Runny nose

Methemoglobinemia - what it is, causes, symptoms and treatment. Methemoglobinemia: what it is, tests, symptoms, causes, treatment. Is it possible to increase the production of methemoglobin reductase?

Test tasks
for a comprehensive interdisciplinary exam
(in the disciplines: “Medical Genetics”,
"Microbiology", "Human Hygiene and Ecology")
in the discipline “Hygiene and Human Ecology”
for students of specialties:
“Nursing”, “General Medicine”, “Midwifery”
2nd year, 4th semester

Tests updated in September 2009 No. 133-166
Instructions: choose 1 correct answer.

Section 1. Subject of human hygiene and ecology

Founder of domestic hygiene in Russia:

a) Dobroslavin A.P.;
b) Semashko N.A.;
c) Soloviev Z.P.;
d) Charles Darwin.

The term "Ecology":

a) biogeography;
b) housing science;
c) geoscience;
d) the science of animal behavior.

Abiotic factor:
The name of the scientist who first proposed the term “ecology”:

a) Humboldt;
b) Darwin;
c) Haeckel;
d) Engler.

The term "hygiene":

a) science of housing;
b) the science of human form and structure;
c) the science of a correct and rational lifestyle;
d) the science of the life activity of a living organism.

Branch of ecology that studies environmental factors:

a) population;
b) the doctrine of ecosystems;
c) factorial ecology;
d) ecology of organisms.

Section 2. Environmental hygiene

Acid rain is caused by increased concentrations in the atmosphere:

a) sulfur oxides; b) ozone;
c) oxygen;
b) nitrogen.

A chemical compound that in high concentrations causes the formation of malignant tumors:

a) carbon monoxide;
b) sulfur oxides;
c) benz(a)pyrene;
d) carbon dioxide.

Optimal relative air humidity in a residential area in %:

a) 15 – 20%;
b) 20 – 30%;
c) 40 – 60%;
d) 80 – 90%.

Instrument used for continuous, automatic recording of air temperature:

a) barograph;
b) thermograph;
c) psychrometer;
d) hygrograph.

Part of the solar spectrum that has a bactericidal effect:

a) visible light;
b) infrared rays;
c) ultraviolet rays;
d) all parts of the spectrum.

The source of carbon monoxide in the air is:

a) transport;
b) street dust;
c) breathing;
d) an industrial enterprise emitting sulfur dioxide with smoke.

Contraindications to artificial UV irradiation:

a) active form of tuberculosis;
c) the presence of age spots;
d) all of the above are true.

The greenhouse effect is associated with an increase in concentration in the atmosphere:

a) sulfur oxides;
b) nitrogen oxides;
c) carbon dioxide;
d) ozone.

The biological effect of ultraviolet radiation from the solar spectrum is:

a) oppressive effect;
b) vitamin-forming;
c) decreased visual acuity;
d) formation of methemoglobin.

Factor that does not affect the microclimate:

a) illumination;
b) air temperature;
c) air humidity;
d) air speed.

Meteotropic diseases include:

a) bronchial asthma;
b) hypertension;
c) rheumatism;
d) all of the above are true.

Digital indicator of oxygen concentration in the atmosphere:

a) 78%;
b) 21%;
c) 0.93%;
d) 0.04%.

Digital indicator of oxygen in a pressure chamber:

a) 16%;
b) 21%;
c) 40–60%;
d) 78%.

A chemical compound in high concentrations that causes pulmonary edema:

a) hydrogen sulfide;
b) nitrogen oxides;
c) photooxidants;
d) carbon dioxide.

Chemical compound that causes ozone depletion:

a) sulfur oxides;
b) freons;
c) carbon oxides;
d) iron oxides.

They have antirachitic effects:

a) infrared rays;
b) blue rays;
c) ultraviolet rays;
d) red rays.

An aneroid barometer is used to assess:

a) temperature;
b) humidity;
c) air speed;
d) atmospheric pressure.

The greatest contributors to urban air pollution currently are:

a) motor transport;
b) heating devices;
c) industrial enterprises;
d) unauthorized dumps.

Sulfur compounds in the air contribute to:

a) irritation of the respiratory tract;
b) formation of methemoglobin;
c) formation of carboxyhemoglobin;
d) caries disease.

Caisson disease occurs as a result of changes in concentration:

a) nitrogen;
b) carbon monoxide;
c) sulfur compounds;
d) oxygen.

Factors influencing the intensity of natural ultraviolet radiation are:

a) polar night;
b) solar activity;
c) the sun is low above the horizon;
d) cloudy weather.

Indications for artificial ultraviolet radiation for prophylactic purposes:

a) active form of tuberculosis;
b) diseases of the thyroid gland;
c) the presence of age spots;
d) hypovitaminosis “D”

Conditions under which a person is exposed to increased atmospheric pressure:

a) work at high temperatures;
b) diving work;
c) climbing mountains;
d) flying on aircraft.

To assess humidity use:

a) thermometer;
b) barometer;
c) anemometer;
d) psychrometer.

To assess the temperature regime use:

a) thermometer;
b) barometer;
c) anemometer;
d) catothermometer.

Diseases and human conditions for which treatment in a pressure chamber is used:

a) diseases of the cardiovascular system;
b) decompression sickness;
c) bronchial asthma;
d) all of the above are true.

Digital indicator of nitrogen concentration in the atmosphere:

a) 4%;
b) 16%;
c) 78%;
d) 0.93%.

Types of effects of sulfur compounds in urban air on the human body:

a) carcinogenic;
b) irritating to the respiratory tract;
c) silicosis;
d) gonadotropic.

The cause of the development of methemoglobinemia in humans may be the introduction into the soil of:

a) potash fertilizers;
b) phosphate fertilizers;
c) nitrogen fertilizers;
d) pesticides.

a) hygroscopicity;
b) breathability;
c) chemical composition of the soil;
d) the number of helminth eggs per gram of soil.

The microorganism does not form spores in the soil:

a) the causative agent of anthrax;
b) the causative agent of tetanus;
c) the causative agent of dysentery;
d) the causative agent of botulism.

Infectious disease, the transmission factor of which is soil:

a) typhus;
b) flu;
c) scabies;
d) anthrax.

The first stage of soil self-purification:

a) formation of humus;
b) nitrification;
c) mineralization;
d) oxygenation.

Diseases of residents with endemic goiter are associated with:

b) with a reduced iodine content in soil and water;

The presence of methemoglobin in the blood is associated with:

a) with the presence of oxygen in the air;
b) with the presence of nitrates in food and water;
c) with the presence of carbon dioxide in the air;
d) with the presence of carbon dioxide in the air.

Getting contaminated soil into a human wound can cause the development of:

a) cholera;
b) salmonellosis;
c) botulism;
d) gas gangrene.

Soil sanitary indicator:

a) the number of eggs and pupae of flies in 0.25 m2;
b) hygroscopicity;
c) breathability;
d) chemical composition of the soil.

Microorganism that forms spores in the soil:

a) the causative agent of typhoid fever;
b) the causative agent of diphtheria;
c) the causative agent of botulism;
d) the causative agent of malaria.

Transmission of pathogens of intestinal diseases to humans from soil occurs:

a) through food products;
b) through damaged skin;
c) through a tick bite;
d) by airborne droplets.

Diseases of residents with caries are associated with:

a) with a high fluorine content in soil and water;
b) with reduced iodine content in soil and soil;
c) with a high iodine content in soil and water;
d) with a reduced fluorine content in soil and water.

The final stage of soil self-purification:

a) formation of humus;
b) nitrification;
c) mineralization;
d) oxygenation.

Diseases of residents with fluorosis are associated with:

a) with an increase in fluorine content in soil and water;
b) with a decrease in iodine content in water and soil;
c) with an increase in iodine content in soil and water;
d) with a decrease in fluorine content in soil and water.

A lack or excess of microelements in the soil leads to:

a) to their deficiency or excess in the human body;
b) disruption of intermediate metabolism;
c) the occurrence of diseases;
d) all of the above are true.

Chemical compound found in drinking water that causes dyspepsia:

a) fluorides;
b) sulfates;
c) nitrates;
d) chlorides.

Microelement, the absence or small amount of which causes dental caries:

a) lead;
b) selenium;
c) zinc;
d) fluorine.

A trace element, the absence or small amount of which causes fluorosis of teeth and other bone formations:

a) copper;
b) arsenic;
c) fluorine;
d) iodine.

Chemical compound used as a coagulant in water treatment:

a) CuSO4;
b) KMnO4;
c) Al2 (SO4)3;
d) HOCl.

Permissible microbial count of drinking water:

a) 50;
b) 120;
c) 150;
d) 200.

Drinking water with high chloride content causes:

a) decreased gastric secretion;
b) increase in body temperature;
c) methemoglobinemia;
d) caries.

To supply domestic drinking water supply systems use:

a) atmospheric waters;
b) sea waters;
c) swamp waters;
d) open bodies of water.

Lethal outcome is caused by the body losing the amount of water (in%):

a) 3 – 5%;
b) 7 – 10%;
c) 15 – 20%;
d) 25 – 30%.

Water consumption rates in fully sewered large settlements:

a) 250 – 350 l/day;
b) 40 - 60 l/day;
c) 170 l/day;
d) 10 l/day.

The main source of iodine for humans:

a) food;
b) water;
c) air;
d) all of the above are true.

Ions that cause water hardness:

a) iron, chlorine;
b) calcium, magnesium;
c) sodium, calcium;
d) copper, magnesium.

What is the optimal water hardness:

a) 3.5 mg eq/l;
b) 7.0 mg eq/l;
c) 10 mg eq/l;
d) 14 mg eq/l.

Chemical compounds that cause methemoglobinemia:

a) chlorides;
b) nitrates;
c) sulfates;
d) fluorides.

Microelement, the deficiency of which leads to the occurrence of endemic goiter:

a) zinc;
b) copper;
c) arsenic;
d) iodine.

Hard water has the following properties:

a) can lead to swelling;
b) increases appetite;
c) speeds up cooking;
d) affects cardiac activity.

Substances characterizing water pollution by protein organic compounds:

a) chlorides;
b) fluorine;
c) nitrites;
d) selenium.

Water clarification method:

a) ozonation;
b) boiling;
c) filtration;
d) chlorination.

The advantage of ozone over chlorine in water disinfection:

a) clarifies the water;
b) cools the water;
c) more effective against pathogenic protozoa;
d) cheaper way.

The main source of fluoride for humans:

a) food;
b) water;
c) air.

Section 3. Environmental and hygienic food problems.

Daily human requirement for protein (in g) per day:

a) 15 – 20;
b) 30 – 40;
c) 50 – 70;
d) 80 – 100.

Daily human requirement for carbohydrates (in g) per day:

a) 50 – 80;
b) 150 – 200;
c) 350 – 400;
d) 500 – 700.

The ratio of proteins, fats and carbohydrates in the diet of people engaged in heavy physical labor:

a) 1 – 0.8 – 3;
b) 1 – 1.3 – 6;
c) 1 – 1 – 4;
d) 1 – 1 – 5.

The main, functional role of water-soluble vitamins:

a) caloric;
b) catalytic;
c) plastic;
d) energy.

Vitamin C is found most in:

a) in cabbage;
b) in carrots;
c) in black currants;
d) in rose hips.

Take-take disease occurs when there is a lack of vitamin in the body:

a) B1 (thiamine);
b) PP (nicotinic acid);
c) D (calciferol);
d) K (phylloquinone).

Nutrients containing vitamins A, D, E, K:

a) fats;
b) proteins;
c) vitamins;
d) mineral salts.

product that is the main source of phosphorus:

a) dried apricots, apricots;
b) peas, beans;
c) fish;
d) beef liver, eggs.

The main biological role of carbohydrates:

a) are a source of energy;
b) are structural elements of cells and tissues;
c) play a protective role;
d) are a source of vitamins.

Conditions that contribute to the destruction of vitamin C in foods:

a) natural product;
b) acidic environment;
c) oxygen;
d) storage in airtight containers.

Vitamin C is preserved better:

a) when preparing puree;
b) frying in fat;
c) when cooking in the “skin”;
d) placing in cold water when cooking.

The symptom “cholera-like diarrhea” belongs to the group of nutritional diseases:

a) nutritional toxicosis (mushroom poisoning);
b) diseases of nutritional inadequacy;
c) enzymopathies;
d) diseases of excess weight.

Product causing solanine poisoning:

a) fly agaric;
b) black henbane;
c) sprouted, green potatoes;
d) “drunken bread.”

Causative agent of food poisoning:

a) the causative agent of dysentery;
b) the causative agent of tuberculosis;
c) Escherichia coli;
d) the causative agent of diphtheria.

Product that is a source of vitamin B1:

a) sauerkraut;
b) fish;
c) butter;
d) bread.

a) botulism occurs when eating fried mushrooms;
b) botulism occurs when consuming canned mushrooms.

Check the correct statement:

a) toxic infections more often occur with massive contamination of products
microorganisms;
b) toxic infections often occur when single microorganisms get into foods and dishes.

The daily human requirement for fat (in g) per day is:

a) 30–40;
b) 50–70;
c) 80–100;
d) 100–120.

The main, functional role of proteins as nutrients:

a) energy;
b) plastic;
c) lytic;
d) catalytic.

The ratio of proteins, fats and carbohydrates in the diet of people engaged in mental work:

a) 1–1–5;
b) 1–1–4;
c) 1–0.8–3;
d) 1–1,3–6.

The appearance of cracks in the skin and mucous membranes is a sign of hypovitaminosis:

a) thiamine (B1);
b) riboflavin (B2);
c) nicotinic acid (PP);
d) tocopherol (E).

A lack of vitamin A in the body causes:

a) decreased bone strength;
b) “night blindness”;
c) porosity of capillaries;
d) reduces blood clotting.

Product that is a source of vitamin A:

a) fish;
b) cheese;
c) butter;
d) all of the above.

Sources of calcium in food are:

a) cottage cheese;
b) beef liver;
c) potatoes;
d) raisins.

The main biological role of fats:

a) source of energy;
b) a source of phosphates and fatty acids;
c) a source of fat-soluble vitamins;
d) a source of B vitamins.

Optimal distribution of caloric content of food in% (with 3 meals a day):

a) 30–45–25;
b) 15–50–35;
c) 20–60–20;
d) 25–50–25.

The loss of vitamin C during cooking is (in%):

a) 10–15%;
b) 30%;
c) 40%;
d) 50%.

What disease occurs when eating grain that has overwintered under snow:

a) nutritional-toxic aleukia;
b) ergotism;
c) botulism;
d) aflatoxicosis.

The root of the plant (sweet taste, aromatic) containing the toxic substance cicutotoxin:

a) black henbane;
b) belladonna;
c) vekh is poisonous;
d) spotted hemlock.

The most common food that causes botulism is:

a) milk;
b) canned vegetables;
c) dried fruits;
d) butter cream.

Foods that are sources of iron:

a) cottage cheese;
b) liver;
c) fish;
d) raisins.

Product containing complete protein:

a) sauerkraut;
b) pomegranate;
c) butter;
d) meat.

Temperature required for storing dairy products:

a) – 2° C;
b) – 20° C;
c) + 4° C - + 6° C;
d) 0° C.

Products and dishes that, if stored incorrectly, can cause staphylococcal poisoning:

a) canned cucumbers;
b) nuts;
c) cottage cheese;
d) poisonous mushrooms.

Staphylococcal poisoning most often occurs:

a) with a decrease in blood pressure and temperature;
b) with low-grade fever.

The quantity and quality of food depends on:

a) from age;
b) gender;
c) climatic conditions;
d) all of the above are true.

People's need for vitamin C increases significantly when:

a) infectious diseases;
b) tuberculosis;
c) gastrointestinal diseases;
d) all of the above are true.

Section 4. The influence of production factors on human health and vital activity.

Means for individual prevention of pneumoconiosis:

a) respirators;
b) glasses;
c) mittens;
d) exhaust devices at the workplace.

Measures to prevent occupational poisoning:

a) control over the state of the air in the working area;
b) automation and sealing of harmful production processes;
c) hygienic standardization of raw materials and finished materials;
d) all of the above are true.

The type of radiation with the highest penetrating ability:

a) α-radiation;
b) β-radiation;
c) X-ray radiation;
d) all of the above are true.

Principle of protection when working with radioactive substances in a closed area:

a) protection by quantity and time;
b) use of personal protective equipment;
c) all of the above are true.

General measures to prevent noise at work include:

a) changes in production technology;
b) ventilation;
c) sealing;
d) all of the above are true.

Industrial vibration sources:

a) diving to great depths;
b) work at high temperatures;
c) forms for vibration compaction of concrete;
d) working with chemicals.

With vibration disease, the following are primarily affected:

a) capillaries of the fingertips;
b) brain vessels;
c) central unequal system;
d) cardiovascular system.

General measures to prevent pneumoconiosis:

a) mechanization and automation;
b) control over the maximum permissible concentration of carbon monoxide in the air of the work area;
c) dry drilling;
d) normal lighting in the workplace.

The most dangerous way for poisons to enter the body at work is

a) gastrointestinal tract;
b) respiratory tract;
c) skin;
d) mucous membranes of the mouth and eyes.

Removal of toxic substances that are highly soluble in water from the body is carried out through:

a) gastrointestinal tract;
b) kidneys;
c) respiratory organs.

Organ important in detoxification and transformation of chemical compounds in the body
a) intestines;
b) liver;
c) endocrine glands;
d) bone tissue.
Personal noise protection equipment:

a) gas mask;
b) safety glasses;
c) headphones.

Industrial noise affects:

a) on a hearing aid;
b) on the gastrointestinal tract;
c) on the skin;
d) musculoskeletal system.

General measures to prevent vibration disease:

a) technical control of ventilation;
b) setting the maximum permissible concentration for gas pollution;
c) wet cleaning;
d) use of remote controls.

When the respiratory system is affected by industrial dust, the following are important:

a) size of dust particles;
b) solubility of dust particles;
c) chemical structure;
d) all of the above are true.

The effect of industrial dust on the body is manifested in the occurrence of:

a) bronchitis;
b) pneumoconiosis;
c) allergic manifestations;
d) all of the above are true.

The harmful effects of industrial dust depend on:

a) on the concentration of dust in the air;
b) duration of action during the shift;
c) the duration of the professional experience;
d) all of the above are true.

Stochastic or probabilistic effects occur when exposed to:

a) threshold doses;
b) small doses;
c) all of the above are true.

Section 5. Urban ecology. Hygienic requirements for the environment in residential and public buildings.

Construction materials must have:

a) low thermal conductivity and high air conductivity;
b) high thermal conductivity and low air conductivity;
c) high thermal conductivity and high air conductivity.

To ensure the thermal comfort of a person’s home, the following indicators are important:

a) air temperature and the magnitude of temperature differences horizontally and
height of the room, temperature of the internal surfaces of the walls;
b) air temperature and the magnitude of temperature differences in altitude;
c) air humidity in the living room.

Recommended orientation of residential premises in Trans-Urals:

a) northern;
b) southeastern;
c) northwestern;
d) northeastern.

In hospital wards, heating systems of the following types are appropriate:

a) water;
b) steam;
c) panel;
d) air.

Optimal standards for residential microclimate:

a) do not depend on age and climatic region;
b) do not depend on age and depend on the climatic region;
c) depend on age and do not depend on the climatic region.

From a hygienic point of view, the optimal heating system for residential premises is:

a) air;
b) panel;
c) water;
d) steam.

The microclimate of the premises is characterized by the following indicator:

a) air temperature;
b) atmospheric pressure;
c) the chemical composition of the air;
d) illumination.

Recommended orientation of operating room windows:

a) southern;
b) northern;
c) eastern;
d) western.

Requirements for artificial lighting:

a) correspond to the purpose of the premises;
b) be sufficient, regulated and safe;
c) do not have a blinding effect;
d) all of the above are true.

The negative side of urbanization:

1) communal improvement
2) high level of culture
3) intense air pollution
4) high economic potential

The positive side of urbanization:

1) intense environmental pollution
2) change in microclimatic conditions
3) high level of culture
4) reducing the intensity of solar radiation

135. Basic principles of urban planning:

1) zoning of territories of a settlement
2) optimal choice of territory
3) taking into account the compass rose
4) all of the above

The following are not classified as types of environmental pollution:

1) natural
2) physical
3) biological
4) chemical

Physical pollution of the environment includes:

1) thermal
2) noise
3) electromagnetic
4) all of the above

Planning measures for environmental protection include:

1) creation of a sanitary protection zone
2) creation of low-waste technologies
3) replacing harmful substances with less harmful ones
4) environmental legislation

Does not apply to the functions performed by green spaces:

1) improve the microclimate
2) absorb carbon dioxide and other toxins
3) increase solar radiation
4) add aesthetics

The industrial zone is located:

1) downwind of the residential area
2) at a distance from a residential area
3) below the residential area along the river
4) all of the above

The maximum permissible CO2 content in a residential area should not exceed:

1) 0,1 %
2) 1%
3) 2%
4) 0,5 %

Natural ventilation is air exchange that occurs under the influence of:

1) humidity
2) pressure differences
3) wind pressure
4) temperature differences between outside and room air

Natural lighting in the room does not depend on:

1) type of lighting fixtures
2) window devices
3) type of curtains
4) painting walls and furniture

Luminous coefficient is:

1) the ratio of the unglazed window surface to the floor area in the room
2) the ratio of the glazed surface of windows to the floor area
3) the ratio of the unglazed surface of the windows to the ground
4) the ratio of the floor area of the premises to the glazed surface of the windows

145. KEO hygienic standard in residential premises

1) not less than 1.5%
2) no more than 2%
3) not less than 0.5%
4) no more than 5%

The depth of the living room should not exceed

1) 10m
2) 6m
3) 3m
4) 15m

Section 6. Healthy lifestyle and personal hygiene.

Elements of a healthy lifestyle:

a) rational nutrition;
b) absence of bad habits;
c) physical education classes;
d) all of the above are true.

The share of the importance of lifestyle in shaping the health of the population:

a) 49 – 53%
b) 10%
c) 20%

The concept of “Hygiene education” is:

a) theory and practice of designing, preserving and strengthening the health of an individual
b) patterns of influence of environmental factors on human health

The object of hygienic education is:

a) external environment
b) healthy person

Factors affecting health:

a) genetic background
b) nutritional habits
c) personal hygiene
d) adequate self-esteem>
d) all of the above

According to WHO definition, health is:

a) absence of disease
b) normal functioning of body systems
c) a state of complete physical, spiritual and social well-being, and not just the absence of diseases and physical defects
d) the state of the human body when the functions of its organs and systems are balanced with the external environment and there are no painful changes

The factor that has the greatest influence on the formation of public health:

a) lifestyle
b) level and quality of medical care
c) heredity
d) environment

Primary health care (PHC) guides the individual in health issues:

a) for passive education
b) personal responsibility

A person’s health depends on his lifestyle on:

a) 50%
b) 20%
c) 10%

Ways to improve the quality of medical care to the population:

a) creation of large hospitals, diagnostic centers
b) increasing the training time for medical workers
c) providing conditions for a healthy lifestyle

The concept of “low physical activity” (hypodynamia) includes:

a) refusal to play sports
b) classes in health groups
c) sedentary activity more than 50% of the time

Systematic principle:

The principle of stimulating consciousness and activity:

a) provides for the permanent, regular nature of its implementation
b) expresses its focus on increasing the activity of an individual or a group of people

Relevance principle:

Consistency principle:

a) focuses on the most important and timely hygienic information
b) provides for the identification of the main stages and their logical continuity

The purpose of hygienic education is to replenish:

a) missing skills and habits for a healthy, safe lifestyle
b) social policy to increase health potential

Disease prevention and health promotion are the goals of hygienic education:

a) the closest
b) long-term

In her professional activities, a nurse is engaged in training:

a) patients and their families
b) student interns
c) junior medical staff
d) colleagues
d) all of the above

A medical worker in hygienic education conducts:

a) lectures
b) conversations
c) group work

Hygienic education is carried out:

a) in the clinic
b) on the site
c) in an infectious outbreak at home
d) all of the above

Section 7. Hygiene of children and adolescents.

For the hygienic assessment of physical education activities with children, the following indicators are used:

a) the total duration and structure of the lesson;
b) general and motor density of the lesson;
c) indicators of the body’s response to physical activity;
d) all of the above are true.

Does not apply to hygienic requirements for clothing:

a) maintaining thermal comfort;
b) do not impede human movements;
c) be fashionable;
d) easy to clean from dirt.

Basic principles of hardening:

a) taking into account the state of health and the degree of hardening;
b) gradualism;
c) complexity;
d) all of the above are true.

Composition of the premises of a group cell of a kindergarten:

a) playroom - dining room;
b) group with a pantry;
c) locker room;
d) all of the above are true.

Features of lesson design in elementary school:

a) variety of activities;
b) visibility;
c) conducting physical education;
d) all of the above are true.

Conditions that contribute to the development of myopia in children and adolescents:

a) insufficient lighting of the workplace;
b) correct orientation of windows;
c) the presence of fittings on the lamps;
d) sufficient lighting.

Basic hygienic requirements for lighting in the classroom:

a) orientation: south, southeast, east;
b) orientation west, southwest;
c) orientation to the north;
d) installation of colored glass.

Sanitary and epidemiological surveillance of children’s learning conditions includes:

a) hygienic assessment of the condition of school buildings (adequacy of space, degree of improvement);
b) assessment of compliance with study load standards;
c) assessment of the school day regime;
d) control of the organization of medical support for schools;
d) all of the above are true.

An element that is not fundamental in the hygienic rationality of organizing a lesson in high school:

a) lesson density;
b) the amount of duration and alternation of activities;
c) application of TSO;
d) availability of physical education minutes.

176. General requirements for school furniture:

a) correspondence to the growth of students;
b) coloring in light colors;
c) lightness;
d) all of the above are true.

Basic hygiene requirements for workshops:

a) sufficient area;
b) isolated placement;
c) sufficient lighting;
d) proper ventilation;
d) all of the above are true.

Components of a kindergarten site:

a) group sites;
b) garden – vegetable garden – berry garden;
c) recreation area;
d) all of the above are true.

179.The daily routine and training sessions must comply with hygienic standards:

a) duration of sleep;
b) wakefulness of different age groups;
c) conducting classes and recreational activities;
d) all of the above are true.

Accelerating the growth and development of children is called:

STANDARD ANSWERS

Methemoglobinemia– a condition characterized by an increased content of methemoglobin (oxidized hemoglobin) in the blood and tissue hypoxia. The development of methemoglobinemia is accompanied by acrocyanosis, weakness, headaches, dizziness, palpitations, and shortness of breath on exertion. A characteristic sign of methemoglobinemia is the brown-chocolate color of the blood. To confirm the diagnosis, an assessment of symptoms, laboratory studies and tests are performed. In case of severe methemoglobinemia, oxygen therapy, administration of ascorbic acid, methylene blue solution, and in some cases, exchange transfusion are indicated.

Methemoglobinemia

Methemoglobinemia is an increase in the level of hemoglobin containing oxidized iron (methemoglobin - MtHb) in red blood cells. Methemoglobin belongs to the so-called dyshemoglobins - derivatives of hemoglobin that are not capable of transporting oxygen. Under normal conditions, a small amount of methemoglobin is present in the blood - no more than 1% of the total Hb content. With methemoglobinemia, endogenous mechanisms are unable to regulate the concentration of dyshemoglobin, as a result of which oxygen transport function suffers. In hematology, methemoglobinemia is divided into hereditary and acquired. The first of them are common among the indigenous populations of Alaska, Greenland, and Yakutia; the incidence of acquired methemoglobinemia is unknown.

Causes of methemoglobinemia

During metabolic transformations in the blood of healthy people, dishemoglobins are formed in very small quantities: carboxyhemoglobin, sulfhemoglobin, methemoglobin (0.1-1%). At the same time, erythrocytes contain a number of factors that maintain the proportion of the methemoglobin fraction at a level not exceeding 1.0-1.5% of total Hb. In particular, the enzyme methemoglobin reductase is involved in the reaction of reduction of methemoglobin into hemoglobin. Unlike oxyhemoglobin (HbO2), which contains reduced iron (Fe++), methemoglobin contains oxidized iron (Fe+++), which is not capable of carrying oxygen. Therefore, with methemoglobinemia, first of all, the oxygen transport function of the blood suffers, which results in tissue hypoxia.

Hereditary forms of methemoglobinemia are represented by either enzymopathies (congenital low activity or absence of the enzyme methemoglobin reductase) or M-hemoglobinopathies (synthesis of abnormal proteins containing oxidized iron).

In the structure of acquired (secondary) methemoglobinemia, toxic exogenous and toxic endogenous forms are distinguished. Methemoglobinemia of exogenous origin can be associated with an overdose of drugs (sulfonamides, nitrites, vikasol, antimalarial drugs, etc.) or poisoning with chemical agents (aniline dyes, silver nitrate, trinitrotoluene, chlorobenzene, drinking water and foods high in nitrates and etc.).

Increased levels of MtHb in the blood are observed in premature and full-term newborns, which is associated with low activity of the enzyme methemoglobin reductase and oxidative stress during childbirth. However, even with severe hypoxia and jaundice in newborns, the rise in MtHb is not so pronounced and clinically significant as to cause methemoglobinemia. However, with diarrhea, bacterial and viral enterocolitis, in conditions of metabolic acidosis, acquired endogenous methemoglobinemia can easily develop in children in the first year of life.

A mixed form of pathology is said to occur if methemoglobinemia develops under the influence of exogenous factors in healthy individuals who are heterozygous carriers of genes for the hereditary form of the disease.

Symptoms of methemoglobinemia

Signs of hereditary methemoglobinemia become noticeable during the neonatal period. Cyanosis is noticeable on the skin and visible mucous membranes of the child (in the area of the lips, nasolabial triangle, earlobes, nail bed). In addition to hereditary methemoglobinemia, other congenital anomalies are often detected in children - changes in the configuration of the skull, underdevelopment of the upper extremities, vaginal atresia, etc. Children are often lagging behind in psychomotor development.

Depending on the level of the MtHb fraction, the severity of manifestations of congenital and acquired methemoglobinemia can vary significantly.

At the concentration of MtHb in the blood:

3-15% - the skin acquires a grayish tint
15-30% - cyanosis develops, the blood becomes chocolate brown
30-50% - weakness, headache, tachycardia, shortness of breath during exercise, dizziness, fainting occur
50-70% - arrhythmia, rapid breathing occurs; metabolic acidosis develops; there are signs of central nervous system depression, coma is possible
>70% - severe hypoxia, death.

All forms of methemoglobinemia are characterized by a slate-gray coloration of the skin, but there are no “drumstick” changes in the nail phalanges, characteristic of cardiopulmonary diseases. Acrocyanosis increases with cooling, eating nitrate-containing foods, with toxicosis of pregnancy in women, as well as taking methemoglobin-forming medications.

Diagnosis of methemoglobinemia

An important diagnostic sign of methemoglobinemia is the dark brown color of blood, which, when placed in a test tube or on filter paper, does not change its color to red. If the test is positive, spectroscopy, determination of MtHb concentration, NAD-dependent methemoglobin reductase activity, and hemoglobin electrophoresis are performed.

A general blood test may show compensatory symptoms, an increase in Hb, reticulocytosis, and a decrease in ESR. When studying biochemical blood parameters, slight bilirubinemia is determined, due to an increase in the indirect fraction of pigment. Chronic methemoglobinemia is characterized by the appearance of Heinz-Ehrlich bodies in erythrocytes.

In patients with enzymopenic or toxic methemoglobinemia, a therapeutic test with intravenous administration of methylene blue is indicative - after the injection, cyanosis quickly disappears, and the skin and visible mucous membranes become pink.

When analyzing the causes of methemoglobinemia, it is important to find out whether the patient had contact with toxic substances or took methemoglobin-forming drugs. If congenital methemoglobinemia is suspected, the pedigree is studied, a geneticist is consulted, and the type of inheritance of the blood pathology is determined. Hereditary methemoglobinemia requires differentiation from congenital heart defects of the blue type, abnormalities of lung development and other conditions accompanied by hypoxia.

Treatment and prevention of methemoglobinemia

Patients with no clinical manifestations do not require special therapy. If there is a significant concentration of MtHb in the blood and extensive symptoms of methemoglobinemia, drug therapy is prescribed to promote the conversion of methemoglobin into hemoglobin. Ascorbic acid and methylene blue have such restorative properties. Ascorbic acid is prescribed orally, first in large doses, and as the condition normalizes - in maintenance doses. A solution of methylene blue is administered intravenously. In case of severe cyanosis, oxygen therapy is performed. Severe methemoglobinemia is an indication for exchange transfusion.

The course of hereditary and drug-induced methemoglobinemia is usually benign. An unfavorable outcome is possible in severe forms of toxic methemoglobinemia with a high content of MtHb in erythrocytes. Patients with this pathology should avoid contact with methemoglobin-forming substances, hypothermia and other provoking factors. Prevention of congenital methemoglobinemia involves conducting medical genetic consultation to identify heterozygous carriers among future parents.

A clinical blood test is a simple and informative test. It is good because blood is taken from a finger, since a minimal amount is required; no special preparation is needed: the only requirement is to take the test on an empty stomach. The technique allows you to evaluate the hemogram, that is, the number and ratio of cells, as well as a number of other important indicators, among which not the least place is given to a blood test for hemoglobin. What does its concentration in the blood depend on? How much hemoglobin should be normal? What else do you need to know about this indicator?

The main function of hemoglobin is transport. It binds to oxygen entering the blood from the pulmonary alveoli, transports it and then releases it to the tissues. But the role of hemoglobin does not end there: it takes carbon dioxide and carries it back to the lungs, from where it is removed into the environment. Thus, this protein is of great importance for respiration: without it, the cells of the human body are not able to fully carry out metabolism.

There are several types of normal hemoglobin:

HbA1
HbA2,

Of these, A1 and A2 are characteristic of adults (with HbA1 accounting for 96-98% of the total), and hemoglobin F - for newborns. In the first days of life, this figure reaches 60-80%, and by the fourth or fifth month of life it decreases to 10%. In human blood, normal hemoglobin is present in three chemical forms: oxyhemoglobin (a compound with oxygen, designated HbO 2), carbhemoglobin (a compound with carbon dioxide, designated HHbCO 2), and reduced hemoglobin (designated HHb). However, this protein is also capable of forming pathological compounds such as carboxyhemoglobin and methemoglobin.

Carboxyhemoglobin is a compound with carbon monoxide. It is not able to transport oxygen and carbon dioxide, which leads to the conclusion that when it is present in the blood, tissues begin to experience severe oxygen starvation. That is why in a fire people die much more often from suffocation than from the fire itself.

Methemoglobin is formed during the oxidation of hemoglobin; the iron in methemoglobin is trivalent (normally it is divalent). This compound binds oxygen tightly and is extremely reluctant to release it to tissues. That is why, during the formation of methemoglobin, tissues also experience severe hypoxia. Methemoglobin appears in the blood during poisoning with oxidizing agents (potassium permanganate, aniline, etc.), nitrates and nitrites.

The hemoglobin blood test itself does not involve determining the presence of carboxyhemoglobin and methemoglobin in the blood. This is not necessary. A similar study is carried out if there are symptoms of poisoning: then the blood is taken to a toxicology laboratory, where the presence of methemoglobin or carboxyhemoglobin is detected using special techniques.

Method of performing a blood test for hemoglobin

To measure the amount of hemoglobin in the blood, there is no need to draw blood from a vein; it is taken from a finger. This is correct, since such sampling is less traumatic and involves the removal of a minimum amount of blood, which is quite sufficient to determine the indicator under study. The analysis does not require special preparation: no diets or additional manipulations are required. The only limitation is that blood should be donated on an empty stomach. Again, the fact that it is taken from a finger makes it possible to avoid hungry fainting, which sometimes occurs when blood is taken from a vein on an empty stomach.

Currently, there are several groups of methods that make it possible to determine the level of hemoglobin in the blood as accurately as possible. Until recently, the Sali method was popular, but it is not reliable enough and does not meet modern requirements. Therefore, instead, colorimetric and gasometric methods have been proposed, as well as a method for measuring the iron content in the hemoglobin molecule. This is correct: time moves forward, and modern technologies are gradually replacing older ones.

In addition to the classic blood sampling from a finger to measure hemoglobin, there is an express method in the laboratory. There is a special device for this - a hemoglobinometer. The operating principle of the device is colorimetric. Blood is also collected from a finger: very little is required to measure it: about 10 microliters.

The procedure takes very little time: the device takes less than a minute from the moment of pricking the finger to obtaining the result. In addition, modern devices have a built-in system that checks how correctly all elements work.

Such a device is quite expensive, so if you need to donate blood for hemoglobin a couple of times a year, then you shouldn’t buy it: it’s easier to get tested for free in a laboratory. However, for those who are forced to constantly monitor hemoglobin concentration, this device must be available. In this case, measurements can be taken several times a day, which is simply necessary for some blood diseases.

Of course, this device is not used as often as, say, devices for determining sugar and cholesterol levels, which is due, on the one hand, to a lack of awareness among the population, and on the other, not to such a high incidence of such pathologies. Of course, the use of such devices does not completely eliminate the need to undergo analysis in a laboratory, where more accurate results are obtained.

Interpretation of research results

The normal hemoglobin content in the blood is 115-145 g/l in women and 130-160 g/l in men. Decoding the results of the analysis involves not only comparing the obtained figures with the target indicators, but also their evaluation in combination with determining the number of red blood cells. For this purpose, there is a special index, which is called a color indicator that reflects the concentration of hemoglobin in the red blood cell. Normally it lies in the range from 0.85 to 1.05.

Low hemoglobin is a sign of anemia. If the color index is also reduced compared to the norm, then such anemia is hypochromic. There are a number of reasons that contribute to a decrease in hemoglobin, but all of them can be divided into two large groups: impaired synthesis and increased breakdown. The formation of hemoglobin can be impaired due to a deficiency of its main components - iron and amino acids, which is associated with poor nutrition, diseases of the gastrointestinal tract, prolonged fever, etc. If all components are present in sufficient quantities, disruption of synthesis may be due to genetic reasons or, for example, lead poisoning.

Increased breakdown of hemoglobin is observed with blood loss (this may be one of the signs of hidden bleeding), hemolysis of red blood cells (with malaria, poisoning with hemolytic poisons, autoimmune damage, etc.), hereditary disorders. Unfortunately, deciphering a clinical blood test does not give an idea of the reasons that led to a decrease in hemoglobin levels. This will require additional research.

An increase in hemoglobin is due to increased production of red blood cells due to hypoxia, increased levels of glucocorticoids or a tumor process. Another reason is blood thickening, which can occur due to stress, dehydration and certain diseases.

There are also special tests to determine the percentage of individual hemoglobin fractions and identify pathological forms (methemoglobin, carboxyhemoglobin). Each of these studies is prescribed by a doctor for specific indications. If there are no abnormalities in hemoglobin in a clinical blood test (or there are no signs of poisoning in the case of carboxy- and methemoglobin), then, as a rule, there is no reason for additional tests.

Hemoglobin is vital for humans. Without it, oxygen starvation of tissues begins, which can lead to the most serious consequences, including death (this is not uncommon in poisonings associated with the formation of carboxyhemoglobin and methemoglobin). Deciphering a blood test for hemoglobin can show existing deviations from the norm, which must be eliminated. Of great importance is not the fight against the symptom itself, but the identification of the cause and proper treatment.

13.10.2017

When diagnosing methemoglobinemia, what it is is of interest to every patient. This disease involves the oxidation of hemoglobin in red blood cells or an increase in the level of methemoglobin.

This leads to disruption of the flow of oxygen into the blood, and at the same time its transportation to the tissues and organs of the body. The disease manifests itself in malaise along with the appearance of shortness of breath and headaches. In this case, the blood turns bright brown.

If the disease is not treated in a timely manner, complications will begin to develop. It is important to consult a doctor promptly.

Blueness of the skin (cyanosis)

Methemoglobinemia: features

One of the components of red blood cells is hemoglobin. It is a complex protein and contains iron. It is responsible for transporting oxygen throughout the body.

With the development of a pathological process such as methemoglobinemia, there is an increase in the level of hemoglobin in the blood, which is saturated with already oxidized iron.

Methemoglobin is a form of this protein that is unable to deliver oxygen to cells. During the normal course of the metabolic process in the body, it is formed in small quantities. In this case, it does not affect the transport function of red blood cells. If its share begins to increase due to the action of certain factors, there is a lack of oxygen in the body, which causes serious negative consequences.

Reasons

Experts name several reasons that can trigger the development of a disease such as methemoglobinemia. They are both congenital and acquired.

Among the most common reasons that can lead to the development of the disease are:

intestinal dysbiosis;
excessive consumption of water and various products that have a high content of nitrates and nitrites (this is most typical for vegetables and fruits, as well as sausages);
problems with the activity of enzymes directly involved in the process of methemoglobin synthesis, which are of a genetic nature;
taking certain medications that have expired;
metabolic acidosis;
innate synthesis of protein containing iron in oxidized form;
poisoning by certain chemicals;
reception and abuse of drugs belonging to the category of quinine and sulfonamides.

Forms and stages of the disease

Experts distinguish only two forms of methemoglobinemia, namely:

Congenital or primary, when methemoglobin accounts for up to 50% of the total hemoglobin in the blood.
Acquired or secondary - its levels can be very different.

The acquired form may be of exogenous or endogenous origin. If the disease is caused by the influence of certain external factors, its specific varieties are diagnosed, including water-nitrate methemoglobinemia due to excessive consumption of foods and water with a high proportion of nitrates in its composition.

If the disease is caused by the influence of internal factors, then it is a consequence of a problem with the production and absorption of nitrates, which is typical for enterocolitis and other similar pathologies.

Regardless of the form of the disease, the stages of development of the pathological process are distinguished:

The proportion of methemoglobin is 3%, the first manifestations appear - gray skin.
At the second stage, its presence increases to 30%, while the blood acquires a dark color and cyanosis appears.
The third stage assumes its presence in quantities of up to 50%. Symptoms of methemoglobinemia in this case will be headache, shortness of breath and regular fainting.
The fourth stage of development of the disease involves real danger, as its presence increases to 70%. This suggests the development of a comatose state of a person, supplemented by serious disturbances in the functioning of the central nervous system.
The fifth stage is the most difficult. The presence of methemoglobin can reach up to 100%, which can lead to sudden death due to lack of oxygen.

Treatment of the disease is most effective in its early stages. Therefore, it is so important to immediately contact a specialist if suspicious symptoms occur.

Symptoms of methemoglobinemia

Manifestations of this disease can be very diverse. They vary depending on the presence of chronic ailments, the general condition of the human body, as well as the stage of development of the disease. Often the symptoms are subtle or completely absent. It can be detected in such cases only by performing a general blood test.

The characteristic manifestations of the disease are:

general malaise;
frequent headaches and dizziness;
rapid breathing;
sleep disturbances, frequent diarrhea;
nervousness;
problems with orientation;
gray skin tone;
impaired breathing, including shortness of breath;
possible fainting;
cramps in the lower extremities;
problems with the functioning of the musculoskeletal system;
sudden mood swings, memory problems.

Among the signs of the disease, experts call diarrhea, which is one of the signals about an increase in the proportion of methemoglobin.

If the disease is congenital, it can be noticed by the color of the skin, which is associated with retardation in mental and physical development. In the future, drowsiness and unreasonable crying may occur.

At the first suspicious manifestations, you need to consult a doctor. Its development can be confirmed or refuted through complex diagnostics. If the disease is detected early, the prognosis is most favorable.

Diagnostics

An external sign of the disease is an unnatural dark brown color of the blood, which does not change to normal. Specific laboratory tests include determination of MtHb concentration along with NAD-dependent methemoglobin reductase activity and spectroscopy.

According to the results of a general blood test, a decrease in the number of ESR in combination with compensatory erythrocytosis is noted. After a biochemical study, bilirubinemia becomes obvious. Heinz-Ehrlich bodies may also appear in red blood cells.

Another specific study for this disease is a therapeutic test involving intravenous administration of methylene blue. After the injection, cyanosis quickly disappears, and the skin turns pink.

If there is a suspicion of the development of methemoglobinemia, the possibility of the patient taking certain medications, as well as his contact with substances of a toxic nature, is determined.

Treatment of the disease

Methemoglobinemia is treated by a hematologist. As soon as the presence of methemoglobin exceeds the 15 nM mark, treatment begins. If the disease is hereditary, treatment may not be carried out.

The basis of treatment is the transfer of iron from the oxidized form to the normal one. To do this, the patient is injected with methylene blue. This allows you to completely get rid of the pathology in a matter of hours.

It is important to choose the dosage of the drug. If its amount is excessive, it can provoke the development of hemolytic anemia.

Treatment is adjusted based on the results of a dynamic examination. As part of therapy, the following techniques can be used:

oxygen therapy for bluish skin;
administration of vitamin B12 by intramuscular injection;
blood transfusion;
drug therapy aimed at transforming methemoglobin;
introduction of ascorbic acid;
glucose intake.

If toxic damage occurs, passive oxygen therapy is prescribed in conjunction with complex treatment of the mucous membranes. Also, in acute toxic forms, it is important to eliminate the damaging factor as soon as possible.

Prevention of methemoglobinemia

To minimize the likelihood of developing methemoglobinemia, it is important to follow several rules, namely:

take a lot of vitamins;
make efforts to strengthen the immune system;
avoid hypothermia;
carry out hardening procedures;
follow healthy eating recommendations.

If the disease is diagnosed early, it has a favorable prognosis. It is important to regularly monitor fluctuations in the level of methemoglobin in the body, since if it exceeds 70%, it can cause death.

A person with such a diagnosis requires a gentle regime, both in life and in work. It involves limited physical activity and exclusion of contacts with oxidizing agents.

Take timely measures to provide the body with oxygen - walk in the fresh air and ventilate the room.

Every day a person uses various medications, comes into contact with chemicals, and buys food in stores. Few people understand that poisoning directly with nitrates can provoke a disease such as methemoglobinemia. What is it?

Brief medical certificate

Hemoglobin is what is included in red blood cells. It contains iron and is responsible for transporting oxygen to all elements of the body. Methemoglobinemia is a pathology accompanied by an increase in hemoglobin saturated with oxidized iron. Its development is accompanied by weakness and headaches, shortness of breath with increased exertion.

Methemoglobin is a protein that has lost its ability to bind and transport oxygen. Normally, it should be formed during metabolism, and is present in the body in small quantities. When its concentration increases, tissues begin to experience oxygen deficiency, reacting to changes with a certain clinical picture.

Methemoglobinemia can be:

Primary, or congenital. In this case, methemoglobin accounts for 20 to 50% of the total volume of the complex protein.
Secondary. Methemoglobin concentrations range from extremely low to dangerously high.

Depending on the causes of development, methemoglobinemia can be of exogenous or endogenous origin. In the first case, the disease occurs under the influence of external factors, and in the second it is diagnosed in patients with impaired synthesis and absorption of nitrates.

Main causes and risk factors

The congenital form of the disease is hereditary and most often develops for the following reasons:

Enzymopathy is a decrease in the activity of methemoglobin reductase. This is a special enzyme characterized by the ability to reduce oxidized iron.
M-hemoglobinopathy. The pathology is manifested by the synthesis of hemoglobin, which initially contains oxidized iron.

Elevated levels of methemoglobin are diagnosed in all newborn babies. This phenomenon is considered a variant of the norm. It is caused by low enzyme activity and the stress that the child experiences during childbirth. Over time, the situation usually normalizes.

There are many reasons for the development of secondary methemoglobinemia in a person. The following elements can be identified as elements that promote iron oxidation:

nitrates;
chlorobenzene;
aniline dyes;
potassium permanganate;
food and water contaminated with nitrates.

In addition, certain medications contribute to the development of the disease. For example, “Paracetamol”, “Dapsone”, “Vikasol”, “Nitroglycerin”, “Lidocaine”, etc. However, do not be afraid to take the listed medications, since a negative reaction is possible only with a significant overdose.

General clinical picture

Many people do not know what methemoglobinemia is. Meanwhile, the symptoms of the disease are varied. Their manifestation depends on the patient’s condition, his age and the presence of chronic pathologies. The stage of development of the disease plays an important role in this matter. For some, symptoms appear when the level of oxidized iron reaches 20%, while for others they are completely absent. Only a complete blood test in the latter case helps to reveal the picture of the pathological process.

Doctors identify common symptoms of methemoglobinemia:

general malaise;
change in skin color to an earthy tone;
dyspnea;
frequent dizziness;
leg cramps;
sleep disturbance;
nervousness;
sudden mood swings.

Most people with an increase in hemoglobin saturated with oxidized iron in the blood experience diarrhea and problems with stool.

Signs of water-nitrate methemoglobinemia

This form of the disease has specific characteristics. After poisoning with toxins, it begins to progress rapidly. After drinking even a small amount of contaminated water, the following symptoms may occur:

blue skin;
violation of orientation in space;
headache.

If you do not seek medical help promptly when you feel unwell, your condition may worsen. In this case, patients experience shortness of breath, arrhythmia, and convulsions.

In adults, water-nitrate methemoglobinemia is usually mild. In children it is accompanied by digestive disorders. Young patients, especially those who are bottle-fed, are more susceptible to the disease. When a mixture is prepared for them using contaminated water, the likelihood of developing serious pathological processes increases several times.

Course of the disease in children

In infants, signs of hereditary methemoglobinemia are noticeable immediately after birth. Such children experience blue discoloration of the mucous membranes, skin of the lips, earlobes and nails. As a rule, the disease is accompanied by a number of other disorders, including the following:

underdevelopment of the limbs;
change in the normal shape of the skull;
thalassemia - a disorder of hemoglobin synthesis;
vaginal atresia (in girls);
delay in psychomotor development.

You should consult a doctor if you suspect congenital methemoglobinemia. The doctor should tell you what it is and how to properly treat the disease at your appointment.

Diagnostic methods

Determining the presence of a pathological process in the body is quite simple. Methemoglobinemia is indicated by a brownish tint to the blood, which does not change color when exposed to oxygen. If this test shows a positive result, a comprehensive examination is prescribed to confirm the preliminary diagnosis. It consists of the following activities:

spectroscopy;
general blood test;
hemoglobin electrophoresis;
biochemical blood test.

In the case of a toxic form of pathology, a test with methylene blue is considered the most indicative. After administration of this substance, cyanosis usually disappears.

Features of therapy

Treatment for methemoglobinemia is not always required. For example, if an increase in methemoglobin levels is caused by taking certain groups of medications, they are simply discontinued. Subsequently, all blood parameters return to normal.

The main goal of a standard course of therapy is to convert oxidized iron to normal. For this, patients are prescribed a solution of methylene blue (“Chromosmon”). As a rule, this measure is enough for all unpleasant symptoms to disappear after a few hours. Also, as part of drug therapy, blood transfusions and ascorbic acid are prescribed. In infants with fermentopathy, therapy is supplemented with riboflavin.

Many pregnant women who have been diagnosed with “methemoglobinemia” (you already know what it is) do not realize that this disease is very serious. Symptoms of pathology usually only intensify under the influence of toxicosis. Such ladies first of all need quality medical care. A long course of the disease can provoke hypoxia in the fetus and various developmental anomalies. Therapy in this case is selected individually.

In acute toxic methemoglobinemia, the causes are eliminated first. Oxygen therapy is then prescribed, during which the patient breathes concentrated oxygen. This approach to treatment guarantees the normalization of metabolic processes and the subsequent destruction of pathological hemoglobin.

Prognosis for recovery

The disease methemoglobinemia has a favorable prognosis. Complications are possible only in the case of a toxic form of the pathology and delay in seeking medical help. In rare cases, death is possible.

Prevention methods

Methemoglobinemia is a fairly serious disease, the symptoms of which cannot be ignored. Is it possible to avoid its development?

Doctors agree that preventing the disease is quite easy. To do this, you must follow a number of rules:

do not self-medicate, but take prescribed medications strictly according to the schedule;
avoid direct contact with toxic substances;
try not to eat foods grown with nitrates and contaminated water;
Before conceiving a child, consult a geneticist.

The rules of prevention in the case of a congenital form of pathology are somewhat different. Doctors recommend avoiding hypothermia, limiting physical activity and periodically strengthening the immune system.