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2 Thematic plan of practical lessons




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2.1. Thematic plan of practical LESSONS




Thematic plan of practical lessonss

hour

1.

Actual questions of acute appendicitis.

4

2.

Hernia of belly wall and their complication

4

3.

Complication of ulcerous illness of stomach and duodenum. Perforative ulcer. Bleeding from a gastroenteric highway

4

4.

Gallbladder stown illness. Acute cholecystitis and pancreatitis

4

5.

Mechanical icterus; differential diagnostics

4

6.

Sharp intestinal impassability

4

7.

The trauma of organs of belly cavity is closed. Peritonitis.

4

8.

Trombophlebitis and posttrombophlebitic syndrome. Sharp diseases of vessels (thromboses, embolism).

4

9.

Inflammatory diseases of soft of fabrics and fingers of brush.

4

10.

Blood transfusion, its components of blood

4

11.

Work in operative room

2

12.

Work is in treatment-diagnostic cabinets

2

13.

Work in to the operating-room

2

14.

Clinical consideration of patients

6

15

Determination of tactic of conduct (principles of operative interferences and conservative treatment, rehabilitations measures) at the most widespread surgical diseases and their complications

2

16

^ Exposure of different clinical variants and complications of the most widespread surgical diseases

2

17

Demonstration of domain of psychological by principles of medical specialist and principles of professional deference to the rank in surgery

2

18

^ First medical aid at the most widespread surgical diseases

2

19

Planning of inspection of patient, interpretation of results of laboratory and instrumental researches at the most widespread surgical diseases and their complications

2

20

^ Leadthrough of differential diagnostics, ground and formulation of previous diagnosis of the most widespread surgical diseases

2

21

Leadthrough of primary and second prophylaxis of the most widespread surgical diseases

2

22

^ Analysis of volume and internalss of primary, second and tertiary medicare to the different contingents of population

2

23

Determination of plan of conservative and operative treatment of surgical diseases depending on nosotropic factors and weight of the state of patient

2

24

^ Demonstration of ability of conduct of medical document is in the clinic of surgical illnesses

2

25

Diagnostics of the exigent states and to give help on to the hospital stage

2

26

^ Diagnostics of the complicated and nontipical forms of the most widespread surgical diseases

2

27

Grant of medicare at the exigent states in the clinic of surgical illnesses but implementation of exigent surgical manipulations and operations

2

28

^ The leadthrough of differential diagnostics of the most widespread surgical diseases is in urgent and planned surgery

2

29

Analysis of results of laboratory and instrumental methods of research

2

30

^ Determination of group belonging of medications in obedience to modern classifications

2

31

Determination of the most widespread clinical symptoms and syndromes is in the clinic of surgical illnesses

2

32

^ Determination of basic etiologic and nosotropic factors of the most widespread surgical diseases

2

33

Demonstration of domain of physiological by principles of medical specialist but principles of professional deference to the rank in surgery

2

34

^ Demonstration of domain by skills of organization of the mode and care of surgical to the patients, implementation of necessary medical manipulations

2

35

Diagnostics and grant of medicare at the exigent states in the clinic of surgical illnesses

2

36

^ Realization of prognosis of life and capacity at the most widespread surgical diseases

2

37

Classification and analysis of typical clinical picture of most widespread surgical diseases

2

38

^ Leadthrough of questioning and phisical of inspection of surgical patients and to analyse their results

2

39

Drafting of plan of inspection and analysis of these laboratory and instrumental inspections at typical motion of the most widespread surgical diseases

2

40

^ Interpretation of general principles of treatment, rehabilitations and prophylaxis of the most widespread surgical diseases

2

41

A test is differentiated

4

In all

108


List to those which are selected for the independent study




^ Thematic plan of independent work of students

hour

1.

Surgical tool. Groups of surgical tool, their setting.

2

2.

Features of method of inspection of surgical patients. Features of inspection of patients with a trauma, acute and chronic surgical by the disease. Common picture of modern methods of inspection and diagnosticians of surgical patients.

2

3.

^ Antiseptics and asepsis. Determination. Types of modern antiseptics. Asepsis as modern method of prophylaxis of surgical infection. Prophylaxis pin and implantation infections.

2

4.

Damage. Classification. Damage of soft of fabrics.

2

5.

Burns. Classification, degrees, area of defeat. Features of ambustial shock. First aid urgent help.

1

6.

Getting frost-bitten. Classification, grant of the first aid. Degrees of getting frost-bitten. Treatment.

1


7.

Electric-trauma. Local and commons phenomena. Grant of the first aid, treatment.

1

8.

Wounds. Classification. Ran across wound process. Types of reparative of wounds. Methods of treatment.

2

9.

Desmurgy. General principles of imposition of bandages. Transporting imobilization. To the type of bandage on the separate areas of body.

2

10.

Necrosises, gangrenes, ulcers. Common concept, reasons of origin. Clinical picture, diagnostics and treatment.

2

11.

Plastic (reconstructive) surgery. Common concept. Biological terms of transplantation of fabrics. Autoplastic, homoplastic, heteroplastic.

2

12.

Disease of colon. Anatomic-physiological features of colon. Classification of diseases. Method of inspection of patients with the diseases of colon.

Ulcerous-necrotic colitis, disease of Hirshprung, of high qualities tumours and pholiposis. Clinic, diagnostics, treatment, complication.

2

13.

^ Disease of rectum. Anatomic-physiological information about a rectum. Classification of diseases. Method of inspections. Piles, crack, proctopolypuss. Clinic, diagnostics, treatment, complication.

2

14.

Disease of esophagus. Classification of diseases of esophagus. Research methods (rethenoscopy, sciagraphy, esophagoscopy).

Chemical burns and cicatrical esophagostenosiss, tumours, diverticulums, the achalasia of esophagus is a clinic, diagnostics, methods of treatment, complication.

2

15.

^ Diseases of lung and pleura. Classification of diseases of lung and pleura. Abscess and gangrene of lung. Defects are innate: clinic. diagnostics, treatment, complication.

Acute festering pleurisy, pyopneumothorax, chronic empyema of pleura: clinic, diagnostics, treatment.

2

16.

^ Disease of mammary gland. Classification of diseases. Methods of inspection of patients with the diseases of mammary gland. Dishormonal diseases, of high qualities tumours sharp venerable: clinic, diagnostics, treatment.

2

17.

Disease of thyroid. Classification of diseases. Methods of inspection of patients. Endemic, sporadic goitre. Thyrotoxicosis, thiroiditis and strumitis. Goitre of Hashimoto, goitre of Ridel: clinic, diagnostics, methods of treatment.

2


18.

^ Chronic diseases of vessels. Classification of diseases. Atherosclerotic defeats of arteries, endarteritis, syndrome of Lerish. Clinic, diagnostics, treatment.

2

19.

Disease of organs of mesoorgan. Tumours and cysts of mesorgan. Classification. clinic, diagnostics, treatment. Syndrome of precava, reasons, diagnostics, treatment.

2

20.

Disease of diaphragm. Diaphragmatic hernia, phrenasthenia. Clinic, diagnostics, methods of surgical treatment.

1

21.

Chronic heterospecific ulcerous colitis. Clinic, methods of diagnostics, roentgenologic signs of ulcerous colitis, complication. The methods of surgical treatment, complication, are in a postoperative period. Features of conduct of patients. Classification, clinic, diagnostics and treatment.

1

22.

^ Portal hypertension. Concept at the intrahepatic, extrahepatic and mixed forms of blockade of portal circulation of blood. Clinic, diagnostics. Methods of treatment.

1

23.

Symptomatic blood pressure high. Renovascular blood pressure high, and diagnostics. methods of treatment. Coarctation of aorta: clinic, diagnostics. methods of surgical treatment. Pheohromocitoma: clinical signs, methods of diagnostics, treatment.

1

24.

^ Innate and traumatic aneurism of bloods vessels. Clinic, methods of diagnostics. Contrasting researches of vessels.

1

25.

"Acute stomach" at thromboses and embolism of mesenteric vessels. Classification, reasons, clinic, diagnostics and treatment.

1

26.

Postoperative period, early postoperative complications and their prophylaxis. Classification, clinic. diagnostics, prophylaxis and treatment.

1

27.

Stomach-oesophageal rephlux. Mechanisms of origin, clinic, methods of diagnostics, conservative and surgical treatment.

1

28.

^ Surgical aspects of white plague. Testimony to surgical treatment of white plague. Diagnostics, methods of operative treatment, complication.

1

In all

46


LIST

PRACTICAL SKILLS AND ABILITIES OF SURGICAL TYPE, WHICH DART OUT FOR VERIFICATION ON THE PRACTICALLY-ORIENTED STATE FINAL EXAMINATION FROM SURGICAL ILLNESSES WITH CHILD'S SURGERY OF MEDICAL FACULTY AFTER SPECIALITY 7.110101 “MEDICAL BUSINESS”

^ ON 2008-2009 SCHOOL YEAR.


GENERAL Surgery FACULTY Surgery, Hospital Surgery

  1. To determine tactic of conduct (principles of operative interferences and conservative treatment, rehabilitations measures) at the most widespread surgical diseases and their complications.

  2. To find out different clinical variants and complication of the most widespread surgical diseases

  3. To demonstrate the domain of deontological principles medical specialist and principles of professional deference to the rank in surgery

  4. To give urgent medical help at the most widespread surgical diseases

  5. To plan the inspections of patient, interpret the results of laboratory and instrumental researches at the most widespread surgical diseases and their complications

  6. To conduct differential diagnostics, ground and formulate the previous diagnosis of the most widespread surgical diseases

  7. To conduct the primary and second prophylaxis of the most widespread surgical diseases

  8. To analyze a volume and quality of primary, second and tertiary medicare to the different contingents of population

  9. To determine the plan of conservative and operative treatment of surgical diseases depending on nosotropic factors and weight of the state of patient

  10. To demonstrate ability of conduct of medical document in the clinic of surgical illnesses

  11. To diagnose the exigent states and give help on to the hospital stage

  12. To diagnose the complicated and nontipical forms of the most widespread surgical diseases

  13. To give medical help at the exigent states in the clinic of surgical illnesses and to execute exigent surgical manipulations and operations

  14. To conduct differential diagnostics of the most widespread surgical diseases in urgent and planned surgery

  15. To analyze the radial semiotics of functionally-morphological changes at pathology of different organs and systems

  16. To analyze the results of laboratory and instrumental methods of research.

  17. To determine clinical symptoms and syndromes are most widespread in the clinic of surgical illnesses.

  18. To determine the basic etiologic and nosotropic factors of the most widespread surgical diseases

  19. To demonstrate the domain of deontological by principles of medical specialist but principles of professional deference to the rank in surgery

  20. To demonstrate the domain by skills of organization of the mode and care of surgical patient, to execute medical manipulations are needed

  21. To apply basic principles of asepsis, antiseptics, anaesthetizing

  22. To carry out the prognosis of life and capacity at the most widespread surgical diseases

  23. To classify and analyze the typical clinical picture of the most widespread surgical diseases

  24. To plan measures and apply the methods of medical physical education in the medical rehabilitation of patients on the stationary and policlinic stages at the diseases, traumas, after surgical interferences

  25. To canvass and phisical inspection of surgical patients and to analyze their results

  26. To make the plan of inspection and analyze information of laboratory and instrumental inspections at typical motion of the most widespread surgical diseases

  27. To interpret general principles of treatment, rehabilitations and prophylaxis of the most widespread surgical diseases

^ ORTHOPAEDY AND TRAUMATOLOGY

  1. To determine the etiologic and nosotropic factors of most widespread neuro-surgical diseases

  2. To determine tactic of conduct of neuro-surgical patients and analyze information of auxiliary inspections

  3. To determine tactic of conduct of patients with traumas and most widespread by the orthopaedic diseases of locomotorium

  4. To demonstrate the domain by the methods of restoration treatment of neuro-surgical patients and by principles of their rehabilitation and readaptation

  5. To demonstrate the domains by the methods of prophylaxis of traumatism and orthopaedic diseases

  6. To diagnose the exigent states at the traumas of locomotorium and give urgent medicare

  7. To explain principles of restoration treatment and rehabilitations of patients with the defeat locomotorium

  8. To present a typical clinical picture and put the previous diagnosis of basic neuro-surgical diseases

  9. To conduct differential diagnostics of traumatic damages locomotorium to the vehicle, to set a previous diagnosis at traumas and most widespread orthopaedic diseases

  10. To diagnose and give urgent medical help to the neuro-surgical patients at the exigent states

ONCOLOGY

  1. To determine possibilities and elect the method of radial therapy of tumours and not tumours diseases

  2. To determine tactic of conduct of patients on the oncologic diseases are most widespread

  3. To determine tactic of inspection and conducts of patients with suspicion on a malignant tumor

  4. To demonstrate ability of conduct of medical document in the clinic of oncologic illnesses

  5. To demonstrate the domain by the methods of early diagnostics of pretumor and oncologic diseases of maxillufacial area

  6. To demonstrate the domain by principles of oncologic deontology

  7. To diagnose malignant tumors which behave to the group of visual localizations (digit inspection of rectum, review and palpation milk and thyroid glands peripheral lymphonoduss and tumors of skin)


^ ANESTESIOLOGY AND REANIMATION

  1. To determine etiologic, nosotropic factors and clinical displays, diagnose exigent state and to give urgent help to the victim in terms natural and technogenic catastrophes

  2. To demonstrate the domain by the methods of diagnostics and grants of help at basic syndromes of violations vitally of important functions

  3. To diagnose the signs of clinical death and terminals states, conduct the pneumocardial and cerebral reanimation

  4. To diagnose and give medical help at the exigent states in a clinic surgical illnesses

  5. To apply general principles and methods of the anaesthetic providing of different operative interferences

  6. To apply the basic algorithms of intensive therapy of the exigent states

  7. To plan the inspection and treatment of patients with violations vitally of important functions

  8. To interpret the basic clinical displays and laboratory indexes of violations vitally important functions

UROLOGY

  1. To determine the etiologic and nosotropic factors of basic diseases of organs by the urinary and masculine chaff of the systems

  2. To determine tactic of conduct of patients by the basic diseases of organs urinary and by the masculine chaff of the systems, to use principles of prophylaxis of this pathology

  3. To diagnose the exigent states at the diseases of organs urinary and masculine by the chaff of the systems and to give urgent medical help

  4. To put a previous diagnosis and conduct differential diagnostics of diseases organs by the urinary and masculine chaff of the systems

^ CHILD'S SURGERY

  1. To determine the features of diseases of new-born children and put previous clinical diagnosis

  2. To determine the displays of possible indirect action of medications and symptoms of overdose, methods them warning and treatment

  3. To determine tactic of conduct of child, patient by the basic surgical diseases

  4. To diagnose the exigent states in the clinic of child's surgery and give urgent medical help to the child

  5. To diagnose and give urgent help at the exigent ground-states in to the clinic of children' illnesses

  6. To find out the different clinical displays of complication and set a previous diagnosis surgical diseases and traumas at children

FACIAL Surgery

  1. To determine connection of stomatological diseases with somatic pathology and by the value of stomatological sanation

  2. To discover innate and purchased defects of maxillufacial area and to determine tactic conduct of these patients

  3. To discover and identify the displays of somatopathies in the cavity of mouth

  4. To demonstrate the domain by principles and methods of primary prophylaxis stomatological diseases

  5. To diagnose and give urgent medical help at most widespread stomatological diseases and traumas of maxillufacial area


It is approved on the methodical conference of department of surgery and eyeing illnesses on June, 20 in 2008 (protocol №14. and on meeting of subject methodical commission on disciplines of surgical type on Junes, 23, 2008 (protocol №1).

METHOD

Leadthrough of the PRACTICALLY-ORIENTED State FINAL EXAMINATION From Surgical ILLNESSES With CHILD'S SURGERY of MEDICAL FACULTY AFTER SPECIALITY 7.110101 “MEDICAL BUSINESS”

(2008-2009 school year)

The practically-oriented state final examination from surgery is included in the second stage of state attestation of graduating students of medical faculty, which is carried out in accordance with Order of Ministry of health of Ukraine from 29.12.2001 for №535 “Claim of changes to the operating curriculum of preparation of doctors in higher educational establishments III-IV levels of accreditation”. This stage of attestation is conducted upon receipt results of the licensed integrated examination “Step 2” from Center of licensing in the form of percent of right answers and marked on a scale “made / did not make”

To the practically-oriented state examination students which abode and satisfies a curriculum are admitted, regardless of result of handing over of the licensed computer-integrated examination “Step 2”.

^ The practically-oriented state examination from surgery consists of two parts: verifications of typical tasks of activity and abilities and testing on verification of abilities and practical skills in obedience to educationally-qualifying description of graduating student.

Verification of typical tasks of activity and abilities in obedience to a list is carried out by the members of roasting PANS on the bases of departments of hospital surgery, general to surgery, orthopaedy, traumatology and neuro-surgery, anesthesiology and reanimathology, bedside patient. It consists in the leadthrough of questioning of patient and verification of skills of sensomotorium, preception and instrumental-calculation groups, ground of previous diagnosis, drafting of plan of inspection and treatment.

A student gets at a secretary of direction, which the medical separation, chamber, last name, is indicated on, name of patient and heads for the proper separation, conducts the inspections of patient and answers bedside sick state examination commission which works in the separation. Handing over of the first part of the practically oriented examination includes the estimation of abilities of every graduating student to collect complaints and anamnesis, conduct the objective inspection of patient, propose and ground a previous diagnosis, ability to give urgent help, make the plans of inspection and treatment. The results of implementation of the first part of examination are entered in the “Minutes of work with to the patients”. Members of examination commission and examiners directly bedside patient estimate the level of preparation of graduating student and if necessary set him additional questions.

After drafting of the first part of examination, a graduating student is admitted to the second part – verification of abilities and practical skills, that contains the evaluation of implementation of the medical manipulations, marked at a list, grant of the first aid (decision of situatioonal tasks).

Depending on character of typical tasks of activity and abilities, practical skills, the proper specialists-examiners adopt examination (surgery, anesthesiology with reanimation, orthopaedy with a traumatology, oncology, stomatology, a child surgery, urology). In this connection in the complement of the State commission the proper managers must be entered by departments and courses. Examination conducts state examination commission in the specially equipped educational classes with evident belongings (by catheters, sciagrams, by plaster casts and others like that). Every student gets „Protocol demonstrations of practical skills and abilities”, where the results of their drafting are fixed.

For preparation to the practically-oriented state examination graduating students get not less one week.

After completion of handing over of the practically-oriented state examination session is held on which the discussion of results of verification of typical tasks of activity and abilities is carried out and practical skills, taking into account the results of the licensed examination “Step-2”, and the chapter of state examination commission declares estimations.

^ CRITERIA OF ESTIMATION

KNOWLEDGES And ABILITIES of STUDENTS 6 COURSE of MEDICAL FACULTY ON the PRACTICALLY-ORIENTED State FINAL EXAMINATION From Surgical ILLNESSES With CHILD'S SURGERY of MEDICAL FACULTY AFTER SPECIALITY 7.110101 “MEDICAL BUSINESS” (2008-2009 school year)


The estimation of knowledges of students from surgical illnesses is conducted it is differentiated taking into account the degree of capture by students by abilities practical by skills and decision of typical tasks of activity, with account of results of the licensed examination “Step-2”.

The results of the practically-oriented state examination are represented after every discipline separately and consist of:

1) estimations of answer of the first to the stage of examination:

An estimation “fine” belongs to the student which deeply and to perfection laid hands on the method of questioning and physical inspection of patient, impeccably conducted the inspections of patient, fine owns the receptions of determination of symptoms of different diseases of internals of surgical type, fully grounded a previous diagnosis, correctly worked out plans of inspection and treatment, a volume knows and correctly interprets information of additional (laboratory, instrumental, renthenologic) methods of research.

An estimation “well” belongs to the student which deeply laid hands on the method of inspection of patient, but 1-2 errors assume insignificant in order of inspection and interpretation of results of laboratory-instrumental methods of inspection; previous diagnosis, plans of inspection and treatments not fully take into account the volume of obtained information.

An estimation “satisfactorily” belongs to the student which laid hands on the method of inspection of patients, but the inspections of patient are conducted superficially, with 3-5 errors, assumes substantial violations all right and method of inspection of patients, in interpretation of results of laboratory and instrumental methods of research; previous diagnosis, plans of inspection and treatments formulated broadly speaking.

An estimation “unsatisfactorily” belongs to the student, if the inspections of patient are conducted chaotically, more than 5 errors are sufferet, a previous diagnosis is put incorrectly, the plans of inspection and treatments do not enable to set a diagnosis and influence on motion of disease.


^ 2) estimations of handing over of abilities and practical skills:

An estimation “fine” belongs to the student which is able without errors to execute from 90 to 100 % standard abilities and practical skills, situational tasks are decided correctly.

An estimation “well” belongs to the student which correctly executes from 76 to 89 % standard abilities and practical skills, is assumed separate inaccuracies situational tasks are decided with 1-2 errors.

An estimation “satisfactorily” belongs to the student which mastered from 60 to 75 % standard abilities and practical skills, in other assumes errors situational tasks are decided with 3-4 errors.

An estimation “unsatisfactorily” belongs to the student, if he executes меньше 60 % standard abilities and practical skills, situational tasks are not decided.

During the discussion of eventual estimation final progress is taken into account also from this discipline during studies.

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