Download MINISTRY OF EDUCATION AND SCIENCE KYRGYZ REPUBLIC

MINISTRY OF EDUCATION AND SCIENCE
KYRGYZ REPUBLIC
OSH STATE UNIVERSITY
_______________MEDICAL________________
(Name of Faculty)
"Approved"
at the meeting of " Internal diseases " department
from "___" ______________ 2015
Head of the department, PhD Mamatova S.M.
WORK PROGRAM
the discipline: "Internal diseases"
for full-time students studying for a degree:
__________Specialty - 530001 Medicine________________________________________________
(Code and specialty)
Hours of the curriculum
Number of hours
Name of the
discipline
Internal diseases
Auditorium lessons
Reportness
IWS
Total
Auditorium
lessons
Lecture
Practical
lessons
Laboratory
IX
X
Exam
145
63
82
-
81
Test
IX sem.
79
34
45
-
44
Test
X sem.
66
29
37
-
37
The work program developed on the basis of the State educational standards of the Ministry of
Education KR.
Compilers: Mamatova S.M. Ph.D., Head of the department
Rysbekova G.S. Teacher of the department
Osh - 2014-2015
Exam
MINISTRY OF EDUCATION AND SCIENCE
KYRGYZ REPUBLIC
OSH STATE UNIVERSITY
MEDICAL FACULTY
"THERAPEUTIC COURSES WITH A COURSE OF ENDOCRINOLOGY"
DEPARTMENT
"APPROVED"
Dean of the International Medical Faculty
_____________
"__" _____________ 2015
Prof. Kalmatov R.K.
"CONSIDERED"
at the meeting of " Internal diseases " department
Protocol №____
from "___" ______________ 2015
Head of the department, PhD Mamatova S.M.
"AGREED" with Educational-methodical department
Chairman of EMD ________________
Turusbekova A.K.
WORK PROGRAM
the discipline: "Internal diseases"
for full-time students studying for a degree:
__________ Specialty - 530001 Medicine________________________________________________
(Code and specialty)
Course - V
Semester - IX-X
Total hours - 145
Lectures - 63
Practical - 82
Independent work of students - 81
Reporting Form - IX semester - test, X semester – exam.
Osh 2015 - 2016
3. Explanatory note
At present the most important tasks of the Kyrgyz health is to improve quality of medical care,
training and education of professionals to modern science and practical requirements.
Creating a curriculum stimulate demand and proposals submitted by the chairs of the specialized
medical disciplines. As a result, somebody has a strategy of integration goals and learning objectives,
was the curricula, linking teaching both "vertical" (between adjacent courses), and on "horizontal"
(between the subjects of one course). This is to avoid irrational loss of training time associated with
duplication, to achieve a more rational redistribution of some of the topics studied in the relevant
departments.
Problems of the discipline:
- The study of the different variants of the major disease forms of disease, including the elderly and
debilitated patients;
- The study of relatively rare forms of disease;
- Mastering the students the basics of the differential diagnosis of the disease variants and their
differential treatment;
- The development of methods to assess emergency conditions, treatment and prevention.
In accordance with the curriculum for 2014-2015 year for 5 course students on major "Medicine"
subject internal medicine is conducted in the following amounts:
Subject
Internal diseases
Total:
Semester
Lecture
Practical lessons
Total
Total
control
IX
34
45
79
Test
X
29
37
66
Exam
63
82
145
4. Aims and purposes (competencies) discipline
After studying the course "internal diseases," according to state standards for "Medicine" The student
should know:
- Etiopathogenesis, clinic, diagnostic criteria for major common diseases-making organs;
- Methods of examination in the common diseases of internal organs;
- Basic principles of treatment of major common diseases of internal organs;
- Methods of prevention, rehabilitation of common diseases of the internal organs.
The student should be able to:
- Diagnose particular forms, variants of the course and complications of common of diseases of the
internal organs, as well as rare nosology;
- Prescribe treatment based options and features of the disease and its complications;
- To own modern laboratory and instrumental methods of diagnosis of disease-tions;
- Be able to provide emergency care for life-threatening conditions;
- Be able to in the prevention and rehabilitation of patients with diseases of internal organs.
Skills that the student should be able to do:
1. Questioning and physical examination the patient.
2. Palpation lymph nodes.
3. Inspection and palpation of the joints.
4. Palpation of the chest.
5. Topographic percussion of the chest.
6. Auscultation lungs.
7. Determination of peak expiratory flow rate, pneumotachometry.
8. Interpretation, lung function.
9. Conduct and interpretation of pleural thoracentesis performance studies of pleural fluid.
10. Taking and interpretation of sputum.
11. Interpretation of bronchoscope results.
12. Inspection and palpation the area of the heart.
13. Palpation peripheral arterial
14. Determination the with of vascular bundle.
15. Auscultation of the heart and great vessels
16. Differentiation of heart murmurs.
17. Checking and interpretation of blood pressure according to the WHO.
18. Making closed cardiac massage.
19. Making vagal samples.
20. Determination of pulse deficit
21. Determination of peripheral venous pulse.
22. Registration and interpretation of key indicators ZKG
23. Interpretation of echocardiography indicators.
24. Interpretation of hemodynamic parameters study.
25. Mouth inspection.
26. Inspection, abdominal palpation and percussion.
27. Auscultation of abdomen.
28. Palpation and percussion of the liver.
29. Palpation of percussion and spleen.
30. Palpation of gallbladder
31. Interpretation of laboratory measures of liver function analysis.
32. Interpretation of performance scanning of the liver and spleen
33. Interpretation of liver biopsy indicators.
34. Interpretation of esophagogastroduodenoscopy results.
35. Interpretation of liver biopsy results.
36. Interpreting the results of a biopsy of the stomach.
37. Interpretation of the scatological results study.
38. Interpretation of results of ultrasound of internal organs.
39. Percussion of the bladder
40. Palpation kidneys, bladder and ureters.
41. Interpretation of results of urine-general analysis, sample of
Nechiporenko, Zemnitsky, Rehberg-Tareev.
42. Interpretation of results radioisotope study of the kidneys.
43. Interpretation of results of renal biopsy.
44. Inspection and palpation of the thyroid gland
45. Interpretation of the results of radioisotope studies of thyroid cancer.
46. Interpretation of biochemical blood tests results.
47. Registration of history.
48. Explanation of clinical diagnosis.
49. Rendering of emergency in anaphylactic shock.
50. Emergency care with fainting and collapse.
51. Emergency care for status asthmaticus.
52. Emergency care in acute left ventricular failure.
53. Emergency care for hypertensive crisis
54. Emergency care for acute myocardial infarction.
55. Emergency care in patients with renal colic.
56. Emergency care for hypoglycemic coma
57. Emergency care for hyperglycemic coma.
58. Conducting gastric lavage.
59. Conducting cleaning and siphon enemas.
60. Conduct of duodenal and gastric sounding study of their contents.
5. Place in the disciplines of the specialty
Discipline "Internal diseases" refers to the cycle of Humanities, which is the base for doctors. Internal
medicine includes independent working students (teacher-led) at the bedside, in the offices and
diagnostic laboratories, intensive care. Provides for the acquisition of practical skills of students in the
assessment of a number of additional methods of examination of patients (overall analyzes of blood,
urine, sputum, ECG, peak flow meters, etc.). Thus, having a good knowledge of the subject, it is
difficult to produce a good doctor - the clinician.
The study of this discipline is based on the following disciplines: physiology, pathophysiology, human
anatomy, pathological anatomy, surgical-mental illness, propedterapii, optional therapy, etc.
The main provisions of the discipline to be used in the future for studying disciplines of internal
medicine at the 6 courses, cardiology, rheumatology, pulmonology, gastroenterology, nephrology,
surgery, evidence-based medicine, outpatient therapy, and in all the many clinical disciplines.
1. Pneumonia. Classification. Communityacquired pneumonia (typical and atypical
variants): etiology, clinical manifestations and
treatment. Pneumonia in patients with immune
deficiency and ventilator-associated pneumonia.
2. Disseminated processes in the lungs
Alveolites: definition, classification. Idiopathic
fibrosing alveolitis: etiology, pathogenesis,
clinical picture, diagnostics and treatment.
3
BS
Т, SР, Е
SР, Е,
3. Chronic obstructive pulmonary disease
(COPD). Definition Diagnosis, differential.
diagnosed with asthma. Oxygen therapy,
indications, techniques, control effectiveness.
4. COPD. Features of current diagnosis in the
elderly and in the high mountains conditions.
2
2
2
3
5. Bronchial asthma. Aspirin asthma: etiology,
pathogenesis, clinical features, diagnosis,
treatment. Asthma phisical efforts.
Complications of drug therapy. Alpine
climatotherapy.
6. Pulmonary emphysema: classification,
clinical manifestations. Pneumosclerosis
Forms of control
2
IWS
Practical
lessons
Name of discipline(module) and theme
categories
Lectures
Auditoria lessons
Using educational
technologies
6. Thematic plan of discipline
2
2
ВS
Т
Т
4
SР
4
T
4
ВS
SP, T, E
7. Bronchiectases. Definition. Pathogenesis.
Secondary bronchiectases and bronchiectatic
disease.. Clinical manifestations. Differential
diagnosis between bronchiectases, and COPD:
key items. Differential diagnosis between
bronchiectases, pulmonary cancer and bronchial
abscess: key items. Complications. Laboratory
and instrumental methods: plan of patient’s
investigations. Тreatment (drugs, doses).
8. Acute cor pulmonale. Etiology, pathogenesis,
classification, clinical manifestations.
Treatment.
9. Suppurative lung disease (abscess and
gangraena of the lung). Etiology, pathogenesis,
classification,
clinical
manifestations.
Treatment.
10. Pleurisies. Etiology and pathogenesis.
Classification. Clinical manifestations of dry
pleurisy. Laboratory and instrumental methods.
Differential diagnosis. Treatment
-Clinical manifestations of exudative pleurisy.
Indication and method of thoracocentesis.
Differential diagnosis between exudates and
transsudates. Laboratory and instrumental
methods. Differential diagnosis.Treatment.
-Pleural empyema: causes. Stages of empyema.
Clinical manifestations and treatment.
Laboratory and instrumental methods.
Differential diagnosis. Outcomes. Treatment.
11.
Pulmonary arterial hypertension. Cor
pulmonale:
etiology,
pathogenesis,
classification, clinical picture, diagnostics,
differential diagnostics, treatment. Respiratory
failure.
12. Thromboembolism of pulmonary artery:
etiology, pathogenesis, classification, clinical
picture, diagnostics, treatment and prophylaxis.
Module # 1
4
T
4
T
2
3
BS
Т, SP,
2
2
BS
Т, SP,
2
3
2
2
T
BS
Т, SP
13. Сardiomyopathy. Etiology, pathophysiology
and classification of primary and specific
cardiomyopathies. Dilated cardiomyopathy.
Hypertrophic
cardiomyopathy.
Restrictive
cardiomyopathy. Myocardial dystrophy.
2
14. Bacterial endocarditis: Etiology,
pathogenesis, clinical manifestations, differential
diagnosis, treatment
15.Arterial hypertension . The main principles of
differential diagnosis of essential and secondary
hypertension.
16.
Neurocirculatory
dystonia.
clinical
manifestations, differential diagnosis, treatment
17. Combined and аssociated heart defects
Etiology, pathogenesis, clinical manifestations,
differential diagnosis, treatment
18. Congenital cardiac malformation: etiology,
hemodynamic, clinical findings, diagnostics and
management.
19. Congenital cardiac malformation: etiology,
hemodynamic, clinical findings, diagnostics and
management.
BS
Т, SP,
4
BS
Т, SP,
4
BS
Т, SP,
3
4
T
2
2
BS
Т, SP,
2
3
BS,
Т, SP,
2
20. Treatment of cardiac arrhythmias
T
4
21. Pericarditis: etiology, pathogenesis and
classification. Clinical presentations, diagnostic
steps and differential diagnosis of pericarditis.
Management of pericarditis. Indications for
pericardiocentesis, technique.
2
3
23. Symptomatic hypertensions: classification;
differential
diagnosis
with
essential
hypertensions. Peculiarities of the course of
different
symptomatic
hypertensions.
Renovascular
and
renoparenchymal
hypertensions,
Phaechromocytoma.
Konn
syndrome.
Cushing
syndrome.
Aorta
coarctation. Aethiology, pathogenesis, clinical
manifestations. Plan of clinical and laboratory
examination. Treatment.
2
2
BS
Т, SP
T
BS
Т, SP,
24. Miocarditis: definition, ethiology,
pathophysiology, classification, clinical features,
diagnostics, differential diagnostics and
treatment.
25. Myocardial infarction, complications.
Сardiac tamponade. Postinfarction Dressler's
syndrome. Ruptures heart.
2
3
BS
Т, SP
2
2
ECG
Т, SP
26. Cifilitichesky aortitis. definition, ethiologу,
clinical features, diagnostics, differential
diagnostics and treatment.
27. Heart failure. Congestive heart failure:
aethiology, pathogenesis, clinical
manifestations. Treatment. Role of different
drug groups (ACE inhibitors, beta-blockers,
glycosides, diuretics etc.) in treatment.
Indications and contraindications; doses.
Surgical treatment: indications,
contraindications, main principles.
28. Atherosclerosis. Definition. Morphology and
morphological stages. Risk factors. Lipid
metabolism and classification of
hyperlipoproteidemias. Lipidogram and its
interpretation. Non-medical and medical
treatment. Classification of lipid-lowering drugs.
Ischemic heart disease: aethiology,
pathogenesis, classifi-cation. Sudden death:
criteria and mechanisms. Secondary coronary
syndrome.
29. Cardiac arrhythmias: Extrasystole.
Рaroxysmal tachycardia. Atrial fibrillation and
atrial flatter. Ventricular fibrillation and
asystolia. Сlinical presentations, diagnostics and
treatment. Electropulse therapy of heart rate and
rhythm disturbances: indications, technique.
30. Conduction disturbances: (sinus node
disfunctions, AV-blocks, bundle branch blocks)
ethiology, pathophysiology,. Classification,
clinical manifestations, ECG, treatment.
Module
2
Test
Р
4
4
ECG
Т, SP
4
ECG
Т, SP
2
3
Т, SP
2
2
Т, SP
31. Renal amyloidosis. Nephrotic syndrome .
Amyloidosis: definition, classifications.
2. AA-amyloidosis.AL-amyloidosis. AFamyloidosis. Autosomal dominant types of AFamyloidosis. Mediterranean fever. pathogenesis,
clinical manifestations and syndromes.
Differential diagnosis between amyloidosis and
glomerulonephritis. Diagnosis and treatment.
Main pathogenetic and clinical features of AS,
AE and AH-amyloidosis.
Nephrotic syndrome. Еthiology,
pathophysiology, classification, clinical
presentations, diagnostics. Treatment
32. Chronic glomerulonephritis: definition,
pathogenesis, main clinical syndromes.
Exacerbation and remission criteria.
2
33. Urolithiasis. Aethiology, pathogenesis,
clinical manifestations, differential diagnosis,
treatment
34.Acute
renal
failure.
Aethiology,
pathogenesis, clinical manifestations, differential
diagnosis, treatment
35. Chronic renal failure. Aethiology,
pathogenesis, clinical manifestations, differential
diagnosis, treatment
2
2
38.
Chronic
enterocolitis.
Aethiology,
pathogenesis, clinical manifestations, differential
diagnosis, treatment
Т, SP
4
BS
Т, SP
4
BS
Т, SP
2
3
36. Complications of gastric ulcer and
duodenum. Postoperative diseases of stomach:
classification, clinical features, diagnosis,
treatment.
37. Peptic ulcer and duodenal features of the
course depending on localization, age and 2
gender. Menetries disease.
BS
3
BS
4
Т, SP
Т, SP
Т, SP
2
4
2
3
ВS
Т, SP
40. Crohn’s disease. Etiology, pathogenesis,
classification, clinical features of intestinal and
extraintestinal manifestations, diagnosis,
treatment. Complications of Crohn’s disease.
2
2
ВS
Т, SP
41. Functional bowel disease. Еtiology,
pathogenesis, classification, diagnosis.
2
3
BS
Т, SP
39. Inflammatory bowel disease: ulcerative
colitis. Etiology, pathogenesis, classification,
clinical features of intestinal and extraintestinal
manifestations,
diagnosis,
treatment.
Complications ofulcerative colitis.
42.Functional disorders of biliary tract: etiology,
pathogenesis, classification, diagnosis. Clinical
features and treatment of dysfunction of
gallbladder .
4
Т, SP
43. Chronic hepatitis Chronic viral hepatitis:
etiology, pathogenesis, clinical features,
diagnosis, treatment, prevention. Differential
diagnosis of diffuse hepatomegaly. Autoimmune
hepatitis: etiology, pathogenesis, clinical
features, diagnosis, treatment.
3
Т, SP
44. Liver cirrhosis: etiology, pathogenesis,
classification, clinical features, diagnosis.
Complications
of
liver
cirrhosis
(portalhypertension, ascites, hypersplenism,
gastroesophageal
varicealhe
morrhage,
hepaticencephalopathy):
clinical
features,
diagnosis, treatment.
3
Т, SP,
45. Diseases of the esophagus. Сlinical features,
diagnosis, treatment.
3
Module #3
46. Systemic sclerosis: etiology, pathogenesis,
clinical manifestations, differential diagnosis,
treatment. Sjogren syndrome.
2
2
Т, SP,
47. Dermatomyositis and polymyositis:
Aethiology, pathogenesis, clinical
manifestations, differential diagnosis, treatment.
48.
Ankylosingspondylitis:
etiology,
pathogenesis, classification, clinicalfeatures,
criteriafordiagnosis,
diagnosis,
differential
diagnosis, treatment.
49. Gout: etiology, pathogenesis, classification,
clinical features, criteria for diagnosis,
diagnosis, differential diagnosis, treatment.
3
2
2
С
Т, SP,
2
2
С
Т, SP,
BS
Т, SP,
BS
Т, SP
50. Osteoporosis. etiology, pathogenesis,
classification, clinical features, criteria for
diagnosis, diagnosis, treatment.
51. Deforming osteoarthritis.: аethiology,
pathogenesis, clinical manifestations, differential
diagnosis, treatment.
52. Reactive arthritis аethiology, pathogenesis,
clinical manifestations, differential diagnosis,
treatment.
53. Systemic vasculites (polyarteriitis nodosa,
non-specific aortoarteriitis; Giant cell arteritis):
Aethiology,
pathogenesis,
clinical
manifestations, differential diagnosis, treatment.
54. . Systemic vasculites (Chorton’s disease,
Wegener’s granulomatosis): Aethiology,
pathogenesis, clinical manifestations, differential
diagnosis, treatment.
55. Drug disease and acute allergies. Еtiology,
pathogenesis, clinical features, diagnosis,
treatment.
Т, SP,
2
3
2
2
2
3
BS
3
2
3
57. High Altitude Medicine. Alpine climate
factors and their effect on the body. Peculiarities
of the main diseases of the internal organs in the
mountains. Therapeutic use of mountain training
3
Total
Exams
63
82
Т, SP
Т, SP
2
56. Anaphylactic shock. Еtiology, pathogenesis,
clinical features, diagnosis, treatment
Module №4
Т, SP,
3
81
BS
Т, SP
BS
Т, SP
Т, SP
7. Technological map
on "Internal Diseases" for 2015-2016 academic year for students of the 5th year on
major “Medicine”
IX semester
1 module
2 module
(32 hours , 30 points)
(47 hours, 30 points)
5p.
10 p.
Total of modules
5p.
10p.
40p.
Rating
Test
Points
20 h. 16h
Control
16h.
IWS
Lectures
41
Practice
IWS
45
Lectures
Prac. (semin/)
34
Соntrol
Lectures
79
Aud. Hours
IWS
Aud. Lessons
120
Practice
Total hours
Aud. Hours
18 h. 25 h. 28 h.
10p.
5p.
C1=5+10+5+10=30p.
10p.
5p.
C2=5+10+5+10=30p.
C3=
40p.
C=C1+C2+
C3=100p.
Points
5
p.
10 p.
5 p.
10 p.
15
h.
19 h. 12 h.
5
p.
10 p.
5 p.
10 p.
40 p.
Rating
Test
18 h. 25h.
Control
14
h.
IWS
Aud.
Hours
Practice
Aud.
Hours
Lectures
40
(45 hours, 30 points)
Control
37
(51 hours, 30 points)
IWS
IWS
29
2 module
Practice
Prac. (semin/)
66
1 module
Lectures
Lectures
10
6
Aud. Lessons
Total hours
X semester
Total of modules
C1=5+10+5+10=30 p.
C2=5+10+5+10=30 p.
C3= C=C1+C2
40 p. +
C3=100 p.
8. Content (up) lecture course
Thematic plan
of lectures on “Internal diseases” for V course students for 2015 - 2016 academic year.
Major: Medicine.
№
Name of sections, modules, themes and educational questions
Quantity of
hours
Name of sections and modules
Pneumonia. Classification. Community-acquired pneumonia (typical and
atypical variants): etiology, clinical manifestations and
treatment.Nosocomial pneumonia: aethilogy, clinical manifestations and
treatment approaches. Pneumonia in patients with immune deficiency and
ventilator-associated pneumonia.
Disseminated processes in the lungs.
Alveolites: definition, classification. Idiopathic fibrosing alveolitis:
etiology, pathogenesis, clinical picture, diagnostics and treatment.
2
COPD. Definition. Aethiological factors. Pathogenesis. Сlinical
manifestations. Clinical forms of COPD.Differential diagnosis: COPD
and asthma. Laboratory and instrumental methods in COPD.Treatment.
Pulmonary emphysema. Aethiology, pathogenesis, Сlassification, clinical
manifestations.
2
5.
Suppurative lung disease (abscess and gangraena of the lung). Aethiology,
pathogenesis, classification, clinical manifestations. Treatment.
2
6.
Pleurites: etiology, pathogenesis, classification. Clinical picture,
diagnostics, the differential diagnosis and treatment of the fibrinous
pleuritis. The differential diagnosis of transudate and exsudate. Etiology,
pathogenesis, clinical picture, diagnostics and treatment of the exudative
pleuritis. Indications to medical thoracocentesis, technics of performance.
2
7.
Cor pulmonale : etiology, pathogenesis, classification, clinical picture,
diagnostics, differential diagnostics, treatment. Respiratory failure.
2
8.
Thromboembolism of pulmonary artery: etiology, pathogenesis,
classification, clinical picture, diagnostics, treatment and prophylaxis.
2
1.
2.
3.
4.
2
2
9.
Cardiomyopathies. Etiology, pathophysiology and classification of
primary and specific cardiomyopathies. Dilated cardiomyopathy.
Нypertrophic cardiomyopathy. Restrictive cardiomyopathy, : clinical
features, diagnostics, clinical features,
and treatment. Myocardial
dystrophy clinical features, diagnostics, clinical features, and treatment.
2
10.
Combined and аssociated heart defects.
Aethiology, pathogenesis, clinical manifestations, differential diagnosis,
treatment
11.
Congenital cardiac malformations: аtrial septal defect, ventricular septal
defect, the patent ductus arteriosus. Нemodynamic, clinical findings,
diagnostics and management.
2
12
Pericarditis: ethiology, pathogenesis and classification. Clinical
presentations, diagnostic steps and differential diagnosis of pericarditis.
Management of pericarditis. Indications for pericardiocentesis, technique.
2
13
Symptomatic hypertensions: classification; differential diagnosis with
essential
hypertensions.
Renovascular
and
renoparenchymal
hypertensions: ethiology, pathophysiology, clinical presentations,
diagnostics and differential diagnostics, treatment. Endocrine
hypertension: Phaechromocytoma. Konn syndrome. Cushing syndrome.
ethiology, pathophysiology, clinical presentations, diagnostics and
differential diagnostics, treatment. Aorta coarctation. Aethiology,
pathogenesis, clinical manifestations. Treatment.
2
14
Miocarditis: definition, ethiology, pathophysiology, classification, clinical
features, diagnostics, differential diagnostics and treatment.
2
15
Myocardial infarction, complications. Сardiac tamponade.
2
2
Postinfarction Dressler's syndrome. Ruptures heart.
16
Cardiac arrhythmias: Extrasystole. Рaroxysmal tachycardia. Atrial
fibrillation and atrial flatter. Ventricular fibrillation and asystolia. Сlinical
presentations, diagnostics and treatment. Electropulse therapy of heart
rate and rhythm disturbances: indications, technique.
2
17
Cardiac arrhythmias: Conduction disturbances: (sinus node disfunctions,
AV-blocks, bundle branch blocks) ethiology, pathophysiology,.
Classification, clinical manifestations, ECG, treatment.
2
Total:
34hours.
1
Renal amyloidosis. nephrotic syndrome.: etiology, classification, clinical
picture, diagnostics, treatment
2
2
Acute renal failure: Etiology, classification, clinical picture, diagnostics,
treatment. Indications to carrying out of hemodialysis.
2
3
Chronic renal failure: Etiology, classification, clinical picture, diagnostics,
treatment. Indications to carrying out of hemodialysis and kidney
transplantation.
2
4
Peptic ulcer and duodenal features of the course depending on
localization, age and gender. Menetries disease.
2
5
Inflammatory bowel disease: ulcerative colitis. Etiology, pathogenesis,
classification, clinical features of intestinal and extraintestinal
manifestations, diagnosis, treatment. Complications ofulcerative colitis.
2
6
Inflammatory bowel disease: Crohn’s disease. Etiology, pathogenesis,
classification, clinical features of intestinal and extraintestinal
manifestations, diagnosis, treatment. ComplicationsofCrohn’s disease.
2
7
Irritable bowel syndrome: definition, classification, clinical features,
diagnosis, treatment.
2
8
Systemic sclerosis (scleroderma): etiology, pathogenesis, classification,
clinical features, diagnosis, differential diagnosis, treatment.
2
9
Dermato- and polymyositis: etiology, pathogenesis, classification, clinical
features, diagnosis, differential diagnosis, treatment.
2
10
Ankylosingspondylitis:
etiology,
pathogenesis,
classification,
clinicalfeatures, criteriafordiagnosis, diagnosis, differentialdiagnosis,
treatment.
2
11
Gout: etiology, pathogenesis, classification, clinical features, criteria for
diagnosis, diagnosis, differential diagnosis, treatment.
2
12
Osteoarthritis: etiology, pathogenesis, classification, clinical features,
diagnosis, differential diagnosis, treatment.
2
13
Systemic vasculites (polyarteriitis nodosa, non-specific aortoarteriitis;
Giant cell arteritis): Aethiology, pathogenesis, clinical manifestations,
differential diagnosis, treatment.
2
Systemic vasculites (Chorton’s disease, Wegener’s granulomatosis):
Aethiology, pathogenesis, clinical manifestations, differential diagnosis,
treatment.
14
Drug disease and acute allergies. Aethiology, pathogenesis, clinical
manifestations, treatment.
3
Total
29
Exams
In total
№
Name of sections, modules, themes and educational questions
Name of sections and modules
1
Lecture number 1.
Topic: Pneumonia. Classification. Atypical form of pneumonia. Nosocomial
pneumonia: etiology, clinical manifestations and treatment approaches.
Criteria of hospitalization. Pneumonia in patients with immune deficiency
and ventilator-associated pneumonia. Indications to hospitalization.
Treatment of pneumonia of serious current.
Plan of the lecture and key questions:
1. Definition of hospital (nosocomial, nosocomial) pneumonia, аtypical form
of pneumonia.
2. Classification of pneumonia?
3. Pathogens of atypical pneumonia, etiology of nosocomial (hospital,
hospital-acquired) pneumonia
4. The main risk factors
5. The pathogenesis of pneumonia?
6. The clinical picture of acute pneumonia according to the agent.
7. Criteria for the diagnosis of nosocomial pneumonia.
Recommended literature:
The basic literature [1, 4]. Additional literature: [2, 9].
Test questions to consolidate the material:
1. Main etiology and pathogenesis of atypical pneumonia
2. What major clinical diagnostic criteria for atypical pneumonia, nosocomial
pneumonia?
3.What main instrumental and laboratory diagnostic criteria for atypical
pneumonia ?
4. What are the criteria of severity of pneumonia?
5. Indications for hospitalization
7. What are antibiotics used for hospital-acquired pneumonia?
8. What are the basic principles of treatment and prevention of atypical
pneumonia
Form of examination – operative questioning.
2
Lecture number №2
Topic: Disseminated processes in the lungs.
Alveolites: definition, classification. Idiopathic fibrosing alveolitis: etiology,
pathogenesis, clinical picture, diagnostics and treatment.
63
Quantity
of hours
2h
2h
3
4
Plan of the lecture and key questions:
- definition of DDPL.
- classification DDPL.
- etiopathogenesis of DDPL.
- clinical picture DDPL.
- diagnostic Features DDPL.
- idiopathic fibrosing alveolitis, etiology, pathogenesis,
- classification
- clinic, diagnosis, treatment.
Recommended literture:
The basic literature: [2, 4]. Additional literature: [1, 5].
Test questions to consolidate the material:
1. Disseminated in the lungs - the concept
2. Classification DDPL
3. What are the main stages in the pathogenesis of alveolitis
4. List the specific clinical signs of alveolitis
5. What is the most informative method of investigation with alveolitis
6. Basic principles of treatment
Form of examination – operative questioning
Lecture number 3
Topic: Chronic obstructive pulmonary disease COPD. Definition. Diagnosis,
differential. diagnosed with asthma. Oxygen therapy, indications, techniques,
control effectiveness.
Plan of the lecture and key questions:
1. Identification "chronic obstructive pulmonary disease?"
2. Etiological factors: hereditary and acquired. Smoker’s indices: smoker’s
index and packs per year index.
3. The pathogenetic mechanisms of COPD?
4. The clinical picture of COPD
5. Laboratory and instrumental methods in COPD
6. Differential diagnosis of COPD and asthma?
7. Treatment of COPD
8. Indications for oxygen therapy?
9. Indications for hospitalization
Recommended literature:
The basic literature [4, 5]. Additional literature: [2, 7].
Test questions to consolidate the material:
1. Mechanisms of underlying the bronchial obstruction in COPD?
2. Causes of airflow limitation in COPD: irreversible and reversible
3. Key symptoms for the diagnosis of COPD?
4. Рlan of patient’s investigations
5. Functional disorders in COPD?
6. Drug treatment of COPD?
7. Indications for antibiotic therapy in patients with COPD?
Form of examination – operative questioning.
Lecture number 4
Topic: Pulmonary emphysema.
Plan of the lecture and key questions:
1. Definition of pulmonary emphysema
2. Classification of anatomical on a pathogenesis pulmonary emphysema
3. Etiology and pathogenesis of pulmonary emphysema
2h
2ч
5
6
4. The clinical picture of emphysema
5. Differential diagnosis
6. Laboratory and instrumental diagnostics
7. Complication of pulmonary emphysema
8. Treatment
Recommended literature:
The basic literature [3, 4]. Additional literature: [2, 3, 4].
Test questions to consolidate the material:
1. Etiology of pulmonary emphysema.
2. Functional disorders in emphysema.
3. The course of pulmonary emphysema.
4. Treatment of primary pulmonary emphysema.
5. Treatment of secondary pulmonary emphysema.
Form of examination – operative questioning.
Lecture number №5
Topic: Suppurative lung disease (abscess and gangraena of the lung).
Plan of the lecture and key questions:
1. Definition
2. Classification
3. Etiology and pathogenesis
4. The clinical picture of the first and second period of lung abscess.
5. Diagnosis of lung abscess and gangrene
6. Differential diagnosis of lung abscess and gangrene
7. Treatment
8. Outcomes of acute infectious destruction
9. Prevention suppurative lung disease
Recommended literature:
The basic literature [3, 4]. Additional literature: [2, 3].
Test questions to consolidate the material:
1. The definition of "lung abscess"
2. The term "lung gangrene"
3. Etiological factors of lung gangrene
4. Clinical syndromes of lung abscess
5. Complications of the disease
6. Principles of treatment and indications for surgical treatment.
Form of examination – operative questioning.
Lecture №6
Topic : Pleurisy
Plan of the lecture and key questions:
1. The definition of "pleurisy"
2. Classification of pleurisy
3. Pathogenesis of pleurisy different etiology?
4. Clinic fibrinous pleurisy?
5. Clinic of exudative pleurisy
6. Diagnosis of pleurisy
7. Laboratory and instrumental diagnostics
8. Complications
9. What are the principles of treatment of pleurisy?
10. Prediction and prevention of pleurisy.
2ч
2h
Recommended literature:
The basic literature [3, 4]. Additional literature: [4, 5].
Test questions to consolidate the material:
1. Causes of infectious pleurisy
2. What are the causes of infectious pleurisy
3. Pathogenesis of infectious pleurisy
4. Pathogenesis of noninfectious pleurisy
5. Clinic of dry (fibrinous) pleurisy
6. X-ray signs of pleural effusion
7. The differential diagnosis of pleurisy
8. What is a transudate, exudate
9. Technique of conducting pleural puncture
7
8
Form of examination – operative questioning.
2ч
Lecture number 7
Topic: Pulmonary arterial hypertension. Cоr pulmonale . Respiratory failure.
Plan of the lecture and key questions:
1. Definition "pulmonary arterial hypertension"
2. The etiology of primary and secondary pulmonary hypertension
3. The pathogenesis of pulmonary hypertension?
4. Diagnosis of pulmonary hypertension
5. The diagnostic features of pulmonary hypertension
6. Treatment of pulmonary hypertension
7. Definition of chronic pulmonary heart
8. Classification of cоr pulmonale
9. The etiology of cоr pulmonale
10. The main pathogenetic mechanisms of cоr pulmonale
11. Clinical signs of compensated of cоr pulmonale
12. Clinical manifestations of decompensated of cоr pulmonale
13. Principles for the treatment of cоr pulmonale
14. Definition of "respiratory failure"?
15. The etiology of respiratory failure
16. Classification of respiratory failure
17. What are the clinical manifestations?
18. Treatment
Recommended literature:
The basic literature [3, 4]. Additional literature: [2, 3].
Test questions to consolidate the material:
1. What are the diagnostic criteria for primary and secondary pulmonary
hypertension?
2. Clinical and laboratory-instrumental signs of respiratory failure
3. List the main instrumental and laboratory diagnostic criteria of chronic
pulmonary heart
4. Features of treatment of pulmonary arterial hypertension
and chronic pulmonary heart. Indications for surgical treatment.
Form of examination – operative questioning.
Lecture number 8
Topic: Pulmonary thromboembolism
Plan of the lecture and key questions:
1. Definition of pulmonary thromboembolism
2. What is the clinical classification of pulmonary thromboembolism?
2h
3. What is the pathogenesis of pulmonary hypertension in pulmonary
thromboembolism?
4. The most characteristic clinical signs of pulmonary thromboembolism
5. Clinical syndromes in pulmonary thromboembolism
6. The most common clinical masks of pulmonary thromboembolism
7. Algorithms for the diagnosis and treatment of pulmonary embolism,
depending on the degree of risk
8. ECG signs of pulmonary thromboembolism
9. Echocardiography signs of pulmonary thromboembolism
10. Аngiopulmonography with pulmonary thromboembolism
11. Stages of treatment
12. Methods for the prevention of pulmonary thromboembolism?
Recommended literature:
The basic literature [2, 4]. Additional literature: [4, 7].
Test questions to consolidate the material:
1. What is the source of thromboembolism with pulmonary
thromboembolism?
2. What diseases are often predispose to pulmonary thromboembolism?
3.What can be identified by ultrasound examination of the deep veins of the
lower extremity
4. What can be detected by ECG and echocardiographic examination of
patients with pulmonary thromboembolism?
5. The most characteristic angiographic features of pulmonary
thromboembolism
6. Plan the treatment of patients with pulmonary thromboembolism?
9
Form of examination – operative questioning.
Lecture №9
Topic: "Cardiomyopathy. Myocardial dystrophy "
Plan of the lecture and key questions:
1. Definition of cardiomyopathy
2. Classification
3. Etiology
4. Pathogenesis
5. The clinical picture
6. The diagnostic role of echocardiography.
7. Differential diagnosis
8. Treatment
9. Forecast and prevention
10. Myocardiodystrophy.
11. The etiology and pathogenesis.
12. Modern classification.
13. The main clinical manifestations and diagnostic criteria.
14. Treatment. Prevention.
Recommended literature:
The basic literature [1, 5]. Additional literature: [3, 5].
Test questions to consolidate the material:
1. The pathogenesis of disorders of intracardiac hemodynamics in patients
with cardiomyopathy.
2. The role of echocardiography in the diagnosis of cardiomyopathy
3. The course and complications of the cardiomyopathy
2h
10
11
4. Features of conservative treatment.
5. Indications for surgical treatment.
6. What methods are used for the diagnosis of myocardial dystrophy
7. Features of treatment of myocardial dystrophy
8. Prevention of myocardial dystrophy
Form of examination – operative questioning.
Lecture №10
Topic: Combined and multivalve heart defects.
Plan of the lecture and key questions:
1. What is heart disease?
2. What is a combined heart defects?
3. Diagnosis of each of these defects, revealing the prevalence of stenosis or
insufficiency in complex defects
4. The differential diagnosis of defects
5. Determination of the severity of valvular disease with combined defects
(by clinical and instrumental data), variants of the course.
6. Principles of treatment
Recommended literature:
The basic literature [1, 2].
Additional literature: [2, 4].
Test questions to consolidate the material:
1. What auscultatory symptoms combined mitral defect?
2. What auscultatory symptoms combined aortic defect?
3. ECG changes in mitral heart defects
4. The combined mitral heart disease
5. Mitral and aortic-tricuspid valvular heart disease
6. The combined aortic valvular disease
7. Complication valvular infective endocarditis
8. Prevention
2h
Form of examination – operative questioning.
2h
Lecture №11
Topic: Congenital Heart Defects
Plan of the lecture and key questions:
1. What are risk factors?
2. What is the classification of the congenital heart disease
3. Common symptoms?
4. What are the clinical features of the ductus arteriosus and coarctation of the
aorta? Features of hemodynamics, symptoms, course. Diagnosis. Indications
for surgical treatment?
5. Atrial and ventricular septal defect. Hemodynamics. Symptoms.
Treatment. Indications for surgical treatment
6. Tetralogy of Fallot hemodynamics, clinical picture, diagnosis, treatment.
7. What is the complication of congenital heart disease (infective
endocarditis)
Recommended literature:
The basic literature [1, 5]. Additional literature: [3, 5].
Test questions to consolidate the material:
1. Changes in hemodynamics in atrial and ventricular septal defect
2. Changes in hemodynamics in ductus arteriosus
3. Clinic of coarctation of the aorta and hemodynamic
12
4. What are the complications of congenital heart disease
5. Prognosis and the congenital heart disease Прогноз и осложнения ВПС
6. Role of instrumental methods of investigation at diagnosis of the
congenital heart disease
Form of examination – operative questioning.
Lecture number 12
Topic: Pericarditis
Plan of the lecture and key questions:
1. Definition of "pericarditis"?
2. Classification of pericarditis?
3. Dry pericarditis. The clinical picture and treatment.
4. Outcomes of fibrinous pericarditis
5. Acute exudative pericarditis. The clinical picture. Diagnosis.
6. Meaning of X-ray examination, echocardiography.
7. Diagnostics tamponade
8. Indications for pericardiocentesis
9. Treatment with the etiologic factor.
10. Adhesive (constrictive) pericarditis. Etiology. Diagnosis.
11. Treatment. Indications for surgical treatment. Prognosis.
Recommended literature:
The basic literature [2, 3]. Additional literature: [2, 3].
2h
Test questions to consolidate the material:
1. Dry, exudative and adhesive pericarditis
2. Initial diagnosis of dry pericarditis
3. Clinic of exudative pericarditis
4. X-ray signs of fluid in the pericardium
5. Echocardiography signs of pericarditis
6. Basic principles of treatment of patients with acute (dry or exudative)
pericarditis
13
Form of examination – operative questioning.
Lecture №13
Topic: Symptomatic arterial hypertension
Plan of the lecture and key questions:
1. Renoparenchymatous and renovascular hypertension.
2. Clinical features and diagnosis
3. Basic types of treatment of renovascular hypertension
4. Rational drug combinations with renovascular hypertension
5. Endocrine forms of symptomatic arterial hypertension: Cushing's
syndrome, pheochromocytoma, primary hyperaldosteronism main clinical
signs
6. Laboratory and special methods of investigation
7. Treatment
8. Coarctation of the aorta, the clinical signs, diagnosis
Recommended literature:
The basic literature [1, 2]. Additional literature: [2, 3].
Test questions to consolidate the material:
1. Symptoms suggestive of a secondary nature AG
2. Diagnostic criteria of renovascular hypertension
2h
14
15
3. What are the clinical and instrumental signs that suggest renovascular
hypertension or renoparenchymatous?
4. Diagnostic criteria for primary hyperaldosteronism Disease Con?
5. The clinical signs of Cushing's syndrome
Form of examination – operative questioning.
Lecture №14
Topic: Myocarditis
Plan of the lecture and key questions:
1. Definition of "myocarditis"?
2. Classification of myocarditis?
3. Etiology and pathogenesis of myocarditis?
4. Clinical diagnosis of myocarditis, diagnostic criteria
5. Current of myocarditis
6. Treatment of myocarditis, depending on etiology.
7. Complications of myocarditis.
8. Prognosis
Recommended literature:
The basic literature [2, 3]. Additional literature: [7, 8].
Test questions to consolidate the material:
1. The main elements of the pathogenesis
2. Signs of myocardial damage
3. Diagnostic criteria: large and small signs
4. ECG signs of myocarditis
5. Prevention of infectious myocarditis
6. Features of treatment of the disease
Form of examination – operative questioning.
Lecture number 15
Topic: Myocardial infarction, complications
Plan of the lecture and key questions:
1. Ruptures heart
2. Risk factors for heart failure
3. The clinical picture prescission period
4. External ruptures free wall of the left ventricle
5. Rupture or dysfunction of the papillary muscles
6. Emergency aid
7. Cardiac tamponade
8. Diagnosis of acute cardiac tamponade
9. Clinical manifestations of post-infarction syndrome (Dressler's)?
10. Aneurysm of heart
11. Diagnosis
12. Treatment
Recommended literature:
The basic literature [3, 5]. Additional literature: [2, 5].
Test questions to consolidate the material:
1. Risk factors for heart failure
2. Clinic of cardiac tamponade
3. Clinic of postinfarction Dressler syndrome.
4. Treatment of postinfarction Dressler syndrome.
5. Diagnosis of heart aneurysm
2h
2h
16
17
Form of examination – operative questioning.
Lecture number 16
Topic: Heart rhythm disturbance: disturbance of excitability
Plan of the lecture and key questions:
1. The definition of "arrhythmia."
2. Extrasystole. Pathogenesis. Clinical manifestations.
3. Diagnosis extrasystole arrhythmia (ECG-signs).
4. Features of medical tactics, indications for antiarrhythmic drugs.
5. Prevention of arrhythmia
6. Рaroxysmal tachycardia. Pathogenesis.
7. The clinical picture of an attack paroksizmal tachycardia. ECG changes.
Changes in systemic hemodynamics an attack of.
8. Drug therapy during an attack of paroxysmal tachycardia (supraventricular
and ventricular). Indications for cardioversion. Preventing attacks. Prognosis.
9. Atrial fibrillation and atrial flutter. Pathogenesis. Classification. The
clinical symptomatology. ECG changes.
10. Impact of atrial fibrillation on the hemodynamics. Complications
Recommended literature:
The basic literature [2, 3]. Additional literature: [5, 7].
Test questions to consolidate the material:
1. Classification of extrasystoles
2. ECG criteria arrythmia
3. Clinical manifestations of supraventricular paroxysmal tachycardia
4. ECG criteria of paroxysmal tachycardia
5. Treatment of paroxysmal ventricular tachycardia
6. ECG criteria for atrial fibrillation and atrial flutter
8. Treatment of paroxysmal atrial fibrillation
7. ECG criteria for atrial fibrillation and ventricular fibrillation
9. Treatment of ventricular fibrillation
Form of examination – operative questioning.
Lecture №17
Topic: Heart rhythm disturbance: conduction disturbances
Plan of the lecture and key questions:
1. Atrioventricular block. Etiology.
2. Clinical and electrocardiographic characteristics of atrioventricular block:
signs on the ECG AB - blockade of 1 degree.
signs on the ECG AB - blockade of 2 degrees (Mobitts Mobitts I and II).
signs on the ECG AB - blockade of 3 degrees.
3. Intraventricular block ECG signs:
complete blockade of the right leg bunch Gisa
complete left bundle branch block
4. Medical Management of acute emerging conduction disturbance.
5. Indications for temporary pacing.
6. Treatment of chronic conduction disturbances.
7. Indications for implantation of cardiac pacemakers. Prognosis.
Recommended literature:
The basic literature [3, 5]. Additional literature: [2, 8].
Test questions to consolidate the material:
1. Signs on the ECG AB - blockade of 1 degree.
2. Signs on the ECG AB - blockade of 2 degrees (Mobitts Mobitts I and II).
2h
2h
3. Signs on the ECG AB - blockade of 3 degrees.
4. ECG signs - bundle-branch block
5. Indications for implantation of pacemakers.
18
19
Form of examination – operative questioning.
Lecture №18
Topic: Amyloidosis of the kidneys. Nephrotic syndrome.
Plan of the lecture and key questions:
1. Defination of renal amyloidosis
2. Classification of renal amyloidosis
3. The etiology and pathogenesis of renal amyloidosis
4. Diagnostic criteria amyloidosis
5. Value biopsy kidney research gingival mucosa and intestines for a proper
diagnosis.
6. Treatment of renal amyloidosis
7. Course and prognosis
8. Defination "nephrotic syndrome"?
9. What are the causes of nephrotic syndrome?
10. The main clinical manifestations of nephrotic sindromaNS?
11. Diagnosis of nephrotic syndrome
12. Features of modern therapy (diet, diuretics, immunosuppressants,
cytotoxic drugs, anticoagulants, nonsteroidal anti-inflammatory drugs,
indications for hemosorption and plasmapheresis).
13. The course and prognosis of nephrotic syndrome?
Recommended literature:
The basic literature [3, 5]. Additional literature: [3, 6].
Test questions to consolidate the material:
1. The etiological factors of renal amyloidosis
2. Laboratory diagnosis
3. General principles of treatment of patients with renal amyloidosis
4. The etiological factors that lead to the development of nephrotic syndrome
5. Laboratory and instrumental data of nephrotic syndrome
6. General principles of treatment of patients with nephrotic syndrome
Form of examination – operative questioning.
Lecture №19
Topic: Acute renal failure.
Plan of the lecture and key questions:
1. How to define the term "acute renal failure" (CRF)?
2. Which leads to the development of acute renal failure?
3. Basic pathogenesis arrester
4. Classification of acute renal failure?
5. The clinical picture of acute renal failure by period?
6. Diagnostics
7. Treatment
8. Indications for hemodialysis
9. The course and prognosis of acute renal failure (ARF)
Recommended literature:
The basic literature [3, 5]. Additional literature: [5, 6].
2h
2h
Test questions to consolidate the material:
1. List the etiological factors
2. The diagnostic criteria for acute renal failure
3. Principles of treatment of acute renal failure
20
21
Form of examination – operative questioning.
Lecture №20
Topic: Chronic renal failure.
Plan of the lecture and key questions:
1. Definition of "chronic renal failure" (CRF)?
2. Definition and classification
3. Etiology
4. Common clinical manifestations of the late stages of chronic kidney
disease?
5. Diagnostics. Laboratory and instrumental investigations
6. Dietary Recommendations
7. Treatment
8. Indications for hemodialysis and its capabilities.
9. Kidney transplantation.
Recommended literature:
The basic literature [2, 3]. Additional literature: [5, 6].
Test questions to consolidate the material:
1. Define the "chronic renal failure" (CRF)
2. List the etiological factors
3. The diagnostic criteria for chronic renal failure
4. Markers of kidney damage
5. What are the indications and methods of preparation for dialysis and
kidney transplantation?
Form of examination – operative questioning.
Lecture number 21
Topic: Stomach ulcer and duodenum. Features of the course depending on
the age, gender, location. Menetries disease.
Plan of the lecture and key questions:
1. Clinic of peptic ulcer disease, depending on the location:
ulcers and cardiac subcardial parts of the stomach
pyloric channel ulcers (ulcers of the pylorus)
Postbulbar ulcers
giant gastric ulcer and duodenum
2. Features of peptic ulcer disease in children and teenagers
3. Features of peptic ulcer disease in elderly patients
4. Features the ulcer in women.
5. Clinical manifestations
6. Treatment:
7. Menetries disease: etiology and pathogenesis, clinical picture, diagnosis,
treatment
Recommended literature:
The basic literature [1, 2]. Additional literature: [3, 4, 5].
2h
2h
Test questions to consolidate the material:
1. Features of the pyloric canal ulcer
2. The clinical picture of giant gastric ulcers and 12 p.k
3. Current peptic ulcer disease in children and teenagers
4. The course of peptic ulcer disease in elderly patients
5. The course of ulcer disease in women
6. Indications for endoscopy of the stomach and duodenum
7. Methods for detection of HP
8. Clinical manifestations of the disease Menetries
22
23
Form of examination – operative questioning.
Lecture number 22
Topic: Ulcerative colitis.
Plan of the lecture and key questions:
1. Definition
2. Etiology and pathogenesis
3. Intestinal and extraintestinal clinical manifestations.
4. Complications.
5. X-ray and endoscopic diagnostic studies.
6. Meaning of of morphological studies to confirm the diagnosis.
7. Treatment Forecast
Recommended literature:
The basic literature [3, 5]. Additional literature: [2, 3, 4].
Test questions to consolidate the material:
1. The character of the defeat at UC
2. Intestinal symptoms
3. Extraintestinal manifestations
4. What are the informative research methods at UC
5. What are the basic therapy for ulcerative colitis
Form of examination – operative questioning.
Lecture number 23
Topic: Crohn's Disease
Plan of the lecture and key questions:
1. Definition
2. Etiology and pathogenesis
3. Intestinal and extraintestinal clinical manifestations.
4. Variants of complications.
5. X-ray and endoscopic examinations.
6. Meaning of morphological studies to confirm the diagnosis.
7. Treatment, prognosis
Recommended literature:
The basic literature [1, 2]. Additional literature: [3, 4].
Test questions to consolidate the material:
1. Intestinal symptoms
2. The character of defeat in Crohn's disease
3. What are the informative research methods in Crohn's disease.
4. What are the basic therapy in Crohn's disease
2ч
2h
24
25
26
Form of examination – operative questioning.
2h
Lecture number 24
Topic: Functional bowel disease.
Plan of the lecture and key questions:
1. Definition
2. Etiology. Pathogenesis
3. Clinical Syndromes
4. Laboratory and instrumental methods of research
5. Diagnostic criteria
6. Treatment
Recommended literature:
The basic literature [2, 3]. Additional literature: [7, 8].
Test questions to consolidate the material:
1. What is irritable bowel syndrome?
2. The current classification of functional bowel disease.
3. The clinical picture of irritable bowel syndrome with constipation
4. The clinical picture of irritable bowel syndrome with diarrhea
predominance
5. The clinical picture of irritable bowel syndrome with predominance of pain
and meteorism
6. Principles of treatment of irritable bowel syndrome depending on the form
Form of examination – operative questioning.
Lecture number 25
Topic: Systemic connective tissue disease (systemic scleroderma).
Plan of the lecture and key questions:
1. Definition
2. Etiopathogenesis
3. Clinical syndromes
4. Laboratory and instrumental methods
5. Diagnostic criteria
6. Treatment
Recommended literature:
The basic literature [2, 5].
Additional literature: [3, 4].
Test questions to consolidate the material:
1. What is systemic scleroderma?
2. What are the etiological factors of systemic sclerosis?
3. What are the pathogenesis of systemic sclerosis?
4. Basic therapy of the disease
Form of examination – operative questioning.
Lecture number 26
Topic: Systemic connective tissue diseases (dermatomyositis).
Plan of the lecture and key questions:
1. Definition
2. The etiology and pathogenesis.
3. Classification
4. The clinical picture. The defeat of the skin, muscles, internal organs and
systems.
2h
2h
5. Laboratory changes.
6. Course of the disease.
7. Criteria for diagnosis.
8. Treatment. prophylaxis.
Recommended literature:
The basic literature [1, 3]. Additional literature: [4, 5].
Test questions to consolidate the material:
1. How to define the concept of "dermatomyositis"?
2. The diagnostic criteria.
3. Laboratory changes
4. Electromyogram
5. Basic therapy DM
27
28
Form of examination – operative questioning.
Lecture number 27
Topic: Seronegative spondylitis
Plan of the lecture and key questions:
1. Definition of spondyloarthropathy (seronegative for rheumatoid factor)
2. Definition of the term "ankylosing spondylitis"?
3. The etiology and pathogenesis of ankylosing spondylitis?
4. Clinical forms of ankylosing spondylitis
5. The clinical picture spondylitis ankylosing
6. Laboratory and instrumental methods of examination
7. Complications
8. Treatment of seronegative spondyloarthropathies
Recommended literature:
The basic literature [3, 5]. Additional literature: [3, 7].
Test questions to consolidate the material:
1. Classification of ankylosing spondylitis
2. Symptoms of early stage AC
3. The diagnostic criteria for ankylosing spondylitis
4. Basic therapy seronegative
Form of examination – operative questioning.
Lecture number 28
Topic: Gout.
Plan of the lecture and key questions:
1. Definition.
2. The etiology and pathogenesis.
3. The clinical picture of acute attack, chronic course. Kidney damage.
4. Criteria for diagnosis.
5. Current. Prognosis.
6. Treatment (diet, non-steroidal anti-inflammatory drugs, agents, eliminates
hyperuricemia).
Recommended literature:
The basic literature [1, 2]. Additional literature: [3, 6].
Test questions to consolidate the material:
1. What are the predisposing factors for gout
2. What is tophi?
2h
2h
3. Diagnostic criteria for gout
4. Basic therapy for gout
29
30
31
Form of examination – operative questioning.
Lecture number 29
Topic: Deforming osteoarthritis.
Plan of the lecture and key questions:
1. Define deforming osteoarthritis.
2. What factors contribute to the development of the disease?
3. What are the main symptoms of the disease.
4. What are the basic principles in the treatment of osteoarthritis deformans.
5. What are the main groups of drugs used for the treatment of patients with
deformation osteoarthritis?
Recommended literature:
The basic literature [2, 3]. Additional literature: [7, 8].
Test questions to consolidate the material:
1. What are the predisposing factors DOA
2. Diagnostic criteria for DOA.
4. Basic therapy DOA
Form of examination – operative questioning.
Lecture number 30
Topic: Systemic vasculitis
Plan of the lecture and key questions:
1. Definition
2. Etiopathogenesis
3. Elinical syndromes
4. Laboratory and instrumental methods
5. Diagnostic criteria
6. Treatment
Recommended literature:
The basic literature [1, 2]. Additional literature: [3, 5].
Test questions to consolidate the material:
1. Classification of periarteritis nodosa
2. Diagnostic criteria of periarteritis nodosa
3. Basic therapy periarteritis nodosa
Form of examination – operative questioning.
Lecture number 31
Topic: Drug disease and acute allergies
Plan of the lecture and key questions:
1. Name the types of allergic reactions.
2. Imagine classification of allergens.
3. What is anaphylaxis? What causes it?
4. Define drug disease.
5. What are the principles of treatment of anaphylactic shock
Recommended literature:
The basic literature [3, 5]. Additional literature: [6, 7].
2h
2h
3h
Test questions to consolidate the material:
1. Name the types of allergic reactions.
2. Imagine classification of allergens
3. Define disease drug
4. Clinical symptoms, diagnosis and treatment
5. What is Lyell's syndrome?
6. What is serum sickness?
Form of examination – operative questioning.
Total
63h
7. content of practical (seminars) lessons
Thematic plan
of practical lessons on the subject of "internal diseases" for 5-year course students of
Osh State University medical faculty for 2015-2016 academic year.
№
Theme
Hours
1
Pneumonia. Classification. Community-acquired pneumonia (typical and
atypical variants): aethiology, clinical manifestations and treatment.Nosocomial
pneumonia: aethilogy, clinical manifestations and treatment approaches.
Pneumonia in patients with immune deficiency and ventilator-associated
pneumonia.
3
2
Disseminated processes in the lungs.
Idiopathic fibrosing alveolitis: etiology, pathogenesis, clinical picture,
diagnostics and treatment.
2
3
COPD. Definition. Aethiological factors. Pathogenesis. Сlinical manifestations.
Clinical forms of COPD.Differential diagnosis: COPD and asthma. Laboratory
and instrumental methods in COPD.Treatment.
3
4
Pulmonary emphysema. Aethiology, pathogenesis, Сlassification, clinical
manifestations.
2
5
Suppurative lung disease (abscess and gangraena of the lung).
Aethiology, pathogenesis, classification, clinical manifestations. Treatment.
3
6
Pleurites: etiology, pathogenesis, classification. Clinical picture, diagnostics,
the differential diagnosis and treatment of the fibrinous pleuritis. The
differential diagnosis of transudate and exsudate. Etiology, pathogenesis,
clinical picture, diagnostics and treatment of the exudative pleuritis.
Indications to medical thoracocentesis, technics of performance.
2
7
Pulmonary arterial hypertension. Cor pulmonaie . etiology, pathogenesis,
classification, clinical picture, diagnostics, differential diagnostics, treatment.
Respiratory failure.
3
8
Thromboembolism of pulmonary artery: etiology, pathogenesis, classification,
clinical picture, diagnostics, treatment andprophylaxis.
2
Module №1
9
Cardiomyopathies.
Ethiology, pathophysiology and classification of
primary and specific cardiomyopathies. Dilated cardiomyopathy.
Нypertrophic cardiomyopathy. Restrictive cardiomyopathy, : clinical
features, diagnostics, clinical features, and treatment. Myocardial
dystrophy clinical features, diagnostics, clinical features, and treatment.
10
3
2
Combined and аssociated heart defects.
Aethiology, pathogenesis, clinical manifestations, differential diagnosis,
treatment
11 Congenital cardiac malformations: аtrial septal defect, ventricular septal
defect, the patent ductus arteriosus, tetralogy of Fallot, coarctation of
the aorta).Нemodynamic, clinical findings, diagnostics and management.
3
12 Congenital heart defects (Tetralogy of Fallot, coarctation of the aorta).
Нemodynamic, clinical findings, diagnostics and management.
2
13
3
Pericarditis: ethiology, pathogenesis and classification. Clinical
presentations, diagnostic steps and differential diagnosis of pericarditis.
Management of pericarditis. Indications for pericardiocentesis, technique.
14
2
Arterial hypertension classification. The main principles of differential
diagnosis of essential and secondary hypertension.
Renal hypertension: classification, ethiology, pathophysiology, clinical
presentations, diagnostics and differential diagnostics, treatment.
Endocrine hypertension: classification, ethiology, pathophysiology, clinical
presentations, diagnostics and differential diagnostics, treatment.
15
Miocarditis: definition, ethiology, pathophysiology, classification, clinical
features, diagnostics, differential diagnostics and treatment.
3
16 Myocardial infarction, complications. Сardiac tamponade. Postinfarction
Dressler's syndrome. Ruptures heart.
2
17
3
Cardiac arrhythmias: conduction disturbances. Extrasystole: definition,
ethiology, pathophysiology, classification, clinical.
Atrial fibrillation and atrial flatter: ethiology, pathophysiology,
classification, clinical presentations, diagnostics and treatment.
Ventricular fibrillation and asystolia: clinical presentations, diagnostics and
treatment.
Electropulse therapy of heart rate and rhythm disturbances: indications,
technique.
18
Cardiac arrhythmias: Conduction disturbances: (sinus node disfunctions,
AV-blocks, bundle branch blocks) ethiology, pathophysiology,.
Classification, clinical manifestations, ECG, treatment.
Module №2
Test
2
19 Renal amyloidosis. nephrotic syndrome.: etiology, classification, clinical
picture, diagnostics, treatment
3
20 Acute renal failure: Etiology, classification, clinical picture, diagnostics,
treatment. Indications to carrying out of hemodialysis.
2
21 Chronic renal failure: Etiology, classification, clinical picture, diagnostics,
treatment. Indications to carrying out of hemodialysis and kidney
transplantation.
3
22 Stomach ulcer and duodenum. Features of the course depending on the
age, sex, location. Menetries disease.
2
23 Ulcerative colitis. Etiology, pathogenesis, classification, clinical features of
intestinal and extraintestinal manifestations, diagnosis, treatment.
Complications
3
24 Inflammatory bowel disease: Crohn’s disease. Etiology, pathogenesis,
classification, clinical features of intestinal and extraintestinal manifestations,
diagnosis, treatment. Complications of Crohn’s disease.
2
25
3
Inflammatory bowel disease: ulcerative colitis. Etiology, pathogenesis,
classification, clinical features of intestinal and extraintestinal manifestations,
diagnosis, treatment. Complications ofulcerative colitis.
Module № 3
26 Systemic connective tissue disease (systemic scleroderma): etiology,
pathogenesis, classification, clinical features, diagnosis, differential diagnosis,
treatment.
2
27 Systemic connective tissue disease (dermatomyositis): etiology,
pathogenesis, classification, clinical features, diagnosis, differential diagnosis,
treatment.
3
28 Ankylosingspondylitis: etiology, pathogenesis, classification, clinicalfeatures,
criteriafordiagnosis, diagnosis, differentialdiagnosis, treatment.
2
29 Gout: etiology, pathogenesis, classification, clinical features, criteria for
diagnosis, diagnosis, differential diagnosis, treatment.
3
30 Osteoarthritis: etiology, pathogenesis, classification,
diagnosis, differential diagnosis, treatment.
features,
2
31 Systemic vasculites (polyarteriitis nodosa, non-specific aortoarteriitis; Giant
cell arteritis): Aethiology, pathogenesis, clinical manifestations, differential
diagnosis, treatment.
3
32 Systemic vasculites (Chorton’s disease, Wegener’s granulomatosis):
Aethiology, pathogenesis, clinical manifestations, differential diagnosis,
treatment.
2
33 Drug disease and acute allergies. Aethiology, pathogenesis, clinical
manifestations, treatment.
2
Module № 4
Exaм
clinical
82
Lesson number 1.
Topic: Pneumonia. Classification. Atypical form of pneumonia. Community-acquired pneumonia.
atypical variants). Nosocomial pneumonia: aethilogy, clinical manifestations and treatment
approaches. Criteria of hospitalization. Pneumonia in patients with immune deficiency and ventilatorassociated pneum Indications to hospitalization. Treatment of pneumonia of serious current.
Lesson plan:
1. Definition
2. Classification
3. Etiology of аtypical , hospital (nosocomial, hospital-acquired) pneumonia
4. Clinical manifestations
5. Criteria of pneumonia diagnosis.
6. A differential diagnosis
7. Features of pneumonia in immunodeficient states
8. Treatment pneumonia depending on the etiology? Outcomes.
Key questions include:
1. Definition of hospital (nosocomial, nosocomial) pneumonia, аtypical form of pneumonia.
2. Classification of pneumonia?
3. Pathogens of atypical pneumonia, etiology of nosocomial (hospital, hospital-acquired) pneumonia
4. The main risk factors
5. The pathogenesis of pneumonia?
6. The clinical picture of acute pneumonia according to the agent. Criteria for the diagnosis of
nosocomial pneumonia.
7. Pneumonia in patients with immune deficiency and ventilator-associated pneum Indications to
hospitalization. Treatment.
8. Additional examination.
9. Complications and outcomes of acute pneumonia.
10. Principles of treatment.
11. Prevention of nosocomial pneumonia.
Test questions to consolidate the material:
1. Main etiology and pathogenesis of atypical pneumonia
2. What major clinical diagnostic criteria for atypical pneumonia, nosocomial pneumonia?
3.What main instrumental and laboratory diagnostic criteria for atypical pneumonia ?
4. What are the criteria of severity of pneumonia?
5. Indications for hospitalization
7. What are antibiotics used for hospital-acquired pneumonia?
8. What are the basic principles of treatment and prevention of atypical pneumonia
Control tests to check students' knowledge:
1. The drug of choice for pneumonia caused by mycoplasma, is:
A) cephalosporin
B) tetracycline
C) Penicillin
D) erythromycin
E) Biseptol
2. Indicative dates antibiotics for pneumonia:
A) before normalizing ESR
B) to the normalization of temperature
C) to complete resorption of infiltration in the lung
D) 4-5 days before normal temperature steadily
E) until the disappearance of cough
3. If you suspect a mycoplasma pneumonia should be given:
A) erythromycin
B) penicillins
C) chlora3phenicol
D) Streptomycin
4. Frequent extrapulmonary complication of acute pneumonia is:
1. toxic infectious shock
2. hepatitis
3. meningitis
4. hyperglycemia
5. When should the efficiency of antibacterial therapy be estimated?
1. within 48-72 hours
2. within the first 48 hours
3. in 5 days
4. after discontinuance of therapy (7-10 days)
6. Pneumonia called atypical are caused by:
a) mycoplasma, chlamydia; b) viruses (influenza, parainfluenza); c) bacteria (Legionella,
mycobacteria); d) All are correct; e) All are incorrect.
7. Drugs of choice for the treatment of atypical рneumonia are: a) penicillins; b) cephalosporins of
the first and second generation; c) macrolides; d) aminoglycoside;
Homework:
- The concept of DDPL
- Classification DDLP
- The concept of alveolitis
- Classification of alveolitis
- Etiopathogenesis alveolitis
- The clinical picture of alveolitis
- Diagnosis and treatment of alveolitis
Recommended Reading: The basic literature [1, 2, 3, 7]. Additional literature: [4, 5, 6].
Lesson number 2.
Topic: Disseminated processes in the lungs.
Alveolites: definition, classification. Idiopathic fibrosing alveolitis: etiology, pathogenesis, clinical
picture, diagnostics and treatment.
Lesson plan:
1. Definition of DDPL.
2. Classification DDPL.
3 . Etiopathogenesis of DDPL.
4. Clinical picture DDPL.
5. Diagnostic Features DDPL.
6. Idiopathic fibrosing alveolitis, etiology, pathogenesis,
classification
7. Сlinic, diagnosis, treatment.
Key questions include:
1. Definition of DDPL
2 Classification DDPL
3 Etiopathogenesis of DDPL
4 Main features DDPL
5 Etiology, pathogenesis IFA
6 The clinical picture
7 Diagnosis of idiopathic fibrosing alveolitis without lung biopsy: large and small criteria
8 Course of the disease
9 Laboratory and instrumental data
10 Complications IFA
10 Treatment of idiopathic fibrosing alveolitis
Test questions to consolidate the material:
1 Disseminated in the lungs - the concept
2 Classification DDPL
3 What are the main stages in the pathogenesis of alveolitis
4 List the specific clinical signs of alveolitis
5 What is the most informative method of investigation with alveolitis
6 Basic principles of treatment
Control tests to check students' knowledge:
1. The main complaint of patients with idiopathic fibrosingalveolitis: a) fever; b) shortness of
breath and nonproductive cough; c) blood spitting; d) All are correct; e) All are incorrect.
2. The characteristic auscultatory phenomenon in idiopathic fibrosingalveolitis is: a) weakened
vesicular breathing; b) hard breathing; c) bronchial breathing; d) crepitus; e) All are incorrect.
3. The characteristic radiographic features of idiopathic fibrosingalveolitis are all, except for: a)
defined nodular-linear dimming; b) cystic enlightenment of the mire of honeycomb lung; c) a uniform
increase transparency lung fields; d) reducing the transparency of lung fields on the type of "ground
glass"; e) Deviation of the trachea to the right, traheomegaliya.
4. The frequent complication of idiopathic fibrosing alveolitis:
1) pneumothorax 2) pleural effusion 3) pulmonary embolism 4) pulmonary hypertension
4. R-logical picture "honeycombing" is characteristic for:
A) fibrosing alveolitis
B) pulmonary hemosiderosis
C) pulmonary sarcoidosis
D staphylococcal pneumonia
E) of pulmonary tuberculosis
Homework:
1. How to define the term "chronic obstructive pulmonary disease" (COPD)?
2. What is the etiology of COPD?
3. What are the pathogenic mechanisms of COPD?
4. What are the pathological changes occur in COPD?
5. What is the clinical picture of COPD?
6. Differential diagnosis of COPD and asthma?
Recommended Reading:
The basic literature: [1, 2, 3, 7].
Additional literature: [4, 5, 6].
Lesson number 3.
Topic: Chronic obstructive pulmonary diseaseCOPD. Definition. Diagnosis, differential. diagnosed
with asthma. Oxygen therapy, indications, techniques, control effectiveness.
Lesson plan:
- Definition
- classification
- Aethiological factors.Pathogenesis.
- Сlinical manifestations
- Diagnosis
- Differential diagnosis
- Тreatment of COPD
Key questions include:
1. IDENTIFICATION "chronic obstructive pulmonary disease?"
2 . Aethiological factors: hereditary and acquired. Smoker’s indices: smoker’s index and packs per
year index.
3. The pathogenetic mechanisms of COPD?
5. The clinical picture of COPD
7. Laboratory and instrumental methods in COPD
9. Differential diagnosis of COPD and asthma?
10. Treatment of COPD
11 Indications for oxygen therapy?
12 Indications for hospitalization
Test questions to consolidate the material:
1. Mehanizmy underlying the bronchial obstruction in COPD?
2. Causes of airflow limitation in COPD: irreversible and reversible
3. Key symptoms for the diagnosis of COPD?
4. Рlan of patient’s investigations
5. Functional disorders in COPD?
6. Drug treatment of COPD?
7. Indications for antibiotic therapy in patients with COPD?
Control tests to check students' knowledge:
1. Tiffeneau index is the index of:
a. total vital capacity of the lungs
b. alveolar ventilation
2. -airway conductance
3. ventilation efficiency
4. maximal oxygen consumption
2. Dyspnea in chronic obstructive bronchitis is caused by the involvement:
1. trachea
2. large bronchi
3. bronchi of average size
4. small bronchi
5. -bronchioles
3. Dyspnea in chronic obstructive bronchitis is caused by the involvement:
1. trachea
2. large bronchi
3. bronchi of average size
4. small bronchi
5. -bronchioles
4. The most important differential diagnostic sign of COPD is most likely:
A) expiratory dyspnea
B) cough with sputum
C) lung sounds with shade boxed
D) partly irreversible airflow obstruction
E) weakened vesicular breathing with prolonged exhalation, dry wheezing
Homework:
1. How to define the concept of emphysema?
2. What is the etiology of pulmonary emphysema?
3. What are the pathogenic mechanisms of pulmonary emphysema?
5. What is the clinical picture of pulmonary emphysema?
10. How is the treatment of primary pulmonary emphysema?
11. How is the treatment of secondary pulmonary emphysema?
Recommended Reading:The basic literature [1, 2, 3, 7]. Additional literature: [4, 5, 6].
Lesson number 4.
Topic: Pulmonary emphysema. Aethiology, pathogenesis, Сlassification, clinical manifestations.
Lesson plan:
- definition
- classification
- etiology and pathogenesis
- clinical picture
- diagnosis
- differential diagnosis
- prognosis
- treatment
Key questions include:
1. Definition of pulmonary emphysema
2. Classification of anatomical on a pathogenesis pulmonary emphysema
3. Etiology and pathogenesis of pulmonary emphysema
4. The clinical picture of emphysema
5. Differential diagnosis
6. Laboratory and instrumental diagnostics
7. Complication of pulmonary emphysema
8. Treatment
Test questions to consolidate the material:
1. Etiology of pulmonary emphysema.
2. Functional disorders in emphysema.
3. The course of pulmonary emphysema.
4. Treatment of primary pulmonary emphysema.
5. Treatment of secondary pulmonary emphysema.
Control tests to check students' knowledge:
1. The main complaint of the patient with emphysema: 1) chest pain 2) cough with sputum 3)
hemoptysis 4) dyspnea
2. The shape of the chest in emphysema
1) asthenic 2) hypersthenic 3) normostenicheskaya 4) barrel shaped
3. Рercussion sound with emphysema
1) boxed 2) timpanichesky 3) blunt 4) clear
4. The radiological signs of emphysema
1) cavity with a horizontal fluid level 2) homogeneous shading with oblique upper boundary
3) patchy shadowing 4) increased transparency of the lung fields
Homework:
1. How you can define the notion of "lung abscess"?
2. What are the main ways of developing the disease.
3. List the main three periods during the disease
4. How can we define the concept of "gangrene"?
5. What are the etiological factors lung gangrene?
3. Complications of the disease
4. What are the main principles of treatment and indications for surgical treatment.
Recommended literature:
The basic literature [1, 2, 3, 7].
Additional literature: [4, 5, 6].
Lesson number №5
Topic: Suppurative lung disease (abscess and gangraena of the lung). Aethiology,
pathogenesis, classification, clinical manifestations. Treatment.
Lesson plan:
- lung abscess, etiology, pathogenesis.
- main clinical syndromes
- gangrene, etiology, pathogenesis
- clinical manifestations
- diagnosis, differential diagnosis.
- principles of treatment
Key questions include:
1. Definition
2. Classification
3. Etiology and pathogenesis
4. The clinical picture of the first and second period of lung abscess.
5. Diagnosis of lung abscess and gangrene
6. Differential diagnosis of lung abscess and gangrene
7. Treatment
8. Outcomes of acute infectious destruction
9. Prevention suppurative lung disease
Test questions to consolidate the material:
1. The definition of "lung abscess"
2. The term "lung gangrene"
3. Etiological factors of lung gangrene
4. Clinical syndromes of lung abscess
5. Complications of the disease
7. Principles of treatment and indications for surgical treatment.
Control tests to check students' knowledge:
1. For lung abscess is characterized by fever
1) undulating 2) hectic 3) perverted 4) constant
2. Hemoptysis and pulmonary hemorrhage may occur when
1) lung abscess 2) asthma 3) acute bronchitis 4) pleural effusion
3. The most informative method of diagnosis of lung abscess
1) blood test 2) sputum 3) X-ray 4) Spirometry
4. radiological signs of lung abscess after breaking into the bronchus
1) rounded shadow 2) cavity with a horizontal fluid level 3) increased transparency of the lung fields
4) shadow light preload
5. In the analysis of blood in lung abscess is defined leukocytosis
1) basophilic 2) neutrophilic 3) eosinophilic 4) all not right +
Homework:
1. How to define the concept of "pleurisy"?
2. What is the classification of pleurisy?
3. What is the pathogenesis of various etiologies pleurisy?
4. What are the pathophysiological processes leading to an accumulation of fluid in the pleural cavity?
5. What are the clinical manifestations of dry (fibrinous) pleurisy?
6. What are the clinical signs of pleural effusion?
8. What are the radiological signs of pleural effusion?
9. What are the laboratory methods
10. What are the principles of treatment of pleurisy?
11. What are the outcomes of pleurisy?
Recommended literature:
The basic literature [1, 2, 3, 7].
Additional literature: [4, 5, 6].
Lesson number 6
Topic : Pleurites: etiology, pathogenesis, classification. Clinical picture, diagnostics, the differential diagnosis
and treatment of the fibrinous pleuritis. The differential diagnosis of transudate and exsudate. Etiology,
pathogenesis, clinical picture, diagnostics and treatment of the exudative pleuritis. Indications to medical
thoracocentesis, technics of performance.
Lesson plan:
- definition
- pleurisy, etiology, pathogenesis
- classification
- clinical manifestations
- diagnosis, differential diagnosis.
- principles of treatment.
Key questions include:
1. The definition of "pleurisy"
2. Classification of pleurisy
3. Pathogenesis of pleurisy different etiology?
4. Clinic fibrinous pleurisy?
5. Clinic of exudative pleurisy
6. Diagnosis of pleurisy
7. Laboratory and instrumental diagnostics
8. Complications
9. What are the principles of treatment of pleurisy?
10. Prediction and prevention of pleurisy.
Test questions to consolidate the material:
1. Causes of infectious pleurisy
2. What are the causes of infectious pleurisy
3. Pathogenesis of infectious pleurisy
4. Pathogenesis of noninfectious pleurisy
5. Clinic of dry (fibrinous) pleurisy
6. X-ray signs of pleural effusion
7. The differential diagnosis of pleurisy
8. What is a transudate, exudate
9. Technique of conducting pleural puncture
Control tests to check students' knowledge:
1. Pain in the chest, worse when you cough, pleural rub typical for
1) bronchitis 2) asthma 3) dry pleurisy 4) exudative pleurisy
2. Еxudative pleurisy can be complicated
1) bronchial asthma 2) bronchitis 3) tuberculosis 4) emphysema
3. Place a puncture during pleural puncture
1) at the upper edge rib 2) at the lower edge rib. 3) All right. 4) all wrong
4. When pleural effusion auscultation determined
1) pleural friction rub 2) the absence of breathing on the affected side 3) crepitus
4) all wrong
Homework:
1. What is "сor pulmonale"?
2. What is the classification of сor pulmonale. ?
3. What are the main causes of сor pulmonale?
4. What are the main pathogenetic mechanisms of сor pulmonale?
5. What is the primary and secondary pulmonary hypertension?
6. What are the clinical signs of chronic compensated сor pulmonalе ?
7. What are the clinical manifestations of chronic decompensated сor pulmonale?
8. What are the principles of treatment of сor pulmonale?
9. What is a "respiratory failure"?
10. What are the main causes of "respiratory failure?
11. What can be said about the classification of "respiratory failure?
12. What are the clinical manifestations of "respiratory failure?
13. What are the principles of treatment "respiratory failure?
Recommended literature:The basic literature: [1, 2, 3, 7]. Additional literature: [4, 5, 6].
Lesson number 7
Topic: Pulmonary arterial hypertension.Cor pulmonaie . Еtiology, pathogenesis, classification, clinical
picture, diagnostics, differential diagnostics, treatment. Respiratory failure.
Lesson plan
- definition
- classification
-etiologic factors
-pathogenesis
- diagnostics
- differential diagnosis
- treatment
Key questions include:
1. Definition "pulmonary arterial hypertension"
2. The etiology of primary and secondary pulmonary hypertension
3. The pathogenesis of pulmonary hypertension?
4. Diagnosis of pulmonary hypertension
5. Treatment of pulmonary hypertension
6. Definition of chronic pulmonary heart
7. Classification of chronic pulmonary heart
8. The main pathogenetic mechanisms of chronic pulmonary heart
9. Clinical signs of compensated chronic pulmonary heart
10. Clinical manifestations of decompensated chronic pulmonary heart
11. Principles for the treatment of chronic pulmonary heart
12. Definition of "respiratory failure"?
13. The etiology of respiratory failure
14. What are the clinical manifestations?
15. Treatment
Test questions to consolidate the material:
1. What are the diagnostic criteria for primary and secondary pulmonary hypertension
2. Clinical and laboratory-instrumental signs of respiratory failure
3. List the main instrumental and laboratory diagnostic criteria of chronic pulmonary heart
4. Features of treatment of pulmonary arterial hypertension
and chronic pulmonary heart. Indications for surgical treatment.
Control tests to check students' knowledge:
Для легочной гипертензии характерны все перечисленные ЭКГ- признаки, КРОМЕ:
A) перегрузки правого желудочка
B) гипертрофии правого желудочка
C) отклонения электрической оси сердца влево+
D) отклонения электрической оси сердца вправо
E) дилатации и гипертрофии правого предсердия
1. The patient with chronic obstructive bronchitis and symptoms of chronic “pulmonary heart”
developed paroxysm of atrial tachycardia. Drug of choice for the paroxysm control is:
1. panangin
2. lidocaine
3. digoxin
4. -verapamil
5. propranol
2. Signs of decompensated chronic pulmonary heart:
1) orthopnea, cold acrocyanosis, ascites 2) fetid sputum 3) warm diffuse cyanosis
4) chest pain
3. The pressure in the pulmonary arteries in chronic pulmonary heart above: 1) 26 mm Hg;
2)15mmHg; 3) 30 mmHg 4) 3 mmHg
4.The main mechanism for the development of pulmonary hypertension in chronic lung
disease:
A) The reduction of pulmonary capillary bed
B) hypercapnia
C) An increase in the synthesis of angiotensin II
D) All incorrect
5. With the development of chronic pulmonary heart x-ray detects the following changes:
1. The extension of the descending branch of the right pulmonary artery;
2. increased vascular pattern of the lungs;
3. increased pulsations of central branch of the pulmonary artery;
4. The increased pulsations of peripheral regions of the pulmonary artery.
Give the correct answer using the scheme:
A) 1.3
B) 1,2,3
C) 2.4
D) 4
6. The mechanism of action of beta-blockers in the treatment of hypertension is ...:
A) decrease in cardiac output B) blockade of the conversion of angiotensin I to angiotensin II
C) increase in blood volume D) decreasing receipts of renin in the blood
7. Causes of chronic pulmonary heart
1. diseases of the lung parenchyma
2. airways disease
3. loss of pulmonary vascular bed
4. sleep apnea
5. All the above *
Homework:
1. What is a "pulmonary embolism"?
2. What is the clinical classification of pulmonary embolism?
3. What is the pathogenesis of pulmonary hypertension with pulmonary embolism?
4. What is a characteristic clinical picture thromboembolism main trunk and main branches of the
pulmonary artery?
5. What is the clinical picture of thromboembolism and medium-or small branches of the pulmonary
artery?
6. What is observed at X-ray examination of patients with pulmonary embolism?
7. What can be detected by electrocardiogram and echocardiography-examination of patients with
pulmonary embolism?
8. What special methods are used to Detect PE?
10. What is the clinical diagnosis of pulmonary embolism?
11. What are the principles of treatment of patients with pulmonary embolism?
12. What are the methods of prevention of pulmonary embolism?
14. What are the diseases and conditions most often predispose to pulmonary embolism?
15. What is the sequence of vascular lesions in PE?
16. What is included in the plan of treatment of patients with pulmonary embolism?
Recommended literature: The basic literature [1, 2, 3, 7]. Additional literature: [4, 5, 6].
Lesson number 8
Topic: Thromboembolism of pulmonary artery: etiology, pathogenesis, classification, clinical picture,
diagnostics, treatment and prophylaxis.
Lesson plan:
- definition of pulmonary thromboembolism
- classification
- etiology
- pathogenesis
- the clinical picture of pulmonary thromboembolism
- diagnostics
- differential diagnosis
- treatment of pulmonary thromboembolism
Key questions include:
1. Definition of pulmonary thromboembolism
2. What is the clinical classification of pulmonary thromboembolism?
3. What is the pathogenesis of pulmonary hypertension in pulmonary thromboembolism?
4. The most characteristic clinical signs of pulmonary thromboembolism
5. Clinical syndromes in pulmonary thromboembolism
6. The most common clinical masks of pulmonary thromboembolism
7. Algorithms for the diagnosis and treatment of pulmonary embolism, depending on the degree of
risk
8. ECG signs of pulmonary thromboembolism
9. Echocardiography signs of pulmonary thromboembolism
10. Аngiopulmonography with pulmonary thromboembolism
11. Stages of treatment
12. Methods for the prevention of pulmonary thromboembolism?
Test questions to consolidate the material:
1. What is the source of thromboembolism with pulmonary thromboembolism?
2. What diseases are often predispose to pulmonary thromboembolism?
3.What can be identified by ultrasound examination of the deep veins of the lower extremity
4. What can be detected by ECG and echocardiographic examination of patients with pulmonary
thromboembolism?
5.The most characteristic angiographic features of pulmonary thromboembolism
6. Plan the treatment of patients with pulmonary thromboembolism?
Control tests to check students' knowledge:
1. Factors predisposing to pulmonary embolism are:
deep vein thrombosis of the lower extremities 2) the early postoperative period
3) mitral stenosis 4) everything is correct
2. Typical clinical signs of pulmonary embolism are:
1. 1) cyanosis 2) dyspnea 3) jugular venous distention
4) everything is correct
3. Urgent diagnostic tests in suspected pulmonary embolism are:
1. sputum examination
2. -electrocardiogram
3. study of the function of external respiration
4. -roentgenography of the thorax
5. -pulmonary angiography
4. Predisposing factors to pulmonary embolism are:
1. -deep vein thrombophlebitis of lower extremities
2. -early postoperative period
3. early activation in postinfarction period
4. -mitral stenosis
5. aortic insufficiency
5.The most likely arrhythmia in pulmonary embolism
1. AV block
2. atrial fibrillation *
3. Sinus node weakness syndrome
4. sinus bradycardia
6. Treatment of pulmonary embolism include the following methods
1. anticoagulation
2. thrombolytic therapy
3. Surgical treatment
4. All answers are correct
7.Complaints with pulmonary embolism:
1. suddenly appeared unexplained dyspnea at rest; *
2. chest pain; coughing up blood; *
4. The drop in blood pressure, collapse *
5. all right
6. all wrong
Homework:
1. What is a "cardiomyopathy"?
2. What is the etiology of each form of "cardiomyopathy"? ?
3. What is the pathogenesis "cardiomyopathy"? depending on the form?
5. What characterizes the clinical manifestations of the"cardiomyopathy"? ?
6. What are the physical examination in patients with "cardiomyopathy"? ?
7. What are the diagnostic methods used in the "cardiomyopathy"? and their results?
8. What is the differential diagnosis of "cardiomyopathy"? ?
9. What is the prognosis?
10. What are the principles of treatment of patients "cardiomyopathy"?
11. What is the prevention of the "cardiomyopathy"? ?
12. What is a "myocardial dystrophy"?
13. What is the classification of myocardial dystrophy ?
14. What is the pathogenesis of myocardial dystrophy ?
16. What characterizes the clinical manifestations of myocardial dystrophy
Recommended literature: The basic literature [1, 2, 3, 7]. Additional literature: [4, 5, 6].
Lesson number 9
Topic: Cardiomyopathies. Dilated cardiomyopathy. Нypertrophic cardiomyopathy. Restrictive
cardiomyopathy, : clinical features, diagnostics, clinical features, and treatment. Myocardial dystrophy
clinical features, diagnostics, clinical features, and treatment.
Lesson plan:
- definition
- the basic variants: hypertrophic, dilated, restrictive.
- classification
- the clinical picture
- diagnosis
- differential diagnosis
- cardiomyopathy treatment, course and complications
Key questions include:
1. Definition of cardiomyopathy
2. Classification
3. Etiology
4. Pathogenesis
5. The clinical picture
6. The diagnostic role of echocardiography.
7. Differential diagnosis
8. Treatment
9. Forecast and prevention
10. Myocardiodystrophy.
11. The etiology and pathogenesis.
12. Modern classification.
13. The main clinical manifestations and diagnostic criteria.
14. Treatment. Prevention.
Test questions to consolidate the material:
1. The pathogenesis of disorders of intracardiac hemodynamics in patients with cardiomyopathy.
2. The role of echocardiography in the diagnosis of cardiomyopathy
3. The course and complications of the cardiomyopathy
4. Features of conservative treatment.
5. Indications for surgical treatment.
6. What methods are used for the diagnosis of myocardial dystrophy
7. Features of treatment of myocardial dystrophy
8. Prevention of myocardial dystrophy
Control tests to check students' knowledge:
1. Which diseases can be associated with myocardiodistrophy?
1. alcoholism
2. chronic renal failure
3. thyreotoxicosis
4. -all the listed above
5. none of the listed above
2. Which pathological states cause myocardiodistrophy?
1. starvation
2. physical exertion
3. climax
4. chronic tonsillitis
5. -all the listed above
3. Which signs differentiate myocardiodistrophy from other cardiac diseases?
1. inflammation process in the myocardium
2. combination of metabolic processes and myocardial inflammation
3. -pathological changes in myocardiocytes metabolism
4. impairments of coronary dynamics
5. immunoallergic impairment of myocardium
4. What can impairments of intracardiac dynamics be due to in restrictive cardiomyopathy?
1. failure of ventricular myocardium relaxation
2. failure of diastolic filling of ventricles
3. decrease of stroke cardiac volume
4. insufficiency of mitral, tricuspid valves
5. -all the listed above causes
5. Which clinical features are typical for hypertrophic cardiomyopathy?
1. -systolic murmur between III-IV ribs on the left margin of the sternum increasing in straining
at the inhaling pitch or after taking nitroglycerin
2. systolic murmur between II-III ribson the right margin of the sternum weakening in straining
at the inhaling pitch or after taking nitroglycerin
3. systolic murmur radiates to the neck vessels
4. II sound over the aorta is weakened
5. all of the listed above are typical
6. Which causes play a part in the developing hypertrophic cardiomyopathy?
1. -autosomaldominant genetic defect with incomplete penetration
2. alcoholism
3. intrauterine viral infection
4. exposure to ionizing radiation
5. all the causes play a part in etiology
Homework:
1. What is heart defects?
2. What is a combined heart defects?
3. Diagnosis of each of these defects, revealing the prevalence of stenosis or insufficiency in complex
defects
4. What diseases differential diagnosis of defects?
5. Determination of the severity of valvular defects with combined (by clinical and instrumental data),
variants of the course.
6. What are the principles of treatment of defects?
Recommended literature: The basic literature [1, 3, 5]. Additional literature: [1, 5, 6].
Lesson number 10
Topic: Combined and аssociated heart defects.
Aethiology, pathogenesis, clinical manifestations, differential diagnosis, treatment
Lesson plan:
- mitral-aortic valvular heart disease
- mitral-aortic, tricuspid valvular heart disease
- etiology
- diagnostics
- treatment
Key questions include:
1. What is heart disease?
2. What is a combined heart defects?
3. Diagnosis of each of these defects, revealing the prevalence of stenosis or insufficiency in complex
defects
4. The differential diagnosis of defects
5. Determination of the severity of valvular disease with combined defects (by clinical and
instrumental data), variants of the course.
6. Principles of treatment
Test questions to consolidate the material:
1. What auscultatory symptoms combined mitral defect?
2. What auscultatory symptoms combined aortic defect?
3. ECG changes in mitral heart defects
4. The combined mitral heart disease
5. Mitral and aortic-tricuspid valvular heart disease
6. The combined aortic valvular disease
7. Complication valvular infective endocarditis
8. Prevention
Control tests to check students' knowledge:
1. Which clinical features are typical for the mitral aortic insufficiency?
1. great difference in systolic and diastolic arterial pressure
2. low or almost zero index of diastolic arterial pressure
3. intensive pulsation of neck vessels (“carotid shudder”)
4. pulsatile headaches
5. -all of them are typical
2. Which features of pathogenesis are typical for the combined mitral stenosis and insufficiency
of the aortic valve with predominating mitral stenosis?
1. -mitral stenosis restricts sufficient overload of the left ventricle
2. mitral stenosis aggravates hemodynamic changes which caused by insufficiency of the aortic
valve
3. mitral stenosis enhances decompensation of the left ventricle caused by insufficiency of the
aortic valve
4. all of them are typical
5. all of them are not typical9.
3. Which disease is characterized by the following signs: hectic fever, profuse perspiration, chill,
shortness of breath, general weakness?
1. rheumocarditis
2. -subacute infectious endocarditis
3. Abramov-Fidler myocarditis
4. myocardial infarction
5. spontaneous angina
4Auscultative signs of mitral stenosis are:
1. weakened sound I at the apex
2. -flapping sound I at the apex
3. weakened sound II at the aorta
4. increased sound II at the aorta
5. sound II accent at the pulmonary artery
6. splitting of sound I
7. sound of opening of the mitral valve
8. protodiastolic murmur at the apex
Homework:
1. What is the "Atrial septal defect ? (ASD)?
2. How changes the hemodynamics in patients with ASD?
3. What is the clinical picture with ASD?
4. What additional research methods are used to confirm a diagnosis of ASD?
5. What is the prognosis of patients with ASD?
6. What is a "ventricular septal defect" (VSD)?
7. How changes the hemodynamics in patients with VSD?
8. What is the clinical picture of VSD in adults?
9. What additional research methods are used to confirm a diagnosis of VSD?
10. What are the principles of treatment of patients with VSD?
11. What is the prognosis of patients with VSD?
12. How changes the hemodynamics in patients with patent ductus arteriosus?
13. What is the clinical picture with patent ductus arteriosus?
14. What additional research methods are used to confirm the diagnosis of patent ductus arteriosus?
15. What are the principles of management of patients with patent ductus arteriosus?
16. What is the prognosis of patients with patent ductus arteriosus?
Recommended literature: The basic literature [1, 3, 5]. Additional literature: [1, 5, 6].
Lesson number 11
Topic: Congenital cardiac malformations: аtrial septal defect, ventricular septal defect, the patent
ductus arteriosus. Нemodynamic, clinical findings, diagnostics and management.
Lesson plan:
1. Definition
2. Classification.
3. Etiology.
4. Pathogenesis.
5. The clinical picture.
6. Laboratory - instrumental data.
7. Criteria for diagnosis.
8. Treatment.
Key questions include:
1. What are risk factors?
2. What is the classification of the congenital heart disease
3. What is the "Atrial septal defect ? (ASD)?
4. How changes the hemodynamics in patients with ASD?
5. What is the clinical picture with ASD?
6. What additional research methods are used to confirm a diagnosis of ASD?
7. What is the prognosis of patients with ASD?
8. What is a "ventricular septal defect" (VSD)?
9. How changes the hemodynamics in patients with VSD?
10. What is the clinical picture of VSD in adults?
11. What additional research methods are used to confirm a diagnosis of VSD?
12. What are the principles of treatment of patients with VSD?
13. What is the prognosis of patients with VSD?
14. How changes the hemodynamics in patients with patent ductus arteriosus?
15. What is the clinical picture with patent ductus arteriosus?
16. What additional research methods are used to confirm the diagnosis of patent ductus arteriosus?
17. What are the principles of management of patients with patent ductus arteriosus?
18. What is the prognosis of patients with patent ductus arteriosus?
Test questions to consolidate the material:
1. Common symptoms?
2. Changes in hemodynamics in atrial and ventricular septal defect
3. Changes in hemodynamics in ductus arteriosus
4. Symptoms.
5. What are the complications of congenital heart disease
6. What is the complication of congenital heart disease (infective endocarditis)
7. Treatment. Indications for surgical treatment
Control tests to check students' knowledge:
1. Which diagnostic possibilities does Echo-computerized tomography have for the
differentiation of congenital interventricular septal defect?
1. visualization and determination of gross and moderate septal defect
2. diagnosing septal fenestration by the method of colour Doppler cartography
3. assessment of the blood flow direction through the defect by the Doppler method
4. evaluation of the myocardial hypertrophy degree and dilatation of the heart chambers
5. -possesses all the mentioned possibilities
2. What is the cause of diffuse cyanosis in patients with congenital interseptal defect?
1. -higher pressure in the right atrium than in the left one
2. decompensation of the left atrial function
3. decompensation of the right atrial function
4. atrial fibrillation
5. all the listed above
3.Where is the interseptal defect of ostiumprimum type formed?
1. in the upper portion of the interventricular septum near the mouth of the upper vena cava
2. in the medial portion of the interventricular septum in the fossa ovalis
3. -near the base of the atrioventricular valves folds
4. in none of the mentioned sites
5. in any of the mentioned sites
4.Where is the interseptal defect of ostiumsecundum type formed?
1. in the upper portion of the interventricular septum near the mouth of the upper vena cava
2. -in the medial portion of the interventricular septum in the fossa ovalis
3. near the base of the atrioventricular valves folds
4. in none of the mentioned sites
5. in any of the mentioned sites
5. Which drug can be effective in medication induced obliteration of the open arterial duct in
preterm infants?
1. -indometacin
2. dimedrol
3. propranol
4. phenobarbital
5. D-penicyllamin
6. Which signs of congenital open arterial duct can be diagnosed by Echocardiography?
1. -visualization of the open arterial duct
2. signs of stenosis of the left artiovenous fistula
3. signs of stenosis of the pulmonary artery
4. all of the listed signs
5. none of the listed signs
7. Which group of congenital heart defects (CHD) is open arterial duct referred to?
1. -to CHD of blue type with venoatrial discharge
2. to CHD of pale type with atriovenous shunt
3. to CDH without discharge but with obstacle for blood discharge from the ventricles
4. to none of the listed groups
5. to any of the listed groups
8. Which group of congenital heart defects (CHD) is interarterialseptal defect referred to?
1.to CHD of blue type with venoatrial discharge
2. to CHD without discharge but with obstacle to blood discharge from the ventricles
3. -to CHD of pale type with atriovenous shunt
4. to none of the listed groups
5. to any of the listed groups
9. Which group of congenital heart defects (CHD) is interventricularseptal defect referred to?
1. -to CHD of pale type with venoatrial discharge
2. to CHD of blue type with atriovenous shunt
3. to CHD without discharge but with obstacle to blood discharge from the ventricles
4. to none of the listed groups
5. to any of the listed groups
Homework:
1. What is a "tetralogy of Fallot" (TF)?
2. How changes the hemodynamics in patients with ТF?
3. What is the clinical picture of TF in adults?
4. What additional research methods are used to confirm the diagnosis of ТF?
5. What are the principles of treatment of patients with ТF?
6. What is the prognosis of patients with ТF?
7. What is "coarctation of the aorta" (CA)?
8. How changes the hemodynamics in patients with СА?
9. What is the clinical picture of the СА?
10. What additional research methods are used to confirm the diagnosis of СА?
11. What are the principles of management of patients with СА?
12. What is the prognosis of patients with СА?
Recommended literature: The basic literature [1, 3]. Additional literature: [3, 4].
Lesson number 12
Topic: Congenital heart defects (Tetralogy of Fallot, coarctation of the aorta).
Нemodynamic, clinical findings, diagnostics and management.
Lesson Plan:
1. Definition.
2. Classification.
3. Etiology.
4. Pathogenesis.
5. The clinical picture.
6. Laboratory - instrumental data.
7. Diagnostic criteria.
8. Treatment.
Key questions include:
1. What is a "tetralogy of Fallot" (TF)?
2. How changes the hemodynamics in patients with ТF?
3. What is the clinical picture of TF in adults?
4. What additional research methods are used to confirm the diagnosis of ТF?
5. What are the principles of treatment of patients with ТF?
6. What is the prognosis of patients with ТF?
7. What is "coarctation of the aorta" (CA)?
8. How changes the hemodynamics in patients with СА?
9. What is the clinical picture of the СА?
10. What additional research methods are used to confirm the diagnosis of СА?
11. What are the principles of management of patients with СА?
12. What is the prognosis of patients with СА?
Test questions to consolidate the material:
1. Common symptoms?
2. Changes in hemodynamics in coarctation of the aorta
3. Changes in hemodynamics in tetralogy of Fallot
4. Symptoms.
7. Treatment. Indications for surgical treatment
Control tests to check students' knowledge:
1. Which place is aortic coarctation most commonly located in?
1. ascending part
2. -at the site of the aortic arch shift to descending aorta
3. descending part
4. thoracic aorta
5. abdominal aorta
8. Which group of congenital heart defects (CHD) is Fallot tetralogy referred to?
1. -to CHD of blue type with venoatrial discharge
2. to CHD of pale type with artriovenous shunt
3. to CDH without discharge but with obstacle for blood discharge from the ventricles
4. to none of the listed groups
5. to any of the listed groups
3. Dyspnea, attacks of a dyspnea, low physical exercise tolerance, infantility, delayed physical
development, systolic murmur in the heart of is most characteristic of:
A) emphysema
B) asthma
C) congenital heart disease
D) acquired heart disease
4. Nonclosure atrial septal, pulmonary stenosis, the total aorta and right ventricular
hypertrophy constitute the anatomopathological substratum:
A) tetralogy of Fallot
B) patent ductus arteriosus
C) coarctation of the aorta
D) ventricular septal defect
Homework:
1. What is a "pericarditis"?
2. What is the classification of pericarditis?
3. What are the most important clinically forms of pericarditis?
6. What are the clinical and instrumental signs of exudative (exudative) pericarditis?
7. What is cardiac tamponade during pericardial effusion?
8. What is the adhesive (adhesive) pericarditis?
10. What are the main clinical and instrumental signs of constrictive pericarditis?
11. What are the basic principles of treatment of pericarditis?
Recommended literature: The basic literature [1, 3, ]. Additional literature: [3, 4].
Lesson number 13
Topic: Pericarditis: ethiology, pathogenesis and classification. Clinical presentations, diagnostic steps and
differential diagnosis of pericarditis.
Lesson plan:
- definition
- classification
- etiopathogenesis
- clinical
- diagnosis
- differential diagnosis
- treatment
Key questions include:
1. Definition of "pericarditis"?
2. Classification of pericarditis?
3. Dry pericarditis. The clinical picture and treatment.
4. Outcomes of fibrinous pericarditis
5. Acute exudative pericarditis. The clinical picture. Diagnosis.
6. Meaning of X-ray examination, echocardiography.
7. Diagnostics tamponade
8. Indications for pericardiocentesis
9. Treatment with the etiologic factor.
10. Adhesive (constrictive) pericarditis. Etiology. The mechanism of development and features of
circulatory disorders, "psevdotsirroz" of the liver. Diagnosis.
11. Treatment. Indications for surgical treatment. Prognosis.
Test questions to consolidate the material:
1. Dry, exudative and adhesive pericarditis
2. Initial diagnosis of dry pericarditis
3. Clinic of exudative pericarditis
4. X-ray signs of fluid in the pericardium
5. Echocardiography signs of pericarditis
6. Basic principles of treatment of patients with acute (dry or exudative) pericarditis,
Control tests to check students' knowledge:
1. The symptoms of compression of the surrounding organs at pericarditis include all of these,
except for:
A) voice hoarseness
B) dyspnea
C) dysphagia
D) heartburn
2. What disease X-ray examination is most likely accompanied by increased heart shadow,
smoothing cardiac contour, the disappearance of "waist" of the heart, pulsation of the
weakened?
A) pleurisy
B) pneumonia
C) pericarditis
D) pulmonary embolism
3. Рathogenic drug treatment fibrinous pericarditis are:
A) Cytotoxic agents
B) Antivirals
C) Non-steroidal anti-inflammatory drugs
D) Antibiotics
4. The main method of diagnosis of dry pericarditis:
A) auscultatory B) pericardiocentesis C) X-ray examination D)echocardiography
Homework:
1. Renoparenchymatous and renovascular hypertension.
2. Clinical features and diagnosis
3. Basic types of treatment of renovascular hypertension
4. Rational drug combinations with renovascular hypertension
5. Endocrine forms of symptomatic arterial hypertension: Cushing's syndrome, pheochromocytoma,
primary hyperaldosteronism main clinical signs
6. Laboratory and special methods of investigation
7. Treatment
8. Coarctation of the aorta, the clinical signs, diagnosis
Recommended literature:The basic literature: [1, 3, 5]. Additional literature: [1, 5, 6].
Lesson number 14
Topic: Symptomatic hypertensions: Renovascular and renoparenchymal hypertensions. Endocrine
hypertension. Aorta coarctation. Aethiology, pathogenesis, clinical manifestations. Treatment.
Lesson plan:
- definition of symptomatic arterial hypertension.
- the etiology and pathogenesis of secondary hypertension.
- classification
- renoparenhimatous and renovascular hypertension.
- The clinical picture and diagnosis endocrine arterial hypertension (Cushing's syndrome,
pheochromocytoma, primary hyperaldosteronism). The clinical picture.
- hemodynamic arterial hypertension (aortic coarctation). Clinical signs
Key questions include:
1. Renoparenchymatous and renovascular hypertension.
2. Clinical features and diagnosis
3. Basic types of treatment of renovascular hypertension
4. Rational drug combinations with renovascular hypertension
5. Endocrine forms of symptomatic arterial hypertension: Cushing's syndrome, pheochromocytoma,
primary hyperaldosteronism main clinical signs
6. Laboratory and special methods of investigation
7. Treatment
8. Coarctation of the aorta, the clinical signs, diagnosis
Test questions to consolidate the material:
1. Diagnostic criteria of renovascular hypertension
2. What are the clinical and instrumental signs that suggest renovascular hypertension or
renoparenchymatous?
3. Diagnostic criteria for primary hyperaldosteronism Disease Con?
4. The clinical signs of Cushing's syndrome
5. The clinical signs of coarctation of the aorta,
Control tests to check students' knowledge:
1. Arterial hypertension with hypokalemia characteristic for:
1) coarctation of the aorta 2) syndrome Konna3) hypertension 4) acromegaly
2. Hypertension with hyperaldosteronemia found at:
1) sindromeKonna 2) pheochromocytoma 3) renal tumors 4) of hypertension
3. The most informative indicator for pheochromocytoma:
A) catecholamines excretion; B) calcium excretion; C) sodium excretion; D) potassium
excretion
4. The factors that lead to high blood pressure:
A) an angiotensin II; B) rennin; C) angiotensinogen; D) angiotensin I
5.The common form of symptomatic arterial hypertension:
A) renal B) endocrine C) hemodynamic D) neurogenic
Homework:
1. What is "myocarditis"?
2. What classification of myocarditis?
3. What are the etiology and pathogenesis of myocarditis?
4. What characterizes the clinical manifestations of myocarditis?
5. What are the physical examination in patients with myocarditis?
6. What is the diagnosis of myocarditis?
7. What are the diagnostic criteria of myocarditis?
8. What is the differential diagnosis of myocarditis?
9. What is the treatment of myocarditis?
Recommended literature:The basic literature: [1, 3, 5]. Additional literature: [1, 5, 6].
Lesson number 15
Topic: Miocarditis: definition, ethiology, pathophysiology, classification, clinical features, diagnostics,
differential diagnostics and treatment.
Lesson plan:
1. Definition of "myocarditis"?
2. Classification of myocarditis?
3. Etiology and pathogenesis of myocarditis?
4. Clinical diagnosis of myocarditis, diagnostic criteria
5. Differential diagnosis of myocarditis?
6. Treatment of myocarditis, depending on etiology.
7. Complications of myocarditis.
8. Prognosis
.
Key questions include: 1. What is "myocarditis"?
2. What classification of myocarditis?
3. What are the etiology and pathogenesis of myocarditis?
4. What characterizes the clinical manifestations of myocarditis?
5. What are the physical examination in patients with myocarditis?
6. What is the diagnosis of myocarditis?
7. What are the diagnostic criteria of myocarditis?
8. What is the differential diagnosis of myocarditis?
9. What is the treatment of myocarditis?
Test questions to consolidate the material:
1. The main elements of the pathogenesis
2. Signs of myocardial damage
3. Diagnostic criteria: large and small signs
4. ECG signs of myocarditis
5. Prevention of infectious myocarditis
6. Features of treatment of the disease
Control tests to check students' knowledge:
1. What is the main cause of myocarditis:
A) infection
B) parasitic invasion
C) noninfectious agents (drugs, vaccines,
serum, thermal and radiochemical effects)
D) collagen diseases
2. In what period of infectious disease most often
develops myocarditis?
A) in the early convalescence phase (end of 1st week or 2 weeks of onset)
B) in the first days at the height of the febrile period
C) in the late convalescence phase (3rd, 4th week and later)
3.For myocarditis is characterized by all except:
A. Treatment should always begin with prednisolone
B. ill people of all ages
B. atypical ECG changes
G. temperature increases is not always
D. pain in the heart may not be available
4.For myocarditis most typical complaint:
A pain in the heart, palpitations, dyspnea
B. heart pains, palpitations, syncope
V. pain in the heart, dyspnea, ascites
G. pain in the heart, dizziness, dyspnea
D. pain in the heart, fever, dry cough
Homework:
1. What complications of acute myocardial infarction period?
2. What complications of subacute phase of myocardial infarction?
3. What are the diagnostic signs of heart aneurysm?
4. What are the diagnostic signs of сardiac tamponade.
5. What are the diagnostic signs of ruptures heart.
6. What are the clinical manifestations of post-infarction syndrome (Dressler)?
7. What are diagnosis
8. What are treatment
Recommended literature : The basic literature [1, 3, 5]. Additional literature: [1, 5, 6].
Lesson number 16
Topic: Myocardial infarction, complications. Сardiac tamponade. Postinfarction Dressler's
syndrome. Ruptures heart.
Lesson plan:
1. Ruptures heart
2. External ruptures free wall of the left ventricle
3. Rupture or dysfunction of the papillary muscles
4. Cardiac tamponade
5. Emergency aid
6. Diagnosis of acute cardiac tamponade
7. Рostinfarction Dressler's syndrome: definition, pathogenesis, clinical picture, diagnosis, treatment
8. Aneurysm of heart, clinical picture, diagnosis, treatment
Key questions include:
1. What are the pathogenesis and clinical picture of cardiogenic shock
2. What are the diagnostic signs of heart aneurysm?
3. What are the diagnostic signs of сardiac tamponade.
4. What are the diagnostic signs of ruptures heart.
5. What are the clinical manifestations of post-infarction syndrome (Dressler)?
6. What are treatment
Test questions to consolidate the material:
1. Diagnosis of acute cardiac tamponad
2. Clinic of cardiac tamponade
3. Clinic of postinfarction Dressler syndrome.
4. Treatment of postinfarction Dressler syndrome.
5. Diagnosis of heart aneurysm
Control tests to check students' knowledge:
1. What drugs should be discontinued in a threat of myocardium rupture?
1.
2.
3.
4.
5.
narcotic analgesics
-anticoagulants
beta-blockers
calcium antagonists
nitrates
2. The drug of choice in true cardiogenic shock is:
1. -dopamine
2. digoxin
3. adrenaline
4. noradrenaline
5. mesatone
3. Of these data for the diagnosis of acute myocardial infarction is sufficient:
A) elevation interval STI, AVL, V 5-6 in conjunction with increased levels of CK-MB
B) pressing pain behind the breastbone
C) deep negative T V 2-5
D) leukocytosis
4. At 3 weeks after myocardial infarction is marked chest pain, fever, increased
erythrocyte sedimentation rate, pericardial rub, a presumptive diagnosis:
1) Dressler's syndrome 2) the distribution of the affected area of the myocardium
3) rupture of the myocardium 4) idiopathic pericarditis
5.Patient 40 years admitted to the hospital with a diagnosis of posterior myocardial
infarction. On the third day of observation suddenly began to increase shortness of
breath, pain appeared and bloating in the right upper quadrant, swelling in the legs.
His condition was grave, pale skin, acrocyanosis. In the lungs, no wheezing. The
respiration rate 24 per minute. Heart sounds deaf, rhythmic. Auscultated pansystolic
murmur parasternal line, determined systolic jitter. The heart rate is 96 beats per
minute. Blood pressure 100/60 mm Hg Liver increased by 6 cm. A presumptive
diagnosis?
a) rheumatic heart disease
b) mitral valve prolapse
c) ventricular septal rupture *
d) Pulmonary embolism
d) pulmonary edema
6. Patient 50 years admitted to the hospital with a diagnosis of myocardial infarction
common front. After 2 days of treatment in the intensive care unit began to complain
of feeling shortage of air, dry cough. Examination revealed a systolic murmur at the
apex and at Botkin, had not listened to. A presumptive diagnosis?
a) PE
b) pneumonia
c) Dressler's syndrome
d) the gap papillary muscle *
Homework:
- Classification of disorders of excitability of the heart
- ECG diagnosis of arrhythmias
- ECG sign of arrhythmia
- ECG signs of paroxysmal tachycardia
- ECG signs of atrial flutter and ventricular
- ECG signs of atrial fibrillation and ventricular
Recommended literature:The basic literature: [1, 3, 5]. Additional literature : [1, 5, 6].
Lesson number 17
Topic: Cardiac arrhythmias: Extrasystole. Рaroxysmal tachycardia. Atrial fibrillation and atrial flatter.
Ventricular fibrillation and asystolia.
Lesson plan:
-
definition of "arrhythmia."
- modern classification of arrhythmias.
- modern ideas about the causes and mechanism of extrasystoles
- arrythmia. Classification. Diagnostics. ECG - criteria. treatment
- paroxysmal tachycardia. The clinical picture. Diagnostika.EKG - criteria. Treatment.
- fibrillation and atrial flutter (atrial fibrillation). Classification. Diagnostics. ECG - criteria.
- fibrillation and ventricular flutter. Clinic. ECG
Key questions include:
1. The definition of "arrhythmia."
2. Extrasystole. Pathogenesis. Clinical manifestations.
3. Diagnosis extrasystole arrhythmia (ECG-signs).
4. Features of medical tactics, indications for antiarrhythmic drugs.
5. Prevention of arrhythmia
6. paroxysmal tachycardia. Pathogenesis.
7. The clinical picture of an attack paroksizmalnoy tachycardia. ECG changes. Changes in systemic
hemodynamics an attack of.
8. Drug therapy during an attack of paroxysmal tachycardia (supraventricular and ventricular). Indications for
cardioversion. Preventing attacks. Prognosis.
9. Atrial fibrillation and atrial flutter. Pathogenesis. Classification. The clinical symptomatology. ECG changes.
10. Impact of atrial fibrillation on the hemodynamics. Complications.
11. Treatment of paroxysmal and persistent atrial fibrillation. Indications for cardioversion.
Management of patients after recovery rate.
12. Prevention of recurrence of atrial fibrillation. Prognosis.
13. Ventricular fibrillation. Pathogenesis. Clinic. ECG signs. Therapy.
14. The role of intensive observations in the prevention, diagnosis and treatment of ventricular
fibrillation
Test questions to consolidate the material:
1. Classification of extrasystoles
2. ECG criteria arrythmia
3. Clinical manifestations of supraventricular paroxysmal tachycardia
4. ECG criteria of paroxysmal tachycardia
5. Treatment of paroxysmal ventricular tachycardia
6. ECG criteria for atrial fibrillation and atrial flutter
8. Treatment of paroxysmal atrial fibrillation
7. ECG criteria for atrial fibrillation and ventricular fibrillation
9. Treatment of ventricular fibrillation
Control tests to check students' knowledge:
1. The patient with chronic obstructive bronchitis and symptoms of chronic “pulmonary heart”
developed paroxysm of atrial tachycardia. Drug of choice for the paroxysm control is:
1. panangin
2. lidocaine
3. digoxin
4. -verapamil
5. propranol
2. A 40-year old patient, the first day of extensive myocardial infarction. On examination:- pale,
mottled cold skin, -sinus tachycardia -140 beats per minute, -blood pressure-70/40mm Hg.
Emergency therapy should be started:
1. with administration of mesatone
2. with administration of digoxin
3. with administration of calcium chloride
4. with administration of pentamine
5. -with administration of dopmine
3. A 70-year old female patient developed a paroxysm of cardiac fibrillation for the first time in
her life. The rate of ventricular contractions was 138 per minute. Against the background an
attack of cardiac asthma occurred. Arterial pressure was 90/70 mm Hg. The method of choice of
paroxysm treatment is:
1. administration of procainamide hydrochloride
2. administration of lidocaine
3. -electric pulse therapy
4. administration of diphenin
5. The method of choice in treatment of paroxysmal ventricular tachycardia complicated by arrhythmic collapse is:
1. carotid sinus massage
2. -electric pulse therapy
3. novocain administration
4. dopamine administration to support hemodynamic parameters
5. administration of polarization solution
6. ECG sings of ventricular tachycardia:
1. ventricular rate 200-300/min
2. -QRS is not less than 0.12 c
3. presence of delta wave
4. equal R-R intervals
5. -AV dissociation, QRS waves outnumbering P waves
7. To control paroxysmal supraventricular tachycardia one may use:
1. -carotid sinus massage
2. lidocaine administration
3. -high-frequency electric atrial pacing
4. -finoptinum administration
5. -adenozintrifosfate administration
8. The drug of choice to treat supraventricular tachycardia is:
1. lidocaine
2. ornid
3. mezatone
4. -verapamil
5. panangin
Homework:
1. Classification of cardiac conduction disorders
2. ECG diagnosis of conduction
3. Anatomy, physiology conduction system
4. ECG signs - Bundle Branch Block
5. ECG signs of atrioventikulyar conductivity
6. ECG signs of disturbances intraatrial conduction
Recommended literature : The basic literature [1, 3, 5]. Additional literature: [1, 5, 6].
Lesson number 18
Topic: Heart rhythm disturbance: conduction disturbances
Lesson plan:
1. Classification of cardiac conduction disorders.
2. Atrioventricular block. Etiology. ECG signs of atrioventikulyar conductivity
3. violation of intraatrial conduction. ECG signs of disturbances intraatrial conduction.
4. ECG signs - Bundle Branch Block
5. Treatment
6. Indications for implantation of cardiac pacemakers.
7. Prognosis.
Key questions include:
1. violation of atrioventricular conduction.
2. Clinical and electrocardiographic characteristics of atrioventricular block:
signs on the ECG AB - blockade of 1 degree.
signs on the ECG AB - blockade of 2 degrees (Mobitts Mobitts I and II).
signs on the ECG AB - blockade of 3 degrees.
3. Intraventricular block ECG signs:
complete blockade of the right leg bunch Gisa
complete left bundle branch block
4. Medical Management of acute emerging conduction disturbance.
5. Indications for temporary pacing.
6. Treatment of chronic conduction disturbances.
7. Indications for implantation of cardiac pacemakers.
Test questions to consolidate the material:
1. Signs on the ECG AB - blockade of 1 degree.
2. Signs on the ECG AB - blockade of 2 degrees (Mobitts Mobitts I and II).
3. Signs on the ECG AB - blockade of 3 degrees.
4. ECG signs - bundle-branch block
5. Indications for implantation of pacemakers ..
Control tests to check students' knowledge:
1. What drugs are used to treat atrioventricular blocks:
1. ethmosine
2. -atropine
3. -isadrine
4. rytmilen
5. lidocain
2. Which of the below is ECG evidence of AV block?
1. -prolongation of PQ interval of more than 0.20
2. gradual shortening of PQ interval followed by disappearance of QRS complex
3. independent atrial and ventricular rate, QRS complexes outnumbering P waves
4. -independent atrial and ventricular rate, P waves outnumbering QRS
5. no P waves on ECG
3. Absolute contraindications to beta-blockers:
A) complete AV block B) sinus arrhythmia C) complete left bundle branch block
D) migration pacemaker
4. ECG sign intraatrial blockade:
A) two-humped tooth P <0,1 sec B) advanced tooth P> 0,1 sec C) interval PQ> 0.2 sec
D) interval PQ <0.2 sec
5.What drugs are used to treat atrioventricular blocks:
1. ethmosine
2. -atropine
3. -isadrine
4. rytmilen
5. lidocain
6. Which of the below is ECG evidence of AV block?
1. -prolongation of PQ interval of more than 0.20
2. gradual shortening of PQ interval followed by disappearance of QRS complex
3. independent atrial and ventricular rate, QRS complexes outnumbering P waves
4. -independent atrial and ventricular rate, P waves outnumbering QRS
5. no P waves on ECG
Homework:
to repeat all the topics
Recommended literature : The basic literature [1, 3, 5]. Additional literature: [1, 5, 6].
Lesson number 19
Topic: Amyloidosis of the kidneys. Nephrotic syndrome.
Lesson plan:
- definition of amyloidosis of the kidneys
- etiology
- classification (idiopatic, hereditary, acquired)
- current concepts of the pathogenesis and morphogenesis
- the clinical picture
- laboratory methods
- outcomes prognosis
- nephrotic syndrome. Diseases leading to the development of nephrotic syndrome.
- the pathogenesis of the major clinical manifestations of the disease.
- the clinical picture.
- laboratory diagnosis.
- treatment
- complication
Key questions include:
1. Defination of renal amyloidosis
2. Classification of renal amyloidosis
3. The etiology and pathogenesis of renal amyloidosis
4. Diagnostic criteria amyloidosis
5. Value biopsy kidney research gingival mucosa and intestines for a proper diagnosis.
6. Treatment of renal amyloidosis
7. Course and prognosis
8. Defination "nephrotic syndrome"?
9. What are the causes of nephrotic syndrome?
10. The main clinical manifestations of nephrotic sindromaNS?
11. Diagnosis of nephrotic syndrome
12. Features of modern therapy (diet, diuretics, immunosuppressants, cytotoxic drugs, anticoagulants,
nonsteroidal anti-inflammatory drugs, indications for hemosorption and plasmapheresis).
13. The course and prognosis of nephrotic syndrome?
Test questions to consolidate the material:
1. The etiological factors of renal amyloidosis
2. Laboratory diagnosis
3. General principles of treatment of patients with renal amyloidosis
4. The etiological factors that lead to the development of nephrotic syndrome
5. Laboratory and instrumental data of nephrotic syndrome
6. General principles of treatment of patients with nephrotic syndrome
Control tests to check students' knowledge:
1. For nephrotic stage of amyloidosis is not characteristic changes in urine:
1) leykotsituriya 2) proteinuria greater than 3.0 g / day
3) eritrotsiturii 4) cylindruria
2. What are the changes in the urine are characteristic of proteinuric stage of amyloidosis:
1) proteinuria of over 100 mg but less than 3.0 g / day 2) proteinuria of up to 100 mg / day
3) proteinuria greater than 3.0 g / day 4) izostenuriya
3.The factor in the pathogenesis of nephrotic syndrome:
1) circulating immune complexes and antibodies to basal membrane
2) ascending urinary tract infection 3) reducing the concentration of kidney function
4) reduction in renal blood flow
4. The main cause of hypoproteinemia with nephrotic syndrome:
1) high proteinuria 2) reducing the production of proteins in hepatocytes
3) increase in protein catabolism 4) malabsorption of protein in the intestine
5. In what syndrome do edemas, hypoproteinemia,proteinuria, hypercholesterolemia develop in the patient with
rheumatoid arthritis?
1. pulmonary syndrome
2. cardiac syndrome
3. -nephrotic syndrome
4. neuropathic syndrome
5. anemic syndrome
6. What renal pathology is more often manifested by nephrotic syndrome in patients with rheumatoid arthritis?
1. -secondary renal amyloidosis
2. primary renal amyloidosis
3. urolithiasis
4. chronic immunocomplex glomerulonephritis
Homework:
1. How to define the concept of "acute renal failure" (ARF)?
2. Which leads to the development of acute renal failure?
3. What are the stages of development of acute renal failure and its types?
4. What is the classification of acute renal failure?
5. What is the clinical picture of acute renal failure?
6. The treatment of acute renal failure
Recommended literature: The basic literature: [1, 2, 6, 7]. Additional literature: [3, 5, 6].
Lesson number 20
Topic: Acute renal failure.
Lesson plan:
- definition
- classification
- the etiology of acute renal failure (ARF).
- the mechanism of acute renal failure.
- the clinical picture, the stage in the development of acute renal failure.
- treatment in stages. Indications for hemodialysis and hemosorption.
- outcomes. Prevention.
Key questions include:
1. How to define the term "acute renal failure" (CRF)?
2. Which leads to the development of acute renal failure?
3. Basic pathogenesis arrester
4. Classification of acute renal failure?
5. The clinical picture of acute renal failure by period?
6. Diagnostics
7. Treatment
8. Indications for hemodialysis
9. The course and prognosis of acute renal failure (ARF)
Test questions to consolidate the material:
- List the etiological factors
- The diagnostic criteria for acute renal failure
- Principles of treatment of acute renal failure
Control tests to check students' knowledge:
1. Glomerular filtration rate by endogenous creatinine clearance is normal:
1) 80 - 120 ml / m 2) 50 - 75 ml / min 3) 125- 145 ml / min 4) 150 - 170 ml / min
2. Acute renal failure is a frequent complication:
1) poisoning by salts of heavy metals 2) burn disease
3) crush syndrome 4) everything is correct
3. In acute renal failure indication for emergency hemodialysis is:
1) the presence of convulsions 2) hyperkalemia more than 7.5 mmol / L
3) hypotension 4) reduction in blood pH to 7.3
4. Which of the following is an indication for emergency hemodialysis treatment failure with
diuretics:
1) blood creatinine above 0.6 mmol / l 2) progressive acidosis, hyperkalaemia and more than 7.5
mmol / L 3) 4 hypertension), nausea and vomiting
5. Complications of acute renal failure are:
1) anemia 2) gastrointestinal bleeding 3) pericarditis 4) everything is correct
Homework:
1. How to define the term "chronic renal failure" (CRF)?
2. Which leads to the development of chronic renal failure?
3. How to characterize the stage of CRF and its types?
4. What is the classification of CRF?
5. What are the characteristics compensated chronic renal failure?
6. What is the clinical picture of end-stage chronic renal failure (uremia)?
7. Treatment of chronic renal failure
Recommended literature : The basic literature: [1, 2, 6, 7]. Additional literature: [3, 5, 6].
Lesson number 21
Topic: Chronic renal failure.
Lesson plan:
- definition
- classification
- the etiology of chronic renal failure (CRF)
- pathogenesis
- basic clinical syndromes
- the differential diagnosis basic disease during the terminal stages of chronic renal failure
- treatment.
Key questions include:
1. Definition of "chronic renal failure" (CRF)?
2. Definition and classification
3. Etiology
4. Common clinical manifestations of the late stages of chronic kidney disease?
5. Diagnostics. Laboratory and instrumental investigations
6. Dietary Recommendations
7. Treatment
8. Indications for hemodialysis and its capabilities.
9. Kidney transplantation.
Test questions to consolidate the material:
1. Define
2. List the etiological factors
3. The diagnostic criteria for chronic renal failure
4. Markers of kidney damage
5. What are the indications and methods of preparation for dialysis and kidney transplantation?
1.Control tests to check students' knowledge:
Reduction in the relative density of urine is characteristic for:
A) chronic renal failure B) renal tumors C) anomalies of the kidney D) acute glomerulonephritis
2. In the diet of the patient with chronic renal failure to reduce:
A) proteins B) fats C) carbohydrates D) the amount of liquid
3.The indications for hemodialysis in chronic renal failure is:
1) blood creatinine 1.2 mg / dL, glomerular filtration 5-10 ml / min
2) glomerular filtration 25-35ml / min, blood creatinine 0.7-0.9 mmol / l
3) glomerular filtration 35-45 ml / min4) blood creatinine 0.4-0.7 mmol / l
4. Anemia, characteristic of chronic renal failure:
A) gipoeritropoetinovaya
B) vit B12 deficiency
C) aplastic
D) folievodefitsitnoy
E) autoimmune hemolytic
5.What does the term “hypostenuria” mean?
1. -increase of urine specific gravity
2. decrease of minute dieresis
3. monotony of urine specific gravity
4. increase of urine specific gravity
5. decrease of minute dieresis in increase of urine specific gravity
Homework:
1. Clinic of peptic ulcer disease, depending on the location:
ulcers and cardiac subcardial parts of the stomach
pyloric channel ulcers (ulcers of the pylorus)
Postbulbar ulcers
giant gastric ulcer and duodenum
2. Features of peptic ulcer disease in children and teenagers
3. Features of peptic ulcer disease in elderly patients
4. Features the ulcer in women.
5. Clinical manifestations
6. Treatment:
7. Menetries disease
Recommended literature : The basic literature: [1, 2, 6, 7]. Additional literature: [3, 5, 6].
Lesson number 22
Topic: Stomach ulcer and duodenum. Features of the course depending on the age, sex, location.
Menetries disease.
Lesson plan:
- definition
- classification
- etiopathogenesis
- the clinical picture
- diagnosis
- differential diagnosis
- treatment
Key questions include:
1. Clinic of peptic ulcer disease, depending on the location:
ulcers and cardiac subcardial parts of the stomach
pyloric channel ulcers (ulcers of the pylorus)
Postbulbar ulcers
giant gastric ulcer and duodenum
2. Features of peptic ulcer disease in children and teenagers
3. Features of peptic ulcer disease in elderly patients
4. Features the ulcer in women.
5. Clinical manifestations
6. Treatment:
7. Menetries disease: etiology and pathogenesis, clinical picture, diagnosis, treatment
Test questions to consolidate the material:
1. Features of the pyloric canal ulcer
2. The clinical picture of giant gastric ulcers and 12 p.k
3. Current peptic ulcer disease in children and teenagers
4. The course of peptic ulcer disease in elderly patients
5. The course of ulcer disease in women
6. Indications for endoscopy of the stomach and duodenum
7. Methods for detection of HP
8. Clinical manifestations of the disease Menetries
Control tests to check students' knowledge:
1. Ranitidine - is:
1. H2 blocker gistaminoretseptorov *
2. The total anticholinergic action
3. antacid
4. miotonik
2. omeprazole is:
1. H2 blocker gistaminoretseptorov
2. The proton pump inhibitor *
4. antacid
5. miotonik
3. The proton pump blockers - it
1. atenolol;
2. lantoprazol; *
3. metoprolol;
4. famotidine.
4. Pains in the right upper quadrant or on an empty stomach at night, characteristic of the
ulcers:
1. stomach;
2. The lower third of the esophagus;
3. 12 duodenal ulcer. *
4. all right
5.The main clinical symptom of peptic ulcer with localization of ulcers in the duodenum:
1. hungry pain in the right upper quadrant; *
2. diarrhea;
3. early pain arising after a meal;
4. nausea.
Homework:
1. The character of the defeat at UC
2. Intestinal symptoms
3. Extraintestinal manifestations
4. What are the informative research methods at UC
5. What are the basic therapy for ulcerative colitis
Recommended literature: The basic literature: [1, 2, 6, 7]. Additional literature: [5, 6].
Lesson number 23
Topic: Ulcerative colitis. Etiology, pathogenesis, classification, diagnosis, treatment. Complications
Lesson plan:
- definition
- classification
- etiopathogenesis
- Clinical
- Diagnosis
- Differential diagnosis
- Treatment
Key questions include:
1. Definition
2. Etiology and pathogenesis
3. Intestinal and extraintestinal clinical manifestations.
4. Complications.
5. X-ray and endoscopic diagnostic studies.
6. Meaning of of morphological studies to confirm the diagnosis.
7. Treatment Forecast
Test questions to consolidate the material:
1. The character of the defeat at UC
2. Intestinal symptoms
3. Extraintestinal manifestations
4. What are the informative research methods at UC
5. What are the basic therapy for ulcerative colitis
Control tests to check students' knowledge:
1. Radiological signs of ulcerative colitis are:
1) scarry narrowing of the lumen 2) multiple ulcers, lack haustration
3) flatness of the relief of the mucous membrane 4) all true
2. What medications are used for the basic anti-inflammatory treatment of patients with
ulcerative colitis?
1) sulfasalazine 2) salofalk (tidokol, mesalazine) 3) salazopiridazina
4) Any of the listed
3. What clinical features are typical of chronic forms of ulcerative colitis?
1) a gradual onset 2) continuously progressive course
3) severe systemic manifestations 4) All typical
4. What relates to the pathogenesis of ulcerative colitis?
1) fixation in the wall of the gut immune complexes 2) neutrophil infiltration, edema of the wall of the
colon 3) ulceration, microabscesses, perforation of the colon wall
4) all true
Homework:
1. What are the inflammatory processes develop in Crohn's disease
2. Nature of the defeat in Crohn's disease
3. What are informative methods of research in Crohn's disease.
4. What are the basic therapy in Crohn's disease
Recommended literature: The basic literature: [1, 2, 6, 7]. Additional literature: [5, 6].
Lesson number 24
Topic: Crohn's Disease. Etiology, pathogenesis, classification, diagnosis, treatment. Complications
Lesson plan:
- definition
- classification
- etiopathogenesis
- clinical
- diagnosis
- differential diagnosis
- treatment
Key questions include:
1. Definition
2. Etiology and pathogenesis
3. Intestinal and extraintestinal clinical manifestations.
4. Variants of complications.
5. X-ray and endoscopic examinations.
6. Meaning of morphological studies to confirm the diagnosis.
7. Treatment, prognosis
Test questions to consolidate the material:
1. Intestinal symptoms
2. The character of defeat in Crohn's disease
3. What are the informative research methods in Crohn's disease.
4. What are the basic therapy in Crohn's disease
Control tests to check students' knowledge:
1. What criteria can be used for differential diagnosis of Crohn's disease and chronic enteritis
in favor of Crohn's disease?
1) manifested by diarrhea 2) appears malabsorption syndrome
3) accompanied by arthritis, erythema nodosum, ocular involvement 4) all the above
2. In what cases should be given prednisolone in Crohn's disease?
1) with severe anemia 2) with severe systemic defeats
3) The high activity of the inflammatory process 4) in all the above cases
3. By radiological signs of Crohn's disease include:
1) the presence of fistulas 2) narrowing of the colon 3) diverticula
4) violation of the bowel haustration
4. Complications of Crohn's disease can be everything except:
1) malabsorption syndrome 2) intestinal bleeding 3) intestinal polyposis
4) perforation of the intestine
5. Anal defeat in the form of fistulas, fissures and ulcers, most chastovstrechayuschimisya at:
1) Crohn's Disease 2) Ulcerative colitis 3) ischemic colitis
4) spastic colitis
6. External and internal fistulas, streaks, is a typical complication:
1) Ulcerative colitis 2) Psedomembranoznogo kolita 3) Crohn's disease 4) Ischemic colitis
Homework:
1.The concept of irritable bowel syndrome
2. What disorders may be in functional bowel disease?
3. Modern classification of functional bowel disease.
4. The clinical picture of irritable bowel syndrome with constipation
5. Principles of treatment of irritable bowel syndrome depending on the form
Recommended literature
The basic literature: [1, 2, 6, 7].
Further reading: [5, 6].
Lesson number 25
Topic: Functional bowel disease.
Lesson plan:
- definition
- classification
- etiopathogenesis
- clinical
- diagnosis
- differential diagnosis
- treatment
Key questions include:
1. Definition
2. Etiology. Pathogenesis
3. Clinical Syndromes
4. Laboratory and instrumental methods of research
5. Diagnostic criteria
6. Treatment
Test questions to consolidate the material:
1. What is irritable bowel syndrome?
2. The current classification of functional bowel disease.
3. The clinical picture of irritable bowel syndrome with constipation
4. The clinical picture of irritable bowel syndrome with diarrhea predominance
5. The clinical picture of irritable bowel syndrome with predominance of pain and meteorism
6. Principles of treatment of irritable bowel syndrome depending on the form
Control tests to check students' knowledge:
1. What antispasmodics may be used in the treatment of pain in patients with irritable bowel
syndrome?
1) ditsetal 2) mebeverin 3) spazmomen (otiloniya bromide) 4) All can be used
2. What factors are important in the etiology of irritable bowel syndrome?
1) psychogenic 2) endocrine and hormonal 3) nutritional 4) all of these
3.The most likely cause of irritable bowel syndrome:
A) stressors B) infektsiyaC) disgormonalnyeD) colon cancer
4. SYNDROME irritable bowel assigned:
A) laxatives; B) antidepressants; C) local anesthetics;
D) anti-inflammatory drugs; E) cleansing and therapeutic enemas.
При синдроме раздраженной кишки с гипомоторной дискинезией показаны:
А. пшеничные отруби + форлакс;
В. пшеничные отруби + дицител;
С. пшеничные отруби + лоперамид;
D. мотилиум;
Е. смекта.
Homework:
1. What is systemic scleroderma?
2. What are the etiological factors of systemic sclerosis?
3. What are the pathogenesis of systemic sclerosis?
4. Basic therapy of the disease
Recommended literature: The basic literature: [1, 2, 6]. Additional literature: [5, 6].
Lesson number 26
Topic: Systemic connective tissue disease (systemic scleroderma).
Lesson plan:
- classification
- etiopathogenesis
- clinical picture
- diagnostics
- differential diagnosis
- dreatment
Key questions include:
1. Definition
2. Etiopathogenesis
3. Clinical syndromes
4. Laboratory and instrumental methods
5. Diagnostic criteria
6. Treatment
Test questions to consolidate the material:
1. What is systemic scleroderma?
2. What are the etiological factors of systemic sclerosis?
3. What are the pathogenesis of systemic sclerosis?
4. Basic therapy of the disease
Control tests to check students' knowledge:
1. In the early stage of diffuse forms of systemic sclerosis is most expedient appointment
antifibrotic drug:
A) D-penicillamine
B) prednisolone
C) triamcinolone
D) cyclophosphamide
2. For are most typical of systemic sclerosis:
A) antibody tropoizomeraze (SCL-70) B) antibodies to double-stranded DNA
C) antinuclear antibodies
D) rheumatoid factor in high titer
3. What is not typical of systemic sclerosis?
1) interstitial pneumonia 2) esophagitis 3) pleural effusion 4) Raynaud's syndrome
4.Patient M., 36 years old was diagnosed with systemic scleroderma. To carry out the basic
treatment is most expedient purpose:
1) D-penicillamine 2) Dimexidum 3) of cyclophosphamide 4) delagila
Homework:
1.How to define the concept of "dermatomyositis"?
2. The diagnostic criteria.
3. Laboratory changes
4. Electromyogram
5. Basic therapy DM
Recommended literature: The basic literature: [1, 2, 3]. Additional literature: [5, 6].
Lesson number 27
Topic: Systemic connective tissue diseases (dermatomyositis).
Lesson plan:
- definition
- classification
- etiopathogenesis
- clinical
- diagnosis
- differential diagnosis
- treatment
Key questions include:
1. Definition
2. The etiology and pathogenesis.
3. Classification
4. The clinical picture. The defeat of the skin, muscles, internal organs and systems.
5. Laboratory changes.
6. Course of the disease.
7. Criteria for diagnosis.
8. Treatment. prophylaxis.
Test questions to consolidate the material:
1. How to define the concept of "dermatomyositis"?
2. The diagnostic criteria.
3. Laboratory changes
4. Electromyogram
5. Basic therapy DM
Control tests to check students' knowledge:
1. Dermatomyositis most feasible assignment:
1) leykerana2) cyclosporin A 3) methylprednisolone 4) D-penicillamine
2.The typical clinical manifestations of dermatomyositis are:
1) myopathy 2) skin lesions 3) artropatiya4) all of the above
3. What could be the etiological factor of dermatomyositis-polymyositis?
1) infection karinovirusami 2) Coxsackie virus infection group
3) the process of tumor in the body 4) any of the above factors
4. Patient G., 36, was diagnosed with idiopathic myositis. Purpose of the drug is most
advisable?
A) prednisolone
B) Plaquenil
C) indomethacin
D) cyclophosphamide
Homework:
1. Classification of ankylosing spondylitis
2. Symptoms of early stage AC
3. The diagnostic criteria for ankylosing spondylitis
4. Basic therapy seronegative
Recommended literature :The basic literature: [1, 2, 3]. Additional literature: [5, 6].
Lesson number 28
Topic: Seronegative spondylitis
Lesson plan:
- definition
- classification
- etiopathogenesis
- clinical
- diagnosis
- differential diagnosis
- treatment
Key questions include:
1. Definition of spondyloarthropathy (seronegative for rheumatoid factor)
2. Definition of the term "ankylosing spondylitis"?
3. The etiology and pathogenesis of ankylosing spondylitis?
4. Clinical forms of ankylosing spondylitis
5. The clinical picture spondylitis ankylosing
6. Laboratory and instrumental methods of examination
7. Complications
8. Treatment of seronegative spondyloarthropathies
Test questions to consolidate the material:
1. Classification of ankylosing spondylitis
2. Symptoms of early stage AC
3. The diagnostic criteria for ankylosing spondylitis
4. Basic therapy seronegative
Control tests to check students' knowledge:
1.For ankylosing spondylitis is characterized by all except:
1) more likely to develop young men 2) is often affected sacroiliac joint
3) there are osteophytes 4) pain mostly alone
2.Early restriction of respiratory excursion of the chest is typical for:
1) osteochondrosis of the thoracic spine 2) periarteritis nodosa
3) Ankylosing spondylitis 4) systemic sclerosis
3.Clinical signs of ankylosing spondylitis are:
1) violation of the mobility of the spine, pain in the sacrum 2) morning stiffness in the small joints of
the hands and OFF3) "start-pain" in the knee and hip sustavah4) ulnar deviation of the wrist
Homework:
1. What are the predisposing factors for gout
2. What is tophi?
3. Diagnostic criteria for gout.
Recommended literature: The basic literature: [1, 2, 3]. Additional literature: [5, 6].
Lesson number 29
Topic: Gout.
Lesson plan:
- Gout: definition, etiology, pathogenesis.
- Gout: clinical picture, diagnostic criteria, treatment.
- Acute gouty attack: pathogenesis, clinical picture, treatment.
Key questions include:
1. Definition.
2. The etiology and pathogenesis.
3. The clinical picture of acute attack, chronic course. Kidney damage.
4. Criteria for diagnosis.
5. Current. Prognosis.
6. Treatment (diet, non-steroidal anti-inflammatory drugs, agents, eliminates hyperuricemia).
Test questions to consolidate the material:
1. What are the predisposing factors for gout
2. What is tophi?
3. Diagnostic criteria for gout
4. Basic therapy for gout
Control tests to check students' knowledge:
1. The most common radiographic signs of joint damage in gout:
1) osteoporosis 2) osteophytes 3) joint space narrowing 4) symptom punch
2.To suppress acute gouty arthritis appoint:
1) allopurinol 2) Voltaren 3) kolhitsin4) prednisolone
Homework:
1. What is osteoarthritis deformans (OAD)?
2. What are the etiological factors osteoarthritis deformans ?
4. What stage of development is isolated by osteoarthritis deformans ?
5. What are the main clinical manifestations of osteoarthritis deformans ?
6. What are the radiological signs are observed in the osteoarthritis deformans ?
8. What are the principles of treatment of osteoarthritis deformans?
Recommended literature: The basic literature: [1, 2, 3]. Additional literature: [5, 6].
Lesson number 30
Topic: Deforming osteoarthritis.
Lesson plan:
Osteoarthritis: definition, etiology, pathogenesis, clinical picture, diagnostic
criteria.
-
Osteoarthritis: differential diagnosis with arthrities of other origin.
-
Osteoarthritis: principles of conservative treatment, indications for orthopedic treatment,
prognosis, prevention.
Key questions include:
1. Define deforming osteoarthritis.
2. What factors contribute to the development of the disease?
3. What are the main symptoms of the disease.
4. What are the basic principles in the treatment of osteoarthritis deformans.
5. What are the main groups of drugs used for the treatment of patients with deformation
osteoarthritis?
Test questions to consolidate the material:
1. What are the predisposing factors DOA
2. Diagnostic criteria for DOA.
4. Basic therapy DOA
Control tests to check students' knowledge:
1.What criteria allow differentiating rheumatoid arthritis and primary osteoarthritis to diagnose rheumatoid
arthritis?
1. involvement mainly of hip, knee overloaded joints
2. -symmetrical lesion of proximal interphalangeal joints without formation of periarthric nodes
3. lesion of distal interphalangeal joints with formation of periarthricHebergen’s nodes
4. all the mentioned criteria
5. none of the mentioned criteria
2. When osteoarthritis is most expedient to use:
1) ampitsillina 2) chondroitin sulfata 3) indometatsina 4) triamcinolone
3. By the diagnostic criteria for the classification of osteoarthritis most likely include:
1) periarticular osteoporosis 2) marked acceleration of ESR
3) identification of rheumatoid factor 4) mechanical nature of pain
4. Patient P., 64 years exhibited a preliminary diagnosis of osteoarthritis. Which of the
following studies of the most informative?
1) X-rays of the joints 2) determination of CRP
3) analysis of synovial fluid 4) determination of rheumatoid factor
Homework:
1. Classification of periarteritis nodosa
2. Diagnostic criteria periarteritis nodosa
3. Horton's disease
4. Takayasu's disease
Recommended literature : The basic literature: [1, 2, 3, 8,9]. Additional literature: [5, 6].
Lesson number 31
Topic: Systemic vasculites (polyarteriitis nodosa, Chorton’s disease): Aethiology, pathogenesis, clinical
manifestations, differential diagnosis, treatment.
Lesson plan:
- definition
- classification
- etiopathogenesis
- clinical
- diagnosis
- differential diagnosis
- treatment
Key questions include:
1. Definition
2. Etiopathogenesis
3. Elinical syndromes
4. Laboratory and instrumental methods
5. Diagnostic criteria
6. Treatment
Test questions to consolidate the material:
1. Classification of periarteritis nodosa
2. Diagnostic criteria of periarteritis nodosa
3. Classification of non-specific aortoarteriitis;
4. Diagnostic criteria of non-specific aortoarteriitis;
5.Classification of Giant cell arteriti
6. Diagnostic criteria of Giant cell arteritis):
7. Basic therapy
Control tests to check students' knowledge:
1. What disorders are typical of nodularpolyarteritis?
1. stenosing arteritis of coronary arteries with myocardial ischemia right up to infarction
2. arteritis of middle arteries in the system of celiac trunk withdyspepsia, gastroduodenal ulcers, bleedings
3. arteritis of mesenteric arteries of average caliber with bleedings, intestinal gangrene
4. -all the listed above disorders are typical of this disease
2.What disorders are typical of nodularpolyarteritis?
1. -inflammation of cephalic and cerebrospinal vessels with disturbed susceptibility, paresis, epilepsy
2. -inflammation and stenosis of testicular arteries with excruciating pain in testicles
3. -vasculitis of arteries feeding endocrine glands with dysfunction of the thyroid gland, adrenal glands
4. inflammation of capillaries and glomerules in the kidneys, glomerulonephritis
3. What is the reason for kidneys affection in patients with nodularpolyarteritis?
1. diffuse immune complex glomerulonephritis
2. necrotizing vasculitis of arterioles in combination with focal segmental glomerulonephritis
3. -stricture formation of renal arteries
4. all the listed above signs are typical of kidney affection in this disease
4. What objective manifestations are typical of nodularpolyarteritis?
1. skin integument looks like marble with erythematic, papular, urticarialrash
2. skin necrosis with ulcerations, tissue defects, nevus pigmentosis
3. painful pulsating nodules along vascular trunks
4. gangrene of toes necessitating amputation of them
5. -all the listed above signs are typical of this disease
5. What objective signs are typical of classical variant of giant cell temporal arteritis?
1. -temporal artery is convoluted, swollen, without signs of pulsation and is acutely painful on palpation
2. temporal arteries are convoluted, thin, dense, painless and without signs of pulsation
3. dense, pulsating nodules (aneurysms) are palpated along temporal arteries
4. any of the listed above symptoms may develop in this disease
Homework:
1. Classification of Wegener's granulomatosis, Chorton’s disease
2. Diagnostic criteria for Wegener's granulomatosis
3. Basic therapy of Wegener's granulomatosis
4. Classification of Takayasu disease
5. The diagnostic criteria for the disease Takayasu
6. Basic therapy Takayasu disease
Recommended literature: The basic literature: [1, 2, 3]. Additional literature: [5, 6].
Lesson number 32
Topic: Systemic vasculites ( Wegener’s granulomatosis, Takayasu disease,): Aethiology,
pathogenesis, clinical manifestations, differential diagnosis, treatment.
Lesson plan:
- definition
- classification
- etiopathogenesis
- clinical
- diagnosis
- differential diagnosis
- treatment
Test questions to consolidate the material:
1. Classification of Wegener's granulomatosis
2. Diagnostic criteria of Wegener's granulomatosis
3. Basic therapy of Wegener's granulomatosis
4.Classification of Chorton’s disease
2. Diagnostic criteria of Chorton’s disease
3. Basic therapy of Chorton’s disease
Control tests to check students' knowledge:
1.What complaints are typical of Wegener's granulomatosis?
1. -complaints about general weakness, fever, myalgia, arthralgia, body weight loss
2. -complaints about persistent rhinitis, pains in the nose, mouth, throat, ears
3. -complaints about pyohemorrhagic discharge from the nose, mouth, nasopharynx
4. complaints about skin itching
5. -complaints about coughhemoptysis
2. What disorders are typical of Wegener's granulomatosis?
1. ulcero-necrotic changes of the respiratory tract
2. infiltrative destructive processes in the lungs
3. focal segmental glomerulonephritis
-all the listed above disorders are typical of Wegener's granulomatosis
3. What symptoms are typical of aortic arch syndrome in patients with nonspecific aortoarteritis?
1. -chilly hands, pains, weakness in the muscles of upper extremities
2. stellate telangiectasias in the skin of superior shoulder girdle
3. -diminution or absence of radial arteries pulse
4. -systolic murmur over clavicular arteries
5. -the difference of arterial pressure on the right and left arms is more than 10mm Hg
4. What pathomorphological types of nonspecific aortoarteritis are there?
1. arteritis of aortic arch and its branches: brachiocephalic trunk, left common carotid and left clavicular arteries
2. arteritis of thoracic and abdominal parts of the aorta with the involvement of renal,celiac, superior and inferior
mesenteric arteries
3. total involvement of the aorta with all going from it large arterial trunks
4. combined arteritis of the aorta and pulmonary artery
5. -all the listed above types of the disease exist
Homework:
1. What types of allergic reactions.
2. Introduce the classification of allergens
3. Define the drug disease
4. Clinical syndromes, diagnosis and treatment
5. What Lyell's syndrome?
6. What is a serum disease?
Recommended literature: The basic literature: [1, 2, 3]. Additional literature: [5, 6].
Lesson number 33
Topic: Drug disease and acute allergies
Lesson plan:
- definition
- classification
- etiopathogenesis
- clinical
- diagnosis
- differential diagnosis
- treatment
Key questions include:
1. Name the types of allergic reactions.
2. Imagine classification of allergens.
3. What is anaphylaxis? What causes it?
4. Define drug disease.
5. What are the principles of treatment of anaphylactic shock
Test questions to consolidate the material:
1. Name the types of allergic reactions.
2. Imagine classification of allergens
3. Define disease drug
4. Clinical symptoms, diagnosis and treatment
5. What is Lyell's syndrome?
6. What is serum sickness?
Control tests to check students' knowledge:
1. What are the causes of drug allergy:
1) long-term, repeated courses of the use of drugs 2) poliprogmaziya
3) genetic predisposition to allergies 4) all true
2. The general principles of prevention of drug-disease:
1) prescribe drugs strictly justified the clinical situation 2) avoid polypharmacy 3) carefully collect drug
history 4) all true.
3.Clinical manifestations of drug allergy may include the following, for
except: a) Anaphylaxis b) Reduction of blood pressure; c) Skin rashes; g) Hallucinations;
4.In the treatment of drug allergy are used: a) β-blockers
b) Penicillin; a) Vitamins; g) Corticosteroids
Recommended literature
The basic literature: [1, 2, 3].
Additional literature: [5, 6].
8. Tasks for independent work of students (IWS)
№
Name of sections, modules, themes and educational questions
Quantity
of hours
IWS. №1. COPD. The course and diagnosis in the elderly and in the high
mountains.
Study Questions: 1. The concept of COPD. 2. Classification 3. Etiopathogenesis
Clinical 5. Diagnostic Criteria 6. Treatment.
1. The most important differential diagnostic of chronic obstructive bronchitis is:
A) lung sounds with a touch of boxed
B) expiratory dyspnea
C) cough with sputum
D)small reversibles аnd irreversible airflow obstruction, including after therapy
E) weakened vesicular breathing with prolonged exhalation, treble and dry rales
2.To irreversible airflow obstruction mechanisms include everything except:
1
A) stenosis and deformation of bronchi
B) Bronchospasm
C) Fibroplastic changes in bronchial wall
D) expiratory collapse
E) emphysema
3. For obstructive pulmonary emphysema characteristic listed below, except for
one:
A) barrel chest
B) Percussion: box sound
C) The restriction of intercostal spaces
D) field extension Kerniga
4. Dyspnea in chronic obstructive bronchitis is caused by the involvement:
6. trachea
3
7. large bronchi
8. bronchi of average size
9. small bronchi
10. -bronchioles
5. Tiffeneau index is the index of:
5. total vital capacity of the lungs
6. alveolar ventilation
7. -airway conductance
8. ventilation efficiency
9. maximal oxygen consumption
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 2]. Additional: [8, 9]
Control of the IWS.
(abstract)
№2. Bronchial asthma. Aspirin asthma: etiology, pathogenesis, clinical
features, diagnosis, treatment. Complications of drug therapy. Alpine climate
therapy.
IWS.
Study questions:
2
1. Give the definition of asthma.
2. List the major non-communicable and infectious allergens.
3. What is atopic and infectious-allergic bronchial asthma?
4. What factors, other than allergens can play a role in the occurrence of asthma?
5. Describe the clinical attack of breathlessness.
6. What are the care and monitoring of patients during the attack?
7. What is status asthmaticus?
8. What are the principles of treatment in the interictal period?
9. What is the prevention of asthma?
1. 35-year-old man for 2 years is suffering from bronchial asthma. Asthma stops
the berotek hormone dependent. Peak expiratory flow rate - 66%. At the time of
examination - shortness of breath at rest, auscultation - whistling dry rales in all
lung fields. Three times in the last hour to use the inhaler with berotek.
What tactics most feasible?
3
A) theophylline per os
B) 10% aminophylline 2.4 mL / in
C) via a nebulizer Ventolin
D) prednisolone / in a dose of 30-60 mg
E) to continue inhalation berotek
2. The appointment of the following drugs is most expedient for cupping
expiratory dyspnea?
A) Intalum
B) bekotid
C) Atrovent
D) ketotifen
E) salbutamol
3.In the differential diagnosis between asthma attacks and the first stage of the
asthmatic status of the most authentic sign:
A) pronounced cyanosis
B) forced position
C) refractory to B2-agonists
D) the severity of expiratory dyspnea
E) the ineffectiveness of intravenous infusion of aminophylline
4.Female 42 years, for a number of years, suffering from bronchial asthma,
complains of asthma attacks that occur several times a week. After injection
diprospana asthma not disturb about a month. On the eve of treatment were
coughing and shortness of breath, there is no effect on berotek. Night condition
worsened. On examination: a woman in a forced position, expressed shortness of
breath, wheezing audible distance.
What is the most feasible therapeutic tactics in this situation?
A) fenoterol intravenously oxygen
B) Ventolinum via a nebulizer, oxygen
C) intravenously at a dose of prednisolone 30-60 mg, oxygen
D) 120 mg methylprednisolone, fenoterol intravenously oxygen
E) intravenously at a dose of prednisone 30 mg aminophylline intravenously oxygen
5. What medical preparations can worsen condition of the patient with aspirin form of
bronchial asthma? a) berodual; b) theophyllinum; c) theophedrinum; d) ditec; e)
antasthman. Choose a correct combination:
1) a, b
2) a, b, d
3) a, c, e
4) b, c, e
5) c, e
344. What is the mechanism of action of inhalation glycocorticoids?
1) dilatation of bronchi
2) antiinflammatory action on bronchi mucosa
3) adrenomimetic action
4) anticholinergic action
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 2]. Additional: [8, 9]
Control of the IWS.
3
(abstract)
IWS. №3. Bronchiectasis
Study questions:
1. What is bronchiectasis?
2. What are the main causes of acquired bronchiectasis?
4. What are the main symptoms of bronchiectasis and its complications.
5. What are the therapeutic measures carried out in the period of acute
bronchiectasis disease?
1. The character of sputum in bronchiectasis:
1) slimy 2) mucopurulent 3) 3-layer 4) purulent
2. The indications for surgical treatment of bronchiectasis are:
1) Bronchiectasis within one lobe, bleeding complications
2) Bilateral diffuse bronchiectasis complicated with pulmonary heart
3) Complicated bronchiectasis in patients with chronic respiratory failure
4) Subclinical bronchiectasis
3. Patients with bronchiectasis usually complain: a) fever, chest pain; b) a cough
with sputum easily, more often in the morning; c) to hemoptysis, pulmonary
hemorrhage; g) of shortness of breath.
4. In the diagnosis of bronchiectasis of decisive importance is: a) X-ray
examination; b) bronchoscopy; c) bronchography.
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 2]. Additional: [8, 9]
Control of the IWS.
(abstract)
3
4
IWS.
№4. Acute pulmonary heart.
Study Questions:
1. What is included in the concept of acute pulmonary heart? 2. What can be said
about the classification of the acute pulmonary heart ?; 3. What are the main causes
of acute pulmonary heart ? 4. What are the main pathogenetic mechanisms of acute
pulmonary heart ? 5. What are the clinical features acute pulmonary heart ? 6.
1. What The etiology of acute heart failure with a high cardiac output:
a) pulmonary heart;
b) anemia;
c) cardiac tamponade;
3
d) myocardial infarction;
e) aortic valve regurgitation is the medical tactics acute pulmonary heart ?
2.The etiology of acute heart failure with low cardiac output:
a) anemia;
b) thyrotoxicosis;
c) myocardial infarction;
g) arteriovenous fistula.
3.The most likely cause of acute right heart failure and sudden appearance of a
rough systolic murmur in a patient with acute myocardial infarction is:
A) rupture of the interventricular septum
B) break free wall of the left ventricle C) papillary muscle rupture D) pulmonary
embolism
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
5
IWS №5. bacterial endocarditis
Study Questions: 1. What is bacterial endocarditis. 2. What are the causes of the
disease. 3. What complaints with bacterial endocarditis? 4. What are the symptoms
can be detected in this disease? 5. What are the principles of treatment of
endocarditis. 6. What are the preventive measures.
1.In the absence of data on infectious agents in subacute infective endocarditis
empirical antibiotic therapy is carried out by the following means:
a) at a dose of penicillin 10 million IU / day intravenously
3
b) ampicillin dose of 2 g to 6 times a day, and gentamicin 1.5 mg / kg intravenously 3
times a day *
c) cephalosporins dose of 3 g / day intravenously
g) oxacillin 3 g / day intravenously
2. Absolute indications for surgical treatment of infective endocarditis:
a) severe heart failure
b) resistance to antibiotic therapy for 3 weeks
c) Heart abscess
d) fungal infection
d) all of the above *
5) 2 and 3 answers are correct
3. Choose the complex of clinical symptoms, typical for infective endocarditis:
1) fever, anemia, splenomegaly, pleuritis, albuminuria, kreatinemia
2) fever, anemia, splenomegaly, protodiastolic murmur at heart base, hematuria,
kreatinemia
3) fever, anemia, splenomegaly, jaundice, reticulocytosis, microspherocytosis
4) fever, pancytopenia, hepatosplenomegaly, ascites, jaundice, nasal bleedings
5) fever, sweating, skin itching, lymphadenopathy, hepatosplenomegaly
4. Indicate the most common type of kidney affection at infective endocarditis:
1) focal nephritis
2) diffuse nephritis
3) renal amyloidosis
4) renal infarct
5) suppurative (apostematous) nephritis
5. At infective endocarditis:
1) echocardiography reveals vegetations
2) vegetations are observed even in cases of successful treatment
3) echocardiography and Doppler analysis allow to reveal hemodynamic disturbances
4) all answers are correct
6. Choose an optimal treatment approach to the patient with infective endocarditis and
negative results of blood culture:
1) penicillin
2) penicillin+aminoglycoside
3) cephalosporin
4) cephalosporin+aminoglycoside
5) surgical treatment
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
6
(abstract)
IWS number 6. Hypertension. Modern diagnostics.
Study questions: 1. Give the definition of hypertension.
2. What factors contribute to the development of hypertension?
3. What are the main complaints of patients with hypertension.
4. Tell us about the clinical manifestations of hypertension.
5. What complications arise in hypertension?
6. What are the basic principles of treatment, including drug therapy ¬ tion and
general activities.
1. Choose the hormone with high pressor action:
1) calcitonin
2) adrenaline
3) insulin
4) aldosterone
5) prolactin
2. Choose the negative effect of -adrenoblocker – prasozin treatment:
1) reflexive tachycardia
2) bradycardia
3) disturbance of potassium metabolism
4) dislipoproteidemia
5) orthostatic hypotension
3. Indicate the normal range of blood pressure in adults:
1) ≤ 140/90 mm Hg
2) < 140/90 mm Hg
3) systolic pressure <150 mm Hg, diastolic pressure = 90 mm Hg
4. Choose the ECG-criteria specific for arterial hypertension:
1) peaked P-wave in II, III standard leads
2) left ventricular hypertrophy
3) left His’ bundle branch block
4) wide, two-humped P-wave in I and II standard leads
5. Choose the drug without hypertensive activity:
1) oral contraceptives
2) -adrenoblockers
3) nonsteroid anti-inflammatory drugs
4) steroids
5) erythropoietin
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
3
Control of the IWS.
(abstract)
________________________________________________________________
IWS
number
7.
Neurocirculatory
dystonia
Study questions: definition, etiology and pathogenesis, clinical manifestations,
diagnosis, treatment.
Пароксизмальное
повышение
артериального
давления,
сопровождающееся чувством жара, потливостью, у лиц старше 45
лет НАИБОЛЕЕ ХАРАКТЕРНО для гипертензии:
A) почечной
B) эндокринной
C) нейрогенной
D) реноваскулярной
E) гемодинамической
{Правильный ответ} =B
{Сложность}= 1
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electronic library of Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
_________________________________________________________________
IWS number 8. Treatment of cardiac arrhythmias.
Study Questions: disturbances of conduction, violation of excitability
1. Choose the appropriate drugs for rapid relief of paroxysmal supraventricular
tachycardia:
1) disopyramide
2) finoptin
3) hiluritmal
4) cordarone
5) all answers are correct
2. The indications for electropulse therapy are:
1) tachiarrythmia attended by rapid progression of acute cardiac failure, coronary and
cerebrovascular insuffuciency
2) bradysystolic form of atrial fibrillation
3) tachiarrhythmia due to glycoside intoxication
3. Contraindications to the reflex methods of rapid relief of supraventricular tachycardia
are:
1) ischemic heart disease, including acute myocardial infarction, postinfarction
cardiosclerosis
2) sick sinus syndrome
3) II-III stages of chronic heart failure
4) all answers are correct
4. Choose the safest and the most effective antiarrhythmic drug for treatment of
tachyarrhythmia caused by digitalis intoxication:
1) procainamide hydrochloride
2) lidocain
3) isoptin
4) inderal
5) quinidine
5. Choose the right antiarrhythmic therapy for ventricular fibrillation in patient with acute
transmural anteroseptal myocardial infarction:
1) strophanthine
2) to carry out cardioversion
3) propranolol
4) cordarone
IWS number 9. Syphilitic aortitis
10
Study Questions: 1. The concept of "syphilitic aortitis";
2. Etiopathogenesis; 3. Clinical manifestations; 4.
Diagnosis; 5. The treatment
1. Больная В., 18 лет жалуется на одышку при физической нагрузке,
утомляемость. В анамнезе - частые бронхолегочные инфекции. При
обследовании: бледность кожи, усиленный верхушечный толчок,
грубый пансистолический шум с эпицентром в четвертом
межреберье слева у края грудины, акцент второго тона на легочной
артерии. При ЭхоКГ определяется шунт из левого желудочка в
правый. К основным осложнениям порока относятся все
перечисленные, ЗА ИСКЛЮЧЕНИЕМ:
A) аортального стеноза
B) инфекционного эндокардита
C) тромбоэмболии легочной артерии
D) левожелудочковой недостаточности
E) эмболий в большой круг кровообращения
{Правильный ответ} =A
{Сложность}= 1
9. Для какого порока сердца характерен высокочастотный, дующий
диастолический шум, чаще выслушивающийся по левому краю
грудины, лучше в положении больного сидя с небольшим наклоном
вперед?
A) стеноза устья аорты
B) недостаточности аортального клапана
C) недостаточности митрального клапана
D) стеноза левого атриовентрикулярного отверстия
E) стеноза правого атриовентрикулярного отверстия
{Правильный ответ} =B
{Сложность}= 1
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
IWS number 10. Atherosclerosis
Study questions:
1. Give a definition of atherosclerosis.
2. What factors contribute to the development of atherosclerosis?
3. Name the main localization of atherosclerotic vascular lesions.
4. What complications are occur in atherosclerosis?
5. What are the main principles of treatment atherosclerosis patients.
6. What are the primary and secondary prevention of atherosclerosis?
К факторам риска развития атеросклероза
перечисленные, ЗА ИСКЛЮЧЕНИЕМ:
относятся
все
A) курения
B) ожирения
C) дислипидемии
D) употребления алкоголя
E) артериальной гипертензии
{Правильный ответ} =D
{Сложность}= 1
2. Фермент гидроксиметил-глутарил-КоА-редуктаза
ключевым и определяющим скорость образования:
A) холестерина
B) хиломикронов
C) фосфолипидов
является
D) триглицеридов
E) липопротеина (а)
{Правильный ответ} =A
{Сложность}= 1
3. У больного Х., 76 лет при осмотре выявлены множественные
ксантомы и ксантелазмы, диагональная складка на мочке уха,
обильный рост волос на ушных раковинах, «симптом червячка».
Какие рекомендации НАИБОЛЕЕ ЦЕЛЕСООБРАЗНЫ?
A) увеличить общее потребление жира
B) уменьшить потребление клетчатки
C) уменьшить потребление сложных углеводов
D) увеличить потребление насыщенных жирных кислот
E) увеличить потребление полиненасыщенных жирных
кислот
{Правильный ответ} =E
{Сложность}= 1
4. Больному с жалобами на боли в икроножных мышцах, онемение
и похолодание конечностей; выявленной при обследовании
гиперхолестеринемией, назначен холестирамин, который относится
к группе:
A) статинов
B) пробукола
C) никотиновой кислоты
D) секвестрантов желчных кислот
E) производных фибровой кислоты
{Правильный ответ} =D
{Сложность}= 1
6. Для статинов характерны все перечисленные механизмы
действия, ЗА ИСКЛЮЧЕНИЕМ:
A) повышенного извлечения из крови и снижения уровня ЛПНП
B) блокирования активности фермента ГМГ-КоА-редуктазы
C) увеличения числа рецепторов к ЛПНП
D) уменьшения образования холестерина
E) секвестрирования желчных кислот
{Правильный ответ} =E
{Сложность}= 1
10. Больной У., 58 лет, перенесший в прошлом инфаркт миокарда,
госпитализирован с жалобами на загрудинные боли, одышку,
приступы удушья по ночам. При обследовании выявлены эпизоды
безболевой ишемии миокарда (БИМ), частота и продолжительность
которых превышала частоту и длительность болевых ангинозных
приступов. БИМ как прогностически неблагоприятный фактор
ассоциируется со всеми перечисленными состояниями, ЗА
ИСКЛЮЧЕНИЕМ:
A) нарушений ритма сердца
B) снижения порога болевой чувствительности
C) наличия многих факторов риска атеросклероза
D) многососудистого поражения коронарного русла
E) более высокого функционального класса стенокардии
{Правильный ответ} =B
{Сложность}= 1Work with the literature: in addition to the recommended
literature for in-depth study of the problem it is necessary to read the monograph,
access the Internet, use the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
11
(abstract
IWS number 11. Heart failure.
Study questions:
1. Give the definition of acute heart failure.
2. List the major diseases at which may develop acute heart failure.
3. How is subdivided acute heart failure (taking into account priority destruction of a division
of the heart)?
4. What complaints in a patient in the development of acute heart failure?
5. What symptoms can be detected by direct investigation of the patient?
6. On the basis of what the symptoms can be distinguished an attack of bronchial asthma
from attack of cardiac asthma?
7. What are the main principles of treatment of acute heart failure.
8. List the main groups of drugs used in the acute heart failure.
9. What non-drug methods are used in acute heart failure?
Женщина 46 лет доставлена в тяжелом состоянии с одышкой,
сопровождающейся кашлем с пенистой розовой мокротой.
Женщина возбуждена, находится в положении ортопноэ. Над всей
поверхностью легких
выслушиваются
жесткое
дыхание с
разнокалиберными влажными хрипами. ЧДД - 38 в мин. Тоны
сердца глухие, тахикардия -128 в мин. АД - 230/140 мм рт. ст.
Какое осложнение НАИБОЛЕЕ вероятно развилось?
A) отек легких
B) астматический статус
C) легочное кровотечение
D) двусторонняя пневмония
E) тромбоэмболия легочной артерии
{Правильный ответ}=A
В кардиологическое отделение доставлена женщина 78 лет с
жалобами на интенсивную жгучую загрудинную боль. Об-но:
кожные покровы серые, покрыты холодным липким потом. Тоны
сердца глухие, ЧСС - 110 в минуту, АД 30/20 мм рт. ст. ЭКГ:
элевация сегмента STII, III, aVF, V2-V6.
Какое из перечисленных осложнений
НАИБОЛЕЕ вероятно
развилось?
A) отек легких
B) кардиогенный шок
C) тромбоэмболия легочной артерии
D) эпистенокардический перикардит
E) острая аневризма левого желудочка
{Правильный ответ}=B
У больного Н., 67 лет, длительно страдающего артериальной
гипертензией, внезапно развился отек легких, по поводу которого
проводилась интенсивная терапия. Критериями купирования отека
легких наиболее вероятно являются все перечисленные, КРОМЕ:
A) уменьшения одышки
B) купирования пенистой мокроты
C) снижения артериального давления
D) увеличения числа сердечных сокращений
12 E) исчезновения влажных хрипов по передней поверхности легких
{Правильный ответ} =D
2. Больной С., 48 лет доставлен в тяжелом состоянии с клокочущим
дыханием,
сопровождающимся кашлем с пенистой, розовой
мокротой. Над всей поверхностью легких выслушивается жесткое
дыхание с разнокалиберными влажными хрипами. ЧД - 32 в мин.
Тоны сердца глухие, ритм правильный, тахикардия -120 в мин. АД
- 240/120 мм рт. ст.
В создавшейся экстренной ситуации
целесообразно введение всех перечисленных препаратов, КРОМЕ:
A) 40 мг фуросемида в/в медленно
B) 120 мг преднизолона в/в струйно
C) 5%-1,0 пентамина в 20 мл NaCl в/в
D) 30 мг натрия нитропруссида в 400 мл NaCl в/в капельно
E) ингаляции 2–3 мл 10% спиртового раствора антифомсилана
{Правильный ответ} =B
{Сложность}= 1
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
)
__________________________________________________________________
IWS number 12. Chronic glomerulonephritis
Study questions:
1. Give the definition of chronic glomerulonephritis and name its main clinical
variants.
2. What are the features of each of the clinical variants of chronic
glomerulonephritis?
3. What are the first symptoms of chronic renal failure?
4. What is the secondary contracted kidney?
5. How is conducted the test of Zimnitskiy?
6. How the laboratory parameters are changing (urine, blood) in patients with
nephrotic variant of chronic glomerulonephritis?
7. What are the general principles for the treatment of patients with chronic
glomerulonephritis.
8. What are the characteristics of diet in different clinical variants of chronic
glomerulonephritis?
9. What are the clinical observation of patients with chronic glomerulonephritis?
256. Most active nephritis at chronic glomerulonephritis is diagnosed at presence of:
1) massive proteinuria > 3,5 g/ds
2) long-term persistent acute nephritic syndrome
3) massive erythrocyturia with moderate proteinuria
4) sustained arterial hypertension
257. What kind of proteinuria is characteristic for chronic glomerulonephritis?
1) glomerular
2) tubular
3) an overflow proteinuria
13
4) strain proteinuria
258. What test allows to detect decrease of glomerular filtration at chronic
glomerulonephritis?
1) Nechiporenko’s test
2) Zimnitsky’s test
3) Reberg-Tareev’s test
4) Addis-Kakovsky’s test
5) Аmburge’s test
259. What signs allow to distinguish chronic glomerulonephritis from an acute one? a)
presence of the dysuria signs; b) hypertrophy of the left ventricle; c) decrease of kidneys
size; d) marked leukocyturia; e) decrease of arterial pressure. Choose a correct
combination of answers:
1) a, d
2), b, c, d
3) a, b, c, d
4) a
5) b, c
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
__________________________________________________________________
IWS number 13. Urolithiasis
Study questions:
1. What are the main reasons of occurrence urolithiasis.
2. What are the instrumental methods used to detect stones?
3. What are the clinical features of urolithiasis depending on the size of the stone ?
4. List the basic principles of treatment urolithiasis.
Examples and problems: 1. When small concretions pelvis and ureter, do not violate
the passage of urine, the most appropriate application:
A) ospamoksa
B) tsistenal
C) cefazolin
D) tetracycline
E) norfloxacin
2. At what size of the stone in the renal pelvis and ureter lithotripsy provides its
destruction?
A) 15 - 25 mm
B) 26 - 30 mm
C) 31 - 35 mm
D) 36 - 40 mm
E) 41 - 45 mm
К нормальным значениям относительной
НАИБОЛЕЕ вероятно относятся:
A) 1000-1008
плотности
мочи
B) 1002-1010
C) 1015-1025
D) 1020-1030
E) 1016-1036
{Правильный ответ}=C
14
{Сложность}=1
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
___________________________________________________________________
IWS number 14. Complications of gastric ulcer and duodenal ulcer. Operated
stomach disease.
Study questions:
1. Define a stomach ulcer.
2. What factors contribute to the development of the disease?
3. What are the complications of peptic ulcer disease?
4. List the major complications of peptic ulcer.
5. What are the clinical and laboratory symptoms of hidden bleeding?
6. Whith what are characterized symptoms of massive bleeding?
7. What are the clinical symptoms of ulcer perforation ?
8. What is typical for the development of pyloric stenosis?
9. What are the prevention of complications of peptic ulcer disease?
14. The treatment of postprandial distress syndrome includes administration of:
1) prokinetic agents
2) M-cholinolytics
3) antispasmodics agents
4) antibiotics
5) antacids
15. The postoperative diseases of stomach and duodenum include all of the following,
except:
1) early dumping syndrome
2) afferent loop syndrome
3) Zollinger-Ellison syndrome
4) efferent loop syndrome
5) late dumping syndrome
16. The early dumping syndrome is characterized by all of the following, except:
1) weakness, diaphoresis (sweating) after meal
2) rumbling in abdomen, diarrhea
3) decreased blood level of glucose
4) dizziness, syncope
5) tachycardia
17. The late dumping syndrome is characterized by all of the following, except:
1) onset of clinical features at 10-20 min after meal
2) diaphoresis (sweating)
3) decreased blood level of glucose
4) sense of hunger
5) tremor of hands and feet
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
___________________________________________________________________
IWS number 15. Chronic enterocolitis
Study questions:
1. What are the main reasons leading to the development of chronic enteritis?
2. Give the definition of chronic colitis.
3. List the main reasons leading to the disease.
4. What are the main symptoms of the disease.
5. List the main drug used for the treatment of chronic colitis.
1.
1.
2.
3.
4.
5.
2.
1.
2.
3.
4.
5.
What drugs should be used to treat chronic enteritis?
vitamin B12
group B vitamins
liposoluble vitamins (A,E)
none of the listed vitamins should be used
-all the vitamins listed above should be used in this disease
What methods should be used in severe chronic enteritis with malabsorption
syndrome?
enteral feeding with introduction of protein preparations and protein hydrolyzates
through a tube
intravenous drop-by-drop introduction of the protein (plasma, albumin)
intravenous drop-by-drop introduction of protein hydrolyzates, amino-acid
mixtures
-all the listed methods should be used
none of the listed methods should be used
8. What criteria can be used for differential diagnostics of Crohn’s disease and
chronic enteritis in favour of Crohn’s disease?
1. it is manifested by diarrhea
2. it is manifested by malabsorption syndrome
3. -it is accompanied by arthritis, erythema nodosum, ocular lesion
4. all the criteria listed above
5. none of the listed criteria
In what syndrome is digestion in the small intestine impaired in chronic
enteritis?
1. exudative enteropathy syndrome
2. malabsorption syndrome
3. -maldigestion syndrome
4. in all the syndromes
5. in none of the syndromes
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
___________________________________________________________________
IWS number 16. Dyskinesia of bilious ways.
Study questions:
1. The concept of biliary dyskinesia
2. Classification
3. Etiopathogenesis
4. The clinical picture
5. Diagnostics
6. Differential diagnostics
7. Treatment
В лечении гипокинетической формы дискинезии желчного пузыря
используют:
A) Холекинетики
B) Спазмолитики
C) Хирургическое лечение
D) Антациды
E) Ферменты
{Правильный ответ} = А
{Сложность}= 2
В лечении гиперкинетической формы дискинезии желчного пузыря
используют:
A) Н2 – блокаторы гистамина
B) Препараты группы сукральфата
C) Спазмолитики
D) Беззондовые тюбажи
E) Хирургическое лечение
{Правильный ответ} = C
{Сложность}= 2
К какой группе препаратов относится метацин:
А. неселективный холинолитик;
В. симапатомиметик;
С. селективный холинолитик;
D. блокатор Н-2-гистаминовых рецепторов;
Е. ингибитор протонной помпы.
{Правильный ответ} = C
{Сложность} = 1
К НАИБОЛЕЕ вероятным симптомам язвенноподобного варианта
функциональной диспепсии относятся:
A) изжога
B) тошнота
C) раннее насыщение
D) голодные и ночные боли
E) чувство тяжести в эпигастрии после еды
{Правильный ответ}=D
{Сложность}=1
Женщина 37 лет предъявляет жалобы на чувство тяжести и
переполнения в эпигастрии, чувство раннего насыщения после
приема пищи, изредко тошноту. При проведении ЭФГДС, УЗИ –
выраженной патологии со стороны органов пищеварения не
выявлено.
Какой из перечисленных диагнозов НАИБОЛЕЕ вероятен?
A) хронический неатрофический гастрит, обострение
B) функциональная диспепсия, неспецифический вариант
C) функциональная диспепсия, дискинетический вариант
D) функциональная диспепсия, язвенноподобный вариант
E) язвенная болезнь желудка, ассоцированная c Helicobaсter pylori
{Правильный ответ}=C
{Сложность}=2
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
____________________________________________________________________
IWS number 17 Chronic hepatitis
Study questions:
1. Define chronic hepatitis.
2. List the main causes of disease.
3. What are the main symptoms of chronic hepatitis?
4. List the basic principles of treatment of chronic hepatitis and name used
medicines.
5. List the preventive measures of disease.
. The most common cause of chronic viral liver disease is:
1) HBV-infection
2) HCV-infection
3) HAV-infection
4) HBV/HDV-infection, HDV-infection
. The standard of treatment of chronic hepatitis Cincludes:
1) ribavirin monotherapy
2) interferon- monotherapy
3) combination therapy of interferon- plus ribavirin
The hypersplenism is characterized by presence of:
1) increase of activity of AST, ALT, and alkaline phosphatase
2)thrombocytopenia, leucopenia, anemia
3)hyperbilirubinemia
4)hypoalbuminemia
5) hypergammaglobulinemia
. The mainstay treatment of autoimmune hepatitisincludes:
1) glucocorticoids plus interferon-
2) immunodepressive agents plus interferon-
3) glucocorticoids plus immunodepressive agents (azathioprine)
4) ursodeoxycholic acid (UDCA) plus glucocorticoids
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
_____________________________________________________________________
IWS number 18 Liver cirrhosis
Study questions:
1. Define cirrhosis.
2. In what is the fundamental difference between chronic hepatitis and cirrhosis of
the liver?
3. Name the etiological factors leading to the development of liver cirrhosis.
4. List the main symptoms of cirrhosis.
5. What are the complications of cirrhosis?
6. What are the main principles of treatment of patients with liver cirrhosis. What
drugs are used ?
7. What is the prevention of cirrhosis of the liver?
{Правильный ответ} = A
{Сложность} = 1
Наиболее ранним признаком первичного билиарного цирроза
печени является:
А) спленомегалия
В) диспептические
55 The pathogenesis of ascites in liver cirrhosis includes all of the following, except:
1)decreased degradation of aldosterone (hyperaldosteronism)
2)hypoalbuminemia
3) portal hypertension and increased production of splanchnic lymph
4)decreased levels of leucocytes and platelets
5)decreased degradation of renin and angiotensin
56. The causes of focal hepatomegalyinclude all of the following, except:
1)liver abscess
2) echinococcosis of liver (hydatid disease)
3)metastatic or primary cancers of liver
4) alcoholic hepatitis
5) cysts of liver
53. The clinical features of hepatic encephalopathy include all of the following, except:
1)asterixis
2) disorders of consciousness
3) disorders of sleep patterns
4) cramps
5)disorders of fine-motor movements (increase of execution time of trail-making test)
54. The treatment of hepatic encephalopathy includes all of the following, except:
1) lactulose
2) prednisolone
3) ornithine-aspartate
4) restriction of dietary protein (20-30 g/d)
явления
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
_____________________________________________________________________
IWS nuber 19 Diseases of esophagus
Study questions:
1. The concept of the diseases of the esophagus
2. Classification
3. Etiopathogenesis
4. The clinical picture
5. Diagnostics
6. Differential diagnosis
7. Treatment
After severe neuro-psychic overstrain the patient developed dysphagia (solid
food passes into the stomach better than fluid food), regurgitation and vomiting
at the end of the meal and at night (wet pillow sign), retrosternal pain
irradiating to the neck, jaw, interscapular region. What disease most probably
causes these symptoms?
1. esophageal diverticulum
2. cancer of the esophagus
3. hernia of esophageal opening
4. -esophageal achalasia
6. Which does one of the following substances increase gastric secretion?
1) gastrin
2) secretin
3) cholecystokinin
4) somatostatin
5) serotonin
7. Which does one of the following medicines decrease gastric secretion?
1) famotidine
2) solcoseryl
3) prosraglandin analogues (misoprostol)
4) sucralfate
5) drotaverine
Больная 56 лет жалуется на изжогу и боли за грудиной,
возникающие после приема пищи, при работе в наклон, ношении
тугого пояса. По поводу болей за грудиной наблюдалась у
кардиолога, принимала нитраты, однако улучшения не отмечает.
Наиболее вероятный диагноз:
А. гастроэзофагеально-рефлюксная болезнь;
В. стенокардия покоя;
С. прогрессирующая стенокардия;
D. ахалазия кардии;
Е. дискинезия пищевода.
{Правильный ответ} = A
{Сложность} = 2
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
_____________________________________________________________________
IWS № 20 Osteoporosis
Study questions:
1. Give the definition of osteoporosis.
2. What factors contribute to the development of the disease?
3. What are the main symptoms of the disease.
4. What are the main principles of treatment .
Мужчина 64
лет выставлен предварительный диагноз остеоартроза. Какое из
перечисленных обследований НАИБОЛЕЕ информативно?
A) определение СРБ
5. What are the group of drugs used to treat patients with osteoporosis?
B) рентгенография суставов
C) анализ синовиальной жидкости
D) определение ревматоидного фактора
E) определение уровня мочевой кислоты в крови
{Правильный ответ}=B
{Сложность}=2
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
_____________________________________________________________________
IWS number 21 Reactive arthritis
Study questions:
1. Give a definition of reactive arthritis.
2. What factors contribute to the development of the disease?
3. What are the main symptoms of the disease.
4. What are the main principles of treatment .
5. What are the main groups of drugs used for the treatment of patients with reactive
arthritis?
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
_____________________________________________________________________
IWS number 22 Anaphylactic shock
Study questions:
1. Name the types of allergic reactions.
2. Introduce the classification of allergens.
3. What is anaphylactic shock? What are its causes?
4. Define the drug disease.
5. What are the principles of anaphylactic shock treatment and list main drugs.
3. What are the causes of drug allergy?
1. -long-term, repeated courses of drugs
2. -injections of depot drugs
3. -polypragmasy
4. -hereditary susceptibility to allergy
7. The general principles of drug-induced disease prevention are:
1. -to prescribe drugs strictly justified by clinical situation
2. -to avoid polypragmasy
3. -to collect an accurate drug anamnesis
4. to administer antibiotics only in a complex with antihistaminic drugs
17. Which of the given conditions is a direct indication for glucocorticoids
administration?
1. -severe asthmatic attack
2. atopic dermatitis (localized form)
3. -Stevens-Johnson syndrome
4. -anaphylactic shock
5. pulmonary eosinophilic infiltration
19. In what diseases is tissue lesion based on anaphylactic reactions?
1. -pollinosis
2. -urticaria
3. -anaphylactic schock
4. thymus hyperplasia
5. diabetes mellitus
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
_____________________________________________________________________
IWS number 23 Highland medicine.
Highland climate factors and their effect to the body. Peculiarities of the major
diseases of internal organs in the mountains. The therapeutic use of highland
training
Study questions:
1. The concept of the high-altitude medicine
2. Factors of highland climate and their effects to the body.
3. The course of the major diseases of internal organs in the mountains.
4. The therapeutic use of highland training
Work with the literature: in addition to the recommended literature for in-depth
study of the problem it is necessary to read the monograph, access the Internet, use
the electroniclibrary Osh State University.
The main literature [1, 4]. Additional: [5, 7]
Control of the IWS.
(abstract)
Modular questions on the subject “Internal medicine”
for the students of V course.
Module number 1
1. What is the clinical and morphological classification of atypical pneumonia?
2. What is the characteristic of chlamydial pneumonia?
3. What is the characteristic of mycoplasma pneumonia?
4. What are the features of the treatment of atypical pneumonia?
5. What are the main etiological factors, as well as the main stages in the pathogenesis of atypical
pneumonia?
6. What is the characteristic of Legionella pneumonia?
7. What are the instrumental and laboratory diagnostic criteria for atypical pneumonia?
8. What is nosocomial pneumonia?
9. How has also called nosocomial pneumonia?
10. With what diseases differentiate hospital (nosocomial) pneumonia?
11. What is the empirical therapy?
12. How can we define the concept of "disseminated proccess in the lungs?"
13. Name the X-ray symptoms DPL?
14. What diseases are DPL?
15. What is idiopathic fibrosing alveolitis?
16. What is disseminated proccess in the lungs?
17. What are the reasons leading to the IFA?
19. What are the pathogenic stage at IFA?
21. The clinical picture of IFA?
22. Name the X-ray symptoms with DPL?
23. What are the diagnostic criteria for IFA?
24. With what diseases differentiate IFA?
25. What are the principles of treatment , depending on the stage of the disease?
26. What is the prognosis at IFA?
27. What is a "chronic obstructive pulmonary disease" (COPD)?
28. What is the etiology of COPD?
29. What are the pathogenic mechanisms of COPD?
30. What are the pathological changes occur in COPD?
31. What is the clinical picture of COPD?
32. What is the differential diagnosis of COPD and asthma?
33. What are the symptoms of COPD exacerbations?
34. With what diseases the detection of acute illness should be conducted a differential diagnosis?
35. What are the functional impairment in COPD?
36. Сourse of the COPD?
37. What are the principles in the treatment of COPD?
38. How is conducted treatment of COPD?
39. What are the indications for oxygen therapy are available?
40. How to define the concept of emphysema?
41. What is the etiology pulmonary emphysema?
42. What are the pathogenic mechanisms pulmonary emphysema?
43. What are the pathological changes occur with emphysema?
44. What is the clinical picture pulmonary emphysema?
45. With what diseases should be conducted a differential diagnosis pulmonary emphysema?
46. How to describe functional disorders with emphysema?
47. Course of _ pulmonary emphysema?
48. How is conducted treatment of primary pulmonary emphysema?
50. How is conducted treatment of secondary pulmonary emphysema?
51. How can we define the concept of "lung abscess"?
52. What are the main ways of developing the disease.
53. List the main 3 periods in the course of disease
54. How can we define the concept of "gangrene"?
55. What are the etiological factors of lung gangrene?
56. What complications can occur with this disease?
57. What are the main principles of treatment and indications for surgical treatment.
58. What is the difference lung abscess from gangrene?
59. Which agent causes abscess and gangrene of the lung?
60. What is the classification of lung abscess?
61. What are the X-ray symptoms of lung abscess and gangrene?
62. What is the clinical picture during the transition of an abscess in the chronic stage?
63. What are the indications for surgical treatment of lung abscess and gangrene?
64. How to define the concept of "pleurisy"?
65. What is the classification of pleurisy?
66. What is the pathogenesis of various etiologies pleurisy?
67. What are the pathophysiological processes leading to an accumulation of fluid in the pleural
cavity?
68. What are the clinical manifestations of dry (fibrinous) pleurisy?
69. What are the clinical signs of pleural effusion?
71. What are the radiological symptoms of pleural effusion?
72. What research should be carried out upon detection of pleural effusion?
73. What are the principles of treatment pleurisy?
74. What are the course and outcomes of pleurisy?
75. What is included in term "pulmonary heart"?
76. What can be said about the classification of chronic cor pulmonale?
77. What are the main causes of CCP?
78. What are the main pathogenetic mechanisms of CCP?
79. What is the pathogenesis of CCP?
80. What is meant by the term "pulmonary arterial hypertension"?
81. What is the primary and secondary pulmonary hypertension?
82. What are the pathological symptoms are found in stable pulmonary hypertension?
83. What are the clinical symptoms of chronic pulmonary heart compensated?
84. How to describe the clinical manifestations of chronic decompensated pulmonary heart?
85. What kind of pathological symptoms found in decompensated CPH?
86. What are the principles of treatment CCP?
87. What is included in term "respiratory failure"?
88. What are the main causes of respiratory failure?
89. What can be said about the classification of respiratory failure?
90. What are the clinical manifestations of respiratory failure?
91. What are the principles of treatment respiratory failure?
92. How to define the concept of "pulmonary thromboembolism"?
93. What is the clinical classification of pulmonary thromboembolism?
94. What is the pathogenesis of pulmonary hypertension with pulmonary thromboembolism?
95. What characterizes the clinical picture thromboembolism main trunk and main branches of the
pulmonary artery?
96. What is the clinical picture thromboembolism medium and / or small branches of the pulmonary
artery?
97. As observed by X-ray examination of patients with pulmonary thromboembolism?
98. What can be detected by electrocardiogram and echocardiography-examination of patients with
pulmonary thromboembolism?
99. What special methods are used to detect pulmonary thromboembolism?
100. What are the methods used for the detection of deep vein thrombosis?
9. Module-rating control of student
Monitoring of students' progress by testing at the end of each em-ment, followed by 5-estimation
ballnoy system. Four times after the 12th-and 27th-over notions and after 35go and 45go lessons of
the module, which is estimated at 100 ballnoy scale. Of these, 36 points can be given lectures, 52 practical exercises 12 - CDS. Also, students have the opportunity to use while taking additional
modules to get another 10 points. If students take two modules taken their average value, that is,
adding the results of the two modules and is divided into two. The module is taken into the classroom
and teachers for receiving modules are not paid. In the week following the date of modules each
teacher individually enter the data into the information system «AVN» Osh State University. If a
student does not pass the module, you are obliged to take a week module, the data are also a
teacher makes to «AVN» during the week.
Sample forms of the current and a landmark performance control
• Colloquium (K)
• Testing (T)
• assessment of the development of practical skills and abilities (IBNR)
• solving situational problems (NW),
• test (CR)
• control task (CC)
• Writing and protection history (IB)
• writing and defense of the course work (SAM)
• writing the essay and protection (P),
• interview questions on control (C),
• Preparation of a report (D)
• etc
Interactive Learning Technologies
Forms
Lecture
Pract.
training
Methods
(hours)
Semin.
master class
(hour)
lessons (hours)
IТ-methods
4
Working in
group
2
Game
searching
2
2
IWS
Total
2
6
2
2
2
meth
Solution of
the situational
problems
2
2
research
method
Total
interactive
sessions
4
6
2
2
2
4
16
10. List of exam questions and scoring
Modular questions on the subject of internal medicine for students V course.
Module № 1
- Clinical and morphological classification of atypical pneumonia.
- Characterization of Chlamydia pneumoniae
- The characteristics of Mycoplasma pneumonia
- Special treatment of atypical pneumonia
- Key etiofaktory and main stages in the pathogenesis of SARS.
- Characteristics of Legionella pneumonia
- List the main instrumental and laboratory diagnostic criteria for the AP.
- Definition alveolitis
- Etiopathogenesis alveolitis
- Clinical alveolitis
- Treatment of idiopathic fibrosing alveolitis
- Definition of emphysema
- The etiology of pulmonary emphysema
- The pathogenesis of emphysema
- The clinical picture of emphysema
- Diagnosis of pulmonary emphysema
- Treatment of pulmonary emphysema
- Definition suppurative lung disease
- Etiology of suppurative lung disease
- The pathogenesis of suppurative lung disease
- Clinical suppurative lung disease
- Diagnosis of suppurative lung disease
- Treatment of suppurative lung disease
- List the causes of infectious pleurisy
- What are the causes of infectious pleurisy
- Pathogenesis of infectious pleurisy
- Pathogenesis noninfectious pleurisy
- Clinic dry (fibrinous) pleurisy
- Differential diagnosis of pleurisy
- Clinic exudative pleurisy
- Differential diagnosis of pleurisy
- What is a transudate, exudate
- Technique of the pleural puncture
- What are the diagnostic criteria for primary and secondary PAH
- Special treatment of PAH. Indications for surgical treatment
- Clinical and laboratory-instrumental signs NAM
- List the main instrumental and laboratory diagnostic criteria for CPH
- Special treatment of DN and CCP. Indications for surgical treatment.
Module number 2
- Pathogenesis of intracardiac hemodynamics in patients with ILC.
- The role of echo in the diagnosis of CG Commission
- Currents and complication of the ILC
- Special treatment of myocardial dystrophy
- Prevention of myocardial dystrophy
- What auscultatory symptoms combined mitral?
- ECG changes in mitral heart defects
- A combined mitral heart disease
- Mitral-aortic-tricuspid heart defects
- A combined aortic heart defect
- Changes in hemodynamics VSD
- Changes in hemodynamics VSD
- Changes in the open arterial hemodynamics Prokom
- Clinic of coarctation of the aorta and hemodynamic
- Forecast and complications UPU
- The role of imaging studies in the diagnosis of CHD
- The value of pathological hereditary and infectious diseases in the formation of the mother UPU
- Symptomatology according to the preferential localization of the process, a variant of the disease:
aortic aneurysm, aortic valve insufficiency coronary insufficiency.
- The value of medical history, clinical, radiological and laboratory studies in the early diagnosis.
- Differential diagnosis (aortic atherosclerosis, rheumatoid parkas, coronary-sion of the heart)
- The pathogenesis of the disease and hemodynamic disorders in pericarditis
- Dry, exudative and adhesive pericarditis "stone heart"
- Clinical and laboratory-instrumental criteria for pericarditis
- The mechanism of development and features of heart failure "Psevdotsirroz" of the liver
- Features of renal hypertension
- End-organ damage in renal hypertension
- Diagnostic searches for SAG
- Tactics introduction of patients with SAG
- Features of infectious myocarditis
- Features of clinical manifestations depending on the variants of the
Prevention of infectious myocarditis
- List the clinical forms O.I.M
- Draw ECG signs for periods of flow O.I.M
-The main forms of complications
- What are gradually helping O.I.M
- Anatomy and physiology of the conducting system
- ECG signs - bundle-branch block closures
- ECG signs of conduction atrioventikulyarnoy
- ECG signs of intraatrial conduction disturbances
- ECG sign of arrhythmia
- ECG signs of paroxysmal tachycardia
- ECG signs of atrial flutter and ventricular
- ECG signs of atrial fibrillation and ventricular
Module № 3
-Definition of renal amyloidosis
- Classification of renal amyloidosis
- Etiology and pathogenesis of renal amyloidosis
- Clinical manifestations of renal amyloidosis
- Treatment of renal amyloidosis
- Etiological factors leading to the development of nephrotic syndrome
- Laboratory and instrumental data of nephrotic syndrome
- General principles of treatment of patients with nephrotic syndrome
- Define a toxic kidney
- List the etiological factors
- Diagnostic criteria for acute renal failure
- Diagnostic criteria for chronic renal failure
- Basic forms of peptic ulcer disease (Menetries, Zollinger-Ellison syndrome, lang Islands
pyloric channel, multiple ulcers, ulcers, juvenile and elderly)
- The differential diagnosis. Therapeutic significance of late postoperative complications.
- What inflammation developed at UC
- The nature of the defeat of UC
- Name informative methods for UC.
- What are the basic therapy for ulcerative colitis.
- What kind of inflammation in Crohn's disease developed
- The nature of lesions in Crohn's disease
- Name informative methods in Crohn's disease.
- What are the basic therapy in Crohn's disease
- The concept of IBS
- What violations may be in functional bowel disease?
- Modern classification of functional bowel disease.
Modulet № 4
- Specific signs of systemic sclerosis
- Specific signs of systemic sclerosis
- Specific symptoms of dermatomyositis
- Classification of ankylosing spondylitis
- Diagnostic criteria for ankylosing spondylitis
- Treatment of ankylosing spondylitis
- Diagnostic criteria for ankylosing spondylitis
- Define gout
- What are the predisposing factors of gout
- What is tophi?
- Diagnostic criteria for gout.
- Basic therapy of gout
- Define deforming osteoarthritis.
- What factors contribute to the development of the disease?
- What are the main symptoms of the disease.
- What are the basic principles in the treatment of osteoarthritis deformans.
-What are the main groups of drugs used for the treatment of patients with osteoarthritis of the
deformation miruyuschim?
- What are the predisposing factors DOA
- Diagnostic criteria for DOA.
- Basic therapy DOA
- Classification of periarteritis nodosa
- Diagnostic criteria of periarteritis nodosa
- Classification of periarteritis nodosa
- Diagnostic criteria of periarteritis nodosa
- Basic therapy periarteritis nodosa
- What types of allergic reactions.
- Provide a classification of allergens.
- What is anaphylaxis? What causes it?
- Define the drug disease.
- What are the principles of treatment of anaphylactic shock and listed ¬ li key drugs.
- What types of allergic reactions.
- Provide a classification of allergens
- Define disease drug
- Clinical symptoms, diagnosis and treatment
- What is the Lyell's syndrome
Questions for test on the subject "Internal Diseases" for the 5 course students on major
"Medicine."
- Clinical and morphological classification of atypical pneumonia.
- Characterization of Chlamydia pneumoniae
- The characteristics of Mycoplasma pneumonia
- Special treatment of atypical pneumonia
- Key etiofaktory and main stages in the pathogenesis of SARS.
- Characteristics of Legionella pneumonia
- List the main instrumental and laboratory diagnostic criteria for the AP.
- Definition alveolitis
- Etiopathogenesis alveolitis
- Clinical alveolitis
- Treatment of idiopathic fibrosing alveolitis
- Definition of emphysema
- The etiology of pulmonary emphysema
- The pathogenesis of emphysema
- The clinical picture of emphysema
- Diagnosis of pulmonary emphysema
- Treatment of pulmonary emphysema
- Definition suppurative lung disease
- Etiology of suppurative lung disease
- The pathogenesis of suppurative lung disease
- Clinical suppurative lung disease
- Diagnosis of suppurative lung disease
- Treatment of suppurative lung disease
- List the causes of infectious pleurisy
- What are the causes of infectious pleurisy
- Pathogenesis of infectious pleurisy
- Pathogenesis noninfectious pleurisy
- Clinic dry (fibrinous) pleurisy
- Differential diagnosis of pleurisy
- Clinic exudative pleurisy
- Differential diagnosis of pleurisy
- What is a transudate, exudate
- Technique of the pleural puncture
- What are the diagnostic criteria for primary and secondary PAH
- Special treatment of PAH. Indications for surgical treatment
- Clinical and laboratory-instrumental signs NAM
- List the main instrumental and laboratory diagnostic criteria for CPH
- Special treatment of DN and CCP. Indications for surgical treatment.
- Pathogenesis of intracardiac hemodynamics in patients with ILC.
- The role of echo in the diagnosis of CG Commission
- Currents and complication of the ILC
- Special treatment of myocardial dystrophy
- Prevention of myocardial dystrophy
- What auscultatory symptoms combined mitral?
- ECG changes in mitral heart defects
- A combined mitral heart disease
- Mitral-aortic-tricuspid heart defects
- A combined aortic heart defect
- Changes in hemodynamics VSD
- Changes in hemodynamics VSD
- Changes in the open arterial hemodynamics Prokom
- Clinic of coarctation of the aorta and hemodynamic
- Forecast and complications UPU
- The role of imaging studies in the diagnosis of CHD
- The value of pathological hereditary and infectious diseases in the formation of the mother UPU
- Symptomatology according to the preferential localization of the process, a variant of the disease:
aortic aneurysm, aortic valve insufficiency coronary insufficiency.
- The value of medical history, clinical, radiological and laboratory studies in the early diagnosis.
- Differential diagnosis (aortic atherosclerosis, rheumatoid parkas, coronary-sion of the heart)
- The pathogenesis of the disease and hemodynamic disorders in pericarditis
- Dry, exudative and adhesive pericarditis "stone heart"
- Clinical and laboratory-instrumental criteria for pericarditis
- The mechanism of development and features of heart failure "Psevdotsirroz" of the liver
- Features of renal hypertension
- End-organ damage in renal hypertension
- Diagnostic searches for SAG
- Tactics introduction of patients with SAG
- Features of infectious myocarditis
- Features of clinical manifestations depending on the variants of the
Prevention of infectious myocarditis
- List the clinical forms O.I.M
- Draw ECG signs for periods of flow O.I.M
-The main forms of complications
- What are gradually helping O.I.M
- Anatomy and physiology of the conducting system
- ECG signs - bundle-branch block closures
- ECG signs of conduction atrioventikulyarnoy
- ECG signs of intraatrial conduction disturbances
- ECG sign of arrhythmia
- ECG signs of paroxysmal tachycardia
- ECG signs of atrial flutter and ventricular
- ECG signs of atrial fibrillation and ventricular
Questions for exam of "Internal Diseases" for the 5 course students on major "Medicine."
- Clinical and morphological classification of atypical pneumonia.
- Characterization of Chlamydia pneumoniae
- The characteristics of Mycoplasma pneumonia
- Special treatment of atypical pneumonia
- Key etiofaktory and main stages in the pathogenesis of SARS.
- Characteristics of Legionella pneumonia
- List the main instrumental and laboratory diagnostic criteria for the AP.
- Definition alveolitis
- Etiopathogenesis alveolitis
- Clinical alveolitis
- Treatment of idiopathic fibrosing alveolitis
- Definition of emphysema
- The etiology of pulmonary emphysema
- The pathogenesis of emphysema
- The clinical picture of emphysema
- Diagnosis of pulmonary emphysema
- Treatment of pulmonary emphysema
- Definition suppurative lung disease
- Etiology of suppurative lung disease
- The pathogenesis of suppurative lung disease
- Clinical suppurative lung disease
- Diagnosis of suppurative lung disease
- Treatment of suppurative lung disease
- List the causes of infectious pleurisy
- What are the causes of infectious pleurisy
- Pathogenesis of infectious pleurisy
- Pathogenesis noninfectious pleurisy
- Clinic dry (fibrinous) pleurisy
- Differential diagnosis of pleurisy
- Clinic exudative pleurisy
- Differential diagnosis of pleurisy
- What is a transudate, exudate
- Technique of the pleural puncture
- What are the diagnostic criteria for primary and secondary PAH
- Special treatment of PAH. Indications for surgical treatment
- Clinical and laboratory-instrumental signs NAM
- List the main instrumental and laboratory diagnostic criteria for CPH
- Special treatment of DN and CCP. Indications for surgical treatment.
- Pathogenesis of intracardiac hemodynamics in patients with ILC.
- The role of echo in the diagnosis of CG Commission
- Currents and complication of the ILC
- Special treatment of myocardial dystrophy
- Prevention of myocardial dystrophy
- What auscultatory symptoms combined mitral?
- ECG changes in mitral heart defects
- A combined mitral heart disease
- Mitral-aortic-tricuspid heart defects
- A combined aortic heart defect
- Changes in hemodynamics VSD
- Changes in hemodynamics VSD
- Changes in the open arterial hemodynamics Prokom
- Clinic of coarctation of the aorta and hemodynamic
- Forecast and complications UPU
- The role of imaging studies in the diagnosis of CHD
- The value of pathological hereditary and infectious diseases in the formation of the mother
UPU
- Symptomatology according to the preferential localization of the process, a variant of the
disease: aortic aneurysm, aortic valve insufficiency coronary insufficiency.
- The value of medical history, clinical, radiological and laboratory studies in the early
diagnosis.
- Differential diagnosis (aortic atherosclerosis, rheumatoid parkas, coronary-sion of the heart)
- The pathogenesis of the disease and hemodynamic disorders in pericarditis
- Dry, exudative and adhesive pericarditis "stone heart"
- Clinical and laboratory-instrumental criteria for pericarditis
- The mechanism of development and features of heart failure "Psevdotsirroz" of the liver
- Features of renal hypertension
- End-organ damage in renal hypertension
- Diagnostic searches for SAG
- Tactics introduction of patients with SAG
- Features of infectious myocarditis
- Features of clinical manifestations depending on the variants of the
Prevention of infectious myocarditis
- List the clinical forms O.I.M
- Draw ECG signs for periods of flow O.I.M
-The main forms of complications
- What are gradually helping O.I.M
- Anatomy and physiology of the conducting system
- ECG signs - bundle-branch block closures
- ECG signs of conduction atrioventikulyarnoy
- ECG signs of intraatrial conduction disturbances
- ECG sign of arrhythmia
- ECG signs of paroxysmal tachycardia
- ECG signs of atrial flutter and ventricular
- ECG signs of atrial fibrillation and ventricular
-Definition of renal amyloidosis
- Classification of renal amyloidosis
- Etiology and pathogenesis of renal amyloidosis
- Clinical manifestations of renal amyloidosis
- Treatment of renal amyloidosis
- Etiological factors leading to the development of nephrotic syndrome
- Laboratory and instrumental data of nephrotic syndrome
- General principles of treatment of patients with nephrotic syndrome
- Define a toxic kidney
- List the etiological factors
- Diagnostic criteria for acute renal failure
- Diagnostic criteria for chronic renal failure
- Basic forms of peptic ulcer disease (Menetries, Zollinger-Ellison syndrome, lang Islands
pyloric channel, multiple ulcers, ulcers, juvenile and elderly)
- The differential diagnosis. Therapeutic significance of late postoperative complications.
- What inflammation developed at UC
- The nature of the defeat of UC
- Name informative methods for UC.
- What are the basic therapy for ulcerative colitis.
- What kind of inflammation in Crohn's disease developed
- The nature of lesions in Crohn's disease
- Name informative methods in Crohn's disease.
- What are the basic therapy in Crohn's disease
- The concept of IBS
- What violations may be in functional bowel disease?
- Modern classification of functional bowel disease.
- Specific signs of systemic sclerosis
- Specific signs of systemic sclerosis
- Specific symptoms of dermatomyositis
- Classification of ankylosing spondylitis
- Diagnostic criteria for ankylosing spondylitis
- Treatment of ankylosing spondylitis
- Diagnostic criteria for ankylosing spondylitis
- Define gout
- What are the predisposing factors of gout
- What is tophi?
- Diagnostic criteria for gout.
- Basic therapy of gout
- Define deforming osteoarthritis.
- What factors contribute to the development of the disease?
- What are the main symptoms of the disease.
- What are the basic principles in the treatment of osteoarthritis deformans.
-What are the main groups of drugs used for the treatment of patients with osteoarthritis of the
deformation miruyuschim?
- What are the predisposing factors DOA
- Diagnostic criteria for DOA.
- Basic therapy DOA
- Classification of periarteritis nodosa
- Diagnostic criteria of periarteritis nodosa
- Classification of periarteritis nodosa
- Diagnostic criteria of periarteritis nodosa
- Basic therapy periarteritis nodosa
- What types of allergic reactions.
- Provide a classification of allergens.
- What is anaphylaxis? What causes it?
- Define the drug disease.
- What are the principles of treatment of anaphylactic shock and listed ¬ li key drugs.
- What types of allergic reactions.
- Provide a classification of allergens
- Define disease drug
- Clinical symptoms, diagnosis and treatment
- What is the Lyell's syndrome?
- What is serum sickness?
11. Training and methodological support of the discipline
11.1. Main Literature
1.Diagnostika and internal medicine. Tom 1,2,3. Guide. M.Meditsina. 1999. EV Gembitskogo.
2. Makolkin VI Ovcharenko, S., 1999. Internal Medicine. M.Meditsina
3. Diagnosis and treatment of internal diseases. Volume 1.
1999 Manual EE Gogina.
4. Internal Medicine NA Mukhin, VS Maiseev., AI Martynov Tom 1,2.2008.
5. Internal Medicine in two volumes (EM Tareev, A.V.Sumarokov, Mukhin NA) - M.
Medicine in 1982.
6.Vnutrennie disease B10-and books. Ed. E. Braunwald. per. from English-M. Medicine,
1993-1997 m.
7. ESTIMATED AS Internal Medicine. M.Meditsina, 1999.
8.Rukovodstvo of Gastroenterology, ed FI Komarov and AL Grebenova. Tom M.Meditsina 13.
9. Clinical guidelines "Standards of management of patients' Issue 2 GEOTAR-Media 2008.
10. Internal Medicine 2.1 is a textbook for university A. Martynov, NA Mukhin, VS My-seev
2005. Moscow GEOTAR - Media
11. Avdeev, OV, Avdeev SN Chuchalin AG Idiopathic fibrosing alveolitis. Russian Medical
Journal. 1998
12. Respiratory diseases. Guide for Physicians in 4 volumes, Volume 4, edited Paleeva NR,
M., Medicine 1990.
11.2. Additional Literature
1.Rukovodstvo in cardiology. In 4 volumes. Ed. EI Chazova. M.Meditsina.1982.
2. Manual Hematology In 2 tomah.Pod Ed A. Vorobyov. M.Meditsina, 1985.
3. Nephrology. Ed. NE Tareeva. M Medicine 2001.
4. Guide pulmonology. Ed. NV Puts. L.Meditsina, 1984.
5. AV Vinogradov Differential diagnosis of internal diseases. M.Meditsina 1999.
6.Terapevtichesky Directory Washington University. Ed. M.Vudli and A.Uelan. per. with. Eng.
M.Praktika, 1995.
7. L. Butler Pneumonia. Diagnosis, treatment, gerontological issues. Russian Journal - 1996,
Volume 4 number 11,
8. Goldstein VD et al. The diagnosis and clinical course of histiocytosis X. clinical medicine 1990, № 10
9. Disseminated processes in the lungs, edited puts NV, M. Medicine, 1984.
Periodical literature (magazines):
• Central Asian Medical Journal.
• Health of Kyrgyzstan.
• Therapeutic Archive
• Clinical Medicine
• Russian Journal of Gastroenterology, Hepatology, Coloproctology
11.4. Software, electronic sources
..............................................................................................
12. Methodological recommendations on development of work program
The methods of online learning are those that contribute to the active involvement of the process of
obtaining and processing knowledge, such as lecture-visualization (LP) problem lecture (PL), a minilecture (ML) Lecture - Press Conference (TIC), occupation - Conference (HCC), training (Tr), the
debate (D), brainstorming (MSH), a master-class (MC), a "round table" (COP), the activation of
creative activity (ADT), the development of critical thinking through reading and letter (KM), regulated
discussion (RD), discussion forum type (F), business training and role-playing game (CI, RI), the
method of small groups (MG) classes using simulators, simulators (IT), computer simulation (Ximena
), the use of computer-based training programs (CPC), an interactive atlas (IA), analysis of clinical
cases (RCC), the preparation and protection of the medical history (IB), visiting medical conference,
Council (APC), participation in scientific conferences (NPC) , congresses, symposia (Sim), teaching
and research work of the student (UIRS), holding Olympiads (O), preparation of written analytical
papers (AP) preparation and defense of abstracts (P) project technology (PT), excursions (E) ,
training and protection of coursework (courses), distance education technologies (DOT), the test (T),
an invitation to a specialist (PS), performance in the role of training (PO), the development of the
project (RP), the solution of case problems (N), presentations using a variety of support services
(Prez) interactive whiteboard (ID), handouts (PM), video (V), slides (C), a multimedia presentation
(MP), tasks for independent work, IT-method (IT), work team (RK), Case-study (method of specific
situations), the search method (TM), a research method (IM), etc.
Interactive methods:
 arouse students' interest;
 encourage the active participation of everyone in the learning process;
 appeal to the feelings of every student;
 promote effective Learning;
 has multiple effects on the students;
 provide feedback (audience response);
 form the students' opinions and attitudes;
 form life skills;
 promote behavior change
13. Criteria for assessing students on the exam and tests.
Grading the examinations and tests carried out on the basis of the principles of objectivity, fairness, a
comprehensive analysis of the quality of student learning, and other provisions that increase the
reliability of assessment of students' knowledge and eliminating subjective factors.
In accordance with the regulations and recommendations of the Ministry of Education and Science
established the following criteria for grading the exams in the humanities, natural, technical, and other
disciplines:
- "Excellent" exposed the student who found the exam a compre-hensive, systematic and in-depth
knowledge of teaching and program material, the ability to freely perform tasks specified in the
program, who learn basic literary tour and find additional literature, the recommended program. As a
rule, the "excellent" exposed the students have learned the basic concepts of the relationship of
discipline and their values for the acquired profession who have demonstrated creative ability of the
understanding, presentation and use of educational software materials;
- "Good" rating is exposed to a student who found the exam complete knowledge training program
material, has successfully completed the tasks envisaged in the program, learn the basic literature, as
recommended in the program. The assessment of "good" exposed students who showed systematic
knowledge of discitis, Pliny and capable of self-fulfillment and updating in further academic work and
professional activities;
- Evaluation of "satisfactory" exposed students who found the knowledge of the ground training
material to the extent necessary for further education and future of work in the profession, to cope
with the implementation of tasks set by my program, which is familiar with the basic literature, the
recommended program. As a rule, the evaluation of "satisfactory" exposes students who committed
the error in on-on veterinary exam and when the examination tasks, but having the knowledge
necessary mymi to eliminate them under the guidance of teacher;
- Evaluation of "unsatisfactory" exposed the student found a gap in the knowledge of the basic
training program material, let's say of the error of principle in the implementation of the program of
tasks, are familiar with the basic literature of the program and not mastered basic knowledge, as
provided for in the discipline and determine the appropriate course program (a list of the essential
knowledge and skills that students should master, is mandatory element of the work program of the
course).
In those cases where, for some disciplines of the curriculum is set set-mark "credited to" put the
student, if his answers or results performed during the Danian, corresponding to at least a satisfactory
evaluation criteria.
Marked "not passed" put the student does not fulfill the program of the practical and seminars, as well
as the laboratory is not satisfied, calculation and graphic art and graphic work in the disciplines,
providing this form of reporting. An assessment "not passed" exposed to a student who during the
offset in the form of oral questioning gave answers that do not meet a minimum criteria for a
satisfactory assessment of the theoretical course.