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ANSWERS ON QUESTIONS
Main part
Patient A., 18 years old, called a local doctor-general practitioner for complaints about
weakness, fever. For 7 days, headache, temperature 38
° C, malaise. Treated on an outpatient basis, the diagnosis of ARVI. On the 8th day of the disease appeared
dark urine, others noticed yellowness of the skin and sclera, in connection with which
hospitalized.
Objectively: ictericity of the skin and visible mucous membranes, adynamia. Notes
minor skin itching. Heart sounds are muffled, pulse - 58 beats per minute, blood pressure -
95/60 mmHg Art. The abdomen is sensitive to palpation in the right hypochondrium.
The liver protrudes 2 cm below the edge of the costal arch, the edge is elastic, sensitive
on palpation. The spleen is not palpable. The urine is the color of “beer,” the stool is discolored. Known
that several people at the place of study fell ill with jaundice.
Hospitalized.
Questions:
1. Assume the most likely diagnosis.
2. Justify your diagnosis.
3. List and justify the clinical syndromes of the peak period of the disease.
4. Draw clinical and pathogenetic parallels between clinical and
pathogenetic syndromes of this disease.
5. Create and justify a laboratory diagnostic plan.
Situational task 97 [K000361]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
Call the local GP therapist. Patient A., 41 years old, became ill acutely 6
hours ago, when the “fog and grid” appeared before my eyes (I couldn’t read the newspaper),
a few hours later a double vision appeared in front of my eyes. Vomiting, diarrhea,
there was no dry mouth. On examination: the general condition is satisfactory. Data
ophthalmometry: decreased visual acuity in both eyes, diplopia, ptosis, mydriasis. Pupils
do not respond to light. Heart sounds are muffled. The pulse is rhythmic, 80 beats per minute.
10 hours before the disease, she ate pickled mushrooms of her own canning.
Her husband and mother, who developed similar symptoms, ate mushrooms with her.
Questions:
1. Assume the most likely diagnosis.
2. Justify your basic diagnosis.
3. Make and justify a laboratory diagnostic plan to confirm
the diagnosis.
4. Which drugs would you assign to the patient as part of
combination therapy? Justify your choice.
5. List the activities in the epidemic focus of the disease.
Situational task 98 [K000362]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
Patient R. 30 years long living in Southeast Asia, turned with
complaints of constant abdominal pain, profuse mushy stool with impurity
mucus and blood. On examination: the patient's condition is moderate. temperature 37.3 ° C.
Pulse - 74 per minute. Vesicular breathing. The tongue is wet, covered with gray coating.
The abdomen is slightly swollen, with palpation painful along the colon,
distinct soreness and infiltration of the sigmoid colon. Fecal stool
mixed with mucus and blood.
Questions:
1. Assume the most likely diagnosis.
2. Justify your diagnosis.
3. Make and justify a plan of examination of the patient in order to confirm
the diagnosis.
4. What drugs would you assign to the patient as part of a combination
etiotropic therapy? Justify your choice.
5. List the dangerous complications of this disease.
Situational task 99 [K000380]
Instructions: READ THE SITUATION AND GIVE EXPLAINED
ANSWERS ON QUESTIONS
Main part
Patient E., 42 years old, turned to the district physician with complaints of
the appearance in the back of a ring-shaped bright pink formation with a diameter
about 15 cm, which was not accompanied by subjective sensations; noticed him
by chance the night before.
From the anamnesis it is known that about 2 weeks ago I was in the forest. After that
independently removed the tick.
On examination, the condition is closer to satisfactory, body temperature 37.5 ° C.
On the skin of the back, in the area of the right shoulder blade, it is clearly delimited from normal skin
area of hyperemia with slightly raised edges, bright pink. Palpation in
the projection of this formation is painless. Pulse - 78 beats per minute,
satisfactory qualities. Heart sounds are rhythmic, muffled. The stomach is soft
painless. The liver and spleen are not enlarged.
Questions:
1. Establish a preliminary diagnosis based on the data obtained, taking into account
syndromic approach and justify it.
2. Give the etiological characteristics of the pathogen, presumably
the cause of the disease, what are the sources of infection and the route of infection.
3. What are the diseases with which it is necessary to conduct differential
diagnostics.
4. What will be the therapeutic tactics at the stage of providing outpatient
outpatient care?
5. List preventative measures to prevent
this disease.
Situational task 100 [K000391]
Дата: 2019-12-10, просмотров: 252.