Assessment of the severity of the condition of patients in the provision of emergency therapeutic and surgical medical care at the prehospital stage.

rors occur, they are quantified on a 10-point scale. The performance of tasks in this test is impaired both in frontal-type dementia and in Alzheimer's dementia and dementia with predominant damage to subcortical structures.

For differential diagnosis of these conditions, in case of incorrect independent drawing, the patient is asked to complete the arrows on the dial with numbers already drawn (by the doctor). In frontal-type dementia and dementia with a predominant lesion of subcortical structures of mild and moderate severity, only independent drawing suffers, while the ability to place hands on an already drawn dial is preserved. In dementia of the Alzheimer's type, both independent drawing and the ability to place hands on a ready-made dial are impaired. Test results can range from 0 to 18 points; while 18 points correspond to the highest cognitive abilities.

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4. ASSIGNMENTS AND TESTS

TO CONTROL THE LEVEL OF KNOWLEDGE

4.1. TESTS FOR MONITORING THE LEVEL OF KNOWLEDGE

Respiratory diseases. Acute respiratory failure (ARF)

1.The main manifestations of ARF include: a) hypoxia;

b) hypoxemia; c) hypercapnia; d) hypotension.

Please indicate the error (1).

2.The following signs are most characteristic of the clinical picture of stage I ARF:

a) the patient is conscious;

b) the skin is pale, moist, with elements of acrocyanosis; c) tachypnea up to 25–30 per minute;

d) arterial hypotension is noted; e) PaO2 decreases to 70 mmHg.

Please indicate the error (1).

3.In case of stage II ARF, the patient is determined by:

a)cyanosis of the skin, sometimes in combination with hyperemia, profuse

sweat;

b)bradycardia;

c)arterial hypertension;

d)PaO2 decreases to 60 mmHg;

e)PaCO2 increases to 50 mmHg.

Please indicate the error (1).

4. Stage III ARF is characterized by the following symptoms:

a)the patient is conscious;

b)rapid transition from tachypnea to bradypnea;

c)arterial hypotension;

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d)decrease in PaO2 to 50 mmHg and below;

e)increase in PaCO2 to 80–90 mmHg and below.

Please indicate the error (1).

5. Absolute indications for mechanical ventilation are:

a)hypoxemic ARF (PaO2 less than 50 mmHg);

b)hypercapnic ARF (PaCO2 more than 60 mmHg);

c)critical decrease in reserve breathing;

d)chest injury;

e)RR is more than 40 per minute, provided that this is not due to other reasons (hyperthermia, severe, unresolved hypovolemia, etc.).

Please indicate the error (1).

6. Relative (differentiated) indications for mechanical ventilation are:

a)coma (the result of assessing the level of wakefulness on the Glasgow scale is less than 8 points);

b)chest injuries;

c)asthmatic status 1st degree (ventilation disorders);

d)hypoventilation syndrome of central origin;

e)the presence of pathological conditions that require muscle relaxation for their treatment.

Please indicate the error (1).

7. ARF of central origin is pathogenetically related:

a)with an effect on the respiratory center of intracranial hypertension;

b)with impaired innervation of the respiratory muscles;

c)with an effect on the respiratory center of the lesion;

d)with impaired breathing mechanics due to chest injuries;

e)with effects on the respiratory center of toxic substances.

Please indicate the error (1).

8. The main causes of airway obstruction syndrome (ADN) are:

a)laryngospasm;

b)bronchiolospasm;

c)asthmatic conditions of various etiologies;

d)convulsive syndrome;

e)foreign body of the upper respiratory tract.

Please indicate the error (1).

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9.The leading role in the pathogenesis of the development of bronchial obstruction syndrome is played by such mechanisms as:

a) spasm of bronchial smooth muscles; b) dysand hypercrinia;

c) inflammatory swelling of the bronchial mucosa; d) swelling of the interstitial tissue of the lungs; e) expiratory collapse of small bronchi.

Please indicate the error (1).

10.The principles of eliminating ARF caused by status asthmaticus in-

clude:

a) oxygen therapy;

b) elimination of hypovolemia; c) prescription of antihistamines;

d) relief of inflammatory edema of the bronchial mucosa; e) relief of bronchial obstruction.

Please indicate the error (1).

11.There are the following types of drowning in water:

a)true;

b)asphyxial;

c)expiratory;

d)syncope (death in water).

Please indicate the error (1).

12.The main clinical variants of pulmonary embolism (PE) are: a) asphyxial;

b) coronary ischemic; c) collaptoid;

d) abdominal; d) comatose.

Please indicate the error (1).

13.The most consistent clinical signs of pulmonary embolism include: a) shortness of breath and tachypnea;

b) increased pressure in the pulmonary artery system; c) rapid formation of the pulmonary heart;

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d)arterial systemic hypertension;

e)angina-like pain syndrome.

Please indicate the error (1).

14.The following clinical signs indicate a high probability of pulmonary embolism:

a) tachycardia (heart rate 95 or more per minute); b) male gender;

c) phenomena of deep vein thrombosis of the lower extremities; d) previously established oncological pathology;

e) surgery, injury (fracture) or disease (CVA), resulting in forced immobilization of the patient over the past month.

Please indicate the error (1).

15.Anatomical landmarks for conicotomy are not:

a)thyroid cartilage;

b)cricoid cartilage;

c)cricoid-thyroid membrane;

d)external carotid artery.

Please indicate the error (1).

16. If the victim has signs of a foreign body in the upper respiratory tract with rapidly increasing symptoms of ARF, it is possible:

a)apply the Heimlik technique;

b)try to remove the foreign body with a finger or a clamp;

c)perform an emergency conicotomy;

d)perform a puncture of the cricothyroid ligament, leaving 2–3 needles of large (at least 2–2.5 mm) diameter in it.

Please indicate the correct answer (1).

Diseases of the cardiovascular system

17. Sudden cardiac death is:

a)death in the presence of witnesses, occurring instantly or within 6 hours from the onset of a heart attack;

b)death occurring instantly or within 6 hours from the onset of a heart attack;

c) death that occurs suddenly, without any previous symptoms, or within 1 hour after the onset of acute symptoms, but the onset of death is unexpected.

Please indicate the correct answer (1).

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18.The diagnosis of acute coronary syndrome (ACS) is highly likely if the patient has:

a) new anginal pain within 2 months;

b) anginal pain lasting 3–5 minutes during normal physical activity; c) anginal pain during excessive physical activity for 3–5 minutes; d) anginal pain of a wave-like nature lasting more than 30 minutes; e) anginal pain at rest for 2–3 minutes.

Please indicate the error (1).

19.Acute coronary syndrome includes:

a)new angina within 1 month;

b)angina pectoris with unrelieved pain within 15 minutes;

c)angina pectoris with relieved pain within 15 minutes;

d)angina at rest, developing more than 5 times a day.

Please indicate the error (1).

20.Atypical forms of MI include: a) asthmatic;

b) arrhythmic; c) cerebral; d) abdominal; e) renal;

e) low-symptomatic (painless).

Please indicate the correct answer (1).

21.Violations of cardiac rhythm and conduction that require emergency elimination include:

a) complete atrioventricular block, accompanied by Morgane — Adams — Stokes attacks;

b) rare ventricular extrasystole; c) sinus tachycardia.

Please indicate the correct answer (1).

22.Acute vascular insufficiency is a condition caused by:

a)impaired venous return due to an increase in the capacity of the vascular bed;

b)impaired venous return due to a decrease in the capacity of the vascular bed;

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c)short-term loss of consciousness due to a decrease in the capacity of the vascular bed;

d)impaired venous return due to increased peripheral vascular resistance.

Please indicate the error (1).

23.Conditions that require an emergency reduction in blood pressure during a hypertensive crisis include:

a) dissecting aortic aneurysm; b) acute coronary syndrome;

c) cardiogenic pulmonary edema; d) cerebral stroke.

Please indicate the error (1).

24.Complications of a hypertensive crisis include:

a)acute hypertensive encephalopathy;

b)cerebral stroke;

c)acute coronary syndrome;

d)pulmonary embolism;

e)aortic dissection.

Please indicate the error (1).

States of shock

25.The most important clinical criteria for microcirculation disorders in-

clude:

a) diuresis less than 30 ml/hour;

b) the temperature gradient between the skin and the rectum is more than 2 °C; c) development of metabolic acidosis;

d) the presence of metabolic alkalosis;

e) symptom of a “white spot” lasting more than 2 seconds, marbling of the skin.

Please indicate the error (1).

26.Pathogenetic variants of shock include:

a)hypovolemic;

b)obstructive;

c)systemic;

d)vasogenic;

e)cardiogenic.

Please indicate the error (1).

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27.Vasogenic types of shock include: a) traumatic;

b) septic;

c) anaphylactic; d) bacterial-septic.

Please indicate the error (1).

28.The following changes in hemodynamic parameters are most characteristic of hypovolemic shock:

a) decreased cardiac output;

b) increased wedge pressure in the pulmonary capillaries; c) decrease in central venous pressure;

d) increase in total peripheral vascular resistance.

Please indicate the error (1).

29.The most characteristic changes in hemodynamic parameters for cardiogenic shock are:

a) decreased cardiac output;

b) increased wedge pressure in the pulmonary capillaries; c) decrease in central venous pressure;

e) increase in total peripheral vascular resistance.

Please indicate the error (1).

30.Anaphylactic shock is characterized by the following changes in hemodynamic parameters:

a) possible decrease in cardiac output;

b) decrease in wedge pressure in the pulmonary capillaries; c) increased central venous pressure;

d) decrease in total peripheral vascular resistance.

Please indicate the error (1).

31.Septic shock is characterized by the following changes in hemodynamic parameters:

a) increased cardiac output;

b) decrease in wedge pressure in the pulmonary capillaries; c) decrease in central venous pressure;

d) increase in total peripheral resistance.

Please indicate the correct answer (1).

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Acute disturbances of consciousness

32. Fainting means:

a)short-term loss of consciousness with impaired postural tone;

b)prolonged loss of consciousness in combination and disturbance of postu-

ral tone;

c)short-term loss of consciousness with transient neurological symptoms;

d)short-term loss of consciousness with a drop in vascular tone and a relative decrease in blood volume;

e)loss of consciousness of varying duration, caused by activation of sympathetic influences.

Please indicate the correct answer (1).

33. Collapse is usually understood as:

a)acute vascular insufficiency, characterized by a drop in vascular tone in combination with a relative decrease in blood volume;

b)acute vascular insufficiency with an increase in vascular tone and a decrease in blood volume;

c)chronic vascular insufficiency with a decrease in vascular tone and a decrease in blood volume due to blood loss;

d)acute vascular insufficiency with a decrease in vascular tone and an increase in blood volume.

Please indicate the correct answer (1).

34.When measuring blood pressure in patients with fainting, the following is revealed:

a) its sharp increase; b) its sharp decline;

c) gradual decrease over several hours; d) blood pressure does not change.

Please indicate the correct answer (1).

35.The duration of fainting (syncope) is usually:

a)from 6 to 60 seconds;

b)exceeds 30 minutes;

c)several tens of minutes;

d)at least 1 hour.

Please indicate the correct answer (1).

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36.The state of stupor during TBI corresponds to the following number of points on the Glasgow coma scale:

a) 13–14; b) 10–12; c) 8–9; d) 6–7; e) 4–5.

Please indicate the correct answer (1).

37.The state of deep coma during TBI corresponds to the number of points on the Glasgow coma scale:

a) 13–14; b) 10–12; c) 8–9; d) 6–7; e) 4–5.

Please indicate the correct answer (1).

38.The state of moderate stunning in a patient with TBI corresponds to the following number of points on the Glasgow coma scale:

a) 13–14; b) 10–12; c) 8–9; d) 6–7; e) 4–5.

Please indicate the error (1).

39.In a state of stupor, the patient has the following symptoms:

a)almost complete absence of consciousness;

b)lack of purposeful defensive movements;

c)opening the eyes to painful and sound stimuli;

d)occasional monosyllabic answers to a question repeated many times;

e)loss of control over pelvic functions.

Please indicate the error (1).

40. The following symptoms correspond to a state of deep coma:

a)lack of consciousness;

b)lack of defensive movements;

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