| Content module 8.
“Simptoms and syndromes in surgery.”
| 4 credits 120 hour.
|
| Lection
| Practical lessons
| SSW
| Control
|
| Educational element- 9
| hour
| hour
| hour
| hour.
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| -
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| Training item 10: "The syndrome of mechanical (obstructive) jaundice. Causes. Differential-diagnostic tactics. Current approaches to treatment. Postcholecystectomy syndrome. Liver failure in surgical diseases, prevention methods and treatment. "
Causes of the syndrome of obstructive jaundice and its classification.
Early complications of obstructive jaundice syndrome:
- Cholangitis, holangiogenic liver abscesses, and biliary sepsis;
- Acute liver and renal failure;
- Holemic bleeding.
Current approaches to diagnosis, surgical and conservative treatment of obstructive jaundice syndrome.
Postcholecystectomy syndrome.
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| Practical skills:
1. Physical examination of the liver. Definition of symptoms Kerr, Murphy, Parturye, Courvoisier.
2. Analysis of the hepatobiliary contrast X-ray band.
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| Control of knowledges about educational element (on practical lesson)
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| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
|
| | | | |
| Training item 11: "The Syndrome of acute abdomen. Abdominal pain, pain assessment features in differential diagnosis of abdominal diseases. Differential diagnosis of acute abdominal diseases. "
Determining the type of acute abdomen: perforated, inflammatory, ischemic. Formation of the diagnostic program, depending on the location and type of acute abdomen and its analysis.
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| Practical skills:
1. Analysis of survey radiographs with perforation of a hollow organ.
2. Analysis of the general clinical and biochemical parameters of blood in acute inflammatory diseases of the abdominal cavity.
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| Control of knowledges about educational element (on practical lesson)
|
| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
|
| | | | |
| Intermediate control of knowledge on the topic: "Syndrome of acute abdomen, jaundice (individual work at home on the clinical case studies)
|
| Possible diagnosis
| Diagnostic program
| Differential diagnosis
| Clinical diagnosis
| Treatment program
| Total
|
| 1-0
| 1-0
| 1-0
| 1-0
| 1-0
| 5-4-3-0
|
| | | | | | |
| Training item 12: "The value of syndromes of dysphagia, vomiting, and violations of the act of defecation in the diagnosis and differential diagnosis of abdominal diseases. Syndrome "false" acute abdomen. "
Determination of acute and chronic intestinal obstruction and its level.
Definition of syndrome of dysphagia and its differential diagnosis.
Causes of syndrome of "false" acute abdomen and its differential diagnosis.
Formation of diagnostic and treatment program based on the identified syndrome.
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| Practical skills:
1. Analysis of survey radiographs in different types of obstruction.
2. Decompression of the small intestine and large intestine intubation probe.
|
| Control of knowledges about educational element (on practical lesson)
|
| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
|
| | | | |
| Training item 13: "Peculiarities of surgical diseases in pregnant women, the elderly. Differential diagnosis of acute abdominal diseases. Surgical complications in patients with infectious diseases. Differential diagnosis between acute surgical and infectious diseases. "
Peculiarities of surgical diseases in pregnancy.
Peculiarities of surgical diseases in the elderly.
Differential diagnosis between acute surgical and infectious diseases.
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| Practical skills:
1. Determination of pathognomonic symptoms of acute appendicitis.
2. Determination of pathognomonic symptoms of acute pancreatitis.
|
| Control of knowledges about educational element (on practical lesson)
|
| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
|
| | | | |
| Training item 14: "Bleeding from the digestive tract. Causes, diagnosis, differential diagnosis and treatment tactics. The syndrome of portal hypertension. "
Syndrome, bleeding from the digestive tract and its manifestations, depending on the pace and level.
Determining the severity of blood loss and its correction.
Diagnostic and therapeutic tactics in bleeding from the digestive tract.
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| Practical skills:
1. Rules of gastroscopy in internal bleeding, the interpretation of endoscopic signs of activity on the Forest of bleeding.
2. Implementation of bleeding from esophageal varicies by Blackmore-Sestaken tube.
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| Control of knowledges about educational element (on practical lesson)
|
| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
|
| | | | |
| Intermediate control of knowledge on the topic: „Bleeding from the digestive tract. ”)
|
| Possible diagnosis
| Diagnostic program
| Differential diagnosis
| Clinical diagnosis
| Treatment program
| Total
|
| 1-0
| 1-0
| 1-0
| 1-0
| 1-0
| 5-4-3-0
|
| | | | | | |
| Training item 15: "Local and widespread purulent inflammation of the abdominal cavity and peritoneum. Peritonitis. Etiology. Pathogenesis. Clinic. Diagnosis. Modern methods of treatment. Complications. Peculiarities of postoperative peritonitis. Syndrome, intestinal fistula (external and internal) diagnostics
Aseptic and bacterial peritonitis. Definition of clinical features depending on the phase of the process. Complications of suppurative peritonitis and their diagnosis.
Modern treatment of widespread peritonitis. Peculiarities of postoperative peritonitis. Diagnosis of the level and completeness of intestinal fistula. The choice of modern methods of treatment depending on the severity of the patient's condition and complications.
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| Practical skills:
1. Rules of the celiocentesis, peritoneal lavage, and dialysis in peritonitis.
2. Determining of the dehydration level in peritonitis (sample Shelestyuka).
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| Control of knowledges about educational element (on practical lesson)
|
| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
|
| | | | |
| Training item 16: "The trauma of the abdomen. Symptoms of damage to abdominal organs (liver, extrahepatic bile ducts and gall bladder, spleen, pancreas, stomach, and 12 duodenum, small and large intestines), and retroperitoneum. Instrumental methods of diagnosis. Therapeutic and diagnostic tactics. "
Diagnostic and treatment program at an open abdominal injury.
Diagnostic and treatment program at the closed abdominal injury.
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| Practical skills:
1. Rules of the puncture of the abdominal cavity, celiocentesis, diagnostic peritoneal lavage, laparoscopy. 2. Determination of blood group ABO and Rh-affiliation, the definition of group and individual blood compatibility.
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| Control of knowledges about educational element (on practical lesson)
|
| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
|
| | | | |
| Training item 17: "Diseases of operated stomach (after resection of stomach and vagotomy). Diagnosis. Differential diagnosis. Modern methods of treatment. "
Features of diagnosis and treatment of organic lesions of the gastrointestinal tract.
Features of diagnosis and treatment of functional syndromes of the gastrointestinal tract.
Rational choice of surgical approach.
|
Practical skills:
- Determination of gastric acid production according to behold phase secretion.
- Interpretation of results of parietal pH-metry.
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| Control of knowledges about educational element (on practical lesson)
|
| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
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| | | | |
| Training item 18: "New technologies in surgery. Modern methods of diagnosis and treatment. The final module control. "
Modern methods of diagnosing diseases of the chest and abdominal cavities (ACP, RCP with 3D processing, MRI, positron emission tomography).
Endoscopic treatment of heart defects, vascular disease.
Endoscopic treatments for diseases of the chest and abdominal cavities.
Robothirurgiya.
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| Practical skills:
1. Registration cards outpatients statistical coupon.
2. Making your hospital record, extracts from medical records.
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| Control of knowledges about educational element (on practical lesson)
|
| Test
| Questioning
| Practical skills, curation
| Total
|
| 5 – 4 – 3 – 0
| 5 – 4 – 3 – 0
| 10 – 8 – 6 – 0
| 20 – 16 – 12 – 0
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| Training item 19: "The final module control."
|
Estimations for the semantic module 8.
| Total bulk-tankers for the semantic module 8 and range of students on estimations:
| | Current Intermediate Together
| Estimation for the semantic module8
| | 180 10 190 - all “5”
144 8 152 - all “4”
108 6 114 - all “3”
| 190 - 162 - 5
161 - 133 - 4
132 - 114 - 3
< 113-2 < 60% knowledge’s
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| |
| Total bulk-tankers for module 4 and range of students on estimations:
|
| Current
| Intermediate
| Together
| Total ranking
| ЕСТ Estimation
(points)
|
| 360-288-216-0
| 20-16-12-0
| 380-304-228-0
| 380 - 323 - (100 - 85%)
322 - 266 - (84-70%)
265 - 228 - (69-60%)
< 227 - (< 60%)
| 120 - 102 points 5
101 - 84 points 4
83 - 72 points 3
< 71 points Fx 2
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| The student admitted to the final module control subject to the requirements of the curriculum and, if the interim and current activities, he scored no less than 72 points (the sum of 228 is formed by all estimates, "3").
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| The final control module (written test control and execution of supervision the patient with a demonstration of physical examination and practical skills, a survey of the problem, x-ray, lab tests) - 6 / 4 hours, SES - 4 decision, the situational problem
|
  Test control
| Curati-on
| Practical skills
| X-rays
| Quest. 1
| Quest. 2
| Quest. 3
| Quest. 4
| SSW
| Together
45-36-27-0
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| 5-4-3-0
| 5-4-3-0
| 5-4-3-0
| 5-4-3-0
| 5-4-3-0
| 5-4-3-0
| 5-4-3-0
| 5-4-3-0
| 5-4-3-0
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| Total points for the final module control and ranking system of ECT
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| Together
| ЕСТ (points) Estimation
|
| 45-39 (100-85%)
38-32 (84-70%)
31-27 (69-60%)
< 27 (< 60% знаний)
| 80-68 points 5
67-56 points 4
55-48 points 3
< 47 points 2
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