2015-09-06
527
SITUATIONAL TASKS
FOR 1 FINAL MODULE CONTROL ON GENERAL HYGIENE
TASK 1
At questioning of patient A. 26 years, plasterer, it is set that he breakfasts and has a supper at home, has dinner in to the dining-room of the building combine. According to a patient is found out that on June 11 in 2 hours after dinner at work felt off, went home. At home pains appeared in area of stomach, vomiting, weakness. A patient paid attention to the off-flavour at kissel, which he took during the dinner. Objective information: temperature of body 37, pulse - 76 in min., breathing without features. A stomach is soft. Small illness in area of stomach. A chair is normal. Nausea. A patient marks astringent taste in to the mouth.
Put and ground the diagnosis of disease. How to confirm a diagnosis? What documents is under obligation a doctor to process in this case? Specify hygienic measures for the prophylaxis of similar diseases.
TASK 2
At the inspection of patient I. it is set: a patient is 30 years, collective farmer, feeds at home. Food stuffs, including flour, gets in a collective farm. 10 May, approximately at 12 o'clock, felt a somnolence, numbness of fingers of hands, sense of crawl of small ants, difficulty of unbending of hands and feet, appeared. The twitch of muscles of person, difficulty of swallowing, appeared then. Objective information: temperature of body of 36,80C. Pulse and breathing without features. Convulsive twitch of muscles of shin. Small sickliness of stomach. Nausea. Dizziness. For the last 2 months 3 cases of similar diseases appeared in his village.
Put and ground the diagnosis of disease. How to confirm a diagnosis? What documents is under obligation a doctor to process in this case? Offer hygienic and prophylactic measures in this case.
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TASK 3
At the inspection of child T. 5 years it is set: on June 20 after dinner middle group of kindergarten with a nursery governess went for a walk in the field, picked flowers. A walk proceeded 1,5 hour. On returning a nursery governess noticed at a child the sharp turning red of person, hoarseness of voice and extended pupils. Objective information: turning red of person. Temperature of 380C, pulse 140, tense. Breathing is frequent. The mucous cavities of mouth are dry. Hoarseness of voice. Pupils are strongly extended. A child is excited, restless, there are visual hallucinations.
Put and ground the diagnosis of disease. How to confirm a diagnosis? What documents is under obligation a doctor to process in this case? What prophylactic measures must be conducted in nursery school?
TASK 4
At the inspection of patient of Å. it is set in order of the first aid: a patient is 18 years, student, feeds in a student dining-room. From conversation with it is found out by a patient, that on May, 18 felt dryness in to the mouth, difficulty of swallowing, sight became worse (sees as in fog). Disorder of chair was not. Objective information: temperature of body of 36,80C. Pulse 70, good filling. A stomach is painless, soft at pressing on. Pupils are extended and is irresponsive on light, small ptimalum, dryness mucous to the cavity of mouth. Voice is hoarse, small lowering of soft palate.
Put and ground the diagnosis of disease. How to confirm a diagnosis? What documents is under obligation a doctor to process in this case? Name medical and prophylactic measures in this case.
Task 5
The child of 3 months (mass is 6 kg) is on the artificial rearing by mixture «Kid». With the purpose of prophylaxis of rickets a doctor appointed adopting the vitamin of D. Mother did not adhere to settings, in place of 3 drops gave to 10 drops in a day during 3 months. A mother marked that a child had become languid, eats badly, after feeding periodically there is vomiting, drinks voraciously, once or twice there was a liquid chair. At examination skin covers are pale, clean, the turgor of fabrics is mionectic, large spring-fed 1,5x1,5 sm, the mucous are dry. Pathologies of internals are not exposed. At laboratory research the big maintenance of salts of calcium is exposed in urine.
Define reason of this state of child. Specify day's dose of vitamin of D. Give necessary recommendations. How to conduct the prophylaxis of rickets in this case?
TASK 6
The group of students resident in a dormitory appealed to the doctor of policlinic with complaints about a general weakness, somnolence, rapid fatigueability, sanguifluousness of gums, slight swelling. It is set at questioning, that students feed not regularly, often by can foods, concentrates. Examination gives the presence of hematousness and sanguifluousness of gums.
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Put a preliminary diagnosis and give his ground.
What objective adequate methods of research of these students can you offer?
What methods is it possible to conduct the mass inspection by with the scope of all students resident in a dormitory?
Give recommendation on the prophylaxis of similar diseases.
Task 7
To the doctor appealed sick patient 63 years, pensionary, which suffers by surplus mass of body, there are the expressed signs of atherosclerosis of coronal vessels, blood pressure high. It is exposed at questioning, that a patient feeds 3 times per a day, avoids fat and sharp food. At the analysis of ration of feed it is set for a day: contents of proteins 70g, fats – 50g, carbohydrates – 400g. On vitamin and mineral composition a ration corresponds to the norms.
Give the estimation of adequacy of feed of patient in obedience to basic principles of rational feed. What are the reasons of oven weight? What group of alimentary diseases does this pathology behave to? What recommendations on the correction of feed of antysclerotic orientation are needed in this case?
Task 8 At the medical inspection of patient A. it is set: a patient is 18 years, student, feeds in a student dining-room and bye some products in the market. Yesterday he felt dryness in to the mouth, difficulty of swallowing, sight became worse (sees as in fog). Dyarrea was not.
Objective information: temperature of body - 36,1 0C. Pulse 70 in min. A stomach is painless, soft at pressing on. Pupils are extended an irresponsive on light, small ptimalum, dryness mucous to the cavity of mouth. Voice is hoarse, small lowering of soft palate.
Put the full diagnosis of disease. How to confirm a diagnosis of disease? What documents for SES must write doctor in this case? Name the necessary medical and prophylactic measures in this case.
Task 9 At the medical inspection of patient K. it is set: a patient is 30 years, workwoman of factory, breakfasts and supper has at home, has dinner at eating-house of factory. Yesterday, in 12.00 she felt off, sight became worse sharply, dryness appeared in to the mouth, hoarse voice, difficulty of swallowing. Ration of feed: at breakfast - vegetable canned foods (own making), eggs, bread; dinner - borsch with meat, chops, coffee, bread; a supper - porridge millet, milk, bread.
Objective information: temperature of body 36,30C, pulse 78 in min. Pupils are unevenly extended, is irresponsive on light. A voice is hoarse, swallowing is difficult. A stomach is soft, painless. Dyarrea is not. A patient is languid, consciousness is stored.
Put the full diagnosis of disease. How to confirm the diagnosis of disease? What documents is under an obligation a doctor to process in this case? Appoint urgent medical measures for patient. Name prophylactic measures in this case.
Task 10 To the doctor of district policlinic a woman appealed with complaints about that after feeding of child 6 months by artificial suckling mixture at him is marked the excitation, cramps, vomiting and diarrhea. At the inspection at a child cyanosys of lips and fingers is exposed.
The increased indexes of met-haemoglobin are exposed in the blood test. It turned out at the question of mother, that for breeding of suckling mixture she used water from a well near home.
Diagnose disease. What could be reason of poisoning? How to confirm a diagnosis of disease? What document is under an obligation to design doctor in this case? What prophylactic measures are needed in this case?
Task 11
The child of 3 months is on the artificial rearing. With the purpose of prophylaxis of rickets a doctor appointed adopting the vitamin of D. Mother did not adhere to settings, in place of 3 drops gave 10 drops in a day during 3 months. After it a mother noticed that a child had become languid, eats badly, after feeding periodically there is vomiting, drinks voraciously, once or twice there was a liquid chair. At examination skin covers are pale, clean, the turgor of skin is lowered, the mucous are dry. Pathologies of internals are not exposed. At laboratory research the increased level of salts of calcium is exposed in blood.
Define the reason of this state of child. Specify day's dose of necessary vitamin. Give necessary recommendations to mother in this case. How to conduct the prophylaxis of rickets in this case (by using UVR)?
Task 12
The group of students, resident in a hostel, appealed to the doctor of policlinic with complaints about a general weakness, somnolence, rapid fatigue, sanguifluousness of gums, slight swelling. It is set at questioning, that students feed not regularly, often by can foods, concentrates. Examination gives the presence of haemorragia of gums.
Put a preliminary diagnosis. What objective adequate methods of research of these students can you offer? What methods is it possible to conduct at the mass inspection of all students, resident in a hostel? Give recommendation on the prophylaxis of similar diseases.
Task 13
To|by| the doctor|physician| appealed patient K.|diseased| 63 years, pension, which has surplus mass of body, there are the expressed signs of atherosclerosis of coronal vessels, high blood pressure.
It is exposed at questioning, that a patient feeds 3 times per a day, avoids fat and sharp food. At the analysis of ration of feed|nourishment| it is set, that he receive for|after| a day: proteins - 70g, fats – 50g, carbohydrates – 400g. On vitamin and mineral composition a ration corresponds to the norms|standards|.
Give the estimation|appraisal| of adequacy of feed|nourishment| of patient according to|in accord with,according to| basic principles of rational feed|nourishment|. What are the reasons|causes| of overweight patient? To what group of alimentary diseases does this pathology|by|? What recommendations on the correction of feed|nourishment| on antysclerotic| orientation are needed in this case?
Task 14
To|by| the doctor|physician| a patient C. 67 years, pension, appealed with a request to give the recommendation on the features of feed|nourishment| for him|it|. His growth|height| of body is165 sm|q.v.| and mass of body 94 kg. He has the signs of atherosclerosis of cerebral and coronal vessels,
It is set at the analysis of food status, that patient feeds 2 – 3 times per day|nourishment|. On the average in the daily ration of feeding|nourishment| proteins make 50g, fats – 80g, carbohydrates – 400g. Contents of vitamin of C in a ration 50 mg in day.
Give the estimation|appraisal| of adequacy of feeding|nourishment| of patient according to|in accord with,according to| basic principles of rational feed|nourishment|. What are reasons|causes| of overweight patient? To what group of alimentary diseases does this pathology|by|? What recommendations on the correction of feeding|nourishment| of antysclerotic| orientation are needed in this case?
