Circulatory disturbance №1.

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All following features are associated with hyperemia EXCEPT one:

@Involved the sympathetic neurogenic mechanism

Depend on the releasing of vasoactive substances

Increased blood flow into capillary beds

Marked dilation of small venues

Caused intensified blue-red coloration

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While playing volleyball a sportsman made a jump and landed on the outside edge of his foot. He felt acute pain in the talocrural joint, active movements are limited, passive movements are unlimited but painful. A bit later there appeared a swelling in the area of external ankle, the skin became red and warm. What type of peripheral circulation disturbance is the case?

@Arterial hyperemia

Venous hyperemia

Stasis

Embolism

Thrombosis

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A 22-year-old second-year medical student develops a “red” face after being asked a question during lecture. Which of the following statements best describes this vascular reaction?

@Active hyperemia

Acute congestion

Non-palpable purpura

Passive hyperemia

Petechial hemorrhage

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A 42-year-old woman with trigeminal nerve neuralgia complaints of redness of right part of her face and neck, feeling of heat rush and increased dermal sensitiveness. What is the arterial hyperemia in this case according to pathophysiological mechanism?

Neuroparalytic

Reactive

Working

@Neurotonic

Metabolic

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A rabbit's nerve that innervates the right ear was cut and its right superior cervical ganglion was removed. Immediately after operation the temperature of ear skin was measured. It was revealed that the temperature of the rabbit's ear skin on the side of denervation was by 1,5⁰C higher than on the opposite intact side. What of the following is the most probable explanation of the above-mentioned effects?

@Atrerial hyperemia induced by metabolic factors

Arterial neuroparalytic hyperemia

Reactive arterial hyperemia

Arterial neurotopical hyperemia

Physiological arterial hyperemia

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Upper neck node of sympathetic trunk was removed from the rabbit on experiment. Reddening and increased temperature of the skin of head is observed. What form of peripheral circulation of the blood developed in the rabbit?

Venous hyperemia

Stasis

Neurotonic arterial hyperemia

Metabolic arterial hyperemia

@Neuroparalytic arterial hyperemia

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A 65-year-old- patient presented with liver cirrhosis. The removal from his abdominal cavity of 10 liters of ascitic liquid resulted a collapse. Grossly his peritoneum was hyperemic. Define the type of hyperemia in peritoneum.

@Post-anemic hyperemia

Collateral hyperemia

Complementary hyperemia

Inflammatory hyperemia

Caused by arteriovenous fistula

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A male with a fracture of the shoulder bone carried on overlapped plaster bandage. Suddenly, an arm and the visible part of the forearm became cyanotic, cold, and edematous. Which of the following is most likely happened?

@Local venous congestion

Local arterial hiperemia

Local anemia

Stasis

Thrombosis

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A patient with closed fracture of humeral bone was bandaged with plaster. The next day the injured hand became swollen, cyanotic and cold. What disorder of peripheral blood circulation are these symptoms typical for?

Thrombosis

Ischemia

Arterial hyperemia

Embolism

@Venous hyperemia

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A 50-year-old male with a myocardial infarction died from the heart failure. A post-mortem revealed the edema of the lungs and petechial hemorrhages at serous and mucus membranes.Microscopic examination indicated marked dystrophic alterations of the nephron's epithelium at proximal canaliculi of kidneys. Also, the centrolobular hemorrhage and necrotic zones were found in the liver. Name the type of the blood circulation disorder.

@Acute general venous congestion.

Arterial hyperemia.

Chronic general venous congestion.

Acute anemia.

Chronic anemia.

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In patient with rheumatic mitral stenosis were revealed the dilatation of right chambers, tricuspid regurgitation, ascities, hydrothorax, edema of low extremities and increased central venous pressure. This state is the finely correlated with:

Acute localized congestion

Acute localized hyperemia

Chronic localized congestion

@Chronic generalize congestion

Chronic generalize hyperemia

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A post-mortem of an elderly man with a long history of the ischemic heart disease and heart failure revealed a nutmeg liver, brown induration of lungs, cyanotic induration of kidney and spleen. Indicate, what type of the blood circulation disorder is most likely?

@Chronic general venous congestion.

Arterial hyperemia.

Acute general venous congestion.

Acute anemia.

Chronic anemia.

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During an autopsy of a man: liver is enlarged, thickened, has rounded edges. On incision the tissue of liver is yellowish-brown in colour with red spots and stripes, looks like nutmeg. What pathological process causes such changes?

@Chronic venous hyperaemia

Acute venous hyperaemia

Arterial hyperaemia

Arterial ischemia

Chronic bleeding

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During an autopsy of a 69 year old man, who died of chronic cardiac failure: liver is enlarged, thickened. On incision the liver is stripy of greyish-yellow colour with dark-red spots. What is the figurative name for such liver?

Stripy

Yellow

Dotty

@Nutmeg

Red

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The histological investigation of a liver detects venous plethora of center lobules, dystrophy and atrophy of hepatocytes in the venous plethora's area, fatty a dystrophy of hepatocytes on the periphery of a lobe. The replacement fibrosis in places of an atrophy of the hepatocytes was also revealed. Which pathological process does this refer to?

@'Nutmeg' liver with precirrhotic phenomena.

Biliary hepatic cirrhosis.

Fatty hepatosis.

Hepatitis.

Toxic dystrophy of a liver.

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A male with a history of myocardial infarct died of cardiovascular failure. A post-mortem revealed a replacement fibrosis, hypertrophy of the myocardium and dilatation of the cavities, especially the right ventricle. The liver was enlarged. Its surface was smooth. Grossly, a motley pattern with dark red dots on the grey a background was revealed. Histologically, central zones of the lobules were hyperemic. On the periphery, around of periportal tracts hepatocytes demonstrated fatty dystrophy. Name these liver changes.

@"Nutmeg" liver (chronic venous congestion)

Pseudo 'nut-meg' liver

Amyloidosis

Cirrhosis of a liver

Steatosis of a liver

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A 65-years-old patient, who presented with a 10 years history of ischemic heart disease, died due to heart failure. An autopsy revealed the cyanotic induration of both spleen and kidneys, brown induration of lungs and "nutmeg" liver. Which is the most likely type of the blood circulation disorder, resulted in such changes of internal organs?

@General chronic venous hyperemia

General acute venous hyperemia

General arterial hyperemia after an anemia

Arterial ischemia as a result of reallocating a blood

Local chronic venous hyperemia

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A patient died under conditions of cardiovascular insufficiency. Autopsy results: postinfarction cardiosclerosis, myocardium hypertrophy and dilatation of its cavities, especially of its right ventricle. Liver is enlarged, its surface is smooth, and incision revealed that it was plethoric, with dark-red specks against the background of brownish tissue. Histologically: plethora of central parts of lobules; peritheral parts around portal tracts contain hepatocytes in a state of adipose degeneration. How are these liver changes called?

Liver cirrhosis

Liver steatosis

@Nutmeg liver

Pseudonutmeg liver

Amyloidosis

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The postmortem of a 48-year-old male, with a long history of a chronic heart failure, revealed an enlarged liver. Grossly, a liver had a motley pattern. Macroscopically, the sectional view looked like a nutmeg on incision. Which term most correctly defines these alteration?

@General venous congestion

General arterial hyperemia

Anemia

Hemorrhage

Bleeding

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A 77-years-old female with unstable angina presents to physician with slowly increasing heart failure symptoms. On the night of admission to the hospital she dies. A post-mortem examination revealed the enlarged liver with dense texture and the rounded edges. Sectional view had a nutmeg pattern with dark red dots on the yellowish background. Which pathological process resulted in liver's alteration?

@Chronic venous congestion

Acute venous congestion

Arterial hiperemia

Arterial anemia

Chronic hemorrhage

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The autopsy of the dead body revealed enlarged, solid with rounded margins liver, on section the tissue was yellow-brown in colour with dark red spots and stripes, which resembled nutmeg. What pathological process led to such liver changes?

Chronic hemorrhage

@ Chronic venous congestion

Acute venous congestion

Arterial hyperaemia

Arterial anemia

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A 54-years old male with a history of ischemic heart disease presents at hospital with recurrent myocardial infarction. Few days later, he died due to cardiac failure. Post-mortem revealed an enlarged solid spleen of dark cherry color on the cut surface. Microscopically, pulp sclerosis and follicles atrophy were found out. What is the most likely term to define spleen's alterations?

@Cyanotic induration of spleen.

Sago spleen.

Lardaceous spleen.

Porphyry spleen.

Septic splenitis

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A patient who had suffered from ischemic heart disease and has had recurrent myocardial infarction died in the background of progressive cardiovascular failure. An autopsy showed enlarged, thickened spleen of cherry colour on incision. Microscopically: follicle atrophy and pulp sclerosis. What term is used to describe such changes?

Porphyry spleen

Sago spleen

Fatty spleen

@Cyanotic spleen induration

Septic spleen

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The patient, who had ischemic heart disease and myocardial infarction, died because of progressive cardiovascular insufficiency. At section an enlarged solid spleen was detected, dark cherry colour when incised. Microscopically: sclerosis of the pulp and the atrophy of follicles were examined. What term can we use to name these changes?

Porphyry spleen

Sago spleen

Tallow spleen

@Cyanotic induration of the spleen

Septic spleen

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Examination of a patient who had been suffering from rheumatism for a long time revealed stenosis of mitral orifice, death was caused by cardiac and pulmonary insufficiency. Autopsy has shown brown induration of lungs. What type of circulation disturbance provokes such changes in lungs?

@Chronic left ventricular insufficiency

Chronic right ventricular insufficiency

Acute right ventricular insufficiency

Portal hypertension

Acute left ventricular insufficiency

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Autopsy of a 73-year-old man who had been suffering from the coronary heart disease along with cardiac insufficiency for a long time revealed: nutmeg liver, brown induration of lungs, cyanotic induration of kidneys and spleen. What kind of circulation disorder was the cause of such effects?

Chronic anaemia

Arterial hyperaemia

Acute anaemia

@General chronic venous congestion

General acute venous congestion

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A 63-year-old patient with long history of ischemic heart disease and repeated myocardial infarction died due to progressive cardiovascular failure. A post-mortem revealed an enlarged, dense spleen with the dark red colour of the sectional view. At the microscopic examination of spleen the pulp's sclerosis and atrophy of the follicles were found. Which term most correcuy ueimca www changes?

@Cyanotic induration of a spleen

Sago spleen

Waxy spleen

Porphyry spleen

Septic spleen

Tissue embolism

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A 52-year-old male with long history of rheumatic heart disease died of chronic heart failure. A post-mortem revealed brown colour, enlarged dense lungs. Name the changes in lungs.

@Brown induration of lungs

Acute bronchitis

Horny-comb lungs

Chronic bronchitis

Chronic emphysema

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An autopsy of a man, who died of chronic cardiac failure, showed: lungs are enlarged, thickened, rusty-coloured with conjunctive tissue expansive growth around bronchi and vessels. What is the most probable diagnosis?

@Brown lung induration

Nidus pneumonia.

Croupous pneumonia

Interstitial pneumonia

Haemorrhagic pneumonia

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A young male with a history of rheumatic heart disease since childhood, gradually develops mitral stenosis, accompanied with episodes of heart failure. He presents to a hospital complaining of coughing with reddish-brown sputum. Name probable changes at patient's lungs.

@Brown induration of lungs

Emphysema of lungs

Atelectasis of lungs

Pneumosclerosis

Bronchiectasis

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A patient with a long history of rheumatic disease died of cardiopulmonary failure. A post-mortem revealed a stenosis of the mitral orifice as well as a brown induration of lungs. Which term most correctly defines this blood circulation disorder?

@Chronic left ventricular failure.

Chronic right ventricular failure.

Acute left ventricular failure.

Acute right ventricular failure.

Portal hypertension.

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Histologic sections of lung tissue from a 68-year-old woman with congestive heart failure and progressive breathing problems reveal numerous hemosiderin-laden cells within the alveoli. Which of the following is the cell of origin of these “heart failure cells”?

Endothelial cells

Eosinophils

Lymphocytes

@Macrophages

Pneumocytes

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During emotionally hard work suddenly died a young man. Autopsy showed uneven blood perfusion of myocardium. Histochemically: decrease of glycogen content. Electronic microscopical research showed mitochondria destruction, myofibrils contractures. Name the most probable blood circulation failure.

Chronic ischemia

@Acute ischemia

Vacate arterial hyperaemia

Acute venous hyperaemia

Angioneurotic arterial hyperaemia

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On examination of a road accident victim a doctor revealed left clavicle fracture and disturbed blood circulation in an extremity (no pulsing of radial artery). What cause of blood circulation disturbance is the most probable?

Compression of vertebral artery

Compression of subclavian vein

@Compression of subclavian artery

Compression of axillary vein

Compression of axillary artery

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A patient, who had fast elimination of 10 liters of an ascitic liquid from abdomen, suddenly lost his consciousness. What was the cause of this phenomenon?

@Ischimia of the brain

Thrombosis of the cerebral arteries

Brain hemorrhage

Arterial hyperemia

Thrombosis of the cerebral veins

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During a section of an 86-year-old woman, who had an atherosclerosis of cerebral vessels, the atrophy of cerebral cortex was determined. Name the atrophy due to the reason.

Pressure

@Insufficiency of blood supply

Physical and chemical factors

Neurotic

Dysfunctional

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A post-mortem of 77-year-old male, with a long history of cerebral atherosclerosis, revealed an atrophy of his cerebral cortex. What was the most likely cause of cortex alterations?

@Insufficiency of blood supply.

Pressure.

Physical and chemical factors.

Neurotic.

Dysfunctional.

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During the autopsy of a 48-year-old man, the obturation of the middle cerebral artery’s lumen by clot was determined. The parieto-temporal part of the left hemisphere had a focus of pappy consistence and of gray colour. Term the most possible reason of such changes.

Fibrinoid necrosis

Sequestrum

Gangrene

Caseous necrosis

@Infarction

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A 56-year-old male with a history of cerebral atherosclerosis suddenly dies. At a there is a thrombus within a middle cerebral artery's lumen. Gross inspection revealed a grey flabby focus at the parietotemporal part of the left hemisphere of his brain .What are the most likely alterations diagnosed in a brain tissues?

@Infarction.

Sequestrum.

Gangrene.

Caseous necrosis.

Fibrinoid necrosis.

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Punctata hemorrhage was found out in the patient after application of a tourniquet. With disfunction of what blood cells is it connected?

Monocytes

Eosinophiles

Neutrophiles

Lymphocytes

@Platelets

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The main intermediate cause of diapedetic hemorrhage is:

@Increased vascular permeability

Increased arterial pressure

Small damages of vascular wall

Sclerosis of vascular wall

Hyalinosis of vascular wall

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A 67-years old female with long state rheumatic mitral stenosis were revealed: marked dilatation of left atrial chamber, the signs of lung circuit hypertension. Was usually associated with intra alveolar hemorrhage. What is the underlying mechanism of this type of hemorrhage:

Hemorrhagia per rhexin

Hemorrhagia per diabrosim

@Hemorrhagia per diapedesis

All the answers are right

All the answers are fals

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During postmortem examination of 34-deceased male, died by suicidal hanging, the multiple subpleural, subepi- and subendocardial minute hemorrhages were established. What is the name of this type of hemorrhage;

@Petechia

Ecchimoses

Purpera

Hematoma

Hemothorax and hemopericardial

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A 20-year-old man incurs blunt trauma to his upper outer arm. On physical examination, there is a 2 x 3 cm contusion. The initial soft tissue bleeding stops in a few minutes and the size of the bruise does not increase. Name this kind of haemorrhage:

Haematoma

@Ecchimoses

Petehii

Purpura

Cyst

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A 42 y.o. patient complains of pain in the epigastral area, vomiting; vomit masses have the colour of "coffee-grounds", the patient has also melena. Anamnesis records gastric ulcer. Blood formula: erythrocytes - 2,8*10¹² /l, leukocytes – 8*10⁹/l, Hb- 90 g/l. What complication is it?

Pyloric stenosis

Penetration

@Haemorrhage

Canceration

Perforation

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During an autopsy in the upper lobe of right lung there was found a big, wedge-like nidus of dark-red, thick tissue. Histologically: necrosis of alveolar walls, alveolar lumen is densely filled with erythrocytes. Name the process.

Gangrene

Carnification

@Haemorrhagic infarction

Bloodstroke

Atelectasis

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An autopsy of a patient who died suddenly at emergency room revealed in his brain a cavity of irregular shape (5 x 3.5 cm) filled with blood clots and macerated cerebral tissue. An area of cavitarydestruction had a rim of brown discoloration. This lesion was found within the subcortex nuclei at the right hemisphere of brain. What is the most likely definition of described pathology?

@Hematoma

Hemorrhagic impregnation

Ischemic infarction

Cyst

Abscess

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An elderly female develops acute disorder of the cerebral blood circulation, followed with coma, resulted in fatal outcome. A post-mortem revealed in the right hemisphere of the brain a large cavity, filled with blood. Which pathological process took place in the brain?

@ Hematoma

Hemorrhagic infiltration

Infarct of the brain

Diapedesis

Edema of the brain

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Autopsy of a man who suffered from essential hypertension revealed a cavity with rust-coloured walls in the cerebral substunce. What preceded the appearance of these changes?

@Hematoma

Plasmorrhagias

Ischemic infarction

Abscess

Diapedetic hemorrhages

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During an autopsy of a man, who suffered from chronic hypertension, there was found a cavity in cerebral tissues, it had rusty walls. What preceded these changes?

Abscess

Diapedetic bleedings

Ischemic infarction

Plasmorrhagias

@Haematoma

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Autopsy of a man who had been suffering from hypertension revealed in his brain a cavity with rubiginous walls. What event preceded development of these changes?

Plasmorrhagias

Ischemic infarction

@Haematoma

Abscess

Diapedetic haemorrhages

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A post-mortem of a 60-year-old female with a history of secondary hypertension revealed a cavity at the right hemisphere of the brain 4x2,5 cm, filled with red clots of blood and softened brain tissue. What term best characterized the brain changes?

@Hematoma

Hemorrhagic impregnation

Ischemic infarct

Cyst

Abscess

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A post-mortem of a 59-year-old patient with long history of idiopathic hypertension revealed in brain a cavity with rusty colour walls. Which process preceded these changes?

@ Hematoma

Diapedesis

Ischemic infarct

Plasmorrhagia

Abscess

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During the right he bemisphere subcortex nuclei autopsy, a distorted cavity (5 x 35 cm) with red concentrated blood and softened cerebral tissue was determined. Term the pathology that developed in this case.

Cyst

Hemorrhagic leakage

Ischemic infarction

@Haematoma

Abscess

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A post-mortem of a 53-year-old male with a long history of hypertension revealed the cavity in the occipital lobe of the brain. It measured 2x1 cm, had a brownish smooth walls and filled with transparent liquid. Which is the most likely diagnosis?

@Cyst after hemorrhages

Softening of the brain

Abscess of a brain

Developmental defect of a brain

Cyst after softening of the brain

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A 78-year-old male, with a history of stroke 2 years ago, died of pneumonia as a complication of severe influenza. At post-mortem, gross investigation of his brain revealed a cerebral cyst with rusty color of its walls. Perls' test was positive. Name the process reveled within a cystic wall.

@Local hemosiderosis.

Common hemosiderosis.

Local hemomelanosis.

Infiltration of bilirubin.

Primary hemochromatosis.

#

After having a hemorrhagic insult, a cerebral cyst developed in a patient. After 2 years he died of grippe pneumonia. At section the cerebral cyst with the walls of whight-rusty color was detected. The Perls’ test is positive. What process in the cystic wall is assigned?

@Local hemosiderosis

Common hemosiderosis

Local hemomelanosis

Infiltration of bilirubin

Primary hemochromatosis

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After restoration of blood circulation in damaged tissue accumulation of lactate comes to a stop and speed of glucose consumption slows down. These metabolic changes are caused by activation of the following process:

@Aerobic glycolysis

Gluconeogenesis

Lipolysis

Glycogen biosynthesis

Anaerobic glycolysis

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A 45 year old patient was taken to the hospital by an emergency team with serious cranial trauma in shock condition. Objectively: unconscious, skin is pale, body t⁰- 35,0⁰С, low muscular tonus, reflexes are absent, pulse is rapid and weak, AP- 50/30 mm Hg. What clinical shock stage is it?

Erectile stage

Torpid stage

Excitement stage

Inhibition stage

@Terminal stage

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Shock and signs of acute renal failure (ARF) developed in the patient due to permanent injury. What is the leading cause of development of ARF in the case?

Urine excretion violation

Increased pressure in the renal arteries

@Decreased arterial pressure

Decreased oncotic BP

Increased pressure in the nephron capsule

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Purulent endometritis developed in a woman after delivery. Treating with antibiotics inhibitors of murein synthesis was ineffective. Wide spectrum bactericidal antibiotic was administered to her. In 6 hours temperature rapidly increased up to 40⁰C with shiver. Muscle pains have appeared. BP dropped down to 70/40 mmHg. Oligura has developed. What is the main reason for the development of this condition?

Toxic effect of preparation

Internal bleeding

@Endotoxic shock

Anaphylactic shock

Bacteremia

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A 22-year-old woman presents with the sudden onset of a high fever, a diffuse erythematous skin rash, and shock. She started menstruating at age 13 and for several years has used tampons. Which of the following is the most likely diagnosis?

Erysipelas caused by Streptococcus pyogenes

Fifth disease caused by human parvovirus B19

Scarlet fever caused by S. pyogenes

Secondary syphilis caused by Treponema pallidum

@Toxic shock syndrome caused by Staphylococcus aureus

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After two weeks in the hospital following a fall in which she incurred a fracture of her left femoral trochanter, a 76-year-old woman now has a left leg that is swollen, particularly her lower leg below the knee. She experiences pain on movement of this leg, and there is tenderness to palpation. Which of the following complications is most likely to occur next after these events?

Gangrenous necrosis of the foot

@Hematoma of the thigh

Disseminated intravascular coagulation

Pulmonary thromboembolism

Soft tissue sarcoma

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Within minutes following a bee sting, a 37-year-old man develops marked respiratory stridor with dyspnea and wheezing. He also develops swelling and erythema seen in his arms and legs. What type of pathological processes has develops in patient?

Hyperaemia

Oedema

Venous congestion

Serous inflammation

@Anafilactic shok

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In order to provide infiltrative anaesthesia a man was injected a solution of ultracaine with adrenaline. Afterwards, suddenly there appeared hyperaemias, swellings with vesicles and itching. What kind of hypersensitivity is this?

Cytotoxic

@Anaphylactic

Immune complex damage

Decelerated hypersensitivity

Granulomatous

#

For the purpose of anaesthetization a patient got injection of local anestheti C. A few minutes later the patient got dyspnea and tachycardia; he lost consciousness. What type of shock is it?

@Anaphylactic

Cardiogenic

Burn

Haemorrhagic

Traumatic

Date: 2016-03-03; view: 2750