Myocardial ischemia is mainly a result of:
- Coronary hypoxemia.
- Coronary artery disease (CAD).
- Acute coronaritis.
- Coronary anemia.
- Heart remodelling.
Myocardial ischemia is:
- Mismatch between import and export of oxygen in the myocardium.
- Inadequacy between arterial and venous circulation of the heart.
- Mismatch between coronary blood flow and myocardial demands.
- Inactivated myocardial oxygen.
- Circadian oxyge nimbalance in the myocardium.
Which of the following causes refer to the "risk factors" for CAD (coronary artery disease):
- Atherogenic dyslipoproteinemia, smoking.
- Arterial hypertension, diabetes.
- Fasting and increased physical activity.
- Obesity, decrease physical activity.
- 1, 2, 4.
- 2, 3, 4.
The main cause of CAD (coronary artery disease) is:
- Coronary atherosclerosis.
- Platelet aggregation in the coronary vessels.
- Impaired oxygen transport function of the blood.
- Coronary spasm induced by gastro-coronary reflex.
- Variations in oxygen demands of the myocardium.
For which forms of CAD coronary artery spasm is the major pathogenetic mechanism:
- Myocardial sclerosis.
- Sudden cardiac death.
- Prinzmetal’s angina pectoris.
- Myocardial infarction.
- Stable angina pectoris.
What is angina?
- Respiratory-related chest pain.
- Transient ischemic chest pain.
- Neuralgic chest pain.
- Chest pain which depends on the position of the body.
- Neuralgic pain in a fixed location.
The clinical manifestation of stable angina is provoked by:
- Physical effort.
- Mental stress.
- Arterial hypertension.
- Prolonged sleep.
- 1, 2, 3.
- 1, 2, 4.
The main pathogenetic mechanism of stable angina pectorisis:
- Increased oxygen requirements of the myocardium.
- Rapidly progressive coronary stenosis.
- Coronary thrombosis.
- Coronary dissection.
- Acute coronaritis.
The main pathogenetic mechanism of unstable angina pectoris is
- Intramural myocardial coronary compression.
- Fixed coronary stenosis with primary arterial hypotension.
- Rapid onset and /or progressive narrowing of the coronary vessel.
- Hormonal oxidative phosphorylation explosion in myocardium.
- Exacerbated coronaritis.
Increased oxygen requirements of the myocardium, can be satisfied primarily by:
- Increasing oxygen capacity.
- Facilitated hemoglobin oxygen release.
- Internal reallocation of the coronary blood flow.
- Adequately increased coronary blood flow.
- Compensatory polycythemia.
Each coronary stenosis (at any time and/or degree) leads to decrease of:
- Myocardial oxygen demands.
- Deposited myocardium oxygen.
- Oxygen content in the coronary sinus.
- Collateral coronary blood flow.
- Coronary heart reserve.
What is acute myocardial infarction?
- Myocardial dystrophy.
- Ischemic necrosis of the myocardium.
- Myocardial fibrosis.
- Acute inflammatory process.
- Spontaneous apoptosis of myocardiocytes.
What is the main pathogenetic unit in myocardial infarction formation?
- Fixed coronary stenosis.
- Turbulence in the coronary blood flow.
- Acute ventricle-coronary reflux.
- Coronary thrombosis.
- Hyperemic coronary shunt.
Which pathogenetic mechanisms in the cell lead to irreversible ischemic necrosis.
- Lack of ATP.
- Lactic acidosis and cytosolic Ca2+ accumulation.
- Direct ischemic genomic paralysis.
- Rapid accumulation of free radicals.
- 1, 2, 3, 4.
- 1, 2, 4.
The most severe complication of acute myocardial infarction is:
- Pulmonary embolism.
- Cardiogenic shock.
- Acute aneurysm.
- Pericardial effusion.
- Ventrical thrombosis.
The most common complications of myocardial infarction in the early hours are:
- Thromboembolism of cerebral vessels.
- Chronic left-sided heart failure.
- Heart aneurysm.
- Rhythm and conduction disorders.
- Acute pericarditis.
Which of the following are complications in chronic phase of myocardial infarction?
- Heart aneurysm.
- Chronic heart failure.
- Cardiogenic shock.
- Rhythm and conduction disorders.
- 1, 2, 4.
- 1, 3, 4.
Which clinical type of CAD is associated with apoptosis and loss of myocardial cells?
- Acute myocardial infarction.
- Atherosclerotic myocardiosclerosis.
- Stable angina.
- Ischemic sudden cardiac death.
- Progressive unstable angina.
What is the main cause of atherosclerotic myocardiosclerosis?
- Acute myocardial ischemia.
- Postischemic immune response against the heart cells.
- Steady chronic myocardial hypoperfusion.
- Progressive inflammatory process in the myocardium.
- Continuous spasm of the coronary vessels.
Which is the most common mechanism of sudden cardiac death?
- Ventricular fibrilation.
- Ventricular rupture.
- Cardiac tamponade.
- Electromechanical ventricular dissociation.
- Sudden block in ventrical contractions.
The lack of pain during myocardial ischemia could be caused by:
- Decreased pain sensitivity.
- Ischemic generation of high-frequency pain impulses.
- Mild ischemia, that does not reach the pain threshold.
- Ischemic block of the pain impulses conduction.
- 1, 3, 4.
- 1, 2, 3, 4.
Main pathogenetic factor for the diastolic dysfunction in pericardial disorders is:
- Pericardial-myocardial pathological reflex.
- Presence of fluid in the pericardium.
- Increased intrapericardial pressure.
- Reduced pericardial-epicardial contact.
- Dysfunction between the left and right side of the heart.
Main pathogenetic mechanism in cardiac tamponade is:
- Reduced myocardial contractility.
- Impaired diastolic filling of the heart.
- Reflex tachycardia.
- Increased afterload.
- Increased blood accumulation in the heart chambers.
Pathophysiological manifestations of pericardial effusions are:
- Diastolic dysfunction and central venous stasis.
- Systolic dysfunction and central venous stasis.
- Diastolic dysfunction with empty central circulation.
- Diastolic dysfunction with arterial hypertension.
- Decompensated ventricular diastolic dysfunction.
Main pathogenetic mechanisms imparing contractility of cardiomyocytes are:
- Reduced capacity of ion-transport mechanisms.
- Reduced effectiveness of cardiac adrenergic regulation.
- Damage to cell membranes and cardiomyocyte enzymes.
- Genomic blocking of myocyte hypertrophy.
- 1,2,3.
- 1,2,3,4.
What kind of changes are induced by the mechanism of Frank-Starling?
- Increasing the strength, speed and amplitude of contraction.
- Increasing the primary length of myofibres and the diastolic volume.
- Increasing the contact area actin/myosin (S/N) and the number of A-N bridges.
- Increasing the amount of Ca 2+ in cardiomyocytes.
- 1, 2, 3.
- 1, 2, 3, 4.
Conditions leading to activation of the Frank-Starling mechanism are:
- Increased afterload.
- Increased preload.
- Sinus tachycardia.
- Physical exercise.
- Increased myocardium contractility.
Compensatory character of myocardial hypertrophy depends on:
- Increased number of sarcomeres.
- Increasing the amount and size of the sarcomeres.
- Adaptive reordering of the sarcomeres.
- Hyperplasia of the myocardiocytes, not associated with the sarcomeres.
- 1, 3.
- 1, 2, 4.
Pathological hypertrophy is characterized by:
- Excessive hypertrophy of organelles, cells and capillaries.
- Hyperplasia of cardiomyocytes.
- Cardiomyocyte polyploidy.
- Multiplication of cardiac connective tissue elements.
- Мassive intramyocardial hemorrhage
What is the main purpose of hypertrophy?
- To progressively increase hyperfunction.
- Attempt to reduce hyperfunction.
- To relatively stabilize the hyperfunction.
- To compensate hyperfunction.
- To provide better functional status of the heart.
Power and rate of contraction and relaxation are compensatory increased via massive Ca2+ release in :
- Increased length of cardiomyocytes.
- Simpathetic adrenal stimulation of the heart.
- Increased force of contraction with unchanged length of cardiomyocytes.
- Increased volume of cardiomyocytes.
- Vagal stimulation.
Prolonged tachycardia has negative effects on the heart due to:
- Shorten diastolic filling.
- Increased oxygen consumption of the myocardium.
- Impaired synchronization between the left and right ventricle.
- Dysfunctionof the valve apparatus.
- 1,2.
- 1,2,3,4.
Pathological consequences of long-standing myocardial hypertrophy are:
- Reduced ventricular compliance.
- Completely suppressed mechanism of Frank-Starling.
- Decreased myocardial contractility.
- Cardiac chronotropic hypersensitivity.
- 1, 3.
- 1, 2, 3, 4.
The most important non-cardiac compensations in heart failure are related to:
- Stimulation of the renin-angiotensin-aldosterone system.
- Increased secretion of ADH (antidiuretic hormone).
- Increasing the concentration of 2,3-DPG in erythrocytes.
- Increased oxygen affinity of hemoglobin.
- 1, 2, 3.
- 1, 2, 3, 4
Heart failure is a clinical manifestation of:
- Ventricular contractile dysfunction.
- Pumping heart failure.
- Electrical instabilityof the heart.
- Decentralization of circulation.
- Inappropriate centralization of blood flow.
Which are the main causes for development of cardiogenic pump deficiency?
- Impaired, reduced and limited ventricular filling.
- Excessively increased resistance in systole.
- Critically lowered blood volume
- Functionally inefficient cardiac contractions.
- 1, 2, 4.
- 1, 2, 3, 4.
Which are the main causes for development of hemodynamic heart failure (HF)?
- Aortic and pulmonary stenosis.
- Pulmonary and systemic hypertension.
- Insufficient valvular defects.
- Myocardial ischemia, myocarditis, cardiomyopathy.
- 1, 2, 3.
- 1, 2, 3, 4.
Energetic type heart failure develops in:
- Coronary artery disease, myocarditis,myocardiodystrophy.
- Stenotic valvular defects.
- Systemic and pulmonary arterial hypertension.
- Congenital valvular defects without cyanosis.
- Prolonged exercise.
What is the main pathogenetic unit of cardiogenic pulmonary edema?
- Decreased pulmonary lymphatic drainage.
- Increased hydrostatic pressure in pulmonary capillaries.
- Low counter pressure in pulmonary interstitium.
- Increased permeability of the alveoli-capillary barrier.
- Reduced plasma concentration.
Which is the most common cause of right-sided heart failure development?
- Chronic obstructive pulmonary disease (COPD).
- Arterial hypertension.
- Congenital and acquired defects of the mitral valve.
- Rhythm and conduction disorders.
- 1, 3.
What is the main pathogenetic factor of “cor pulmonale” development:
- Arterial hypertension.
- Pulmonary hypotension.
- Pulmonary hypertension.
- Stagnant bloodflow in the pulmonary circulation due to weakness of the left ventricle.
- Arterial hypercapnia.
Which of the following could be a cause of rhythm and conduction heart disorders?
- Intoxication.
- Metabolic disorders.
- Emotional stress.
- Electrolyte imbalance.
- Excessive physical exercise.
- All stated.
What are the basic mechanisms for arrhythmias development?
- Increased automaticityof the heart.
- Occurrence of re-entry mechanism.
- Occurrence of ectopic excitatory pulse.
- Ventricular hypo- and akinesia.
- 1, 3, 4.
- 1, 2, 3
Pathogenesis of reumocarditis is based on
- Streptococcal induced myocardial intoxication.
- Crossed (streptococcus A / cardiomyocytes) immunological reactivity.
- Autoimmune reaction against cardiac immunologically privileged antigens.
- Generalized immune deficiency.
- Genetic defects in myocardium.
Etiology is still unclear in:
- Acute bacterial myocarditis.
- Ischemic myocardial damage.
- Cardiomyopathy.
- Myocardiodystrophy.
- Tezaurismozes of the myocardium.
Hemodynamic disorders in acute myocarditis are closest to those of:
- Acute myocardial infarction.
- Dilated cardiomyopathy.
- Acute pericardial injury
- Chronic atherosclerotic cardiomyopathy.
- Obstructive-restrictive cardiomyopathy.