Ministry of Health Protection of Ukraine

Bukovinian State Medical University

Medical Faculty №3

“Approved”

Central guidance committee of Bukovinian State Medical University

“14” March 2013 year (protocol №6) Head of the central guidance committee, Vice-Rector for scientific-pedagogic work Associate professor ________I.V. Gerush

Clinical Task №32

for practical-oriented state exam on

internal, occupational and infectious diseases

for 6^th year students of medical faculty №3

Occupational skill “Algorithm of diagnosis, emergency treatment and rehabilitative measures at occupational pathology”

1. What is preliminary diagnosis?

2. Suggest treating and rehabilitative measures for the patient.

Female 40 years old has been working at factory for production of paints. She has a contact with benzol and aniline, exhaust ventilation was malfunctioning. Complaints on acute headache, vertigo, buzzing in the ears, flicking in the eyes.

Objectively: cyanosis of mucous membranes, nose, auricles. Heart tones are muffled, pulse is labile, BP-160/90 mm Hg. Patient is disoriented, speech is disjointed.

CBC: Er - 4,6x10¹²/l, Hb-143 g/l, reticulocytes-18%, CI-0,9, L-5,6x10⁹/l, bodies of Geihns-Erlich-14%, methhemoglobin-36%, ESR-5mm/h.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk

Ministry of Health Protection of Ukraine

Bukovinian State Medical University

Medical Faculty №3

“Approved”

Central guidance committee of Bukovinian State Medical University

“14” March 2013 year (protocol №6) Head of the central guidance committee, Vice-Rector for scientific-pedagogic work Associate professor ________I.V. Gerush

Clinical Task №33

for practical-oriented state exam on

internal, occupational and infectious diseases

for 6^th year students of medical faculty №3

Occupational skill “Algorithm of diagnosis, emergency treatment and rehabilitative measures at occupational pathology”

1. What is preliminary diagnosis?

2. Suggest treating and rehabilitative measures for the patient.

In worker from paint-and-lacquer materials production after accident on the factory the general weakness, vertigo, painfulness in lumbar and right hypochondrium appeared.

Objectively: icteric shadow of sclera. Heart tones are muffled, BP-100/60. Liver is found 3 cm lower than right costal margin.

CBC: Er-2,0x10¹²/l, Hb-90 g/l, L-5,6x10⁹/l, bodies of Geihns-Erlich, ESR-15 mm/h. Biochemical blood analysis: unconjugated bilirubin-54mcmol/l.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk

Ministry of Health Protection of Ukraine

Bukovinian State Medical University Medical Faculty №3

“Approved”

Central guidance committee of Bukovinian State Medical University

“14” March 2013 year (protocol №6) Head of the central guidance committee, Vice-Rector for scientific-pedagogic work Associate professor ________I.V. Gerush