Practical lesson number 1 Theme: "Articular syndrome Practical lesson number 1 Theme: "Articular syndrome. Diseases that occur with articular syndrome. The most dangerous diseases that occur with articular syndrome. Differential diagnosis of rheumatism and rheumatoid arthritis. Tactics GPs. Tactics GPs. Indications for referral to a specialist or hospital admissions in the profile department. Principles of treatment of clinical supervision, control and rehabilitation in the SVP or SP. Principles of prophylaxis. Principles of teaching topics. "  

The aim of study: Teach students to solve the problem of syndromic patients and principles of conduct in terms of primary health care to provide medical care, including prevention, early diagnosis, differential diagnosis and management of patients with diseases of the internal organs, provided the requirements of "Qualification characteristics of general practitioners (GPs)" doctor - graduate specialty "Medicine".

Learning objectives: • To teach students timely and early diagnosis of diseases based on syndromic approach. • To teach students to differentiate the disease, accompanied by a specific syndrome. • Improve the knowledge, skills and practical skills (gathering information, identifying problems and physical examination, as well as the ability to reasonably prescribe laboratory and instrumental methods of research, counseling skills); • To teach students to reasonably choose tactics. • To teach students the targeted implementation of therapeutic and prophylactic measures. • To teach students the principles of clinical supervision and monitoring in rural health units (AEP) or family clinics (SP).

general practitioner should know: 1. Differential diagnosis of arthritis and arthralgia. 2. Treatment with various arthritides and arthralgias species (drug selection, dosage, administration route, duration, combination, side effects). GPs tactics. 3. The principles of treatment (drug and non-drug) in these diseases. 4. Principles of clinical supervision and monitoring of patients in a hovercraft or a joint venture. 5. The principles of primary, secondary and tertiary prevention in these diseases.

general practitioner should know: Data Analysis and complaints history for diagnosing rheumatism, rheumatoid arthritis Perform a visual inspection of the patient with the above diseases accompanied by arthritis or arthralgia. Establish the diagnosis and differential diagnosis spend with arthritis or arthralgia. Interpret the results of analyzes, data from laboratory and instrumental studies in patients with arthritis or arthralgia. Prescribe treatment for patients with arthritis, caused by different etiological factors. See the list of arthritis and arthralgia and subject further examination and / or treatment in a specialized department. To teach students the principles of clinical supervision and monitoring in rural health units (AEP) or family clinics (SP).

The symptoms of rheumatoid arthritis and Rheumatism diagnostic importance: Revmatoid arthritis Mean age and more Begins with the defeat of the small and medium joints Changes in the joints are sustainable Symmetrical joint damage Morning stiffness (at least 30-60 minutes) Oligoarthritis of polyarthritis contracture ankylosis The development of deformation - "field walrus", "Leben neck" РевмRheumatism 7-14 years Changes in the joints are volatile in nature Primarily affects medium and large joints Oligoarthritis or polyarthritis Manifestations of articular syndrome lasts from several hours to several weeks May occur either as arthralgias and arthritis as Changes in the joints have consequences (ie without organic changes) Leaves no: deformation contracture ankylosis

The symptoms of rheumatoid arthritis diagnostic importance: regional muscles rapid atrophy encounters inflammation, acute phase indicators (SOE. S-protein) RF (Enclosures - Rose reaction lateks- test) Painless, mobile rheumatoid knots The emergence of R-4 logical according to the stage osteoporosis, joints and crack narrows signs and ankiloz internal organs the probability of infestation (pleurisy, gastritis, myocardium, perekardit command amyloidosis, poly serous and others)