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ANSWERS ON QUESTIONS
Main part
A student who visited a sick friend had chills on day 2,
body temperature 39.1 ° C, severe headache in the frontal region, pain in the eyes
apples, muscles and joints, nausea, weakness, lack of appetite. By the end of 1 day
diseases appeared nasal congestion, sore throat, dry nasal cough with
pain behind the sternum.
An objective examination revealed hyperemia and puffiness of the face,
nasal congestion, in the throat diffuse moderate hyperemia of the posterior pharyngeal wall and its
grain. In the lungs - harsh breathing, single dry rales. Pulse - 102 beats per
minute, rhythmic, blood pressure - 115/80 mm RT. Art. Heart sounds are muffled. The stomach is soft
painless. The liver and spleen are not enlarged. There are no meningeal symptoms.
Questions:
1. Assume the most likely diagnosis.
2. Justify your diagnosis.
3. Make and justify a plan for an additional examination of the patient.
4. Indicate the treatment plan for this patient.
5. After 1 month, the patient has no complaints. Good condition and well-being. Your
further tactics for the management of this patient.
Situational task 89 [K000325]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
Patient N. 23 years old went to the clinic on the 3rd day of illness. He got sick on June 2
acutely, when there was general weakness, chills, body aches, fever
body to 38.3 ° C, paroxysmal pains occurred in the lower abdomen. Chair 6 times per
day, at the beginning of a plentiful, then meager, mushy, with an admixture of mucus. June 3rd
feeling unwell. Body temperature was kept at 38.5 ° C,
headache, body aches persisted, abdominal pain disturbed, more on the left, stool
remained frequent (10-12 times a day). On June 4, I noticed, in addition to mucus, meager
blood streaks in feces, sometimes noted lack of stool in painful
urge to defecate. I went to the doctor. The doctor found out that the patient lives in a dormitory
for workers. He came from another city, works as a builder for hire. On the eve of
Diseases consumed unwashed fruits bought in the market.
Objectively: a state of moderate severity. Body temperature 38.1 ° C, the face is pale.
The skin is clean, dry, warm. Peripheral lymph nodes not
enlarged. Vesicular breathing, no shortness of breath. Heart sounds are slightly muffled, pulse -
92 beats per minute, satisfactory filling, not stressful. HELL - 110/60 mm RT. Art.
Tongue coated with white coating, rather dry. The abdomen is soft, painful in the area
spasmodic sigmoid colon. There are no symptoms of peritoneal irritation. Liver and
spleen not enlarged. The symptom of lumbar effusion is negative on both
parties. Diuresis is normal.
Questions:
1. Assume the most likely diagnosis.
2. Justify your diagnosis.
3. Make and justify a plan for an additional examination of the patient.
4. Indicate the treatment plan for this patient.
5. After 1 month, the patient has no complaints. Good condition and well-being. What is
Your further tactics?
Situational task 90 [K000337]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
Patient T., 21 years old, went to the clinic on the 5th day of illness with complaints of
headache in the frontal region, slight dizziness, photophobia, chills,
nasal congestion with copious mucous-serous discharge from the nasal passages.
The disease began acutely: body temperature rose to 38 ° C, appeared
moderate headache, eyeball pain, photophobia, lacrimation, burning in
eyes, severe runny nose, sore throat when swallowing. The next day and all
the following days, body temperature up to 40 ° C. The disease associates with hypothermia.
Upon examination of the patient, body temperature 38 ° C, sluggish. General condition average
gravity. Difficult nasal breathing, profuse serous-mucous discharge from
nasal passages. The eyelids are great. The conjunctiva of both eyes is sharply hyperemic. Identified
moderate hyperemia of the arches, tongue, tonsils and moderate hyperemia and granularity
back wall of the pharynx. Tonsils not enlarged. Palpable soft, painless
submandibular, cervical and axillary lymph nodes. In lungs with auscultation
hard breathing, wheezing is not heard. Pulse - 102 beats per minute, rhythmic,
satisfactory filling. Heart sounds are distinctive. The tongue is clean, moist.
The abdomen is soft, painless. The liver and spleen are not palpable. Meningeal
no symptoms.
Laboratory diagnostics.
Blood: red blood cells - 3.5 × 10 12 / l, HB - 116 g / l, white blood cells - 7.8 × 10 9 / l, eosinophils
1%, stab - 8%, segmented - 53%, lymphocytes - 36%, monocytes - 2%.
Urine: without pathology.
Chest x-ray - without pathology.
Questions:
1. Formulate and justify a preliminary diagnosis.
2. What are the diseases with which it is necessary to conduct differential
diagnostics.
3. Create a survey plan.
4. Make a treatment plan.
5. What is the tactics of the local GP?
Situational task 91 [K000341]
Дата: 2019-12-10, просмотров: 285.