Thematic module №1 Practical employment № 21 Theme: Sharp festering-inflammatory diseases of soft fabrics: abscess, phlegmon, furuncle, carbuncle.

Tests

1. What name a phlegmon?

а) festering-inflammatory diseases of sweat-glands;

b) festering-inflammatory diseases of oil-glands;

c) the limited inflammation of cellulose;

d) the inflammation of cellulose poured out

e) festering inflammation of joints.

2. How to treat a phlegmon at presence of symptom of softening influence?

а) hot compress;

b) cut and drainage

c) ointment bandage;

d) cold compress;

e) pricking all round by Novocain with antibiotics.

3. What complication occurs characteristically for the carbuncle of overhead lip?

а) sepsis;

b) necrosis of skin;

c) meningitis;

d) osteomielitis;

e) thrombosis of cavenosis sinus

4. A phlegmon is named mediastinitis at localization in:

а) muscles;

b) pleural cavity;

c) stuffing-box;

d) to the front abdominal wall;

e) mediastinum

5. At suspicion it is necessary on an abscess:

а) to impose a ointment compress;

b) to do a cut;

c) to impose a hot compress;

d) to conduct puncture

e) to apply the ultraviolet irradiation

6. What is applied at a carbuncle ?

а) excision of carbuncle

b) ultraviolet irradiation;

c) squeezing of bars out;

d) puncture of abscess;

e) cut and drainage.

7. Which from the diseases is complicated by a festering infection?

а) malignant diseases;

b) hepatic insufficiency;

c) kidney insufficiency;

d) mellitus diabetes

e) lung fever.

8. What medical measures are applied at furuncles?

а) raising of leeches;

b) massage;

c) wiping of skin out by ether;

d) wiping out by a 70% alcohol

e) squeezing of abscesses out.

9. At the carbuncle of neck in the stage of infiltration apply:

а) h-similar cut;

b) z- similar cut;

c) conservative medical treatment

d) ice-bag;

e) puncture.

10. The symptom of fluctuation is not determined at:

а) abscess;

b) to the phlegmon;

c) mastitis;

d) hemothorax

e) paraproctitis.

11. A drug addict after introduction of drug to the femoral vein marks the rise of temperature of body to 40^o С, appearance of sickly infiltration, increase of volume of thigh, hyperemia of skin. What previous diagnosis?

а) carbuncle;

b) phlegmon

c) erysipelas;

d) osteomyelitis;

e) paraproctitis.

12. At a patient on the back infiltrate in the diameter of 7 sm, blue color in the center of which necrosis, at pressing on through a few opening a pus is selected. Your diagnosis?

а) abscess;

b) phlegmon;

c) erysipelas;

d) carbuncle

e) furuncle.

13. What operative medical treatment of phlegmon consists in?

а) dissection of abscess;

b) dissection and tamponade with antiseptics;

c) dissection and drainage

d) dissection, finger revision and drainage

e) dissection, deleting of pus, imposition of stitches.

14. What operative medical treatment of carbuncle consists in?

а) dissection of abscess;

b) dissection and tamponade with antiseptics;

c) dissection and drainage;

d) carving of necrosis fabrics, deleting of pus

e) dissection, deleting of pus, imposition of stitches.

15. A patient with P., 25 years, is hospitalized in the surgical separation with complaints on pain in a right buttock, temperature to 39^o С. It is known from anamnesis, that 9 days to that with the purpose of anaesthetizing in the area of right buttock was executed intramuscular injection of analgin. St. Pr. Ob.: in the overhead-outward quadrant of right buttock sickly infiltrate 5 is determined 4 sm., skin above him hyperemia, hot by a touch. Put a correct diagnosis.

а) post injection abscess of right buttock

b) erysipelas of right buttock.

c) carbuncle of right buttock.

d) abscessed furuncle of right buttock.

e) hematoma of right buttock.

Situation tasks

1. Sick Yu., 43 years, during 10 years is ill mellitus diabetes, the ІІ type, heavy form. Grumbles about pain, appearance of tumuli education in an intershoulder-blade region by sizes to 5 sm in a diameter with the phenomena of the expressed hyperemia, edema. In a center 5 festering apexes in a diameter to 0,2-0,3 sm. The Palpation sharp sickliness. What disease at the given patient?

A. Phlegmon

B. Abscess

C. Carbuncle

D. Furuncle

E. Lymphangoitis

2. A patient, 35 years, grumbles about the rise of temperature of body, pain in overhead-outward quadrant-right buttock, which appeared after injection. It is ill 3 days. In the place of injection hyperemia of skin, sickly infiltrate with softening influence in a center. A diagnosis is set: the after injection abscess of right buttock. Subsequent tactic of surgeon?

A. Contra inflammation therapy, massage and dry heat on a right buttock

B. Hospitalization of patient, setting of antibiotics physical therapy

C. Puncture of abscess, deleting of pus with subsequent introduction of antiseptics

D. Laser irradiation on 10-15 mines on a right buttock

E. Opening of abscess, sanation and drainage of cavity

3. A patient, 33 years, appealed with complaints about the rise of temperature to 38°S, pain in a lumbar region, slight swelling, during examination in a right lumbar region sickly infiltrate measuring 5h6sm is found, skin above him purple color in a center a lot of purulent-necrotic fistula which a pus is selected from. What most credible diagnosis?

A. Abscess lumbar region

B. Carbuncle of lumbar region

C. Erysipelas

D. Paranephritis

E. Kidney colic

4. Patient In., 48 years, grumbles about pain presence of compression in a right buttock. Four days ago in the domestic terms of patient was executed injection of a 50% solution of analgin with the purpose of reduction of pain in small of the back. Through a day the compression of fabrics and then pain appeared in a buttock. Put compresses. At examination - skin on the right buttock of red color, at palpation sickly infiltrate, positive symptom of fluctuation is determined. Put a previous diagnosis.

A. Paraproctitis

B. Phlegmon

C. Carbuncle

D. Furuncle

E. The after injection abscess

5. Patient T., 26 years, grumbles about pain in a right brush during 4 days. Pain appeared in place of callosities on palm's surface at foundation the II and III fingers. A little rather began to grow edema and slight swelling of rear of brush. The II and III fingers half-bent in between phalanges joints, a brush has the appearance of “rakes”. Your diagnosis.

A. The U-similarity phlegmon of right brush

B. The adenophlegmon right brush

C. Subcallosity abscess of right brush.

D. Phlegmon of the second between phalanges space of right brush

E. Tendovaginitis

6. At sick F., 42 years, on a 5 day after falling on beaten glass the slight swelling, turn red appeared in the area of rise of the first finger of right overhead extremity, local rise of temperature. The indicated area sickly at motions and palpation is characterized by the phenomena of fluctuation. What medical treatment it follows to apply?

A. Puncture area of suppuration with introduction of proteolitic enzymes

B. General antibacterial therapy

C. physical therapy

D. Opening of phlegmon, drainage, antibacterial therapy

E. Spirit compresses and antibiotic therapy

7. Patient To., 18 years, appealed to the doctor with complaints about great pain, presence of sickly infiltration, on the back surface of neck, rise of temperature of body, chill, general weakness, loss of appetite. Objectively: slight swelling on the back surface of neck measuring 3 h 4 sm with the dark blue-purple coloring and necrosis of skin in a center, dense consistency, sharply sickly. What medical treatment needs to be applied?

A. Puncture with subsequent bacteriological research

B. Cold (hypothermia)

C. Cruciform cut, excision of necrotic fabrics, drainage, general antibiotic therapy

D. physical therapy is that general antibacterial therapy

E. Novocaine blockade with antibiotics

8. A patient with complaints about pain and slight swelling in the left mandible region appealed to the policlinic, general weakness, rise of temperature to 38,5^o C With and the labored opening of mouth. It is objectively present slight swelling, turn of skin red sickliness at palpation, fluctuation in a center. About what it is possible to think and what medical treatment is needed?

A. Physical therapy

B. Local appliques of dimexide

C. Setting of antibiotics of wide spectrum of action and sulfanilamid preparations

D. Dissection and drainage of abscess, setting of antibiotics of wide spectrum of action

E. Introduction of contra inflammation whey and preparations for stimulation of immunity

9. A patient, 34 years, grumbles about intensive pain edema in the area of the left forearm, rise of temperature to 40 ^o C, general weakness and anorexia, which arose up on 2 days after the wound of forearm by an awl. Objectively there are the edema and compression of fabrics of forearm with softening influence in a center, hyperemia of skin without clear scopes, positive symptom of fluctuation. At a patient expressed leukocytosis is exposed with the change of leukocytes formula to the left. What method of local medical treatment it follows to apply?

A. Guillotine amputation of overhead extremity at the level of shoulder

B. Application of spirits compresses

C. Pricking all round of the staggered area by antibiotics

D. Repeated puncture with sucking of pus

E. Opening and drainage of festering process of forearm

10. At a patient 50 years, that suffers on mellitus diabetes of 2nd type, on the back surface of neck sickly infiltrate measuring 5 appeared sharply?6 sm., a skin above him dark blue-purple color with the necrotic opening from which is selected pus. The common state of patient is heavy, a temperature arrives at 40^o C, in a blood leukocytosis to 20*10⁹/л, the promoted level of glucose – 15mmol/l, an acetone appeared in urine (++). Diagnose:

A. Carbuncle

B. Furuncle

C. Hydradenitis

D. Abscess

E. Phlegmon

11. By a surgeon the sick T is examined., 42 years. Diagnosis: furuncle of right forearm, pus-necrotic stage. Dissection of furuncle is conducted. A bandage with what preparation needs to be imposed in the phase of hydratation?

A. Ointment Vishnevsky

B. Hypertensive solution

C. Ichtial ointment

D. Bandage with chloramin

E. Bandage with dimexide

12. At a patient 15 years after squeezing of ache rash out the sickly compression of fabrics and turn of skin red appeared on a face, the temperature of body rose by 38^o C. Objectively: in the area of noose-lip triangle there is the edema and turn of skin red. At palpation the sickly compression of fabrics of the rounded form is determined, by sizes 2х2 sm, without the signs of softening influence. Your diagnosis?

A. Carbuncle

B. Furuncle

C. Inflammatory infiltrate

D. Abscess

E. Phlegmon

13. At a patient in place of intramuscular injection (executed at a home) through 2 days sickly infiltrate appeared, the temperature of body rose to 37,8^o C. A patient treated oneself by the appendix of warm hot-water bottle. The improvement did not come, a alternating temperature was saved, a skin above limited infiltrate got a purple-red color, softening influence in the center of infiltrate appeared. What complication it follows to think about in this case ? Tactic of medical treatment?

A. Erysipelas. Antibacterial therapy

B. Hematoma. Dissection and drainage

C. Erysipelas. Antibacterial therapy

D. Phlegmon. Dissection and drainage

E. Abscess. Dissection and drainage

14. Patient, 42 years, the “carbuncle of lumbar region” was directed from a policlinic in the surgical separation of hospital with a diagnosis. Objectively: in a lumbar region inflammatory infiltrate of purple color is determined, measuring 8х8 sm. On the surface of infiltrate there is a few opening with thick greenish-grey festering excretions. What the volume of operation must be?

A. Cut of carbuncle

B. By excision of carbuncle

C. Drainage of carbuncle

D. Pricking all round of carbuncle by novocaine, physical therapy

E. Pricking all round by novocaine with an antibiotic

15. Patient 20 years, appealed with complaints on pains in area of right buttock, presence there edema. At examination in area of buttock a local sickliness, slight swelling above which hyperemia skin, is marked. The local hypertermia is marked. The symptom of fluctuation is positive. The presence of abscess is definite. Your tactic?

A. Physical therapy

B. Local appliques with dimexide

C. Setting of antibiotics of wide spectrum of action and sulfanilamide preparations

D. Dissection and drainage of abscess, setting of antibiotics of wide spectrum of action

E. Introduction of antitetanus whey and preparations for stimulation of immunity

16. A patient grumbles about pain in area of the back of head, limitation of motions by a head, rise of temperature of body to 38^o C. Objectively: it was swollen hyperemia of skin measuring 6 - 7sm. with a presence in the center of cone-shaped dark-grey hearth with festering content; at palpation all indicated area is strongly sickly and hard. About what it is possible to think and what is needed medical treatments?

A. Puncture with subsequent bacteriological research

B. Cold (hypothermia)

C. Cruciform cut, excision of necrotic fabrics, drainage, antibiotic therapy

D. physical therapy is that general antibacterial therapy

E. Novocaine blockade with antibiotics