Modul 2 Symptoms and syndromes in diseases of internal organs Text test

1. 
   Sinus arrhythmia
   
2. 
   * Atrial fibrillation
   
3. 
   Ventricular fibrillation
   
4. 
   AV block
   
5. 
   Normal findings
   

The patient’s condition is severe. During general inspection marked acrocyanosis as well as swelling of crues, feet were revealed. Swelling of neck veins is observed. The liver is enlarged, symptom of “drum-type rodes”,. “the watch glasses” are present. What syndrome are these symptoms typical for?

1. 
   Syndrome of the left ventricular failure
   
2. 
   * Syndrome of the right ventricular failure
   
3. 
   Syndrome heart rrhythm disorders
   
4. 
   Acute coronary syndrome
   
5. 
   Syndrome of vascular insufficiency
   

How apex beat will be changed in mitral stenosis?

1. 
   Not changed
   
2. 
   * Reduced
   
3. 
   Negative
   
4. 
   Diffuse
   
5. 
   Resistant
   

How the square of absolute cardiac dullness will change in chronic obstructive pulmonary disease with pulmonary emphysema?

1. 
   The square of absolute cardiac dullness will not change
   
2. 
   The square of absolute cardiac dullness will increase
   
3. 
   * The square of absolute cardiac dullness will decrease
   
4. 
   The square of absolute cardiac dullness decrease and then turns to be normal
   
5. 
   Not changed
   

How the square of absolute cardiac dullness will change in bronchial asthma attack in patient with mild course of the disease ?

1. 
   The square of absolute cardiac dullness will not change
   
2. 
   The square of absolute cardiac dullness will increase
   
3. 
   The square of absolute cardiac dullness will decrease
   
4. 
   * The square of absolute cardiac dullness decreases during attack and normalises aftr finish of attack
   
5. 
   Not changed
   

If the left border of relative cardiac dullness is located on 2 cm laterally from the left midclavicular line – it means …

1. 
   Compensatory emphysema of the right lung
   
2. 
   Hyperthrophy of the right ventricle
   
3. 
   Enlargement of the left atrium
   
4. 
   Normal location of the border
   
5. 
   * Enlargement of the left ventricle
   

If the right border of relative cardiac dullness is located on 3 cm laterally from the right sternal border – it means …

1. 
   Compensatory emphysema of the right lung
   
2. 
   Hyperthrophy of the right ventricle
   
3. 
   * Enlargement of the right ventricle
   
4. 
   Enlargement of the left atrium
   
5. 
   Normal location of the border
   

In which disease apex beat may be found in IV interspace 3 cm medially from left midclavicular line?

1. 
   Cardioneurosis
   
2. 
   Angina pectoris
   
3. 
   Arterial hypertension
   
4. 
   * Mitral stenosis
   
5. 
   No correct answer
   

In which disease apex beat may be found in VI interspace on anterior axillary line?

1. 
   Cardioneurosis
   
2. 
   Angina pectoris
   
3. 
   * Arterial hypertension
   
4. 
   Mitral stenosis
   
5. 
   No correct answer
   

In which disease apex beat may be found in VI interspace on anterior axillary line?

1. 
   Cardioneurosis
   
2. 
   Angina pectoris
   
3. 
   * Aortal stenosis
   
4. 
   Mitral stenosis
   
5. 
   No correct answer
   

In which disease apex beat may be found in VI interspace on anterior axillary line?

1. 
   Cardioneurosis
   
2. 
   Angina pectoris
   
3. 
   * Heart failure
   
4. 
   Mitral stenosis
   
5. 
   No correct answer
   

Pulse of different filling on both arms is typical for:

1. 
   Incompetence of aortal valve
   
2. 
   Stenosis of aortal valve
   
3. 
   * Incompetence of mitral valve with dilataion of the left atrium
   
4. 
   Combined aortal defect
   
5. 
   No correct answer
   

What characteristics of pain in the case of cardioneurosis?

1. 
   Burning, lasts by hours, days
   
2. 
   Intensive pain irradiating to spinal cord and along aorta
   
3. 
   * Pressing, burning pain at heart apex, disappears after taking of validol or nitroglycerin
   
4. 
   Retrosternal, burning paine, irradiates to the left hand, disappears after taking of Validol or nitroglycerin
   
5. 
   Stubbing pain in precordium, does not irradiate
   

What characteristics of pain in the case of dissecting aortal aneurism?

1. 
   Burning, lasts by hours, days
   
2. 
   * Intensive pain irradiating to spinal cord and along aorta
   
3. 
   Pressing, burning pain at heart apex, disappears after taking of validol or nitroglycerin
   
4. 
   Retrosternal, burning paine, irradiates to the left hand, disappears after taking of validol or other sedatives
   
5. 
   Stubbing pain in precordium, does not irradiate
   

What characteristics of pain in the case of myocardial infarction?

1. 
   Burning, lasts by hours, days
   
2. 
   Dull, diffuse ache, irradiates to the left hand
   
3. 
   * Pressing, burning, irradiates to the left hand, does not disappear after taking of Validol or nitroglycerin, lasts for some days
   
4. 
   Retrosternal, burning paine, irradiates to the left hand, disappears after taking of validol or nitroglycerin, lasts for 15 minutes
   
5. 
   Stubbing pain in precordium, does not irradiate
   

What characteristics of pain in the case of myocarditis?

1. 
   * Permament dull boring pain,which intensifies in physical load
   
2. 
   Dull, diffuse ache, irradiates to the left hand
   
3. 
   Pressing, burning, irradiates to the left hand, does not disappears after taking of validol or nitroglycerin
   
4. 
   Retrosternal, burning paine, irradiates to the left hand, disappears after taking of validol or nitroglycerin
   
5. 
   Stubbing pain in precordium, does not irradiate
   

What characteristics of pain in the case of pericarditis?

1. 
   Burning, lasts by hours, days
   
2. 
   Dull, diffuse ache, irradiates to the left hand
   
3. 
   Pressing, burning, irradiates to the left hand, does not disappears after taking of validol or nitroglycerin
   
4. 
   Retrosternal, burning paine, irradiates to the left hand, disappears after taking of validol or nitroglycerin
   
5. 
   * Stubbing pain in precordium, synchronous with heart contractions, does not irradiate
   

What characteristics of pain in the case of angina pectoris attack?

1. 
   Burning, lasts by hours, days
   
2. 
   Dull, diffuse ache, irradiates to the left hand
   
3. 
   Pressing, burning, irradiates to the left hand, does not disappears after taking of validol or nitroglycerin
   
4. 
   * Retrosternal, burning paine, irradiates to the left hand, disappears after taking of validol or nitroglycerin
   
5. 
   Aching pain in one point of precordium, does not irradiate
   

Which complaints of patients with heart diseases are caused by increased blood pressure in systemic circulation?

1. 
   dizziness, headache
   
2. 
   flickering before eyes, hum in ears
   
3. 
   * all mentioned
   
4. 
   dyspnea, cough, asthma, blood spitting
   
5. 
   nausea, vomiting
   

In a healthy person, 25 years old, blood pressure was found 120/80 mm Hg on the brachial artery. What data of blood pressure should you expect on the legs?

1. 
   100-120/70-80
   
2. 
   120-140/80-90
   
3. 
   * 140-150/90-100
   
4. 
   150-160/100-110
   
5. 
   160-180/110-120
   

Data of percussion of patient’s heart: the borders of relative heart dullness: the right is 2,5 cm laterally from the right edge of the sternum, the left one is on 1.5 cm medially from midclavicular line, the upper one is at the upper edge of the III rib. The borders of absolute heart dullness are as follows: the right is at the left edge of the sternum, the left one is 1 cm medially from the relative one, the upper one is on the level of the IV rib. Which pathological condition are these signs typical for?

1. 
   Enlargement of the left ventricle
   
2. 
   * Enlargement of the right ventricle
   
3. 
   Enlargement of the left atrium
   
4. 
   Norm
   
5. 
   All answers are wrong
   

Data of percussion of patient’s heart: the borders of relative heart dullness: the right is on 1 cm laterally from the right edge of the sternum, the left one is on 0.5 cm laterally from midclavicular line, the upper one is at the upper edge of the III rib. The borders of absolute heart dullness are as follows: the right is at the left edge of the sternum, the left one is 1 cm medially from the relative one, the upper one is on the level of the IV rib. Which these signs are typical for?

1. 
   * Enlargement of the left ventricle
   
2. 
   Enlargement of the right ventricle
   
3. 
   Enlargement of the left atrium
   
4. 
   Enlargement of the right atrium
   
5. 
   Norm
   

Data of percussion of patient’s heart: the borders of relative heart dullness: the right is on 1 cm laterally from the right edge of the sternum, the left one is on 1.5 cm medially from midclavicular line, the upper one is at the upper edge of the II rib. The borders of absolute heart dullness are as follows: the right is at the left edge of the sternum, the left one is on the left midclavicular line, the upper one is on the level of the IV rib. Which these signs are typical for?

1. 
   Enlargement of the left ventricle
   
2. 
   Enlargement of the right ventricle
   
3. 
   * Enlargement of the left atrium
   
4. 
   Enlargement of the right atrium
   
5. 
   Norm
   
6. 
   
   

The borders of patient’s absolute heart dullness show its enlargement: the right border is at mediane line, the left one is 1 cm medially of the left midclavicular line, the upper one is on the level of the V rib. What may be a reason of these changes?

1. 
   * Retrocardial tumour
   
2. 
   Left-sided pleural effuion
   
3. 
   Right-sided pleural effuion
   
4. 
   Acute pulmonary emphysema
   
5. 
   Normal data
   

During examination of patient S. aortal stenosis was revealed. The patient complains of headache, periodical dizziness. Skin palenes is visible as well as carotic arteries pulsation. How the heart borders may change?

1. 
   Displacement of right border of relative cardiac dullness rightward
   
2. 
   * Displacement of the left heart border of relative cardiac dullness leftward
   
3. 
   Displacement of the upper heart border of relative cardiac dullness upward
   
4. 
   Displacement of the left heart border of relative cardiac dullness leftward, the right border – rightward and the upper one – upward
   
5. 
   Displacement of the right heart border of relative cardiac dullness rightward and the upper one – upward
   

During general inspection of a patient the specific face appearance was revealed with sticky eyes, opened mouth and expression of suffer and tiredeness (Corvisar’s face). What pathological condition are thеse signs typical for?

1. 
   * Chronic heart failure
   
2. 
   Acute left ventricular heart failure
   
3. 
   Septic endocarditis
   
4. 
   Rheumatic fever
   
5. 
   Hypertonic crisis
   

During general inspection of a patient the specific face appearance was revealed with sticky eyes, opened mouth and expression of suffer and tiredeness. How is this facial expression called?

1. 
   * Corvisar’s face
   
2. 
   Mitral face
   
3. 
   Basedovic face
   
4. 
   Myxedematous face
   
5. 
   Hippocratic face
   

During general inspection of patient К. a doctor had noticed specific light-brown colouring of patient’s skin (“coffee with milk”). Septic endocarditis was diagnosed. Which skin rash is possible to reveal in this disease?

1. 
   * Petechial hemorrhagic rash on conjunctivas and skin of the trunk
   
2. 
   Erythema annulare
   
3. 
   Erythema nodosum
   
4. 
   Nettle rash
   
5. 
   No rash
   

During general inspection of patient К. petechial hemorrhagic rash on conjunctivas and skin of the trunk was revealed. Which skin color is it possible to reveal in this disease?

1. 
   * Light-brown (like “coffee with milk”)
   
2. 
   Erythema
   
3. 
   Cyanosis
   
4. 
   Yellow
   
5. 
   Pink
   

During general inspection of patient К. with rheumatic fever a doctor revealed specific rash on his skin. Whish type of rash is typical for rheumatic fever?

1. 
   Petechial hemorrhagic rash on conjunctivas and skin of the trunk.
   
2. 
   * Erythema annulare
   
3. 
   Papulas
   
4. 
   Nettle rash
   
5. 
   No rash
   

Patient D., 70 years old, is on long-standing treatment in therapeutic department because of rheumatic fever with pericardial effusion. What forced position is typical in this case?

1. 
   Tends to sit with the lowered legs
   
2. 
   * Tends to sit bending forward
   
3. 
   Horizontal position
   
4. 
   On the left side
   
5. 
   Forced position is not typical
   

Patient M., 22 years old, suffers with rheumatic heart disease since childhood. By inspection there were revealed movements of his head in anterioposterior direction. How is this sign called?

1. 
   ”Carotic shudder”
   
2. 
   *Musse’s sign
   
3. 
   Koher’s sign
   
4. 
   Durosier’s sign
   
5. 
   Botkin-Erb’s sign
   

Patient M., 72 years old, suffers with atherosclerosis. He complains of headache and periodical dizziness. By inspection it was revealed movements of his head in anterioposterior direction and pulsation of carotic arteries. Heart valvular defect is diagnosed by auscultation and ultrasound examination. Which skin color is it possible to expect in this patient?

1. 
   * Paleness
   
2. 
   Hyperemia
   
3. 
   Cyanosis
   
4. 
   Yellow
   
5. 
   Pink
   

Patient К. was hospitalised ito the therapeutic department of a clinic with disease of a heart. His pulse is irregular. Each second wave is of decreased filling. How is this pulse called?

1. 
   Dull pulse
   
2. 
   * Pulsus alternans
   
3. 
   Thready pulse
   
4. 
   Mild pulse
   
5. 
   Dictotic pulse
   

During general inspection edema on patient’s legs was revealed. Edema occurs in the evening, skin above it is cyanotic, cold and dense. Which pathology is this edema typical for?

1. 
   Liver cirrhosis
   
2. 
   Hypopropeinaemia on fasting
   
3. 
   Renal failure
   
4. 
   * Heart failure
   
5. 
   Normal finding
   

A patient suffers from heart failure. What is the typical characteristics of cyanosis in cardiovascular system disturbances?

1. 
   Central cyanosis is typical for these disturbances
   
2. 
   * It is located on distal parts of patient’s body (acrocyanosis)
   
3. 
   Cyanosis of the affected part of patient’s body
   
4. 
   Cyanosis on limbs which occurs in cold
   
5. 
   All mentioned above
   

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?

1. 
   I heart sound
   
2. 
   II heart sound
   
3. 
   * III and IV heart sounds
   
4. 
   Opening snup sound
   
5. 
   Pericardial click
   

Evaluate such correlation of the waves: Wave P is present before each complex QRS, it is maximal in II standart leads, diffenetce of RR intervals is not more than 0,10 - 0,15 sec; heart rate is 60-90 per minute.

1. 
   Hypertrophy of the left ventricle,
   
2. 
   Hypertrophy of the right ventricle,
   
3. 
   Ectopic rrhythm,
   
4. 
   Heart block,
   
5. 
   * Normal sinus rrhythm
   

Evaluate such correlation of the waves: Wave P is present before each complex QRS, it is maximal in I standart lead, diffenetce of RR intervals is less than 0,10 - 0,15 sec; heart rate is 60-90 per minute.

1. 
   * Hypertrophy of the left ventricle,
   
2. 
   Hypertrophy of the right ventricle,
   
3. 
   Ectopic rrhythm,
   
4. 
   Heart block,
   
5. 
   Normal sinus rrhythm.
   

In a patient weakened first and second heart sounds are recorded, rasping systolic murmur is auscultated in the second intercostal space rightwards from the sternum which is conducted to arotic and subclavial arteries. What heart defect are conduction of the murmur typical for?

1. 
   Stenosis of mitral orifice
   
2. 
   * Stenosis of aortic orifice
   
3. 
   Pulmonary trunk valve incompetence;
   
4. 
   Stenosis of pulmonary artery;
   
5. 
   Tricuspid valve incompetence
   

In patient C. with aortal incompetence systolic thrill in the ІІ intercostal space of the right chest was determined. Indicate, please, expected changes of his blood pressure.

1. 
   Low systolic and diastolic
   
2. 
   High systolic and diastolic
   
3. 
   High systolic and low diastolic
   
4. 
   * Low systolic and high diastolic
   
5. 
   No changes.
   

In patient C. with aortal stenosis systolic thrill in the ІІ intercostal space of the right chest was determined. Indicate, please, expected changes of his pulse.

1. 
   * Low and slow
   
2. 
   Quick and high
   
3. 
   Irregular
   
4. 
   Of different filling and tension
   
5. 
   Without changes.
   

In patient C. with aortal stenosis systolic thrill in the ІІ intercostal space of the right chest was determined. Indicate, please, expected changes of the heart borders position.

1. 
   Displacement of right border of relative cardiac dullness rightward,
   
2. 
   * Displacement of the left heart border of relative cardiac dullness leftward
   
3. 
   Displacement of the upper heart border of relative cardiac dullness upward,
   
4. 
   Displacement of the left heart border of relative cardiac dullness leftward, the right border – rightward,
   
5. 
   Displacement of the right heart border of relative cardiac dullness rightward and the upper one – upward.
   

In patient S. the slapping І sound above the heart apex is heard as well as opening snup sound and slapping ІІ heart sound above pulmonary artery. Pulse deficiency is 15 per minute. What kind of disease is it possible to reveal in that case?

1. 
   Mirtal incompletence
   
2. 
   * Mitral stenosis
   
3. 
   Aortal incompletence
   
4. 
   Stenosis of ostium of aorta
   
5. 
   Hypertension
   

In patient S. the slapping І sound above the heart apex is heard as well as a slapping and reduplicated ІІ heart sound above the pulmonary artery. Pulse deficiency is 15 per minute. Mitral stenosis was diagnosed. What cardiac murmur is it possible to reveal by auscultation?

1. 
   Systolic at aortal valve,
   
2. 
   Diastolic at Botkin-Erb’s point
   
3. 
   Systolic at heart apex
   
4. 
   Diastolic at aortal valve
   
5. 
   * Diastolic at heart apex
   

One the phonocardiogram of a patient with acquired valvular heart disease the diamond-shaped systolic murmur is registered with maximal amplitude in II interspace rightward of the sternum. Which heart valvular defect this murmur is typical for?

1. 
   Aortal incompetence,
   
2. 
   Mitral incompetence,
   
3. 
   * Aortal stenosis
   
4. 
   Mitral stenosis,
   
5. 
   Tricuspidal stenosis.
   

In patient A., 32 y.o., eho suffers fromsevere anemia, attending doctor has revealed relative heart murmur during auscultation. Organic systolic murmur differs from the relative one because it:

1. 
   Depends on a phase of respiration
   
2. 
   Is blowing, mild and low in pitch
   
3. 
   Varies at exertion
   
4. 
   * Is conducted to other parts of a body
   
5. 
   Is heard at all points of auscultation
   

Patient O., 40 years old, was admitted to the clinic because of hypertension of the II stage. Data of ECG: R1>RII>RIII. RV6>RV5>RV4, SIII>SII>SI. What do these data testify about?

1. 
   Hypertrophy of the right ventricle
   
2. 
   * Hypertrophy of the left ventricle
   
3. 
   Block of the right bundlebranch of Hiss
   
4. 
   Block of the left bundlebranch of Hiss
   
5. 
   Subepicardial ischemia
   

Patient O.,40 years old, complains of faints and frequent attacks of dizziness. From patient’s anamnesis: she had attack of rheumatic fever 20 years ago. The signs of aortic stenosis are revealed by examination. What kind of murmur is typical for this disease?

1. 
   * Systolic.
   
2. 
   Presystolic.
   
3. 
   Mesodiastolic.
   
4. 
   Protodiastolic.
   
5. 
   Holodiastolic.
   

The patient’s heart is extended leftward, upwards and rightwards; slapping I sound is heard at the apex as well as II sound and adventitious heart sound that together create triple rrhythm. What obvious component of triple rrhythm was not named?

1. 
   I heart sound,
   
2. 
   II heart sound
   
3. 
   III heart sound
   
4. 
   * Opening snup sound
   
5. 
   Pericardial click
   

The patient L., 75 years old, suffers from atherosclerosis. The aortic valve incompletence was diagnosed. What auscultatory phenomenon is it possible to listen to on the femoral artery?

1. 
   Systolic sound,
   
2. 
   Diastolic sound,
   
3. 
   * Double Traube’s sound
   
4. 
   Opening snup sound,
   
5. 
   No any sounds
   

The patient L., 75 years, suffers from atherosclerosis. The aortic valve incompletence was diagnosed. What murmur is it possible to listen to on the femoral artery?

1. 
   Systolic
   
2. 
   Diastolic
   
3. 
   * Double Durozier’s murmur
   
4. 
   Nunt’s murmur,
   
5. 
   No any murmur.
   

The patient L., 75 years old, suffers from rheumathic heart disease. The mitral stenosis was diagnosed. What adventitious heart sound is it possible to listen to by auscultation of his heart?

1. 
   III heart sound,
   
2. 
   IV heart sound,
   
3. 
   Pericardial click sound
   
4. 
   * Opening snup sound
   
5. 
   No any sounds
   

The patient with diagnosis “arterial hypertension” is 64 years old. His ECG data are the following: increased wave R in leads V5-6 and deep wave S v1v2, segment ST is displaced downward in left leads. What that ECG changes indicate on?