Five boys from the orphanage were ill acutely.

Beginning with vomiting 5 - 6

times, abdominal pain, fever up to 39,00S. Children get sick after taking the fish
cakes. What anti-epidemic measures necessary to carry out in the source of
infection?©
isolate the sick children in the hospital, to conduct the current disinfection in the
kitchen at home baby ©
isolate the sick children in the hospital, to conduct final disinfection in the kitchen
at home baby ©
isolate the sick children in the hospital, to conduct the current disinfection in all
areas of the child's home ©
isolate the sick children in the hospital, to conduct final disinfection in all areas of
the child's home, to examine contacts ©
+isolate the sick children in the hospital, an emergency notice to submit to a
regional UGDSEN, examine the contacts
***
The child, 9 months. Located seventh day in hospital with adenoviral infection,
bronchitis, pneumonia receives antibiotic therapy. Against the background of
improvement on the 7 th day the sharp deterioration fever, repeated vomiting,
frequent stools with mucus and blood. Justify the period of infection and indicate
the possible cause of the disease course©
recurrence due to inadequate antibiotic therapy ©
+superinfection, as there is a nosocomial infection ©
reinfection because there is an intestinal infection, prolonged course ©
aggravation, because there is a non-smooth course of the disease ©
the height, because acute course considered disease duration up to 1.5 months
***
Baby 4 months, was admitted to hospital on the 7th day of disease with complaints
about the increase in temperature during all the days before 38,5-390S, cough,
shortness of breath, dyspnea. From the history of life: a month ago suffered
pneumonia. Specify the type of first-line therapy in this case and justify its
necessity©
+pathogenetic (infusion) therapy, because the child has expressed intoxication ©
symptomatic therapy (antipyretics), because the child has persistent fever ©
pathogenetic therapy (mucus-thinning drugs), because the child has inflammation
in the bronchial mucosa ©
immunomodulatory (interferon preparations) therapy, because a child burdened
with premorbid background ©
etiotropic (antibacterial) therapy, because the child not smooth course of the
disease
***
Call on the house local doctor to a child under the age of 5 months. On
examination, the child can not drink, he was painfully irritating, it does not vomit
after every meal or drink. The body temperature of 39C. Your tactics on IMCI©
+immediately sent to the hospital because the child has a general danger sign ©
give paracetamol and leave home ©
give the appropriate antibiotic for 3 days ©
direct on additional inspection ©
treated on an outpatient basis
***
At the basic task of laboratory enters carrying out bacteriological researches of
tests of clinical material, serological (immunological), sanitary and bacteriological
researches and delivery of results of laboratory researches for ©
+objectification of the clinical diagnosis and monitoring of treatment of patients
with infectious diseases and conditions caused by pathogenic and opportunistic
pathogenic microorganisms, evaluation of the system status of anti-infective
resistance of the body of the patient, obtaining information for events of of
epidemiological surveillance of hospital morbidity©
evaluation of the system status of anti-infective resistance of a patient's body ©
obtaining information for activities of epidemiological surveillance of hospital
morbidity ©
carrying out organizational and methodological work consists of the analysis of
infectious morbidity, mortality, level of the diagnosis and quality of treatment of
infectious patients, conducted by clinic doctors. development and participation in
the implementation of measures to optimize these parameters©
participation in the drafting of the work plan for the preventive vaccination of the
population and monitoring its implementation
***
Mom addressed to clinic with child 2 years with complaints on that the child can
not drink. On examination, the child is not lethargic, he did not have convulsions,
he had no vomit after every meal. When the doctor gave the child the water, he
could not make swallowing movements. The body temperature of 37.8 C. On
examination, noted an increase in cervical lymph nodes, white coating in the throat
is absent. Assign treatment of the child by IMCI©
+bicillin-1 x 600 000 IU once daily i/m, immediately sent to hospital ©
bicillin-1 x 600 000 IU i/m, paracetamol 0.2 on ½ tab for 2 days ©
soften the throat by a secure means, paracetamol 0.2 on ½ Tab ©
bicillin-1 x 120,000 IU i/m 3 days, paracetamol 0.2 on ½ tab, at a high temperature
body ©
bicillin-1 x 120,000 IU i/m for 5 days, to soften the throat using a secure means
***
Natasha 1.5 years became ill sharply with increasing temperature to 37.8 deg.,
Appeared running nose, was treated on an outpatient basis in occasion ARVI. On
day 5 of illness temperature was maintained to 37.5 deg., Appeared swelling in the
neck. On admission state of moderate severity, the weight of 11.100, pulse 125 in 1
min, breathing 28 minutes. nose breathing is difficult, there is no discharge. In
throat tonsils are enlarged. Anterior cervical and posterior cervical lymph nodes in
the form of a "chain". In the lungs vesicular breathing. The liver protruded from
under the costal arch by 4 cm, spleen - 2 cm, stool and urination is not violated.
CBC: Er - 3,5 х 1012/l, Hb-120 g/l, CI-0,9, Leu-20 х 109/l, Eos-1%, stab/n-2%,
seg/n-17%, lymph-53%, M-10%, atypical mononuclear cells 17%.diagnose©
diphtheria throat, localized form, mild severity ©
adenoviral infection, pharyngoconjunctival fever, moderate severity ©
scarlet fever, typical form, moderate severity ©
+infectious mononucleosis typical form, medium severity ©
lacunar angina of moderate severity
***
Mom addressed to clinic with child 2 years with complaints on that the child can
not drink. On examination, the child is not lethargic, he did not have convulsions,
he had no vomit after every meal. When the doctor gave the child the water, he
could not make swallowing movements. The body temperature of 38 C. On
examination, noted an increase in cervical lymph nodes, white coating in the throat
is absent. Classify condition of the child on IMCI program. Assign treatment ©
+throat abscess, bicillin 1, immediately sent to the hospital, give one dose of
paracetamol at pains or high fever ©
streptococcal pharyngitis, give bicillin 1, paracetamol, refer to hospital ©
streptococcal pharyngitis, give bicillin 1, paracetamol at pains, soften throat using
a secure means to explain to the mother when to return immediately, follow-up
visit after 2 days ©
not streptococcal pharyngitis, soften the throat via a secure means, give
paracetamol at pains ©
not streptococcal pharyngitis, soften the throat using a secure means of follow-up
visit after 3 days
***
The child, 7 years old, entered the hospital on the 4th day of illness. When viewed
severe condition. Sluggish, pallor of the skin. Tonsils moderately hyperemic,
converge on the midline, covered with dense white coating (+ cloth). Smell from
the mouth is sweet. Swelling of cervical tissue to the clavicle on both sides, sounds
of the heart are muffled. Assign treatment©
ADS 5 thousand. AE i/m, penicillin 100 thousand units/ kg for 5 days ©
ADS 15 thousand. AE by method for determining the sensitivity to foreign protein,
penicillin 500 thousand units/kg for 7 days ©
ADS 50 тыс. АЕ by method for determining the sensitivity to foreign protein,
penicillin 500 thousand units/kg for 14 days ©
+ADS 100 тыс. АЕ by method for determining the sensitivity to foreign protein,
penicillin 100 thousand units/kg for 14 days ©
ADS 220 тыс АЕ by method for determining the sensitivity to foreign protein,
penicillin 500 thousand units/kg for 14 days
***
Madina 4.5 years complains of pain in the throat when swallowing. The doctor ask
can the child to drink? Mom said he could. On examination, noted an increase in
cervical lymph nodes, white coating in the throatis absent. The body temperature
of 37.7 C. Classify condition of the child on IMCI program. Assign treatment©
throat abscess, bicillin 1, immediately sent to the hospital ©
streptococcal pharyngitis, give bicillin 1, paracetamol, refer to hospital ©
streptococcal pharyngitis, give bicillin 1, paracetamol at pains, soften throat using
a secure means to explain to the mother when to return immediately, follow-up
visit after 2 days ©
+not streptococcal pharyngitis, soften the throat via a secure means, give
paracetamol at pains, explain to the mother when to return immediately, follow-up
visit after 2 days ©
not streptococcal pharyngitis, soften the throat using a secure means, give
paracetamol at pains, explain to the mother when to return immediately, follow-up
visit after 3 days
***
child (15 kg) in need of antibacterial drugs for the treatment of pneumonia. Name
single dose of amoxicillin (250 mg per tablet, a single dose of 25 mg / kg in 2
hours)©
1 tablet©
½ tablet ©
+1½ tablet©
2 tablets ©
1¼ tablets
***
Daniyar, 8 months. Body temperature is 39 ° C. From the words of mother boy
refuses the breast and another drink. The child lethargic. He did not look at the
medical worker and their parents when they were talking. The doctor counted 55
breaths per minute and found a chest indrawing. The boy had a sharp sound while
inhaling. Your action in this case©
+urgently admitted to hospital as at child "very severe disease or severe
pneumonia»©
urgently admitted to hospital as at child "Severe febrile illness» ©
urgently admitted to hospital as at child "Possible bacterial infection» ©
spend three times the inhalation of bronchodilator, as the child's "no pneumonia,
wheeze» ©
appoint amoxicillin as at child "Pneumonia"
***
Milana, 5 years old, was admitted with complaints of severe headaches, fever up to
39.5, pain in the eyeballs and in the temple, loss of appetite, sluggish, weakness,
malaise. At the height of the temperature was vomiting. Sick for a day.
Objectively: general state severe, feeling violated. Child sluggish. The skin is
moist and warm to the touch. In throat - moderate hyperemia the posterior wall of
the pharynx and grain. From the nose - a mucous discharge. Light: harsh breathing,
no rales. CBC: hb- 115 g/l, Er- 3,48 х 1012/l, ESR- 10 mm/h, Л- 4,8 х 109/l,
stab/n-1, Eos-7, seg/n-25, lymph-65, M-2. Diagnose.©
+adenoviral infection, pharyngoconjunctival fever, severe severity ©
enterovirus infection, gerpangina. moderate severity ©
influenza typical form, severe severity ©
parainfluenza, typical form, of moderate severity ©
infectious mononucleosis, a typical form of moderate severity
***
Sasha, 4 years old, the body temperature is 38.0oC. No common signs of danger.
Cough for three days. RR 48 at rest in 1 minute. No chest indrawing, stridor,
wheezing. Classify the condition of the boy, and assign the appropriate treatment©
© pneumonia
pneumonia, amoxicillin - 3 days ©
pneumonia, amoxicillin - 3 days to soften the throat using a secure means ©
pneumonia, amoxicillin - 3 days to soften the throat using a secure means to
explain when to return immediately ©
+pneumonia, amoxicillin - 3 days to soften the throat using a secure means to
explain when to return immediately, follow-up visit through the 2 days
***
A woman with a child 8 years old, addressed to the clinic with complaints of
headache and pain in the frontal region and the orbits of the eyes, chills, aching
muscles, bones and joints, sore throat, nasal congestion, fever up to 39 ºC. When
viewed on the 2nd day of illness marked hyperemia and puffiness of the face,
injection vessels of sclera, runny nose, dry cough, tachycardia. Assign etiotropic
treatment the child ©
rimantadine 5 mg/kg per day in two doses, oxolinic ointment 0.25% - lubricate
nasal passages ©
+rimantadine 100 mg per day in two divided doses ©
Arbidol 200 mg in 3 divided doses ©
oseltamivir 75 mg in 2 divided doses ©
acyclovir 5 mg/kg three times a day
***
The child, 3 years old, arrived in hospital on the first day of the disease with
meningococcal meningitis. Assign therapy ©
penicillin sodium salt per 1 kg weight at 100 thousand. 3 times per day i/m ©
penicillin potassium salt at 120 thousand. units per 1 kg of 3 times i/m ©
penicillin sodium salt 200 thousand. units per 1 kg of weight per day after 4 hr i/m,
ie 6 times ©
+penicillin sodium salt 500 thousand. units per 1 kg of body weight per day to 8
times i/m ©
penicillin potassium salt at 300 thousand. units per 1 kg of weight per day after 4
hour i/m
***
Natasha, 4 years old, complains of weakness, loss of appetite, fever up to 37,6-
38оС Fever for 7 days. On examination, the general condition of moderate severity.
Common signs of danger is not. The skin is clean, pale. is not neck Rigidity. Your
actions in accordance with IMCI ©
+give one dose of paracetamol, refer the child to the survey ©
give the first dose of a/b drug and send to hospital treatment ©
give one dose of paracetamol, explain the mother when to return immediately,
follow-up visit after 2 days ©
give one dose of paracetamol, send the child to home ©
give one dose of paracetamol, give the first dose of a/b preparation, refer the child
to the survey
***
A child of 4 years, is sick for five days, beginning with a sharp rise in temperature
to 38,5oC, watery eyes and cough, on the fifth day developed rash on the face.
OBJECTIVE: pasty face, rash on the face large maculopapular character, on an
unchanged background, prone to merger. diagnose ©
+measles, typical, of moderate severity ©
scarlet fever, typical, of moderate severity ©
enterovirus infection: exanthema, of moderate severity ©
rubella, typical, of moderate severity ©
varicella, the typical, of moderate severity
***
What indicators are taken into account and assessed in the classification of
"measles" in the sick child on IMCI program? ©
a common symptom of danger, corneal opacity, mouth ulcers ©
a common symptom of danger, corneal opacity, mouth ulcers, purulent discharge
from the eyes ©
a common symptom of danger, corneal opacity, mouth ulcers, purulent discharge
from the eyes, generalized rash ©
a common symptom of danger, corneal opacity, mouth ulcers, purulent discharge
from the eyes, generalized rash, runny nose ©
+a common symptom of danger, corneal opacity, mouth ulcers, purulent discharge
from the eyes, generalized rash, runny nose, eye redness
***
Damir, 3 years old, a fever for 2 days. The temperature during the inspection 38.4o
C. At the time of inspection, the child had convulsions tonic-clonic character.
There neck stiffness by 2 cross fingers. Diagnose according to the IMCI program,
determine treatment©
+very severe febrile disease, give a single dose of an appropriate antibiotic to send
urgently to the hospital, give paracetamol with increasing temperature of 38.5 o C
and above ©
prolonged fever, urgently sent to hospital ©
possible bacterial infection, give appropriate antibiotic ©
uncomplicated fever, give paracetamol ©
severe febrile illness, give one dose of an appropriate antibiotic to send urgently to
the hospital, give paracetamol with increasing temperature of 38.5 o C and above
***
Child 7 years old, addressed on the fourth day of disease with complaints of fever,
malaise, pain when chewing and opening the mouth. Objectively: temperature is
38,3oC. On examination - in front of the ear, behind the ear on both sides marked
swelling of dough consistency, moderately painful on palpation. Marked
tenderness on pressure on the tragus, mastoid. On the oral mucosa hyperemia
around the external opening of the salivary gland excretory duct. Diagnose ©
CMV infection is acquired, generalized form, moderate ©
CMV infection is acquired, localized form, sialadenitis, moderate ©
epidemic parotitis, typical, severe degrees of severity, not smooth during ©
epidemic parotitis, combined form, typical, of moderate severity ©
+epidemic parotitis, glandular form, typical, of moderate severity
***
Masha, 1 year old, hospitalized after 2 weeks from onset of disease with
complaints about paroxysmal cough. In connection with the change of place of
residence, received the first vaccination at 11 months. The disease gradually began
with the appearance of dry cough, raising the temperature to 37,2-37,4oC. During
the 1st week of coughing became persistent and acquired paroxysmal character (up
to 20 times a day), despite on conducted outpatient treatment. Objective data: puffy
face. In light hard breathing, single dry rales. diagnose©
+pertussis typical, of moderate severity, period of whooping cough, uncomplicated
©
pertussis typical, of moderate severity, preconvulsive period acute course ©
pertussis typical, of moderate severity, period of whooping cough, prolonged
duration ©
pertussis typical, of moderate severity, period of whooping cough. Complications:
Pneumonia ©
pertussis typical, severe degrees of severity, period of whooping cough.
Complication: bronchitis
***
Child 3 months, arrives at hospital on the 3rd week of onset of disease with
complaints about paroxysmal cough. The disease gradually began with the
appearance of dry cough. During the first week of coughing it became more often
acquired paroxysmal in nature up to 20 times a day; vomiting after coughing notes.
Face puffy, perioral cyanosis. When coughing child becomes red. In light
inconstant moist medium bubbling rale. CBC: Hb – 128 g/l, Er – 3,8*10 12/l, Leu
– 25*109/l, lymph – 80% ESR – 10 mm/h. Diagnose©
pertussis typical, mild severity, period of whooping cough ©
pertussis typical, mild severity, preconvulsive period ©
+pertussis typical, moderate severity, spasmodic period ©
respiratory syncytial infection: obstructive bronchitis, moderate severity ©
respiratory syncytial infection, complicated by pneumonia
***
Natasha N., 1 year old, was admitted to the infectious department after a week of
onset of the disease with complaints about paroxysmal cough. The disease
gradually began with the appearance of dry cough, feeling and appetite were not
violated. T-37,2-37,4 degrees. During the 1st week coughing became more often
up to 12 times a day, became stubborn, prolonged and acquired paroxysmal in
nature, despite on conducted by outpatient treatment. Status of moderate severity.
Face puffy, bleeding on the sclera. throat clean, hard breathing in the lungs, single
dry rales. Tones of heart is rhythmic. Select a drug for treatment ©
penicillin 500 thousand units/kg 6 times per day i/m ©
furazolidone 10 mg/kg 4 times a day ©
+aminazin in lytic mixture 1-2 mg/kg/day x 2 times a day i/m ©
prednisolone1-3 mg/kg two times a day i/m ©
blood transfusion
***
Misha., 6 years old became ill acutely, temperature rose to 39 deg., Headache,
vomited twice. On admission to hospital revealed swelling in the right and left
parotid region of moderate density and pain. There have meningeal symptoms.
Enter diagnosis©
+mumps infection, combined form, mumps, meningitis, moderate severity ©
influenza typical form, severe gravity, complication: neurotoxicosis 1 degree ©
secondary purulent meningitis ©
infectious mononucleosis typical form, severe severity ©
tuberculous limfoadenit
***
At the child of the first year of life with acute viral hepatitis B on 20 day has
increased body temperature to 38,oC, appeared adynamia, alternating bouts of
excitation convulsive jerks in individual muscle groups. Reaction to light - is
preserved. Responds to inspection. Tachycardia, abdominal distension, repeated
vomiting with blood impurity are noted. The liver is at the edge of the costal arch.
HR – 150 per min.
Diagnose©
Viral hepatitis B, a typical form, non-smooth course©
+Viral hepatitis B, a malignant form, hepatic encephalopathy ©
Viral hepatitis B, a typical form, severe severity ©
Viral hepatitis B, a typical form of moderate severity ©
Viral hepatitis B, a typical form, severe severity, DIC-syndrome
***
Patient M., 6 months., Arrived on the 5th day of illness. 5 days ago has appeared
weakness, decreased appetite. Before entering the hospital deteriorated. Appeared
vomiting, slackness, darkening of the urine, icteric sclera. Three months ago, the
child was treated pneumonia, received two transfusions of blood components. In
contact with patients with viral hepatitis was not. On admission state of moderate
severity, sluggish. The skin and the sclera icteric coloration. The liver +2 cm,
spleen +1 cm. Biochemical analysis of blood: bilirubin total-78,2 mkmol/l, direct -
68,2 mkmol/l, inderect -10,0 mkmol/l, ALT-2,5 mkkat/l, tymol test - 12 Ut.
Diagnose©
viral hepatitis A typical form ©
viral hepatitis A, atypical form ©
+viral hepatitis B, a typical form moderate severity ©
viral hepatitis, atypical form, severe severity ©
viral hepatitis B, a malignant form severe severity
***
Child, 4 years old, attends a kindergarten, where during the last 3 months there are
cases of Virial hepatitis. In a study of contact, at the child showed increased
transaminases (ALT-2 mmol / L, AST-1 mmol / L). An objective examination of
state moderate severity, skin and sclera moderate yellowness. Peripheral lymph
nodes are not changed. The mucous membrane of the soft palate icteric. Liver 2 cm
below costal arch. The spleen is not palpable. Stool and urine are not violated.
Dark urine, feces discolored. Formulate a diagnosis©
+viral hepatitis A typical form, moderate severity ©
Viral hepatitis B typical form moderate severity ©
Viral hepatitis B atypical form moderate severity ©
viral hepatitis A atypical form, light duration ©
Viral hepatitis E prolonged duration
***
Patient M., 6 months., Arrived on the 5th day of illness. 5 days ago has appeared
weakness, decreased appetite. Before entering the hospital deteriorated. Appeared
repeated vomiting, slackness, darkening of the urine, icteric sclera. Three months
ago, the child was treated pneumonia, received two transfusions of blood. In
contact with patients with viral hepatitis was not. On admission state of moderate
severity, sluggish. vomiting. icteric of skin and sclera expressed. The liver +2 cm,
spleen +1 cm. Jaundice and symptoms of intoxication increased. Biochemical
analysis of blood: Biochemical analysis of blood: bilirubin total-78,2 mkmol/l,
direct - 68,2 mkmol/l, inderect -10,0 mkmol/l, ALT-25 mkkat/l, tymol test - 12 Ut.
Diagnose©
viral hepatitis A typical form, severe course ©
viral hepatitis A prolonged duration ©
+acute viral hepatitis B typical form, moderate severity ©
chronic viral hepatitis B, typical form moderate severity ©
Viral hepatitis B typical prolonged duration
***
At the child with viral hepatitis B on the 10th day of illness marked deterioration in
the form of episodes of psychomotor agitation, followed by periods of adynamia,
sleepiness. The child stopped stare at the toys from time to time do not recognize
mother. On pain irritants responds cry. In the morning observed vomiting "coffee
grounds". An objective examination revealed a reduction in liver size. Assign
treatment and justify ©
prednisolone because stops the inflammatory autoimmune component ©
+Hepa Merz, because reduces the level of ammonia in the blood ©
recombinant interferon, as through activation of enzymes leads to the suppression
of virus replication ©
ribavirin as inhibits the synthesis of viral DNA ©
essentiale because improves metabolic processes in the liver
***
A child 4 months. Was born from the second pregnancy (mother used injecting
drugs during pregnancy), second emergency births with a weight of 2.0 kg. From
birth three times suffered of acute purulent otitis media, twice -sided pneumonia.
During the last one and a half months have seen infrequent diarrhea, low-grade
fever, candidiasis oral mucosa, is not amenable to conventional therapy. An
objective examination: body mass deficit is 25% (Is exclusively breastfed);
increased necks, axillary, inguinal lymph nodes to II-III size. In the study by PCR
detected HIV RNA.WHO classification diagnosis?©
HIV - infection, I clinical stage ©
HIV - infection, II clinical stage ©
+HIV - infection, III clinical stage ©
HIV - infection, IV clinical stage ©
for diagnosis is necessary to know the immune status
***
A child has in anamnesis blood transfusion within 2 months periodically low-grade
fever, intermittent diarrhea syndrome, persistent lymphadenopathy. To confirm
your diagnosis it is necessary to appoint©
PHA with Yersinia diagnosticum ©
ELISA leptospirosis diagnosticum ©
ELISA with listeriosis diagnosticum ©
+ELISA for the detection of antigens of HIV-1 and HIV-2 ©
RPGA with Salmonella diagnosticum
***
What is the chemoprophylaxis of HIV infection in newborn ©
azidothymidine from 3 months of age©
azidothymidine from the 8th hour of life©
+azidothymidine - 0.002 g / kg from 8-hour of life©
levamisole dose of 5 mg / kg from 8-hour of life©
lamivudine dose of 40 mg / kg

***
Child 2 years old is in orphanage within two months. The mother was deprived of
parental rights, suffered from chronic alcoholism, his father - a drug addict. At
receipt boy was examined for HIV - negative. Over the last month the child
dropped the weight by 1 kg, subfebrility, sweating, Unstable stool. Previously
treated stationary about pneumonia, intestinal dysbiosis. Aimed at consultation. On
examination found lymphadenopathy, in the mouth - thrush, pharynx hyperemic.
The liver is up to 2 cm, painless, spleen at the edge of the costal arch. Select an
effective drug for the treatment of a patient ©
+azidothymidine©
Timlin ©
rimantadine©
viferon©
interferon
***
The criterion for diagnosis of AIDS is ©
+presence one of AIDS marker disease and/or reduction of T-helper cells below
500 cells/mkl ©
The criterion for diagnosis of AIDS is ©
presence one of AIDS marker disease and/or reduction of T-helper cells below 200
cells/mkl ©
The criterion for diagnosis of AIDS is ©
presence one of AIDS marker disease and/or reduction of T-helper cells below 100
cells/mkl ©
The criterion for diagnosis of AIDS is ©
presence one of AIDS marker disease and/or reduction of T-helper cells below 50
cells/mkl ©
The criterion for diagnosis of AIDS is ©
presence one of AIDS marker disease
***
Baby 7 months. acutely became ill, with a rise in temperature to 38 ° C, appearance
of frequent, watery, copious stools mixed with mucus, vomit once. Objective data:
serous discharge from the nose, moderate hyperemia of throat, granularity of
posterior pharyngeal wall. At palpation of the abdomen is marked swelling,
flatulence, rumbling on palpation along the intestine. The liver is not increased.
Positive results of investigation of feces for viruses.
Diagnose:©
+rotavirus gastroenteritis, moderate severity ©
rotavirus infection, atypical erased form ©
rotavirus enterocolitis, moderate severity ©
rotavirus infection, atypical subclinical form ©
rotavirus infection, generalized form
***
A child at the age of of 4 months ill for 4 days. All days vomiting 1-2 times a day,
copious watery yellow stool. Weight loss is 7%. Physical findings: listless,
apathetic. The skin is cold to the touch, acrocyanosis, "marbling" of the skin.
Sharply reduced soft tissue turgor and elasticity of the skin, facial features
sharpened. Temperature 36,0oC. Belly swollen, peristalsis is weak. Determine the
tactics of therapy©
infusion therapy (crystalloid and colloid solutions), parenteral antibiotics ©
infusion therapy (glucose-saline solutions), oral antibiotics ©
+infusion therapy (crystalloid and colloid solutions), antidiarrheal preparations ©
oral rehydration for 4 hours, parenteral antibiotics, biological preparations ©
infusion therapy (crystalloid and colloid solutions), oral antibiotics
***
Madi 2 months, weight 12 kg, had diarrhea within three days, drink greedily,
sunken eyes, painfully irritating. Assign treatment ©
rehydron 100 ml after each liquid stool ©
rehydron 200 ml after each liquid stool ©
rehydron 720 ml within 4 hours ©
+rehydron 900 ml within 4 hours ©
350 ml Ringer solution's i\v on for 1 hour, then assessment
***
The patient, 7 years old, became ill suddenly: appeared frequent liquid stool, on the
2nd day of illness repeated vomiting without previous nausea. Epidemiological
anamnesis - on the eve eating fried eggs; 4 days ago returned from a tourist trip
from Tashkent with parents. Objectively: temperature 36.3 C, the skin dry, the
light shadows under the eyes, soft tissue turgor and elasticity of the skin is slightly
reduced Cor tones are muffled, tachycardia. Tongue lightly coated with white
bloom, Abdomen retracted, painless, frequent stools, liquid, watery. diagnose©
Salmonellosis, gastrointestinal form moderate severity ©
escherichiosis, gastroenteritis, severe severity ©
+Cholera, typical form, moderate ©
shigellosis, typical form, moderate ©
rotavirus gastroenteritis
***
Child 3 months., on artificial feeding. Sick for 5 days. Infrequent regurgitations,
liquid stool, watery, up to 8 times per day. Low-grade temperature. On admission a
state of moderate severity. Moderate symptoms of toxicosis are expressed.
Abdomen slightly swollen. Sigma does not spasmodic. The anus is closed. Stool
orange color, watery. diagnose©
shigellosis, typical form, moderate severity ©
salmonellosis, typical form, moderate severity ©
+ escherichiosis, gastroenteritis, moderate severity ©
enterovirus infection, enteritis, moderate severity ©
adenoviral infection moderate severity
***
Child 3 years old became ill acute with temperature rise of up to 38o C, single
vomiting, liquid stool. On admission state moderate severity. The skin is pale. Lips
bright, dry. Language sparsely coated. Belly retracted. Sigma spasmodic, painful
on palpation. Anus malleable. Stool as "rectal spitting." diagnose©
salmonellosis, typical gastroenterocolitis form moderate severity ©
escherichiosis, Enteroinvasive typical, moderate severity ©
salmonellosis, typical, typhoid form, moderate severity ©
+dysentery, typical, moderate severity, uncomplicated ©
dysentery, typical, moderate severity, relapsing course
***
Child 3 years old(15 kg) became ill acute with temperature rise of up to 38o C,
single vomiting, liquid stool. On admission state moderate severity. The skin is
pale. Lips bright, dry. Language sparsely coated. Belly retracted. Sigma
spasmodic, painful on palpation. Anus malleable. Stool as "rectal spitting."
diagnose©
Ampicillin 500 mg - 3 times per day i/m ©
+furazolidon- on 1 tab. - 3 times per day ©
furazolidon- 1/2 tab. - 3 times per day ©
no-spa - 1/4 tab. - 2 times per day ©
penicillin at 500,000 Ed- 3 times per day i/m
***
Child 5 years old became ill acute with temperature rise of up to 39o C, single
vomiting, liquid stool. On admission state moderate severity. The skin is pale. Lips
bright, dry. Language sparsely coated. Belly retracted. Sigma spasmodic, painful
on palpation. Anus malleable. Stool as "rectal spitting." diagnose©
staphylococcal gastroenterocolitis, moderate severity ©
escherichiosis, Enteroinvasive typical, moderate severity ©
salmonellosis, typical, typhoid form, moderate severity ©
+dysentery, typical, moderate severity, uncomplicated ©
dysentery, typical, moderate severity, relapsing course
***
In the hospital admitted the child on 2 days from the onset of the disease with an
increase in temperature to 38°C, single vomiting, liquid stool 3 times.
Epidemiological history: on the eve was eating scrambled eggs. Objective: health
suffers, the child sluggish, T 38.3, in the Emergency room has repeated vomiting.
Abdomen soft, painful around the navel. Stool, with the admixture of green liquid
and mucus in the form of “marsh slime”. Your diagnosis©
+Salmonellosis, gastrointestinal form gastroenterocolitis, moderate severity ©
dysentery, typical, moderate severity ©
escherichiosis gastroenterocolitis, moderate severity ©
salmonellosis, typhoid form, moderate severity ©
salmonellosis, septic form
***
Boy 4 years admitted to the hospital on the third days of illness, the beginning
from rise in body temperature to 38oC, single vomiting and frequent liquid stool up
to 10 times the meager with mucus, the last 2 times streaked with blood.
Objectively: general state of moderate severity. Abdomen soft, painful in the left
iliac region, sigma spasm. Before the act of defecation child worries. Specify
etiotropic treatment in this case,©
prednisolone 3 mg/kg two times a day i/m ©
+nevigramon 60 mg /kg 3 times a day per os ©
oxacillin 100 mg/kg 4 times a day ©
macrofoams 40 m g/kg 3 times a day per os ©
penicillin 100 thousand units/kg 4 times a day i/m
***
Patient S., age 7, became ill acutely with chills, fever, headache, repeated
vomiting. Objectively: the state of moderate severity, temperature 38.1 C, on the
skin - single small spotted rash, in the throat - moderate hyperemia. Determined
meningeal signs - muscular rigidity of nape - 2 cm, Kernig positive symptom. At
spinal puncture liquor flowed frequent drops, transparent, cell count of 400 cells,
including lymphocytes - 70% protein, 0.66 g/l. Enter your diagnosis©
meningococcal infection, a generalized form meningitis, moderate severity ©
meningococcal infection, a generalized form meningitis + meningococcemia,
moderate severity ©
tuberculosis, serous meningitis ©
mumps infection, meningitis ©
+enterovirus infection, meningitis, moderate severity
***
The child, 3 years, became ill acute fever up to 39,2° C, became restless, there was
a single vomiting, was treated on an outpatient basis regarding ARVI. After 3 days
temperature returned to normal, but the child stopped to turn on their feet. On the
3rd day of illness hospitalized in the infectious department. The general condition
of moderate severity. In the lower extremities are absent active motion, passive
movements are not restricted. Tone and strength of muscle sharply reduced.
Tendon reflexes feet are not called. Abdominal reflexes are absent. Sits with
support. Positive the symptom of tension (Lasegue). The patient was discharged on
the 50th day of illness with little improvement. Specify diagnosis ©
acute viral respiratory disease moderate severity ©
polio-similar disease©
+poliomyelitis spinal form moderate severity ©
poliomyelitis Pontin form mild severity ©
poliomyelitis meningeal form moderate severity
***
.
The child, 3 years old, became ill acutely raise the temperature to 38 deg., Became
restless, disturbed sleep, appetite deteriorated. On the 4th day of illness
temperature normalized, remained weakness, slackness, marked distortion of face
in left, in connection with the child is hospitalized in a clinic General condition is
violated a little. Pale skin, especially head skin. In the lungs vesicular breathing.
Heart sounds clear, rhythmic. Abdomen soft, painless. Stool and urination without
features In the mind, answers the questions correctly. Right flattening the
nasolabial folds, mouth angle omitted. Taste sensitivity retained, skin sensitivity is
not changed Formulate a diagnosis ©
+poliomyelitis Pontin form moderate severity ©
poliomyelitis meningeal form, mild severity©
poliomyelitis spinal form, mild severity ©
polio-similar disease ©
enterovirus infection, meningitis, moderate severity
***
The child, 2 years old, became ill acute from rise in temperature to 39 C, fatigue,
sleep disturbance and appetite. Objectively: the state of moderate severity,
temperature 38oC, the face is hyperemic, injected sclera, nasal - scanty discharge.
In the pharynx – hyperemia of palate arches, there are single vesicular elements on
the mucosa of the soft palate; on the skin of the trunk maculopapular rash. For
other organs data without features. CBC – Hb-110 g/l, Er-3,5 х 1012/l, ESR-5, Leu-
5 х 109/л, seg/n-40, lymph-55, M-5. Your diagnose©
adenoviral infection. pharyngoconjunctival fever, moderate severity ©
+enterovirus infection, combined form. gerpangina, rash, moderate severity ©
measles, typical form, moderate severity ©
scarlet fever, typical form, moderate severity ©
pseudotuberculosis, a typical form moderate severity
***
Patient S., age 7, became ill acutely with chills, fever, headache, repeated
vomiting. Objectively: the state of moderate severity, temperature 38.1 C, on the
skin - single small spotted rash, in the throat - moderate hyperemia. Determined
meningeal signs - muscular rigidity of nape - 2 cm, Kernig positive symptom. At
spinal puncture liquor flowed frequent drops, transparent, cell count of 400 cells,
including lymphocytes - 70% protein, 0.66 g/l. Enter your diagnosis©
meningococcal infection, a generalized form meningitis, moderate severity ©
meningococcal infection, generalized form, meningitis, meningococcemia
moderate severity ©
tuberculosis, serous meningitis ©
mumps infection, nervous form, meningitis, moderate severity ©
+enterovirus infection, combined form, rash, meningitis, moderate severity
***
Child 5 years old, addressed on the 3 day of disease with complaints of fever,
malaise, pain when chewing and opening the mouth. Objectively: temperature is
37,8oC. On examination - in front of the ear, behind the ear on both sides marked
swelling of dough consistency, moderately painful on palpation. Marked
tenderness on pressure on the tragus, mastoid. On the oral mucosa hyperemia
around the external opening of the salivary gland excretory duct. Diagnose
©
CMV infection acquired, generalized form, moderate severity©
CMV infection acquired, localized form, sialadenitis, moderate severity ©
epidemic parotitis, typical, severe degrees of severity, not smooth during ©
epidemic parotitis, combined form, typical, moderate severity ©
+epidemic parotitis, glandular form, typical, moderate severity
***
Child 9 years old, addressed on the 3 day of disease with complaints of fever
38,3oC, malaise, pain when chewing, repeated vomiting, severe headaches.
Objectively: temperature is 37,8oC. On examination - in front of the ear, behind the
ear on both sides marked swelling of dough consistency, moderately painful on
palpation. Marked tenderness on pressure on the tragus, mastoid. Neck stiffness
expressed, passively to straighten the leg, bent at the knee and hip joints are not
completely succeed. diagnose ©
+epidemic parotitis, combined ( glandular + nervous) form typical, moderate
severity ©
CMV infection acquired, localized form, sialadenitis, meningitis, moderate
severity ©
epidemic parotitis, glandular form, typical, moderate severity, complicated by
meningitis ©
epidemic parotitis, combined form, typical, moderate severity ©
epidemic parotitis, glandular form, typical, moderate severity.
***

In the hospital admitted a child 4 years old, on the 4th day of illness with
complaints of fever, malaise, weakness and swelling in the left parotid gland.
Objective: general state of moderate severity. Feeling violated, temperature 38 oC.
The skin is clean, pale color. The left parotid gland is slightly increased. Mucous
wet, clean. The throat - hyperemia and swelling of the tonsils. Heart sounds are
muffled, rhythmic, moderate bradycardia. Your prospective diagnosis ©
+epidemic parotitis, glandular form, parotitis, moderate severity ©
infectious mononucleosis, typical form, moderate severity ©
Reiter's disease ©
erysipelas, erythematous form, moderate severity ©
lymphadenitis
***
In the hospital admitted a child 4 years old, on the 4th day of illness with
complaints of fever, malaise, weakness and swelling in the left parotid gland.
Objective: general state of moderate severity. Feeling violated, temperature 38 oC.
The skin is clean, pale color.The left parotid gland is slightly increased. Mucous
wet, clean. The throat - hyperemia and swelling of the tonsils. Heart sounds are
muffled, rhythmic, moderate bradycardia. Abdomen soft, painless. Which changes
in the blood are characteristic of this disease ©
Leukocytosis ©
accelerated ESR up to 40 mm/h ©
+leukopenia with lymphocytosis ©
neutrophilia ©
Lymphopenia
***
A child of 12 years became ill acutely when the temperature rose to 38.5 deg.,
Appeared swelling of the left parotid gland. In the classroom, where he studied the
sick, two weeks ago, there were cases of epidemic parotitis. On the third day of
illness temperature was normalized on day 6 - again rose to 39 degrees, has
appeared headache, abdominal pain, vomiting, two-time. On examination, the
child's condition serious. Complaints of abdominal pain, nausea and pain in the
parotid area when chewing. At palpation abdomen painful in epigastric. Meningeal
signs negative. CBC: L-5 х 109/l, Er-4 х 1012/l, Hb-120 g/l, EOS-0, stab/n-2%,
seg/n-37%, lymph-59%, М-2%, ESR-8 mm/h. Diastase of urine - 128 units.
Formulate a clinical diagnosis ©
Gastritis©
epidemic parotitis, meningeal form. moderate severity ©
+epidemic parotitis, glandular form, parotitis, pancreatitis, severe severity ©
viral hepatitis A, typical form, moderate severity ©
infectious mononucleosis typical form, moderate severity
***
Patient S., 5 years old, entered on third day of illness. Acutely ill: the temperature
increases to 39 C, headache, weakness, loss of appetite, malaise, burning and
itching of the lips, nose wings .Objectively: the state of moderate severity,
temperature 38 C, the normal skin color. On mucosa of the upper lip, nose wings
are marked grouped vesicles with clear content, surrounded by halo of hyperemia.
On the internal organs - data without pathology. CBC – Hb-120 g/l, Er-3,5 х 1012/l,
ESR-5 mm/h, Leu-4 х 1012/l, Stab/n-1, seg/n-30, lymph-54, M-5. Your diagnose©
varicella, the typical form, severe severity ©
erysipelas, erythematous-bullous form, moderate severity ©
+herpes infection, mucocutaneous form: H.labialis, h. Nazalis, moderate severity
©
herpes zoster, is a typical form moderate severity ©
eczema
***
Child, 5 years old, entered the hospital on the third day. Became ill acutely with
increase in body temperature to 37.5oC, malaise, appearance of the unit popular
rash on the body. On the 2nd day the child began to worry before urinating. Child
disorganized, constantly playing with the kids in the yard. Objectively: general
state of moderate severity. Feeling violated, the body temperature is 38 o C. On the
skin of the trunk, face are popular-vesicles elements. The mucous membrane of the
genitals hyperemic, there is a rash in the form of erosion. Diagnose©
varicella typical ©
varicella, moderate severity ©
+varicella, typical form, moderate severity ©
Enterovirus infection, rash, moderate severity ©
herpes infection, moderate severity
***
Child, 3 years old, entered the hospital on the third day. Became ill acutely with
increase in body temperature to 38.5oC, malaise, appearance of the unit popular
rash on the body. Objectively: general state of moderate severity. Feeling violated,
the body temperature is 38o C. On the skin of the trunk, face are popular-vesicles
elements. Name the solution used for processing vesicles in this disease ©
furatsilin solution 1: 5000 ©
sea buckthorn oil ©
hydrogen peroxide ©
iodine ©
+alcoholic solution of brilliant green
***
Children 3 years old, entered on third day of illness. Acutely ill: the temperature
increases to 39 C, weakness, loss of appetite, malaise. Objectively: the state of
moderate severity, temperature 38 C, the normal skin color. On the mucous skin of
the upper lip, marked grouped vesicles with clear content, surrounded by
hyperemia halo. Your diagnosis©
varicella, typical form, severe severity ©
enterovirus infection, gerpangina, moderate severity ©
+herpes infection, mucocutaneous form: H.labialis, moderate severity ©
herpes zoster, typical form moderate severity ©
enterovirus infection, rash, moderate severity
***
Children 3,5 years old, entered on third day of illness. Acutely ill: the temperature
increases to 39,2 C, weakness, loss of appetite, malaise. Objectively: the state of
moderate severity, temperature 38,3 C, the normal skin color. On the mucous skin
of the upper lip, marked grouped vesicles with clear content, surrounded by
hyperemia halo. On the buccal mucosa, tongue, are aphthous elements. According
to the internal organs - no pathology data. Your diagnosis ©
chicken pox, typical form, severe severity ©
enterovirus infection, gerpangina, moderate severity ©
+herpes infection, h.labialis, stomatitis moderate severity ©
herpes infection, typical form, moderate severity ©
enterovirus infection, stomatitis, moderate severity
***
At the woman 24 years old the child was born at 36 weeks gestation weighing
2100 g., condition of the child severe, jaundiced skin color, on the limbs, trunk
hemorrhagic rash. Self does not suck, is fed through a tube. Head hydrocephalic
shape. In the lungs weakened respiration, respiratory rate - 68 per minute.
Determined hepatosplenomegaly. CBC: Hb- 140 g/l, Er-3,72×1012, Leu-9,2×109,
stab/n-8%, seg/n- 42%, lymph-50%, ESR-14 mm/h, platelets -100×109/l. total
bilirubin - 180 mmol/l, direct - 40 mmol/l, indirect - 140 mmol/l, ALT - 0.80
mkkat/l, HBsAg-negative, anti CMV-IgM and IgG- tokso- positive. Assign the
treatment of this disease©
+cytotect 2 ml/kg/ day with the introduction of alternate days, at the course - 3-5
injections ©
Acyclovir 4-6 mg/kg/day with the introduction of alternate days, at the course - 3-5
injections ©
cytotect 7 ml/kg/day with the introduction of alternate days, at the course - 10
injections ©
neovir 4-6 mg/kg/day with the introduction of alternate days, at the course - 5-7
injections ©
cyclopheron 250 mg 1 time per day/per, a course
***
The baby 3 months. From the second week of life, yellowness of the skin and
sclera. Preventive vaccination was only in the hospital. On admission: icteric skin,
sclera icteric, liver +5.0 cm, spleen +1.0 cm, stool шы decolorized, dark urine.
Biochemistry of blood: ALT- 0.68 mkkat/l, total bilirubin -292.7 mkmol/l, direct-
221.8 mkmol/l. Cystoscopy of saliva: giant cells, having a form of "owl eyes"
Diagnose©
+Congenital cytomegalovirus infection, moderate severity ©
Congenital cytomegalovirus infection, localized form: hepatitis, moderate severity,
acute course ©
Congenital cytomegalovirus infection, localized form: hepatitis, moderate severity,
chronic course ©
Congenital cytomegalovirus infection, localized form: hepatitis, moderate severity,
prolonged duration ©
acquired cytomegalovirus infection: hepatitis, moderate severity
***
The baby 3 months. From the second week of life, yellowness of the skin and
sclera. Preventive vaccination was only in the hospital. On admission: icteric skin,
sclera icteric, liver +5.0 cm, spleen +1.0 cm, stool шы decolorized, dark urine.
Biochemistry of blood: ALT- 0.68 mkkat/l, total bilirubin -292.7 mkmol/l, direct-
221.8 mkmol/l Cystoscopy of saliva: giant cells, having a form of "owl eyes".
Assign treatment
+Ganciclovir - i/v 5-7.5 mg/kg/day in 2 doses 12 hour interval ©
Acyclovir 4-6 mg/kg/day with the introduction of alternate days, at the course - 3-5
injections ©
cytotect 7 ml/kg/day with the introduction of alternate days, at the course - 10
injections ©
rimantadine of 4-6 mg/kg/day with the introduction of alternate days, the course -
5-7 injections ©
cyclopheron 250 mg 1 time per day i/v per course
***
The baby 3 months. From the second week of life, yellowness of the skin and
sclera. Preventive vaccination was only in the hospital. On admission: icteric skin,
sclera icteric, liver +5.0 cm, spleen +1.0 cm, stool шы decolorized, dark urine.
Biochemistry of blood: ALT- 0.68 mkkat/l, total bilirubin -292.7 mkmol/l, direct-
221.8 mkmol/l Cystoscopy of saliva: giant cells, having a form of "owl eyes". An
indicator of the effectiveness of treatment of this disease is ©
the absence of clinical symptoms ©
absence of CMV in the blood (virus antigen or DNA) ©
absence of anti-CMV IgM and anti-CMV IgG with low avidity ©
the presence of anti-CMV IgG with high avidity ©
+the absence of clinical symptoms, the absence of CMV in the blood (viral antigen
or DNA), the absence of anti-CMV IgM and anti-CMV IgG with low avidity, the
presence of anti-CMV IgG with high avidity.
***
The baby 3 months. From the second week of life, yellowness of the skin and
sclera. Preventive vaccination was only in the hospital. On admission: icteric skin,
sclera icteric, liver +5.0 cm, spleen +1.0 cm, stool шы decolorized, dark urine.
Biochemistry of blood: ALT- 0.68 mkkat/l, total bilirubin -292.7 mkmol/l, direct-
221.8 mkmol/l. Cystoscopy of saliva: giant cells, having a form of "owl eyes"
HbsAg- negative antibodies CMV-IgM positive. Diagnose ©
+Congenital cytomegalovirus infection, generalized form: hepatitis, moderate
severity, acute course ©
Congenital cytomegalovirus infection, localized form: hepatitis, moderate severity,
acute course ©
cytomegalovirus infection, generalized form, moderate severity, acute course ©
Congenital cytomegalovirus infection, localized form, moderate severity ©
cytomegalovirus infection: hepatitis, moderate severity, acute course
***
Baby 7 months, weight 7 kg with the problem of "diarrhea". On examination:
irritable skin pinch goes back immediately, eyes not sunken, drinks eagerly.
Classify the condition and determine treatment©
diarrhea. Severe dehydration. Intravenously 210 ml of Ringer's solution for 30
minutes and 490 ml 2.5 hours ©
diarrhea. Severe dehydration. Intravenously 210 ml of Ringer's solution for 1 hour,
and 490 ml for 5 hours ©
+diarrhea. Moderate dehydration. Regidron 525 ml for 4 hours at 130 ml per hour
of ©
diarrhea. Moderate dehydration. Regidron 725 ml for 4 hours at 180 ml per hour of
©
diarrhea. No dehydration. Regidron 200 ml after each stool
***
baby 8 months (weight 8 kg), complained of an increase in temperature to 39oC,
repeated vomiting, liquid watery stools up to 10 times a day for 3 days. Objective:
The child painfully irritated eyes sunken, drinks greedily. Skin pinch goes back
immediately. Classify the problem of "diarrhea" on IMCI program and specify the
amount of oral rehydration therapy©
"diarrhea. No dehydration "Plan A -100 ml after each liquid chair ©
+"Moderate dehydration," Plan Б -600 ml within 4 hours ©
"Severe dehydration" plan B - 240 ml into a vein for 2.5 hours ©
"diarrhea. No dehydration "Plan A - 200 ml after each loose stool ©
"Severe dehydration" plan В -800 ml within 6 hours
***
Baby 7 months, weight 7 kg with the problem of "diarrhea". On examination:
irritable skin pinch goes back immediately, eyes not sunken, drinks eagerly.
Classify the condition and determine treatment©
diarrhea. Severe dehydration. Intravenously 210 ml of Ringer's solution for 30
minutes and 490 ml 2.5 hours ©
diarrhea. Severe dehydration. Intravenously 210 ml of Ringer's solution for 1 hour,
and 490 ml for 5 hours ©
+diarrhea. Moderate dehydration. Regidron 525 ml for 4 hours at 130 ml per hour
of ©
diarrhea. Moderate dehydration. Regidron 725 ml for 4 hours at 180 ml per hour of
©
diarrhea. No dehydration. Regidron 200 ml after each stool
***
Madi 10 months, 9 kg of weight, has diarrhea for three days, drink greedily,
sunken eyes, painfully irritating. Assign treatment ©
rehydron 100 ml after each liquid stool ©
rehydron 70 ml after each liquid stool ©
rehydron 720 ml within 4 hours ©
+rehydron 675 ml for 4 hours ©
Ringer's solution, 270 ml i\v in 1 hour, followed by assessment of the state
***
Baby 5 months (weight 7.5 kg) with complaints of liquid stools, vomiting and
fever during the inspection restless, painful irritated skin pinch goes back slowly
38,7oC temperature. Diarrhea lasts 12 days, the liquid stool, with mucus and
greens. Classify the condition of the child according to the IMCI program and
determine treatment ©
no dehydration, because not enough signs; OPC - 100 ml after each loose stool©
+mild dehydration because there are two signs; 565 ml of ORS within 4 hours ©
severe dehydration, because there are two signs; 750 ml of Ringer's solution within
6 hours ©
dysentery, because diarrhea is invasive; 0.25 Ciprofloxacin - on ¼ tablet - 2 times
a day ©
possible bacterial infection, because There are two signs; Erythromycin 0.25 - at ½
tablet, 3 times a day
***
Child 8 years old arrived with a fever to 39oC and pain when swallowing.
Objectively: dry skin, in the natural folds on the flexor surfaces of the hands and
inner thighs has punctulate rash. In the throat - delimited bright hyperemia in
lacunas of tonsils purulent coating. CBC: Er - 3,8*1012/l, Hb-130 g/l, CI-0,9,
Leu-12*109/л, Eos - 1%, stab/n-4%, seg/n-78%, lymph-13%, M-4%, ESR-22
mm/h. Diagnose©
+scarlet fever, typical form, moderate severity ©
measles, typical form ©
scarlet fever, extra-buccal form ©
measles, mitigated form ©
rubella, typical form
***
A child with a burn appeared on hyperemic background punctulate rash all over the
body with concentration in the folds, pale nasolabial triangle. Angina is not. Set the
preliminary diagnosis ©
scarlet fever, typical form ©
allergic rash ©
+scarlet fever, extra-buccal form, moderate severity ©
pseudotuberculosis ©
Sepsis
***
The patient, 2 years became ill sharply in the last 10 hours, beginning with chills,
anxiety, raising the temperature to 39,9oC. Physical findings: on the surrounding
reacts sluggishly, pale skin, on the skin of the buttocks and trunk has a
hemorrhagic rash with irregular edges and a central necrosis. The extremities are
cold to the touch. Heart sounds deaf, barely listened. CBC: Leu-22*109/l, stab/n-
7%, Seg/n-70%, lymph-18%, M-5%, ESR-35 mm/h. diagnose©
+Meningococcal disease: meningococcemia, severe severity ©
Meningococcal disease: meningococcemia, meningitis moderate severity ©
meningococcal infection, generalized form: meningococcemia, severe severity ©
Enterovirus meningitis, severe severity ©
tuberculous meningitis, severe gravity
***
The child 1year 3 months., Directed with a diagnosis ARVI, when viewed in the
emergency department in the mouth found spots of Filatov-Koplik. Diagnose ©
+measles, typical form, moderate severity ©
scarlet fever, typical, mild course ©
rubella, typical form, moderate severity ©
measles mitigated form ©
enterovirus infection, gerpangina, moderateи
***
Jania 4 years, acutely became ill, the temperature rose to 38 °. All over his body of
small-spotted rash. Palpable occipital lymph nodes. Pharynx slightly hyperemic.
No rhinitis. Formulate a preliminary diagnosis ©
measles, typical form, moderate severity ©
scarlet fever, typical, severe severity ©
allergic rash ©
+rubella, typical, moderate severity ©
varicella, the typical, moderate severity, smooth during