DanarTi 32 sarezidento programa `saojaxo medicina~



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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 sazogadoebebiPain Societies - amerikis tkivilis medicinis sabWos (American Board of Pain Medicine), evropis tkivilis sabWoebis saqmianobebis mimoxilva.

uwyveti samedicino ganaTlebaContinuing 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 mzrunvelobaEnd of LifeCare - ZiriTadi aspeqtebis ganxilva - cxovrebis xarisxis gaumjobeseba, tkivilis Semsubuqeba, movlaSi fsiqosocilauri da sulieri aspeqtebis CarTva.

unarSezRudulobaDisability - 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 tkivilisChronic Intratable Pain -klasifikaciis sxvadasxva modelebis gacnoba/ganxilva, mkurnalobis sxvadaxsva meTodebis gamoyenebis gzebi.

nociceptiuri tkivilisNociceptive 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 drosHIV Pain - aiv infeqciis dros warmoqmnili nocicepturi, visceraluri da neiropaTiuri tkivilis saxeebis ganxilva.

kancerogenuli tkiviliCancer Releated Pain - intervenciebTan dakavSirebul mwvave da qronikul tkivilis formebi. tkivilis kontrolis meqanizmebi.

zepiri Sefaseba

tkivilis saxeebi: trigeminuli nevralgiaTrigeminal Neuralgia - samwvera nervis nevralgiis (Tic Douloureux) da atipuri saxis tkivilisagan (Atypical Facial Pain) ganmasxvavebeli niSnebi. mkurnalobis sqemebi.

Sakiki – migrenozuli tkiviliMigraine Headaches -intrakranialuri an eqstrakranialuri mizeziT warmoqmnili Sakikis formebi. analgeziuri mkurnalobis taqtika.

kisris an Tavis uecari moZraobiT gamowveuli travmaWhiplash - paTofiziologia, periferiuli nociceptiuri da neiropaTiur procesebis ganxilva centralur sensitizaciasTan kombinaciaSi. mkurnalobis taqtika.

zepiri Sefaseba

tkivilis saxeebi: arTritiArthritis - anTebis sawinaaRmdego preparatebiT da opioidebiT mkurnalobis taqtika. fibromialgiaFibromyallgia - Tanamedrove kvlevebis hipotezebis mimoxilva.

miofascialuri tkiviliMyofascial 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


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