Examined and Approved at Interdepartmental Meeting
Protocol № 9 from 30.04.14
Head of Surgery Department with Pediatric
Surgery and Urology Course Prof. Leonov V.V.
MINISTRY OF EDUCATION AND SCIENCE OF UKRAINE
SUMY STATE UNIVERSITY
MEDICAL INSTITUTE
Discipline “Confirmed”
“Surgery with Pediatric Surgery” The Head of Medical Sumy State University
Practical skills «___» ______________ V.A. Smiyanov
BLOCK 6. “Interpretation of roentgenograms” Task 16
A child (age 10) with enlarged abdomen but with low body weight. Dermal tegument is pale grey. According to mother’s words, the child’s got stool detentions since the very first months of life, so his bowels was cleared with enemas every 1-2 days. The child’s belly grows bigger in the last year. The child is observed by pediatricians. During examination the abdomen is enlarged, not sore, a thickened sigmoid colon is palpated. What roentgenologic research was made? What is a clinicoroentgenologic diagnosis?
А. Nonspecific ulcerative colitis.
В. Hirschsprung's disease.
С. Ileus.
Examined and Approved at Interdepartmental Meeting
Protocol № 9 from 30.04.14
Head of Surgery Department with Pediatric
Surgery and Urology Course Prof. Leonov V.V.
MINISTRY OF EDUCATION AND SCIENCE OF UKRAINE
SUMY STATE UNIVERSITY
MEDICAL INSTITUTE
Discipline “Confirmed”
“Surgery with Pediatric Surgery” The Head of Medical Sumy State University
Practical skills «___» ______________ V.A. Smiyanov
BLOCK 6. “Interpretation of roentgenograms” Task 17
During surgery concerning chronic calculous the surgeon’s attention was drawn by a bile duct dilated to 1.5 cm. After the gallbladder, where up to 10 small gallstones (0.5 – 0.8 cm) were located, was removed, the doctors decided to give additional examination of bleary system. Which intraoperative examination method was used? Interpret the results.
А. Cholangiography.
В. Cholangiotonometry.
С. Duodenography.
Examined and Approved at Interdepartmental Meeting
Protocol № 9 from 30.04.14
Head of Surgery Department with Pediatric
Surgery and Urology Course Prof. Leonov V.V.
MINISTRY OF EDUCATION AND SCIENCE OF UKRAINE
SUMY STATE UNIVERSITY
MEDICAL INSTITUTE
Discipline “Confirmed”
“Surgery with Pediatric Surgery” The Head of Medical Sumy State University
Practical skills «___» ______________ V.A. Smiyanov
BLOCK 6. “Interpretation of roentgenograms” Task 18
Ambulance took the patient P. (female, age 40) with complaints about sharp pain in abdomen. Skin is covered with cold clammy sweat, pale. The patient is excited, remains in enforced right lateral decubitus with adducted legs. During palpation the abdomen is sharply painful, muscle tension of anterior wall of abdominal cavity is detected. Hepatic flattening is not detected during percussion. Which diagnostics method is used? Interpret the results.
А. Plan radiography of the abdominal cavity organs. Free gas in abdominal cavity.
В. Plan radiography of the abdominal cavity organs. Free liquor in abdominal cavity.
С. Plan radiography of the abdominal cavity organs. Signs of acute intestinal obstruction.
Examined and Approved at Interdepartmental Meeting
Protocol № 9 from 30.04.14
Head of Surgery Department with Pediatric
Surgery and Urology Course Prof. Leonov V.V.
MINISTRY OF EDUCATION AND SCIENCE OF UKRAINE
SUMY STATE UNIVERSITY
MEDICAL INSTITUTE
Discipline “Confirmed”
“Surgery with Pediatric Surgery” The Head of Medical Sumy State University
Practical skills «___» ______________ V.A. Smiyanov
BLOCK 6. “Interpretation of roentgenograms” Task 19
Ambulance took the patient Z. (age 22) to the regional hospital. Complaints about sharp pain in abdomen, which appeared suddenly. Skin is pale, covered with cold sweat, hypopnoe, tachypnoe. Abdomen is tense, acutely painful during palpation. In past history duodenal ulcer, chronic pancreatitis. Which additional examination method was used? Interpret the result.
А. Plan radiography of the abdominal cavity organs. Free gas in abdominal cavity.
В. Plan radiography of the abdominal cavity organs. Signs of acute intestinal obstruction.
С. Plan radiography of the abdominal cavity organs. Free liquor in abdominal cavity.
Examined and Approved at Interdepartmental Meeting
Protocol № 9 from 30.04.14
Head of Surgery Department with Pediatric
Surgery and Urology Course Prof. Leonov V.V.
MINISTRY OF EDUCATION AND SCIENCE OF UKRAINE
SUMY STATE UNIVERSITY
MEDICAL INSTITUTE
Discipline “Confirmed”
“Surgery with Pediatric Surgery” The Head of Medical Sumy State University
Practical skills «___» ______________ V.A. Smiyanov
BLOCK 6. “Interpretation of roentgenograms” Task 20
The child (age 4) refuses to eat, worried, sleeps bad, lost weight during the last week. During examination the abdomen is swollen, tense. While palpation the child reacts with weeping, remains in enforced position with constantly adducted legs. Vomiting with gastric contents for weveral times. Specify the method of the additional examination and the possible diagnosis.
А. Plan radiography of the abdominal cavity organs. Congenital stomach stenosis.
В. Plan radiography of the abdominal cavity organs. Signs of intestinal obstruction.
С. Plan radiography of the abdominal cavity organs. Free gas in abdominal cavity.
Examined and Approved at Interdepartmental Meeting
Protocol № 9 from 30.04.14
Head of Surgery Department with Pediatric
Surgery and Urology Course Prof. Leonov V.V.
MINISTRY OF EDUCATION AND SCIENCE OF UKRAINE
SUMY STATE UNIVERSITY
MEDICAL INSTITUTE
Discipline “Confirmed”
“Surgery with Pediatric Surgery” The Head of Medical Sumy State University
Practical skills «___» ______________ V.A. Smiyanov
BLOCK 6. “Interpretation of roentgenograms” Task 21
The patient (female, age 83) consulted the doctor in an admission room. Complains about absence of stool, abdominal swelling, paroxysmal pain and vomiting, which brings no release. During examination the abdomen is enlarged, tense. Positive Sklyarov’s symptom. Which additional examination method was used by the doctor? Interpret the result.
А. Plan radiography of the abdominal cavity organs. Ileus.
В. Plan radiography of the abdominal cavity organs. Pneumoperitoneum.
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