Chronic glomerulonephritis

# 162

*! Boy 13 years old. Complaints of paroxysmal cough, wheezing, shortness of breath. From the anamnesis: atopic dermatitis, periodically short-term attacks of suffocation,

docked independently; father has hay fever. The real attack came in contact with a cat. On examination: dry cough, wheezing, BH 26 in 1 min, in the lungs - percussion-like shade of sound, mass of dry wheezing in all fields.
What is the MOST probable diagnosis of this patient?

Bronchial asthma

# 163

*! Mom with a child aged 10 months went to the doctor with complaints of curvature of the lower extremities. From the anamnesis: a child from І pregnancy, І urgent birth. Objectively: the skin is pale. The frontal and parietal tubercles, the “Harrison groove”, on the ribs of the “rosary”, on the wrists of the “bracelet”, varus deformity of the extremities are protruding. Muscular hypotension is noted. C heart and lungs without pathology. The abdomen is swollen, the liver protrudes 1.5 cm from under the edge of the costal arch, the edge is soft, elastic. Stool 1 time in 2-3 days, urination is normal.

What clinical symptoms are MOST likely to help the doctor in diagnosing and determining the severity of the disease in this child?

“Bracelets”, “pearl strands”, “rosary”, deformation of the upper limbs

 

# 164

*! A boy of 8 years old, diagnosed with dysfunction of the biliary tract, hypokinetic form.

What clinical symptoms will be MOST characteristic?

* + nausea, bitterness in the mouth, flatulence, constipation, aching pain in the right hypochondrium

* cramping pains in the right hypochondrium, irradiation of pain in the left shoulder blade, bitterness in the mouth

* colicky pains in the right hypochondrium, irradiation of pain on the back, nausea, vomiting, constipation

* stitching pains in the right hypochondrium, irradiation of pain in the left hypochondrium, flatulence, constipation

* aching pain in the right hypochondrium, irradiation of pain on the back, bitterness in the mouth, vomiting, heartburn

 

# 165

*! A girl of 15 years old, complaints of severe paroxysmal pain in the epigastric region, most often at night. On palpation of the abdomen, pain in the pyloroduodenal zone is noted. Preliminary diagnosis: duodenal ulcer.

What methods of diagnosing H. pylori MOST informative?

* biochemical blood test, bacteriological, brush cytological, biopsy

* + bacteriological, brush cytological, urease breath test, PCR

* general blood test, biochemical blood test, general urinalysis, coprogram

* enzyme immunoassay, biopsy, bacteriological, PCR

* general blood test, biochemical blood test, urease breath test, PCR

 

# 166

*! A 11-year-old boy is registered with a diagnosis of chronic gastroduodenitis, remission. Sanatorium treatment with chloride - atrium mineral waters has been prescribed.

Which hospitals in Kazakhstan are MOST likely?

* Merke, Mankent * Borovoe, Almaty

 

* + Mankent, Saryagash
* Zhanakorgan, Rakhmanov keys

* Almaty, Aksay

 

# 167 (hint, in all answers except the correct one there is hypotrophy, and a 13-year-old girl can’t put it, hypotrophy seems to be only up to 1 year old)

*! A girl of 13 years old is observed with a diagnosis of celiac disease from 3 years of age. Gluten-free diet practically does not comply. Complaints of general weakness, diarrhea, growth and weight lag, menstrual irregularities, pain in bones and joints, memory impairment, decreased attention. FGDS: atrophic duodenitis, unit, biopsy: partial and subtotal villous atrophy.

What diseases are most likely to develop in the prognosis?

* + osteoporosis, nanism, autoimmune thyroiditis, iron deficiency anemia

* chronic glomerulonephritis, malnutrition, iron deficiency anemia, dwarfism

* chronic pyelonephritis, atherosclerosis, malnutrition, gigantism

* rickets, malnutrition, atopic diathesis, autoimmune thyroiditis

* autoimmune thyroiditis, malnutrition, nanism, atopic diathesis

 

# 168

*! The girl is 13 years old, two weeks after suffering a sore throat, she was diagnosed with acute glomerulonephritis.

What changes in urine analysis are MOST likely for this child?

* uraturia, xanthuria, glucosuria

* oxaluria, hemoglobinuria, bacteriuria

* + hematuria, proteinuria, leukocyturia

* glucosuria, proteinuria, phosphaturia

* bacteriuria, hemoglobinuria, glucosuria

 

# 169

*! A girl of 5 months, complaints from the mother’s words about the pallor of the skin and mucous membranes, lethargy, loss of appetite. The local doctor put diaznoz: Iron deficiency th anemia I first degree. Girl find tons to I n and artificially m feeding and. Objectively: the skin is pale, clean. Zev is calm. For organs without pathology.

What are the MOST characteristic changes or diseases that occur in iron deficiency anemia with secondary immunodeficiency syndrome?

* + frequent pneumonia, acute respiratory infections, acute respiratory viral infections

* dysbiosis, maldigestion, decreased appetite

* fatigue, perversion of taste and smell

* hypotension, lethargy, decreased appetite

* perversion of taste, smell, pallor

 

# 170

*! A girl of 5 months, complaints from the mother’s words about the pallor of the skin and mucous membranes, lethargy, loss of appetite. The local doctor put diaznoz: Iron deficiency th anemia I first degree. Girl find tons to I n and artificially m feeding and. Objectively: the skin is pale, clean. Zev is calm. For organs without pathology.

What are the MOST probable symptoms of cardiovascular syndrome with iron deficiency anemia?

* + shortness of breath, hypotension, tachycardia, functional noise

* hypertension, clear tones, fatigue, shortness of breath

* weakening of tones, decrease in stroke volume, decrease in minute volume, bradycardia

* hypotension, fatigue, bradycardia, shortness of breath

* systolic murmur, increased stroke volume, increased minute volume, shortness of breath

 

# 171

*! A girl of 9 years old, is registered at the clinic with a diagnosis of chronic pancreatitis. Currently observed with exacerbation.

What symptoms are MOST characteristic of the disease?