Medical education

1.What are the requirements for entering a medical university in Ukraine? Speak on EAT.

To enter a medical university applicant should pass external admission testing and only those who
get good results are accepted.

External admission testing which has been recently introduced in Ukraine presents some benefits
for applicants. They may not only demonstrate high efficiency in some subjects but also present
results of admission tests to a couple of universities, which gives applicants a possibility to make a
better choice. As for future medical students they should have high academic achievements in
such subjects as physics or math, chemistry or biology and (of course) Ukrainian language.

2. What is the period of training at Ukrainian higher medical schools? Speak on the module
system and «Steps»
The period of training at most Ukrainian higher medical schools is 5 years to become a pharmacist
or a dentist and 6 years to become a specialist in a great variety of medical specialties.
At the end of the third and the six course medical students pass the Step 1 and Step 2.
Passing the "Step 1" examination students should demonstrate profound knowledge in the
following subjects: medical biology, anatomy (normal and pathological), histology, physiology
(normal and pathological), biochemistry, microbiology and pharmacology.
Passing the "Step 2" examination students demonstrate their professional knowledge in such
clinical subjects as therapy, surgery, gynecology and infectious diseases, ophthalmology, and
other.

3. What is the period of internship in Ukraine?

The period of internship in Ukraine is one to three years and it depends on the chosen medical
career.

4. When and where do medical students have practical training? What do they do during their
practical course?
After the 4th year of studying students must undertake a practical course during which they work
as doctor’s assistants in hospitals. It gives a possibility to learn the importance of good doctor-
patient relationships.

5. Speak on the faculties of our university from 1930 to 2015 History of medicine
In 1930 the first three faculties were organized in the Institute. They were curative, pediatric, and
the faculty of sanitation and hygiene.

In 1993 it was licensed to train students of four specialties: medical, paediatric, stomatological,
and medicoprophylactic.

In 1997 two new faculties were organized at our University: the first in Ukraine military medical
faculty to train doctors for the Armed Forces of our country and a pharmaceutical faculty.

There are 8 faculties at the University now: The First, Second, Third and Fourth Medical,
Pharmaceutical, Stomatological, Medico Psychological and the Faculty for Training Military
Doctors.
 History of medicine

6. What methods of treatment did folk medicine prescribe?

In ancient times people believed that diseases were caused by the evil spirits or due to the anger
of the gods. So the earliest "cures" were prayers and use of magic.

In ancient civilization medical advice came not only from healers, but from the folk wisdom of
many generations. Folk medicine prescribed a dirty sock around the neck if you wanted to cure
the common cold or a pair of shoes placed upside down under the bed to relieve leg cramps.
Tobacco juice was supposed to heal an earache and black pepper to cure asthma. Folklore was
also full of warnings. Amulets were trusted medical devices.

7. Define the term "acupuncture» and describe its action.

Acupuncture is a form of treatment that involves inserting very thin needles through a person's
skin at specific points on the body. It’s been a part of chinese medicine since ancient times and
scientists believe that the needles may stimulate the brain to produce morphine like painkillers
called endorphins and enkephalins.

8. Speak on Hippocrates' contribution into medicine.

Hippocrates, the father of medicine, was born in Greece in 460 (4 hundreds sixty) B.C. He thought
that disease had only natural causes, that it’s symptoms were the reactions of the natural forces of
the body.The famous Hippocratic Oath is named for him.

His medical observations became well-known in the Western world and physicians are still required
to take the Hippocratic Oath and they promise to pay respect for human life and to respect the
confidentiality of the doctor-patient relationship. Hippocrates was the first to separate art and
science of medicine from the practice of religion.

One of the greatest works of Hippocrates was entitled "On Prognostics". This book teaches that
only a physician, who knows how to make an accurate (точный) prognosis, can acquire the
confidence(завоевать доверие) of the patient. Great importance in treatment was attributed to
diet, gymnastics, exercise, massage, sea bathing.

9. Speak on the medicine during Dark Ages, Middle Ages and Renaissance. What medical
discoveries and advances were made in the 19th and the 20th centuries?

The period from 500 A.D. to about 1000 A.D. - Dark Ages, as there was lack (отсутствие) of
progress in the ability of people to understand and control their environment.

During Middle Ages (date from about 500 A.D. to about 1500 A.D.) many hospitals were built in
Europe.
In the middle of the 14th century the bubonic plague killed one-fourth of the European
population.
During the Renaissance, the first accurate textbook on human anatomy was published.
In 1515 the first public dissection (публичное рассечение) of a human cadaver was performed.
In 1545, the first pharmacy was opened in London.
In 1590 the microscope was invented. Laboratory technicians use it regularly to analyze of blood,
urine and tissue. English physician William Harvey discovered how blood circulates in the body and
published the first medical book describing this circulation and the role of the heart.
In 1667, the first blood transfusion was performed.

In the 19th century, modern surgery was made possible by two revolutionary discoveries:
1. the invention of safe methods of anesthesia
2. the control of wound (рановой) infection by the use of antiseptics and sterile equipment

In 1895, Roentgen discovered the X-ray to detect abnormalities (аномалии) inside the body.

The 20th century has brought medical advances in every area of medicine. Openheart surgery has
been developed. Organ transplants are often successful. Vaccines have almost eliminated
(устранили) the threat (угрозу) of poliomyelitis.
The ECG, EEG and CT help physicians to detect heart and brain malfunctions.
Due (благодаря) to early diagnosis and more effective treatment more and more cancer victims
are surviving.
X-ray examination helps to make more accurate diagnosis and more effective treatment. Lasers
become very helpful in surgery.

The human body

10. What are the principal parts of the human body?

The human body consist of three principal parts: the trunk the head and the upper and lower
extremities. The trunk consists of the chest, the abdomen and the back and connected with the
head by the neck. The arms are the upper extremities and the legs form the lower extremities.

11. What are the upper and lower extremities divided into?
• The upper extremities are the arms. The upper extremity is divided into the shoulder (or upper
arm), the forearm and the hand. Between the upper arm and the forearm there is an elbow.
Between the forearm and the hand there is a joint called the wrist. Each hand has five fingers. At
the tips of the fingers there are the fingernails.
• The lower extremities are the legs. The parts lower extremity are the thigh The back of the lower
leg is called the calf. Between the thigh and the lower leg there is a new joint. The joints
between the lower legs and the feet are the ankles. The foot consists of the heel, the sole and
the toes.

12 . Speak on the human head. What are the organs of senses?

The head consists of three parts: the top of head, the front part, and the back part.
The front part of the head is the face. The upper part is composed of the forehead and temples.
The two sides of the lower face are called the cheeks. The two jaws (upper and lower) form the
framework of the mouth. The lower jaw also gives shape to the chin.
The top and the back part of the head are covered with hair.
The organs of the special senses in the face are the eyes, which help us to see; the nose, which
helps us to smell, and the ears, which help us to hear. The eye is set in a bony socket called the
orbit. The eyes are protected by the eyelashes, eyelids and eyebrows. The ear includes three
principal parts: the external ear, the middle ear, and the internal ear. The nose has two openings
called nostrils.

13. Name three main cavities in the body. What are the principal organs in the chest and
abdominal cavity?
Humans have four body cavities: the cranial cavity is situated in the head and contains the brain;
the thoracic cavity that encloses the heart, lungs, air passages, the esophagus and some of the
large blood vessels; the abdominal cavity that encloses most of the digestive organs (the stomach,
the liver, the gall bladder, the spleen and the intestines) and kidneys; and the pelvic cavity is the
lowest part of abdominal cavity that encloses the urinary bladder, the lower part of the intestine
and reproductive organs.
The thorax is separated from the abdomen by a dome-shaped sheet of muscle known as the
diaphragm.

14. What is skeleton and how many bones does it comprise? Speak on the axial and the
appendicular skeleton?
The skeleton is the bony framework of the body supporting the soft tissues and protecting the
vital organs within the skull, rib cage and pelvis. The 206 bones that comprise the adult human
skeleton are usually divided into two parts: the central axial skeleton, consisting of the bones of
the skull, rib cage and the vertebral column, and the appendicular skeleton, consisting of the
bones of the shoulders, arms, hips and legs.
The appendicular skeleton consists of the bones of the extremities, as well as the bones of the
shoulder and hips which attach the bones of the extremities to the axial skeleton. The shoulder is
composed of the clavicle and the scapula. The clavicle, or the collarbone, is a thin bone forming
the front of the shoulder. The scapula, or shoulder blade, is a large flat bone located in the upper
part of the back. The arm contains only one large bone the humerus. The forearm is composed of
two bones, the radius and the ulna. The wrist consists of eight car- pal bones articulating with the
metacarpals of the hand. The finger bones are known as phalanges. The pelvic girdle is composed
of two large hip bones forming the sides and front, and the sacral and coccygeal vertebrae that
form the back. Analogically to the arm, the thigh also contains one bone. It is the femur, the
longest and the heaviest bone of the body. The leg is composed of two bones, the tibia and fibula.
The bones of the ankle are known as the tarsals. Five smaller tarsal bones and five metatarsals
form the remainder of the foot The toes, like the fingers, are composed of 14 bones referred to as
phalanges.
What about the axial skeleton, the skull is made up of the 22 bones. The cranium containing and
protecting the brain consists of 8 bones united by immovable structures called sutures. The bones
of the face include 14 bones of which only the mandible is an independent one. The rib cage
contains 12 pairs of ribs (or 24 ribs). The first seven pairs extend from the vertebral column to the
breastbone. The next 3 pairs are attached with cartilage to the sternum and the two pairs of
floating are unattached in front. The vertebral column serving as the main supporting structure is
composed of a number of separate bones, the vertebrae. The 33 vertebrae can be divided into 5
regions according to where they are found: the 7 cervical vertebrae located in the neck, 12
thoracic vertebrae contained at the back of the chest, 5 lumbar in the small of the back, 5 sacral
and 4 coccygeal fused together to form the sacrum and the coccyx, respectively. The first two
vertebrae are known as the atlas and the axis.

15. Speak on the main systems of the body and their functions. There are the next systems in
our organism.
• The digestive system consists of the mouth, pharynx, esophagus, stomach, intestines, liver, gall
bladder, pancreas. All the organs and glands of this system involved in the ingestion and
digestion of food, from the mouth to the anus.
• Urinary/ excretory system contains kidneys, ureters, urinary bladder, urethra. This system
removes urea and other waste materials from the body in a liquid called urine.
• Respiratory system consists of the nose, pharynx, larynx, trachea, lungs. This system brings
oxygen into the body and removes carbon dioxide.
• Reproductive system contains ovaries, vagina, mammary glands, testes, urethra, penis, prostate
gland. This system enables human beings to have offsprings.
• Endocrine system consists of the thyroid gland , pituitary gland, sex glands, adrenal glands,
pancreas, parathyroid glands, pineal gland, thymus gland. The ductless glands produce internal
secretions.
• Nervous system contains brain, spinal cord, nerves and collections of nerves. This is a system of
nerve cells that handle the functions of reception of and response to stimuli.
• Cardiovascular system consists of the heart and blood vessels ( arteries, veins and capillaries).
This system carries blood to various parts of the body.
• Muscular system consists of the muscles. Skeletal system contains bones and joints. These
systems protects and supports the internal organs and also helps the body move.
• Integumentary system consists of the skin and its associated structures, including hair, nails,
and sweet and sebaceous glands.

16. Name three essential parts of the circulatory system and tell about its function.
The circulatory system, the chief transport system of the body consists of three essential parts: the
blood, the heart and blood vessels. Function of the heart is to pump blood, blood feeds nutrients
to every cell and blood vessels provide blood transport. The function of circulatory system is to
deliver energy and food substances to each cell and to remove waste products of cell metabolism
and carbon dioxide.

17. What is the heart and what does it consist of?

Heart is the main organ of the cardiovascular system. Function of the heart is to pump blood
The human heart consists of four chambers, two atria and two ventricles, each made of several
layers of cardiac muscle arranged in circles and spials. During the contraction phase, called the
systole blood is pumped out of the left ventricle into the aorta and then the arteries which carry
blood to all parts of the body, and out of the right ventricle into the pulmonary artery and then the
lungs. Used blood carrying carbon dioxide is returned to the right atrium through veins to the vena
cava during the diastole or relaxation period and newly oxygenated blood returns from the lungs
to the left atrium. Valves control the flow all blood from one part of the heart to another.

18. Speak on the blood: composition, types of cells and their functions.
The blood is made up of two parts, plasma and blood cells.
Plasma is composed mostly of water and waste substances.
The blood cells are corpuscles and they’re divided into red, white and colourless corpuscles.
Erythrocytes (red corpuscles): contain hemoglobin (the coloured pigment), carry the oxygen to the
organs.
Leukocytes (white corpuscles): function – to protect the organism against infections.
Thrombocytes (platelets, colourless corpuscles): provide blood clotting.

19. What are the organs of alimentary canal and their functions?
The alimentary canal begins at the mouth and ends at the rectum. It consists of:

1. oral cavity
2. esophagus
3. the stomach
4. small & large intestines

Mouth: in the oral cavity the food is chewed or crushed between the teeth, the saliva flows into
the mouth and is mixed with the food to form a bolus, which can be swallowed.

The tongue is pushing it into the upper part of the throat (pharynx) and pass it down through the
esophagus into the stomach.

Stomach: the process of digestion occurs by means of the gastric juices, which are acid and act on
meats. From the stomach the food is passed into the upper end of the small intestine.

Small intestine: food is digested in the duodenum, the first part, which receives bile from liver and
gall bladder, and pancreatic juice from the pancreas. Chyme is passes in peristaltic waves to the
second part, the jejunum. The jejunum connects with the third section, the ileum. Some part of
the food is absorpted into the blood with the structures on the small intestine wall.

Large intestine: Process of digestion ends with the absorption of water. The undigested parts of
the food mixed with the useless remains of the digesting fluids and eliminated from the body.

20. What are the accessory organs? Speak on digestive juices.

The accessory organs of digestive system are an organs that help with digestion but are not parts
of the digestive tract.

1. the tongue
2. hard and soft palates
3. teeth
4. salivary glands
5. pancreas
6. liver
7. gall bladder

The juices which are secreted by the various glands to help in the digestion process are called as
digestive juices.
- The saliva starts the digestion of the starchy parts to maltose.
- The gastric juise acts on meat and digesting proteins in amino acids.
- Pancreatic juice acts on all classes of food continuing the action of saliva and gastric juice.
- Bile from the liver helps in the breaking up of fats to the lipids.
- Intestinal juices completes the digestion of meat food in the intestine.

Hospitals
21. What is the hospital? What are the two main kinds of hospitals? What kind of services do
they provide?
The most familiar health care institution is the hospital. Hospitals provide care for the sick and
injured. There are 2 main types of hospitals:

1. General or community hospital - patients of all ages with all kinds of illness and medical
condition are treated.
2. Specialty hospitals. Some treat patients with chronic illness, such as tuberculosis, requiring
long-term care, or patients of one age group, like children. Specialty hospitals including also
rehabilitation and psychiatric ones.

22. What are the types of hospitals according to means of their financial support?
Hospitals can also be categorized by their means of financial support.

 Public hospitals - hospitals which are operated and financed by the government of their
country/city/state etc.
 Private, non-profit institutions, known as voluntary hospitals – nongovernmental;
their primary mission is to benefit the community in which they are located.
 Proprietary or investor-owned hospitals – owned and financed by individuals, partnerships
or corporations.
23. What are inpatient and outpatient facilities? Why are emergency units important?

Despite hospitals growth in numbers, hospitals cannot provide service for all medical needs or
patients. As a result, many hospitals are developing outpatient facilities.

Inpatient – стационар, леч.учреждение с койками для временного пребывания.

Outpatient – амбулатория, мед.учреждение, которое оказывает помощь пациентам на
приёме либо на дому, но не имеет койко-мест.

Inpatient - patient who stay in the hospital to get constant (постоянное) medical attention.
Outpatient – it’s a person who visits the hospital only when it’s needed. For example, after a
hospital stay, physical or occupational therapy, and psychiatric day-care patients.

The emergency units are so important because they can provide the first aid for critically ill or
injured patients and take them to the hospital for subsequent treatment.

24. Name medical specialties and subspecialties and define each?

Physicians trained in family medicine/general practice or general internal medicine are called
generalists or primary care physicians (PCPs), while those dealing with non-primary care are
called specialists. The common medical specialists include anaesthesiologists, cardiologists, family
medicine doctors, neurologists, obstetricians and gynaecologists, ophthalmologists (eye doctors),
pathologists, paediatricians, radiologists and others.
25. What kinds of nurses do you know? What are their professional qualifications?

Nurses constitute the largest group of health care professionals. There are two types of
nurses. Registered nurses must complete an associate's degree (2-3 years, offered by community
and junior colleges), a diploma program (2-3 years, offered by hospitals) or a baccalaureate degree
(4-5 years, offered by colleges and universities). Licensed practical nurses must complete a state-
approved program in practical nursing and a national written examination.

Taking a history

26. What are the components of clinical examination? Why does history-taking come first?
A clinical examination has three components: the history, the examination, and the explanation,
where the doctor discusses the nature of the clinical findings. Taking a patient's history comes first
because it may give valuable information about the nature of the patient's problem and provide
the necessary clues to help the doctor establish a preliminary or differential diagnosis. It could be
visual inspection, palpation, percussion, and auscultation.

27 . Define taking a history process. What is its main aim?

Taking a patient's history is the initial part of clinical examination and its main aim is to find out the
patient's present problem and how it affects the quality of their life. The history is a review of the
patient's current state of health and past medical condition.
History of presenting complaint. The main symptoms should be clearly defined as soon as
possible, to find out the cause of admission or seeking medical advice. The onset, severity,
progression, associated features or symptoms are all important. A special focus is also made on
pains associated or not with specific organs.
1. History of present illness. The patient is requested to give an account of recent events in
their own words which in this way may be recorded in the history sheet.
2. Systemic enquiry also known as the review of systems. The history is taken of the main
symptoms of the major bodily systems.
3. Past medical history. Patients are asked about their previous medical/surgical diseases.
4. Drug history and allergies. Information is obtained on any medication prescribed, self-
administered drugs.
5. Family history provides information about any predisposition to disease, and relevant
information on relatives.
6. Social history. Information is collected about the patient's occupational, social, personal
factors, such as habits, employment, housing, interests, sports, hobbies, physical exercise, the use
of alcohol, tobacco, recreational drugs.

28. What are the components of a patient’s history?

The history-taking process is a well established and commonly used sequence:
- History of presenting complaint
- History of present illness
- Systemic enquiry
 -Past medical history
-Drug history
-Family history
-Social history
There are some recommendations for the effective doctor-patient communication:
Show the patient your attention.
Start by eliciting the presenting complaint.
Let the patient tell story in their own words.
Try not to interrupt.
Use the language which the patient understands.
Summarize the story for the patient to check, correct and add more relevant details.
Obtain the patient's history also from other sources of information.

29. What body systems are reviewed during examination and what symptoms are they
associated with?
The history is taken of the main symptoms of the major bodily systems:
• General: mood, fatigue, anorexia, fever, night sweats, rashes(висипи), heat/ cold intolerance.
(непереносимість жари/холоду)
• Cardiovascular system (CVS): chest pain, palpitations.
• Respiratory system (RS): shortness wheeze, haemoptysis(кровохаркання).
• Gastrointestinal system (GS): nausea, vomiting, indigestion, abdominal pain, heartburn, change
in bowel habit(запор) , dyspepsia.
• Genitourinary system (GUS): nocturia(нічне сечовипускання), frequency,
incontinence(нетримання сечі), change in color/smell of urine, menstrual difficulties.
• Central nervous system (CNS): headaches, weakness, dizziness, fits, faints, vertigo.

Surgery

30. What is surgery? What does it deal with and what methods does it use?
Surgery is a branch of medicine, which treats diseases, injuries, deformities and other pathological
conditions by methods which involve opening, manipulating and repairing a part of body. It applies
different manual interventions such amputation, excision, incision, stretching, resection and other.

31. What are the main controlling factors in surgery? Define them.

The main controlling factors in surgery are anaesthesia and asepsis.

Anaesthesia is used to avoid shock in a patient and to make him insensitive to pain. It is produced
by anaesthetic drugs.

Asepsis is a complex of measures (меры) used to prevent introduction of microorganisms into the
wound. Everything which comes into contact with the wound must be carefully germ-free.

32. What is anaesthesia? What are its main types? Speak on them.
There are different types of general anesthesia:
General anaesthesia resulting in amnesia with a loss of protective airways reflection.
Also analgesia and muscle relaxation can be present.
Regional anaesthesia is a loss of pain sensation in certain regions of the body. It is administered
with local anaesthesia to peripheral nerve bundles.
Spinal anaesthesia: it is regional block resulting from a small volume of local anaesthetics being
injected into spinal canal( between th 4th and 5th lumbar vertebrae, because the spinal cord stops
at the 1st lumbar vertebrae). It is used for surgery of the abdomen, lower back and legs.
Epidural anaesthesia: injection of a large volume of local anaesthetic into the epidural space.
(injection around the spinal canal)
Local anaesthesia is similar to regional anaesthesia, but exerts(надає) it effect on a smaller area of
the body.it is used for medical examination, diagnoses, minor surgical and dental procedures.

Я не думаю, що це потрібно але на всякий случай:

Complications after anaesthesia:
It can occur under general anaesthesia. They include loss of blood pressure, irregular heart beat,
heart attack, vomiting and sometimes it can lead to coma and death.

33. What should the surgical nurse prepare? What are the methods of surgical
instruments sterilization?
Nurses should prepare surgical instruments sterilizing them in special machines: autoclaves
and sterilizers.

The methods of sterilization include :

• boiling
• low or high pressure steam sterilization
• cold sterilization by strong antiseptics.

Also the surgical nurse should prepare the necessary set of surgical instruments, prepare the
apparatuses for blood transfusion, check up the presence of blood substituting solutions and
preserved blood.
Surgical nurses also help surgeon during the operation.

34. What are the required procedures to prepare the patient for an operation?
What are the postoperative procedures?

• He shouldn’t eat or drink anything for twelve hours before the operation to avoid
complication of anaesthesia.
• A patient is often given an enema before the operation to empty the colon frow wastes.
• The area to be operated is thoroughly, shaved and painted with a solution of iodine.
• The patient is put on a operation table, covered with a sterilized cloth and administered
narcosis.

After the operation the patient is under special care and attention, his wound is frequently
carefully bandaged. The surgeon prescribes the patient proper post operative treatment.

35. What instruments and equipment are used during the operation?

• high intensity lights

• anaesthesia machine
• vacuum machines to suck out the excessive blood and other fluids from the part of the body
which is operated.

The main instrument table is covered with a large collection of scalpels, forceps, suture needles,
retractors, scissors, a hammer and so on.

Medical emergency

36. What is a medical emergency? Give examples of medical emergency cases? Define
them.

A medical emergency - an injury or illness that is acute and poses an immediate risk to a person's
life or health.

One of the most serious emergencies occurs when the person has stopped breathing. This may be
the result of asphyxiation, electrocution, drowning, a heart attack or another type of accident.
Artificial respiration must be started immediately.

The second most critical emergency is severe bleeding, especially from a main artery.

A condition which accompanies many medical emergencies is circulatory shock, commonly known
simply as shock. It is a serious, life-threatening medical condition in which the victim's bodily
tissues do not receive enough oxygenated blood.

Another serious emergency situation occurs when a poisonous substance is swallowed. This
usually happens in a household where a child swallows any chemical household product
(ammonia, bleach or even shampoo), or takes an overdose of medicine.

Poisoning is a condition when a person swallows a toxic substance or takes on overdose of

medicine.

37. What is the ABC of the first aid? Name its key points.

Different natural and man made disasters and such as floods, earthquakes, hurricanes, crowds,
traffic accidents, gas or nuclear explosions, fire, result in emergency situation and great number of
victims who urgently need first aid.

The key aims of first aid can be summarized in three key "P" points: TO PRESERVE LIFE, TO
PREVENT FURTHER HARM and TO PROMOTE RECOVERY.

The ABC of the first aid refers to the assessment of person's Airways, Breathing and Circulation.

38. What is CPR? Describe its aspects.

CPR – or Cardiopulmonary Resuscitation (рэсюситейшн) – is an emergency lifesaving

procedure performed when the heart stops beating.
 Immediate CPR can double or triple chances of survival after cardiac arrest. The
cardiopulmonary resuscitation (CPR) of a victim in these instances involves two aspects:

1) getting oxygen into the blood by blowing air into the lungs
2) heart massage – application of chest pressure to compress the heart and squeeze blood out
of it into the circulatory system.

39. What is circulatory shock? What are its signs? What are the basic recommendations for
managing it? What can it result in?

Shock - it’s a serious, life-threatening medical condition in which the victim's bodily tissues do not
receive enough oxygenated blood.

The main types of shock include:

• Cardiogenic shock (due to heart problems)
• Hypovolemic shock (caused by too little blood volume)
• Anaphylactic shock (caused by allergic reaction)
• Septic shock (due to infections)
• Neurogenic shock (caused by damage to the nervous system)

Signs of shock:
- tachycardia/tachypnoea
- hypotension
- signs of poor organ perfusion (such as low urine output, confusion or loss of consciousness)
- nausea, vomiting or diarrhea

The victim should be put supine with feet raised. No food or drink should be given. Any bleeding
should be controlled and the victim should be kept warm and comfortable until professional
assistance arrives. Shock may lead to hypoxia (a lack of oxygen in blood) or cardiac arrest (the
heart stopping).

????What types of circulatory shock do you know? How to classify the severity of
shock??????
1. Hypovolemic shock. This shock based on insufficient circulating volume. Its primary cause is
loss of fluid from the circulation. Causes may include internal bleeding, traumatic bleeding etc.
2. Cardiogenic shock. This type of shock is caused by the failure of the heart to pump
effectively.
3. Distributive shock. As in hypovolemic shock there is an insufficient intravascular volume of
blood. Examples of this form of shock are:
 Septic shock. It caused by an overwhelming systemic infection resulting vasodilation
leading to hypotension.
 Anaphylactic shock. It caused by a severe anaphylactic reaction to an allergen, antigen,
drug or foreign protein causing the release of histamine which causes widespread
vasodilation, leading to hypotension and increased capillary permeability. • Neurogenic
 shock. It caused by trauma to the spinal cord resulting in the sudden loss of autonomic and
motor reflexes below the injury level.
4. Obstructive shock. In this situation the flow of blood is obstructed which impedes circulation
and can result in circulatory arrest.
The severity of shock can be graded 1-4, based on the physical signs. This approximates to the
effective loss of blood volume.
Grade 1. Up to about 15 % loss of effective blood volume.
Grade 2. Between 15-30% loss of blood volume.
Grade 3. At 30-40 % loss of effective blood volume.
Grade 4. At 40-50 % loss of effective blood volume.

40. What is a first aid kit? What should it contain and what for?
A first aid kit is a collection of equipment that is used to give medical treatment.

Any first aid kit should contain:

- sterile cotton wool
- adhesive bandages and gauze pads for cleaning wounds
- saline for cleaning wounds or washing out foreign bodies from the eyes
- antiseptic wipes or sprays to reduce the risk of infection in abrasions or around the wounds.

Simple medications:
- aspirin
- painkillers
- antihistamines
- activated charcoal
- emetics to induce vomiting, - tranquilizers
- smelling salts .........

There should be some medications for topical application:

- antiseptic ointment, fluid, or spray, iodine or brilliant green solution, burn gel or spray, mild
anesthetic and others

A more elaborate kit might also contain :

- forceps
- disposable syringes
- hypodermic needles
- a stethoscope for measuring the heartbeat or listening to the lungs
- a hemomanometer
- tracheotomy
- suture kits
- supplies of dextrose, plasma and saline solutions

41. What is the first aid for suspected poisoning? What is the first aid for bleeding?

Serious emergency situation occurs when a poisonous substance is swallowed. First of all it is
necessary try to find this poisonous substance and read its instruction. The antidote for each
substance is different; thus, instructions on the container should be followed strictly. In some
cases, the victim should be forced to vomit or even gastric lavage in hospital may be needed.
The second most critical emergency is severe bleeding, especially from a main artery. It can
usually be stopped with direct pressure above the place of bleeding. If a vein bleeds, the extremity
must be elevated.

Injuries

42.What is trauma? What are the possible causes and outcomes of trauma?

Trauma is a physical wound or injury, such as a fracture or blow.

The causes can be different: heavy blow, traffic accidents, falling, home accident, etc.

The outcomes of injuries include: circulatory shock, respiratory failure, osteoparosis, blood clots
formation, bone cancer, etc.

43. What are the most serious injuries and their warning signs? How should a patient be
treated?

If the skull is fractured or a victim suffers concussion from a heavy blow, the brain can be
irreversibly (непоправимо) damaged.

Warning signs of damaged include unconsciousness, excessive sleepiness, drowsiness, vomiting,

several headaches, bleeding, paralysis and irregular breathing.

No sedatives, alcohol or pain medications should be given. Food and fluids should be kept at a
minimum.

44. Define the types of fractures. What is first aid in case of fracture?

There are many different types of fractures: closed, open, complete, incomplete, comminuted,
impacted, displaced etc.

 A closed fracture bone fragments don’t pierce the skin.

 In open fracture bone fragments pierce the skin.
 Comminuted one is an injury, when the bone has be broken into many pieces.
 Impacted fracture is an injury when bone fragments are driven into each other.
 Incomplete (common for children) is a crack in the bone tissue.

It is neccesory to fix the damaged area or patient, to put a temporary splint (временная шина)
until medical attention is available. We can use a wooden stick or rolles newspapers for a splint.
Painkillers are also recommended.

45. What is sprain and strain? What are the causes, symptoms and treatment? How to
differentiate them from fractures?
A strain (разрыв) is an injury to a muscle or tendon in which the muscle fibres tear as a result of
overstretching, sharp movements or heavy lifting. The most frequent causes are sudden, sharp
movements or heavy lifting.

A sprain (растяжение связок) a more serious injury of a joint caused by a forcible twisting, with
damage to the surrounding blood vessels, nerves and mainly ligaments.

The symptoms include swelling, painful muscle spasm, severe pain stiffness, bruising. People can`t
walk or step on the injured part.

!!!!It`s necessary to do the x-ray to differentiate them from fractures!!!!!!

46. What soft tissues injuries do you know? Define them.

A bruise is usually the result of contusion that causes blood vessels to break with the resulting
bleeding into tissues.

An abrasion is the scraping of the skin surface.

Lacerations are cuts in tissue in which the skin is opened. These are usually minor injuries and
wounds that do not require serious medical intervention and heal on their own without
treatment.
Deep lacerations can damage nerves and large blood vessels. Smaller cuts do not require stitches.

47. What methods of drug administration do you know?

I know such ways of administration as:

- oral
- sublingual
- rectal
- parenteral
- inhalation
- topical

The route used to give a drug depends on three main factors:

1. the part of the body being treated
2. the way the drug works within the body
3. formula of the drug.

48. What is the difference between oral and sublingual ways of drug administration?

The difference between oral and sublingual ways of administration is that the route of the first one
is by mouth, so person should swallow it and then, after passing the stomach, drugs absorb into
the bloodstream through the intestinal wall, while in the route of the sublingual administration
drugs are not swallowed, just placed under the tongue and dissolve in saliva.
Also, oral administration provides slower action of a medication.

49. What are the ways of parenteral administration? Special the usual locations for each of
them?

Types of parenteral injections that i know are subcutaneous, intramuscular, intravenous,

intradermal, intrathecal and intracavitary injections.

• Subcutaneous injection, which is also called a hypodermic injection, is given under the several
layers of the skin (it is usually the outer surface of the arm and anterior surface of the skin).
• Intrathecal administration is a route of administration for drugs like an injection into the spinal
canal, or into the subarachnoid space so that it reaches the cerebrospinal fluid.
• Intramuscular injection is the injection of a substance directly into muscle.
• Intradermal injection is a shallow injection which is made into the upper layers of the skin.
• Intravenous injection is given directly into the veins.
• Intracavitary injection is made into a body cavity.

50. What diseases can be treated by inhalation? What forms of drugs are used for inhalation?
By inhalation can be relieved conditions like cystic fibrosis, asthma and chronic bronchitis.
Inhalation is also relief for the vocal cords (голосовые связки).

Usually aerosols are administered by inhalation so vapors or gases are taken into the nose or
mouth are absorbed into the bloodstream through the thin walls of the air sacs in the lungs.