Respiratory Midterm Exam PDF

Respiratory System MCQs Lung Borders & Scapular/Parasternal Lines Q. Which rib corresponds to the lower border of the lung along the scapular line? =>X =>VII =>VIII =>IX => VI Q. Which rib corresponds to the right lower border of the lung along the parasternal line? =>V =>VII =>VIII =>IX => X Resp...

Respiratory System MCQs Lung Borders & Scapular/Parasternal Lines Q. Which rib corresponds to the lower border of the lung along the scapular line? =>X =>VII =>VIII =>IX => VI Q. Which rib corresponds to the right lower border of the lung along the parasternal line? =>V =>VII =>VIII =>IX => X Respiratory Sounds 1. Main noise during auscultation: Vesicular 2. Secondary noise: Wheezing 3. Vesicular breathing mechanism: Alveolar wall vibrations 4. Bronchial breathing mechanism: Air through glottis or secretion-filled bronchus Pathological Breathing 1. Harsh breathing: Inflammatory edema of small bronchi 2. Weakened vesicular breathing: Decreased alveolar wall vibration 3. Crepitation: Alveolar adhesion/unsticking 4. Pleural friction noise: Rough pleural surfaces Auscultation Techniques 1. Forced expiration: Detect hidden bronchial obstruction 2. Stethoscope pressure: Differentiate pleural noise from wheezing Specific Sounds & Syndromes 1. Amorphic breathing: Cavity less than 5 cm connected to bronchus 2. Lobar pneumonia: Bronchial breathing 3. Hard breathing syndrome: Obstruction 4. Moist rales: Bronchitis 5. Dry wheezing: Asthma 6. Weakened vesicular breathing: Pneumonia Case-Based Diagnosis 1. Right chest lagging, increased fremitus, dull percussion: Lobar consolidation 2. Barrel chest, weakened fremitus, box-like sound: Chronic emphysema INTERNAL DISEASE Breathing Patterns and Terminology Q. What is the name of deep and noisy breathing? a)Kussmaul b) Biotta c) Cheyne-Stokes d) Grokko e) mixed breathing Q. What is the name of rare breathing with a gradual increase, then decrease in the depth of breathing, alternating with periods of apnea? Kussmaul b) Biotta c) Cheyne-Stokes d) Grokko e) mixed breathing Q. Indicate the normal number of breaths per minute: 10-14 b) 16-20 24-28 32-36 36-40 Q. The number of breaths per minute is 10-14, what is this breathing called? tachypnea apnea norm dyspnea bradypnea Q. Respiratory rate of 36 per minute, what is this breathing called? ) apnea b) norm c) dyspnea d) tachypnea e) bradypnea Respiratory Failure Q. What type of respiratory failure is most typical for obstruction in the upper respiratory tract? => stridor breathing => expiratory dyspnea =>Kussmaul breathing => mixed dyspnea => inspiratory dyspnea Q. What type of respiratory failure is typical for spasm of the small bronchi? => expiratory dyspnea =>stridor breathing =>Kussmaul breathing => mixed dyspnea => inspiratory dyspnea Q. What type of respiratory failure is typical for exudative pleurisy? => mixed dyspnea => stridor breathing =>expiratory dyspnea =>Kussmaul breathing => inspiratory dyspnea Vocal Fremitus Changes Q. How will the vocal fremitus change over unilateral exudative pleurisy? =>weakening on one side =>no change => increased on both sides =>increased on one side =>weakened on both sides Q. How will vocal fremitus change in case of pneumothorax? Variant weakening on one side =>increased on both sides =>no change =>increased on one side => weakened on both sides Q. How will vocal fremitus change in case of incomplete obstructive atelectasis? Variant weakening on one side => no change => increased on both sides => increased on one side => weakened on both sides Q. How will vocal fremitus change in the syndrome of the presence of a cavity in the lung communicating with the bronchus? => increased on one side => weakened on one side => increased on both sides =>weakened on both sides =>No change Q. How will vocal fremitus change in obesity? => weakened on both sides =>weakened on one side => no change =>increased on both sides Q. How will vocal fremitus change in broncho-obstructive syndrome? =>weakening on both sides =>strengthening on one side => weakening on one side =>no change => strengthening on both sides Chest Elasticity Q. How will the elasticity of the chest change with pulmonary emphysema? => decreased elasticity on both sides => decreased elasticity on one side => increased elasticity on both sides => no change Q. How will the elasticity of the chest change with unilateral hydrothorax? =>decreased elasticity on one side => decreased elasticity on both sides C => increased elasticity on one side => increased elasticity on both sides E => no change Q. How will the elasticity of the chest change with unilateral pneumothorax? Variant decreased elasticity on one side =>decreased elasticity on both sides C => increased elasticity on one side => increased elasticity on both sides =>no change Q. How will the elasticity of the chest change with unilateral obstructive atelectasis? => decreased elasticity on one side => decreased elasticity on both sides variant increased elasticity on one side < => increased elasticity on both sides =>no change Q. Goals of comparative lung percussion? Comparative lung percussion Q. Specify the error in comparative percussion: =>First percuss one, then the other half of the chest =>Percuse strictly in symmetrical areas. =>Apply blows with uniform force across the plessimeter =>Strike the middle phalanx =>Percussion is performed along the intercostal spaces Percussion Sounds → Hydrothorax: Dull → Pneumothorax: Tympanic → Focal lung consolidation: Dull → Clear pulmonary percussion sound: Loud, long, low → Dull percussion sound: Quiet, long, high → Lobar consolidation of lung tissue: Dull → Obstructive atelectasis onset: Dull Q. What percussion sound is characteristic of hydrothorax? Dull Q. What percussion sound is characteristic of pneumothorax? =>tympanic =>dumb =>boxed => dull-tympanic =>clear pulmonary Q. What percussion sound is characteristic of focal consolidation of lung tissue? Dull Q. What properties in strength, pitch and duration correspond to a clear pulmonary percussion sound? =>Loud, long, low =>Loud, long, high =>Quiet, short, tall => Quiet, long, high => Quiet, long, low Q. What properties in strength, pitch and duration correspond to a dull percussion sound? Quiet, long, high. Q. What percussion sound is characteristic of lobar consolidation of lung tissue? Dull Q. What percussion sound is determined above the onset of obstructive atelectasis? =>dumb =>dull Variant tympanic => boxed => venous pulmonary Chest Exam Observations Q. Examination of the chest revealed an increase in the volume of one half. This is typical for: => hydrothorax =>obstructive atelectasis =>removal of the entire lung => pneumosclerosis => bronchial asthma Q. Examination of the chest revealed a decrease in the volume of one half. This is typical for: Obstructive atelectasis. Q. What are the characteristic changes in the chest in pulmonary emphysema? - barrel- shaped chest => increase in the anteroposterior and transverse dimensions of the chest, expansion of the intercostal spaces => reduction of half of the chest, its retraction and lag in breathing => lag in breathing, enlargement of half of the chest and smoothing of intercostal Intervals =>only lag in breathing of half of the chest =>asthenic chest Q. What are the characteristic changes in the chest observed in obstructive atelectasis? => reduction of half of the chest, its retraction and lag in breathing => lag in breathing, enlargement of half of the chest and smoothing of intercostal =>only lag in breathing of half of the chest =>hypersthenic chest => increase in the anteroposterior and transverse dimensions of the chest, expansion of the intercostal spaces Q. What characteristic changes in the chest are observed with unilateral hydrothorax? =>retardation of breathing, enlargement of half of the chest and smoothing of the intercostal space Q. What is the nature of the percussion sound in the acute stage of lobar pneumonia? Dull Q. What is the percussion sound determined by the narrowing of the bronchial lumen by viscous exudate (acute bronchitis)? => venous pulmonary => boxed => blunted => stupid => dull-tympanic Q. What percussion sound is determined when the pleural cavity is filled with fluid? => stupid => clear pulmonary => tympanic => boxed => blunted Q. What percussion sound occurs when there is no air in the entire lobe of the lung or part of it? => stupid => clear pulmonary => tympanic => boxed => blunted Kroening Fields Q. What pathology is characterized by widening of the Kroening fields? => emphysema =>lung cancer => pulmonary tuberculosis => upper lobe pneumonia =>acute bronchitis Q. In what pathological condition is narrowing of the width of the Kroening fields observed? =>consolidation of the upper lobe of the lung (pleural air) =>consolidation of the lower lobe of the lung => presence of an air cavity in the upper lobe => increased airiness of the lung tissue =>accumulation of air in pleural cavity Q. Which rib corresponds to the lower border of the lung along the scapular line? =>X =>VII =>VIII =>IX => VI Q. Which rib corresponds to the right lower border of the lung along the parasternal line? =>V =>VII =>VIII =>IX => X Q. What condition causes unilateral downward displacement of the lower border of the lungs? =>right-sided pneumothorax => ascites =>renarosplenomegaly => obturational atelectasis =>pulmonary emphysema Q. What condition causes unilateral upward displacement of the lower border of the lungs? =>renatomegaly =>ascites; => flatulence => right pneumothorax =>pulmonary emphysema Q. The excursion of the lower pulmonary edge along the midclavicular line on the right is normally: =>4-6 cm; =>4-10 cm; =>2-3 cm; => 6–8 cm; => 1-2 cm. Q. What is the main respiratory noise during auscultation? Vesicular Q. What is the secondary respiratory noise during auscultation? Wheezing Q. Name the mechanism of formation of vesicular breathing: =>as a result of vibration of the alveolar walls during inhalation and exhalation =>when air passes through the glottis < =>due to the adhesion of the alveolar walls in the exhalation phase and the unsticking < =>Due to friction of the rough surface of the visceral and parietal pleura in the inhalation phase < < =>when air passes through the narrowed lumen of the bronchus Q. Name the mechanism of formation of bronchial breathing: =>when air passes through the glottis of the walls =>as a result of vibration of the alveolar during inhalation and exhalation =>due to the adhesion of the alveolar walls in the exhalation phase and unsticking in the inhalation phase => when air passes through a bronchus filled with liquid secretion => when air passes through a narrowed bronchial lumen caused by bronchospasm or swelling of the mucosa Q. Name the possible location for listening to bronchovesicular (mixed) breathing in the norm. Sternal area. Q. What factors lead to the appearance of pathological bronchial breathing? => presence of an air cavity in the lung connected to the bronchus => decreased elasticity of lung tissue => swelling of the alveolar walls of a part of the lung and a decrease in the vibration of their walls during inhalation and exhalation =>obstruction of the main bronchus by a tumor =>increased vibrations of the alveolar wall during breathing Q. What factors lead to the appearance of harsh breathing? < =>narrowing of the lumen of the small bronchi due to inflammatory edema of their mucosa =>decrease in the elasticity of lung tissue => obstruction of the main bronchus by a tumor =>swelling of the alveolar walls of a part of the lung and a decrease in the vibration of their walls during inspiration and Exhalation => presence of an air cavity in the lung connected to the bronchus Q. What factors lead to the appearance of weakened vesicular breathing? =>swelling of the alveolar walls of a part of the lung and a decrease in the vibration of their walls during inspiration and Exhalation =>narrowing of the lumen of the small bronchi due to inflammatory swelling of their mucosa => increased vibrations of the alveolar wall during breathing =>narrowing of the bronchial lumen due to spasm => presence of an air cavity in the lung connected to the bronchus Q. Name the mechanism of crepitation formation: =>due to the adhesion of the alveolar walls in the exhalation phase and unsticking in the inhalation phase =>as a result of vibration of the alveolar walls during inhalation and exhalation => when air passes through the glottis => when air passes through a bronchus filled with liquid secretion =>> when air passes through a narrowed lumen of the bronchus Q. Name the mechanism of formation of pleural friction noise: => in contact and sliding of rough surfaces of pleura => as a Result of vibration of the alveolar walls during inhalation and exhalation => when air passes through the glottis =>due to the adhesion of the alveolar walls in the exhalation phase and unsticking in the inhalation phase => when air passes through the narrowed lumen of the bronchus Q. Name the mechanism for the formation of moist rales: => when air passes through a bronchus or cavity filled with liquid contents =>when air passes through the glottis =>due to the adhesion of the alveolar walls in the exhalation phase and unsticking in the inhalation phase < < variant when air passes through the narrowed lumen of the bronchus Variant due to friction of the rough surface of the visceral and Q. Name the mechanism for the formation of dry rales: =>when air passes through a narrowed bronchial lumen caused by bronchospasm or constriction Mucous =>as a result of vibration of the alveolar walls during inhalation and exhalation =>when air passes through the glottis =>due to the adhesion of the alveolar walls in the exhalation phase and unsticking in the inhalation phase =>when air passes through a bronchus filled with liquid secretion Q. For what purpose is an additional technique used during lung auscultation - forced expiration? => to identify hidden bronchial obstruction; =>in order to distinguish pleural friction noise from crepitus =>in order to distinguish dry rales from wet rales; =>to distinguish wheezing from crepitus =>for better listening to pathological bronchial breathing. Q. For what purpose is the additional technique used during lung auscultation - pressing the stethoscope on the chest? =>to distinguish pleural friction noise from wheezing => to identify hidden bronchial obstruction =>in order to distinguish dry rales from wet rales =>to distinguish wheezing from crepitus =>for better listening to pathological bronchial breathing Q. What kind of breathing noise is heard in the presence of a cavity connecting to the bronchus (less than 5 cm in diameter)? =>amorphic breathing =>weakened vesicular breathing => bronchial breathing => hard breathing => mixed bronchovesicular breathing Q. What is the main respiratory sound heard in the stage of lobar pneumonia? =>weakened vesicular breathing =>amorphic breathing => bronchial breathing => hard breathing => increased bronchovesicular breathing Q. What is the main respiratory sound heard in partial airway obstruction? =>weakened vesicular breathing =>amorphic breathing => bronchial breathing => hard breathing => mixed bronchovesicular breathing Q. What syndrome is characterized by hard breathing? Obstructive Q. What syndrome is characterized by consonant moist rales? Bronchitis Q. What syndrome is characterized by dry wheezing? Asthma Q. For which syndrome is weakening of vesicular breathing characteristic? Pneumonia Q. In what pathology is weakened vesicular breathing, crepitation, and pleural friction noise heard during auscultation over the inflammation zone? Pleurisy Q. During examination, the patient's right half of the chest lags behind during breathing. Vocal fremitus is increased upon palpation. Percussion in the lower parts of the lungs produces a dull sound. What can be assumed? =>Lobar compaction of lung tissue =>Presence of a cavity in the lung =>Accumulation of fluid in the lung => Accumulation of air in the lung =>Syndrome of increased airiness in the lung Q. During examination, the patient has a barrel-shaped chest. On palpation, the vocal fremitus is the same on both sides, somewhat weakened. Percussion reveals a box-like sound. What can be assumed? Chronic obstructive pulmonary disease (COPD). Q. A 25-year-old patient, while playing sports, felt a sharp pain in the right half of the chest and shortness of breath. On examination, the right half of the chest lags behind in the act of breathing, vocal fremitus is weakened, percussion reveals a tympanic sound. What syndrome is detected in the patient? =>Pneumothorax => Seal Pulmonary tissue =>Obstructive atelectasis =>Hydrothorax =>Increased airiness of the lung tissue. Q. A 72-year-old patient has been smoking 1 pack of cigarettes a day for many years, coughing in the morning with the release of viscous gray sputum. An objective examination revealed a barrel-shaped chest, weakened vocal fremitus and weakened vesicular breathing. How will the position of the lung borders and the mobility of the lower pulmonary edges change? =>The upper ones will rise and the lower ones will fall, mobility is limited =>The boundaries and mobility of the pulmonary edges will not change =>The lower boundaries will drop, mobility is not limited =>The lower boundaries will not change, mobility will be limited =>The upper and lower borders will be lowered, mobility will be limited Q. On examination, the patient was found to have a lag in breathing on the affected side of the chest, percussion revealed dullness of sound, vocal fremitus and bronchophony above this area are not determined. What pathological process should we think about? =>Compression atelectasis syndrome =>Syndrome of the presence of air in the pleural cavity. =>Bronchi obstruction syndrome =>Cavity syndrome < =>Syndrome of increased airiness of lung tissue Q. On examination, a lag in breathing on the left half of the chest was noted. On palpation, vocal fremitus is increased. Percussion reveals a tympanic sound. What can we assume? Pneumothorax Q. A patient with mixed (bronchovesicular) breathing has a side respiratory noise, very similar in nature to "crackle" noises. The noise is heard in both phases of breathing, but is better on inhalation, and decreases with coughing. What kind of noise is this? =>moist fine bubbling rales; =>dry wheezing; =>crepitus; =>pleural friction noise; =>moist medium bubbling rales Q. A patient has bronchial breathing in both phases of breathing and a side respiratory noise, very similar in nature to a "hair friction" noise. The noise does not change when coughing and increases when pressing a stethoscope on the chest. What kind of noise is this? Pleural friction noise. Q. Palpation of the chest on the left under the scapula revealed a sharp increase in vocal fremitus. Comparative percussion also revealed dullness of the percussion sound. What is the main respiratory noise that will be heard in this area? Bronchial breathing. Q. A 49-year-old patient was admitted to the department. Complaints of an attack of suffocation with difficult exhalation, which occurred 2 hours ago at home, cough with scanty viscous transparent sputum. Upon examination - the condition is serious, the position is orthopnea. The chest is emphysematous. RR is 16 per minute, exhalation is prolonged. What pathological process can we think of? =>Bronchial obstruction syndrome =>Condensation syndrom =>Fluid accumulation syndrome =>Bronchi inflammation syndrome < =>Bronchi obstruction syndrome Visual Diagnostics 1. Basic X-ray method for assessing the condition of the lungs A. General overview radiograph B. Ultrasound examination C. Computed tomography D. Magnetic resonance imaging E. Radionuclide research 2. What is the number of x-ray projections used to evaluate a foreign body of the respiratory tract by x-ray method? A. Directly B. Two - {Two projections (usually frontal and lateral) are necessary to localize the foreign body in three dimensions.} C. Three D. Left oblique E. right oblique 3. Under what conditions should the X-ray method be used for respiratory organs? A. Premature infant with respiratory disorder B. to a baby with high body temperature C. For a baby whose blood composition has changed D. to a baby with a heart murmur E. For a child born with a large weight (more than 5 kg) 4. What are the limitations of bronchography? A. due to its invasiveness B. because it provides little information C. due to technical difficulties D. because it requires the use of pain relievers E. because the method is expensive 5. After what kind of examination can CT of the respiratory system be performed? After collecting the history of A B. after laboratory data C. after radiography and radiography D. before x-rays and x-rays E. only in hospital conditions 6. The preferred method for diagnosing interthoracic diseases? A. roentgenoscopy B. X-ray C. computed tomography D. magnetic resonance imaging E. ultrasound examination 7. Fluctuation of lung image means: A. Deformation of lung image B. normal view of lung imaging C. an increase in the caliber and number of pulmonary imaging elements D. decrease in the caliber and number of lung imaging elements E. Deformation of the caliber and number of lung picture elements 8. Where are the roots of the lungs located? A. At the level of the I-II rib B. At the level of II-III rib C. At the level of II-IV ribs D. At the level of the IV-V wall E. At the level of the V-VI rib 9. What is the uniformity of blackness? To the extent of A B. to the edges C. to the location D. to the structure E. density 10. What size blackening is called focal? A. From 1 to 10 mm C. 14 to 16 mm B. 10 to 14 mm D. 16 to 18 mm E. From 18 to 20 mm 11. How do the lymph nodes in the root of the lung look like in normal conditions? A. circular blackening B. circular illumination C. darkening of the line D. oval-shaped illumination E. Not visible 12. Anatomical version of the review will be: A. normal lung tissue B. compaction of lung tissue C. shaking of lung tissue D. accumulation of air in lung tissue E. thinning of lung tissue 13. In what cases is the picture of the lungs considered compatible? A. if it does not reach the edge of the lung by 3-4 cm B. if it does not reach the edge of the lung by 5-6 cm C. if it does not reach the edge of the lung by 1-2 cm D. when reaching the edge of the lung E. if not visible at all OPTION C - Explanation: A lung picture is considered compatible when there is a small gap (1-2 cm) from the edge, indicating that the imaging is likely capturing the relevant structures without significant distortion or missing areas. OPTION D - Reason: The compatibility of the lung image usually means that it extends to the edges, indicating a complete and thorough imaging that includes all necessary areas for evaluation. 14. What is the original anatomical version of the lung picture? A. image of the bronchi B. breast cell image C. image of lymphatic vessels D. image of the vessels of the small circulatory circle - Reason: The original anatomical version typically refers to the primary structures involved. For the lungs, this involves the vessels of the small circulatory circle (pulmonary vessels), as they are integral to lung function and structure. E. visceral pleural image - Explanation: The original anatomical version of a lung picture often refers to the depiction of the visceral pleura, which outlines the lungs and is crucial for understanding their anatomical context in imaging 15. Which radiograph is considered compatible A. if the shadow of all vertebrae is visible on the roentgenogram B. If the shadow of all the vertebrae is not visible on the radiograph, the image of the vertebrae is clearly visible C. if the image of the upper 2-3 thoracic vertebrae is visible on the X-ray D. 2-3 bands on the roentgenogram E. if the image of the heart is clearly visible 16. How is the symptom of valve blockage of the bronchus described A. with a shift of the shadow of the interthoracic organs to the healthy side during inhalation B. total illumination of one lung; with inclination; C. interthoracic organs do not change their position; D. displacement of the shadow of interthoracic organs does not depend on the act of breathing; E. the shadow of the interthoracic organs during exhalation to the healthy side with displacement. 17. What are the symptoms of croupous pneumonia? A. Subtotal darkening of both lungs; B. focal darkening of one lung; D. Focal darkening of both lungs; E. subtotal darkening of one lung. 18. Bronchitis (bronchospasm)" symptom is characteristic of what pathology? A. pulmonary echinococcus B. to croupous pneumonia C. to central lung cancer D. to peripheral lung cancer E. to an air cyst 18.Pneumonia which stage lungs on the field changes will not happen - Early congestion stage 20. What cases are considered comprehensive? A. darkening of one lung B. 2 cm diameter round blackening C. view of the dashed line near the accessory interstitial opening D. darkening of the root of the lung E. semicircular darkening near the visceral pleura 21. How does the symptom of complete blockage of the bronchus appear in an X-ray study? A. in the form of hyperventilation B. disc shape view C. in the form of atelectasis D. in the form of focal darkening E. in the form of a large circular illumination 22. In what pathology is a round formation with a cloud-like indistinct edge? A. in croupous pneumonia B. in nodular pneumonia C. in lung cancer D. in exudative pleurisy E. in infiltrative tuberculosis 23. What method is used to determine changes in lymph nodes at the root of the lung? A. X-ray of general overview B. linear tomography C. objective radiography D. lateral radiograph E. Laterography 24. What are the symptoms of acute pneumonia? A. total examination of one lung B. subtotal darkening of one lung C. focal darkening of one or both lungs D. subtotal illumination of one lung E. Focal calcification of the upper part of one lung 25. What symptom is characteristic of the primary tuberculosis complex in the lungs? A. damage to lymph nodes with lung tissue B. Changes in lung tissue only C. damage to the lymph nodes of the lung root D. damage to the upper lung area only E. damage to the lower lung area only 26. A round, non-homogeneous structure in the lungs, with smooth and clear edges, is characteristic of what pathology? A. to Echinococcus B. to an abscess C. tuberculosis D. to peripheral cancer E. to central cancer 27. What symptoms are characteristic of nodular tuberculosis? A. small nodular spots near the roots B. Scattered spots in the lower part of the lungs C. cluster of nodular spots in the tip of the right lung D. round spots of different sizes on both sides of the lung E. cellular deformation of the lung image in the lower part of the lungs 28. What is the x-ray appearance of lung cancer? A. cloud-like shadow B. annular shadow C. round cavity D. focal structures at the tip of the lung E. round shadow with a ray edge 29. Symptoms of pneumonia A. homogeneous spreading blackening B. uniform diffuse illumination C. non-homogeneous darkening D. beveled upper edge E. smooth edges, clearly circular lightening 30. Describe the X-ray appearance of pneumothorax. A. Extensive darkening of the pleural cavity and displacement of the interthoracic shadow towards the affected side B. Extensive darkening of the pleural cavity and shift of the interthoracic shadow to the healthy side C. pleural cavity lightening and displacement of the interthoracic shadow towards the affected area; D. local darkening, interthoracic shadow does not shift: E. local illumination limited to the colden level at the bottom 31. Which symptom is evidence of exudative pleurisy? A. the presence of black spots in the lung area. B. inhomogeneity of blackness. The round shape of C black; D. the slant of the upper edge of the forehead; E. The presence of round lights on the dark background 32. Name the pathology in which the interthoracic shadow is shifted to the healthy side. A. stage of croup pneumonia B. Closed phase of echinococcus cyst: C. partial atelectasis: D. nodular pneumonia of the lower part; E. exudative pleurisy. In exudative pleurisy, the accumulation of fluid in the pleural space pushes the mediastinal structures (including the interthoracic shadow) toward the healthy side. 33. Which of the lung diseases should be prescribed ultrasound? A exudative pleurisy. B. lung cancer; C. echinococcus: D. pneumothorax; E lung abscess. Ultrasound is most useful for detecting pleural effusions in exudative pleurisy, as it helps visualize and quantify fluid accumulation. 34. In what direction does a large amount of bone accumulated in the pleural cavity displace the central organs? A. to the sick side; B. does not displace; C. upper jaw; D. to the healthy side; E. to the back and lower jaw. 35. Characteristic sign of exudative pleurisy? A. View of one side spreading homogeneous structure B. Lightening of one side with a homogeneous structure; C. total blackening of non-homogeneous structure; D. multifocal carcinoma in all lung area E. lightening of a homogeneous structure in both lungs 36. Name the pathology in which the lung picture is not visible. A. in focal tuberculosis B. in focal pneumonia C. limited pneumothorax D. in total exudative pleurisy In E. pneumoconiosis 37. Under what conditions does free air appear in the pleural cavity? A. in hydrothorax B. in emphysema C. in an air cyst D. in pneumothorax E. In pneumonia 38. In the case of water accumulation in the pleural cavity, what additional sign is considered important in the lung X-ray? A. The darkness of Karayu B. homogeneity of darkening C. amount of blackening D. the condition of the central organs E. the condition of the next lung. 39. What is the most suitable and basic method of visual diagnosis that determines the displacement of central organs? A. radionuclide diagnostics B. X-ray in direct projection C. radiograph taken from the edge D. laterography E. ultrasound examination 40. Which research method is used to detect a small amount of fluid in the pleural cavity? A. in the general X-ray examination of the lungs B. in the laterogram C. in ultrasound D. in a linear tomogram E. in the prescribed radiograph 41. What is the X-ray sign of the lung cavity? A. circular homogeneous darkening B. circular uniform illumination C. review the total art D. flood lighting E. round the art 42. What is the amount of liquid in the pleural cavity detected by ultrasonography? A. 20 ml B. 50 ml C. 100 ml D. 150 ml E. 120 ml 43. What kind of pathology is determined together with volume lightening and darkening in the chest cavity? A. hydropneumothorax B. in croupous inflammation C. in watery pleurisy D. in abscess-forming pneumonia E. in the semi-labor stage of echinococcus cyst. 44. New born defined? in the baby onesided lungs in atelectasis , x-ray view what direction Answer: X-ray view typically shows the collapsed lung as an area of consolidation or increased density, which shifts the mediastinum toward the affected side. The other lung will often appear more expanded due to the shift. 45. What is tomography? Taking an image of a certain longitudinal section of the organ++ Answer: Tomography is an imaging technique that captures detailed images of specific sections or slices of an organ or body area. This allows for better visualization of internal structures without superimposed objects, improving diagnostic accuracy. 46.Roentgenoscopy method what determines ? object from the screen or look at+ + computer from the monitor Answer: Roentgenoscopy (fluoroscopy) is a dynamic imaging method used to observe real-time movement or function of structures inside the body, such as the heart or lungs. The image is viewed on a screen or monitor, providing immediate feedback during diagnostic procedures. 47. What is the normal level of domes of the diaphragm in adults? right-frontVI, 1-2 cm lower on the left side++ Explanation: In adults, the right diaphragm dome typically appears at the level of the sixth rib (VI), while the left diaphragm dome is 1-2 cm lower due to the position of the liver on the right side. 48.How is the orientation of the front parts of the wall located on the radiograph? convex side facing downwards and not reaching interthoracic shadow++ Explanation: On a radiograph, the convex side of the wall (such as the diaphragm) faces downwards and does not reach the interthoracic shadow. This positioning helps in identifying structures like the diaphragm and determining any abnormality in the chest cavity. 49. Computed tomography is taken in case of which lung disease? Lung cancer++ Diagnosing interthoracic diseases Explanation: Computed Tomography (CT) is highly useful in diagnosing and staging lung cancer, as it provides detailed images of the lungs, mediastinum, and lymph nodes. CT is also crucial for assessing other intrathoracic diseases, including infections, fibrosis, and pleural conditions, as it offers superior resolution compared to regular X-rays. 50. Name the characteristic X-ray sign of cavernous tuberculosis. closed ring shadow with thick wall+ Explanation: In cavernous tuberculosis, the characteristic X-ray appearance is a closed ring shadow with a thick wall. This occurs due to the formation of a cavity (cavern) in the lung tissue, often seen in advanced tuberculosis. The thick walls are indicative of chronic infection and fibrosis surrounding the cavity. PHARMACOLOGY A patient with chronic bronchitis who had been suffering from chronic bronchitis was treated with an expectorant drug. in a week the symptoms of rhinitis, tearing, itching of skin rashes appeared. 1. what agent will cause these side effects? 2. Explain the mechanism of action? Guaiphent Task 2 An antitussive agent (1 tablet 3 times a day) was administered to a patient. Cough has decreased but the patient has started complaining of dizziness, general weakness and arterial hypotension has been' revealed. 1.Indicate the drug. 2. Explain the mechanism of action codein Task 3 A female patient suffering from acute bronchitis complains about respiratory obstruction and cough with thick viscous sputum. She was prescribed a mucolytic agent that stimulates surfactant synthesis. 1. What mucolytic agent was prescribed? 2. Explain the mechanism of action and side effects of the drug Ambronol Task 4 A patient with chronic bronchitis has been administered an expectorant that disintegrates disulphide bonds of sputum glycosaminoglycan thus reducing its viscosity. The patient has been also warned about possible bronchospasm. 1.What drug has been administered? 2. Explain the side effects of the drug N-acetylcysteine Task 5 A patient has acute laryngotracheitis with nonproductive cough that is very exhaustive. 1.Prescribe an antitussive drug 2. Explain the mechanism of action and side effects of the drug Dextromethrophan directly acting- acetylcysteine & ambroxof → Task 6 A 46-year-old patient suffering from chronic bronchitis came to a pharmacy. 1. What expectorative drug may be recommended? 2. Explain the mechanism of action and side effects of the drug reflex acting drug- guaiphenesin 1. Mark the adverse effects of codeine. Answer: Respiratory failure Reason: Codeine is an opioid that suppresses the respiratory center in the medulla oblongata, leading to hypoventilation or respiratory failure, especially in high doses or in susceptible individuals like the elderly or those with existing respiratory conditions. 2. Specify the mechanism of action of lobelin. Answer: Inhibits H-cholinoreceptors Reason: Lobeline stimulates the respiratory center by acting on peripheral chemoreceptors and has an inhibitory action on H-cholinoreceptors. 3. Specify the group of drugs used for respiratory asthma. Answer: B² adrenergic agonists Reason: Drugs like salbutamol or terbutaline are B² adrenergic agonists. They relax bronchial smooth muscles, providing quick relief during asthma exacerbations. 4. Which of the following M3-cholinoblocking agents is bronchoselective and is used as an antiasthmatic agent? Answer: Tiotropium Reason: Tiotropium is a selective M3-cholinoreceptor antagonist that blocks parasympathetic-mediated bronchoconstriction, making it effective for asthma and chronic obstructive pulmonary disease (COPD). 5. Label antibiotics of the beta-lactams group. Answer: Penicillins Reason: Beta-lactam antibiotics, including penicillins, inhibit bacterial cell wall synthesis by targeting penicillin-binding proteins. 6. Note the characteristic property of salbutamol. Answer: Activation of B2 receptors Reason: Salbutamol is a selective beta-2 adrenergic agonist that relaxes bronchial smooth muscle, causing bronchodilation. 7. Label an antibiotic that violates the integrity of the cytoplasmic membrane. Answer: Polymyxin B Reason: Polymyxins disrupt the bacterial cytoplasmic membrane by interacting with its phospholipids, leading to increased permeability and cell death. 8. Designate an antibiotic from the group of penicillins resistant to beta-lactamase (penicillinase). Answer: Oxacillin Reason: Oxacillin is a beta-lactamase-resistant penicillin, making it effective against beta-lactamase- producing staphylococcal infections. 9. Determine broncholytic prescribed parenterally: short-time effect used only to eliminate bronchospasm, causes tachycardia, increases blood pressure, increases glycogenolysis, and lipolysis. Answer: Adrenaline (epinephrine) Reason: Adrenaline is a non-selective adrenergic agonist that works quickly to relieve bronchospasm but has systemic effects such as tachycardia and increased glycogenolysis. 10. Name an antibiotic that often causes allergic reactions. Answer: Benzylpenicillins Reason: Penicillins are commonly associated with allergic reactions, ranging from rashes to anaphylaxis. 11. Indicate a non-opioid antitussive drug with central action. Answer: Glaucine Reason: Glaucine acts centrally to suppress the cough reflex without the addictive potential of opioids. 12. A drug from the Theophylline group with antispasmodic effects, used parenterally or enterally for bronchospasm. Answer: Euphylin (Aminophylline) Reason: Euphylin is a theophylline derivative that relaxes bronchial smooth muscle and is used for acute bronchospasm. 13. An antibiotic effective for dysentery and dangerous infections, with broad- spectrum action and side effects like photosensitivity. Answer: Tetracycline Reason: Tetracycline inhibits bacterial protein synthesis and is effective for dysentery, plague, and other severe infections, but it can cause photosensitivity and dental discoloration. 14. Determine the bronchodilator used by inhalation that reduces bronchial secretions but is not used for glaucoma. Answer: Ipratropium bromide Reason: Ipratropium bromide is a muscarinic antagonist used for bronchodilation but contraindicated in glaucoma because it can increase intraocular pressure. 15. A mucolytic drug that depolymerizes sputum composition and increases surfactant production. Answer: Bromhexine Reason: Bromhexine reduces sputum viscosity by depolymerizing mucopolysaccharides and promotes surfactant secretion. 16. Identify an antibiotic from the macrolide group effective for syphilis and other infections. Answer: Erythromycin Reason: Erythromycin inhibits bacterial protein synthesis and is used for gram-positive infections and atypical pathogens like rickettsia and chlamydia. 17. The mechanism of mucolytic action of ambroxol. Answer: Depolymerization of mucus proteins Reason: Ambroxol breaks down mucopolysaccharides in mucus, reducing its viscosity and facilitating expectoration. 18. Treatment failure for croup pneumonia with benzylpenicillin after 3 days. Answer: Resistance of the pathogen to benzylpenicillin Reason: If there is no improvement, the causative organism may be resistant to penicillin, requiring a switch to a broader-spectrum antibiotic. 19. A drug combination effective for respiratory and urinary tract infections with a bactericidal effect. Answer: Co-trimoxazole Reason: Co-trimoxazole (a combination of sulfamethoxazole and trimethoprim) inhibits folate synthesis in bacteria, leading to a bactericidal effect. 20. Mark an antiallergic drug that prevents calcium entry into mast cells. Answer: Ketotifen Reason: Ketotifen stabilizes mast cell membranes by inhibiting calcium influx, preventing histamine release. 1. Mark the adverse effects of codeine... Respiratory failure 2. specify the mechanism of action of lobelin... Inhibits H-cholinereceptors 3. specify the group of drugs used for respiratory asthma... B²adrinom 4. Which of the following M3-cholinoblocking agents is bronchoselective and is used as an antiasthmatic agent? Tiotropium 5. label antibiotics of the beta-lactams group... Penicillins 6. Note the characteristic property of salbutamol...  Activation of B2 receptors 7. label an antibiotic that violates the integrity of the cytoplasmic membrane... Polymixim M 8. designate an antibiotic from the group of penicillins resistant to beta-lactamase (penicillinase).. Oxacillin. 9. Determine broncholytic: prescribed parenterally: short-time effect used only to eliminate bronchospasm causes tachycardia, increases blood pressure, increases glycogenolysis and lipolysis... Adernaline, epinephrine 10. Name an antibiotic that often causes allergic reactions... Benz penicillins 11. Indicate non-opioid antitussive drug with a central action... Glaucine 12. It is considered a drug of the Theophylline group. It has a direct antispasmodic effect on the single branched muscles of the bronchi. It is used to eliminate and prevent bronchospasm. It is prescribed parenterally and enterally. Determine the drug... Euphylin 13. It has a broad spectrum of antimicrobial action, inhibits protein synthesis in microbial cells, has a bacteriostatic effect, is the antibiotic of choice for particularly dangerous infections (plague, cholera, brucellosis), and has a bactericidal effect in dysentery, increases skin sensitivity to ultraviolet rays, and is preserved in the bones and tissues of teeth. Dyspeptic disorderswhich the liver and dysbacteriosis call… Tetracycline 14. Determine broncholytic: prescribed parenterally: short-time effect used only to eliminate bronchospasm causes tachycardia, increases blood pressure, increases glycogenolysis and lipolysis... Adenaline 15. Determine the bronchodilator: used by inhalation, reduces the secretion of salivary and bronchial glands, is not used for glaucoma... Prapotoum bromide 16. Refers to mucolytic drugs, dilutes it by depolymerizing the composition of sputum. Increases the product of endogenous surfactant, is prescribed for drinking. Determine the drug... Bromhexine 17. Belongs to antibiotics of the macrolide group. It mainly has a bacteriostatic effect on the coccyx flora, rickets, chlamydia, pathogenic spirochetes. It is characterized by a rapid development of drug resistance. It is a reserve antibiotic in the treatment of syphilis. Side effects-dyspeptic disorders, allergic reactions… Identify the drug and indicate its group affiliation by the mechanism of action… Erythromycin, erythromycin 18. Belongs to antibiotics of the macrolide group. It mainly has a bacteriostatic effect on the coccyx flora, rickets, chlamydia, pathogenic spirochetes. It is characterized by a rapid development of drug resistance. It is a reserve antibiotic in the treatment of syphilis. Side effects-dyspeptic disorders, allergic reactions… Identify the drug and explain the mechanism of antibacterial action… Erythromycin 19. Belongs to antibiotics of the macrolide group. It mainly has a bacteriostatic effect on the coccyx flora, rickets, chlamydia, pathogenic spirochetes. It is characterized by a rapid development of drug resistance. It is a reserve antibiotic in the treatment of syphilis. Side effects-dyspeptic disorders, allergic reactions… Identify the drug and explain the mechanism of antibacterial action… Erythromycin 20. The principle of action of myotropic broncholytic drugs... Direct effect on single beonchi 21. What is the mechanism of mucolytic action of ambroxol... Depolarization of mucu protein 22. Patient Z., 22 years old was diagnosed with left-sided croup pneumonia. After the penicillin test was negative, benzylpenicillin sodium was administered intramuscularly at a dose of 500,000 IU 3 times a  day. Within 3 days, the patient's condition did not improve: Temperature-38○ C. pain in the left half of the chest, cyanosis, shortness of breath… Why treatment is not effective... Both have same effect since they are in same group 23. A patient with polyarthritis, who had not previously been treated with penicillin, was prescribed benzylpenicillin sodium during an exacerbation of the disease. After the injection, 3-5 minutes appeared: anxiety, itching of the skin, palpitations, suffocation, redness of the face were replaced by pallor, elements of acrocyanosis, urticaria appeared, blood pressure dropped sharply. Allergic reaction 24. The patient was 25 years old with hypochromic anemia, taking iron supplements. After the onset of pneumonia, he was prescribed the antibiotic tetracycline. But the healing effect was not observed. According to the mechanism of action, tetracycline belongs to which group of antibiotics… Intracellular protein synthesis inhebitor 25. Mark the antiallergic drug used for respiratory asthma: Ketotifin 26. Identify a characteristic feature of zafirlukast... Inhibition leuktrean receptors 27. Establish the use of cititon in medical practice... Hylation electrolytic replacement 28. Mark the properties inherent in biseptol... High antimicrobial activity and bactericidal effect 29. Label mucolytic drugs... Ambroxil/bromohexine 30. Label antibiotics that have a narrow spectrum of action and affect gram-negative microorganisms... Polymyrins 31. Label antibiotics that have a bacteriostatic effect on microorganisms... Erythromycin, tetracycline chloramphenicol 32. What is the mechanism of expectorant action of ipecaquana drugs... Stimulation of gastric receptors and increase the reflex in bronchial gland secretion 33. Indicate a drug from the group of fluoroquinolones, which is effective when used enteral for pathogens of respiratory infections... Levofloxcin 34. What is the mechanism of mucolytic action of ambroxol... 35. Label a topical antibiotic that has antibacterial and anti-inflammatory effects... Furafunginia /fussictic acid 36. Note the antiallergic drug that prevents the penetration of Ca++ into mast cells... Ketotifin 37. The ambulance team discovered a 45-year-old patient. Upon slight physical exertion, the patient experienced sharp shortness of breath, and the color of his face and mucous membranes turned crimson due to high levels of carboxyhemoglobin in the blood. Blood pressure was 100/50 mmHg. The diagnosis of carbon monoxide poisoning was made, and Lobeline hydrochloride was prescribed. Indicate to which pharmacological group and subgroup the prescribed drug belongs. Refkex respiratory stimulation/N choline metics 38. What properties of glucocorticoids make it possible to use them in the treatment of bronchial asthma... Stabilize membrane muscle 39. Treatment measures for the patient due to hyperacid gastritis. In addition, he suffered from an acute row of the upper respiratory tract, which is difficult to expectorate. As an expectorant, the doctor will prescribe an infusion of thermopsis grass. The manifestation of gastritis in the patient began to increase. What expectorant should be prescribed in this case? Thermopsis/ Pecacunate 40. A drug paired with sulfamethoxazole trimethoprim, shows a bactericidal effect, is quickly absorbed into the gastrointestinal tract, is most effective in respiratory and urinary tract infections, as well as for  pneumocyst pneumonia in patients with AIDS. Determine the drug and its mechanism of antibacterial action… Co trimoxazole/inhibition Dihydroptereat Synthesis and Dihydroptereat reduction 41. A sick 7-year-old boy complained of a dry, painful cough and rashes spreading on his body, characteristic of whooping cough. The child was prescribed codeine tablets. Indicate the mechanism of the antitussive effect of the prescribed drug... It inhibits the central part of the cough refkex located in the medulla oblengata 42. The patient who complained of a severe cough was prescribed an antitussive in tablet form. The patient chewed and swallowed the medicine. After a while, the cough went away somewhat. But since taking the medicine, the patient has noticed that his mouth is "numb". What drug is prescribed to the patient? PhenoxdiAzne 43. Antibiotic belonging to the first generation of the aminoglycoside group. High toxic drug. It is used only externally for wound infections, phlegmon, abscesses, is included in the composition of ointments in combination with glucocorticoids. Determine the drug and indicate the pharmacological group by the mechanism of action… Amino glycocides 44. Representative of antibiotics in the group of azalides. Similar in spectrum and activity to erythromycins. The duration of exposure is 24 hours. Takes 1 time a day. The durability is good, the therapeutic effect persists for 5 days after its disappearance. Not used in the presence of allergies to erythromycin and other macrolides…Determine the drug and indicate its pharmacological affiliation according to the type of action on bacteria… Erythromycin 45. Patient P., age of 55, pneumonia caused by Mycoplasma, prescribed a broad-spectrum antimicrobial antibiotic, has a bacteriostatic effect, is the antibiotic of choice for particularly dangerous infections (plague, cholera, brucellosis)and bacillary dysentery, increases the sensitivity of the skin to ultraviolet rays, persists in the bones and tissues of the teeth. Dyspeptic disorders and dysbacteriosis… Explain the mechanism of action and indicate the drug… Tetracycline (inhibition of Intracellular protein By bactual ribosone 46. Patient E., 45 years old, suffering from pneumonia, was prescribed a broad-spectrum antibiotic. In terms of their chemical structure and mechanism of antimicrobial action, they are similar to antibiotics from the benzylpenicillin group. Resistant to beta-lactamase (penicillins). They are the antibiotic of choice for staphylococcal infections resistant to benzylpenicillin. Identify the drug and explain the mechanism of antibacterial action. Oxacillin ,nafcillin Pathophysiology Pathophysiology Sayed Imad Shah…. 1. Ensures maintenance of normal gas content in the blood: A. ventilation, diffusion, perfusion of alveoli B. ventilation of alveoli, shortness of breath, diffusion S. hyperpnea, tachypnea, perfusion D. perfusion, hyperventilation, polypnoea E. external breathing, gas exchange in the lungs 2. Obstructive type of shortness of breath develops: A. narrowing of airways B. in the failure of the small circulatory circle C. lack of obstruction to air movement D. increase in resistance to air movement E. decrease in resistance to air movement 3. The main factor in the pathogenesis of RDS syndrome in infants: A. reduction of surfactant; B. arterial hypotension C. pulmonary hypertension; D. disturbance of gas diffusion E. violation of pulmonary perfusion 4. Types of terminal breathing include: A. Kussmaul breath, apnea, gasping breath B. apnea, Kussmaul breathing, bradypnea C. tachypnea, gasping breath, eupnea D. apneic breathing, polypnoea E. bradypnea, Chain-Stokes, dyspnea 5.In what pathological processes there is a decrease in pulmonary perfusion: A. violation of contractility of the right ventricle B. if the contact time of blood with alveolar air decreases C. if the total membrane volume decreases D. alveolar-capillary membrane thickening E. in the syndrome of hyaline membranes 6. Pulmonary perfusion disorders play a major role in the development of shortness of breath in which pathology: A. Thromboembolism of the pulmonary artery B. Right ventricular heart failure C. Pulmonary asthma D. Pulmonary tuberculosis E. Pulmonary emphysema 7. Regional mismatch between alveolar ventilation and capillary blood flow leads to: A. Ventilation-perfusion relationship B. To alveolar hyperventilation C. To alveolar hypoventilation D. Lung perfusion capacity E. Diffusion capacity of the lungs 8. What capacity of the lungs depends on lung perfusion, the number of alveoli, the thickness of the alveolar-capillary membrane is functioning normally: A. diffusion capacity B. ventilation-perfusion center C. pulmonary perfusion D. lung elasticity F. Lung elasticity 9. There is an increase in airiness of lung tissue: 10. Obstructive form of shortness of breath develops 11. The restrictive type of shortness of breath develops in the following pathology: A. Reduction of lung elasticity B. External compression of airways C. Thickening of airway wall during inflammation D. Reduction of lung elasticity, pulmonary stenosis E. External compression of airway wall 12. State the reasons leading to RDS syndrome in adults: A. Damage to pulmonary capillaries B. TO injury C. long crying D. altitude and mountain sickness E. excessive cooling of the body 13. Patient S., 33 years old, came to the clinic with a complaint of suffocation and intermittent cough caused by negative emotions. Breathing is characterized by short inhalation and long exhalation, audible wheezes. General condition: The patient is in a forced position, shoulder, back, and abdominal muscles are involved in the act of breathing. Breathing rate is 25 times in 1 minute. On auscultation: there are dry crackles in the lungs. After a thorough examination, the diagnosis of “respiratory asthma” was made. Specify the type of shortness of breath, the pathogenetic factor and the type of shortness of breath. A. obstructive type; change in sensitivity and reactivity of bronchi; Expiratory shortness of breath B. restrictive type; violation of bronchial permeability, inspiratory shortness of breath C. obstructive type; sensitization; Inspirational inspiration D. mixed type; degenerative changes of mucous layers of bronchi; Expiratory shortness of breath E. restrictive type; change of immunological reaction; Inspirational inspiration 14. Patient H., 53 years old, suffers from chronic bronchitis. He came to the clinic with a complaint of shortness of breath, “unsatisfactory” feeling of exhalation. During the inquiry, it was revealed that he works as a packer in a cement manufacturing workshop, where there is no fire, and that he has been smoking since he was young. After a thorough examination, a diagnosis was made: “secondary pulmonary emphysema.” Etiofactor, changes in indicators of lung ventilation and the main pathogenetic factor. A. cement dust; Enzymatic decomposition of the fibrous structure of lung tissue B. nicotine; stretching of lung tissue C. getting cold; violation of lung elasticity; D. cigarette smoke; defect of elastin, collagen structure E. age; excessive action of proteolytic enzymes 15. Before the illness, the patient played in the brass band and the saxophone. After suffering from croupous pneumonia, a doctor’s opinion was given to change the type of work. Specify the pathogenetic factor: A. lung tissue stretching and elasticity disorder B. violation of lung recovery C. change in sensitivity and reactivity of bronchi D. formation of connective tissue in lung parenchyma E. formation of granuloma in lung tissue; 16. Patient M. entered the clinic with a body temperature of 37.7 °C. Breathing is frequent and superficial, the frequency of breathing is 24 times. General weakness, cough and chills are observed, sputum comes out after constant long cough. In the anamnesis, it was found that he had frequent colds in his childhood, his mother has respiratory asthma, he works in construction, he smoked 1 pack of cigarettes a day for 10 years. Objectively: there are no significant changes in the cardiovascular and other systems. In terms of: HR – 85 beats in 1 minute, blood pressure – 120/80 mmHg. On auscultation: in the right lower part of the lung, there is weak breathing, crepitation and wet Indian rales of various calibers. Health: ESR – slightly increased, leukocytosis. ЖЗА: unchanged. [17:09, 15.10.2024] Zulfira Kudaibergen: Sputum analysis: color – yellowish-green; leukocytes – 10-15; bacteria streptococcus++++; Bact. Koha – no R-gram: signs of darkening are visible in the lower part of the right lung. Show what pathology the patient has and how the indicators of lung ventilation change, what type of breathing. A. pneumonia; TC, reserve inspiratory volume and expiratory volume are reduced B. pulmonary tuberculosis; TC (DO), reserve inspiratory volume and expiratory volume are reduced C. pulmonary emphysema; TC, reserve inspiratory volume and expiratory volume are reduced D. pleurisy; TC, reserve inspiratory volume and expiratory volume E. chronic bronchitis; РСС and РСС – reduced 17. Patient S., 24 years old, was admitted to the clinic with complaints of fatigue, increased heart rate during physical exertion and pain in the apex of the heart. During coughing, a small amount of sputum mixed with blood comes out. After a thorough examination, the doctor noted pulmonary hypertension. In terms of: HR – 85 beats in 1 minute, blood pressure – 120/80 mmHg. On auscultation: there is a dry crackle at the level of the lower eyelid, wet crackles. State the cause of this disease and the main link in its pathogenesis: A. mitral stenosis - a blockage in the small blood circulation circle due to the filling of the left atrium with blood; of the flap B. failure of the aortic valve – a hemodynamic disorder in the arterial blood flows of the large circulatory circle; keeping the correct daily schedule C. aortic stenosis – lack of cerebral and coronary blood vessels; commissurotomy D. deficiency of the mitral valve – a blockage in the circle of large blood circulation due to the filling of the left ventricle with blood; heart failure (conservation) E. mitral defect – difficulty of blood flow from the small circulatory circle to the large circulatory circle at the level of the left atrioventricular opening; playing sports 18. In a patient with diabetes, a coma manifested by Kussmaul’s breath developed (difficult breathing, rare and superficial). Your opinion: the pathogenesis of coma in the patient, what type of breath, indicate the pathogenetic factor of said breath. A. poisoning with ketone bodies; terminal breath is a violation of the function of the respiratory center B. hypoglycemia; Agonal breath is a stoppage of the center of inhalation and exhalation C. hyperglycemia; apneic breath – arousal of the apneic center D. poisoning with ketone bodies; agonal breath – the excitation of the gasping center E. hypoglycemia; Kussmaul’s breathing is a suppression of the inspiratory center 19. The patient has shortness of breath, chest cavity is barrel-shaped and respiratory excursion is reduced, percussive-box sound in the lungs. On the X-ray, the transparency of the lungs has increased. What is the pathology and pathogenetic factor in the patient? A. pulmonary emphysema, expansion of the air space B. pulmonary tuberculosis, progressive fibrosis C. pneumocaniosis, development of interstitial fibrosis D. respiratory asthma, change in bronchial reactivity E. RDS syndrome, alveolo-capillary membrane damage 20. An ambulance brought a newborn child to the clinic with symptoms of respiratory failure. After examination, the doctor of the reception department made a diagnosis of “respiratory distress syndrome of newborn children”. From the anamnesis: the child was born prematurely, low birth weight, severe obstetric anamnesis in the mother during pregnancy (cardiovascular disease in the mother) Your opinion: what is the main link of the pathogenesis of this syndrome and its meaning. A. decrease in the amount of surfactant; prevents alveolar adhesion B. lack of surfactant; participates in the formation of dipalmithiolphosphatidiolcholine C. increase of surfactant; reduces lung elasticity D. increase in blood shunting; includes the absence of blood stasis in the lungs E. reduction of surfactant; increases lung elasticity 21. Patient T., with thyroid gland disease, is under “D” report at the endocrinologist. During the regular medical examination: the color of the skin and cream layers is normal. Heart rhythms are clear, rhythmic, tachycardia is observed, blood pressure is 130/90 mm Hg, breathing is frequent and shallow. After examining the doctor, he said that he had shortness of breath due to an enlarged thyroid gland. State the cause and type of respiratory failure: A. compression of respiratory tract walls from the outside; Obstructive form of respiratory failure B. respiratory tract obstructive disorder; obstructive type of respiratory failure C. violation of innervation of respiratory muscles; restrictive form of respiratory failure D. laryngospasm, obstructive form of shortness of breath E. restrictive lung damage; restrictive form of respiratory failure 22. Patient S., 54 years old, came to the clinic with shortness of breath due to carbon monoxide poisoning. Complaints: headache, dizziness, dry cough, nausea, vomiting. Specify the cause and pathogenesis of these complaints, pathogenetic treatment: A. carboxyhemoglobin; hypoxemia; oxygen therapy; B. reduced hemoglobin, hypercapnia; providing oxygen with a mixture of helium; C. carbhemoglobin; hypoxia; hyperbarotherapy; D. methemoglobin; hypoxemia; breathing oxygen with carbon dioxide; E. oxyhemoglobin; hypoxemia; hyperbarotherapy; 23. Show the pathogenetic factor of Cheyne-Stokes breathing: A. decrease in the sensitivity of the respiratory center to carbon dioxide, resumption of breathing due to excess accumulation of carbon dioxide in the blood B. increased sensitivity of the respiratory center to carbon dioxide C. decrease in elasticity of lung tissue D. stimulating effect of adrenaline on the cells of the respiratory center E. increased pulmonary perfusion 24. Mechanism of development of cardiogenic pulmonary edema: A. acute failure of the left parts of the heart, increased pressure in the left atrium B. Due to the release of large amounts of norepinephrine, the redistribution of blood between the large and small blood circulation increases the filling of the lungs with blood [17:09, 15.10.2024] Zulfira Kudaibergen: C. filtration of the liquid part of the plasma from the pulmonary capillaries into the lung tissue D. damage to the surfactant system by microbial agents E. increased pressure in the right chambers of the heart 25. Pathogenic factors of inspiratory shortness of breath: A. Slow-developing irritation of the vagus nerve during respiration resulting in delayed Goering-Breyer reflex B. rapidly developing irritation of the vagus nerve during breathing C. increased respiratory center excitability D. suppression of bronchioles during exhalation E. respiratory muscle damage 26. 43-year-old patient Y., after repeated poisoning with sulfur gas in the mine, clinical signs of pulmonary emphysema were revealed, especially shortness of breath. Gas composition indicators of arterial blood: Ra O2 – 86 mm Hg, Ra CO2 – 48 mm. s.b.b., Spirometry indicators: ESR (OEL) – increased, ETS (WIND) – decreased, Reserve inhalation volume and reserve exhalation volume – decreased. SSC (OOL) – increased, Tiffno coefficient – decreased. Specify the type of respiratory failure and the pathogenetic factor: A. obstructive alveolar hypoventilation, loss of lung elasticity B. restrictive alveolar hypoventilation, loss of lung elasticity C. Alveolar hypoventilation of irregular type, disturbance of pulmonary blood flow D. restrictive alveolar hypoventilation, airway compression E. restrictive alveolar hypoventilation, lung perfusion disorder 27. Show the causes of shortness of breath that leads to a violation of the excursion of the chest cell: A. pneumothorax, ascites, kyphoscoliosis B. bronchospasm, kyphoscoliosis C. hydrothorax, pneumosclerosis, ascites D. brain tumor, atelectasis E. pneumonia, acute respiratory distress syndrome 28. What is the type of external respiratory failure in the reduction of the respiratory surface of the lungs Show that evolves: A. restrictive respiratory failure B. irregular shortness of breath C. obstructive respiratory failure D. obstructive alveolar hypoventilation E. obstructive alveolar hyperventilation 29. Violation of diffuse properties of cellular capillary membranes is seen: A. in interstitial lung cancer B. during surfactant synthesis disorder C. during bronchial asthma D. in case of a tumor E. during pneumonia 30. Which symptoms are characteristic of the 1 st stage of asphyxia: A. inspiratory asthma, tachycardia B. tachycardia, shortness of breath C. bradycardia, hypoxia D. decrease in arterial pressure E. expiratory asthma, bradycardia 31. Pathogenesis of periodic breathing: A. decrease in the sensitivity of the respiratory center to CO2 B. respiratory center damage, hypoxia C. increased sensitivity of the respiratory center to oxygen D. Increased sensitivity of the respiratory center to CO2 E. hypoxia of the respiratory center 32. Show the types of terminal breathing: A. gasping, Kusmaul B. Biot breath, agonal breath C. Kussmaul respiration, Cheyne-Stokes respiration D. vesicular breathing, tachypnea E. bradypnea, dyspnea 33. End of nasal breathing disorder: A. Developmental defects of genital organs, nocturnal urinary incontinence B. hyperventilation, increased blood pressure C. increased intracerebral pressure, shortness of breath D. headache, increased ventilation E. loss of consciousness, decrease in intracranial pressure 34. The end of hyperpnea: A. respiratory muscle fatigue B. shortness of breath, pressure rise C. asphyxia, apnea D. pressure rise E. hypoventilation 35. Causes of the perfusion type of respiratory failure: A. pulmonary artery stenosis, pulmonary embolism B. pneumonia, pneumothorax, thrombosis C. mitral stenosis, alveolar-capillary membrane swelling D. massive pneumonia, shock, sepsis E. Airway obstructions 36. List the possible causes of asphyxia 37. A ventilation-perfusion ratio greater than 1.0 is observed when: A. in spasm of pulmonary arterioles B. in bronchospasm C. in atelectasis of the lungs D. in chronic obstructive bronchitis E. when fluid accumulates in the alveoli 38. Placing a rat in a barochamber, the air was pressurized to 180 mm.s.b. for three minutes. Will pump up to the level. How do indicators of acid-alkaline balance and gas content of blood change? A. Hypoxemia, hypocapnia, and gas alkalosis B. Hypoxemia, hypercapnia, gas acidosis C. Hypoxemia, hypocapnia, and gas acidosis D. Hypoxemia, hypercapnia, gas alkalosis E. Hyperoxemia, hypercapnia, mixed acidosis 39. One of the negative consequences of pulmonary hypertension is: A. development of right heart failure and heart strain B. development of hypertensive disease C. development of bronchospasm D. development of pneumosclerosis E. development of exudative pleurisy 40. Bronchial obstruction develops valve mechanism A. Pulmonary emphysema B. Surfactant deficiency C. Removal of part of the lung D. Pulmonary edema E. Pneumonia 41. Pathogenesis of respiratory distress syndrome in newborns State the prime factor: A. lack of surfactant B. arterial hypotension C. pulmonary hypertension D. gas diffusion disorder E. violation of pulmonary perfusion 42. Postcapillary pulmonary hypertension develops A. mitral valve defect B. pulmonary arteriole compression C. pulmonary arteriolar occlusion D. pulmonary arteriole narrowing E. a severe decrease in the specific pressure of oxygen in the breathing air 43. What is intermittent breathing characterized by? A. with alternating periods of breathing with apnea B. with frequent breathing C. with a change in the ratio of inhalation and exhalation D. with breathing that varies in depth E. with respiratory arrest 45 This type of respiratory failure develops when there are growths and foreign objects in the trachea, scar stenosis of the trachea, bronchial asthma. This type of respiratory failure is characterized by: 46 A patient with COPD has a paroxysmal cough, secretion of mucous sputum, general weakness, shortness of breath with difficulty exhaling. He has been sick for 3 years. Smokes for 6 years. What pathogenetic factor contributes to the development of cough in a patient? A 47-year-old man has an increase in body temperature up to 40 C, chills, cough with secretion of viscous mucous sputum mixed with blood, pain in the chest during coughing and deep breathing. Signs of pulmonary edema are detected during X-ray examination. What pathogenetic factor causes the development of pulmonary edema in a patient? 48 A premature baby born after a complicated pregnancy has cyanosis and shortness of breath with the involvement of accessory muscles. What pathogenetic factor is the main pathogenesis of respiratory distress syndrome in infants? 49 A 35-year-old patient was brought to the hospital unconscious in a diabetic coma. The patient is adynamic and sleepy. Breathing is deep and noisy at rest. What causes the patient to develop Kussmaul respiration?  A 50-year-old patient was hospitalized due to tachycardia and shortness of breath. In the anamnesis: rheumacorditis, mixed failure of the mitral valve. What pathogenetic factor is the basis of respiratory disorder in the patient? Childhood disease 1. Condition with box-like sound above the lungs Answer: Emphysema or pneumothorax. Reason: A box-like (hyperresonant) sound on percussion indicates increased air content in the lungs or pleural space, as seen in emphysema or pneumothorax. 2. Breathing in healthy children in the first months of life Answer: Rapid and shallow breathing. Reason: Newborns and infants have immature lungs and higher metabolic rates, resulting in faster respiratory rates (30-60 breaths per minute). 3. Not a functional indicator of the respiratory system Answer: Blood glucose level. Reason: Functional indicators include oxygen saturation, respiratory rate, and tidal volume, while blood glucose is unrelated to lung function. 4. Cause of tympanic sound on chest percussion Answer: Pulmonary cavities or pneumothorax. Reason: Tympanic sounds suggest air-filled spaces like cavities or pneumothorax, creating a drum-like resonance. 5. Side noise with weakened breathing that doesn’t disappear with coughing Answer: Pleural friction rub. Reason: A pleural friction rub, caused by inflamed pleurae, persists regardless of coughing and is accentuated by pressing the stethoscope. 6. Symptom of bronchial obstruction syndrome Answer: Wheezing and prolonged expiration. Reason: Bronchial obstruction leads to narrowed airways, causing wheezing and difficulty in exhaling. 7. Description of bronchial breathing Answer: Harsh and tubular sound, similar during inspiration and expiration. Reason: Bronchial breathing occurs when consolidated lung tissue transmits sounds from large airways. 8. Condition with dry wheezing Answer: Asthma or chronic bronchitis. Reason: Dry wheezing is caused by airflow through narrowed or obstructed airways, typical of asthma or chronic obstructive pulmonary disease (COPD). 9. Disease with paroxysmal cough and "reprises" Answer: Whooping cough. Reason: Bordetella pertussis infection causes violent coughing fits with "whoop" sounds during inspiration. 10. Cough in bronchiectasis Answer: Productive cough with purulent sputum. Reason: Bronchiectasis is associated with chronic infection, causing a persistent productive cough with thick, purulent sputum. 11. Lung segments in infants with poor aeration Answer: Posterior segments of lower lobes. Reason: Infants primarily use diaphragmatic breathing, leading to less effective ventilation in dependent lung regions. 12. Manifestation of congenital stridor Answer: Inspiratory stridor that worsens when lying down. Reason: Congenital stridor, caused by laryngomalacia, leads to noisy breathing due to floppy airway structures. 13. Cause of inspiratory dyspnea Answer: Upper airway obstruction (e.g., laryngeal edema or croup). Reason: Inspiratory dyspnea results from resistance to airflow during inspiration, commonly due to upper airway obstruction. 14. Degree of respiratory failure with oxygen saturation of 70-90% Answer: Moderate respiratory failure. Reason: Oxygen saturation levels between 70-90% indicate moderate impairment in gas exchange. 15. Characteristics of bronchial obstruction Answer: Wheezing, hyperinflation, and prolonged expiration. Reason: Bronchial obstruction increases airway resistance, leading to wheezing and air trapping. 16. Characteristics of harsh breathing Answer: Loud and rough with minimal pauses between phases. Reason: Harsh breathing suggests turbulence in inflamed or narrowed airways. 17. Not a cause of high respiratory rate in children under one year Answer: Low hemoglobin. Reason: High respiratory rates in infants are typically due to infections, fever, or metabolic demands, not anemia. 18. Not typical for a young child's nose Answer: Fully developed paranasal sinuses. Reason: Paranasal sinuses are underdeveloped in young children, making them less prone to sinusitis. 19. Disease/condition with weakened breathing Answer: Pleural effusion or atelectasis. Reason: Fluid or collapsed lung tissue impairs sound transmission, weakening breath sounds. 20. Disease with barrel-shaped chest Answer: Chronic obstructive pulmonary disease (COPD) or severe asthma. Reason: Air trapping leads to hyperinflation and a barrel-shaped chest. 21. Not typical for the structure of bronchi in young children Answer: Large diameter relative to body size. Reason: Children's bronchi are narrower and more susceptible to obstruction than adults. 22. Disease with weakened bronchophony Answer: Pleural effusion. Reason: Fluid in the pleural space dampens sound transmission, weakening bronchophony. 23. Condition with box-like sound above the lungs Answer: Emphysema or pneumothorax. Reason: Excess air in the lungs or pleural cavity enhances resonance. 24. Structural feature of the lungs in young children Answer: Less developed alveoli and thinner walls. Reason: Alveoli continue to develop postnatally, leading to less efficient gas exchange. 25. Cause of tympanic sound on percussion Answer: Pulmonary cavities or pneumothorax. Reason: Air-filled spaces produce tympanic sounds, characteristic of these conditions. Newborns – 46-50 up to 3 months – 40-45 4-6 months – 35-40 7-12 months – 30-35 2-3 years – 25-30 5-6 years - about 25 10-12 years – 20-22 over 12 years – 18-20