patologiuri q avl, v1 – v6 ganxrebsi miutitebs · infeqciuri endokarditis camoyalibebasi: \\...

$: paTologiuri Q avL, V1 – V6 ganxrebSi miuTiTebs · infeqciuri endokarditis CamoyalibebaSi: \\ qronikul tonzilits; \\\ qronikul otits; \\\ qronikul rinits; \\\ qronikul cistits; \\\$
1

\\\\ paTologiuri Q kbilis arseboba I da avL, V1 – V6 ganxrebSi miuTiTebs\\\ ukana kedlis infarqtze;\\ wina gavrcelebul infarqtze\\\ wina da ukana kedlebis gavrcelebul infarqtze;\\\ septalur infarqtze;\\\ wina - mwvervalis infarqtze.

\\\\ CamoTvlilidan ra aris damaxasiaTebeli atrioventrikuluri blokadisaTvis?\\\ QRS intervalis gaxangrZliveba;\\\ QTÅintervalis gaxangrZliveba;\\ PQ intervalis gaxangrZliveba;\\\ R kbilis deformacia;\\\ yvela CamoTvlili.

\\\\ hipertenziis mqone pacientebis gamokvleva unda moxdes:\\\ Tirkmelebis ultrabgeriTi gamokvleviT;\\\ gulmkerdis rentgenografiiT;\\\ kaliumis donis gansazRvriT sisxlis SratSi;\\\ ojaxuri anamneziT;\\ yvela CamoTvliliT.

\\\\ hipertonuli daavadebisas reninis Semcveloba sisxlSi:\\\ mniSvnelovnadaa momatebuli;\\ zog SemTxvevaSi momatebulia, zog SemTxvevaSi normis farglebSia.\\\ umniSvnelodaa momatebuli;\\\ normis farglebSia;\\\ daqveiTebulia;

\\\\ CamoTvlilidan ra ar axasiaTebs aortul stenozs:\\\ stenokardia;\\\ sinkope;\\ arteriuli hipertenzia\\\ gulis ukmarisoba;\\\ Tavbrusxveva;

\\\\ CamoTvlilidan ra ar aris damaxasiaTebeli mitraluri stenozisTvis?\\\ marcxena winagulis dilatacia;\\ sistoluri Suili mwvervalze;\\\ diastoluri Suili mwvervalze;\\\ mitraluri sarqvlis gaRebis xmianoba;\\\ tkacuna I toni.

\\\\ CamoTvlilidan ra aris gulis tamponadis damaxasiaTebeli niSani?\\\ paradoqsuli pulsi;\\\ arteriuli hipotenzia;\\\ dabali pulsuri wneva;\\\ kisris venebis Seberva;\\ yvela CamoTvlili.

\\\\ CamoTvlilidan ra aris kardiuli asTmisTvis damaxasiaTebeli?\\\ marjvena tipis ekg;\\ marcxena tipis ekg.\\\ eqspiraciuli qoSini;\\\ mSrali, mstvinavi xixini;\\\ webovani, gamWvirvale naxveli;

\\\\ gulis SegubebiTi ukmarisoba maRali wuTmoculobis fonze SeiZleba Segvxvdesyvela qvemoT CamoTvlili paTologiis dros, garda:\\\ beri-beri;\\\ hiperTireozi;\\ mitraluri stenozi;

2

\\\ anemia;\\\ arterio-venuri fistula.

\\\\ qvemoT moyvanili Sratis fermentebidan romeli warmoadgens miokardiumis dazianebisspecifikur kriteriums?\\\ laqtatdehidrogenaza-4;\\\ laqtatdehidrogenaza-5;\\ kreatinfosfokinaza-MB;\\\ aspartataminotransferaza;\\\ glutamat-oqsalacetat transaminaza.

\\\\ ekg-ze P-kbili dadebiTia, PQ -intervali 0, 22 wm, QRS- kompleqsis xangrZlivoba 0, 09wm. daasaxeleT riTmis moSlis saxe:\\\ parkuWovani eqstrasisitola;\\\ mocimcime ariTmia;\\\ arasruli atrioventrikuluri blokada (II xarisxis);\\ arasruli atrioventrikuluri blokada (I xarisxis);\\\ sruli artrioventrikuluri blokada.

\\\\ kardiomiopaTia SesaZlo diagnozia yvela SemTxvevaSi, garda:\\\ asimptomuri avadmyofi, romelmac mogvmarTa ekg-ze cvlilebebis gamo;\\\ asimptomuri avadmyofi, romelic gamogzavnilia gamokvlevisTvis kardiomegaliisgamo, romelic gamovlinda gulmkerdis profilaqtikuri rentgenologiurigamokvlevisas;\\ avadmyofi, romelsac gamokvlevisas gamouvlinda marcxena winagulis izolirebuligadidebis da mitraluri regurgitaciuli Suili;\\\ avadmyofi, romelsac TiTqmis erTdroulad ganuviTarda marcxena da marjvena gulisSegubebiTi ukmarisobis niSnebi;\\\ avadmyofi, romelsac awuxebs sisuste, daRla da qoSini fizikuri datvirTvisas

\\\\ CamoTvlilidan ra axasiaTebs yvelaze xSirad marcxena winagulis miqsomas?\\\ cxeleba;\\ sinkope.\\\ arTralgiebi;\\\ periferiuli Tromboemboliebi;\\\ eds -is momateba;

\\\\ amoarCieT ufro marTebuli debuleba nitroglicerinis moqmedebis Sesaxeb:\\\ aiSviaTebs gulis muSaobas;\\\ aZlierebs marcxena parkuWis SekumSvas;\\ aqveiTebs miokardiumis moTxovnilebas Jangbadze;\\\ aumjobesebs sisxlis ganawilebas;\\\ afarTovebs koronarebs.

\\\\ paTologiuri Q kbilis arseboba ÌV1-V6 ganxrebSi mowmobs:\\\ ukana kedlis infarqtze;\\\ wina da ukana kedlebis gavrcelebul infarqtze;\\ wina gavrcelebul infarqtze;\\\ septalur infarqtze;\\\ wina - mwvervalis infarqtze.

\\\\ CamoTvlilidan romeli warmoadgens mocimcime ariTmiis sadiagnozoeleqtrokardiografiul kriteriums?\\\ deformuli p kbilebi;\\\ Tanabari R-R intervalebi;\\ araTanabari R-R intervalebi da winagulebis TrTolvis aRmniSvneli f talRebisarseboba;\\\ ST - segmentis da T kbilis deformacia;\\\ STÅkompleqsebis deformacia.

3

\\\\ hipertenziul avadmyofebSi sikvdlianobis uxSires mizezad iTvleba yvela qvemoTCamoTvlili, garda:\\\ Tavis tvinis insulti;\\\ Tirkmelebis ukmarisoba;\\ nawlavis infarqti fibrinoiduli nekrozis gamo;\\\ miokardiumis infarqti;\\\ gulis SegubebiTi ukmarisoba.

\\\\ CamoTvlilidan ra axasiaTebs mitraluri sarqvlis prolafss:\\\ xSiria mamakacebSi;\\\ baqteriuli endokarditis profilaqtikis Catarebis Cvenebaa;\\ mogvianebiTi sistoluri Suili mwvervalze;\\\ ekg-ze specifiuri cvlilebebi;\\\ yvela CamoTvlili.

\\\\ postdatvirTvis Semcireba Cveulebriv mizanSewonilia yvela CamoTvlil SemTxvevaSi,garda:\\\ SegubebiTi kardiomiopaTia;\\\ aortuli naklovaneba;\\ subaortuli stenozi.\\\ arteriuli hipertenzia;\\\ gulis ukmarisoba;

\\\\ qvemoT CamoTvlilidan romelia damaxasiaTebeli SokisaTvis:\\\ sistoluri wneva naklebia 90 mm vcx. wy sv-ze;\\\ diurezi naklebia 20 ml/sT-ze;\\\ gulis wuTmoculoba daqveiTebulia;\\\ daqveiTebulia qsovilTa perfuzia;\\ yvela maTgani.

\\\\ avadmyofi mamakaci, 53 wlis, uCivis simZimis SegrZnebas marjvena ferdqveSa midamoSi,qvemo kidurebis SeSupebas, romelic ufro gamoxatulia saRamos. kani cianozuria.palpaciiT aRiniSneba qvemo kidurebis SeSupeba. auskultaciiT - gulis tonebimoyruebuli, sufTa; pulsi xSiri, ritmuli, saSualo avsebis da daWimulobis. sisxlisarteriuli wneva 140/90 oosu. venuri wneva idayvis venaSi 180. gamoyaviT swori pasuxiqvemoT moyvanili paTologiuri mdgomareobebidan:\\\ mwvave koronaruli ukmarisoba;\\\ marcxena parkuWis mwvave ukmarsoba;\\\ marcxena parkuWis qronikuli ukmarisoba;\\ marjvena parkuWis qronikuli ukmarisoba;\\\ arteriuli hipertenziis sindromi.

\\\\ marjvena parkuWis ukmarisobisas aRiniSneba yvela CamoTvlili simptomi, garda:\\\ qvemo kidurebis SeSupeba;\\ filtvis kapilarebSi wnevis sagrZnobi momateba;\\\ hepatomegalia;\\\ kisris venebis Seberva;\\\ marjvena parkuWSi saboloo diastoluri wnevis momateba.

\\\\ tkivili gulmkerdSi da perikardiumis xaxunis xmianoba umetes wilad gvafiqrebinebs:\\\ miokardiumis intramurul infarqtze;\\ transmurul infarqtze;\\\ gulmkerdis travmaze;\\\ virusul pnevmoniaze;\\\ aortis ganSrevebad anevrizmaze.

\\\\ CamoTvlili simptomebidan romelia paTognomuri stenokardiisTvis:\\\ CxvletiTi xasiaTis tkivili gulis areSi fizikuri datvirTvisas;\\\ parkuWovani eqstrasistolia fizikuri datvirTvis Semdeg;\\\ Q - kbili III da avF ganxrebSi;\\ tkivili mkerdis Zvlis ukan da ST- segmentis depresia datvirTvisas;

4

\\\ negatiuri T kbili V2 - V6 ganxrebSi.

\\\\ ekg-ze normaluri PQRST kompleqsis Semdeg aRiniSneba deformirebuli QRSTkompleqsi, romlis wina R-R - Ê intervali Semoklebulia, Semdegi ki gaxangrZlivebuli.P kbili gamoxatuli ar aris. daasaxeleT aritmiis tipi:\\\ sunTqviTi aritmia;\\\ winagulovani eqstrasistola;\\ parkuWovani eqstrasistola;\\\ mocimcime aritmia;\\\ arasruli atrioventrikuluri blokada (I xarisxis).

\\\\ parkuWovani eqstrasistoliisTvis damaxasiaTebelia yvela CamoTvlili, garda:\\ eqstrasistoluri QRSÊkomleqsis xangrZlivoba ar aRemateba 0,10 wm-s;\\\ eqstrasistolis win P kbilis ar arseboba;\\\ sruli kompensatoruli pauza;\\\ eqstrasistoluri QRSÛkompleqsis deformacia;\\\ eqstrasistoluri TÅkbilisa da ÉQRSÛ kompleqsis diskordantoba.

\\\\ romeli daavadebisTvisaa damaxasiaTebeli sarqvlis dazianeba subfebriluritemperaturiT, eds-is momatebiT da emboliebiT:\\\ miokarditi;\\\ revmatiuli karditi;\\ infeqciuri endokarditi;\\\ perikarditi;\\\ Tromboflebiti.

\\\\ dilataciuri kardiomiopaTiisTvis CamoTvlili simptomebidan auskultaciiTdamaxasiaTebelia:\\\ diastoluri Suili filtvis arteriaze;\\\ mwvervalze diastoluri Suili;\\\ tkacuna I toni;\\ Wenebis ritmi;\\\ gaZlierebuli II toni.

\\\\ verapamili warmoadgens preparats, romelic:\\\ iwvevs beta-adrenoreceptorebis blokirebas;\\\ gamoiyeneba sinusis kvanZis sisustis dros;\\ gamoiyeneba paroqsizmuli supraventrikuluri taqikardiis samkurnalod;\\\ xSirad iZleva taqikardias;\\\ aqvs diurezuli efeqti.

\\\\ CamoTvlili diagnostikuri testebidan romelia ufro specifiuri filtvis arteriisemboliisaTvis:\\\ ekg-ze gamoxatuli S1, Q3;\\\ arteriuli pO2 -is gansazRvra;\\\ filtvebis izotopuri skenireba;\\ filtvebis kompiuteruli tomografia angiografiul reJimSi;\\\ fibrinogenis da misi daSlis produqtebis gansazRvra plazmaSi.

\\\\ romeli daavadebis dros aris winaaRmdegnaCvenebi gaxangrZlivebuli moqmedebisnitratebis didi dozebiT gamoyeneba:\\\ aortis sarqvlis sklerozi;\\\ aortuli naklovaneba;\\\ mitraluri naklovaneba;\\ hipertrofiuli subaortuli stenozi.\\\ SegubebiTi kardiomiopaTia;

\\\\ paTologiuri Q kbilis arseboba III da aVF ganxrebSi miuTiTebs:\\\ wina gavrcelebul infarqtze;\\\ wina da ukana kedlebis gavrcelebul infarqtze;

5

\\ ukana kedlis infarqtze;\\\ septalur infarqtze;\\\ wina mwvervalis infarqtze.

\\\\ ra axasiaTebs srul atriovertikulur blokadas?\\\ R-R intervalis mkveTri gaxangrZliveba;\\\ araTanabari PQ- intervalebi;\\\ TanabariÊRRÊintervalebi;\\\ Tanabari PP intervalebi;\\ yvela CamoTvlili.

\\\\ renovaskulur hipertenziasTan dakavSirebiT romeli debulebaa WeSmariti:\\\ damaxasiaiTebelia reninis hipersekrecia;\\\ efeqturia kaptopriliT mkurnaloba;\\\ xSirad gvxvdeba axalgazrda qalebSi;\\\ orive Tirkmlis arteriis stenozisas kaptoprilis daniSvna safrTxiloa;\\ yvela debuleba WeSmaritia.

\\\\ CamoTvlili mdgomareobebidan romlisTvis aris damaxasiaTebeli swrafi "mxtunavi"pulsi (kariganis pulsi)?\\\ mitraluri stenozi;\\\ mitraluri naklovaneba;\\ aortuli naklovaneba;\\\ aortuli stenozi;\\\ aortis koarqtacia.

\\\\ CamoTvlilidan ra ar axasiaTebs aortul naklovanebas?\\\ diastoluri Suili;\\\ maRali pulsuri wneva;\\ sistoluri Suili;\\\ marcxena parkuWis hipertrofia da dilatacia;\\\ mwvervalze I tonis Sesusteba.

\\\\ gulis wuTmoculobis gasaumjobeseblad postdatvirTvis Semcireba mizanSewoniliayvela qvemoT CamoTvlil SemTxvevebSi, garda:\\\ miokardiumis mwvave infarqti - hipertenziiT;\\\ mwvave aortuli naklovaneba;\\ mitraluri stenozi.\\\ mwvave mitraluri naklovaneba;\\\ hipertonuli krizi;

\\\\ avadmyofi mamakaci, 59 wlis, awuxebs sunTqvis ukmarisobis SegrZneba, Zlieri SeteviTiSereuli xasiaTis qoSini, gulis friali. obieqturad imyofeba iZulebiT mjdomaremdgomareobaSi, zemo kidurebiT eyrdnoba muxlebs, mkveTrad gamoxatulia cianozi.sunTqva zerele, wuTSi 32. filtvebis qvemo wilebze moismineba mravlobiTi sveliwvrilbuStukovani xixini, gulis tonebi Sesustebuli, pulsi wuTSi 126, ritmuli.arteriuli wneva 150/90 oosu. daasaxeleT am mdgomareobis mizezi:\\\ marcxena parkuWis qronikuli ukmarisoba;\\ marcxena parkuWis mwvave ukmarisoba;\\\ bronquli asTma;\\\ marjvena parkuWis qronikuli ukmarisoba;\\\ arteriuli hipertenziis sindromi.

\\\\ marcxena parkuWis ukmarisobisTvis damaxasiaTebeli simptomebia yvela CamoTvlili,garda:\\\ qoSini;\\ kisris venebis Seberva;\\\ Wenebis ritmi;\\\ filtvebis fuZeze krepitacia;\\\ kardiuli asTma.

6

\\\\ avadmyofi qali, 50 wlis, Semovida intensiuri Terapiis ganyofilebaSi CivilebiTtkivilze gulis areSi, romelic grZeldeba 2 saaTis ganmavlobaSi. ekg-ze miokardiumisukana kedlis infarqti da eqstrasistoluri aritmia. filtvebSi - sveli xixini qvemowilebSi.gulmkerdis rentgenogramaze gulis zomebi normis farglebSia, pilusebiumniSvnelod gafarToebuli. mkurnaloba Sedgeba yvela qvemoT CamoTvlilisagan, garda:\\\ intravenurad heparinis Seyvana;\\\ intravenurad lidokainis Seyvana;\\ digoqsinis Seyvana.\\\ oqsigenoTerapia;\\\ morfinis Seyvana;

\\\\ rodis aris mocimcime aritmiis ganviTarebis naklebi albaToba:\\\ koronaruli arteriebis aTerosklerozi;\\ bikuspidaluri sarqvliT gamowveuli aortuli stenozi;\\\ Tireotoqsikozi;\\\ mitraluri stenozi;\\\ hipertonuli daavadeba.

\\\\ supraventrikuluri eqstrasistoliisaTvis damaxasiaTebelia yvela qvemoTCamoTvlili, garda:\\\ P kbilis deformacia;\\ QRSTÅkompleqsis deformacia;\\\ arasruli kompensatoruli pauza;\\\ QRST kompleqsis Seucvleloba;\\\ PQ - intervalis Secvla.

\\\\ "mcire" gulis da mwvervalis biZgis ararsebobis dros marjvena parkuWis ukmarisobisniSnebi uxSiresad miuTiTebs:\\\ dilataciur kardiomiopaTiaze;\\ konstriqciul perikarditze;\\\ mitralur naklovanebaze;\\\ gulis anevrizmaze;\\\ arteriul hipertenziaze.

\\\\ 25 wlis avadmyofi qali gamokvleulia eqimis mier gulis Suilebis Sesafaseblad.avadmyofi anamnezSi ar aRniSnavs revmatizms da Suils, romelic adre moismineboda. Ida II tonebi normaluria, kardiomegalia ar aRiniSneba. marjvniv II neknTaSua sivrceSiismis gandevnis sistoluri Suili. savaraudo diagnozia:\\\ aortis xvrelis sarqvelovani stenozi;\\ idiopaTiuri hipertrofiuli subaortuli stenozi;\\\ funqciuri Suili;\\\ mitraluri naklovaneba;\\\ filtvis arteriis xvrelis stenozi.

\\\\ hipertrofiuli obstruqciuli kardiomiopaTiis dros, romeli preparatiwarmoadgens absolutur ukuCvenebas:\\\ propranololi;\\\ verapamili;\\ digoqsini.\\\ qinidini;\\\ lidokaini;

\\\\ ra paTologia ar aZlierebs I tonis intensiurobas?\\\ Tireotoqsikozi;\\\ mitraluri stenozi;\\ mwvave aortuli naklovaneba.\\\ sinusuri taqikardia;\\\ winagulTaSua Zgidis defeqti;

\\\\ paTologiuri Q kbilis arseboba V1 da V2 ganxrebSi miuTiTebs:

7

\\\ wina gavrcelebul infarqtze;\\\ ukana kedlis infarqtze;\\ septalur infarqtze;\\\ wina da ukana kedlebis gavrcelebul infarqtze;\\\ wina - mwvervalis infarqtze.

\\\\ venkebaxis tipis atrioventrikuluri blokada xasiaTdeba:\\\ PQ- intervalis progesirebadi SemoklebiT;\\ PQ- intervalis progresirebadi gaxangrZlivebiT da parkuWovani kompleqsis SemdgomigamovardniT;\\\ taqikardiiT;\\\ PQ- intervalis progesirebadi gaxangrZlivebiT;\\\ fiqsirebuli blokadiT 2:1.

\\\\ CamoTvlilidan romeli Seesabameba arteriuli wnevis normas:\\\ sistoluri wneva 160 mm vwy.sv;\\\ sistoluri wneva 155 mm vwy. sv;\\ diastoluri wneva 84 mm vwy. sv;\\\ diastoluri wneva 108 mm vwy. sv;\\\ diastoluri wneva 98 mm vwy. sv.

\\\\ CamoTvlili simptomebidan ra ar aris damaxasiaTebeli mitraluri sarqvlisnaklovanebisTvis?\\\ sistoluri Suili;\\ tkacuna I toni.\\\ mwvervalze I tonis Sesusteba;\\\ marcxena parkuWis hipertrofia da dilatacia;\\\ marcxena winagulis hipertrofia da dilatacia;

\\\\ romeli Tandayolili manki ar rTuldeba baqteriuli endokarditiT:\\\ parkuWTaSua Zgidis defeqti;\\\ Ria botalis sadinari;\\ winagulTaSua Zgidis defeqti.\\\ hipertrofiuli subaortuli stenozi;\\\ aortuli stenozi;

\\\\ ra saxis hemodinamikur darRvevebs aqvs adgili mitraluri stenozis dros?\\\ marcxena parkuWis saboloo diastoluri moculobis gazrda;\\\ marcxena parkuWis gandevnis fraqciis gazrda;\\ marcxena winagulSi wnevis momateba;\\\ arteriuli hipertenzia;\\\ yvela CamoTvlili.

\\\\ qvemoT CamoTvlili mdgomareobebidan romels axasiaTebs alternaciuli pulsi:\\\ anemia;\\ gulis ukmarisoba;\\\ parkuWTaSua Zgidis asimetriuli hipertrofia;\\\ aortuli naklovaneba;\\\ Tireotoqsikozi.

\\\\ avadmyof mamakacs awuxebs haeris ukmarisoba da gulis friali umniSvnelo fizikuridatvirTvisas. qoSini Zlierdeba horizontalur mdgomareobaSi, ris gamoc avadmyofiiZulebulia daiZinos naxevrad .damjdar pozaSi. pulsi xSiria, riTmuli, gulis tonebisufTaa, moyruebuli. sisxlis arteriuli wneva - 139/80ümmHg. filtvebis qvemo wilebzemoismineba erTeuli sveli wvrilbuStukovani xixini. venuri wneva normis farglebSia.daasaxeleT zemoT aRwerili mdgomareobis mizezi:\\\ mwvave koronaruli ukmarisoba;\\\ bronqopnevmonia;\\ marcxena parkuWis qronikuli ukmarisoba;

8

\\\ marcxena parkuWis mwvave ukmarisoba;\\\ marjvena parkuWis qronikuli ukmarisoba.

\\\\ miokardiumis infarqtis Semdeg mesame kviraze avadmyofs aReniSneba tkiviligulmkerdis areSi. sxeulis temperaturis momateba, eds-is mateba, perikardiumis xaxunisxmianoba. savaraudo diagnozia:\\\ infarqtuli dazianebis zonis gafarToeba;\\ postinfarqtuli dresleris sindromi;\\\ idiopaTiuri perikarditi;\\\ miokardiumis ruptura;\\\ gulis qordebis gagleja.

\\\\ ekg-ze P-kbilebi ar aRiniSneba, gamoxatulia talRovani xazi fàtalRebiT. RRintervalebi sxvadasxva xangrZlivobisaa. daasaxeleT aritmiis saxe:\\\ winagulovani eqstrasistola;\\ mocimcime ariTmia;\\\ parkuWovani eqstrasistola;\\\ sruli antrioventrikuluri blokada;\\\ winagulebis TrTolva.

\\\\ parkuWTa fibrilaciisTvis damaxasiaTebeli ekg-uli cvlilebebia:\\\ QRST kompleqsebis deformacia da gafarToeba;\\\ QRST komplesebis erTnairi amplituda;\\ ekg elementebis diferencirebis SeuZlebloba.\\\ ST segmentis Serwyma T kbilTan;\\\ winagulebis TrTolvis da cimcimis aRmniSvneli f talRebis arseboba;

\\\\ qronikuli infeqciis CamoTvlili kerebidan romels aqvs umetesi mniSvnelobainfeqciuri endokarditis CamoyalibebaSi:\\ qronikul tonzilits;\\\ qronikul otits;\\\ qronikul rinits;\\\ qronikul cistits;\\\ qronikul pielonefrits.

\\\\ CamoTvlili preparatebidan romeli aZlierebs gulis kumSvadobas:\\\ natriumis nitroprusidi;\\ digoqsini;\\\ verapamili;\\\ furosemidi;\\\ propranololi.

\\\\ perikarditi Cveulebriv Tan axlavs yvela CamoTvlil mdgomareobas, garda:\\ qunTruSa.\\\ revmatizmi;\\\ tuberkulozis;\\\ sistemuri wiTeli mglura;\\\ miokardiumis infarqti;

\\\\ ekg-is gamoyeneba rodisaa arainformaciuli:\\\ miokardiumis axali infarqtis dros;\\\ aritmiebis dros;\\\ xelovnuri riTmis wamyvanis efeqturobis Sefasebisas;\\ gulis ukmarisobis xarisxis dasadgenad.\\\ blokadebis dros;

\\\\ rodis iTvleba diastoluri arteriuli wneva normalurad:\\\ diastoluri wneva >115 mm vwy.sv;\\\ diastoluri wneva <85 mm vwy.sv;\\ diastoluri wneva <90 mm vwy.sv.\\\ diastoluri wneva 90-104 mm vwy.sv. farglebSia;\\\ diastoluri wneva 105-114 mm vwy.sv. farglebSia;

9

\\\\ ra asakSi gvxvdeba yvelaze xSirad hipertoniuli daavadeba?\\ 30-dan 60 wlamde;\\\ 20 wlamde;\\\ 20-dan 30 wlamde;\\\ 60-dan 70 wlamde;\\\ 70 welze ufros asakSi.

\\\\ CamoTvlili biologiuri faqtorebidan romeli iwvevs arteriuli wnevis uSualomomatebas?\\ angiotenzin II;\\\ renini;\\\ angiotenzinogeni;\\\ angiotenzin I;\\\ angiotenzinis gardamqneli fermenti.

\\\\ CamoTvlilidan romelia hipertoniuli daavadebis yvelaze xSiri garTuleba.\\ hipertoniuli krizi;\\\ miokarditi;\\\ gulis mwvave ukmarisoba (filtvebis SeSupeba);\\\ perikarditi;\\\ Tirkmlebis qronikuli ukmarisoba.

\\\\ CamoTvlili niSnebidan romelia wamyvani hipertoniuli krizis diagnozisTvis?\\ cerebruli simptomebi;\\\ Sardis sindromi;\\\ azotemia;\\\ kardialgia;\\\ cvlilebebi Tvalis fskerze.

\\\\ CamoTvlili daavadebebidan romelia insultis ganviTarebis yvelaze xSiri mizezi:\\ hipertoniuli daavadeba;\\\ cerebruli aTerosklerozi;\\\ Tavis tvinis sisxlZarRvebis Tandayolili paTologia;\\\ Tirkmelebis daavadebebi;\\\ CamoTvlilidan arc erTi.

\\\\ romeli daavadebisTvisaa damaxasiaTebeli upiratesad sistoluri wnevis momateba?\\\ qronikuli glomerulonefriti;\\\ qronikuli pielonefriti;\\\ diabeturi glomerulosklerozi;\\\ feoqromocitoma.\\ aortis aTerosklerozi;

\\\\ CamoTvlilidan ra aris yvelaze damaxasiaTebeli hipertoniuli daavadebisTvishipervolemiis niSnebiT:\\\ arteriuli wnevis labiluroba;\\ Sardmdeni saSulebebis maRali efeqturoba;\\\ midrekileba SeSupebebisken;\\\ temperaturis momateba subfebrilur cifrebamde;\\\ arc erTi CamoTvlili.

\\\\ CamoTvlili rentgenologiuri niSnebidan romelia yvelaze damaxasiaTebeli aortiskoarqtaciisaTvis?\\\ filtvis suraTis gaZliereba;\\\ gulis marcxena nawilebis gadideba;\\\ aortis aRmavali nawilis gafarToeba;\\ neknebis qveda kideebis uzuracia.\\\ gulis marjvena nawilebis gafarToeba;

\\\\ romeli daavadebis dros mimdinareobs hipertoniuli krizi yvelaze mZimed?

10

\\\ qronikuli pielonefriti;\\ feoqromocitoma;\\\ pirveladi aldosteronizmi;\\\ hipertoniuli daavadeba;\\\ hiperTireozi.

\\\\ klofelinis erTbaSad moxsna saxifaToa, radganac SeiZleba ganviTardes:\\\ Tirkmelebis ukmarisoba;\\\ gamoxatuli taqikardia;\\ mZime hipertonuli krizi;\\\ gulis ukmarisoba;\\\ CamoTvlilidan arc erTi.

\\\\ romeli jgufis preparatis daniSvnaa ufro mizanSewonili hipertoniuli daavadebissamkurnalod moxucebul avadmyofebSi?\\\ Sarddmdenebi;\\\ centraluri vazodilatatorebi;\\ agf inhibitorebi;;\\\ rauvolfias preparatebi;\\\ beta blokerebi;

\\\\ CamoTvlili preparatebidan romeli ar unda dainiSnos arteriuli hipertenziisdros, Tu mas Tan axlavs bronquli asTma:\\ araseleqtiuri beta blokerebi;\\\ centraluri vazodilatotirebi;\\\ agf inhibitorebi;\\\ Sardmdenebi;\\\ kalciumis arxebis blokerebi;

\\\\ CamoTvlilidan romeli preparatia ukunaCvenebi Tavis tvinis insultTanasocirebuli hipertenziis samkurnalod?\\\ nitratebi;\\ nifedipinis tipis kalciumis arxebis blokerebi;\\\ labetololi;\\\ Sardmdenebi;\\\ agf inhibitorebi.

\\\\ CamoTvlili mdgomareobebidan romlis drosaa upiratesad naCvenebi kaliumisSemnaxveli diurezuli saSualebebis daniSvna?\\\ arteriuli hipertenziis dabalreninuli forma;\\\ hiperaldosteronizmi;\\ hiperkaliemia;\\\ hipertonuli krizi;\\\ kaptopriliT mkurnaloba.

\\\\ CamoTvlili daavadebebidan romeli ar iwvevs marcxena parkuWis ukmarisobisganviTarebas:\\\ aortuli stenozi;\\\ mitraluri naklovaneba;\\ qronikuli obstruqciuli bronqiti;\\\ aortuli naklovaneba;\\\ postinfarqtuli kardiosklerozi.

\\\\ CamoTvlili daavadebebidan romeli ar iwvevs pirvelad marjvenaparkuWovaniukmarisobis ganviTarebas:\\\ mitraluri stenozi;\\\ qronikuli obstruqciuli bronqiti;\\\ filtvis arteriis Tromboembolia;\\ hipertonuli daavadeba.\\\ filtvis tuberkulozi;

11

\\\\ ra xasiaTis SeSupebaa damaxasiaTebeli gulis SegubebiTi (totaluri)ukmarisobisTvis?\\\ faruli SeSupeba;\\ anasarka;\\\ hidroperikardiumi;\\\ qvemo kidurebis SeSupeba;\\\ SegubebiTi movlenebi filtvebSi.

\\\\ romeli klinikuri simptomia damaxasiaTebeli filtvebis alveoluri SeSupebisTvis?\\\ sveli xixini filtvebSi;\\\ qoSini;\\\ qafiani vardisferi naxvelis gamoyofa;\\\ avadmyofis iZulebiTi mjdomare mdgomareoba;\\ yvela CamoTvlili.

\\\\ CamoTvlilidan romeli warmoadgens sagule glikozidebis daniSvnis pirdapirCvenebas gulis qronikuli ukmarisobis dros?\\\ postinfarqtuli kardiosklerozi;\\ mitraluri manki mocimcime aritmiis taqisistoluri formiT;\\\ mocimcime aritmiis normosistoluri forma;\\\ ritmis darRvevis ar arseboba;\\\ yvela CamoTvlili.

\\\\ ra warmoadgens glikoziduri intoqsikaciis adreul gamovlinebas?\\\ taqikardia;\\\ bronqoobstruqciuli sindromi;\\\ gulis ukmarisobis simptomebis gaZliereba;\\ dispepsiuri sindromi;\\\ atrioventrikuluri blokada.

\\\\ CamoTvlilidan ra ar miekuTvneba glikoziduri intoqsikaciiseleqtrokardiografiul niSnebs?\\\ bradikardia;\\ maRali R kbili V1-3 ganxrebSi;\\\ parkuWovani eqstrasisitola;\\\ ST segmentis depresia da uaryofiTi T kbili V5-6 ganxrebSi;\\\ atrioventikuluri blokada.

\\\\ CamoTvlili eleqtrokardiografiuli niSnebidan romelia yvelaze metaddamaxasiTebeli dilataciuri kardiomiopaTiisTvis?\\\ R kbilis amplitudis momateba V4-6 ganxrebSi;\\ R kbilis voltaJis daqveiTeba, TÅkbilis dadableba an inversia;\\\ PQ -Éintervalis Semcireba;\\\ QTÉ- intervalis gaxangrZliveba;\\\ yvela CamoTvlili.

\\\\ CamoTvlilidan ra ar aris damaxasiaTebeli hipertrofiuli kardiomiopaTiisTvis?\\\ ojaxuri anamnezi;\\\ avadmyofis axalgazrda asaki;\\ kisris venebis pulsacia, asciti.\\\ stenokardiuli Civilebi;\\\ Tavbru an gulis friali sinkopuri mdgomareobebiT;

\\\\ qvemoT CamoTvlili simptomebidan gamoyaviT ararevmatiuli genezis miokarditispaTognomuri simptomi:\\\ advilad daRla;\\\ oflianoba;\\\ qoSini mcire datvirTvisas;\\ ar arsebobs.\\\ kardialgia;

12

\\\\ ararevmatiuli miokarditis dros ekg-ze yvelaze xSiria:\\\ RS-is voltaJis daqveiTeba;\\ ST segmentis depresia, T kbilis gabrtyeleba an inversia;\\\ paTologiuri Q kbilis gamoCena ÌV1-6 ganxrebSi;\\\ ST segmentis elevacia;\\\ arc erTi CamoTvlili.

\\\\ romeli virusi iwvevs yvelaze xSirad miokardits?\\ koqsakis;\\\ gripis;\\\ yviTeli cxelebis;\\\ herpes zosteris;\\\ yvavilis.

\\\\ romelia yvelaze informaciuli diagnostikuri meTodi eqsudaciuriperikarditisTvis?\\\ auskultacia;\\ eqokardiografia;\\\ perkusia;\\\ ekg;\\\ gulmkerdis rentgenoskopia.

\\\\ romeli daavadebis dros viTardeba epistenokardiuli perikarditi?\\\ restriqciuli kardiomiopaTia;\\\ fidleris miokarditi;\\ miokardiumis transmuruli infarqti;\\\ baqteriuli miokarditi;\\\ virusuli miokarditi.

\\\\ CamoTvlili preparatebidan, romlebi iZlevian swraf efeqts alergiuliperikarditis mkurnalobisas:\\\ arasteroiduli anTebis sawinaaRmdego saSualebebi;\\\ antibiotikebi;\\ glukokortikoidebi;\\\ oqros preparatebi, citostatikebi;\\\ antihistaminuri saSualebebi.

\\\\ gulis alkoholuri dazianebis gamovlinebebs miekuTvneba:\\\ taqikardia;\\ marcxena parkuWis dilatacia;\\\ marcxena parkuWis hipertrofia;\\\ yvela CamoTvlili;\\\ arc erTi CamoTvlilidan.

\\\\ gamokvlevis romeli meTodia yvelaze informaciuli gulis SeZenili mankebisdiagnostikaSi.?\\\ auskultacia;\\ eqokardiografia;\\\ ekg;\\\ gulmkerdis retgenografia;\\\ perkusia.

\\\\ marcxena parkuWis dilatacia viTardeba yvela CamoTvlili paTologiis dros, garda:\\\ mitraluri naklovaneba;\\\ aortuli naklovaneba;\\ mitraluri stenozi;\\\ aortuli stenozi;\\\ hipertonuli daavadeba.

\\\\ marjvena parkuWis dilatacia ar viTardeba:\\\ dekompensirebuli aortuli mankis dros;

13

\\ marjvena atrioventrikuluri xvrelis stenozis dros;\\\ filtvis arteriis stenozis da naklovanebis dros;\\\ winagulTaSua Zgidis defeqtis dros;\\\ parkuWTaSua Zgidis defeqtis dros.

\\\\ mitraluri mankis operaciuli mkurnalobis absoluturi ukuCvenebaa:\\\ orsuloba;\\ gulis ukmarisobis IV funqciuri klasi;\\\ postinfarqtuli kardiosklerozi;\\\ sagule glikozidebiTa da SardmdenebiT efeqturi mkurnaloba;\\\ yvela CamoTvlili.

\\\\ CamoTvlilidan ra ar axasiaTebs falos tetradas:\\\ aortis deqstrapozicia;\\\ parkuWTaSua Zgidis defeqti;\\\ marjvena parkuWis hipertrofia;\\ marcxena parkuWis gamosavali traqtis stenozi;\\\ filtvis arteriis stenozi.

\\\\ CamoTvlil niSnebidan romeli ar axasiaTebs mitralur stenozs?\\\ sisxliani naxveli;\\\ infeqciuri endokarditi;\\ maRali pulsuri wneva;\\\ filtvebis SeSupeba;\\\ mocimcime ariTmia.

\\\\ samkariani sarqvlis naklovaneba vlindeba yvela CamoTvlili niSniT, garda:\\\ RviZlis gadideba;\\\ kisris venebis Seberva;\\ filtvebis SeSupeba;\\\ periferiuli SeSupeba;\\\ trikuspidaluri regurgitacia.

\\\\ veloergometriuli sinjis pozitiurobis xarisxi ganisazRvreba:\\ STÅsegmentis cdomis sididiT;\\\ ST segmentis cdomis formiT;\\\ ST segmentis cdomis gamoCenisTvis saWiro drois xangrZlivobiT;\\\ arteriuli hipotenziis niSnebis ganviTarebiT;\\\ yvela CamoTvliliT.

\\\\ romeli gamokvlevis Catarebaa aucilebeli pacientisTvis stenokardiis qirurgiulimkurnalobis dawyebamde:\\\ veloergometriis;\\\ stres-eqokardiografiis;\\ seleqtiuri koronarografiis;\\\ miokardiumis perfuziuli scintigrafiis;\\\ magnitur-rezonansuri tomografiis.

\\\\ miokardiumis wina kedlis infarqti gansxvavdeba ukana kedlis infarqtisagan:\\\ nekrozis didi farTobiT.\\\ anevrizmis ganviTarebis meti sixSiriT.\\\ kedlismieri Trombozis ganviTarebis meti sixSiriT.\\\ cudi prognoziT.\\ yvela CamoTvliliT.

\\\\ miokardiumis ukana-bazaluri infarqtisTvis damaxasiaTebelia ekg cvlilebebi SemdegganxrebSi:\\\ I, II, aVL, V5-6, Î;\\\ II, III, aVF, D;\\\ I, aVL, V1-6,, A,I;.

14

\\ III, aVF, V7-9,, D;\\\ V1-4, Ô.

\\\\ parkuWTaSua Zgidis rupturas miokardiumis infarqtis dros axasiaTebs:\\\ uxeSi sistoluri Suilis uecari gaCena;\\\ marjvena parkuWis ukmarisobis swrafi ganviTareba;\\\ mwvave tkivili gulis areSi;\\\ sisxlis gadasrola marcxena parkuWidan marjvenaSi (eqokardiografiiT);\\ yvela CamoTvlili.

\\\\ avadmyofs miokardiumis mwvave infarqtiT aReniSneba politopuri jgufuriparkuWovani eqstrasistolebi. risi gakeTebaa aucilebeli:\\ lidokainis intravenuri Seyvana jer nakadiT, Semdeg wveTovnad 200 mg.;\\\ etacizini 1 tableti samjer dReSi;\\\ atf-is intravenuri Seyvana nakadiT - 12mg.;\\\ novokainamidis Seyvana mezatonTan erTad;\\\ strofantini 0,05% 1ml intravenurad (nela).

\\\\ CamoTvlili preparatebidan romeli iwvevs yvelaze metad intervalisgaxangrZlivebas?\\\ lidokaini;\\\ kordaroni;\\ qinidini;\\\ strofantini;\\\ furosemidi.

\\\\ daasaxeleT preparati, romliTac efeqturad xsnian sinusuri kvanZis sisustissindroms.\\ ar arsebobs;\\\ kordaroni;\\\ lidokaini;\\\ atropini;\\\ anaprilini.

\\\\ normotenziur avadmyofTan miokardiumis infarqtiT, romelic garTulda marcxenaparkuWovani mwvave ukmarisobiT, sinusuri taqikardiiT (gulis cemis sixSire <120)SeiZleba gamoviyenoT yvela CamoTvlili, garda:\\\ morfini;\\\ nitroglicerini;\\\ laziqsi;\\ anaprilini;\\\ oqsigenoTerapia.

\\\\ Tanamedrove monacemebis Tanaxmad, romeli CamoTvlili preparati ganapirobebssicocxlis gaxangrZlivebas gulis ukmarisobis mqone pacientebSi?\\\ sagule glikozidebi;\\\ Ca-is antagonistebi;\\\ Sardmdenebi;\\ agf inhibitorebi;\\\ I klasis antiariTmiuli saSualebebi.

\\\\ CamoTvlili antihipertenziuli saSualebebidan romelma SeiZleba gamoiwvios mZimemoxsnis sindromi:\\\ hipoTiazidma;\\ klofelinma;\\\ enalaprilma;\\\ amiloridma;\\\ spironolaqtonma.

15

\\\\ Ca -is antagonistebis jgufidan romeli preparatia umjobesi hipertonuli kriziskupirebisTvis, usafrTxoa þ adrenoblokatorebTan kombinaciaSi da am miznisTvisiniSneba sublingvalurad:\\\ diltiazemi;\\\ verapamili;\\ nifedipini;\\\ nikardipini;\\\ isradipini.

\\\\ yvela qvemoT CamoTvlil preparats aqvs dadebiTi inotropuli efeqti da gamoiyenebagulis mZime ukmarisobis mkurnalobisTvis, garda erTisa:\\\ dofamini;\\ qinidini;\\\ dobutamini;\\\ levodopa;\\\ fosfodiesTerazas inhibitori (amrinoni).

\\\\ CamoTvlili Sardmdenebidan romelia yvelaze efeqturi filtvebis SeSupebis dros:\\\ hipoTiazidi;\\ furosemidi;\\\ triamtereni;\\\ spironolaqtoni;\\\ amiloridi.

\\\\ intensiuri Terapiis ganyofilebaSi Semovida avadmyofi CiviliT Zlier tkivilzemkerdis Zvlisa da epigastriumis areSi. ekg-s safuZvelze daisva miokardiumis ukanakedlis infarqtis diagnozi. eleqtrokardiogramaze gamovlenili romeli cvlilebebiadamaxasiaTebeli am diagnozisaTvis:\\\ dabali voltaJi da R kbilis dakbilva V1-2 ganxrebSi;\\\ ST segmentis depresia IØ da avL ganxrebSi;\\\ ST segmentis depresia ÌV2-4 ganxrebSi;\\ Q II, III, avL>R-is 1/3-ze, ST segmentis elevaciasTan erTad;\\\ atrioventrikuluri blokadis niSnebi (I xarisxis).

\\\\ mimReb ganyofilebaSi Semovida avadmyofi mamakaci 64 wlis, CivilebiT gulisfrialze. gamokvlevisas gamovlinda pulsis deficiti. CamoTvlili aritmiebidanromeli Seesabameba am fenomens?\\\ sinusuri aritmia;\\\ winagulovani eqstrasistolia;\\ mocimcime aritmia;\\\ ritmis wamyvanis migracia;\\\ supraventrikuluri taqikardia.

\\\\ 72 wlis mamakacma, romelic mkurnalobs digoqsiniT da hidroqlorTiazidiT gulisSegubebiTi ukmarisobis gamo, erTmaneTSi auria medikamentebis dozebi. ekg-ze gamoCndabigeminia, Sratis kaliumis done 2,0mekv/l. SratSi digoqsinis donis gansazRvrasesaWiroeba 24 sT. risi gakeTebaa aucilebeli am momentSi?\\\ Jangbadis miwodeba;\\\ lidokaini intravenurad;\\\ verapamili peroralurad;\\\ propranololi intravenurad;\\ kaliumis qloridi peroralurad.

\\\\ novokainamidis swrafi intravenuri Seyvanisas ZiriTadi gverdiTi efeqtia:\\\ krunCxvebi;\\\ winagulebis cimcimi;\\ hipotenzia;\\\ gulis sruli atrioventrikuluri blokada;\\\ sinusuri bradikardia.

\\\\ ra doneze xdeba PQ intervalis yvelaze metad gaxangrZliveba?

16

\\\ sinusuri kvanZi;\\\ sinoaurikuluri SeerTeba;\\\ winaguli;\\ atrioventrikuluri kvanZi;\\\ hisis kona.

\\\\ revmatizmis sadiagnozo jonsis ZiriTad kriteriumebs miekuTvneba yvela CamoTvlili,garda:\\\ qorea;\\\ kvanZovani eriTemia;\\\ karditi;\\ arTralgia;\\\ kanqveSa kvanZebi.

\\\\ yvela CamoTvlili simptomi gvxvdeba gulis tamponadis dros, garda:\\\ sinusuri taqikardia;\\\ pulsuri wnevis Semcireba;\\\ CasunTqvisas arteriuli wnevis 10 mmHg-ze metad daqveiTeba;\\\ venuri hipertenzia;\\ alternaciuli pulsi.

\\\\ CamoTvlili aritmiebidan, romlebic Tan axlavs digitalizacias, romeli SeiZlebadaamZimos hiperkaliemiam:\\\ parkuWovani bigeminia;\\\ winagulebis cimcimi xSiri, regularuli parkuWovani ritmiT;\\\ araparoqsizmuli kvanZovani taqikardia;\\ sruli atrioventrikuluri blokada;\\\ parkuWovani taqikardia.

\\\\ gulis romeli Tandayolili manki SeiZleba Semcirdes an gaqres dabadebis Semdeg?\\\ falos tetrada;\\\ Tandayolili sruli atrioventrikuluri blokada;\\ parkuWTaSua Zgidis defeqti;\\\ winagulTaSua Zgidis meoradi defeqti;\\\ winagulTaSua Zgidis pirveladi defeqti.

\\\\ CamoTvlili diurezuli saSualebebidan romels gaaCnia yvelaze Zlieri efeqti?\\\ hidroqlorTiazids;\\\ acetazolamids;\\ furosemids;\\\ spironolaqtons;\\\ amilorids.

\\\\ preparatebi romlebic amcireben postdatvirTvas (mag. hidralazini) upiratesadmoqmedeben:\\\ aortaze;\\\ kunTovan arteriebze;\\ arteriolebze;\\\ kapilarebze;\\\ parkuWis miokardiumze.

\\\\ marcxena parkuWis postdatvirTvaze SeiZleba vimsjeloT:\\\ gulis SekumSvaTa sixSiris mixedviT;\\\ wuTmoculobis mixedviT;\\ diastoluri arteriuli wnevis mixedviT;\\\ marcxena parkuWis saboloo diastoluri moculobis mixedviT;\\\ filtvebis kapilaruli wnevis mixedviT.

\\\\ CamoTvlili antihipertenziuli preparatebidan romlis gamoyeneba iwvevshipertriqozis ganviTarebas?\\\ atenololi;

17

\\\ nifedipini;\\ minoqsidili;\\\ klofelini;\\\ hidralazini.

\\\\ ra iwvevs orTopnoes?\\\ arteriuli wnevis momateba horiozontalur mdgomareobaSi;\\\ Sardis Sekaveba;\\\ narCeni moculobis gazrda filtvebSi;\\ venuri wnevis gadanawileba;\\\ baroreceptorebis gaRizianeba.

\\\\ avTvisebiani hipertoniis klinikuri niSnebia:\\\ Tirkmlebis ukmarisoba;\\\ marcxena parkuWis hipertrofia;\\\ mxedvelobis nervis dvrilis SeSupeba;\\\ Tavis tvinis insulti;\\ yvela CamoTvlili.

\\\\ romeli paTologia ar aZlierebs I tons?\\\ Tireotoqsikozi;\\\ mitraluri stenozi;\\\ sinusuri taqikardia;\\\ winagulTaSua Zgidis defeqti;\\ mwvave aortuli naklovaneba.

\\\\ yvela CamoTvlili mdgomareobisas adgili aqvs marcxena parkuWis moculobiTgadatvirTvas, garda:\\ winagulTaSua Zgidis defeqti;\\\ parkuWTaSua Zgidis defeqti;\\\ aortuli sarqvlis naklovaneba;\\\ botalis Ria sadinari;\\\ mitraluri sarqvlis naklovaneba.

\\\\ yvela CamoTvlilma mdgomareobam SeiZleba gamoiwvios stabiluri stenokardiisgadasvla arastabilurSi, garda:\\\ miokardiumis infarqti;\\\ ritmis darRveva;\\\ Tromboqsanis koncentraciis momateba;\\ prostaciklinis koncentraciis momateba;\\\ koronarebis xangrZlivi daavadeba.

\\\\ yvela CamoTvlili preparati gamoiyeneba parkuWovani ritmis Sesanelebladwinagulebis fibrilaciisas, garda:\\\ digoqsini;\\ qinidini;\\\ propranololi;\\\ verapamili;\\\ diltiazemi.

\\\\ CamoTvlili gverdiTi efeqtebidan, romelia damaxasiaTebeli propranololisTvis?\\\ impotencia;\\\ lupus reaqcia;\\\ periferiuli SeSupeba;\\ bronqospazmi;\\\ gemovnebis dakargva.

\\\\ CamoTvlili gverdiTi efeqtebidan, romelia damaxasiaTebeli hidralazinisTvis:\\\ impotencia;\\ lupus-reaqcia;\\\ periferiuli SeSupeba;

18

\\\ bronqospazmi;\\\ gemovnebis dakargva.

\\\\ eqokardiografiuli da doplerokardiografiuli gamokvlevebi informaciuliaSemdeg SemTxvevebSi:\\\ aortuli stenozis;\\\ winagulTaSua Zgidis defeqtis;\\\ trikuspiduri regurgitaciis;\\\ mitraluri stenozis;\\ yvela CamoTvlil SemTxvevaSi.

\\\\ 42 wlis qals aReniSneba orive koW-wvivis saxsris SeSupeba, romelic cota xnis winganviTarda. sauRle venuri pulsi uaryofiTia. CamoTvlili mdgomareobebidan romeliar SeiZleba iyos SeSupebis mizezi?\\\ menjis Tromboflebiti;\\\ venebis varikozi;\\\ cikluri SeSupeba;\\\ hipoalbuminemia;\\ marjvena parkuWis ukmarisoba.

\\\\ qvemo kidurebis arteriebis emboliis yvelaze xSiri wyaroa:\\\ muclis aortis anevrizma;\\\ gulmkerdis aortis dawylulebuli folaqi;\\ guli;\\\ barZayis arteriis Trombozi;\\\ arc erTi.

\\\\ CamoTvlili paTologiebidan romlebi gvxvdeba ufro xSirad qalebSi, vidremamakacebSi?\\\ filtvis arteriis stenozi;\\ takaiasus daavadeba;\\\ aortis koarqtacia;\\\ arc erTi CamoTvlilidan;\\\ yvela CamoTvlili.

\\\\ gulis funqciuri mdgomareobis (muSaobis) ganmsazRvrav faqtorebs miekuTvneba yvelaCamoTvlili, garda erTisa:\\\ miokardiumis inotropuli funqcia;\\\ marcxena parkuWis postdatvirTva;\\\ marcxena parkuWis predatvirTva;\\ hematokriti;\\\ yvela CamoTvlili sworia.

\\\\ 38 wlis qals gulis SegubebiTi ukmarisobiT aReniSneba parkuWovanieqstrasisotolia da warsulSi parkuWovani taqikardiis ramodenime epizodi. arteriuliwneva normaluria, guli sagrZnoblad gadidebuli. Suilebi ar moismineba, koronaruliangiografia paTologias ar avlens, savaraudo diagnozia.\\\ mwvave revmatiuli cxeleba;\\\ Tandayolili fibroelastozi;\\\ konstriqciuli perikarditi;\\\ miokardiumis infarqti;\\ dilataciuri kardiomiopaTia.

\\\\ ekg cvlilebebidan winagulebis hipertrofiis damaxasiaTebelia:\\\ QRS kompleqsis deformacia da gafarToeba;\\\ PQ intervalis gaxangrZliveba;\\\ T kbilis deformacia da gafarToeba;\\ Pkbilis deformacia da gafarToeba;\\\ yvela zemoT CamoTvlili.

19

\\\\ marcxena parkuWis hipertrofiis dros qvemoTCamoTvlili ekg niSnebidan romeliadamaxasiaTebeli\\\ marcxena tipis ekg;\\\ QRST kompleqsis deformacia da gafarToeba;\\\ QT intervalis gaxangrZliveba;\\\ T kbilisQRS inversia;\\ yvela zemoT aRniSnuli.

\\\\ marjvena parkuWis hipertrofiis dros qvemoTCamoTvlili ekg niSnebidan romeliadamaxasiaTebeli?\\\ marjvena tipis ekg;\\\ S kbilebis gafarToeba da deformacia;\\\ QT intervalis gaxangrZliveba;\\\ QRS kompleqsis deformacia;\\ yvela zemoTaRniSnuli.

\\\\ avadmyofis ekg-ze V1 da V2 ganxrebSi aRiniSneba maRali R kbili da V5 da V6

ganxrebSi Rrma S kbili, ras niSnavs aRniSnuli cvlilebebi?\\\ marjvena winagulis hipertrofia;\\ marjvena parkuWis hipertrofia;\\\ marcxena winagulis hipertrofia;\\\ marcxena parkuWis hipertrofia;\\\ orive parkuWis hipertrofia.

\\\\ avadmyofs ekg-ze aReniSneba orfaziani Pp kbili, romlis xangnrZlivoba 0,12wm-ia,gulis romeli nawilis hipertrofiam SeiZleba ganapirobos aRniSnuli?\\\ marjvena winaguli;\\ marcxena winaguli;\\\ marjvena parkuWi;\\\ marcxena parkuWi;\\\ orive parkuWi.

\\\\ vazorenaluri hipertenziis dros racionaluri Terapia gulisxmobs:\\\ diuretikebis gamoyenebas;\\\ beta-adrenoblokatorebis gamoyenebas;\\\ umarilo dietas;\\ qirurgiul mkurnalobas;\\\ apresinis gamoyenebas.

\\\\ gulis SegubebiTi ukmarisoba maRali wuTmoculobiT gvxvdeba yvela qvemoTCamoTvlili paTologiis dros, garda:\\\ hiperTireozi;\\ arteriuli hipertenzia;\\\ anemia;\\\ beri-beri;\\\ arterio-venozuri fistulebi.

\\\\ ekg-ze aRiniSneba paTologiuri Q kbili 1, avL, V4, V5 da V6 ganxrebSi, ST-segmentiscdoma izoeleqtrul xazs zeviT da koronaruli T kbilis arseboba, aRniSneTmiokardiumis infarqtis lokalizacia\\\ parkuWTaSorisi Zgidis infarqti;\\\ Zgidisa da mwvervalis infarqti;\\\ marcxena parkuWis wina kedlis infarqti;\\\ marcxena parkuWis gverdiTi kedlis infarqti;\\ marcxena parkuWis wina-gverdiTi kedlis infarqti.

\\\\ qvemoTCamoTvlili romeli diuretikiT mkurnaloba SeiZleba garTuldeshiperkaliemiiT:\\\ hipoTiazidi;\\ triamtereni;

20

\\\ furosemidi;\\\ uregiti;\\\ diakarbi.

\\\\ qvemoTCamoTvlili simptomebidan romelia paTognomuri stenokardiisTvis?\\\ CxvletiTi tkivili gulis areSi fizikuri datvirTvis dros;\\\ parkuWovani eqstrasistolia fizikuri datvirTvis Semdeg;\\ tkivili mkerdis Zvlis ukan da ST segmentis depresia, warmoSobili erTdrouladdatvirTvis dros;\\\ Rrma Q kbili mesame da avF ganxrebSia;\\\ negatiuri T kbili V1-V6 ganxrebSi.

\\\\ stenokardia aris gamoxatuleba:\\\ mitraluri stenozis;\\ absoluturi da SedarebiTi koronaruli ukmarisobis;\\\ venuri sisxlis gulisken dinebis Semcirebis;\\\ pulmonaluri ukmarisobis;\\\ aortis aTerosklerozis.

\\\\ qvemoT CamoTvlili sisxlis Sratis fermentebidan romlis momateba ufrospecifikuri kriteriumia miokardiumis dazianebisaTvis:\\\ laqtatdehidrogenaza (gama)\\\ laqtatdehidrogenaza 1 (gama1)\\\ kreatinfosfokinaza (MM)\\ kreatinfosfokinaza (MB)\\\ glutamat oqsalatacetat transaminaza

\\\\ koronaruli arteriebis dazianebidan romeli qvemoT CamoTvlili aris prognozuladyvelaze arakeTilsaimedo:\\\ marjvena koronaruli arteriis sruli daxSoba\\\ marcxena wina daswvrivi koronaruli arteriis sruli daxSoba, romelic ZgideSigaxsnili pirveli arteriis proqsimalurad mdebareobs\\ marcxena koronaruli arteriis Reros obstruqcia 95%-iT\\\ marjvena koronaruli da marcxena wina daswvrivi koronaluri arteriebisobstruqcia 95%-iT\\\ marjvena koronaruli arteriis stenozi

\\\\ romeli qvemoT CamoTvlili meqanizmi aris ZiriTadi janmrTel gulSi koronalurisisxlis mimoqcevis gaumjobesebis TvalsazrisiT?\\\ gulis wuTmoculobis gazrda\\\ sistoluri arteriuli wnevis gazrda\\ periferiuli koronaruli rezistentobis Semcireba\\\ proqsimaluri koronaruli sisxlZarRvTa gafarToeba\\\ arc erTi zeviT CamoTvlili

\\\\ stenokardiuli SetevisTvis upiratesad damaxasiaTebelia:\\\ taqikardia\\\ iSemiuri ubnis SekumSvis unarianobis darRveva\\\ marcxena parkuWSi saboloo-diastoluri wnevis momateba\\\ sistoluri wnevis momateba\\ yvela zemoT CamoTvlili

\\\\ 40 wlis avadmyofi Semovida intensiuri Terapiis palataSi tkiviliT gulis areSida kardiogramiT, romelic miuTiTebs miokardiumis mwvave qveda infarqtze, ritmi 2:1,AV bloki, romelia swori:\\\ yvelaze dasaSvebia, rom blokada lokalizebulia atrioventrikulur kvanZSi\\\ bloki gardamavalia\\\ atropini Seamcirebs AV blokadis xarisxs\\ yvela zemoT CamoTvlili\\\ arc erTi zemoT CamoTvlili

21

\\\\ ra aris yvelaze mniSvnelovani stenokardiis prognozis savaraudod\\\ anginozuri Setevebis sixSire\\\ anginozuri Setevebis xangrZlivoba\\ koronaluri arteriis obstruqciis xarisxi\\\ datvirTvis odenoba, romelic saWiroa tkivilis provocirebisaTvis

\\\\ qvemoT CamoTvlilidan romelia atrioventrikularuli blokadis ekg maCvenebeli\\\ QRS intervalis gaxangrZliveba\\\ ST intervalis gaxangrZliveba\\ PQ intervalis gazrda\\\ R kbilis deformacia\\\ yvela zemoT aRniSnuli

\\\\ qvemoT CamoTvlilidan romelia parkuWSiga blokadis ekg maCvenebeli?\\\ PQ intervalis gaxangrZliveba\\\ ST intervalis gaxangrZliveba\\ QRS intervalis gaxangrZliveba\\\ Q kbilis deformacia\\\ arcerTi zemoT aRniSnuli

\\\\ aRniSneT nawilobrivi atrioventrikularuli blokadis ekg niSnebi:\\\ ST intervalis gaxangrZliveba\\\ QTPintervalis gazrda\\ PQ intervalis gaxangrZliveba\\\ PQQintervalis Semcireba\\\ R kbilis deformacia

\\\\ aRniSneT sruli atrioventrikularuli blokadis ekg niSnebidan romelia swori:\\\ RR intervalis mkveTri gazrda\\\ PQ intervalebi araTanabaria\\\ RR intervalebi Tanabaria\\\ TT intervalebi Tanabaria\\ yvela zemoT aRniSnuli

\\\\ supraventrikuluri eqstrasistoliis dros aRiniSneba yvela qvemoT CamoTvlili ekgniSnebi, garda erTisa:\\\ Pkbilis deformacia\\\ arasruli kompensatoruli pauza\\\ QRST kompleqsi ar icvleba\\ QRST kompleqsis deformacia

\\\\ parkuWovani eqstrasistoliis dros aRiniSneba yvela qvemoT CamoTvlili ekg niSnebi,garda erTisa:\\\ eqstrasistolas win ar uZRvis P kbili\\\ sruli kompensatoruli pauza\\ eqstrasistoluri QRS kompleqsebis xangrZlivoba ar aRemateba 0,10-s\\\ eqstrasistoluri QRST kompleqsebis deformacia\\\ eqstrasistolur kompleqsSi T kbilis diskordantoba RS kompleqsis udidesi kbilismimarT

\\\\ parkuWovani paroqsizmuli taqikardiis dros aRiniSneba yvela CamoTvlili ekgniSnebi, garda erTisa:\\\ RR intervalebis Semcireba\\\ QRS kompleqsebis deformacia da gafarToeba\\ normaluri PQ intervalebi\\\ ST segmentisa da T kbilis diskordantuli cvlilebebi

\\\\ hisis konis marcxena fexis blokadis dros ekg-ze aRiniSneba yvela CamoTvlili ekgniSnebi, garda erTisa:

22

\\\ marcxena tipis ekg\\\ QRST kompleqsis deformacia\\ QRS intervali ar aRemateba 0,10-s\\\ ST segmentisa da T kbilis diskordantuli cvlilebebi\\\ RR intervalebi Tanabaria

\\\\ ekg-ze P kbili dadebiTia, PQ -intervali 0,22 wm, QRS kompleqsis xangrZlivoba 0,09wm. daasaxeleT ritmis darRvevis saxeoba:\\\ parkuWovani eqstrasistolia\\\ mocimcime aritmia\\ I xarisxis nawilobrivi atrioventrikuluri blokada\\\ II xarisxis nawilobrivi atrioventrikuluri blokada\\\ sruli atrioventrikuluri blokada

\\\\ ekg-ze normaluri QRST kompleqsis Semdeg zogjer aRiniSneba deformirebuli QRSTkompleqsi, romlis

winac RR intervali Semoklebulia, miuTiTeT aritmiis saxeoba:\\\ respiratoruli aritmia\\\ winagulovani eqstrasistolia\\\ mocimcime aritmia\\ parkuWovani eqstrasistolia\\\ pirveli xarisxis nawilobrivi atrioventrikuluri blokada

\\\\ romel SemTxvevaSia yvelaze naklebad mosalodneli mocimcime aritmiis aRmoceneba?\\\ koronaruli arteriis aTerosklerozi\\\ Tireotoqsikozi\\ aortis stenozi bikuspidaluri aortuli sarqvlis arsebobisas\\\ mitraluri stenozi

\\\\ daxedviT kisris midamoSi aRiniSneba venuri pulsacia, palpatorulad SeigrZnobagulis saZgeri da epigastraluri pulsacia. romeli sarqvlovani aparatis dazianebaiwvevs zemoaRniSnul simptomebs:\\\ orkariani sarqvlis naklovaneba\\ samkariani sarqvlis naklovaneba\\\ mitraluri stenozi\\\ aortis xvrelis stenozi\\\ aortis sarqvlis naklovaneba

\\\\ avadmyofis gamokvlevisas aRiniSneba gulis zemo da marjvena perkutorulisazRvris gadideba. daasaxeleT manki, romelic mizezia aRniSnuli cvlilebebisa:\\\ orkariani sarqvlis naklovaneba\\ mitraluri stenozi\\\ aortis sarqvlis naklovaneba\\\ aortis sarqvlis stenozi\\\ samkariani sarqvlis naklovaneba

\\\\ qveviT CamoTvlili romeli paTologiaa xSirad Serwymuli aortulregurgitaciasTan:\\ aortuli stenozi\\\ filtvis arteriis stenozi\\\ parkuWTaSua Zgidis defeqti\\\ mitraluri stenozi\\\ yvela zemoT CamoTvlili

\\\\ gulis auskultaciisas moismineba moyruebuli I da II toni, aortazeprotodiastoluri Suili "dekreSCendos" tipis, romelic tardeba me-5 wertilSi(botkin-erbi). romeli manki SeiZleba iyos am auskultaciuri monacemebis mizezi:\\\ mitraluri sarqvlis naklovaneba\\\ mitraluri stenozi\\ aortis sarqvlis naklovaneba\\\ samkariani sarqvlis naklovaneba

23

\\\ aortis xvrelis stenozi

\\\\ aortuli regurgitaciisa da gulis mZime ukmarisobis dros romeli fizikurifenomeni ar aRiniSneba?\\\ mezodiastoluri Suili mwvervalze\\\ gulis me-4 (Wenebis) toni\\\ sisxlis wneva 90/40-ze\\ maRali pirveli toni\\\ sistoluri Suili sternalurzeda fosoSi

\\\\ yvela qvemoT CamoTvlili paTologia SeiZleba warmoadgendes mitraluri stenozisgarTulebas, garda erTisa:\\\ filtvebis hipertenzia da SeSupeba\\\ marjvena parkuWis hipertrofia\\ marcxena parkuWis hipertrofia\\\ winagulebis cimcimi\\\ gulis wuTmoculobis Semcireba

\\\\ Semdegi SemTxvevebidan rodis aris naklebad savaraudo cianozi?\\ winagulTaSorisi didi defeqti\\\ filtvis arterio-venuri fistula\\\ parkuWTaSorisi Zgidis mniSvnelovani defeqti\\\ erTi parkuWi\\\ persistirebuli zeda Rru venis mniSvnelovani drenireba marcxena winagulSi

\\\\ gulmkerdis areSi tkivilis uecari dawyebisa da adreuli diastoluri SuilisganviTarebisas, aortuli naklovanebis dros unda vivaraudoT:\\\ mwvave baqteriuli endokarditi\\ aortis ganSreveba\\\ parkuWTaSua Zgidis defeqti\\\ aortis sarqvlis miqsomatozuri prolafsi\\\ valsalvis sinusis anevrizmis gaskdoma

\\\\ stabiluri stenokardiis mqone avadmyofSi prognozis gansazRvrisaTvis romeliklinikuri parametria yvelaze arsebiTi:\\\ xSiri stenokardiuli Setevebi\\\ datvirTvis tolerantobis gansazRvra tredmiliT\\\ datvirTvis sinjiT gamowveuli eqstrasistolia\\\ risk-faqtorebis raodenoba\\\ pacientebis regularuli fizikuri varjiSis sixSire\\ 2+4

\\\\ romel daavadebas axasiaTebs sarqvlis dazianeba, romelsac Tan erTvissubfebriluri temperatura, eds-is momateba da emboliebi:\\\ miokarditi\\ infeqciuri endokarditi\\\ revmatuli karditi\\\ perikarditi\\\ tromboflebiti

\\\\ noradrenalini iwvevs vazokonstriqcias yvela qvemoTCamoTvlil organoSi, garda:\\ guli\\\ kani\\\ ConCxis kunTebi\\\ RviZli\\\ wvrili da msxvili nawlavebi

\\\\ qvemoTCamoTvlili SemTxvevebidan rodis gaaCniaT avadmyofebs infeqciuriendokarditis ganviTarebis SedarebiT dabali riski\\\ gulis sarqvlebis protezirebisas\\ winagulTaSua Zgidis defeqtis dros

24

\\\ parkuWTaSua Zgidis defeqtis dros\\\ Ria arteriuli sadinaris dros\\\ aortis koarqtaciisas

\\\\ daasaxeleT perikarditis yvelaze xSiri mizezi:\\\ sxva organoebidan anTebiTi procesis gavrceleba\\ virusuli genezis\\\ sefsisi\\\ revmatizmi\\\ neoplazma

\\\\ dilataciuri kardiomiopaTiis dros auskulataciiT damaxasiaTebelia:\\\ diastoluri Suili filtvis arteriaze\\ Wenebis ritmi\\\ tkacuna pirveli toni\\\ diastoluri Suili gulis mwvervalze\\\ me-2 tonis gaZliereba

\\\\ Tu restriqciuli kardiomiopaTiiT daavadebul avadmyofs ganuviTardeba gulisukmarisoba, unda mivceT:\\\ izolanidi\\ furosemidi\\\ propranolili\\\ eufilini\\\ oqsigenoTerapia

\\\\ kardiomiopaTiiT daavadebulebSi SeiZleba ganviTardes:\\\ sistemuri embolia\\\ infeqciuri endokarditi\\ parkuWovani aritmia\\\ Tirkmlis mwvave ukmarisoba\\\ yvela zemoT CamoTvlili

\\\\ marcxena parkuWovani ukmarisobisaTvis damaxasiaTebelia Semdegi niSnebi, gardaerTisa:\\\ qoSini\\\ galopis ritmi\\ kisris venebis daberva\\\ krepitacia filtvis fuZesTan\\\ kardiuli asTma

\\\\ ra RonisZiebas CaatarebT mwvaved ganviTarebuli kardiuli asTmis dros?\\\ presoruli aminebis Seyvana\\ furosemidi venaSi\\\ eufilini dasalevad\\\ anaprilini dasalevad\\\ inhalacia simpatomimeturi saSualebebiT

\\\\ qvemoT CamoTvlilidan romels gamoiyenebT bradikardiis dros\\\ beta-adrenoblokerebi\\\ Ca -is antagonistebi\\ atropini da platifilini\\\ sagule glikozidebi

\\\\ qvemoT CamoTvlilidan romels gamoiyenebT sruli gardigardmo blokadissamkurnalod:\\ eleqtrokardiostimulacia\\\ eleqtruli defibrilacia\\\ beta-adrenoblokerebi\\\ sagule glikozidebi

25

\\\\ aRniSneT romelia sagule glikozidebiT intoqsikaciis niSani:\\\ mkveTri bradikardia\\\ atrioventrikuluri blokada\\\ politopuri eqstrasistolia\\\ parkuWebis fibrilacia\\ yvela CamoTvlili

\\\\ aRniSneT sagule glikozidebis daniSvnis ukuCveneba:\\\ taqisistoluri mocimcime aritmia\\\ paroqsizmuli taqikardia\\\ supraventrikuluri taqikardia\\ politopuri parkuWovani eqstrasistolia

\\\\ glikozidebis miRebiT gamowveuli romeli CamoTvlili aritmia SeiZleba gaaRrmavos(gaauaresos, gaamwvavos) hiperkaliemiam:\\\ parkuWovani bigeminia\\\ winagulebis cimcimi xSiri, regularuli parkuWovani ritmiT\\\ paraproqsimaluri kvanZovani taqikardia\\ sruli atrioventrikuluri blokada\\\ parkuWovani taqikardia

\\\\ stenokardiiT Sepyrobil avadmyofebSi nitroglicerinis ZiriTadi samkurnaloefeqti upiratesad dakavSirebulia:\\\ koronaruli arteriebis gafarToebasTan\\\ periferiuli arteriebis gafarToebasTan\\ periferiuli venuri sistemis dilataciasTan\\\ gulis cemis sixSiris gazrdis Sedegad koronaruli sisxlis mimoqcevis gazrdasTan\\\ SekumSvis sixSiris SenelebasTan da miokardiumis mier Jangbadis moTxovnilebisSemcirebasTan

\\\\ cirkulaciaSi arsebuli sisxlis saerTo raodenobis ra procentia venur sisxlSi?\\\ 5-10%\\\ 25-30%\\\ 50-55%\\ 75-80%\\\ 90%-ze meti

\\\\ prolongirebuli nitratebis maRali dozebis xmareba ar aris sasurveli Semdegidaavadebebis mkurnalobisas:\\\ aortis sklerozi\\\ aortaluri sarqvlebis naklovaneba\\\ mitraluri sarqvlebis naklovaneba\\\ dilataciuri kardiomiopaTia\\ hipertrofiuli kardiomiopaTia

\\\\ novokainamidis venaSi swrafad Seyvanis dros ZiriTad gverdiT moqmedebad iTvleba:\\\ krunCxvebi\\\ winagulebis cimcimi\\ hipotenzia\\\ gulis sruli ganivi blokada\\\ sinusuri taqikardia

\\\\ gaurTulebeli qolecisteqtomiis Semdeg gaRviZebidan 1 sT-is Semdeg 49 wlis qals,romelsac ar aReniSneboda gulis daavadeba, ganuviTarda winagulebis fibrilacia,xSiri parkuWovani eqstrasistolebiT, avadmyofs gamoxatuli klinikuri niSnebi araaqvs, arteriuli sisxlis wneva normaluria, rogoria gadaudebeli Terapia:\\ lidokainis intravenurad Seyvana\\\ dauyovnebeli eleqtrodefibrilacia\\\ digoqsinis venaSi Seyvana\\\ digoqsinis peroralurad miReba

26

\\\ karotiduli sinusis masaJi

\\\\ antikoagulanti heparini ra gziT axdens antikoagulaciur moqmedebas:\\\ koagulaciis ramdenime faqtoris damuxruWebiT\\\ astimulirebs histaminis gamonTavisuflebas\\ ukavSirdeba alfa-2 globulins (antiTrombin 3) da am gziT xels uSlis koagulacias\\\ iwvevs Trombocitopenias\\\ sisxlidan aZevebs fibrogens

\\\\ antikoagulantebi ukunaCvenebia pacientebisaTvis:\\\ Saqriani diabetiT an steatoreiT\\\ anamnezSi 12-goja nawlavis wyluliT\\ aqtiuri sisxldeniT\\\ epilefsiformuli SetevebiT\\\ baqteriuli infeqciiT

\\\\ qvemoTmoyvanili SemTxvevebidan rodis ufro xSirad viTardeba filtvis embolia:\\ sefsisuri aborti\\\ zedapiruli Tromboflebiti\\\ winagulTaSorisi Zgidis defeqti\\\ pielonefriti\\\ koronaruli angiografia

\\\\ qvemoTCamoTvlili monacemebidan romelia Sokis ganmsazRvreli:\\\ sistoluri wnevis daweva 90 mm vwy-ze qvemoT\\\ bolo 2 saaTis ganmavlobaSi diurezi saaTSi 20 ml-sT-ze naklebia\\\ gulis wuTmoculobis daqveiTeba\\ qsovilovani perfuziis daqveiTeba\\\ yvela

\\\\ mitraluri stenozis diagnostikaSi romel hemodinamikur maCveneblebs aqvs ZiriTadimniSvneloba:\\\ wneva filtvis arteriaSi\\\ wneva marcxena winagulSi\\\ wneva marjvena parkuWSi\\\ wneva marjvena winagulSi\\ marcxena winagulisa da marcxena parkuWis diastolur wnevas Soris arsebuli wnevisgradienti.

\\\\ aortis romel ubans axasiaTebs ufro xSirad misi aTerosklerozuli anevrizma\\ muclis aorta\\\ aortis rkali\\\ misi aRmavali nawili\\\ valsalva-s sinusi\\\ koronaruli arteriis SesarTavi

\\\\ muclis aortis araganSrevebadi anevrizma:\\\ yvelaze xSirad aqvT avadmyofebs, romelTac aqvT tkivili mucelSi\\\ axla gvxvdeba iSviaTad sifilisuri aortitebis Semcirebis gamo\\\ SemTxvevaTa 80% dakavSirebulia hipertenziasTan\\ warmoadgens aTerosklerozis garTulebas\\\ xSirad meoradia naRvlis buStis nekrozis dros

\\\\ sifilisuri infeqciis romel stadiaSi xdeba gulsisxlZarRvTa sistemis luesuridazianebis manifestireba:\\\ pirvel stadiaSi\\\ meore stadiaSi\\ mesame stadiaSi\\\ pirvel da meore stadiebSi\\\ meore da mesame stadiebSi

27

\\\\ filtvebis perkusiiT-filtvis naTeli xmianoba, auskultaciiT-mkvrivi sunTqva. sadaris lokalizebuli paTologiuri procesi:\\ bronqebSi\\\ filtvebis parenqimaSi\\\ plevris furclebSi\\\ traqeaSi\\\ perikardiumSi

\\\\ qvemoT CamoTvlilidan ra aris damaxasiaTebeli mwvave kerovani pnevmoniisTvis:\\\ xvela Jangiani naxveliT\\\ hemaptie\\\ bronquli sunTqva da plevris xaxunis xmianoba\\ rentgenologiurad wvrilkerovani, subsegmenturi, an segmenturi daCrdilva, filtvissuraTis gaZliereba\\\ yvela CamoTvlili

\\\\ avadmyofi mamamakaci, 48 wlis, awuxebs xvela "Jangisferi" naxveliT, temperaturismomateba, tkivili marjvena gverdSi. inspeqciiT - gulmkerdis marjvena naxevariCamorCeba sunTqvaSi. palpaciiT - marjvniv beWis qvemo areSi moyrueba. imave midamoSiauskultaciiT moismineba bronquli sunTqva, gamoxatuli bronqofonia.daasaxeleT daavadeba, romelsac axasiaTebs zemoT aRwerili simptomebi:\\\ mwvave bronqiti\\\ qronikuli bronqiti\\\ bronqopnevmonia\\ krupozuli pnevmonia\\\ eqsudaciuri plevriti

\\\\ plevris Rrus eqsudatisTvis ra aris damaxasiaTebeli:\\ xvedriTi wona >1015\\\ tute reaqcia\\\ cilis Semcveloba <30 g/l-ze\\\ naleqSi ujredebis mcire raodenoba\\\ yvela zemoT CamoTvlili

\\\\ avadmyofi mamakaci 54 wlis, awuxebs qoSini gaZnelebuli amosunTqviT mcirefizikuri datvirTvis dros. anamnezSi-eweva sigarets didi raodenobiT. inspeqciiT-kasriseburi gulmkerdi. filtvis perkusiiT-kolofiseburi xmianoba. auskultaciiT-Sesustebuli vezikuluri sunTqva. daasaxeleT paTologiuri procesi, romelic iZlevazemoT aRweril simptomokompleqss:\\\ filtvebis qronikuli anTebiTi daavadebebi\\\ filtvis qsovilis anTebiTi gamkvriveba - infiltracia\\\ filtvis qsovilSi haeris arseboba - ateleqtazi\\ filtvis qsovilis elastiurobis daqveiTeba - emfizema\\\ filtvis qsovilis Cirqovani rRveva - abscesi

\\\\ zemoT CamoTvlili paTologiebidan romels SeuZlia gamoiwvios perkutorulixmianobis Semokleba:\\\ eqsudaciur plevrits\\\ plevrul Svartebs (Sexorcebebs)\\\ filtvis ateleqtazs\\\ krupozul pnevmonias\\ yvela CamoTvlils

\\\\ yvela qvemoT CamoTvlil daavadebas SeuZlia gamoiwvios sisxliani xvela, garda:\\\ mitraluri stenozi\\\ gudpasCeris sindromi\\ aerzis daavadeba\\\ vegeneris daavadeba\\\ filtvis infarqti

28

\\\\ avadmyofi qali 30 wlis, awuxebs qoSini difuziuri datvirTvisas, arTralgia,cxeleba, kvanZovani tipis gamonayari. fizikuri gamokvleviT daudginda hepato-splenomegalia, limfadenopaTia. gulmkerdis rentgenogramaze ormxrivi limfadenopaTia.savaraudo diagnozia:\\\ limfogranulomatozi\\\ tuberkulozi\\\ revmatizmi\\ sarkoidozi\\\ revmatoiduri arTriti

\\\\ CamoTvlilidan ra aris damaxasiaTebeli gudpasCeris sindromisTvis:\\\ anemia\\\ hematuria\\\ proteinuria\\\ naxvelSi hemosiderinis Semcveli makrofagebi\\ yvela CamoTvlili

\\\\ pnevmoniis mkurnalobis ra meTodi unda gamoviyenoT, Tu daniSnuli antibiotikiTmkurnalobis 3 dRis Semdeg efeqti ar aris:\\\ gavzardoT antibiotikis doza\\\ damatebiT davniSnoT sulfanilamidebi\\\ davumatoT kortikosteroidebi\\ avarCioT sxva antibiotiki mikrobis mgrZnobelobis gaTvaliswinebiT\\\ yvela CamoTvlili

\\\\ CamoTvlilidan ra axasiaTebs bronqul asTmas?\\\ eqspiraciuli qoSini\\\ mcire raodenobiT naxveli\\\ perkusiiT-kolofisebri xmianoba\\\ auskultaciiT mstvinavi xixini\\ yvela CamoTvlili

\\\\ qronikuli bronqitis garTuleba SeiZleba iyos yvela qvemoT CamoTvlili, garda:\\\ filtvebis emfizemia\\\ difuzuri pnevmosklerozi\\\ filtvismieri guli\\ mSrali plevriti\\\ bronqoeqtaziuri daavadeba

\\\\ CamoTvlilidan ras SeuZlia gamoiwvios pnevmoToraqsi:\\\ kerovan pnevmonias\\\ ucxo sxeulis aspiracias\\ filtvis abscess\\\ filtvis arteriis Tromboembolias\\\ yvela CamoTvlils

\\\\ CamoTvlili meTodebidan romelia nakleb efeqturi bronqoeqtaziuri daavadebissamkurnalod:\\\ bronquli xis sanacia\\\ bronqis sanaTurSi mukolizuri preparatebisa da proteolizuri fermentebis Seyvana\\\ bronqis sanaTurSi antibiotikebis Seyvana\\ intravenuri antibiotikoTerapia\\\ yvela CamoTvlili

\\\\ filtvis emfizemisTvis damaxasiaTebelia yvela CamoTvlili, garda:\\ gulze diastoluri Suili\\\ II tonis aqcentis filtvis arteriaze\\\ farTo epigastruli kuTxe\\\ qoSini\\\ kolofiseburi xmianoba filtvebis perkusiisas

29

\\\\ CamoTvlili paTologiuri mdgomareobebidan romels SeuZlia gamoiwvioshidroToraqsi:\\\ Suasayris simsivnes\\\ RviZlis cirozs\\\ konstriqciul perikardits\\\ nefrozul sindroms\\ yvela CamoTvlils

\\\\ CamoTvlilidan ra aris damaxasiaTebeli spontanuri pnevmoToraqsisTvis:\\\ tkivili gulmkerdis areSi\\\ plevris RruSi haeris arseboba\\\ civi ofli da cianozi\\\ filtvis kolafsi\\ yvela CamoTvlili

\\\\ daasaxeleT daavadeba, romlis drosac naxvelSi aris kurSmanis spiralebi daSarko-leidenis kristalebi:\\\ bronqoeqtaziuri daavadeba\\\ filtvebis emfizema\\ bronquli asTma\\\ krupozuli pnevmonia\\\ filtvis abscesi

\\\\ CamoTvlilidan ra aris paTognomuri qronikuli filtvismieri gulisTvis:\\\ gulis marcxena sazRvris gadideba\\\ mocimcime ariTmia\\ venuri wnevis momateba\\\ filtvis arteriis Tromboembolia\\\ yvela CamoTvlili

\\\\ CamoTvlili testebidan ra ganasxvavebs filtvebis restriqciul daavadebebsobstruqciulisagan yvelaze zustad:\\\ filtvebis sasicocxlo tevadoba\\\ sunTqviTi moculoba\\\ forsirebuli amosunTqvis moculoba\\ forsirebuli amosunTqvis moculoba/filtvebis sasicocxlo tevadobasTan (tifnosindeqsi)\\\ narCeni moculoba

\\\\ filtvebis ra saxis dazianebaa damaxasiaTebeli sistemuri wiTeli mglurasTvis:\\\ filtvebis intersticiuli fibrozi\\\ plevruli Svartebi (Sexorcebebi)\\ pnevmoniti, eqsudaciuri plevriti\\\ bronqebis kedlebis infiltrati\\\ yvela CamoTvlili

\\\\ wilovani pnevmoniis garTulebebs miekuTvneba yvela CamoTvlili, garda:\\ filtvis emfizemis\\\ septicemiis\\\ meningizmis\\\ plevris empiemis\\\ filtvis abscesis

\\\\ 30 wlis, avadmyofi mamakaci, klinikaSi Semovida SebrunebiTi morecidive pnevmoniisdiagnoziT, qronikuli produqtiuli xveliT Cirqovani naxvelis gamoyofiT, zogjersisxlis minareviT zolebis saxiT, xvela Zlierdeba dilaobiT da dawolisas, mtevnisfalangebis frCxilebi dolis Cxirebis formis. filtvebis ukana-qvemo wilebze ismissveli xixini. savaraudo diagnozia:\\ bronqoeqtazia\\\ qronikuli bronqiti\\\ filtvis diseminirebuli tuberkulozi

30

\\\ filtvis kibo\\\ filtvebis emfizema

\\\\ qvemoT CamoTvlilidan ra axasiaTebs filtvebis emfizemas:\\\ cianozi\\\ Sesustebuli sunTqva\\\ filtvebis eqskursiis SezRudva\\\ filtvebis qsovilis gamWvirvalobis gaZliereba rentgenologiuri gamokvleviT\\ yvela CamoTvlili

\\\\ CamoTvlilidan ra aris paTognomuri filtvis abscesisTvis:\\\ maRali temperatura\\\ leikocitozi\\\ xvela savse piriT\\ infiltratis fonze mrgvali Rrus arseboba siTxis horizontaluri doniT\\\ yvela CamoTvlili

\\\\ CamoTvlili simptomebidan romelia damaxasiaTebeli eqsudaciuri plevritisaTvis:\\\ perkutoruli xmianobis moyrueba\\\ moyruebis areSi sunTqvis Sesusteba an gaqroba\\\ Suasayris organoebis cdoma gverdze, paTologiuri procesis sawinaaRmdego mxares\\\ moyruebis iribi xazi\\ yvela CamoTvlili

\\\\ filtvebSi Segubebis mizezi SeiZleba iyos yvela qvemoT moyvanili mdgomareoba,garda:\\\ mitraluri stenozis\\\ gulis anevrizmis\\\ aortis sarqvelebis naklovanebis\\\ marcxena parkuWis ukmarisobis\\ pnevmoniis

\\\\ CamoTvlilidan ra warmoadgens filtvebis hiperventilaciis Sedegs:\\ sunTqviTi alkalozi\\\ sisxlis ÇÐ-is daqveiTeba\\\ arteriuli wnevis momateba\\\ sisxlSi rZismJavas donis momateba\\\ sisxlSi bikarbonatebis donis momateba

\\\\ CamoTvlilidan ra axasiaTebs gudpasCeris sindroms:\\\ rkina-deficituri anemia\\\ sisxldena filtvebidan\\\ filtvebSi infiltratebis rentgenologiuri niSnebi\\\ progresirebadi glomerulonefriti\\ yvela CamoTvlili

\\\\ CamoTvlilidan ra axasiaTebs bronquli asTmis Setevas:\\\ tkivili gulmkerdis areSi\\\ sisxliani xvela\\\ filtvebis SeSupeba\\ eqspiraciuli qoSini\\\ yvela CamoTvlili

\\\\ avadmyofi mamakaci 39 wlis, uCivis SeteviTi xasiaTis eqspiraciuli tipis qoSins.Setevis CaTavebisas uCndeba xvela lorwovani naxvelis gamoyofiT. avadmyofs aqvsiZulebiTi mjdomare mdebareoba, gamoxatuli cianozi. filtvebis perkusiiT -kolofisebri xmianoba. auskultaciiT mravlobiTi mSrali mstvinavi xixini. daasaxeleTdaavadeba, romelic xasiaTdeba zemoT aRniSnuli simptomebiT:\\\ qronikuli bronqiti\\\ filtvebis emfizema\\ bronquli asTma

31

\\\ bronqoeqtaziuri daavadeba\\\ bronqopnevmonia

\\\\ CamoTvlilidan ra SeiZleba iyos pnevmoniis mizezi:\\\ ucxo sxeulis aspiracia\\\ filtvis arteriis Tromboembolia\\\ limfogranulomatozi\\\ gulis SegubebiTi ukmarisoba\\ yvela CamoTvlili

\\\\ plevris RruSi hemoragiuli siTxe vlindeba:\\\ tuberkulozuri plevritis dros\\\ filtvebSi araspecifiuri anTebiTi procesis dros\\\ sakvercxeebis simsivnis dros\\ filtvis infarqtis dros\\\ plevris empiemis dros

\\\\ CamoTvlilidan ra axasiaTebs bronqoeqtaziebs:\\\ xvela savse piriT\\\ Sreobrivi naxveli\\\ dolis Cxirisebri TiTebi\\\ msxvili da saSualo buStukovani xixini\\ yvela CamoTvlili

\\\\ CamoTvlilidan ra axasiaTebs plevris Rrus transudats:\\\ rivaltas uaryofiTi reaqcia\\\ xvedriTi wona <1015\\\ cila <3g%\\\ baqteriologiuri gamokvleviT mikroorganizmebi ar aRmoCndeba\\ yvela CamoTvlili

\\\\ CamoTvlili rentgenologiuri niSnebidan ra aris damaxasiaTebelipnevmoToraqsisaTvis:\\\ plevris RruSi haeris arseboba\\\ filtvis kolafsi\\\ Suasayris organoebis cdoma sapirispiro mxares\\\ CamoTvlilidan arc erTi\\ yvela CamoTvlili

\\\\ sunTqvis mwvave ukmarisobis mizezebia yvela CamoTvlili, garda:\\\ laringospazmis\\\ bronquli asTmis\\ kerovani pnevmoniis\\\ filtvis arteriis Tromboemboliis\\\ xorxis mwvave SeSupebis

\\\\ CamoTvlili paTologiebidan romels SeuZlia gamoiwvios sasunTqi sistemisdazianeba:\\\ revmatoidul arTrits\\\ sistemur wiTel mgluras\\\ gudpasCeris sindroms\\\ sistemur sklerodermias\\ yvela CamoTvlils

\\\\ pnevmoniis yvelaze tipiuri gamomwvevi:\\\ stafilokoki\\\ virusi\\ pnevmokoki\\\ klebsiela\\\ nawlavis Cxiri

32

\\\\ 25 wlis narkomani mamakaci Semovida klinikaSi mSrali xvelis da qoSinis 4 kvirianianamneziT. rentgenogramaze Cans difuzuri intersticiuli daCrdilva. savaraudodiagnozi:\\\ filtvis arteriis embolia\\ pnevmocisturi pnevmonia\\\ kapoSis sarkoma\\\ laimis daavadeba\\\ kerovani pnevmonia

\\\\ axalgazrda qali mwvave uveitiT da kvanZovani eriTemiT, aqvs bilateralurihilusuri da paratraqeuli adenopaTia, gulmkerdis simptomebis gareSe. savaraudodiagnozia:\\\ tuberkulozi\\\ Sidsi\\ sarkoidozi\\\ laimis daavadeba\\\ revmatoiduli arTriti

\\\\ 50 wlis alkoholiks, romelsac aReniSneba Zlieri kariesi, aqvs sisuste da tkiviligulmkerdis areSi marjvena mxares 2 kviris ganmavlobaSi, subfebriluri cxeleba daproduqciuli xvela suniani Cirqovani naxveliT. ÊrentgenografiiT dadginda 2 sm-isdiametris siTxiT savse Rru marjvena filtvis zemo nawilSi. aRniSnuli suraTiganpirobebulia Semdegi paTologiiT:\\ abscesi\\\ bronqoeqtazia\\\ filtvis infarqti\\\ filtvis sqvamozur ujredovani karcinoma\\\ tuberkulozi

\\\\ 62 wlis mamakacs ukanaskneli sami wlis ganmavlobaSi hqonda marjvena qvemo wilispnevmoniis oTxi epizodi. am epizodebs Soris aReniSneboda xvela lorwovan-CirqovaninaxveliT da iSviaTad hemaptoe. naxveli upiratesad gamoiyofoda dilaobiT daWurWelSi qmnida sam Sres. bronqoskopiuli gamokvleviT ar dadginda simsivne anobstruqcia. am monacemebze dayrdnobiT savaraudo diagnozia:\\\ filtvis abscesi\\\ alveolurujredovani karcinoma\\\ aspiraciuli pnevmonia\\ bronqoeqtazia\\\ lupoiduri pnevmonia

\\\\ pnevmoniis garTulebebidan yvelaze saxifaTo sicocxlisaTvis aris:\\\ filtvebis abscesi\\\ plevriti\\\ miokarditi\\\ perikarditi\\ infeqciur-toqsiuri Soki

\\\\ romelia I rigis antibiotiki:\\\ ampicilini\\\ III Taobis cefalosporini\\ penicilini\\\ eriTromicini\\\ gentamicini

\\\\ pnevmoniis dros antibiotikoTerapiis saorientacio vadebia:\\\ temperaturuli reaqciis normalizaciamde\\\ infiltratis srul gawovamde\\\ eds-is normalizaciamde\\ 4-5 dRe normaluri temperaturis Semdeg\\\ xvelis gaqrobamde

33

\\\\ pnevmoniebis dros glukokortikoidebis daniSvnis pirdapiri Cvenebaa:\\\ mZime mimdinareoba gamoxatuli intoqsikaciiT\\\ gamoxatuli hiperTermia\\\ infiltratis neli gawova\\ Tanmxlebi bronqospazmuri sindromi\\\ eqsudaciuri plevriti

\\\\ streptokokuri pnevmoniisTvis damaxasiaTebelia:\\\ remisiuli cxeleba\\\ qoSini\\\ Raribi perkutoruli da auskultaciuri monacemebi\\\ garTulebebis swrafi ganviTareba plevritis da pnevmoniuri kerebis abscedirebissaxiT\\ yvela CamoTvlili

\\\\ ZiriTadi faqtori, romelic ganapirobebs mwvave pnevmoniis gadasvlas qronikulSi:\\\ respiratoruli aparatis virusuli infeqcia\\\ mikrofloris Tvisebebis Secvla\\\ bronquli obstruqcia\\\ zeda sasunTqi gzebis da damatebiTi Rruebis qronikuli anTebiTi procesebi\\ pnevmoniis gvian dawyebuli da araadeqvaturi mkurnaloba

\\\\ mwvaved ganviTarebuli filtvismieri gulis dros adreul klinikur simptomebsmiekuTvneba yvela CamoTvlili, garda:\\\ mkveTrad gamoxatuli qoSinis\\\ gulis frialis\\\ mwvave tkivilis marjvena ferdqveSa areSi\\\ cianozis\\ qvemo kidurebis SeSupebis

\\\\ qronikuli filtvismieri gulis ganviTarebis mizezi SeiZleba iyos yvelaCamoTvlili, garda:\\\ filtvis morecidive emboliis\\\ filtvebis qronikuli obstruqciuli daavadebebis\\\ gulmkerdis deformaciis\\ filtvebis kerovani tuberkulozis

\\\\ mcire wris hipertenziis eleqtrokardiografiuli niSania:\\\ gulis eleqtruli RerZis gadaxra marcxniv\\\ gulis eleqtruli RerZis gadaxra marjvniv\\\ atrioventrikuluri blokada\\ maRali wvetiani P kbili II, III, avF ganxrebSi

\\\\ filtvis arteriis Tromboemboliisa da miokardiumis ukana kedlis infarqtisdiferencialur diagnostikaSi mniSvnelovani eleqtrokardiografiuli niSania:\\\ parkuWovani eqstrasistolebi\\ pulmonaluri "p" kbiliçãäüùòôäó\\\ winagulebis cimcimis paroqsizmi\\\ hisis konis marjvena fexis blokada\\\ Rrma Q III da avF ganxrebSi, ST elevacia, T kbilis inversia amave ganxrebSi da amcvlilebaTa ukudinamika

\\\\ pnevmonia iTvleba gaxangrZlivebulad Tu:\\ avadmyofoba grZeldeba 4 kviraze metxans\\\ daavadebis niSnebi ar qreba dawyebidan 4 kviris ganmavlobaSi\\\ miuxedavad Catarebuli mkurnalobisa rentgenogramaze rCeba filtvis suraTiscvlilebebi 4 kviraze metxans klinikuri niSnebis alagebis Semdeg\\\ mkurnalobis 4 kviris Semdeg klinikur-rentgenologiuri monacemebi uaresdeba

\\\\ yvelaze informaciuli meTodi filtvis periferiuli kibos sadiagnozod aris:\\\ bronqoskopia

34

\\\ bronqografia\\ tomografia\\\ naxvelis gamokleva atipiuri ujredebis aRmosaCenad\\\ auskultacia

\\\\ bronqoeqtaziebis sadiagnozo yvelaze informaciuli meTodia:\\\ rentgenografia\\\ tomografia\\ bronqografia\\\ bronqoskopia\\\ auskultacia

\\\\ plevraluri punqciis absoluturi Cvenebaa:\\\ plevris RruSi siTxis nebismieri raodenoba\\\ plevritis ucnobi genezi\\ plevris RruSi didi raodenobiT siTxe, Suasayris cdoma, sunTqviTi ukmarisoba\\\ maRali temperatura\\\ yvela CamoTvlili SemTxveva

\\\\ tkivili mSrali plevritis dros SeiZleba ar arsebobdes, Tu dazianebulia:\\\ diafragmuli plevra\\\ gulmkerdis kedlismieri plevra\\ wilTaSorisi plevra\\\ mediastinuri plevra\\\ yvela CamoTvlil SemTxvevaSi

\\\\ filtvis kibos dros metastazebi yvelaze xSirad gvxvdeba:\\\ laviwzeda limfur kvanZebSi\\\ RviZlSi\\\ iRliis qveSa limfur kvanZebSi\\\ mediastinur limfur kvanZebSi\\ yvela CamoTvlili SemTxveva sworia

\\\\ filtvebis CamoTvlili daavadebebidan romlebi rTuldeba ateleqtaziT:\\\ centraluri kibo\\\ tuberkulozuri bronqoadeniti\\\ ucxo sxeuliT bronqis obturacia\\\ CamoTvlilidan arc erTi\\ yvela CamoTvlili

\\\\ mwvave abscesis operaciul Cvenebas warmoadgens:\\\ avadmyofis asaki 60 wlamde\\ Tu Rru ar daixura 8 kviris ganmavlobaSi\\\ RruSi siTxis horizontaluri done\\\ hemoptoe\\\ leikocitozi

\\\\ masiuri plevraluri eqsudatis dros rekomendirebulia punqciiT gamoReba siTxisaraumetes:\\\ 0,5 litrisa\\\ 1 litrisa\\ 1,5 litrisa\\\ 2 litrisa\\\ 3 litrisa

\\\\ didi raodenobiT naxvelis gamoyofa pirveladi plevritis dros gvafiqrebinebs:\\ plevrobronquli fistulis arsebobaze\\\ Cirqovani endobronqitis ganviTarebaze\\\ pnevmoniaze\\\ plevritis tuberkulozur genezze\\\ CamoTvlilidan arc erTze

35

\\\\ silikozis II stadiisTvis damaxasiaTebeblia yvela CamoTvlil klinikur-rentgenologiuri niSani, garda:\\\ wvrilkerovani ormxrivi diseminaciis filtvebis Sua wilebSi\\\ pnevmosklerozis\\\ filtvebis fesvebis gafarToebis\\ filtvismieri gulis\\\ profesiuli anamnezis monacemebis

\\\\ CamoTvlilidan yvela warmoadgens spontanuri pnevmoToraqsis ganviTarebis mizezs,garda erTisa:\\ mikobaqteriebis hematogenuri gavrceleba plevris furclebze\\\ kavernis gaxsna plevris RruSi\\\ empiemis garRveva bronqSi\\\ operaciis Semdgom periodSi bronqis takvis ukmarisoba\\\ bulozuri emfizema

\\\\ daasaxeleT mwvave abscesis ganmasxvavebeli niSani filtvis kavernulituberkulozisagan:\\\ mikobaqteriebis ar arseboba naxvelSi\\\ Rru mkveTri gareTa da aramkveTri SigniTa konturebiT\\\ irgvliv mdebare filtvis qsovilis kerovani da fibrinozuli cvlilebebis arqona\\\ siTxis donis arseboba\\ yvela CamoTvlili

\\\\ filtvis arteriis Tromboemboliis wyaroa:\\\ marcxena winaguli\\\ marcxena parkuWi\\\ mcire wris sisxlZarRvebis aTerosklerozi\\ qvemo kidurebis TromboflebiTi\\\ yvela CamoTvlili

\\\\ uecrad ganviTarebuli filtvebidan sisxldenis mkurnalobis racionaluri taqtikaa:\\\ vikasolis Seyvana\\\ kalciumis qloridis Seyvana\\ avadmyofis saswrafo hospitalizacia\\\ eriTromasis gadasxma\\\ gulmkerdis saswrafo rentgenografia

\\\\ filtvis arteriis Trombo-emboliisaTvis yvelaze damaxasiaTebelia:\\\ uecrad ganviTarebuli tkivili gulmkerdSi\\\ Jangisferi naxveli\\\ temperaturis momateba\\\ arteriuli wnevis momateba\\ uecrad ganviTarebuli Sereuli tipis qoSini, cianozi

\\\\ filtvSi araintensiuri daCrdilva, xvelis ar arseboba, Civilebi nerwyvis denaze,madis daqveiTebaze, tkivilze Wipis midamoSi, sisxlis analizSi umniSvneloleikocitozi hipereozinofiliiT (25%-mde), askaridebis kvercxebis aRmoCena ganavalSi,yvelaze metad gvafiqrebinebs:\\\ filtvis tuberkulozze\\\ eqinokokze\\\ sarkoidozze\\ filtvis eozinofilur infiltratze\\\ qronikul pnevmoniaze

\\\\ meigsis sindromisTvis damaxasiaTebelia:\\\ Cirqovani plevriti\\ marjvenamxrivi hidroToraqsi\\\ qiloToraqsi\\\ hemoragiuli plevriti

36

\\\ spontanuri pnevmoToraqsi

\\\\ sunTqviTi ukmarisobis mizezebi SeiZleba iyos:\\\ cns-is paTologia\\\ nerv-kunTovani paTologia\\\ Torakodiafragmuli paTologia\\\ bronqebis da filtvebis paTologia\\ yvela CamoTvlili

\\\\ obstruqciuli sunTqviTi ukmarisobis mizezi SeiZleba iyos:\\\ ucxo sxeulis aspiracia\\\ bronqis sanaTuris anTebiTi SeSupeba\\\ bronqospazmi\\\ bronqis sanaTuris simsivnuri daxSoba da zewola simsivniT\\ yvela CamoTvlili

\\\\ qvemoT CamoTvlil niSanTagan romelia paTognomuri obstruqciuli sunTqviTiukmarisobisaTvis?\\\ eqspiraciuli qoSini\\ mkveTri cianozi\\\ sasunTqi gzebis winaaRmdegobis koeficientis gazrda\\\ filtvebis sasicocxlo moculobis Semcreba

\\\\ qvemoT CamoTvlil niSanTagan romelia damaxasiaTebeli sunTqvis restriqciuliukmarisobisaTvis?\\\ filtvebis sasicocxlo moculobis Semcireba\\ forsirebuli amosunTqviTi moculobis daqveiTeba\\\ filtvebis elastiurobis daqveiTeba\\\ filtvebis narCeni funqciuri moculobis gazrda

\\\\ romeli daavadebisaTvis aris damaxasiaTebeli sunTqvis mZime ukmarisoba?\\\ mwvave bronqiti\\\ bronqopnevmonia\\\ filtvis abscesi\\ aierzis sindromisaTvis\\\ filtvis eqinokoki

\\\\ qvemoT CamoTvlil simptomTagan romelia damaxasiaTebeli filtvismierigulisaTvis?\\\ policitemia\\\ sisxlis webovnebis gazrda\\\ marjvena parkuWis hipertrofia\\\ qvemo kidurebis SeSupeba\\ yvela CamoTvlili

\\\\ qvemoT CamoTvlil simptomTagan romelia damaxasiaTebeli bronquli asTmisSetevisaTvis?\\\ tkivili gulmkerdSi\\\ sisxliani xvela\\\ mwvave Segubeba sisxlis mimoqcevis mcire wreSi\\ eqspiratoruli xasiaTis sulxuTva

\\\\ qvemoT CamoTvlil niSanTagan romelia damaxasiaTebeli bronquli asTmisaTvis?\\\ sunTqvis gaiSviaTeba\\\ mcire raodenobiT naxvelis gamoyofa Setevis bolos\\\ kolofiseburi xmianoba gulmkerdis perkusiisas\\\ SeteviTi xvela da qoSini\\ yvela CamoTvlili

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli qronikuli obstruqciulibronqitisaTvis?

37

\\\ lorwovan-Cirqovani an Cirqovani naxveli\\\ xSiri gamwvaveba civi an nestiani amindis dros\\\ gaxangrZlivebuli amosunTqva\\\ mSrali mstvenavi xixini forsirebuli amosunTqvisas\\ yvela

\\\\ qvemoTCamoTvlil simptomTagan romelia damaxasiaTebeli bronquli asTmisSetevisaTvis?\\\ Sereuli tipis qoSini\\\ iZulebiTi mjdomare mdgomareoba\\\ sveli xixini filtvebis qvemo wilebSi\\ mravlobiTi mSrali xixini

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli bronqo-pulmonaluriaspergilozisaTvis?\\\ anamnezSi lpobad TivasTan an kompostTan muSaoba\\\ filtvebSi gardamavali infiltratebis arseboba\\\ eozinofilia\\\ bronquli asTmis ganmeorebiTi Setevebi\\ yvela

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli filtvis bronqogenulikibosaTvis?\\ xvela sisxliani naxveliT\\\ bronqoobstruqciuli sindromis arseboba\\\ zemo Rru venis zewolis sindromi\\\ cianozi

\\\\ qvemoT CamoTvlili gamokvlevebidan romelia wamyvani filtvis bronqogenuli kibosdiagnostikisaTvis?\\\ gulmkerdis rentgenografia\\\ gulmkerdis tomografia\\\ garegani sunTqvis funqciis Seswavla\\ bronqoskopia Semdgomi biofsiiT

\\\\ romeli instrumentuli meTodia aucilebeli bronqebis ucxo sxeuliT obstruqciisdiagnostikisa da mkurnalobisaTvis?\\\ gulmkerdis rentgenoskopia da rentgenografia\\\ sasunTqi gzebidan sekretis aspiracia\\\ spirografia\\ bronqoskopia

\\\\ qvemoT CamoTvlili simptomebidan romeli SeiZleba axldes Tan sasunTq gzebSiucxo sxeulis aspiracias?\\ sisxliani xvela\\\ filtvebis ateleqtazi\\\ xorxis SeSupeba\\\ Suasayarze zewolis sindromi

\\\\ qvemoT CamoTvlil simptomTagan romelia damaxasiaTebeli mwvave pnevmokokuripnevmoniisaTvis?\\ tkivili da plevris xaxuni daavadebuli filtvis mxares\\\ bronquli sunTqva da krepitacia\\\ temperaturis momateba da leikocitozi\\\ gaxangrZlivebuli amosunTqva

\\\\ instrumentuli gamokvlevebis romeli monacemia damaxasiaTebeli mwvave krupozulipnevmoniisaTvis ?\\\ filtvebis sasicocxlo moculobis daqveiTeba\\\ bronqoskopiiT bronqis sanaTuris Seviwroveba

38

\\\ rentgenologiurad wilakovani, subsegmenturi an segmenturi Crdilebis arseboba,filtvis suraTis gaZliereba\\ rentgenologiurad filtvis wilis an misi garkveuli nawilis homogenuri daCrdilva

\\\\ qvemoT CamoTvlili monacemebidan romelia damaxasiaTebeli mwvave kerovanipnevmoniisaTvis?\\\ xvela Jangisferi naxveliT\\\ plevris xaxuni\\\ bronquli sunTqva\\ rentgenologiurad wilakovani, subsegmenturi, segmenturi Crdilebis arseboba,filtvis suraTis gaZliereba

\\\\ qvemoT CamoTvlil simptomTagan romelia damaxasiaTebeli filtvebisemfizemisaTvis?\\\ cianozi\\\ sunTqvis Sesusteba\\\ filtvebis eqskursiis SezRudva\\\ rentgenologiurad filtvis gamWvirvalobis gazrda da filtvis qsovilis suraTisgaRaribeba?\\ yvela

\\\\ qvemoTCamoTvlil simptomTagan romelia yvelaze damaxasiaTebelialveolaTaxarixebis dazianebiT mimdinare (WeSmariti) emfizemisaTvis?\\\ sisxliani xvela\\\ gaxangZlivebuli amosunTqva\\\ krepitacia\\ Zlieri qoSini

\\\\ qvemoTCamoTvlili darRvevebidan romelia ganmsazRvreli pnevmosklerozisCamoyalibebaSi?\\\ filtvis parenqimisa da intersticiuli qsovilis anTeba\\\ filtvis qveda segmentebis bronqebis distaluri nawilebis anTeba\\\ bronqebis lorwovanis gafaSreba\\ anTebis Sedegad filtvebSi SemaerTebeli qsovilis Canacvleba

\\\\ qvemoTCamoTvlili mizezebidan romeli Seuwyobs xels difuzuri pnevmosklerozisganviTarebas ?\\\ qronikuli obstruqciuli bronqiti\\\ pnevmokoniozi\\\ filtvebis tuberkulozi\\\ mitraluri stenozi\\ yvela

\\\\ qvemoTCamoTvlili simptomTagan romelia damaxasiaTebeli difuzuripnevmosklerozisaTvis?\\\ Sereuli tipis qoSini\\\ difuzuri cianozi\\\ lorwovani, Cirqovani, zogjer sisxliani naxveli\\\ gafantuli mSrali da sveli xixini\\ yvela

\\\\ garegani sunTqvis romeli darRvevebia damaxasiaTebeli pnevmosklerozisaTvis?\\\ sunTqvis gaxSireba mosvenebul mdgomareobaSi\\\ filtvebis sasicocxlo moculobis daqveiTeba\\\ filtvebSi narCeni haeris moculobis gazrda\\\ tifnos indeqsis daqveiTeba\\ yvela CamoTvlili

\\\\ qvemoTCamoTvlil faqtorTagan romelTanaa dakavSirebuli filtvebis kistozurihipoplazia (polikistozi)?\\\ bronqebis obstruqciul dazianebasTan

39

\\\ filtvebis parenqimis SemaerTebel qsovilovan displaziasTan\\\ filtvebis specifiur da araspecifiur qronikul anTebasTan\\ igi filtvebis ganviTarebis Tandayolili anomaliaa

\\\\ qvemoTCamoTvlili rentgenologiuri monacemebidan romelia upiratesaddamaxasiaTebeli filtvebis polikistozisaTvis?\\\ filtvis suraTis gaZliereba da fiWiseburi Seneba\\\ Suasayaris organoTa cdoma dazianebuli filtvis mxares\\\ filtvis suraTis calmxrivi gaRaribeba\\ tomografiiT mravlobiTi Txelkedliani Rruebis gamovlena\\\ arc erTi

\\\\ qvemoTCamoTvlil mizezTagan romelma SeiZleba gamoiwvios plevris RruSi siTxisdagroveba?\\\ specifiuri da araspecifiuri genezis infeqciebi\\\ filtvis da plevris simsivneebi\\\ SemaerTebeli qsovilis sistemuri paTologia\\\ filtvis infarqt-pnevmonia\\ yvelam

\\\\ qvemoT CamoTvlil niSanTagan romeli ar aris damaxasiaTebeli plevris RruSisiTxis dagrovebisaTvis?\\\ moyrueba\\ filtvebis eqskursiis ormxrivi SezRudva\\\ moyruebis ubanze sunTqvis Sesusteba an gaqroba\\\ Suasayaris organoebis cdoma moyruebis sapirispirod

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli plevris eqskudaciuriSigTavsisaTvis?\\\ xvedriTi wona 1015-ze naklebi\\\ tute reaqcia\\\ naleqSi ujredebis mcire raodenoba\\ cilis Semcveloba 3 g%-ze meti

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli plevraSi transudatisarsebobisaTvis?\\ siTxeSi cilis Semcveloba 3 g%-ze naklebi\\\ siTxis qarvisebri Seferiloba\\\ xvedriTi wona 1015-ze meti\\\ naleqSi neitrofiluri ujredebis arseboba

\\\\ qvemoTCamoTvlili paTologiuri mdgomareobebidan romels SeuZlia gamoiwviosplevris RruSi siTxis Cadgoma (hidroToraqsi)?\\\ gulis ukmarisobas\\\ hipoproteinemias\\\ farisebri jirkvlis hipofunqcias\\\ sakvercxeebis fibromas\\ yvela

\\\\ qvemoT CamoTvlili daavadebebidan romelma SeiZleba gamoiwvios hidroToraqsi?\\\ Suasayris simsivnem\\\ RviZlis cirozma\\\ konstriqciulma perikarditma\\\ nefrozulma sindromma\\ yvela

\\\\ qvemoTCamoTvlili avadmyofobebidan romels SeuZlia gamoiwvios hidroToraqsi?\\\ alimentur distrofias\\\ gulis dekompensirebul mankebs\\\ anemias

40

\\\ filtvebis tuberkulozs\\ yvela maTgans

\\\\ qvemoTCamoTvlili monacemebidan romeli gvafiqrebinebs mdgomareobisgaumjobesebaze eqsudaciuri plevritis dros?\\ punqtatis naleqSi neitrofiluri ujredebis Secvla limfocitebiT\\\ punqtatis naleqSi neitrofiluri ujredebis raodenobis gazrda\\\ moyruebis ubanze plevris xaxunis gaCena\\\ plevraluri punqtatis xvedriTi wonis Semcireba

\\\\ qvemoTCamoTvlilTagan romeli rendgenologiuri maCvenebeli metyvelebsplevraluri Svartebis arsebobis sasargeblod?\\\ peribronqul zonebSi Cakiruli kerebis arseboba\\\ filtvis qsovilis kolabirebis suraTi\\ daCrdilva Suasayris organoTa cdomiT daavadebul mxares\\\ daCrdilva Suasayris organoTa cdomiT janmrTel mxares

\\\\ qvemoTCamoTvlili paTologiuri mdgomareobebidan romlisTvisaa damaxasiaTebelimoyruebis gaCena filtvze?\\\ plevraluri SvartebisaTvis\\\ filtvis masiuri ateleqtazisaTvis\\\ filtvis alveoluri kibosaTvis\\ eqsudaciuri plevritisaTvis

\\\\ qvemoTCamoTvlili niSnebidan romelia damaxasiaTebeli spontanuri pnevmoToraqsisdiagnozisaTvis?\\\ tkivili gulmkerdSi\\\ rentgenologiurad plevris RruSi haeris arseboba\\\ civi ofli da cianozi\\\ filtvis kolabireba\\ yvela CamoTvlili

\\\\ qvemoT CamoTvlil rentgenologiur niSanTa Soris romelia damaxasiaTebelispontanuri pnevmoToraqsisaTvis?\\\ filtvis kolabireba\\\ Suasayaris organoTa cdoma dazianebis sawinaaRmdego mxares\\\ filtvis suraTis gaZliereba\\ plevris RruSi haeris arseboba

\\\\ qvemoT CamoTvlil mizezTagan romeli iwvevs pnevmokoniozs?\\\ mtvris alergenebTan kontaqti\\\ xSiri pnevmonia\\\ lpobad TivasTan da kompostTan xangrZlivi kontaqti\\ mineraluri mtvris xangrZlivi SesunTqva

\\\\ qvemoTCamoTvlili daavadebebidan romeli ganekuTvneba pnevmokoniozTa jgufs?\\\ karbokoniozi\\\ beriliozi\\ azbestozi\\\ aspergilozi

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli pnevmokoniozisaTvis?\\\ bulozuri emfizemis arseboba\\\ anamnezSi xangrZlivi kontaqti mineralur da metalur mtverTan\\\ filtvis tranzitoruli infiltratis arseboba\\ kvanZovani pnevmofibrozi

\\\\ romeli niSania damaxasiaTebeli filtvis infarqtisaTvis?

41

\\\ tkivili gverdSi\\\ sisxliani xvela\\\ plevropnevmoniis klinikuri suraTis Camoyalibeba\\\ qoSini\\ yvela CamoTvlili

\\\\ qvemoTCamoTvlil niSanTagan romeli ar aris sakvanZo filtvis arteriisTromboemboliis diagnostikisaTvis?\\ filtvis narCeni funqciuri moculobis gazrda\\\ Zlieri Sereuli tipis qoSini\\\ xvela sisxliani naxveliT\\\ mwvave marjvenaparkuWovani ukmarisoba

\\\\ CamoTvlili laboratoriul-instrumentuli monacemebidan romelia damaxasiaTebelifiltvis arteriis TromboemboliisaTvis?\\\ rentgenologiurad filtvis suraTis calmxrivi gaRaribeba\\\ ekg-ze miokardiumis infarqtisaTvis damaxasiaTebeli cvlilebebi II, III, aVF ganxrebSi\\\ forsirebuli amosunTqviTi moculobis Semcireba\\ angiografiiT arteriuli takvisa da avaskularizaciis zonis arseboba

\\\\ qvemoTCamoTvlili ekg monacemebidan romelia damaxasiaTebeli filtvis arteriisTromboemboliisaTvis?\\\ marcxena parkuWis gadaZabvis niSnebi\\ marjvena parkuWis gadaZabvis niSnebi\\\ ST segmentis elevacia I, II, aVL ganxrebSi\\\ hisis konis marjvena fexis blokadis suraTi

\\\\ qvemoTCamoTvlil simptomTagan romelia damaxasiaTebeli filtvis arteriispirveladi sklerozisaTvis (aierzis sindromi)?\\\ difuzuri zogadi cianozi da qoSini\\\ policitemia\\\ marjvena parkuWis hipertrofia\\\ ventilaciuri darRvevebis naklebad gamoxatuli xarisxi\\ yvela

\\\\ qvemoTCamoTvlil rentgenologiur niSanTagan romelia damaxasiaTebeli filtvisarteriis pirveladi sklerozisaTvis (aierzis sindromi)?\\\ filtvis arteriis rkalis gamodrekad segmenturi sisxlZarRvebis Crdilebisamputacia\\\ difuzuri pnevmofibrozi\\ filtvis arteriis gaZlierebuli pulsacia

\\\\ qvemoTCamoTvlil niSnebidan romelia damaxasiaTebeli bronqoeqtaziuridaavadebisaTvis?\\\ naxvelis amoReba savse piriT\\\ Segrovili naxvelis Sreobrioba\\\ "dolis Cxirisebri" TiTebi\\\ saSualo da msxvilbuStukovani sveli xixini periferiaze\\ yvela CamoTvlili

\\\\ qvemoTCamoTvlil rentgenologiur niSanTagan romelia paTognomiuribronqoeqtaziuri daavadebebisaTvis?\\\ filtvis qsovilis infiltracia\\\ plevruli Sexorcebebi\\\ Suasayaris cdoma dazianebul mxares\\ fiWisebri Seneba filtvis gaZlierebuli suraTis fonze\\\ yvela CamoTvlili

42

\\\\ qvemoTCamoTvlil niSanTagan romelia paTognomuri dekompensirebuli filtvismierigulisaTvis?\\\ difuzuri zogadi cianozi\\\ policitemia\\\ SegubebiTi movlenebi sisxlis mimoqcevis did wreSi\\\ anamnezSi filtvebis qronikuli specifiuri an araspecifiuri daavadebis arseboba\\ yvela

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli dekompensirebuli qronikulifiltvismieri gulisaTvis?\\\ kisris venebis daberiloba\\\ mocimcime ariTmia\\\ venuri wnevis momateba\\\ filtvis arteriis Tromboemboliis klinika\\ yvela maTgani

\\\\ qvemoTCamoTvlil instrumentul meTodTagan romeli adasturebs utyuaradbronqoeqtaziuri daavadebis arsebobas?\\ bronqografia\\\ gulmkerdis rentgenografia\\\ fluorografia\\\ bronqoskopia

\\\\ qvemoTCamoTvlil daavadebaTagan romeli ganekuTvneba retikuloendoTelurisistemis sistemur keTilTvisebian granulomatozur dazianebaTa jgufs?\\ sarkoidozi\\\ tuberkulozi\\\ filtvis simsivnuri paTologia\\\ vegeneris granulomatozi

\\\\ qvemoTCamoTvlili organoebidan romeli ziandeba sarkoidozis dros?\\\ kani\\\ filtvebi\\\ RviZli da elenTa\\\ limfuri kvanZebi\\ yvela

\\\\ qvemoTCamoTvlili simptomebidan romelia damaxasiaTebeli sarkoidozisaTvis?\\\ paratraqealuri, traqeobronquli, bronqopulmonuri limfuri kvanZebis ormxrivisimetriuli gadideba\\\ filtvis karTan dakavSirebuli Sua da qveda wilebis ormxrivi diseminacia dainfiltracia\\\ limfadenopaTia\\\ kvanZovani eriTema\\ yvela CamoTvlili

\\\\ qvemoTCamoTvlili kliniko-laboratoriuli monacemebidan romelia metaddamaxasiaTebeli sarkoidozisaTvis?\\\ tuberkulozisadmi adgilobrivi mgrZnobelobis daqveiTeba\\\ specifiuri antigenis Seyvanis adgilze kvanZis gaCena\\\ neitrofiluri leikocitozi\\ limfopenia

\\\\ qvemoTCamoTvlili simptomebidan romelia damaxasiaTebeli gudpasCerissindromisaTvis?\\\ bronquli obstruqciis sindromi\\\ filtvebis emfizemis klinikuri suraTi\\ filtvebidan sisxldena\\\ progresirebadi glomerulonefriti

43

\\\\ qvemoTCamoTvlil simptomTagan romelia damaxasiaTebeli filtvebiskandidomikozisaTvis?\\\ qronikuli bronqitis klinikuri suraTi\\\ rentgenologiurad infiltratis arseboba filtvis qsovilSi\\\ plevraluri Svartebis arseboba\\ naxvelSi miceliumis arseboba

\\\\ qvemoTCamoTvlil mizezTagan romelia xelSemwyobi kandidomikozisaRmocenebisaTvis?\\\ saliciloTerapia\\\ xangrZlivi hormonoTerapia\\\ xangrZlivi vitaminoTerapia\\ xangrZlivi antibiotikoTerapia

\\\\ qvemoTCamoTvlili avadmyofobebidan romelma SeiZleba gamoiwvios plevris,bronqebis da filtvebis dazianeba?\\\ revmatoidulma arTritma\\\ sistemurma wiTelma mgluram\\\ mwvave da qronikulma leikozma\\\ sistemurma sklerodermiam\\ yvelas

\\\\ qvemoTCamoTvlil niSanTagan romelTa Serwyma xdis utyuars filtvebSideseminirebuli procesis arsebobas?\\\ Zlieri qoSini fizikuri datvirTvisas, romelic ar aris dakavSirebuli gul-sisxlZarRvTa paTologiasTan\\\ filtvebis sasicocxlo moculobis da elastiurobis daqveiTeba\\ rentgenologiurad difuzuri da (an) kerovani cvlilebebi filtvebSi\\\ forsirebuli amosunTqviTi moculobis daqveiTeba

\\\\ qvemoTCamoTvlili paTologiuri mdgomareobebidan romeli ganekuTvneba sasunTqisistemis ormxriv dazianebas?\\\ spontanuri pnevmoToraqsi\\\ filtvis infarqti\\\ ucxo sxeulis aspiracia\\ bronquli asTma

\\\\ filtvis centraluri kibos garTuleba SeiZleba iyos:\\\ filtvis hipoventilacia\\\ filtvis ateleqtazi\\\ pnevmonia (SesaZlo abscedirebiT)\\ yvela CamoTvlili

\\\\ qvemoTCamoTvlili romeli faqtorebis arseboba zrdis filtvis avTvisebianisimsivnis diagnozis dasmis SesaZleblobas?\\\ simsivnuri daCrdilvis zoma aRemateba 4 sm-s\\\ Semawuxebeli xvela sisxliani naxvelis gamoyofiT\\\ avadmyofis wonaSi dakleba\\\ avadmyofis asaki aRemateba 35 wels\\ yvelasi

\\\\ qvemoTCamoTvlil simptomTagan romels SeiZleba hqondes "paraneoplastiuri"mniSvneloba filtvis metastazuri simsivnis dros?\\\ hormonebis eqtopiur sekrecias\\\ migrirebad Tromboflebits\\\ limfadenitsa da osteoliziss\\ "dolis Cxirisebri" TiTebi-hipertrofiuli osteoarTropaTias

44

\\\\ romelma SeiZleba gvafiqrebinos filtvis simsivnis keTilTvisebian genezze?\\\ ori da meti wlis ganmavlobaSi simsivnuri Crdilis stabilurma zomam\\ simsivnurma Crdilma, romelic saSualod 100 dRis ganmavlobaSi zomaSi ar ormagdeba\\\ tomografiiT simsivnuri Crdilis Sreobrivi kalcifikaciis dafiqsirebam\\\ tomografiiT simsivnuri Crdilis centraluri kalacifikaciis dafiqsirebam

\\\\ tuberkuloziT daavadebis riski imatebs:\\\ tuberkuloziT daavadebulTan mWidro kontaqtisas\\\ imunosupresiuli preparatebis gamoyenebisas\\\ alkoholizmis, narkomaniis, Sidsis dros\\\ Saqriani diabetis dros\\ yvela CamoTvlil SemTxvevaSi

\\\\ qvemoTCamoTvlil bronqoskopiul monacemTa Soris romelia utyuari bronqogenulikibosaTvis?\\\ respiratoruli moZraobis ararseboba da bronquli sekretis wveTebis umoZraoba("mkvdari SesarTavis sindromi")\\\ bronquli milis pasiuri gadanacvleba\\\ bronqis kedlis gamkvriveba\\ xrtilovani rgolebis suraTis waSla

\\\\ qvemoTCamoTvlil bronqoskopiur monacemTa Soris romelia utyuari filtvisbronqogenuli kibosaTvis?\\\ bronqis lorwovanis sisxlmdinaroba da lokaluri hiperemia\\\ bronqisa da traqeis kedlis infiltracia\\ bronqSi simsivnuri zrda an uformo warmonaqmnis aRmoCena\\\ bronqis lorwovanis gafaSreba

\\\\ ras warmoadgens Sarko-leidenis kristalebi?\\\ daSlil eriTrocitebs\\\ daSlil limfocitebs\\\ daSlil alveolur epiTels\\\ daSlil monocitebs\\ daSlil eozinofilebs

\\\\ filtvis periferiulad ganlagebuli simsivnis saukeTeso diagnostikuri saSualebaa:\\\ tomografia\\\ bronqoskopia\\\ bronqografia\\ transTorakaluri punqcia\\\ naxvelis analizi

\\\\ qvemoTCamoTvlil faqtorTagan romeli SeiZleba gaxdes mwvave filtvismieri gulisCamoyalibebis mizezi?\\\ filtvis arteriis embolia\\\ sarqvlovani pnevmoToraqsi\\\ bronquli asTmis gaxangrZlivebuli Seteva\\\ swrafad progresirebadi difuzuri intersticiuli fibrozi\\ yvela CamoTvlili

\\\\ qvemoTCamoTvlili faqtorebidan romelia wamyvani policitemiis CamoyalibebaSifiltvebis qronikuli daavadebebis dros?\\ metaboluri acidozi\\\ filtvis qsovilis elastiurobis daqveiTeba\\\ intersticiuli fibrozi

45

\\\ prostaglandinebis sekreciis daqveiTeba

\\\\ naxvelis citologiuri Seswavlisas qvemoTCamoTvlili maCveneblebidan romelimiuTiTebs anTebiTi procesis intensiurobaze qronikuli bronqitis dros?\\\ lorwos didi raodenoba\\\ makrofagebis didi raodenoba\\\ bronquli epiTelis didi raodenoba\\ neitrofiluri leikocitebis didi raodenoba\\\ limfocitebis didi raodenoba

\\\\ qvemoTCamoTvlili saSualebebidan romelia yvelaze metad naCvenebibronqoeqtaziuri daavadebebis dros?\\\ bronquli xis sanacia Cirqovani SigTavsis dacliT\\\ bronqis sanaTurSi mukolizuri preparatebis da proteolizuri fermentebis Seyvana\\\ bronqis sanaTurSi antibiotikebis Seyvana\\\ intravenuri antibiotikoTerapia\\ yvela CamoTvlili

\\\\ qvemoTCamoTvlilidan rogor samkurnalo taqtikas airCevdiT pnevmoniis mZimemimdinareobisas?\\\ vumkurnalebT 2,3 antibaqteriuli preparatis kombinaciiT paralelurad\\\ antibiotikebTan erTad gamoviyenebT sulfanilamidur preparatebs\\\ gamoviyenebT kortikosteroidul Terapias\\\ gamoviyenebT pirdapiri moqmedebis antikoagulantebs (heparini)\\ yvela

\\\\ ras moimoqmedebT gaxangrZlivebuli pnevmoniis samkurnalod\\\ gavzrdiT penicilinis dozas\\\ davumatebT sulfanilamidur preparatebs\\\ davumatebT kortikosteroidul Terapias\\\ SevarCevT axal antimikrobul preparats, misi antimikrobuli speqtrisa dagamomwvevisadmi mgrZnobelobis gaTvaliswinebiT\\ yvela

\\\\ qvemoTCamoTvlili simptomebidan romelia gadamwyveti filtvis abscesisdiagnozisaTvis\\ infiltraciis fonze Rru (momrgvalo) siTxis horizontaluri doniT\\\ maRali temperatura\\\ leikocitozi\\\ xvela savse piriT

\\\\ qvemoTCamoTvlili garTulebebidan romelia damaxasiaTebeli filtvisabscesisaTvis?\\\ plevris empiema\\\ bronquli asTmis Setevebi\\\ traqeobronquli diskinezia\\ piopnevmoToraqsi

\\\\ qvemoTCamoTvlili meTodebidan romelia naCvenebi filtvebis emfizemismkurnalobisaTvis?\\\ antibiotikoTerapia\\\ sulfanilamidebiT mkurnaloba\\ oqsigenoTerapia\\\ Terapia kortikosteroidebiT

\\\\ bronquli asTmis mkurnalobisaTvis mowodebulia eufilini, qvemoTCamoTvliliTvisebebidan romelia damaxasiaTebeli am preparatisaTvis?\\\ iwvevs taqikardias\\\ aqveiTebs sistolur arteriul wnevas\\\ aqveiTebs wnevas filtvis arteriaSi

46

\\\ aqvs Sardmdeni efeqti\\ yvela

\\\\ bronquli asTmiT Sepyrobili avadmyofebisaTvis rodisaa naCvenebikortikosteroiduli hormonebis daniSvna?\\\ yvela SemTxvevaSi\\\ sxva samkurnalo saSualebebis uefeqtobisas\\ mdgomareobis gauaresebisas Tuki adre itarebda steroidul Terapias\\\ daavadebis virusuli genezis dadgenisas

\\\\ qvemoTCamoTvlili niSnebidan romelia damaxasiaTebeli infeqciuri genezisbronquli asTmisaTvis?\\\ araproduqtiuli xvela\\\ eozinofilia\\\ avadmyofis asaki 30 welze metia\\ gamwvavebis sezonuroba

\\\\ qvemoTCamoTvlili niSnebidan romelia damaxasiaTebeli atopiuri bronquliasTmisaTvis?\\\ sunTqvis obstruqciuli tipi\\\ xvela naxveliT\\\ sisxlSi eozinofilebi\\ memkvidreobaSi bronquli asTma

\\\\ CamoTvlilidan ra axasiaTebs saylapavis kibos:\\\ disfagia\\\ tkivili saylapavis areSi\\\ naxvelSi sakvebis narCenebis arseboba\\\ gemovnebis gaukuRmarTeba da hipersalivacia\\ yvela CamoTvlili

\\\\ CamoTvlilidan ra SeiZleba iyos mwvave gastritis mizezi:\\\ alkoholi\\\ Termuli faqtorebi\\\ qimiuri faqtorebi\\\ infeqcia\\ yvela CamoTvlili

\\\\ yvela CamoTvlils Tan axlavs kuWis wylulis ganviTareba, garda:\\\ Tirkmlebis qronikuli ukmarisobis\\\ RviZlis cirozis\\\ kardiogenuri Sokis\\\ damwvrobis\\ qronikuli pankreatitis

\\\\ avadmyofi mamakaci, 55 wlis, anamnezSi 10 wlis xangrZlivobis kuWis wylulovanidaavadebiT, mkurnalobda araregularulad, periodulad aRniSnavda gamwvavebas.ukanaskneli wlis manZilze tkivili epigastriumSi gauZlierda, avadmyofma dakargawona, fibroskopiiT did simrudeze aRiniSneba msxvili wylulovani defeqti.CamoTvlilidan ra ufro mizanSewonilia, vurCioT avadmyofs:\\\ sasawrafod gaikeTos operacia\\\ operaciuli mkurnaloba unda Catardes mxolod aqiliis gamovlenis SemTxvevaSi\\\ daeniSnos konservatiuli mkurnaloba da 5-6 kviris Semdeg gadavwyvitoT sakiTxioperaciuli Carevis Sesaxeb\\ CavataroT gastrofibroskopia bofsiiT, ris Semdegadac gadavwyviToT sakiTximkurnalobis taqtikis Sesaxeb\\\ rentgenologiuri gamokvlevis Catareba wylulis malignizaciis gamosaricxad

47

\\\\ yvela CamoTvlili iwvevs naRvlis Segubebas, garda:\\\ kvebis reJimis moSlis\\\ orsulobis\\\ hipodinamiis\\\ fsiqoemociuri stresis\\ faRaraTis

\\\\ lupoiduri hepatitis damaxasiaTebeli simptomia yvela CamoTvlili, garda:\\ disfagiis\\\ arTralgiebis\\\ limfadenopaTiebis\\\ mialgiebis\\\ poliserozitis

\\\\ demping-sindromisTvis damaxasiaTebelia yvela CamoTvlili, garda erTisa:\\\ Wamis Semdeg gamoxatuli sisuste\\\ hipoglikemiis ganviTareba Wamidan 1-2 sT-is Semdeg\\\ sislZarRvovani da neirofsiqiuri darRvevebi\\\ naxSirwylebis autanloba\\ naRvlovani Rebineba

\\\\ qronikuli pankreatitis diagnostikis kriteriumad gamodgeba yvela qvemoTCamoTvlili, garda erTisa:\\\ sisxlSi da SardSi pankreasis fermentebis aqtivobis momateba\\\ steatorea\\ pankreasis fermentebis momateba duodenur SigTavsSi\\\ kreatorea\\\ glukozisadmi tolerantobis moSla

\\\\ CamoTvlilidan ra warmoadgens naklebad mizanSewonils ascitiT garTulebulicirozis sawyisi TerapiisTvis:\\ Tiaziduri Sardmdeni\\\ sakvebSi marilis SezRudva\\\ siTxis miRebis SezRudva\\\ aldaqtoni\\\ yvela CamoTvlili

\\\\ CamoTvlilidan ra ar axasiaTebs uiplis daavadebas:\\\ heqtiuri cxeleba\\\ yabzoba\\\ wonaSi dakleba\\\ tramqeobronqiti\\ poliarTralgiebi

\\\\ kuW-nawlavidan sisxldenis uxSiresi mizezi aris:\\\ eroziuli gastriti\\ 12-goja nawlavis wyluli\\\ ezofagiti\\\ saylapavis venebis varikozuli gaganiereba\\\ kuWis wyluli

\\\\ CamoTvlilidan ra uwyobs xels wylulovani daavadebis ganviTarebas:\\\ sisxlis I (0) jgufi\\\ memkvidreobiTi faqtori\\\ Tambaqos weva\\\ nervuli gadaZabva\\\ kampilobaqteriis arseboba\\ yvela CamoTvlili

\\\\ kuWis wylulis dros informaciuli diagnostikuri meTodia:

48

\\\ rentgenologiuri gamokvleva\\ endoskopia\\\ ganavlis analizi farul sisxldenaze\\\ kuWis sekreciis gamokvleva\\\ fizikuri gamokvleva (perkusia, palpacia)

\\\\ colinger-elisonis sindromi Seicavs yvela qvemoT CamoTvlils, garda erTisa:\\\ wylulebis warmoqmna kuWsa da 12-goja nawlavSi\\\ diarea\\\ kuWis wvenis hipersekrecia\\\ steatorea\\ hiperkalcemia

\\\\ kurvuazies simptomi vlindeba yvela qvemoT CamoTvlili mdgomareobisas, garda:\\\ fateris dvrilis kibos\\\ pankreasis Tavis kibos\\\ naRvlis saerTo sadinaris kibos\\ qronikuli qolecistitis\\\ yvela CamoTvlil SemTxvevaSi vlindeba

\\\\ yvela CamoTvlili niSani damaxasiaTebelia biliaruli cirozisTvis, garda:\\\ hiperbilirubinemiisa koniugirebuli bilirubinis xarjze\\\ bilirubinuriis\\\ osteoporozis\\\ qsanTelazmebis\\ urobilinuriis

\\\\ RviZlis diagnostikuri punqciuri biofsiis Catareba arainformaciulia:\\\ daudgeneli genezis hepatosplenomegaliisas\\\ RviZlis funqciuri sinjebis myari darRvevisas\\\ qronikuli alkoholuri hepatitisas\\\ hemoqromatozze eWvis dros\\ RviZlis angiomaze eWvisas

\\\\ hepatolentikuluri degeneraciisTvis (konovalov-vilsonis daavadeba)damaxasiaTebelia yvela qvemoT CamoTvlili gamovlineba, garda:\\\ nevrologiuri darRvevebis\\\ hepatosplenomegaliis\\\ siyviTlis\\\ SardiT spilenZis gaZlierebuli eqskreciis\\ sisxlSi ceruloplazminis donis momatebis

\\\\ yvelaze mniSvnelovani laboratoriuli maCvenebeli qronikuli pankreatitissadiagnozod aris:\\ sisxlSi da SardSi amilazis done\\\ leikocitozi\\\ aminotransferazebis done\\\ tute fosfatazis done\\\ hiperglikemia

\\\\ CamoTvlili meTodebidan romelia yvelaze zusti araspecifiuri wylulovanikolitis sadiagnozod:\\\ irigoskopia\\\ nawlavuri floris Seswavla\\\ koprologiuri gamokvleva\\ kolonoskopia

49

\\\ eqoskopia

\\\\ qronikuli pankreatitis SemTxvevaSi tkivilis kupirebisTvis SeiZleba gamoviyenoTyvela CamoTvlili saSualeba, garda:\\\ novokainis\\\ fentanilis\\\ baralginis\\\ analginis\\ morfiumis

\\\\ steatorea SeiniSneba yvela qvemoTCamoTvlil SemTxvevebSi, garda:\\\ qronikuli pankreatitis\\\ kronis daavadebis\\ nawlavTa polipozis\\\ nawlavTa amiloidozis\\\ wvrili nawlavis rezeqciis

\\\\ CamoTvlilidan ra axasiaTebs qronikul anacidur gastrits:\\\ yabzoba\\\ tkivili uzmoze\\\ Ramis tkivili\\\ kuWis wvenis hipersekrecia\\ kuWis lorwovanis atrofia

\\\\ axalgazrda qali xSirad iRviZebs Rame tkivilisagan epigastriumis areSi. savaraudodiagnozia:\\\ kuWis kibo\\\ divertikuliti\\\ qolangiti\\\ kronis daavadeba\\ 12-goja nawlavis wyluli

\\\\ kuW-nawlavidan sisxldenis qvemoT CamoTvlili mizezebidan Cveulebriv romeli arvlindeba rentgenologiuri gamokvleviT, magram SeiZleba dadgindes endoskopiisgamoyenebiT:\\\ melori-veisis sindromi\\\ kuWis erozia\\\ stresuli gastriti\\\ randiu-osleris sindromi\\ yvela CamoTvlili

\\\\ hemoqromatozis klinikuri simptomokompleqsi moicavs yvela CamoTvlils, garda:\\ sisxlSi rkinis Semcvelobis daqveiTebis\\\ melanodermiis\\\ hiperglikemiis\\\ hepatomegaliis\\\ kardiomiopaTiis

\\\\ hipertonuli tipis naRvlis buStis diskineziis klinikuri simptomokompleqsiSeicavs yvela qvemoT CamoTvlils, garda:\\\ gardamavali siyviTlisa\\\ duodenuri zondirebisas naRvlis gamoyofis Semcirebisa B ulufaSi\\\ naRvlovani kolikis perioduli Setevebisa\\ naRvlis buStis dayovnebuli daclisa misi zomebis gadidebiT qolecistografiisas\\\ yvela CamoTvlilis

\\\\ RviZlis ukmarisobisas yvela CamoTvlili mtkiceba WeSmaritia, garda erTisa:\\\ proTrombinis done mkveTrad daqveiTebulia

50

\\\ antihemofiluri faqtorebi mkveTrad daqveiTebulia\\\ xSiria hemoragiuli sindromis SemTxvevebi\\ sisxlSi aspartat- da alaninaminotransferzebis aqtiuroba normalauria\\\ pigmenturi cvla moSlilia, bilirubinis done Zlier momatebulia sisxlSi

\\\\ qvemoT CamoTvlili preparatebidan romlis daniSvna moqmedebs ufrokeTilsaimedod qronikuli pankreatitis prognozze:\\ proteolizuri inhibitori\\\ H2 histaminuri receptorebis blokatorebi\\\ antibiotikebi\\\ qolinolizuri saSualebebi\\\ arc erTi CamoTvlilTagan

\\\\ 22 wlis avadmyofi mamakaci uCivis tkivils muclis areSi, sisxlian ganavals,saerTo sisustes. obieqturad aRiniSneba muclis mkveTri mtkivneuloba msxvilinawlavis mTels proeqciaze. qvemoT CamoTvlili diagnozebidan romeli aris yvelazemetad savaraudo:\\\ nawlavis tuberkulozi\\\ dizenteriuli koliti\\\ qronikuli pankreatiti\\\ kronis daavadeba\\ araspecifiuri wylulovani koliti

\\\\ 45 wlis avadmyofi mamakaci uCivis tkivils ileocekalur midamoSi, sxeulis zemonawilis hiperemias, xanmokle Sexurebebis epizodebs, oflianobas, taqikardias,hipotonias da diareas. glukozis done sisxlSi normis farglebSia. analogiuriklinikuri suraTi viTardeba 50 ml aryis miRebidan 5-10 wuTis Semdeg. yvelaze metadsavaraudo diagnozia:\\\ pankreatogenuri qolera\\\ funqciuri diarea\\\ gastrinoma\\\ feoqromocitoma\\ karcinoiduli sindromi

\\\\ qvemoT CamoTvlili preparatebidan romeli aZlierebs RviZlis naRvelwarmomqmnelfunqcias:\\\ beladonas preparatebi\\ aloqoli\\\ M qolinoblokatorebi\\\ spazmolizuri preparatebi\\\ yvela CamoTvlili preparati

\\\\ 45 wlis avadmyof mamakacs arTralgiiT, diareiT, malabsorbciiT, kanishiperpigmentaciiT, VII nervis dambliT, aqvs klinikuri remisia trimetoprim-sulfametoqsazoliT mkurnalobiT erTwliani kursis Semdeg. misi diagnozia:\\\ nawlavis limfoma\\\ miliaruli tuberkulozi\\\ tropikuli spru\\\ wylulovani koliti\\ uiplis daavadeba

\\\\ Tormetgoja nawlavis wylulovani daavadebis dros rogor unda dainiSnosqolinolizuri saSualebebi:\\\ Wamidan 30 wuTis Semdeg\\\ Wamidan 1-2 saaTis Semdeg\\\ mxolod RamiT\\\ sakvebis miRebis dros\\ Wamamde 30 wuTiT adre

51

\\\\ sklerodermiis gastrointestinur gamovlinebebs miekuTvneba:\\\ pankreatiti\\ refluqs-ezofagiti\\\ naRvlis buStis kalkulozi\\\ 12-goja nawlavis wyluli\\\ arc erTi CamoTvlilTagan

\\\\ kuWis wyluli yvelaze xSirad lokalizebulia:\\\ kardiul nawilSi\\\ fundusSi\\\ did simrudeze\\\ prepirolur nawilSi\\ mcire simrudeze

\\\\ yovelive qvemoT CamoTvlili damaxasiaTebelia 12-goja nawlavis gaurTulebeliwylulisTvis, garda:\\ Rebinebisa, pirnaReb masaSi wina dRiT miRebuli sakvebis nawilakebis arsebobiT\\\ mSieri tkivilebisa\\\ sezonuri tkivilebisa\\\ tkivilis gaZlierebisa 2-3 saaTis Semdeg sakvebis miRebidan\\\ tkivilis droebiTi Semsubuqebis natriumis bikarbonatis miRebis Semdeg.

\\\\ ra aris damaxasiaTebeli 12-goja nawlavis wylulovani daavadebisTvis:\\\ aqilia\\\ cximiani sakvebis autanloba\\\ boyini laye kvercxis suniT\\\ faRaraTi\\ Ramis tkivilebi

\\\\ qvemoT CamoTvlilTagan ra aris damaxasiaTebeli qronikuli qolecistitisTvis?\\\ mSieri tkivili\\\ aqilia\\\ boyini laye kvercxis suniT\\\ Ramis tkivili\\ cximiani sakvebis autanloba

\\\\ pikis cirozisTvis damaxasiaTebelia yvela CamoTvlili niSani, garda:\\ normaluri centraluri venuri wnevis arseboba\\\ hepatomegaliis\\\ ascitis\\\ kisris venebis Sebervis\\\ splenomegaliis

\\\\ CamoTvlilidan ra uwyobs xels msxvili nawlavis kibos ganviTarebas:\\\ polipozi\\\ araspecifiuri wylulovani koliti\\\ datvirTuli memkvidreoba\\\ qronikuli yabzoba\\ yvela CamoTvlili

\\\\ qvemoT CamoTvlilTagan ra niSnebiT xasiaTdeba kronis daavadeba:\\\ anusis naxeTqebiT, fistulebiT, hemoroiduli kvanZebiT\\\ nawlavis kedlis granulomatozuri dazianebiT\\\ kolinjis elenTis kuTxe naklebad ziandeba\\\ arTritebiT\\ yvela CamoTvliliT

52

\\\\ qvemoT CamoTvlili preparatebidan romeli uwyobs xels tkivilis sindromismoxsnas qronikuli pankreatitis dros:\\\ almageli\\\ diakarbi\\\ aloqoli\\\ oqsafenamidi\\ atropini

\\\\ romeli gverdiTi efeqtebi aRiniSneba cimetidinis miRebisas:\\\ gastriti\\\ Seuqcevadi leikopenia\\\ Tirkmlis elviseburi ukmarisoba\\\ glomerulonefriti\\ CamoTvlilTagan arc erTi

\\\\ diarea axasiaTebs yvela qvemoT CamoTvlili daavadebas, garda:\\ megakolonis\\\ kronis daavadebisa\\\ araspecifiuri wylulovani koliti\\\ celiakiis\\\ pelagris

\\\\ saylapavis karcinomis risk-faqtorebs miekuTvneba:\\\ mamrobiTi sqesi\\\ eTnikuri faqtori\\\ alkoholi\\\ Tambaqo\\ yvela CamoTvlili

\\\\ mwvave virusuli È hepatitis dasawyisSi serologiuri gamokvleviT aRmoCndeba:\\\ IgG klasis anti HBc antisxeulebi\\\ anti HBc antisxeulebi\\\ anti HBs antisxeulebi\\\ yvela CamoTvlili\\ pozitiuri HBs antigeni

\\\\ kuWis karcinomis metastazis yvelaze xSiri lokalizaciaa:\\\ peritoneumi\\\ filtvebi\\\ Tirkmelzeda jirkvlebi\\ RviZli\\\ Zvlebi

\\\\ hepatoceluluri karcinomis sadiagnozod saukeTeso tumoruli markeria:\\\ qorionuli gonadotropini\\\ karcinoembrionuli antigeni\\\ tute fosfataza\\ alfa-fetoproteini\\\ S 100 antigeni

\\\\ 25 wlis qals aReniSneba zomieri persistuli arakoniugirebuli hiperbilirubinemia,savaraudo diagnozi:\\\ krigler - naiaris sindromi\\ memkvidreobiTi glukuronil - transferazas deficiti (Jilberis sindromi)\\\ dabin - jonsonis sindromi\\\ mwvave hemolizuri anemia\\\ qronikuli aqtiuri hepatiti

53

\\\\ 30 wlis mamakaci Semoyvanili iqna megobrebis mier Terapiul ganyofilebaSikoltebis Semcvleli sisxliani RebinebiT. megobrebisgan Sekrebili anamnezis Tanaxmad,pacientma miiRo didi raodenobiT alkoholi saRamos ganmavlobaSi da ramodenimejeraRebina, sanam daewyeboda sisxldena, romelic ukve 1 saaTia, grZeldeba. am mdgomareobissavaraudo mizezi:\\\ mwvave gastriti\\\ mwvave pankreatiti\\\ Tormetgoja nawlavis wyluli\\\ saylapavis qvemo nawilis ruptura\\ gastroezofaguri lorwovani Sris naxeTqi (melori-veisi sindromi)

\\\\ 60 wlis mamakacs 2 dRea, aqvs gulisreva, pirRebineba, aReniSneba mtkivneuliwarmonaqmni marjvena sazardulis areSi, romelic kargad isinjeba. yvelaze marTebulitaqtika:\\\ analgeziuri da Rebinebis sawinaaRmdego saSualebebis miReba da gamokvleva\\ saswrafo operacia\\\ bariumis oyna\\\ warmonaqmnis biofsia\\\ warmonaqmnis Semcirebis mcdeloba

\\\\ kronis daavadebisTvis damaxasiaTebelia:\\\ kazeozuri granulomatozi\\ arakazeozuri granulomatozi\\\ dazianebuli nawlavis kedlis gaTxeleba\\\ swori nawlavis anTeba\\\ CamoTvlilTagan arc erTi

\\\\ 12 goja nawlavis wylulovani daavadebis gamwvavebis periodSi ZiriTadi simptomebia:\\\ tkivili Wamis Semdeg\\\ gulisreva\\\ boyini\\ mSieri tkivili\\\ diarea

\\\\ romelia wylulovani daavadebis pirdapiri rentgenologiuri niSani:\\\ 12 goja nawlavis deformacia\\\ pilorusis spazmi\\\ kardiis spazmi\\\ avsebis defeqti\\ niSa

\\\\ romeli simptomi gvafiqrebinebs wylulovani daavadebis penetraciiT garTulebaze:\\\ mSieri tkivilebis gaZliereba\\ 12 goja nawlavis wylulovani daavadebis cikluri mimdinareobis gaqroba datkivilis mudmivi xasiaTi\\\ Ramis tkivilebi\\\ gulZmarva\\\ boyini

\\\\ CamoTvlii preparatebidan romeli ar Trgunavs uSualod mJava-peptiur faqtors:\\\ ranitidini\\ de-noli\\\ gastrocepini\\\ famotidini\\\ cimetidini

\\\\ H2-histaminoreceptorebis mablokirebeli saSualebaa:

54

\\\ intali\\\ atropini\\\ almageli\\\ platifilini\\ ranitidini

\\\\ kuWis simptomuri wylulebis mizezi SeiZleba iyos:\\\ arasteroiduli anTebis sawinaaRmdego saSualebebis miReba\\\ stresuli situacia\\\ aTerosklerozuli dazianebebi\\\ colinger-elisonis sindromi\\ yvela CamoTvlili

\\\\ CamoTvlili preparatebidan romeli iwvevs yvelaze xSirad qolestazs:\\\ androgenuli hormonebi da anaboluri steroidebi\\\ mao-s inhibitorebi, meTiluracili\\\ adrenoblokatorebi, prazozini\\ izoniazidi, kanamicini, etakrinis mJava\\\ kalciumis antagonistebi

\\\\ CamoTvlili preparatebidan romeli iwvevs alergiul qolestazur hepatits yvelazexSirad:\\\ agf-is intibitorebi\\\ tetraciklinis jgufis antibiotikebi\\ fenoTiazinis warmoebulebi, paski, merkazolili\\\ karsili, esenciale, lipostabili\\\ CamoTvlilidan arc erTi.

\\\\ romelia RviZlis eqinokokozisTvis damaxasiaTebeli niSani:\\\ rkinis Warbi dagroveba RviZlSi, rac aRmoCndeba perlsis dadebiTi reaqciiT\\\ kaizer-fleiSesis rgoli Tvalis rqovanaze\\\ dadebiTi reaqcia á fetoproteinze\\\ fruqtozuria\\ dadebiTi hemaglutinaciis da kaconis reaqciebi

\\\\ gregersenis dadebiTi reaqcia, Tu mas Tan axlavs wonis daqveiTeba, yvelaze xSiradgvxvdeba:\\\ qronikuli gastritis dros\\ kuWis kibos dros\\\ kuWis funqciuri moSlilobisas\\\ kuWis wylulovani daavadebis dros\\\ saylapavis xvrelis Tiaqris dros

\\\\ ra saxis anemia ar aris damaxasiaTebeli qronikuli enteritisTvis:\\\ rkinadeficituri\\\ È12 deficituri\\\ arc erTi CamoTvlilTagan\\ hemolizuri\\\ yvela CamoTvlili damaxasiaTebelia

\\\\ ra daavadebebTan aris saWiro araspecifiuri wylulovani kolitis diferencialuridiagnozis gatareba:\\\ qronikul dizenteriasTan\\\ msxvili nawlavis kibosTan\\\ kronis daavadebasTan\\\ CamoTvlilidan arc erTTan\\ yvela CamoTvlilTan

55

\\\\ ra asakSi gvxvdeba yvelaze xSirad qronikuli gastriti gamoxatuli sekretoruliukmarisobiT:\\\ yvela asakSi\\\ bavSvobis asakSi\\\ axalgazrda asakSi\\\ saSualo asakSi\\ moxucebulebSi

\\\\ ra preparati gamoiyeneba kuWis wvenis sekreciis stimulaciis mizniT:\\\ magniumis sulfati\\\ adrenalini\\ histamini\\\ atf\\\ atropini

\\\\ romel antibaqteriul preparatebs ar gaaCniaT hepatotoqsiuri moqmedeba:\\\ tetraciklini\\\ gentamicini\\\ sulfanilamidebi\\\ kanamicini\\ penicilini

\\\\ CamoTvlili preparatebidan romeli ar gamoiyeneba qronikuli gastritebissamkurnalod:\\\ vikalini\\ indometacini\\\ atropini\\\ festali\\\ metronidazoli

\\\\ qronikuli aqtiuri hepatitis ZiriTadi ganmasxvavebeli niSani qronikuli hepatitebissxva formebisgan aris:\\\ RviZlis fermentebis donis momateba\\\ hepatomegalia\\ histologiuri cvlilebebi\\\ siyviTle\\\ yvela CamoTvlili faqtori

\\\\ RviZlis qronikuli daavadebebidan romeli warmoadgens imunodepresoruli Terapiisdawyebis klasikur Cvenebas:\\\ qronikuli persistuli hepatiti\\ qronikuli aqtiuri hepatiti\\\ biliaruli cirozi\\\ RviZlis simsivne\\\ yvela CamoTvlili

\\\\ CamoTvlilidan romeli warmoadgens qronikuli pankreatitis yvelaze xSir mizezs:\\\ virusuli infeqcia\\\ kuWis paTologia\\\ cilis deficiti dietaSi\\\ virusuli hepatiti\\ alkoholuri intoqsikacia

\\\\ CamoTvlili faqtorebidan romlis zegavleniT Zlierdeba kuWqveSa jirkvlissekrecia:\\\ qolecistokininis\\\ atropinis\\\ askorbinis mJavas

56

\\ sekretinis\\\ acetilsalicilis mJavas

\\\\ romeli preparati ar ainhibirebs kuWqveSa jirkvlis fermentebis aqtiurobas:\\\ kontrikali\\\ gordoqsi\\\ trasiloli\\ prednizoloni\\\ yvela CamoTvlili

\\\\ CamoTvlili mdgomareobebidan romlisTvis ar aris damaxasiaTebeliarakoniugirebuli hiperbilirubinemia:\\\ hemolizuri siyviTlisTvis\\\ Jilberis sindromisTvis\\ parenqimuli siyviTlisTvis\\\ krigler-naiaris sindromisTvis\\\ CamoTvlilidan arc erTisTvis

\\\\ meqanikuri siyviTlisaTvis damaxasiaTebelia:\\\ arakoniugirebuli hiperbilirubinemia, alanin da aspartat-aminotransferazebisdonis momateba\\\ koniugirebuli hiperbilirubinemia, qolesterinis, alanin- daaspartataminotransferazebis donis mkveTri momateba\\\ arakoniugirebuli hiperbilirubinemia\\ koniugirebuli hiperbilirubinemia, tute fosfatazas donis mkveTri momateba\\\ yvela CamoTvlili

\\\\ CamoTvlili sindromebidan romlisTvis aris damaxasiaTebeli qavili,koniugirebuli hiperbilirubinemia, tute fosfatazis, qolesterinis momateba:\\\ hepatoceluluri siyviTlisTvis\\\ Jilberis sindromisTvis\\\ krigler-naiaris sindromisTvis\\ RviZlisqveda (meqanikuri) siyviTlisTvis\\\ hemolizuri siyviTlisTvis

\\\\ avadmyofs, romelsac aqvs heqtiuri cxeleba, hepatomegalia, neitrofilurileikocitozi marcxniv gadaxriT da toqsiuri marcvlovanebiT, savaraudod migvaniSnebs:\\\ mwvave virusul hepatitze\\\ qronikul hepatitze\\\ cirozze\\\ RviZlis kiboze\\ RviZlis abscesze

\\\\ CamoTvlilTagan yabzoba ufro damaxasiaTebelia:\\\ hipoaciduri gastritisTvis\\\ qronikuli enteritisTvis\\ 12-goja nawlavis wylulovani daavadebisTvis\\\ uiplis daavadebisTvis\\\ yvela CamoTvlili paTologiisTvis

\\\\ diareis kombinacia tkivilis sindromTan da mezenteriuli limfuri kvanZebisgakirvasTan erTad yvelaze metad damaxasiTebelia:\\\ msxvili nawlavis kibosTvis\\\ kronis daavadebisTvis\\ tuberkulozuri ileotiflitisTvis\\\ araspecifiuri wylulovani kolitisTvis\\\ amebiazisTvis

\\\\ tkivlis rogori iradiaciaa damaxasiaTebeli qronikuli qolecistitisTvis:\\\ marcxena mxarSi, beWSi, laviwSi

57

\\ marjvena mxarSi, beWSi, laviwSi\\\ marjvena fexSi\\\ yvela varianti\\\ arc erTi CamoTvlilidan

\\\\ qolecistografia ukunaCvenebia avadmyofebisTvis:\\\ cximebis autanlobiT\\\ virusuli hepatitis Semdgom periodSi\\\ naRvlkenWovani daavadebiT\\\ yvela CamoTvlil SemTxvevaSi\\ idiosinkraziiT iodis mimarT

\\\\ wvrilkvanZovani cirozis ganviTarebas iwvevs:\\\ virusuli hepatiti\\\ sanaRvle gzebis daavadebebi\\\ cximovani hepatozi\\ alkoholizmi\\\ yvela CmoTvlili

\\\\ msxvilkvanZovani cirozis ganviTarebas iwvevs:\\\ alkoholizmi\\\ kvebiTi reJimis darRveva\\ virusuli hepatiti\\\ qolestazi\\\ yvela CamoTvlili

\\\\ wvrilkvanZovani cirozis (dekompensaciis sawyis etapze) gamovlinebebia upiratesad:\\\ hepatocelularuli ukmarisobis niSnebi\\\ qolestazis niSnebi\\ portuli hipertenziis niSnebi\\\ yvela CamoTvlili\\\ arc erTi CamoTvlilidan

\\\\ RviZlis cirozis garTulebebs ar miekuTvneba:\\\ sisxldena varikozuli venebidan\\\ koma\\\ RviZlis kibo\\ qolecistiti\\\ yvela CamoTvlili

\\\\ RviZlis cirozis diagnostikaSi gadamwyveti bioqimiuri testia:\\\ bromsulfaleinis cda\\\ bilirubinis gansazRvra\\\ aminotransferazebis gansazRvra\\\ yvela CamoTvlili\\ CamoTvlilTagan arc erTi

\\\\ hiperglikemia da glukozuria erT-erTi adreuli simptomia:\\\ naRvlis buStis kibosi\\\ pankreasis tanis kibosi\\\ nawlavis kibosi\\\ kuWis kibosi\\ pankreasis kudis kibosi

\\\\ tipi I Saqriani diabetis dros (sami wlis anamnezi) RviZlis gadidebis mizeziSeiZleba iyos:\\\ hemoqromatozi\\\ amiloidozi

58

\\ hepatozi\\\ RviZlis cirozi\\\ qronikuli hepatiti

\\\\ 40-60 wlis mamakacebSi diarea, steatorea, poliarTritTan da limfocitozTan erTadupirvelesad gvafiqrebinebs:\\\ gastrogenur faRaraTze\\\ spruze\\\ sklerodermiaze\\ uiplis daavadebaze\\\ qronikul enteritze

\\\\ kardiis aqalaziis dros kardiodilataciis winaaRmdegCvenebad iTvleba yvelaqvemoTCamoTvlili, garda erTisa\\\ daavadebis mimdinareoba Zlieri RebinebiT\\\ gamoxatuli ezofagiti\\ kardiis aqalaziis I tipi\\\ saylapavis venebis varikozi\\\ Zlier gafarToebuli da atonuri saylapavi

\\\\ ezofagitis ganviTarebis xelSemwyobi mizezia yvela qvemoTCamoTvlili, gardaerTisa:\\\ sistemuri sklerodermia\\\ cxeli da uxeSi sakvebis xSiri miReba\\ qronikuli anaciduri gastriti\\\ cxvirxaxis qronikuli anTeba\\\ wylulovani daavadeba

\\\\ qronikuli refluqsezofagitis samkurnalod gamoiyeneba yvela CamoTvlili, gardaerTisa:\\\ antacidebisa\\\ spazmolizuri saSualebebisa\\\ naxevradmjdomare mdgomareobaSi Zilisa\\ intensiuri fizikuri varjiSisa\\\ qirurgiuli mkurnalobisa

\\\\ qvemoTCamoTvlili simptomebidan romelia damaxasiaTebeli saylapavis kibosaTvis:\\\ disfagia\\\ tkivili saylapavis gaswvriv\\\ zogjer naxvelSi sakvebi nawilakebis arseboba\\\ gemos SegrZnebis gaukuRmarTeba da hipersalivacia\\ yvela maTgani

\\\\ saylapavis qvemoTCamoTvlili daavadebebidan romelia ufro xSiri:\\\ kardiis aqalazia\\\ saylapavis nawiburovani Seviwroeba\\\ saylapavis kibo\\\ idiopaTiuri ezofagospazmi\\ kardiis ukmarisoba

\\\\ qvemoT moyvanili faqtorebidan romeli SeiZleba gaxdes mwvave gastritis mizezi\\\ alkoholi\\\ Termuli faqtorebi\\\ qimiuri faqtorebi\\\ infeqcia\\ yvela maTgani

\\\\ qvemoTmoyvanili romeli dietaa mizanSewonili mwvave gastritis dros:\\\ mxolod meqanikurad damzogavi dieta\\\ mxolod qimiurad damzogavi dieta

59

\\\ sruli SimSili pirvel dRes\\ meqanikurad da qimiurad damzogavi dieta

\\\\ qronikuli gastritis diagnostikaSi wamyvania:\\\ rentgenologiur gamokvleva\\\ fibrogastroskopia\\ fibrogastroskopia biofsiiT da masalis morfologiuri SeswavliT\\\ eqsfoliatiur citodiagnostika

\\\\ kuWis wylulovani daavadebis dros wylulis lokalizacia yvelaze ufro xSiria:\\\ kardialur nawilSi\\\ fundusSi\\\ did simrudeze\\ mcire simrudeze\\\ prepilorulad

\\\\ Tormetgoja nawlavis gaurTulebeli wylulisaTvis yvela qvemoTCamoTvlilisimptomebia damaxasiaTebeli, garda erTisa:\\\ mSieri da Ramis tkivili\\\ gamwvavebis sezonuroba\\\ tkivilis gaZliereba sakvebis miRebidan ori-sami saaTis Semdeg\\ Rebineba da amonaReb masaSi wina dRes miRebuli sakvebis arseboba\\\ tkivilis droebiTi Semsubuqeba natriumis bikarbonatis miRebis Semdeg

\\\\ mwvave gastroduodenuri sisxldenis dros qvemoTCamoTvlili RonisZiebebidanromeli maTgani ar migaCniaT mizanSewonilad:\\\ axali Tanamosaxele sisxlis gadasxma\\\ fiziologiuri xsnaris gadasxma\\\ etamzilatis ineqcia\\ mezatonis ineqcia\\\ yinulis parki epigastriumis midamoSi

\\\\ avadmyofi, mamakaci 55 wlis, avad aris kuWis wylulovani daavadebiT 10 welia,mkurnalobda araregularulad, daavadeba periodulad umwvavdeboda. bolo 1 TveagauZlierda tkivili epigastriumis areSi, daiklo wonaSi, dauqveiTda mada.fibroskopiiT did simrudeze aRiniSneba mozrdili wylulovani defeqti. qvemoTmoyvanili gadawyvetilebebidan romeli migaCniaT sworad:\\\ avadmyofs urCevT dauyovnebliv gaikeTos operacia\\ gaukeTebT gastrofibroskopias biofsiiT, masalis ramdenime adgilidan aRebiT damisi mikromorfologiuri Seswavlis Semdeg gadawyvitavT mkurnalobis Semdgomtaqtikas\\\ operacias urCevT mxolod im SemTxvevaSi, Tu kuWis sekreciuli funqciisgamokvleviT iqneba aqilia\\\ dauniSnavT konservatiul mkurnalobas da 5-6 kviris mkurnalobis Semdeg gadawyvetTsakiTxs saWiroa Tu ara operaciuli Careva\\\ gaukeTebT kuWis rentgenologiur gamokvlevas wylulis malignizaciis gamoricxvismizniT

\\\\ qvemoTCamoTvlili simptomebidan demping-sindromisaTvis damaxasiaTebelia yvela,garda:\\\ Zlieri sisuste Wamis Semdeg\\\ Wamidan 1-2 saaTis Semdeg hipoglikemiis ganviTareba\\ naRvlovani Rebineba\\\ sisxlZarRvovani da nervul-fsiqiuri moSlilobani\\\ naxSirwylebiT mdidari sakvebis autanloba

\\\\ qvemoTmoyvanili formulirebidan wylulovan daavadebas miesadageba yvela, gardaerTisa:\\\ wylulovani daavadebis ganviTarebaSi monawileobas Rebulobs genetikuri faqtorebi\\\ wylulis lokalizacia Tormetgoja nawlavSi 7-jer ufro xSiria, vidre kuWSi

60

\\\ wylulovani daavadebiT genetikurad damZimebul avadmyofebSi kuWis amomfeniepiTeli orjer ufro metia, vidre im avadmyofebSi, sadac ara gvaqvs saqme genetikuraddamZimebul SemTxvevebTan\\\ wylulovani daavadebis genetikurad damZimebul SemTxvevebSi daklebulia alfa-1-antitrifsini\\A(II) jgufis sisxli ufro xSirad gvxvdeba wylulovani daavadebis mqone avadmyofebSi

\\\\ kuWis mwvave gaganiereba SeiZleba ganviTardes qvemoTCamoTvlili yvela daavadebisdros, garda erTisa:\\\ miokardiumis mwvave infarqti\\\ kuWis sisxlZarRvTa Trombozi\\\ mwvave peritoniti\\ wylulovani daavadeba kuWis mcire simrudeze wylulis lokalizaciiT\\\ zurgis tvinis dazianeba

\\\\ histaminis 0.5 ml. ineqciiT miRebuli kuWis wvenis mJavobis normaluri maCveneblebia:\\\ 60/40 s.e.\\\ 80/60 s.e\\ 100/80 s.e. .\\\ 40/20 s.e.\\\ 140/120 s.e.

\\\\ romeli faqtoria naklebad mniSvnelovani gastritis provocirebis TvalsazrisiT:\\\ indometacini\\ steroidebi\\\ aspirinis peroraluri miReba\\\ salicilatebi parenteralurad\\\ alkoholi

\\\\ romeli marcvlovani SeiZleba mieces glutenis daavadebiT (aratropikuli spru)daavadebul avadmyofebs:\\\ qeri\\\ xorbali\\\ brinji\\ Svria

\\\\ romeli gverdiTi efeqti axlavs Tan cimetidiniT mkurnalobas:\\\ gastriti\\\ Seuqcevadi leikopenia\\\ RviZlis ukmarisoba\\\ glomerulonefriti\\ arcerTi

\\\\ kuWis mTavari jirkvlebis dazianebis dros kuWis wvenis mJavoba\\\ ar icvleba\\\ matulobs sekreciis bolos\\ klebulobs\\\ matulobs\\\ zogjer matulobs, zogjer klebulobs

\\\\ wylulovani daavadebis yvelaze saimedo sadiagnozo meTodia:\\\ rentgenologiuri gamokvleva\\\ ganavlis analizi farul sisldenaze\\\ kuWis sekreciis gamokvleva\\ endoskopia\\\ fizikuri gamokvleva (perkusia, palpacia)

\\\\ kuWis wylulovani daavadebisa da kibos diferencialur diagnostikaSi yvelazemniSvnelovania:

61

\\\ rentgenologiuri gamokvleva\\\ kuWis sekreciis gamokvleva\\\ ganavlis gamokvleva farul sisxldenaze\\\ kuWidan amonarecxi wylebis citologiuri gamokvleva\\ gastroduodenoskopia biofsiiT

\\\\ kronis daavadebis (terminaluri ileiti) mimarTebaSi romeli debuleba ar arismarTebuli:\\\ SeiZleba daiwyos uecari maRali sicxiT, RebinebiT da mwvave tkiviliT ileocekalurmidamoSi\\\ axasiaTebs analuri midamos wylulovani dazianeba da naxeTqebi\\\ nawlavis rentgenoskopiiT vlindeba Snuris simptomi\\ damaxasiaTebelia nawlavidan xSiri profuzuli sisxldena\\\ damaxasiaTebelia nawlavis fistulebi

\\\\ qvemoT moyvanili gamokvlevebidan romels unda mieces upiratesoba araspecifiuriwylulovani kolitis dasadgenad\\\ irigoskopias\\\ nawlavis floris Seswavlas\\\ D-qsilozis testis warmoebas\\ kolonoskopias\\\ koprologiur gamokvlevas

\\\\ qvemoT moyvanili faqtorebidan romeli SeiZleba CaiTvalos xelSemwyobad msxvilinawlavis kibos ganviTarebaSi\\\ msxvili nawlavis polipozi\\\ araspecifiuri wylulovani koliti\\\ memkvidreoba\\\ qronikuli yabzoba\\ yvela CamoTvlili

\\\\ klinikuri monacemebiT savaraudoa msxvili nawlavis simsivnis arseboba. kvlevisromeli meTodiT daiwyebdiT avadmyofis gamokvlevas?\\\ kompiuteruli tomografia\\\ kolonoskopia\\\ laparaskopia\\ rentgenologiuri gamokvleva (irigoskopia)\\\ DÂ-qsilozis testis warmoeba

\\\\ msxvili nawlavidan sisxldenis dros sisxldenis adgilis dasadgenad qvemoTCamoTvlili meTodebidan yvelaze ufro informaciulia:\\\ nawlavebis Cveulebrivi rentgenologiuri gamokvleva\\\ nawlavebis rentgenologiuri gamokvleva ormagi kontrastirebiT\\\ kolonoskopia\\\ irigoskopia\\ seleqciuri arteriografia

\\\\ qvemoT CamoTvlili daavadebebidan romlis dros ufro xSiria nawlavidansisxldena?\\\ wylulovani koliti\\\ nawlavis simsivneebi\\\ sisxlZarRvebis gafarToeba\\ msxvili nawlavis divertikuli\\\ nawlavTa polipozi

\\\\ faRaraTobisa da yabzobis monacvleoba damaxasiaTebelia yvela qvemoT CamoTvlilidaavadebebisaTvis, garda erTisa:\\\ msxvili nawlavis kibo\\ gastrinoma

62

\\\ msxvili nawlavis divertikuli\\\ funqciuri nevrogenuli diarea\\\ Tireotoqsikozi

\\\\ diarea erT-erTi damaxasiaTebeli niSania yvela qvemoT CamoTvlilidaavadebebisaTvis, garda erTisa:\\\ colinger-elisonis sindromi\\\ msxvili nawlavis zomieri stenozi\\\ wylulovani koliti\\\ qolera\\ wylulovani daavadeba

\\\\ kuW-nawlavis normaluri mikrofloris TvalsazrisiT yvela qvemoTCamoTvlilidebuleba sworia, erTis garda:\\\ janmrTeli adamianis kuWidan kuWis wvenis mJavianobis saSualo da dabalimaCveneblebis pirobebSi SeiZleba amoiTesos streptokoki, stafilokoki, nawlavis Cxirida sxva.\\ msxvili nawlavis mikroflora warmodgenilia Tanabari raodenobiT aerobuli (50%)da anaerobuli (50%) mikrobebiT\\\ janmrTeli adamianis wvrili nawlavis SigTavsis 1 ml-Si baqteriebis raodenoba araRemateba 104-s\\\ janmrTel adamianSi laqtobacila da safuaris msgavsi soko kandida kuW-nawlavistraqtSi arsebul mikrobTa eubiozis regulirebas uwyobs xels\\\ kuWis wvenis maRali mJavianobis pirobebSi kuWis SigTavsidan ZiriTadad ori saxismikrobi iTeseba: safuaris msgavsi soko kandida da laqtobacila

\\\\ qvemoT CamoTvlilidan romeli ufro mniSvnelovania qronikuli pankreatitisdiagnostikaSi\\\ kuWqveSa jirkvlis eqoskopia\\\ ganavalSi cximis gansazRvra\\ sekretin-pankreoziminis testi\\\ arcerTi maTgani\\\ yvela CamoTvlili meTodi

\\\\ RviZlis paTologiis dros citolizis maCvenebelia:\\\ dadebiTi bromsulfaleinis cda\\\ disproteinemia\\\ eriTrocitebis daleqvis siCqare\\\ sisxlSi tute fosfatazis koncentraciis momateba\\ sisxlSi aminotransferazebis koncentraciis momateba

\\\\ qronikul aqtiur hepatits sxva qronikuli hepatitebisagan ganasxvavebs:\\\ RviZlis fermentebis mniSvnelovani momateba\\\ histologiuri cvlilebebi\\\ hepatomegalia\\ imunologiuri monacemebi\\\ siyviTle

\\\\ RviZlSida qolestazze yvelaze xSirad metyvelebs:\\\ bromsulfaleinis sinjis maCveneblebis momateba\\ tute-fosfatazis donis momateba\\\ gamaglobulinis donis momateba\\\ aminotransferazebis donis momateba\\\ mJave fosfatazis donis momateba

\\\\ hepatomegalia, splenomegalia da melena eWvs iwvevs\\\ Tormetgoja nawlavis sisxlmden wylulze\\\ mezenterialuri arteriebis Trombozze

63

\\\ araspecifiur wylulovan kolitze\\ saylapavis varikozuli venebidan sisxldenaze\\\ kuWis sisxlmden wylulze

\\\\ ra aris gadamwyveti qronikuli hepatitis diagnozisaTvis\\\ gadatanili virusuli hepatiti\\\ sisxlis SratSi avstraliuri antigenis aRmoCena\\\ perioduli subfebriliteti, iqteroba, tkivili marjvena ferdqveSa areSi\\\ SratSi alfa-fetoproteinis aRmoCena\\ RviZlis histologiuri gamokvlevis monacemebi

\\\\ qolecistografia ukunaCvenebaa\\\ cximebis autanlobisas\\\ virusuli hepatitis Semdeg\\\ naRvel-kenWovani daavadebis dros\\ iodis mimarT idiosinkraziis dros\\\ yvela zemoT CamoTvlil SemTxvevaSi

\\\\ qronikuli arakalkulozuri qolecistitiT daavadebuli avadmyofisaTvis remisiisfazaSi damaxasiaTebelia\\\ faRaraTis monacvleoba yabzobiT\\\ tkivilebi marjvena ferdqveSa midamoSi\\\ gulZmarva\\ cximiani sakvebis autanloba\\\ arcerTi maTgani

\\\\ RviZlis qronikuli daavadebisas rodisaa naCvenebi imunodepresoruli Terapia:\\\ meoradi biliaruli cirozi\\\ qronikuli persistuli hepatiti\\\ RviZlSi moculobiTi procesi\\ qronikuli aqtiuri hepatiti\\\ arcerTi CamoTvlilTagani

\\\\ RviZlis cirozis yvelaze xSiri mizezia\\\ hemoqromatozi\\\ konovalov-vilsonis daavadeba\\\ xangrZlivi qolestazi\\\ gulis qronikuli ukmarisoba\\ virusuli hepatiti

\\\\ RviZlis cirozis diagnostikaSi gadamwyvet testad iTvleba\\\ bromsulfaleinis cda\\\ Timolis sinji\\\ bilirubinis gansazRvra\\\ aminotransferazebis gansazRvra\\ arcerTi maTgani

\\\\ RviZlis cirozis dros ascitis ganviTarebas xels uwyobs\\\ meoradi hiperaldosteronizmi\\\ hipoalbuminemia\\\ portuli hipertenzia\\\ arcerTi maTgani\\ yvela CamoTvlili

\\\\ hemolizur siyviTles axasiaTebs yvela, garda erTisa:\\\ arapirdapiri bilirubinis momateba sisxlSi\\\ anemia\\\ splenomegalia

64

\\ osteoporozi\\\ retikulocitozi

\\\\ melori-veisis sindromis dros pirvel rigSi mizanSewonilia:\\\ kuWis rentgenoskopia\\\ sisxldenis SemaCerebeli saSualebebis gamoyeneba\\\ brZola arteriul hipotoniasTan\\\ sisxlis gadasxma\\ fibrogastroduodenoskopia

\\\\ osteofitebis warmoqmna damaxasiaTbelia:\\\ revmatoiduli arTriti\\\ sistemuri sklerodermia\\\ revmatizmi\\\ sistemuri wiTeli mglura\\ madeformirebeli osteoarTrozi

\\\\ podagris paTognomuri rentgenologiuri niSania:\\\ sasaxre napralis Seviwroeba\\\ epifizebis lizisi\\\ eroziebi\\ ,,saxvretelas" simptomi\\\ ZvalSida kistebi

\\\\ podagris dros alopurinolis gamoyeneba mizanSewonilia:\\\ mwvave podagruli krizis dros\\\ renuli hiperurikemiis dros\\\ hiperurikemiis Sereuli formis dros\\ metaboluri hiperurikemiis dros\\\ yvela zemoT CamoTvlilis SemTxvevaSi.

\\\\ podagris samkurnalod gamoyenebuli preparatebidan, romlis efeqturobaa miCneulipodagris sadiagnozo kriteriumad:\\\ alopurinoli\\\ miluriti\\\ anturani\\\ benemidi\\ kolxicini

\\\\ romeli daavadebisaTvis aris damaxasiaTebeli heberdenis da buSaris kvanZebi?\\\ revmatioduli arTriti\\ osteoarTrozi\\\ podagra\\\ bexterevis daavadeba\\\ idiopaTiuri kalcinozi

\\\\ romeli daavadebisaTvis aris damaxasiaTebeli sisxliani xvela?\\\ filtvis tuberkulozi;\\\ ronqoeqtaziuli daavadeba;\\\ filtvis gangrena;\\\ filtvis arteriis embolia;\\ yvela CamoTvlili.

\\\\ naxvelis citologiuri maCveneblidan upiratesad romeli miuTiTebs anTebiTiprocesis intensiurobaze qronikuli bronqitis dros?\\\ lorwos didi raodenobiT arseboba;\\\ makrofagebis didi raodenoba;\\\ bronquli epiTelis didi raodenoba:

65

\\ neitrofiluri leikocitebis didi raodenoba;\\\ limfocitebis didi raodenoba;

\\\\ qvemoTCamoTvlili saSualebebidan romelia naCvenebi bronqoeqtaziuli daavadebissamkurnalod?\\\ bronquli xis sanacia, Cirqovani SigTavsisagan misi ganTavisufleba;\\\ bronqis sanaTurSi mukolizuri preparatebis da proteolizuri fermentebis Seyvana;\\\ bronqis sanaTurSi antibiotikis Seyvana;\\\ bronqolizuri saSualebebis micema;\\ yvela zemoT CamoTvlili.

\\\\ qvemoTCamoTvlili saSualebebidan, romeli preparatebia mowodebuli filtvisarteriis Tromboemboliis mwvave dasawyis periodSi?\\\ antibiotikebi\\\ sagule glikozidebi;\\ fibrinoliziri saSualebebi;\\\ Sardmdenebi;\\\ angispazuri saSualebebi;

\\\\ romeli daavadebebis dros aRiniSneba Suasayris cdoma daavadebis mopirdapiremxares?\\\ filtvis qronikuli obstruqciuli daavadeba;\\\ fibrokavernozuli tuberkulozi;\\\ filtvis kibo;\\ eqsudaciuri plevriti;\\\ pnevmokoniozi;

\\\\ qvemoTCamoTvlili simptomebidan romel simptoms eniWeba upiratesoba filtvisabscesis diagnozis dasadgenad;\\\ temperaturis momateba;\\\ leikocitozi;\\\ xvela-naxveli savse piriT;\\\ eqspiraciuli qoSini;\\ rentgenologiurad Rrus arseboba horizontaluri doniT, SemofargluligarsiT.

\\\\ romeli daavadeba miekuTvneba bronqoobstruqciul daavadebebs;\\\ filtvis arteriis Tromboembolia;\\\ eqsudaciuri plevriti;\\ qronikuli bronqiti;\\\ filtvis tuberkulozi;\\\ gudpasCeris sindromi;

\\\\ broqoeqtaziuli daavadebis paTogenezSi ZiriTadia:\\\ alveoluri makrofagebis funqciis daTrgunva.\\\ bronquli jirkvlebis sekreciuli hipofunqcia;\\ wamwamovani epiTeliumis elastiurobis daqveiTeba;\\\ prostaglandinebis gamomuSavebis daqveiTeba;\\\ bronqospazis arseboba;

\\\\ sisxliani xvela ar axasiaTebs:\\\ filtvis kibos;\\\ gudpasCeris daavadebas;\\\ vegeneris daavadebas;\\ eqsudaciur plevrits;\\\ filtvis gangrenas;

66

\\\\ 45 wlis mamakacs ukanaskneli sami Tvis manZilze awuxebs subfebriluritemperatura. Civilebidan aRniSnavs mxolod sisustes. fizikuri gamokvlevisasmniSvnelovani cvlilebebi ar gamovlinda. Sardis analizSi gamoxatulialeikocituria, baqteriologiuri gamokvleviT SardSi baqteriebi ar gamovlinda. qvemoTCamoTvlili paTologiebidan romeli aris metad savaraudo:\\\ Tirkmlis karcinoma\\\ Tirkmlis infarqti\\\ Tirkmlebis polikistozi\\ Tirkmlis tuberkulozi\\\ Tirkmlis venis Trombozi

\\\\ 57 wlis mamakacs wlebis manZilze awuxebs arTriti, ris gamoc Rebulobsarasteroidul anTebis sawinaaRmdego saSualebebs (aspirini, fenacetini, acetaminofeni)didi dozebiT (>3gr). qvemoT CamoTvlilTagan romeli paTologiis ganviTarebis riskiaqvs mas?\\\ Tirkmlis milakebis mwvave nekrozi\\ qronikuli intersticiuli nefriti\\\ difuzuri glomerulonefriti\\\ Tirkmlis karcinoma\\\ nefroliTiazi

\\\\ 37 wlis mamakacs uecrad xanmokle drois manZilze ganuviTarda sisuste,gulisrevis SegrZneba da Zilianoba. gamokiTxvisas man aRniSna, rom Sardis ferigamuqda. fizikuri gamokvlevisas paTologia ar gamovlinda. arteriuli wneva135/90mmHg.Llaboratoriuli monacemebiT sisxlis SratSi momatebulia narCeni azotisda kreatininis done. avadmofs Cautarda Tirkmlis biofsia. romelia prognozuladufro mZime biofsiuri monacemebi:\\\ hipercelularuli glomerulebi neitrofilebiT\\\ nodularuli glomerulosklerozi\\ glomeruluri "naxevarmTvareebi"\\\ qronikuli intersticiuli anTeba\\\ epiTeliumis cilindrebi Tirkmlis milakebSi

\\\\ 44 wlis mamakacs sisxlis SratSi gamouvlinda narCeni azoti 50mg%, kreatinini5.8mg%. Sardis analizisQromeli maCvenebeli miuTiTebs yvelaze metadglomerulonefritis arsebobaze?\\ eriTrocituri cilindrebis arseboba\\\ ovaluri cximovani warmonaqmnebi\\\ izolirebuli proteinuria eriTrocituriis gareSe\\\ hialinuri cilindrebi arseboba\\\ leikocituri cilindrebi arseboba

\\\\ 60 wlis qals aReniSneba anemia, tkivilebi welis areSi da swrafad progresirebadiTirkmlebis ukmarisoba. sisxlis analizi: narCeni azoti - 48mg%, kreatinini - 2,8mg%,saerTo cila - 8,5g%, albuminebi - 3,9g%. qvemoT CamoTvlilTagan savaraudo diagnozia:\\ mielomuri daavadeba\\\ sistemuri wiTeli mglura\\\ adenokarcinomis metastazi\\\ Saqriani diabeti\\\ qronikuli limfocituri leikemia

\\\\ CamoTvlilTagan romeli antibiotikis daniSvna aris winaaRmdegnaCvenebi Tirkmlebisqronikuli ukmarisobis dros:\\\ qloramfenikoli\\\ ampicilini\\ qlortetraciklini\\\ doqsiciklini\\\ izoniazidi

\\\\ ra ar axasiaTebs Tirkmlis amiloidozs?

67

\\\ proteinuria\\\ SeSupeba\\\ Tirkmlebis zomis gadideba\\\ hierqolesterinemia

\\\\ ra ar axasiaTebs Saqrian diabets?\\\ glukozisadmi tolerantobis momateba;\\ hipoglikemia;\\\ hiperglikemia;\\\ poliuria;\\\ glukozisadmi ujredebis membranis ganvladobis momateba.

\\\\ Tireotoqsikozs axasiaTebs:\\\ sxeulis temperaturis daqveiTeba;\\\ Tireoiduli hormonis sekreciis daqveiTeba;\\ Tireoiduli hormonis sekreciis momateba;\\\ bradikardia;\\\ ufro xSiria mamakacebSi.

\\\\ ra ar aris damaxasiaTebeli uSaqro diabetisaTvis?\\\ didi raodenobis dabali xvedriTi wonis Sardis gamoyofa (poliuria);\\\ antidiurezuli hormonis _ vazopresinis ukmarisoba;\\\ Tirkmlis milakebSi wylis Sewovis darRveva;\\ sisxlSi Sardovanas momateba.\\\ Zlieri wyurvili (polidifsia);

\\\\ ra ar aris damaxasiaTebeli hipoTireozisTvis:\\ egzofTalmi.\\\ farisebri jirkvlis hipofunqcia;\\\ ZiriTadi cvlis daqveiTeba;\\\ lorwovani SeSupeba;\\\ sicivis SegrZneba;

\\\\ ra ar aris damaxasiaTebeli akromegaliisaTvis:\\\ Zvlebis proporciuli gaZlierebuli zrda;\\\ adenohipofizis mier somatotropinis Warbi produqcia;\\\ somatostatinis sekreciis daqveiTeba;\\\ hipofizis eozinofiluri ujredebis adenoma;\\ Sinagani organoebis zomebi ar icvleba.

\\\\ romeli debuleba ar aris marTebuli aldosteronis Sesaxeb:\\\ astimulirebs Tirkmlis milakebSi natriumis reabsorbcias da kaliumis eqskrecias;\\\ angiotezin 11-i iwvevs misi sekreciis gaZlierebas;\\\ mis sekrecias ainhibirebs atriuli natriurezuli faqtori;\\\ mTavari mineralokortikoidia;\\ veroSpironi aldosteronis sinergistia.

\\\\ kuSingis sindromisaTvis ar aris damaxasiaTebeli:\\ hipoglikemia.\\\ Tirkmelzeda jirkvlis mier glukokortikoidebis Warbi produqcia;\\\ simsuqne;\\\ arteriuli wnevis momateba;\\\ osteoporozi;

\\\\ adisonis daavadebisaTvis ar aris damaxasiaTebeli:\\\ arteriuli hipotenzia;\\\ Tirkmelzeda jirkvlis qerqovani qsovilis destruqcia;\\\ glukokortikoidebis da mineralokortikoidebis produqciis Semcireba;\\\ kanisa da lorwovani garsis ujredebSi melaninis dagroveba;\\ kortizolis donis momateba sisxlSi.

68

\\\\ feoqromocitomisaTvis ar aris damaxasiaTebeli:\\\ Zlieri Tavis tkivili;\\\ taqikardia;\\\ Pprofuzuli oflianoba;\\\ arteriuli hipertenzia\\ sisxlSi kateqolaminebis daqveiTeba.

\\\\ qronikul A tipis gastritTan dakavSirebuli romeli debulebaa marTebuli:\\ A tipis gastriti xSirad asocirebulia perniciozul anemiasTan.\\\ A tipis gastriti asocirebulia H. pylori-iT inficirebasTan.\\\ A tipis gastriti ufro xSiri formaa B tipis gastritTan SedarebiT.\\\ A tipis gastriti azianebs kuWis pilorul nawils.

a\\\\ araspecifiuri wylulovani kolitis dros ufro xSirad ziandeba:\\ daswvrivi kolinji, sigma, swori nawlavi.\\\ kuWi, sigmoiduri nawlavi\\\ RviZli, swori nawlavi\\\ Tormetgoja nawlavi

d\\\\ romeli simptomia yvelaze metad damaxasiTebeli araspecifiuri wylulovankolitisaTvis:\\\ yabzoba\\ xSiri Txieri ganavali sisxlis minarevebiT\\\ tkivili saxsrebSi\\\ tkivili marjvena ferdqveSa areSi.

a\\\\ kronis daavadebis dros yvelaze xSirad ziandeba:\\ TeZos nawlavis distaluri nawili\\\ saylapavi\\\ sigmoiduri nawlavi\\\ kuWi.

b\\\\ RviZlis pirveladi kibos dros RviZlis cirozisgan gansxvavebiT aRiniSneba:\\\ bilirubinis donis momateba.\\\ siyviTle\\\ xorkliani RviZli\\\ aminotransferazebis donis momateba

\\ fetoproteinis donis momatebad

\\\\ CamoTvlilTagan romeli ar warmoadgens RviZlis cirozis garTulebas:\\\ hepatorenuli sindromi;\\\ RviZlismieri encefalopaTia;\\\ hepatocelularuli karcinoma;\\ cximovani hepatozi.

d\\\\ CamoTvlilTagan romeli ar warmoadgens mwvave pankreatitis garTulebas:\\\ pankreasis abscesi;\\\ pankreasis nekrozi;\\ pankreasis adenoma;\\\ pankreasis flegmona.

g\\\\ romel kriteriums ar emyareba colinger-elisonis sindromis diagnostika:\\\ gastrinoma;\\\ kuWis gaZlierebul bazalur sekrecia;\\\ sisxlSi gastrinis maRal koncentracia;\\ yabzoba.

d\\\\ qvemoT CamoTvlili preparatebidan romeli ekuTvnis protonuli tumbosinhibitorebs:\\\ mizoprostali

69

\\ omeprazoli\\\ cimetidini\\\ almageli

g\\\\ arteriuli hipertenziis ganviTarebis paTogenezSi sawyisi periodisaTvisdamaxasiaTebelia:\\\ renin- angiotenzinis sistemis gaaqtiveba;\\\ Tirkmlis hiperplazia;\\\ natriumis momateba sisxlZarRvTa kedelSi;\\ simpaTikur-adrenaluri sistemis gaaqtiveba;

\\\\ simptomuri arteriuli hipertenziis mizezia:\\\ anemia;\\ feoqromocitoma;\\\ mitraluri stenozi;\\\ wylulovani daavadeba.

\\\\ ra unda SeizRudos arteriuli hipertenziiT daavadebuli pacientis kvebiTracionSi?\\\ cximebi;\\\ sufris marili;\\\ naxSirwylebi;\\\ arcerTi CamoTvlili;\\ yvela CamoTvlili.

\\\\ hipotenziuri preparatebis romeli jgufis warmomadgenlis daniSvnaa mizanSewoniliSaqriani diabetiT daavadebul hipertenziul pacientebSi:\\ agf-is inhibitorebi;\\\ beta-adrenoblokerebi;\\\ centraluri moqmedebis simpaTolizuri saSualebebi;\\\ alfa-adrenoblokerebi.

\\\\ glazgos Skalis mixedviT komis xarisxi fasdeba:\\\ muxlis refleqsis SefasebiT;\\ pacientis aqtivobiT, masTan kontaqtis damyarebis SesaZleblobiT, Tvalebis gaxeliT;\\\ gugis zomisa da sinaTleze reaqciis SefasebiT;\\\ garegani sunTqvis funqciis adeqvaturobis SefasebiT.

\\\\ avadmyofs SenarCunebuli aqvs orientacia, Tvalebs axels mxolod TxovnisSemTxvevaSi. tkivilze pasuxad aqvs damcveli qmedebebi, mimarTvisas iZleva swor, magramSenelebul pasuxs. rogor SevafasebT glazgos skalis mixedviT tvinis zogadidarRvevis siRrmes?\\ gabrueba\\\ naTeli goneba;\\\ sopori;\\\ koma;\\\ tvinis sikvdili.

\\\\ tkivilze pasuxad avadmyofi xandaxan axels Tvals, Zlieri gaRizianebisas CndebadamcvelobiTi reaqcia. mimarTvisas pasuxobs abneulad. rogor SeafasebT tvinis zogadidarRvevis siRrmes glazgos skalis mixedviT?\\\ gabrueba\\\ naTeli goneba;\\ sopori;\\\ koma;\\\ tvinis sikvdili.

\\\\ avadmyofi sityvier mimarTvaze ar pasuxobs, cxvir-xaxis Zlier, mtkivneulgaRizianebaze Cndeba kidurebis tonuri moxriTi da gaSliTi moZraobebi, sunTqvaSenarCunebulia. rogor SeafasebT glazgos skalis mixedviT tvinis zogadi darRvevissiRrmes?

70

\\\ tvinis sikvdili.\\\ naTeli goneba;\\\ gabrueba\\\ sopori;\\ koma;

\\\\ ra ar axasiaTebs komatozur mdgomareobas:\\\ babinskis ormxrivi simptomi;\\\ myesebis refleqsebis daqveiTeba;\\\ muxlis refleqsebis daTrgunva;\\\ gugis reaqciebis daTrgunva;\\ mizanmimarTuli dacviTi reaqciebi.

\\\\ klinikurad riT ar vlindeba ketoacidozuri koma:\\\ mkrTali da mSrali kanis safarveli;\\\ sxeulis normaluri temperatura;\\ arteriuli hipertenzia;\\\ arteriuli hipotenzia;\\\ kusmaulis sunTqva, haerSi acetonis suni.

\\\\ ketoacidozuri komis dros natriumis bikarbonatis Seyvanis aucilebeli Cvenebaa:\\\ SeyavT ketoacidozuri komis yvela SemTxvevaSi;\\\ PH-is daqveiTeba 7,36-ze metad;\\\ tvinis SeSupebis dawyeba:\\ PH-is daqveiTeba 7,1-ze metad;\\\ Tanmxlebi laqtacidozi.

\\\\ hiperosmolaruli komisTvis damaxasiaTebelia:\\\ glukozis done sisxlSi 250-550mg%(14-30mmoli/l);\\\ gamoxatuli ketonemia;\\\ arteriuli sisxlis PH-is daqveiTeba;\\ sisxlis plazmis osmolaroba 300-500m.osm./l;\\\ sisxlis plazmaSi HCO 3-is koncentraciis daqveiTeba.

\\\\ cerebro-hipofizuri ukmarisobis aRmocenebis mizezebi SeiZleba iyos:\\\ Tavis qalis travma Semdgomi sisxlCaqceviT;\\\ Turquli kexis simsivne;\\\ tuberkulozi;\\\ meningoencefaliti;\\ yvela CamoTvlili.

\\\\ 30 wlis mamakaci, romelic muSaobs qimiur mrewvelobaSi, klinikaSi SemovidaCivilebiT uecrad ganviTarebul gulisrevasa da Rebinebaze, mucelSi tkivilsa da Saviferis ganavalze Sekrulobis fonze. amasTanave, aRniSnavs liTonis gemos. aRniSnulitkivilebi, SedarebiT naklebi intensivobiT, aReniSneboda erTi Tvis winac. muclispalpaciiT tkivilis intensivoba Semcirda. savaraudo toqsikuri agentia:\\\ vercxliswyali;\\ tyvia;\\\ spilenZi;\\\ meTanoli;\\\ dariSxani.

\\\\ dariSxaniT mowamvlis klinikuri suraTisTvis ra ar aris damaxasiaTebeli:\\\ mtkivneuli faRaraTi tenezmebiT;\\\ keracidebi da frCxilebis dazolianeba;\\\ sisuste, adinamia, cnobierebis abneva, gulyrebi;\\ cxeleba;\\\ intravaskuluri hemolizi.

\\\\ ra ar aris damaxasiaTebeli vercxliswyliT intoqsikaciisTvis:

71

\\\ toqsiuri dermatiti, papulur-peteqiuri gamonayaris saxiT;\\\ mwvave intersticiuri pnevmonia;\\\ Tirmlis milakebis mwvave toqsokogenuri nekrozi;\\\ hiperrefleqsia, tremori;\\ agranulocitozi.

\\\\ antidoturi Terapia yvelaze xangrZlivad unda vawarmooT:\\ mZime metalebiT intoqsikaciis dros.\\\ alkoholuri intoqsikaciis dros;\\\ trankvilizatorebiT intoqsikaciis dros;\\\ antidepresantebiT intoqsikaciis dros;\\\ narkotikuli nivTierebebiT intoqsikaciis dros;

\\\\ heparinis dozis gadametebisas specifikuri antagonistia:\\ kalciumis glukonati\\ protaminis sulfati;\\\ varfarini;\\\ uniTioli;\\\ K-vitamini;

\\\\ Tirkmlis mwvave ukmarisobis gamowveva SeuZlia antibiotikebis Semdeg jgufebs:\\ aminoglikozidebs;\\\ makrolidebs;\\\ tetraciklinebs;\\\ penicilinebs;\\\ cefalosporinebs.

\\\\ qolecisteqtomiis Semdgomi garTulebis gamo avadmyofs daeniSna gentamicini( 70mg. 8saaTSi erTxel) da cefalotini(2gr. dReSi 4-jer) aTi dRis ganmalobaSi. bolo dReebSiaRiniSna hiperkreatinemia, Tumca diurezi ar Semcirebula, arteriuli wnevanormaluria. ramdenime dReSi gamoixata Tirkmlebis mwvave ukmarisobis klinikurisuraTi.qvemoTCamoTvlilTagan ram gamoiwvia Tirkmlebis dazianeba?\\\ sefsisma(operaciis Semdgomma garTulebam);\\\ operaciis dros Tirkmlis dazianebam;\\ gentamicinma;\\\ mwvaved ganviTarebulma glomerulonefritma;\\\ cefalotinma.

\\\\ tipiuri baqteriuli pnevmoniis mimdinareobaSi paTomorfologiurad gamoyofenfazebs:\\ wiTeli da ruxi "gaRviZlebis"\\\ infiltraciis, rRvevisa da moTesvis;\\\ nekrozisa da kalcinaciis;\\\ eqsudaciis, transudaciis da fibrinis daleqvis;\\\ obstruqciis, restriqciis da destruqciis;

\\\\ "atipiuri” pnevmoniis terminis qveS igulisxmeba:\\\ pnevmokokuri pnevmonia;\\\ virusuli bronqopnevmonia;\\\ eozinofiluri infiltrati;\\ pnevmonia, gamowveuli legioneloziT, qlamidiebiT, an mikoplazmebiT;\\\ pnevmonia, gamowveuli gramuaryofiTi mikroflorisgan;

\\\\ pnevmoniis diagnozis formulirebisas romeli maxasiaTeblebis CamoTvla ar arissaWiro:\\\ nozologiuri forma etiologiis gaTvaliswinebiT;\\ arteriul sisxlSi Jangbadis done;\\\ filtvis anTebis lokalizacia da gavrceleba;\\\ simZimis xarisxi;\\\ garTulebebis arseboba;

72

\\\\ miRebulia pnevmonias ewodos nozokomialuri, romelic viTardeba:\\\ 48 saaTiT adre pacientis hospitalizaciidan;\\\ orsul qalebSi 20 kviris orsulobis Semdeg;\\ pacientis hospitalizaciidan 48 saaTis Semdeg;\\\ avadmyofebSi sxva daavadebis gamo binaze mkurnalobis SemTxvevaSi;\\\ winaT aranamkurnaleb adamianebSi;

\\\\ abscesiT garTulebuli mZime pnevmoniis dros eqimma pirvel rigSi unda:\\\ moaxdinos xvelis kupireba xvelis refleqsis daTrgunvis saSualebiT;\\ aRadginos bronqialuri xis drenaJi;\\\ gamoikvlios naxveli pnevmokokebis arsebobaze;\\\ Caataros kveimis sinji;\\\ Caataros mediastinoskopia.

\\\\ saerTaSoriso konsensusisa da ruseTis Terapiuli oqmis Tanaxmad, pnevmoniisklasifikaciaSi Seyvanilia:\\\ alergiuli, benzinismieri, posttravmuli, profesiuli;\\\ mwvave, qvemwvave, gaxangrZlivebuli, qronikuli;\\ arahospitaluri, hospitaluri(saavadmyofosSida), imunodeficitiT daavadebulebSi,aspiraciuli;\\\ romelic moiTxovs, an ar moiTxovs qirurgiul mkurnalobas;\\\ Tandayolili da SeZenili.

\\\\ arahospitaluri pnevmoniiT daavadebulebSi empiriuli Terapiis arCevis preparatebswarmoadgens:\\\ linkomicini da levomicetini;\\\ ciprofloqsacini, plefloqsacini, ofloqsacini;\\\ streptomocini da gentamicini;\\\ imipenemi da meropenemi;\\ penicilini, eriTromicini, azitromicini.

\\\\ sxivuri diagnostikis yvelaze informaciul meTods filtvebSi kerovani dabeWdiseburi Crdilebis arsebobisas warmoadgens:\\\ rentgenoskopia;\\\ fluorografia;\\\ pnevmomediastinumi;\\ kompiuteruli tomografia;\\\ mediastinografia.

\\\\ "sunTqvis ukmarisobis" terminis qveS igulisxmeba:\\\ bronquli gamtareblobis darRveva;\\\ hemodinamikis darRveva sisxlismimoqcevis mcire wreSi;\\ filtvebSi ventilaciis, Jangabadis transportisa da utilizaciis darRveva;\\\ sisxlis airebis transportis funqciis darRveva;\\\ Jangbadis qsovilovani metabolizmis darRveva.

\\\\ pnevmokokebs uwodeben:\\\ Chlamidia pneumoniae;\\\ Klebsiella pneumoniae;\\\ Legionella pneumophila;\\ Streptococcus pneumoniae;\\\ Bordetela pertisis.

\\\\ Tambaqos gamonabolqvis zemoqmedebis ZiriTadi Sedegi filtvis adgilobrivi dacvissistemaze aris:\\ antiproteazuli dacvis Semcireba;\\\ alveolaruli makrofagebis fagocituri aqtivobis daTrgunva;\\\ bronqul sekretSi sulfhidruli jgufis Semcireba;\\\ limfocitebSi arisulfatis aqtivobis daTrgunva;\\\ sisxlis SratSi IgA Semcvelobis momateba.

73

\\\\ qronokuli obstruqciuli bronqitis simZimes gansazRvravs:\\ garegani sunTqvis funqciis gamokvleva;\\\ filtvis auskultacia;\\\ filtvis perkusia;\\\ ekg;\\\ bronqografia;

\\\\ "qronikuli obstruqciuli bronqitis" diagnozis formulirebisas ar arisaucilebeli miTiTebuli iyos:\\\ procesis simZimis xarisxi;\\ procesis lokalizacia segmentebis mixedviT;\\\ procesis fazebi (gamwvaveba, remisia);\\\ garTulebebis arseboba:\\\ sunTqvis ukmarisobis xarisxi.

\\\\ emfizemis swrafad ganviTarebas xels uwyobs:\\\\ dnm -hirazas deficiti.\ alfa-1 antitrifsinis deficiti;\\\ ldh deficiti;\\\ adenilatciklazas deficiti;\\\ fosfodiesTerazas deficiti;

\\\\ filtvebis emfizemiT daavadebuli pacientebis gamokvlevis yvelazesaimedo(sarwmuno) meTodia:\\\ bronqografia;\\\ rentgenoskopia;\\ kompiuteruli tomografia;\\\ magnitur-rezonansuli tomografia;\\\ ultrabgeriTi gamokvleva.

\\\\ romel gamokvlevis meTods eniWeba upiratesoba mitraluri sarqvlis prolafsissadiagnozod?\\\ veloergometria.\\\ gulmkerdis rentgenografia;\\\ eleqtrokardiografia;\\ eqokardiografia;\\\ gulis kaTeterizacia;

\\\\ gandevnis fraqcia normaSi aris\\ 56-78%;\\\ 45-55%;\\\ 30-45%;\\\ 90%;\\\ 15-30%.

\\\\ ra saxis hipertrofia vlindeba eqokardiografiulad gulis parkuWis moculobiTigadatvirTvis SemTxvevaSi\\ eqscentruli;\\\ koncentruli;\\\ izolirebuli Zgidis;\\\ koncentruli remodelireba;\\\ hipertrofia am dros saerTod ar vlindeba.

\\\\ ra saxis Suili gvxvdeba winagulTaSua Zgidis defeqtis dros?\\\ diastoluri Suili fuZeze;\\\ sistoluri Suili mwvervaloze;\\\ rombisebri sistoluri Suili meore neknTaSua areSi marjvena parasternalurxazze;\\ sistoluri Suili meore-mesame neknTaSua areSi marcxena parasternalur xazze;\\\ uwyveti xasiaTis sistoluri Suili V mosasmen wertilze.

74

\\\\ lutembaSes sindromi viTardeba winagulTaSua Zgidis defeqtis SerwymiT:\\\ filtvis arteriis stenozTan;\\\ SeZenil aortul stenozTan;\\\ SeZenil trikuspidur stenozTan;\\ SeZenil mitralur stenozTan;\\\ SeZenil aortul naklovanebasTan.

\\\\ tkacuna I toni damaxasiaTebelia:\\\ aortuli naklovanebisTvis;\\\ dilataciuri kardiomiopaTiisTvis;\\\ mitraluri naklovanebisTvis;\\ mitraluri stenozisTvis;\\\ aortuli stenozisTvis.

\\\\ aortuli naklovanebisTvis damaxasiaTebelia:\\\ sistoluri Suili mwvervaloze;\\\ fizikuri datvirTvis dros stenokardiuli tkivili da gonebis dakargva;\\ swrafi, maRali da xSiri periferiuli pulsi;\\\ sistoluri Suili aortaze;\\\ arteriuli hipotonia.

\\\\ gulis mankis yvelaze xSiri saxeobaa:\\\ aortuli stenozi;\\\ trikuspiduri stenozi;\\\ aortuli naklovaneba;\\ mitraluri sarqvlis prolafsi;\\\ mitraluri stenozi.

\\\\ CamoTvaleT ra aris damaxasiaTebeli AV blokadisaTvis:\\\ QRS-intervalis gaxangrZliveba.\\\ Q-T intervalis gaxangrZliveba.\\ P-Q intervalis gaxangrZliveba.\\\ R kbilis deformacia\\\ yvela CamoTvlili

\\\\ ekg-ze P kbili dadebiTia, P-Q intervali 0,22 wami, QRS kompleqsis xangrZlivoba 0,09wm. daaxasiaTeT riTmis moSlis saxe.\\\ parkuWovani eqstrasistolia\\ arasruli atrioventrikuluri blokada ( I xarisxis).\\\ mocimcime ariTmia\\\ arasruli atrioventrikuluri blokada (II xarisxis)\\\ sruli atriventrikuluri blokada.

\\\\ paTologiuri Q kbilis arseboba V1-V6 ganxrebSi miuTiTebs:\\ wina gavrcelebul infarqtze.\\\ ukana kedlis infarqtze.\\\ wina da ukana kedlis gavrcelebul infarqtze.\\\ septalur infarqtze.\\\ wina mwvervalis infarqtze.

\\\\ CamoTvlilidan ra warmoadgens mocimcime ariTmiisTvis sadiagnozoeleqtrokardiografiul kriteriums?\\\ Tanabari Q-T intervali\\\ araTanabari R-R intervali\\ f talRebis arseboba\\\ S-T segmentis da T kbilis deformacia.\\\ QRST -kompleqsis deformacia.

\\\\ CamoTvlili simptomebidan romelia paTognomuri stenokardiisTvis?\\\ Q kbili III da AVF ganxrebSi.

75

\\ tkivili mkerdis Zvlis ukan da ST-segmentis depresia datvirTvisas.\\\ CxvletiTi xasiaTis tkivili gulis areSi fizikuri datvirTvisas.\\\ parkuWovani eqstrasistolia fizikuri datvirTvis Semdeg.\\\ negatiuri T kbili V2- V6 ganxrebSi.

\\\\ ekg- ze zogjer normaluri PQRST kompleqsis Semdeg aRiniSneba deformiuli QRSTkompleqsi, romlis winac R-R intervali Semoklebulia, Semdegi P kbili gamoxatuliar aris, daasaxeleT ariTmiis tipi:\\\ mocimcime ariTmia\\\ sunTqviTi ariTmia\\\ winagulovani eqstrasistolia;\\ parkuWovani eqstrasistolia;\\\ arasruli atriventrikuluri blokada (I xarisxi).

\\\\ parkuWovani eqstrasistoliisaTvis ar aris damaxasiaTebeli:\\\ sruli kompensatoruli pauza.\\\ eqstrasistoliis win P kbilis ararseboba.\\ eqstrasistoluri QRS- kompleqsis xangrZlivoba ar aRemateba 0, 10 wm.\\\ eqstrasistoluri kompleqsis deformacia.\\\ eqstrasistoluri T kbilisa da QRS kompleqsis maqsimaluri diskordinatoba.

\\\\ paTologiuri Q kbilis arseboba III da AVF ganxrebSi miuTiTebs :\\\ wina-gavrcelebul infarqtze.\\ ukana kedlis infarqtze.\\\ wina da ukana kedlis gavrcelebul infarqtze.\\\ septalur infarqtze.\\\ wina mwvervalis infarqtze.

\\\\ ra asaxavs srul atrioventrikulur blokadas?\\\ araTanabari P-Q intervali.\\\ R-R intervalis mkveTri gaxangrZliveba:\\\ Tanabari R-R intervali .\\\ Tanabari P-P intervali.\\ yvela CamoTvlili.

\\\\ supravenrtikuluri eqstrasistolisTvis ar aris damaxasiaTebeli;\\\ arasruli kompensatoruli pauzis;\\\ QRST- kompleqsis Seucvlelobis;\\\ P kbilis deformaciis;\\\ P-Q intervalis Secvlis;\\ QRST kompleqsis deformaciis;

\\\\ paTologiuri Q kbilis arseboba V1-V2 ganxrebSi miuTiTebs:\\\ ukana kedlis infarqtze;\\ septalur infarqtze.\\\ wina da ukana kedlis gavrcelebul infarqtze;\\\ wina gavrcelebul infarqtze;\\\ wina mwervalis infarqtze;

\\\\ venkenbaxis tipis atrioventrikuluri blokada xasiaTdeba;\\\ P-Q intervalis progresirebadi SemoklebiT;\\\ P-Q- intervalis progresirebadi gaxangrZlivebiT;\\ P-Q intervalis progresirebadi gaxangrZlivebiT da parkuWovani kompleqsisSemdgomi gamovardniT;\\\ taqikardiiT;\\\ fiqsirebadi blokadiT 2:1;

\\\\ ekg-ze P kbilebi ar aRiniSneba, R-R intervalebi sxvadasxva xangrZlivobisaa,aRiniSneba f talRebi, daasaxeleT ariTmiis saxe;\\\ winagulovani eqstrasistolia;

76

\\\ winagulovani TrTolva;\\\ parkuWovani eqstrasistolia;\\\ sruli atrioventrikuluri blokada;\\ mocimcime ariTmia;

\\\\ parkuWovani fibrilaciisaTvis damaxasiaTebeli ekg cvlilebebia:\\\ QRST-kompleqsebis erTnairi amplituda;\\\ ST segmentis Serwyma T kbilTan;\\\ QRST kompleqsebis deformacia da gafarToeba;\\ ekg elementebis diferencirebis SeuZlebloba;\\\ f talRebis arseboba;

\\\\ CamoTvlili ekg niSnebidan, romelia yvelaze damaxasiaTebeli dilataciurikardiomiopaTiisaTvis?\\\ P-Q intervalis Semcireba ;\\\ R-kbilis amplitudis momateba V4-V6 ganxrebSi;\\ R -kbilis voltaJis daqveiTeba, T kbilis dadableba an inversia;\\\ Q-T intervalis gaxangrZliveba;\\\ yvela CamoTvlili;

\\\\ miokardiumis ukana bazaluri infarqtisaTvis damaxasiaTebelia cvlilebebi SemdegganxrebSi:\\ III-aVF, V7-9, D;\\\ I-III, aVL, V5-6, I;\\\ II-III; aVF, D;\\\ I, aVL, V1-6, A, I;\\\ V1-4, A.

\\\\ winagulebis hipertrofiisas ekg-cvlilebebidan romelia damaxasiaTebeli?\\\ P-Q-intervalis gaxangrZliveba;\\\ QRS-kompleqsis deformacia da gaxangrZliveba;\\ P-kbilis deformacia da gafarToeba;\\\ T-kbilis deformacia da gafarToeba;\\\ yvela zemoT CamoTvlili.

\\\\ marcxena parkuWis hipertrofiis dros qvemoT CamoTvlili ekg niSnebidan, romeliadamaxasiaTebeli?\\\ QRST kompleqsis deformacia da gafarToeba;\\\ marcxena tipis ekg;\\\ QRS- intervalis gaxangrZliveba.\\\ T- kbilebis inversia;\\ yvela zemoT aRniSnuli;

\\\\ marjvena parkuWis hipertrofiis dros qvemoT CamoTvlili ekg niSnebidan romeliadamaxasiaTebeli?\\\ S-kbilis gafarToeba da deformacia.\\\ marjvena tipis ekg\\\ QRS-intervalis gaxangrZliveba;\\\ QRST-kompleqsis deformacia;\\ yvela zemoT CamoTvlili;

\\\\ bronquli asTmis dros yvela qvemoTCamoTvlili monawileobs obstruqciisCamoyalibebaSi, garda:\\ laringospazmi;\\\ lorwoTi bronqis sanaTuris daxSoba;\\\ sasunTqi gzebis anTeba\\\ bronqospazmi;\\\ sasunTqi gzebis SeSupeba;

77

\\\\ bronqoeqtaziis uxSiresi mizezia:\\\ tuberkulozi;\\\ bronquli asTma;\\\ yivanaxvela;\\ bronqopnevmonia;\\\ gripi

\\\\ CamoTvlili testebidan yvelaze zustad ra ganasxvavebs filtvebis restriqciuldaavadebebs obstruqciulisagan;\\\ sunTqviTi moculoba;\\\ filtvebis sacicocxlo tevadoba;\\\ forsirebuli amosunTqvis moculoba;\\ forsirebuli amosunTqvis moculoba/filtvebis sacicocxlo tevadobasTan (tifnosindeqsi);\\\ narCeni moculoba.

\\\\ filtvebis ra saxis dazianebaa damaxasiaTebeli sistemuri wiTeli mglurasTvis;\\ pnevmoniti, eqsudaciuri plevriti;\\\ filtvebis intersticiuli fibrozi;\\\ plevruli Svartebi ( Sexorcebebi);\\\ bronqebis kedlis infiltrati;\\\ yvela CamoTvlili.

\\\\ CamoTvlilidan ra aris paTognomuri qronikuli filtvismieri gulisaTvis:\\\ mocimcime aritmia;\\\ gulis marcxena sazRvris gadideba;\\ venuri wnevis momateba;\\\ filtvis arteriis Tromboembolia;\\\ yvela CamoTvlili.

\\\\ qronikuli bronqitis garTuleba ar SeiZleba iyos;\\\ difuzuri pnevmofibrozi;\\\ filtvebis emfizema;\\\ filtvismieri guli;\\ mSrali plevriti;\\\ bronqoeqtaziuri daavadeba.

\\\\ CamoTvlilidan ra aris paTognomuri filtvebis abscesisaTvis?\\\ leikocitozi;\\\ maRali temperatura;\\\ xvela savse piriT;\\\ infiltraciis fonze mrgvali Rrus arseboba horizontaluri doniT;\\ yvela CamoTvlili.

\\\\ filtvebis SeSupebis mizezi ar SeiZleba iyos:\\\ gulis anevrizma;\\ pnevmonia.\\\ mitraluri stenozi;\\\ aortis sarqvlis naklovaneba;\\\ marcxena parkuWis ukmarisoba;

\\\\ mwvave respiratoruli ukmarisobis mizezi ar SeiZleba iyos;\\\ laringospazmi;\\\ xorxis mwvave SeSupeba.\\\ bronquli asTmi;\\ kerovani pnevmonia;\\\ filtvis arteriis Tromboembolia;

\\\\ kuW-nawlavis refluqss ar iwvevs;\\\ izosorbid dinitrati;\\\ dilTiazemi;

78

\\ qlorpropamidi\\\ atropini;\\\ Tambaqo;

\\\\ kuW-saylapavis refluqsis samkurnalod ar gamoiyeneba;\\ M-qolinolizuri saSualebebi;\\\ antacidi;\\\ H2-receptorebis blokerebi;\\\ protonuli tumbos inhibitori;\\\ prokinetikebi;

\\\\ qvemoT CamoTvlili klinikuri niSnebidan romeli ar axasiaTebs gastro-ezofagurrefluqss?\\\ disfagia;\\\ regurgitacia;\\\ odinofagia;\\\ gulZmarva;\\ slokini.

\\\\ gulmkerdSi ucnobi genezis tkivilis yvelaze xSiri mizezia:\\ kuW-saylapavis refluqsi;\\\ saylapavis motoruli funqciis darRveva;\\\ Zval-kunTovani aparatis dazianeba;\\\ fsiqikis darRveva;\\\ Semomsartyveli liqeni.

\\\\ CamoTvlilTagan kuWis romel nawilSi viTardeba yvelaze xSirad B tipis gastriti?\\\ mcire simrude;\\ antraluri midamo;\\\ didi simrude;\\\ subkardiuli nawili;\\\ fundaluri nawili.

\\\\ CamoTvlilTagan romeli samkurnalwamlo saSualebebi iTvleba dReisaTvis yvelazeefeqturad peptiuri wylulis samkurnalod?\\\ antisekreciuli saSualebebi;\\\ gastrocitoproteqtorebi;\\ antisekretoruli da antibaqteriuli saSualebebi;\\\ antibaqteriuli preparatebi;\\\ antacidebi.

\\\\ pankreasis kunZulovani qsovilis simsivnis diagnozisTvis, CamoTvlilTagan romelimeTodia yvelaze mgrZnobiare?\\\ endoskopiuri retrograduli pankreatoqolangiografia;\\\ ultrabgeriTi skanireba;\\ endoskopiuri ultrabgeriTi skanireba;\\\ kompiuteruli tomografia;\\\ magnitur rezonansuli tomografia.

\\\\ CamoTvlilTagan romeli mdgomareobaa WeSmariti gaRizianebuli nawlavissindromisaTvis?\\\ imunuri meqanizmis darRveva;\\\ laqtazis deficiti;\\ nervul-kunTovani da hormonuli defeqti;\\\ kiboswinare mdgomareoba;\\\ fekaluri masebis Seukavebloba.

\\\\ romelia iSemiuri kolitis yvelaze ,,sayvareli” (xSiri) ganviTarebis adgili?\\\ brma nawlavi;

79

\\\ swori nawlavi;\\\ sigmuri kolinji;\\ elenTis kuTxe;\\\ RviZlis kuTxe.

\\\\ colinger-elisonis sindromTan asocirebuli simsivne (gastrinoma) yvalaze xSiradlokalizdeba:\\\ kuWSi;\\\ nawlavSi;\\ pankreasSi;\\\ elenTaSi;\\\ limfur jirkvlebSi.

\\\\ CamoTvlil paTologiaTagan, romeli araa damaxasiaTebeli kronis daavadebisaTvis?\\\ afTozuri wyluli\\\ striqturebi;\\\ fistulebi da mikrofisurebi;\\ fsevdopolipozi;\\\ granuloma.

\\\\ wylulovani kolitisaTvis damaxasiaTebelia yvela CamoTvlili niSani, garda:\\ striqturebi da fistulebi;\\\ sisxldena;\\\ fsevdopolipozi;\\\ diarea;\\\ kvanZovani eriTema.

\\\\ yvelaze xSirad romeli simptomi vlindeba mwvave glomerulonefritis dros?\\\ SeSupeba;\\\ leikocituria;\\ proteinuria;\\\ arteriuli hipertenzia;\\\ tkivili welis areSi.

\\\\ romeli simptomi ar aris damaxasiaTebeli qronikuli nefrozuli sindromisaTvis?\\\ SeSupeba;\\ arteriuli hipertenzia;\\\ hipoalbuminemia;\\\ proteinuria.

\\\\ hipertonuli tipis qronikuli glomerulonefritis gamwvavebisaTvisdamaxasiaTebelia yvela simptomi, garda:\\ SeSupeba;\\\ proteinuria;\\\ hematuria;\\\ cilindruria;\\\ arteriuli hipertenzia.

\\\\ ra aris Tirkmlebis qronikuli ukmarisobis damadasturebeli niSani;\\\ arteriuli hipertenzia;\\\ oliguria;\\\ proteinuria;\\\ hiperkaliemia;\\ kreatininis momateba sisxlSi;

\\\\ ra aris Cveneba hemodializisaTvis?\\\ infeqciuri garTulebani;\\\ gamoxatuli SeSupeba;\\ kreatininis momateba sisxlSi;\\\ stabiluri arteriuli hipertenzia;\\\ mxedvelobis daqveiTeba.

80

\\\\ mwvave nefrozuli sindromi xasiaTdeba:\\ SeSupebiT, hipo da disproteinemiiT, hiperqolesterinemiiT;\\\ arteriuli hipertenziiT, SeSupebiT, proteinuriiT, hematuriiT;\\\ arteriuli hipertenziiT, hiperqolesterinemiiT.

\\\\ Tirkmlebis mwvave ukmarisobisas sicocxlisaTvis uSualo safrTxes warmoadgens:\\\ sisxlSi Sardovanas Semcvelobis momateba;\\\ sisxlSi kreatininis Semcvelobis momateba;\\ hiperkaliemia;\\\ hiperfosfatemia;\\\ hiperurikemia.

\\\\ Sardis daTesvas azri aqvs:\\\ mwvave Cirqovani pielonefritis;\\\ qronikuli aqtiuri pielonefritis;\\\ qronikuli latenturi pielonefritis;\\\ arc erT CamoTvlil SemTxvevaSi;\\ yvela CamoTvlil SemTxvevaSi.

\\\\ meoradi amiloidizi SesaZloa ganviTardes:\\\ revmatoiduli arTritis;\\\ fsoriazuli arTritis;\\\ simsivneebis;\\\ bronqoeqtaziuri daavadebis;\\ yvela CamoTvlil SemTxvevaSi.

\\\\ urografia saSualebas iZleva;\\\ dadgindes Tirkmlis zomebi;\\\ dadgindes Tirkmlis mdebareoba;\\\ gamoavlinos konkrementebi;\\\ Sefasdes Tirkmlis funqcia;\\ yvela CamoTvlili pasuxi sworia.

\\\\ qvemoT CamoTvlili simptomebidan romelia yvelaze damaxasiaTebeli gulismarcxenamxrivi ukmarisobis dros?\\\ kisris venebis Seberiloba;\\ orTopnoe;\\\ asciti;\\\ anoreqsia;\\\ SeSupeba.

\\\\ qvemoTCamoTvlili mizezebidan, romeli ganapirobebs yvelaze xSirad SegubebiTikardiomiopaTiis ganviTarebas?\\\ endokrinopaTiebi (hipoTireozi);\\\ metaboluri darRvevebi (hipofosfatemia);\\ deqsorubicinis (onkologiuri preparati) didi dozebiT mkurnaloba;\\\ qronikuli alkoholizmi.

\\\\ qvemoTCamoTvlilidan romeli niSani miuTiTebs gulis tamponadis ganviTarebaze?\\\ maRali pulsuri wneva;\\\ kusmaulis simptomi;\\\ gaZlierebuli gulis saZgeri;\\ paradoqsuli pulsi.

\\\\ qvemoTCamoTvlilidan romeli adasturebs konstriqciuli perikarditis diagnozs?\\\ gulis pirveli da meore tonebis gaZliereba;\\ kisris venebis Seberva SesunTqvis fazaSi;\\\ araerTnairi wneva diastolis fazaSi gulis oTxive kameraSi;\\\ marcxenamxrivi ukmarisobis niSnebis prevalireba.

81

\\\\ perikarditis mizezebia yvela, garda erTisa:\\ toqsiuri zemoqmedeba;\\\ miokardiumis infarqti;\\\ onkologiuri daavadebebi;\\\ revmatiuli daavadebebi;\\\ uremia.

\\\\ kardiomiopaTia warmoadgens SesaZlo diagnozs yvela CamoTvlili avadmyofisaTvisgarda:\\\ asimptomuri avadmyofi, romelmac mogvmarTa ekg-ze cvlilebebis gamo;\\ avadmyofi, romelmac mogvmarTa gamokvlevisaTvis marcxena winagulis izolirebuligadidebisa da mitraluri regurgitaciuli Suilis gamo;\\\ asimptomuri avadmyofi, romelic gamogzavnilia gamosakvlevad kardiomegaliis gamo;\\\ avadmyofi, romelsac TiTqmis erTdroulad ganuviTarda marcxena da marjvena gulisSegubebiTi ukmarisobis niSnebi;\\\ avadmyofi, romelsac awuxebs sisuste, daRla da qoSini fizikuri datvirTvisas.

\\\\ dilataciuri kardiomiopaTiisaTvis auskultaciurad damaxasiaTebelia:\\\ diastoluri Suili filtvis arteriaze;\\\ tkacuna I toni;\\\ mwvervalze diastoluri Suili;\\\ gaZlierebuli Ivtoni;\\ galopis riTmi.

\\\\ perikarditi Cveulebriv Tan axlavs yvela CamoTvlil mdgomareobas, garda:\\\ revmatizmi;\\ qunTruSa;\\\ tuberkulozi;\\\ sistemuri wiTeli mglura;\\\ miokardiumis infarqti.

\\\\ kalcinozi, reinos sindromi, ezofagiti, sklerodaqtilia, teleangieqtaziebi (CRESTsindromi) damaxasiaTebelia:\\\ sistemuri wiTeli mglurasTvis;\\ sistemuri sklerodermiisTvis;\\\ revmatoiduli arTritisTvis;\\\ kvanZovani periarteritisTvis;\\\ dermatomiozitisTvis.

\\\\ leikopenia xSirad vlindeba:\\\ kvanZovani poliarteritis dros;\\\ sistemuri sklerodermiis dros;\\ sistemuri wiTeli mgluras dros;\\\ dermatomiozitis dros;\\\ revmatoiduli arTritis dros.

\\\\ CamoTvlili fermentebidan romelia yvelaze specifikuri dermatomiozitisaTvis?\\\ laqtatdehidrogenaza;\\\ aspartat-aminotransferaza;\\\ alanin-aminotransferaza;\\ kreatinfosfokinaza;\\\ tute-fosfataza.

\\\\ revmatoiduli arTritis klinikur suraTSi yvelaze xSirad gvxvdeba SemdeginiSnebi, garda:\\\ kunTebis atrofia;\\\ proqsimaluri falangTaSorisi da sxiv majis saxsrebis dazianeba;\\\ revmatoiduli kvanZebi;\\ heberdenis kvanZebi;\\\ dilis SebiWiloba.

82

\\\\ takaiasus sindromi xasiaTdeba:\\\ dabali wneviT qvemo kidurebze da maRali wneviT zemo kidurebze;\\ maRali wneviT qvemo kidurebze da dabali wneviT zemo kidurebze;\\\ arteriuli hipertenziiT;\\\ diastoluri SuiliT mwvervalze.

\\\\ kvanZovanma poliarteritma SeiZleba gamoiwvios gul-sisxlZarRvTa sistemis yvelaCamoTvlili dazianeba, garda erTisa:\\\ arteriuli hipertenzia;\\\ mwvave koronaruli ukmarisoba;\\ aortuli sarqvelis dazianeba;\\\ perikarditi;\\\ miokarditi.

\\\\ Tirkmlis ukmarisobis miuxedavad, romeli daavadebebis dros gvxvdeba TirkmlisSedarebiT didi zomebi:\\\ qronikuli pielonefriti;\\ amiloidozi;\\\ diabeturi nefropaTia;\\\ qronikuli glomeluronefriti.

\\\\ hipernefromis gamovlineba SeiZleba iyos yvela qvemoT CamoTvlili niSani, garda:\\\ policitemia;\\\ Semcivneba da cxeleba;\\ piuria;\\\ hematuria;\\\ arteriuli hipertonia.

\\\\ CamoTvlili daavadebebidan, romelma SeiZleba gamoiwvios Tirkmlis amiloidozi:\\\ qronikuli pielonefriti;\\\ qronikuli glomerulonefriti;\\\ mgluras nefriti;\\\ diabeturi nefropaTia;\\ mielomuri daavadeba.

\\\\ Tirkmlis mwvave ukmarisoba SeiZleba ganviTardes yvela SemTxvevaSi, garda:\\\ mwvave glomeluronefriti;\\ Tirkmlis polikistozi;\\\ fenacetinis gamoyeneba;\\\ Soki.

\\\\ qvemoT CamoTvlili faqtorebidan, romelma SeiZleba gamoiwvios Tirkmlis mwvaveukmarisoba:\\\ posthemoragiuli hipotenzia;\\\ profuzuli diarea;\\\ xSiri, uwyveti Rebineba;\\\ araTanamosaxele jgufis sisxlis gadasxma;\\ yvela CamoTvlili.

\\\\ romeli maCvenebeli iTvleba yvelaze damajereblad hemodializze gadasvlisaTvisTirkmlis qronikuli daavadebis dros:\\ konservatiuli mkurnalobis mimarT refraqteruli hiperkaliemia 7 mmoli/l-zemeti;\\\ kreatininis done 500 mmoli/l farglebSi;\\\ hipermagniemia;\\\ uremiuli perikarditi;\\\ uremiuli encefalopaTia.

\\\\ qvemoT CamoTvlili preparatebidan romeli ar iwvevs Tirkmlis mwvave ukmarisobas:\\ beta-blokerebi;\\\ aminoglikozidebi;

83

\\\ citostatikebi;\\\ anTebis sawinaaRmdego arasteroiduli preparatebi.

\\\\ am daavadebebidan romeli SeiZleba garTuldes nefrozuli sindromiT:\\\ konis sindromi;\\\ Tireotoksikozi;\\\ adisonis daavadeba;\\ Saqriani diabeti;\\\ uSaqro diabeti.

\\\\ romeli simptomi ar aris swori nefrozul sindromTan mimarTebaSi:\\ hipoqolesterinemia\\\ proteinuria;\\\ hipoproteinemia;\\\ arteriuli hipertenzia;\\\ SeSupeba.

\\\\ nefrozuli sindromi SeiZleba Tan axldes yvela qvemoT CamoTvlil arainfeqciurdaavadebas garda:\\ idiopaTiuri kardiomiopaTia;\\\ sistemuri wiTeli mglura;\\\ filtvis kibo;\\\ kvanZovani poliarteriiti;\\\ Sonlain – henoxis daavadeba.

\\\\ qvemoT CamoTvlili daavadebebidan romels axasiaTebs aseptiuri piuria:\\\ qronikuli glomerulonefriti;\\\ Tirkmlis polikistozi;\\\ Tirkmlia amiloidozi;\\\ qronikuli pielonefriti;\\ Tirkmlis tuberkulozi.

\\\\ minimaluri cvlilebebiT mimdinare glomerulonefriti xasiaTdeba yvela qvemoTCamoTvlili niSnebiT garda:\\\ ufro xSirad avaddebian bavSvebi;\\ araseleqciuri proteinuriiT;\\\ nefrozuli sindromiT;\\\ xSirad win uZRvis zeda sasunTqi gzebis virusuli infeqcia;\\\ hiperfibrinogenemiiT.

\\\\ diabeturi nefropaTiis dros mikroalbuminuriis prevencia, an misi regresiSesaZlebelia yvela qvemoT CamoTvlili saSualebebiT, garda:\\\ hiperglikemiis xSiri kontroli;\\\ arteriuli wnevis marTva;\\ beta-adrenoblokatorebi;\\\ agf-inhibitorebi;\\\ agf-receptorebis blokerebi.

\\\\ meoradi glomerulopaTia damaxasiaTebelia yvela qvemoT CamoTvlilidaavadebebisaTvis, garda:\\ kuWisa da Tormetgoja nawlavis peptiuri wyluli;\\\ Saqriani diabeti;\\\ kvanZovani poliarteriiti;\\\ limfogranulomatozi;\\\ vegeneris granulomatozi.

\\\\ romeli klinikuri niSniT ar SeiZleba gamovlindes mgluras nefriti:\\\ izolirebuli Sardis sindromi;\\ baqteriuria;\\\ mwvave nefrituli sindromi;\\\ nefrozuli sindromi;

84

\\\ Tirkmlebis mwvave ukmarisoba.

\\\\ qronikulad mimdinare pielonefritisaTvis damaxasiaTebelia yvela qvemoTCamoTvlili niSani, garda:\\\ baqteriuria, leikocituria;\\\ niqturia;\\\ poliuria;\\ eriTrocituria;\\\ arteriuli hipertenzia.

\\\\ Tirkmlis meoradi amiloidozi gvxvdeba yvela qvemoT CamoTvlili daavadebis dros,garda:\\\ tuberkulozi;\\\ bronqoeqtaziuli daavadeba;\\ wiTeli mglura;\\\ revmatoiduli poliarTriti;\\\ mielomuri daavadeba.

\\\\ mwvave pielonefritisaTvis damaxasiaTebelia yvela CamoTvlili simptomi, garda:\\\ sxeulis temperaturis mateba;\\ SeSupeba;\\\ dizuria;\\\ piuria;\\\ tkivili welis areSi.

\\\\ mwvave nefrituli sindromisaTvis damaxasiaTebelia yvela, garda:\\\ proteinuria;\\\ hematuria;\\ mioglobinuria;\\\ gorglovani filtraciis siCqaris daqveiTeba;\\\ arteriuli hipetenzia.

\\\\ nefrozul sindroms axasiaTebs yvela niSani, garda:\\ oqsaluria;\\\ hipoproteinemia;\\\ proteinuria;\\\ hiperqolesterinemia;\\\ dislipidemia.

\\\\ romeli monacemi ar aris damaxasiaTebeli mwvave post-streptokokuriglomeluronefritisaTvis:\\\ hematuria;\\\ oliguria;\\ cxeleba;\\\ SeSupeba;\\\ arteriuli hipertenzia.\\\\ miokardiumis staningis Sesaxeb marTebulia yvela qvemoTmoyvanili mtkiceba, gardaerTisa:\\\ staningi SesaZloa iyos globaluri an regionaluri;\\\ staningi viTardeba koronaruli Suntirebis Semdeg;\\\ stanigis ganviTarebas xels uwyobs Jangbadis Tavisufali radikalebisa daintraceluluri kalciumis dagroveba;\\\ staningi iwvevs rogorc sistolur, ise diastolur disfunqcias;\\ es aris miokardiumis funqciis daqveiTeba, rac gamowveulia qronikulihipoperfuziiT.

\\\\ hiperlipidemiis mkurnalobis Sesaxeb marTebulia yvela mtkiceba, garda erTisa:\\\ estrogenebiT mkurnalobis Sedegad izrdeba trigliceridebis done;\\ agf-inhibitorebi cvlian lipidur profils;\\\ alfa adrenerguli blokerebi ar cvlian lipidur profils;\\\ kalciumis antagonistebs gaaCniaT neitraluri efeqtebi lipidebis mimarT;

85

\\\ araseleqciuri beta-blokerebi zrdian Zalian dabali simkvrivis lipoproteinebisdones.

\\\\ arastabiluri stenokardiis dros antiagregantebisa da antikoagulantebis SesaxebmarTebulia yvela qvemoT moyvanili mtkiceba, garda erTisa:\\\ aspirini amcirebs miokardiumis infarqtis ganviTarebis sixSiresa da sikvdilianobas50%-Si;\\ aspirinis mcire dozebi <160mg ar axdens gavlenas sikvdilianobasa da reinfarqtebissixSireze;\\\ arastabiluri stenokardiis dros Setevebis profilaqtikis mizniT mkurnalobaufro mizanSewonilia hepariniT, vidre aspiriniT mkurnaloba;\\\ aspirinisa da heparinis kombinacia ufro mizanSewonilia, vidre mxolod heparinisgamoyeneba, radgan heparinis moxsnis Semdeg stenokardiuli Seteva ufro naklebisixSiriT viTardeba;\\\ aspirinis ukuCvenebis SemTxvevaSi mizanSewonilia tiklopidiniT mkurnaloba.

\\\\ qvemoT moyvanili yvela mtkiceba gulis areSi tkivilis Sesaxeb ar axasiaTebskoronarul daavadebas, garda erTisa:\\\ tkivilis intensivoba Zlierdeba Rrma CasunTqvis Sedegad;\\\ tkivilis intensivoba mcirdeba horizontalur mdgomareobaSi gadasvlis Sedegad;\\\ tkivilis lokalizaciis midamo Seesabameba TiTis wveris zomas;\\ tkivili iwyeba TandaTanobiT da aRwevs maqsimalur intensivobas ramodenime wuTisganmalobaSi;\\\ tkivili mcirdeba wylis miRebis Semdeg.

\\\\ qvemoT moyvanili yvela mtkiceba miokardiumis mwvave infarqtis Sesaxeb marTebulia,garda erTisa:\\\ autofsiis Sedegebis mixedviT miokardiumis infarqtis mqone pacientTa mcireraodenobas aRmoaCnda normaluri koronaruli arteriebi;\\ autofsiiT pacientTa or mesamedSi vlindeba erTi koronaruli arteriis kritikuliobstruqcia;\\\ miokardiumis infarqtis mwvave fazaSi angiografiis Catareba SedarebiT usafrTxoa;\\\ miokardiumis transmuruli infarqtis pirvel saaTebSi pacientTa 90%-s aReniSnebaSesabamisi arteriis totaluri okluzia;\\\ spontanuri Trombolizisis Sedegad SesaZloa Semcirdes sisxlZarRvis totaluriokluzia miokardiumis infarqtis dros.

\\\\ RviZlis cirozis niSnebia:\\\ hepatosplenomegalia;\\\ hiperbilirubinemia;\\\ "sisxlZarRvovani varskvlavebi";\\\ hepatoencefalopaTia;\\ yvela zemoT CamoTvlili.

\\\\ RviZlis cirozis garTulebebia:\\\ sisxldena saylapavis venebidan;\\\ asciti;\\\ hepatoencefalopaTia;\\\ kibod transformacia;\\ yvela zemoT CamoTvlili.

\\\\ RviZlis cirozisa da pirveladi kibos ganmasxvavebeli niSania:\\\ alfa-fetoproteinis momateba;\\\ tomogramaze kerovani dazianeba;\\\ eqoskenirebiT kerovani dazianeba;\\\ izotopuri skenirebiT izotopis CarTvis kerovani defeqti;\\ yvela zemoT CamoTvlili.

\\\\ qronikuli pankreatitis samkurnalod gamoiyeneba:\\\ sandostatini (somatostatinis jgufi)

86

\\\ kontrikali (proteolizis inhibitori)\\\ gordoqsi (proteolizis inhibitori)\\\ kreoni (fermentuli preparati)\\ yvela zemoT CamoTvlili.

\\\\ wylulovani daavadebis samkurnalod gamoiyeneba:

\\\ omeprazoli; protonuli tumbos inhibitorი;\\\ famotidini (H2-receptorebis antagonisti;\\\ bismutis trikalium dicitrati (Semogarsveli)\\\ antibiotiki;\\ zemoT CamoTvlili preparatebis kombinacia.

\\\\ araspecifiuri wylulovani kolitis samkurnalo preparatebia:\\\ anTebis sawinaaRmdego;\\\ faRaraTis sawinaaRmdego;\\\ imunomodulatorebi;\\\ probiotikebi;\\ yvela zemoT CamoTvlili.

\\\\ yabzobis samkurnalo universaluri sqema:\\\ cerukali da dufalaki;\\\ cerukali, dufalaki da reqtaluri sanTeli;\\ dufalaki, duspatalini da reqtaluri sanTeli;\\\ dufalaki da reqtaluri sanTeli;\\\ dufalaki.

\\\\ klebsielebiT gamowveuli (fridlenderis) pnevmoniisTvis damaxasiaTebelia:\\\ mSrali plevriti;\\\ mTeli wilis dazianeba;\\ filtvis kerovani dazianeba;\\\ ormxrivi dazianeba.

\\\\ “rentgenonegatiuria”:\\\ krupozuli pnevmonia;\\ mikoplazmuri pnevmonia;\\\ stafilokokuri pnevmonia;\\\ streptokokuli pnevmonia.

\\\\ eqsudaciuri plevritiT ufro xSirad rTuldeba:\\\ virusuli pnevmonia;\\\ riketsiuli pnevmonia;\\ pnevmokokuri pnevmonia (krupozuli pnevmonia);\\\ mikoplazmuri pnevmonia.

\\\\ araproduqtiuli xvela ufro metad axasiaTebs:\\ mikoplazmur pnevmonias;\\\ krupozul pnevmonias;\\\ stafilokokur pnevmonias;\\\ streptokokur pnevmonias.

\\\\ pnevmocisturi pnevmoniebis dros samkurnalod gamoiyeneba:\\\ klaforani;\\\ amoqsicilini;\\ biseptoli;\\\ gentamicini.

\\\\ legionerebis daavadebis gaCena xSirad ukavSirdeba:\\\ aspiracias;\\ aorTqlebad kondicionerebs;\\\ xangrZliv woliT mdebarobas;\\\ Saqrian diabets.

87

\\\\ riketsiuli pnevmoniis samkurnalod gamoiyeneba:\\ tetraciklini.\\\ raciocefi;\\\ amikacini;\\\ biseptoli;

\\\\ dadgenili pnevmoniis SemTxvevaSi, romeli gamokvleva gvexmareba mkurnalobisoperatiulad dawyebaSi:\\ naxvelis gramis wesiT SeRebva;\\\ sisxlis saerTo analizi;\\\ sisxlis baqteriologiuri gamikvleva;\\\ eleqtrokardiogrfia.

\\\\ romeli instrumentuli monacemebi axasiaTebs krupozul pnevmonias?\\\ filtvebis sasicocxlo moculobis daqveiTeba\\\ bronqis sanaTuris Seviwroeba bronqoskopiiT\\ rentgenologiurad filtvis wilis homogenuri daCrdilva\\\ leikocitozis da eds-is momatebis asimetriuloba – “makratelis sindromi”

\\\\ CamoTvlilidan ra axiasiaTebs saylapavis kibos?\\\ disfagia, upiratesad mkvriv sakvebze\\\ mudmivi tkivili saylapavis areSi, gansakuTrebiT sakvebis miRebisas\\\umadoba da hipersalivacia\\\ rentgenologiurad avsebis defeqti\\ yvela zemoTCamoTvlili

\\\\ peptiuri wylulis samkurnalod gamoyenebuli saSualebebidan romeli moqmedebs Na,K atf-azis daTrgunvis gziT\\\ ranitidini\\\ cimetidini\\ omeprazoli\\\ bismutis preparatebi\\\ aluminis hidroqsidi

\\\\ RviZlis pirvelad simsivnes RviZlis cirozisagan ganasxvavebs:\\\ siyviTlis arseboba\\\ transaminazebis donis momateba\\\ bilirubinis donis momateba\\ alfa-fetoproteinis donis momateba

\\\\ siyviTlis aresoboba ar moiTxovs gamoiricxos CamoTvlilTagan Semdegi anemia:\\\ mikrosferocitozi (minkovski-Sofaris daavadeb\\\\\\ Talasemia\\ sideroaqristiuli anemia\\\ namgliseburujredovani anemia\\\ Ramis paroqsizmuli hemoglobinuria (markiafava-mikelis daavadeba)

\\\\ miokardiumis mwvave infarqtis formebia yvela qvemoTCamoTvlili, garda:\\\ “Cumi” (utkivilo) forma\\ krizuli forma\\\ Sokuri forma (kardiogenuli Soki)\\\ asTmuri forma\\\ abdominaluri forma

\\\\ SeZenili imunodeficitis sindromis arsebobisas pnevmoniis gamomwvevi uxSiresiagentia:

88

\\\ pnevmokoki;\\\ klebsiela;\\\ mikoplazma;\\ pnevmocista;\\\ nawlavis Cxiri;

\\\\ sarkoidozis dasawyis niSnad SeiZleba CaiTvalos lefgrenis sindromi, romelicgamovlindeba:\\\ qoSiniT, xveliT, cxelebiT;\\\ cxelebiT, qoSiniT, mkerdSida limfuri kvanZebis gadidebiT;\\\ qoSiniT, xveliT, periferiuli limfuri kvanZebis gadidebiT;\\ cxelebiT, kvanZovani eriTemiT, poliarTralgiiT;\\\ qoSiniT, xveliT, sxvadasxva jgufis limfuri kvanZebis gadidebiT;

\\\\ dermatomioziti SeiZleba ukavSirdebodes:\\\ simsivnur process\\\ bavSvTa asaks,\\\ wamlis miRebas\\\ Warb insolacias\\ yvela zemoTCamoTvlils\\\ arcerT zemoTCamoTvlils

\\\\ saylapavis hiperkineziuli diskinezia ganpirobebulia:\\\ eroziuli ezofagitiT;\\\ saylapavis wyluliT;\\\ saylapavis nervuli aparatis moSlilobiT;\\\ nevrozebiT;\\ yvela CamoTvliliT;

\\\\ peptiuri wylulis samkurnalod gamoyenebuli saSualebebidan romeli moqmedebs Na,K-atf-azis daTrgunvis gziT\\\ cimetidini\\ omeprazoli\\\ ranitidini\\\ bismutis preparatebi\\\ aluminis hidroqsidi

\\\\ daalageT Tanmimdevrulad sdSs (dik_) sindromis stadiebi:- a) hiperkoagulacia, b) moxmarebis koagulopaTia, g) gardamavali, d) aRdgeniTi,

\\\ b), g), a), d)\\\ a), b), g), d)\\\ b), a), g), d)\\ a), g), b), d)

\\\\ hiperosmolaruli komisTvis damaxasiaTebelia:\\\ glukozis done sisxlSi 250_550mg% (14_30mmoli/l);\\\ gamoxatuli ketonemia;\\ sisxlis plazmis osmolaroba 300_500m.osm./l;\\\ arteriuli sisxlis PH_is daqveiTeba\\\ sisxlis plazmaSi HCO 3_is koncentraciis daqveiTeba

\\\\ CamoTvlili simptomebidan romelia damaxasiaTebeli stenokardiisTvis:\\\ CxvletiTi xasiaTis tkivili gulis areSi fizikuri datvirTvisas

89

\\\ parkuWovani eqstrasistolia fizikuri datvirTvis Semdeg\\\ Q_kbili III da avF ganxrebSi\\ tkivili mkerdis Zvlis ukan da ST_segmentis depresia datvirTvisas\\\ negatiuri ÅT kbili ìV2 _ V6 ganxrebSi.

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli plevris eqsudaciuriSigTavsisaTvis?\\\ xvedriTi wona 1015_ze naklebi\\ cilis Semcveloba 30 g/l_ze (3%_ze) meti\\\ tute reaqcia\\\ naleqSi ujredebis mcire raodenoba

\\\\ yvela CamoTvlili daavadeba profesiuli xasiaTisaa, garda:\\ aspergilozisa;\\\ silikozisa;\\\ karbokoniozisa;\\\ baritozisa;\\\ silikatozisa;

\\\\ hemofiliis mizezia:\\\ sisxlSi fibrinogenis ukmarisoba\\ plazmaSi araaqtiuri Trombokinazis (Tromboplastinogenis) ararseboba

\\\ plazmis VII, X, XI faqtorebis deficiti\\\ yvela zemoCamoTvlili\\\ arcerTi zemoTCamoTvlili

\\\\ Savi feris ganavali SeiZleba ganapirobos:\\\ kuWis wylulma\\\ bismutis preparatebis miRebam\\\ sisxldenam mekelis divertikulidan\\\ eroziulma gastroduodenitma\\\ arcerTma zemoTCamoTvlilma\\ yvela zemoTCamoTvlilma

\\\\ `ucnobi warmoSobis cxeleba~ (“fever of unknown origin”) ewodeba mdgomareobas,romelsac axasiaTebs:\\\ pirveladi gamokvlevebis Sedegad diagnozis ararseboba\\\ cxelebis xangrZlivoba 3 kviraze metad\\\ intermisiuli an mudmivi tipis cxeleba\\\ eqimis an eqTnis mier verificirebuli temperaturis mateba\\ yvela zemoTCamoTvlili

\\\\ B12_deficituri anemiis da foliumis mJavis deficitiT gamowveuli anemiisganmasxvavebeli niSania:\\\makrocitozi\\ funikuluri mielozi\\\ hiperqromia\\\ anizocitozi\\\ arcerTi zemoTCamoTvlili

\\\\ miokardiumis infarqtis kardinalur ekg niSnebSi ar Sedis:\\\ paTologiuri Q_kbili\\\ S-T segmentis elevacia\\\ T kbilis inversia\\ parkuWovani eqstrasistoluri kompleqsebi

\\\\ lokaluri SeSupeba ar axasiaTebs Semdeg daavadebas:\\\ venebis varikozul gaganierebas

90

\\\ qvinkes SeSupebas\\ miqsedemas\\\ limfuri sadinris stazs\\\ yvela zemoTCamoTvlils axasiaTebs lokaluri SeSupeba

\\\\ dermatomiozitis dros kunTebis dazianeba morfologiurad igivea, rac:\\\ miasTeniis dros\\ polimiozitis dros\\\ revmatuli polimialgiis dros\\\ eozinofiluri miozitis dros

\\\\ perioduli daavadebis dros mwvave muclis sindromis SemTxvevaSi eqimis taqtikaunda iyos:\\\ avadmyofis gadayvana qirurgiul ganyofilebaSi\\\ laparoskopia\\ mwvave muclis sxva SesaZlo mizezebis gamoricxva\\\ maRali gamwmendi oynis gakeTeba gauvalobis gamosaricxad\\\ narkotikuli analgetikebis Seyvana yovel 3 saaTSi mwvave muclis sindromismoxsnamde

\\\\ peptikuri wylulis garTulebebia yvela CamoTvili, garda erTisa:\\\ sisxldena;\\\ perforacia;\\\ penetracia;\\ demping_sindromi;\\\ stenozi;

\\\\ RviZlis cirozisaTvis damaxasiaTebeli laboratoriuli darRvevebia:\\\ hiperbilirubinemia\\\ proTrombinis drois gaxangrZliveba\\\ hipoalbuminemia\\ yvela zemoTCamoTvlili

\\\\ 25 wlis narkomani mamakaci Semovida klinikaSi intermisiuli cxelebis, mSralixvelis da qoSinis 4 kviriani anamneziT. rentgenogramaze Cans difuzuri intersticiulidaCrdilva, eds – 25 mm/sT, leikocitebi – 5500, limfocitebi 14%. savaraudo diagnozi:\\\ filtvis arteriis embolia\\\ vegeneris granulomatozi\\ pnevmocisturi pnevmonia\\\ sarkoidozi\\\ filtvis qronikuli obstruqciuli daavadeba

\\\\ “subfebrilurs” uwodeben cxelebas, rodesac temperatura:\\\ meryeobs 37°C-sa da 37,4° C Soris\\ arasdros iwevs 38°C maRla\\\ arasdros eSveba 37°C qvemoT\\\ temperatura mudmivia, miuxedavad momatebis xarisxisa

\\\\ tuberkulozma SeiZleba daazianos:\\\ filtvebi\\\ Tirkmlebi da SardsawveTi\\\ plevra\\\ peritoneumi\\ yvela zemoTCamoTvlili

\\\\ qronikul cianozs axasiaTebs:\\\ kompensatoruli eriTrocitozi\\\ hiperhemoglobinemia\\\ dolis joxisebri TiTebi\\\ saaTis minisebri frCxilebi\\ yvela zemoTCamoTvlili

91

\\\\ kuWis kibo klinikurad SeiZleba gamovlindes yvela qvemoTCamoTvlili simptomiT,garda:\\\ umadoba, sakvebis, gansakuTrebiT xorcis SeZuleba\\\ gaurkveveli xasiaTis diskomforti muclis (epigastriumis) areSi – simZimis SegrZnebaWamis Semdeg\\\ wonaSi mniSvnelovani dakleba\\ tkivili ixsneba sakvebis an antaciduri saSualebebis miRebiT\\\ gulisreva da xSiri Rebineba yavis naleqis msgavsi masis amonaRebi masiT

\\\\ ra laboratoriuli monacemi CaiTvleba diagnozis damadastureblad takaiasusdaavadebis dros?\\\ anemia\\\ leikocitozi\\\ Trombocitozi\\\ eds_is momateba\\ arcerTi zemoTCamoTvlili\\\ yvela zemoTCamoTvlili

\\\\ mwvave muclis romel mizezs axasiaTebs uecari movliTi tkivili, romelicdasawyisSi periodulia – axasiaTebs tkivilis (da Rebinebis) arsebobis da gaqrobisepizodebis monacvleoba, xolo ramdenime saaTSi an dReSi icvleba mudmivi tkiviliT?\\\ mwvave pankreatits\\\ mwvave qolecistits\\\ wylulovani daavadebis perforacias\\\ kuWis Semogrexas\\ mwvave gauvalobas\\\ arcerT zemoTCamoTvlils

\\\\ bronqoeqtaziis sadiagnostiko yvelaze informatiuli meTodia:\\\ gulmkerdis rentgenografia;\\\ naxvelis mikroskopiuli da baqteriologiuri gamokvleva;\\\ bronqoskopia;\\ bronqografia;\\\ auskultacia;

\\\\ Tirkmlebis amiloidozisTvis damaxasiaTebelia yvela qvemoT CamoTvlili niSani,garda:\\\ proteinuriis\\\ SeSupebis\\\ Tirkmlebis zomis gadidebis\\ arteriuli hipertenziis\\\ hiperqolesterinemiis

\\\\ sisxldenis SemTxvevaSi, Tu Sokis indeqsi aris 1, rogori xarisxis sisxldenas aqvsadgili?\\\ msubuqs;\\\ mZimes\\ saSualos\\\ sisxldena SeCerebulia.

\\\\ verlhofis daavadebisaTvis damaxasiaTebelia:\\\ wvrili arteriebis mravlobiTi Trombozebi\\\ pancitopenia

\\\ peteqiebi kanze da lorwovanze\\ peteqiebic da nazaluri sisxldenebic

\\\\ sarkoidozisaTvis damaxasiaTebelia:

92

\\\ cxeleba;\\\ limfadeniti;\\\ kvanZovani eriTema\\\ ariTmia an blokada;\\ yvela zemoTCamoTvlili

\\\\ hemosiderozis arseboba asocirdeba:\\\ limfadenopaTiasTan\\\ B12_deficitur anemiasTan\\\ TalasemiasTan\\ rkinadeficitur anemiasTan

\\\ yvela zemoTCamoTvlilTan

\\\\ stenokardiisaTvis aratipiuria:\\ Zlieri, meysieri xanjlis Cacemis msgavsi tkivili gulis mwvervalTan\\\ haeris ukmarisoba, ZiriTadad _ fizikuri datvirTvis dros\\\ moWeriTi tkivili mkerdis Zvlis ukan iradiaciiT marcxena beWSi

\\\\ sinusis kvanZis sisustis sindroms ar axasiaTebs:\\\ gamoxatuli mdgradi sinusuri bradikardia\\\ sinusuri ritmis perioduli Canacvleba sxva eqtopiuri ritmiT\\\ taqikardia_bradikardiis sindromi\\\ gamoxatuli da myari mocimcime bradiaritmia\\ venkenbaxis periodebi – PQ intervalis TandaTanobiTi zrda sabolood parkuWovanikompleqsis gamovardnamde

\\\\ komatozur mdgomareobas ar axasiaTebs:\\\ myesebis refleqsebis daqveiTeba;\\\ babinskis ormxrivi simptomi;\\\ muxlis refleqsebis daTrgunva;\\\ gugis reaqciebis daTrgunva;\\ mizanmimarTuli dacviTi reaqciebi\\\ yvela zemoTCamoTvlili axasiaTebs komatozur mdgomareobas.

\\\\ ekg_ze P kbili dadebiTia, PQ_intervali 0,22 wm, QRS_kompleqsis xangrZlivoba 0,09wm. daasaxeleT riTmis moSlis saxe:\\\ parkuWovani eqstrasisitola\\ arasruli atrioventrikuluri blokada (I xarisxis)\\\ arasruli atrioventrikuluri blokada (II xarisxis)\\\ mocimcime ariTmia\\\ sruli atrioventrikuluri blokada

\\\\ qvemoTCamoTvlili paTologiuri mdgomareobebidan romels SeuZlia gamoiwviosplevris RruSi siTxis Cadgoma (hidroToraqsi)?\\\ gulis ukmarisobas\\\ hipoproteinemias\\\ farisebri jirkvlis hipofunqcias\\\ sakvercxeebis fibromas\\ yvela zemoTCamoTvlils

\\\\ 28 wlis mamakaci, romelic narkotikuli saSualebebis intravenuri momxmarebelia,Semovida klinikaSi mSrali xvelisa da qoSinis 1 Tviani anamneziT. rentgenogramaze Cansdifuzuri intersticialuri daCrdilva savaraudo diagnozi;\\ pnevmocisturi pnevmonia;\\\ filtvis arteriis embolia;\\\ kapoSis sarkoma;\\\ legionerebis daavadeba;\\\ stafilokokuri pnevmonia;

\\\\ romeli qvemoTCamoTvlili simptomi SeiZleba iyos saerTo sistemuri wiTelimgluras, revmatizmisa da revmatoidul arTritisaTvis?

93

\\\ beWdisebri eriTema\\\ simetriuli madeformirebeli poliarTriti\\\ pancitopenia;\\\ nefriti\\ poliarTralgia;\\\ arcerTi zemoTCamoTvlili

\\\\ Tireotoqsikuri krizisaTvis damaxasiaTebelia yvela qvemoTCamoTvlili, garda:\\\ Zlieri tkivili muclis areSi,\\\ faRaraTi,\\\ tremori,\\\ fsiqiuri aRgzneba,\\\ taqikardia\\ hipotenzia,

\\\\ hepatoceluluri karcinomis sadiagnozod saukeTeso tumoruli markeria:\\\ qorionuli gonadotropini\\\ karcinoembrionuli antigeni\\ alfa_fetoproteini\\\ tute fosfataza\\\ S_100 antigeni

\\\\ RviZlis cirozis garTulebebia yvela CamoTvlili, garda:\\\ hepatocelularuli karcinoma\\\ hepatorenuli sindromi\\ cximovani hepatozi\\\ RviZlismieri encefalopaTia

\\\\ romel daavadebas axasiaTebs poliarTralgiebi, anti_streptolizin O_s titrismomateba da cxeleba?\\\ revmatoidul arTrits\\\ kvanZovan periarteriits,\\ revmatul cxelebas\\\ sistemur wiTel mgluras

\\\\ mwvave pankreatitis garTulebebs ekuTvnis yvela CamoTvlili, garda:\\\ pankreasis nekrozi\\ pankreasis adenoma\\\ pankreasis abscesi\\\ pankreasis flegmona

\\\\ romeli simptomi ar axasiaTebs nefrozul sindroms:\\\ proteinuria\\\ hipoproteinemia\\\ arteriuli hipertenzia\\ hipoqolesterinemia\\\ SeSupeba

\\\\ monacemebi, romelic Seexeba feoqromocitomas, yvela sworia, garda erTisa:\\\ saxezea wnevis awevis xSiri epizodebi\\\ hiperreninemia SeiZleba iyos TvalsaCino\\ xSiria orTostatuli hipotenzia\\\ plazmis moculoba aris Semcirebuli\\\ Sratis kalcitonini SeiZleba iyos momatebuli

\\\\ ekg_ze P_kbilebi ar aRiniSneba, gamoxatulia talRovani xazi fàtalRebiT. RRintervalebi sxvadasxva xangrZlivobisaa. daasaxeleT aritmiis saxe:\\\ winagulovani eqstrasistola\\\ parkuWovani eqstrasistola\\\ sruli antrioventrikuluri blokada

94

\\ mocimcime ariTmia\\\ winagulebis TrTolva

\\\\ parkuWovani eqstrasistoliis dros aRiniSneba yvela qvemoT CamoTvlili ekg niSnebi,garda erTisa:\\\ eqstrasistolas win ar uZRvis P kbili\\ eqstrasistoluri QRS kompleqsebis xangrZlivoba ar aRemateba 0,10_s\\\ sruli kompensatoruli pauza\\\ eqstrasistoluri QRST kompleqsebis deformacia\\\ eqstrasistolur kompleqsSi T kbilis diskordantoba RS kompleqsis udidesi kbilismimarT

\\\\ plevraluri punqciis absoluturi Cvenebaa:\\\ plevris RruSi siTxis nebismieri raodenoba\\\ plevritis ucnobi genezi\\\ maRali temperatura\\ plevris RruSi didi raodenobiT siTxe, Suasayris cdoma, sunTqviTi ukmarisoba\\\ yvela CamoTvlili SemTxveva

\\\\ bronqoeqtaziuri daavadebiT avadmyofebis filtvebis auskultaciisas Cveulebrivvlindeba:\\\ bronqoeqtaziis zonaSi aramudmivi mSrali xixini;\\ lokaluri msxvil_ da saSualo_ buStukovani xixini, xandaxan _ Sereuli mSralxixinTan\\\ lokaluri wvrilbuStukovani da krepitaciuli xixini;\\\ bronquli sunTqva;

\\\\ sisxlZarRvSida diseminirebuli Sededebis (sdS_ anu Trombohemoragiuli)sindromisaTvis damaxasiaTebelia:\\\ daavadebis meoradi genezi\\\ mikroTrombebis da hemoragiebis ganviTareba\\\ mikrocirkulaciis moSla sxvadasxva organoebSi\\ yvela zemoCamoTvlili

\\\\ cxeleba, limfuri jirkvlebis gadideba, RviZlis gadideba da arTralgiebi SeiZlebaaxasiaTebdes yvela qvemoTCamoTvlil daavadebebs, garda _\\\ sistemuri wiTeli mglura\\\ limfogranulomatozi\\\ feltis sindromi\\\ RviZlis cirozi\\ periarTriti

\\\\ megaloblasturi anemiis mizezi SeiZleba iyos yvela qvemoTCamoTvlili daavadeba,garda:\\ metroragiisa\\\ celiakiisa (spru)\\\ aqiliuri gastritisa\\\ kuWis kibosa\\\ foliumis mJavis deficitisa

\\\\ aplaziuri anemiis diagnozi dgindeba:\\\ RviZlis gadidebis SemTxvevaSi\\ Zvlis tvinis bioptatSi _ Zvlis tvinis elementebis cximovani ujredebiT CanacvlebisSemTxvevaSi\\\ SratSi rkinis deficitis SemTxvevaSi\\\ eriTrocitebis raodenobis 1 mln_ze metad Semcirebis SemTxvevaSi\\\ arcerTi ar aris swori

\\\\ hemoragiuli vaskulitisaTvis damaxasiaTebelia:\\\ simetriuli gamonayari qveda kidurebze

95

\\\ saxsrebis dazianeba, romelic vlindeba maTi SesiebiT da arTralgiiT\\\ sisxlCaqcevebi nawlavis kedelSi an jorjlis subserozul garsSi, romelic iwvevsSeteviTi xasiaTis tkivils muclis areSi.\\ yvela zemoTCamoTvlili.

\\\\ infeqciur mononukleozs axasiaTebs:\\\ cxeleba\\\ angina\\\ limfuri kvanZebis gadideba\\\ elenTis gadideba\\ yvela zemoTCamoTvlili

\\\\ miokardiumis infarqtis ganviTarebisas, Cveulebriv, yalibdeba dazianebis:\\\ erTi zona\\\ ori zona\\ sami zona\\\ oTxi zona

\\\\ takaiasus arteriitis sinonimuri saxelia:\\\ upulso daavadeba\\\ aortis rkalis daavadeba\\\ araspecifiuri aortoarteriiti\\ yvela zemoTCamoTvlili

\\\\ romeli daavadebis dros diarea, Cveulebriv, ar aris Tanxlebuli cxelebiT?\\\ kronis daavadeba\\\ araspecifiuri wylulovani koliti\\\ fsevdomembranozuli koliti\\ gaRizianebuli nawlavis sindromi

\\\\ qvemoT moyvanili mtkicebebidan kronis daavadebis mimarT, romeli ar aris swori?\\\ SeiZleba daiwyos uecari maRali sicxiT, RebinebiT, uecari tkiviliT iliocekalurmidamoSi;\\\ analuri midamos wylulovani dazianeba da naxeTqebi;\\ damaxasiaTebelia nawlavidan xSiri profuzuli sisxldena;\\\ nawlavis rentgenoskopiiT “Snuris” simptomi;\\\ damaxasiaTebelia nawlavebis fistulebi;

\\\\ RviZlismieri komis saSiSroebis dros dietaSi unda SeizRudos:\\\ naxSirwylebi;\\ cximebi;\\ cilebi;\\\ siTxe;\\\ mineraluri marilebi;

\\\\ uecrad ganviTarebuli erTjeradi Rebineba, romlis Semdeg gulisreva rCeba, TumcakuWis SigTavsi ar amodis, pirvel rigSi gvafiqrebinebs:\\\ tvinis SeSupebaze\\ kuWis Semogrexaze\\\ kuWis mwvave gaganierebaze\\\ kuWis kiboze

\\\\ Tirkmlis mwvave ukmarisobis gamowveva SeuZlia antibiotikebis Semdeg jgufebs:\\\ penicilinebs;\\\ makrolidebs;\\ aminoglikozidebs;\\\ tetraciklinebs;

\\\\ "sunTqvis ukmarisobis" terminis qveS igulisxmeba:

96

\\ filtvebSi ventilaciis, Jangabadis transportisa da utilizaciis darRveva;\\\ hemodinamikis darRveva sisxlismimoqcevis mcire wreSi;\\\ bronquli gamtareblobis darRveva;\\\ sisxlis airebis transportis funqciis darRveva;\\\ Jangbadis qsovilovani metabolizmis darRveva

\\\\ RviZlis cirozis garTulebebia:\\\ sisxldena saylapavis venebidan\\\ asciti\\\ hepatoencefalopaTia\\\ kibod transformacia\\ yvela zemoTCamoTvlili

\\\\ feoqromocitomisaTvis ar aris damaxasiaTebeli:\\\ arteriuli hipertenzia\\\ Zlieri Tavis tkivili;\\\ profuzuli oflianoba;\\ sisxlSi cirkulirebadi kateqolaminebis donis daqveiTeba\\\ taqikardia;

\\\\ supraventrikuluri eqstrasistoliisaTvis damaxasiaTebelia yvela qvemoTCamoTvlili, garda:\\\ P kbilis deformacia\\\ arasruli kompensatoruli pauza\\ QRST kompleqsis deformacia\\\ QRST kompleqsis Seucvleloba\\\ PQ _ intervalis Secvla

\\\\ qvemoTCamoTvlil mizezTagan romelma SeiZleba gamoiwvios plevris RruSi siTxisdagroveba?\\\ specifiuri da araspecifiuri genezis infeqciebma\\\ filtvis da plevris simsivneebma\\\ SemaerTebeli qsovilis sistemuri paTologiam\\\ filtvis infarqt_pnevmoniam\\ yvela zemoTCamoTvlilma

\\\\ hemodinamikur hipertenziebs Aar miekuTvneba Semdegi daavadebebiT ganpirobebuliwnevis momateba:\\\ aortis sarqvlebis naklovaneba\\ Sonlein_henoxis daavadeba\\\ takaiasus daavadeba\\\ yvela zemoTCamoTvlili

\\\\ sistemur sklerodermias SeiZleba axasiaTebdes yvela qvemoTCamoTvlili simptomi,garda:\\\ reinos fenomeni\\\ sklerodaqtilia\\\ bazaluri pnevmosklerozi\\\ kalcinozi\\ antisxeulebi fosfolipidebis mimarT\\\ teleangieqtaziebi

\\\\ kuWis wylulis penetraciiT garTulebaze metyvelebs:\\ tkivilis stereotipurobis Secvla, ritmulobisa da periodulobis gaqroba;\\\ uecari Zlieri tkivili muclis areSi;\\\ Wamis Semdeg Rebineba;\\\ ucrad ganviTarebuli kolafsi;\\\ `mSieri~ da `Ramis~ tkivilebi;

\\\\ “anemia” niSnavs:\\\ hemoglobinis donis da feradobis maCveneblis daqveiTebas

97

\\\ eriTrocitebis, leikocitebis da Trombocitebis raodenobis Semcirebas\\ hemoglobinis donis da/an eriTrocitebis raodenobis Semcirebas\\\ sisxlis feradobis maCveneblis daqveiTebas

\\\\ eriTrocituria da sisxliani xvela moiTxovs gamoiricxos:\\\ gudpasCeris sindromi\\\ iatrogenuli daavadeba (antikoagulantebis gadametdozireba)\\\ tuberkulozi\\\ vegeneris granulomatozi;\\\ yvela zemoTCamoTvlili

\\\\ splenomegaliis da cxelebis kombinaciis dros diferencialuri diagnozisaTvisgaTval;iswinebuli unda iqnas yvela qvemoTCamoTvlili daavadeba, garda:\\\ muclis tifisa\\ qolerisa\\\ limfogranulomatozisa\\\ salmonelozisa\\\ malariisa

\\\\ vilebrandis daavadebis (memkvidruli fsevdohemofiliis) dros sisxldenis ZiriTadimizezia:\\\ Sededebis VIII faqtoris ararseboba\\\ proTrombinis deficiti\\ Sededebis VIII faqtoris ararsebobis SeuRleba sisxlZarRvTa kedlisarasrulfasovnebasTan\\\ plazmis IX faqtoris ararseboba\\\ plazmis X faqtoris ararseboba

\\\\ periferiuli cianozis mizezi ar SeiZleba iyos:\\\ reinos sindromi\\\ livedo retikularis\\ methemoglobinemia\\\ zeda Rru venis sindromi

\\\\ sisxliani xvela ar axasiaTebs;\\\ filtvis kibos;\\\ filtvis gangrenas;\\\ gudpasCeris daavadebas;\\ eqsudaciur plevrits;\\\ vegeneris daavadebas;

\\\\ gaxangrZlivebuli cxeleba, sisxliani xvela, limfadenopaTia, gaxdoma daoflianoba uxSiresad axasiaTebs:\\\ limfogranulomatozs\\\ pnevmokoniozs\\ kvanZovan periarteriits\\\ filtvebis emfizemas\\\ yvela zemoTCamoTvlils

\\\\ hipernefromis gamovlineba SeiZleba iyos yvela qvemoT CamoTvlili niSani gardaerTisa:\\\ policitemia;\\\ Semcivneba da cxeleba;\\ piuria;\\\ hematuria\\\ arteriuli hipertonia

\\\\ meigsis sindromisTvis damaxasiaTebelia:\\\ Cirqovani plevriti\\\ qiloToraqsi

98

\\ marjvenamxrivi hidroToraqsi\\\ hemoragiuli plevriti\\\ spontanuri pnevmoToraqsi

\\\\ cxviridan xSiri sisxldena da sisxliani xvela febrilitetTan erTad yvelazesavaraudos xdis:\\ vegeneris granulomatozs;\\\ bexCetis daavadebas\\\ filtvis abscess;\\\ sistemur wiTel mgluras;\\\ arcerT zemoTCamoTvlils

\\\\ sisxliani xvela, asTmuri sindromi, cxeleba, maRali edsi, polinevriti da wonaSiprogresuli dakleba savaraudos xdis:\\\ behCetis sindroms\\\ takaiasus daavadebas\\\ sistemur sklerodermias:\\\ polimiozits;\\ arcerT zemoTCamoTvlils

\\\\ adisonis daavadebisaTvis ar aris damaxasiaTebeli:\\\ Tirkmelzeda jirkvlis qerqovani qsovilis destruqcia;\\\ glukokortikoidebis da mineralokortikoidebis produqciis Semcireba;\\\ kanisa da lorwovani garsis ujredebSi melaninis dagroveba;\\ kortizolis donis momateba sisxlSi\\\ arteriuli hipotenzia;

\\\\ diarea axasiaTebs yvela qvemoT CamoTvlil daavadebas, garda:\\\ kronis daavadeba;\\\ araspecifikuri wylulovani koliti;\\\ celiakia;\\ megakoloni\\\ pelagra;

\\\\ sefsisisaTvis yvelaze metad damaxasiaTebelia Semdegi tipis cxeleba:\\\ remisiuli;\\\ intermisiuli;\\\ SebrunebiTi;\\ heqtiuri\\\ mudmivi

\\\\ CamoTvlil daavadebaTagan romels axasiaTebs Semdegi simptomokompleqsi: cxeleba,moZraobis SezRudva, kunTebis tkivili, kanis moiisfro Seferiloba Tvalebis irgvliv,eriTemuli laqebi, arTralgia\\ dermatomiozits\\\ revmatul poliarTrits\\\ adisonis daavadebas\\\ polimiozits\\\ melanomas\\\ revmatul polimialgias

\\\\ rkinadeficituri anemiis gamomwvevi mizezi SeiZleba iyos yvela, garda:\\ sakvebSi marilis SezRudva\\\ kuWis rezeqcia\\\ orsuloba da laqtacia\\\ qronikuli sisxldena\\\ yvela zemoTCamoTvlili

\\\\ CamoTvlili daavadebebidan Cveulebriv romels ar axasiaTebs hipotenzia?\\\ uSaqro diabets\\\ alimentur distrofias

99

\\\ miqsedemas\\ filtvismier guls\\\ qoleras

\\\\ parkuWSida kedlisamyoli Trombebi damaxasiaTebelia:\\\ gulis iSemiuri daavadebisaTvis\\\ hemofiliisaTvis\\ dilataciuri kardiomiopaTiisaTvis\\\ jorjlis arteriis TrombozisaTvis\\\ arcerTi zemoTCamoTvlilisaTvis

\\\\ mwvave nefrozuli sindromi xasiaTdeba;\\\ arteriuli hipertenziiT, SeSupebiT, proteinuriiT, hematuriiT;\\ SeSupebiT, hipo_ da disproteinemiiT, hiperqolesterinemiiT.\\\ arteriuli hipertenziiT, hiperqolesterinemiiT;

\\\\ ra xasiaTis SeSupebebia damaxasiaTebeli gulis SegubebiTi (totaluri)ukmarisobisTvis?\\\ faruli SeSupeba\\ anasarka\\\ hidroperikardiumi\\\ qvemo kidurebis SeSupeba\\\ SegubebiTi movlenebi filtvebSi

\\\\ qvemoTCamoTvlilidan romelia parkuWSiga blokadis ekg maCvenebeli?\\\ PQ intervalis gaxangrZliveba\\\ ST intervalis gaxangrZliveba\\\ Q kbilis deformacia\\ QRS kompleqsis gaxangrZliveba\\\ arcerTi zemoTaRniSnuli

\\\\ gulis anginozuri tkivilis gamomwvevi mizezi SeiZleba iyos:\\\ kvanZovani periarteriiti\\\ koronariti\\\ Zlieri fizikuri datvirTva\\\ gamoxatuli anemia\\ yvela zemoTCamoTvlili

\\\\ qronikuli bronqitis dros sisxlis mimoqcevis mcire wris hipertenziisganviTarebas ganapirobebs yvela qvemoTCamoTvlili, garda:\\\ sisxlis mimoqcevis mcire wris sisxlZarRvebis spazmi, ganpirobebuli filtvisaraTanabari ventilaciiT;\\\ sisxlis mimoqcevis mcire wris wvrili sisxlZarRvebis obliteraciapnevmosklerozis ganviTarebis Sedegad;\\ sisxlis mimoqcevis mcire wris sisxlZarRvebis elastiurobis momateba;\\\ sisxlis mimoqcevis mcire wris sisxlZarRvebis obliteracia da kolabireba filtviscentraluri emfizemisa da filtvebSi bulebis ganviTarebis dros;

\\\\ romel qvemoTCamoTvlil daavadebebs SeiZleba Tan axldes saxsrovani sindromi?\\\ kronis daavadebas\\\ dizenterias\\\ araspecifiur wylulovan kolits\\\ virusul hepatits\\ yvela zemoTCamoTvlils

\\\\ CamoTvlilidan ra axasiaTebs qronikul anacidur gastrits?\\\ yabzoba\\\ `mSieri tkivili~\\ kuWis lorwovanis atrofia\\\ `Ramis tkivili~\\\ kuWis wvenis hipersekrecia

100


\\\\ RviZlis pirvelad simsivnes RviZlis cirozisagan ganasxvavebs:siyviTlis arseboba\\\ transaminazebis donis momateba\\\ bilirubinis donis momateba\\ alfa_fetoproteinis donis momateba

\\\\ romeli qvemoTCamoTvlili laboratoriuli testi aris yvelaze informatiulisistemuri wiTeli mgluras diagnostikaSi?\\ orspiraliani dnm_is mimarT antisxeulebis maRali titri\\\ mgluras ujredebis aRmoCena\\\ maRali eds_i\\\ revmatoiduli faqtori\\\ arcerTi zemoTCamoTvlili

\\\\ gulis iSemiur daavadebas miekuTvneba yvela qvemoTCamoTvlili, garda:\\\ spontanuri stenokardiisa\\ dilataciuri kardiomiopaTiisa\\\ postinfarqtuli kardiosklerozisa\\\ miokardiumis ara_Q_kbilovani infarqtisa

\\\\ qvemoT CamoTvlilidan romelia atrioventrikularuli blokadis ekg maCvenebeli?\\\ QRS intervalis gaxangrZliveba\\\ S_T intervalis gaxangrZliveba\\\ R kbilis deformacia\\ P_QP intervalis gazrda\\\ yvela zemoTCamoTvlili

\\\\ qvemoTCamoTvlili paTologiuri mdgomareobebidan romels SeuZlia gamoiwviosplevris RruSi siTxis Cadgoma (hidroToraqsi)?\\\ gulis ukmarisobas\\\ hipoproteinemias\\\ farisebri jirkvlis hipofunqcias\\\ sakvercxeebis fibromas\\ yvela zemoTCamoTvlils

\\\\ mwvave bronqitiT simptomebis arsebobisas avadmyofis rentgenologiuri gamokvlevabronqopnevmoniis gamoricxvis mizniT naCvenebia:\\\ daavadebis klinikuri mimdinareobis damZimebisas;\\\ fizikuri gamokvlevisas filtvebis Semofarglul nawilSi perkutoruli bgerisSemcirebisa da sveli xixinis dros;\\\ periferiul sisxlSi leikocitebis matebisa da edsi_is aCqarebisas;\\\ mkurnalobis fonze 3 dReze metxans cxelebis arsebobisas;\\ yvela CamoTvlil SemTxvevaSi;

\\\ romel qvemoTCamoTvlil revmatologiur daavadebas SeiZleba Tan axldes reinossindromi?\\\ revmatoidul arTrits\\\ CREST sindroms\\\ Sereul SemaerTebelqsovilovan daavadebas\\\ Sogrenis sindroms\\ yvela zemoTCamoTvlils\\\ arcerT zemoTCamoTvlils

101

\\\\ peritoneumis anTeba SeiZleba gamoiwvios:\\\ tuberkulozma\\\ sistemurma wiTelma mgluram\\\ xmelTaSua zRvis cxelebam (periodulma daavadebam)\\\ sakvercxis kistis gadagrexam\\ yvela zemoTCamoTvlilma

\\\\ CamoTvlilidan romel daavadebas axasiaTebs gamoxatuli arteriuli hipotenzia?\\ adisonis daavadebas\\\ gudpasCeris daavadebas\\\ greivsis daavadebas\\\ konis sindroms

\\\\ gulis mankis CamoTvlili formebidan romels axasiaTebs diastoluri Suili?\\\ aortaluri xvrelis stenozs\\\ trikuspidaluri sarqvlis naklovanebas\\\ mitralur stenozs\\\ parkuWTaSua Zgidis defeqts\\\ arcerT zemoTCamoTvlils

\\\\ mwvave pielonefritisaTvis damaxasiaTebelia yvela CamoTvlili simptomi, garda:\\\ sxeulis temperaturis matebisa\\\ dizuriisa\\ SeSupebisa\\\ piuriisa\\\ welis areSi tkivilisa

\\\\ kardiul asTmas axasiaTebs:\\\ diliT `savse piriT~ xvela\\\ sqeli webovani naxveli eqspiratoruli qoSinis fonze;\\\ mSrali xvela yivilis xmiT\\ qafiani movardisfro uxvi naxveli\\\ arcerTi zemoTCamoTvlili

\\\\ CamoTvlili daavadebebidan romlisaTvis ar aris damaxasiaTebeligastrointestinuri sisxldenis ganviTareba\\\ wylulovani daavadeba\\ vakezis daavadeba (WeSmariti policitemia\\\ kronis daavadeba\\\ Sonlein_henoxis daavadeba\\\ randiu_osleris daavadeba

\\\\ CamoTvlili daavadebebidan, romels axasiaTebs yvelaze metad Semdegisimptomokompleqsi _ heqtiuri cxeleba, limfuri jirkvlebis gadideba, splenomegalia,myari poliarTriti, leikocitozi, eriTemuli gamonayari?\\ stilis sindroms (iuveniluri revmatoiduli arTritis sistemuri varianti)\\\ sistemur sklerodermias\\\ muclis tifs\\\ virusul hepatits

\\\\ avadmyofis anamnezSi sisxliani xvelis arseboba gamoricxavs Semdeg daavadebebs:\\\ mukoviscidozs;\\\ filtvis periferiul kibos:\\\ filtvis eqinokokozs;\\\ filtvis askaridozs;\\\ krupozul pnevmonias\\ arcerT zemoTCamoTvlils\\\ yvela zemoTCamoTvlils

\\\\ ra aris gadamwyveti qronikuli hepatitis diagnozisaTvis?

102

\\\ gadatanili virusuli hepatiti;\\\ sisxlis SratSi avstraliuri antigenis aRmoCena;\\\ perioduli subfebriliteti, aqtiuroba, tkivili marjvena ferdqveSa areSi;\\ RviZlis histologiuri gamokvlevis monacemebi;\\\ SratSi alfa_fetoproteinis aRmoCena;

\\\\ romeli qvemoTCamoTvlili garTuleba axasiaTebs sistemur wiTel mgluras?\\\ reinos sindromi\\ perikarditi\\\ bronqoobstruqciuli sindromi\\\ yvela zemoTCamoTvlili:

\\\\ sisxliani pirRebinebis da kuprisferi ganavlis kombinacia miuTiTebsgastrointestinuri sisxldenis lokalizaciaze:\\\ saylapavis zemo mesamedSi\\\ wvril nawlavis distalur nawilSi\\\ msxvili nawlavis proqsimalur nawilSi\\ treitcis iogis zemoT

\\\\ ra saxis diarea (paTofiziologiuri meqanizmis mixedviT) viTardeba avadmyofebSilaqtozis deficitiT?\\\ sekretoruli diarea;\\ osmosuri diarea\\\ nawlavis lorwovani garsis destruqciasTan dakavSirebuli diarea;\\\ gadaWarbebuli peristaltikiT gamowveuli diarea;\\\ Senelebuli peristaltikiT gamowveuli diarea;

\\\\ memkvidreobiTi hemolizuri anemia SeiZleba gamovlindes yvela CamoTvlilidaavadebis dros, garda:\\\ minkovski_Sofaris daavadeba\\ moSkoviCis daavadeba (hemolizur_uremiuli sindromi)\\\ Talasemia\\\ glukozo_6_fosfatdehidrogenazis deficiti\\\ namglisebrujredovani anemia

\\\\ qronikul cianozs axasiaTebs:\\\ kompensatoruli eriTrocitozi\\\ hiperhemoglobinemia\\\ dolis joxisebri TiTebi\\\ saaTis minisebri frCxilebi\\ yvela zemoTCamoTvlili

\\\\ princmetalis stenokardias axasiaTebs:\\\ dawyeba mosvenebis mdgomareobaSi\\\ dawyeba erTsa da imave dro\\\ dawyeba RamiT\\\ S_T segmentis xanmokle elevacia\\ yvela zemoTCamoTvlili

\\\\ qvemoT CamoTvlili simptomebidan romelia yvelaze damaxasiaTebeli gulismarcxenamxrivi ukmarisobis dros?\\\ kisris venebis Seberiloba\\\ asciti\\ orTopnoe\\\ anoreqsia\\\ gulismieri SeSupebebi

\\\\ ketoacidozuri koma klinikurad vlindeba yvela CamoTvlili niSniT, garda:\\\ mkrTali da mSrali kanis safarveli;\\\ sxeulis normaluri temperatura;

103

\\\ arteriuli hipotenzia;\\ arteriuli hipertenzia;\\\ kusmaulis sunTqva, haerSi acetonis suni.

\\\\ CamoTvlilidan romeli warmoadgens mocimcime ariTmiis sadiagnozoeleqtrokardiografiul kriteriums?\\\ deformuli p kbilebi\\\ QRST kompleqsebis deformacia\\\ Tanabari T_ intervalebi\\ f talRebis arseboba\\\ ST _ segmentis da T kbilis deformacia

\\\\ aRniSneT nawilobrivi atrioventrikularuli blokadis ekg niSnebi:\\\ QRST kompleqsis gaxangrZliveba\\\ PQQintervalis Semcireba\\ PQ intervalis gaxangrZliveba\\\ QT intervalis gazrda\\\ R kbilis deformacia

\\\\ marjvena parkuWis gadaZabva SeiZleba gamoiwvios yvela Semdegma daavadebam, gardaerTisa:\\\ bronquli asTma\\ samkaredi xvrelis stenozi\\\ filtvis arteriis stenozi\\\ filtvebis qronikuli obstruqciuli daavadeba\\\ pnevmoToraqsi

\\\\ romeli anemiebis erTmaneTisagan diferencireba warmoadgens siZneles?\\ B12_deficituri da foliummJavadeficituri\\\ B12_deficituri da rkinadeficituri\\\ hipoqromuli da megaloblasturi\\\ hemolizuri da aplaziuri

\\\\ Trombocitebis disfunqciis mizezi SeiZleba iyos:\\\ dsS (diseminirebuli sisxlZarRvSida Sededebis) sindromi\\\ mielomuri daavadeba\\\ arasteroiduli anTebissawinaaRmdego preparatebis miReba\\\ arcerTi zemoTCamoTvlili\\ yvela zemoTCamoTvlili

\\\\ romeli simptomkompleqsi axasiaTebs partaxtian tifs?\\ temperaturis momateba SemcivnebiT, kolaptoiduri mdgomareobiT da me_4_5 dResmowiTalo mravlobiTi gamonayariT, romelic mere yavisferi xdeba\\\ mudmivi cxeleba, vardisferi mravlobiTi gamonayari mecelze, limfadenopaTia,bradikardia\\\ cxeleba, mfrinavi poliarTriti, gulis friali, kvanZovani eriTema\\\ arcerTi zemoTCamoTvlili.

\\\\ subfebriluri temperatura axasiaTebs Semdeg nozologiebs:\\\ bronqis kibos;\\\ sinusits;\\\ tuberkulozs;\\\ prostatits;\\\ tonzilits;\\ yvela zemoTCamoTvlils

\\\\ qvemoTCamoTvlili simptomebidan romelia damaxasiaTebeli sarkoidozisaTvis?

104

\\\ paratraqealuri, traqeobronquli, bronqopulmonuri limfuri kvanZebis ormxrivisimetriuli gadideba\\\ filtvis karTan dakavSirebuli Sua da qveda wilebis ormxrivi diseminacia dainfiltracia\\\ limfadenopaTia\\\ kvanZovani eriTema\\ yvela zemoTCamoTvlili

\\\\ sisxliani xvela yvela CamoTvlil daavadebas, garda:\\\ filtvis tuberkulozis kavernul formas\\ filtvis arteriis stenozs\\\ bronqoeqtaziul daavadebas\\\ filtvis arteriis Tromboembolias

\\\\ sisxliani pirRebinebiT xSirad SeiZleba gamovlindes:\\\ mwvave hepatiti;\\ RviZlis cirozi;\\\ mlivi nawlavis kibo\\\ arcerTi zemoTCamoTvlili

\\\\ romeli paTologiisTvis aris damaxasiaTebeli saylapavis kedlis gluvkunTovaninawilis atrofia, qveda spinqteris ukmarisoba, rentgenologiurad saylapavis Sua daqveda nawilebis gaganiereba, peristaltikis ararseboba, gastroezofaguri refluqsi?\\\ avTvisebiani miasTenia;\\\ cerebruli insultis;\\ sklerodermiis;\\\ gafantuli sklerozi;\\\ sistemuri wiTeli mglura;

\\\\ araspecifikur wylulovan kolits axasiaTebs yvela qvemoTCamoTvlili, garda:\\\ anTebiTi cvlilebebi ZiriTadad gamoxatulia msxvili nawlavis lorwovan garsSi\\\ anTebiTi procesi SesaZlebelia gavrceldes lorwqveSa garsze\\ wvrili nawlavis xSiri dazianeba\\\ xSiria reqtraluri aris dazianeba – wylulovani proqtiti\\\ xSiria sigmoiduri nawlavis dazianeba – proqtosigmoiditi

\\\\ nefrozuli sindromi axasiaTebs yvela zemoTCamoTvlil daaavadebas, garda:\\\ mwvave glomerulonefritisa\\\ diabeturi nefropaTisa\\ kalkulozuri pielonefritisa\\\ Tirkmlis amiloidozisa\\\ mielomuri daavadebisa

\\\\ qvemoTCamoTvlil niSanTagan romelia damaxasiaTebeli plevraSi transudatisarsebobisaTvis?\\\ siTxis qarvisebri Seferiloba\\\ xvedriTi wona 1015_ze meti\\ siTxeSi cilis Semcveloba 30 g/l_ze (3%_ze) naklebi\\\ naleqSi neitrofiluri ujredebis arseboba

\\\\ aseptiuri plevriti SeiZleba axasiaTebdes:\\\ sistemur wiTel mgluras\\\ filtvis infarqts\\\ miokardiumis infarqts\\\ qronikul mieloleikozs\\ yvela zemoTCamoTvlils

\\\\ hemofiliis mizezia:\\ plazmaSi araaqtiuri Trombokinazis (Tromboplastinogenis) ararseboba\\\ plazmis VII, X, XI faqtorebis deficiti

105

\\\ yvela zemoCamoTvlili\\\ sisxlSi fibrinogenis ukmarisoba\\\ arcerTi zemoTCamoTvlili

\\\\ diarea axasiaTebs yvela qvemoTCamoTvlil daavadebas, garda:\\\ kronis daavadebisa\\\ araspecifiuri wylulovani kolitisa\\ megakolonisa\\\ celiakiisa

\\\\ B12_deficituri anemiis da foliumis mJavis deficitiT gamowveuli anemiisganmasxvavebeli niSania:\\\ makrocitozi\\\ anizocitozi\\\ hiperqromia\\ funikuluri mielozi\\\ arcerTi zemoTCamoTvlili

\\\\ Cirqovani destruqciuli procesebis dros sdSs (dik_) sindromis Tavidanasacileblad avadmyofbs antibaqteriul preparatebTan erTad unda daeniSnos:\\\ proteazebis inhibitorebi\\\ antiTrombozuli preparatebi\\ yvela zemoTCamoTvlili\\\ sisxlis reologiuri Tvisebebis gamaumjobeseblebi

\\\\ saWmlis momnelebeli traqtidan sisxldenis mizezi SeiZleba iyos:\\\ jorjlis arteriis Trombozi\\\ RviZlis cirozi\\\ mekelis divertikuli\\\ malori_veisis sindromi\\ yvela CamoTvlili

\\\\ Savi feris ganavali SeiZleba ganapirobos:\\\ kuWis wylulma\\\ bismutis preparatebis miRebam\\\ sisxldenam mekelis divertikulidan\\\ eroziulma gastroduodenitma\\\ arcerTma zemoTCamoTvlilma\\ yvela zemoTCaTvlilma

\\\\ sarkoidozisaTvis damaxasiaTebelia:\\\ cxeleba\\\ limfadeniti\\\ kvanZovani eriTema\\\ ariTmia an blokada\\ yvela zemoTCamoTvlili

\\\\ hemosiderozis arseboba asocirdeba:\\\ limfadenopaTiasTan\\ rkinadeficitur anemiasTan\\\ B12_deficitur anemiasTan\\\ TalasemiasTan\\\ yvela zemoTCamoTvlilTan

\\\\ aplaziuri anemiis diagnozi dgindeba:\\\ RviZlis gadidebis SemTxvevaSi\\\ SratSi rkinis deficitis SemTxvevaSi

106

\\ Zvlis tvinis bioptatSi _ Zvlis tvinis elementebis cximovani ujredebiT CanacvlebisSemTxvevaSi\\\ eriTrocitebis raodenobis 1 mln_ze metad Semcirebis SemTxvevaSi\\\ arcerT zemoTCamoTvlil SemTxvevaSi

\\\\ hemoragiuli vaskulitisaTvis damaxasiaTebelia:\\\ simetriuli gamonayari qveda kidurebze\\\ saxsrebis dazianeba, romelic vlindeba maTi SesiebiT da arTralgiiT\\\ sisxlCaqcevebi nawlavis kedelSi an jorjlis subserozul garsSi, romelic iwvevsSeteviTi xasiaTis tkivils muclis areSi.\\ yvela zemoTCamoTvlili.

\\\\ infeqciur mononukleozs axasiaTebs:\\\ cxeleba\\\ angina\\\ limfuri kvanZebis gadideba\\\ elenTis gadideba\\ yvela zemoTCamoTvlili

\\\\ diseminirebuli sisxlZarRvSida Sededebis (dsS_ anu dik_) sindromis ganviTarebaSeiZleba moxdes Semdegi sameano paTologiebis dros:\\\ masiuri hipotoniuri sisxldena adreuli loginobis xanaSi\\\ normalurad mimagrebuli placentis adreuli acla\\\ sanayofe siTxiT embolia\\\ saSvilosnoSi mkvdari nayofis arseboba\\ yvela zemoTCamoTvlili

\\\\ sisxliani xvela damaxasiaTebelia Semdegi daavadebebisaTvis:\\ filtvis arteriis Tromboembolia\\\ filtvis arteriis stenozi\\\ aortaluri naklovaneba\\\ marjvena parkuWis infarqti\\\ yvela zemoTCamoTvlili

\\\\ sisxlZarRvSida diseminirebuli Sededebis (sdS_ anu dik_) sindromis dasawyisSixdeba yvela qvemoTCamoTvlili nivTierebis raodenobis Semcireba, garda _\\\ plazminogeni\\ Trombini\\\ antiTrombin III\\\ prekaliklikreini

\\\\ rkinadeficituri anemiis gamomwvevi mizezi SeiZleba iyos yvela, garda:\\ sakvebSi marilis SezRudva\\\ kuWis rezeqcia\\\ orsuloba da laqtacia\\\ qronikuli sisxldena\\\ yvela zemoTCamoTvlili

\\\\ perioduli sisxliani xvela SeiZleba axasiaTebdes:\\\ adneqsits\\\ orqits;\\\ prostatits\\ endometriozs;\\\ arcerT zemoTCamoTvlils

\\\\ vitamin B12_deficituri anemias axasiaTebs:

107

\\\ “lakirebuli ena”\\\ disfagia\\\ kuWis wvenis dabali mJavianoba\\\ nervuli sistemis dazianebis niSnebi\\ yvela zemoTCamoTvlili

\\\\ diseminirebuli intravaskularuli koagulaciis (dik) sindromis drosheparinoTerapiis uaryofiTi mxarea:\\\ heparinoTerapia uefeqtoa dik_sindromis hiperkoagulaciis fazaSi\\\ hepariniT gamowveuli Trombocitozi\\ plazmaSi antiTrombin_III raodenobis Semcireba\\\ yvela zemoTCamoTvlili

\\\\ CamoTvlili daavadebebidan romlisaTvis ar aris damaxasiaTebeligastrointestinuri sisxldenis ganviTareba\\\ wylulovani daavadeba\\\ kronis daavadeba\\\ Sonlein_henoxis daavadeba\\\ randiu_osleris daavadeba\\\ vakezis daavadeba (WeSmariti policitemia)

\\\\ CamoTvlili daavadebebidan, romels axasiaTebs yvelaze metad Semdegisimptomokompleqsi _ heqtiuri cxeleba, limfuri jirkvlebis gadideba, splenomegalia,myari poliarTriti, leikocitozi, eriTemuli gamonayari?\\\ sistemur sklerodermias\\ stilis sindroms (iuveniluri revmatoiduli arTritis sistemuri varianti)\\\ muclis tifs\\\ virusuli hepatits

\\\\ Trombocitebis disfunqciis mizezi SeiZleba iyos:\\\ dik_sindromi\\\ mielomuri daavadeba\\\ arasteroiduli anTebissawinaaRmdego preparatebis miReba\\\ arc_erTi zemoTCamoTvlili\\ yvela zemoTCamoTvlili

\\\\ qvemoTCamoTvlili simptomebidan romelia damaxasiaTebeli sarkoidozisaTvis?\\\ paratraqealuri, traqeobronquli, bronqopulmonuri limfuri kvanZebis ormxrivisimetriuli gadideba\\\ filtvis karTan dakavSirebuli Sua da qveda wilebis ormxrivi diseminacia dainfiltracia\\\ limfadenopaTia\\\ kvanZovani eriTema\\ yvela zemoTCamoTvlili

\\\\ sisxlis Sededebis unaris daqveiTebiT (koagulopaTiebiT) ganpirobebul hemoragiuldiaTezebs miekuTvneba yvela qvemoTCamoTvlili, garda _\\ verlhofis daavadebisa\\\ hemofiliisa\\\ K vitaminis deficitisa\\\ vilebrandis daavadebisa

\\\\ sdSs (deisminirebuli intravaskularuli koagulaciis - dik) sindromis mwvaveformis dros aRiniSneba sisxldena am variantis dros mizanSewonili mkurnalobistaqtika SeiZleba moicavdes yvelas, garda _

108

\\ streptokinazis an urokinazis gadasxma\\\ ZiriTadi daavadebis mkurnaloba\\\ aqtiuri plazmis da krioplazmis gadasxma\\\ Trombocituli masis gadasxma\\\ plazmaferezi da citoferezi

\\\\ sisxliani xvela araa damaxasiaTebeli Semdegi daavadebebisaTvis:\\\ bronqoalveoluri kibo\\\ bronqis adenoma\\\ bronqoeqtaziuli daavadeba\\\ hemosiderozi\\ sarkoidozi\\\ vegeneris granulomatozi

\\\\ hemolizur anemias ar axasiaTebs\\\ siyviTle\\\ arapirdapiri hiperbilirubinemia\\\ retikulocitozi\\\ muqi feris ganavali\\\ hemoglobinuria\\ arteriuli krizi

\\\\ qvemoTCamoTvlil daavadebaTagan romeli ganekuTvneba retikuloendoTelurisistemis sistemur keTilTvisebian granulomatozur dazianebaTa jgufs?\\\ tuberkulozi\\\ filtvis simsivnuri paTologia\\ sarkoidozi\\\ vegeneris granulomatozi\\\ yvela zemoTCamoTvlili

\\\\ alisferi sisxli an koltebi ganavalSi saWiros xdis Semdegi daavadebebisgamoricxvas:\\\ kronis daavadeba\\\ araspecifiuri wylulovani koliti\\\ msxvili nawlavis divertikuli\\\ buasili\\ yvela zemoTCamoTvlili

\\\\ malarias axasiaTebs cxelebis kombinacia:\\ hemolizur anemiasTan\\\ hiperqromul anemiasTan\\\ pancitopeniasTan\\\ aplaziur anemaisTan\\\ arcerT zemoTCamoTvlilTan

\\\\ axalgazrda qali mwvave uveitiT da kvanZovani eriTemiT, aqvs bilateralurihilusuri da paratraqeuli adenopaTia, filtvebis paTologiis klinikuri simptomebisgareSe. savaraudo diagnozia:\\\ tuberkulozi\\\ Sidsi\\\ laimis daavadeba\\ sarkoidozi\\\ revmatoiduli arTriti

\\\\ romel daavadebas axasiaTebs Trombocitebis umwifari formebis gamoCenaperiferiul sisxlSi?\\\ sistemur wiTel mgluras

109

\\ verlhofis daavadebas\\\ minkovski_Sofaris daavadebas\\\ moSkovicis daavadebas

\\\\ splenomegalia, rogorc wesi, axasiaTebs\\\ posthemoragiul anemias\\\ mwvave hemolizur anemias\\\ B12_deficitur anemias\\ qronikul hemolizur anemias\\\ yvela zemoTCamoTvlils


\\\\ asTmuri statusis ZiriTadi klinikuri sindromebia:\\\ sunTqvis progresirebadi ukmarisoba;\\\ filtvismieri hipertenziis mkveTri gaZliereba;\\\ mZime neirofsiqikuri sindromi;\\ yvela CamoTvlili;

\\\\ romel qvemoTCamoTvlil daavadebebs ar axasiaTebs oftalmologiuri problemebi?\\\ Sogrenis sindromi\\\ reiteris sindromi\\\ behCeTis sindromi\\\ iuveniluri revmatoiduli arTriti\\ revmatuli arTriti\\\ maankilozirebeli spondiliti

\\\ filtvismieri gulis mizezi ar SeiZleba iyos:\\\ aerzas daavadeba\\\ filtvis tuberkulozi\\\ gulmkerdis kifoskoliozi\\\ eqsudaciuri plevriti\\ pikis cirozi

\\\\ komis xarisxis Sefaseba glazgos skalis mixedviT efuZneba Semdegs:\\\ muxlis refleqsis Sefaseba;\\ pacientis aqtivoba, masTan kontaqtis damyarebis SesaZlebloba, Tvalebis gaxela;\\\ gugis zomisa da sinaTleze reaqciis Sefaseba;\\\ garegani sunTqvis funqciis adeqvaturobis Sefaseb\\\

\\\\ sefsisis formas, rodesac xdeba metastazuri abscesebis gavrceleba sxvadasxvaorganosa da qsovilSi, ewodeba:\\\ septicemia\\ septikopiemia\\\ sefsisuri endokarditi\\\ qroniosefsisi

\\\\ qvemoT moyvanili Sratis fermentebidan romeli warmoadgens miokardiumisdazianebis specifiur kriteriums infarqtis dros?\\\ laqtatdehidrogenaza_4\\\ laqtatdehidrogenaza_5Ø.

110

\\ troponini T da I\\\ ast\\\ glutamat_oqsalacetat transaminaza

\\\\ sisxlis Sededebis unaris daqveiTebiT (koagulopaTiebiT) ganpirobebul hemoragiuldiaTezebs miekuTvneba yvela qvemoTCamoTvlili, garda _\\\ hemofilia\\\ K vitaminis deficiti\\ verlhofis daavadeba\\\ vilebrandis daavadeba

\\\\ kisris da yuris ukana (retroaurikuluri) limfuri jirkvlebis gadideba dacxeleba ar axasiaTebs:\\\ ybayuras\\\ infeqciur mononukleozs\\ mielomur daavadebas\\\ wiTuras\\\ qronikul limfoleikozs

\\\\ romeli Semdgomi preparatis gadametdozireba ar gazrdis sisxldenis Sanss?\\\ streptokinazis\\\ aspirinis\\ askorutinis\\\ heparinis\\\ varfarinis

\\\\ sisxliani xvela damaxasiaTebelia Semdegi daavadebebisaTvis:\\\ filtvis arteriis stenozi\\\ aortaluri naklovaneba\\ filtvis arteriis Tromboembolia\\\ marjvena parkuWis infarqti\\\ yvela zemoTCamoTvlilisTvis

\\\\ Semdeg daavadebaTagan romeli araa saWiro iqnas ganxiluli diferencialurdiagnozis gasatareblad gulmkerdis areSi tkivilis SemTxvevaSi?\\\ filtvis arteriis Tromboembolia\\ herpes labialis\\\ diafragmis Tiaqari\\\ dresleris sindromi\\\ Suuasayris simsivne\\\ yvela zemoTCamoTvlili

\\\\ diareis kombinacia muclis tkivilis sindromTan da mezenteriuli limfurikvanZebis kalcifikaciasTan damaxasiaTebelia:\\\ msxvili nawlavis kibosaTvis\\\ kronis daavadebisaTvis\\\ araspecifiuri wylulovani kolitisaTvis\\\ amebiazisaTvis\\ tuberkulozuri ileotiflitisaTvis

\\\\ qvemoT moyvanili gamokvlevebidan romels unda mieces upiratesoba araspecifiuriwylulovani kolitis dasadgenad?\\\ irigoskopias\\\ nawlavis floris Seswavlas\\ kolonoskopias\\\ D_qsilozis testis warmoebas\\\ koprologiur gamokvlevas

\\\\ sklerodermiis gastrointestinur gamovlinebebs miekuTvneba:\\\ pankreatiti;

111

\\ refluqs_ezofagiti;\\\ naRvlis buStis kalkulozi;\\\ 12_goja nawlavis wyluli;\\\ arcerTi pasuxi ar aris swori;

\\\\ Tirkmlis kenWovan kolikas _ hidronefrozs axasiaTebs yvela qvemoTCamoTvliliniSani, garda:\\\ maRali temperatura\\ eqoskopiurad – SeWmuxnuli Tirkmlis fonze kenWis arseboba\\\ mikro_ da makrohematuria SemdgomSi normaluri Sardis analiziT\\\ pasternackis simptomi

\\\\ RviZlis pirvelad simsivnes RviZlis cirozisagan ganasxvavebs:\\\ siyviTlis arseboba\\\ transaminazebis donis momateba\\\ bilirubinis donis momateba\\ alfa_fetoproteinis donis momateba

\\\\ splenomegalia, rogorc wesi axasiaTebs:\\\ posthemoragiul anemias\\\ mwvave hemolizur anemias\\\ B12_deficitur anemias\\ qronikul hemolizur anemias\\\ yvela zemoTCamoTvlils\\\ arcerT zemoTCamoTvlils

\\\\ parkuWovani eqstrasistoliisTvis damaxasiaTebelia yvela CamoTvlili, garda:\\\ eqstrasistolis win P kbilis ararseboba\\ eqstrasistoluri QRSÊkompleqsis xangrZlivoba ar aRemateba 0,10 wm_s\\\ sruli kompensatoruli pauza\\\ eqstrasistoluri QRSÛkompleqsis deformacia\\\ eqstrasistoluri T kbilisa da QRS kompleqsis maqsimaluri diskordantoba

\\\\ miokardiumis infarqtis ekg diagnostika sakmaod gaZnelebulia, Tuki arisTanmxlebi:\\ hisis konis marcxena fexis blokada\\\ mocimcime bradiariTmia\\\ supraventrikularuli eqstrasistoluri ariTmia\\\ hisis konis marjvena fexis blokada

\\\\ filtvis arteris Tromboemboliis sadiagnostiko saukeTeso meTodia:\\\ Torakocentezi;\\\ gulmkerdis mimoxilviTi rentgenografia;\\\ spirometria;\\\ gazebis Semcveloba arteriul sisxlSi;\\ filtvis arteriis angiografia;

\\\\ sistemuri sklerodermiis garTulebebi SeiZleba iyos:\\\ disfagia\\\ miokardis nawiburovani cvlilebebi _ `usimptomo infarqti~\\\ swrafad ganviTarebuli Tirkmlis ukmarisoba\\ yvela zemoTCamoTvlili

\\\\ qvemoT CamoTvlili daavadebebidan muclis areSi tkivilis mizezi SeiZleba iyos:\\\ bronqopnevmonia\\\ filtvebis emfizema\\ plevropnevmonia diafragmuli plevritiT\\\ yvela zemoTCamoTvlili

112

\\\\ avadmyofs diafragmis saylapavi xvrelis TiaqriT Seecvala daavadebis klinikurisuraTi: gaqra gulZmarva da regurgitacia, gauCnda disfagia mkvrivi sakvebis miRebisas,eds_ma moimata 28 mm/sT_mde, hemoglobini daqveiTda 85 g/l_mde. savaraudo diagnozia:\\\ Tiaqris CaWedva\\\ pilorostenozis ganviTareba\\\ melori_veisis sindromi;\\ saylapavis kibos ganviTareba\\\ arcerTi zemoTCamoTvlili;

\\\\ vilson_konovalovis daavadebis diagnostikur maCvenebels miekuTvneba yvela qvemoTCamoTvlili, garda erTisa:\\\ TvalSi, rqovanaze kaizer_fleiSeris rgolebis arseboba;\\\ sisxlSi spilenZis maRali koncentracia;\\ sisxlis SratSi SardmJavas maRali done;\\\ sisxlis SratSi ceruloplazminis dabali done;\\\ nevrologiur_fsiqikuri darRvevebi

\\\ hemolizur anemias ar axasiaTebs\\\ siyviTle\\ arteriuli krizi\\\ arapirdapiri hiperbilirubinemia\\\ retikulocitozi\\\ muqi feris ganavali\\\ hemoglobinuria

\\\\ vazorenaluri (renovaskularuli) hipertenziis dros etiopaTogenezuri Terapiagulisxmobs:\\\ diuretikebis gamoyenebas\\ qirurgiul mkurnalobas\\\ beta_adrenoblokatorebis gamoyenebas\\\ umarilo dietas\\\ vazodilatatorebis xanmokle kursebs

\\\\ qvemoTCamoTvlili kliniko_laboratoriuli monacemebidan romelia damaxasiaTebeligudpasCeris sindromisTvis?\\\ anemia\\\ hematuria\\\ proteinuria\\\ naxvelSi hemosiderinis Semcveli makrofagebis aRmoCena\\ yvela zemoTCamoTvlili

\\\\ qvemoTCamoTvlil daavadebaTagan romeli ganekuTvneba retikuloendoTelurisistemis sistemur keTilTvisebian granulomatozur dazianebaTa jgufs?\\\ tuberkulozi\\\ filtvis simsivnuri paTologia\\ sarkoidozi\\\ vegeneris granulomatozi\\\ yvela zemoTCamoTvlili

\\\\ alisferi sisxli an koltebi ganavalSi saWiros xdis Semdegi daavadebisgamoricxvas:\\\ kronis daavadeba\\\ araspecifiuri wylulovani koliti\\\ msxvili nawlavis divertikuli\\\ buasili\\ yvela zemoTCamoTvlili

\\\\ B12_deficitur anemias xSirad agreTve moixsenieben, rogorc:\\\ perniciozul anemias

113

\\\ hiperqromul anemias\\\ adison_birmeris daavadebas\\\ megaloblastur anemias\\ yvela zemoTCamoTvlils

\\\\ Ca_is antagonistebis jgufidan romeli preparati SeiZleba iyos gamarTlebulisublingvalurad misaRebad hipertonuli krizis kupirebisTvis adrenoblokatorebTankombinaciaSi?\\\ dilTiazemi\\ nifedipini\\\ verapamili\\\ yvela zemoTCamoTvlili\\\ arcerTi zemoTCamoTvlili

\\\\ zemoT CamoTvlili paTologiebidan romels SeuZlia gamoiwvios perkutorulixmianobis Semokleba:\\\ eqsudaciur plevrits\\\ plevrul Svartebs (Sexorcebebs)\\\ filtvis ateleqtazs\\\ krupozul pnevmonias\\ yvela CamoTvlils

\\\\ marjvenaparkuWovani ukmarisobisas aRiniSneba yvela CamoTvlili, garda:\\\ qvemo kidurebis SeSupeba\\\ hepatomegalia\\ filtvis kapilarebSi wnevis sagrZnobi momateba\\\ kisris venebis Seberva\\\ marjvena parkuWSi saboloo diastoluri wnevis momateb\\\

\\\\ romel daavadebas axasiaTebs poliarTralgiebi, anti_streptilizin-O_s titrismomateba da cxeleba?\\ revmatul cxelebas\\\ revmatoidul arTrits\\\ kvanZovan periarteriits,\\\ sistemur wiTel mgluras

\\\\ gulis areSi uecari, metad Zlieri tkivili, romelsac mohyveba profuzulioflianoba, taqikardia da wnevis dacema, axasiaTebs:\\\ miokardits\\\ subendokardul infarqts\\\ filtvis arteriis Trombozs\\ aortis anevrizmis ganSrevebas\\\ yvela zemoTCamoTvlils\\\ arcerT zemoTCamoTvlils

\\\\ romelia C vitaminis qronikuli deficitis mTavari klinikuri simptomi?\\\ purpura\\\ hemataqsisi\\ gingiviti\\\ hematomebi\\\ arcerTi zemoTCamoTvlili

\\\\ sistemuri wiTeli mgluras dasawyisi SeiZleba ukavSirdebodes:\\\ virusul infeqcias\\\ Sratismier daavadebas\\\ wamlis (hidralazini, antibiotiki da a.S.) miRebas\\\ orsulobas an aborts\\ yvela zemoTCamoTvlils\\\ arcerT zemoTCamoTvlils

114

\\\\ mwvave muclis dros diferencialur diagnozSi SeiZleba ganvixiloT yvelaqvemoTCamoTvlili paTologia, garda:\\\ miokardiumis infarqti\\\ Sonlein_henoxis purpura\\\ elenTis infarqti\\ RviZlis cirozi\\\ perioduli daavadeba\\\ jorjlis arteriis Trombozi

\\\\ romeli daavadebisaTvis aris damaxasiaTebeli heberdenis da buSaris kvanZebi?\\\ revmatiuli arTriti\\\ podagra\\ osteoarTrozi\\\ bexterevis daavadeba\\\ idiopaTiuri kalcinozi

\\\\ qronikuli gastritis diagnostikaSi gadamwyveti mniSvneloba eniWeba:\\\ kuWis rentgenologiur gamoklvevas\\\ kuWis wvenis gamokvlevas\\ kuWis lorwovani garsis biofsias da bioptatis histologiur Seswavlas\\\ ezofagogastroduodenoskopias\\\ yvela CamoTvlils

\\\\ sisxliani xvela, asTmuri sindromi, cxeleba, maRali edsi, polinevriti da wonaSiprogresuli dakleba savaraudos xdis:\\\ behCetis sindroms\\\ takaiasus daavadebas\\\ sistemur sklerodermias:\\\ polimiozits;\\ arcerT zemoTCamoTvlils

\\\\ wylulidan faruli gastrointestinuri sisxldenis pirvel saaTebSi yvelaze naklebinformatiulia:\\\ gastroduodenofibroskopia\\\ sisxlis saerTo analizi (hemoglobini, eriTrocitebi da eds)\\ hemoglobinis maCvenebeli\\\ wyluliT gamowveuli tkivilis intensivobis Semcireba

\\\\ kardiomegaliis mizezi SeiZleba iyos:\\\ sistemuri wiTeli mglura\\\ gulis sarqvlovani mankebi\\\ revmatizmi\\\ eqsudaciuri perikarditi\\ yvela zemoTCamoTvlili

\\\\ nefrozuli sindromi axasiaTebs yvela zemoTCamoTvlil daaavadebas, garda:\\\ mwvave glomerulonefritisa\\\ diabeturi nefropaTisa\\ kalkulozuri pielonefritisa\\\ Tirkmlis amiloidozisa\\\ mielomuri daavadebisa

\\\\ simptomuri hipertenziis erT_erTi SesaZlo mizezi SeiZleba iyos:\\\ mitraluri stenozi;\\\ rkinadeficituri anemia;\\\ adisonis daavadeba\\ feoqromocitoma;\\\ uSaqro diabeti

115

\\\\ ekg_ze zogjer normaluri kompleqsis Semdeg aRiniSneba deformirebuli QRSTkompleqsi, romlis winac R-R intervali Semoklebulia, Semdeg ki gaxangrZlivebuli. Pkbili gamoxatuli ar aris. daasaxeleT aritmiis tipi:\\\ sunTqviTi aritmia\\\ winagulovani eqstrasistolia\\ parkuWovani eqstrasistolia\\\ mocimcime aritmia\\\ arasruli atrioventrikuluri blokada (I xarisxis)

\\\\ malarias axasiaTebs cxelebis kombinacia:\\\ hiperqromul anemiasTan\\\ aplaziur anemaisTan\\ hemolizur anemiasTan\\\ pancitopeniasTan\\\ arcerT zemoTCamoTvlilTan

\\\\ kumbsis testis gamoyeneba saSualebas iZleva:\\ diferencirdes SeZenili autoimunuri hemolizuri anemia araautoimunuriTanadayolili hemolizuri anemiisagan\\\ diferencirdes posthemoragiuli anemia perniciozuli anemiisagan\\\ diferencirdes hemolizuri anemia danarCeni tipis anemiebisagan\\\ diferencirdes hipoqromuli anemia hiperqromuli anemiisagan

\\\ diferencirdes B12_deficituri anemia yvela danarCeni tipis anemiebisagan.

\\\\ sisxldenis simZimis gansasazRvravad iyeneben e.w. Sokis indeqss (Si), romelicwarmoadgens:\\\ pulsis Sefardebas hemoglobinis maCvenebelTan\\\ pulsis Sefardebas diastolur wnevasTan\\ pulsis Sefardebas sistolur wnevasTan\\\ diastoluri wnevis Sefardebas sistolur wnevasTan

\\\\ hepatomegalia, nevrologiuri da fsiqiuri somptomatika (disfagia, dizarTria,tremori, koordinaciis darRveva, ataqsia, maniakalur_depresiuli fsoqozi), Tvalisrqovana garsisa da skleris sazRvarze oqrosferi an momwvano_oqrosferi rgolisarseboba, SardSi spilenZis koncentraciis mateba axasiaTebs:\\\ hemoqromatozs\\\ pirvelad biliarul cirozs\\\ idiopaTiur qronikul hepatits\\ vilsonis daavadebas (hepatolentikuluri degeneraci\\\\\\ mwvave hepatits

\\\\ 25 wlis narkomani mamakaci Semovida klinikaSi intermisiuli cxelebis, mSralixvelis da qoSinis 4 kviriani anamneziT. rentgenogramaze Cans difuzuri intersticiulidaCrdilv\\\ eds – 25 mm/sT, leikocitebi – 5500, limfocitebi 14%. savaraudo diagnozi:\\\ filtvis arteriis embolia\\\ vegeneris granulomatozi\\ pnevmocisturi pnevmonia\\\ sarkoidozi\\\ filtvis qronikuli obstruqciuli daavadeba

\\\\ revmatizmis dros kanis damaxasiaTebeli dazianebas warmoadgens:\\\ hiperkeratozi\\\ fotodermatozi\\\ hiperpigmentacia\\ beWdisebri eriTema\\\ eqsudaciuri eriTema

\\\\ osteofitebis Camoyalibeba axasiaTebs:\\\ revmatoidul arTrits\\\ sistemur sklerodermias\\ madeformirebel osteoarTrozs;

116

\\\ revmatizms\\\ sistemur wiTel mgluras

\\\\ CamoTvlili preparatebidan romeli aris ukunaCvenebi arteriuli hipertenziis dros,Tu mas Tan axlavs bronquli asTma:\\\ klofelini,\\\ kapoteni,\\ anaprilini.\\\ nifedipini,\\\ hipoTiazidi

\\\ Tirkmlebis amiloidozisTvis damaxasiaTebelia yvela qvemoT CamoTvlili niSani,garda:\\\ proteinuriisa\\\ SeSupebisa\\\ Tirkmlebis zomis gadidebisa\\ arteriuli hipertenziisa\\\ hierqolesterinemiisa

\\\\ mwvave gastritebis mkurnalobis Sesaxeb yvela mosazreba sworia, garda erTisa:a. mwvave da qronikuli gastritis dros efeqturia antaciduri saSualebebi da/an H2blokerebi;b. H.pilory_sTan asocirebuli mwvave gastritis dros efeqturia tetraciklinis,metronidazolis da bismutis preparatebis kombinacia;\\\ koroziuli gastritis dros rekomendirebulia didi raodenobiT wylis miReba dakuWis amorecxva;\\ tuteebis zemoqmedebiT gamowveuli koroziuli gastritis samkurnalod efeqturiamJaveebis miReba;\\\ flegmonuri gastritis mkurnalobisadmi rezistentobis SemTxvevaSi keTdebagastreqtomia;

\\\\ cxviridan xSiri sisxldena da sisxliani xvela febrilitetTan erTad yvelazesavaraudos xdis:\\\ filtvis abscess;\\ vegeneris granulomatozs;\\\ bexCetis daavadebas\\\ sistemur wiTel mgluras;\\\ arcerT zemoTCamoTvlils

\\\\ moSkoviCis daavadebis mTavari klinikuri triada warmoadgens:\\\ perniciozul anemias, hematurias da filtvebis dazianebas\\ hemolizur anemias, Tirkmlis dazianebas da Trombocitopenias\\\ rkinadeficitur anemias, Trmobocitopenias da limfadenopaTias\\\ arcerT zemoTCamoTvlils

\\\\ romel daavadebas axasiaTebs samiznismagvari eriTrocitebi periferiul sisxlSi?\\\ pancitopenias\\\ namglisebrujredovan anemias\\\ malarias\\\ tularemias\\ arcerT zemoTCamoTvlils\\\ hemolizur anemias

\\\\ simptomuri hipertenziis erT_erTi SesaZlo mizezi SeiZleba iyos:\\\ mitraluri stenozi;\\\ rkinadeficituri anemia;\\\ adisonis daavadeba\\ feoqromocitoma;\\\ uSaqro diabeti

117

\\\\ mwvave muclis romel mizezs axasiaTebs uecari movliTi tkivili, romelicdasawyisSi periodulia – axasiaTebs tkivilis (da Rebinebis) arsebobis da gaqrobisepizodebis monacvleoba, xolo ramdenime saaTSi an dReSi icvleba mudmivi tkiviliT\\\ mwvave pankreatiti\\\ mwvave qolecistiti,\\\ wylulovani daavadebis perforacia\\\ kuWis Semogrexa\\ mwvave gauvaloba\\\ arcerT zemoTCamoTvlils

\\\\ venkenbaxis tipis atrioventrikuluri blokada xasiaTdeba:\\\ PQ_intervalis progresirebadi SemoklebiT\\\ PQ_intervalis progesirebadi gaxangrZlivebiT\\ PQ_intervalis progresirebadi gaxangrZlivebiT da parkuWovani kompleqsis SemdgomigamovardniT\\\ taqikardiiT\\\ fiqsirebuli blokadiT 2:1

\\\\ CamoTvlili rentgenologiuri niSnebidan romelia damaxasiaTebeli kavernozulituberkulozisaTvis?\\\ rgolisebri daxSuli Crdili;\\\ fesvisken mimarTuli biliki;\\\ siTxis horizontaluri donis arseboba;\\\ bronqogenuli diseminacia;\\ yvela CamoTvlili;

\\\\ instrumentuli monacemebidan ra axasiaTebs krupozul pnevmonias?\\ rentgenologiurad _ filtvis wilis homogenuri daCrdilva\\\ auskultaciiT _ mSrali mstvinavi xixini\\\ bronqoskopiiT _ bronqis sanaTuris Seviwroeba\\\ leikocitozis da eds_is momatebis asimetriuloba – “makratelis sindromi”

\\\\ CamoTvlilidan ra axasiaTebs qronikul anacidur gastrits?\\\ yabzoba\\\ “mSieri tkivili”\\ kuWis lorwovanis atrofia\\\ “Ramis tkivili”\\\ kuWis wvenis hipersekrecia

\\\\ CamoTvlilidan ra axasiaTebs saylapavis kibos?\\\ disfagia, upiratesad mkvriv sakvebze\\\ mudmivi tkivili saylapavis areSi, gansakuTrebiT sakvebis miRebisas\\\ umadoba da hipersalivacia\\\ rentgenologiurad avsebis defeqti\\ yvela zemoTCamoTvlili

patologiuri q avl, v1 – v6 ganxrebsi miutitebs · infeqciuri endokarditis camoyalibebasi: \\...

Documents