full CBC
|
urinalysis
|
Level
|
Result
|
Level
|
Result
|
Hemoglobin, g/l
|
118 г/л
|
amount of urine
|
50 ml
|
Red blood cells х1012/l
|
4,1*1012/л
|
COLOR
|
Light yellow
|
MCH
|
1,0
|
odour
|
-
|
White blood cells, х109/l
|
18,9*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%
|
4%
|
BLD
|
abs
|
LYM %
|
24%
|
LEU
|
abs
|
ESR
|
44
|
epithelial cells
|
1-2 hpf
|
|
Cellular casts
|
abs
|
crystals
|
abs
|
mucus
|
abs
|
bacteria
|
abs
|
yeast
|
abs
|
Repeated PCR test for SARS-CoV-2 is positive.
Chest X-ray in two projections
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 №30
A repeat-giving woman came to the next doctor's appointment in full-term pregnancy.
From anamnesis: Pregnancy 2nd. The first was three years ago, a caesarean section was performed due to the transverse position of the fetus. The postoperative period proceeded without complications.
Registered in a women's clinic from 8 weeks of pregnancy. Examined in full. There is no gynecological or somatic pathology.
Objectively: The general condition is satisfactory. The skin is of normal color, clean, there is no swelling. The pulse is 78 in 1 minute. Blood pressure 100/70 mm hgst, Body weight - 36.3◦S. The abdomen is soft, with palpation it is painless, the liver and spleen are not enlarged. The symptom of "beating" is negative. Urination is independent, painless, stools are regular.
Obstetric status: abdominal circumference - 99 cm. The height of the uterine fundus is 38 cm . The position of the fetus is longitudinal, position 2, head presentation. There is a postoperative scar on the anterior abdominal wall, healed by primary tension. Palpation of the uterus is painless. When the skin scar is displaced, changes in the uterine wall are not detected.
Test results:
Full CBC: Нв-104 g/l, RBC – 3,7*1012/l, WBC – 7,0*109/l, PLT – 154,0, ESR – 22 мм/час
UA: pH - acidic, SG 1016, PRO – аbs, LEU -2-3 hpf
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 №31
Pregnant 21 years old. The gestation period is 8 weeks. Complaints of weakness, constant nausea, vomiting more than 15 times a day. It doesn't hold food. In 10 days, the body weight decreased by 3.5 kg.
From the anamnesis: The second pregnancy, the first ended with premature induced labor at 32-33 weeks, complicated by severe preeclampsia, there was an increase in blood pressure to 180/100 mmHg, the child is alive. He is not registered for pregnancy. Somatic diseases: chronic diseases of the gastrointestinal tract, gastric ulcer since youth.
Objectively: The patient's condition is severe. Exhausted, the smell of acetone from the mouth. The temperature is subfebrile, the skin is jaundiced, dry. Pulse 110 beats / min, weak filling and tension. Blood pressure is 90/60 mm Hg. Heart tones are muted. The tongue is covered with a white coating, dry. The abdomen is soft, painless. Diuresis is reduced to 400 ml per day.
Test results:
1. biochemical test: total protein - 65.8 g/l, urea - 12.8 mmol/l, nitrogen - 40.1 mmol/l, AsaT -45 units/l, ALaT-52 units/l, creatinine - 56.7 mmol/l, total bilirubin - 40 mmol/l, glucose - 4.74 mmol/l, albumin-15 g/l, cholesterol - 1.0 mmol/l, potassium-1.8 mg-eq/l.
2. UA: the amount of urine - 100 ml, SG- 1030, color - rich yellow, transparency - cloudy, pH - 6.0, protein - 1.0 g/l, epithelial cells - 10-12 hpf, LEU - 5-6 hpf, Cellular casts 20-25 hpf ,
3. Ketones in urine +++
Questions:
1. Preliminary diagnosis?
2. Examination plan?
3. Interpretation of test results.
4. Differential diagnosis and final diagnosis.
5. Treatment tactics
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