The main stage

At this stage the student will continue to build professional skills. Particularly at the bedside student demonstrates the ability to collect complaints, history of disease and life, to make an objective examination of the patient by different systems and organs and on the basis of the data to the differential diagnosis to establish a preliminary diagnosis. To support his opinion, the student makes the plan an additional examination of the patient. Synthesizing all the data obtained during examination of the patient, the student formulates a final clinical diagnosis according to modern classification and diagnostic criteria.
Analysis of the results allows the student to prescribe appropriate treatment of the patient depending on clinical variant and degree of activity, complications, comorbidities and give recommendations for further treatment and lifestyle.

The final stage

Assessment of action of each student during class and standardized end control. It conducted the analysis of student achievement, announced rating of each student and put in the book of visits and student achievement. Parish groups simultaneously puts rating in accounting performance and attendance of students. The teacher assures them his signature.

Brief information for students on the theme of the next lesson and instructional techniques to prepare for it.

Task №1.

Patient R., 57-year-old man, which overuses alcogol and smookes, entered the hospital complaining of marked general weakness, disappearance of appetite, pain in the chest on the right, in subscupular region; dyspnea, chills, fever up to 38,7⁰C and pronounced sweating during the fall of temperature; productive cough, which appeared two days ago, the allocation of approximately 50 ml of purulent sputum. He considers himself sick 7 days.

On examination: pale, clear skin. Temperature is 38,3 ° C. Heart rate 100/min, BP 135/80 mmHg. Respiratory rate is 24/min. Dull percussion note, ronchial breathing and crackles on the right side in subscupular region, but in center of this region - tympanic percussion note and amhporic rales.

The ECG: diffuse changes in the myocardium. CBC: Er - 4,0 ∙ 1012 / l, Hb - 129 g / l, Leuk. - 16,0 ∙ 109 / L, segm. - 77, lymph. - 12%, mon. - 11%, platelets - 205 ∙ 109 / l, ESR - 45 mm / h. Common sputum analysis: leukocytes: 55 in visual field, neutrophils: 40 in visual field, alveolar macrophages: 12 in visual field, elastic fibers. X-ray chest: enhanced pulmonary image, increasing the size of the root of the right lung, darkening irregular shape, enlightenment in center and horizontal liquid level in the projection of 10 and 9 segments of the right lung.

1.Make the diagnosis.

2.What is the treatment should be prescribed for patient?

Recommended literature:

А. Main:

1. Davidson’s Principles and Practice of Medicine, 2006, P. pages 526 - 532.

Materials for self-control:

А. The questions for self-control:

1. Name the main aetiological factors of BROCHIECTASIS AND LUNG ABSCESS.

2. Give the main principles of the modern classification of BROCHIECTASIS AND LUNG ABSCESS.

3. What are the main clinical syndromes of BROCHIECTASIS AND LUNG ABSCESS?

4. Make the plan of additional investigation of the patient with BROCHIECTASIS AND LUNG ABSCESS.

6. Name the main drugs for the treatment of BROCHIECTASIS AND LUNG ABSCESS.

B. Tests for self-control:

Methodic recommendations made by DM Ostapchuk O.I.

Дата добавления: 2015-10-30