Кафедра овп №1,2

жүктеу/скачать 387,43 Kb.

бет	4/11
Дата	11.06.2023
өлшемі	387,43 Kb.
	#100452

1 2 3 4 5 6 7 8 9 10 11

urinalysis

Level	Result		Level		Result
Hemoglobin, g/l	128 г/л		amount of urine		50 ml
Red blood cells х10¹²/l	4,0*10¹²/л		COLOR		Light yellow
MCH	1,0		odour		-
White blood cells, х10⁹/l	4,0*10⁹/л		CLA		clear
PLT, х10⁹/l	296*10⁹/л		SG		1025
Segmented neut %	59%		(pH)		6,8
rod - shaped neut %	2%		PRO		0
EO	2%		GLU		0
BA	5%		KET		0
MON%	2%		BLD		abs
LYM %	30%		LEU		abs
ESR	15		epithelial cells		1-2 hpf
		Cellular casts		abs
		crystals		abs
		mucus		abs
		bacteria		abs
		yeast		abs

Analysis of feces for helminth eggs – negative.

Questions:
1. Preliminary diagnosis?
2. Examination plan?
3. Interpretation of test results.
4. Differential diagnosis and final diagnosis.
5. Treatment tactics

Discipline "General medical practice No. 1"
Practical exam (stage 1)

SITUATIONAL TASK №7

The child is 4 years old. The parents turned to the local doctor with complaints: poor appetite, drowsiness, pallor, sweating of the skin, frequent "jams" in the corners of the mouth, transverse striation of the nails of the thumbs.

From anamnesis: a child from 2 pregnancies, 2 births. The age of the mother is 25 years old. Pregnancy proceeded against the background of toxicosis in the 1st and 2nd half of pregnancy. Labor with stimulation, anhydrous period of 8 hours, was born with a single entwining of the umbilical cord around the neck. Born on time with a weight of 3000gr, height-51cm. It is attached to the chest immediately. From 6 months he was transferred to artificial feeding.
Social and living conditions are satisfactory.
Objectively: the child's condition is satisfactory. Body temperature is normal. The skin and visible mucous membranes are pale, dry. Height-97cm, weight-15kg. The child is under-nourished, the turgor is reduced. Often suffers from respiratory diseases. It's quiet in the mouth. Nasal breathing is not difficult. In the lungs, breathing is vesicular, there are no wheezes. The abdomen is soft, painless. Tendency to constipation. Diuresis is normal.
Test results:

full CBC		urinalysis
Level	Result		Level		Result
Hemoglobin, g/l	89 г/л		amount of urine		50 ml
Red blood cells х10¹²/l	2,9*10¹²/л		COLOR		Light yellow
MCH	0,7		odour		-
White blood cells, х10⁹/l	7,7*10⁹/л		CLA		clear
PLT, х10⁹/l	296*10⁹/л		SG		1018
Segmented neut %	59%		(pH)		6,8
rod - shaped neut %	2%		PRO		0,33
EO	2%		GLU		0
BA	5%		KET		0
MON%	2%		BLD		abs
LYM %	30%		LEU		abs
ESR	8		epithelial cells		1-2 hpf
Anisocytosis + Poikilocytosis +		Cellular casts		abs
		crystals		abs
		mucus		abs
		bacteria		abs
		yeast		abs

Biochemical blood analysis:
serum iron 10.5 mmol/l,
the total iron binding capacity of the serum is 78 mmol/l,
transferrin saturation coefficient with iron - 13%),
serum ferritin 25 ng/ml.

Questions:

1. Preliminary diagnosis?

2. Examination plan?
3. Interpretation of test results.
4. Differential diagnosis and final diagnosis.
5. Treatment tactics

Discipline "General medical practice No. 1"
Practical exam (stage 1)

SITUATIONAL TASK №8

The boy is 2 months old, arrived at the polyclinic from another city, was not observed by doctors before, the child was from 1 full-term pregnancy, the pregnancy proceeded without pathology. She has been breastfed since birth. Weight-5300gr., height 55cm.

Objectively: The condition is satisfactory. The skin and visible mucous membranes are clean. There is puerile breathing in the lungs, no wheezing. The heart tones are clear, the rhythm is correct. The abdomen is soft and painless. The stool is normal.
When assessing the neuropsychiatric development of the child and notes that the child smoothly traces the moving red ball, listens to the voice of the doctor, smiles, lying on his stomach raises and holds the head, makes separate sounds in response to the conversation of the mother with him.
Test results:

full CBC		urinalysis
Level	Result		Level		Result
Hemoglobin, g/l	134 г/л		amount of urine		50 ml
Red blood cells х10¹²/l	2,9*10¹²/л		COLOR		Light yellow
MCH	0,7		odour		-
White blood cells, х10⁹/l	4,0*10⁹/л		CLA		clear
PLT, х10⁹/l	296*10⁹/л		SG		1022
Segmented neut %	63%		(pH)		2,2
rod - shaped neut %	9%		PRO		0
EO	1%		GLU		0
BA	2%		KET		0
MON%	5%		BLD		abs
LYM %	20%		LEU		abs
ESR	5		epithelial cells		1-2 hpf
		Cellular casts		abs
		crystals		abs
		mucus		abs
		bacteria		abs
		yeast		abs

Questions:
1. Preliminary diagnosis?
2. Examination plan?
3. Interpretation of test results.
4. Differential diagnosis and final diagnosis.
5. Treatment tactics
Discipline "General medical practice No. 1"
Practical exam (stage 1)

SITUATIONAL TASK №9

A 1.5-year-old child is sitting at a doctor's appointment. Complaints of coughing during the week, runny nose, refusal to eat, shortness of breath.

On examination: the condition is of moderate severity, the child is sluggish. Body temperature 38.70C. RR 30 per minute. There is a slight hyperemia in the throat, there is no plaque. Both halves of the chest are involved in the act of breathing. Auscultation - weakened breathing in the basal zone on the right, sonorous small-bubbly wheezing. Pulse - 96 times per minute. Blood pressure 95/60 mmHg.
Test results:

full CBC		urinalysis
Level	Result		Level		Result
Hemoglobin, g/l	132 г/л		amount of urine		50 ml
Red blood cells х10¹²/l	4,4*10¹²/л		COLOR		Light yellow
MCH	1,0		odour		-
White blood cells, х10⁹/l	12,5*10⁹/л		CLA		clear
PLT, х10⁹/l	220*10⁹/л		SG		1015
Segmented neut %	60%		(pH)		6,2
rod - shaped neut %	6%		PRO		0
EO	5%		GLU		0
BA	1%		KET		0
MON%	2%		BLD		abs
LYM %	26%		LEU		abs
ESR	27		epithelial cells		1-2 hpf
		Cellular casts		abs
		crystals		abs
		mucus		abs
		bacteria		abs
		yeast		abs

Chest X-ray in two projections

Questions:

1. Preliminary diagnosis?

A boy, 8 years old, the child's mother turned to the pediatrician with complaints of high fever for 3 days, cough.

It is known from the anamnesis that the child is from the first physiological pregnancy, urgent independent childbirth. Birth weight 3,540 g, height 51 cm. He was breastfed for up to 1 year. Early development corresponded to age. Vaccinated on schedule. Transferred diseases - frequent acute respiratory diseases, chickenpox at the age of 3 years. A real disease within 3 days. The child became acutely ill with an increase in body temperature to 38.5 OC, a dry cough appeared on the first day. There were no symptoms of the disease in the family of relatives at the time of examination.
Epidemiological history: the boy is organized - attends school. A week ago, he suffered acute nasopharyngitis. They were treated independently. A PCR study on SARS-CoV was conducted - the result is negative.
On examination, the condition is of moderate severity. The temperature is 37.8 oc. Proper physique, satisfactory nutrition. Weight 25 kg, height 124 cm. The skin is pale, clean, moist. Mucous membranes are clean, moderate hyperemia of the arches. Peripheral lymph nodes are enlarged, isolated, painless. SpO2 - 93% and local symptoms on the part of the lungs – weakening of the percussion sound and small-bubbly wet wheezing in the lower left. Heart rate - 94 per minute. The heart tones are clear, rhythmic.
Test results:

жүктеу/скачать 387,43 Kb.

Достарыңызбен бөлісу:

1 2 3 4 5 6 7 8 9 10 11