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The task 11 Patient Z., 32 years old, plumber, entered the hospital with complaints of a sharp General weakness, post. aching pain in the right hypochondrium, icteric staining of the skin and sclera, dark unine and discolored feces, loss of appetite, nausea, pruritus. Sick for about two years. For no reason appeared icteric staining of the skin and eyes, darkened urine, discolored feces. Within a month he was treated at the clinic of infectious diseases in acute viral hepatitis. In the next 1.5 years was on a diet, refrain from drinking alcoholic beverages, feel a satisfactory, though he felt ar heaviness in the right hypochon drium, sometimes nausea. The deterioration is connected with violation of the food and alcohol. Gradually increasing the symptoms listed above, what was the reason for hospitalization. The examination found: yellowniess.of skin and sclera, spider neavy on the face, neck, chest and back, "liver" palm. The liver is palpated bellow a costaf arch for 4 sm, derse, the surfaceis smooth, edge sharp, the spleen is palpated bellow the costal arch for 3 cm, dense, painless. Laboratory researdh: Total Bilirubin 254 µmol1 (unconjugated - 115 mmol1, conjugated – 139 mmol1), total protein 52g1 (N 60-90 g1), albumin 25% (N 35-55%), globulins 48 % ( 15-30%), thymol test of 9.8 units (normally – 5 units), transaminases: aspartic acid 300 mmollhour (N 0-35 mmollhour), alaninova 570 mmol lhour (N 0-45 mmol1hour The task: 1. Formulate and justify a presumptive diagnosis. List the main syndromes 2. What more research is needed. 3. List the possible complications. 4. What type of jaundice is characteristic for this disease? Describe its laboratory features.

Английский язык

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dmitrievanata83538

ответ

- Hi, Andrew. How are you doing?

- Hi, Anthony. That's all right. We haven't seen each other for ages!

- Yes, I'm very glad to see you. Did you have a good summer?

- That was really great. I went to Ireland with my family.

- Yes, that's great! You must have really liked it there.

- Yeah, I had a good summer. Next time we plan to spend it in the same way.

- In Ireland? 

- Oh, no. My elder brother Daniel has long wanted to visit the Netherlands.

- You know, I was there last year. Elizabeth and I loved it very much.

- I suppose it'll be interesting for us, too!

- Well, so long.

- See you. Good luck.

Объяснение:

- Привет, Эндрю. Как ты?

- Привет, Энтони. Всё в порядке. Мы не видели друг друга целую вечность!

- Да, я очень рад тебя видеть. Хорошо провел лето?

- Знаешь, действительно здорово. Я ездил в Ирландию с семьей.

- Да, это здорово! Должно быть, тебе там очень понравилось.

- У меня действительно было хорошее лето. В следующий раз мы планируем провести его таким же образом.

- В Ирландии? 

- О, нет. Мой старший брат Даниил давно хотел посетить Нидерланды.

- Знаешь, я был там в году. Элизабет и мне очень там понравилось.

- Я полагаю, эта страна будет интересна и для нас тоже!

- Ну, пока.

- Увидимся. Удачи!

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The task 11 Patient Z., 32 years old, plumber, entered the hospital with complaints of a sharp General weakness, post. aching pain in the right hypochondrium, icteric staining of the skin and sclera, dark unine and discolored feces, loss of appetite, nausea, pruritus. Sick for about two years. For no reason appeared icteric staining of the skin and eyes, darkened urine, discolored feces. Within a month he was treated at the clinic of infectious diseases in acute viral hepatitis. In the next 1.5 years was on a diet, refrain from drinking alcoholic beverages, feel a satisfactory, though he felt ar heaviness in the right hypochon drium, sometimes nausea. The deterioration is connected with violation of the food and alcohol. Gradually increasing the symptoms listed above, what was the reason for hospitalization. The examination found: yellowniess.of skin and sclera, spider neavy on the face, neck, chest and back, "liver" palm. The liver is palpated bellow a costaf arch for 4 sm, derse, the surfaceis smooth, edge sharp, the spleen is palpated bellow the costal arch for 3 cm, dense, painless. Laboratory researdh: Total Bilirubin 254 µmol1 (unconjugated - 115 mmol1, conjugated – 139 mmol1), total protein 52g1 (N 60-90 g1), albumin 25% (N 35-55%), globulins 48 % ( 15-30%), thymol test of 9.8 units (normally – 5 units), transaminases: aspartic acid 300 mmollhour (N 0-35 mmollhour), alaninova 570 mmol lhour (N 0-45 mmol1hour The task: 1. Formulate and justify a presumptive diagnosis. List the main syndromes 2. What more research is needed. 3. List the possible complications. 4. What type of jaundice is characteristic for this disease? Describe its laboratory features.
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