#1
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ÊÐÎÌÅ ýíäîêðèíîëîãîâ
Âîïðîñû äëÿ âñåõ êîëëåã, ÊÐÎÌÅ ýíäîêðèíîëîãîâ!!!Ýíäîêðèíîëîãîâ ïîïðîøó íå ïîäñêàçûâàòü.
(Ìû òàê óâëåêëèñü áåñåäàìè "çà æèçíü".....Äàâàéòå, ëó÷øå òåñòû ïîðåøàåì...) Èòàê: 1. Ðåçóëüòàò àíàëèçà ó 4-õäíåâíîãî íîâîðîæäåííîãî (ñêðèíèãîâàÿ ïðîãðàììà) ïîêàçàë íèçêèé óðîâåíü Ò4 â ñûâîðîòêå (< 90 nm/L) è âûñîêèé óðîâåíü TSH ( > 100mU/L) Ðåçóëüòàòû äàëüíåéøåãî îáñëåäîâàíèÿ - íîðìàëüíûé óðîâåíü TBG, îòñóòñòâèå TSH receptor-binding àíòèòåë. Íàèáîëåå âåðîÿòíûé äèàãíîç ó ýòîãî ìëàäåíöà: - À. Ñåìåéíûé äåôèöèò TRH (Familiar deficiency of TRH). - B. Ñèíäðîì íèçêîãî Ò3 íåäîíîøåííûõ (Low T3 syndrom of prematurity). - C. Thyroid disgenesis. - D. Transient hypothyroxinemia of prematurity. - E. Transient primary hypothyroidism of prematurity. 2. Ó äîíîøåííîãî íîâîðîæäåííîãî ñ Congenital hypothyroidism íàèáîëåå ÷àñòûì ïåðâûì ñèìïòîìîì áóäåò: - À. Áðàäèêàðäèÿ. - Â. Çàïîðû. - Ñ. Diastasis recti è ïóïî÷íàÿ ãðûæà. - Ä. Ìûøå÷íàÿ ãèïîòîíèÿ. - Å. Ïðîëîíãèðîâàííàÿ æåëòóõà (prolonged jaundice). 3. Íàèáîëåå ÷àñòàÿ ïðè÷èíà ïðèîáðåòåííîãî ãèïîòèðîèäèçìà ó äåòåé - À. Àóòîèìóííûé òèðåîèäèò. - Â. Îòñðî÷åííàÿ ïåðâàÿ ïðåçåíòàöèÿ thyroid disgenesis - C.Endemic thyroid deficiency. - D.Progressive TSH deficiency. - E. Thyroid hormone resistance. 4. Íàèáîëåå çíà÷èìûé ïðèçíàê (ñèìïòîì) ãèïîòèðåîèäèçìà ó äåòåé - À. Çàìåäëåííîå ðàçâèòèå çóáîâ. - Â. Îòñòàâàíèå â ðîñòå (Growth failure). - Ñ. Ìûøå÷íàÿ ãèïîòîíèÿ. - D. Progressive developmental regression. - E. Sexual immaturity. 5. Òî, ÷òî ãîðìîíàëüíàÿ êîððåêöèÿ ïðîâîäèòñÿ ïðàâèëüíî, îöåíèâàåòñÿ ëó÷øå âñåãî ïî - À. Äîñòèæåíèå íîðìàëüíîãî ñêåëåòíîãî âîçðàñòà. - Â. Íîðìàëèçàöèÿ óðîâíåé TSH è Ò4 â ñûâîðîòêå. - Ñ. Âîçâðàò ê íîðìàëüíîìó èíòåëëåêòóàëüíîìó óðîâíþ. - D. Âîçâðàò ê íîðìå ìåòàáîëè÷åñêèõ ïîêàçàòåëåé.  êàæäîì âîïðîñå òîëüêî îäèí îòâåò ïðàâèëüíûé. |
#2
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À ýíäîêðèíîëîãàì-òî èíòåðåñíåé âñåõ! Íó åù¸ ïåäèàòðàì.
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#3
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À âû, äîðîãèå ýíäîêðèíîëîãè, ïîòîì âûëîæèòå ñâîè ïðàâèëüíûå îòâåòû.
À ïîêà ïóñòü íå-ýíäîêðèíîëîãè ïîäóìàþò. Ýòî âåäü íå èç ñáîðíèêà òåñòîâ ïî ýíäîêðèíîëîãèè, à èç ñáîðíèêà òåñòîâ äëÿ ñåìåéíîãî âðà÷à. Ò.å. îòâåòû íà ýòè âîïðîñû - èç ñåðèè "ýòî äîëæåí çíàòü êàæäûé" (âðà÷). |
#4
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Ñëîæíî. Íî ëþáîïûòíî.
1.Å 2.Â, íàâåðíîå. 3.Íå çíàþ. Íàóãàä - Å 4.Åñëè ïåðâûå ïðîÿâëåíèÿ â ñòàðøåì âîçðàñòå -  5. Íó âîò, ìîæíî áðîñàòüñÿ ïîìèäîðàìè |
#5
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1. ïî-ìîåìó, Ñ
2. îïÿòü íåíàâèñòíûé âûáîð "íàèáîëåå ïðàâèëüíîãî îòâåòà".... Ñàìûå ðàííèå ïðèçíàêè: - À. Áðàäèêàðäèÿ. - Ä. Ìûøå÷íàÿ ãèïîòîíèÿ. - Ñ. Diastasis recti è ïóïî÷íàÿ ãðûæà. Îê, îñòàíîâèìñÿ íà áðàäèêàðäèè, ñêðåïÿ ñåðäöå. Îòâåò: A. 3. Äóìàþ, ÷òî Â, ïîòîìó ÷òî, åñëè ñìîòðåòü ñòàòèñòèêó, ïîëàãàþ, ÷òî ó ìíîãèõ äåòåé âðîæäåííûé ãèïîòèðåîç ïðîñòî íå äèàãíîñòèðóåòñÿ, à "âñïëûâàåò" ïîòîì, ñëó÷àéíîé íàõîäêîé. 4. Îïïÿÿÿÿòü.... Èðà, ÷òî çíà÷èò "çíà÷èìûé"? Çíà÷èìûé äëÿ êîãî? Äëÿ ðåáåíêà èëè äëÿ äèàãíîñòà? Îòâåò D (Ä) 5. B |
#6
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Öèòàòà:
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#7
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Îòâåòû:
1. - C 2. - E 3. - A 4. - D 5. - B Ýíäîêðèíîëîãè, ÿ ïðàâà? Â ýòîì ñáîðíèêå íåò íàïèñàííûõ îòâåòîâ. |
#8
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Èðà, ÿ ñîãëàñíà ñ Âàøèìè îòâåòàìè. Ìîãó òîëüêî äîáàâèòü ïî ïóíêòó 2, ÷òî âàðèàíòû D è Ñ òîæå õàðàêòåðíû, íî, ïî ëèòåðàòóðíûì äàííûì, çàòÿíóâøàÿñÿ æåëòóõà, äåéñòâèòåëüíî áûâàåò ÷àùå äðóãèõ ñ-ìîâ.
ß æ íå ïåäèàòð, íå ñòàëêèâàþñü ÿ ñî âñåì ýòèì íà ïðàêòèêå... |
#9
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À ïî ïåðâîìó ïóíêòó - ãäå íàïèñàíî, ÷òî ìëàäåíåö íåäîíîøåííûé?
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#10
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Öèòàòà:
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#11
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Öèòàòà:
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