Thch Vn Mnh

TYD-K55

CNG N THI HT HC PHN

MN: Bnh ngoi khoa th y
Hc k I nm hc 2013-2014
1. Khi nim, phn loi chn thng?
a. Khi nim
- Chn thng l tng hp nhng bin i hnh thi, ri lon chc nng, xut hin trong
m bo c quan ng vt do yu t gy chn thng tc ng. Nhn t gy chn thng
bao gm nhn t ni sinh( bn trong c th) v nhn t ngoi sinh( bn ngoi c th).
b. Phn loi
Cn c vo bn cht ca nhn t gy chn thng ngi ta chia chn thng
lm 5 loi
- Chn thng c gii : do tc ng lc c gii gy ra tng thng khc nhau vi m
bo v c quan. Do v b nh p bng gy, gc, m chm, hc nhau, gy rch
da, nim mc gi l tn thng c gii h. Chn thng gy dp c, dn gy chng, gy
xng nhng da, nim mc ko rch c gi l tn thng c gii kn
- Chn thng vt l : xy ra do tc ng ca yu t vt l: nhit , nh sng, dng
in, sm st,
- Chn thng ha hc : xy ra do tc ng ca yu t ha hc : acid, kim
- Chn thng sinh hc: xy ra do cc yu t sinh hc : vi sinh vt, virus, k sinh trng
ht cht dinh dng,c nc,
- Chn thng tm thn : so stress, k thut chn nui ko p ng c nhu cu ca v,
mt nui ng,
2. Khi nim, phn loi vim?
a. Khi nim
- Vim l phn ng thch ng phng v ca c th v bc cao p tr li cc yu t tn
thng khc nhau, xut hin di tc ng ca cc nhn t gy chn thng nh : c
gii, vt l, ha hc, sinh hc,.. Vim l c s sinh bnh hc ca nhiu bnh khc nhau
ngoi tr bnh v di truyn v trao i cht. Trong cng 1 hon cnh, cng 1 nguyn
nhn tc ng, cng 1 mc kch thch nhng vi v th ny c phn ng vim nng
vi c th khc li nh hn hoc ko c biu hin vim.
b. Phn loi vim theo thi gian tin trin c 4 loi
- Vim qu cp tnh : qu trnh vim xy ra nhanh t 1h vi ngy vi cc phn ng
mnh lit. Do kch thch qu mnh gy ra. Con vt c th cht khi cha c cc triu
chng r rt.
- Vim cp tnh : qu trnh vim xy ra t 1 v ngy 1 vi tun . Triu chng in
hnh sng, nng, , au. Ti cc b xung huyt, ph n, vim nng. Ton thn c ri
lon iu ha thn nhit st cao. Ri lon h tim, h hp, tiu ha iu tr tch cc
s c kt qu tt . Nu ko iu tr chuyn sang vim cp tnh v mn tnh.

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- Vim cp tnh : vim qu trnh tin trin chm t 2-3 tun phn ng xung huyt, ph
xy ra chm nu sc khng c th mnh ln chuyn qua vim cp tnh iu tr
tt. Nu sc khng yu chuyn qua vim mn tnh
- Vim mn tnh : din ra chm ko di 3 tun tr nn c khi hng thng, hng nm.
Triu chng vim ko in hnh. Th vim ny thng gp trng hp c th c sc
khng cn bng vi yu t gy bnh
3. Nguyn tc iu tr vim?
- Loi tr nh hng n c th ca nhn t gy bnh
- m bo s yn tnh cho con bnh v c quan b tn thng, ngn cn s ti kch thch
h thng thn kinh hay ct b ti kch thch xut hin
- To k thun li nht v nui dng, chm sc v m m bo khu phn n king ly
li cn bng cho c th.
- Phng php iu tr tng hp, kt hp tr cc b, tr ton thn , iu tr nguyn nhn
v iu tr triu chng.
4. iu tr vim bng Novocain v thuc ng?
a. iu tr bng novocain
- Vo nhng gi u tin sau chn thng dng Novocain 0,25% tim phong b.
Lm yu dn i kch thch mch v nhng trung tm thn kinh v b phn thn
kinh thc vt. qu trnh hung phn ca v no c cn bng
S to min dch, qu trnh thc bo, qu trnh ti sinh c hot ha.
Cng hy hoi trong vim c gim thp.
- Tc dng c tng cng khi kt hp Novocain vi hydrocortizon hay vi khng sinh
v c 3 s kt hp kt qu iu tr tt.
- Tim Novocain vo mch mu c thc hnh trong tr qu trnh vim qu cp tinh
hay g u qu trnh vim cp tnh : ngy 1 ln iu tr 3-5 ngy.
b. iu tr bng thuc ng
- Mc ch bo v v no khi ti kch thch, xung ng au, ct cc c ch qu mc xut
hin trong n, bnh thng ha chc nng ca v no. Ci thin qu trnh thch ng
phng v v qu trnh khc ca c th.
- Dng natri brommua 10% tim tn mch v nh 5-10ml, v ln 50-100ml trong 3 ngy
u mi ngy 2 ln. vi 3 ngy tip theo tim liu liu trn.
- Dng aminazin tim di da cho v c sng 1mg/1kgTT
5. iu tr vim bng thuc khng vim?
- S dng hormone v tuyn thng thn
Tc dng tch cc trong iu tr vim mng hot dch, vim bao khp, vim bao
co, vim bao gn, vim da d ng, vim da thn kinh, cc vim dng thp.
- Hydrocortizon dng ung t c use.
- Huyn dch tim 2,5% c s dng trong tr vim khp. vim bao khp bng cch
tim thng vo cc c quan hoc xung quanh n.

Thch Vn Mnh
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- M Hydrocotizon c dng bi trn da b tn thng nh vim da d ng, vim da thn
kinh, eczema,
- M hydrocorizon acetat 0,5% c dng tr mt
- Desamethazone c dng thuc nc nh, thuc m tra mt, thuc tim gim vim.
- Thuc khng vim c ch nh trong mi qu trnh v mi giai on vim.
6. iu tr vim bng thuc kch thch tiu vim?
- Tc pht trin cc qu trnh vim cp tnh, cp tnh, mn tnh thng rt chm, ko
di thi gian vim, bin chng phc tp gy kh khn trong iu tr.
Vic use thuc kch thch tiu vim tc tin trin chng vim nhanh hn,
sm kt thc kt thc thun li.
- Cn iod 5-10% l cht st trng mnh, c s dng vi t cch thuc tiu vim trong
mi qu trnh v giai on vim. Dng n bi vo ch vim ngay lc nhim trng v
nhng ngy u qu trnh vim ngng pht trin.
- Cc ch phm dng thuc nc gm c hn hn 4:3:1 ( 4 cn long no 10%, 3 cn
ammoniac 10% 1 phn tinh du thng), cc loi du gi, tinh du nng bi vng vim
ngy 3-4 ln kt hp xoa bp.
- Ch phm dng keo dn, thuc m: cao sao vng, ichthyol, dng bi ln b mt tn
thng ngy 3-4 ln hoc pht vo vi gc ri bng li,..
- Khi s dng cc thuc kch thch tiu vim liu trnh thng ko di iu tr n khi
khi bnh.
7. iu tr vim bng nc lnh <5 C ?
- Nc lnh c tc dng lm co mch mu tc dng cm mu,gim tnh thm thu ca
thnh mch gim dch r vim.
- Nc lnh cn gim tnh truyn kch thch ca thn kinh cm gic gim au.
- Ch nh: iu tr vim qu cp tnh, g u qu trnh vim cp tnh ko nhim trng.
- Chng ch nh: vim ha m, m bo hoi t, hoi th, c th b thiu mu.
- Cch dng : Ngm vng bnh vo nc lnh hoc chm lnh . Mi ln 30p ngy 1-3
ln.
*** Ch : khng c ko di s gy thiu mu cc b.
8. iu tr vim bng nc nng?
- Nc nng c tc dng lm xung huyt, tng tun hon cc b, dch r vim s c
khuch tn, hp thu nhanh, khng tch t, gim tnh au, tng kh nng xuyn mch v
thc bo ca bch cu.
- Ch nh: giai on cui qu trnh vim cp tnh, vim cp tnh, vim mn tnh.
- Chng ch nh: con vt b chy mu, ri lon tim mch, khi u c tnh.
- Cch dng : ngm, tm, chm, phun hi nc nng mi ln 20-30p ngy 1-3 ln.
*** ch : ko c dng nc qu nng cht m bo.
9. iu tr vim bng paraffin nng chy?
- Paraphin rn nng chy 52-55 C nng ln 65-85 dng iu tr

Thch Vn Mnh
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- Truyn nhit rt chm, gi nhit lu, un nng 90 C vn ko gy bng cho v.
- Khi dng tr paraphin nng chy truyn nhit cho m bo cc b, si m cho c
quan c iu tr thc y qu trnh vim. C ch tc ng, ch nh, chng ch nh
ging dng nc nng iu tr.
- S dng paraphin tr c u im hn v ko di thi gian tc ng, ko lm cng, rat c
quan tr, tng khuch tn , hp thu dch r vim.
- Trc khi tr cn ct b lng bi ln b mt 1 lp vaselin mng khi tr d bc ra.
Dng c un paraphin ko c ln nc trnh gy bng cho v.
- Cch dng c th dng 1 trong cc phng php sau tr :
Phng php pht
Phng php chm
Phng php bng b
Phng php ngm
- S dng paraphin tr mi ngy 1 ln liu trnh tr n khi khi.
10. iu tr vim bng n hng ngoi?
- Tia hng ngoi c mu , mang nhit lng , c kh nng xuyn su vo m bo ti
3cm lm si m c quan c tr.
- C ch tc ng, ch nh, chng ch nh ging tr bng nc nng.
- Phi xc nh khong cch t n n v thch hp trnh bng v nu qu gn v ko
tc dng nu qu xa.
- Thng dng mu bn tay ca ngi s dng th nhit .
11. iu tr vim bng n sollux?
- Bng n trn pht ra nh sng trng, c cng sut 500-1000W mang nhiu nhit lng.
- C ch tc ng, ch nh, chng ch nh ging nc nng.
- Cch dng ging n hng ngoi.
12. Khi nim phn loi nhim trng ngoi khoa?
a. Khi nim
- Nhim trng ngoi khoa l loi nhim trng c hiu qu iu tr t c tt nht nu
iu tr bng phng php ngoi khoa vi nhng cht khng khun v khng s pht
sinh bnh khc.
- Nhim trng ngoi khoa xut hin trn nn nhng tn thng.
- Thng thng nhim trng ngoi khoa s bt u ti ch xm nhp ca tc nhn gy
kch thch nhng 1 s trng hp tc nhn gy bnh mch v c lc cao m c th li
thiu ht i phn ng phng v lan ta mm bnh xut hin nhim trng ngoi
khoa ton thn.
b. Phn loi
Cn c vo tc nhn gy bnh ngi ta phn lm 4 loi

Thch Vn Mnh
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- Nhim trng ngoi khoa hiu kh : b gy ra bi cc vk hiu kh ( cn Oxy) Vd:
staphylococcus, streptococcus, bacillus pyocyaneus, E.coli . c trung ca nhng vk ny
l ch yu sinh m.
- Nhim trng ngoi khoa ym kh : gy ra bi cc vk ym kh( qu trnh tn ti ko i hi
Oxy). VD: Clostridium perfringens, Clostridium hystolyticus,
- Nhim trng ngoi khoa thi ra :gy ra bi vk ym kh ty tin ( vk pht trin trong k
c hay ko c Oxy u c) VD: E.coli, Bacillus ,i khi kt hp vi staphylococcus,
Streptococcus,... Nhim trng ny c trng bi s thi ra m bo v s to dch r
vim mi thi ln mu m thi. u tin mu xanh , xm sau c mu nc tht bn.
- Nhim trng ngoi khoa c bit : 1 s bnh truyn nhim, kst c lin quan n bnh l
ngoi khoa hay kt qu chn on ,tr chng t kt qu tt nht = pp ngoi khoa nn
c gi l nhim trng ngoi khoa c bit. VD: Bnh un vn ( tetanus) , bnh sy
thai truyn nhim ( Brucellosis) , bnh lao ( tuberculosis) , bnh x khun ( action
mycosis), bnh u sn nhiu u ( coenurus) , bnh kn nc ( Echinococcus)
13. Nguyn tc phng nhim trng ngoi khoa ?
- Khng cho s xm nhp ca cc tc nhn gy nhim trng vo c th v. Tun th
nguyn tc v trng, kh trng khi tim phu thut, can thip sn khoa v can thip
khc.
- Khi c m bo cht cn phi nhanh chng loi b chng bng phng php phu thut.
- m bo k l tng cho s thot dch t do t nhim trng.
- S dng cc b nhng dung dch st trng v b km hm ptr vi khun. S dng liu
trnh khng sinh , sulfamid thch hp.
- Gim trng thi mn cm ca c th v trnh ti kch thch h thng tk bng cc cht tr
bo tn.
- Tt c cc bp trn c tin hnh trong k thc n y protid, glucid, lipid, vitamin,
mui khong, chm sc, khai thc v ng n.
14. Nguyn nhn, triu chng, iu tr nhim trng ngoi khoa hiu kh?
a. Nguyn nhn
- Do cc vi khun hiu kh gy ra . Trong cc nhim trng hiu kh thng phn lp
c : E.coli, Staphylococcus, Streptococcus, Bacillus pyocyaneus
b. Triu chng
- C th phn ng li bng vim m cp tnh, c th din ra 1 cch m m hay d di.
Th m m
Th d di
- din ra m m, s nh v th hin r
- din ra d di
- s hy hoi m bo l ti thiu.
- ti nhim trng quan st c hoi t m rng.
- vng ph vim v thm nhim m bo ko c ranh
- vng ph vim v thm nhim m bo c gii r.
ranh gii x.
- c biu hin vim hch lympho v mch lympho.
- ko c biu hin vim hch lympho v
- thn nhit cao. Bn vng.
mch lympho.
- v au mnh hn, ri lon tnh ngon ming v qu
- c th st nhe.
trnh tiu ha.

Thch Vn Mnh
- nhp tim, h hp tng nh.
Quan st c nhim trng dng ny khi
v mc : mn nht, vim da m, p xe lnh
tnh,

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- qu trnh nhim trng lan ta cc m bo xung
quanh.
- c th b nhim c nng.
- ti kch thch d di b phn ngoi vi lon dng
thn kinh ng k.
Quan st c dng ny khi v b : p xe c tnh,
phlegmone, vim v nng, vim t cung tch m,

c. iu tr
- iu tr bo tn
15. Khi nim , triu chng, iu tr p xe?
a. Khi nim
- p xe hay bc m l xoang bnh l c gii hn lp y m, xut hin do qu trnh vim
thng l vim cp tnh ha m ca m lin kt tha, i khi m bo v c quan khc.
- Cn phn bit p xe v xoang tch m: p xe l tch m xoang bnh l mi hnh thnh
cn xoang tch m cng l qu trnh vim thoi ha m nhng m sinh ra c tch li
trong cc xoang gii phu.
b. Triu chng
- Phn loi:
Nhim trng
Da vo s c mt ca vi trng

V trng
p xe hnh thnh

Cn c vo thi gian

p xe ang pht trin

p xe chn

Cn c vo thi gian

p xe nng
p xe su

- Triu
Lm
sng: chng:
Lnh, p tnh, di cn, lnh
+ p xe nng: Sng, nng , au v tr ngi c nng.
+ p xe su: Khi p xe hnh thnh di cc lp c v m bo khc, c vng sng ln,
gii hn khng r rng ti cc b nhit ln cao, mu sc t thay i .
Con vt rt au v t ngi c nng r rt.
p xe chn, n tay vo c du hiu sng ng su
Ch tiu

p xe hnh thnh

p xe thnh thc

p xe chn

Sng

Hnh bn cu hay u v cng u trn dn, mm dn t Hnh bn cu mm ton b,

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chc gii hn xung quanh khng nh. Gii hn xung quanh tr vng chn, gii hn xung
r rng
dn r rt hn
quanh r rng
Mu sc

ng ton b vng sng sau nh xut hin vng trng Mu trng c ton b, n
chuyn dn sang mu thm c lan rng dn, xung tay vo thy mm ch cn
quanh sm
sm chn

Nng

Rt nng

Nhit nh xung lan Ton b vng sng khng

rng tng ng vi vng cn nng. Ch nng t
mm
xung quanh chn

au

Rt au

au dn t nh, tng Khng au ch cn au 1

ng vi vng mm
cht xung quanh chn

Tr ngi +++
c nng

++

c. iu tr
iu tr p xe phi ph hp vi giai on tin trin ca n.
* p xe mi hnh thnh: Khi p xe mi pht, con vt rt au ph vim mnh dng cc bin
php sau:
+ Chm lnh: Dng ti nc p vo p xe 10 15 pht khng c ko di.
+ Phong b bng Novacain 0,25% kt hp vi khng sinh Penicinllin, ampicillin
+ Dng Novacain kt hp vi khng sinh tim vo TM cho kt qu iu tr cao.
+ Dng thuc khng vim: hydrocactizon tim di da ngy 1 -2 ln khng c ko
di s dng phi xen k cc t.
+ Tim calci clorid v TM.
* p xe ang thnh thc:
+ Phong b Novacain 0,25% kt hp khng sinh.
+ B sung 1 cch hp l khng sinh c hot ph rng: Amtyo, hanmolin.
+ Dng thuc khng vim khng dng ko di.
+ Tim calci clorid v TM.Dng cc loi Vita min A, B1; C
* p xe thnh thc:
+ Phng php chc ht: ly bn tim ni vi kim c ln bng ng cao su, nha chc vo
p xe. Bm 1 lng va Novacain 0,25% + khng sinh 15 20 pht mi ht.=> Ra
xoang p xe: Bng dung dch st trng, bm dung dch st trng ri li ht ra -> n khi
khng sinh m l c.
+ Phng php phu thut: M bng dao, chnh v tr thp nht -> lm sch m v dch r
vim, ra bng dung dch st trng -> thm kh -> cho bt km khun hn hp

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Sulfanilamid vi Iadofem (t l 9-1). Hng ngy ra v cho thuc, thay dn lu -> ht m
th thi.
+ i vi p xe t v: Nu ch v khng v tr thp nht ca p xe chng ta phi m
thm ming mi.

16. Nguyn nhn, triu chng, iu tr nhim trng ngoi khoa ym kh?
a. Nguyn nhn
- Do cc vi khun ym kh gy ra nh:
Clostridium perfringens
Clostridium oedematiens
Clostridium hystolyticuc

b. Triu chng
* p xe kh: di tc dng ca cn bnh l kh gy hoi t t chc v sinh hi kt hp
vi dch r vim to thnh bt kh, khi bt khisddur ln lm xng phng b mt ti m p
xe gi l p xe kh.
c im:
+ Hnh thnh nhanh, n tay thy mm -> to m v tc.
+ Gii hn thng khng r rng ch sng khng nng, au v tr ngi c nng khng
r rng.
+ Chc r r, vim bn, ln bt kh -> hi thi.
+ ng v thnh p xe chc khng bng phng.
* Vt thng: Su ming hp c nhiu t chc cht cc mu ng v ngoi vt hnh thnh
cc hang ti.
-> Biu hin b mt vt thng kh khng c dch xut huyt, hin tng ph vim nng
xng lan trn gii hn t chc lnh khng r rng, khi mc nng -> lt thnh vt
thng ngc ln ch mu xm, ch th ln bn (tht luc d).
c. iu tr
- iu tr phng php ngoi khoa c tr kt hp vi iu tr sinh bnh hc v bin php
thm thu oxy ha.
- Cch ly cc vt nui khi b bnh v khng b bnh.
- M rng vt thng su ming hp, ly ht cc mu ng, m bo cht m ngang cc p
xe khi hnh thnh.
- Ra vt thng vt m bng vt mui u trng 5 10% nng 400C b xung oxy gi 3%
thuc tm 1% thi gian 20 pht.
100ml mui n 20%

- t dn lu mm tm hn hp

100ml oxy gi 3%

100ml du c

Thch Vn Mnh
- S dng KS v Sulfamid 1 cch hp l.
- iu tr bng cc kch thch phi c hiu tng sc khng ca vt nui.

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17. Khi nim , triu chng , phn loi vt thng?

a. Khi nim
- Vt thng l s tn thng c gii h ca da, nim mc v nhng c quan, m bo
nm su hn; c trng = s au, h ming, chy mu v ri lon chc nng. Ph thuc
v tr tn thng v loi vt thng m s th hin ca mi du hiu ny l ln hn hay
nh hn.
b. Triu chng
- au xut hin ngay sau tn thng theo thi gian . Cng v di ph thuc vo v
tr vt thng, da c nhiu u mt thn kinh, c im tn thng, loi ng vt, c th
trng thnh hoc ng vt non.
- Chy mu xut hin ngay sau tn thng . Mc chy mu ph thuc : v tr tn
thng, t chc vt thng, mch qun b tc ng. Gm 2 loi chy mu tin pht l
chy mu ngay sau tn thng, chy mu th pht l chy mu sau khi tn thng vi
gi. Nguyn nhn chy mu do : cc mu ng b v, thay bng tho ch ko ng k
thut , chn thng m bo, c th thiu cht chng ng mu. Khi lng mu b mt
con vt cht.
- h:
Tnh cht vt thng
Rng hay hp ph thuc vo

Vng m bo, c quan b tn thng

Qu trnh nhim trng

c. Phn loi
- Vt thng m
- Vt thng ct
- Vt thng chm
- Vt thng ng gip
- Vt thng t
- Vt thng p
- Vt thng cn
- Vt thng ha kh
- Vt thng c
18. Cc dng vt thng?
a. Vt thng m

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b. Vt thng chm

c. Vt thng ct

d. Vt thng

19. Qu trnh lnh ca vt thng?

a. Lnh vt thng thi k I
- t c nhng phu thut v trng v vt thng ngu nhin c x l ngoi
khoa, tha mn nhng iu kin sau:
Khng nhim trng
Trong xoang vt thng khng c vt l
Cm mu hon ton
Tn thng m bo t, ko c qu trnh vim, hoi t.
M bo b, thnh, y vt thng c kh nng sng.
khuyt m bo ko qu ln
Lnh vt thng dng ny l hon m nht trong thi hn ngn 5-7 ngy.
b. Lnh vt thng thi k II
- Xy ra nhng vt thng hoc vt m nhim trng h ln, vt thng ln, cc mu
ng, t chc hoi t trong vt thng.
- Phn ng vim tng tnh thm thnh mch, xut hin bch cu xuyn mch, kt hp
t chc cc b hnh thnh ln cc u g, bu hnh thnh cc t chc ht phn t
biu b thnh so.

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TYD-K55
- Thi gian lnh ph thuc vo mc tn thng, v tr v nt c bit hnh thi chc
nng c nhng m bo, c quan b tn thng.
- Thi gian lnh ti thiu 3-4 tun, trung bnh 1,5-2 thng c th lu hn na.
- Lnh di vy: gp loi gm nhm, lp chim, ng vt c v khi xy xt nh, vy
c hnh thnh do cc mu ng, si fibrin kt hp m bo cht.
20. S cu vt thng?
- Cm mu: vt thng bao gi cng chy mu, mt mu nhiu -> con vt s xung
sc khng nhim trng cao -> sc -> cht.
- cm mu tm thi dng cc phng php: Dng tay, tampon, panh kp mu, ga
r cm mu trit : thm p, panh kp mu, tht bng ch
- Lm sch bn ngoi vt thng: Ct hoc co tht sch lng xung quanh vt
thng bng x phng v nc sch.
- Lm sch bn trong: Ra sch vt thng bng cc dung dch st trng cn 90%
nc oxi gi 3% thuc tm 0,1%... ly ht cc ngoi vt, m bo cht khu s b
su h ca vt thng.
21. Nguyn nhn lu lnh ca vt thng?
- Vt thng nhim trng
- Trong vt thng c vt l
- Mc tn thng ln
- Kch thch lu di bi cht ha hc, dn lu, cn trng v cc yu t khc ca mi
trng.
- S vn ng thi qu ca ng vt mc bnh
- Tui gi, suy dinh dng, s pht trin c tnh ca nhng khi u
- Bnh tim mch, tha thiu vitamin
- Nhim trng ton thn, nhim c mn tnh
- Ri lon tt c cc dng trao i cht
- Tn thng phng x
- Mi trng sng khng m bo v sinh
- Thao tc iu tr cu th.
- Trong nhng vng chuyn ng ca c th, s v nh k ca cc mao qun gy ra
s chy mu t chng v to thnh nhng vt nt n tng ca m ht s km hm
s lnh ca vt thng.
22. iu tr cc b vt thng mi?
23. iu tr cc b vt thng nhim trng
24. iu tr ton thn i vi vt thng?

25. Nguyn nhn, triu chng, iu tr U mu?

a. Nguyn nhn

Thch Vn Mnh
TYD-K55
b. Triu chng
- Thi gian xut hin u mu nhanh ngay sau khi tn thng
- Tc pht trin nhanh sau 5-10p n t cc i
- Cc mu ng nhanh chng c hnh thnh tc dng vt mch mu b v li.
- Khi n tay vo u mu cc cc mu ng nh b v ra nghe thy ting lp bp
- Gii hn u mu vi m bo xung quanh r rt
- Chc thm d thy cc mu ng bt trong lng kim.
c. iu tr
- U mu nh ko cn tr
- U ln phu thut : Gy m, gy t nu cn thit
- Rch da v tr thp nht khi con vt t th ng thot dch t do
- Ly ht cc cc mu ng , tm mch mu t tht li
- Ra xoang bnh l bng dung dch st trng thng dng
- Cho bt km khun , nu xoang ca u mu ln nn t dn lu mm.
26. Nguyn nhn, triu chng, iu tr U lympho?
a. Nguyn nhn
b. Triu chng
- U lympho xut hin chm sau tn thng vi ba ngy.
- Tc pht trin chm do dch lympho dch chuyn trong hch lympho rt chm
- Sau khi mch lympho v dch lympho t t thot ra ngoi.
- U lympho ngy cng ln v khng c gii hn.
- Gii hn u lympho vi m bo xung quang ko r rt
- n tay nghe ting v nc trong n
- u lympho ko c biu hin vim nu ko nhim trng
- chc thm d thy dch lympho trong sut, nht, hi ng vng . ng trong a
lng 5-10p sau s ng nh thch
c. iu tr
- i vi u lympho nh vn phi tr v n cng ngy cng ln ln
- iu tr bo tn khi ko b nhim trng : dng kim chc ht dch lympho ri bm
vo xoang bnh l hn hp st trng v vt mch lympho sau khi bm nn xoa nh
bn ngoi dch phn tn vo trong
- iu tr bng phu thut : ch nh khi nhim trng : chch u lympho ch thp
nht t th ng , ken ht dch m, ra = cn iod 5% , x l vi cc hp cht
khng khun,sau t dn lu.
27. Chn on phn bit U mu, U lympho vi cc trng hp d nhm khc?
- Da vo triu chng lm sang , chc thm d so snh vi cc trng hp khc.
28. Nguyn nhn, triu chng,iu tr bng do nhit cao?

Thch Vn Mnh
TYD-K55
a. Nguyn nhn
- Do s tc ng ca nhit cao khi b la chy
- Dm vo than nng, nc si di vo, n phi thc n qu nng.
b. Triu chng
- cn c mc tn thng chia lm 4 loi bng
Bng 1 ( bng ban ) : lng b chy xm, da sung huyt ni ban . Vng thy
thng c gii hn do tnh thm thnh mch tang ln. Con vt au rt.
Bng 2 ( bng bng nc ) lp biu b chy cng li, bong ra. Da v m bo di
da b thy thng nng, hnh thnh bng nc. M bo xung quanh bng nc b vim
nng, c mu ng. v biu hin au hn rt nhiu, triu chng ton thn.
Bng 3 ( bng chy en ) . M bo b chy to thnh vy mu en. Da v cc m
lin kt di da b kh li. B mt vt bng kh ro nhng cc phn su b thy thng
rt nng. Mt nc v mt cht in gii xut hin. Con vt au n, b chong.
Bng 4 ( bng ha than) m bo tn thng b chy en thnh than , Ty mc
m c th chy da, m lk di da, c, ph tng cng c th b chn. Chy n u th
cc lp nm su hn b cng li.
c. iu tr
- iu tr ti cc b : h nhit vng m bo b bng : ngm, chm nc lnh, nc
, bi kem chng bng. Dng cc cht lm se da, bo v da, di ra vt borg bng
cc dung dch acid tanic 5%,Nu bng c bng nc rt nc ra bm
Novocain kt hp khng sinh. Khi qu trnh vim gim nn dng thuc kch
thch qu trnh hi phc ti sinh: du c + khng sinh bi hay p vo vng phu
thut.
- iu tr ton thn : dng thuc an thn aminazin 2,5% tim bp, novocain 0,25%
tim chm vo tnh mch. Truyn dung dch glucose 5% + nc mui sinh l.
Tim tnh mch canci clorid + glucose. phng trng c toan tim natri
hydro carbonat 5%. S dng cc loi vitamin v cc kch thch phi c hiu.
29. Nguyn nhn, triu chng,iu tr bng do nhit thp?
a. Nguyn nhn
- Pht nc l bng do nhit thp
- Lm vic nhiu, n t, tri rt but ko di nn lm tru b pht cc 4 chn.
ng vt b qu nng nm nhiu hn ng gy ng hang lot k pht bnh
ng tiu ha, thng kt thc bng ci cht hoc m tht.
a. Triu chng
- 4 mc pht ci
- Cc 1. Da cha c bin i cu trc hnh thi, ch thy vng tn thng da hi
dy ln cht. Cng hn bnh thng, mu xanh xm, hi ph n, mt cm gic, 1
phn t bo thng b bong ra.

Thch Vn Mnh
TYD-K55
- Ci 2 : bt u c bin i hnh thi, hoi t xut hin biu b v 1 phn da,
ph n nng hn, xut hin bng nc cha dch mu nu, con vt nga, gi mn
nc v ra. Nhim trng k pht lm chn sng to ln, au.
- Cc 3 : da tn thng hoi t, mu ti xm, lnh v cng, mt cm gic, ph
n nng hn, da nt n nh qu da b, xut hin m hoi t ln di da. Con vt
au, i li kh khn, vng da tn thng rng.
- Cc 4 : da tn thng hon ton , dy cng nh g, cc lp m bo di da k
c xng, sn u tn thng, con vt au nhiu, qu nng, thng k pht 1 s
bnh : chng hi d c, lit d c,kt thc bng s loi thi ng vt.
a. iu tr
- Si m cho con vt
- Ngm chn vo nc nng nhit tng dn ko qu 40
- Dng n sollux, hng ngoi chiu vo vng da b bnh
- Dng thuc xoa bp long no, cao sao vng
- Dng gng, ring gi nh cho ru vo mng xoa bp ngy 3-4 ln mi ln 20-30p

30. Nguyn nhn, triu chng,iu tr bng do acid?

a. Nguyn nhn
- do cc acid mch nh H2SO4, HCl,
- do con vt vn chuyn ha cht cc tai nn xe, v bnh ha cht
- dm ln, n phi ha cht vng vi
- tht h vi ang ti hay ti nhng cn nng
- b tn cng bi ha cht c kh nng gy bng.
b. Triu chng
- gy hoi t kh cho m bo
- m bo cc b bin thnh 1 khi dy cng
- bng nng, hp, t nhim trng k pht
- m bo lp su hn b thy thng nng, chy mu
- da b khuyt, qu trnh vim ko di, da mt kh nng hi phc
- so ln co ko lm bin dng c quan
c. iu tr
- Ra sch vi nc vng tn thng dng lng nhiu, ko di, nn to dng chy
- Dng ha cht i khng trung ha dng nc vi trong, NaOH ra.
- Tip tc dng cc bp nh iu tr vi bng nhit cao
31. Nguyn nhn, triu chng,iu tr bng do kim?
a. Nguyn nhn
- do cc cht kim mch nh NaOH, KOH,
- do con vt vn chuyn ha cht cc tai nn xe, v bnh ha cht
- dm ln, n phi ha cht vng vi
- tht h vi ang ti hay ti nhng cn nng

Thch Vn Mnh
TYD-K55
- b tn cng bi ha cht c kh nng gy bng.
b. Triu chng
- tan ra t bo, m bo gy hoi t t
- c su, rng hn bng toan
- b mt vt bng t, bn, c mu m bo lng thong nhim trng k pht.
- cc m bo lp su thy thng nng, chy mu, vim ko di
- da khuyt mt kh nng hi phc
- so ln dm d lm bin dng c quan.
c. iu tr
- Ra sch vi nc vng tn thng dng lng nhiu, ko di, nn to dng chy
- Dng ha cht i khng trung ha dng acid acetic 2% ( dm), nc da, vt
qu chanh.
- Tip tc dng cc bp nh iu tr vi bng nhit cao

32. Khi nim,nguyn nhn, triu chng, iu tr Hoi t?

a. Khi nim
- S cht ca 1 b phn nh ca c th, trong khi s sng ca ton b c quan vn
c bo tn gi l hoi t
- Qu trnh cht dn ca m bo v c quan trn nn thiu mu v nhng bin i
thoi ha su sc c gi l bnh hoi t.
b. Nguyn nhn
- s dp thng, rch, p, nhit qu cao hay qu thp, dng in nng lng nh
sng, vi sinh vt, s ri lon tun hon mu, ri lon ni tit, ri lon tk thc vt dn n
s lon dng m bo.
c. Triu chng
d. iu tr
33. Khi nim, nguyn nhn, triu chng, iu tr Hoi th?
a. Khi nim
- Hoi th l dng c bit ca hoi t, b phn ln m bo hay c c quan b cht
c mu xm hoc en, di tc ng ca cc nhn t bn ngoi hay ca vi sinh vt.
b. Nguyn nhn
- Nguyn nhn bn ngoi
Dp nt m bo c bit c s v, rch mch mu, thn kinh
S p lu di cc phn c th, c quan khi nm trn nn cng
Bng qu cht , tht caro qu chat,
Bng do nhit cao, nhit thp mc III, IV
Tc ng ca acid, kim hay cht ha hc khc.
Rut b hernia hay xon rut
Nhim khun trn nn tn thng nng

Thch Vn Mnh
- Nguyn nhn bn trong
Nghn hoc v mch mu
Cn c tht mch qun khi b ng c nm ca g
Ri lon thn kinh v chc nng ca h thng ni tit.
Thiu h tim mch, mt mu qu nhiu, bnh l nng,
c. Triu chng
d. iu tr

TYD-K55

34. Lot l g? Phn loi lot?

a. Khi nim
- l s hy hoi b mt nim mc, da v cc m bo nm su hn , khng c khuynh
hng lnh nhanh chng v din ra s phn hy cc thnh phn ca t bo v pht trin
m ht bnh l.
b. Phn loi
- Lot n gin : qu trnh hi phc, ti sinh chim u th hn so vi qu trnh hoi t
mc d n tin trin chm nhng s lin so
- Lot lit : qu trnh hy hoi v hi phc ti snh cn bng nhau, c trng ca nhng
nt lot do lit thn kinh dinh dng. Kch thc ca chng trong khong thi gian di
ko gim i v cng ko tang ln, nhng nt lot dng ny khng c xu hng lin so.
- Lot tng tin : qu trnh hy hoi chim u th hn so vi qu trnh hi phc ti
sinh, in hnh ca nhng nt lot tng tin. Nhng kch thc ban u ca chng
nhanh chng hay dn dn tng ln do s hoi t , phn hy nhng m bo ln cn.
c. Nguyn nhn
+ S thiu ht chc nng thn kinh ni tit, ri lon qu trnh chao i cht tun hon mu
v dinh dng m bo.
+ S tc ng ca cc tc nhn c gii, vt l, ha hc.
+ S xm nhp ca vt l v m bo.
+ S hoi t su ca nhng m mm v xng do nghn mch.
d. Triu chng
+ Nhng ch khuyt ban u ca s hoi t da, nim mc c ln v hnh thi khc nhau b
mt che ph bng vy m che ph bng nhng ht nh mu hng.
+ Khi b lot lit, ng vin biu m khng c hay rt m nht.
+ Nhng nt lot n gin c ra thoi mi vi ng vin biu m y ca n
+ Nhng nt lot tng tin, ch trng bng nhng tan ra hoi t m bo ca ch khuyt b
n mn, ht c mu xanh tm, tit nhiu dch.
e. iu tr

Thch Vn Mnh
iu tr: Loi b nhng nguyn c nh hng n tin trin ca bnh lot.

TYD-K55

S dng du c hay cc loi thuc m bi vo cc nt lot n

gin
Ti cc b

Chiu bng n Sollux, hng ngoi nhng trng hp lot hoi th

dng hn hp tinh du thng. Ct b ra v ht nhng nt lot th
chaisau khu vt thng li.
Trng hp nt lot hnh thnh lu phi phu thut ct b to
vt thng mi -> khu khi tha mn 5 iu kin.

35. Khi nim, phn loi, iu tr l r ?

Tng cng sc khng cho c th: n ngay
a. Khi nim
Tng cng ti sinh m bo
Ton- thn
b. Phn loi Trng hp nt lot nhiu phi dng n t ngoi.
c. iu tr
Nguyn tc:Ch t c kt qu iu tr khi pht hy cc l r.
- i vi l r mi hinhg thnh c th lo vt, t bng tinh th AgNO3 KMnO4 nht cc
ht tinh th v l r i 30 pht dng tha hoc cn dao no vt ht cc t chc ht bnh l
khi no t chc ra mu u th thi.
- V l r hnh thnh lu ng i a dng phi kim tra ng i cu l r, dy t chc
bnh l phng mt mu nhiu.
Ch : Tng k nng t ng mu u c th bng CaCl2
- Nhum cc l r bng xanh metylen 3% bm vo trong 12 -24 gi mi phu thut.
M l r: M hnh ch T: 1 ng ngang ming phu l r v mt ng theo chiu
dc mc ch m rng v cc l cc ht bnh l trong l r ct b ri nhum xanh.

36. Khi nim , phn loi Hernia

a. Khi nim
- hernia l s i ra hay di chuyn ca nhng c quan ni tng( rut, mng treo rut, bng
quang, t cung,) ra ngoi gii hn xoang gii phu , qua l t nhin hay bnh l ca
thnh bng v thnh ngc
b. Phn loi
- cn c ngun gc c Hernia bm sinh, hernia mc phi
- cn c mc ca s dch chuyn ca vt hernia v nhng triu chng lm sang c :
* hernia ko hi phc
* hernia hi phc
* hernia b kt
- theo s nh v ca hernia ngi ta chia ra:
* hernia rn
* hernia thnh bungh
* hernia m nang,

Thch Vn Mnh

TYD-K55

37. Chn on phn bit Hernia vi cc trng hp d nhm khc ?

38. Nguyn nhn, triu chng, chn on v iu tr Hernia rn ?
a. Nguyn nhn
- Thng do bm sinh l ch yu, do ct rn khng ng, nhim trng rn hay gp ng vt
non, ch yu ln con.
b. Triu chng
- Khi rn hi phc: Ti vng rn cu gia xc xut hin 1 bc hnh bn cu, bc ny c gii
hn r rt vi xung quanh khi s nn thy mm, bc hecni khng nng khi n tay hay dc
ngc con vt -> bc hecni nh i dng ng nghe c th thy nhu ng rut.
- Khi rn khng hi phc: Da bc hecni ng khi cng phng, s nn, th con vt au,
khi n tay khng thy hecni nh li con vt au bng b n, tc rut khng i ngoi. Thn
nhit cao, ri lon, khng iu tr kp thi -> vim phc mc -> cht.
c. Chn on
- Da trn triu chng lm sng.
d. iu tr
- Phng php gy vim cc b t s dng v dng phng php phu thut.
+ C nh dng vt: thng l nm nga.
+ V sinh: ct lng vng hecni, ra sch, lau kh, st trng bng cn iot 5%.
+ Gy (ch) b ln gy t.
+ M bc hecni: dng dao dch chnh gia bc hecni. Nu l hecni hi phc th a vt
hecni vo trong xoang bng. nu l hecni khng hi phc phi bc tch lp vim dnh, ct
b on rut hoi t ri tin hnh khu ni rut.
+ Ct b vng rn, to thnh vt thng mi hon ton, ri khu bt l rn li.
+ Che bt km khun + ct b da tha+ khu.
+ Chn sc h l.
39. Nguyn nhn, triu chng, chn on v iu tr Hernia m nang ?
a. Nguyn nhn
- thng do bm sinh, hay gp ln, nga, tru b
- Qu trnh bo thai ng bn qu rng
b. Triu chng
a. C th xy ra gs trc thin v sau thin
b. Do bao dch hon gia sc cng to, np nhn t nhin bin mt. S nm c cm
gic mm, khi n tay th vt herni bin mt. Gia sc n ung hot ng bnh
thng.
c. Hernia khng hi phc: rut dnh vo di da bao d hon -> bao dch hon
cng to, -> tm bm; s vo con vt au -> b n. nga c triu trng ton
thn r rt: B n, st cht
c. Chn on
- Da vo triu chng lm sng in hnh.
d. iu tr

Thch Vn Mnh
TYD-K55
Phu thut
- Phng php gy vim cc b t s dng v dng phng php phu thut.
+ C nh dng vt: thng l nm nga.
+ V sinh: ct lng vng hecni, ra sch, lau kh, st trng bng cn iot 5%.
+ Gy (ch) b ln gy t.
+ M bc hecni: dng dao dch chnh gia bc hecni. Nu l hecni hi phc th a vt hecni vo
trong xoang bng. nu l hecni khng hi phc phi bc tch lp vim dnh, ct b on rut hoi
t ri tin hnh khu ni rut.
+ Ct b vng rn, to thnh vt thng mi hon ton, ri khu bt l rn li.
+ Che bt km khun + ct b da tha+ khu.
+ Chn sc h l.
40. Nguyn nhn, triu chng, chn on v iu tr Hernia thnh bng ?
a. Nguyn nhn
- Do tn thng c gii l ch yu: b nh p, hc hoc do phu thut thnh bng ko
ng phng php
b. Triu chng
+ V tr: vch bng, hay sy ra trc v sau rn, tru b thng l ti hm hng tri.
-Kch thc: to nh ph thuc ging loi gia sc, mc tn thng
+ giai on u: Con vt c biu hin vim cp tnh ph vim, thy thng hnh thnh u
mu
+giai on sau: Khi phn ng vim gim, ti vng tn thng hnh thnh khi hnh cu,
hnh trng t hoc khng au, mm v c gii hn ra. Nu dng tay s nn gia bc heeni
c l ca heeni.
Nu c biu hin triu chng ton thn, ngc vn c biu hin ton thn + Hernia ko hi
phc -> hin tng tc rut: Con vt au bng t ngt khng i tiu c, st cao, mch
nhanh v yu huyt p.
c. iu tr
- Phng php gy vim cc b t s dng v dng phng php phu thut.
+ C nh dng vt: thng l nm nga.
+ V sinh: ct lng vng hecni, ra sch, lau kh, st trng bng cn iot 5%.
+ Gy (ch) b ln gy t.
+ M bc hernia: dng dao dch chnh gia bc hernia. Nu l hernia hi phc th a vt
hernia vo trong xoang bng. nu l hernia khng hi phc phi bc tch lp vim dnh, ct
b on rut hoi t ri tin hnh khu ni rut.
+ Ct b vng rn, to thnh vt thng mi hon ton, ri khu bt l rn li.
+ Che bt km khun + ct b da tha+ khu.
+ Chn sc h l.

41. Nguyn nhn, triu chng,iu tr Vim nang lng ?

a. Nguyn nhn
- Do m nh hnh thnh xung quanh chn lng
- Do da v lng v nhim bn
- L chn lng ko bt kn tch t cht bi tit.

Thch Vn Mnh
TYD-K55
- Tn thng c gii lm xy xt da v s xm nhp ca nhng tc nhn gy nhim trng
vo l chn lng
b. Triu chng
- Trn b mt da, quanh chn lng c nhng nt nh , sau 3-5 ngy hnh thnh mn m
cha m trng ng. Trung tm mn m l chn lng. Ra m ng.
- Mn t v hoc dng kim m m chy ra. y m c 1 lp m ht ti
- Mn m kh dn t xung quanh vo tm v ng vy. khi vy kh i hnh thnh lp
sng mi.
- Triu chng lm sng th hin r trn vng da t lng v hu nh ko r khi c lp ng
bnh l che ph.
c. iu tr
- Loi b nguyn nhn v lp lng che ph.
- Bi cn iod 5%
- Dng kim chc vo mn m 1 cch nh nhng . Dng panh kp bng cn formalin 2%
hoc iod 5% lo b m.
- Khi ly ht m bi li cn iod 5% v rc khng sinh sulfamid vo.
- Ko s dng thuc m bi v s bt l chn lng ko o thi cn b nng thm.
- Khi c nhiu mn m ti 1 vng s dng pp chiu tia t ngoi vo vng bnh vi liu
thp v hng ngy. Cho bnh sc tm nng.
d. Phng bnh
- Ko lng, da nhim bn, tm chi thng xuyn cho v
- Cho n y cht dd, vitamin A,B,C,D,E
- i do, tm nng hp l.
42. Nguyn nhn, triu chng,iu tr Mn nht ?
a. Nguyn nhn
- Vim l chn lng l tin to mn xy ra khi mn l chn lng ko r v m nhim
trng lan rng vo su hn n ti lng v tuyn nhn.
- Do s xm nhp ca staphylococcus khi b hy hoi vng biu b.
- Nguyn nhn m ng u tin l k nui dng bn. nhng cht thi, v c, hu c,
ri lon chc nng tit tuyn nhn v m hi.
- Ri lon trao i cht, thiu vitamin, gim dd t vo v chc nng bo v da.
b. Triu chng
- Giai on u tin l mn, khi cn hin din ca lng v da rt kh xc nh.
- Ch sng au c hnh nn cng nh ht mn.
- Vng da ko c sc t ch sng hoc ng
- Trung tm ca ch sng c th bc l mu vng hoc xanh lc.
- i vi mn chn t au, mn c s sng ng bn trong. Khi n mnh v v chy
m ra mu vng trng .
- Khi tn thng ln, s c mt ca nhiu mn m cc giai on ptr khc nhau l c
trng ca triu chng lm sng.
c. iu tr

Thch Vn Mnh
TYD-K55
- Khi iu tr mn nht cn ch n g ca mn, mc tn thng, trng thi ton
thn ca con vt.
- iu tr cc b : ct lng, ra vng da tn thng, lau kh, st trng = cn iod 5%. Giai
on ph v thm nhim Phong b = novocain + ampicillin . Tip bi vng mn 1
lp ichthyol v sau chiu bng n hng ngoi hoc n sollux. Giai on mn chn
chch cn thn ko lm tn thng hng ro ranh gii. Sau khi loi b ht mn dng
panh kp bng tm cn iod 5% st trng xoang mn. Nu sau khi m nhng mn t
v m ko th loi b ngi mn ph khn tm dung dch mui n hay MgSO4 5-10%
loi b ngi mn. Khi mn cha chn ko c bng gc nng m, m v s lm lan
trn vk lan rng nhim trng v hy hoi hng ro t bo ht.
- iu tr ton thn : iu tr = khng sinh sulfamid + thuc b trong 6-10 ngy . Tim
tnh mch hng ngy dung dch urotropin + glucose + vitamin C. Nu c bnh km theo
s dng bp iu tr triu chng ph hp. Cn to k thun li cho bnh sc v nui
dng, chm sc, khai thc.
43. Nguyn nhn, triu chng,iu tr Eczema ?
a. Nguyn nhn
- Bao gm nhn t ni sinh v nhn t ngoi sinh
- Nhn t ni sinh l : ri lon tk chc nng thc vt, ri lon chc nng tuyn gip, dch
hon, vim d dy, vim thn, vim gan, vim ti mt,
- Nhn t ngoi sinh l : c gii ( gi, c st, nhim bn da), Ha hc( xoa thuc m,
huyn dch c tnh kch thch, ra saphong qu nhiu, ngm trong nc bn,) Vt l :
tc ng ca nh sng, nhit . Vi sinh vt : do sn phm phn hy ca vi sinh vt.
b. Triu chng
c. iu tr
44. Nguyn nhn, triu chng,iu tr gy xng v trt khp ?
a. Nguyn nhn
- Bm sinh
- Nguyn nhn trc tip : chn thng c gii
- Nguyn nhn gin tip : k pht t cc bnh ci xng, mm xng, ung th xng, trt
khp.
b. Triu chng
- au
- Ri lon chc nng c quan
- Thay i hnh thi gii phu ca c quan
- S vn ng ca xng ngoi khp
- Vn ng b ng nghe ting lo xo
c. iu tr
- C nh xng gy
- Loi thi i i ng vt ln s dng sc cy ko

Thch Vn Mnh
45. Nguyn nhn, triu chng,iu tr trt khp ?
a. Nguyn nhn
- Bm sinh
- Chn thng c gii
- Bnh dy chng khp
b. Triu chng
- au
- Ri lon chc nng c quan
- Bin i hnh thi ca khp
- Khng c s chuyn ng t do trong khp.
- Vn ng b ng nghe c m trm l c trn ca trt khp hon ton.
c. iu tr
- C nh khp.

TYD-K55

46. Nguyn nhn, triu chng,iu tr vim bao hot dch ?

a. Nguyn nhn
- Chn thng c gii
- Vim lan
- Bnh truyn nhim.
b. Triu chng
- Vim bao hot dch thng gy ra qu nng
- Khp vim b sng to. Thy khi u ni ln cao v nh v 1 pha.
- Con vt au khi s vo
- Con vt st nh, i li kh khan, ko mun co dui chn, nm t th c th dui chn b
au
- Nu bnh ko di bao hot dch c th v ra.
c. iu tr
- Cn phi loi tr nguyn nhn gy bnh
- Nu l vim cp tnh v trng c th chm lnh v bng p.
- Bnh tin trin cp tnh th chm nng hay bi thuc kch thch tiu vim.
- Bao sng to c th iu tr bng phng php chc ht.
- iu tr bng phu thut i vi nhng trng hp vim ha m hay vim mn tnh
tng sinh.
47. Nguyn nhn, triu chng,iu tr H mng ?
a. Nguyn nhn
- Nn chung thng xuyn m t.
- Vi khun ym kh tc ng
- B ko c gt sa mng thng xuyn, mng pht trin ko bnh thng, y mng
khng bng phng.
b. Triu chng
- Bnh thng pht ra 2 chn sau.

Thch Vn Mnh
TYD-K55
- Bnh nh con vt vn i li nhng chm chp. khi nm xung ng dy rt kh khn.
- Cc bp tht mng, i ca chn b h thng run mi khi nm xung hoc ng dy
- Con bnh nm lu dn n k pht 1 s bnh ng tiu ha, l lot trn da.
- Kim tra vng y mng c nhiu vt lm hnh trn, bu dc vi mu en trn b mt
chnh l nhng nt h.
- No nt h thy m sng cht b mn ra, mu en, mi thi.
- Kch thch vo nhng nt h con vt rt au.
c. Phng v iu tr
- Gi cho nn chung c kh ro, sch s
- Gt sa mng , gt ht phn sng mng b bin tnh, lm cho y mng tht bng
phng.
- Bi vng bnh bng cn iod 5%
- Cho cc bt km khun vo vt h su ri bng li.
48. Nguyn nhn, triu chng,iu tr Thi mng ?
a. Nguyn nhn
- B sa nui nht, thiu vn ng
- B khng c chm sc mng thng xuyn
- K pht t bnh H mng.
b. Triu chng
- Bnh pht ra ch yu 2 chn sau thng c 2 loi
- Thi phn sng ca y mng hoc k mng
- Thi phn sng ca y mng : giai on u xy ra nh h mng sau tin trin
nng hn con vt i ng kh khn . kim tra thy 1-2 vt lot bng u ngn tay . M
sng b hoi t mn nh mn ca, mu en , mi thi.
- Bnh k mng : vt lot xut hin k mng to thnh vt thng nhim trng ym
kh n su vo gia 2 mng bnh tin trin nhanh c th lan ti t qun , t cu ca
ngn chn. th ny con vt qu rt nng khng i li c. K pht cc bnh ng tiu
ha, l lot trn da
c. iu tr
- vt ht m sng cht
- Ra sch bng thuc tm 1%
- Cho bt km khun
- Pht 1 lp ichthyol
- Bng li hng ngy ra vt thng v quan st n khi vt sng c lp y.
49. Nguyn nhn, triu chng,iu tr Vim tnh mch ?
a. Nguyn nhn
- Chn thng c gii
- Khi tim tnh mch cc loi thuc c tnh kch ng mnh b lt ra ngoi.
- Vim lan
- Bnh truyn nhim.

Thch Vn Mnh
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b. Triu chng
- C 2 th : vim tnh mch ha m v vim tnh mch hnh thnh cc mu ng
Vim tnh mch ha m
Vim tnh mch hnh thnh cc mu ng
- tnh mch sng to, ni ln nh si dy thng, - thnh trong mch qun b vim tng sinh tr
nng au vi s thy thng nng dc theo tnh ln nhm, x x, hp li, cn tr s lu thng
mch b vim
mu.
- khi tim cc thuc b lt ra ngoi p xe bn - t bo mu va chm vo nhng ch nhm c
cnh tnh mch. Phn tnh mch pha ly tm
th b v, hnh thnh cc cc mu ng, bin
phnh to, phn tnh mch hng ly tm b xp
chng nhi huyt cc kh quan.
- ng vt c biu hin ton thn
- bin chng : nhim trng huyt.
c. iu tr
- Vim tnh mch ha m : phu thut ct b
- Vim tnh mch hnh thnh cc mu ng : dng a y hc, dng hyrudin.
50. Nguyn nhn, triu chng,iu tr Vim kt mc ?
a. Nguyn nhn
- Tn thng c gii, vt l, ha hc
- Bnh truyn nhim
- Vim lan.
b. Triu chng
- Vim kt mc cp tnh
Hai m mt sng to, kt mc sung huyt
Nc mt chy ra nhiu long trong , sau t dn v tr nn c c c d mt.
ng vt s nh sng mt nhm nghin
Vt nga mt, c gi nhiu dn n tn thng phc tp hn.
-

Vim kt mc mn tnh
Kt mc tng sinh, 2 m mt sng to, lt ra ngoi che lp gic mc, con vt khng
nhn c na.
Bin chng vim lan sang gic mc.
c. iu tr
- Vim kt mc cp tnh : chm lnh ch dng g u qu trnh vim cp tnh, ko ko di,
c trng hp ch dng 1 ln duy nht. Ra mt = cc dung dch nc mui 0,9% ; acid
boric 2%, bc nitrat 2%, dung dch long cc thuc khng sinh. Tim novocain kt hp
khng sinh vo h thi dng. Tra m tiu vim c kt hp khng sinh.
- Vim kt mc mn tnh : phu thut ct b cc phn kt mc tng sinh.
51. Nguyn nhn, triu chng,iu tr Vim gic mc ?
a. Nguyn nhn
- Tn thng c gii, vt l, ha hc
- Vim lan

Thch Vn Mnh
TYD-K55
- Bnh truyn nhim
b. Triu chng
- u tin thng th hin th cp tnh : mt sng, gic mc sung huyt, nc mt nhiu
long trong , vt s nh sng ; nga mt, c gi nhiu.
- Tin trin chm dn gic mc c
- Gic mc c mu trng, trong sut th ko iu tr c khi na.
c. iu tr
- Chm lnh : ch nh g u qu trnh vim cp tnh, ko dng ko di trnh thiu mu
cc b. c trng hp ch dng 1 ln duy nht.
- Ra = dung dch st trng
- Tim Novocain kt hp khng sinh vo h thi dng.
- Tra m tiu vim kt hp khng sinh
- Khi ko ci nhn th thi vo mt cc bt :
Nga : calomen 5 phn, saccaroza 5 phn
- v loi nhai li : v c nhi kh, t thnh than, tn nh mn kt hp vi 1 t bt khng
sinh.
52. Nguyn nhn, triu chng,iu tr Hp bao quy u ?
a. Nguyn nhn
- Bm sinh
- Tn thng c gii
- Vim lan
b. Triu chng
- Vt kh i tiu, nc tiu ko ra thnh dng m bn thnh tia
- Nc tiu thot ra ngoi ko ht bin chng vim niu ao.
- Vi c ging : tinh dch c ln mu, thng ko phm cht. Phi ging trc tip cng
ko c kt qu.
c. iu tr
- Phu thut m rng bao quy u.
Thch Vn Mnh TYD K55