Practical skills
1) collect past medical history and properly assess Volkovych-Kocher sign;
2) physical examination of all organs and systems of the patient;
3) assess patient's pulse and blood pressure;
4) properly assess the presence, location and severity of pain and rigidity of muscles
of abdominal wall and lumbar area;
5) demonstrate Rovsing sign and assess its severity (negative, weakly positive,
positive, strongly positive);
6) demonstrate Sitkovskiy’s sign and assess its severity (negative, weakly positive,
positive, strongly positive);
7) demonstrate Voskresenskyj’s sign and assess its severity (negative, weakly
positive, positive, strongly positive);
8) demonstrate Bartomje-Michelson’s sign and assess its severity (negative, weakly
positive, positive, strongly positive);
9) demonstrate Blumberg sign and assess its severity (negative, weakly positive,
positive, strongly positive);
10) demonstrate Jaure-Rozanov sign and assess its severity (negative, weakly
positive, positive, strongly positive);
11) demonstrate Coupe sign and assess its severity (negative, weakly positive,
positive, strongly positive);
12) assist in performing the appendectomy and perform separate stages of surgery;
13) make an individual program of postoperative management of patients with acute
appendicitis;
14) make dressings;
15) care for drains, wash drains and enter the in them medications;
16) remove drainage from abdominal cavity;
17) remove sutures;
18) wash the stomach;
19) make a cleansing enema;
20) introduce iv medications, establish an intravenous catheter;
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21) stop bleeding from a wound in the superficial layers of the abdominal wall;
22) establish a catheter into the bladder in men and women;
23) make medical history;
24) issue a medical certificate;
25) issue a prescription for medication;
26) properly assess the nature of pain and its irradiation, pulse and blood pressure,
body temperature in patients with acute cholecystitis;
27) identify and assess jaundice, skin pigmentation from the use of heaters, veins of
the anterior abdominal wall ("Caput Medusa");
28) identify and evaluate protective muscle rigidity in the area of right upper
quadrant, enlarged painful gallbladder or infiltration, the presence of fluid in the
abdominal cavity;
29) demonstrate the presence of symptoms and degree of severity (negative, weakly
positive, positive, strongly positive): Zakharyin, Kera, Courvouasie, Murphy,
Obraztsov,
Ortner,
Mussi-Georgijevskij
,
Botkin
(cholecystitis-cardiac),
Blumberg;
30) assist on cholecystectomy and perform separate stages of surgical intervention
(including miniinvasive and laparoscopic);
31) assist at catheterization of central veins;
32) lead the patient in the postoperative period: assess the general condition of the
patient, make dressings, care for drains, introduce medications through drains into
the abdominal cavity and the bile duct, remove drainage from the abdominal
cavity and the bile duct, remove sutures, assist at surgical wounds debridement in
case of purulent complications;
33) make history, write preoperative epicrisis and protocol of operation in a patient
with cholecystitis;
34) give correct recommendations in postoperative period (feeding regime,
employment);
35) collect anamnesis, conduct inspection, palpation, percussion, auscultation in
patients with acute pancreatitis;
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36) choose from past medical history most typical signs of acute pancreatitis;
37) properly evaluate the data of physical examination in patients with acute
pancreatitis;
38) identify and properly evaluate the severity (negative, weakly positive, positive,
strongly positive) the following symptoms: Kerte, Mayo-Robson, _Blumberg,
Johnson-Cullen-Grunwald, Mondor;
39) issue medical history write preoperative epicrisis and protocol of operation;
40) issue extract;
41) carry out clinical diagnostic studies in patients with bleeding peptic ulcer : collect
past medical history, examination of the patient, palpation, percussion
auscultation, digital rectal examination;
42) carry out preparation of the patient for surgical intervention;
43) identify syndrome and assess the degree of severity (_Blumberg, Valya, Kivulya,
Mathieu-Sklyarov, Shlange, Vilsa, Chugueva, Shimone-Dansa, Tsehe von
Manteuffel, Golda);
44) technique of enterography;
45) perform gastric lavage and estimate the amount and nature of the content;
46) perform a "trap" enema and evaluate its diagnostic and therapeutic significance;
47) collect past medical history, conduct inspection, palpation, percussion,
auscultation of the patient with acute peritonitis;
48) make individual diagnostic program a particular patient with acute peritonitis;
49) evaluate the results of laboratory and instrumental methods of examination;
50) choose from past medical history information indicating the presence of
subjective symptoms of abdominal hernia (which indicate pain, discomfort deep in
the belly with an increase in intraabdominal pressure, urination disorders,
dysfunction of the gastrointestinal tract, etc.);
51) check for symptoms of cough shock;
52) carry out digital examination of the inguinal canal with determination of the inner
and outer inguinal rings, the ratio of the hernia sac to spermatic cord;
53) determine the size of hernial gate at different hernias;
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54) palpatory and auscultatory determine the content of the hernial sac;
55) assist on operations for diseases of the stomach and duodenum;
56) methods of examination of the patient: a study of lymph nodes (cervical, axillary,
inguinal), peripheral arteries and veins;
57) methods of physical examination of the breast;
58) methods of physical examination of thyroid gland;
59) methods of physical examination of of the colon;
60) methods of physical examination of the stomach;
61) methods of physical examination of liver, spleen;
62) methods of physical examination of of the patient with a hernia;
63) method for determination of blood group;
64) performe tests for compatibility, Rh compatibility and biological sample in case
of blood transfusion;
65) method of measuring of central venous pressure;
66) preparation of patients for routine and emergency operations;
67) conducting premedication;
68) catheterization and suprapubical puncture of the bladder;
69) temporary stop of external bleeding;
70) methods of stopping venous bleeding;
71) methods of restoring patency of the upper airway;
72) methods of mechanical ventilation;
73) indirect heart massage;
74) digital rectal examination;
75) technique of sigmoidoscopy;
76) orientation in appointment of surgical instruments: surgical needles (cutting,
stabbing, atraumatic), needle holders, clamps haemostatic (soft straight, curved
lung), , abdominal mirrors, intestine holders (straight and curved), scalpels,
scissors, machines that crosslinking apparatus for applying gastrointestinal
anastomoses;
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77) puncture of a vein in the elbow bend and connection of the system for
transfusion of blood substitutes;
78) technique of celiocentesis;