5. List possible causes of heart attack in the absence of pre-infarct symptomatology (for example, angina pectoris) 6. List the most common complications of acute myocardial infarction 7. What is the most likely mechanism of the development of sinus bradycardia in a patient.
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- TASK N 4 A 39-year-old man, who previously considered himself to be practically healthy, felt severe pain in the epigastric region and strong weakness while performing heavy physical work. After 20 minutes the pains weakened but there were complaints of nausea and vomiting. On examination: the state of moderate severity, arterial pressure is 70/45 mm Hg, sinus bradycardia. Careful palpation revealed no signs of a gastrointestinal pathology. After ECG registration, the patient was hospitalized with the diagnosis "Acute left ventricular infarction". Questions: 1. Indicate the form of infarction with such unusual localization of the pain syndrome and the presence of dyspeptic disorders. 2. Describe the most typical localization of pain during myocardial infarction. 3. What changes on the ECG are typical for myocardial infarction? 4. Which plasma enzymes can be measured in order to confirm the diagnosis? 5. List possible causes of heart attack in the absence of pre-infarct symptomatology…TASK No 2 A 44-year-old patient, suffering from varicose veins for a long time, complains of calf muscle cramps and leg swelling, which increase with physical activity. On examination: skin is thin, cyanotic, edematous, cold to the touch. In the area of the inner ankle of the right leg, a painless ulcer is found. Questions: 1. Name the disorder of regional circulation that has led to the development of edema on the legs. 2. Give the definition of edema. 3. Name the initial pathogenetic factor of edema development in this case. 4. What other reasons can lead to the inclusion of this factor of edema development?TASK No 4 At a patient of 40 years old after a trauma of the right arm there was a pain, delicacy and difficulties of any movements. On examination: the skin is dry and thinned; there is atrophy and a decrease in the tone of skeletal muscles, weakening of tendon reflexes. Questions: 1. Indicate the cause of hypokinesia in the patient. 2. Describe the level of damage that initiates the patient's hypokinesia. Justify the answer. 3. Describe the patient's hypokinesia by severity of lesions. Give the definition of this type of hypokinesia.
- TASK No 4 At a patient of 40 years old after a trauma of the right arm there was a pain, delicacy and difficulties of any movements. On examination: the skin is dry and thinned; there is atrophy and a decrease in the tone of skeletal muscles, weakening of tendon reflexes. Questions: 4. Describe the patient's hypokinesia for the prevalence of the lesion. 5. Explain the occurrence of muscle atrophy in the patient. 6. Explain the weakening of tendon reflexes in the patient. 7. What kind of sensitivity disorders are typical for this lesion?TASK No 2 A 44-year-old patient, suffering from varicose veins for a long time, complains of calf muscle cramps and leg swelling, which increase with physical activity. On examination: skin is thin, cyanotic, edematous, cold to the touch. In the area of the inner ankle of the right leg, a painless ulcer is found. Questions 5. Describe the osmotic factor of edema development. 6. Is it possible to its inclusion in this case? Justify your answer. 7. Describe the mechanism of cyanosis development in the patient?TASK N 2 A 45-year-old patient suffers from arterial hypertension. There are complaints about progressive obesity, weakness, fatigue, headaches. On examination: height - 170 cm, body weight - 96 kg. There are dyspnea at rest, edema of feet and calves. Arterial blood pressure is 190/95 mm Hg. A blood test for iodine-containing thyroid hormones and glucocorticoids is normal. General blood and urine tests are normal. Questions: 1. What types of typical pathological processes should the patient have? 2. List the patient's heart failure symptoms. 3. Describe heart failure by its origin, the mechanism of development, mainly affected part of the heart, the severity of the clinical course. 4. Explain the pathogenesis of edema in this patient. 5. Indicate the most likely morphological changes in the myocardium and coronary vessels of the patient. 6. Why hypertension is a risk factor for heart failure? 7. Why is obesity a risk factor for heart failure?
- TASK N 4 Patient B., 60 years old, was hospitalized with the diagnosis "Myocardial infarction". On examination: cold and cyanotic skin. Respiration is frequent, superficial, arterial pressure 90/60 mm Hg, pulse - 110 beats / min (normal 60-90 beats per minute). The patient is transferred to the intensive care unit. Questions: 1. What kind of typical pathological process (TPP) develops with myocardial infarction? 2. Define this TPP. 3. Describe the TPP, developed in the patient, according to the speed of its development, prevalence, cause of occurrence.TASK №o 1 A patient of 19 years old felt weak, dizzy, pain in the neck, nausea after four hours spending in a hot bath. On examination: the skin is moist, strongly hyperemic. Body temperature is 39° C. Questions: 1. What pathological process has been developing in the patient? Give its definition. 2. Indicate the cause of this pathological process. 3. List the stages of development of this pathological condition. 4. Indicate its possible complications 5. Indicate changes in metabolism, typical for the pathological condition that has developed in the patient. 6. What type of typical pathological process (TPP) is needed to be differentiated in the patient? Give its definition. 7. Conduct a comparative analysis of this TPP and pathological process in the patient.TASK 1 A 30-year-old patient is hospitalized with the diagnosis "Infectious-allergic myocarditis". There are complaints about weakness, fatigue, subfebrile fever, pain in the heart area during physical exertion, which is not being suppressed by nitroglycerin. These symptoms appeared a month after the flu and have been progressing for the last 6 months. On examination: shortness of breath, swelling of the cervical veins, edema of the both feet. According to percussion data, the left and right borders of the heart are widened. On the ECG: a persistent decrease in the T wave, ventricular extrasystole. In the blood - neutrophilic leukocytosis with a nuclear shift to the left, increasing the MB-fraction of creatine phosphokinase. Questions: 1. Define the concept of "myocarditis". 2. Describe the etiology and pathogenesis of that disease. 3. Explain the mechanism of the blood changes, revealed in the patient. 4. List the patient's heart failure symptoms. 5. Violation of which properties of…
- TASK No 4 A patient of 48 years old complains of irritability, fatigue, weight loss with increased appetite, sweating, sleep disturbance. At inspection: body temperature - 37,6 C, the skin is wet and hot to the touch. There is a tremor of the fingers. The border of the heart is widened to the left, the pulse is 130 beats per minute, arterial pressure is 150/70 mm Hg. Thyroid gland is diffusely enlarged, soft and elastic, with palpation. Exophthalmos is noted. Pathological immunoglobulins (LATS - factors) were found in the patient's blood. Questions: 1. What is a thyroid disease in the patient? 2. Describe the mechanism of its development. 3. How is changed the level of thyroid hormones and thyroid- stimulating hormone in the patient's blood? 4. How must be changed the metabolism of lipids, proteins and fats change in this pathology? 5. Describe the mechanism of development of arterial hypertension in the patient. 6. Describe the mechanism of exophthalmos development in the patient. 7.…TASK No 4 A patient of 48 years old complains of irritability, fatigue, weight loss with increased appetite, sweating, sleep disturbance. At inspection: body temperature - 37,6 C, the skin is wet and hot to the touch. There is a tremor of the fingers. The border of the heart is widened to the left, the pulse is 130 beats per minute, arterial pressure is 150/70 mm Hg. Thyroid gland is diffusely enlarged, soft and elastic, with palpation. Exophthalmos is noted. Pathological immunoglobulins (LATS - factors) were found in the patient's blood. Questions: 6. Describe the mechanism of exophthalmos development in the patient. 7. Name the most dangerous complication of the patient's disease.TASK No 4 A patient 65 years old after a subtotal resection of the thyroid gland complained of weight gain, muscle weakness, fatigue, memory impairment, swelling of the face and extremities. At inspection: the face is pale and edematic, the skin is dry. Patient's speech is indistinct. Body temperature - 35.4° C, the pulse is very slow, arterial pressure is 95/60 mm Hg. Questions: 4. What are the other possible causes that lead to this form of pathology? 5. How must be changed the level of thyroid-stimulating hormone (TSH) in the patient's blood? 6. Descrive typical changes of lipid, protein and carbohydrates metabolism with this endocrine pathology? 7. Explain the mechanism of the onset of edema in the patient.