1. What are the functions of the respiratory system?

The major function of the respiratory system is gas exchange. Oxygen diffuses out of the lungs and
into the blood, while carbon dioxide diffuses in the opposite direction, out of the blood and into the
lungs. Also the process of gas exchange regulates the acid-base balance of the body - the component
of homeostasis.
The respiratory system also helps maintain body temperature and eliminate excess water from the
body. The movement of gas through the larynx, pharynx, and mouth allows humans to speak.

2. What is bronchitis? What types of it do you know? Speak on its causes, clinical pattern, treatment and
complications.

Bronchitis is an acute inflammation of the air passages within the lungs. It occurs when the
trachea and the large and small bronchi became inflamed because of infection or irritation.
Bronchitis occurs most often during the cold and flu season, usually coupled with an upper
respiratory infection. It also occurs when a person inhales irritating fumes of dust, chemical solvent
and smoke. Doctor diagnoses bronchitis on a basic symptoms and a physical examination.
Methods of diagnostics: blood test, X-ray, oxygen saturation measurement, pulmonary
function test.

Acute bronchitis most commonly occurs after an upper respiratory infection such as the
common cold or a sinus infection. The affected person may have symptoms such as fever with
chills, muscle aches, nasal congestion, and sore throat. The cough may be dry or may produce
phlegm, which can last for 2 weeks. Wheezing may occur because of the muscular tightness and
inflammation of the airways. Chronic bronchitis is characterized by the presence of a productive
cough that lasts for three months at least two years. Chronic bronchitis occurs when person inhales
dust, chemicals while working. Symptoms may include wheezing, dyspnoea. The cough is often
worse after awakening and the sputum produced may have a yellow or green color.

Treatment: First of all, antipyretics such as aspirin, tylenol will help with fever and muscle
aches. Drinking a lot of fluids is also important. A cool mist vaporizer can help decrease bronchial
irritation. An over-the-counter cough suppressant may be helpful. Bronchodilator inhalers will
help open airways and decrease wheezing. For natural treatment we can use honey, lemon, ginger,
bay leaf. If the doctor suspects a bacterial infection, antibiotics will be prescribed for 4-5 days.
And different immunomodulators should be given too. In some cases patients may have
complications such as pneumonia, recurrent respiratory infections, emphysema, right-sided heart
failure, pulmonary hypertension.

3. What is pneumonia? What are the causes and symptoms of pneumonia? Speak on its treatment and
complications.

It’s an inflammation of lung tissue.

The infection causes the air sacs of the lung, where oxygen passes into the blood, to become
clogged with pus and other secretions, so that the supply of oxygen to the blood is reduced.
Causes: Pneumonia is divided into viral and bacterial form. An infection leading to pneumonia can
be due to a variety of agents, including fungi, protozoa, bacteria or viruses.
The resulting symptoms include shortness of breath, fever, chills, and persistent cough that brings
up phlegm discolored by pus and sometimes by blood and chest pain. +chest pain, sweating,
wheezing.
 Treatment: Viral pneumonia does not respond to antibiotic treatment (anti-viral drugs), but
antibiotics may be given if there is a bacterial infection. Other treatments given for all cases of
pneumonia include medications to ease a cough and reduce pain. Patient may be hospitalized to get
an oxygen therapy. Nonsteroidal anti-inflamatory drugs – redce pain and fever. Cough
suppressants, mucolytic drugs – to thin sputum and ease cough.
The complications are pleural effusion, empyema, abscess, pulmonary oedema.

4. What is TB? What is its cause? What types of it do you know? What are the symptoms and possible
complications of TB? Speak about treatment.
Pulmonary tuberculosis is a contagious bacterial infection caused by Mycobacterium tuberculosis.
TB can develop after inhaling droplets sprayed into the air from a cough or sneeze by someone
infected with bacteria.
It can occur in 2 forms: dormant disease and active form.
Symptoms: The primary stage doesn’t have symptoms. After the developing the TB, symptoms may
include minor cough, mild fever, fatigue, unintentional weight loss, coughing up blood, phlegm-
producing cough. Additional symptoms are wheezing, excessive sweating especially at night, chest
pain, breathing difficulty, clubbing of fingers, unusual breath sounds.
Treatment is typically lasts 6 months with anti antitubercular drugs (Izonaizid, Rifamin).
Hospitalization may be indicated to prevent the spread of the disease to others until the contagious
period has been resolved.
Complications: drug resistance to particular TB strains, Relapse of the disease.

5. What are the functions of the cardiovascular system?

Cardiovascular system is represented by a system of vessels that convey blood to and from tissues
throughout the body, bringing nutrients and oxygen and removing wastes and carbon dioxide.
Cardiovascular system consists of heart and blood vessels.
The vessels carrying blood away from the heart are arteries, which are divided into arterioles, which
branch into capillaries.The capillaries then emerge from the cellular environment and form venules,
which form veins.

6. What is ischemic heart disease? What types of it do you know? What factors may cause it? What are
the symptoms and possible complications? Treatment.
Ischemic heart disease is a disease characterized by ischemia (reduced blood supply) of the heart
muscle.
There two types of IHD: stable (symptoms appear at predictable level of exertion and can be managed
by the patient) and unstable (symptoms appear at unpredictable level of exertion and are poorly
managed by the patient; new symptoms may appear or angina may worsen). Symptoms of stable IHD
include angina (chest pain) and decreased exercise tolerance. Symptoms of unstable IHD include
chest pain at the rest or rapidly worsening angina. +shortness of breath, arrhythmia, weakness,
anxiety, Nausea and vomiting, Heart palpitations, Swelling in the legs and feet and abdomen,
Difficulty sleeping, Cough caused by fluid in the lungs.
The main causes of IHD are atherosclerosis, thrombosis, embolism, hypotension, heart failure, renal
failure. Its risk increases with age, smoking, hypercholesterolemia, diabetes, hypertension and genetic
predisposition.
The main complications of IHD include cardiac insufficiency, myocardial infarction, myocarditis,
ventricular hypertrophy, acute coronary syndrome.
Treatment: depending on symptoms and risk, it can be with medication which includes aspirin (to
prevent blood clotting), beta-blockers (to reduce heart rate), statins (to reduce level of LDL),
nitroglycerin (to dilate coronary arteries). Diuretics to rid the body of excess fluid, which reduces the
 amount of blood that needs to be pumped, leading to reduced blood pressure and less work for the
heart muscle
Sometimes surgical treatment may be needed such as percutaneous coronary transluminal angioplasty,
coronary artery bypass surgery.

7. What is acute myocardial infarction? Describe its pathogenesis.

Myocardial infarction commonly known as a heart attack, is an interruption of blood supply to a part
of the heart, causing heart cells to die.
The heart attack happens when blood flow apart of the heart muscle is blocked. It is harmful because
the heart muscle is no longer getting oxygen from the blood. Most heart attacks are caused by a blood
clot in one of the coronary arteries. Occasionally a heart attack can be caused by a spasm of coronary
artery - the blood vessels that supply oxygenated blood to the heart muscle. The artery's lining
becomes hardened,stiffened and swollen with all sorts of gunge-including calcium deposits, fatty
deposits, and abnormal inflammatory cells - to form a plague that protrude into the channel of an
artery and the blood flow to the muscle is decreased. The heart may not be able to pump the blood
very well. This can cause a chest, jaw, neck or back pain, shortness of breath.
The main causes of myocardial infarction include: atherosclerosis of coronary artery, aneurism,
rupture of aorta, hyper or hypotension, bacterial infection, anemia, stenosis. The risk factors include:
previous cardiovascular disease, older age, tobacco smoking, high blood levels of lipids and low level
of high density lipoproteins, diabetes, high blood pressure, obesity, chronic kidney disease, heart
failure, living in polluted areas.

8. What are patients’ complains during the attack? What are the treatment options for myocardial
infarction?
The main symptoms of myocardial infarction are: chest pain, which is described as a sensation of
tightness, pressure; shortness of breath; diaphoresis and fatigue; weakness; lightheadedness; fainting;
fear of death, nausea and vomiting; palpitations and sometimes loss of consciousness.
Treatment: The aim of treatment is to save as much myocardium as possible.
First aid of myocardial infarction includes: oxygen, painkillers, aspirin, and nitroglycerin.
Depending on clinical picture further treatment may include: Oxygen, ACE-inhibitors, Beta-blockers to
reduce heart rate, aspirin or heparin to prevent blood clotting, morphine or other painkillers to relieve
pain, nitroglycerin to dilate coronary arteries, statins to reduce level of LDL.
Depending on the condition surgery may be needed.

9. . What is hypertension, its types, possible causes, symptoms, treatment and complications?
Hypertension - it is a high blood pressure in the arteries. It can be divided into two types: systolic and
diastolic. This means the systolic reading (the pressure as the heart pumps blood around the body) is
over 140 mmHg (millimeters of mercury) or the diastolic reading (as the heart relaxes and refills with
blood) is over 90 mmHg. The main causes of hypertension include: physical inactivity, a salt-rich
diet and fatty food, alcohol and tobacco use, kidney disease, cancer, congenital adrenal hyperplasia,
hyperthyroidism. Risk factors include: age, race, obesity and diabetes, lifestyle, family history and
chronic stress. Symptoms: most people with high blood pressure have no signs or symptoms, even if
blood pressure readings reach dangerously high levels. A few people with high blood pressure may
have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren't specific and
usually don't occur until high blood pressure has reached a severe or life-threatening stage. For
treatment the hypertension your doctor may recommend you eat a healthy diet with less salt, exercise
regularly, quit smoking and maintain a healthy weight. But sometimes lifestyle changes aren't enough.
 Medications include: thiazide diuretics, beta-blockers, angiotensin-converting enzyme inhibitors,
calcium channel blockers, renin inhibitors, vasodilators. Uncontrolled high blood pressure can lead
to: heart attack or stroke, aneurism, heart failure, narrowed blood vessels, metabolic syndrome,
trouble with memory or understanding.

10. What is atherosclerosis? Speak on its causes and pathogenesis. Clinical pattern, prevention, treatment.
What can it lead to?
Atherosclerosis is a condition in which an artery wall thickens as a result of build-up of fatty materials
such as cholesterol. It is a chronic inflammatory response in the walls of arteries, mainly due to the
accumulation of macrophage white blood cells and promoted by low-density lipoproteins without
adequate removal of fats by high-density lipoproteins.
The way of developing:

LDL oxidized by free radicals;

Oxidized LDL comes in contact with an artery wall and damages it;

the body’s immune system sends specialized white blood cells to absorb the oxidized LDL
forming foam cells;
White blood cells are not able to process the oxidized-LDL and rupture depositing a great
amount of oxidized cholesterol into the artery wall;
the cholesterol plaque causes the muscle cells to enlarge and form a hard fibrous cover;

this cover causes a narrowing of the artery, reduces blood flow and increases blood pressure.

At the higher risk of atherosclerosis are people, who has obesity, diabetes, high blood pressure,
congenital stenosis, genetic predisposition and who is smoking, drinking alcohol and eating fatty
food.
Atherosclerosis has different treatment and prevention according to its type. Atherosclerosis in the
ocular arteries has symptoms such as poor-eye-sight, which can lead to blindness. Atherosclerosis
in arteries of extremities can cause fever, sweating, pains, cold extremities, which can lead to
gangrene. Atherosclerosis in arteries of the brain can cause mental difficulties and lead to stroke or
necrosis of the brain's tissues. Atherosclerosis in arteries of kidneys can cause intoxication, anuria,
oliguria, fatigue, sugaruria, pains in the back, fever, general malaise, mental difficulties, which can
lead to kidney failure or renal coma. Treatment is divided into two types: pharmaceutical and non-
pharmaceutical. The last one includes life style changes, diet, cessation of smoking, regular
exercises. Pharmaceutical includes thrombolitic therapy, aspirin, vitamins, bypass surgery and
angioplasty.
Complications: hypertension, myocardial infarction, IHD, Stroke, Necrosis of organs.

11. Describe the process of digestion. What are the main functions of the digestive system in general?
The
12. digestive system has two main functions: breaking down large food molecules into
small molecules and absorbing small molecules into the body, which go to the body cells.
The first step of digestion begins in the mouth. The saliva helps moisten food particles and begins the
breakdown of carbohydrates. The food is chewed to form a bolus and is forced to the pharynx. The
oesophagus is a straight, muscular tube connecting the pharynx to the stomach. The stomach is a c-shaped
organ lying in the upper left part of abdomen. The muscle layer churns food and breaks into a chyme. The
gastric glands secrete gastric juice, which contains hydrochloric acid, mucus, pepsinogen. The small
intestine is divided into three parts: duodenum, jejunum, ileum. Pancreas secretes enzymes, which go to
the pancreatic duct, which opens into duodenum. Bile, which breaks down large fat molecules into
smaller, enters the duodenum through the bile duct. The surface of intestine contains villi, which can
absorbed molecules. The large intestine consists of caecum, ascending colon, transverse colon,
descending colon, sigmoid colon and rectum. The function is to reabsorb water, ions and vitamins. It
stores the materials not digested by the body and forms the faeces, which consists of water, inorganic
salts, bacteria and undigested food.

12. What is gastritis? What are its causes and symptoms? What increases the risk of getting gastritis?
Gastritis is an inflammation of the lining of the stomach. There are two types of gastritis: acute and
chronic. Acute gastritis has causes such as excessive alcohol consumption; prolonged use of non-steroidal
anti-inflammatory drugs; surgery; traumatic injury; burns and severe infections, non-healthy diet,
smoking. Chronic gastritis can be caused by untreated acute, irregular diet, stress, the infection with
bacteria primarily H. Pylori; chronic bile reflux; stress; autoimmune disorders. Symptoms may include
pain in the stomach; feeling of fullness; heartburn; bloating; belching; vomiting; headache; general
malaise; weakness; diarrhea; loss of appetite. The risk of having gastritis increases with preferring hot,
spicy, oiled, salty, fast food, using drugs, alcohol, smoking.

13. How to diagnose and treat gastritis? What does the therapy depend on?
To diagnose gastritis doctors may use gastroscopy, blood tests: blood cell count, presence of H.
Pylori, urinalysis, stool sample, checking for blood in the stool, X-rays, EGGs, endoscopy, stomach
biopsy. Treatment for acute gastritis includes absorbents, light tea without sugar, diet without spicy,
hot, cold, salty food. Treatment of chronic gastritis can be divided into two types according to the
pathology: hypoacidic and hyperacidic. For treating hyperacidic doctor prescribes antacids and proton
pump inhibitors. For treating hypoacidic doctor should prescribe hydrochloric acid, vinegar to
decrease the pH in the stomach.

14. What is the stomach cancer? How does it spread in the body?
Stomach or gastric cancer is a malignant tumor arising from the lining of the stomach. Stomach
cancers are classified according to the type of tissue: adenocarcinoma, lymphoma, sarcoma.
Adenocarcinoma usually begins in cells, the building blocks that make up tissues, which make up
organs. Normally cells grow and divide to form new cells. As cells grow old, they die and new cells
take their place. Sometimes this process goes wrong. New cells form when body doesn’t need them
and old cells don’t die as they should. The build-up of extra cells often forms a mass of tissues called
tumor. Stomach cancer can spread by breaking away from the original tumor. Cells enter into blood
vessels or lymph vessels which branch all the tissues of the body. Cells may attach to other tissues and
form new tumors (metastasis).

15. Speak on the stages of stomach cancer development. What symptoms may develop during cancer
progressing? How is the stomach cancer treated? What is the role of nutrition for cancer patients?

There are 5 stages of stomach cancer:

• At the 0 stage the tumor is found only in the inner layer of the mucosa of the stomach.

• At the 1 stage the tumor has invaded only the submucosa. Cancer cells may be found in up to 6
lymph nodes. Or in another case, the tumor has invaded the muscle layer or subserosa and cancer
cells have not spread to lymph nodes.

• At the 2 stage the tumor has invaded only the submucosa. Cancer cells have spread to 7-15
lymph nodes. Or in another case, the tumor has invaded the muscle layer or subserosa and cancer
cells have spread to 1-6 lymph nodes.Or the tumor has penetrated the outer layer of the stomach
and cancer cells have not spread to lymph nodes.

• At the 3 stage the tumor has invaded the muscle layer or subserosa. Cancer cells have spread to
7-15 lymph nodes. Or in another case, the tumor has penetrated the outer layer. Cancer cells have
spread to 1-15 lymph nodes. Or the tumor has invaded nearby organs such as the liver, colon or
spleen. Cancer cells have not spread to lymph nodes.

• At the 4 stage cancer cells have spread to more than 15 lymph nodes. Or in another case, the
tumor has invaded nearby organs and at least 1 lymph node. Or cancer cells have spread to distant
organs.

Early stomach cancer often does not cause symptoms. As the cancer develops, the most common
symptoms are: pain in the stomach area; difficulties in swallowing; nausea and vomiting; weight
loss; feeling of fullness or bloating after a small meal; vomiting blood or having blood in the stool.
Treatment of the stomach cancer depends on the size, location of tumor, the stage and general
health. It is divided on stages:
• surgery - removing the whole tumor stomach or the part that has cancer;
• chemotherapy - using drugs to kill cancer cells;
• radiation therapy - using high energy rays to kill cancer cells;
• nutrition - the patient needs the right amount of calories, protein, vitamins, and minerals to
maintain his strength to heal. He may need to take daily supplements of vitamin D, B12, calcium
and iron

17. What liver diseases do you know? What symptoms are typical of them?

The liver is the largest gland in the body and one of the most important accessory organs of the
digestive system. There are a lot of diseases that can affect on the liver. They include cirrhosis,
alcohol abuse; hepatitis A, B, C, D, E; non-alcoholic fatty liver disease; hemochromatosis; biliary
diseases. The symptoms may include jaundice, a lack or loss of appetite, weight loss, fatigue,
bloating, weakness, itching, yellowing of the whites of the eyes, nausea and vomiting, low-grade
fever.

18. What is hepatitis and its types? Compare different types of viral hepatitis (causes, way of
transmission, duration incubation period).

Condition defined by the inflammation of the liver parenchyma.

Hepatitis can be infectious and non-infectious.
Non-infectious hepatitis can be caused by toxic drugs, toxins or diseases of immune system (a
condition where the immune system attacks and destroys liver cells as foreign bodies).
Infectious hepatitis is caused by viruses A, B, C, D, E (viral) and bacteria (bacterial) and parasites.

Hepatitis A is acquired by consuming materials contaminated with faecal matter of an individual

who already has disease. It is usually communicated as a result of poor hygiene or through personal
contact. The virus is able to survive at normal room temperature for hours on a hard surface. The
incubation period for hepatitis A lasts about 2-6 weeks. Most patients recover within a few months.
Hepatitis B is spread through infected body fluids like blood, semen, saliva, suppurating sores,
breast milk. It doesn’t spread by simple physical contact. The incubation period lasts from 1 to 6
months. After recovering the infected person will be immune to any later reinfection with this
particular virus. Some individuals may fully recover and have no symptoms and yet remain a
capable of infecting others through sexual contact, shared hypodermic needles, food or drinks.
Hepatitis C has no symptoms. Most people become chronically infected. People with strong
immune system may recover without treatment. Those with chronic hepatitis C who are not treated
or cured may live normal lives but they remain carriers of the disease and can infect other people.
Some patients with hepatitis C develop complications like cirrhosis, liver failure or liver cancer.
Incubation period lasts 2weeks-six months.
Hepatitis D attacks only individuals with hepatitis B. A person may get 2 forms at the same time.
It is transmitted through the same routs as hepatitis B. Hepatitis D can be suspected when the
condition of someone with hepatitis B suddenly becomes worse. It can be diagnosed with tests that
reveal hepatitis D antibodies in the blood.
Hepatitis E (waterborne disease) is similar to hepatitis A and is transmitted contaminated water
supplies. Incubation period lasts about 2 or 6 weeks. Most people with hepatitis E recover from it
on their own within a few months. This type of hepatitis is spread in Certain African countries and
in Asia.

19. What symptoms are typical of hepatitis? When is it considered chronic? How is it possible
to treat cirrhosis?
Hepatitis can be acute or chronic. If an individual with hepatitis remains symptomatic for more
than a few months, the condition is considered chronic. All forms have similar symptoms: dark
urine, loss of appetite, fatigue, bloating, jaundice, yellowing of whites of the eyes, nausea and
vomiting, low-grade fever, weight loss, general malaise.
In patients with acute viral hepatitis, the initial treatment consists of bed rest, abstaining from
alcohol, relieving symptoms of nausea, vomiting, and abdominal pain. It is necessary to provide
intravenous fluids to prevent dehydration caused by vomiting. Patients with severe nausea
and/or vomiting may need to be hospitalized for treatment and intravenous fluids.
• Most patients who have hepatitis A and E get well on their own after a few weeks.
• Hepatitis B and C can be treated with drugs.
It is important to remember that only necessary medications should be administered since the
impaired liver is not able to eliminate drugs normally.
Treatment of chronic viral hepatitis include well-balanced diet, avoiding further liver damage
from alcohol or NSADs, regular exercises, cessation of smoking, avoiding salty food if there is
a tendency to accumulate fluids.
In general, the goals of therapy are to reduce liver inflammation and fibrosis and to prevent
progression to cirrhosis and its complications.
Liver transplant may be an option for people whose hepatitis progresses to liver failure and who
fail to respond to treatment or cannot tolerate treatment.
Corticosteroids are used to suppress the immune system are the main treatment of autoimmune
chronic hepatitis. These drugs usually decrease symptoms, reduce liver inflammation and
prolong survival.

20. What is cirrhosis, its types and causes? What are the symptoms and complications cirrhosis?
Cirrhosis is a late stage of fibrosis of the liver caused by many forms of liver diseases and
conditions, such as hepatitis and chronic alcoholic abuse. It is a condition in which the liver does
not function properly due to long-term damage. The main causes of developing cirrhosis are:
alcohol abuse; hepatitis B, C; bacterial infections, gall bladder stones; biliary diseases; drugs and
some cases are idiopathic. There are different types of cirrhosis:
alcoholic cirrhosis usually occurs after many years of heavy drinking and may affect up to
15% of all alcoholics.
Cryptogenic cirrhosis is a term used to describe cirrhosis of unknown origin.
Primary biliary cirrhosis occurs due to inflammation of the small bile ducts inside the liver,
leading to scarring and obstruction.
 haemochromotosis is a disease in which excessive amounts of iron accumulate in the liver.

The symptoms of cirrhosis include: enlarged liver or spleen; the appearance of spider-like blood
vessels; jaundice; a lack of appetite; weight loss; weakness; fatigue; easy bruising; itching;
esophageal bleeding.
Cirrhosis can develop in different conditions such as:
• bruising and bleeding
• jaundice
• itching because of bile salt products deposited in the skin
• hepatic encephalopathy - the liver doesn’t clear nitrogenous substances from the blood, which are
carried to the brain
• hepatocellular carcinoma
• portal hypertension - high blood pressure in the portal vein
• ascites - fluid leaks into the abdominal cavity
• hepatorenal (hepatopulmonary) syndrome - reduced blood supply to the kidneys (lungs) causing
renal failure (cyanosis and dyspnoea)
• esophageal varices - the vessels in the stomach and oesophagus may become enlarged.

21. What are the components and functions of the immune system? What two main types of
immunity do you know?

The immune system is a system that protects human’s body against disease-causing microorganisms
and cancer cells. It consists of lymphatic vessels, lymph nodes, lymph fluid and lymphocytes. There
are two main types of immunity. Humoral immunity involves substances found in the extracellular
fluids, such as antibodies and proteins. Cell-mediated immunity doesn’t involve antibodies, but
rather involves the activation of lymphocytes.

22. What is HIV infection? Speak on two main strains of HIV. What does HIV affect in the
human body?
It is infection in which certain immune cells are destroyed by HIV, it results in loss of the body’s
ability to protect itself against infectious diseases.
HIV has 2 main strains HIV-1 and HIV-2.
HIV is a lentivirus (a subgroup of retrovirus) that causes the acquired immunodeficiency syndrome
(AIDS)
The HIV itself doesn’t kill the patient. It destroys the immune system, leaving the patient
susceptible to other diseases.
HIV infects a specific type of white blood cells (T-cells). The virus attacks T-cells that have a
protein known as CD4 on the outer membrane. This kind of cell is essential in triggering the
immune response to infection or other foreign materials. The HIV invades CD4 cells and inserts its
own genetic material into them. Thus, it uses the cell’s resources to create more copies of the virus
and eventually kills the CD4 cell. After CD4 cells are destroyed, the body is no longer able to fight
off infections or kill cancer cells.

23. What are the ways of HIV transmission?

The HIV is transmitted through body fluids such as blood, breast milk, semen, vaginal fluids,
sharing needles for IV drugs. The virus can be transmitted through organ or tissue transplants. An
infected mother may pass the virus on to her unborn child through placenta. Susceptibility to HIV
infection increases if there is damage in or mucous membranes, which allows the virus enter the
bloodstream.
HIV can’t be transmitted through simple physical contact.

24. What does the term “opportunistic disease” mean? Name and speak on some of them.
Opportunistic disease is a disease that occurs more often in people with weakened immune system.
AIDS patients may have the following opportunistic diseases:
- Kaposi’s sarcoma – that is a type of skin cancer;
- Thrush – is a fungal infection caused by the Candida albicans;
- Pneumocystic pneumonia – is a fungal infection of the lungs caused by Pneumocystis
carinii;
- Tuberculosis;
- Gastrointestinal infection;
- Cytomegalovirus – which affects the retina and causes blindness;
- Cervical cancer etc.

25. Describe the course and possible treatment options of the disease.
Various drugs have been developed to fight the HIV infection. They are AZT (zidovudine), DDI
(didanosine). These drugs try to disrupt key chemical reactions in HIV’s metabolic cycle, including
those controlling its reproduction. But the virus mutates rapidly, and the drugs lose their
effectiveness.
However, there are new antiviral drugs that are used to treat HIV infection. They are protease
inhibitor, entry inhibitor, reverse transcriptase inhibitor, and integrase inhibitor. These classes of
drugs prevent creation, assembly, and spread of new viruses. A doctor may prescribe a combination
of these drug classes known as highly active antiretroviral therapy (HAART).
Treatment for AIDS consists of treatment for HIV infection and treatment for opportunistic
infections. It includes medications specific for each type of infection.

26. How to reduce the risk of being infected with AIDS?

To prevent the HIV infection I-V needles should be safely disposed and shouldn’t be shared, blood
for transfusion should be tested before use, people should practice safe sex, and a pregnant woman
with AIDS should take zidovudine to reduce the chances of passing HIV to the foetus.

27. What is allergy? What are the most common allergens? What are the ways of their penetrating
into body?
It is an abnormal reaction of the immune system which is characterized by hypersensitivity of an
organism to a previously encountered usually harmless substance.
The most common allergens are dust, pollen, mould, animal dander, drugs, food (such as milk, fish,
wheat, eggs, fruit, vegetables, peanuts, walnuts, almonds, hazelnuts etc.), insect venom, poison ivy,
heat and cold. These allergens can penetrate into our body through: the air (when we inhale it), skin
contact and gastrointestinal tract.

28. When does an allergic reaction occur? What is the role of IgE in the allergic reaction? Describe
the symptoms of different types of allergic reactions.
It occurs when the body encounters some particle or substance. The specific antibodies produced in
all allergic reactions are known as Immunoglobulin E (IgE). These antibodies trigger the release of
histamine when exposed to an allergen.
Symptoms vary depending on the type of allergen and location:
 - An inhaled allergen (such as dust, pollen or mould) can cause: sinus congestion, runny nose,
watery, itchy or red eyes, wheezing, sneezing, impaired breathing and asthma.
- A contacting allergen (such as animal dander) can cause: itching, rash (or atopic dermatitis,
eczema), hives (or urticaria), itchy bumps and swelling.
- Food or drugs may cause: abdominal pain, indigestion, swelling, hives, and inability to
breath.
Food allergy shouldn’t be confused with food intolerance, which involves only digestive symptoms.

29. How to determine the cause of allergy? What is the treatment for different types of allergy?
Methods of diagnostics:
Taking anamnesis
Skin test – the small amounts of suspected allergen are placed on the skin of the upper arm or back.
The skin is scratched to allow entry of the allergen is injected. Swelling and redness at the test site
are considered a positive result. Several allergens are usually tested at the same time.
The Radioallergosorbent Test measures the amounts of specific IgE antibodies in the blood stream.
The results are not immediately available.
Blood test which may show the high level of eosinophils.
Treatment:
If a food allergy is suspected, one food for a time is eliminated from the diet and then added back to
determine if it is triggering the allergic reaction.
Antihistamines are the drugs most often used to control symptoms of allergic reactions.
Symptomatic treatment may be applied. Vasoconstrictors (nasal drops) are used to relieve nasal
congestion. Ocular drops are used against red and watery eyes. Topical ointments with
corticosteroids relieve itching.
A shot of epinephrine is given in the case of severe allergic reactions.
Corticosteroids are injected to stop severe allergic reactions such as hives, Quincke’s oedema,
anaphylactic shock.
Allergy shots or immunotherapy can be administered to eliminate the allergy entirely. In
immunotherapy, a small amount of an allergen is injected in order to stimulate the body to produce
an antibody to neutralize it. This, in turn, blocks the IgE antibodies from reacting with the allergen
and provoking the allergic response.

30. What is anaphylactic shock? Name the first aid measures in case of anaphylactic shock.
Anaphylactic shock is a severe life-threatening allergic reaction. It can be triggered by allergens,
such as insect venom, drugs or food. Shock occurs when the allergic reaction triggers the blood
vessels to dilate, causing circulatory failure and a drastic drop in blood pressure. In the case of
anaphylaxis – epinephrine should be given.

31. What are the functions of the endocrine system?

The main functions of the endocrine system are productive and regulative. Endocrine glands
produce different hormones, which can be water- and lipid-soluble. With the help of such hormones
endocrine system regulates the functions of other body organs.

32. Speak on the glands that make up the endocrine system and hormones they produce? Name
some hormonal disorders.
The major glands, which make up the human endocrine system, are the hypothalamus, which is
located in the lower central part of the brain and regulates the pituitary gland: The pituitary gland is
located on the base of the brain and is called the “master gland”, because it controls other glands. It
is divided into anterior and posterior lobes; Pineal gland is located in the middle part of the brain
and is responsible for our wake-sleep cycle; Adrenal glands are located on the top of each kidney
and is divided into adrenal cortex and adrenal medulla; Thyroid and parathyroid glands are located
in the anterior part of the neck; Gonads, that produce androgens in men and estrogens in women;
And endocrine part of the pancreas, that is responsible for carbohydrate metabolism.
Each glands of endocrine system produce different hormones.
Hypothalamus produces releasing and inhibiting hormones, which regulate anterior pituitary. Also
it produces antidiuretic hormone, that regulates body water balance, and oxytocin, that triggers
uterine contractions during labour.
The pituitary gland produces hormones, that control other glands; These hormones are: growth
hormone (which stimulates protein synthesis and causes growth), follicle-stimulating hormone (that
stimulates development and maturation of a follicle in a woman’s ovary), luteinizing hormone (that
causes ovulation and the formation of corpus luteum), prolactin (which activates milk production in
breastfeeding women), thyroid-stimulating hormone and corticotropin (which stimulate production
of thyroid and adrenal hormones).
Adrenal cortex produces corticosteroids, which regulate salt and water balance, and metabolism.
Adrenal medulla produces adrenalin and noradrenalin, which regulate the body’s response to
stress, increase blood pressure, heartbeat, respiration and sweating.
Male gonads (testes) produce testosterone, and female gonads (ovaries) produce estrogen. These
hormones regulate body changes associated with sexual development. Ovaries also produce
progesterone that regulates menstrual cycle and pregnancy.
Thyroid gland produces calcitonin, thyroxine and triiodothyronine, which regulate calcium
balance and metabolism. Parathyroid glands produce parathyroid hormone that also regulates
calcium balance.
Pineal gland produces melatonin that regulates the wake-sleep cycle and skin pigmentation.
Pancreas produces insulin and glucagon, which regulate carbohydrate metabolism.
Excessive or insufficient amount of different hormones may result in hormonal disorders, such as:
- Cushing’s syndrome, which is excessive amount of glucocorticoid hormones due to tumour
in the pituitary gland;
- Addison’s disease, that is deficiency of adrenal hormones, caused by autoimmune reaction
or cancer;
- Virilization, which is the development of exaggerated masculine characteristics due to
excessive production of androgens;
- Hypoglycaemia, that is abnormally low level of glucose;
- Galactorrhoea, which is characterized by production of breast milk in men or women, who
aren’t breastfeeding;
- Precocious puberty, that is excessive production of gonadotropins leading to body changes
at an abnormally young age;
- Seasonal affective disorder, which is excessive production of melatonin, especially during
winter.

33. What types of diabetes mellitus do you know? What are the causes, symptoms, treatment and
complications of both diabetes types?
Diabetes mellitus is a disorder that is characterized by abnormally high level of glucose in the
blood. There are two types of diabetes mellitus: type I diabetes mellitus (or insulin-dependent
diabetes), and type II diabetes mellitus (or non-insulin-dependent diabetes). In type I most of
insulin-producing cells are destroyed, and a patient must regularly inject insulin to survive. In type
II the pancreas continues to produce insulin, but the body develops resistance to its effects.
Causes of diabetes mellitus include: viral infection or nutritional factor in childhood, genetic
predisposition, high level of corticosteroids, pregnancy, drugs and poisons. Symptoms of diabetes
are: polyuria, polydipsia (abnormal thirst), polyphagia (hunger), blurred vision, drowsiness, nausea,
decreased endurance during exercise, susceptibility to infections. Treatment of diabetes include:
keeping blood sugar levels within the normal range, weight control, exercise, diet, insulin
replacement therapy, and oral hypoglycaemic medications. Complications may include: diabetic
retinopathy, skin ulceration, ketoacidosis, hyperglycaemia, hypoglycaemia, diabetic coma,
nephropathy, cardiomyopathy, neuropathy etc.

34. What are the complications?

A patient may develop diabetic coma if a level of glucose in his blood is extremely high or low.
The damage to small blood vessels leads to a microangiopathy, which can cause one or more of
the following:
Diabetic cardiomyopathy, damage to the heart muscle.
Diabetic nephropathy, damage to the kidney which can lead to chronic renal failure.
Diabetic neuropathy, abnormal and decreased sensation starting with the feet but potentially in
other nerves, later often fingers and hands. When combined with damaged blood vessels this can
lead to diabetic foot (see below). Diabetic retinopathy, growth of friable and poor-quality new
blood vessels in the retina which can lead to severe vision loss or blindness.
Diabetic encephalopathy is the increased cognitive decline and risk of dementia- including the
Alzheimer's type- observed in diabetes.
Macrovascular disease leads to cardiovascular disease, to which accelerated atherosclerosis is a
contributor:
Coronary artery disease, leading to angina or myocardial infarction
Peripheral vascular disease, which contributes to intermittent claudication as well as diabetic foot.
Diabetic foot, often due to a combination of sensory neuropathy (numbness or insensitivity) and
vascular damage, increases rates of skin ulcers (diabetic foot ulcers) and infection and, in serious
cases, necrosis and gangrene.
Stroke (mainly the ischemic type)

35. What are the risk factors for developing diabetes? How is it possible to prevent it?
Risk factors for type I diabetes mellitus include: genetic predisposition, environmental and
nutritional factors. Risk factors for type II diabetes mellitus include: obesity, inactivity, genetic
predisposition, age, race, high blood pressure and high cholesterol level. Prevention of diabetes
includes: control level of sugars, weight control and physical activity.

36. What is diabetes insipidus? Speak on it.

Diabetes insipidus is a condition characterized by excessive thirst and excretion of large amount of
urine. It is caused by a deficiency of antidiuretic hormone (central diabetes insipidus), by
insensitivity of the kidneys to ADH (nephrogenic diabetes insipidus), or by drug use (iatrogenic
diabetes insipidus). Symptoms of diabetes insipidus include: excessive urination, extreme thirst,
dehydration, loss of appetite, weight loss, fever, vomiting, and diarrhea. Tests for diagnosing
include: measurement of blood glucose, electrolytes, bicarbonate and calcium levels, urinalysis, a
fluid deprivation test and pituitary hormone testing.

37. What are the functions of the nervous system? How is the nervous system classified?
The nervous system is a complex collection of nerves and neurons. It transmits signals, which let
the parts of the body communicate. The nervous system is divided into the CNS and PNS. The CNS
includes the brain and spinal cord. It provides higher mental functions, such as thinking, memory,
behavior, speech, mood, and also controls our reflexes. The PNS includes nerves and ganglia. It is
responsible for transmission of signals from the CNS to the other parts of the body.
38. What brain diseases do you know? Define them.
The human brain is susceptible to degenerative disorders, such as Parkinson’s disease, multiple
sclerosis and dementia. Parkinson’s disease is characterized by slow degeneration of the central
brain areas, causing problems with movement and coordination. Multiple sclerosis is a disorder in
which myelin sheath (cover) is damaged. Dementia is a decline in cognitive function resulting from
death of nerve cells in the brain. The most common form of dementia is Alzheimer’s disease.
Another brain disorders are: stroke – that is an interruption of blood supply of the brain; cerebral
edema – swelling of the brain tissue; hydrocephalus – an abnormally increased amount of
cerebrospinal fluid inside the skull; brain tumour – abnormal tissue growth inside the brain;
meningitis – is an inflammation of the brain caused by infection.
A number of psychiatric conditions, such as schizophrenia and depression, are caused by brain
dysfunction, although the nature of such disorders is not well understood.

39. What is stroke? What are the types of brain stroke?

It is the acute interruption of the blood supply to the brain which may result in death of the brain
cells.
There are two chief types of strokes: Ischemic stroke and Hemorrhagic stroke.
ISCHEMIC STROKE is the result of a blocked artery due to blood clot. This is the most common
type of stroke and it is the cause of 90% of all strokes. This type of stroke can occur in 2 ways:
Thrombotic stroke - This occurs when the blood clot (thrombus) forms in an artery that supplies
blood to your brain due to a blood vessel that is already narrow. The clot deprives a part of the brain
of oxygen and blood causing the cells of that part of the brain to die.
Embolic stroke -This is also called cerebral embolism and it occurs when a blood clot or other
debris breaks off (embolus) from a blood vessel away from your brain and travels through your
bloodstream to lodge in narrower brain arteries.
HEMORRHAGIC STROKE - The second chief type of stroke occurs when a blood vessel in a
part of the brain becomes weak and leaks or ruptures, causing blood to leak into the brain
(Hemorrhage). Hypertension (high blood pressure) and aneurysms (weak spots in blood vessels) are
the most common causes of brain hemorrhages. It may also be caused by the rupture of a defective
blood vessel. There are two types of hemorrhagic stroke.
Intracerebral hemorrhage and Subarachnoid hemorrhage

40. What are the risk main causes of stroke?

Risk factors for having stroke, which can’t be controlled by an individual, are age, gender and
genetics. Other risk factors can be controlled. They include: high blood pressure, high cholesterol
level, diabetes, obesity, smoking, physical inactivity and stress. The main causes of stroke are
atherosclerosis of brain arteries, embolism (or blood clot), ruptured aneurysm etc.

42. What do the symptoms and treatment of the brain stroke depend on? What are they?

Symptoms: Sudden numbness or weakness in the face, arm, or leg, especially on one side of the
body, Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble
seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of
coordination. Sudden severe headache with no known cause.
If you think someone may be having a stroke, act F.A.S.T. and do the following simple test:
F—Face: Ask the person to smile. Does one side of the face droop?
A—Arms: Ask the person to raise both arms. Does one arm drift downward?
S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T—Time: If you observe any of these signs, call 113 immediately.
Treatment of a brain stroke depends on its type. The goal of the treatment
Ischemic stroke may be treated by medication to break up the clot causing the stroke. Tissue
plasminogen activator is usually prescribed.
Anticoagulants are prescribed to prevent the development of blood clots.
Statins may be prescribed to reduce the level of cholesterol in blood.
Surgery may be necessary to remove the inner wall of the carotid artery (carotid endarterectomy).
Unlike the ischemic stroke, the treatment for hemorrhagic stroke doesn’t involve anticoagulants.
Thinning the blood would increase the amount of blood being lost in the brain. In case of
hemorrhagic stroke emergency surgery may be necessary to repair damaged arteries or reduce the
pressure of the blood on the brain.
The patient may be given medication to help the brain’s blood flow return to normal.
As soon as patient is no longer acutely ill he or she must follow the rehabilitation therapy in order
to regain his or her functional abilities.

43. What are the complications of the brain stroke? What do they depend on?
The complications of the brain stroke depend on the location of blood interruption. They include:
- Swelling of the brain;
- Accumulation of cerebrospinal fluid inside the skull (hydrocephalus);
- Coma;
- Paralysis or loss of muscle movement;
- Memory loss;
Complications of stoke are related to the immobility of the patient.
The most common complications are bedsores, pneumonia, urinary tract infection, depression.

44. What therapy does rehabilitation of the patient after the stroke include?
Rehabilitation depends on the complications, which occur after the stroke. It includes:
- Speech therapy – to regain ability to talk;
- Occupational therapy – to regain dexterity in arms;
- Physical therapy – to improve strength and walking.

-Psychological therapy.

45. Speak on the anatomy and physiology of the urinary system.

Urinary system consists of kidneys, ureters, urinary bladder and urethra.
Kidneys are bean-shaped organs with hilum on the medial side. Parenchyma is divided into the
outer part (or cortex) and inner part (or medulla). The functional unit of the kidney is the nephron.
It consists of renal corpuscle and renal tubule, which continues to renal pelvis.
One of the main kidney functions is the production of urine. The process of urine production
consists of filtration of blood, reabsorption of water and ions and secretion of waste materials.
The walls of ureters, bladder and urethra are divided into three parts: outer layer (fibrous connective
tissue), middle layer (smooth muscles) and inner layer (mucosa). Functions of ureters are transport
of urine to the bladder and prevention of urine back-flow. Urinary bladder stores urine and expels it
into the urethra. Urethra starts with the internal urethral sphincter and transports urine to the
outside.

46. What are the main types of kidney diseases? Speak on them.
The main types of kidney diseases are hereditary, congenital and acquired.
Hereditary disorders include polycystic kidney disease, Alport’s syndrome, hereditary nephritis,
primary hyperoxaluria and cystinuria.
Congenital diseases usually include malformations of genitourinary tract, which can progress to
chronic kidney failure. Acquired kidney diseases involve many disorders, such as
glomerulonephritis, pyelonephritis, kidney stones, nephrotic syndrome etc.

47. Speak on the kidney stones: the causes, symptoms, ways of treatment.
Kidney stones refer to acquired kidney disorders. They are accumulations of material like calcium
oxalate, calcium phosphate or uric acid, which form in the urinary tract.
Causes of kidney stones may include changes in balance of water, salts and minerals, which lead to
dehydration; lack of plain water. Also kidney stones can be triggered by gout, hypercalciuria or
dietary factors.
Symptoms include severe pain, frequent urination, and hematuria, abnormal colored urine, painful
urination.
Treatment includes alphablockers (to relax the wall of the ureter), shock wave therapy,
ureteroscopy, normal water consumption and healthy diet.
+ NSAIDs to relieve pain.

48. What is pyelonephritis? What are the symptoms, causes and treatment of pyelonephritis and
complications?
Pyelonephritis is an inflammation of renal pelvis. It is more common in adult women.
Pyelonephritis is caused by bacteria, which come from the bladder by the backward flow of urine.
Symptoms include fever, chills, fatigue, burning and frequent urination, cloudy or bloody urine,
aching pain in the lower back. Treatment includes antibiotics, and depends on the type of bacteria.
If the type cannot be identified, a broad-spectrum antibiotic will be used. Untreated pyelonephritis
may lead to bacteraemia, hypertension, and permanent kidney damage, acute kidney failure, acute
nephritic syndrome, hypertension, chronic urinary tract infection.