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 №4

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 P., 42 years old, is occupied at heat-insulating materials production for 23 years. Immission limit of silicium oxide in connection with metal is exceeded. Complains of progressing dyspnea, even at slight physical exertion, attack-like cough with viscous sputum, pressing pain in chest, general weakness, quick tiredness.

Skin is grey with sallow shade. There are warts on the skin of fingers. Box percussion sound. Breathing is firm, with prolonged exhalation, dry rales, pleura friction sounds. In lower parts of the lungs – small- and medium-bubbling moist rales. X-ray: lung roots are thickened and expanded, vessel-bronchial picture is intensified, it has rough netting structure with darkening – a picture of “pounded glass”, pleura-diaphragmatic commissures.

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 №5

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 P., 47 years old, is occupied at slate production for 18 years. He complains of dyspnea at slight physical exertion, painful cough with viscous sputum, pain in chest of pressing character, headache, quick tiredness, loss of weight. Sometimes nausea occurs.

Colour of skin is grayish, diffuse cyanosis. Barrel-like chest. Breathing is firm, with prolonged exhalation, lots of dry and moist rales, pleura friction. Edema on lower extremities. Sputum investigation: small amount of yellow and gold-brown bodies of elongated form, with square-headed masses at ends. X-ray: tensioned shadows 5-6 mm, pleura-diaphragmatic commissures, symptom of “haired heart”.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk