18.2 SPECIFY THE SYMPTOMS OF THE PHYSIOLOGICAL SPLITTING OF II HEART SOUND:
a) the constancy of this phenomenon;
b) the impermanence of this phenomenon; c) the appearance during inhalation.
19.THE PATIENT HAS A PRONOUNCED ATHEROSCLEROTIC DISEASE OF THE ASCENDING AORTA AND AORTIC VALVE. MYOCARDIAL CONTRACTILITY OF THE LEFT VENTRICLE SATISFACTORY, THE AMPLITUDE OF THE DISCLOSURE OF THE AORTIC VALVE IS SUFFICIENT. WHAT IS THE LIKELY CHANGE IN II TONE IN THE SECOND INTERCOSTAL SPACE TO THE RIGHT OF THE STERNUM?
a) enhanced II tone (accent II tone on the aorta); b) weakened II tone;
in) II unmodified tone.
20.THE PATIENT HAS LARGE FOCUS OF POSTINFARCTION CARDIOSCLEROSIS OF THE LEFT VENTRICLE AND OBJECTIVE SIGNS OF MYOGENIC DILATATION (THE WEAKENING AND SHIFT TO THE LEFT OF THE DIFFUSE APEX BEAT, OFFSET TO THE LEFT RELATIVE DULLNESS OF THE HEART). WHAT 3 CHANGES OF HEART TONES WE CAN IDENTIFY IN THIS SITUATION?
a) the strengthening of tone I on the top; b) I weakening tone at the apex;
c) increased the I tone at the base of the xiphoid process;
d) the appearance of the pathological III tone heart at the apex; f) the appearance of the pathological IV tone heart at the apex; g) appearance at the top of the tone of mitral valve opening.
21.GIVE THE DEFINITION OF "VALVULAR REGURGITATION" (CHOOSE ONE ANSWER):
a) any turbulent blood flow through the valve opening;
b) turbulent blood flow through the sash of the diseased valve during systole; c) turbulent blood flow through the sash of the diseased valve in diastole;
d) blood flow through the affected valve flaps, incapable of full closure; e) blood flow through the affected valve flaps, are not able to fully open.
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22.SPECIFY THE NATURE AND AREA OF THE BEST LISTENING OF MURMURS, IF THE PATIENT HAS THE MITRAL STENOSIS:
a) systolic murmur at the apex; b) diastolic murmur at the apex;
c) systolic murmur in the second intercostal space to the right of the sternum; d) diastolic murmur in the second intercostal space to the right of the sternum; e) systolic murmur in the second intercostal space left of the sternum;
23.SPECIFY THE NATURE AND AREA OF THE BEST LISTENING OF MURMURS, IF THE PATIENT HAS PULMONARY ARTERY VALVE INSUFFICIENCE
a) systolic murmur at the apex; b) diastolic murmur at the apex;
c) systolic murmur in the second intercostal space to the right of the sternum; d) diastolic murmur in the second intercostal space to the right of the sternum; e) systolic murmur in the second intercostal space left of the sternum;
f) diastolic murmur in the second intercostal space left of the sternum; g) systolic murmur at the base of the xiphoid process.
24.SPECIFY THE NATURE AND AREA OF THE BEST LISTENING OF MURMURS, IF THE PATIENT HAS SWELLING AND PULSATION OF THE JUGULAR VEINS OF THE NECK, COINCIDING WITH THE PULSATION OF THE APEX BEAT?
a) systolic murmur at the apex; b) diastolic murmur at the apex;
c) systolic murmur in the second intercostal space to the right of the sternum; d) diastolic murmur in the second intercostal space to the right of the sternum; e) systolic murmur in the second intercostal space left of the sternum;
f) diastolic murmur in the second intercostal space left of the sternum; g) systolic murmur at the base of the xiphoid process.
25.WHAT 2 GROUPS OF HEART MURMURS ARE FUNCTIONAL?
a)murmurs resulting from lesions of the heart valves and great vessels;
b)murmur occurring due to a decrease in blood viscosity or increased blood flow velocity;
c)murmur arising from the relative insufficiency or valve stenosis holes;
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d)pericardial RUB and pleuropericardial murmur;
e)the murmur arising from congenital heart defects.
26.ON SOME OF THESE HEART LESIONS CAN BE CONSIDER IF THE PATIENT STUDY REVEALED: INCREASED I TONE AND MESOCESTOIDES LOW FREQUENCY RUMBLING MURMUR AT THE APEX OCCURRING AFTER AN AUDIBLE TONE BY OPENING OF THE MITRAL VALVE?
a) mitral valve insufficiency; b) mitral stenosis;
c) the aortic insufficiency; d) aortic stenosis.
27.HOW TO CHANGE THE LOUDNESS OF THE SYSTOLIC MURMUR OF MITRAL REGURGITATION WITH INCREASING THE CONTRACTILITY OF THE LEFT VENTRICLE?
a) decreases;
b) will increase; in) will not change.
28.GIVE A DETAILED CHARACTERIZATION OF THE MURMUR ORGANIC MITRAL REGURGITATION (GIVE ANSWER 4):
a) auscultated at the apex; b) is the systolic;
c) is the diastolic;
d) starts immediately after the I tones; e) starts some time after I tone;
f) is held in the left axillary region;
g) is carried out on the carotid and subclavian arteries.
29.GIVE A DETAILED CHARACTERIZATION OF THE ORGANIC MURMUR OF AORTIC VALVE INSUFFICIENCY (GIVE 5 ANSWERS):
a) auscultated in the 2nd intercostal space right of the sternum; b) auscultated in the 2nd left intercostal space from the sternum;
c) auscultated left of the sternum, in the area of attachment of III – IV ribs; d) is the systolic;
e) is diastolic;
f) starts immediately after the II tone;
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g)starts some time after II tone;
h)is held in the left axillary region;
i)is carried out according to the flow of blood from the aorta into the left ventricle.
30.SPECIFY 2 PERCUS AND RADIOGRAPHIC SYMPTOM OF MITRAL CONFIGURATION OF THE HEART:
a) displacement of right border of relative dullness of heart to the right; b) the offset of the left border of relative dullness of heart to the left;
c) the displacement of the upper borders of relative dullness of the heart upward; d) accentuated waist of heart;
e) waist smoothed heart.
31.DESCRIBE THE APEX BEAT IN A PATIENT WITH MITRAL VALVE INSUFFICIENCY IN THE STAGE OF COMPENSATION DEFECT (REPLY 3): a) enhanced apex beat;
b) weakened apex beat;
c) the displacement of the apex beat to the left only;
d) the displacement of the apex beat to the left and down (6th – 7th intercostal space); e) apex beat advanced;
f) apex beat concentric.
32.CHECK THE 4 TYPICAL SYMPTOMS OF DECOMPENSATION OF MITRAL HEART DEFECTS:
a) acrocyanosis;
b) dense bluish swelling of legs and feet; c) fluid effusion in the pleural cavity;
d) shortness of breath on exertion;
e) pain in the heart area character (removed nitroglycerin); f) enlargement of the liver.
33.HOW TO CHANGE THE PERCUS SHAPE OF THE HEART IN A PATIENT WITH MITRAL VALVE STENOSIS AT THE STAGE OF COMPENSATION (ONE ANSWER)
a) displacement of the upper border of relative dullness of heart - up, and the waist smoothed heart.;
b) significant shift of the left border of relative dullness of heart to the left.
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34.WHICH 3 OF THE FOLLOWING COMPLAINTS ARE CHARACTERISTIC FOR A MITRAL VALVE INSUFFICIENCY PATIENT?
a) shortness of breath during physical exertion and in the supine position;
b) pain in the heart area and behind the breastbone radiating to the left arm and under the shoulder blade;
c) sensations of faults in work of heart and heartbeat ("chaotic rhythm hearts");
d) swelling of the feet (more towards evening);
e) dizziness and (sometimes) momentary fainting during physical load;
f) dyspnea and cough with blood streaks at night.
35.WHAT ARE 2 VARIATIONS OF THE PULSE AT THE RADIAL ARTERIES ARE TYPICAL OF PATIENTS WITH MITRAL VALVE STENOSIS WITH ATRIAL FIBRILLATION?
a) high and imminent ("galloping" - pulse Corrigan); b) low and slow;
c) pulsus deficience;
d) different (pulsus difference); e) pulsus paradoxus.
36.SPECIFY 2 AUSCULTATION SIGN OF ATRIAL FIBRILLATION :
a)correct the heart rhythm;
b)single failures in the activities of the heart on the background of the right rhythm;
c)"chaotic" (completely irregular) heart rhythm;
d)strengthening of tone I at the apex;
e)changing the volume I tone at the apex.
37.SPECIFY 3 MAIN DIAGNOSTIC AUSCULTATION SIGNS OF STENOSIS THE MITRAL VALVE (RHEUMATIC ETIOLOGY):
a) the strengthening of tone I at the apex; b) I weakening tone at the apex;
c) the presence of pathological III tone at the apex;
d) the presence of the tone of mitral valve opening at the apex;
e) low-frequency diastolic murmur at the apex without holding in other areas.
38.SPECIFY 2 PERCUSSION AND RADIOGRAPHIC CHARACTERISTIC AORTIC CONFIGURATION OF THE HEART:
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