2

CUPRINS: 1. ATI 2. %2/,,1)(&,2$6( . 11 3. CARDIOLOGIE

Cardiologie 1 .. 26 Cardiologie 2 41 Cardiologie 3 50 ,QVXILFLHQ&DUGLDF 62 HTA 72

4. PNEUMOLOGIE Pneumologie 1 80

Penumologie 2 ......... 99 5. CHIRUR GIE Chirurgie 1 108

Chirurgie 2 .... 115 6. DERMATOLOGIE 122 7. 1875,,(,,$%(7 . 127

Obezitatea la adult . 135 8. ENDOCRINOLOGIE . 140 9. GASTROENTEROLOGIE . 150 10. GERIATRIE . 162 11. NEUROLOGIE . 168 12. OFTALMOLOGIE . 175 13. 2%67(75,&,*,1(&2/2*,( .. 178 14. ONCOLOGIE .. 188 15. O.R.L. ... 195 16. ORTOPEDIE .. 203 17. PEDIATRIE . . 207 18. PEDOPSIHIATRIE . . 227 19. PSIHIATRIE . . 233 20. RADIOLOGIE . . 242 21. REUMATOLOGIE . . 245 22. HEMATOLOG IE . . 255 23. NEFROLOGIE . . 268 24. 0(,&,1,17(51 . . 281 25. UROLOGIE

Urologie 1 Urologie 2 .... 297

3

ATI

Stopul cardio-respirator 1. In clasificarea etiologiei stopului cardiac se regasesc urmatoarele, cu exceptia:

A. Infarct miocardic B. Intoxicatii C. Ritm cardiac D. Hipoxie E. Inecul

2. Disocierea electromecanica se intalneste in urmatoarele patologii: A. Embolia pulmonara masiva B. Infarct miocardic C. Soc circulator D. Disectia aortica E. Cardiomiopatie hipertrofica

3. Urmatoarele afirmatii sunt adevarate: A. Principala cauza a stopului cardiac nu este IMA B. Etiologia stopului cardiac va fi clasificata in functie de cauza C. Fibrilatia ventriculara declanseaza intotdeauna un stop cardiac D. Tahicardia ventriculara nu declanseaza stopul cardiac decat in anumite

circumstante E. FV nu este spontan reversibila

4. Urmatoarele sunt manevre de baza in reanimarea cardio-pulmonara: A. Notarea debutului reanimarii B. Masaj cardiac la un ritm de 80 compresii pe minut C. Alternanta a 20 compresii toracice la 5 insuflari D. Eliberarea cailor aeriene E. Intubatia si ventilatia trebuie realizate cat mai repede

5. Alcalinizarea nu este indicata decat in caz de: A. Hiperpotasiemie B. Hipopotasiemie C. Stopul cardiac in cadrul unei intoxicatii cu stabilizanti de membrana D. Infarct miocardic E. Soc cardiogen

6. Care afirmatii sunt corecte: A. Hipotermia terapeutica vizeaza protejarea creierului de aminoacizii

neuroexcitanti B. In caz de stop cardiac prin asistolie se administreaza 2 mg de adrenalina

4

C. Stopul cardiac survine in prezenta unui martor in mai mult de 10% din cazuri

D. FV nu este spontan reversibila E. In absenta unei cai venoase adrenalina nu se poate administra

7. In cadrul reanimarii specializate afirmatiile urmatoare sunt false: A. Adrenalina nu este singura catecolamina indicata in caz de asistolie B. Lidocaina nu mai este recomandata ca tratament antiaritmic C. Scopul injectiei cu adrenalina este de a restabilii tonusul venos D. Adrenalina exercita in mod normal o actiune batmotropica E. Dupa administrarea unui SEE se recomanda reluarea manevrelor RCP

6WDUHDGHRF 8. In socul hipovolemic:

A. Pacientul este tahicardic B. Predomina vasodilatatia periferica C. Predomina vasoconstrictia periferica D. Organismul se adapteaza prin bradicardie E. O cauza poate fi ingestia masiva de lichide

9. Socul cardiogen: A. Se datoreaza scaderii functiei de pompa cardiaca B. DC scade C. Infarctul miocardic poate determina soc cardiogen D. Tensiunea arteriala creste reactiv in stare de soc cardiogen E. Pulsul periferic nu se modifica, doar cel central

10. Socul anafilactic: A. Prezinta vasodilatatie masiva B. Constrictia cailor aeriene se asociaza cu o crestere a TA C. Stimularea simpatica cu eficienta scazuta D. Stimulare simpatica cu eficienta crescuta E. Este un raspuns al anticorpilor imunoglobulinici la un numar mare de

alergeni

7URPER]DYHQRDVSURIXQGLHPEROLDSXOPRQDU 11. Semnele clinice functionale ale trombozei venoase profunde sunt:

A. Durere spontana la nivelul gambei B. Durere provocata la nivelul gambei C. Durere de-a lungul traiectului venos D. Pierderea capacitatii de balans a gambei E. Semnul Homans

5

12. Semnele clinice generale ale trombozei venoase profunde sunt: A. Febra > 38 grade C B. Subfebrilitate C. Tahicardie clasic SURJUHVLY D. Bradicardie E. Simptome congestive cardiace drepte

13. Tratamentul trombozei venoDVHSURIXQGHDUHXUPWRDUHOHFDUDFWHULVWLFL $6HUHFRPDQGRGLKQDODSDW B. QFD]GHLQVXILFLHQWUHQDOVHYHUSDFLHQWXOVHVSLWDOL]HD] & &RQWHQWLD YHQRDV SRDWH SUHYHQL PDODGLD SRVWIOHELWLF SHQWUX R SHULRDG

minima de doi ani &RQWHQWLDYHQRDVQXSRDWHSUHYHQLPDODGLDSRVWIOHELWLFSHQWUXRSHULRDG

minima de doi ani (,15WLQWHVWHGH 3

14. 7UDWDPHQWXO DQWLWURPERWLF SUHYHQWLY vQ WURPER]D YHQRDV SURIXQG DUHXUPWRDUHOHLQGLFDWLL

A. Pacientii PHGLFDOL FX YkUVW> 40 ani, imobilizati, care pUH]LQWGHFRPSHQVDUHFDUGLDFVDXUHVSLUDWRULHDFXW

%3DFLHQWLFXYkUVW< 40 DQLPRELOL]DWLFDUHSUH]LQWRLQIHFWLHVHYHU & 3DFLHQW FX YkUVWD ! DQL FX DQWHFHGHQWH WURPEHPEROLFH YHQRDVH

LQVXILFLHQWFDUGLDFVLVLQGURPPLHORSUROLIHUDWLY D. PaciHQWL FKLUXUJLFDOL WUDWDWL SULQ FKLUXUJLH RUWRSHGLF D PHPEUXOXL

inferior (3DFLHQWLFKLUXUJLFDOLWUDWDWLSULQFKLUXUJLHXURORJLFQRQ FHOLRVFRSLF

15. Semnele clinice de diagnostic ale emboliei pulmonare sunt: A. Dispnee, polipnee, tuse, hemoptizie B. %UDGLFDUGLHVLQFRSDQ[LHWDWH C. Simptome congestive cardiace drepte D. Simptome congestive cardiace stangi E. Palpitatii, tahicardie si anxietate

16. QHPEROLDSXOPRQDUUDGLRJUDILDWRUDFLF A. Poate fi normala %3RDWHUHIOHFWDDWHOHFWD]LHvQEDQG C. 3RDWHUHIOHFWDRSDFLWDWHWULXQJKLXODUSHIRQGSOHXUDO 2SDFLWDWHFODVLFDXQXLFDPSSXOPRQDU E. Semnul Westermarck

17. 6FRUXO:HOOVFXSULQGHXUPWRULLSDUDPHWULL $)UHFYHQWFDUGLDFD!80 bat/min > +1.5 B. 6HPQHFOLQLFHGHWURPER]YHQRDVSURIXQG> +3

6

C. Hipotensiune > +1 $QWHFHGHQWHGHWURPERHPEROLVPYHQRDVVDXGHHPEROLHSXOPRQDU> +1.5 E. )HEU> +1

18. Durata WUDWDPHQWXOXLDQWLFRDJXODQWGXSXQSULPDFFLGHQWWURPERHPEROLF $QFD]GHDQWLFRDJXODQWGHWLSOXSLFWUDWDPHQWSUHOXQJLWSkQODDQL %QSUH]HQWDXQXLIDFWRUIDYRUDELOUHYHUVLELOWUHLOXQL &QDEVHQWDXQXLIDFWRUIDYRUDELOSkQODOXQL QFD]GHQHRSOD]LHHYROXWLYSkQODGLVSDULWLDQHRSOD]LHL (QFD]GHGHILFLWGHDQWLWURPELQOXQLvQDEVHQWDULVFXOXLGHVkQJHUDUH

19. (YDOXDUHDULVFXOXLvQHPEROLDSXOPRQDUVHED]HD]DSHWUHLFULWHULL A. Hipotensiune arteriala %LVIXQFWLHFDUGLDFVWkQJYL]LELOODHFRJUDILH &LVIXQFWLHFDUGLDFGUHDSWYL]LELOODHFRJUDILHVDXSULQFUHVWHUHDQLYHOXOXL

BNP D. Asocierea trombozei venoase profunde a membrelor inferioare ($IHFWDUHDPLRFDUGLFGHPRQVWUDWGHRFUHVWHUHDFRQFHQWUDWLHLSODVPDWLFH

a troponinei cardiace I sau C

20. 7UDWDPHQWXOVLPSWRPDWLFvQHPEROLDSXOPRQDUPDVLYFXSULQGH A. Oxigenoterapie cu debit mic, pentru obtinerea unei saturatii a

KHPRJORELQHLvQR[LJHQvQVkQJHOHSHULIHULF!98% %,QWXEDUHVLYHQWLODUHPHFDQLFvQFD]GHKLSR[LHVHYHU &RXFLYHQRDVHFHQWUDOH ([SDQVLXQHDYROHPLFvQSULPDLQVWDQWSULQFULVWDORLGHVDXFRORLGH E. Spitalizare si reanimare

21. La un pacient cu embolie pulmonara, radiografia pulmonara poate decela: A. Atelectazie in banda B. Hipertransparenta unui camp pulmonar C. Supraelevatia domului pleural D. Pleurezie E. Hipertransparenta spatiului pleural

22. La un pacient cu embolie pulmonara, electrocardiograma poate decela: A. Tahicardie sinusala B. Bloc de ramura dreapta C. Bloc de ramura stanga D. Unde negative in V1, V2, V3 E. Unda S in D3, unda Q in D1

7

23. La un pacient cu embolie pulmonara: A. ECG poate fi normal B. Radiografia pulmonara poate fi normala C. Gazele sanguine arteriale pot fi normale D. Modificarile ECG, atunci cand apar, sunt specifice emboliei pulmonare E. Modificarile radiologice, atunci cand apar, snt specifice emboliei

pulmonare

24. Aspectul ECG de tip S1Q3 (una S in D1 si unda Q in D3) poate apare in: A. Embolie pulmonara B. Infarct miocardic acut C. Insuficienta cardiaca acuta dreapta D. Insuficienta cardiaca acuta stanga E. Criza de astm bronsic

25. In diagnosticul de certitudine al emboliei pulmonare A. Un nivel al d-Dimerilor < 500 micrograme/litru exclude diagnosticul de

embolie pulmonara B. CT toracic cu substanta de contrast permite diagnosticul de certitudine C. Angio-computer tomografia spirala este investigatia de electie pentru

diagnosticul de ceritudine D. Scintigrafia pulmonara de ventilatie perfuzie poate conduce la

diagnosticul corect E. Rezonanta magneica nucleara este utila in cazurile in care computer-

tomografia este neconcludenta

26. Urmatoarele simptome sunt semne de gravitate la un pacient cu embolie pulmonara:

A. Hipotensiunea arteriala B. Hipertensiunea arteriala C. Insuficienta cardiaca dreapta D. Scaderea nivelului seric al peptidului natriuretic de tip B (BNP) E. Cresterea concentratiei plasmatice a troponinei cardiace I sau C

27. Fac parte din semnele clinice definitorii pentru tromboza venoasa profunda a membrelor inferioare

A. Durerea la nivelul gambei B. Febra constant crescuta peste 39 grade C C. Tahicardie D. Edem inflamator al gambei E. Claudicatie intermitenta

8

28. In strategia diagnostica pentru managementul pacientului cu suspiciune de tromboza venoasa profunda (TVP):

A. d-dimeri negativi la un pacient cu semne clinice nespecifice exclud TVP B. d-dimeri pozitivi implica obligativitatea efectuarii unui Eco-Doppler venos

al vaselor membrelor inferioare C. d-dimerii nu sunt diagnostici pentru TVP D. Eco-Doppler venos al vaselor membrelor inferioare are capacitatea de a

confirma diagnosticul la pacientul cu suspiciune clinica de TVP E. Eco-Doppler venos pozitiv al membrelor inferioare nu impune inceperea

tratamentului medicamentos anti TVP

29. *Tratamentul curativ in TVP are urmatoarele tinte terapeutice: A. obtinerea unui aPTT de 1,5-2,5 ori mai mare decat valorile normale daca se

foloseste heparina fractionata (cu greutate moleculara mica) B. obtinerea unui aPTT de 2,5-3,5 ori mai mare decat valorile normale daca se

foloseste heparina fractionata (cu greutate moleculara mica) C. obtinerea unui aPTT de 1,5-2,5 ori mai mare decat valorile normale daca se

foloseste heparina sodica D. obtinerea unui aPTT de 2,5-3,5 ori mai mare decat valorile normale daca se

foloseste heparina sodica E. obtinerea unui INR tinta intre 2 si 3 daca se foloseste heparina sodica

30. In tratamentul curativ al TVP: A. in cazul heparinelor fractionate, dozele sunt: bolus 80 U / kg, urmat de 500

U/kg/zi in perfuzie continua B.se administreaza heparine cu greutate moleculara mica daca cleareance-ul

de creatinina este > 30 ml / min C. INR tinta in tratamentul cu anticoagulante orale este 1,5-2,5 D. repausul la pat este obligatoriu pentru a preveni mobilizarea trombilor E. suprapunerea tratamentului cu heparine / anticoagulante orale trebuie

facuta cel putin 5 zile

31. Tratamentul preventiv al TVP cuprinde: A. antiinflamatorii nonsteroidiene B. antiagregante plachetare C. heparine cu greutate moleculara mica D. antivitamine K E. inhibitori selectivi ai factorului Xa

32. Tratamentul preventiv al TVP se indica urmatoarelor tipuri de pacienti chirurgicali:

A. pacienti supusi unor operatii oncologice B. pacienti supusi unor interventii pe cord deschis C. pacienti supusi unor interventii endoscopice urologice

9

D. pacienti supusi unor interventii de amploare pe tractul digestiv E. pacienti supusi unor interventii de stabilizare a coloanei vertebrale

33. Tratamentul peventiv al TVP se indica urmatoarelor tipuri de pacienti cu patologie medicala:

A. pacienti sub 40 de ani, neinternati, neimobilzati la pat, cu decompensare severa respiratorie

B. pacienti peste 40 de ani, neinternati, imobilizati la pat, cu infectii severe C. pacienti peste 40 ani, internati, cu decompensare cardiaca severa D. pacienti cu sindrom mieloproliferativ, doar la varsta peste 75 de ani E. pacienti cu sindrom mieloproliferativ imobilizati la pat

34. Diagnosticul emboliei pulmonare cuprinde: A. dispnee B. polipnee C. dureri toracice D. tahicardie E. asociere obligatorie cu semne de tromboza venoasa profunda

35. * Urmatoarele semne / simptome nu fac parte din simptomatologia emboliei pulmonare:

A. turgescenta venelor jugulare B. hipotensiunea arteriala C. tusea D. hemoptizia E. hematemeza

10

56381685, Stopul cardio-respirator 1. A, B, D, E 2. A, D 3. C, D, E 4. A, D, E 5. A, C 6. A, D 7. A, C 6WDUHDGHRF 8. A, C 9. A, B, C 10. A, C 7URPER]DYHQRDVSURIXQGLHPEROLDSXOPRQDU 11. A, B, C, E 12. B, C 13. B, C, E 14. A, C, D, E 15. A, C, E 16. A, B, C, E 17. B, D 18. B, C, D 19. A, C, E 20. B, D, E 21. A, B, C, D 22. A, B, D 23. A, B, C 24. A, C, E 25. A, C, D 26. A, C, E 27. A, C, D 28. A, B, D 29. C 30. B, E 31. C, E 32. A, D, E 33. B, C, E 34. A, B, C, D 35. E

11

BOLI INFECTIOASE

Febra acuta la adult 7HUPHQXOGHIHEUDFXWUHFHQWVHUHIHUODIHEUDFHGXUHD]GH

A: peste 20 de zile B: 5-20 de zile C: mai putin de 5 zile D: 3-10 zile E: mai putin de 20 de zile

/DWR[LFRPDQLLSHFDOHLQWUDYHQRDVHWLRORJLDIHEUHLDFXWHSRDWHIL $LQIHFWLHXULQDU %KHSDWLWDOFRROLFDFXW &SDQFUHDWLWDFXW WXEHUFXOR] (HQGRFDUGLWGUHDSW

3*. Pentru febra acXWQHvQVRWLWGHVHPQHGHWROHUDQWGLILFLOVHUHFRPDQG A: antibioticoterapie B: antiinflamatoare nesteroidiene C: antiinflamatoare steroidieine D: tratament simptomatic E: antivirale

4. Etiologia febrei acute la pacientul alcoolic poate fi: A: infectia cu HIV B: pneumopatia prin inhalare &LQIHWLHXULQDU KHSDWLWDOFRROLFDFXW (SDQFUHDWLWDDFXW

5. Dintre substantele pirogene fac parte: A: interleuchinele B: lizozimul &IDFWRUXOGHQHFUR]WXPRUDO D: interferonul E: lactoferina

6. Din categoria pacientilor cu risc crescut de a face febra acuta fac parte A: nou-nascutii B: gravidele C: homosexualii D: subiectii cu proteze valvulare E: subiectii recent operati

12

&DUHVXQWXUJHQWHOHLQIHFWLRDVHvQIDWDXQHLIHEUHDFXWH A: meningoencefalita %PHQLQJLWDEDFWHULDQ &IDULQJRDPLJGDOLWDYLUDO D: septicemia (HQGRFDUGLWDLQIHFWLRDV

LQWUHSDWRORJLLOHQHLQIHFWLRDVHSRWILFDX]GHIHEUDFXWXUPDWRDUHOH A: bolile metabolice %LQWR[LFDWLDFXILHUODPHQRSDX] C: osteoporoza D: meningoencefalita acuta E: tumorile hematologice

9. Marcati afirmatiile false in ceea ce priveste etiologia febrei acute: A: in cazul unei etiologii bacteriene febra poate fi semnul unei infectii cu HIV B: o buna toleranta a febrei si o vindecare spontana ne sugereaza o etiologie virala C: alergiile medicamentoase nu sunt o cauza de febra acuta D: la pacientii sondati febra poate fi cauza unei infectii de tract urinar E: la toxicomani pe cale intravenoasa febra poate fi cauzata de o infectie cu HIV, de o celulita, de endocardita stanga

)XQFWLDGHWHUPRUHJODUHHVWHDVLJXUDWGH A: hipotalamus %KLSRIL] C: trunchiul cerebral D: suprarenale E: corticosuprarenale

Meningitele infectioase si meningoencefalitele adultului 1.* In fata unei suspiciuni de meningita infectioasa trebuie facut de urgenta:

A: o ecografie abdominala B: ionograma serica C: radiografii de sinusuri D: examenul LCR E: radiografie toracica

2.* In meningita infectioasa antibioticele se administreaza inainte de punctia lombara in caz de:

A: febra peste 39 grade C B: pacient obnubilat C: purpura fulminans D: pacient varstnic sondat urinar

13

E: prezenta unui sindrom meningean

3*: Meningita cu pneumococi are urmatoarele caracteristici cu exceptia: A: debut brutal B: este frecventa la pacientii varstnici C: frecventa la pacientii purtatori ai unei brese osteomeningiene D: frecventa la etilici E: nu apar tulburari de vigilenta

&DUHGLQWUHXUPDWRDUHOHFRQGLWLLQXDSDUHvQFXUVXOHYROXWLHLXQHLPHQLQJLWHFXLCR purulent?

A. soc septic B. coma, epilepsie, hidrocefalie C. Sindrom de hipertensiune intracraniana D. coagulare intravasculara diseminata (CIVD) E. dezvoltare de xantoame

QFD]XOXQXLSDFLHQWGLDJQRVWLFDWFXPHQLQJLWGHHWLRORJLHSUREDELOLQIHF LRDVFDUHGLQWUHVLWXD LLOHXUPWRDUHQXFRUHVSXQGHFXVXVSLFLXQHDHWLRORJLF"

$FRSLLPLFLQHYDFFLQDWLFXIRFDUHVXSXUDWLYHvQVIHUD25/ VHVXVSLFLRQHD]implicarea Haemophilus influenzae

%WLQHULFHSUH]LQWXQVLQGURPSXUSXULF VHVXVSLFLRQHD]LPSOLFDUHDNeisseria meningitidis

&SDFLHQWFXHOHPHQWHGHPHQLQJRHQFHIDOLWDFXWUHFHQWvQWRUVGLQWU-o FOWRULHvQ ULOHVFDQGLQDYH VHVXVSLFLRQHD]QHXURSDOXGLVPXO

D/&5FODUFXSUHGRPLQHQ DOLPIRFLWHORULKLSRJOLFRUDKLH- VHVXVSLFLRQHD]neurotuberculoza

(/&5FODUQRUPRJOLFRUDKLFFXSURWHLQRUDKLHJOSDFLHQWFXHYROX LHVSRQWDQEXQ VHVXVSLFLRQHD]HWLRORJLDYLUDO

6. Identificati afirmatiile false:

A: diagnosticul de meningita se stabileste daca in examenul LCR identificam > 5 elemente/ mm3

B: diagnosticul de meningita se stabileste daca in examenul LCR identificam > 50 elemente/ mm3

C: diagnosticul de meningita purulenta se stabileste daca in examenul direct din LCR majoritatea elementelor nu sunt polinucleare

D: diagnosticul de meningita cu lichid clar se stabileste daca in examenul direct din LCR majoritatea elementelor sunt limfocite

E: diagnosticul de meningita cu lichid clar se stabileste daca in examenul direct din LCR majoritatea elementelor sunt eozinofile

14

7. Meningitele neinfectioase sunt : A: iatrogene postchimioterapie intratecala B: tumorale C: date de herpes virus D: imunoalergice E: date de virusul HIV

8: Meningita cu Hemophillus influenzae este : A: meningita cu lichid purulent B: meningita cu lichid clar C: examenul bacteriologic direct din LCR arata prezenta bacililor Gram negativ D: examenul bacteriologic direct din LCR arata prezenta bacililor Gram pozitiv E: LCR este limfocitar si hipoglicorahic

9*: Care dintre urmatoarele nu este o complicatie a meningitelor purulente: A: Soc septic, coma, epilepsie B: Tulburari hidroelectrolitice C: Sechele intelectuale D: Tulburari imunoalergice E: Tulburari de mers

&DUHGLQWUHXUPWRDUHOH PHQLQJLWHVHGHFODUVHUYLFLXOXLHSLGHPLRORJLF" $PHQLQJLWDPHQLQJRFRFLF %PHQLQJLWDSQHXPRFRFLF &PHQLQJLWDWXEHUFXORDV D: meningita cu Listeria monocytogenes E: meningita cu Haemophilus influenzae

11. Diagnosticul diferential al meningitei infectioase este: A: Meningita neinfectioasa B: Meningism: Meningita fara germene identificat la culturile din LCR C: Reactie meningiana fara infectie: sindrom meningian cu examen LCR

normal D: Meningismul este satelit virozelor E: Reactia meningiana fara germene impune cautarea unei infectii

parameningiene active Gripa 1. * Virusurile gripale sunt:

A: virusuri ARN B: virusuri ADN C: responsabile de infectii respiratorii cronica la om si la animal D: patru tipuri de virusuri gripale sunt patogene la om E: nici un raspuns nu este corect

15

QFDUHGLQWUHVLWXDWLLGLDJQRVWLFXOGHJULSHVWHLPSUREDELO $EROQDYFXPDQLIHVWULGHYLUR]UHVSLUDWRULHvQFRQWH[WHSLGHPLFJULSDO %VLPSWRPHUHVSLUDWRULLLFRQWDFWUHFHQWFXXQSDFLHQWFRQILUPDWFXJULS C: debut brXVFDOXQHLVXIHULQ HUHVSLUDWRULLGHDVSHFWYLUDOGXSDRLQFXED LH

VFXUW-3 zile) WDEORXFOLQLFFDUDFWHUL]DWGHIHEUULGLFDWIULVRDQHVHPQHUHVSLUDWRULL

DUWURPLDOJLLFHIDOHHDPH HOL E: tablou hematologic periferic caracterizat prin leucocito]LKLSHUHR]LQRILOLH

&DUHFRPSOLFD LHQXDSDUHvQLQIHF LDFXYLUXVXOJULSDO" $VXSUDLQIHF LLEDFWHULHQH %GHFRPSHQVDUHFDUGLDFDODSHUVRDQHGLDJQRVWLFDWHFXLQVXILFLHQ FDUGLDFD

JUDYVDXYDOYXORSDWLLJUDYH C: decompensarea respiratorie la persoanele cunoscute cu bronhopneumopatii

cronice VLQGURPXOGHGHWUHVDUHVSLUDWRULHDFXW E: anizocorie

4. Forma simpla de infectie cu virusul gripal este caracterizata prin : A: febra inalta 39-40 C B: frisoane, astenie C: detresa respiratorie acuta D: anorexie E: pneumopatiei cu pneumococ

5. Care afirmatie legata de infectia cu virusul gripal este adevarata: A: incubatia este de 1-3 zile B: incubatia este de 7 zile C: contetul epidemic nu este important pentru a stabilii diagnosticul de gripa D: perioada de contagiozitate se intinde de la 6 zile inaintea aparitiei semnelor

clinice la 2-3 zile dupa aparitia acestora E: suprainfectiile bacteriene sunt responsabile de o mare parte din decese

&DUHGLQWUHDILUPD LLOHXUPWRDUHUHIHULWRDUHODWUDWDPHQWXOJULSHLHVWHIDOV" $vQSUH]HQWVHXWLOL]HD]XUPWRDUHOHDQWLYLUDOHFXDF LXQHVSHFLILF

RVHOWDPLYLU]DQDPLYLUDPDQWDGLQ %DQWLELRWLFHOHDQWLEDFWHULHQHQXVHIRORVHVFGHFkWvQFD]XULOH GHVXSUDLQIHF LH

GRYHGLW &HVWHLQGLFDWKLGUDWDUHDEROQDYXOXLSHQWUXFRPEDWHUHDSLHUGHULORUVHFXQGDUH

febrei ridicate VHXWLOL]HD]PHGLFDPHQWHDQWDOJLFHUHVSHFWLYDQWLSLUHWLFH (VHLQGLFUHSDXVXOIL]LF

16

&DUHGLQWUHXUPWRDUHOHDILUPD LLUHIHUitoare la fiziopatologia gripei sunt DGHYUDWH"

$YLUXVXOJULSDOSHQHWUHD]FHOXODUFXDMXWRUXOQHXUDPLQLGD]HL %GXSSHQHWUDUHYLUXVXOJULSDOVHUHSOLFLQWUDFHOXODU &HOLEHUDUHDQRLORUYLULRQLHVWHIDFLOLWDWGHFDWUHKHPDJOXWLQLQ D: la nivelul aparaWXOXLUHVSLUDWRUYLUXVXOJULSDOGHWHUPLQOL]FHOXODULUHDF LLinflamatorii (VXSUDLQIHF LLOHEDFWHULHQHDSDUREOLJDWRULXvQHYROX LDJULSHL

8UPWRDUHOHFDWHJRULLGHSHUVRDQHDXLQGLFD LHGHYDFFLQDUHDQWLJULSDOSJ $VXJDULLSHVWHYkUVWD de 3 luni %YkUVWQLFLLSHVWHGHDQL &SHUVRDQHOHFXVXIHULQ HEURQKRSXOPRQDUHFURQLFH JD]GHOHVSHFLDOHFDUHSUH]LQWGHILFLWHLPXQLWDUHFHOXODUHPDLDOHVLQIHF LD

HIV) (SHUVRDQHOHFXQRVFXWHFDILLQGDOHUJLFHODRYDOEXPLQ

Infectia cu HIV 1. * Gasiti afirmatia falsa despre istoria naturala a infectiei cu HIV:

A: manifestarile clinice ale infectiei cu virusul HIV sunt dominate de infectiile oportuniste

B: faza de primo-infectie este deseori simptomatica C: in faza de latenta apare o diminuare progresiva a CD4 D: faza simptomatica sau boala SIDA este legata de un deficit imun grav E: principalele enzime ale virusului Hiv sunt transcriptaza inversa, proteaza,

integraza

LDJQRVWLFXOLQIHFWLHLFX+,9VHED]HD]SH A: tipare limfocitara CD4/CD8 B: test ELISA combinat de generatia a patra C: determinarea nivelului limfocitelor CD4 WHVWJHQRWLSLFGHUH]LVWHQW E: imunofenotipare

&DUHHVWHFHDPDLIUHFYHQWLQIHFWLHRSRUWXQLVWvQWkOQLWODSDFLHQWLLLQIHFWDWLFXHIV:

$SQHXPRFLVWR]DSXOPRQDU %WR[RSODVPR]DFHUHEUDO C: criptococoza D: sarcomul Kaposi (OHXFRHQFHIDORSDWLDPXOWLIRFDOSURJUHVLY

17

3URILOD[LDSULPDUSHQWUXSQHXPRFLVWR]LWR[RSODVPR]DODpacientii infectati cu HIV se face cu:

A: foscarnet B: fluconazol &SLULPHWDPLQ D: ganciclovir E: cotrimoxazol

&HDPDLIUHFYHQWORFDOL]DUHDLQIHFWLHLFXFLWRPHJDOYLUXVODSDFLHQWLLLQIHFWDWLFXHIV este:

$KHSDWLF %JDQJOLRQDU &SXOPRQDU D: UHWLQLDQ E: cerebral

3ULQFLSDOHOHHQ]LPHGLQVWUXFWXU+,9VXQW $WUDQVFULSWD]DLQYHUV B: proteaza C: neuraminidaza D: integraza E: hemaglutinina

7. Tratamentul antiretroviral in infectia HIV A: scade morbiditatea si mortalitatea B: reface partial capacitatea imuna a pacientului infectat cu HIV C: este indicat daca pacientul este simptomatic D: este indicat daca pacientul are CD4

18

10. Profilaxia transmiterii materno-fetale a infectiei cu HIV cuprinde: A: tratarea mamei pe timpul sarcinii B: alimentatia la VkQDQRX-QDVFXWXOXLWLPSGHVSWPkQL C: profilaxia cu cotrimoxazol D: tratament profilactic antiretroviral pentru nou-QVFXWWLPSGHVSWPkQL E: nasterea asistata de o echipa antrenata

QOHJDWXUFXOHXFRHQFHIDORSDWLDPXOWLIRFDOSURJUHVLYVXQWDGHYUDWHDILUPD LLOH

A: este determinata de Cryptococcus neoformans %VHPDQLIHVWSULQWXOEXUULQHXURORJLFHJUDYH &HVWHRVXIHULQWGHPLHOLQL]DQW VHWUDWHD]FXYRULFRQD]RO (HVWHGHWHUPLQDWGHYLUXVXO-&

12: Clasificarea CDC in infectia cu virusul HIV: A. stadiul A= primoinfectie, faza de latenta B. stadiul B = faza de latenta C. stadiul C= simptome definind SIDA D. clasa biologica 1= CD4>500 /mm3 E. clasa biologica 3= CD4 intre 200-400/mm3

Boli cu transmitere sexuala 1. Managementul unei IST cuprinde :

$3URILOD[LDSULPDULVHFXQGDU B: Tratamentul curativ C: Vaccinarea anti-+39LQGLIHUHQWGHYkUVW D: Profilaxia recidivelor E: Tratamentul factorilor de risc

2. In cadrul tratamentului sifilisului, reactia Herxheimer consta in: A: sangerari gingivale B: febra C: anorexie D: eruptie cutanata E: poliadenopatii

3*. Diagnosticul de IST nu se poate stabili folosind : A: TPHA, VDRL B: Serologie virusurilor hepatitice A, B, C &6HURORJLH+,9L D: Prelevat uretral sau vaginal E: Hemoleucograma

19

4. *CaUHGLQWUHXUPWRDUHOHLQIHF LLQXHVWHRLQIHFWLHFXWUDQVPLWHUHVH[XDOD $,QIHF LDVWDILORFRFLFD %,QIHF LLOHFXJRQRFRF &,QIHF LLOHFXFKODPLGLD D: Sifilisul ((FWRSDUD]LWR]HOHVFDELDLSHGLFXOR]HOH

5. Chlamydia trachomatis A: este frecvent implicata in uretrite si cervicite B: portajul latent favorizeaza diseminarea bacteriei C: la nou nascut se poate intalnii forma oftalmica dupa infectarea din timpul

nasterii D: este responsabila de sterilitatea tubara E: nici o varianta nu este corecta

6. In cadrul sifilisului se disting urmatoarele stadii A: stadiul primar caracterizat prim aparitia sancrului sifilitic B: stadiul primar : sancrul dur este localizat mai ales la nivelul mucoasei

vaginale si mucoasei bucale C: Stadiul secundar caracterizat prin aparitia rozeolei sifilitice D: stadiul secundar: leziunile tardive numite sifilide sunt foarte contagioase E: sifilisul tertiar caracterizat prin aparitie manifestarilor viscerale dupa zeci de

ani de evolutie

&DUHGLQWUHXUPWRDUHOHDILUPD LLUHIHULWRDUHODLQIHF LLOHFXWUDQVPLWHUHVH[XDO(IST) este falsa:

$QSUH]HQ DXQHL,67VHYRUFXWDvQWRWGHDXQDDOWH,67 %6HYDLQVLVWDDVXSUDPVXULORUGHSURILOD[LH &,67FXSULQGLIRUPHOHDVLPSWRPDWLFHGHERDO 6HYRUGHSLVWDLWUDWDSDUWHQHULLVexuali E: Antecedentele de IST nu constituie un factor de risc

Infectiile nosocomiale 5HIHULWRUODLQIHF LLOHQRVRFRPLDOHVXQWIDOVHXUPWRDUHOHDVSHFWH

$VXQWLQIHF LLDVRFLDWHvQJULMLULORUPHGLFDOH %VXQWLQIHF LLDVRFLDWHDXWRPHGLFDWLHLODGLPLFLliu &VXQWLQIHF LLDVRFLDWHDFWLYLW LORUGHSURILOD[LH VXQWLQIHF LLDVRFLDWHDFWLYLW LORUGHGLDJQRVWLF (VXQWLQIHF LLDVRFLDWHDFWLYLW LLGHvQJULMLUHFXUDWLY

2.* Informarea pacientului afectat de o infectie nosocomiala: A: este obligatorie B: depinde de decizia medicului curant

20

C: nu poate duce la despagubiri deoarece nu se poate demonstra producerea infectiei in timpul managementului medical

D: toate variantele sunt corecte E: nici o varianta nu e corecta

3. *Cele mai frecvente infectii nosocomiale sunt: A: Infectiile de plaga operatorie B: Infectiile urinare C: Pneumopatiile infectioase D: Infectiile de tract digestiv E: Micozele

4. Pneumopatiile infectioase nosocomiale sunt caracterizate prin: A: aparitia febrei, a expectoratiei purulente B: semne radiologice: hiperinflatie pulmonara C: semne biologice: izolarea unui germen din exudatul faringian sau nazal D: izolarea unui germen intr-un prelevat din caile respiratorii inferioare E: factor de risc:intubarea endotraheala

,QIHF LLOHQRVRFRPLDOHGHSODJRSHUDWRULHVHFDUDFWHUL]HD]DSULQ A: aspect clinic: prezenta eritemului migrans B: serologic: teste bacteriologice pozitive &PLFURELRORJLFFXOWXUSR]LWLYGLQWU-RSUREUHFROWDWGHODQLYHOXOSOJLL

operatorii D: semne clinice si ELRORJLFHDSUXWHvQSULPHOH]LOHGHODPRPHQWXO

LQWHUYHQ LHLLQGLIHUHQWGHWLSXODFHVWHLD (VHPQHFOLQLFHVLELRORJLFHDSDUXWHvQGHFXUVGHOXQLGH]LOHGHOD

LQWHUYHQ LHvQFD]XOLPSODQWULLGHPDWHULDOVWULQ

6. Semnele biologice pe care se ba]HD]GLDJQRVWLFXOSQHXPRSDWLLOHLQIHFWLRDVHnosocomiale sunt:

A: hemoculturi pozitive %OHXFRSHQLHFXOLPIRFLWR] &L]RODUHDXQHLEDFWHULLGLQH[SHFWRUD LH OHXFRFLWR]FXQHXWURILOLH E: izolarea unei bacterii din lavajul bronhoalveolar

7. Infectiiile legate de catetere sunt: A: intotdeauna nosocomiale B: mai frecvente la cateterele centrale decat la cele periferice C: rareori nosocomiale D: diagnosticul este stabilit de o cultura pozitiva a cateterului E: diagnosticul este stabilit de o hemocultura pozitiva

21

Septicemiile 1. *: Bacteriemia este definita ca fiind:

$RLQIHF LHVLVWHPLFFRQILUPDW %RLQIHF LHDVRFLDWFXGLVIXQF LDXQXLRUJDQ &UDVSXQVXOLQIODPDWRUDORUJDQLVPXOXLODRDJUHVLXQHLQIHF LRDVVDX

neinfectioasa SUH]HQWDGHEDFWHULLvQVkQJHRELHFWLYDWDSULQXQDVDXPDLPXOWHKHPRFXOWXUL E: nici o varianta de mai sus

2. * Socul septic este definit ca fiind: A: sepsis cu hipotensiune arteriala persistenta B: sepsis cu hipertensiune arteriala C: sepsis cu disfunctie hematologica D: sepsis insotit de coma (VHSVLVJUDYFXKLSRWHQVLXQHDUWHULDOSHUVLVWHQWvQFLXGDXQHLXPSOHUL

YDVFXODUHDGDSWDWHFHOSX LQPOVLVDXQHFHVLWDWHDGHDUHFXUJHODDPLQHvasoactive)

3. * In sepsis avem urmatoarele, cu EXCEPTIA:

A: febra B: infectie confirmata C: frecventa cardiaca >90 bpm D: frecventa respiratorie

22

&VHIDFHSHFDOHLYFHOPDLDGHVHDLQELWHUDSLHSHRSHULRDGGH-15 zile, sau mai mult

VHIDFHSHURVvQPRQRWHUDSLHSHRSHULRDGGHFHOSX LQVSWPkQL E: va fi ulterior adaptat rezultatelor microbiologice

Diareea acuta si deshidratarea la adult 1. Diareea acuta la adult se defineste ca fiind:

A: emisie de mai mult de 5 scaune moi sau lichide B: emisie de mai mult de 2 scaune moi sau lichide C: survine brusc D: cea mai mare parte a diareilor acute sunt autolimitate E: majoritatea diareilor acute sunt de cauza neinfectioasa

2. Deshidratarea severa este descrisa ca fiind: A: legata de un teren fragil B: este de cele mi multe ori vorba de o deshidratare intracelulara C: apare hipertensiunea ortostatica D: venele jugulare externe colabate E: deshidratarea globala este insotita de sete mai intensa, uscaciunea

mucoaselor, febra, tulburari neuropsihice

3. Sindromul gastroenteritic este definit ca: A: diaree banala, putin severa B: afectare intestinala C: sindrom septic moderat D: risc de deshidratare severa E: risc de soc septic

4. * Care din urmatoarele nu poate descrie sindromul holeriform: A: Afectarea intestinala prin mecanism toxic B: Afectarea intestinala prin mecanism toxinic C: sindrom septic moderat D: deshidratare severa cu risc de deces in lipsa unei asistente medicale adaptate E: evolutie rapid favorabila

QHWLRORJLDVLQGURPXOXLGL]HQWHULFHVWHLPSOLFDWSJ-406) A: clostridium perfrigens B: calicivirus C: rotavirusuri D: shigella sp. E: vibrio cholerae

23

QGLDUHHDDFXWFRSURFXOWXUDSHPHGLLVHOHFWLYHHVWHLQGLFDWvQFD]GH A: sindrom dizenteric B: sindrom gastroenteritic C: diaree > 5 zile GLDUHHDSDUXWGXSXn tratament antibiotic (GLDUHHDSDUXWGXSFKLPLRWHUDSLH

7. *Diareea calatorilor este data de: A: Vibrio cholerae B: Campilobacter jejuni C: Bacillus cereus D: Clostridium perfringens E: E. Coli enterotoxinogen

8. Salmonelozele pot fi descrise ca sindroame dizanterice avand urmatoarele caracteristici:

A: cele minore, non-tifice responsabile de majoritatea toxinfectiilor alimentare colective

B: responsabile de febrele tifoide si paratifoide C: citoliza hepatica si leucopenie D: sindrom apendicular E: complicatie postinfectioasa : poliradiculonevrita acuta Guillan-Barre

7UDWDPHQWXOvQGLDUHHDDFXWLPSOLF A: spitalizare obligatorie %UHKLGUDWDUHSDUHQWHUDOvQFD]GHGHVKLGUDWDUHVHYHU &PRGXODWRDUHGHPRWLOLWDWHFXHIHFWGHvQFHWLQLUHDWUDQ]LWXOXLLQWHVWLQDOvQ

VXVSFLXQLOHGHGLDUHHLQYD]LY D: rehidratare oraOvQFD]GHGHVKLGUDWDUHVHYHU (DQWLELRWLFRWHUDSLHHPSLULFLQGLFDWvQWRDWHFD]XULOHGHGLDUHHDFXWSkQOD

elucidarea cauzei

)HEUDWLIRLGVHFDUDFWHUL]HD]SULQXUPWRDUHOHDVSHFWH $FOLQLFHUXS LHUR]HROLIRUPSXOVGLVRFLDWVFDXQHGLDreice %ELRORJLFOHXFRFLWR]FLWROL]DKHSDWLF &ELRORJLFOHXFRSHQLHFLWROL]KHSDWLF FRSURFLWRORJLFKHPDWLLLHR]LQRILOHDEXQGHQWH (KHPRFXOWXULOHLVHURORJLD:LGDOSRWDMXWDODVWDELOLUHDGLDJQRVWLFXOXL

Profilaxia tetanosului 1. Tetanosul este definit ca fiind:

A: o boala infectioasa B: o parazitoza C: data de un bacil Gram negativ, aerob: Clostridium tetani

24

D: boala este data de efectul neurogen al exotoxinei bacilului E: Toxina blocheaza eliberarea de neurotransmitatori la nivel sinaptic

2. Tabloul clinic al tetanosului cuprinde : A: incubatia medie este de o saptamana dar poate varia intre 3-30 zile B: in faza de prodrom apare trismusul C: trismusul este reductibil, asociat cu un sindrom febril D: contracturile musculare sunt generalizate responsabile de opistotonus E: progresia bolii este lenta si ireversibila

3. Tratamentul curativ in caz de tetanos implica: A: curatarea si debridarea plagii B: antibioterapie C: corticoterapie D: seroterapie E: anticoagulare profilactica

4. Managementul unui caz de tetanos implica: ASODJDVHFXU LVHGHEULGHD] %SODJDVHDFRSHUFXXQJXHQWHJUDVHLVHSDQVHD]RFOX]LY &VHSUDFWLFDQWLELRWHUDSLH3HQLFLOLQD*DGPLQLVWUDWLY VHSUDFWLFVHURWHUDSLHDGPLQLVWUDUHDGHDQWLFRUSLXPDQLVSHFLILFLFXURO

neutralizant al toxinei) E: bolnavul va fi ulterior vaccinat antitetanic

5. Complicatiile specifice tetanosului sunt : $FRPSOLFD LLWURPERHPEROLFH %VXSUDLQIHF LLSXOPRQDUHSULQDVSLUD LH &QHYUDOJLLJDPELHUHVLPHWULFHFXFDUDFWHUGHDUVXU D: sindroame disautonome E: decompensarea tarelor preexistente

LDJQRVWLFXOGHWHWDQRVWUHEXLHDYXWvQYHGHUHLQXUPDWRDUHOHVLWXDWLL $SOJLFXWDQDWHVDXPXFRDVH %SOJLFHFUHD]DFRQGL LLORFDOHGHDQDHURELR]LVFKHPLHQHFUR]H C: paralizii simetrice, flasce, descendente WULVPXVGHFHODWODRSHUVRDQvQYkUVWD (VXJDUSURYHQLWGLQ ULvQFXUVGHGH]YROWDUHFHSUH]LQWDGLILFXOW LGH

alimentare

25

RASPUNSURI CORECTE Febra acuta la adult 1. C 2. E 3. D 4. B, D, E 5. A, C, D 6. A, B, D, E 7. A, B, D, E 8. A, E 9. A, C, E 10. A Meningitele infectioase si meningoencefalitele adultului 1. D 2. C 3. E 4. E 5. C 6. B, C, E 7. A, B, D 8. A, C 9. D 10. A, C 11. A, D, E Gripa 1. A 2. E 3. E 4. A, B, D 5. A, E 6. A 7. B, D 8. B, C, D

HIV 1. B 2. B 3. A 4. E 5. D 6. A, B, D 7. A, B, C, D 8. B 9. A, B, C 10. A, D, E 11. B, C, E 12. A, C, D Boli cu transmitere sexuala 1. A, B, D, E 2. B, D, E 3. E 4. A 5. A, B, C, D 6. A, C, D, E 7. E Infectiile nosocomiale 1. B 2. A 3. B 4. A, D, E 5. C 6. A, C, E 7. A, B, D

Septicemiile 1. D 2. E 3. D 4. B, C, D, E 5. A, B, C 6. A, B, C, E LDUHHDDFXWDi deshidratarea la adult 1. B, C, D 2. A, D, E 3. A, B 4. E 5. D 6. A 7. E 8. A, B, C 9. B 10. A, C, E Profilaxia tetanosului 1. A, D, E 2. A, B, D 3. A, B, D 4. A, C, D, E 5. A, B, D, E 6. A, B, D, E

26

CARDIOLOGIE 1 6WDUHDGHUXSLHUGHUHDFXQRWLQ HLFUL]DFRPL LDOODDGXlt 6LQFRSDHVWHGHILQLWGUHSW

$VWDUHGHUXGHEXWDWUDSLG %SLHUGHUHDFRPSOHWDVWULLGHFRQWLHQ GHVFXUWGXUDW &SLHUGHUHDLQFRPSOHWDVWULLGHFRQWLHQ SLHUGHUHDFRPSOHWDVWULLGHFRQWLHQ GHGXUDWOXQJ E. pierderea cRPSOHWDVWULLGHFRQWLHQ vQVR LWGHFRQYXOVLL

QHWLRORJLDVLQFRSHORULQWUFDX]H A. cardiace, B. vasculare, C. reflexe, D. renale, E. digestive

3. Dintre cauzele cardiace ale sincopei fac parte: $WDKLFDUGLDYHQWULFXODU %ILEULOD LDDWULDla cu conducere foarte rapida, &WRUVDGDYkUIXULORU D. sindromul W-P-W, E. sincopa vaso-YDJDO

4. Dintre cauzele cardiace ale sincopelor fac parte: $VWHQR]DDRUWLFVWUkQV %FDUGLRPLRSDWLDKLSHUWURILF &KLSRWHQVLXQHDRUWRVWDWLF D. tumori intracardiace obstructive, (VWHQR]DSXOPRQDU

5. Dintre sincopele de cauza vasculara fac parte: $KLSRWHQVLXQHDDUWHULDO %GLVDXWRQRPLDQHXURYHJHWDWLY &VLQFRSDSRVWPLFWLRQDO VLQFRSDWXVLY (VLQFRSDGLQDWDFXOGHSDQLF

6. Dintre cauzele vascularHDOHVLQFRSHLSRWILXUPWRDUHOH $KLSRWHQVLXQHDDUWHULDO %KLSHUVHQVLELOLWDWHDVLQRFDURWLGLDQ &IXUWXOGLQDUWHUDVXEFODYLFXODU GLVDXWRQRPLDQHXURYHJHWDWLY E. drop-atacul

27

7. Dintre cauzele non cardiovasculare ale sincopei fac parte: A. criza de epilepsie B. hipersensibilitatea sino-FDURWLGLDQ C. criza de isterie D. accidentul ischemic tranzitor E. drop-atacul

3HQWUXvQFDGUDUHDHWLRORJLFDVLQFRSHLDXYDORDUH $SURGURDPHOHLVHPQHOHIXQF LRQDOHDQJLQGLVSQHHSDOSLWD LLHWF B. pieUGHUHDFRPSOHWVDXLQFRPSOHWDVWULLGHFRQWLHQ &SLHUGHUHDFRPSOHWGHGXUDWDVWULLGHFRQWLHQ H[LVWHQ DXQHLSHULRDGHSRVWFULWLFHFXVHPQHIXQF LRQDOH (H[LVWHQ DXQHLEROLFDUGLDFHFXQRVFXWHVDXDXQXLWUDWDPHQWDQWLDULWPLFVDXantihipertensiv cunoscut

9. Pentru diagnosticul etiologic al sincopei nu au valoare: $GXUDWDSLHUGHULLVWULLGHFRQWLHQ %SURGURDPHOHVDXVHPQHOHIXQF LRQDOHGHvQVR LUH &SLHUGHUHDGHXULQLPXFDUHDOLPELL H[LVWHQ DXQHLEROLFDUGLDFHQHXURORJLFe, psihice E. date culese de la martori sau pacient

9DORDUHD(&*vQVWDELOLUHDHWLRORJLHLVLQFRSHLFRQVWvQ A. identificarea ritmului inimii %LGHQWLILFDUHDXQRUWXOEXUULGHFRQGXFHUHDWULR-ventriculare sau intra-ventriculare C. identificarea ischemiei miocardice D. excluderea ischemiei miocardice E. identificarea unei anomalii electro-fiziologice

%LODQ XOSUREHORUELRORJLFHHIHFWXDWSRVWVLQFRSDUHYDORDUHvQ $HYLGHQ LHUHDGH]HFKLOLEUXOXLKLGUR-electrolitic %HYLGHQ LHUHDLVFKHPLHLPLRcardice C. excluderea ischemiei miocardice HYLGHQ LHUHDXQRUWR[LFH E. verificarea glicemiei

3HQWUXHWLRORJLDVLQFRSHLSRWILOXDWHvQFRQVLGHUDUH A. hipo sau hiperpotasemia B. hiperglicemia C. hipoglicemia HYLGHQ LHUHDXQRUWR[LFHPHGLFDPHQWH VDXVXEVWDQ H E. hipercalcemia

28

6SLWDOL]DUHDVHHIHFWXHD]vQXUPWRDUHOHVLWXD LLFXH[FHS LD $KLSRWHQVLXQHDRUWRVWDWLFFXQHFHVLWDWHDXQRUDGDSWULWHUDSHXWLFHFRPSOH[H %H[LVWHQ DXQHLEROLFDUGLDFHvQHYROX LH &VLQFRSDYDVRYDJDOFXUHYHQLUHUDSLGIUPRGLILFULSH(&* H[LVWHQ DXQRUPRGLILFULQHXURORJLFH (VLQFRSDUHFXUHQW

(FRFDUGLRJUDPDDUHYDORDUHvQXUPWRDUHOHVLWXD LL A. diagnosticarea bolilor valvulare B. depistarea shunturilor intracardiace &DSUHFLHUHDSHUIRUPDQ HL cardiace D. aprecierea chineticii segmentare E. depistarea unor anomalii electro-fiziologice

QGLDJQRVWLFDUHDWXOEXUULORUGHULWPVDXGHFRQGXFHUHGUHSWFDX]HDOHVLQFRSHLau valoare:

A. electrocardiograma de repaus B. monitorizarea Holter ECG C. telemetria D. explorarea electro-IL]LRORJLFLVWXGLXOYXOQHUDELOLW LLYHQWULFXODUH E. tilt testul

%RDODFDUGLDFLVFKHPLF. XUHUHDWRUDFLFDFXWLFURQLF. XUHUHD WRUDFLF GH WLS MXQJKL FX VHGLXO ODWHUR-WRUDFLF DFWLYDW GH SDOSDUH LintensifLFDWGHLQVSLUSURIXQGHVWHFDUDFWHULVWLFGXUHULLGLQ

$DQJLQ %GLVHF LHGHDRUW &DIHFWDUHSHULFDUGLF DIHFWDUHSOHXUDO (HVRIDJLW

XUHUHDWRUDFLFGLQDQJLQDUHVHGLXOFDUDFWHULVWLF A. dorsal B. latero-toracic sau la baza toracelui C. transfixiant sau migrator D. epigastric E. retro- LPHGLRVWHUQDOvQEDUDVDXFHUYLFDO

,UDGLHUHDGXUHULLWRUDFLFHGLQDQJLQDUHXUPWRDUHOHVHGLLFXH[FHS LD $GHODHSLJDVWUXODJkW %vQIOFL &vQXPU vQPHPEUHOHVXSHULRDUH E. intercostal.

29

19. Care sunt semnele respiratorii asociate durerii toracice? A. tuse %H[SHFWRUD LH &KHPDWHPH] D. dispnee E. disfagie

/D H[DPHQXO FOLQLF vQ GXUHUHD WRUDFLF VHPQHOH FDUGLRYDVFXODUH FDUDFWHULVWLFHGLVHF LHLGHDRUWVXQW

A. puls paradoxal, %DVLPHWULHWHQVLRQDO C. ischemie a membrelor, VXIOXGHLQVXILFLHQ DRUWLF E. abolirea pulsului periferic.

Q GXUHUHD WRUDFLF (&* HVWH GLILFLO GH LQWHUSUHWDW vQ XUPWRDUHOH FD]XUL FXH[FHS LD

A. stimulator cardiac %WXOEXUULKLGURHOHFWrolitice (hipopotasemia) C. tratament digitalic EORFXOPDMRUGHUDPXUDGUHDSW (EORFGHUDPXUDVWkQJ

QGXUHUHDWRUDFLFVXSUDGHQLYHODUHDVHJPHQWXOXL67UHPLVGXSDGPLQLVWUDUHDQLWURJOLFHULQHLVXJHUHD]

A. spasm coronarian %SHULFDUGLWDFXW C. sindrom Prinzmetal DQHYULVPYHQWULFXODUVWkQJ E. infarct pe cale de constituire

QGXUHUHDWRUDFLFFUHWHUHDWURSRQLQHLVHvQWkOQHWHvQXUPWRDUHOHVLWXD LLFXH[FHS LD

$DQJLQLQVWDELOFRPSOLFDWFXLQIDUFWUXGLPHQWDU %HQGRFDUGLWLQIHF LRDV &HPEROLHSXOPRQDU PLRSHULFDUGLWYLUDO (LVFKHPLHPLRFDUGLFIXQF LRQDOVHFXQGDURFXOXLKHPRGLQDPLF

Q GXUHUHD WRUDFLF L VXVSLFLXQH GH HPEROLH SXOPRQDU VH UHFRPDQGefectuarea:

A. troponinei B. mioglobinei C. titrului ASLO

30

D. D-dimerilor (VDWXUD LHL22

QGXUHUHDWRUDFLFHFRFDUGLRJUDPDHVWHLQGLFDWvQXUPWRDUHOHVLWXD LL $GXUHUHODGHJOXWL LH %SHQWUXDSUHFLHUHDFLQHWLFLLVHJPHQWDUHLJOREDOH &vQGLDJQRVWLFXOGHXUJHQ DOVXIHULQ HLSHULFDUGLFH vQGLDJQRVWLFXOGHXUJHQ DOSDWRORJLHLDRUWHLDVFHQGHQWHWUDQVHVRIDJLDQ (GXUHUHHSLJDVWULF

$WLWXGLQHDWHUDSHXWLFvQGLVHF LDGHDRUWLQFOXGH A. controlul strict al TA %FKLUXUJLHGHXUJHQ vQGLVHF LDGHWLS%IUDIHFWDUHDDRUWHLDVFHQGHQWH &WUDWDPHQWPHGLFDOvQGLVHF LDDRUWHLDVFHQGHQWHWLS$ LQVWLWXLUHDGHXUJHQ DWUDWDPHQWXOXLDQWLFRDJXODQW E. control tensional optimal +/- HQGRSURWH] YDVFXODU vQ LVFKHPLD GH RUJDQ vQ

GLVHF LLOHGHWLS%

$WLWXGLQHDWHUDSHXWLFvQHPEROLDSXOPRQDUSUHVXSXQH A. tratament antibiotic %WURPEROL]vQRFKHPRGLQDPLF &VHHIHFWXHD](&*UDGLRJUDILHSXOPRQDU-GLPHULLVDWXUD LDvQ22 D. confirmarea trombozei venoase profunde prin eco Doppler E. confirmara emboliei prin angioCT spiralat VDXVFLQWLJUDILHSXOPRQDU

8UPWRDUHOHDIHF LXQLDEGRPLQDOHSRWFDX]DGXUHUHWRUDFLFFXH[FHS LD A. abces subfrenic %FROLFDELOLDU &DSHQGLFLWDDFXW SLHORQHIULW (SDQFUHDWLWDDFXW

XUHUHD WRUDFLF QHFHVLW VSLWDOL]DUH SHQWUX VXSUDYHJKHUH - GH RUH vQXUPWRDUHOHVLWXD LLFXH[FHS LD

$ELODQ XOHQ]LPDWLFL(&*UPkQQHPRGLILFDWH %GXUHUHDHSHUVLVWHQWFXDQRPDOLLPLQLPHDOH(&* & DQJLQ VWDELO OD XQ FRURQDULDQ FXQRVFXW IU PRGLILFUL QRLpe ECG sau

enzimatice SDFLHQWXODUHFXPXOGHIDFWRULGHULVFSHQWUXDWHURVFOHUR] E. pacientul este sub tratament anti-LVFKHPLFFXPRGLILFULSH(&*

31

Angina pectoral LLQIDUFWXOPLRFDUGLF.Angina stabil 30*. Raportul dintre aportul/consumul de oxigen al miocardului (MVO2) nu este LQIOXHQ DWGH

$IUHFYHQ DFDUGLDF %IUHFYHQ DUHVSLUDWRULH C. tratament cu beta-blocante WHQVLXQHDSDULHWDODPLRFDUGXOXL (WUDWDPHQWXODQWLDQJLQRVFXQLWUD L

31. Caracteristic pentru durerea aginoasa este: A. apaUHODDFHODLWLSGHHIRUW %VHUHPLWHODvQWUHUXSHUHDHIRUWXOXL &DSDUHvQHJDOPVXUDODHIRUWLvQUHSDXV QXHVWHLQIOXHQ DWGHvQWUHUXSHUHDHIRUWXOXL (QXUVSXQGHODDGPLQLVWUDUHDGHQLWURJOLFHULQD

6LPSWRPHOHFDUHVHDVRFLD]IUHFYHQWGXrerii de tip anginos sunt: A. dispneea %UHVSLUD LDXLHUWRDUH C. tusea SDOSLWD LLOH E. anxietatea

7UDWDPHQWXOXLDQJLQHLVWDELOHLQFOXGHFXH[FHS LD $FRUHF LDIDFWRULORUGHULVFFDUGLR-vasculari B. antiagregant plachetar C. tratament anticoaJXODQWGHGXUDW GHULYD LQLWUD L E. beta-blocant

,QIDUFWXOPLRFDUGLFvQID]DFXW 6LQGURPXOFRURQDULDQDFXWDUHXUPWRDUHOHFDUDFWHULVWLFL

$HVWHRGXUHUHWRUDFLFFXFDUDFWHUGHDQJLQ B. poate surveni de novo, FXGXUDWSUHOXQJLW C. poate apUHDODSDFLHQ LFXDQWHFHGHQWHFRURQDULHQH SRDWHDSUHDODSDFLHQ LIUDQWHFHGHQWHFRURQDULHQH (HOHFWURFDUGLRJUDPDHVWHQRUPDOvQHSLVRGXOGXUHURV

6LQGURPXOFRURQDULDQDFXWFXVXSUDGHQLYHODUHSHUPDQHQWDVHJPHQWXOXL67 35. SCA cu ST+ poate fi coQVHFLQ D

A. ocluziei coronariene incomplete %GLVHF LHLFRURQDULHQH C. emboliei coronariene D. spasmului coronarian

32

(RFOX]LHLFRURQDULHQHFRPSOHWHSULQILVXUDSOFLLGHDWHURP

XUHUHDDQJLQRDVGLQ6&$FX67DUHXUPWRDUHOHFDUDFWHULVWLFL A. durHD]PDLSX LQGHGHPLQXWH %FHGHD]ODDGPLQLVWUDUHGHQLWUD L &GXUHD]PDLPXOWGHPLQXWHIUHFYHQW QXFHGHD]ODDGPLQLVWUDUHGHQLWUD L (VHGDWRUHD]XQXLVSDVPFRURQDULDQ

Q6&$67FXLVFKHPLHFRQVWLWXLWvQWHULWRULXOLQIHULRUSRWH[LVWDPRGLILFULSH(&*vQGHULYD LLOH

A. DII, DIII, aVF B. V5,V6 C. V1,V2,V3 D. V3,V4 E. DI, aVL

Q6&$FX67VHDGRSWXUPWRDUHDDWLWXGLQH A. tratament ambulator, cu supraveghere prin medicul de familie %LQWHUQDUHGHXUJHQ vQXQLWDWHDFRURQDULDQ &WUDWDPHQWFXQLWUD L UHSHUIX]LHSULQDQJLRSODVWLHFRURQDULDQ (UHSHUIX]LHSULQWURPEROL]

7UDWDPHQWXOFXEHWDEORFDQ LvQ6&$FX67HVWHLQGLFDWvQDLQWHDUHYDVFXODUL]ULLvQXUPWRDUHOHVLWXD LL

A. infarctul inferior B. tahicardie YHQWULFXODUVXV LQXW &RFXOFDUGLRJHQLF D. infarctul de ventricul drept (+7$VHYHU

LQWUHFRPSOLFD LLOHSUHFRFHDOHLQIDUFWXOXLDFXWIDFSDUWHXUPWRDUHOHWXOEXUULGHULWPFXH[FHS LD

$ILEULOD LDYHQWULFXODU B. blocurile atrioventriculare &WXOEXUULOHGHULWPDWULDOH D. extrasistole ventriculare sistematizate E. ritmul idioventricular accelerat

6WDGLXO,,vQFODVLILFDUHDLQWHUQD LRQDO.LOOLSDLQIDUFWXOXLLPSOLFXUPWRDUHOH $RFFDUGLRJHQLF B. edem pulmonar acut cu raluri puOPRQDUHFDUHGHSHVFMXPWDWHGLQFkPSXULOHpulmonare

33

& HGHP SXOPRQDU DFXW FX UDOXUL SXOPRQDUH FDUH QX GHSHVF MXPWDWH GLQFkPSXULOHSXOPRQDUH LQIDUFW PLRFDUGLF QHFRPSOLFDW FX DEVHQ D UDOXULORU FUHSLWDQWH OD DVFXOWD LDSXOPRQDU E. stopul cardio-respirator resuscitat

6LQGURPXOFRURQDULDQDFXWIUVXSUDGHQLYHODUHSHUPDQHQWDVHJPHQWXOXL67 6LQGURPXO FRURQDULDQ DFXW IU VXSUDGHQLYHODUH SHUPDQHQW D VHJPHQWXOXL 67FXSULQGHXUPWRDUHOHVLWXD LL

$DQJLQDSHFWRUDOVWDELO B. angina de repaus C. angina Printzmetal D. angina crescendo E. angina de novo

43*. Sindromul coronarian acut ST- VHGDWRUHD] A. spasmului coronarian prelungit %HPEROLHLvQFRURQDU &UXSWXULLSOFLLGHDWHURP VFGHULL7$VXEROLPLW E. hipoxemiei prelungite

Q sindromul coronarian acut ST- necroza este : $WUDQVPXUDO %QHWUDQVPXUDO &VXEHQGRFDUGLF VXEHSLFDUGLF (QHGHILQLW

LQ SXQFW GH YHGHUH DO OH]LXQLORU FRURQDULHQH vQ VLQGURPXO FRURQDULDQ FX 67- sunt caracteristice:

A. leziuni tritronculare subocluzive, complexe %H[LVWUH HDGHFRODWHUDOHFDUHSHUPLWHVQXVHFRQVWLWXLHLQIDUFWWUDQVPXUDO &OH]LXQHDFRURQDULDQHVWHPRQRWURQFXODU OH]LXQHDFRURQDULDQHVWHPRQRWURQFXODURFOX]LY E. leziuni multitronculare subocluzive care favorizeaz UHFLGLYD DQJLQHL LHYROX LDVSUHLQVXILFLHQ FDUGLDF

([DPHQXOFOLQLFvQVLQGURPXOFRURQDULDQDFXW67-DUHvQYHGHUH $H[FOXGHUHDXQRUGLDJQRVWLFHFDHPEROLDSXOPRQDUGLVHF LDGHDRUW LQVXILFLHQ DUHVSLUDWRULHFURQLFHWF B. analiza factRULORUFDUHDXPRGLILFDWFDUDFWHUXODQJLQHLWXOEXUULGHULWPLVDXde conducere, anemie, hipoxemie, etc) &LGHQWLILFDUHDFRPSOLFD LLORULQVXILFLHQ FDUGLDFVWkQJGUHDSWRFHWF

34

GHWHUPLQUL DWHURVFOHURWLFH OD GLVWDQ FDURWLGH DUWHUH SHULferice, aorta DEGRPLQDOHWF (VWDUHDFHUHEUDO

([DPHQHOH FRPSOHPHQWDUH SHQWUX vQFDGUDUHD VLQGURPXOXL FRURQDULDQ DFXW IUST-FRQVWDXvQ

$HOHFWURFDUGLRJUDPHVHULDWHvQVSHFLDOvQHSLVRGGXUHURV B. enzimele miocardice, troponina/CPK C. radiogUDILDWRUDFLF D. probe ventilatorii (HFRFDUGLRJUDP

$WLWXGLQHDWHUDSHXWLFvQID DSDFLHQWXOXLFXVLQGURPFRURQDULDQDFXW67- este: $UHSUH]LQWRXUJHQ VLVHLQWHUQHD] %UHSUH]LQWRXUJHQ LVHLQWHUQHD]vQXQLWDWHDFRURQDULDQ C. se punHvQUHSDXVODGRPLFLOLX VHWULPLWHODLQYHVWLJD LLFRPSOHPHQWDUHvQDPEXODWRU (VHIL[HD]WUDWDPHQWLvLFRQWLQXDFWLYLWDWHD

7UDWDPHQWXOvQVLQGURPXOFRURQDULDQDFXW67- YDFRQVWDvQ $GHULYD LQLWUD LLYDGPLQLVWUDUHFRQWURODWFXVHULQJDDXWRPDW B. anticoagulant &DQWLJOLFRSURWHLQ,,E,,,D5HRSUR,QWHJULOLQHWF D. sedarea durerii (WURPEROL]

50. Examenele complementare post infarct acut ST+ cu angioplastie, sunt : A. electrocardiograma (ST supradenivelat persistent) B. ecocardiograma C. coronarografia D. Holter ECG (H[SORUDUHDL]RWRSLFGHUHSDXVLGHHIRUW

7UDWDPHQWXOSRVWLQIDUFWDFXWXUPUHWH A. consolidarea tratamentului post- revascularizare B. controlul factorilor de risc &FRQWUROXOLQVXILFLHQ HLFDUGLDFH DSURILOD[LDPRU LLVXELWH E. cicatrizarea zonei infarctizate

7UDWDPHQWXOSRVWLQIDUFWDFXWVWHQWDWVHHIHFWXHD]FX $DVSLULQ-325mg/zi B. clopidogrel 75mg/zi sau prasugrel 10mg/zi &EHWDEORFDQ L

35

D. inhibitori ai enzimei de conversie a angiotensinei E. anticoagulant

,QKLELWRULL LQIOX[XOXL GH FDOFLX VH XWLOL]HD] vQ WUDWDPHQWXO SRVW LQIDUFW vQXUPWRDUHOHVLWXD LL

$GDFSDFLHQWXODUHLQVXILFLHQ FDUGLDF %GDFSDFLHQWXOHVWHKLSHUWHQVLY &GDFSUH]LQWDQJLQYDVRVSDVWLFSRVWLQIDUFW GDFEHWDEORFDQ LLVXQWFRQWUDLQGLFD L (GDFDQJLQDSRVWLQIDUFWQXUVSXQGHODEHWDEORFDQ LSOXVQLWUD L

3UHVFULHUHDLVXSUDYHJKHUHDXQXLWUDWDPHQWDQWLWURPERWLF.Tromboliticele 547URPEROLWLFHOHVXQWVXEVWDQ HFDUHOL]HD]FKHDJXOSULQ

A. liza FKHDJXOXLDOELURX %OL]DUH HOHLGHILEULQ C. efect antiagregant plachetar D. efect anticoagulant E. efect vasodilatator

$F LXQHDWURPEROLWLFXOXLVHSURGXFHvQWUHXUPWRDUHOHHOHPHQWH A. plasminogen B. tPA &SODVPLQ ILEULQ E. chinine

56. 7URPEROLWLFHOHXWLOL]DWHvQSUH]HQWvQLQIDUFWXODFXWVXQW A. alteplaza B. tenecteplaza C. fondaparinux D. streptochinaza E. inhibitorii glucoproteinei IIb/IIIa

7UDWDPHQWXOWURPEROLWLFHVWHLQGLFDWvQ A. infarctul miocardic cu supradenivelare ST vQSULPHOHRUH %RULFHLQIDUFWPLRFDUGLFDFXWvQSULPHOHRUH C. orice infarct miocardic acut indiferent de timpul scurs de la debut LQIDUFWXOPLRFDUGLFDFXWFXRFFDUGLRJHQ E. infarctul miocardic acut cu stop cardiac resuscitat

7URPEROL]DVHHIHFWXHD]LvQDOWHDIHF LXQL $HPEROLDSXOPRQDUFXWXOEXUDUHKHPRGLQDPLF %WURPER]DRFOX]LYDXQHLSURWH]HYDOYXODUH

36

C. accidentXO YDVFXODU FHUHEUDO LVFKHPLF vQ SULPHOH RUH OD FDUH V-a exclus KHPRUDJLDLQWUDFUDQLDQ D. orice accident vascular cerebral (RFOX]LDXQXLFDWHWHUYHQRVFHQWUDOFXFDPHU

&RQWUDLQGLFD LLOHDEVROXWHDOHWUDWDPHQWXOXLWURPEROLWLFVXQW $PDOIRUPD LHYDVFXODUFHUHEUDOVDXWXPRULQWUDFUDQLDQ %WUDXPDWLVPVDXLQWHUYHQ LHFKLUXUJLFDOPDUHFXYHFKLPH]LOH &VkQJHUDUHJDVWUR-LQWHVWLQDOFXYHFKLPHOXQ FRDJXORSDWLHFXQRVFXW (YkUVWD!DQL

&RQWUDLQGLFD LLOHUHODWLYHDOHWUDWDPHQWXOXLWURPEROLWLFVXQWFXRH[FHS LH A. hemoragia cerebromeningee cu vechime > 1 an %VDUFLQDLSHULRDGDSRVWSDUWXPVSWPkQD C. hipertensiunea arteriala > 180 mm Hg FLUR]DKHSDWLF (HQGRFDUGLWDLQIHF LRDV

Heparinele 61. Efectul anticoagulanWDOKHSDULQHLQHIUDF LRQDWHVHGDWRUHD]EORFULLIDFWRULORU

$IDFWRUXO,,DEORFKHD]DF LXQHDWURPELQHL B. factorul V C. factorul IXa D. factorul Xa E. factorul XIa

+HSDULQHOH FX JUHXWDWH PROHFXODU PLF DX HIHFW DQWLFRDJXODQW SULQ EORFDUHDfactorilor: A. blocarea factorului IIa B. blocarea factorului Xa (raportul factor IIa/Xa este de 1/3) C. blocarea factorului V D. blocarea factorului VII, (QLFLXQHIHFWSHIDFWRULLHQXPHUD L

7UDWDPHQWXOFXKHSDULQQHIUDF LRQDWHVWHLQGLFDWvQXUPWRDUHOHVLWXD LL $SUHYHQ LDWURPERIOHELWHLSURIXQGHLDHPEROLHLSXOPRQDUH B. tratamentul tromboflebitei profunde C. tratamentul emboliei pulmonare VLQFRS (GLVIXQF LDQRGXOXLVLQXVDO

37

7UDWDPHQWXOFXKHSDULQQHIUDF LRQDWHVWHLQGLFDWvQXUPWRDUHOHVLWXD LL $DFFLGHQWXOYDVFXODUFHUHEUDOLVFKHPLFGHRULJLQHHPEROLF %SURWH]YDOYXODUPHFDQLF &VLQFRS D. Sindrom coronarian acut cu ST+ E. Sindrom coronarian acut cu ST-

65. Trecerea de la tratamentul cu heparine, la tratamentul cu anWLYLWDPLQ . VHHIHFWXHD]GXSFXPXUPHD]

$ SUHFRFH vQ ]LXD VDX ]LXD GDF H[LVW QHFHVLWDWHD WUDWDPHQWXOXLanticoagulant prelungit % VH FRQWLQX DGPLQLVWUDUHD KHSDULQHL vQ GR] HILFLHQW SkQ FkQG ,15 HVWH vQ]RQDWHUDSHXWLF &VHRSUHWHDGPLQLVWUDUHDKHSDULQHLFkQGVHvQFHSHDGPLQLVWUDUHDDQWLYLWDPLQHL. VHRSUHWHDGPLQLVWUDUHDKHSDULQHLFkQG,15HVWHHILFLHQW ( WUDWDPHQWXO FX DQWLYLWDPLQD . VH SRDWH vQFHSH OD XQ LQWHUYDO GH RUH VDX ]LOHGXSWUDWDPHQWXOFXKHSDULQ

Antivitamine K 66*. AnWLYLWDPLQHOH . IDPLOLH GH PHGLFDPHQWH DX HIHFW DQWLFRDJXODQW UHGXFkQGVLQWH]DKHSDWLFDXUPWRULORUIDFWRULGHSHQGHQ LGHYLWDPLQD.FXRH[FHS LH

A. factorul II (protrombina) B. factorul V C. factorul VII (proconvertina) D factorul X (Stuart) E. factorul IX (antihemofilic B)

67. Antivitaminele K (familie de medicamente) au efect anticoagulant prin mecanism complex:

$UHGXFVLQWH]DKHSDWLFDSURWHLQHORU&L6DQWLFRDJXODQWH %UHGXFVLQWH]DIDFWRULORUGHFRDJXODUHGHSHQGHQ LGHYLWDPLQD. C. inWHUIHUHD]FXPHGLFDPHQWHFDUHLQIOXHQ HD]WUDQ]LWXOLQWHVWLQDO LQWHUIHUHD]FXPHGLFDPHQWHFDUHVHPHWDEROL]HD]vQILFDW E. reduc agregarea trombocitelor

XUDWDWUDWDPHQWXOXLDQWLFRDJXODQWFXDQWLYLWDPLQH.HVWHGLIHULWvQIXQF LHGH A. localizarea trombozei venoase profunde % FRQGL LLOH GH DSDUL LH IDFWRU GH ULVF WUDQ]LWRULX FKLUXUJLH WUDXPDWLVPLPRELOL]DUHWUDWDPHQWKRUPRQDOHWFSHQWUXHPEROLHSXOPRQDU C. asocierea tromboflebitei profunde sau a emboliei pulmonare cu cancer D. timpul GHUH]ROX LHDOWURPERIOHELWHLSURIXQGH (UHFXUHQ DWURPERIOHELWHLSURIXQGHVDXDHPEROLHLSXOPRQDUH

38

)DFWRULLGHULVFWURPERHPEROLFODSXUWWRULLGHSURWH]HYDOYXODUHVXQW $ vQORFXLUH YDOYXODU FX SURWH] PHFDQLF vQ SR]L LD PLWUDO WULFXVSLG Vau SXOPRQDU %DQWHFHGHQWHGHHPEROLHDUWHULDOFHUHEUDOPHPEUHOHLQIHULRDUH &IUDF LDGHHMHF LHD96 YkUVWD (DWULXOVWkQJGLODWDW!PP

7UDWDPHQWXOFXDQWLYLWDPLQH.HVWHFRQWUDLQGLFDWODSDFLHQ LLFX A. proteze valvulare biologice %SDFLHQ LFXFDWHWHUFHQWUDO &VDUFLQVDXDOSWDUH KHPRUDJLHvQFXUV (LQWHUYHQ LHFKLUXUJLFDOUHFHQWSHFUHLHUVDXRFKL

QWLPSXOWUDWDPHQWXOXLFXDQWLYLWDPLQH.VHYHULILF $HILFLHQ DSULQGHWHUPLQDUHD,15 %SUREHOHKHSDWLFHLUHQDOH C. hemograma inclusiv trombocitele D. glicemia E. lipidele

Antiagregante plachetare $JUHJDUHDSODFKHWDUVHSRDWHDFWLYDSHXUPWRDUHOHFL

A. prin sinteza prostaglandinelor, prin intermediul ciclooxigenazei B. prin sinteza adenozin-GLIRVIDWXOXLvQmembranele celulare C. prin activarea receptorilor GP IIb/IIIa prin fibrinogen D prin intermediul vitaminei K E prin intermediul factorilor proteinelor C, S

$VSLULQDDUHXUPWRDUHOHHIHFWH $LQKLEFLFORR[LJHQD]D B. reduce sinteza de prostaglandine, C. reduce sinteza factorilor de coagulare la nivelul ficatului, D. reduce sinteza de tromboxan, (UHGXFHVLQWH]DGHILEULQ

,QGLFD LLOHDVSLULQHLVXQW $VLQGURPXOFRURQDULDQDFXW67L67- B. post infarct acut &DQJLQVWDELO D. accident vascular cerebral E. embolii arteriale

39

,QGLFD LLOHWUDWDPHQWXOXLFXLQKLELWRULGH*3,,E,,,DVXQW A. sindrom coronarian acut ST + cu tromb masiv B. sindromul coronarian ST- cu risc crescut &DQJLRSODVWLHFRURQDULDQGLILFLO D. post by pass aorto-coronarian (SRVWLPSODQWGHSURWH]YDOYXODU

40

5VSXQVXULFRUHFWH

1) B 2) A,B,C, 3) A, B, C, D 4) A, B, D, E 5) A, B 6) A, B, C, D 7) A, C, D, E 8) A, D, E 9) A, C 10) A, B, C, E 11) A, B, D, E 12) A, C, D, E 13) C 14) A, B, C, D 15) A, B, C, D 16) D 17) E 18) A, E 19) A, B, D 20) B, C, D, E 21) D 22) A, C 23) B 24) A, D, E 25) B, C, D 26) A, E 27) B, C, D, E 28) C 29) A, C 30) B 31) A, B 32) A, D, E 33) C 34) A, B, C, D 35) B, C, E 36) C, D 37) A 38) B, D, E 39) B, E 40) B 41) C 42) B, D, E

43) C 44) C 45) A, B, E 46) A, B, C, D 47) A, B, C, E 48) B 49) A, B, C 50) A, B, D, E 51) A, B, C, D 52) A, B, C, D 53) B, C, D, E 54) B 55) A, B, C, D 56) A, B, D 57) A 58) A, B, C, E 59) A, B, C, D 60) A, 61) A, C, D, E 62) A, B 63) A, B, C 64) A, B, D, E 65) A, B, D 66) B 67) A, B, C, D 68) A, B, C, E 69) A, B, C, E 70) C, D, E 71) A, B, C 72) A, B, C 73) A, B, D 74) A, B, C, D 75) A, B, C

41

CARDIOLOGIE 2

*1. Criteriile majore Duke pentru diagnosticul endocarditei bacteriene: a. Hemoculturi pozitive b. Predispozitii genetice c. )HEU!& d. Fenomene imunologice e. Anevrism micotic

7UDWDPHQWXOHQGRFDUGLWHLEDFWHULHQHSHSURWH]VHIDFHFX

a. Vancomicina b. Rifampicina c. Aminozide d. Toate de mai sus e. 1LFLXQUVSXQVFRUHFW

*3. Profilaxia endocarditei bacteriene se face cu:

a. J$PR[LFLOLQS.o. b. J$PR[LFLOLQSR c. J$PR[LFLOLQLY d. QFD]GHDOHUJLHODDPR[LFLOLQVHXWLOL]HD]FOLQGDPLFLQPJLY e. QFD]GHDOHUJLHODDPR[LFLOLQVHXWLOL]HD]FOLQGDPLFLQJSR

7UDWDPHQWXOFKLUXUJLFDOVHUHFRPDQGGHXUJHQWODSDFLHQWXOFXHQGRFDUGLW

EDFWHULDQvQ a. ,QVXILFLHQWFDUGLDFVHYHUVHFXQGDUXQHLUHJXUJLWULPDVLYH b. ,QVXILFLHQWDRUWLFIUVHPQHFOLQLFHGHLQVXILFLHQWFDUGLDF c. (QGRFDUGLWIXQJLF d. (QGRFDUGLWFXPLFURRUJDQLVPHPXOWLUH]LVWHQWH e. Vegetatii

42

d. 6 luni e. 1LFLXQUVSXQVFRUHFW

$XXQULVFULGLFDWGHHQGRFDUGLWEDFWHULDQSDFLHQWLLFX

a. 3URWH]YDOYXODU b. $QWHFHGHQWHGHHQGRFDUGLWLQIHFWLRDV c. Cardiopatii congenitale operate cu succes d. %LFXVSLGLHDRUWLF e. 3URODSVGHYDOYPLWUDO

*86XSUDGHQLYHODUHDGH67FRQFDYvQVXVIUVHPQHvQRJOLQGvQWkOQLPvQ

a. Sindromul coronarian acut b. Infarctul miocardic c. 3HULFDUGLW d. 0LRFDUGLW e. 7XOEXUULGHFRQGXFHUH

5HGXFHUHDIUHFYHQWHLFDUGLDFHvQILEULODWLDDWULDOVHSRDWHIDFHFX

a. Digitalice b. Betablocante c. Antagonisti calcici dihidropiridinici d. $PLRGDURQ e. 1XHVWHQHFHVDUFRQWUROXOIUHFYHQHLFDUGLDFH

7DKLFDUGLDYHQWULFXODUVXVWLQXWDUHRGXUDWGHSHVWH

a. 60s b. 30s c. 1 minut d. 2 minute e. 60 minute

)UHFYHQWDDFWLYLWWLLDWULDOHvQIOXWWHU-ul atrLDOHVWHvQPRGRELVQXLWGH

a. 150 b. 300 c. 600 d. 250 e. 90

3HHOHFWURFDUGLRJUDPH[WUDVLVWROHOHYHQWULFXODUH

a. Sunt precedate de unda P b. 5HSUH]LQWGHSRODUL]DUHYHQWULFXODUHSUHFRFHODUJ c. 1XVXQWSUHFHGDWHGHXQG3 d. 3RWILRUJDQL]DWHvQGXEOHWHWULSOHWHVDOYH e. PHVWH(69VHYRUEHWHGHVSUHWDKLFDUGLHYHQWULFXODU

43

&DX]HGHH[WUDVLVWROHYHQWULFXODUHVLWDKLFDUGLHYHQWULFXODU a. 5HYUVDWSHULFDUGLF b. &DUGLSDWLHLVFKHPLF c. 6WLPXODUHDGUHQHUJLF d. XSPHGLFDPHQWHGLJLWDOD e. Toate de mai sus

QEORFXO$9GHJU,I de tip 1 (Wenckebach), blocarea undelor P se face:

a. Intermitent b. XSDOXQJLUHDSURJUHVLYDLQWHUYDOXOXL35 c. Undele P nu sunt blocate d. Nu apar unde P e. Undele P sunt total disociate de undele R

(OHFWURFDUGLRJUDPDvQEORFXOGHUDPXUGUHDSWDUDW

a. QRS > 120ms vQFD]GHEORFFRPSOHW b. 565vQ9 c. 6ODUJvQ,,,D9)99 d. Aspect Q1S3 e. 565vQ9

0HGLFDPHQWHFHSRWGHWHUPLQDWXOEXUULGHFRQGXFHUH$9

a. Betastimulatorii b. Digitala c. Imipraminice d. Inhibitori ai canalelor de calciu bradicardizanti e. betablocante

* $QWLDULWPLFHGHUHFRPDQGDWvQSUHYHQWLDUHFLGLYHORUGHILEULODWLHDWULDOHOD

YkUVWQLFLLFXSDWRORJLHFDUGLDFVHYHU a. Sotalol b. Dronedarona c. Flecainida d. Amiodarona e. Metoprolol

&ODVLILFDUHDvQIXQFWLHGHGXUDWDGHHYROXWLHDXQXLDFFHVGHILEULODWLHDWUiala:

a. 3DUR[LVWLF b. 3HUVLVWHQW c. 3HUPDQHQW d. 6XEDFXW e. &URQLF

44

(OHFWURFDUGLRJUDPDvQILEULODWLDDWULDO a. Absenta activitatii electrice atriale organizate b. Ritm neregulat c. Complex QRS intotdeauna ingust d. Ritm ventricular regulat e. Unde P prezente

*20. Etiologia insuficientei aortice ELIDWLUVSXQVXOLQFRUHFW

a. Sifilis b. Bicuspidia c. HJHQHUDWLY d. 5HXPDWLVPDO e. 0HGLFDPHQWRDV

*21. Coronarografia, in cadrul bilantului preoperator al insuficientei aortice, nu este

LQGLFDWOD a. Barbat > 40ani b. Femei tinere c. Suspiciune de cardiopatie ischemica d. Pacienti cu cel putin un factor de risc cardiovascular e. )HPHLODPHQRSDX]

0HGLFDWLDGHSULPLQWHQWLHvQLQVXILFLHQWDDRUWLFHVWHFX

a. IEC b. Nitrate c. Betablocante d. Digitala e. Blocante de calciu

,QVXILFLHQWDPLWUDOIXQFWLRQDOSUesupune:

a. Fuziunea comisurilor b. Dilatarea inelului mitral c. Defect de coaptare a valvelor prin tractiunea de cordaje d. 9DOYHVLFRUGDMHvQJURVDWH e. Valve calcificate

24. Caracteristicile bolii Barlow sunt:

a. Clickul mezosistolic b. Suflul telesistolic c. Etiologia reumatLVPDO d. Afectarea valvei aortice e. 3UH]HQWDXQHLFRPXQLFULLQWHUYHQWULFXODUH

45

*25. Aria VWHQR]HLDRUWLFHVWUkQVHHVWH a.

46

$XVFXOWDWLDvQVWHQR]DDRUWLF a. VHIDFHvQLQVSLU b. VHIDFHvQH[SLU c. suflul este aspru d. LUDGLD]ODQLYHOXOYDVHORUJkWXOXL e. VHDXGHvQPH]RVLVWRO

6HPQHOHIXQFWLRQDOHGHVWHQR]DRUWLFVXQW

a. DQJLQ b. sincop c. dispnee d. YUVWXUL e. SDOSLWD LL

8UPWRDUHOHDILUPDWLLGHVSUHHQGRFDUGLWDLQIHFWLRDVVXQWIDOVH

D%DFLOLLJUDPQHJDWLYLGHWHUPLQPDULGLVWUXFWLLtisulare E)HEUDHVWHvQWRWGHDXQDSUH]HQW F/DWR[LFRPDQLFHOPDLIUHFYHQWHVWHDIHFWDWYDOYDWULFXVSLG G$QWLELRWHUDSLDVHLQVWLWXLHGHXUJHQWvQDLQWHDUHFROWULLSUREHORUSHQWUX

KHPRFXOWXU H7UDWDPHQWXOLPSOLFDQWLELRWHUDSLHvQGR]HSXWHUQLFHLYEDFWHULFLG

)DFWRULGHSURJQRVWLFQHJDWLYSHQWUXHQGRFDUGLWVXQW

DYkUVWDDQL b. soc septic FHQGRFDUGLWFXIXQJL GGLDJQRVWLFFXvQWkU]LHUH e. teren debilitat

3HQWUXHQGRFDUGLWDSRVLELOVXQWQHFHVDUH

a. 2 criterii majore b. 1 criteriu major + 1 criteriu minor c. 3 criterii minore d. 5 criterii minore e. 1 criteriu major + 3 criteriu minore

7UDWDPHQWXOFKLUXUJLFDODOHQGRFDUGLWHLDUHXUPWRDUHOHLQGLFDWLLKHPRGLQDPLFH

a. EPA masiv b. soc FLQVXILFLHQWFDUGLDF GLQIHFWLHQHFRQWURODW HWRDWHUVSXQVXULOHVXQWFRUHFWH

47

3HUVLVWHQWDIHEUHLGXS]LOHGHWUDWDPHQWDQWLbiotic instituit pentru endocardita LQIHFWLRDVDUHXUPWRDUHOHFDX]H

a. anevrism micotic b. tratament antibiotic neadaptat c. abces paravalvular GSHULFDUGLW e. complicatii embolice

38. Semnul Musset:

DVHvQWkOQHVWHvQLQVXILFLHQWDDRUWLF b. este pUH]HQWvQFD]XOVWHQR]HLPLWUDOH FUHSUH]LQWEDODQVDUHDFDSXOXLODILHFDUHEWDLHFDUGLDF GUHSUH]LQWGXEOXVXIOXLQWHUPLWHQWFUXUDO HQLFLXQUVSXQVQXHFRUHFW

,QVXILFLHQWDPLWUDODFXWHVWHGHWHUPLQDWGH

DUXSWXUGHFRUGDMH b. sindromul Ehler-Danlos FPL[RPDODWULXOXLVWkQJ GGLVIXQFWLHLVFKHPLFDSLOLHULORU e. sclerodermie

40. Boala Barlow:

DSRDWHHYROXDFXLQVXILFLHQWDRUWLF ESRDWHHYROXDFXLQVXILFLHQWPLWUDO FDXVFXOWDWLDHVWHQRUPDO GDXVFXOWDWLDSHUFHSHvQPRGFODVLc un click mezosistolic urmat de suflu telesistolic HVXIOXOSRDWHILKRORVLVWROLFvQFD]GHLQVXILFLHQWPLWUDOLPSRUWDQW

41. Complicatiile insuficientei mitrale sunt:

DILEULODWLDDWULDO EHQGRFDUGLWEDFWHULDQ FLQVXILFLHQWFDUGLDFVWkQJ d. blocuri atrio-ventriculare HPRDUWHVXELWSULQWXOEXUULGHULWPYHQWULFXODUH

8UPWRDUHOHDILUPDWLLVXQWDGHYUDWH

DELFXVSLGLDDRUWLFVHDVRFLD]IUHFYHQWFXGLODWDUHDDRUWHLDVFHQGHQWH EVWHQR]DDRUWLFGHWHUPLQKLSHUWURILHGHWLSFRQFHQWULc FVXSUDIDWDQRUPDODYDOYHLDRUWLFHGHDSUR[LPDWLYFP2 GKLSSXVSXSLODUVHvQWkOQHVWHvQLQVXILFLHQWDDRUWLF

48

HVXIOXOGLQLQVXILFLHQWDPLWUDOHVWHGLDVWROLFvQMHWGHYDSRULFHLUDGLD]vQD[LO

8UPWRDUHOHDILUPDWLLVXQWDGHYUDWHGHVSUe complexul QRS, cu exceptia:

D456PPVHvQWkOQHVWHvQFD]GHPL[HGHPVLUHYUVDWSHULFDUGLF b. S din V1 + R din V5/V6 t PPVHPQLILFRKLSHUWURILHYHQWULFXODUVWkQJ FXQGHOH4VXQWIL]LRORJLFHvQD95 GDOXQJLUHDGXUDWHLFRPSOH[XOXL456VHvQWkOQHVWHvQEORFXULGHUDPXUVDX

preexcitatie HGXUDWDQRUPDOHVWHVXEPV

8QGHOH4GHQHFUR]VHFDUDFWHUL]HD]SULQ

a. amplitudine t 30% din cea a undei R b. durata t 40 ms c. repartizarea pe un teritoriu coronarian d. amplitudine t 50% din cea a undei R HQLFLXQUVSXQVFRUHFW

49

RASPUNSURI:

1) A 2) D 3) A 4) A 5) A,E 6) A 7) A,B 8) C 9) A,B 10) B 11) B 12) B,C,D,E 13) E 14) B 15) A,B 16) B,C,D,E 17) D 18) A,B,C 19) A,B 20) E 21) B 22) A,E

23) B,C 24) A,B 25) B 26) B 27) C 28) B 29) B 30) B 31) B,C,D,E 32) A,B,C,E 33) B,D 34) B,C,D,E 35) B,C 36) A,B,C 37) A,B,C,E 38) A,C 39) A,D 40) B,D,E 41) A,B,C,E 42) A,B,C,D 43) B 44) A,B,C

50

CARDIOLOGIE 3

3(5,&$5,7$$&87 3HULFDUGLWDDFXWLPSOLFREOLJDWRULX

$SUH]HQ DXQXLOLFKLGSHULFDUGLF %LQIODPD LDODQLYHOXOSHULFDUGXOXL &DSDUL LDXQHLSHULFDUGLWHFRQVWULFWLYH DSDUL LDKHPRSHULFDUGXOXL (DEVHQ DXQXLOLFKLGSHULFDUGLF

2. CompliFD LLOHSHULFDULFDUGLWHLDFXWHVXQWXUPWRDUHOH

A. hemopericard %WDPSRQDGDFDUGLDF &SHULFDUGLWDFURQLFFRQVWULFWLY D. miocardiopericardita E. sindrom febril

XUHUHDSHULFDUGLFVHFDUDFWHUL]HD]SULQ

$HVWHGHVFXUWGXUDW %FHGHD]OD inpirul profund &FHGHD]ODWXVH LQVHQVLELOODWULQLWULQ (FDOPDWvQSR]L LDH]kQG

)UHFWXUDSHULFDUGLFVHFDUDFWHUL]HD]SULQ

A. zgomot constant %]JRPRWYDULDELOvQWLPS &VHDXGHPDLELQHvQRUWRVWDWLVP SHUVLVWvQDSQHH E. disSDUHvQDSQHH

&DUHGLQXUPWRDUHOHPRGLILFUL(&*VXQWSUH]HQWHvQSHULFDUGLWDFXW

A. negativarea undelor T B. aplatizarea undelor T C. subdenivelate de segment ST concav D. supradenivelarea segmentului PQ (WXOEXUULGHULWPDWULDO

6. Care dLQXUPWRDUHOHPRGLILFUL(&*VXQWSUH]HQWHvQSHULFDUGLWDFXW

$WDKLFDUGLHVLQXVDO %DPSOLWXGLQHDFRPSOH[XOXL456PDLPLFGHFkWPP &DPSOLWXGLQHDFRPSOH[XOXL456PDLPLFGHFkWPP DOWHUQDQ HOHFWULF (EUDGLFDUGLHVLQXVDO

51

0RGLILFUL UDGLRORJLFHvQSHULFDUGLWDDFXWVXQW $UHYUVDWSOHXUDO %DVSHFWXOGHFRUGvQFDUDI C. aspect normal radiologic D. buton aortic calcificat (FDOFLILFULSOHXUDOH

&DX]DFHDPDLIUHFYHQWGHSHULFDUGLWDFXWHVWH

A. post-infarct B. tuberculoza &YLUDO PL[HGHPDWRDV (QHRSOD]LF

&DX]HUDUHGHSHULFDUGLWDFXWVXQW

$LQVXILFLHQ UHQDO %LQVXILFLHQ KHSDWLF C. reumatism articular acut D. boala Hodgkin (RADIOTERAPIA DIN LH) (SHULFDUGLWDSXUXOHQW

RASPUNSURI:

1) B 2) B,C,D 3) D,E 4) B,D 5) A,B,E 6) A,B,D 7) A,B,C,E 8) C 9) A,C,D,E

52

3$72/2*,$$257(,$57(5(/253(5,)(5,&(,3$72/2*,$9(12$6$0(0%5(/25,1)(5,2$5( 1. 3ULQWUHHWLRORJLLOHUDUHDOHDQHYULVPXOXLGHDRUWDEGRPLQDO$$$VHQXPU

A. boala Marfan B. boala Takayasu C. aterosecleroza D. boala Elher-Danlos E. hipertensiunea arterial

2. )DFWRULLGHULVFLPSOLFD LvQDSDUL LDDQHYULVPXOXLGHDRUWDEGRPLQDOVXQW A. sexul feminin B. sexul masculin C. fumatul D. KLSHUWHQVLXQHDDUWHULDO E. diabetul zaharat

3. *([DPHQXOFHOPDLVLPSOXGHGHSLVWDUHLGLDJQRVWLFDUHvQXUJHQ DDQHYULVPHORUGHDRUWDEGRPLQDOHHVWHUHSUH]HQWDWGH

A. RMN B. CT abdominal C. Aortografia D. (FRJUDILDDEGRPLQDO E. (QGRVFRSLDVXSHULRDU

4. &7DEGRPLQDOvQERDODDQHYULVPDO

A. SHUPLWHPVXUDUHDGLPHQVLXQLLDQHYULVPXOXL B. YL]XDOL]HD]WURPEXOLQWUD-anevrismal C. DSUHFLD]JUDGXOGHFDOFLILFDUHDOSHUHWHOXLDRUWLF D. vQORFXLHWH,50vQFD]GHLQVXILFLHQ UHQDO E. QXSUH]LQWQLFLXQLQWHUHV

5. 3ULQWUHFRPSOLFD LLOHDQHYULVPXOXLGHDRUWDEGRPLQDOVHQXPU A. ruptura B. JUHIDEDFWHULDQ C. emboliile D. compresiile E. LQVXILFLHQ DFDUGLDF

6. *&DUHGLQWUHXUPWRDUHOHDILUPD LLSULYLQGUXSWXUDDQHYULVPXOXLGHDRUW

DEGRPLQDOvQGXRGHQHVWHDGHYUDW A. HVWHRFRPSOLFD LHIRDUWHUDU B. VHvQVR HWHGHGXUHULDEGRPLQDOHLKHPRUDJLHGLJHVWLYLQIHULRDUPLQLP C. HVWHRFRPSOLFD LHIUHFYHQW D. se vQVR HWHGHHGHPHDOHPHPEUHORULQIHULRDUH

53

E. HVWHDFRPSDQLDWGHVLQGURPEOXHWRH 7. &RPSUHVLLOHDQHYULVPHORUGHDRUWDEGRPLQDOHSRWILODQLYHOXO

A. venei cave inferioare B. venei cave superioare C. duodenului D. aparatului urinar E. traiectelor nervoase

8. Compresiile GXRGHQDOHDOHDQHYULVPXOXLGHDRUWDEGRPLQDOVHSRWPDQLIHVWD

prin: A. KLGURQHIUR] B. edeme periferice C. FROLFUHQDO D. YUVWXUL E. WXOEXUULGHWUDQ]LW

9. &DUHGLQWUHXUPWRDUHOHUHSUH]LQWLQGLFD LLGHWUDWDPHQWvQDQHYULVPXOGHDRUW

DEGRPLQDO A. anevrism cu evolu LHUDSLG B. anevrism cu diametrul de sub 2cm C. anevrism simptomatic D. anevrism cu diametrul mai mare sau egal de 5cm E. anevrism cu semne de compresie

10. Riscurile tehnicii de arteriografie Seldinger sunt:

A. HPEROLDGLVWDO B. HPEROLJD]RL C. emboli de colesterol D. fals anevrism E. KHPDWRPODORFXOSXQF LHL

11. &DUHGLQWUHXUPWRDUHOHDILUPD LLSULYLQGPVXUDUHDWUDQVFXWDQDWDSUHVLXQLLvQ

R[LJHQHVWHDGHYUDW A. VHLQGLFvQVWDGLLOHGHLVFKHPLH,,,VL,9/HULFKH)RQWDLQH B. VHLQGLFvQVWDGLXOGHLVFKHPLH,/HULFKH)RQWDLQH C. o valoaUHFXSULQVvQWUHLPP+JWUDGXFHSUH]HQ DXQHLKLSR[LL

continue D. o valoare peste 35mmHg este dovada unei hipoxii critice E. VHLQGLFvQDSUHFLHUHDLQVXILFLHQ HLYHQRDVHFURQLFH

54

12. *&DUHGLQWUHXUPWRDUHOHDILUPD LLSULYLQGIL]LRSDWRORJLDLVFKHPLHLDFXWH a PHPEUHORUHVWHIDOV

A. LVFKHPLDSURYRDFOL]FHOXODU B. LVFKHPLDSURYRDFDOFDOR]PHWDEROLF C. LVFKHPLDSURYRDFHOLEHUDUHGHSRWDVLXLQWUDFHOXODU D. LVFKHPLDSURYRDFKLSHUNDOLHPLH E. LVFKHPLDSURYRDFHOLEHUDUHGHLRQL+

13. Printre semnele clinice caracteristicHLVFKHPLHLDFXWHGHPHPEU8VHQXPU

A. PHPEUXFDOGWXPHILDWURX B. membru rece, palid apoi cianotic C. VFXUWDUHDWLPSXOXLGHUHFRORUDUHFXWDQDW D. DOXQJLUHDWLPSXOXLGHUHFRORUDUHFXWDQDW E. pulsuri prezente

14. *&DUHGLQWUHXUPWRDUHOHUHSUH]LQWPHFDQLVPHHPEROLFH ale ischemiei acute de

membru: A. GLVHF LDSRVWFDWHWHULVP B. phlegmatia cerulae C. arterita Behcet D. arterita Horton E. VWHQR]DPLWUDO

15. 3ULQWUHFDX]HOHFDUGLDFHLPSOLFDWHvQPHFDQLVPXOHPEROLFGHDSDULWLHDO

LVFKHPLHLDFXWHGHPHPEUXVHQXPU A. VWHQR]DPLWUDO B. fibrila LDDWULDO C. endocardita D. mixomul atrial E. EORFXOPDMRUGHUDPXUVWkQJ

16. 6HPQHOHQHXURORJLFHLQGLFDWRDUHGHJUDYLWDWHvQLVFKHPLDDFXWGHPHPEUXVXQW

A. hiperestezia B. anestezia C. hipoestezia D. deficitul motor E. WXOEXUULWURILFHFXWDQDWH

17. %LODQ XOSUHRSHUDWRUFODVLFvQLVFKHPLDDFXWGHPHPEUHFXSULQGH

A. grupa sanguina B. UDGLRJUDILHWRUDFLF C. examen Astrup D. FXWDUHDGHDQWLFRUSLDQWLWURPERFLWDUL E. KHPRJUDP

55

18. QFD]GHLVFKHPLHDFXWGHPHPEUXVHVXVSLFLRQHD]HPEROLHSHDUWHUHVQWRDVHvQID DXUPWRDUHORUFDUDFWHULVWLFL

A. isFKHPLHVHYHUIUDQF B. debut subacut C. abolirea celorlalte pulsuri D. numerosi factori de risc cardiovasculari E. debut brutal

19. *$EROLUHDFHORUGRXSXOVXULIHPXUDOHVHPQLILF A. REVWUXF LHLOLDFVDXIHPXUDOFRPXQ B. ocluzie a arterelor gambei C. REVWUXF LHDDUWHUHLSRSlitee D. REVWUXF LHDELIXUFD LHLDRUWLFH E. REVWUXF LHDIHPXUDOHLVXSHUILFLDOH

20. (PEROHFWRPLDFXVRQG)RJDUW\

A. DERUGHD]VXEDQHVWH]LHWULXQJKLXOOXL6FDUSD B. HVWHGHHOHF LHvQSUH]HQ DOH]LXQLORUDWHURPDWRDVH C. HVWHGHSUHIHUDWvQFD]GHREVWUXF LHvQDOW D. este uWLOvQWUDWDPHQWXOHPEROLLORUSHDUWHUHVQWRDVH E. se poate complica cu leziuni ale peretelui

21. &DUHGLQWUHXUPWRDUHOHDILUPD LLSULYLQGVLPSDWHFWRPLDvQWUDWDPHQWXOEROLLDWHURPDWRDVHVXQWDGHYUDWH

A. VHLQGLFvQGXUHULGHGHFXELWFX,6! B. se utilizea]vQSUDFWLFODELIXUFD LDIHPXUDOHL C. VHLQGLFvQWXOEXUULWURILFHOLPLWDWH D. HVWHSX LQXWLOL]DW E. VHSRDWHFRPSOLFDFXGHJHQHUHVFHQ GHJUHIRQ

22. ,QGLFD LLOHWHUDSHXWLFHvQVWDGLXO,DOFODVLILFULL/HULFKH)RQWDLQHVXQW

A. managementul factorilor de risc B. tratamentul medicamentos cu antiagregant+statine+IECA C. KHSDULQHFXJUHXWDWHPROHFXODUPLF D. ELODQ PXOWLIRFDORGDWODDQL E. chirurgie de revascularizare

23. 6HSUHWHD]ODSRQWDMSULQSURWH]DFURQVDXYHQVDIHQXUPWRDUHOHVLWXD LL

A. VWHQR]HFRPSOH[HvQWLQVHFXGLODWDUHDQHYULVPDO B. stenoze neaccesibile angioplastiei C. LVFKHPLHFULWLFIUJHVWGHUHYDVFXODUL]DUHSRVLELO D. VWHQR]HVWUkQVHSUR[LPDOHXQLFHSX LQFDOFLILFDWH E. WXOEXUUWURILFHOLPLWDWH

56

24. *Gestul cel mai important al managementului ischemiei acute de membru este: A. tratamentul analgezic B. protejarea membrului inferior ischemic C. vQOWXUDUHDREVWDFROXOXLDUWHULDO D. heparinoterapie E. WHUDSLHDQWLDJUHJDQWSODFKHWDU

25. *&DUHGLQWUHXUPWRDUHOHDILUPD LLSULYLQGDQHYULPXOGHDRUWDEGRPLQDOHVWH

IDOV A. aterosclHUR]DHVWHUHVSRQVDELOGHSHVWHGLQWUHDQHYULVPH B. ODH[DPHQXOFOLQLFDSDUHFDRPDVSXOVDWLOH[SDQVLYLQGRORUFXVXIOX C. VHPQXOH%DNH\WUDGXFHSR]L LDVXEKHSDWLFDDQHYULVPXOXL D. FHODWHURVFOHURWLFHVWHPDLIUHFYHQWODEUED L E. HVWHvQJHQHUDODV\mptomatic

26. LDJQRVWLFXOGLIHUHQ LDODOLVFKHPLHLFURQLFHGHPHPEUHvQSUH]HQ DFODXGLFD LHL

intermitente se face cu: A. anevrismul arterial B. FRDUFWD LDGHDRUW C. VWHQR]DDRUWLF D. FDQDOORPEDUVWUkPW E. FODXGLFD LDPHGXODU

27. QFD]XOLVFKHPLHLFULWLFHGHPHPEUXWDEORXOFOLQLFFXSURJQRVWLFORFDOL

general negativ este definit prin: A. dureri de decubitus B. JDQJUHQHSLFLRUGHJHWHGHFHOSX LQ]LOH C. WHQVLXQHDUWHULDOVLVWROLFVXEPP+JODJOH]Q D. WHQVLXQHDUWHULDOVLVWROLFVXEPP+JODKDOXFH E. WHQVLXQHDUWHULDOVLVWROLFVXEPP+JODJOH]Q

28. 6LQGURPXOGHILVXUDUHUHWURSHULWRQHDODDQHYULVPXOXLGHDRUWDEGRPLQDOVH

PDQLIHVWSULQ A. colaps moderat B. dureri abdominale spontane C. PDVEDWDQWGXUHURDVODSDOSDUH D. radiculagie E. sindrom de "blue toe"

29. Durerile de decubituVGLQDUWHULRSDWLDFURQLFREOLWHUDQWDPHPEUHORULQIHULRDUH

LPSXQGLDJQRVWLFGLIHUHQ LDOFX A. FDUGLRSDWLDKLSHUWHQVLY B. QHXURSDWLDGLDEHWLF C. SROLQHYULWDDOFRROLF

57

D. FDQDOORPEDUVWUkPW E. QHIURSDWLDGLDEHWLF

30. Arteriografia, angio-&7LVDXDQJLR-RMN sunt sistePDWLFUHDOL]DWHvQFD]GH

A. ischemie stadiul I Leriche B. ischemie stadiul III Leriche C. vQDLQWHGHUHYDVFXODUL]DUH D. ischemie de efort E. ischemie stadiul IV Leriche

31. InsuficieQ DYHQRDVFURQLFDUHSULQWUHIDFWRULLIDYRUL]DQ L

A. 7URPERIOHELWDVXSHUILFLDO B. Obezitatea C. ,PRELOL]DUHDSUHOXQJLW D. 9kUVWD E. Sarcina

32. *Varicele : A. 6XQWGHWHUPLQDWHGHLQVXILFLHQWDYHQRDVFURQLF B. $SDUGDWRULWXQRUWURPER]HVXSHUILFLDOH C. Sunt mai frecvente la femei D. 6XQWRDQRPDOLHDQDWRPLFDXQHLDVDXPDLPXOWRUYHQHVXSHUILFLDOH E. 1XGHWHUPLQQLFLRGDWLQVXILFLHQ YHQRDVFURQLF

33. ,QVXILFLHQ DYHQRDVFURQLF

A. 6HDVRFLD]vQWRWGHDXQDFXREVWUXF LHYHQRDV B. $IHFWHD]QXPDLVLVWHPXOYHQRVSURIXQG C. (VWHRGLVIXQF LHDLVWHPXOXLYHQRVSULQLQFRQWLQHQ YDOYXODU D. 3RDWHDIHFWDLVLVWHPXOYHQRVVXSHUIicial E. (VWHvQWRWGHDXQDGREkQGLW

34. 5H HDXDYHQRDVSURIXQG

A. (VWHVDWHOLWDUWHUHORU B. (VWHIRUPDWGLQYHQHOHVDIHQLQWHUQLH[WHUQ C. 1XDUHDQDVWRPR]HFXUH HDXDVXSHUILFLDO D. &RQ LQHHWDMXOVXUDOIHPXUDOLLQJKLQDO E. 1XHVWHVDWHOLWDUWHUHORU

35. *Venele perforante :

A. )DFSDUWHQXPDLGLQUH HDXDYHQRDVVXSHUILFLDO B. 5HSUH]LQWDQDVWRPR]DvQWUHFHOHGRXUH HOHYHQRDVH C. $SDUQXPDLvQLQVXILFLHQ DYHQRDVFURQLF D. &RPXQLFFXYHQHOHFRPXQLFDQWH E. Sunt satelite arterelor

58

36. Returul venos este asigurat prin : A. IncontiQHQ DYDOYXOHORU B. 3RPSDPXVFXODUVXUDO C. LODWDUHDYHQRDV D. $SVDUHDEROWHLSODQWDUH E. 3UHVLXQHDUH]LGXDODUH HOHLYHQRDVH

37. 0HFDQLVPXOSDWRORJLFvQLQVXILFLHQ DYHQRDVFURQLFHVWHUHSUH]HQWDWGH

A. 3UHVLXQHDQHJDWLYJHQHUDWGHUHVSLUD LH B. &RQWLQHQ DYDOYXOelor C. LVWUXF LDYDOYXOHORU D. ,QIODPDUHORFDODVRFLDWFXKLSR[HPLDWLVXODU E. 3RPSDPXVFXODUFUXUDO

38. Agenezia venelor profunde :

A. (VWHPDLIUHFYHQWODIHPHL B. HWHUPLQDSDUL LDYDULFHORUVHFXQGDUH C. Este un defect congenital D. 1XGHWHUPLQDSDUL LDYDULFHORU E. SuQWVHFXQGDUHGLVWUXF LHLYDOYXODUH

39. QLQVXILFLHQ DYHQRDVFURQLFPDQLIHVWULOHFOLQLFHVXQWUHSUH]HQWDWHGH

A. Mialgii de efort B. 3LHUGHUHDSLOR]LW LLPRGLILFULDOHXQJKLLORU C. -HQvQRUWRVWDWLVP D. 3DUHVWH]LLDOHJDPEHORUFDUHVHDPHOLRUHD]ODPLFDUe E. 6HQ]D LDGHWHJXPHQWHUHFL

40. /DH[DPHQXOIL]LFvQWU-RLQVXILFLHQ YHQRDVFURQLFVHSRDWHHYLGHQ LD

A. ,QFRQWLQHQ DYDOYXODUSULQWHKQLFD6FKZDUW] B. 3DORDUHDWHJXPHQHORUGXSHIRUWLH[SXQHUHODIULJ C. (GHPXQHRULvQVR LWGHLQVXILFLHQ OLPIDWLF D. TulbXUULWURILFHWHJXPHQWDUH E. Varice

41. 7XOEXUULWURILFHIUDXOFHUDSDUvQ A. ,QVXILFLHQ DYHQRDVFURQLFFODVD B. ,QVXILFLHQ DYHQRDVFURQLFFODVD C. 1XDSDUvQLQVXILFLHQ DYHQRDVFURQLF D. ,QVXILFLHQ DYHQRDVFURQLFFODVD E. ,QVXILFLHQ DYHQRDVFURQLFFODVD

59

42. (FRJUDILDRSSOHUYHQRDVDPHPEUHORULQIHULRDUHHVWHQHFHVDU A. Pentru diagnosticul varicelor B. ,QFD]XOSUH]HQ HLXOFHUHORUPELQI C. QWURPERIOHELWHOHVXSHUILFLDOH D. 3HQWUXXQELODQ SUHVFOHUR] E. Pentru confirmarea unei tromboze venoasa

43. Flebitele superficiale :

A. 6XQWFRPSOLFD LLDOHXQHLLPRELOL]ULSUHOXQJLWH B. Au semnul Homans pozitiv C. 6HQXPHVFLSDUDIOHELWH D. $SDUvQPRGIL]LRORJLFFXYkUVWD E. 3UH]LQWXQFRUGRQYHQRVLQGXUDW

44. &RPSOLFD LLOHLQVXILFLHQ HLYHQRDVHFURQLFHVXQW

A. Rupturi de varice B. *DQJUHQXVFDW C. (F]HPFXSUXULW D. *DQJUHQXPHG E. 3DUDIOHELW

45. * Teleangectaziile :

A. Sunt leziuni eritemato-scuamoase B. Sunt zone nevasculare C. Au sediu perimaleolar D. 6XQWGLODWULDOHSOH[XOXLYHQRVGLQGHUPXOVXSHUILFLDO E. $SDUGDWRULWLQIODPD LHL HVXWului celular subcutanat

46. Ulcerul varicos :

A. Este unic B. Are margini netede C. Este de mici dimensiuni D. Este localizat pe laba piciorului E. $IHFWHD]LQL LDOSXOSDGHJHWHORU

47. 7XOEXUULOHWURILFHGLQLQVXILFLQ DYHQRDVFURQLFVXQWUHSUH\HQWDWHGH

A. $QKLGUR] B. Leziuni eritemato-scuamoase C. Aspect marmorat al tegumentelor D. HUPLWRFU E. Teleangectazii

60

48. QLQVXILFLHQ DYHQRDVFURQLFVHLQGLF A. Tratament antiagregant B. 9DFFLQDUHDQWLWHWDQLF C. &RERUkUHDPHPEUXOXLLQIHULRU D. Mersul pe jos E. Ortostatism prelungit

61

RASPUNSURI:

1) A,B,D 2) B,C,D,E 3) D 4) A,B,C 5) A,B,C,D 6) A 7) A,C,D,E 8) D,E 9) A,C,D,E 10) A,C,D,E 11) A,C 12) B 13) B,D 14) E 15) A,B,C,D 16) B,C,D,E 17) A,B,C,E 18) A,E 19) D 20) A,C,D,E 21) A,C,D 22) A,D 23) A,B 24) C 25) C 26) A,B,D,E 27) A,B,E 28) A,B,C 29) B,C 30) B,C,E 31) B,D,E 32) D 33) C,D 34) A,D 35) B 36) B,D 37) C,D 38) B,C 39) A,C,D 40) A,C,D,E 41) E 42) B,D,E

43) C,E 44) A,C,E 45) D 46) A,B 47) B,D,E 48) B,D

62

,168),&,(1$&$5,$& 1. QLQVXILFLHQ DFDUGLDFVHSRWDGPLQLVWUD

a) IECA sau ARA II. b) Diuretice tiazidice. c) Blocante calcice. d) Beta-blocante. e) Antialdosteronice.

2. (WLRORJLDLQVXILFLHQWHLFDUGLDFHSULQWXOEXUULDOHIXQF LHLGHSRPS

a) 6WHQR]DRUWLFFRDUFWD LHGHDRUWD b) Cardiomiopatie hipertrofica obstructiva. c) Diabet zaharat. d) Lupus sistemic. e) Insuficienta mitrala acuta sau cronica.

3. In insuficienta cardiaca NYHA III:

a) Nici o limitare a activitatii fizice. b) Dispnee ca urmare a activitatii obisnuite, chiar usoare. c) Dispnee ca urmare a activitatii fizice importante. d) Fara jena in repaus. e) Limitare franca a activitatilor.

4. Digitalicele in insuficienta cardiaca:

a) Nu modifica prognosticul, dar raman utilizabile ca antihipertensive daca hipertensiunea persista in ciuda diureticelor, a IECA si a -blocantelor.

b) Nu amelioreaza mortalitatea, dar reduce frecventa spitalizarilor. c) Indicate in caz de fibrilatie atriala permanenta cu transmiterea

ventriculara rapida in context de insuficienta cardiaca sau insuficienta cardiaca refractara (std. IV) in ciuda unui tratament maximal.

d) (IHFWHOHORUDVRFLD]DRYDVRGLODWDWLHDUWHULDOD;DSRVWVDUFLQLLVLRYDVRGLODWYHQRDVD;SUHVDUFLQLL

e) Se pot da in caz de trombi endocavitari.

5. Etiologia I.C. diastolice: a) Hipertrofie miocardica (HTA, stenoza Ao, CMHO). b) Cardiopatie ischemica. c) Cardiopatie restrictiva. d) Tireotoxicoza. e) Pericardita constrictiva.

6. Edeme unilaterale, prin obstacol de intoarcere venoasa se pot intalni in:

a) Tromboflebita. b) Erizipel. c) Filarioza.

63

d) Insuficienta cardiaca. e) Metastaza ganglionara a unui cancer.

7. Contraindicatii Diuretice tiazidice:

a) HTA, edeme de origine renala, hepatica sau cardiaca. b) Insuficienta renala cronica c) Tulb. hidro-electrolitice necorectate (hiponatremie100mmHg:

a) Repaus la pat, pozitie semisezanda, picioare atarnate. b) Oxigenoterapie nazala. c) Diuretice cu actiune lent a pe cale orala, diuretice tiazidice. d) Diuretice cu actiune rapida pe cale i.v.: Furosemid ~ 1mg/kg pentru a se

obtine o diureza/24h de ~ 2-3 l. e) Amine cu activitate inotropa: Dobutamina.

9. Transplantul cardiac contraindicatii:

a) Varsta: 40-45 de ani. b) Insuficienta cardiaca refractara sub tratament maximal. c) Neoplazie. d) Varsta>60-65 de ani. e) Insuficienta hepatica sau renala.

10. In Insuficienta cardiaca clasa NYHA III se pot administra:

a) IECA si/sau ARA II. b) -blocante. c) Diuretice tiazidice. d) Diuretice de ansa (in caz de semne congestive). e) Digitalice.

11. Factori de prognostic negative in Insuficienta cardiaca:

a) stdadiul III/IV NYHA. b) Varsta inaintata. c) FEVS normala. d) FEVS prabusita. e) Tulburari ventriculare de ritm.

12. Tulburarile functiei de pompa apar in:

a) Miocardita b) Persistenta canal arterial c) Insuficienta aortica si mitrala acuta

64

d) Boli de sistem : LES e) Diabet

13. Insuficienta ventriculara dreapta: care din afirmatiile de mai jos enumerate

sunt corecte: a) Apare in stenoza aortica stransa b) Apare in stenoza mitrala stransa c) Apare in HTA d) Apare in infarctul miocardic de ventricul drept e) Apare in displazie aritmogena de VD

14. Insuficienta cardiaca cu debit crescut nu apare in:

a) Hipertiroidism b) Anemie cronica c) Hipotiroidism d) Carenta de vitamina B6 e) Boala Paget.

15. *Stadalizarea NYHA este folosita pentru:

a) Hipertensiunea arteriala b) Insuficienta circulatorie venoasa c) Hipercolesterolemie d) Infarctul miocardic e) Insuficienta cardiaca.

16. Ascultatia cardiaca in cadrul insuficientei cardiace releva urmatoarele:

a) Bradicardie b) Galop c) Zgomotul 1 accentuat in focarul aortic d) Zgomotol 2 accentuat in focarul pulmonar e) Tahicardie.

17. *Restrictia hidrica in cazul de hiponatremie de diluatie este:

a) 1000 ml/zi b) 100-200 ml/zi c) 2000 ml/zi d) < 500-750 ml/zi e) 100-1500 ml/zi.

18. IECA in tratamentul insuficientei cardiace: afirmatii corecte:

a) Tratament de referinta in insuficienta cardiaca stanga b) Preventie remodelare ventriculara c) Reduce mortalitatea prin vasoconstrictie arteriala si venoasa d) Se vor da in doze descrescatoare

65

e) Betablocantele sunt indicate in caz de intoleranta la IEC.

19. Betablocantele afirmatii eronate: a) Reduce mortalitatea cardio vasculara b) Se introduc in acelasi timp cu IECA si diuretice c) Cresc numarul de spitalizari d) Cresc numarul de morti subite e) Amelioreaza jena functionala

20. Resincronizarea ventriculara prin implantare de pacemaker tricameral

afirmatii corecte: a) Insuficienta cardiaca clasa NYHA I/II b) Insuficienta cardiaca clasa NYHA III/IV c) FEVS 35-40 % d) QRS larg (> sau egal 120 m/s) e) QRS < sau egal 120 m/s

21. Defibrilatorul implantabil afirmatii corecte: a) Stop cardiac prin FV sau TV fara cauza acuta sau reversibila b) TV sau FV in faza acuta a unui sindrom coronarian acut necesita

implantare defibrillator c) Stop cardiac prin fibrilatie atriala necesita implantare defibrilator d) TPSV nu necesita defibrilator implantabil e) Toate afirmatiile sun corecte

22. Insuficienta ventriculara dreapta poate fi determinate de:

a) Miocardita virala. b) Cordul pulmonar cronic. c) Displazie aritmogena de ventricul drept. d) Tahiaritmii supraventriculare (Fibrilatie atriala). e) Stenoza mitrala stransa.

23. Insuficienta cardiaca cu debit crescut apare in:

a) Carenta de tiamina. b) In tromboembolismul pulmonar. c) Hipertiroidism. d) Bronhopneumopatia obstructiva cronica. e) Hipertensiune arteriala pulmonara.

24. In insuficienta cardiaca:

a) Intarirea zgomotului II in focarul pulmonar este dovada unei HTAP asociate.

b) Ralurile sibilante nu pot apare in examinarea unui pacient cu semne si simptome de insuficienta ventriculara stanga.

66

c) Clasa NYHA III denota o limitare franca a activitatilor fizice. d) Edeme ale membrelor inferioare sunt caracteristice pentru insuficienta

cardiaca stanga. e) Edemul pulmonar acut este manifestarea clinica cea mai severa a

insuficientei ventriculare stangi.

25. Indicatiile de resincronizare ventriculara prin implant de pacemaker tricameral sunt:

a) Insuficienta cardiaca clasa NYHA III-IV sub tratament medical optim. b) Pacientul care a supravietuit unei morti subite cardiace. c) )UDFWLDGHHMHFWLHDYHQWULFXOXOXLVWDQJ d) Prezenta blocului de ramura stanga. e) Dilatare marcata a VS (DTDVS>45mm/m2).

26. 0HFDQLVPHOHFRPSHQVDWRULLODQLYHOFDUGLDFLQLQVXILFLHQ DFDUGLDFVXQW

a) Tahicardie b) 6FDGHUHDIUDF LHLGHHMHF LH c) &UHVWHUHDIUDF LHLGHHMHF LH d) LODWDUHDYHQWULFROXOXLVWkQJ e) +LSHUWURILDYHQWULFXOXOXLVWkQJ

27. 0HFDQLVPHOHFRPSHQVDWRULLODQLYHOSHULIHULFLQLQVXILFLHQ DFDUGLDFVXQW

a) $FWLYDUHDDGUHQHUJLF b) $FWLYDUHDVLVWHPXOXLUHQLQ-DQJLRWHQVLQ-aldosteron c) Activarea factorului natriuretic atrial d) Inhibarea simpaticului e) Dilatarea ventriculului stang

28. &DX]HGH,QVXILFLHQ FDUGLDFFXGHELWFUHVFXWVXQW:

a) Hipertiroidismul b) $QHPLDFURQLF c) 6WHQR]DDRUWLF d) &DUHQ DGHWLDPLQYLW% e) Diabet

29. &DX]HGHLQVXILFLHQ FDUGLDFSULQVXSUDLQFUFDUHGe presiune:

a) +LSHUWHQVLXQHDDUWHULDO b) Lupus sistemic c) 3HULDUWHULWDQRGRDV d) &DUGLRPLRSDWLDKLSHUWURILFREVWUXFWLY e) 6WHQR]DDRUWLF

67

30. &DX]HGH,QVXILFLHQ YHQWULFXODUGUHDSWD a) ,QVXILFLHQ DYHQWULFXODUVWDQJHYROXDW b) 6WHQR]PLWUDOVWUkQV c) Cordul pulmonar cronic d) Feocromocitom e) Infarct miocardic de ventricul drept

31. ,QVXILFLHQ DFDUGLDFFODVD1

68

36. &DUHDILUPD LLVXQWDGHYUDWH a) BNP

69

d) ,QGLFD LHGHGLXUHWLFHFRQRPLVLWRUGHSRWDVLXLQWUDWDPHQWXOGHIRQGDOLQVXILFLHQ HLFDUGLDFH

e) 7UDWDPHQWXOGHUHIHULQ DOLQVXILFLHQ HLFDUGLDFHVWQJL

42. 7UDWDPHQWXOIDUPDFRORJLFDO,QVXILFLHQ HLFDUGLDFHFXSULQGH a) Diureticele b) IECA c) Betablocante d) Inotroape negative e) Digitala

43. Care medicamente reduc mortalitatea cardio-vasculara:

a) Diureticele b) IECA c) HULYD LLQLWUD LL d) Digitala e) Betablocante

44. 7UDWDPHQWXOQHIDUPDFRORJLFDO,QVXILFLHQ HLFDUGLDFHFXSULQGH

a) Resincronizare ventriculara b) Defibrilator implantabil c) $VLVWHQ FLUFXODWRULH d) Transplantul cardiac e) Valvuloplastie in caz de valvulopatii usoare

45. &DX]HGH,QVXILFLHQ FDUGLDFDGLDVWROLF

a) +LSHUWURILDPLRFDUGLF b) 3HULFDUGLWDFRQVWULFWLY c) Cardiopatii restrictive d) &DUGLRSDWLDLVFKHPLF e) +LSRWHQVLXQHDDUWHULDOVWHQR]DPLWUDOD

46. ,Q(GHPXOSXOPRQDUDFXWFX7$V!PP+JVHUHFRPDQG

a) Oxigenoterapie b) Betablocante c) Hidratare d) Furosemid e) HULYD L QLWUD L

47. ,Q(GHPXOSXOPRQDUDFXWFX7$VPP+JVHUHFRPDQG

a) Oxigenoterapie b) REXWDPLQ c) Furosemid d) HULYD LQLWUD L

70

e) Betablocante

48. ,Q,QVXILFLHQ DFDUGLDF1

71

REZULTATE:

1. A,C,D,E 2. ABE 3. BDE 4. BC 5. ABCE 6. ABCE 7. BCDE 8. ABD 9. CDE 10. ABDE 11. ABDE 12. BC 13. B,D,E 14. CD 15. E 16. BDE 17. D 18. AB 19. BCD 20. BD 21. AD 22. BCE 23. AC 24. ACE 25. AD 26. ADE 27. ABC 28. ABD 29. ADE 30. ABCE 31. BCD 32. A 33. ABCD 34. ABCD 35. ADE 36. DE 37. D 38. BCDE 39. D, E 40. ABC 41. ABCD 42. ABCE

43. ABE 44. ABCD 45. ABCD 46. ADE 47. ABC 48. AD 49. ACE

72

+,3(57(16,81($$57(5,$/ 1. +7$HVWHGHILQLWSULQWU-o:

a) TA VLVWROLF -PP+J7$GLDVWROLF -99 mm Hg b) 7$VLVWROLFPP+J7$GLDVWROLFPP+J c) 7$VLVWROLF -PP+J7$GLDVWROLF -109 mm Hg d) 7$VLVWROLF!PP+J7$GLDVWROLF!PP+J e) 7$VLVWROLFPP+J7$GLDVWROLFPP+J

2. 3UHYDHQD+7$HVHQLDOHVWHGLQFD]XUL a) 10 b) 15 c) 25 d) 90 e) 80

3. 8UPWRULLQXVXQWIDFWRULGHULVFFDUGLR-vasculari:

a) 9kUVWDDQLODEUEDW b) 9kUVWD!DQLODIHPHLH c) Tabagismul d) ,QIDUFWPLRFDUGLFvQDLQWHGHYkUVWDGHDQLODRUXGGHJUDG, de sex

masculin e) Colesterolul seric < 100mg/dl

4. Semne clinice ale HTA:

a) ,QIDUFWPLRFDUGLFDQJRUUHYDVFXODUL]DUHFRURQDU b) ,QVXILFLHQFDUGLDFFRQJHVWLY c) 3DQFUHDWLWDFXW d) 5HWLQRSDWLHDYDQVDWKHPRUDJLLVDXH[XGDWHHGHPSDSLODU e) Proteinurie < 30 mg/24h

5. Printre sfaturile igieno-GLHWHWLFHDOHWUDWUDPHQWXOXL+7$HVHQLDOHVXQW

a) Limitarea aportului de sare (5-6g/zi) b) Sedentarismul c) 7UDWDPHQWXOFHORUODOLIDFWRULGHULVF d) &UHWHUHDFRQVXPXOXLGHOLSLGHVDWXUDWH e) 1RUPDOL]DUHDJUHXWLL

6. Tratamentul medicamentos dHEXWHD]

a) Cu o monoterapie sau biterapie cu doze mici pentru fiecare medicament b) QFD]GHSHUVLVWHQD+7$GXSUHVSHFWDUHDUHJXOLORULJLHQR-dietetice c) LQVWDUWvQFD]GHULVFFDUGLR-vascular crescut d) Cu administrare de alfa-EORFDQWHLDQWLKLSHUWHQVRDUHFentrale e) Cu administrare de diuretice sau beta-blocante sau IECA

73

7. +LSHUWHQVLXQHDDUWHULDOFXULVFFDUGLR-vascular crescut este: a) HTA de gradul III b) HTA de gradul I c) QFD]GHSUH]HQDGLDEHWXOXL]DKDUDWLVDX6LQGURP0HWDEROLF d) $IHFWDUHDGHRUJDQLQW e) QFD]GHERDOFDUGLR-YDVFXODUVDXUHQDO

8. Dintre cele 5 clase terapeutice de medicamente antihipertensive utilizate de prima

intentie fac parte: a) Diureticele b) Alfa-blocantele c) Beta-blocantele d) IECA e) Antihipertensoarele centrale

9. 0HGLFDPHQWHOHDQWLKLSHUWHQVLYHXWLOL]DWHvQD GRXDLQWHQLHVXQW

a) Alfa-blocantele b) Antihipertensivele centrale c) Diureticele d) IECA e) Sartani

10. 0HGLFDPHQWHOHDQWLKLSHUWHQVLYHUHFRPDQGDWHvQVDUFLQ

a) Metildopa b) Labetalolul c) Inhibitori calcici d) Beta-blocantele e) Diureticele

11. +7$VHFXQGDUVHYDDYHDvQYHGHUHvQXUPWRDUHOHVLWXDLL

a) Falsa HTA, HTA de halat alb b) +7$ODVXELHFWXOWkQU c) +7$UHVLWHQ d) +7$FXDSDULLHVDXDJUDYDUHUDSLG e) +7$ODSDFLHQWXOFXVWHQR]VWUkQVGHDUWHUUHQDOXQLODWHUDOVDX

ELODWHUDO

12. +7$VHFXQGDULDWURJHQSRDWHDSUHDGXSFRQVXPGH a) Simpaticomimetrice/vasoconstrictoare nazale b) ,QKLELWRULGHSRPSGHSURWRQL c) Corticoizi d) Inhibitori de receptori H2 +LVWDPLQHUJLFL5DQLWLGLQHWF e) Estroprogestative

74

13. +7$VHFXQGDUSRDWHDSUHDGXSXUPWRDUHOHWR[LFH a) Alcool b) &RFDLQ c) $PIHWDPLQ d) 0XFWXUDGH insecte e) 9HQLQXOGHDUSH

14. &DUHGLQXUPWRDUHOHQHIURSDWLLSRWGXFHOD+7$VHFXQGDU

a) *1$L,5$ b) GNC c) /LWLD]DUHQDO d) PNA e) 1HIURSDWLLLQWHUVWLLDOHFURQLFH

15. +7$UHQRYDVFXODU

a) $SDUHODSDFLHQLLFXVWHQR]GHDUWHUUHQDOXQLODWHUDOVDXELODWHUDO b) $UHFDL FDX]HDWHURVFOHUR]DPDLUDUILEURGLVSOD]LDGLVHFLDVDXVWHQR]D

SRVWWUDXPDWLF c) 3RDWHDSUHDDVLPHWULHGHGLPHQVLXQHDULQLFKLORU d) Apare un suflu lombar sau paraombilical e) 7UDWDPHQWXOFRQVWvQDGPLQLVWUDUHGH,(&$GDFVWHQR]DDUWHUUHQDO

ELODWHUDO

16. Q )HRFURPRFLWRPvQWkOQLP a) 7XPRUFXFHOXOHFURPDWRILQHFDUHVHFUHWJOXFRFRUWLFRL]L b) Triada: cefalee-WUDQVSLUDLL-SDOSLWDLL c) R]DUHDPHWDQHIULQHORULQRUPHWDQHIULQHORUXULQDUHSHRUH d) Dozarea cortizolului plasmatic e) Tratament chirugical suba alfa- LEHWD- blocante

17. $OWHFDX]HGH+7$VHFXQGDUVXQW

a) &RDUFWDLDGH$RUW b) Neoplasmul de colon transvers c) Boala Cushing d) +LSHUWURILDGHSURVWDW e) Hiperparatiroidia

18. &DX]DGH+7$VHFXQGDUVXQW

a) Acromegalia b) &RDUFWDLDGHDRUW c) Neoplasmul mamar d) Hipertiroidismul e) Boala Cushing

75

19. 5VXQHWXOYLVFHUDOvQ+7$PDOLJQVHPQLILF a) AVC, encefalopatie b) Eclampsie c) &DUGLRSDWLDKLSHUWHQVLY d) 1HIURSDWLDKLSHUWHQVLYUHWLQRSDWLDKLSHUWHQVLY e) 1HIURDQJLRVFOHUR]PDOLJQ

20. &UL]DDFXWKLSHUWHQVLYVHPQLILF

a) &UHWHUHDEUXWDOD7$SHVWHPP +J 7$VLVWROLFLVDXR7$GLDVWROLFPP+J

b) &UHWHUHDEUXWDOD7$SHVWHPP+J 7$VLVWROLFLVDX7$GLDVWROLFPP+JODXQSDFLHQWGHRELFHLQRUPRWHQVLY

c) 7$!PP+JvQVRLWGHVXIHULQYLVFHUDO d) 7$!PP+JvQVRLWGHUHWLQRSDWLHKLSHUWHQVLYVHYHU e) TA = 140/85 mm Hg

21. +7$PDOLJQVHPQLILF

a) &UL]DFXW