The module 2: surgical infection. Bases of clinical oncology. Curation of surgical patients. The thematic module 1

Surgical infection. Necrosis

Practical employment №22

Theme: Suppurative infectious diseases of soft tissues:

hydradenitis, mastitis, erysipelas, lymphadenitis, lymphangiitis, anorectal abscess

Theoretical questions for the independent study and discussion on practical employment №22:

1. To know the general etiologic and pathogeny mechanisms of development of local surgical infectious diseases (α=ІІ).

2. To know determination of concepts of separate local surgical infectious diseases (α=ІІ).

3. To know general and local symptoms of acute surgical infectious diseases of soft tissues (α=ІІ).

4. Able to diagnose the clinical displays of purulent infection (α=ІІІ).

5. Able to formulate principles of complex treatment of local purulent diseases and execute his separate stages (α=ІІІ).

Literature:

Basic:

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

2. Gostishchev V.K. General surgery / The manual.– M.: GEOTAR-MED, 2003.– P. 150-151, 155-159.

3. Shevchenko S.I. and others. Surgery. – Kharkov. 2004. – P. 211-214, 231-235, 238-241, 261-266.

Additional:

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

2. Methodological recommendations on surgical patients care. – Vinnitsa National Pirogov Memorial medical university. 2006.

Distributing of marks which can be got by a student:

At mastering of theme № 22 a thematic module № 1 for educational activity to the student the estimation for 4th is proposed to the traditional scale which is then converted in marks as follows:

Estimation	Balls
“5” (perfectly)	6
“4” (well)	4
“3” (satisfactorily)	2
“2” (unsatisfactorily)	0

Interdisciplinary integration

Discipline	To know	Able
Disciplines which provide
Anatomy (normal, topographical)	Anatomy of different parts of organism (taking into account the possible ways of distribution of festering-septic processes)	To define the anatomic location of local purulent process
Histology	Histological structure of fabrics of organism
Pathologic anatomy	Pathologic anatomy signs of inflammation	To recognize macro- and microscopic signs of inflammation
Pathologic physiology	Local and general signs of inflammation	To recognize the signs of local and system inflammatory answer
Pharmacology	Basic groups of antibacterial preparations, them pharmacokinetics and pharmacodynamics	To write the recipes of antibacterial and antiphlogistic preparations
Next disciplines
Faculty surgery	Clinical signs of mastitis, lymphadenitis, lymphangiitis, anorectal abscess	Able to diagnose and define medical tactic at mastitis, lymphadenitis, lymphangiitis, anorectal abscess
Hospital surgery	Clinical signs of lymphadenitis, lymphangiitis, anorectal abscess	Able to diagnose and define medical tactic at lymphadenitis, lymphangiitis, anorectal abscess
Inside disciplinary integration
Asepsis and antisepsis	Rules of asepsis and antisepsis	To impose an aseptic bandage, appoint preparations of chemical and biological antisepsis
Desmurgy	Rules of imposition of bandages	To impose bandages
Immobilization	Rules of conducting of immobilization	To conduct immobilization
Wounds	Classification, clinical flow of wound process	To render the first aid patients with wounds
Preoperative period	Rules of preparation of patient to the operation	To prepare a patient to the operation
Anaesthesiology	Types of anaesthesia	Choose adequate method of anaesthesia
Postoperative period	Features of care of patients after an operation	To see to the patients in a postoperative period

Tests for verification of initial level of knowledges

1. Whatever clinical signs are characteristic for hydradenitis?

а) formation of dense sickly knot;

б) presence of follicle pustule (+);

в) leaving to rot the selection of creamous;

г) presence of necrotic center (+);

д) origin of dense infiltrate.

2. What area or part of body is not hydradenitis in?

а) in an armpit cavity;

б) on hairy part of head;

в) in perianal and genital areas;

г) on palm's surface of brush (+);

д) in area of nipples of suckling gland.

3. At the serous stage of acute mastitis not shown:

а) warning of stagnation of milk by straining;

б) setting of antibiotics;

в) retromammarial novocaine blockade

г) dissection of inflammatory hearth (+);

д) quadrantectomy (+).

4. What is executed cut at dissection of retromammarial mastitis:

а) radial;

б) paraareolar;

в) above the overhead edge of gland;

г) on the transitional fold of suckling gland (+);

д) semioval (+).

5. The what pregnant are included in the group of high risk of development mastitis?

а) with the anomaly of development of sucklings glands (+);

б) sportswomen;

в) women at which the repeated births;

г) with the festering infection of different localization in anamnesis (+);

д) immunized by staphylococcus аnаtоxin.

6. Inflammation at an erysipelas spreads on:

а) epidermis;

б) papillary layer;

в) all of layers of skin (+);

г) lymphatic vessels (+);

д) hypodermic cellulose.

7. Most often at an erysipelas struck:

а) head, face (+);

б) mucous membranes;

в) forearm;

г) fingers of brush;

д) lower extremities (+).

8. At treatment erysipelas are contra-indicated:

а) antibiotics;

б) moist bandages (+);

в) ultraviolet radiation;

г) baths;

д) treatment of hearth of defeat 1 % by solution of diamond green.

9. What does lymphangiitis differ from an erysipelas?

а) by the presence of bubbles;

б) by absence of sharp scopes of hyperemia (+);

в) by the expressed edema of skin;

г) by a skin itch;

д) by the presence of shallow abscesses.

10. Characteristic clinical display of lymphangiitis:

а) presence of red bars on motion of lymphatic vessels (+);

б) hyperemia of skin with sharp scopes;

в) edema of skin;

г) pour;

д) increase of lymphatic nodules.

11. Distinguish the followings types of lymphatic nodules inflammation:

а) serous (+);

б) putrid;

в) necrotic;

г) productive (+);

д) specific.

12. If the capsule of lymphatic nodule and surrounding tissues is engaged in a purulent process, develops:

а) abscess;

б) adenophlegmon (+);

в) adenoids;

г) carbuncle;

д) phlegmon.

13. At anorectal abscess inflame originally:

а) anal glands (+);

б) outward sphincter of anus;

в) internal sphincter of anus;

г) perianal skin;

д) anal crypts of Morgan'i (+).

14. In relation to the fibres of outward sphincter of anus purulent motion at anorectal abscess can be disposed:

а) ectad (+);

б) through sphincter (+);

в) ahead;

г) behind;

д) from one side.

15. What does radicalism of operation consist in at anorectal abscess?

а) dissection and drainage of abscess (+);

б) taking in of postoperative wound a catgut;

в) introduction to the road clearance of rectum of gas outlet pipe;

г) liquidation of purulent motion and entrance gate of infection – internal foramen in anal crypt (+);

д) imposition of sigmostoma.