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Emergency care
  • Адель Тлеужанова

  • 問題数 45 • 5/10/2024

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    問題一覧

  • 1

    Emergency care for uncomplicated hypertensive crisis

    Nifedipine

  • 2

    Emergency drug for an attack of mild bronchial asthma

    Salbutamol

  • 3

    It is used to relieve convulsive syndrome in children with RVI

    Diazepam

  • 4

    #12 *!Emergency care for hypoglycemic coma includes intravenous administration of:

    40% glucose sol

  • 5

    The symptom complex that most allows establishing the diagnosis of brain confusion

    Focal

  • 6

    Antidote for narcotic analgesics

    Naloxone

  • 7

    26 *!Girl 19 years old. While on public transport, I suddenly felt weak, dizzy, and lost consciousness for 2-3 minutes. Objectively: the condition is of moderate severity. Consciousness is clear. The skin is cold and pale. In the lungs there is vesicular breathing, no wheezing. NPV 18 per minute. Heart sounds are clear, rhythmic, heart rate 100 per minute. Blood pressure 90/50 mmHg . (slave 100\60 mm Hg st ) MOST likely provisional diagnosis:

    Fainting

  • 8

    #27 *!The patient abruptly got out of bed in the morning. I felt severe weakness, dizziness, and lost consciousness. History: I was often bothered by heartburn, pain in the epigastric region after eating, and nausea. Consciousness is stunned. The skin is pale and dry. Blood pressure 100/60 mmHg. Heart sounds are muffled and rhythmic. There are no wheezes in the lungs. The abdomen is soft and painful in the epigastrium. The liver is not enlarged, painless. Which of the following is the MOST likely cause of loss of consciousness?

    Orthostatic collapse

  • 9

    #3 3 *!Patient, 72 years old. Complaints of a feeling of lack of air, shortness of breath, weakness, dizziness, nausea. History: Arterial hypertension for more than 20 years. Working blood pressure 160/100 mmHg . Takes capozide , diroton . The condition worsened an hour ago. Objectively: The position is forced – orthoptic . Pale pink foam is released from the nose and mouth. The breathing in the lungs is harsh, there is a mass of moist medium- and large-caliber wheezing throughout all fields. NPV 28 per minute. Heart sounds are muffled and rhythmic. Heart rate 108/min. Blood pressure 190/110 mmHg . ECG: There are no negative dynamics in comparison with previous ECGs. The MOST likely complication that developed in the patient:

    Pulmonary edema

  • 10

    #38 *!A 57-year-old patient suddenly lost consciousness during examination; short-term tonic-clonic convulsions and cyanosis of the skin appeared. ECG: chaotic irregular rhythm, QRS complexes and T waves are absent. MOST likely rhythm disturbance:

    Ventricular fibrillation

  • 11

    #40 *! A 73-year-old man complains of pain in the chest, lasting more than 1 hour, and shortness of breath. During examination, the skin is pale and moist. Heart sounds are muffled. BP105/80 mm Hg Art . On the ECG - heart rate 108 per minute, rise of the ST interval in leads I, II, avL , V1-V4 by 5 mm, pathological Q wave in leads I, II, avL , QRS complex 0.09 sec. MOST likely provisional diagnosis:

    Acute myocardial infarction of the anterior wall

  • 12

    #41 *! The patient is 59 years old. Complaints of squeezing pain in the heart area, lasting more than 40 minutes, mixed shortness of breath, fear of death, severe weakness. The condition is extremely serious. Forced position with the head end raised. The skin is pale and moist. Heart rate 120/min, blood pressure 90/70 mm Hg . The ECG shows ST segment elevation in leads III, avF , deep, wide Q wave in leads III, avF . Which of the following diagnoses is MOST correct?

    Ami of the posterior wall of the left ventricle

  • 13

    #44 *! The patient’s ECG does not have P waves, instead f waves of different amplitudes and durations are better visible in leads II , III , avF , V 1- V 2. Which rhythm disorder is MOST likely?

    Atrial fibrillation

  • 14

    #45 *!A 32-year-old patient’s condition worsened due to pneumonia, shortness of breath, stupor, profuse sweat, cyanosis of the skin, increased, respiratory rate 40 per minute. with the participation of auxiliary muscles, heart rate 140 per minute.​ Which of the following complications is MOST correct?

    Acute Respiratory failure stage II

  • 15

    # 63 *! Child, 11 months old, sick for the first day: runny nose, increased body temperature to 39.9C, suddenly lost consciousness, turned blue, convulsive twitching throughout the body. Objectively: inhibited, reacts passively to examination. The pharynx is hyperemic, there is no plaque. Rhinorrhea. Which of the following diagnoses is MOST likely?

    Аcute respiratory viral infection, febrile convulsions

  • 16

    #65 *!The man sought emergency medical care on the 1st day of illness. He became acutely ill, 6 hours after being a guest: epigastric pain, nausea, repeated vomiting, frequent loose stools. Temperature 3 8 0 S, pale, sunken eyes. Pain in the epigastrium. The stool is copious, watery, and green in color . MOST likely provisional diagnosis:

    Acute gastroenteritis

  • 17

    #70 *!A 38-year-old woman complains of speech impairment, weakness in the right limbs, headache, nausea, vomiting, increased blood pressure for 2 hours. She had a history of using hormonal contraceptives for a long time. Objectively: consciousness is slightly stunned, passive position. Strength and muscle tone in the right extremities are moderately reduced. NPV - 17 per minute. Heart sounds are clear, rhythm is correct, tachycardia. Blood pressure - 140/70 mm. Hg art., heart rate - 94 per minute. MOST likely diagnosis:

    Acute cerebrovascular accident

  • 18

    #72 *! A man with a traumatic brain injury: his eyes do not open, his speech is inarticulate sounds, he flexes his limbs in response to painful stimuli. What level of consciousness is MOST likely in the patient?

    Coma

  • 19

    #73 *!In a car accident, a man standing on a bus falls, the muscles of his face, neck, and limbs contract randomly, and foamy liquid comes out of his mouth. After 3-4 minutes the convulsions stopped, my breathing became even, and I fell asleep. MOST likely provisional diagnosis:

    Epilepsy attack

  • 20

    # 74 *!Male 50 years old, after a car accident. Complaints of headache, dizziness, single vomiting. Neurological status: retrograde amnesia, anisocoria, nystagmus, stiff neck on 2 fingers. MOST likely provisional diagnosis?

    Brain contusion

  • 21

    # 75 *!During a football match, an athlete was kicked in the stomach. Complaints of severe abdominal pain. Upon examination, sharp pain is detected in the left hypochondrium, the Shchetkin-Blumberg symptom is positive. MOST likely provisional diagnosis?

    Blunt isolated abdominal injury

  • 22

    #81 *!A man was found unconscious on the beach. On examination, the skin is hyperemic, body temperature is 40 0 , respiratory rate is 23 per minute, blood pressure is 110\70 mm. Hg Art. ECG: sinus tachycardia 110 per minute. EOS is normal. Without acute coronary pathology. Blood glucose level is 3.6 mmol/l. MOST likely provisional diagnosis:

    Sunstroke

  • 23

    #82 *!A 19-year-old patient has multiple rib fractures and acute respiratory failure. An increase in cyanosis, a decrease in blood pressure, unilateral bulging of the chest on the right side, and widening of the intercostal spaces were noted. What is the MOST likely cause of the development of ARF?

    Tension pneumothorax

  • 24

    #99 *!Due to ice, 4 cars collided, as a result of which 10 people were injured and were taken to the hospital with various injuries, 3 died at the scene. Which category should this situation be classified into?

    Emergency

  • 25

    #100 *! During a devastating earthquake, an unconscious man was found under the rubble of a house, the pulse was 116 beats per minute, thread-like, the skin of the right leg was pale with a bluish tint, blisters with cloudy-reddish contents were visible. MOST likely provisional diagnosis

    Long-term compression syndrome

  • 26

    #104 *!A 37-year-old man complains of sharp pain in the right half of the pelvis after a car accident. I didn’t lose consciousness. On examination: in the area of the wing of the right ilium there is an extensive subcutaneous hematoma, sharp pain on palpation of the pubic and ischial bones, as well as in the area of the wing of the ilium on the right. The right leg is bent at the knee and hip joints and slightly rotated outward. MOST likely provisional diagnosis?

    Pelvic bone fracture

  • 27

    #107 *! During the flood, a young man was taken out of the water unconscious, the skin is cold, bluish, there is no consciousness, breathing and pulse in the main vessels, water flows from the mouth and nose, there is no reaction of the pupils to light, a symptom of “cat’s eye”. Please indicate your preliminary diagnosis.

    Biological death

  • 28

    #108 *! During the examination, the patient lost consciousness, cyanosis of the skin developed, breathing, and pulse in the carotid artery were absent. On the heart monitor: straight line. By which of the following mechanisms did circulatory arrest develop?

    Asystole

  • 29

    #109 *!Patient with complaints of lack of air, pain in the right half of the chest. The complaints appeared 1 hour ago after a car accident, I was driving a car. Objectively: the skin is pale, the right side of the chest lags behind in the act of breathing, respiratory sounds are not detectable. On percussion there is a box sound; on auscultation, breathing is not heard on the right. MOST likely provisional diagnosis?

    Pneumothorax

  • 30

    #121 *! The patient is 46 years old. Complaints of weakness, a feeling of fear, squeezing pain in the heart area. The attack occurred for the first time after physical activity 1 hour ago. I took nitroglycerin 3 times, the effect was short-term. Pale, scared. In the lungs, breathing is vesicular, there are no wheezes, respiratory rate is 22 beats. per minute Heart sounds are loud and rhythmic. Blood pressure 110/70 mm. Hg Art. ECG sinus tachycardia 102 bpm. Normal EOS. Negative T in the hole. I , II , AVL . Specify the groups of drugs for emergency care:

    narcotic analgesics, antiplatelet agents, anticoagulants

  • 31

    #128 *! A 56-year-old patient has been suffering from arterial hypertension for a long time, against the background of an increase in blood pressure to 230/130 mm Hg. shortness of breath occurred. On auscultation, moist fine bubbling rales are heard up to the upper edge of the scapula. What drugs are MOST indicated for emergency care?

    enalaprilat, lasix, oxygen through alcohol

  • 32

    #138 *! A 2-year-old child fell ill yesterday: weakness, hoarseness, barking cough, loss of appetite. Body temperature is 37.5 0 C. On examination, breathing can be heard at a distance, inspiratory shortness of breath is at rest. Excited, restless, sleep disturbed. The skin is pale, perioral cyanosis increases during a coughing attack, tachycardia. NPV 31 per minute. Breathing in the lungs is harsh, with occasional dry wheezing. The MOST appropriate drug for emergency care:

    Prednisolone

  • 33

    #162 *! A 55-year-old patient is unconscious and does not respond to external stimuli. According to relatives, he suffers from diabetes. The skin is pale and moist. Blood pressure 100/50 mm. Hg Art., heart rate 110 per minute. Blood glucose 1.4 mmol⁄liter. The MOST appropriate drug for emergency care:

    Dextrose 40% sol

  • 34

    #166 *!Male 7 4 years old. He usually complained of headache, numbness and weakness of the upper left limb, and slurred speech. I got sick in the morning. Objectively: the condition is of moderate severity. Smoothness of the nasolabial fold on the left, symptom parus a, tongue deviation to the right . Speech is slurred. Left-sided hemiparesis is moderate. After two hours of observation and treatment, positive dynamics were noted, the nasolabial fold on the left was smoothed, hemiparesis disappeared, speech became understandable , and the general condition improved. The MOST optimal method of transportation in the position:

    Horizontal, with raised headboard

  • 35

    #169 *! An 80-year-old man stumbled on the street and fell on his left side. Severe pain appeared in the groin area. When examined by an emergency physician: the right leg was rotated outward. He cannot place his foot vertically on his own. An attempt to do this with outside help leads to severe pain in the hip joint, the “ sticky heel symptom.” Tapping on the heel and greater trochanter is painful. THE MOST effective drug for pain relief?

    Promedol

  • 36

    #172 *!An elderly patient slipped and fell, leaning on the palm of her outstretched right hand. Severe pain appeared in the wrist joint. She called an ambulance. Objectively: the right wrist joint is swollen, movements in it are very painful and limited. A “bayonet-shaped” deformity of the joint is determined (the distal fragment together with the hand is displaced to the rear). Palpation of the dorsal surface of the joint is painful. What is the EMERGENCY physician's BEST priority action?

    Pain relief

  • 37

    #176 *!A 2-year-old child developed maculopapular rashes. I ate an orange the day before. Which group of drugs is the MOST priority in providing assistance?

    Antihistamines

  • 38

    #177 *!Child 9 years old. Complaints of swelling of the eyelids and lips. The condition worsened after eating nuts. HIGHEST priority emergency drug:

    Prednisolone

  • 39

    #179 *!Woman 36 years old. Complaints of inspiratory shortness of breath, suffocation, dry cough after using a new perfume. The condition is serious. Excited. The skin is pale and moist. Vesicular breathing in the lungs. Deafness of heart sounds, heart rate 54/min, weak pulse, blood pressure 80/4 0 mmHg. Drug of choice for emergency care:

    Epinephrine

  • 40

    #181 *!Patient with complaints of severe weakness, dizziness, palpitations, feeling of lack of air. Symptoms appeared with intravenous drip administration of 5% glucose. Objectively: the skin is pale and moist. There is vesicular breathing in the lungs, no wheezing. NPV 22 per minute. Heart tones are clear and rhythmic. Heart rate 90/min. Blood pressure 80/60 mmHg. BEST priority actions?

    Stop drug administration

  • 41

    #185 *!A person with hypersalivation, bronchorrhea, agitation, miosis. The antidote MOST indicated for the patient?

    Atropine

  • 42

    #186 *!Young man in a comatose state. For two months he complained of significant weakness, thirst, and lost 10 kg. A sharp deterioration is noted over the course of two days. Objectively: the skin is dry, pale, turgor is reduced, areflexia. Kussmaul breath, smell of acetone from the mouth. Blood pressure 90/60 mm. Hg art, pulse 92, soft, small filling. On palpation of the abdomen - bloating, the abdominal wall is tense. The MOST appropriate drug for emergency care:

    Sodium chloride 0,9% sol

  • 43

    #193 *! As a result of a residential fire, a person received burns to the head, front surface of the torso and upper extremities. The patient is extremely excited, there are ruptured blisters on his face, a dense dark crust on the front surface of the chest, and ruptured blisters in the abdominal area. Slow, pulse rapid. Blood pressure 75\50 mmHg The drug MOST indicated for pain relief is:

    Trimeperidine (promedol)

  • 44

    #196 *!After eating unknown berries in a pioneer camp, 11 children developed agitation, high fever, photophobia, wide pupils, and dry skin. Which antidote is MOST indicated?

    Proserin

  • 45

    #200 *!Victim with a traumatic brain injury, unconscious, blood pressure 190/110, periodic vomiting. Method of transportation in an ambulance:

    Lying on side