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Task 9; BRUCELLOSIS

Patient A; 32 years, veterinary physician, addressed to physician with complain on the general malaise, weakness, quick fatigueability, increasing of the temperature, pains in muscles and joints, shivering, and sweating. He has been ill for 3 weeks. The last few days temperature of his body has been 37.5 – 39 *C, shivering, body perspiration increased, condition is grave. Under objective examination not sharply expressed increase cervical, submandibular and inguinal lymph nodes. The liver and spleen are increased

1. Preliminary diagnosis
2. What is the given epidemiologic anamnesis
3. Plan of examination

Task 10; HEPATITIS B

Patient I; 45 years notes icteric sclera, skins, dark urine, weakness, repulsion of food, light sickness. It has been 6 days. During three days, the temperature was within 37.2 – 37.5 *C, pain in large joints, loss of appetite, headache. The last two days dark urine, icteric skin and sclera. Took analgina nd antigrippin.

Three months ago treated in neurologic department where he got intravenous and subdermal injection

The general condition is grave. The body temperature is 36.8*C. Sclera and skin is icteric. Peripheral lymph nodes are not changed. The pulse is 54 / min. BP is 110 / 60 mmHg. Vesicular breathing. The abdomen is soft and painful in epigastrium. The liver emerges 3 cm from the rib arc. Lower pole of spleen is palpable. Urine is dark brown and faeces are sulphur colour.

1. Preliminary diagnosis
2. Differential diagnosis
3. Plan of examination and treatment

Task 11; HIV; SEROUS MENINGITIS

Patient S; 71 years, has entered the hospital on January 19^th with complains on the strong pains in left half of the head, oedema on the left side and connected with difficulty of the vision, skin inflammations on left half of the head. Pain after the general undercooling, headache, pain in the body on the left side of the body. In three days temperature increased to 37.8*C. On skin of forehead and hairy part of head, and vesicular rash. Palpations of the points of 1^st and 2^nd branches of trigeminal nerve is painful. Corneal reflex is reduced on this side, left eyelid is oedematous, sclera is injected. There is no other pathologies on the skin. The lymph nodes are not increased. In the oral pharynx there are no changes. Pulse is 90 / min. the tones are mute. Weakly denominated rigidity in the occipital muscles and Kurnig’s symptom is positive

The result of the study of CSF; colourless, transparent, cytosis 0.06 x 10⁹/L, lymphocytes – 90 %, proteins – 0.45 g / L

1. Diagnosis
2. Plan of examination and treatment