ANSWERS ON QUESTIONS
Main part
A 52-year-old patient was diagnosed with coronary heart disease (CHD),
stable angina pectoris, FC II ". From the age of 30 suffers from atopic bronchial
moderate asthma. As a basic therapy, Seretide receives inhalation.
Asthma attacks stop with salbutamol. About IHD began to receive
Metoprolol 25 mg 2 times a day. On the second day of starting Metoprolol in
asthma attacks became more frequent, peak volume velocity decreased
exhale.
Questions:
1. Suppose the cause of increased asthma attacks and decreased peak speed
exhale.
2. Suggest alternative antianginal drugs in this situation.
3. What undesirable effects can verapamil cause?
4. During ECHO cardiography, a patient ejection fraction of 35% was detected. Verapamil
canceled Offer antianginal therapy.
5. Bisoprolol also has a negative inotropic effect. Will it
latent heart failure contraindication
Bisoprolol?
Situational task 80 [K000310]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
A 30-year-old patient has chronic osteomyelitis. From the separated fistula sown
the causative agent is Staphylococcus aureus, methicillin-resistant (MRSA).
Questions:
1. Offer a first-line antibiotic for the treatment of osteomyelitis, indicate its dosage.
2. On the 3rd day of treatment with an antibacterial drug, the clinical effect
missing. Assume the reason for the lack of effect, the tactics of patient management.
3. Suggest alternative antibiotics in this situation.
4. What is the optimal tactic for antibiotic therapy in this situation?
5. 2 days after the start of the use of the antibacterial drug appeared
skin rash, in connection with which they began to administer ceftaralin, after 3 weeks the drug
canceled, even after a week the condition worsened (fistula opening, temperature
37.5 ° C, anorexia). Explain the reason for the deterioration and suggest further
treatment tactics.
Situational task 81 [K000311]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
A 65-year-old patient with a diagnosis of hypertension of the II degree, IHD,
stable angina pectoris, FC II, hyperlipidemia (OXC - 6 mmol / L, LDL - 4
mmol / l, HDL - 1.0 mmol / l), chronic heart failure (CHF) stage II,
FC II ". HELL - 135/95 mm RT. Art., there is atrial fibrillation, a constant form,
CSJ - 85 beats per minute.
The patient receives treatment: Enalapril 5 mg 2 times, Nifedipine 10 mg 2 times,
Isosorbitadinitrate prolonged 40 mg 2 times, Hypothiazide 25 mg 1 time in the morning,
Digoxin 0.25 mg 1 time per day; Verapamil 120 mg 3 times. The patient’s condition is not
is improving.
Questions:
1. Assess the validity of the drugs.
2. Which group of drugs is most important for coronary heart disease, heart failure and fibrillation
atria?
3. What complications are possible with a constant form of atrial fibrillation?
What preventive measures should be taken?
4. What anticoagulant is needed? What are the measures for monitoring effectiveness and
security?
5. What are the measures to combat hyperlipidemia in a patient?
Situational task 82 [K000314]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
Patient K., 45 years old, went to the polyclinic to a local physician
complaints of dizziness, interruptions in the work of the heart, flickering of "flies" before
eyes. Suffers hypertension for 5 years, occasionally with
Captopril is taken to increase blood pressure. Today after heavy physical exertion
(lifted the closet to the 2nd floor) a similar state appeared.
Objectively: the skin of the face and upper half of the body
hyperemic. Arrhythmic heart sounds, heart rate - 120 beats per minute, frequent
extrasystoles. HELL - 180/100 mm RT. Art. In the lungs, breathing is carried out in all departments,
no wheezing is heard, BH - 18 per minute.
There are no peripheral edemas. ECG: sinus rhythm interrupted by frequent
atrial extrasystoles, signs of left ventricular hypertrophy, heart rate - 120
beats per minute.
Questions:
1. Highlight the leading clinical syndromes.
2. Make a diagnosis.
3. Justify your diagnosis.
4. Select drugs for the relief of hypertensive crisis in this
the patient. Justify your choice.
5. Determine the planned treatment of hypertension in this patient.
Situational task 83 [K000317]
Дата: 2019-12-10, просмотров: 261.