11. Heshelin sa - tnm classification of malignant tumors and complete cure in the bathroom at tech onkol patients. - Kyiv, "Health", 1996. - 184 pages

12. Lecture on

13. Handwriting structures and themes

 

After mastering on the theme proposed move to the solution in cational problems.

 

Teaching Problem

Task 1.

Patient 23 years old, complained of pain that suddenly emerged in the abdomen, bl th vote. On gynecological examination revealed a painful swelling in the right avenue and donations. In terms of blood - leukocytosis, increased SHSE. What is the most likely diagnosis in the case of Anna?

A. Acute appendicitis;

B. Acute salpingitis;

C. Rupture of ovary;

D. Torsion legs ovarian cyst.

 

Task 2.

Patient '25 complains of pain in the abdomen, which increases however I deposited a few hours, vomiting, palpitations, weakness. During gynecological examination determined pain and erection of rear overhang vaginal sensitivity right appendages. In terms of blood leukocytosis, increased SHSE. What is the most likely diagnosis in this case?

A. Acute appendicitis;

B. Acute salpingitis;

C. Rupture of ovary;

D. Torsion legs ovarian cyst.

 

 

 

Task 3

Patient B., 62 years with severe ascites, after laparotse Mr. thesis (deleted to 8 liters of fluid) was determined by the limited mobile, painless swelling in the right iliac area. When ultrasound determined tumor right ovary 15h13 cm, homogeneous structure, with clear contours. Cytology in ascitic fluid - puhlynovydni cells were not found. What research should be done to clarify the diagnosis?

A. Fibergastroduodenoscopy;

B. Diagnostic laparotomy;

C. Laparoscopy;

D. Fibrokolonoskopiyu;

E. Urine for Bence-Jones protein.

 

Problem 4

Patient G., 58 years appealed to the doctor about the rapid increase in same and vota in volume, the pain in his lower divisions, dyspnea on exertion, pastoznost leg weakness. Located on the records about coronary heart disease. As most correct to interpret the symptoms described?

A. Chronic intestinal obstruction;

B. Ascites obscure origins;

C. Decompensated heart failure;

D. Fibroids of the uterus;

E. Ascitic form of ovarian cancer.

 

Problem 5.

Woman '60 addressed the precinct gynecologist with complaints about cr tion and Sanne External genital tract, which appeared two months ago. Obese III level, hypertension of II. Menopause 10 years. When rektovahinalnomu study uterus is not enlarged, epididymis involyutni. Infiltrates in the pelvis there. The cervix is not changed.

What additional test method can offer the patient for further diagnosis?

A. Diagnostic vyskoblennya uterus;

V. Pelvic ultrasound;

S. hysterography;

D. CT abdomen;

E. Colposcopy.

 

Problem 6.

Woman '38 suffers menstrual cycle during the last year. When rectal examination and pelvic ultrasound uterus and ovaries are not enlarged. Infiltrates in the pelvis there. Done diagnostic vyskoblennya uterus, endometrial polyp elements derived from ozloyakisnennyam. What is the best treatment option?

A. Chemotherapy;

B. Hormone;

S. supravaginal amputation of uterus with appendages;

D. Bilateral ovariectomy;

E. hysterectomy with appendages.

 

Problem 7.

Female 56 years old, indicating intense acyclic month for the last 3 years, pain in the abdomen. In the history of two sorts, one abortion. When rektovahinalnomu study enlarged uterus before 12 weeks of pregnancy, represented by individual nodes to 3.5 cm in diameter, mobile. In fig at first ultrasound pelvic nodes in the uterus are subserous. Appendages not enlarged. What diagnosis can put this patient?

A. Fibroids of the uterus;

B. Glandular endometrial hyperplasia;

S. Polyp endometrial

D. Cervical erosion;

E. uterine cancer.

 

Task 8.

Woman '55 appealed to the district gynecologist with complaints of blood and Sanne External genital tract, which appeared two months ago. Obese III level, hypertension of II. Menopause 5 years. When rektovahinalnomu study uterus is not enlarged, epididymis involyutni. Infiltrates in the pelvis there. At cervix ulcer with protruding edges and yellow bottom. What additional test method can be proposed at nate patient for further diagnosis?

A. Diagnostic vyskoblennya uterus;

B. CT abdomen;

C. Hysterography;

D. Ultrasound of the pelvic

E. Colposcopy.

 

Problem 9

Patient K., 52 years old, turned on the appearance within their last 3 months of contact bleeding from the genital tract. Examination revealed plans to nor denied Ca in situ of the cervix.

What is the best treatment option?

A. Chemotherapy;

B. Hormone;

S. Diatermoelektroekstsyziya cervical

D. Bilateral ovariectomy;

E. hysterectomy with appendages.

 

Problem 10

Patient '66 morphologically verified diagnosis "Cervical cancer stage II." What is the treatment strategy?

A. Symptomatic therapy;

B. Chemotherapy;

S. Immunochemotherapy;

D. Combined radiotherapy;

E. Surgical treatment and radiation therapy

 

Problem 11

Patient S., 42, who works as a teacher, the treatment for cancer of the cervix 1st. How to evaluate the performance of the patient?

A. Not broken

B. Temporarily lost

C. Steadily lost

D. It can not work with children

E. Requires the reduction of working time

Standards of answers: 1 - D, 2 - C, 3 - C, 4 - E, 5 - A, 6 - EC, 7 - A, 8 - E,

9 - E, 10 - E, 11 - B.