Emergency care for acute diseases and injuries of the nervous system, and in psychiatry

Question number 1. The degree of oppression of consciousness includes (find the wrong answer):

1. stun;

2. sopor;

3. coma;

& 4. delirium;

Question number 2. The Glasgow scale is used to evaluate:

& 1. level of oppression of consciousness;

2. severity of shock;

3. severity of respiratory disorders in coma;

4. state of the newborn.

Question number 3. The signs assessed on the Glasgow scale include (find the wrong answer):

1. the patient’s ability to speak;

2. the patient’s ability to open his eyes;

& 3. patient’s ability to breathe spontaneously;

4. motor reactions of the patient.

Question number 4. Sopor on the Glasgow scale corresponds to a score equal to:

fifteen;

2.7;

& 3.9;

4.13.

Question number 5. Coma according to the Glasgow scale corresponds to a score equal to (find the wrong answer):

thirteen;

2.5;

3.7;

& 4.9.

Question number 6. Hyperventilation of the lungs (spontaneous or associated with artificial ventilation) is accompanied by (find the wrong answer):

1. hypocapnia;

& 2. expansion of cerebral vessels;

3. reduction of cerebral edema;

4. decrease in cerebral blood flow.

Question number 7. The corneal reflex is inhibited when:

1. damage to the brain stem;

2. damage to the cerebellum;

3. meningeal syndrome;

& 4. Dyscirculatory encephalopathy.

Question number 8. Normal pupil diameter under normal lighting is approximately equal to:

1. 0.5mm;

2. 1-1.5mm;

3. 2-2.5mm;

& 4. 3-4mm

Question number 9. With anisocoria, one-sided is revealed:

& 1. pupil dilation or contraction;

2. decrease or increase in the reaction of the pupil to light;

3. decrease in the corneal reflex;

4. drooping of the eyelid.

Question number 10. Unilateral sharp pupil dilation with loss of reaction to light in a patient in a coma indicates (find the wrong answer):

& 1. atropine intoxication;

2. growth of intracranial hematoma in traumatic brain injury;

3. growth of intracranial hematoma in case of rupture of cerebral aneurysm;

4. acute dislocation syndrome in brain tumors.

Question number 11. A symptom of herniated brainstem syndrome is (find the wrong answer):

1. progressive oppression of consciousness;

& 2. narrow pupils with preserved reaction to light;

3. convulsive syndrome;

4. tendency to bradycardia.

Question number 12. The rational volume of therapy for the ambulance team in identifying signs of herniation of the brain stem is:

1. urgent hospitalization in the intensive care unit of the nearest hospital without additional medical measures;

2. urgent hospitalization in the intensive care unit of a neurosurgical hospital without additional medical measures;

& 3. use of a laryngeal tube, artificial lung ventilation in hyperventilation mode, urgent hospitalization in the intensive care unit of a neurosurgical hospital;

4. intravenous administration of lasix, the introduction of respiratory analeptics (caffeine, cordiamine) and oxygen therapy in case of respiratory failure, urgent hospitalization in the intensive care unit of a neurosurgical profile.

Question number 13. The complex of therapeutic measures for the prevention or treatment of cerebral edema includes (find the wrong answer):

1. adequate respiratory support (oxygen therapy or mechanical ventilation);

& 2. Intravenous Lasix;

3. intravenous administration of magnesium sulfate;

4. transporting the patient with the head end of the stretcher raised at an angle of 30 degrees.

Question number 14. Cerebral symptoms include (find the wrong answer):

1. headache;

2. vomiting;

3. dizziness;

& 4. anisocoria.

Question number 15. Focal neurological symptoms include (find the wrong answer):

& 1. oppression of consciousness;

2. anisocoria;

3. dissociation of tendon reflexes;

4. hemiparesis.

Question number 16. A disorder of higher cortical functions is:

1. anisocoria;

& 2. aphasia;

3. nystagmus;

4. central paralysis.

Question number 17. Peripheral paralysis manifests itself (find the wrong answer):

& 1. violation of voluntary movements while maintaining involuntary;

2. decreased muscle tone;

3. areflexia;

4. fibrillar muscle twitching.

Question number 18. Central paralysis manifests itself (find the wrong answer):

& 1. violation of all types of movements;

2. spastic increase in muscle tone;

3. the appearance of pathological reflexes;

4. the appearance of defensive movements.

Question number 19. Bulbar palsy manifests itself (find the wrong answer):

1. fibrillar twitching of the tongue;

2. violation of swallowing;

3. blurred speech and nasality;

& 4. increased gag reflex.

Question number 20. Bulbar paralysis is accompanied by (find the wrong answer):

1. botulism;

2. brain tumor;

& 3. violation of cerebral circulation in the basin of the middle cerebral arteries;

4. myasthenia.

Question number 21. Pseudobulbar palsy manifests itself (find the wrong answer):

1. violation of swallowing and hoarseness of voice;

2. symptoms of oral automatism;

& 3. paroxysms of violent laughter and crying;

4. disappearance of the pharyngeal reflex.

Question number 22. The defeat of the cerebellum manifests itself (find the wrong answer):

1. imbalance;

2. horizontal nystagmus;

3. “scanned” speech;

& 4. anisocoria.

Question number 23. Extrapyramidal disorders are manifested (find the wrong answer):

1. muscle rigidity;

2. hypokinesis;

3. hyperkinesis;

& 4. general hyperesthesia.

Question number 24. An acutely developed unilateral positive Babinsky symptom is detected when:

& 1. cerebral hemispheres on the opposite side;

2. cerebral hemispheres on the same side;

3. cerebellum;

4. brain stem.

Question number 25. Meningeal syndrome manifests itself (find the wrong answer):

1. severe headache combined with vomiting;

2. general hyperesthesia;

3. stiff neck;

& 4. unilateral positive Babinski’s sign.

Question number 26. Positive Kernig’s sign

1. bending the head with bringing the chin to the chest;

& 2. extension of the lower leg with the thigh bent at a right angle to the body;

3. pressure on the pubic joint;

4. raising the straightened leg at the knee joint.

Question number 27. In the event of a seizure at the prehospital stage, the following is used:

& 1. relanium;

2. caffeine;

3. lidocaine;

4. ketolorac.

Question number 28. The drug used to stop the convulsive status at the prehospital stage is (find the wrong answer):

1. diazepam;

& 2. aminofillin;

3. sodium hydroxybutyrate;

4. hexenal.

Question number 29. If it is impossible to stop the convulsive status at the prehospital stage with traditional drugs (diazepam, sodium oxybutyrate), the following is used:

1. caffeine;

2. 40% glucose solution:

& 3. listenone;

4. lidocaine.

Question number 30. Expanded convulsive seizure in epilepsy manifests itself (find the wrong answer):

1. generalized tonic and clonic convulsions;

& 2. maintaining a clear mind during and after a seizure;

3. involuntary urination;

4. injuries after a fall.

Question number 31. Myasthenic crisis manifests itself (find the wrong answer):

& 1. miosis;

2. sharply increasing muscle weakness;

3. tendency to tachycardia;

4. respiratory failure.

Question number 32. Myasthenic crisis is stopped by the introduction:

1. atropine;

& 2. prozerin;

3. caffeine and cordiamine;

4. naloxone.

Question number 33. Subarochnoid hemorrhage manifests itself (find the wrong answer):

1. sudden onset headache, often following physical exertion;

& 2. high fever at the very beginning of the disease;

3. tachycardia, sweating, nausea, vomiting;

4. meningeal symptoms.

Question number 34. Hemorrhagic stroke manifests itself (find the wrong answer):

& 1. slow increase in cerebral symptoms;

2. inconsistency of focal symptoms with a specific vascular pool;

3. vomiting;

4. arterial hypertension.

Question number 35. If you suspect a rupture of an aneurysm of the cerebral vessels or a hemorrhagic stroke at the prehospital stage, you must enter:

1. reopoliglyukin;

2. lasix;

& 3. antihypertensive drugs for systolic blood pressure above 170 mm Hg;

4. aminocaproic acid;

Question number 36. If a rupture of an aneurysm of the cerebral vessels or a hemorrhagic stroke is suspected, the minimum level of systolic blood pressure, the excess of which is an indication for antihypertensive therapy at the prehospital stage, is:

1. 130 mm Hg;

2. 150 mm Hg;

& 3. 170 mmHg;

4. 200 mmHg

Question number 37. Ischemic stroke caused by cerebral embolism manifests itself (find the wrong answer):

1. acute development of focal symptoms simultaneously with loss of consciousness;

2. correspondence of focal symptoms to a certain vascular pool;

& 3. meningeal symptoms;

4. normal or low blood pressure;

Question number 38. Ischemic stroke caused by cerebral thrombosis or cerebrovascular insufficiency manifests itself (find the wrong answer):

1. the gradual appearance of cerebral symptoms, followed by the addition of focal symptoms;

2. correspondence of focal symptoms to a certain vascular pool;

& 3. meningeal symptoms;

4. normal or low blood pressure;

Question number 39. The volume of prehospital therapy for ischemic stroke includes the introduction of:

& 1. neuroprotective drugs;

2. antihypertensive drugs for systolic blood pressure above 150 mm Hg

3. diuretics;

4. aminocaproic acid.

Question number 40. The minimum level of systolic blood pressure, the excess of which in ischemic stroke is an indication for antihypertensive therapy at the prehospital stage is:

1. 150 mm Hg;

2. 170 mm Hg;

& 3. 200 mmHg;

4. 220 mmHg

Question number 41. In acute cerebrovascular accident, neuroprotectors at the prehospital stage are used (find the wrong answer):

1. magnesium sulfate

2. mexidol;

& 3. piracetam;

4. glycine.

Question number 42. Violation of cerebral circulation in the basin of the carotid arteries manifests itself (find the wrong answer):

1. a sharp weakening or absence of pulsation on the internal carotid artery on the side of the lesion;

& 2. meningeal symptoms;

3. hemiparesis on the side opposite to the vascular lesion;

4. impaired vision on the side of the lesion.

Question number 43. Insufficiency of cerebral circulation in the vertebrobasilar system manifests itself (find the wrong answer):

1. dizziness;

2. loss of balance;

3. vomiting;

& 4. meningeal symptoms.

Question number 44. A sign that distinguishes occlusion of the lower segment of the abdominal aorta from ischemia in the lower vascular basin of the spinal cord is:

1. lower paraplegia;

2. conduction disturbance of sensitivity;

3. dysfunction of the pelvic organs;

& 4. lack of pulsation on the arteries of the lower extremities;

Question number 45. A sign of secondary radicular syndrome in the cervical spine is (find the wrong answer):

1. local pain;

2. irradiation to the upper limb;

& 3. neck stiffness;

4. spastic torticollis.

Question number 46. The differential diagnosis of secondary radicular syndrome in the thoracic spine at the prehospital stage is more appropriate to carry out with (find the wrong answer):

1. pleurisy;

2. shingles;

3. acute coronary syndrome;

& 4. pancreatitis.

Question number 47. With secondary radicular syndrome in the lumbar spine with severe pain syndrome, the paramedic of the ambulance must (find the wrong answer):

1. make a differential diagnosis with renal colic;

2. conduct anesthesia with non-steroidal anti-inflammatory drugs;

& 3. perform paravertebral novocaine blockade;

4. to hospitalize a patient with acute motor and sensory disorders in the lower extremities.

Question number 48. A concussion manifests itself (find the wrong answer):

1. headache, nausea. vomiting;

2. an episode of loss of consciousness;

3. retrograde amnesia;

& 4. focal neurological symptoms.

Question number 49. A sign that distinguishes a brain contusion from a concussion is:

1. loss of consciousness;

& 2. presence of focal neurological symptoms;

3. severe headache and vomiting;

4. nystagmus.

Question number 50. The detection of anisocoria in traumatic brain injury indicates (find the wrong answer):

1. brain injury;

2. subdural hematoma;

3. epidural hematoma;

& 4. concussion.

Question number 51. The progression of cerebral edema with impaired vital functions in patients with severe traumatic brain injury at the prehospital stage is an indication for:

& 1. tracheal intubation or laryngeal tube insertion and hyperventilation;

2. intravenous drip of 5% glucose solution;

3. intravenous administration of lasix;

4. performing a lumbar puncture.

Question number 52. The signs of spinal cord injury in spinal cord injury detected at the prehospital stage include (find the wrong answer):

1. flaccid paraparesis below the level of damage;

& 2. spastic hemiparesis;

3. violation of sensitivity below the level of damage;

4. Absence of tendon reflexes below the level of injury.

Question number 53. If spinal cord injury is suspected at the prehospital stage, it is necessary to inject intravenously:

& 1. glucocorticoid drugs;

2. lasix;

3. piracetam;

4. lidocaine.

Question number 54. The provision of psychiatric care (examination and, if necessary, hospitalization) by the ambulance service is justified (find the wrong answer):

& 1. always, if the patient is registered in a neuropsychiatric dispensary;

2. when the patient is in danger for himself and others;

3. if there is a threat of harm to the patient’s health as a result of the progression of a psychiatric disease;

4. when the patient is unable to satisfy his vital needs on his own.

Question number 55. Involuntary hospitalization in a psychiatric hospital by an ambulance service is carried out if the patient has ( find the wrong answer):

1. disorders of consciousness with psychomotor agitation;

& 2. chronic mental disorder without exacerbation at the request of relatives or neighbors;

3. suicidal manifestations or tendencies;

4. imperative hallucinations and other mental disorders. Threatening the life and health of people.

Question number 56. The tasks of the linear ambulance team when leaving for a patient suffering from a mental disorder include ( find the wrong answer):

1. relief of excitation that poses a danger to the patient and others;

2. provision of medical care in the presence of concomitant somatic pathology;

3. active monitoring of the patient until the arrival of the psychiatric ambulance team;

& 4. Immediate admission to a psychiatric hospital.

Question number 57. The paramedic of the ambulance justifiably calls the mobile psychiatric team “on himself” to the patient with (find the wrong answer):

1. acute alcoholic psychosis;

& 2. alcohol intoxication of any degree (without psychiatric manifestations) with variants of withdrawal symptoms;

3. suicidal attempts in the absence of the need for emergency somatic assistance;

4. reactive psychosis accompanied by depression, aggressive or suicidal manifestations.

Question number 58. A sign of clouding of consciousness is ( find the wrong answer):

1. disorientation in place and time;

& 2. maintaining clarity of thought;

3. detachment from the outside world;

4. amnesia for the period of clouding of consciousness.

Question number 59. Acute psychotic disorder is characterized by ( find the wrong answer):

& 1. maintaining a sense of reality;

2. development of delirium;

3. the presence of true hallucinations;

4. the presence of pseudohallucinations.

Question number 60. Acute psychotic disorders include (find the wrong answer):

1. delirium;

& 2. hysteria;

3. manic-depressive psychosis;

4. reactive psychosis.

Question number 61. Manic affective syndrome manifests itself (find the wrong answer):

1. mood enhancement;

2. motor excitation;

& 3. slow thinking;

4. ideational-psychic excitement.

Question number 62. Depressive affective syndrome manifests itself (find the wrong answer):

1. painfully low mood;

2. motor retardation;

3. slow thinking;

& 4. ideational-psychic excitement.

Question number 63. For the relief of arousal in acute psychotic disorders at the prehospital stage, the following are effective:

1. tranquilizers;

& 2. antipsychotics;

3. nootropics;

4. psychostimulants.

Question number 64. The development of acute neuroleptic syndrome is due to the use of:

1. atropine;

& 2. Antipsychotics;

3. tranquilizers;

4. opiates.

Question number 65. Acute neuroleptic syndrome manifests itself ( find the wrong answer):

1. severe muscle rigidity;

& 2. psychomotor agitation;

3. feeling of heat, excessive sweating;

4. tachycardia, arterial hypertension.

Question number 66. Acute dyskinetic disorders caused by taking antipsychotics are stopped:

& 1. tranquilizers;

2. prozerin;

3. piracetam;

4. caffeine.

Question number 67. A neurotic disorder is characterized by:

& 1. maintaining a sense of reality;

2. development of delirium;

3. the presence of true hallucinations;

4. the presence of pseudohallucinations.

Question number 68. Neuroses include (find the wrong answer):

1. neurasthenia;

2. hysteria;

3. obsessive-compulsive disorder;

& 4. acute reactive psychosis.

Question number 69. For the relief of acute neurotic disorders at the prehospital stage, the following are used:

& 1. tranquilizers;

2. neuroleptics;

3. nootropics;

4. psychostimulants.

Question number 70. Acute alcoholic psychoses (delirium, hallucinations) at the prehospital stage are stopped:

& 1. chlorpromazine;

2. haloperidol;

3. diazepam;

4. cordiamine.

Question number 71. An early manifestation of the withdrawal syndrome in opiate addiction is (find the wrong answer):

1. tear and salivation;

2. hyperhidrosis;

& 3. miosis;

4. tremor.

Question number 72. The delayed manifestation of the withdrawal syndrome in opiate addiction is (find the wrong answer):

1. chills;

& 2. bradycardia;

3. nausea;

4. aches in the joints.

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