Эталоны ответов

2-й вариант

1
1. - Prednisolonum 60-120 mg intravenously infusion
- Suprastinum 2 % - 1 ml intramuscularly
- Lasixum 1 %-2,0 in 10 mls of an isoosmotic solution of Sodium chloridum injected slowly
intravenously
- enterosorbents
2
1. Hospitalisation in intensive care ward of infections diseases department. Intensive detoxification
therapy (saline solutions, rheopoliglukin). For the first day Prednisolonum 60 mg. Phyto- and
enterosorbents. A short course of antibacterial therapy (ampicillin or gentamicin).

3
1. First medical assistance
Aethaperazinum repeatedly about 6 times per day, aminazine upto 1 ml 0,5 % sol. i/m, Atropinum 1
ml 0,1 % sol. subcutaneously, Cordiaminum, caffeine, phenylephine hydrochloride 1 ml 1 % sol.
i/m.
4
1. To calm the patient. Semi-sitting position. Pentaminum 5 % - 1,0 mls intravenously in 20 mls of an
isoosmotic solution, Etamsylatum 12,5 % - 2 mls subcutaneously, the gluconate of calcium 10 % -
10,0 intravenously in Sodium chloridum, Acidum aminocapronicum 5 % sol. - 100 mls is
intravenously trickling, Vicasolum 1 % р-р 2 mls intramuscularly.

5
1. Keeping of a diet in limens 5 tables. Exception of alcohol; restriction of protein in nutrition (till 20-
40 g per day); antibacterial therapy (for example, kanamycin); parenteral power supply (glucose,
seralbumin); correction of acid-base balance, electrolytic infringements; diuretic drugs (Lasixum,
Spironolactonum), vitamin therapy (Acidum ascorbinicum, Riboflavinum, Acidum folicum),
efferent therapy (Dufalac, sorbents), hepatoptotectiv (for example, Heptral).

6
1. The expedited hospitalisation in resuscitation department is shown to the patient. On pre-admission a
stage is shown the purpose inhalation 2 agonists of short action everyone 20 minutes for one hour
(Berotec, Salbutamol). Oxygen therapy, anticholinergic drugs, methylxanthines are administered
intravenously, on deterioration – systemic glucocorticoids. At an opportunity an intubation and
artificial ventilation mild.
7
1. Emergency treatment: anaesthesia (narcotic analgesic is intravenous – Morphinum 1 % - 2-5 mg,
neuroleptanalgesia – Fentanylum, Droperidolum or Thalamonalum), oxygentherapy – 100 %
Oxygenium with feed rate 8-15 L/min, thrombolytic therapy (Fibrinolysinum 80,000 U on 500мл
physiological solution +40,000 U of Heparinum, Streptokinase, Streptodecasum, Heparinum),
haemodynamic monitoring (catheterisation of central vein with the purpose of monitoring the
pressure in right chamber of heart and pulmonary artery). Downstroke of peripheral vascular
resistance – peripheral vasodilators (30 mg of Sodium nitroprussidum dissolved in 400 mls of an
isoosmotic solution of Sodium chloridum and introduce). Myocardial contractile is increased with
Dopaminum – 5 g/ kilogram /min infusion.
8
1. Spasmolytic and analgetic therapy for intramusc. and subcutaneous injections (no-spanum,
atropinum, platyphyllinum, promrdolum); if after this therapy bad response – such medicine must
 use for intraveneous injections with 0,9% - 100,0 ml NaCl or 5% - 200,0 ml glucose. After treatment
of acute symptoms of billiary colic - surgery consultation for the operation.

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1. Patient must lay down with high head bad margin (30o).
- Good conduction of respiratory tract , oxygentherapy (2-4 L/min).
- measuring of ECG, must be the moderate hypertention (160-180/90 – 100 mm Hg), for the
decreasing of BP – Labetalolum on 20 mg befor 10 min. (150-300 mg) or Clofellinum 0.01% - 1ml
with sol. NaCl 0,9% - 10,0 ml intraveneous slouly.
- treatment of brain edema – sol. Mannitolum 10% - 200 ml intraveneous every 6 hours,
suprastinum2,0 ml, diclofenac – 3,0 ml.
- treatment of hypertermy – paracetamolum 500 mg, cold on the region of carotis arteries, inguinal
regions.
- urinary retantion – catheterization of bladder.
- hemostatic therapy – sol. Dicinonum 12,5% - 4,0 ml; 5% 100,0 acidum aminocapronicum 4 times
per day.
- hospitalisation to neurosurgery hospital for operation.

10
1. Using shot acting insylin 10 – 20 U in/muscular, then 6-10 intraveneous in dropper with control of
glucose in blood. If during 2 hours from the begining of insulinotherapy the level of glucose isn`t
decreased, the dose of insulin must increased on 12 U in hour. When the level of glucose is
decreased on 9,9 mmol/L the dosage of insulin must decreased on 2-4 U in hour.
- regidratation: intravenous sol. Ringer, sol. NaCl 0,9% near 4 – 6 L;
- correction of acidosis: NaCO3 2,5% - 200,0-400,0 ml (pH 7,0);
- symptomatic therapy: antibiotics, acidum ascorbinicum, mesatonum, prednisolon 60 mg.

11
1. Emergency measures: steroides in/v (prednisolon 60-90-120mg every 3-4 houres), transfusion
therapy (sol. Ringer, 5% glucose, reosorbilact), bronchodilatators – sol. Theophylline – 2,4% - 5-6
mg /kg of weight; oxygentherapy, mucolytics.

12
1. Emergency measures: patient must sit down, sedative therapy: morphin 1% - 1,0 ml in/v or sol.
Droperidoli 1% - 5,0); diuretics – lasix – 40-60-80 mg; oxygentherapy; lung ventilation, inhalation
of oxygen with spiritus or intravenes spiritus 96% 10-20 ml with 15 ml sol. Glucose 5%, prednisolon
60 mg when the BP was decreased.
13
1. Emergency measures: transfusion therapy- Reosorbilact 10% - 500,0 intravenes; anabolic steroides –
Retabolil 5% - 1,0 intramuscular 1 time in 2 weeks; diuretics – Lasix – 1% - 2,0-4,0 intravenes,
enterosorbtion, desintoxicating therapy; chronic hemodialisis, renal transplantation.

14
1. First aid: Drainage of pleura cavity with aspiration of air for Bilau in VIII - IX intercostal spaceon a
back armpit line (2-5 days). Delete a drainpipe through days after the complete straightening of lung.
15
1. First aid:
Antispasmodic therapy (2% - 2 ml papaveryni gydrochlorydi or 2% - a 2 ml solution of No-shpa or
0,2% - 1ml platyphyllyni gydrotartratis, meteospasmyn);
Treatment of basic disease:
Valuable, fractional feed with the enough body of vegetable cellulose, vitamins and minerals
Sedative therapy (grasses sedative facilities: fytosed, novo-pasyt 1 tea spoon 3 times per days).
 Treatment of diarrhea syndrome: immodium 1 tablet in days; enzymes facilities (mesim-fort, creon
10000 U after food, panzynorm) fight against dysbacteriosis (bifiform, lyneks, symbiter).

16
1. The first aid must be directed to control an attack of pain syndrome and obstruction of urine flow
ways: baralgin intravenously slowly in 200 ml a 0,9% solution of sodium of chloride or glucose-
novocain mixture (glucose 5% - 100ml + novocain 0,25% - 100ml + platyphyllyn gydrotartratis 0,2%
- 2,0 + No-spa 2% - 2ml + baralgyn of 5,0 ml).
Avysan for 0,05-0,1 gr 3-4 times on pores or fytolyt for 3-4 pills 3 times per days.
Hip-bath 37–38C during 10-20 minutes or warm hot-water bottle to the place of maximal sickliness
on 15 minutes.
Drinkable mode: 2-3 litres in days (water-melons, melons, kidney grasses collections).

17
1. First aid:
At arrhythmic shock it is necessary immediately to liquidate arrhythmia (electropulse therapy or
cardio stimulating).
Conducting of commons measures:
Anaesthetizing (nitroglycerine 0,5 mg under a language, morphine 1% 2-5 mg through each 30-60
min, intravenously)
Oxygenotherapy -100% oxygen is 8-15 L/min.
Thrombolytic therapy (fibrinolizyn 80000-100000 U). Hemodynamic monitoring.
Intravenous introduction of liquid (NaCl).
18
1. To control an attack of pain syndrome, hospitalize in the heart attack department with subsequent
EKG-monitoring. First aid: morphine a 1 mg intravenously stream, nitroglycerine with 10 Mkg/min,
multiplying a dose on 5-10 Mkg/min on every 5-10-15 min, a maximal dose must exceed not 200
Mkg/min, thrombolytic therapy (streptokinase 1500000 U during a hour), anticoagulants (heparin
intravenously tiny 1000-1500 U/hour after bolus 5000-1000 U (100 U/kg)), beta-blokes (metoprolol
5 mg intravenously stream three times with an interval 5 minutes.

19
1. Urgent therapy:
for treatment use the following groups of preparations: vasodilators (isosorbit dinitrat - retard 60-120
mgs 1-2 per a day), calcium antagonists (amlodipin 5-10 mgs 1 a day), expediently application of
curantil 225 mg per day, thrombolytic drugs apply at patients with the angiography changed coronal
arteries.
20
1. Urgent therapy: per oral or sublingual's reception nyphedipyn (5-10 mgs, possibly repeatedly through
30 mines, further every 6 hours) either klonydyn (0,075-0,3 mgs) or captopryl (12,5-50 mgs) or
prazozyn (0,5-5 mgs) or labetalol (200-400 mgs) or propranolon (20-80 mgs). Dybazol 8-10 ml is
entered (0,5% or 4-5 ml a 1% solution intravenously, slowly, in breeding by NaCl – 0,9%). To
control an attack of psychoneurological excitation is carried out by the use of rausedyl (ampoules for
1 ml 0,1% or 0,25%); enter it for 1-2,5 mgs intravenously or tranquilizer of sybazon (synonyms:
relanyum, seduksen) - 0,5% - 2,0-4,0 ml.
If there is no effect it is recommended to enter klofelyn (1 ml a 0,01% solution) or benzogeksony
12,5-25 mgs (0,5-1 ml a 2,5% solution), hypodermic or intramuscular. A medical effect comes
during 10-30 mines or obzidan (5-10 mgs, slowly, intravenously, in breeding by NaCl – 0,9%).