INFLAMATIA

23 ani ,astenie fizica,indispozitie,inapetenta,greata,durere in flancul dr,stare subfebrila

Ex laborator
Vsh:30 mm/h 45 mm/2h
Leuc:12000mmc
Protein totale:7gr/100ml ser
Albumin/globuline 0.9
Haptoglobina serica 280mg/100ml
Fibrinogen 5gr/l
Diag:reactie inflamat “’probabil apendicita acuta’’

SNC
1. 25 ani.Mot intern:de 2 luni prezinta oboseala,somnolenta scadere in greutate,iar de 14 zile
hiperestezie,mialgii,fotofobie.
-tata internat ptr pleurezie T.B.C.
LCR aspect:clar (dupa repaus de 3 ore la temp camerei-val dens)
Densitate:1013
Presiune:25cmH2 O
Proteine:1,5g/l
Glucoza:0,30g/l
Cloruri:sub 6,5 g/l
Nr.elemente:250/mmc
Limfocite:90%
P.M.N.10%
Culturi ptr bacil Koch poz la 2 sapt
Diagn:meningita tuberculoasa

2. 40 ani.Motv internarii:febra ,frison,cefalee,varsaturi,hiperestezie cutanata,mialgii,fotofobie.

Clinic:semen meningiene prezente
A.P.traumatism cranian in urma cu 5 zile.
Ex.laborator:L.C.R.ASPECT PURULENT
Denisitate:1025
Presiune:25cmH2 O
Proteine 4 g/l
Pandy +++
N.A.+++
Cloruri 6,5g/l
Glicorahie 0,2g/l
Nr elemente 400/mmc
P.M.N. 90%
Limfocite 10%
Examen sange:Proteina C reactiva 150mg/l (V.N=max 10 mg/l)
Nr leucocite 12000/mmc
V.S.H:20 mm/l 45mm/2h
Diagn:meningita bacteriana
LEUCOCITAR

1.40 DE ANI
Clinic:stare gen alterata,febra,junchi thoracic,tuse neproductiva
Ex.laborator:LEUCOCITE :26000/mmc
P.M.N. nesegmentate=28%
P.M.N.segmentate=54%
Bazofile=0%
Eozinofile=0%
Limfocite=13%
Monocite=5%
Diagn:infectie bacteriana acuta(obs.pneumonie bacteriana)

2. 19 ani
Clinic:paloare,petesii,stare subfebrila,micropoliadenopatii
Ex.laborator
HB.5g%
HR.14g%
G.A.20.000/mmc
Tromb.8000/mmc
P.M.N.10%
Limfoblasti.86%
Limfocite.4%
Ex.citoenzimatic.F.A.L=+
P.A.S=+++
P.O.X=-
Frotiu de maduva:produsul de punctie este ocupat aproape in intregime de un proliferat monomorf
de limfoblasti.
Diagn:lucemie limfoblastica acuta

LIPIDIC
1. 23 ani
Clinic:xantoame tendinoase dureri retrosternale la effort
Ex.laborator:Ser la 4 c=clar
Col.total=3,54g/l
TG=0,75g/l
HDL-COL=0,57g/l
LDL-COL=2,75g/l
Electroforeza lipoproteinelor banda beta intense
Diagn:HLP tip2a esentiala

2. 66ani
Clinic:poliurie,polidipsie,polifagie,claudicatie intermitenta la membrele inferioare
Examen laborator:
Glicemie.3,8g/l
Ser la 4 grade=opalescent
Col.total=2,18g/l
Electroforeza lipoproteinelor banda prebeta intense
Diagn:1 Diabet zaharat
2 HLP tip 4 secundara
PROTEIC
1. 18 ani
Proteine totale=7g/100ml
Albumine=3,8g/100ml
Globuline=3,2g/100ml
Fibrinogen=9g/l
VSH=40mm/l h=85mm/2h
Timol=6u ML
Gros=1,2/2,3ml
Kunkel=12u ML
Diagn:disproteinemie cu hiper alfaglobulinemie si hiperfibrinogenemie

2. 25 ani
Proteine totale=4,6g/100ml
Albumine=2,3g/100ml
Globuline=2,3g/100ml(alfa beta)
Fibrinogen=8g/l
VSH=50mm/lh;90mm/2h
Timol=15uML
Gros=0,8/1,1ml
Kunkel=18u ML
Diagn:hipoproteinemie cu hipoalbuminemie si hiperfibrinogenemie.

RESPIRATOR

1. 54 ANI
Motv intern:dispnee la eforturi medii ,tuse productive de 6 ani,fumator de 20 de ani cate 10 tigari pe
zi.
Radiogarfie :intarirea desenului mediohilar si hipertransparenta pulmonara
Volume pulmonare statice
CV=2,91l(72%)
VR=5,50l(250%)
CPT=8,35l(131%)
CRF=6,25l(187%)
VR/CPT=64,7%

VEMS=1,04l
Test farmacodinamic cu aerosloli bronhodilatatori
%VEMS initial= +20%
VEMS/CV=35,2%
Diagn:disfunctie ventilatorie obstructive severa cu insuficienta resp manifestata (de repaus)
 2. femeie, 27 ani, nefumatoare
MI : dispnee progresiva, tuse productive, continua cu evolutie de 4 ani
Rx: opacitati micronodulare (miliare) numeroase, disseminate in ambele campuri pulmonare

Val pulmonare statice:

CV= 1,52 l (43%)
VR= 0,49 l (37,1%)
CPT = 2,01 l ( 42,1%)
CRF = 1,14l (43,7%)
VR/CPT = 24,4%
Debite ventilatorii : VEMS = 1,36l (44%)

Test farmacodinamic cu aerosloli bronhodilatatori

%VEMS initial= +10%
VEMS/CV=89.5%

Gaze sanguine:
PaO2 repaus = 70mmHg
PaCO2 repaus = 38mmHg
Diagn: disfunctie ventilatorie restrictiva severa , cu hipoxemie in repaus

3. 32 de ani
MI : crize de dispnee de 3 ani cu frecventa bilunara
Volume pulmonare statice:

Initial ( in tp crizei) Dupa bronhodilatatoare

CV= 3,47l (94.5%) 4.20 l (114%)
VR= 2.16 l (169%) 1.06 l (82,8%)
CPT= 5.64l (116%) 5.26l (108,7%)
VR/CPT= 38,5 20,4
Debite ventilatorii
VEMS 1,33L (41,8%) 3,36L (105,7%)
VEMS/CV 38,3% 80%
Gaze sanguine:
PaO2 repaus = 76mmHg 91mmHg
PaCO2 repaus= 36,8mmHg 38,2mmHg

Diagn: disfunctie ventilatorie obstructiva severa in criza de astm bronsic , reversibila prin
bronhodilatatie.