List of questions for Final module control

List of questions for Final module control

Module: General neurology. Special neurology

Content module 1. Introduction. Pathology of sensitive, reflexive and motor functions of the nervous system.

1. History of the neurology development. Domestic and foreign neurological schools. Contemporary trends of the neurological science development.
2. Main stages of phylogenesis and ontogenesis of the nervous system. Structural and functional unit of the nervous system.
3. Basic principles of the nervous system structure and functioning.
4. Main anatomic and topographic branches of the nervous system, their structure and functions.
5. Concept of reception and sensitivity. Pavlov’s studies of analyzers. Anatomy of sensitive analyzer.
6. Sensitivity classification.
7. Peculiarities of the superficial and deep sensitivity fibers movement.
8. Kinds and types of sensitive fibers.
9. Syndromes of the sensitive tracts lesions on different levels.
10. Nociceptive and antinociceptive brain systems.
11. Reflexes. Classification of unconditioned reflexes. Reflex arch, its structure and function. Segmentary and reflex apparatus of the spinal cord and brain stem.
12. Muscular tone. Support and regulation of the muscular tone.
13. Pyramidal system. Peculiarities of its structure. Functions of the pyramidal system.
14. Pathological reflexes, their biogenetic characteristics and role in the nervous system afflictions diagnostics.
15. Clinical characteristic of the central palsies, pathogenesis of their symptoms appearance.
16. Clinical characteristic of the peripheral palsies, pathogenesis of their symptoms appearance.
17. Impairment syndromes of cortico-muscular tract on different levels.
18. Anatomy of extrapyramidal system. Connection of extrapyramidal system with other branches of brain and spinal cord.
19. Physiology of extrapyramidal system. Its role in the provision of unconditioned reflexes, realization of stereotypical automatic movements, readiness of muscles to move.
20. Biochemistry of extrapyramidal system. Contemporary imaginations concerning the exchange and concentration of catecholamines in nigrostriatal system.
21. Syndromes of extrapyramidal system afflictions. Pathogenesis of their symptoms appearance.
22. Basic principles of extrapyramidal afflictions correction.
23. Anatomical and physiological peculiarities of cerebellum. Connections of cerebellum with different branches of brain and spinal cord. Afferent and efferent tracts of cerebellum.
24. The cerebellum functions.
25. Syndromes of the cerebellum afflictions. Kinds of ataxias.

Content module 2. Cranial nerves pathology. Disorders of autonomic nervous system and higher cerebral functions.

1. Anatomy of olfactory and optic analyzers.
   1. Pathology of olfactory analyzer.
   2. Pathology of optic analyzer. Amaurosis, amblyopia, hemianopsia (its kinds). Optic agnosia. Irritation syndromes of optic analyzer cortical part.
   3. Difference between optic tract and cortical hemianopsias.
   4. Fundal changes in case of neurological diseases.
   5. Group of oculomotor nerves. Anatomical and physiological data (nuclei, radixes, nerves).
   6. Pathology of the ІІІ, ІV, VІ pairs of cranial nerves.
   7. Alternating Weber’s and Benedict’s syndromes.
   8. The eye vegetative innervation. Bernar-Gorner’s syndrome.
   9. Argyll Robertson’s (pupil) syndrome.
   10. The look innervation, pathology.
   11. The V, VІІ, VІІІ pairs of cranial nerves (anatomical and physiological data).
   12. The V, VІІ pairs of cranial nerves pathology. Peripheral and central palsies of mimic muscles. Millar-Gubler‘s and Fovill‘s alternating syndromes.
   13. Auditory and vestibular analyzers.
   14. Auditory and vestibular disorders in case of analyzers lesions on different levels. Weber’s and Rinne’s tuning fork tests
   15. Nerves of cerebellopontine angle. Syndrome of cerebellopontine angle impairment.
   16. Bulbar group of cranial nerves (anatomical and physiological data).
   17. Pathology of the ІХ, Х, ХІ, ХІІ pairs of cranial nerves.
   18. Bulbar and pseudobulbar syndromes.
   19. Medulla oblongata alternating syndromes.
   20. Cerebral hemispheres structure. Cyto- and myeloarchitectonics of the cortex.
   21. Localization of functions in the cerebral hemispheres.
   22. Conception of hemispheres functional asymmetry, complementary hemispheres.
   23. The syndromes of impairments and irritation of cerebral hemispheres different parts.
   24. Higher cortical dysfunctions (gnosis, praxis, speech).
   25. Anatomical and physiological peculiarities and functions of the autonomous nervous system.
   26. Non-segmentary part of the autonomous nervous system, its structure, functions, pathology.
   27. Segmentary part of the autonomous nervous system (sympathetic and parasympathetic), structure and functions.
   28. Syndromes of segmentary parasympathetic part of the autonomous nervous system impairments.
   29. Syndromes of segmentary sympathetic part of the autonomous nervous system impairments.
   30. Levels of pelvic functions regulations, their impairments. Neurogenic urination impairments.

Content module 3. Liquor system pathology. Meningeal and hypertensive syndromes. Patient’s management. Additional investigation methods. Cerebral and spinal vascular diseases, neurointoxications. Closed craniocerebral and spinal trauma. Cerebral and spinal tumour. Perinatal nervous system impairments. Children cerebral palsy.

1. Liquor content in normal and pathological conditions. Meningeal and hypertensive syndromes.

2. Main topic neurological syndromes.

3. Consequence of neurological patient’s examination.

4. Conception of topical diagnostics, its substantiation.

5. Principles of differential diagnosing.

6. Requirements for the detailed clinical diagnosis registration.

7. Requirements for the case history writing of a neurological patient.

8. Electrophysiologic, X-ray and ultrasonographic examination methods of neurological patients.

9. Neurovisualizing examination methods of neurological patients.

1. Cerebral and spinal blood supply.
2. Mechanisms of cerebral blood supply autoregulation. Syndromes occurring in reaction damage of cerebral blood supply autoregulation.
3. Classification of cerebral and spinal vascular diseases.
4. Initial manifestations of cerebral blood supply deficiency.
5. Contemporary views on pathogenesis of transient disturbances of cerebral blood circulation. Clinical picture, prevention and treatment of transient disturbances of cerebral blood circulation. Acute hypertonic encephalopathy. Clinical picture, treatment.
6. Slow progressing cerebral and spinal circulation impairments. Clinical manifestations, prevention, treatment.
7. Ischemic stroke, kinds of it; its etiology, pathogenesis, clinical picture, diagnostics, prevention and treatment.
8. Hemorrhagic stroke, kinds of it; its etiology, pathogenesis, clinical picture, diagnostics, prevention and treatment.
9. Anatomical and physiological peculiarities of spinal cord blood supply. Acute and sub-acute spinal circulation impairments.
10. Closed craniocerebral and spinal trauma; pathogenesis, clinical picture, diagnostics and treatment.
11. Cerebral tumours. Classification (topical and pathohistological). Clinical picture, diagnostics, treatment.
12. Spinal cord tumours. Classification, clinical manifestations of extramedullar and intramedullary tumours; diagnostics, treatment.
13. Exogenous neurointoxications. Clinical types, manifestations, diagnostics and treatment. Botulism, food poisoning.
14. The nervous system impairments due to physical factors effect. Vibration disease, radiation impairments of the nervous system.
15. Perinatal and natal nervous system impairments.
16. Children cerebral palsy, etiology, pathogenesis, clinical types, treatment.

Content module 4. Infectious, infectious-allergic, demyelinating, parasitic diseases of nervous system; prion infections, neuroborreliosis. Neurosyphilis, lateral amyotrophic sclerosis. Syringomyelia, Headache, its main types; migraine.

Meningitis, its classification. Ways of meningitis pathogen penetrating into the liquor.

1. Meningeal syndrome and its manifestations (general cerebral symptoms and proper meningeal). Characteristic of syndromes of infectious disease and inflammatory liquor changes in case of meningitis.
2. Etiology, pathogenesis, clinical picture, diagnostics and treatment of meningococcal meningitis.
3. Complications of meningococcal meningitis. Remote consequences of meningococcal meningitis.
4. Etiology, pathogenesis, clinical picture, diagnostics and treatment of secondary pyogenic meningitis (pneumococcal, influenza-meningitis, staphylococcal, streptococcal).
5. Tuberculosis meningitis. Etiology, pathogenesis, peculiarities of clinical picture, diagnostics and treatment.
6. Viral meningitis (enteroviral, parotitic, influenza, herpetic, etc.). Pathogenesis, clinical picture, diagnostics and treatment.
7. Arachnoiditis. Classification, etiology, pathogenesis, peculiarities of course. Clinical picture of cerebral and spinal arachnoiditis. Diagnostics and treatment.
8. Classification of encephalitis. General infectious, general cerebral and focal symptoms of encephalitis. Diagnostics and treatment.
9. Arbovirus infections. Ways of contamination in arbovirus infections. Tick-borne encephalitis. Etiology, pathogenesis, clinical picture, diagnostics and treatment.
10. Economo’s epidemic encephalitis. Etiology, pathogenesis, clinical picture of acute and chronic stages. Clinical types of acute stage.
11. Enteroviral encephalitis. Clinical picture, diagnostics and treatment.
12. Herpetic encephalitis. Pathogenesis, clinical picture, diagnostics and treatment.
13. Influenza virus nervous system affliction. Influenza encephalitis. Pathogenesis, clinical picture, diagnostics and treatment.
14. Brain abscess. Etiology, pathogenesis, clinical picture, diagnostics and treatment.
15. Post-vaccine encephalitis. Pathogenesis, clinical picture, and treatment.
16. Rheumatic encephalitis. Pathogenesis, clinical picture, and treatment.
17. Acute frontal poliomyelitis. Etiology. Pathogenesis, clinical picture of paralytic and non-paralytic poliomyelitis. Prevention and treatment.
18. Myelitis. Etiology, pathogenesis, clinical picture and treatment.
19. Parasitic diseases of nervous system. Etiology, pathogenesis, clinical picture and treatment.
20. Neuroborreliosis (Lime’s disease). Etiology, pathogenesis, clinical picture, prevention and treatment.
21. Impairments of nervous system in case of HIV infection. AIDS-dementia, acute meningoencephalitis, atypical aseptic meningitis, myelopathy, peripheral nervous system impairments. Tumours and cerebral circulation impairments in case of AIDS.
22. Herpetic lesions of the nervous system.
23. Neurosyphilis. Clinical types, diagnostics and treatment.
24. Prion infections. Creutzfelt-Jakob’s disease.
25. Multiple sclerosis pathogenesis. Clinical manifestations, course, stages, diagnostics. Up-to-date methods of multiple sclerosis treatment.
26. Acute multiple encephalitis. Etiology, pathogenesis, clinical picture and treatment.
27. Lateral amyotrophic sclerosis. Pathogenesis, clinical types and treatment.
28. Kinds and nosological types of headache. Etiology, clinical picture, diagnostics. Emergency aid. Migraine, clinical types, diagnostics and treatment. Cluster headache. Tension headache.
29. Syringomyelia. Craniovertabral abnormalities.

Content module 5. Peripheral nervous system diseases, somatoneurologic syndromes. Hereditary degenerative diseases of nervous system, congenital vertebral and spinal defects, syringomyelia. Paroxysmal states in neurology, epilepsy. Case history defense. Drugs used in neurology.

1. Classification of peripheral nervous system diseases.
2. Neuropathy of cranial and spinal nerves. Etiology, pathogenesis, clinical picture and treatment.
3. Compressive – ischemic mononeuropathies in upper and lower extremities.
4. Neuralgias: trigeminal, of pterygopalatine ganglion. Etiology, pathogenesis, clinical picture, diagnostics and treatment.
5. Etiology of polyneuropathies. Clinical manifestations, diagnostics and treatment.
6. Peculiarities of alcohol, diabetic and post-diphtheric polyneuropathies.
7. Vertebrogenous impairments of peripheral nervous system (reflectory, radical, radical-vascular syndromes of cervical, thoracic and lumbar-sacral regions). Clinical manifestations, diagnostics and treatment.
8. Kinds of plexopathies. Etiology and varieties of humeral plexopathies. Clinical manifestations, diagnostics and treatment.
9. Hereditary defects of neuro-muscular apparatus. Primary progressive muscular dystrophies. Clinical manifestations, diagnostics and treatment.
10. Secondary progressive muscular dystrophies. Clinical manifestations, diagnostics and treatment.
11. Myasthenia. Etiology, clinical manifestations, diagnostics and treatment. Myasthenic and cholinergic crises.
12. Hereditary diseases with the impairment of pyramidal, extrapyramidal and coordinating systems:  Strümpell’s paraplegia, Parkinson’s disease, chronic degenerative chorea (Huntington’s chorea), hepatocerebral degeneration, Friedreich’s and  Pierre-Marie’s  ataxias. Clinical picture, diagnostics and treatment.
13. Somatoneurologic syndromes. The nervous system impairments due to the heart, lungs, liver, kidneys and gastrointestinal tract diseases, diabetes mellitus, collagenosis.
14. Main groups of drugs used in neurology.
15. Substantiation of topical and clinical diagnoses in examined patients during his management, the differential diagnostics performance.
16. Substantiation of treatment and recommendations for the examined patient.
17. Epilepsy. Classification of epilepsies and epileptic seizures. Epilepsy diagnostics. Epileptic status. Treatment of epilepsy and epileptic status.
18. Non-epileptic paroxysmal states in neurology. Diagnostics, emergency aid.

List of practical skills and tasks which the students have to achieve during the module study.

General neurology

1. To master the methods of investigating the sensitivity superficial types.
2. To master the methods of investigating the sensitivity deep types.
3. To master the methods of investigating the sensitivity complex types.
4. To determine kind and type of sensitivity impairments.
5. To indicate the syndrome of sensitive impairments.
6. To indicate the level of sensitivity analyzer impairment.
7. To master the methods of investigating the unconditioned reflexes examination.
8. To obtain the skills of determining foot pathological reflexes of extensor group.
   1. To obtain the skills of determining foot pathological reflexes of flexor group.
   2. To obtain the skills of determining oral automatism reflexes.
   3. To obtain the skills of determining the level of reflectory arches lesions.
   4. To master the methods of examining the patient’s motor function.
   5. Taking into account the discovered pathological symptoms to determine the character of muscular paralysis and level of motor neurons lesion.
   6. To master the methods of investigating the patient’s extrapyramidal system, to determine the symptoms of extrapyramidal system impairment.
   7.  Taking into account the discovered pathological symptoms to establish the syndrome of extrapyramidal disorders and level of extrapyramidal system impairment of a patient.
   8. To master the methods of investigating the cerebellum functions.
   9.  To identify the cerebellar disorders, to determine the level of cerebellum impairment; to differentiate the identified ataxia in a patient.
   10. To master the methods of investigating the І, ІІ pairs of cranial nerves functions.
   11. To determine the level of olfactory optic analyzers impairments.
   12. To master the methods of investigating the ІІІ, ІV, VI pairs of cranial nerves functions, and pupil’s reaction.
   13. To reveal the pathology of oculomotor nerves and look paralysis.
   14. To master the methods of investigating the V, VII, VIII pairs of cranial nerves functions, to establish topical diagnosis if there is pathology of these nerves.
   15. To master the methods of investigating the bulbar group nerves, to reveal the symptoms of these nerves impairment.
   16. To reveal the signs of bulbar and pseudobulbar syndromes.
   17. To obtain the skills of examining the higher cerebral functions (gnosis, praxis, speech, reading, writing) in patients.
   18.  To reveal the higher cerebral dysfunctions, symptoms of left and right hemispheres, and cerebral lobes impairments in patients.
   19.  To determine the localization of cerebral cortex impairment taking into account the symptoms of functions “irritation” and “impairment”.
   20. To master the methods of investigating the autonomous nervous system, to be able to diagnose the vegetative impairments and determine the level of the autonomous nervous system afflictions.

Special neurology.

1. To assess the changes of liquor content, to analyze the results of liquordynamics tests.
2. To reveal the signs of meningeal and liquor-hypertensive syndromes.
3. To investigate the meningeal symptoms.
4. To reveal the signs of hydrocephaly.
5. To investigate the Laseg’s, Neri’s, Dejerine’s, Wasserman’s, Маtskevych’s stretch symptoms.
6. To explain the main indices of additional examination methods in neurological practice (electrophysiologic, X-ray, ultrasonographic and neurovisualizing).
7. To be able to examine a patients with neurological pathology on one’s own.
8. To determine the leading neurological syndrome in a patient.
9. To substantiate the topical diagnosis in an examined patient.
10. To make a plan of examination and to analyze the data of patient’s examination additional methods.
11. To establish a provisional clinical diagnosis taking into account the clinical and anamnestic data.
    1. To perform the differentiated diagnostics.
    2. To establish and substantiate the final clinical diagnosis.
    3. To determine the etiology, peculiarities of pathogenesis and disease course, and disease complications in an examined patient.
    4. To make a plan of treatment, substantiate it, and to give recommendations to a patient.
    5. To determine the prognosis of a disease course in a definite patient.
    6.  To fill in a case history of the examined patient during his management.