Ministry of Health Protection of Ukraine

Bukovinian State Medical University

Medical Faculty №3

“Approved”

Central guidance committee of Bukovinian State Medical University

“14” March 2013 year (protocol №6) Head of the central guidance committee, Vice-Rector for scientific-pedagogic work Associate professor ________I.V. Gerush

Clinical Task №6

for practical-oriented state exam on

internal, occupational and infectious diseases

for 6^th year students of medical faculty №3

Occupational skill “Algorithm of diagnosis, emergency treatment and rehabilitative measures at occupational pathology”

1. What is preliminary diagnosis?

2. Suggest treating and rehabilitative measures for the patient.

Patient K., 36 years, is occupied at chrysoberillium production for 15 years. He complains of weakness, increasing tiredness, attacks-like dry cough, dyspnea at walking, periodical pain in chest, large joints, sweating, unpleasant feelings in heart region, sometimes heart beating, loss of 7 kg of weight for last 3 months.

Objectively: body temperature 38,1°C. Box percussion sound over the lungs, dry rales, vesicular sound is weakened a little in lower parts of the lungs, there a focus of moist small-bubbling rales is found, pleura friction sound. X-ray: lung roots are thickened, intensification of lung picture, solitary small-spotted shadows, pleura-diaphragmatic commissures. Positive Kurtis’ test.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk

Ministry of Health Protection of Ukraine

Bukovinian State Medical University

Medical Faculty №3

“Approved”

Central guidance committee of Bukovinian State Medical University

“14” March 2013 year (protocol №6) Head of the central guidance committee, Vice-Rector for scientific-pedagogic work Associate professor ________I.V. Gerush

Clinical Task №7

for practical-oriented state exam on

internal, occupational and infectious diseases

for 6^th year students of medical faculty №3

Occupational skill “Algorithm of diagnosis, emergency treatment and rehabilitative measures at occupational pathology”

1. What is preliminary diagnosis?

2. Suggest treating and rehabilitative measures for the patient.

Patient Z., 54 years, is occupied at coal extraction for 24 years. He complains of non-intensive needle-like pain in chest, slight dyspnea, especially at physical exertion, cough with mucous grey-black sputum.

Objectively: a chest is expanded in anterior-posterior size, box percussion sound in lower parts of the lungs, auscultation – firm vesicular sound, dry rales. X-ray: tensioned shadows 2-3 mm wide in both lung fields. Bronchoscopy: “tatoo” symptom of mucous layer of bronchi and trachea.

Head of the department of internal medicine,

professor O.I. Fediv

Head of subject-methodical commission on

therapeutic disciplines, professor V.K. Taschuk