Introduction into the Infectious Diseases. Infections with fecal-oral mechanism of transmission. Infections with droplet mechanism of transmission. Tests
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Leptospirosis Epidemic typhus * Flu Enteroviral infection A patient 56 years old, workwomen of pig farm, on a background chills appeared, the temperature rose to 39,9 °C, headache, nausea. The next day marked pains in the muscles of lower extremities appeared, the nose bleeding began. At the receipt, on the 3rd day common state deteriorated. Hyperemic spots, subecteric appeared. Liver +3 cm. Daily – diuresis 700 ml. What is the previous diagnosis?
A patient A., 30 years old, on the 4th day of illness a district doctor marked such subjective and objective data: insignificant indisposition, mild headache, hoarseness of voice, itching in throat, breakingdry cough, temperature of the body 37,4 °C. Pulse 86/min., difficult nasal breathing, insignificant serous excretions from nose. Which acute respiratory infection does the patient carry?
A patient admitted in the infectious department with diagnosis of acute respiratory viral infection. Became ill suddenly, the disease is accompanied by the increase of temperature of body till 39 °C, by severe headache, mainly in area of frontal, temporal, above eyes, dryness in nose, itching in throat, dry cough, dull pain in all body. He had bleeding from nose twice at home. Which acute respiratory disease has the patient?
A patient becomes sick very fast: chills, increasing of temperature to 40,1 оC, headache in frontal and temporal regions, pain in eyeballs, close nose, dry cough and pain in the chest. The nose bleeding, nausea, double vomits. Objectively: conjunctivitis, hyperemia, edema, hemorrhages in mucous of otopharhynx, tachycardia. Blood pressure is low. Difficult breathing . What is the most possible 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., was hospitalized on the 2nd day of illness with complaints about hoarseness of voice, rough barking cough, labored breathing. Objectively: the state is severe, uneasy, pallor, temperature 37.1 °C, BR 30/min., breathing is noisy, can hear from the distance, with participation of auxiliary musculature. Which viruses could cause development of similar state?
A patient caused a doctor home. Age – 75 years. Complaints of a subfebrile temperature, general weakness, pharyngalgia, conjunctivitis. In family a child is ill the acute adenoviral disease. A patient considers itself a patient the second day. At a review are found out the signs of acute blepharoconjunctivitis, pharyngitis. There are megascopic lymphatic knots: neck front and back, arm-pits and inguinal, to 1 sm in a diameter, soft, not is soldered between itself and with a surrounding cellulose. A pharynx is hyperemic, tonsills are hypertrophied and hyperemic. In lights of wheezes it is not. Breathing clean. Tones of heart are muffled. BP is 140/80 mm Hg. Ps – 80 per 1 minute. Stomach soft. A megascopic liver which comes forward on 3 cm below costal arc and spleen are palpated – soft, painless. Choose the most credible diagnosis:
A patient fell ill very rapidly: chills, increase of temperature to 40.1 °C, headache in frontotemporal regions, pain in eyeballs, close nose, dry cough, and chest pain. Nose bleeding, nausea, vomiting appeared after 4 hours. Objectively: conjunctivitis, hyperemia, edema, point hemorrhages in mucus of epiglottis, tachycardia. Blood pressure is low. Weaken breathing in the lungs. What is the most possible diagnosis?
A patient H., 22 years old, with flu was hospitalized into infectious department with the acute worsening of the common state. Consiousness is stored. The patient strangles. Pallor of skin with cynosis. Respiratory rate 50 per min, AP 80/55 mmHg, pulse 110 per a min, temperature 39.8 оC. During percussion of lungs tympanic sound with dullness in lower quadrant was found. Crackles in the lower-back parts of lungs. What complication of influenza has developed in that patient?
A patient J., 23 years old, became ill suddenly. Profuse diarrhea with frequent and large amount vomits. A patient arrived from one of countries of south-east Asia, where was near 3 weeks. T 36,1 °C. An abdomen is pulled in, painless. The stool has the appearance of rice-water. What most reliable changes will be in a blood?
A patient K., 23 years old, with 3 days of moderate illness, with high temperature of body to 40.0 °C, headache and petechial rash on skin, is hospitalized. After introduction of penicillin at 2 o’clock, the BP fell down to 40/10 mm of hg. Peripheral pulse and мeningeal signs does not concerne. What is the diagnosis of the patient?
A patient L., who returned from Crimea, developed diarrhea at 5AM. Bowel movements are each 1-1.5 hrs, watery, without mucus and blood. In 12 hrs a single episode of vomiting developed. The temperature of body at first rise to 37.3 C, stomach-aches is present. he was examined by the doctor of first-aid and delivered to an infectious isolation with the diagnosis of acute intestinal infection.Which disease is most probable for the patient?
A patient of 5 years old, which treated at home on an occasion of flu by aspirin, calcium gluconatis, on the second day from the beginning of disease “coffee grounds” vomiting appeared, melena. What complication arises?
A patient on the background of ARVI the fever developed to 40,1 °C, frequency of breathing is 40 for a minute. What measures are necessary?
A patient P., 14 years old, is hospitalized in the infectious dept. in grave condition. Complaints on headache, mainly in frontal and temporal regions, superciliary arcs, vomiting on severe pain, pain on movement of eyeballs, in muscles, joints. Objectively – a patient is excited, temperature of the body 39 °C. BP 100/60 mmHg. Bradycardia was replaced by tachycardia. Tonic cramps appeared. Doubtful meningial signs. From anamnesis it is found that at home his brother has flu. What preparations must be injected?
A patient with flu complicated by pneumonia, during some days there are the displays of infectious-toxic shock of ІІ degree. In BA the level of urea and creatinine increases. What from these preparations is not recommended to enter in such a situation?
A patient with temperature of body 40.0 °C, nonproductive cough, photophobia, puffiness of face, dots on gums, blushes on the mucus of cheeks your diagnosis?
A patient Т., 45 years old, was hospitalized at the 2nd day of disease. One week ago got back from India (sailor of the distant swimming). Complains of temperature 41.3 °C, great headache, shortness of breathing; cough with foamy pink colour sputum. Objectively: pale of face, cyanosis of mucous, breath rate 24/min, tachycardia. Lungs: breathing is hyposthenic, moist wheezes in both lungs, crepitation. What is possible 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 the skin of low extremities, trunk and buttocks there are a lot of different sizes hemorrhagic spots, acrocyanosis. Consiouness is preserved. Meningeal signs are absent. What is the previous diagnosis?
A patient, 75 years old, called a doctor to home. Rashes and subfebrile temperature, general weakness, pharyngalgia, conjunctivitis. In family a child is ill with acute adenoviral disease. A patient considers himself ill on the second day. At a review there are signs of pharyngitis. There are enlarged lymphatic nodes: of neck, front and back, armpits and inguinal up to 1 cm in diameter, soft. Pharynx is hyperemic, tonsils are hypertrophy and hyperemic. Both lungs have wheezing sounds. Not clean breathing. Tones of heart are muffled. AP 140/80 mm Hg. Heart rate 80 for 1 minute. Stomach is soft. Enlarged liver 3 cm below costal arch and spleen is palpable. Palpation is soft, painless. Choose the most possible diagnosis:
A sick 15 years old, 3rd day of illness. On the background the catarrhal pneumonia, weakness in hands appeared, double vision, cross-eye. Voice is weak. Palatoplegia and extended extremities. Pulse 90/min. AP 130/90 mm Hg .What is your previous diagnosis?
A Sick 18 years, hospitalized in an infectious department with diagnosis of cholera, as heavy as lead motion, dehydration of IV degree. What measures are possible primarily?
A sick 19 years old, fell ill rapidly, when a temperature rose to 39,2 °C, coughing appeared, closed nose. Pains in muscles and joints. On the 3rd day of disease, shallow spots on the trunk appeared, extremities with hyperemia and edematous feet. Generalized lymphadenopathy, hyperemia of cheeks, enlargement of the liver were found out. What is previous diagnosis?
A sick 70 years old, became ill sharply, the temperature of body rose to 39.2 °C, excited, euphoric, hyperemia of face, Rozenberg’s exanthema appears. Ricketsia titer is 1:160, IgG – 87 %. What is diagnosis?
A sick explorer of train, 39 years old is hospitalized on the 4th day of illness with complaints about headache, weakness, dizziness, chills, insomnia, fever. The person is hyperemic, conjunctivitis. On the transitional fold of conjunctiva there is a single rash. On the skin of trunk, thorax, stomach, extremities there are abundant red coloured rashes. Tachycardia. AP 100/60 mm of Hg. Tremor of tongue. Liver and spleen were enlarged. Stool fistula is detained. What is the most reliable diagnosis?
A sick person, 45 years old, was hospitalized after 2 days of disease. On Sunday he came back from India (sailor). Complains about increasing of temperature to 41 оC, severe headache, shortness of breath, cough, with sputum. Objectively: pallor, cyanosis of mucous, tachycardia. Breathing is weaken, crackles in the lower-back parts of the lungs, crepitation. What is the possible diagnosis?
A sick woman, 42 years old, complaints about temperature 39.3 °C, headache in the frontal area, pain in the eyeballs, photophobia, pain in muscles, dry cough. Became ill suddenly one day before. Objectively: state is severe. Hyperemia of the face, eyes shinny, injection of scleras. Pulse 96/min., rhythmic. Tones of heart are hypotonic. Both lungs are dissipated. Dry wheezes. Mucosa of epiglottis is hyperemic, grainy, vessels are extended. Meningeal symptoms are not present. Analysis of blood: leuk – 3?109/l, еos – 1 %, band – 6 %, seg – 51 %, lymp – 35 %, mono – 7 %. What is the most possible diagnosis?
A sick, 29 years, emptying watery stool repeatedly, frequent vomiting. Objectively: total cyanosis, dryness of mucus membrane, turgor of skin is decreased Temperature of body 35,2 ?C. Pulse in radial artery is not determined. Tachypnea, musle spasm, urination is absent for 6 hours. What is the state of the patient?
A sick, 54 years old, hospitalized in infectious department in the grave condition. Complaints about expressed headache, mainly in frontal and temporal areas superciliary arcs, origin of vomiting on peak of pain. Objectively: patient is excited, temperature of body 39 оC, AP 100/60 mm Hg. Bradycardia changed to tachycardia. Tonic cramps, meningeal signs appeared. From anamnesis it is known that father is also sick. What treatment should be prescribed?
A student, 18 years old, for 7 days complains about weakness, hyperthermia to 37.8 °C, mucous excretions from a nose, pharyngalgia at swallowing, pain in eyeballs. Objectively: increased lymph nodes of neck and mandible, lymphadenitis, edema and injection of conjunctiva, hyperemia of mucous of epiglottis, hypertrophy of tonsils. What is the most reliable diagnosis:
A woman 27 years old, complaints about the general weakness, absence of appetite, coughing, fever up to 37.5 °C for three weeks. Ulcerous illness of stomach, myocarditis is in anamnesis. What inspection is primarily need to do?
A woman who came back from a tour trip, the next day called emergency help. It is known from the anamnesis, that within a week the temperature of body was moderately high. Complains of bad sleep and bad appetite, pain in the stomach. During the assessment of the sick it is found out roseolas on the pale skin of breasts and abdomen. Pulse is normal, temperature of body 38,2 °C, hepatospleenomegaly. What is your previous diagnosis?
An unconscious patient is delivered in the intensive department. Pale dark circles around eyes. Skin is cold with sticky sweat. Temperature of body 35,6 ?C. Pulse 140/min and weak. Blood pressure is 40 /0 mm of Hg. Tongue is dry. Emptying is involuntary and “watery”, vomited twice. What infusion must be given as intensive therapy.
At patient with pediculosis rapidly rise temperature of body up to 41.2 °C, headache, euphoria appeared in 4 days from the beginning of illness. Red colour rash on the lateral thorax and back. Titer of Rickettsia antibodies 1:640, Ig M – 89 %. What is diagnosis?
Citizen of Pakistan, 30 years became ill rapidly with frequent watery stool which appears like a rice water. Objectively: temperature of body 35.4 ?C, skin is cold, acrocynosis, elasticity of skin and turgor is decreased. By what method may estimate the degree of dehydration?
For a patient E., 37 years old, a disease began rapidly, 6 hours the frequent liquid emptying appeared onto the plain rise of normal temperature of body, vomit joined then. At an inspection: aphonia, eyes are hollow, pulse frequent, threadlike, low blood pressure cramps appeared in lower extremities. Liver and spleen are not enlarged. Choose preparations for starting etiotropic therapy.
For a patient E., 37 years, bodyweight of 70 kg, frequent liquid emptying appeared with rise of body temperature, frequent vomiting joined in later. At an inspection: aphonia, eyes are hollow, pulse with frequent threadlike, blood pressure is not determined, tachypnea, total cramps. Liver and spleen are not enlarged. What volume of salt solutions must be entered for primary rehydration?
For a patient in 35, the disease begun rapidly with a chill, increase of temperature to 39 ?C, vomitting, pain in epigastrium, diarrhea with the watery stinking emptying. 6 hours before the disease he ate a raw egg, potato with the braised meat and drink juice. What exciter did cause the similar state probably?
For the rehydration in dehydration shock it is necessary to conduct the permanent careful account of all losses of liquid in each:
In a patient of 16 years old, the disease began gradually, from the catarrhal syndrome. For 2-3 days the temperature of body increase till 38,5 °C, cold, severe cough with the negligible quantity of mucous sputum, «souring» eyes. Peripheral lymph nodes are soft, painless and some enlarged. Mucous of pharynx is hyperemic, granules on posterior part of pharynx. General state is satisfactory. What is the drug of choice?
In girl V., 1 year old, appeared the thump of nose, dry cough, body temperature rose till 37,5 ?C. Next day cough become attack like with the excretion of small amount of viscid sputum. Noisy breathing. Sharply expressed expiratory dyspnea, breating rate 40 times/minute. During examination: acrocyanosis and emphysematous thorax, at lungs dissipated dry and single moist rales. Tear of frenulum of tongue. What will be the preliminary diagnosis? Yüklə 1,25 Mb. Dostları ilə paylaş:
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