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ТОР 5 статей:
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КАТЕГОРИИ:
|
Standards of answers for a clinical case
« Type 2 diabetes, new cases decompensation of metabolic processes. Obesity 2 degrees, exogenous-constitutional form. Arterial hypertension 2 degree, Risk factor 4. Circulatory failure 0 »
№
| Criteria for evaluation steps
| 1.
| The Collection of complaints and anamnesis
| Spend consistently and systematically
| 2.
| Detailing symptoms of the disease with the help of additional questions
| Specified duration and character of the symptoms
| 3.
| Physical examination
| Measured height, weight, BMI, described skin covers
| 4.
| Waist measurement
| Measured waist circumference. Marked performance standards waist circumference in men and women.
The presence of abdominal obesity in this patient.
| 5.
| Cardiovascular system examination
| Spend auscultation of the heart to meet the sequence of listening points
|
| Measuring arterial pressure, pulse rate
| Measured arterial pressure and pulse rate compliance with the rules.
|
| Lower extremities examination
| An examination of the lower extremities for the presence of ulcers, swelling, deformation of nails. Determined ripple on arteria dorsalis pedis. Determine the sensitivity of the stop.
|
| Preliminary diagnosis grounding and formulation
| Considering the complaints, medical history, family history of diabetes, age, and objective data exhibited a preliminary diagnosis: Type 2 Diabetes
|
| Purpose of the laboratory survey plan
| OAM Biochemical analysis of blood: glucose, urea, creatinine, potassium, sodium, lipid profile. The results glycosylated hemoglobin level (HbA1C)
|
| Purpose of the instrumental survey plan
| 1. Abdominal ultrasound, ECG
|
| Interpretation of biochemical analysis of blood
| Increased glucose, cholesterol, LDL, triglycerides, normal levels of creatinine, urea, potassium, sodium.
|
| Interpretation of general urinalysis
| OAM: glycosuria - 3%, ketonuria - absent
|
| Interpretation of glycemia
| improving glucose fasting and postprandial 2 hours;
|
| Interpretation HbA1C (glycated haemoglobin)
| a high level of HbА1С appropriate stage decompensated diabetes
|
| Interpretation of ultrasonography of the organ of abdomen, ECG
| Description ultrasound of the abdomen: the signs of fatty liver. Described ECG.
|
| Conducting differential diagnosis
| Spend the differential diagnosis between type 2 diabetes and prediabetes
|
| Grounding and formulation of a final diagnosis
| Given the prior informed diagnosis, as well as increased glucose; the presence of glycosuria, high HbA1C diagnosed: Type 2 diabetes, new cases decompensation. Obesity 2 degrees, exogenous-constitutional form. Arterial hypertension 2 degree, Risk factor 4. Circulatory failure 0
|
| Defining the principles of treatment
| 1. Described the diet for 1200 kkall- exception of easily digestible carbohydrates, animal fats.
2. Described dosage physical load
| 3. Considering insulin resistance, justified the need for the appointment biguanide incretins.
4. Described the treatment of comorbidity-fighting hypertension, hypercholesterolemia
5. Substantiated patient education in school diabetes
|
| Establishing optimum contact with the patient
| Installed the optimum contact with the patient
|
| Total points
|
| Оснащение симуляции:
1. Листок с заданием, сценарий для волонтера (пациента), критерии оценки шагов
2. Анализы: общеклинические анализы мочи, биохимический анализ крови, гликемический профиль, уровень гликозилированного гемоглобина;
3. Заключение УЗИ брюшной полости, ЭКГ
4.Тонометр, фонендоскоп, сантиметровая лента, весы.
1. Актер – пациент, 2. актер – врач или ассистент врача
Обстановка: учебная комната – кабинет врача ВОП.
1. Кушетка-1
2. Стол для инструментов – 1
3. Медицинский шкаф с препаратами.
Разработчик: ассистент кафедры Ильмалиева А.Ж.
Рецензент:
Обсужден и утвержден на заседании кафедры эндокринологии (28 сентября 2015, протокол № 4)
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