Download Task №1

Task №1.
According to the formula to calculate SV and CO: AP 140/80 mm Hg, age 13 years. HR 100 per
minute.
Task №2.
The patient X., who suffers from hypertension and diabetes, appealed to the clinic with
complaints of breathlessness periodically emerging with difficulty and dissatisfaction breath,
especially during physical exertion expressed. How days ago he appeared fit severe inspiratory
dyspnea ("choking") with the fear of death. On this occasion, an ambulance was called, the doctor
diagnosed a "cardiac asthma". The examination of the patient in the clinic found: BP 155/120
mmHg, with fluoroscopy - the expansion of the left ventricle.
Questions:
1. Identify the reasons for the development and pathogenesis of this condition?
2. What, in your opinion, can develop a complication in this patient?
3. Based on the pathogenesis, determine the tactics of medical care in this case?
Task №3.
The child revealed stenosis of the pulmonary artery. On examination revealed: systolic
murmur in the 2nd intercostal space on the left, accent 2 tones of the pulmonary trunk, right
ventricular hypertrophy, cyanosis, chest pain especially during exercise. Answer the questions.
Questions:
1. What form of heart disease developed in a patient? Arguments answer.
2. What, in your opinion, a causal relationship between the development of this disease and physical
examination data? Arguments answer.
3. What is the most likely cause of the condition is accompanied by pain in the chest?
4. What additional research is needed to confirm myocardial damage.
Task №3.
The patient Z., 18 years old, suffering from tuberculosis, complained of shortness of breath;
pain in the right upper quadrant, low-grade fever. These complaints have emerged, and gradually
began to grow about 4 weeks ago. On examination: face pale and puffy, orthopnea (patient sits
leaning forward); percussion: the expansion of the boundaries of the relative dullness of the heart to
the left and to the right by 2 cm, HR 100, BP 90/60 mm Hg .; Auscultation: heart sounds dull, finely
wheezing in the lungs in basal, respiratory rate 26 per minute; swollen neck veins, the liver
performs at 3 cm from under the edge of the costal arch, painful on palpation, pasty legs. When Xrays of the chest: spherical shadow heart.
Questions:
1. Does the patient's heart failure? What is the evidence of that?
2. What additional research methods should be used to clarify the forms of heart disease?
3. Explain the mechanism of these symptoms on the basis of the pathogenesis of heart failure.
4. Make conclusions about the form of heart failure.
Task №5
Patient B., 18 years old who has a history of insulin-dependent diabetes mellitus appealed to
the clinic with complaints of abdominal enlargement, the emergence of leg edema, which are
amplified in the evening. It is also concerned about the patient chest pain compressive nature, the
intensity of which increases in time of physical activity. When viewed from a doctor: accumulation
of fluid in the abdominal cavity, increasing the boundaries of the heart, muffled heart sounds.
Tolerance to the physical. loads dramatically reduced.
Questions:
1. Does the patient's heart failure? What is the evidence of that?
2. By what circulation occurs stagnation? What information about this show?
3. Explain the mechanism of these symptoms on the basis of the pathogenesis of heart failure. What
was the impetus for this disease?
Task №6
According to the formula to calculate SV and CO: BP 130/80 mm Hg, age 10 years. Heart rate 90
per minute.
Task №7
According to the formula to calculate SV and CO: BP 150/80 mm Hg, age 16 years. Heart rate 90
per minute.
Task №8
Patient U., 80 years old is in the coronary care department about the myocardial infarction
complicated by pulmonary edema. Objectively: pale skin, expressed acrocyanosis. Mouth pink
frothy sputum, above the light heavy finely wheezing. The tone of the heart abruptly muted, blood
pressure 80/60 mm Hg
Questions:
1. Based on the pathogenesis, explain on what systemic circulation blood stasis has occurred?
2. On the basis of the development of a mechanism to explain the appearance of these symptoms?
Task №9
Patient D., 90 years, complains of shortness of breath, swelling of the feet, an increase in size
of the abdomen, a sharp decrease in exercise tolerance. On examination, pronounced swelling of the
lower extremities, accumulation of fluid in the abdominal cavity, abundant finely wheezing over the
lungs, heart sounds muffled percussion expansion of the boundaries of the heart.
Questions:
1. Explain in what systemic circulation blood stasis has occurred?
2. On the basis of the development of a mechanism to explain the appearance of these symptoms