2020-06-29
437
# 2
*! What population is subject to follow-up after salmonellosis? Food Service Workers
# 3
*! What is the most common transmission route for brucellosis infection: Alimentary and contact routes
# 4
*! What part of the respiratory tract is affected mainly with influenza? Trachea
# 5
*! Does it refer to a localized form of meningococcal infection? Nasopharyngitis, pneumonia, meningococcal congestion
* Infectious diseases in the work of GPs * 2 * 23 *
#1
*! Man, 31 years old, he fell ill acutely, with fever up to 39 of the C, the appearance of fever, pain in the frontal and retro-orbital areas, aches in the muscles, bones and joints, pain and sore throat, dry cough, nasal congestion. On examination, on the 2nd day of the disease, hyperemia and puffiness of the face, vascular injection of the sclera were noted. In the oropharynx: bright hyperemia of the palatine arches, tonsils are not enlarged, no deposits, granularity of the posterior pharyngeal wall.
Which of the following diagnoses is the most likely? Flu
# 2
*! A young man of 18 years old, turned to a local therapist with complaints for 3 days, there was chills, headache, aching all over the body, low-grade fever, sore throat and along the trachea, a rough barking cough. On examination, mild hyperemia of the pharynx, tonsils behind the damsels, no raids, rapid and labored breathing, profuse serous discharge from the nose, hoarseness of the voice. Heart sounds are muffled by the rhythm correct heart rate 82 beats / min, blood pressure 100/60 mm Hg The abdomen is soft, painless. Urinates adequately.
Which of the following diagnoses is the most likely? Parainfluenza
#4
*! A young man of 17 years old, was admitted to the hospital. Complaints of fever up to 37.7С, headache, sore throat and along the trachea, a rough barking cough. On examination: moderate hyperemia of the mucous membrane of the oropharynx, tonsils are not enlarged. Rapid and labored breathing, profuse serous discharge from the nose, hoarseness of the voice. Heart sounds are muffled, pulse 82 beats / min, blood pressure 100/60 mm Hg The abdomen is soft, painless. Urinates adequately.
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Which part of the upper respiratory tract is affected by parainfluenza? Larynx
#5
*! A man of 28 years old, became acutely ill with a headache in the frontal region and orbits of the eyes, body aches, in bones and joints, sore throat, nasal congestion, hospital. When viewed on the 2nd day of the disease: in the oropharynx - bright hyperemia, hyperemia and puffiness of the face, vascular injection of the sclera, nose is blocked. In the lungs - hard breathing, no wheezing. Cardiac tones are muffled, tachycardia, heart rate 98 beats / min, blood pressure 100/60 mm Hg Abdomen soft painless, increase in body temperature up to 39 of the C. I took teraflu and paracetamol on my own, but without effect. Caused BSMP, delivered to the infectious
What syndrome is predominant in the clinical picture? Intoxication
# 6
*! A woman, 30 years old, went to the doctor on the 1st day of illness. She became ill sharply, the temperature increased with chills up to 39.5 ° C, there was a headache in the frontal region, in the eye sockets, nasal congestion, sore throat and sore throat, dry cough, muscle pain, photophobia. Epidemiological history: 3 days ago a child was ill. On examination: a moderate condition, the face is hyperemic, vascular injection of the sclera. The pharynx is brightly hyperemic. The nose is blocked, breathing through the mouth. Pulse 108 beats. in minutes HELL 100/60 mm Hg The abdomen is soft, painless.
MOST probable diagnosis? Flu
# 7
*! A girl of 19 years old, became acutely ill with the appearance of malaise, headache, nasal congestion, a feeling of dryness and a feeling of soreness in the nasopharynx. Soon there appeared profuse serous, and then mucous discharge from the nose, frequent sneezing. Objectively: Body temperature - 37.4C. With rhinoscopy: hyperemia and swelling of the nasal mucosa, profuse rhinorrhea. At the nasal openings, the skin is macerated. Heart sounds are muffled, the rhythm is correct. Heart rate - 80 bpm, blood pressure - 110/60 mm Hg The abdomen is soft, painless. Urinates adequately.
Which of the following is the most likely diagnosis? Rhinovirus infection
# 8
*! A woman, 20 years old, became ill gradually with the appearance of malaise, headache, nasal congestion and tickle in the nasopharynx. On the 2nd day, the condition worsened, body temperature increased to 38.5 ° C, the cough intensified and became paroxysmal in nature, sputum joined. Objectively: a serious condition. Acrocyanosis. In the throat: the mucous membrane is hyperemic, granular. Heart sounds are muffled, rhythmic. NPV - 20 per min. With percussion of the lungs, areas with a boxy tint of sound, alternating with areas of blunting, are noted. During auscultation, breathing is tough; dry and small-bubble moist rales are heard.
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What is the most likely diagnosis in this clinical case? RCI
# 9
*! A 26-year-old man turned to a district doctor on the 3rd day of illness. The disease began gradually with the appearance of a runny nose and cough, slight sore throat. Low-grade fever lasts all days. Epigastric pains are noted, 1-2 times there was a loose stool. On examination: facial hyperemia, vascular injection of the sclera and conjunctiva, moderate hyperemia and granularity of the mucosa of the posterior pharyngeal wall. Cervical, submandibular lymph nodes are enlarged slightly. Unilateral conjunctivitis.
Which of the following diagnoses is MOST probable?
Adenovirus infection
# 10
*! A man, 20 years old, was admitted to an infectious diseases hospital. He became acutely ill with the appearance of chills, headache, vomiting, fever up to 39C. The next day, an abundant hemorrhagic rash appeared on the skin of the lower extremities. On examination: body temperature 39.0C. In the pharynx: the mucous membrane is hyperemic, the follicles of the posterior pharyngeal wall are hypertrophied. The skin is pale. In the region of the legs, feet of both legs - a hemorrhagic rash of a star-shaped form. Heart sounds are muffled, rhythmic. HELL - 100/60 mm Hg White blood cells in the KLA - 21.5x10 9 / L.
What form of the disease is MOST likely in this clinical case? meningococcemia
# 11
*! A student of 20 years entered February 2 on the 2nd day of illness. Complaints: an increase in body temperature to 40.0 ° C, stubborn headache, vomiting that does not bring relief. On examination: serious condition. In the mind, lies with his eyes closed. In the pharynx diffuse hyperemia and granularity of the posterior pharyngeal wall. The skin is hot to the touch. On palpation, moans due to pain. On the skin of the lower extremities is an abundant petechial rash. In the KLA: lake-25 × 10 9 / l, semi-neutral neutr. - 18%, secondary neutr.-72%, lymph. - 5%, mon.-5%.
What is the most likely diagnosis? Meningococcal infection, meningitis, meningococcemia
# 12
*! A man, 25 years old, fell ill acutely with fever up to 39-40 ° C, severe headache, vomiting once, loss of appetite, weakness, body aches. On examination: clear consciousness, in the throat-slight hyperemia, tonsils behind the arches, no raids. On the skin of the feet is a single hemorrhagic rash. HELL 100/60 mm Hg, pulse 100 beats / min. The local doctor diagnosed SARS, prescribed outpatient treatment, leaving the patient at home.
What symptom should alert the local doctor about meningococcemia?
Hemorrhagic rash
#thirteen
*! A girl, 19 years old, fell ill on March 15, acutely, in full health. Complaints of fever up to 38 0 C, headache, weakness, nasal congestion, sore throat. The state of moderate severity. In the throat: hyperemia of the mucosa, hypertrophy of the follicles of the posterior pharyngeal wall, mucopurulent deposits on the posterior wall. Heart sounds are muffled, pulse -88 beats / min., Blood pressure - 110/70 mm Hg. In the hemogram: white blood cells - 15.0x10 9 / l., ESR - 20 mm / hour. A culture of N was isolated from nasopharyngeal mucus. meningitidis.
What is the MOST correct diagnosis for this patient? Meningococcal infection, nasopharyngitis
14
*! A man, 20 years old, fell ill acutely with fever up to 40 ° C, headache, vomiting, weakness, body aches. On the same day, a hemorrhagic rash appeared on the feet, lower leg, and thighs. The skin is pale. Stiff neck. HELL 90/60 mm Hg, pulse 100 beats / min. In the hemogram: leukocytes - 20x10 9 / l., Leukoformula: myelocytes - 2, s / I - 14, s / I - 78, monocytes -2, lymphocytes - 4, ESR - 40 mm / hour. Cerebrospinal fluid: turbid, flowing out under pressure, Pandy reaction (+++), cytosis of 1500 cells in 1 μl due to neutrophils (95%).
What is the patient’s form of meningococcal infection? Meningococcal infection, mixed form
# 15
*! A girl, 16 years old, a student of the Lyceum, was admitted to the clinic on the 1st day of illness. The disease began acutely with a sudden increase in temperature to 40 ° C, a sharp headache, vomiting, which does not bring relief. At admission: general condition is extremely serious, stupor. Pupils dilated, photoreaction saved. Rigidity of the occipital muscles sharply "+", Kernig symptom "+". General hyperesthesia is noted. In the lungs, vesicular breathing. Heart sounds are deaf, pulse is 130 beats per minute, blood pressure is 100/50 mm Hg.
What form of meningococcal infection should be thought of? Meningitis, generalized form
#sixteen
*! A woman of 25 years, examined on the 2nd day of illness in the emergency room of the infectious diseases hospital. Complaints about Quest shaped abdominal pain, nausea, headache, diarrhea up to 10 times a day, tenez we, false desires. On examination: body temperature - 36.0 ° C, blood pressure - 90/60 mm RT. Art. Pulse - 110 beats per minute. On palpation of the abdomen: pain in the left iliac region, whitefish movidnaya gut spasm. The stool is calcite, mucus streaked with blood. At OAK: er. - 4.0x10 12 / l, Hb -145 g / l, lake-11.4x10 9 / l, e - 1, n - 2, s - 75, l - 18, m - 5. ESR - 17 mm /
Which of the following diagnoses is most likely? Dysentery / acute shigillosis
# 17
*! A woman, 40 years old, turned to a therapist on the 1st day of illness. Ill acutely after 4 hours after pre byvaniya visiting: epigastric pain, nausea around the navel, 4-5 times vomiting, diarrhea to 7-8 times. On admission: temperature - 38ºС. The abdomen is not swollen, palpation painful in the epigastrium and right iliac region. There is no bowel spasm. HELL - 100/60. Pulse - 90 beats per minute Urinates. The chair is plentiful, with mucus, dark greenish in color, fetid.
What is the most likely diagnosis? Acute Salmonellosis
# 18
*! A man, 30 years old, went to the clinic on the 2nd day of illness. He became acutely ill 8 hours after eating poorly fried eggs at home. They began to disturb the pain in the epigastrium, around the navel, nausea, vomiting 3-4 times, frequent loose stools up to 5-7 times a day. On admission: temperature - 38ºС. The abdomen on palpation is painful in the epigastrium and the right iliac region. HELL - 100 / 70mm Hg Urinates. The chair is plentiful, with mucus, dark greenish in color, fetid. The doctor suggested that the patient had salmonellosis.
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Which of the clinical forms (variant) of salmonellosis is the most likely in this case? Gastrointestinal form
# 19
*! A student, 18 years old, lives in a dormitory, became acutely ill with an increase in body temperature to 39C, the appearance of chills, headache, and weakness. Almost simultaneously, cramping abdominal pains appeared, 1 time there was vomiting, loose stools up to 15 times a day. The abdomen is soft, painful in the left iliac region. The stool is fluid, sparse, with mucus and streaks of blood.
Which of the following diagnoses is MOST probable? Acute shigellosis
#twenty
! A man, 18 years old, was admitted on the 3rd day of illness with complaints of cramping abdominal pain, weakness, fever, loose stools up to 15 times a day, false desires. On the eve was at a party, ate a variety of foods (salads, fried mushrooms), drank alcohol. At home he drank water from the column, ate cucumbers, apples from the garden. Body temperature - 37.6ºС. AD-100/70 mm RT. Art. Pulse 90 beats. in 1 min. The stomach is soft. The sigmoid colon is spasmodic, painful on palpation. The stool is sparse, with mucus and streaks of blood. Acute shigellosis
The MOST probable diagnosis in this clinical case is:
# 21
*! A 42-year-old man was taken to the emergency room of the Mangistau Regional Hospital with complaints of temperatures up to 39-40C with tremendous chills, body aches, severe headache, pain in the armpit on the right, and wheezing. He fell ill acutely last night. 3 days ago he participated in the slaughter of a sick camel, cut his hand. The patient's condition is severe due to severe intoxication. BH-20 in 1 min. Pulse - 120 in 1 min., AD-90/60 mm / hour. In the axillary region on the right, a sharply painful, dense motionless conglomerate is palpated, the skin over which is hyperemic.
In the hemogram: white blood cells - 24 x 10 9 / l, p / I neutroph. -14%, s / I neutroph - 82%, lymph. - 2%, mon. -2%. Do not urinate during the day.
What organizational event should you hold first?
