METHODICAL INSTRUCTIONS
FOR INDIVIDUAL WORK OF THE STUDENTS
IN PREPARATION FOR PRACTICAL CLASS
Subject
Topic
Year
Faculty
NEUROLOGY
Individual supervision with making a case history
IV
Medical
1. Topicality: patient supervision is necessary for the students to strengthen their theoretical
knowledge and practical skills obtained during the studies of neurology. It is important that
in the process of supervision students learn to fill out medical documents. Great attention in
medical practice is paid to a doctor’s ability to communicate with a patient and his relatives,
to collect anamnesis, to treat patients kindly and compassionately. Individual examination of
patients and evaluation of received data contribute into the development of clinical thinking
of the future doctors, their psychological readiness for medical responsibility.
2. Specific purposes:
1. In the process of supervision and communication with patient’s relatives students must
apply obtained knowledge of deontology.
2. To learn to treat patients with compassion, mercy and understanding.
2
3. To strengthen theoretical knowledge and practical skills in the process of patient’s
supervision.
4. To learn to fill in medical documents according to the rules.
3. Basic knowledge, skills, competences necessary for learning the topic:
№
Subject
Students’ Knowledge
Students’ Skills
1.
Medical
Psychology
To communicate with patients
and their relatives
2.
Propaedeutics of
Internal Diseases
3.
Pharmacology
4.
Nervous Diseases
Basics of medical deontology,
peculiarities of neurological
patients’ psychology
To know the contents of a case
history, means of complaints
collecting, life anamnesis,
diseases, and ways of evaluating
general somatic status. To know
the definitions of symptom,
syndrome, basic, clinical,
associated diagnoses, main
disease complications.
Medicine groups and their
specific forms used for nervous
diseases.
Topical neurology. To know
main parts of nervous system,
methods of their explorations,
symptoms and syndromes of
their lesion. Clinical neurology.
To know main groups of
nervous system diseases, their
main features, classifications of
nervous diseases, methods of
their diagnostic and treatment.
To be able to collect complaints,
life anamnesis, diseases. To
examine and evaluate generallysomatic condition (skin
integument, respiratory,
cardiovascular, alimentary,
urogenital systems). To evaluate
clinical and laboratory
researches.
To write prescriptions for drugs
for nervous diseases.
To be able to examine
neurological condition of a
patient, to define symptoms and
formulate them into syndromes.
To be able to collect complaints,
anamnesis and to define the
character of a disease, verify
diagnosis on the basis of
complaints, anamnesis,
neurological status, to make
examination plan or to evaluate
auxiliary examinations of a
patient, to create an individual
treatment plan.
4. Assignments for individual work during preparation for the classes:
The list of basic terms, characteristics, which students must learn during the preparation
for the classes:
-
State of consciousness
aphasia
apraxia
agraphia
alekia
agnosia
peripheral paresis
central paresis
combined paresis
bulbar syndrome
alternating syndrome
3
-
akinetico-rigid syndrome
hyperkinetic syndrome
cerebellar ataxia
sensitive ataxia
meningeal syndrome
syndrome of pelvic functions damage
epileptical syndrome
myasthenic syndrome
The list of theoretical questions:
1.
2.
3.
4.
5.
6.
7.
8.
Syndromes of motor system lesions (pareses, paralyses, hyperkinetic, hypokinetic,
ataxias).
Syndromes of sensitivity lesion.
Syndromes of cranial nerves lesion.
Syndromes of lesion of brain cortex and linings.
A notion of topical, nosological, clinical diagnoses.
Possibilities of auxiliary examination methods REG, EEG.ACT,MRI.
Classifications of the main neurological diseases – vascular, inflammatory, demyelizing,
inherent.
Principles of neurological patients treatment.
6.2 List of nervous system diseases for supervision:
1. General CNS diseases (meningitis, arachnoiditis, encephalitis, myelitis) in various stages
of an illness.
2. Vascular diseases of cortex and spinal cord – acute and chronic (strokes, discircular
encephalopathy) in various stages of an illness.
3. Diseases of peripheral nervous system – vertebrageneous (osteochondrosis neurological
complications) and unvertebrageneous (polyneuropathies, plexites, facial nerve neuritis,
trifacial neuralgia).
4. Demyelinating diseases (disseminated sclerosis, acute disseminated encephalomyelitis).
5. Syringomyelia.
6. Amyotrophic lateral sclerosis.
7. Inherent diseases of neuromuscular apparatus: myopathies, amyotrophies, myasthenia.
8. Infantile cerebral paralysis.
9. Epilepsy.
10. Toxic lesions of nervous system – acute and chronic: encephalopathies, myelopathies,
polyneuropathies.
The list of practical skills that are to be mastered at the classes:
1. Individual supervision of patients with neurological pathology with making a case
history.
2. Definition of dominant neurological syndrome in a patient.
3. Verification of a topical diagnosis in the examined patient.
4. Conduction of differential diagnostics.
5. Verification of a stipulated clinical diagnosis.
6. Definition of the etiology of a disease, peculiarities of pathogenesis, disease development
and its complications in the examined patient.
7. Verification of a treatment administered to the patient.
8. Definition of the prognosis of a disease development in the given patient.
4
5. Students’ self-preparation curriculum:
1. To learn theoretical questions of the topic
2. To see the scheme of a case history
3. To know the methodic of neurological status examination
4. To know classifications of neurological diseases
5. To know the principles of neurological diseases diagnostics and treatment
6. Materials for self-control
1. To make a list of main neurological syndromes
2. To make a list of diagnostic criteria of vascular, inflammatory, demyelinating,
degenerative diseases of nervous system.
Information Sources
Lecture
1. Shcrobot S.I., Hara I.I. Neurology in lecture (Selected lectures) . Ternopil, TSMU,
«Ukrmedknyha», 2008. 319 p.
2. Reinhard Rohkamm. Color Atlas of Neurology © 2004 Thieme. 440 p.
3. Crash course Neurology by Anish Bahra and Katia Cikurel. Copyright 2006, Elsevier,
Inc. 244 p.
4. Adams and Victors. Principles of neurology. © 2005 McGraw-Hill . Medical Publishing
Division.
5. Mayo Clinic Internal Medicine Review 2006-2007. Chapter 18. Editor-in-Chief Thomas
M. Habermann, MD