Questions for the oral or written part of the examination,
credit-test, differentiated credit-test
DIFFERENTIAL DIAGNOSTICS
1. Differential diagnosis of edema syndrome.
2. Differential diagnosis of rheumatism and bacterial endocarditis.
3. Differential diagnosis of pain in myocardial infarction and aortic stenosis.
4. Differential diagnosis of pain in myocardial infarction and aortic valve insufficiency.
5. Differential diagnosis of typical and atypical forms of myocardial infarction.
6. Differential diagnosis of pain syndrome in angina pectoris and vertebral cardialgia.
7. Differential diagnosis of pain in chronic pancreatitis.
8. Differential diagnosis of angina and focal myocardial infarction.
9. Differential diagnosis of cardiac and bronchial asthma.
10. Differential diagnosis of endocrine arterial hypertension.
11. Differential diagnosis of the syndrome of inflammatory infiltration of the lung tissue.
12. Differential diagnosis of purulent-obstructive bronchitis and bronchiectasis.
13. Differential diagnosis of cavities in the lungs.
14. Differential diagnosis of obstructive bronchitis and bronchial asthma.
15. Differential diagnosis of pneumonia, taking into account the etiological factor.
16. Differential diagnosis of pain in gastric ulcer and duodenal ulcer.
17. Differential diagnosis of chronic gastritis type "a" and "b".
18. Differential diagnosis of intestinal dyspepsia.
19. Differential diagnosis of pneumonia and lung abscess according to clinical data.
20. Differential diagnosis of gastric secretion according to clinical data.
21. Differential diagnosis of unstable angina.
22. Differential diagnosis of focal and lobar pneumonia.
23. Differential diagnosis of hypertensive crises.
24. Differential diagnosis of constipation.
25. Differential diagnosis of jaundice.
26. Differential diagnosis of pain in chronic cholecestitis.
27. Differential diagnosis of hemodynamic arterial hypertension.
28. Differential diagnosis of renal arterial hypertension.
29. Differential diagnosis of chronic hepatitis.
30. Differential diagnosis of liver cirrhosis.
URGENT CARE
1. Emergency care for pulmonary hemorrhage.
Localized pulmonary bleeding usually requires local treatment, like bronchoscopic therapy,
bronchial artery embolization or surgery. Diffuse alveolar haemorrhage must be treated
systemically, i. e. by immunosuppressive therapy in cases of vasculitis or by medical treatment of
coagulation disorders.
Tracheal suction, oxygen, positive pressure ventilation, and correction of underlying abnormalities
such as disorders of coagulation. A blood transfusion may be necessary.
2. Gastroduodenal bleeding. Causes, clinic. Therapist tactics in emergency care
CAUSE: in DU bcoz of high vasculature,GU, Hemorrhagic gastropathy & erosions, MalloryWeiss syndrome, Gastric varices, reflux oesophagitis.
Mallory-Weiss syndrome: Laceration of the distal esophagus and proximal stomach during
vomiting, retching, or hiccups.
CLINICAL:
o constipation, then melena, vomiting with coffee ground mass
o Melena shows chronic relapse of bleeding
o After bleeding, pain disspear bcoz of its alkaline rXn that neutralizes stomach’s acid.
o Presence of weakness, vertigo, pale skin, tachycardia, dyspnea.
TACTIC:
o Place cold compression on GI region or per os (can put pieces of ice)
o Transfusion of crystalloids, colloids RBC mass
o Stop bleeding by – vicasol (vit K), detsonone (aggregation of thrombocyte), epsilone amino
caproic acid.
o Surgical- Fibrogastroduodenoscopy: coagulation of vessels & tamponade of vessels.
 Resection of stomach & Bilroth 1@ 2 or gastrostomy
3. Asthmatic status. Emergency care at stage i.
4. Asthmatic status. Emergency care at stage ii.
5. Asthmatic status. Emergency care at stage iii.
 Rehydration eg glucose solution 3-4L daily
 Correction of electrolyte balance
 Heparin: improve rheological blood and sputum
 Euphyllines 6mg/kg
 Glucocort: depending on stages 1mg/kg
 Oxygen therapy
 In 2nd stage, do artificial lung ventilation with bronchial lavage
 Mechanical ventilation: correct hypoxemia, avoid hyperinflation, decrease VE and tidal
volume
 Manual compression of chest: for hyperinflation
 Anesthetics, Leukotrien inhibitors
6. Emergency care for paroxysmal arrhythmias in patients with myocardial infarction.
If adenosine does not work, atrioventricular (AV) nodal blocking agents like calcium channel
blockers or beta-blockers should be used. Patients with symptomatic Wolff-Parkinson-White
(WPW) syndrome should not be treated with calcium channel blockers or digoxin
7. Emergency help with hypoglycemic coma.
- Quick-acting carbohydrate 15-20 g is given by mouth, either in liquid form (eg, 150-200 ml
pure fruit juice - but don't use fruit juice if there is renal failure) or as granulated sugar (two
teaspoons) or sugar lumps.
- 5-7 Dextrosol® tablets or 4-5 Glucotabs® Gel - may be used.
Repeat capillary blood glucose after 10-15 minutes; if the patient is still hypoglycaemic then the
above can be repeated (probably up to 3 times).
8. Emergency care for ketoacid coma.
 Fluid and electrolyte replacement (potassium)
 Insulin therapy: When your blood sugar level falls to about 200 mg/dL (11.1 mmol/L) and
your blood is no longer acidic, you may be able to stop intravenous insulin therapy and
resume your normal subcutaneous insulin therapy.
 Hydration and education
9. The attack of bronchial asthma. Clinic. Relief of attack.
CLINICAL SYMPTOMS
Divided into 3 stages:
1st: Beginning/Initial
 Nasal raining
 Emotional changes
 Cough
 Itching
 Changes of smell/taste
2nd: During attack
 Expiratory dyspnea
 Orthopnea/Tripod posture (for easier usage of additional resp mm)
 Central cyanosis
 Distant rales
3rd: Stop of attack:
 Enlargement of sputum volume
 Stop of dyspnea
 Weakness
 Patient wants to sleep
EMERGENCY CARE (Oxford 795)
 Inhalation short activating beta-2 symphatomimetics
 10ml, 2.4% solution theophylline
 IV glucort eg prednisalone 60mg
 Inhalation glucocort
10. Emergency care for reflex cardiogenic shock.
11. Emergency care for true cardiogenic shock.
Emergency care
1. General measure : Complete rest, continuous 60% O2 therapy and analgesics,
antianxiety drugs are given.
2. Normal Pulmonary Arterial(or capillary) Wedge Pressure is 15 – 20mmHg. If less than
18mmHg, infusion therapt of fluid is necessary. If more than 25mmHg, Short-acting
venous dilator (Glyceryl trinitrate / sodium nitroprusside) is administered IV.
3. if excessive elevation of PAWP inotropic drugs should be administered to reduce it. The
goal is to increase contractility (inotropic drug is used) without increased heart rate
(Chronotropic drugs not used). Dopamine & Norepinephrine give inotropic and
vasoconstriction action that is useful in persistence hypotension. Dobutamine give
inotropic and venodilator action may substitute previous drugs once arterial blood
pressure is return to normal.
4. if pulmonary congestion occurs, IV frusemide is used.
5. inadequate response to above measure, Myocardial pumping function can be restored by
intraaortic balloon counterpulsation to permit recovery of Myocardial function.
6. Last measures are, Myocardial revascularization , lastly, Urgent Heart transplantation.
12. Emergency care for uncomplicated hypertensive crisis.
The drugs of choice in treating patients with a hypertensive crisis and eclampsia or preeclampsia are hydralazine, labetalol, and nicardipine (5,6). Angiotensin-converting enzyme
inhibitors, angiotensin receptor blockers, direct renin inhibitors, and sodium nitroprusside are
contraindicated in treating these patients.
13. Hepatic coma. Clinic. Urgent care.
CLINICAL PICTURE
Metabolic hepatic coma
Jaundice, small liver, encephalopathy, deterioration of consciousness from drowsiness, confusion and
disoreientation to unresponsive coma with convulsations, fetor hepaticus, spasticity and extension of arms
and legs, plantar response remain flexed, cerebral oedema, infections, GIT bleeding, respiratory arrest,
renal failure and pancreatitis
Portocaval coma
Signs before coma:
Patient becomes increasingly drowsy and comatose, fetor hepaticus, constructional apraxia ptt can’t draw
or write, decreased mental function, convulsions, nausea, vomiting and weakness, hyperreflexia and ↑
tone
TREATMENT
Metabolic hepatic coma
Ptt in reanimation room
Identify and remove possible precipitating cause e.g. drugs, protein diet, infection s etc.
Symptomatic therapy
 Bleeding – vit K, platelets, blood, fresh frozen plasma
 Infection – antibiotics
 Respiratory failure – artificial respiration
 Renal failure – hemodialysis
 Infusion therapy - correct electrolyte imbalance and detoxification
Portocaval coma
 Ptt in reanimation room
 Evacuation of bowels, restrict protein intake
 Identify and remove possible precipitating cause e.g. drugs, protein diet, infection s etc.
 Give purgation and enemas to empty bowels from nitrogenous substances
 Infusion therapy – correct electrolyte imbalance and detoxification
 Give antibiotics
14. Emergency care for complicated hypertensive crisis (pulmonary edema).
Diuretics are indicated for patients with fluid overload. Furosemide (frusemide) should be given by slow
intravenous injection.
Routine use of morphine is not recommended because of its adverse effects. Oxygen should only be
administered in cases of hypoxaemia.
Inotropic drugs should only be started when there is hypotension and evidence of reduced organ perfusion.
In these cases, dobutamine is usually first-line treatment.
15. Emergency care for cardiac asthma.
Supplemental oxygen, noninvasive ventilation (NIV), and proper positioning of the patient also are
important. Proper positioning, in which the patient stands erect or sits upright with feet hanging off the side
of the bed, will result in decreased venous return.
Symptomatic improvement in patients with pulmonary congestion is seen with an initial recommended
furosemide dosage of 40 mg IV. Some patients may exhibit persistent pulmonary congestion despite
aggressive diuresis. In these instances, an IV nitrate (e.g., nitroglycerin) may be used adjunctively in both
hypertensive and normotensive patients.
16. Emergency care for pulmonary edema.
Diuretics are indicated for patients with fluid overload. Furosemide (frusemide) should be given by slow
intravenous injection.
Routine use of morphine is not recommended because of its adverse effects. Oxygen should only be
administered in cases of hypoxaemia.
Inotropic drugs should only be started when there is hypotension and evidence of reduced organ perfusion.
In these cases, dobutamine is usually first-line treatment.
17. Emergency care for arrhythmic cardiogenic shock.
Anti-arrhythmic drug options for ventricular and atrial arrhythmia suppression, in the setting of cardiogenic
shock, are relatively limited. Common class I agents are excluded due to the inherent abnormal cardiac
structure and function in the setting of cardiogenic shock. Class III drug options include dofetilide and
amiodarone. The other Class III agents, sotalol and dronedarone, are excluded
18. Tactics of treating patients with atrial fibrillation for the first time.
The first step is to try to find the cause of the atrial fibrillation. If a cause can be identified, you
may only need treatment for this.
* Anti-arrhythmics
* Beta blocker
* Ca channel blocker
* Nifedipine
19. Tactics of treating patients with bradyarrhythmias in myocardial infarction.
20. The main indications for thrombolytic and anticoagulant therapy of patients with myocardial
infarction.
Indications



Clinical history and presentation strongly suggestive of myocardial infarction within 6 hours plus
one or more of:1 mm ST elevation in two or more contiguous limb leads2 mm ST elevation in
two or more contiguous chest leadsNew left bundle branch block2 mm ST depression in V1-4
suggestive of true posterior myocardial infarction
Patients presenting with above within 7-12 hours of onset with persisting chest pains and ST
segment elevation
Patients aged <75 years presenting within 6 hours of anterior wall myocardial infarction should
be considered for recombinant tissue plasminogen activator
21. Principles of treatment of patients with bronchial asthma.
EMERGENCY CARE (Oxford 795)
 Inhalation short activating beta-2 symphatomimetics
 10ml, 2.4% solution theophylline
 IV glucort eg prednisalone 60mg
 Inhalation glucocort
BASIC TREATMENT ACCORDING TO STEPS
1st step: Stop contact with origin, and use inhalants of beta-2 agonists (eg ventalin no more
than 4x a day) and NSAIDS (intal, keto)
2nd step: Inhalation of beta-2 agonists (short activating) for every day and also antiinflammatory drugs eg intal, tyled
3rd step: All drugs in 2nd step + inhalation of glucocorticosteroids 200-300 microgram daily
eg becodisk + bronchodilators (long activating) eg salmetarol
4th step: All drugs in 3rd step + inhalation of glucocorticosteroids 800-1200 micrograms daily
+ bronchodilators (long activating) + systemic/parallel glucocort.
22. Tactics of treating patients with myocardial infarction without st-segment elevation.
Consists of two components: to alleviate the patient's complaints of pain and anxiety and to prevent
recurrences of ischemia and progression to (or to limit) myocardial infarction
Drug treatment routinely includes β blockers, which reduce myocardial oxygen demand by reducing heart
rate and blood pressure and reduce the risk of arrhythmias and recurrent ischaemia. Sedatives and analgesics
may be used with the same goals, by reducing anxiety and pain. Vasodilators, such as nitrates and calcium
channel blockers, are used to reduce the dynamic (spastic) component of coronary obstruction, and to lower
blood pressure
22. Tactics of treating patients with myocardial infarction with st segment elevation.
Antianginal drugs
i.) Nitrates should be given 1st sublingually or by buccal spay (0.3-0.6mg). If pain persists after
3doses given 5minutes apart, IV nitroglycerine (5-10microgram/min) given. The rate of
infusion can be increased to 10microgram/min every 3-5minit until symptoms are relieved.
ii.) Beta adregernic blockers : IV beta blockers (Metoprolol/Esmolol) followed by oral beta
blockers targeted to heart rate of 50-60beats/min.
Analgesics
If pain persist, morphine sulfate 1-5mg IV can be given every 5-30minutes.
Antithrombotics
Anticoagulant
i.) Heparin (unfractioned heparin) – Bolus 60-70 U/kg (max 5000 U) IV followed by infusion of
12-15 U/kg/hour.
Antiplatelet
- Example : Aspirin, Dipyridamole
- These could be combined together with beta-blockers & ACEinhibitors.
23. Tactics of relief of pain in myocardial infarction.
LOOK ABOVE ANALGESIC AND ANTIANGINAL
24. Pulmonary embolism. Algorithm urgent action.
25. Principles of treatment of patients with pneumonia.
Pathogenetic Treatment
1. Mild community acquired
Amoxicillin 500mg, 3 times daily
2. Severe community acquired
Cefuroxime 1.5g, 3 times daily
Erythromycin 1.0g, 4 times daily
3. Atypical pneumonia
Erythroycin 500mg, 4 times daily
4. Hospital acquired
Cefuroxime 1.5g 3 times daily
26. Emergency aid in case of sudden death (asystole, ventricular fibrillation, tampon-de-heart)
27. Intoxication with cardiac glycosides. Urgent care.
DIGOXIN IMMUNE FAB, OXYGEN THERAPY, FLUIDS
28. Tactics of management of patients with complications of peptic ulcer disease (perforation,
penetration, pyloric stenosis)
30. Treatment of ascites in patients with liver cirrhosis.
Tense ascites is treated by paracentesis, followed by albumin infusion and diuretic therapy. Treatment
options for refractory ascites include repeated paracentesis and transjugular intrahepatic portosystemic
shunt placement in patients with a preserved liver function
LABORATORY-TOOL DIAGNOSTICS
1. Laboratory syndromes in chronic hepatitis.
- CYTOLISIS, SPLENOMEGALY, HEPATODEPRESSION.
2. Laboratory diagnosis of ketoacidotic coma.
- HIGH PCO2, BLOOD PH <7.3, INCREASED SERUM OSMOLARITY
3. Peptic ulcer disease. Direct and indirect radiological signs.
- ULCER CRATER, SMOOTH ULCER MOUND WITH FOLDS THAT REACH THE
MARGIN, HAMPTOM’S LINE.
- IRREGULAR/SHALLOW CRATER, NODULAR/ANGULAR ULCER MOUND, GASTRIC
FOLDS DO NOT REACH ULCER MARGIN, CARMAN MENISCUS SIGN
4. Treatment of instrumental methods of research in peptic ulcer disease.
- X-RAY, Ba SWALLOING, ENDOSCOPY, TISSUE BIOPSY
5. Basic laboratory data for pneumonia.
- SPUTUM SAMPLE, CULTURE TEST, BLOOD ANALYSIS/COUNT, FEV-FVC (total
capacity), THROAT/NASAL SWAB TEST, URINE TEST, PLEURA FLUID TEST
6. Radiological methods of research in pneumonia.
- PLANE CHEST X-RAY, CT SCAN, MRI
7. Laboratory and instrumental diagnosis of chronic pancreatitis.
U/sound - ∆ in size(enlargement),form,density,calcification
- edematous,fibrosis,cyst(stones)
X-ray : direct-stones, wit contrast – disorders of duodenum ass wit pancreas.
a) enlargement of duodenum, ↑duodenal papilla,dislocation&deformation due to enlarge
pancreas
b)calcification(stones)
c) ↑ retrogastric space
d)dilated ducts,central loop of small bowel,dilatation of transverse colon
Fibroduodenogastroscopy – stones, ∆in Sphincter Odi
Endoscopic-pancreato-cholangiography- stones,stenosis in diff levels of tracts
Angiography- deformn+dilatation of arteries, abnorm distribution,disappearance of atrteries
CT scan- size of organ,edema,calcification of pancreas,cyst, fibrosis,(obstructn of biliary
tract:stones),dilated vessels, differentiate wit tumor
LAB INVESTIGATION: 1) Blood & biochem analysis – Leucocytosis wit shift to the
L,↑ESR,hypochromic anemia, ↑enz:amylase, tripsin, lipase, ↑transaminase,hypercalcemia,∆in
tolerance to glucose(glucosuria)in 2’ DM, bilirubin in blood if affectn of the head of pancreas
1) Corprology : Steatorrhea(lipid),Amylorrhea(glu),Creatorrhea (prot)
2) Pancreatic juice Xm
8. Laboratory and instrumental diagnosis of chronic cholecystitis.
Instrumental: 1) U/sound : thickening of GB wall >3cm
- Shape&size,presence of stones, dislocation,deformation of GB,↓mobility,presence of
crystals of cholesterol
2) X-ray:a) Plain - stones
b) wit contrast – done thru per os,IV,SC,retrograde pancreato-cholangiography, percutaneous
transhepatic cholangiography
- winding,narrowing of ducts,deformation of shadow/absence of GB,presence of stones,
functional disorder(emptying)
3) CT
4) hepatobiliary scintigraphy
5) thermography wit Tc( ↑isotopes)
Lab :1)Blood analysis – leucocytosis,shift to the L,↑ESR,↑acute phase prot,↑α2& γglobulin,↑fibrinogen,↑bilirubin, if present liver prob: ∆in ALT,AST
2) urine analysis unchanged
3) Bile aspiration – 3 portions taken : 1st frm duodenum,2nd frm GB,3rd frm bile duct
In the 2nd portion-leucocytosis,mucus,cylinder epithelium,cholesterol crystals, pathological no of
bact.,spec. pigmented cells
9. Laboratory and instrumental diagnosis of chronic enterocolitis.
1) X-ray :distension of bowel, abnorm position of plica, fast/slow evacuation of barium,
signs of hypotonia, feather-like pattern of mucosa, presence of gas&liquid, info abt motor
func, length,position,shape,tone,haustration
2) fibrocolonoscopy :can find atrophic mucosa, could be pale/inflamed wit visible vessels
- presence of oedema & mucus covering the mucosa, polyps, ulcers, erosions, diverticula
- can take specimens of intestinal mucosa
- can diagnose cancer tumor
10. Laboratory and instrumental diagnosis of chronic bronchitis.
1) General blood analysis : leucocytosis shift to the left, ↑ ESR
2) Urine analysis : no changes
3) Sputum examination : vol, character, colour, √ epithelium & neutrophiles in sputum
4) ECG : hypertrophy of the left ventricle and atrium
5) X-ray : enlargement root of the lung & diffusion pneumosclerosis
: if develop emphysema, present features of emphysema
6) Fibrobronchoscopy: used for differential diagnosis in cancer & bronchoectatic disease
7) U/S : changes in right heart in case of lung hypertension dev
: changes in gas level of blood → decrease O2 level
11. Laboratory and instrumental diagnosis of renal arterial hypertension.

Initial identification with ultrasonography, magnetic resonance angiography, or
radionuclide imaging

Confirmation with renal angiography (also may be therapeutic)

Creatinine, GFR
12. Laboratory and instrumental diagnosis of endocrine arterial hypertension.
13. Diagnostic tests for the detection of coronary insufficiency.
 ECG- signs of LV hypertrophy & sometimes coronary insufficiency. ST changes ( doen
sloping ST segment & T inversion), LBBB. ECG can be normal even in severe stenosis.
 X ray- aortic configuration of heart with LV hypertrophy & post stenotic dilatation of
ascending aorta.
 Auscultation- at apex, dimished S1 due to over filling of LV & prolongation of systole. S2
diminished over aorta & can be inaudible of aortic cusps adhere & are immobile. Rough
systolic murmur over aorta & is heard when patients sit in 2nd ICS. Murmur is conducted by
blood into carotids & can be heard in the interscapular space & in the neck. This murmur is
an ejection systolic murmur that is of crescendo-decrescendo type.
 US- in US we measure the diameter of the aortic valve orifice. In soft degree it’s 1.2-2cm
square, moderate it’s 0.75-1.2 cm square & severe is less than 0.75 cm square.
 PCG
14. Differential diagnosis of angina pectoris and myocardial infarction according to laboratory
data.
15. Basic diagnostic methods in pulmonology.
- Spirometry, bronchoscopy, x-ray, US, MRI, FEV-FVC.
- Blood count, bacterial culture
16. The main diagnostic methods in cardiology.
- ECG, EKG, Holster test, angiography, x-ray
17. Treatment of instrumental data in mitral valve insufficiency (electrocardiography, x-ray,
doppler echocardiography).
X-ray: LA AND LV ENLARGEMENT, VALVE CALCIFICATION
ECG: BIFID P WAVE, LV HYPERTROPHY, ATRIAL FIBRILATION
EKG: SHOWS DILATED VALVES, DOPPLER DETERMINE THE VELOCITY OF
REGURGITATION
18. Treatment of instrumental data in mitral stenosis (electrocardiography, x-ray, doppler
echocardiography).
ECG: BIFID P WAVE, P MITRALE, P PULMONALE, RETROGRADE P, ATRIAL
FIBRILATION, RV HYPERTROPHY
X-RAY: MITRAL CONFIGURATION
EKG: EXTENT OF DESTRUCTION, THICKNESS, SIZE OF CHAMBER
19. Ecg recording technique.
20. Treatment of instrumental data for aortic valve insufficiency (electrocardiography, x-ray,
doppler echocardiography).
ECG: LV HYPERTROPHY, LV OVERLOAD, VETRICULAR ARRHYTHMIA
X-RAY: ATRIAL CONFIGURATION, CALCIFICATION, LV HYPERTROPHY
EKG: VIGOROUS CONTRACTIONS, DILATED LV, AORTIC ROOT ENLARGEMENT,
DYASTOLIC FLUTTERING, REGURGITATION DEGREE
21. Treatment of instrumental data for tricuspid valve insufficiency (electrocardiography, x-ray,
doppler echocardiography).
22. Interpretation of instrumental data for stenosis of the aortic orifice (electrocardiography, x-ray,
doppler echocardiography).
23. Methods of studying respiratory function, the main groups of indicators.
FEV-FVC, spirometry, bronchoscopy, sputum analysis
24. Algorithm of reading ecg
9 STEPS TO ECG INTERPRETATION
IS THE RHYTHM REGULAR? CHECK THE QRS SEGMENT OF THE ECG TO DETERMINE
IF THE DEPOLARIZATION WITHIN THE VENTRICLES IS REGULAR. ...
CALCULATE HEART RATE. ...
DIAGNOSE THE P WAVES. ...
MEASURE THE P-R INTERVAL. ...
MEASURE THE QRS SEGMENT. ...
CHECK THE T WAVE. ...
NOTE ANY ECTOPIC BEATS. ...
DETERMINE THE ORIGIN.
25. Treatment of doppler echocardiography data.
EKG: SHOWS DILATED VALVES, DOPPLER DETERMINE THE VELOCITY OF
REGURGITATION
DOPPLER DETERMINE THE VELOCITY OF REGURGITATION
26. Treatment of fibrogastroduodenoscopy data.
Fibrogastroduodenoscopy : 1)Location,size,shape
2)condition of gastric mucosa( ∆ in colour,surface,growths)
3) presence of bile in gastric juice ( if reflux present)
4) height,width,density of folds
5) reveal tumor/ulcers and coagulation of vessels & tamponade of
vessels.
27. Interpretation of research data of the pleural fluid.
Some pleural fluid and serum markers have shown extremely high diagnostic accuracy in patients
with PE; for instance, interleukin-27 (IL-27),12 interferon-gamma13 and adenosine deaminase
(ADA)14 pleural fluid levels for tuberculous PE and serum N-terminal pro-brain natriuretic peptide
(NT-proBNP) for CHF
28. Additional research methods in hepatology.
X-ray, angiography, pancreatic enzymes,
29. Laboratory data for abscess and gangrene of the lungs.
1. Blood pic : ↑ ESR, leukocytosis shift to the left
2. Biochem : ↑ inflmtory prots (C-reactive prots)
3. Sputum exam : 1st stage – not specific
2nd stage – presence of 3 layers (mucous, serous, purulent)
30. Physical and instrumental methods of research vessels