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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

- leucocytosis 3 x 1010/l-3 x 1011/l;

- red blood cell count decreased;

- platelet count decreased;

- between 70 and 90% of white cells on blood film appear as mature lymphocytes;

- the structure of their nuclea and cytoplasm is sometimes quite peculiar;

- the cells are very soft and arc easily destroyed, when preparing a smear;

- specific Botkin-Gymprecht shadows are formed.

Bone marrow: bone marrow aspiration shows lymphocyte replacement of normal marrow elements. Lymphocytes comprise 25 - 95% of all the cells in early stage; in terminal stage total lymphoid metaplasia.

Enlargement of mediastinal lymph nodes can be detected by standard X-ray examination or by tomography.

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.

Topic 17. The main symptoms and syndromes in diabetes mellitus. The main clinical manifestations of thyroid gland diseases.

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: The main risk factors and mechanisms of developing II and I types diabetes mellitus. The complaints, the peculiarities of patients` examination and physical examination data in II and I types diabetes mellitus. Modern laboratory diagnostics of diabetes mellitus diagnostic significance of the content of glycosyled hemoglobin and immune reactive insulin. The most frequent states of coma in diabetes mellitus (hyperketonemic and hypoglycemic coma), the mechanisms of its development, clinical signs and first aid.

The main etiological factors in thyroid gland disease. Hyperthyroid and hypothyroid syndromes in the thyroid gland disease. Diffuse toxic goiter. The main patients` complaints, the results of physical, instrumental and laboratory examination. The notion of thyrotoxic crisis. The main clinical manifestations of myxedema, the notion of hypothyroid coma.

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