The 1st semester topics
1. Interviewing of the patient. Revealing of the main and general complaints. Compilation of history of present condition and past history of the patient.
2. General examination of the patient. Assessment of general condition of the patient, state of consciousness, position, body builds, technique of inspection of the patient’s face, investigation of skin and visible mucosae, subcutaneous fat tissue, lymph nodes, muscular systems, bones and joints.
3. Inspection of the chest, evaluation of it’s form, type of respiratory movements, rate, amplitude and rhythm respirations, lagging of the chest sides at respiration, involvement of accessory muscles in respiration. Technique of palpation of the chest, location of tender areas, resistance of the chest and vocal fremitus.
4. Procedure and technique of percussion. Practicing of indirect finger-mediated percussion. Definition of percussion notes. Comparative percussion of the lungs.
5. Topographical percussion of lungs, assessment of upper borders of lungs at front and at the back, position of lower borders of lungs and their mobility.
6. Procedure and technique of auscultation. Auscultation of normal respiratory sounds: vesicular and bronchial breathing, types of vesicular and pathological bronchial breathing. Assessment of bronchophony.
7. Auscultation of accessory respiratory sounds: dry and moist rales, crepitation, pleural rub.
8. Instrumental methods of investigation: bronchography, bronchoscopy, respiratory function testing. Check of practical skills of investigation of the patient.
9. Laboratory methods of investigation of sputum. Common clinical analysis of sputum. Investigation of pleural fluid.
10. Investigation of the patient with consolidation of the lung syndrome (at the examples of pneumonia and atelectasis): technique of interviewing, general examination, investigation of respiratory organs. Analysis of X-ray films and data of laboratory and instrumental methods of examination at this syndrome.
11. Investigation of the patient with a syndrome of acute bronchial obstruction (at the example of bronchial asthma): technique of interviewing, general examination, investigation of respiratory organs. Analysis of X-ray films and data of laboratory and instrumental methods of examination at this syndrome.
12. Investigation of the patient with a syndrome of increased pulmonary air content (at the example of emphysema of lungs): technique of interviewing, general examination, investigation of respiratory organs. Analysis of X-ray films and data of laboratory and instrumental methods of examination at this syndrome.
13. Investigation of the patient with cavitation of the lung and suppurative processes in a lung syndromes (at the examples of abscess of the lung and bronchoectatic disease): technique of interviewing, general examination, investigation of respiratory organs. Analysis of X-ray films and data of laboratory and instrumental methods of examination at this syndromes.
14. Investigation of the patient with accumulation of fluid and gas in a pleural cavity syndromes (at the examples of exudative pleurisy, hydrothorax and pneumothorax): technique of interviewing, general examination, investigation of respiratory organs. Analysis of X-ray films and data of laboratory and instrumental methods of examination at this syndromes.
15. General examination of the patient with diseases of cardio-vascular system: evaluation of position of the patient, data of inspection of the skin and visible mucosae, revealing of edemas of subcutaneous fat tissue, technique of inspection and palpation of great vessels and precordial area (pulsation of carotid arteries, engorgement and pulsation of jugular veins, precordial beat and apical impulse).
16. Percussion of the heart. Delimitation of relative and absolute heart dullness, diameter of relative heart dullness, width of vascular bundle and height of aortic arch position.
17. Auscultation of normal and pathological cardiac sounds. Rules of auscultation of the heart, mechanisms of formation of main cardiac sounds, definition and differentiation of the 1 and 2 cardiac sounds. Accentuation, diminishing and splitting of heart sounds, extra sounds and gallop rhythm.
18. Auscultation of murmurs of the heart. Mechanism of formation of murmurs and their classification.
19. Definition of timing of murmur (systole or diastole), location of maximal intensity (origin of murmur), type of murmur according to the pitch, quality, intensity, shape, radiation or transmission of murmur.
20. Investigation of the vessels. Definition of properties of peripheral arterial pulse and blood pressure. Analysis of sphygmograms. Assessment of venous pressure and velocity of blood flow.
21. Principle of ECG recording and procedure of analysis of normal electrocardiogram.
22. Principle of PCG examination and its diagnostic significance.
23. Arrhythmias of the heart. Clinical and ECG diagnostics of arrhythmias: sinus arrhythmia, sinus tachy- and bradycardia; atrial, nodal and ventricular extrasystole; cardiac fibrillation; incomplete and complete atrioventricular block, block of branches of the bundle of His, disorders of atrial and ventricular conductivity. Concept of defibrillation.
24. Investigation of the patients with syndrome of mitral valve incompetence, clinical and instrumental methods of diagnostics.
25. Investigation of the patients with syndrome of left atrioventricular ostium stenosis, clinical and instrumental methods of diagnostics.
26. Investigation of the patients with syndrome of the treecuspid valve incompetence and right atrioventricular ostium stenosis, clinical and instrumental methods of diagnostics.
27. Investigation of the patients with syndrome of aortic valve incompetence, clinical and instrumental methods of diagnostics.
28. Investigation of the patients with syndrome of aortic stenosis, clinical and instrumental methods of diagnostics.
29. Investigation of the patients with a syndrome of systemic hypertension.
30. Investigation of the patients with a syndrome of myocardial ischemia (at the example of angina pectoris and myocardial infarction).
31. Investigation of the patients with various stages of congestive heart failure.
The 2nd semester topics
32. Interviewing, inspection, percussion at diseases of a gastro-intestinal tract. The acquisition of the complaints, history of present condition and past history.
33. Technique of general examination of the patient, inspection and percussion of an abdomen.
34. Palpation of abdominal organs. Technique of superficial palpation.
35. Technique of deep palpation by the method of Obraztsov and Strazhesko.
36. Diagnostic significance of assessment of gastric secretion. Diagnostic significance of coprological investigation. Coprological syndromes: stomach maldigestion, pancreatic exocrine insufficiency, lack of intestinal bile secretion, impaired intestinal absorbtion.
37. Technique of investigation of the patient with peptic ulcer disease of stomach and duodenum: interviewing, general examination, percussion and palpation of abdomen. Assessment of data of instrumental methods of diagnostics (roentgenologic, endoscopic, laboratory).
38. Technique of liver percussion: determination of upper, lower and left borders and height of liver dullness. Percussion of the spleen: measurement of width and length. Technique of palpation of the liver and spleen.
39. Investigation of the patients with syndrome of hyperbilirubinemia. Technique of interviewing, general examination, investigation of abdomen in the patients with prehepatic, hepatic and posthepatic jaundice. Analysis of laboratory investigations (blood, urine, stools) in jaundices of various types.
40. Investigation of the patients with syndromes of portal hypertension, hepatolienal and hepatic failure.
41. Technique of inquiry, general examination, percussion and palpation of an abdomen in patients with diseases of the gallbladder (cholecystitis, cholelithiasis). Evaluation of data of instrumental methods (roentgenologic, laboratory and other instrumental methods).
42. Technique of interviewing, general examination, examination of abdomen in the patients with at chronic hepatites and liver cirrhoses. Evaluation of results of instrumental and laboratory.
43. Investigation of the patients with pancreatic pathology.
44. Investigation of the patients with diseases of small and large intestine.
45. Technique of inquiry, general examination of the patient, examination of kidneys. Urinary syndromes: nephritic (glomerulonephritis and pyelohephritis) and nephrotic.
46. Investigation of the patients with renal syndromes: disorders of diuresis, renal hypertension, renal neuroretinitis, eclampsia, uremia, nephrotic (at acute and chronic glomerulonephritis, pyelohephritis, urinary stone disease).
47. Evaluation of the data of instrumental tests. Common urine analysis. Diagnostic significance of urine physical properties. Zimnitsky's test. Diagnostic significance of proteinuria, glucosuria, ketonuria, bilirubinuria. Microscopy of urinary deposit. Investigation of urinary deposit according to the Addis-Kakovsky, Netchiporenko methods, 3-portions test.
48. Investigation of the patients with syndrome of anemia (posthemorrhagic, В12- and folic acid deficiency anemia). Technique of interviewing, general examination of the patient, examination of spleen.
49. Investigation of the patients with myeloproliferative (myeloid leukemia) and lymphoproliferative (lymphocytic leukaemia) syndromes. Technique of interviewing, general examination, investigation of spleen. Diagnostic significance of investigation of peripheral blood morphology.
50. Leukocytosis, leukopenia. Acute-phase reactions, TBC at anaemias (iron-deficiency and vitamin В12-deficiency) and leukaemias.
51. Investigation of the patients with diseases of thyroid gland (diffuse and nodular toxic goiter, myxedema). Technique of interviewing, general examination, investigation of thyroid gland. Evaluation of data of instrumental and laboratory diagnostic methods.
52. Investigation of the patients with diabetes mellitus. Technique of interviewing, general examination, investigation of the other systems. Evaluation of laboratory data (blood and urine).
53. Endoscopic and ultrasound methods of investigation in the clinic of internal diseases.
