THE LIST OF QUESTIONS FOR GRADED TEST
• Diabetes mellitus, classification, etiology, pathogenesis, clinical picture, diagnostics: algorithms and diagnostic protocols.
• Diabetes mellitus type 1 and type 2, modern methods of therapy.
• Acute and chronic complications of diabetes. Features of the course and treatment of diabetes in surgical patients and during pregnancy: algorithms and protocols for the treatment of hypoglycemic coma, diabetic ketoacidotic coma, diabetic neuropathy, diabetic nephropathy, retinopathy, syndrome of diabetes.
• Iodine deficiency diseases of the thyroid gland. Endemic signs in accordance with WHO. Clinical picture, diagnosis, prevention and treatment. Hypothyroidism and thyroiditis. Classification, diagnosis, clinic, treatment: algorithms for diagnosis and treatment of iodine deficiency diseases, hypothyroidism, thyroiditis.
• Thyrotoxicosis. Clinical forms. Diagnosis, treatment. Thyroid cancer. Classification, clinic, diagnosis, treatment. Diseases of the thyroid gland: algorithms for the diagnosis and treatment of thyrotoxicosis, thyroid cancer, hyperparathyroidism and hypoparathyroidism.
• Adrenal disease. Chronic insufficiency of the adrenal cortex. Etiology, pathogenesis, clinical manifistations, diagnosis, prevention and treatment. Hormone-active tumors of the adrenal glands: algorithms for diagnosis and treatment of chronic adrenal insufficiency, Cushing syndrome, pheochromocytoma.
• Diseases of the hypothalamic-pituitary system. Obesity. Sexual glands diseases: algorithms for the diagnosis and treatment of somatotropic insufficiency, Cushing disease, acromegaly, hyperprolactinemia, diabetes incipitus, hypopituitarism, obesity, sexual glands disease.
• Hemophilia and thrombocytopenic purpura. Definition. Etiology and pathogenesis, major clinical syndromes. Criteria for diagnosis. Differential diagnosis. Treatment. Prevention of bleeding. Primary and secondary prevention. Prognosis and workability.
• Anemia (post-hemorrhagic, iron deficiency, B12-deficiency, foliate deficiency, aplastic, hemolytic).Definition. Etiological factors and pathogenesis. Mechanisms of intravascular and intracellular hemolysis. Features of the clinic and laboratory diagnostics of various forms. Differential diagnosis. Complication. Treatment of various forms of anemia. Transfusion of blood components and blood substitutes. Primary and secondary prevention. Prognosis and workability.
• Acute leukemia. Definition. Modern views on the etiology and pathogenesis. Classification. Main clinical-hematological syndromes. Clinical manifestations. Criteria for diagnosis. Differential diagnosis. Complication. Principles of treatment. Supportive therapy. Bone marrow transplantation. Primary and secondary prevention. Prognosis and workability.
• Chronic leukemia. Determination of chronic myeloid leukemia, chronic lymphoid leukemia, myeloma, true polycythemia. Modern views on the etiology and pathogenesis. Classification. Main clinical manifestations and clinical-hematological syndromes. Criteria for diagnosis. Differential diagnosis. Complication. Principles of treatment. Bone marrow transplantation. Primary and secondary prevention. Prognosis and workability.
• Chronic obstructive pulmonary disease. Definition. The importance of smoking, environmental, occupational factors and infection in the development of chronic obstructive pulmonary disease. Classification. Clinical manifestations, data of laboratory and instrumental methods of study depending on the stage (severity). Differential diagnosis. Complications. Treatment. Primary and secondary prevention. Immunoprophylaxis. Prognosis and workability.
• Bronchial asthma. Definition. Etiology, features of pathogenesis. Classification. Clinical manifestations, data of laboratory and instrumental methods of investigation. Differential diagnosis. Complications. Treatment. First aid in the attack of bronchial asthma. Primary and secondary prevention. Prognosis and workability.
• Pneumonia. Definition. Etiology. Classification. Clinical manifestations and features of the course depending on the pathogen. Data from laboratory and instrumental methods of investigation. Differential diagnosis. Complications (acute respiratory distress syndrome, destruction of lung tissue, acute respiratory failure and others). Differentiated treatment. Primary and secondary prevention. Prognosis and workability.
• Pleurisy. Definition. Etiological factors. Classification. Clinical manifestations, data of laboratory and instrumental methods of research. Differential diagnosis. Complications. Indications for pleural puncture and drainage of the pleural cavity. Treatment. Primary and secondary prevention. Prognosis and workability.
• Infectious and destructive lung diseases. Definition. Factors that contribute to the development of bronchiectasis, abscess and gangrene of the lungs. Clinical manifestations, data of laboratory and instrumental methods of investigation. Differential diagnosis. Complication. Treatment. Indications for surgical treatment. Primary and secondary prevention. Prognosis and workability.
• Respiratory failure. Definition. Classification. Causes. Features of clinical course of various forms. Diagnosis, examination of the function of external respiration, gases of arterial and venous blood, indicators of acid-base state of blood. Differential diagnosis. Therapeutic tactics. Primary and secondary prevention. Prognosis and workability.
• Gastroesophageal reflux disease. Definition. Etiology, pathogenesis. Classification. Erosive and non-erosive GERD. Clinical manifestations depending on the variant and stage. Data from laboratory and instrumental research methods. Criteria for diagnosis, differential diagnosis. Complications. Differentiated therapy. Primary and secondary prevention.
• Dyspepsia. Definition of dyspepsia. Etiology and pathogenesis. The role of H. pylori in development of gastroduodenal pathology. Classification. Unexplored and functional dyspepsia. Criteria for diagnosis. Differential diagnosis. Current approaches to the treatment of functional dyspepsia. Primary and secondary prevention. Prognosis and workability.
• Chronic gastritis. Definition, etiology and pathogenesis of chronic gastritis. The role of H. pylori in development of chronic gastritis. Classification. Clinical manifestations, data of laboratory and instrumental methods of research. The value of endoscopic (with morphology) examination. Current approaches to the treatment of different types of chronic gastritis. Primary and secondary prevention. Prognosis and workability.
• Peptic ulcer of the stomach and duodenum. Definition. The main causes of peptic ulcers (H. pylori, medicines, etc.). Classification. Clinical manifestations. Complications (perforation, penetration, bleeding, stenosis, malignancy). The value of instrumental and laboratory diagnostic methods. Methods for the diagnosis of Hp infection. Tactics of patient management. Eradication therapy, control of the effectiveness of eradication. Drug therapy for Hp-negative ulcers. Indications for surgical treatment. Primary and secondary prevention. Prognosis and workability.
• Celiac disease and other enteropathies. Definition. Etiology, pathogenesis. The role of intolerance of components of food, immune factors and enzymopathies (rejection of lactose, fructose, galactose, etc.). Malabsorption and maldigestion syndromes. Criteria for diagnosis, differential diagnosis. Complication. Differentiated therapy. Primary and secondary prevention. Prognosis and workability.
• Inflammatory bowel disease. Non-specific ulcerative colitis and Crohn’s disease: definition, etiology and pathogenesis. Classification. Features of the clinical course depending on the degree of activity, severity and phase of the course. Laboratory and instrumental diagnostics. Criteria for diagnosis, differential diagnosis. Intestinal and intestinal complications and diseases associated with inflammatory bowel disease (toxic dilation, perforation, sclerosing cholangitis, spondylitis, arthritis, dermatoses, uveitis, etc.). Treatment. Primary and secondary prevention. Prognosis and workability.
• Irritable bowel syndrome, definition. Etiology and pathogenesis. Classification. Clinical manifestations of different options. Roman diagnostic criteria. Differential diagnostics. Treatment of various forms. Primary and secondary prevention. Prognosis and workability.
• Cholelithiasis, chronic cholecystitis and functional biliary disorders. Definition. Etiology, pathogenesis. The importance of infection, motility and dyscholia in the development of chronic cholecystitis, cholangitis and cholelithiasis. Classification. Features of the clinical course. Laboratory and instrumental methods of diagnostics. Differential diagnosis. Complications of gallstone disease. Treatment. Indications for surgical treatment. Primary and secondary prevention. Prognosis and workability.
• Chronic hepatitis. Definition. Classification. Role of virus persistence, toxic and drug agents, immune disorders and alcohol. Methods of diagnosis of viral infection. Autoimmune hepatitis, chronic viral, toxic (drug) hepatitis. Alcoholic liver disease. The main clinical and biochemical syndromes. Features of clinical course and diagnostics of separate forms. Differential diagnosis. Complication. Features of treatment of various forms. Primary and secondary prevention. Prognosis and workability.
• Liver cirrhosis. Definition. The meaning of viral infection, nutritional factors, alcohol, toxic substances and immune disorders. Classification. Features of clinical manifestations and diagnostics of different variants. Differential diagnosis. Liver failure and other complications. Differentiated therapy. Immediate therapy for complications. Primary and secondary prevention. Prognosis and workability.
• Chronic pancreatitis. Definition. The value of different etiological factors. Classification. Features of clinical course, diagnostics and differential diagnostics depending on the form and localization of the pathological process. Complication. Research methods in the diagnosis of pancreatitis. Differentiated treatment. Primary and secondary prevention. Pharmacological and non-pharmacological treatment.
• Principles of evidence-based medicine. Definition of the concept. The role of evidence-based medicine in modern clinical practice. Components of evidence-based medicine. Basic concepts of clinical research. Medical and ethical aspects of evidence-based medicine.
• Diagnosis and treatment of diseases of the internal organs in elderly. Features of metabolism in elderly. Frequency of comorbid pathology in elderly. Features of the action of drugs on the body of an elderly person. Features of diagnostics and treatment of diseases of internal organs in old age.
• Obesity and its effects. The urgency of the problem. Methods for calculating excess weight (body mass index) and determining obesity. Classification of obesity. The main medical consequences of obesity are metabolic syndrome, diabetes mellitus, cardiovascular disease, and gastrointestinal diseases. Modern approaches to pharmacological and non-pharmacological treatment.

LIST OF PRACTICAL SKILLS AND TASKS
List of common tasks and activities that are tested during the control:
• Working with the patient
– Collection of complaints, life history, history of disease;
– To collect information about the patient’s general condition (consciousness, constitution) and assess the appearance (examination of the skin, subcutaneous fat, palpation of the lymph nodes, thyroid and mammary glands), examine the condition of the musculoskeletal system, joints;
– To examine the state of the respiratory system (examination of the chest, palpation of the chest, percussion and auscultation of the lungs);
– To examine the state of the cardiovascular system (examination and palpation of the area of the heart and blood vessels, percussion of the borders of the heart and auscultation of the heart and blood vessels);
– To examine the state of the digestive system (examination, percussion, superficial and deep palpation);
– To examine the condition of the urinary system (examination of the lumbar region, palpation of the kidneys).
• To make a preliminary diagnosis of the disease (List 1).
• To assign and justify laboratory and / or instrumental examination of the patient with the disease (List 1).
• To interpret laboratory and instrumental findings (List 2)
• To Perform differential diagnosis in diseases (List 1).
• To make a clinical diagnosis of the disease (List 1).
• To determine the appropriate regimen and diet of the patient with the disease (List 1).
• To determine the principles and nature of the treatment (conservative, operative) of the disease (List 1).
• To diagnose and provide emergency care (List 3)
• To perform medical procedures (List 4)
• To determine the tactics of secondary prevention of patients to be supervised.
• To keep medical documentation.

LIST 1 (DISEASES)
Diseases of hematopoietic organs
1. Anemia.
2. Acute and chronic leukemia.
3. Hemophilia.
4. Thrombocytopenic purpura.
Respiratory diseases
1. Chronic obstructive pulmonary disease.
2. Bronchial asthma.
3. Pneumonia.
4. Pleurisy.
5. Infectious-destructive lung diseases.
6. Respiratory failure.
Digestive diseases
1. Gastroesophageal reflux disease.
2. Functional disorders of the stomach, gallbladder, biliary tract and intestines.
3. Chronic gastritis and duodenitis.
4. Peptic ulcer of the stomach and duodenum.
5. Celiac disease and other enteropathies.
6. Non-specific ulcerative colitis, Crohn’s disease.
7. Cholelithiasis; chronic cholecystitis.
8. Chronic hepatitis.
9. Liver cirrhosis.
10. Chronic pancreatitis.
Diseases of the endocrine system
1. Diabetes mellitus, type 1.
2. Diabetes mellitus, type 2.
3. Iodine deficiency diseases of the thyroid gland.
4. Hypothyroidism.
5. Thyroiditis.
6. Thyrotoxicosis.
7. Thyroid cancer.
8. Cushing’s Syndrome and Disease.
9. Pheochromocytoma.
10. Aldosteroma.
11. Metabolic syndrome.
12. Somatotropic insufficiency.
13. Acromegaly.
14. Hyperprolactinemia.
15. Diabetes mellitus.
16. Hypopituitartism.
17. Obesity.
18. Diseases of the sexual glands.

LIST 2 (LABORATORY AND INSTRUMENTAL RESEARCH METHODS)
1. Analysis of pleural fluid
2. Analysis of ascitic fluid
3. Urinalysis for diastasis
4. Biochemical indicators of serum iron exchange.
5. Acute-phase indicators of blood, total blood protein and its fractions.
6. Investigations on bile
7. pH-metry of the stomach and esophagus
8. Breath tests with 13C-urea, 13C-triglycerides, 13C-starch,
13C-lactose and hydrogen breath tests with glucose and lactulose
9. General blood test.
10. General analysis of urine.
11. General analysis of the sternal punctate
12. General analysis of sputum
13. Blood electrolytes
14. Blood and urine ketone bodies, ioduria.
15. Coagulogram
16. Coprocytogram
17. Markers of viral hepatitis
18. Microbiological study of biological fluids and secretions
19. Methanephrine in urine
20. Indicators of acid-base state of blood.
21. Level of TSH, T4, T3, antibodies to thyroperoxidase (ATPO), antibodies to TSH receptors, antibodies to thyroglobulin
22. ACTH, cortisol, aldosterone, and renin levels
23. Glucose tolerance test, glycemic profile, C-peptide, glycated hemoglobin, fructosamine
24. Blood transaminases, total bilirubin and its fractions, alkaline phosphatase
25. Blood alpha-amylase
26. Fecal elastase-1
27. Investigation of the function of external respiration
28. Sonography, scanning, computer and magnetic resonance imaging of the thyroid and adrenal glands
29. Radiography of abdominal organs
30. Radiography of the chest cavity
31. Radiography examination of the skull and bones
32. Endoscopic examination of the bronchi
33. Endoscopic examination of the digestive tract
34. Cytological examination of the lymph node biopsy specimen.

LIST 3 (EMERGENCY CONDITIONS)
1. Addison crisis
2. Hypoglycemic coma
3. Acute respiratory failure
4. Acute hepatic encephalopathy
5. Diabetic ketoacidotic coma
6. Billiary colic
7. Severe exacerbation of bronchial asthma
8. Thyrotoxic crisis
9. Esophageal and gastrointestinal bleeding.

LIST 4 (MEDICAL MANIPULATIONS)
1. To do injections of medicines (subcutaneous, intramuscular, intravenous)
2. To determine the group of blood.

TO KNOW THE CLINICAL PHARMACOLOGY OF THE MAIN GROUPS OF MEDICINES
1. Antibacterial
2. α and β- adrenostimulants
3. Expectorants
4. Hemostatics
5. Proton pump inhibitors
6. H2-histamine blockers
7. Oral hypoglicemic and insulin, thyroxine, imidazole agents
8. Iron preparations
9. Cholinolytics.

SKILLS FOR MAKING MEDICAL DOCUMENTATION
1. Medical card of a hospital patient
2. Excerpt from the medical record of a hospital patient
3. Medical certificate of death
4. Spa map
5. Recipes for all sections of the discipline.

 

 

 

 






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