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MINISTRY OF EDUCATION AND SCIENCE KYRGYZ REPUBLIC Osh State University International Medical Faculty Department of "Clinical disciplines IMF" "Approved" at the session of the department "Clinical disciplines” Protocol №______ of «___» ______________ 2015y. head of department__________________, PhD, Associate Professor SM Mamatova TRAINING PROGRAM STUDENTS SYLLABUS (7 semesters, 2015 academic year) Discipline: Internal disease Specialty: General medicine Total: 5 credits Course: 4 Semester: VII Lectures: 30 hours Practice: 45 hours Laboratory: Number of boundary control (RC): 2 SRSP: Independent work of students: 75hours Compilers Exam: 7th semester Total classroom hours: 75 hours Total extracurricular hours: 75 hours The total complexity: 150 hours Syllabus prepared on the basis of state standard SES-3, and the work program of Internal Medicine 2____________________________________________________________________________ _____________________________________________________________________________ Compilers: PhD, Associate Professor S.M Mamatova, assistant Salieva R.SH. Osh sity - 2015 2.Title and code of discipline: Internal disease 3. This of lecturer: Head of the department of clinical disciplines Mamatova SM. Associate Professor Ph.D. work experience ped.-9y.o., the total work experience of 33 years. 3.Information assistant: Salieva R.Sh. assistant, Department of clinical disciplines, the overall work experience of 6 years. 4. Contact iformatsii: Every day from 8.00 to 16.30. phone 0773714471 5. Quantity credit: 5 credits 6. Date: 2015-2016 academic year 7th semester 7. Course Objectives The objectives of the development of the discipline "of faculty therapy": Education of professional and personal qualities of the physician, occupational and social competence on the basis of teaching students the methods of examination of the patient and diagnosis of major diseases of internal organs, the development of the ability to apply this knowledge in practice. • Ensure that the assimilation of knowledge and practical skills necessary for the diagnosis, treatment and prevention of the most common diseases of internal organs. • Create an advanced understanding of the etiology, pathogenesis, clinical manifestations of major diseases of internal organs. • Create clinical judgment, to consolidate and develop the ability to independently establish and substantiate the clinical diagnosis, to use the methods of differential diagnosis, resolve questions of treatment and prevention in a patient with typical basic forms, the most frequently observed diseases of internal organs. • To teach the diagnosis and treatment of emergency conditions. • To teach the basics of pharmacotherapy of the main entities that learn the principles of rational pharmacotherapy. • Formation of skills of the relationship with the patient, using the rules of medical ethics and medical deontology. In the course of development of the discipline the student creates and exhibits the following general cultural and professional competence: GC-8, PC-5 PC-12, PC-17, PC-18 and PC-19. Tasks of discipline "Faculty therapy": 1. Acquiring knowledge of the etiology and pathogenesis, clinical course and outcomes of the main typical forms most frequently observed diseases of internal organs. 2. Mastering the therapeutic method of direct examination of the patient, interpretation of the results of additional skills (laboratory, instrumental) research methods. 3. The development of clinical thinking skills with the development of formulation and justification of the clinical diagnosis, the formation of the diagnostic process and monitoring of patients, prescribing treatment, prognosis. 4. Develop skills of supervision of the patient, the ability to monitor the clinical and paraclinical signs of illness with writing academic history. 5. Development of the students choosing the optimal scheme of medical treatment the most common diseases. 6. The development of the total volume of therapeutic, rehabilitative and preventive measures in patients with the most common diseases of internal organs. 7. Assimilation rules of medical ethics and medical deontology. 8. Course Description Discipline «Internal Medicine (7th semester)" studies the etiology, pathogenesis, classification, diagnosis, treatment, complications, prognosis and prevention of the most common diseases of internal organs Therapeutic circulatory and respiratory systems in adults. Map competencies discipline 1. Name of discipline competencies (which competencies are to be achieved in the time of the discipline) 1.1. Universal 1.1.1. General scientific (GC): - Analyze socially significant problems and processes, to practice the methods of the humanities, natural sciences, medico-biological and clinical sciences in various kinds of professional and social activities (GC-1); - Ability and willingness to study a foreign language at the level of everyday communication, in written and oral communication in the national language and official languages (GC-6); - Carry out their activities in view of socially accepted moral and legal norms, comply with the rules of medical ethics, laws and regulations for handling confidential information, keep patient confidentiality (UC-8). 1.1.2. Instrumental competences (IC): - Able to work independently on the computer (IC-1); - Ready for written and oral communication in the state and official languages, is able to master a foreign language at the level of everyday communication (IC-2); - Is ready to work with information from various sources (IC-4). 1.1.3. Socio-personal and general cultural competence (SPC): - Is able to realize the ethical and deontological aspects of medical practice in communicating with colleagues (doctors, middle and junior medical staff) and adults (SPC-1); - It is able to identify the natural essence of the scientific problems arising in the course of professional activities of doctor (SPC-2); - Is able to analyze health information, based on the principles of evidence-based medicine (SPC-3). 1.2. Professional (PC) 1.2.1. Professional competence: - Able to conduct and interpret the survey, physical examination, clinical examination, the results of modern laboratory and instrumental studies, the morphological analysis of biopsy, operational and material sectioned patients, arrange medical records outpatient and inpatient adult patient (PC-2); - Is able to carry out the analysis of clinical syndromes, use reasonable methods of diagnosis, treatment, rehabilitation and prevention of diseases of the internal organs of adults (PC-3); 1.2.2. Diagnostic activity: - Capable of making a diagnosis based on the results of laboratory diagnostic tests of biological material taking into account features of the disease visceral adults (PC-11); - Is able to analyze the results of the main clinical and laboratory studies and assess the functional status of the internal organs of an adult organism with the purpose of timely diagnosis of internal diseases (PC-12); - Is able to identify adult patients major symptoms and syndromes of internal diseases, use an algorithm of diagnosis (primary, collateral, complications), taking into account the ICD-10, to perform basic diagnostic measures to detect emergency conditions (PC-13). 1.2.3. Therapeutic activity: - Able to perform basic medical measures at the most common diseases of the internal organs in the adult population (PC-14); - Is able to assign adult patients with pathology of internal organs adequate treatment according to the diagnosis (PC-15); - Is capable of the adult population with the pathology of the internal organs first medical aid (-16 pc); - Able in case of emergency and life-threatening conditions to direct hospitalization in a planned and urgently adult patients with pathology of internal organs (PC-18). 1.2.4. Educational activities: - Capable of training middle and junior medical staff and patients of the rules of hygiene and sanitary regime, ethical and deontological principles (PC-21); - Is able to learn the rules of the adult population health behavior, conduct hygiene and the formation of healthy lifestyle skills (PC-22). 1.2.5. Research activities: - Is ready to study the scientific and medical information, national and international experience on the subject of study (PC-27). Competently composition course "Internal Medicine" List of Formation technology means and technology competencies assessment Volume (credits) GC – 6 Independent work Reports 5 GC -8 Workshops, IWS abstracts IC -1 Individual homework Reports IC-2 Reports, abstracts SPC-2 Workshops Individual homework Workshops Individual homework Workshops Individual homework Independent works SPC -3 Workshops, IWS Interview PC-2 workshops, group work demonstration student sitters PC-3 workshops, group work Case studies, Medical history PC-11 Lecture, workshops, IWS Medical history, Interview PC-12 Lecture, workshops, IWS Tests, medical history PC-13 Lecture, workshops, IWS Case studies PC -14 workshops, group work PC -15 Lecture, workshops, IWS Case studies , medical history Report, abstract PC- 16 Lecture, workshops,IWS abstract, report IC -4 SPC -1 Presentation presentation presentation on the PC- 17 Lecture, workshops, IWS abstract, report PC – 18 workshops, group work report, abstract PC - 21 workshops, group work abstract, report PC-22 workshops, group work Abstract, report PC-27 Lecture, workshops, IWS Abstract, report Future specialist doctor as a result of studying the discipline "Internal Medicine 2": Must know: Etiology, pathogenesis, classification, clinical, laboratory and instrumental diagnosis, treatment, prevention and prognosis of these most common internal diseases of the respiratory system and cardiovascular system of adults: - Pneumonia; - Suppurative lung disease; - COPD; - Bronchial asthma; - Lung hypertension. Pulmonary heart disease. - Hives; - Anaphylactic shock; - Hypertonic disease; - Hypertensive crisis; - Hyperlipidemia; - Coronary heart disease - Sudden cardiac death; - Angina pectoris; - Acute coronary syndrome; - Myocardial infarction; - Heart failure - Infective endocarditic; - Acute rheumatic fever - Mitral and aortic valvular heart disease; Should be able to: - On the basis of complaints, medical history and physical examination of the patient make a preliminary diagnosis; - A plan of laboratory and instrumental examination to confirm the presumptive diagnosis and interpret the results; - Formulate a detailed clinical diagnosis, guided the modern classification of diseases; - To make the details of the diagnosis in individual patients, namely, the etiology, the mechanism of the disease, complications; - Make study of the clinical diagnosis in individual patients with the evaluation of the survey results and to identify criteria for diagnosis; - Appoint an adequate individual therapy; - To determine the prognosis of the disease in individual patients;- Identify measures of prevention and disability expertise; - Recognize the clinical manifestations of emergency conditions at the above mentioned diseases of the internal organs of respiration and circulation. 9. Prerequisites course "At the entrance" in accordance with the curriculum of the study of the subject 'Internal Medicine 2 (7th semester) "performed in the VII semester. Basic knowledge necessary for studying the discipline formed in the previous cycle, the following subjects: - Latin language - Chemical - Biochemistry - Biology - Normal anatomy - Pathological anatomy - Normal physiology - Pathological Physiology - Pharmacology - Internal Medicine 1 - Surgical disease 1 - Pediatrics 1 10. Postrekvizity course "Output" lays the foundation for the study of these students future clinical disciplines: - Internal Medicine 3,4 - Surgical disease 2 - Pediatrics 2 - obstetrics and gynecology - neurology - Family Medicine - Clinical Pharmacology - And other clinical disciplines. 11. Thematic plan of internal medicine VII semester Classroom training 3 1. 1. Pneumonia. 2 LV, MP ARVI. 2. 2. Suppurative lung disease. Influenza. 3. Bronchial asthma. 3. 2 3 4. Chronic bronchitis. 3 2 5. COPD. 2 6. Pulmonary arterial hypertension. Chronic pulmonary heart. LV, MP 3 LV, MP 3 ASC, T R 5 2 ASC, T R 5 Allergic rhinitis. 6. LV, MP 3 ASC, T R 5 Tobacco addiction. 5. LV, MP 5 2 ASC, T R 5 Pulmonary insufficiency 4. Used educational technology IWS lecture Practical lessons Name of the theme. Shapes control № ASC, T R LV, MP ASC, T Atopic dermatitis. 5 7. 7. Hives. Anaphylactic shock. 2 3 Insect and food allergy. 8. 8. Hypertonic disease. Hypertensive crisis. 9. Hyperlipidemia. 2 3 2 10. CHD. Angina. LV, MP 3 3 ASC, T R LV, MP 5 2 ASC, T R 5 ECG cardiomegaly. 10. LV, MP 5 ECG is normal. 9. R ASC, T R LV, MP Т 11. ECG in ischemic heart disease. 11. CHD. Myocardial infarction. 5 2 3 Atherosclerosis. 12. R LV, MP 5 T R 12. Heart failure. 2 3 Acute coronary syndrome. LV, MP ASC, T R 5 13. Infective endocarditis. 13. 2 3 For the first time emerged angina. 14. 14. Acute rheumatic fever. 5 2 3 Unstable angina 15. 15. Acquired heart defects. Mitral and aortic heart defects. LV, MP R LV, MP 5 2 3 Curation of patients. ASC, T ASC, T R LV, MP ASC, T 5 Protecting medical history. Module № 1 Total: 30 45 75 Note: MP - multimedia presentation, LV - Lecture - visualization, ACS - analysis of clinical situations, T – testing. 12.1. Calendar-thematic plan for the distribution of hours of occupations, themes. Lectures: № 1 Name of sections, modules, themes and educational issues Lecture № 1. Topic: Pneumonia. hours 2h Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. What is community-acquired pneumonia? 2. Modern classification of pneumonia WHO. 3. Contributing to promote and causing factors in the etiology. 2. The main syndromes and symptoms of pneumonia. 3. The principles of treatment. Control questions to consolidate the material: 1. Auscultation picture of lungs in pneumonia. 2. Diagnostic criteria for severe. 3. What is the empirical antibiotic therapy? The form testing knowledge Operational survey. Literature: Main: [1.3]. Additional [2, 4] 2. Lecture № 1. Topic: Suppurative lung disease. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. Endo and peribronchial the development of bronchiectasis. 2. The radiological and endoscopic techniques in the diagnosis. 3. Clinic with regard to the stage and localization process. Control questions to consolidate the material: 1. What is congenital bronchiectasis? The main risk factors for acquired bronchiectasis. 2. Auscultation picture of bronchiectasis. 3. What type of ventilation disorders characteristic of BE? 4. What is a restrictive type of violation? 5. The characteristic radiographic signs of bronchiectasis. 2h 6. What is the most informative objective clinical sign for the diagnosis of localized form of bronchiectasis is sick? The form testing knowledge Operational survey. Literature: Main: [1.3]. Additional [2, 4] 3. Lecture № 3. Topic: Bronchial asthma. Plan of the lecture: 1. Definition 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. 2h. General questions: 1. The modern definition of asthma according to guide GINA. 2. The main risk factors for asthma. 3. The pathogenesis of bronchial obstruction. 4. Clinical and Instrumental the specifications of bronchial obstruction syndrome. 5. Monitoring the severity of asthma. Control questions to consolidate the material: 1. What is bronchial obstruction? 2. The criteria for the diagnosis of asthma (which is a positive bronchodilation test). 3. Causes of aggravation asthma. 4. Objective assessment of the severity of an exacerbation. 5. What is sequential therapy? 6. What medications is the first-line treatment of exacerbations of asthma? 7. List second-line drugs for the treatment of acute asthma. 8. Indication of oxygen therapy. The form testing knowledge Operational survey. Literature: Main: [1.3]. Additional [2, 4] 2h. 4. Lecture № 3. Topic: Chronic bronchitis. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. 2. 3. 4. 5. Relevance of the topic. Epidemiology of chronic bronchitis. The clinical picture of chronic bronchitis. The criteria for the diagnosis of chronic bronchitis. X-ray picture of chronic bronchitis. Control questions to consolidate the material: 1. What is pulmonary fibrosis? 2. Predisposing factors of chronic bronchitis. 3. Non medical treatment of chronic bronchitis. The form testing knowledge Operational survey. Literature: Main: [1, 3]. Additional [2, 4] 2h. 5. Lecture № 5. Topic: COPD Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. The general concept of COPD. 2. Role of exogenous factors in the development of COPD. 3. Respiratory and systemic signs of acute phase. 4. Laboratory and functional methods of examination. 5. Treatment of COPD in stable phase. 6. Indications for antibiotics for use of glucocorticoids, their method of use. Control questions to consolidate the material: 1. What is COPD? 2. Differencial diagnosis of COPD with asthma. 3. Diagnostic criteria for acute phase. 4. What positive symtom Votchala-Tifno. 5. Indications for hospitalization of patients with COPD. The form testing knowledge Operational survey. Literature: Main: [1, 3]. Additional [2, 4] Lecture № 6. Topic: Pulmonary hypertension. Chronic pulmonary heart. 2h. 6. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. The concept of the pulmonary hypertension. 2. The role of pulmonary arterial hypertension with prolonged vasoconstriction and vascular remodeling. 3. Basic options pulmonary arterial hypertension. 4. Promotional and predisposing factors. 5. The diagnostic criteria. 6. Possible complications PH. 7. The concept of the CPH. 8. Classification etiology and severity of the pathological process. 9. Features of treatment of right ventricular failure. Control questions to consolidate the material: 1. The main causes of pulmonary heart. 2. What is hypercapnia, and acidosis. 3. Clinical and instrumental features compensated pulmonary heart. 4. The clinical picture of decompensated pulmonary heart. The form testing knowledge Operational survey. Literature: Main: [1, 3]. Additional [2, 4] 7. Lecture № 7. Topic of the lecture: Urticaria. Anaphylactic shock. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. Risk factors for acute urticaria. 2. Risk factors for chronic urticaria. 3. Clinical and laboratory Environmental Specifications urticaria. 4. Complications of angioedema. 3. What is anaphylactic shock? 6. Emergency assistance in anaphylactic shock. Control questions to consolidate the material: 1. What is dermographism? 2h. 2. What is the immediate allergic reaction? 3. What is an allergy? The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] 8. Lecture № 8. The theme of the lecture: Hypertensive heart disease. Hypertensive crisis. 2h. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. What is essential hypertension, the major risk factors? 2. What is symptomatic hypertension? 3. Under what nosologies meets symptomatic hypertension. 4. The classification of blood pressure levels. 5. Modifiable risk factors and non-modifiable HD. 6. The role of the sympathetic-adrenal system in raising blood pressure. 7. Roll endothelial factors, metabolism of sodium increase blood pressure. 8. The hemodynamic effects of hypertension and target organ damage. 8. Selection of antihypertensive drugs. Control questions to consolidate the material: 1. What is an ACE inhibitor? 2. Contraindications of beta-blockers. 3. Side effects of diuretics. The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] 9. Lecture № 9. Topic: Hyperlipidemia. Coronary heart disease. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 2h. 5. Diagnostics. 6. Treatment. General questions: 1. What is hyperlipidemia? 2. The social significance of the problem. 4. Risk factors for hyperlipidemia (the smoking violation of lipid metabolism, of thrombosis, diabetes and a number of factors working and living conditions). 5. Features of clinical manifestations, laboratory, instrumental and angiographic methods. 6. Primary and secondary preventation. Control questions to consolidate the material: 1. Contributing factors IHD. 2. Risk groups. 3. ECG change at IHD. The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] 10. Lecture № 10. The theme of the lecture: CHD. Angina Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. Relevance of the topic (social importance). 2. The value of the risk factors. 3. The role of functional and anatomical factors. 4. Pathogenesis of pain. 5. Clinical variants. 6. ECG to identify coronary insufficiency (pharmacological and stress tests). 7. Treatment. Relief of pain and prevention of attacks. 8. Principles speed drug therapy. Control questions to consolidate the material: 1. Veloergometry, indications and contraindications. 2. What is the questionnaire Rose? 3. The indications for surgical treatment. 2h. The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] 11. Lecture № 11. The theme of the lecture: CHD. Myocardial infarction. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. 2h. General questions: 1. Relevance of the topic. 2. Risk Factors. 3. The mechanisms of destabilization of atherosclerotic plaque. 3. The clinical picture of the disease, taking into account periods. 4. Clinical variants of onset of the disease. 5. diagnosis. ECG, blood analysis, biochemical parameters, cardiac markers. 6. Complications: cardiogenic shock, rhythm and conduction disturbances, heart failure, first and late aneurysm, cardiac tamponade, Dressler's syndrome. 7. The value of the early hospitalization and pain relief. Control questions to consolidate the material: 1. What is a symptom of flags? 2. What Dressler's syndrome? 2. What is the thrombolytic therapy? The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] 12. Lecture № 14. The theme of the lecture: Heart failure. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. The concept of AHF. 2. The concept of CHF. 3. The concept of "latent heart failure." 4. Characteristics of changes metobalism infarction. 2h. 5. Mechanisms and systolic dysfunction diastolic ventricular failure. 6. The nature of hemodynamic changes (systemic and regional). 7. The role of the kidneys and endocrine factors in violation of waterelectrolyte balance. 8. Clinical and instrumental the specifications of acute and chronic heart failure. 9. Emergency medical assistance in cardiac asthma and pulmonary edema. Control questions to consolidate the material: 1. ECG signs of hypertrophy of the left atrium. 2. Which diseases observed AHF? 3. What is heart failure? 5. In what diseases occur CHF? 6. Cardiac compensation mechanisms. 7. Rules for the application of cardiac glycosides and diuretics. The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] 13. Lecture 13. Topic: Infective endocarditis. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. Type of infection affecting the endocardium. 2. The conditions (promoting and predisposing factors) in the occurrence of the disease. 3. Definitions: the primary and secondary IEK. 4. Clinical -patogeneticheskie especially with the defeat of targets. 5. Infectious-toxic, immunnovospalitelnaya and dystrophic stage. 6. Features of fever acute and subacute stages of the disease. 7. Have sipmtomov characteristic lesions in the study of the skin, mucous membranes, nails and fingers of the hands, the feet. 8. Physical signs of damage to the heart, liver, spleen. 9. Diagnostic difficulties. 10. Treatment. Indications to surgical treatment (relative and absolute) Control questions to consolidate the material: 1. Laboratory and instrumental signs. 2. Diagnostic criteria for infective endocarditis. 2h. 3. The role of echocardiography in the dynamics. 4. Plan examined patients with IE. The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] 14. Lecture № 14. The theme of the lecture: Acute rheumatic fever. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. Relevance of the topic. 2. The role of streptococcal infection of family and genetic predisposition in the occurrence of diseases, the dependence of age and living conditions. 3. Pathology of inflammation of connective tissue and organ damage. 4. Features of latent symptoms and symptomatic periods in the development of rheumatic fever with organ damage (heart, joints, skin, serous membranes, brain). 5. Large and small display with additional criteria to identify disease activity. 6. Terms of the use of antibacterial and anti-inflammatory therapy. 7. Primary and secondary prevention. Control questions to consolidate the material: 1. What's chorea? 2. What is the big chorea? 3. Identify the process activity. 4. Indications for antibacterial drugs. 5. List the complications. The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] 2h. 2h Lecture № 15. The theme of the lecture: Acquired heart defects. Mitral and aortic heart defects. Plan of the lecture: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. Diagnostics. 6. Treatment. General questions: 1. Features defeat anatomical and morphological structures of valvular heart disease in patients with chronic rheumatic disease. 2. Violation of intracardiac and general hemodynamics in heart diseases with features dependent on the location of the lesion. 3. Clinic with features specific to each of the flogging of the heart and in the presence of a combination of them. 4. Stages flow. 5. ECG, echocardiography signs in each of parkas. 6. The basic principles of treatment. 7. Primary and secondary prevention. Control questions to consolidate the material: 1. Characteristic complaints of patients. 2. The general examination of patients. 3. The specifications auscultation heart murmurs. 4. What is mitral stenosis? 5. Mitral valve prolapse. 6. Failure of the mitral valve. 7. Tricuspid valve. 8. Aortic valve. 9. Combined heart disease. The form testing knowledge Operational survey. Literature: Main: [1, 2, 3]. Additional [2, 4] The content of practical training № Name sections and modules 1 Lesson № 1. Study subject: Community-acquired pneumonia. hours 3h Lesson Plan: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. The clinical picture. 6. Diagnostics. 7. Treatment. General questions: 1. The general concept of pneumonia. 2. Contributing to promote and causing factors in the etiology. 3. The most frequent infectious agents. 4. clinicoanamnestic especially community-acquired pneumonia. 5. The diagnostic criteria for severe. Additional (paraclinical) diagnostic methods, their interpretation of the results. 6. Construction of a clinical diagnosis and its rationale. 7. Indications for hospitalization, study the admissibility of treatment on an outpatient basis. 8. Antibiotic therapy: Empirical rational selection of antibiotics, enteral, parenteral and step how to use them. 9. Criteria for assessing effectiveness. Detoxication and immune-boosting drugs. Outcomes. Forecast. Equipment class: 1. Test questions for pneumonia. 2. Case studies. 3. Case reports of patients with pnemonia. 4. Patient with pneumonia. Control questions to test students' knowledge: 1. The main complaints of patients with pneumonia. 2. Physical findings of pneumonia. 3. Laboratory data for pneumonia. 4. Tool data syndrome seal lung. Task for IWS: ARVI The form of examination The survey, testing, problem solving. Literature: Summary: [1, 2, 3]. General: [4, 5] 2 3h Lesson № 2. Study subject: Suppurative lung disease Lesson Plan: Bronchiectasis. 1. Determination. 2. Endo and peribronchial path of development of bronchiectasis. 3. Types of bronchiectasis. 4. Etiology: the role of childhood diseases (measles, whooping cough), pulmonary malformations. 5. X-ray and endoscopic techniques in the diagnosis. 6. Clinic, complications. 7. Antibiotic therapy, mucolytics, therapeutic bronchoscopy, postural drainage. Indications for surgical treatment. Abscesses and gangrene. 1. Aspiration, hematogenically-embolic and traumatic way of development 3. Clinic with regard to the stage, location, type of infection. Complications. 4. X-ray and tomography in the diagnosis. 5. Bronchoscopic drainage, segmental bronchi catheterization. 6. Antibiotic therapy. 7. Pokazaniya to surgical treatment. General questions: 1. What is suppurative lung disease? 2. The main symptoms of bronchiectasis. 3. Risk factors for bronchiectasis 4. General inspection of patients with bronchiectasis. 5. Physical findings of bronchiectasis. 6. Laboratory data. 7. The general principles of treatment. Equipment classes: 1. Tests. 2. Patients with bronchiectasis. Control questions to test students' knowledge: 1. Characteristic complaints of patients with bronchiectasis. 2. The physical data in bronchiectasis. 3. Laboratory and instrumental data. Task for IWS: Influenza. The form of examination Poll testing. Literature: Summary: [1, 2, 3, 6]. General: [4, 5] 3. Lesson № 3. Study subject: Asthma. Lesson Plan: 1. Definition of asthma 2. Ehtiopatogenez BA 3. Clinic and examination. 4. Surveys and the differential diagnosis. 3h 5. Treatment. Questions: 1. Predisposes and contributing factors of asthma. 2. The pathophysiological and clinical criteria in the definition of asthma. 3. Pathogenesis of bronchial obstruction. 4. Atopic and non-atopic options. 5. The severity and diagnostic criteria. 6. Basic anti-inflammatory and bronchodilator therapy. 7. Monitoring of the degree of severity. 8. Education program patients. Equipment classes. 1. Tests. 2. Case studies. 3. Patients with asthma. Control questions to test students' knowledge: 1. What is bronchial obstruction? 2. Criteria for the diagnosis of asthma (which is a positive bronchodilation test). 3. Causes of aggravation asthma. 4. An objective assessment of the severity of an exacerbation. 5. What is a sequential therapy? 6. What medications is the first-line treatment of exacerbations of asthma? 7. List the second-line drugs for the treatment of acute asthma. 8. Indication of oxygen therapy. The form of examination The survey, testing, problem solving Task for CPC: Respiratory failure. Literature: Summary: [1, 2, 3,6]. General: [4, 5] 4 Lesson № 4. Study subject: Chronic bronchitis. Lesson Plan: 1. The definition of chronic bronchitis. 2. Ehtiopatogenez. 3. Classification. 4. The clinical picture. 5. The diagnostic criteria. 6. Treatment. General questions: 1. The general concept of chronic bronchitis. 2. The syndrome of bronchial obstruction and Environmental Specifications. 3. The difference from the obstructive bronchitis obstructive bronchitis. 4. Definition, etiology and pathogenesis, clinical presentation, and chronic bronchitis 3h 5. The principles of treatment in an outpatient setting. Control questions to test students' knowledge: 1. The clinical picture of the syndrome of bronchial obstruction. 2. Causes of chronic bronchitis. 3. Clinical characteristics of the cough syndrome 4. Laboratory and instrumental data of chronic bronchitis. Equipment classes. 1. Tests. 2. Case studies. 3. Patients with chronic bronchitis. The form of examination The survey, testing Task for IWS: Tobacco dependence. Literature: Summary: [1, 2, 3,6]. General: [4, 5] 5 Lesson № 5. Study subject: COPD. Lesson Plan: 1. Definition. 2. Ehtiopatogenez. 3. Clinic and examination. 4. Classification of COPD 5. Survey and holding diff.diagnostiki 6. Treatment Questions: 1. Relevance of the topic. 2. The role of exogenous factors (smoking, occupational, ecological), a genetic predisposition. 3. Role inflammatory reaction in the bronchi, the failure of the mucociliar system and local immunity factors. 4. The diagnostic criteria for COPD I to IV stage in a stable phase, respiratory and systemic signs of exacerbation. 5. Modern methods of examination and tests for the reversibility of airflow obstruction. 6. Treatment in a stable phase of COPD exacerbation treatment process. 7. Indications for antibiotics, the use of glucocorticoids. 8. Сlinical examination Equipment classes: 1. Test questions. 2. Patients with COPD. Control questions to test students' knowledge: 1. Indication to corticosteroid therapy. 3h 2. The differential diagnosis with other obstructive syndromes. 3. What does the decline in FEV1? 4. What is the Index Tifno? 5. The main types of violation of the ventilation. The form of examination The survey, testing, control work Task for IWS: Allergic rhinitis. Literature: Summary: [1, 2, 3, 6]. General: [4, 5] 6 Lesson № 6. Study subject: Pulmonary arterial hypertension. Chronic pulmonary heart. Lesson Plan: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. The clinical picture. 6. Diagnostics. 7. Treatment. General questions: 1. The concept of the PAH 2. The role of pulmonary arterial hypertension with prolonged vasoconstriction and vascular remodeling. 3. Significant hemodynamic changes. 4. Basic variants of pulmonary arterial hypertension. 5. Promote and predisposing factors of PAH. 6. Diagnostic criteria CPH. 7. Possible complications. 8. The concept of the CPH. 9. The mechanism of CPH. 10. Classification etiology and severity of the pathological process. 11. Clinical and instrumental signs of decompensated CPH. 12. Principles of treatment. Control questions to test students' knowledge: 1. The main causes of pulmonary heart. 2. What is hypercapnia, and acidosis? 3. Clinical and instrumental features compensated pulmonary heart. 4. The clinical picture of decompensate pulmonary heart. Equipment classes. 1. Tests. 2. Case studies. 3. Patients with PAH and CPH. The form of examination 3h 7 The survey, test, test. Task for IWS: Atopic dermatitis. Literature: Summary: [1, 2, 3]. General: [4, 5] Lesson № 7. Study subject: Urticaria. Angioedema. Anaphylactic shock. 3h Lesson Plan: 1. Definition of urticaria, angioedema, anaphylactic shock. 2. Ehtiopatogenez. 3. Classification. 3. Clinic and study, diagnosis. 4. Treatment. Questions: 1. The causes of urticaria. 2. Risk Factors. 3. The clinical picture. 4. Methods of treatment. 5. Emergency assistance in anaphylactic shock. Control questions to test students' knowledge: 1. The etiology of acute urticaria. 2. The clinical picture of anaphylactic shock. 3. The etiology of chronic urticaria 4. The clinical picture in angioedema. Equipment classes. 1. Tests. 2. Case studies. 3. Patients with chronic urticaria. The form of examination The survey, testing, control work. Task for IWS: Insect and food allergy. Literature: Basic: [1, 2, 3]. General: [4, 5] 8. Lesson № 8. Study subject: Hypertensive heart disease. Hypertensive crisis. Lesson Plan: 1. Determination of GB 2. Ehtiopatogenez GB 3. Clinic and examination. 4. Examination, treatment, early detection. 5. Drug-free and medication. Questions: 1. What is essential hypertension? 2. Contributing factors. 3. Risk groups. 4. The classification levels of blood pressure, according to the stages and degrees. 3h 5. Pathogenesis: the ratio of cardiac output and total peripheral vascular resistance and increase blood pressure, the role of the central nervous system to increase blood pressure, the role of sympathoadrenal, endothelial factors. 5. The clinical signs. 6. Complications. Hypertensive crisis. 7. Selection of antihypertensive drugs. 8. Methods of measurement of blood pressure. Control questions to test students' knowledge: 1. What is essential hypertension? 2. Contributing factors. 3. Risk groups. 4. What is the hypertensive crisis? Equipment classes. 1. Tests. 2. Case studies. The form of examination The survey, testing, control work The task for the IWS: The ECG is normal. Literature: Summary: [1, 2, 3]. General: [4, 5] 9 Lesson № 9. Study subject: Hyperlipidemia CHD. Lesson Plan: 1. Definition. 2. Classification. 3. Etiology. 4. Pathogenesis. 5. The clinical picture. 6. Diagnostics. 7. Treatment. Questions: 1. Relevance of the topic. 2. The causes of hyperlipidemia. The social significance of the problem. Risk factors: poor diet, lack of exercise, age, gender, heredity, smoking, obesity, diabetes. 3. The formation of lipid spots and stripes. The formation of the fibrous plaque. Formation of "complicated" plaque. 4. The effects of ischemic myocardial injury. 5. Classification of the BSC. 6. Features of clinical picture and diagnostics. 7. Primary and secondary prevention. Control questions to test students' knowledge: 1. The concept of coronary heart disease. 2. Ehtiopatogenez CHD. 3. Risk factors for CHD. 3h 3. Diagnosis of CHD. 4. Primary and secondary prevention of CHD. The form of examination The survey, test, test. Equipment classes. 1. Tests. 2. Case studies. Task for IWS: ECG cardiomegaly. Literature: Summary: [1, 2, 3]. General: [4, 5] 10 Lesson № 10. Study subject: Angina. Lesson Plan: 1. Definition. 2. Classification. 3. Clinic picture. 4. Diagnosis. 5. Treatment. Questions: 1. Relevance of the topic. 2. The social significance of the problem. 3. Risk Factors. Meaning smoking violation of lipid metabolism, of thrombosis, diabetes, conditions of life and work. 4. Classification: stable angina; Spontaneous angina; silent myocardial ischemia; Micro vascular angina syndrome ("X") 5. Pathogenesis features 6. Features of clinical picture. 7. Laboratory, X-ray, angiography in the diagnosis. 8. Primary and secondary prevention. 9. The role of physical activity, a balanced diet. 10. Treatment and preventive use of drugs. Control questions to test students' knowledge: 1. Risk factors angina. 2. Characteristics of pain. 3. Principles of therapy of patients with CLO Equipment classes: 1. Tests. 2. Patients with angina. The form of examination Poll testing. Task for IWS: ECG CHD. Literature: Summary: [1, 2, 3, 4]. General: [4, 5] 3h 11 Lesson № 10. The theme of the activity: coronary artery disease. Myocardial infarction. Lesson Plan: 1. Definition of MI. 2. Classification MI. 3. Clinic and diagnosis of myocardial infarction. 4. Treatment. Questions: 1. Relevance of the topic. 2. The concept of acute coronary syndromes: unstable angina, myocardial infarction, sudden death. 3. The pathogenesis of acute coronary syndromes. The mechanisms of destabilization of atherosclerotic plaques. Thrombosis. 4. The clinical picture of "uncomplicated" myocardial infarction tooth Q. 5. Features of clinical picture of myocardial infarction without tooth Q. 6. Laboratory diagnosis of myocardial infarction. 7. ECG, echocardiography. Coronary angiography. 8. Treatment "uncomplicated" myocardial infarction tooth Q. 9. Complications of myocardial infarction: DOS. Rhythm and conduction disturbances. Left ventricular aneurysm. 3h Control questions to test students' knowledge: 1. Clinical variants of myocardial infarction. 2. Classification of myocardial infarction by the nature of the disease and localization process. 3. What is the state of preinfarction? 4. Indications for emergency coronary angiography. 5. Method of thrombolysis. Obsalyute and relative contraindications of thrombolytic therapy. 6. Complications of reperfusion therapy. 7. The most common complications of MI. Equipment classes. 1. Tests. 2. Case studies. 3. ECG materials with AMI. Form of examination survey testing. Task for IWS: Atherosclerosis. Literature: Summary: [1, 2, 3,4]. General: [4, 5] 12 Lesson № 12. Topic: Heart Failure Lesson plan: 1. Definition of heart failure. 2. Ehtiopatogenez HF. 3. Clinic and examination of patients with heart failure. 4. Features of the survey and conduct, differential diagnosis 5. Treatment. Questions: 1. The etiology of heart failure: the defeat of the heart muscle (myocardial insufficiency); hemodynamic overload of the ventricles of the heart; violation of 3h the filling of the ventricles of the heart; increase the metabolic needs of the tissues. 2. Pathogenesis: Mechanisms of systolic and diastolic ventricular failure; cardiac compensation mechanisms; extra cardiac compensation mechanisms. 3. The main clinical forms of heart failure: acute heart failure, chronic systolic heart failure. 4. Scale of assessment of the clinical status of patients with chronic heart failure (SHOKS). 5. Criteria for diagnosis of AHF and CHF. 6. The basic principles of treatment of heart failure. 7. Drug and non-drug therapies Control questions to test students' knowledge: 1. ECG signs of hypertrophy of the left atrium. 2. Which diseases observed AHF? 3. What is heart failure? 5. In what diseases occur CHF? 6. Cardiac compensation mechanisms. 7. Rules for the application of cardiac glycosides and diuretics. Equipment classes. 1. Tests. 2. Case studies. 3. Patients with chronic heart failure. The form of examination A survey of the problem Task for CPC: Acute coronary syndrome. Literature: Summary: [1, 2, 3]. General: [2, 3, 4] 13 Lesson № 13. Study subject: Infective endocarditis. Lesson plan: 1. Determination of IE. 2. Epidemiology of IE. 3. Ehtiopatogenez IE. 4. Classification. 5. Clinic and examination of patients with IE. 6. Features of the survey and conduct differential. diagnostics. 7. Treatment. General questions: 1. Relevance of the topic. 2. Type of infection affecting the endocardium. 3. Contributing and predisposing factors in causing the disease. 4. The concept of "primary" and "secondary" IAC. 5. Clinical and pathogenetic features of a lesion of the target. 6. Infectious-toxic, immuno and dystrophic stage. 7. Features of fever in acute and subacute onset of the disease. 3h 8. The characteristic symptoms of the skin, fingers and nails of the hands, the feet. 9. Physical signs of damage to the heart, liver, spleen. 10. Laboratory tests of blood and urine in the diagnosis. Buck. Blood cultures. 11. The role of echocardiography in the diagnosis. 12. Features IE in elderly and senile patients, drug addicts, have prosthetic valves. 13. Pharmacological and non-pharmacological treatments 4. Indications for surgical treatment. Control questions to test students' knowledge: 1. Laboratory and instrumental signs. 2. Diagnostic criteria for infective endocarditis. 3. The role of echocardiography in the diagnosis 4. The plan of examination of patients with IE. Equipment classes. 1. Tests. 2. Case studies. The form of examination A survey of the problem. The task for the SIW: first time emerged angina. Literature: Summary: [1, 2, 3]. General: [2, 3, 4] Lesson №14. Subject: Acute rheumatic fever. Lesson plan: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. The clinical picture. 6. Diagnostics. 7. Treatment. Questions: 1. Relevance of the topic. 2. The role of streptococcal infection of family and genetic predisposition in the occurrence of diseases, the dependence of age and living conditions. 3. Pathology of inflammation of connective tissue and organ damage. 4. Features of latent symptoms and symptomatic periods in the development of rheumatic fever with organ damage (heart, joints, skin, serous membranes, and brain). 5. Large and small display with additional criteria to identify disease activity. 6. Terms of the use of antibacterial and anti-inflammatory therapy. 3h 7. Primary and secondary prevention of streptococcal infection. Control questions to test students' knowledge: 1. What's chorea? 2. What is the big chorea? 3. Identify the process activity. 4. Indications for antibacterial drugs. 5. List the complications. Equipment classes. 1. Tests. 2. Case studies. Forms of examination The survey, problem solving. Task for SIW: Unstable angina. Literature: Summary: [1, 2, 3]. General: [3, 4] 15. Lesson № 15. The theme of the activity: Acquired heart defects. Mitral and aortic heart defects. Lesson plan: 1. Definition. 2. Etiology. 3. Pathogenesis. 4. Classification. 5. The clinical picture. 6. Diagnostics. 7. Treatment. General questions: 1. Classification: Mitral stenosis; Mitral valve insufficiency; Aortic stenosis; Aortic valve insufficiency; Tricuspid stenosis; Lack of pulmonary artery valve. 2. Features defeat anatomical and morphological structures of valvular heart disease in patients with chronic rheumatic disease. 3. Violation of intra cardiac and general hemodynamics in heart diseases with features dependent on the location of the lesion. 4. The clinic with features specific to each of the flogging of the heart and in the presence of a combination of them. 5. Stages flow. 6. ECG, echocardiography signs in each of parkas. 7. Basic principles of treatment. 8. Primary and secondary prevention. 3h Control questions to test students' knowledge: 1. Characteristic complaints of patients. 2. The general examination of patients. 3. The specifications auscultation heart murmurs. 4. What is mitral stenosis? 5. Mitral valve prolapse. 6. Failure of the mitral valve. 7. Tricuspid valve. 8. Aortic valve. 9. Combined parkas heart. Equipment classes. 1. Tests. 2. Case studies. 3. Patients with CHRD. Forms of examination The survey, case studies. Task for SIW: Curation of patients. Protecting medical history. Literature: Summary: [1, 2, 3]. General: [3, 4] 13. Chart students' independent work. № Name sections, themes and educational issues 1 № 1. Subject SIW. Acute respiratory viral infection. Task: 1. In the infectious disease department of a hospital or outpatient conducting questioning and examination of the patient with SARS 2. To be able to fill out a medical history and outpatient card Study questions: 1. Definition 2. Classification 3. Etiology. 4. Pathogenesis. 5. The clinical picture. Control of the SIW: 1. Summary. 2. Oral survey. 3. Case History Literature: number of hours deadline 5 1 boundary control maxim um points 0.3 2 Summary: [1, 2, 3]. General: [3, 4] № 1. Subject SIW. Acute respiratory viral infection Task: 1. In the infectious disease department of a hospital or outpatient conducting questioning and examination of the patient with the flu. 2. To be able to fill out a medical history and outpatient card Study questions: 1. Definition 2. Classification 3. Etiology. 4. Pathogenesis. 5. The clinical picture. Control of the SIW: 1. Summary. 2. Oral survey. 3. The history of the disease Literature: Summary: [1, 2, 3]. General: [3, 4] 5 1 boundary control 0.3 3 № 1. Subject SIW. Respiratory failure. 5 Task: 1. In pulmonology therapeutic outpatient department of a hospital or conducting questioning and examination of patients with diseases of the respiratory system 2. To be able to fill out a medical history and outpatient card. Study questions: 1. Definition 2. Classification 3. Etiology. 4. Pathogenesis. 5. The clinical picture. Control of the SIW: 1. Summary. 2. Oral survey. 3. The history of the disease Literature: Summary: [1, 2]. General: [3, 4] 1 boundary control 0.3 4 № 1. Subject SIW. Tobacco addiction Task: 1. In pulmonology or therapeutic department of a hospital or outpatient conduct auscultation of patients with pathology of respiratory and cardiac systems familiarization with the methodology of the lab tests of patients with respiratory diseases 2. To be able to fill out a medical history and outpatient card. Study questions: 1. Definition 2. Classification 3. Harmful effects of smoking on the body. Control of the SIW: 1 boundary control 0.3 5 1. Summary. 2. Oral survey. 3. The history of the disease Literature: Summary: [1, 2.3]. General: [3, 4] 5 № 1. Subject SIW. Allergic rhinitis. Task: 1. Allergic or therapeutic outpatient department of a hospital or conducting questioning and examination of patients with diseases of allergy diseases. 2. Be familiar with basic principles of the symptoms and treatment of allergic rhinitis. Study questions: 1. Definition; 2. Classification; 3. Etiology; 4. Pathogenesis; 5. The clinical picture; 6. Treatment. Control of the SIW: 1. Summary. 2. Oral survey. 3. The history of the disease Literature: Summary: [1, 2, 3, 4]. General: [3, 4] 5 1 boundary control 0.3 6 № 1. Subject SIW. Insect and food allergy. Task: 1. Allergic or therapeutic outpatient department of a hospital or conducting questioning and examination of the patient with an allergy. 2. Be familiar with basic principles of the symptoms and treatment of Insect and food allergies. Study questions: 1. Definition 2. Classification 3. Etiology. 4. Pathogenesis. 5. The clinical picture. Control of the SIW: 1. Summary. 2. Oral survey. 3. The history of the disease Literature: Summary: [1, 2]. General: [3, 4] 5 1 boundary control 0.3 7 № 1. Subject SIW. ECG is normal. In cardiology, or therapeutic department of a hospital or outpatient holding ECG interpretation. Study questions: 5 1 boundary control 0.3 1. The function of the heart. 2. Structure and function of the cardiac conduction system. 3. Vector magnitude. 4. The electric field. 5. Electrophysiological basics of electrocardiography. 6. The course of excitation and repolarization of the myocardium as a whole. 7. Electrocardiograph leads. 8. Method of recording an electrocardiogram. Control of the SIW: 1. Summary. 2. Oral survey. 3. The history of the disease Literature: Summary: [1, 2]. General: [3, 4] 8 № 1. Subject SIW. ECG cardiomegaly. Task: In cardiology, or therapeutic department of a hospital or outpatient holding ECG interpretation. 1. Hypertrophy of the right atrium. 2. Overloading the right atrium. 3. Hypertrophy of the left atrium. 4. Overload of the left atrium. 5. Left ventricular hypertrophy. 6. Right ventricular hypertrophy 5 1 boundary control 0.3 5 1 boundary control 0.3 1 boundary control 0,3 Control of the SIW: 1. Summary. 2. Oral survey. 3. The history of the disease Literature: Summary: [1, 2]. General: [3, 4] 9 № 1. Subject SIW. ECG in ischemic heart disease. Study questions: 1. Signs of myocardial scarring. 2. Signs of passing myocardial ischemia. 3. Signs of subendocardial myocardial ischemia. Control of the SIW: 1. Summary. 2. Oral survey. Demonstration of the patient Literature: Summary: [1, 2, 3]. General: [3, 4] 10. № 1. Subject SIW: Atherosclerosis. Study questions: 1. Definition; 2. Classification; 3. Etiology; 4. Pathogenesis; 5. The clinical picture; 6. Treatment. Control of the SIW: 1. Summary. 2. Oral survey. Demonstration of the patient Literature: Summary: [1, 2, 3]. General: [3, 4] 11. № 1. Subject SIW. Тема: Acute coronary syndrome Study questions: 1. Determination; 2. Classification; 3. Etiology; 4. Pathogenesis; 5. The clinical picture; 6. Treatment. Control of the SIW: 1. Summary. 2. Oral survey. 3. The history of the disease Literature: Summary: [1, 2, 3]. General: [3, 4] 5ч. 1 boundary control 0.4 12. № 1. Subject SIW. Тема: For the first time emerged angina. 5ч. 1 boundary control 0.4 5ч. 1 boundary control 0.4 Study questions: 1. Definition; 2. Ehtiopatogenez; 3. The clinical picture and principles of treatment. Control of the SIW: 1. Summary. 2. Oral survey. Demonstration of the patient Literature: Summary: [1, 2, 3]. General: [3, 4] 13. № 1. Subject SIW. Тема: Spontaneous and unstable angina. Study questions: 1. Definition; 2. Ehtiopatogenez; 3. The clinical picture and principles of treatment. Control of the SIW: 1. Summary. 2. Oral survey. Demonstration of the patient Literature: 14. Summary: [1, 2, 3]. General: [3, 4] № 14. Subject SIW. Curation of patients. 5ч. 1 boundary control 0,8 Know and own methods of clinical, laboratory and instrumental studies supervised patient. Control of the SIW: 1. The history of the disease. 2. Oral survey. Demonstration of the patient Literature: Summary: [1, 2, 3]. General: [3, 4] 15 Protecting medical history. Module №1. 75 5 14. Literature. 14.1. Main references: 1.Harrisons PRICIPLES OF INTERNAL MEDICINE Seventeenth Edition Copyright 2008 Fauci, Braunwald, Kasper, Longo, Jameson, Loscalzo 2. Davidsons Principles & Practice of Medicine 21st Edition Nicki R. College, Brain R. Walker, Stuart H. Ralston. 3. Current Medical diagnosis & Treatment 2009 Stephen J. McPhee, Maxine A. Papadakis, Eds. Ralph Gonzales, Roni Zeiger, Jnline Eds. 4. First aids Internal Medicine boards 2nd Edition Copyright 2008 by Tao Le. All rights reserved. 14.2. Additional literature. 1. Common symptom Answer Guide a family medicine reference 2004 by The MC Graw-Hill Companies Jhon Wasson, MD, Ivan Oransky, MD 2. Lab Notes Guide to Lab & diagnostic tests Copyraight 2005 F.A.Davis Tracey Hopkins, BSN,RN. 3. Oxford handbook of clinical Medicine, 6th Edition Copyright BC 2004 Oxford university Press Murray Longmore, Lan B Wilkinson, Supraj R Rajagopaian 4.Common Symptom Answer Guide A family medical reference Copyright 2004 by The McGraw-HiII Companies, John Wasson,MD,Timothy WaIsh,MD, Mary C.LaBrecque,ARNP| MSN, Robert PanteII,MD,HaroId C.Sox,Jr., D.Ivan Oransky,MD. 5. Oxford handbook of general practice 4th edition Published in 2014 Chantal Simon, Hazel Everitt, Francoice van Dorp, Matt Burkes. 6. Clinical examination a systematic guide to physical diagnosis This edition 2014. Elsevier Austalia. 7. USMLE Step2 Internal Medicine Notes CAPLAN MEDICAL Charles J Faselis.M.D. Conrad Fisher, M.D., Scot Hines, M.D. 14.4. Electronic sources: 1. www.plaintest.com 2. www.booksmed.com 3. www.bankknig.com 4. www.wedmedinfo.ru 5. www.spr.ru 15. Information on the assessment (Bulletin №18, p. 12-15) The scale of assessments of academic achievement: Rating (Points) 87 – 100 81– 86 74 – 80 65 -73 61 – 64 31-60 0 - 30 Based on letter The digital system equivalent of assessment А 4,0 В 3,33 С 3,0 Д 2,33 Е 2,0 FX 0 F 0 Based on the traditional system Excellent Good satisfactorily unsatisfactorily I - evaluation, display, if the student does not have time for any valid reasons (serious illness (documented), travel or participate in events held by the University of emergency in the family), what he has to tell the teacher and Registration Office . I estimate I exhibited a teacher. If a student has not corrected estimate I within one month from the beginning of the next semester (excluding summer semester), he is automatically a grade F (not used in calculating GPA). P - Assessment, allows students to earn credit only. Estimate P is made only in the disciplines of choice (not used in calculating GPA). FX - a student who receives rating of FX can fix it within one month from the beginning of the next semester (or in the summer semester). The right to correction rating of FX provided under the personal application of the student in accordance with the approved schedule Registration Office. The procedure and conditions fixes rating of FX set by the relevant provision. If a student has not corrected rating of FX on time, it is automatically a grade F (not used in calculating GPA). F - a student who was rated F, must repeat the same academic discipline again if it is a compulsory subject. If the student will receive a second F for mandatory education program for this discipline, he can not continue to participate in this program. W - Evaluation, confirming the refusal of the student to continue the study of this discipline. Assessment W teacher can stand only in the terms established in the academic calendar. The student signs a form established by the Office of Registration and must re-learn this discipline, if it is mandatory (not used in calculating GPA). X - Score, which indicates that the student has been removed from the discipline teacher. The established form signed by the teacher and the head of the program. The student must repeat the course if it is a required course. If a student receives a second X, it is automatically placed F. Conditions X rating items specified in the syllabus of discipline (not used in calculating GPA). According to the results of the intermediate (semester) student performance exhibited: Number of units of credit, describing the complexity of the development of the discipline; Differentiated assessment of the quality of the development of student knowledge and skills within the discipline. As a result of performance calculated GPA , the maximum expression of which is 4.0 points. GPA (Grade Point Average) - average assessment of the level of educational achievements of students. Average calculated on the basis of student learning outcomes in each semester and at the end of training according to the formula: Where, n - number of courses per semester (for the last period of study) The results are recorded in the student's academic achievement sheet, where the current is put control in the light of the date of the check points and control points. 16. Politics scoring. One of the elements of the educational process in the conditions of the loan program is the use of score-rating system of evaluation of educational achievements of students. Grading Policy should be based on the principles of objectivity, transparency, flexibility and high differentiation. Conducting examinations as the main form of testing students involves a number of conditions to ensure the effectiveness of teaching evaluation procedure. The most important among them: a) The coverage of the sections of the curriculum and the understanding of the linkages between them; b) The depth of understanding of the specific issues being discussed, as well as the relevance and practical significance of the study subjects; the range of knowledge of the literature of the discipline; c) Logically correct, consistent, coherent and reasoned response to the construction of the exam; d) the level of independent thinking with elements of a creative approach to the presentation of the material. "Excellent" deserves a response that contains: - Possession of knowledge in the discipline of a study program; - A profound and systematic knowledge of the entire program material and the structure of a particular discipline, as well as the main content and innovation lecture course compared to the textbooks; - Clear and fluent conceptual apparatus, scientific language and terminology relevant science; - Clear and convincing formulation of response fluency skills and the results obtained on the practical and laboratory lessons; - Can apply the theoretical results and their own research in practice and in dealing with a difficult situation; - Basic knowledge of literature and exploring the further recommended reading; - Own view of the matter disclosed. "Good" deserves a response that contains: - Knowledge of the key problems of the program and the main content of the lecture course; - The ability to use conceptual and conceptual apparatus in the analysis of the main problems the program; - Knowledge of the most important works in the list of recommended reading; - The ability to perform tasks under the program; - In general it is logically correct, but not always accurate and reasoned statement of the answer; - Possession of knowledge on a subject matter of the full program, but has some gaps in the difficult sections, and partly on their own when leading questions gives a more or less complete answers to exam questions; - In their answers less logical than an A student, it is not always the most significant highlights, but does not allow serious errors in the answers can solve moderately severe situational theoretical and practical tasks; - Ownership of research methods, introduction to some of the literature of the discipline;- The student has sufficient ideological thinking and outlook "Satisfactory" assessment deserves a response that contains: - Fragmented, superficial knowledge of the most important sections of the program and the content of the lecture course; - Difficulties with the use of scientific and conceptual apparatus and terminology of the discipline; - Incomplete familiarity with the recommended literature; - A partial obstruction to the implementation of tasks under the program; - The desire is definitely a logical and consistent the answers; - Difficulties in self-expression responses plumage imprecise wording; - No release of the most significant, the answers are not quite convincing and logically consistent; suffers literary style of speech of acceptance of response bias; insufficient knowledge and practical skills of laboratory research; - The student is able to solve only the easiest case studies, has only a minimum of mandatory methods of research and independent work; - Insufficient guidance on the methodology, the fear to express their own judgments. The rating "Unsatisfactory" deserves a response that contains: - Lack of knowledge about the fragmentary representation of educational and program material; - Inability to perform tasks under the program; - Completely mastering minimum knowledge required for trainingdiscipline; - The student is not able to answer the exam questions, even with additional leading questions; - The lack of laboratory skills - Practical and independent work; - Not in the theoretical orientation of the materials is not the possession of practical skills; - Slight acquaintance with the basic and additional literature; - If the student does not respond to further questions from the examiner. 17. Politics course Requirements: a) Compulsory attendance; b) Activity during lectures and seminars; c) Preparation for classes to homework and IWS. Unacceptable: a) Delay and care from employment; b) The use of cell phones during class; c) Cheating and plagiarism. d) Late submission of assignments. Bonus points. 1. Preparation of presentations - 3 points. 2. Manufacture stands - 3 points. 3. Manufacture tables: 1tablitsa - 1 point. 4. Preparation of abstract messages - 1 point. 5. Systematic active work during the semester on a practical training - 2 points. Penalty points. 1. Being late to class - 1 point. 2. Disrespect to the medical staff, patients, Teachers - 2 points. 3. Smoking in the territory of hospital – 3points. 4. Untidy appearance, no robe, hood, spare shoes - 1 point. 5. Damaging government property, equipment - 3 points. 6. Systematic unprepared practical training - 3 points. 7. Regular lateness to class - 2 points. 18. The list of issues on the forms of control. Landmark control 1 Section Pneumology, Allergology. 1. The emergence of chronic bronchitis contribute to: a) smoking, exposure to industrial pollutants, adverse climatic factors; b) the pathology of the musculoskeletal system (scoliosis of the spine, ankylosing spondylitis); c) chronic diseases of the upper respiratory tract; d) a family history of lung disease; d) all of the above. 2. Bronchodilator drugs of purine derivatives (methylxanthines) sustained-release include the following: a) theophylline; b) Teofedrin; c) teopek, retafil; d) eufillin. 3. bronchial obstruction in asthma is caused by: a) bronchospasm; b) inflammatory edema of the bronchial mucosa; c) the closure of the bronchi viscous secret; d) spadenie small airways on exhalation; d) all the above. 4. The main clinical syndrome in asthmatic status are: a) progressive respiratory failure; b) increasing pulmonary hypertension; c) severe neuropsychiatric syndrome; d) all of the above. 5. Auscultation of the lungs in patients with pneumonia can be identified: a) reduced air in the absence of wheezing; b) dry wheezing; c) large bubbling crackles; g) finely crackles; d) crepitus wheezing; e) all of the above. 6. If you suspect a mycoplasma pneumonia should be given: a) penicillins; b) erythromycin; c) chloramphenicol; g) streptomycin; d) tseporin. 7. Factors contributing to the development of pneumonia: a) fatigue, b) emotional 8. Stress; c) trauma; d) cooling; d) the use of alcohol; e) all of the above. 9. life-threatening complications of pneumonia: a) lung abscess; b) pleurisy; c) myocarditis; d) pericarditis; e) infectious toxic shock. 10. The main cause of acute bronchitis in patients general health system are: a) the inhalation of gases and aerosols, irritating the mucous membrane of the airways, and b) hypothermia; c) viral and bacterial infections; d) Smoking; 11. In emphysema breathing: a) vesicular; b) vesicular weakened; c) vesicular strengthened; g) bronchial; d) saccadic. 12. Bronchial obstruction in asthma is caused by: a) bronchospasm; 13. b) inflammatory edema bronchial mucosa; c) the closure of the bronchi viscous secret; d) to fall small airways on exhalation; d) all the above. 14. The main treatment of asthma is: a) bronchodilator, b) anti-inflammatory - to) antibacterial; d) desensitizing; d) all of the above. 15. The most significant clinical sign indicating the status asthmaticus transition from I to stage II, is: a) the progression of shortness of breath; b) increase in cyanosis; c) the disappearance of previously listened to in pulmonary - wheezes; d) increase in blood pressure. 16. Mitral stenosis is often a result of: a) rheumatic fever; b) infective endocarditis; c) systemic lupus erythematosus; g) atherosclerosis. 17. The area of the left atrioventricular opening normally is: a) 1-2 cm²; b) 4-6 kv.sm.v) 8-10 square centimeters, d) all of the answers wrong 18. In mitral stenosis the tone (click) the opening of the mitral valve in the PCG appears after the II tone through: a) 0,08-0,11 sec; b) 0.2-0.3 sec .; c) 0.4-0.5 sec; r) 0.6-0.8 seconds. 19. In patients with mitral valve insufficiency percussion relative dullness of heart increased: a) up and to the left; b) left; c) is not increased; d) all of the answers are wrong. 20. Noise Flint is listened to at the apex of the heart: a) mitral stenosis; b) aortic stenosis; c) aortic valve regurgitation; d) failure of the mitral valve. 21. Listening to the "double" sound Duroziez femoral typical for: a) aortic stenosis; b) pulmonary valve insufficiency.; c) aortic valve regurgitation; d) failure of the mitral valve. 22. phonocardiograms unusual for patients with aortic stenosis is: a) a decrease in the amplitude of the aortic component of the 2nd tone; b) systolic murmur diamond shape; c) increase in the amplitude of the 1st tone. Landmark control 2 Section of Cardiology. 1. The optimum blood pressure WHO - are: a) 110/80 mm Hg .; b) 125 / 85mm Hg .; c) 130 / 85mm Hg .; g) 140 / 90mm Hg 2. The bodies - "target" is striking at the GB does not include: a) heart; b) the brain; c) liver; d) kidneys. 3. Signs of organ damage do not include: a) left ventricular hypertrophy; b) proteinuria, transient increase in creatinine; c) angiopathy of the vessels of fiber; d) angina. 4. Angiotenzii - converting enzyme ACE is involved in the following transition: a) renin angiotensinogen; b) renin angiotenzinI; c) angiotenzinaI to angiotensin 2 g) in angiotenzinI angiotensinogen. 5. To produce an inhibitor of ACE does not apply: a) hood; b) kantopril; c) ednit; d) Ernits. 6. The reason for the development of hypertensive crisis can be: a) psycho-emotional stress; b) excessive intake of salt; c) The sudden cancellation of clonidine; d) Only a true; d) All right. 7. The drug of choice for uncomplicated GB in patients with low-risk group of the following drugs is. a) Hydrochlorothiazide; b) Hydrolysinum; c) furosemide d) clonidine. 8. Which of the following laboratory signs has the greatest importance in laboratory diagnosis of myocardial infarction? a) leukocytosis; b) increase in the level of CK-MB; c) increase of ESR; d) an increase in creatinine. 9. trismuralnom myocardial infarction on ECG recording complex type. a) QRS; b) qRS; a) RS; d) QS. 10. pathological tooth Q-ECG sign that occurs when: a) the hypertrophy of the left ventricle; b) hypertrophy of the right stomach; c) acute myocardial infarction; d) mitral valve stenosis. 11. Monophasic curve or a symptom of "flag" on the ECG are: a) ST-segment depression below contours combined with a negative T wave; b) ST-segment elevation above the contour and its merger with positive T-wave; c) ST-segment elevation above the contours combined with a negative T wave; d) ST-segment depression below contours combined with a positive T wave 12. In order to relieve pain in myocardial infarction did not apply the following remedies: a) morphine; b) diphenhydramine; c) droperidol; g) fentanyl. 13. The sudden loss of consciousness, lack of pulse in the central arteries, respiratory arrest, the lack of reaction of pupils to light, ie, the development pattern of clinical death, characteristic of complications following myocardial infarction: a) cardiogenic shock; b) ventricular fibrillation; c) pulmonary edema; d) Dressler's syndrome. 14. Define the functional class of a patient suffering from angina, which pain occurs when walking and climbing 200m to the third floor: a) I; b) II; a) III; g) IV. 15. Because of the radiographic techniques for the diagnosis of atherosclerosis of the coronary arteries is used: a) aortography; b) angiography; c) selective cardiography; d) ventriculography. 16. Primary prevention of atherosclerosis and coronary artery disease are the following events, except: a) reduction vesv to normal values; b) daily physical activity; c) smoking cessation; d) more than 30g alcohol a day. 17. Determine the functional class of a patient suffering from angina pectoris, in which pain occurs when walking up to 15-20 meters: a) I; b) II; a) III; g) IV. 18. With the development of acute left ventricular heart failure is not typical: a) pulmonary congestion; b) shortness of breath; c) tachycardia; d) an increase in liver. 19. Which of the following methods of diagnosis is necessary to determine the functional class of angina when: a) radioisotope research; b) ventriculography; c) coronary angiography; d) ECG in conjunction with exercise stress. 20. Which of the following is not included in the term "resorption necrotic syndrome": a) fever; b) pericardial rub; c) neutrophilic changes in blood; d) an increase in erythrocyte sedimentation rate; d) detection of C-reactive protein in the. The examination tests Option 1 1. The drug of choice for treatment of lobar pneumonia: a) erythromycin; b) streptomycin; c) cephalosporins; g) penicillin; d) chloramphenicol. 2. The leading complaint of patients with acute bronchitis are: a) productive cough; b) cuhoy cough; c) chest pain. 3. Sputum of bronchiectasis: a) mucous b) purulent; c) putrefactive d) is absent. 4. For the treatment of focal pneumonia apply: a) penicillin; b) ampioks c) kefzol; g) a tetracycline. 5. Which of the drugs indicated for the initial treatment of bronchial asthma attacks: a) hydrocortisone; b) 2-stimulants c) eufillin d) Intal; d) beclomethasone. 6. manifestation of bronchial obstruction in chronic bronchitis is everything, except: a) hacking cough; b) dry wheezing on exhalation; c) shortness of breath; d) difficulty in sputum; d) spiral Kurshmana sputum. 7. Which factor is not involved in the mechanism of breathlessness in asthma: a) alveolar edema; b) swelling of the bronchial mucosa; c) bronchoconstriction; g) increased mucus secretion; d) violation of sputum. 8. Elements of sputum is indicative of an allergic process in the bronchial tree, is: a) a spiral Kurshmana; b) Charcot-Leyden crystals; c) eosinophils; d) the leukocytes. 9. The features that distinguish bacterial from viral pneumonia, is: a) infiltrative changes on chest radiograph; b) leukocytosis with a shift to the left; c) The physical Just noticeable changes; vz) pulse corresponds to the temperature; d) cough with purulent sputum.10. For lobar pneumonia is characterized by all the signs, except: a) dullness, respectively share or segment; b) finely crackles; c) crepitus; g) bronchial breathing; d) enhanced bronhofoniya. 11. Which of the drugs indicated for the initial treatment of bronchial asthma attacks: a) -stimulants; c) aminophylline; d) Intal; d) beclomethasone. 12. Percussion in patients with chronic obstructive bronchitis is defined by: a) box sound; b) lung sounds; c) shortening of percussion sounds; d) tympanitis; d) lung sounds with tympanic shade. 13. Which drug is not indicated for patients with chronic catarrhal bronchitis: a) penicillin; b) aminophylline; c) inhalation acetylcysteine; g) Atrovent; d) teopek. 14. The most significant clinical sign indicating the status asthmaticus transition from I to stage II, is: a) the progression of shortness of breath; b) increase in cyanosis; c) the disappearance of previously listened to wheezes in lungs; d) increase in blood pressure. 15. Early in the functional signs of bronchial obstruction is: a) a decrease in FEV1; b) a decrease in the index Tiffno; c) a decrease POSvyd; c) reduction of all these indicators. 16. The main symptom of chronic bronchitis, flowing with a primary lesion of the mucous membrane of bronchial tubes - it is: a) a strong hacking cough; b) cough; c) shortness of breath; d) equity and segmental pulmonary fibrosis. 17. Auscultation of the lungs in patients with pneumonia can be identified: a) reduced air in the absence of wheezing; b) dry wheezing; c) large bubbling crackles; g) finely crackles; d) crepitus 18. Diagnostic criteria of chronic bronchitis are: a) "history of cough" at least two years for three consecutive months; b) the absence of other respiratory pathology, causes "cough history"; c) the presence of inflammatory changes in the bronchi bronchoscopy; d) breathlessness. 19. As a first-line drugs for the basic treatment of chronic obstructive bronchitis is recommended: a) astmopent b) berotek c) eufillin d) Atrovent e) salbutamol. 20. Indications for general antibiotic therapy for acute bronchitis include: a) severe clinical course of the disease; b) the appearance of purulent sputum; c) leukocytosis; d) anemia. 21. By the risk of disease with essential hypertension include all of the above, except: a) a genetic predisposition; b) excessive intake of salt; c) ulcer disease; d) overweight; d) low physical activity, chronic stress. 22. Blood pressure is determined by: a) the work of the heart (minute volume); b) peripheral resistance; c) both factors. 23. Which of the following is the leading features in the diagnosis of hypertensive crisis: a) urinary syndrome; b) azotemia; c) cerebral symptoms; d) kardialgiya; d) changes in retinal vessels. 24. What level of hell do you react to the soft phase of essential hypertension: a) 130/80. Hg. Art. b) 140/96 mm. Hg. st.v) 150/100 mm. Hg. Art. g) 160/104 mm. Hg. Art. d) 1220/80 mm. Hg. Art. 25. On the concept of unstable angina include: a) new-onset angina; b) progressive angina; c) variant angina; d) myocardial infarction. 26. Risk factors for coronary artery disease include: a) arterial hypertension; b) psychoemotional stress; c) smoking; d) obesity. 27. Classification of Diseases of WHO coronary heart disease are: a) sudden death (the primary circulatory arrest); b) cardiac arrhythmia; c) heart failure; d) atrial fibrillation. 28. The immediate cause of the angina attack can be: a) the excitement; b) access to the cold; c) physical activity; d) increase in blood pressure. 29. Risk factors for coronary artery disease include: a) arterial hypertension; b) psychoemotional stress; c) smoking; d) obesity. 30. In the treatment of heparin-control test is: a) the level of prothrombin; b) the level of fibrinogen; c) the clotting time; d) bleeding time; d) platelet count. 31. Of the following risk factors for atherosclerosis, the most important is: a). emotional stress; b) lack of exercise; c) arterial hypertension; d) overweight. 32. When atherosclerosis affects: a) the arteries of muscular type; b) artery musculo-elastic type; c) elastic arteries; g) any artery. 33. Symptoms of angina are: a) pain in the left half of the chest with a load; b) irradiation of sensations to the left - on the medial surface of the left hand; c) the effect of the nitroglycerin or termination load for 1-3 minutes; d) fibrillation. 34. The most typical localization of discomfort associated with physical activity in angina, is: a) the area of the heart (the left of the sternum); b) in the chest; c) in the apical impulse; d) next to the xiphoid process of the sternum. 35. The duration of an attack of angina after termination load usually amounts to: a) a few minutes (less than 10 minutes); b). Less than 30 seconds; c) 15-20 min. 36. In patients with angina pectoris FC II attacks occur: a). when climbing stairs less than one floor (less than 2 - flights of stairs); b). When climbing stairs more than one floor (2 - x flights of stairs); at). Only at very high physical activity, and d) if any, even minimal physical exertion. 37. Patients with advanced (unstable) angina noted: a) the occurrence of seizures in a light load; b) the occurrence of attacks of angina at rest; c) an increase in the duration of attacks of angina pectoris; d) reduction of the effect of nitroglycerin. 38. During the exercise test ECG signs of myocardial ischemia are: a) the appearance of negative teeth T; b) horizontal ST segment depression greater than 1 mm; c) the occurrence of ventricular arrhythmias; d) fibrillation. 39. From all of the following pharmacological tests in the diagnosis of coronary artery disease should be used only with the sample: a) potassium; b) nitroglycerin; c) dipyridamole (Curantylum); d) anaprilinom (obzidanom). 40. For the treatment of angina medications used all of the following except: a). Nitrosorbid; b) propranolol (obzidan); c) finoptin (verapamil); g). corinfar (kordafen, nifedipine); e) papaverine.The examination tests Option 2 1. The emergence of chronic bronchitis contributes to: a) smoking, exposure to industrial pollutants, adverse climatic factors; b) the pathology of the musculoskeletal system (scoliosis of the spine, ankylosing spondylitis); c) chronic diseases of the upper respiratory tract; g) genetic predisposition to lung disease. 2. Bronchodilator drugs of purine derivatives (methylxanthines) sustained-release include the following: a) theophylline; b) Teofedrin; c) teopek, retafil; d) eufillin. 3. Bronchial obstruction in asthma is caused by: a) bronchospasm; b) inflammatory edema of the bronchial mucosa; c) the closure of the bronchi viscous secret; d) spadenie small airways on exhalation. 4. The main clinical syndrome in asthmatic status are: a) progressive respiratory failure; b) increasing pulmonary hypertension; c) severe neuropsychiatric syndrome; d) shortness of breath. 5. When pneumonia affects all of the above, except: a) the large bronchi; b) respiratory bronchioles; c) the alveoli; d) interstitial lung. 6. Auscultation of the lungs in patients with pneumonia can be identified: a) reduced air in the absence of wheezing; b) dry wheezing; c) large bubbling crackles; g) finely crackles; d) krepitiruyuschie wheezing. 7. Agents of hospital (nosocomial) pneumonia are all these microbes, except: a) pneumococcus; b) Staphylococcus; c) Klebsiella; d) chlamydia. 8. Pneumonia designates all these drugs, in addition: a) etiotropic; b) expectorants; c) Bronchospasmolytic; d) immunomodulating; d) drugs. 9. If you suspect a mycoplasma pneumonia should be given: a) penicillins; b) erythromycin; c) chloramphenicol; g) streptomycin; d) tseporin. 10. Rheumatism is often preceded by upper respiratory tract infection caused by: a) viridans streptococci; b) Epstein Bar virus; c) the Staphylococcus aureus; d) beta - hemolytic streptococcus group A; d) enterococcus. 11. In rheumatoid arthritis: a) affects mainly large joints, aspirin can completely arrest arthritis; b) the repeated attacks develop joint deformities, broken traffic in them; c) arthritis occurs in 90% of cases; d) primarily affects the small joints of the hands. 12. The weakening of the first tone is generally observed when the following heart disease, except for one: a) failure of the mitral valve; b) the failure of the tricuspid valve; c) failure of the aortic valve; d) stenosis of the left atrioventricular opening; e) aortic stenosis. 13. Rhythm quail "auscultation of the heart is characterized by: a) the appearance of the III-rd pathological tone; b) weakening I-th tone in combination with an additional tone; c) strengthening of the I-st tone with abnormal tone III-m; d) increasing the I-st tone with an additional W m-tone. 14. Emphasis II-nd tones in II-th intercostal space on the left shows: a) stenosis of the pulmonary valve; b) stenosis of the aortic valve; c) pulmonary hypertension; g) hypertension. 15. Diastolic murmur at the apex of the heart is listened when: a) mitral insufficiency; b) tricuspid insufficiency; c) tricuspid stenosis; d) aortic insufficiency. 16. Tricuspid valve is listened: a) I weakening tone combined with systolic murmur; a) enhancing the tones I in combination with systolic murmur; c) I gain tone with a diastolic murmur; d) I weakening tone with diastolic murmur. 17. If mitral valve stenosis occurrence of heart murmur due to: a) a turbulent flow of blood from the left ventricle into the aorta; b) the regurgitation of blood from the left ventricle into the left atrium; c) a turbulent flow of blood from the left atrium into the left ventricle; g) regurgitation of blood from the aorta to the left ventricle. 18. Aortic insufficiency is characterized by: a) decreasing systolic noise; b) decreasing diastolic noise; c) systolic diamond noise; g) diamond diastolic noise. 19. Reflex Kitaeva is due to: a) mitral regurgitation; b) stretching the pulmonary veins; c) reducing the pressure gradient "left atrium - left ventricle"; d) increasing the flow of blood to the heart; d) increasing the pressure in the cavity of the left ventricle. 20. Typical symptoms of rheumatic fever are not the primary concerns: a) myocardial inflammation (myocarditis), b), chorea, c) arthritis, d) nephritis, etc.) Subcutaneous nodules. 21. In common rheumatism (except heart) is striking: a) joints, b) the central nervous system, c) kidney, g) skin. 22. The most common cause of IE is: a) enterococcus; b) zelenyaschy streptococcus; c) viruses; d) beta-hemolytic streptococcus group A; d) Streptococcus pneumoniae. 23. Risk factors for IE is everything, except: a) cystoscopy; b) venous catheterization; c) pulmonary hypertension; d) scraping the uterine cavity; d) congenital heart disease. 24. What type of pain is uncharacteristic for angina attack: a) compressive chest pain; b) burning pain in the heart; c) pressing chest pain radiating to the left arm; d) stabbing heart pains associated with breathing; d) a sense of discomfort in the heart, resulting in physical and psychological and emotional stress. 25. What is the criterion corresponds to the concept of "new-onset angina": a) the occurrence of prescription pain - 6 months; b) the emergence of prescription pain - 4 months; c) the occurrence of prescription pain up to 1 month; d) the appearance of prescription pain - 2-3 months; d) all of the above is not true. 26. Does not apply to complications in acute myocardial infarction? a) rupture of the myocardium; b) cardiogenic shock; c) Dressler's syndrome; d) violation of the heart rate; d) conduction disturbances. 27. The signs of transmural infarction on ECG infarct are: a) segment ST rise and formation of pathological wave Q; b) lifting segment ST; a) ST segment depression in combination with Twave inversion; d) negative T waves in the left precordial leads; d) a significant reduction in the amplitude of the R-wave and T-wave inversion 28. The gold standard in the diagnosis coronary atherosclerosis is considered: a) echocardiography; b) coronary angiography; c) ECG; d) imaging. 29. The outward signs of atherosclerosis considered as well) xanthomas, xanthelasma, lipoid arc of the cornea; B) Bouchard nodules; B) Lukina_libmana spots; d) Osler nodes; d) erythema nodosum. 30. The main target of antihyperlipidemic therapy is considered to be: a) HDL cholesterol; b) triglycerides; c) phospholipids; d) holesterin LPNP; d) polyunsaturated fatty acids. 31. The most effective lipid-lowering drugs are: a) fibrates; b) a statin, c) preparations containing omega-3polinenasyschennye fatty acids; d) ACE inhibitors; d) betaadrenoblokator. 32. The immediate cause of the angina attack can be: a) the excitement; b) access to the cold; c) physical activity; d) increase in blood pressure; d) all of the above. 33. In the early hours of acute myocardial infarction recommended rate of administration of heparin following: a) one thousand. ED per hour, b) 5 th. ED in an hour) 3 thousand. ED h, g) 10 thousand. ED hour. 34. pathogenetic method of treatment for acute myocardial infarction is the use of: a) thrombolytic b) antiplatelet agents, c) anticoagulants d) hormones. 35. What organs are affected at GB: a) the heart and liver, and b) the kidneys, lungs, heart, and c) the eyes, kidneys, spleen, d) heart, kidneys, blood vessels, etc.), heart, eyes, feet. 36. What criteria are not a sign of mild hypertension: a) no signs of kidney damage, and b) no signs of LVH in) blood pressure 156/98 mm Hg, g) BP 170/112 mm. Hg. Art., d) all of the answers are correct, except at). 37. GB characterized by all complications except: a) CRF, b) heart failure, and c) a hemorrhagic stroke, g) neyroretinopatii, d) neuroendocrine failure. 38. The typical form of myocardial infarction: a) abdominal; b) anginal; c) asthma attack; d) painless; e) peripheral. 39. Severe headache, nausea, vomiting, "flies" before his eyes, intense pulse observed when: a) a swoon; b) collapse; c) hypertensive crisis; g) angina. 40. During the exercise test ECG signs of myocardial ischemia are: a) the appearance of negative teeth T; b) horizontal ST segment depression greater than 1 mm; c) the occurrence of ventricular arrhythmias; d) fibrillation. Schedule of modules (current and boundary control): Module №1 (M1). Section of Pulmonology and Allergology. Type of training Type of control Classroom student work (CSW) a) blanks testing on materials lectures b) Oral answers to questions, the decision of situational problems and work at the bedside of practical training materials Total CSW Independent work a) the application forms for materials testing sessions of students (IWS) IWS b) Oral answers to questions, the decision of situational problems and work at the bedside of practical training materials Total IWS landmark Control a) Testing based on lectures and IWS 1 (LC1) in the 8th b) interview, defense history, analysis of clinical week situations. Total LC1 Total №1 (М1) Note: Module №1 at the end of 1-8 weeks is held on the 8th week Type of training Classroom student work (CSW) Independent work of students (IWS) landmark Control 1 (LC1) in the 8th week Module №2 (M2). Section of Cardiology Type of control a) blanks testing on materials lectures b) Oral answers to questions, the decision of situational problems and work at the bedside of practical training materials Total CSW a) the application forms for materials testing sessions IWS b) Oral answers to questions, the decision of situational problems and work at the bedside of practical training materials Total IWS a) Testing based on lectures and IWS b) interview, defense history, analysis of clinical situations. Total LC1 Total №2 (М2) maximum points 5 5 10 5 5 10 5 5 10 30 maximum points 5 5 10 5 5 10 5 5 10 30 Final control Scale exam grade. The final control is carried out in the form of examination. The maximum rate of progress of the final control is 40%. Total Score performance on discipline is defined as the sum of the performance of the modules №1 and 2 (maximum 60 points) and the Final control (maximum 40 points). The maximum total control of a maximum of 100 points 35 Points Total units Total (maximum points) 5p 10p 5p 10p К1=5+10+5+10=30 б. 16 24 40 5p 10p 5p К2=5+10+5+10=30 10p 10p 20p SIW SIW 21 practice practice 14 Final control (40p). Lecture Lecture 75 SIW SIW 30 practice Lecture 45 Lecture classroom training 150 Current control landmark control Total hours Current control Module №2 (M2) (maximum 60 points) landmark control Module №1 (M1) (maximum 60 points) 10p T=10+20+10=40 б. К=К1+К2+T=30+30+40=100б