Case study №1.
Pregnant I. 27 years, pregnancy III. Last menstrual period - on 30 March. Came the next
appointment on December 22. From history: 15 years is the dispensary Registered with
rheumatism. Palpitations, shortness of breath when walking. The general condition is
satisfactory. Skin and visible mucous normal color. No edema. Rhythmic heart sounds, systolic
murmur at the apex. A / D 110/70, 110/70 mm Hg Pulse 92 beats per minute. The uterus is a
normal tone, presenting part of the fetus head. Fetal heart rate 138 ud.v minute. Abdominal
circumference 86cm, GMR 37 cm.
question:
1. Your preliminary diagnosis.
2.Taktika GP
answer:
1.Beremennost III, 38 weeks, birth III. Rheumatism in remission, PPP.
Mitral stenosis. HC1 Art.
2.Gospitalizatsiya dlyareshenie on the choice of mode of delivery
Case study №2.
A pregnant 23 years old. Pregnancy the first 11 weeks. Appealed to the clinic with complaints of
fever up 39oS, pain in the joints. As a child, was at the dispensary about rheumatism. AD100 /
60-100 / 70 mmHg Pulse 96 beats per 1minute. Muffled heart sounds, systolic murmur at the
apex.
question:
1.Predvaritelny diagnosis:
2.Taktika GP
answer:
1.Beremennost I, 11 weeks, Rheumatism active phase.
2.Gospitalizatsiya in the hospital for a decision on the continuation of pregnancy.
Case study №3
Patient B., 30 years old, sixth pregnancy. The term of her pregnancy 30 weeks. She visited the
antenatal clinic at 20 weeks of gestation, and then it was discovered that she had mild anemia.
She was prescribed iron supplements and folic acid, and gave a sufficient number of tablets for
2 weeks, until the next clinic visit. B. The patient did not come to the clinic on the appointed day,
because she was busy with household chores. It came today, 10 weeks later, at her shortness
of breath, drowsiness and fatigue.
question:
1. The preliminary diagnosis:
ASSESSMENT (History, physical examination, screening procedures / laboratory tests)
You have completed your assessment of the patient B. and revealed the following:
B. The patient tells you that dyspnea uney started about a month ago, especially when she was
doing housework and looking after the children. Since then it has more and more tired. She has
normal temperature and blood pressure, respiratory rate 30 breaths per minute. Uney severe
pallor of the conjunctiva and palms. Uterine size corresponds to the gestational age. . Normal
fetal heart tones. Hemoglobin 6.5 g / dl. B. The patient had no episodes of malaria within 2
years. She lives in the region endemic helminthic infestation, but has not received anthelmintic
treatment for 3 years.
Based on these data, what is the diagnosis of the patient B., and why?
2. Answer: The symptoms and signs of the patient B. (eg., Shortness of breath, pallor of the
conjunctiva and palms, drowsiness and fatigue) indicate severe anemia.