Methodical pointing for work of students on the practical lesson

Module 2

Thematic module 5

Practical employment № 28

Theme: Necrosis. Gangrene. Ulcers. Fistula. Foreign bodies. (2 hours)

Theoretical questions for the off-hour independent study and discussion on practical lesson

№ 28:

1. Reasons of origin of the necrosis, gangrene, ulcer, fistula.

2. The classification of the necrosis, gangrene, ulcer, fistula.

3. Clinical symptoms of the necrosis, ga ngrene, ulcer, fistula.

4. Diagnostic features of different types of the necrosis, gangrene, ulcer and fistula.

5. Modern looks on phases of the necrotic-ulcerous process.

6. Methods of the treatment of the necrosis, gangrene, ulcer and fistula.

7. Principles of the diagnostic and the medical tactic at foreign bodies.

8. Features of the method of the executing of the bandaging at the ulcer and the fistula.

9. Method of care of bedsores, the prophylaxis of bedsores.

10. Method of the executing of the fistulographic.

11. Method of the executing of the test with the using of dye.

Literature:

1. Butursky A. “General surgery”. (Simferopol 2004)

2. S. I. Shevchenko; A. A. Tolkoglas and etc. “Surgery” (Kharkov 2004)

3. Methodical pointing

Distribution of the marks appropriated to the students:

At learning of the theme №28 of the module №5 for educational activity to the student mark is proposed after 4th to the ball (traditional) scale which is then converted in marks as follows:

Mark	Balls
“5”(excellent)	7
“4” (good)	5
“3”(satisfactory)	3
“2” (unsatisfactory)	0

Tests for verification of an initial level of knowledge

1. It is the reason of origin of the gangrene of lower extremity:

A. A fracture of the thigh-bone

B. A dislocation of thigh

C. A thrombosis of the main artery (+)

D. A congenital dysplasia of the coxofemoral joint

E. The rheumatoid polyarthritis

2. It is the reason of origin of the gangrene of lower extremity:

A. A fracture of the thigh-bone

B. A dislocation of thigh

C. An embolism of the main artery(+)

D. A congenital dysplasia of the coxofemoral joint

E. The rheumatoid polyarthritis

3. It is the reason of origin of the gangrene of lower extremity:

A. A fracture of the thigh-bone

B. A dislocation of thigh

C. A trauma of the main artery (+)

D. A congenital dysplasia of the coxofemoral joint

E. The rheumatoid polyarthritis

4. A mummification necrosis is characterized:

А. By development of the putrescent infection, by the presence of the line of demarcation

B. By presence of the line of demarcation, by intoxication

C. By development of the putrescent infection, by intoxication and mummification

D. By development of the putrescent infection, by absence of intoxication

E. By presence of the line of demarcation, by absence of intoxication, by mummification (+)

5. It is the reason of moist gangrene of lower extremity:

А. Rapid development of disorders of regional circulation of blood (+)

B. An adiposis

C. A putrescent infection

D. Obliterated atherosclerosis

E. Gradual development of disorders of regional circulation of blood

6. The clinic of moist gangrene includes:

А. The edema of tissues, discoloration of the skin, absence of the line of demarcation

B. The intoxication, edema of tissues, discoloration of the skin, absence of line of demarcation, the putrid smell (+)

C. The exact line of demarcation, the putrid smell, the intoxication, edema of tissues

D. The putrid smell, absence of the line of demarcation, mummified tissues

E. The putrid smell, the mummified tissues, absence of the intoxication, absence of the sensitiveness in the area of pathologic process

7. It is the reasons of origin of trophic ulcers:

A. A burn

B. Violation of innervation (+)

C. Decrease of the blood volume

D. Violation of the function of the intestine

E. The fracture of bones of extremity

8. It is the reasons of origin of trophic ulcers:

A. A burn

B. Violation of arterial hemodynamics (+)

C. Decrease of the blood volume

D. Violation of the function of the intestine

E. The fracture of bones of extremity

9. It is the reasons of origin of trophic ulcers:

A. A burn

B. Violation of venous hemodynamics (+)

C. Decrease of the blood volume

D. Violation of the function of the intestine

E. The fracture of bones of extremity

10. Basic principles of treatment of trophic ulcers:

A. excision of the ulcer, necrectomy, stimulation of regeneration

B. excision of the ulcer, necrectomy, stimulation of regeneration, the pathogenetic treatment

C. excision of the ulcer, stimulation of regeneration, necrectomy, the dermatoplasty of ulcerous defect

D. Stimulation of regeneration, the pathogenetic treatment, the necrectomy, the dermatoplasty of ulcerous defect (+)

E. Provide facilities in sanatoria and health resorts

11. It is the method of the treatment of the lip-form colorectal fistula

A. Conservative

B. Sealing of the fistula

C. Diathermocoagulation of the fistula

D. The resection of the intestinal loop carrying the fistula (+)

E. Deligation on the fistulous tract

12. At what debriding is a necrectomy conducted on the basis of direct signs:

А. Primary

B. Secondary (+)

C. Early

D. Late

E. Deferred

13. It is sign for conduct a necrectomy at the primary surgical treatment of the wound:

А. Direct

Б. Late

В. Indirect (+)

Г. Return

Д. Laboratory

14. It is sign for conduct a necrectomy at the secondary surgical treatment of the wound:

А. Direct (+)

Б. Late

В. Indirect

Г. Return

Д. Laboratory

15. It is the most frequent form of purulent-necrotizing defeat of foot against a background diabetes mellitus:

А. Furuncle

B. Carbuncle

C. Phlegmon (+)

D. Abscess after injection

E. Chemical burn

16. It is the most frequent form of purulent-necrotizing defeat of foot against a background diabetes mellitus:

А. Furuncle

B. Carbuncle

C. Gangrene of fingers (+)

D. Abscess after injection

E. Chemical burn

17. It is the most frequent form of purulent-necrotizing defeat of foot against a background diabetes mellitus:

А. Furuncle

B. Carbuncle

C. Neurotic ulcer (+)

D. Abscess after injection

E. Chemical burn

18. What is the danger of the foreign bodies predestined by?

А. Development of the lymphostasis

B. Encapsulation

C. Malignant change

D. Development of the inflammation and infection (+)

E. Emergence of the bleeding

19. It is the most informing method for research of fistulas:

A. A fistulography (+)

B. The test with a colouring material

C. An endoscopy

D. A probe of the fistula

E. A plain radiograph

20. It is possible to the prophylaxis of bedsores:

A. The treatment of “dangerous” areas of the body of patient by 5% alcoholic solution of iodine

B. The treatment of “dangerous” areas of the body of patient by 10% solution of spirit of camphor (+)

C. Application to the places of possible defeat of the spirit compress

D. Providing to the patient of permanent position on the back

E. appendix to the "dangerous" area of hot-water bottle