Internal Disease PDF Past Paper

# Internal Disease ## Made by Amir (347A) ### Question 1 - Name a sign of acute heart failure: - Fainting ### Question 2 - Pain for pericarditis decrease in the patient's position: - Sitting with little forward ### Question 3 - "Dance Karotid" notes: - Aoratic insufficiency ### Question 4 - W...

# Internal Disease ## Made by Amir (347A) ### Question 1 - Name a sign of acute heart failure: - Fainting ### Question 2 - Pain for pericarditis decrease in the patient's position: - Sitting with little forward ### Question 3 - "Dance Karotid" notes: - Aoratic insufficiency ### Question 4 - With an attack of angina pectoris, the pain is stopped by the technique: - Nitroglycerin ### Question 5 - The effect of taking nitroglycerin occurs through: - 1-2 min ### Question 6 - The pain in myocardial infarction stops: - Necrotic Analgenis ### Question 7 - Heart asthma appears: - Horizantal Position during Sleep ### Question 8 - Syndrome of intermittent lameness is caused by: - Damage to Artries Of lower Extremities ### Question 9 - Where are the hearty edema localized? - Feet ### Question 10 - What is cyanosis in the pathology of the cardiovascular system? - Acrocyanosis ### Question 11 - Facies Mitralis - this is: - Stagnant hyperemia of chest ### Question 12 - "Dance of Karotid" is due to: - Pulsation of carotid artery due to high pulse pressure ### Question 13 - A forced position sitting and leaning forward is observed at: - Pericarditis ### Question 14 - Anasarka is: - Massive edema ### Question 15 - One of the leading causes of edema in patients with chronic heart failure: - Increase venous pressure in circulation ### Question 16 - The situation in bed in patients with chronic heart failure: - Lying with the rest in right side ### Question 17 - The position of orthopnea is characteristic of: - Chronic heart failure ### Question 18 - The nature of the pain with angina pectoris: - Pressure pain behind sternum for 1015 min ### Question 19 - The nature of the pain in myocardial infarction: - Intensive pain of sternum more than 30 min ### Question 20 - The nature of the pain in myocardium: - Prolonged not related to the physical exercise ### Question 21 - The nature of the pain in the acute coronary syndrome: - Pressing and burning pain behind sternum ### Question 22 - Feeling of interruptions in the work of the heart happens with: - Rhythm disorder syndrome ### Question 23 - Facial expression with total heart failure: - Corvizar ### Question 24 - Characteristic of the face of "Corvizar" is: - Puffy face dell eyes ### Question 25 - An important sign of increased central venous pressure is: - Swellens jugular veins ### Question 26 - The patient is forced to sit, bending forward, in: - Exudative pericarditis ### Question 27 - The color of the skin "café au lait" is found in: - Infective endocarditis ### Question 28 - "Facies mitralis" is characteristic of: - Mitral stenosis ### Question 29 - Increased height and strength of the apical impulse is caused by: - Hypertrophy of left ventricle ### Question 30 - Epigastric pulsation, increasing on inspiration, is caused by: - Right ventricular hypertrophy ### Question 31 - Diastolic thrill at the apex is caused by: - Mitral stenosis ### Question 32 - Asymmetric pulse (Popov-Savelyev symptom) is observed with: - Mitral stenosis ### Question 33 - Filiform pulse is: - Quick filling pulse ### Question 34 - Slow and low pulse is observed in: - Aoratic stenosis ### Question 35 - Epigastric pulsation in right ventricular failure is explained by: - Right ventricular deletitiom ### Question 36 - Positive venous pulse and true pulsation of the liver is detected in: - Tricuspid insufficiency ### Question 37 - In what disease is a paradoxical pulse observed: - (Adhesive pericarditis) ### Question 38 - In what pathology is a slow and small pulse (pulsus tardus et parvus) observed: - Aoratic stenosis ### Question 39 - Diffuse apical impulse does not occur in: - Exudative pericarditis ### Question 40 - Negative apical impulse is observed in: - Adhesive pericarditis ### Question 41 - What kind of tremor is there in aortic stenosis: - Aoratic systolic thrill ### Question 42 - The apical impulse is formed by: - Left ventricular contraction ### Question 43 - Epigastric pulsation, more clearly noticeable in a standing position and on inspiration, indicates: - Hypertrophy and dilation of right ventricle ### Question 45 - Apical impulse in aortic valve insufficiency: - High increased diffuse dron shaped ### Question 46 - In left ventricular aneurysm pulsation is detected: - 3-4 intercoastal space ### Question 47 - The symptom of systolic "cat's purr" is determined by: - Aoratic stenosis ### Question 48 - Diastolic "cat's purr" is characteristic of: - Mitral stenosis ### Question 49 - A fast, high and large pulse is characteristic of: - Aoratic valve insufficiency ### Question 50 - "Slow and small pulse" is characteristic of: - Aoratic stenosis ### Question 51 - Pulse deficit is: - The number of pulse wave is less than number of heart beat ### Question 52 - The following type of pulse *is typical for mitral stenosis: - Difference ### Question 53 - Pulsus differens is typical for: - Mitral stenosis ### Question 54 - Absolute cardiac dullness formed by: - Right ventricle ### Question 55 - Shift of the apical impulse to the left and downwards is caused by: - Hypertrophy and dilatation of left ventricle ### Question 56 - The right border of relative cardiac dullness is formed by: This is - Stagnant hyperemia of chest ### Question 57 - The width of the vascular bundle is normally: - 4-6 cm ### Question 58 - With aortic defects, the heart has the shape of: - Aoratic configuration ### Question 59 - The upper limit of relative cardiac dullness is formed by: - Left atrium ### Question 60 - Normally, the borders of the vascular bundle are determined by: - 2nd intercoastal space along the edges of sternum ### Question 61 - Absolute cardiac dullness is formed by: - Right ventricle ### Question 62 - Projection of the mitral valve on the anterior chest wall: - 3rd rib on the left ### Question 63 - Projection of the aortic valve on the anterior chest wall: - In middle of sternum and at the level of 3rd rib ### Question 64 - The boundaries of relative cardiac dullness in mitral valve insufficiency expand: - Left Side ### Question 65 - The right border of relative cardiac dullness is normally located: - 4 Intercostal Space 1-2cm outward from right edge of sternum ### Question 66 - The left border of relative cardiac dullness is normally located: - 1-2Cm INVERT FROM THE MIDCLAVICULAR LINE ### Question 67 - The upper limit of relative cardiac dullness is normally located: - 3rd intercoastal at left ### Question 68 - The left border of absolute cardiac dullness is normally located: - 1-2cm inverted from the relative cardiac dullness in 5th intercoastal space ### Question 69 - The right border of relative cardiac dullness is formed by: - Right atrium ### Question 70 - The left border of relative cardiac dullness is formed by: - Left ventricle ### Question 71 - The upper border of relative cardiac dullness is formed by: - Left atrial appendage ### Question 72 - The vascular bundle is formed by: - Aorata uper vena cava pulmonary artery ### Question 73 - The projection site of the pulmonary trunk valves on the chest wall is: - 2nd intercoatsal space on left edge of sternum ### Question 74 - The projection site of the tricuspid valve on the chest wall is: - Middle of distance between the attachment point of 3rd rib on left and 5th rib on the right of sternum ### Question 75 - A weakening of the first heart sound is not typical for: - Mitral stenosis ### Question 76 - "Mitral valve opening tone" is heard with: - Flipping first tone on the apex ### Question 77 - "Quail rhythm" is - Flipping of first tone, 2nd tone, tone of opening mitral valve ### Question 78 - Place of mitral valve auscultation: - Apex of heart ### Question 79 - "Quail rhythm" is detected in: - Mitral stenosis ### Question 80 - The main factors determining the appearance of functional murmurs are: - Acceleration of blood flow and decrease in blood viscosity ### Question 81 - Auscultatory picture characterizing an increase in blood pressure: - Accent of the 2nd tone of aorata ### Question 82 - Specify the auscultatory sign of acute overload of the right heart: - Appearance of pronounced axient on pulmonary artery ### Question 83 - The loudness of the first tone is determined primarily by: - Integrity of valve apparatus ### Question 84 - Erb's point is located: - At 3rd intercoastal space left edge of sternum ### Question 85 - The sequence of auscultation of the heart (from point I to V) is associated with: - Frequency of heart valve damage ### Question 86 - At what point of auscultation is the 2nd tone assessed: - At 2nd and 3rd point ### Question 87 - Weakening of the second tone occurs: - Aoratic stenosis ### Question 88 - With which valve defect is the quail rhythm heard? - Mitral stenosis ### Question 89 - What defect is characterized by systolic murmur at the 2nd point of auscultation, transmitted to the vessels of the neck? - Aoratic stenosis ### Question 90 - Specify the location of auscultation of the 3-cuspid valve: - At base of xphyoid process on the right ### Question 91 - At the beginning of the ventricular systole phase, the following occurs: - Closure of atrioventricular valves of heart ### Question 92 - At the beginning of the diastole phase of the ventricles occurs: - Closure between aoratic and pulmonary valves ### Question 93 - Specify the audible component of the first heart sound: - Valvular component ### Question 94 - Specify the audible component of the second heart sound: - Oscilltation of aoratic and pulmonary artery valves ### Question 95 - The first tone at the apex increases with: - Mitral Stenosis ### Question 96 - The second tone weakens with: - Arotic Stenosis ### Question 97 - Accent of the 2nd tone on the aorta is characteristic of: - Increased Bp in Aorta ### Question 98 - Diastolic murmur in a limited area at the apex of the heart is characteristic of: - Mitral Stenosis ### Question 99 - In what position is the murmur best heard with mitral defect: - Lying on the left side ### Question 100 - A 63-year-old patient has been suffering from high blood pressure for many years, how and where will the second heart sound change? - Starighthing Of 2nd tone on aorta ### Question 101 - The period of closed valves occurs during: - Isometric Contraction of Ventricles ### Question 102 - At the beginning of ventricular systole occurs: - Closing of Av wall of heart ### Question 103 - At the beginning of ventricular diastole occurs: - Closing Of Aortic and pulmonary artey opening ### Question 104 - Point of auscultation of the mitral valve: - Apex of the heart ### Question 105 - Tricuspid valve auscultation point: - At the base of xiphiod process ### Question 106 - Pulmonary valve auscultation point: - 2nd intercostal space yo the left of sternum ### Question 107 - II heart sound is caused by: - Slamming of Aortic and pulmonary artery cusps ### Question 108 - The mitral valve opening sound is heard in: - Stenosis of left arterio ventricular ### Question 109 - An 18-year-old patient complains of heaviness in the heart area, periodic palpitations, mixed dyspnea when walking, pain knee joint. From the anamnesis in childhood, she often suffered from tonsillitis. She has been feeling unwell for about 6 months. Auscultation revealed a weakening of the first tone at the apex, a systolic murmur of a decreasing nature with an epicenter at the apex, conducted to the left axillary fossa. What defect can we think of? - Mitral valve Insufficiency ### Question 110 - A 35-year-old patient complains of shortness of breath during physical exertion and at night in a horizontal position. He has been observed since childhood for mitral stenosis. What objective signs can be revealed during examination? - Fascius mitralis on face,pulse diffrenetion dystolic thrill at flapping first Heart sound quiet rythym dystolic murmurs at Apex ### Question 111 - A diastolic murmur of a decreasing nature is heard in the second intercostal space on the right at the edge of the sternum, beginning immediately after the second tone, occupying 2/3 of diastole. The noise is conducted to Botkin's point and to the apex. What valve damage is expected in the patient? - Aortic Insufficiency ### Question 112 - The nature of pain in myocardial infarction: - Acute retrosternal squeezing pain lasting more than 30 minutes accompanied by weekenes cold sweat and by narcotics ### Question 113 - Specify the nature of pain in angina pectoris: - Acute Squeezing pain lasting 10-15 minutes relieved by nitroglycerin ### Question 114 - Pain in angina differs from pain in myocardial infarction: - Duration and intensity ### Question 115 - A 72-year-old patient has been complaining of squeezing pain when climbing to the 1st floor for the past few years, the pain lasts up to 10 minutes. The pain goes away on its own or after taking nitroglycerin. What do you think? - Attack of Angina pectoria FC2 ### Question 116 - A 50-year-old patient felt a sharp weakness, a burning pain behind the sternum, and a cold sweat after physical exertion. Pain lasting 2 hours. What is your presumptive diagnosis? - Myocardial Infaction ### Question 117 - A 45-year-old patient visits a doctor and complains of squeezing pain behind the breastbone. To make a diagnosis, it is necessary to first clarify? - Relationship of pain with exercise duration of pain affect of nitroglycerin ### Question 118 - Typical angina pain is usually localized: - Behind the sternum ### Question 119 - Pain during a heart attack requires the use of: - Narcotic Analgesics ### Question 120 - A 53-year-old patient complains of shortness of breath during physical exertion. History of myocardial infarction. Objectively, acrocyanosis, pulsation in the chest area on the left in the third - fourth intercostal spaces to the left of the sternum. What is your preliminary diagnosis? - Left Ventricular Aneurysm ### Question 121 - A 55-year-old patient is bothered by squeezing pain behind the sternum, which first appeared 10 days ago during significant physical exertion. The pain radiates to the left shoulder, left arm, quickly passes within 5-7 minutes at rest. The patient is overweight, BMI is 32. The apical impulse is not palpable. The left border of the heart is determined in the 5th intercostal space along the midclavicular line. Heart sounds are rhythmic, the 1st sound is weakened at the apex. What heart damage should we think about? - Acute coronary insufficiency Syndrome ### Question 112 - An ambulance doctor was called to patient K., 60 years old. The patient is sitting, complaining of a sharp pressing pain behind the sternum, which spreads to the left arm, neck, jaw, under the left shoulder blade. Objectively, moderate pallor of the skin is noted, the pulse is rapid, the heart sounds are muffled at the apex, the second sound on the aorta is increased. BP 160/100 mm Hg. What pathology of the cardiovascular system should the doctor think about? - Acute coronary Syndrome ### Question 123 - Indicate the level of blood pressure fluctuations in the norm (in mmHg): - Systolic 90/139 Dystolic 60/89 ### Question 124 - Specify the target organs in hypertension: - Kidney heart brain fundus ### Question 125 - The patient has a severe headache, flashing spots before the eyes, dizziness, palpitations. Deterioration of health within a few hours. BP 220/110 mm Hg. HR 86 beats per 1 min. What is wrong with the patient? - Hypertensive Crisis ### Question 126 - A 65-year-old patient complains of palpitations and headache. Objectively, facial hyperemia, palpation reveals that the apical impulse is shifted to the left and increased. Blood pressure is 220/110 mm Hg, pulse is 98 beats per minute, pulsus durus. What is your preliminary diagnosis? - Syndrome of arterial hypertension ### Question 127 - Select the signs of acute left ventricular failure (pulmonary edema): - Sharp shortness of breath, suffacation jurgling breathing with discharge of formy pink suputum weekeness, cold sweat ### Question 128 - Specify the signs of acute vascular insufficiency with internal bleeding: - Dizzines, progressive weekeness decrease Hb level, cold sweat ### Question 129 - A 48-year-old patient was urgently delivered to the emergency department of the City Hospital with complaints of suffocation, cough with pink sputum, severe weakness. BP 180/100 mmHg, HR 100 bpm. 2 months ago suffered a myocardial infarction, attacks of angina of effort and rest persist. Signs of what syndrome are suspected in the patient? - Acute left ventricular heart failure(pulmonary edema) ### Question 130 - A 60-year-old patient was delivered to the emergency room in extremely serious condition. History of gastric ulcer. Objectively unconscious, passive position. Severe pallor of the skin. BP 40/0 mmHg, pulsus filiformis. What is your preliminary diagnosis? - <variant>acute vascular insufficiency syndrome ### Question 131 - In which circulatory system do the patient's complaints of attacks of suffocation, accompanied by hemoptysis, gurgling breathing in the chest, forced orthopnea and acrocyanosis indicate blood stagnation: - Chronic RV heart Failure ### Question 132 - A feeling of heaviness in the right hypochondrium, swelling of the feet and shins in the evening, bothering the patient for a long time are a sign of: - Chronic RV heart failure ### Question 133 - Chronic right ventricular failure is characterized by: - Combination of Edema with acute Acrocyanosis ### Question 134 - Sudden, more often at night, asphyxiation, accompanied by hemoptysis, is characteristic of: - Acute LV Failure ### Question 135 - Specify the symptom of acute left ventricular failure: ### Question 136 - External appearance in total heart failure: - Orthopenia Anasarca Carviasorface ### Question 137 - An 18-year-old female patient complains of heaviness in the heart area, periodic palpitations, mixed dyspnea when walking, and pain in the knee joint. According to the anamnesis, she often had tonsillitis in childhood. She has been feeling unwell for about 6 months. Auscultation revealed a weakening of the first heart sound at the apex, a systolic murmur of a decreasing nature with an epicenter at the apex, conducted to the left axillary fossa. What defect can we think of? - Mitral valve Insufficiency ### Question 138 - A 35-year-old patient complains of shortness of breath during physical exertion and at night in a horizontal position. Has been observed since childhood for mitral stenosis. What objective signs can be identified during examination? - Facius mitralis face, pulses diffrientis, dystolic thrill at Apex, flapping first Heart tone, dystolic murmur at Apex ### Question 139 - A diastolic murmur of a decreasing nature is heard in the second intercostal space on the right at the edge of the sternum, beginning immediately after the second tone, occupying 2/3 of diastole. The noise is transmitted to Botkin's point and to the apex. What valve lesion is suspected in the patient? - Aortic Insufficiency ### Question 140 - A 50-year-old woman, a housewife, came to the clinic due to increasing shortness of breath, with attacks of suffocation, a cough with the release of pink sputum, noisy breathing, palpitations and weakness. An objective examination revealed signs of mitral stenosis syndrome. The patient is overnourished. How do you explain the patient's complaints? - Left Ventricular heart failure due to impaired cardiac Hemodynamics in mitral Stenosis ### Question 141 - Diastolic thrill at the apex in a patient with mitral stenosis is explained by the same reasons as: - Dystolic murmur at the Apex ### Question 142 - A 58-year-old patient complains of shortness of breath during physical exertion. History of rheumatism. Objectively, acrocyanosis, palpation reveals the apical impulse is shifted to the left and downwards. "Carotid dance", "Musset" symptom. What is your preliminary diagnosis? - Aortic valve Insufficiency ### Question 143 - The patient complains of shortness of breath during physical exertion, coughing sometimes with the release of a small amount of sputum, sometimes hemoptysis. Upon examination, cyanosis of the lips and blush on the cheeks are noted. The cardiac impulse is determined. Upon palpation - diastolic "cat's purr" at the apex of the heart. What heart lesion should we think about? - Mitral Stenosis ### Question 144 - What valvular lesion should we think about in a patient if, upon examination, we observe skin thinning, capillary pulse, "carotid dance", "Musset" symptom, and upon palpation an apical impulse that lifts in the 6th intercostal space, closer to the anterior axillary line? - Aortic valve Insufficiency ### Question 145 - What valvular apparatus lesion should be considered in a patient if examination reveals skin thinning, capillary pulse, "carotid dance", "Musset" symptom, and palpation reveals a lifting apical impulse in the 6th intercostal space, closer to the anterior axillary line? - Aortic valve Insufficiency ### Question 146 - A systolic murmur is heard at the apex of the patient's heart, which is transmitted to the axillary region, to Botkin's point and to the projection area of the mitral valve. Its maximum auscultation is the apex of the heart, it weakens at other points. What heart lesion should be considered? - Mitral valve Insufficiency ### Question 147 - A patient came to the doctor complaining of shortness of breath, palpitations and general weakness. During examination of the patient, severe pallor of the skin, "lifting" apical impulse, pulsation of the carotid arteries and shaking of the head, synchronous with heart contractions, were found. BP 120/40 mmHg. What are you thinking about? - Aortic valve Insufficiency ### Question 148 - Percussing the heart, the doctor determined an increase in the heart size upwards. (relative dullness at the level of the second intercostal space), the right border of relative dullness is 2.5 cm to the right of the right edge of the sternum. The left one is along the left midclavicular line. On fluoroscopy, the left cardiovascular angle is not expressed, but on the contrary, there is a bulge. The location of the diaphragm is unchanged. In what pathology do these changes occur? - Aortic valve Insufficiency ### Question 149 - Patient B., 48 years old, complained of squeezing pain behind the sternum radiating to the left arm, dizziness, and sometimes fainting. Objectively, the skin is pale. The heart has an aortic configuration, the second tone on the aorta is sharply weakened, over the region of the heart, more at the 2nd point of auscultation, a systolic murmur is heard. The pulse is small, slow and rare. What should the doctor have thought about? - Stenosis of Aortic Oriface ### Question 150 - Patient D, 28 years old, came to the general practitioner with complaints of shortness of breath during physical exertion, palpitations. In childhood, she often suffered from tonsillitis. Percussing the heart, the doctor determined an increase in the heart upward. (relative dullness at the level of the second intercostal space), the right border of relative dullness is 2.5 cm to the right of the right edge of the sternum. The left one is along the left midclavicular line. A click of the mitral valve opening. Diastolic murmur at the apex. On fluoroscopy, the left cardiovascular angle is not pronounced, but on the contrary, there is a bulge. The location of the diaphragm is unchanged. What heart pathology should the doctor think about first of all? - Mitral Stenosis ### Question 151 - A 52-year-old man came to the general practitioner with complaints of squeezing pain behind the sternum radiating to the left arm, left shoulder blade, shortness of breath during physical exertion, general weakness. During examination of the patient, sharp pallor of the skin, a "lifting" apical impulse, pulsation of the carotid arteries and shaking of the head, synchronous with heart contractions were found. The first tone is weakened WHERE?, diastolic murmur on the aorta and at the Botkin-Erb point. BP 140/50 mmHg. The ECG shows signs of left ventricular hypertrophy. What should the doctor have thought about? - Aortic Insufficiency