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Practical classes

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1. /propedvnutrmed 2011 2012/propedvnutrmed_bioetika 3/KTP_CPC_UA.doc
2. /propedvnutrmed 2011 2012/propedvnutrmed_bioetika 3/KTP_UA.doc
3. /propedvnutrmed 2011 2012/propedvnutrmed_bioetika 3/MVOPR_EN.doc
4. /propedvnutrmed 2011 2012/propedvnutrmed_bioetika 3/MVOPR_UA.doc
5. /propedvnutrmed 2011 2012/propedvnutrmed_bioetika 3/PROGRAM.doc
6. /propedvnutrmed 2011 2012/propedvnutrmed_bioetika 3/Time_EN, UA, RU.doc
7. /propedvnutrmed 2011 2012/propedvnutrmed_doglyad 2/KTP_EN .doc
8. /propedvnutrmed 2011 2012/propedvnutrmed_doglyad 2/KTP_UA.doc
9. /propedvnutrmed 2011 2012/propedvnutrmed_doglyad 2/MVOPR_EN.doc
10. /propedvnutrmed 2011 2012/propedvnutrmed_doglyad 2/MVOPR_UA.doc
11. /propedvnutrmed 2011 2012/propedvnutrmed_doglyad 2/PROGRAM.doc
12. /propedvnutrmed 2011 2012/propedvnutrmed_doglyad 2/Time_EN, UA, RU.doc
13. /propedvnutrmed 2011 2012/propedvnutrmed_doglyad 2/VOPR_EN 10.doc
14. /propedvnutrmed 2011 2012/propedvnutrmed_doglyad 2/VOPR_UA 10.doc
15. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/ISTORIA_UA.doc
16. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/KTP_EN.doc
17. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/KTP_UA .doc
18. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/KTP_UA.doc
19. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/MVOPR_EN.doc
20. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/MVOPR_UA.doc
21. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/OTHER_EN.doc
22. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/OTHER_UA.doc
23. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/PROGRAM.doc
24. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/TIME_UA.doc
25. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/VOPR_EN.doc
26. /propedvnutrmed 2011 2012/propedvnutrmed_propedvnutrmed 3/VOPR_UA.doc
27. /propedvnutrmed 2011 2012/propedvnutrmed_sestr/KTPSelf _worc.doc
28. /propedvnutrmed 2011 2012/propedvnutrmed_sestr/KTP_CPC_UA.doc
29. /propedvnutrmed 2011 2012/propedvnutrmed_sestr/KTP_EN.doc
30. /propedvnutrmed 2011 2012/propedvnutrmed_sestr/KTP_UA.doc
31. /propedvnutrmed 2011 2012/propedvnutrmed_sestr/MVOPR_EN.doc
32. /propedvnutrmed 2011 2012/propedvnutrmed_sestr/MVOPR_UA.doc
33. /propedvnutrmed 2011 2012/propedvnutrmed_sestr/PROGRAM.doc
34. /propedvnutrmed 2011 2012/propedvnutrmed_sestr/Time_EN, UA, RU.doc
Декан лікувального факультету 27. 01. 2012 р. Протокол №8
Проф. С. М. Смірнов 2012р
List of questions for the preparation to module determination of notion „safety of vital functions”
Перелік питань для засвоення модулю визначення поняття „безпека життєдіяльності”
На кафедрі пропедевтики внутрішньої медицини у весняному семестрі
“confirmed” Confirmed at the Сhair Sitting 2012
Затверджую затверджено на засіданні кафедри
List of practical skills for final module control in “taking care of patients
Перелік практичних навичок для підсумкового модульного контролю з виробничої практики "догляд за хворими терапевтичного профілю"
Міністерство охорони здоров’я україни дз „луганський державний медичний університет”
На кафедрі пропедевтики внутрішньої медицини у весняному семестрі
Questions for studies in taking сare of (looking after)
Перелік запитань
Методичні рекомендації з клінічного обстеження хворого терапевтичного профілю І методики написання історії хвороби на кафедрі пропедевтики внутрішньої медицини
“Confirmed” Confirmed at the Сhair Sitting
Затверджую затверджено на засіданні кафедри
Проф. Смірнов С. М. 2010р
Main purposes and objects of study of propaedeutic medicine
Перелік теоретичних питань
Methodical directions for the i-st III- rd year students
На кафедрі пропедевтики внутрішньої медицини у осінньому семестрі
Practical classes
Перелік питань, що підлягають вивченню на практичних заняттях з пропедевтики внутрішньої медицини
“confirmed” confirmed at the Сhair Sitting 2011
Календарно-тематичний план
Confirmed” “confirmed” at the Сhair Sitting
Затверджую затверджено на засіданні кафедри
List of practical skills for final module control „basic duties and professional actions of medical nurse of therapeutic departament”
Перелік практичних навичок для підсумкового модульного контролю з модулю 1 „основні обов'язки та професійні дії медичної сестри терапевтичного відділення”
Міністерство охорони здоров’я україни дз „луганський державний медичний університет”
На кафедрі пропедевтики внутрішньої медицини у весняному семестрі


Theme of

practical classes

Questions for Studying


Role and position of propaedeutics of internal diseases among clinical disciplines of therapeutic specialization.

  1. Propaedeutics of internal medicine as introduction in clinical practice.

  2. History of formation of propaedeutics of internal medicine in Ukraine and abroad.

  3. Contribution of well-known clinicians M.Ya. Mudrov, G.А.Zakharyin, S.P.Botkin, О.О.Оstroumov, T.G. Yanovskiy, V.P. Obraztsov, M.G. Kurlov, M.М. Gubergrits, М.D. Strazhesko, М.P.Konchalovskiy, М.V.Chernorutskiy, G.F.Lang, О.L.Мyasnikov, B.S.Shklyar to the progress of home propaedeutic school.

  4. Main purposes and objects of study of propaedeutic medicine.

  5. Main methods of examination of patients in clinic of internal diseases: physical, instrumental, laboratory.


Scheme of Case Record. Questioning of patient.

  1. Medical case history: its main units and writing rules.

  2. Method of questioning of patient and its diagnostic value carrying out with taking into account individual, intellectual and psychological peculiarities of patient.

  3. Main structural parts of questioning: (passport part, complaints of patient, additional inquiry on systems and organs, anamnesis of disease, anamnesis of life).

  4. Role of Ukrainian and Russian clinical scientists in development of professional craft of patient’s questioning.


General visual examination of patient.

  1. Methods of carrying out of general examination of patient.

  2. Determination of general condition of patient (states of general conditions and their criteria)

  3. Evaluation of state of patient’s consciousness (types of consciousness disorder), postures, gaits (kinds of patient’s bearing and gaits in different diseases), patients’ positions in bed (active, passive, forced and their variants).

  4. Anthropometric examinations.

  5. Constitutional types and their main criteria.


General visual examination of patient. Visual examination of parts of patient’s body.

  1. Skin and its properties (colour, elasticity, humidity, temperature, rash elements, pigmented nevuses, scars) and pathological changes.

  2. Evaluation of hair and nails condition, subcutaneous fat (development, distribution, types of obesity), state of muscular system and osteoarticular apparatus).

  3. Sequence of lymph nodes palpation.

  4. Diagnostic value of symptoms which were received during general examination of patient.

  5. Methods of carring out and sequence of visual examination of head, neck, extremities and chest, anterior abdominal wall and chest.

  6. Diagnostic value of symptoms which were received during visual examination of separate parts of patient’s body.


Questioning and visual examination of patients with diseases of pulmonary system. Visual examination and palpation of patient’s chest.

  1. Sequence of determination and specification main subjective symptoms.

  2. Their semiotics and evaluation.

  3. Peculiarities of questioning of anamnesis of disease and life.

  4. Methodics ofcarring out of static and dynamic examination of patient’s chest.

  5. Establishment of topographic areas and physiological formations on а patient’s chest and their diagnostic value.

  6. Phisiological and pathological forms of chest and their criteria.

  7. Pathologocal forms of respiration (Cheyne-Stokes, Biot’s, Kussmaul’s, Grokko’s), their characteristics and causes of appearance.

  8. Sequence of carring out of patient’s chest palpation.

  9. Determination of vocal fremitus and semiological evaluation of its results.


Percussion as a method of physical examination of lungs.

Methodics and technique of comparative percussion.

  1. History of percussion development as a method physical examination.

  2. Role of percussion in determination of lungs’ condition.

  3. Percussion classification according to purposes, strength of percussion stroke, methodics of carring out.

  4. Variants and conditions of percussion sounds occurrence.

  5. Main topographic areas and formations on the chest surface.

  6. Main tasks and methodics of carring out comparative percussion of lungs.

  7. Sequence of characteristics and diagnostic value of facts which were received.

  8. Causes of occurrence of dull, tympanic, dull-tympanic, bandbox percussion sounds above the lungs.


Topographic percussion of lungs.

  1. Main topographic lines on the chest surface.

  2. Main tasks and sequence of carring out topographic percussion of lungs.

  3. Determination of upper level of the apices of lungs posteriorrly and anteriorly, width of Krenig’s areas.

  4. Sequence of determination of lower borders of lungs, active and passive mobility of lower borders of lungs. Trauber’s space and its value in lungs pathology.


Auscultation as a method of physical examination of lungs.

Methodics of auscultation of lungs.

Basic respiratory murmurs.

  1. History of progress of auscultation of lungs as a method of physical examination of patient.

  2. Rules of stethoscope and phonendoscope application.

  3. Methods of carring out comparative auscultation of lungs.

  4. Main respiration sounds: vesicular and bronchial respiration their quantitative and qualitative changes, conditions of. their occurrence.

  5. Methodics of determination of bronchophony and its diagnostic value.


Auscultation of lungs: secondary respiratory murmurs (rales, crepitation, pleura friction sound).

  1. Classification of additional respiratory sounds (rales, crepitation, pleura friction sound).

  2. Causes of occurrence of dry and moist rales and their variants.

  3. Diagnostic value of consonating and non-consonating rales.

  4. Conditions of occurrence of crepitation and pleura friction sound.

  5. Differential signs of additional respiration sounds.

  6. Additional auscultative phenomena (Hippocratic’s succusion sound, falling-drop sound (gutta cadens), ‘water pipe’ noise), causes of their occurrence and their diagnostic value.


Instrumental and laboratory methods of examination of pulmonary system.

  1. Indications and methodics of carring out spirography and pneumotachometry.

  2. Main parameters in norm, their changes in obstructive and restrictive variants of respiratory insufficiency.

  3. Acquaintance with method of carring out and diagnostic value of bronchoscopy and bronchography.

  4. Pleurocentesis (thoracocentesis) its carring out technique and laboratory examination of pleural liquid.

  5. Laboratory examination of sputum.

  6. X-ray (roentgenological) examination of chest organs, its variants and diagnostic value.

  7. Computerized tomography of chest organs, main indications for its use.


Physical methods of examination of cardiovascular system. Questioning and general examination of patients with cardio-vascular pathology.

  1. Diagnostic value of main physical methods of examination of cardio-vascular system (questioning,visual examination, palpation, percussion, auscultation).

  2. Sequence of determination and specification of complaints of patient with cardio-vascular disease.

  3. Peculiarities of patient’s interview about history of disease and life.

  4. Carring out general examination of patient with cardio-vascular disease.


Examination of pulse (arterial, venous, pseudocapillary) and arterial blood pressure.

  1. Vessels which are accessible for feeling the pulse (arterial and venous).

  2. Rules and sequence of examination of the pulse on the radial artery.

  3. Determination of main properties of pulse (synchronism, rhythm, frequency (rate), tension, volume, size, velocity, uniformity).

  4. Determination of pulse deficit , lability, paradoxicality, dicrotisity of pulse.

  5. Rules of measuring arterial blood pressure.

  6. Main methods of measuringarterial pressure.

  7. Notion of Korotkov’s tones.

  8. Main parameters which determine data of systolic and diastolic arterial pressure.

  9. Notion of pulse and mediumdynamic arterial pressure.

  10. Normal parameters of arterial pressure according to WHO criteria (1999).


Visual examination and palpation of heart area. Percussion of borders of relative and absolute dullness of heart, determination of heart’s vascular bundle width.

  1. Sequence of carrying out visual examination of heart’s area.

  2. Diagnostic value of heart’s hump, pulsation of heart’s area and neck.

  3. Methods and technique palpation of precardial area: apex beat (localization, area, force, height, resistance, displacement, causes of appearance of negative apex beat).

  4. Heart beat, causes of its appearance and methods of determination; pulsation of epigastric part of aorta liver, Plesh’s symptom, pulsation of ascending part of aorta and its arch, determination of lung trunk’s pulsation.

  5. Presystolic and systolic tremble (“cat’s purr” symptom), causes of appearance.

  6. Notion of relative and absolute heart dullness, their percussion determination (sequence: right, upper, left borders) and changes in pathological conditions.

  7. Anatomical formation which form vascular bundle, percussion determination of its width.


Auscultation of heart.

Normal heart tones. Splitting and reduplication of heart tones. Additional tones (triple and gallop rhythms).

  1. Methods and technique of auscultation of heart according of Kiev therapeutic school.

  2. Main and additional auscultation points.

  3. Areas of projection and the best listening of heart’s valves.

  4. Mechanism of formation of heart tones.

  5. Causes of increased and weekend tones. Tone accent.

  6. Tone’s changes in timbre ( banging, relatively dull, velvet, metal, canon) Notion of splitting and characteristics.

  7. Additional tones – click of mitral valve’s opening, gallop rhythms (protodiastolic, mesodiastolic, presystolic gallop rhythms).

  8. Methodical peculiarities of auscultation of heart- immediate, by stethoscope, phonendoscope: in standing position of patient, in lying position, at rest and physical activity.


Auscultation of heart: organic and functional heart noises.

  1. Causes of appearance and classification heart’s noises (intracardial, extracardial, organic and functional, systolic and diastolic, ejection murmurs, filling, regurgitation ).

  2. Rules of heart’s listening and algorithm of characteristics of heart’s noises: relation to phases heart activity, points the best listening of noises, points their conduction, character, intensity, form, connection with heart’s tones depend on position of patient’s body (vertical, horisontal) and physical exertion.

  3. Determination of auscultative symptoms Sirotinin-Kukoverov and Udintsev.

  4. Notions of functional noises and their difference from organic.

  5. Extracardial noises.

  6. Pericardium friction noise, pleuropericardial noise, cardiopulmonal, “humming-top” (“whirligig”) noise on jugular vein.

  7. Double Trauber’s tone and Vinigradov-Durozye noise on femoral artery: methods of determination, causes and mechanism of appearance.


ECG method of examination, of heart


Method of registration and calculation ECG. ECG-signs of hypertrophy of atriums and ventricles.

  1. Clinico-diagnostic value of ECG method.

  2. Biophysical and physiological basis of ECG.

  3. Structure and function of heart’s pacemakers and conduction system.

  4. Main and additional heart’s ways of electric impulse conduction.

  5. Methods and technique of ECG registration: standard lids, unipolar lids,extremities, chest lids.

  6. Main ECG elements: which indices duration and amplitude waves, duration intervals and segments in norm.

  7. Algorithm and methodic calculation of ECG. ECG –signs of hypertrophy right and left atriums and ventricles.


Infringement of automatism and excitability. Arrhythmias of heart. Clinical and ECG – diagnostics.

  1. Main heart’s anatomical formations which provide of heart’s automatism function.

  2. ECG-signs of heart’s automatism disorders: sinus tachycardia, sinus bradycardia, sinus arrhythmia, weekend sinus-noud syndrom.

  3. Types of extrasystoles.

  4. ECG –signs of sinus, atrial, atrio-ventricular and ventricular extrasystols.

  5. Differentiation of right and left ventricular extrasystoles.

  6. Classification of ventricular extrasystols. Variants of allorhythmias


Blocks of heart. Clinical and ECG diagnostics of infringements of conductivity and excitability (atrial and ventricular flutter and fibrillation). ECG examination in combined disorder of heart rhythm.

Principles of carring out of electric pulses therapy.

  1. Time of conduction impulse along different parts of cardiac conduction system.

  2. ECG –signs of sino-atrial and intra-atrial blocks.

  3. Classification and ECG –signs of atrioventricular blocks.

  4. Stokes-Adams attacks, causes of their occurrence (onset) and clinical picture.

  5. Intraventricular blocks.

  6. Differential diagnostic between right and left branch block of His bundle.

  7. ICG and clinical signs of atrial flutter and fibrillation.

  8. Clinical picture and ECG in different paroxysmal tachycardia, ventricular flutter and fibrillation.
  9. Acquaintance with indicates of carring out and rules of electro-impuls therapy application.


Others instrumental methods examination of cardio-vascular system.

  1. Acquaintance with phonocardiography.

  2. Diagnostic value of method and, methodic and technic registration PCG.

  3. Main principles calculation of PCG.

  4. Polycardiography.

  5. Echocardiography: diagnostic value of method, methodic and technic echocardiography examination.

  6. Main echocardiographic parameters – volumes heart cavities, ejection fraction, (EF), interventricular septum and left ventricul posterior wall thickness.

  7. Doppler ography of heart and vessels.

  8. Phlebography, rheovasographic – diagnostic value of methods.

  9. Methodic and technic examination.


Inspection of students skills and knowledge of instrumental methods examination of cardio-vascular system.

Mastering of ECG- diagnostics of various infringements of a rhythm and conductivity.


Questioning and visual inspection of patients with diseases of digestive system. Visual examination and superficial palpation of abdomen.

Deep methodical sliding palpation (according Obraztsov and Strazhesko) of parts of intestine, stomach, liver.

  1. Inquiry, inspection, palpation, percussion and auscultation patients with diseases of bodies of digestion.

  2. To learn to establish communication (connection) between symptoms and diseases of bodies of digestion (stomach, an intestines, hepato-billary system, pancreas.

  3. Methodic and technique of carrying out of methodical, deep, sliding palpation according to Obraztsov and Strazhesko.

  4. Determination sizes of liver and spleen according to Kurlov.

  5. Symptoms irritation of gall bladder and pancreas revelation points and areas of tenderness.


Instrumental and laboratory methods examination digestive system.

Inspection of patients with diseases of kidneys. The technique of inspection of patients with a pathology of system of urino-excretory systems. Clinical symptoms, laboratory researches of urine, blood and tool (ultrasonic, closed biopsy, roentgenography) of kidneys.

  1. Techniques of a capture of gastric juice and duodenal contents.

  2. Reseach feces, urine, blood.

  3. Evaluation of skills of an estimation of results of blood, urine, coprology, gastric juice and bile and also the instrumental methods examination for diagnostic diseases of digestive system.

  4. Inquiry, inspection, palpation, percussion of patients with diseases of kidneys and urino-excretory ways.

  5. An estimation of results of inspection of urine by Nechiporenko, Zimnitsky, 1-glass and 3-glasses tests.

  6. An estimation of results of tool researches.

  7. Evaluation of skills of an estimation of results of inspection of urine, the blood, the given tool inspection for diagnostics of diseases of kidneys and urino-excretory ways.


Mitral valvular diseases. Tricuspid insufficiency: main symptoms and syndromes which are reveling with instrumental methods of diagnostic.

Aortal valvular diseases: main symptoms and syndromes which are reveling with clinico-instrumental methods of examination.

  1. Symptomathology of mitral regurgitation and mitral stenosis.

  2. Cause of valvula diseases.

  3. Symptomathology and diagnostics aortal valvular diseases


Main symptoms and syndromes at essential arterial hypertension and symptomatic. Hypertensive crises

Ischemic heart disease (IHD): main symptoms and syndromes at stenocardia and myocardial infarction.

  1. Diagnostics of arterial hypertension forms.

  2. Methods of diagnostics of essential [idiopathic, primary] hypertension.

  3. Clinical and additional methods of examination.

  4. Study of clinic of IHD, risk factors.

  5. Diagnostics of different clinical forms.

  6. Diagnostics of myocardial infarction. ECG- signs of large-focal myocardial infarction (with pathologic wave Q – transmural and subepicardial myocardial infarction).

  7. Small-focal myocardial infarction (microinfarction- without wave Q).

  8. Laboratory diagnostics.

  9. Emergency treatment.


Main clinical signs at chronic bronchitis and bronchial asthma.

Chronic obstructive pulmonary diseases.

Syndrom of respiratory insufficiency of broncho-pulmonary system.

  1. A syndrome of infringement of bronchial passableness.

  2. Determination of symptoms of acute and chronic bronchitis, bronchiectatic diseases.

  3. Principles of diagnostic and substantiation of the diagnosis.

  4. Mechanism of bronchial asthma development it symptomatic and tipes.

  5. The urgent help during attacks of the asthma.

  6. The asthmatic status, stages, rendering of the urgent help.

  7. A syndrome of the increased airiness of the lungs (emphysema).

  8. Study of causes, types, forms and steps respiratory insufficiency.

  9. Methods examination of respiratory function.

  10. Evaluation of indexes at different steps of respiratory insufficiency.


Pneumonias (focal and lobar): symptoms and syndromes which are reveling with clinico-instrumental and laboratory methods examination. Abscess of lungs, cancer of lungs. Pneumosclerosis. Main symptoms and syndromes at dry and exudative pleurisies.
  1. Symptomathology and principles of diagnostic and substantiation of the clinical diagnosis.

  2. Syndroms of focal consolidation of lung tissues, cavity in the lung.

  3. Determination of symptoms of pneumonias (focal and lobar) during of clinical examination of the patient.

  4. Symptoms of abscess of lungs and cancer of lungs.

  5. Kinds and the reason of occurrence of pleurisies.

  6. A syndrome of accumulation of a liquid and air in a pleural cavity.

  7. Diagnostics of pleurisies.


Curation (examination) of patients for writing a case history (case report).

Every student will have to examination the patient for writing a case history, acquisition of skills of writing a case history.


Clinico-instrumental and laboratory methods examination of the patients with chronic gastritis, stomach and duodenum ulcer.

Main symptoms and syndromes of the diseases of bill-excretory ways: cholecystitis, cholangitis, pancreatitis, cholelithiasis.

Main clinical and laboratory symptoms of chronic hepatites and cirrhoses.
  1. Examination of patients with diseases of stomach and gall bladder.

  2. Substantiation of the diagnosis.

  3. Main symptoms and syndromes gastritis and stomach and duodenum ulcer.

  4. Examination of the patients with diseases of bill –excretory system, gall-bladder and pancreas.

  5. Clinical picture chronic cholecistitis, cholelithiasis, chronic pancreatitis.

  6. Clinical syndroms at diseases of liver: jaundice, portal hypertension, ascites, hepatomegaly, liver insufficiency, hepatolienal and hepato-renal.

  7. Substantiation of diagnoses of hepatitis and cirrhosis.


Main symptoms and syndromes at diseases of kidneys – acute and chronic glomerulonephritis, pyelonephritis, urolithiasis.

Main symptoms and syndromes in anemias.

Clinical analysis of the blood.
  1. Inquiry, examination, palpation of patients with pyelonephrites, glomerulonephrites, urolithiasis.

  2. Diagnostic of nephrotic syndrome.

  3. Revelation and modern classification of anemias.

  4. Main laboratory criteria of iron-deficiency and pernicious (Biermer's) anemias.

  5. Congenital and acquired hemolytic anemias.

  6. Sins of general anaemic, jondis syndromes, spleno-megaly, hemosiderosis of internal organs.

  7. Analysis and interpretation of clinical analysis of blood.


Main symptoms and syndromes in diabetes mellitus. Main clinical signs diseases of thyroid gland.

Symptomatology diseases of thyroid gland, diabetes mellitus. Emergency treatment of diabetic and hypoglycemic coma.

Defense of a case history.

  1. Examination of the patients with hyper- and hypothyroidisms, diabetes mellitus.

  2. Determination of symptoms of the diseases and formulation of diagnoses.

  3. Treatment of diabetic and hypoglycemic comas.


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