10

Ministry of health of ukraine

Vinnitsa national medical university of n.I.Pirogova

"Approved"

At methodical meeting of chair

Internal medicine №1

Head of the department

____________ prof. Stanislavchuk M. A.

«______» _______________ 200 ___

Methodical recommendations For students

Subject matter	Principles of internal medicine
Module № 1	Principles of internal medicine (gastroenterology, pulmonology, hematology)
Substantial module № 1	Principles of diagnosis, treatment and prevention of basis diseases in Gastroenterology
Subject of the lesson	Peptic ulcer disease and other stomach and duodenal ulcers.
Course	4
Faculty	Medical № 1

Vinnytsia 2012

The aim: The students must be able to diagnose Peptic ulcer disease (PUD) and its complications, define PUD symptoms, make the differential diagnosis, determine the severity, and prescribe the proper treatment.

Topicality: PUD is still affects approximately 10% of all adults at some time in their life.

Educational goal:

1. Determine main etiological factors of PUD .

2. Learn the modern classification of PUD .

3. Define the clinical symptoms of PUD.

4. Make the plan of additional investigation of the patient and analyze their results.

5. Make the clinical diagnosis of the patient with PUD.

6. Prescribe the proper treatment.

The student must know:

1. Aetiology and pathogenesis of PUD.

2. Clinical symptoms of PUD.

3. Modern classification of PUD.

4. Methods of diagnostics of PUD.

5. Complications of PUD.

6. Principles and methods of treatment of PUD.

7. Primary and secondary prevention of disease.

The student must be able:

1. To define the clinical features of PUD.

2. To assess the symptoms of PUD.

3. To make the scheme of investigation for the determination of PUD.

4. To analyze the barium meal examination and methods for the diagnosis of Helicobacter Pylori infection.

5. To make the differential diagnosis of PUD.

6. To make the diagnosis of PUD.

7. To determine the treatment of the patient and to estimate the efficacy of the therapy.

4. To prescribe the proper treatment for the patient with PUD.

5. To prescribe the drugs for secondary prevention of disease.

6. 2. Basic level of training

   №п/п	The names of previous courses	The obtained skills
   1.	Normal anatomy	To know the anatomical structure of the organs of gastrointestinal system, their topography, blood supply and innervation.
   2.	Histology	Aware of the cellular structure of the organs of gastrointestinal system.
   3.	Biochemistry	Know the biochemical composition of gastric juice. Have an idea about the process of splitting macronutritions of food by enzymes of gastric juice
   4.	Normal physiology	Have an understanding of basic physiological processes, which provide digestion: 1) neuro-hormonal regulation of the production of hydrochloric acid and enzymes of gastric juice, stomach motility; 2) synthesis elements of the gastric juice and mucus by the parietal, main and additional glands; 3) synthesis of hormones APUD system in the gastrointestinal tract to regulate the working of stomach (histamine, serotonin, gastrin, enterogastrin, bombesin, motilin, somatostatin, gastrointestinal peptide, vasointestinal peptide), 4) chemical processing of food lump in the stomach.
   5.	Physiopathology	Know the main endogenous and exogenous factors of peptic ulcer disease and pathogenetic mechanisms through which they operate. Know the physiological substantiation manifestation of clinical symptoms and possible complications of this disease.
   6.	Pharmacology	Toknowthemechanismofaction,indicationsandcontraindicationsofmedicines, which is used in treating patient with ulcer disease of stomach and duodenum and be able to write them in the form of recipes.
   8.	Propaedeutic therapy	Demonstrate skills in examination of patients with ulcer disease of stomach and duodenum (collecting complaints, history of disease and life, doing an objective examination, analyzing the results diagnostic testing).

The main problems of the lesson:

Peptic ulcer disease (PUD) is a problem of the gastrointestinal tract characterized by mucosal damage secondary to pepsin and gastric acid secretion.

Peptic ulcers are defects in the gastric or duodenal mucosa that extend through the muscularis mucosa.