The Ministry of Health of the Republic of Uzbekistan Tashkent Medical Academy The department of internal diseases №3 of medical an Medical Pedagogical Faculty
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- Bu səhifədəki naviqasiya:
- Evaluation Perfect Good Satis, Unsatis.
- 85%-71% 70-55% 54%-37% 36% and less
- Evaluation Perfect Good Satis. Unsatis
- Demonstration of practical skills mastered 5.1. Criteria for evaluation of knowledge and skill to practical skills of students.
- Evaluation Perfect Good Satis. Unsatis.
- 14-11 point 10,8-7,4 point 7,2 point
- point 27-18,5 point 18 point 3
- 8,1-5,5 point 5,4 point 4
- point 5,4 point
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2) 37 year old man turned to the GP complaining of aching pain in the epigastric region radiating to the region of the heart, nausea, heartburn, general weakness. The pain occurs in 20-30 minutes after ingestion. From history: last spring, there were also similar pains. The patient was not treated, the pain itself passed in a month. Objectively: general condition is satisfactory. Skin is clean, pale pink color. The tongue is coated with thick grayish-white coating. On palpation of the abdomen there was a huge local tenderness in the left upper quadrant and mesogaster. The liver and spleen were not enlarged. Negative sign of a beating from both sides. The chair is prone to constipation. Urine output is regular. 1. List at least 5 of diseases which can be above symptoms-15 points. 2. Your initial diagnosis, 25 points. 3. What additional research is needed to clarify the diagnosis for 15-points. 4. What complications can occur with this disease, 20 points. 5. The tactics of the GP-10 points. 6. The principles of conservative treatment, 15 points. 3) 20 year-old student complains of hunger and night pain in the abdomen, irradiruyuschie in the spine, headaches, dizziness periodically, and constipation. Sometimes the pain bother 1.5-2 hours after eating. Objectively: the patient malnutrition, skin pale pink, tongue coated, abdominal palpation there was a huge local pain in the epigastric region to the right. The liver is not increased. UAC: Hb - 100 g / l erythrocytes - 3,0 '10 ¹ ² / L, WBC - 8.7 "109 / L ESR - 20 mm / hour. 1. List at least five probable diseases, which are the above symptoms-15 points. 2. Your initial diagnosis, 30 points. 3. List the etiological types of this disease, 25 points. 4. The tactics of the GP-10 points. 5. Principles of treatment of 20-points. 4) The reception was at the GP 18 year old student complains of hunger and night pain in the abdomen, irradiruyuschie in the spine, occasionally heartburn, acid regurgitation, constipation. . History of big brother is suffering a stomach ulcer 12 duodenal ulcer. Objectively: the patient malnutrition, skin and visible mucous membranes pale, tongue coated. On palpation of the abdomen there was a huge local pain in the epigastric region to the right, and constipation. 1. List at least four probable diseases for which there are symptoms listed above; 2. Your preliminary diagnosis; 3. List the factors of protection (at least five), opposing the emergence of this disease; 4. Tactics GPs and treatment guidelines. 5) 28 year-old patient at a reception GP notes abdominal cramping and pain reduction of such emptying. From history revealed that the patient is a child suffered dysentery. An objective examination of a large belly, swollen, with palpation and rumbling in the projection of the colon, tenderness. Constipation. Sheep feces in 3-4 days 1 times. 1. List at least three diseases that manifest the above symptoms; 2. Your preliminary diagnosis; 3. Additional tests to confirm the diagnosis; 4. What you need to carry out research tool for diagnosis; 5. Tactics GPs and treatment. 6). Patient is 64 years old, turned to the GP with complaints of epigastric pain colicky after 20 - 40 minutes after eating, bloating and rumbling in the abdomen, constipation alternating with diarrhea, weight loss. In history: suffering for many years from diabetes type II diabetes, coronary heart disease. Took home nitroglycerin, then noted some improvement. On-no: the patient malnutrition, skin and mucous membranes are pale and clean. Heart of: the tones are muted, rhythmic. Pulse 80 beats. 1 min. BP - 130/80 mm Hg In the lungs, vesicular breathing. Tongue dry, coated with white bloom. The abdomen was soft, painful on palpation in the epigastric. Auscultation of abdominal aortic systolic murmur auscultated. The liver and spleen were not enlarged. Chair - constipation alternating with diarrhea. 1.Perechislite at least five diseases in which there is the above mentioned symptoms; 2. A presumptive diagnosis; 3. Informative research methods; 4. Reschayushy research method for confirmation of the diagnosis; 5. The tactics of the GP with a detailed description of administration (medical and non-medical) patients;
1.Perechislite at least three diseases in which there is the above mentioned symptoms; 2. A presumptive diagnosis; 3. Informative research methods; 4. The tactics of the GP with a detailed description of administration (medical and non-medical) patients;
1.Perechislite at least three diseases in which there is the above mentioned symptoms; 2. A presumptive diagnosis (main complication); 3. Informative research methods; 5. Necessary assistance conditional prehospital (drug-free and drug-induced); 9) Patient 72 years appealed to the GP, complaining of pain in the left iliac region, constipation, feeling of incomplete emptying of the bowel, fatigue, lack of appetite. Objectively: the patient malnutrition, skin pale and clean. Heart of: Muted tones, rhythmic. Pulse of 100 beats. 1 min. Blood pressure 110/60 mm Hg In the lungs auscultated vesicular breathing. The tongue is coated with a grayish bloom. The abdomen was soft, limited swelling is determined by the left part of the abdomen, visible to the eye peristalsis, pain in the left iliac region. The liver and spleen were not zoom. Chair - constipation. In the UAC - anemia, leukocytosis, increased ESR - 40 mm per hour. In the feces - admixture of blood and mucus. 1.Perechislite not less than five and less than three disease complications in which the above mentioned symptoms are observed; 2. A presumptive diagnosis; 3. Informative research methods; 4. The tactics of the GP; 10) Patient F. 36 years old, asked the GPs. He complains of pain in the epigastric region an hour after eating, hungry and night pain, constipation, heartburn. He considers himself a patient for 7 years, exacerbation of notes in the spring and fall. She was treated Vikalin, vitamin U, gastrofarm. This morning, suddenly appeared dizziness, nausea, bloody vomiting, severe weakness. Objectively: a serious condition, anxiety, skin and visible mucous membranes pale. The extremities are cold. Heart sounds are sonorous, clean, soft pulse of 100-120 in 1 min, A / W 85/45 mm Hg Tongue coated with white bloom, dry. Abdominal palpation is soft, painful in the epigastric region radiating to the back. After vomiting notes the decrease in pain. Blood test: Hb -70 g / l, erythrocytes - 2,8 * 1012 1 ml / l, Lek - 9.2 * 109, ESR - 20mm/chas. 1.Perechislite at least three diseases in which there is the above mentioned symptoms; 2. A presumptive diagnosis; 3. Informative research methods; 4. The tactics of the GP; 5. Required prehospital pomosh (drug-free and drug-induced); 11). Female 52 years appealed to the GP complaining of swelling and pain around the stomach, worse after eating and calming after a bowel movement or flatus, irritability, constipation for 4 - 5 days, a bad dream. From history: ill 6 years. Objectively: general condition is relatively satisfactory. Skin and visible mucous membranes of normal color. Subcutaneous fat is moderately developed. In the lungs, vesicular breathing. Heart sounds are average sonorities, rhythmic. BP 130/60 mmHg Pulse 90 beats per 1 minute. Tongue coated plaque, tooth prints on the edges. The abdomen is moderately distended, soft, palpation - pain in the sigmoid. The liver and spleen were not palpable. Chair - constipation. Symptom tapping the kidneys negative on both sides. Urination is free and painless. Sigmoidoscopy: catarrhal changes in the mucous of the line and the sigmoid colon, the mucus. 1.Perechislite at least three diseases in which there is the above mentioned symptoms; 2. A presumptive diagnosis; 3. Informative research methods; 4. The tactics of the GP with a detailed description of administration (medical and non-medical) patients; 12) Patient M., 74 years old, complains of slight abdominal pain, with no clear localization, the delay in the chair for 4 - 5 days, occasionally noted blood in the stool, fever up to 37.3 C, and weakness. In the last 4 days - loss of appetite, nausea. OBJECTIVE: malnutrition, the skin is dry. In the lungs, vesicular breathing. Heart sounds are average sonorities, rhythmic. Blood pressure 130/85 mm Hg Pulse 70 beats per 1 minute. Tongue coated plaque, tooth prints on the edges. On palpation of the abdomen is painful, more in the left iliac region, there is palpable education, still, with clear margins. No abdominal muscle strain. In UAC anemia, leukocytosis, accelerated erythrocyte sedimentation rate. 1.Perechislite at least four diseases in which there is the above mentioned symptoms; 2. A presumptive diagnosis; 3. Informative research methods; 4. The tactics of the GP; 13) Patient S. 59, appealed to the GP complaining of heaviness in the right upper quadrant, itching, loss of appetite, poor tolerance of fatty foods, belching, nausea, constipation, discolored feces. From history: 16 years ago, underwent viral hepatitis, itching of the skin disturbs one month, during which time due to poor appetite lost 4 kg. OBJECTIVE: yellowness of the skin, with traces of scratching, lymph nodes were not palpable. In the lungs - vesicular breathing. Pulse 65 beats / min, rhythmic. A / D 110/70 mm Hg Heart sounds are sonorous. The tongue is red. The abdomen was soft, tenderness in the right upper quadrant. The liver extends from under the costal margin of 2 cm and soft. Spleen probe fails. Blood test: er - 3700000, Nv - 78 g / l, tsv.pok. - 0.9, Lei. - 8.0 thousand, ESR - 23 mm / hour. Urinalysis: response to positive bile pigments. 1.Perechislite at least four diseases in which there is the above mentioned symptoms; 2. A presumptive diagnosis (main complication); 3. Informative research methods; 4. The tactics of the GP; Tests with one correct answer 1. Treatment of chronic functional constipation atonic nature does not include: a) sparing diet (pasta, semolina) b) a diet rich in fiber, bran a) drugs rhubarb or other laxatives d) psychotherapy d) physical therapy, exercise therapy 2. A patient 56 years old complained of constipation, blood in stool, change in stool form (tape-like), pain in the lower abdomen. Objectively: general condition is satisfactory, skin and mucous palely, moderately distended stomach, the rest of palpation of the abdomen was normal. What research is needed to conduct or recommend a general practitioner to the patient in the first place? a) irrigoscopy b) coprogram c) a digital rectal examination g) sigmoidoscopy e) fibrocolonoscopy 3. During the year, the patient concerned dull, aching pain in the right upper quadrant, worse after eating, bloating, constipation. objectively normal. When holetsistografii gallbladder well filled by contrast, after receiving 2 egg yolks are not reduced. Your diagnosis? a) chronic cholecystitis in the acute stage b) Biliary hypotonic biliary type d) Biliary bile duct hypertensive type d) Chronic persistent hepatitis Tests with two or more correct answers 4. The occurrence of constipation in chronic gastritis with normal and elevated secretion explain the three factors a) to acidic contents of the stomach to the motor function of the intestine b) the development of dyskinesia intestine hypotonic type c) Eating Disorders g) Hypertonus vagus nerve e) Violation of hydrochloric acid e) hypotonicity vagus 5. For gipomotornoy dyskinesia of the colon characterized by: a) blood in the stool b) atonic constipation c) Diarrhea g) blunt abdominal pain d) persistent headaches e) mucus in the stool 6. What are the 3 types of constipation? a) nutritional b) neurogenic c) prostate inflammation d) prostatic d) ulcerative e) reflex 7. Name 3 signs of slowing evacuation of the colon? a) a solid dark brown feces b) a small number of muscle fibers c) significant amounts of fatty acids e) in the feces of a significant amount of undigested fiber e) quickly detachable cal 8. List the three pathological changes in fecal enterocolitis? a) a considerable amount of fatty acids b) increase in the release of enzymes in the faeces c) the detection of proteins in the feces d) changes in the flora e) in the feces of a significant amount of undigested fiber e) the absence of changes in the flora 9. Name 3 endoscopy used in enterocolitis: a) sigmoidoscopy b) EGDFS c) colonoscopy g) sigmoidoscopy e) ECG
e) echocardiography sophisticated tests 10. A patient 17 years appealed to the GP with complaints of epigastric pain, belching, constipation. Has irregular eating mostly dry rations. 1. Your presumptive diagnosis: a) chronic Ghasri with reduced secretion b) peptic ulcer, 12 duodenal ulcer c) peptic ulcer d) chronic pancreatitis d) chronic colitis A patient 17 years appealed to the GP with complaints of epigastric pain, belching, constipation. Has irregular eating mostly dry rations. 1. Your presumptive diagnosis: a) chronic Ghasri with reduced secretion b) peptic ulcer, 12 duodenal ulcer c) peptic ulcer d) chronic pancreatitis d) chronic colitis
4.2.2 A graphic organizer, "pyramid" Means layering ideas. Develops and activates the system, creative, analytical thinking. 1. Acquainted with the rules of construction of the scheme. Individually / in pairs build scheme: write the main problem, then sub-problems, and from each of them assign "small branches" that are essential for a more detailed consideration of sub-problems or tasks. With this trace the development of each of the ideas to a considerable depth in detail. 2. Combined in pairs or small groups, compare and complement their schemes. Reduce the overall scheme 3. Presentation of results.
1. Perform a visual inspection of patients with constipation. 2. The interpretation of laboratory and instrumental investigations for constipation.
5. Control forms of knowledge, skills and abilities • Verbally • In writing • The decision of situational problems • Demonstration of practical skills mastered 5.1. Criteria for evaluation of knowledge and skill to practical skills of students.
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