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Brief guidelines for the work of students in the practice

Originally performed input control knowledge through tests and oral answers, solving situational problems. Students begin to himself constantly at work with patients under the supervision of the teacher. Collects ana m nezu, physical examination of patients with stomach cancer, study data added t Covo examination of patients. A leading detection syndromes, d and ferentsiyuvannya disease and other previous study dia g nozu. Outline a treatment plan. During the test, each student at Lane dit physical examination of the patient (inspection, palpation of lymph nodes, abdomen, percussion, auscultation). During classes, students interpret Chapter boratorni data ultrasonographycal endoscopic, radiological, and c tolohichnyh and histopathological studies. In intensive care and resuscitation students learn principles of intensive therapy and supervision wa Kimi min at the same rhyme. Work in a dressing room, operating room. Next conducted final test. Summarizes lessons, oholoshuyut b Xia results counter at human knowledge and skills.




Process Map practical lessons


Stages classes

Training time


Prospect Place at driving lessons

Mr. Means and learning



Determination of n con t o Primary role of knowledge

30 min

Tests survey uvannya

Slides and would face, renth e nohramy



Addressing Mr. and vchalnyh with a t e inthis we


Case patients at historical Rhee minutes at the paper, the development and l lit diagnostician and ki and medication in the bathroom

Stories about patients like leaves appointments, CT-grams, MRI program, radiographs

Chamber scarf in vibrational, and operations on, classrooms, and endoscope ical room and no


Definition in s tern level sform at vanosti knowledge and skills. Summing pi d bag.

30 min

Tests survey uvannya

Slides and would face, renth e nohramy, ci f we



Due to the fact that the department conducted watershed and final evaluation, as an example, give a few tests


Final test and control

Test number 1

Patient A., 45 years. Complaints of excessive fatigue, constant pain epih and striae, iradyyuyuchi in the back. OBJECTIVE: low power, the left nadkl th chychniy zone schilnoelastychnyy l / v to 1.5 cm in diameter. The abdomen was soft, with pain in the epigastrium tion, which is determined hilly formation to 8 cm in diameter. What additional research most informative in this case?

A. Fibrogastroduodenoscopy with biopsy.

B. Radiography of the stomach.

C. Retropnevmoperytoneum.

D. Enema.

E. CT abdomen.


Test number 2.

Patient A., 56 years. Complaints dull epigastric pain, belching bal t ryam, and constipation. He considers himself a patient for 2 years. 1 year ago fibrogastroduodenoscopy - xp at night atrophic gastritis. Conservative treatment - without effect. Objects in but: peripheral l / in not enlarged, the abdomen is soft, painful epigastric. Stoves n ka increased by 3 cm, hilly land. What disease most likely in this case?

A. Cholecystopancreatitis.

B. Chronic gastritis.

C. Cancer of the stomach.

D. Hepatitis.

E. Disease Menetries.


Test number 3.

Patient 80 years. Complaints of pain in the epigastric area related Admission at IOM food aversion to meat, cutting overall weakness. On examination: low power, peripheral l / v is increased. Abdomen soft, painful in epihas t ry. Liver near edge of the arc. Kal black with D k Talne review. What are the most informative methods of examination in this case?

A. Fibrogastroduodenoscopy with biopsy.

B. Radiography of the stomach.

C. Enema.

D. Fibrokolonoskopiyu with biopsy.

E. Ultrasonography of the abdomen.


Test number 4

Patients matched C.. 59 years. Complains of trudnennya for passage of solid food through the esophagus, the loss in weight of 6 kg for 3 months. When fibrogastroduodenoscopy in cardia gastric lumen narrowing determined by exophytic co m components. OBJECTIVE: peripheral l / v is increased. Abdomen soft, painful epigastric. Liver not enlarged. With digital examination of the rectum pathological changes were detected. What is the most informative study district is necessary for clarifying the prevalence of process?

A. Radiography of the abdomen.

B. Radiography of the chest.

C. CT of the chest and abdomen.

D. Ultrasonography of the abdomen.

E. Scintigraphy bones.


Test number 5

Patient A., 66 years. She complains of intermittent sharp epigastric pain, which provoked meal. He considers himself a patient for 1, 5 years, at p deterioration in the last 2 weeks. OBJECTIVE: overall relatively satisfactory. In the area of the navel schilnoelastychne formation to 2 cm in diameter. Abdomen zoom f ing by free fluid. Liver + 6 cm, the edge of hilly, dense. When renthendoslidzhenni stomach - stomach cancer, total defeat. What is the treatment strategy?

A. Surgical.

B. Chemotherapy.

C. Radiotherapy.

D. Symptomatic therapy.

E. Observations.


Test number 6

Patient complaints '65 epigastric pain, weakness, fast us and tion. During palpation in the area of holes under the breast is determined by a dense, MBP is Woman in the chome district formation to 5 cm in diameter. What is your diagnosis?

A. stomach cancer

B. pancreatitis

C. Pancreatic Cancer

D. ulcer

E. gastritis


Test number 7

The patient complains of '75 vomiting daily dish eaten for 3 weeks, lost 20 kg of weight, sharp weakness. What preliminary g diameter noz?

A. initial cancer of the stomach with stenosis

B. duodenal ulcer

C. ulcer

D. acute gastritis

E. acute pancreatitis


Test number 8

Patient '50 at fibrogastroscopy zone angle on the lesser curvature of the stomach revealed a flat mucosa covering ulcers with raised edges and we are up to 5 cm in diameter. What additional research is needed to establish a definitive diagnosis?

A. biopsy

B. radiography of the stomach

C. Abdominal ultrasound

D. CT abdomen



Test number 9

In patients with gastric cancer after laparotomy, during the audit of the June e Economy by oral tumor detected moving body of the stomach, with regional limfovu Do not zbilsheni.Yakyy necessary volume of surgical treatment?

A. gastrectomy

B. distal gastric resection

C. proximal gastric resection

D. gastrostomy

E. hastroenterostomiya


Test number 10

In a patient with gastric cancer performed gastrectomy, obtained histological conclusion: adenocarcinoma that invades all layers of the stomach wall with meth and stasis in 5 lymph nodes along the left gastric artery. Which plan filed b pects of the patient?

A. adjuvant chemotherapy

B. radiotherapy

C. hormone

D. immunotherapy

E. without treatment of 12

Standards of answers: 1 - A, 2 - C, 3 - A, 4 - A, 5 - D, 6 - A, 7 - A, 8 - A,

9 - A, 10 - A

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