Introduction into the Infectious Diseases. Infections with fecal-oral mechanism of transmission. Infections with droplet mechanism of transmission. Tests
Yüklə 1,25 Mb.
|
Sick E., the student of 11 class, where the noted cases of ARVI have happened, appealed to the policlinic on the 3rd day of illness with complaints about a chill, general weakness moderate pharyngalgia, cold, edema of tongue. Objectively: insignificant hyperemia of palatal tonsils on a background the moderate edema of fabrics. Conjunctivitis. Soft, unpainfull submandibular, neck and inguinal lymphatic nodes were revealed. A liver and spleen were moderate inlarged. What is most credible diagnosis?
Sick F., 16 years old, complaints about a general weakness, painfull swallowing, pharyngalgia. Objectively: the mucous membrane of mouth is brightly red, tonsils are covered by white raids, which were taken off easily, increasing of all groups of lymphonodes, 1-3 cm in diameter, dense, elastic, not soldered between itself. A liver is megascopic on 3 cm, spleen – on 1 Cm. Common blood analysis: leucocytosis, mononuclear – 20 %. What is credible diagnosis?
Sick K., 29 years old, complaints about increasing of temperature to 38.2 °C, headache, weakness, pharyngalgia, which increase at swallowing. Disease began sharply 2 days ago. Objectively: pallor of skin surface. Pulse 110 per 1 min. Tones of heart are muffled, especially first. Tender systolic noise. AT 100/65 mm Hg. Inflammatory changes of tonsils and soft palate. On the spot of tonsils pale-grey cover which spreads out of their borders, is heavy to taken off, dense. Increasing of regional lymph nodes. There is the edema of hypoderm, which reaches to the middle of the neck. What is the most credible diagnosis:
Sick patient, 25 years old, was consulted by a doctor on the third day of illness with complaints about pouring out on lips, wings of nose and ears, pain and swelling in the places of these pouring out. Objectively: temperature of body – 37.7 °C, unchanged skin of overhead lip, wings of nose, auricles, there is vesicular scars 1-2 mm with the group location. What disease you may think about?
Sick person with complaints about increase of temperature to 37,8 °C, moderate pharyngalgias during 3 days appealed to the doctor. Objectively: increasing of submandibular lymph nodes to 3 cm. Hypertrophy of tonsils, they are covered by the grey pellicle that spreads on a tongue, front palatal arches. What is most credible diagnosis?
Sick, 17 years old, became ill sharply after supercooling: fever 39,5 °C, pain of head and muscles, pharyngalgia at swallowing, aching pain at lumbar region, palpitation. Palate and tonsils are hypertrophied, bright red, in the lacunes festering raid. A lacunar quinsy is diagnosed. What method of laboratory research most effective in this case?
Sick, 24 years old, complaints on a pain in a throat, general weakness. Objectively: temperature 38,0 °C. pulse 96 shots per a min., dermahemia mucus of otopharynx bloodshot, tonsils are enlarged in sizes, loose. During palpation-enlarged posterior cervical and submandibular lymph nodes, a spleen comes forward from under the edge of costal arc on 1 cm. About what disease it is necessary to think?
Sick, 49 years old, became ill 3 days ago: fever 37,2 °C, pharyngalgia. On right tonsill grey pellicle for a gum-blush by a thickness 2-3 mm, spreads on a soft palate. Previous diagnosis: Diphtheria of right tonsill and soft palate. What method of laboratory research most effective in this case?
Sick, 49 years old, came to the doctor with complaints of pain. On the 3rd day he became ill, first marked heartburn and pain in thorax, yesterday is pouring out. At examination: temperature of body 37,8 °C, after motion of the V-VI intercostals intervals on a hyperemic skin group of the blisters filled by transparent maintenance. What is the diagnosis?
Sick, in 24, disturbs a pharyngalgia, general weakness. Objectively: temperature – 38 °C. Pulse 96 shots per min, dermahemia mucus of otopharynx bloodshot, tonsills are megascopic in sizes, loose. Palpated megascopic back neck and submandibular lymphatic knots., a spleen comes forward from under the edge of costal arc of to 1 sm. What methods of diagnostics is it possible to confirm a diagnosis by?
Student, 25 years old, has signs of acute disease – fever (t 40 °C), rapid intoxication, headache, sore throat. Objective status: tonsil is swollen with thick gray-white pellicle, which is hardly removed with bleeding, pellicle is not soluble. Doctor supposes it is diphtheria of pharynx. What is the most rational tactic of treatment?
The boy 12 years old, with catarrhal phenomena seen an increase of all the lymph nodes, sclera, hyperplasia of tonsils white layers on them as islands, existing single maculo-papular rash, increased liver and spleen size. What additional research should appoint?
The otolaryngologist during the review of patient marked hyperemia, considerable edema of tonsills with the grey raid on them. During the microscopy of raid it was found out sticks located under a corner to each other. What disease does it follow to think about?
The patient, 58 years old, was hospitalised in the infectious department with complaints of pain in the left half of thorax, fever. At a review: temperature of body 37.5 °C, in XI-XII intercostal area the grouped shallow blisters on a hyperemic-filling background are filled by transparent maintenance. Preparation of choice for treatment of this patient is:
The patients, 20 years old, with 5 days fever, pain in the throat during swallowing, pain in muscles. During review – there is thick, congested tonsils with purulent layers that are easily removed, enlarged neck, and inframaxillary lymph glands, liver + 1.5 cm possible palpation of edge of spleen. What additional research should be done?
The sick 49 years old grumbles about pain at swallowing, weakness, fervescence to 38,7 °C. Skin pale. In the area of tonsills, tongue and soft palate considerable edema hyperemia accented cyanochroic and greyish dense pellicle. The pellicle are not taken off. Megascopic front-neck lymphonoduss, edema of hypoderm of neck to the first neck fold. Tones of heart are deaf, pulse 100 shots per minute, BP 120/90 mm Hg. What from the methods of research is not obligatory?
To the infectious diseases department was admitted patient M. 58 years old, with complains of pain in left part of thorax, fever. During a review: body temperature 37,5 ?C, on the level of XI–XII intercostals spaces on hyperemic-edemous shadow grouped small vesicles with transparent content. Preparation of choice for treatment of this patient?
With epidbonfire hospitalized sick Н. 23 years old with a diagnosis diphtheria of pharynx, widespread form. At the review of pharynx on tonsills pellicles stratifications of color of gum-blush accented mother-of-pearl, which were heavily taken off by a spatula, a surface bleed under them. When will she can be written out?
Young 17 years patient complaints about headache, pharyngalgia, increasing of temperature. He feels bed during 2 days. At examination: the state is severe, temperature – 38.5 °C, hyperemia of mucous of oropharynx, edema of pellicles stratifications on tonsils. Increasing of lymphatic nodes, edema of soft tissues of the neck. What is previous diagnosis?
Two girls came to a hospital, because they had 38 0С fever, a headache, weakness, dizziness, and a pain in epigastry and round a navel, a nausea, vomiting 3 times, excrements 4 times per a night, watery diarrhea, foamy, fetid, with mucus impurity. It is known from the history that the day before the girls ate pastries with cream which were not stored in a refrigerator. Objectively: a tongue is dry, furred by white touch, the stomach is bloated moderately, rumbles in palpation, painful in epigastry, pulse is 80 bpm, and the blood pressure is 110/70 mm mercury column. To define the diagnosis.
Two girls came to a hospital, because they had 38 0С fever, a headache, weakness, dizziness, and a pain in epigastry and round a navel, a nausea, vomiting 3 times, excrements 4 times per a night, watery diarrhea, foamy, fetid, with mucus impurity. It is known from the history that the day before the girls ate pastries with cream which were not stored in a refrigerator. Objectively: a tongue is dry, furred by white touch, the stomach is bloated moderately, rumbles in palpation, painful in epigastry, pulse is 80 bpm, and the blood pressure is 110/70 mm mercury column. To make the treatment plan.
A 17 years old boy, got ill suddenly: the temperature rose up-to 40,3 °С, extremely sharp headache, makes him to yell. The patient is agitated and vomits frequently. Tremor of fingers of extremities is observed. The star like hemorrhagic rash of different form and sizes appeared, mainly on buttocks, thighs, shins, and trunk. Meningeal signs are positive. What is the most credible diagnosis?
A 17 years old boy, got ill suddenly: the temperature rose up-to 40,3 °С, extremely sharp headache, makes him to yell. The patient is agitated and vomits frequently. Tremor of fingers of extremities is observed. The star like hemorrhagic rash of different form and sizes appeared, mainly on buttocks, thighs, shins, and trunk. Meningeal signs are positive. What is the most credible diagnosis?
A 24 y/o man .was seen by a doctor on the 2d day of illness with complaints about a fever up-to 38,1 °C, painful swallowing, malaise. On the skin of trunk and extremities, especially in natural folds, point rash on hyperemic background was faund. The nasolabial triangle was white with no rash. Enantema on a soft palate, and purulent exudates on tonsils were observed. A few enlarged and painful submandibular lymph nodes were palpated. What is the most probable diagnosis?
A 24.y/o man was seen by a doctor on the 2d day of illness with complaints about subfebrile temperature, and insignificant catarrhal phenomena. On the skin of trunk and extremities spotted-papular elements of rash without a tendency to congregate was observed. The mucous membrane of oro-pharinx was not changed. A few enlarged and painful cervical lymph nodes were found. What is the diagnosis?
A 24.y/o patient was seen by a doctor on the 2d day of illness with complaints about a fever up-to 38 °C, headache, and malaise. On the skin of hairy part of head, runk and extremities vesicular rash with red hallow was found. Also some vesicular elements were found on the mucous membrane of pharynx. Lymph nodes were not palpable. What is the most probable diagnosis?
A 4 years old child complains about: cough, temperature of body 38,1 °C. Skin without rashes. Conjunctiva hyperemic. Exanthema on skin. On mucous of cheeks there are points of hyperemia gum blushs. In lungs difficult breathing. What is the most possible diagnosis?
A child 10 years old presents with temperature 38 °C, renitis, conjunctivitis, moist cough. On the mucous membrane of cheeks, lips, gums there are greyish-white points, reminding a farina. What is the 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 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 became ill sharply. Severe pain of head, frequent vomits appeared in the morning. Temperature of body rose to 39,9 °C. Adopted febrifuge, however much the state got worse. Till the evening patient lost consciousness. Excited, sharply expressed meningeal signs. What is most reliable diagnosis?
A patient became ill sharply. Severe pain of head, frequent vomits appeared in the morning. Temperature of body rose to 39,9 °C. Adopted febrifuge, however much the state got worse. Till the evening patient lost consciousness. Excited, sharply expressed meningeal signs. What is most reliable diagnosis?
A patient C., 25 years old, fell suddenly ill. Every morning severe headache, frequent vomiting, temperature of the body is 39,9 °C. Adopted fatigue, then state got much worse. In the evening lost of consciousness. Expressed muscles pains of back and head. Positive Кеrning’s symptom. Leukocytes – 18,0?109. What is the most reliable diagnosis?
A patient C., 25 years old, fell suddenly ill. Every morning severe headache, frequent vomiting, temperature of the body is 39,9 °C. Adopted fatigue, then state got much worse. In the evening lost of consciousness. Expressed muscles pains of back and head. Positive Кеrning’s symptom. Leukocytes – 18,0?109. What is the most reliable diagnosis?
A patient is sick with meningococcal meningitis. He take a massive dose of penicillin. 4 days temperature of body 36,6-36,8 °C. Meningeal signs are negative. When is it possible to stop the antibiotic therapy.
A patient is sick with meningococcal meningitis. He take a massive dose of penicillin. 4 days temperature of body 36,6-36,8 °C. Meningeal signs are negative. When is it possible to stop the antibiotic therapy.
A patient sharply had a chill, head pain, vomits, temperature of body rose up to 38,5 °C. Till evening rigidity of muscles, Kernig symptom appeared. Herpetic blisters are marked on mucouse of lips and nose. Neurological symptoms is not found out expressed. What disease will you suspect?
A patient sharply had a chill, head pain, vomits, temperature of body rose up to 38,5 °C. Till evening rigidity of muscles, Kernig symptom appeared. Herpetic blisters are marked on mucouse of lips and nose. Neurological symptoms is not found out expressed. What disease will you suspect?
A patient with meningococcal meningitis gets penicillin during 7 days. Last 4 days temperature of body is normal. Meningeal signs are absent. When is it possible to abolish an antibiotic?
A patient with meningococcal meningitis gets penicillin during 7 days. The temperature of body is normal 4 days. Meningeal signs are negative. When is it possible to stop the antibiotic therapy.
A patient with meningococcal meningitis gets penicillin during 7 days. The temperature of body is normal 4 days. Meningeal signs are negative. When is it possible to stop the antibiotic therapy.
A patient with meningococcal meningitis gets penicillin during 7 days. Last 4 days temperature of body is normal. Meningeal signs are absent. When is it possible to abolish an antibiotic?
A patient, 20 years old, during few days complains about pharyngalgias. After supercooling the state became worse : sudden chills, increase of temperature to 40,6 °C, headache. On skin of lower extremities trunk and buttocks there are a lot of different sizes of hemorragic spots, acrocyanosis. Consiouness is preserved. Meningeal signs are absent. What is the previous diagnosis?
A patient, 20 years old, during few days complains about pharyngalgias. After supercooling the state became worse : sudden chills, increase of temperature to 40,6 °C, headache. On skin of lower extremities trunk and buttocks there are a lot of different sizes of hemorragic spots, acrocyanosis. Consiouness is preserved. Meningeal signs are absent. What is the previous diagnosis?
A patient’s temperature is 40 °C. There are olso deep and unproductive cough, photophobia, face puffiness whitish points on the mucous membrane of cheeks opposite molar teeth. What is the most possible diagnosis?
Among the students of PTU 2 cases of generalized form of meningococcal infection are registered. What preparation does it follow to enter to the contact persons with the purpose of urgent prophylaxis?
Among the students of PTU 2 cases of generalized form of meningococcal infection are registered. What preparation does it follow to enter to the contact persons with the purpose of urgent prophylaxis?
?At a patient with meningococcal meningitis 44 years old, rose up general clonic-tonic cramps, abundant sweat, hyperemia of person, bradycardia quickly changed on tachycardia, violation of breathing (Cheyne-Stokes type). What complication develop?
?At a patient with meningococcal meningitis 44 years old, rose up general clonic-tonic cramps, abundant sweat, hyperemia of person, bradycardia quickly changed on tachycardia, violation of breathing (Cheyne-Stokes type). What complication develop?
At a patient with meningococcal meningitis, in 52, there was the syndrome of cerebral hypotension on the 6th day of illness. Objectively: expressed toxicosis and dehydration of organism, meningial symptoms disappeared, muscles tones was low and areflexia developed. What complication arose up?
At a patient with meningococcal meningitis, in 52, there was the syndrome of cerebral hypotension on the 6th day of illness. Objectively: expressed toxicosis and dehydration of organism, meningial symptoms disappeared, muscles tones was low and areflexia developed. What complication arose up?
At a patient with meningococcal nasopharynsitis in 2 days from the beginning of illness the temperature of body rose to 41°С, head pain, vomit, positive Kernig and Brudzinsky symptoms appeared. In cerebrospinal liquid: cytosis 15 000 in 1 mkl, 90 % are neutrophils. What diagnosis?
At a patient with meningococcal nasopharynsitis in 2 days from the beginning of illness the temperature of body rose to 41°С, head pain, vomit, positive Kernig and Brudzinsky symptoms appeared. In cerebrospinal liquid: cytosis 15 000 in 1 mkl, 90 % are neutrophils. What diagnosis?
At a patient, 35 years, sharp beginning of disease happened. Symptoms of nasopharyngitis. Body temperature – 39,5 °С, head ache, which is accompanied with vomits, myalgias. Hemorrhagic rash, that are localized on scleras, brushes, feet, buttocks. Rigidity of cervical muscles, Kernig and Brudzinsky symptoms are expressed. Neutrophilic leucocytosis in common blood analisis.What is most credible diagnosis?
At a patient, 35 years, sharp beginning of disease happened. Symptoms of nasopharyngitis. Body temperature – 39,5 °С, head ache, which is accompanied with vomits, myalgias. Hemorrhagic rash, that are localized on scleras, brushes, feet, buttocks. Rigidity of cervical muscles, Kernig and Brudzinsky symptoms are expressed. Neutrophilic leucocytosis in common blood analisis.What is most credible diagnosis?
Etiology agent of meningitis is:
For the treatment of acidosis at meningococcal meningitis is better to use.
How is it possible to specify the diagnosis of meningococcal meningitis.
In a patient, 27 y.o., on the 5th day of respirator disease, there was sharp head pain, that was accompanied by nausea, repeated vomits, hyperesthesia, photophobia. At a review: lies with the neglected head, feet are bended to the trunk, expressed rigidity of muscles of the back of head, positive symptoms of Kerning’s, Brodzinsky’s. It is not found out paresises. Select a basic neurological syndrome.
In a patient, 27 y.o., on the 5th day of respirator disease, there was sharp head pain, that was accompanied by nausea, repeated vomits, hyperesthesia, photophobia. At a review: lies with the neglected head, feet are bended to the trunk, expressed rigidity of muscles of the back of head, positive symptoms of Kerning’s, Brodzinsky’s. It is not found out paresises. Select a basic neurological syndrome.
In a patient, 35 y.o., sharp beginning of disease, precedingnasopharyngitis, t° 39,5°C, headache, which is accompanied with vomits, myalgias, hemorrhagic rash, that is localized on sclera, fists, feet, buttocks; rigidity of cervical muscles, symptoms of Kering’s and Brudzinsky’s are positive, expressed neutrophilic leukocytosis. What most credible diagnosis?
In a patient, 35 y.o., sharp beginning of disease, precedingnasopharyngitis, t° 39,5°C, headache, which is accompanied with vomits, myalgias, hemorrhagic rash, that is localized on sclera, fists, feet, buttocks; rigidity of cervical muscles, symptoms of Kering’s and Brudzinsky’s are positive, expressed neutrophilic leukocytosis. What most credible diagnosis?
In the kindergarden a child had a meningococcal infection. She was immediately hospitalized. After clinical convalescence in child sowed meningococcus. To which category can the carrier (child) of pathogen belongs?
In the kindergarden a child had a meningococcal infection. She was immediately hospitalized. After clinical convalescence in child sowed meningococcus. To which category can the carrier (child) of pathogen belongs?
In what daily interval should the dose of benzylpenicillin at meningococcal meningitis administered.
In what dose should| benzyl penicillin be administered at meningococcal meningitis?
Meningococemia and DIC-syndrome require above all things.
Patient ?. 27 years old, was admited on the 4th day of illness with the diagnosis of viral URTI, and allergic dermatitis”. The patient felt ill suddenly with increase of temperature up-to 38 °C, headache, sore throat, and intensive cough. On the 3d day rash appeared on the skin of neck and face. Patient was taking aspirin in order to decrease the temperature. Objectively: temperature of body 38,8 °C. The face of patient looks puffy. Signs of conjunctivitis, and renitis were observed. On the skin of neck face and chest there was intensive papular rash, without itch. Mucous membrane of oropharynx was brightly hyperemic. Submandibular and frontal neck lymph nodes were enlarged. The liver and spleen were not palpable. What is the diagnosis?
Patient A 24y/o. Appealed on the 5th day of illness with complaints about cough, malaise, fever up-to 38,1 °C. On face and behind the ears maculo-papular rash, appeared a day ago, and other areas of skin are without rash. Conjunctiva is hyperemic. Enantema on a soft palate, on the mucous membrane of cheeks are whitish points with the halo of hyperemia. There is the hard breathing in the lungs. Most credible diagnosis is
Patient A., 23 years suddenly experienced intensive head pain, nausea, pain in a neck, and lumbar. Examination is delivered in a clinic. Objectively: hemorrhagic rashes on a body. Temperature 40,2 °C. Expressed meningeal symptoms. Light, haptic, pain hypesthesia. Blood: leucocytes – 25 thousand/l, ERS-29 mm/hr. A neurolymph is turbid, neutrophilic erythrocytosis, meningococci. What is your diagnosis?
Patient A., 23 years suddenly experienced intensive head pain, nausea, pain in a neck, and lumbar. Examination is delivered in a clinic. Objectively: hemorrhagic rashes on a body. Temperature 40,2 °C. Expressed meningeal symptoms. Light, haptic, pain hypesthesia. Blood: leucocytes – 25 thousand/l, ERS-29 mm/hr. A neurolymph is turbid, neutrophilic erythrocytosis, meningococci. What is your diagnosis?
Patient B., 38 years, delivered by emergency doctor, anamnesis is unknown. However, according to neighbours, patient 2 days ago was healthy. At a review: consciousness is absent, motion of left overhead and lower extremities is absent, increasing of muscular tone is marked in the same extremities. Periodically are clonic-tonic cramps in right extremities. Expressed asymmetry of person. Sharply expressed rigidity of muscles of the back of head, positive Кеrnig symptom, positive overhead and lower Brudzinsky symptom. On the skin of overhead and lower extremities, buttocks, trunk abundant hemorrhagic rashes “star shape” character with necrosis in a center. Acrocyanоsis is marked, temperature of body 38,8 °С, hyperemia of pharynx Breathning 36/min, unrhythmical. Vesicular breathing during auscultation. Pulse 72/min, weak filling and tension. Heart tones are muffled, AP 80/50 mm/hg. Tongue is dry, assessed by the white raid. Physiology sending in a norm. Your diagnosis?
Patient B., 38 years, delivered by emergency doctor, anamnesis is unknown. However, according to neighbours, patient 2 days ago was healthy. At a review: consciousness is absent, motion of left overhead and lower extremities is absent, increasing of muscular tone is marked in the same extremities. Periodically are clonic-tonic cramps in right extremities. Expressed asymmetry of person. Sharply expressed rigidity of muscles of the back of head, positive Кеrnig symptom, positive overhead and lower Brudzinsky symptom. On the skin of overhead and lower extremities, buttocks, trunk abundant hemorrhagic rashes “star shape” character with necrosis in a center. Acrocyanоsis is marked, temperature of body 38,8 °С, hyperemia of pharynx Breathning 36/min, unrhythmical. Vesicular breathing during auscultation. Pulse 72/min, weak filling and tension. Heart tones are muffled, AP 80/50 mm/hg. Tongue is dry, assessed by the white raid. Physiology sending in a norm. Your diagnosis?
Patient D., 30 y.o., teacher, examined by the doctor of first-aid and delivered to a clinic on the 2nd day of illness. Fell ill sharply, temperature 40 °C, sharp head pain, repeated vomits photophobia. The general condition is severe, consciousness is darkened. On the skin of stomach, buttocks and lower extremities is зірчаста rash. Sharply expressed rigidity of neck muscles, positive Kernig symptom. Pulse 100 min, weak; tones of heart deaf, AP 60/30 mmHg. Your diagnosis?
Patient D., 30 y.o., teacher, examined by the doctor of first-aid and delivered to a clinic on the 2nd day of illness. Fell ill sharply, temperature 40 °C, sharp head pain, repeated vomits photophobia. The general condition is severe, consciousness is darkened. On the skin of stomach, buttocks and lower extremities is зірчаста rash. Sharply expressed rigidity of neck muscles, positive Kernig symptom. Pulse 100 min, weak; tones of heart deaf, AP 60/30 mmHg. Your diagnosis?
Patient D., 30 years, have been examined by emergency doctor and delivered in a clinic on the 2th day of illness. Fell ill sharply, temperature 40 °С, sharp head pain, repeated vomits, photophobia. The common state is severe, consciousness is darkened. Star-like shape rashes at the skin of abdomen, buttocks and lower extremities appeared. Sharply expressed rigidity of cervical muscles, positive Kernig symptom been present. Pulse 100/min, weak, tones of heart seak, BP 60/30 mm/hg. Your diagnosis?
Patient D., 30 years, have been examined by emergency doctor and delivered in a clinic on the 2th day of illness. Fell ill sharply, temperature 40 °С, sharp head pain, repeated vomits, photophobia. The common state is severe, consciousness is darkened. Star-like shape rashes at the skin of abdomen, buttocks and lower extremities appeared. Sharply expressed rigidity of cervical muscles, positive Kernig symptom been present. Pulse 100/min, weak, tones of heart seak, BP 60/30 mm/hg. Your diagnosis?
Patient K., 21 y.o.., the disease began from the increase of temperature to 39,0°C, headache, chill, repeated vomit. Objectively: temperature of 39,3°C, pulse 76 tense. Rigidity of muscles of the back of head. The tendon reflexes are expressed. Analysis of liquor: cytosis 1237 in 1 ml, from them: 84 % neutrophiles, 16 % lymphocytes, reaction to Panda ++, albumen 0,66 g/l, liquid is turbid, flows out under the promoted pressure. Bacterioscopy found out in liquor gram.(-) cooks morphologically similar with meningococcus. What disease is most reliable?
Patient K., 21 y.o.., the disease began from the increase of temperature to 39,0°C, headache, chill, repeated vomit. Objectively: temperature of 39,3°C, pulse 76 tense. Rigidity of muscles of the back of head. The tendon reflexes are expressed. Analysis of liquor: cytosis 1237 in 1 ml, from them: 84 % neutrophiles, 16 % lymphocytes, reaction to Panda ++, albumen 0,66 g/l, liquid is turbid, flows out under the promoted pressure. Bacterioscopy found out in liquor gram.(-) cooks morphologically similar with meningococcus. What disease is most reliable?
Patient S., 20 years old refered to the doctor with such complaints: prodromal respiratory illness, sore throat, fever, headache, stiff neck, vomiting, confusion, irritability. Previous diagnosis. What main methods can confirm the diagnosis?
Patient S., 20 years old refered to the doctor with such complaints: prodromal respiratory illness, sore throat, fever, headache, stiff neck, vomiting, confusion, irritability. Previous diagnosis. What main methods can confirm the diagnosis?
Patient Н., 21 year, entered hospital on the 7th day of disease with complaints about the expressed weakness, pains in muscles and joints, head pain, nausea. The disease began with irritation on the throat, chill, general weakness. After 2 days the state became worse, temperature increased to 39-40°С. Objectively: patient adynamic, consciousness is stored. Temperature of body 37,5 °С, the state as severe, pale skin, lips and nail phalanxes cyantic, hemorrhagic rashes on the skin of trunk and hands, the scopes of heart are extended to the left on 1,5 cm, tones deaf, pulse 130/min, weak filling, BP 80/40 mm/hg. Vesicular breathing. Tongue is assessed, moist, phenomena of pharyngitis present. Inlargement of neck lymphonodes. Meningeal symptoms are not present. Oliguria. What is previous diagnosis?
Patient Н., 21 year, entered hospital on the 7th day of disease with complaints about the expressed weakness, pains in muscles and joints, head pain, nausea. The disease began with irritation on the throat, chill, general weakness. After 2 days the state became worse, temperature increased to 39-40°С. Objectively: patient adynamic, consciousness is stored. Temperature of body 37,5 °С, the state as severe, pale skin, lips and nail phalanxes cyantic, hemorrhagic rashes on the skin of trunk and hands, the scopes of heart are extended to the left on 1,5 cm, tones deaf, pulse 130/min, weak filling, BP 80/40 mm/hg. Vesicular breathing. Tongue is assessed, moist, phenomena of pharyngitis present. Inlargement of neck lymphonodes. Meningeal symptoms are not present. Oliguria. What is previous diagnosis?
Patient, 15 y.o., became ill 3 days ago. Complains of headache, закладеність nose, pain in a throat, temperature of 37,4°C. Next days : headache increased, a temperature risen to 38,3°C, repeated vomits. Objectively: a skin is pale, without rash. Mucous membrane of posterior wall of throat is moderately hyperemic, swollen. Pulse 86, satisfactory filling. Meningeal signs are positive. What is needed to conduct the selection of pathogen:
Patient, 15 y.o., became ill 3 days ago. Complains of headache, закладеність nose, pain in a throat, temperature of 37,4°C. Next days : headache increased, a temperature risen to 38,3°C, repeated vomits. Objectively: a skin is pale, without rash. Mucous membrane of posterior wall of throat is moderately hyperemic, swollen. Pulse 86, satisfactory filling. Meningeal signs are positive. What is needed to conduct the selection of pathogen:
Patient, 16 y.o., during 3 days there was a increase of temperature to 38 °C, sore throat, indisposition. Next 2 days felt better. A temperature was normal. There was a chill on a 6th day, a temperature rose to 40 °C, intensive, quickly increased headache, through 3 hours – repeated vomits. The state is heavy, consciousness is absent, psychomotor violations expressed meningeal signs. Meningitis is suspected. What is its etiology?
Patient, 16 y.o., during 3 days there was a increase of temperature to 38 °C, sore throat, indisposition. Next 2 days felt better. A temperature was normal. There was a chill on a 6th day, a temperature rose to 40 °C, intensive, quickly increased headache, through 3 hours – repeated vomits. The state is heavy, consciousness is absent, psychomotor violations expressed meningeal signs. Meningitis is suspected. What is his etiology?
Patient, 23 y.o., suddenly experienced intensive head pain, nausea, pain in a neck and lumbar area.. БШМД is delivered to the clinic. Objectively: on a body hemorrhagoc rash.. Temperature of 39,2°C. Expressed meningeal symptoms. Light, tactile, pain hyperesthesia. Blood: leucocytes-25x10 9/l, ESR-29 mm/hour. What method of inspection is most informing?
Patient, 23 y.o., suddenly experienced intensive head pain, nausea, pain in a neck and lumbar area.. БШМД is delivered to the clinic. Objectively: on a body hemorrhagoc rash.. Temperature of 39,2°C. Expressed meningeal symptoms. Light, tactile, pain hyperesthesia. Blood: leucocytes-25x10 9/l, ESR-29 mm/hour. What method of inspection is most informing?
Person 16 years entered permanent establishment on 6 day of illness. Illness began from a cold and cough. Temperature 37,7 °C. The state became worse: severe head pain, frequent vomits unconnected with a meal appeared. The common state is heavy. Pupils are extended, photoharmose is not present. Positive meningeal symptoms. General hyperesthesia. Tones of heart are deaf, BP 100/50 mm/hg. What reliable diagnosis?
Person 16 years entered permanent establishment on 6 day of illness. Illness began from a cold and cough. Temperature 37,7 °C. The state became worse: severe head pain, frequent vomits unconnected with a meal appeared. The common state is heavy. Pupils are extended, photoharmose is not present. Positive meningeal symptoms. General hyperesthesia. Tones of heart are deaf, BP 100/50 mm/hg. What reliable diagnosis?
Sick 15 year old, became ill 3 days back. Disturbed| headache, running nose, pharyngalgia, temperature of 37,4 °C. Next days: headache increased, a temperature had rose to 38,3 °C, repeated vomiting. objectively: a skin is pale, without rash. Mucus of the posterior wall of pharyx moderate bloodshed filling out. Pulse 86/min satisfactory filling. Meningeal signs positive. It is needed to conduct for the selection of exciter.
Sick 15 year old, became ill 3 days back. Disturbed| headache, running nose, pharyngalgia, temperature of 37,4 °C. Next days: headache increased, a temperature had rose to 38,3 °C, repeated vomiting. objectively: a skin is pale, without rash. Mucus of the posterior wall of pharyx moderate bloodshed filling out. Pulse 86/min satisfactory filling. Meningeal signs positive. It is needed to conduct for the selection of exciter.
?Sick C., 8 years, appealed to the infectious hospital on the second day of disease with complaints about a pharyngalgia at swallowing, increase of temperature. Objectively: temperature 38,6 °C, sharp hyperemia of soft palate, tonsills, filling out, loose, on both there are festering stratifications which are taken off by a spatula. Megascopic sickly submandibular lymphonoduses are palpated. Pulse – 114 per a min. Present roseol-papular pouring out on all body. Pastia‘s symptom is positive. It is known from epidemogical anamnesis, that its comrade had alike symptoms. It is not found out the change from the side of other organs. What previous diagnosis can be suspected?
Sick C., 8 years, appealed to the infectious hospital on the second day of disease with complaints about a pharyngalgia at swallowing, increase of temperature. Objectively: temperature of body – 38,6 °C, sharp hyperemia of soft palate, tonsills, filling out, loose, on both there are festering stratifications which are taken off by a spatula. Palpated megascopic, sickly submandibular lymphonoduses. Pulse – 114 shots per min. Present roseol-papular pouring out on all body. Pastia symptom is positive. It is known from epid anamnesis, that at its comrade were alike symptomes. It is not found out the change from the side of other organs. What previous diagnosis can be suspected?
Sick, 54, hospitalized in an infectious department in a severy condition. Complaint about the expressed headache, mainly in frontal and temporal areas, superciliary arcs, origin of vomit on height of pain, pain at motions by eyeballs, in muscles and joints. Objectively: a patient is excited, temperature of body 39 °C, BP?100/60 mm Hg. Bradycardia changed by tachycardia. There were tonic cramps. Doubtful meningeal signs. From anamnesis it is known that at home a woman is ill. What preparations must be entered?
Sick, 54, hospitalized in an infectious department in a severy condition. Complaint about the expressed headache, mainly in frontal and temporal areas, superciliary arcs, origin of vomit on height of pain, pain at motions by eyeballs, in muscles and joints. Objectively: a patient is excited, temperature of body 39 °C, BP?100/60 mm Hg. Bradycardia changed by tachycardia. There were tonic cramps. Doubtful meningeal signs. From anamnesis it is known that at home a woman is ill. What preparations must be entered?
Source of meningitis is:
What antibiotics preparations of choice of etiotropic therapy at a meningococcal infection.
What are the rules| at taking of smear material on the discovery of meningococal infection?
What is taken for serum research for confirmation of meningococcal infection?
What is used as specific prophylaxis in the period of epidemic spreading of meningococcal infection.
What laboratory methods should be taken to discharge meningitis?
What measures are conducted in the place of meningococcal infection?
What temperature terms is it needed for cultivation of meningococcal on artificial mediums?
When does the laboratory give the results of bacteriological examination of smear from throat?
Which preparation has a bacteriostatic action, and is more expedient to begin etiotropic therapy in the case of infectious toxic shock.
Witch of these symptoms are often present in patients with meningitis?
Family (three persons) came to permanent establishment with the disease which is connected with the use of fish can food of the domestic making. These patients had a similar clinic: violation of sight, clouds before eyes, impossibility to read a small font, they appealed to the oculist. What link of pathogenesis is characteristic for this disease?
Worker, 22 y.o., became ill sharply: t 39°C, great pain of head, frequent vomits. Objectively: the condition is severe, psychomotor excitation, moans due to the great pain of head, expressed rigidity of neck muscles. Sharply positive symptoms of Brudzinsky’s and Kernig’s, general hyperesthesia. What needs to be done for clarification of diagnosis?
Test to figures
|