Самостоятельная аудиторная работа

• Сбор анамнеза и жалоб.

• Общий осмотр больного, пальпация периферических лимфатических узлов, поверхностная и глубокая пальпация органов брюшной полости, пальцевое ректальное обследование.

• Методика ректороманоскопии та колоноскопии, методика езофагогастроскопии.

ЛИТЕРАТУРА:

Основная:

1. Билынский Б.Т. и соавт. Онкология.- Львов, 1998.- С. 153-158,

2. Билынский Б.Т. и соавт. Онкология.- Львов, 2007.-С. 256-320.

3. Щепотин И.Б.и соавт. Онкология.- К.: Книга плюс.- 2006. - С.161-169, 196-214,

   1. 232-273.

4. Материалы лекции.

Дополнительная:

1.Онкология. Избранные лекции для студентов и врачей/ Под редакцией В.Ф. Чехуна.- Киев: Здоров’я Украины, 2010.-768с.

2.Щепотин И.Б., Бондарь Г.В., Ганул В.Л. и др. Алгоритмы современной онкологии. Киев.- Книга плюс.-2006.С.. 66-70, 70-87, 106-11

Lesson 2

CANCER OF ESOPHAGUS AND STOMACH, DIAGNOSTICS, CLINIC, TREATMENT

1. Theme Topicality:

In the last decade the cancer of gullet and stomach takes the second place in Ukraine after lung cancer. About 80% of patients are usually revealed on the late stages and that is why the lethality cases till one year reaches 70%. At the same time, in case of appropriate preparation of medical staff, we will create necessary conditions for early and timely detection of this severe disease.

1. The goal of the lesson:

The student should give basis for timely detection and diagnosis of gullet and stomach cancer.

Concrete aims: Basic level of knowledge and skills for the

The student should know how to: student:

1. Analyze statistic data concerning the spread of 1. Knowledge of general data about the spread of malignant

gullet and stomach cancer tumors

2. Obtain the case history when there is a suspect 2. Knowledge of general principals of history obtaining

of gullet and stomach malignant tumor in case of nonmalignant diseases. Rules deontology

3. Interpret data of laboratory examinations 3. Knowledge of gastric juice indices in health and disease

of benign character

4. Interpret data of roentgen, endoscope and cytology 4. Knowledge of roentgen, endoscope and cytomorphology

examinations picture in health and disease of benign character

5. Clinical implications in cases of gullet and stomach 5. Have the skills to examine, evaluate the general state,

cancer conduct palpation of abdominal cavity organs

6. Prescribe necessary treatment 6. Knowledge of indications and contradictions to different treatment methods

ORIENTATION CHART

for the independent work of students over academic literature

during their preparation for practical classes

Content and sequence of actions	Instructions for education activity
Statistic data concerning morbidity of gullet and stomach cancer in Ukraine and other countries	Usage of cancer-register data of Ukraine
Benign and pre-cancer diseases of gullet and stomach. Clinic history, diagnostics, treatment	Structure peculiarities of gullet and stomach walls. Give description of gullet and stomach epithelium
Clinical classification of gullet and stomach cancer. Classification according to TNM system	Histogenetic classification of malignant tumors. Disclose the classification essence (kernel)
Clinic history of gullet and stomach cancer. Early stages of gullet and stomach cancer.	Give description of characteristic cases of gullet and stomach cancer appearance on the basis of case history and physical examination of a patient
Diagnostics of gullet and stomach cancer. Peculiarities of gullet and stomach cancer appeared on the basis of chronic diseases	Data of laboratory, roentgen, endoscope, cytomorphology examinations during gullet and stomach cancer
Treatment methods of gullet and stomach cancer	Indications and contraindications for the usage of surgery, radiation and chemical therapy methods. Evaluation of their effectiveness
Dissemination of gullet and stomach cancer	Dissemination ways of gullet and stomach cancer. Virchow's, Schnitzler's and Krukenberg's metastases.

Questions to control the obtained knowledge

1. Risk factors of gullet and stomach cancer. Carcinogenesis mechanisms

2. Pre-cancer diseases. Localization, diagnostics, treatment.

3. Early stages of gullet and stomach cancer. Classification and clinic history.

4. Peculiarities of gullet and stomach cancer appeared on the basis of chronic diseases.

5. Modern diagnostic methods of gullet and stomach malignant diseases.

6. Radical and palliative treatment methods of gullet and stomach cancer. Rehabilitation and prognosis.

Situation problems

1. A 55 year man appeals to the policlinic having complaints on difficulties of food passing after it has been swollen, eructation, general weakness, weight loss to 5 kg. In the case history there has been pointed out that the patient is a chain smoker. Please, set the diagnosis.

2. A 45 year old man has complaints on pains in the stomach pit, appetite loss, general weakness and foul-smelling (rotten egg) eructation. During physical examinations there has been palpated a movable painful tumor. Metastases haven’t been found. Indicate what other examination methods should be applied. Set, please, preliminary diagnosis.

Task for study-research activity of a student

The student should write an essay “Reasons of neglected gullet and stomach cancer according to the data of oncology dispensary (for the 3 months of the current year)”

Literature

1. Lecture materials.

2. Cancer medicine. BC Decker Inc.- Hamilton.- London.- 2003

МЕТОДИЧНА ВКАЗІВКА