Тест: Understanding Edema and Heart Failure Mechanisms — 10 въпроса

1. Which mechanism best explains hydrostatic edema?

A. Lymph vessels fail to drain protein-rich fluid back to the blood

B. Increased capillary pressure pushes fluid out into the tissue

C. Histamine damages red blood cells and causes tissue swelling

D. Low albumin reduces water binding in the blood

Answer: (B)

Обяснение

Hydrostatic edema is caused by increased pressure in the capillaries, which forces fluid into the interstitial space. Low albumin causes oncotic edema instead, and lymphatic failure causes lymphatic edema.

2. Why does left-sided heart failure commonly cause shortness of breath?

A. The right ventricle becomes overfilled and directly blocks the airways

B. The kidneys stop filtering, causing carbon dioxide to accumulate

C. Blood backs up in the lungs, making them stiffer and promoting fluid leakage

D. The lungs produce too much mucus because of low oxygen delivery

Answer: (C)

Обяснение

When the left ventricle cannot move blood forward effectively, blood accumulates in the pulmonary circulation, increasing pressure and causing lung congestion and fluid leakage. This makes breathing more difficult and leads to dyspnea.

3. How do ACE inhibitors help in heart failure?

A. They increase aldosterone so the kidneys excrete more sodium

B. They block formation of angiotensin II, lowering resistance and fluid retention

C. They directly strengthen cardiac muscle contraction

D. They dissolve clots in the pulmonary circulation

Answer: (B)

Обяснение

ACE inhibitors reduce conversion of angiotensin I to angiotensin II, which lowers peripheral resistance and decreases aldosterone-driven salt and water retention. That reduces the workload on the heart.

4. What is a key non-drug measure in chronic heart failure management?

A. Monitoring weight and fluid balance to detect fluid retention early

B. Avoiding all physical activity to reduce cardiac demand

C. Using antibiotics routinely to prevent lung congestion

D. Increasing salt intake to prevent dehydration

Answer: (A)

Обяснение

Regular monitoring of weight and fluid status helps detect fluid retention early and supports timely adjustment of treatment. This is a central non-medication measure in chronic heart failure.

5. What best characterizes emphysema in COPD?

A. Persistent mucus production due to chronic airway inflammation

B. Sudden collapse of the lung from air in the pleural space

C. Infection of the pleura causing fluid around the lungs

D. Destruction of alveolar walls with reduced elastic recoil

Answer: (D)

Обяснение

Emphysema is defined by destruction of alveolar walls, which reduces elastic recoil and makes exhalation harder. Chronic mucus production is more typical of chronic bronchitis.

6. What is the most common source of a pulmonary embolus?

A. A clot that forms in the deep veins and travels to the lungs

B. Inflammation of the lung tissue causing vessel spasm

C. Atherosclerotic plaque that breaks loose from the coronary arteries

D. Air that enters the bloodstream during breathing

Answer: (A)

Обяснение

Pulmonary emboli most often arise from venous thrombosis, usually in the deep veins, and then travel to the pulmonary arteries. Treatment focuses on stopping clot growth and preventing new emboli.

7. Which description fits prerenal acute kidney failure?

A. Blockage of urine outflow after the kidneys

B. Direct damage to the kidney tissue itself

C. Reduced blood flow to the kidneys without primary kidney tissue damage

D. Excess hormone production causing protein loss in urine

Answer: (C)

Обяснение

Prerenal acute kidney failure is caused by reduced renal perfusion before the kidney tissue is damaged, which lowers filtration. Renal and postrenal causes involve damage to the kidney tissue or obstruction of urine outflow.

8. Which problem is especially important in chronic kidney failure because it can increase cardiac risk?

A. Low sodium intake from increased thirst

B. Hypoglycemia from excess insulin secretion

C. Hyperkalemia from reduced potassium excretion

D. Respiratory alkalosis from excessive ventilation

Answer: (C)

Обяснение

Chronic kidney failure reduces potassium excretion, so hyperkalemia is a key complication and can be dangerous for the heart. Acid-base disturbances and other electrolyte imbalances often occur alongside it.

9. What is the core cause of type 1 diabetes mellitus?

A. Autoimmune destruction of insulin-producing cells

B. Resistance to insulin caused mainly by obesity

C. Failure of the liver to store glucose

D. Excess insulin secretion from the pancreas

Answer: (A)

Обяснение

Type 1 diabetes is an autoimmune disease in which the immune system destroys insulin-producing cells, leading to insulin deficiency. That lack of insulin causes poor glucose regulation and hyperglycemia.

10. What best describes Type A adverse drug effects?

A. Reactions that occur only in patients with liver disease

B. Dose-related and predictable from the drug’s known action

C. Rare immune reactions unrelated to dose

D. Effects caused only by food-drug interactions

Answer: (B)

Обяснение

Type A adverse effects are largely predictable from the pharmacology of the drug and become more likely as the dose increases. They are the most common category of adverse effects.