Download Situational problems

Situational problems
Problem №1
Schoolboy P., aged 14, was suddenly taken ill: the temperature up to 39,5 ° C, there was a pain in the right side
of the chest, severe shortness of breath (private shallow breathing), cough with scanty sputum. Noted heavy
overall condition. On the same day the child was hospitalized with a diagnosis of right-sided lobar pneumonia.
At the hospital, under the influence of the treatment the patient's condition improved, and 14 days later he was
discharged home in good condition.
1) What is the quantitative assessment of the reactivity of the patient you give during his illness (increased,
decreased reactivity)?
2) What is the resistance in this patient (increased, decreased resistance)?
3) What is the main indicator shows the resistance of the patient?
4) How can you call the reactivity of the student according to the classification A.D.Ado?
Standards of answers to questions situational problem №1
1) hyperreactivity
2) increased resistance
3) a rapid and complete recovery
4) the individual pathological reactivity
Problem №2
The man asthenic body adding 82 years, two months ago, there were malaise, weakness, low-grade fever (37,2 37,4 ° C) of the body, shortness of breath, coughing. To the doctor did not address, was treated with home
remedies for colds. Treatment did not help. Caused a local doctor, who diagnosed: chronic bilateral
bronchopneumonia. The patient was hospitalized, received the necessary treatment, but his condition did not
improve significantly. 10 days after the hospital stay, there was a pain in his right side, the temperature shot up
to 38,5 ° C, increased shortness of breath, there was pallor, cyanosis, dry barking cough, condition worsened,
there was a sharp weakness, leukopenia, and 2 months after admission to hospital patient died with symptoms
of pneumonia and sepsis, abscess.
1) What is the quantitative assessment of the reactivity of you will give to the early and late stages of the
disease (increased, decreased reactivity)?
2) How can we evaluate the resistance of the patient during the illness (increased, decreased resistance)?
3) What is the main indicator shows the resistance of the patient?
4) What are the factors of individual reactivity could play a role in the patient's response to pathogenic stimuli.
Рroblem №3
During severe flu epidemic in the student group: 1) one person suffered a severe form of the disease with
complications in the form of severe chronic interstitial pneumonia; 2) 12 people have fallen ill mild or moderate
forms of the flu, and after 5-6 days had already visited the Institute; 3) 8 people, despite the obvious contact
with influenza patients, the flu did not get sick; 4) the grandmother of one of the cases of students felt the first
symptoms of the disease on the second day after contact with sick grandchild and in serious condition with
symptoms of cerebral edema was admitted to intensive care unit of the Infectious Diseases Hospital, where on
the 9th day after unsuccessful treatment died.
What are the options for the formation of functional systems save lives you met here in 1), 2), 3). 4) cases. Call
options.
Standards of answers to questions situational problem №3
1) With regard to the optimal functional system of survival;
2) Optimum functional system of preservation of life with negative feedback;
3) Absolutely optimal functional system of preservation of life with negative feedback
4) Sub-optimal functional system of preservation of life with a positive feedback.
Рroblem №4
In the intensive care department of the regional hospital of "K" almost simultaneously received 2 patients: 1) an
elderly man of 67 years with a diagnosis of a massive heart attack the front wall of the heart, cardiogenic shock;
2) a young woman 32 years old with a diagnosis of bilateral lobar pneumonia, respiratory failure grade 3-4
(severe hypoxia).
1) What is the option to generate a sub-optimal functional system of preservation of life is possible in 1) and 2)
cases?
2) What is the best option of forming a functional system of preservation of life is possible in 1) and 2) cases?
Рroblem №5.
The ward for cardiac patients are 4 patients:
1) 18 years old girl with a diagnosis of congenital aortic stenosis. She is lying on the examination before the
forthcoming operation on the blemish.
2) A woman of 45 years due to the carry-forward of the rear wall myocardial heart, she continues treatment
after a 10-day stay in the intensive care unit
3) Mature woman 75 years old with a diagnosis of hypertension, stage 2, exacerbation as a hypertensive crisis
4) School for 14 years with a diagnosis of post-infectious myocarditis, atrial premature beats high.
All carried out and to be an effective therapy for the underlying disease
What is the best option of forming a functional system of preservation of life is possible in this case 1), 2), 3),
4) cases?