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MINISTRY of HEALTH of UKRAINE
BUKOVYNIAN STATE MEDICAL UNIVERSITY
«ASSERT»
Act. prorector
of educational work
Professor. Yu.T.Akhtemiychuk
«____» ___________ 2009
REFERENCE BOOK FOR STUDENTS OF STUDY OF DISCIPLINE
INTERNAL MEDICINE (MODULE 2)
(structure, goals, content of the subject, principles of rating, control questions)
Student’s reference book is composed on the basis of actual educational plan and
program on educational subject of “internal medicine” for students of higher medical
educational institutions of III-IVth accreditation levels (MHP of Ukraine, K., 2008).
It is approved on the methodical conference of the department of internal medicine, clinical
pharmacology and occupational diseases on June, 15, 2009 (protocol № 41) and on meeting of
subject methodical commission on therapeutic disciplines on June, 24, in 2009 (protocol № 16)
Chief of the department of internal
medicine, clinical pharmacology and
occupational diseases, professor
O.S. Chuchlina
Chief of the subject methodical commission
on therapeutic disciplines, professor
V.K.Tashchuk
Chernivtsi, 2009
2
Educational discipline is «Internal medicine»
1. Introduction
Definition of the subject
Quantity of educational hours: 270 (9 credits ECTS), including: lectures – 30 hours.
Practical tutorials: 150 hours.
Independent work of students – 90 hours.
Contents of the subject is structured into 4 modules and 9 contents modules.
Module 2
270/9
4
№6-9
27
5
4
Traditional marks
4
3
3
2,5
2
0
4
Minimal balls quantity*
Convertation of traditional marks into balls
Balls for completion of
individual task as a way
of SIW
Quantity of practical tutorials
Quantity of contents modules,
their numbers
Module number, quantity of
educational hours /quantity of
ECTS credits
2. The structure of “Internal Medicine” (module 2) discipline and calculation of balls for current
learning activity (convertation of traditional marks into balls; rating in balls for completion of
individual tasks, if suggested by working educational program).
70
* Minimal balls quantity, which student must collect for current educational activity during studing
this module, to be accepted to pass an final module control.
3. Final aims of learning of educational discipline according to Educational-professional
program (EPP)*:
3770 to determine etiological and pathogenetic factors of the main therapeutic disease
according to the list 1 ОКХ
3771 to analyse typical clinical presentation of the mostly widespread therapeutic disease
3774 to reveal different clinical variants ot the diseases of internal organs
3775 to make differentional diagnostic, to improve and form preliminary diagnosis of the
mostly spreaded diseases of internal organs
3776, 3791 to determine the tactic of working (recommendations concerning regime, diet,
medical treatment, rehabilitation) with patient of the mostly spreaded diseases of internal organs and
their complications
3798 (3805) to make up the plan of investigation for the patient and to analyse the results of
laboratory and instrumental investigations in case of the typical conduction of the mostly spreaded
therapeutic disease
3801 to estimate prognosis for the life and earning capacity in case of the mostly spreaded
therapeutic disease
20153 (3803) to diagnose and to give first medical aid in case of urgent state of the diseases of
internal organs
6106 (3791) to carry out primary and secondary prevention of the mostly spreaded diseases of
internal organs
to make manipulations according the list 5 ОКХ
20158 (20152) to show the possession of moral and deontological principles and principles of
profession subordination in therapeutic department
3
4.1. Thematic plan of lectures
№
Theme
1.
2.
3.
4.
5.
6.
7.
8
9
10.
11.
Acute coronary syndromes
Chronic forms of ischemic heart diseases
Arterial hypertension
Heart failure
Myocarditis and cardiomyopathies. Neurocirculatory asthenia
Disorders of myocardial rhythm and conduction
Chronic obstructive pulmonary disease
Bronchial asthma
Pneumonia
Anemia
Hemoblastosis
Amount of
hours
2
2
2
2
2
4
2
4
2
2
4
12.
Hemorrhagic diathesis
In All
2
30
4.2. Thematic plan of tutorials
№
Name of theme
12
Main clinical symptoms in cardiology, methods of investigation in
cardiology (including ECG practice) – the lesson is held at the basis of
cardiological clinic
Primary arterial hypertension. Secondary arterial hypertensions.
Neurocirculatory asthenia
Acute coronary syndrome. Acute myocardial infarction – the lesson is
held at the basis of cardiological clinic
Chronic forms of ischemic heart diseases. Atherosclerosis
Congenital heart defects– the lesson is held at the basis of
cardiological clinic
Acquired heart defects
Infective endocarditis
Myocarditis and cardiomyopathies. Pericarditis – the lesson is held at
the basis of cardiological clinic
Cor pulmonale. Pulmonary thromboembolism – the lesson is held at
the basis of cardiological clinic
Heart failure – the lesson is held at the basis of cardiological clinic
Arrhythmias, blockades (paroxismal rhythm disorders) – the lesson is
held at the basis of cardiological clinic
Arrhythmias, blockades (including ECG test)
13
The cardiology concluding test
1
2
3
4
5
6
7
8
9
10
11
14
15
16
17
18
Main clinical symptoms in pulmonology, methods of investigation in
pulmonology. Pneumonia
Chronic Obstructive Pulmonary Disease: chronic bronchitis and
pulmonary emphysema
Bronchial asthma
Pleurisy and pleural effusion. Infectious and destructive pulmonary
diseases and pulmonary insufficiency
The pulmonology concluding test
Amount of
hours
5
10
5
5
5
5
5
5
5
5
5
5
5
10
5
5
5
5
4
№
19
20
21
22
23
24
25
26
27
28
Name of theme
The main hematologic symptoms, methods of investigation in
hematology
Acute leukemia
Chronic leukemia, lymphoma, multiple myeloma
Anemias
Hemophilia, thrombocytopenic purpura
The hematology concluding test
Independent inspection of patients, writing of training case record
Defence of training case record.
Peculiarities of clinical pictuure and treatment of the diseases in senile
patients. Main principles of medico-social expertise
Final module control
In All
Amount of
hours
5
5
5
5
5
5
5
5
5
5
150
4.3.The types of extracurricular work of students during studying
№
1
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
2.
3.
4.
Theme
Preparation to the tutorials of the module. Individual work on themes,
which are not included in the plan of tutorials:
Hypertensive crisis
Acute circulatory collapse
Metabolic syndrome X
Hypertension of pulmonary circulation
Mucoviscidosis. Sarcoidosis
Cancer of lungs
Multiple bronchiectasis
Drug disease. Anaphylactic shock emergency
Disseminated intravascular coagulation syndrome
Agranulocytosis
Lymphoadenopathy
Haemorrhage, loss of blood. Hemotransfusion therapy
Writing of training case history.
Individual work:
 Report of the essay on the practical tutorials
 Report on the clinical conferences of the department
 Report of case history on the practical tutorials
 Writing of abstracrs, article
Independent curation of the patients with filling in the list of
investigations of the patient and making up the plan of treatment
In All
Amount of
hours
60
5
5
5
5
5
5
5
5
5
5
5
5
20
5
5
90
5
6. Estimation of educational activity of students *
Control forms and evaluation system are carried out in accordance with the requirements of the
program of discipline and Instruction about the system of evaluation of educational activity of students
at credit-module to the system of organization of educational process, Ukraine ratified by MH (2005)
An estimation for the module is determined as a sum of estimations of current
educational activity (in score points) and estimation of final module control (in score points),
which is proposed at the evaluation of theoretical knowledge’s and practical skills in accordance
with lists, certain the program of discipline.
Maximal amount of score points, which is appropriated to the students at mastering each to the
module (test credit), – 200, in a that number for current educational activity – 120 points (60%), as a
result of module final control – 80 points (40%).
Current control in performed according to precise aims at each practical tutorial, adoption of
contents modules (intermediate control) – at the last tutorial of each contents module. Next means of
preparation level diagnostics of students are recommended: computer tests, control of practical skills
conduction of patient investigation methods with next results interpretation, analysis of results of
instrumental and laboratory investigations.
Evaluation of current educational activity:
The value of each topic inside the limits of one module has to be equal and is determined by
the topics quantity in a module.
The mark for “Internal Medicine” (module 2) subject is a rating-based and is determined by
taking into account of current student’s educational activity and rates for adoption by him of modules
maintained by a program. Current evaluation of students by corresponding topics is conducted by
traditional 4-ball system (excellent, good, satisfactory, unsatisfactory) with further converting into
multi-ball scale.
“Excellent” rate is put in case student is familiar with full-size contents of the tutorials and
lecture material, illustrates responses with various examples; gives exclusively precise and clear
responses without any directing questions; lays out material without mistakes and inaccuracy; freely
finds solutions for tasks and fulfils practical tutorials of different complicity grade.
“Good” rate is put in case student is familiar with contents of the tutorials and understands it
well, responses to questions gives correctly, systematically and in proper sequence, but they are not
precisely detailed, throughout student answers additional questions without mistakes; student solves all
tasks and conducts practical tasks, feeling difficulties only in the most complicated cases.
“Satisfactory” rate is put to student on the basis of his knowledge of all contents of the
subject and in case of satisfactory level of its understanding. Student is able to solve modified
(simplified) tasks, with assistance of directing questions; he solves tasks and performs practical skills
feeling difficulties in simple cases; is not able to give independent systematic answer, but answers
properly direct questions.
“Unsatisfactory” rate is put in case student’s knowledge and expertness don’t meet criteria of
“unsatisfactory” rate.
Evaluation of independent work:
Evaluation of student’s independent work suggested in the topic in parallel to auditory work, is
conducted during current control of the topic on the corresponding auditory tutorial. Evaluation of the
topics put to independent work only and not included to topics of auditory educational classes is
performed during final module control.
Conversion of a rate by multi-ball scale is conducted with taking into account of practical
tutorials quantity in each of modules: 22 tutorials in module 1, 14 tutorials in module 2.
6
Criteria of rating of students while module 1 studying.
Maximal balls of students rating while module 1 studying
Module 2. Principals of internal medicine (cardiology, pulmonology, hematology, general
questions of internal medicine)
Topic №
Maximal ball
Contents module 1
Contents module 2
Contents module 3
Contents module 4
Case history
Student’s individual work
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
8
4
Conversion of current student’s progress in module 2 learning:
“Excellent” rate – 4 balls
“Good” rate – 3 balls
“Satisfactory” rate – 2,5 balls
“Unsatisfactory” rate – 0 balls
Criteria for case history evaluation, which writing is suggested while module 2 studying:
“Excellent” rate - 8 balls – is written methodically properly, without remarks;
“Good” rate - 5 balls – is written methodically properly, but some chapters are detailed not
enough;
“Satisfactory” rate - 2,5 ball – some separate remarks concerning details and sequence of
chapters description have place;
“Unsatisfactory” rate - 0 balls – schedule and guidelines of case history writing are violated (in
this case student has to re-write case history taking into account tutor’s remarks).
Maximal valuation that may be gained by student for extracurricular work are 4 balls.
Balls quantity that may be gained by student for current activity while studying module 2 is 120
balls maximum. This estimation calculated by multiplication of balls quantity corresponding
7
“excellent” rate (4 balls) to topics quantity in a module with adding balls for writing case history on
“excellent” (8 balls) and maximal balls quantity for individual independent work (4 balls).
27 themes х 4 = 108 + 8 + 4 (IIW) = 120 balls.
Minimal balls quantity that may be gained by student while studying module 2 is calculated by
multiplication of balls quantity corresponding “satisfactory” rate (2,5 balls) to topics quantity (27
themes) in module with adding balls for writing case history on “satisfactory” (2,5 balls):
27 themes х 2,5 = 67,5 + 2,5 = 70 balls.
Final module control on module 2.
Students who completed the program of present module and gained not less than 70 balls for
current progress are admitted to final module control.
Final module control on module 2 suggests answering test control’s 50 questions,
demonstration of practical skill performance (from a list mentioned at the end of the module – physical
examination of the patient, cardiopulmonary reanimation) and analysing of results of patient’s
laboratory/instrumental investigation (situational problem – decoding of ECG, X-ray picture,
spirogram, normal and pathological blood account) and oral conversation. Maximal balls quantity that
may be gained by student during module control comprises 80. In this case 5 balls is maximal rate for
test control, 28 balls – for analysis of laboratory/instrumental investigation results (ECG – 20 balls, Xray picture, spirogram, blood account – 8 balls), 27 balls – for demonstration of practical skill
performance (examing the patient – 20 balls, cardiopulmonary reanimation – 7 balls) and oral
conversation – 30 balls (6 balls for every of 4 questions and case).
Criteria of rating the performance of practical skills:
“Excellent” – without any mistakes;
“Good” – performed with non-principal faults corrected during performance by student
himself;
“Satisfactory” – performed with faults corrected by a tutor;
“Unsatisfactory” – not performed
Criteria of rating for the test control:
“Excellent” – answering 46-50 tests – 5 balls;
“Good” – answering 41-45 tests – 4 balls;
“Satisfactory” – answering 36-40 tests – 3 balls;
“Unsatisfactory” – answering 35 and less – 0 balls;
Final control is supposed to be put into account if student gained not less 50 balls (not less 3
balls for tests control, 12 balls for analysis of laboratory/instrumental investigation results (ECG – 7
balls, X-ray picture, spirogram, blood account – 5 balls), 15 balls for demonstration of practical skill
performance (patient examination – 10 balls, cardiopulmonary reanimation – 5 balls ) and 20 balls for
oral answer - 4 balls for every of 4 questions and case ).
Encouraging balls according to Scientific Board decision may be added to ball quantity for
subject for students who have scientific publications or possessed prize positions for participation in
subject Olympiad carried out between higher educational institutions of Ukraine etc.
Objectivity of estimation of student’s educational activity has to be checked by statistical
methods (correlation quotient between current progress and results of final module control).
Evaluation of the “Internal Medicine” subject
Mark for the internal medicine is put to students who have put into account all 4 modules on
subject on 6 course.
Conversion of balls quantity for subject into rates by ECTS scale and 4-ball (traditional)
According to ECTS
By national scale
By BSMU scale (in balls)
A (excellent)
180-200
Excellent
B (very good)
165-179
Good
C (good)
150-164
D (good)
135-149
Satisfactory
E (weak)
120-134
70-119
FX
Unsatisfactory
8
with possibility of re-passing
1-69
Unsatisfactory
with obligatory repeated course
Balls quantity on subject, put into account of students, is conversed into ECTS scale next way:
Students’ percentage is determined on selection of present study year students within the limits
of corresponding specialty.
F
ECTS rate
A
B,C
D,E
FX,F
Rate by 4-ball scale
“5”
“4”
“3”
“2”
FX, F rate is put of students who have just one module not put to account on subject after
completion of studying it.
FX (“2”) rate is put to students who obtained minimal balls quantity for current educational
activity, but did not pass final module control. They have a right to pass repeatedly the final module
control but not more than two times according to curriculum ratified by the rector.
Students who obtained F rate after completion of the subject (did not fulfill educational
program just on one module or did not gain minimal balls quantity for current educational activity)
have to pass education on the subject repeatedly. The decision is taken by university stuff leaders
according to normative documents approved according to maintained order.
7. List of questions for final module control
Adopting of module 2: “Principals of internal medicine (cardiology, pulmonology,
hematology, general questions of internal medicine)”
PART I
CARDIOVASCULAR DISEASES
1. Mitral stenosis. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical
treatment.
2. Mitral regurgitation. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical
treatment.
3. Aortic valve stenosis. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical
treatment.
4. Aortic insufficiency. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical
treatment.
5. Pulmonary stenosis. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical
treatment.
6. Tricuspid regurgitation. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment.
Surgical treatment.
7. Patent ductus arteriosus. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment.
Surgical treatment.
8. Ventricular septal defect, atrium septal defect. Etiology, pathogenesis. Hemodynamics. Clinical
finding, treatment. Surgical treatment.
9. Coarctation of aorta. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical
treatment.
10. Tetralogy of Fallot. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical
treatment.
11. Infective endocarditis. Etiology, pathogenesis. Clinical finding. Laboratory diagnostics.
Differentional diagnostic. Prognosis. Treatment, prevention.
12. Myocarditis. Etiology, pathogenesis. Clinical finding. Laboratory diagnostics. Differentional
diagnostic. Prognosis. Treatment, prevention.
9
13. Metabolic cardiomyopathies (myocardiodystrophy). Etiology, pathogenesis. Clinical finding.
Laboratory diagnostics. Differentional diagnostic. Prognosis. Treatment, prevention.
14. Cardiomyopathies. Etiology, pathogenesis. Clinical finding. Laboratory diagnostics. Differentional
diagnostic. Prognosis. Treatment, prevention.
15. Pericardities. Etiology, pathogenesis. Pericarditis sicca. Clinical finding. Diagnostics. Treatment.
16. Acute exudative pericardities. Clinical finding. Diagnostics. Treatment.
17. Adhesive pericarditis. Mechanism of hemodynamic disorders. Clinical finding. Diagnostics.
Treatment.
18. Ischemic heart disease. Classification. Diagnostics. Primary and secondary prevention.
19. Ischemic heart disease. Diagnostic criteria. Diagnostic of latent coronary insufficiency with help of
ECG with pharmacological tests and load tests.
20. Angina pectoris. Classification. Clinical finding. Diagnostics. Treatment.
21. Myocardial infarction. Etiology, pathogenesis. Classification. Clinical findings of the acute period.
Diagnostics. Myocardial infarction without pathologic Q. Treatment.
22. Myocardial infarction with pathologic Q. Diagnostics. Differentional diagnostic. Prognosis.
Treatment.
23. Myocardial infarction without pathologic Q. Diagnostics. Differentional diagnostic. Prognosis.
Treatment.
24. Complications of myocardial infarction: cardiogenic shock, disorders of rhythm and conduction,
heart failure, aneurysm of the heart, cardiac tamponade. Postinfarction syndrome. Treatment.
25. Cardiosclerosis. Etiology, pathogenesis. Clinical finding. Diagnostics. ECG changes. Treatment.
26. Neurocirculatory asthenia. Etiology, pathogenesis. Clinical finding, main symptoms. Laboratory
diagnostics. Differentional diagnostic. Prognosis. Treatment.
27. Primary arterial hypertension (essential hypertension). Classification. Clinical finding. Diagnostics.
Laboratory findings. Differentional diagnostic. Prognosis. Treatment.
28. Secondary arterial hypertensions because of kidney disorders. Pathogenesis. Clinical finding.
Diagnostics. Differentional diagnostic. Prognosis. Treatment.
29. Secondary arterial hypertensions of hemodynamic disorders. Pathogenesis. Clinical finding.
Diagnostics. Differentional diagnostic. Prognosis. Treatment.
30. Secondary arterial hypertensions of endocrine disorders. Pathogenesis. Clinical finding.
Diagnostics. Differentional diagnostic. Prognosis. Treatment.
31. Differentional diagnostic of essential hypertension with secondary arterial hypertensions.
32. Extrasystole. Etiology, pathogenesis. Classification. Clinical finding. Diagnostics. ECG changes.
Treatment. Prevention.
33. Arrhythmia due to disorders of automatic performance of sinoatrial node (sinus tachycardia, sinus
bradycardia, sinus arrhythmia, sick sinus syndrome). Etiology, pathogenesis. Clinical finding. ECG
changes. Treatment.
34. Disorders of the conduction of the heart. Etiology, pathogenesis. Clinical finding. ECG changes.
Treatment.
35. Sinoatrial block, intra-atrial heart block, atrioventricular heart block. Etiology, pathogenesis.
Clinical finding. ECG changes. Treatment.
36. Heart failure. Etiology, pathogenesis. Hemodynamics changes. Classification. Treatment.
37. Heart failure. Latent heart failure. Clinical finding of acute and chronic left- and rightventricular
heart failure. Diagnostics. Additional methods of investigation. Treatment.
38. Heart failure. Treatment. Main groups of medicine, mechanisms of their action. Complications of
medical treatment.
39. The diseases of aorta. Syphilitic aortitis. Symptoms according to the localization of the prcess:
aortic aneurysm, aortic insufficiency, coronary insufficiency. Diagnostics. Differentional
diagnostic. Treatment.
1.
PART II
DISEASES OF RESPIRATORY SYSTEM. ALLERGIC DISEASES
Chronic bronchitis. Etiology, pathogenesis. Classification. Clinical finding, diagnostics.
Methods of diagnostic of external respiration. Differentional diagnostic. Treatment.
10
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Chronic obstructive pulmonary disease (COPD). Ethiology, pathogenesis. Classification.
Clinical finding, diagnostic features. Methods of external breathing function investigation.
Differential diagnosis. Treatment, prevention.
Variants of the pneumonia clinical course. Ethiology. Classification. Clinical finding.
Diagnostic features. Differential diagnosis. Complications.
Pleuritis. Ethiology, pathogenesis. Classification. Clinical finding, diagnostic features.
Treatment. Indications to thoracocentesis.
Acute pleuritis with effusion. The causes. Clinical finding, diagnostic features. Emergency.
Encysted pleuritis. Pathogenesis. Clinical finding, diagnostic features. Treatment. Indications
to thoracocentesis.
Multiple bronchiectasis. Ethiology, pathogenesis. Clinical findings. Diagnostic features.
Treatment. Indications to surgery treatment. Prevention.
Lung abscess and gangrene. Ethiology, pathogenesis. Clinical findings, diagnostic features.
Differential diagnosis. Treatment. Indications to surgery treatment. Prevention.
Pulmonary emphysema. Ethiology, pathogenesis. Classification. Clinical findings, diagnostic
features. Treatment, prevention.
Bronchial asthma. Ethiology, pathogenesis. Classification. Diagnostic features. Differential
diagnosis with diseases with chronic airway obstruction.
Managed therapy of bronchial asthma. Treatment according to the stage of the disease.
Complications of bronchial asthma. Asthmatic status, diagnostic features and course stages.
Emergency. Treatment of bronchial asthma between attacks. Prevention.
Lung cancer. Classification. Clinical finding, diagnostic features. Treatment. Possibilities of
surgery treatment.
Respiratory failure: obstructive, restrictive, mixed. Pathogenesis of pulmonary circulation
hypertension. Degrees of severity. Diagnostic features. Treatment.
Chronic pulmonary heart. Mechanism of development. Clinical findings. Diagnostic features
of acute and chronic pulmonary heart. Treatment.
Drug disease. Aetiology, pathogenesis. Clinical variants. Treatment, prevention.
Pulmonary circulation hypertension.
Mucoviscidosis.
Sarcoidosis.
PART III
BLOOD AND HEMATOPOIETIC ORGANS’ DISEASES
1. Iron-deficiency anaemia. Aetiology and pathogenesis. The main clinical syndromes. Diagnostic
features. Differential diagnostics. Treatment, prevention.
2. Megaloblastic anaemias (B12- and folate deficiency). Aetiology and pathogenesis. Clinical
syndromes. Diagnostic features. Differential diagnostics. Treatment, prevention.
3. Hypo- and aplastic anaemias. Aetiology and pathogenesis. The main clinical syndromes.
Laboratory findings. Differential diagnostics. Treatment, prevention. Prognosis.
4. Haemolytic anaemias. Mechanism of hemolysis and main causes. Classification. Clinical findings.
Diagnostic features. Treatment.
5. Hemoblastosis. Up-to-day views on aetiology and pathogenesis. Classification. Main clinicalhematological syndromes.
6. Acute leukaemias. Classification. Clinical features. Laboratory-morphological diagnostic. Course
and complications. Treatment. Prognosis.
7. Erythremia. The main clinical syndromes. Stages of course. Diagnostic criterias. Differential
diagnostics. Complications. Treatment. Prognosis.
8. Chronic myeloid leukaemia. Clinical features. Stages of course. Laboratory-morphological
diagnostic. Treatment. Prognosis.
9. Chronic lymphocytic leukaemia. Up-to-day classification. Clinical features. The main syndromes.
Stages of course. Laboratory-morphological diagnostic. Prognosis. Treatment.
10. Hodgkin’s disease (lymphogranulomatosis). Aetiology and pathogenesis. Classification. Clinical
findings, diagnostic features. Differential diagnostics. Treatment. Prognosis.
11
11. Multiple myeloma. Aetiology and pathogenesis. Classification. Clinical features. Diagnostic
features. Differential diagnostics. Treatment. Prognosis.
12. Agranulocytosis. Classification. Aetiology and pathogenesis. Clinical variants. Diagnostic features.
Course and complications. Treatment, prevention.
13. Hemophilia. The role of hereditary factor in disease development. Pathogenesis of bleeding.
Clinical findings, disease course. Diagnostic features. Differential diagnostics. Prognosis.
Treatment. Prevention.
14. Thrombocytopenia. Main aetiological factors. Pathogenesis of bleeding. Clinical findings.
Diagnostic features. Differential diagnostics. Treatment.
15. Hemorrhagic vasculitis. Aetiology. Pathogenesis of bleeding. Clinical findings. Variants of course.
Diagnostic features. Treatment. Prognosis. Prevention.
16. Haemorrhage, loss of blood. Components of blood transfusion. Methods of blood grouping and
compatibility testing. Complications of transfusion. Treatment, prevention.
17. Disseminated intravascular coagylation syndrome.
PART IV.
EMERGENCY IN CLINIC OF INTERNAL DISEASES
1. Cardiac asthma. Causes, pathogenesis. Clinical features, diagnostic findings. Emergency.
2. Pulmonary edema. Causes, pathogenesis. Clinical features, diagnostic findings. Emergency.
3. Arterial hypertensive crisis. Classification. Clinical features, diagnostic findings. Emergency.
4. Attack of angina. Treatment, prevention.
5. Cardiac shock. Causes, pathogenesis. Clinical features, diagnostic findings. Emergency.
6. Collapse. Causes. Clinical features, diagnostic findings. Emergency.
7. Ventricular paroxysmal tachycardia. Causes. Clinical features, ECG-diagnostics. Emergency.
8. Supraventricular paroxysmal tachycardia. Causes. Clinical features, ECG-diagnostics. Emergency.
9. Morgagni-Adams-Stockes syndrome. Causes. Clinical features, diagnostic findings. Emergency.
10. Ventricular flutter and fibrillation. Pathogenesis. Clinical features, ECG-diagnostics. Emergency..
11. Acute right ventricular heart failure. Causes. Clinical features, diagnostic findings. Emergency.
12. Acute left ventricular heart failure. Causes. Clinical features, diagnostic findings. Emergency.
13. Atrial fibrillation paroxysm. Causes. Clinical features, diagnostic findings, ECG-diagnostics.
Emergency.
14. Atrial flutter. Causes. Clinical features, diagnostic findings. Treatment..
15. Cardiac glycoside intoxication. Causes. Main groups of symptoms. Treatment.
16. Acute respiratory failure. Causes. Clinical features, diagnostic findings. Emergency.
17. Asthmatic status. Causes. Clinical features, diagnostic findings. Emergency..
18. Syndrome of bronchial obstruction. Causes, pathogenesis. Clinical features, diagnostic findings.
Differential diagnostics. Emergency of acute forms.
19. Pulmonary hemorrhage and hemophthysis. Causes. Clinical features, diagnostic findings.
Emergency.
20. Artery pulmonalis thromboembolia. Causes. Clinical features, diagnostic findings. Emergency.
21. Spontaneous pneumothorax. Causes. Clinical features, diagnostic findings. Emergency.
22. Pulmonary infarction. Causes. Clinical features, diagnostic findings. Emergency.
23. Pulmonary atelectasis. Causes. Clinical features, diagnostic findings. Emergency.
24. Acute thoracic empyema. Causes. Clinical features, diagnostic findings. Emergency.
25. Hemolytic crisis. Causes. Clinical features, diagnostic findings, complications. Emergency.
26. Hemorrhagic diathesis. Emergency of acute bleedings.
27. Acute alcohol poisoning. Clinical features. Emergency.
28. General principles of emergency of acute poisonings.
29. Main means of antidote therapy of acute poisonings.
30. Methods of active detoxications of acute poisonings.
31. Chlorhydropenic (hypochloremic) coma. Causes. Clinical features, diagnostic findings.
Emergency.
32. Anaphylactic shock. Causes. Clinical features, diagnostic findings. Emergency.
33. Shock. Classification. Aetiology, pathogenesis. Clinical features. Emergency.
12
34. Angioneurotic edema (Kwink’s edema). Aetiology, pathogenesis. Clinical features, diagnostic
findings. Emergency.
PART V.
GENERAL QUESTIONS
1. The role of sanatorium-and-spa treatment in rehabilitation of the patients with the diseases of
internal organs. Contraindications for sanatorium-and-spa treatment.
2. Peculiarities of duration of cardiovascular diseases in juvenile, elderly and senile aged patients.
Tactics of therapeutist.
3. Peculiarities of duration of diseases of respiratory system in juvenile, elderly and senile aged
patients. Tactics of therapeutist.
4. Peculiarities of duration of blood in juvenile, elderly and senile aged patients. Tactics of
therapeutist.
5. The question of working capacity examination in the practical work of therapeutist of outpatient
department
8. LIST OF PRACTICAL SKILLS
Module2 «Bases of internal medicine (cardiology, pulmonology, hemotology, general
questions of internal medicine)»
1.
2.
3.
4.
To obtain the skills of interpretation of radiological examinationof the chest.
To obtain the skills of interpretation of bronchoscopy.
To obtain the skills of interpretation of the results of external respiration.
To obtain the skills of analysing of the laboratory tests (blood test, general protein and protein
fractions, coagulation value, general and microbiologic investigation of the sputum, general
and microbiologic investigation pleural effusion).
5. To obtain the skills of giving first aid in case of acute respiratory insufficiency.
6. To obtain the skills of giving first aid in case of external bleeding.
7. To obtain the skills of determining of blood group.
8. To obtain the skills of transfusion of blood components and blood substitutes.
9. To obtain the skills of analysing general blood test, marrow punctate.
10. To obtain the skills of interpretation of Doppler echocardioscophy.
11. To obtain the skills of interpretation of the results of stress tests.
12. To obtain the skills of interpretation of electrocardiograms.
13. To obtain the skills of interpretation of the results of angiocardiography.
14. To obtain the skills of interpretation of the results of pneumonograms
15. To obtain the skills of analysing of the laboratory methods of investigation (microbiologic
blood investigation, acute phase blood data, general protein and protein fractions, transaminasis
of the blood, coagulation value, laboratory markers of myocardium necrosis, blood lipids,
creatinine of the blood, clearance of creatinine, electrolytes of the blood, serum diagnostics
during autoimmune process).
16. To obtain the skills of giving first aid in case of acute heart insufficiency, collapse, shocks.
17. To obtain the skills of giving first aid in case of hypertensive crisis.
18. To obtain the skills of giving first aid in case of paroxysmal rhythm disorders, MorgagniAdams-Stokes disease.
19. To obtain the skills of giving first aid in case of circulatory arrest, respiratory standstill,
conducting of cardiopulmonary resuscitation.
20. To obtain the skills of registration and interpretation of electrocardiograms.
21. To obtain the skills of measurement of blood pressure.
13
9. Literature
1. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update
2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the
European Society of Cardiology. Eur Heart J Jun 01, 2005; 26: 1115-1140.
2. 2007 Guidelines for the management of arterial hypertension: The Task Force for the
Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of
the European Society of Cardiology (ESC). Eur Heart J Jun 02, 2007; 28: 1462-1536.
3. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The
Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology
(ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J Jan 01,
2007; 28: 88-136.
4. Guidelines on the management of stable angina pectoris: executive summary: The Task Force
on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur
Heart J Jun 01, 2006; 27: 1341-1381.
5. Guidelines on the management of valvular heart disease: The Task Force on the Management
of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J Jan 02, 2007; 28:
230-268.
6. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis Executive
Summary: The Task Force on Infective Endocarditis of the European Society of Cardiology.
Eur Heart J Feb 01, 2004; 25: 267-276.
7. Braunwald Eugene, P. Zipes Douglas P., Libby Peter, Bonow Robert. Heart Disease: A
Textbook of Cardiovascular Medicine, Single Volume. 7th ed. Saunders W. B., 2004. 2183 p.
8. Taylor R. Cardiovascular Diseases: A Handbook. Springer, 2005. 294 p.
9. Topol Eric J, Califf Robert M, Prystowsky Eric N, Thomas James D, Thompson Paul D.
Textbook of Cardiovascular Medicine. 3rd ed. Lippincott Williams & Wilkins, 2006. 1664 p.
10. Morris Francis, Edhouse June, Brady William J, Camm John. ABC of Clinical
Electrocardiography. BMJ Publishing Group, 2003. 80 p.
11. Hosenpud
Jeffrey
D.
Congestive
Heart
Failure
Third Edition. Lippincott Williams & Wilkins, 2007. 833 p.
12. Jones Shirley A. ECG Notes: Interpretation And Management Guide. F. A. Davis Company,
2005. 210 p.
13. Chan Kwan-Leung, Embil John M. Embil. Endocarditis Diagnosis and Management. SpringerVerlag London Limited, 2006. 258 p.
14. Feigenbaum Harvey, Armstrong William F., Ryan, Thomas. Echocardiography, 6th Edition.
Lippincott Williams & Wilkins, 2005. 773 p.
15. Fuster Valentin, Alexander R. Wayne, O’Rourke Robert A., Roberts Robert, King Spencer B.,
Prystowsky Eric N., Nash Ira. Hurst’s The Heart, 11th Edition. McGraw-Hill Professional,
2004. 2400 p.
16. Driscoll, David J.Title: Fundamentals of Pediatric Cardiology, 1st Edition. Lippincott Williams
& Wilkins, 2006. 176 p.
17. Kaplan Norman M. Clinical Hypertension. Lippincott Williams & Wilkins, 2005. 518 p.
18. Hampton John R. The ECG in Practice. Churchill Livingstone, 2003. 325 p.
19. Kasper Dennis L., Braunwald Eugene, Fauci Anthony, Hauser Stephen, Longo Dan, Jameson J.
Larry. Harrison’s Principles of Internal Medicine, 16th ed. McGraw-Hill Professional, 2004.
2800 p.
20. Boon Nicholas A., Colledge Nicki R., Walker Brian R., Hunter John. Davidson’s Principles
and Practice of Medicine. Churchill Livingstone, 2006. 1392 p.
21. Katzung Bertram G. Basic & Clinical Pharmacology. McGraw-Hill Medical, 2006. 1179 p.