1 PROPAEDEUTICS OF INTERNAL DISEASES EXAMINATION SYLLABUS Part I - General 1. History taking plan of history taking, sections, questions. 2. History taking - rules. 3. Current state of health - study plan. 4. Basic physical methods of examination the patient. 5. General state of health of the patient. 6. Constitution, constitutional types. 7. Body temperature. Kind of temperature curves. 8. Disease manifestations of the skin. 9. Examination of the head. 10. Examination of the neck. 11. Respiratory failure. 12 Dyspnea, asthma. Changes in the frequency, type and rhythm of breathing. 13. Cyanosis. 14. Cough. Sputum. 15. Chest pain. 16. Inspection of the chest, pathological chest deformities. 17. Palpation of the chest- pathologic changes. 18. Percussion of the lungs - principles, normal findings. 19. Percussion of the lungs - pathological changes. 20. Auscultation of the lungs - types of breathing and mechanism of formation. 21. Auscultation of the lungs - added noise, mechanism of formation. 22. Spiro metric test and blood gas analysis. Disturbances in lung diseases. 23. Puncture of the pleura, examination of the pleural content. 24. Acute circulatory failure - shock, syncope, sudden death. 25. Arterial hypertension, blood pressure measurement. 26. Chronic heart failure. 27. Clinical manifestations and types of left-sided heart failure. 28. Clinical manifestations and types of right-sided heart failure. 29. Premature beats, paroxysmal tachycardias. 30. Atrial fibrillation and flutter. 31. Disturbances in conducting, types of blocks. 32. Inspection and palpation of the precordium- pathological changes. 33. Percussion of the heart pathologic abnormalities. 34. Auscultation of the heart. Mechanisms of formation of heart sounds. 35. Cardiac murmurs type of murmurs, mechanisms of formation. 36. Distinguishing between organic and functional heart murmurs. 37. Examination of the arteries and arterial pulse. 38. Examination of the veins, venous pulse, venous pressure. 39. Electrocardiography - normal and pathological patterns. 40. Other functional methods of examination of the cardiovascular system.
2 41. Acute renal failure. 42. Chronic renal failure. 43. Physical examination of the kidneys and urinary tract. 44. Proteinuria, nephrotic syndrome. 45. Haematuria, pyuria. 46. Tests of urine dilution and concentration. 47. Biochemical indicators of renal function, clearance tests. 48. X-ray, isotopic and other methods of examination of the urinary system. 49. Physical examination of the abdomen. Ascites. 50. Signs and symptoms of the esophagus, methods examination of the esophagus. 51. Signs and symptoms of the stomach, methods of examination of the stomach. 52. Diarrhea. Constipation. Melena. 53. Maldigestion and malabsorption syndromes. 54. Signs and symptoms of the colon. Methods of examination of the colon. 55. Liver failure. 56. Jaundice types of jaundice, mechanisms of formation. 57. Portal hypertension - pathogenesis. 58. Physical examination of the liver. 59. Laboratory, functional and instrumental examination of the liver. 60. Examination of the bile ducts. Duodenal exploration. 61. Signs and symptoms of the pancreas. Physical and functional examination of the pancreas. 62. Physical examination of the spleen. Pathologic changes. 63. Acute and chronic blood loss, oligaemia, anemia. 64. Methods of examination of the pituitary gland. 65. Methods of examination of the thyroid gland. 66. Methods of examination of the parathyroid glands. 67. Methods of examination of the adrenal glands. 68. Disease manifestations of bones and joints. Methods of examination. Part II - Special 69. Acute tracheobronchitis, acute bronchitis, bronchiolitis. 70. Chronic bronchitis - etiology, pathogenesis, clinical presentation, types, 71. Bronchial asthma - etiology, pathogenesis, clinical presentation, types, 72. Bronchiectasis - etiology, pathogenesis, clinical presentation, 73. Pulmonary emphysema - etiology, pathogenesis, clinical presentation, forms 74. Pulmonary embolism and lung infarction - etiology, pathogenesis, clinical presentation, 75. Pneumonia - etiology, pathogenesis, classification. 76. Lobar pneumonia - etiology, pathogenesis, pathomorphology, clinical picture, 77. Bronchopneumonia - etiology, pathogenesis, clinical presentation, 78. Viral and secondary pneumonia. 79. Lung cancer - etiology, pathogenesis, clinical presentation, forms 80. Echinococcus lung - etiology, pathogenesis, clinical presentation, 81. Abscess and gangrene of the lung - etiology, pathogenesis, clinical presentation, 82. Pulmonary tuberculosis - primary forms. 83. Pulmonary tuberculosis post primary forms. 84. Pleurisy - etiology, pathogenesis, clinical presentation, types, 85. Pneumothorax, hydrothorax.
4 presentation, 123. Hemolytic anemia - etiology, pathogenesis, clinical presentation, 124. Polycythemia - clinical presentation, 125. Acute leukemia - etiology, pathogenesis, clinical, hematological forms, 126. Chronic myeloid leukemia - etiology, pathogenesis, clinical and hematologic presentation, 127. Chronic lymphoid leukemia - etiology, pathogenesis, clinical and hematologic picture 128. Agranulocytosis and pan myelopathy - etiology, pathogenesis, clinical and hematologic presentation 129. Bleeding diathesis, types - etiology, pathogenesis Lymphogranulomatosis - etiology, pathogenesis, clinical and hematologic picture 131. Myelomatosis - etiology, pathogenesis, clinical and hematological picture. 132 Acromegaly. Gigantism. Dwarfism - etiology, pathogenesis, clinical presentation, 133. Diabetes insipidus - etiology, pathogenesis, clinical presentation, 134. Thyrotoxicosis. Graves' disease. Toxic adenoma-etiology, pathogenesis, clinical presentation, 135. Myxedema. Endemic and sporadic goiter. Cretinism - etiology, pathogenesis, clinical presentation, 136. Hyperparathyroidism - etiology, pathogenesis, clinical presentation, 137. Hyperparathyroidism - etiology, pathogenesis, clinical presentation, 138. Disease syndrome Cushing. Pheochromocytoma Addison's Disease and acute adrenal insufficiency - etiology, pathogenesis, clinical picture Diabetes mellitus - etiology, pathogenesis, biochemistry Diabetes mellitus - clinical picture, complications, 142. Obesity. Emaciation - etiology, pathogenesis, clinical presentation, 143. Gout - etiology, pathogenesis, clinical presentation, 144. Rheumatoid arthritis - etiology, pathogenesis, clinical presentation, 145. Ankylosing spondylitis (Bechterew disease) - etiology, pathogenesis, clinical presentation, 146. Osteoarthritis - etiology, pathogenesis, clinical presentation, Part III - Practical 147. History taking at the bedside General state of health Examination of the head Examination of the neck Physical examination of lymph nodes Examination of the skin Examination of the thorax (lung and patient) Palpation of the thorax Percussion of the lungs Comparative percussion lung Examination of the lung and respiratory borders Pleural puncture.
5 159. Examination of pleural effusion Auscultation of the lungs Examination of the vessels. Arterial and venous pulse Examination of the precordium 163. Palpation of the precordium Percussion of the heart - the determination of the relative dullness Percussion of the heart - the determination of the absolute dullness Auscultation of the heart. 167 ECG - normal and pathological patterns, myocardial infarction, arrhythmias, blocks Physical examination of the urinary system Percussion of the abdomen Palpation of the abdomen types of palpation Physical examination of the digestive tract Examination of ascites Physical examination of the liver Percussion of the liver Palpation of the liver types of palpation Percussion of the spleen Palpation of the spleen Physical examination of the pancreas Physical examination of the thyroid gland Overall, clinical and microscopic examination of urine - clinical interpretation Examination of joints Examination of gastric juice - methods. Chemical and microscopic examination of gastric juice. Clinical significance Examination of duodenal juice. Microscopic, macroscopic and chemical examination. Methods. Clinical significance Hemoglobin - normal values, importance, methods of determination Hematocrit - methods of determination - normal values, clinical significance The sedimentation rate of erythrocytes. Method of Vestergreen. Normal values. Clinical significance Differential blood count. RBC morphology Differential blood count. Morphology of leukocytes Myelogram. Morphology of the cells from the erythroblast cell line 190. Myelogram. Morphology of the cells of the granulocytic cell line. Textbooks and Manuals 1. Manual of Clinical Medicine- Edition 2014, B.Kanazirev, J.Georgieva 2. Bate Guide to Physical Examination and History Taking, 2014, Lynn Bickley 3. Harrison Principles of Internal Medicine, 2014, E. Braunwald Department of Internal Medicine Head, Assoc.Prof. B. Kanazirev
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