Educational work

  1. INTRODUCTION
    • Goals and objectives of study.

Gain of knowledge for full and correct urology diseases diagnostics, recognition of acute conditions and prescription full and effective treatment at rural medical point (RMP) (city medical point(CMP)), according to services categories, or the patient should be sent to the adviser or the expert in other establishment.

The gain of knowledge for rehabilitation and medical examination of patients with prolonged health problems, preventive measures among patients and the public.

Gain of skills for the full, appropriate and necessary level of examination of patients, performing the necessary volume of procedures and manipulations at RMP (CMP).

      Objectives of training:

  1. Gain of knowledge about the semiotics of urological diseases and methods of examination of urological patients.
  2. Gain of knowledge about etiology, pathogenesis, classification, clinical manifestations, diagnostics, treatment and prophylactics of most spread urological diseases.
  3. The development of practical skills necessary for the survey of urological patients at rural health units.

1.2 Demands to knowledge and skills of students

Upon termination of a cycle of urology the student should know:

– Symptoms of urological diseases and methods of examination of urological patients.

– An etiology, a pathogenesis, clinic, diagnostics, treatment and preventive maintenance of following urological diseases: an infection of the upper urinary ways (an acute and chronic pyelonephritis, complications of pyelonephritis), an infection of the lower urinary ways and genitals at men (urethrites, cystitis, prostatites, an orchiepididymitis), an urolithiasis, varicocele, benign prostate hyperplasia (BPH) and a prostate cancer.

– To interpret laboratory, urodynamic, ultrasonic, X-ray, instrumental and other methods research results.

Students should be able:

  1. To carry out the full and correct diagnostics, full and effective treatment at other conditions and diseases, to carry out reabilitational and preventive actions at medical doctor level which doctor should be able to carry out completely and independently in most cases under usual circumstances; only in exceptional cases, when the condition of the patient doesn’t improve, the patient should be sent to the adviser or the expert in other establishment (an out-patient department, hospital) for reception or additional consultation or full treatment (service of 1 category):
  2. Acute and chronic pyelonephritis (uncomplicated);
  3. Urethritis, cystitis, acute prostatitis, orchiepididymitis.
  4. To carry out whenever possible correct diagnostics, otherwise to distinguish acute conditions and to prescribe correct treatment at possibility and necessity of that (at least partly) at medical doctor, and to send the patient to the adviser in other establishment (an out-patient department, hospital) for carrying out full and correct diagnostics, receptions of additional consultation or for full treatment at other adviser or the expert. To carry out after treatment and prophylactic medical examination of patients passing treatment to medical doctor or other establishments and having long disorders of health, who requires special care and observation (service of 2 categories):
  5. Acute and chronic pyelonephritis (complicated). A carbuncle, a kidney abscess. Paranephritis.
  6. Chronic cystitis, chronic prostatitis.
  7. Man’s sterility. Erectile dysfunction. Pejrony disease.
  8. Benign prostate hyperplasia.

 

Should carry out independently (practical skills) fully, corresponding (correct, adequate and effective) and necessary procedures, manipulations and researches to patient at medical doctor level which should be carried out competently, and independently (services 3.1. categories):

  • To collect of complains and the anamnesis, survey of urological patients.
  • Palpation and percussion of kidneys.
  • Palpation and percussion of bladder.
  • Palpation of men external genitals.
  • Digital rectal research of a prostate.
  • Care of nephrostomic and cystostomic drainages and urethral catheter.
  • Bladder catheterization
  • To interpret ultrasound scanning data of kidneys and bladder.
  • To interpret the data of plain radiography of kidneys, ureters and bladder (KUB) and intravenous urography.
  • To interpret results of microscopy of urine sedimentation, assays Nechiporenko, Stamey-Meyers tests, bacteriological research of urine.

To carry out full, corresponding and necessary procedures, manipulations and researches by means of patient direction from medical doctor in other establishments, where such procedures, manipulations and researches can be held, for which medical doctor should know indications and a place, where such procedures can be carried out (services 3.2. categories).

  • Plain radiography of kidneys, ureters and bladder
  • Intravenous urography.
  • Ultrasonic research of kidneys and pelvic organs.
  • Kidneys and prostate biopsy.

The provision of individual preventive and educational support (training, consulting, demonstrations, etc.) for healthy individuals exposed to specific risks and their specific needs, and patients, visiting the rural health units for various reasons (service category 4).

  • Personal hygiene
  • Mobile lifestyle and a healthy sex
  • Water regimen
  • Regulation of intestinal functions
  • Prevention focal infection, hypothermia
  • Problems of children and elderly
  • Family planning
  • Phytotherapy
  • Employment assistance

I.3. List of academic disciplines and their need for the study of urology:

Human Anatomy (urinary system and male genital system)

Histology (urinary system and male genital system)

Normal physiology (nephron as a functional unit of kidney, renal function as an organ of homeostasis, physiology of the urinary tract, basic physiology of male genital system)

Organic chemistry and biochemistry (physical and physic-chemical properties of urine, urinary stones, types, the basic biochemical processes of kidney)

Pathophysiology (pathological physiology of the kidney)

Pathological anatomy (kidney diseases, urinary tract diseases, diseases of male genital system)

Topographic anatomy and operative surgery (lumbar area and the retroperitoneal space, the topography of kidneys, ureters, bladder and urethra, topography of male genital system, renal, ureters and bladder surgery)

Propaedeutics of internal diseases (clinical signs of kidney disease, methods of investigation of urinary tract, clinical and laboratory studies)

Therapy (kidney diseases)

Surgery (differential diagnosis of acute abdominal diseases with renal colic)

Children diseases (kidney and urinary tract diseases)

 

  1. Volume of an academic load
 

Work capacity

 

Distribution of volume of an academic load by types

classroom occupations (at a hour)

Independence work
Total Lectures Practical lessons Workshops Laboratory work
100 60 8 52 40

 

  1. Lecture course

3.1. Thematic plans of lectures

 

 

 

Theme

 

Hours amount

 

Lecture 1.

 

Lecture 2.

 

Lecture 3.

 

Lecture 4.

 

 

Urinary tract infection.

 

Pyelonephritis and its complications.

 

Benign prostate hyperplasia.

 

Urolithiasis.

 

 

2-hours

 

2-hours

 

2-hours

 

2-hours

 

 

3.2. Lectures contain.

 

Lecture № 1. Urinary tract infection

Epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment and prevention of urinary tract infections. The agents of non-specific urinary tract infections. Identification of major infectious syndromes. Pathways of bacteria in the genitourinary system. Primary infection. Unresolved bacteriuria. Bacterial persistence or recurrence of infection. Reinfection. Susceptibility factors and protection mechanisms for UTI. Virulence factors of bacteria. Susceptibility factors in women. Susceptibility factors in men. Uretheral and renal factors. Methods of diagnosis, differential diagnosis, treatment and prevention of UTI.

                                                                        Used literature

Fundamental

  1. Textbook in urology for medical institutes. Andijan, 2008, p. 480.
  2. Lopatkin N.A. (The textbook for students of medical institutes) -М. Medicine, 2004, p.512.
  1. The guidance to urology in 3 volumes. N.A. Lopatkin М, 1998.

Supplementary

  1. Donald Smith’s Urology. Editors: E. Tanago. and Dj. Macaninch. Traslated from English by «Practics». М. 2005. –p. 819
  2. Guidelines of European Association of Urology. 2015.
  3. European Urology update series 2015.
  4. Nospecific infections of the Genitourinary Tract. Edwin M. Meares, Jr. M.D. Facs Fidsa, Fidsa. Urology. Ch.Smithis.  13. 1996.
  5. Campbells Urology. Seventh Edition, vol. 1, 2, 3. 2010.

Lection № 2 Pyelonephritis and its complications

Current information on the epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, complications and prevention of pyelonephritis. Definition and concept of pyelonephritis. Pathogens of pyelonephritis: Gram-negative (E.coli, Proteus vulgaris, mirabilis, Klebsiella, cytrobacter, Enterobacteriaceae, Pseudomonas aeruginosa and other Enterobacteria), Gram-positive (staphylococci, streptococci, enterococci and other) aerobes. Obligate anaerobes. The most frequent causative agents of pyelonephritis – Escherichia coli (E.coli). Pathways of infection into kidney. The role of urodynamic disorders, vesicoureteral reflux, the phenomenon of bacteria adhesion to the urothelium cells in the pathogenesis of pyelonephritis. Morphological characteristics of pyelonephritis. Acute pyelonephritis (uncomplicated and complicated). Chronic pyelonephritis. Complications of pyelonephritis (kidney abscess and carbuncle, paranefritis). Methods of diagnosis, differential diagnosis and treatment of pyelonephritis and prevention.

Used literature

Fundamental

  1. Textbook in urology for medical institutes. Andijan, 2008, p. 480.
  2. Lopatkin N.A. (The textbook for students of medical institutes) -М. Medicine, 2004, p.512.
  1. The guidance to urology in 3 volumes. N.A. Lopatkin М, 1998.

Supplementary

  1. Donald Smith’s Urology. Editors: E. Tanago. and Dj. Macaninch. Traslated from English by «Practics». М. 2005. –p. 819
  2. Guidelines of European Association of Urology. 2015.
  3. European Urology update series 2015.
  4. Nospecific infections of the Genitourinary Tract. Edwin M. Meares, Jr. M.D. Facs Fidsa, Fidsa. Urology. Ch.Smithis.  13. 1996.
  5. Campbells Urology. Seventh Edition, vol. 1, 2, 3. 2010.

Lecture № 3. Benign prostate hyperplasia

Epidemiology, etiology, pathogenesis, diagnosis and treatment of benign prostatic hyperplasia. Definition of BPH. Growth factors. Morphological characteristics of BPH. Dynamic and mechanical components of urinary tract obstruction in BPH. Clinical manifestations of BPH. Lower urinary tract symptoms (irritative and obstructive). International prostate symptoms score (I-PSS). Methods of diagnostics of BPH. Mandatory diagnostic tests during the initial survey. Optional tests. Differential diagnosis of BPH. Complications of BPH. Methods of BPH treatment. Careful waiting. Pharmacotherapy (treatment with inhibitors of 5-alpha reductase, alpha blockers, phytotherapy). Surgical options. Clinical examination and rehabilitation of patients with BPH.

Used literature

Fundamental

  1. Textbook in urology for medical institutes. Andijan, 2008, p. 480.
  2. Lopatkin N.A. (The textbook for students of medical institutes) -М. Medicine, 2004, p.512.
  1. The guidance to urology in 3 volumes. N.A. Lopatkin М, 1998.

Supplementary

  1. Donald Smith’s Urology. Editors: E. Tanago. and Dj. Macaninch. Traslated from English by «Practics». М. 2005. –p. 819
  2. Guidelines of European Association of Urology. 2015.
  3. European Urology update series 2015.
  4. Nospecific infections of the Genitourinary Tract. Edwin M. Meares, Jr. M.D. Facs Fidsa, Fidsa. Urology. Ch.Smithis.  13. 1996.
  5. Campbells Urology. Seventh Edition, vol. 1, 2, 3. 2010.
  6. 5-th International Consultation on Bening Prostatic Hiperplasia (BPH). Paris, 2000. – p.535.

Lection № 4 Urolitiasis

Epidemiology, etiology, pathogenesis, diagnosis and treatment of urolitiasis. Determination of the urolitiasis. Genesis of kidney stones: the causal, and formal. Features of kidney stones genesis in arid zones. General and local factors of stone formation. The composition of urinary stones: calcium oxalate, urate, phosphate, cystine stones, infectious stones. Morphological changes in kidneys in nephrolithiasis. The symptoms and clinical course of disease (pain, renal colic, disorders of the gastrointestinal tract in renal colic, dysuria, hematuria, pyuria). Diagnosis and differential diagnosis of urolithiasis. Methods of treatment of urolithiasis (drug therapy, and endoscopic techniques, percutaneous surgery, traditional surgery). Clinical examination and rehabilitation of patients with urolithiasis.

Used literature

Fundamental

  1. Textbook in urology for medical institutes. Andijan, 2008, p. 480.
  2. Lopatkin N.A. (The textbook for students of medical institutes) -М. Medicine, 2004, p.512.
  1. The guidance to urology in 3 volumes. N.A. Lopatkin М, 1998.

Supplementary

  1. Donald Smith’s Urology. Editors: E. Tanago. and Dj. Macaninch. Traslated from English by «Practics». М. 2005. –p. 819
  2. BJU International 2010.
  3. Guidelines of European Association of Urology. 2015.
  4. European Urology update series 2015.
  5. Campbells Urology. Seventh Edition, vol. 1, 2, 3. 2010.

 

  1. Practical lessons

4.1. Thematic plans of practical lessons

 

 

Name of subject of a practical training Amount of hours
Lesson 1 Functional anatomy, physiology of kidneys and urinary ways. 5 hours

 

Lesson 2 Semiotics of urological diseases. 6 hours
Lesson 3 Methods of diagnostics of urological diseases (physical examination, laboratory, instrumental, urodynamic, ultrasonography, X-ray). 6 hours

 

 

Lesson 4 Bacterial Infections of the upper urinary tract. Acute pyelonephritis (uncomplicated and complicated).  Chronic pyelonephritis.  Complications  of pyelonephritis (renal abscess, carbuncle, paranephritis). 6 hours

 

 

 

Lesson 5 Bacterial Infections of the lower urinary tract. Acute and chronic cystitis. Prostatitis. Urethritis. Orchitis. Epididimitis. 6 hours
Lesson 6 Varicocele. Peyroni disease. Erectile dysfunction. Man’s infertility. 6 hours

 

Lesson 7 Benign prostate hyperplasia  (BPH) 6 hours
Lesson  8 Urolithiasis 6 hours
Lesson 9 Injuries of kidneys, urinary ways and man’s genitals. 5 hours
Total: 52 hours.

 

 

 

 

 

 

 

4.2. Content of practical lessons.

Subjects of practical lessons

 

№ of appropriate lecture The name of theme of practical lesson and its content Link to literature.
1.

 

 

 

 

 

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

Functional anatomy, physiology of kidneys and urinary ways.

– Kidneys, a structure, topography.

– A nephron – structural and a functional kidney unit. A structure of a calyx and pelvis, ureters, a bladder and urethra.

– Kidney functions, as homeostasis regulator.

– Function of calyxes, pelvis and ureters.

– Urodinamic of the upper urinary ways.

– Bladder function. Urination physiology.

– Function of a prostate and testicles.

– Features of anatomy of kidneys and  urinary ways in children

Carrying out business game: solution of test tasks

Fundamental:  1,2,3

 

Supplementary: 1,6,11

 

 

2 No

 

 

 

 

 

 

 

 

 

 

 

 

Semiotics of urological diseases.

Pains, their localization, intensity, continuity, irradiation, the reasons and the mechanism of pains origin at urological diseases.

– Speeded up, painful, complicated urination. The ischuria, and paradoxa with overflow. Not continence and urine hold deficiency.

– Polyuria. Oliguria. Anuria.

– Urethrorrhagia. Haematuria.

– Pyuria, bacteriuria, fosfate and oxalate salts in urine

 

Carrying out business game: solution of test tasks and composition organizers (“Chart Vienna” – on urination disturbance, “skeleton of fish” – on a hematuria, “Why? ” – on renal colic). The business game “Round Table” – the reasons of renal colic. Analysis of situational tasks.

Fundamental: 1,2,3

 

Supplementary:

4,5,6,11

3. No

 

Methods of diagnostics of urological diseases.

-Questionnaire. The anamnesis collecting.

-Physical examination of area of kidneys, suprapubic area and genitals. Digital rectal examination of prostate. Palpation, percussion of bladder. Area auscultation renal arteries, techniques and value.

– Microscopy of urine sediments. Nechiporenko test. Urine bacteria research. Antibiotics resistance research. Stamey-Meyers assay, a performance technique, data interpretation.

– Bladder catheterization. Toolkit, indications, complications.

– Plain radiography of kidneys, ureters and bladder

Intravenous urography. Indications to performance, data interpretation.

– Cystourethrography. Indications to performance, data interpretation.

– A kidney and a prostate biopsy. Indications. Interpreting.

– Ultrasound scanning of kidneys, bladder, prostates. Indications to performance. Data interpretation.

– A computer tomography and MRI visualization of kidneys, a bladder and a prostate. Indications to performance. Data interpretation.

Diagnostics of urological diseases in children.

Carrying out business game: solution of test tasks, the business game “Round Table” – at interpretation of results of radiological researches. Analysis of situational tasks.

 

Fundamental: 1,2,3

 

Supplementary:

4,5,6,11.

4.

 

1,2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Upper urinary tract infections.

Definition of concept of upper urinary tract infection, an etiology, most often registered originators in patients with UTI, pathogenesis, pathogenic factors, which  lead  to development of UTI, UTI classification . Asymptomatic bacteriuria. Contamination. Hospitalism.

Acute (uncomplicated and complicated) a pyelonephritis. A chronic pyelonephritis.

– Concept. Frequency of disease. An etiology. Ways of infection spread in urinary tract and penetration of bacteria into a kidney. A pathogenesis. The pathogenic factors promoting development of a pyelonephritis (an asymptomatic bacteriuria, disturbance of  urodinamics, a renal haemodynamic and a lymph drainage system).

– Pyelonephritis classification.

– A clinical symptoms of acute and chronic pyelonephritis. Diagnostics. Localization assays. Topical and differential diagnostics of various forms of infectious-inflammatory lesions of kidneys and urinary passage ways. A role of ultrasonic, X-ray, instrumental and other methods of research.

– Treatment. Indications to conservative treatment, its essence. Appointment principles of antibiotics therapies. Modern methods of a urine derivation (PCN, ureteral stents).

– Features of clinics and treatment of pyelonephritis in children.

– Reabilitation and prophylactic medical examination of patients with pyelonephritis. Pyelonephritis preventive maintenance.

Pyelonephritis complications. Apostematous pyelonefritis, a carbuncle and a kidney abscess.

– Concept. An etiology. The most frequent originators of a carbuncle and a kidney abscess. A pathogenesis. Infections entrance passage ways. The pathogenic factors promoting development of a carbuncle and an abscess of a kidney.

– Modern classification of complications of a pyelonephritis (cortical and corticomedullar abscesses).

– Clinical symptoms of pyelonefritis complications. Diagnostics. Treatment. After treatment and prophylactic medical examination. Preventive maintenance.

– A paranephritis. An etiology. A pathogenesis. Classification. Clinic. Diagnostics. Treatment. Rehabilitation and prophylactic medical examination. Preventive maintenance.

Carrying out business game: solution of test tasks, composition organizers (“Chart Pyramid” – on pyelonephritis classification, “A skeleton of fish” – on etiopathogenesis of UTI, “Cluster” – on tactics of treatment of pyelonephritis). The business game “Black Box” – on clinical manifestation of acute pyelonephritis. Analysis of situational tasks.

Fundamental: 1,2,3

 

Supplementary:

4,5,6,11.

5. 1,2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Infections of the lower urinary tract.

      Acute and chronic cystitis.

– Etiology. Pathogenesis. Classification. Concept of chronic cystitis. Clinical symptoms of acute and chronic cystitis. Diagnostics. Localization assays. Role of laboratory, endoscopic and other methods of research. Treatment. Principles of appointment of antibacterial therapy.

Features of clinics and treatment cystitis in children.

Prostatitis

– Frequency. Etiology. Pathogenesis. Modern classification of prostatites. Clinical symptoms of a bacteriemic and abacterial prostatitis. Diagnostic. Treatment. Preventive maintenance.

Urethritis

– Etiology. Role of an infection transferred by a sexual way. Pathogenesis. Classification. Clinic. Diagnostics. Treatment. Preventive maintenance.

        Orchitis. An epididymitis

– Etiology. Pathogenesis. Clinic. Diagnostics. Treatment. Preventive maintenance.

Features of orchiepididimitis in children.

Carrying out business game: solution of test tasks, composition organizers (“Skeleton of fish” – on etiopathogenesis of prostatitis). The business game “Web” – on acute cystitis. Analysis of situational tasks.

Fundamental: 1,2,3

 

Supplementary:

3,4,5,6,7,8,9, 10, 11.

6 No

 

 

 

 

 

 

 

 

 

 

 

 

 

Varicocele

Etiology. Pathogenesis. Clinic. Diagnostics. Treatment.

Peyroni disease.

Etiology. Pathogenesis. Clinic. Diagnostics. Treatment.

Erectile dysfunction.

Etiology. Pathogenesis. Clinic. Diagnostics. Treatment.

Man’s sterility.

Etiology. Pathogenesis. Clinic. Diagnostics. Treatment.

Carrying out business game: solution of test tasks and composition organizers (“A skeleton of fish” – on etiopathogenesis erectile dysfunction, “Why? ” – on the reasons of varicocele). The business game “Black Box” – on man’s infertility. Analysis of situational tasks.

Fundamental: 1,2,3

 

Supplementary: 1,3,4,5,6,7,8,9,11.

 

7. 3

 

 

 

 

 

 

 

 

 

 

 

Benign prostate hyperplasia  (BPH)

– Epidemiology

– Etiology

– Pathogenesis

– Clinical symptoms

– Diagnostics

– Treatment

– The prognosis

Carrying out business game: solution of test tasks and composition organizers.

(“Chart Vienna” – on symptoms of lower urinary tract, “Why?” – on the reasons of failure of urination). The business game “Round Table” – on DGP diagnostics. Analysis of situational tasks.

Fundamental: 1,2,3

 

Supplementary: 3,4,5,6,7,8,9,11, 12.

8. 4

 

 

 

 

 

 

 

 

 

 

 

Urolithiasis

– Epidemiology

– Etiology (risk factors)

– Pathogenesis (lithogenesis types)

– Clinic

– Diagnostics

– Treatment

– Preventive maintenance. Methaphilactics

– Features of clinics and treatment of urolithiasis in children

Carrying out business game: solution of test tasks and composition organizers (“Skeleton of fish” – on etiopathogenesis of urolithiasis. The business game “Web” – on clinical manifestation of urolithiasis. Analysis of situational tasks.

Fundamental: 1,2,3

 

Supplementary:

3,4,5,6,7,8,9,11.

9 No

 

 

 

 

 

 

 

 

 

 

 

 

Kidneys, urinary ways and external men genitals traumas

Classification.

– Clinical implication.

– Diagnostics. Differential diagnostics.

– Rendering emergency medical aid.

– Inspection and treatment tactics.

– Rehabilitation and prophylactic medical examination.

 

Carrying out business game: solution of test tasks, composition organizers (Camomile” – on the reasons of injuries of a kidney. The business game “Round Table” – on clinical manifestation of injuries of bladder. Analysis of situational tasks.

Fundamental: 1,2,3

 

Supplementary:

4,5,6,7,8,9,11.

 

  1. Labs subject in the medical program and medico-educational departments, are not provided.

 

  1. Individual work of students

6.1. The list of individual work of students

 

 

The name of theme of practical lesson Amount of hours
Lesson 1 Segmentary structure of  kidney 3 hours
Lesson 2 Pain in scrotum. 3 hours
Lesson 3 Computed tomography and magnetic resonance imaging 4 hours
Lesson 4 Pyelonephritis of pregnant women. Urosepsis. 5 hours
Lesson 5 Tuberculosis of kidneys.Tuberculosis of urinary ways and  genitals. 5 hours
Lesson 6 Neoplasm of scrotum and inguinal area. Anomaly of  urethra and testis. 5 hours
Lesson 7 Conservative methods of treatment of BPH. Modern alternative methods of treatment. 5 hours
Lesson  8 Modern methods of treatment of urolithiasis. Hydronephrosis 5 hours
Lesson 9 Posthemorrhagic shock. Urinary purulent peritonitis 5 hours
                                                                                                    Total:               40 hours

 

6.2. The list of content of individual work of students.

 

№ темы № name of   a subject of IWS Name of subject and its content

of individual work of students

 

 

Link to literature.
1 1 Segmentary structure of  kidney

Kidney segments. Significance of a segmentary structure of a kidney. Methods of definition of renal segments.

Carrying out business game: make a slide or drawing of a segmentary structure of a kidney.

Fundamental: 1,2,3

 

Supplementary:

1,11.

2 2 Pain in scrotum.

Reasons. Development mechanism. Clinical manifestation. Assistance at pain in scrotum. Inspection and  treatment  tactics. Rehabilitation and medical examination.

Carrying out business game: make up organizers, presentation and preparation of situational tasks and tests.

Fundamental: 1,2,3

 

Supplementary:

4,5,6,11.

3. 3. Computed tomography, magnetic resonance imaging of research of kidneys and urinary tract.

Indications to performance of CT and a nuclear magnetic resonance of kidneys, bladder, prostate. Principles of work of KT and nuclear magnetic resonance. Performance technique. Interpretation.

Carrying out business game: make up multimedia slides and  presentation

Fundamental: 1,2,3

 

Supplementary:

4,5,6,11.

4.

 

4.

 

Pyelonephritis in pregnancy. Urosepsis.

Etiology. Pathogenesis. Clinic. Diagnostics. Treatment.

Carrying out business game: drawing up organizers, presentation and preparation of situational tasks and tests.

Fundamental: 1,2,3

Supplementary:

3,4,5,6,7,8,9,10, 11.

5. 5. Tuberculosis of kidneys.Tuberculosis of urinary ways and  genitals.

Etiology. Pathogenesis. Clinic. Diagnostics. Treatment.

Carrying out business game: drawing up organizers, presentation and preparation of situational tasks and tests.

Fundamental: 1,2,3

Supplementary:

3,4,5,6,7,8,9,10, 11.

6 6 Neoplasm of scrotum and inguinal area. Anomaly of  urethra and testis.

Etiology. Pathogenesis. Clinic. Diagnostics. Treatment.

Carrying out business game: drawing up organizers, presentation and preparation of situational tasks and tests.

Fundamental: 1,2,3

Supplementary:

1,3,4,5,6,7,8,9,11.

7. 7. Conservative methods of treatment of BPH.

Indications to application. Phytotherapy. Alpha blokers. Inhibitors of 5- alpha reductases. Treatment duration. Assessment of efficiency of treatment.

Modern alternative methods of treatment.

Indications to application. Transurethral resection of prostate. Transurethral needle ablation of prostate. Transurethral thermotherapy. Prostate electrovaporization. Prostate laser therapy. Complications of alternative methods of treatment of BPH.

Carrying out business game: drawing up organizers, presentation and preparation of situational tasks and tests.

Fundamental: 1,2,3

 

Supplementary:

3,4,5,6,7,8,9,11, 12.

8. 8. Modern methods of treatment of urolithiasis.

Indications to application. ESWL. Endoscopic and  percutaneous methods of treatment of renal stones, ureter and bladder. Complications of modern  methods of treatment of urolithiasis.

Hydronephrosis.

Classification. Clinic. Diagnostics. Treatment.

Carrying out business game: drawing up organizers, presentation and preparation of situational tasks and tests.

Основная: 1,2,3

 

Дополнительная:

3,4,5,6,7,8,9,11.

9 9 Posthemorrhagic shock.

Reasons. Pathogenesis. Clinic. Diagnostics. Treatment.

Urinary purulent peritonitis

Reasons. Pathogenesis. Clinic. Diagnostics. Treatment.

Carrying out business game: drawing up organizers, presentation and preparation of situational tasks and tests.

Основная: 1,2,3

 

Дополнительная:

4,5,6,7,8,9,11.

 

  1. The list of practical skills in a subject urology
  2. Medical examination of patients.
  3. The palpation and percussion of kidneys.
  4. The palpation and percussion of the bladder.
  5. Digital rectal examination of
  6. Bladder catheterization with elastic catheter.
  7. Care of urinary drainages.
  8. Interpretations of results of clinical analyses
  9. Interpretation of radiological inspections urinary systems.
  10. Interpretation of results ultrasonography.
  11. Execution of the medical card.
  12. Rating systems and criteria of the estimation of the knowledges and

 skills in the department of urology

The Main criterion quality to preparednesses of the student is his(its) rating, being composed of from the current estimation and estimations of the total checking.

In urology the indicator of learning of the student during a cycle is assessed on the 100 mark system.

These forms of assessment are divided on the following:

A control form The Maximum point Coefficient A pass mark
1 Current control + IWS 50 0,5 27,5
2 Concluding control 50 0,5 27,5
TOTAL: 100 1,0 55,0

 

Criterion of estimation of a practical training is the current estimation developing of control of readiness of the student to employment and estimations of quality of performance of the task.

The criteria of the estimation of the current checking.

Forms of the checking the knowledges and skills: spoken, written, decision of the situational tasks, tests, participation in interactive game.  Following criteria are taken into account At estimation of the current checking:

Progress  (%) Estimation Level of the knowledge of  student

 

1 96-100  

 

 

 

 

 

 

 

Excellent

«5»

The full correct answer to questions. Takes stock of and comes to a conclusion, creative imaginative, by itself analyses. The situational tasks solves correctly, with creative approach, with full motivation of the answer. Actively, creative participates in interactive plays, it is correct takes the motivated decisions and takes stock of, analyses. More than 96% of test questions has solved correctly.
2 91-95 The full correct answer to questions. Creative imaginative, by itself analyses. The situational tasks solves correctly, with creative approach, with motivation of the answer. Actively, creative participates in interactive plays, conclusions are correct.  91-95% of test questions has solved correctly.
3 86-90 The assigned questions on subject explained completely, but there is 1-2 inexactnesses in answer. By itself analyses. The inexactnesses at decision of the situational tasks, but under correct approach. Actively participates in interactive plays, takes the correct decisions. 86-90% of test questions has solved correctly.
4 81-85  

 

 

 

 

 

Good

«4»

The assigned questions on subject explained completely, but there are 2-3 inexactnesses, errors. Puts into practice, understands a question essence, tells confidently, has exact representations. Situational tasks are solved correctly, but answer substantiation insufficiently full. 81-85 % of test questions has solved correctly.
5 76-80 Correct, but incomplete explanation of question. Understands a question essence, tells confidently, has exact representations. Actively participates in interactive plays. On situational tasks gives incomplete decisions. 76-80 % of test questions has solved correctly.
6 71-75 Correct, but incomplete explanation of question. Understands a question essence, tells confidently, has exact representations. In interactive plays does not participate actively. On situational tasks gives incomplete answers. 71-75 % of test questions has solved correctly.
7 66-70  

 

 

Satisfactory

«3»

The right answer on half of put questions. Understands a question essence, tells confidently, has exact representations only on theme individual questions. Situational tasks are solved truly, but there is no answer substantiation. 66-70 % of test questions has solved correctly.
8 61-65 The right answer on half of put questions. Tells uncertainly, has exact representations only on theme individual questions. Commits errors at the decision of the situational tasks. 61-65 % of test questions has solved correctly.
9 55-60 The answer with errors on half of put questions. Tells uncertainly, has partial representations on a theme. Situational tasks are solved incorrectly. 55-60 % of test questions has solved correctly.
10 54 -30 Poor «2» Has no exact representation about lessons theme. Does not know the reasons and the mechanism of occurrence urological diseases.
11

 

20-30 Poor «2» For presence of the student on the lesson, in due form, itself has writing-books.

 

Criteria of estimation of independent work of the student (IWS).

Independent work of the student is supervised by the teacher of group. IWS is estimated together with current control, and makes 10 % of a current estimation.

At estimation IWS following criteria are considered:

Progress  (%) Estimation Level of the knowledge of  student

 

1. 86-100 Excellent

«5»

The full right answers on questions. Sums up and makes decisions, creatively thinks, independently analyzes. Situational tasks solves correctly, with the creative approach, with a full substantiation of the answer. Actively, creatively participates in interactive plays, correctly makes well-founded decisions and sums up, analyzes.
2. 71-85 Good

«4»

The assigned questions on subject explained completely, but there are 2-3 discrepancies, errors. Puts into practice, understands a question essence, tells confidently, has exact representations. Situational tasks are solved correctly, but an answer substantiation insufficiently full.
3. 55-70 Satisfactory

«3»

The right answers on half of put questions. Tells uncertainly, has exact representations only on theme individual questions. Situational tasks are solved incorrectly.
4. 0- 54 poor «2» Has no exact representation about lessom. Does not know the reasons and the mechanism of occurrence urological diseases.

Criteria of an estimation of total control.

Total control of realization of an estimation of mastering of theoretical and practical knowledge (skills) on the objective structured clinical examination (ОSCЭ). ОSCЭ it is spent at 8 stations on which for an estimation of practical skills models, volunteers from among students, tasks on interpretation of analyses or radiologic researches, situational tasks are used. At each station practical skill is estimated on the basis of estimated sheet of the given skill, each skill is estimated as much as possible in 100 points. The total estimation is found from average arithmetic value of the score, typed on all stations.

For example: the task for interpretation of x-ray picture.

  1. The name of x-ray picture. What is represented in this picture?
  2. What are revealed changes?
  3. Conclusion.

Estimated sheet of skill for the examiner

Stages  № Answers Max. score The right answer The wrong answer
1. Has correctly noted the name of a x-ray picture. 20 20 0
2. Has correctly noted available pathological changes. 40 40 0
3. Has drawn a correct conclusion on the basis of available pathological changes. 40 40 0
Total 100

 

Criteria of assessment of practical skills.

Each practical skill consists of several steps (stages), and is estimated as much as possible

in 100 points.

  1. Inspection of the patient.
Number of stage Action Is not executed (0 points) Correctly executed
1. Conversation with the patient and anamnesis gathering 0 20
2. The General examination of the patient and an estimation of the general condition 0 20
3. Inspection of respiratory organs (a palpation, percussion,auscultation) 0 20
4. Inspection of blood circulatory system Обследование органов кровообращения  (a palpation, percussion,auscultation) 0 20
5. Inspection of digestive and urinary system (a palpation, percussion,auscultation) 0 20
Total 100

 

  1. Palpation and percussion of kidneys.
Number of stage Action Is not executed (0 points) Correctly executed
1. Position of the patient. 0 20
2. Position of the doctor. 0 20
3. Technics of palpation of kidneys. 0 30
4. Technics of palpation of kidneys. 0 30
Total 100

 

  1. Palpation and percussion of the bladder.
Number of stage Action Is not executed (0 points) Correctly executed
1. Position of the patient. 0 20
2. Position of the doctor. 0 20
3. Technics of a palpation of  the bladder. 0 30
4. Palpation of  the bladder (technics, the characteristic) . 0 30
Total 100

 

 

 

 

 

 

 

 

  1. Digital rectal examination of
Number of stage Action Is not executed (0 points) Correctly executed
1. Position of the patient. 0 20
2. Technics of research. 0 40
3. Algorithm of inspection. 0 40
Total 100
  1. Bladder catheterization with elastic catheter.
Number of stage Action Is not executed (0 points) Correctly executed
1. Position of the patient. 0 10
2. Indications to the bladder catheterization. 0 10
3. Technics the bladder catheterization. at women. 0 30
4. Technics the bladder catheterization the bladder catheterization at men. 0 30
5. Contra-indications to the bladder catheterization 0 20
Total 100
  1. Care of urinary drainages.
Number of stage Action Is not executed (0 points) Correctly executed
1. Care of nephrostomic tube 0 40
2. Care of cyctostomic tube 0 30
3. Care of urethral catheter 0 30
Total 100
  1. Interpretations of results of clinical analyses
Number of stage Action Is not executed

(0 points)

Correctly

executed

1.  Interpretation of  results of microscopy of   urine 0 20
2. Interpretation of results of  urine by Nechiporenko 0 20
3. Interpretation of results of  the  bacteriological analysis of urine 0 20
4. Interpretation of results of  the analysis of   prostate secret 0 20
5. Interpretation of results of  the analysis of sperm 0 20
Total 100
  1. Interpretation of radiological examinations urinary systems
Number of stage Action Is not executed

(0 points)

Correctly

executed

1. To estimate position, the sizes and forms of kidneys 0 25
2. To define condition the pelvicalyceal systemof kidneys 0 25
3. To define patency ureters 0 25
4. To define presence of salts and  stones 0 25
Total 100
  1. Interpretation of results of ultrasonography.
Number of stage Action Is not executed

(0 points)

Correctly

executed

1. Interpretation of ultrasound of the kidneys 0 25
2. Interpretation of ultrasound of the  scrotum 0 25
3. Interpretation of ultrasound of  the  bladder 0 25
4. Interpretation of ultrasound of  the prostate 0 25
Total 100
  1.  Execution of the medical card
Number of stage Action Is not executed

(0 points)

Correctly

executed

1. Competent statement of complaints, the anamnesis of illness, the anamnesis of life and the general survey 0 10
2. Substantiation of the preliminary diagnosis 0 10
3. Writing of the plan of inspection of the patient 0 10
4. Substantiation of the clinical diagnosis 0 15
5. Carrying out of the differential diagnosis 0 15
6. Substantiation of the definitive diagnosis 0 10
7. Appointment of a diet and the treatment plan 0 15
8. To write the recipe 0 15
Total 100

 

Criteria of an estimation of practical skills in urology subject

Practical skills Coefficient The lowest

passing score

The maximum

point

1. Medical examination of patients 0,1 5,5 10,0
2. The palpation and percussion of kidneys 0,1 5,5 10,0
3. The palpation and percussion of the bladder 0,1 5,5 10,0
4. Digital rectal examination of  prostate 0,1 5,5 10,0
5. Bladder catheterization 0,1 5,5 10,0
6. Care of urinary drainages 0,1 5,5 10,0
7. Interpretations of results of clinical analyses 0,1 5,5 10,0
8. Interpretation of radiological inspections urinary systems 0,1 5,5 10,0
9. Interpretation of results ultrasonography 0,1 5,5 10,0
10 Execution of the medical card 0,1 5,5 10,0
Total 1,0 55,0 100,0

 

Each practical skill is estimated on 100 ball system and this point is multiplied by the corresponding factor. The general point of the student for practical skills consists of the sum of the typed points for all practical skills. The lowest passing score should make not less than 55 % from the maximum point.

  1. Information technology tools

Computers, VCR, TV, feature videos, equipment (ultrasound scanners, X-ray apparatus, urodynamic equipment), slide projectors, tools (urethrocystoscope, ureteroscope, nephroscope, catheters) negatoscopes, training tables, a set of X-ray films, slides, kits, a phantom.

For improvement of quality of training, except traditional methods, modern educational technologies are applied: computer test programs, the supervising – training computer programs, thematic educational video movies, etc.

Use of web sites: “Gateway portal: HINARI”, medscape.com, uro.ru, uroweb.ru, uroweb.org, Alltheweb.com, Yahoo.com, E-medicine.com.

  1. Literature

Fundamental

  1. Lopatkin N.A. (The textbook for students of medical institutes) -М. Medicine, 1982.
  2. Textbook in urology for medical institutes. Andijan, 2008, p. 480.
  3. Lopatkin N.A. (The textbook for students of medical institutes) -М. Medicine, 1995, 2004.

Supplementary

  1. Standard protocols for the case of students of GPs. Tashkent, 2005.
  2. Guide of GP. J. Mert, M “Practice” 1998
  3. The guidance to urology in 3 volumes. N.A. Lopatkin М, 1998.
  4. Human Physiology and urinary tract. Pytel YA, Borisov VV 1992
  5. Secrets of Urology.St. Petersburg, 1998.
  6. Actual questions of diagnostics, treatment and profilaxy of urolithiasis. Collection of scientific papers.Tashkent, 1988y, p 95.
  7. 5-th International Consultation on Bening Prostatic Hyperplasia (BPH).Paris, 2000.– p.535.
  8. The texts of lectures: pyelonephritis and its complications, urinary tract infection and prostatitis, kidney stones, benign prostatic hyperplasia.
  9. Donald Smith’s Urology.Editors: E. Tanago.and Dj. Macaninch. Translated from English by «Practics».М. 2005. –p. 819
  10. The guidance to andrology. O.A. Tiktinskiy. Leningrad. 1990
  11. Urology and andrology in questions and answers. O.A. Tiktinskiy, V.V. Mihaylenko. Piter.Saint-Peterburg. 1998.
  12. Emergency urology.Yu.A. Pitel, I.I. Zolotarev. M. Medicine. 1985.
  13. Text of lecture: urinary tract infection, pyelonephritis and its complications, urolithiasis, beningn prostate hyperplasia.tma.uz
  14. BJU International 1999-2015.
  15. Guidelines of European Association of Urology. 2010-2015.
  16. European Urology update series 2015.
  17. Nonspecific infections of the Genitourinary Tract. Edwin M. Meares, Jr. M.D. Facs Fidsa, Fidsa. Urology. Ch.Smithis. 1996.
  18. Campbells Urology.Seventh Edition, vol. 1, 2, 3. 2010.

Sites:

www.tma.uz.

www.medscape.com

www.uro.ru

www.uroweb.ru

www.uroweb.org