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Training target: using diagnostic algorithms, be able to establish a diagnosis of mumps, determine the clinical form of the disease, complications and prescribe adequate treatment.
Assignment for independent study of the topic.
Using a textbook and lecture material to acquire the necessary basic knowledge, learn the following sections for practical training:
1. Etiology, pathogenesis, clinical manifestations of mumps and its complications.
2. Clinical and laboratory diagnosis of mumps and lesions of the salivary glands of another etiology.
3. Criteria for the differential diagnosis of mumps and lesions of the salivary glands of another etiology.
4. Principles and methods of treating patients with uncomplicated and complicated forms of mumps.
Test your knowledge by answering the following questions:
- pathophysiological mechanisms of the occurrence of organ damage in mumps;
- syndromes and symptoms characterizing mumps;
- clinical and laboratory data on which the diagnosis of mumps is based;
- The most common complications of mumps;
- clinical and laboratory data showing the development of complications in a patient with mumps;
- ways to prevent the development of possible complications of mumps;
- The main methods and means of treating patients with uncomplicated and complicated forms of mumps.
The solution of situational clinical problems N ......
Materials for independent preparation for a practical lesson on the stages of diagnosis and treatment. In order to clarify the indicative basis of actions during the examination of patients with mumps, analyze the algorithms, schemes and tables located in accordance with a phased diagnostic treatment search.
The algorithm for the diagnosis of mumps.
Questions for self-control:
- The symptoms characterizing the syndrome of general infectious intoxication in patients with mumps;
- features of the temperature curve in uncomplicated and complicated forms of mumps;
- salivary glands affected by the causative agent of mumps;
- clinical differences in salivary gland inflammation in mumps of purulent mumps, from lymphadenitis;
- additional laboratory and allergological methods used to diagnose mumps.
The algorithm for determining the clinical form of mumps
Questions for self-control:
- criteria for assessing the severity of the condition (clinical form) with mumps;
- the period of the disease in which complications arise;
- the possibility of complications with a mild form of mumps;
- complications and their role in changing the degree of suitability for military service, access to flights of flight-lifting personnel, scuba diving and diving descents, who have had complicated forms of mumps.
Differential diagnosis of lesions of the parotid salivary glands
Note: in cases of edema of the subcutaneous tissue of the neck in the area of the parotid salivary glands or submandibular salivary glands, mumps must be differentiated from toxic pharyngeal diphtheria; with toxic diphtheria, the syndrome of general infectious intoxication is more pronounced, the retromandibular fossa is free from edema, regional lymphadenitis is noted, and with pharyngoscopy, swelling of the pharyngeal mucosa and fibrinous deposits with spread beyond the palatine tonsils are determined.
An algorithm for determining the complications of mumps
Note: with mumps, in addition to inflammation of the testicles and pancreas, lesions of other glands of ectodermal origin (mammary, thyroid, prostate, Bartholin's, ovaries) may develop; rare complications of mumps are labyrinthitis, auditory nerve neuritis, arthritis.
Questions for self-control:
- differential diagnostic signs that distinguish between serous meningitis caused by the mumps virus and the causative agent of tuberculosis;
- studies to help identify pancreatic inflammation in mumps;
- the nature of the temperature curve in complicated forms of mumps;
- the pathogenesis of complications in mumps.
The treatment regimen for patients with mumps
Questions for self-control:
- indications for the appointment of patients with mumps gamma globulin, antiviral drugs;
- therapeutic tactics of a doctor in acute pancreatitis;
- residual effects of mumps;
- rules for extracting convalescents after mumps; military-medical expert decision of the military-medical commission (medical-flight commission) in relation to patients with mumps (uncomplicated and complicated course).
Tasks for self-monitoring in the clinical evaluation of laboratory tests
Evaluate a general clinical study of the cerebrospinal fluid of a patient with mumps complicated by serous meningitis:
color and transparency colorless, transparent
pressure 300 mm aq
cytosis 450 cells in 1 μl
neutrophil cytogram - 46%
lymphocytes - 54%
protein 0.99 g / l
Pandy reaction +
Nonne-Apelt reaction +
sugar 2.9 mmol / l (in blood - 5.6 mmol / l)
chlorides 117 mmol / l
no fibrin film
microflora of sediment -
Evaluate the activity of amylase in the blood and urine of a patient with mumps: in the blood (Caraway method) - 150 mg / (s l); in the urine - 630 mg / h ml.
Prescribe recipes: furatsillina solution for rinsing the mouth, contracal for intravenous administration, analginum inside.
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Mumps (mumps) - refers to acute contagious viral diseases, characterized by fever, general intoxication, an increase and soreness of the salivary glands, mainly the parotid. Etiology. The virus causative agent of mumps infection is unstable, is inactivated by heating (at a temperature of 70 ° C for 10 min), ultraviolet radiation, exposure to formalin solutions
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