PLAN
of practical training with students of the 6th course of medical (foreign) faculty
on 2019 - 2020  year (autumn semester)
Discipline: Phthisiology

Module No. 4. 

Clinical forms of tuberculosis. During the module students supervise patients with various forms of tuberculosis, with writing of the educational clinical сase history.

Lesson No. 1. Principles of creation of classification of tuberculosis (pathogenetic, pathoanatomical, clinical-radiological and microbiological). Modern classification, basic principles of creation of modern classification. The sections  of classification reflecting the main clinical forms, the characteristic of tuberculosis process and its complications, residual changes after the cured tuberculosis. Structure of the diagnosis of tuberculosis and its change in result of treatment. 
Primary tubercular infection. Epidemiological and pathogenetic features. Signs of primary infection by results of immunodiagnosis of tuberculosis. Primary tuberculosis. Tuberculosis intoxication. Tuberculosis of intra chest lymph nodes. Primary tubercular complex. Clinic, diagnostics, differential diagnostics, treatment.

Lesson No. 2. Disseminate tuberculosis of lungs. Classification, pathogenesis and pathological anatomy of disseminate tuberculosis of lungs, clinic, diagnostics, differential diagnostics and treatment.

Lesson No. 3. Focal tuberculosis of lungs. Pathogenesis and pathological anatomy of focal tuberculosis of lungs. Value of an exogenous superinfection and endogenous reactivation in development of focal tuberculosis of lungs. Identification methods, clinic and current of focal forms of tuberculosis. Value of fluorography and radiological methods for identification and diagnosis of focal tuberculosis. Reasons of progressing of focal tuberculosis and formation of widespread processes. Features of treatment and outcomes of focal tuberculosis of lungs. Differential diagnosis. Methods of determination of activity of the tuberculosis foci.

Lesson No 4. Infiltrative tuberculosis of lungs. Pathogenesis and pathological anatomy of infiltrative tuberculosis. Clinical manifestations. Radiological variants: lobulyar, roundish, cloudy, peritsissuritis, lobitis. Features of treatment. Types of residual changes. Outcomes and prognosis of infiltrative tuberculosis. Differential diagnosis of infiltrative tuberculosis  and acute pneumonias. Caseous pneumonia. Pathogenesis and pathological anatomy lobar and lobulyar caseous pneumonia. Features of a clinical picture, radiological characteristic. Outcomes and forecast of caseous pneumonia. Differential diagnosis of caseous and non specific bacterial pneumonia.

Lesson No. 5. Tuberculoma. Pathogenesis and pathological anatomy of tuberculoma of lung. Features of a clinical picture tubercuoma of lungs, clinical forms. Value of radiological methods in identification and diagnostics tuberculoma. Main radiological signs. A current, features of treatment and outcomes tuberculoma depending on size and a phase of a current, value of a surgical method of treatment. Differential diagnostics with roundish educations in lungs. Cavernous tuberculosis of lungs. Pathogenesis of a cavity of a lung. A morphological structure of cavities and their version (fresh, created, chronic, sanified). Dynamics of cavernous tuberculosis and nature of his transformation. Clinical manifestations. The main radiological and laboratory signs of a cavity in a lung. Clinical characteristic of cavernous tuberculosis of lungs. Features of treatment. Main types of healing of cavities. Differential diagnostics with band educations in lungs. 

Lesson No. 6. Fibrous-cavernous and cirrhosis tuberculosis of lungs. Epidemiological value of chronic forms of destructive tuberculosis. Pathogenesis. Development reasons. Morphological features. Clinic and rentgenologic options of a current Fibrous-cavernous tuberculosis of lungs. Complications. Features of treatment. Current and outcome. 
 
Lesson No. 7. Tubercular pleuritys. Pathogenesis and pathological anatomy of tubercular pleurisy. Nature of defeat (morphologically nonspecific inflammation, allergic tuberculosis pleuritis, pleura tuberculosis). Clinical picture of dry (fibrinouse) and ekssudative tubercular pleurisy. Features of treatment. Radiological signs. Characteristic of a pleural exudate. Indications to a biopsy and a endoscopy of pleural cavity. Differential diagnosis of exsudative pleurisy. Tuberculosis empyema, clinic, current and outcome. 

Lesson No8. Tuberculosis of brain covers and central nervous system. Pathogenesis and pathological anatomy of tuberculosis meningitis. Clinical manifestations of the main forms of meningitis (basilar, spinal and encephalomeningitis). Features of clinic and current. Neurological symptomatology. Differential diagnosis of tuberculosis meningitis. Microbiological and serological diagnostics, changes of indicators of cerebrospinal fluid. Features of treatment and outcome. 

Module control No. 4. Report of the educational case history.

Educational and methodical ensuring discipline

a) main educational literature
1. Manual of tuberculosis/ R. Prasad. New Delhi 2015 P. 312/

b) additional educational literature

1. Phthisiology: national.management. edition M.I. Perelman. - M.: GEOTAR-media, 2007. - 512 pages - (National leaders).
2. Tuberculosis at children and teenagers / under the editorship of V.A. Aksenova. - M.: GEOTAR-media, 2007. - 272 pages. 
3. Order MH of the Russian Federation No. 951 from 12/29/2014. About the APPROVAL of METHODICAL RECOMMENDATIONS ABOUT IMPROVEMENT of DIAGNOSTICS AND TREATMENT of TUBERCULOSIS of RESPIRATORY ORGANS.
4. Order MH of the Russian Federation No. 109 of 2003. 

PLAN
of lectures with students of the 6th course of medical (foreign) faculty
on 2019 - 2020  year (autumn semester)
Discipline: Phthisiology

Lecture
	Date	Lecturer	
1. Primary tuberculosis. Features of pathogenesis and pathomorphology of primary forms of tuberculosis. Development of methods for collecting anamnesis and physical examination of patients. Assessment of clinical and laboratory data. The diagnosis of primary forms of tuberculosis and concomitant disease. Features of treatment and differential diagnosis. Main features of primary tuberculosis. 
	02.09.2019	Ten M.B.

(Labutin I.V.)	
2. Focal pulmonary tuberculosis of the lungs. Features of pathogenesis and pathomorphology of fresh and chronic focal tuberculosis. Development of methods for collecting anamnesis and physical examination of patients. Assessment of clinical and laboratory data. The diagnosis of focal tuberculosis and concomitant disease. Features of treatment and differential diagnosis.
	16.09.2019	Labutin I.V.

(Ten M.B.)	
3. Infiltrative pulmonary tuberculosis. Caseous pneumonia. Features of pathogenesis and pathomorphology of infiltrative tuberculosis. Development of methods for collecting anamnesis and physical examination of patients. Assessment of clinical and laboratory data. The diagnosis of disseminated tuberculosis and its complication. Features of treatment and differential diagnosis. The main clinical forms of infiltrative tuberculosis.
	30.09.2019	Labutin I.V.

(Ten M.B.)	
4. Disseminated tuberculosis of the lungs. Features of pathogenesis and pathomorphology of disseminated tuberculosis. Development of methods for collecting anamnesis and physical examination of patients. Assessment of clinical and laboratory data. The diagnosis of disseminated tuberculosis and its complication. Features of treatment and differential diagnosis. The main clinical forms of disseminated tuberculosis.
	14.10.2019	Ten M.B.

(Labutin I.V.)	
5. Tuberculoma. Cavernous tuberculosis of the lungs.Features of pathogenesis and pathomorphology of cavernous tuberculosis and tuberculosis. Development of methods for collecting anamnesis and physical examination of patients. Assessment of clinical and laboratory data. The diagnosis and possible complications. Features of treatment and differential diagnosis. Indications for surgical treatment.
	28.10.2019	Labutin I.V.

(Ten M.B.)	
6. Fibrous-cavernous pulmonary tuberculosis and cirrhotic tuberculosis.
Features of pathogenesis and pathomorphology of destructive forms. Development of methods for collecting anamnesis and physical examination of patients. Assessment of clinical and laboratory data. The diagnosis and possible complications. Features of treatment and differential diagnosis. Indications for surgical treatment.
	11.11.2019	Labutin I.V.

(Ten M.B.)	
7. Tuberculous pleurisy and meningitis. Features of pathogenesis and pathomorphology of tuberculous pleurisy and meningitis. Development of methods for collecting anamnesis and physical examination of patients. Assessment of clinical and laboratory data. The diagnosis and possible complications. Features of treatment and differential diagnosis. Indication for surgical treatment of TB.
	25.11.2019	Ten M.B.

(Labutin I.V.)	

Head the Department of  Phthisiology and Pulmonology. 			V.R. Mezhebovsky	
MD, PhD, Professor