Clinical Task №13
for practical-oriented state exam on
Internal, occupational and infectious diseases
for 6th 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 B., 36 years, a worker of varnished-painted production, took part in liquidation of an accident with air emission of large amount of nitrogen oxide. He complains of cough with foamy pinkish sputum, pressure in chest, breathlessness, acute dyspnea and asphyxia.
Objectively: cyanosis of skin and mucous layers. BR-48/min, body temperature – 37,9°C, PR-100/min, rhythmical, tensioned, AP-170/95, distantly – gurgling breathing, moderate dullness in lower parts of the lungs, breathing is vesicular, weakened, small-bubbling moist rales. X-ray: lung picture is indistinct, small spotted shadows of low intensity in lower and medium regions of lungs – the appearance of “cloudy” sky. Blood gas composition – hypercapnic hypoxemia.
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
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