DanarTi 32 sarezidento programa `saojaxo medicina~

Teoriuli kursis Sinaarsi, moculoba	Sefasebis meTodebi
tkivilis marTva - Pain Management - tkivilis marTvis taqtikis SemuSavebis ZiriTadi principebis gansazRvra. menejmentis riskfaqtorebi - Risk Management - samedicino sabWoebis federaciis (Federation of State Medical Boards) gaidlainebis ZiriTadi debulebebis gacnoba kontrolirebadi substanciebis gamoyenebis Sesaxeb. saerTaSoriso kvlevebi tkivilis Sesaxeb – Pain Research - 2000 – 2010 wlebi gamocxadebuli tkivilis kvlevis dekadis farglebSi Sesrulebuli kvlevevbis analizi. tkivilis sazogadoebebi – Pain Societies - amerikis tkivilis medicinis sabWos (American Board of Pain Medicine), evropis tkivilis sabWoebis saqmianobebis mimoxilva. uwyveti samedicino ganaTleba – Continuing Medical Education - amerikis tkivilis marTvis akademiis (American Academy of Pain Management) mier mowodebuli specializirebuli saswavlo kursebebis mimoxilva.	zepiri Sefaseba
tkivili, rogorc daavadeba – The Disease of Pain. tkivilis medicina – Pain Medicine. tkivili rogorc socialuri daavadeba - Pain as a Social Disease - tkivilis programebis da funqcionaluri aRdgenis programebis multidisciplinuri midgomis safuZvlebi. biofsiqosocialuri medicina - Biopsychosocial Model biologiuri, fsiqologiuri da socilauri aspeqtebis ganxilva qronikuli tkivilis CamoyalibebaSi.	zepiri Sefaseba
paliaturi mzrunveloba – End of LifeCare - ZiriTadi aspeqtebis ganxilva - cxovrebis xarisxis gaumjobeseba, tkivilis Semsubuqeba, movlaSi fsiqosocilauri da sulieri aspeqtebis CarTva. unarSezRuduloba – Disability - socialuri dazRveva unarSezRudulobis gamo, socialuri dazRvevis indeqsi, muSakTa droebiTi da mudmivi kompensacia da kerZo dazRveva. specialistebTan mimarTva – Specialy Referrals qronikuli tkivilis mqone pacientebis Sefaseba – Evalution of Chronic Pain Patients - pacientis struqturuli dazianebebis molekuluri aspeqtebis analizis saSulebiT mkurnalobis gegmis SemuSaveba	zepiri Sefaseba
tkivilis (periferiuli, centraluri) molekuluri safuZvlebi – Molecular Pain Processes - neirotransmiterebis stimulaciasa da gamoyofis principebi - substancia P, glutamati, dofamini, norepinefrini, serotonini, histamini, acetilqolini da nervis zrdis faqtori (Nerve Growth Factor).	prezentacia
aramedikamentozuri meTodebi – Non Medication Modalites - funqcionaluri aRdgenis programebis (Functional Restoration Programs) mimoxilva. damxmare mkurnaloba – Complementary Treatment - masaJi, akupunqtura, homeopaTia, naturopaTia da moZraobiTi Terapia – gamoyenebis aspeqtebi. fsiqosocialuri meTodebi – Psychosocial Modalities -fsiqologiuri Sefasebis, kognitiuri funqciis da socialuri kavSirebis Seswavlis aspeqtebi.	zepiri Sefaseba
racionaluri farmakoTerapia – Rational Polypharmacology - qronikuli tkivilis mkurnalobisas gamoyenebuli racionaluri farmakoTerapiis principebi - medikamentebis SerCeva, gverdiTi efeqtebis gaTvaliswinebiT. medikamentebis moqmedebis principebi – Medications -opioidebi, neiromodulatorebi, antidepresantebi, koqsibebi, alfa-2 agonistebi, NMDA receptorebis antagonistebi. invaziuri meTodebi – Invasive Modalities - diagnostikuri da Terapiuli blokadebis, nervebis ablaciis, implantaciis da qirurgiul Carevebis Cvenebebis ganxilva.	prezentacia
tkivilis saxeebi: mwvave tkivilis - Acute Pain - samkurnalod gamoyenebuli safexurebrivi midgomis ganxilva. qronikuli tkivilis – Chronic Intratable Pain -klasifikaciis sxvadasxva modelebis gacnoba/ganxilva, mkurnalobis sxvadaxsva meTodebis gamoyenebis gzebi. nociceptiuri tkivilis – Nociceptive Pain -centraluri meqanizmebis modelirebaSi medikamentozuri da aramedikamentozuri Carevebi. neiropaTiuri tkivili – Neuropathic Pain - simptomi, daavadeba, gamomwvevi mizezebi, eqtopia, centraluri sensitizacia. kompleqsuri mkurnalobis meqanizmebis gansazRvris meTodologia. centraluri tkivili - Central Pain - warmoqmnis meqanizmebi, melzekis (Melzak) Teoria (neiromatricis Sesaxeb). mkurnalobis taqtika. nervuli daZabulobiT gamowveuli tkivili - Wind-up Pain - daavadeba Tu simptomi. NMDA receptorebis aqtivaciis roli.	zepiri Sefaseba
tkivilis saxeebi: areklili tkivili – Referred Pain koncefcia, lokalizaciis wyaroebi. ganaxlebadi tkivili - Rebound Pain - warmoqmnis meqanizmebi. informacia samkurnalo preparatebis Terapiuli efeqtisa da dozis Sesaxeb. kompleqsuri regionaluri tkivilis sindromi - Complex Regional Pain Syndrome - tipebi 1 da 2, diagnostikur kriteriumebi. diskis degeneraciuli daavadeba - Degenerative Disc Disease - mwvave da qronikuli formebi, Tanmxlebi procesebi, mkurnalobis SerCevis diferencirebuli midgomebi. Sida diskis naxeTqi - Internal Disc Disruption - medikamentozuri da invaziuri procedurebi- mkurnalobis principebi.	zepiri Sefaseba
tkivilis saxeebi: pulpozuri birTvis Tiaqari – Herniated Nucleus Pulposis - intervertebraluri diskebis Tiaqaris konservatiul RonisZiebebis gacnoba. mcireinvaziuri Carevebi. saxsris arTropaTia – Facet Arthropathy - faceturi arTropaTiT gamowveuli miofasciuri tkivilis sindromi. spondilolistezi – Spondylolistehesis - etiologia, Tandayolili, yelis (isthmic, isthmian), degenraciuli, travmuli, paTologiuri da postqirurgiuli formebi. araqnoiditi – Arachnoiditis - aRwera, warmoqmnis mizezebi, mkurnalobis taqtika. postherpesuli nevralgia - Post Herpetic Neuralgia - periferiuli da centraluri gavrcelebis meqanizmebi. antivirusuli preparatebiT, gabapentiniT da opioiduri preparatebiT mkurnalobis meqanizmebi.	zepiri Sefaseba
tkivilis saxeebi: diabeturi neiropaTia – Diabetic Neuropathy - qvetipebis – Sereuli, simetriuli polineiropaTia, fokaluri/ multifokaluri neiropaTiebis warmoqmnis meqanizmebi. simptomuri mkurnalobis taqtika. tkivili aiv infeqciis dros – HIV Pain - aiv infeqciis dros warmoqmnili nocicepturi, visceraluri da neiropaTiuri tkivilis saxeebis ganxilva. kancerogenuli tkivili – Cancer Releated Pain - intervenciebTan dakavSirebul mwvave da qronikul tkivilis formebi. tkivilis kontrolis meqanizmebi.	zepiri Sefaseba
tkivilis saxeebi: trigeminuli nevralgia – Trigeminal Neuralgia - samwvera nervis nevralgiis (Tic Douloureux) da atipuri saxis tkivilisagan (Atypical Facial Pain) ganmasxvavebeli niSnebi. mkurnalobis sqemebi. Sakiki – migrenozuli tkivili – Migraine Headaches -intrakranialuri an eqstrakranialuri mizeziT warmoqmnili Sakikis formebi. analgeziuri mkurnalobis taqtika. kisris an Tavis uecari moZraobiT gamowveuli travma – Whiplash - paTofiziologia, periferiuli nociceptiuri da neiropaTiur procesebis ganxilva centralur sensitizaciasTan kombinaciaSi. mkurnalobis taqtika.	zepiri Sefaseba
tkivilis saxeebi: arTriti – Arthritis - anTebis sawinaaRmdego preparatebiT da opioidebiT mkurnalobis taqtika. fibromialgia – Fibromyallgia - Tanamedrove kvlevebis hipotezebis mimoxilva. miofascialuri tkivili – Myofascial Pain - botulinis toqsinis ineqciebis gamoyenebis SesaZlobebi.	saboloo zepiri Sefaseba

Tavi III. programis II etapi
muxli 19.
1. sarezidento programis II etapi moicavs klinikaSi rotaciebis 11 ZiriTad da 2 eleqtiur moduls, sul 13 moduls saerTo xangrZlivobiT 17 Tve:

#	modulis dasaxeleba	xangrZlivoba
ZiriTadi modulebi – 15 Tve
1	kardiologia	1 Tve
2	filtvebis daavadebebi da tuberkulozi	1 Tve
3	endokrinologia	1 Tve
4	infeqciuri sneulebebi	1 Tve
5	hematologia	1 Tve
6	paliatiuri medicina	1 Tve
7	gadaudebeli medicina da travma	2 Tve
8	bavSvTa janmrTeloba	3 Tve
9	qalTa janmrTeloba	2 Tve
10	fsiqikuri janmrTeloba	1 Tve
11	narkologia	1 Tve
eleqtiuri modulebi – 2 Tve
12	eleqtiuri moduli 1	1 Tve
13	eleqtiuri moduli 2	1 Tve

2. mzadebis II etapis ZiriTad nawils rezidentebi/maZieblebi mTlianad saavadmyofoSi atareben modulze pasuxismgebeli piris – stacionaris maswavleblis zedamxedvelobiT. perioudlad, sul mcire, TveSi erTxel, rezidenti/maZiebeli xvdeba tutors.

M muxli 20.
1. moduli II.1. modulis dasaxeleba, xangrZlivoba – ,,kardiologia~, 1 Tve.

2. modulis mizani - kardiologiuri daavadebebis marTvis unar-Cvevebs gamomuSaveba pirvelad jandacvaSi.

3. literaturis nusxa:

a) klinikuri praqtikis erovnuli gaidlainebi Sinagani medicinis sferoSi (tkivili gulmkerdis areSi, stabiluri stenokardia, ST segmentis elevaciiT mimdinare infarqti, arastabiluri stenokardia, gulis ukmarisoba, supraventrikuluri ariTmiebis marTva, arteriuli hipertenzia;

b) diagnostikuri Zieba Sinagan sneulebaTa klinikaSi, giorgi qavTaraZe, 2009, `codna~, Tbilisi, saqarTvelo;

g) lipiduri cvlis darRvevebi Sinagan sneulebaTa klinikaSi, daviT kezeli, maia sulaqveliZe, 2010, Tbillisi;

d) HARRISON’S Manual of Medicine, 16th edition, 2005, The McGraw-Hill Companies, Inc. Medical Publishing Division;

e) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

v) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

z) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins;

T) Greenspan's Basic & Clinical Endocrinology, David G. Gardner et al. 8th edition, (Lange Endocrinology), 2007; The McGraw-Hill Companies, Inc.;

i) Williams Hematology. 7th edition, Marshall A. Lichtman et al. 2007; The McGraw-Hill Companies, Inc.;

k) Current Rheumatology, 2nd edition, John B. Imboden et al. 2007; The McGraw-Hill Companies, Inc.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

Teoriuli kursi	profesiuli unar-Cvevebi	Sesasrulebeli manipulaciis raodenoba	Sefasebis meTodebi
arteriuli hipertenzia; gulis iSemiuri (koronaruli) daavadeba (stenokardia, mwvave koronaruli sindromi, gulis gaCereba – `cardiac arrest~); gulis ukmarisoba; ariTmia (eqstrasistolia, winagulebis cimcimi da TrTolva, viwro da farTokompleqsovani taqikardiebi, bradiariTmiebi); gulis sxva daavadebebi (sarqvlovani paTologia, miokardiumis da endokardiumis daavadebebi, Tandayolili anomaliebi); periferiuli sisxlZarRvebis daavadebebi (arteriebis da venebis); cerebrovaskuluri daavadebebi (insulti da gardamavali/tranzitoruli iSemiuri Seteva); Tromboemboliuri daavadeba	detaluri anamnezis Segrovebis unar-Cveva gulsisxlZarRvTa sistemis paTologiis dros; detaluri fizikuri gasinjvis unar-Cveva gulsisxlZarRvTa sistemis paTologiis dros; instr. kvlevis Sedegebis interpretacia: ekg, 24-saaTiani ekg; arteriuli wnevis ambulatoriuli monitorireba; mimoxilviTi rentgenografia; da sxv. lab. kvlevis Sedegebis interpretacia	gatarebuli pacientebi raodenoba – 10; morigeoba – 4; samedicino Canawerebi – 30; ekg gadaReba da interpretacia – 30; iv punqcia da/an kaTeterizacia – 20; iv infuzia – 10	Sesrulebuli samuSao dReebi; morigeobebi; gatarebuli pacientebi; modulze pasuxismgebeli piris Sefaseba; tutoris Sefaseba ukukavSiris sesiis dros

muxli 21.
1. moduli II.2. modulis dasaxeleba, xangrZlivoba – `filtvebis daavadebebi da tubekulozi~, 1 Tve.

2. modulis mizani - filtvebis gavrcelebuli daavadebebisa da tuberkulozis marTvis unar-Cvevebs gamomuSaveba.

3. literaturis nusxa:

a) Treatment of Tuberculosis: Guidelines, 4th edition; 2009; WHO;

b) Guidelines for Programmatic Management of drug-resistant Tuberculosis; 2008; WHO

g) rezistentuli tuberkulozis gaidlaini; 2007; saqarTvelo;

d) International Standarts for Tuberculosis Care; 2006; WHO;

e) tuberkulozis marTvis saerTaSoriso standartebi”; 2008; Targmani;

v) Management of Tuberculosis; A Guide to the Essentials of Good Practice" Sixth edition; 2010; UNION;

z) tomanis tuberkulozi - SemTxvevaTa gamovlena, mkurnaloba, monitoringi; 2005; Targmani;

T) “tuberkulozi - saxelmZRvanelo pirveladi jandacvis muSakebisaTvis”, 2003;

i) “tuberkulozi – saxelmZRvanelo samedicino institutis studentebisaTvis’’ ;

k) diagnostikuri Zieba Sinagan sneulebaTa klinikaSi, giorgi qavTaraZe, 2009, `codna~, Tbilisi, saqarTvelo;

l) HARRISON’S Manual of Medicine, 16th edition, 2005, The McGraw-Hill Companies, Inc. Medical Publishing Division;

m) Current Medical Diagnosis & Treatment 2013, Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

n) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

o) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

Teoriuli kursi	profesiuli unar-Cvevebi	Sesasrulebeli manipulaciis raodenoba	Sefasebis meTodebi
zeda da qveda sasunTqi gzebis infeqciebi, mwvave arainfeqciuri respiratoruli problemebi, qronikuli arainfeqciuri respiratoruli problemebi, filtvis kibo. tuberkulozis epidemiologia tuberkulozTan brolis Tanamedrove strategiis principebi; tuberkulozis gadacemis gzebi, daavadebis risk-faqtorebi; tuberkulozze eWvmitanili pacientis amocnoba da drouli mimarTva tubsawinaaRmdego qselSi; diagnostikis Tanamedrove meTodebi; konsultaciaze mosul pacientebSi tuberkulozze saeWvo niSnebis amocnoba; filtvgareSe tuberkulozis diagnostikis meTodebi; tuberkulozis stacionaruli da ambulatoriuli mkurnalobis meTodebi.	sunTqvis sistemis fizikuri fizikuri gamokvleva; pikfloumetria; inhalatoris gamoyeneba da swavleba sxvebisTvis; spirometris gamoyeneba da misi Sedegebis interpretacia. tuberkulozze saeWvo pacientis fizikuri gamokvleva; naxvelis Segrovebis procedurebi; drouli referali tubsawinaaRmdego qselSi; TanamSromloba zemoaRniSnl qselTan	sunTqvis sistemis fizikuri gasinjva – 30; maT Soris, tuberkulozze saeWvo niSnebis arsebobisas – 15; samedicino Canawerebis warmoeba – 30; naxvelis Segroveba – 10	Sesrulebuli samuSao dReebi; morigeobebi; gatarebuli pacientebi; modulze pasuxismgebeli piris Sefaseba; tutoris Sefaseba ukukavSiris sesiis dros

Mmuxli 22.
1. moduli II.3. modulis dasaxeleba, xangrZlivoba – `endokrinologia~, 1 Tve.

2. modulis mizani - endokrinologiuri daavadebebis marTvis unar-Cvevebs gamomuSaveba pirvelad jandacvaSi;

3. literaturis nusxa:

a) klinikuri praqtikis erovnuli gaidlainebi endokrinuli paTologiis sakiTxebze: Saqriani diabeti, hipoTireozi, metaboluri sindromi, osteoporozi, simsuqne bavSvebSi, simsuqne mozrdilebSi, dislipidemia;

b) diagnostikuri Zieba Sinagan sneulebaTa klinikaSi, giorgi qavTaraZe, 2009, `codna~, Tbilisi, saqarTvelo;

g) lipiduri cvlis darRvevebi Sinagan sneulebaTa klinikaSi, daviT kezeli, maia sulaqveliZe, 2010, Tbilisi;

d) Greenspan's Basic & Clinical Endocrinology, David G. Gardner et al. 8th edition, (Lange Endocrinology), 2007; The McGraw-Hill Companies, Inc;

e) HARRISON’S Manual of Medicine, 16th edition, 2005, The McGraw-Hill Companies, Inc. Medical Publishing Division;

v) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc;

z) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

T) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

Teoriuli kursi	profesiuli unar-Cvevebi	Sesasrulebeli manipulaciis raodenoba	Sefasebis meTodebi
simsuqne; diabeti; glukozisadmi tolerantulobis darRveva; hipoTireozi; hiperTireozi; hiperlipidemia; hiperurikemia; hipofizis, Trikmelzeda jirkvlis da farsiebraxlo jirkvlis dazianebebis drouli amocnoba da referali	detaluri anamnezis Segrovebis unar-Cveva endokrinuli paTologiis dros; detaluri fizikuri gasinjvis unar-Cveva endokrinuli paTologiis dros; instr. kvlevis Sedegebis interpretacia: lab. kvlevis Sedegebis interpretacia	gatarebuli pacientebi raodenoba – 10; samedicino Canawerebi – 30; glukozis eqspres-testi – 20	Sesrulebuli samuSao dReebi; morigeobebi; gatarebuli pacientebi; modulze pasuxismgebeli piris Sefaseba; tutoris Sefaseba ukukavSiris sesiis dros

M muxli 23.
1. moduli II.4 modulis dasaxeleba, xangrZlivoba – `infeqciuri sneulebebi~, 1 Tve.

2. modulis mizani - infeqciuri daavadebebis marTvis unar-Cvevebis gamomuSaveba pirvelad jandacvaSi.

3. literaturis nusxa:

a) klinikuri praqtikis erovnuli gaidlainebi infeqciuri sneulebebis sakiTxebze;

b) diagnostikuri Zieba Sinagan sneulebaTa klinikaSi, giorgi qavTaraZe, 2009, `codna~, Tbilisi, saqarTvelo;

g) HARRISON’S Manual of Medicine, 16th edition, 2005, The McGraw-Hill Companies, Inc. Medical Publishing Division;

d) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

e) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

v) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi

Teoriuli kursi	profesiuli unar-Cvevebi	Sesasrulebeli manipulaciis raodenoba	Sefasebis meTodebi
gastroenteriti; virusuli hepatitebi; aiv infeqcia/Sidsi; cns-is infeqciuri da anTebiTi daavadebebi, meningitis CaTvliT; mwvave infeqciebiT gamowveuli mdgomareobebi, romlebic gadaudebl daxmarebas saWiroeben	detaluri anamnezis Segrovebis unar-Cveva infeqciuri daavadebebis dros; detaluri fizikuri gasinjvis unar-Cveva infeqciuri daavadebebis dros; instr. kvlevis Sedegebis interpretacia: lab. kvlevis Sedegebis interpretacia	gatarebuli pacientebi raodenoba – 10; morigeoba – 4; samedicino Canawerebi – 30; iv punqcia da/an kaTeterizacia – 20; iv infuzia – 15	Sesrulebuli samuSao dReebi; morigeobebi; gatarebuli pacientebi; modulze pasuxismgebeli piris Sefaseba; tutoris Sefaseba ukukavSiris sesiis dros