Plan of conducting of training.
| № | Elements of practical training | Time (minutes) |
| 1. 2. 3. 4. 5. 6. | Test control with the purpose of estimation of initial level of knowledge and its analysis. Demonstration of method of clinical examination with estimation of the state of the endocrine system in children. Distributing of patients for IWS. Independent work of students with the patients. Registration of protocols of examination of patient with estimation of the state of the endocrine system and ground of clinical syndrome. Round of children, which students worked with, analysis of patients. Signing of protocols. Final control of knowledge, solving of clinical situation tasks. Results of training and final estimation of knowledge and abilities of students and task for independent preparation to a next training. List of literature. | 15 min. 30 min. 45min. 40 min. 20 min. 10 min. Total: 160 min. |
List of theoretical questions:
1) Anatomic and physiologic features of endocrine system in children of a different age and their clinical value.
2) Method of clinical examination of patient with pathology of the endocrine system:
а). questioning;
b). features of examination: general inspection with estimation of physical development, proportion of body building, state of skin, inspection of face, inspection of neck, inspection of thorax, inspection of genitals;
c). palpation of pulse and its description;
d). palpation of thyroid gland;
e). estimation of sexual development: in girls- axillary pilosis, pilosis of pubis, development of mammary glands, character of menstrual function; in boys – pilosis of face, axillaries, pubis; forming of the Adam's apple, age changes of voice;
f). determination of arterial pressure, age norms;
3. Semiotics of defeats of the endocrine system:
a).hypo and hyperfuntion of adrenal glands;
b). hypo and hyperfuntion of thyroid;
c). hypo and hyperfuntion of pancreas
d). syndrome of violation of physical development;
e). hypo and hyperfuntion of sexual glands.
Method of conducting of practical training:
1. Students answer in writing on the tests of entrance control of base knowledge. Then is distributed for implementation of practical work with patients.
2. Students in the wards of department conduct the method of clinical examination of patient with pathology of the endocrine system.
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3. Then teacher conduct round of patients together wit the students.
Students design protocol of inspection of patient with estimation of the state of the endocrine system. A teacher conducts the analysis of patients with the analysis of substantiation pathological clinical syndrome. Signing of protocols.
4. A teacher conducts the final control of knowledge and practical skills of students on this theme with the use of situation clinical tasks.
5. A teacher works out the resume of training, gives estimation of knowledge and abilities of students. Assigns for independent preparation to a next training.
Forms and methods of self-control
Tests:
1. What hormone determines the level of metabolism in an organism?
A. adrenocorticotropin
B. thyiroxin
C. oxitocin
D. luteinizing hormone
E. prolactinum
2. What hormone determines growth and differentiation of child’s organism on the first year of life?
A. adrenocorticotropin
B. thyiroxin
C. oxitocin
D. luteinizing hormone
E. prolactinum
3. What hormone is produced the ß-cells of pancreas?
A. glucagon
B. Insulin
C. somatostatin
D. thyroxin
E. somatotropin
4. Level of sugar in the blood of healthy children on empty stomach:
A. 6,6-8,5 mmol/l
B. 7,4- 10,2 mmol/l
C. 3,3-5,5 mmol/l
D. 10,0-15,8 mmol/l
E. 2,1-3,4 mmol/l
5. The antagonist of insulin is:
A. glucagon
B. parathormone
C. somatostatin
D. thyroxin
E. somatotropin
Standards of answers:
1. B
2. B
3. B
4. C
5. A
Situation tasks
Task 1.
Doctor-endocrinologist has established to 12 years old boy diagnosis diabetes mellitus. What are the main symptoms of this disease?
Task 2.
After birth in a child were marked the following symptoms: jaundice, increase size of abdomen, weak sucking reflex, heavy nasal breathing, somnolence, lower position of umbilicus, low timbre of voice. What endocrine pathology doctor can suspect?
Task 3.
14 years girl came to the doctor with complaints on rising irritability, emotional lability, tremor of hands, loss of mass of body. What pathological syndrome you can suspect?
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Standards of answers:
1. Polyuria, polydipsia, hyperglycemia, glycosuria
2. Congenital hypothyros
3. Hyperthyros.
Hardwares and material providing of training:
1) Tables:
“Indexes of sexual development of children”
“Endocrine glands and their hormones”
2) Charts:
Symptoms of diabetes mellitus
Syndrome of hypofunction of thyroid gland
Reasons of low height in children
3) Set of test tasks of entrance control (10 examples).
4) Set situation clinical tasks (10 examples).
5) Mtetodical developments:
“Anatomic and physiologic features of the endocrine system in children”
“Indexes of arterial pressure in children of different age”.
“Method of examination of the endocrine system”
“Syndromes in pediatrics”
Information sources.
А) Basic:
1. Kapitan T. Propedeutics of children’s diseases and nursing of the child. – Vinnitsa, 2006. – P. 619-632
B) Additional:
1. Мазурин А.В., Воронцов И.М. Пропедевтика детских болезней.- M: Медицина, 2001. – С.622-670.
2. Пропедевтика детских болезней / под ред. А.А.Баранова. – М.: Медицина, 1998. – С.304-314.
Program of self-preparation of students to the theme:
1. To study basic and additional information sources according to the theme of training.
2. To be able to conduct the method of examination of the endocrine system in children: inspection, estimation of physical and sexual development, palpation of thyroid gland.
3. To be able to take a care of children with the defeat of the endocrine system.
4. To pay attention and learn the basic pathological syndromes of defeats of endocrine system in children.
Semantic module 11. Immune system and system of blood in children.
Concrete aims:
• To collect anamnesis and expose information which specify on the changes from the side of the immune system and system of blood in children.
• To conduct the objective examination of the immune system and system of blood taking into account age features.
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• To select the clinical signs of the immunodeficiency, anemia, to establish leading syndromes.
• To interpret the results of laboratory-instrumental methods of examination.
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