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Situational tasks
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Situational tasks
TASK 1
At questioning of patient A. 26 years, plasterer, it is set that he breakfasts and has a supper at home, has dinner in to the dining-room of the building combine. According to a patient is found out that on June 11 in 2 hours after dinner at work felt off, went home. At home pains appeared in area of stomach, vomiting, weakness. A patient paid attention to the off-flavour at kissel, which he took during the dinner. Objective information: temperature of body 37, pulse - 76 in min., breathing without features. A stomach is soft. Small illness in area of stomach. A chair is normal. Nausea. A patient marks astringent taste in to the mouth.
Put and ground the diagnosis of disease. How to confirm a diagnosis? What documents is under an obligation a doctor to process in this case? Specify hygienic measures for the prophylaxis of similar diseases.
TASK 2
At the inspection of patient I. it is set: a patient is 30 years, collective farmer, feeds at home. Food stuffs, including flour, gets in a collective farm. 10 May, approximately at 12 o'clock, felt a somnolence, numbness of fingers of hands, sense of crawl of small ants, difficulty of unbending of hands and feet, appeared. The twitch of muscles of person, difficulty of swallowing, appeared then. Objective information: temperature of body of 36, 80C. Pulse and breathing without features. Convulsive twitch of muscles of shin. Small sickliness of stomach. Nausea. Dizziness. For the last 2 months 3 cases of similar diseases appeared in his village.
Put and ground the diagnosis of disease. How to confirm a diagnosis? What documents is under an obligation a doctor to process in this case? Offer hygienic and prophylactic measures in this case.
TASK 3
At the inspection of child T. 5 years it is set: on June 20 after dinner middle group of kindergarten with a nursery governess went for a walk in the field, picked flowers. A walk proceeded 1, 5 hour. On returning a nursery governess noticed at a child the sharp turning red of person, hoarseness of voice and extended pupils. Objective information: turning red of person. Temperature of 380C, pulse 140, tense. Breathing is frequent. The mucous cavities of mouth are dry. Hoarseness of voice. Pupils are strongly extended. A child is excited, restless, there are visual hallucinations.
Put and ground the diagnosis of disease. How to confirm a diagnosis? What documents is under an obligation a doctor to process in this case? What prophylactic measures must be conducted in nursery school?
TASK 4
At the inspection of patient of Å. it is set in order of the first aid: a patient is 18 years, student, feeds in a student dining-room. From conversation with it is found out by a patient, that on May, 18 felt dryness in to the mouth, difficulty of swallowing, sight became worse (sees as in fog). Disorder of chair was not. Objective information: temperature of body of 36, 80C. Pulse 70, good filling. A stomach is painless, soft at pressing on. Pupils are extended and is irresponsive on light, small ptimalum, dryness mucous to the cavity of mouth. Voice is hoarse, small lowering of soft palate.
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Put and ground the diagnosis of disease. How to confirm a diagnosis? What documents is under an obligation a doctor to process in this case? Name medical and prophylactic measures in this case.
Task 5
The child of 3 months (mass is 6 kg) is on the artificial rearing by mixture «Kid». With the purpose of prophylaxis of rickets a doctor appointed adopting the vitamin of D. Mother did not adhere to settings, in place of 3 drops gave to 10 drops in a day during 3 months. A mother marked that a child had become languid, eats badly, after feeding periodically there is vomiting, drinks voraciously, once or twice there was a liquid chair. At examination skin covers are pale, clean, the turgor of fabrics is mionectic, large spring-fed 1, 5x1, 5 sm, the mucous are dry. Pathologies of internals are not exposed. At laboratory research the big maintenance of salts of calcium is exposed in urine.
Define reason of this state of child. Specify day's dose of vitamin of D. Give necessary recommendations. How to conduct the prophylaxis of rickets in this case?
TASK 6
The group of students resident in a dormitory appealed to the doctor of policlinic with complaints about a general weakness, somnolence, rapid fatigueability, sanguifluousness of gums, slight swelling. It is set at questioning, that students feed not regularly, often by can foods, concentrates. Examination gives the presence of hematousness and sanguifluousness of gums.
Put a preliminary diagnosis and give his ground. What objective adequate methods of research of these students can you offer? What methods is it possible to conduct the mass inspection by with the scope of all students resident in a dormitory? Give recommendation on the prophylaxis of similar diseases.
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