Education
Thematic plan for course Ambulatory polyclinic therapy
Practical exercises
|
№ |
The name of the topic of the practical lessons= |
Hours | |
| theoretical | practical | ||
| Stationary Therapy | |||
| 1 | Fundamentals of family medicine.
GP functions. Features of work. Medical documentation. The rights of the doctor and the patient. Ethics and deontology in the work of the GP. Factors contributing to communication. Difficulties in communication. Interpersonal communication. Practical advice. Consulting. Types of consultations. Counseling principles. The responsibility of the patient for their own health. |
3
(2/1) |
3 |
| 2 | Differential diagnosis in GP practice.
Estimated diagnosis. Principles of building a clinical diagnosis in a hospital and outpatient practice. The concept of the most dangerous diseases . diagnostic errors. Illness mimics. Mental disorders and simulation. Causes, nature of medical errors in the clinic of internal diseases. Polypharmacy in the practice of GPs. |
3 | 3 |
| 3 | Cough with expectoration
Differential diagnosis of community-acquired and nosocomial pneumonia. Pneumonia of various etiologies (bacterial, viral, mycoplasmal ). Differentiated approach to treatment . The tactics of the GP in the detection of pneumonia. |
3
|
3 |
| 4 | Darkening syndrome in the lungs Differential diagnosis in pulmonary dissemination. Differential diagnosis in lobar occlusion of the lungs: lobar pneumonia, infiltrative pulmonary tuberculosis, pulmonary infarction. Differential diagnosis for hematogenous disseminated form of TBC of the lungs, pneumoconiosis, cancer metastasis to the lungs. GP tactics and prevention methods. | 3 | 3 |
| 5 | Chest pain associated with lung disease
Differential diagnosis in dry, exudative pleurisy. Types of exudative pleurisy. Opportunities and tactics of the GP in the early detection of pleurisy .. |
3 | 3 |
| 6 | Syndrome of hemoptysis
Medical tactics and differential diagnosis of various nosological forms (cancer, suppurative lung diseases, pulmonary embolism, tuberculosis). Tactics of GP in PE at the pre – and hospital stage . |
3
(2/1) |
3 |
| 7 | Shortness of breath, suffocation
Differential diagnosis of diseases occurring with bronchial obstruction (bronchial asthma, COPD, lung tumors). Differential diagnosis of dyspnea in cardiac and pulmonary pathology. OP tactics. |
3
(2/1) |
3 |
| 8 | Arrhythmias
Differential diagnosis of sinus tachycardia, pacemaker migration, sick sinus syndrome, extrasystoles , atrial and ventricular flutter and fibrillation, paroxysmal tachycardia, WPW syndrome . GP tactics depending on the class of arrhythmia . Definition of a high risk group () . GP tactics depending on the class of arrhythmia . Definition of a high-risk group |
3
|
3 |
| 9 | Arrhythmias
Differential diagnosis in blockade: intra -atrial and atrioventricular . Differential diagnosis in intraventricular blockade. Tactics of GP and therapy for rhythm and conduction disorders. Indications for EX . |
3
(2/1) |
3 |
| 10 | Arterial hypertension
Differential diagnosis of hypertension with endocrine hypertension. Types of endocrine hypertension ( pheochromacy -toma, Kohn’s syndrome, Itsenko- Cusheng ‘s syndrome , thyrotoxicosis). Selection of antihypertensive therapy for hypertension and symptomatic hypertension. Tactics of GP in hypertensive crises. Indications for surgical treatment. Prevention. |
3
|
3 |
| 11 | Arterial hypertension
Differential diagnosis of hypertension with hemodynamic and cerebral hypertension (traumatic brain injury, vertebrobasilar syndrome, arachnoiditis, encephalitis, brain tumors), sclerotic hypertension. Prevention . OP tactics. Selection of antihypertensive therapy for hypertension and symptomatic hypertension. Tactics of GP in hypertensive crises. Indications for surgical treatment. Prevention. |
3
(2/1) |
3 |
| 12 | Pain in the region of the heart
Differential diagnosis for chest pain of coronary origin and choice of management tactics. Differential diagnosis of pain syndrome in IHD , stable and unstable angina. Clinical, laboratory, ECG diagnostics of stable and unstable angina pectoris. N violation of lipid metabolism. The value of the ECG with physical activity in diagnosing the degree of damage to the coronary arteries. Clinical assessment of the results of the stress test . Prevention. GP tactics |
||
| 13 | Pain in the region of the heart
Differential diagnosis of pain syndrome in coronary artery disease Acute coronary syndrome. Differential diagnosis of various clinical variants, stages in myocardial infarction. ECG diagnosis of myocardial infarction. Prevention. GP tactics. |
3
(2/1) |
3 |
| 14 | Heart murmurs and cardiomegaly
Differential diagnosis of functional (myocardial, anemic, with blood changes, fever) and organic (mitral and aortic defects) heart murmurs. Early prevention of complications, indications for surgical treatment. Tactics of the GP. Differential diagnosis in congenital heart diseases. The significance of risk factors for the disease, the implementation of preventive measures with VHF. Timely clinical, laboratory and instrumental diagnostics, risk factors, development of CHD. management of patients with bacterial endocarditis. |
3
(2/1)
|
3 |
| 15 | Heart murmurs and cardiomegaly
Differential diagnosis of myocarditis and various cardiomyopathies ( dilated, restrictive, hypertrophic, arrhythmogenic right ventricular dysplasia ). Early detection of CMP. Prevention and tactics of GPs. |
3
|
3 |
| 16 | Dysphagia
Differential diagnosis of esophagitis, reflux esophagitis, dysphagia in scleroderma , tumors of the esophagus, etc. Prevention. GP tactics |
3
|
3 |
| 17 | Stomach ache
Differential diagnosis of gastritis and peptic ulcer (stomach and duodenal ulcer), chronic cholecystitis and chronic pancreatitis, nonspecific ulcerative colitis and Crohn’s disease. Prevention. GP tactics |
3
(2/1)
|
3 |
| 18 | Hepatomegaly and jaundice
Differential diagnosis of active and inactive chronic hepatitis. Differential diagnosis of chronic hepatitis and liver cirrhosis. Gallstone disease with tumors of the biliary -pancreatic zone (tumors of the liver, gallbladder, pancreas). Early diagnosis of jaundice . Prevention and tactics of GPs |
3
(2/1) |
3 |
| 19
|
Articular syndrome
Differential diagnosis of rheumatic fever and rheumatoid arthritis, seronegative spondyloarthritis Prevention. GP tactics. |
3
(2/1) |
3 |
| 20 | Urinary sediment changes
Differential diagnosis of proteinuria and pathological urinary sediment (pyelonephritis, glomerulonephritis and interstitial nephritis). GP Tactics . Chronic kidney disease. Differential diagnosis of amyloidosis and nephropathies (pregnant, diabetic , drug). OP tactics. |
3
|
3 |
| Hours for in-patient therapy | 100 | ||
| Out–patient therapy | |||
| 1 | Family work. Features of work. Psychological environment in the family. Features of work. Psychological environment in the family. Problems of religion. Family consultation. Practical advice. Responsibility of the patient for his health (dispensary observation and monitoring in primary care). Children, adolescents, women of childbearing age, pregnant women, men, the elderly. Socially unprotected. Sick, difficult patients, dying patients. Tasks of medical examination and rehabilitation of therapeutic patients. Employability examination. | 3
|
3 |
| 2 | Prevention in the activities of GPs. Prevention of infectious and non-infectious diseases. Immunization. Programs and activities. Sanitary educational work. The degree of mortality and the impact on the main factors of morbidity. Strengthening the psychological status. Ecology and professional factors. Education of patients – “schools of health”. Methods for conducting preventive examinations. Screening. | 3 | 3 |
| 3 | Prevention in GPactivities
Prevention of communicable and non-communicable diseases. Immunization. Programs and activities. Sanitary education. The degree of mortality and the impact on the main factors of morbidity. Strengthening the psychological status. Ecology and professional factors. Teaching patients is a “school of health”. Methods of preventive examinations. Screening. |
3 | 3 |
| 4 | Healthy food
Healthy eating, description, food composition, healthy eating pyramid, healthy eating – prevention of various diseases. Diet therapy for diseases of the cardiovascular system, gastrointestinal tract, respiratory and excretory systems, Fundamentals of non-drug therapy. The concept of adherence to non-drug therapy |
3 | 3 |
| 5 | Cough with expectoration
Differential diagnosis of acute respiratory infections, acute bronchitis and pneumonia. OP tactics. Prevention and treatment of respiratory diseases in primary care. |
3 | 3 |
| 6 | Syndrome of shortness of breath and suffocation
Diagnosis of Chronic Obstructive Pulmonary Diseases and Bronchial Asthma in primary health care (LUDR). GP tactics. Treatment and prevention of COPD and AD in the LUDR ()CЎOK va BA ni birlamchi link sharoitida davolash va prevention of ishlari (during and outside the attack, observation and outpatient treatment). Indications for outpatient treatment. Control of AD and spg treatment. Management of patients with DN. |
3 | 3 |
| 7 | Chest pain
Tactics of GP for chest pain of a non-coronorogenic nature. Outpatient treatment. Primary care and prevention |
3
|
3 |
| 8 | Heartbeat
Tactics of GP and prevention for various types of arrhythmias and blockades (determination of high-risk groups). Features of treatment on an outpatient basis. Indications of emergency and planned electropulse therapy. Prevention of heart rhythm disorders. |
3 | 3 |
| 9 | Heart murmurs and cardiomegaly
Differential diagnosis of congenital heart defects. The importance of risk factors for the disease, carrying out preventive measures with HFV. Timely clinical, laboratory and instrumental diagnostics, risk factors, development of CHD. methods of managing a patient with bacterial endocarditis. |
3 | 3 |
| 10 | Headache
Stratification of the risk group in hypertension. OP tactics. Prevention of hypertension and SAH in the primary care. |
3 | 3 |
| 11 | Arterial hypertension
Selection of antihypertensive therapy for hypertension and symptomatic hypertension. Tactics of GP in hypertensive crises. Indications for surgical treatment. Prophylaxis. |
3 | 3 |
| 12 | Joint syndrome
Differential diagnosis of rheumatic fever and rheumatoid arthritis, seronegative spondy loarthritis Prevention. GP tactics |
3 | 3 |
| 13 | Joint syndrome
Primary, secondary, tertiary prevention of arthrosis and principles of clinical examination. |
3 | 3 |
| 14 | Dyspepsia (heartburn, nausea, vomiting). Diseases occurring with impaired secretion : gastric ulcer and duodenal ulcer, biliary dyskinesia, cholecystitis, postcholecystectomy syndrome, condition after gastric surgery. Treatment and prevention. | 3 | 3 |
| 15 | Prevention of diseases occurring with epi-, meso-, hypogastric pains. Diarrhea. Differential diagnosis of diarrhea and infectious and non-infectious etiology. SRK. Classification and criteria. OP tactics. Prevention of IBS, constipation in the elderly, malignant neoplasms of the large intestine. OP tactics. | 3 | 3 |
| 16 | Hepatomegaly
Prevention of acute, chronic hepatitis, alcoholic liver disease, liver cirrhosis of various etiologies. OP tactics. |
3 | 3 |
| 17 | Dysuria
Prevention of acute and chronic pyelonephritis, cystitis and uric acid diathesis. OP tactics. |
3 | 3 |
| 18 | Edematous syndrome
Differential diagnosis of edematous syndrome of various genesis: generalized (heart failure, kidney disease (nephritic syndrome; nephrotic syndrom, liver disease (cirrhosis, chronic hepatitis, liver cancer), diseases of the gastrointestinal tract, accompanied by protein loss, prolonged starvation, cachexic conditions, endocrine diseases, oncological slaughter) and local edema |
3
(2/1) |
3 |
| 19 | Fever
Types and types of fever. Fever of unknown origin. GP Tactics. |
3
(2/1) |
3 |
| 20 | Geriatrics. Problems of the age norm. Functional and organic changes during aging
Patterns of aging processes. The mechanism of development of age-related changes. Physiology and hygiene of nutrition of the elderly. Clinical manifestations of atherosclerosis and dynamic observation. Emphysema in the elderly. Age-related changes predisposing to the development of COPD in the elderly. GP tactics and methods of observation when detecting these conditions in the elderly. Problems of the elderly with diseases of the gastrointestinal tract. Problems of the elderly with diseases of the urinary system. Age-related changes that predispose to these diseases. |
2 | 2 |
| Out–patient Therapy Hours | 114 | ||
| Total | 214 hrs | ||
Practical classes are held in an equipped auditorium separately for each academic group. Practical classes are conducted using interactive teaching methods.
- Independent work
| № | SIW Topics | Volume |
| 1 | Myocardial functions. Normal ECG. (Extracurricular work) | 4 |
| 2 | Pharmacodynamics of antiarrhythmic drugs. (Extracurricular work) | 4 |
| 3 | Etiology and pathogenesis of conduction disorders (Extracurricular work) | 4 |
| 4 | Arterial hypertension, hypertension, etiology, pathogenesis and classification of nephrogenic arterial hypertension. (Extracurricular work) | 6 |
| 5 | Arterial hypertension and etiology, pathogenesis and classification of endocrine arterial hypertension. (Extracurricular work) | 5 |
| 6 | Classification of antihypertensive drugs (Extracurricular work) | 5 |
| 7 | Etiology, pathogenesis of hemodynamic and cerebral hypertension and classification of antihypertensive drugs (Extracurricular work) | 4 |
| 8 | Etiology, pathogenesis and classification of coronary heart disease. Principles of IHD treatment. (Extracurricular work) | 6 |
| 9 | Etiology, pathogenesis of myocardial infarction. Pharmacodynamics of drugs used in treatment of myocardial infarction. (Extracurricular work) | 4 |
| 10 | Causes of the development of cardiomegaly , forms of cardiomegaly , clinical variety of symptoms, ECG and X-ray diagnostics, treatment. Etiology, pathogenesis, clinic, diagnosis of mitral heart disease. (Extracurricular work) | 4 |
| 11 | Causes of malformations in rheumatism, infective endocarditis, aortic atherosclerosis. ECG and X-ray diagnostics, treatment. Etiology, pathogenesis, clinic, diagnosis of aortic heart disease. (Extracurricular work) | 4 |
| 12 | Etiology of malformations, pathogenesis, mechanism of murmurs, functional and organic, auscultatory pattern of murmurs, direct and indirect signs, signs of increased pressure in the pulmonary circulation, course of malformations. (Extracurricular work) | 6 |
| 13 | Causes of cardiomegaly , forms of cardiomegaly, clinical variety of symptoms. ECG and X-ray diagnostics. Treatment, features of the use of adrenoblockers and cardiac glycosides. (Extracurricular work) | 4 |
| 14 | Etiology, pathogenesis, classification of circulatory failure, clinical picture. The use of cardiac glycosides, β-blockers, ACE inhibitors, diuretics, methods of treating heart failure. (Extracurricular work) | 4 |
| 15 | Etiology, pathogenesis, treatment of myocarditis and myocardial dystrophy. Pharmacodynamics of drugs used in the treatment of myocarditis and myocardial dystrophy. (Extracurricular work) | 4 |
| 16 | Reasons for the development of pericarditis, diagnosis. Etiopathogenesis and clinic of PE, dissecting aortic aneurysm ( Extracurricular work) | 4 |
| 17 | Etiology, classification of pneumonia, tuberculosis and pulmonary infarction, clinical signs and variants of pneumonia, tuberculosis and pulmonary infarction, research methods , complications (Extracurricular work) | 4 |
| 18 | Etiology, classification of pneumonia, clinical signs and variants of pneumonia , abscess , cancer and echinococcus of the lungs, research methods, complications. (Extracurricular work) | 4 |
| 19 | Etiology, classification of COPD, clinical signs, research methods, complications. (Extracurricular work) | 4 |
| 20 | Diagnostic criteria for rheumatism, rheumatoid arthritis. Criteria for the diagnosis of rheumatic fever. (Extracurricular work) | 4 |
| 21 | Diagnostic criteria for seronegative spondyloarthritis (reactive arthritis, Bechterew’s disease, psoriatic arthritis. Criteria for the diagnosis of rheumatism. (Extracurricular work) | 5 |
| 22 | Diagnosis and criteria of activity, methods of treatment of DBST. (Extracurricular work) | 5 |
| 23 | Etiology, pathogenesis, classification, clinical syndromes, diagnosis, methods of treatment, pharmacodynamics of drugs used to treat CKD. (Extracurricular work) | 5 |
| 24 | Diagnostics and activity criteria, methods of treatment, prevention of SV and DM. Pharmacodynamics of drugs used in the treatment of SV and DM. (Extracurricular work) | 4 |
| 25 | Diagnosis and activity criteria, methods of treatment, prevention of NPP and UP. Pharmacodynamics of drugs used in the treatment of NSP and UP. (Extracurricular work) | 4 |
| 26 | Etiology, pathogenesis, clinical manifestation of the disease, diagnosis, criteria for the activity of immunoinflammatory and inflammatory diseases of the kidneys. (Extracurricular work) | 4 |
| 27 | Definition, etiology, pathogenesis of nephropathies. (Extracurricular work) | 4 |
| 28 | Etiology, pathogenesis, classification, clinical syndromes, diagnosis, methods of treatment, pharmacodynamics of drugs used to treat CKD. (Extracurricular work) | 4 |
| 29 | Etiology, pathogenesis, clinical manifestation of the disease, diagnosis, edematous syndrome (Extracurricular work) | 4 |
| 30 | Etiology of dysphagia, pathogenesis, mechanism of pain. Risk factors in the development of dysphagia (Extracurricular work) | 5 |
| 31 | Clinical manifestations, clinical and laboratory criteria, complications, treatment of peptic ulcer (Extracurricular work) | 4 |
| 32 | Etiopathogenesis of pancreatitis, classification of pancreatitis. Diagnostic studies of pancreatic tumors. (Extracurricular work) | 4 |
| 33 | Complications of UC and diagnostic criteria for studies (Extracurricular work) | 4 |
| 34 | Etiopathogenesis , clinical manifestations, syndromic diagnosis of diseases accompanied by hepatomegaly . (Extracurricular work) | 4 |
| 35 | Etiopathogenesis , clinical manifestations, diagnosis of liver cirrhosis (Extracurricular work) | 4 |
| 36 | Etiopathogenesis , clinical manifestations, syndromic diagnosis of diseases accompanied by jaundice. (Extracurricular work) | 4 |
| 37 | Features of pharmacotherapy of gastrointestinal diseases and tactics in case of complications. (Extracurricular work) | 4 |
| 38 | Diagnostic criteria for aging, physiology of the senile organism, age norms. Etiology, pathogenesis, diagnostic criteria for osteoporosis, physiology of the senile organism a ( Extracurricular work) | 4 |
| 39 | Diagnostic criteria for atherosclerosis, emphysema in the elderly (Extracurricular work) | 4 |
| 40 | The concept of fever, types, curve. Diseases that occur with fever (Extracurricular work) | 4 |
| Total | 178 hrs |
