Methodical pointing for work to the students on practical employment

Module №2

Thematic module №1

Practical employment № 21

Theme: Sharp festering-inflammatory diseases of soft fabrics: abscess, phlegmons, furuncle, carbuncle.

Theoretical questions for the extra auditory independent study and discussion to practical employment № 21.

1. General etiologic and pathogenetical machineries for development of local surgical infectious diseases.

2. Determination for notions of separate sharp festering-inflammatory diseases of soft fabrics.

3. General and local symptoms of sharp surgical infectious diseases of soft fabrics.

4. Diagnostics clinical displays of festering infection - abscesses, phlegmons, furuncles, carbuncles.

5. Diagnostics of phases of flow of local sharp festering-inflammatory diseases of soft fabrics.

6. Basic principles of complex medical treatment for local festering diseases and implementation for separate stages.

7. Testimonies to operative medical treatment of sharp festering-inflammatory diseases of soft fabrics and its basic principles

ІІІ. Providing of initial level of knowledge-abilities

The basic literature:

1. Butyrsky A. General surgery. – Simferopol. 2004.

2. Schevchenko S.I. and others. Surgery. – Kharcov. 2004

The additional literature:

1. Kushnir R. Lectures of General surgery. – 2005.

2. Lyapis M.A. Methods of examination of a surgical patients. – 2004.

3. Methodological recommendations on surgical patients care. – Vinnitsa medical national university. 2006.

Distributing of marks, that students can get:

at mastering of theme № 21 from the thematic module № 1 educational activity to the student the estimation for 4th is proposed by a ball (traditional) scale which are after converted in marks as follows:

Оцінка	Бали
5 (відмінно)	6 балів
4 (добре)	4 балів
3 (задовільно)	2 балів
2 (незадовільно)	0 балів

Module №2

Thematic modul №1

Practical employment № 21

Theme: Sharp festering-inflammatory diseases of soft fabrics: abscess, phlegmon, furuncle, carbuncle.

І. Actuality of theme.

Patients with a surgical infection make substantial part of sick surgical stationary and policlinic separations. Patients with the festering-inflammatory diseases of soft fabrics make a to 40% common number of patients surgical permanent establishments from 28. Lethality at a festering infection and its complications practically does not diminish and make from 40 to 60%. A surgical infection in modern terms took on special significance. High material expenditures on medical treatment of these patients, defined the rise of level of lethality high interest to this problem. The general pathanatomy lie in the basis of origin and development of sharp festering diseases of soft fabrics, pathphysiological, microbiological and immunological machineries, that predetermines general approaches to their medical treatment. For this reason the adopted theme is studied within the framework of discipline “general surgery”. The simultaneous mastering of theoretical disciplines of general pathology and pharmacology is regulated by on-line tutorials, allows us deep to understand the clinical aspects of diagnostics and medical treatment, necessary for the subsequent teaching of student and practical medical activity.

ІІ. Purpose of employment:

1. To know the general etiologic and pathogenetical machineries of development of local surgical infectious diseases.

2. To know determination of notions of separate sharp festering-inflammatory diseases of soft fabrics.

3. To know general and local symptomatic of sharp surgical infectious diseases of soft fabrics.

4. To be able to diagnose the clinical displays of festering infection - abscesses, phlegmons, furuncles, carbuncles.

5. To be able to diagnose the phases of flow of local sharp festering-inflammatory diseases of soft fabrics.

6. To know basic principles of complex medical treatment of local festering diseases and execute separate its stages.

7. To know testimonies to operative medical treatment of sharp festering-inflammatory diseases of soft fabrics and its basic principles.

ІІІ. Providing of initial level of knowledge-abilities

The basic literature:

3. Butyrsky A. General surgery. – Simferopol. 2004.

4. Schevchenko S.I. and others. Surgery. – Kharcov. 2004

The additional literature:

4. Kushnir R. Lectures of General surgery. – 2005.

5. Lyapis M.A. Methods of examination of a surgical patients. – 2004.

6. Methodological recommendations on surgical patients care. – Vinnitsa medical national university. 2006.

Tests and tasks for verification of output level of knowledge

1. What name a phlegmon?

а) festering-inflammatory diseases of sweat-glands;

b) festering-inflammatory diseases of oil-glands;

c) the limited inflammation of cellulose;

d) the inflammation of cellulose poured out (+);

e) festering inflammation of joints.

2. How to treat a phlegmon at presence of symptom of softening influence?

а) hot compress;

b) cut and drainage (+);

c) ointment bandage;

d) cold compress;

e) pricking all round by Novocain with antibiotics.

3. What complication occurs characteristically for the carbuncle of overhead lip?

а) sepsis;

b) necrosis of skin;

c) meningitis;

d) osteomielitis;

e) thrombosis of cavernous sinus (+).

4. A phlegmon is named mediastinitis at localization in:

а) muscles;

b) pleural cavity;

c) stuffing-box;

d) to the front abdominal wall;

e) mediastinum (+).

5. At suspicion it is necessary on an abscess:

а) to impose a ointment compress;

b) to do a cut;

c) to impose a hot compress;

d) to conduct puncture (+);

e) to apply the ultraviolet irradiation

6. What is applied at a carbuncle ?

а) excision of carbuncle (+);

b) ultraviolet irradiation;

c) squeezing of bars out;

d) puncture of abscess;

e) cut and drainage.

7. Which from the diseases is complicated by a festering infection?

а) malignant diseases;

b) hepatic insufficiency;

c) kidney insufficiency;

d) mellitus diabetes (+);

e) lung fever.

8. What medical measures are applied at furuncles?

а) raising of leeches;

b) massage;

c) wiping of skin out by ether;

d) wiping out by a 70% alcohol (+);

e) squeezing of abscesses out.

9. At the carbuncle of neck in the stage of infiltration apply:

а) h-similar cut;

b) z- similar cut;

c) conservative medical treatment (+);

d) ice-bag;

e) puncture.

10. The symptom of fluctuation is not determined at:

а) abscess;

b) to the phlegmon;

c) mastitis;

d) hemothorax (+);

e) paraproctitis.

11. A drug addict after introduction of drug to the femoral vein marks the rise of temperature of body to 40^o С, appearance of sickly infiltration, increase of volume of thigh, hyperemia of skin. What previous diagnosis?

а) carbuncle;

b) phlegmon(+);

c) erysipelas;

d) osteomyelitis;

e) paraproctitis.

12. At a patient on the back infiltrate in the diameter of 7 sm, blue color in the center of which necrosis, at pressing on through a few opening a pus is selected. Your diagnosis?

а) abscess;

b) phlegmon;

c) erysipelas;

d) carbuncle (+);

e) furuncle.

13. What operative medical treatment of phlegmon consists in?

а) dissection of abscess;

b) dissection and tamponade with antiseptics;

c) dissection and drainage

d) dissection, finger revision and drainage (+);

e) dissection, deleting of pus, imposition of stitches.

14. What operative medical treatment of carbuncle consists in?

а) dissection of abscess;

b) dissection and tamponade with antiseptics;

c) dissection and drainage;

d) carving of necrosis fabrics, deleting of pus (+);

e) dissection, deleting of pus, imposition of stitches.

15. A patient with P., 25 years, is hospitalized in the surgical separation with complaints on pain in a right buttock, temperature to 39^o С. It is known from anamnesis, that 9 days to that with the purpose of anaesthetizing in the area of right buttock was executed intramuscular injection of analgin. St. Pr. Ob.: in the overhead-outward quadrant of right buttock sickly infiltrate 5 is determined 4 sm., skin above him hyperemia, hot by a touch. Put a correct diagnosis.

а) post injection abscess of right buttock (+).

b) erysipelas of right buttock.

c) carbuncle of right buttock.

d) abscessed furuncle of right buttock.

e) hematoma of right buttock.