Chapter III. Prevention, diagnosis and treatment of diseases of therapeutic section in the polyclinic.
The list of exam questions “Polyclinic therapy” for 6-course students.
Chapter I – General questions of out-patient polyclinic help organization
- Out-patient polyclinic therapeutic help organization. The concept of primary health care. Prophylaxis direction of out-patient polyclinic help.
2. Legal aspects of medical care in the Russian Federation. The Constitution of the Russian Federation. The main provisions of the Federal law " Protection of health of citizens of the Russian Federation".
3. Prophylaxis: definition, classification, main tasks and directions. Formation of healthy lifestyle. Non-infectious diseases risk factors. Sanitary-educational work.
4. Organizational-methodical bases of medical rehabilitation outpatient level. Definition of rehabilitation, rehabilitation potential abilities.
5. The procedure for conducting examinations (dispensarization) in the adult population.
6. Organization and conducting of dispensary observation of patients with chronic non-infectious diseases and patients with a high risk of developing them.
7. Organization of the work of the local therapist. The main sections. Features of patients in outpatient settings.
8. Criteria for evaluating the quality of medical care in an outpatient setting. Performance indicators the therapeutic department clinics. The concept of incidence, morbidity, mortality and morbidity.
9. Urban polyclinic: structure, tasks, functions. Organization and content of the therapeutic Department clinics. Organization of home care. Continuity in the provision of preventive and curative care.
10. Sanitary and epidemiological work of general practitioner.
- Clinical expert work in a health care setting. Medical commission: composition, functions, tasks.
- Inability expertise. Types of disability. Stages of examination. The concept of medical and social criteria that define disability. Duration of incapacity. Recovery and rehabilitation.
- The procedure for issuing of documents attesting to the temporary disability of the citizens. Functions of the physician during the examination of temporary disability.
- Long-term inability. Invalidity. The procedure for sending and carrying out medical and social expertise (MSE). Re-examination of persons with disabilities. The cause of disability. The procedure for issuing sick leave of incapacity when the direction of MSE.
- Palliative care, the role of the general practitioner GP.
- Order for referral to sanatorium treatment. Indications and contraindications to sanatorium-resort treatment.
- Procedure of appointment and prescribing drugs. The notion of a list of essential medicines.
- Ethics and deontology in medicine. Features patient counseling in conflict situations. Burnout Syndrome among doctors.
- Basic principles of healthy nutrition. Correct eating habits. The feeding habits of heart and vascular diseases.
- Risk factors of major non-infectious diseases. The role of the general practitioner clinics in their modifications.
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Chapter II – The important syndromes in general practitioner practice.
- Cough - causes and characteristics, complications. Diagnostic program for coughing patient. Diagnostic algorithms for acute and chronic cough. Out-patient treatment.
- Retrosternal pain. Diseases can cause chest pain syndrome. Cardialgies of different etiology.
3. Definition of “long-term sub febrile fever”, “hyperthermia” and “fever of unknown cause”. Causes of long-term sub febrile fever. Diagnostic algorithm for fever of unknown cause.
4. Anemic syndrome: hypo-, normo- hyperchromic anemia. Diagnostic algorithm.
5. Syncope in practice general practitioner clinics. Differential diagnosis of syncope. Tactics.
- Nephrological syndromes. Tactics. Diagnostic algorithm of searching in the clinic.
7. Urinary syndrome. Differential diagnosis when proteinuria. Diagnostic significance of proteinuria.
8. Urinary syndrome. Differential diagnosis with hematuria and leucocyturia.
9. Chronic renal disease (CRD). Risk factors, screening test, diagnostic criteria CRD. Classification CRD.
10. Chronic renal disease (CRD). Prevention and basic approaches to the treatment of CRD. Principles nephro-and cardio- protective therapy.
11. Edematous syndrome in medical practice clinics causes. Differential diagnosis.
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12. Articular syndrome in medical practice clinics. Differential diagnosis. Tactics district therapist.
13. Diagnostic search with abdominal pain. The disease, which should be deleted in the first place when abdominal pain syndrome appeared.
14. Diagnostic search with generalized skin irritation (itching). Tactics district therapist.
15. Diagnostic search in arterial hypertension. Symptomatic arterial hypertension.
- Bronchial obstruction syndrome. Direction of diagnostic search.
- Hypothyroidism syndrome. Tactics therapist clinics.
- Thyrotoxicosis syndrome. Tactics of the therapist.
- Disease occurring with constipation and diarrhea syndrome, differential diagnosis. Irritable bowel syndrome. Tactics of the therapist.
- Paraneoplastic syndromes in practice of general practitioner clinics. Diagnostic algorithm. Tactics.
Chapter III. Prevention, diagnosis and treatment of diseases of therapeutic section in the polyclinic.
1. Modern recommendations about an etiology and pathogenesis of osteoarthritis (OA). The epidemiology of the disease. The classification of OA. Clinical picture. Outcomes. Forecast (medical and occupational). Diagnosis. Differential diagnosis.
2. Prevention of osteoarthritis (OA). The treatment of OA. Non-pharmacological and pharmacological treatment. Indications for surgical treatment.
3. Methods of investigations of biliary system. Cholelithiasis, epidemiology, classification, etiology and pathogenesis, diagnosis of the disease. The tasks of the district doctor-therapist in the management of the patients with gall-stone disease.
4. The definition of chronic noncalculous cholecystitis, the etiology and pathogenesis of the disease. Classification of of chronic noncalculous cholecystitis. The clinical picture, course of the disease in elderly and senile age. Diagnosis of chronic noncalculous cholecystitis in polyclinic. Required and additional laboratory tests.
5. Treatment of chronic noncalculous cholecystitis in polyclinic in the period of exacerbation and remission. The indications for hospitalization. Urgent help at an attack of biliary colic. Indications to consultation of the surgeon. Examination of disability. Indications and contraindications to sanatorium-resort treatment, primary and secondary prevention of noncalculous cholecystitis.
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6. Definition of cardiomyopathy (CMP). Classification of CMP. The etiology and pathogenesis of the disease. The main clinical manifestations, differential diagnosis with other diseases. The volume of laboratory and instrumental investigations.
7. Treatment (pharmacological and non-pharmacological) of cardiomyopathy. Prevention. Examination of disability.
8. Classification of secondary (symptomatic) hypertension (SAH). The complex of laboratory and instrumental studies in the diagnosis of SAH. Clinical and laboratory manifestations of renal hypertension.
9. Clinical and laboratory manifestations of endocrine arterial hypertension (AH). Clinical and laboratory manifestations of hemodynamic hypertension. Clinical and laboratory manifestations in organic lesions of the CNS.
10. Definition and classification of chronic heart failure (CHF). The etiology and pathogenesis. Factors of progression of CHF. Algorithm of diagnosis in the outpatient conditions.
11. Outpatient pharmacotherapy in patients with chronic heart failure (CHF). Non-pharmacological methods of treatment. Dispensary observation of patients with CHF. Examination of temporary disability. Procedure for direction to MSE.
12. Tactics in management of the patients with atrial fibrillation (AF) in the polyclinic. Classification of antiarrhythmic drugs used in the treatment of AF. Prophylaxis of thromboembolic conditions. Examination of temporary disability, indications for planned and emergency hospitalization of patients with AF. The order of the dispensary observation.
13. Acute respiratory viral infections (ARVI): etiology, clinical symptoms (General and local), diagnosis and treatment in polyclinic. Examination of disability.
14. Flu serotypes, the peculiarities of clinical manifestations. Diagnosis and treatment in a clinic. Complications.
15. Complications of acute respiratory viral infections. The indications for hospitalization. Influenza vaccination: indications and contraindications. Populations that are subject to obligatory vaccination.
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16. Angina (acute tonsillitis). Diagnosis, differential diagnosis. Therapy in polyclinic. Observation of the patient with preceding angina.
17. Treatment of arterial hypertension (AH) in the context of the medical area in different categories of patients. Outpatient observation . Expert examination of temporary disability.
18. The course and therapy of arterial hypertension (AH) in the elderly and pregnant women.
19. Acute coronary syndrome. Causes, necessary diagnostic measures. Tactics of management of patients with acute coronary syndrome. Emergency care at the prehospital stage.
20. Definition of chronic obstructive pulmonary disease (COPD). The etiology and pathogenesis of COPD. Clinical manifestations of the disease. Laboratory and instrumental methods of diagnosis of COPD. Differential diagnosis.
21. Tactics patient with chronic obstructive pulmonary disease (COPD) in polyclinic: basic therapy, the principles of emergency therapy. Outpatient observation . Examination of temporary disability, indications for planned and emergency hospitalization of patients with COPD.
22. Acid-related diseases in practice of district therapist . Diagnosis. The principles of therapy.
23. The diseases associated with H. pylori infection. The main theses of the Maastricht V (2016).
24. Clinical and laboratory manifestations of iron deficiency anemia (IDA). Clinical and laboratory manifestations of hemolytic anemias. Clinical and laboratory manifestations of hypo-, aplastic anemia. Clinical and laboratory manifestations of B12, folic acid-deficienсу anemia.
25. The indications for hospitalization with iron deficiency anemia (IDA). Indications for direct of the patient with the syndrome of anemia to the hematologist. Treatment of IDA. Primary and secondary prevention of IDA.
26. Definition of chronic glomerulonephritis. The etiology and pathogenesis. Classification. Clinical manifestations of the disease. Laboratory and instrumental methods of diagnostics of chronic glomerulonephritis. Differential diagnosis.
27. Management of the patient with chronic glomerulonephritis in polyclinic: the basic approaches to therapy. Outpatient observation . Examination of temporary disability, indications for planned and emergency hospitalization of patients with chronic glomerulonephritis.
28. Etiology, pathogenesis, classification of chronic pyelonephritis and infections of the urinary tract, differential diagnosis, and clinical management of patients in polyclinic.
29. Rheumatoid arthritis, epidemiology, etiology and pathogenesis of the disease. Diagnostic criteria of rheumatoid arthritis. Methods of clinical, laboratory and instrumental diagnostics. Differential diagnosis with other diseases that occur with articular syndrome.
30. Rheumatoid arthritis: therapy in the onset of the disease and in patients with resistant forms. Indications for use of genetically engineered drugs.
31. Osteoporosis: risk factors, prevention. Modern diagnosis of osteoporosis and the basic principles of therapy. The rational employment of patients with diseases of musculoskeletal system; examination of disability (temporary and permanent).
32. The definition of chronic hepatitis. Etiology, pathogenesis and classification. Clinical and laboratory syndromes in the diagnosis of liver diseases. Functional diagnostic methods. The value of invasive and non-invasive methods of diagnosis of chronic hepatitis.
33. Definition, etiology, pathogenesis and classification of liver cirrhosis. Clinical and laboratory diagnosis. Classification of cirrhosis according to Child-Pugh. The principles of therapy.
34. Hepatoprotectors. Classification. The principles of drugs choice in cases of various diseases of the liver.
35. Complications of liver cirrhosis, prevention of their occurrence. Principles of therapy of hepatic encephalopathy, portal hypertension. Examination of temporary and permanent disability.
36. Definition, etiology, pathogenesis, classification of diabetes mellitus. Diagnosis of diabetes in the outpatient setting. Major complications of diabetes. Classification of complications, diagnosis.
37. The goals of treatment of diabetes 2 type. Oral antihyperglycemic drugs. Indications for use of insulin therapy. The indications for planned and emergency hospitalization.
38. Chronic pancreatitis, the etiology and pathogenesis of the disease. Modern classification of chronic pancreatitis. Clinical, laboratory and instrumental diagnostics of diseases. Treatment of chronic pancreatitis in the clinic. The indications for hospitalization.
39. Inflammatory bowel disease (ulcerative colitis and Crohn's disease). Definition, classification. Clinical diagnostic criteria. Laboratory and instrumental methods of diagnosis. Differential diagnosis. Principles of therapy in the outpatient setting. Prevention of complications of therapy.
40. Diagnosis and treatment of community-acquired pneumonia. Differential diagnosis. The indications for hospitalization.
41. Stable ischemic heart disease. Etiology, pathogenesis, diagnosis, classification. The direction of therapy. Primary and secondary prevention.
42. Clinic, diagnosis of acquired and congenital heart diseases (mitral stenosis, mitral regurgitation, aortic stenosis, aortic valve regurgitation, insufficiency of the tricuspid valve). Indications for surgical treatment of patients with heart defects and direction of patients for highly specialized medical care in the practice of the local doctor.
43. Noncoronary heart disease (endocarditis). Etiology, pathogenesis, diagnosis, classification. The principles of therapy. Primary and secondary prevention. Clinical supervision. Examination of temporary disability.
44. Noncoronary heart disease (pericarditis). Etiology, pathogenesis, diagnosis, classification. The principles of therapy. Primary and secondary prevention. Clinical supervision. Examination of temporary disability.
45. Systemic diseases of connective tissue. Etiology, pathogenesis, diagnosis, classification. The principles of therapy. Primary and secondary prevention.
46. Hepatoprotectors. Classification. The principles of drugs choice in cases of various diseases of the liver.
47. Clinic, diagnosis of acquired and congenital heart diseases (mitral stenosis, mitral regurgitation, aortic stenosis, aortic valve regurgitation, insufficiency of the tricuspid valve). Indications for surgical treatment of patients with heart defects and direction of patients for highly specialized medical care in the practice of the local doctor.
48. Inflammatory bowel disease (ulcerative colitis and Crohn's disease). Definition, classification. Clinical diagnostic criteria. Laboratory and instrumental methods of diagnosis. Differential diagnosis. Principles of therapy in the outpatient setting. Prevention of complications of therapy.
49. Definition of chronic obstructive pulmonary disease (COPD). The etiology and pathogenesis of COPD. Clinical manifestations of the disease. Laboratory and instrumental methods of diagnosis of COPD. Differential diagnosis.
50. Angina (acute tonsillitis). Diagnosis, differential diagnosis. Therapy in polyclinic. Observation of the patient with preceding angina.
51. Diagnostic search with generalized skin irritation (itching). Tactics district therapist.
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