Samples of Situational tasks.

Situational task N 1

The worker of chemical combine, 35 years old, appealed to the doctor of policlinic with complaints about the bad feel, insomnia, decline of memory, sense of causeless alarm and fear. Experience of work on this production 5 years. At the inspection is exposed astenic-vegetative syndrome, asymmetrical tremor of hands, in the cavity of mouth is gingivitis and stomatitis, black border on gums. Lumfocytosis and monocytosis is exposed in blood.

Diagnose the professional poisoning. How to confirm the diagnosis of professional poisoning, what way of influence of harmful factors on an organism? What documents must be processed by the doctor in this case? What rehabilitation and prophylactic measures are needed in regard to this worker and on the whole at a chemical combine?

Situational task N 2

In a classroom by the area 40m2 get busy 40 schoolboys. All school desks have the yellow marking. Differention of desk and chair makes 1/5 growth of children, distance of seat +2 sm. Light factor – 1/10, Coefficient of natural illumination – 1%, General artificial illumination – 100 lux.

Give the hygienic estimation of classroom. What functional violations or diseases can arise up at children? How to improve hygienic conditions in class?

Situational task N 3

In the operating block of hospital there is operating hall on 2 tables (area 54m²). Ventilation is influx-extraction (+4, -5). Local luminosity of the operating field - 1500 lux. General artificial luminosity - 200 lux. Temperature of air during the operation - 26⁰C, relative humidity - 80%. Content of CO₂-0,15%, general microbe number in air before the operation 1000 in 1m3.

Give the hygienic estimation of operating block. How to improve hygienic conditions in operation hall?

Situational task N 4

At the annual clinical inspection in a district policlinic of the worker of storage of agrochemicals of agriculture enterprise from him are exposed the complaints about head pains, weakness, sickliness in area of liver, unsteady chair, nausea. In a worker it is asteno-vegetative syndrome, symptoms of hepatitis. In the biochemical laboratory of hospital at the analysis of blood is marked the decline of activity of cytochromoxidase on 45%, erytropenia and leucopenia, lymphocytosis.

Diagnose the professional disease. What is way of influence of harmful factors on organism in this case? How to confirm the diagnosis of professional disease? What document is under an obligation to design doctor in this case? What prophylactic and rehabilitation measures are needed for this worker and storage of agrochemicals on the whole?

Situational task N 5

It is set at the sanitary inspection of the working conditions of medical personnel in the x-ray cabinet of policlinic, that the dose of external irradiation of personnel for a week made 150 mili BER, what at calculating on a year gives 7,5 BER.

Give the hygienic estimation of conditions of work of medical personnel in the x-ray cabinet. What occupational disease it is possible at personnel under these conditions? What remote effects of influencing of radiation can arise up, what are it display? What measures of radiation defense must be strengthened in the x-ray cabinet?

Situational task N 6

Hospital ward of general type on 4 beds has area 20 m². In a chamber is 1 window: 5m2, CNI – 0,75%. Sound level at night - 25 dB. Common lamplight: 50 lux, local - 80 lux. Frequency of natural ventilation is 1,5\h, the concentration of CO₂is 0,15 %.

Give a hygienic estimation to the chamber. Name necessary measures for creation optimal conditions in a hospital ward for patients.

Situational task N 7

Nursery school is in the center of micro region. There is 20 m² of lot land on one child. On the area there are the green planting, occupying 50% areas. In a group room area is 60m² on 30 children of preschool age. CNI - 1,5 %, light coefficient – 1:5, luminosity by luminescent lamps – 200 lux. Temperature of air – 24°C, humidity – 70%.

Give the hygienic estimation of nursery school. What is your recommendation on optimization of hygienic terms in nursery school?

Situational task N 8

What reasons|causes| could result in these rejections in physical development? By what another methods is it possible to estimate|evaluates| physical development of boy?

Situational task N 9

Put the hygienic conclusion|detention| about conditions of work. What professional diseases| of working it is possible at these terms, what it diagnostics and prophylaxis?

Situational task N 10

Diagnose professional poisoning, what way of influence of harmful factor on an organism took place? How to confirm a diagnosis on the conditions of work? What documents|papers| is under an obligation a doctor|physician| to process in this case? What hygienic and rehabilitation measures are needed in regard to this worker and hothouse economy on the whole|all in all|?

Control questions

1. Concept “Municipal Hygiene”, it main divisions and methods of the investigation.

2. Concept about climate and microclimate. Climate-forming factors. Factors of microclimate.

3. Influence factors of microclimate on the thermoregulation system of person.

4. Influence climatic factors on the organism. Problems of acclimatization.

5. Methods of measurement factors of microclimate, devices, norms for various premises (rooms) and it substantiation.

6. Kinds of infringement of thermoregulation of the person in conditions of a hot climate, it mechanisms and prevention.

7. Methods of complex estimation of microclimate and it application. Norms of parameters and ways of it definition.

8. Basic weather-forming factors and it influence on the person. Medical estimation and classification of weather.

9. Heliometheotropic reactions of the man, it display. Diseases, accompanying by such reactions. Prevention Heliometheotropic reactions in patients.

10. Structure of atmospheric air, action of its components on the person.

11. Pathogenesis, symptoms and prevention of the mountain (high-altitude) and kesson (decompression) illness.

12. Contents CO 2 in atmosphere, its dynamic and reasons. Action on the man various concentration CO 2.

13. MPC of CO2 in air of premises (rooms) and its substantiation.

14. Basic sources and factors of pollution of atmosphere, ways of it self-purification.

15. Factors, influencing at level of air pollution in concrete region. Kinds of air-clearing structures.

16. Direct negative influence of atmospheric pollution on health of the people and condition of their life, its versions and examples.

17. Indirect negative influence of atmospheric pollution on health of the people and condition of their life, its versions and examples.

18. Protection of atmosphere from anthropogenous pollution: the basic directions and examples. Standartization harmful substances in atmospheric air.

19. Importance of solar radiation. The reasons, display and prevention solar starvation.

20. Biological effects of ultra-violet irradiation, its mechanism. Biodoze of ultra-violet irradiation, method of definition.

21. Structure of solar light at a surface of the Earth. Action components of solar light on the person.

23. The hygienic requirements to natural illumination in inhabited, educational and hospital premises (rooms), its indicators, methods of estimation and specifications.

24. The hygienic requirements to artificial illumination, kinds and systems of such illumination, methods of estimation and specifications in various premises (rooms).

25. The hygienic characteristic of sources of water supply. Zones of sanitary protection water sourses and it purpose.

26. Main kinds of water using, hygienic requirements to quality of water, structure of waterpipe.

27. The hygienic requirements to quality of drinking water. Organoleptic parameters of drinking water, it importance, methods of definition and norms.

28. The hygienic requirements to chemical structure of water, diseases caused by its changes, it reasons, displays and prevention.

29. Epidemical importance of water, attributes of water epidemics, parameters epidemical safety of water.

30. The methods of improvement quality of water. Methods of clearing water, control it efficiency.

31. The methods of disinfection water, it hygienic estimation and control it efficiency.

32. The chemical methods of disinfection water, it hygienic estimation and control it efficiency.

33. Chlorination water, its kinds, scheme, parameters of efficiency, lacks of this method disinfection water.

34. The basic sources and factors of pollution of reservoirs, ways self-purification of reservoirs.

35. Protection reservoirs from anthropogenous pollution. Hygienic standartization pollutants in water.

36. Hygienic importance of ground, its basic parameters. Basic pollutants and ways self-purification of ground.

37. Endemical importance of ground: endemic diseases – reasons, display, prevention.

38. The attributes of harm at standartization harmful substances in ground. Protection ground from anthropogenous pollution.

39. Urbanization and its hygienic estimation. The modern town-forming factors and it importance for development of cities.

40. Hygienic estimation systems of planning cities and inhabited quarters. Functional zones in cities.

41. The hygienic requirements to inhabited rooms (microclimate, ventilation, illumination).

42. The methods of clearing of the occupied places from firm waste. Methods of removing of firm household and industrial wastes.

43. Methods of clearing of waste water. Natural and artificial methods of clearing waste waters.

EXAMPLES OF Situational tasks for 2 FINAL MODULE CONTROL.

Task 1

In the town N. the big level of morbidity of population by arterial blood pressure and caries high is marked as compared to middle indexes on a region. With the purpose of search of reasons of growth of this pathology researches of drinking-water are conducted. At the analysis of water from an artesian mining hole providing a city by water, it is set: Оrganoleptic indexes – in a norm, a dry remain is 2300 mg/l, maintenance of chlorides is 670 mg/l, sulfates are 750 mg/l, nitrates is 42 mg/l, ferrum is 0,2 mg/l, fluorine are 0,8 mg/l.

Give a hygienic estimation to water. Is there the connection of increase of these diseases with quality of drinking-water? What yet are the diseases possible in this town? How to reduce the level of these diseases among the population?

Task 2

At the analysis of morbidity of population in a district T. the increased level of of sharp intestinal infections (SII) is exposed. At the analysis of superficial water sources in this period it is set in a district: the smell of water is 2-3 marks, taste is 1-2 marks, turbidity 1-2 mg/l, dry remain 800 mg/l, oxidableness of water 5 – 6 mg of O2 /l, coli-titr – 150 – 200.

Could quality of water to serve by reason of growth of SII? What are possible reasons of changes of quality of water? What indexes of water must be explored additionally? Specify need measures for improvement quality of water in this district.

Task 3

In the town K. the last few years there is sharp growth of morbidity of population by illnesses of breathing organs. With the purpose of search of reasons of this phenomenon the local SES are conducted researches of air. In mid air cities found out the row of pollutants, including maintenance of oxides of nitrogen at the level of 0,8 MPC, oxide of carbon in the concentration 0,6 MPC. At the joint affecting organism these matters possess an additive effect (summation).

Give the hygienic estimation of degree of contamination of air in town. Can contamination of air in town influence on multiplying this pathology? What other factors of risk influence on the increase of morbidity of population? What hygienic measures are needed on the decline of contamination of air?

Task 4.

At the analysis of water from an artesian mining hole providing a city by water, it is set: organoleptic indexes – in a norm, a dry remain is 1300 mg/l, maintenance of chlorides is 570 mg/l, sulfates are 550 mg/l, nitrates are 20 mg/l, iron is 0,2 mg/l, fluorine are 0,8 mg/l.

Give a hygienic estimation to water. What diseases can be related to quality of drinking-water? How to reduce the level of these diseases among the population?

Task 5

At the analysis of water it is set from the rural plumbing:

Smell is 2 ball Oxidableness is 7 mg of O2/l

Taste is 3 ball Fluorine is 0,7 mg/l

Turbidity is 1 mg/l Nitrates are 5 mg/l

Dry remain is 2000 mg/l Microbe number - 80

Sulfates are 500 mg/l Coli-index - 5

Give a hygienic estimation to water, how possibly its use in drinkable aims, or the methods of improvement of quality of water are required (what?)? To what violations of health can bring the use over of this water?

Task 6

At research of microclimate it is set in a dwelling room, that time of cooling of katatermometer is 100 sec., factor of katatermometer - 600. Effective temperature – 16,5 ⁰EТ.

Give an estimation to the microclimate. What devices were used for researches? How to improve a microclimate in a room?

Task 7

At the sanitary inspection of living room are set that in a room 2 men live by the sizes of 2,5 m x 4m x 5m, due to natural ventilation in a room acts 40 m3 air in hour. Temperature of air 21 ⁰C, rate of his movement 0,1 m/s, effective temperature 22,5 ⁰ EТ.

Give a hygienic estimation to the terms in a room, what index it is necessary to explore additionally?

Task 8

In the operating block of hospital there is operating room on 2 tables (area 54m2). Ventilation is influx-extraction ( +4, -5). Luminosity of the operating field - 1500 lux. General luminosity - 200 lux. Temperature of air during the operation - 26⁰C, relative humidity - 80%. Content of CO2 -0,15%, general microbe number in air before the operation 1000 in 1m3.^.

Give the hygienic estimation of operating block. How to improve hygienic conditions in operation hall?

Task 9

In a nursery group room by the area 45 m2 there are 25 children. It is set at measuring of microclimate: temperature of air 18°C, relative humidity of air 75%, the rate of movement of air is 0,4 m/s, effective temperature 16°ET. Indexes of luminosity: coefficient of natural illumination (CNI) - 1,0%, light coefficient (LC) – 1:7, luminosity by luminescent lamps – 200 lux. The multiplicity of ventilation is 1 time in h. Contents of CO2 - 0,23%.

Give the hygienic estimation of group room. Give recommendation on optimization of conditions in a nursery group room.

Task 10

Examples of licension tests

1. Researches of water, which is selected from mine well, are carried out. It fixed: transparence - 18 sm, color - 15 °, smell - 3 points, rigidity - 12 mg/equivalent, oxidability - 4 mg/l, the contents of nitrogen - 0,2 mg/l, Sodium of nitritums nitrogen - 0,05 mg/l, Sodium of chlorids - 80 mg/l, coli-titer - 80, coli-index - 12. Prove a hygienic conclusion concerning quality of drinking water.

A. Water does not answer hygienic requirements, carrying out of its harmless is necessary

B. Water answers hygienic requirements

C. Water does not answer hygienic requirements, carrying out of its clearing is necessary

*D. Water does not answer hygienic requirements, carrying out of its disinfection is necessary

E. Water does not answer hygienic requirements, carrying out of its deactivation is necessary

2. Before release in a sewer network of city sewage of infectious hospital are cleared and disinfected on local constructions into which complex devices enter: a lattice, airotanke, a secondary sediment bowl, the contact tank, dehelmintizator. In what from the resulted devices there is a biological clarification of sewage?

A. Dehelmintizator

B. In a secondary sediment bowl

C.In the contact tank

D. A lattice

*E. Airtannk

3. At inhabitants of settlement A., posed in 3 climatic girdle, are mass defeat by fluorosis of teeth. At what concentration of F-ion in drinking water the defeat by fluorosis can be observed?

A. 0,7 *B. 1,5 C. 1,0 D. 0,3 E. 0,1

4. Diseases of children by a methemoglobinemia are registered in the house of the baby. By inspection was fixed, those children’s alimentary admixtures diluted of drinking water. What surplus of chemical substance in drinking water can be causing this disease?

A. Chlorides B. Sulfates *C. Nitrates D. Lead E. Mercury

5. At the hygienic estimation of conditions of sewage dump in a reservoir of 1-st category of water use has been determined, that conditions of dump do not correspond to hygienic requirements on biological consumption of oxygenium (BCO). What standard of BCO of quality of water of a reservoir was used in that case?

*A. No more than 3 mg of О₂/dm³

B. No more than 2 mg of О₂/dm³

C. No more than 4 mg of О₂/dm³

D. No more than 5 mg of О₂/dm³

E. No more than 6 mg of О₂/dm³

6. The epidemic of typhoid of a water origin is registered in settlement NN. What from the listed attributes is not characteristic for given epidemic?

A. An epidemic tail (loop)

B. Sharp rise of curve disease

*C. Three - phase character of curve disease

D. Falling a level of disease after liquidation of failure on a waterpipe

E. The contingent of the fallen ill population lives in one microdistrict

7. During the laboratory analysis of potable water from an artesian borehole it is established, that the transparency makes 50 sm; chromaticity - 200; turbidity - 0,5 mg/l; smell and smack - 1 point; general hardness - 12,5 mg/l; fluorine - 1,5 mg/l; oxidability - 0,7 mg/l; coli-titer -500 mg/l; coli-index - 2; microbic number - 10. What method of clarification listed is necessary for carrying out for improvement of quality of potable water?

A. Disinfecting

B. Deodorization

C. Disfluorisation

*D. Softeining

E. Clarification

8. The settlement receives potable water from an artesian chink. Water has passed a full work cycle of water-preparation. Results of the analysis of potable water: the Transparency - 30 sm, Chromaticity - 20, Smell - 1 point, dry rest 1000 mg/dm³ , dense rest - 5,5 mg/dm³, nitrates - 20 mg/dm³, fluorine - 4,0 mg/dm³, coli-titer - 300 ml, microbic number - 100. The level of desease of what pathology will be influenced with the use of this water?

A.Urolithic illness *B. Fluorosis C. Chronic gastritis D. Water-nitrogen mеthemoglobinemia

E. Lacking iron an anemia

9. The researches of quality of potable water in city A. carried out. Determine that organoleptical parameters are lower than properties of water, rigidity - does not exceed, and nitrates and coli - titer are higher than the specified sizes in State standart «Water drinking». At the use of the specified water can be:

A. Urolithiasis B. Infectious disease of intestinal group C. Cholelithic illness

D. *Меthemoglobinemia E. It is unpleasant to drink

10. In hospital ward by the size 5 х 3,5 m2 are two windows. The aeration of ward is carried out by reusable opening window leaves within day. Definition of the contents of carbon dioxyde carried out by the passing container with air through absorber Petry with an alkaline solution. Name allowable contents of carbonei dioxydum in air of ward (in %).

A. 0,04 *B. 0,1 C. 0,01 D. 0,15 E. 0,20

11. At definition of influence of quality of atmospheric air on health of the population take into account a degree of danger of impurity of atmospheric air. At what degree of danger of pollution of atmospheric air it is possible to expect increase of frequency of specific and nonspecific desease, cases of a sharp poisoning, increase of death rate?

A. Poorly dangerous

B. Moderately dangerous

C. Dangerous

*D. Very dangerous

E. Rather dangerous

13. For a disinfection of air in operational it is planned to use a source of ultra-violet radiation. At carrying out of calculations with the purpose of established a necessary regimen of irradiation 5 regimens has been tested. An estimation of efficiency of disinfection of air has been carried out with the help of device Krotov. Efficiency of sanitation (in %) is designed. Specify an optimum dose.

A. 55 % B. 85 % C. 75 % D. 65 % *E. 95 %

14. At laboratory research of air of settlement of M it fixed, that concentration of some chemical substances exceed maximum permissible concentration in 5 times. What changes are expected in a state of health of the population?

A. Changes on some functional parameters

B. Body height of a specific and not specific case rate

*C. Expressed physiological infringements

D. Acute poisonings

E. Lethal poisonings

15. At laboratory research of the air environment quality of ward it has been established in the summer, that bacterial contamination - 4 cells / m³, hemolytics streptococcus - 25 colony formation unit per 1 m³, the contents of carbon dioxid - 0,1 %. Estimate a degree of cleanliness of air.

A. Very clean B. Clean C. Polluted *D. Satisfactory clean E. Very much polluted

16.Patient with thyreotoxicisis is in the 2 beds hospital ward of therapeutic department. The area of the ward is 18 m2, height 3 m, ventilation rate 2,5 /hr. Air temperature - 20оС, relative humidity 45\%, air movement velocity 0,3 m/s, light coefficient 1/5, noise level 30 dB. Do hygienic assessment of the conditions

*A discomfortable microclimate

B.non-effective ventilation

C.poor lighting

D. high level of noise

E.all conditions are OK

17. Under orders of the doctor the medical sister has carried out gaugings which are necessary for an estimation of microclimatic conditions of chamber of therapeutic branch. Results of gaugings: the average temperature of air makes 20°С, rate of movement of air - 0,02 km/s, relative humidity of air - 58 %. State a hygienic estimation of a microclimate of chamber.

A. A microclimate discomfortable heating type

B. A microclimate discomfortable cooling type

*C. Microclimate comfortable

D. A microclimate discomfortable with the increased humidity of air

E. A microclimate discomfortable with the increased rate of air

18. In branches of an infectious hospital the tool control over an overall performance of ventilating system and keeping of optimum parameters of a microclimate is planned. Devices are prepared for this: device of Krotov, aneamometr in wings form, a thermograph, a catathermometer, aspirational psychrometr of Assman. What listed devices are intended for gauging speed of air movements in hospital premises?

A. Aspirational psychrometr of Assman

B. Anemometr in wings form

*C. Catathermometer

D. Device of Krotov

E. Thermograph

19. The doctor - cardiologist of Chernigov city has received the urgent report of a bureau of weather: "Owing to chromospheric flash on the Sun it is possible to expect the big magnetic storm". Give the recommendation about changes in the plan of treatment of patients with chronic ischemic illness of heart in a hospital.

A. To continue the treatment appointed before

B. To appoint hypotensive preparations

C. To appoint a confinement to bed

*D. To strengthen of spasmolytic and anticoagulant therapy

E. To cancel the serious medical - diagnostic procedures appointed on the eve

20. In a class room in the sizes 6 х 10 m2 fixed 6 light points, equipped by filament lamps capacity 150 Watt everyone. Illuminating intensity on workplaces changes in borders 70-80 lk. State a hygienic estimation to artificial illumination of a class.

A. Artificial illumination of a class uniform and sufficient: illuminating intensity on workplaces low

B. Artificial illumination of a class uniform: illuminating intensity on workplaces low

C. Artificial illumination of a class non-uniform, but sufficient: illuminating intensity on workplaces sufficient

D. Artificial illumination of a class uniform and sufficient: illuminating intensity on workplaces sufficient

*E. Artificial illumination of a class non-uniform and insufficient: illuminating intensity on workplaces low

CRITERIA OF ESTIMATION

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