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 №30

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 G., 43 years, laboratory assistant in pharmaceutical laboratory, complains of pain and feeling of heaviness in right subcostal region, bitterness in mouth which are intensified after fried and fatty food, periodical headache, pain in heart region, sleep disorders, apathy, tiredness, eyesight disorders.

Objectively: general condition is moderately grave. Skin and hair are of yellow shadow. Breathing is vesicular. PR-72/min, rhythmical, AP-110/60. Heart tones are muffled, slight systolic murmur over the apex. Abdomen is swollen. Liver is found 2 cm lower than right rib arc, its rim is painful.

CBC: Er-3,5x10¹²/l, Hb-110g/l, CI-0,9, reticulocytes-5%, L-4,4x10⁹/l, bodies of Geihns-Erlich-solitary, methemoglobin-6%. ESR-5mm/h.

Cystoscopy: papilloma of urinary bladder.

Ophthalmologist: bilateral toxic cataract of I degree.

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 №31

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 rubber factory at summer has been working in hyperthermia conditions. He complains on general weakness, increased fatigability, headache, memory decrease, disturbances of dreams, depression.

On physical examination at hospital there were revealed moderate cyanosis, expressed paleness, hyperhidrosis, lability of blood pressure.

CBC: erythrocytes-2,8х10¹²/l, Hb-110 g/l, CI-0,9, bodies of Geihns-Erlich, leucocytes-7,2х10⁹/l, normoblasts 1%, reticulocytes 4%, methhemoglobin-8%, sulfhemoglobin-1,5%, ESR 3 mm/hour.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk