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Frostbites.Solar and heatstroke.




Warmisolateddressing - this is

+ Gauze bandage, soaked with alcohol

cotton - gauze bandage with furacilini

cotton - gauze bandage with vaseline oil

a sterile cotton-gauze bandage with polyethylene or rubber cover

a sterile cotton-gauze bandage

***

 

Forcedwarmingallowsfrostbite, reaching

Freezing of tissues

4 degree

3 degree

+1 and 2 degrees

4 and 5 degrees

***

 

First aid before the reactive period includes

 

rapid warming, rubbing with snow

the forced warming of frostbitten extremeties, plunging her into a bath with the water temperature in 40

the forced warming, including warming lamp or hair dryer

treatment with alcohol

+ treating the alcohol, application of warmisolatedbandage

 

***

 

 

How many degrees of the frostbite do you know

+4 degree

5 degree

2 degree

.3 degree

1 degree

***

 

 

What kind of periods of frostbite

 

+prereactive and reactive

primary and reactive

subacute and acute

prereactive and subacute

subacute

***

 

.How many stages of frostbite do you know

Stages

Stages

Stages

Stages

Stages

 

 

In the reactive period necroectomy should perform

on 1st day

on the third day

+ at the 5-6th day

on ​​14-15th day

for 8-10th day

***

 

Amputation and disarticulation after frostbite can be listed at all, except

primary

secondary

lated

+thedeferred

primary-secondary

***

 

The primary amputation for deep and extensive frostbite conducted


immediately on admission to prereactive period

in the early hours of prereactive period

the first day of prereactive period

+ for 4-5 day of reactive period

after 3-4 weeks in a reactive period

***

 

What kind of stage of frostbite characterized by absence of pain

3 stage

4 stage

+ 1 stage

2 stage

1-2 stages

***

 

How do correctly implement active, but not the forced warming in water bath

+ Warming starts with water temperature 18 C, raising it to 35 C for 10-15 min

Warming water temperatures begin with a 0 C, raising it to 55 C for 5 min

Warming starts with water temperature 40 C without temperature lift

From reduction of the general temperature of the body till 25ѩ

Reinforcement function defense mechanisms of the organism

***

 

The intensity of pain after warming at frostbite depends on

the total rate of cooling

+ the depth and spread of the pathological process

the total reduction in body temperature to 25 C

strengthening the functions of protective mechanisms of the organism

Warming begin with temperature of water in 40 without ascent of the temperature

***

Poisoning

Etiopatogenetic classification includes poisoning, except

random

intentional

+ pathochemical

production

household

***

 

Syndrome of lesions of the respiratory syndrome includes

convulsions

+ hypoxic hypoxia

OSSN

pain

exotoxic shock

***

 

Methods to enhance the natural detoxification of the body all, except

gastric lavage

forced diuresis

therapeutic hyperventilation

purgation

+ the exchange of blood replacement

***

 

At poisoning with carbon monoxide when there is severe condition

headache, nausea

dyspnoes,hortness of breath

loss of consciousness, facial flushing

vertigo, vomiting

+ convulsions, paresis, paralysis

***

 

What complications can be from the point of cardio-vascular system in the administration of alkaline

+ non-specific tachycardia, drop in blood pressure

bradycardia, hypoxia

atrial fibrillation

tachycardia, sustained increase in blood pressure

no complications

***

 

The main syndrome in the administration of alkaline is

alcohol intoxication

shortness of breath, dry cough

+ burn of the digestive tract

perforation of the colon

acute respiratory failure

***

 

The patient A., 25 years old admitted to the hospital by ambulance, objectively: the moderate severity state, consciousness confused, delirious, pupils contracted, nausea, and vomiting. Relatives say that 4 hours ago he ate mushrooms, among which poisoned ones were. What can you do to help


+ Atropine injection

Conduct a hemodialysis


Heparine injection

The proteolytic enzymes injection

perforation of colon

***

Bites and stings.

What is a form of allergic reaction at stings

generalized urticaria, itch, weakness, fear feeling

dyspnoe, pain in abdomen, nausea, dizziness, vomiting

asphyxia, dysphagia, inconsequence of thoughts, hoarse voice, feeling of doom

shock, cyanosis, falling of AP, collapse, defecation, loss of consciousness

+ All answers are right.

***

 

The body of these insects has length mare than 1 cm. At their stings during first 15 minutes expressed spastic pains in muscles, perspiration, and vomiting appear. For occupation of pains morphine can be used. Has considered, that atropine has favorable action in this situations

 

+ sting of spider

bite of snake

bite of scorpion

sting of tick

sting of bee.

***

 

To the department of first medical aid a 7-th years patient with complains on the pain in the right extremity and dizziness was hospitalized. In inspection there is a pale skin. There are 2 pricking wounds with expressed edema, blushing and hemorrhage under skin in the area of thigh. The body temperature is 38 degree by Celcia, AP is 80/60 mm Hg. Your preliminary diagnosis is

 

+Poisoning with snakepoison

Hydrophobia

Poisoning with carbon monoxide

Poisoning with sinile acid

PTI.

***

 

The first aid at bite by venomous snake is

+Horizontal position, rest, sucking out of poison by mouth during 10 minutes, process place of bite by spirits, applying of antiseptic bandage

Horizontal position, rest, applying of tourniquet on damaged extremity

 

The position is sitting, sucking out of poison by mouth during 10 minutes, process a place of bite by spirits, applying of antiseptic bandage

Washing a place of bite by water, applying of tourniquet on damaged extremity

All answers are right

***

 

What symptoms dont characterizes a place of sting by karakurt

A pain in the place of bite disappears soon

No edema in the place of bite;

Sharp exciting, fear of death, dyspnoe

Strong pains in all body, in the area of abdomen, chest, small of the back

+Sharp intense of abdominal muscles

***

 

A patient of 42 years old was admitted to the urgent medical aid with a bite (sting). A bite (sting) was 20 days ago. A patient has inconsequent speech, spasm and pricking at the place of bite (sting), salivation, muscular weakness. What pathology has this clinic

Fever

General intoxication

Cerebral paralysis

+ Hydrophobia

Botulism

***

 

A patient of 42 years old was admitted to the urgent medical aid with a bite (sting). A bite (sting) was 20 days ago. A patient has inconsequent speech, spasm and pricking at the place of bite (sting), salivation, muscular weakness. In palpation: pain in place of bite (sting), edema, blushing. What will be your following tactic of treatment

 

Antibacterial therapy

+Vaccination

Conservative treatment by analgetics

Usage of hepacidic preparations

Citostatics

***

 

In bites (stings) the following signs can appear, except

Rash and urticaria;

Dizziness, weakness; ;

Increasing of respiration rate and pulse rate too

Discoloration of fecalium

+ Nausea and vomiting

***

 

Determine the first aid at bite by dog with suspicion on hydrophobia

Abundant washing of wound by water

applying of sterile bandage on the wound

Urgent address to the doctor

+ Vaccination

Washing of stomach

***

The patient was admitted to the doctor with a cutting wound. The wound is not deep, a bottom is in the middle layer of subcutaneous tissue. In asking the patient said, that damage was made in fight with razor about 2 hours before. In inspection: the wound is localized on the anterior abdominal wall, there is no pus and pollution by anaerobic microflora of wound and surrounding tissue visually. What is your tactic

+Processing and applying of sutures

Processing and cutting of wound borders

Applying of pressing bandage

Applying of aseptic moist-dying bandage

Drainage of wound

***

 

Which form of asphyxia is asphyxia and drown

Instantaneous

Electrical

Anaerobic

+ Mechanical

Slow

***

 

Determine the extent of electrical injury: loss of consciousness, disturbance or cardiac or respiratory system (or both together)

1 degree

2 degree

+ 3degree
4 degree

degree is not defined as data are insufficient

***

hat should be injected at respiratory depression

strophanthin

+ lobeline


adrenaline

neostigmine methylsulfate (proserine)

ascorbic acid

***

 

In the reactive period necroectomy should perform

on 1st day

on the third day

+ at the 5-6th day

on ​​14-15th day

for 8-10th day

***

The main syndrome in the administration of alkaline is

alcohol intoxication

shortness of breath, dry cough

+ burn of the digestive tract

perforation of the colon

acute respiratory failure

***

Methods to enhance the natural detoxification of the body all, except

gastric lavage

forced diuresis

therapeutic hyperventilation

purgation

+ the exchange of blood replacement

 

Call at home. Boy 10 years old. Complaints: fever, cramps, headache, stuffiness in nose, frequent painful cough, anxiety, drowsiness. He ill acutely, when the body temperature increased till 38.10 C, headache, in the morning appeared often painful cough, spasms of hands; the body temperature reached 39.00 C, drowsiness. The boy had been in contact with flu patient 3 days before the disease. Objective: expressed depression of consciousness, the child is sleeping, not responding to inspection. The generalized convulsions are observed. Body temperature 40,00 C. The skin is pale, the single petechial rash in the neck. The marked hyperemia of the soft palate with an injection of blood vessels and petechial hemorrhages to mucosa are observed. The breathing is arhythmic, dry rales are auscultated. The tachycardia, softened tones are hear on auscultation. Put a preliminary diagnosis:

+cerebral coma II degree

influenza, severe form

febrile cramps

viral meningitis

staphylococcal sepsis

***

Call to the girl of 2 years. At the girl against the catarrhal phenomena (the hyperemia of the soft palate and conjunctives, cold) raised body temperature to 40,20 and suddenly attack of general spasms of the clonic-tonic character, proceeding developed about 3 minutes. At survey the consciousness is depressed to sopor degree, skin pale, with marble shade, acrocyanosis. Tones of heart are muffled, HR 162 per minute. RR 80 per minute. The abdomen is soft. The liver and spleen were not enlarged. Put a preliminary diagnosis:

meningococcal nasopharyngitis

encephalitis

neurotoxicosis II degree

+febrile seizures

child tetany, laryngospasm

***

Calling a girl seven years old, desperately ill three days ago, with a body temperature of 39.20 C in a background of moderate catarrhal symptoms. On the 2nd day - in a rash of small, closely spaced bubbles in the hyperemic background around the nose, around the lips and on the right ear, accompanied by a distinct local pain. On the third day at the height of the temperature 40.30 C - attack of tonic-clonic seizures. Seizures spontaneously stopped, but did not come into consciousness, stopped answering questions, touching, the reaction to painful stimuli only. Hypertonicity in the legs, increased deep tendon reflexes, positive Kernig's symptoms, Brudzinskii, anisocoria right, stiff neck for 2 muscles transverse finger. Put a preliminary diagnosis:

encephalomyelitis, infectious-allergic

+encephalitis herpes, cerebral coma

flu, a heavy, neurotoxicosis II degree

meningoencephalitis, parainfectious

child tetany, carpo-pedal spasm

***

Calling a child 12 months, morning body temperature suddenly rose to 39.70 C, there is concern, worsened appetite. By lunchtime, the child became very sluggish, marked pallor, acrocyanosis and persistent marbling of the skin, seizures. The child is given paracetamol, but the temperature is maintained within the 380C. The family has the flu. Heart rate 300 per minute. The ECG character set sinus tachycardia. Put a preliminary diagnosis:

meningococcal disease, meningococcal nasopharyngitis

an attack of paroxysmal tachycardia, supraventricular form

+neurotoxicosis II degree, tachycardia syndrome, neurogenic

influenza, severe degrees of severity, hyperthermia syndrome

influenza of moderate severity, hyperthermia syndrome

***

Calling a child 10 months. Ill two days ago, raising the temperature to low-grade, small serous nasal discharge, catarrhal conjunctivitis. Then the body temperature rose to 39.50 C, became lethargic, refused food, there was vomiting, not related to meals, once clonic-tonic convulsions. On examination: general condition difficult. Listless, crying. The body temperature of 39.20C. Lying on your back with outstretched arms at your sides and bent at the knee and hip joints of your feet. There is tilting the head back, a bulging fontanelle large, sometimes jerking of the limbs. Skin pale. In the throat flushing the posterior pharyngeal wall. Muffled heart sounds, heart rate = 138 per minute. Pees a little. Put a preliminary diagnosis:

+ meningitis

encephalitis

neurotoxicosis

febrile seizures

child tetany

***

Calling a child of 9 years. After a tick bite, which happened 10 days ago, acute fever, and appeared to 390C malaise, headache, vomiting, dizziness, sleep disturbances, muscle pain and tension of the back of the neck muscles. After 5 days the temperature returned to normal, but rose again in a week. This was accompanied by intense headache, repeated vomiting, unsteady gait. On examination, determined not sharply marked meningeal symptoms, light hemiparesis. Put a preliminary diagnosis:

severe meningococcal meningoencephalitis, severe

acute encephalitis, febrile form of severe

+acute tick-borne meningoencephalitis, two-wave during

encephalitis, poliomieliticheskaya form during acute

epidemic encephalitis, subacute

***

Calling a child of 5 years. On examination, the doctor found an ambulance symptoms of intoxication in the form of fever, tachycardia, blood pressure and shortness of breath. In the area of the buttocks, thighs and lower legs revealed the presence of hemorrhagic rash - a crude, which has the form of stars of different shapes and sizes, dense to the touch, protruding above the skin. Roughly pronounced meningeal symptoms. Put a preliminary diagnosis:

meningococcal meningitis, nasopharyngitis

meningococcal meningitis, meningoencephalitis

meningococcal infection, viral meningitis

+meningococcal meningitis, meningococcemia

meningococcal infection, fungal meningitis

***

Call an ambulance for a child 8 years old. The child developed generalized weakness, painful headache and muscle pain, fever sharply to 39 C. The patient was difficult to keep her head - she "falls" on the chest, it's hard to raise their hands up, take in hand. It is known that 10 days ago, a patient bitten by a tick. Put a preliminary diagnosis:

tick-borne meningoencephalitis, febrile form

+encephalitis, a form of poliomieliticheskaya

epidemic encephalitis Economo, the primary

parainfectoius encephalitis, secondary

encephalitis after vaccination against tick-borne encephalitis

***

Calling a child 11 years old. Complaints of recurrent headaches. In the afternoon, after physical overstrain, he felt "a blow to the head", was vomiting and transient loss of consciousness. At survey: psychomotor agitation. Rough meningeal syndrome - a hypersensitivity to light and sound, neck muscles regidnost 4 cm. Positive Kernig's symptoms, the symptoms of upper and lower Brudzinsky. Put a preliminary diagnosis and the development of the disease is caused by

hemorrhage in the right frontal lobe due to cardiac disease

hypertensive crisis due to the defeat of the cortico-tract nuclei

hypertensive crisis caused by physical overexertion

subdural hemorrhage due to trauma

+subarachnoid hemorrhage due to aneurysm

***

Calling a child of 5 years. Complaints from the words of my mother, shortness of breath, fainting, seizures. On examination: The child in the state soporous. Respiration irregular. Percussion clear lung sounds, auscultation, vesicular breathing, no wheezing. Tachycardia. Diffuse muscular hypotonia, absent tendon reflexes, dilated pupils as on both sides, there is no reaction to light, the eyeballs are fixed. What drug and for what purpose it is necessary to introduce a child in this case

heparin, because the effect of hypo-coagulation has

metamizole sodium because it has an analgesic effect

+furosemide because of the dehydration effect has

polyglukin, because the effect has volemic

aminocaproic acid, because it has a hemostatic effect

***

Tactic of emergency doctor at laryngostenosis of III - IV degree:

intramuscular or intravenous introduction of antioxidants

+intubation of trachea or conicotomy

introduction of stomach probe

intramuscular or intravenous introduction of hormonal drugs

lying transportation

***

A patient is 14 years old with the attack of dispnoea. The brigade of emergency aid is caused. In anamnesis: attacks of dispnoea are during 7 years. Acute attacks of disease arise in a cold season. Deterioration of the condition is during 12 hours on a background of AVRI. For past 12 hours salbutamol repeatedly used, in the beginning with an insignificant effect, after - without an effect. At examination: the condition heavy. Sits, leaning hands in knees. Dry rales an be heart in the distance, expiration difficulties. Skin pale with a cyanotic shade. Number of breathing - 30 in 1 min. Cough is dry, "uneffective". Pulse is 100 in 1 minute, rhythmic. In lungs are dry sibilant rales above all pulmonary fields, in lower parts breathing is diminished. Put a preliminary diagnosis

laryngospasm

obstructive bronchitis

acute pneumonia

+bronchial asthma

destruction of lungs

***

A child is 2 months. Became ill sharply from the increase of temperature till 380C, cough, and rhinitis. During the following 3 days the condition deteriorations, a cough had become paroxysmal, an appetite`s loss, a patient became anxiety. Perioral cyanosis, acrocyanosis, "oral" crepitation, retraction of compliant places of thorax is observed, breathing to 72 in a minute. Vesiculotympanitic resonance, mass of small moist rales on both side. Put a preliminary diagnosis

pneumonia

+bronchiolitis

obstructive bronchitis

acute bronchitis

tracheobronchitis

***

To the child of 10 months emergency ambulance is caused. According to a mother, a child during weeping turned blue, the stop of breathing, twitch of extremities, narrowing of pupils, was marked. During an attack a child threw back a head back; a death-damp was marked. In 20 seconds, breathing was restored. Put a preliminary diagnosis

bronchospasm

+laryngospasm

episyndrom

febrile spasm

laryngostenosis

***

Call of brigade of first-aid. Child of 1 year 4 months is, 3th day of illness. Became ill sharply: anxiety, rhinitis, temperature of 37,40 appeared. To the evening there was hoarseness of voice, rough "barking" cough, breathing difficulty. During the 3th days of child treated at home. The attacks of difficulty in breathing in every next night became all heavier and longer, appetite bad. At examination a girl pale, flabby, is capricious. At breathing participation an auxiliary musculature of thorax is marked, dyspnoea to 50 in min. Hoarseness of voice, sometimes complete aphonia, cyanosys. Hoarseness of voice, sometimes complete aphonia, cyanosys of nasolabial triangle. Pulse rhythmic, tachycardia to 160 in min. Put a preliminary diagnosis

acute laryngotracheobronchitis

+laryngostenosis

diphtheria of larynx, true croup

obstructive bronchitis

acute pharyngitis

***

Call to the child of 3 years old. On a background of ARVI in boy appeared: obtrusive cough, dispnoea and whistling breathing. Doctor-pediatrician 3 days back appointed to the child inhalation salbutamol and ambroxol in tablet. In the moment of examination: boy anxiety, temperature of body 36,80 C, skin pale, a cough present, breathes noisily, dispnoea with the difficulty expiration, breathing rate-48 in a minute, in lungs rough breathing, on all surface examined mass of dry whistling rales. Define emergency doctors tactic to this child

to appoint to consultation of pulmonologist

to appoint to consultation of allergist

to increase the dose of inhalation salbutamol

+to hospitalize inpatient department

to add antibacterial preparation in treatment

***

Call to the child of 1year 2 months. From words of mother a child ill during 3 days. In the moment of examination: boy anxiety, temperature of body 37,00C, skin is pale, paroxysmal cough, noisy breathing heard in the distance, dispnoea with the difficulty expiration, breathing rate-45 in a minute, in lungs rough breathing, on a front surface examined the moist rales of different caliber in a small amount. Put a diagnose

laryngostenosis

foreign body

acute bronchitis

+obstructive bronchitis

acute respiratory viral infection

***

Call to the child of 8 years old. Became ill sharply, 4 days back when a cough and increase of temperature till 39,00 appeared. In the moment of examination: boy flabby, temperature of body is 37,70, skin pale, moist cough, dispnoea with participation an auxiliary musculature, and breathing rate-30 in a minute. There is the rough breathing in lungs, in an interscapular area locally examined to single moist small bubble and crepitus rales on height of inspiration. Put a diagnose

intrahospital pneumonia, local, acute current, respiratory failure

extrahospital pneumonia, segmentary, prolonged current, respiratory failure

extrahospital pneumonia, local, acute current, respiratory failure

+extrahospital pneumonia, local, acute current, respiratory failure

intrahospital pneumonia, total, acute current, respiratory failure

***

In child of 4 months the signs of anxiety appeared on a background external wellbeing, difficulty breath with retraction on inspiration jugular and subclavian fosses, dry obtrusive "barking" cough, easy perioral cyanosis. Temperature of body 36,80, sweating is marked. At examination found out the signs of easy rickets. A muscle tone decreases. Meningeal symptoms are not present. Inner organs are without pathology. Your preliminary diagnosis is

ARVI

laryngotracheostenosis

+spasmophilia, laryngospasm

acute bronchitis

obstructive bronchitis

***

Call to the child of 4 months. Complaint from mother`s words on a sudden anxiety, difficulty breath with retraction on inspiration jugular and subclavian fosses, dry obtrusive "barking" cough, easy perioral cyanosis. Temperature of body 36,80, sweating is marked. At examination found out the signs of easy rickets. A muscle tone decreases. Meningeal symptoms are not present. Inner organs are without pathology. The emergency doctor at this disease will appoint

+calcium gluconate i/m

luminalum peros

seduxeni i/m

prednisolonum i/m

thiaminum i/m

***

Call to the child of 3 years old. Became ill two week ago, sharply, when rhinitis, cough appeared with the insignificant secretion of light sputum, increase of temperature till 38C, in 3 days a temperature went down till 37,2C. However a dry cough increased, "whistle" and dispnoea appeared. In anamnesis: frequent ARVI, during a year twice carried an acute bronchitis with the prolonged dry cough till vomiting. llergoanamnesis: in child a rash and edema of eyelids on citrus was marked. Heredity: the mother of child reported that in summer during a few years in her stuffiness of nose, a sneeze, lacrimation, itch of nose and eyes appears. Objectively: temperature of body 36,7C, skin is pale, dry, nasolabial triangle with cyanotic shade, breathes with open mouth, stuffiness of nose, under eyes blue circles. Fauces of usual colour is. Thorax of ordinary form is. An auxiliary musculature participates in the act of breathing. At percussion lung sound with a small box shade is. At auscultation: rough breathing with prolonged expiration, with dry whistling and buzzing rales audible identically above all surface of thorax. BR 30 in min. Heart tones are sounding, rhythmic, HR 110 in min. Abdomen is soft, painless. Stool and dieresis are in a norm. What must be appointed to the patient at this disease

+salbutamol, because gives a rapid bronchodilatator effect

euphyllini, because possesses a broncholytic activity

seduxeni, because possesses a sedative action

salmeterol, because possesses the prolonged action

ampicillin. because possesses an antibacterial action

***

Call to the child of 3 years old. Became ill two week ago, sharply, when rhinitis, cough appeared with the insignificant secretion of light sputum, increase of temperature till 38C, in 3 days a temperature went down till 37,2C. However a dry cough increased, "whistle" and dispnoea appeared. In anamnesis: frequent ARVI, during a year twice carried an acute bronchitis with the prolonged dry cough till vomiting. llergoanamnesis: in child a rash and edema of eyelids on citrus was marked. Heredity: the mother of child reported that in summer during a few years in her stuffiness of nose, a sneeze, lacrimation, itch of nose and eyes appears. Objectively: temperature of body 36,7C, skin is pale, dry, nasolabial triangle with cyanotic shade, breathes with open mouth, stuffiness of nose, under eyes blue circles. Fauces of usual colour is. Thorax of ordinary form is. An auxiliary musculature participates in the act of breathing. At percussion lung sound with a small box shade is. At auscultation: rough breathing with prolonged expiration, with dry whistling and buzzing rales audible identically above all surface of thorax. BR 30 in min. Heart tones are sounding, rhythmic, HR 110 in min. Abdomen is soft, painless. Stool and dieresis are in a norm. What preparations can not be used for this state, except

+berotec

calcium gluconate

broncholytin

solutan

aminazinum

***

Call to the child 8 months. Child with signs of atopic dermatitis on a skin and mucous membranes, patient with a respiratory disease is. On 4-th day of disease a barking rough cough, common anxiety, appeared, dispnoea with retraction of compliant places of thorax on inspiration, noisy breathing, hoarse voice. What do appearing symptoms testify about

+croup syndrome

congenital stridor

attack of whooping-cough

foreign body

acute pneumonia

***

Call an ambulance to a child 5 years old. In the words of my mother, after eating the cake, by 6:00 there was nausea, there was frequent vomiting. OBJECTIVE: The state of moderate severity. The child was pale, there is nausea. On palpation of the abdomen is marked tenderness in the epigastric region. The liver and spleen did not appear from under the costal arch. Emergency physician performed gastric lavage. Specify the length of the probe, for which he was introduced

from the ear lobe to the tip of the nose

from nose to ear lobe + base xiphoid process

from the back of the nose to the base of the ear lobe + xiphisternum

from nose to tip of nose to base + xiphisternum

+from the earlobe to the tip of the nose to the ground + xiphisternum

***

Call an ambulance to a child 7 years old. After the use of poor-quality food in the dining room after 6 hours there was nausea, there was frequent vomiting, headache, weakness. Indicate the total amount of fluid needed to flush the stomach:

600-800 ml

800-1000ml

1000-3000m

3000-5000ml

+5000-7000ml

***

Indicate which of the drugs has sorbing action and why?

no-spa, as lowers the tone of smooth muscles of internal organs, and intestinal peristalsis, dilates blood vessels. It has no effect on the autonomic nervous system, does not penetrate the CNS.

because Rehydron used to correct electrolyte and fluid losses from diarrhea or vomiting.

+because the smectite efficiently absorbs and removes the body of viruses, bacteria, toxins, intestinal gas and bile salts.

because suprastin has anticholinergic activity and moderate inflammatory properties.

as imodium reduces motility and increases the time of the contents of the intestines. Increases the tone of the anal sphincter, contributing to a better retention of stool and reduce fecal urgency.

***

A child 2 years, 6 hours after ingestion of yogurt increased body temperature up to 380S, there was nausea, 3-fold vomiting, and headache. Indicate emergency indications for gastric lavage Prehospital:

in the first 2 hours after receipt of the poison in the gastrointestinal tract, and only in cases of poisoning with cauterizing is not poisonous

+in the first 12 hours after receipt of the poison in the gastrointestinal tract, and only preserved awareness

regardless of the time that has elapsed since receipt of the poison in the gastrointestinal tract, and if the patient had no vomiting

if there was a spontaneous vomiting, flushing it need not be repeated and only if the patient had no vomiting

after receipt of the poison in the gastrointestinal tract and all patients with suspected acute poisoning

***

Caused by the ambulance, the child was 3 months (birth weight was 3400.0 g). Complaints from the words of my mother, to raise the body 39.8 t 0, expressed by pale skin, cold extremities, lethargy. Your tactic of pre-hospital?

Seduxenum 2.0 ml / m and 1.0%, 0.5 ml of atropine, prednisolone 80mg, emergency hospitalization

the child warm (hot-water bottles to the feet, hands), w / o no-spa 0.2 ml, 1% dibazol 0.2 ml, 2% papaverine, 0.2 ml, 0.2 ml of nicotinic acid, paracetamol syrup ½ tsp.

the introduction of lytic mixture / m 50% solution was injected dipyrone at a dose of 0.4 ml of 2% papaverine solution was 0.4 ml, 1% solution of 0.4 ml dimedrol.

the child warm (hot-water bottles to the feet, hands), w / o no-spa 0.1 ml, 1% dibazol 0.1 mL, papaverine 2% 0.1 ml, 0.1 ml of nicotinic acid, 0.5% relanium 0 4 ml / m

+the child warm (hot-water bottles to the feet, hands), w / o no-spa 0.1 ml, 1% dibazol 0.1 mL, papaverine 2% 0.1 ml, 0.1 ml of nicotinic acid.

***

Calling hide with a child 3 years old. From history: 20 minutes ago accidentally swallowed a small amount of reserpine tablets. Objective: The child's grave. Periodically there are convulsions. Skin face hyperemic sclera, nasal breathing is difficult. Peripheral cyanosis, marbling of the skin. Shortness of breath to 50V min. PS - 150 per minute. BP 50/20 mm. mercury. column. Abdomen soft and painless. The liver is 1.0 cm from under the costal arch. Your tactic of pre-hospital:

oxygen, relanium 0.1 ml / m, gastric lavage, activated charcoal 0.5 g, emergency hospitalization in the intensive care unit

relanium 0.4 ml / m, gastric lavage, activated charcoal, 2.0 g, emergency hospitalization

oxygen therapy, Seduxenum 1.0 ml / m and 1.0%, 0.2 ml of atropine, gastric lavage, activated charcoal 1.5 g, prednisolone 60mg, emergency hospitalization.

oxygen therapy, Seduxenum 0.8 ml / m and 1.0%, 0.1 ml of atropine, gastric lavage, activated charcoal 1.0 g, prednisolone 10mg, emergency hospitalization

+relanium 0.2 ml / m, gastric lavage, activated charcoal, 2.0 g, emergency hospitalization in the intensive care unit

***

Calling the child is 2 years old, who at night have stomach pain, 3-fold vomiting, profuse with the remnants of undigested food. In the evening, according to the mother, the child ate with great appetite, a lot of dumplings. My mother, said that in the last vomit was bile. Place a provisional diagnosis?

Acute phlegmonous appendicitis

Acute intestinal intussusceptions

obstructive ileus

dynamic ileus

+functional dyspepsia

***

Calling the child is 2 years old, who at night have stomach pain, 3-fold vomiting, profuse with the remnants of undigested food. In the evening, according to the mother, the child ate with great appetite, a lot of dumplings. My mother, said that in the last vomit was bile. Your tactics and the sequence of actions:

gastric lavage, giving laxatives, cleansing enema formulation, activated charcoal method

receiving activated charcoal, gastric lavage, giving laxatives, cleansing enema formulation

gastric lavage, giving laxatives, cleansing enema formulation, activated charcoal method

gastric lavage, cleansing enema formulation, giving laxatives

+gastric lavage, activated charcoal, cleansing enema formulation, hospitalization

***

Call an ambulance for a child 9 months, became ill in the morning when the body has risen 39.7 t 0, became restless. The child is given paracetamol at 4 h 39.7 t 0.Rebenok body is crying. Breathing hard, scattered wet and dry rales. RR 48 per minute. Auscultation of heart sounds are muffled. Heart rate = 138 per minute. Abdomen soft and slightly swollen. The liver and spleen were not enlarged. Urinating in the morning last. The chair was once in the last two days designed. Indicate which of the drugs used in this case and why?

heparin, because that increases renal blood flow, increases the resistance of cerebral vessels, has a hypolipidemic effect, enhances the activity of parathyroid hormone.

diazepam, since, has a depressing effect on the CNS, which is realized mainly in the thalamus, hypothalamus and limbic system. It possesses anxiolytic, sedative, hypnotic, and anticonvulsant action of miorelaksiruyuschim.

+dopamine, as has a positive inotropic effect (strengthens cardiac contractility), increases coronary and renal blood flow, increases mesenteric blood vessels and increases urine output.

adrenaline, because, increases blood pressure and increases heart rate, despite the fact that the vessels are narrowed. Release of digestive pauses, as blood pours from the stomach and intestines to the muscles and replenished

zhelatinol as drug increases the BCC, dilute (lower viscosity) of blood, improve microcirculation, has a diuretic effect, due to the fact that it is rapidly excreted by the kidneys from the body

***

The baby 3 months., With right-sided pneumonia, within 2 days progressively deteriorated. Temperature 39-40 degree, accompanied by chills. Consciousness confused, occasionally marked convulsive twitching of facial muscles and limbs. Pale skin with marble pattern, earthy shade, acrocyanosis. Dyspnea was increased to 70 min. with nasal flaring, the participation of auxiliary muscles. Tachycardia 200 per minute, pulse voltage and weak filling. Blood pressure 60/80 mmHg, CVP 2 mm. waters. Art. Oliguria. There paresis of the gastrointestinal tract, repeated vomiting. pH 7.22, pCO2 -33mm Hg BE - -18mmol / l. Put a preliminary diagnosis.

hemorrhagic shock

+anaphylactic shock

cardiogenic shock

infectious toxic shock

syndrome Waterhouse-Friderichsen

***

The baby 3 months., With right-sided pneumonia, within 2 days progressively deteriorated. Temperature 39-40, accompanied by chills. Consciousness confused, occasionally marked convulsive twitching of facial muscles and limbs. Pale skin with marble pattern, earthy shade, acrocyanosis. Dyspnea was increased to 70 min. with nasal flaring, the participation of auxiliary muscles. Tachycardia 200 per minute, pulse voltage and weak filling. Blood pressure 60/80 mmHg, CVP 2 mm. waters. Art. Oliguria. There paresis of the gastrointestinal tract, repeated vomiting. CBS: pH 7.22, pCO2 -33mm Hg BE - -18mmol / l. The first step is to enter:

prednisolone

Sodium Bicarbonate

atropine

dopamine

+adrenaline

***

A child 12 years after intravenous radiopaque substances after 2 min. sharply deteriorated. Consciousness was absent, pupils dilated, without their reaction to light. The skin faded dramatically. Pulse thready. Tones of heart deaf sharply. BP is not detected, breathing is shallow, arrhythmic, alternates with apnea. Place a preliminary diagnosis.

hemorrhagic shock

+septic shock

cardiogenic shock

infectious toxic shock

hypovolemic shock

***

The child 12 years after intravenous radiopaque substances after 2 min. sharply deteriorated. Consciousness was absent, pupils dilated, without their reaction to light. The skin faded dramatically. Pulse thready. Tones of heart deaf sharply. BP is not detected, breathing is shallow, arrhythmic, alternates with apnea. Intensive therapy should first be aimed at:

improvement of microcirculation

improve gas exchange

+recovery volume of blood circulation

the elimination of acidosis

stabilize blood pressure

***

At the dentist's surgical office boy 12 years old at the time of dental health after the posterior superior alveolar nerve block were dizziness, nausea, chest tightness, cramping, blood pressure 80/40 mm Hg. Art., the pulse 120 beats per minute. Put a preliminary diagnosis.

syncope

orthostatic collapse

hysterics

+anaphylactic shock

cardiogenic shock

***

Call the emergency physician to the school. Boy 14 years after the end of the match in basketball he felt discomfort in the heart, heartbeat, severe weakness, dizziness. At the time of inspection: pale skin, wet, cyanosis of nasolabial triangle. Marbling of the skin, a symptom of "white spots" 7 seconds. Auscultation of the lungs vesicular breathing, even the boundaries of the heart within the normal range, the tones are punctuated, no noise. BH 34 in 1 minute. Pulse weak filling and voltage of more than 200 beats per 1 minute. Blood pressure was 65/20 mm Hg. Art. Abdomen soft, painless. Machine emergency arrived 20 minutes after the call. Upon arrival service SMP: BH 36 in 1 minute, heart rate more than 200 in 1 minute, blood pressure 60/20 mm Hg.. ECG - QRS complex is narrow, P is not visible, ST contours below.Put a preliminary diagnosis.

+cardiogenic shock

angidremichesky shock

orthostatic collapse

neurogenic shock

obstructive shock

***

Girl 13 years after the adoption of the vertical position suddenly lost consciousness and fell. On examination pallor face, the skin of the forehead perspiration, breathing weakened, the pulse at the carotid and radial artery is rare, weak muscles of the trunk and limbs relaxed. What is the reason sudden loss of consciousness?

organic disturbance of CNS

+the sudden brain anemia

congenital disorders of brain

sudden bleeding in the brain

beginning atrophy of the cerebral cortex

***

Emergent call. It was a crash accident 12 years old girl was saved from the obstruction. Her legs were pressed by the slab. After removement of slab girl became unconscious. Breathing is free, tachypnea till 42 per min. Heart tones are rhythmical, pulse is sharply increased till 140 per min. BP=70/40 mm per mer., PS=100 per min. Skin of both extremities is bluish color, cold at palpation. Fractures are absent. Pain sensation is sharply decreased. Liver and spleen are not enlarged. Consciousness of child is spontaneously restored. Point out the consequence of emergent aid at extra-hospital stage?

rubber tourniquet applying, aseptic bandage, external cooling of extremity, indirect cardiac massage providing, AVL, cardiac glycosides

free the pressed extremity, local anesthesia, infusion, applying rubber tourniquet

local anesthesia, free the pressed, infusion

local anesthesia, free the pressed extremity, applying aseptic bandage

+applying rubber tourniquet, infusion, applying the aseptic bandage, external cooling of extremity

***

A girl of 11 years, was in the somatic department clinics, before calling the doctor felt dizziness, ringing in the ears, darkening of the eyes, nausea, syncope. The skin faded dramatically. Pupils are narrowed, their reaction to light is missing. Limbs are cold to the touch, covered with sweat. Breathing superficial. Pulse rare, weak filling and stress. Blood pressure 80/30 mm Hg Peripheral veins empty. A few minutes later, the girl regained consciousness. She raised her eyelids began to move his lips, to respond to their surroundings. Returned to normal color of the skin. Recovered cardiovascular activity and adequate breathing. Put a preliminary diagnosis.

hysteria

epilepsy

+syncope

collapse

acute heart failure

***

The child of 7 years, with acute hematogenous osteomyelitis, suddenly deteriorated dramatically. Consciousness soporous. Lying motionless. Pale skin with a marble figure, covered with cold sweat. The facial features sharpened. Nasolabial triangle - cyanotic. Sunken eyeballs, pupils dilated, their reaction to light sluggish. Breath superficial. Pulse frequent, weak filling and tension. BP and CVP decreased, heart sounds are muffled. Put a preliminary diagnosis.

syncope

+collapse

epilepsy

hysteria

acute heart failure

***

Strangulation of small intestine relates to one of this next types of intestinal obstruction:

obstruction

+strangulational

mixed

spastic

dynamic

***

Name character & localization of pain at acute appendicitis

+constant, intensive pain in the right iliac region

constant, sudden pain in the right subcostal region

attack-like, sudden pain in the right subcostal region

diffuse blunt pain, without clear localization

"dagger" pains in epigastric region

***

Child of 6 years complaints on vomiting, pain in abdomen, hemorrhagic discharge from rectum. From mother's words pain in the abdomen arised suddenly. Inspection: child retarded, painful face, knees adducted to the chest, tenderness of abdominal muscles, in the upper right abdomen palpated seal oblong. The chair, according to the mother, with blood and mucus in the form of raspberry jelly. Put a preliminary diagnosis:gastric-intestinal bleeding

Rey syndrome

intestinal invagination

+ulcerous-necrotic colitis

ulcer disease of duodenum

ulcer of duodenum

***

Calling an ambulance. A child 14 years old, suffering from a stomach ulcer, complained of weakness, vomiting "coffee grounds", a cold clammy sweat, dizziness. Objectively: skin and visible mucous membranes pale. In the lungs vesicular breathing. Muffled heart sounds, tachycardia to 120 beats per 1 minute, systolic murmur at the apex, BP 90/60 mm Hg A chair in black. Put a preliminary diagnosis

acute intestinal obstruction

+gastric-intestinal bleeding

acute peritonitis

acute destructive pancreatitis

Rey syndrome

***

Calling the ambulance to a child 10 years with abdominal pain. There was a single vomit.On examination: The child lies on the right side of the body temperature of 37.30 C, tongue coated with white bloom, dry, painful on palpation and passive muscle tension in the right iliac region, the appearance of pain in the right iliac region with a sharp jerk-pressure in the left iliac region and when coughing. Put a preliminary diagnosis

acute cholecystitis

acute pancreatitis

+acute appendicitis

renal colic

acute intestinal obstruction

***

Call an ambulance to a child 5 years old with complaints of cramping pain in the right half of the abdomen accompanied by vomiting of food ingested. Long suffering from constipation. Lucid intervals between the attacks gradually diminish, the pain becomes severe and permanent. Enhanced motility, the stomach is asymmetrical, due to swelling of his right-hand half. Put a preliminary diagnosis

+acute intestinal obstruction

irritable bowel syndrome

acute calculous cholecystitis

acute gastritis

duodenal ulcer

***

To a child 2 years due ambulance. During the day the child is cranky, sleep surface, not sleeping, lying on his right side, vomiting, and diarrhea. On palpation of the abdomen child is restless, crying, straining the abdominal muscles. Pulse 132 per minute. The body temperature of 38.10 C. Put a preliminary diagnosis

+acute appendicitis

intestinal colic

intussusceptions

gastric bleeding

acute intestinal obstruction

***

Call an ambulance to a child six years old, complains of a one-time vomiting, pain in the epigastric region, and then around the abdomen. Temperature 37.50 C. There was a single chair. Pain tends to shift to the right iliac region. Put a preliminary diagnosis

+acute appendicitis

perforation of gastric ulcer

acute gastroduodenitis

diskinesy of biliary tract

acute cholecystitis

***

Calling the ambulance. In patient 13 years for two hours before calling an ambulance suddenly appeared severe cramping abdominal pain occurring after meals. There was repeated vomiting, poor single chair. Disease was preceded by a week-long course of fasting, self-conducted patient. His condition was grave, anxious, rushing to the bedside. Acrocyanosis, pained expression on his face, breathing, learning the, pulse 112 beats per minute, blood pressure - 100/60 mm. mercury. of Art. The abdomen is moderately distended, asymmetrical. In mesogaster palpable tight elastic rounded education.At the height of cramping pain auscultated enhanced, resonant peristalsis. Determined by "splashing". Put a preliminary diagnosis

acute calculous cholecystitis

+acute intestinal obstruction

flegmanozny simple appendicitis

peptic ulcer

chronic erosive gastritis

***

Call an ambulance to a child 13 years old. Complaints of pain in the right upper quadrant, nausea, repeated vomiting, bitter taste in the mouth, delayed stool. The appearance of pain relates to the uncertainty in the diet. On examination, tongue coated, stomach distended, tenderness to palpation in the right upper quadrant and effleurage on the right costal arch. Put a preliminary diagnosis:

acute pancreatitis

acute appendicitis

renal colic

+acute cholecystitis

ileus

***

Calling the ambulance to a child 10 years from onset of abdominal pain. There was a single vomit. On examination: The child lies on the right side of the body temperature of 37.30 C, tongue coated with white bloom, dry, painful on palpation and passive muscle tension in the right iliac region, the appearance of pain in the right iliac region with a sharp jerk-pressure in the left iliac region and when coughing. What is the tactic of emergency medicine at the pre-hospital emergency hospitalization, along with and why?

antispasmodics, because eliminate spasms, and reduce pain

laxative, because it stimulates the motor and evacuation function of the intestine

enema, because movement causes increased intestinal

gastric lavage, because it promotes the evacuation of toxins from the stomach

+ice pack because it narrows the blood vessels and reduces pain

***

In girl of 13 years old during 3 days abdominal pains, increase of temperature, vomiting was marked. At examination a child is pale, flabby, complains on abdominal pains. Temperature of body is 37,90. From the side of organs of pectoral cavity it is not changed. Pulse is 92 in 1 minute. An abdomen is not distentioned; at palpation in a right iliac area sickly immobile formation of 6 6 sm is determined. Symptom of Schetkin-Blumberg is positive. Tactics of emergency doctor in this case?

carrying of desintoxication therapy

entering of anaesthetic preparations

entering of febrifuge preparations

+hospitalization to surgical department

recommend to address to the surgery on place of residence

***

Emergency call to child 5 years. Emergency doctor diagnosed food poisoning. In child stool as "marsh slime" that for characteristic of:

dysenteries

esherichiosis

+salmonellosis

enteroviral infections

botulism

***

Emergency call to child 7 years with signs of acute abdomen. Emergency doctor at palpation of the abdomen has detected the protective muscle tension that for characteristic of:

+acute peritonitis

edemic form of pancreatitis

invagination of intestine

gastric hemorrhage

acute intestine obstruction

***

Emergency call to child 10 years with signs of acute abdomen. Emergency doctor at palpation of the abdomen has detected at the same time as with the other symptoms of acute abdomen positive Sitkovskiy symptom, which observed at:

acute cholecystitis

acute pancreatitis

+acute appendicitis

renal colic

acute intestinal obstruction

***

Emergency call. In patient 13 years old for two hours before calling an ambulance suddenly appeared strong cramping abdominal pain occurring after meals. There was repeated vomiting, poor single stool. Disease was preceded by a one-week course of starvation, the autonomous patient. The patient's condition is serious, worried, tossing in bed. Acrocyanosis, pained expression on face, tachypnoea, pulse 112 beats per minute and blood pressure - 100/60 mm. Hg. The abdomen is moderately distended, asymmetrical. In mesogaster palpated hard elastic rounded formation. At the height of cramping pain auscultated enhanced, resonant peristalsis. "Splashing sound determined. Appearance of splashing sound symptom at acute intestinal obstruction is explained:

presence of exudate in abdominal cavity

+mass of liquids and gas in adducting loop of the intestine

mass of liquids in abducting loop of the intestine

mass of the gas in abducting loop of the intestine

presence of the free gas in abdominal cavity

***

Emergency call to child 12 years. Emergency doctor suspects in child mechanical intestine obstruction. The most frequent reason of mechanical obstruction of small intestine is:

foreign body

gallstones

tumors

+commissures of abdominal cavity

helminths

***

Emergency call to child 2 months. Emergency doctor suspects in child volvulus of intestine. Volvulus of small intestine belongs to one of the following type of the intestine obstruction:

obturation

+strangulated

mixed

spastic

dynamic

***

Sick 14 years with dyspneas attack. Emergency call. From anamnesis - dyspneas attack from 7 years. The exacerbations appear at cool time of the year. The deterioration of the condition is for 12 hours on background of ARI. During last 12 hours repeatedly used salbutamol, with small effect in the beginning, then - without effect. At survey: condition heavy. She sits, leaning hands on knees. On distance heard dry rales, the expiration lengthened. The skin is pale with cyanotic shape. The respiration rate is 30 in 1 minutes. Cough dry, "inefficient". The pulse is 100 in 1 minute, rhythmic. In lungs a dry whistling rales on all pulmonary fields, in lower parts breathing is weakened. Emergency doctor is made EKG: negative wave T in II, III, avF; the deep wave S in breast abductions. Put the preliminary diagnosis

laryngospasm

obstructive bronchitis

acute pneumonia

+bronchial asthma

lung destruction

***

Emergency call to child 10 months, in heavy condition. From the words of mother install that child ill 2 days ago. The disease began with increasing of the temperature of the body up to subfebrile, insignificant serous nasal catarrh, catarrhal conjunctivitis. Then, the condition of child deteriorates, the temperature of the body increased up to 39,5 degrees, child became flaccid, refused from meal, appeared the vomiting, not connected with receiving the food and water, one-time clonic-tonic spasms. Objective: at survey general condition child heavy. Flaccid, cried. The temperature of the body 39,2 degrees. The child lays on back with extended along trunk hand and bent in knee and hip joints legs. It is noted throw one`s head back, bulging of anterior fontanel, periodical appear the convulsive twitches of the limbs. The skin is pale, dry. Visible mucous is clean, rose. In fauces moderate hyperemia of back wall of pharynx is. HR is 138 in minute. Put the preliminary diagnosis

+meningitis

encephalitis

neurotoxicosis II degree

febrile spasms

spasmophilia

***

Emergency call. The child 14 years, suffering from peptic ulcer of the stomach, complains of weakness, coffee-grounds vomiting, cold sticky sweat, and dizziness. Objective: skin and visible mucous are pale. In lungs vesicular breathing is. The tones of heart muted, tachycardia up to 120 in 1 minute, systolic murmur on apex, BP 90/60 mm. Hg. The stool is black color. Put the preliminary diagnosis:

acute intestinal obstruction

+gastrointestinal hemorrhage

acute peritonitis

acute pancreatitis

Reyo syndrome

***

Emergency call. The hild 8 years is in heavy condition. The skin is gray, arterial pressure 90/60 mm Hg, pulse 120 in minute, rhythmic. At sick during day was noted 6 once vomiting and frequent fluid stool. The tonic- clonic spasms developed in 20 minutes. After entering by ambulance GOOA from calculation 100 mg/kg spasms relief, but were then repeated again. What else medicinal preparations are used for spasms relief

nootropil

pyracetam

+diasepam

lasix

actovegin

***

Emergency call. A girl 11 years, before calling the physician has felt the dizziness, ringing in ears, darkening in eyes, nausea. Then she lost the consciousness. The skin is sharply pale. The pupil of eyes constricts, reaction them on light is absent. The limbs cold at palpation and cover sweat. The breathing is superficial, even. The pulse is rare, weak filling and tension. BP is 80/30 mm Hg. Peripheral veins are empty. Through several minutes consciousness in girl was restored. Has raised the ayelids, became to move by lips, respond on environment. The normal coloration of skin returned. It was restored hearty-vascular activity and adequate breathing. Put the preliminary diagnosis

epilepsy

affected- respiratory crisis

+syncope

collapse

tumor of the brain

***

Emergency call to child 7 years. From anamnesis: acute hematogenous osteomyelitis. The condition suddenly sharply deteriorates. The consciousness is sopor. He lies still. The skin is pale with marmorota, cover by cold sweat. The lines of face become more pointed. Cyanosis of nasolabial triangle is. The eyeballs are hollow, pupil of an eyes dilated, reaction them on light flaccid. The breathing is increased the frequency of, superficial. The pulse is frequent, weak filling and tension. BP is reduced, tones of heart muted. Put the preliminary diagnosis

neurotoxicosis

affected- respiratory crisis

syncope

+collapse

tumor of the brain

***

Emergency call. The child 1 year 4 months, 3-rd day of disease. Acutely ill: appeared the malaise, nasal catarrh, the temperature 37,40. Soundless voice observed to evening, "barking" cough, difficulty of the breathing. During 3-rd days child give treatment at home. The attacks of dyspnea became heaviest and lengthiest in each following night, appetite bad. At survey a girl is pale, faded, and capricious. It Is noted significant retraction of compliant places of the thorax at breathing, dyspnea up to 50 in minutes. Soundless voice, periodically full aphonia, cyanosis of nasolabial triangle is. The pulse rhythmic, tachycardia up to 160 in minutes is. Put the preliminary diagnosis

bronchospasm

+laryngotracheitis with stenosis

bronchopneumonia

obstructive bronchitis

bronchiolitis

***

Emergency call to child 2 years. During day child capricious, the dream superficial, does not sleep, lies on right side, vomiting, diarrhea. At palpation of abdomen the child anxieties, cries, tenses the muscles of abdomen. The pulse is 132 at minute. The temperature of the body is 38,10. Put the preliminary diagnosis

+acute appendicitis

edemic form of pancreatitis

invagination of intestine

stomach hemorrhage

acute intestinal obstruction

***

Emergency call to girl of 12 years in heavy condition, in 1-st day of the disease. She ill acutely: repeated vomiting, pain in abdomen, then frequent, fluid stool, with greenery streaks. At survey: the temperature 390, skin dry, cyanosis of the lips, pulse 120 in minute, weak filling. The abdomen is soft, painful in epigastria and around umbilicus. Put the preliminary diagnosis

dysentery

esherichiosis

+salmonellosis

enteroviral infections

botulism

***

Emergency call. Several members to families have recovered influenza. A child of 2 years ill; in the night increased the temperature up to 400C, was repeated vomiting. At survey in the morning: the child is pale, on the face and neck single petechial elements, in fauces slightly hyperemia; neck stiffness. Has a fever. Put the preliminary diagnosis

influenza, toxic form

+influenza, meningitis

meningococcal infection

meningococcemia + meningitis

meningitis

***

Emergency call. A child of 4 month ill acutely, the temperature of the body increased up to 380. Repeated vomiting after meal and drinks is, stool during day 8 once, fluid, brown-green color, as "marshy slime". At survey condition heavy, is anxiety, evident thirst. The skin is pale, periorbital cyanosis. The lips are bright, dry. Anterior fontanel is hollow. The tones of heart muted. Moderate abdominal distension is, borborygmus on motion of small intestine. Put the preliminary diagnosi

+salmonellosis

shigellosis

paratyphoid fever ©

esherichiosis

viral diarrhea

***

Emergency call. From words of the mother, in her 8-years son on 7 days of disease complaints on dizziness, indistinct speech, reeling gait, does not keep the head, 3 weeks ago father was ill the herpes zoster. There is neck stiffness at survey, on trunk - drying out a little vesicle





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