Introduction into the Infectious Diseases. Infections with fecal-oral mechanism of transmission. Infections with droplet mechanism of transmission. Tests
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Sick P, 36 years, farmer, became acutely ill when the temperature of body rised. There were a chills, pain in chest, flatulence and nausea. In the moment of admition grumbles about terminal diarrhoea with 15 times day. The stool is liquid, sticky with the admixtures of pus and blood. Tongue is covered with whitecovering. Stomach is distended, painfu colon, enlarged liver is palpable. In blood neutrophilic leucocytosis with the shift of formula to the left and anemia. At a rectoscopy, deep ulcers with unequal, sharped areas which are placed along the folds was found. What disease will you think about?
Sick P., 25 years old, presents with frequent vomitting. Objectively: dryness of skin and mucous membranes, brief cramps in gastrocnemius muscles, the temperature of body is normal, voice is hoarsed, moderate tachycardia and hypotension. The compensated metabolic acidosis is marked. About what degree of dehydration is it possible to think?
Sick P., 25 years old, presents with frequent vomitting. Objectively: dryness of skin and mucous membranes, brief cramps in gastrocnemius muscles, the temperature of body is normal, voice is hoarsed, moderate tachycardia and hypotension. The compensated metabolic acidosis is marked. About what degree of dehydration is it possible to think?
Sick X., which returned from vacations from Turkey within 5 hrs in the morning, diarrhea began. Emptying each 1-1.5 hrs, with abundant watery without mucus and blood. In future bloodless watery, abundant vomitting appeared through 12 hrs. The temperature of body at first rise to 37.5 ?C afterwards became 35.7 ?C is delivered in an infectious department. What disease did you suspect?
Sick X., which returned from vacations from Turkey within 5 hrs in the morning, diarrhea began. Stool every 1-1.5 hrs, with abundant watery feces without mucus and blood. In future bloodless watery, abundant vomiting appeared through 12 hrs. The temperature of body at first rise to 37.5 C afterwards became 35.7 CC is admitted in an infectious department. What disease did you suspect?
Sick, 20 year old, apeared to the hospital with complaints about the frequent emptying without a stomach-ache, vomit without nausea, pain in calve. Objectively: temperature of body – 36,2 ?C. A skin is pale and cold, a tongue is dry, voice getting hoarse. A stomach is pulled in, painless, emptying like a “rice-water”. What are the criterias for discharging of the patient from the hospital?
Sick, 20 year old, apeared to the hospital with complaints about the frequent emptying without a stomach-ache, vomit without nausea, pain in calve. Objectively: temperature of body – 36,2 C. A skin is pale and cold, a tongue is dry, voice getting hoarse. A stomach is pulled in, painless, emptying like a “rice-water”. What are the criterias for discharging of the patient from the hospital?
Sick, 45 years old was sick for 17days, lives in a village. The sick grumbles about strong stomach-ache, frequent 15 times and more on a day emptying, nausea, vomit, headache and fever. Objectively: person is pale, eyes are hollow, the turgor of skin is sharply decreased.Tongue is dry assessed white coating, stomach is sharply blown away, at palpation pain takes place in the area of colons. Liver is moderately enlarged. At hemanalysis leucocytosis 16*109, eosinophills 1 %, ESR – 7mm/hr. Change of leucocyte formula takes place. Emptying with addition of bloods, has a pungel smell. At rectoscopy at the area sigmoid and bowels was found deep ulcers with undetermined edges. What most probable pathology which predetermines such picture?
Sick, 45 years old was sick for 17days, lives in a village. The sick grumbles about strong stomach-ache, frequent 15 times and more on a day emptying, nausea, vomit, headache and fever. Objectively: person is pale, eyes are hollow, the turgor of skin is sharply decreased.Tongue is dry assessed white coating, stomach is sharply blown away, at palpation pain takes place in the area of colons. Liver is moderately enlarged. At hemanalysis leucocytosis 16*109, eosinophills 1 %, ESR – 7mm/hr. Change of leucocyte formula takes place. Emptying with addition of bloods, has a pungel smell. At rectoscopy at the area sigmoid and bowels was found deep ulcers with undetermined edges. What most probable pathology which predetermines such picture?
Student, 22 years old fell ill within a month after return from Ethiopia.Dull stomach-ache appeared and liquid emptying. Emptying is abundant up to 10 times a day, as “raspberry jelly” excrement, stomach-ache that increase during defecation. In times of illness lost 6 kg of body weight. Your diagnosis will be?
The ill patient in severe state was delivered to infectious department with no consciousness. Pale dark circles around eyes. Skin is cold, covered with sticky sweat. Temperature of body 35.6 ?C. Pulse 140/min and weak.Blood pressure is 40 and 0 m of Hg. Tongue is dry. Emptying is involuntary and watery. Three times vomited like “fountain”.What is the state of the patient?
The ill patient in severe state was delivered to infectious department with no consciousness. Pale dark circles around eyes. Skin is cold, covered with sticky sweat. Temperature of body 35.6 C. Pulse 140/min and weak.Blood pressure is 40 and 0 m of Hg. Tongue is dry. Emptying is involuntary and watery. Three times vomited like “fountain”.What is the state of the patient?
The inhabitant of a village, admitedwith wit complaints about great pain in a stomach, and diarrhea. The stool is liquid with mixtures of blood. About what disease it is possible to think about?
V. Leptospirosis
V. Leptospirosis
Veterinarian 57 years old, on the 3rd day of disease appealed to the doctor with complaints of headache, high temperature, pain in gastrocnemius muscles, icterus, dark urine and diminishing of its amount. Objectively: temperature of body is 38 °C, sclerotic big peteachia on overhead part of thorax, hepatospleenomegaly. Most reliable preliminary diagnosis will be:
Veterinarian 57 years old, on the 3rd day of disease appealed to the doctor with complaints of headache, high temperature, pain in gastrocnemius muscles, icterus, dark urine and diminishing of its amount. Objectively: temperature of body is 38 °C, sclerotic big peteachia on overhead part of thorax, hepatospleenomegaly. Most reliable preliminary diagnosis will be:
Veterinarian 57 years old, on the 3rd day of disease appealed to the doctor with complaints of headache, high temperature, pain in gastrocnemius muscles, icterus, dark urine and diminishing of its amount. Objectively: temperature of body is 38 °C, sclerotic big peteachia on overhead part of thorax, hepatospleenomegaly. Most reliable preliminary diagnosis will be:
Woman 24, complains about colic pain in the liver area during 3 days with an irradiation in the back. Signs of icterus are absent. Last menstruation 5 weeks ago. Appointed ultrasonic research of abdominal region and small pelvis was found marked progress uterogestation. Expansion of common biliary tract, inflammation of gall-bladder, bulge of its wall, presence of crystal sediment.The extend loops of small intestines are visualized. On investigation of common biliary tract, additional ехogenic structures as a “ribbon”, which is displaced on investigation and changes form without distal acouctical shadow are found. Most probable diagnosis will be:
Woman 24, complains about colic pain in the liver area during 3 days with an irradiation in the back. Signs of icterus are absent. Last menstruation 5 weeks ago. Appointed ultrasonic research of abdominal region and small pelvis was found marked progress uterogestation. Expansion of common biliary tract, inflammation of gall-bladder, bulge of its wall, presence of crystal sediment.The extend loops of small intestines are visualized. On investigation of common biliary tract, additional ехogenic structures as a “ribbon”, which is displaced on investigation and changes form without distal acouctical shadow are found. Most probable diagnosis will be:
Woman 24, complains on heaviness in the area of liver during 3 days, with an irradiation in the back. Signs of icterus are not present. Last menstruation – 5 weeks ago. Appointed ultrasonic research of abdominal region and small pelvis was, found marked progress uterogestation. Expansion of common biliary tract, inflammation of gall-bladder, bulge of its its wall, presence of crystal sediment, extended loops of small intestines are visualized. Investigation of colonoscopy found additional exogenic structures as a “ribbon”, which is displaced in intestine and changes form without distal acoustic shade. Most probable diagnosis is:
Woman 24, complains on heaviness in the area of liver during 3 days, with an irradiation in the back. Signs of icterus are not present. Last menstruation – 5 weeks ago. Appointed ultrasonic research of abdominal region and small pelvis was, found marked progress uterogestation. Expansion of common biliary tract, inflammation of gall-bladder, bulge of its its wall, presence of crystal sediment, extended loops of small intestines are visualized. Investigation of colonoscopy found additional exogenic structures as a “ribbon”, which is displaced in intestine and changes form without distal acoustic shade. Most probable diagnosis is:
Woman 24, complains on heaviness in the area of liver during 3 days, with an irradiation in the back. Signs of icterus are not present. Last menstruation – 5 weeks ago. Appointed ultrasonic research of abdominal region and small pelvis was, found marked progress uterogestation. Expansion of common biliary tract, inflammation of gall-bladder, bulge of its its wall, presence of crystal sediment, extended loops of small intestines are visualized. Investigation of colonoscopy found additional exogenic structures as a “ribbon”, which is displaced in intestine and changes form without distal acoustic shade. Most probable diagnosis is:
A 23 years old person, became ill sharply: fever 38.2 °C, moderate diffuse pharyngalgia at swallowing, pain and itching in the right eye. Objectively: tonsillitis, pharyngitis, conjunctivitis. What is previous diagnosis?
A 25 years old patient, fell ill rapidly, with chills and temperature rose to 39,9 оC, headache appeared in frontotemporal regions, pain in eyeballs, dull pain in all trunk, closed nose. Dry cough after 2 days of illness, there was nose bleeding. Objectively: hyperemia with sputum, isolated petechial rash and shallow grittiness of soft palate. Difficult breathing in lungs. What is the most possible diagnosis?
A 4 years old child complains about: cough, temperature of body 38.1 °C. Conjunctiva is hyperemic. On mucous of cheeks there are points of hyperemia gum blushs. Weaken breathing in the lungs. What is the most possible diagnosis?
A child 10 years old with temperature 38,0 °C, conjunctivitis, moist cough, hyperemia of the mucous membranes of cheeks and lips. Gums are pallor. What is your diagnosis?
A child 3 years old is found in the grave condition – naughty, forced breathing, dry «barking» coughing, voice is hoarse, perioral cyanosis. The third day, temperature of body is subfebrile, mild common cold. In lungs single dry wheezes can be heard. Moderate tachycardia. For which disease these symptoms are characteristic?
A child of age 2 years has temperature of body 37.3 °C, cold, hoarse voice “barking cough” appeared suddenly the anxiety, shortness of breath, appeared with participation of auxiliary muscles. Supposed diagnosis?
A farmer O., 50 years old, hospitalized in a moderate condition with complaints about dryness in mouth, multiple vomitings, pain in the epigastriums and frequent watery stool. First aid to the patient is?
A patient 14 years old, hospitalized in the infectious department in severe condition with considerable headache mainly in frontal and temporal area, pain in eyeballs, in muscles and joints. Objectively: patient is excited, temperature of the body is 39 оC. Bradycardia changed by tachycardia. Muscles tonic and clonic cramps. Positive meningeal signs. It is found in epidemic anamnesis, his brother is also sick. What is your diagnosis?
A patient 17 years old, became suddenly ill: temperature rose to 40,3 °C. Severe headache, motive excitation, frequent vomiting, tremor of fingers of extremities. Hemorrhagic spots of round form and different sizes, more frequently as stars, mainly on buttocks and trunk. Meningeal signs are positive. What is the most possible diagnosis?
A patient 17 years, 11th class student, were a lot of cases of ARI (acute respiratory infection) have happened, appealed to a doctor in clinic at 3rd day of disease with complaints of chills, general weakness, a moderate sore throat, running nose, swelling of face, watering from eyes Objective examination: minor palatal hyperemia brackets and tonsillitis, on a background of moderate edema of tissues. Conjunctivitis. During palpation not painful enlarged inframaxillary lymph nodes, and enlarged neck lymph nodes were found. Crepitation can’t be find. Liver and spleen moderately increased. What is the most likely diagnosis?
A patient 18 years old, with complaints about headache, pharyngalgia, weakness, high temperature. Objectively: all groups of lymphonodes, 1-3 cm in a diameter, dense, elastic, enlarged, hepatospleenomegaly. Blood analysis: leukocytosis, mononuclear – 15 %. What is possible diagnosis?
A patient 20 years old fell ill rapidly with increasing of temperature to 39.9 °C. complains about headache in frontotemporal region, pain in eyeballs, dull ache in whole trunk, closed nose, scrapes in the throat, dry cough. There was nose-bleeding. What diagnosis is most possible?
A patient 20 years old, complains about increasing of temperature up to 39 оC, headache in frontal area, pain in eyeballs, photophobia, pain in muscles, dry cough. Became ill sharply. Objectively: severe state. Face is hyperemic, eyes brilliant, injections of scleras. Pulse 96/min, rhythmic, tones of heart are hyposthenic. Menengial symptoms are not present. Blood analysis: leuk 9?109, е 1 %, bands 6 %, seg 51 %, lymp 35 %, mono 7 %. What is the most possible diagnosis?
A patient 26 years old, became sick rapidly: temperature 39.5 оC, severe headache, mainly in frontal and temporal areas, pain in muscles and joints. Examined on the 2nd day of illness: state of middle weight, skin is clean. Moderate hyperemia with cyanosis, pulse 120 per min, rhythmic. Heart activity is rhythmic, tones are muffled, in lungs there is vesicular breathing. What is the treatment of this patient?
A patient 27 years old, entered clinic on the 4th day of illness with a diagnosis ARVI, allergodermia. Fell ill with the rise of temperature to 38,0 °C, headache, hyperemia of the throat, then barking cough appeared. On the 3rd day rash appeared on the skin and neck. Was treated by aspirin. Objectively: temperature 38.8 °C. Face is puffy, conjunctivitis. On the skin of neck and upper part of chest is abundant red-papular rashes as rings which does not itch. Mucosa of epiglottis is brightly hyperemic. Submandibular and neck lymphadenitis. Liver and spleen were not enlarged. What is your diagnosis?
A patient 52 years old, hospitalized with the severe form of viral hepatitis B. The signs of flu appeared in the department. The indexes of bilirubin rose up and transaminase falls down. What complication can arise in that patient?
A patient 56 years old, the day before felt easy indisposition, insignificant headache, and weakness. Afterwards the increasing of temperature appeared to 38,5 оC with chills, headache increased considerably, mainly in forehead and temples. Skin and conjunctiva is hyperemic, dry, barking cough. Pharynx is hyperemic. On soft palate present grainy granules, placed point hemorrhages. Difficult breathing. What is the most possible diagnosis?
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