A *Cererbrovascular dementia
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E Muscle-cutaneous nerve
42 In travpunkt asked the patient to the trauma glass bottom third of the forearm. OBJECTIVE: broken flexion IV and V fingers, reduced sensitivity of the inner surface of the back and palm of the hand and finger IV. What nerve is injured? A * ulnar B radial C Median
E axillary 43 The patient 38 years after the lifting came a pain in the lumbar spine with radiation to the back of his left leg. The pain increases when the position of the body and in an upright position. The examination revealed the positive symptoms of tension. What preliminary diagnosis can be made to the patient? A * Pathology of the intervertebral discs B Spinal cord tumor C arahnomielit D polyneuritis E myelopathy 44
infant does not produce active abduction, rotation and flexion of the shoulder joint.Range of motion in the elbow is limited, and in the radiocarpal joint and joints of fingers saved. Diagnosis? A * Upper brachial plexus palsy. B Lower brachial plexus palsy. C fracture of the clavicle. D fracture of the humerus. E Congenital contracture of the shoulder joint. 45 To the hospital a patient appealed with complaints about violation pain and haptic to the sensitiveness, pain in the eventual phalanxes of fingers, that arises up after work. On an enterprise he works with mechanical devices. What pathology is necessary to be suspected? A * Oscillation illness B Decompression sickness C Murmur illness D Signs of overstrain E Hypovitaminosis of vitamin of B_1 46 Analysing the results of periodic physical examination workers-polish of artistic glass was educed, that at 40% workers with the protracted experience in age 30-45 years neuritis of ulnar is set nerve, at 21% is vegetative-sensible полиневрит, at 12% - Vegetomiofascitis overhead extremities. Workers polish wares by means of revolved abrasive disk. To the action of what unfavorable factor data are related pathologies? A Vibration B the Unfavorable microclimate C Dust D Murmur
E Electromagnetic leakage field 47 A driver repaired a machine in the closed garage, whereupon appealed with by complaints about a headache, dizziness, nausea, muscular weakness, somnolence., at examination, making more frequent of pulse, breathings, excitation is marked, hypertension, craze of pursuit. Most credible diagnosis A *Intoxication by the oxide of carbon B Intoxication by the ethylated petrol C Posttraumatic encephalopathy D the Hypertension stroke E Astheeia-vegetative syndrome 48 At the machine-building plant, stripping of founding is conducted with a help fitting machines which are the source of local vibration. What most effective prophylactic measures for warning of her harmful influence on the organism of working? A *the use of gloves which extinguish a vibration B of realization of previous and periodic physical examinations C massage of racemes of hands D acceptance of warm baths for hands E realization of sanitary-educational work among workers 49 On physical examination the machinist of port faucet produced complaints on dizziness, nausea, feeling of pressure on ear-drums, chills tremor, motion in area of bowels, difficulty in breathing, cough. Works executed on height of, related to nervously-emotional tension. On workers operate vibration: general and local, murmur, infra-sound, steam-disengaging in summer cooling the winter microclimate. With the action of what factor you do you link the complaints of worker? A *Vibration B Murmur C Infra-sound D Tension of labour E of Work on height of 50 Workers of laboratory on making of measuring devices (manometers, thermometers and others like that) grumble about metallic taste in to the mouth, stomatitis, dyspepsia phenomena, parahypnosis, shaky gait, fall-off of cardiac activity. Specify reason of origin of this poisoning. A * Mercury. B Lead. C Manganese. D Toluene. E Tetraethyllead. 51 A 52 y.o. man has recurrent transient ischemic attacks. Auscultation of the carotid arteries detects murmur. What diagnostic method is necessary to apply first? A. Ultrasound dopplerography B. Cerebral angiography C. MRI of the brain D. Electroencephalography E. CT of the brain 52 A patient, aged 16, complains of headache, mainly in the frontal and temporal areas, superciliary arch, appearing of vomiting at the peak of headache, pain during the eyeballs movement, joint's pain. On examination: excited, t0- 390С, Ps- 110/min. Tonic and clonus cramps. Uncertain meningeal signs. What is the most likely diagnosis? A. Influenza with cerebral edema manifestations B. Adenovirus infection C. Respiratory syncytial virus D. Influenza, typical disease duration E. Parainfluenza 53.
A full-term new-born suffered ante- and intranatal hypoxia, was born in asphyxia (Apgar score 2-5 points). After birth baby's excitation is progressing, occurs vomiting, nystagmus, spasms, squint, spontaneous Babinski and Moro's reflexes. What is the most probable location of the intracranial haemorrhage in this case? A. Subarachnoid hemorrhages B. Haemorrhages in ventricles of brain C. Subdural hemorrhages D. Small hemorrhages in brain tissue E. Periventricular hemorrhages 54. Male 30 y.o., noted growing fingers and facial scull, changed face. Complains of poor eyesight, weakness, skin darkening, loss of body weight. X-ray shows broadening of sella turcica, thinning of tuberculin sphenoidale, signs of increased intracranial pressure. What diagnosis can you make? A. Adenoma of hypophysis B. Tumor of pondo-cerebellar corner C. Adrenal gland tumor D. Encephalitis of truncus E. Optico - hiasmatic arachnoiditis 55.
A newborn aged 3 days with hyperbilirubinemia (428 mkmol/L) developed following disorders. From beginning there were severe jaundice with poor suckling, hypotomia and hypodynamia. Little bit later periodical excitation, neonatal convulsions and neonatal primitive reflexes loss are noted. Now physical examination reveals convergent squint, rotatory nystagmus and setting sun eye sign. How to explain this condition? A. Encephalopathy due to hyperbilirubinemia B. Spastic cerebral palsy C. Hydrocephalus D. Skull injury E. Brain tumour 56. During intramuscular DTP vaccination in clinic, a 3 m.o. child developed signs of laryngospasm, paleness of skin, cyanosis of lips, "cock cry", stop of respiration, tension of the whole body with overturned backward head. Allergological history of the child is not complicated. What is the most probable diagnosis? A. Spasmophilia, tonic spasms B. Meningoencephalitic reaction, clonic and tonic spasms C. Meningism, clonic and tonic spasms D. Cerebral haemorrhage, tonic spasms E. Anaphylactic shock, clonic spasms
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A 65 y.o. woman complains of complicated mouth opening following foot trauma 10 days ago. Next day she ate with difficulties, there were muscles tension of back, the back of the head and abdomen. On the third day there was tension of all muscle groups, generalized convulsions every 10-15 min. What is the most probable diagnosis? A. Tetanus B. Tetania C. Meningoencephalitis D. Hemorrhagic stroke E. Epilepsy 58. Ambulance was called to a 48 y.o. man. From the words of relatives he has had three episodes of lost consciousness and attacks during the day. On examination: the following fit is observed: patient is unconscious, fell on the floor, tonic and then clonic convuesions of trunk and extremities happened. The attack lasted for 4 minute, ended by involuntary urination. What type of attack was observed? A. Major epileptic seizure B. Fainting C. Absence D. Vegetatic crisis E. Episode of hysteria
59 On the 5-th day of the respiratory disease a 24 y.o. man has developed progressive headaches systemic dizziness, feeling of seeing double, paresis of mimic muscles on the right, choking while swallowing. Acute viral encephalitis has been diagnosed. What is the main direction of urgent therapy? A. Zovirax B. Glucocorticoids C. Hemodesis D. Lasix E. Ceftriaxon 60 A 14 y.o. child suffers from of vegetovascular dystonia of pubertal period. He has developed sympathoadrenal crisis. What medicine should be used for crisis reduction? A. Obsidan B. Euphyline C. Corglicone D. Amisyl E. No-shpa 61 A 70 y.o. male patient with mild headaches complains of speech disorder, weakness in right limbs. There was a history of miocardial infarction and arrhythmia. On nu eroligical examination there are elements of motor aphasia, central paresis of VII and XII cranial nerves pairs on the right side, cental type of hemiparesis and hemihyperesthisia on the same side. What is the most probable diagnosis? A. Ischemic stroke B. Hemorrhagic stroke C. Cerebral tumor D. Epidural hematoma E. Transitory ischemic attack
A 60 y.o. patient complains of having passing reduction of strength in his left extremities for a month. Some time later he has got persistent weakness of extremities in the mornings. Objectively: AP- 140/90 mm Hg, conscious, central paresis of the VII and XII pair of left-side cranial nerves, central hemiparesis and hemihyperesthesia also on the left side. What medicines should be chosen for the differentiated treatment of the patient? A. Anticoagulants B. Diuretics C. Hypotensive D. Corticosteroids E. Hemostatics
The disease of a 21 y.o. patient began with raise of temperature up to 39,00С, headache, chill, repeated vomiting. Rigidity of occipital muscles is determined. The analysis of liquor revealed: cytosis - 1237 in 1 ml, including: 84% of neutrophils, 16% of lymphocytes. On bacterioscopy: gram-negative cocci are found in liquor. What is the most probable disease? A. Meningococcal infection: purulent meningitis B. Meningococcal infection: serous meningitis C. Serous meningitis D. Secondary purulent meningitis E. Infectious mononucleosis
A 54 y.o. man was admitted to the hospital with complaints of sudden intense headache in occipital region and vomiting. In the medical hystory: moderate arterial hypertension, the patient was taking hydrochlorothiazide. Three days ago he consulted a therapeutist about intense headache that was suppressed by an analgetic. Objectively: consciousness is confused, left pupil is mydriatic. Evident photophobia and tension of neck muscles. Left-side hemiparesis with increased muscle tonus and reflexes. Body temperature is low, rash is absent. AP- 230/130 mm Hg, Ps- 50 bpm, BR- 12/min. What is your preliminary diagnosis? A. Acute subdural hematoma B. Migraine C. Acute bacterial meningitis D. Myasthenia E. Disseminated sclerosis 65 A 47 y.o. woman complains of having paroxysmal headaches for the last 5 years. The pain is one-sided, intense, localised in frontal region of head, accompanied by nausea and stomach discomfort, begins one of a sudden. Onset is usually preceded by vision reduction. Anamnesis gives evidence of periodical AP rise, but at the moment the woman doesn't take any medicines. Inbetween the onsets of headache her state is satisfactory. Objectively: high-calorie diet (body weight index - 29), AP- 170/95 mm Hg. Neurologic state has no pecularities. What is the most probable diagnosis? A. Migraine B. Hypertensive encephalopathy C. Epilepsy D. Chronic subdural hematoma E. Benign intracranial hypertension 66 A 38 y.o. patient lifted a heavy object that resulted in pain in the lumbar part of spine irradiating to the posterior surface of his left leg. The pain increases during changing body position and also in the upright position. Examination revealed positive symptoms of tension. What is the preliminary diagnosis? A. Pathology of intercostals disks B. Polyneuritis C. Myelopathy D. Spinal cord tumor E. Arachnomyelitis
A 75 y.o. woman with coronary heart disease constantly takes warfarin. She was taken to the acute care department with complaints of sudden sensation of weakness in the left half of her body and eyeball deviation to the left. What examination of the patient will be a primary task? A. Computer tomography of brain B. Ultrasonic examination of carotid arteries C. Magnetic resonance tomography of brain D. Electroencephalogram E. Spinal punction 68 A 43 y.o. patient complains of periodical pain attacks in the right half of her face. The attack is characterized by spasm of mimetic muscles of the right face's half, reddening of skin on this side. Blood has no pathologies. She was diagnosed with right-sided trifacial neuralgia. What medication should be prescribed? A. Finlepsin B. Actovegine C. Indometacin D. Prednisolone E. Analgine
A 7 y.o. girl has mild form of varicella. Headache, weakness, vertigo, tremor of her limbs, ataxia, then mental confusion appeared on the 5th day of illness. Meningeal signs are negative. Cerebrospinal fluid examination is normal. How can you explain these signs? A. Encephalitis B. Meningoencephalitis C. Myelitis D. Meningitis E. Neurotoxic syndrome
Woman of 60-th years, about 15-th years suffers by arterial hypertention After the repeated stroke grumbles about the amotivational decline of mood, weight of concentration of attention, forgets to close entrance doors, does not remember the event of past day. On CT - areas of poststrokes changes are in crust postfrontal areas. What diagnosis is most reliable at patient? A *Cererbrovascular dementia B Illness of Al'cgeymer’s C Illness of Gentington’s E Dissociativ amnesia
Patient of 68-th years, office worker. There are about two years disorders of memory had began : patient is helpless in work and way of life, did not get along at official duties. Gradually began to forget the names of relatives, names of objects, became helpless, speech was violated. Lost skills of letter, reading, care of itself. At CT research: atrophy of cortex of large hemispheres of brain. What diagnosis is most reliable ? A *Illness Al'cgeymer’s B Peak illness C Atherosclerotic dementia D Senil'naya dementia E Progressive paralysis
Patient of 31 years, economist, from youth age suffers epilepsy with large convulsive attacks, constantly accepted anticonvulsive treatment. Entered in hospital with the considerable becoming more frequent of attacks. In a separation there are serial attacks between which a patient does not come in consciousness. What measures is it most expedient to use? A *Inta venois infusion of cybazon’s. B Parenteral'noe introduction of aminazin. C To increase doses of medicine usually used by patients. D Introduction of camphorae. E Elektro - shocking therapy.
A woman of 56 years on a background a climax have attacks which are characterized great head pain, by the increase of arterial pressure to 180/ 100 мм of Hg, tachycardia, the shortness of breath, general shaking. Duration of attack 30-40 min. An attack ends with urination. What type of crysis is it more possible? A * Simpato-adrenalin’s crysis B Vago-insulin’s crysis C Low blood pressure crysis D Hypertensive crysis E Epileptic attack
A girl of 18 years got illnes sharply: there is a cold, cough, stomach-aches, temperature of 38,5С. To the third day the catarrhal phenomena diminished, temperature of 36,6С. On a fourth day of illnesses are a weakness in a right foot. Objectively: active motions absent in a leg, passive – sickly. The muscles of thigh are languid, sickliness on motion nervous barrels. Knee and axilles reflex on a right foot not caused, the symptom of “triangle” is positive. In blood leuc. - 4,2*109., SFE – 6 mm/min. Credible diagnosis? A *Poliomyelitis, spinal form B Poliomyelitis, pontine form C Sausage-poisoning D Encephalomielit E Tick encephalitis
The attacks of twitches of right foot, which spread on all of leg and lasted during a few minutes, appeared for a patient. Not lost consciousness. At examination: paresis of right foot after an attack, deep reflexes on a right foot are promoted, symptom of Babinskogo on the right. Specify the type of attack: A *Jeckson’s epilepsy B Kozhevnikovskiy epilepsy C Miokloniya D Genaral tonico-clonic attack E Absans
A man of 35 years worked 13 years a bulldozerman. Grumbles about dizziness, head pain at the end of working day, numbness of fingers and pain in the muscles of feet at night. At an inspection violations of pain and tactil sensitiveness are exposed on a peripheral type, sickliness of sural muscles, pulsation on and dorsalis pedis is stored. What disease most probably? A *Vibration illness B Illness of Reyno C Siringomieliya D Vegetative (ANS) polyneuripathy E Obliterating atherosclerosis
The patient of 22 years grumbles about sudden palenaess of finger-tips, developing at cooling. At warming fingers acquire at first cyanosis, and then purple colouring. Preparation of choice for treatment of this syndrome is: A *Nifedipin B Dipiridamol C No-shpa D Aspirin E Nitrates
A man is neat in the street in the unconscious state and delivered in hospital. With small intervals he have the repeated attacks of tonic and clonic cramps of hands and feet. Consciousness is lost, pupils are wide, irresponsive on light. In language are biting tracks. There was involuntary urination. Signs of hearth defeat of cerebrum it is not exposed. AP - 140/ 90 мм Hg. The head of patient can be freely resulted to the breast. you will define the most credible pathology. A Epilepsy, epileptic status B Brain hemorrhage C Ishemic stroke D Stupor
E Sharp meningoencephalitis 10 7- years schoolboy during lessons to on once or twice became inattentive, began to smack lips. During short "absence" he did not respond to the name. Falling and cramps at this time were not observed. A mother noticed such phenomena and before, but did not attach a significance them, considering that a child was thoughtful. What most reliable diagnosis ? A Absans B Generalized myoclonick attack C Adversive attack E Dzhekson’s partial attack 11 At a 25-years-old woman the attack of the following character developed on a background the signs of vegetative dystonia: pains appeared in area of heart, feeling of difficulty in breathing, nausea, dizziness, redness of person, the loss of consciousness, lasting about minute, came after. ABP is 80/60 мм of Hg. Frequency of pulse - 56 /min. Vagoinsulyar crysis is diagnosed, syncopes. What Is basic direction of therapy? A Simpatomimetic preparations B Simpatolytic preparations C Kholinomimetic preparations D Vasjactive E Degidrative
In patient of 17 years a disease arose up very sharply and developed stormily: chill, increase of temperature to 40,0 With, intensive poured out head pain, vomiting, the loss of consciousness came afterwards . Objectively: menigeal signs. SCF (liquor) turbid. Cells - 4600 /mm3., an albumin is 1680 mgs/l, sugar - 2,5 mml/l, chlorides -100 mml/l, neutrophils - 98 %, lymfocytes - 2 %. What Is the most credible diagnosis? A Meningococcal meningitis B Tubercular meningitis C Limphocyte choriomeningitis D Enterovirus meningitis E Parotitis meningitis 13 A girl of 17 years got electro-trauma. After conducting of reanimation there was hospitalized. Which from the followings complications, dangerous for life, possible through a few clock or days after it: A Fibrillation of ventricles B Stop of breathing C pulmonary edema D Comatose state E Violation of neuro-muscular conductivity
The woman of 45-th years complains on sudden unbearable pain in the left half of face by duration 1-2 minutes. Attacks are provoked mastication. Start of illness two months back after supercooling. Objectively: pain in points the output of trigeminal nerve on the left. A touch near the wing of nose on the left causes a next attack with the tonic cramp of muscles of face. What from this diagnoses is most reliable? A Tic douloureux B Neuralgia of n.glosssofarineus C Arthritis of low jaw joint D Facial migraine E Antritis
The man of 38-th years entered hospital in the unconscious state. Start of problem was yesterday: head pain, nausea, vomiting, appeared T 38,5 C, there was disorientation, delirium, . During the last 4 days grumbled about pain and decline of ear on a left ear. Objectively: state of sopor, rigidity of cervical muscles, symptom of Kernig’s on either side, general hyperaesthesia, suppuration from a left ear. What is from this diagnoses most reliable? A Second festering meningitis B Primary festering meningitis C Tubercular meningitis D Subarachnoidite hemorrhage E Brain hemorrhage 16 At a woman 46 years old through one day after the beginning of flu head pain increased, appeared disorientation, nausea. Objectively: consciousness is stored, psychomotorical excitation; general hyperaesthesia, midle meningale syndrome. Nistagm. Tendon reflexes on the right is higher, force of muscles is reduced in right extremities, on the right side is pathological reflexes of Babinskiy. CCF: transparent, pressure 220 мм. item, cytosis - 46,3, mainly lymphocytis. What from diagnoses is most reliable ? Yüklə 263,31 Kb. Dostları ilə paylaş:
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