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Cитуационные задачи на гос.экзамены для мед ВУЗов

PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE


Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases






Situational task № 1
The patient complains of a sharp shortness of breath, which increases with physical activity. Complaints appeared sharply 2 hours ago at work: sharp pain in the left thorax, coughing. The pain decreased, but increased shortness of breath, dizziness, paleness, cold sweats, cyanosis. Missing vesicular breathing, X-ray - blackout on the left side.
What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?













Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.                                

PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE


Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases



Situational task № 2
The patient 56 years old complains of shortness of breath with difficulty of exhalation, sputum excretion in the morning for a period of 22 years. Smokes 1 pack of cigarettes per day from the age of 18. During the examination of the function of external respiration, the reversibility of obstruction is 10%.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?















Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE


Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases



Situational task № 3
The patient is 27 years old In the history of which is bronchial asthma, bitten by a bee. Appeared feeling of pressure in his thorax, dyspnea, difficulty exhaling, a feeling of heat in the upper half of the trunk, vertigo, pronounced itching, convulsion.
Objectively: breathing is noisy, whistling, blood pressure - 90/60 mm Hg, pulse - 110 / min, heart - rhythmic tones, weakened over lungs - breathing hard, dry whistling wheezing.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?














Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE


Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases



Situational task № 4
Childbirths are timely, continue for 8 hours, in a pregnant woman with stenosis of the mitral opening of the third stage. The pregnant woman is sitting in bed with lowered legs down. Complaints of shortness of breath, breathing with an open mouth, face and upper body covered with sweat, cyanosis. At a distance you can hear wheezing, and from the mouth is allocated foamy, with impurities of blood, sputum. Pulse 130-150.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?















Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE


Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases



Situational task № 5
In the chronic smoker at the age of 52 years with physical activity suddenly a strong prickly pain appeared in the left half of the thorax, cough, severe shortness of breath, tachycardia, and decreased blood pressure. On the ECG signs of overloading the right heart departments. On the radiograph of the thorax, there is no pulmonary pattern in the left half of the chest, the mediastinal organs are shifted to the right.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?

















Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE



Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases



Situational task № 6
A woman of 23 years complains of acute pain in the left half of the thorax, shortness of breath, which increases with any hands. He suffers from bronchial asthma, the above complaints arose during an attack of asphyxia, which was accompanied by a long cough.
When examining a moderate cyanosis of the face, the left half of the thorax lags behind in the act of breathing. Percussion left tympanitis, weakened breathing. Respiration rate - 26 / min. Tones of the heart are weakened. Heart rate is 96 / min.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?












Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE


Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases



Situational task № 7
The patient 58 years old suffers from type 2 diabetes. Delivered to the clinic in a difficult condition, unconscious. The patient consumed the large doses of diuretic drugs. Objectively: the condition is hard, the smell of acetone in the air that exhales, is absent. The skin is dry, pulse - 120 /min., BP- 80/40 mm Hg, blood glucose – 52 Mmol/l, acetone in urine + , рН-7,30; creatinine - 230 micromoll/l.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?















Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE




Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases





Situational task № 8
Patient 60, who for 20 years suffered from hypertension, after a stressful situation sudden attack of breathlessness. Objectively: orthopnetic position, Ps — 120 min., BP - 210/120 mm Hg. 1 tone above the tip of the heart is relaxed, in the diastole an additional tone is heard. Breathing frequency - 32/min. Breathing of lower regions of the lungs weakened, single wet tiny wheezing.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?











Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE




Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases





Situational task № 9
A woman 64 years old, with an unstable angina during the walk, suddenly fell. Another physician at the examination of the patient stated absence of consciousness, ripple on arteria carotis and heart tones; Narrow pupils and liquid, superficial breath.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?













Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE



Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases



Situational task № 10
The patient is 64 years old with a diagnosis coronary heart desease: Stable angina functional class II, heart failure IIA. Accepts prescribed a doctor treatment complex (nitrates, inhibitors Angiotensin converting enzyme, statins), she noted a decrease in the frequency and strength of angina attacks, but there was a headache, dizziness.

What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?















Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE




Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases





Situational task № 11
The patient is 30 years old, complains of headache and heartbeat after emotional stress. Suffering from hypertension within 2 years. When examined, the patient is excited, the face is hyperemic, the skin is moistened. Pulse -  100 per min., BP - 180/90 mm Hg.
What emergency condition arose in the patient?
Which drug should be prescribed for emergency care?














Head of the Chair of Surgical and
internal diseases with the course of pediatrics
MD, Professor. Goncharuk O.
PRIVATE HIGHER EDUCATIONAL ESTABLISHMENT
THE INTERNATIONAL ACADEMY OF ECOLOGY AND MEDICINE



Specialty: 7.12010001, General medicine
Discipline: internal, infectious and occupational diseases



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