Translated from Russian to English - www.onlinedoctranslator.com
Problem 1
A 62-year-old patient was admitted with increasing shortness of breath, mainly
of the expiratory type. For many years he smokes 1-1.5 packs a day. For several
years he noted a cough with difficult to separate viscous sputum, worsening during
the last month. The body temperature did not rise. Took2agonists and
aminophylline without effect. Objectively, there are signs of pulmonary
emphysema. On auscultation, breathing with increased exhalation, dry rales over the
entire surface of the lungs. HELL 180 \ 105mm Hg. pulse 90 per minute.
On radiography: enhanced pulmonary pattern, pulmonary emphysema.
Spirography FEV1–49% Tiffno's test - 55% VC 59%
1. Presumptive diagnosis.
2. What are the physical signs of pulmonary emphysema and its pathogenesis?
3. Signs and main cause of bronchial obstruction.
4. Therapeutic tactics
5. What is the mechanism of action of the drugs.
Problem 2
A 46-year-old patient has been coughing for many years. The last 3 years with
the release of mucopurulent sputum up to 100 ml per day, shortness of breath on
exertion, periodically low-grade body temperature. Has been smoking for 20 years.
Objectively: reduced nutrition. In the lungs, a percussion sound with a box shade,
hard breathing, scattered dry wheezing.
1. Presumptive diagnosis (justification)
2. What research is needed to confirm the diagnosis?
3. Therapeutic tactics
4. What is the mechanism of action of the drugs.