Кафедра овп №1,2



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Дата11.06.2023
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Байланысты:
1 Экзамен по дисциплине ОВП 2 на англ.

Objective data: The condition of moderate severity. The skin and visible mucous membranes are pale pink in color. Blood pressure - 80/50 mmrtst, pulse - 120 beats per minute. RR – 20 per minute. The abdomen is enlarged due to pregnancy, according to the gestation period. The uterus is tense, painful when palpated along the anterior wall, does not relax. The position of the fetus is longitudinal, the head of the fetus is lying. Fetal heartbeat is not monitored. There are pronounced edema on the lower extremities and anterior abdominal wall.


On examination: The mucous membrane of the vagina and cervix are clean, pink in color. The discharge is bloody and moderate. During vaginal examination: the cervix is rejected posteriorly, 3.5 cm long, dense.
Test results:
Full CBC Hb – 80 г/л, RBC – 2,4*1012 г/л, WBC – 11,0*109 г/л, PLT – 220*109 г/л.
UA: LEU – 2-3 hpf, epithelial cells – 3-4 hpf, bacteria – abs, PRO – 0,6 г/л.
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 №34

A 28-year-old pregnant woman went to the doctor at 33 weeks + 5 days of pregnancy with complaints of swelling of the lower extremities.




From anamnesis: Pregnancy is the first. Of the transferred diseases, chronic pyelonephritis is noted (she was registered at a dispensary, she was removed from the medical register 2 years ago). The weight gain was 14 kg, for the last week – 1.0 kg.
Objectively: the general condition is satisfactory. The skin and visible mucous membranes of the usual color. Pulse 64 beats per minute, satisfactory filling and tension. Blood pressure 120/80 and 115/80 mmHg. The abdomen is soft, painless. Diuresis is free, painless. The stool is normal.
The circumference of the abdomen is 88 cm . The height of the standing of the uterine floor above the womb is 35 cm. The uterus is not tense, it is painless on palpation. The position of the fetus is longitudinal, the head is lying, movable above the entrance to the pelvis. The tones of the fetus are clear, rhythmic, 140 beats per minute. Edema of the lower extremities.


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