Methodical recommendation
to practical lesson for the students
IV course of stomatological faculty
Lesson № 4 (practical – 6 hours)
Themes: 1. Tuberculosis of the unstated localization. Pathogenesis, clinic, diagnostics, differential diagnostics, treatment, consequences. . (2 h).
2. Tuberculosis of intrathoracic lymphatic nodes. Pathogeny, pathomorphology, clinic, diagnostics, differential diagnostics, treatment, consequences Primary tuberculosis complex. Pathogeny, pathomorphology, clinic, diagnostics, differential diagnostics, treatment, consequences. . (2 h).
3. Complications of primary forms of tuberculosis. Features of motion of primary forms of tuberculosis at children and teenagers. Curation of patients. . (2 h).
Purpose: To learn to diagnose and treat primary tuberculosis at children, independently to inspect patients with lung tuberculosis, to recognize the disease, to propose a clinical diagnosis according to modern classification, to conduct differential diagnostics with similar diseases, to make the plan of medical treatment.
Professional orientation of students: Early diagnostics of primary forms of tuberculosis is important for practical doctors. From ability to expose, to estimate the clinical displays of primary tuberculosis at children, to give them faithful interpretation and in good time send a child the efficiency of medical treatment of patient and prognosis of disease depends to phthisiologist.
І. Program of selfpreparation of students to lesson:
Theme № 1 practical lesson
1. Ways of penetration and distribution of mycobacterium tuberculosis in an child organism.
2. Methods of early exposure of primary forms of tuberculosis at children.
3. Determination of primary tuberculosis and his feature (description).
4. Tubercular intoxication at children (tuberculosis without established localization) (determination, clinic, diagnostics, differential diagnostics, consequences).
Theme № 2 practical lesson
1. What groups of intrathoracic lymphatic nodes can be struck at tuberculosis?
2. Determination of tuberculosis of intrathoracic lymphatic nodes (pathogeny, pathological anatomy, clinico-roentgenologic variants, clinic and diagnostics, consequences).
3. Basic diseases which differential diagnostics of tuberculosis of intrathoracic lymphatic nodes is conducted with.
4. Primary tuberculosis complex. Pathogeny, clinic, diagnostics.
Theme № 3 practical lesson
1. Complications of primary forms of tuberculosis (primary tubercular complex and tuberculosis of vnutrigrudnih lymphatic knots).
2. Medical treatment of primary forms of tuberculosis.
3. Features of flow of tuberculosis at children and teenagers.
4. Curation patients.
1. Standards of test tasks and situation tasks
Situation tasks
Task №
Task № 2. At prophylactic examination at 17 years boy the bilateral increase of bronhopulmonary lymphatic nodes are exposed. Common state – satisfactory, complaints are not present. At the inspection the pathological changes are not exposed. Reaction for Mantoux test with 2 TU – negative. General blood test without pathological rejections. Most credible diagnosis.
Test № 1. What is meant by the diagnosis “tuberculous intoxication in children”?
A. A symptom complex of functional and objective signs of intoxication as a result of primary infestation with tuberculosis mycobacteria with unestablished localization.
B. An intoxication syndrome at a small form of tuberculosis of intrathoracic lymphatic nodes.
C. An intoxication syndrome at a primary tuberculous complex.
D. An intoxication syndrome at a primary tuberculous complex of ileocecal section of
intestine.
E. Subfebrile body temperature, perspiration appeared, cough, voice hoarseness.
Test № 2. What is the primary tuberculosis?
A. First diagnosed tuberculosis
B. Tuberculosis that develops in firstly infected persons.
C. Tuberculosis what has developed after the primary tuberculous complex.
D. Tuberculosis revealed during the prophylactic examination.
E. Tuberculosis caused by mycobacteria of beef type.
Test № 3. Paraspecific manifestations of primary tuberculosis:
A. Micropolyadenitis, nodual erythema, phlyctenuar keratoconjunctivitis
B. Tuberculosis of skin and tonsils
C. Amiloidosis of internal organs, pleural empyema
D. Tuberculosis pleurisy and pericarditis
E. Tuberculous peritonitis and tuberculosis of intestine
1. Right answers for situation tasks and tests
Task № 1. Answer: tuberculosis of intrathoracic lymphatic nodes.
Task № 2. Answer: sarkoidosis
Test №
Test № 2. B.
Test №
4. REFERENCES
1. Phthisiology: A teaching manual in Ukrainian and English I.T.Pyatnochka, S.I.Kornaga, V.I.Pyatnochka / By general editorship of Doctor of Medical Sciences, Prof. Pyatnochka I.T.- Ternopil Ukrmedknyha, 2002.- 260 p.
2. Tuberculosis: A teaching manual in English /By general editorship of Doctor of Medical Sciences, Prof. Pyatnochka I.T.- 2005. –248 р.
3. David Schlossberg. Tuberculosis and nontuberculous mycobacterial infections –
4. Lecture.
5. Practical classes materials.
5. Method of implementation of practical work: (9.00-12.00)
Theme № 1 practical lesson
Work 1. Inspection of patient with tubercular intoxication.
Work 2. To analyse the results of laboratory researches, data of tuberculinodiagnostics, roentgeno– and tomogram. To expose the signs of primary forms of tuberculosis. To formulate a clinical diagnosis, to conduct differential diagnostics, to appoint medical treatment.
Work 3. Untiing of tests of plural choice. Verification and discussion of answers.
Theme № 2 practical lesson
Work 1. Inspection of patient with a primary tubercular complex, tuberculosis intrathoracic lymphatic nodes.
Work 2. To analyse the results of laboratory researches, data of tuberculinodiagnostics, roentgeno– and tomogram. To expose the signs of primary forms of tuberculosis. To formulate a clinical diagnosis, to conduct differential diagnostics, to appoint medical treatment.
Work 3. Untiing of tests of plural choice. Verification and discussion of answers.
Theme № 3 practical lesson
Work 1. To inspect primary tuberculosis patient with complications. To analyse the results of laboratory researches, data of tuberculinodiagnostics, roentgeno– and tomogram. To expose the signs of lung tuberculosis. To formulate a clinical diagnosis, to conduct differential diagnostics, to appoint medical treatment.
6. Seminar discussion of theoretical questions and practical work (12.30-14.00)
7. Initial level of knowledges and abilities (14.15-15.00)
1. Decision of situation task.
2. Answers on a curation patient.
3. To describe the archived roentgenogram.
4. Answer for a structural question.
5. Answer for tests to the type «Krok».
Made the methodical pointing: doc. Kornaha S.I.
It is discussed and it is ratified on meeting of department
24“ __05________2012 ”, protocol № 13
It is revised and it is ratified on meeting of department
