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 №19

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.

Machine operator from mercury metallurgical plant, aged 38, with working experience of 13 years. After the data from sanitary-hygienic characteristics mercury concentration in the air of working place is from 0,02 to 0,3 mg/m3 while maximal permissible concentration (MPC) is 0,01 mg/m3. After periodical medical checkup he was directed to the clinics of institute of occupational diseases with complaints on headache, irritability, troubled sleep, rapid fatigability, heart-beating, hyperhidrosis, metallic taste in mouth, numbness in extremities. On objective examination: expressed emotional lability, general hyperhidrosis, stable red dermographism. Arterial pressure 120/80 - 140/90 mm Hg, pulse rate 86 b.p.m. Tendon reflexes are expressed. Unsteadiness in Romberg’s posture, eyelid and fingers tremor. Intention tremor in finger-nose test. Signs of gingivitis.

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 №20

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 aged 39, battery attendant. Admitted to the surgical hospital with complaints on sharp contractious cramping pains in abdomen, stable constipations. In anamnesys: ulcerous disease, but during last 2 years there was no exacerbations. Objectively: BP – 170/100 mm Hg., inverted abdomen, painfulness at palpation, mostly around umbilicus. Symptoms of peritoneum irritation are negative.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk