Standards of answers for a clinical case

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« 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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