night rest of patients with
asthma
D. steroids must be included into treatment of severe asthma
E. prognosis of disease depends on age of the asthma onset
408.
A.
B.
C.
D.
E.
The alveolar hypoventilation often develops in case of:
correct only A. and B.
all answers are correct
metabolic alkalosis
emphysema and asthma
raised intra-abdominal pressure
409.
What would be like gasometry of a 63-year old patient with chronic bronchitis
exacerbation?
A. all answers correct
B. correct only A. and B.
C. pH-7.58, standard bicarbonat 18 mmol/l
D. PaO2 -10.4 cPa(78 mm of mercury)
E. PaO2- 5.6 cPa(42 mm of mercury)
410.
A.
B.
C.
D.
What is the reason which declines diffusive possibility of lungs?
correct only A. and B.
correct only A. and C.
hepatitis
polycythemia
E. *emphysema
411.
A.
B.
C.
D.
E.
What are the indications for ALV of a patient with a syndrome of Guillain-Barre?
all answers are wrong
all answers are correct
loss of reflexes
*general pulmonary capacity less than 2 litres
the forced vital capacity less than 15 ml/kg
A.
B.
C.
D.
E.
Development of spontaneous pneumothorax is related with:
correct only A. and B.
all answers are correct
arthritis
*asthma
MI
A.
B.
C.
D.
E.
Late complication of prolongated intubation is:
dysphagia
*bronchoplevral fistula
damage of nervus laryngeus reccurens
trachea stenosis
granulomatosis
412.
413.
414.
What are the adventages of controlled ALV in case of mobile chest and multiple
rib fractures?
A. all answers are correct
B. acceleration of fractures consolidation
C. prevention of pneumothorax
D. elimination of pulmonary infection
E. *decline of paradoxical ventilation and possibility of PEEP usage
415.
A.
B.
C.
D.
E.
Choose true statements about pulmonary embolism:
correct A. and B.
correct B. and C.
there is a possibility of icterus development
*there are characteristic ECG signs
level of LDG is normal
416.
What are clinical symptoms of chronic bronchitis complicated with acute
respiratory failure?
A. all answers are correct
B. edema optical nerve disk
C. muscular twitches
D. cold limbs
E. *pulse of the promoted filling
417.
A.
B.
C.
D.
E.
Accidental surgical pneumothorax is probable during
*all answers are correct
all answers are wrong
thyroidectomia and traheostomia
neck sympathectomy
catheterisation of v. subclavia
418.
What would be the result of PEEP 10 mbar ventilation of a patient with lobar
pneumonia?
A. increase of physiological dead space
B. reduction of functional remaining capacity
C. system hypertension
D. *increasing of PaCO2
E. decline of PaO2
419.
A.
B.
C.
D.
E.
The increase of PaCO2 can be expected in case of:
all answers are correct
diabetic coma
kidney insufficiency
moderately severe asthma attack
*massive pulmonary embolism
420.
In case of severe pneumonia caused by gastric contents aspiration what index will
not grow?
A. interstitial water in lungs
B. *compliance of lungs
C. pressure in the pulmonary artery
D. V/Q correlation
E. resistance of airways
421.
In case of acute respiratory distress syndrome of adults:
A. *pulmonary arterial pressure decreases
B.
C.
D.
E.
422.
kidney insufficiency might be a reason
hypoxemia is an answer to the rise of FiO2
a functional remaining capacity is promoted
general pulmonary water is diminished
In case of acute respiratory distress syndrome of adults takes place:
A.
B.
C.
D.
E.
decline of airways resistance
rise lungs compliance
*decline of pulmonary surfactant a ctivity
decline alveolar - arterial pO2 gradient
rise of alveolar ventilation
423.
What are the receptors responsible for stimulation of the respiratory center in
hypoxemia?
A. * The respiratory center is not a reflex stimulated carotid chemoreceptors
B. The oxygen tension in arterial blood is reduced to 60 mm Hg
C. A person inhales a gas mixture with 15% of oxygen
D. The man rises to a height of 4000 m
E. Patient anemic
424.
A.
B.
C.
D.
E.
Child's sharply breathing can be caused by the following factors exept:
Epiglotitis
foreign body of larynx
stenosing laryngotracheitis
* Acute bronhiolospasm
Submucose edema
425.
A.
B.
C.
D.
E.
Kussmaul breathing :
Occurs when renal excretory alkalose
Is the respiratory compensation of diabetic ketoacidosis
* Often observed at coma
It is a characteristic feature of hyperosmolar diabetic coma
Reduces alveolar ventilation
426.
Possible iatrogenic causes of acute respiratory distress syndrome may be the
following factors exept:
A. artificial ventilation, the concentration of oxygen in the inspired gas is not higher
than 40%
B. artificial ventilation with oxygen concentration in the inspired gas is not higher
than 70%
C. Transfusion of blood incompatible
D. Operations using the heart-lung machine
E. * Severe hypovolemic shock
427.
Synchronous intermittent mandatory ventilation (SIMV) compared with
controlled ventilation:
A. Reduces blood pressure and cardiac output
B. Reduces the work of respiratory muscles
C. Reduces the energy cost of breathing
D. * Allows you to reduce the pressure on the height of inspiration
E. Lowers pH and raises the pCO2
428.
The patient during intubation anesthesia using mechanical ventilation suddenly
emerged cyanosis on the background of normal hemodynamic indexes. Ungual
phalanges cyanosis not decrease. All is the proper, exept:
A. Check tightness of breathing system
B. Remove the flow of nitrous oxide (if applicable)
C. Increase the supply of oxygen
D. Check patency and position of endotracheal tube
E. * Change absorber of carbon dioxide
429.
The rapid drop of carbon dioxide tension in arterial blood from a high level to
normal can lead to:
A. Arterial hypertension
B. * Arrhythmias
C. Cephaledema
D. Increase in coronary perfusion
E. None of the above
430.
After 20 minutes of ventilation with pure oxygen arterial pO2 of patient was 60
mm Hg .
What is the mechanism of respiratory disorders?
A. alveolar hypoventilation
B. Violation of diffusion through the alveolar-capillary membrane
C. Violation of ventilation-perfusion ratios in lungs
D. Intrapulmonary shunting up to 10%
E. * Toxicity of oxygen
431.
After a 2-sided carotid endarterectomy in a patient:
A. changes of the regulation of respiration
B. No reaction of pCO2
C. There is a shortness of breath in response to hypoxemia
D. * The main impetus of the respiratory center is to increase the pH and pCO2
intracerebral interstitial fluid
E. None of the above
432.
Airway resistance during turbulent flow of gas depends on the following factors
exept:
A. pipe radius
B. gas viscosity
C. The gas density
D. Bit stream
E. * Lung compliance
433.
A.
B.
C.
D.
E.
All statements about spontaneous pneumothorax are true, exept:
The most common among men 20-40 years
* the trachea is mooving in the patient side
Increased risk for women during menstruation
Increased risk in smokers
There are people with a genetic predisposition
A.
B.
C.
D.
E.
Alveolar hypoventilation leads to everything, exept:
hypoxemia during air breathing
* hypoxemia while breathing oxygen
hypercapnia when breathing air
Hypercapnia during oxygen breathing
Anything with the above listed
A.
B.
C.
D.
E.
Anatomical dead space is increased by the action of the following factors exept:
* pleurorrhea
Atropine
Inhalation of phtorotan
Introduction aminophylline
None of the above
434.
435.
436.
At the function cilliaris apparatus of the lower respiratory tract adversely affect
the following factors exept:
A. incense
B. dehydration
C. Hyperhydration
D. Atropinisation
E. * Introduction glucocorticoids
437.
Before all chemical substances, the most powerful regulator of alveolar ventilation
in normal conditions is:
A. Oxygen
B. * Carbon dioxide
C. Hydrogen ions
D. Lactic acid
E. Nitrogen
438.
Breathing of Biott is characterized by:
A.
B.
C.
D.
E.
Short and long breath exhalation
Duration of breath and short breath
* A frequent deep breathing, alternating with breathing pauses
Smoothly varying amplitude of the respiratory volume
Ensures adequate ventilation
A.
B.
C.
D.
E.
Carbon dioxide tension in alveolar air in normal conditions is:
More when breathing air under a pressure of 2 atmosphere
Less when breathing air under a pressure of 2 atmosphere
* It depends only on the alveolar ventilation and CO2 production
Less when breathing with pure oxygen
More when breathing with pure oxygen
A.
B.
C.
D.
E.
Cheyne - Stokes respiration is characterized by:
Short and long breath exhalation
Duration of breath and short breath
respiration pauses, before the frequent deep breathing
* Smoothly varying amplitude of tidal volume with short pauses
Provides breathing
439.
440.
441.
B.
C.
D.
E.
Choose the wrong answer. Respiratory distress syndrome of newborns:
* The probability of its development is reduced by the use of corticosteroids in
pregnant
Linked to hypoplasia of bronchial tree
It is characterized by an increase of the respiratory muscles
Effective treatment with artificial surfactant
Usually develops in preterm
A.
B.
C.
D.
E.
Choose the wrong answer. Lung surfactant:
produced pneumocites of type 2
It consists mainly of lipoproteins
Not for respiratory distress syndrome of newborns
* Increases the surface tension of fluid in the alveoli
None of the above
A.
B.
C.
D.
E.
Compared with atmospheric air alveolar gas has:
The lower total pressure
Higher pO2
Lower pCO2
* Higher partial pressure of water vapor
Higher partial pressure of nitrogen
A.
442.
443.
444.
Cromolyn Na (INTAL) may be effective in the treatment of bronchial asthma
because of the following steps:
A. Blockade of histamine receptors
B. Inhibition of phosphodiesterase
C. Activation of beta 2-adrenoceptor
D. * Blocks bronhokonstriktivnyh substances
E. None of the above listed
445.
Cyanosis is not indicative of the presence of hypoxemia if a concentration of
hemoglobin is equal to:
A.
B.
C.
D.
E.
70 g / l
100 g / l
140 g / l
* 170 g / l
In the absence of hypoxemia and congestive heart failure cyanosis will be present
446.
Cyanosis of the skin and visible mucose will be possible to detect with a decrease
in oxygen saturation of arterial blood below:
A. 70%
B. * 80%
C. 90%
D. 100%
E. 20%
447.
A.
B.
C.
D.
E.
Dead space is reduced by all exept:
In the supine position compared with the vertical position
Intubation
After the imposition of tracheostomy
* After the upper laporotomia
None of the above
448.
Direct reading of spirographic data can be used to measure the following volumes,
exept:
A. tidal volume
B. * residual lung volume
C. lung capacity
D. Expiratory reserve volume
E. Inspiratory reserve volume
449.
A.
B.
C.
D.
E.
Each gram of hemoglobin can bind:
0.03 ml of oxygen
0.57 ml of oxygen
* 1,34-1,39 ml of oxygen
1 ,48-1, 56 ml of oxygen
2.0 ml of oxygen
A.
B.
C.
D.
E.
Fit bronchoconstriction in atopic form of bronchial asthma can be docked using:
Intal
* Betta adrenostimulators
Calcium
Diphenhydramine
Chloride
450.
451.
For acute respiratory distress syndrome characterized by the following symptoms
exept:
A. Increases in intrapulmonary shunting
B. Violations of the permeability of the alveolar-capillary membrane
C. Increase the amount of free water in the lungs
D. * Increases elasticity (compliance) of the lungs
E. Education pneumosclerosis and hyaline membrane
452.
For which of the above indices was best to evaluate the adequacy of mechanical
ventilation?
A. Hemodynamics
B. pH of arterial blood
C. * arterial blood gas composition
D. pH of venous blood
E. Gas composition of venous blood
453.
A.
B.
C.
D.
E.
Frequency of atelectasis is less:
* For men compared with women
For women compared with men
In patients with low birth weight
After laparoscopic surgery
After low laporotomic cuts
A.
B.
C.
D.
E.
Functional dead space is increased by:
Reducing the partial pressure of oxygen in the inspired gas
Growth of intrapulmonary shunting
* hypovolemia
Anemia
Trendelenburg position of patient
A.
B.
C.
D.
E.
Functional dead space is likely increase if the following drugs used exept:
ganglion blocking
Atropine
Nitroglycerin
Dehydrobensperidol
* Neostigmine
454.
455.
456.
A.
B.
C.
D.
E.
457.
A.
B.
C.
D.
E.
458.
High-frequency ventilation:
Considered as such if the tidal volume above the volume of anatomic dead space
More effective in patients with low extensibility (compliance) of light compared
to conventional mechanical ventilation
Helps increase intrathoracic pressure compared with conventional mechanical
ventilation
Reduces the risk of pulmonary barotrauma compared with conventional
mechanical ventilation
* Safer than conventional mechanical ventilation in patients with bronhopleural
fistulas
Hyperventilation is developed under the following conditions, exept:
Metabolic acidosis
Hypovolemia
* barbiturate poisoning
Hyperthermia
Nothing from the above listed
Hypoxic hypoxia is characterized by the following symptoms exept:
A. Violations of consciousness
B.
C.
D.
E.
Cyanosis of the skin and visible mucous
Reduction of alveolar pO2
Reduction of arterial pO2
* Increasing arteriovenous oxygen difference
459.
In the case of elevated methemoglobin in the blood and the development of tissue
hypoxia is shown the application:
A. Atropine
B. Inhibitors of holinesterase
C. * Methylene blue
D. Glucose
E. Diphenhydramine
460.
A.
B.
C.
D.
E.
In what form of hypoxia is inefficient oxygen therapy:
Hypoxic
circulatory
Hemical
* Hystotoxic
None of the above
A.
B.
C.
D.
E.
Increasing of alveolar-arterial oxygen difference did not depend from:
Violations of the diffusion of gases through the alveolar-capillary membrane
The increase in the shunting pulmonary
ventilation with pure oxygen
* Moderate anemia
By increasing blood flow
A.
B.
C.
D.
E.
Indicators of pulse oximetry:
* Depends on the state of tissue perfusion
Do not respond with a decrease in arterial pO2 to 60 mm Hg
No Avis of light effects in the determination
Do not depend on the state of the external gas exchange
None of the above
A.
B.
C.
D.
E.
Intermediate bronchus of the right lung holds air:
In the upper part
The average share
In the lower part
* In the middle and lower lobe
In the upper and middle lobe
A.
B.
C.
D.
E.
It can be expected that the pO2 will be normal arterial in:
Decrease in partial pressure of oxygen in inhaled air
Violations of diffusion through the alveolar-capillary membrane
alveolar hypoventilation
Smoke gas poisoning
* Anemia
461.
462.
463.
464.
465.
It is known that a healthy young man:
A. The lungs are easy to stretch more than the thorax
B. The lungs are easy to stretch less than the thorax
C. * Tensile elongation of lungs are equal to the thorax
D. The total elongation more than elongation of one lung
E. None of the above
466.
A.
B.
C.
D.
E.
Low oxygen tension in the inspired gas leads to:
Increasing of tension and oxygen saturation of arterial blood
It shifts the oxyhemoglobin dissociation curve to the left
It increases the pulmonary arteriols
* With prolonged exposure leads to pulmonary hypertension
Nothing from the above listed
A.
B.
C.
D.
E.
Lung diffusion capacity is probably not broken in the case of:
* myasthenia
interstitial pulmonary edema
severe attack of bronchial asthma
Acute respiratory distress syndrome
Nothing from the above listed
467.
468.
In which case will be the greatest stimulation of the respiratory center carotid
chemoreceptors?
A. Carbon Monoxide Poisoning
B. methemoglobinemia
C. Severe anemia
D. * Increased intrapulmonary shunting
E. Pronounced metabolic alkalosis
469.
A.
B.
C.
D.
E.
Normally, the maximum concentration of hemoglobin in the erythrocyte is:
10%
21%
27%
* 34%
50%
A.
B.
C.
D.
E.
Normally, the percentage of dead space on the tidal volume is:
5%
15%
* 30%
50%
60%
470.
471.
Oxygen and carbon dioxide tension markedly fluctuate during inspiration and
expiration if it were not :
A. The reserve volume inspiratory
B. Respiratory volume
C. * Residual lung capacity
D. Vital lung capacity
E. Minute volume of breathing
472.
Possible complications of tracheostomy are, exept:
A.
B.
C.
D.
E.
Infection of lower respiratory tract
* The increase of the dynamic resistance to breathing
Formation of a fistula
Tracheal stenosis
Bleeding from the respiratory tract
A.
B.
C.
D.
E.
Pulmonary vascular resistance drops:
Alveolar Hypoxia
Alveolar hypercapnia
* prostacyclin
Carbon dioxide
Catecholamines
A.
B.
C.
D.
E.
Recurrent laryngeal nerve:
* It is a branch of the vagus nerve
Is only the sensory nerves
As a rule, is not damaged during surgery in the neck
With his injury is not observed speech disorders
Nothing from the above listed
473.
474.
475.
Reduced of which muscle has the greatest significance for the creation of high
pressure in the airway by coughing before the opening of the glottis?
A. intercostal muscles of expiration
B. Diaphragm
C. trapesius
D. bronchialis
E. * None of the above
476.
Reduced production and function of pulmonary surfactant leads to the following
effects exept:
A. Increases in the elastic resistance of lungs
B. * Increases in the dynamic resistance (bronchial tree)
C. Atelektasation
D. Increases in the work of respiratory muscles
E. Interstitial pulmonary edema
477.
Reduced the forced expiratory volume will probably be observed in all states
exept:
A. Asthma
B. Emphysema
C. chronic bronchitis
D. * Lung abscess
E. None of the above
478.
A.
B.
C.
D.
E.
Reducing the partial pressure of oxygen causes spasm:
coronary
* pulmonary vascular
receptacles of splanhnic zone
Vessels of striated muscles
Nothing from the above listed
479.
A.
B.
C.
D.
E.
Sensitive innervation of the larynx by branches:
trigeminal
facial nerve
Vestibulokohlearnogo nerve
Glossopharyngeal nerve
* Vagus
A.
B.
C.
D.
E.
Shortness of breath may be caused directly by the following factors, exept:
Decrease in arterial pO2
* Enhancement of arterial pO2
Reduction of Hb saturation of venous blood oxygen
Increased blood pCO2
Decrease in pH of arterial blood
480.
481.
Stimulation of the Hering-Breuer reflex resulting from stimulation of stretch
receptors in the lungs, can lead to:
A. The increase in inspiratory and expiratory
B. * Switching from inhalation to exhalation, when tidal volume is more than 1 liter
C. Reduction of alveolar ventilation
D. decreasing the alveolar ventilation
E. Anything of the above
482.
A.
B.
C.
D.
E.
Tachypnea is characterized by:
The increase of minute volume of respiration
* By increasing the frequency of breathing
By increasing the depth of respiration
Decrease paCO2 below 35 mm Hg
Nothing from the above listed
A.
B.
C.
D.
E.
Tensile properties (compliance) of lungs is reduced when:
The normal production of surfactant
* Pulmonary edema
Open pneumothorax
Breathing the hypoxic mixture
None of the above
483.
484.
The best way to treat "oxygen apnea", developed due to increased oxygen tension
in arterial blood of patients with hypoxic respiratory stimulation type is:
A. Application of respiratory analeptics
B. Cessation of oxygen supply
C. * Increased content CO2 in the inspired gas
D. ALV
E. Introduction of alkalify solutions
485.
The concentration of COHb (carboxyhemoglobin) in the patient is 30%. When it
will drop to 7.5% in the case of breathing with atmospheric air?
A. 1 hour
B. 5 hours
C. * 10 hours
D. 24 hours
E. 48 hours
486.
The following factors lead to alveolar hypoventilation after curaresation in the
postoperative period, exept:
A. Hypothermia
B. Applications of dalacin
C. Applications of furosemide
D. Hypokalemia
E. * Applications of beta-blockers
487.
The following symptoms are characteristic of hypercapnia, hypoxia is not
accompanied by:
A. Cyanosis of the skin and visible mucous
B. Expression of peripheral spasm
C. Bradycardia
D. * Sweats
E. Reduction of cerebral blood flow
488.
The long-existing pulmonary hypertension is characterized by the following
symptoms exept:
A. Increasing vascular resistance
B. Increase pulmonary bypass
C. Increase of the load of the right ventricle of the heart
D. * Hypertrophy of the left ventricle
E. polycythemia
489.
A.
B.
C.
D.
E.
The main reasons of pulmonary respiratory failure are the following, exept:
Increasing the concentration of oxygen in the inspired gas
* Reduction of alveolar ventilation
Violations of the diffusion of gases through the alveolar-capillary membrane
Violations of ventilation-perfusion ratios in lungs
Increased intrapulmonary shunting
A.
B.
C.
D.
E.
The most common pulmonary embolism develops in:
* proven deep vein thrombosis
prolonged immobilization
recent orthopedic surgery
Obesity
Availability of ELA in history
A.
B.
C.
D.
E.
The partial pressure of water vapor in the alveolar gas depends on:
Composition of inhaled gas
The values of atmospheric pressure
* The body temperature
Alveolar pO2
Alveolar pCO2
A.
B.
C.
D.
E.
The pharmacological effect of bronchial spasmolytic can be realized by all, exept:
Preemption effect of acetylcholine
* increase of GMPh
Increase of AMPh
Blockade of release of cell mediators for adhession
Blockade of Ca-channels
490.
491.
492.
493.
A.
B.
C.
D.
E.
The poisoning is fatal if carbon monoxide is minimal links:
20% of blood hemoglobin
40% of blood hemoglobin
54% of blood hemoglobin
* 76% of blood hemoglobin
100% of blood hemoglobin
A.
B.
C.
D.
E.
The pressure in the pulmonary artery is reduced in the case of :
Acidosis
exercise
Introduction propranolol
Hypoxia
* All the answers are not true
494.
495.
The therapeutic effect of sympathomimetics for relieving of bronchospasm is
associated with:
A. blockade of adenosine receptors of bronchial muscles
B. blockade of calcium tubules of bronchial muscles
C. C. blockade of histamine receptors of bronchs
D. * By increasing the content of cAMP in the cells of bronchial muscles
E. Oppression bronhospasticheskih reflexes
496.
A.
B.
C.
D.
E.
To the respiratory muscles of expiration are all listed, exept:
* Diaphragm
Internal intercostal muscles
External and internal oblique abdominal muscles
Lateral and ventral abdominal muscles
None of the above
A.
B.
C.
D.
E.
To the respiratory muscles of inhalation are all listed, exept:
Diaphragm
outdoor intercostal muscle
* Internal intercostal muscles
Scalenus
None of the above
A.
B.
C.
D.
E.
What applies to the drugs 'first appointment' acute attack of asthma?
aminophylline
Crank
Parenteral beta 2-adrenomimetics
* Inhaled beta 2-adrenomimetics
Cholineblocker
A.
B.
C.
D.
E.
What are the normal values of carbon dioxide tension in arterial blood?
20-30 mm Hg
30-40 mm Hg
* 35-45 mm Hg
45-55 mm Hg
50-60 mm Hg
497.
498.
499.
500.
What could be the immediate causes of circulatory hypoxia?
A.
B.
C.
D.
E.
Alveolar hypoventilation
Increased intrapulmonary shunting
Renal insufficiency
* Violation of blood microcirculation
Carbon monoxide
A.
B.
C.
D.
E.
What is the most characteristic radiological sign for pulmonary embolismrterii?
Expanding the root of the lung
Pulmonary infiltration
The rise of the dome diaphragm
Symptom Hampton (wedge-shaped infarct of the lung)
* Chest radiograph remains normal
A.
B.
C.
D.
E.
What is the normal value of minute breathing volume in an adult?
2-4 L / min
* 5-10 l / min
8-12 l / min
10-15 l / min
20 l / min
A.
B.
C.
D.
E.
What is the smallest of these lung volumes?
* respiratory volume
Vital lung capacity
Residual lung volume
Expiratory reserve volume
None of the above
501.
502.
503.
504.
What percentage of CO2 directly or indirectly transferred by means of
hemoglobin?
A. 5%
B. 10%
C. 50%
D. * 90%
E. 20%
505.
What should be the minimum pressure at the peak of inspiration from a patient
with healthy lungs with normal weight and normal extensibility of the chest that would
provide the necessary injection of tidal volume?
A. 8-10 cm water station
B. * 14-20 cm of water station
C. 20-30 cm of water station
D. 30-40 cm of water station
E. 50-60 cm of water station
506.
A.
B.
C.
D.
E.
507.
What's wrong? Anatomical characteristics of the trachea:
The average length is 10-18 cm
Bifurcation is located at 5 th thoracic vertebra
Motionless, fixed to the surrounding tissue
About half of is above sternum
* Length varies with body position
Which from these factors can reduce the excretion of carbon dioxide?
A.
B.
C.
D.
E.
Alveolar hyperventilation
Climb up to the highlands
Breathing with pure oxygen under atmospheric pressure
* Breathing with pure oxygen under pressure of 3 atmosphere
Nothing from the above listed
508.
Which of the factors plays the greatest role in creating the elastic resistance of
normal lung:
A. Elastic skeleton of light
B. * Surface tension of alveolar fluid
C. Intrapleural pressure
D. Cross-sectional area of the bronchi and bronchioles
E. None of the above
509.
Which of the following indicators may serve as one of the criteria for transfer of
patient on mechanical ventilation?
A. The respiratory rate in adults over 20/min
B. Vital lung capacity, equal to 20 ml / kg
C. inspiratory force greater than 25 cm water station
D. Arterial pO2 in 65-year-old patient, equal to 60 mm Hg
E. * Arterial pCO2 greater than 55 mm Hg
510.
Which of the following symptoms may be useful for differential diagnosis of
hypoxic and circulatory hypoxia, exept?
A. Nature cyanosis
B. Alveolar pO2
C. Arterial pO2
D. * pH of arterial blood
E. Arteriovenous oxygen difference
511.
A.
B.
C.
D.
E.
Which of these factors are not causes shortness of breath?
* The oxygen tension in arterial blood of 80 mm Hg
Metabolic acidosis
Hypercapnia
Hyperthermia
Nothing used above listed
A.
B.
C.
D.
E.
With the catheter of Swan-Gans it can be defined the following parameters, exept:
Pressures in the right atrium
Pressure in the right ventricle
Pressure in the pulmonary artery
Pressure occlusion (wedge), pulmonary artery
* End-diastolic pressure in the left ventricle
512.
513.
With the development of a massive pulmonary haemorrhage are shown the
following activities, exept:
A. * Urgent introduce calcium preparations
B. Lay the patient in position Trendeleburga on the side of bleeding
C. You must create a controlled hypotension
D. Urgent call for a consultation thoracic surgeon
E. When continuous bleeding translate to one-lung ventilator
514.
With the introduction of excessively deep endotracheal tube most of its end is
located in:
A. The right main bronchus
B. Left main bronchus
C. * Intermediate bronchus
D. Right distal bronchus
E. The left distal bronchus
515.
A.
B.
C.
D.
E.
Intravenous pyelogram (IVP)
2, 3, 1, 4, 5
* 2, 1, 3, 5, 4
3, 2, 1, 5, 4
1, 4, 2, 3, 5
2, 1, 5, 3, 4
516.
A 1-week-old cyanotic infant presents in shock. History is significant for feeding
difficulties and worsening URI symptoms over the past 2 days. The baby is limp,
minimally responsive to noxious stimuli, and has an O2 saturation of 72 percent on
room air (with little change after oxygen administration). RR is 60, HR is 200, blood
pressure is undetectable, and rectal temperature is 38.0°C. Chest auscultation shows
rales but no murmur. What is the BEST course of action?
A. Oxygen, prostaglandin E1 titrated to effect, and consultation with a tertiary
pediatric institution for possible transfer
B. Morphine, oxygen, and phenylephrine; place the infant in the knee-to-chest
position
C. A septic work-up and antibiotics; defer lumbar puncture until the baby is
stabilized
D. * A and C
E. B and C
517.
A 1-year-old baby presents with signs of severe dehydration and shock during a
severe bout of gastroenteritis. Which of the following is the most appropriate fluid
therapy?
A. * Isotonic crystalloid bolus of 20 mL/kg
B. Isotonic crystalloid infusion at 20 mL/kg/h
C. D5W 0.45 NS bolus of 20 mL/kg
D. D5W 0.45 NS infusion at 20 mL/kg/h
E. D5W 0.25 NS infusion at 20 mL/kg/h
518.
A 1-year-old boy presents to the ED with gastroenteritis that is unresponsive to
oral rehydration attempts. After physical examination, your assessment is that this 10kg child has 5 percent dehydration. Which of the following represents the total 24-h
fluid requirement?
A. 1100 mL
B. 1200 mL
C. 1300 mL
D. 1400 mL
E. * 1500 mL
519.
A 10-year-old female presents to the ED with left upper extremity pain and
swelling after a fall onto an outstretched arm 2 h before. She has a tense forearm,
moderate swelling at the elbow, and tenderness to palpation of the distal humerus.
Passive extension of the fingers elicits pain, and she complains of tingling in the hand.
Radial and ulnar pulses are present. What are the most appropriate immediate actions?
A. Splint the arm in flexion and send the patient to x-ray
B. Splint the arm in flexion, consult orthopedics, and send the patient for x-ray
C. Splint the arm in flexion, start an intravenous line, obtain immediate x-ray,
consult orthopedics, and prepare to reduce the fracture
D. Splint the arm in extension and send the patient for x-ray
E. * Splint the arm in extension, start an intravenous line, obtain immediate x-ray,
consult orthopedics, and prepare to reduce the fracture
520.
A 13-year-old female presents with the complaint that she cannot move her right
leg. There are no other associated symptoms and no history of trauma, head-ache, or
prior medical problems. The symptom began on the day she was to meet her father for
the first time. Which of the following would be LEAST helpful in the management of
this patient?
A. Perform a Hoover test
B. * Tell her that nothing is wrong
C. Hypnosis
D. Tell her that she can talk with her father on the telephone rather than in person
E. Reassure the patient that she will walk again
521.
A 13-year-old male is brought in by his parents for right hip stiffness and groin
discomfort after activity. He feels well otherwise and denies fevers or chills. On
examination he is ambulatory with a slight limp and mild discomfort with internal
rotation. Which of the following is the most likely diagnosis?
A. Congenital hip dislocation
B. Septic arthritis
C. Transient synovitis
D. Legg-Calvй-Perthes disease
E. * Slipped capital femoral epiphysis
522.
A 14-month-old irritable but nontoxic toddler presents with several days of upper
respiratory infection (URI) symptoms and a rectal temperature of 40.0°C. On
examination you do not find a specific source for the fever but note a few urticarial and
nonblanching tiny petechiae on the baby's lower abdomen. Which of the following is
the most appropriate action?
A. CBC, blood and urine cultures, oral antibiotics, and close outpatient follow-up
B. CBC, blood and urine cultures, home without medications, and follow-up every
24 h pending culture results
C. * Immediate respiratory isolation; CBC; blood, urine, and cerebrospinal fluid
(CSF) cultures; intravenous antibiotics; admission
D. Diphenhydramine for the urticaria, home with follow-up in 24 h or sooner if
worse
E. immediate respiratory isolation; CBC, blood and urine cultures; intravenous
antibiotics; admission
523.
A 14-year-old male presents with acute onset of inability to walk and severe pain
in the left groin, thigh, and knee. He is afebrile and appears nontoxic but is obviously
distressed. Examination shows an externally rotated thigh and apparent limb
shortening. What is the most likely diagnosis?
A. Legg-Calvй-Perthes disease (coxa plana)
B. * Slipped capital femoral epiphysis (SCFE)
C. Septic arthritis of the hip
D. Toxic tenosynovitis of the hip
E. Osgood-Schlatter's disease
524.
A 16-month-old child presents with seven watery, nonmucoid, nonbloody stools
beginning that day. The mother is not sure when he had his last void because the diaper
is always wet with stool. The mother inserted a trimethobenzamide (Tigan) rectal
suppository 1 h before. The child seems thirsty but has occasional clear emesis when he
takes fluids. Vital signs are remarkable for a rectal temperature of 38.0°C, RR of 30,
and pulse of 160, all taken while the child is screaming in triage. He appears vigorous
but has a dry mouth and no tears. Appropriate ED management for this child would
include all of the following exept
A. oral rehydration solution, 5 cc by mouth at a time, every 5 min
B. intravenous rehydration with 20 to 40 cc/kg LR or NS
C. * oral rehydration at home with clear liquids, followed by the BRATT diet in 24 h
D. regular milk within the first 24 h
E. discontinue and discourage use of antiemetic/antimotility agents
525.
A 2-week-old infant presents with congestion, mild wheezing, and a history of a
"feeling warm." Exept for wheezing and mildly increased respiratory effort, the baby
has normal vital signs and a normal examination. All the following historical elements
would place this child at increased risk for apnea exept
A. sluggish feeding and progressive increase in constipation
B. frequent paroxysms of cough, often followed by emesis, but no color change
C. * 1-week duration of symptoms
D. 2-day duration of symptoms
E. premature birth
526.
A 2-week-old vaginally delivered infant with an unremarkable perinatal course
presents with a rectal temperature of 38.0°C and reluctance to feed for 1 day. There is
no history of URI symptoms, vomiting, diarrhea, or rash. The baby's siblings (aged 13
months and 3 years) have colds, but no one else at home is ill. The infant's only
medication is acetaminophen, administered by the mother 3 h before arrival at the ED.
What is the most appropriate course of action?
A. Home after blood culture
B. Home after blood culture, CBC with differential, catheterized urine and urine
culture
C. * Admit after blood, catheterized urine, CSF cultures, CBC, urinalysis, and
intravenous ampicillin and gentamicin
D. Admit after blood, urine, and CSF cultures for intravenous ampicillin and
ceftriaxone
E. Home with close follow-up on no medications
527.
A 2-year-old male is brought to the ED by his parents for refusing to use his right
arm. He was well until 30 min before, when his cousin tried to lift him up a curb by that
arm. He now holds the elbow slightly flexed and pronated and will not use the injured
arm. Which is the most appropriate initial approach?
A. Obtain emergent orthopedic consultation
B. Order plain radiographs of the elbow
C. Attempt to reduce the elbow by pronation and extension
D. * Attempt to reduce the elbow by supination and flexion
E. Prepare to reduce the elbow under conscious sedation
528.
A 2-year-old male presents to the ED with a 5-day history of a high fever,
malaise, and irritability. Vital signs are a HR of 130, blood pressure of 84/44, RR of 24,
and temperature of 40°C. Examination shows an alert, uncomfortable-appearing boy,
with bilateral nonpurulent conjunctivitis, no nuchal rigidity, a strawberry tongue,
bilateral enlarged cervical nodes, palmar and plantar erythema, and a polymorphous
rash over the trunk. Chest x-ray is normal, as are a lumbar puncture and urinalysis.
Blood cultures are sent, and empiric antibiotics are started. Which of the following is
the most appropriate treatment?
A. Admit and start aspirin
B. Admit and start glucocorticoids
C. * Admit and start IVIG
D. Start aspirin and discharge with next-day follow-up
E. Start glucocorticoids and aspirin and discharge with next-day follow-up
529.
A 20-year-old female undergraduate student presents complaining of a gradual
onset of right-sided headache. The headache is accompanied by nausea and
photophobia and prevents her from studying for exams. Which of the following is
LEAST likely to be associated with her headache?
A. Aura
B. Birth control pills
C. Family history of similar headaches
D. Menstruation
E. * Unilateral tearing with conjunctival injection
530.
A 24-year-old unhelmeted motorcycle rider is declared brain dead 2 days after
hitting a truck at freeway speeds. Per his prior expressed wishes, his family wants him
to be considered for organ donation. During your night shift, the ICU nurse calls you
because he is concerned that the patient's blood pressure is falling. For this patient to be
considered an organ donor, all of the following are true exept
A. he should receive CMV-negative blood transfusions to maintain a hematocrit of at
least 30 percent
B. central venous pressure must be sustained at > 10 cm H2O
C. pO2 must be > 80 mm Hg, pCO2 must be 35 to 45 mm Hg, and pH must remain
between 7.30 and 7.45
D. the patient must have a negative chest x-ray
E. * HLA matching must be performed
531.
A 25-year-old female presents with right elbow pain after a fall while doing
gymnastics. The elbow is deformed and flexed at 45 degrees. Plain radiographs show
an elbow dislocation, with both radius and ulna displaced posteriorly. Which of the
following neurovascular structures is most likely to be injured?
A. Axillary nerve
B. Radial nerve
C. * Ulnar nerve
D. Radial artery
E. Brachial plexus
532.
A 25-year-old male is brought to the ED by ambulance on a psychiatric hold after
wandering in a residential area looking for the source of the evil voices that he states
are controlling his thoughts. Upon arrival, he is screaming and wildly agitated. Which
of the following represents an appropriate initial dose of intramuscular haloperidol for
this patient?
A. 0.05 mg
B. 0.5 mg
C. * 5.0 mg
D. 50 mg
E. 500 mg
533.
A 25-year-old male is brought to the ED by his sister who states that he started
vomiting that morning after complaining of a severe headache. On examination, he is
drowsy but arousable with mild nuchal rigidity and no focal neurologic deficit. Which
of the following is LEAST likely to be needed for his work-up and treatment?
A. CT of the head
B. Blood glucose determination
C. Antiemetic
D. * Lumbar puncture
E. Nimodipine
534.
A 26-year-old female is brought to the ED after three successive witnessed grand
mal seizures without recovery of consciousness. Upon arrival, she is obtunded with no
spontaneous eye opening and withdraws to pain only. Initial ED management could
include all of the following exept
A. endotracheal intubation
B. * barbiturate coma
C. phenytoin infusion
D. determination of blood glucose
E. gastric lavage
535.
A 26-year-old soccer player presents after a direct blow to the shoulder. On
examination, she has tenderness over the acromioclavicular joint, but no step-off or
deformity. X-rays show no fracture, subluxation, or dislocation. Which of the following
is the most appropriate management?
A. Arrange immediate orthopedic follow-up for possible operative repair
B. Place the shoulder in a figure-of-eight brace, with orthopedic follow-up in 1 to 2
weeks
C. * Place the shoulder in a simple sling, with instructions for early range of motion
D. Place the shoulder in a shoulder immobilizer for 2 to 3 weeks
E. Tell the patient that immobilization is not necessary but that she should apply ice
and use analgesics as needed for pain control
536.
A 27-year-old male presents with left wrist pain after falling on an outstretched
hand. He has an obvious deformity of the wrist but is neurovascularly intact. Xray
shows a transverse distal radius fracture with dorsal angulation. On the lateral view, the
ulna is displaced dorsally. Which of the following terms describes this fracture?
A. * Galeazzi's fracture
B. Monteggia's fracture
C. Colles' fracture
D. Smith's fracture
E. Barton's fracture
537.
A 28-year-old female overdosed on her father's lithium. She presents with
complaints of nausea, vomiting, and blurred vision. Initial lithium level is 2 mEq/L.
Which of the following would not be appropriate ED management?
A. Intravenous hydration
B. Correction of electrolyte imbalance
C. Urine pregnancy test
D. * Discharge to an inpatient psychiatric facility if asymptomatic after a 4-h
observation period
E. Alkalinization of the urine
538.
116. A 3-month-old male presents with a fever of 39.5°C for several days,
occasional vomiting with a few loose watery stools, mild URI symptoms, and a
decreased appetite. He is irritable but consolable and appears nontoxic. Which of the
following tests would be most likely to show the source of this child's fever?
A. CBC with differential
B. Blood culture
C. * Urine culture
D. CSF culture
E. Chest x-ray
539.
A 3-week-old infant with a 2-day duration of whitish eye drainage presents to the
ED. The child had a normal spontaneous vaginal delivery. The mother reports mild
URI symptoms for the past 3 days, but the older siblings (13 months and 3 years) also
have colds. The child is eating and acting normally. Which of the following is most
appropriate?
A. * Fluorescein staining of the cornea; if no dendritic changes, Gram stain and
culture of the eye drainage for gonorrhea; if the Gram stain is negative for gramnegative diplococci, obtain a culture of nasopharyngeal aspirate for chlamydia;
prescribe oral antibiotics
B. Fluorescein staining of the cornea; if no dendritic changes, Gram stain for
gonorrhea, culture eye drainage for chlamydia and gonorrhea; prescribe topical
eye drops
C. Topical antibiotic eye drops
D. Treat with hot packs and lacrimal duct massage for presumptive lacrimal duct
stenosis
E. Fluorescein staining of the cornea; if no dendritic changes, topical antibiotic eye
drops
540.
A 3-year-old female with hemoglobin sickle cell (HbSS) disease presents with a
fever of 38.5°C after several days of URI symptoms, lower leg pain, and abdominal
pain in the usual locations of her pain crises. She has scleral icterus and a spleen tip
palpable on abdominal examination. The mother is concerned that the patient looks
pale. RR is 18, HR is 110, blood pressure is 100/62, and O2 saturation is at 90 percent.
She takes penicillin and folic acid daily. Work-up and treatment should include all of
the following exept
A. * normal saline infusion at twice maintenance levels
B. CBC with differential, reticulocyte count, blood and urine cultures, CXR, blood
for type and screen
C. presumptive treatment with parenteral antibiotics, active against encapsulated
organisms
D. opioids in adequate doses, at frequent intervals to control the pain
E. O2 for hypoxia
541.
A 3-year-old preschool male presents with a 3-day history of high fever
accompanied by sore throat, mild abdominal pain, headache, and vague pain "all over."
Examination shows a diffuse erythematous rash, especially in the perianal area. He
complains of itching in areas where the rash is peeling. You also note red oral mucosa,
prominent papillae consistent with strawberry tongue, and cervical adenopathy.
Appropriate actions at this point could include all the following exept
A. performing a culture of the throat to rule out group A hemolytic strep (GABHS)
B. treating for presumptive GABHS with oral or intramuscular penicillin
C. * giving intravenous gamma globulin
D. delaying treatment until you have the results of a complete blood count (CBC)
with differential, ESR, and LFTs
E. administering oral diphenhydramine
542.
A 30-year-old pregnant female presents to the ED complaining of vaginal
bleeding. All of the following statements are true concerning this patient exept
A. most patients with bleeding in early pregnancy have normal pregnancy outcomes
B. urinary tract infection can precipitate spontaneous abortion
C. * lack of adnexal mass on bedside ultrasound makes ectopic unlikely
D. she should have her Rh status checked
E. the quantitative RhCG level should be monitored
543.
A 35-year-old female presents with posterior ankle pain, which occurred suddenly
while playing volleyball. Thompson's test is positive. What is the most likely
diagnosis?
A. Posterior talofibular ligament injury
B. Achilles tenosynovitis
C. * Achilles tendon rupture
D. Posterior talotibial dislocation
E. Calcaneal fracture
544.
A 35-year-old female with a history of newly diagnosed myasthenia gravis
presents to the ED with profound generalized muscle weakness for 2 days without a
known precipitant. A test dose of 2 mg intravenous edrophonium results in visible
muscle fasciculations and slowing of the patient's respiratory rate and depth. Which of
the following actions is INAPPROPRIATE?
A. * Administering neostigmine
B. Preparing for intubation
C. Consulting a neurologist
D. Establishing aspiration precautions
E. Admission to the ICU
545.
A 35-year-old male presents after a significant hyperextension injury to the right
knee while playing soccer. On examination the knee is severely unstable in both
anteroposterior and lateral directions. A palpable hematoma is present in the popliteal
fossa. Plain films demonstrate no bony abnormality. Which of the following tests must
be performed emergently?
A. Magnetic resonance imaging of the knee
B. * Arteriography
C. Bone scan
D. CT of the knee
E. Electromyography
546.
A 37-year-old male intravenous drug user (IVDU) presents with the complaint of
several days of general malaise, difficulty swallowing, occasional double vision, and
subjective fever. On examination, the patient is noted to have grossly intact cranial
nerves II to XII, a distended bladder, and a temperature of 99.1°F. What is the most
appropriate next step?
A. Admit to the ED observation unit
B. Admit to the floor for observation
C. * Admit to the ICU
D. Discharge to home with reassurance
E. Discharge to home with follow-up in several days
547.
A 4-month-old infant presents with a rectal temperature of 38.7°C, a respiration
rate (RR) of 60, a heart rate (HR) of 160, and an SpO2 on room air of 92 percent. He is
smiling, drooling, and taking his bottle well, despite prominent intercostal retractions.
On auscultation, he has diffuse coarse breath sounds with sibilant wheezes at both
bases. All other household members have colds. There is no family history of atopy or
asthma; no one smokes. ED therapy for this child could include all the following exept
A. supplemental O2 (by blow-by or nasal cannula as tolerated by the child)
B. a trial of nebulized albuterol
C. a trial of nebulized racemic epinephrine
D. * a dose of glucocorticoids
E. admission
548.
A 45-year-old male presents with foot pain after an automobile accident. The
examination shows tenderness, swelling, and ecchymosis over the midfoot. X-ray
shows fracture of the base of the second metatarsal and lateral displacement of the
second, third, fourth, and fifth metatarsals. What is the optimal management of this
patient?
A. Posterior splint, with orthopedic follow-up as needed
B. * Urgent orthopedic consultation for possible open reduction and internal fixation
C. Splint the patient in equinus and follow up with orthopedics in 2 to 3 days
D. Cast the foot and follow up with orthopedics in 2 to 3 days
E. Hard-sole shoe, weight bearing as tolerated, follow-up in orthopedics as needed
549.
A 58-year-old female is brought to the ED by her family. They state that her
words do not make sense, the right side of her face is drooping, and she is weak on the
right side. On examination you note that the patient is awake and alert, has an
expressive aphasia, right-sided facial droop, three-fifths right arm strength, four-fifths
right leg strength, and decreased sensation to pin-prick on the right side. Which stroke
syndrome is most likely?
A. Anterior cerebral artery infarction
B. Basilar artery occlusion
C. * Middle cerebral artery infarction
D. Lacunar infarction
E. Intracerebral hemorrhage
550.
A 60-year-old male presents complaining of a typical spring headache, 2 months
after a femoral-popliteal bypass. He states that the pain is excruciating, began over the
left eye, and is causing the eye to tear and throb. Which abortive therapy is the LEAST
appropriate?
A. * Ergotamine
B.
C.
D.
E.
Ketorolac
Prochlorperazine
Oxygen inhalation
Intranasal lidocaine
551.
A 62-year-old female with a history of TIA affecting the right side complains of 8
h of a dense right-sided paralysis and dysarthria. No previous studies have been
completed. What is the most appropriate disposition?
A. * Admit to the medical ward
B. Admit to the rehabilitation ward
C. Discharge to home and arrange follow-up with the primary care physician
D. Transfer the patient to a skilled nursing facility
E. Conduct a stroke work-up in the ED and then discharge to home
552.
A 7-year-old male presents to the ED 6 months status post revision of a CSF
shunt. He complains of a persistent headache for 1 week, occasional nausea, and
vomiting three to four times that day. Evaluation for shunt infection should include all
of the following exept
A. CT of the head
B. shunt survey (plain films of the skull, chest, and abdomen)
C. compression of the reservoir
D. neurosurgical consult
E. * lumbar tap
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
A.
B.
C.
D.
E.
A local anesthetic that is ineffective topically is –
* Cocaine
Mepivacaine
Hexylcaine
Lidocaine
Tetracaine
553.
554.
555.
A nontoxic, playful, 18-month-old toddler is febrile to 40.5°C but has no focus for
fever on examination. A 24-h follow-up visit is arranged. Which of the following
would be INAPPROPRIATE management?
A. Blood and urine cultures; intramuscular ceftriaxone
B. Blood and urine cultures, intramuscular ceftriaxone only if WBC > 15,000
C. Intramuscular ceftriaxone, no cultures
D. Blood and urine cultures, no antibiotics
E. * B, C, and D are all inappropriate
556.
A previously healthy 9-month-old child presents with a soft, nontender abdomen
and a history of vomiting at home. Which of the following strongly suggests a
nonsurgical etiology for the emesis?
A. No bile present in the emesis
B. Negative blood in stool by guaiac
C. Normal KUB and left lateral decubitus film
D. Soft, nontender belly without masses
E. * None of the above
557.
A.
B.
C.
D.
E.
A successful stellate ganglion block can produce –
Hypotension
* Horner's syndrome
Brachial plexus involvement
Hemifacial anaesthesia
Hypertension
558.
A woman in the third trimester of pregnancy presents to the ED complaining of
abdominal pain without vaginal bleeding. Vital signs are remarkable for a systolic
blood pressure of 160, heart rate of 105, and a respiratory rate of 18. Which one of the
following statements is true concerning this patient?
A. A normal ultrasound excludes the diagnosis of placental abruption
B. Lack of vaginal bleeding excludes the diagnosis of placental abruption
C. A pelvic examination should be avoided
D. * A CBC, electrolytes, and renal and liver function tests (LFTs) should be
obtained
E. Immediate delivery is indicated
559.
A.
B.
C.
D.
E.
560.
All are surface anaesthetics exept –
Lidocaine
* Bupivacaine
Procaine
Cinchocaine
None
E.
All of following are true of asthma in pregnancy exept
asthma worsens in about one-third of cases
* oral steroids should not be prescribed
agonists are the mainstay of therapy
chest radiographs should be ordered for the same indications as for nonpregnant
patients
pulmonary function tests are not significantly changed during pregnancy
A.
B.
C.
D.
E.
All of the following are consistent with multiple sclerosis (MS) exept
multiple discrete lesions of the white matter
increase of immunoglobulin in the CSF
worsening spasticity with urinary tract infection
* diminution of symptoms with fever
optic neuritis as first symptom
A.
B.
C.
D.
561.
562.
All of the following are indications for maternal transport to a tertiary perinatal
center exept
A. placental bleeding
B. * premature labor with cervical dilation to 6 cm
C. blood pressure of 160/110 mm Hg and proteinuria
D. premature rupture of membranes
E. term labor in a insulin-dependent diabetic
563.
A.
B.
C.
D.
E.
All of the following are risk factors for pelvic inflammatory disease (PID) exept
multiple sexual partners
adolescence
history of gonococcal salpingitis
use of intrauterine (IUD) contraceptive device
* low socioeconomic status
A.
B.
C.
D.
E.
All of the following are symptoms of physician burnout exept
* illicit drug use
chronic fatigue
excessive irritability
feelings of helplessness
negative attitudes toward work
564.
565.
A.
B.
C.
D.
E.
566.
A.
B.
C.
D.
E.
567.
All of the following are true of HELLP syndrome exept
the majority of women complain of right upper quadrant or epigastric pain with
nausea and vomiting
platelet count is < 100,000/mL
urinalysis is positive for protein
* 10 percent calcium gluconate should be administered
hypertension is key to the diagnosis
All of the following are true of infections during pregnancy exept
A. 40 percent of Cytomegalovirus infections are transmitted to the fetus
B. * to be effective, Varicella zoster immune globulin should be given to
seronegative women within 24 h of chicken pox exposure
C. erythema infectiosum exposure can cause SAB
D. infection with rubella in the first trimester is associated with congenital rubella
syndrome
E. fetuses exposed to maternal toxoplasmosis have a 10 percent chance of
contracting congenital toxoplasmosis
568.
A.
B.
C.
D.
E.
569.
All of the following are true concerning vulvovaginitis exept
bacterial vaginosis is the most common etiology
alkaline cervical secretions predispose a woman to infection
older women usually do not have symptoms until the vulvovaginitis is advanced
pinworms (Enterobius vermicularis) can cause vaginal irritation
* the classic "strawberry cervix" is commonly seen in patients with Trichomonas
vaginalis
All of the following are true of intraperitoneal blood and culdocentesis exept
* the test is positive when clotting blood is aspirated
cervical motion tenderness may be present in a patient with intraperitoneal blood
a ruptured corpus luteum cyst can produce a positive test
culdocentesis is positive in the majority of ectopic pregnancies, ruptured and
unruptured
aspiration of clear fluid denotes a negative test
All of the following are true of premature rupture of membranes (PROM) exept
A. the finding of a "ferning" pattern is diagnostic of amniotic fluid
B. nitrazine paper changes to dark blue
C. * the pH of amniotic fluid is 4.5 to 6.0
D. 90 percent of term patients with PROM will go into labor within 24 h
E. infections can precipitate PROM
570.
All of the following are true of spontaneous abortion (SAB) exept
A. more than 50 percent of the abortuses have chromosomal abnormalities
B. most SABs occur before 8 or 9 weeks of gestation
C. * maternal factors such as uterine adhesions and pelvic structural abnormalities
may lead to SABs
D. the incidence of SAB climbs with increasing maternal age
E. the pain associated with SAB usually occurs after the bleeding has commenced
571.
A.
B.
C.
D.
E.
572.
All of the following are true of trauma in pregnancy exept
rapid deceleration may cause uterine rupture
* pelvic fractures preclude a woman from having a vaginal delivery
life-threatening hemorrhage is most often localized to the retroperitoneum
splenic rupture, kidney injury, and liver laceration are the most common
intraabdominal injuries
the Kleihauer-Betke assay is recommended
All of the following are typical of a failure-to-thrive (FTT) baby exept
alopecia over a flattened occiput
* inappropriate wide-eyed, affectionate reaction to strangers
increased muscle tone and scissoring
a relatively larger deviation from the weight curve than predicted by length or
head circumference
E. poor hygiene
A.
B.
C.
D.
573.
All of the following characteristics are associated with an increased suicide risk
exept
A. psychosis
B. unemployment
C. chronic illness
D. * first attempt
E. readily available lethal weapon
574.
All of the following increase the likelihood of the need for hospital admission in
an asthma patient exept
A. multiple previous admissions
B. a second ED visit within the preceding 3 days
C. medication regimen includes systemic steroids at the time of ED presentation
D. * third-trimester pregnancy
E. history of previous intubation due to asthma
575.
All of the following may have a role in the acute management of severe asthma
exept
A. magnesium
B. * salmeterol
C. halothane
D. helium
E. ketamine
576.
All of the following physiologic changes take place during normal pregnancy
exept
A. * respiratory rate is increased
B. blood volume increases
C. systolic blood pressure decreases
D. serum blood urea nitrogen (BUN) decreases
E. leukocyte count increases
577.
All of the following regimens are recommended for the treatment of acute PID
exept
A. * ceftriaxone 125 mg intramuscularly plus doxycycline 100 mg orally twice a day
for 10 to 14 days
B. cefoxitin 2 g intravenously every 6 h plus doxycycline 100 mg intravenously
twice a day or orally for 10 to 14 days
C. cefoxitin 2 g intramuscularly plus probenecid 1 g orally and ofloxacin 400 mg
orally twice a day for 14 days
D. clindamycin 900 mg intravenously every 8 h plus gentamycin loading dose of 2
mg/kg intravenously followed by a maintenance dose of 1.5 mg/kg every 8 h
E. cefotetan 2 g intravenously every 12 h plus doxycycline 100 mg intravenously
twice a day or orally for 10 to 14 days
578.
All of the following statements about fractures of the proximal humerus are true
exept
A. * any fracture involving the surgical neck may result in compromised blood
supply to the articular segment
B. fracture of the lesser tuberosity suggests a potential posterior shoulder dislocation
C. significant displacement of a greater tuberosity fragment implies a possible
rotator cuff tear
D. markedly angulated surgical neck fractures are at risk for neurovascular damage
E. emergent orthopedic consultation is recommended for multipart fractures
579.
All of the following statements about hemorrhagic shock and encephalopathy
syndrome are true exept
A. the etiology is unknown
B. the prodrome is usually a mild, nonspecific illness
C. profuse, watery diarrhea progresses to bloody diarrhea
D. hypoperfusion, seizures, metabolic acidosis, and DIC occur
E. * laboratory abnormalities are limited to acid-base and hematologic dysfunction
580.
All of the following statements about Volkmann's ischemic contracture are true
exept
A. Volkmann's ischemic contracture is a complication of supracondylar fracture
B. signs include refusal to open the hand in children, pain with passive extension of
fingers, and forearm tenderness
C. local edema causes decreased venous outflow and arterial inflow, resulting in
local tissue ischemia
D. muscle and nerve necrosis may occur, leading to permanent disability
E. * absence of radial pulse is diagnostic
581.
All of the following statements are true about moderate dehydration in an infant
exept
A. the skin has decreased turgor
B.
C.
D.
E.
582.
mucous membranes are dry
tears are diminished
the child is irritable
* oliguria, tachycardia, and profound shock are present
All of the following statements are true of endometritis exept
A. the incidence is greater in patients who have had a cesarean section than in those
who have had a spontaneous vaginal delivery
B. many infections are polymicrobial
C. when patients present with endometritis 48 h to 6 weeks after delivery, chlamydia
and mycoplasma should be considered as primary etiologies
D. * the speculum examination always reveals a purulent discharge
E. the clinical diagnosis is based on the symptoms of fever, malaise, lower
abdominal pain, and foul-smelling lochia
583.
All of the following statements are true regarding aerosolized anticholinergic
medications for asthma management exept
A. the effect is additive when they are used in combination with adrenergic agonists
B. they affect large central airways
C. * they can cause clinically significant adverse mucous plugging and systemic
toxicity
D. results of studies comparing them with Я-adrenergic agonists are conflicting
E. they may reduce symptoms in patients with chronic obstructive pulmonary
disease (COPD)
584.
All of the following statements are true regarding dynamic CT of the chest exept
a negative study does not rule out pulmonary embolism (PE)
it can detect pneumonia and acute aortic dissection
* its specificity is lower than that of a high-probability V./Q. scan
it is most reliable for pulmonary emboli that extend up to the subsegmental level
of the pulmonary vessels
E. it requires the injection of contrast material
A.
B.
C.
D.
585.
A.
B.
C.
D.
E.
All of the following statements concerning drugs in pregnancy are true exept
with the exeption of large molecules, virtually all drugs cross the placenta
category A drugs are safe during the first trimester of pregnancy
diuretics are not generally recommended in pregnancy
* erythromycin estolate can be safely prescribed in pregnancy
cephalosporins can be used at any time during pregnancy
586.
All of the following statements regarding a child with hypernatremic dehydration
are true exept
A. there is at least a 10 percent fluid deficit
B. the skin may appear dry or doughy
C. muscle tone is increased
D. the sensorium fluctuates between lethargy and hyperirritability
E. * rapid rehydration is indicated
587.
All of the following statements regarding bone remodeling are true exept
A. young children have a greater capacity for remodeling than adults
B. remodeling is related to the degree of angulation
C. angulation near the end of a long bone will remodel more satisfactorily than
angulation near the midshaft
D. angulation in the natural plane of the joint motion will remodel more successfully
than angulation outside the plane of joint motion
E. * injuries involving the epiphyseal plate are more likely to remodel successfully
588.
All of the following statements regarding hyponatremic dehydration in children
are true exept
A. serum sodium is less than 130 mEq/L
B. sodium deficit exceeds water deficit
C. * osmolar load is less in the intracellular fluid (ICF) than in the extracellular fluid
(ECF) compartment
D. water shifts from the ECF compartment into the ICF compartment during
equilibration
E. possible sequelae include decreased circulatory volume, cerebral edema, seizures,
and coma
589.
All of the following statements regarding isotonic dehydration in children are true
exept
A. it is the most common type of dehydration
B. serum sodium remains within the normal range of 130 to 150 mEq/L
C. sodium and water deficits are proportionate
D. * calculated fluid deficit should be replaced at a uniform rate over 24 h
E. initial fluid boluses should be subtracted from the calculated fluid deficit
590.
All of the following suggest that a child with asthma needs to be admitted exept
persistent respiratory distress after albuterol and glucocorticoid treatments
a peak flow of < 60 percent predicted in a cooperative child
persistent vomiting of medications
underlying bronchopulmonary dysplasia, congenital heart disease, or cystic
fibrosis
E. * SaO2 < 95 percent on room air upon arrival
A.
B.
C.
D.
591.
All the following are major side effects of immunosuppressant drugs used in lung
transplant patients exept
A. * hypokalemia
B. hypertension
C. bilirubinemia
D. gastric dysmotility
E. neurotoxicity
592.
A.
B.
C.
D.
E.
Amaurosis fugax is caused by occlusion of which one of the following arteries?
Anterior cerebral artery
Basilar artery
* Carotid artery
Posterior cerebral artery
Vertebral artery
593.
An 11-month-old patient with no primary care physician is called back to the ED
for reevaluation because blood that was drawn the day before as part of a work-up of
fever is positive for N. meningitidis. The clinical impression at discharge was otitis
media, and the patient was treated with amoxicillin and acetaminophen. The patient is
now afebrile and playful. What is the most appropriate action?
A. Repeat blood culture, intravenous ceftriaxone, admit
B. * Repeat blood culture, perform lumbar puncture and CSF culture, start
intravenous ceftriaxone, admit
C. Repeat blood culture, intramuscular ceftriaxone, home with follow-up in 24 h
D. Repeat blood culture, continue oral amoxicillin, follow up in 24 h or sooner if
worse
E. Home after thorough history and physical examination, with reassurance to the
parents
594.
An 18-month-old male is brought to the ED for evaluation of a brief episode of
tonic-clonic extremity movements immediately after a spanking in the grocery store.
The child reportedly screamed, became limp and pale, fell to the ground, and exhibited
the unusual movements. The episode lasted about 1 min and occurred about 30 min
before. The toddler is now interactive, appears healthy, and has normal vital signs.
What is the most likely diagnosis?
A. * Breath-holding spell
B. Head trauma
C. Toxic ingestion
D. Prolonged QT syndrome
E. Idiopathic (afebrile) seizure of childhood
595.
An 8-month-old nontoxic infant is brought to the ED with a new rash. Physical
examination shows numerous 0.5- to 1.0-cm bullae and red, round, denuded lesions of
similar size scattered all over but primarily in the diaper area. Because the child has
spent the weekend at the father's house, where many people smoke, the mother is
concerned that these may represent cigarette burns. What is the most appropriate
action?
A. Apply neomycin ointment to the lesions and call social services
B. Administer topical mupirocin and local wound care
C. * Give oral cephalexin and local wound cleaning
D. Admit for intravenous cephalosporin therapy
E. Perform a Tzanck smear, invoke isolation precautions, and begin acyclovir
596.
An 8-year-old female is brought to the ED because of longstanding vague
abdominal complaints, with new onset of dysuria. An extensive medical and social
history and physical examination (including inspection of the genitourinary area) are
unremarkable. The maternal grandmother, who is the patient's guardian, suspects that
the child may have been a victim of sexual abuse. Which of the following statements is
true?
A. Because the genitourinary examination is normal, sexual abuse is unlikely
B. A pelvic examination is necessary to rule out abuse and sexually transmitted
diseases (STDs)
C. Vaginal secretions should be sent for rapid antigens to detect STDs
D. Syphilis and HIV serologies should be sent
E. * Social service should be called and child protective services (CPS) involved
even if the general physical and genitourinary examinations are normal
597.
An increased dose of epidural anaesthetic is obligatory in a patient who has –
A. Ascities
B. * Increased height of the patient
C. Pregnant
D. Age after 50
E. Obese
598.
An otherwise healthy 7-week-old baby presents with a rectal temperature of
40.0°C. Thorough physical examination does not show a source for the fever. Which of
the following tests is most likely to show a source of infection?
A. * Culture of a catheterized urine specimen
B. Peripheral blood culture
C. CBC and differential
D. Culture of the CSF
E. CXR
599.
An unimmunized 5-month-old infant presents with an indurated, red-violet
quarter-sized area on the cheek and a fever of 39.5°C of 1 day's duration. He is irritable
but consolable and has a supple neck. What is the most appropriate action?
A. * Admit after blood cultures, catheterized urine, wound aspirate, lumbar puncture,
CBC, and intravenous ceftriaxone
B. Admit after blood cultures, catheterized urine, wound aspirate, and intravenous
ceftriaxone
C. Home with close follow-up after wound-edge aspirate cultures, intramuscular
ceftriaxone
D. Home with close follow-up after blood cultures and oral amoxicillin
E. Home with close follow-up after blood cultures and oral amoxicillin-clavulanic
acid
600.
Any pregnant woman beyond 20 weeks of gestation who presents to the ED and
appears to be actively contracting may need an emergent delivery. All of the following
are true of emergency delivery exept
A. inability to detect fetal heart tones does not rule out a viable pregnancy
B. amniotomy may result in prolapse of the umbilical cord
C. * once the mother feels an urge to push, she should be encouraged to proceed
D. if the physician delivering the baby notices a "turtle sign," an assistant should
apply suprapubic pressure
E. once the head is delivered, it is imperative to check for a nuchal cord (present in
25 percent of deliveries)
601.
A.
B.
C.
D.
E.
Aspirin therapy is used in all of the following conditions exept
Kawasaki syndrome
polyarticular juvenile rheumatoid arthritis
acute rheumatic fever
Henoch-Schцnlein purpura
* Kohler disease
A.
B.
C.
D.
E.
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
1 year
602.
603.
Cauda Equina syndrome can be caused by
A.
B.
C.
D.
E.
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
General anaesthesia
604.
Clinical features consistent with acute rejection in a lung transplant patient include
all of the following exept
A. bilateral interstitial infiltrates
B. cough, chest tightness, and fatigue
C. a rise in temperature of 0.5°C over baseline
D. a normal chest x-ray
E. * FEV1 drop of at least 25 percent below baseline over 48 h
605.
A.
B.
C.
D.
E.
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
6
10
A.
B.
C.
D.
E.
Complication of epidural anaesthesia is exept* Headache
Nausea
Hypotension
Bladder distension
Dizziness
606.
607.
Complications of Mycoplasma pneumonia infection include all of the following
exept
A. Guillain-Barrй syndrome
B. aseptic meningitis and encephalitis
C. hemolytic anemia
D. pericarditis and myocarditis
E. * septic arthritis
A.
B.
C.
D.
E.
Concerning Barbotage –
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
Technique used Epidural Analgesia
Technique popularized in caudal Analgesia
Cannot be carried out under hypothermic condition
All of the above
A.
B.
C.
D.
E.
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
608.
609.
610.
Cyclosporine levels are affected by all the following exept
A. type of laboratory assay
B.
C.
D.
E.
* use of nonsteroidal antiinflammatory drugs
length of time since the transplant was performed
use of macrolides and antiepileptics
use of calcium channel blockers
611.
During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
612.
During initial evaluation of a 1-month-old distressed infant with URI symptoms, a
heart murmur is detected. Which of the following would be LEAST helpful in
providing evidence for congenital heart disease?
A. CXR
B. * Baseline CBC, blood gas, and blood chemistries
C. Finding of a rounded liver edge 2 cm below the right costal margin
D. Detecting a holosystolic murmur with radiation to the back
E. EKG
A.
B.
C.
D.
E.
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
A.
B.
C.
D.
E.
Epidural blocks is indicated in all excpect* Patients in hypovolemia
Patients with asthma and bronchitis
Post-operative pain relief
Obstetric analgesia
In urologic surgery
A.
B.
C.
D.
E.
Epidural morphine cause Miosis
Retention of urine
Abolishes pain
* All
None
A.
B.
C.
D.
E.
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
613.
614.
615.
616.
617.
First Fibres to be blocked at spinal anaethesia is –
A. Afferent motor nerve
B.
C.
D.
E.
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
A.
B.
C.
D.
E.
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
A.
B.
C.
D.
E.
For brachial plexus block needle is inserted –
Medial to subclavian artery
* Lateral to subclavian artery
Medial to subclavian vein
Lateral to subclavian vein
Inferior to subclavian vein
A.
B.
C.
D.
E.
Hypercapnia can result from all of the following exept
rapid, shallow breathing
* increased CO2 production
small tidal volume
underventilation of the lung
reduced respiratory drive
618.
619.
620.
621.
In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
622.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
A.
B.
C.
D.
E.
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
623.
624.
In spinal anaesthesia, the first nerve fibre to get blocked is A. * Autonomic preganglionic fibres
B. Temperature fibres
C. Somatic motor fibres
D. Vibratory and proprioceptive fibres
E. Vegetates fibers
625.
A.
B.
C.
D.
E.
In spinal anaesthesia, the last fibres affected is * Pressure
Pain
Temperature
Touch
Somatic
626.
In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
627.
A.
B.
C.
D.
E.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
628.
Initial ED tests for a patient status post lung transplant could include all of the
following exept
A. chest x-ray
B. arterial blood gas
C. cyclosporine level
D. * azathioprine level
E. complete blood count (CBC) with differential
629.
Laparoscopy is being used more frequently to aid in the diagnosis of pelvic
disease and to perform gynecologic surgeries. When a patient presents to the ED after
one of these procedures, all of the following are true exept
A. * free air under the diaphragm is a normal finding 1 week after surgery
B. pelvic infections are uncommon after this procedure
C. a traumatic bowel injury is less problematic than a thermal injury
D. infection is an infrequent complication
E. patients with increasing abdominal pain after the procedure have perforated bowel
until proven otherwise
630.
A.
B.
C.
D.
E.
631.
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
Lidocaine can be used in all exept –
A. Ventricular fibrillation
B.
C.
D.
E.
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
A.
B.
C.
D.
E.
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
A.
B.
C.
D.
E.
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
A.
B.
C.
D.
E.
Longest acting local anaesthetic solution isLignocaine
Chlorprocain
Amethocaine
* Bupivacine
Novocaine
A.
B.
C.
D.
E.
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
A.
B.
C.
D.
E.
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
A.
B.
C.
D.
E.
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
632.
633.
634.
635.
636.
637.
638.
On chest x-ray, an increased anteroposterior diameter, flattened diaphragms,
increased parenchymal lucency, and an attenuation of pulmonary vasculature are most
consistent with which one of the following?
A. Chronic bronchitic disease
B. Bronchiectasis
C. Dominant bronchitic disease in COPD
D. * Emphysema
E. Pneumonia
639.
One day after discharge from the normal newborn nursery, a jaundiced infant
exhibits fleeting bicycling movements of the limbs, sucking of the lips, and occasional
apneic episodes with color change. You interpret these as possible neonatal seizures.
Work-up and treatment should include all of the following exept
A. evaluation for inborn errors of metabolism (including urine for reducing
substances, organic amino acids, serum for lactate, pyruvate, and ammonia)
B. correction of electrolyte, calcium, magnesium, glucose, and acid-base imbalances
C. sepsis work-up
D. * administration of diazepam as a first-line drug to control seizures
E. loading with phenobarbital
640.
A.
B.
C.
D.
E.
Parkinson's disease is characterized by all of the following exept
akinesia or bradykinesia
cogwheel rigidity
* intention tremor
Lewy bodies
impairment in posture and equilibrium
A.
B.
C.
D.
E.
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
A.
B.
C.
D.
E.
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
A.
B.
C.
D.
E.
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
A.
B.
C.
D.
E.
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
641.
642.
643.
644.
645.
Post spinal headache is due to A. Injury to spinal cord
B.
C.
D.
E.
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
646.
Reducing of oxygen transport function of preserved blood may occur as a result
of the following reasons:
A. Reduction of pH
B. * Reduction of 2,3-diphosphoglycerate in erythrocytes
C. Reduction of 2,3-diphosphoglycerate in the plasma
D. Increasing the extracellular concentration of potassium ions
E. Violations of the rheological properties
647.
Regarding supracondylar fractures, which of the following radiographic finding is
LEAST likely?
A. Subtle or nonvisible fracture line
B. Posterior fat pad sign
C. Loss of angulation of the anterior capitellum
D. Imaginary anterior humeral line bisects the anterior capitellum
E. * Imaginary anterior humeral line bisects the posterior two-thirds of the
capitellum
648.
A.
B.
C.
D.
E.
Risk factors for SIDS include all of the following exept
* sleeping in the supine position
being born to a mother with a substance-abuse problem during pregnancy
prematurity or low birth weight
having a sibling with SIDS
history of a previous apneic episode of life-threatening proportions (ALTE)
A.
B.
C.
D.
E.
Risk factors for spontaneous pneumothorax include all of the following exept
smoking
Marfan's syndrome
* female sex
sarcoidosis
COPD
A.
B.
C.
D.
E.
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
A.
B.
C.
D.
E.
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
649.
650.
651.
652.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseA. Gives deep analgesia
B.
C.
D.
E.
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
653.
.Strategies for the management of uncomplicated COPD include all of the
following exept
A. broad-spectrum antibiotics
B. * cromolyn sodium
C. glucocorticoid therapy
D. anticholinergics
E. Я-adrenergic agonists
654.
A.
B.
C.
D.
E.
Subarachnoid block as anesthesia is contraindicated inIschemic heart disease ,
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
655.
Symptoms heralding respiratory arrest during an asthma exacerbation include all
of the following exept
A. lethargy
B. * severe respiratory alkalosis and the use of accessory muscles of respiration
C. a normal pCO2 on arterial blood gas
D. a silent chest on auscultation
E. agitation
656.
Temporal arteritis is a vasculitis that affects women more frequently than men.
Which one of the following is not usually associated with temporal arteritis?
A. Age > 50 years
B. ESR > 50
C. Ischemic papillitis
D. * Tender, pulsatile temporal artery
E. Polymyalgia
657.
The anterior drawer sign, Lachman's test, and the pivot shift are used to measure
stability of which knee structure?
A. Medial collateral ligament
B. Lateral collateral ligament
C. * Anterior cruciate ligament
D. Posterior cruciate ligament
E. Medial meniscus
658.
A.
B.
C.
D.
E.
659.
The device suited for introducing epidural catheter is Mitchell needle
Gordh needle
* Tuohy needle
Sise introducer
Nick needle
The duration of effect of spinal anaesthesia depends upon –
A.
B.
C.
D.
E.
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
A.
B.
C.
D.
E.
The effects of chiling in refrigeration analgesia includes –
Interference with conduction of nerve impulse
Reduction of metabolic rate and oxygen requirement
Inhibition of bacterial growth and infection
Retardation of healing
* All of the above
A.
B.
C.
D.
E.
The following factors can cause damage to the lung surfactant, exept for:
Aspiration of gastric contents
* Durable ventilation with 30% oxygen
Pulmonary embolism
Extracorporeal oxygenation
Inhalation of toxic gases
A.
B.
C.
D.
E.
The following is not used when giving local anaesthesia in the fingers 2 % xylocaine
Rubber tourniquet
Ring block
* Adrenaline
Atropin
A.
B.
C.
D.
E.
The partial pressure of oxygen in alveolar gas depends on the whole, exept:
Atmospheric pressure
The concentrations of oxygen in the inspired gas
The partial pressure of carbon dioxide in the alveoli
* The values of cardiac output
Temperatures
660.
661.
662.
663.
664.
The patient tidal volume is 500 ml, minute volume of breath is 5000 ml, dead
space - 100 ml. What is alveolar ventilation?
A. * 4000 ml
B. 3500 ml
C. 3000 ml
D. 2500 ml
E. 2000 ml
665.
The severity of pulmonary injury from aspiration is based on all of the following
factors exept
A. the presence of bacterial contamination
B. the pH of the aspirate
C. the volume of the aspirate
D. the presence of particulate matter
E. * the position of the patient at the time of aspiration
666.
The spinal cord terminates opposite-vertebra –
A. * Lumbar 1
B.
C.
D.
E.
Lumbar 2
Sacral l
Sacral 2
Thoracal 12
667.
To make the diagnosis of toxic shock syndrome, all of the following must be
present exept
A. hypotension
B. temperature greater than 38.9°F
C. rash with subsequent desquamation
D. * negative serologic test for streptococcal infection
E. involvement of three of the following organ systems: gastrointestinal,
musculoskeletal, renal, mucosal, hepatic, hematologic, or central nervous system
668.
A.
B.
C.
D.
E.
Treatment for atypical pneumonia includes all of the following exept
erythromycin
azithromycin
tetracycline
* penicillin and/or cephalosporins
bronchodilators, expectorants, and cough suppressants
A.
B.
C.
D.
E.
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
669.
670.
What are the pathogenic factors of acute respiratory failure in an open
pneumothorax?
A. * Shutdown of ventilation on the affected side
B. Expression of shunting blood to the lungs in a healthy side
C. Free motion of gas from one lung to another
D. Flotation of the mediastinal organs during respiration
E. Severe disorders of blood circulation in the lungs
671.
A.
B.
C.
D.
E.
What is the BEST position in which to place a patient with massive hemoptysis?
Affected side up
* Affected side down
Trendelenburg
Reverse Trendelenburg
None of the above
672.
What is the drug of choice for the endemic fungal pneumonias (histoplasmosis,
Blastomycosis, and coccidioidomycosis)?
A. Amikacin
B. * Amphotericin B
C. Rifampin
D. Pentamidine
E. Fluoroquinolones
673.
What is the drug of choice for treatment of uncomplicated lung abscess?
A.
B.
C.
D.
E.
* Clindamycin
Ceftriaxone
Gentamicin
Erythromycin
Tetracycline
A.
B.
C.
D.
E.
What is the first study you should order on this patient?
Urinalysis
Complete blood count (CBC)
Quantitative RhCG
* Qualitative RhCG
Ultrasound
A.
B.
C.
D.
E.
What is the method of choice for diagnosing PCP?
Gallium scan
Cytologic sputum analysis
* Fiberoptic bronchoscopy
Direct fluorescence of sputum with monoclonal antibodies
Fungal culture
A.
B.
C.
D.
E.
What is the most common cause of preload disorders in children?
Distributive shock
* Hypovolemic shock from vomiting and diarrhea
Congestive heart failure
Severe anemia
Hypoxemia
674.
675.
676.
677.
What is the most common chest x-ray finding seen in patients with Mycoplasma
pneumonia?
A. * Acute interstitial, patchy infiltrates
B. Lung abscess
C. Large pleural effusions
D. Mediastinal lymphadenopathy
E. Cavitary lesions
678.
A.
B.
C.
D.
E.
What is the most common site for a compartment syndrome?
* Anterior compartment of the lower leg
Peroneal compartment of the lower leg
Deep posterior compartment of the lower leg
Volar compartment of the forearm
Dorsal compartment of the forearm
679.
What is the optimal humidity of inhaled gas for the patient breathing through
intubation tube?
A. 40%
B. 60%
C. * 95-100%
D. Humidity does not matter
E. 80%
680.
When a gravid female presents in cardiac arrest, all of the following statements
are true exept
A. the "human wedge" is useful in bystander CPR
B. * ideally, a Cardiff wedge should be placed under the patient's left hip and flank
C. manual displacement of the uterus off the inferior vena cava helps increase
venous return
D. pregnant women are in an edematous state that can make intubation difficult
E. the use of a femoral line to deliver medications should be discouraged
681.
When evaluating for possible otitis media, which of the following is of the
LEAST diagnostic value?
A. History of a new onset of ear pulling starting several days after URI
B. * Presence of the light reflex
C. Translucency of the tympanic membrane (TM)
D. Mobility in response to pneumatoscopy
E. Fluid level behind the TM
682.
A.
B.
C.
D.
E.
Which of the following are complications of aspiration pneumonia?
Lung abscess
Pulmonary fibrosis
Hemoptysis
Empyema
* All of the above
683.
Which of the following BEST characterizes the typical chest x-ray findings seen
in PCP infection?
A. Normal chest x-ray
B. * Diffuse bilateral interstitial infiltrates
C. Hilar lymphadenopathy
D. Pneumothorax
E. Pleural effusions
684.
Which of the following BEST describes the classic chest x-ray findings in primary
tuberculosis?
A. * Parenchymal infiltrates in any area of the lung with unilateral lymphadenopathy
B. Infiltrate or nodule with calcification
C. Infiltrates of the upper lobe or superior segment of the lower lobes
D. Cavitary lesions
E. Pleural effusion
685.
A.
B.
C.
D.
E.
Which of the following chest x-ray findings favors lung abscess over empyema?
An air-fluid level at the site of a previous pleural effusion
A cavity with an air-fluid level that tapers at the pleural border
An air-fluid level that crosses a fissure
An air-fluid level that extends to the lateral chest wall
* None of the above
686.
Which of the following chest x-ray findings is LEAST consistent with
pneumococcal pneumonia?
A. Single, lobar consolidation
B. Pleural effusion
C. Patchy, multilobar involvement
D. * Pneumothorax
E. Bulging fissure
687.
A.
B.
C.
D.
E.
Which of the following distinguishes delirium from dementia?
Global cognitive impairment
Periods of acute worsening of symptoms
* Clouded sensorium
Reversibility
Gradual onset of symptoms
A.
B.
C.
D.
E.
Which of the following drugs have a selective beta-2 adrenergic effect:
Epinephrine
Izadrin
Euphyllin
* Salbutamol
Ephedrine
A.
B.
C.
D.
E.
Which of the following groups has a high prevalence of tuberculosis?
Elderly and nursing home patients
Immigrants
HIV-infected patients
Alcoholics and illicit drug users
* All of the above
688.
689.
690.
Which of the following groups of pediatric patients are at increased risk for
hypoglycemia?
A. Patients with glycogen storage disease type I
B. Children younger than 18 months, after a period of fasting
C. Children who have ingested alcohol but have no clinical signs of intoxication
D. Children with an abdominal mass
E. * All of the above
691.
Which of the following hip fractures is most likely to disrupt perfusion of the
femoral head?
A. * Subcapital fracture
B. Intertrochanteric fracture
C. Subtrochanteric fracture
D. Pubic ramus fracture
E. Avulsion of the greater trochanter
692.
Which of the following immunocompromised patients are not at increased risk for
contracting fungal pneumonia?
A. Patients with acquired immunodeficiency syndrome (AIDS)
B. Organ transplant patients
C. Patients on chronic steroids
D. Cancer patients
E. * Patients with sickle cell disease or splenectomy
693.
Which of the following injuries is most likely to be associated with disruption of
the cruciate ligaments?
A. Patellar fracture
B. Femoral condyle fracture
C. Avulsion of the tibial tuberosity
D. Tibial plateau fracture
E. * Tibial spine fracture
694.
Which of the following is an appropriate initial treatment for pulmonary
tuberculosis?
A. INH
B. INH plus rifampin
C. INH, rifampin, and ethambutol
D. * INH, rifampin, ethambutol, and pyrazinamide
E. INH, rifampin, ethambutol, and streptomycin
695.
A.
B.
C.
D.
E.
Which of the following is beneficial if pulmonary aspiration has occurred?
Irrigation of the tracheobronchial tree with neutral or alkaline saline
Steroids
Prophylactic antibiotics
* Bronchoscopy
All of the above
A.
B.
C.
D.
E.
Which of the following is false regarding myasthenia gravis?
* The clinical hallmark is nonfatigable muscle weakness
Myasthenia gravis is often associated with other autoimmune diseases
Confirmation of myasthenia is possible with the edrophonium test
Overmedication can produce a clinical picture that mimicks myasthenic crisis
Thymectomy is advocated for most myasthenic patients
A.
B.
C.
D.
E.
Which of the following is LEAST consistent with a panic attack?
* Hallucinations
Palpitations
Chest tightness
Dizziness
Dyspnea
A.
B.
C.
D.
E.
Which of the following is LEAST consistent with Guillain-Barr syndrome?
Ascending paralysis
Preceded by exposure to toxins
Sensory involvement
* Intact reflexes
Resolution of symptoms in months
696.
697.
698.
699.
Which of the following is more consistent with bulimia than with anorexia
nervosa?
A. Hypoglycemia
B. Tachydysrhythmia
C. Stress fracture
D. * Dysphagia
E. Cathartic colon
700.
A.
B.
C.
D.
E.
Which of the following is most impaired by REM sleep deprivation?
Physical recuperation
Intellectual tasks
* Psychological well being
Social life
Manual tasks
701.
A.
B.
C.
D.
E.
Which of the following is not a cause of peripheral cyanosis?
Congestive heart failure
Peripheral vascular disease
Cold exposure
* Intracardiac shunting
Arterial or venous obstruction
A.
B.
C.
D.
E.
Which of the following is not a chlamydial organism that can cause pneumonia?
C. trachomatis
psittaci
The TWAR agent
* Mycoides
All of the above are chlamydial agents that cause pnuemonia
A.
B.
C.
D.
E.
Which of the following is not a clinical characteristic of Legionella pneumonia?
Toxic appearance
* Lack of GI symptoms
Pleuritic chest pain and hemoptysis
Relative bradycardia
Mental status changes
A.
B.
C.
D.
E.
Which of the following is not characteristic of Klebsiella pneumonia?
Most frequently occurs in alcoholics and patients with diabetes and COPD
Empyema and abscess formation are common complications
Pleuritic chest pain is a common symptom
Sputum is often brown and proteinaceous
* Patients usually respond to outpatient antibiotics
A.
B.
C.
D.
E.
Which of the following is not characteristic of pneumococcal pneumonia?
Acute onset, tachycardia, and tachypnea
* Recurrent rigors
Pleuritic chest pain
Thick, rusty sputum
Malaise, flank or back pain, and vomiting
702.
703.
704.
705.
706.
Which of the following is the BEST view to request when assessing for the
presence of pneumothorax on chest x-ray?
A. Supine anteroposterior
B. Upright posteroanterior (PA)
C. Inspiratory PA
D. Lateral decubitus with the patient lying on the unaffected side
E. * Expiratory PA
707.
Which of the following is the LEAST consistent with a clinical diagnosis of acute
appendicitis?
A. Normal temperature
B. Normal white blood cell (WBC) count
C. Presence of hunger
D. * Vomiting preceding the onset of abdominal pain
E. Recent gastroenteritis
708.
Which of the following is the most common effect of pregnancy on an asthma
patient?
A. An improvement in respiratory function
B. An exacerbation of asthma symptoms
C. A decrease in asthma symptoms
D. A worsening in overall respiratory function
E. * An increase in maternal complications and perinatal mortality
709.
A.
B.
C.
D.
E.
Which of the following is the most common ligament injured during ankle sprain?
* Anterior talofibular ligament
Posterior talofibular ligament
Calcaneofibular ligament
Deltoid ligament
Anterior tibiofibular ligament
A.
B.
C.
D.
E.
Which of the following is true regarding Legionella pneumonia?
Accounts for less than 2 percent of bacterial pneumonias
Has a higher incidence in the winter and spring
Mode of transmission is through person-to-person contact
Usually resolves without sequelae, even if not treated with antimicrobials
* The organism is a gram-negative rod
710.
711.
A.
B.
C.
D.
E.
Which of the following is true regarding scapular fractures?
Most are treated with open reduction and internal fixation
Approximately 50 percent are associated with intrathoracic injuries
They frequently result in long-term disability
They account for approximately 8 percent of all fractures
* The mechanism of injury is from direct blow, trauma to the shoulder, or fall on
an outstretched arm
712.
Which of the following is true regarding treatment of a child with diabetic
ketoacidosis (DKA)?
A. Volume replacement is the mainstay of therapy and should be generous and rapid
B. An initial bolus of 0.1 U/kg insulin must be given before beginning an insulin
infusion
C. The insulin infusion should be discontinued once the patient's glucose has fallen
below 200 to 250 mg/dL
D. * Cerebral edema may occur 6 to 8 h into therapy, after apparent clinical
improvement
E. Potassium supplementation is not needed in the child with DKA who is still
acidotic, provided the serum potassium is normal
713.
A.
B.
C.
D.
E.
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
714.
Which of the following laboratory values is LEAST consistent with Pneumocystis
carinii pneumonia (PCP) infection?
A. * Elevated WBC count
B.
C.
D.
E.
Low CD4 count
Elevated LDH and ESR
Marked hypoxia on arterial blood gas
Increased A-a gradient on arterial blood gas
715.
Which of the following mechanisms is most likely to result in an anterior
glenohumeral dislocation?
A. * Abduction, extension, and external rotation
B. Forceful internal rotation and adduction
C. Electric shock
D. Seizure
E. Direct force to the anterior shoulder
716.
Which of the following mechanisms of hypoxia during general anesthesia is
associated with a normal alveolar-arterial gradient of O2 and CO2 and is easily
corrected by the addition of O2?
A. Intracardiac shunt
B. * Hypoventilation
C. Violation of ventilation-perfusion ratio
D. Pulmonary shunt
E. Low cardiac
717.
Which of the following methods is most appropriate for collecting a urine
specimen for culture?
A. Bag specimen in a circumcised infant boy
B. Suprapubic tap in an infant girl with labial fusion
C. Catheterization in a circumcised, 3-year-old boy
D. Catheterization in an uncircumcised, 5-year-old boy
E. * Clean catch in an uncircumcised, 5-year-old boy
718.
A.
B.
C.
D.
E.
Which of the following most likely represents vertigo of peripheral origin?
Ataxia
Diplopia
Dysphagia
Facial numbness
* Unilateral hearing loss
719.
Which of the following must be monitored in a schizophrenic patient controlled
with clozapine?
A. Liver function tests
B. Amylase
C. Glucose
D. * CBC
E. Urinalysis
720.
Which of the following organisms is associated with multilobar involvement,
large pleural effusions, a rapidly progressive course, and a high mortality?
A. * Group A streptococcal pneumonia
B. Staphylococcal pneumonia
C. Haemophilus influenza pneumonia
D. Mycoplasma pneumonia
E. Pneumococcal pneumonia
721.
Which of the following patient groups is LEAST likely to require admission for
pneumonia?
A. Pregnant patients
B. Immunocompromised or debilitated patients
C. Patients toxic in appearance
D. Patients unable to care for themselves at home
E. * Patients with mild hypoxia on blood gas analysis
722.
Which of the following personality disorders is seen in a disproportionate number
of ED patients?
A. * Antisocial
B. Borderline
C. Obsessive-compulsive
D. Dependent
E. Paranoid
723.
A.
B.
C.
D.
E.
724.
Which of the following reflex findings would be pathologic in an adult?
Bilateral patellar hyperreflexia
Bilateral patellar hyporeflexia
* Bilateral snout reflexes
Bilateral plantar reflexes
Superficial anal reflex
E.
Which of the following regarding viral pneumonia is false?
Hantavirus has a high associated mortality
* Influenza vaccine is generally ineffective in preventing influenza pneumonia
Viral pneumonias often occur as epidemics, but sporadic cases may be seen
Complications include bacterial superinfection, respiratory failure, and
bronchiolitis obliterans-organizing pneumonia (BOOP)
Supportive care is the mainstay of treatment
A.
B.
C.
D.
E.
Which of the following relations is LEAST likely to exist?
Crime and substance abuse
Trauma and alcohol abuse
Mental illness and suicide gestures
Cocaine and sexually transmitted diseases
* Intravenous drug use and long life expectancy
A.
B.
C.
D.
725.
726.
Which of the following represents INAPPROPRIATE management of fever in
children?
A. Unwrapping the bundled child and retaking the temperature after 15 min
B. * Documenting the temperature accurately by using a tympanic thermometer,
especially in infants
C. Ibuprofen orally in a maximum dose of 40 mg/kg/day divided between 6 and 8 h
D. Slow cooling by sponging with tepid water
E. Administration of ibuprofen and acetaminophen simultaneously
727.
Which of the following seizure patients requires electroencephalographic (EEG)
monitoring for optimal treatment?
A. 35-year-old status post a witnessed tonic-clonic seizure with resolution of the
postictal period in 10 min
B. 40-year-old alcoholic status post two witnessed seizures in the ED, with lucid
periods after each seizure
C. 20-year-old status post first seizure
D. 28-year-old with status epilepticus controlled with fosphenytoin
E. * 30-year-old with refractory status epilepticus requiring vecuronium
728.
A.
B.
C.
D.
E.
729.
A.
B.
C.
D.
E.
Which of the following statements about anterior shoulder dislocations is false?
Nerve injury occurs in 10 to 25 percent of acute dislocations
Most neural injuries involve the axillary nerve
Successful reduction occurs in 70 to 90 percent of cases, regardless of technique
Associated rotator cuff injuries occur in 80 percent of patients older than 60 years
* Vascular injuries are rare but, when they occur, tend to involve the brachial
artery
Which of the following statements about lunate fractures is false?
The most common mechanism is a fall on an outstretched hand
Lunate fractures are the third most common type of carpal fracture
The lunate occupies two thirds of the radial articular surface
* X-rays reliably demonstrate the fracture
This fracture may be associated with avascular necrosis of the lunate
730.
Which of the following statements about management of hemorrhage in pelvic
fractures is false?
A. Patients with double breaks in the ring require blood products more often than
those with single breaks
B. Aggressive fluid and blood replacement is a mainstay of therapy
C. An external fixator may be useful to reduce bleeding in some pelvic fractures
D. Angiography and embolization can be done to control small bleeding sites
E. * Laparotomy provides definitive therapy
731.
Which of the following statements about sternoclavicular dislocations is false?
A. The medial clavicular epiphysis is the last epiphysis of the body to close (at age
22-25 years)
B. CT is the imaging modality of choice
C. Anterior dislocations are more common than posterior dislocations
D. * Closed reduction is frequently successful
E. Posterior dislocations are associated with injuries to thoracic structures
732.
Which of the following statements is true concerning genital herpes?
HSV-1 accounts for up to 50 percent of the cases of genital herpes
Systemic acyclovir decreases the frequency of recurrences
* Systemic symptoms are common with the initial presentation of genital herpes
Tzanck smears are positive in the majority of cases
Cultures of fluid obtained from herpes vesicles are positive only a third of the
time
A.
B.
C.
D.
E.
733.
A.
B.
C.
D.
Which of the following statements regarding bacterial meningitis is false?
Some bacteria are able to spread directly into the CNS, whereas others depend on
hematogenous seeding
Brudzinski's sign is not pathognomonic for meningitis
Dexamethasone can be given to adult patients suspected of having meningitis
Oral antibiotics change the clinical course
E. * Patients should receive prophylactic phenytoin to prevent seizures
734.
E.
Which of the following statements regarding hip dislocations is false?
The risk of avascular necrosis increases if reduction is delayed
Traumatic hip dislocations in children are rare
Reduction should be done as soon as possible and always within 6 h
* In patients with anterior dislocations, the extremity is shortened and internally
rotated
Posterior dislocations are more common than anterior dislocations
A.
B.
C.
D.
E.
Which one of the following can cause pancreatitis?
* Azathioprine
Prednisone
Cyclosporine
Tacrolimus
All of the above
A.
B.
C.
D.
735.
736.
Which one of the following children with diarrhea requires antibiotics?
A. * A 3-month-old infant whose rectal swab from three nights before grew
Salmonella
B. A 10-year-old patient with stool culture positive for Salmonella whose bowel
movements have decreased in frequency and volume
C. A 4-year-old patient with sickle cell trait whose stool grew Salmonella
D. A 12-month-old with mild dehydration whose rectal swab from a previous ED
evaluation grew Salmonella
E. A 5-year-old patient with moderate bloody diarrhea that began after completing a
course of amoxicillin for otitis media
737.
A.
B.
C.
D.
E.
Which one of the following has the highest sensitivity for pulmonary embolism?
A high-probability ventilation-perfusion radionuclear scan
A medium-probability ventilation-perfusion radionuclear scan
A low-probability ventilation-perfusion radionuclear scan
Transesophageal echocardiography (TEE)
* Dynamic (spiral) computed tomography (CT)
A.
B.
C.
D.
E.
Which one of the following indicates severe asthma?
Pulsus paradoxus < 20 mm Hg
Pulsus paradoxus < 10 mm Hg
* Pulsus paradoxus > 20 mm Hg
Pulsus paradoxus > 10 mm Hg
Pulsus paradoxus < 30 mm Hg
738.
739.
A.
B.
C.
D.
E.
Which one of the following is considered the hallmark of COPD?
* Exertional dyspnea
Chronic dry cough
Chronic cough productive of yellow sputum accompanied by global diminution of
breath sounds
Increased anteroposterior diameter
Pursed-lip exhalation
740.
Which one of the following is the LEAST consistent with a diagnosis of
intussusception?
A.
B.
C.
D.
E.
Intermittent colicky abdominal pain, interspersed with symptom-free periods
Grossly normal appearing stool
Normal plain films of the abdomen
* Previously healthy 9-year-old child
Altered, lethargic appearance
741.
Which one of the following pulmonary function tests is the most useful at the
bedside?
A. * Peak expiratory flow rate (PEFR)
B. Forced expiratory volume in 1 s (FEV1)
C. Forced vital capacity (FVC)
D. Total lung capacity
E. Arterial blood gas
742.
Which one of the following V./Q. findings (coupled with the clinical description)
is LEAST suggestive of pulmonary embolism?
A. * Multiple matched defects between ventilation and perfusion scans with a low
clinical index of suspicion
B. One moderately sized mismatched defect between ventilation and perfusion scans
with a low clinical index of suspicion
C. Bilateral mismatched defects between ventilation and perfusion scans with a
moderate clinical index of suspicion
D. A low-probability scan with a high clinical index of suspicion
E. An intermediate-probability scan with a low clinical index of suspicion
743.
. Which statement about antibiotic therapy is true for COPD patients?
A. Broad-spectrum antibiotic therapy is indicated to treat tracheobronchitis only
when it is mucopurulent
B. In mild to moderate cases of bronchitis, antibiotic therapy should be started
selectively only after sputum culture and sensitivities are available
C. * In mild to moderate cases of bronchitis, broad-spectrum antibiotics can be
started before the availability of results of sputum culture and sensitivities
D. Antibiotic therapy is reserved for the treatment of coexistent pneumonia
E. Antibiotics are reserved to treat pneumonia and severe cases of bronchitis
744.
A.
B.
C.
D.
E.
Which type of pelvic fracture is most often associated with severe hemorrhage?
Anterioposterior compression
* Vertical shear
Lateral compression
Crush injuries
Combination injuries
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
745.
746.
A local anesthetic that is ineffective topically is –
A. * Cocaine
B.
C.
D.
E.
Mepivacaine
Hexylcaine
Lidocaine
Tetracaine
A.
B.
C.
D.
E.
A successful stellate ganglion block can produce –
Hypotension
* Horner's syndrome
Brachial plexus involvement
Hemifacial anaesthesia
Hypertension
A.
B.
C.
D.
E.
All are surface anaesthetics except –
Lidocaine
* Bupivacaine
Procaine
Cinchocaine
None
A.
B.
C.
D.
E.
An increased dose of epidural anaesthetic is obligatory in a patient who has –
Ascities
* Increased height of the patient
Pregnant
Age after 50
Obese
A.
B.
C.
D.
E.
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
1 year
A.
B.
C.
D.
E.
Cauda Equina syndrome can be caused by
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
E.General anaesthesia
A.
B.
C.
D.
E.
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
6
10
A.
B.
C.
D.
Complication of epidural anaesthesia is except* Headache
Nausea
Hypotension
Bladder distension
747.
748.
749.
750.
751.
752.
753.
E. Dizziness
A.
B.
C.
D.
E.
Concerning Barbotage –
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
Technique used Epidural Analgesia
Technique popularized in caudal Analgesia
Cannot be carried out under hypothermic condition
All of the above
A.
B.
C.
D.
E.
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
754.
755.
756.
During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
A.
B.
C.
D.
E.
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
A.
B.
C.
D.
E.
Epidural blocks is indicated in all excpect* Patients in hypovolemia
Patients with asthma and bronchitis
Post-operative pain relief
Obstetric analgesia
In urologic surgery
A.
B.
C.
D.
E.
Epidural morphine cause Miosis
Retention of urine
Abolishes pain
* All
None
A.
B.
C.
D.
E.
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
757.
758.
759.
760.
A.
B.
C.
D.
E.
First Fibres to be blocked at spinal anaethesia is –
Afferent motor nerve
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
A.
B.
C.
D.
E.
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
A.
B.
C.
D.
E.
For brachial plexus block needle is inserted –
Medial to subclavian artery
* Lateral to subclavian artery
Medial to subclavian vein
Lateral to subclavian vein
Inferior to subclavian vein
761.
762.
763.
764.
In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
765.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
A.
B.
C.
D.
E.
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
A.
B.
C.
D.
E.
In spinal anaesthesia, the first nerve fibre to get blocked is * Autonomic preganglionic fibres
Temperature fibres
Somatic motor fibres
Vibratory and proprioceptive fibres
Vegetates fibers
766.
767.
768.
In spinal anaesthesia, the last fibres affected is A. * Pressure
B.
C.
D.
E.
Pain
Temperature
Touch
Somatic
769.
In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
A.
B.
C.
D.
E.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
A.
B.
C.
D.
E.
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
A.
B.
C.
D.
E.
Lidocaine can be used in all except –
Ventricular fibrillation
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
A.
B.
C.
D.
E.
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
A.
B.
C.
D.
E.
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
770.
771.
772.
773.
774.
775.
Longest acting local anaesthetic solution isA. Lignocaine
B. Chlorprocain
C. Amethocaine
D. * Bupivacine
E. Novocaine
A.
B.
C.
D.
E.
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
A.
B.
C.
D.
E.
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
A.
B.
C.
D.
E.
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
A.
B.
C.
D.
E.
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
A.
B.
C.
D.
E.
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
A.
B.
C.
D.
E.
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
A.
B.
C.
D.
E.
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
776.
777.
778.
779.
780.
781.
782.
783.
A.
B.
C.
D.
E.
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
A.
B.
C.
D.
E.
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
A.
B.
C.
D.
E.
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
A.
B.
C.
D.
E.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseGives deep analgesia
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
A.
B.
C.
D.
E.
Subarachnoid block as anesthesia is contraindicated inIschemic heart disease ,
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
A.
B.
C.
D.
E.
The device suited for introducing epidural catheter is Mitchell needle
Gordh needle
* Tuohy needle
Sise introducer
Nick needle
A.
B.
C.
D.
E.
The duration of effect of spinal anaesthesia depends upon –
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
784.
785.
786.
787.
788.
789.
790.
The effects of chiling in refrigeration analgesia includes –
A. Interference with conduction of nerve impulse
B. Reduction of metabolic rate and oxygen requirement
C. Inhibition of bacterial growth and infection
D. Retardation of healing
E. * All of the above
791.
A.
B.
C.
D.
E.
The following is not used when giving local anaesthesia in the fingers 2 % xylocaine
Rubber tourniquet
Ring block
* Adrenaline
Atropin
A.
B.
C.
D.
E.
The spinal cord terminates opposite-vertebra –
* Lumbar 1
Lumbar 2
Sacral l
Sacral 2
Thoracal 12
A.
B.
C.
D.
E.
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
A.
B.
C.
D.
E.
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
A.
B.
C.
D.
E.
A local anesthetic that is ineffective topically is –
* Cocaine
Mepivacaine
Hexylcaine
Lidocaine
Tetracaine
A.
B.
C.
D.
A successful stellate ganglion block can produce –
Hypotension
* Horner's syndrome
Brachial plexus involvement
Hemifacial anaesthesia
792.
793.
794.
795.
796.
797.
E. Hypertension
798.
A.
B.
C.
D.
E.
Acute intestinal obstruction first of all causes such disorders of haemostasis:
intoxicative syndrome
violations of breathing
* hypohydration, violations of electrolytic concentrations
acute renal and liver failure
sepsis as a consequence of translocation phenomena
A.
B.
C.
D.
E.
All are surface anaesthetics except –
Lidocaine
* Bupivacaine
Procaine
Cinchocaine
None
A.
B.
C.
D.
E.
An increased dose of epidural anaesthetic is obligatory in a patient who has –
Ascities
* Increased height of the patient
Pregnant
Age after 50
Obese
A.
B.
C.
D.
E.
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
1 year
A.
B.
C.
D.
E.
Cauda Equina syndrome can be caused by
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
E.General anaesthesia
799.
800.
801.
802.
803.
Choose the best calorie amount for parenteral nutrition of a patient in
postoperative period:
A. 40 kkal/kg
B. 10 kkal/kg
C. 20 kkal/kg
D. * 30 kkal/kg
E. 50 kkal/kg
804.
Choose the list of necessary postoperative corrective therapy:
A. narcotic analgesics, antibiotics, cardiovascular medicines, electrolytes, vitamins
B. * correction of haemostasis, pain relief, parenteral nutrition, exercise therapy
C. pain relief, correction of breathing and volume of hydremia, stimulation of
intestinal peristalsis
D. pain relief, usage of central respiratory stimulators, antibiotics, parenteral
nutrition
E. correction of haemostasis, pain relief, antibiotics, exercise therapy
805.
A.
B.
C.
D.
E.
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
6
10
A.
B.
C.
D.
E.
Complication of epidural anaesthesia is except* Headache
Nausea
Hypotension
Bladder distension
Dizziness
A.
B.
C.
D.
E.
Concerning Barbotage –
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
Technique used Epidural Analgesia
Technique popularized in caudal Analgesia
Cannot be carried out under hypothermic condition
All of the above
A.
B.
C.
D.
E.
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
806.
807.
808.
809.
During anaesthesia of the patient with peritonitis the risk of which complication
will grow greatly?
A. * inhibition of respiratory centre as a consequence of pulmonary oedema
B. bronchiolospasm
C. acute heart failure as a consequence of mediastinum displacement, caused by the
elevated diaphragm
D. regurgitation and aspiration
E. hyperpotassemic cardiac arrest
810.
During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
811.
A.
B.
C.
D.
During the intestinal obstruction greatly growth the risk of:
* regurgitation and aspiration
sepsis
multiple organ failure
liver failure
E. pain shock
812.
of:
A.
B.
C.
D.
E.
During the postoperative period it’s necessary to use infusion therapy at the level
813.
A.
B.
C.
D.
E.
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
A.
B.
C.
D.
E.
Epidural blocks is indicated in all excpect* Patients in hypovolemia
Patients with asthma and bronchitis
Post-operative pain relief
Obstetric analgesia
In urologic surgery
A.
B.
C.
D.
E.
Epidural morphine cause Miosis
Retention of urine
Abolishes pain
* All
None
A.
B.
C.
D.
E.
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
A.
B.
C.
D.
E.
First Fibres to be blocked at spinal anaethesia is –
Afferent motor nerve
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
A.
B.
C.
D.
E.
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
814.
815.
816.
817.
818.
50 ml/kg
10 ml/kg
20 ml/kg
* 40 ml/kg
30 ml/kg
819.
A.
B.
C.
D.
E.
For brachial plexus block needle is inserted –
Medial to subclavian artery
* Lateral to subclavian artery
Medial to subclavian vein
Lateral to subclavian vein
Inferior to subclavian vein
820.
In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
821.
A.
B.
C.
D.
E.
In case of reactive peritonitis hemodynamics is usually characterised with:
collapses
hypodynamic regimen
* hyperdynamic regimen
hypovolemic shock
dependence on the initial blood pressure
A.
B.
C.
D.
E.
In case of toxic peritonitis cardiac output:
depends on the blood pressure
growth
doesn’t change much
* lowers
depends on the initial blood pressure
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
A.
B.
C.
D.
E.
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
A.
B.
C.
D.
E.
In spinal anaesthesia, the first nerve fibre to get blocked is * Autonomic preganglionic fibres
Temperature fibres
Somatic motor fibres
Vibratory and proprioceptive fibres
Vegetates fibers
822.
823.
824.
825.
826.
In spinal anaesthesia, the last fibres affected is A. * Pressure
B.
C.
D.
E.
Pain
Temperature
Touch
Somatic
827.
In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
A.
B.
C.
D.
E.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
A.
B.
C.
D.
E.
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
A.
B.
C.
D.
E.
Lidocaine can be used in all except –
Ventricular fibrillation
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
A.
B.
C.
D.
E.
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
A.
B.
C.
D.
E.
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
828.
829.
830.
831.
832.
833.
Longest acting local anaesthetic solution isA. Lignocaine
B. Chlorprocain
C. Amethocaine
D. * Bupivacine
E. Novocaine
A.
B.
C.
D.
E.
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
A.
B.
C.
D.
E.
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
A.
B.
C.
D.
E.
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
A.
B.
C.
D.
E.
Parenteral nutrition should be used for the patients, when:
* when enteral is impossible
all patients in intensive care department
all patients in bad conditions
when vital functions are disordered
in postoperative period
A.
B.
C.
D.
E.
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
A.
B.
C.
D.
E.
Peritonitis is classified next way:
* reactive, toxic, terminal
compensated, uncompensated, terminal
stages I, II, III
upper and lower parts of the abdomen
early and late
A.
B.
C.
D.
E.
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
834.
835.
836.
837.
838.
839.
840.
841.
A.
B.
C.
D.
E.
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
A.
B.
C.
D.
E.
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
A.
B.
C.
D.
E.
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
A.
B.
C.
D.
E.
Right after the operation with aesthesia proserin is used for:
renewal of respiratory centre activity
removal of residual curaresation after usage of depolarizing muscle relaxant
* removal of residual curaresation after usage of nondepolarizing muscle relaxant
stimulation of intestinal peristalsis
prevention of bronchiolospasm
A.
B.
C.
D.
E.
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
A.
B.
C.
D.
E.
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
A.
B.
C.
D.
E.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseGives deep analgesia
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
842.
843.
844.
845.
846.
847.
848.
Subarachnoid block as anesthesia is contraindicated inA. Ischemic heart disease ,
B.
C.
D.
E.
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
A.
B.
C.
D.
E.
The best anaesthesia for the patients with peritonitis is:
* I/v with myoplegia and ALV
inhalation through the mask
epidural anaesthesia
spinal anaesthesia
conduction and infiltrative anaesthesia
A.
B.
C.
D.
E.
The device suited for introducing epidural catheter is Mitchell needle
Gordh needle
* Tuohy needle
Sise introducer
Nick needle
A.
B.
C.
D.
E.
The duration of effect of spinal anaesthesia depends upon –
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
A.
B.
C.
D.
E.
The duration of preoperative preparing of patient with peritonitis is limited with:
conduction of necessary examinations
* stabilisation of haemostasis
readiness of surgeons
preparation to the anaesthesia
all answers are correct
A.
B.
C.
D.
E.
The effects of chiling in refrigeration analgesia includes –
Interference with conduction of nerve impulse
Reduction of metabolic rate and oxygen requirement
Inhibition of bacterial growth and infection
Retardation of healing
* All of the above
A.
B.
C.
D.
E.
The following is not used when giving local anaesthesia in the fingers 2 % xylocaine
Rubber tourniquet
Ring block
* Adrenaline
Atropin
A.
B.
C.
D.
The most common disorder of haemostasis during peritonitis are:
* metabolic acidosis
respiratory acidosis
thrombosis of deep veins of lower limbs, thromboembolism
respiratory alkalosis
849.
850.
851.
852.
853.
854.
855.
E. metabolic alkalosis
856.
The most common reason of early complications of operations with arduanum
usage is:
A. * falling back of the root of the tongue
B. inhibition of respiratory centre
C. dehydration
D. laryngospasm
E. bronchiolospasm
857.
The most common reason of early complications of operations with central
anaesthesia is:
A. * depression of respiration
B. bronchiolospasm
C. hypotension
D. cardiac arrest
E. acute liver impairment
858.
The most common reason of early complications of operations with dithylinum
usage is:
A. laryngospasm
B. inhibition of respiratory center
C. collapses
D. * falling back of the root of the tongue
E. arrhythmia
859.
The most common reason of early complications of operations with ketamine
usage is:
A. laryngospasm
B. rhythm disturbance
C. collapses
D. * hallucinosis, inadequate behaviour
E. respiratory “anarchy”
860.
A.
B.
C.
D.
E.
The spinal cord terminates opposite-vertebra –
* Lumbar 1
Lumbar 2
Sacral l
Sacral 2
Thoracal 12
861.
The vital functions of the body are:
A. haemodynamics, conciseness
B. breathing, activity of kidneys, liver, gastro-intestinal tract
C. * breathing haemodynamics, somatic and vegetative nervous system activity of
kidneys, liver, gastro-intestinal tract
D. breathing, circulation, activity of liver
E. breathing, haemodynamics
862.
To the parenteral nutrition belong next:
A. poliglukin
B. albumin
C. plasma
D. derivative of starch
E. * lipofundin
863.
A.
B.
C.
D.
E.
To the parenteral nutrition belong next:
* 10% solution of glucose
albumin
plasma
derivative of starch
carbicarb
A.
B.
C.
D.
E.
To the parenteral nutrition belong next:
plasma, solution of kasein-hydrolizate
albumin
solution of kasein-hydrolizate
* protein
polivinilpirolidon
A.
B.
C.
D.
E.
To the parenteral nutrition does not belong next:
* dextrins
protein hydrolisates
10% solution of glucose
20% solution of glucose
lipomays
A.
B.
C.
D.
E.
To the parenteral nutrition does not belong next:
* hydroxyetylstarch
hydrolysin
kasein-hydrolizate
10% solution of glucose
lipofundin
A.
B.
C.
D.
E.
Uncompensated pylorostenosis is dangerous first of all because of:
intoxicative syndrome
* hyponatremia and hypohydration
respiratory alkalosis and metabolic acidosis
hypokaliemia, hypochloremia, metabolic alkalosis
acute suprarenal failure
A.
B.
C.
D.
E.
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
864.
865.
866.
867.
868.
What way do the indexes of hemoconcentration change in case of acute intestinal obstruction?
F. * Hematocrit elevates because of the hemoconcentration, but the level of
haemoglobin and protein lowers in connection with intoxication
G. B. lower
H. C. do not change greatly
I. D. greatly lowers haemoglobin because of intoxication and electrolytic disorders
J. E. grow
869.
A.
B.
C.
D.
E.
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
870.
What are the receptors responsible for stimulation of the respiratory center in
hypoxemia?
A. * The respiratory center is not a reflex stimulated carotid chemoreceptors
B. The oxygen tension in arterial blood is reduced to 60 mm Hg
C. A person inhales a gas mixture with 15% of oxygen
D. The man rises to a height of 4000 m
E. Patient anemic
871.
A.
B.
C.
D.
E.
Child's sharply breathing can be caused by the following factors except:
Epiglotitis
foreign body of larynx
stenosing laryngotracheitis
* Acute bronhiolospasm
Submucose edema
A.
B.
C.
D.
E.
Kussmaul breathing :
Occurs when renal excretory alkalose
Is the respiratory compensation of diabetic ketoacidosis
* often observed at coma
It is a characteristic feature of hyperosmolar diabetic coma
Reduces alveolar ventilation
872.
873.
Possible iatrogenic causes of acute respiratory distress syndrome may be the
following factors except:
A. artificial ventilation, the concentration of oxygen in the inspired gas is not higher
than 40%
B. artificial ventilation with oxygen concentration in the inspired gas is not higher
than 70%
C. Transfusion of blood incompatible
D. Operations using the heart-lung machine
E. * Severe hypovolemic shock
874.
Synchronous intermittent mandatory ventilation (SIMV) compared with
controlled ventilation:
A. Reduces blood pressure and cardiac output
B. Reduces the work of respiratory muscles
C. Reduces the energy cost of breathing
D. * Allows you to reduce the pressure on the height of inspiration
E. Lowers and raises the pH pCO2
875.
The patient during intubation anesthesia using mechanical ventilation suddenly
emerged cyanosis on the background of normal hemodynamic indexes . In the case of
massage ungual phalanges cyanos does not decrease. All that is the proper, except:
A. Check tightness of breathing system
B. Remove the flow of nitrous oxide (if applicable)
C. Increase the supply of oxygen
D. Check patency and position of endotracheal tube
E. * Change absorber of carbon dioxide
876.
The rapid drop of carbon dioxide tension in arterial blood from a high level to
normal can lead to:
A. Arterial hypertension
B. * Arrhythmias
C. cephaledema
D. Increase in coronary perfusion
E. None of the above
877.
After 20 minutes of ventilation with pure oxygen arterial pO2 of patient was 60
mm Hg .
What is the mechanism of respiratory disorders?
A. alveolar hypoventilation
B. Violation of diffusion through the alveolar-capillary membrane
C. Violation of ventilation-perfusion ratios in lungs
D. Intrapulmonary shunting up to 10%
E. * Toxicity of oxygen
878.
After a 2-sided carotid endarterectomy in a patient:
did not disturb the regulation of respiration
No reaction to the rise of paCO2
There is a shortness of breath in response to hypoxemia
* The main impetus of the respiratory center is to increase the pH and pCO2
intracerebral interstitial fluid
E. None of the above
A.
B.
C.
D.
879.
Airway resistance during turbulent flow of gas depends on the following factors
except:
A. pipe radius
B. gas viscosity
C. The gas density
D. Bit stream
E. * Lung compliance
880.
A.
B.
C.
D.
E.
881.
All statements about spontaneous pneumothorax are true, except:
The most common among men 20-40 years
* the trachea is mooving in the patient side
Increased risk for women during menstruation
Increased risk in smokers
There are people with a genetic predisposition
Alveolar hypoventilation leads to everything, except:
A. hypoxemia during air breathing
B. * hypoxemia while breathing oxygen
C. hypercapnia when breathing air
D. Hypercapnia during oxygen breathing
E. Anything with the above listed
882.
A.
B.
C.
D.
E.
Anatomical dead space is increased by the action of the following factors except:
* pleurorrhea
Atropine
Inhalation of phtorotan
Introduction aminophylline
None of the above
883.
At the function cilliaris apparatus of the lower respiratory tract adversely affect
the following factors except:
A. incense
B. dehydration
C. Hyperhydration
D. Atropinisation
E. * Introduction glucocorticoids
884.
Before all chemical substances, the most powerful regulator of alveolar ventilation
in normal conditions is:
A. Oxygen
B. * Carbon dioxide
C. Hydrogen ions
D. Lactic acid
E. Nitrogen
885.
A.
B.
C.
D.
E.
Breathing of Biott is characterized by:
Short and long breath exhalation
Duration of breath and short breath
* A frequent deep breathing, alternating with breathing pauses
Smoothly varying amplitude of the respiratory volume
Ensures adequate ventilation
A.
B.
C.
D.
E.
Carbon dioxide tension in alveolar air in normal conditions is:
More when breathing air under a pressure of 2 atmosphere
Less when breathing air under a pressure of 2 atmosphere
* It depends only on the alveolar ventilation and CO2 production
Less when breathing with pure oxygen
More when breathing with pure oxygen
A.
B.
C.
D.
E.
Cheyne Stokes respiration is characterized by:
Short and long breath exhalation
Duration of breath and short breath
respiration pauses, before the frequent deep breathing
* Smoothly varying amplitude of tidal volume with short pauses
Provides breathing
886.
887.
888.
Choose the wrong answer. Respiratory distress syndrome of newborns:
A. * The probability of its development is reduced by the use of corticosteroids in
pregnant
B. Linked to hypoplasia of bronchial tree
C. It is characterized by an increase of the respiratory muscles
D. Effective treatment with artificial surfactant
E. Usually develops in preterm
889.
A.
B.
C.
D.
E.
Choose the wrong answer.Lung surfactant:
produced pneumocites of type 2
It consists mainly of lipoproteins
Not for respiratory distress syndrome of newborns
* Increases the surface tension of fluid in the alveoli
None of the above
A.
B.
C.
D.
E.
Compared with atmospheric air alveolar gas has:
The lower total pressure
Higher pO2
Lower pCO2
* Higher partial pressure of water vapor
Higher partial pressure of nitrogen
890.
891.
Cromolyn Na (INTAL) may be effective in the treatment of bronchial asthma
because of the following steps:
A. Blockade of histamine receptors
B. Inhibition of phosphodiesterase
C. Activation of beta 2-adrenoceptor
D. * Blocks education bronhokonstriktivnyh substances
E. None of the above listed
892.
Cyanosis is not indicative of the presence of hypoxemia if a concentration of
hemoglobin is equal to:
A. 70 g / l
B. 100 g / l
C. 140 g / l
D. * 170 g / l
E. In the absence of hypoxemia and congestive heart failure cyanosis will be present
893.
Cyanosis of the skin and visible mucose will be possible to detect with a decrease
in oxygen saturation of arterial blood below:
A. 70%
B. * 80%
C. 90%
D. 100%
E. 20%
894.
A.
B.
C.
D.
E.
Dead space is reduced by all except:
In the supine position compared with the vertical position
Intubation
After the imposition of tracheostomy
* After the top laporotomi
None of the above
895.
26. Direct reading of spirographic data can be used to measure the following
volumes, except:
A. tidal volume
B. * residual lung volume
C. lung capacity
D. Expiratory reserve volume
E. Inspiratory reserve volume
896.
A.
B.
C.
D.
E.
Each gram of hemoglobin can bind:
0.03 ml of oxygen
0.57 ml of oxygen
* 1,34-1,39 ml of oxygen
1 ,48-1, 56 ml of oxygen
2.0 ml of oxygen
A.
B.
C.
D.
E.
Fit bronchoconstriction in atopic form of bronchial asthma can be docked using:
Inta
* Betta adrenostimulyatorov
Calcium glyukanata
Diphenhydramine
Chloride
897.
898.
For acute respiratory distress syndrome characterized by the following symptoms
except:
A. Increases in intrapulmonary shunting
B. Violations of the permeability of the alveolar-capillary membrane
C. Increase the amount of free water in the lungs
D. * Increases elasticity (compliance) light
E. Education pneumosclerosis and hyaline membrane
899.
For which of the above indices was best to evaluate the adequacy of mechanical
ventilation?
A. Hemodynamics
B. pH of arterial blood
C. * arterial blood gas composition
D. pH of venous blood
E. Gas composition of venous blood
900.
A.
B.
C.
D.
E.
Frequency of atelectasis is less:
* For men compared with women
For women compared with men
In patients with low birth weight
After laparoscopic surgery
After low laporotomic cuts
A.
B.
C.
D.
E.
Functional dead space is increased by:
Reducing the partial pressure of oxygen in the inspired gas
Growth of intrapulmonary shunting
* hypovolemia
Anemia
Trendelenburg position of patient
901.
902.
Functional dead space is likely increase if the following drugs used except:
A. ganglion blocking
B. Atropine
C. Nitroglycerin
D. Dehydrobensperidol
E. * Neostigmine
903.
High-frequency ventilation:
A. Considered as such if the tidal volume above the volume of anatomic dead space
B. More effective in patients with low extensibility (compliance) of light compared
to conventional mechanical ventilation
C. Helps increase intrathoracic pressure compared with conventional mechanical
ventilation
D. Reduces the risk of pulmonary barotrauma compared with conventional
mechanical ventilation
E. * Safer than conventional mechanical ventilation in patients with fistulas
bronhoplevralnymi
904.
A.
B.
C.
D.
E.
Hyperventilation is developed under the following conditions, except:
Metabolic acidosis
Hypovolemia
* barbiturate poisoning
Hyperthermia
Nothing from the above listed
A.
B.
C.
D.
E.
Hypoxic hypoxia is characterized by the following symptoms except:
Violations of consciousness
Cyanosis of the skin and visible mucous
Reduction of alveolar pO2
Reduction of arterial pO2
* Increasing arteriovenous oxygen difference
905.
906.
In the case of elevated methemoglobin in the blood and the development of tissue
hypoxia is shown the application:
A. Atropine
B. Inhibitors of holinesterase
C. * Methylene blue
D. Glucose
E. Diphenhydramine
907.
A.
B.
C.
D.
E.
In what form of hypoxia is inefficient oxygen therapy:
Hypoxic
circulatory
Hemical
* Hystotoxic
None of the above
A.
B.
C.
D.
E.
Increasing of alveolar-arterial oxygen difference did not depend from:
Violations of the diffusion of gases through the alveolar-capillary membrane
The increase in the shunting pulmonary
ventilation with pure oxygen
* Moderate anemia
By increasing blood flow
908.
909.
Indicators of pulse oximetry:
A. * Depends on the state of tissue perfusion
B.
C.
D.
E.
Do not respond with a decrease in arterial pO2 to 60 mm Hg
No Avis of light effects in the determination
Do not depend on the state of the external gas exchange
None of the above
A.
B.
C.
D.
E.
Intermediate bronchus of the right lung holds air:
In the upper part
The average share
In the lower part
* In the middle and lower lobe
In the upper and middle lobe
A.
B.
C.
D.
E.
It can be expected that the pO2 will be normal arterial in:
Decrease in partial pressure of oxygen in inhaled air
Violations of diffusion through the alveolar-capillary membrane
alveolar hypoventilation
Smoky gas poisoning
* Anemia
A.
B.
C.
D.
E.
It is known that a healthy young man:
The lungs are easy to stretch more than the thorax
The lungs are easy to stretch less than the thorax
* Tensile elongation of lungs are equal to the thorax
The total elongation more than elongation of one lung
None of the above
A.
B.
C.
D.
E.
Low oxygen tension in the inspired gas leads to:
Increasing of tension and oxygen saturation of arterial blood
It shifts the oxyhemoglobin dissociation curve to the left
It increases the pulmonary arteriols
* With prolonged exposure leads to pulmonary hypertension
Nothing from the above listed
A.
B.
C.
D.
E.
Lung diffusion capacity is probably not broken in the case of:
* myasthenia
interstitial pulmonary edema
severe attack of bronchial asthma
Acute respiratory distress syndrome
Nothing from the above listed
910.
911.
912.
913.
914.
915.
In which case will be the greatest stimulation of the respiratory center carotid
chemoreceptors?
A. Carbon Monoxide Poisoning
B. methemoglobinemia
C. Severe anemia
D. * Increased intrapulmonary shunting
E. Pronounced metabolic alkalosis
916.
Normally, the maximum concentration of hemoglobin in the erythrocyte is:
A. 10%
B. 21%
C. 27%
D. * 34%
E. 50%
917.
A.
B.
C.
D.
E.
Normally, the percentage of dead space on the tidal volume is:
5%
15%
* 30%
50%
60%
918.
Oxygen and carbon dioxide tension markedly fluctuate during inspiration and
expiration if it were not :
A. The reserve volume inspiratory
B. Respiratory volume
C. * Residual lung capacity
D. Vital lung capacity
E. Minute volume of breathing
919.
A.
B.
C.
D.
E.
Possible complications of tracheostomy are, except:
Infection of lower respiratory tract
* The increase of the dynamic resistance to breathing
Formation of a fistula
Tracheal stenosis
Bleeding from the respiratory tract
A.
B.
C.
D.
E.
Pulmonary vascular resistance drops:
Alveolar Hypoxia
Alveolar hypercapnia
* prostacyclin
Carbon dioxide
Catecholamines
A.
B.
C.
D.
E.
Recurrent laryngeal nerve (laryngeal):
* It is a branch of the vagus nerve
Is only the sensory nerves
As a rule, is not damaged during surgery in the neck
With his injury is not observed speech disorders
Nothing from the above listed
920.
921.
922.
Reduced of which muscle has the greatest significance for the creation of high
pressure in the airway by coughing before the opening of the glottis?
A. intercostal muscles of expiration
B. Diaphragm
C. trapesius
D. * Abs
E. None of the above
923.
Reduced production and function of pulmonary surfactant leads to the following
effects except:
A. Increases in the elastic resistance of lungs
B. * Increases in the dynamic resistance (bronchial tree)
C. Atelektasation
D. Increases in the work of respiratory muscles
E. Interstitial pulmonary edema
924.
Reduced the forced expiratory volume will probably be observed in all states
except:
A. Asthma
B. Emphysema
C. chronic bronchitis
D. * Lung abscess
E. None of the above
925.
A.
B.
C.
D.
E.
Reducing the partial pressure of oxygen causes spasm:
coronary
* pulmonary vascular
receptacles of splanhnic zone
Vessels of striated muscles
Nothing from the above listed
A.
B.
C.
D.
E.
Sensitive innervation of the larynx by branches:
trigeminal
facial nerve
Vestibulokohlearnogo nerve
Glossopharyngeal nerve
* Vagus
A.
B.
C.
D.
E.
Shortness of breath may be caused directly by the following factors, except:
Decrease in arterial pO2
* Enhancement of arterial pO2
Reduction of Hb saturation of venous blood oxygen
Increased blood pCO2
Decrease in pH of arterial blood
926.
927.
928.
Stimulation of the Hering-Breuer reflex resulting from stimulation of stretch
receptors in the lungs, can lead to:
A. The increase in inspiratory and expiratory
B. * Switching from inhalation to exhalation, and vice versa when tidal volume is
more than 1 liter
C. Reduction of alveolar ventilation
D. decreasing the alveolar ventilation
E. Anything of the above
929.
A.
B.
C.
D.
E.
930.
Tachypnea is characterized by:
The increase of minute volume of respiration
* By increasing the frequency of breathing
By increasing the depth of respiration
Decrease paCO2 below 35 mm Hg
Nothing from the above listed
Tensile properties (compliance) of lungs is reduced when:
A. The normal production of surfactant
B.
C.
D.
E.
* Pulmonary edema
Open pneumothorax
Breathing the hypoxic mixture
None of the above
931.
The best way to treat "oxygen apnea", developed due to increased oxygen tension
in arterial blood of patients with hypoxic respiratory stimulation type is:
A. Application of respiratory analeptics
B. Cessation of oxygen supply
C. * Increased content CO2 in the inspired gas
D. ALV
E. Introduction of alkalify solutions
932.
The concentration of COHb (carboxyhemoglobin) in the patient is 30%. When it
will drop to 7.5% in the case of breathing with atmospheric air?
A. 1 hour
B. 5 hours
C. * 10 hours
D. 24 hours
E. 48 hours
933.
The following factors lead to alveolar hypoventilation after curaresation in the
postoperative period, except:
A. Hypothermia
B. Applications of dalatsin C
C. Applications of furosemide
D. Hypokalemia
E. * Applications of beta-blockers
934.
The following symptoms are characteristic of hypercapnia, hypoxia is not
accompanied by:
A. Cyanosis of the skin and visible mucous
B. Expression of peripheral spasm
C. Bradycardia
D. * Sweats
E. Reduction of cerebral blood flow
935.
The long-existing pulmonary hypertension is characterized by the following
symptoms except:
A. Increasing vascular resistance
B. Increase pulmonary bypass
C. Increase of the load of the right ventricle of the heart
D. * Hypertrophy of the left ventricle
E. polycythemia
936.
A.
B.
C.
D.
E.
The main reasons of pulmonary respiratory failure are the following, except:
Increasing the concentration of oxygen in the inspired gas
* Reduction of alveolar ventilation
Violations of the diffusion of gases through the alveolar-capillary membrane
Violations of ventilation-perfusion ratios in lungs
Increased intrapulmonary shunting
937.
A.
B.
C.
D.
E.
The most common pulmonary embolism develops in:
* AA proven deep vein thrombosis
prolonged immobilization
recent orthopedic surgery
Obesity
Availability of ELA in history
A.
B.
C.
D.
E.
The partial pressure of water vapor in the alveolar gas depends on:
Composition of inhaled gas
The values of atmospheric pressure
* The body temperature
Alveolar pO2
Alveolar pCO2
938.
939.
The pharmacological effect of bronchial spasmolytic can be realized by all,
except:
A. Preemption effect of acetylcholine
* increase of GMPh
C. Increase of AMPh
D. Blockade of release of cell mediators for adhession
E. Blockade of Ca-channels
940.
A.
B.
C.
D.
E.
The poisoning is fatal if carbon monoxide is minimal links:
20% of blood hemoglobin
40% of blood hemoglobin
54% of blood hemoglobin
* 76% of blood hemoglobin
100% of blood hemoglobin
A.
B.
C.
D.
E.
The pressure in the pulmonary artery is reduced in the case of :
Acidosis
exercise
Introduction propranolol
Hypoxia
* All the answers are not true
941.
942.
The therapeutic effect of sympathomimetics for relieving of bronchospasm is
associated with:
A. blockade of adenosine receptors of bronchial muscles
B. blockade of calcium tubules of bronchial muscles
C. C. blockade of histamine receptors of bronchi
D. * By increasing the content of cAMP in the cells of bronchial muscles
E. Oppression bronhospasticheskih reflexes
943.
A.
B.
C.
D.
E.
944.
To the respiratory muscles of expiration are all listed, except:
* Diaphragm
Internal intercostal muscles
External and internal oblique abdominal muscles
Lateral and ventral abdominal muscles
None of the above
To the respiratory muscles of inhalation are all listed, except:
A.
B.
C.
D.
E.
Diaphragm
outdoor intercostal muscle
* Internal intercostal muscles
Scalenus
None of the above
A.
B.
C.
D.
E.
What applies to the drugs 'first appointment' acute attack of asthma?
aminophylline
Crank
Parenteral beta 2-adrenomimetics
* Inhaled beta 2-adrenomimetics
Cholineblocker
A.
B.
C.
D.
E.
What are the normal values of carbon dioxide tension in arterial blood?
20-30 mm Hg
30-40 mm Hg
* 35-45 mm Hg
45-55 mm Hg
50-60 mm Hg
A.
B.
C.
D.
E.
What could be the immediate causes of circulatory hypoxia?
Alveolar hypoventilation
Increased intrapulmonary shunting
Renal insufficiency
* Violation of blood microcirculation
Carbon monoxide
A.
B.
C.
D.
E.
What is the most characteristic radiological sign for pulmonary embolismrterii?
Expanding the root of the lung
Pulmonary infiltration
The rise of the dome diaphragm
Symptom Hampton (wedge-shaped infarct of the lung)
* Chest radiograph remains normal
A.
B.
C.
D.
E.
What is the normal value of minute breathing volume in an adult?
2-4 L / min
* 5-10 l / min
8-12 l / min
10-15 l / min
20 l / min
A.
B.
C.
D.
E.
What is the smallest of these lung volumes?
* respiratory volume
Vital lung capacity
Residual lung volume
Expiratory reserve volume
None of the above
945.
946.
947.
948.
949.
950.
951.
What percentage of CO2 directly or indirectly transferred by means of
hemoglobin?
A. 5%
B. 10%
C. 50%
D. * 90%
E. 20%
952.
What should be the minimum pressure at the peak of inspiration from a patient
with healthy lungs with normal weight and normal extensibility of the chest that would
provide the necessary injection of tidal volume?
A. 8-10 cm water station
B. * 14-20 cm of water station
C. S.20-30 cm of water station
D. 30-40 cm of water station
E. 50-60 cm of water station
953.
A.
B.
C.
D.
E.
What's wrong? Anatomical characteristics of the trachea:
The average length is 10-18 cm
Bifurcation is located at 5 th thoracic vertebra
Motionless, fixed to the surrounding tissue
About half of is above sternum
* Length varies with body position
A.
B.
C.
D.
E.
Which from these factors can reduce the excretion of carbon dioxide?
Alveolar hyperventilation
Climb up to the highlands
Breathing with pure oxygen under atmospheric pressure
* Breathing with pure oxygen under pressure of 3 atmosphere
Nothing from the above listed
954.
955.
Which of the factors plays the greatest role in creating the elastic resistance of
normal lung:
A. Elastic skeleton of light
B. * Surface tension of alveolar fluid
C. Intrapleural pressure
D. Cross-sectional area of the bronchi and bronchioles
E. None of the above
956.
Which of the following indicators may serve as one of the criteria for transfer of
patient on mechanical ventilation?
A. The respiratory rate in adults over 20/min
B. Vital lung capacity, equal to 20 ml / kg
C. inspiratory force greater than 25 cm water station
D. Arterial pO2 in 65-year-old patient, equal to 60 mm Hg
E. * Arterial pCO2 greater than 55 mm Hg
957.
Which of the following symptoms may be useful for differential diagnosis of
hypoxic and circulatory hypoxia, except?
A. Nature cyanosis
B. Alveolar pO2
C. Arterial pO2
D. * pH of arterial blood
E. Arteriovenous oxygen difference
958.
Which of these factors are not causes shortness of breath?
A.
B.
C.
D.
E.
* The oxygen tension in arterial blood of 80 mm Hg
Metabolic acidosis
Hypercapnia
Hyperthermia
Nothing used above listed
959.
With the catheter of Swan-Gans it can be defined the following parameters,
except:
A. Pressures in the right atrium
B. Pressure in the right ventricle
C. Pressure in the pulmonary artery
D. Pressure occlusion (wedge), pulmonary artery
E. * End-diastolic pressure in the left ventricle
960.
With the development of a massive pulmonary haemorrhage are shown the
following activities, except:
A. * Urgent introduce calcium preparations
B. Lay the patient in position Trendeleburga on the side of bleeding
C. You must create a controlled hypotension
D. Urgent call for a consultation thoracic surgeon
E. When continuous bleeding translate to one-lung ventilator
961.
With the introduction of excessively deep endotracheal tube most of its end is
located in:
A. The right main bronchus
B. Left main bronchus
C. * Intermediate bronchus
D. Right distal bronchus
E. The left distal bronchus
962.
A 13-year-old female presents with the complaint that she cannot move her right
leg. There are no other associated symptoms and no history of trauma, head-ache, or
prior medical problems. The symptom began on the day she was to meet her father for
the first time. Which of the following would be LEAST helpful in the management of
this patient?
A. Perform a Hoover test
B. * Tell her that nothing is wrong
C. Hypnosis
D. Tell her that she can talk with her father on the telephone rather than in person
E. Reassure the patient that she will walk again
963.
A 20-year-old female undergraduate student presents complaining of a gradual
onset of right-sided headache. The headache is accompanied by nausea and
photophobia and prevents her from studying for exams. Which of the following is
LEAST likely to be associated with her headache?
A. Aura
B. Birth control pills
C. Family history of similar headaches
D. Menstruation
E. * Unilateral tearing with conjunctival injection
964.
A 25-year-old male is brought to the ED by ambulance on a psychiatric hold after
wandering in a residential area looking for the source of the evil voices that he states
are controlling his thoughts. Upon arrival, he is screaming and wildly agitated. Which
of the following represents an appropriate initial dose of intramuscular haloperidol for
this patient?
A. 0.05 mg
B. 0.5 mg
C. * 5.0 mg
D. 50 mg
E. 500 mg
965.
A 25-year-old male is brought to the ED by his sister who states that he started
vomiting that morning after complaining of a severe headache. On examination, he is
drowsy but arousable with mild nuchal rigidity and no focal neurologic deficit. Which
of the following is LEAST likely to be needed for his work-up and treatment?
A. CT of the head
B. Blood glucose determination
C. Antiemetic
D. * Lumbar puncture
E. Nimodipine
966.
A 26-year-old female is brought to the ED after three successive witnessed grand
mal seizures without recovery of consciousness. Upon arrival, she is obtunded with no
spontaneous eye opening and withdraws to pain only. Initial ED management could
include all of the following EXCEPT
A. endotracheal intubation
B. * barbiturate coma
C. phenytoin infusion
D. determination of blood glucose
E. gastric lavage
967.
A 28-year-old female overdosed on her father's lithium. She presents with
complaints of nausea, vomiting, and blurred vision. Initial lithium level is 2 mEq/L.
Which of the following would NOT be appropriate ED management?
A. Intravenous hydration
B. Correction of electrolyte imbalance
C. Urine pregnancy test
D. * Discharge to an inpatient psychiatric facility if asymptomatic after a 4-h
observation period
E. Alkalinization of the urine
968.
A 30-year-old pregnant female presents to the ED complaining of vaginal
bleeding. All of the following statements are true concerning this patient EXCEPT
A. most patients with bleeding in early pregnancy have normal pregnancy outcomes
B. urinary tract infection can precipitate spontaneous abortion
C. * lack of adnexal mass on bedside ultrasound makes ectopic unlikely
D. she should have her Rh status checked
E. the quantitative ЯhCG level should be monitored
969.
A 35-year-old female with a history of newly diagnosed myasthenia gravis
presents to the ED with profound generalized muscle weakness for 2 days without a
known precipitant. A test dose of 2 mg intravenous edrophonium results in visible
muscle fasciculations and slowing of the patient's respiratory rate and depth. Which of
the following actions is INAPPROPRIATE?
A. * Administering neostigmine
B. Preparing for intubation
C. Consulting a neurologist
D. Establishing aspiration precautions
E. Admission to the ICU
970.
A 37-year-old male intravenous drug user (IVDU) presents with the complaint of
several days of general malaise, difficulty swallowing, occasional double vision, and
subjective fever. On examination, the patient is noted to have grossly intact cranial
nerves II to XII, a distended bladder, and a temperature of 99.1°F. What is the MOST
appropriate next step?
A. Admit to the ED observation unit
B. Admit to the floor for observation
C. * Admit to the ICU
D. Discharge to home with reassurance
E. Discharge to home with follow-up in several days
971.
A 58-year-old female is brought to the ED by her family. They state that her
words do not make sense, the right side of her face is drooping, and she is weak on the
right side. On examination you note that the patient is awake and alert, has an
expressive aphasia, right-sided facial droop, three-fifths right arm strength, four-fifths
right leg strength, and decreased sensation to pin-prick on the right side. Which stroke
syndrome is MOST likely?
A. Anterior cerebral artery infarct
B. Basilar artery occlusion
C. * Middle cerebral artery infarct
D. Lacunar infarct
E. Intracerebral hemorrhage
972.
A 60-year-old male presents complaining of a typical spring headache, 2 months
after a femoral-popliteal bypass. He states that the pain is excruciating, began over the
left eye, and is causing the eye to tear and throb. Which abortive therapy is the LEAST
appropriate?
A. * Ergotamine
B. Ketorolac
C. Prochlorperazine
D. Oxygen inhalation
E. Intranasal lidocaine
973.
A 62-year-old female with a history of TIA affecting the right side complains of 8
h of a dense right-sided paralysis and dysarthria. No previous studies have been
completed. What is the MOST appropriate disposition?
A. * Admit to the medical ward
B. Admit to the rehabilitation ward
C. Discharge to home and arrange follow-up with the primary care physician
D. Transfer the patient to a skilled nursing facility
E. Conduct a stroke work-up in the ED and then discharge to home
974.
A 7-year-old male presents to the ED 6 months status post revision of a CSF
shunt. He complains of a persistent headache for 1 week, occasional nausea, and
vomiting three to four times that day. Evaluation for shunt infection should include all
of the following EXCEPT
A. CT of the head
B. shunt survey (plain films of the skull, chest, and abdomen)
C. compression of the reservoir
D. neurosurgical consult
E. * lumbar tap
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
A.
B.
C.
D.
E.
A local anesthetic that is ineffective topically is –
* Cocaine
Mepivacaine
Hexylcaine
Lidocaine
Tetracaine
A.
B.
C.
D.
E.
A successful stellate ganglion block can produce –
Hypotension
* Horner's syndrome
Brachial plexus involvement
Hemifacial anaesthesia
Hypertension
975.
976.
977.
978.
A.
B.
C.
D.
E.
979.
A.
B.
C.
D.
E.
All are surface anaesthetics except –
Lidocaine
* Bupivacaine
Procaine
Cinchocaine
None
All of the following are consistent with multiple sclerosis (MS) EXCEPT
multiple discrete lesions of the white matter
increase of immunoglobulin in the CSF
worsening spasticity with urinary tract infection
* diminution of symptoms with fever
optic neuritis as first symptom
980.
All of the following are risk factors for pelvic inflammatory disease (PID)
EXCEPT
A. multiple sexual partners
B. adolescence
C. history of gonococcal salpingitis
D. use of intrauterine (IUD) contraceptive device
E. * low socioeconomic status
981.
All of the following are symptoms of physician burnout EXCEPT
A. * illicit drug use
B.
C.
D.
E.
chronic fatigue
excessive irritability
feelings of helplessness
negative attitudes toward work
A.
B.
C.
D.
E.
All of the following are TRUE concerning vulvovaginitis EXCEPT
bacterial vaginosis is the most common etiology
alkaline cervical secretions predispose a woman to infection
older women usually do not have symptoms until the vulvovaginitis is advanced
pinworms (Enterobius vermicularis) can cause vaginal irritation
* the classic "strawberry cervix" is commonly seen in patients with Trichomonas
vaginalis
982.
983.
All of the following are true of intraperitoneal blood and culdocentesis EXCEPT
* the test is positive when clotting blood is aspirated
cervical motion tenderness may be present in a patient with intraperitoneal blood
a ruptured corpus luteum cyst can produce a positive test
culdocentesis is positive in the majority of ectopic pregnancies, ruptured and
unruptured
E. aspiration of clear fluid denotes a negative test
A.
B.
C.
D.
984.
All of the following are TRUE of spontaneous abortion (SAB) EXCEPT
A. more than 50 percent of the abortuses have chromosomal abnormalities
B. most SABs occur before 8 or 9 weeks of gestation
C. * maternal factors such as uterine adhesions and pelvic structural abnormalities
may lead to SABs
D. the incidence of SAB climbs with increasing maternal age
E. the pain associated with SAB usually occurs after the bleeding has commenced
985.
All of the following characteristics are associated with an increased suicide risk
EXCEPT
A. psychosis
B. unemployment
C. chronic illness
D. * first attempt
E. readily available lethal weapon
986.
All of the following physiologic changes take place during normal pregnancy
EXCEPT
A. * respiratory rate is increased
B. blood volume increases
C. systolic blood pressure decreases
D. serum blood urea nitrogen (BUN) decreases
E. leukocyte count increases
987.
All of the following regimens are recommended for the treatment of acute PID
EXCEPT
A. * ceftriaxone 125 mg intramuscularly plus doxycycline 100 mg orally twice a day
for 10 to 14 days
B. cefoxitin 2 g intravenously every 6 h plus doxycycline 100 mg intravenously
twice a day or orally for 10 to 14 days
C. cefoxitin 2 g intramuscularly plus probenecid 1 g orally and ofloxacin 400 mg
orally twice a day for 14 days
D. clindamycin 900 mg intravenously every 8 h plus gentamycin loading dose of 2
mg/kg intravenously followed by a maintenance dose of 1.5 mg/kg every 8 h
E. cefotetan 2 g intravenously every 12 h plus doxycycline 100 mg intravenously
twice a day or orally for 10 to 14 days
988.
A.
B.
C.
D.
E.
Amaurosis fugax is caused by occlusion of which one of the following arteries?
Anterior cerebral artery
Basilar artery
* Carotid artery
Posterior cerebral artery
Vertebral artery
A.
B.
C.
D.
E.
An increased dose of epidural anaesthetic is obligatory in a patient who has –
Ascities
* Increased height of the patient
Pregnant
Age after 50
Obese
A.
B.
C.
D.
E.
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
1 year
A.
B.
C.
D.
E.
Cauda Equina syndrome can be caused by
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
E.General anaesthesia
A.
B.
C.
D.
E.
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
D*6
10
989.
990.
991.
992.
993.
A.
B.
C.
D.
E.
Complication of epidural anaesthesia is except* Headache
Nausea
Hypotension
Bladder distension
Dizziness
994.
Concerning Barbotage –
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
B. Technique used Epidural Analgesia
C. Technique popularized in caudal Analgesia
D. Cannot be carried out under hypothermic condition
E. All of the above
995.
A.
B.
C.
D.
E.
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
996.
During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
A.
B.
C.
D.
E.
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
A.
B.
C.
D.
E.
Epidural blocks is indicated in all excpect* Patients in hypovolemia
Patients with asthma and bronchitis
Post-operative pain relief
Obstetric analgesia
In urologic surgery
997.
998.
999.
Epidural morphine cause A. Miosis
B. Retention of urine
C. Abolishes pain
D. * All
E. None
1000.
A.
B.
C.
D.
E.
1001.
A.
B.
C.
D.
E.
1002.
A.
B.
C.
D.
E.
1003.
A.
B.
C.
D.
E.
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
. First Fibres to be blocked at spinal anaethesia is –
Afferent motor nerve
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
For brachial plexus block needle is inserted –
Medial to subclavian artery
* Lateral to subclavian artery
Medial to subclavian vein
Lateral to subclavian vein
Inferior to subclavian vein
1004. In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
1005.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
1006.
A.
B.
C.
D.
E.
1007.
A.
B.
C.
D.
E.
1008.
A.
B.
C.
D.
E.
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
In spinal anaesthesia, the first nerve fibre to get blocked is * Autonomic preganglionic fibres
Temperature fibres
Somatic motor fibres
Vibratory and proprioceptive fibres
Vegetates fibers
In spinal anaesthesia, the last fibres affected is * Pressure
Pain
Temperature
Touch
Somatic
1009. In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
1010.
A.
B.
C.
D.
E.
1011.
A.
B.
C.
D.
E.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
Lidocaine can be used in all except –
A. Ventricular fibrillation
1012.
B.
C.
D.
E.
1013.
A.
B.
C.
D.
E.
1014.
A.
B.
C.
D.
E.
1015.
A.
B.
C.
D.
E.
1016.
A.
B.
C.
D.
E.
1017.
A.
B.
C.
D.
E.
1018.
A.
B.
C.
D.
E.
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
Longest acting local anaesthetic solution isLignocaine
Chlorprocain
Amethocaine
* Bupivacine
Novocaine
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
1019.
A.
B.
C.
D.
E.
1020.
A.
B.
C.
D.
E.
1021.
A.
B.
C.
D.
E.
1022.
A.
B.
C.
D.
E.
1023.
A.
B.
C.
D.
E.
1024.
A.
B.
C.
D.
E.
Parkinson's disease i s characterized by all of the following EXCEPT
akinesia or bradykinesia
cogwheel rigidity
* intention tremor
Lewy bodies
impairment in posture and equilibrium
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
1025. Reducing of oxygen transport function of preserved blood may occur as a result
of the following reasons:
A. Reduction of pH
B.
C.
D.
E.
1026.
A.
B.
C.
D.
E.
1027.
A.
B.
C.
D.
E.
1028.
A.
B.
C.
D.
E.
1029.
A.
B.
C.
D.
E.
* Reduction of 2,3-diphosphoglycerate in erythrocytes
Reduction of 2,3-diphosphoglycerate in the plasma
Increasing the extracellular concentration of potassium ions
Violations of the rheological properties
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
Spinal anaesthesia is preferred in lower abdominal surgeries becauseGives deep analgesia
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
Subarachnoid block as anesthesia is contraindicated inIschemic heart disease ,
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
1030. Temporal arteritis is a vasculitis that affects women more frequently than men.
Which one of the following is NOT usually associated with temporal arteritis?
A. Age > 50 years
B. ESR > 50
C. Ischemic papillitis
D. * Tender, pulsatile temporal artery
E. Polymyalgia
1031.
A.
B.
C.
D.
The device suited for introducing epidural catheter is Mitchell needle
Gordh needle
* Tuohy needle
Sise introducer
E. Nick needle
1032.
A.
B.
C.
D.
E.
1033.
A.
B.
C.
D.
E.
1034.
A.
B.
C.
D.
E.
1035.
A.
B.
C.
D.
E.
1036.
A.
B.
C.
D.
E.
The duration of effect of spinal anaesthesia depends upon –
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
The effects of chiling in refrigeration analgesia includes –
Interference with conduction of nerve impulse
Reduction of metabolic rate and oxygen requirement
Inhibition of bacterial growth and infection
Retardation of healing
* All of the above
The following factors can cause damage to the lung surfactant, except for:
Aspiration of gastric contents
* Durable ventilation with 30% oxygen
Pulmonary embolism
Extracorporeal oxygenation
Inhalation of toxic gases
The following is not used when giving local anaesthesia in the fingers 2 % xylocaine
Rubber tourniquet
Ring block
* Adrenaline
Atropin
The partial pressure of oxygen in alveolar gas depends on the whole, except:
Atmospheric pressure
The concentrations of oxygen in the inspired gas
The partial pressure of carbon dioxide in the alveoli
* The values of cardiac output
Temperatures
1037. The patient tidal volume is 500 ml, minute volume of breath is 5000 ml, dead
space - 100 ml. What is alveolar ventilation?
A. * 4000 ml
B. 3500 ml
C. 3000 ml
D. 2500 ml
E. 2000 ml
1038.
The spinal cord terminates opposite-vertebra –
A.
B.
C.
D.
E.
1039.
A.
B.
C.
D.
E.
* Lumbar 1
Lumbar 2
Sacral l
Sacral 2
Thoracal 12
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
1040. What are the pathogenic factors of acute respiratory failure in an open
pneumothorax?
A. * Shutdown of ventilation on the affected side
B. Expression of shunting blood to the lungs in a healthy side
C. Free motion of gas from one lung to another
D. Flotation of the mediastinal organs during respiration
E. Severe disorders of blood circulation in the lungs
1041.
A.
B.
C.
D.
E.
What is the first study you should order on this patient?
Urinalysis
Complete blood count (CBC)
Quantitative ЯhCG
* Qualitative ЯhCG
Ultrasound
1042. What is the optimal humidity of inhaled gas for the patient breathing through
intubation tube?
A. 40%
B. 60%
C. * 95-100%
D. Humidity does not matter
E. 80%
1043.
A.
B.
C.
D.
E.
1044.
A.
B.
C.
D.
E.
1045.
Which of the following distinguishes delirium from dementia?
Global cognitive impairment
Periods of acute worsening of symptoms
* Clouded sensorium
Reversibility
Gradual onset of symptoms
Which of the following drugs have a selective beta-2 adrenergic effect:
Epinephrine
Izadrin
Euphyllin
* Salbutamol
Ephedrine
Which of the following is FALSE regarding myasthenia gravis?
A. * The clinical hallmark is nonfatigable muscle weakness
B.
C.
D.
E.
1046.
A.
B.
C.
D.
E.
1047.
A.
B.
C.
D.
E.
Myasthenia gravis is often associated with other autoimmune diseases
Confirmation of myasthenia is possible with the edrophonium test
Overmedication can produce a clinical picture that mimicks myasthenic crisis
Thymectomy is advocated for most myasthenic patients
Which of the following is LEAST consistent with a panic attack?
* Hallucinations
Palpitations
Chest tightness
Dizziness
Dyspnea
Which of the following is LEAST consistent with Guillain syndrome?
Ascending paralysis
Preceded by exposure to toxins
Sensory involvement
* Intact reflexes
Resolution of symptoms in months
1048. Which of the following is more consistent with bulimia than with anorexia
nervosa?
A. Hypoglycemia
B. Tachydysrhythmia
C. Stress fracture
D. * Dysphagia
E. Cathartic colon
1049.
A.
B.
C.
D.
E.
1050.
A.
B.
C.
D.
E.
Which of the following is MOST impaired by REM sleep deprivation?
Physical recuperation
Intellectual tasks
* Psychological well being
Social life
Manual tasks
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
1051. Which of the following mechanisms of hypoxia during general anesthesia is
associated with a normal alveolar-arterial gradient of O2 and CO2 and is easily
corrected by the addition of O2?
A. Intracardiac shunt
B. * Hypoventilation
C. Violation of ventilation-perfusion ratio
D. Pulmonary shunt
E. Low cardiac
1052.
Which of the following MOST likely represents vertigo of peripheral origin?
A. Ataxia
B.
C.
D.
E.
Diplopia
Dysphagia
Facial numbness
* Unilateral hearing loss
1053. Which of the following must be monitored in a schizophrenic patient controlled
with clozapine?
A. Liver function tests
B. Amylase
C. Glucose
D. * CBC
E. Urinalysis
1054. Which of the following personality disorders is seen in a disproportionate number
of ED patients?
A. * Antisocial
B. Borderline
C. Obsessive-compulsive
D. Dependent
E. Paranoid
1055.
A.
B.
C.
D.
E.
1056.
A.
B.
C.
D.
E.
Which of the following reflex findings would be pathologic in an adult?
Bilateral patellar hyperreflexia
Bilateral patellar hyporeflexia
* Bilateral snout reflexes
Bilateral plantar reflexes
Superficial anal reflex
Which of the following relations is LEAST likely to exist?
Crime and substance abuse
Trauma and alcohol abuse
Mental illness and suicide gestures
Cocaine and sexually transmitted diseases
* Intravenous drug use and long life expectancy
1057. Which of the following seizure patients requires electroencephalographic (EEG)
monitoring for optimal treatment?
A. 35-year-old status post a witnessed tonic-clonic seizure with resolution of the
postictal period in 10 min
B. 40-year-old alcoholic status post two witnessed seizures in the ED, with lucid
periods after each seizure
C. 20-year-old status post first seizure
D. 28-year-old with status epilepticus controlled with fosphenytoin
E. * 30-year-old with refractory status epilepticus requiring vecuronium
1058.
Which of the following statements regarding bacterial meningitis is FALSE?
A. Some bacteria are able to spread directly into the CNS, whereas others depend on
hematogenous seeding
B. Brudzinski's sign is not pathognomonic for meningitis
C. Dexamethasone can be given to adult patients suspected of having meningitis
D. Oral antibiotics change the clinical course
E. * Patients should receive prophylactic phenytoin to prevent seizures
1059. With respect to the patient in question 369, which of the following is the LEAST
likely etiology of the pain?
A. Ectopic pregnancy
B. * Mittelschmerz
C. Ovarian torsion
D. Endometriosis
E. Appendicitis
1060.
.If Hb is 130 g/l, how much oxygen is in one litter of arterial blood?
A. A.*nearly 180 ml
B. B.nearly 130 ml
C. C.nearly 140 ml
D. D.nearly 160 ml
E. nearly 220 ml
1061. .What are the signs of acute respiratory failure ?
A. . all answers are correct
B. B.. hypoxia and compensatory hypocapnia
C. hypercapnia
D. hypoxia
E. *hypoxia, hypercapnia or their combination
1062. 3. What blood saturation is a critical marker for beginning of ALV?
A. SaO2 < 95%
B. SaO2 < 75%
C. *SaO2 < 90%
D. SaO2 < 85%
E. SaO2 < 80%
1063. .What is the criterion of AVL necessity?
A. pCO2 doesn’t matter, the main point is pO2
B. pCO2 > 55 mm. of mercury
C. pCO2 > 75 mm. of mercury
D. *pCO2 > 60 mm. of mercury
E. pCO2 > 45 mm. of mercury
1064. .What is the clinical symptom of hypercapnia?
A. all answers are correct
B. marblelike mottling of the skin
C. bradycardia
D. *hyperhydrosis of purple-cyanotic skin
E. manifested cyanosis
1065. .What is hypercapnia?
A. ineffectiveness of the external breathing function
B. tissue hypoxia
C. state, which occurs during intensive metabolic reactions of the body
D. excessive production of CO2 in tissues
E. *increasing of CO2 concentration in the blood
1066. What is the critical meaning of pO2, which requires artificial lung ventilation of
the patient?
A. pO2 is not being used as a AVL necessity criterion
B. pO2 < 65 mm. of the mercury
C. *pO2 < 75 mm. of the mercury
D. pO2 < 55 mm. of the mercury
E. pO2 < 85 mm. of the mercury
1067.
.What are the most typical sings of the terminal breathing disorders?
. deep inhibition of the CNS
hypotension
. decreasing of venous blood saturation
. decreasing of arterial blood saturation
. *ll mentioned
1068. .What is a clinical symptom of respiratory impairment on initial stages?:
A. decreasing of the saturation of arterial blood
B. arising of excitation, restlessness, probable euphoria
C. decreasing of the saturation of venous blood
D. increasing of the cardiac output
E. *verything mentioned below
1069. .Acute respiratory failure is a state of:
A. *ll answers are correct
B. inadequate lungs ventilation
C. expiratory dyspnoea
D. inspiratory dyspnoea
E. inadequate saturation of the blood
1070. . Who works at the department of anaesthesiology and intensive care:
A. *naesthesiologists
B. intensivive care workers
C. other specialists
D. resuscitation specialists
E. all answers are correst
1071. .What is the correct name of hospital department for severe patients?
A. all answers are correct
B. wards of intensive care
C. *partment of anaesthesiology and intensive care
D. resuscitation department
E. department of urgent states
1072. .In what year did anesthesiology become a science?
A. .1943
B. .1772
C. .*1846
D. .1902
E. .1886
1073. . How do the indexes of hemoconcentration change in case of acute intestinal
obstruction?
A. grow
B. hemoglobin lowers because of intoxication and electrolytic disorders
C. almost do not change
D. lower
E. *Hematocrit elevates because of the hemoconcentration, but the level of
haemoglobin and protein lowers due to intoxication
1074. . During the intestinal obstruction greatly growth the risk of:
A. pain shock
B. liver failure
C. multiple organ failure
D. sepsis
E. *
regurgitation and aspiration
1075. . Noncompensated pylorostenosis first of all is dangerous because of:
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
. acute suprarenal failure
*
hypokaliemia, hypochloremia, metabolic alkalosis
respiratory alkalosis and metabolic acidosis
hyponatremia and hypohydration
intoxication syndrome
1076. . Primary hemostasis disorders in case of acute intestinal obstruction are:
A. sepsis as a consequence of translocation phenomena
B. acute renal and liver failure
C. *
hypohydration, violations of electrolytic concentrations
D. respiratory violations
E. intoxication syndrome
1077. . What is the best anesthesia for the patients with peritonitis:
A. . conduction and infiltrative aaesthesia
B. . spinal anesthesia
C. . epidural anesthesia
D. . inhalational anesthesia
E. *
I/v anesthesia with myscle relaxation and ALV
1078. The duration of preoperative care for patient with peritonitis is limited with:
A. all answers are correct
B. . preparation to the anesthesia
C. . readiness of surgeons
D. *
. stabilisation of haemostasis
E. . necessary examinations and tests
1079. In case of toxic peritonitis cardiac output:
A. depends on the initial blood pressure
B. *
lowers
C. doesn’t change much
D. grows
E. depends on the blood pressure
1080. . In case of reactive peritonitis hemodynamics is usually characterised with?
A. dependence on the initial blood pressure
B. hypovolemic shock
C. *
hyperdynamic reaction
D. hypodynamic reaction
E. collapse
1081. What is the most common haemostasis disorder during peritonitis?
A. . metabolic alkalosis
B. . respiratory alkalosis
C. . thrombosis of lower limbs deep veins, thromboembolism
D. respiratory acidosis
E. *
. metabolic acidosis
1082. . What is the most probable anaesthesia complication in case of the patient with
peritonitis ?
A. hyperpotassemic cardiac arrest
B. . regurgitation and aspiration
C. *
acute heart failure as a consequence of mediastinum displacement, caused
by hypotension
D. . bronchiolospasm
E. inhibition of respiratory centre as a consequence of pulmonary oedema
1083. . What stages of peritonitis do you know?
A. . early and late
B. . upper and lower parts of the abdomen
C. . stages I, II, III
D. compensated, uncompensated, terminal
E. *
reactive, toxic, terminal
1084. . Choose components of postoperative correction:
A. correction of haemostasis, pain relief, antibiotics, activation of the patient
B. pain relief, usage of central respiratory stimulators, antibiotics, parenteral
nutrition
C. pain relief, correction of breathing and hemodynamics, stimulation of intestinal
peristalsis
D. *
correction of haemostasis, pain relief, parenteral nutrition, activation of
the patient
E. pain killers, antibiotics, cardiovascular medicines, electrolytes, vitamins
1085. . What is proserin used for right after the operation?
A. prevention of bronchiolospasm
B. stimulation of intestinal peristalsis
C. *
removal of residual muscle relaxation after usage of nondepolarizing
muscle relaxant
D. removal of residual muscle relaxation after usage of depolarizing muscle relaxant
E. stimulation of respiratory centre
1086. . The most common early complication with central anaesthesia is:
A. acute liver impairment
B. cardiac arrest
C. hypotension
D. bronchiolospasm
E. *
depression of respiration
1087. . The most common early complications of ketamine anesthesia is:
A. respiratory disorders
B. *
hallucination, inadequate behaviour
C. collapse
D. rhythm disorders
E. laryngospasm
1088. The most common early complication of anesthesia with arduanum usage is:
A. .bronchiolospasm
B. . laryngospasm
C. . dehydration
D. inhibition of respiratory centre
E. *
falling back of the tongue
1089. The most common early complication after anesthesia with suxamethonium usage
is:
A. arrhythmia
B. *
disorders of airway potency (falling back of the tongue)
C. collapse
D. inhibition of respiratory center
E. laryngospasm
31.
. What is not a kind of parenteral nutrition?
F. lipofundin
G. 10% solution of glucose
H. kasein-hydrolizate
I. hydrolysin
J. *
colloid solutions
1090. What is not a kind of parenteral nutrition?
A. lipomays
B.
C.
D.
E.
1091.
A.
B.
C.
D.
E.
1092.
A.
B.
C.
D.
E.
1093.
A.
B.
C.
D.
E.
1094.
A.
B.
C.
D.
E.
1095.
A.
B.
C.
D.
E.
1096.
A.
B.
C.
D.
E.
1097.
A.
B.
C.
D.
E.
1098.
A.
B.
C.
D.
20% solution of glucose
. 10% solution of glucose
protein hydrolisates
*
dextrins
. What is a kind of parenteral nutrition?
polivinilpirolidon
*
protein
solution of kasein-hydrolizate
albumin
plasma, solution of kasein-hydrolizate
. What is a kind of parenteral nutrition?
carbicarb
. derivative of starch
. plasma
albumin
*
10% solution of glucose
What is a kind of parenteral nutrition:
*
lipofundin
. derivative of starch
plasma
albumin
poliglukin
What are the indications for parenteral nutrition?
postoperative period
vital functions disorders
difficult condition of a patient
intensive care unit stay
*
impossibility of enteral nutrition
What is energetic demand of a patient after operation (parenteral nutrition)?
50 kkal/kg
*
30 kkal/kg
20 kkal/kg
10 kkal/kg
40 kkal/kg
. The vital functions of the body are:
breathing, haemodynamics
breathing, circulation, activity of liver
* breathing haemodynamics, somatic and vegetative activity of nervous system,
functioning of kidneys, liver and gastro-intestinal tract
breathing, activity of kidneys, liver, gastro-intestinal tract
haemodynamics, conciseness
In postoperative period infusion therapy should be provided at the level of:
30 ml/kg
*
40 ml/kg
20 ml/kg
10 ml/kg
50 ml/kg
Selik Method is:
All answers are wrong
usage of probe to decompress the stomach
*
pressure on cricoid cartilage during anesthesia induction
extension of neck before trachea intubation
E. pressure on an epygastrium
1099. Percussion findings on the side of hemothorax will be:
A. all answers are wrong
B. normal resonant lung sound
C. bell sound
D. tympanic resonance
E. *
dullness of percussion sound
1100. Usually on the side of pneumothorax you can hear:
A. all answers are wrong
B. dry rales
C. harsh breathing
D. bronchial breathing
E. *
diminished breath sounds
1101. What respiration rate is an indication for ALV?
A. <16 in 1 min.
B. <10 in 1 min.
C. > 25 in 1 min.
D. <15 in 1 min.
E. *
> 40 in 1 min.
1102. What anesthesia method is mostly used in thoracic surgery?
A. all answers are wrong
B. spinal anaesthesia
C. regional anesthesia
D. exploratory anesthesia
E. *
Multicomponent i/v anesthesia with trachea intubation and ALV
1103. What is used to restore the volume of blood circulation after spinal anesthesia ?
A. all answers are wrong
B. 10 % of glucose
C. 0.9% solution of sodium hydroxybutyrate
D. 0.9% solution of sodium bicarbonate
E. *
physiologic saline
1104. What medicine is used to slow the anesthetic resorbtion during regional
anesthesia?
A. Histamin
B. Atselizin
C. Arkuron
D. Atropin
E. *
Adrenalin
1105. What is an immediate complication of supraclavicular blockade of brachial
plexus?
A. Hypothermia
B. Hypocapnia
C. Arthritis
D. Bursitis
E. *
Pneumothorax
1106. What is the most common complication of spinal anesthesia?
A. All answers are wrong
B. Vomiting
C. Hypothermia
D. Hypocapnia
E. *
Low blood pressure
1107. What method should be recommended for elected surgery on lower extremities?
A.
B.
C.
D.
E.
All answers are wrong
local anaesthesia
surface anesthesia
infiltration anesthesia
*
spinal anesthesia
1108. What anesthesia method is recommended for nail phalanxes surgery of the hand:
A. All answers are wrong
B. I|/v anesthesia with ALV
C. infiltration anesthesia
D. surface anesthesia
E. *
conduction anesthesia
1109. What anesthesia method is recommended for patients with ENT pathology (earnose-throat)?
A. All answers are wrong
B. Guided hypertension
C. Guided hypoesthesia
D. Guided hypothermia
E. *
Guided hypotension
1110. What method do we use to eliminate cerebral edema?
A. All answers are wrong
B. All answers are right
C. Ventilation with normal respiratory rate
D. Ventilation in the mode of moderate hypoventilation
E. *
Ventilation in the mode of moderate hyperventilation
1111. What concentration of lidocaine is used for block anesthesia?
A. 6% - solution
B. 5% - solution
C. 0.5%- solution
D. 2% - solution
E. *
1% - solution
1112. What medicine given before operation does suppress neurovegetative reactions?
A. Recofolum
B. Dythyllinum
C. Arduan
D. Adrenalin
E. *
Atropin
1113. What anesthetic is most frequently used in neurosurgery?
A. sodium hydroxybutyrate
B. ketamine
C. tiotriazolinum
D. sodium thiosulfate
E. *
thiopental sodium
1114. What anesthesia method should be used for the plastic operation of the hard palate
(cleft palate)?
A. Local anesthesia
B. Mask anesthesia
C. Multicomponent i/v
D. Multicomponent i/v with orotracheal intubation
E. *
Multicomponent i/v with nasotracheal ventilation
1115. What is used in premedication to avoid neurovegetative reactions?
A. histamine antagonists
B. adrenoceptor antagonists
C. adrenoreceptor agonists
D. Cholinergic agonists
E. *
Cholinergic antagonists
1116. What method of general anesthesia does provide airways protection from
aspiration in case of oral cavity surgery?
A. All answers are wrong
B. All answers are correct
C. Mask anesthesia
D. I/v without trachea intubation
E. *
I/vein with trachea intubation
1117. What is used together with local anesthetic to minimize bleeding during face and
jaw surgery?
A. histamine antagonists
B. bronchial spasmolytic
C. adrenoceptor antagonists
D. cholinergic agonists
E. *
adrenoreceptor agonists
1118. What method of anesthesia is most frequently used during the extraction of the
tooth?
A. All answers are wrong
B. All answers are correct
C. arterial anesthesia
D. surface anesthesia
E. *
conduction anesthesia
1119. 45-an annual man in plenty of weight is in the chamber of intensive care after the
planned operation (opened biopsy lungs). What methods you should provide like the
best prevention of thrombosis of deep veins?
A. - pneumatic tire
B. - bandaging of feet by an elastic bandage
C. - a heparin for 1ml through each 8 hours intravenously
D. * - early mobilization
E. - infusion of reopoglyukin during an operation
1120.
A.
B.
C.
D.
E.
1121.
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
A local anesthetic that is ineffective topically is –
* Cocaine
Mepivacaine
Hexylcaine
Lidocaine
Tetracaine
A successful stellate ganglion block can produce –
A. Hypotension
B. * Horner's syndrome
1122.
C. Brachial plexus involvement
D. Hemifacial anaesthesia
E. Hypertension
1123.
A.
B.
C.
D.
E.
1124.
A.
B.
C.
D.
E.
1125.
A.
B.
C.
D.
E.
1126.
A.
B.
C.
D.
E.
1127.
A.
B.
C.
D.
E.
1128.
A.
B.
C.
D.
E.
1129.
A.
B.
C.
D.
E.
Acute respiratory failure is defined with:
inadequate saturation of the blood
inspiratory dyspnoea
expiratory dyspnoea
inadequate ventilation of lungs
* all answers are correct
Alcohol delirium develops after an operation more frequent all:
- during 24 hours
* – during 2-3 days
– in 4-5 days
– in 6-7 days
– at once after awakening, as a result of provocative action of anesthetics
All are surface anaesthetics except –
Lidocaine
* Bupivacaine
Procaine
Cinchocaine
None
An increased dose of epidural anaesthetic is obligatory in a patient who has –
Ascities
* Increased height of the patient
Pregnant
Age after 50
Obese
Antihypoxic dose of sodium oxybutirat:
- 1-5 mg/kg
* – 20-40 mg / kg
– 80-100 mg / kg
– 0,1-0,2 g
– does not own antihypoxic properties
At the department of anaesthesiology and intensive care work:
all named here doctors
resuscitation specialist
sub specialists
reanimatologists
* anaesthesiologists
At the initial stages of the ineffective external respiratory function is possible:
* everything mentioned below
increasing of the cardiac output
decreasing of the saturation of venous blood
arising of excitation, restlessness, probable euphoria
decreasing of the saturation of arterial blood
1130.
A.
B.
C.
D.
E.
1131.
A.
B.
C.
D.
E.
At what stage of ether anesthesia is contra-indicated to operative interferences?
–I
* – II
– III
– IV
–V
At which rate of Hb patient will become cyanotic (SaO2 86%)?
30 g/l
60 g/l
* 120 g/l
in any case
cyanosis will not appear
1132. At which rate of Hb will patient become cyanotic ( function of external breathing
is normal)?
A. 180 g/l
B. 140 g/l
C. 120 g/l
D. in any case
E. * cyanosis will not appear
1133.
A.
B.
C.
D.
E.
1134.
A.
B.
C.
D.
E.
1135.
A.
B.
C.
D.
E.
1136.
A.
B.
C.
D.
E.
1137.
Ataralgesia is anesthesia with the use:
- to the ketamine and phentanyl
- neuroleptics and narcotic analgetics
– propofol, phentanyl, morelaxants
– muscular relaxants and SHVL
* – sedative remedies and narcotic analgetics
Average blood pressure is:
* diastolic+1/3 of pulse pressure
systolic + diastolic / 2
blood at aorta
systolic + central venous blood / 2
synonym of pulse blood
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
1 year
Cauda Equina syndrome can be caused by
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
E.General anaesthesia
Central analgesia is arrived at by injection:
A.
B.
C.
D.
E.
1138.
A.
B.
C.
D.
E.
1139.
A.
B.
C.
D.
E.
1140.
A.
B.
C.
D.
E.
1141.
A.
B.
C.
D.
E.
1142.
A.
B.
C.
D.
E.
1143.
A.
B.
C.
D.
E.
1144.
- middles for stabilizing of TSNS
- narcotic analgetics, miorelaxants of central action
- large doses of barbiturates, neuroleptics, analgetics
* - large doses of narcotic analgetics
- middles for the leadthrough of neuro-surgical operations
Closed contour of anesthetisation:
– patient breathes in air and anesthetic, breathes out him in adsorber
– patient breathes in oxygen and anesthetic, fully breathes out in an atmosphere
* – patient breathes in oxygen and anesthetic, fully breathes out him in adsorber
– patient breathes in oxygen and anesthetic, partly breathes out him in adsorber
– patient breathes in air and anesthetic, breathes out him in an atmosphere.
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
D*6
10
Complication of epidural anaesthesia is except* Headache
Nausea
Hypotension
Bladder distension
Dizziness
Complication of the anesthetisation with sodium of oxybutirat:
* - primer language in an early postoperative period
- sharp kidney insufficiency
-sharp hepatic insufficiency
- bronchoconstriction
- hyperpotassemia
Concerning Barbotage –
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
Technique used Epidural Analgesia
Technique popularized in caudal Analgesia
Cannot be carried out under hypothermic condition
All of the above
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
Depolarising operates preparation:
A. - traktium
B. - arduan
C. - tubocurarin
D. * - sukcinilholin
E. – norkuron
1145.
A.
B.
C.
D.
E.
1146.
A.
B.
C.
D.
E.
1147.
A.
B.
C.
D.
E.
1148.
A.
B.
C.
D.
E.
1149.
A.
B.
C.
D.
E.
Dinitrogen oxide is kept:
– in the fluidized state force-feed 150atm
– in small bottles for 250ml
– in the bulbs of white colour
* – in the fluidised state force-feed 50atm
– in rotametres for a deinitrogen oxide
Dinitrogen oxide:
– it is let to apply with oxygen only in correlation 5:1
– it is let to apply with oxygen in correlation 10:1
– it is let to apply with oxygen in correlation 8:1
* – in using without oxygen will cause a hypoxia
– it is let to apply in mixture with oxygen only < 50 %
Dinitrogen oxide:
– apply only in quality of monoanesthesia
* – apply in combination with other anesthetics for strengthening of their action
– it is possible to use in quality of azeotrope
– it is possible to use only with ftorotanom
– it is contra-indicated to apply with uninhalation anesthetics
Disorders of microcirculation in conditions of hypovolemia appear because of:
* spasm of arterioles
arteriospasm
paresis of arterioles
activation of the arterial-venous anastomoses
peripheric vasodilatation caused with deficit of circulating blood volume
During anaerobic respiration in patient with hypoxia glucose is metabolised to:
ketone bodies
pyruvic acid
molecules of ATP( in limited quantity), CO2 and H2O
* lactic acid
metabolism of glucose is impossible
1150. During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
1151. During the leadthrough of ambulatory operations under anesthesia which can be
the most frequent reason of hospitalization of patients?
A. - hypotension
B. - complication from the side of breathing
C. - impossibility to send patients home
D. - postoperative pain
E. * - nausea and vomit
1152.
A.
B.
C.
D.
E.
1153.
A.
B.
C.
D.
E.
1154.
A.
B.
C.
D.
E.
1155.
A.
B.
C.
D.
E.
1156.
A.
B.
C.
D.
E.
1157.
A.
B.
C.
D.
E.
1158.
A.
B.
C.
D.
E.
Enflyuran:
- weak anesthetic and strong analgetic
- weak anesthetic and analgetic
- strong anesthetic and analgetic
* - expressed anesthetic, weak analgetic
– at application only enfluran of patient it is impossible to enter in anesthesia
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
Epidural blocks is indicated in all excpect* Patients in hypovolemia
Patients with asthma and bronchitis
Post-operative pain relief
Obstetric analgesia
In urologic surgery
Epidural morphine cause Miosis
Retention of urine
Abolishes pain
* All
None
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
Ether – it is:
- gas odourless
- yellow liquid
* - colourless volatile liquid
- fluidized gas
- fluidized gas of specific smell
Ether acts as:
– as adrenolithyk
– as symphatolithyk
– as parasimphatomymethyk
– as parasymphatolithyk
* – as simphatomymethyk
1159. Ether anesthesia is contra-indicated to the patients with such concomitant
diseases:
A. - is kidney insufficiency
B. - an innate heart-disease
C. * – diabetes mellitus
D. - oblitering diseases of vessels
E. – by the allergic states
1160.
A.
B.
C.
D.
E.
1161.
A.
B.
C.
D.
E.
1162.
A.
B.
C.
D.
E.
1163.
A.
B.
C.
D.
E.
Ether for anesthesia – it is:
- local anesthetic
- unnarcotic analgetic
- muscular relaksant
* - anesthetic
- a narcotic analgetic
First Fibres to be blocked at spinal anaethesia is –
Afferent motor nerve
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
For brachial plexus block needle is inserted –
Medial to subclavian artery
* Lateral to subclavian artery
Medial to subclavian vein
Lateral to subclavian vein
Inferior to subclavian vein
1164. For patients with easy or moderate system disorders propose the degree of
anaesthetic risk:
A. – 1
B. * – 2
C. – 3
D. – 4
E. – 5
1165.
A.
B.
C.
D.
E.
For patients with heavy system disorders propose the degree of anaesthetic risk:
–1
–2
*–3
–4
–5
1166. For patients with the extremely expressed system disorders propose the degree of
anaesthetic risk:
A. – 1
B. – 2
C. – 3
D. * – 4
E. – 5
1167. For the purpose of prophylaxis of regurgitation it is necessary at introductory
anesthesia:
A. - to intubate patient on a side
B. - to provide to the patient of position of Trendelenburga
C. * - to provide to the patient position of Fovler
D. - to intubate patient only after introduction of stomach-pump
E. - to press on a front abdominal wall in a epigastrium area
1168.
A.
B.
C.
D.
E.
1169.
A.
B.
C.
D.
E.
1170.
A.
B.
C.
D.
E.
1171.
A.
B.
C.
D.
E.
1172.
A.
B.
C.
D.
E.
1173.
Ftorotan for anesthesia more expedient to apply at:
* – to bronchial asthma
– hepatitis
– traumatic shock
– neuro-surgical operations
– operations on a heart
Ftorotan is contra-indicated:
* – at application of sympathomimetics
– at bronchial asthma
– for people years old
– to the babies
– for high blood pressures
Ftorotan:
* – not explosive
– burns well
– supports burning in mixture with dinitrogen oxide
– it is possible to apply only in mixture with ether
– at a hit on a skin can cause burns
Grade of CNS injury is diagnosed basing on:
Maastricht Scale
Manheim index
APACH-II
* Scale of Glasgow
classification of USA neurologists’ association
Half-closed contour of anesthetisation:
* – patient breathes in oxygen and anesthetic, partly breathes out in adsorber
– patient breathes in oxygen and anesthetic, fully breathes out in an atmosphere
– patient breathes in air and anesthetic, breathes out in adsorber
– patient breathes in oxygen and anesthetic, fully breathes out in adsorber
– patient breathes in air and anesthetic, breathes out in an atmosphere.
Half-open contour of anesthetisation:
A.
B.
C.
D.
E.
1174.
A.
B.
C.
D.
E.
* – patient breathes in oxygen and anesthetic, fully breathes out in an atmosphere
– patient breathes in oxygen and anesthetic, fully breathes out him in adsorber
– patient breathes in air and anesthetic, breathes out him in adsorber
– patient breathes in oxygen and anesthetic, partly breathes out him in adsorber
– patient breathes in air and anesthetic, breathes out him in an atmosphere.
Hexenalum – it is:
- weak anesthetic
- a powerful analgetic
* - anesthetic with an insignificant anesthetic effect
- drastic anesthetic and analgetic
- average for stabilizing of neurovegetation functions
1175. If Hb is 130 g/l and the main exchanges – normal, how much oxygen is there in
one litter of venous blood?
A. А – near 60 ml
B. В – near 90 ml
C. С – near 80 ml
D. * D – near 130 ml
E. E – near 150 ml
1176.
A.
B.
C.
D.
E.
If Hb is 130 g/l, how much oxygen is there in one litter of arterial blood?
nearly 220 ml
nearly 160 ml
nearly 140 ml
nearly 130 ml
* nearly 180 ml
1177. In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
1178.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
1179. In order to prevent aspiration of gastric contents during regurgitation it’s
necessary to:
A. gastric lavage
B. immediately elevate the upper part of the body
C. block airways
D. * down the upper part of the body
E. infuse muscle relaxants
1180.
In order to prevent regurgitation it’s necessary to:
A.
B.
C.
D.
E.
1181.
A.
B.
C.
D.
E.
1182.
A.
B.
C.
D.
E.
1183.
A.
B.
C.
D.
E.
* attach to the patient position with elevated upper part of the body
attach to the patient position with upper part of the body down
infuse atropine
attach to the patient side position
infuse solution of cerucal
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
In spinal anaesthesia, the first nerve fibre to get blocked is * Autonomic preganglionic fibres
Temperature fibres
Somatic motor fibres
Vibratory and proprioceptive fibres
Vegetates fibers
In spinal anaesthesia, the last fibres affected is * Pressure
Pain
Temperature
Touch
Somatic
1184. In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
1185.
A.
B.
C.
D.
E.
1186.
A.
B.
C.
D.
E.
1187.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
In which state of the patient hyperhidrosis will not appear?
hypoglycemic coma
hypothermia
* hypoxia II grade
poisoning with PhOS
hypercapnia of II grade
Inhalation anesthesia can not be conducted on such contour:
A. – closed
B. – opened
C. – half-open
D. – half-closed
E. * – extracorporal
1188. Is there what most frequent reason of hypoxia for patients in an early
postoperative period ?
A. - violation of correlation of ventilation/circulation
B. * - hypoventilation
C. - insufficient maintenance of oxygen in gas mixture
D. – by passing of blood in lights
E. - violation of diffusion of gases as a result of application of inhalation anesthetics
1189.
A.
B.
C.
D.
E.
1190.
A.
B.
C.
D.
E.
1191.
A.
B.
C.
D.
E.
1192.
A.
B.
C.
D.
E.
1193.
A.
B.
C.
D.
E.
1194.
A.
B.
C.
D.
It is expedient to apply sodium oxybutirat as middle for anesthesia for patients:
* - with decompensated pathology of parenhimatosus organs
– in ambulatory practice
– wherein the maximal anaesthetizing is needed
– in ophthalmology
– for children
It is produced tiopental:
* – in powder, for 0,5 and 1g
– in solution, 20%
– in small bottles, for 10ml of solution
– in ampoules, for 2ml 0,5% solution
– in 5% solution
Izoflyuran:
* – not explosive, does not burn
– can entail an explosion
– easily supports burning
– burns in presence a nitrous oxide
– bursts in application with Ftorotanom
Ketaminum causes:
- hypotension
- miorelaksatsiya
- parasimpatomymhetyk effect
* - dissociative anesthesia
– depression of respiratory centre
Ketaminum is produced in a kind:
* - 1 % but 5 % solution in small bottles
- 0,5 % solution in ampoules
- powder for a 1g, in small bottles
– 20 % solution
– in small bottles, for 0,4ml
Ketaminum is rotined for anesthesia for patients:
* - with the deficit of OTSK
- at hypertensive illness
- at saccharine diabetes
- in neurosurgery
E. – at sharp kidney insufficiency
1195.
A.
B.
C.
D.
E.
1196.
A.
B.
C.
D.
E.
1197.
A.
B.
C.
D.
E.
1198.
A.
B.
C.
D.
E.
1199.
A.
B.
C.
D.
E.
1200.
A.
B.
C.
D.
E.
1201.
A.
B.
C.
D.
E.
1202.
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
Lidocaine can be used in all except –
Ventricular fibrillation
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
Longest acting local anaesthetic solution isLignocaine
Chlorprocain
Amethocaine
* Bupivacine
Novocaine
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
Most common complication of spinal anaesthesia is-
A.
B.
C.
D.
E.
1203.
A.
B.
C.
D.
E.
1204.
A.
B.
C.
D.
E.
Post spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
One of the manifestations of microcirculation disorders at shock condition is:
* decreasing of the diuresis
paresis of intestine
apparent hypotonia
gooseflesh
petechia
Opened contour of anesthetisation:
– patient breathes in air and anesthetic, breathes out in adsorber
– patient breathes in oxygen and anesthetic, fully breathes out in adsorber
* – patient breathes in air and anesthetic, breathes out in an atmosphere
– patient breathes in oxygen and anesthetic, partly breathes out in adsorber
– patient breathes in oxygen and anesthetic, fully breathes out in an atmosphere
1205. Patient 67 years, with concomitant diabetes mellitus in the stage of compensation
is prepared to operation depended a calculary cholecystitis. Specify the degree of
operating risk by Gologorsky
A. – 1В
B. * – 2 B
C. – 3 A
D. – 4 С
E. – 5 D
1206.
A.
B.
C.
D.
E.
1207.
A.
B.
C.
D.
E.
1208.
A.
B.
C.
D.
E.
1209.
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
Post spinal headache can last forA. 1 to 2 hour
B.
C.
D.
E.
1210.
A.
B.
C.
D.
E.
1211.
A.
B.
C.
D.
E.
1212.
A.
B.
C.
D.
E.
1213.
A.
B.
C.
D.
E.
1214.
A.
B.
C.
D.
E.
1215.
A.
B.
C.
D.
E.
1216.
A.
B.
C.
D.
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
Propofol operates:
- insignificantly sedative, expressed – analgesic
- expressed hypnotically and analgesic
- myorelaxing
- neurostabilising
* – expressed hypnotically and sedative, insignificantly - analgesic
Propofol produce in a kind:
- 0,1g of powder, in ampoules
- 20 % solution in ampoules
- 0,5 % to solution in ampoules
* - lipophylic in ampoules for 20ml
- for 1,0g of powder, in small bottles
Propofol using is not good :
- in ambulatory practice
- at laparoskopick operative interferences
* - for patients with the deficit of VCB
- for the exhausted patients
- at concomitant hypertensive illness
Regurgitation might appear:
in first hours after mushrooms poisoning
* when patient is in coma state
after stimulation of intestine peristaltic
in case of hyperacid gastritis
without any pathology
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
E. Novocaine
1217. Specify the most right answer: ether anesthesia is the method of choice at
operations:
A. – at pathology of lights
B. * – for patients in a state of shock
C. – at saccharine diabetes
D. – in neuro-surgery
E. – in gerontology
1218.
A.
B.
C.
D.
E.
1219.
A.
B.
C.
D.
E.
1220.
A.
B.
C.
D.
E.
1221.
A.
B.
C.
D.
E.
1222.
A.
B.
C.
D.
E.
1223.
A.
B.
C.
D.
E.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseGives deep analgesia
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
Subarachnoid block as anesthesia is contraindicated inIschemic heart disease ,
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
Symptom of “white spot” normally lasts for:
to 1 second
3-5 seconds
* to 3 seconds
depends on the blood pressure
normally doesn’t exist
The device suited for introducing epidural catheter is Mitchell needle
Gordh needle
* Tuohy needle
Sise introducer
Nick needle
The duration of effect of spinal anaesthesia depends upon –
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
The effects of chiling in refrigeration analgesia includes –
Interference with conduction of nerve impulse
Reduction of metabolic rate and oxygen requirement
Inhibition of bacterial growth and infection
Retardation of healing
* All of the above
1224.
A.
B.
C.
D.
E.
1225.
A.
B.
C.
D.
E.
1226.
A.
B.
C.
D.
E.
1227.
A.
B.
C.
D.
E.
1228.
A.
B.
C.
D.
E.
1229.
A.
B.
C.
D.
E.
1230.
A.
B.
C.
D.
E.
The following is not used when giving local anaesthesia in the fingers 2 % xylocaine
Rubber tourniquet
Ring block
* Adrenaline
Atropin
The most common reason of anestesiologic complications is:
aspiration pneumonia
* hypoxemia and hypercapnia
circulation insufficiency
acute toxic hepatitis
malignant hyperpyrexia
The most effective mean of liquidation of laringospasm is:
- introduction of glucocorticoids
- leadthrough of konikothomia
- leadthrough of SHVL
* - introduction of muscular relaxants, ALV
- application of solution of atropine of sulfate
The phenomenon of recurisation is:
* - repeated action of relaxants after proceeding in muscular tone
- the repeated injection of depolarizing relaxants
- the repeated injection of antidepolarizing relaxants
- weakening of muscles after introduction “curare”
- absence of breathing as a result of defeat of respiratory centre
The reception of Sellik is applied:
* - for visualisation of glottis, warning of aspiration
- for deleting of extraneous body from overhead respiratory tracts
- for liquidation of remaining action of muscular relaxants
- for the leadthrough of probe in a stomach
- obligatory reception for the intubation of trachea
The sodium oxybutirat is produced:
- in ampoules, 0,5 % solution
- in powder, in small bottles
* – in ampoules, 20 % solution
– in small bottles, 5 % solution
– in ampoules, for 0,4ml
The sodium oxybutirat is used for:
* - sleep for weak patients
- is anaesthetising during anesthesia
– myoplegia
- stabilizing of neurovegetation functions of organism
- providing of optimum function of the external breathing
The spinal cord terminates opposite-vertebra –
A. * Lumbar 1
B. Lumbar 2
1231.
C. Sacral l
D. Sacral 2
E. Thoracal 12
1232.
A.
B.
C.
D.
E.
1233.
A.
B.
C.
D.
E.
1234.
A.
B.
C.
D.
E.
The state of neurolepsia is characterised with:
heightened reflex excitability
* amnesia and analgesia
mioplegia
preservation of adequate reaction to the environment
narcotic sleep
The temperature of boiling of ether is
* – 37 °С
– 50 °С
– 100 °С
– 75 °С
– 150 °С
There are such pathologic types of breathing:
breathing of Chain-Stocks, Biot
* breathing of Chain-Stocks, Biot, Kussmaul
breathing of Chain-Stocks, Biot, Bi-Braun
breathing of Chain-Stocks, Biot, Embden-Meergof
breathing of Chain-Stocks, Biot, Knoop
1235.
To measure general resistance of peripheric vessels you need to:
catheterize peripheric vessel
* take cardiac output and average blood pressure
take average blood pressure and central venous pressure
place cuff at the limb and measure the pressure, under which the peripheric
pulsation will disappear
E. call vascular surgeon
A.
B.
C.
D.
1236.
A.
B.
C.
D.
E.
1237.
A.
B.
C.
D.
E.
1238.
A.
B.
C.
D.
To sodium oxybutirat in a dose 70-120 mg / kg causes narcotic sleep duration:
- 0,5 hours
- 5 minutes
* - 2-3 hours
- 6-8 hours
– this is an antihypoxic dose, a patient from it will not fall asleep
Transfusion therapy during an operation provides:
* - specially selected doctor
- anaesthetist which conducts anesthesia
- doctor from the station of blood transfusion
- administrator
– only head to the separations
VCB normally is:
12% of the body weight
10% of the body weight
5% of the body weight
depends on the basal metabolism
E. * 7% of the body weight
1239.
A.
B.
C.
D.
E.
1240.
A.
B.
C.
D.
E.
1241.
A.
B.
C.
D.
E.
1242.
A.
B.
C.
D.
E.
1243.
A.
B.
C.
D.
E.
1244.
A.
B.
C.
D.
E.
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
What anesthetics do belong to inhalation ?
* - ftorotan, foran, etran, trichloroethylene
- ftorotan, dioxide of nitrogen, ketamine, ether
- dioxide of nitrogen, ether, hexenalum, ftorotan
– propofol, ftorotan, foran, ether, ftorotan
- ether, GOMK, enfluran, isofluran
What anesthetics do belong to uninhalation?
* – propofol, GOMK, ketamine, viadril
- ftorotan, dioxide of nitrogen, ketamine, ether
- dioxide of nitrogen, ether, hexenalum, ftorotan
– propofol, ftorotan, foran, ether, ftorotan
- ether, GOMK, enfluran, isofluran
What local anesthetic does not use for epidural anaesthesia ?
* – dikain
- lidocaine
– bulivakain
- trimecaine
– ultakain
What blood saturation with oxygen is critical marker for ALV?
SaO2 < 80%
SaO2 < 85%
* SaO2 < 90%
SaO2 < 75%
SaO2 < 95%
What components do not belong to the anaesthetic providing of operations?
- anaesthetizing
- medicinal sleep
* - placing of patient on an operating table
- neurovegetation defence
– myoplegia
1245. What features are most typical for the terminal disorders of the external
respiratory function?
A. * all mentioned
B. decreasing of the saturation of arterial blood
C. decreasing of the saturation of venous blood
D. hypotension
E. deep inhibition of the CNS
1246.
A.
B.
C.
D.
E.
1247.
A.
B.
C.
D.
E.
1248.
A.
B.
C.
D.
E.
1249.
A.
B.
C.
D.
E.
1250.
A.
B.
C.
D.
E.
1251.
A.
B.
C.
D.
E.
1252.
A.
B.
C.
D.
E.
1253.
What from middles does behave to myorelaxants with antidepolarising action?
* - tubocurarin
- ditilin
- miorelaxin
– sukcinilholin
– listenon
What from the indicated is necessary during an anesthetisation?
- anesthesia vehicle
- electric pump
– solution of atropine
* - respirator
- defibrillator
What is catheter of Svan-Gans used for?
gastric intubation
fluid therapy
transfusion therapy
catheterisation of great vessels
* measuring of systemic haemodynamics’ characteristics
What is hypercapnia?
* increasing of the CO2 concentration in blood
excessive production of CO2 in tissues
state, which arises during intensive metabolic reactions of the body
tissue hypoxia
ineffectiveness of the external breathing function
What is normal oxygen saturation of venous blood?
SaO2 < 80%
* SaO2 < 70%
SaO2 < 60%
SaO2 < 50%
SaO2 < 40%
What is normal partial pressure of oxygen in venous blood?
* 36-44 mm. of mercury column
40-48 mm. of mercury column
46-54 mm. of mercury column
50-58 mm. of mercury column
56-64 mm. of mercury column
What is the clinical expression of hypercapnia?
manifested cyanosis
* hyperhydrosis of purple-cyanotic skin
bradycardia
marmoreal skin
all answers are correct
What is the criterion of AVL necessity?
A. pCO2 > 45 mm. of mercury column
B. * pCO2 > 60 mm. of mercury column
C. pCO2 > 75 mm. of mercury column
D. pCO2 > 55 mm. of mercury column
E. pCO2 doesn’t matter, the main thing is pO2
1254. What is the critical meaning of pO2, which need artificial lung ventilation of the
patient?
A. pO2 < 85 mm. of the mercury column
B. pO2 < 55 mm. of the mercury column
C. * pO2 < 75 mm. of the mercury column
D. pO2 < 65 mm. of the mercury column
E. pO2 is not useful at this case
1255.
A.
B.
C.
D.
E.
1256.
A.
B.
C.
D.
E.
1257.
A.
B.
C.
D.
E.
1258.
A.
B.
C.
D.
E.
1259.
A.
B.
C.
D.
E.
1260.
A.
B.
C.
D.
What is the name of patient’s position in bed with elevated head end?
* Fowler
Trendelenburg
Obrazcov
cardio-vascular
pulmonary
What is the name of patient’s position in bed with head end down?
Fowler
* Trendelenburg
Obrazcov
renal
orthopaedic
What is the name of the hospital department for critical patients?
department of urgent states
reanimation department
* department of anaesthesiology and intensive care
wards of intensive care
all answers are correct
What is the probable surface area of the body normally?
nearly 1,2 m3
nearly 2,5 m3
* nearly 1,7 m3
nearly 1,0 m3
nearly 2,0 m3
What kind of anesthesia does belong to uninhalation?
– intramuscular
– intravenous
– intestinal
– peroral
* – intubation
What kind of anesthesia does not belonged to explorer anaesthesia:
- spinal anaesthesia
- infiltration anaesthesia
- pleksusis anaesthesia
- epidural anaesthesia
E. * - superficial anaesthesia
1261.
A.
B.
C.
D.
E.
1262.
A.
B.
C.
D.
E.
1263.
A.
B.
C.
D.
E.
1264.
A.
B.
C.
D.
E.
1265.
A.
B.
C.
D.
E.
1266.
A.
B.
C.
D.
E.
1267.
A.
B.
C.
D.
E.
What should be used for treating apnoea caused by dytylin?
transfusion of the blood
infusion of proseryn
infusion of proseryn and atropine
intravenous injection of anticholinesterase medicine
* ALV
What stage of ether anesthesia is belonged to surgical?
–I
– II
* – III
– IV
–V
What way does the acute respiratory failure exist ?
* hypoxia, hypercapnia or their combination
hypoxia
hypercapnia
hypoxia and compensatory hypocapnia
all answers are correct
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
Which pathology will be the most probable reason of vomiting?
coma of III grade
acute respiratory failure
* hypertonic crisis
clinic death
coma of II grade
Which statement is wrong: to avoid aspiration of gastric contents you need:
gastric lavage with the help of gastric sound
rising of gastric pH
inhibit H1 receptors
inhibit H2 receptors
* use method of Sellik
Which year did become the beginning of “anesthesiology” as a science?
1886
1902
* 1846
1772
1943
1268. Youn man is ill 12 hours. His diagnosis is: sharp appendicitis. Concomitant
pathology it is not discovered. Expose degree of operating risk after Gologorsky
A. – 1 A
B. – 2 B
C. – 1 С
D. * – 1 AE
E. – 2 A
1269.
A.
B.
C.
D.
E.
1270.
A.
B.
C.
D.
E.
1271.
A.
B.
C.
D.
E.
1272.
A.
B.
C.
D.
E.
1273.
A.
B.
C.
D.
E.
1274.
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
A hypercapnia causes the spasm of vessels:
- of brain
- of myocardium
* - of the small circle of circulation of blood
- of uterus
- all of answer correct
A local anesthetic that is ineffective topically is –
* Cocaine
Mepivacaine
Hexylcaine
Lidocaine
Tetracaine
A respirator alkalosis can draw the followings disorders, after an exception:
- increase of excitability of myocardium
- infringement of cardiac rhythm
* - increase of cerebral blood stream
- infringement of transporting of oxygen to fabrics
- decrease of concentration of the ionized calcium of plasma
A respirator alkalosis can result in such violations, except:
- increase of excitability of myocardium and violation of rhythm of heart
* - of increase of cerebral blood stream
- infringement of transport of oxygen to tissues
- decrease of concentration of the ionized calcium of plasma of blood
- all of answer correct.
A sharp respiratory alkalosis can not be investigated in the case of:
- hemoragic shock
- embolism of pulmonary artery
- bakteriemia
* - increase of рН of cerebrospinal liquid
- all of answer correct
A successful stellate ganglion block can produce –
A. Hypotension
1275.
B.
C.
D.
E.
1276.
A.
B.
C.
D.
E.
1277.
A.
B.
C.
D.
E.
1278.
A.
B.
C.
D.
E.
1279.
A.
B.
C.
D.
E.
1280.
A.
B.
C.
D.
E.
1281.
A.
B.
C.
D.
E.
1282.
A.
B.
C.
D.
* Horner's syndrome
Brachial plexus involvement
Hemifacial anaesthesia
Hypertension
About what does testify PH of plasma of blood 7, 3?
* - subcompensated acidosis
- Subcompensated alkalosis
- decompensated alkalosis
- decompensated acidosis
- hypohydration
About what does testify PH of plasma of blood 7, 5?
- subcompensated acidosis
* -subcompensated alkalosis
- decompensated acidosis
- decompensated alkalosis
- hypohydration
All are surface anaesthetics except –
Lidocaine
* Bupivacaine
Procaine
Cinchocaine
None
An „anionic hole” is formed by all except for:
- sulphates
- phosphates
- fibers of plasma of blood
- organic acids
* - urea
An increased dose of epidural anaesthetic is obligatory in a patient who has –
Ascities
* Increased height of the patient
Pregnant
Age after 50
Obese
Application of antiacid preparations can assist to development of acidosis at:
- Ulcer
- Long term of application
* -chronic to kidney insufficiency
- Carrying out of protracted ARF
- No of faithful answer
At the increase of рН solution from 7,4 to a 8,4 concentration of hydrions:
- increases in 2 times
* - decreases in 10 times
- decreases in 2 times
- increases in 10 times
E. - all of answer wrong
1283.
A.
B.
C.
D.
E.
1284.
A.
B.
C.
D.
E.
Average daily maintenance of K for adult human is:
10 mmol
* 90 mmol
150 mmol
300 mmol
500 mmol
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
1 year
1285. By the result of the use of sodium hydrogene of carbonate for a correction lactat
acidosis can be all is transferred after an exception:
A. - hypernatriumia
B. - hypersmolarity of plasma of blood
C. - increase of рСО2
D. - decrease of endocellular рН
E. * - oligoanuria
1286.
A.
B.
C.
D.
E.
Cauda Equina syndrome can be caused by
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
E.General anaesthesia
1287. Choose a wrong answer. For hypertensive dehydration the peculiar followings
signs:
A. -Thirst
B. -Turgidity
C. -Increase of VCB
D. * -Decrease of VCB
E. - Increase of concentration of sodium is in plasma of blood
1288.
Choose assertions which touch the buffer systems of organism:
A. - hydrogen-carbonate system is contained only in plasma of blood
B. * - Except for the hydrogen-carbonate system in plasma of blood there are protein
and phosphatic buffer systems
C. - hydrogen-carbonate system there is only the buffer system of protein in plasma
of blood
D. - in the intracellular liquid the main buffer system is hydrogen carbonate
E. - all of answer correct
1289.
Choose incorrect statement considering potassium exchange:
A. Cells of different organs contain the same quantity of potassium
B. Cells of different organs contain different quantity of potassium
C. Intracellular concentration of potassium is greater than extra cellular
D. Correlation between intracellular and extra cellular potassium is 30
E. * Brain and muscles have the greatest amounts of potassium
1290.
A.
B.
C.
D.
E.
1291.
A.
B.
C.
D.
E.
1292.
A.
B.
C.
D.
E.
1293.
A.
B.
C.
D.
E.
1294.
A.
B.
C.
D.
E.
1295.
A.
B.
C.
D.
E.
Choose wrong position which touches sodium lactat:
- Near 25 % in a norm appears in red corpuscles
* - Basic place of formation is a liver
- In a liver and in a bark substance of kidneys turns to glucose
- Formation diminishes in the case of acidosis
- All of answer correct
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
D*6
10
Complication of epidural anaesthesia is except* Headache
Nausea
Hypotension
Bladder distension
Dizziness
Concentration of ionic Ca increases in case of:
Acidosis
Alkalosis
Deficiency of Na
* Dehydration
Deficiency of K
Concerning Barbotage –
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
Technique used Epidural Analgesia
Technique popularized in caudal Analgesia
Cannot be carried out under hypothermic condition
All of the above
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
1296. What is the normal loss of water with urine per day for a man with body weight
100 kg?
A.
1600 ml
B.
1500 ml
C.
1000 ml
D.
1200 ml
E.
*2400 ml
1297.
What is the water distribution in the body of a man with weight 100 kg
(general water - intracellular - extracellular)?
A.
55 – 30 – 25
B.
40 – 20 – 20
C.
50 – 30 – 20
D.
70 – 40 – 30
E.
*60 – 40 - 20
1298.
A.
B.
C.
D.
E.
1299.
A.
B.
C.
D.
E.
1300.
A.
B.
C.
D.
E.
рН of the patient is 7,3, VE - - 2, PaCO2 – 48. What is your diagnosis?
subcompensated respiratory alkalosis
* mixed subcompensated acidosis
subcompensated metabolic acidosis
decompensated metabolic alkalosis
subcompensated metabolic alkalosis
рН of the patient is 7,3, VE - + 1, PaCO2 – 48. What is your diagnosis?
subcompensated respiratory alkalosis
*subcompensated respiratory acidosis
subcompensated metabolic acidosis
decompensated metabolic alkalosis
subcompensated metabolic alkalosis
A.
B.
C.
D.
E.
рН of the patient is 7,3, VE - - 2, PaCO2 - 40. What is your diagnosis?
subcompensated respiratory alkalosis
decompensated metabolic acidosis
*subcompensated metabolic acidosis
decompensated metabolic alkalosis
subcompensated metabolic alkalosis
1302.
рН of the patient is 7,2, VE - - 2, PaCO2 – 40. What is your diagnosis?
1301.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
рН of the patient is 7,3, VE - + 2, PaCO2 – 48. What is your diagnosis?
subcompensated respiratory alkalosis
*subcompensated respiratory acidosis with metabolic alkalosis
subcompensated metabolic acidosis
decompensated metabolic alkalosis
subcompensated metabolic alkalosis
subcompensated respiratory alkalosis
*decompensated metabolic acidosis
subcompensated metabolic acidosis
decompensated metabolic alkalosis
subcompensated metabolic alkalosis
1303. рН of the patient is 7,5, VE - - 2, PaCO2 – 32. What is your diagnosis?
subcompensated respiratory alkalosis
*subcompensated respirator alkalosis with metabolic acidosis
subcompensated metabolic acidosis
decompensated metabolic alkalosis
subcompensated metabolic alkalosis
A.
B.
C.
D.
E.
1304. рН of the patient 7,5, VE - + 2, PaCO2 – 32. What is your diagnosis?
subcompensated respiratory alkalosis
decompensated metabolic acidosis
subcompensated metabolic acidosis
*mixed subcompensated alkalosis
subcompensated metabolic alkalosis
A.
B.
C.
D.
E.
1305. рН of the patient is 7,5, VE - + 1,5, PaCO2 – 32. What is your diagnosis?
*subcompensated respiratory alkalosis
decompensated metabolic acidosis
subcompensated metabolic acidosis
decompensated metabolic alkalosis
subcompensated metabolic alkalosis
A.
B.
C.
D.
E.
1306. рН of the patient is 7,6, VE - + 2, PaCO2 – 40. What is your diagnosis?
subcompensated respiratory alkalosis
decompensated metabolic acidosis
subcompensated metabolic acidosis
*decompensated metabolic alkalosis
subcompensated metabolic alkalosis
A.
B.
C.
D.
E.
1307. рН of the patient is 7,5, VE - + 2, PaCO2 - 40. What is your diagnosis?
- subcompensated respiratory alkalosis
- decompensated metabolic acidosis
- subcompensated metabolic acidosis
- decompensated metabolic alkalosis
-* subcompensated metabolic alkalosis
What is not a sign of respiratory alkalosis?
decreased concentration of the ionized plasma calcium
disorders of oxygen transportation
*increased cerebral perfusion
violations of cardiac rhythm
increased excitability of myocardium
1308.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
1309. When does administration of antiacids help in development of acidosis?
all answers are wrong
in case of myocardial infarction
*in case of chronic renal insufficiency
in case of duodenal ulcer
in case of gastric ulcer
When does metabolic acidosis develop?
all answers are wrong
in case of diuretics (saluretics) administration
*in case of carbonic anhydrase inhibitors administration
in case of antiacids administration
E.
uncontrollable vomiting
1310.
A.
B.
C.
D.
1311.
A.
B.
C.
The major buffer of the extracellular liquid is:
all answers are wrong
hemoglobin
protein
D.
E.
1312.
A.
B.
C.
D.
E.
1313.
A.
B.
C.
D.
E.
1314.
A.
B.
C.
D.
E.
A.
A.
The strength of acid is determined with:
all answers are wrong
base strength
ability of giving electrons
*dissociation constant
solubility
What does plasma pH 7, 3 state?
hypohydration
decompensated acidosis
decompensated alkalosis
subcompensated alkalosis
*subcompensated acidosis
What does plasma pH 7, 5state?
hypohydration
decompensated alkalosis
decompensated acidosis
*subcompensated alkalosis
subcompensated acidosis
1315. Which answer does represent water distribution of a newborn?
general liquid is 85% from the body weight
B.
general liquid is 95% from the body weight
C.
general liquid is 70% from the body weight
D.
*general liquid is 80% from the body weight
E.
general liquid is 90% from the body weight
1316. What is not a sign of tetany?
syndrome of pancreatic insufficiency
B.
decreased levels of calcium in plasma and urine
C.
*reduced concentration of phosphates in plasma and urine
D.
increased concentration of 1, 25-dihydroxycalciferol in plasma
E.
increased concentration of parathironine in plasma
1317.
A.
B.
C.
D.
E.
1318.
A.
phosphate buffer
*bicarbonate buffer
What is not a sign of calciferol deficient tetany?
maintenance of 1,25-dihydroxycalciferol in plasma
*decreased concentration of parathironine
Increased concentration of alkaline phosphate in plasma
Normal concentration of phosphates in plasma and urine
decreased concentration of calcium in plasma and urine
What is not a sign of gastric alkalosis tetany ?
increased PH and BE of blood
B.*decreased concentration of 1,25-dihydroxycalciferol in plasma
C.increased concentration of parathironine in plasma
D.
E.
hypochloremia
normal concentration of plasma general calcium and declined concentration of ionized
calcium
What is not a sign of hypertonic dehydration?
increased concentration of sodium in plasma
*decreased VCB
increased of VCB
D.all answers are wrong
thirst
1319.
A.
B.
C.
E.
What solution should be used in case of hypertonic dehydration first of all?
all answers are wrong
Isotonic solutions of sorbitol, glucose
*Colloid solutions
Hypertonic solution of NaCl
Hypertonic solution of glucose
1320.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
1321. What is a sign of hypertonic dehydration?
All answers are correct
normal plasma osmotic pressure
normal Na level
decreased Na level
*increased Na level
A.
B.
C.
D.
E.
1322. What is not a reason of hypertonic dehydration?
hypo- and isostenuria of patients with kidney diseases
osmotic diuresis
massive infusion of hypertonic NaCl solution
*inadequate control and thus infusion therapy of perspiration loss
watery diarrhea of patients with cholera or dysentery
A.
B.
C.
D.
E.
1323. What is the best solution for isotonic dehydration correction?
Isotonic glucose solution
Hypertonic glucose solution
*Colloid and electrolytic solutions
Electrolytic solutions
Colloid solutions
A.
B.
C.
D.
E.
1324. In case of isotonic dehydration:
All answers are correct
CVP is increased
*Osmotic pressure of plasma is normal
Osmotic pressure of plasma is decreased
Osmotic pressure of b plasma is increased.
A.
B.
C.
D.
E.
1325. What isn’t a reason of hypotonic dehydration?
renal diseases, which violate electrolytes absorption
*diarrhea with Na-poor stool
diarrhea with hypertonic stool
suprarenalism
mineralocorticoid insufficiency of adrenal glands
1326.
A.
When does concentration of ionic Ca increase?
Acid-base balance doesn’t influence level of Ca
*deficiency of Na
B.
C.
D.
E.
Hypohydration
Alkalosis
Acidosis
1327.
What is not a reason of isotonic dehydration?
wounds
peritonitis
bleeding
intestinal obstruction
*massive Na-solutions infusion
A.
B.
C.
D.
E.
1328.
Name the most common reason of hypocalcaemia of adults:
massive infusions of citrated blood
*surgical damage of parathyroid glands
hepatocirrhosis, alkalosis, hypomagnesaemia
destructive pancreatic inflammetion
chronic renal insufficiency
A.
B.
C.
D.
E.
1329.
Name the drug, which is not used in case of hypercalcemia crises:
sodium salt of EDTA
*calcium gluconate
furosemid
steroids
isotonic solution of NaCl
A.
B.
C.
D.
E.
1330.
The most common reason of hypercalcemia is:
decreased level of plasma aldosterone
increased level of plasma aldosterone
Thyrotoxicosis
Primary and secondary hypoparathyroidism
*Primary and secondary hyperparathyroidism
A.
B.
C.
D.
E.
1331.
Concentration of ionic Ca increases in case of:
deficiency of K
*dehydration
deficiency of Na
Alkalosis
Acidosis
A.
B.
C.
D.
E.
1332.
Daily maintenance of Ca for an adult is:
100 g
10 g
5g
1 mg
*1 g
A.
B.
C.
D.
E.
1333.
A.
B.
C.
D.
How will adrenal failure affect electrolytic balance?
All answers are wrong
will not affect it at all
Increase the level of K in urine
Increase the level of K in cells
E. *Increase the level of Na in the body
1334.
A.
B.
C.
D.
E.
1335.
A.
B.
C.
D.
E.
1336.
Choose incorrect statement about potassium exchange:
*Brain and muscles have the greatest amounts of potassium
Correlation between intracellular and extracellular potassium is 30
Intracellular concentration of potassium is greater than extracellular
Cells of different organs contain different quantity of potassium
Cells of different organs contain the same quantity of potassium
Normally the correlation of extra and intracellular potassium is:
7:1
2:1
30:1
*1:30
1:5
A.
B.
C.
D.
E.
Normally the water amount in the body depends on:
climate conditions
*quantity of consumed liquid
level of base exchange
development of lipid tissue (it contains more water, than other tissues)
development of lipid tissue (it contains less water, than other tissues)
A.
B.
C.
D.
E.
How does aging influence water amount in the body?
stays constant and depends on sex
stays constant and depends on the fat tissue content
stays constant with small oscillations
*decreases
increases
1337.
1338. Electrolytic compositions of interstitial and intravascular liquids mainly differ in
amount of:
A. Protein
B. Ca
C. Cl
D. *Na
E. K
1339.
A.
B.
C.
D.
E.
1340.
A.
B.
C.
D.
E.
1341.
Average daily maintenance of K for an adult is:
A.500 mmol
B.300 mmol
C.150 mmol
D.*90 mmol
E.10 mmol
ECG-signs of hypokaliemia are:
All answers are wrong
B.*high, sharp T wave
prolongation of P-Q
Extensive (wide) QRS
Ventricular tachycardia, extrasystolia
The main intracellular cations are:
A. Mg and Cl
B.
C.
D.
E.
1342.
A.
B.
C.
D.
E.
Ca and Cl
Ca and Mg
Ca and Cl
*Na and Ca
The concentration of potassium in serum:
doesn’t depend on acid-base balance
decreases in case of alkalosis
*increases in case of acidosis
decreases in case of acidosis
increases in case of alkalosis
1343. Which statement does correctly describe changes in water amount in the bodies of
people with different amount of fat?
A.
All answers are incorrect
B.
Absolute water content is almost equal in all mentioned cases
C.
People with normal weight have lower related and absolute water
amount than people with obesity
D.
People with normal or low weight have greater water content, than
people with obesity
E.
*People with obesity have related content of water greater, than
people with normal or low weight
1344. What index from the listed below might be an evidence of low plasma osmotic
molarity?
A.
B.
C.
D.
E.
1345.
A.
B.
C.
D.
E.
1346.
A.
B.
C.
D.
E.
1347.
Hypoglycemia
Ketoacidosis
*Hyperglycemia
Hyponatremia
Hypernatremia
What is normal molar concentration of plasma?
150-170
310-340
*285-310
260-280
240-260
What type of dehydration is accompanied with hypernatremia?
All answers are wrong
All answers are correct
Isotonic
*Hypertonic
Hypotonic
What is daily water maintenance for a healthy adult?
A. 1,2-1,5 ml/kg/hour
B. 2,7-2,9 ml/kg/hour
C. *1,5-1,7 ml/kg/hour
D. 3-4 ml/kg/hour
E. 2-3 ml/kg/hour
1348.
How does the water loss of patients with hyperthermia change?
A. Decreases on 0,25 ml/kg/hour for each extra degree of temperature
B. Increases on 0,5 ml/kg/hour for each extra degree of temperature
C. Doesn’t change
D. Decreases on 0,25 ml/kg/hour for each extra degree of temperature
E. *Increases on 0,25 ml/kg/hour for each extra degree of temperature
1349.
What is endogenous water?
A. All answers are correct
B. Intracellular water
C. *Water, which is generated during fat, protein and carbohydrates
catabolism
D. Water, which is generated during fat catabolism
E. Water, which is generated during protein catabolism
1350.
What is normal perspiration water loss?
A. *0,5 ml/kg/hour
B. 1,5 ml/kg/hour
C. 0,8 ml/kg/hour
D. 2 ml/kg/hour
E. 1 ml/kg/hour
1351.
A.
B.
C.
D.
E.
1352.
A.
B.
C.
D.
E.
1353.
A.
B.
C.
D.
E.
1354.
A.
B.
C.
D.
E.
1355.
What is the amount of water loss with urine (normally)?
0,8 ml/kg/hour
1,5 ml/kg/hour
0,5 ml/kg/hour
2 ml/kg/hour
*1 ml/kg/hour
Which way does the hematocrit change in case of hyperhydration?
All answers are correct
*Increases greatly
Doesn’t change
Decreases
Increases insignificantly
The reason of hypohydration might be everything, except:
*Ascites , hydrothorax
Hyperthermia
Bleedings
Burn disease
Diseases, which cause vomiting and diarrhea
What is the amount of extra cellular water in the body?
15% of the body weight
*20% of the body weight
50% of the body weight
40% of the body weight
30% of the body weight
What is the amount of intracellular water in the body?
A. 60% of the body weight
B.
C.
D.
E.
1356.
*40% of the body weight
35% of the body weight
55% of the body weight
45% of the body weight
What is the amount of water in the body of adult human?
75% of body weight
85% of body weight
55% of body weight
80% of body weight
*60% of body weight
62.
A.
B.
C.
D.
E.
1357.
A.
B.
C.
D.
E.
Daily maintenance of Ca for adult human is:
*1g
1 mg
5g
10 g
100 g
1358. Development of alkalosis it is possible to expect in the case of uncommunicating a
digestive channel in an area:
A. * - duodenum
B. - thin bowels
C. - cross-section- rim bowels
D. - sygma bowels
E. - all of answer correct
1359.
A.
B.
C.
D.
E.
Development of metabolic alkalosis can be expected in cases:
* - of hyperaldosteronism, Kushing desease
- diarrhea
- noncompensated of saccharine diabetes
- all of answer correct
- all of answer wrong
1360. Distribute water on the water sectors of organism for a man with mass 100 kg
(general water - intracellular - extracellular):
A. * -60 – 40 - 20
B. -70 – 40 – 30
C. -50 – 30 – 20
D. -40 – 20 – 20
E. -55 – 30 – 25
1361.
A.
B.
C.
D.
E.
1362.
During aging relative amount of water in the body of human is:
increasing
* decreasing
staying constant with small oscillations
staying constant and depends on the fat tissue content
staying constant and depends on sex
During aging the content of water in the human body:
A. increases
B.
C.
D.
E.
* decreases
stays constant with small oscillations
stays constant and depends on the fat tissue content
stays constant and depends on sex
1363. During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
1364. During hospitalization of patient with intoxication by unknown poison in the state
of coma of рН 7,02, PaCO2 – 75,5, VE - is a 14,5. Violation of Acid-base state
predefined:
A. - noncompensated by metabolic acidosis
B. - noncompensated by respirator acidosis
C. * - mixed respirator-metabolic by acidosis
D. - metabolic by acidosis of middle degree
E. - all of answer correct
1365.
A.
B.
C.
D.
E.
ECG-signs of hypokaliemia are:
Ventricular tachycardia, extrasystolia
Extensive (wide) QRS
prolongation of P-Q
* high, sharp T
All answers are incorrect
1366. Electrolytic compositions of interstitial and intravascular liquids mainly differ in
amount of:
A. K
B. * Na
C. Cl
D. Ca
E. Protein
1367.
A.
B.
C.
D.
E.
1368.
A.
B.
C.
D.
E.
1369.
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
Epidural blocks is indicated in all excpect* Patients in hypovolemia
Patients with asthma and bronchitis
Post-operative pain relief
Obstetric analgesia
In urologic surgery
Epidural morphine cause -
A.
B.
C.
D.
E.
1370.
A.
B.
C.
D.
E.
1371.
A.
B.
C.
D.
E.
1372.
A.
B.
C.
D.
E.
Miosis
Retention of urine
Abolishes pain
* All
None
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
First Fibres to be blocked at spinal anaethesia is –
Afferent motor nerve
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
1373. For an overventilation at ALV such variant of violation of ABS is peculiar: (рН -,
PaCO2 –, VE -):
A. - 7,35 -, 55 - +6
B. - 7,55 -, 47 - + 10
C. - 7,2 -, 29 -, - 13
D. - 7,35 -, 28 -, - 8
E. * - 7,48 -, 32 -, - 3
1374.
A.
B.
C.
D.
E.
For brachial plexus block needle is inserted –
Medial to subclavian artery
* Lateral to subclavian artery
Medial to subclavian vein
Lateral to subclavian vein
Inferior to subclavian vein
1375. For diabetic cetoacidosis such variant of violation of ABS is peculiar: (рН -,
PaCO2 –, VE -):
A. -7,35 -, 55 - +6.
B. -7,55 -, 47 - + 10.
C. * - 7,2 -, 29 -, - 13.
D. -7,35 -, 28 -, - 8.
E. -7,48 -, 32 -, - 3.
1376. For gastric alkalosis tetaniya such changes are peculiar by a, for exception:
A. -normal to maintenance in plasma of blood of general calcium and decline ionized
B. - hypochlorinemia
C. - Increase of content of parathironine is in plasma of blood
D. * - Decrease of content of 1,25-dihydroxycalciumferol is in plasma of blood
E. - Increase of PH and BE of blood
1377.
A.
B.
C.
D.
E.
For steathorenium tetaniya such changes are peculiar by a, for exception:
- Increase of content of parathironine in plasma of blood
- Increase of content of 1, 25-dihydroxycalciumferol is in plasma of blood
* - The reduced content of phosphates in plasma of blood and urine
- Decrease of content of calcium is in plasma of blood and urine
- Presence of clinical syndrome of insufficiency of pancreas
1378. For stenosis of pyloric department of stomach peculiar is such variant of violation
of ABS (рН -, PaCO2 –, VE - ):
A. - 7,35 -, 55 - +6
B. * - 7,55 -, 47 - + 10
C. - 7,2 -, 29 -, - 13
D. - 7,35 -, 28 -, - 8
E. - 7,48 -, 32 -, - 3
1379. For tetaniya of, which develops as a result of deficit of calciferol peculiar changes,
after an exception?
A. - Decrease of content of calcium is in plasma of blood and urine
B. - Normal content of phosphates in plasma of blood and urine
C. - Increase of alkaline phosphate is in plasma of blood
D. * Decrease of content of parathironine
E. - Normal maintenance of 1,25-dihydroxycalciumferol in plasma of blood
1380.
A.
B.
C.
D.
E.
1381.
A.
B.
C.
D.
E.
1382.
A.
B.
C.
D.
E.
For the correction of isotonic dehydration the best solutions are:
Colloid solutions
Electrolytic solutions
* Colloid and electrolytic solutions
Hypertonic glucose solution
Isotonic glucose solution
Force of acid is determined:
- Step of solubility
* - Constant of dissociation
- Ability to give electrons
- acid by a remain
- No of faithful answer
From the resulted humoral factors most strengthens suction of calcium in bowels:
- Parathiryn
- calciumnothynum
- somatostathynum
* - 1,25-dehydroxycholecalciferon
- All of answer correct
1383. Hematokrit 0,3, Sodium – 155 mmol/l. Specify the type of violation of
homoeostasis:
A. - hypertensive hypohydration
B. - hypotonic hypohydration
C. - isotonic hypohydration
D. * - hypertensive to the overhydratation
E. - hypotonic overhydratation
1384. Hematokrit 0,5, Sodium – 140 mmol/l. Specify the type of violation of
homoeostasis:
A. - hypertensive hypohydration
B. - hypotonic hypohydration
C. * - isotonic hypohydration
D. - hypertensive overhydratation
E. - hypotonic overhydratation
1385. Hematokrit 0,5, Sodium – 155 mmol/l. Specify the type of violation of
homoeostasis:
A. * - hypertensive hypohydration
B. - hypotonic hypohydration
C. - isotonic hypohydration
D. - hypertensive overhydratation
E. - hypotonic overhydratation
1386.
A.
B.
C.
D.
E.
How does the water loss of patients with hyperthermia change?
* Increase on 0,25 ml/kg/hour for every extra degree of temperature
Decrease on 0,25 ml/kg/hour for every extra degree of temperature
Doesn’t change
Increase on 0,5 ml/kg/hour for every extra degree of temperature
Decrease on 0,25 ml/kg/hour for every extra degree of temperature
1387. In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
1388.
A.
B.
C.
D.
E.
1389.
A.
B.
C.
D.
E.
1390.
In case of hypertonic dehydration first of all should be infused:
Hypertonic solution of glucose
Hypertonic solution of NaCl
* Colloid solutions
Isotonic solutions of sorbitol, glucose
All answers are incorrect
In case of hypertonic dehydration:
* The level of Na is above normal
The level of Na is below normal
The level of Na is normal
Osmotic pressure of blood plasma is normal
All answers are correct
In case of isotonic dehydration:
A. * Osmotic pressure of blood plasma is increased.
B. Osmotic pressure of blood plasma is decreased
C. Osmotic pressure of blood plasma is normal
D. CVP is increased
E. All answers are correct
1391.
A.
B.
C.
D.
E.
1392.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
In patient with metabolic alkalosis BE may be:
* - (–5)
-0
-1
-2
- all of answer correct
1393. In polarizing solution the best correlation of K and Mg for disorders correction
should be:
A. 1:20
B. 20:1
C. 1:8
D. * 8:1
E. All answers are incorrect
1394.
In spinal anaesthesia the drug is deposited betweenA. Dura and arachnoid
B. * Pia and arachnoid
C. Dura and vertebra
D. Into the cord substance
E. Dura and mild
1395. In spinal anaesthesia, the first nerve fibre to get blocked is A. * Autonomic preganglionic fibres
B. Temperature fibres
C. Somatic motor fibres
D. Vibratory and proprioceptive fibres
E. Vegetates fibers
1396. In spinal anaesthesia, the last fibres affected is A. * Pressure
B. Pain
C. Temperature
D. Touch
E. Somatic
1397. In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
1398. In which space is intra cardiac adrenaline given –
A.
B.
C.
D.
E.
1399.
A.
B.
C.
D.
E.
1400.
A.
B.
C.
D.
E.
1401.
A.
B.
C.
D.
E.
1402.
A.
B.
C.
D.
E.
1403.
A.
B.
C.
D.
E.
1404.
A.
B.
C.
D.
E.
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
Ketoatsidoz can develop in such states after an exception:
- insulin-dependent of saccharine diabetes
* - cirrhosis of liver
- alcoholism
- long application of corticosteroids
- starvation
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
Lidocaine can be used in all except –
Ventricular fibrillation
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
Longest acting local anaesthetic solution isLignocaine
Chlorprocain
Amethocaine
* Bupivacine
Novocaine
Lumbar puncture is done in the following positions –
A. Rt. Lateral
B. Lt. Lateral
C. Sitting with head below flexed knees
1405.
D. * All of the above
E. None of above
1406.
A.
B.
C.
D.
E.
1407.
A.
B.
C.
D.
E.
1408.
A.
B.
C.
D.
E.
1409.
A.
B.
C.
D.
E.
1410.
A.
B.
C.
D.
E.
1411.
A.
B.
C.
D.
E.
1412.
A.
B.
C.
D.
E.
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
Metabolic acidosis for a patient develops at:
- Unruly to vomit
- Reception of antiacid preparations
* - use of diuretic (inhibitors of carbounhydrasium)
- Use of diuretics (saluretics)
- No of faithful answer
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
Name the drug, which is not used in case of hypercalcemia crises:
isotonic solution of NaCl
glucocorticoids
furosemid
* calcium gluconate
sodium salt of EDTA
Name the most common reason of hypocalcaemia of adults:
chronic renal insufficiency,
destructive pancreatitis
hepatocirrhosis, alkalosis, hypomagnesaemia
* surgical damage of parathyroid glands
massive infusions of citrated blood
Normally the correlation of extra and intracellular potassium is:
1:5
* 1:30
30:1
2:1
7:1
Normally the water amount in the body depends on:
the quantity of lipid tissue (it contains less water, than other tissues)
the quantity of lipid tissue (it contains more water, than other tissues)
level of Base Exchange
* the quantity of coming (consumed) liquid
climatic conditions
1413. Patient PaCO2 makes 40 mm mercury, and standard hydrogen carbonate – 12,
then рН makes:
A. - 7,0
B. - 7,1
C. * - 7,2
D. - 7,3
E. - 7,4
1414.
A.
B.
C.
D.
E.
1415.
A.
B.
C.
D.
E.
1416.
A.
B.
C.
D.
E.
1417.
A.
B.
C.
D.
E.
1418.
A.
B.
C.
D.
E.
1419.
A.
B.
C.
D.
E.
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
Respirator and mixed acidosis it is possible to correct:
- sodium hydrohen of carbonate
* - trisaminum, to sodium by a lactat
- hydrochloric acid
- all of answer correct
- all of answer wrong
1420. Results of laboratory researches: рСО2 – 50, рН – 7,12, HCO3 – 13. Your
diagnosis:
A.
B.
C.
D.
E.
1421.
A.
B.
C.
D.
E.
1422.
A.
B.
C.
D.
E.
1423.
A.
B.
C.
D.
E.
- compensated respirator acidosis
- noncompensated metabolic alkalosis
- respiratory alkalosis, metabolic acidosis
* - metabolic acidosis respiratory acidosis
- all of answer faithful
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
Specify on the most frequent reason of development of hypocalciemia for adults:
- chronick renal failure
- destructive pancreatitis
- cirrhosis of liver, alkalosis
* - operating shock of shield-similar glands
- massive transfusions of citrate blood
1424.
kg:
A.
B.
C.
D.
E.
Specify what norm of loss of water with urine for days for a man with mass 100
1425.
Specify what norm of perspirations losses for a man with mass 100 kg:
-2400 of ml
* -1200 of ml
-1000 of ml
-1500 of ml
-1600 of ml
A.
B.
C.
D.
E.
* - 2400 ml
-1200 of ml
-1000 of ml
-1500 of ml
-1600 of ml
1426. Specify which from the transferred facilities it is impossible to use during a
hypercalcium crisis:
A. - isotonic soluble-sodium of chloride or glucose
B. - glucocorticoids
C. - furosemide
D. * - calcium gluconate
E. - hemodialysis
1427.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseA. Gives deep analgesia
B.
C.
D.
E.
1428.
A.
B.
C.
D.
E.
1429.
A.
B.
C.
D.
E.
1430.
A.
B.
C.
D.
E.
1431.
A.
B.
C.
D.
E.
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
Subarachnoid block as anesthesia is contraindicated inIschemic heart disease ,
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
Surplus of bases appears in cases:
* - of the incessant vomiting
- expressed sweaty state
- expressed overventilations
- fever
- all of answer correct
The concentration of ionic Ca increases in case of:
Acidosis
Alkalosis
Hypohydration
* deficiency of Na
Acid-base balance doesn’t influence rate of Ca
The concentration of potassium in serum:
increases in case of alkalosis
decreases in case of acidosis
* increases in case of acidosis
decreases in case of alkalosis
doesn’t depend on acid-base balance
1432.
for:
A.
B.
C.
D.
E.
The correction of acidosis is carried out buds by the all transferred ways except
1433.
The device suited for introducing epidural catheter is Mitchell needle
Gordh needle
* Tuohy needle
Sise introducer
Nick needle
A.
B.
C.
D.
E.
- deducing of hydroids with hydrophosphates
- deducing of hydroids with salts to the ammonium
* - deducing of hydroids with salts of coal acid
- reabsorption of hydroxylic ions
- A, B
The duration of effect of spinal anaesthesia depends upon –
A. The site of injection
B. Quantity of drug injected
C. Type of drug used
1434.
D. * All the above
E. None of above
1435.
A.
B.
C.
D.
E.
The effects of chiling in refrigeration analgesia includes –
Interference with conduction of nerve impulse
Reduction of metabolic rate and oxygen requirement
Inhibition of bacterial growth and infection
Retardation of healing
* All of the above
1436. The following is not used when giving local anaesthesia in the fingers A. 2 % xylocaine
B. Rubber tourniquet
C. Ring block
* Adrenaline
E. Atropin
1437.
A.
B.
C.
D.
E.
1438.
A.
B.
C.
D.
E.
1439.
A.
B.
C.
D.
E.
The main intracellular cat ions are:
* Na and Ca
Ca and Cl
K and Mg
K and Cl
Mg and Cl
The major buffer of the extracellular liquid is:
* - hydrocarbonate
- phosphatic
- Protein
- haemoglobin
- No of faithful answer
The most common reason of hypercalcemia is:
* Primary and secondary hyperparathyreosis
Primary and secondary hypoparathyreosis
Thyrotoxicosis
Growth of blood plasma aldosterone rate
Reduction of blood plasma aldosterone rate
1440. The most common reasons of isotonic dehydration are all from the listed below
except:
A. * extra inflow of Na
B. bowel obstruction
C. bleeding
D. peritonitis
E. wound
1441.
A.
B.
C.
D.
E.
The reason of hypohydration might be everything, from the named below, except:
Diseases, which cause vomiting and diarrhea
Burn disease
Bleedings
Hyperthermia
* Ascite, hydrothorax
1442. The reason of hypotonic dehydration might be everything from the listed below,
except:
A. insufficiencies of mineral corticoid function of adrenal glands
B. hyper function of adrenal glands
C. diarrhoea with hypertonic stool
D. * diarrhoea with Na-poor stool
E. diseases of kidneys, which damage electrolytes absorption
1443. The reasons of hypertonic dehydration might be every, from the listed below,
except:
A. Watery stool of patients with cholera or salmonellas disease
B. * Inadequate completing of perspiration loss
C. Excessive infusion of hypertonic solution of NaCl
D. Osmotic diuresis
E. Hypo and isostenuria of patients with kidney diseases
1444.
A.
B.
C.
D.
E.
1445.
A.
B.
C.
D.
E.
The spinal cord terminates opposite-vertebra –
* Lumbar 1
Lumbar 2
Sacral l
Sacral 2
Thoracal 12
The use of antiacid preparations can assist to development of acidosis in case:
- stomach ulcer
- long use
* - chronic nephritic insufficiency
- carrying out of long ALV
- all of answer correct
1446. To a chlorine over of resistant form of metabolic alkalosis such states can bring
after an exception:
A. - hyperaldostenorismus
B. * - vomiting
C. -use of mineralcorticoids
D. - use of glucocorticoids
E. - all of answer correct
1447. To a chlorine-sensitive form of metabolic alkalosis such states can bring after an
exception:
A. - hypovolemia
B. - vomiting
C. - use of saluretics
D. * - of hyperaldosteronism
E. - all of answer correct
1448.
A.
B.
C.
D.
To trisaminum peculiar all except for:
- synthetic containing sodium solution which creates a basic environment
* - sodium hydrogen of carbonate well adjusts the intracellular acidosis
- in time of hit in pair a venous cellulose is caused by necrosis of fabric
- with the rapid intravenous introduction represses breathing
E. - contraindicated at the parafunction of buds
1449.
A.
B.
C.
D.
E.
1450.
A.
B.
C.
D.
E.
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
What from the transferred violations of ABS are peculiar for myasthenia gravis:
- respiratory alkalosis
* - respiratory acidosis and metabolic acidosis
- metabolic alkalosis
- respiratory alkalosis, metabolic alkalosis
- A,C
1451. What from the variants of analyses peculiar for a metabolic alkalosis, partly
compensated by a respirator component: рН – PaCO2– HCO3:
A. - 7,1 – 27 – 8
B. - 7,34 – 70 – 39
C. - 7,56 – 26 – 23
D. - 7,0 – 70 – 16
E. * - 7,5 – 46 – 36
1452. What index from the listed below might be an evidence of low osmotic molarity
of blood plasma?
A. Hypernatremia
B. * Hyponatremia
C. Hyperglikemia
D. Ketoacidosis
E. Hypoglycaemia
1453.
A.
B.
C.
D.
E.
1454.
A.
B.
C.
D.
E.
1455.
A.
B.
C.
D.
What is endogen water?
Water, which is generated during protein catabolism
Water, which is generated during fat catabolism
* Water, which is generated during fat, protein and carbohydrates catabolism
Intracellular water
All answers are correct
What is normal molar concentration of plasma?
240-260
260-280
* 285-310
310-340
150-17
What is normal perspiration water loss?
1 ml/kg/hour
2 ml/kg/hour
0,8 ml/kg/hour
1,5 ml/kg/hour
E. * 0,5 ml/kg/hour
1456.
A.
B.
C.
D.
E.
1457.
A.
B.
C.
D.
E.
1458.
A.
B.
C.
D.
E.
1459.
A.
B.
C.
D.
E.
1460.
A.
B.
C.
D.
E.
1461.
A.
B.
C.
D.
E.
What is perspiration water loss?
Water loss with stool
Water loss with urine
* Water loss through skin and breathing passages
All answers are correct
All answers are incorrect
What is the amount of extra cellular water in the body?
30% of the body weight
40% of the body weight
50% of the body weight
* 20% of the body weight
15% of the body weight
What is the amount of intracellular water in the body?
45% of the body weight
55% of the body weight
35% of the body weight
* 40% of the body weight
60% of the body weight
What is the amount of water in the body of adult human?
* 60% of body weight
80% of body weight
55% of body weight
85% of body weight
75% of body weight
What is the amount of water loss with urine (normally)?
* 1 ml/kg/hour
2 ml/kg/hour
0,5 ml/kg/hour
1,5 ml/kg/hour
0,8 ml/kg/hour
What positions correctly represent distributing of water in new-born:
- general liquid is 90% from mass of body
* - general liquid is 80% from mass of body
- general liquid is 70% from mass of body
- general liquid is 95% from mass of body
- general liquid is 85% from mass of body
1462. What quantity of liquid should normally come to the body of healthy human every
day?
A. 2-3 ml/kg/hour
B. 3-4 ml/kg/hour
C. * 1,5-1,7 ml/kg/hour
D. 2,7-2,9 ml/kg/hour
E. 1,2-1,5 ml/kg/hour
1463.
A.
B.
C.
D.
E.
What type of dehydration is accompanied with hypernatremia?
Hypotonic
* Hypertonic
Isotonic
All answers are correct
All answers are incorrect
1464. What value of рН plasma of blood is answered by the concentration of hydrions
of 40 nmol/l:
A. - 7,0
B. - 7,35
C. * - 7,4
D. - 7,44
E. - 7,6
1465.
A.
B.
C.
D.
E.
1466.
A.
B.
C.
D.
E.
What violations of ABS are most peculiar for cardiogenick shock:
- respiratory acidosis
- metabolic alkalosis
- respiratory acidosis, metabolic alkalosis
- respiratory alkalosis
* - respiratory alkalosis, metabolic acidosis
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
1467. Which statement does correctly describe changes in water amount in the bodies of
people with different amount of fat?
A. * People with obesity have related content of water greater, than people with
normal or lowered nourishment
B. People with normal or lowered nourishment have greater water content, than
people with obesity
C. People with normal nourishment have lower related and absolute water content
than people with obesity
D. Absolute water content is almost equal in all mentioned cases
E. All answers are incorrect
1468.
A.
B.
C.
D.
E.
Which way does the hematocrit change in case of hyperhydration?
Increases insignificantly
Decreases
Doesn’t change
* Increases greatly
All answers are correct
1469. Which way will the loss of adrenal glands function influent the electrolytic
balance?
A. * Increases the rate of Na in the body
B. Increases the rate of K in cells
C. Increases the rate of K in urine
D. Doesn’t influent electrolytic exchange
E. All answers are incorrect
1470.
A.
B.
C.
D.
E.
1471.
A.
B.
C.
D.
E.
1472.
A.
B.
C.
D.
E.
1473.
A.
B.
C.
D.
E.
1474.
A.
B.
C.
D.
E.
1475.
A.
B.
C.
D.
E.
1476.
A.
B.
C.
D.
E.
рН of patient 7,2, VE - - 2, PaCO2 – 40. Your diagnosis:
- subcompensated metabolic alkalosis
- decompensated metabolic alkalosis
- subcompensated metabolic acidosis
* - decompensated metabolic acidosis
- subcompensated respirator alkalosis
рН of patient 7,3, VE - - 2, PaCO2 - 40. Your diagnosis:
- subcompensated metabolic alkalosis
- decompensated metabolic alkalosis
* - subcompensated metabolic acidosis
- decompensated metabolic acidosis
- subcompensated respirator alkalosis
рН of patient 7,3, VE - - 2, PaCO2 – 48. Your diagnosis:
- subcompensated metabolic alkalosis
- decompensated metabolic alkalosis
- subcompensated metabolic acidosis
* - is mixed the subcompensated acidosis
- subcompensated respirator alkalosis
рН of patient 7,3, VE - + 1, PaCO2 – 48. Your diagnosis:
- subcompensated metabolic alkalosis
- decompensated metabolic alkalosis
- subcompensated metabolic acidosis
* - subcompensated respirator acidosis
- subcompensated respirator alkalosis
рН of patient 7,3, VE - + 2, PaCO2 – 48. Your diagnosis:
- subcompensated metabolic alkalosis
- decompensated metabolic alkalosis
- subcompensated metabolic acidosis
* - subcompensated respirator acidosis with a metabolic alkalosis
- subcompensated respirator alkalosis
рН of patient 7,5, VE - - 2, PaCO2 – 32. Your diagnosis:
- subcompensated metabolic alkalosis
- decompensated metabolic alkalosis
- subcompensated metabolic acidosis
* - subcompensated respirator alkalosis with metabolic acidosis
- subcompensated respirator alkalosis
рН of patient 7,5, VE - + 1,5, PaCO2 – 32. Your diagnosis:
- subcompensated metabolic alkalosis
- decompensated metabolic alkalosis
- subcompensated metabolic acidosis
- noncompensated metabolic acidosis
* - subcompensated respirator alkalosis
1477.
A.
B.
C.
D.
E.
1478.
A.
B.
C.
D.
E.
1479.
A.
B.
C.
D.
E.
рН of patient 7,5, VE - + 2, PaCO2 - 40. Your diagnosis:
* - subcompensated metabolic alkalosis
- decompensated metabolic alkalosis
- subcompensated metabolic acidosis
- noncompensated metabolic acidosis
- subcompensated respirator alkalosis
рН of patient 7,5, VE - + 2, PaCO2 – 32. Your diagnosis:
- subcompensated metabolic alkalosis
* - is mixed the subcompensated alkalosis
- subcompensated metabolic acidosis
- noncompensated metabolic acidosis
- subcompensated respirator alkalosis
рН of patient 7,6, VE - + 2, PaCO2 – 40. Your diagnosis:
- subcompensated metabolic alkalosis
* - decompensated metabolic alkalosis
- subcompensated metabolic acidosis
- noncompensated metabolic acidosis
- subcompensated respirator alkalosis
1480. If you suspect neck backbone injury, backwards head titling might lead to:
A. all answers are wrong
B. all answers are correct
C. *damage of spinal cord
D. asphyxia
E. damage of synocarotid sinuses
1481. What should you do at the beginning of resuscitation action, if clinical death was
caused by mechanical injury?
A. all answers are wrong
B. electrical defibrillation
C. heart massage
D. ALV
E. *precordial thump
1482. What kind of drawning guarantees the most favorable prognosis?
A. all answers are wrong
B. all answers are correct
C. syncopal drowning
D. true drowning
E. *dry drowning
1483. What does develop in case of salt water true drowning?
A. all answers are wrong
B. B.
hypotonic hyperhydration
C. *hypertonic hypohydration
D. hypertonic hyperhydration
E. hypotonic hypohydration
1484. What is used during third stage of resuscitation of patients with salt water true
drowning?
A.
B.
C.
D.
E.
all answers are wrong
solution of sodium bicarbonate
*solution of hypotonic infusible ions
solution of magnesia sulfate
solution of sodium chlorides
1485. During the third study of resuscitation patient with natural drawing in fresh water
use infusion therapy
A. all answers are wrong
B. *solution of sodium bicarbonate
C. hypotonic solutions
D. solution of magnesium sulphate
E. physiologic saline
1486. What should be the first resuscitation action in case of true drowning?
A. all answers are wrong
B. external cardiac massage.
C. *ALV
D. turning of the patient face down
E. pericordial thump
1487. What should be done in order to prevent secondary drowning of patients with true
drowning during first 24 hours after it?
A. A.all answers are wrong
B. all answers are correct
C. ALV with normal respiratory rate
D. ALV with NEEP
E. *ALV with PEEP
1488. . What is the reason of natural drowning?
A. A.all answers are wrong
B. *respiratory movements.
C. hypoxia
D. damage of reflective areas
E. regurgitation
1489. What is the reason of dry drowning?:
A. all answers are wrong
B. respiratory movements
C. *hypoxia
D. damage of reflective areas
E. regurgitation
1490. What is not a type of drowning?
A. all answers are wrong
B. dry drawing.
C. *artificial drawing
D. syncopal drawing
E. true drawing
1491. Prognosis of resuscitation is more favorable in the case of:
A. all answers are wrong
B. all answers are correct
C. primary cardiac arrest
D. primary death of brain
E. *primary respiratory arrest
What is not a sing of brain death?
all answers are wrong
lack of conciseness.
lack of electrical activity on electroencephalogram
*livores mortis
lack of spontaneous breathing, areflexia
1492.
A.
B.
C.
D.
E.
What is the most common reason of primary cardiac arrest?
all answers are wrong
* all answers are correct
advanced deficit of circulating blood volume
advanced obstruction of great vessels
advanced cardiac decompensation
1493.
A.
B.
C.
D.
E.
1494. What is the most common death reason after primary respiratory arrest?
A. all answers are wrong
B. all answers are correct
C. violation of respiratory biomechanics
D. *damages of respiratory centre
E. obstruction of airways
1495. Why aren’t glucose solutions being used when glucose blood level is more than 8
mmol/l ?
A. all answers are wrong
B. all answers are correct.
C. *because they might cause brain edema (hyperosmolar solutions).
D. because they might overfill bloodstream
E. because they are dangerous for diabetics;
1496. What kind of heart massage is used in the operating room in case of cardiac
tamponade?
A. all answers are correct
B. all answers are wrong.
C. mixed
D. *open heart massage
E. closed cardiac massage
1497. What is the aim of ICU specialist during unconsciousness period?
A. all answers are wrong
B. all answers are correct.
C. *protection of brain from hypoxia
D. providing of cardiac output
E. normalization of skin colour
1498. What medicine is “forbidden” in the case of ”ineffective heart”, caused by acute
reduction of circulating blood volume?
A. all answers are wrong
B. *lipofundin
C. hemodynamics medicine
D. steroids
E. crystalloids
1499. What is ECG picture of asystolia?
A. all answers are wrong
B. ineffective heart
C.atrial fibrillation
D. ventricular fibrillation
E. *flat line
1500. Where should you place hands during CPR?
A. all answers are wrong
B. 2 fingers to the left from xiphoid process.
C. 2 fingers to the right from xiphoid process.
D. *2 fingers to the top of xiphoid process.
E. 2 fingers down from xiphoid process.
1501. When is solution of calcium chloride used during CPR:
A. all answers are wrong
B. *in case of hyperkaliemia
C. in case of electric injury;
D. in case of ventricular fibrillation
E. in case of asystolia;
1502. . When is solution of lidocaine used during CPR?
A. all answers are wrong
B. *in case of ventricular fibrillation
C. when it’s necessary to eliminate atropine influence on heart
D. in case of central veins catheterization
E. asystolia;
1503. What way of medicine introduction is not used during CPR?
A. all answers are wrong
B. endotracheal
C. *intramuscular;
D. intra-arterial introduction;
E. intravenous introduction
1504.
A.
B.
C.
D.
E.
What part of triple Safar method is “forbidden” in case of trauma patients?
all answers are wrong
forward jaw movement
all answers are correct.
opening of the mouth ;
*titling of the head backwords;
1505. What is the third stage of CPR according to P. Safar?
A. all answers are wrong
B. medical therapy, electrocardiography
C. external cardiac massage, defibrillation, ALV;
D. *renewal of brain functioning, correction of all body systems and organs
E. farmaceutical therapy , electrocardiography, defibrillation;
1506.
What is the second stage of CPR according to P. Safar?
A.
B.
C.
D.
E.
all answers are wrong
external cardiac massage, defibrillation,
trachea intubation, ALV.
external cardiac massage, defibrillation, ALV;
*farmaceutical therapy, electrocardiography, defibrillation ;
1507. What condition does demand prolonged resuscitation?
A. all answers are wrong
B. young age of the patient
C. electric trauma;
D. drugs overdose;
E. *hypothermia;
1508. What is not a criterium of CPR cessation?
A. all answers are correct
B. all answers are wrong
C. ineffective resuscitation during 7 minutes .
D. *ineffective resuscitation during 30 minutes;
E. renewal of spontaneous circulation and breathing
1509. What is the energy of first defibrillation in case of biphasic defibrillators?
A. 320 J
B. 350 J;
C. 100 J,
D. 220-230 J,
E. *150-200 J;
1510. What is the energy of first and subsequent defibrillations in case of monophasic
defibrillators?
A. 220 J
B. 150 J;
C. the first - 100 J, all next – 200 J.
D. 200 J, all next -400 J;
E. *360 J;
1511. What are the indications for defibrillation?
A. all answers are wrong
B. *ventricular fibrillation.
C. electrical activity without pulse;
D. asystole;
E. cardiac arrest;
1512. What ECG lead is used during CPR for evaluation of the rhythm?
A. I standard lead
B. III standard lead
C. *II standard lead.
D. leads by Neb
E. all standard and chest leads;
1513. What types of cardiac arrest do you know?
A. all answers are wrong
B. asystolia
C. ineffective heart;
D. ventricular fibrillation;
E. *atrial fibrillation
1514. When is used solution of sodium bicarbonate during CPR?
A. all answers are wrong
B. in case of РН> 7,4
C. * in case of РН< 7,1
D. in all cases ;
E. all answers are correct;
1515. When is 2% solution of euphylline used during CPR?
A. all answers are wrong
B. after shock;
C.in case of atropine resistant bradycardia
D. *in case of drowning
E. all answers are correct
1516. When is cordarone used during CPR?
A. all answers are wrong
B. during PEA
C.during asystole,.
D. *during ventricular fibrillation;
E. always;
1517.
A.
B.
C.
D.
E.
What is the dose of Atropine sulphate 0,1% used during CPR?
all answers are wrong
1 mg every 1 min intravenously;
10 mg every 3 – 5 min intravenously;
5 mg every 3 – 5 min intravenously;
*3 mg once intravenously;
1518.
What is the dose of 0,1 % adrenalin solution used during CPR?
A. all answers are wrong
B. 1 mg every 1 min intravenously;
C. 10 mg every 3 – 5 min intravenously;
D. 5 mg every 3 – 5 min intravenously;
E. *1 mg every 3 – 5 min intravenously;
How should be changed the dose of a medicine in case of endotracheal
administration?
all answers are wrong
Increased by 4 times
Increase by 3 times
*Increase by two times;
shouldn’t change in comparing with intravenous administration
1519.
A.
B.
C.
D.
E.
What way of administration should not be used during CPR?
all answers are wrong
endotracheal way
*subcutaneous introduction
intraarterial administration;
intravenous administration;
1520.
A.
B.
C.
D.
E.
1521.
What is not an indication for external heart massage?
A.
B.
C.
D.
E.
all answers are wrong
*cardiac infarction.
suspicion of a clinical death ;
massive pulmonary thromboembolism;
absence of оpen chest during surgery;
What does prove effectiveness of cardiac massage?
all answers are wrong
return of consciousness
*pulse on the main arteries
spontaneous respiratory movements
normalization of skin color;
1522.
A.
B.
C.
D.
E.
What is the frequency of compressions during CPR?
120 per min
110 per min
*100 per min’
80 per min.;
60 per min
1523.
A.
B.
C.
D.
E.
What in the ration between compressions and rescue breaths during CPR?
1:5
2:1
10:4
5:1
*30:2
1524.
A.
B.
C.
D.
E.
1525. Where should be placed your hands during heart massage?
A. all answers are wrong
B. *between lower and middle thirds of the sternum.
C. upper third of the chest;
D. xiphoid process;
E. in the heart area;
1526. Choose the correct statement about ALV :
A. all answers are wrong
B. triple method of Safar is necessary.
C. attempts of medical stimulation of breath should be performed;
D. *without control of ALV air might get to the stomach;
E. chest excursion sholdn’t be controlled;
1527. Precordial thump is:
A. all answers are wrong
B. element of defibrillation
C. sharp pressure on the side of the chest.
D. *sharp thump to a specific location on the sternum (it’s middle part)
E. sharp thump to a specific location on the sternum (cardiac apex);
1528. What can cause mouth-to-mouth ventilation with exceed tidal volume?
A. all answers are wrong
B. intestine injury
C. *air in stomach
D. falling back of the tongue;
E. lung injury;
1529. During ALV tidal respiratory volume is:
A. 200-300 ml
B. *tidal volume of person performing ALV
C. 500-600 ml.
D. 300-400 ml;
E. 100-200 ml
1530. What is inspiration volume during artificial lung ventilation ?
A. 800-1000 ml
B. *500-600 ml
C. 400 ml.
D. 300 ml.
E. all answers are wrong;
1531. „Triple method„ of P. Safar includes:
A. all answers are wrong
B. evaluation of general condition, external cardiac massage , intubation, lung ventilation;
C. trachea intubation, ALV, external cardiac massage .
D. * titling the head backwords, opening of the mouth, thrusting the jaw forward
E. evaluation of general condition, external cardiac massage , pulmonary ventilation;
1532. The first stage of CPR includes:
A. all answers are wrong
B. trachea intubation, defibrillation, heart massage;
C. *providing of airways potency, respiratory support, circulation support
D. trachea intubation, defibrillation, external cardiac massage;
E. defibrilation, external cardiac massage , pharmaceutical therapy;
1533.
A.
B.
C.
D.
E.
Stages of CPR include:
all answers are wrong
artificial ventilation , external cardiac massage, after resuscitation care
evaluation of general condition, external cardiac massage , pulmonary ventilation
(intubation);
*emergency oxygenation , basic life support, renewal of spontaneous circulation,
cerebral resuscitation and post resuscitation actions
artificial ventilation, external cardiac massage , defibrillation;
What is not a sign of biological death?
A. all answers are wrong
B. cadaveric rigidity
C. *hypertonic muscles;
D. dry cornea;
E. livores mortis
1534.
1535. What is a reason not to provide CPR?
A. all answers are wrong
B. total skin cyanosis
C. all answers are correct;
D. hard injuries of chest
E. *if it is known, that from the moment of death passed more than 25 minuets.
1536. What is an indication for CPR?
A. all answers are wrong
B. lack of pulse on peripheral arteries
C. unconsciousness;
D. biological death;
E. *clinical death;
1537. What is an additional sign of clinical death?
A. all answers are correct
B. All answers are wrong
C. *dilatation of pupils
D. unconsciousness;
E. lack of pulse on main arteries
1538. What is the main singn of clinical death?
A. all answers are wrong
B. atonia, areflexia.
C. *lack of pulse on main arteries
D. lack of skin sensitivity
E. unconsciousness .
1539. Resuscitation is:
A. all answers are wrong
B. *process of main vital functions replacement
C. process of dying
D. science about mechanisms of vital functions replacement
E. all answers are correct
1540.
A.
B.
C.
D.
E.
Main stages of dying are:
all answers are wrong
*preagoni, terminal pause, agony, clinical death.
agony, , terminal state , biological death.
death of brain, biological death.
shосk, terminal pause, clinical death, biological death.
Triple method„ of Safar includes:
estimate of total state , external cardiac massage , pulmonary ventilation;
* neck extending, opening of mouth, move outing of jow.
incubation of trachea, APV, external cardiac massage .
estimate of total state , external cardiac massage , intubation, pulmonary
ventilation;
E. all answers are false
1541.
A.
B.
C.
D.
1542.
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
A local anesthetic that is ineffective topically is –
A. * Cocaine
B. Mepivacaine
C. Hexylcaine
1543.
D. Lidocaine
E. Tetracaine
1544.
A.
B.
C.
D.
E.
1545.
A.
B.
C.
D.
E.
1546.
A.
B.
C.
D.
E.
1547.
A.
B.
C.
D.
E.
1548.
A.
B.
C.
D.
E.
1549.
A.
B.
C.
D.
E.
1550.
A.
B.
C.
D.
E.
A successful stellate ganglion block can produce –
Hypotension
* Horner's syndrome
Brachial plexus involvement
Hemifacial anaesthesia
Hypertension
Additional sign of clinical death is:
Absence of pulsation on the central artery .
Absent of conciseness;
* Stretching of pupils.
All answers are false
All answers are right
An increased dose of epidural anaesthetic is obligatory in a patient who has –
Ascities
* Increased height of the patient
Pregnant
Age after 50
Obese
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
1 year
Cauda Equina syndrome can be caused by
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
E.General anaesthesia
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
D*6
10
Complication of epidural anaesthesia is except* Headache
Nausea
Hypotension
Bladder distension
Dizziness
1551.
A.
B.
C.
D.
E.
1552.
A.
B.
C.
D.
E.
1553.
A.
B.
C.
D.
E.
1554.
A.
B.
C.
D.
E.
1555.
A.
B.
C.
D.
E.
1556.
A.
B.
C.
D.
E.
1557.
A.
B.
C.
D.
E.
1558.
Concerning Barbotage –
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
Technique used Epidural Analgesia
Technique popularized in caudal Analgesia
Cannot be carried out under hypothermic condition
All of the above
Conditions need prolongation of resuscitation are:
cooling of organism;
overdosing of drugs;
electro trauma;
* young age of patient
all answers are false
Contraindication for reanimation is:
* if it is known, that from moment of death past more than 25 minuets.
massiv breaking of webbing
presents of auricle trembling;
total cyanosis of skin.
all answers are false
Cordarone apply in scheme CPR in case :
allways;
* during ventrical [ventricular] fibrillation;
during asystole,.
during systole
all answers are false
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
Criteria’s of stopping of reanimation actions are all exept:
renewal independent circulation and breath;
not affectivity of reanimation during 30 minuits;
* not affectivity of reanimation during 7 minuits .
all answers are false
all answers are true
Dosing solution of adrenalin 0,1% during reanimation:
* 1 mg every 3 – 5 min intravenously;
5 mg every 3 – 5 min intravenously;
10 mg every 3 – 5 min intravenously;
1 mg every 1 min intravenously;
all answers are false
Dosing solution of atropine sulphate 0,1% in CPR:
A. * 3 mg only one time intravenously;
B. 5 mg every 3 – 5 min intravenously;
C. 10 mg every 3 – 5 min intravenously;
D. 1 mg every 1 min intravenously;
E. all answers are false
1559.
A.
B.
C.
D.
E.
1560.
A.
B.
C.
D.
E.
1561.
A.
B.
C.
D.
E.
During APV are wrong all excepting :
absent of control of excursion of chest ;
absent of control hit air into the stomach ;
attempt of medical stimulation of breath;
* making triple steps by Safar.
all answers are false
During APV respiratory volume must compound
100-200 ml
300-400 ml;
500-600 ml.
* volume of inspiration of person performed APV
200-300 ml
During artificial pulmonary ventilation volume of inspiration is:
volume of max forsation ;
300 ml.
400 ml.
500-600 ml
* 800-1000 ml
1562. During endotracheal injection to patient in clinical death you should increase dose
of drugs comparing with intravenous dose in
A. * 2 once again
B. 3 once again
C. 4 once again
D. 5 once again
E. once again
1563. During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
1564.
A.
B.
C.
D.
E.
1565.
During external cardiac massage frequency of compression must compound:
60 in min
80 in min.;
* 100 in min’
110 in min
120 in min
During external cardiac massage pressing made on:
A. projection tip of the heart ;
B. processus xiphoideus;
C. top third of the chest;
D. * between second and third third of the sternum.
E. all answers are false
1566.
A.
B.
C.
D.
E.
1567.
A.
B.
C.
D.
E.
1568.
A.
B.
C.
D.
E.
1569.
A.
B.
C.
D.
E.
1570.
A.
B.
C.
D.
E.
1571.
A.
B.
C.
D.
E.
1572.
A.
B.
C.
D.
E.
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
Epidural blocks is indicated in all excpect* Patients in hypovolemia
Patients with asthma and bronchitis
Post-operative pain relief
Obstetric analgesia
In urologic surgery
Epidural morphine cause Miosis
Retention of urine
Abolishes pain
* All
None
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
Exceed allowed respiratory volume during APV „mouth to mouth ” can lead to
break of pullmone;
sink down of root of tongue;
* presence air in stomach
hit air in intestine
all answers are false
First Fibres to be blocked at spinal anaethesia is –
Afferent motor nerve
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
1573.
A.
B.
C.
D.
E.
1574.
A.
B.
C.
D.
E.
For brachial plexus block needle is inserted –
Medial to subclavian artery
* Lateral to subclavian artery
Medial to subclavian vein
Lateral to subclavian vein
Inferior to subclavian vein
Forecast of reanimation is more favorable in the case of:
* primary stop of breath
primary death of brain
stop circulation of blood
d ) all written before variants
all answers are false
1575. In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
1576.
A.
B.
C.
D.
E.
1577.
A.
B.
C.
D.
E.
1578.
A.
B.
C.
D.
E.
1579.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
In spinal anaesthesia, the first nerve fibre to get blocked is * Autonomic preganglionic fibres
Temperature fibres
Somatic motor fibres
Vibratory and proprioceptive fibres
Vegetates fibers
In spinal anaesthesia, the last fibres affected is * Pressure
Pain
Temperature
Touch
Somatic
1580. In the case of ”non effective heart”, predetermined sharp reduction of circulated
blood volume you should use all remedies exept:
A.
B.
C.
D.
E.
1581.
A.
B.
C.
D.
E.
1582.
A.
B.
C.
D.
E.
crystalloids
glucocortycoids
hemodynamics remedies
* lipofundin
all answers are false
In the case of drawing there are such variants teratogenesis except:
natural drawing
syncopal drawing
* artificial drawing
d ) asphyctic drawing.
all answers are false
In the case of intra- tracheal introduction of drugs their dose is :
the same like during intravenous introductions ;
* Increase in two times;
Increase in 3 times
Increase in 4 times
all answers are false
1583. In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
1584.
A.
B.
C.
D.
E.
1585.
A.
B.
C.
D.
E.
1586.
A.
B.
C.
D.
E.
1587.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
Indication for external cardiac massage is all except:
absence of оpened chest in conditions of surgical ;
massive pulmonary thromboembolism;
suspiction on period unnoticed clinical death ;
* acute cardiac infarction.
a, b
Indication for resuscitation is:
* clinical death;
biological death;
Absent of concsesness;
Absent of pulsation on peripheric arteri
all answers are false
Indication for using of calcium chloride in scheme of CPR:
A. asistolia;
B. fibrillation of ventricle;
C. during bliding;
D. * during hypercaliemia
E. all answers are false
1588.
A.
B.
C.
D.
E.
1589.
A.
B.
C.
D.
E.
1590.
A.
B.
C.
D.
E.
1591.
A.
B.
C.
D.
E.
1592.
A.
B.
C.
D.
E.
1593.
A.
B.
C.
D.
E.
1594.
A.
B.
C.
D.
E.
Indication for using of lidocain in scheme CPR is:
asistolia;
catheterization central veins ;
for elimination of influence on the cardio of atropin;
* ventricle fibrillation
all answers are false
Indications for defibrillation is:
circulatory arrest;
assistole;
electrical activity without puls;
* ventrical fibrillation.
all answers are false
Introduction of drugs during CPR fobbiden:
introvenously
b )introarterialy;
* intramuscularly;
intratracheal
all answers are false
Introduction of remedies in CPR forbidden:
intravenously;
intra-arterial;
* under skin;
intra- tracheal way .
all answers are false
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
Lidocaine can be used in all except –
Ventricular fibrillation
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
1595.
A.
B.
C.
D.
E.
1596.
A.
B.
C.
D.
E.
1597.
A.
B.
C.
D.
E.
1598.
A.
B.
C.
D.
E.
1599.
A.
B.
C.
D.
E.
1600.
A.
B.
C.
D.
E.
1601.
A.
B.
C.
D.
E.
1602.
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
Longest acting local anaesthetic solution isLignocaine
Chlorprocain
Amethocaine
* Bupivacine
Novocaine
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
Main stages of organism’s living functions extinction are:
shосk, terminal pouse,clinical death,biological death.
death of brain, biological death.
agoni, , terminal state , biological death.
* preagoni, terminal pause, agony,clinical death.
all answers are false
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
Pneumothorax is a complication of A. * Brachial plexus block
B.
C.
D.
E.
1603.
A.
B.
C.
D.
E.
1604.
A.
B.
C.
D.
E.
1605.
A.
B.
C.
D.
E.
1606.
A.
B.
C.
D.
E.
Epidural block
Axillary block
High spinal blook
Low spinal block
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
Pre-cordial strike is:
strike on chest in projection of top of heart;
* strike on chest in projections of middle of sternum:
sharp press on side surface of chest.
element of defibrillation
all answers are false
1607. Proportion number of compression on the chest and number of breath during CPR
must compound
A. * 30:2
B. 5:1
C. 10:4
D. 2:1
E. 1:5
1608.
A.
B.
C.
D.
E.
1609.
Reasons of asphyctic drawing is:
regurgitation
damaging of reflexogenic zones
* hypoxia
breath movements
all answers are false
Reasons of natural drawing is:
A. regurgitation
B. damaging of reflexogenic zones
C. hypoxia
D. * breath movements.
E. all answers are false
1610.
A.
B.
C.
D.
E.
1611.
A.
B.
C.
D.
E.
1612.
A.
B.
C.
D.
E.
1613.
A.
B.
C.
D.
E.
1614.
A.
B.
C.
D.
E.
1615.
A.
B.
C.
D.
E.
1616.
A.
B.
C.
D.
E.
Reasons of syncopal drawing is:
regurgitation
* trauma of reflexogenic zones
gipoxia
breath movements
all answers are false
Resuscitation is
process of organism’s living functions extinction:
science of mechanism of organism’s living functions extinction
process of dying away of organism’s living functions
* process reproduction of organism’s living functions
all answers are false
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
Shortest acting local anesthetic Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
Sign of biological death is not
livores mortis
drying of cornea;
* hypertonus of muscls;
corps numbness.
all answers are false
Sign of correctness making external cardiac massage is:
* bouing of the chest on 5-6 cm;
presence of movement of air from respiratory waves ;
presence of pulsation on the central arteries .
presence of conscious
all answers are false
Sign of intravital death of brain is all except:
absent of spontal breath, areflexia
* livores mortis
absence of electrical activity on electroencephalogram
absent of conciseness.
all answers are false
1617.
A.
B.
C.
D.
E.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseGives deep analgesia
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
1618.
Stages of CPR are:
A. artificial breth, external cardiac massage , defibrilation;
B. * emergency oxygenation и elementary support of life, renewal of spontan blood
circulation cerebral reanimation and post reanimation actions
C. estimation of total state of organism, intubation of trachea, [external cardiac]
massage
D. artificial breth , external cardiac massage, post reanimation
E. all answers are false
1619.
A.
B.
C.
D.
E.
1620.
A.
B.
C.
D.
E.
1621.
A.
B.
C.
D.
E.
1622.
A.
B.
C.
D.
E.
1623.
A.
B.
C.
D.
E.
1624.
Subarachnoid block as anesthesia is contraindicated inIschemic heart disease ,
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
Terminal conditions are
* preagonia, terminal pause, agonia, clinikal death
agonia, clinikal and biological death
coma, agonia, clinikal death
preagonia, terminal pause, agonia, clinikal and social death
coma, clinikal death
The device suited for introducing epidural catheter is Mitchell needle
Gordh needle
* Tuohy needle
Sise introducer
Nick needle
The dose of atropin 0,1% solution intravenously during resuscitation is
1 ml
2 ml
* 3 ml
4 ml
5 ml
The duration of clinical death in condition of normothermia is
7-12 min
1-3 min
* 4-5 min
5-7 min
till 10 min
The duration of effect of spinal anaesthesia depends upon –
A.
B.
C.
D.
E.
1625.
A.
B.
C.
D.
E.
1626.
A.
B.
C.
D.
E.
1627.
A.
B.
C.
D.
E.
1628.
A.
B.
C.
D.
E.
1629.
A.
B.
C.
D.
E.
1630.
A.
B.
C.
D.
E.
1631.
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
The effects of chiling in refrigeration analgesia includes –
Interference with conduction of nerve impulse
Reduction of metabolic rate and oxygen requirement
Inhibition of bacterial growth and infection
Retardation of healing
* All of the above
The first charge during defibrilation should be
* 200 J
220 J
250 J
300 J
350 J
The first stage CPR has such steps:
defibrilation, external cardiac massage , medical therapy;
trachea intubation, defibrillation, external cardiac massage;
* renewal permeability of respiratory tract , support of breath , support of blood
circulation.
trachea intubation, defibrillation, external pulmonary massage;
all answers are false
The following is not used when giving local anaesthesia in the fingers 2 % xylocaine
Rubber tourniquet
Ring block
* Adrenaline
Atropin
The frequentsy of pressing on chest during hurt massage is
* 100 pressing a min
60 pressing a min
80 pressing a min
150 pressing a min
180 pressing a min
The heart stops in sysole during clinical death in
60 % of patients
80 % of patients
* 90 % of patients
40 * of patients
30 % of patients
The main sign of clinical death is
A. absent of conciseness.
B. painless of cutaneous covering
C. * absent of pulsation on the central artery
D. atonia, areflexia.
E. all answers are false
1632.
A.
B.
C.
D.
E.
1633.
A.
B.
C.
D.
E.
1634.
A.
B.
C.
D.
E.
1635.
A.
B.
C.
D.
E.
The most often reason of death during primary respiratory failure:
obstruction of respiratory ways
* damages of activity of respiratory centre
damaged of biomechanics of breath
all written before variants.
all answers are false
The most often reason of primary stop of the heart
high cardiac decompensation
high obstruction of magisterial vessels
high deficit of volume of circulated blood
* all written before variants
all answers are false
The second stage of CPR by Safar consist of next steps:
* medical therapy, electrocardiography, defibrillation ;
external cardiac massage, defibrillation, APV;
assessment of general conditions ,intubation of trachea , APV.
external cardiac massage, defibrillation,
all answers are false
The spinal cord terminates opposite-vertebra –
* Lumbar 1
Lumbar 2
Sacral l
Sacral 2
Thoracal 12
1636.
The third study CPR by Safar consist of next steps:
A. medical therapy, electrocardiography, defibrillation;
B. * external cardiac massage, defibrillation, APV;
C. assessment of general conditions, renewal of mental work, correction of the
function of all systems of organism;
D. medical therapy, electrocardiography
E. all answers are false
1637. The volume of minute ventilation during artifitial lung ventilation should increase
normal minute volume of ventilation on
A. * 30-40 %
B. 10-20 %
C. 50 %
D. 15 %
E. 70 %
1638.
Tipes of circulatory arrest are all exist:
A. * atrial fibrillation
B. ventricle fibrillation;
C. c ) non effective heart;
D. asystolia
E. all answers are false
1639.
A.
B.
C.
D.
E.
1640.
A.
B.
C.
D.
E.
1641.
A.
B.
C.
D.
E.
1642.
A.
B.
C.
D.
E.
Using of sodium bicarbonate in CPR?
not indicated ;
indicated in all cases ;
* indicated if РН< 7,1
indicated if РН> 7,4
all answers are false
Using of solution of euphilline 2,0 % in CPR?
not indicated ;
* indicated after drawing;
indicated during bradycardia wich is resisted to atropine.
indicated after shock;
all answers are false
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
What action is first prioritized during natural drawing?
pericardial push
over turn patient
* APV
external cardiac massage.
all answers are false
1643. What energy of the first and next discharge must be used with employed
monopolary defibrilator?
A. * 360 J;
B. 200 J, all next -400 J;
C. the first - 100 J, all next – 200 J.
D. 150 J;
E. 220 J
1644. What energy of the first discharge must be used with employed bipolar
defibrilator?
A. * 150-200 J;
B. 220-230 J,
C. 100 J,
D. 350 J;
E. 320 J
1645.
A.
B.
C.
D.
What is registed electrocardiography during assistolia?
* straight line
ventricular complex
atrial fibrillation
not effective hart .
E. all answers are false
1646.
A.
B.
C.
D.
E.
1647.
A.
B.
C.
D.
E.
1648.
A.
B.
C.
D.
E.
1649.
A.
B.
C.
D.
E.
What is the aim of reanimation workers during renewal of conciseness?
on renewal of colors of skin covering
on makings hart push
* protection of brain from hypoxia
no one from before written variants.
all answers are false
What is the wright disposition of arms during CPR?
2 fingers lower xiphoid process.
* 2 fingers higher of xiphoid process.
2 fingers to the right of xiphoid process.
2fingers to the left of xiphoid process.
all answers are false
What kind of massage of heart is used in operating room during cardiac tapenade?
closed massage of heart
* open massage of heart
mixed
no one from written before variants.
a, b
What leads use in resuscitation practice for estimating of ECG:
all standart and pectoral leads;
leads by Neb
* II standart lead.
III standart lead
I standart lead
1650. What moment is forbidden to use during „tripled ” method injured in a road
accident:
A. * through backing of head;
B. opening of mouth ;
C. moving -out of lowing jaw.
D. moving –in of lowing jaw
E. all answers are false
1651. What volume of air you should inbreath in patients during artificial lung
ventilation
A. 1700-2000 ml
B. 500-700 ml
C. 1200-1600 ml
D. * 800-1100 ml
E. 2000-2300 ml
1652.
A.
B.
C.
D.
E.
Which of below signs is not sign of clinical death
* absence of systolick blood pressure
absence of breathing
absence of photoreaction, midriasis
absence of pulse under femoral artery
absence of pulse under jugular artery
1653.
A.
B.
C.
D.
E.
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
1654. Why solution of glucose is not used when glucose level in blood is more than 8
mmol/l ?
A. dangerous appearance of diabetes;
B. not to overfill volume of circulating blood
C. * dangerous hyperosmolar damaged of cells of brain.
D. all written before variants.
E. all answers are false
1655.
A.
B.
C.
D.
E.
1656.
A.
B.
C.
D.
E.
You should increase the next each charge during defibrilation on
* 500 W
100J
1000 W
1500 W
2000 W
A complete atrioventricular block is characterised
* by absence of conducting of impulses from an autriums to ventricles
by a idioventricoular rhythm
by the attacks Morgani - Adamsa - Stocsa
all answers are faithful
all answers are right
1657. A doctor decided to perform the defibrillation to patient with ciliary arrhythmia,
using a synchronizer. The digit of defibrilyater must be synchronized:
A. * with wave Q
B. with the descending phase of R
C. by an T
D. consideration of phase of ECG-complex not important
E. there is no right answer
1658.
A.
B.
C.
D.
E.
1659.
A.
B.
C.
D.
E.
A history of stokes-Adams attacks, giddiness, collapse or fainting suggests –
* Complete block
Unstable block
Hemi block
All of the above
None
A leading symptom for the diagnosis of stop of circulation of blood is:
wide pupils, that are irresponsive on light
absence of consciousness
absence of breathing
* absence of pulse on a carotid
cyanosis
1660.
A.
B.
C.
D.
E.
1661.
A.
B.
C.
D.
E.
A local anesthetic that is ineffective topically is –
* Cocaine
Mepivacaine
Hexylcaine
Lidocaine
Tetracaine
A main direct danger for a patient with acute bleeding is
deficit of haemoglobin
* Hypovolemiya
Hypoproteinemiya
coagoulopatiya
deficit of fibrinogenou
1662. A most threat for the life through possible transformation in ventricles fibrilation
is presented by arrhythmia
A. ventricle premature beats more than 20 in a minute
B. * ventricle tahicardiya
C. arrhythmias, that unite with lengthening of intraventricular conductivity blockade
of the left leg of bunch of Gis
D. blinking arrhythmia
E. all answers are correct
1663.
A.
B.
C.
D.
E.
1664.
A.
B.
C.
D.
E.
1665.
A.
B.
C.
D.
E.
1666.
A.
B.
C.
D.
E.
A successful stellate ganglion block can produce –
Hypotension
* Horner's syndrome
Brachial plexus involvement
Hemifacial anaesthesia
Hypertension
All are surface anaesthetics except –
Lidocaine
* Bupivacaine
Procaine
Cinchocaine
None
All medicine have vasodilatational and lowering postload, belong:
nitrates
* ganglioblocers
nitroprousid
morfin
faithful all answers
An increased dose of epidural anaesthetic is obligatory in a patient who has –
Ascities
* Increased height of the patient
Pregnant
Age after 50
Obese
1667. Anafilactic shock appeared at a patient. The state heavy and progressively gets
worse. HBA – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the
rescue of life of patient above all things?
A. * Adrenalin.
B. Chloride of calcium.
C. Prednizolon.
D. Dofamin.
E. Suprastin.
1668.
A.
B.
C.
D.
E.
At veritable cadiogenic shock obligatory medicine are:
osmodiuretics
salureticsi
adrenalin
* doboutamin
analgetics
1669. At a patient 20 years on a background the injection of vitamin B1 suddenly there
was excitation, fear of death, falling of AP to 50 mm rt.st., hard breathing. Which of
medicine it is necessary to inject firstly?
A. * Adrenalin
B. Prednizolon
C. Calcium
D. Dimedrol
E. Eufilin
1670. At a patient 22 years, which was delivered in the induction centre with heavy
politrauma and hemorhagia, there is sucking of air in in a needle during punction and
cateterization of v. Subclavia dextra.
A. It is typical for:
B. * Negative CVT
C. Erroneous punction of artery
D. Right-side pmeumothorax
E. Edema of lungs
1671. At a patient 60 years with the third day after an exterpation uterus acute
insufficiency of breathing developed suddenly, a skin became at first cyanotic, and then
ash-colored color. Tachypnoe, cough with bloody sputum, retrosternal pain. BP –
100/70 mm. mercury, HR – 120, BR – 32 in 1 min., CVP – 300 mm wt.col. What most
reliable reason of worsening of the state of patient ?
A. * Tromboemboliya of pulmonary artery
B. Bleeding
C. Pain shock
D. Hypostatic pneumonia
E. Heart attack of myocardium
1672. At a patient in the ward of intensive therapy you marked appearance on the
monitor of fibrillation of ventricules. Your first actions?
A. * To conduct defibrillation three times
B. B To inject adrenalin
C. To inject a chloride
D. D To begin the closed massage of heart
E. To inject lidocain
1673. At a patient with concomitant cardiac insufficiency acutely the expressed
anaemia. Which from offered remedies for transfusion prevails?
A. * erithromass
B. fresh blood
C. fresh-frozen plasma
D. there are all right answers
E. all answers are faithful
1674. At a patient with the acute heart attack of myocardium best of all to warn
relapsing fibrillation of ventricles with :
A. cordaronum
B. lidocainum
C. ornidinum
D. * electrocardiostimulation
E. there is no right answer
1675.
A.
B.
C.
D.
E.
At anafilactic shock obligatory medicine are:
* antihistaminic facilities
adrenalin, ephedrine, mezaton
dobutamin
hormones
calcium
1676. At development of signs of toxic action digocsinum medical treatment includes
intravenous injection
A. verapamilum
B. * lidocainum
C. chlorid calcium
D. right A) and C)
E. faithful all answers
1677.
A.
B.
C.
D.
E.
At hypovolumic shock obligatory medicine are:
osmodiuretics
* infusion therapy (crystalloids +koloids)
adrenalin
doboutamin
hormones
1678. At medical treatment of atrioventricular block III, that developed after the heart
attack of myocardium, is intravenously used:
A. Lidocain
B. Propranolol
C. Novocainamid
D. * Izuprel
E. Metaraminol
1679.
A.
B.
C.
D.
At medical treatment of paroxysmal tachycardia it is not prescribed to apply
antagonists of beta-adrenoretseption
electric cardioversia
pressure on a carotid sine
* lidocain
E. verapamil
1680.
A.
B.
C.
D.
E.
At tamponade of heart is not observed
rise of central vein pressure
* noise of systole
cyanosis
paradoxical pulse
rise of pulmonary capillary pressure of wedging (PCWP)
1681. At the patient operated concerning the festering peritonitis coused by perforation
of gastric ulcer, in a postoperation period appeared: high temperature, frequency of
breathing 35/min., AP – 70/40 mm of merc. item, diuresis -20 ml/h temperature of body
to 39C., leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of chlorous
sodium and 0,8 of solution of reopoliglucin did not improve general condition. Central
vein pressure – 130 mm wt.st. For stabilization of hemodinamics will be optimum
infusion:
A. * Dopamin
B. Mezaton
C. Adrenalin
D. Noradrenalin
E. Ephedrine
1682. At the ventilated patient with the edema of lungs at low pressure and septic shock
intravenous infusion 7,5 mcg/kg/min dopamini will increase
A. RaO2, saturation of oxygen of the mixed vein blood, consumption of oxygen
B. diuresis
C. * cardiac systolic volume
D. right A) and B)
E. faithful all answers
1683.
A.
B.
C.
D.
E.
1684.
A.
B.
C.
D.
E.
1685.
A.
B.
C.
D.
At traumatic shock tactic of doctor on a prehospital stage:
providing of permeability of respiratory tracts and adequate ventilation of lungs
imobilisation extremities
infousion therapy
* analgesia
injection of vazopresors
. At which types of arrhythmia intravenous injection to potassium is effective?
Ventricular tahycardia
Nodular tahycardia
Ventricular extrasystolia
Supraventricular arrhythmia
* At all of indicated types of arrhythmia
Average time for persistence of post spinal headache is 4 hours
24 hours
* 3-4 days
3-4 weeks
E. 1 year
1686.
A.
B.
C.
D.
E.
1687.
A.
B.
C.
D.
E.
1688.
A.
B.
C.
D.
E.
1689.
A.
B.
C.
D.
E.
1690.
A.
B.
C.
D.
E.
1691.
A.
B.
C.
D.
E.
1692.
Cardiotoxic properties of hypercalciemia is taken off by application:
Adrenalin
Coffeinum
Ephedrine
* Molar solution of lactat natrium
10 % solution of glucose
Cardiotoxicity action of hypercalciumemia buys by application:
adrenalin
ephedrine
* preparations of calcium
a 10% solution of glucose
corticosteroid
Cauda Equina syndrome can be caused by
* Spinal anaesthesia
Epidural anaesthesia
Both
D.None
E.General anaesthesia
Characteristic signs for different types of shocks are:
Oppression of consciousness
* Lowering of arterial pressure
Lowering of shock index Algovera
Lowering TSVD
Oppression of breathing
Commonest Cranial nerve affected in spinal anaesthesia *2
3
4
D*6
10
Complication of epidural anaesthesia is except* Headache
Nausea
Hypotension
Bladder distension
Dizziness
Concerning Barbotage –
A.
B.
C.
D.
E.
1693.
A.
B.
C.
D.
E.
* Fluid (spinal) is alternately withdrawn and reinjected under pressure
Technique used Epidural Analgesia
Technique popularized in caudal Analgesia
Cannot be carried out under hypothermic condition
All of the above
Cranial nerve not involved in spinal anaesthesia * 1 and 10
3 and 6
2 and 4
7and 8
9
1694. During epidural analgesia the following points suggests that needle is in the
extradural space –
A. Loss of resistance sign
B. Negative pressure sign
C. Mackintosh extradural space indicator
D. * All of the above
E. Only A and C is true
1695. During the operation concerning strangular impassability of bowels, which
conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac
diyal-nosti happened 50 years in the moment of mesenretium streching by the surgeon.
What would prevent the stop of heart in this case?
A. * i/v injection atropin
B. i/v injection of cardiac glycozidis
C. Deepening of general anaesthesia.
D. Additional injection of relaxants
E. Additional injection droperidol
1696.
A.
B.
C.
D.
E.
1697.
A.
B.
C.
D.
E.
1698.
A.
B.
C.
D.
E.
ECG-sign of subendocardial myocardial ischemia is:
* rise of segment S-T higher to the izoelectrichniy line more than on 2 mm
decline of segment S-T below to the izoelectrichniy line more than on 2 mm
inversion of indent T
A, B, C
A, B
Effects of noradrenalinum:
Spasm of arteries and dilatation of veins
Expansion of arteries and spasm of veins
* Spasm of arteries and veins, except of coronal and cerebral vessels
Spasm of all arteries and veins
There is the no correct answer
Electrocardiostymulation is not prescribed at:
to the complete atrioventricular block
syndrome of weakness of sine knot with the attacks Morgani-Adams-Stocs
ciliary arrhythmia with rare contraction of ventricles
* bradiarhythmia, by the caused intoxication by cardiac glucoside
all answers are faithful
1699.
A.
B.
C.
D.
E.
1700.
A.
B.
C.
D.
E.
1701.
A.
B.
C.
D.
E.
1702.
A.
B.
C.
D.
E.
1703.
A.
B.
C.
D.
E.
1704.
A.
B.
C.
D.
E.
1705.
A.
B.
C.
D.
E.
Endotraheal it is possible to enter the following preparations, except for:
* noradrenalin
adrenalin
lidocain
atropine
oxybutirat
Epidural anesthesia is preferred to spinal anesthesia because –
Hypotension is absent
* Dura is not penetrated
Low dose of anesthetic is used
Level of block easily changed
Hypertension is present
Epidural blocks is indicated in all excpect* Patients in hypovolemia
Patients with asthma and bronchitis
Post-operative pain relief
Obstetric analgesia
In urologic surgery
Epidural morphine cause Miosis
Retention of urine
Abolishes pain
* All
None
Epidural narcotic is preferred over epidural LA because it causes –
Less respiratory depression
Not causes retention of urine
* No motor paralysis
Less dose required
Cardiac depression
First Fibres to be blocked at spinal anaethesia is –
Afferent motor nerve
Efferent motor nerves
* Sympathetic preganglonic
Sensory fibres
Parasympathetick nerve
First wich is paralised after spinal anaesthesia is
* Sympathetic
Parasympathetic
Motor
Sensory
Vision
For brachial plexus block needle is inserted –
A. Medial to subclavian artery
B. * Lateral to subclavian artery
1706.
C. Medial to subclavian vein
D. Lateral to subclavian vein
E. Inferior to subclavian vein
1707.
A.
B.
C.
D.
E.
For the Hypovolemia is not characteristic:
reduction of volume of circulatory blood
decline of BP, tahicardiya
reduction of shock volume and cardiac troop landing
* rise CVP
decline of pressure of filling of the left ventricle
1708. For the prophylaxis of cardiogenick shock it does not use at the acute heart attack
follow
A. beta-adrenoblocers
B. anaesthetizing, sedation
C. inhalation O2
D. beta-adrenostimulators
E. * all answers are not complete
1709.
A.
B.
C.
D.
E.
1710.
A.
B.
C.
D.
E.
1711.
A.
B.
C.
D.
E.
Geparin behaves to the group;
* Direct anticoagoulyants
Trombolitic facilities
Vasoconstrictors
Indirect anticoagoulyants
There is no right answer
High vein pressure, hypotension and acute circulation insufficiency, are at:
tense pneumathoracs
embolisms of pulmonary artery
to vein air embolism
* correctly A) and B)
right all answers
Hypotension at anaphylactic shock develops as a result of
* increase of permeability of vessels and loss of volume of intravascular liquid
losses of likable tone
frees of prostaglandini
bradicardia
all are right
1712. In 2 hours after renewal of cardial activity at a patient, that carried the sudden stop
of heart on a background hemorhagic shock (blood lost near 2,5 l) and is found on
ALV, unstable hemorhagia (AP – 80/40 – 90/60 mm of merc. item, tahycardia)is
marked, central vein pressure – 5 mm wt.st. It is related to:
A. * By Hypovolume syndrome
B. By cardia insufficiency
C. By the inadequate interchange of gases
D. Vasoplegia
E. By the inadequate anaesthetizing
1713. In a clinic a patient with the traumatic tearing of both lower extremities off at the
level of knee-joints is delivered. A patient is extremly inert, languid, pale, pulse 140
bmin, threadlike, AP 500. On both lower extremities there are the imposed plaits.
Bleeding at the receipt is not present. From the words of doctor of first-aid, lost about
3 litres of blood in place of event. What principal reason of heavy of the state of
patient?
A. * acute hemorrhage.
B. Pain shock.
C. S. Ishemia of extremities as a result of application of tourniquet
D. Fatty embolism
E. acute kidney insufficiency
1714. In acute convulsions due to toxicity to local anaethetic most important step in
immediate management is –
A. * Secure airway
B. Adrenaline
C. Atropine
D. IV short acting barbiturate
E. Diazepam IV
1715.
A.
B.
C.
D.
E.
1716.
A.
B.
C.
D.
E.
1717.
A.
B.
C.
D.
E.
1718.
A.
B.
C.
D.
E.
1719.
A.
B.
C.
D.
E.
In doing a phrenic nerve block, it is best to infiltrate
Scalenus anterior
Scalenus posterior
* Posterior border of sternomastoid
Anterior border of sternomastoid
Scalenus lateralis
In spinal anaesthesia the drug is deposited betweenDura and arachnoid
* Pia and arachnoid
Dura and vertebra
Into the cord substance
Dura and mild
In spinal anaesthesia, the first nerve fibre to get blocked is * Autonomic preganglionic fibres
Temperature fibres
Somatic motor fibres
Vibratory and proprioceptive fibres
Vegetates fibers
In spinal anaesthesia, the last fibres affected is * Pressure
Pain
Temperature
Touch
Somatic
In the case of Hypovolemia you should use remedies except :
preparates of plasma
cardiac glicozides
simpatomimetics
* beta-blocers
corticosteroids
1720. In the origin of hypererdinamic type of circulation of blood at patients with a
sepsis, acute bleeding the following reactions take part:
A. * shunting of circulation
B. centralization of circulation of blood
C. violations of microcirculation, disorders of tissue exchange
D. faithful all answers
E. right B,C
1721. In the treatment of presistent ventricular arrhythmias, the recommended infusion
rate of
A. lidocaineisB. 5.0 to 10.0 mg/min
C. 2.0 to 4.0 mg/min
D. * 0 to 1.5mg/min
E. 0.5 to 1.0 mg/min
1722.
A.
B.
C.
D.
E.
1723.
A.
B.
C.
D.
E.
In which space is intra cardiac adrenaline given –
Mid axillary line
Xiphisternum
2ICS leftside
* 4ICS left side
8ICS left side
Indicate the reason of ventricular extrasystolia:
Alcalosis
Hypocaliemia
Overdosage of glycosides
* The protracted prescribing of diuretics
All answers are faithful
1724. Intravenous injection of morfin at the cardiogenic edema of lungs can be attained
the following positive effects:
A. Venodilatation and decentralization of circulation of blood
B. sedatsii, reduction of frequency of breathing
C. unloading of small circle of circulation of blood
D. * right all answers
E. faithful all answers
1725.
A.
B.
C.
D.
E.
1726.
A.
B.
C.
D.
E.
Late medullary depression following epidural anesthesia may be caused by Fentanyl
Pentazocine
* Morphine
Buprenorphine
Analgin
Lengthening of interval R-R more than 0,2 sec is observed at:
Fibrillation of auricles
Sine bradycardia
Alternuous pulse
* cardial block 1
Bigemenia
1727.
A.
B.
C.
D.
E.
1728.
A.
B.
C.
D.
E.
1729.
A.
B.
C.
D.
E.
1730.
A.
B.
C.
D.
E.
1731.
A.
B.
C.
D.
E.
1732.
A.
B.
C.
D.
E.
1733.
A.
B.
C.
D.
E.
1734.
Lidocaine can be used in all except –
Ventricular fibrillation
Spinal anaesthesia
Epidural anaesthesia
* Convulsions
Local anaesthesia
Lidocaine can cause Cardiac arrest
Syncope
Convulsions
* All of the above
Myocardium infarction
Local anesthetics act byForming area of nerve block along a neuron
Binding to calcium receptor on nerve membrane
Blocking calcium chanels of nerve membrane
* Inhibiting the sodium pump
Blocking sodium chanels
Longest acting local anaesthetic solution isLignocaine
Chlorprocain
Amethocaine
* Bupivacine
Novocaine
Lumbar puncture is done in the following positions –
Rt. Lateral
Lt. Lateral
Sitting with head below flexed knees
* All of the above
None of above
Maximum dose of Xylocaine for local anaesthesia 200 mg
250mg
300mg
* 650mg
all doses are wrong
Medical treatment of anafilactic shock includes the use
adrenalin
antihistaminic preparations
neuroplegic
* right A) and B)
faithful all answers
Medical treatment of patient with acute left side ventricular insufficiency includes
A. ALV at the permanent promoted pressure
B.
C.
D.
E.
1735.
A.
B.
C.
D.
E.
1736.
A.
B.
C.
D.
E.
infusion of nitroglycerinum
ingibitor of fphosphodiesterase, furosemide
* all answers are faithful
right only A) and B)
Medicine of choice at paroxysmal supraventricular tachycardia is:
digocsin
lidocain
* izoptin
novocainamid
polarized mixture
Most common complication of spinal anaesthesia isPost spinal headache
Arrythmias
* Hypotension
Meningitis
Hypertension
1737. On a 4 day after incompatible (on a group) blood transfusion at a patient acutely
reduced diuresis, anuria developed, the common state became worse acutely, arterial
pressure rose. At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma 24 mmol/l. What illness and what stage of illness it follows to think about in the first
place?
A. * Acute kidney insufficiency, anuria
B. Anaphylactic shock, acute kidney insufficiency, anuria
C. Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
D. Posthemoragic acute kidney insufficiency, anuria
E. acute interstitsial nephritis, postrenal anuria
1738.
A.
B.
C.
D.
E.
Percentage of Xylocaine used in spinal anaesthesia1%
* 2%
3%
0,5%
6%
1739. Pharmacological medicine, that diminish the (afterload) left ventricle at a patient
with the acute heart attack of myocardium, are not included
A. nitroglycerine
B. fentolamin
C. nitroproussid sodium
D. * esmolol (brevibloc)
E. nifedipinum
1740.
A.
B.
C.
D.
E.
Pneumothorax is a complication of * Brachial plexus block
Epidural block
Axillary block
High spinal blook
Low spinal block
1741.
A.
B.
C.
D.
E.
1742.
A.
B.
C.
D.
E.
1743.
A.
B.
C.
D.
E.
1744.
A.
B.
C.
D.
E.
Post spinal headache can be prevented by * Thinner needle
Early ambulation
Induced hypotension
Decrease dose of local anaesthetic
Induced hypertension
Post spinal headache can last for1 to 2 hour
2 to 3 days3 to 7 days
* 2 to 3 weeks
1 year
Post spinal headache is due to Injury to spinal cord
* CSF leak from dura
Meningitis
Meningioma
Neurinoma
Properties of blood reology are fixed:
By viscidity of blood
By physical and chemical stability of suspenzion of uniform elements
By the state of vessels wall
* All answers are correct
There is no right answer
1745. Reliable reason of sudden shortness of breath, growth of pressure in jugular
veins, systolic and diastolic noise at a patient with an infectious endocarditis include
A. acute tamponade of heart
B. heart attack of myocarditis
C. * turn of leaf of mitral valve or break of aortic valve
D. aneurism of aorta, that rozsharovoue
E. there is no right answer
1746. Removing a pain syndrome at the urgent call concerning the acute heart attack of
myocardium is possible simpler than all:
A. * by injection of narcotic and unnarcotic analgetic
B. epidural analgesia
C. by inhalation of nitrous oxide, xenon with O2(1:1)
D. there is no right answer
E. all answers are faithful
1747.
A.
B.
C.
D.
E.
1748.
Shortest acting local anaesthetic is –
Procaine
Xylocaine
Bupivacaine
Amethocaine
* Chlorprocaine
Shortest acting local anesthetic -
A.
B.
C.
D.
E.
Procaine
Xylocaine
Bupivacaine
* Chlorprocaine
Novocaine
1749. Signs of local myocarditis recovering are represented best of all by the changes of
wave
A. P
B. Q
C. T
D. * R
E. S
1750.
A.
B.
C.
D.
E.
1751.
A.
B.
C.
D.
E.
1752.
A.
B.
C.
D.
E.
1753.
A.
B.
C.
D.
E.
1754.
A.
B.
C.
D.
E.
1755.
Spinal anaesthesia is preferred in lower abdominal surgeries becauseGives deep analgesia
Gives good relaxation of abdominal muscles
Patient is conscious and co-operative
* All of above
Intestines so that other viscera are seen well
Stretched neck veins in standing position are observed at
* tamponade of heart
tense pneumothorax
to pulmonary embolism
faithful all answers
right A) and B)
Subarachnoid block as anesthesia is contraindicated inIschemic heart disease ,
Burgers disease
Atherosclerotic gangrene
Full stomach
* Hemophilia
The acute cardiogenic edema of lungs is conditioned:
by the rise of hydrostatical pressure in pulmonary capillaries
by the promoted pulmonary capillary permeability
by insufficiency of the left ventricle
* A, B, C
faithful all answers
The basic sign of heart death is:
agonalni complexes
mechanical asistolia with saving of electric systole
electric asistolia during 30 min, not looking on cordial - pulmonary reanimation
and proper medical therapy
* isoelectric line on ECG during 15 min
all answers are faithful
The device suited for introducing epidural catheter is A. Mitchell needle
B.
C.
D.
E.
1756.
A.
B.
C.
D.
E.
1757.
A.
B.
C.
D.
E.
1758.
A.
B.
C.
D.
E.
1759.
A.
B.
C.
D.
E.
1760.
A.
B.
C.
D.
E.
Gordh needle
* Tuohy needle
Sise introducer
Nick needle
The dosage of biocarbonate of sodium in case of stopping of heart makes:
the first injection 1 mmol/Kg
the first injection 2 mmol/Kg
the repeated injections 0.5 mэcv/cg every 10 mines
* approximatelly 100 ml for each min of clinical death
faithful all answers
The duration of effect of spinal anaesthesia depends upon –
The site of injection
Quantity of drug injected
Type of drug used
* All the above
None of above
The effects of chiling in refrigeration analgesia includes –
Interference with conduction of nerve impulse
Reduction of metabolic rate and oxygen requirement
Inhibition of bacterial growth and infection
Retardation of healing
* All of the above
The following is not used when giving local anaesthesia in the fingers 2 % xylocaine
Rubber tourniquet
Ring block
* Adrenaline
Atropin
The forcing function of heart is supported:
By the normal level of energy exchange in myocardium
By the sufficient vein turning to the heart
By the compensate possibilities keeping
By the normal rhythm of heart
* All answers are faithful
1761. The injection of the following medicing may prevent the attack of paroxysmal
auricles tahycardia, except of :
A. * Izoproterenol
B. Mezatonum
C. Digitalis and hinidinum
D. Metocsaminum
E. Morphynum
1762.
The insufficiency of left ventricule can be caused:
A. * by insufficient flow of blood to the heart
B. by the overload volume of blood
C. by the decline of retractive power of myocardium
D. right only B) and C)
E. faithful all answers
1763. The most expressed positive inotropny effect at cardiogenic shock is observed at
injection of:
A. noradrenalinum
B. * dopaminum
C. digocsinum
D. isadrinum
E. ephedrinum
1764.
A.
B.
C.
D.
E.
The most frequent reason of embolism is:
Trauma
Cardial insufficiency
Aneurism
Atherosclerosis
* Fibrillation of auricle
1765. The patient 60 years is delivered in the department of intensive therapy with a
diagnosis: bite of bee, anafilactic shock.. Which medicine will be primary and most
effective?
A. * Adrenalin
B. Calcium the chloride
C. Prednizolon
D. Dimedrol
E. Suprastin
1766. The permission to use lidocainum in the process of cardiac-pulmonary
reanimation are:
A. * fibrillation of ventricles
B. electromechanics dissociation
C. fibrillation of atriums
D. right all answers
E. correctly only A and B)
1767.
A.
B.
C.
D.
E.
1768.
A.
B.
C.
D.
E.
The satisfactory oxygen capacity of blood is provided by hematocrit, not below
20-25%
* 30%
35%
40%
45%
The signs of acute heart attack of myocardium during anesthesia are:
Hypotensia
changes of ECG, arrhythmia
increase of pulse pressure
* right A) and B)
right A) and C)
The spinal cord terminates opposite-vertebra –
A. * Lumbar 1
B. Lumbar 2
1769.
C. Sacral l
D. Sacral 2
E. Thoracal 12
1770.
A.
B.
C.
D.
E.
1771.
A.
B.
C.
D.
E.
1772.
A.
B.
C.
D.
E.
1773.
A.
B.
C.
D.
E.
1774.
A.
B.
C.
D.
E.
1775.
A.
B.
C.
D.
E.
The stop of heart during unsynchronous defibrillation is linked
with direct damaging of myocardium
with the hit of impulse on the P wave of ECG
with the hit of impulse on ascending part of T wave
* with the hit of impulse on descending part of T wave
all answers are faithful
The unfavorable cardial effects of calcium are included
* increase of irritating of myocardium
decline of retractive power of myocardium
spasm of coronal vessels
faithful all answers
right all answers
To arrhythmias, that are accompanied by acute cardiac insufficiency, belong:
fibrilyatsiya of ventricles
complete atrioventricul block
high-frequency trembling of atriums
faithful all answers
* right all answers
Vital capacity of the lung is very low in –
Prone
* Lithotomy
Trendelenberg
Supine
Back
What is represented on a picture ?
* Punction of v. subclavia
Anaesthesia by Coulencampf
Punction of pleura for liquidation of hemothorax
Applying of heart rhythm driver
Punction of pleura for liquidation of pneumothorax
What medicine is using for medical treatment of atrio-ventricular block III?
Lidocain
Inderal
Novocainamid
* Izuprel
There is no right answer
1776. What must be applied from following during haemotransfusion for saving of
blood properties, that take part in coagulation?
A. Warmed-up blood
B. Calcium
C. Oxygen
D. Blood of two-week remoteness
E. * Fresh blood
1777.
A.
B.
C.
D.
E.
What type of hypoxia changes greatly oxygen satiation of arterial blood ?
Circulatoric
Anaemic
* Hypoxic
Tissue
There is no right answer
1778. What type of imunoglobulins take part in the anafilactic reaction of immediate
type:
* Imunoglobulin E
B. Imunoglobulin M
C. Imunoglobulin A
1779.
A.
B.
C.
D.
E.
1780.
A.
B.
C.
D.
E.
1781.
A.
B.
C.
D.
E.
1782.
A.
B.
C.
D.
E.
When fibrillation will not be effective?
At wrong situation of electrodes
At inadequate ventilation of lungs
acidosis
* When the previous massage of heart was uneffective
All answers are faithful
Which of medicines are most contra-indicated at ventricular tahycardia
Digitalis
Hinidinum
Novocainamid
* Calcium
Novocaine
Which of the following changes on ECG is typical for hypercaliemia?
fibrillation of ventricules
fibrillation of auricles
* High and narrow indent T
Decline of indent T and appearance of indent V
Decline of segment S-T
Which of the following is used to produce epidural analgesia* Fentanyl
Morphine
Fortwin
Piroxican
Analgin
Situational tasks
1. A patient on meningococcemia had signs of syndrome of Waterhouse-Fridrikson.
What method of therapy can be considered on pathogenetic ground?:
A. *A. high dose of GKS (5-10 mg/kg of prednizon and more)
B. piracetam
C. Inhibitors of protease
D. Heparinum
E. Cardiac glycoside
2. Ambulance was called to teenager. In his anamnesis is diabetes mellitus. It is
observed weakness, pallor, loss of consciousness. Objectively: consciousness absents,
a skin is pale, "marble", extremities are cyanochroic, cold, sweating. Periodically are
convulsive tremor, breathings, superficial, frequent; takhikardiya, from a mouth is a
smell of alcohol. Specify, what medicine it is necessary immediately to inject a
patient intravenously:
A. *A. 40% solution of glucose 40 ml
B. Insulin of short action in a dose 0,1 ED/kg
C. a 0,9% solution of chloride of sodium is in the dose of 20 ml/kg
D. a 0,45% solution of chloride of sodium is in a 5% solution of glucose
E. Naloxonum in a dose 0,1 mg/kg
3. Ambulance was called to unconsious person. It was established absence of breathing.
Sign of effective artificial ventilation of lungs:
A. *A. excursion of thorax;
B. Narrowing of pupils
C. Noise at insufflation of air ;
D. Thrusting out of epigastral area is at insufflation;
E. Dizziness” of anesthesiologist
4. Ambulance was called to unconsious person. It was established clinical death. Sign of
stop of cardiac activity:
A. *A. Dilatation of pupils
B. Sudden loss of consciousness
C. Cyanosis of skin
D. A pulse above a radial artery is arrithmical
E. Absence of arteriotonus
5. Ambulance was called to unconsious person. It was established clinical death. For
endocardial injection of medications a needle is pricked:
A. *A. In 4th intercostal spase, on 1-2 sm on the left of breastbone
B. In 5th intercostal spase, in the point of projection of apex of heart
C. In 3th intercostal spase, on the left of breastbone
D. On the lower edge of 4th cost., on the left of breastbone
E. In the place of projection of cardiac shove
6. Ambulance was called to unconsious person. It was established clinical death. Each
next charge of bipolar defibrilator should be increased on ?
A. *A. 500 W
B. 250 W
C. 200W on 1 kg of mass of body
D. 1000 W
E. Charge can not be promoted
7. Ambulance was called to unconsious person. It was established clinical death. During
CPR soluble-sodium bicarbonate is used with with a purpose:
A. *A. Decreasing of metabolic acidosis
B. Warning of development of metabolic acidosis
C. An increase of time of survival of cerebrum in the conditions of hypoxia
D. Liquidations of hypoxia
E. To influence on the curve of dissociation of oxyhemoglobin
8. Ambulance was called to unconsious person. It was established clinical death. What
is the most credible laboratorical index of blood for patients after the real sinking in
fresh water?
A. *A. hyperkaliemia
B. High hemoconcentration indexes
C. High level of transaminases
D. High level of urea, creatine
E. Hypernatremia
9. For a patient observed increasing weakness, decline of appetite, pain in joints with
appearance of icterus on 4th day. The temperature of body is normal. Liver is
enlarged by 2,5 sm. After 3 days of therapy the state was worsened: there were
anorexia, vomiting, somnolence, pain in right chest, petechial rash. Size of liver
diminish, symptoms of irritation of peritoneum were not esteblished What
complication we can think of?:
A. *A. acute hepatic insufficiency
B. Sharp cholecystitis
C. Sharp holecistopancreatitis
D. Sharp kidney insufficiency
E. Rosacea
10. In postpartum period of patient T.,conducted scraping of walls of uterus cavity
concerning post-natal metroendometriasis on a background of necrosis of decidual
layer, complication appeared with sudden decline of AP to 80/50 mmhg., Pulse of
110 min. Skin is pale, covered with sticky death-damp. The uterine bleeding absent.
What should we begin the first aid from ?
A. *A. artificial ventilation of lungs
B. infusion therapy
C. Antibacterial therapy
D. Support of cardiac
E. Laparotomia with next extraction of uterus
11. Patient , 30 years old, was transferred to the to the infection department with a
diagnosis: food toxicoinfection. Nausea, vomit increased during the first day.
Conscious, skin covers are dry, rough by touch, col The lines of person are sharp,
eyes hollow, eyeballs are soft. Breathing is noisy, as Kusmaull, strong smell of aceton
in mid air. Tones of heart are deaf. Pulse is 93 for a minute, BP is 90/60 mm mer Er
5,2*1012/l, Hb – 131 g/l . Glukose of blood 22 mmol/l. Glucose, ketonic bodies are
determined in urin Your most first actions?
A. *A. Insulin 0,1 U/kg (aktrapid) on a 0,9% solution of NaCl
B. Glibenclamidis
C. 0,1 U/kg of ultralong insulin on 0,9% Nacl
D. Washing of stomach
E. IV 1% - 1 ml solution of mezatoni
12. Patient , 52 years old, hospitalized with the heavy form of viral hepatitis . The signs
of flu appeared in permanent establishment. During a day the indexes of
transamynases and bilirubinum rosed sharply. What complication of viral hepatitis
can arise up for a patient?
A. *A. acute hepatic insufficiency
B.
C.
D.
E.
Electrolyte comma
Gastric bleeding
Mechanical icterus
Cerebral comma
13. Patient L is hospitalised in gynecological department with the temperature of 39
degrees C, with complaints of pain in the bottom of stomach, vomit, diarrhea.
Criminal abortion have been done 4 days befor AP 80/60, breathing is difficult,
psychosomatic excitation. Symptom of Schotkin-blumberg is positiv Uterus is
enlarged as on 9 weeks of pregnancy, limitedly mobile, painless. Pus with blood
appeare Your Diagnosis?
A. *A. septic shock
B. Perforation of uterus
C. Pelvic peritonitis
D. Acute appendicitis
E. Acute adnexia inflammation
14. Patient M, 44 years old, admited to the infectious isolation with a diagnosis:
Leptospirosis. On 7th day of treatment his state was sharply worsened, pain appeared
in lumbar region, somnolence, sickliness, cramps, head pain, diuresis diminished to
100 ml/day.blood: RBC -2,6*1012/L, Creatinine - 438 mkmol/l, urea - 13,0 mmol/l.
What complication developedin patient?
A. *A. acute kidney insufficiency
B. Sharp hepatic insufficiency
C. Chronic pyelonephritis
D. Ischemic stroke
E. MI
15. Patient N., 28 years ol 6 day after the complicated births. The clinical hematological
signs of subacute disseminate intravascular coagulation syndrome developed after
skin hemorrhage and uterine bleeding. The state of patient is very ba blood: Er-2,7 of
T/l, Hb-78 of gm/l, CI - 0,93, L-4,7 of Gm/l, thrombocytes-88 of gm/l, time of blood
cloating - 16 min, prothrombin time - 25 sec, ethanol test +, fibrinogen-1,4 gramme/l,
What preparations should be prescribed ?
A. *A. plasma
B. Heparinum
C. Reopoliglycin
D. Cryoprecipitate
E. U-aminokapric acid
16. The patient 20 years old, delivered to ambulance department on the 2nd day of illness
in a grave condition: temperature of body 39°c, symptoms of intoxication are
expresse On extremities, trunk, buttocks, present hemorrhagic rash as eczema with
necrosis in the center. One day before cut his leg. Now has the wound in that plac In
2 hours the decline of AP is registered from 100/70 to 60/30 mm of Hg, diffused
cyanosis. Application of prednisolon of 120 mg and reopoliglycin did not give any
effect. What complication does it follow to think about?
A. acute sub renal failure
B. *B. Septic shock
C. hipovolemic shock
D. Hemorragic shock
E. Respirator distress syndrom of adults
17. To the terminal states belong:
A. *A. pre-agony, terminal pause, agony, clinical death
B. Agony, clinical and biological death
C. Commas, agony, clinical death
D. Pre-agony, agony, clinical, social death;
E. Lowering of AT is to 80 mm of rt.st., comma, clinical death.
18. . You should perform CPR to patient The best place of performing of closed
massage of heart by hands:
A. *A. over lower third of breastbone, fingers parallel to the ribs
B. On breastbone, by fingers to the chin
C. On middle third of breastbone
D. In 4 subcostal space on the left of breastbone
E. On a thorax, in the place of projection of apex of heart.
19. You should perfrm CPR to patient During artificial respiration by method “mouth to
the mouth” it is need to blow air in volume:
A. *A. 800-1100 ml
B. 500-700 ml
C. 1200-1600 ml
D. 1700-2000 ml;
E. To carry out maximal inhalations
20. You should perfrm CPR to patient L. Clinical death lasts :
A. *A. 4-5 minutes;
B. 1-3 minutes
C. 5-7 minutes
D. To 10 minutes
E. 7-12 minutes
21. You should perfrm CPR to patient N. All the below signs are the signs of of clinical
death except:
A. *A. arterial pressure is not determined
B. Absence of pulsation above femoral artery
C. Absence of breathing
D. pupils are irresponsive to light;
E. Absence of pulsation on carotid artery.
22. A patient 25 years is hospitalized in the surgical department with a diagnosis:
penetrable wound of abdominal region. Objectively: it is excited, skin covers and
visible mucous shells are pale; peripheral pulse of the weak filling, frequent, AP –
110/60 mm mercury Positive symptom of ”desolation” of peripheral hypodermic
veins. Diuresis is decreased. How to characterize this state?
A. *A. The compensated shock
B. Preagonia
C. Circulating shock
D. Agony
E. Irreversible shock
23. 2. A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the
surgical department with complaints on vomiting by "coffee-grounds", diarhea,
moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a
tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25
ml/h. Blood test: Er. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in
medical treatment:
A. *A. solutions with colloid
B. 5% solution of glucose
C. Whole blood
D. Red corpuscles mass
E. Colloid solutions with red corpuscles mass
24. :A patient entered the department with a diagnosis: acute intestinal impassability.
Complaints: insignificant thirst, dizziness at an attempt to get up from a be at a
review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with
cracks. Pulse – 110 min., AP – 80 /60 mm of mer item, diuresis – 25 ml /h.
Electrolyte composition: Na+ - 142 mmol/l, C+ - 4 mmol/l, glucose – 6 mmol/l, urea
– 7 mmol/l. What variant of infusion is most expedient during operation?
A. *A. Transfusion of crystalloids.
B. Transfusion of solution of glucos
C. Transfusion of albumen.
D. Transfusion of native plasm
E. Transfusion of poliglucin.
25. A patient is in the intensive care unit during a week. 4 days ago a level of
consciousness was on a Glasgow coma scale - 8 ball, now makes 3 ball. Verification
of level of consciousness was conducted during 6 hours, a dynamics absents, death of
cerebrum was diagnose. How correctly a leadthrough of establishment of such
diagnosis was?
A. *A. for establishment of diagnosis of death of cerebrum the presence of
complex of clinical criteria is needed, duration of supervision must be no less
than 12 hours for the primary defeat of brain and 24 for the second defeat;
B. all was conducted right. A main criterion is a negative dynamics of level of
consciousness, and depth of coma 3 ball on a Glasgow coma scale;
C. no, For establishment of diagnosis the level of consciousness does not matter.
Basic are results of laboratory tests;
D. all was conducted right. It was enough monitoring during 3 hours.
E. no,. For establishment of diagnosis of death of cerebrum a presence is needed
complex clinical criteria, duration of supervision must be no less than 48
hours for the primary defeat of brain and 72 for the second defeat.
26. A patient, 28 years, 2 hours ago fell down from the ground floor of hous Sopor,
pale, there are the plural scratches of face, the lacerated hemorhagic wounds on the
left forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l,
Hb – 100, AP – 90/40 mm of rt. item In the blood test: red corpuscles – 3,5 g/l. What
medicine for i/v injection does not need to be used for medical treatment of shock?
A. *A. 5% solution of glucose
B. Solution of crystalloids
C. Solutions gelatin
D. Solutions of calcium
E. Solution of albumen
27. Anafilactic shock appeared at a patient. The state heavy and progressively gets
worse. HBA – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for
the rescue of life of patient above all things?
A.
B.
C.
D.
E.
*A. Adrenalin.
Chloride of calcium.
Prednizolon.
Dofamin.
Suprastin.
28. At a patient 20 years on a background the injection of vitamin B1 suddenly there was
excitation, fear of death, falling of AP to 50 mm rt.st., hard breathing. Which of
medicine it is necessary to inject firstly?
A. *A. Adrenalin
B. Prednizolon
C. Calcium
D. Dimedrol
E. Eufilin
29. At a patient in the ward of intensive therapy you marked appearance on the monitor
of fibrillation of ventricules. Your first actions?
A. *A. To conduct defibrillation three times
B. To inject adrenalin
C. To inject a chloride
D. To begin the closed massage of heart
E. To inject lidocain
30. At a patient with the acute heart attack of myocardium in the region of partition on a
5th day after the brief episode of loss of consciousness there is reduction of
frequency of pulse to 32 in a minut BP - 80/40 mm Consciousness at the level of
sopor. He immediately needs :
A. to put right a craniocerebral hypothermia, to enter lasics, prednisoloni,
cerebrolizini
B. an atropine, eufilin
C. *C. to conduct urgent cardiostimoulation
D. all answers are faithful
E. there is no right answer
31. At a patient with the acute heart attack of myocardium best of all to warn relapsing
fibrillation of ventricles with :
A. cordaronum
B. lidocainum
C. ornidinum
D. *D. electrocardiostimulation
E. there is no right answer
32. At a patient, carried to a 2 year ago the heart attack of myocardium, the acute decline
of cholecystyties planned cholecystectomy, signs of electric instability of
myocardium . Actions of anaesthesiologist must include:
A. injection of prednisoloni, lidocaini, hyperventilation, take the ECG
B. *B. injection of dopamini, after stabilisation of BP - nitroglycerine + infusion
therapy under the control CVP, conducting of neurovegetative defence, take
the ECG
C. injection of streptodecasol, stream infusion of reopoliglyocinum, injection of
lidocainum, increase of dose of analgetics
D. correctly A) and C)
E. all answers are faithful
33. At a patient, that is found on medical treatment in the therapeutic department, the
sudden stopping of circulation of blood happene Medical personnel begun the
reanimation measures. Define the most rational way of injection of adrenalin for
renewal of heart abbreviations in default of vein access:
A. *A. 3 ml solution of adrenalin in a trachea
B. 1 ml solution of adrenalin in muscl
C. adrenalin in muscle, multiplying a dose in 3 times.
D. intracardial injection.
E. adrenalin could not be injected
34. At a patient, that is found under the permanent electrocardioscopic supervision,
microwave fibrillation of myocardium and diagnosed clinical death develope It is
necessary to do:
A. to inject the solution of calcium in cor
B. *B. to conduct high-voltage electric defibrillation
C. to inject solution of atropine in cor
D. to inject solution of adrenalin in cor
E. All answers are wrong
35. At the patient operated concerning the festering peritonitis coused by perforation of
gastric ulcer, in a postoperation period appeared: high temperature, frequency of
breathing 35/min., AP – 70/40 mm of mer item, diuresis -20 ml/h temperature of
body to 39 , leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of
chlorous sodium and 0,8 of solution of reopoliglucin did not improve general
condition. Central vein pressure – 130 mm wt.st. For stabilization of hemodinamics
will be optimum infusion:
A. *A. Dopamin
B. Mesaton
C. Adrenalin
D. Noradrenalin
E. Ephedrine
36. At the ventilated patient with the edema of lungs at low pressure and septic shock
intravenous infusion 7,5 mcg/kg/min dopamini will increase
A. RaO2, saturation of oxygen of the mixed vein blood, consumption of oxygen
B. diuresis
C. *C. cardiac systolic volume
D. right A) and B)
E. faithful all answers
37. During the operation concerning strangular impassability of bowels, which
conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac
function happened 50 years in the moment of mesenretium streching by the surgeon.
What would prevent the stop of heart in this case?
A. *A. i/v injection atropin
B. i/v injection of cardiac glycozidis
C. Deepening of general anaesthesia
D. Additional injection of relaxants
E. Additional injection droperidoli
38. In postpartum period of patient T.,conducted scraping of walls of uterus cavity
concerning post-natal metroendometriasis on a background of necrosis of decidual
layer, complication appeared with sudden decline of AP to 80/50 mmhg., Pulse of
110 min. Skin is pale, covered with sticky death-damp. The uterine bleeding absent.
What should we begin the first aid from ?
A. *A. artificial ventilation of lungs
B. infusion therapy
C. Antibacterial therapy
D. Support of cardiac extrass
E. Laparotomia with next extraction of uterus
39. It is typical for:
A. *A. Negative CVT
B. Erroneous punction of artery
C. Right-side pmeumothorax
D. Edema of lungs
E. Hypodermic emphysema
40. On a 4 day after incompatible (on a group) blood transfusion at a patient acutely
reduced diouresis, anuria developed, the common state became worse acutely. At
laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma - 24 mmol/l.
What illness and what stage of illness it follows to think about in the first place?
A. *A. Acute kidney insufficiency, anuria
B. Anaphylactic shock, acute kidney insufficiency, anuria
C. Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
D. Posthemoragic acute kidney insufficiency, anuria
E. acute interstitsial nephritis, postrenal anuria
41. On an enterprise with plenty of workers educational practical work is conducted on
the leadthrough of cardiopulmonary reanimation. It is foremost needed to teach the
workers of «chain of survival», which plugs in itself:
A. forming from the people chain on which will be passed to instruction in
relation to correct implementation of urgent measures;
B. set of tools and medical preparations for a grant to the first aid at clinical
death;
C. the «chains of survival» study only in the specialized higher educational
establishments with the receipt of the special diploma for its use;
D. immediate informing of guidance of establishment and direct chief of victim,
bringing in to the reanimation of the medical cabinet, deliveries of patient to
the nearest medical establishment.
E. *E. early activating of service to medical first-aid, early beginning of
elementary sustentation, early defibrillation by automatic external
defibrillator, early beginning of further sustentation.
42. Patient 20 years for verification of the functional state of kidneys the X- ray
examination with v/v injection of cardiotrast is conducte At the end of injection the
state of patient acutely became worse, the shortness of breath, hyperemia of skin, AP
– 60/20 mm, HBA – 132/min. A similar research was conducted 3 months ago, such
effects were not observed. What most reliable diagnosis?
A. *A. Medicinal anafilactic shock
B. Acute kidney insufficiency
C. Tromboembolism of pulmonary artery
D. Stress on the conducted manipulation
E. Heart attack miocardium
43. Patient 30 years after a road-transport failure complaints of the acute tahypnoe Obly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax, stomach,
right side of the neck. Auscultative: breathing on the right side is not conducted; pulse
– 130/min., AP – 80/60 mm.mercury., CVP – 140 mm., FB – 30 /min., Ht – 0,27, Hb
– 90 g/l. Subsequent therapy must include above all things:
A. *A. punction of pleura cavity.
B. Urgent ALV
C. Massive infusion therapy of the crystalloid solutions
D. Infusion of dofamin, 2-5 mcg/cg/min
E. 100% oxygen
44. Patient 38 years, native plasma was poure. At the end of infusion the state became
worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36
on 1 min., AP – 70/40 mm of mer item, whistling dry wheezes. Which from the
following mediceni must be injected firstly?
A. *A. Adrenalin.
B. Eufilin.
C. Suprastin.
D. Noradrenalin.
E. Prednizolon.
45. Patient, 40 years, with the trauma of both thighs is delivered from the scene of
accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of
the neck, tahypnoe, AP 60/40 mm mer st., HBA=120 /min, in lungs moist wheezes,
diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses most reliable?
A. *A. Fatty embolism
B. Traumatic shock
C. Hemorhagic shock
D. Pain shock
E. Tromboembolism
46. The patient 32 years have infusion of native plasm At the end of infusion the state
became worse: disorientation, cyanosys, excitation, appeared hypersalivation,
tahypnoe, AP =70/40 mm mer st., in lungs – the dissipated dry wheezes. What
medicine must be injected firstly?
A. *A. Adrenalin.
B. Suprastin.
C. Gidrocortizon.
D. Dopamin.
E. Eufilin.
47. The patient 60 years is delivered in the department of intensive therapy with a
diagnosis: bite of bee, anaphylactic shock.. Which medicine will be primary and most
effective?
A. *A. Adrenalin
B. Calcium the chloride
C. Prednizolon
D. Dimedrol
E. Suprastin
48. The patient of 2 days carried the state of clinical death back. During the first days of
postasystolic period the state was stabilized with a tendency to the improvement.
Now there is worsening of the state, hypoxemia of PaO2 65 mm Hg, shortness of
breath to 30 per min., tachycardia, high blood pressur What conclusions can be
done?
A. postasystolic illness begins;
B. cardiopulmonary reanimation conducted inadequately;
C. *C. ІІІ stage of postasystolic illness;
D. for a patient chronic pathology was intensifyed;
E. the fever of lungs makes progress for a patient.
49. To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of
correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was
conducted. A doctor went out from a chamber after conducting of necessary tests
before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient
without consciousness. The cyanosys of upper body part. Irregular breathing with the
selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on
peripheries and arterial pressure are not determine Tones of heart are deaf,
unrhythmical. An ampoule and transfusion system is empty. What complication arose
up as a result of hemotransfusion?
A. *A. Air embolism of pulmonary artery
B. Tromboembolism of pulmonary artery
C. Edema of lungs
D. Heart attack of myocardium
E. Syndrome of massive hemotransfusion
50. To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v was
quickly injected. Tahycardiya, arterial hypotension, cyanosys, shortness of breath
appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.st.
acute insufficiency of what part of the cardial-vascular system is observed at a
patient?
A. Right ventricle of heart
B. *B. The left ventricle of heart
C. Both ventricles of heart
D. Vessels
E. Uneffective heart
51. Patient 30 years after a road-transport failure complaints of the acute tahypnoe. Obly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax, stomach,
right side of the neck. Auscultative: breathing on the right side is not conducted; pulse
– 130/min., AP – 80/60 mm.mercury., CVP – 140 mm wt., FB – 30 /min., Ht – 0,27,
Hb – 90 g/l. Subsequent therapy must include above all things:
A. *A. punction of pleura cavity.
B. Urgent ALV
C. Massive infusion therapy of the crystalloid solutions
D. Infusion of dofamin, 2-5 mcg/cg/min
E. 100% oxygen
52. A patient 25 years is hospitalized in the surgical department with a diagnosis:
penetrable wound of abdominal region. Objectively: it is excited, skin covers and
visible mucous shells are pale; peripheral pulse of the weak filling, frequent, AP –
110/60 mm mercury. Positive symptom of ”desolation” of peripheral hypodermic
veins. Diuresis is lowered. How to characterize this state?
A. *A. The compensated shock
B. Preagonia
C. Circulating shock
D. Agony
E. Irreversible shock
53. A patient 25 years is hospitalized in the surgical department with a diagnosis:
penetrable wound of abdominal region. Objectively: it is excited, skin covers and
visible mucous shells are pale; peripheral pulse of the weak filling, frequent, AP –
110/60 mm mercury Positive symptom of ”desolation” of peripheral hypodermic
veins. Diuresis is lowered. How to characterize this state?
A. *A. The compensated shock
B. Preagonia
C. Circulating shock
D. Agony
E. Irreversible shock
54. A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical
department with complaints on vomiting by "coffee-grounds", diarhea, moderately
expressed thirst. Objectively: a skin is pale, covered by a death-damp, a tongue is dry,
AP – 80/60 mm rt.st., HR – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test:
Er. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in medical treatment:
A. *A. solutions with colloid
B. 5% solution of glucose
C. Whole blood
D. Red corpuscles mass
E. Colloid solutions with red corpuscles mass
55. A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical
department with complaints on vomiting by "coffee-grounds", diarhea, moderately
expressed thirst. Objectively: a skin is pale, covered by a death-damp, a tongue is dry,
AP – 80/60 mm rt.st., HR – 120/min., BF – 28/min., diuresis – 25 ml/h. Blood test:
Er. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in medical treatment:
A. *A. colloid solutions
B. 5% solution of glucose
C. Whole blood
D. Red corpuscles mass
E. Colloid solutions with red corpuscles mass
56. A patient 48 years the second day in dpartment of intensive therapy concerning the
acute front-partition heart attack of myocardium. During a review “wheezing”
suddenly, non-permanent tonic constricting of muscles is marked, pupils are
extended, pulse on a. carotis is absent. What doctor have to do in the first place?
A. *A. Triple Safar method
B. Record of ECG
C. Cardial hit in the area of heart
D. Artificial respiration by the method of Silvester
E. Intracardial injection of adrenalin with an atropine
57. A patient entered the department with a diagnosis: acute intestinal impassability.
Complaints: insignificant thirst, dizziness. At a review: patient apathetical, turgor is
lowered, eyeballs are soft, tongue is dry with cracks. Pulse – 110 min., AP – 80 /60
mm of mer item, diuresis – 25 ml /h. Electrolyte composition: Na+ - 142 mmol/l, C+
- 4 mmol/l, glucose – 6 mmol/l, urea – 7 mmol/l. What variant of infusion is most
expedient during operation?
A. *A. Transfusion of crystalloids.
B. Transfusion of solution of glucos
C. Transfusion of albumen.
D. Transfusion of native plasma.
E. Transfusion of poliglucin.
58. A patient with a traumatic shock AP – 60/0 mm mercury, HR – 90 /1 min. Define a
shock index:
A. *A. 1,5
B. 2,5
C. 1,5
D. 0,5
E. 0,3
59. A patient, 28 years, 2 hours ago fell down from the ground floor of hous Sopor, pale,
there are the plural scratches of face, the lacerated hemorhagic wounds on the left
forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l, Hb –
100, AP – 90/40 mm of rt. item In the blood test: red corpuscles – 3,5 g/l. What
infouziyniy serednic does not need to be used for medical treatment of shock?
A. *A. 5% solution of glucose
B. Solution of crystalloids
C. Solutions gelatin
D. Solutions of calcium
E. Solution of albumen
60. Anafilactic shock appeared at a patient. The state heavy and progressively gets wors.
HR – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the rescue
of life of patient above all things?
A. *A. Adrenalin.
B. Chloride of calcium.
C. Prednizolon.
D. Dofamin.
E. Suprastin.
61. At a patient, that is found on medical treatment in the therapeutic department, the
sudden stopping of circulation of blood happened. Medical personnel begun the
reanimation measures. Define the most rational way of injection of adrenalin for
renewal of heart abbreviations in default of vein access:
A. *A. To enter to a 3 ml solution of adrenalin in a trachea.
B. To enter to a 1 ml solution of adrenalin in muscl
C. To enter adrenalin in muscle, multiplying a dose in 3 times.
D. The intracardial injection.
E. Adrenalin can be not entered.
62. In a clinic a patient with the traumatic tearing of both lower extremities off at the
level of knee-joints is delivered. A patient is extremly inert, languid, pale, pulse 140
bmin, threadlike, AP 50/0. On both lower extremities there are the imposed plaits.
Bleeding at the receipt is not present. From the words of doctor of first-aid, lost
about 3 litres of blood in place of event. What principal reason of this?
A. *A. Acute hemorrhage
B. Pain shock.
C. Ishemia of extremities as a result of application of tourniquet
D. Fatty embolism
E. acute kidney insufficiency
63. . It is typical for:
A. *A. Negative CVT
B. Erroneous punction of artery
C. Right-side pmeumothorax
D. Edema of lungs
E. Hypodermic emphysema
64. On a 4 day after incompatible (on a group) blood transfusion at a patient acutely
reduced diouresis, anuria developed, the common state became worse acutely. At
laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma - 24 mmol/l.
What illness and what stage of illness it follows to think about in the first place?
A. *A. Acute kidney insufficiency, anuria
B. Anaphylactic shock, acute kidney insufficiency, anuria
C. Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
D. Posthemoragic acute kidney insufficiency, anuria
E. acute interstitsial nephritis, postrenal anuria
65. On a 4 day after incompatible (on a group) blood transfusion at a patient acutely
reduced diouresis, anuria developed, the common state became worse acutely, arterial
pressure ros At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma 24 mmol/l. What illness and what stage of illness it follows to think about in the first
place?
A. *A. Acute kidney insufficiency, anuria
B. Anaphylactic shock, acute kidney insufficiency, anuria
C. Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
D. Posthemoragic acute kidney insufficiency, anuria
E. acute interstitsial nephritis, postrenal anuria
66. Patient 20 years for verification of the functional state of kidneys the X- ray
examination with v/v injection of cardiotrast is conducte At the end of injection the
state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch
appeare AP – 60/20 mm of mer item, HR – 132/min. A similar research was
conducted 3 months ago, such effects were not observe. What most reliable
diagnosis?
A. *A. Medicinal anafilactic shock
B. Acute kidney insufficiency
C. Tromboembolism of pulmonary artery
D. Stress on the conducted manipulation
E. Heart attack miocardium
67. Patient 20 years for verification of the functional state of kidneys the X- ray
examination with v/v injection of cardiotrast is conducted. At the end of injection the
state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch
appeare AP – 60/20 mm of mer item, HR – 132/min. A similar research was
conducted 3 months ago, such effects were not observe What most reliable diagnosis?
A. *A. Medicinal anafilactic shock
B. Acute kidney insufficiency
C. Tromboembolism of pulmonary artery
D. Stress on the conducted manipulation
E. Heart attack miocardium
68. Patient 38 years, native plasma was poure At the end of infusion the state became
worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36
on 1 min., AP – 70/40 mm of mer item, whistling dry wheezes. Which from the
following mediceni must be injected firstly?
A. *A. Adrenalin.
B. Eufilin.
C. Suprastin.
D. Noradrenalin.
E. Prednizolon.
69. Patient 40 years with the acute gastro - intestinal bleeding a canned blood was poured
in a volume 400 ml after conducting of all tests on compatibility. After
hemotransfusion the state of patient became worse, appeared head pains and pains in
muscles the temperature of body rose to 38,8 What can explaine the state of patient?
A. Pirogenic reaction of middle heavy
B. *B. By development of hemotransfusion shock
C. Alergic reaction
D. By development of bacterial-toxic shock
E. By air embolism
70. Patient 62 years the third day of presense in department of intensive therapy
concerning the acute transmural heart attack of myocardium of front-partition
localization. At night woked up from a suffocating cough, feeling of fear and trouble.
At a review: cyanosys, FB – 30 after 1 min., HR – 132/ min., a rhythm is correct,
tones of heart are deaf, accent ІІ tone above a pulmonary artery, AP – 180/110 mm
mercury. There is the loosened breathing above lungs with the far of moist wheezes
in lower fates. What probably became the reason of worsening of the state?
A. *A. Edema of lungs
B. Embolism of pulmonary artery
C. The repeated heart attack miocardium
D. Hypertensive crisis
E. Attack of bronchial asthma
71. Patient N., 40 years, groom. In anamnesis there is an allergy to nonsteriidal
antiinflammatory. After injection of antitetanus on a method Besredco concerning the
hammered wound of right shin, through 20 min, there was a acute weakness,
labouring breath, through 10 min, loss of consciousness. What mechanism of
development of anafilactic form of illness?
A. *A. Sensitization to the albumen of horse whey
B. Low quality of horse whey
C. Breach of the technique of PPS injection
D. Presence in anamnesis of medical allergy
E. Infection of whey
72. Persons 48 years, patient by the heart attack of miocardium, suddenly lost
consciousness, breathing and palpitation. On ECG of highwave fibrilation of
ventricules. Conducted defibrilation. Did not pick up normal cardial activity. What
medicine needs to be entered for the rise of sensuality to defibrillation?
A. *A. Amiodaron
B. Propranolon
C. Lidocain
D. Strofantin
E. Atropini sulfati
73. The patient 60 years is delivered in the department of intensive therapy with a
diagnosis: bite of bee, anafilactic shock.. Which medicine will be primary and most
effective?
A. *A. Adrenalin
B. Calcium the chloride
C. Prednizolon
D. Dimedrol
E. Suprastin
74. The patient 60 years is delivered in the department of intensive therapy with a
diagnosis: bite of bee, anafilactic shock.. Which medicine will be primary and most
effective?
A. *A. Adrenalin
B. Calcium the chloride
C. Prednizolon
D. Dimedrol
E. Suprastin
75. To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of
correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was
conducte A doctor went out from a chamber after conducting of necessary tests
before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient
without consciousness. The cyanosys of upper body part. Irregular breathing with the
selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on
peripheries and arterial pressure were not determined. Tones of heart are deaf,
unrhythmical. An ampoule and transfusion system is empty. What complication arose
up as a result of hemotransfusion?
A. *A. Air embolism of pulmonary artery
B. Tromboembolism of pulmonary artery
C. Edema of lungs
D. Heart attack of myocardium
E. Syndrome of massive hemotransfusion
76. To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v is
quickly injected. Tahycardiya, arterial hypotension, cyanosys, shortness of breath
appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.c.
acute insufficiency of what part of the cardial-vascular system is observed at a
patient?
A. *A. Right ventricle of heart
B. The left ventricle of heart
C. Both ventricles of heart
D. Vessels
E. Uneffective heart
77. A patient 48 years the second day in department of intensive therapy concerning the
acute front-partition heart attack of myocardium. During a review “wheezing”
suddenly, non-permanent tonic constricting of muscles is marked, pupils are
extended, pulse on carotis not palpitat. What doctor have to do in the first place?
A. *A. Triple Safar method
B. Record of ECG
C. Cardial hit in the area of heart
D. Artificial respiration by the method of Silvester
E. Intracardial injection of adrenalin with an atropine
78. At a patient 20 years on a background the injection of vitamin B1 suddenly there was
excitation, fear of death, falling of AP to 50 mm rt.st., hard breathing. Which of
medicine it is necessary to inject firstly?
A. *A. Adrenalin
B. Prednizolon
C. Calcium
D. Dimedrol
E. Eufilin
79. At a patient 60 years with the third day after an exterpation uterus acute insufficiency
of breathing developed suddenly, a skin became at first cyanotic, and then ashcolored color. Tachypnoe, cough with bloody sputum, retrosternal pain. BP – 100/70
mm. mercury, HR – 120, BR – 32 in 1 min., CVP – 300 mm wt.col. What most
reliable reason of worsening of the state of patient ?
A. *A. Tromboemboliya of pulmonary artery
B. Bleeding
C. Pain shock
D. Hypostatic pneumonia
E. Heart attack of myocardium
80. At a patient in the ward of intensive therapy you marked appearance on the monitor
of fibrillation of ventricules. Your first actions?
A. *A. To conduct defibrillation three times
B. To inject adrenalin
C. To inject a chloride
D. To begin the closed massage of heart
E. To inject lidocain
81. At the patient operated concerning the festering peritonitis coused by perforation of
gastric ulcer, in a postoperation period appeared: high temperature, frequency of
breathing 35/min., AP – 70/40 mm of mer item, diuresis -20 ml/h temperature of
body to 39 , leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of
chlorous sodium and 0,8 of solution of reopoliglucin did not improve general
condition. Central vein pressure – 130 mm wt.c. For stabilization of hemodinamics
will be optimum infusion:
A. *A. Dopamin
B. Mezaton
C. Adrenalin
D. Noradrenalin
E. Ephedrine
82. During the operation concerning strangular impassability of bowels, which
conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac
activity happened 50 years in the moment of mesenretium streching by the surgeon.
What would prevent the stop of heart in this case?
A. *A. i/v injection atropin
B. i/v injection of cardiac glycozidis
C. Deepening of general anaesthesi
D. Additional injection of relaxants
E. Additional injection droperidol
83. In 2 hours after renewal of cardial activity at a patient, that carried the sudden stop of
heart on a background hemorhagic shock (blood lost near 2,5 l) and is found on ALV,
unstable hemorhagia (AP – 80/40 – 90/60 mm of mer item, tahycardia) is marked,
central vein pressure – 5 mm wt.c. It is related to:
A. *A. By Hypovolume syndrome
B. By cardia insufficiency
C. By the inadequate interchange of gases
D. Vasoplegia
E. By the inadequate anaesthetizing
84. In a clinic a patient with the traumatic tearing of both lower extremities off at the
level of knee-joints is delivere A patient is extremly inert, languid, pale, pulse 140
b/min, threadlike, AP 50/0. Bleeding at the receipt is not present. From the words of
doctor of first-aid, lost about 3 litres of blood in place of event. What principal reason
of heavy of the state of Patient?
A. *A. acute hemorrhag
B. Pain shock.
C. Ishemia of extremities as a result of application of tourniquet
D. Fatty embolism
E. acute kidney insufficiency
85. Patient 40 years with the acute gastro - intestinal bleeding a canned blood was
poured in a volume 400 ml after conducting of all tests on compatibility. After
hemotransfusion the state of patient became worse, appeared head pains and pains in
muscles, the temperature of body rose to 38,8. What can explaine the state of patient?
A. Pirogenic reaction of middle heavy
B. *B. By development of hemotransfusion shock
C. Alergic reaction
D. By development of bacterial-toxic shock
E. By air embolism
86. Patient 62 years the third day of presense in department of intensive therapy
concerning the acute transmural heart attack of myocardium of front-partition
localization. At night woked up from a suffocating cough, feeling of fear and trouble.
At a review: cyanosys, FB – 30 in 1 min., HR – 132/ min., a rhythm is correct, tones
of heart are deaf, accent ІІ tone above a pulmonary artery, AP – 180/110 mm
mercury. There is the loosened breathing above lungs with the far of moist wheezes
in lower fates. What probably became the reason of worsening of the state?
A. *A. Edema of lungs
B. Embolism of pulmonary artery
C. The repeated heart attack miocardium
D. Hypertensive crisis
E. Attack of bronchial asthma
87. Patient M. 25 years old, was transferred in intensive care department with a
diagnosis: Poisoning of tubazidum. From the moment of reception is 5 hours. The
condition is heavy. Unconscious. BP is 140/100 mm mer , pulse - 120 a min. It is
necessary to conduct the followings medical measures:
A. *A. Acute hemodialisis
B. Unithiolum, plasmapheresis
C. Atropin, forced diuresis
D. Proserin
E. Oxybutirate sodium
88. Patient S. 41 years treated oneself in a therapeutic department with sharp poisoning
by an ethanol. What is a reason of death at the sharp poisoning by an ethanol:
A. *A. Acute respiratory insufficiency
B. Sharp hepatic insufficiency
C. Sharp kidney insufficiency
D. Sharp cardiac insufficiency
E. Collapse
89. Patient S. 43 years treated oneself in a therapeutic department with sharp poisoning
by vinegar essenc A patient had drunk 60 ml of vinegar essence. He needs:
A. *A. Sodium bicarbonate IV
B. To wash a stomach Sodium bicarbonate solutions
C. Unitiol IV
D. Enterosorbents
E. Cardial remedies
90. Patient S. 46 years treated oneself in a therapeutic department with pneumonia of
lower dole of right lung. Planned antibacterial therapy - amoxiklav. After 40 min
after intramuscular injection of duty dose, the patients feeled dizziness, pain behind a
breastbon AT 60/40 mm mer , pulse, - 120 a min., rhythmical. During examination
of lungs: wheezes under both lungs. Temperature is 38,5 What is worsening of the
condition related to?
A. *A. Anaphylactic shock
B. Infectious toxic shock
C. Collapse
D. Tromboembolia of pulmonary artery
E. Infectious shock
91. Patient S., 35 years old, was delivered in reception department of hospital with
complaints on general weakness, tachycardi It was examined by duty doctor.
Conscious, skin covers are cyanochroic, dry. Strong smell of aceton. Tones of heart
are muffled, pulse is 90 per min. BP is 85/55 mm mer Glukose of blood is 18
mmol/l. What is tactic of duty doctor?
A. *A. Small doses of simple insulin with rehydratation IV
B. Introduction of large doses of simple insulin
C. Permanent IV infusion of 7,5% solution of KCl
D. Permanent IV infusion of simple insulin is with glucose
E. Combination of insulin is with preparations of sulphaniluria
92. Patient with poisoning with barbiturates. You should use
A. *A. Solution of reamberin
B. Bemegridum
C. Kordiamin
D. Unithiolum
E. Cytitonum
93. Patient Yu., 22, delivered to the hospital the brigade of ambulans The condition is
heavy. Consciousness is entangle Skin covers are dry. A smell of aceton Pulse 115 a
min., rhythmi BP is 95/65 mm mer Breathing is noisy, as Kusmaull. The activity of
heart is rhythmic, tones are muffle Liver + 2 sm. Is there the most informing method
of inspection for clarification of genesis of comma ?
A. *A. Determination of glucose in blood
B. To define the level of ADG of blood
C. To define the kreatinine of blood
D. To define the level of bilirubinu of blood
E. All answers are wrong.
94. Patient, 40 years, with the trauma of both thighs is delivered from the scene of
accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of
the neck, tahypnoe, AP 60/40 mm mer it., HBA=120 /min, in lungs moist wheezes,
diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses most reliable?
A. *A. Fatty embolism
B. Traumatic shock
C. Hemorhagic shock
D. Pain shock
E. Tromboembolism
95. Sick D., 67 years, long time suffers from hypertension, obesity of the III degree,
uncontrolledly accepts diuretics. The state was worsened a few days ago: appeared
strong thirst, dryness, general weakness, polyuria, somnolence. The lines of person
are sharp, eyes are hollow, a turgor and elasticity is mionecti Stuffiness. Pulse is 98 a
min. BP 90/50 mm mer Tones of heart are muffle Osmolarity of plasma is 400
mosm/l. Glukose of blood 15,5 mmol/l. Your tactic?
A. *A. Injection of insulin of short action with injection of hypotonic solutions
B. A correction with the peroral insulindecreasing remedies
C. Dopamin
D. Injection of of insulin of the protracted action
E. Solution of Ringer-Lokk
96. The patient 32 years have infusion of native plasm At the end of infusion the state
became worse: disorientation, cyanosys, excitation, appeared hypersalivation,
tahypnoe, AP =70/40 mm mer st., in lungs – the dissipated dry wheezes. What
medicine must be injected firstly?
A. *A. Adrenalin.
B. Suprastin.
C. Gidrocortizon.
D. Dopamin.
E. Eufilin.
97. Woman had drunk 40 pills of ftivazidum with a suicidal purpose. Delivered to the
therapeutic department with complaints on nausea, vomit, pain in a stomach,
headache. Tremor of extremities. Your subsequent actions:
A. *A. Injection of vitamin of V6
B. Hemodialysis
C. Injection of vitamin of V6
D. Injection of vitamin of Vit. C
E. All answers are wrong
98. A girl , 12 years old, entered in hospital with dizziness, head pain, hallucinations,
periodic cramps, hypersalivation, cough, permanent nausea and vomit, pain in
stomach. Pulse is 120 per min.,increase of liver, icterical color of scin. Her mother
uses psyhotropical medications. There were chlororganic substanses and
phosphororganic substanses at home of girl. Your previous diagnosis:
A. Poisoning with psyhotropical medications
B. Poisoning with chlororganic substanses
C. *C. Poisoning with phosphororganic substanses
D. Poisoning with food
E. Poisoning with acid
99. A patient on meningococcemia had displays of syndrome of Waterhouse-Fridrikson.
What method of therapy can be considered on pathogenetic ground?:
A. *A. high dose of GKS (5-10 mg/kg of prednizolon and more)
B. piracetam
C. Inhibitirs of protease
D. Heparinum
E. Cardiac glycoside
100. Ambulance was called to teenager. In his anamnesis is diabetes mellitus. It is
observed weakness, pallor, loss of consciousness. Objectively: consciousness absents,
a skin is pale, "marble", extremities are cyanochroic, cold, sweating. Periodically are
convulsive tremor, breathings, superficial, frequent; tahycardia, from a mouth is a
smell of alcohol. Specify, what from medicine it is necessary immediately to inject a
patient intravenously:
A. *A. 40% solution of glucose 40 ml
B. Insulin of short action in a dose 0,1 ODES/kg
C. a 0,9% solution of chloride of sodium is in the dose of 20 ml/kg
D. a 0,45% solution of chloride of sodium is in a 5% solution of glucose
E. Naloxonum in a dose 0,1 mg/kg
101. Ambulance was called to unconsious person. It was established absence of
breathing. Sign of effective artificial ventilation of lungs:
A. *A. excursion of thorax;
B. Narrowing of pupils
C. Noise at insufflation of air ;
D. Thrusting out of epigastral area is at insufflation;
E. Dizziness of anesthesiologist
102. Ambulance was called to unconsious person. It was established clinical death.
Sign of stop of cardiac activity:
A. *A. Dilatation of pupils
B. Sudden loss of consciousness
C. Cyanosys of skin
D. A pulse above a radial artery is arrithmical
E. Absence of arteriotonus
103. Ambulance was called to unconsious person. It was established clinical death.
For endocardial injection of medications a needle is pricked:
A. *A. In 4th intercostal spase, on 1-2 sm on the left of breastbone
B. In 5th intercostal spase, in the point of projection of apex of heart
C. In 3th intercostal spase, on the left of breastbone
D. On the lower edge of 4th rib, on the left of breastbone
E. In the place of projection of cardiac shove
104. Ambulance was called to unconsious person. It was established clinical death.
Each next charge of bipolar defibrilator should be increased on ?
A. *A. 500 W
B. 250 W
C. 200W on 1 kg of mass of body
D. 1000 W
E. Charge can not be promoted
105. Ambulance was called to unconsious person. It was established clinical death.
During CPR soluble-sodium bicarbonate is used with with a purpose:
A. *A. Decreasing of metabolic acidosis
B. Warning of development of metabolic acidosis
C. An increase of time of survival of cerebrum in the conditions of hypoxia
D. Liquidations of hypoxia
E. To influence on the curve of dissociation of oxyhemoglobin
106. Ambulance was called to unconsious person. It was established clinical death.
What is the most credible laboratorical indexe of blood for patients after the real
sinking in fresh water?
A. *A. hyperkaliemia
B. High hemoconcentration indexes
C. High level of transaminases
D. High level of urea, creatine
E. Hypernatremiy
107. For a patient observed increasing weakness, decline of appetite, pain in joints
with appearance of icterus on 4th day. The temperature of body is normal. Liver is
enlarged by 2,5 sm. After 3 days of therapy the state was worsened: there were
anorexia, vomiting, somnolence, pain in right chest, petechial rash. Size of liver
diminish, symptoms of irritation of peritoneum were not esteblished What
complication we can think of?:
A. *A. acute hepatic insufficiency
B. Sharp cholecystitis
C. Sharp cholecistopankreatitis
D. Sharp kidney insufficiency
E. Appendicitis
108. In postpartum period of patient T.,conducted scraping of walls of uterus cavity
concerning post-natal metroendometriasis on a background of necrosis of decidual
layer, complication appeared with sudden decline of AP to 80/50 mm hg., Pulse of
110 min. Skin is pale, covered with sticky death-damp. The uterine bleeding absent.
What should we begin the first aid from ?
A. *A. artificial ventilation of lungs
B. infusion therapy
C. Antibacterial therapy
D. Support of cardiac activity
E. Laparotomii with next extraction of uterus
109. Patient , 30 years old, was transferred to the to the infection department with a
diagnosis: food toxicoinfection. Nausea, vomit increased during the first day.
Conscious, skin covers are dry, rough by touch, cold. The lines of person are sharp,
eyes hollow, eyeballs are soft. Breathing is noisy, as Kusmaull, strong smell of aceton
in mid air. Tones of heart are deaf. Pulse is 93 for a minute, BP is 90/60 mm mer Er
5,2*1012/l, Hb – 131 g/l . Glukose of blood 22 mmol/l. Glucose, ketonic bodies are
determined in urin Your most first actions?
A. *A. Insulin 0,1 U/kg (aktrapid) on a 0,9% solution of Nacl
B. Glybenklamid
C. 0,1 U/kg of ultralong insulin on 0,9% Nacl
D. Washing of stomach
E. IV 1% - 1 ml solution of mezaton
110. Patient, 52 years old, hospitalized with the heavy form of viral hepatitis . The
signs of flu appeared in permanent establishment. During a day the indexes of
Transamynases and bilirubin rose sharply. What complication of viral hepatitis can
arise up for a patient?
A. *A. acute hepatic insufficiency
B. Electrolyte comma
C. Gastric bleeding
D. Mechanical icterus
E. Cerebral comma
111. Patient L. is hospitalized in gynecological department with the temperature of 39
degrees C, with complaints of pain in the bottom of stomach, vomit, diarrhea .
Criminal abortion have been done 4 days befor AP 80/60, breathing is difficult,
psychosomatic excitation. Symptom of Schotkin-Blumberg is positive. Uterus is
enlarged as on 9 weeks of pregnancy, limitedly mobile, painless. Pus with blood
appeared. Your Diagnosis?
A. *A. septic shock
B. Perforation of uterus
C. Pelvic peritonitis
D. Acute appendicitis
E. Acute adnexia inflammation
112. Patient M, 44 years old, admited to the infectious isolation with a diagnosis:
Leptospirosis. On 7th day of treatment his state was sharply worsened, pain appeared
in lumbar region, somnolence, sickliness, cramps, head pain, diuresis diminished to
100 ml/day, blood: RBC -2,6*1012/L, Creatinine - 438 mkmol'/l, urea - 13,0 mmol/l.
What complication developed in patient?
A. *A. acute kidney insufficiency
B. Sharp hepatic insufficiency
C. Chronic pyelonephritis
D. Ischemic stroke
E. atroke of kidneys
113. Patient N., 28 years ol 6 day after the complicated births. The clinical
hematological signs of subacute disseminate intravascular coagulation syndrome
developed after skin hemorrhage and uterine bleeding. The state of patient is very ba
blood: Er-2,7 of T/l, Hb-78 of gm/l, CI - 0,93, L-4,7 of Gm/l, thrombocytes-88 of
gm/l, time of blood cloating - 16 min, prothrombin time - 25 sec, ethanol test +,
fibrinogen-1,4 gramme/l, What preparations should be prescribed ?
A. *A. freezed plasma
B. Heparinum
C. Reopoliglycin
D. Cryoprecipitate
E. U-aminokapric acid
114. The patient 20 years old, delivered to ambulance department on the 2nd day of
illness in a grave condition: temperature of body 39°c, symptoms of intoxication are
expressed. On extremities, trunk, buttocks, present hemorrhagic rash as eczema with
necrosis in the center. One day before cut his leg. Now has the wound in that plac In
2 hours the decline of AP is registered from 100/70 to 60/30 mm of Hg, diffused
cyanosis. Application of prednisolon of 120 mg and reopoliglycin did not give any
effect. What complication does it follow to think about?
A. acute sub renal failure
B. *B. Septic shock
C. hipovolemic shock
D. Hemorragic shock
E. Respirator distress syndrom of adults
115.
To the terminal states belong:
A. *A. pre-agony, terminal pause, agony, clinical death
B. Agony, clinical and biological death
C. Commas, agony, clinical death
D. Pre-agony, agony, clinical, social death;
E. Lowering of AT is to 80 mm of rt.st., commas, clinical death.
116. You should perform CPR to patient. The best place of performing of closed
massage of heart by hands:
A. *A. over lower third of breastbone, fingers parallel to the ribs
B. On breastbone, by fingers to the chin
C. On middle third of breastbone
D. In 4 subcostal space on the left of breastbone
E. On a thorax, in the place of projection of apex of heart.
117. You should perform CPR to patient During artificial respiration by method
“mouth to the mouth” it is need to blow air in volume:
A. *A. 800-1100 ml
B. 500-700 ml
C. 1200-1600 ml
D. 1700-2000 ml;
E. To carry out maximal inhalations
118.
. You should perform CPR to patient L. Clinical death lasts :
A. *A. 4-5 minutes;
B.
C.
D.
E.
1-3 minutes
5-7 minutes
To 10 minutes
7-12 minutes
119. You should perform CPR to patient N. All the below signs are the signs of of
clinical death except:
A. *A. arterial pressure is not determined
B. Absence of pulsation above femoral artery
C. Absence of breathing
D. pupils are irresponsive to light;
E. Absence of pulsation on carotid artery.
120. A patient 25 years is hospitalized in the surgical department with a diagnosis:
penetrable wound of abdominal region. Objectively: it is excited, skin covers and
visible mucous shells are pale; peripheral pulse of the weak filling, frequent, AP –
110/60 mm mercury.Positive symptom of ”desolation” of peripheral hypodermic
veins. Diuresis is lowere. How to characterize this state?
A. *A. The compensated shock
B. Preagonia
C. Circulating shock
D. Agony
E. Irreversible shock
121. A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the
surgical department with complaints on vomiting by "coffee-grounds", diarhea,
moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a
tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25
ml/h. Blood test: Eras. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in
medical treatment:
A. *A. solutions with colloid
B. 5% solution of glucosee
C. Whole blood
D. Red corpuscles mass
E. Colloid solutions with red corpuscles mass
122. :A patient entered the department with a diagnosis: acute intestinal impassability.
Complaints: insignificant thirst, dizziness at an attempt to get up from a be At a
review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with
cracks. Pulse – 110 min., AP – 80 /60 mm of mer item, diuresis – 25 ml /h.
Electrolyte composition: Na+ - 142 mmol/l, C+ - 4 mmol/l, glucosee – 6 mmol/l, urea
– 7 mmol/l. What variant of infusion is most expedient during operation?
A. *A. Transfusion of crystalloids.
B. Transfusion of solution of glucose
C. Transfusion of albumen.
D. Transfusion of native plasm
E. Transfusion of poliglucin.
123. A patient is in the intensive care unit during a week. 4 days ago a level of
consciousness was on a Glasgow coma scale - 8 ball, now makes 3 ball. Verification
of level of consciousness was conducted during 6 hours, a dynamics absents, death of
cerebrum was diagnose How correctly a leadthrough of establishment of such
diagnosis was?
A. *A. no, For establishment of diagnosis of death of cerebrum the presence of
complex of clinical criteria is needed, duration of supervision must be no less
than 12 hours for the primary defeat of brain and 24 for the second defeat;
B. all was conducted right. A main criterion is a negative dynamics of level of
consciousness, and depth of coma 3 ball on a Glasgow coma scale;
C. no, For establishment of diagnosis the level of consciousness does not matter.
Basic are results of laboratory tests;
D. all was conducted right. It was enough monitoring during 3 hours.
E. no,. For establishment of diagnosis of death of cerebrum a presence is needed
complex clinical criteria, duration of supervision must be no less than 48
hours for the primary defeat of brain and 72 for the second defeat.
124. A patient, 28 years, 2 hours ago fell down from the ground floor of hous. Sopor,
pale, there are the plural scratches of face, the lacerated hemorhagic wounds on the
left forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l,
Hb – 100, AP – 90/40 mm of rt. item. In the blood test: red corpuscles – 3,5 g/l. What
liquid does not need to be used for medical treatment of shock?
A. *A. 5% solution of glucosee
B. Solution of crystalloids
C. Solutions gelatin
D. Solutions of calcium
E. Solution of albumen
125. Anafilactic shock appeared at a patient. The state heavy and progressively gets
wors HBA – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the
rescue of life of patient above all things?
A. *A. Adrenalin.
B. Chloride of calcium.
C. Prednizolon.
D. Dofamin.
E. Suprastin.
126. At a patient 20 years on a background the injection of vitamin B1 suddenly there
was excitation, fear of death, falling of AP to 50 mm rt.st., hard breathing. Which of
medicine it is necessary to inject firstly?
A. *A. Adrenalin
B. Prednizolon
C. Calcium
D. Dimedrol
E. Eufilin
127. At a patient 60 years with the third day after an exterpation uterus acute
insufficiency of breathing developed suddenly, a skin became at first cyanotic, and
then ash-colored color. Tachypnoe, cough with bloody sputum, retrosternal pain. BP
– 100/70 mm. mercury, HR – 120, BR – 32 in 1 min., CVP – 300 mm wt.col. What
most reliable reason of worsening of the state of patient ?
A. *A. Tromboemboliya of pulmonary artery
B. Bleeding
C. Pain shock
D. Hypostatic pneumonia
E. Heart attack of myocardium
128. At a patient in the ward of intensive therapy you marked appearance on the
monitor of fibrillation of ventricules. Your first actions?
A. *A. To conduct defibrillation three times
B. To inject adrenalin
C. To inject a chloride
D. To begin the closed massage of heart
E. To inject lidocain
129. At a patient with the acute heart attack of myocardium in the region of partition
on a 5th day after the brief episode of loss of consciousness there is reduction of
frequency of pulse to 32 in a minut . BP - 80/40 mm . Consciousness at the level of
sopor. He immediately needs :
A. to put right a craniotserebral hypothermia, to enter lasics, prednisoloni,
tserebrolizin
B. to enter an atropine, eoufilin, to begin injection of aloupenta
C. *C. to conduct urgent cardiostimoulation
D. all answers are faithful
E. there is no right answer
130. At a patient with the acute heart attack of myocardium best of all to warn
relapsing fibrillation of ventricles with :
A. cordaronum
B. lidocainum
C. ornidinum
D. *D. electrocardiostimulation
E. there is no right answer
131. At a patient, carried to a 2 year ago the heart attack of myocardium, the acute
decline of cholecystyties planned cholecystectomy, signs of electric instability of
myocardium . Actions of anaesthesiologist must include:
A. injection of prednisoloni, lidocaini, hyperventilation, take the ECG
B. *B. injection of dopamini, after stabilisation of BP - nitroglycerine + infusion
therapy under the control CVP, conducting of neurovegetative defence, take
the ECG
C. injection of streptodecasol, stream infusion of reopoliglyocinum, injection of
lidocainum, increase of dose of analgetics
D. correctly A) and C)
E. all answers are faithful
132. At a patient, that is found on medical treatment in the therapeutic department, the
sudden stopping of circulation of blood happene Medical personnel begun the
reanimation measures. Define the most rational way of injection of adrenalin for
renewal of heart abbreviations in default of vein access:
A. *A. To enter to a 3 ml solution of adrenalin in a trache
B. To enter to a 1 ml solution of adrenalin in muscl
C. To enter adrenalin in muscle, multiplying a dose in 3 times.
D. The intracardial injection.
E. Adrenalin can be not entered.
133. At a patient, that is found under the permanent electrocardioscopic supervision,
microwave fibrillation of myocardium and diagnosed clinical death develope It is
necessary to do:
A. to inject the solution of calcium in cor
B. *B. to conduct high-voltage electric defibrillation
C. to inject solution of atropine in cor
D. to inject solution of adrenalin in cor
E. All answers are wrong
134. At the patient operated concerning the festering peritonitis coused by perforation
of gastric ulcer, in a postoperation period appeared: high temperature, frequency of
breathing 35/min., AP – 70/40 mm of mer item, diuresis -20 ml/h temperature of
body to 39 , leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of
chlorous sodium and 0,8 of solution of reopoliglucin did not improve general
condition. Central vein pressure – 130 mm wt.st. For stabilization of hemodinamics
will be optimum infusion:
A. *A. Dopamin
B. Mezaton
C. Adrenalin
D. Noradrenalin
E. Ephedrine
135. At the ventilated patient with the edema of lungs at low pressure and septic shock
intravenous infusion 7,5 mcg/kg/min dopamini will increase
A. RaO2, saturation of oxygen of the mixed vein blood, consumption of oxygen
B. diuresis
C. *C. cardiac systolic volume
D. right A) and B)
E. faithful all answers
136. During the operation concerning strangular impassability of bowels, which
conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac
activity happened 50 years in the moment of mesenretium streching by the surgeon.
What would prevent the stop of heart in this case?
A. *A. i/v injection atropin
B. i/v injection of cardiac glycozidis
C. Deepening of general anaesthesi
D. Additional injection of relaxants
E. Additional injection droperidol
137. In 2 hours after renewal of cardial activity at a patient, that carried the sudden
stop of heart on a background hemorhagic shock (blood lost near 2,5 l) and is found
on ALV, unstable hemorhagia (AP – 80/40 – 90/60 mm of mer item, tahycardia)is
marked, central vein pressure – 5 mm wt.st. It is related to:
A. *A. By Hypovolume syndrome
B. By cardia insufficiency
C. By the inadequate interchange of gases
D. Vasoplegia
E. By the inadequate anaesthetizing
138. In postpartum period of patient T.,conducted scraping of walls of uterus cavity
concerning post-natal metroendometriasis on a background of necrosis of decidual
layer, complication appeared with sudden decline of AP to 80/50 mmhg., Pulse of
110 min. Skin is pale, covered with sticky death-damp. The uterine bleeding absent.
What should we begin the first aid from ?
A. *A. artificial ventilation of lungs
B. infusion therapy
C. Antibacterial therapy
D. Support of cardiac extrass
E. Laparotomii with next extraction of uterus
139.
It is typical for:
A. *A. Negative CVT
B. Erroneous punction of artery
C. Right-side pmeumothorax
D. Edema of lungs
E. Hypodermic emphysema
140. On a 4 day after incompatible (on a group) blood transfusion at a patient acutely
reduced diouresis, anuria developed, the common state became worse acutely, arterial
pressure ros At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma 24 mmol/l. What illness and what stage of illness it follows to think about in the first
place?
A. *A. Acute kidney insufficiency, anuria
B. Anaphylactic shock, acute kidney insufficiency, anuria
C. Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
D. Posthemoragic acute kidney insufficiency, anuria
E. acute interstitsial nephritis, postrenal anuria
141. On an enterprise with plenty of workers educational practical work is conducted
on the leadthrough of cardiopulmonary reanimation. It is foremost needed to teach the
workers of «chain of survival», which plugs in itself:
A. forming from the people chain on which will be passed to instruction in
relation to correct implementation of urgent measures;
B. set of tools and medical preparations for a grant to the first aid at clinical
death;
C. the «chains of survival» study only in the specialized higher educational
establishments with the receipt of the special diploma for its use;
D. immediate informing of guidance of establishment and direct chief of victim,
bringing in to the reanimation of the medical cabinet, deliveries of
пострадавшего on an official machine to the nearest medical establishment.
E. *E. early activating of service to medical first-aid, early beginning of
elementary sustentation, early defibrillation by automatic external
defibrillator, early beginning of further sustentation.
142. Patient 20 years for verification of the functional state of kidneys the X- ray
examination with v/v injection of cardiotrast is conducte At the end of injection the
state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch
appeare AP – 60/20 mm of mer item, HBA – 132/min. A similar research was
conducted 3 months ago, such effects were not observe. What most reliable
diagnosis?
A. *A. Medicinal anafilactic shock
B. Acute kidney insufficiency
C. Tromboembolism of pulmonary artery
D. Stress on the conducted manipulation
E. Heart attack miocardium
143. Patient 30 years after a road-transport failure complaints of the acute tahypno
Ob-ly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax,
stomach, right side of the neck. Auscultative: breathing on the right side is not
conducted; pulse – 130/min., AP – 80/60 mm.mercury., CVP – 140 mm wt., FB – 30
/min., Ht – 0,27, Hb – 90 g/l. Subsequent therapy must include above all things:
A. *A. punction of pleura cavity.
B. Urgent ALV
C. Massive infusion therapy of the crystalloid solutions
D. Infusion of dofamin, 2-5 mcg/cg/min
E. 100% oxygen
144. Patient 38 years, native plasma was poure At the end of infusion the state became
worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36
on 1 min., AP – 70/40 mm of mer item, whistling dry wheezes. Which from the
following mediceni must be injected firstly?
A. *A. Adrenalin.
B. Eufilin.
C. Suprastin.
D. Noradrenalin.
E. Prednizolon.
145. Patient, 40 years, with the trauma of both thighs is delivered from the scene of
accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of
the neck, tahypnoe, AP 60/40 mm mer st., HBA=120 /min, in lungs moist wheezes,
diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses most reliable?
A. *A. Fatty embolism
B. Traumatic shock
C. Hemorhagic shock
D. Pain shock
E. Tromboembolism
146. The patient 32 years have infusion of native plasm At the end of infusion the
state became worse: disorientation, cyanosys, excitation, appeared hypersalivation,
tahypnoe, AP =70/40 mm mer st., in lungs – the dissipated dry wheezes. What
medicine must be injected firstly?
A. *A. Adrenalin.
B. Suprastin.
C. Gidrocortizon.
D. Dopamin.
E. Eufilin.
147. The patient 60 years is delivered in the department of intensive therapy with a
diagnosis: bite of bee, anafilactic shock.. Which medicine will be primary and most
effective?
A. *A. Adrenalin
B. Calcium the chloride
C. Prednizolon
D. Dimedrol
E. Suprastin
148. The patient of 2 days carried the state of clinical death back. During the first days
of postasystolic period the state was stabilized with a tendency to the improvement.
Now there is worsening of the state, hypoxemia of PaO2 65 mm Hg, shortness of
breath to 30 per min., tachycardia, high blood pressur What conclusions can be
done?
A. postasystolic illness begins;
B. cardiopulmonary reanimation conducted inadequately;
C. *C. ІІІ stage of postasystolic illness;
D. for a patient chronic pathology was intensifyed;
E. the fever of lungs makes progress for a patient.
149. To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of
correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was
conducte A doctor went out from a chamber after conducting of necessary tests
before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient
without consciousness. The cyanosys of upper body part. Irregular breathing with the
selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on
peripheries and arterial pressure are not determine Tones of heart are deaf,
unrhythmical. An ampoule and transfusion system is empty. What complication arose
up as a result of hemotransfusion?
A. *A. Air embolism of pulmonary artery
B. Tromboembolism of pulmonary artery
C. Edema of lungs
D. Heart attack of myocardium
E. Syndrome of massive hemotransfusion
150. To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v is
quickly injecte Tahycardiya, arterial hypotension, cyanosys, shortness of breath
appeared, acute swelling of veins /of neck, extension of liver, CVT to 200 mm wt.st.
acute insufficiency of what part of the cardial-vascular system is observed at a
patient?
A. Right ventricle of heart
B. *B. The left ventricle of heart
C. Both ventricles of heart
D. Vessels
E. Uneffective heart
151. Patient 30 years after a road-transport failure complaints of the acute tahypnoe.
Ob-ly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax,
stomach, right side of the neck. Auscultative: breathing on the right side is not
conducted; pulse – 130/min., AP – 80/60 mm.mercury., CVP – 140 mm wt., FB – 30
/min., Ht – 0,27, Hb – 90 g/l. Subsequent therapy must include above all things:
A. *A. punction of pleura cavity.
B. Urgent ALV
C. Massive infusion therapy of the crystalloid solutions
D. Infusion of dofamin, 2-5 mcg/cg/min
E. 100% oxygen
152. A patient 25 years is hospitalized in the surgical department with a diagnosis:
penetrable wound of abdominal region. Objectively: it is excited, skin covers and
visible mucous shells are pale; peripheral pulse of the weak filling, frequent, AP –
110/60 mm mercury. Positive symptom of ”desolation” of peripheral hypodermic
veins. Diuresis is lowere. How to characterize this state?
A. *A. The compensated shock
B. Preagonia
C. Circulating shock
D. Agony
E. Irreversible shock
153. A patient 25 years is hospitalized in the surgical department with a diagnosis:
penetrable wound of abdominal region. Objectively: it is excited, skin covers and
visible mucous shells are pale; peripheral pulse of the weak filling, frequent, AP –
110/60 mm mercury Positive symptom of ”desolation” of peripheral hypodermic
veins. Diuresis is lowere How to characterize this state?
A. *A. The compensated shock
B. Preagonia
C. Circulating shock
D. Agony
E. Irreversible shock
154. A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the
surgical department with complaints on vomiting by "coffee-grounds", diarhea,
moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a
tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25
ml/h. Blood test: Eras. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in
medical treat
A. *A. solutions with colloid
B. 5% solution of glucose
C. Whole blood
D. Red corpuscles mass
E. Colloid solutions with red corpuscles mass
155. A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the
surgical department with complaints on vomiting by "coffee-grounds", diarhea,
moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a
tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25
ml/h. Blood test: Eras. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in
A.
B.
C.
D.
E.
*A. solutions with colloid
5% solution of glucose
Whole blood
Red corpuscles mass
Colloid solutions with red corpuscles mass
156. A patient 48 years the second day in department of intensive therapy concerning
the acute front-partition heart attack of myocardium. During a review “wheezing”
suddenly, non-permanent tonic constricting of muscles is marked, pupils are
extended, pulse on a. carotis not palpitat. What doctor have to do in the first place?
A. *A. Triple Safar method
B. Record of ECG
C. Cardial hit in the area of heart
D. Artificial respiration by the method of Silvester
E. Intracardial injection of adrenalin with an atropine
157. A patient entered the department with a diagnosis: acute intestinal impassability.
Complaints: insignificant thirst, dizziness at an attempt to get up from a be At a
review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with
cracks. Pulse – 110 min., AP – 80 /60 mm of mer item, diuresis – 25 ml /h.
Electrolyte composition: Na+ - 142 mmol/l, C+ - 4 mmol/l, glucose – 6 mmol/l, urea
– 7 mmol/l. What variant of infusion is most expedient during operation?
A. *A. Transfusion of crystalloids.
B. Transfusion of solution of glucos
C. Transfusion of albumen.
D. Transfusion of native plasma.
E. Transfusion of poliglucin.
158. A patient with a traumatic shock AP – 60/0 mm rt.st., HBA – 90 /1 min. Define a
shock index:
A. *A. 1,5
B. 2,5
C. 1,5
D. 0,5
E. 0,3
159. A patient, 28 years, 2 hours ago fell down from the ground floor.Sopor, pale,
there are the plural scratches of face, the lacerated hemorhagic wounds on the left
forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l, Hb –
100, AP – 90/40 mm of rt. item In the blood test: red corpuscles – 3,5 g/l. What fluid
does not need to be used for medical treatment of shock?
A. *A. 5% solution of glucose
B. Solution of crystalloids
C. Solutions gelatin
D. Solutions of calcium
E. Solution of albumen
160. Anafilactic shock appeared at a patient. The state heavy and progressively gets
wors HBA – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the
rescue of life of patient above all things?
A. *A. Adrenalin.
B. Chloride of calcium.
C. Prednizolon.
D. Dofamin.
E. Suprastin.
161. At a patient, that is found on medical treatment in the therapeutic department, the
sudden stopping of circulation of blood happene Medical personnel begun the
reanimation measures. Define the most rational way of injection of adrenalin for
renewal of heart abbreviations in default of vein access:
A. *A. To enter to a 3 ml solution of adrenalin in a trachea.
B. To enter to a 1 ml solution of adrenalin in muscl
C. To enter adrenalin in muscle, multiplying a dose in 3 times.
D. The intracardial injection.
E. Adrenalin can be not entered.
162. In a clinic a patient with the traumatic tearing of both lower extremities off at the
level of knee-joints is delivere A patient is extremly inert, languid, pale, pulse 140
bmin, threadlike, AP 500. On both lower extremities there are the imposed plaits.
Bleeding at the receipt is not present. From the words of doctor of first-aid, lost
about 3 litres of blood in place of event. What principal reason of heavy of the state
of Patient?
A. *A. Acute hemorrhag
B. Pain shock.
C. Ishemia of extremities as a result of application of tourniquet
D. Fatty embolism
E. acute kidney insufficiency
163.
It is typical for:
A. *A. Negative CVT
B. Erroneous punction of artery
C. Right-side pmeumothorax
D. Edema of lungs
E. Hypodermic emphysema
164. On a 4 day after incompatible (on a group) blood transfusion at a patient acutely
reduced diuresis, anuria developed, the common state became worse acutely, arterial
pressure ros At laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma 24 mmol/l. What illness and what stage of illness it follows to think about in the first
place?
A. *A. Acute kidney insufficiency, anuria
B. Anaphylactic shock, acute kidney insufficiency, anuria
C. Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
D. Posthemoragic acute kidney insufficiency, anuria
E. acute interstitsial nephritis, postrenal anuria
165. On a 4 day after incompatible (on a group) blood transfusion at a patient acutely
reduced diouresis, anuria developed, the common state became worse acutely. At
laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma - 24 mmol/l.
What illness and what stage of illness it follows to think about in the first place?
A. *A. Acute kidney insufficiency, anuria
B. Anaphylactic shock, acute kidney insufficiency, anuria
C. Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
D. Posthemoragic acute kidney insufficiency, anuria
E. acute interstitsial nephritis, postrenal anuria
166. Patient 20 years for verification of the functional state of kidneys the X- ray
examination with i/v injection of cardiotrast is conducte At the end of injection the
state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch
appeare AP – 60/20 mm of mer item, HBA – 132/min. A similar research was
conducted 3 months ago, such effects were not observe. What most reliable
diagnosis?
A. *A. Medicinal anafilactic shock
B. Acute kidney insufficiency
C. Tromboembolism of pulmonary artery
D. Stress on the conducted manipulation
E. Heart attack miocardium
167. Patient 20 years for verification of the functional state of kidneys the X- ray
examination with i/v injection of cardiotrast is conducte. At the end of injection the
state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch
appeare AP – 60/20 mm of mer item, HBA – 132/min. A similar research was
conducted 3 months ago, such effects were not observe. What most reliable
diagnosis?
A. *A. Medicinal anafilactic shock
B. Acute kidney insufficiency
C. Tromboembolism of pulmonary artery
D. Stress on the conducted manipulation
E. Heart attack miocardium
168. Patient 38 years, native plasma was poure At the end of infusion the state became
worse: Patient confused, excited, cyanosys, hypersalivation. Breathing frequency 36
on 1 min., AP – 70/40 mm of mer item, whistling dry wheezes. Which from the
following medicine must be injected firstly?
A. *A. Adrenalin.
B. Eufilin.
C. Suprastin.
D. Noradrenalin.
E. Prednizolon.
169. Patient 40 years with the acute gastro - intestinal bleeding a canned blood was
poured in a volume 400 ml after conducting of all tests on compatibility. After
hemotransfusion the state of patient became worse, appeared head pains and pains in
muscles ,the temperature of body rose to 38,8 . What can explaine the state of
patient?
A. Pirogenic reaction of middle heavy
B. *B. By development of hemotransfusion shock
C. Alergic reaction
D. By development of bacterial-toxic shock
E. By air embolism
170. Patient 62 years the third day of presense in department of intensive therapy
concerning the acute transmural heart attack of myocardium of front-partition
localization. At night woked up from a suffocating cough, feeling of fear and troubl
At a review: cyanosys, FB – 30 after 1 min., HBA – 132/ min., a rhythm is correct,
tones of heart are deaf, accent ІІ tone above a pulmonary artery, AP – 180/110 mm
mercury. There is the loosened breathing above lungs with the far of moist wheezes
in lower fates. What probably became the reason of worsening of the state?
A. *A. Edema of lungs
B. Embolism of pulmonary artery
C. The repeated heart attack miocardium
D. Hypertensive crisis
E. Attack of bronchial asthma
171. Patient N., 40 years, groom. In anamnesis there is an allergy to nonsteriidal
antiinflammatory. After injection of antitetanus on a method Besredco concerning the
hammered wound of right shin, through 20 mines, there was a acute weakness,
labouring breath, through 10 minutes, loss of consciousness. What way of
development of anafilactic form of illness?
A. *A. Sensitization to the albumen of horse whey
B.
C.
D.
E.
Low quality of horse whey
Breach of the technique of PPS injection
Presence in anamnesis of medical allergy
Infection of whey
172. Persons 48 years, patient by the heart attack of miocardium, suddenly lost
consciousness, breathing and palpitation. On ECG of highwave fibrilation of
ventricules. Conducted defibrilation. Did not pick up normal cardial activity. What
medicine needs to be entered for the rise of sensuality to defibrillation?
A. *A. Amidaron
B. Propranolon
C. Lidocain
D. Strofantin
E. Atropini sulfati
173. The patient 60 years is delivered in the department of intensive therapy with a
diagnosis: bite of bee, anafilactic shock.. Which medicine will be primary and most
effective?
A. *A. Adrenalin
B. Calcium the chloride
C. Prednizolon
D. Dimedrol
E. Suprastin
174. The patient 60 years is delivered in the department of intensive therapy with a
diagnosis: bite of bee, anafilactic shock.. Which medicine will be primary and most
effective?
A. *A. Adrenalin
B. Calcium the chloride
C. Prednizolon
D. Dimedrol
E. Suprastin
175. To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of
correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was
conducte. A doctor went out from a chamber after conducting of necessary tests
before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient
without consciousness. The cyanosys of upper body part. Irregular breathing with the
selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on
peripheries and arterial pressure are not determine Tones of heart are deaf,
unrhythmical. An ampoule and transfusion system is empty. What complication a
rose up as a result of hemotransfusion?
A. *A. Air embolism of pulmonary artery
B. Tromboembolism of pulmonary artery
C. Edema of lungs
D. Heart attack of myocardium
E. Syndrome of massive hemotransfusion
176. To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v is
quickly injecte Tahycardiya, arterial hypotension, cyanosys, shortness of breath
appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.st.
Acute insufficiency of what part of the cardial-vascular system is observed at a
patient?
A. *A. Right ventricle of heart
B. The left ventricle of heart
C. Both ventricles of heart
D. Vessels
E. Uneffective heart
177. A patient 48 years the second day in dpartment of intensive therapy concerning
the acute front-partition heart attack of myocardium. During a review “wheezing”
suddenly, non-permanent tonic constricting of muscles is marked, pupils are
extended,it isnt pulse on arteria carotis . What doctor have to do in the first place?
A. *A. Triple Safar method
B. Record of ECG
C. Cardial hit in the area of heart
D. Artificial respiration by the method of Silvester
E. Intracardial injection of adrenalin with an atropine
178. At a patient 20 years on a background the injection of vitamin B1 suddenly there
was excitation, fear of death, falling of AP to 50 mm rt.st., hard breathing. Which of
medicine it is necessary to inject firstly?
A. *A. Adrenalin
B. Prednizolon
C. Calcium
D. Dimedrol
E. Eufilin
179. At a patient 60 years with the third day after an exterpation uterus acute
insufficiency of breathing developed suddenly, a skin became at first cyanotic, and
then ash-colored color. Tachypnoe, cough with bloody sputum, retrosternal pain. BP
– 100/70 mm. mercury, HR – 120, BR – 32 in 1 min., CVP – 300 mm wt.col. What
most reliable reason of worsening of the state of patient ?
A. *A. Tromboemboliya of pulmonary artery
B. Bleeding
C. Pain shock
D. Hypostatic pneumonia
E. Heart attack of myocardium
180. At a patient in the ward of intensive therapy you marked appearance on the
monitor of fibrillation of ventricules. Your first actions?
A. *A. To conduct defibrillation three times
B. To inject adrenalin
C. To inject a chloride
D. To begin the closed massage of heart
E. To inject lidocain
181. At the patient operated concerning the festering peritonitis coused by perforation
of gastric ulcer, in a postoperation period appeared: high temperature, frequency of
breathing 35/min., AP – 70/40 mm of mer item, diuresis -20 ml/h temperature of
body to 39 , leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of
chlorous sodium and 0,8 of solution of reopoliglucin did not improve general
condition. Central vein pressure – 130 mm wt.st. For stabilization of hemodinamics
will be optimum infusion:
A. *A. Dopamin
B. Mezaton
C. Adrenalin
D. Noradrenalin
E. Ephedrine
182. During the operation concerning strangular impassability of bowels, which
conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac
diyal-nosti happened 50 years in the moment of mesenretium streching by the
surgeon. What would prevent the stop of heart in this case?
A. *A. i/v injection atropin
B. i/v injection of cardiac glycozidis
C. Deepening of general anaesthesi
D. Additional injection of relaxants
E. Additional injection droperidol
183. In 2 hours after renewal of cardial activity at a patient, that carried the sudden
stop of heart on a background hemorhagic shock (blood lost near 2,5 l) and is found
on ALV, unstable hemorhagia (AP – 80/40 – 90/60 mm of mer item, tahycardia)is
marked, central vein pressure – 5 mm wt.st. It is related to:
A. *A. By Hypovolume syndrome
B. By cardia insufficiency
C. By the inadequate interchange of gases
D. Vasoplegia
E. By the inadequate anaesthetizing
184. In a clinic a patient with the traumatic tearing of both lower extremities off at the
level of knee-joints is delivere A patient is extremly inert, languid, pale, pulse 140
bmin, threadlike, AP 500. On both lower extremities there are the imposed plaLits.
Bleeding at the receipt is not present. From the words of doctor of first-aid, lost
about 3 litres of blood in place of event. What is a principal reason of heavy of the
state of patient?
A. *A. acute hemorrhag
B. Pain shock.
C. Ishemia of extremities as a result of application of tourniquet
D. Fatty embolism
E. acute kidney insufficiency
185. Patient 40 years with the acute gastro - intestinal bleeding a canned blood was
poured in a volume 400 ml after conducting of all tests on compatibility. After
hemotransfusion the state of patient became worse, appeared head pains and pains in
muscles ,the temperature of body rose to 38,8 . What can explaine the state of
patient?
A. Pirogenic reaction of middle heavy
B. *B. By development of hemotransfusion shock
C. Alergic reaction
D. By development of bacterial-toxic shock
E. By air embolism
186. Patient 62 years the third day of presense in department of intensive therapy
concerning the acute transmural heart attack of myocardium of front-partition
localization. At night woked up from a suffocating cough, feeling of fear and troubl
At a review: cyanosys, FB – 30 after 1 min., HBA – 132/ min., a rhythm is correct,
tones of heart are deaf, accent ІІ tone above a pulmonary artery, AP – 180/110 mm
mercury. There is the loosened breathing above lungs with the far of moist wheezes
in lower fates. What probably became the reason of worsening of the state?
A. *A. Edema of lungs
B. Embolism of pulmonary artery
C. The repeated heart attack miocardium
D. Hypertensive crisis
E. Attack of bronchial asthma
187. Patient M. 25 years old, was transferred in intensive care department with a
diagnosis: Poisoning of tubazidum. From the moment of reception is 5 hours. The
condition is heavy. Unconscious. BP is 140/100 mm mer , pulse - 120 a min. It is
necessary to conduct the followings medical measures:
A. *A. Acute hemodialisis
B. Unithiolum, plasmapheresis
C. Atropin, forced diuresis
D. Proserin
E. Oxybutirate sodium
188. Patient S. 41 years treated oneself in a therapeutic department with sharp
poisoning by an ethanol. What is a reason of death at the sharp poisoning by an
ethanol:
A. *A. Acute respiratory insufficiency
B. Sharp hepatic insufficiency
C. Sharp kidney insufficiency
D. Sharp cardiac insufficiency
E. Collapse
189. Patient S. 43 years treated oneself in a therapeutic department with sharp
poisoning by vinegar essenc A patient had drunk 60 ml of vinegar essence. He
needs:
A. *A. Sodium bicarbonate IV
B. To wash a stomach Sodium bicarbonate solutions
C. Unitiol IV
D. Enterosorbents
E. Cardial remedies
190. Patient S. 46 years treated oneself in a therapeutic department with pneumonia of
lower dole of right lung. Planned antibacterial therapy - amoxiklav. After 40 min
after intramuscular injection of duty dose, the patients feeled dizziness, pain behind a
breastbon AT 60/40 mm mer , pulse, - 120 a min., rhythmical. During examination
of lungs: wheezes under both lungs. Temperature is 38,5 What is worsening of the
condition related to?
A. *A. Anaphylactic shock
B. Infectious toxic shock
C. Collapse
D. Tromboembolia of pulmonary artery
E. Infectious shock
191. Patient S., 35 years old, was delivered in reception department of hospital with
complaints on general weakness, tachycardia. It was examined by duty doctor.
Conscious, skin covers are cyanochroic, dry. Strong smell of aceton. Tones of heart
are muffled, pulse is 90 per min. BP is 85/55 mm mer Glukose of blood is 18
mmol/l. What is tactic of duty doctor?
A. *A. Small doses of simple insulin with rehydratation IV
B. Introduction of large doses of simple insulin
C. Permanent IV infusion of 7,5% solution of KCl
D. Permanent IV infusion of simple insulin is with glucose
E. Combination of insulin is with preparations of sulphaniluria
192.
Patient with poisoning with barbiturates. You should use
A. *A. Solution of reamberin
B. Bemegridum
C. Kordiamin
D. Unithiolum
E. Cytitonum
193. Patient Yu., 22, delivered to the hospital the brigade of ambulans. The condition
is heavy. Consciousness is entangle. Skin covers are dry. A smell of aceton. Pulse
115 a min., BP is 95/65 mm mer. Breathing is noisy, as Kusmaull. The activity of
heart is rhythmic, tones are muffle. Liver + 2 sm. Is there the most informing method
of inspection for clarification of genesis of comma ?
A. *A. Determination of glucose in blood
B. To define the level of ADG of blood
C. To define the kreatinine of blood
D. To define the level of bilirubinu of blood
E. All answers are wrong.
194. Patient, 40 years, with the trauma of both thighs is delivered from the scene of
accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of
the neck, tahypnoe, AP 60/40 mm mer st., HBA=120 /min, in lungs moist wheezes,
diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses most reliable?
A. *A. Fatty embolism
B. Traumatic shock
C. Hemorhagic shock
D. Pain shock
E. Tromboembolism
195. Sick D., 67 years, long time suffers from hypertension, obesity of the III degree,
uncontrolledly accepts diuretics. The state was worsened a few days ago: appeared
strong thirst, dryness, general weakness, polyuria, somnolenc The lines of person are
sharp, eyes are hollow, a turgor and elasticity is mionecti Stuffiness. Pulse is 98 a
min. BP 90/50 mm mer Tones of heart are muffle Osmolarity of plasma is 400
mosm/l. Glukose of blood 15,5 mmol/l. Your tactic?
A. *A. Injection of insulin of short action with injection of hypotonic solutions
B. A correction with the peroral insulindecreasing remedies
C. Dopamin
D. Injection of of insulin of the protracted action
E. Solution of Ringer-Lokk
196. The patient 32 years have infusion of native plasm. At the end of infusion the
state became worse: disorientation, cyanosys, excitation, appeared hypersalivation,
tahypnoe, AP =70/40 mm mer st., in lungs – the dissipated dry wheezes. What
medicine must be injected firstly?
A. *A. Adrenalin.
B. Suprastin.
C. Gidrocortizon.
D. Dopamin.
E. Eufilin.
197. Woman had drunk 40 pills of ftivazidum with a suicidal purpos. Delivered to the
therapeutic department with complaints on nausea, vomit, pain in a stomach,
headache. Tremor of extremities. At a receipt a stomach was your subsequent
actions:
A. *A. Injection of vitamin of V6
B. Hemodialysis
C. Injection of vitamin of V6
D. Injection of vitamin of Vit. C
E. All answers are wrong
198. Anafilactic shock appeared at a patient. The state heavy and progressively gets
wors HBA – 110 in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the
rescue of life of patient above all things?
A. *A. Adrenalin.
B. Chloride of calcium.
C. Prednizolon.
D. Dofamin.
E. Suprastin.
199. At a patient 20 years on a background the injection of vitamin B1 suddenly there
was excitation, fear of death, falling of AP to 50 mm rt.st., hard breathing. Which of
medicine it is necessary to inject firstly?
A. *A. Adrenalin
B. Prednizolon
C. Calcium
D. Dimedrol
E. Eufilin
200. At a patient 60 years with the third day after an exterpation uterus acute
insufficiency of breathing developed suddenly, a skin became at first cyanotic, and
then ash-colored color. Tachypnoe, cough with bloody sputum, retrosternal pain. BP
– 100/70 mm. mercury, HR – 120, BR – 32 in 1 min., CVP – 300 mm wt.col. What
most reliable reason of worsening of the state of patient ?
A. *A. Tromboemboliya of pulmonary artery
B. Bleeding
C. Pain shock
D. Hypostatic pneumonia
E. Heart attack of myocardium
201. At a patient with the acute heart attack of myocardium in the region of partition on
a 5th day after the brief episode of loss of consciousness there is reduction of
frequency of pulse to 32 in a minut BP - 80/40 mm Consciousness at the level of
sopor. He immediately needs :
A. to put right a craniotserebral hypothermia, to enter lasics, prednisoloni,
tserebrolizin
B. to enter an atropine, eoufilin, to begin infusion of aloupenta
C. *C. to conduct urgent cardiostimoulation
D. all answers are faithful
E. there is no right answer
202. At a patient, carried to a 2 year ago the heart attack of myocardium, the acute
decline of cholecystyties planned cholecystectomy, signs of electric instability of
myocardium . Actions of anaesthesiologist must include:
A. injection of prednisoloni, lidocaini, hyperventilation, take the ECG
B. *B. injection of dopamini, after stabilisation of BP - nitroglycerine + infusion
therapy under the control CVP, conducting of neurovegetative defence, take
the ECG
C. injection of streptodecasol, stream infusion of reopoliglyocinum, injection of
lidocainum, increase of dose of analgetics
D. correctly A) and C)
E. all answers are faithful
203. At a patient, that is found on medical treatment in the therapeutic department, the
sudden stopping of circulation of blood happene Medical personnel begun the
reanimation measures. Define the most rational way of injection of adrenalin for
renewal of heart abbreviations in default of vein access:
A. *A. To enter to a 3 ml solution of adrenalin in a trache
B. To enter to a 1 ml solution of adrenalin in muscl
C. To enter adrenalin in muscle, multiplying a dose in 3 times.
D. The intracardial injection.
E. Adrenalin can be not entered.
204. At a patient, that is found under the permanent electrocardioscopic supervision,
microwave fibrillation of myocardium and diagnosed clinical death develope It is
necessary to do:
A. to inject the solution of calcium in cor
B. *B. to conduct high-voltage electric defibrillation
C. to inject solution of atropine in cor
D. to inject solution of adrenalin in cor
E. All answers are wrong
205. At the patient operated concerning the festering peritonitis coused by perforation
of gastric ulcer, in a postoperation period appeared: high temperature, frequency of
breathing 35/min., AP – 70/40 mm of mer item, diuresis -20 ml/h temperature of
body to 39 , leucocitosis. Transfusion during 12 hours 1,8 of a 0,9% solution of
chlorous sodium and 0,8 of solution of reopoliglucin did not improve general
condition. Central vein pressure – 130 mm wt.st. For stabilization of hemodinamics
will be optimum infusion:
A. *A. Dopamin
B. Mezaton
C. Adrenalin
D. Noradrenalin
E. Ephedrine
206. At the ventilated patient with the edema of lungs at low pressure and septic shock
intravenous infusion 7,5 mcg/kg/min dopamini will increase
A. RaO2, saturation of oxygen of the mixed vein blood, consumption of oxygen
B. diuresis
C. *C. cardiac systolic volume
D. right A) and B)
E. faithful all answers
207. During the operation concerning strangular impassability of bowels, which
conducted under general anaesthesia of i/v with ALV, at a patient the stop of cardiac
happened 50 years in the moment of mesenretium streching by the surgeon. What
would prevent the stop of heart in this case?
A. *A. i/v injection atropin
B. i/v injection of cardiac glycozidis
C. Deepening of general anaesthesi
D. Additional injection of relaxants
E. Additional injection droperidol
208. In 2 hours after renewal of cardial activity at a patient, that carried the sudden
stop of heart on a background hemorhagic shock (blood lost near 2,5 l) and is found
on ALV, unstable hemorhagia (AP – 80/40 – 90/60 mm of mer item, tahycardia)is
marked, central vein pressure – 5 mm wt.st. It is related to:
A. *A. By Hypovolume syndrome
B. By cardia insufficiency
C. By the inadequate interchange of gases
D. Vasoplegia
E. By the inadequate anaesthetizing
209. In postpartum period of patient T.,conducted scraping of walls of uterus cavity
concerning post-natal metroendometriasis on a background of necrosis of decidual
layer, complication appeared with sudden decline of AP to 80/50 mmhg., Pulse of
110 min. Skin is pale, covered with sticky death-damp. The uterine bleeding absent.
What should we begin the first aid from ?
A. *A. artificial ventilation of lungs
B. infusion therapy
C. Antibacterial therapy
D. Support of cardiac extrass
E. Laparotomii with next extraction of uterus
210.
It is typical for:
A. *A. Negative CVT
B. Erroneous punction of artery
C. Right-side pmeumothorax
D. Edema of lungs
E. Hypodermic emphysema
211. On a 4 day after incompatible (on a group) blood transfusion at a patient acutely
reduced diuresis, anuria developed, the common state became worse acutely. At
laboratory research: creatinin plasma – 680 mlmol/l, urea of plasma - 24 mmol/l.
What illness and what stage of illness it follows to think about in the first place?
A. *A. Acute kidney insufficiency, anuria
B.
C.
D.
E.
Anaphylactic shock, acute kidney insufficiency, anuria
Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
Posthemoragic acute kidney insufficiency, anuria
acute interstitsial nephritis, postrenal anuria
212. On an enterprise with plenty of workers educational practical work is conducted
on the leadthrough of cardiopulmonary reanimation. It is foremost needed to teach the
workers of «chain of survival», which plugs in itself:
A. forming from the people chain on which will be passed to instruction in
relation to correct implementation of urgent measures;
B. set of tools and medical preparations for a grant to the first aid at clinical
death;
C. the «chains of survival» study only in the specialized higher educational
establishments with the receipt of the special diploma for its use;
D. immediate informing of guidance of establishment and direct chief of victim,
bringing in to the reanimation of the medical cabinet, deliveries on an official
machine to the nearest medical establishment.
E. *E. early activating of service to medical first-aid, early beginning of
elementary sustentation, early defibrillation by automatic external
defibrillator, early beginning of further sustentation.
213. Patient 20 years for verification of the functional state of kidneys the X- ray
examination with v/v injection of cardiotrast is conducte At the end of injection the
state of patient acutely became worse, the shortness of breath, hyperemia of skin, itch
appeare AP – 60/20 mm of mer item, HBA – 132/min. A similar research was
conducted 3 months ago, such effects were not observe What most reliable diagnosis?
A. *A. Medicinal anafilactic shock
B. Acute kidney insufficiency
C. Tromboembolism of pulmonary artery
D. Stress on the conducted manipulation
E. Heart attack miocardium
214. Patient 30 years after a road-transport failure complaints of the acute tahypnoe.
Ob-ly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax,
stomach, right side of the neck. Auscultative: breathing on the right side is not
conducted; pulse – 130/min., AP – 80/60 mm.mercury., CVP – 140 mm wt., FB – 30
/min., Ht – 0,27, Hb – 90 g/l. Subsequent therapy must include above all things:
A. *A. punction of pleura cavity.
B. Urgent ALV
C. Massive infusion therapy of the crystalloid solutions
D. Infusion of dofamin, 2-5 mcg/cg/min
E. 100% oxygen
215. Patient, 40 years, with the trauma of both thighs is delivered from the scene of
accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of
the neck, tahypnoe, AP 60/40 mm mer st., HBA=120 /min, in lungs moist wheezes,
diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses is most reliable?
A. *A. Fatty embolism
B. Traumatic shock
C. Hemorhagic shock
D. Pain shock
E. Tromboembolism
216. The patient 32 years have infusion of native plasm At the end of infusion the
state became worse: disorientation, cyanosys, excitation, appeared hypersalivation,
tahypnoe, AP =70/40 mm mer st., in lungs – the dissipated dry wheezes. What
medicine must be injected firstly?
A. *A. Adrenalin.
B. Suprastin.
C. Gidrocortizon.
D. Dopamin.
E. Eufilin.
217. The patient 60 years is delivered in the department of intensive therapy with a
diagnosis: bite of bee, anafilactic shock.. Which medicine will be primary and most
effective?
A. *A. Adrenalin
B. Calcium the chloride
C. Prednizolon
D. Dimedrol
E. Suprastin
218. The patient of 2 days carried the state of clinical death back. During the first days
of postasystolic period the state was stabilized with a tendency to the improvement.
Now there is worsening of the state, hypoxemia of PaO2 65 mm Hg, shortness of
breath to 30 per min., tachycardia, high blood pressure. What conclusions can be
done?
A. postasystolic illness begins;
B. cardiopulmonary reanimation conducted inadequately;
C. *C. ІІІ stage of postasystolic illness;
D. for a patient chronic pathology was intensifyed;
E. the fever of lungs makes progress for a patient.
219. To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of
correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was
conducte A doctor went out from a chamber after conducting of necessary tests
before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient
without consciousness. The cyanosys of upper body part. Irregular breathing with the
selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on
peripheries and arterial pressure are not determine Tones of heart are deaf,
unrhythmical. An ampoule and transfusion system is empty. What complication arose
up as a result of hemotransfusion?
A. *A. Air embolism of pulmonary artery
B. Tromboembolism of pulmonary artery
C. Edema of lungs
D. Heart attack of myocardium
E. Syndrome of massive hemotransfusion
220. To the patient 45 years with suspicion on holecystitis the rentgen contrast i/v is
quickly injecte Tahycardiya, arterial hypotension, cyanosys, shortness of breath
appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.st.
acute insufficiency of what part of the cardial-vascular system is observed at a
patient?
A. Right ventricle of heart
B.
C.
D.
E.
*B. The left ventricle of heart
Both ventricles of heart
Vessels
Uneffective heart
221. The patient 32 years have infusion of native plasma. At the end of infusion the
state became worse: disorientation, cyanosys, excitation, appeared hypersalivation,
tahypnoe, AP =70/40 mm merc.st., in lungs – the dissipated dry wheezes. What
medicine must be injected firstly?
A. *A. Adrenalin.
B. Suprastin.
C. Gidrocortizon.
D. Dopamin.
E. Eufilin.
222. A patient 25 years is hospitalized in the surgical department with a diagnosis:
penetrable wound of abdominal region. Objectively: it is excited, skin covers and
visible mucous shells are pale; peripheral pulse of the weak filling, frequent, AP –
110/60 mm mercury Positive symptom of ”desolation” of peripheral hypodermic
veins. Diuresis is lowered. How to characterize this state?
A. *A. The compensated shock
B. Preagonia
C. Circulating shock
D. Agony
E. Irreversible shock
223. A patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the
surgical department with complaints on vomiting by "coffee-grounds", diarhea,
moderately expressed thirst. Objectively: a skin is pale, covered by a death-damp, a
tongue is dry, AP – 80/60 mm rt.st., HBA – 120/min., BF – 28/min., diuresis – 25
ml/h. Blood test: Eras. - 2,8 1012/l, Hb – 98 g/l. What will be most expedient in
medical treatment:?
A. *A. solutions with colloid
B. 5% solution of glucose
C. Whole blood
D. Red corpuscles mass
E. Colloid solutions with red corpuscles mass
224. A patient 48 years the second day in dpartment of intensive therapy concerning
the acute front-partition heart attack of myocardium. During a review “wheezing”
suddenly, non-permanent tonic constricting of muscles is marked, pupils are
extended, pulse on a. carotis not palpitate. What doctor have to do in the first place?
A. *A. Triple Safar method
B. Record of ECG
C. Cardial hit in the area of heart
D. Artificial respiration by the method of Silvester
E. Intracardial injection of adrenalin with an atropine
225. A patient entered the department with a diagnosis: acute intestinal impassability.
Complaints: insignificant thirst, dizziness at an attempt to get up from a bed. At a
review: patient apathetical, turgor is lowered, eyeballs are soft, tongue is dry with
cracks. Pulse – 110 min., AP – 80 /60 mm of merc. item, diuresis – 25 ml /h.
Electrolyte composition: Na+ - 142 mmol/l, C+ - 4 mmol/l, glucose – 6 mmol/l, urea
– 7 mmol/l. What variant of infusion is most expedient during operation?
A. *A. Transfusion of crystalloids.
B. Transfusion of solution of glucose.
C. Transfusion of albumen.
D. Transfusion of native plasma.
E. Transfusion of poliglucin.
226. A patient with a traumatic shock AP – 50/0 mm rt.st., HBA – 160 /1 min. Define
a shock index:
A. *A. 3,2
B. 2,5
C. 1,5
D. 0,5
E. 0,3
227. A patient, 28 years, 2 hours ago fell down from the ground floor of house. Sopor,
pale, there are the plural scratches of face, the lacerated hemorhagic wounds on the
left forearm. The closed break of the left shoulder and thigh. Pulse –110, Lc-10T/l,
Hb – 100, AP – 90/40 mm of rt. item. In the blood test: red corpuscles – 3,5 g/l. What
infusion fluid does not need to be used for medical treatment of shock?
A. *A. 5% solution of glucose
B. Solution of crystalloids
C. Solutions gelatin
D. Solutions of calcium
E. Solution of albumen
228. At a patient with the acute heart attack of myocardium in the region of partition
on a 5th day after the brief episode of loss of consciousness there is reduction of
frequency of pulse to 32 in a minute. BP - 80/40 mm Consciousness at the level of
sopor. He immediately needs :
A. to put right a craniotserebral hypothermia, to enter lasics, prednisoloni,
tserebrolizin
B. to enter an atropine, eoufilin, to begin infouziyo of aloupenta
C. *C. to conduct urgent cardiostimoulation
D. all answers are faithful
E. there is no right answer
229. At a patient, carried to a 2 year ago the heart attack of myocardium, the acute
decline of cholecystyties planned cholecystectomy, signs of electric instability of
myocardium . Actions of anaesthesiologist must include:
A. injection of prednisoloni, lidocaini, hyperventilation, take the ECG
B. *B. injection of dopamini, after stabilisation of BP - nitroglycerine + infusion
therapy under the control CVP, conducting of neurovegetative defence, take
the ECG
C. injection of streptodecasol, stream infusion of reopoliglyocinum, injection of
lidocainum, increase of dose of analgetics
D. correctly A) and C)
E. all answers are faithful
230. At a patient, that is found on medical treatment in the therapeutic department, the
sudden stopping of circulation of blood happened. Medical personnel begun the
reanimation measures. Define the most rational way of injection of adrenalin for
renewal of heart abbreviations in default of vein access:
A. *A. To enter to a 3 ml solution of adrenalin in a trachea.
B. To enter to a 1 ml solution of adrenalin in muscle.
C. To enter adrenalin in muscle, multiplying a dose in 3 times.
D. The intracardial injection.
E. Adrenalin can be not entered.
231. At a patient, that is found under the permanent electrocardioscopic supervision,
microwave fibrillation of myocardium and diagnosed clinical death developed. It is
necessary to do:
A. to inject the solution of calcium in heart
B. *B. to conduct high-voltage electric defibrillation
C. to inject solution of atropine in heart
D. to inject solution of adrenalin in heart
E. there is no right answer
232. Patient 20 years for verification of the functional state of kidneys the X- ray
examination with intravenously injection of cardiotrast is conducted. At the end of
injection the state of patient acutely became worse, the shortness of breath, hyperemia
of skin, itch appeared. AP – 60/20 mm of merc. item, HBA – 132/min. A similar
research was conducted 3 months ago, such effects were not observed. What most
reliable diagnosis?
A. *A. Medicinal anafilactic shock
B. Acute kidney insufficiency
C. Tromboembolism of pulmonary artery
D. Stress on the conducted manipulation
E. Heart attack miocardium
233. Patient 30 years after a road-transport failure complaints of the acute tahypnoe.
Ob-ly: a skin is pale, cyanosis. Hypodermic emphysema in the region of thorax,
stomach, right side of the neck. Auscultative: breathing on the right side is not
conducted; pulse – 130/min., AP – 80/60 mm.mercury., CVP – 140 mm wt., FB – 30
/min., Ht – 0,27, Hb – 90 g/l. Subsequent therapy must include above all things:
A. *A. punction of pleura cavity.
B. Urgent ALV
C. Massive infusion therapy of the crystalloid solutions
D. Infusion of dofamin, 2-5 mcg/cg/min
E. 100% oxygen
234. Patient 38 years, native plasma was poured. At the end of infusion the state
became worse: Patient confused, excited, cyanosys, hypersalivation. Breathing
frequency 36 on 1 min., AP – 70/40 mm of merc. item, whistling dry wheezes.
Which from the following medicine must be injected firstly?
A. *A. Adrenalin.
B. Eufilin.
C. Suprastin.
D. Noradrenalin.
E. Prednizolon.
235. Patient 40 years with the acute gastro - intestinal bleeding a canned blood was
poured in a volume 400 ml after conducting of all tests on compatibility. After
hemotransfusion the state of patient became worse, appeared head pains and pains in
muscles ,the temperature of body rose to 38,8 C. What can explaine the state of
patient?
A. Pirogenic reaction of middle heavy
B. *B. By development of hemotransfusion shock
C. Alergic reaction
D. By development of bacterial-toxic shock
E. By air embolism
236. Patient 62 years the third day of presense in department of intensive therapy
concerning the acute transmural heart attack of myocardium of front-partition
localization. At night woked up from a suffocating cough, feeling of fear and trouble.
At a review: cyanosys, FB – 30 after 1 min., HBA – 132/ min., a rhythm is correct,
tones of heart are deaf, accent ІІ tone above a pulmonary artery, AP – 180/110 mm
mercury. There is the loosened breathing above lungs with the far of moist wheezes
in lower fates. What probably became the reason of worsening of the state?
A. *A. Edema of lungs
B. Embolism of pulmonary artery
C. The repeated heart attack miocardium
D. Hypertensive crisis
E. Attack of bronchial asthma
237. Patient N., 40 years, groom. In anamnesis there is an allergy to nonsteriidal
antiinflammatory. After injection of antitetanus on a method Besredco concerning the
hammered wound of right shin, through 20 mines, there was a acute weakness,
labouring breath, through 10 mines, loss of consciousness. What way of development
of anafilactic form of illness?
A. *A. Sensitization to the albumen of horse whey
B. Low quality of horse whey
C. Breach of the technique of PPS injection
D. Presence in anamnesis of medical allergy
E. Infection of whey
238. Patient, 40 years, with the trauma of both thighs is delivered from the scene of
accident by a “passing transport”. Objectively: cyanosys, rubor of the lower half of
the neck, tahypnoe, AP 60/40 mm merc.st., HBA=120 /min, in lungs moist wheezes,
diuresis – 20 ml/h., Nb 100 g/l. Which from the offered diagnoses most reliable?
A. *A. Fatty embolism
B. Traumatic shock
C. Hemorhagic shock
D. Pain shock
E. Tromboembolism
239. Persons 48 years, patient by the heart attack of miocardium, suddenly lost
consciousness, breathing and palpitation. On ECG of highwave fibrilation of
ventricules. Conducted defibrilation. Did not pick up normal cardial activity. What
medicine needs to be entered for the rise of sensuality to defibrillation?
A. *A. Amiodaron
B. Propranolon
C. Lidocain
D. Strofantin
E. Atropini sulfati
240. To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of
correction of anaemia transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was
conducted. A doctor went out from a chamber after conducting of necessary tests
before hemotransfusion. In 20 minutes he was quickly asked to the patient. Patient
without consciousness. The cyanosys of upper body part. Irregular breathing with the
selection of a plenty of foamy, with the admixtures of blood, phlegm. Pulse on
peripheries and arterial pressure are not determined. Tones of heart are deaf,
unrhythmical. An ampoule and transfusion system is empty. What complication arose
up as a result of hemotransfusion?
A. *A. Air embolism of pulmonary artery
B. Tromboembolism of pulmonary artery
C. Edema of lungs
D. Heart attack of myocardium
E. Syndrome of massive hemotransfusion
241. To the patient 45 years with suspicion on holecystitis the rentgen contrast i/v is
quickly injected. Tahycardiya, arterial hypotension, cyanosys, shortness of breath
appeared, acute swelling of veins of neck, extension of liver, CVT to 200 mm wt.st.
acute insufficiency of what part of the cardial-vascular system is observed at a
patient?
A. *A. Right ventricle of heart
B. The left ventricle of heart
C. Both ventricles of heart
D. Vessels
E. Uneffective heart