Реактивная депрессия, антидепрессанты

*психомоторлық қозу; антидепрессанттар, нейролептиктер

*+ажитацияланған депрессия; транквилизаторлар, стимулдеуші антидепрессанттар

* сандырақтық-галлюцинаторлық қозу; антидепрессанттар,транквилизаторлар

*гебефрениялық қозу; антидепрессанттар, нейролептиктер

* ажитацияланған депрессия; транквилизаторлар, седативті антидепрессанттар

 

 

#17

*! Female, 35 years old, complains of fear of contracting viral hepatitis. For 2 years she has been obsessed with constantly controlling the cleanliness of both the room and her hands. Frequently washes her hands, wipes them with alcohol, does not open doors without gloves. Has become indecisive, sluggish, and spends a lot of time on the ritual of cleaning her hands. Understands the futility of the rituals performed, considers them a symbolic attempt to prevent danger. What treatment is indicated for this patient?РАЦИОНАЛЬНАЯ ПСИХОТЕРАПИЯ,НЕЙРОЛЕПТИКИ, АНТИДЕПРЕСС

*гипнотерапия, антидепрессанттар.

* нейролептиктер, транквилизаторлар, 

*+рациональды психотерапия, нейролептиктер, антидепрессанттар

*рациональді психотерапия, треанквилизаторлар, антидепрессанттар

*суггестивті психотерапия, нейролептиктер, транквилизаторлар

 

#18

*! Patient, 45 years old; previously treated twice in a psychotherapy department.

At an appointment with a local doctor, said that for two years she had been bothered by constant anxiety, sleep disturbance, shallow sleep, "waking up terrified, then I cannot sleep, experiencing anxiety, palpitations, heart pain", "panic attacks at night", Seems depressed, low mood. Talks about how she can hardly relax and is constantly stressed.

Which of the following is the most likely diagnosis? СМЕШАННАЯ,,,,, И ДЕПРЕССИВНЫЕ РАССТРОЙСТВА

* + Аралас үрейлі және депрессивті бұзылыс (F41.2)

* Органикалық эмоциональді лабильділік (F06.6),

* Жеңл депрессивті эпизод (F32.0),

* Адаптацияның бұзылысы (F43.2)

* Көңіл күйдің органикалық бұзылысы (аффективті) (F06.3)

 

#19

*! A 17-year-old female patient accompanied by her mother came to the clinic with complaints of weakness, fatigue, depressed mood, anxiety, fear, mood swings, sleep disturbances. From her words, for the first time fear and panic attacks began to occur at the age of 16 and passed within an hour on their own, or with the help of breathing exercises, she did not connect their occurrence with anything. At the age of 17 during her study at the institute of higher education she had debts in the subject and against this background her anxiety increased, her mood lowered, "I could not see anything good, there was a constant tension...". However after successfully passing the course, the lowered mood, anxiety, poor sleep persisted for 3 months, in connection with which she applied to the local psychiatrist and was referred for hospitalization.

Which of the following diagnoses is the most probable? СМЕШАННАЯ,,,,, И ДЕПРЕССИВНЫЕ РАССТРОЙСТВА

* Жеңіл депрессивті эпизод (F32.0)

* Органикалық эмоциональді –лабильді бұзылыс (F06.6),

* Адаптация бұзылыстар (F43.2)

* Реккурентті депрессивті бұзылыстар, жеіл депрессивті эпизод (F33.0),

*+ Аралас үрейлі және депрессивті бұзылыс (F41.2)

 

#20

*! Patient 70 years old; comes to the outpatient clinic with fatigue, sleep disturbance, weakness, tearfulness, headaches, tinnitus, anxiety, rushes of thoughts. From life history: seen by a general practitioner, cardiologist, neurologist with diagnoses: CHD, postinfarction cardiosclerosis. Arterial hypertension 3 risk 4. Vascular encephalopathy, grade 2. Osteoarthritis of knee joints, NPS, grade 1 and 2. Osteochondrosis of the spine. She underwent surgery for a fracture of the femoral neck and artificial knee joints. Mental status, in the foreground, mild mnestic disturbances in the form of memory loss, exhaustion and distraction of attention, affective swings towards irritability.

Which of the following diagnoses is most likely? ОРГАНИЧЕСКАЯ ЭМОЦИОНАЛЬНО ЛАБИЛЬНОЕ РАССТРОЙСТВО

* Аралас үрейлі және депрессивті бұзылыс (F41.2)

* + Органикалық эмоциональді –лабильді бұзылыс (F06.6),

* Жеңіл депрессивті бұзылыс (F32.0),

* Адаптация бұзылыстары (F43.2)

* Көңіл күйдің органикалық бұзылыстары (аффективті) (F06.3)??????

 

#21

*! Patient, 28 years old. First consulted a local psychiatrist with complaints of bad mood, tearfulness, fatigue. During the visit: Consciousness is clear, available for contact. Sitting in a bent posture, shrinking. Her face expression was joyless, with the color of suffering and dissatisfaction. She answered willingly, in terms of what was being asked. She told that she had been ill for 2 months after getting a new house: "I told my husband many times that I wanted to live separately from his mother, now we have moved to a new house, we furnished it... we chose the house for a long time, found the one we dreamed of... I do not know what is wrong with me... Mood is absent during the conversation, she feels guilty: "As if I let everybody down, my husband's birthday is coming up, but I am not in the mood...". In the course of the conversation, she perks up and is emotionally sanguine. She actively searches for help, there is criticism of her condition.

What is your tactics as GP, according to the Standards of psychiatric care in the RK? СИОЗС И ПСИХОТЕРАПИЯ

*+ СИОЗС; психотерапия

*Нормотимик; психотерапия

*Нейролептик; психотерапия

*Транквилизатор; психотерапия

*Ноотропы; психотерапия

 

#22

*! Patient, 56 years old; Premorbid with asthenic personality traits.

For two years she has been actively complaining of headaches, gets tired quickly, does almost nothing at home, citing her state of health. Irritability and tearfulness not noticed before appeared. Does not seem interested in conversation, answers in muffled voice, expresses displeasure on face, asks to prescribe medications for headaches. Her attention is distracted. Says she has become forgetful. She plays 6 out of 10 words in 5 minutes. Intellect corresponds to her age. Anamnesis includes arterial hypertension, CHT without loss of consciousness. 

Which of the following diagnoses and medication therapy is NEARLY adequate?

* Аралас үрейлі депрессивті бұзылыстар (F41.2); антидепрессанттар и транквилизаторлар.

*+ Органикалық эмоциональді лабильді (астениялық) бұзылыстар (F06.6); ноотроптар, қантамырлық препараттар, витаминотерапия, кіші нейролептик.

* Жеңіл депрессивті бұзылыс (F32.0); антидепрессанттар, нормотимиктер.

* Адаптация бұзылыстары (F43.2); антидепрессанттар, психотерапия.

*көңіл күйдің органикалық бұзылыстары (аффективті) (F06.3); ноотроптар, антидепрессанттар

 

#23

*! A 6-year-old child, at an appointment with a GP, parents complained that the child had difficulties in mastering the school curriculum from the first days: insufficient development of handwriting and drawing skills, cannot solve arithmetic problems. Assimilation of the educational material not at the expense of understanding, but as a result of mechanical remembering. Mastered letter-by-letter reading, can write his name, last name and age. Uses simple phrases for communication. Vocabulary is limited. Attention is distracted, distracted by the slightest sounds and movements during conversation. The background of the mood is elevated. Parents describe him as suggestible and susceptible to bad influences. 

Which of the following is most likely consistent with this case?

ЛЕГКАЯ УМСТЕННАЯ ОТСТАЛОСТЬ -ОЛИГОФРЕНИЯ

* Рецептивті сөйлеу бұзылысы

* Экспрессивті сөйлеу бұзылысы

* Эпилепсияда жүре пайда болған афазия

*. Оқудың арнайы бұзылыстары

* +Жеңіл дәрежедегі ақыл-естің кемдігі

 

#24

*! The 5-year-old boy has outwardly no need for contact with others, indifference to loved ones, an inability to differentiate between people and inanimate objects, insufficient reactions to visual and auditory stimuli, which gives him a resemblance to the blind and deaf. He reacted to the visit to the doctor by screaming and protesting to come into the office. At the appointment, after some time, stereotypic hand pronation-supination movements appeared.

Which of the following is the most likely disorder in this case?

ДЕТСКИЙ АУТИЗМ

*. Ақыл естің кемдігімен атипиялық мутизм

* Ақыл естің кемдігінсіз атипиялық мутизм

* Шизотипиялық бұзылыстар 

* Аспергер аутизмі

*+Балалар аутизмі

 

#25

*! Patient B, 7 years old, is in the first grade; his parents complained about a speech impairment in which the child understands the meaning and significance of the words he hears, can read written words, is able to write them, but cannot pronounce them. In response to a question, he or she most often nods and makes a gesture to show that he or she cannot say anything, or when pronouncing individual words, has difficulty naming objects or actions correctly.

 Which of the following disorders is the most likely in this case?

МОТОРНАЯ АФАЗИЯ

* моторлық алалия

* сенсорлық алалия

*элективті мутизм

*+ моторлы афазия

*сенсорлы афазия

 

#26

*! The 7-year-old boy is prone to affective outbursts and aggressive behavior, grossly frustrated attention (up to aproachesy), peculiar "clinginess" of attachment. On examination, irritable, capricious, easily excitable on the slightest occasion. He often has affective outbursts without any visible external influences, can be accompanied by both aggression and autoaggression, destructive actions.

Which form of mental retardation, according to the clinical-physiological classification, most likely fits this description?

ДИСФОРИЧЕСКАЯ ФОРМА

* атониялық

* апатикалық

* стеникалық 

* астеникалық

*+Дисфориялық 

 

#27

*! Patient A, 6 years old, is in Grade 0. Parents complained about speech and behavior disorders, he is not assertive during classes, can throw all the items on the floor and cry. Anamnesis of one pregnancy, one term delivery, weight 3100 and Apgar score of 5. Obstetric history is aggravated (in the second trimester, the mother had an acute respiratory infection, asphyxia for 5 minutes). Communication with the child revealed speech disorders in the form of dyslalia. Examination revealed pathology of the tongue in the form of a short frenulum and malocclusion. What is your further medical tactics as a GP?

*Логопед, невролог кеңесі

*Психиатр, невролог кеңесі

* +психиатр, психолог, логопед,невролог кеңесі

 *психолог, логопед, невролог кеңесі

* логопед, психолог кеңесі

 

#28

*! An 8-year-old child with his parents has an appointment at the GP's office. Externally, stigmata of dysontogenesis are detected: low ears

 The child was born at 7 months of age and had a high "gothic palate", mild convergent strabismus. He was born at seven months. Weight 2600g. Labor activity was suspended due to prolonged waterless period. Cried after spanking. First words came at the age of 3, phrasal speech at the age of 4.5. At the age of 2 1/2, we had a convulsive attack with high temperature. In kindergarten, he couldn't memorize verses, couldn't distinguish colors for a long time, confused finger counting, was mocked by children, was unkempt, couldn't eat his own food. He went to school at 7, for a long time he could not master counting within 20, was counting on his fingers and "didn't see a line" when writing. He was transferred to a program for children with mental and speech development delays. At age 8, he was able to do syllabic reading, mathematical counting and operations on visual material only. Generally accessible to contact, follows instructions, responds vividly to encouragement. Hygiene skills are inoculated. Referred for psychological, medical and pedagogical commission.

Which of the following options is the most appropriate for this case?

В ШКОЛБНЫХ УСЛОВИЯХ УЧИТЬ ПО ДОПОЛНИЕТЛЬНОЙ ПРОГРАММЕ

*Жеке тәсілмен, дамудың артта қалу бағдарламасымен оқыту. 

*+ Мектеп жағдайында қосымша бағдарламамен оқыту. 

* Қосымша бағдарламамен үйде оқыту

* Жалпы бағдарламамен үйде оқыту

* Жалпы бағдарламамен мектепте оқыту

 

#29

*! The boy is 9 years old. In the early development without any peculiarities. At preschool age, mental retardation was noticed. He started going to school at age 6, duplicated twice in the second grade of a regular school, by PMPK decision he was transferred to an auxiliary education program where he copes with his studies. He reads with the syllables, counts up to 100, but cannot solve the task of the 2nd grade program. He does not understand the figurative meaning of proverbs. She is brought up at home under the conditions of hyperopedic care.

Which of the following disorders does this case REALLY correspond to?

ПЕДАГОГИКАЛЫК САЛГЫРТТЫК НАТИЖЕСЫНДЕГИ

*Имбецильдік сатысындағы олигофрения 

*балалар шизофрениясы

*+Педагогикалық салғырттық нәтежиесіндегі психикалық дамудың тежелуі.

*ОЖЖ-нің органикалық зақымдануындағы интеллектуальды жетіспеушілік 

*Дебильдік сатысындағы олигофрения

 

#30

*! A 5-year-old girl consulted a GP and her parents complained that the girl suddenly stopped talking to her parents, first went to kindergarten a week ago, communicated with her grandmother and tutor in their absence. From the anamnesis, earlier development without any peculiarities. When examined by the doctor, the girl is able to comply with requests, commands, nodding her head to express agreement or denial.

Which of the following disorders does this case most likely correspond to?

ЭЛЕКТИВНЫЙ МУТИЗМ

* моторлық алалия

* сенсорлық алалия

* + элективті мутизм

* моторлық афазия

* сенсорлық афазия

 

#31   

*! A 25-year-old patient, a driver, consulted his local therapist complaining of episodes of choking with difficult exhalation, cough with sputum difficult to detach almost daily. Choking episodes occur 2-3 times a week, more often at night, and disappear spontaneously after an hour, with the disappearance of all symptoms. Slight dyspnea on physical exertion. Did not take any medications. Smokes 1.5 packs a day for 3 years, up to 1 pack a day. Characterized by mental, but also physical dependence. Not sharply expressed withdrawal syndrome formed, appearing in a few hours after smoking, tolerance to nicotine grows. During withdrawal there are neurological disorders in the form of headaches, irritability, instability of mood and emotions, as well as insomnia, reduced efficiency.

Which of the following disorders is most likely consistent with this case?

ТАБАКОЗАВИСИМОСТЬ 2 СТАДИЯ

* Токсикомания

*+++ Темекі шегу 2 кезең

* Темекі шегу 1 кезең

* Ұшқыш заттар

*нейролептектер

 

#32

*! atient is 38 years old, an engineer, and has been a tobacco smoker since he was 15 years old. In the beginning smoked 1-2 cigarettes a day, for the last 3 years - at least 20 cigarettes. If he cannot smoke a cigarette, he becomes irritable, restless, has an irresistible desire to smoke, cannot work, has cough, headache, dizziness. These phenomena completely disappear after smoking a cigarette. In recent years began to get tired faster than his non-smoking peers, signs of IBS, chronic bronchitis, chronic gastritis, often more acute respiratory infections. Became less able to cope with his work, often making mistakes. Notices that it is more difficult for him to restrain his displeasure and irritation. Several times he tried to quit smoking, but with no success.

What treatment is more advisable in this case?

АНТИНИКОТИНОВАЯ ТЕРАПИЯ

* дезинтоксикациялық терапия

*+антиникотинді терапия, психотерапия,

* қан тамырлары, ноотропными

* нейролептиктер

*антидепрессанты

 

#33  

*! Teenager, 15 years old. Grew up nervous, became capricious and rude early on, gradually began to "set the tone in the family," demanding satisfaction of all desires. Skipped classes, complained that the teachers undervalued her grades. He started demanding to buy new things, and in cases of refusal, he was confrontational. The day before, he complained of a sore throat and did not go to school; in the evening, he went to the movies with friends. His mother did not allow it. In response to his mother's refusal, he rudely insulted her, tried to attack her with his fists and spat on her. He could not calm down for a long time. For the last 5 months, he was taking laxatives, diuretics, tolerating up to 30-40 pills a day.

What treatment is more advisable in this case?

ЖАЛПЫ НЫГАЙТАТЫН ДАРИЛЕР,ПСИХОТЕРАПИЯ

* дезинтоксикациялық терапия

* + жалпы нығайтатын дәрілер, психотерапия

* вазодилятаторлар, ноотроптар

*нейролептектер

*транкцилизаторлар

 

#34  

*! A 65-year-old patient consulted a physician with complaints of general weakness, headaches, noise intolerance, heart pain, dizziness, nausea, sharp muscle weakness, insomnia at night and sleepiness during the day. He also reported that sleep was often accompanied by nightmares. By the end of the conversation with the doctor, exhaustion was noticeable, attention became distracted, it was more and more difficult to understand each following question, then he refused to talk to the doctor, citing weakness.

What is the preliminary syndromal diagnosis?

АСТЕНИЧЕСКИЙ СИНДРОМ

* Депрессивті

* Ипохондриялық

* + Астениялық

* Дисморфофобиялық

*Сандырақ

 

 

#35    

*! A 42-year-old woman, at a doctor's appointment, sitting with her head down. Speaks in a low voice, answers after pauses. Her face was full of sadness and melancholy. On inquiries, she said she had been sleeping badly for a month, had had a reduced appetite, had lost weight, had unpleasant chest pains, felt depressed in the morning and had difficulty getting up, by the end of the day her condition slightly improved. Clarified that she felt guilty before the family: could not cook, clean, look after her children and husband.

Objectively: pale skin, dry tongue, BP fluctuations, tachycardia.

What is your preliminary syndromal diagnosis?

ДЕПРЕССИВНЫЙ

* +Депрессивті

 * Ипохондриялық

 * Астениялық1

 * Дисморфофобиялық

 * Маниакальды

 

 

#36

*! A 27-year-old female patient complains of intermittent pains in the heart area, poor night sleep, increased appetite, weight gain over the last 2 months, has become secluded, her favorite job has become uninteresting. Condition worse in the morning, relieved in the evening. Anamnesis - there were episodes of "moping", which passed without treatment.

What is the preliminary syndromic diagnosis?

ДЕПРЕССИВНЫЙ

* Фобиялық

*+ Депрессивті

*Ипохондриялық

*Дисморфофобиялық

*Маниакальды

 

#37

*! A 48-year-old woman consulted a physician with complaints of periodic attacks of severe headache lasting several hours, usually involving half of the head. Before the headaches, she experiences dizziness, an unpleasant odor, and lethargy.

Your preliminary diagnosis?

МИГРЕНЬ С АУРОЙ Мигрень с аурой

* Үлкен тырыспа

* Кіші тырысқақ ұстамасы

* + Мигрень

 

 

#38

*! An 18-year-old woman, who unexpectedly learned that her lover, with whom she intended to marry later, was actually married and had children, began to behave incongruously: babbling, not zipping her clothes properly, whimpering, eating with her hands, not answering questions. The most likely diagnosis:

ИСТЕРИЧЕСКИЙ ПСИХОЗ

*шизофрения

*эпилепсия

*+реактивті психоз

*ипохондриялық невроз

*психикалық аурудың белгісі жоқ.

#39

*! A 35-year-old woman has suffered from a number of psychotraumatic events over the last two years (burglary of her apartment, heart attack on her husband, conflicts at work). After that her mood gradually changed, her sleep became disturbed, she became tearful, constantly worried about the future, sometimes cannot find herself at home, calls her adult children several times a day just to find out if they are alright, has lost 10 kg in weight. During the visit she expresses thoughts about her inferiority, considers herself a bad wife and mother, since she has stopped coping with household chores. Actively seeks help, is critical of painful manifestations.

Which of the following syndromes and psychiatric disorders is most likely?

ПСИХОГЕННАЯ ДЕПРЕССИЯ,

*+Аралас үрейлі-депрессивті бұзылыс, үрейлік-депрессивтік синдром

* Оганикалық үрейлі-депрессивті бұзылыс, обсессивті-фобиялық синдром

* Оганикалық үрейлі бұзылыс, астено-невротикалық синдром

*Неврастения, астено-невротикалық синдром

* МДП, депрессивті синдром

 

#40

*! Female, 32 years old, complains of fear of contracting viral hepatitis. For 2 years she has been obsessed with constantly controlling the cleanliness of both the room and her hands. Frequently washes her hands, wipes them with alcohol, does not open doors without gloves. Has become indecisive, sluggish, and spends a lot of time on the ritual of cleaning her hands. Understands the futility of the rituals performed, considers them a symbolic attempt to prevent danger. What treatment is indicated for this patient?

РАЦИОНАЛЬНАЯ ПСИХОТЕРАПИЯ

*гипнотерапия, антидепрессанттар.

* нейролептиктер, транквилизаторлар, 

*+рациональды психотерапия, нейролептиктер, антидепрессанттар

*рациональді психотерапия, треанквилизаторлар, антидепрессанттар

*суггестивті психотерапия, нейролептиктер, транквилизаторлар

 

 

#41

*! A mother and her 3.5-year-old child went to a general practitioner. According to the mother, the child has poor appetite, sits badly, walks badly, does not ask to go to the potty, has practically no play activity, lags behind his peers in physical development. Which disorder is most characterized by these symptoms?

РАССТРОЙСТВО ПСИХОЛОГИЧЕСКОГО РАЗВИТИЯ

* Балалар шизофрениясында

* Жас нормаларына сәйкес дамыту

* + Психикалық дамудың бұзылуында

* Педагогикалық тежелу кезінде

* Депрессия

 

 

#42

*! A mother came to see her 9-year-old child. According to his mother, the boy constantly complains of abdominal pain, headache, nausea; he often refuses to go to school, has recently appeared to have nocturnal urinary incontinence, has started sucking his thumb. According to the data of objective examination and consultations of narrow specialists, no pathology was detected. What mental disorder is most likely to occur in the child?

ЭМОЦИОНАЛЬНОЕ НАРУШЕНИЕ

* естің

* + эмоциялар

* интеллектттің

* мінез-құлық

* қозғалыс-еріктің

 

 

#43

*! At an appointment with a general practitioner, a mother with a 4-year-old child. According to the mother's words, the child does not sit still, has constant tantrums. The kindergarten teachers complain that the child is excessively chatty and mobile, is inattentive in play-based activities, constantly bumps into something, tries to get into something, constantly fights with children. Which mental health disorder is most likely to occur in a child?

РАССТРОЙТСВО ПОВЕДЕНИЯ

* + мінез-құлық

* ойлау

* эмоциялар

* ерік

* сана

 

#44

*! A mother brought her 4.5-year-old child to see a general practitioner, concerned about his behavior. According to his mother, the child refuses to do what he is told, whines, quarrels with children in kindergarten, "hysterics" 2-3 times a week, but quickly recovers. Upon objective examination, his mental and physical development is within the age norm. What condition is the most typical for this child?

ВЫЗЫВАЮЩЕЕ ПОВЕДЕНИЕ

* психикалық дамудың тежелуі

* +өзіне қарататын мінез-құлық

* ақыл-ой кемістігі

* назар тапшылығы синдромы

* психопатия

 

#45

*! At an appointment with a general practitioner, a mother and her child, 10 years old. According to the mother, the child does not cope with the school program, has difficulties in communicating with his classmates, and cannot do his homework. What is your medical tactic as a GP, primarily in accordance with the mh-GAP program? ОЦЕНКА ВСЕХ ПСИХИЧЕСКИХ ФУНКЦИЙ

* психиатрға консультацияға жіберу қажет

* мектептен мінездеме сұрастыру қажет

* психотерапевтке кеңес беру

* +барлық проблемалы психикалық функцияларды бағалау қажет

* невропатолог кеңесіне жіберу

 

#46

*! A woman came in for a follow-up visit with an 8-year-old child who you identified as emotionally disturbed. What are your recommendations for further education of the child?

ОТСАВИТЬ В ПРЕЖДНЕЙ ШКОЛЕ

* үйде оқытуға көшіру

* сыныптардағы балалар саны 5 адамнан аспайтын жабық жеке мектепке ауыстыру

* баланы қосымша бағдарлама бойынша мектепке ауыстыру

* арнайы оқу орнын табу

* +бұрынғы мектепте қалдыру, бірақ буллинг жағдайын болдырмау

 

#47

*! You, a general practitioner, have parents with a 9 year old child whom you have been seeing for the last 6 months with a diagnosis: Attention deficit syndrome, in dynamics and at the time of the examination you do not see any improvement in his mental state. What is your medical course of action? ОТПРАВИТЬ НА КОНСУЛТЬАЦИЮ К ПСИХИАТРУ

* +мүмкіндігінше психиатрға консультацияға жіберіңіз

* өздігінен психотроптық препараттарды тағайындаңыз

* невропатолог кеңесіне жіберіңіз

* нейропротективті ем тағайындаңыз

* жалпы бекітетін терапияны тағайындау

 

#48

*! A grandmother came to see you with her 5-year-old grandson. According to the grandmother, the child does not communicate with anyone, speaks poorly, walks badly, does not ask to go to the potty, eats poorly on his own, there is almost no play activity, does not respond to the name. We also tried to take him to a preschool, but the child could not adapt there, and the educators suggested he go to a medical facility. What are your medical tactics as a GP in accordance with the recommendations of the mh-GAP program?

ПРОВЕРКА НА ТУГОУХОСТЬ

* психотроптық препараттарды тағайындау

* +бірінші кезекте есту қабілетінің бұзылуын болдырмау қажет

* витаминотерапия тағайындау

* нейропротективті ем тағайындау

* дефектолог-педагогқа жүгіну ұсынылсын

 

#49

*! A 13-year-old boy, accompanied by his father, came to the doctor's appointment on the recommendation of the school psychologist. The boy's father said that they did not live together, as he had been divorced for the past year, but that he communicated with the child. According to the father, they were advised to see a general practitioner since they refused to see a psychiatrist. During the interview with the school psychologist, the teenager said that he did not want to live and was thinking about killing himself. The father reports that his son has been reluctant to communicate with him lately, although he has always had a warm relationship, blames himself for his parents' divorce, as his behavior and poor academic performance caused his parents to quarrel constantly, and considers himself an unworthy person. The teenager enters into conversation reluctantly, his facial expression is sorrowful and he says he is not worth listening to at all. He speaks in a low voice, in one sentence, saying that "he is not worthy to live, that he is grey, a bad son, a bad friend, that his parents divorced because of him," and also reported that he even tried to commit suicide, but, his mother came home early and he did not have time to do everything, but, his mother did not notice. Assess this teenager's suicide risk.

РИСК ВЫСОКИЙ,ЗНАЧИТЛЕЬНЫЙ

* суицид қаупі жоқ, тек атаөанасының назарын аудару тәсілі

* + елеулі немесе төтенше тәуекел

* орташа тәуекел

* төмен немесе болмашы тәуекел

* суицид тәуекелін бағалаудың қажеті жоқ

 

#50

*! An adolescent boy, 12 years old, at a follow-up visit to a general practitioner accompanied by his mother after a diagnostic examination. At the first visit, upon careful questioning, the boy complained of a bad mood, unwillingness to play even computer games, unwillingness to do anything, unwillingness to go for a walk. His mother was concerned that his school performance had dropped, and there were frequent absences from school because the child would not go to school because he complained of headaches and stomach aches. In connection with the above, the child was thoroughly examined and consulted by narrow specialists, who found no pathology. What is the MOST characteristic illness of this adolescent?

ДЕПРЕССИЯ

* бала мүлдем сау, жай ғана мектепке барғысы келмейді

* + депрессия

* аутизм

* шизофрения

* назар жетіспеушілік синдромы

 

#51

*! There is a girl, 16 years old, accompanied by her mother, who brought her in because in the last 2 months her daughter had lost a lot of weight, refused to eat, did not sleep well, was constipated. The teenager herself says that she is unattractive, fat, ugly, and that this is why her boyfriend left her. She complained about a feeling of hopelessness, melancholy, her own worthlessness and unwillingness to live. From anamnesis you know that two months ago, she broke up with a young man, he initiated the breakup. The patient was examined by different specialists in private practice, underwent instrumental examination and no pathology was detected. And, as it is necessary to be released from the examinations, I applied to the local doctor.

What disease is most likely to occur in a teenager and what is your medical tactic?

ДЕПРЕССИЯ

* + депрессия

* бейімделудің бұзылуы

* аралас алаңдаушылық-депрессиялық бұзылулар

* соматоформды бұзылулар

* ипохондриялық бұзылулар

 

#52

*! Teenager E., 16 years old, a college student. According to her parents, for a month her mood is lowered mainly in the morning hours, appetite is reduced, she lost weight, has lost interest in activities and sports, which she was enthusiastic about, often there is no reaction to surrounding circumstances, but there are characteristic diurnal fluctuations, when suddenly there are short bursts to former hobbies. Became irritable, moody, tearful, expresses various complaints about her health, but examination did not reveal any somatic diseases.

Which group of psychotropic drugs is this patient primarily indicated for?

АНТИДЕПРЕССАНТЫ

* нейролептиктер

* антиконвульсанттар

* литий тұздары

* + антидепрессанттар

* нормотимиктер

 

#53

*! The child is 8 years old and is being seen by a general practitioner, accompanied by his parents. The parents are concerned that the child has not been playing his favorite games for the past month, does not read, does not want to go anywhere, has started saying he is bad, has not been eating and sleeping well. In the interview, the boy confirms the parents' fears. What groups of medications should the child NOT be prescribed in the first place?

АГТИДЕПРЕССАНТЫ НЕ НАЗНАЧАЮТСЯ ДО 12 ЛЕТ

* + 12 жасқа дейін антидепрессанттарды тағайындау ұсынылмайды

* антидепрессанттар

* нейролептиктер

* ұйықтататын препараттар

* нормотимиктер

 

#54

*! A 7-year-old child, brought to the appointment by her grandmother, with whom the child lives, because the child's parents had gone abroad to study. The grandmother noticed that her grandson stopped eating, and if she can get him to eat, he does not eat much and reluctantly, she also noticed that he does not fall asleep for a long time, he does not want to talk to her, his friends stopped coming to him and he stopped going to them, he does nothing at home. I brought him to the appointment because I was worried if my grandson was sick. The boy himself says that he is bad, that he is stupid, why play with him so stupid, that he misses his parents a lot, that he is not worthy to be taken away by his parents. Your doctor's tactic?

НЕ НАЗНАЧАТЬ АНТИДЕПРЕССАНТЫ

* Осы бала туралы алғашқы психикалық денсаулық орталығына хабарлау

* оған антидепрессанттармен емдеуді тағайындау

* осы бала туралы қамқоршылық және қорғаншылық органдарына хабарлау

* +антидепрессанттарды тағайындамау, психоәлеуметтік факторларға назар аудару, тұрақты бақылау жасау

* барлық әлеуметтік қызметтер мен милицияны осы отбасын бақылауға тарту

 

#55

*! In the anamnesis the boy of 7 years old has an advanced development - at 9 months he distinctly pronounced separate words, differentiated faces of people around him, played games - "ladushki", "koo-koo", independently used a spoon, coped with physiological needs when putting him on the potty. He tried to get up and took several steps holding onto the edge of the playpen. After the fall from the couch at the age of 10 months, signs of inverse development - he stopped using speech, could only repeat individual words spoken by adults, simply manipulated the spoon in his hands, did not understand what it was for, he stopped crawling, gradually his emotional coloring levelled off, he did not show the reactions of animation to his mother and father which he had before.

Determine the correct route for the patient:

ПСИХИАТР-ПСИХОЛОГ-НЕВРОЛГ-ЛОГОПЕД

* Балалар неврологының, балалар психиатрының, логопедтің консультациясы

* Логопедтің, балалар неврологының, психологтың кеңесі

* Психолог, логопед және балалар психиатрына кеңес беру

* Психиатр, балалар неврологы, психолог кеңесі.

*+ Балалар психиатрының, психологтың, балалар неврологының, логопедтің консультациясы.

 

#56

*! Young man, 18 years old, euphoric, lethargic, does not immediately understand the speech addressed to him, Speech slurred, one-syllable answers. On examination: sharp constriction of the pupils, sparse breathing, pulse - 45 per minute, smell of alcohol is not felt. Determine the type of intoxication:

*барбитуратармен

*+апиынмен

*гашишпен

*кокаинмен

*амфетаминмен

 

 

#57

*! An 18-year-old male is euphoric, lethargic, sleepy, speech slurred, coordination of movements disturbed, does not immediately understand the speech addressed to him, face slightly hyperemic, pupils not sharply dilated, smell of alcohol is not felt. Determine the type of intoxication:

*+барбитуратармен

*апиынмен

Гашишпен

*кокаинмен

*эфедринмен

 

#58

*! Young man 18 years old, euphoric, somewhat excited, dancing on the spot, laughing, eyes shining. On examination: sclerae injected, face hyperemic, nasolabial triangle pale, licks dry mouth, no smell of alcohol. Diagnosis:

*маниакальды синдром

*апиындық масаю

*+гашиштік масаю

*кокаиндік масаю

*барбитураттармен масаю

 

#59

*! Young man of 16, euphoric, somewhat excited, verbose, impulsive, occasionally aggressive, pale face, wide pupils, blood pressure - 160/90, tachycardia and slight tremor noted, complains of pain in the sternum. Diagnosis:

*маниакальды синдром

*апиындық масаю

* алкогольмен масаю

+кокаиндік масаю

*канабиноидтармен масаю

 

#60

*! A young man of 23 was detained by the police due to severe agitation and incongruous behavior. He was running away from imaginary pursuers, screaming, and attacking a policeman. He regained consciousness on the way to the hospital. In the emergency room, the smell of alcohol on his breath was noted. Correctly oriented to place, time, his own personality. Did not reveal any psycho-productive symptoms during the interview.

The condition can be qualified as:ПОМРАЧЕНИЕ СОЗНАНИЯ

*онейроид

*+сананың қарауытуы

*делирий

*эпилептикалық статус

*аменция

 

 

#61

*! The patient has been abusing alcohol for 5 years. During the period of abstinence, he becomes irritable, his mood lowers, and he experiences a strong craving for alcohol. In order to achieve "satiety" he needs more and more doses of alcohol, he initiates the use of alcohol in company. Often forgets individual events of the previous "drinking party. What is your medical tactic depending on the diagnosis?