Тернопільська державна медична академія

June 19, 2024
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I.Ya. HORBACHEVSKY TERNOPIL STATE MEDICAL  UNIVERSITY

 

Internal Medicine Propedeutics and Tuberculosis Department

 

                         “Approved”

     Vice-rector for education & training

 _______Professor   Ihor R. Mysula

                                                              ____________ 2008

 

 

 

SYLLABUS

on Internal Diseases

for the  speciality  № 7.100.106

Stomatological faculty

 

 

Course

 

Subject

 

Semesters

Hours quantity

 

    

Type of control

Hours quantity

 

 

 

Total

Auditorial

SAIW

 

Total

 

Lectures

Practical clases

 

 

 

IV year

Internal diseases

VII-VІІІ

141

68

73

exam

 

Emergency cases

32

8

16

8

 

Therapy of emergency cases

16

2

8

6

 

 

 

 

The Syllabus was compelled by: prof. S.M.Andreychyn, ass.-prof. Т.Yu. Chernets, ass.-prof.. B.H. Buhai, ass.-prof. N.Z. Yarema, ass.-prof.. N.A. Khabarova, 

ass.-prof. М.М. Ruda, ass.-prof.. N.Ya. Vereschahina, ass. N.А. Bilkevych

 

 

 

Is addopted at the chair sitting  __14___”______05________2008

Minutes № __10___

The Head of the Department                                    Prof. S.M.Andreychyn

 

 

Is authorized by the Cycle Methodological Commission sitting

«____25___»______06__________ 2008,

minutes   ___5____

 

The Head of Cycle Commission                                                  Prof. S.M.Andreychyn

 

 

 

 

 

 

 

 

 

Ternopil, 2008


 

WORK  PROGRAM

I. The main task of the course:

         to perform interview with a patient being under the conditions of  a dental room, an outpatient clinic, in-patient department of at patient’s home and to use the results. To obtain information about patient’s complaints, anamnesis of the disease, life anamnesis (including professional anamnesis) and data of review of systems

in any conditions (in a treatment-prophylactic establishment, at patient’s home etc) being mastered in knowledge about a human, his organs and systems, to be able to do the following according special algorrhythms:

  – to obtain information about general condition of a patient (consciousness, constitution, nutrition) and appearance (skin colour, subcutaneous fat tissue, palpation of lymph nodes and thyroid gland);

         to evaluate psychomotor anf physical development of a patient;

                      to examine detaily condition of maxillofacial region

To be able to outline and record the leading clinical symptom and syndrome being followed  certain ethical and juridical norms, being be able to use previous data of patient’s anamnesis, knowledge about a human, his organs and systems and to do all mentioned above by acception of a well-grounded decision.

         To make a plan of examination of stomatological patient, to make interpretation of the results of laboratory and instrumental investigations in the most wide-spread diseases of internal organs and their complications.

         To analyse the results of main laboratory and instrumental methods of investigation of patients with those somatic diseases which require special tactik in management of stomatological patient.

         To carry our examination of patients by functional methods

         To formulate syndromal diagnosis according to the classification

         To show ability to use moral and deontological principles of a medical professional and principles of  professional subordination in therapy.

 

 

2. Structure and content of the subject

 

Thematic plan of lecures

For the 3rd year students, stomatological faculty

Spring semester,   2008-2009 year

 

Topic

Lector

1.

Diseases of kidneys and urinary ducts.Acute and chronic glomerulonephritis and pyelonephritis. Clinical pattern. Diagnostics. Complications. Emergency care. Principles of treatment.

Ass.-prof. N.Ya. Vereschahina

2

Anemias. Differential diagnosis. Clinical pattern.. Diagnostics. Typical changes in oral cavity in different types of anemia. Emergency care in blood loss, agranulosytosis. Nonmalignant affectionj of leukocytes: agranulocytosis and leukaemia. The role of a doctordentist in treatment of oral cavity affections in leukaemias.

Ass.-prof. N.Z.Yarema

13.

Diabetes mellitus. Insulin-dependent and insulin-independent DM. Ethiology. Pathogenesis. Principles of treatment. Diabetic coma. Hypoglycaemic coma. Emergency care.

Ass.-prof. N.Ya. Vereschahina

14.

Thyroid gland diseases. Diffuse toxic goitre. Hypothyreosis. Endemic goitre. Ethiology. Clinical pattern. Daignostics. Complications. Principles of treatment.

Thyrotoxic crisis. Hyrothyreoid coma. Emergency care.

Ass.-prof. N.Ya. Vereschahina

15.

Diseases of diffuse connective tissue decomposition. Modern concepse about  ethiology,  clinical pattern, diagnostics, complications, principles of treatment. Signs in oral cavity. The role of a dentist in early diagnostics.

Ass.-prof. N.Z.Yarema

6

Emergency in pulmonology and gastroenterology

Доц. Верещагіна Н. Я.

7

Emergency in cardiology: angina pectoris attack, acute myocardial infarction and its complications, acute left ventricular heart failure, collapse, faint, hypertonic crisis. Hypotonic crisis. Emergency care.

Доц. Верещагіна Н. Я.

8

Emergency iephrology and endocrinology

 

9

Emergency in hematology and allergology

 

10

Emergency in extremal situations

 

 

 

 

 

 

 

 

Thematic plan of practical classes

for the 3rd year students, medical faculty

spring semester 2008-2009 year of education

 

п\п

Topic

Hours

1

Clinical and laboratory methods of examination of patients with diseases of respiratory system. Instrumental methods of examination in pulmonology. Main pulmonological syndromes

6

2

Acute and chronic bronchitis. Etiology and pathogenesis. Clinical pattern, diagnostics. Treatment. Complications. Prognosis. Syndrome of respiratory insufficiency.

 Bronchial asthma. Clinical pattern. Diagnostics. Treatment. Complications. Syndrome of air hyperinflation of the lungs. Clinical pattern of bronchial asthma attack. Emergency care. The role of a doctor-dentist in prophylaxis of chronic bronchitis and bronchial asthma.

6

3

Pneumonia. Definition. Classification. Clinical pattern. Syndrome of consolidation of pulmonary tissue. Diagnostics. Treatment. Complications. Prognosis.

Lung cancer. Etiology. Clinical pattern. Diagnostics. Treatment.

Pleuricy. Syndrome of fluid accumulation in pleural cavity. Etiology. Clinical pattern. Diagnostics. Treatment.

6

4

Purulent inflammatory processes in the lungs: abscess, gangrene, bronchiectasia.   Etiology. Clinical pattern. Diagnostics. Treatment.

Pulmonary heart. Pulmonary artery thrombembolissm. Clinical pattern. Diagnostics. Treatment.

Prognosis. Emergency care

6

5

Clinical, laboratory and  instrumental methods of examination of patients with diseases of cardiovascular system. Instrumental  methods of examination in pulmonology. Main cardiological syndromes

6

6

Acute rheumatic fever. Chronic rheumatic heart disease.  Definition. Etiology.  Pathogenesis. Clinical pattern, diagnostics. Treatment. Prophylaxis. 

Bacterial endocarditis. Etiology and pathogenesis. Clinical pattern, diagnostics. Treatment. Prophylaxis.

The role of a doctor-dentist   in prophylaxis.

6

7

Mitral heart defects. Ethiology, pathogenesis, clinical pattern, diagnostics, treatment.  Prophylaxis

Aortal heart defects. Ethiology, pathogenesis, clinical pattern, diagnostics, treatment.  Prophylaxis

Atherosclerosis. Ischemic heart disease. Sudden coronary death.

6

8

Angina pectoris. Clinical pattern. Diagnostics. ECG and ultrasound diagnostics. Treatment. Prophylaxis.  Emergency care. Complications.

Myocardial infarction. Definition.  Clinical pattern. Diagnostics. Emergency care Complications of MI: cardiogenic shock, acute left-ventricular failure. Diagnostics.  Emergency care in ambulatory conditions. Treatment. The role of  a doctor-dentist in primary prophylaxis.

6

9

Cardiac arrhythmias: extrasystoly, paroxismal tachycardia. Definition. Etiology.  Pathogenesis. Clinical pattern. ECG diagnostics. Treatment. Prophylaxis.  Electrodefibrillation. Tactics of a doctor-dentist.

Atrial fibrillation, heart blocks, Morgagni-Adams-Stocks attack. Etiology.  Pathogenesis. Clinical pattern. ECG diagnostics. Treatment. Prophylaxis. Tactics of a doctor-dentist. 

6

10

Arterial hypertension. Definition. Etiology.  Pathogenesis. Classification. Clinical pattern.  Treatment.

Symptomatic arterial hypertensions. Etiology.  Pathogenesis. Classification. Clinical pattern.  Treatment Hypertonic crisis.  Clinical pattern. Classification. Emergency care. Prophylaxis of complications

6

11

Arterial hypertension. Acute vascular insufficiency: faint, collapse, shock. Diagnostics. Emergency care. Tactics of  a doctor-dentist   in ambulatory conditions.

Acute and chronic heart failure. Definition. Etiology.  Pathogenesis. Classification. Clinical pattern. Diagnostics. Treatment. Emergency care.

6

12

Clinical, instrumental and laboratory methods of examination in rheumatology. Ostheoarthrosis.

Остеоартроз. Classification. Clinical pattern.  Diagnostics Treatment.

6

 

 

 

Schedule of lecures

For the 3rd year students, stomatological faculty

Spring semester,   2008-2009 year

 

п/п

Topic

Date

Time

Lecture hall

Group

Lector

1.

Chronic obstructive pulmonary disease. Bronchial asthma. Ethiology. Clinical pattern. Daignostics. Complications. Principles of treatment.

19.01.

900-1000

9

1-12

prof. S.M. Andreichyn

2.

Pneumonias and purulent diseases of the lungs. Ethiology. Clinical pattern. Daignostics. Complications. Principles of treatment.

26.01

1250-1350

9

1-12

prof. S.M. Andreichyn

3.

Rheumatic fever. Ревматична лихоманка. Ethiology. Criteria of diagnosis. Complications. Principles of treatment. Aortal and mitral heart defects. Ethiology. Clinical pattern. Daignostics. Complications. Principles of treatment.

9.02

900-1000

9

1-12

Ass.-prof. N.Z.Yarema

4.

Ischemic heart disease. Classification of WHPO. Angina pectoris. Classification. Emergency care. Cardiopulmonary resuscitation. Myocardial infarction. Clinical forms, laboratory and ECG diagnostics. Early signs and complications.  Principles of treatment of non-complicated MI.

13.02

900-1000

9

1-12

prof. S.M. Andreichyn

5

Heart arrhythmias. Clinical and ECG diagnostics. Ventricular extrasystole. Paroxismal tachycardia. Atrial fibrillation. Complete atrioventricular block. Emergency care in heart arrhthmias.

2.03

900-1000

9

1-12

Ass.-prof. N.Z.Yarema

6

Arterial hypertensions. Hypertonic disease. Hypertonic crisis. Ethiology. Clinical pattern. Daignostics. Principles of treatment.

 

 

9

1-12

Ass.-prof. N.Z.Yarema

7

Chronic heart failure. Definition. Classification. . Clinical pattern. Daignostics.Treatment.

 

 

9

1-12

prof. S.M. Andreichyn

8

Chronic gastritis. Peptic ulcer of a stomach and duodenum. Ethiology. Clinical pattern. Daignostics. Complications. Principles of treatment.

 

 

9

1-12

Ass-prof. N.A. Khabarova

9

Diseases of a liver: chronic hepatitis, liver cirrhosis. Ethiology. Clinical pattern. Daignostics. Complications. Principles of treatment.

 

 

9

1-12

Ass-prof. N.A. Khabarova

10

Diaseases of kidneys and urinary ducts. Acute and chronic glomerulonephritis and pyelonephritis Ethiology. Clinical pattern. Daignostics. Complications. Emergency care. Principles of treatment.

 

 

 

1-12

Ass.-prof. N.Ya. Vereschahina

11

Anemias. Differential diagnosis. Clinical pattern.  Typical changes in oral cavity in different types of anemias. Emergency care in bleeding, agranulocytosis. Non-malignant disorders of leukocites: agranulocytosis and leukaemia. The role of a dentist in prophylaxis of oral cavity  affections.

 

 

 

1-12

Ass.-prof. N.Z.Yarema

12

Diabetes mellitus. Insulin-dependent and insulin-independent DM. Ethiology. Pathogenesis. Principles of treatment. Diabetic coma. Hypoglycaemic coma. Emergency care.

 

 

 

1-12

Ass.-prof. N.Ya. Vereschahina

13

Thyroid gland diseases. Diffuse toxic goitre. Hypothyreosis. Endemic goitre. Ethiology. Clinical pattern. Daignostics. Complications. Principles of treatment.

Thyrotoxic crisis. Hyrothyreoid coma. Emergency care.

 

 

 

1-12

Ass.-prof. N.Ya. Vereschahina

14

Diseases of diffuse connective tissue decomposition. Modern concepse about  ethiology,  clinical pattern, diagnostics, complications, principles of treatment. Signs in oral cavity. The role of a dentist in early diagnostics.

 

 

 

1-14

Ass.-prof. N.Z.Yarema

 

 

Schedule of practical classes

for the 3rd year students, medical faculty

spring semester 2008-2009 year of education

 

 

п\п

Topic

Hours

Date

1

Clinical and laboratory methods of examination of patients with diseases of respiratory system. Instrumental methods of examination in pulmonology. Main pulmonological syndromes

6

21.01-6.02.09

2

Acute and chronic bronchitis. Etiology and pathogenesis. Clinical pattern, diagnostics. Treatment. Complications. Prognosis. Syndrome of respiratory insufficiency.

 Bronchial asthma. Clinical pattern. Diagnostics. Treatment. Complications. Syndrome of air hyperinflation of the lungs. Clinical pattern of bronchial asthma attack. Emergency care. The role of a doctor-dentist in prophylaxis of chronic bronchitis and bronchial asthma.

6

27.01-12.02. 09

3

Pneumonia. Definition. Classification. Clinical pattern. Syndrome of consolidation of pulmonary tissue. Diagnostics. Treatment. Complications. Prognosis.

Lung cancer. Etiology. Clinical pattern. Diagnostics. Treatment.

Pleuricy. Syndrome of fluid accumulation in pleural cavity. Etiology. Clinical pattern. Diagnostics. Treatment.

6

5.02.-4.03. 09

4

Purulent inflammatory processes in the lungs: abscess, gangrene, bronchiectasia.   Etiology. Clinical pattern. Diagnostics. Treatment.

Pulmonary heart. Pulmonary artery thrombembolissm. Clinical pattern. Diagnostics. Treatment.

Prognosis. Emergency care

6

19.02- 10.03. 09

5

Clinical, laboratory and  instrumental methods of examination of patients with diseases of cardiovascular system. Instrumental  methods of examination in pulmonology. Main cardiological syndromes

6

3.03.- 31.03.  09

6

Acute rheumatic fever. Chronic rheumatic heart disease.  Definition. Etiology.  Pathogenesis. Clinical pattern, diagnostics. Treatment. Prophylaxis. 

Bacterial endocarditis. Etiology and pathogenesis. Clinical pattern, diagnostics. Treatment. Prophylaxis.

The role of a doctor-dentist   in prophylaxis.

6

18.03.- 3.04. 09

7

Mitral heart defects. Ethiology, pathogenesis, clinical pattern, diagnostics, treatment.  Prophylaxis

Aortal heart defects. Ethiology, pathogenesis, clinical pattern, diagnostics, treatment.  Prophylaxis

Atherosclerosis. Ischemic heart disease. Sudden coronary death.

6

7.04. -23.04. 09

8

Angina pectoris. Clinical pattern. Diagnostics. ECG and ultrasound diagnostics. Treatment. Prophylaxis.  Emergency care. Complications.

Myocardial infarction. Definition.  Clinical pattern. Diagnostics. Emergency care Complications of MI: cardiogenic shock, acute left-ventricular failure. Diagnostics.  Emergency care in ambulatory conditions. Treatment. The role of  a doctor-dentist in primary prophylaxis.

6

13.04. -28.04. 09

9

Cardiac arrhythmias: extrasystoly, paroxismal tachycardia. Definition. Etiology.  Pathogenesis. Clinical pattern. ECG diagnostics. Treatment. Prophylaxis.  Electrodefibrillation. Tactics of a doctor-dentist.

Atrial fibrillation, heart blocks, Morgagni-Adams-Stocks attack. Etiology.  Pathogenesis. Clinical pattern. ECG diagnostics. Treatment. Prophylaxis. Tactics of a doctor-dentist. 

6

22.04.-21.05. 09

10

Arterial hypertension. Definition. Etiology.  Pathogenesis. Classification. Clinical pattern.  Treatment.

Symptomatic arterial hypertensions. Etiology.  Pathogenesis. Classification. Clinical pattern.  Treatment Hypertonic crisis.  Clinical pattern. Classification. Emergency care. Prophylaxis of complications

6

6.05.-5.06. 09

11

Arterial hypertension. Acute vascular insufficiency: faint, collapse, shock. Diagnostics. Emergency care. Tactics of  a doctor-dentist   in ambulatory conditions.

Acute and chronic heart failure. Definition. Etiology.  Pathogenesis. Classification. Clinical pattern. Diagnostics. Treatment. Emergency care.

6

27.05.-16.06. 09

12

Clinical, instrumental and laboratory methods of examination in rheumatology. Ostheoarthrosis.

Остеоартроз. Classification. Clinical pattern.  Diagnostics Treatment.

6

12.06.-25.06. 09

 

 

 

 

Types of independent students’ work

Topic

Hours quantity

1

Preparation for practical lessons theoretical and training in methods of physical examination of a patient:           

 

 

inquiry of patients with diseases of internal organs       

3,5

 

– general inspection of  a patient, inspection of separate parts of his body           (head, neck, rtunk, limbs, chest, abdomen)

4

 

– palpation of a chest

1

 

comparative and topographic percussion of a chest

2

 

auscultation of lungs

3

 

palpation of a heart region

1

 

determination of pulse qualities

1

 

percussion of relative and absolute cardiac dullness borders

1

 

auscultation of a heart

3

 

           superficial palpation of abdominal wall and deep sliding methodical palpation of  intestine, stomach, liver, spleen, kidneys

2

 

determination of liver and spliin dimensions by percussion

1

2.

Possessing of practical skills in instrumental investigations performance:

 

 

spirography and pneumotachimetry

1

 

recording of ECG and PCG

2

3.

Posessing of abilities to analyse:

 

 

the results of external respiratory function investigations

1

 

data of ECG and PCG

7

 

the results of stomach and duodenal  contents examination

1

4.

Independent work at the topics have beeot included into the plan of auditorial classes:

ECG investigation in combined  disorders of heart rrhythm

 

 

2

5.

Management of a patient and recording of anamnesis data in the form of a case history

2

6.

Individual activity:

Examination of  external respiratory function in typical patients, analysis of obtained data and report in the class

  Registration of ECG, participation in instrumental examinations in typical patients, analysis of obtained data and report in the class

Examination of a typical patient and preparation of literature summary about the investigated case

 

2

 

2

 

 

2

7.

Preparation for final control of mastering module 1

4

 

Total

48,5

 

 

 

The Head of the Department                                    Prof. S.M.Andreychyn

 

 

 

1.5.          FORMS OF CONTROL AND EVALUATION OF STUDENTS ON THE SUBJECTINTERNAL DISEASES PROPEDEUTICS

Forms of control and system of evaluation are performed according to the requirements of the Typical Program and Instructions about the system of evaluation of students education activity approved by the Ministry of health Protection of Ukraine   (2005).

The mark for the module is determined  as a summation of the current aducational activity (in points) and the mark for the total module control (in points). The last one is put at evaluation of theoretical knowledge and practical skills according to the lists determined by the Program.

At the current and final stage  of each content module the following methods of control are used: computer tests, cheking of practical skills of examination of patients with diseases of internal organs and interpretation of obtained data, analysis of the results of instrumental and laboratory examinations.

Evaluation of the current and final aducation activity:

After each topic within one module it should be equal and is determined with the amount of topics in the module.

The current evaluation of students on correspondent topic is performed according to the traditional 4 point system (excellent, good,  satisfactory, unsarisfactory) and with the following calculation into the multipoint scale.

“Excellent” mark is put when a student knows the content of the lesson and lecture material in full volume, completes his answer with different examples, gives completely exact and clear answers without any guide questions, answers without any mistakes  and inexactness, freely solves real life situations (tasks) and performs practical  skills of differend degree of complication.

“Good” mark  is put when a student knows the content of the lesson and understand it well, answers for questions correctly,  consequently and systematically, but the answer is not  complete, but the student can answer for additional questions without mistakes, he solves all real life situations (tasks) and feel difficulties only in complicates cases.

“Satisfactory” mark is put for a student on the basis of his knowledge of all the lesson content and if he understand this content satisfactory. The student is able to solve changed ( by simplification) tasks after guide questions,  solves real life situations (tasks) and performs practical skills and feels difficulties in simple cases, he is not able to deliver answer independently and systematically, but when is asked directly  he answers correctly.

“Unsatisfactory” mark is put when student’s knowledge and abilities don’t correspond to the requirements for the mark “satisfactory”.

 

Evaluation of independent students work

Evaluation of independent students work is performed during the current control of the topic at correspondent auditorial class. Evaluation of topics which are not included into the plan of practical lessons are performed at final module control.

Calculation of the mark on multipoint scale is performed taking into account of quantity of practical lessons in each module: in the module 1-22 lessons, in the module 2 – 12 lessons.

 

Criteria of evaluation of students in mastering module 1. maximal points of evaluatuin of the module

Module 1. Main methods of examinations of patients in the clinics of diseases of internal organs

Maximal point for the topic

Content

module 1

Content

module 2

Content

module 3

Content

module 4

Content

module 5

Case history

Students individual work

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

3

7

Calculation of students’  current progress in mastering module 1:

 “Excellent” mark-5 points

“Good” mark  4 points

“Satisfactory” mark – 3 points

“Unsatisfactory” mark – 2 points

 

Students can take maximum 120 points for the current evaluation/ This mark is elaborated by multiplication of amount of points have been taken for “excellent” marks on the amount of topics in the module plus amount of points for individual student’s work (maximum 7) and evaluation of a case history (maximum 3).

 

Criteria of evaluation of  a case history (module 1):

3 points – it is written methodically correctly without any remarks;

2 points – it is written methodically correctly, but there are some chapters writteot enough detailed;

1 point – there are some remarks about detalisation and sequence of description;

0 points – the scheme and rules of description are changed (in this case the student must rewrite the case history with taking into account teacher’s remarks).

Minimal quantity of points a student can take in studeing module 1 is equal to 67 ( З х 22 + 1 = 67).

 

Total module control of module 1.

A student is allowed to pass the final control  when he has not less than 67 points for the current study.  This control means answer for 40 questions of test control, demonstration of practical skill (from the list mentioned above) and analysis of the results of instrumental examination of a patient (real-life situation). Maximal points quantity a student can take at control is 80, this includes points for test control (maximum 40 points), real-life situation ( maximum 10 points) and  practical skill (maximum 30 points).

 

Criteria of evaluation of practical skill:

– Performed without mistakes – 30 points;

         performed with non-sufficient mistakes and corrections made by the student himself – 20 points;

         performed with mistakes and corrections made by a teacher – 10 points;

         is not performed – 0 points.

 

Final control is count when a stunned has not less than 50 points (not less than  30 points for test control, 10 points for real-life situation with demonstration of practical skill).

 

 

Criteria of evaluation of students in mastering module 2. maximal points of evaluatuin of the module

 

Maximal point for the topic

Content

module 6

Content

module 7

Content

module 8

Content

module 9

Students individual work

1

2

3

4

5

6

7

8

9

10

11

12

9

9

9

9

9

9

9

9

9

9

9

9

12

 

 

Calculation of students’  current progress in mastering module 1:

 “Excellent” mark-5 points

“Good” mark  4 points

“Satisfactory” mark – 3 points

“Unsatisfactory” mark – 2 points

The Head of the Department                                    Prof. S.M.Andreychyn

 

 

 

 

 

 

 

 

 

The list of questions for the final control of  mastering

 

1. The Kyiv therapeutical school: inculcation of  V.Pbrastsov, Т.H.Yanovsky, М.D.Strazjesko, V.М.Іvanov, В.H.Vasilenco, М.М.Huberhritz into the development of medicine.

2. methodological principles of diagnostics of internal ograns.

3. Main methods of internal diseases diagnostics.

4. The scheme of inquiry of a patient. Main structural components of anamnesis.

5. Sequence of performance of general inspection of a patient.

6. Types of body built and their main criteria.

7. The sequence of lymph nodes palpation and characteristics of obtained data.

8. Rules of inspection of a head and a neck.

9. The sequence of inspection of a trunk and limbs.

10. Static inspection of a chest, diagnostic value of main symptoms.

11. Dynamic inspection of a chest, diagnostic value of main symptoms.

12. Inspection of heart region, diagnostic value of main symptoms.

13. Sequence of performance of inspection of an abdomen, determination of maon symptoms.

14. main peculiarities of pulse, rules and sequence of their determination

15. Rules of taling blood pressure.  Determination of systolic and diastolic pressure by Korotkov method, calculation of pulse and middinamic pressure.

16. Palpation of a chest: sequence of performance, clinical value of main symptoms.

17. Palpation of  heart region: determination and clinical value of main symptoms.

18. Superficial palpation of an abdomen: algorrhythm of performance and analysis of obtained data.

19. Theoretical basis and principles of deep methodical sliding palpation of an abdomen.

20. Palpation of a sigmoid, cecum, terminal part of ileum, their properties iorm.

21. Rules of palpation of ascending and descending colon, their properties iorm.

22. Methods of determination of the stomach lower border position.

23. Palpation of transverse colon, its main properties.

24. Rules of palapation of a liver, diagnostic meaning of obtained data

25. palpation of a spleen

26. Methods of determination of fluid in abdominal cavity.

27. Sequence of comparative percussion of lungs. Main percutory sounds and mechanism of their creation.

28. Sequence of topographic percussion of lungs. Topographic parameters of lungs in norm and in pathology.

29. Percussion of a heartrelative heart dullness: normal borders and their displacement in changes of heart chambers.

30. Percussion of a heartabsolute heart dullness: normal borders and their displacement due to intracardial and  extracardial causes.

31. Percussion of vascular bundle, its diagnostic value.

32. Percussion of a liver by Obrastsov method: sequence of performance, parameters iorm and in pathology.

33. Percussion of a liver by Kurlov method: sequence of performance, parameters iorm and in pathology.

34. percussion of a spleen. Rules of performance, causes of spleen enlargement.

35. Auscultation of lungsdetermination of main respiratory sounds, changes of their quantity and quality

36. Auscultation of lungsdetermination of adventitious respiratory sounds, their classification, algorrhythm, characteristics of auscultatorial pattern of lungs.

37. Mechanisms of creation and types of rales, their diagnostic meaning.

38. Main causes of creation of crepipation and pleural friction. Their diagnostic meaning and differentiation.

39. Rules and sequence of investigation of bronchophonia, its diagnostic meaning.

40. Auscultation of a heartheart sounds,  mechamism of their creation and changes of their intensity and timbre.

41. Splitting and reduplication of heart sounds, accentuation of heart sound.

42. Adventitious  heart soundstriple and gallop rrhythms.

43. Auscultation of heart murmurs: classification and conditions necessary for development.

44. Auscultation of heart murmurs: sequence, characteristics, diffenetce between organic and relative murmurs.

45. Daistolic relative murmurs (Flints murmur, Cumbs murmur, GrahamSteel murmur): conditions necessary for development and diagnostic meaning

46.  Rules of analysis of ECG. Calculation of heart rate and determination of heart electrical axis position.

47. ECGsigns of disorders of automaticity.

48. ECGsigns of disorders of excitability. Differentiation of main types of extrasystoles.

49. ECGsigns of disorders of conduction. Classification of disorders of conduction.

50. ECGsigns of atrial flutter and fibrillation. Mechanisms of their development.

 

 

 

1.8.          Sources of information:

Main:

1.                                                                            Barbara Bates. A Guide to Physical Examination. Third Edition. J.B.Lippincott Company. Philadelphia.

2.                                                                            Macleod’s clinical examination. Edited by G.Douglas, F.Nicol, C.Robertson. 11th edition.

3.                                                                            Ivashkin V., Okholobystin A. Internal diseases propedeutics. Texbook. Moscow, 2005.

4.                                                                            Vasylenko V. Propaedeutics of internal diseases. Mosow, 1989. – 647 p.

5.                                                                            Bogolubov I. Internal diseases. Moskow, 1987.

6.                                                                            Thung S. N., Gerber M.A.. Liver diseases. Differential  diagnostics in pathology. – 1995. – 163 p.

7.                                                                            Braunwald W., Petersdorf I., Root M.F.. Harrison’s principles of internal medicine. 12th edition. – 1991. – 750 p.

8.                                                                            Chamberlain’s clinical examination. 9th edition. 1998.

9.                                                                            Hampton J.R.. The E.C.G. made easy. – 1992. – 100 p.

 

Additional:

10.                                                                        Falk S.A.. Thyroid disease. Endocriniligy, surgery, medical  medicine and radio-therapy. – 1990. – 600 p.

11.                                                                        The thyroid. A fundamrntal and clinical Text. 3rd edition. – 1971. – 870 p.

12.                                                                        Medical management of type 2 diabetes. 4th edition. American Diabetes Association. – 1998. – 139 p.

13.                                                                        Smith W.. Diabetes, liver and digestive disease. – 1988. – 150 p.

14.                                                                        Vhernecky C.C., Krech R.L., Berger B.J.. Laboratory tests and diagnostic procedures. – 940 p.

15.                                                                        McCombs R.P.. Fundamentals of internal medicine. A physiologic and clinical approach to disease. – 1971. – 860 p.

16.                                                                        Wynyarden J.B., Smith L.U.. Textbook of medicine. In 2 vol. – 1982.

17.                                                                        R.O. Branderburg, V. Fuster, E.R. Guiliani, D.S. McGoon. Cardiology. Fundamentals and practice. In 2 vol. – 1987.

18.                                                                        Cardiology. Heger J.W., Roth R.F., Niemann J.T., Crilly J.M. 3rd edition. – 1982. – 370 p.

19.                                                                        Cohn P.F.. Silent myocardial ischemia and infarction. 3rd edition. – 1993. – 260 p.

20.                                                                        A. Simmonds. Hematology. A combined theoretical and technical approach. – 1989.

21.                                                                        Textbook of advanced cardiac life support. American Heart Association. 2nd edition. – 1990. – 298 p.

22.                                                                        The practice of cardiology. Eagle K.A., Haber E., DeSanctis R.W., Austen W.G. 2nd edition. – 1980. – 890 p.

23.                                                                         Duerinckx A.I., Higgins Ch.B., Pettigrew R.I.. MRI of the cardiovascular system. – 1994. – 284 p.

24.                                                                        DeWeerdt S.E.. Vital  signs. Discoveries in diseases of the heart, lungs and blood. – 1998. – 260 p.

 

 

 

 

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