Topic: MITRAL DISEASES: BASIC SYMPTOMS AND SYNDROMES ON THE BASIS OF CLINICAL AND INSTRUMENTAL METHODS OF EXAMINATION

1. What hemodynamic changes cause complaints of patients with mitral stenosis for cough, shortness of breath, hemoptysis? A. reduction of systemic ; B. increased pressure in the small circulatory system; C. stagnation of blood in the liver; D. enlargement of the left atrium and contraction of the mediastinum; E. Reduction of blood flow from the left ventricle.

2. What complaints are caused by a decrease in minute volume of blood in patients with mitral stenosis? A) cough, shortness of breath, hemoptysis; C) fever, joint pain, general weakness; C) heartache, , palpitations; D) lower extremity swelling, heaviness in the right hypochondrium; E) headache, dizziness, general weakness, fatigue.

3. Data of the heart area with mitral stenosis: A) no change is observed; B) displaced to the left, resistant; C) apex beat weakened or undetectable; D) there is an increased pulsation in the second intercostal space to the left; E) there is a systolic "cat murmur" in the second intercostal space to the right.

4. What forced position can occupy a patient with mitral stenosis? A) knee-; B) a Bedouin who prays; C) orthopnoe; D) opistotonus; E) outside the pointing dog

5. What does the face of a patient with mitral stenosis look like? A) swollen, cyanotic; B) swollen, pale, enophthalmos observed; C) the face of a "wax doll"; D) swollen, pale, with swelling under and above the eyes; E) pale, with cyanotic blush, of the tip of the nose, ear lobes, chin.

6. What are the findings of cardiac area examination in a patient with mitral stenosis? A) high ascending, domed apex beat; B) high apex beat, shifted to the left and down; C) visible abdominal pulsation, exacerbated by inhalation; D) pulsation in the second intercostal space to the left near the edge of the sternum; E) no changes.

7. Data palpation of the cardiac region in mitral stenosis: A) no changes; B) apex beat displaced to the left, resistant; C) there is an increased pulsation in the second intercostal space to the left near the edge of the sternum; D) there is an increased abdominal pulsation, the amplitude of which increases on the breath; E) there is a systolic cat murmur in the second intercostal space to the right near the edge of the sternum.

8. Data of palpation of the cardiac region in mitral stenosis: A) no changes; B) apex beat displaced to the left, resistant; C) increased pulsation in the second intercostal space to the left; D) there is diastolic cat’s purr at the top of the heart or at the Botkin point; E) is determined systolic feline murmur in the second intercostal space to the right near the edge of the sternum.

9. Causes of diastolic cat’s purr in mitral stenosis: A) increased contraction of the left atrium; B) increase of pressure in a small circulation; C) the occurrence of a mitral valve opening click; D) low-frequency oscillations of the blood and the mitral valve as blood passes through the narrowed mitral opening; E) hypertrophy of the muscles of the right ventricle and dilatation of its cavity.

10. What changes occur in cardiac in a patient with mitral stenosis? A) displacement of the left border of the heart to the left; B) displacement of the right border of the heart to the right; C) expansion of the vascular bundle due to the aorta; D) displacement of the left and right boundaries of relative stupidity; E) there is no displacement of the upper border of the heart upwards.

11. Protodiastolic attenuation murmur in mitral stenosis is associated with: A) active left atrial systole; B) deposition of blood clots in the left atrium; C) regurgitation of blood from the left ventricle to the left atrium; D) a significant pressure gradient between the left atrium and left ventricle; E) development of relative insufficiency of pulmonary artery valves.

12. Cardiac examination data for mitral valve insufficiency: A) apex beat is undetectable; B) apex beat enhanced, spilled, displaced to the left, sometimes down; C) apex beat is high, rising, domed, displaced to the left and down; D) there is a pulsation in the second intercostal space to the right; E) there is a pulsation in the second intercostal space to the left.

13. Data of with insufficiency of the mitral valve: A) enhanced, clapping first tone; B) weakened, muted first tone; C) click on the opening of the mitral valve; D) protodiastolic ; E) presystolic rhythm of gallop.

14. Data of auscultation of heart at insufficiency of a mitral valve: A) enhanced, clapping first tone on apex; B) second tone emphasis on the pulmonary artery; C) a second tone accent on the aorta; D) quail rhythm; E) increasing presystolic murmur.

15. What are the results of auscultation in patients with mitral stenosis? A. a loud, clapping I tone at the apex of the heart; B. opening tone of the mitral valve; C. weakened I tone at the apex of the heart; D. accent II tone over the aorta; E. accent II tone over the pulmonary artery; F. systolic murmur at the apex of the heart; G. diastolic murmur at the apex of the heart.

16. What are the results of the cardiovascular system in patients with mitral valve insufficiency? A. spilled apex beat, shifted to the left; B. increased apex beat; C. resistant apex beat; D. apex beat of normal localization, area, height and strength; E. displacement of the upper border of relative cardiac dullness upwards; F. displacement of the upper border of relative cardiac dullness downwards; G. displacement of the left border of relative cardiac dullness to the left; H. Aortic configuration with pronounced cardiac waist.

17. What are the results of X-ray examination of patients with mitral stenosis? A. disappearance of the heart waist; B. rounding of the heart apex; C. enlargement of the left auricle; D. enlargement of the right ventricle; E. stressed waist of the heart; F. protrusion of the pulmonary trunk; G.deviation of the esophagus along the arc of small radius in the second oblique projection (use a suspension of barium sulfate).