Exam

Question 1

What is the angina pectoris?

Answer 1

is a form of coronary artery disease, characterized by paroxysmal pain in the heart area caused by myocardial ischemia (without the development of necrosis).

Question 2

Risk factors for angina pectoris?

Answer 2

• increase in blood pressure;
• violations of cholesterol metabolism;
• diabetes mellitus, poor control of blood glucose levels;
• smoking;
• male gender;
• sedentary lifestyle;
• the presence of IHD among blood relatives;
• the regular use of certain drugs (nicotine, caffeine, as well as cocaine, amphetamine,
  inhaled beta-stimulants, or agonists, methylxanthines (theophylline)), emotional and physical stress.

Question 3

atherosclerotic

Answer 3

تصلب الشرايين

Question 4

Pathogenesis of the angina pectoris?

Answer 4

1.atherosclerotic (تصلب الشرايين ) coronary artery disease (stable angina)
2.transient vascular thrombus (جلطه ) formation (unstable angina)
3. decrease in coronary blood flow due to spasm or increased tone of the coronary artery
(dynamic obstruction).

Question 5

The clinical picture of the angina pectoris?

Answer 5

*Angina pectoris of exertion and rest.
Pain in angina pectoris is provoked تستفز by physical exertion, most often localized behind the
sternum, sometimes slightly to the left, it has a pressing or compressive character of varying intensity
* most often the pains begin gradually, then intensify.
* At the time of an attack,
1) patients try to maintain a stationary position(في وضع ثابت )
2) they are afraid to take a deep breath
3) pallor of the skin due to vasospasm,
4) increased sweating
5) Sometimes there are burning pains, they resemble heartburn
6) symptoms of tightness in the chest
7) feeling of suffocation
8) Typical is the irradiation of pain to the hands, more often to the left along its inner surface to the little finger.
9) Often the pain radiates to the left shoulder blade, neck, and lower jaw.
10) Some patients have the urge to urinate and defecate. Sometimes nausea, vomiting, dizziness, trembling all over the body begin

Question 6

What provokes the angina pectoris?

Answer 6

Pain in angina pectoris is provoked by physical exertion

Question 7

What is the location of angina pectoris pain ?

Answer 7

most often localized behind the
sternum, sometimes slightly to the left

Question 8

What is happening during the angina attack

Answer 8

During an attack, the pulse slows down or speeds up, and blood pressure rises. heart sounds are often muffled مكتوم .

Question 9

concomitant diseases

Answer 9

الامراض المصاحبه لمرض ما

Question 10

What is the Laboratory tests of angina pectoris ?

Answer 10

1) Clinical blood test: Changes in the results of a clinical blood test make it possible to identify concomitant diseases (anemia, erythremia, leukemia, etc.) that provoke myocardial ischemia.

2) Determination of biochemical markers of myocardial damage

Question 11

What is the Instrumental methods angina pectoris ?

Answer 11

1) ECG at rest
2) Exercise ECG
3)Echocardiography at rest allows you to detect or exclude other disorders (for example, valvular heart disease or hypertrophic cardiomyopathy) as the cause of symptoms, as well as assess the function of the ventricles, the size of the heart cavities, etc
4) Stress echocardiography.
5) Coronary angiography in patients with cardiac arrest

Question 12

For relief of an attack of the angina pectoris we need ?

Answer 12

Nitroglycerin

Nitroglycerin is a vasodilatory drug used primarily to provide relief from anginal chest pain.

Question 13

Treatment of the angina pectoris ?

Answer 13

For relief of an attack, nitroglycerin (interval 5 min)
Basic therapy:
1) antiplatelet agents (aspirin)
2) statins (atorvostatin)
3) drugs to reduce myocardial oxygen demand (B-blockers or calcium channel blockers)
4) ACE inhibitors
Angiotensin-converting enzyme (ACE) inhibitors are medicines that help relax the veins and arteries to lower blood pressure. ACE inhibitors prevent an enzyme in the body from making angiotensin 2, a substance that narrows blood vessels.

5) metabolic therapy

Question 14

hyperhidrosis

Answer 14

فرط التعرق

Question 15

hiccups

Answer 15

زغطه

Question 16

belching

Answer 16

تقريعه (تحدث بعد الاكل )

Question 17

aneurysm

Answer 17

تمدد الاوعيه الدمويه

Question 18

pericarditis

Answer 18

التهاب التامر المحاور للقلب

Question 19

syncope

Answer 19

الاغماء

Question 20

First medical aid.

Answer 20

الاسعافات الاوليه

Question 21

hypovolemia

Answer 21

نقص حجم الدم

Question 22

Arrhythmogenic

Answer 22

عدم انتظام ضربات القلب

Question 23

hypotension

Answer 23

انخفاض ضغط الدم

Question 24

hypoperfusion

Answer 24

نقص الامداد الدموي

Question 25

Anaphylactic reactions

Answer 25

رد الفعل التحسسي

Question 26

Dehydration

Answer 26

خفاف

Question 27

Hypothermia

Answer 27

انخفاض في درجات الحراره

Question 28

suffocation

Answer 28

اختناق

Question 29

cyanosis

Answer 29

زرقه الاطراف

Question 30

Oliguria

Answer 30

قلة البول هي انخفاض إنتاج البول. وتتراوح كمية البول المُنتجة خلال اليوم ما بين 100-400 مل.

Question 31

anuria

Answer 31

توقف انتاج البول

Question 32

CHF

Answer 32

Chronic heart failure

Question 33

What is the IHD?

Answer 33

ISchemic heart disease

Question 34

What is the definition of ISchemic heart disease?

Answer 34

IHD is an acute or chronic heart disease, caused by a decrease of blood supply to the myocardium (عضله القلب ) due to atherosclerotic (تصلب الشراين ) lesions of the coronary arteries, and disrupts the balance between coronary blood flow and myocardial oxygen demand.

Question 35

What is the Acute myocardial infarction (AMI)?

Answer 35

is a clinical syndrome that occurs as a result of damage to the heart muscle when there is a unbalance between myocardial oxygen demand and the possibility of its delivery

Question 36

Pathogenesis of myocardial infarction ?

Answer 36

rupture of atherosclerotic plaques;هو الدهون والكولسترول المسبب لتكوين عائق
- coronary artery thrombosis;
- coronary spasm.

Question 37

Clinic feature of ISchemic heart disease?

Answer 37

1) Painful variant : pain, independent of position of the body The pain is pressing, choking, burning, tearing, localization behind the sternum, in the entire anterior chest wall with possible irradiation to the shoulders, neck, arms, back, epigastric region, combination with hyperhidrosis (فرط التعرق ) severe general weakness, pallor of the skin

2)Abdominal option - a combination of epigastric pain (الم المعده )with dyspeptic symptoms عسر الهضم
- nausea(غثيان ), which does not bring relief from vomiting, hiccups, (زغطه), abdominal distension, (انتفاخ البطن )constipation,( امساك)irradiation of back pain, tension of the abdominal wall and pain on palpation in the epigastrium
3) Asthmatic ازمه ربو- an attack of shortness of breath due to acute congestive heart failure (pulmonary edema)
4) Arrhythmic عدم انتظام ضربات القلب

Question 38

Diagnostics ISchemic heart disease?

Answer 38

1) Clinic
2) ECG changes

Question 39

When Early complications in acute myocardial infarction ?

Answer 39

Early complications - occur in the first hours or in the most acute period (3-4 days)

1)rhythm and conduction disturbances, cardiogenic shock, pulmonary edema, cardiac asthma, acute mitral regurgitation, acute rupture of the IVS and LV outer wall, LV aneurysm, early pericarditis (episthenocarditis), parietal LV thrombosis
2) from other organs and systems: gastrointestinal tract paresis, bleeding,central nervous system, mental disorders

Question 40

Prehospital treatment of myocardial infarction?

Answer 40

-Nitroglycerin 0.4 mg under the tongue

-Acetylsalicylic acid 250mg + clopidogrel 300 mg

Question 41

What is the Nitroglycerin?

Answer 41

Nitroglycerin is a vasodilation

Question 42

What is the Acute vascular insufficiency ?

Answer 42

Acute vascular insufficiency is a pathophysiological condition characterized by a drop in vascular tone or a violation of the adequate ratio between the capacity of the vascular system and the volume of circulating blood (hypovolemia), leading to impaired blood supply to organs and tissues

Question 43

syncope

Answer 43

الاغماء

Question 44

What is the syncope or fainting ?

Answer 44

Fainting is a sudden short-term loss of consciousness resulting from acute brain hypoxia;

Question 45

Classification of Fainting /syncope?

Answer 45

I. Fainting in organic heart disease:

II.Vascular syncope

III.Fainting with obstruction of cerebral arteries

Question 46

Fainting in organic heart disease

Answer 46

1) Arrhythmogenic:
A) Ectopic tachycardia
B) AV blockade 2-3 degrees
C) Sick sinus syndrome
D) Frequent blocked extrasystoles
2) With mechanical blockade of cardiac output:
A) Aortic stenosis
B) Stenosis of the pulmonary artery
C) TELA
D) Myxoma or thrombus in the atrial cavity

Question 47

II.Vascular syncope:

Answer 47

1) Associated with a drop in arterial tone:
A) Vasopressor (vasovagal)
B) Increasing the sensitivity of the carotid tone
C) Reflex (diseases of the pharynx, larynx, esophagus, irritation of the pleura, peritoneum,
pericardium)
2) Associated with a drop in venous tone:
A) Orthostatic (constitutional, decreased blood volume, taking or overdose of drugs:
nitroglycerin, ganglion locators) B) VNS diseases

Question 48

III.Fainting with obstruction of cerebral arteries

Answer 48

1) Spasm or transient thrombosis
2) Compression of the vertebral arteries (spondylosis)
3) Hyperventilation syndrome

Question 49

Pathogenesis of Acute vascular insufficiency ?

Answer 49

-Acute decrease in cerebral circulation (narrowing of cerebral vessels) and / or systemic blood flow (hypotension) leads to a narrowing with disorders of cardiovascular and respiratory activity
-Loss of consciousness, developing for 5-10 s, with hypoperfusion of the brain, is accompanied by the activation of autonomous centers that regulate blood circulation and the restoration of adequate cerebral circulation and consciousness

Question 50

Clinic (diagnostic algorithm) of Acute vascular insufficiency or syncope

Answer 50

1) Sudden loss of consciousness

2) The patient is pale, Coldness of the limbs, Skeletal muscles are relaxed, There may be
clonic twitching (رعشه )of the face and trunk

3) Pulse is weak, difficult to palpate (may be arrhythmicعدم انتظام في ضربات القلب ), decreased blood pressure, shallow breathing, may be cold sweat
4) Consciousness is restored quickly and completely after 10-30 seconds remember what preceded the fainting;

Question 51

First aid Acute vascular insufficiency or syncope?

Answer 51

1) Lay the patient down with his head lowered, legs raised (60-70 degrees) or, if conditions do not allow, sit down and lower his head below the knees
2) Unbutton the collar or relax tight clothing
3) If the patient is in a horizontal position, turn his head to one side so that the tongue does not burn
4) Sprinkle cold water on face and neck
5) Give an inhalation of ammonia vapors (from a moistened cotton wool or bandage) 6) Warm the patient
7) Reflex effects: massage of the fingers of the hands, pressure at the base of the nail,
squeezing the earlobes several times

Question 52

Medication therapy of Acute vascular insufficiency - syncope?

Answer 52

1) Cordiamine - subcutaneously 1-2 ml

2) Caffeine Na benzoate - 10% solution 1-2 ml subcutaneously

3)Mezaton - 1% solution 1 ml subcutaneously
4) With bradyarrhythmia - ephedrine hydrochloride - 5% solution - 1 ml subcutaneously
5) Atropine sulfate - 0.1% solution - 1 ml subcutaneously

Question 53

What is the bradyarrhythmia

Answer 53

Bradyarrhythmia is an abnormally slow resting heart rate, typically below 60 beats per minute.

Question 54

What is the Acute vascular insufficiency ?

Answer 54

Acute vascular insufficiency is a pathophysiological condition characterized by a drop in vascular tone or a violation of the adequate ratio between the capacity of the vascular system and the volume of circulating blood (hypovolemia), leading to impaired blood supply to organs and tissues

Question 55

What is Collapse ?

Answer 55

Collapse is an acutely developing vascular insufficiency, characterized by a drop in vascular tone or a rapid decrease in circulating blood volume (BCC), characterized by a sharp but reversible drop in blood pressure. Unlike fainting, loss of consciousness is optional;

Question 56

Pathogenesis Acute vascular insufficiency - collapse.

Answer 56

an acute drop in vascular tone and (or) a rapid decrease in the mass of circulating blood, leading to a decrease in venous flow to the heart, a drop in arterial and venous pressure, brain hypoxia and suppression of vital body functions.

Question 57

Etiology of Acute vascular insufficiency - collapse ?

Answer 57

Infection
- Intoxication
-Anaphylactic reactions
-Blood redistribution (orthostasis, acute diseases of the abdominal cavity) -Dehydration (diarrhea, vomiting)
- Hypothermia, overheating
-Oppression of the vasomotor center (sharp pain syndrome, etc.)

Question 58

Collapse diagnostic algorithm of the Acute vascular insufficiency - collapse.?

Answer 58

1) Sudden onset of severe weakness
2) Dizziness
3) The patient is conscious
4) Sluggish
5) indifferent
6) Has difficulty answering questions
7) The facial features are pointed
8) The skin and mucous membranes are pale
9) Cold clammy sweat
10) The limbs are cold
11) Breathing is shallow, the patient has no feeling of suffocation
12) The pulse is slightly palpable
13) Veins are collapsed, empty, the boundaries of the heart are not changed 14) Acute drop in blood pressure below 80 mm Hg

Question 59

First aid of Acute vascular insufficiency?

Answer 59

1) Horizontal position with raised legs
2) Warm the patient (hot strong tea)
3) oxygen therapy

Question 60

drug therapy of Acute vascular insufficiency?

Answer 60

-Noradrenaline 0.2% -1ml
-Prednisolone-60mg (2ml) intravenous stream

Question 61

abdominal distension

Answer 61

انتفاخ البطن

Question 62

constipation

Answer 62

امساك