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MINISTRY of HEALTH of UKRAINE

BUKOVYNIAN STATE MEDICAL UNIVERSITY







«ASSERT»


Act. prorector
of educational work

Professor. Yu.T.Akhtemiychuk

«____» ___________ 2009




Reference book for students of STUDY OF DISCIPLINE


Internal medicine (module 2)


(structure, goals, content of the subject, principles of rating, control questions)


Student’s reference book is composed on the basis of actual educational plan and program on educational subject of “internal medicine” for students of higher medical educational institutions of III-IVth accreditation levels (MHP of Ukraine, K., 2008).


It is approved on the methodical conference of the department of internal medicine, clinical pharmacology and occupational diseases on June, 15, 2009 (protocol № 41) and on meeting of subject methodical commission on therapeutic disciplines on June, 24, in 2009 (protocol № 16)


^ Chief of the department of internal

medicine, clinical pharmacology and

occupational diseases, professor O.S. Chuchlina


Chief of the subject methodical commission

on therapeutic disciplines, professor V.K.Tashchuk


Chernivtsi, 2009


Educational discipline is «Internal medicine»

1. Introduction

Definition of the subject

Quantity of educational hours: 270 (9 credits ECTS), including: lectures – 30 hours.

Practical tutorials: 150 hours.

Independent work of students – 90 hours.

Contents of the subject is structured into 4 modules and 9 contents modules.


^ 2. The structure of “Internal Medicine” (module 2) discipline and calculation of balls for current learning activity (convertation of traditional marks into balls; rating in balls for completion of individual tasks, if suggested by working educational program).


Module number, quantity of educational hours /quantity of ECTS credits

Quantity of contents modules, their numbers

Quantity of practical tutorials

Convertation of traditional marks into balls

Minimal balls quantity*

Traditional marks

Balls for completion of individual task as a way of SIW

5

4

3

2

Module 2

270/9

4

№6-9

27

4

3

2,5

0

4

70


* Minimal balls quantity, which student must collect for current educational activity during studing this module, to be accepted to pass an final module control.


^ 3. Final aims of learning of educational discipline according to Educational-professional program (EPP)*:

  • 3770 to determine etiological and pathogenetic factors of the main therapeutic disease according to the list 1 ОКХ

  • 3771 to analyse typical clinical presentation of the mostly widespread therapeutic disease

  • 3774 to reveal different clinical variants ot the diseases of internal organs

  • 3775 to make differentional diagnostic, to improve and form preliminary diagnosis of the mostly spreaded diseases of internal organs

  • 3776, 3791 to determine the tactic of working (recommendations concerning regime, diet, medical treatment, rehabilitation) with patient of the mostly spreaded diseases of internal organs and their complications

  • 3798 (3805) to make up the plan of investigation for the patient and to analyse the results of laboratory and instrumental investigations in case of the typical conduction of the mostly spreaded therapeutic disease

  • 3801 to estimate prognosis for the life and earning capacity in case of the mostly spreaded therapeutic disease

  • 20153 (3803) to diagnose and to give first medical aid in case of urgent state of the diseases of internal organs

  • 6106 (3791) to carry out primary and secondary prevention of the mostly spreaded diseases of internal organs

  • to make manipulations according the list 5 ОКХ

  • 20158 (20152) to show the possession of moral and deontological principles and principles of profession subordination in therapeutic department



^ 4.1. Thematic plan of lectures




Theme

Amount of hours

1.

Acute coronary syndromes

2

2.

Chronic forms of ischemic heart diseases

2

3.

Arterial hypertension

2

4.

Heart failure

2

5.

Myocarditis and cardiomyopathies. Neurocirculatory asthenia

2

6.

Disorders of myocardial rhythm and conduction

4

7.

Chronic obstructive pulmonary disease

2

8

Bronchial asthma

4

9

Pneumonia

2

10.

Anemia

2

11.

Hemoblastosis

4

12.

Hemorrhagic diathesis

2

In All

30


^ 4.2. Thematic plan of tutorials




Name of theme

Amount of hours

1

Main clinical symptoms in cardiology, methods of investigation in cardiology (including ECG practice) – the lesson is held at the basis of cardiological clinic

5

2

Primary arterial hypertension. Secondary arterial hypertensions. Neurocirculatory asthenia

10

3

Acute coronary syndrome. Acute myocardial infarction – the lesson is held at the basis of cardiological clinic

5

4

Chronic forms of ischemic heart diseases. Atherosclerosis

5

5

Congenital heart defects– the lesson is held at the basis of cardiological clinic

5

6

Acquired heart defects

5

7

Infective endocarditis

5

8

Myocarditis and cardiomyopathies. Pericarditis – the lesson is held at the basis of cardiological clinic

5

9

Cor pulmonale. Pulmonary thromboembolism – the lesson is held at the basis of cardiological clinic

5

10

Heart failure – the lesson is held at the basis of cardiological clinic

5

11

Arrhythmias, blockades (paroxismal rhythm disorders) – the lesson is held at the basis of cardiological clinic

5

12

Arrhythmias, blockades (including ECG test)

5

13

The cardiology concluding test

5

14

Main clinical symptoms in pulmonology, methods of investigation in pulmonology. Pneumonia

10

15

Chronic Obstructive Pulmonary Disease: chronic bronchitis and pulmonary emphysema

5

16

Bronchial asthma

5

17

Pleurisy and pleural effusion. Infectious and destructive pulmonary diseases and pulmonary insufficiency

5

18

The pulmonology concluding test

5



^ Name of theme

Amount of hours

19

The main hematologic symptoms, methods of investigation in hematology

5

20

Acute leukemia

5

21

Chronic leukemia, lymphoma, multiple myeloma

5

22

Anemias

5

23

Hemophilia, thrombocytopenic purpura

5

24

The hematology concluding test

5

25

Independent inspection of patients, writing of training case record

5

26

Defence of training case record.

5

27

Peculiarities of clinical pictuure and treatment of the diseases in senile patients. Main principles of medico-social expertise

5

28

Final module control

5

In All

150


^ 4.3.The types of extracurricular work of students during studying




Theme

Amount of hours

1

Preparation to the tutorials of the module. Individual work on themes, which are not included in the plan of tutorials:

60

1.1

Hypertensive crisis

5

1.2

Acute circulatory collapse

5

1.3

Metabolic syndrome X

5

1.4

Hypertension of pulmonary circulation

5

1.5

Mucoviscidosis. Sarcoidosis

5

1.6

Cancer of lungs

5

1.7

Multiple bronchiectasis

5

1.8

Drug disease. Anaphylactic shock emergency

5

1.9

Disseminated intravascular coagulation syndrome

5

1.10

Agranulocytosis

5

1.11

Lymphoadenopathy

5

1.12

Haemorrhage, loss of blood. Hemotransfusion therapy

5

2.

Writing of training case history.

20

3.

Individual work:

  • Report of the essay on the practical tutorials

  • Report on the clinical conferences of the department

  • Report of case history on the practical tutorials

  • Writing of abstracrs, article

5

4.

Independent curation of the patients with filling in the list of investigations of the patient and making up the plan of treatment

5

In All

90



^ 6. Estimation of educational activity of students *


Control forms and evaluation system are carried out in accordance with the requirements of the program of discipline and Instruction about the system of evaluation of educational activity of students at credit-module to the system of organization of educational process, Ukraine ratified by MH (2005)

An estimation for the module is determined as a sum of estimations of current educational activity (in score points) and estimation of final module control (in score points), which is proposed at the evaluation of theoretical knowledge’s and practical skills in accordance with lists, certain the program of discipline.

Maximal amount of score points, which is appropriated to the students at mastering each to the module (test credit), – 200, in a that number for current educational activity – 120 points (60%), as a result of module final control – 80 points (40%).

Current control in performed according to precise aims at each practical tutorial, adoption of contents modules (intermediate control) – at the last tutorial of each contents module. Next means of preparation level diagnostics of students are recommended: computer tests, control of practical skills conduction of patient investigation methods with next results interpretation, analysis of results of instrumental and laboratory investigations.

^ Evaluation of current educational activity:

The value of each topic inside the limits of one module has to be equal and is determined by the topics quantity in a module.

The mark for “Internal Medicine” (module 2) subject is a rating-based and is determined by taking into account of current student’s educational activity and rates for adoption by him of modules maintained by a program. Current evaluation of students by corresponding topics is conducted by traditional 4-ball system (excellent, good, satisfactory, unsatisfactory) with further converting into multi-ball scale.

^ Excellent” rate is put in case student is familiar with full-size contents of the tutorials and lecture material, illustrates responses with various examples; gives exclusively precise and clear responses without any directing questions; lays out material without mistakes and inaccuracy; freely finds solutions for tasks and fulfils practical tutorials of different complicity grade.

^ Good” rate is put in case student is familiar with contents of the tutorials and understands it well, responses to questions gives correctly, systematically and in proper sequence, but they are not precisely detailed, throughout student answers additional questions without mistakes; student solves all tasks and conducts practical tasks, feeling difficulties only in the most complicated cases.

^ Satisfactory” rate is put to student on the basis of his knowledge of all contents of the subject and in case of satisfactory level of its understanding. Student is able to solve modified (simplified) tasks, with assistance of directing questions; he solves tasks and performs practical skills feeling difficulties in simple cases; is not able to give independent systematic answer, but answers properly direct questions.

^ Unsatisfactory” rate is put in case student’s knowledge and expertness don’t meet criteria of “unsatisfactory” rate.

Evaluation of independent work:

Evaluation of student’s independent work suggested in the topic in parallel to auditory work, is conducted during current control of the topic on the corresponding auditory tutorial. Evaluation of the topics put to independent work only and not included to topics of auditory educational classes is performed during final module control.

Conversion of a rate by multi-ball scale is conducted with taking into account of practical tutorials quantity in each of modules: 22 tutorials in module 1, 14 tutorials in module 2.


^ Criteria of rating of students while module 1 studying.

Maximal balls of students rating while module 1 studying


Module 2. Principals of internal medicine (cardiology, pulmonology, hematology, general questions of internal medicine)




Topic №


Maximal ball

Contents module 1

1

4

2

4

3

4

4

4

5

4

6

4

7

4

8

4

9

4

10

4

11

4

12

4

13

4

Contents module 2

14

4

15

4

16

4

17

4

18

4

Contents module 3

19

4

20

4

21

4

22

4

23

4

24

4

Contents module 4

25

4

26

4

27

4

Case history

8

Student’s individual work

4


Conversion of current student’s progress in module 2 learning:

“Excellent” rate – 4 balls

“Good” rate – 3 balls

“Satisfactory” rate – 2,5 balls

“Unsatisfactory” rate – 0 balls

Criteria for case history evaluation, which writing is suggested while module 2 studying:

“Excellent” rate - 8 balls – is written methodically properly, without remarks;

“Good” rate - 5 balls – is written methodically properly, but some chapters are detailed not enough;

“Satisfactory” rate - 2,5 ball – some separate remarks concerning details and sequence of chapters description have place;

“Unsatisfactory” rate - 0 balls – schedule and guidelines of case history writing are violated (in this case student has to re-write case history taking into account tutor’s remarks).

Maximal valuation that may be gained by student for extracurricular work are 4 balls.

Balls quantity that may be gained by student for current activity while studying module 2 is 120 balls maximum. This estimation calculated by multiplication of balls quantity corresponding “excellent” rate (4 balls) to topics quantity in a module with adding balls for writing case history on “excellent” (8 balls) and maximal balls quantity for individual independent work (4 balls).

^ 27 themes х 4 = 108 + 8 + 4 (IIW) = 120 balls.

Minimal balls quantity that may be gained by student while studying module 2 is calculated by multiplication of balls quantity corresponding “satisfactory” rate (2,5 balls) to topics quantity (27 themes) in module with adding balls for writing case history on “satisfactory” (2,5 balls):

^ 27 themes х 2,5 = 67,5 + 2,5 = 70 balls.


Final module control on module 2.

Students who completed the program of present module and gained not less than 70 balls for current progress are admitted to final module control.

Final module control on module 2 suggests answering test control’s 50 questions, demonstration of practical skill performance (from a list mentioned at the end of the module – physical examination of the patient, cardiopulmonary reanimation) and analysing of results of patient’s laboratory/instrumental investigation (situational problem – decoding of ECG, X-ray picture, spirogram, normal and pathological blood account) and oral conversation. Maximal balls quantity that may be gained by student during module control comprises 80. In this case 5 balls is maximal rate for test control, 28 balls – for analysis of laboratory/instrumental investigation results (ECG – 20 balls, X-ray picture, spirogram, blood account – 8 balls), 27 balls – for demonstration of practical skill performance (examing the patient – 20 balls, cardiopulmonary reanimation – 7 balls) and oral conversation – 30 balls (6 balls for every of 4 questions and case).

Criteria of rating the performance of practical skills:

“Excellent” – without any mistakes;

“Good” – performed with non-principal faults corrected during performance by student himself;

“Satisfactory” – performed with faults corrected by a tutor;

“Unsatisfactory” – not performed

Criteria of rating for the test control:

“Excellent” – answering 46-50 tests – 5 balls;

“Good” – answering 41-45 tests – 4 balls;

“Satisfactory” – answering 36-40 tests – 3 balls;

“Unsatisfactory” – answering 35 and less – 0 balls;

Final control is supposed to be put into account if student gained not less 50 balls (not less 3 balls for tests control, 12 balls for analysis of laboratory/instrumental investigation results (ECG – 7 balls, X-ray picture, spirogram, blood account – 5 balls), 15 balls for demonstration of practical skill performance (patient examination – 10 balls, cardiopulmonary reanimation – 5 balls ) and 20 balls for oral answer - 4 balls for every of 4 questions and case ).

Encouraging balls according to Scientific Board decision may be added to ball quantity for subject for students who have scientific publications or possessed prize positions for participation in subject Olympiad carried out between higher educational institutions of Ukraine etc.

Objectivity of estimation of student’s educational activity has to be checked by statistical methods (correlation quotient between current progress and results of final module control).

^ Evaluation of the “Internal Medicine” subject

Mark for the internal medicine is put to students who have put into account all 4 modules on subject on 6 course.


Conversion of balls quantity for subject into rates by ECTS scale and 4-ball (traditional)

^ According to ECTS

By national scale

By BSMU scale (in balls)

A (excellent)

Excellent

180-200

B (very good)

Good

165-179

C (good)

150-164

D (good)

Satisfactory

135-149

E (weak)

120-134

FX

Unsatisfactory

with possibility of re-passing

70-119

F

Unsatisfactory

with obligatory repeated course

1-69

Balls quantity on subject, put into account of students, is conversed into ECTS scale next way:

Students’ percentage is determined on selection of present study year students within the limits of corresponding specialty.


ECTS rate

Rate by 4-ball scale

A

“5”

B,C

“4”

D,E

“3”

FX,F

“2”


FX, F rate is put of students who have just one module not put to account on subject after completion of studying it.

FX (“2”) rate is put to students who obtained minimal balls quantity for current educational activity, but did not pass final module control. They have a right to pass repeatedly the final module control but not more than two times according to curriculum ratified by the rector.

Students who obtained F rate after completion of the subject (did not fulfill educational program just on one module or did not gain minimal balls quantity for current educational activity) have to pass education on the subject repeatedly. The decision is taken by university stuff leaders according to normative documents approved according to maintained order.


7. List of questions for final module control

Adopting of module 2: “Principals of internal medicine (cardiology, pulmonology, hematology, general questions of internal medicine)”


PART I

^ CARDIOVASCULAR DISEASES

  1. Mitral stenosis. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  2. Mitral regurgitation. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  3. Aortic valve stenosis. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  4. Aortic insufficiency. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  5. Pulmonary stenosis. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  6. Tricuspid regurgitation. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  7. Patent ductus arteriosus. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  8. Ventricular septal defect, atrium septal defect. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  9. Coarctation of aorta. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  10. Tetralogy of Fallot. Etiology, pathogenesis. Hemodynamics. Clinical finding, treatment. Surgical treatment.

  11. Infective endocarditis. Etiology, pathogenesis. Clinical finding. Laboratory diagnostics. Differentional diagnostic. Prognosis. Treatment, prevention.

  12. Myocarditis. Etiology, pathogenesis. Clinical finding. Laboratory diagnostics. Differentional diagnostic. Prognosis. Treatment, prevention.

  13. Metabolic cardiomyopathies (myocardiodystrophy). Etiology, pathogenesis. Clinical finding. Laboratory diagnostics. Differentional diagnostic. Prognosis. Treatment, prevention.

  14. Cardiomyopathies. Etiology, pathogenesis. Clinical finding. Laboratory diagnostics. Differentional diagnostic. Prognosis. Treatment, prevention.

  15. Pericardities. Etiology, pathogenesis. Pericarditis sicca. Clinical finding. Diagnostics. Treatment.

  16. Acute exudative pericardities. Clinical finding. Diagnostics. Treatment.

  17. Adhesive pericarditis. Mechanism of hemodynamic disorders. Clinical finding. Diagnostics. Treatment.

  18. Ischemic heart disease. Classification. Diagnostics. Primary and secondary prevention.

  19. Ischemic heart disease. Diagnostic criteria. Diagnostic of latent coronary insufficiency with help of ECG with pharmacological tests and load tests.

  20. Angina pectoris. Classification. Clinical finding. Diagnostics. Treatment.

  21. Myocardial infarction. Etiology, pathogenesis. Classification. Clinical findings of the acute period. Diagnostics. Myocardial infarction without pathologic Q. Treatment.

  22. Myocardial infarction with pathologic Q. Diagnostics. Differentional diagnostic. Prognosis. Treatment.

  23. Myocardial infarction without pathologic Q. Diagnostics. Differentional diagnostic. Prognosis. Treatment.

  24. Complications of myocardial infarction: cardiogenic shock, disorders of rhythm and conduction, heart failure, aneurysm of the heart, cardiac tamponade. Postinfarction syndrome. Treatment.

  25. Cardiosclerosis. Etiology, pathogenesis. Clinical finding. Diagnostics. ECG changes. Treatment.

  26. Neurocirculatory asthenia. Etiology, pathogenesis. Clinical finding, main symptoms. Laboratory diagnostics. Differentional diagnostic. Prognosis. Treatment.

  27. Primary arterial hypertension (essential hypertension). Classification. Clinical finding. Diagnostics. Laboratory findings. Differentional diagnostic. Prognosis. Treatment.

  28. Secondary arterial hypertensions because of kidney disorders. Pathogenesis. Clinical finding. Diagnostics. Differentional diagnostic. Prognosis. Treatment.

  29. Secondary arterial hypertensions of hemodynamic disorders. Pathogenesis. Clinical finding. Diagnostics. Differentional diagnostic. Prognosis. Treatment.

  30. Secondary arterial hypertensions of endocrine disorders. Pathogenesis. Clinical finding. Diagnostics. Differentional diagnostic. Prognosis. Treatment.

  31. Differentional diagnostic of essential hypertension with secondary arterial hypertensions.

  32. Extrasystole. Etiology, pathogenesis. Classification. Clinical finding. Diagnostics. ECG changes. Treatment. Prevention.

  33. Arrhythmia due to disorders of automatic performance of sinoatrial node (sinus tachycardia, sinus bradycardia, sinus arrhythmia, sick sinus syndrome). Etiology, pathogenesis. Clinical finding. ECG changes. Treatment.

  34. Disorders of the conduction of the heart. Etiology, pathogenesis. Clinical finding. ECG changes. Treatment.

  35. Sinoatrial block, intra-atrial heart block, atrioventricular heart block. Etiology, pathogenesis. Clinical finding. ECG changes. Treatment.

  36. Heart failure. Etiology, pathogenesis. Hemodynamics changes. Classification. Treatment.

  37. Heart failure. Latent heart failure. Clinical finding of acute and chronic left- and rightventricular heart failure. Diagnostics. Additional methods of investigation. Treatment.

  38. Heart failure. Treatment. Main groups of medicine, mechanisms of their action. Complications of medical treatment.

  39. The diseases of aorta. Syphilitic aortitis. Symptoms according to the localization of the prcess: aortic aneurysm, aortic insufficiency, coronary insufficiency. Diagnostics. Differentional diagnostic. Treatment.

PART II

^ DISEASES OF RESPIRATORY SYSTEM. ALLERGIC DISEASES

  1. Chronic bronchitis. Etiology, pathogenesis. Classification. Clinical finding, diagnostics. Methods of diagnostic of external respiration. Differentional diagnostic. Treatment.

  2. Chronic obstructive pulmonary disease (COPD). Ethiology, pathogenesis. Classification. Clinical finding, diagnostic features. Methods of external breathing function investigation. Differential diagnosis. Treatment, prevention.

  3. Variants of the pneumonia clinical course. Ethiology. Classification. Clinical finding. Diagnostic features. Differential diagnosis. Complications.

  4. Pleuritis. Ethiology, pathogenesis. Classification. Clinical finding, diagnostic features. Treatment. Indications to thoracocentesis.

  5. Acute pleuritis with effusion. The causes. Clinical finding, diagnostic features. Emergency.

  6. Encysted pleuritis. Pathogenesis. Clinical finding, diagnostic features. Treatment. Indications to thoracocentesis.

  7. Multiple bronchiectasis. Ethiology, pathogenesis. Clinical findings. Diagnostic features. Treatment. Indications to surgery treatment. Prevention.

  8. Lung abscess and gangrene. Ethiology, pathogenesis. Clinical findings, diagnostic features. Differential diagnosis. Treatment. Indications to surgery treatment. Prevention.

  9. Pulmonary emphysema. Ethiology, pathogenesis. Classification. Clinical findings, diagnostic features. Treatment, prevention.

  10. Bronchial asthma. Ethiology, pathogenesis. Classification. Diagnostic features. Differential diagnosis with diseases with chronic airway obstruction.

  11. Managed therapy of bronchial asthma. Treatment according to the stage of the disease.

  12. Complications of bronchial asthma. Asthmatic status, diagnostic features and course stages. Emergency. Treatment of bronchial asthma between attacks. Prevention.

  13. Lung cancer. Classification. Clinical finding, diagnostic features. Treatment. Possibilities of surgery treatment.

  14. Respiratory failure: obstructive, restrictive, mixed. Pathogenesis of pulmonary circulation hypertension. Degrees of severity. Diagnostic features. Treatment.

  15. Chronic pulmonary heart. Mechanism of development. Clinical findings. Diagnostic features of acute and chronic pulmonary heart. Treatment.

  16. Drug disease. Aetiology, pathogenesis. Clinical variants. Treatment, prevention.

  17. Pulmonary circulation hypertension.

  18. Mucoviscidosis.

  19. Sarcoidosis.


PART III

^ BLOOD AND HEMATOPOIETIC ORGANS’ DISEASES

  1. Iron-deficiency anaemia. Aetiology and pathogenesis. The main clinical syndromes. Diagnostic features. Differential diagnostics. Treatment, prevention.

  2. Megaloblastic anaemias (B12- and folate deficiency). Aetiology and pathogenesis. Clinical syndromes. Diagnostic features. Differential diagnostics. Treatment, prevention.

  3. Hypo- and aplastic anaemias. Aetiology and pathogenesis. The main clinical syndromes. Laboratory findings. Differential diagnostics. Treatment, prevention. Prognosis.

  4. Haemolytic anaemias. Mechanism of hemolysis and main causes. Classification. Clinical findings. Diagnostic features. Treatment.

  5. Hemoblastosis. Up-to-day views on aetiology and pathogenesis. Classification. Main clinical-hematological syndromes.

  6. Acute leukaemias. Classification. Clinical features. Laboratory-morphological diagnostic. Course and complications. Treatment. Prognosis.

  7. Erythremia. The main clinical syndromes. Stages of course. Diagnostic criterias. Differential diagnostics. Complications. Treatment. Prognosis.

  8. Chronic myeloid leukaemia. Clinical features. Stages of course. Laboratory-morphological diagnostic. Treatment. Prognosis.

  9. Chronic lymphocytic leukaemia. Up-to-day classification. Clinical features. The main syndromes. Stages of course. Laboratory-morphological diagnostic. Prognosis. Treatment.

  10. Hodgkin’s disease (lymphogranulomatosis). Aetiology and pathogenesis. Classification. Clinical findings, diagnostic features. Differential diagnostics. Treatment. Prognosis.

  11. Multiple myeloma. Aetiology and pathogenesis. Classification. Clinical features. Diagnostic features. Differential diagnostics. Treatment. Prognosis.

  12. Agranulocytosis. Classification. Aetiology and pathogenesis. Clinical variants. Diagnostic features. Course and complications. Treatment, prevention.

  13. Hemophilia. The role of hereditary factor in disease development. Pathogenesis of bleeding. Clinical findings, disease course. Diagnostic features. Differential diagnostics. Prognosis. Treatment. Prevention.

  14. Thrombocytopenia. Main aetiological factors. Pathogenesis of bleeding. Clinical findings. Diagnostic features. Differential diagnostics. Treatment.

  15. Hemorrhagic vasculitis. Aetiology. Pathogenesis of bleeding. Clinical findings. Variants of course. Diagnostic features. Treatment. Prognosis. Prevention.

  16. Haemorrhage, loss of blood. Components of blood transfusion. Methods of blood grouping and compatibility testing. Complications of transfusion. Treatment, prevention.

  17. Disseminated intravascular coagylation syndrome.


PART IV.

^ EMERGENCY IN CLINIC OF INTERNAL DISEASES

  1. Cardiac asthma. Causes, pathogenesis. Clinical features, diagnostic findings. Emergency.

  2. Pulmonary edema. Causes, pathogenesis. Clinical features, diagnostic findings. Emergency.

  3. Arterial hypertensive crisis. Classification. Clinical features, diagnostic findings. Emergency.

  4. Attack of angina. Treatment, prevention.

  5. Cardiac shock. Causes, pathogenesis. Clinical features, diagnostic findings. Emergency.

  6. Collapse. Causes. Clinical features, diagnostic findings. Emergency.

  7. Ventricular paroxysmal tachycardia. Causes. Clinical features, ECG-diagnostics. Emergency.

  8. Supraventricular paroxysmal tachycardia. Causes. Clinical features, ECG-diagnostics. Emergency.

  9. Morgagni-Adams-Stockes syndrome. Causes. Clinical features, diagnostic findings. Emergency.

  10. Ventricular flutter and fibrillation. Pathogenesis. Clinical features, ECG-diagnostics. Emergency..

  11. Acute right ventricular heart failure. Causes. Clinical features, diagnostic findings. Emergency.

  12. Acute left ventricular heart failure. Causes. Clinical features, diagnostic findings. Emergency.

  13. Atrial fibrillation paroxysm. Causes. Clinical features, diagnostic findings, ECG-diagnostics. Emergency.

  14. Atrial flutter. Causes. Clinical features, diagnostic findings. Treatment..

  15. Cardiac glycoside intoxication. Causes. Main groups of symptoms. Treatment.

  16. Acute respiratory failure. Causes. Clinical features, diagnostic findings. Emergency.

  17. Asthmatic status. Causes. Clinical features, diagnostic findings. Emergency..

  18. Syndrome of bronchial obstruction. Causes, pathogenesis. Clinical features, diagnostic findings. Differential diagnostics. Emergency of acute forms.

  19. Pulmonary hemorrhage and hemophthysis. Causes. Clinical features, diagnostic findings. Emergency.

  20. Artery pulmonalis thromboembolia. Causes. Clinical features, diagnostic findings. Emergency.

  21. Spontaneous pneumothorax. Causes. Clinical features, diagnostic findings. Emergency.

  22. Pulmonary infarction. Causes. Clinical features, diagnostic findings. Emergency.

  23. Pulmonary atelectasis. Causes. Clinical features, diagnostic findings. Emergency.

  24. Acute thoracic empyema. Causes. Clinical features, diagnostic findings. Emergency.

  25. Hemolytic crisis. Causes. Clinical features, diagnostic findings, complications. Emergency.

  26. Hemorrhagic diathesis. Emergency of acute bleedings.

  27. Acute alcohol poisoning. Clinical features. Emergency.

  28. General principles of emergency of acute poisonings.

  29. Main means of antidote therapy of acute poisonings.

  30. Methods of active detoxications of acute poisonings.

  31. Chlorhydropenic (hypochloremic) coma. Causes. Clinical features, diagnostic findings. Emergency.

  32. Anaphylactic shock. Causes. Clinical features, diagnostic findings. Emergency.

  33. Shock. Classification. Aetiology, pathogenesis. Clinical features. Emergency.

  34. Angioneurotic edema (Kwink’s edema). Aetiology, pathogenesis. Clinical features, diagnostic findings. Emergency.

PART V.

^ GENERAL QUESTIONS

  1. The role of sanatorium-and-spa treatment in rehabilitation of the patients with the diseases of internal organs. Contraindications for sanatorium-and-spa treatment.

  2. Peculiarities of duration of cardiovascular diseases in juvenile, elderly and senile aged patients. Tactics of therapeutist.

  3. Peculiarities of duration of diseases of respiratory system in juvenile, elderly and senile aged patients. Tactics of therapeutist.

  4. Peculiarities of duration of blood in juvenile, elderly and senile aged patients. Tactics of therapeutist.

  5. The question of working capacity examination in the practical work of therapeutist of outpatient department


^ 8. LIST OF PRACTICAL SKILLS

Module2 «Bases of internal medicine (cardiology, pulmonology, hemotology, general questions of internal medicine)»


  1. To obtain the skills of interpretation of radiological examinationof the chest.

  2. To obtain the skills of interpretation of bronchoscopy.

  3. To obtain the skills of interpretation of the results of external respiration.

  4. To obtain the skills of analysing of the laboratory tests (blood test, general protein and protein fractions, coagulation value, general and microbiologic investigation of the sputum, general and microbiologic investigation pleural effusion).

  5. To obtain the skills of giving first aid in case of acute respiratory insufficiency.

  6. To obtain the skills of giving first aid in case of external bleeding.

  7. To obtain the skills of determining of blood group.

  8. To obtain the skills of transfusion of blood components and blood substitutes.

  9. To obtain the skills of analysing general blood test, marrow punctate.

  10. To obtain the skills of interpretation of Doppler echocardioscophy.

  11. To obtain the skills of interpretation of the results of stress tests.

  12. To obtain the skills of interpretation of electrocardiograms.

  13. To obtain the skills of interpretation of the results of angiocardiography.

  14. To obtain the skills of interpretation of the results of pneumonograms

  15. To obtain the skills of analysing of the laboratory methods of investigation (microbiologic blood investigation, acute phase blood data, general protein and protein fractions, transaminasis of the blood, coagulation value, laboratory markers of myocardium necrosis, blood lipids, creatinine of the blood, clearance of creatinine, electrolytes of the blood, serum diagnostics during autoimmune process).

  16. To obtain the skills of giving first aid in case of acute heart insufficiency, collapse, shocks.

  17. To obtain the skills of giving first aid in case of hypertensive crisis.

  18. To obtain the skills of giving first aid in case of paroxysmal rhythm disorders, Morgagni-Adams-Stokes disease.

  19. To obtain the skills of giving first aid in case of circulatory arrest, respiratory standstill, conducting of cardiopulmonary resuscitation.

  20. To obtain the skills of registration and interpretation of electrocardiograms.

  21. To obtain the skills of measurement of blood pressure.


9. Literature


  1. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J Jun 01, 2005; 26: 1115-1140.

  2. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J Jun 02, 2007; 28: 1462-1536.

  3. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J Jan 01, 2007; 28: 88-136.

  4. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J Jun 01, 2006; 27: 1341-1381.

  5. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J Jan 02, 2007; 28: 230-268.

  6. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis Executive Summary: The Task Force on Infective Endocarditis of the European Society of Cardiology. Eur Heart J Feb 01, 2004; 25: 267-276.

  7. Braunwald Eugene, P. Zipes Douglas P., Libby Peter, Bonow Robert. Heart Disease: A Textbook of Cardiovascular Medicine, Single Volume. 7th ed. Saunders W. B., 2004. 2183 p.

  8. Taylor R. Cardiovascular Diseases: A Handbook. Springer, 2005. 294 p.

  9. Topol Eric J, Califf Robert M, Prystowsky Eric N, Thomas James D, Thompson Paul D. Textbook of Cardiovascular Medicine. 3rd ed. Lippincott Williams & Wilkins, 2006. 1664 p.

  10. Morris Francis, Edhouse June, Brady William J, Camm John. ABC of Clinical Electrocardiography. BMJ Publishing Group, 2003. 80 p.

  11. Hosenpud Jeffrey D. Congestive Heart Failure
    Third Edition. Lippincott Williams & Wilkins, 2007. 833 p.

  12. Jones Shirley A. ECG Notes: Interpretation And Management Guide. F. A. Davis Company, 2005. 210 p.

  13. Chan Kwan-Leung, Embil John M. Embil. Endocarditis Diagnosis and Management. Springer-Verlag London Limited, 2006. 258 p.

  14. Feigenbaum Harvey, Armstrong William F., Ryan, Thomas. Echocardiography, 6th Edition. Lippincott Williams & Wilkins, 2005. 773 p.

  15. Fuster Valentin, Alexander R. Wayne, O’Rourke Robert A., Roberts Robert, King Spencer B., Prystowsky Eric N., Nash Ira. Hurst’s The Heart, 11th Edition. McGraw-Hill Professional, 2004. 2400 p.

  16. Driscoll, David J.Title: Fundamentals of Pediatric Cardiology, 1st Edition. Lippincott Williams & Wilkins, 2006. 176 p.

  17. Kaplan Norman M. Clinical Hypertension. Lippincott Williams & Wilkins, 2005. 518 p.

  18. Hampton John R. The ECG in Practice. Churchill Livingstone, 2003. 325 p.

  19. Kasper Dennis L., Braunwald Eugene, Fauci Anthony, Hauser Stephen, Longo Dan, Jameson J. Larry. Harrison’s Principles of Internal Medicine, 16th ed. McGraw-Hill Professional, 2004. 2800 p.

  20. Boon Nicholas A., Colledge Nicki R., Walker Brian R., Hunter John. Davidson’s Principles and Practice of Medicine. Churchill Livingstone, 2006. 1392 p.

  21. Katzung Bertram G. Basic & Clinical Pharmacology. McGraw-Hill Medical, 2006. 1179 p.



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