1. Classification of pleurisy.
2. Clinic of dry pleurisy.
3. Diagnosis of dry pleurisy.
4. Differential diagnosis of dry pleurisy.
5. Clinic exudative pleurisy.
6. Diagnosis of exudative pleurisy.
7. Differential diagnosis of exudative pleurisy.
8. Tactics GPs in pleurisy.
8. References.
The main
1. Kasalliklar testes, Sharapov UF T: Ibn Sina, 2003
2. Kasalliklar testes, Bobozhanov S. T: Yangi Asr avlod 2008
3. Internal Medicine, Volume 1 Mukhin, NA M. GEOTAR - Media 2009
4.Textbook of Internal Medicine Editor-in-Chief William N. Kelley 1997
Additional
1. Umumy amaliet vrachlar Uchun maruzalar tuples, Gad, A., T., 2012
2. General practice, Ed.F. G.Nazirova, A.G.Gadaeva.M. GEOTAR Media, 2009.
3. Directory GP. Dzh.Merta. M.: Practice, 1998.
4.Collection of practical skills for general practitioners. Gadaev A. Akhmedov Kh.S. T., 2010.
5. Umumy amaliet vrachlar Uchun Amal kunikmalar tuplyu Gadaev AG, Akhmedov, HS, 2010.
6. Therapeutic Guide Washington, Ed. M.Vudli M. Practice, 2000.
7. Umumy amaliet shifokori Uchun kullanma F.G.Nazirov, A.G.Gadaev Tahrah. M. GEOTAR-Media, 2007.
8. Treatment of diseases of the internal organs. AN hams All tomy.2005.
9. Differential diagnosis of internal diseases. AV Vinogradov Moscow: Medical News Agency, 2009.
10. Internal medicine: a textbook. - A 2-ton (2 volumes) Ed. Martynov, etc. M.: GEOTAR - Media, 2005:
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www.medlook.ru
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www.medbok.ru
9. Chronological content classes
Time
|
Events
|
Contents
|
Materials
|
Duration of training
|
8.30-9.30
|
Morning conference
|
The report of the doctor on duty and duty subordinators on duty.
|
Medical history, ECG, overhead projector.
|
1 hour
|
9.15-10.00
|
Clinical audit to prescribe patients.
|
A detailed report on the students' prescription patients.
|
|
45 minutes
|
10.05-10.45
|
Theoretical analysis of the topic
|
Checking the initial level of preparedness of students using the "snowball" and the solution of the situational problem.Article udentam heard case studies on the topic, they need to analyze and give an opinion.
|
Case studies, educational boards, tables, corresponding to a subject class.
|
40 minutes
|
10.45 -11.05.
|
Study of practical skills.
|
Student under the supervision of a teacher must complete at least two practical skill.
|
The patient or volunteer.
|
20 minutes
|
11.05-11.45
|
Curation of patients
in the department
|
Each student is supervised by a particular patient wards.
|
The patient, stethoscope, sphygmomanometer, medical history (with data of clinical and laboratory findings).
|
40 minutes
|
11.45-12.15
|
Break
|
|
|
30 min
|
12.20-13.20
|
Analysis of case-patients
|
At the choice of the teacher conducted a full examination of the patient on the theme of employment or patients preparing for discharge, data analysis, laboratory and instrumental studies, the rationale for the preliminary and final clinical diagnoses REFLECTION.Ed determined treatment plan with the doses of drugs.
|
The patient, stethoscope, sphygmomanometer, medical history (data of clinical and laboratory findings).
|
1 hour
|
KNOWLEDGE Requirements and skills in teaching students on the basis of Solutions to the problem of patients
with shortness of breath or choking
Purpose: Teach students posindromalnomu addressing patients with shortness of breath or choking, as well as the principles of their management in primary health care as part of the qualifying characteristics of GPs
The main learning objectives:
To teach the students solve the problem associated with shortness of breath or choking.
Giving students timely diagnosis in the presence of the problems associated with shortness of breath or choking.
To teach students to differentiate the disease, accompanied with shortness of breath or choking.
To improve the knowledge, skills and practical skills in solving problems of patients with shortness of breath or choking (gathering information, identifying problems and physical examination, as well as the ability to reasonably prescribe laboratory and instrumental methods of research);
To teach students to reasonably choose the tactics;
To teach students to exercise reasonable medical and preventive measures and monitoring in SAP and SP.
When parsing the problem of patients the key moments of assessing students must be:
Ability to identify the underlying problem, which is reflected in the quality of life of patients.
Asking the ancillary issues of rational history.
Ability to identify the presence of risk factors.
The ability to transfer disease or condition which may cause the problem.
The ability to reasonably conduct physical examination.
Ability to use sound laboratory and laboratory studies in a hovercraft or a joint venture.
Ability to identify the need for additional research outside the SVP or joint venture.
Based on this information the ability to identify the root cause (diagnosis) of the problem.
The ability to identify tactics on the basis of the qualifying characteristics of GPs.
The ability to provide non-pharmacological advice.
The ability to identify drug treatment based on evidence-based medicine
The ability to identify preventive measures at the level of primary health care.
The ability to define the principles of clinical examination and rehabilitation of patients in a hovercraft or a joint venture.
What the student needs to know to solve the problems of patients with shortness of breath or choking:
Number
|
The list of knowledge
|
The basic level
|
1
|
The list of diseases that present with shortness of breath or choking
|
The student should know at least 10 of the most common diseases
|
2
|
A list of the most dangerous diseases that present with shortness of breath or choking
|
The student should know at least 5 diseases
|
3
|
The list of conditions that require management in SAP or SP (1 category)
|
According to the characteristics of the GP qualifying
|
4
|
The list of states that require a specialist consultation or hospitalization (category 2)
|
According to the characteristics of the GP qualifying
|
5
|
A list of studies requiring in SAP or SP (3.1 category)
|
According to the characteristics of the GP qualifying
|
6
|
The list of research areas requiring outside SVP or SP (3-2 category)
|
According to the characteristics of the GP qualifying
|
7
|
Key points (criteria) diagnosis of diseases occurring with shortness of breath or choking
|
The student must know the characteristics and manifestations of each disease, and the criteria for their diagnosis.
|
8
|
Symptoms of cardiac asthma or pulmonary edema
|
The student must list the symptoms
|
9
|
Symptoms of asthma
|
The student must list the symptoms
|
10
|
Symptoms of heart failure
|
The student must know the manifestation
|
11
|
Signs of respiratory distress
|
The student must know the manifestation
|
12
|
Symptoms of internal organ
|
The student should know the symptoms of
|
13
|
The principle of "traffic light"
|
The student should know levels of peak expiratory flow (PEF), depending on the color of the traffic light
|
14
|
Indicators of laboratory results
|
the student should know:
- Normal values, as well as their changes in pathology.
|
15
|
Therapeutic tactics
|
The student must know the techniques and principles of treatment (including non-drug).
|
16
|
The principles of primary, secondary and tertiary prevention
|
The student should know the basic activities required for the primary, secondary and tertiary prevention
|
17
|
The principles of clinical examination and rehabilitation of disorders that occur with shortness of breath or choking in a hovercraft or a joint venture (category 4)
|
The student must list the main activities for clinical examination and rehabilitation
|
What the student should be able to solve the problems of patients with shortness of breath or choking:
Number
|
The list of skills
|
The basic level
|
|
Ask the patient and his relatives
|
The student should be able to ask questions of management concise questions that really helps to set the probable diagnosis.
The student should be able to specifically identify and assess the patient's complaints.
The student must be able to analyze medical history: the beginning of the disease, the first symptoms, the causal relationship and the dynamics of their development.
The student must be able to analyze the history of life: the identification of risk factors, the health of parents and close relatives.
|
|
Identify risk factors
|
The student must be able to identify the managed and unmanaged risk factors such as on questioning the patient, so on the basis of an objective approach
|
|
Calculate the index weight / body
|
The student must be able to identify signs:
- Underweight
- Increased weight.
|
|
Measure blood pressure.
|
The student should be able to tonometry with the incremental principle.
|
|
Perform visual inspection of the skin
|
The student must be able to detect the presence of:
Pale-
- Cyanosis
-Presence of lesions
|
|
Explore the pulse of the carotid, radial and femoral arteries
|
The student should be able to find:
- The presence or absence of a pulse
The student should be able to evaluate the performance of the radial artery.
|
|
Examine the thyroid gland
|
The student should be able to inspect and palpate the thyroid gland and identify signs of increase, and depending on the size of the thyroid gland to distinguish the degree of goiter
|
|
Palpate the chest
|
the student should be able to:
- To evaluate the excursion of the chest
- To evaluate voice trembling
- To estimate the elasticity of the chest
|
|
Conduct percussion respiratory
|
the student should be able to:
a change in pulmonary sound and interpret them
|
|
To conduct auscultation of the respiratory
|
the student should be able to:
assess bronchial and vesicular breathing, as well as the presence of abnormal noise or wheezing, interpret them.
|
|
To conduct palpation of the heart
|
The student must be able to identify:
- Cardiac impulse
- Systolic and diastolic tremor
The student must be able to assess the apical impulse.
|
|
Conduct percussion heart
|
The student must be able to identify:
- Boundaries of relative and absolute dullness of heart
- The boundaries of the vascular bundle
- The diameter of the heart
Configuration and the waist of the heart.
The student must be able to identify:
- Signs of hypertrophy of the heart
- Configuration of the mitral
-Aortic configuration
|
|
Conduct a cardiac auscultation
|
The student must be able to identify:
- Easing I and II sound
- I gain tones on top
- Accent II tone of the aorta or pulmonary artery
- Systolic and diastolic murmur, and to identify their epicenter
To be able to differentiate functional from organic heart murmur.
- Noise pericardial friction
|
|
To conduct palpation, percussion of the abdomen
|
The student should be able to superficial and deep palpation of the abdomen
The student must be able to identify:
- Hepatomegaly splenomegaliiyu
|
|
Inspect the limb
|
The student should see the limbs and body, and to be able to find:
- Local or generalized edema. The fingers must be able to exert pressure on the back of the foot to discover:
- There is a hole or not.
|
|
Perform a visual inspection of bones and joints
|
The student should be able to find:
- The presence of articular syndrome
|
|
Inspection of the throat
|
The student should be able to inspect the throat with the principle of step and identify the signs of angina.
|
|
Conduct a peak flow meter
|
The student should be able to hold the peak flow meter, taking into account the principle of step
|
|
Interpret the results of peak flow
|
The student must:
- Know how to use tables and charts PSV normal values based on gender, age and height of the patient.
- Be able to calculate the percentage of predicted PEF values depending on gender, age and height of the patient.
- Be able to analyze and predict the results
|
|
Interpret clinical, instrumental and biochemical analyzes
|
The student must be able to detect a shift from the norm
|
|
Interpret the X-ray picture of light
|
The student must be able to identify signs:
- Pneumonia
- Pneumothorax
- Pleurisy
- Lung cancer and tuberculosis
|
|
Remove the ECG and decrypt it
|
3. The student should be able to record the ECG with the incremental principle.
4.The student must be able to decipher the results of the ECG and identify signs:
- Ischemia
- Myocardial infarction
- Hypertrophy of the heart.
-Rhythm and conduction disturbances
|
|
Differentiate between diseases accompanied with shortness of breath or choking
|
The student must be able to differentiate the disease on the basis of the distinctive features (history, physical examination, laboratory and instrumental investigations).
The student must be able to differentiate asthma from cardiac asthma on the basis of objective data.
The student must be able to differentiate NC from respiratory failure on the basis of objective data.
|
|
Post a non-drug advice
|
the student should be able to:
- Educate patients on self-monitoring
- Advise on diet
- Advise on healthy lifestyles
|
|
To provide pre-hospital care
|
The student must be able to provide pre-hospital care in a fit of asthma, spontaneous pneumothorax, cardiac asthma or pulmonary edema and myocardial infarction.
|
|
To hold the pleural puncture
|
The student must be able to carry out pleural puncture technique for spontaneous pneumothorax.
|
|
Rational use of medicines in the treatment of diseases that occur with shortness of breath or choking
|
The student should be able to choose drugs with proven efficacy.
When selecting a drug student should be able to evaluate:
Efficiency
safety
- Eligibility
Efficiency.
|
|
Conduct monitoring and surveillance of patients
|
The student must be able to carry out monitoring and control:
FBC
- The level of the A / D.
- X-ray
- PSV
|
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