30 жастағы ер адам тренажер залында жаттығудан кейін семсер сұққандай бас ауруына

14
У мужчины, 37 лет, жалобы на головную боль, повышение температуры до 38 градусов, сонливость около 2 недель, двоение в глазах. Объективно: расходящееся косоглазие, птоз, реакция зрачка на свет сохранена, а на конвергенцию отсутствует.

15
! Мужчина, 40 лет, отмечает сильную головную боль, рвоту, гипертермию. Выявляются менингеальные симптомы, периферический парез мышц шеи, плечевого пояса. 2 недели назад отдыхал в горах.

16
У мальчика, 8 лет, атлетическое телосложение, затруднение в начале ходьбы, невозможность расслабить мышцы после их сокращения, при ударе молоточком по мышце формируется «валик». У отца и брата такая же болезнь.

Какой диагноз НАИБОЛЕЕ вероятен?

17
! У молодого человека, 18 лет, симметричная атрофия мышц стоп и голеней, ходит высоко поднимая стопы(степпаж), гипостезия по типу носков, у брата отца было данное заболевание

18
A girl, 20 years old, after any minor actions there is a strong weakness in the muscles, it is difficult to speak, breathe, open her eyes.

* anticholinesterase drugs

19
A young man, 28 years old, a forester, after a tick bite noted skin rashes in the form of rings, fever, headaches, nausea and vomiting. Objectively: on the skin "ring-shaped erythema", meningeal symptoms, mild hemiparesis on the right.

What drugs for etiotropic treatment are unredeemable?

20
n a man, 45 years old, fascicular twitching in the muscles of the hands is noted, the weakness in them gradually increases over 2 years, weight loss. Objectively: flaccid paraparesis in the arms, in the legs - a hint of pathological stop reflexes.

*stroke
* heart attack

21
A child, 5 years old, has polymorphic seizures: myotonic, tonic axial, atypical absences, myoclonic with impaired consciousness. A marked delay in psycho-speech development with elements of autism is also noted.

22
A boy, 5 years old, has gait disturbance, fatigue, muscle weakness of the lower extremities. On examination, muscular hypotension was revealed mainly in the proximal limbs. Hypotrophy of the muscles of the proximal lower extremities. Muscle strength is reduced in the upper limbs to 3.5 points, in the lower limbs to 2.5 points in the proximal sections. He gets up using the techniques of "ladder". Pseudohypertrophy of the calf and gluteal muscles.

* Thomson's myotonia

23
A young man, 15 years old, has an atactic gait, in the Romberg position is unstable, nystagmus, there is kyphoscoliosis, feet with a high arch - “horse foot”, there is a heart defect.

24
A girl, 30 years old, complains of attacks of pulsating unilateral headaches, accompanied by intolerance to light and sounds, nausea, vomiting, drowsiness, visual disturbances in the form of photopsies and scotomas precede the headache.

25
A girl, 8 years old, complaints from the words of her mother, sometimes as if freezes like a statue with an empty look, at such moments she is not in contact, does not react to the environment, the attack lasts 10-20 seconds.