Blennorea with inclusions. Blennorrhea in newborns Prognosis, consequences and complications

Acute infectious eye diseases occur in children during the first days of life. Blennorrhea in newborns is a serious pathology, accompanied by purulent discharge from the conjunctiva. Infection is dangerous with complications: blindness and death of the eye.

Gonococcal conjunctivitis is a disease that affects both eyes. It occurs due to intrauterine infection or with improper hygiene after birth. It is also transmitted through the birth canal from a sick mother. The causative agent is gonococcus. The mucous membrane of the eye of a newborn is severely affected. Perhaps its thinning, after which the bacteria affect the cornea of the eye, causing irreversible consequences.

Immediately after infection, the disease does not manifest itself, and the first signs are obvious after two or three days (more often the infection is noticed even in the maternity hospital). The source of spread is the bacterium gonococcus, which affects the mother, or unsanitary conditions in the delivery room.

Symptoms of concern

Blennorrhea in a newborn is always the same, it is characterized by the following symptoms:

severe sealing of the eyelids, redness of the skin around the eyes;
it is difficult to open the eyes of the baby for examination;
the conjunctiva becomes loose, often accompanied by bleeding;
profuse serous discharge, pus outlet;
eyelids stick together and dry;
the newborn becomes capricious;
the temperature rises.

Note! A complex form of gonoblennorrhea in newborns often requires hardware opening of the eyelids for diagnostic examination and treatment. After a few days, the eyes open easily on their own.

Diagnostic methods

Correct diagnosis is essential before starting treatment. A newborn's discharge from the eyes is being studied in the laboratory. In the presence of gonococcus in the test results, blennorrhea is confirmed.

Ophthalmic rhea is determined by direct examination of the eyes of the newborn. It is important not to confuse blennorrhea with purulent conjunctivitis or dacryocystitis. Therefore, you need to seek help from a competent ophthalmologist.

At the same time, the pathology of the cornea of the eyeball is excluded, for this, the newborn is prescribed biomicroscopy, diaphanoscopy, as well as a fluorescein installation test.

What is hardware opening of the eyelids?

If the baby fails to open the eyes stuck together from pus in a conservative way, then they resort to the hardware method. For this, a special tool is used that penetrates under the baby's upper eyelid and breaks through a dense purulent sac.

Drug therapy for gonococcal infection of the eye of a child

Several types of medicines are used to treat blennorrhea in newborns and babies up to a year old.

Moms take note! Before use, local antiseptic preparations must be diluted with water, as these agents are concentrated and can cause allergic reactions. It is necessary to dilute the medicine in the ratio of 3 drops to 1 tbsp. l. boiled water.

Medication

The course of treatment is individual for each small patient. The dosage of drugs depends on the age of the newborn, it is prescribed by a doctor.

Treatment of blennorrhea in a child up to a year is carried out in a strict sequence:

Alternative therapy for blennorrhea

From a medical point of view, the use of folk remedies for the treatment of diseases of the visual organs is prohibited. They do not bring the desired result and are used only as additional ones. On the basis of some medicinal herbs, you can prepare a decoction for washing the eyes after drug treatment. To do this, use pharmacy chamomile, ripe rose hips, fresh dill seeds, strong tea leaves.

The kids are talking! The son (4 years old) was with his grandparents for a long time, he missed him, he says to them:
- I'm worried about my mom.

Doctors urge parents: do not use decoctions of medicinal herbs for washing the eyes of newborns without an examination by an ophthalmologist. These actions often contribute to the propagation of the infection, especially if hygiene is not observed during the procedure.

Advice! At home, to alleviate the condition of a newborn with a diagnosis of gonoblenorrhea, it is recommended to wash the eyes with warm boiled water three to four times a day. This procedure must be done in the process of rehabilitation.

Complications of blennorrhea

When left untreated or misdiagnosed, gonococcal conjunctivitis in infants becomes a complication that is often irreversible to health. There is an extensive lesion of the cornea, cloudy spots and ulcers on the eyeballs are noticed. Further, the pus moves into the remaining tissues of the eye, causing its death.

If this process is not stopped, the gonococci move into the newborn's bloodstream, damaging the joints and causing gonococcal arthritis. This pathology is accompanied by hyperthermia, aching joints.

Prevention of ophthalmic rhea in a child

You can reduce the risk of infection of a newborn baby with blennorrhea by following the algorithm corresponding to SanPin:

Labor should be carried out under sterile conditions for both the mother and the newborn. Sick nurses, doctors and midwives are not allowed to work.
If a mother has gonorrhea during pregnancy, she must be treated in the second trimester, otherwise there is a risk of congenital blennorrhea in the newborn.
Before childbirth, for prevention, the mother is sanitized under the supervision of an experienced gynecologist.
After the baby is born, he must be instilled into the eyes of Sulfacyl Sodium or Silver Nitrate 2% to exclude the manifestation of ophthalmoblenia.
Newborn care items are sterilized, even if they are new.

At the end of the article, watch a video that talks about the risks of blennorrhea and what prevention should be.

Blennorrhea in newborns is an inflammation of the conjunctiva. Blennorrhea is acute and purulent in nature and has an infectious onset. Most often this disease causes gonococcus, less often - pneumococcus, staphylococcus, streptococcus, chlamydia.

How infection occurs

Most often, children become infected when they pass through the birth canal of a mother with gonorrhea. Infection is also possible immediately after childbirth. The source of infection, in this case, will be dirty hands, linen, water. Non-compliance with asepsis and antisepsis increases the likelihood of neonatal blenorrhea. With an early opening of the fetal bladder, a long anhydrous period, prolonged childbirth, there is a possibility of intrauterine infection. In such a situation, the child is already born with blenorrhea. Of course, now this unpleasant ailment is not so common due to good prevention, but still remains quite relevant.

Symptoms of blennorrhea in newborns

The incubation period takes from several hours to a couple of days. Both eyes of the child are usually affected in blenorrhea. At the beginning of the disease, the conjunctiva of the eye turns red, which, when touched, begins to bleed, there may be discharge in a small amount, which is serous-hemorrhagic in nature. Eyelids swollen, tight. The eyes of a newborn are difficult to open on examination.

There are three periods during the disease

Infiltrative period. On the third day from the onset of the disease, the eyelids become a little softer, the swelling subsides a little. At the same time, a purulent thick secret begins to stand out from the eyes continuously and in large quantities, which glues the eyelids, flows down onto the child's face. The duration of this period is 24-48 hours.
Purulent period. Suppuration from inflamed eyes during this period reaches its maximum. The eyelids become even softer, but they are glued together due to a large amount of pus. The duration of the period is from three days to two weeks.
Period of papillary hypertrophy. In this period, the amount of secreted pus already decreases, it becomes not so thick, it takes on a more serous character. Papillary growths and folds appear on the conjunctiva, it gradually acquires a healthy appearance. The duration of the period reaches from two to four weeks.

Complications of blennorrhea for newborns

Perhaps the most severe complication of neonatal blennorrhea is the involvement of the cornea in the infectious process. This usually happens during the period of maximum suppuration. As a result of infection and disturbance of trophism, the cornea becomes dull, an infiltrate appears on its surface, which soon turns into an ulcer. With a favorable outcome, the ulcer epithelizes and only a small superficial spot remains on the cornea. With an unfavorable course, the process progresses, as a result, a thorn may remain on the cornea.

Treatment of blennorrhea in newborns

The most effective is the treatment with antibacterial and sulfa drugs. Antibiotics commonly used are penicillins. They are prescribed to the child intramuscularly, also instilled into the eyes after washing with an isotonic solution.

For certain reasons, the child is affected by this disease.

It causes the baby's body severe harm Therefore, parents need to think about treatment as early as possible.

We will talk about the symptoms and prevention of gonorrhea in newborns in the article.

How to treat hyperexcitability syndrome in newborns? Learn about it from ours.

general information

Gonoblenorrhea is acute conjunctivitis which is caused by gonococcus. This is a fairly severe eye disease. It is usually transmitted to newborns from the mother at the time of birth.

If the disease is not treated, the infection spreads. From the mucosa, it can enter neighboring tissues and affect the entire body, causing myositis, endocarditis.

Pathology is dangerous because affects the cornea, her nutrition is disturbed. This leads to the formation of pus.

The process is so serious and dangerous that it leads to the baby, and in severe cases to blindness.

It is necessary to start treatment immediately, preventing the infection from spreading.

Causes of the disease

The disease occurs in newborns for the following reasons:

The causative agent of the disease is Neisseria gonorrhoeae. Neisser's gonococcus gets on the conjunctiva of the secret. Then the infection spreads from the mucous membrane of the infected eye, which leads to a generalization of the disease.

The factors for the development of the disease include non-compliance with hygiene, weakened immunity of the baby, lack of timely treatment, ignoring the symptoms of the disease that have arisen.

How does infection occur?

If a mother has gonorrhea, during the birth of the baby, she will infect him. This happens when the baby passes through the birth canal.

The infection settles on the walls of the pathways and, upon contact with the body of the baby, penetrates into it. At birth, the disease does not make itself felt, but begins to actively influence. Its first signs appear on the 2-3 day.

Pathogenesis

Baby's eyelids sharply and rapidly swell, become inflamed. They acquire a bluish-purple hue.

The swelling of the eyelids is very dense, and this leads to the fact that the child cannot close the eyelids on his own.

A serous substance is secreted from the eyes. As the disease progresses, the discharge becomes plentiful. This is very disturbing for the baby, he cries.

Symptoms and clinical picture

The disease is not difficult to determine, it is accompanied by pronounced symptoms:

puffiness. There is a thickening of the eyelids. They slightly increase in size and turn red.
Can't turn eyelids out. Slightly open the palpebral fissure is possible with great difficulty.
Selection liquids. It may be liquid at first, but thickens over time, the baby cannot open his eyes.
Appearance pus. It is released in a certain amount and settles on the surface of the eyelids.
Capriciousness. The child cries, feels discomfort. Possible sleep disturbance.

Newborns during illness are restless, capricious. This negatively affects the functioning of the nervous system.

Complications and consequences

If you do not start treatment on time, complications may occur:

Corneal lesion, disruption of her nutrition. This leads to abundant discharge of pus and the spread of the disease.
emergence purulent ulcers. They can grow in size and infect the eyeball with an infection.
Inflammation of the eyeball. It threatens with visual impairment and the risk of blindness. This cannot be allowed.

By starting treatment on time, it will be possible to avoid negative consequences.

Diagnostics

It is impossible to determine the disease on your own. Diagnosis of the disease carried out in a hospital by a doctor. For this, these diagnostic methods are used:

Examination of the patient. The doctor examines the child's eyes.
Examination of discharge from the eyes. The material is studied in the laboratory. This allows you to determine the presence of infection.

These methods allow you to quickly and effectively determine the disease. It is diagnosed very quickly, after which the patient is immediately treated.

What is the danger of a hematoma on the head of a newborn after childbirth? find out right now.

Treatment Methods

Pharmaceutical products, injections are used to treat a child.

Preparations

Specialists appoint antibacterial drugs:

chloramphenicol solution 0.25%;
miramistin solution 0.01%;
sulfacyl sodium solution 10%.

These drugs are used in the form of drops. They are diluted with water before use.

For 2-3 drops of medicine, you need to use at least a tablespoon of water. These funds are used 2-3 times a day. Accurate dosage, the duration of treatment is prescribed by the doctor.

It is necessary to take the medicine one tablet in the morning and in the evening. newborn pre-crushed tablet and mixed with water, as he will not be able to swallow the tablet on his own.

Ointments

Doctors recommend using ointments:

ofloxacin ointment 0.3%;
tetracycline ointment 1%;
ciprofloxacin ointment.

These funds are applied to the eyelids of the child 2-3 times a day. They contribute reduction of secretions, removal of puffiness, recovery. The duration of application of ointments depends on the stage of the disease.

Injections

Injections are an effective method of treatment. The child is given the following medications:

Ceftriaxone. Enter intramuscularly at 25 mg / kg once a day for the first three days of treatment.
Cefotaxime. It is administered intravenously every eight hours, one gram. The child is treated for the first three days, but no more in order to avoid complications.

These drugs help to quickly destroy the pathogen, stop the development of the disease. They restore the health of the child, eliminate the symptoms of the disease.

It is impossible to administer drugs by injection on your own, this must be done by a doctor, correctly calculating the dosage of drugs.

Antibiotics

Antibiotics are used by doctors only as a last resort, if the above drugs do not work. Antibiotics are selected very carefully, based on the health of the patient, the individual characteristics of the organism.

Do not buy antibiotics on your own because it can harm the body. The following antibiotics are commonly used:

ampicillin;
chloramphenicol;
tetracycline.

Dosage and duration of antibiotic use determined strictly by the doctor.

Specialists do not recommend treating a child with folk remedies, since this is a serious disease and folk remedies will not bring the desired effect. Folk remedies will not be able to defeat the pathogen, they can only be used to relieve the primary symptoms of the disease.

The baby can wash the eyes warm boiled water, tea. Very carefully, these funds remove purulent discharge on the surface of the eyelids, and alleviate the patient's condition. Such procedures are carried out 3-4 times a day.

However, in addition to them, it is necessary to give the child medication.

Prevention

For the prevention of gonorrhea, a certain algorithm of actions according to SanPiN is used. Experts recommend:

This disease very dangerous for a child, so it is necessary to start treatment immediately. For this child, the doctor is urgently shown and diagnosed.

You can learn about the rules for caring for the eyes of a newborn for the prevention of gonorrhea from the video:

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Purulent conjunctivitis or blennorrhea in newborns is most often caused by gonococcal infection. The disease is characterized by severe swelling of the eyelids, profuse suppuration. Untimely therapy of a severe form of gonoblenorrhea threatens with loss of vision. Thanks to special preventive measures, the pathology of gonococcal origin is extremely rare.

Causes of the disease

Eye diseases caused by bacteria of a different etiology account for about a third of all cases and occur in a milder form. Blennorrhea in newborns can develop as a result of circumstances such as:

The ingress of bacteria on the mucous membrane of the baby's eyes when it moves along the birth canal, infected with the causative agent of gonorrhea.
A prematurely opened fetal bladder or a difficult birth that led to infection inside the womb.
Infection of a child with the help of care items, water, hands due to violation of hygiene rules.

Pathologists call. the following triggers:

gonococcus;
chlamydia trachomatis;
staphylococcus;
coli;
streptococcus;
Koch Wicks stick;
Pneumococcus;
mixed microflora.

Symptoms

At first, such a baby may have swollen eyelids.

Manifestations of the disease as a result of intrauterine infection are visible in the born child immediately. After infection during childbirth, signs of the disease occur a couple of days after birth. More often there is a simultaneous defeat of both eyes, less often - in turn. The disease has 3 stages, during which the signs are somewhat transformed. The main symptoms are presented in the table:

Diagnostics

After the birth of the organs of vision, the baby is examined by a specialized doctor.

The presence of blennorrhea in a child and its etiology is determined by the ophthalmologist based on the results of the initial examination by opening the eyelids. Severe puffiness and thickening sometimes require effort to open them. It is necessary to isolate the patient's eyes with cotton swabs, since the accumulated pus during the opening of the eyelids can be intensively released. After an external examination, a smear is taken from the mucous membrane of the eye.

To prescribe effective therapy, laboratory tests are carried out to help determine which pathogen caused the pathology. These include:

microbiological test;
polymerase chain reaction;
linked immunosorbent assay;
RIF diagnostics.

In addition, instrumental methods are used. Studies are carried out to prevent pathologies of the cornea and lesions of the internal structures of the eye. These include the following procedures:

biomicroscopy;
fluorescein instillation test;
diaphanoscopy.

Blennorey at the child serves as the basis for inspection of parents. The well-being of a newborn depends on their health.

Treatment of the disease

In the treatment of the disease, injectable antibiotics can be used.

General and local therapy is aimed at the destruction of the causative agent of the pathology, lasts approximately 2 weeks. In complex treatment, in addition to a pediatrician and an ophthalmologist, a dermatovenerologist is involved. The acute course of blennorrhea requires the systemic use of antibacterial drugs. A second smear is also taken to determine the effectiveness of the therapy. Main activities:

Regular (every 1-1.5 hours) jet cleansing of the conjunctival cavity with saline.
The use of an antibacterial drug for instillation of the eyes or intramuscular injection.
Laying antimicrobial ointment for the eyelids.
Use of a protective bandage for a healthy eye for warning purposes.

Preparations

Washing of the mucous membrane of the eyes is carried out with solutions of sodium chloride, "Furacilin", potassium permanganate. After the cleansing procedure, the eyes are instilled with sulfanilamide or antibacterial agents - Albucid, Tetracycline, Penicillin. With exacerbation, antibiotics are prescribed in the form of injections. In case of damage to the cornea, antimicrobial liniments are used, including erythromycin ointment or containing tetracycline.

Folk recipes

To treat the organs of vision of a child, a decoction of sage can be used.

It is recommended to supplement the treatment of blennorrhea with the use of herbal decoctions. The most effective are chamomile, sage, calendula. Several times during the day, the affected eyes are washed with decoctions to remove purulent deposits. The use of such products accelerates recovery, as the plants have an antibacterial and disinfectant effect. One of the ways to prepare a medicinal potion:

Pour 1 tbsp. l. flowers with 200 ml water.
Boil.
Insist in a thermos for 40-50 minutes.
Filter through 2-3 layers of gauze.
Rinse eyes with decoction or apply compresses.

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The patient mistakenly drank several sips of vinegar essence. She came in with unbearable, burning pain when swallowing and behind the sternum. Your prehospital activities should include a) administering pain medication b) gastric lavage through a tube with large amounts of water

A patient suffering from varicose veins of the lower extremities for a long time went to the doctor with complaints of bleeding from a varicose vein on the leg. Your tactics a) apply a pressure bandage to the bleeding site, apply a tourniquet proximal and distal to the bleeding site and send to the surgical hospital

A patient with hemorrhoids should be referred to a surgical hospital for surgical treatment a) with thrombosis of hemorrhoids b) with repeatedly recurring hemorrhoidal bleeding e) with a combination of hemorrhoids with a chronic fissure of the anal canal

A patient with an injury to the lower third of the thigh and bleeding from the site of injury must be transported to a remote hospital. Which of the following regarding the application of a hemostatic tourniquet is correct in this case? a) the tourniquet is applied for no more than 2 hours, during which it is necessary to periodically dissolve the tourniquet for a short time;

An 18-year-old patient complained of pain in the eyelids, narrowing of the palpebral fissure on the right. c) outer barley

A 23-year-old patient complains of palpitations, frequent attacks of which have been bothering him for 5 years. c) Wolff-Parkinson-White syndrome

A 26-year-old patient was injured by fragments of a broken spectacle glass and went to the nearest emergency room. b) solution of chloramphenicol 0.25%

A 30-year-old patient complained of pain in the area of the second finger of the right hand. He notes that he injured his finger with a needle 3 days ago. Body temperature - 37.5°C. Locally in the injection zone there is an infiltrate, a drop of pus appears under the epidermis. The patient was diagnosed with cutaneous panaritium. a) skin-subcutaneous panaritium ("cufflink")

A 30-year-old patient with type I diabetes mellitus was found in a coma 3 hours after insulin administration. e) inject 20 ml of 40% glucose solution

A 32-year-old patient complains of acute "dagger" pain in the epigastric region. It is known that the patient suffers from duodenal ulcer for a long time. What complication of the disease should be considered in the first place? b) about perforation

A 33-year-old patient found in the morning that the eyelids in both eyes were swollen, stuck together, his eyes were sharply reddened. b) acute purulent conjunctivitis

A 35-year-old patient complained of frequent (2-3 times a year) tonsillitis. a) chronic tonsillitis

A 40-year-old patient complained of a tumor-like formation on the right leg, which did not cause any discomfort. On examination: on the outer surface of the lower leg in the thickness of the soft tissues there is a rounded, painless, dense formation, not connected with the skin and bone, moderately mobile, 1.5 × 1.5 cm in size, the skin above it is not changed, there are no skin sensitivity disorders in this area. It is most likely that the patient d) fibroma

A 40-year-old patient, on the first day of extensive myocardial infarction. On examination - pale with a "marble" pattern of cold skin, sinus tachycardia 140 per minute, blood pressure - 70/40 mm Hg. Art. Emergency therapy should be started e) with the introduction of dopamine

A 40-year-old patient, a carpenter by profession, complained of a rounded tumor-like formation on the palmar surface of the skin. a) epithelial cyst

A 43-year-old patient complains of weakness, sweating, subfebrile condition, enlarged cervical and submandibular lymph nodes. On palpation, the nodes are dense, somewhat painful, soldered together. d) tuberculosis

A 45-year-old patient with long-term stable high arterial hypertension complained of headache, severe weakness, recurrent swelling of the face in the morning. b) Kohn's syndrome

A 50-year-old patient has been suffering from an ingrown toenail of the first toe of the right foot for a long time, periodically undergoing conservative treatment. a) after the relief of acute inflammation with conservative measures (baths with an antiseptic solution, antibiotics), surgical intervention on the nail, nail layer and periungual fold is performed on an outpatient basis

A 50-year-old patient applied 4 days after an episode of prolonged (up to 5 hours) retrosternal pain. On the ECG - a complete blockade of the left leg of the bundle of His. When deciding on the presence of acute myocardial infarction, diagnostic value will be d) determination of lactate dehydrogenase activity

A 50-year-old patient after a bath suddenly felt a sharp decrease in hearing in the right and left ears. No fever, pain or dizziness was noted. a) sulfur plug

A 52-year-old patient complained of profuse bleeding with scarlet blood from the anus. Your tactics b) urgent referral to the surgical hospital by ambulance, lying down

A 53-year-old patient has been suffering from coronary heart disease for a long time with frequent attacks of angina, provoked by physical and emotional stress. b) as a syndrome of irritable weakness

A 53-year-old patient complained of hoarseness, cough, itching, discomfort when swallowing. These complaints disturb the patient for six months, the last month and a half notes difficulty in breathing, the appearance of shortness of breath. b) cancer of the larynx

A 53-year-old patient complained of constipation, blood in the feces, bloating of the left half of the abdomen. b) wrong

A 56-year-old patient complained of constipation, blood in the stool, change in the shape of the stool (ribbon-like), pain in the lower abdomen. Objectively: the general condition is satisfactory, c) digital examination of the rectum

A 60-year-old patient applied 6 hours after the onset of sharp pains in both lower extremities. Suffering from mitral heart disease, atrial fibrillation, hypertension. a) thromboembolism in the area of aortic bifurcation

A 60-year-old patient was examined in a polyclinic. Suspected diagnosis of acute catarrhal cholecystitis. Your next steps c) urgent hospitalization in a surgical hospital

A 62-year-old patient with a history of myocardial infarction consulted a doctor about headaches and dizziness. On examination, the pulse is 86 per minute, blood pressure is 200/100 mm Hg. Art., b) finoptin

A 64-year-old patient for 2 years notes a gradual decrease in vision in both eyes, for 3 months he does not distinguish objects with both eyes, his eyes did not turn red, they did not hurt. b) mature senile (age) cataract

A 67-year-old patient complains of frequent urination, nocturia, thinning of the urine stream. Similar phenomena appeared about 2 years ago. It is most likely that the patient has a) prostate adenoma

A 70-year-old patient consulted a doctor 2 days after an inguinal hernia incarceration due to fever up to 39°C. On examination: in the area of hernial protrusion - a sharp swelling and hyperemia of tissues, fluctuation. It is most likely that the patient has a) phlegmon of the hernial sac

The patient is unconscious. On examination: cyanosis, convulsions, pulse on the carotid artery is not determined. What urgent action should be taken first? c) carrying out artificial ventilation of the lungs and external heart massage

A patient in the process of developing diabetic ketoacidosis may present the following complaints EVERYTHING IS CORRECT

The patient had suffered a severe traumatic brain injury in the past. d) Jacksonian seizure (focal)

The patient has been suffering from convulsive seizures for many years, which have recently become more frequent. a) focal seizure

The patient sits motionless on the bed, his gaze is fixed in space. Facial expression interested. Answers questions formally, in monosyllables. c) as oneiroid

The patient went to the doctor after being discharged from the hospital, where he was treated for appendicular infiltrate, the appendix was not removed. In this situation, it is necessary b) to follow the recommendations given to the patient upon discharge from the surgical hospital

The patient complained of pain in the region of the G2 tooth. On examination: in the G2 area, edema, gingival hyperemia, suppuration from the gingival pocket, tooth mobility of the III degree. The patient suffers from rheumatism without exacerbation. The optimal tactic for this patient is a) tooth extraction

The patient complained of double vision. On examination: the left eye is deviated inwards, the angle of strabismus in the diseased eye is 30°, in the healthy eye it is 10°, there is a lack of mobility of the diseased eye inwards. 10 years ago, the patient suffered a blunt head injury. It is most likely that the patient has b) paralytic convergent strabismus, central abducens nerve palsy

The patient complained of a change in the appearance of the back of the tongue that he accidentally discovered. b) desquamative glossitis

The patient suffered generalized urticaria with Quincke's edema after administration of tetanus toxoid. What variants of cross-sensitization can this patient have? c) horsemeat d) dandruff

The patient suffered a rheumatic attack 3 years ago. She is currently being examined and has no complaints. Physical examination reveals mitral valve insufficiency. b) inactive

The patient received a burn of the hand and forearm by steam. On examination: there is swelling and hyperemia of the skin, in places with small blisters filled with light yellow exudate, not tense. Specify the degree of damage a) 1-2 degree

The patient was injured in the popliteal region with a cutting object. There is heavy bleeding from the wound. What methods of temporary stop of bleeding can be effective in this case? a) maximum flexion of the knee joint d) application of a hemostatic tourniquet on the upper third of the thigh

The patient complains of acute pain in the perineal region, radiating to the sacrum and suprapubic region. Body temperature increased to 39.5°C. Urination is difficult, painful. It is most likely that the patient

e) acute prostatitis

A patient with shoulder dislocation notes a feeling of numbness in the fingers. Active abduction of the first finger is sharply limited. The weakening of the pulse of the radial artery on the affected side is determined. Medical tactics in this case involves a) immediate reduction of the dislocation

A patient with a dislocated shoulder indicates a feeling of numbness in the fingers. Objectively: active abduction of the first finger is sharply limited, the pulse of the radial artery is weakened compared to the healthy one. The dislocation must be reduced a) immediately

A patient with a severe form of lacunar tonsillitis, if necessary, should be hospitalized d) in the infectious diseases department

A patient with liver cirrhosis needs a) refusal of alcohol b) exclusion of hepatotoxic drugs c) dispensary observation d) periodic biochemical monitoring of liver tests

The patient, a 40-year-old man, has no complaints. At an objective examination: on the mucous membrane of the right cheek, along the line of closing of the teeth, there is a whitish area, somewhat denser to the touch compared to the healthy mucous membrane, b) leukoplakia

A 30-year-old patient underwent resection of 2/3 of the stomach for a perforated ulcer, according to Billroth I. Subsequently, the patient developed palpitations, dizziness, profuse sweat, and orthostatic hypotension 30-40 minutes after a heavy meal. It is most likely that the patient has e) dumping syndrome

The patient is always shown hospitalization in the localization of the boil a) in the area of the nasolabial triangle and the upper half of the face

A patient at work got a foreign body in his eye. The factory paramedic found a piece of metal on the surface of the cornea and removed it.

A patient with hay fever is shown a course of specific hyposensitization by pollen allergens a) 1-3 months before the flowering of plants

The patient was diagnosed with appendicular colic. There are no changes in the clinical analysis of blood, the body temperature is normal. Your actions c) observation in dynamics