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Teaching Problem

Task 1.

The patient complains of '65 appearing on the face sores, to about May does not heal, formed thick bundles in place. On examination, the skin of the right cheek determined rounded liykovydni ulcers covered with yellow in cotton gray crust with valykopodibnymy edges. Also marked infiltration of underlying tissues. What is the likely diagnosis?

A. Melanoma skin.

B. Bazalnoklitynnyy skin cancer.

C. Squamous cell skin cancer neorohoviyuchyy face.

D. Squamous cell skin cancer orohoviyuchyy face.

E. Keratopapiloma skin.

 

Task 2.

Patient S., 21, turned in oncologic dispensary about the increased "mole", which gradually increased from 3 mm to 1 cm in diameter. The skin of the chest is the formation of soft consistency browned on w and Rocky stem diameter of 1 cm, the skin around is not changed. Previous e iahnoz?

A. Melanoma skin.

B. Bazalnoklitynnyy skin cancer.

C. Squamous cell skin cancer neorohoviyuchyy.

D. Squamous cell skin cancer orohoviyuchyy.

E. Keratopapiloma skin.

 

Problem 3.

Patient 70 years complains formation appearing on the skin and ear p kovyny. The skin of the ear is defined by two tenacious, Bumpy, Oct. color at first nodule on a broad basis, 5 and 7 mm in diameter, which merge together. Peripheral lymph nodes were not enlarged. What additional research is crucial to clarify the diagnosis?

A. Common blood and urine;

B. Biochemical analysis of blood;

C. Urine for Bence Jones protein;

D. Cytological verification by fine needle biopsy;

E. Cytological verification by zskribka surface formations.

 

Problem 4.

Patient M., '31 complaining about the presence of the formation of the skin of the nose, which is rapidly increasing in size. On examination of the skin and nasal defined etsya dense tumor with rough, crusty, size and rum to 0.5 cm. Peripheral lymph nodes were not enlarged. In cytological d at slidzhenni zskribka of formation obtained conclusion - orohoviyuchyy flat at cell carcinoma. What is your tactic?

A. Clear formation of crusts mazove treatment.

B. Hospitalize patients in the surgical ward.

C. Refer the patient to an oncologist.

D. Run dermatoscopy.

E. Refer to the beautician.

 

Task 5

Patient 29 years old, complained of the presence of pigment formation with mo k Nuti center in transitional folds right breast, but I have deposited 1.5 months. Mammary glands are the same size, not deformed. If n and lpatsiyi tumors in the breast parenchyma is not defined. Peripheral Does MF in ouzl and not enlarged. What is the most specific method of examination in railway and nomu case?

A. mammography;

B. duktohrafiya breast;

C. smear-imprint cytology of the tumor;

D. computed tomography of the chest and its organs;

E. axillary lymphography collector.

 

Problem 6

Patient M., 76 years old, complained of the presence of a smooth seal in the left parotid, found that 5 years ago. Addressed through collection and lshennya formation in size and sores last. She studied samolikuva Mr. tion - handles ulcer infusion of herbs. When the smears dia g noz set cytologically - rodent ulcer. The doctor decided VIC at Nata excision of the tumor. How should the cuts be made?

A. top to bottom;

B. upwards;

C. along the lines of tension of skin;

D. along the branches of "crow's feet";

E. right to left

 

Problem 7

Patient K., 68 years old, turned to the doctor complaining of feeling drive at mfortu and pain in the back of the neck, weakness, sensitivity is smite Noah area. Described symptoms noted for several months. On examination means pitting under a crust of pidrytymy edges and sanious from at kremlyuvanym. Which methods of examination do you recommend to verify the diagnosis?

A. Ultrasound;

B. trepan-biopsy;

C. ekstsyzi and on biopsy;

D. complete blood count;

E. zskrebok.

 

Task 8

Patient 55 years old, suffers from diabetes for 10 years, calls Mr. nulasya complaining of increasing pigment formation of the skin lateral behavior p Their neck left. Surgeon for UTO h tion began ekstsyzi diagnosis and biopsy well. Where can ekstsyzi and lead to biopsy or moderate form of height and tion in melanoma?

A. postoperative wound.

B. lymphostasis.

C. massive hematogenous metastasis

D. Mr. limfohe no metastasis

E. low immunity.

 

Problem 9

Patient, 28 years old, male, asthenic constitution addressed Derm and toloha complaining of itchy skin, weight loss, fever up to 38 0 C in the evening. The patient was prescribed desensybilizu yu chu and hepatotropic therapy for 20 days. The effect of treatment was not, began to disturb night sweats, skin rash pustular back appeared. after treatment in the patient surgeon was appointed antybakteri and lnu and Immunotropic therapy. Objectively, besides the aforementioned changes proved collection and lshennya 2 lymph nodes right axillary area; lymph nodes up to 2.5 cm, soft flexible, mobile, not soldered between themselves and others and TC nynamy

A. Staph hroniosepsis

B. Limfohranulem and TOZ

C. Pyoderma skin

D. lymphosarcoma nodes right accessories and polar plots

E. Retykulosa p coma right axillary area

 

Problem 10

The boy 9 years revealed conglomerate lymph nodes in the neck on the left. Lymph nodes with a diameter of 1.5 cm, painless, not interconnected and environ at some extra and we tissues. The liver and spleen were not enlarged. Symptoms of intoxication percent in the TNI. In the blood: erythrocyte sedimentation rate 30 mm / h, 68% neutrophils, 18% lymphocytes, cells Berezovs someone Sternberg. The most probable diameter d noz?

A. Nonspecific lymphadenitis

B. Acute Leukemia

C. Infectious mononu k leoz

D. Toxoplasmosis

E. Lymphogranulomatosis

 

Problem 11

Patient '38 complains of weakness, fever up to 38 0, night sweating. Sick almost 3 weeks. Asked the doctor, treated over HIVZ - no improvement. 3 days ago I noticed increased limfov in fusion neck with law. Asked the oncologist was made ​​puncture lymph nodes. B and revealed Sternberg cells. What is the preliminary diagnosis?

A. Non-Hodgkin's lymphoma

B. Limphadenitis

C. Lymphoma Berkita

D. Lymphogranulomatosis

E Metastases at PLN quality tumors of the head and neck

 

 

Task 12

Patient in '38 was a doctor with complaints of shortness of breath, and odutlov dence at least lychchya. On examination - a doctor noticed an increase nezluchenyh interconnected nodes neck subcutaneous veins of the face and neck sharply expanded. Shadows among the wall at very advanced. Permissible your dia g noz?

A. Hodgkin desease

B. Lung Cancer

C. Esophageal cancer

D. Cancer of stomach

E Colon w ki ki

 

Standards of answers: 1 - B, 2 - A, 3 - E, 4 - C, 5 - C, 6 - D, 7 - E, 8 - C, 9 - B, 10 - E, 11 - D, 12 - A.

 

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