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 №39

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.

Patient F., 28 years, was sprinkling trees and bushes with pesticides for several hours without individual defensive means. After work gripes in eyes, coryza, sneezing appeared. In half an hour dry cough, breathlessness, headache, dizziness, pain in abdomen, vomiting and fever up to 38,4°C joined.

General condition is moderately grave. Consciousness is not clear. Face skin hyperaemia, injections of conjunctive vessels. BR-20/min, breathing is vesicular, firm. PR-96/min, rhythmical, weak. AP-90/60. Heart borders are normal, tones are clear, additional sounds are not heard. Abdomen is strained, painful in umbilical area. Liver is found 1 cm lower than right rib arc, its rim is sharp and painful.

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 №40

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.

Patient M., 50 years, complains of irritation of mucous layers of nose and mouth, sneezing, delacrimation, dry cough, hoarse voice, sweet taste in mouth, general weakness. It is known that she were unloaded sacks with calcium arsenate.

General condition is moderately grave. Tremor of palm fingers. Skin is pale and clean. Hyperemia of mucous layers of upper respiratory tracts. BR-18/min, vesicular. PR-72/min, AP-100/60. Heart tones are muffled, systolic murmur on apex. Abdomen is strained, soft and painful in right subcostal area at palpation. Liver is found 1,5-2 cm lower than right rib arc, its rim is round, soft and painful. Regions of large intestine – without peculiarities.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk