Modul 2 Symptoms and syndromes in diseases of internal organs Text test
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The changeable murmur is auscultated leftwards in the third - fourth intercostal spaces between medioclavicular and anterior axillary lines, it is heard very close to the ear of the examiner. The murmur intensifies at deep inspiration, corresponds to respiration and heart rate. What is this murmur?
48-aged patient has chronic obstructive bronchitis, lung emphysema, diffuse pneumosclerosis. ECG investigation showed in him: Рп.ш is more than 2,5 mm; in V1 and V2 QRS is of qR-type (large R wave); interval S-T is displaced downwards to 1-2 mm and negative, QRS in v5.6 is of RS shape. What that ECG changes indicate on?
Data of auscultation of a heart: near the left edge of the sternum in third - fourth intercostal spaces the changeable murmur is listened which is heard very close to the ear of the examiner, strengthens at inclination of the patient’s trunk forward and if to press the bell of the stethoscope to the chest wall. The murmur is synchronous with heart contractions. What kind of murmur is present?
Data of ECG: rrythm is sinus, regular, heart rate is 60 per min. Voltage is decreased. Electrical axis is vertical. What is the angle ά in this case?
Data of ultrasound examination of a heart: widening of aortic rout, sickness and calcification of its walls. What pathological condition is present in the patient?
During analysis of ECG a student has made conclusion that electrical heart axis is deviated leftwards. What signs are necessary to find out in ECG standard leads to make such a conclusion?
During examination of a patient with mitral stenosis the following auscultation picture was revealed: the heart sounds are weakened, tachycardia, specific rrhythm is heard at the apex which is better auscultated when the patient is lying on the left side. How such a rhythm is called?
During examination of a patient’s heart the following auscultation picture was revealed: the heart sounds are weakened, tachycardia, tripple rrhythm is heard at the apex which is better auscultated when the patient is lying on the left side. In which pathology does it occur?
During inspection, palpation, percussion and auscultation of a patient the congestion in his lungs is revealed, which is caused by severe left ventricular failure. Which adventitious heart sound may be auscultated at the apex of the patient’s heart?
During examination of patient E, 20 years old, it was revealed elevation of the lower part of his sternum. What is the type of the chest?
During examination of patient A, 16 years old, it was revealed protrusion of the sternum forward. The chest resembles those in birds. What is the type of the chest?
Morning cough is typical for:
Morning cough is typical for:
Patient P, a woman, complains of dyspnea. Patient feels that it is difficult both to inhale and exhale air. How is this type of dyspnea called?
Patient P, a woman, complains on dizziness, faintness, dyspnea. Patient feels that it is difficult to inhale air. How is this type of dyspnea called?
Patient P, 54 years old, suffers with bronchial asthma for 10 years. By inspection of his chest it was revealed that its anterior-posterior diameter is enlarged, the chest is of barrel shape. What type of chest is present in this patient?
Patient C.,19 y.o. Data of inspection of the chest: sternum is protruded forward as a comb. What type of the chest does take place in this case?
Patient R. is on long-standing treatment because of lung disease. 1 hour ago he occasionally has expectorated up for about 200 ml of purulent sputum in one coughing act. Which disease is it typical for?
Patient R. is on long-standing treatment because of lung disease. 1 hour ago he occasionally has caughed up about 200 ml of purulent sputum. Caughing with large amount of sputum (with full mouth) in the morning is typical for:
Patient A.,20 y.o., was fallen ill 2 days before. The onset was acute with chills, t-38 °С, paint in the throat, dry cough accompanied with pierching sensations behind the sternum. Objective data: general condition is close to satisfactory, body temperature is normal, during auscultation vesicular breathing is heard in the lungs, respiratory rate is 20 per min. Which disease may be suspected?
Patient A.,20 y.o., has developed a disease 2 days before. The onset was acute with chills, t-38 ?С, paint in abdominal region, nausea, dry cough. The same symptoms were 3 weeks before. Objective data: dull percussion sound and moist fine rales above the lower right part of the chest are heard. Which adventitious examinations are necessary to prove diagnosis?
Patient B., 42 y.o., complains of cough with expectoration of mucopurulent sputum, dyspnea, fever, headache, general weakness. He was fallen ill 3 days before after overcooling. Objective data: above the lungs bandbox percussion sound is heard, during auscultation- harsh breathing, diffuse dry whistling rales. Data of complete blood count: leuk. – 9,8х10л12/l, ESR – 18 mm per hr. Which adventitious examinations are necessary to prove diagnosis?
During auscultation of an adolescent person intensified vesicular breathing above all parts of lungs was revealed after the patient has performed physical exercises. What is probably cause of such a finding?
A patient aged 30 y.o. complains of low grade fever, dry cough, nasal excretions and headache. The onset was acute 2 days before. Objective data: general condition is close to satisfactory, harsh breathing is heard in the lungs. Pointed lung pattern on X-ray. Which disease may be suspected?
Patient S., 42 y.o., complains of pain and sensation of heaviness and overfilling in the right part of the chest, dyspnea, cough with hemopthysis, marked general weakness. He has lost 10 kg of body weight for the last 2 months. During objective and X-ray examination pleural fluid was revealed. During procedure of pleurocentesis the hemorrhagic pleural content was obtained. Which disease should be suspected?
A patient complains of mixed expiratory dyspnea. Objective data: barrel chest, bandbox percussion sound, weakened vesicular breathing in auscultation. Which syndrome are these data typical for?
A patient developed complete atelectasis of the whole lung lobe. Which data of auscultation will be in the patient?
A patient developed dry pleurisy. Which data of auscultation will be in the patient?
A patient developed lobar pneumonia of the right lover lung lobe. Which data of auscultation will be above affected part of the lung in I stage of the disease?
A patient developed lobar pneumonia of the right lover lung lobe. Which data of auscultation will be above affected part of the lung in II stage of the disease?
A patient developed pleurisy with accumulation of a large volume of liquid. Which data of auscultation will be at the zone of collapsed lung just above the liquid?
A patient developed pleurisy with effusion. Which data of auscultation will be at the projection of accumulated liquid?
A patient developed syndrome of air accumulation in pleural cavity. How will main respiratory sounds change in this case?
A patient with bronchiectatic disease developed decompencation of chronic pulmonary heart. Which method is the most informative in verification of this pathological condition?
A patient with chronic dyspnea and hemopthysis is suspected to have central lung cancer. Which method is the most effective in verification of this syndrome?
A patient with chronic pain in the chest and hemopthysis is suspected to have peripheral lung cancer. Which method is the most effective in verification of this syndrome?
A patient with cough and pain in the chest is suspected to develop pneumonia. Which method is necessary to prescribe for verification of this disease?
A patient with pneumonia developed dry pleurisy. Which data of auscultation is to be expected above affected part of the lung?
A patient with tuberculosis experienced a large cavern in the right upper lung lobe. Which data of auscultation is to be expected at affected part of the lung?
A patient with tuberculosis developed pneumothorax. Which data of auscultation is to be expected above affected side of the chest?
A young boy was examined by military commission and the conclusion was made that he is healthy. Which data of auscultation of lungs are to be expected?
At examination of patient X. the following findings were obtained as: complaints on fever, cough, nightly sweating; at objective examination: thin chest wall; vocal fremitus is not changed, tympanic percussion sound is heard at the right subscapular region, while by auscultation amphoric breathing is heard in the same region. Which pathological condition do these signs indicate on?
Data of chest X-ray of a patient indicate on cavity in the lungs. Which actually changes will be on X-ray?
Data of chest X-ray of a patient indicate on diffuse pneumofibrosis. Which actually changes will be on X-ray?
Data of chest X-ray of a patient indicate on tuberculosis. Which actually changes will be on X-ray?
Data of chest X-ray of a patient indicate on pleurisy with effusion. Which actually changes will be on X-ray?
Data of chest X-ray of a patient indicate on pneumonia. Which actually changes will be on X-ray?
Data of chest X-ray of a patient indicate on pulmonary emphysema. Which actually changes will be on X-ray?
During auscultation of patient P., 60 years old, who experienced COPD, dry whistling rales above all parts of the lungs were heared as well as weakened vesicular breathing. What is the mechanism of such auscultatory phenomena origin?
During auscultation of a patient with croupous pneumonia a doctor found bronchial breathing above the medial lobe of the right lung. Which changes of vocal fremitus, bronchophonia and percussion sound should you expect?
During auscultation of a patient a doctor found in him pulmonary emphysema. Which changes of vocal fremitus, bronchophony and percussion sound should be expected in this case?
During auscultation of a young boy with fever a doctor found in him pulmonary tissue consolidation syndrome. Which changes of vocal fremitus, bronchophony and percussion sound should be expected in this case?
During auscultation of a young female with long-term low grade body temperature a doctor revealed a focus of amphoric breathing in her lungs. Which pathological condition is it necessary to suspect in the patient?
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