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CONTROL QUESTIONS AND TASKS. 1. The patient, aged 17, developed tachycardia, dyspnea up to 40 per minute on the 5-th day after a grave CC1

1. The patient, aged 17, developed tachycardia, dyspnea up to 40 per minute
on the 5-th day after a grave CC1. Cutaneous coverings are pale, acrocyanosis.
Body temperature — 39°C. On auscultation there are moist rales of different
calibers on the background of diminished respiration, loss of dullness. On
X-ray there is a shadowing in the lower sections of the right lung. By laboratory
findings — stab neutrophils — 20%. Indicate a proper diagnosis:

A. Pulmonary emphysema

B. TEPA

C. Acute pneumonia

D. Pneumothorax

E. Pulmonary edema

2. A patient, aged 40, suffered from a traffic accident, was admitted with a
fracture of ribs, tachypnea, pressing pain in the chest upon inspiration. There
is an absence of respiration over the right half of the chest upon auscultation,
a bandbox sound — upon percussion. Indicate a proper diagnosis:

A. Obturation of the right primary bronchus

B. TEPA

C. Massive pneumonia

D. Pneumothorax

E. Hemothorax

3. After catheterization of subclavian vein according to Seldinger — a
pressing pain has developed in the chest on the right, and dyspnea. There is a
visual poor expansion of the right half of the chest in the act of breathing. On
auscultation a diminished respiration is noted on the right. What are the doctor's
tactics?

A. Tracheal intubation and APV

B. Oxygen inhalation

C. Administration of analgetics

D. Puncture of pleural cavity on the right

E. Administration of broncholytics

4. A female patient, aged 20, was operated for ovarian apoplexy under
endotracheal narcosis NLA + oxygen + nitrous oxide. Upon termination of the
operation when the supply of nitrous oxide had stopped anesthesiologist carried
on oxygen inhalation for 5 minutes more. A need in oxygen inhalation after
cessation of nitrous oxide supply was caused by the danger of development of:

A. Hypercapnea

B. Diffusion hypoxia

C. Arterial hypotension

D. Bradycardia

E. Tachycardia

5. A female patient, aged 43, was admitted to the resuscitation department
in the asthmatic state. What is the most reliable criterion of respiration
efficiency?

A. Respiration rate

B. Respiratory volume

C. Minute respiratory volume

D. Dead space determination

E. Pa C0₂ and Pa 0₂

6. A female patient, with bronchial asthma, was admitted to the department
in the asthmatic state, she was excited and experienced a feeling of fear. Which
of the following prescriptions is the most rational?

A. Seduxen — 0.1 mg/kg

B. Morphine — 1 ml 1% solution subcutaneously

C. Promedol — 1 ml 2% solution subcutaneously

D. Lasix — 40 mg

E. Cordiamine — 2 ml subcutaneously

7. In a female patient admitted to the department in the asthmatic state a
bronchospasm was arrested. The most objective indicator of bronchospasm
arresting is:

A. Absence of tracheobronchial secretion

B. Disappearance of swelling of cervical veins

C. CVP — 20 cm water column

D. Pa C0₂ — 40 mm Hg

E. Decrease of heart dimensions

8. A patient being in the asthmatic state was administered helium-oxygen
mixture. What effect does this mixture possess?

A. Elimination of bronchospasm

B. Rarefaction of bronchial secretion

C. Decreases respiration resistance

D. Possesses sedative properties

E. Stimulates respiratory center

9. A female patient admitted to the resuscitation department was delivered
by the ambulance in connection with uncontrollable attack of asphyxia
accompanied by a cough, sputum expectorated with difficulty, pronounced
dyspnea with difficult expiration at rest. Establish a provisional diagnosis:

A. Status asthmaticus

B. Acute bronchitis

C. Foreign body in the bronchus

D. Spontaneous pneumothorax

E. Hypertensive crisis

10. A patient, aged 40, was admitted to the intensive care department with
uncontrollable attack of asphyxia after administration of high doses of
glucocorticoids. What are your measures at the stage of "silent lung"?

A. Lavage of tracheobronchial tree

B. To increase the dose of glucocorticoids 2 times

C. Intravenous administration of adrenalin

D. Drop-by-drop administration of euphilline

E. Intravenous narcosis with ketamine

11. An operation of cholecystectomy is planned for a woman, aged 32,
suffering from bronchial asthma of allergic genesis. Which of the following
preparations should be included in premedication with preventive purpose?

A. Seduxen

B. Pipolphen

C. Aminazine

D. Promedol

E. Droperidol

12. A female patient, aged 42, was delivered to the department with
expiratory asphyxia. In the anamnesis: she suffers from bronchial asthma for
about 15 years, this attack has developed as a result of salbutamol overdosage.
Objectively: inhibited, cutaneous coverings are cyanotic, covered with clammy
sweat, tachycardia, tachypnea, AP — 90/60 mm Hg, expiratory dyspnea. There
are bandbox sounds over the lungs, over some areas respiratory murmurs are
not auscultated. With what is it necessary to start to control status asthmaticus?

A. Significant doses of prednisolone i/v drop-by-drop + euphilline i/v
drop-by-drop.

B. 5% glucose solution + rheopoliglucin

C. Berotec + intal

D. Berotec + dimedrol

E. Penicillin 3 000 000 U/day

13. A female patient, aged 30, was delivered by an ambulance with complaints
of the attack of expiratory asphyxia that had begun to develop yet in the yesterday's morning. The patient is cyanotic, sits having fixed the upper shoulder girdle. Tachycardia and dullness of cardiac sounds are noted. There are bandbox sounds over the lungs, diminished vesicular respiration, though the patient's heavy breathig is heard at a distance. Sputum does not come off. She notes that repeated berotec inhalations do not remove the attack, but only aggravate her condition. What condition development is being observed in the patient?

A. Status asthmaticus, a stage of relative compensation

B. Status asthmaticus, a stage of "silent lung "

C. Protracted attack of bronchial asthma

D. Attack of cardiac asthma

E. Exacerbation of chronic bronchitis

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