Past Paper PDF - Pathophysiology Questions

1.Indicate which of the following is the basis of pathogenetic therapy: Key links in pathogenesis 2.Indicate a characteristic sign of a typical pathological process: Monopathogenesis 3.Name the cause of cell hyperhydration during damage: Increase in intracellular osmotic pressure 4.Name the disea...

1.Indicate which of the following is the basis of pathogenetic therapy: Key links in pathogenesis 2.Indicate a characteristic sign of a typical pathological process: Monopathogenesis 3.Name the cause of cell hyperhydration during damage: Increase in intracellular osmotic pressure 4.Name the disease to which a person with a hypersthenic body type is predisposed: Diabetes mellitus 5.Indicate the correct sequence of allergy reaction stages: Immunological, pathochemical, pathophysiological 6.Indicate the primary immunodeficiency associated with secondary albinism: Chediak-Higashi syndrome 7.Indicate which of the following arterial hyperemias is physiological: Myogenic-working 8.Indicate how venous hyperemia can be reproduced in an experiment: By ligating the draining vein 9. Indicate what characterizes the acute inflammatory response: Accumulation of neutrophils in the area of inflammation 10. Name the inflammatory mediator that plays an important role in the development of fever:. Interleukin-1 11. Indicate the characteristic manifestations of the second stage of fever: Hyperemia of the skin 12. What is the reason for the decrease in heat transfer in the first stage of fever: Spasm of the skin vessels 13. Name what causes hyperglycemia in type 1 diabetes mellitus: Reduction of glucose utilization by cells 14. Name the mechanism that is involved in the development of local edema in venous hyperemia: Hydrodynamic 15.Specify the mechanism of realization of the membranogenic factor of edema development: Increased permeability of the vascular wall 16. Name the organ where very low density lipoproteins are synthesized: Liver 17. Name the compensation mechanism that occurs during the development of respiratory alkalosis: Increased excretion of bicarbonate in the urine 18. Name one of the causes of the development of exogenous acidosis: Accidental acetic acid poisoning 19. Specify the name of the rearrangement of the chromosome, which leads to a change in the location of genes inside the chromosome: Inversion 20. Name the disease that is inherited by an autosomal recessive type: Phenylketonuria 21. What are the main producers of tumor necrosis factor? Monocytes 22. Specify which of the following answers is a genomic mutation: Polyploidy 23. Name the type of hypoxia that develops in the first minutes after massive acute blood loss in the body: Circulatory 24. What type of hypoxia is characterized by a normal oxygen content in arterial blood, combined with hypocapnia, with simultaneous hypoxemia of venous blood:. Circulatory 25. Name the key link in the pathogenesis of cardiogenic shock: Weakening of the heart's pumping function 26. Indicate which type of coma develops with insulin overdose: Hypoglycemic 1. Indicate which condition can lead to the development of megaloblastic anemia: Intestinal helminthiasis 2. Indicate what is characteristic of megaloblastic anemia: Jolly bodies and Cabot rings 3. Indicate the characteristic change in the leukocyte formula that may serve as an additional diagnostic sign of allergy: Eosinophilia 4. Name the process that leads to a decrease in the contractile function of cardiomyocytes in heart failure: Decreased ATP production, lowered pH 5. Indicate what is considered "calcium stress": Overload of cardiomyocytes with Ca²⁺ ions 6. Name the conditions under which myocardial resistance to ischemia is increased: Physical training 7. Name the condition for which primary surfactant deficiency is characteristic: Newborn distress syndrome 8. Name the cause of obstructive pulmonary ventilation disorders: Bronchial asthma 9. Indicate what increases in the blood with hemolytic jaundice: Indirect bilirubin 10. Specify the pathogenic effect of which substance is observed in cholemia syndrome: Bile acids 11. Indicate what may appear in the urine when the nephron tubules are damaged: Red blood cells 12. Specify the deficiency of which hormone is associated with hypogonadism in women: Estrogens 13. Name which of the following types of sensitivity is complex: Localization sense 14. Specify the form of paralysis of one limb: Monoplegia 1. During an external examination of a patient admitted to the gynecology department for IVF (in vitro fertilization), a scar was found in the lower abdomen. From the anamnesis, it follows that this scar is associated with a cesarean section. Indicate which category of pathology this scar belongs to:Pathological condition 2. A 19-year-old female patient complains of darkening of the eyes, dizziness, nausea, and vomiting. The condition developed 15 minutes after a bee sting. This condition is observed for the first time. Objectively: urticarial rashes are not abundant around the sting and on the body. Blood pressure is 90/50 mm Hg, pulse is 100 beats per minute. Heart sounds are muffled. No wheezing. Guess what kind of allergic reaction is being discussed: Anaphylactic shock 3. A 24-year-old non-smoking female student consulted a therapist complaining of a chronic non-productive cough that had been bothering her for a year. The cough usually gets worse with physical exertion and causes her to wake up at night several times a week. Her medical history includes irritable bowel syndrome and childhood eczema. A spirometric test was performed. The forced expiratory volume per second and forced vital capacity were 3.1 and 3.7 liters, respectively (with predicted values of 3.3 and 3.8 liters, respectively). Blood eosinophils were 5%. Based on the complaints, laboratory data, and spirometric test results, what allergic disease does the patient have? Bronchial asthma 4.A few minutes after applying mustard plasters to the chest, heat is locally felt, a slight burning sensation and a distinct redness of the skin is observed. Find out from the description what kind of regional blood circulation occurs in this case? Arterial hyperemia 5. Patient S., 17 years old, went to the doctor complaining of pulsating pain in the upper lip area, general weakness, headache, body temperature up to 36.6 degree, total number of leukocytes -12*10(9), erythrocyte sedimentation rate - 18mm/h. Objectively: the upper lip is edematous, a dense infiltrate is felt, the skin above which is red on the periphery and cyanotic in the center. What is the typical pathological process that the patient has developed? Inflammation 6. A tuberculosis patient developed exudative pleurisy. After puncture, a protein greater than 0.3 g/l, lymphocytes, specific gravity-1.022 was found in the pleural fluid. Name a typical pathological process that is the basis for this disease: Inflammation 7. A few hours after contact with a flu patient, the student felt chills, felt a muscle tremor and "goose bumps" appeared on his body. The skin was pale and dry. The body temperature rose to 39 degrees, and with further measurement, its increase was noted. Name a typical pathological process, the development of which is observed in a student: Fever 8. Patient K., 50 years old, turned to the doctor with complaints of progressive weight gain, lethargy, weakness, apathy. A year ago, the patient underwent surgery to remove a thyroid tumor. The examination revealed a decrease in the production of thyroid hormones T3 and T4. Objectively: a patient with a hypersthenic physique. Subcutaneous fat is excessively developed. BMI (body mass index)=32.1kg/m2. Assume the most likely type of secondary obesity that occurred in this patient: Hypothyroid 9. A group of tourists from the middle zone of the European part of the CIS was flown to the Pamir tourist camp, located at an altitude of 2500 meters above sea level. When examining one of them on the 2nd day of stay in the camp, the following indicators of acid-base state were revealed: arterial blood pH = 7.48, raSO2 = 32 mmHg. The frequency of respiratory movements is 25. Name the violation of the acid-base state that developed in the patient: Decompensated respiratory alkalosis 10. A 52-year-old woman, an employee of a confectionery factory, turned to a dermatologist with complaints of itching and the appearance of pustules. He considers himself ill for 2 years. A patient with an increased diet, a body mass index of 30 kg / cm2. Of the additional complaints, he notes increased fatigue, dry mouth, increased appetite. Which of the listed laboratory tests will help in making a diagnosis? Blood glucose 11. A 32-year-old man is seeing a therapist with complaints of muscle cramps, aching muscle pain, tingling sensations, and numbness in his lips and tongue, which occur periodically, as well as irritability. It was established from his history that a few months ago he underwent surgery to remove his thyroid gland. A deficiency of which ion has led to the patient’s condition? Ca²⁺ 12.A 60-year-old patient, a former stoker, was admitted to the ENT clinic with complaints of general weakness, severe weight loss, hoarseness, difficulty breathing, bad breath, and a dry cough. From the medical history, it is known that the patient is a heavy smoker. Laryngoscopy revealed a bumpy ulcerated tumor covering more than half of the larynx. The cervical lymph nodes are enlarged, firm to the touch, and painless. Blood tests showed anemia, leukocytosis, and an elevated ESR. Based on the above data, make a diagnosis for this patient: Malignant tumor of the larynx 13.Patient M., 65 years old, turned to a therapist with complaints of cough (sputum with streaks of blood), shortness of breath, which increases with physical exertion, weight loss, pain in the right half of the chest, fever in the evening to 38 ° C. He was diagnosed with lung cancer. During the examination of the patient, he was found to have an increased concentration of antidiuretic hormone (ADH) in the blood serum. Highlight which example of tumor cell atypism is indicated in the task: Functional 14.Patient M., 20 years old, was taken to a therapeutic clinic with complaints of severe headache, nausea, shortness of breath, palpitations, weakness. Respiratory rate is 30 per minute, pulse is 100 per minute, low filling. In the analysis of peripheral blood: erythrocytes 5.2×10/12/ l, reticulocytes 2%. It was established from the anamnesis that the patient closed the chimney in the evening until the coal burned out completely, as a result of which carbon monoxide poisoning occurred. Specify the type of hypoxia that developed in this patient: Hemic - 1. A 58-year-old woman complains of weakness, fatigue, and shortness of breath that have developed over the past six months. She also notes pain in her tongue and tingling in her feet. On examination, a bright red, smooth tongue with atrophy of the papillae is observed. Laboratory analysis data: Hb – 86 g/L, platelets – 110,000/mm³, leukocytes – 3,500/mm³, reticulocytes – 0.3%. Suggest the most likely diagnosis: Vitamin B12 deficiency anemia 2. For the past 10 years, the patient has been unable to carry a pregnancy to term. At 30 weeks of pregnancy, there was premature rupture of the amniotic fluid and placental abruption. Six hours after the onset of labor, the woman experienced bleeding from the birth canal, followed by hemorrhages on the skin, and her blood pressure began to drop. Examination showed a shortened clotting time by Lee-White, worsening partial thromboplastin time, prothrombin time, prolonged antithrombin time, and activation of fibrinolysis. Based on the clinical and laboratory findings, what blood pathology is indicated? Disseminated intravascular coagulation (DIC) syndrome 3. A 40-year-old patient with tuberculosis presented with complaints of shortness of breath, pain in the right hypochondrium, and low-grade fever. These symptoms appeared and gradually worsened over the last four weeks. On examination, the face is pale and puffy, the patient exhibits orthopnea, heart rate is 100, and blood pressure is 90/60 mmHg. Heart sounds are muffled, fine crackles are heard in the basal areas of the lungs, respiratory rate is 26 per minute, the neck veins are distended, and the liver is palpable 3 cm below the costal margin, tender to palpation. There is leg edema. Cardiac ultrasound shows pericardial effusion. Identify the form of heart failure described: Total 4. A 54-year-old patient has suffered from hypertension for 15 years with periodic crises. He smokes heavily, enjoys spicy and salty food. During a recent hypertensive crisis, he developed sharp chest pain radiating to the left arm, which did not subside after taking nitroglycerin, along with weakness and cold sweats. On examination, the patient is confused, skin and mucous membranes are pale, extremities are cold and moist. Pulse is 130 bpm, weak, and thready. Blood pressure is 90/60 mmHg, heart sounds are muffled. ECG shows a negative T wave. The patient is 175 cm tall and weighs 95 kg. Based on the information provided, determine the cardiac pathology: Myocardial infarction 5. A 62-year-old patient consulted a district therapist with complaints of severe shortness of breath, palpitations, and swelling in the shins and feet. At the time of examination, her blood pressure was 155/100 mm Hg. From her medical history, it is known that she has suffered from arterial hypertension for 13 years and takes her medication irregularly. It is also known that she abuses alcohol and smokes. Based on her complaints and history, determine which complication has developed in this patient: Chronic heart failure 6. A patient in the intensive care unit, being treated for a traumatic brain injury, suddenly experienced seizures after regaining consciousness, followed by brief respiratory arrest, and then single breaths with a fading pattern. What type of breathing has developed in the patient? Gasping 7. A 26-year-old woman has been under observation in the hospital for 2 months. She complains of yellowing of the skin and mucous membranes, weakness, nausea, and itching. The malaise began immediately after childbirth. The liver is enlarged and tender, blood tests show direct bilirubin at 82 μmol/L, bilirubin detected in urine, no urobilin, and the reaction to stercobilin is weakly positive. Red blood cells: 3.8 x 10¹²/L, Hb: 110 g/L. Name the syndrome observed in the patient: Hyperbilirubinemia 8. A 32-year-old man was brought to the hospital after a motorcycle accident. He is conscious and complains of severe pain in the pelvic area and abdomen, as well as an inability to urinate. The alcohol test is positive. X-rays revealed a pelvic bone fracture. What could be the cause of his anuria? Rupture of the bladder or urethra 9. Patient R., 25 years old. Height: 192 cm, moon-shaped face with a purplish hue, excessive fat deposits on the abdomen and thighs, thin bones, red stretch marks on the skin of the abdomen and shoulders. Blood pressure: 160/90 mm Hg. Blood sugar: 10.0 mmol/L. CT scan showed an enlarged pituitary gland, and ultrasound revealed bilateral adrenal enlargement with cortical hyperplasia. Based on the above, suggest the patient’s diagnosis: Cushing's disease 10.When a specific part of the medulla oblongata is damaged in an animal, death occurs due to respiratory arrest. Damage to certain structures in the midbrain and pons results in changes in breathing. Name the center that unites these structures: Respiratory 1. A 49-year-old man of normosthenic build, a geologist, got lost in the taiga in December. He had food for 2 days. He was found exhausted 9 days later. Two days later, he began to feel increasingly weak, developed shortness of breath and a slight cough. Body temperature is 36.8. There is a zone of dullness of percussion sound under the right shoulder blade, crepitus on auscultation. A preliminary diagnosis of focal pneumonia has been made. It is possible that reactivity has changed under the influence of other factors. Prescribe an additional diagnostic method that will help confirm this diagnosis? Radiography 2. A 27-year-old patient sought help at a hospital. The following symptoms appeared 10 minutes after the spider bite: darkening in the eyes, dizziness, nausea, vomiting, and later a rash appeared. This condition is observed for the first time. Objectively: not abundant rash around the bite and on the body. Blood pressure is 95/65 mm Hg, pulse is 99 beats per minute. Heart sounds are muffled. No wheezing. Anaphylactic shock was diagnosed. Prescribe a resuscitation drug that should be administered in this case? Adrenaline 3. A 5-year-old boy was diagnosed with alimentary-constitutional obesity of the 1st degree. The child's diet is dominated by flour and sweet products. The diet is 3-4 times a day, mainly in the afternoon. Prescribe recommendations for this patient to prevent the progression of obesity: Low-calorie diet, physical activity 4. A 45 year old woman has no symptoms of diabetes, but an elevated blood glucose level (7,5 mmol/l) is determined on empty stomach. Which indicator should be determined to clarify the diagnosis? Glucose tolerance 5. As a result of the fire, the clothes on the child ignited. The flames were extinguished. On examination: the condition is severe, inhibited, unresponsive, pulse is rapid, blood pressure is low, breathing is shallow. There are bubbles with transparent contents on the skin of the face, burst bubbles, areas of charred skin. The presumed diagnosis is a 2-3 degree thermal burn. Burn shock. What needs to be done first: The introduction of painkillers 1. A boy of 7 years old, became acutely ill after hypothermia. There was a rise in temperature to 38.8 ° C, headache, dry painful cough. On examination: the condition is of moderate severity. BH – 36 in 1 minute. Percussion: on the right, below the shoulder blade, the area of bluntness is determined. Auscultation: breathing is hard, weakened above the area of dullness, there are no wheezes, crepitation is heard.SO2 = 94%.Clinical blood test: Hb - 105 g/l, erythr. – 3.8x10/12/l, leukemia.– 1.6x10/9/L, n/I – 10%, s/I – 61%, e – 1%, L – 23%, m – 5%,ESR – 38 mm/hour. Community-acquired pneumonia was diagnosed, pneumococcus was detected during sowing. Choose the principle of treatment for this patient: Etiotropic 2. A 6-year-old boy develops severe bleeding after tooth extraction. The child has had cases of hemarthrosis in the past, even after minor injuries. The activated partial thromboplastin time of the patient is 50 seconds (the norm is 25.1-36.5 seconds), the prothrombin time is 12 seconds (the norm is 11-16 seconds). Assign a blood clotting factor to the boy's plasma to normalize the activated partial thromboplastin time: VIII 3. A 57-year-old patient suffering from stable angina pectoris, for several years noted the appearance of angina pectoris 1-2 times daily when walking. During the last week, the number of seizures gradually reached 10-15 per day. I did not go to the doctors, I did not take antianginal drugs. On the day of hospitalization, a severe angina attack developed, which was not stopped by nitroglycerin. Upon admission: the patient is pale, complains of severe pain behind the sternum. Blood pressure is 90/60 mmHg, pulse is 100 beats. in min. On the ECG - in leads I, aVL, V1-V6 –a high rise in CT. The echogram shows thinning of the wall of the left ventricle. Schedule an additional laboratory test to confirm the diagnosis: Troponin-I 4.A man, 56 years old, turned to a local therapist with complaints of pressing pains behind the sternum, radiating into the left shoulder, during physical exertion, disappearing at rest. This complaints have been bothering the patient for three months. From anamnesis:he smokes about 11 years. Assign a diagnostic method to this patient to identify latent coronary insufficiency: Bicycle Ergometry 5. A 69-year-old patient was admitted to the clinic with acute pain in the right hypochondrium and pronounced jaundice of the mucous membranes and skin. In the blood test : total bilirubin-50 mmol/l, indirect bilirubin 15 mmol/ L, direct 35 mmol /l, alkaline phosphatase concentration 187 IU/l, AST-52 IU/L, ALT -58 IU/L. Taking into account the laboratory data, assign an additional examination method for differential diagnosis? Ultrasound examination 6. A 57-year-old patient, who has long suffered from chronic pancreatitis, complains of unstable stool, occasional moderate diarrhea, and abdominal bloating, which he associates with the consumption of fatty meat. Coproscopy revealed a large amount of fat. What additional diagnostic method should be prescribed in this case? Abdominal ultrasound 7. A 65-year-old patient complains of strong urges to urinate and inability to empty the bladder. From his medical history, it is known that he has suffered from chronic prostatitis for many years. During examination, ultrasound data show a bladder volume of 1000 mL. What will you do as first aid for this patient? Bladder catheterization 8. A 30-year-old woman has been noticing gradual weight gain over the past two years. She also complains of deteriorating vision and irregular menstrual cycles. On examination, she has a moon-shaped face with excessive hair growth, central-type obesity, purple-red stretch marks on the anterior and lateral abdominal walls, and a slow-healing ulcer on her right shin. Blood pressure is 150/100 mm Hg, and fasting glucose level is 9.3 mmol/L. Choose the most likely diagnosis from the following: Cushing's disease 9.30-year-old woman has been noticing gradual weight gain over the past two years. She also complains of deteriorating vision and irregular menstrual cycles. On examination, she has a moon-shaped face with excessive hair growth, central-type obesity, purple-red stretch marks on the anterior abdominal wall, and a slow-healing ulcer on her right shin. Blood pressure is 150/100 mm Hg, and fasting glucose level is 9.3 mmol/L. She underwent surgery to remove a pituitary adenoma. Afterward, she experienced episodes of hypoglycemia. Which hormone is indicated for treatment to correct hypoglycemia? Hydrocortisone 10.24-year-old woman noticed that for the past four months, a milk-like fluid has been discharged from her breasts when pressed. An MRI of the brain revealed a 4 mm pituitary adenoma. Which of the following symptoms is likely to be present in the clinical picture? Amenorrhea 11.A patient with acute respiratory viral infection (ARVI) comes to the therapist's office. He has been ill for three days. Symptoms include weakness, sore throat, loss of appetite, but most concerning are headache and muscle pain. Prescribe a pain reliever that will help alleviate the patient's condition: Paracetamol