Vіi. System of teaching tasks for verification of eventual level of knowledges.

Situation tasks.

1. A patient 54 years, sicking with a diabetes mellitus during 10 years. Three days ago hard sickly infiltration appeared on the back of head. Temperature of body – a 38,5⁰ C. After review the skin in the area of the back of head is hyperemia, in a center its sickly infiltration 4х3 cm, on which 3 small festering blisters. Ground your diagnosis? Tactic and medical treatment..

Answer: Carbuncle of neck (large infiltrate, 3 festering bubbles (blisters), high temperature, typical localization for a carbuncle. A patient needs operative medical treatment in the conditions of surgical permanent establishment.

2. A patient, 30 years, appealed for the help in a surgical cabinet with complaints about sharp pain in the area of the second finger of the left brush, violation of function of finger, general weakness, and rise of temperature. Became ill 3 days ago since injured a finger. Objective: the a condition of the patient is satisfactory. Pulse a 90 per minute, AP 120/80 mm. hydr. col., temperature of body – 37,5⁰С. The middle phalanx of the second finger of the left brush is sharply enlarged in the sizes, deformed. Skin is tense with cyanosis. Active motions not in complete to the volume. At palpation in the center of phalanx infiltrate on the middle of which a skin is softened is determined. Diagnosis? Medical treatment. At a necessity operative interference which is needed anaesthetizing?

Answer: Hypodermic (subcutaneous) whitlow (felon) of 2nd finger of the left brush. It is necessary to conduct operative medical treatment (opening and drainage). It is possible to use local anesthesia – blockade for Lucashevich- Oberst.

3. A sick women of 51 years old, on the surgical reception complained about a new formation on a parietal area, which grows gradually, prevents to comb a hair. It is ill near 10 years. The last 2-2,5 years of a new formation are multiplied. Objectively in the parietal area of the form rounded off the tumor of 4x5cm, mobile, is dense, painless, unconnected with a bone. Regional lymphatic nodules are not enlarged. Diagnosis? Medical treatment.

Answer: Atheroma of parietal area. Surgical medical treatment is recommended (deleting of atheroma).

4. Patient., 29 years of old, working in a workshop, by a chance dashed a glass old tub with sulfuric acid. The two-bit of liquid pleased on a right thigh. The victim at once appealed to the policlinic with complaints about the smart sharp turn of skin red, spoiled dressed. What plan of actions?

Answer: For neutralization, immediately it is necessary to process the site of damage by a 1-2% solution by hydro carbonate of sodium (solution of soda), to enter anesthetic and send the victim to the burn center, or in the surgical department.

5. A sick women of 69 years old, suffers a diabetes mellitus within 10 years. It is exposed on the reception, that all fingers of right foot – black-brown color, foot – dark-purple color with bubbles and with an unpleasant smell. What previous diagnosis and which must be tactic of surgeon of policlinic?

Answer: Previous diagnosis - a diabetes mellitus. Gangrene of right foot. Sick it is necessary quickly to send in the surgical department for stationary medical treatment.

6. Electrician Michael, 22 years, executing repair of illumination in the cabinet of surgeon, by a chance fell down from a chair, has hit about a table and cut the left eyebrow. Bleeding began. A surgeon instantly transported a patient in bandaging, processed a wound, did primary surgical treatment and imposed primary stitches with an aseptic bandage. What method of stop of bleeding was executed?

Answer: The mechanical method of eventual stop of bleeding was used.