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Module 2: Symptoms and syndromes in diseases of internal organs.doc
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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.

The Contents of Module 7. Basic Symptoms and Syndromes of the Diseases of Respiratory System.

Concrete aims:

  • to combine the results of questioning, physical and instrumental examination of a patient with specific pathology of respiratory organ and differentiate the basic symptoms and syndroms of their damage

  • to identify the basic syndroms of the diseases of respiratory system and explain the mechanisms of their development

  • to choose the adequate methods of examination in specific pathology of broncho-pulmonary system

  • to interpret the basic results of laboratory and instrumental examination of respiratory organs in specific pathology

  • to demonstrate the possessing of modern classifications of the diseases of respiratory system

Topic7. The Basic Clinical Symptoms of Chronic Bronchitis and Bronchial Asthma. Chronic Obstructive Pulmonary Diseas.

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:Modern classification of chronic obstructive pulmonary disease. Definition and the basic mechanisms of the development of chronic bronchitis and bronchial asthma. Chronic bronchitis and bronchial asthma, the basic complaints and physical examination of the patients. A syndrome of bronchial obstruction, mucocellular insufficiency and the increased lightness of the lungs. The basic methods of instrumental diagnostics. Laboratory findings of bronchial asthma according to the general blood tests and sputum examination. Bronchiectasis, definition and the basic clinical syndroms.

Chronic obstructive pulmonary disease (copd)

A disease characterized by chronic bronchitis or emphysema and airflow obstruction that is generally progressive, may be accompanied by airway hyperreactivity, and may be partially reversible.

Patients who have features of chronic bronchitis or emphysema without airflow obstruction have one or both of those diseases but not COPD. Most patients with COPD, who by definition have airflow obstruction, have features of both chronic bronchitis and emphysema. Patients whose asthma is characterized by incomplete reversibility of airway obstruction are considered to have a form of COPD (called asthmatic bronchitis or asthmatic COPD in the USA), because they often cannot be differentiated from those who have chronic bronchitis and emphysema with reversible airway obstruction and airway hyperreactivity. Those with completely reversible airflow obstruction without features of chronic bronchitis or emphysema have asthma but not COPD.

Etiology. Smoking is the dominant risk factor for the development and progression of COPD; however, not all smokers develop COPD, and COPD does occur in persons who have never smoked,1 suggesting that other factors are important in the etiology of COPD. α1-antitrypsin deficiency is an important cause of COPD in a very small percentage of cases. Other undefined genetic factors certainly play an important role in COPD development. The role of infections in both the development and progression of COPD is receiving increased attention, including the role of adenoviral infections in emphysema and the role of intracellular infections (eg, mycoplasma) in asthma. Occupational and environmental exposures to various pollutants (eg, particulate matter, agricultural dusts) are also important factors in the development of COPD.

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