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CONTROL QUESTIONS AND TASKS. 1. Patient is sharply inhibited, arterial pressure is not defined, pulse is weak and rapid, cutaneous coverings are spotted

1. Patient is sharply inhibited, arterial pressure is not defined, pulse is weak
and rapid, cutaneous coverings are spotted. Breathing is shallow and hurried.
Name the kind of terminal state:

A. Preagonal state

B. Agonal state

C. Clinical death

D. Theological death

E. Biological death

2. In the patient, after a sharp acceleration of breathing suddenly its complete
cessation advanced, corneal reflexes are rapidly extinguishing, rare ectopic
impulses are registered on the ECG. Name the kind of terminal state:

A. Biological death

B. Theological death

C. Clinical death

D. Agonal state

E. Preagonal state

3. Which of the enumerated below factors increase a survivability of cerebral
cortex?

A. Children s age

B. Elderly age

C. Moderate arterial hypotension

D. Moderate arterial hypertension

E. Application of antibiotics

4. Duration of the period of clinical death:

A. 3—4 minutes in hyperthermia

B. 3-4 minutes in normothermia

C. 6-8 minutes in normothermia

D. 8-10 minutes in normothermia

E. 10-12 minutes in normothermia

5. In the 56-year old patient in the time of operation for suturing of
perforating ulcer a ventricular fibrillation was registered on cardiomonitor. A
primary measure must be:

A. Adrenalin administration

B. Lidocaine administration

C. Electrical defibrillation

D. Atropine administration

E. Calcium chloride administration

6. During the operation for strangulation ileus in the patient, aged 61, a
cardiac arrest occurred at the moment of pulling on a mesentery by the surgeon.
Indicate the most probable cause:

A. Nonreplenished blood loss

B. Overdosage of anesthetic

C. Inadequate muscular relaxation

D. Overirritation of vagus nerve

E. Surface anesthesia

7. A girl was transported to the resuscitation department by ambulance team
who was drawn out from the river in 5 minutes after a true drowning. A cardiac
activity was restored in 3 minutes by the rescue team. APV was carried out by
endotracheal method. What will be a characteristic feature of pathologic
changes in the biochemical blood investigations of the victim?

A. Decrease of potassium plasma level

B. Elevation of hematocrit level

C. Elevation of potassium plasma level

D. Elevation of sodium plasma level

E. Metabolic alkalosis

8. In the patient, aged 67, after cholecystectomy (in anamnesis —
disturbances of cardiac rhythm, IHD, hypertension) a small-wave ventricular
fibrillation has occurred according to cardiomonitoring findings. Which of
the given preparations is it necessary to introduce to increase the effectiveness
of electric defibrillation?

A. Corglycon

B. Atropine

C. Calcium chloride

D. Potassium chloride

E. Adrenalin

9. A clinical death was diagnosed in the victim suffered from TA. What
position should be given to the victim before the beginning of cardiopulmonary
resuscitation?

A. Horizontal, dorsal position

B. Dorsal position with a slightly raised head end (Fowler 's position)

C. Dorsal position with a lowered head end (Trendelenburg's position)

D. On the right side

E. On the left side

10. Carrying out a cardiopulmonary resuscitation at the prehospital stage
in case of ineffective pulmonary ventilation one should:

A. To throw one's head back, to bring forward a lower jaw and to continue resuscitation measures

A. To lower the head end

B. To raise slightly the head end

C. To turn the victim on the right side

D. To turn the victim on the left side

11. A man, aged 30, had suffered as a result of traffic accident. His
consciousness is absent. Pulse on the carotid artery is not palpated and no
breathing. There is a broad leather belt at the victim's girdle. What actions
should be undertaken?

A. To start immediately an artificial pulmonary ventilation and
closed-chest cardiac massage not wasting time to remove the belt

B. To carry out artificial pulmonary ventilation and closed-chest
cardiac massage after a preliminary removal of the belt to avoid
a rupture of the liver and spleen.

C. To turn the victim on the right side

D. To turn the victim on the left side

E. Do not touch the victim until the arrival of traffic inspection

12. A 12-year old victim was drawn out from the cold river water in 15
minutes after drowning without signs of life. What measures should be
undertaken:

A. Not to carry out resuscitation measures

B. To transport the victim to the nearest medical institution for
carrying out resuscitation measures

C.Not wasting time for a removal of water from the respiratory tracts to proceed to cardiopulmonary resuscitation

D. To free the respiratory tracts from water, to create drainage position, to proceed to conducting measures aimed at the restoration of respiration and blood circulation

F. To call in an ambulance

13. A man, aged 56, lost suddenly his consciousness in the street. Pulse on
the carotid arteries is absent, no breathing, cutaneous coverings are cyanotic,
pupils are dilated. An emergency team arrived at the place of accident has
successfully carried out resuscitation measures: cardiac activity was restored,
but spontaneous breathing is absent. It is necessary:

A. To continue APV

B. To administer strophantin

C. To administer bemegride

D. To administer cytiton

E. To apply tracheostoma

14. A patient lies without consciousness and pulse, with solitary inspirations,
on a crash cart in the admission department. Cutaneous coverings and lips are
cyanotic, a mouth is open, oral cavity is clear. What is your FIRST action?

A. Intubation of trachea

B. APV with a mask or mouth

C. Intracardiac administration of atropine, adrenalin, calcium
chloride

D. Catheterization of central or peripheral vein

E. To transfer the patient urgently to the resuscitation department

15. A cardiac arrest occurred in the course of operation with the patient
under endotracheal narcosis with catheterized central vein. There is a sinusoid
on a cardioscope display. What is your FIRST action?

A. Sodium bicarbonate intravenously

B. Atropine intravenously

C. Adrenalin intravenously

D. Calcium chloride intravenously

E. Closed-chest cardiac massage

16. After intubation of trachea and the onset of APV the patient's breathing
is auscultated on the right better, than on the left. What is to be done?

A. To reintubate

B. To introduce the tube deeper

C. To pull the tube up

D. To inflate the cuff

E. To carry out pleurocentesis

17. A patient, being in the state of clinical death, is carried on a cardiac
massage and APV. There are irregular (unsystematic) waves on the display of
cardioscope. What is your FIRST action?

A. Adrenalin into the trachea

B. Adrenalin intravenously

C. Adrenalin — intracardiac administration

D. Defibrillation

E. Calcium chloride — intracardiac administration

18. A cardiac arrest has occurred with the intubated patient with
subclavicular catheter on the background of APV. There is an isoline on a
cardioscope. What is your FIRST action?

A. Closed-chest cardiac massage

B. Thoracotomy and open-chest cardiac massage

C. Sodium hydrocarbonate intravenously

D. Adrenalin intravenously

E. Adrenalin — intracardiac administration

19. A cardiac arrest has occurred with the intubated patient with
subclavicular catheter on the background of APV. There is an isoline on a
cardioscope. What is your FIRST action?

A. Adrenalin intravenously

B. Atropine intravenously

C. Sodium hydrocarbonate intravenously

D. Calcium chloride intravenously

E. Open-chest cardiac massage

20. A cardiac arrest has occurred with the intubated patient with
subclavicular catheter on the background of APV. There is an isoline on a
cardioscope. What is your FIRST action?

A. Adrenalin intravenously

B. Adrenalin — intracardiac administration

C. Adrenalin — intratracheal administration

D. Open-chest cardiac massage

E. Sodium hydrocarbonate intravenously

21. There is a crash cart at the sanitary check-point with the unconscious
patient without pulse, with solitary inspirations. His lips are blue, the mouth
is open and oral cavity is clear. What is your FIRST action?

A. Intubation of trachea

B. APV with a mask or mouth

C. Atropine, adrenalin, calcium chloride — as intracardiac
administration

D. Puncture (catheterization) of central or peripheral vein

E. Run to the resuscitation room (it is nearby)

22. In an hour after the operation and extubation the patient became sharply
cyanotic. There are no breathing and pulse, his mouth is open and oral cavity
is clear. What is your FIRST action?

A. Intubation of trachea

B. APV with a mask or mouth

C. Closed-chest cardiac massage

D. Manual respiration according to Silvester

F. Puncture (catheterization) of central or peripheral vein

23. You have started resuscitation (cardiac massage and APV) in the patient

with tracheal intubation, without venipuncture. There is an isoline on the display of cardioscope. What is your FIRST action?

A. Defibrillation

B. Adrenalin intratracheally

C. Sodium bicarbonate intratracheally

D. Adrenalin — intracardiac administration

E. Calcium chloride intratracheally

24. A cardiac arrest occurred in the intubated patient with subclavicular
catheter during APV. There are irregular waves on the cardioscope. What is
your FIRST action?

A. Sodium bicarbonate intravenously

B. Closed-chest cardiac massage

C. Atropine intravenously

D. Adrenalin intravenously

E. Calcium chloride intravenously

25. A cardiac arrest occurred in the intubated patient with subclavicular
catheter during APV. There is an isoline on the cardioscope. What is your
FIRST action?

A. Electrical defibrillation

B. Closed-chest cardiac massage

C. Thoracotomy and open-chest cardiac massage

D. Adrenalin intravenously

E. Sodium bicarbonate intravenously

26. Medical personnel run into the admission department with a crash cart.
There is a patient lying on it without pulse, with solitary inspirations. His lips
are cyanotic, mouth is open, oral cavity is clear. What is your FIRST action?

A. Intubation of trachea

B. APV with a mask or mouth

C. Puncture (catheterization) of central or peripheral vein

D. Closed-chest cardiac massage

E. Connection of cardioscope

27. A newborn does not breathe, it is relaxed and gives no response to the
suction from the nose. His skin is pale, HR — 72. What is to be done?

A. To introduce bemegride

B. To introduce aethimizolum

C. To start APV

D. To administer cocarboxylase

E. To administer calcium chloride

28. A newborn does not breathe, it is relaxed and gives no response to the
suction from the nose. His skin is cyanotic, HR — 144. What is to be done?

A. To slap on his buttocks

B. To slap on his heels

C. To compress (massage) his chest

D. To administer glucose with cocarboxylase

E. To carry out APV

29. A two-year old child, diagnosis is "ARVI" (acute respiratory virus
infection). His consciousness is confused, lips are cyanotic, the breast bone
and intercostal spaces are retracted on inhalation, RR — 66. What is to be
done at once?

A. To administer diazepam (seduxen, relanium, sibazonum)

B. To administer aethimizolum

C. Cytiton or lobeline

D. To intubate the trachea

E. To administer sodium oxybutyrate

30. After the tracheal intubation and beginning of APV, the patient's breathing
is auscultated better on the right than on the left. What is to be done?

A. To reintubate

B. To introduce the tube deeper

C. To pull up the tube

D. To inflate the cuff

E. To carry out a pleuracentesis

31. After the tracheal intubation and beginning of APV, the patient's
breathing is auscultated better on the right than on the left. The most probable
cause is:

A. Acute dilatation of the stomach as a result of esophageal intubation

B. Aspiration of gastric contents before intubation

C. Intubation of the left bronchus

D. Intubation of the right bronchus

E. Acute left ventricular failure

32. A bottle with blood was finished. After its replacement the patient began
to gasp for breath and to turn blue, the pulse disappeared, over the heart — a
"mill wheel murmur". What has happened?

A. Thromboembolism in the basin of pulmonary artery

B. Air embolism in the basin of pulmonary artery

C. Anaphylactic shock

D. Anaphylactoid reaction

E. All is wrong

33. A bottle with blood was finished. After its replacement the patient began
to gasp for breath and to turn blue, the pulse disappeared, over the heart — a
"mill wheel murmur". What is to be done?

A. To raise the left side and the lower half of the body

B. The same + inhalation or APV with pure oxygen

C. Euphilline and papaverine i/v

D. Polyglucin — stream administration, and adrenalin i/v

E. To raise the head end and to start APV and cardiac massage

34. A bottle with blood was finished. After its replacement the patient began
to gasp for breath and to turn blue, the pulse disappeared, over the heart — a
"mill wheel murmur". What is the error?

A. Calcium chloride or gluconate was not introduced

B. Sodium bicarbonate was not introduced

C. A level of liquid in the dropper was not lifted

D. One had not to infuse glucose just after a blood transfusion

E. Prevention of hypercoagulability was not being sufficiently
carried out

35. After uterus extirpation, with blood loss and hemotransfusion, the urine
became of blood colour. A blood was drawn and centrifuged, its serum is yellow.
Most probably it is —

A. Hemolysis

B. "Shock kidney" syndrome

C. Syndrome of disseminated intravascular coagulation (DIC) in the
phase of coagulopathy of consumption

D. Syndrome of disseminated intravascular coagulation (DIC) in the
phase of fibrinolysis.

E. Injury of the ureter

36. What is to be done with a burned surface in the first minutes of thermal
trauma?

A. To pour a cold water over

B. To cover with a dry aseptic dressing

C. To cover with a dressing moistened with furacilin solution

D. To apply Vishnevsky's ointment

E. To oil with badger s lard

37. Asystolia — it is the same as

A. Absence of systolic arterial pressure

B. Cardiac arrest

C. Collapse

D. Cerebral hemorrhage

E. Disturbance of conductivity (complete A-V block)

38. A closed-chest cardiac massage should be carried out:

A. Only in asystolia

B. Only in the small-wave fibrillation

C. Only in the macro-wave fibrillation

D. In all cases indicated above

E. All is wrong

39. Electric defibrillation in the time of cardiopulmonary resuscitation is
indicated in the presence (on the display of cardioscope) of:

A. Isoline

B. Irregular (unsystematic) waves

C. Sinus bradycardia

D. Nodal rhythm

E. All the above indicated

40. In the period of cardiopulmonary resuscitation without a venous
approach one may introduce into the trachea:

A. Adrenalin

B. Norepinephrine

C. Calcium chloride

D. Calcium gluconate

E. Sodium hydrocarbonate

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