EDUCATIONAL ESTABLISHMENT “VITEBSK STATE ORDER OF PEOPLES’ FRIENDSHIP MEDICAL UNIVERSITY”
DEPARTMENT OF PHTHISIOPULMONOLOGY
«APPROVED»
Vice-rector of Educational Work
and Foreign Affairs,
Professor
_______________ N.Yu.Konevalova
«___» June 2011
Reg.No.____________________
________________________Phthisiopulmonology_______________________
(Name of a discipline)
WORKING PROGRAM
____1-790101____
(Speciality code)
General Medicine____________
(Name of a discipline)
2011
COMPOSERS:
A.M.Budritsky, the Head of Phthisiopulmonology Department of VSMU, PhD,
Associate Professor
READERS:
T.I.Dmitrachenko, the Head of Infectious Diseases Department of VSMU, ScD,
Professor
S.B.Volf, the Head of Department of Grodno State Medical University, PhD, Associate Professor
RECOMMENDED TO BE APPROVED:
By Phthisiopulmonology Department (Protocol № 15, dated 06.06.2011)
Central Scientific-Methods Council of Educational Establishment “Vitebsk State
Medical University” (Protocol № ___, dated «___» _______ 2011)
Responsible for edition: A.M.Budritsky
Responsible for publication: A.M.Budritsky
1
EXPLANATORY NOTE
GOALS AND OBJECTIVES OF THE DISCIPLINE
AND ITS PLACE IN EDUCATIONAL PROCESS
The main purpose of the course “Phthisiopulmonology” is preparing of students in the field of tuberculosis as infectious disease and of another pulmonary pathology.
The objectives of Phthisiopulmonology studying are defined in accordance
with educational program: definition of the discipline subject; lighting epidemiology, microbiology, pathological anatomy, pathogenesis and immunology of tuberculosis at the present stage; study of the basic methods of radiation diagnosis, lung
and blood circulation function, tuberculin and laboratory diagnosis of tuberculosis;
study clinical forms of primary and secondary pulmonary tuberculosis including
combined with dust related occupational lung diseases, diabetes, COPD, gastric ulcer and duodenal ulcer, alcoholism, mental illness, lung cancer and other diseases;
study of basic principles and methods of treatment TB patients, including emergency care for acute complications and conditions in tuberculosis - hemoptysis,
pulmonary hemorrhage, spontaneous pneumothorax; study of the structure, objectives, TB facilities and organization of their work on the prevention of tuberculosis.
The list of preceding tuberculosis disciplines: Microbiology with Virology
and Immunology, General and Clinical Pharmacology, Pathological Anatomy and
Histology, Pathological Physiology, Radiological Diagnosis and Oncology, Neurology and Neurosurgery, Propedeutics of Internal Diseases, Internal Diseases
/Pulmonology/; Social Hygiene, Organization of Management and Health Economics.
2
SAMPLE THEME PLAN
XI-XII semester
Number of classroom hours
Name of theme
1. Epidemiology of tuberculosis in different
countries. General principles for identification,
diagnosis and treatment
of TB patients
in accordance with WHO
recommendations
Lecture
Laboratory
Lecture № 1,
2 hours
PLAN
of practical classes on Phthisiopulmonology
for the 6-year overseas students of Overseas students Training Faculty
Name of theme
1. Epidemiological situation of tuberculosis in different countries of the
world. DOTS strategy.
2. Radiographic methods
for diagnosis of tuberculosis. Solid and sampling
methods of the population
examination.
3. Early detection of tuberculosis in children by
tuberculin
diagnostics.
Primary tuberculosis in
children.
4. Secondary tuberculosis: focal, infiltrative, disseminated, tuberculosis
pleurisy,
tuberculous
meningitis. Differential
diagnosis. Treatment.
Number of classroom hours
Practical
Lectures
Practical class № 1,
6 hours
Practical class № 2,
6 hours
Practical class № 3,
6 hours
Practical class № 4,
6 hours
3
5. The course and clinical
manifestations of chronic
and complicated forms of
secondary pulmonary tuberculosis with collapse
peculiarities. TB detection peculiarities in persons with high risk disease (COPD, diabetes,
peptic ulcer disease,
pneumoconiosis, chronic
alcoholism, pregnancy,
AIDS).
6. Emergency care for
complications of tuberculosis. Basic principles of
treatment and chemotherapy of patients with
pulmonary tuberculosis in
the WHO recommendations. Selection of persons for surgical treatment.
7. Working in dispensary
department.
Outpatient
reception of patients.
Methods of tuberculosis
prevention in children,
teenagers and adults.
Credit-test on Phthisiopulmonology.
Practical class № 5,
6 hours
Practical class № 6,
6 hours
Practical class № 7,
6 hours
NOTE: according to the curriculum 6 hours practical training out of 42 is reserved
for independent practice of skills under the guidance of a teacher on the following
topics:
1. Making a case report, demonstration of a TB patient at clinical conferences, rounds.
2. Making a referral to TB specialist with details of compulsory diagnostic
minimum (CDM) for tuberculosis with setting of presumptive diagnosis according
to clinical classification.
At the last practical class a credit test on the discipline with situational clinic
problems solving and radiographs reading is held.
4
CONTENT OF THE DISCIPLINE
Epidemiology of tuberculosis in various countries of the world. General
principles of detection, diagnosis and treatment of tuberculosis patients in accordance with WHO recommendations. Prevalence of tuberculosis in countries with
different economic levels. Infection, incidence, morbidity and mortality from tuberculosis in different age groups. Strategy of DOTS.
Current state and prospects of tuberculosis control. State System of TB control in the Republic of Belarus.
Basic methods of radiological diagnosis of pulmonary tuberculosis. The advantage of X-ray and rentgenocomputing research methods in tuberculosis clinic.
Segmental structure of lungs in X-ray image in frontal and lateral views. Description of pathological shadow-formation in lungs on basic radiological signs.
Continuous and differential (selective) prevention roentgenofluorographic
survey. Indications for continuous professional survey of population taking into
account epidemiological situation in a region. Diagnostic roentgenofluorographic
population survey for tuberculosis for cause, multiplicity of studies, rationale for.
The definition of “compulsory contingents”, frequency of their examination.
High-risk groups (“threatened contingents”) for tuberculosis. Social groups of
risk, health risk factors, epidemiological risk factors, multiplicity of “threatened
contingents” survey. Indications and technique of supplementary examination of
persons with radiographically identified changes in lungs. Flyuoroteka, shelf-life of
rentgendocuments in a clinic.
Early detection of tuberculosis by tuberculin diagnosis in children. Objectives of tuberculin diagnosis in mass screening of population and in clinical
practice. Types of tuberculin tests. Tuberculin types: CCA, PAP-A; pharmaceutical
form, storage conditions.
Methodology of a single intracutaneous Mantoux test with 2 TE PPD-L in
standard dilution version. Mantoux test results evaluation. The concept of hyperergic, normergic, doubtful and anergic reactions. Indications for use of diagnostic
Koch tests with subcutaneous injection of different doses / 20.50 or 100 TE / tuberculin. Evaluation of common, focal and injective reactions at subcutaneous injection of tuberculin.
Primary tuberculosis in children. Primary tuberculosis, definition. Primary
infection, importance of tuberculin tests in the identification of "conversion". Pathogenesis of primary tuberculosis in children and adolescents. Peculiarities of primary period of tuberculosis infection: the notion of latent microbism and development of hypersensitivity of delayed type (HSDT). Nature of functional abnormalities, clinical manifestations and morphological reactions occurring during primary
infection (nonspecific, paraspecific and specific).
Main differentia of secondary tuberculosis primary forms. Importance of
chemoprophylaxis in primary tuberculosis prevention.
Secondary tuberculosis.
Focal pulmonary tuberculosis. Definition of focal pulmonary tuberculosis
clinical form. Pathomorphological and radiological variants of focal pulmonary tu5
berculosis. Making diagnosis according to clinical classification. Prevalence of focal tuberculosis and its proportion among other clinical forms of secondary tuberculosis. Sources of infection and pathogenesis of soft-focal and fibro-focal tuberculosis of lungs. Clinical symptoms and objective examination of a patient data in
soft-focal and fibro-focal pulmonary tuberculosis. "Masks" of focal tuberculosis of
lungs.
Infiltrative pulmonary tuberculosis. Definition of infiltrative tuberculosis
as clinical form of secondary tuberculosis. Prevalence and proportion in morbidity
structure among other clinical forms of pulmonary tuberculosis. Pathogenesis and
pathomorphology of infiltrative tuberculosis. Radiographic types of infiltrative tuberculosis: broncholobular, rounded, cloud-like, periscituritis, lobitis.
Miliary tuberculosis, subacute and chronic disseminated pulmonary tuberculosis. Definition of clinical form. Making diagnosis according to clinical
classification. Pathogenesis of hematogenic, lymphogenic and bronchogenic dissemination of tuberculosis mycobacteria: sources of tuberculosis infection, weakening of natural resistance of organism, mycobacteria tuberculosis pathways in a
body. Peculiarities of miliary tuberculosis X-ray diagnosis. Clinical picture, diagnosis and treatment of disseminated pulmonary tuberculosis different variants.
Caseous pneumonia. Caseous pneumonia as one of acute extensive forms
of pulmonary tuberculosis. Pathogenesis of primary and secondary caseous pneumonia. Clinical-radiographic and pathomorphological versions of caseous pneumonia. Clinical picture, diagnosis, differential diagnosis of acute purulent destruction of lungs.
Tuberculous pleurisy. Tuberculous pleurisy as clinical form of pulmonary
tuberculosis. Pathogenesis of pleurisies of tuberculous etiology, morphological
changes of pleura in different types of tuberculous pleurisy. Classification of tuberculous pleurisy. Phases of development exudative pleurisy. Clinical and radiographic diagnosis of various kinds of tuberculous pleurisy. Examination, palpation,
percussion and auscultation results in exudative pleurisy. Indications for puncture
and evacuation of pleural fluid, methods of their realization. Cytological diagnosis
of pleural fluid, difference of serous exudate from transudate. Treatment of patients
with exudative tuberculous pleurisy. Outcomes of exudative pleurisy and prognosis.
Tuberculosis of the meninges (meningitis). Pathogenesis and pathomorphological variants of tuberculous meningitis. Periods of course and clinical picture of tuberculous meningitis (generalized and neurological symptoms). Nature of
cerebrospinal fluid laboratory study in tuberculous meningitis (color, pressure, loss
of membrane, levels of protein, sugar, chlorides, cytosis and ratio of blood elements in a smear of liquor sediment, reaction of Pandy and Nonne-Apelt, detection
of tuberculosis mycobacteria). Differential diagnosis of tuberculous meningitis,
differential signs from serous, virus, purulent meningitis. peculiarities of treatment
and outcome of tuberculous meningitis.
Cavernous pulmonary tuberculosis. Pathogenesis of cavernous form of
tuberculosis. Destruction and cavernous tuberculosis formation reasons. Morphological signs of various forms of tuberculosis and cavernous forms decomposition
6
phases: caverns types depending on morphological structure of the wall. Clinical
symptoms of destruction in a lung and cavernous form of tuberculosis. Radiographic signs distinguishing cavernous tuberculosis from other forms of tuberculosis in the phase of disintegration and fibro-cavernous tuberculosis . Differential diagnosis of cavernous tuberculosis from congenital and parasitic cysts, empty lung
abscess, decaying of malignant tumors.
Fibro-cavernous pulmonary tuberculosis. Making diagnosis according to
clinical classification. Formation reasons and pathogenesis of fibro-cavernous tuberculosis. Morphological signs of fibrous caverna. Clinical variants of fibrocavernous pulmonary tuberculosis course. Radiographic signs of fibro-cavernous
tuberculosis. Complications of fibrous-cavernous tuberculosis, exacerbation and
progression reasons. Methods of patients with fibro-cavernous pulmonary tuberculosis treatment. Outcomes in fibro-cavernous tuberculosis and prognosis.
Cirrhotic pulmonary tuberculosis. Definition of cirrhotic pulmonary tuberculosis as a clinical form of pulmonary tuberculosis. The principal difference of
cirrhotic pulmonary tuberculosis from cirrhosis of a lung. Reasons of cirrhotic tuberculosis formation, pathogenesis. Morphology of cirrhotic pulmonary tuberculosis. Main clinical symptoms and radiological signs in cirrhotic pulmonary tuberculosis. Differential diagnostics of cirrhotic tuberculosis from cirrhotic non-specific
changes in lungs.
Pulmonary tuberculosis in combination with other diseases: Tuberculosis
in elderly peorsons. Tuberculosis and AIDS. Tuberculosis and maternity. Pulmonary tuberculosis in combination with other diseases (COPD, diabetes, peptic ulcer
disease, silicosis, chronic alcoholism).
Emergency in pulmonary tuberculosis complications. Pulmonary hemoptysis and pulmonary hemorrhage, pathogenesis. Pathomorphological processes in
vessels and tissue surrounding a vessel, channels of blood penetration into bronchi
lumen - diapedetic or erosive, initiating agents. Clinical picture of pulmonary hemorrhage and hemoptysis, differences between them. Spontaneous / pathological /
pneumothorax, etiology, mechanism of nascency. Pathogenesis of spontaneous
pneumothorax in pulmonary tuberculosis, development causes and initiating
agents. Types of spontaneous pneumothorax / closed, open, valvular/. Clinical picture of spontaneous pneumothorax depending on a type of pneumothorax, volume
of inlet air into pleural cavity, its ingress speed and nature of sensitivity to the
complications.
Principles and methods of tuberculous patients treatment. Anti-TB preparations, international and national classification according to their effectiveness
degree. Vitally important or essential (main), and reserve preparations for tuberculous patients chemotherapy. Basic principles of tuberculosis treatment. Basic principles of chemotherapy (the notion of "regime of chemotherapy"). Improved
methods of tuberculous patients chemotherapy in WHO recommendations. Side
effects of antituberculosis preparations, classification, clinical manifestations, diagnosis. General principles of prevention and ways of antituberculosis preparations
side effects elimination. Methods of pathogenetic treatment of patients with tuber7
culosis. The notion of collapse therapy, main indications and contraindications for
curative application of IP and PP.
Selection of persons for surgical treatment. Types of surgical interventions in pulmonary tuberculosis, indications and their limitations.
Working in a dispensary room. TB dispensaries: types, structure, objectives and organization of work. System of TB service organization in the Republic of Belarus and other countries near and far abroad. Anti-tuberculosis dispensaries. Types of dispensary establishments, structure. Tuberculosis dispensary tasks
and organization of its work with other medical institutions of general medical system.
Outpatient reception. Grouping TB establishments contingents, treatment
and surveillance organization. TB service in polyclinic. Organization of preventive
population-based surveys for tuberculosis, their value for annual health examinations of population. Methods of risk-group patients examination for tuberculosis.
Indications for sending them to a TB specialist. TB activity of specialized medical
and rehabilitation expert committee / MEDNC/. Temporary incapacity for tuberculosis, terms, indications for referral to MEDNC.
Methods of tuberculosis prevention. Specific prevention of tuberculosis.
Definition of tuberculosis BCG vaccine. Types of tuberculosis BCG vaccine, the
release form and storage conditions. The purpose of vaccination and revaccination
of children and adults. Indications and contraindications for vaccination of newborns. Peculiarities of vaccination in preterm infants as well as children who was
not vaccinated at maternity hospital because of medical contraindications and must
be vaccinated in children's polyclinics. Technique of vaccination. Chemoprophylaxis of tuberculosis. The purpose of chemoprophylaxis of tuberculosis. The concept of primary, secondary and anti-relapsing chemoprophylaxis of tuberculosis.
Methods of chemoprophylaxis. Contingents of different age groups in need for
specific chemoprophylaxis. Sanitary prophylaxis of tuberculosis. Detection of tuberculosis infection nidus. Characteristic of tuberculosis infection nidus on the degree of epidemiological risk.
8
4
42
6
5
-
7
8
TM*
Form of achievement control
controlled independent work
6
Literature
2
3
2
Phthisiopulmonology
(44 hours)
1.1 The 6 course of Medical Faculty
1.1.1 Work in the broncho- 2
logical room and aerosol
therapy
room.
Methods of pathological material getting for
BC laboratory detection.
Work in a clinical department. Supervision
of patients. Evaluation
of clinical and laboratory data in supervised
patients, substantiation
of clinical diagnosis,
preparation of clinical
observations journals.
Work in the clinical and
bacteriological laboratories. Mastering the
techniques of microscopy and familiarization with the methods
of bacteriological investigations for detection
of tuberculosis mycobacterium. Classifica-
practical (seminar)
classes
laboratory classes
Number of auditorium hours
A class material support
(visual methodical aids, etc)
1
I.
Name of division,
theme, class; list of
studied questions
lectures
No of division, class theme
TEACHING DISCIPLINE CARD
[1] essay
[3]
[5]
[11]
9
tion of tuberculous infection
nidus
and
measures for their improvement. Definition
of bacillary criteria in
TB patients.
Massiveness of bacterioexcretion.
1.1.2 Work in a clinical department. Supervision
of patients, performance of scheduled
medical manipulations
by supervised patients.
Paperwork.
Work in X-ray room in
a dispensary. Radiographic methods of tuberculosis diagnosis. Xray
computer
test
(RCT) of chest organs,
computer tomography
examination. Technique
of radiographic changes
in lungs description,
making
radiological
conclusions.
Radiographs with various
forms of pulmonary tuberculosis reading, improvement of practical
skills. Work in fluorography room in a dispensary. Importance and
technique of fluorographic examination for
the early detection of
tuberculosis and other
pathological changes of
chest. Reading of fluorogram.
1.1.3 Supervision of patients.
Achievement control on
the topic: "Early detection of tuberculosis by
6
Light
stand
“Clinical
forms
of pulmonary
TB”
[1]
[3]
[9]
[11]
Demonstration
of a patient on
clinic conference
6
Light
stand
“Clinical
forms
[1] essay
[3]
[5]
[11]
10
tuberculin diagnostics.
Clinical classification
of tuberculosis. Peculiarities of pulmonary tuberculosis and extrapulmonary forms of primary tuberculosis (TB
of peripheral, mesenteric lymph nodes, tuberculous meningitis) manifistarion.
Work in a children
room: mastering the
technique of tuberculin
test setting. Reading
and evaluation of Mantoux, Koch tuberculin
skin test in patients under treatment. Tuberculin skin test setting for
students.
1.1.4 Achievement control on
the topic: “Peculiarities
of manifestation and
course
of
limited
"small" forms and acute
forms of tuberculosis.”
Supervision of patients,
improvement of practical skills.
Clinical analysis of patients with focal and infiltrative forms of tuberculosis, tuberculous
pleurisy, miliary and
subacute disseminated
pulmonary tuberculosis,
caseous
pneumonia.
Reading of radiograms,
tomograms. Differential
diagnosis.
Prophylaxis of transition from acute forms
of
tuberculosis
to
chronic.
of pulmonary
TB”
6
TM
[1]
[3]
[9]
[11]
11
1.1.5 Achievement control on
the topic: " Course and
clinical manifestations
peculiarities of chronic
(chronic disseminated,
fibrous-cavernous, cirrhotic) and complicated
forms of secondary
pulmonary tuberculosis
with collapse, seeding,
bronchi
tuberculosis,
colorectal and peritoneum tuberculosis. Differential diagnosis.
Supervision of patients.
Peculiarities of TB detection in high-risk persons (with COPD, diabetes, peptic ulcer disease, pneumoconiosis,
chronic
alcoholism,
pregnancy,
AIDS).
Clinical analysis of patients on the class topic.
1.1.6 Achievement control on
the topic: "Emergency
in tuberculosis complications
(hemoptysis,
pulmonary hemorrhage,
spontaneous pneumothorax), improvement
of practical skills. AntiTB preparations, grouping in dependence on
efficiency degree. Basic
principles of treatment
and chemotherapy of
pulmonary tuberculosis
patients. Supervision of
patients. Schemes of
tuberculosis
patients
chemotherapy in accordance with therapeutic categories of WHO
recommendations.
6
pneumothorax
apparatus,
roentgen
computer apparatus
[1]
[3]
[9]
[11]
6
TM
[1]
[3]
[9]
[11]
12
Methods of TB patients
intensive treatment (intravenous introduction,
intratracheally infusion
of preparations and in
aerosols,
artificial
pneumothorax, pneumoperitonium, patients
selection for surgical
treatment.
1.1.7 Work in a dispensary
(outpatient) department.
Outpatient reception of
patients. Choosing rational methods of tuberculosis
patients
treatment in outpatient
setting. WHO recommendations for outpatient treatment.
Methods of tuberculosis
prevention in children,
adolescents and adults
(social, sanitary and
specific
prevention,
vaccination and revaccination, chemoprophylaxis). Importance
of health education in
anti-tuberculosis
efforts.
Test on Phthisiopulmonology. Clinical situation tasks. Reading
roentgenograms with a
conclusion. Assessment
of basic practical skills.
Interview on program
questions of phthisiology.
6
TM
[1] Credit test
[3]
[9]
[11]
6-year students of Overseas Students Training Faculty have credit test on the
discipline on the last practical class.
INFORMATIONAL-METHODICAL PART
13
Basic Literature:
Samtsov V.S., Gorbach I.N. “Lecture course on Phthisiology”, Vitebsk,
2001.
2. Samtsov V.S., Volosevich G.V., Gorbach I.N., Romanovsky R.V.
“Phthisiopulmonology”, Vitebsk, 2001.
3. Perelman M.I., Koryakin V.A., Bogodelnikova I.V. “Phthisiology”, the
3rd revised and enlarged edition. Moscow, “Meditsina”, 2004, 518 p.
4. Perelman M.I., Koryakin V.A. “Phthisiology” /textbook/. M., 1996.
5. Perelman M.I., Koryakin V.A., Protopopova N.M. “Tuberculosis”
/textbook/. M., 1990.
6. Lomako M.N., Sudnik S.I., Sobol S.A. “Guide on Phthisiology”.
Minsk, 1991.
7. Samtsov V.S. Study-guide on Phthisiopulmonology for independent
preparing to practical classes on Tuberculosis for 4-year medical students of Medical University. Vitebsk, 2006, p.64.
8. Samtsov V.S. Course-book for independent preparing to practical
plasses on Tuberculosis for 4-year overseas medical students of Medical University. Vitebsk, 1995.
9. Samtsov V.S., Gorbach I.N., Romanovsky R.V. Study-guide on
Phthisiopulmonology for independent preparing to practical classes on
Tuberculosis for 6-year medical students of Medical University. Vitebsk, 2006, p.40.
10. Gurevich G.L., Skryagina E.M., Kalechits O.M. Clinical guide on tuberculosis treatment. Minsk, Belsense, 2009, 125p.
1.
Additional Literature
1.
2.
3.
4.
5.
6.
7.
Tuberculosis of respiratory organs. Guide for physicians. Under editorship of Khomenko A.G., 1988.
Tuberculosis. Guide on internal diseases. Under editorship of Khomenko A.G., 1996.
Vizel A.A., Guryleva M.A. Tuberculosis (etiology, pathogenesis,
clinical forms, diagnostics, treatment). M., 1999.
Vasilyev N.A. Tuberculosis (Study guide). M., 1990.
Sarcoidosis. Under editorship of Khomenko A.G., Shvaiger O., M.,
1982.
Bogadelnikova I.V., Perelman M.I. Antibacterial therapy of pulmonary
tuberculosis. M., Universum Publishing, 1997.
The Order of Ministry of Health of the Republic of Belarus № 143 dated 28.07.1992 “About improvement of antituberculosis service in the
Republic of Belarus and measures of its improvement”.
14
The Order of Ministry of Health of the Republic of Belarus № 266 dated 06.12.1996 “About additional measures on strengthening of antituberculsis activity”.
9. The Order of Ministry of Health of the Republic of Belarus № 106 dated 04.07.2002 “About improvement of dispensary observation and tuberculosis patients detection in the Republic of Belarus”.
10. Kroftan D., Horn N., Miller F. Clinical picture of tuberculosis (translation from English). Under editorship of Khomenko A.G., M., 1996.
11. Tuberculosis treatment/Regulations for National programs/.WHO, Geneva.
8.
Visual aids: color table on clinical forms of tuberculosis, tables on classification of tuberculosis clinical forms, antituberculosis preparations, mandatory and
threatened contingent in investigation for tuberculosis, as well as differential diagnosis and collapse therapy; a light stand “Clinical forms of respiratory organs tuberculosis”; training models on respiratory system; thematic sets of training radiograms with various forms of tuberculosis and other pulmonary pathology; personal
computers in the department and university computer labs; training tests on the
discipline with the standard of answers; training clinical tasks with the standard of
answers; negatoscopes, fluoroscopes, flexible bronchoscopes, pneumothorax apparatus; roentgen computer apparatus (RIC) for chest study; tele-video equipment,
devices and diagnostic equipment of functional divisions of regional tuberculous
dispensary.
PROGRAM QUESTIONS
to credit test on Phthisiopulmonology for 6-year students
of Overseas Students Training Faculty
1. Epidemiology of tuberculosis in developed and developing countries.
2. System of TB service organization in different countries.
3. Clinical diagnostics of pulmonary tuberculosis. (Characteristics of intoxication syndrome and “thoracic” complaints).
4. Organization and technique of bacteriological diagnostics of tuberculosis.
5. Antiepidemic actions in tuberculosis infection nidus.
6. Methods of tuberculosis detection in children and adolescents.
7. Organization and technique of timeous pulmonary tuberculosis detection
in adults.
8. Importance and information value of different methods of X-ray diagnostics in pulmonary tuberculosis.
9. Clinical classification of tuberculosis in the countries of CIS.
10.Tuberculosis risk-groups and prophylactic measures for them.
11.Tuberculosis prevention in children and adults.
12.Tuberculosis dispensary groups in the countries of CIS. Primary registration of patients according to the WHO recommendations.
15
13. Focal pulmonary tuberculosis and its differential diagnostics.
14. Infiltrative pulmonary tuberculosis and its differential diagnostics.
15. Disseminative tuberculosis and its differential diagnostics.
16. Pulmonary tuberculoma and its differential diagnostics.
17. Cavernous tuberculosis and its differential diagnostics.
18. Fibrous-cavernous pulmonary tuberculosis and its differential diagnostics.
19. Tuberculous pleurisy and its differential diagnostics.
20. Primary tuberculous complex and its differential diagnostics.
21. Tuberculosis of intrathoracic lymph nodes and its differential diagnostics.
22. Course peculiarities and prognosis in acute-evolving pulmonary tuberculosis forms.
23. Primary tuberculosis course peculiarities in children and adults.
24.Tuberculous meningitis and its differential diagnostics.
25. Standard chemotherapy scheme of previously untreated tuberculous patients – I and III categories (according to WHO experts’ recommendations).
26. Standard chemotherapy scheme of patients with recrudescence and
backsets of tuberculosis and previously treated ineffectively – II category
(according to WHO experts’ recommendations).
27.Patients dividing into categories in dependence on character and course
of tuberculous process with prescription of polychemotherapy definite
condition (according to WHO experts’ recommendations).
28.Standard scheme of chemotherapy of the I medical category patients according to WHO recommendations.
29. Standard scheme of chemotherapy of the II medical category patients according to WHO recommendations.
30. Standard scheme of chemotherapy of the IV medical category patients
according to WHO recommendations.
31. Standard scheme of chemotherapy of the III medical category patients
according to WHO recommendations.
32. International antituberculous program “DOTS” recommended by WHO.
33. Methods of chemo preparations application control in out-patient conditions.
34. Emergency in pulmonary hemorrhage.
35. Emergency in spontaneous pneumathorax.
Oral examination cards on Sate Examination “Internal Diseases” will include the following questions on Phthisiopulmonology.
16
PROGRAM QUESTIONS
ON PHTHISIOPULMONOLOGY
on State Examination “Internal Diseases”
for 6-year students
of Overseas Students Training Faculty
1. Organization and technique of timeous pulmonary tuberculosis detection
in adults.
2. Organization and technique of bacteriological diagnostics of tuberculosis.
3. Compulsory diagnostic minimum of a patient with suspected tuberculosis
examination when directed to dispensary.
4. Primary forms of pulmonary tuberculosis, differential diagnostics.
5. Disseminative and milliard pulmonary tuberculosis, differential diagnostics.
6. Focal pulmonary tuberculosis, its differential diagnostics.
7. Infiltrative pulmonary tuberculosis, differential diagnostics.
8. Acute-evolving pulmonary tuberculosis forms, prognosis, differential diagnostics.
9. Tuberculous meningitis, differential diagnostics.
10. Pulmonary tuberculoma, differential diagnostics.
11. Cavernous tuberculosis, differential diagnostics.
12. Fibrous-cavernous pulmonary tuberculosis, differential diagnostics.
13. Tuberculous pleurisy, differential diagnostics.
14. Sarcoidosis of respiratory system, diagnostics. Lefgren syndrome.
15. Emergency in pulmonary hemorrhage.
16. Early detection of tuberculosis in risk groups, preventive measures.
17. Detection and prophylaxis of tuberculosis in elderly people.
17
PROTOCOL OF APPROVAL
OF THE DISCIPLINE EDUCATIONAL PROGRAM
“Phthisiology” as a special discipline is not basic among clinic subjects and
therefore when mastering knowledge of previous discipline is necessary.
However, interaction with concerned clinical departments is performed in
accordance with cross-cutting integrate program.
There are Protocols of educational programs approval with basic clinical departments.
Name of Department of interacdiscipline tion
Phthisio- Anatomy Department
pulmonology
Phthisiopulmonology
Neurology with Medical Generics and Neurosurgery Department
Suggestions in order of educational material presentation
1. At Anatomy Department
studying of the structure, lungs
and pleura topography is conducted on system principle
from a perspective of their
functional anatomy taking into
account phthisiopulmonology
clinic needs, showing studied
organs in anatomical specimens
and radiograms.
2. At the Department of
Phthisiopulmonology
to
demonstrate anatomical structures while examining and
treating patients, applying
modern anatomical terminology for designation of organs.
1. At the Department of
Neurology a plan of neurological examination of patients
with meningeal syndrome and
syndrome of intracranial hypertension, the method of
lumbar puncture with studying
of cerebrospinal fluid laboratory parameters are practiced.
Differential diagnosis of infectious and infectious-allergic
diseases of the nervous system.
2. At the Department of
Phthisiopulmonology
practiced questions pathogenesis of
Decision
taken
Protocol
№ __ dated
__.06.2009
of a decision taken
by Anatomy Department
Protocol
№ __ dated
__.06.2009
18
Phthisiopulmonology
Oncology and Radial
Diagnostics Department
Phthisiopulmonology
General and Clinical
Pharmacology Department
tuberculous meningitis and
central nervous system, clinical pictures, course peculiarities, diagnosis and treatment
techniques and outcomes of
the disease are practiced.
1. At the Department of Oncology and Radiation Diagnostics methods of radiation diagnosis of respiratory diseases,
radiation anatomy of lungs in
the norm with lobar and segmental structure, description
scheme of pathological shadows on lungs radiograph, acquaintance with radiation pattern of the most common lesions of lungs are practiced.
2.
At the Department of
Phthisiopulmonology questions
of radiation diagnosis of different clinical forms and variants
of pulmonary tuberculosis in
dynamic observation in progression or reverse the development process to recovery
with formation of any residual
post-tuberculous changes are
studied
1. At the Department of
Pharmacology questions of
general characteristics and
classification of anti-TB drugs,
the main pharmacological
properties of each, pharmakinetics of drugs, side effects
are presented.
2. At the Department of
Phthisiopulmonology
practiced the basic principles and
patterns of combined chemotherapy of different therapeutic
categories patients with the
definition of treatment courses
duration according to WHO
Protocol
№ __ dated
__.06.2009
Protocol
№ __ dated
__.06.2009
19
recommendations, as well as
questions of prevention and
ways to manage side effects
when using anti-TB drugs are
practiced
AMENDMENTS AND ADDITIONS
to the educational program on Phthisiopulmonology
for 6-year students
of Overseas Students Training Faculty of VSMU
№
Amendments and additions
Reason
20
In connection with the Order of the Council of Ministers of the Republic of
Belarus "About State program "Tuberculosis" for 2005-2009" a working program
on Phthisiopulmonology for 6-year students of Overseas Students Training Faculty
must include the main objectives, tasks of the program and main expected results
for its implementation.
The educational program was reconsidered and approved on the meeting of
the Department of Phthisiology (Protocol №__, dated «___» _______.2011)
(the name of department)
Head of the Department
21
PhD, associate professor
(degree, title)
____________
(signature)
A.M.Budritsky
(print name)
APPROVE
Dean of the Faculty
MD, professor
(degree, title)
____________
(signature)
V.M.Semyonov
(print name)
22