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 №41

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.

Male after 1 hour of cleaning of transport tank for pesticides felt sharp general weakness, fatigue. Appeared vomiting, than he lost his consciousness.

Objectively: patient’s skin, expired air smells badly. Cold sweat. Hypersalivation, repeated vomiting. Pupils are miotic, with no reaction on light. There is areflexia, expressed muscular hypotonia on extremities, involuntary urination and defecation. Wave-like convulsive twitching of trunk and face. Breathing rate is increased up to 50 per 1 minute, multiple dry rales in lungs. Pulse 60 per minute, BP 119/70 mm Hg.

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

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 №42

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.

Worker from a chemicals warehouse performed the pesticides unloading. After several hours since start of working a headache, hypersalivation, lacrimation, dyspnea appeared.

Objective examination: general state is of moderate severity. The patient is excited. Skin is wet. Miotic pupils. Convulsions in separate face muscles. Hard breathing, dry and sonorous big-bubbling moist rales. Respiration rate– 26 /min. Heart tones are muted, rhythmic. Pulse-50/min, of weak filling. Arterial blood pressure-120/70 mm Hg.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk