ÌÅÒHODOLOGICAL INSTRUCTION

FOR THE V-th YEAR STUDENTS

foreign students faculty

 

LESSON ¹ 1 (6 hours)

 

Theme 1: Structure and function of immune system. Immunology of the age. Evaluation of the immune state. Methods of the research. Standart immunogramm. Main symptoms of the immune system disorders.

Aim: to form the complete picture of the immunologic anamnesis, structure of immunopathology, to give understanding of 1st, 2nd and 3rd level tests’ results and their interpreting.

Professional motivation: immunologic diagnosis and strategy of therapy of immunopathology depends on the stage of immune homeostasis disorders. So, possibility of immune analysis interpreting is necessary for every doctor.

 

Methodology of Practical Class

Introduction by the teacher, control the initial level of knowledge – 09.00-09.30

Individual students' work with patients - 09.30-12.00

Break – 12.00-12.30

Seminar (discussion of theoretical questions, practical work with patients) - 12.30-14.00

Break – 14.00-14.15

Individual work 1415-1500 (students who didn`t pass the tests in Moodle system, complete the individual work).

 

Algorithm of students’ communication with patients with pathology in subject (communication skills):

During examination of the patient students have to use such communicative algorithm:

Complaints and anamnesis taking in patients

1. Friendly facial expression and smile.

2. Gentle tone of speech.

3. Greeting and introducing.

4. Take complaints and anamnesis in a patient.

5. Explain to the patient results of his/her lab tests correctly and accessibly.

6. Explain to the patient your actions concerning him/her (the necessity of hospitalization, certain examinations and manipulations), which are planned in future.

7. Conversation accomplishment.

Objective examination:

Physical methods of examination of patients with internal diseases

1. Friendly facial expression and smile.

2. Gentle tone of speech.

3. Greeting and introducing.

4. Explain to a patient, what examinations will be carried out and get his/her informed consent.

5. Find a contact with the patient and make an attempt to gain his/her trust.

6. Inform about the possibility of appearing of unpleasant feelings during the examination.

7. Prepare for the examination (clean warm hands, cut nails, warm phonendoscope, etc.).

8. Examination (demonstration of clinical skill).

9. Explain to the patient results of his/her lab tests correctly and accessibly.

10. Conversation accomplishment.

Estimation of laboratory and instrumental investigations

Informing about the results of examination of patients with internal diseases

1. Friendly facial expression and smile.

2. Gentle tone of speech.

3. Greeting and introducing.

4. Explain to a patient results of his/her lab tests correctly and clearly.

5. Involve the patient into the conversation (compare present examination results with previous ones, clarify whether your explanations are clearly understood).

Planning and prognosis the results of the conservative treatment

Friendly facial expression and smile.

1. Gentle tone of speech.

2. Greeting and introducing.

3. Correct and clear explanation of necessary treatment directions.

4. Discuss with a patient the peculiarities of taking medicines, duration of their usage, possible side effects; find out whether your explanations are clear for him/her or not.

5. Conversation accomplishment.

 

WORK 1: Curation of the thematic patient. Taking of immunological anamnesis/

WORK 2: Evaluation of immunogram’s data. Main immunopathologic syndromes.

WORK 3: To compare immunogram in different age.

 

Students' Independent Study Program

1. Cells and tissues of immune system.

2. Antibodies: structure and function.

3. Congenital and acquired immunity.

4. Cytokines: intracellular messengers of proliferation and function. Regulation of immune response.

5. The mucosal immune system.

6. Immunity to microorganisms.

7. Interpreting of immune tests’ results. Normal rates of immune indices.

8. Immune tests’ results in case of acute and chronic inflammation.

9. Immune tests’ results in case of physiologic atipic reaction.

10. The immune response of normal children and elderly people. Immune tests’ interpreting in children elderly people.

Seminar discussion of theoretical issues:

1.           Definition and types of immunity.

2.           Central and peripheral organs of the immune system.

3.           Factors of immunity.

4.           Major histocompatibility complex: structure, properties and function. Regulation of

5.           immunity.

6.           Features immunological history.

7.           Clinical methods for evaluating the immune system.

8.           Instrumental methods for evaluating  the immune system.

9.           Laboratory methods for evaluating the immune system: humoral  innate protective factors, evaluation of cellular immunity comprehensive assessment of  local immunity.

10.      The main complaints of patients with immune disorders.

11.      Features  immunological diagnosis.

12.      Determination of the main symptoms and syndromes of immune disorders.

13.      5. Physical symptoms of immune pathology. Methods of physical examination of patients  with disorders of the immune system (ultrasound, radiology, immunohistochemistry, etc.).

14.      Age features of bone marrow, thymus and peripheral organs limfoyidnyh.

15.      Age features of the functioning of immune cells.

16.      Age features of inflammatory reactions.

17.      The role of maternal immunity in the formation of the child.

18.      Imune system of the fetus, the newborn child i in different age periods.

19.      Thymus and aging. Approaches to the use immunotropic treatment based on age.

 

Test evaluation and situational tasks:

 

1. All the cells are effectors except:

A. T-cytotoxic.

B. NK-cell.

C. Plasma cell.

D. T-helper.

E. None of above

2. How many types of the immune globulines do you know?

A. 6.

B. 3.

C. 4.

D. 5.

E. 2.

3. All the markers are of T-cells except:

A. CD4.

B. CD8.

C. CD3.

D. CD19.

E. None of above

4. What type of immunoglobulins has the most important role in case of acute respiratory infection?

A. IgA.

B. IgM.

C. IgG.

D. IgD.

E. IgE

5. What is the function of plasma cells?

A. participation in immune cooperation.

B. immunoglobulin production.

C. IFN production.

D. participation in neoplasia control.

E. immunosuppression.

6. What is the function of NK-cells?

A. participation in immune cooperation.

B. immunoglobulin production.

C. IFN production.

D. participation in neoplasia control

E. immunosuppression.

7. What class of immunoglobulin increases in case of helminth invasion?

A. IgA.

B. IgM.

C. IgG.

D. IgDE. IgE.

 8. What class of immunoglobulin can go through placenta?

A. IgA.

B. IgM.

C. IgG.

D. IgD.

E. IgE.

 9. All the medicines could be useful in case of anaphylactic reactions except:

A. epinephrine

B. diphenhydramine

C. zaditen

D. dobutamine

E. betametason

10. AIDS is caused by a human retrovirus that kills

A. B lymphocytes

B. lymphocyte stem cells

C. CD4-positive T lymphocytes

D. CD8-positive T lymphocytes

E. None of above

 

Initial level of knowledge and skills are checked by solving situational tasks for each topic, answers in test evaluations and constructive questions (the instructor has tests & situational tasks)

 

Students should know:

1. Cell and tissue of immune system.

2. Antibodies: structure and function.

3. Congenital and acquired immunity.

4. Cytokines: intracellular messengers of proliferation and function. Regulation of immune response.

5. The mucosal immune system.

6. Immunity to microorganisms.

7. Interpreting of immune tests’ results. Normal rates of immune indices.

8. Immune tests’ results in case of acute and chronic inflammation.

9. Immune tests’ results in case of physiologic atypical reaction.

10. The immune response of normal children. Immune tests’ interpreting in children and elderly people.

 

Students should be able to:

1. Analyse 1st level of immune analysis.2. Diagnose allergic reactions and diseases.

3. Diagnose pseudoallergic reactions.

4. Diagnose paraallergic reactions.

5. Choose the treatment for patient with allergic reactions and diseases.

6. Choose the treatment for patient with pseudoallergic reactions.

7. Choose the treatment for patient with paraallergic reactions.

8. Choose the complex of immediate treatment for patient with anaphylaxis

 

Correct answers of test evaluations and situational tasks: 1B, 2D, 3D, 4A, 5B, 6D, 7E, 8C, 9C, 10C.

 

References.

À - Basic:

1.     Stephen Holgate. Martin Church. David Broide Fernando Martinez,  Allergy Hardbound, Published: November 2011.- 432 p.

2.     Mark Peakman. Diego Vergani. Basic and Clinical Immunology with STUDENT. - Imprint: Churchill Livingstone Published: - April 2009.

3.     Roderick Nairn, Matthew Helbert.  Immunology for medical students /  Hardboun - 2012 –326 p.

4.     Web -sites:

a.     http://intranet.tdmu.edu.ua : Structure and function of immune system

b.     http://emedicine.medscape.com/

 

B – Additional:

1.                       Linda Cox.  Allergen Immunotherapy, An Issue of Immunology and Allergy Clinics.- / Published: May 2011.-  Hardbound, - 312 p.

2.                       Dédée Murrell. Autoimmune Diseases of the Skin, An Issue of Immunology and Allergy Clinics. -  Imprint: Saunders.- Published: May 2012.

 

 

Methodical instruction has been worked out by assoc. prof.  Volodymyr Horodetskyy

Methodical instruction was discussed and adopted at the Department sitting: “01” October 2013, Minute ¹3