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Module 2: Symptoms and syndromes in diseases of internal organs.doc
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Additional methods of examination

Clinical blood analysis: leukocytosis, neutrophilia, shift of leukocyte formula to the left, accelerated ESR, in prolonged duration - hypo- or normochromic anemia.

Sputum analysis: large amount of mucopurulant, purulent or mucopurulent bloody strong smell sputum that form lays on standing (pus, plasma and upward mucus). In microscopic study are revealed a lot of columns ciliated epithelium, leucocytes, alveolar macrophages, fibrin fibers and large quantity of microorganisms (bacterial flora).

X-ray examination: augmentation and deformity of lung picture with character in lower regions, thick wall cavities sometimes with fluid level, lung's "amputation", increased in transparent regions with healthy lung tissue.

Test of ventilatory function (spirometric recording and pneumotachymetry): impaired ventilatory function: restrictive type - significant decrease of total lung capacity; obstructive type - decrease of respiratory reserve and forced expiratory vital capacity or mixed type - significant decrease of total lung capacity and forced expiratory vital capacity.

ECG: deviation of electric axis of the heart to the right, P-pulmonale in II, III, AVF leads.

Literature

1. Internal diseases an introductory course. - Vasilenko V., Grebenev A. - M.: Mir . Publishers, 1990. - 647 p

2. Propedeutics to internal medicine. Part 1.-Vinnytsya: NOVA KNYHA, 2006.- 424 p.

3. Propedeutics to internal medicine. Part 2.-Vinnytsya: NOVA KNYHA, 2007.- 264 p.

4. Introduction to the course of internal diseases. Book 1. Diagnosis: [Textbook/Zh.D. Semidotskaya, O.S. Bilchenko, et al.].-Kharkiv: KSMU, 2005. -312p.

5. Michael Swash Hutchison’s clinical methods / XIX edition. ELBS, 1989. -618p.

6. Mark H., Beers M.D., Robert Berkow The Merck Manual of diagnosis and therapy / XVII edition.- Published by Merk research laboratories, 1999.- 2833 p.

7. Harrison΄s principles off internal medicine / Fauci, Braunwald, Isselbacher and al.-XIV edition. - Vol. 1 and 2. - International edition, 1998.

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Topic 8. Pneumonias: Symptoms and Syndromes on the Basis of Clinical - Instrumental and Laboratory Methods of Examination. Pneumosclerosis. Tumors of the Lungs.

Class lasts: 3 hours

Chronological class structure:

Control of initial standard of knowledges- 20 min.

Teacher′s demonstration of practical skills - 60 min.

Sudents′ independent work: - 30 min.

Control of ultimate standard of knowledges- 15 min.

Sum up of the class, homework- 10 min.

Questions for theoretical preparation: Definition and modern classification of pneumonias (hospital-acquired, non-hospital-acquired, aspiration, pneumonia at immunodeficiency persons), classification by character of affection of the lungs (pleuropneumonia, bronchopneumonia, interstitial pneumonia). The basic etiology factors of pneumonias. Lobar and bronchopneumonia: complaints and physical methods of examination of the patients. Criteria of heavy current of pneumonia. Instrumental diagnostics of consolidation of pulmonary tissue. Laboratory findings of an inflammatory syndrome at pneumonias. Principal causes of development of pneumosclerosis. Pneumosclerosis, physical and instrumental examination of a patient. The basic clinical forms of tumors of the lungs: clinical features in the central and peripheral localization of tumor. A syndrome of consolidation of pulmonary tissue.

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