Questions oske 5 course
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Questions OSKE 5 course 1 . At the patient with epilepsy twilight frustration of consciousness developed.
2. At the patient of 28 years the syndrome developed sharp depressive and crazy.
3.The patient has the chronic alcoholism, the second stage.
4 . The patient of 37 years after divorce with the husband had irritability, irascibility, mood differences with tearfulness, sensitivity, • Specify symptoms of mental violation. • Your preliminary diagnosis. • Preventive 5. The patient has a depression with suicide thoughts. In the anamnesis suicide attempt. • Specify symptoms of mental violation. Preventive 7. The patient of 32 years has an increased mood, is verbose, гипердинамичен. It is stirred sexually up. I spent all money for unnecessary things. Doesn't sleep.
8. Patient of 49 years. I transferred sharp violation of brain blood circulation. In half a year decrease in memory, ingenuity is noted, became confused, constantly cries.
9. At the patient psychomotor excitement developed.
10. The patient of 23 years arrived in therapeutic office with an exacerbation of rheumatism. Soon I began to behave inadequately, it was disoriented in a place and time, about myself I supplied the correct information. Looks around, something looks for, sees behind a window black silhouettes. The fear, motive concern increased in the evening.
11 . On reception mother with the son of eight years. Complaints to poor progress, difficulties of training, despite diligence of the pupil. During conversation concreteness of thinking, impossibility to carry out generalizations comes to light. The lexicon is poor. • Your preliminary diagnosis. Preventiv 12 . The patient of 24 years arrived with complaints to irritability, irascibility, mood swings which appeared in 16 years. The last year the specified lines amplified, became aggressive to native, gives protest reactions. • Your preliminary diagnosis. • Plan of diagnostic inspection. • Preventive 13 . The patient is 47 years old. Abuses alcohol within 12 years, freshens the nip. The last 3 days I stopped drinking then the dream worsened, I began to feel fear in the evening, there were visual hallucinations. I ran behind vodka in the morning and it was brought down by the car, received heavy bsi with consciousness loss. Specify symptoms of mental violation. Your preliminary diagnosis. • Preventive 14 . The patient during 3х receives days a haloperidol in injections. On 4й day there was a constraint, increase of a muscular tone, a rare blinking. Define a condition and your actions • Specify structural components of a condition. • Preventive 15 . The patient To. 37 years, with alcoholic beverages got acquainted in 17 years. In the last 5 years hard drinkings for 20-25 days are observed. The disease was preceded by hard drinking lasting a month. Within several days the sleep was interrupted. Next day I "heard" that behind a window two men speak about it, call by name, invite to drink. I ran down the street, I asked to help it, hid at neighbors. At survey: it is disturbing, suspicious, focused in a place of time, own personality. From time to time feels the most severe fear. I shouted that it rescued, didn't allow to kill. "Voices" takes for the real. • Your preliminary diagnosis. • Preventive 16 . The patient of Page, 33 years, abuses the last 3 years alcoholic beverages, often freshens the nip. Once the wife came with the girlfriend who praised highly and admired the new colleague. After leaving of the girlfriend quarreled with the wife, " about her feelings", I began to compare "facts" of delay of the wife from work. I timed time "convicting of deception", incorrectnesses later. In a state of intoxication I demanded recognition in change, I asked to name "lover", it was rough, tactless. Was interested at colleagues in behavior of the wife at work, I called to check, whether on a place the wife, imperceptibly I saw off the wife from work. Specify symptoms of mental violation. Your preliminary diagnosis. • With what diseases it is necessary to carry out the differential diagnosis. 17 . The teenager is sure that people around treat badly him because of him "repellent appearance". Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 18 . As a result of an earthquake in the face of the patient all family perishes. The patient is placed in hospital, thus completely immobilized, refuses food. In the 3rd days of the patient again began to move, but a situation don’t remember. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 19 . The patient with a depression had a sharp excitement, rushes about, shouts, groans, beats breast and in the head. Your preliminary diagnosis. Preventive 20 . The sick N, 46 years, within the last 10 years abuses alcohol. After the next alcoholic excess and the conflict in a family I went to business trip by train. Night I didn't sleep, I heard "voices" from the next compartment which agreed with it to finish, in persons of people around I saw bandits. I jumped off from the train and with changes it is hospitalized in traumatology office. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 21 . The patient of 64 years, within a year is in psychiatric hospital. At conversation it becomes clear that it doesn't know number, month year. The doctor designates by it the current date, after the 2nd, 3rd phrases in conversation can't reproduce this date. Assures that the doctor told nothing to it. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 22 . And. 19 years, serviceman. Suddenly I fell, having hit about a bed back. Muscles of extremities, trunks are sharply strained, then there were rhythmical spasms at which were extended, strained, relaxed. Breath was absent, the person tsianotichno, foam followed from a mouth with blood impurity. The involuntary urination was noted. Your preliminary diagnosis. • Plan of diagnostic inspection. Preventive 23 . The patient of B., 28 years, addressed to the doctor with complaints to the periodic headaches amplifying at mental work, feeling of constant weakness and increased fatigue. Performance of usual work began to demand the big tension of spiritual and physical forces. In the second half of the working day the head becomes fresher, but by the evening feels absolutely broken. Houses everything drives up the wall, irritate loud sounds. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 24 . Patient. 30 years, constantly hear the man's "voices" which are distributing because of a wall from the next chamber, believing that they belong to the patients who have got into office to persecutors. "Voices" threaten it with murder, report about punishment expected it, discuss ways of its destruction. Doesn't doubt reality of "voices" as they don't differ than from usual human speech, tries to tell whom they belong. Closes ears cotton wool, closes the head a pillow. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 25 . Sick with Page, 36 years, on character whimsical, theatrical, demanding to itself special attention. In time to conversation with the doctor, desperately sobbing, breaking hands, I told about the to "the only and one-way love". When the doctor soothingly noticed, what not everything in her life is lost, everything is formed, indignantly jumped, stood, and then was tumbled down on a floor. The trunk was curved by an arch, leaning on a nape and heels then became soft. Chaotically knocks feet, grits the teeth, swings hands. Doesn't allow to look at itself, strong blinks, laments, demands to stop survey, "while with me didn't pass". Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 26 . At the patient developed with antipsychotic a syndrome. • Clinical manifestations of an antipsychotic syndrome. • The factors promoting development of an antipsychotic syndrome. • Preventive 27 . The sick M, 28 years, at survey face skin grease, a rigidnost of muscles, a look stiffened, amimichny, to contact is inaccessible. Considers that is in the other world, it is sacred, the Satan and God as the good and evil, fight in his soul, and depends on it, whether there will live mankind. Neighbors in chamber considers dead, revives them, recognizes in them acquaintances. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 28 . Sick in the N, 56 years, in the past I worked as the nurse in kindergarten, lives with a family of the son. After a retirement I worried that will live dependent on the son. Lately I began to suspect the daughter-in-law of theft of the things, I considered that it wants "to exhaust" it, addressed in militia. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 29. The patient To. 38 years, it is divorced, many years abuses alcohol. In 25 years I received bsi with consciousness loss then felt headaches. The last month began to sleep badly, became intense, looks back, something whispers. I reported that hears a set of "voices" which accuse him, threaten, and others protect, ask to forgive him. Your preliminary diagnosis. Preventive 30 . At the patient To. 32 years, against long treatment by big doses of neuroleptics the muscular rigidnost, an akineziya, dystonia, tachycardia, increase the HELL, a gipersalivation developed. Your preliminary diagnosis. Preventive 31. The patient of Page of 16 years, is detained by militia in connection with hooligan actions in relation to neighbors. I broke a window, quarreled, I threatened to revenge for that they steal his thoughts, operate it, his behavior, force to commit crimes. Your preliminary diagnosis. Preventive 32 . The patient is 58 years old, worked as the accountant. The last 2 years I began to note fatigue, forgetfulness, confusion. The mood is reduced, is irritable because of the insolvency. Notes sharp decrease in memory on the current events, confuses dates, forgets events of the last years. On KT – an atrophy of back and frontal departments of the left hemisphere. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 33. The patient of 31 years, in the anamnesis convulsive attacks once a year, didn't address to doctors, treatment didn't accept. Suddenly, without the external reasons I became confused, I didn't understand the speech turned to it, I ran out from the house. It was detained by militia in some hours on other end of the city. Where was that did, doesn't remember. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 34 . The child is 12 years old, the 2nd year studies in the 3rd class, the training program doesn't acquire, can't read, considers within 10. At patopsikhologic experiment suffers both mediated, and mechanical storing, categorial level of thinking isn't available, proverbs and sayings understands literally, Helps with house cleaning, works at a kitchen garden. Specify symptoms of mental violation. Your preliminary diagnosis. • Preventive 35 . The sick Page, 32 years, against long reception of neuroleptics had restlessness, internal concern, a tremor of hands, feet, lips, a salivation Your preliminary diagnosis. Preventive 36 . The sick N, 41 years, doesn't abuse alcohol. During road accident I received the expressed deformation of a facial skull, cicatricial changes on a face. I worried, I lost a dream, considers that you shouldn't live, asks to give "a deadly injection". Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 37 . The patient is 75 years old, arrived from the street, can't call the surname, the home address, doesn't remember a name of the doctor, number, year, is scattered, slovenly. The intelligence is sharply reduced, a tremor of the fingers, shuffling gait. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 38. The patient of 56 years, arrived in clinic accompanied by the daughter. The disease began gradually. I became sluggish, inactive, forgetful, I clashed with neighbors. On reception: can't pick up proper words, the account with mistakes, doesn't understand figurative sense of proverbs and sayings. Your preliminary diagnosis with justification. Preventive 39 . The sick Item, 37 years, hears voices of aliens in the head which operate his thoughts, movements. By means of the special substances extending from the special equipment, operate all events on a planet: cause wars, natural disasters. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 40. Patient X. 47 years, abuse alcohol within 19 years. Recently accuses the wife of change with the friend of their son with whom it "on the special exchanges glances", motivates with that "the lover had a new car", "it is bought on money of the wife", the wife leaves the house, dressing nothing under a jacket that it was easier to change. The patient demands recognition in change, applying threats and physical force. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 41 . The sick M, 27 years, has an epileptic illness from 17 years. Suddenly with horror expression on a face began to rush about about the room, rushed on the brother, I began to smother him. Then I fell asleep. In the subsequent the condition completely dosn.t remember Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 42 . The patient of 26 years has schizophrenia. At home I accepted neuroleptics. The akineziya, muscular rigide, gipersalivation developed. Your preliminary diagnosis. • The factors promoting this condition. • Preventive 43. The patient is 78 years old, the pensioner. I arrived in psychiatric hospital in connection with memory violation: doesn't remember that ate for a breakfast, doesn't remember that the mail carrier brought it pension. Being on treatment in office, doesn't remember how call the doctor, neighbors in chamber. Events of youth remembers well, violation of memory accrues. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 44. The patient of 28 years, after death of the sister became unsociable, became reserved. There were ideas of a self-accusation, considers that she has no need to live, ceased to look after itself. The look sad, sluggish, apathetic, braked, complains of anguish, tried to make a suicide as doesn't see sense in life. In such condition is within 3 months. Your preliminary diagnosis. • With what diseases it is necessary to carry out the differential diagnosis. Preventive 45. The patient is 29 years old, arrives initially. Complaints on lowered by mood, that the language middle failed, the stomach atrophied and "a month there is no chair". Than isn't interested, for days on end stays at home, having stared in one point. Due to the refusal of food it is hospitalized in a hospital. Your preliminary diagnosis. • Your tactics with justification. 46 . The patient To. 43 years, for the second day after heavy hard drinking run on a yard with a gun, shouts, chases "gnomes", sends from itself insects whom to itself doesn't admit, threatens with a gun. Your preliminary diagnosis. Preventive 47. Patient of 54 years. Person sad. Silent, complains of lack of appetite, locks, palpitation attacks, feeling of shortage of air. The mood oppressed, declares: "there is no meaning of the life". Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 48. The patient is 38 years old. it is inactive, lacking initiative. The begun work quickly stops as loses interest. Ceased to be interested in the appearance (hasn't a shave, doesn't brush teeth). Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 49. At sick Page, the mental condition in 60 years for the first time changed. Refuses food, it is sure that the wife encloses a poison in food, changes to it, demands recognition, is aggressive. Your preliminary diagnosis. • Your tactics with justification. 50. The patient is 48 years old, in the last 10 years systematically drinks, freshens the nip, doesn't work. At receipt it is disoriented in time and a place, can't report date of the vital events, doesn't remember a name of the doctor, chamber number. Considers that yesterday I worked in a workshop though it is hospitalized 3 days ago. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 51. The patient is 75 years old, arrived from the street. Can't call a surname, the address, date, can't remember a name of the doctor, answers terse, it is slovenly, the tremor of fingers of the hands, shuffling, tripping gait is observed. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 52 . The patient of 25 years complains of a stomach pains, a pulsation which waves goes to brain area in this connection "the brain swells up". The patient suffers from anguish from feeling of burning and a turning in a brain. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 53. The sick River of 72 years, long time is in psychiatric hospital. It is disoriented in a place and time. Tells that yesterday I was at work, I sold tickets at cinema, at provocative questions I told that, going from work, home I came into shop to do shopping. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 54. The patient is 20 years old, the student. It is sick with flu. Sleeps badly. Once at sunrise I saw a silhouette of by the window man of an athletic constitution. The silhouette started peering "thawed". Then in drawings of wall-paper figures of people, animals, insects began to seem. At lighting inclusion all "visions" disappeared. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 55. Patient of 22 years. Is in continuous excitement, wriggles, plays the fool, makes faces, loudly laughs loudly. Climbs on a window sill, on a table and with loud aggressive shout jumps on a bed, then climbs under a bed and growls, trying to seize passable people by feet. Left for a minute without supervision, instantly something will do: will pull off a blanket from the patient, will break glass. Once I unscrewed jams from hot-water bottles and I lowered them in a toilet bowl. From time to time excitement reaches fury degree. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 56 . The patient To. 58 years, on character are disturbing the hypochondriac. Has reputation of the honest, conscientious worker. Works as the cashier. Once I found in cash desk shortage of the large sum. There was a fear, alarm that it will be accused of plunder. I noticed that employees whisper, on views understood that him consider as the thief. According to separate phrases of people around I understood that it is specially arranged that to put him in prison. In the suitable employee I recognized the prosecutor. It became extremely raised, tried to jump out of a window. Your preliminary diagnosis. • With what diseases it is necessary to carry out the differential diagnosis. Preventive 57 . Sick with Highway, 61 g. For many years abuses alcohol. I transferred alcoholic deliriya twice. The last years sells things from the house, drinks wine, gets drunk with small doses. A week ago the sleep was interrupted, there was an alarm, hardly moves, "feet don't go". It is hospitalized in neurology. At receipt doesn't know number, month, year. Doesn't remember the attending physician, the chamber, considers that today did the cleaning at home, it isn't critical. Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 58. The patient on reception at the doctor cries, says that "life has no what sense", it "is absolutely lonely", notes that doesn't test satisfaction neither from communication, nor from reading. Specify symptoms of mental violation. Your preliminary diagnosis. Preventiv 59. The patient, many years suffering schizophrenia, days on flight lies in a bed, than isn't engaged, doesn't talk, to everything is indifferent, slovenly. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 60. The patient, after death of the of 20 day children doesn't sleep at night, doesn't eat. Considers that the child died on her fault as it "overlooked" that it "killed the child the thoughts", and for it will be punished by God. People around, looking at it, mentally condemn her, accusing of murder of the child. Your preliminary diagnosis. Preventive 61. Sick in the M, 58 years, in premorbide rigide, suspicious, I arrived for the first time in psychiatric hospital accompanied by the daughter. On reception complains of the bad relation of the daughter and grandsons to her. Grandsons, despite the door closed on the lock, get into its room, steal products which it stores at herself since the daughter "holds it half-starving". • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 62 . The patient To. 47 years, addressed with complaints to emergence recently the spasms beginning with the right hand and extending down, covering the right foot against clear consciousness. Your preliminary diagnosis. Plan of diagnostic inspection. Preventive 63 . Patient Z. 36 years, I arrived in psychiatric hospital. Mental status: all types of orientation are kept. Itself calls the founder of the Universe, says that he is much stronger than God. Now struggles with demons who already won and destroyed some planets, try to destroy the earth. Hears their voice, a voice of Earth which asks it the help. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 64. The patient To. 26 years, suffering schizophrenia, I arrived in surgical office concerning peritonitis. Operation is performed. The patient is intense, considers that him want to kill. During operation to it "inserted the device" by means of which doctors operate it, make experiment. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 65. The patient To. 24 years, addressed with complaints palpitation, feeling of interruptions, constant pricking pains in heart, the general weakness, irritability, emotional lability, times feeling of the alarm, quashed mood, decrease in working capacity. The disease arose a month ago after a long mental travmatization. The last year mother had a serious illness, the patient looked after her, worried, was tired. At the same time the relations with the husband worsened, they divorced. After divorce also there was this disease. Somatic status: pulse of 72-80 beats/min, rhythmical, labile. Heart borders within norm, tones clear, aren't present noise. HELL of 150/80 mm hg. Neurologic status: easy tremor of fingers of hands, hiperhydroze Electrocardiogram - norm. The blood analysis - norm. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 66 . Sick Century, 48 years. Complaints to suspiciousness, fastidiousness, fear of infection with the infectious diseases, the suppressed mood, increased fatigue, a bad dream and appetite. Differed accuracy, pedantry, and also some uneasiness, suspiciousness. In 46 years during walk the cat scratched. Then, having met the infectiologist, I learned that it can lead to infection with rage. The patient in alarm carried out all night long, but couldn't calm down at thought that it caught rage. After carrying out inoculations when real danger of infection was excluded by rage, the condition of the patient didn't improve. I felt fear before infection with rage and alarm when saw dogs, cats and even birds. I threw work. The house I demanded from mother that hand soaps are more often, "not to bring an infection". Itself I took hard the condition, but "I could do nothing with myself". • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 67 . On an appointment of policlinic the patient of 32 years with complaints to the general weakness, violation of a dream, appetite, headache, irritability, irascibility which arose after the conflicts in a family addressed. Mental status: the consciousness clear, contact good, willingly reports about itself. Thinking consecutive, nonsense and hallucinations it isn't possible to reveal. Mood unstable, inclined to the lowered. During conversation it is tearful. Complaints to fast fatigue, mental and physical, intolerance of bright light, loud sounds, pungent smells. The work demanding tension, attention is carried out hardly. The attention unstable, is complicated storing new and reproduction of a necessary material. Disturb headaches, perspiration, feeling of shortage of air, pain in heart. The intelligence corresponds to the got education. It is critical to the condition. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 68. The patient of 25 years addressed to the psychiatrist for the solution of a question of inspection concerning the condition. A month ago at the patient mother died of a chronic heart disease. Relatives had no mental diseases. The patient disturb: the reduced mood, alarm, concern. The patient hardly copes with a loss situation, can't adapt to a new condition, became irritable, experiences difficulties of concentration of attention, can't carry out earlier habitual duties, there were sudden attacks of crying and difficulty of a zasypaniye. Despite the absence of pathology, at inspection, disturb palpitation attacks, fear of death for cardiac arrest. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 69. The patient of 40 years the manager, addressed to the therapist with the complaint to frequent episodes of the complicated breath and the palpitation, being accompanied plentiful sweating and nausea. These symptoms are connected with a situation of sudden audit to possible judicial proceedings. During such episodes the patient feels fear and is afraid that it has a heart attack. On survey looks grown thin, tired and uneasy (agitated). Against increasing loadings at work the dream became faltering, ability to concentrate attention decreased. The patient complains of the reduced mood and alarm concerning attacks, suicide ideas aren't present, but thoughts that to his family will be easier without him sometimes come. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 70. Sick with the Lake, 38 years, after sudden death of the only daughter I ceased to eat. I wrote farewell notes, I accused myself of insufficient love to the daughter, I heard a voice of the daughter and I saw her image, I didn't believe in her death, I went on a cemetery, I asked to dig out her daughter. Having realized death of the daughter. I made suicide attempt. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive 71. Sick in the N, 27/. For the first time I ached in 16 years when the melancholy was noted, despair, movie it was braked, sluggish, I stated ideas of self-abasement and a self-accusation, I tried to commit suicide, refused food, badly I slept. After recovery well I felt within 11 years, studied, I worked, I married. Lately for no apparent reason I became sad, it was suppressed, oppressed, almost I ceased to talk, I answered in monosyllables. In clinic: it is braked, refused food, I stated ideas of a self-accusation. Sleeps badly. Deeply sighs. Mimicry monotonous, mournful, inactive. Suffers locks. Skin dry, pupils are expanded. The condition slightly improved by the evening. • Specify symptoms of mental violation. Your preliminary diagnosis. Preventive Yüklə 33,37 Kb. Dostları ilə paylaş:
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