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ANSWERS ON QUESTIONS
Main part
Patient A., 18 years old, a student, fell ill 4 days ago when body temperature
increased to 38 ° C, weakness, body aches, headache appeared.
The general practitioner diagnosed an acute respiratory disease,
prescribed treatment at home.
On the 5th day of illness, the temperature decreased, but dark urine appeared, on the 6th day -
yellowness of the skin and sclera.
Re-examined by a general practitioner. Sent to a hospital.
An objective examination showed ictericity of the skin and
visible mucous membranes, adynamia. The tongue is covered with a thick, white coating. Plain belly
forms, soft, sensitive in the right hypochondrium. The liver is enlarged by 3 cm,
tight elastic consistency, sensitive. The spleen is not palpable. Urine
the color of "beer", feces are acholic.
At the same time, several more students fell ill.
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 93 [K000351]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
A 32-year-old male slaughterhouse worker complained of persistent pain in
lower back, prolonged fever.
Considers himself ill for a year. When first contacting a doctor,
the local therapist was diagnosed with the flu.
During the examination, marked soreness along the sciatic
nerve, in the subcutaneous tissue of the lumbosacral region, dense
painful formations of an elongated form, a positive symptom of Lasseg,
enlarged liver and spleen.
Questions:
1. Assume the most likely diagnosis.
2. Justify the diagnosis.
3. Make and justify a plan for an additional examination of the patient.
4. What rehabilitation methods do you recommend to the patient? Justify your choice.
5. What etiotropic treatment should this patient have received with the right
diagnosis at initial medical attention?
Situational task 94 [K000354]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
A 32-year-old patient came from Uzbekistan 7 days ago. The disease began with
increase in temperature to 38 ° C, weakness, loss of appetite. Within 5 days
temperature in the morning 38 ° C, in the evening 39 ° C, headache, weakness increased, disappeared
appetite, delayed stool, insomnia. When examined by a general practitioner
day of illness - moderate severity, temperature 38.4 ° C, sluggish, dynamic.
The skin is pale, dry, on the skin of the abdomen revealed a rose-colored single rash. In the lungs without
pathology. Heart sounds are muffled, blood pressure - 90/60 mm RT. Art., pulse - 78 beats per minute.
The tongue is covered with a thick gray coating at the root, teeth imprints on the lateral surfaces.
The abdomen is swollen, palpation is soft, painless. Palpated liver and spleen.
Hospitalized.
Questions:
1. Assume the most likely diagnosis.
2. Justify your diagnosis.
3. Make and justify a laboratory diagnostic plan to confirm
the diagnosis.
4. Which group of drugs would you assign to the patient as part of a combination
etiotropic therapy? Justify your choice.
5. List pathogenetically caused and dangerous complications in this
disease.
Situational task 95 [K000356]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
Call the local GP physician to the patient P. 19 years old regarding complaints
for sharp cramping abdominal pains, frequent painful urges to defecate (in
the first 6 hours of the disease, the stool cannot be counted), headache, dizziness,
chills, fever up to 39 ° C. He fell ill acutely 6 hours ago when he appeared
the above complaints. On examination: the patient is in serious condition. Listless, pale
the skin is dry, clean. Pulse - 100 beats per minute. Vesicular breathing.
Heart sounds are muffled, blood pressure - 90/60 mm RT. Art. The tongue is wet, covered with gray coating.
The abdomen is slightly swollen, with palpation painful along the colon,
distinct soreness and spasm of the sigmoid colon. Tenesmus. The chair is sparse
calcite-free, in the form of a lump of bloody mucus.
Questions:
1. Assume the most likely diagnosis.
2. Justify your diagnosis.
3. Make and justify a laboratory diagnostic plan to confirm
the diagnosis.
4. Which group of drugs would you assign to the patient as part of a combination
therapy? Justify your choice.
5. List anti-epidemic measures and tactics for members
the family of patient P. with whom he lives: mother - an employee of the catering department, sister -
office manager and 5-year-old niece, attends DDU.
Situational task 96 [K000358]
Дата: 2019-12-10, просмотров: 271.