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krok-2-English-2007-2017-PHTHYSIOLOGY- /COMPLETE SOLUTION RATED A

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A patient suffering from infiltrative pulmonary tuberculosis was prescribed streptomycin, rifampicin, isoniazid, pyrazinamide, vitamin C. One month after the beginning of the treatment the patient started complaining of reduced hearing and tinnitus. What drug has such a side effect? 2) krok 2017 DISCIPLINE PHTHISIOLOGY TOPIC: Tuberculous meningitis. Pathogenesis, pathomorphology, clinical course, diagnostics, differential diagnostics. A 20-year-old patient complains of severe headache, double vision, weakness, fever, irritability. Objectively: body temperature is 38,1oC , the patient is reluctant to contact, sensitive to stimuli. There are ptosis of the left eyelid, exotropia, anisocoria S>D, pronounced meningeal syndrome. On lumbar puncture the cerebrospinal fluid flowed out under a pressure of 300 mm Hg, the fluid is clear, slightly opalescent. 24 hours later there appeared fibrin film. Protein - 1,4 g/l, lymphocytes - 600/3 per mm3, sugar - 0,3 mmol/l. What is the provisional diagnosis? 3) krok 2017 DISCIPLINE PHTHISIOLOGY TOPIC: Disseminated tuberculosis of the lung. Miliary tuberculosis. Pathogenesis, pathomorphology, clinical course, diagnostics, differential diagnostics. A 42-year-old woman working at a poultry farm complains of dyspnea, thoracic pain on the left, increased body temperature up to 38-39oC in the evening, and cough. The patient suffers from essential hypertension. Objectively: vesicular respiration in the lungs, vesicular resonance without alterations. X-ray of both lungs reveals numerous small low-intensity foci, 2-3 mm in size, located in a row along the blood vessels. ESR- 32 mm/hour. What is the most likely diagnosis? 4) krok 2017 DISCIPLINE PHTHISIOLOGY TOPIC: Tuberculous meningitis. Pathogenesis, pathomorphology, clinical course, diagnostics, differential diagnostics. A 43-year-old man, who has been abusing alcohol and suffering from pulmonary tuberculosis, in the course of two weeks gradually developed general weakness, headache, diplopia, vomiting. Objectively: ptosis on the left, anisocoria S>D, exotropia of the left eye, neck stiffness; Kernig’s and Brudzinski’s signs are positive. In cerebrospinal fluid: lymphocytic pleocytosis, low glucose, precipitation of cerebrospinal fluid resulted in production of fibrin film. What is the most likely diagnosis? 5) krok 2016 DISCIPLINE PHTHISIOLOGY TOPIC: Extrapulmonary tuberculosis: tuberculosis of skeletal system. A 48-year-old woman complains of pain in the thoracic spine, sensitivity disorder in the lower body, disrupted motor function of the lower limbs, body temperature rise up to 37, 5oC . She has been suffering from this condition for 3 years. Treatment by various specialists was ineffective. X-ray reveals destruction of adjacent surfaces of the VIII and IX vertebral bodies. In the right paravertebral area at the level of lesion there is an additional soft tissue shadow. What diagnosis is most likely?

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