SHEI ”I

SHEI ”I.Ya.HORBACHEVSKY ТERNOPIL STATE MEDICAL UNIVERSITY”

 

 

 

SYLLABUS

The Curriculum structure on the

“OCCUPATIONAL DISEASES “

 

DEPARTMENT OF INTERNAL MEDICINE № 2

Speciality “Medicine ” (7.110101)

 

On 5 course for 2013 – 2014 st.y.

 

 

 

 

 

 

1. EXPLANATORY MESSAGE AND STRUCTURE OF DISCIPLINE.

In the general system of preparing of doctor, professional pathology is one of the general therapeutic disciplines. The main task of course of professional pathology is to teach students the methods of inspection of the patient, diagnosis and  treatment of the most widespread occupational diseases, the organizational measures of prevention of occupational diseases, principles of conducting of examination of working capacity.

professional diseases as studying discipline:

-is based on studying medical of chemistry, of biological and bioorganic chemistry, medical and biological physics, pathophysiology and pathomorphology, pharmacology and hygiene and ecology, social medicine, organization and economic of public health, internal medicine, dermatology, narcology, neurology, traumatology and is integrited with this disciplines;

-gives the bases of studying by students internal medicine and other clinical disciplines that means the integration of teaching with this disciplines and formation skills of implying this knowledge  from   professional diseases in the process of further studying and in the professional activity;

-gives the bases of healthy life and prophylactic of disturbances of function in the process of working activity.

The educational process is achieved according to the demands of Bolognas process.

According to this plan of teaching of occupational diseases on the V course the amount of hours is 60: 6- lectures, 24 – practical lessons and 30 – individual work .

Discipline “OCCUPATIONAL DISEASES“ consists of 1 modules, which includes blocks of content modules

Module contents:

1. Approaches to occupational diseases diagnosing. Occupational diseases caused by influence of industrial aerosols.

2. Occupational diseases, caused by physical factors and diseases connected with physical exertion of different organs and systems

3. Diseases caused by influence of chemical factors with prevalence action on haemopoetic system.

4. Diseases with predominant affection of respiratory organs, hepatobiliary system, kidneys and excretory tracts,. Diseases caused by action of agricultural chemicals poisonings.

5. Diseases with predominant affection of nervous systems and diseases caused by influence of occupational factors with allergic and carcinogenic action.

Teaching of the basics of occupational diseases at the 5 course conducted by cycle system. Duration of practical class 6 hours. The basis of the purpose of the course – to familiarize students with various aspects of medicine adults.

Studing and improving of history taking, collecting the patient’s chief complaint, history of presentillness, past medical history, social, family, occupational histories and complete a review of systems.Perform a physical examination in a logical, organized and thorough manner. Demonstrate the ability toconstruct an assessment and plan for an individual patient organized byproblem, discussing the likelydiagnosis and plan of treatment.  Demonstrate the ability to record the history and physical in a legibleand logical manner.  Demonstrate the ability to write daily progress notes on the ward and appropriate outpatient progress notes.  Diagnostic Decision Making –Formulate a differential diagnosis based on the findings from the history and physical examination. Use the differential diagnosis to help guide diagnostic test ordering and its sequence. Participate in selecting the diagnostic studies with the greatest likelihood of useful results. Recognize that tests are limited and the impact of false positives/falsenegatives on information.

Test Interpretation.  Therapeutic Decision Making

Students note patients’ clinical data and show them to the teacher every day. At least module teacher evaluates history case and performing of physical examination.

Credit carries out at the last day of module.

According to the curriculum types of students studying work are following, a) lectures, b) practical classes, c) independent work.

Thematic plans of lectures, practical classes and independent studying work realize all topics of content modules. Topics of lectures show problematic questions of corresponding cycles of occupational diseases.

Practical classes (6 hours) are performed in clinical departments.

Patient management includes:

1) Collection of complaints, present illness and past history, family history, review system

2) Performing of physical examination and determination of main symptoms of the disease

3) Interpretation of the results of laboratory and instrumental investigations

4) Making of the diagnosis

5) Prescription of the treatment

6) Determination of primary and secondary prophylaxis

7) Defence of the results of the patient’s examination, discussion of the diagnosing, differential diagnosis, plan of investigation, tactics of treatment, prognosis and work capacity

Independent students work amounts 30 % of studying program. It forms of:

–  Mastering of topics, not included in schedule of practical classes

–  Outclasses students working in the clinical departments, laboratories, interpretation of laboratory and instrumental investigations

–  Mastering of practical skills

–  Individual independent work (participations in conferences, research presentation, articles)

Students are recommended to fulfill patients’ evaluation form, where they record summary of thepatients examination, diagnostic Decision Making –Formulate a differential diagnosis based on thefindings from the history and physical examination. Use the differential diagnosis to help guidediagnostic test ordering and its sequence. Participate in selecting the diagnostic studies with the greatestlikelihood of useful results. Recognize that tests are limited and the impact of false positives/falsenegatives on information.

Test Interpretation.  Therapeutic Decision Making

Student individual work takes 50% of the curriculum. It contains:

– Study of topics not included in the plan classroom

– The work of students in departments of clinical databases departments, including laboratories and offices (offices) functional testing, data interpretation laboratory and instrumental methods in internalpathology in extracurricular time

– Mastering of practical skills using phantoms and work with patients (according to the list)

– Individual bid (speech at the scientific conference clinics, writing articles, report essay on a practicallevel, etc.).

Teachers and support staff of department provide the possibility to perform ISW during the workshopsand final module control conduct monitoring and evaluation of its performance. Topics presented for individual study, evaluated only during the final module control.

 

The curriculum structure of the discipline		Quantity of hours				Course/Year of study	Semester	Type of evaluation
		Total hours/ credits	Audience		Students’ individual work
Module name	Name of module content		Lectures	Practical classes
Module 1.General questions of occupational diseases. Occupational diseases, caused by influence of industrial aerosols, physical and chemical factors.	1. Approaches to occupational diseases diagnosing. Occupational diseases caused by influence of industrial aerosols. 2. Occupational diseases, caused by physical factors  and diseases connected with physical exertion of different organs and systems 3. Diseases caused by influence of chemical factors with prevalence action on haemopoetic system. 4. Diseases with predominant affection of respiratory organs, hepatobiliary system, kidneys and excretory tracts, Diseases caused by action of agricultural chemicals poisonings. 5. Diseases with predominant affection of nervous systems and diseases caused by influence of occupational factors with allergic and carcinogenic action.	60/2,0	6/0,2	24/0,8	30/1	5	Х	Final module evaluation at the end of the semester
Practical skills								OSKI
Total hours/ credits		60/2,0	6/0,2	24/0,8	30/1

 

 AIM OF EDUCATIONAL DISCIPLINE STUDYING.

In lectures on occupational diseases the questions of etiology and pathogenesis of professional diseases, their clinic, treatment, prophylaxis and examination of  working capacity taking into account modern achievements of medicine are substantiated, coming from the theory of integrity of organism and his indissoluble communication with an environment. The aim of studying discipline is to teach students to diagnose the basic diseases caused by professional harmful factors, to be able  to conduct differential diagnosis, to appoint treatment, and to know how to make the of examination of working capacity and prophylaxis.

 

3. CONTENT OF PROGRAM.

Module 1. Common questions of  occupational diseases. Occupational diseases, caused by influence of industrial aerosols, physical and chemical factors.

 Total hours – 60/2:  6- lectures, 24 – practical classes and 30 – students’ individual work.

 

Content module 1. Approaches to occupational diseases diagnosing. Occupational diseases caused by influence of industrial aerosols

Specific aims

 

Students have to:

 

–     define a role and value industrial harmfulness  for development professional diseases;

–     analyze and use data of sanitary and hygienic characteristic of job place for detection of communication of a disease with working conditions;

–     define extent of loss of working capacity in patients with professional diseases;

–  analyze stages of formation of professional pathology as clinical discipline of internal medicine and contribution of some scientists at each stage of development.

–     Organization of previous and periodic medical examination of the workers.

–     Have to develop skills and to acquire experience relevant to management of patients with occupational diseases, in particular those with pneumoconiosis.

-Studing of classification of the pneumoconiosis, etiology, and pathogenesis, clinical and roentgenological characteristics of silicosis, diagnostics, treatment, prophylaxis and examination of working capacity.

– studing of etiology, pathogenesis, clinical and roentgenological picture of silicatosis (asbestosis, cement pneumoconiosis,talcosis). Complications of pneumoconiosis, examination of working capacity. Peculiarities of pneumoconiosis of electric welder.

– Performing of clinical exam of patients with pneumoconiosis. Reveal main clinical syndromes of pneumoconiosis.  Draft a plan of laboratory and instrumental evaluation of patients with pneumoconiosis. Assess the results of laboratory and instrumental evaluation of patients with pneumoconiosis. Diagnose the condition and formulate the diagnosis according to current classification.Perform differential diagnosis of pneumoconiosis. Prescribe the appropriate therapy of patients with pneumoconiosis.

 

Theme №1.General questions of professional pathology.

 Concept, subject and problems of professional pathology, its place among clinical and hygienic disciplines.

 Organization of professional pathological service and structure of professional incidence.

Main stages of development and formation of professional pathology as sciences and as studying subject and contribution of some scientists at each stage of development. The solution of questions of working capacity in patients with professional diseases.

Studying of classification of professional harmfulness and classification of the occupational diseases.

Characteristic to the physical, chemical and biological factors of production environment and working process.

Peculiarities of clinical examination of the patients with professional diseases.

Main tasks of examination of working capacity. Value of the analysis professional route of the patient with professional diseases.

Principles of the diagnostics, treatment and prophylaxis of the occupational diseases.

To make the examination of working capacity. Organization of previous and periodic medical examination of the workers of industrial factories and of agriculture.  The main task of previous medical examination. Prophylaxis of professional diseases.

 

Theme 2. Pneumoconiosis.

Concept about a pneumoconiosis. Etiology, pathogenesis and classification of pneumoconiosis. Radiological, clinical and functional characteristic of pneumoconiosis.Clinical picture, roentgenological forms and stages of silicosis. Etiology, pathogenesis, clinical picture and  stages of  silicatosis (asbestosis, talcosis).  Differential diagnostic of pneumoconiosis. Complications, treatment and prophylaxis of pneumoconiosis.  Examination of working capacity.Disease pneumoconiosis of electric welder. Clinical picture and peculiarities of pneumoconiosis of electric welder. Treatment and prophylaxis of pneumoconiosis of electric welder. Examination of working capacity.

 

Theme 3. Chronic  bronchitis and chronic obstructive pulmonary disease of dusting etiology.

Chronic  bronchitis and chronic obstructive pulmonary disease of dusting etiology. Etiology, pathogenesis, clinical picture and classification. Treatment and prophylaxis of chronic obstructive pulmonary disease of dusting etiology. Examination of working capacity.

 

Content module 2. Occupational diseases, caused by of physical factors and diseases connected with physical exertion of different organs and systems

Specific aims

 

Students have to:

–develop skills and to acquire experience relevant to management of patients with occupational diseases, in particular those with vibration disease.

–  study to put vibration disease diagnose, that is caused by local and general vibration of different parameters, to study methods of functional diagnostics and treatment of the patients with vibration disease.

– study to diagnosed altitude sickness and decompression sickness, methods of clinical diagnostics, to study principles of treatment and prophylaxis of occupational diseases, caused by physical factors.

– study professional route of the patient with vibration disease, altitude sickness and decompression sickness. To make the examination of working capacity of patients with vibration disease, altitude sickness and decompression sickness.

-make on objective examination and laboratory and instrumental examination of the patients with vibration disease,altitude sickness and decompression sickness To make differential diagnosis of vibration disease, altitude sickness and decompression sickness. Prescribe the treatment to patients with vibration disease, altitude sickness and decompression sickness.

– Examination of working capacity of patients with vibration disease, altitude sickness and decompression sickness.

 

Theme 4. Vibration disease and neurosensory deafness.

Etiology, classification and pathogenesis of vibration disease. Specific signs and symptoms of vibration disease. Main clinical syndromes in vibration disease.  Clinical forms, stages and clinical manifestations of vibration disease. Laboratory and instrumental examination of patients with vibration disease.  Differential diagnosis of vibration disease.  Principles of treatment and prophylaxis of vibration disease. Etiologyand pathogenesisofneurosensory deafness.

Theme 5. Altitude sickness and decompression sickness.

Etiology, classification and pathogenesis of altitude sickness and decompression sickness. Specific signs and symptoms of altitude sickness and decompression sickness. Clinical forms, stages of altitude sickness and decompression sickness. Laboratory and instrumental examination of patients with altitude sickness and decompression sickness, differential diagnosis of altitude sickness and decompression sickness. Principles of treatment and prophylaxis of altitude sickness and decompression sickness.  Examination of working capacity.

 

Content module 3. Diseases caused by influence of factors with prevalence action on haemopoetic system.

Specific aims

Students have to:

–     study pathogenesis of chronic intoxication by benzol, clinical picture, diagnostics, treatment, prophylaxis and to make examination of working capacity;

–     study toxicological characteristic of nitrocompounds and oilsperses of benzol;

–     study pathogenesis, clinical picture, diagnostics, treatment and prophylaxis of intoxications;

–     study to diagnosed chronic intoxication by lead, to make differential diagnosis and to prescribe treatment, to make examination of working capacity.

Theme 6. Professional intoxication by benzol.

Properties of benzene, ways of occurrence of benzene to an organism. Pathogenesis of chronic intoxication by benzol. Clinical picture and forms of intoxication by benzol. Evaluation of basic signs and symptoms of intoxication by benzole. Diagnostics of intoxication by benzol. Differential diagnosis of intoxication by benzole. Treatment and prophylaxis. Examination of working capacity.

Theme 7. Professional intoxication by nitrocompounds and oilsperses of benzol. Intoxication by carbon oxide.

Pathogenesis of chronic intoxication by nitrocompounds and oilsperses of benzol. Clinical picture and forms of intoxication by nitrocompounds and oilsperses of benzol. Diagnostics of intoxication by nitrocompounds and oilsperses of benzol. Treatment and prophylaxis of intoxication by nitrocompounds and oilsperses of benzol. Pathogenesis of chronic intoxication by carbon oxide.Clinical picture and forms of intoxication by carbon oxide.  Diagnostics and differential diagnosis of intoxication by carbon oxide. Treatment and prophylaxis of intoxication by carbon oxide. Examination of working capacity.

Theme 8. Professional intoxication by lead. Acute and chronic toxicity of arsenic compounds

Pathogenesis of lead intoxication. Main symptoms of lead intoxication. Clinical picture and forms of lead intoxication. Principles of treatment of patients with intoxication by lead. Prophylaxis of intoxication by lead. Examination of working capacity.

Ways of penetration of poison into the body. Pathogenesis. The clinical picture, the major syndromes. Features of the course. Changes in blood. Prevention and treatment. Examination of working capacity and rehabilitation.

 

Content module 4. Diseases with predominant affection of respiratory organs, hepatobiliary system, kidneys and excretory tracts. Diseases caused by action of agricultural chemicals poisonings.

Specific aims

Students have to:

–     develop skills and to acquire experience relevant to management of patients with occupational diseases, in particular those with  toxic  affection of respiratory organs, hepatobiliary system, kidneys and excretory tracts;

–     study etiology, pathogenesis, clinical picture and stages of the intoxication, diagnostics, treatment and prophylaxis of toxic  affection of respiratory organs, hepatobiliary system, kidneys and excretory tracts;

–     Relevant terminology, definitions and classifications of intoxication by agriculture chemical poisonings.

–     Evaluation of basic signs and symptoms of intoxication by agriculture chemical poisonings.

–  Methods of physical examination, laboratory and instrumental evaluation  of patients with intoxication by agriculture chemical poisonings.

–     Principles of management patients with intoxication by agriculture chemical poisonings.

–     Prophylaxis of intoxication. Examination of working capacity.

 

Theme 9. Occupational intoxication with pesticides used in agricultural work

Occupational poisoning by agricultural chemicals. Classification of pesticides. Acute and chronic poisoning by chlorine ,phosphorus , and arsenic compounds , derivatives of carbamic acids. Pathogenesis of intoxication . Clinical implications.Possible complications. Prevention. Therap . The issue of drug- employment examination and vocational rehabilitation .

Acute and chronic lung toxic- chemical etiology. Chemicals toxic and irritating action . Pathogenesis . Acute lesions of bronchopulmonary system. Clinical and morphological forms of acute and chronic toxic lesions of bronchopulmonary system: pulmonary edema, bronchitis and toxic pneumonitis. Diagnosis . Treatment. Prevention and treatment.Examination of working capacity and rehabilitation.

 

Content module 5. Diseases with predominant affection of nervous systems and diseases caused by influence of occupational factors with allergic and carcinogenic action.

Specific aims

 

Students have to:

–     develop skills and to acquire experience relevant to management of patients with occupational diseases, in particular those with intoxication by agriculture chemical poisonings;

–     study toxicological characteristics of phosphorus organic and arsenic substances, chlorine organic and mercury organic substances that is used in agriculture;

–     study their etiology, pathogenesis, clinical picture, diagnostics, to make differential diagnostics and to prescribed treatment, to make examination of working capacity;

–     study the main principals of emergency treatment of acute professional intoxications in place of accident and in hospitals.

Theme 10. Occupational neurotoxicosis.

Pathogenesis of intoxication by tetraethyl lead, by manganese, by mercury.  Clinical picture and forms of intoxication by tetraethyl lead, by manganese, by mercury. Diagnostics of intoxication by tetraethyl lead, by manganese, by mercury. Treatment and prophylaxis of intoxication by tetraethyl lead, by manganese, by mercury. Examination of working capacity.Pathogenesis of intoxication with chlorinated hydrocarbon. Clinical picture and forms of intoxication with chlorinated hydrocarbon. Diagnostics of intoxication with chlorinated hydrocarbon. Treatment and prophylaxis of intoxication with chlorinated hydrocarbon. Examination of working capacity.

Professional cancer. Tumours of organs of breathing, digestive system , urinary bladder. Connections which can cause the oncologic diseases of professional etiology. etiology, pathogenesis, clinical pictures. Methods of physical examination, laboratory and instrumental evaluation. Treatment, examination of working capacity and rehabilitation.