Introduction into the Infectious Diseases. Infections with fecal-oral mechanism of transmission. Infections with droplet mechanism of transmission. Tests
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Patient 38 y.o., entered infectious hospital with complaints of nausea, vomits, схваткоподібний abdominal pain, chills. Became ill suddenly three hours after since he ate meat salad in the cafe. Common state of middle severity, temperature 37,8 C, pulse – 90 in a min, AP 110-60 mmHg. Abdomen is painful in epigastria, emptying- liquid, 1 time without admixtures. What research need to be conducted for confirmation of diagnosis of toxic food-borne infection?
Patient 45 years old, became ill within 10 hours after consumption of grinded meat. Complains of vomiting, pain in epigastric region, diarrhea of green color, increasing of temperature up to to 39 °C. During objective examination revealed that: patients general condition is sever, pain in the muscles of the lower limbs, pale face, acrocyanosis. Pulse 130 per min,. B.P 70/40 mm Hg. weak cardiac sounds, dry tongue, brown-whitecovering . abdomen cramps, painful iliac and epigastric regions. What is the most likely diagnosis.
Patient B., 32 years old, an employ of poultry was hospitalized with complains of pain in abdomen, mostly in sigmoid area, fever up to 38,8 ?C, nausea, vomiting, diarrhea with dark-green colour of stool, without any pathological changes. Skin and mucous membranes are dry, moderate tension in epigastric region and pain in the right iliac area. The most likely diagnosis.
Patient B., 36 years old, complains for a great headache, general weakness, insomnia, fever to 39,7 °C. Fell ill gradually. Objectively: skin is pale, on a abdomen are singles roseolas. A tongue with the imprints of teeth and white raid, edges and tag is clean. Flatulence. A liver and spleen is enlarged. Dulling of percussive sound is in a right iliac area. Pulse 70 per a min, BP 100/60 mm Hg. In lights there are the dissipated dry wheezes, hard breathing. Blood test: leycocytosis 3,1?109/l, RSE 25 mm/hour, eos. 0 %, n/n 9 %, s/n 51 %, lymphs. 31 %, monocyts 5 %. What is the most credible diagnosis?
Patient B., 38 years old, became ill quickly: appeared frequent vomit with the admixtures of meal, pain in epigastriums, green watery stool, increases of temperature, to 39 °C. Objectively: state severe. Pains in the muscles of lower extremities. Expressed pallor acrocianosis. Pulse 120 per a min, frequent, BP 80/60 mm Hg. Tones of heart are muffled. A tongue is dry, assessed by the whiter-brown coat. A stomach is blown away, painful in epigastria and ileocecal regions. 12 hours before to the disease ate a galantine. What is the most credible diagnosis?
Patient B., 38 years old, came to the admission department with the complains of fever up to 38 °C, vomiting 4 times in a day, diarrhea up to 6 times in a day. During objective examination revealed that B.P 125/75 mm Hg, pulse 80 per min, abdomen is soft,painful in the right iliac and epigastric area .According to anamnesis he took salad of boiled eggs and sausage. What treatment should be started first.
Patient B., 55 years old, was hospitalized in an infectious hospital with complains on frequent vomiting, liquid excrements, abdominal pain, mainly in the right iliac area and epigastrium. Pale skin, dry tongue with a touch of gray, hypotension, tachycardia. The doctor was suspected salmonella. What laboratory test is need to perform.
Patient C, 27 years old, complaints of headache, weakness, pain in the epigastral area, repeated vomits, diarrhoea (9 per day, greenish colour). He eats raw chicken eggs 12 hours before the disease. Objectively: temperature 38,8 °C. A tough is coated by the white coat, pain in the epigastria and peryumbilical area. What diagnosis is most reliable?
Patient C. with the complains of diarrhea with mucus, stabing pain in epigastric area , rumbling in the stomach, fever. According to his anamnesis he took preserved milk, eggs, salad of fresh vegetables. What is the disease most likely.
Patient C., 17 years old, working vegetable base. Acutely ill, 2 days ago. His illness is linked to eating dirty roots. The disease started with chills, body temperature increase to 38,1 ?C, headache, pain in muscles and joints of all groups, weakness, nausea, Cramping in the stomach around the navel, in epigastrium, diarrhea up to 5 times. Excrements liquid, viscous, bed smell, normal colour. Objective inspection: scleritis, conjunctivitis, hyperemia of soft palate, “raspberry” tongue. In palpation of abdomen - the moderate morbidity in epigastrium. What is diagnosis.
Patient C., 22 years old, hospitalized in an infectious department complaining of chills, temperature increase to 38,5 ?C, vomiting, pain in epigastrii, frequent stool. 7 hours before the disease, ate raw eggs, potatoes with braised meat, drink tomato juice. What kind of organism most likely to cause disease.
Patient C., 30 years old, was hospitalized with a preliminary diagnosis of salmonellosis. Body temperature – 40 °C, repeated vomiting, profused diarrhea. Hypotension (BP 55/30 mm Hg), expressed tachycardia (pulse to 120/min), face pale, pain mainly in right iliac area and epigastrium, hepatosplenomegaly were found. What treatment tactic will be most effective in this case.
Patient C., 35 years old, the disease has started severe chills, raising the temperature to 39 ?C, vomiting, pain in epigastric region, diarrhea with water-smelly bowel movement. Over 6 hours after eating raw eggs, potatoes with braised meat, drank juice. What kind of agent is likely to cause this condition.
Patient C., 36 years old, periodically goes on a business trip in Egypt, desperately ill. Complaints about the increasing body temperature up to 39,4 ?C with chills and sweating, pain in the right under rib, emaciation. A slight jaundice. Increased liver density, painful. In blood neutrophils leukocytosis, increased ESR. When USD revealed multiple liver abscesses. What kind of illness need to think.
Patient D., 13 y.o., hospitalized with complains of nausea, переймоподібні abdominal pains, liquid emptying without pathological admixtures with an unpleasant smell 6 times per day. The day before had a supper by meat salad. What is a first aid?
Patient F., 25 years old, was hospitalized in the infectious hospital with complains on frequent vomiting, liquid stool, abdominal pain in epigastrium. Pale skin, dry tongue with a grey cover, hypotension, tachycardia. The doctor was suspected salmonella. What serologic study is need to perform.
Patient G., 22 years old, hospitalised in an infectious department complaining of chills, stabing pain in epigastrium, diarrhea, temperature increased up to 39,6 °C, repeated vomiting. Feces copious, watery, without pathological changes. 4 hours before the onset of symptoms ate the meat, salad. What is the most appropriate drug to be prescribe.
Patient G., 24 years old., at 6 am after taking his breakfast with boiled eggs, a cup of coffee appeared chill, fever up to 38,8 ?C, pain in left inguinal area, nausea,vomiting, rumbling in the stomach, then frequent diarrhea, feces copious, watery, mudy-green. What is the most likely diagnosis.
Patient I., 28 years old, hospitalized on the 9th day of illness with complaints about the increase of temperature to 39,2 °C, headache, general weakness, absent of defecation. There are singles roseolas on the abdomen, pulse 78 per a min, a liver + 2 cm. What is credible diagnosis?
Patient K., 20 years old, 8 hours ago eated mushroom. She complained about lacrimation, salivation, abdominal cramps, diarrhea, vomiting. What is the previous diagnosis?
Patient K., 30 y.o., a sensitiveness to the cold, nausea, vomits, pain in epigastria and around umbilicus. Vomits frequent. The temperature of body rarely rose to the high numbers. A skin is pale, dry. A tongue is covered by the white or grey cover. Pulse frequent, arterial pressure low. 2 hours prior to the origin of symptoms fed in a dining-room. What is the most possible diagnosis?
Patient K., 30 y.o., the disease began from diarrhea; defecation is not accompanied by an abdominal pains and increase of temperature. Vomits arose up later, without nausea and did not bring facilitation. Dehydration of organism developed quickly. With similar clinics his wife was admitted yesterday. What is the most possible diagnosis?
Patient K., 30 years old, came with complains of nausea, vomiting, pain in epigastrium and paraumbilical area. High body temperature, pale skin, dry. tongue covered with whitish-gray coating. quick pulse, low blood pressure. 2 hours before the onset of symptoms of the disease he ate in cafe. What is the diagnosis most likely.
Patient K., 40 years old, hospitalised with the diagnosis of intestinal infection. Complaining general weakness, headache and diarrhea. Symptomes appeared suddenly 2 hours after consumption of cake with custard. Suddenly there were chills, nausea, profuse repeated vomiting, frequent diarrhoea, abdominal pain and short-term loss of consciousness, temperature increased to 38,6 °C. What is the preliminary diagnosis?
Patient K., 40 years old, hospitalised with the diagnosis of salmonellosis, with symptoms of rise of body temperature to 40 °C, repeated vomiting, diarrhea. Objectively: AP 60/20 mm Hg, pulse 120/minute, pale face, increased intestinal peristalsis, enlarged liver and spleen. What is the best treatment.
Patient L., 20 years old, had appendectomy on the 5th day of disease. During operation was found an appendix with the signs of catarrhal inflammation and hyperplasia of lymphatic nodes of mesentery. After a day his state became severe: temperature – 40 °C, with hallucinations, hepatosplenomegaly. Single roseols elements appeared on the skin of abdominal on a 10th day. The tongue is great, covered with grey coating, with the imprints of teeth, wound is in normal. In the analysis of blood is leucopenia, relative lympho- and monocytosis. In anamnesis was contact with a patient with typhoid fever. What is the most credible diagnosis?
Patient L., 32 years old, was admitted to the infectious office complaining of chills, headache, expressed general weakness, cutting pain in epigastrii, diarrhea. The temperature of 39 °C, repeated vomiting. Excrement abundant, greenish color, without pathological impurities. Over 4 hours to illnesses used the meat salad in the factory canteen. Which drugs will be most effective for the treatment of this patient.
Patient L., 33 years old, admitted to the hospital with the complains of untolarable pain in the abdomen, mostly in sigmoid region, fever up to 38,8 ?C, nausea, vomiting , diarrhea of dark-green colour in every1-1,5 hour, without admixture of blood and mucus. The condition progressively deteriorated, increasing hypotension, paleness, weak cardiac sounds, decreased intestinal peristalsis with moderate tension in epigastric region and pain in the right iliac region. What tactics of treatment?
Patient L., 43 years old, entered to the clinic of infectious diseases with a diagnosis „fever not clearing etiology”. He has been ill 15 days: temperature of body – 39,3 °C. Skin is pale. Pulse – 86 per a min, satisfactory properties. BP is 110/70 mm Hg. Tongue is dry, assessed by the coverings, with the imprints of teeth on a lateral surface. On a stomach are 10-12 roseolas to 5 mm in a diameter. A liver and spleen is enlarged. What is the most credible diagnosis?
Patient N., 22 years old, was admitted to the infectious office complaining of chills, headache, expressed general weakness, cutting pain in sigmoid area, diarrhea. The temperature of the body of 39,3 °C, vomiting. Faces watery. Patient was used the salad with sausage and eggs. For further diagnosis doctor was prescribed RIGA with salmonella diagnosticums. When it’s necessary to take blood for the investigation.
Patient N., 30 years old, works in a restaurant, admitted to the hospital complaining of unbearable pain in the abdomen, increase of temperature 38,8 ?C, nausea, vomiting, diarrhea of dark-green colour, He took eggs, mushrooms, canned food. Objective state: general condition is moderately sever, skin and mucous membranes are dry, pain in epigastric region. Name the disease.
Patient P., 45 years old, entered on consultation, with a diagnosis „fever not clearing etiology”. He has been ill 8 days. The disease developed gradually, appeared headache, insomnia, adynamia. Temperature – 39,5 °C, skin is pale. Pulse – 88 per a min. A tongue on a center is assessed by the thick grey coat. A stomach is exaggerated, grumbles in a right iliac region. A liver and spleen is enlarged on 2 cm. What is the most credible diagnosis?
Patient R., 35 years old, entered to the clinic on the ninth day of illness with complaints of the increased Т to 39,0 °C, headache, general weakness, delay of emptying, violation of sleep. At a review: on the skin of abdomen are single roseollas, a tongue is assessed by the brown covering, Ps. 78 shots in a min., rhythmic, a liver is enlarged for 2сm. What is reliable diagnosis?
Patient S., 23 years old, became ill at the end of summer, when a temperature rose to 37,2 °C, insignificant headache, weakness appeared. To 7 day of illness treated oneself ambulatory as an ARI (acute respiratory infection). The state became worse, hospitalized in permanent establishment. Temperature – 40 °C, pale, weakness. Pulse 96 per a min, BP 110/70 mm Hg. Tongue with the imprints of teeth, abdomen soft, distended, hepatosplenomegaly. Stool is not present. There is hyperemia and hyperplasia of palatine tonsils, on the surface of right palatine tonsils are ulcers. What disease is it needed to think about?
Patient T., 30 years old, fell ill suddenly, when appeared chill, increased a temperature to 39,9 °C, appeared pain in a epigastria region, frequent vomiting, in 25 min – diarrhea, with the unpleasant smell of emptying. The amount of urine diminished on the 3th day of illness. What diagnosis is most the credible?
Patient U., who arrived from the Crimea, at 5 o'clock in the morning appeared diarrhea in an intervel of 1-1.5 hour. with copious watery increments, without admixtures of mucous and blood. He was admtted in an infectious dipartment with the diagnosis of "acute intestinal infection". What laboratory tests are necessary to confirm the etoilogical diagnosis.
Patient with a diagnosis “typhoid fever” is hospitalized in an infectious hospital. He lives in the isolated apartment with a woman and two children. What preparations is the mean defense from typhoid fever for persons with contact with the patient?
Patient Н., 28 years old, entered to the clinic on the ninth day of illness with complaints of the increased Т to 39,0 °C, headache, general weakness, delay of emptying, violation of sleep. At a review: on the skin of abdomen are single roseollas, a tongue is assessed by the brown covering, Ps. 78 shots in a min., rhythmic, a liver is enlarged for 2сm. What changes will be from the side of the cardio-vascular system?
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