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

Clinical blood analysis: normocytic, microcytic or macrocytic anemia (pernicious-like). Macrocytic anemia is associated with vitamin B12 malabsorption. Leukocyte, lymphocyte and platelet count are normal, accelerated ESR.

Biochemical blood analysis: elevated serum creatine kinase (MM fraction) concentration due to the release from skeletal muscle as a result of increased sarcolemmal permeability.

The serum concentration of total and low density lipoprotein cholesterol and sometimes triglycerides are elevated; hypoalbuinmemia with hyperglobulinemia.

Elevated serum lactate dehydrogenase, aminotransferase concentrations iron deficiency in premenopausal women.

Radioimmunologocal method: diminishing of thyroxin level (T4) and triiodothyronin (T3). Thyroidal radioiodine uptake is reduced in most patients with hypothyroidism.

ECG: bradycardia, low amplitude P wave and QRS complex, conduction disturbances, depressed ST-segment and inverted T-wave.

Echo-CG: septal and wall thickening, decreased myocardial contractility and relaxation, pericardial effusion.

Ultrasound examination of thyroid gland allows reveal the changes at echogenic density.

Radioisotope scanning by thechnetium-99 gives the information about functional activity of gland, size, form, presence of "cold" and "hot" zones.

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.

Contens

The Contents of Module 6. Basic Symptoms and Syndromes in Diseases of Cardiovascular System.

Topic 1. The Main Syndromes of Heart Failure 4

Topic 2. Rheumatism 16

Topic 3. Mitral Valvular Diseases of the Heart: the Main Syndromes and Symptoms on the Basis of Clinical and Instrumental Methods of Investigation. 19

Topic 4. Aortal Valvular Diseases of the Heart: the Main Syndromes and Symptoms on the Basis of Clinical and Instrumental Methods of Investigation. 24

Topic 5. The Main Syndromes and Symptoms of Arterial Hypertension. Hypertenic Crisis. 27

Topic 6. Ischemic Heart Disease. The Main Syndromes and Symptoms of Angina Pectoris and Myocardial Infarction .33

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

Topic 7. The Basic Clinical Symptoms of Chronic Bronchitis and Bronchial Asthma. Chronic Obstructive Pulmonary Diseas. 45

Topic 8. Pneumonias: Symptoms and Syndromes on the Basis of Clinical - Instrumental and Laboratory Methods of Examination. Pneumosclerosis. Tumors of the Lungs.56

Topic 9. The Basic Symptoms and Syndromes in Dry Pleurisy and Pleural Effusion. Syndrome of Respiratory Failure in the Pathology of Broncho-Pulmonary System.

Curation of the patients 63

The Contents of Module 8. Basic Symptoms and Syndroms in Diseases of the Digestive System and Urinary System.

Topic10. Clinical, Instrumental and Laboratory Examination of the Patients with Chronic Gastritis, Gastric and Duodenal Ulcer and Diseases of the Intestine.73

Topic 11. Basic Symptoms and Syndroms in Biliary Diseases: Chronic Cholecystitis, Cholangitis, Cholelithiasis 78

Topic 12. Basic Clinical and Laboratory Features in Chronic Hepatitis and Hepatic Cirrhosis. 84

Topic 13. The main symptoms and syndromes in renal disease-acute and chronic glomerulonephritis and pyelonephritis . 90

The Contents of Module 9. Endocrine Diseases, Blood System Pathology and the Interpretation of Laboratory Methods of Examination Results.

Topic 14. The main symptoms and syndromes in anemia. General clinical blood tests. 99

Topic 15. Hemorrhagic syndromes and the pathology of blood coagulation system. The syndrome of disseminated intravascular blood micro coagulation 110

Topic 16. The main syndromes in leucosis.

Chronic lympholeucosis and myeloleucosis. 114

Topic 17. The main symptoms and syndromes in diabetes mellitus. The main clinical manifestations of thyroid gland diseases. 119

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