Вінницький національний медичний університет ім.М.І.

Пирогова

Кафедра внутрішньої медицини № 1

Завідувач кафедри: проф. М.А.Станіславчук

Викладач: ____________________________

ІСТОРІЯ ХВОРОБИ

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Основний діагноз:

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Ускладнення:

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Супутні захворювання:

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Куратор : Студент(ка) ___ курсу ___ групи

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( ПІБ студента)

Вінниця – 2023
ПАСПОРТНА ЧАСТИНА

П.І.Б. пацієнта ___________________________________________________________________________

Вік _____ Стать ________

Професія _______________________________________________________________________________

СКАРГИ:
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Деталізація основних скарг:

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Скарги по іншим органам та системам:

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АНАМНЕЗ ЗАХВОРЮВАННЯ
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АНАМНЕЗ ЖИТТЯ
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Сімейний:
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Професійний:
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Алергологічний: _________________________________________________________________________

Шкідливі звички: ________________________________________________________________________

ОБ’ЄКТИВНЕ ОБСТЕЖЕННЯ

ЗАГАЛЬНИЙ ОГЛЯД:

Загальний стан __________________________________________, температура тіла ______________°С

Положення пацієнта _____________________________, рівень свідомості ________________________

Зріст ______м, вага ____ кг, ІМТ ______ кг/м 2 . Конституційний тип _____________________________

Шкіра:
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Видимі слизові оболонки:

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Наявність набряків:
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Лімфатичні вузли:
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СЕРЦЕВО - СУДИННА СИСТЕМА

ОГЛЯД :

Видима пульсація на шиї __________________________________________________________________

Видимий верхівковий поштовх _____________________________________________________________

ПАЛЬПАЦІЯ :

Властивості пульсу :
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Артеріальний тиск на лівій руці ________________ мм рт.ст., на правій руці ________________мм рт.ст.

Верхівковий поштовх:
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ПЕРКУСІЯ :

Межі відносної серцевої тупості:

Права __________________________________________________________________________________
Верхня _________________________________________________________________________________

Ліва ___________________________________________________________________________________

Межі абсолютної серцевої тупості:

Права __________________________________________________________________________________

Верхня _________________________________________________________________________________

Ліва ___________________________________________________________________________________

АУСКУЛЬТАЦІЯ СЕРЦЯ:

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ТРАВНА СИСТЕМА

ОГЛЯД :

Ротової порожнини
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Живіт
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ПАЛЬПАЦІЯ :

Поверхнева пальпація:
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Глибока пальпація:

Сигмовидна кишка
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Сліпа кишка
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Висхідна ободова кишка __________________________________________________________________

Нисхідна ободова кишка __________________________________________________________________

Поперечна ободова кишка ________________________________________________________________

Печінка
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Селезінка _______________________________________________________________________________

Підшлункова ____________________________________________________________________________

ПЕРКУСІЯ :

Розміри печінки :

По лініям Розмір, см
Перший
Другий
Третій
Розміри селезінки:

По лініям Розмір, см
Довжник
Поперечни
к

АУСКУЛЬТАЦІЯ:

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ДИХАЛЬНА СИСТЕМА

ОГЛЯД:

Форма грудної клітки_____________________________________________________________________

Структура дихання
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ПАЛЬПАЦІЯ:

Болючість плевральних точок ______________________________________________________________

Еластичність грудної стінки ________________________________________________________________

Рухливість грудної клітки __________________________________________________________________

Голосове тремтіння ______________________________________________________________________

ПОРІВНЯЛЬНА ПЕРКУСІЯ ЛЕГЕНЬ:

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ТОПОГРАФІЧНА ПЕРКУСІЯ ЛЕГЕНЬ:

Висота стояння верхівок легень ____________________________________________________________

Ширина полів Креніга ____________________________________________________________________

Екскурсія нижнього краю легень

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Нижня межа легень Ліва легеня Права легеня

Пригруднинна лінія
Середньоключична лінія
Передня пахвинна лінія
Середня пахвинна лінія
Задня пахвинна лінія
Лопаткова лінія
Паравертебральна лінія

АУСКУЛЬТАЦІЯ:

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СЕЧО - СТАТЕВА СИСТЕМА

ОГЛЯД :

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ПАЛЬПАЦІЯ :

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ПЕРКУСІЯ :

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ОПОРНО - РУХОВА СИСТЕМА

ОГЛЯД :

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ПАЛЬПАЦІЯ :

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ЕНДОКРИННА СИСТЕМА

ОГЛЯД :

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ПАЛЬПАЦІЯ :

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ПОПЕРЕДНІЙ ДІАГНОЗ

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ПЛАН ОБСТЕЖЕННЯ

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КОНСУЛЬТАЦІЯ СУМІЖНИХ СПЕЦІАЛІСТІВ

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ОЦІНКА ДОДАТКОВИХ МЕТОДІВ ДОСЛІДЖЕННЯ

ЛАБОРАТОРНІ ДОСЛІДЖЕННЯ

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ІНСТРУМЕНТАЛЬНІ ДОСЛІДЖЕННЯ

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ОГЛЯД СУМІЖНИХ СПЕЦІАЛІСТІВ

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ДИФЕРЕНЦІЙНА ДІАГНОСТИКА

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ЗАКЛЮЧНИЙ КЛІНІЧНИЙ ДІАГНОЗ

Основний діагноз:
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Ускладнення:
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Супутні захворювання:

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ЩОДЕННИКИ
ЛІКУВАННЯ

НЕ МЕДИКАМЕНТОЗНЕ

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МЕДИКАМЕНТОЗНЕ

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ЕПІКРИЗ

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ПРОГНОЗ

Для життя ______________________________________________________________________________

Для одужання ___________________________________________________________________________

Для працездатності ______________________________________________________________________

РЕКОМЕНДАЦІЇ

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ВИКОРИСТАНА ЛІТЕРАТУРА

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Дата __________ Підпис куратора ___________