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„Approved”
on methodical conference
department of infectious diseases and epidemiology
„____” ____________ 200 р.
Protocol № _____
Chief of Dept., professor __________ V.D. Moskaliuk
METHODOLOGICAL INSTRUCTIONS
to a fifth year student of the Faculty of Medicine
on independent preparation for practical training
Topic: Differential Diagnosis of Zoonosis and Skin
Infections, Concluding Lesson
Subject:
Major:
Educational degree
and qualification level:
Year of study:
Hours:
Prepared by assistant professor
Infectious Diseases
Medicine
Specialist
5
2
Sydorchuk A.S.
1. Topic: Differential Diagnosis of Zoonosis and Skin Infections, Concluding Lesson
2. Lesson duration: 2 hours
Aims of the lesson:
3. Students are to know:
• etiology, pathogenesis and pathologic morphology of plaque;
• etiology, pathogenesis and pathologic morphology of anthrax;
• etiology, pathogenesis and pathologic morphology of rabies;
• etiology, pathogenesis and pathologic morphology of tetanus;
• etiology, pathogenesis and pathologic morphology of tularemia;
• etiology, pathogenesis and pathologic morphology of HIV/AIDS;
• etiology, pathogenesis and pathologic morphology of erysipelas;
• epidemiology of plaque;
• epidemiology of anthrax;
• epidemiology of rabies;
• epidemiology of tetanus;
• epidemiology of tularemia;
• epidemiology of HIV/AIDS;
• epidemiology of erysipelas, glanders, foot-and-mouth-disease;
• classification of zoonotic and skin infections;
• symptoms and development of plaque;
• symptoms and development of anthrax;
• symptoms and development of rabies;
• symptoms and development of tetanus;
• symptoms and development of tularemia;
• symptoms and development of HIV/AIDS;
• diagnostic possibilities of additional methods of zoonotic and skin infections examination
(bacteriological, virologic, biological, serology examination and allergy examination);
• prognosis at different zoonotic and skin infection forms;
• peculiarities of treatment and prophylaxis of zoonotic and skin infections;
• antiepidemic measures against zoonotic and skin infections.
3.2. Students are to be able:
• to question a patient in order to obtain information on complaints and disease history;
• to question a patient in order to obtain information on epidemiologic anamnesis;
• to make a provisional diagnosis of zoonotic and skin infection based on symptoms, development
and epidemiologic information;
• to make a differential diagnosis including distinguishing between different zoonotic and skin
infections;
• to prepare a plan of patient examination;
• to make sampling and inoculation of material for bacteriological or virologic examination;
• to evaluate results of serologic reactions and allergic tests;
• to prepare a plan of basic sanitary at onset of zoonotic and skin tract infections;
• to perform prophylaxis of zoonotic and skin infections.
3.3. Students are to acquire the following skills:
• to draw up an urgent notification;
• to take blood samples for inoculation into nutrient media;
• to take samples of vomit, feces for bacteriological test and ELISA
• to estimate liquid volume for desintoxication;
• to perform emergency aid at toxic-infective shock;
• to master Bezredka method of serum introduction;
• to perform allergy tests using appropriate allergen.
4. Advices to the student:
During differentiation a student must remember, that blood and skin infections belongs to
group of quarantine diseases. Such infections as plaque, anthrax, and hemorrhagic fevers are
especially dangerous diseases that demand on immediately anti-epidemic measures in nidus. But
first of all, a doctor must recognise a disease, estimate a course severity of disease in concrete
patient. Then organise a plan of examination with basic and additional methods, after that prescribe
the adequate treatment due to concrete disease. Thus, for case of plague will be necessary to put
patient in isolative ward, also student must remember that maximum incubative period of plaque is
6 days.
Student should pay a regard to similar clinical features of skin forms of plaque and anthrax,
which accompanied with regional lymphadenitis. But unlike plaque in case of anthrax it will be
different an oedema degree of surrounding tissue (Stefansky symptom).
It will be helpfull for specialist to questioning other people in nidus and contact persons on
the subject of possible clinical diagnosis, it means that epidemiologic data has a big value for
proving suspected diagnosis.
Also student must remember that generalized forms of plaque and anthrax such as
pulmonary and septic, intestinal have very similar symptoms – intoxication, bloody couph, or
bloody stool, with the next development of infection-toxic shock and soon death.
5. Test questions:
1. What are the pathogens to cause plaque?
2. What are the pathogens to cause anthrax?
3. What are the pathogens to cause rabies?
4. What are the pathogens to cause tetanus?
5. What are the pathogens to cause tularemia?
6. What are the pathogens to cause HIV/AIDS?
7. What are the pathogens to cause erysipelas?
8. What are the principal pathogenic links of plaque?
9. What are the principal pathogenic links of anthrax?
10. What are the principal pathogenic links of rabies?
11. What are the principal pathogenic links of tetanus?
12. What are the principal pathogenic links of tularemia?
13. What are the principal pathogenic links of HIV/AIDS?
14. What are the principal pathogenic links of erysipelas?
15. Mechanism and ways of respiratory tract infection transmission.
16. Classification of plaque.
17. Classification of HIV/AIDS.
18. Classification of tularemia.
19. Classification of anthrax.
20. Characteristic symptoms of different forms of plaque.
21. Characteristic symptoms of different forms of anthrax.
22. Characteristic symptoms of different forms of rabies.
23. Characteristic symptoms of different forms of tetanus
24. Characteristic symptoms of different forms of tularemia.
25. Characteristic symptoms of different forms of HIV/AIDS.
26. Characteristic symptoms of different forms of erysipelas.
27. Criteria for making diagnosis of plaque.
28. Criteria for making diagnosis of anthrax.
29. Criteria for making diagnosis of rabies.
30. Criteria for making diagnosis of tetanus.
31. Criteria for making diagnosis of tularemia.
32. Criteria for making diagnosis of HIV/AIDS.
33. Criteria for making diagnosis of erysipelas.
34. Bacteriological test at different zoonotic and skin infections.
35. What are the specific methods used for diagnosis of different zoonotic and skin infections?
36. Making of differential diagnosis including distinguishing between different zoonotic and skin
infections.
37. Etiologic and pathogenic treatment of zoonotic and skin infections.
38. Veterinary and sanitary as well as sanitary and hygienic measures for prophylaxis of zoonotic
and skin infections.
39. Specific immunization against controllable zoonotic and skin infections.
40. Emergency aid at zoonotic and skin infections complications (toxic shock, acute renal failure,
brain oedema, lungs oedema).
6. Literature:
А. Basic:
Infectious disiseases /Edited by: prof. E. Nikitin, prof. M. Andreychyn.-Ternopil «Ukrmedknyga»,
2004.-364 p.
B. Adding:
1. The Merck Manual of Diagnosis and Therapy.-Merck Sharp, 1987.-2696 p.
2. Reese R.E. A Practical Approach to Infectious Diseases-Boston-Toronto: Little,
Brown&Company, 1986.-782 p.
3. Ellner P.D., Neu H.C. Understanding Infectious Diseases – Mosby Year Book, 1992.- 343 p.