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QUESTIONS FOR INSUFFICIENT MARK RESIT. No 1. Practical class topic - Tuberculosis epidemiology. Questions Main epidemiological indices calculating and interpreting; Tuberculosis transmission ways; Tuberculosis risk factors and risk groups; Mycobacteria pathogenic and nonpathogenic types; Main links of the disease pathogenesis; Phases of the immunological transformation; Diagnosis formulation (clinical type of the disease, category, cohort, bacterial discharging, histological type). Most common complaints and anamnesis’ data; Typical plan of patient with the suspicion of tuberculosis examination (obligate and additional methods); Methods of mycobacteria detecting, each method’s advantages and disadvantages; Methods of tuberculosis radiological detecting, each method’s advantages and
- Tuberculosis etiology and pathogenesis. Immunity and tuberculosis. Tuberculosis clinical classification. - General approaches for case detecting. - Special methods of case detecting; a) Microbiological tests
b) Radiological methods c) Tuberculin tests
- Primary tuberculosis:
- Pre-local tuberculosis
- Intrathoracic lymph nodes
tuberculosis. - Primary tubercle complex
disadvantages; Principle radiological syndromes of pulmonary diseases; Anterior-posterior and lateral view of the chest X-ray description; The tuberculin solution, its type and dosage; Types of the tuberculin responses; Mantoux skin test procedure and interpreting; Post-vaccine and infectious reaction differentiating; Mantoux skin test conversion. Definition and intervention. Primary period of the tubercle infection. Principle differences between primary and secondary tuberculosis; Primary tuberculosis clinical types; Pre-local tuberculosis definition and diagnostical algorithm; Pre-local tuberculosis deferential diagnosis; Intrathoracic lymph nodes tuberculosis definition and diagnostical algorithm. Different clinical variants if the disease; Intrathoracic lymph nodes tuberculosis deferential diagnosis; Primary tubercle complex definition and principle elements. Diagnostical algorithm; Primary tubercle complex phases; Primary tubercle complex differential diagnosis; Plain X-ray of primary tuberculosis cases description; Primary tuberculosis complications; Physiological age peculiarities which produce primary tuberculosis clinical course differences; Primary tuberculosis age differences in children, adolescents and adults. The factors producing dissemination; Types of disseminative tuberculosis; Subacute and chronic disseminative tuberculosis definition and diagnostical
complications. - Primary tuberculosis age differences in children, adolescents and adults. Disseminative tuberculosis.
Tuberculosis of the system and meninges.
Secondary types: - Focal - Infiltrative
algorithm; Disseminative tuberculosis differentiation from pneumonia, disseminated lung cancer, sarcoidosis, pneumoconiosis; Plain X-ray of miliary tuberculosis cases description; Miliary tuberculosis definition and clinical variants; Tubercle granuloma peculiarities in miliary tuberculosis; Miliary tuberculosis differentiation from pneumonia, typhoid fever, disseminated lung cancer; Miliary tuberculosis diagnostical algorithm; Tuberculosis of the nervous system clinical types; Periods of the disease; Clinical and laboratory criteria of the tubercle meningitis; Differential diagnosis in meningeal syndrome cases; Meningeal tuberculosis diagnostical algorithm. Secondary tuberculosis definition and clinical types; Focal tuberculosis definition, morphological variants and typical clinical course; Tuberculosis activity appreciation; Plain X-ray of focal tuberculosis cases description; Infiltrative tuberculosis definition, clinico-radiological variants; Infiltrative tuberculosis diagnostical algorithm, clinical peculiarities depending on infiltrate radiological type; Infiltrative tuberculosis differentiation from pneumonia, atelectasis, lung cancer; Plain X-ray of infiltrative tuberculosis cases description; Tuberculoma definition, morphological variants and typical clinical course; Tuberculoma differentiation from pulmonary benign and malignant tumors, aspergiloma, echinococcosis; Diagnostical algorithm in round opacity cases; Plain X-ray of round opacity cases description;
- Fibrous-cavernous and cirrhotic tuberculosis
Tuberculosis complications: -hemoptysis and pulmonary hemorrhage
-spontaneous pneumathorax -secondary hypertension - amyloidosis Tubercle pleurisy pulmonary
General principles of tuberculosis treatment. Antituberculosis drugs. Standard treatment regimen.
Fibrous-cavernous tuberculosis definition, morphological and clinical variants of the disease; Typical clinical course and diagnostical approaches at the disease; Plain X-ray of fibrous-cavernous cases description; Cirrhotic tuberculosis definition, morphological and clinical peculiarities; Plain X-ray of cirrhosis cases description. Tuberculosis specific and nonspecific complications; Main pathogenesis variants of the pulmonary hemorrhage; Differential diagnosis from bleeding of other localization (esophageal, nasal, gastric ones); Severity appreciation; Critical care algorithm; Spontaneous pneumathorax definition and principle pathogenesis; Spontaneous pneumathorax critical care algorithm; Secondary pulmonary hypertension mechanism; Secondary pulmonary hypertension diagnostical criteria; Secondary pulmonary hypertension management; Amyloidosis pathogenesis, diagnosis and management; Tubercle pleurisy definition and pathogenetical variants; Clinical feature and laboratory diagnosis of pleurisy; Differential diagnosis in pleurisy of different origin (tuberculosis, non-specific, malignant); Plain X-ray of pleurisy cases description. General principles of tuberculosis treatment, DOTS-strategy; An expanded treatment conception; Existing antituberculosis drugs classifications; Treatment-directed cases categories; The phases of the treatment;
Tuberculosis prevention. Social, medical, sanitary approach.
Tuberculosis in diabetes mellitus. Tuberculosis in pneumoconiosis.
Tuberculosis and pregnancy.
Recovery criteria; Principle preventive measures; Main socially-based approaches; Tuberculosis hotbed definition and hazard appreciation; Preventive activity in the hotbed (disinfection, screening, chemoprophylaxis); Chemoprophylaxis definition and types; Indications and contraindications for chemoprophylaxis; Existing chemoprophylaxis regimens; BCG-vaccine characteristics; Vaccination procedure and post-vaccinate evolution; Contraindications for BCG-vaccination; Post-vaccine complications. Principle pathogenesis mechanisms of the HIV-associated tuberculosis; Most common tuberculosis clinical types in HIV-positive patients versus HIVnegative; HIV-associated tuberculosis management; Tuberculosis prevention among HIV-positive patients; Diabetes mellitus as a tuberculosis risk factor; Clinical, diagnostical and managerial peculiarities of the tuberculosis combined with diabetes mellitus; The type of pneumoconiosis which produces tuberculosis the most frequently; Clinical, diagnostical and managerial peculiarities of the tuberculosis combined with pneumoconiosis; Plain X-ray of the tuberculosis combined with pneumoconiosis cases description; Pregnancy as a tuberculosis risk factor. The highest risk periods of the pregnancy; Clinical, diagnostical and managerial peculiarities of the tuberculosis in pregnant women; Management of the newborn from the mother suffering from tuberculosis.
TB control system. Organizational principles of DOTS (Directly observed treatment short course).
Main organizational principles of the DOTS strategy; Elements of the DOTS strategy; Existing approach for the case detecting; Tuberculosis-control systems in the countries with different level of tuberculosis prevalence.
Approved on chair meeting «____»__________________2008р. Protocol№ ________ Head of the Phtisiology chair, Professor _______________Yu.G.Poostovyy Methodic board head , Professor _______________Yu.N.Kolchin
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