Systemic scleroderma

part of ventricular premature beats even with severe heart failure

part of supraventricular arrhythmias, even with severe heart failure

digitalisnaya intoxication

2249. What is true of the provisions for the patient with chronic heart failure related to I functional class

1. 
   simptomy heart disease identified only instrumental methods in conditions of maximum physical exertion
   
2. 
   Ordinary physical activity causes fatigue, palpitation, dyspnea, angina pain*
   
3. 
   is the ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain
   
4. 
   Fatigue, palpitations, shortness of breath, anginal pain occur when physical activity is less common
   
5. 
   The patient is not capable of performing any whatsoever exercise without causing discomfort
   

2250. What is preferred in heart failure on the basis of mitral regurgitation

1. 
   nitrosorbid inside
   
2. 
   Intravenous nitroglycerin
   
3. 
   captopril inside*
   
4. 
   Digoxin intravenously with the transition to supporting ingestion
   
5. 
   Furosemide inside
   

2251. At low cardiac output as a result of circulatory failure

1. 
   Impaired microcirculation
   
2. 
   Partial pressure of oxygen falls
   
3. 
   Reduced diffusion of oxygen out of the blood into the tissue
   
4. 
   There is a venous congestion and interstitial edema
   
5. 
   All of the above is true*
   

2252. In the event of edema of cardiac origin into play all these factors, in addition to

1. 
   Increasing hydrostatic pressure in the capillaries and slowing blood flow
   
2. 
   Vtorichnogoaldosteronizma delayed extracellular sodium
   
3. 
   Increasing the permeability of vascular wall
   
4. 
   Violation of protein metabolism with a shift in the direction of fine proteins*
   
5. 
   Reduction of the final pressure of the plasma
   

2253. By the early clinical signs of circulatory failure is all of the above, except

1. 
   Shortness of breath and heart beat that occur during exercise
   
2. 
   The appearance of lip cyanosis on exertion
   
3. 
   The appearance of wheezes in lungs
   
4. 
    Increase diuresis*
   
5. 
   The occurrence of nocturia
   

2254. By the late clinical signs of circulatory failure are

1. 
   Constant crackles in the low back of the lungs
   
2. 
   Occurrence of peripheral edema, ascites, anasarca
   
3. 
   Enlargement of the liver
   
4. 
   Gipervolemia
   
5. 
   Mark all listed*
   

2255. Lack of blood circulation is characterized by the appearance of shortness of breath, fatigue, palpitations only with exertion There myocardial hypertrophy Reduced work capacity Determine the stage for circulatory failure Strazhesko Vasilenko

1. 
   I stage*
   
2. 
   IIA stage
   
3. 
   Stage IIB
   
4. 
   III stage
   
5. 
   IV stage
   

2256. Shortness of breath and tachycardia continued and intensified after a small load has myogenic dilatation of the heart, the stagnation in the small circle, a slight enlargement of the liver, patients with severely limited capacity for work Determine the stage for circulatory failure Strazhesko Vasilenko

1. 
   I stage
   
2. 
   Stage IIA*
   
3. 
   Stage IIB
   
4. 
   III stage
   
5. 
   IV stage
   

2257. The patient has congestion in small and large circulation, increased (congestive) liver, peripheral edema During the cardiac and diuretic therapy reduced symptoms of circulatory failure Employability lost Determine the stage for circulatory failure Strazhesko Vasilenko

1. 
   I stage
   
2. 
   IIA stage
   
3. 
   Stage IIB*
   
4. 
   III stage
   
5. 
   IV stage
   

2258. The patient determined cirrhosis denominated peripheral edema, ascites, hydrothorax, cachexia Symptoms of circulatory insufficiency are persistent in nature and difficult to treat Determine the stage for circulatory failure Strazhesko Vasilenko

1. 
   I stage
   
2. 
   IIA stage
   
3. 
   Stage IIB
   
4. 
   III stage*
   
5. 
   IV stage
   

2259. The normal ejection fraction is the percentage

1. 
   55-61*
   
2. 
   10-20
   
3. 
   30-40
   
4. 
   40-50
   
5. 
   80-90
   

2260. What process is the basis of development of circulatory failure

1. 
   Infringement of the total peripheral resistance
   
2. 
   The peripheral blood circulation
   
3. 
   Violation of venous circulation
   
4. 
   Violation of cardiac pump function*
   
5. 
   An increase in cardiac output
   

2261. The etiology of acute heart failure with a high cardiac output

1. 
   Pulmonary heart
   
2. 
   Anemia*
   
3. 
   Cardiac tamponade
   
4. 
   Myocardial infarction
   
5. 
   Insufficiency of the aortic valve
   

2262. The etiology of acute heart failure with a high cardiac output

1. 
   Pulmonary heart
   
2. 
   Insufficiency of the aortic valve
   
3. 
   Cardiac tamponade
   
4. 
   Myocardial infarction
   
5. 
   Hyperthyroidism*
   

2263. The etiology of acute heart failure with a high cardiac output

1. 
   Pulmonary heart
   
2. 
   Cardiac tamponade
   
3. 
   Myocardial infarction
   
4. 
   Insufficiency of the aortic valve
   
5. 
   Acute glomerulonephritis with hypertension*
   

2264.Furosemide is a diuretic

1. 
   Thiazide
   
2. 
   Loop*
   
3. 
   Potassiumsparing
   
4. 
   main
   
5. 
   Tubular
   

2265. The optimal maintenance dose of digoxin in patients with chronic heart failure

1. 
   0,5-1,0 mg / day
   
2. 
   0,4-0,6 mg / day
   
3. 
   0,25-0,375 mg / day*
   
4. 
   0,1-1,0 mg / day
   
5. 
   0,01-0,1 mg / day
   

2266. A typical rhythm disturbance at a glycoside intoxication

1. 
   Sinus tachycardia
   
2. 
   Nonparoksizmal AV nodal tachycardia*
   
3. 
   Paroxysmal ventricular tachycardia
   
4. 
   Sinus arrhythmia
   
5. 
   Atrial fibrillation
   

2267. Drug that promotes an increase in life expectancy of patients with heart failure

1. 
   Furosemide
   
2. 
   Captopril
   
3. 
   Spironolactone*
   
4. 
   Molsidomin
   
5. 
   Enalapril
   

2268. Refractory heart failure is

1. 
   Levodeludochkovaya failure
   
2. 
   III stage chronic heart failure
   
3. 
   No effect on the treatment of heart failure*
   
4. 
   II stage of chronic heart failure
   
5. 
   I stage of chronic heart failure
   

2269.The most common form of chronic heart failure

1. 
   Systolic*
   
2. 
   Diastolic
   
3. 
   Mixed
   
4. 
   Hidden
   
5. 
   Heavy
   

2270. Ejection fraction of the left ventricle diastolic heart failure is reduced

1. 
   much
   
2. 
   slightly*
   
3. 
   to 0
   
4. 
   does not change
   
5. 
   Is increasing
   

2271. II A stage of chronic heart failure, ND Strazhesko, VHVasilenko

1. 
   Heavy hemodynamic large and small circulation
   
2. 
   Hemodynamic pulmonary circulation*
   
3. 
   Hide heart failure
   
4. 
   No circulatory disorders
   
5. 
   Encephalopathy
   

2272.Clinical manifestations of right heart failure

1. 
   Dyspnea
   
2. 
   Ascites liver enlargement*
   
3. 
   Hydrothorax
   
4. 
   Swelling of the legs
   
5. 
   Cardiac asthma
   

2273.Cardiomegaly diagnosed with an increase of the Xray

1. 
     The longitudinal dimension of the heart
   
2. 
   Transverse dimension of the heart*
   
3. 
   Aortic arch
   
4. 
   Diameter of the atrial
   
5. 
   Is not determined on the radiograph
   

2274.Display to overlay venous tourniquet on a limb

1. 
   bronchial asthma
   
2. 
   fainting
   
3. 
   stenokardiya
   
4. 
   cardiac asthma*
   
5. 
   gipotenziya
   

2275. Edema of cardiac origin appear

1. 
   In the morning on the face
   
2. 
   In the morning on the feet
   
3. 
   In the evening on the feet*
   
4. 
   In the evening on the face
   
5. 
   only on the stomach
   

2276. Gout a disease associated with the purine metabolic disorders and is characterized by the following features:

1. 
   The increase of serum uric acid*
   
2. 
   Increase in the content of uric acid in urine
   
3. 
   Loss of urate excretion in the vessel
   
4. 
   Redness of the skin
   
5. 
   Detection of RF in the blood
   

2277.What are the primary pathogenic form of gout:

1. 
   Metabolic (increase of uric acid synthesis in the body)*
   
2. 
   Metabolic (increased excretion of uric acid in the kidneys)
   
3. 
   Kidney (increase urates deposition in the parenchyma)
   
4. 
   Hepatic (liver delayed release of urates)
   
5. 
   Kidney (increase of uric acid synthesis in the body)
   

2278.What are the disease that often causes a secondary gout:

1. 
   Diabetes*
   
2. 
   Chronic liver failure
   
3. 
   Chronic hepatitis
   
4. 
   Diabetes insipidus
   
5. 
   Diffuse goiter
   

2279.Name the risk factors for gout:

1. 
   Consumption of foods rich in purines (meat, brain, liver, beans, chocolate)*
   
2. 
   Consumption of foods rich in purines (rice, noodles, onion)
   
3. 
   No systematic use of alcohol
   
4. 
   Increased physical activity
   
5. 
   Hunger
   

2280.Describe the sign of articular syndrome in gout:

1. 
   Acute pain, rapid development of crimson, then cyanotic soft tissue tumors, often in the 1st metatarsophalangeal foot*
   
2. 
   Gradual onset, lasting from a few weeks to a few months
   
3. 
   Increased pain in the daytime
   
4. 
   Acute pain with bleeding sores on his feet
   
5. 
   Moderate increase in local temperature
   

2281.What is accompanied by an attack of acute gouty arthritis?

1. 
   Intense itching of the skin over the affected joint
   
2. 
   An expression of stiffness in the affected joint
   
3. 
   Expressed pain in the affected joint*
   
4. 
   All of the above is true
   
5. 
   All of the above is untrue
   

2282.Elevated levels of substance in the blood is prerequisite or cause gout attack?

1. 
   Urea
   
2. 
   Uric acid*
   
3. 
   Creatinine
   
4. 
   Hemoglobin
   
5. 
   Bilirubin
   

2283.What is the most affected part of the body during gout attack?

1. 
   Thumb
   
2. 
   Pinky hands
   
3. 
   Large toe*
   
4. 
   Pinky legs
   
5. 
   Kneejoint
   

2284.Сomplication of gout are the socalled gouty nodes What are their medical name?

1. 
   Testicles
   
2. 
   Eczema
   
3. 
   Heberden’snodules
   
4. 
   Tophi*
   
5. 
   Rheumatoid nodules
   

2285.Urate nephropathy is alesion of

1. 
   Heart
   
2. 
   Liver
   
3. 
   Kidney*
   
4. 
   Pancreas
   
5. 
   Lungs
   

2286.What medicine (xanthine oxidase inhibitor) is widely used to prevent gout attacks?

1. 
   Aspirin / acetylsalicylic acid
   
2. 
   Allopurinol*
   
3. 
   Penicillin
   
4. 
   Furosemide
   
5. 
   Sulfasalazine
   

2287.Gout often occur in:

1. 
   Men up to 30 years
   
2. 
   Men of 35-50 years*
   
3. 
   Women under 30 years
   
4. 
   Children
   
5. 
   Women 35 to 50 years
   

2289.Gout initially disruptsthe exchangeof:

1. 
   Urea
   
2. 
   Lactic acid
   
3. 
   Uric acid*
   
4. 
   Urea and uric acid
   
5. 
   Urea and lactic acid
   

2290.Risk factors for gout include:

1. 
   Heredity and physical overload
   
2. 
   Physical stress and overeating
   
3. 
   Overeating and drinking*
   
4. 
   Purinepoor diet and heredity
   
5. 
   Purinepoor diet and physical overload
   

2291.What is the composition of gouty tophi?

1. 
   Calcium carbonate
   
2. 
   Uric acid salts*
   
3. 
   Cholesterol
   
4. 
   Fibrin clots
   
5. 
   Fibrous tissue
   

2292.The characteristic features of acute gout arthritis include:

1. 
   Intensive pain, local redness, swelling,*
   
2. 
   Intense pain and local hyperemia without edema
   
3. 
   Intense pain and swelling without local hyperemia
   
4. 
   Intense pain
   
5. 
   Swelling without local hyperemia
   

2293.What causes kidney damage in gout?

1. 
   Interstitial nephritis
   
2. 
   Deposits of tophi in the parenchyma
   
3. 
   The formation of stones in the renal pelvis
   
4. 
   All of the above is true*
   
5. 
   All of the above is untrue
   

2294.Patients with gout are often observed with:

1. 
   hypertension*
   
2. 
   bronchial asthma
   
3. 
   irondeficiency anemia
   
4. 
   stomach ulcer
   
5. 
   pneumonia
   

2295.What may happen spontaneously with gouty tophi?

1. 
   Inflammation
   
2. 
   Eruption*
   
3. 
   Necrosis
   
4. 
   All of the above is true
   
5. 
   All of the above is untrue
   

2296.The group of uric ureticsinclude:

1. 
   Anturan and allopurinol
   
2. 
   Allopurinol and hydrochlorothiazide
   
3. 
   Furosemide and etamide
   
4. 
   Etamide and anturan*
   
5. 
   Anturan and hydrochlorothiazide
   

2297. Colchicine can be usedin gout to:

1. 
   Reduce acute arthritis*
   
2. 
   Preventchronic hyperuricemia
   
3. 
   Preventand treatnephropathy
   
4. 
   Induce resorption of the subcutaneous tophi
   
5. 
   Reduce hypertension
   

2298.The reasons for the delayed excretion of uric acid by the kidneys include:

1. 
   Chronic renal failure
   
2. 
   Diuretics
   
3. 
   Dehydration
   
4. 
   Mark all of the above*
   
5. 
   None of the above
   

2299.What are the changes in laboratory values not typical for an acute attack of gout:

1. 
   Leukocytosis
   
2. 
   Increase of CRP 
   
3. 
   Leukopenia*
   
4. 
   Increased ESR
   
5. 
   Increase of uric acid
   

2300.Specifythe type of hyperuricemia when uric acid concentration in the blood serum is the lowest:

1. 
   Metabolic
   
2. 
   Renal*
   
3. 
   Mixed
   
4. 
   Hepatic
   
5. 
   Metabolic and hepatic
   

2301.Enter the normal concentration of uric acid in the serum of women:

1. 
   0,150- 0,350 mmol/l*
   
2. 
   0,210- 0,420 mg/dL
   
3. 
   0,150- 0,530 mg/dL
   
4. 
   0,360- 0,480 mmol/l
   
5. 
   0,150 -0,380 mg/dL
   

2302.Enter the normal concentration of uric acid in the serum of women:

1. 
   0,150- 0,350 mg/dL
   
2. 
   0,210 -0,420 mmol/l*
   
3. 
   0,150- 0,530 mg/dL
   
4. 
   0,360- 0,480 mmol/l
   
5. 
   0,150- 0,380 mg/dL
   

2303.What diseases are often associated with gout:

1. 
   CHD
   
2. 
   peptic ulcer*
   
3. 
   hyperlipidemia
   
4. 
   obesity
   
5. 
   arterial hypertension
   

2304.Check the stateswhen the renalexcretion of urate is reduced

1. 
   dehydration
   
2. 
   acidosis
   
3. 
   ketosis
   
4. 
   hypothyroidism
   
5. 
   allof the above*
   

2305.Most unfavorable type of gouty nephropathy is

1. 
   proteinuric*
   
2. 
   latent
   
3. 
   urolithiasis
   
4. 
   hypertensive
   
5. 
   mixed
   

2306.In identifying the overproduction of uric acid the drug of choice is

1. 
   Allopurinol*
   
2. 
   Probenecide
   
3. 
   Colchicine
   
4. 
   Aspirin
   
5. 
   Furosemide
   

2307.What is not applicable in treatment of acute attack of gout

1. 
   Colchicine
   
2. 
   Intraarticular corticosteroids
   
3. 
   Systemic corticosteroids
   
4. 
   Probenicide*
   
5. 
   NSAIDs
   

2308.Uric acid in norm

1. 
   Fully filtered in the glomeruli
   
2. 
   Subjected to reverse reabsorption in the proximal tubule
   
3. 
   Secreted in the distal tubule
   
4. 
   All the answers are wrong
   
5. 
   All the answers are correct*
   

2309.What is not allowed in acute gouty arthritis?

1. 
   Administration of hypouricemic drugs
   
2. 
   Cancelling hypouricemic drugs
   
3. 
   Administration of furosemide
   
4. 
   Route to the spa treatment
   
5. 
   Neither of the above*
   

2310.Excretion rate of uric acid in the renal form of hyperuricemia: 

1. 
   reduced*
   
2. 
   normal
   
3. 
   increased
   
4. 
   above normal
   
5. 
   slightlyincreased
   

2311.Uricosuricremedies include:

1. 
   Milurite
   
2. 
   Allopurinol
   
3. 
   Furosemide
   
4. 
   Sulfinpirasone*
   
5. 
   Verospirone
   

2312.Treatment of "acute gouty kidney" does not include:

1. 
   forced diuresis
   
2. 
   alkalization of urine
   
3. 
   allopurinol
   
4. 
   hemodialysis
   
5. 
   plasmopheresis*
   

2313.Who is more susceptible to the goutdisease?

1. 
   Men under the age of 40 years
   
2. 
   Men older than 40 years*
   
3. 
   Women of childbearing age
   
4. 
   Men and women equally
   
5. 
   Pregnant women
   

2314.What is allowed in diet with gout?

1. 
   Dry red wine
   
2. 
   Liver pate
   
3. 
   Beans
   
4. 
   All of the above
   
5. 
   None of the above*
   

2315.What drugs are nondesirable to administer to patients with gout?

1. 
   Aspirin*
   
2. 
   Indomethacin
   
3. 
   Diclofenacsodium
   
4. 
   Phenylbutazone
   
5. 
   All of the above
   

2316.What is characteristic of gout?

1. 
   Polyarthritis
   
2. 
   Monoarthritis*
   
3. 
   Periarthritis
   
4. 
   All of the above
   
5. 
   None of the above
   

2317.What contributes to allopurinol?

1. 
   Excretion of uric acid from the body
   
2. 
   Decrease in formation of uric acid*
   
3. 
   Decrease in activity of the inflammatory process
   
4. 
   All of the above is true
   
5. 
   All of the above is untrue
   

2318.Anturan is effective in

1. 
   Decrease in the activity of the inflammatory process
   
2. 
   Reduce the formation of uric acid
   
3. 
   Excretion of uric acid from the body*
   
4. 
   All of the above is true
   
5. 
   All of the above is untrue
   

2319.What drug is better to use for relief of acute gouty arthritis?

1. 
   Aspirin
   
2. 
   Allopurinol
   
3. 
   Anturan
   
4. 
   Colchicine*
   
5. 
   Dibasole
   

2320.What is typical for acute gouty arthritis?

1. 
   Severe stiffness in the affected joint
   
2. 
   Reynaud’s syndrome
   
3. 
   Symmetry of joint damage
   
4. 
   Severe congestion, an increase in temperature of the skin over the joint*
   
5. 
   Rapidly progressive joint ankylosis
   

2321.What is most affected in acute gouty arthritis?

1. 
   Hip joint
   
2. 
   Kneejoint
   
3. 
   Metatarsophalangeal joint of the first toe*
   
4. 
   Interphalangeal proximal joint of the first toe
   
5. 
   Distal interphalangeal joint of the first toe
   

2322.When an attack of acute gouty arthritisusually begins?

1. 
   Late evening
   
2. 
   At night
   
3. 
   Early morning*
   
4. 
   Before noon
   
5. 
   Afternoon
   

2323.Which of the following is not characteristic of ankylosing spondylitis

1. 
   more likely to develop in young age
   
2. 
   more likely to develop in women*
   
3. 
   higher mortality from pulmonary heart and kidney disease than in populations
   
4. 
   eye involvement may be the first manifestation of the disease
   
5. 
   difficulties when driving
   

3101. 
      Which of the following signs are rare in ankylosing spondylitis
      

1. 
   ESR elevation
   
2. 
   HLAB27*
   
3. 
   sacroileitis
   
4. 
   rheumatoid factor
   
5. 
   entesopathia
   

2324.Mark clinical signs for ankylosing spondylitis

1. 
   restriction of mobility in the spine
   
2. 
   pain by palpation of sacroiliac joints
   
3. 
   subcutaneous nodules*
   
4. 
   reduction of chest excursion
   
5. 
   acute anterior uveitis
   

3101. 
      What is not characteristic of ankylosing spondylitis
      

1. 
   nightly back pain
   
2. 
   female gender*
   
3. 
   reduction of pain after exercise
   
4. 
   availability of back pain among blood relatives of patients
   
5. 
   young age
   

2325.Which of the following manifestations are not characteristic of ankylosing spondylitis

1. 
   apical lung fibrosis
   
2. 
   kyphosis
   
3. 
   aortic insufficiency
   
4. 
   peripheral arthritis
   
5. 
   chronic conjunctivitis*
   

2326.Which laboratory values are being changed only in ankylosing spondylitis

1. 
   none of those
   
2. 
   elevated ESR
   
3. 
   HLA B27*
   
4. 
   antinucleic factor
   
5. 
   all of the above
   

2327.What sign is often lacking when Reiter's disease

1. 
   achilloiditis
   
2. 
   recurrent iritis
   
3. 
   frequent lesion small joints brushes*
   
4. 
   aortic insufficiency
   
5. 
   conjunctivitis
   

2328.Cause of reactive arthritis

1. 
   hereditary predisposition