რეზიდენტურის პროგრამა ბავშვთა ......3. saswavlo programa 11 3.1. zogadi pediatriis saswavlo kursi 11 3.2. saswavlo kursi pediatriul

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რეზიდენტურის პროგრამა ბავშვთა

ნევროლოგიაში

sarCevi

gv.

1. Sesavali 2 1.1. definicia 2 1.2. saswavlo programis miznebi 4

2. saswavlo programis Sinaarsi 6 2.1. pediatriuli nevrologiis Teoriuli codna 6 2.2. pediatriuli nevrologiiT gaTvaliswinebuli

unar-Cvevebi 9

3. saswavlo programa 11 3.1. zogadi pediatriis saswavlo kursi 11 3.2. saswavlo kursi pediatriul nevrologiaSi 23

a. ZiriTadi modulebi 23 b. specialuri sferoebi 69 g. kvleviTi treiningi 69

4. pedagogebi 70 5. saswavlo baza 70 6. swavleba 72 7. Sefaseba/gamocda 73 8. kurikulumis marTva 85

1. Sesavali

pediatriuli nevrologia evropaSi ukve 50 welze metia rac calke dargad arsebobs. bavSvTa nevrologebis umetesoba gadamzadebuli pediatrebia, xolo zogierT qveyanaSi specializacias bavSvTa nevrologiaSi gadian mozrdilTa nevrologebi.

mimdinare programa asaxavs rezidenturis samwlian saswavlo kurss pediatriul nevrologiaSi. igi regularulad (yovel sam weliwadSi) unda ganicdides gadaxedvasa da adaptacias.

1.1 pediatriuli nevrologia - definicia

pediatriuli nevrologia warmoadgens samedicino disciplinas, romelic moicavs centraluri nervuli sistemisa da periferiuli nerv-kunTovani sistemis rogorc normalur, aseve anomaliur ganviTarebas mucladyofnis periodidan mozrdilobis asakamde. igi moicavs aRniSnuli sistemebis

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daavadebaTa diagnostikas, mkurnalobas, kvleviT muSaobasa da Semdgomi unarSezRudulobis srulfasovan marTvas.

bavSvTa nevrologiis rezidenturis momzadebis programis kurikulumi unda moicavdes eqimis trenirebas da swavlebas damoukidebeli muSaobisaTvis bavSvTa nevrologiaSi. am momzadebiT rezidentma unda SeiZinos kompetenciebi qvemoTCamoTvlil eqvsive sferoSi:

1. pacientis movla:

anamnezis srulyofili Segroveba

pacientis srulyofili nevrologiuri gasijva

nevrologiuri niSnebis lokalizaciis dadgenis srulyofileba

hospitalSi mosaTavsebeli pacientis diagnozis maRali sizuste

hospitalSi moTavsebuli pacientis xarjTefeqturi marTva rogorc farmakologiuri, aseve arafarmakologiuri mkurnalobis meTodebiT

nevrologiuri da sxva samedicino problemebis amocnoba da prioritetebis mixedviT ranJireba

teqnikuri unarebis - mag.: lumbaluri punqciis warmoebis - srulyofa

nevrologiuri pacientis xangrZlivi movlis srulfasovani da xarjTefeqturi dagegmva

samedicino da qirurgiuli Carevebis nevrologiuri garTulebebis prevencia, amocnoba da drouli marTva

hospitaluri movlis gaumjobeseba

pacientis movlis aseTi kisnormebis dacva da gulisxmieri damokidebuleba

2. samedicino codna:

bazisuri nevrologiuri codnis gaumjobeseba

codnis gaRrmaveba gadaudebeli stacionirebis saWiroebebismqone nevrologiuri daavadebebis Sesaxeb, rogoricaamiasTenia, gafantuli sklerozis gamwvaveba, gilen-bares sindromi, mwvave gulyra an epilefsiuri statusi, Sakikis statusi, meningiti/encefaliti, pediatriuli insulti da sxva

xSirinevrologiuridaavadebebisSefasebisadadiagnostikisgaumjobeseba

laboratoriulidadiagnostikuriteqnologiebiscodna, amteqnologiebisusafrTxo, efeqturidaekonomikurigamoyeneba

daavadebisaTumkurnalobismosalodneligarTulebebisdrouliamocnobisadamarTvisunari

pacientisdaavadebasTandakavSirebulisamedicinoinformaciisadasamecnieromtkicebulebebiskritikuliSefasebisunari

3. interpersonuli da komunikaciuri unar-Cvevebi:

pacientebsa da maT ojaxebTan efeqturi komunikaciis unari, rac moicavs pacientis da misi ojaxis wevrebis mosmenas da gagebas, kulturuli da religiuri Taviseburebebis gaTvaliswinebas da daZlevas,

kolegebTan efeqturi komunikacia rogorc zepiri, aseve werilobiTi

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pacientis yvela momvlelTan da qronikul marTvaSi CarTul personalTan efeqturi komunikacia

pacientis Sesaxeb informaciis mkafiod gadmocemis unari rogorc zepiri Sefasebisas, aseve werilobiT

kolegebisa da studentebis efeqturi swavlebis unari

4. praqtikaze dafuZnebuli swavleba da gaumjobeseba:

pediatriuli nevrologiuri daavadebis mqone hospitalizebul pacientTa daavadebis Sesaxeb sakuTari codnisa da unarebis deficitisa da susti mxareebis amocnoba da maT gaumjobesebaze muSaoba

pacientis movlis gasaumjobeseblad mecnieruli da praqtikuli literaturidan Tanamedrove informaciis mopoveba

praqtikuli muSaobis gasaumjobeseblad da Sesafaseblad Sesabamisi sistemebis Seswavla, maT Soris pacientis mxridan Sefaseba da gamosavlis analizi

samedicino literaturis kritikuli Sefasebis unari

codnis gaumjobesebis zogadi da individualuri strategiis SemuSaveba

5. profesionalizmi:

gamoavlinos pativiscema, TanagrZnoba, erTianoba pacientsa da mis ojaxTan

iyos gulisxmieri da pativi sces pacientis asaks, kulturul Rirebulebebs, sqess, religiur mrwamss

daicvas eTikuri principebi, pacientis konfidencialurobis ufleba da aseve informirebuli Tanxmobis aucilebloba

profesiuli muSaobis procesSi iyos punqtualuri, sando, Tanmimdevruli, hqondes damoukidebeli swavlis da profesiuli ganviTarebis unari

pativi sces ufrosebs, kolegebs, studentebs da samedicino gundis yvela wevrs

6. sistemaze dafuZnebuli praqtika:

jandacvis mTeli sitemis muSaobis codna, maT Soris im praqtikuli gaidlainebisa da resursebisa, rac gaaumjobesebs pacientis cxovrebis xarisxs da gavlenas moaxdens pacientis movlis yvela aspeqtze

icnobdes da iyenebdes multidisciplinuri, gunduri midgomis principebs qronikuli pacientebis marTvis procesSi

saukeTeso movlis gamxorcielebisaTvis samedicino gundis sxva wevrebTan axorcielebdes efeqtur kolaboracias

pacientis movlis procesSi iyenebdes mxolod mtkicebulebebze dafuZnebul, xarjTefeqtur strategiebs

aanalizebdes pacientis qronikuli movlis Soreul zegavlenas mis socialur-ekonomikur statusze

pacientis individualuri finansuri SezRudvebis pirobebSi xelmisawvdomi resursebis efeqturi gamoyeneba

jandacvis arsebuli sistemis farglebSi praqtikuli medicinis samarTlebrivi sakiTxebis codna.

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1.2 saswavlo programis miznebi

nevrologiuri darRvevebis mqone bavSvTa marTvis gaumjobeseba; bavSvTa janmrTelobisa da keTildReobis uzrunvelsayofi yvela samedicino servisisa da masSi monawile samedicino personalis mxardaWera

bavSvTa nevrologTa saTanado umaRlesi ganaTlebisaTvis aucilebeli Teoriuli codnisa da praqtikuli unar-Cvevebis standartebis dadgena

pediatriul nevrologiaSi kvleviTi muSaobis ganviTareba da xelSewyoba

pediatriul nevrologiaSi sxvadasxva qveynis saswavlo programebis harmonizacia da evropaSi bavSvTa nevrologiis maRali profesiuli standartebis mxardaWera

2. saswavlo programis Sinaarsi

pediatriul nevrologiaSi eqimTa specializacia moicavs sxvadasxva etapebs:

bavSvTa nervuli sistemis normaluri da anomaliuri funqcionirebis bazisuri codna

bavSvTa da mozardTa asakis nevrologiur paTologiaTa farTo speqtris klinikuri Sefasebis uSualo gamocdileba

saswavlo kursis Catareba srulad aRWurvil ganyofilebaSi, romelic Tavis mxriv mudmivad imyofeba maregulirebeli sabWos meTvalyureobis qveS

mocemul bazaze zogierTi specifikuri aRWurvilobisa da gamocdilebis uzrunvelyofis SeuZleblobis SemTxvevaSi sxva hospitalSi individualuri trening-programis ganxorcielebis uzrunvelyofa

pediatriul nevrologiaSi praqtikuli moRvaweobisas warmoqmnili fsiqosocialuri da multidisciplinuri aspeqtebis saswavlo programaSi gaTvaliswineba

kvleviTi muSaobis araaucileblobis miuxedavad rezidentisTviskvleviTi muSaobiswarmoebis uzrunvelyofa

2.1. pediatriuli nevrologiis Teoriuli codna

a. pediatriuli nevrologiis bazisuri sferoebi

normaluri ganviTarebis Sesaxeb detaluri informacia da anomaliuri ganviTarebis ZiriTadi aspeqtebi

tvinis antenataluri ganviTarebis ZiriTadi principebi, rogorc normaluri, ise anomaliuri

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neonataluri nevrologia: mwvave da qronikuli,neonatalur periodSi manifestirebuli nevrologiuri daavadebebi

Semdegi mdgomareobebis epidemiologia, etiologia, paTogenezi, klinika, mkurnaloba da gamosavali:

a. bavSvobis asakis nevrologiuri daavadebebi, maT Soris metaboluri genezis

b. ganviTarebis Seferxeba (mentaluri retardacia), daswavlis siZneleebi da swavlis specifikuri gaZneleba, metyvelebisa da komunikaciis kompleqsuri darRvevebi

g. genetikuri da unarSezRudulobis gamomwvevi nevrologiuri mdgomareobebi bavSvTa asakSi

bavSvobis asakis gavrcelebuli qceviTi darRvevebis arsi da manifestacia, maT Soris autisturi speqtris darRvevebis, yuradRebis deficitis/hiperaqtivobis, depresiis, SfoTvis, mozardTa fsiqozis da anorexia nervosa-s

gadaudebeli mdgomareobebi bavSvTa nevrologiaSi. mag.: epilefsiuri statusi an koma

neiroqirurgiuli daavadebebi bavSvTa asakSi, maT Soris cerebrospinaluri siTxis normaluri cirkulaciis darRveviT mimdinare darRvevebi

nevrologiur daavadebaTa urTierTkavSiri sxva organoTa sistemebis funqcionirebasTan, maT Soris zrdasa da kvebasTan, kvebis gaZnelebasTan, gastro-ezofagur refluqsTan da aspiraciasTan

pediatriuli orTopedia, orTozebis gamoyenebisa da bioinJineriis klinikuri aspeqtebi

genetikuri aspeqtebi, rogoricaa genealogiuri xis Sedgena, ganmeorebis riski, prenataluri diagnostika, genebis lokalizacia, impritingi da molekuluri genetikis principebi

profilaqtika pediatriul nevrologiaSi (ubedur SemTxvevaTa prevencia, fsiqoaqtiur medikamentTa moxmareba, imunizaciis programebi)

bavSvTa dacvis samarTlebrivi sakiTxebi

b. diagnostikuri saSualebebi

nevrologiuri darRvevebis prenataluri diagnostika

bavSvTa nevrologiuri daavadebebis bioqimiuri da neirometaboluri kvlevebi

bavSvTa nevrologiuri daavadebebis genetikuri da imunologiuri kvlevebis meTodologia

qsovilTa biofsia, histologiuri anomaliebis interpretacia

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neiroradiologia, nevropaTologia da klinikuri neirofiziologia, iseve rogorc nervuli sistemis funqcionirebisa da intrakraniuli wnevis monitoringisaTvis saWiro teqnologiebi

saTanado fsiqologiuri testebi da Sedegebis interpretaciis unari

funqcionirebis, unarSezRudulobisa da davadebaTa saerTaSoriso klasifikaciebi

g. mkurnaloba

yvela saxis nevrologiuri daRvevis mtkicebiTi mkurnalobis gegma da ganviTarebadi meTodebi

neirofarmakologia

neirounarSezRudulobis mqone bavSvTa reabilitaciis principebi

qceviTi darRvevebis marTvis principebi, farmakoTerapia, konsultacia da fsiqoTerapia

mkurnalobisa da reabilitaciis procesSi gamoyenebuli saSualebebi, smenisa da mxedvelobis daqveiTebis dros damxare saSualebebi, sayrdeni da mobilurobis gasaumjobesebeli, komunikaciis damxmare saSualebebi, kompiuteri, orTozebi, damxmare ventilacia da a.S.

kvebis da gastrointestinuri aspeqtebi

alternatiuli da aratradiciuli mkurnalobis meTodika da maTi SesaZlo gamosavali

d. multidisciplinuri marTva

nevrologiur darRvevaTa da unarSezRudulobis gunduri marTvisas bavSvTa nevrologis pasuxismgebloba, maT Soris fizikuri, okupaciuri da metyvelebis Terapevtebis, fsiqoTerapevtis, eqTnis, dietologis, fsiqologis, pedagogisa da socialuri muSakis

sxva medikosTa da paramedikosTa mier gamoyenebadi meTodebi

nevrologiuri darRvevebis mqone bavSvTa sazogadoebrivi marTva

nevrologiuri darRvevebis mqone bavSvTa swavla

mkurnaloba bavSvTa asakidan mozrdilTa servisze gardamaval etapze

e. socialuri movla

qveyanaSi dadgenili socialuri servisebi/daxmareba

v. eTikuri aspeqtebi

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klinikuri pediatriuli nevrologiis eTikuri aspeqtebi myari unarSezRudulobis da progresuli mdgomareobebis, maT Soris prenataluri diagnostikis sakiTxebi, sasicocxlo funqciebis SemanarCunebeli movla

bavSvTa asakSi kvleviTi saqmianobis warmoebis eTikuri aspeqtebi; informirebuli Tanxmoba

klinikuri kvlevebis CatarebisaTvis aucilebeli eTikis sakiTxebi da Tanxmobis miRebis uzrunvelyofa

bavSvTa dacvis Sesaxeb gaerTianebuli erebis organizaciis konvencia da qveyanaSi moqmedi sxva sakanonmdeblo aqtebi

o saqarTvelos kanoni “janmrTelobis dacvis Sesaxeb” o saqarTvelos kanoni “saeqimo saqmianobis Sesaxab” o saqarTvelos kanoni “pacientis uflebebis Sesaxeb”

2.2.pediatriuli nevrologiiT gaTvaliswinebuli unar-Cvevebi a. klinikuri unar-Cvevebi

samedicino istoriis adekvaturi warmoeba

nebismieri asakis (0-dan 18 wlamde asakis) bavSvisa da mozardis klinikuri gasinjva da ganviTarebis Sefaseba

klinikuri kvleva da analizi, romelic moicavs normalur da anomaliur ganviTarebas, TamaSs, motorul unarebs

saTanado diagnostikuri saSualebebis gamoyeneba pacientis klinikuri mdgomareobis interpretaciisaTvis, saTanado daskvnebis gamotana da saWiro mkurnalobis dagegmva

smenisa da mxedvelobis Sefaseba

sikvdilis faqtis konstantirebisaTvis nevrologiuri kriteriumebis gamoyeneba

kritikuli mdgomareobebis dros marTvis koordinacia: gadaudebeli nevrologiuri mdgomareobebis marTva da multisistemuri daavadebebis nevrologiuri aspeqtebi

SesaZlo nevrologiuri darRvevebis mqone pacientTa da maTi ojaxis wevrebis mimarT adekvaturi da efeqturi midgoma, maTi emociuri mdgomareobis Sefaseba. rTuli informaciis gadacemis saTanadod uzrunvelyofa, konsultirebis procesis saWiroebisamebr uzrunvelyofa, ufro gamocdili da/an sxva fsiqologis daxmarebis saWiroebis droulad gansazRvra

sxva pediatriuli konsultaciis uzrunvelyofa

b. akademiuri unar-Cvevebi literaturis mimoxilvisa da miRebuli klinikuri Sedegebis

kritikuli Sefaseba

xelnawerTa momzadeba

zepiri prezentaciebis momzadeba

aqtiuri kvleva an kvlevis mxardaWera

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formaluri da araformaluri pedagogiuri muSaoba studentebsa da dabali kursis rezidentebTan

3. saswavlo programa aRniSnuli programis gasavlelad saWiro periodi moicavs 3 wels. erTi mniSvnelovani etapi moicavs zogad pediatrias (erTi weli), romelsac mosdevs saswavlo kursi pediatriul nevrologiaSi (ori weli).

dasawyisi Cveulebriv moicavs ganacxadis Setanas vakantur adgilze, romelic gamocxaddeba qveynis masStabiT da dadgenili wesiT.

saswavlo kursi Sedgeba Semdegi komponentebis kombinaciisagan:

1. pacientTa klinikuri marTva zedamxedvelobis qveS

2. saswavlo programa, Semdgari leqcia-seminarebisagan

3. mecadineobebiaraformaluri klinikuri da samuSao Sexvedrebis saxiT

4. qveynis SigniT da saerTaSoriso masStabis treningebi

5. biblioTekaSi muSaoba

3.1 zogadi pediatriis saswavlo kursi pediatriis kursi gulisxmobs swavlebis erT wels, rac aucileblad unda iTvaliswinebdes neonatologias, gadaudebeli da intensiuri Terapiis modulebs.

swavlebam unda moicvas rogorc stacionaruli, aseve ambulatoruli pacientebi da pacientebis aqtiuri movla.

pediatriuli nevrologiis momzadebis I weli – pediatria moicavs Semdeg modulebs:

1. zogadpediatriuli stacionari – 5 Tve 2. samSobiaro bloki/axalSobilTa ganyofileba – 1 Tve 3. neonataluri stacionari – 1 Tve 4. bavSvTa gadaudebeli daxmareba – 2 Tve 5. bavSvTa reanimacia da intensiuri Terapia – 2Tve

3.1.1. moduli zogadpediatriuli stacionari

modulis xangrZlioba: 5 Tve

modulis mizani: Seaswavlos rezidents hospitalizebuli pacientis

damoukideblad gasinjva, mdgomareobis simZimis Sefaseba, wamyvani klinikuri sindromis gamovlena, diferencialuri diagnozi da marTva.

modulis amocanebi:

1. პედიატრიული სტაციონარის სტრუქტურა და მუშაობის პრინციპები.

2. პედიატრიული ისტორია.

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3. პედიატრიული პაციენტის გასინჯვის ტექნიკა: ინსპექცია, პალპაცია, პერკუსია,

აუსკულტაცია. შეფასებასისტემებისმიხედვით. კლინიკურიანალიზი.

დიფერენციალურიდიაგნოზი. გამოკვლევისგეგმისდასახვა. მკურნალობისშერჩევა.

4. სასუნთქისისტემისანატომიურ-ფიზიოლოგიურითავისებურებებიბავშვთაასაკში.

დაზიანებისსემიოტიკა.

5. გულ-სისხლძარღვთასისტემისანატომიურ-

ფიზიოლოგიურითავისებურებებიბავშვთაასაკში. დაზიანებისსემიოტიკა.

6. კუჭ-ნაწლავთასისტემისანატომიურ-ფიზიოლოგიურითავისებურებებიბავშვთაასაკში.


7. შარდ-სასქესოსისტემისანატომიურ-ფიზიოლოგიურითავისებურებებიბავშვთაასაკში.


8. ნერვული სისტემის ანატომიურ-ფიზიოლოგიური თავისებურებები ბავშვთა ასაკში.

დაზიანების სემიოტიკა.

9. კანის, კანქვეშა ქსოვილების, ლიმფური ჯირკვლების ანატომიურ-ფიზიოლოგიური

თავისებურებები ბავშვთა ასაკში. დაზიანების სემიოტიკა.

10. ძვალ-სახსროვანი სისტემის ანატომიურ-ფიზიოლოგიური თავისებურებები ბავშვთა

ასაკში. დაზიანების სემიოტიკა.

11. ლაბორატორიული კვლევის მეთოდები: კლინიკური, ბაქტერიოლოგიური,

სეროლოგიური, ბიოქიმიური. შედეგების ინტერპრეტაცია.

12. ინსტრუმენტულიკვლევისმეთოდები: რადიოლოგიური, სონოგრაფიული,

ენდოსკოპიური, კომპიუტერულიტომოგრაფია, მაგნიტურ-რეზონანსულიკვლევა.

შედეგების ინტერპრეტაცია.

13. ბიოფსია. მორფოლოგიური კვლევა.

14. წამყვანიკლინიკურისიმპტომებისდიფერენციალურიდიაგნოზი. ცხელება.

ცხელებალოკალურისიმპტომატიკისგარეშე. უცნობიეტიოლოგიისცხელება. გამონაყარი.

ლიმფადენოპათია. მუცლის ტკივილი.ღებინებისა და წამოქაფების

სინდრომი.სტრიდორი.მსტვენავი

ხიხინი.ხველა.ციანოზი.შუილი.ართრიტი.ანემია.კრუნჩხვა.ჰემატურია.სიყვითლე.თავის

ტკივილი.დიარეა. ყაბზობა.მენინგიალური სინდრომი. რაქიტი და რაქიტისმაგვარი

დაავადებები.კვების ქრონიკული მოშლა. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba:

# profesiuli unar-Cvevebi raod. davaleba

1. pediatriuli pacientis anamnezis Sekreba, damoukideblad gasinjva da Sefaseba

50 rezidentmaunda daweros TveSi erTi referati, sasurvelia gaakeTos prezentacia an moxseneba rezidentTa konferenciisaTvis

modulisSefasebaxdebaxelmZRvanelismieryoveliTvis bolos zepiri

2. sunTqvis sixSiris daTvla da Sefaseba 50

3. guliscemis sixSiris daTvla da Sefaseba 50

4. arteriuliwnevisgasinjvadaSefasebaasakobrivWrilSi 30

5. xaxis daTvaliereba 50

6. Termometria (aqsilaruli, reqtaluri, oraluri) 20

7. kuWis amorecxva 10

8. gamwmendi oyna, hipertonuli oyna 10

9. kunTSi da venaSi ineqcia, venaSi infuzia 30

10. inhalacia 20

10

11. reqtaluri (TiTiT gasinjva) 5 gasaubrebis gziT da modulis bolos testuri CaTvlis da unar-Cvevebis aTvisebis donis SemowmebisgziT

12. xaxis nacxis aReba 10

13. sisxlis jgufis da rezusis gansazRvra 5

14. sisxlis, Sardis, ganavlis mikroskopuli kvleva 15

15. hematokritis gansazRvra 15

16. kvebiTi statusis Sefaseba 20

3.1.2. samSobiaro bloki/axalSobilTa ganyofileba


modulis mizani: aswavlos rezidents fiziologiuri axalSobilis marTva samSobiaro saxlSi, pirveladi reanimaciis principebi samSobiaro blokSi, dedebis konsultireba movlis da kvebis meTodebTan dakavSirebiT.

modulis amocanebi:

1. nayofis antenataluri ganviTareba. teratogenuli faqtorebis gavlenanayofze antenataluri ganviTarebis sxvadasxva periodSi.

2. maRali riskis orsulebi da axalSobilebi:

dedis mwvave da qronikuli daavadebebi. diabetiT daavadebuli dedis axalSobili. alkoholuri embriofetopaTia. teratogenuli medikamentebi.

damZimebuli sameano anamnezi. oligo, polihidramniozi. tyupidan tyupze transfuziis sindromi. hestozebi. sanayofe garsebis mTlianobis naadrevi darRveva / mSrali mSobiaroba.placentis paTologia. naadrevi aSreveba. placentis winamdebareoba.

3. axalSobilTa hestaciuri asaki. drouli, dRenakli axalSobili, axalSobilivadagadasuli orsulobidan. hestaciur asakTan SedarebiT mcire masis, Zalian mcire masis, didi masis axalSobili.

4. axalSobilTa asfiqsia. axalSobilTa reanimacia samSobiaro blokSi.apgaris Skala. asfiqsiis adreuli da Soreuli garTulebebi.

5. axalSobilTa respiraciuli distres-sindromi. mizezebi. manifestacia.mkurnalobisa da prifilaqtikis meTodebi. surfaqtantis gamoyenebis perspeqtivebi.

6. samSobiaro travma. samSobiaro simsivne. cefalohematoma. sisxlCaqcevakoniuqtivaSi da retinaSi. zurgis tvinis dazianebis semiotika. intrakranialurihemoragia. mxris wnulis, diafragmis, qalas nervebis dazianebis niSnebi.motexilobebi. visceruli organoebis travma.

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7. axalSobilTa pirveladi tualeti da rutinuli movla.koniuqtivitisa

da hemoragiuli sindromis profilaqtika.vitaminiKK.axalSobilTa Termoregulacia. gadacivebis niSnebi dagarTulebebi.

8. axalSobilTa siyviTle.

9. axalSobilTa imunizacia samSobiaro saxlSi.

10. axalSobilTa skriningi metabolur daavadebebze.

11. parafiziologiuri mdgomareobebi.

Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba:

modulis gavlis Semdeg

rezidents unda

SeeZlos

profesiuli unar-Cvevebi

(minimaluri odenobis miTiTebiT)

davaleba

axalSobilis gasinjva

hestaciuriasakisgansazRvra _10

upiroborefleqsebisSemowmeba- 10

rezidentmaundadawerosTveSierTireferati, sasurveliagaakeTosprezentaciaanmoxsenebarezidentTakonferenciisaTvis

modulisSefasebaxdebaxelmZRvanelismieryoveliTvisboloszepirigasaubrebisgziTdamodulisbolostesturiCaTvlisdaunar-CvevebisaTvisebisdonisSemowmebisgziT.

axalSobilis piris da cxviris sanacia baloniT an eleqtroamomwoviT

axalSobilis piris da cxviris sanacia baloniT an eleqtroamomwoviT _ 5

ABCD reanimaciis principebi, daxmarebis gaweva neonatologisTvis axalSobilTa reanimaciis procesSi

12

sunTqvis daTvla, guliscemis daTvla, kanis feris Sefaseba, centraluri da periferiuli cianozis diferencireba. apgaris SkaliT Sefaseba

sunTqvis daTvla _ 10

guliscemis daTvla _ 10

xaxis sanacia _ 5

apgaris SkaliT Sefaseba. _ 10

gulis xelovnuri masaJis, niRbiT da tomriT ventilaciis da oqsigenoTerapiis principebi da reJimi. am RonisZiebebis gatareba eqim-reanimatologis meTvalyureobis qveS

gulis xelovnuri masaJi _ 2

niRbiT da tomriT ventilacia _ 2

oqsigenoTerapia _ 5

Wipis takvis damuSaveba

Wipis takvis damuSaveba _ 5

Tvalebis damuSaveba

Tvalebis damuSaveba _ 5

axalSobilis awona da gazomva

axalSobilis awona da gazomva_ 10

pirveli kvebis ritualis Catareba

saubari dedasTan ZuZuTi kvebis mniSvnelo

konsultaciis gaweva ZuZuTu kvebis teqnikis, reJimis, xangrZliobis

13

bis Sesaxeb qalisa da bavSvis janmrTelobisaTvis.

Sesaxeb_ 10

vaqcinacia samSobiaroSi. .

BCG da B-hepatitis sawinaaRmdego vaqcinacia _ 5

3.1.3. neonataluri stacionari


modulis mizani: Seaswavlos rezidents axalSobilTa uxSiresi daavadebebis amocnoba da marTvis principebi hospitalis pirobebSi, sicocxlisaTvis saSiSi mdgomareobebis gamovlena da gadaudebeli daxmareba.

modulis amocanebi:

1. axalSobilTa kanis daavadebebi.

Tandayolili: teleangieqtazia. hemangioma. melanozi. ixtiozi. bulozuri epidermolizi. dune kanis sindromi. elers-danlosis sindromi.

SeZenili arainfeqciuri daavadebebi: gamoyelva. ixtiozi. adiponekrozi. sklerema. skleredema.seboreuli dermatiti.

SeZenili infeqciuri daavadebebi: stafilokokuri vezikulo-pustulozi. pemfigusi. riteris eqsfoliatiuri dermatiti figneris fsevdofurunkulozi. streptodermia. mastiti .nekrozuli flegmona.

2. respiraciuli darRvevebi da daavadebebi.

axalSobilTa respiraciuli distres_sindromi. klinika. marTva.garTulebebi (emfizema, pnevmomediastinumi, pnevmoToraqsi, bronqopulmonuri displazia,dRenaklTa retinopaTia).

axalSobilTa tranzitoruli taqipnoe.filtvis pirveladi hipertenzia. apnoe. axalSobilTa pnevmonia.

3. hematologiuri darRvevebi

hemolizuri daavadeba (jgufis, rezus SeuTavsebloba). klinikuri variantebi da marTva. sisxlis SenacvlebiTi Terapiis Cvenebebi. fotoTerapia.posthemoragiuli anemia (mwvave, qronikuli). hemoragiuli daavadeba. policitemia

4. axalSobilTa hiperbilirubinemia.laboratoriuli evaluacia da marTva.bilirubinuli encefalopaTia

5. axalSobilTa sefsisi (adreuli, gviani)

14

6. metaboluri darRvevebi. hipoglikemia. hipokalciemia.

7. wylulovan-nekrozuli enterokoliti

8. Rebinebisa da wamoqafebis sindromi

9. perinataluri infeqciuri daavadebebi.

10. axalSobilTa krunCxva.

11. centraluri nervuli sistemis paTologia. posthipoqsiuri encefalopaTia. intrakranialuri hemoragia. meningiti.


modulis gavlis Semdeg rezidents unda SeeZlos


(minimaluri

odenobis

miTiTebiT)

davaleba

axalSobilis gasinjva. wamyvani sindromis gamoyofa da diferencialuri diagnozi

hestaciuri askis Sefaseba _ 10



axalSobilTahemolizuridaavadebisdiagnostikadamarTva

infuzuri Terapia _ 10

perinataluriimfeqciebzesaeWvoaxalSobilebisamocnoba

nazogastraluri zondis Cadgma _ 5

axalSobilTa siyviTlis diferencialuri diagnozi

fotoTerapia _ 3

sefsisis diagnostika da marTva

parenteraluri kveba _ 5

15

axalSobilTa krunCxvis marTva

neirosonoskopia. Sedegebis interpretacia _ 5

meningitis diagnostika lumburi punqcia _ 2

antibiotikoTerapiis empiriuli SerCeva sefsisisa, meningitis, wylulovan-nekrozuli kolitis da sxva infeqciuri daavadebebis dros wamyvani infeqciuri agentebis gaTvaliswinebiT

kuWis amorecxva _ 5

gamwmendi oyna. _ 5

samedicino dokumentaciis gaformeba

perinataluri da neonataluri sikvdilobis analizi

3.1.4. bavSvTa gadaudebeli daxmareba


modulis mizani:Seaswavlos rezidents avadmyofis gadaudebeli samedicino daxmareba prehospitalur etapze

modulis amocanebi:

1. gadaudebeli daxmarebis organizacia pediatriaSi. Etapurobisprincipi.daxmareba binaze, ambulatoriaSi, gadaudebeli daxmarebis departamentSi, reanimaciul ganyofilebaSi.

2. bavSvTa letalobis mizezebi.

3. pediatriuli travma, rogorc bavSvTa sikvdilobis wamyvani mizezi.

4. prehospitaluri daxmarebis principebi pediatriuli tramvis dros

(swrafi Sefaseba ABCD principiT, imobilizacia, transportireba). pediatriuli tramvis Skala.

5. pediatriuli tramvis principebi gadaudebeli daxmarebis

departamentSi. pirveladi Sefaseba ABCD principiT modifikaciiT travmaze. triaJi anu avadmyofTa skriningi gadaudebeli daxmarebis gawevis rigiTobis gansazRvris mizniT. reanimacia. ganmeorebiT Sefaseba. postreanimaciuri monitoringi. reabilitacia.

16

6. Tavis tramva. qalasSida sisxlCaqceva. tvinis Seryeva. daJeJiloba.

mentaluri statusis swrafi Sefaseba AVPU Skalis safuZvelze.

7. zurgis tvinis tramva. imobilizaciis principebi.

8. gulmkerdis travma. pnevmoToraqsi.

9. muclis travma (Ria, daxuruli)

10. elenTis, RviZlis, Tirkmlis, pankreasis travma.

11. damwvroba. damwvrobis simZimis Sefaseba siRrmis ,farTis, lokalizaciis mixedviT. dazianebuli zedapiris farTis gamoTvla. marTva.

13. Wriloba. Wrilobis damuSavebis principebi.

14. motexilobebi.

15. nakbenebi (ZaRli, kata, morieli, gveli, oboba, futkari).

16. ucxo sxeulis aspiracia. pirveladi daxmareba CvilebSi, erT welze meti asakis bavSvebSi ( heimlikis meTodi ), ugono mdgomareobaSi myof bavSvebSi. ucxo sxeulis eqstraqcia stacionaris pirobebSi.

17. mowamvlebi. (medikamenturi, sayofacxovrebo, qimiuri nivTierebebiT, SxamebiT, sokoTi).

18. hiperTermiuli sindromi. febriluri gulyra.

19. muclis mwvave tkivili. (naRvlis kolika, Tirkmlis kolika, mwvave muceli)



profesiuli unar-Cvevebi (minimaluri odenobis

miTiTebiT)

davaleba

gadaudebelimdgomareobisSefaseba, adekvaturistrategiisSemuSaveba

periferiulivenebispunqciadakaTeterizacia _ 15 arteriuliwnevisgasinjva. asakobrivimaCveneblebisgamoTvla _ 10


mentaluri statusis swrafi Sefaseba

pediatriuli travmis Skalis mixedviT Sefaseba _ 10

Tavis tramvis marTva pirveladi daxmareba krunCxvis dros _ 5

zurgis tvinis tramvis marTva lumburi punqcia _ 3

gulmkerdis travmis marTva plevris punqcia _ 2

17

muclis travmis marTva peritonealuri punqcia _ 2

Sardis buStis kaTeterizacia _ 3


pirveli daxmareba damwvrobis dros

Wrilobis damuSaveba.

motexilobebis marTva

Wrilobis pirveladi damuSaveba _ 3

imobilizacia _ 3

mowamvlebis marTva kuWisamorecxva _ 5

gamwmendioyna _ 5 hipertonulioyna _ 5

dehitrataciisxarisxisgansazRvra. rehidrataciisprincipebi. rehidrataciis ”a,” “b”, “g” gegmebi _infuzuriTerapiisdagegmvawyal-marilovanicvlisdaregulirebismizniTdeficitis, mimdinaredanakargebis, sadReRamisomoTxovnilebisdajamebissafuZvelze _ 20

3.1.5. bavSvTa reanimacia da intensiuri daxmareba


modulis mizani: kritikuli mdgomareobebis diagnostireba, poliorganuli ukmarisobis sindromuli mkurnaloba

modulis amocanebi:

1.reanimaciuli ganyofilebis organizacia da muSaobis principebi.

2. kardio-pulmonuri funqciis swrafi Sefaseba A(sasunTqi

gzebisgamavloba),B(sunTqva), C(cirkulacia) midgomis safuZvelze kritikuli mdgomareobebis dros.

3. mdgomareobebi, romlebic moiTxoven gadaudebel Carevas:kardiopulmonuri aresti.kardiuopulmonuri ukmarisoba.respiraciuli distresi/respiraciuli ukmarisoba.Soki

4.sunTqvis ukmarisoba. mizezebi, klinikuri da laboratoriuli niSnebi. marTva.

5. Soki. Sokis tipebi. gamomwvevi niSnebi. klinikuri niSnebi. marTva.

6. koma. glazgos komis Skala. glazgos Skalis modifikacia CvilebisaTvis. mizezebi. marTva.

18

7. gadaudebeli daxmareba pulmonologiaSi.mwvave laringotraqeiti.epiglotiti.bronquli asTmis Seteva, asTmuri statusi.filtvis SeSupeba.bronqis ucxo sxeuli.pnevmoToraqsi, piopnevmoToraqsi.

8. gadaudebeli daxmareba kardiologoaSi.gulis ukmarisoba.mwvave sisxlZarRvovani ukmarisoba (kolafsi,Soki).gulis ritmis darRveva (paroqsizmuli taqikardia, mocimcime ariTmia, morgan-adam-atoqsis sindromi).hipertonuli krizi.

9. gadaudebeli daxmareba gastroenterologiaSi.sisxldena kuW-nawlavis traqtidan.RviZlis ukmarisoba.hepato-renuli ukmarisoba. portuli hipertenzia.

10. gadaudebeli daxmareba nefrologiaSi.mwvave oligo/anuria (prerenuli, renuli, postrenuli).Tirkmlis ukmarisoba.hemolitiko-uremiuli sindromi.hemasorbcia. hemodializi.

11. gadaudebeli daxmareba endokrinologiaSi.Tirkmelzeda jirkvlis mwvave ukmarisoba.diabeturi koma.hipoglikemiuri koma.

12. gadaudebeli daxmareba hematologiaSi.sisxldena. hemostazis principebi.sisxlZarRvSida Sededebis sindromi.

13. gadaudebeli daxmareba nevrologiaSi.meningialuri sindromi.encefaluri reaqcia. krunCxva. krunCxviTi statusi.

14. gadaudebeli daxmareba infeqciuri daavadebebis dros.sefsisuri Soki. dehidratacia/eqsikozi. hiperTermiuli sindromi.

15. mwvave alergiuli reaqciebi. anafilaqsiuri Soki. kvinkes SeSupeba.urtikaria. Sratismieri daavadeba.




(minimaluri odenobis miTiTebiT)

davaleba

bavSvismdgomareobissimZimisSefaseba, reanimaciuliRonisZiebebisaucileblobisdasabuTeba, adeqvaturistrategiisSemuSaveba

centraluri venebis punqcia da kaTeterizacia _ 10

rezidentma unda daweros TveSi erTi referati, sasurvelia gaakeTos prezentacia an moxseneba rezidentTa konferenciisaTvis

modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT dbolos testuri CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.

sunTqvis ukmarisobis diagnostika da marTva

lumburi punqcia. punqtatis mikroskopia. mikroskopuli, bioqimiuri da baqteriologiuri kvlevis Sedegebis interpretacia _ 5

Sokis diagnostika da marTva traqeis intubacia _ 3

19

komis diagnostika da marTva filtvebis meqanikuri ventilacia niRbiT da tomriT _ 5

zeda sasunTqi gzebis obstruqciiT mimdinare

daavadebebis marTva

filtvis xelovnuri ventilacia _ 2

ucxo sxeuli sasunTq gzebSi. traqeobronquli sanacia _ 5

mwvave alergiuli reaqciebis marTva

oqsigenoTerapia _ 5

kolafsi, gulis riTmis darRveva

arteriuligazebisdamJava-tutovaniwonasworobismonacemebisSefaseba _ 10

sisxldena. sisxlZarRvSida Sededebis sindromi.

parenteraluri kveba _ 10

dehidratacia / eqsikozi. infuzuriTerapiawyal-marilovanicvlis, mJava-tutovaniwonasworobis, hematokritiskoregirebismizniT _ 20

krunCxviTi sindromi lumburi punqcia _ 3

20

3.2 saswavlo kursi pediatriul nevrologiaSi swavlebis miznebi da safuZvlebi:

1. sruli nevrologiuri istoriis da yvela asakis bavSvisa da mozardis gasinjvis warmoebis unari

2. nevrologiuri niSnebis anatomiuri lokalizaciis gansazRvrisa da misi praqtikaSi gamoyenebis unari

qveda da zeda motoneironis dazianebis diferencireba (tonusis garCeva Zalisagan, spastikis definicia)

saxis nervis centraluri da periferiuli dazianebis garCeva

sensoruli deficitis diferencireba dazianebis donis mixedviT (radikulopaTia, neiropaTia, pleqsopaTia da sxva)

komaSi myofi pacientis gasinjvisas diferencireba: a. decerebraciisa da dekortikaciis b. gugebis paTologiis c. okulo-vestibuluri refleqsis Catareba/Sefaseba d. herniaciuli sindromebis codna

3. sxvadasxvanevrologiurdaavadebaTakardinalurigamovlinebiscodnadaamcodnisdemonstrirebisunari, maTSoris:

epilefsia

Tavis tkivili

Secvlili cnobierebis mdgomareobebi/travma

nervulisistemisinfeqciuridapostinfeqciuridaavadebebi

genetikuri/metaboluri daavadebebi

moZraobiTi aSlilobebi

nerv-kunTovani daavadebei

neiroganviTarebiTi daavadebebi

neirokutaneuli daavadebebi

malformaciebi

sxva paTologiebi

a. ZiriTadi modulebi struqtura warmodgenilia ori ZiriTadi nawiliT mwvave pediatriuli nevrologia da neiroreabilitacia. mwvave pediatriuli nevrologia Tavis mxriv Sedgeba savaldebulo modulebisgan, romelTagan TiToeuli gulisxmobs sagangebo bazas da unar-Cvevebs.

mwvave pediatriuli nevrologia rezidenti muSaobs sertificirebul specialistTan. aRniSnuli periodis ganmavlobaSi iTvisebs saTanado codnas nevrologiuri daavadebebis mqone Cvilebis, bavSvebisa da mozardebis diagnostikisa da marTvis procesSi. uSualod monawileobs pacientTa marTvaSi axalSobilTa da intensiuri Terapiis ganyofilebebSi. modulma unda moicvas neiroqirurgiuli Carevis saWiroebis mqone pacientTa marTvac. modulis farglebSi rezidenti unda daeswros kvleviT Sexvedrebs (radiologiur, genetikur, paTomorfologiur da neirofiziologiurs), rac klinikuri marTvis aucilebel nawils warmoadgens. mwvave pediatriuli nevrologiis xangrZlivoba moicavs minimum 15 Tves.

21

unarSezRuduloba–neiroreabilitacia rezidenti muSaobs sertificirebul/akreditirebulbavSvTa nevrologiur/reabilitaciis centrSi, romelic moicavs multidisciplinur gunds umaRlesi samedicino personalis paralelurad fsiqologis,okupaciuri Terapevtis, da sxva specialistebisSemadgenlobiT. rezidenti eufleba unarSezRudulobis mqone yvela asakis bavSvTa diagnostikasa da marTvas. minimaluri xangrZlivoba 5 Tve.

SeniSvna: mwvave da unarSezRudulobis modulebi erTad unda Seadgendes sul 20 Tves. SesaZlebelia maTi integracia. gaTvaliswinebulia rom specialistebis nawili SesaZloa fokusirdes mwvave nevrologiaze da am modulze gansazRvros 18 Tve, xolo sxva fokusirdes neirounarSezRudulobaze. pediatriuli nevrologiis modulebi (20 Tve):

1) pacientis nevrologiuri Sefaseba – 1 Tve 2) Tavis tkivili – 1 Tve 3) intrakraniuli hipertenzia, koma da Tavis tvinis sikvdili – 1 Tve 4) epilefsia, araepilefsiuri paroqsizmebi da Zilis darRvevebi – 2 Tve 5) nervuli sistemis infeqciebi – 1 Tve 6) nervulisistemissimsivneebi, malformaciebidasisxlZarRvovanidarRvevebi

– 1Tve 7) ataqsia da moZraobiTi darRvevebi – 1 Tve 8) nervulisistemisdazianebiTmimdinaregenetikuridametaboluridarRvevebi –

1 Tve 9) Tavisa da zurgis tvinis travmuli da anoqsiuri dazianebebi – 1 Tve 10) neiroganviTarebiTi darRvevebi – 1 Tve 11) neiroqceviTi darRvevebi – 1 Tve 12) nerv-kunTovani daavadebebi – 1 Tve 13) avtonomiurinervulisistemis,

neiroendokrinulidasistemuridaavadebebisTanmxlebinevrologiuridarRvevebi – 1 Tve

14) neonataluri nevrologia – 1 Tve 15) neiroreabilitaciis safuZvlebi – 5 Tve

3.2.1.moduli: pacientis nevrologiuri Sefaseba xangrZlivoba: 1 Tve

modulis mizani

mwvave da qronikuli nevrologiuri darRvevebis mqone pacientis Sefaseba: eqimis bavSvTan urTierTobis Taviseburebebis codna, yvela asakis bavSvis nevrologiuri gasinjva da am unar-Cvevebis praqtikaSi gamoyeneba. neirodiagnostikuri kvlevis ZiriTadi meTodebis da Cveneba-ukuCvenebebis codna, monacemTa swori interpretireba da klinikur praqtikaSi gamoyeneba.

modulis amocanebi

rezidentma unda icodes:

22

1) kortikospinaluri gzis da qveda motoneironis anatomiuri da funqciuri Taviseburebebi, dazianebis sindromebi;

2) naTxemis anatomia, funqciuri dayofa da dazianebis niSnebi; 3) qerqqveSa kvanZebis anatomiur-funqciuri Taviseburebebi, hiper- da

hipokinezuri sindromebi; 4) Tavis tvinis nervebis anatomiur-funqciuri Taviseburebebi,

dazianebis sindromebi; 5) mgrZnobelobis gzebi, saxeebi, dazianebis tipebi, topikuri

diagnostika; 6) cnobierebis moSlis saxeebi, Sefasebis skala; 7) Tavis tvinis dazianebis fokaluri nevrologiuri sindromebi; 8) 1 wlis asakamde bavSvis ganviTarebis Taviseburebebi da Sefasebis

skalebi; 9) nevrologiuri praqtikaSi gamoyenebuli specialuri kvlevis

meTodebis Cveneba-ukuCveneba da SesaZleblobebi: o sisxlis citologiuri, bioqimiuri da baqteriologiuri

kvleva; o liqvoris citologiuri, bioqimiuri da baqteriologiuri

kvleva; o eeg; o emg da nervis gamtarebloba; o smenis Sefaseba; o mxedvelobis Sefaseba, mxedvelobis gamowveuli potencialebi o citogenetikuri kvleva o imunologiuri kvleva o kani da kunTis biopsia o ultrabgera, kt da mrt o metaboluri skrininguli da specifikuri kvleva o prenataluri diagnostika o siarulis analizis principebi o intrakraniuli wnevis monitoringi o Tavis tvinis sikvdilis dasadgeni testi

modulis farglebSi gaTvaliswinebuli unar-Cvevebi rezidents unda SeeZlos: 1. anamnezuri monacemebis Segroveba, mSoblis an pacientis mier

mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT daavadebaze eWvis mitana;

2. yvela asakis bavSvis nevrologiuri gasinjva, maT Soris:: axalSobilobis periodSi, axalSobilobidan 2 wlis asakamde da 2 welze zeviT asakSi;

monitorireba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba:

Teor. kursi profesiuli unar-Cvevebi raod-ba davaleba

bavSvis neiroganviTareba da nevrologiuri gasinjva

Tavis qalas garSemowerilobis gazomva da monacemis interpretireba

40 2 ref

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da 5

SemT

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is

prez

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Rrma refleqsebis Sefaseba 40

msxvili mtoruli funqciis Sefaseba 35

23

naTxemis funqciis Sefaseba 35

sensoruli sistemis Sefaseba 35

martivi refleqsebis Sefaseba 25

kunTTa tonusis da siarulis tipis Sefaseba 35

glazgos komis gamoyenebiT pacientis cnobierebis donis Sefaseba

15

anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze saeWvo daavadebis gamoyofa da diagnozis dazustebisTvis saWiro kvlevis meTodebis SerCeva

35

sisxlis, liqvoris da Sardis citologiuri, bioqimiuri da baqteriologiuri kvlevis monacemta interpretireba

35

eeg kvlevis monacemTa interpretireba 40

emg da nervis gamtareblobis kvlevis monacemTa interpretireba

20

smenis da mxedvelobis Sefasebis monacemebis interpretireba

20

smenis da mxedvelobis gamowveuli potencialebis monacemTa interpretireba

5

citogenetikuri kvlevis monacemTa interpretireba 15

imunologiuri kvlevis monacemTa interpretireba 20

kanisa da kunTis biofsiis monacemTa interpretireba 5

neirogamosaxviT kvlevaTa interpretireba 30

metaboluri skrininguli da specifikuri kvlevis monacemTa interpretireba

20

prenataluri diagnostikis kvlevis monacemta interpretireba

20

modulis Sefasebis meTodebi

rezidentma unda daweros 2 referati da gaakeTos 5 SemTxvevis prezentacia.

modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis

aucilebeli da rekomendebuli literaturis nusxa:

1. janeliZe m., klinikuri nevrologia, 2009, 724 gv.

2. tatiSvili n. gabunia m. bokeria i, bavSvTa nevrologiur daavadebaTa mkurnaloba, 2011.

3. Volpe Joseph J.:Neurology of the Newborn, Fourth edition 912, 2001, 4. Berman Stephen, Pediatric Decision Making, Fourth Edition 895p,2003. 5. Barkovich A.James;Pediatric Neuroimaging, Rhied Edition,850, 1997.

24

6. Swaiman Kenneth F. ; Stephen Ashwal , pediatric Neurology Principles and Practice,Third Edition, 1494,1999.

7. Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes,Second Edition, 289 p, 2002.

8. Blume Warren T. and Kaibara Masako: Atlas of Pediatric Electroencephalography Second Edition, 391, 1999.

9. King M., Stephenson J., Handbook of Neurological Investigations, Mac Keith Press, 2009, 399 p.

3.2.2. moduli: Tavis tkivili da tkivilis sxva sindromebi xangrZlivoba: 1 Tve

mizani

Tavis tkivilis klasifikaciis, pacientis asakis da paTfiziologiuri Taviseburebebis gaTvaliswinebiT Tavis tkivilis mqone pacientis Sefaseba, diagnostika da adekvaturi marTva. nocicepturi da neiropaTiuri tkivilis farmakologiuri da arafarmakologiuri marTva.

modulis amocanebi


o Tavis tkivilis epidemiologia, klasifikacia, paTfiziologia; o Tavis tkivilis mqone pacientis Sefasebis Taviseburebebi; o diferenciuli diagnozi, kliniko-laboratoriuli testebi; o Tavis tkivilis specifikuri sindromebi; o Sakiki da Sakikis variantebi; o qronikuli progresirebadi da araprogresirebadi Tavis tkivili; o Tavis tkivilis marTva, farmakologiuri Terapia. o pediatriuli tkivilis Sefasebis saSualebebi o nocicepturi tkivilis meqanizmi da mkurnaloba o neiropaTiuri tkivilis meqanizmi da mkurnaloba

Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba

Teoriuli kursi

profesiuli unar-Cvevebi manipulaciis

raod-ba

davaleba

bavSvTa asakis Tavis tkivili da tkivilis sxva sindromebi

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT daavadebaze eWvis mitana;

30 1 ref

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prez

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Tavis tkivilis mqone bavSvis nevrologiuri Sefaseba;

30

eeg kvlevis monacemTa interpretireba 30

neirogamosaxviT kvlevaTa interpretireba 30

pacientis mdgomareobis adekvaturi Sefaseba, diagnostika da marTva.

30


25

rezidentma unda daweros 1 referati da gaakeTos misi prezentacia.

modulis Sefaseba xdeba xelmZRvanelis mier modulis dasrulebis Semdeg zepiri gasaubrebiT, testuri CaTvliT (dadebiTi pasuxi testebis >75%) da unar-Cvevebis aTvisebis donis Semowmebis gziT.


1. janeliZe m., klinikuri nevrologia, 2009, 724 gv. 2. Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003. 3. Barkovich A.J. Pediatric Neuroimaging, third Edition, 850p, 1997. 4. Swaiman Kenneth F, Ashwal S, Pediatric Neurology: Principles and Practice, Third

Edition, 1494p,1999. 5. Blume Warren T. and Masako Kaibara: Atlas of Pediatric Electroencephalography,

Second Edition, 391, 1999. 6. King M., Stephenson J., Handbook of Neurological Investigations, Mac Keith Press,

2009, 399 p. 7. Lewis D. W., Ashwal S., G. Dahl, D. Dorbad, D. Hirtz, A. Prensky and I. Jarjour

Neurology and the Practice Committee of the Child Neurology Society Report of the Quality Standards Subcommittee of the American Academy of Practice parameter: Evaluation of children and adolescents with recurrent headaches 2002;59;490-498 Neurology.

8. Lewis D., Ashwal S., A. Hershey, D. Hirtz, M. Yonker and S. Silberstein Society Standards Subcommittee and the Practice Committee of the Child Neurology and adolescents: Report of the American Academy of Neurology Quality Practice Parameter: Pharmacological treatment of migraine headache in children2004;Neurology 63;2215-

9. Hershey, A, et al. Headaches. Curr Opin Pediatr. 2007; 19: 663-669.

3.2.3. moduli: intrakraniuli hipertenzia, koma da Tavis tvinis sikvdili

xangrZlivoba: 1 Tve

mizani

komaSi myofi pacientis adekvaturi Sefaseba klinikuri gasinjvis, glazgos komis skalis da neirodiagnostikuri kvlevis saSualebis gamoyenebiT;

tvinis sikvdilis diagnostika;

intrakraniuli hipertenziis diagnostika, monitoringi da marTva.

modulis amocanebi


o cnobierebis moSlis saxeebis definicia, klasifikacia, klinikuri niSnebi;

o cnobierebis Sefasebis skalebi; o cnobierebis SenarCunebis paTofiziologia, moSlis saxeebi; o pacientis Sefaseba fizikuri da nevrologiuri gasinjvis mixedviT; o herniaciuli sindromebi; o cnobierebis moSlis marTva da gamosavlis prognozireba; o tvinis sikvdilis sixSire da etiologia;

26

o tvinis sikvdilze saeWvo pacientis nevrologiuri Sefaseba da neirodiagnostikuri kvlevebis: eeg, cerebruli angiografia, transkraniuli dopleri, Tavis tvinis kt, pet, mrt da gamowveuli potencialebi, monacemTa swori interpretireba;

o cnobierebis Secvlis Taviseburebebi axalSobilobis periodSi; o intrakraniuli wnevis warmoqmnis da liqvorodinamikis meqanizmi; o intrakraniuli hipertenziis paTofiziologia, monitoringis

meTodologia da gamoyeneba; o intrakraniuli hipertenziis klinikuri niSnebi da marTva; o Pseudotumor cerebri, diabeturi ketoacidozis Tanmxlebi tvinis

SeSupeba, gareTa hidrocefalia da kraniostenozi. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba

Teoriuli kursi

profesiuli unar-Cvevebi manipulaciis

raod-ba

davaleba

intrakraniulihipertenziissindromebi, komebi, Tavistvinissikvdili

komatozuri an Secvlili cnobierebis mqone pacientis Sefaseba nevrologiuri gasinjvis da neirodiagnostikuri kvlevis meTodebis gamoyenebiT;

20 1 ref

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is

prez

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glazgos komis skalis gamoyeneba; 30

komatozuri an Secvlili cnobierebis mqone pacientis diagnostika da adekvaturi marTva;

20

tvinis sikvdilis diagnostika; 10

intrakraniuli hipertenziis amocnoba, etiologiis dadgena, monitoringi da marTva.

30



modulis Sefaseba xdeba xelmZRvanelis mier modulis dasrulebis Semdeg zepiri gasaubrebiT, testuri CaTvliT (dadebiTi pasuxi testebis >75%) da unar-Cvevebis aTvisebis donis Semowmebis gziT.


1. Nishisaki A, Sullivan J, Steger B, Carey R. Bayer, Retrospective analysis of the prognostic value of electroencephalography patter obtained in pediatric in-hospital cardiac arrest survivors during three years, Pediatr Crit Care Med 2007; 8:10–17;

2. Barkovich A.J, Pediatric Neuroimaging, third edition, 850p, 1997. 3. Berman S, Pediatric Decision Making, Fourth Edition 895p, 2003. 4. Blume Warren T. and Kaibara Masako: Atlas of Pediatric Electroencephalography

Second Edition, 391, 1999. 5. Wijdicks E.F.M., Hijdra A., Young G.B., Bassetti C.L., MD; and S. Wiebe, MD,

Practice Parameter: Prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review), NEUROLOGY 2006;67:203–210;

6. King M., Stephenson J., Handbook of Neurological Investigations, Mac Keith Press, 2009, 399 p.

27

3.2.4. moduli: epilefsia, araepilefsiuri paroqsizmebi da Zilis darRvevebi

xangrZlivoba: 2 Tve

mizani

epilefsiuri gulyrebis amocnoba rogorc klinikuri, aseve eleqtrofiziologiuri maxasiaTeblebiT, epilefsiuri gulyrebis marTvisas medikamentebis gamoyeneba da sxva alternaciuli saSualebebis codna;

araepilefsiuri paroqsizmebis amocnoba, Zilis fiziologiis codna, dissomniebis da parasomniebis amocnoba, sunTqvis Sekavebis Setevebis, refleqsuri anoqsiuri gulyrebis, sinkopes da sxva araepilefsiuri paroqsizmebis marTva.

modulis amocanebi


o epilefsiis epidemiologia, paTfiziologia, epilefsiuri gulyrebis klasifikacia, normaluri eeg;

o generalizebuli gulyrebi, difdiagnozi, eeg, etiologia, mkurnaloba, prognozi;

o gansakuTrebuli epilefsiebi-epilefsiuri encefalopaTiebi, difdiagnozi, eeg, etiologia, mkurnaloba, prognozi;

o parcialuri gulyrebi, klasifikacia, etiologia, eeg, marTvis principebi, antikonvulsantebi, marTvis yvelaze xSiri Secdomebi, qirurgiuli mkurnaloba;

o kogniciuri simptomebiT mimdinare epileftiformuli darRvevebi, etiologia, paTfiziologia, mkurnaloba;

o mioklonia da miokloniuri gulyrebi, klasifikacia, mkurnaloba; o neonataluri periodis gulyrebis Taviseburebebi; o febriluri gulyrebi, epidemiologia, genetika, marTva; o epilefsiuri statusi, paTfiziologia, klasifikacia, epidemiologia,

etiologia, marTva, prognozi; o antiepilefsiuri medikamenturi mkurnaloba, principebi,

farmakokinetika, bavSvTa asakis Taviseburebebi, medikamentebis urTierTqmedeba, farmakodinamika, dozireba da miRebis gzebi, klinikuri da laboratoriuli monitoringi, gverdiTi movlenebi, wamlis SerCeva;

o ketogenuri dieta, efeqturoba, moqmedebis meqanizmi, kandidatebis SerCeva, Cveneba-ukuCveneba, garTulebebi;

o epilefsiis mkurnalobis alternatuli meTodebi; o epilefsiuriqirurgia, Cvenebebi, preoperaciuliSefaseba, miznebi; o qceviTi, kogniciuridasocialurisiZneleebiepilefsiisdros; o sunTqvisSekavebisSetevebisklinikuriniSnebi, paTofiziologia,

genetikadamkurnaloba; o refleqsurianoqsiurigulyrebi, klinikuriniSnebi, paTofiziologia,

laboratoriulitestebi, mkurnaloba;

28

o sinkope, epidemiologia, saxeebi; o sxva araepilefsiuri paroqsizmebi; o Zilisfiziologia, ZilisdarRvevebismqonepacientisSefaseba,

dissomniebidaparasomniebi, maTisaxeebi. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba


bavSvTa asakis epilefsiuri da araepilefsiuri paroqsizmebi, Zilis darRvevebi

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT daavadebaze eWvis mitana;

60 2 ref

erat

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a 10

SemT

xveveb

is pr

ezentac

ia

anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze saeWvo daavadebis gamoyofa da zusti diagnostikisTvis saWiro kvlevis meTodebis SerCeva;

60

eeg kvlevis monacemTa interpretireba; 60

neirogamosaxviTi kvlevebis monacemTa interpretireba;

65

epilefsiuri sindromebis klasificireba; 60

epilefsiuri sindromis mqone pacientisTvis medikamentozuri mkurnalobis adekvaturi SerCeva da marTva;

60

araepilefsiuri paroqsizmebis, dissomniebis da parasomniebis amocnoba da adekvaturi marTva.

70



modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.


1. Barkovich A. J, Pediatric Neuroimaging, 4th Edition, 850 p, 1997. 2. Berman Stephen, Pediatric Decision Making, 4th Edition, 895 p, 2003. 3. Blume Warren T. and Kaibara Masako: Atlas of Pediatric Electroencephalography,

Second Edition, 391p, 1999. 4. Niedermayer E., EEG, 2005,1280p.; 5. Pellock J., B. Bourgeious, W. Dodson, Pediatric Epilepsy, 2008, 883p.; 6. King M., Stephenson J., Handbook of Neurological Investigations, Mac Keith Press,

2009, 399 p. 7. Privitera M., J.Cavitt, D.Ficker, Clinitians Guide to AED Use, 2006, 159p.; 8. Varelas P., Seizures in Critical Care, 2005, 395p.; 9. Swaiman Kenneth F. Ashwal Stephen, Pediatric Neurology: Principles and Practice

,Third Edition, 1494 p,1999. 10. Tatum W., A.Husein, S.Benbadis, Handbook of EEG Interpratation, 2008, 290p.; 11. Friedman MJ. Seizures in Children. Pediatr Clin N Am 2006, 53:257-77. 12. Olson, D. Paroxysmal Events. Differentiating Epileptic Seizures from Nonepileptic

Spells. Consultant for Pediatricians 2008; 461-69.

29

13. Zupanc ML. Neonatal seizures. Pediatr Clin N Am 2004; 51:961-978. 14. Breningstall GN. Breath-holding spells. Pediatr Neurol 1996;14:91-97. 15. Hirtz D et al. Practice parameter: Evaluating a first nonfebrile seizure in children. Neurol

2000;55:616-623. 16. Hirtz D et al. Practice parameter: Treatment of the child with a first unprovoked seizure.

Neurol 2003;60:166-175. 17. Jarrar RG and Buchhalter JR. Therapeutics in pediatric epilepsy, part 1: the new

antiepileptic drugs and the ketogenic diet. Mayo Clin Proc 2003;78:359-370. 18. Practice Parameter: the neurodiagnostic evaluation of the child with a first simple febrile

seizure. Pediatr 1996;97:769-772. 19. Baumann RJ and Duffner PK. Treatment of children with simple febrile seizures: the

AAP practice parameter. Pediatr Neurol 2000;23:11-17. 20. Summary of status epilepticus treatment protocolHolmes GL and Riviello JJ. Midazolam

and Pentobarital for Refractory Status Epilepticus. Pediatr Neurol 1999;20:259-264. 21. Riveiello, J et al. Practice Parameter: Diagnostic assessment of a child with status

epilepticus. Neurology 2006; 67: 1542-1550. 22. Hrachovy, R Infantile Epileptic Encephalopathy with Hypsarrhythmia (Infantile

Spasms/West Syndrome). J Clin Neurophys 2003; 20(6):408-425.

3.2.5. moduli: nervuli sistemis infeqciebi

xangrZlivoba: 1 Tve

mizani

nervuli sistemis virusuli, baqteriuli, sokovani, riketsiuli da parazituli infeqciebis diagnostika, prognozireba da marTva.

modulis amocanebi


o nervuli sistemis baqteriuli infeqciebis epidemiologia, klinikuri niSnebi, diagnostika, garTulebebi, paTogenezi, marTvis principebi, prognozi, prevencia, imunizacia;

mwvave baqteriuli meningiti Tavis tvinis abscesi mikobaqteriuli infeqciebi: tuberkulozi, leprozi spiroqetuli infeqciebi;

o nervuli sistemis virusuli infeqciebis epidemiologia, klinikuri niSnebi, diagnostika, marTva:

aseptikuri meningiti; encefaliti; sxva nevrologiuri darRvevebi;

o nervuli sistemis sokovani, riketsiuli da parazituli infeqciebis epidemiologia, klinikuri niSnebi, diagnostikuri testebi, marTva.



bavSvTa asakis nervuli sistemis

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT

25 1 ref

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6

30

infeqciebi daavadebaze eWvis mitana;

yvela asakis bavSvis nevrologiuri gasinjva;


lumbaluri punqcia;

30

sisxlis, liqvoris da Sardis citologiuri, bioqimiuri da baqteriologiuri kvlevis monacemTa interpretireba;

50



30

neiroinfeqciebis diagnostika da marTva. 25





1. Aicardi J., Diseases od Nervous System in Childhood, Mac Keith Press, 2009, pp 383-445;

2. Baker LK, Long CJ, et al, editors. Red Book: 2006 Report of the Committee on InfectiousDiseases. 27th edition. ElkGroveVillageAmericanAcademy of Pediatrics; 2006. p. 310–8.

3. Goodwin F., Kennedy C., Encephalitis, in Harvey S. Singer, Eric H. Kossoff, Adam L. Hartman O. Crawford, book Treatment of Pediatric Neurologic Disorders, 2005 by Taylor, pp 293-303;

4. Jones Ch, Meningitis, in Harvey S. Singer, Eric H. Kossoff, Adam L. Hartman,O. Crawford, book Treatment of Pediatric Neurologic Disorders, 2005 by Taylor, pp 287-293;

5. Kaplan SL. Clinical presentations, diagnosis, and prognostic factors of bacterial meningitis. Infect Dis Clin North Am 1999;13:579–94;

6. King M., J.Stephenson, Handbook of Neurological Investigations, Mac Keith Press, 2009, 399p.;

7. Lavoie FW, Caucier JR. Central nervous system infections. In: Marx JA, Hockberger RS, 8. Leen W G., Corry M. Weemaes, MD, PhD Marcel M. Verbeek, PhD Michèl A.

Willemsen, MD, PhD, and Jan J. Rotteveel, MD, PhD; 9. Loring KE. CNS infections. In: Tintinalli JE,KelenGD, Stapczynski JS, editors.

Emergency medicine: a comprehensive study guide. 6th edition. New York: McGraw-Hill; 2004. p. 1431–7.

10. Maria B., J.Bale, Infections of Nervous System, in Menkes, John H.; Sarnat, Harvey B.; Maria, Bernard L. Child Neurology, 7th Edition 2006 Lippincott Williams & Wilkins pp. 432-556;

11. Scheld W.M., R.J. Whitley, C.M.Marra, Infections of CNS, Lippincott Williams, 2004, 921p.;

31

12. Sharon E. Mace, Acute Bacterial Meningitis, Emerg Med Clin N Am,38 (2008) 281–317; 13. Somand D, Meurer W, Central Nervous System Infections, Emerg Med Clin N Am 27

(2009) 89–100; 14. Talati N J, Rouphael N, Krutika Kuppalli, Carlos Franco-Paredes, Spectrum of CNS

disease caused by rapidly growing mycobacteria, Lancet Infect Dis 2008;8: 390–98; 15. Walls RM, et al, editors.Rosen’s emergencymedicine concepts and clinical practice. 6th

edition. Philadelphia: Mosby Elsevier; 2006. p. 1710–25. 16. Ziai WC. Advances in the management of central nervous systems infections in the ICU.

Crit Care Clin 2006; 22(4):661–94.

3.2.6. moduli: nervuli sistemis simsivneebi, malformaciebi da sisxlZarRvovani darRvevebi

xangrZlivoba: 1 Tve

mizani

nervuli sistemis simsivneebis amocnoba klinikuri niSnebis da neirovizualizaciuri kvlevis monacemebis mixedviT da marTvis principebis codna;

cerebrovaskuluri daavadebebis diagnostika klinikuri da paraklinikuri monacemebis mixedviT da adekvaturi marTva.

mucladyofnis periodSi nervuli sistemis normaluri ganviTarebis da ganviTarebis darRvevis sxvadasxva variantebis codna, klinikuri niSnebis da neirovizualizaciuri kvlevis monacemebis safuZvelze maTi diagnoscireba.

amocanebi


o Tavistvinissimsivneebisepidemiologia, sixSire, histopaTologiuridalokalizaciuridayofa, diagnostika, marTvisZiriTadiprincipebi, qirurgia, radiacia, qimioTerapia;

o zurgistvinissimsivneebistipebi, klinikuriniSnebi, diagnostika, marTva, garTulebebi;

o cns-is dazianeba leikemiis da limfomis dros da misi marTva; o cns-is simsivneebis mkurnalobis mogvianebiTi efeqti da axali

midgomebi mkurnalobaSi; o bavSvTa asakis cerebrovaskuluri daavadebebis paTofiziologia,

klinikuri niSnebi, risk-faqtorebi, radiologiuri niSnebi, mkurnaloba, gamosavali;

o arteriuli iSemiuri insulti o sinovenozuri Trombozi o hemoragiuli insulti – intracerebruli da

subaraqnoiduli hemoragia o vaskuluri malformacia.

o nervuli sistemis normaluri ganviTareba o nervuli sistemis malformaciebis etiologiuri Taviseburebebi o nervuli lulis defeqtebi o proliferacia-deferenciaciis darRvevebi

32

o migraciuli darRvevebi o naTxemis malformaciebi o Tavis qalas da nakerebis Tandayolili anomaliebi o am tipis darRvevebis epidemiologiuri monacemebi, o etiologia, o paTogenezi, o paTologia, o klinikuri niSnebi, o marTva da gamosavali.



bavSvTa asakis nervuli sistemis simsivneebi, malformaciebi da sisxlZarRvovani darRvevebi

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT cns-is simsivnis an cerebrovaskuluri darRvevis arsebobaze eWvis mitana;

40 3 ref

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a 5 SemT

xveveb

is pr

ezentac

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yvela asakis bavSvis nevrologiuri gasinjva, anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze diagnostikisTvis saWiro kvlevis meTodebis SerCeva;

40


40


emg da nervis gamtareblobis kvlevis monacemTa interpretireba;

20

nervuli sistemis simsivnuri da vaskuluri daavadebebis amocnoba, diagostika da marTva.

20


30

centraluri nervuli sistemis malformaciebis amocnoba, klinikuri niSnebis da neirovizualizaciuri monacemebis saSualebiT;

20

centraluri nervuli sistemis malformaciebis darRvevebis mqone konkretuli pacientis xangrZlivi marTva.

20





33

1. Catherine Amlie-Lefond, Guillaume Sébire, Heather J Fullerton, Recent developments in childhood arterial ischaemic stroke, Lancet Neurol 2008; 7: 425–35;

2. DeVeber Gabrielle, Kirkham Fenella, Guidelines for the treatment and prevention of stroke in children, the Lancet.com/neurology Vol 7 November 2008, p.983-85;

3. Hartman A.L, Lunney K.M, Serena J.E,Pediatric Stroke: Do Clinical Factors Predict Delays in Presentation?, J Pediatr 2009;154:727-32;

4. Janjua N, Nasar A, Lynch JK, Qureshi AI. Thrombolysis for ischemic stroke in children: data from the nationwide inpatient sample. Stroke 2007 38: 1850–54.

5. Monagle P, Chalmers E, Chan A, et al. Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 2008; 133: 887S–968S.

6. Roach ES, Golomb MR, Adams R, et al. Management of stroke in infants and children: a scientifi c statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 2008; 39: 2644–91

7. Satoshi Kuroda, Kiyohiro Houkin, Moyamoya disease: current concepts and future perspectives, Lancet Neurol 2008; 7: 1056–66;

3.2.7. moduli: ataqsia da moZraobiTi darRvevebi xangrZlivoba: 1 Tve

mizani

ataqsiis mqone pacientis anamnezuri da klinikuri monacemebis Sefaseba, diagnostika da marTva;

moZraobiTi darRvevebis amocnoba, diagnostika, moZraobiTi darRvevebiT mimdinare daavadebaTa diagnostika da marTva.

amocanebi


o naTxemisanatomia, funqciuridayofadadazianebisniSnebi; o ataqsiismqonepacientisanamnezuri,

klinikuridalaboratoriulimonacemebisSefaseba; o mwvavedaqronikuli –

spinocerebelarulidegeneraciebiTgamowveuliataqsiebi; o moZraobiTi darRvevebis neiroanatomia, neirotransmiterebi,

pacientis Sefaseba; o qorea, aTetozi, distonia, tremori, balizmi, mioklonia, tikebi,

maTi difdiagnostika; o moZraobiTi darRvevebiT Tanxlebuli bazaluri gangliebis

daavadebebi. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba


bavSvTa asakis ataqsia da moZraobiTi darRvevebi

ataqsiis mqone pacientis adekvaturi Sefaseba; 10 2 ref

erat

i

da 2

SemT

xveveb

is

prez

entac

ia

moZraobiTi darRvevebis amocnoba da tipebis identificireba;

20

arsebuli darRvevis savaraudo etiologiis dadgena; 20

34

ataqsiis mqone pacientis marTva. 10

moZraobiTi darRvevi mqone pacientis marTva. 20




aucilebeli da rekomendebuli literaturis nusxa

1. Affifi A., Bazal Ganglia, Neuronal Networks, Vol 10, No 1 (March), 2003: pp 3-10; 2. Barkovich A.J. Pediatric Neuroimaging, Fourth Edition,850, 1997 3. Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003 4. Blume Warren T. and Masako Kaibara: Atlas of Pediatric Electroencephalography,

Second Edition, 391p, 1999. 5. Caviness J., Pathophysiology of Myoclonus,Neurol Clin 27 (2009) 757–777; 6. Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289 p,

2002 7. Pranzatelli M., Myoclonus in Childhood, Vol 10, No 1 (March), 2003: pp 41-51 8. Swaiman K. F., Ashwal S., Pediatric Neurology: Principles and Practice, Third Edition,

1494,1999

3.2.8. moduli: nervuli sistemis dazianebiT mimdinare genetikuri da metaboluri darRvevebi

xangrZlivoba: 1 Tve

mizani

memkvidreobiTobis molekuluri safuZvlebis, adamianis genomis organizaciis, klinikuri citogenetikis, memkvidreobiTobis tipis, qromosomuli anomaliebis codna, nevrologiuri darRvevebiT Tanxlebuli genetikuri daavadebebis amocnoba da marTva.

Tandayolili metaboluri darRvevebis diagnostikis, klinikuri niSnebis da adekvaturi marTvis sakiTxebis codna da klinikur praqtikaSi gamoyeneba.

modulis amocanebi


o memkvidreobiTobis molekuluri safuZvlebi; o adamianis genomis organizacia; o memkvidreobiTobis qromosomuli safuZvlebi; o molekuluri genetikis teqnologiebi; o mutacia da normaluri variaciebi; o klinikuri citogenetika; o memkvidreobiTobis tipebi;

35

o memkvidreobiTTbis araklasikuri paternebi; o adamianis genis ruqa; o populaciuri genetika; o genetikuri riski; o aminoacidopaTiebi da organuli acidemiebi; o amoniumis metabolizmis daavadebebi; o naxSirwylovani metabolizmis darRvevebi; o lizosomuri daavadebebi; o JangviTi metabolizmis darRvevebi; o mitoqondriuli daavadebebi; o peroqsisomuli darRvevebi



bavSvTa asakis nervuli sistemis dazianebiT mimdinare genetikuri da metaboluri darRvevebi

qromosomuli anomaliebis epidemiologiis da klinikuri niSnebis gaTvaliswinebiT sindromis amocnoba da adekvaturi marTva;

10 2 ref

erat

i d

a 2 SemT

xveveb

is

prez

entac

ia

citogenetikuri kvlevis monacemTa interpretireba;

metaboluri skrininguli da specifikuri kvlevis monacemTa interpretireba;

10

prenataluri diagnostikis kvlevis monacemTa interpretireba;

10

mSoblebis da ojaxis wevrebisTvis genetikuri rCeva-darigebis micema;

10

memkvidruli darRvevebis amocnoba, kvlevis meTodebis SerCeva dea xangrZlivi marTva.

10





1. Barkovich A.J; Pediatric Neuroimaging, Fourth Edition, 850p, 1997 2. Berman S, Pediatric Decision Making Fourth Edition, 895p,2003 3. Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289p,

2002 4. Ferreti P., Tikkey A.and D.Moore, Emgrios, Genes and births Defects,2006, 590p.; 5. Moeschler John B., Michael Shevel, and the Committee on Genetics, Clinical Genetic

Evaluation of the Child With Mental Retardation or Developmental Delays, Clinical, J. Pediatrics, 2006, pp01006-1008;

6. Swaiman K F. ; Ashwal S, Pediatric Neurology: Principles and Practice ,Third Edition, 1494,1999

36

3.2.9. moduli: Tavisa da zurgis tvinis travmuli da anoqsiuri dazianebebi

xangrZlivoba: 1 Tve

mizani

Tavisa da zurgis tvinis travmuli dazianebebis amocnoba, klinikuri gasinjvis da neirodiagnostikuri kvlevis saSualebebis monacemebis mixedviT mdgomareobis Sefaseba, diagnostika, prognozireba da marTva.

hipoqsiur-iSemiuri encefalopaTiis ganviTarebis meqanizmis da klinikuri paTofiziologiis codna, postanoqsiuri garTulebebis da prognozis gansazRvra da marTva.

modulis amocanebi


o qala-tvinis travmis anatomiuri da paTogenezuri Taviseburebebi; o Tavis tvinis travmuli dazianebis mqone pacientis nevrologiuri

gasinjva, radiologiuri kvleva, lumbaluri punqcia; o Tavis tvinis travmis mqone pacientis marTva:

intrakraniuli hipertenzia posttravmuli epilefsia Tavis tvinis SeSupeba

o Tavis travmis klinikuri tipebi, maTi paTofiziologia: skalpis dazianeba difuzuri aqsonuri dazianeba tvinis Seryeva da SeryevisSemdgomi

sindromi tvinis daJeJiloba mwvave epiduruli da subduruli

hematoma qvemwvave da qronikuli subduruli

hematoma o Tavis tvinis mwvave travmis prognozi da gamosavali; o zurgis tvinis dazianebis anatomiuri da paTogenezuri

Taviseburebebi, nevropaTologia; o zurgis tvinis dazianebis mqone pacientis Sefaseba nevrologiuri

gasinjvis da radiologiuri kvlevis monacemebis mixedviT; o zurgis tvinis dazianebis klinikuri sindromebi da maTi marTva. o Tavis tvinis anoqsiuri dazianebis meqanizmi; o klinikuri paTofiziologia; o gulisgaCerebiTTanxlebulidarRvevebidamaTiklinikurigamosavali; o gulis gaCerebis Semdgomi nevrologiuri garTulebebi; o anoqsiuri dazianebis gamosavlis prediqtorebi; o anoqsiuri dazianebis mkurnaloba da potenciuri Terapia.



37

Tavisa da zurgis tvinis travmuli da anoqsiuri dazianebebi bavSvTa asakSi

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT Tavisa da zurgis tvinis travmul dazianebaze eWvis mitana;

20 1 ref

erat

i d

a 2 SemT

xveveb

is pr

ezentac

ia

anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze zusti diagnostikisTvis saWiro kvlevis meTodebis SerCeva;

20

glazgos komis skalis gamoyeneba;

lumbaluri punqcia;

20


20


20

travmis mqone pacientis marTva rogorc mwvave periodSi, aseve mwvave periodis Semdeg;

20

postanoqsiuri encefalopaTiis Sefaseba nevrologiuri gasinjvis, eeg-s, gamowveuli potencialebis, bioqimiuri markerebis da neirogamosaxvis mixedviT;

20

anoqsiuri dazianebis prehospitaluri da hospitaluri marTva.

20





1. Avarello Jahn T., Pediatric Major Trauma: An Approach to Evaluation and Management, Emerg Med Clin N Am 25 (2007) 803–836; Guideline commissioned by the National Institute for Clinical Excellence, 2003, 246p;

2. Barkovich A.J; Pediatric Neuroimaging, Fourth Edition, 850p, 1997 3. Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003 4. Blume Warren T. and Masako Kaibara: Atlas of Pediatric Electroencephalography,

Second Edition, 391p, 1999 5. Brain injuries after blunt head trauma. Ann Emerg Med 2003;42(4):492– 506. 6. Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289p,

2002 7. Kopjar B, Wickizer TM. Age gradient in the cost-effectiveness of bicycle helmets. Prev

Med 2000;30:401-406. 8. Palchak MJ, Holmes JF, Vance CW, et al. A decision rule for identifying childre 9. Swaiman K F. ; Ashwal S, Pediatric Neurology: Principles and Practice ,Third Edition,

1494,1999

38

10. Thiessen Mary L., Woolridge Dale P., Pediatric Minor Closed Head Injury, Pediatr Clin N Am 53 (2006) 1 – 26;

3.2.10. moduli: neiroganviTarebiTi darRvevebi

xangrZlivoba: 1 Tve

mizani

pacientis ganviTarebis Sefaseba, sxvadasxva asakis bavSvis ganviTarebis Sesafasebeli skalebis codna; motoruli, metyvelebis da gonebrivi ganviTarebis darRvevebis Sefaseba, prognozireba da marTva;

neirodermaluri sindromebis (e.w. fakomatozebis) adreuli sadiagnostiko niSnebis mixedviT amocnoba da adekvaturi marTva;

TeTri da ruxi nivTierebis degeneraciuli daavadebebis paTofiziologiis, bioqimiis, klinikuri niSnebis da genetikis codnis safuZvelze am daavadebaTa amocnoba da marTva;

modulis amocanebi


o ganviTarebis Seferxebis prenataluri, perinataluri, postnataluri da idiopaTiuri etiologia;

o ganviTarebis regresis mizezebi da Taviseburebebi; o metyvelebis darRvevebis klasifikacia, difdiagnozi, specifikuri

sindromebi; o disleqsia, misi epidemiologia, etiologia, paTofiziologia,

diagnostika, marTva; o mentaluri retardacia, misi epidemiologia, etiologia,

diagnostika, marTva; o Sefasebis skalebi; o neirofibromatozis, tuberozuli sklerozis, Sturge-veberis

sindromis, fon-hipel-lindaus daavadebis, ataqsia-teleangieqtaziis da sxva iSviaTi fakomatozebis klinikuri niSnebi, paTologia, genetika da neirovizualizaciuri korelatebi;

o pirveladad ruxi nivTierebis degeneraciiT mimdinare daavadebaTa (menkesis sindromi, infantiluri progresirebadi poliodistrofia, retis sindromi, nervuli seroiduli lipofuscinoziebi) paTologia, bioqimia, klinikuri maxasiaTeblebi, genetika, laboratoriuli kvlevis monacemebi da marTva;

o pirveladad TeTri nivTierebis degeneraciiT mimdinare daavadebaTa (gafantuli sklerozi, Silderis daavadeba, mwvave diseminirebuli encefalomieliti, hipo- da madismielinizirebeli darRvevebi – peliceus-merzbaxeris daavadeba, kanavanis daavadeba, aleqsandres daavadeba da leikoencefalopaTiebi) paTologia, bioqimia, klinikuri maxasiaTeblebi, genetika, laboratoriuli kvlevis monacemebi da marTva;


39


neiroganviTarebiTi darRvevebi

rezidentma unda SeZlos Seafasos: pacientis fizikuri ganviTareba, Tanmxlebi Tvalis, kanis, smenis, Tmis darRvevebi, hepatosplenomegalia, metaboluri acidozi da sxva darRvevebi;

motoruli, gonebrivi da metyvelebis ganviTareba;

30 3 ref

erati d

a 3 SemT

xveveb

is pr

ezentac

ia

mdgomareobis prognozireba; 30

sruli SefasebisTvis saWiro specialistTa da kvlevebis SerCeva;

30

ganviTarebis darRvevis mqone pacientis marTva; 30

uxSiresi neirodermaluri sindromebis amocnoba klinikuri da neirovizualizaciuri niSnebis mixedviT, simptomuri mkurnaloba da xangrZlivi marTva;

20

TeTri da ruxi nivTierebis degeneraciuli daavadebebis amocnoba, diagnostika da marTva;

20





1. Barkovich A.J; Pediatric Neuroimaging, Fourth Edition, 850p, 1997 2. Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003 3. Chavarska K, Klin A, Volkmar F.R, Autism spectrum Disordres in Infants and Toddlers,

The Guilford Press, 348 p, 2008. 4. Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289p,

2002 5. Coleman M, The Neurology of Autism, 2007. 6. Filipek P. A., Accardo P. J., Ashwal S., Baranek G. T., E. H. Cook, Jr., G. Dawson, B.

Neurology Society Standards Subcommittee of the AmericanAcademy of Neurology and the Child Practice parameter: Screening and diagnosis of autism: Report of the Quality, 2000;55;468-479 Neurology;

7. Gupta VidyaBhushan, "AutisticSpectrumDisordersinChildren (PediatricHabilitation)", 2008.

8. Richman S, "Encouraging Appropriate Behavior for Children on the Autism Spectrum: Frequently Asked Questions", 2009.


10. Volkmar Fred R."Handbook of Autism and Pervasive Developmental Disorders, Two Volume Set", 2006.

3.2.11. moduli: neiroqceviTi darRvevebi

xangrZlivoba: 1 Tve

40

mizani

yuradRebis deficitis da hiperaqtiurobis sindromis, swavlebis siZneleebis, tikebis, turetis sindromis da autisturi darRvevebis klinikuri niSnebis, diagnostikuri kriteriumebis, prognozis da marTvis Taviseburebebis codna da klinikur praqtikaSi gamoyeneba.

modulis amocanebi


o yuradRebis deficitis da hiperaqtiurobis sindromis klinikuri niSnebi, Tanmxlebi darRvevebi (swavlebis siZneleebi, SfoTviTi da bipolaruli darRvevebi, tikebi), maTi gamosavali, farmakoTerapia, arafarmakologiuri Terapia;

o tikebi da turetis sindromi – neiroanatomiuri lokalizacia, neirofsiqologiuri problemebi, akademiuri moswrebis siZneleebi da maTi marTva;

o autisturi darRvevebis klinikuri niSnebi, diagnostika, autizmis neiroanatomia, neirogamosaxviTi kvlevis monacemebi, neiroqimia, genetika da marTvis Taviseburebebi.



neiroqceviTi darRvevebi

neiroqceviTi darRvevebiT mimdinare nevrologiuri daavadebebis amocnoba

30 1 ref

erat

i d

a 2 SemT

xveveb

is

prez

entac

ia

diagnostikuri kriteriumebis gamoyeneba 30

marTva medikamentozuri da arafarmakologiuri mkurnalobis gamoyenebiT.

30





1. Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003 2. Chavarska K, Klin A, Volkmar F.R, Autism spectrum Disordres in Infants and Toddlers,

The Guilford Press, 348 p, 2008. 3. Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289p,

2002 4. Coleman M, The Neurology of Autism, 2007. 5. Filipek P. A., Accardo P. J., Ashwal S., Baranek G. T., E. H. Cook, Jr., G. Dawson, B.

Neurology Society Standards Subcommittee of the AmericanAcademy of Neurology and the Child Practice parameter: Screening and diagnosis of autism: Report of the Quality, 2000;55;468-479 Neurology;

41

6. Gupta VidyaBhushan, "AutisticSpectrumDisordersinChildren (PediatricHabilitation)", 2008.

7. Luna B, Garver KE, Urban TA, et al. Maturation of cognitive processes from late childhood to adulthood. Child Dev 2004;75:1357-1372.

8. Richman S, "Encouraging Appropriate Behavior for Children on the Autism Spectrum: Frequently Asked Questions", 2009.


10. Volkmar Fred R."Handbook of Autism and Pervasive Developmental Disorders, Two Volume Set", 2006.

11. Walkup JT, Labellarte MJ, Ginsburg GS. The pharmacological treatment of childhood anxiety disorders. Int Rev Psychiatry 2002; 14:135–142.

12. Warren T.blume and Masako Kaibara: Atlas of Pediatric Electroencephalography, Second Edition, 391p, 1999

3.2.12. moduli: nerv-kunTovani daavadebebi

xangrZlivoba: 1 Tve

mizani

nerv-kunTovani daavadebebis amocnoba, diagnostika, eleqtroneiromiografiuli kvlevis monacemTa interpretireba, ojaxisTvis genetikuri rCeva-darigebis micema da marTva.

modulis amocanebi


o normaluri kunTis anatomiuri da struqturuli Taviseburebebi, klinikuri bioqimia, eleqtroneirografia, kunTis biofsia;

o nerv-kunTovani daavadebebis epidemiologia, klasifikacia, klinikuri niSnebi, diagnostika, memkvidreobiToba, paTofiziologia, marTva da prognozi:

winarqovani daavadebebi

periferiuli neiropaTiebi

mwvave da qronikuli mademielinizirebeli neiropaTiebi

nerv-kunTovani kavSiris darRvevebi (miasTenia, lambert-itonis miasTeniuri sindromi, botulizmi)

kunTTa distrofiebi (duSenis, bekeris, kidur-sartylovani, landuJi-deJerinis, skapuloperonealuri, miotonuri, Tandayolili)

Tandayolili miopaTiebi

metaboluri miopaTiebi

anTebiTi miopaTiebi

miotoniuri darRvevebi da perioduli damblebi. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba


nerv-kunTovani

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da

30 2 ref

erat

i da

42

daavadebebi mdgomareobis mimdinareobis gaTvaliswinebiT daavadebaze eWvis mitana;

yvela asakis bavSvis nevrologiuri gasinjva;


30

emg da nervis gamtareblobis kvlevis monacemTa interpretireba;

30

citogenetikuri kvlevis monacemTa interpretireba;

kunTis biofsiis monacemTa interpretireba;

30


30

nerv-kunTovani daavadebis arsebobis amocnoba, diagnostika da marTva.

30





1. Grewal PK, Hewitt JE. Glycosylation defects: a new mechanism for muscular atropies,Hum Mol Genet 2003; 12:R259–R264.

2. Dubowitz V. Muscle Disorders in Childhood. 2d ed. Saunders, 1995. 3. Bushby K, Mellies U, Wallgren-Pettersson C. Ventilatory support in congenital neuro-

muscular disorders. 117th ENMC Workshop, Naarden, The Netherlands 4–6th April2003. Neuromusc Disord 2004; 14:56–69.

4. Goebel HH. Congenital myopathies at their molecular dawning. Muscle Nerve 2003;27:527–548.

5. Darras BT, Menache CC, Kunkel LM. Dystrophinopathies. In: Jones HR, DeVivo DC, 2008.

6. Darras BT, eds. Neuromuscular Disorders of Infancy, Childhood, and Adolescence—A Clinicians Approach. Amsterdam: Butterworth Heinemann, 2003:649–700.Hill, New York Myology. 2003.

7. Mankodi A, Thornton CA. Myotonic syndromes. Curr Opin Neurol 2, 2009. 8. Wang C.,Bonnehmen C.,Rutkovski A. et al. Consensus Statement of Standart of Care

Congenital Muscular Dystrophies, Journal of Child Neurology, 25 (12), 2010.p.1559-1581

9. Bushby K., Fenkel G.,Birkrant D. et al. Diagnosis and Management of Duchene Muscular Dysthrophy, Lancet neurology, 11, 2009, p.1116-1174

3.2.13. moduli: avtonomiuri nervuli sistemis, neiroendokrinuli da sistemuri daavadebebis Tanmxlebi nevrologiuri darRvevebi

xangrZlivoba: 1 Tve

43

mizani

hipoTalamuridahipofizisdarRvevebisendokrinuligamovlinebebis, avtonomiurinervuli sistemis sindromebis, Sardvisa da defekaciis darRvevebis diagnostika da marTva;

revmatuli darRvevebis, mowamvlis, gulis da renaluri daavadebebis, kvebis deficitis, kuW-nawlavis daavadebebis da imunizaciis Tanmxlebi nevrologiuri darRvevebis diagnostika da marTva.

modulis amocanebi


o neiroendokrinologiis anatomiur-fiziologiuri da kliniko-paTologiuri safuZvlebi, Tandayolili struqtureuli defeqtebis da nevrogenuli endikrinuli darRvevebis diagnostika, klinika, neirovizualizaciuri Taviseburebebi da marTva;

o avtonomiuri nervuli sistemis anatomiuri, bioqimiuri da farmakologiuri maxasiaTeblebi, klinikuri testebi, sindromebi da maTi marTva;

o Sardvisa da defekaciis darRvevebis paTofiziologia, pacientis Sefaseba, diagnostika da marTva;

o revmatuli darRvevebis (revmatoiduli arTriti, mwvave revmatizmi, laimis daavadeba, wiTeli mglura, sklerodermia, Sagrenis sindromi, kvanZovani poliarteriti, leikocitoklasturi vaskuliti, granulomatozuri angiiti, giganturujredovani arteriti) nevrologiuri gamovlinebebis klinikuri niSnebi, diagnostika, nevrologiuri gamovlinebebis mkurnaloba;

o mwvave da qronikuli mowamvlis mqone pacientis Sefaseba, diagnostika, marTva;

o gulis qirurgiis, mankebis da SeZenili gulis daavadebebis Tanmxlebi nevrologiuri darRvevebis diagnostika da marTva;

o renaluri problemebis da nevrologiuri darRvevebis kavSiri: uremiuli encefalopaTia, hipertenziuli encefalopaTia, dializis garTulebebi, uremiuli neiropaTia, transplantaciis garTulebebi, renul-nevraluri daavadebebi, maTi amocnoba da marTvis Taviseburebebi, nevrologiuri daavadebebis marTva Tirkmlis daavadebis dros;

o kuW-nawlavis traqtis daavadebebis, kvebis darRvevebis da wyal-marilovani cvlis darRvevebis Tanmxlebi nevrologiuri problemebis amocnoba da marTva;

o imunizaciis nevrologiuri garTulebebis diagnostika da marTva. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba


avtonomiuri nervuli sistemis, neiroendokrinuli da sistemuri daavadebebis

neiroendokrinuli, avtonomiuri nervuli sistemis, Sardvis da defekaciis darRvevebis mqone pacientTa Sefaseba, diagnostika da marTva;

30 2 ref

erat

i d

a 2 SemT

xveveb

is

prez

entac

ia

revmatuli darRvevebis, mowamvlis, gulis da renaluri daavadebebis, kvebiTi deficitis, kuW-

30

44

Tanmxlebi nevrologiuri darRvevebi

nawlavis daavadebebis da imunizaciis Tanmxlebi nevrologiuri darRvevebis amocnoba, diagnostika da marTva.





1. Axelrod FB. Genetic disorders as models to understand autonomic dysfunction. ClinAuton Res 2002; 12(suppl 1).

2. Bos AP, van der Meche FG, Witsenburg M, van der Voort E. Experience with Guillain-Barre ´ syndrome in pediatric patients. Intensive Care Med 1987; 13:328–331.

3. Ellies M, Rohrbach-Volland S, Arglebe C, Wilkins B, Lakawi R, Hanfeld F. Successful management of drooling with botulinum toxin A in neurologically disabled children. Neuropediatrics 2002; 33:327–330.

4. Gadoth N. Familial dysautonomia. Handbook of autonomic nervous system dysfunction. New York: Marcel Dekker Inc., 1995:95–115.

5. Lahat E, Goldaman M, Barr J, Bistrizer T, Berkovitch M. Intranasal midazolam as a treatment of autonomic crises in patients with familial dysautonomia. Pediatr autonomic nervous system.Ann Intern Med 2002; 137:753–763.

6. Shatzky S, Moses S, Levy J, Pinsk V, Hershkovitz E, Herzog L, Shorer Z, Luder A, Parvari R. Congenital insensitivity to pain with anhidrosis (CIPA) in Israeli-Bedouins:genetic heterogeneity, novel mutations in the TRKA=NGF receptor gene, clinical findings and results of nerve conduction studies. Am J Med Genet 2000; 92:353–360.

7. Stewart JM. Orthostatic intolerance in pediatrics. J Pediatr 2002; 40:404–411.Neurol2000; 22:19–22.

3.2.14. moduli: neonataluri nevrologia

xangrZlivoba: 1 Tve

mizani

axalSobilis adekvaturi nevrologiuri Sefaseba, neonataluri periodis nevrologiuri daavadebebis amocnoba, diagnostika da marTva.

modulis amocanebi


o axalSobilis nevrologiuri Sefasebis skalebi; o axalSobiliseegdaneirovizualizaciuriTaviseburebebi; o axalSobilobisperiodisnevrologiurdaavadebaTaklinikuriTavisebu

rebebi, diagnostikurisirTuleebidamarTvisZiriTadimiznebi: o Tavis tvinis hipoqsiur-iSemiuri dazianebebi; o intrakraniuli hemoragiebi; o qalasmeqanikuritravmiTgamowveulidazianebeb

i; o zurgis tvinis da mxris wnulis dazianebebi;

45

o kerniqterusi; o kunTis tonusis darRvevebi; o metaboluri darRvevebi; o Tandayolili infeqciuri daavadebebi; o baqteriuli meningiti; o neonataluri gulyrebi.



neonataluri nevrologia

axalSobilis Sefaseba nevrologiuri gasinjviT; 80 4 ref

erat

i d

a 8

SemT

xveveb

is

prez

entac

ia

neonataluri eeg da neirovizualizaciuri monacemebis swori interpretireba;

80

neonataluri periodis nevrologiur darRvevaTa amocnoba/diagnostika;

80

neonataluri periodis nevrologiur darRvevaTa marTva.

80





1. Aicardi J, Diseases of the nervous system in childhood, 3rd edition, 964 p, 2009. 2. Futagi Y, Suzuki Y, Toribe Y, Nakano H, Morimoto K. Neurodevelopmental outcome in

children with posthemorrhagic hydrocephalus. Pediatr Neurol 2005;33:26-32; 3. Golomb MR, Garg BP, Williams LS. Outcomes of children with infantile spasms after

perinatal stroke. Pediatr.Neurol 2006;34:291-295. 4. James J. Filiano, MD, Neurometabolic Diseases in the Newborn,Clin Perinatol 33 (2006)

411– 479; 5. King M.D. Stephenson B.P, A Handbook of neurological investigations in children, 399 p,

2009. 6. Michael J. Noetzel, MD, Perinatal Trauma and Cerebral Palsy, Pediatr.Neurol

2006;34,120-128; 7. Volpe Joseph J.:Neurology of the Newborn, Fourth edition, 912 p, 2001. 8. Yasuyuki Futagi, MD, Yasuhisa Toribe, MD, Kana Ogawa, MD, and Yasuhiro Suzuki,

MD,Neurodevelopmental Outcome in Children With Intraventricular Hemorrhage,Pediatr Neurol 2006;34:219-224.;

3.2.15. moduli: neiroreabilitaciis safuZvlebi

xangrZlivoba: 5 Tve

mizani

nevrologiur daavadebaTa reabilitaciis neiromecnieruli safuZvlebis codna;

46

unarSezRudulobis mqone pacientis motoruli da gonebrivi funqciis Sefaseba;

neiroreabilitaciuri samedicino problemebis marTva.

modulis amocanebi


o unarSezRudulobis da invalidobis saerTaSoriso klasifikacia; o unarSezRudulobis epidemiologia; o reabilitologiis roli; o reabilitaciiis mecnieruli safuZvlebi: o motoruli kontroli da kunTTa plastikuroba; o kognicia; o aRdgenis biologiuri meqanizmi: o zogadi meqanizmebi o eqsperimentuli miRwevebi o pacientis Sefasebis Taviseburebebi; o msxvili motoruli funqciis Sefasebis skala; o msxvili motoruli funqciis klasifikacia; o cerebruli damblis simZimis klasifikacia; o aqtiuri moZraobis da Zalis skala; o kunTTa spastikurobis aSuortis skala; o yofiTunarianobis barTelis skala; o funqciuri damoukideblobis skala; o gonebriviganviTarebisSefasebisskalebiasakismixedviT; o neiroreabilitaciuri mkurnalobis gunduri midgomis

prioritetulobis safuZvlebi; o kunTTa spastikis paTofiziologia, Sefaseba, biomeqanikuri da

eleqtrofiziologiuri teqnikebi, eleqtromiografiuli da kinematuri meTodebi, marTvis fizikuri saSualebebi, eleqtruli stimulacia, farmakoTerapia, qirurgiuli Careva;

o kontraqturebis tipebi, sakoreqcio varjiSebi da damxmare saSualebebi;

o nevrogenuli Sardis buStis paTofiziologia da marTva; o nawlavTa disfunqciis paTofiziologia da marTva.



neiroreabilitologia

unarSezRudulobis gamomwvevi nervuli sistemis daavadebaTa adreuli reabilitaciuri daxmarebis efeqrurobis gaTvaliswinebiTCarevis miznebis gansazRvra

60 6 ref

erati da 24

SemT

xvevi

s

prez

entac

ia pacientis unarSezRudulobis gamomwvevi ZiriTadi

problemis gamoyofa, realuri miznebis dasaxva da mkurnalobis xanmokle da xangrZlivi gegmis Sedgena;

unarSezRudulobis mqone pacientebis mdgomareobis Sesafaseblad motoruli da gonebrivi funqciis Sefasebis skalebis gamoyeneba;

60

spastikis da kontraqturebis Sefaseba da marTva. 60

47

nevrogenuli Sardis buStis da nawlavTa disfunqciis Sefaseba da marTva.

30





1. Accardo PJ. Freud on diplegia: Commentary and translation. American Journal of Diseases of Children. 1982;136:452-456

2. Batshaw M. In: Children with disabilities. 5th ed. Baltimore: Brooks Publishing Co; 2002;p. 443-466

3. Bennett F. Diagnosing cerebral palsy–the earlier the better. Contemporary Pediatrics. 1999;16:208-216

4. Blair E, Stanley F. Interobserver agreement in the classification of cerebral palsy. Developmental Medicine and Child Neurology. 1985;27:615-622

5. Boyle C, Decoufle P, Yeargin-Allsopp M. Prevalence and health impact of developmental disabilities in US children. Pediatrics. 1994;93:399-403

6. Clark SL, Hankins GD. Temporal and demographical trends in cerebral palsy–fact and fiction. American Journal of Obstetrics and Gynecology. 2003;188:628-633

7. Dormans JP, Pellegrino L. Caring for children with cerebral palsy. Baltimore: Brooks Publishing; 1998;

8. Fedrizzi E, Facchin P, Marzaroli M, Pagliano E, Botteon G, Percivalle L, et al. Predictors of independent walking in children with spastic diplegia. Journal of Child Neurology. 2000;15:228-234

9. Futagi Y, Otani K, Goto M. Prognosis of infants with ankle clonus within the first year of life. Brain Development. 1997;19:50-54

10. Gibson CS, MacLennan AH, Goldwater PN, Dekker GA. Antenatal cause of cerebral palsy: Associations between inherited thrombophilias, viral and bacterial infection, and inherited susceptibility to infection. Obstetrics Gynecology Survey. 2003;58:209-220

11. Grether J, Nelson K, Emory E. Prenatal and perinatal factors and cerebral palsy in very low birth weight infants. Journal of Pediatrics. 1996;128:407-414

12. Han TR, Bang MS, Lim JY, Yoon BH, Kim IW. Risk factors of cerebral palsy in preterm infants. American Journal of Physical Medicine and Rehabilitation. 2005;81:297-303

13. Hutton J, Pharoah P. Effects of cognitive, motor, and sensory disabilities on survival in cerebral palsy. Archives of Diseases in Childhood. 2002;86:84-89

14. Katz RT. Life expectancy for children with cerebral palsy and mental retardation: Implications for life care planning. NeuroRehabilitation. 2003;18:261-270

15. Kuban K, Leviton A. Cerebral palsy. The New England Journal of Medicine. 1994;330:188-195

16. Molnar G. In: Pediatric Rehabilitation. 2nd ed. Baltimore: Lippincott Williams & Wilkins; 1992;p. 492-500

17. Molnar GE, Gordon SU. Cerebral palsy: Predictive value of selected clinical signs for early prognostication of motor function. Archives of Physical Medicine and Rehabilitation. 1976;57:153-158

18. Morgan AM, Aldag JC. Early identification of cerebral palsy using a profile of abnormal motor patterns. Pediatrics. 1996;98:642-649

19. Moster D, Lie RT, Irgens L, Bjerkedal T, Markestad T. The association of Apgar score with subsequent death and cerebral palsy: A population-based study in term infants. Journal of Pediatrics. 2001;138:798-803

48

20. Pueyo R, Junque C, Vendrell P. Neuropsychologic differences between bilateral dyskinetic and spastic cerebral palsy. Journal of Child Neurology. 2003;18:845-850

21. Roberts G, Palfrey J, Bridgemohan C. A rational approach to the medical evaluation of a child with developmental delay. Contemporary Pediatrics. 2004;Retrived May 9, 2004, from www.comtemporypeds.com

22. Rosembaum P. Cerebral palsy: What parents and doctors want to know. British Medical Journal. 2003;326:970-974

23. Rosenbaum PL, Walker SD, Hanna SE, Palisano RJ, Russell DJ, Raina P, et al. Prognosis for gross motor function in cerebral palsy: Creation of motor development curves. Journal of the American Medical Association. 2002;288:1357-1363.

mozrdilTa nevrologia rezidenti muSaobs mozrdilTa nevrologiis akreditebul centrSi rogorc stacionarul, aseve ambulatorul pacientebTan. eswreba kvleviT Sexvedrebs (radiologiuri, genetikuri, paTomorfologiuri, neirofiziologiuri). moduli SeiZleba gaerTiandes pediatriuli nevrologiis modulTan da SesaZloa moicvas mozardebisTvis gankuTvnili klinika. minimaluri xangrZlivoba 2 Tve

moduli: mozrdilTa nevrologia

xangrZlivoba: 2 Tve

mizani: mozrdili nevrologiuri pacientis gasingva, anamnezis Sekreba, nevrologiuri statusis Sefaseba, mozrdilTa nevrologiuri daavadebebis kargi codna, pediatriul nevrologiuri daavadebebTan minmarTebaSi TaviseburebaTa codna.

modulis amocanebi


mozrdili nevrologiuri pacientis gasinjva, nevrologiuri statusis Sefaseba.

cnobierebis darRveva

cnobierebis darRvevis Sefaseba, gabrueba, deliriumi, paTologiuri Zilianoba, sopori, koma;

nevrologiuri statusis Sefaseba cnobierebis darRvevis dros, Sesabamisi nevrologiuri kvlevebis warmoeba,

cnobierebis daTrgunvis gamomwvevi ZiriTadi daavadebebeis amocnoba, diagnostika, mkurnaloba.

Tavis tkivili

Tavis tkivilis epidemiologia, klasifikacia, paTfiziologia;

Tavis tkivilis mqone pacientis Sefasebis Taviseburebebi;

diferenciuli diagnozi, kliniko-laboratoriuli testebi;

mwvave generalizebuli, mwvave lokalizebuli Tavis tkivili

mwvave morecidive Tavis tkivili /Sakiki, Sakikis variantebi/

qronikuli araprogresirebadi Tavis tkivili

qronikuli progresirebadi Tavis tkivili

sxvadasxvagvari Tavis tkivili

Tavis tkivilis sindromTa Taviseburebani mozrdilTa asakSi

Tavis tkivilis specifikuri sindromebi;

Tavis tkivilis marTva, farmakologiuri Terapia. inteleqtis darRveva

49

gonebrivi ganviTarebis CamorCena

demencia Tavbru

Tavbrus Sefaseba: vestibularuli Tavbrusxveva, sinkope da kolafsi, wonasworobis kargva, Tavbrusxvevis msgavsi gaurkveveli mdgomareobebi.

vestibularuli Tavbrus klinikuri da paraklinikuri Sefaseba, kvleva.

vestibularuli TavbruTi da wonasworobis kargviT midinare uxSiresi daavadebebis diagnostika da mkurnaloba / vestibuluri neironiti, keTilTvisebiani poziciuri Tavbru, posttravmuli Tavbru, menieris sindromi, labirinTiti, funqciuri Tavbru, tvinis Reros gardamavali iSemia, insulti da sxv./

zurgis tkivili

malTaSua diskis Tiaqari

osteoqondrozi

spondilolizi da spondilolistozi

xerxemlis sxva dazianebani: ankilozirebadi spondiloarTriti, pevmatoiduli arTriti, pejetis daavadeba

simsivnis metastazebi

Zvlebis metaboluri dazianebani epilefsia

epilefsiis epidemiologia, paTfiziologia, epilefsiuri gulyrebis klasifikacia, normaluri eeg;

generalizebuli gulyrebi, difdiagnozi, eeg, etiologia, mkurnaloba, prognozi;

gansakuTrebuli epilefsiebi-epilefsiuri encefalopaTiebi, difdiagnozi, eeg, etiologia, mkurnaloba, prognozi;

parcialuri gulyrebi, klasifikacia, etiologia, eeg, marTvis principebi, antikonvulsantebi, marTvis yvelaze xSiri Secdomebi, qirurgiuli mkurnaloba;

kognitiuri simptomebiT mimdinare epileftiformuli darRvevebi, etiologia, paTfiziologia, mkurnaloba;

mioklonia da miokloniuri gulyrebi, klasifikacia, mkurnaloba;

epilefsiuri statusi, paTfiziologia, klasifikacia, epidemiologia, etiologia, marTva, prognozi;

antiepilefsiuri medikamenturi mkurnaloba, principebi, farmakokinetika, bavSvTa asakis Taviseburebebi, medikamentebis urTierTqmedeba, farmakodinamika, dozireba da miRebis gzebi, klinikuri da laboratoriuli monitoringi, gverdiTi movlenebi, wamlis SerCeva;

ketogenuri dieta, efeqturoba, moqmedebis meqanizmi, kandidatebis SerCeva, Cveneba-ukuCveneba, garTulebebi;

epilefsiis mkurnalobis alternatuli meTodebi;

epilefsiuriqirurgia, Cvenebebi, preoperaciuliSefaseba, miznebi;

qceviTi, kogniciuridasocialurisiZneleebiepilefsiisdros;

sinkope, epidemiologia, saxeebi;

sxva araepilefsiuri paroqsizmebi;

Zilisfiziologia, ZilisdarRvevebismqonepacientisSefaseba, dissomniebidaparasomniebi, maTisaxeebi.

tvinis sikvdili

tvinis sikvdilis kriteriumebi

50

qronikuli vegetatiuri mdgomareoba cerebrovaskularuli darRvevebi

iSemiuri da hemotagiuli insulti

sisxlis mimoqcevis gardamavali moSla

subaraqnoidaluri hemoragia. Simsivneebi

Tavis tvinis simsivneebis epidemiologia, sixSire, histopaTologiuri da lokalizaciuri dayofa, diagnostika, marTvis ZiriTadi principebi, qirurgia, radiacia, qimioTerapia;

zurgis tvinis simsivneebis tipebi, klinikuri niSnebi, diagnostika, marTva, garTulebebi;

cns-is dazianeba leikemiis da limfomis dros da misi marTva;

cns-is simsivneebis mkurnalobis mogvianebiTi efeqti da axali midgomebi mkurnalobaSi;

avTvisebiani glioma

supratentorialuri astrocitoma da oligodendroglioma

cns pirveladi limfomebi

meningiomebi

Svanoma,

hiofizis adenoma

metastazuri simsivneebi da sxv. travma

Comocio , Contusion cerebri

epiduruli, subduruli, intracerebruli hemoragia

subaraqnoiduli hemoragia. mademielinizebeli daavadebebi

gafantuli sklerozi

optikuri nevriti

mwvave diseminirebuli encefalomieliti

mwvave transversiuli mieliti toqsiuri da metaboluri darRvevebi

RviZlismieri encefalopaTia

qronikuli hepatocerebruli degeneracia

vilsonis daavadeba

reies sindromi

uremiuli encefalopaTia

uremiuli neiropaTia

hemodializis nevrologiuri garTulebebi

Tirkmlis transplantaciis nevrologiuri garTulebebi

porfiria

mZime metalebiT intoqsikacia

alkoholuri intoqsikacia, alkoholuri abstinencia

vernikes encefalopaTia

barbituratebiT intoqsikacia

cns –ze damTrgunveli efeqtis mqone sxva nivTierebebiT intoqsikacia

amfetaminiT, salicilatebiT, antidepresantebiT intoqsikacia

avTvisebiani neiroleptiuri sindromi

51

hipovitaminozebi.

moZraobiTi darRvevebi

piramiduli, naTxemis, qerqqveSa birTvebis dazianeba

medikamenturi eqstrapiramiduli darRvevebi

parkinsonis daavadeba

hentinqtonis daavadeba

torsiuli distonia, spastiuri kisermrudoba, paroqsizmuli qoreoaTetozi

tikebi, tremori, mioklonusi

mousvenari fexebis sindromi.

nervkunTovani daavadebebi

miopaTiebi

miotoniebi

poilimioziti

triqinelozi

rabdomiolizi,

glikogenozebi

paroqsizmuli mioplegiebi

miasTenia

botulizmi

tetanusi

avTvisebiani hiperTermia da avTvisebiani neiroleptiuri sindromi

gien-bares sindromi

qronikuli neiropaTiebi /hipovitaminozis, Sqaqriani diabetis, vegetatiuri, toqsiuri neiropaTiebi/

arxovani neiropaTiebi

belis dambla

gverdiTi amiotrofiuli sklerozi

spinaluri amiotrofia. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba


mozrdilTa nevrologia

anamnezuri monacemebis Segroveba, pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, pacientis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT daavadebaze eWvis mitana;

30 2 ref

erat

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a 10 SemT

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is

prez

entac

ia


30



35

eleqrtomiografiuli kvlevis Sedegebis 30

52

interpretacia

laboratoriuli kvlevis monacemTa interpretireba 30

pacientisTvis medikamentozuri mkurnalobis adekvaturi SerCeva da marTva;

30





1. janeliZe m., klinikuri nevrologia, 2009 2. Maurice Victor; Aiian H. Ropper; Princioles of Neurology. McGrowhill. 9th edition. 2009. 1572. 3. W. Michael Scheld; Richard J. Whitley; Cristina M. Marria; Infections of the Central Nervous

System. Third edition. Lippincott Williams & Wilkins. 2004. p939. 4. M.J.Aminof, D.A.Greenberg, R.P.Simon, Clinical Neurology, Lange, 6th edition,2005, 401p. 5. Kenneth W. Lindsay PHD FRCS. Neurology and Neurosurgery Illustrated. Churchill Livingstone;

2005. 5th edition. p612. 6. Lewis P. Rowland; Timothy A. Pedley MD. Merritt's Neurology. Lippincott Williams & Wilkins; 12

Har/Psc edition (2009). 1216 pages. 7. Duglas Gelb MD; Introduction to Clinical Neurology. Oxford University Press, USA; 4th edition

(2010). 528 pages 8. Jose Biller MD, Practical Neurology. Lippincott Williams & Wilkins; 4th Edition (2012). 748 pages.

bavSvTa fsiqiatria moduli SesaZloa gavlili iqnas arasruli dRis grafikiT an SeTavsebuli iqnas bazisur pediatriul an pediatr-nevrologiur modulebTan. igi moicavs zedamxedvelobis qveS fsiqiatriuli paTologiis mqone bavSvTa klinikur zedamxedvelobas zogad an neirofsiqiatriul ganyofilebaSi. moduli SesaZloa gaerTiandes sxva bavSvTa nevrologiur modulebTan. minimaluri periodi 1 arasruli dRe/kviraSi 6 Tvis manZilze an Sesabamisi eqvivalenti.

moduli: bavSvTa fsiqiatria

xangrZlivoba: 2 Tve

mizani

bavSvTa asakis qceviTi da emociuri aSlilobebisa da socialuri problemebis safuZvlebis codna;

mentaluri problemebis mqone bavSvis/mozardis da misi ojaxis Sefaseba;

fsiqotropuli medikamentebis Cvenebebisa da ukuCvenebebis codna;

mentaluri problemebis aramedikamentozuri marTva.

53

modulis amocanebi


o mentaluri janmrTelobis perinataluri da adreuli bavSvobis asakis risk- da dacviTi faqtorebi

o bavSvTa da mozardTa qceviTi, emociuri da socialuri problemebis epidemiologia;

o skolamdeli asakis bavSvis socialur-emociuri ganviTareba; o mentaluri problemebis, maT Soris:

o ganviTarebiTi darRvevebis: daswavlis problemebis enurezis enkoprezis autisturi speqtris aSlilobebis

o qceviTi darRvevebis: yuradRebis deficitisa da hiperaqtiurobis sindromis opoziciur-gamomwvevi qceviTi aSlilobis

o guneba-ganwyobis aSlilobebis depresiis bipolaruli aSlilobis suicidi da TviTdamazianebeli qcevis

o tikozuri aSlilobebis o SfoTviTi aSlilobebis o kvebiTi aSlilobebis o somatoformuli aSlilobebis

klinikuri gamovlinebebi, SeZlos diagnostika da marTva multidisciplinur gundTan erTad;

o fsiqometruli testirebis interpretireba; o bavSvTa fsiqiatriis gadaudebeli mdgomareobebis amocnoba da

marTva; o mentaluri janmrTelobis neiromecnieruli safuZvlebi da misi

gamoyeneba klinikur praqtikaSi. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba


bavSvTa fsiqiatria

skolamdeli asakis bavSvis socialur-emociuri ganviTarebis skrininguli da sadiagnostiko Sefaseba

20 2 ref

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da

6 SemT

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pacientis da ojaxis problemebis identificireba, miznis gamoyofa, struqturirebuli kiTxvaris gamoyeneba, multidisciplinur gundSi muSaoba

10

qceviTi darRvevebis diagnostika da Terapiis saWiroebis da moculobis gansazRvra

10

autisturi speqtris aSlilobebis skriningi da diagnostika

10

qceviTi da emociuri aSlilobebis multidisciplinuri gunduri diagnostika da marTvis aramedikamenturi meTodebis, maT Soris qceviTi, fsiqoTerapiuli, xelovnebiT Terapiis gamoyeneba

10

54


rezidentma unda daweros ori referati da gaakeTos eqvsi SemTxvevis prezentacia.



1. oqsfordis mokle saxelmZRvanelo fsiqiatriaSi, me-5 gamocema, maikl gelderi, pol harisoni, filip qoueni, globaluri iniciativa saqarTveloSi, Tbilisi, 2012;

2. Fleischhacker WW and Brooks DJ, Neurodevelopmental Disorders, Springer Wien NewYork, 2005;

3. Klykylo WM, Kay J, Clinical Child Psychiatry, John Wiley&Sons, 2005; 4. Rey J. M. (editor) IACAPAP Textbook of Child and Adolescent Mental Health,

IACAPAP, Geneva, 2012; 5. http://www.medscape.com/resource/child-adolescent-psychiatry

http://iacapap.org/publications specialuri sferoebi pediatriul nevrologiaSi zogierTi sfero saWiroebs sagangebo swavlebas. isini ar aris savaldebulo. rezidentma SesaZloa moindomos am sferoSi fokusireba pedagogTan SeTanxmebiT. qvemoT mocemulia zogierTi:

pediatriuli neiroimijingi

pediatriuli neirofiziologia

pediatriuli nevropaTologia

neirogenetika

pediatriuli neirometaboluri daavadebebi

pediatriuli neirointensiuri marTva

neonataluri nevrologia

pediatriuli epileftologia

pediatriuli da mozardTa neirofsiqiatria.

. kvleviTi treningi pediatriul nevrologiaSi mniSvnelovania rom rezidentebi CarTuli iyvnen kvlevaSi. rigi centrebi saTanadodaa aRWurvilia kvleviTi treningebis Casatareblad, kvlevis zedamxedvelobisa da kvleviTi jgufebis organizebisaTvis. kvlevis klinikuri nawili ganxilul unda iyos rogorc maTi klinikuri modulis nawili kursis xelmZRvanelTan SeTanxmebiT da qveynis kanonmdeblobis gaTvaliswinebiT.

4. pedagogebi saswavlo kurss xelmZRvanelobs pedagogiur da klinikur sferoSi gamocdili bavSvTa nevrologi. sasurvelia mas hqondes bavSvTa nevrologiis sferoSi samecniero muSaobis gamocdileba. igi ecnoba

http://www.medscape.com/resource/child-adolescent-psychiatry

http://iacapap.org/publications

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yvela rezidents kursis dawyebisas, meTvalyureobs programas da afasebs rezidentTa swavlebas yovelwliurad. xanmokle periodis ganmavlobaSi TiToeuli rezidentis saqmianobas meTvalyureobs pedagogi. rezidenti awarmoebs dRiurs, romelSic asaxulia yvela misi aqtivoba. modulis warmatebiT dasruleba dasturdeba saTanado mowmobiT, romelic detalurad asaxavs rezidentis mier gaweul samuSaos da aTvisebul masalas.

5. saswavlo baza swavleba mimdinareobs Sesabamis centrebsa da ganyofilebebSi, romelTa SerCeva warmoebs klinikuri da pedagogiuri SesaZleblobebis gaTvaliswinebiT da maTi SesabamisobiT modulebis moTxovnilebebTan.

6. swavleba rezidentis swavlebis sakiTxebi unda iTvaliswinebdes Sesabamisi kompetenciebis specifikas: I. pacientze zrunva/movla

1. pacientis kontrolirebadizrunva/movlis gamocdileba pasuxismgeblobis TandaTanobiTi matebiT, maT Soris ambulatoriuli da stacionaruli:

o anamnezis Segroveba pacientisa da misi ojaxis wevrebisgan an sxva naTesavebisgan

o fizikuri da nevrologiuri gasinjvis Sesruleba o diferenciuli diagnostikis ganviTareba, maT Soris

savaraudo nevrologiuri lokalizacia da/an genetikuri an metaboluri anomaliebi

o diagnostikisTvis laboratoriuli, radiologiuri da eleqtrofiziologiuri Sefasebis ganviTareba da implementacia

o testirebis Sedegebis interpretacia o Terapiuli gegmis ganviTareba da implementacia o pediatriul gundTan, kvebasTan, fizikur da okupaciur

Terapiasa da jandacvis damxare sxva konsultantebTan SeTanxmebiT zrunva/movlis gegmis koordinireba

2. konsultireba pediatriuli gadaudebeli daxmarebis, neonataluri da pediatriuli intensiuri Terapiis ganyofilebebSi sicocxlisaTvis saxifaTo nevrologiuri darRvevis mqone pacientis marTvisas. nevrologiuri procedurebis kontrolirebadi Sesruleba palataSi, intensiuri Terapiis ganyofilebasa da klinikaSi, maT Soris: o lumbaluri punqcia o kaloriuli cda o edrofoniumis testi

3. nevropaTologiur servisSi rotireba, sadac unda Seasrulos: o Tavisa da zurgis tvinis avtofsiuri masalis momzadeba da

saTanado Senaxva

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o pediatriul nevropaTologiur konferenciaze SemTxvevis prezentaciis momzadeba da wardgena

o mozrdilTa da pediatriul nevropaTologiur konferenciebze daswreba

4. klinikur konferenciebSi aqtiuri monawileoba, maT Soris: o neiroradiologiur o klinikuri SemTxvevebis yovelkvireul o pediatriul nevropaTologiur o epilefsia/eeg-s konsensus-ganxilvebSi

II. samedicino codna

klinikuri swavleba zeda kursis rezidentebis da eqimebis mier swavlebis kursis dros ambulatoriuli da stacionaruli servisebis ganxorcielebisas

klinikuri swavleba pediatriuli reabilitaciis, bavSvTa fsiqiatriis, epilefsiis, neirofiziologiis da pediatriuli nevrologiis qvespecialobebSi rotaciisas

SemTxvevaTa ganxilvebi nevrologiaSi, neiroradiologiaSi, nevropaTologiaSi da eeg/neirofiziologiaSi

didaqtiuri leqciebi klinikur nevrologiaSi da neiromecnierebebSi, maT Soris yovelkvireuli ganyofilebis Semovlebi

nabeWdi teqtidan, Jurnalebidan da kompiuteridan bavSvTa nevrologis ZiriTadi kurikulumis Sesabamisi masalis damoukideblad swavla

internetidan masalis moZieba klinikuri muSaobisa da swavlisTvis saganmanaTleblo lokalur da qveynis masStabiT mimdinare

kursebSi (maT Soris uwyveti samedicino ganaTlebis) monawileoba

III. interpersonuli da komunikaciuri unar-Cvevebi monawileoba interdisciplinuri gundis muSaobaSi pacientis marTvisas gamoyenebul sakonsultacio servisebTan

komunikacia ojaxTan Sexvedrebis xelmZRvaneloba pacientis, marTvis

gadawyvetilebis, sicocxlis bolo etapis gadawyvetilebis, servisis gagrZelebis gadawyvetilebis Sesaxeb informaciis gaziarebisTvis

yoveldRiuri kursusebis, klinikuri aRniSvnebis da gaweris epikrizis warmoeba

IV. praqtikaze dafuZnebuli swavleba da misi gaumjobeseba departamentis SemTxvevaTa ganxilvis konferenciebSi monawileoba Cvenebis mixedviT klinikuri meTodis gamoyeneba gamoqveynebuli praqtikuli parametrebis mimoxilva

V. profesionalizmi klinikis interdisciplinuri gundis muSaobaSi monawileoba eTikuri normebi (maT Soris pospitalis Sinaganawesis, paliatiuri

movlis, Tavis tvinis sikvdilis, reanimaciul RonisZiebebis ardaqvemdebarebuli SemTxvevebis Sesaxeb)

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VI. sistemaze dafuZnebuli praqtika klinikaSi muSaoba bavSvisa da misi ojaxisaTvis da lideris rolis

TandaTanobiT mateba internet-gverdebis perioduli mimoxilva axali praqtikuli

parametrebis da gaidlainebis gasacnobad daavadebaTa an mSobelTa organizaciebis, maTi samarTlebrivi dacvis

meqanizmebis codna ambulatoriuli pacientis xangrZlivi marTva swavlebis meTodebi

didaqtikuri meTodi - orsaaTiani swavleba kviraSi 3jer, nevrologiis ZiriTad sakiTxebze, maT Soris 4 kvira gadaudebeli nevrologiis sakiTxebis ganxilviT;

rezidentis mier pacientis gasinjva/ganxilva kviraSi orjer, maT Soris 4 kvira gadaudebeli nevrologiuri mdgomareobebis mqone pacientTa;

rezidenturis xelmZRvanelis mier kviraSi 2 pacientis saCvenebeli gasinjva/ganxilva sruli anamneziT, istoriiT da diskusiiT;

yovelwliurad 5 pacientis SemTxvevis momzadeba prezentaciisaTvis;

kursis xelmZRvanelTan erTad TveSi½1 Ramis morigeobis Sesruleba 7. Sefaseba/gamocda SesaZlebelia yvela departamentma ver uzrunvelyos aRniSnuli programis yvela aspeqtis srulad dakmayofileba. saboloo Sefasebis mizani ar unda iyos ubralod “yvela grafis Sevseba”, aramed mTeli saswavlo kursis Sedegebis analizi da imis gansazRvra ramdenad Seesabameba rezidentis codna arsebul standartebs. rezidenturis swavlebis kursis ganmavlobaSi rezidentis Sefaseba unda moxdes kompetenciebis specifikis gaTvaliswinebiT: I. pacientze zrunva/movla saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier

palatasa da klinikur sesiebze saerTo da kompetencia-specifikuri Sefaseba zeda kursis rezidentis

da mozrdilTa nevrologiis rotaciaze myofi rezidentis mier monawileoba bavSvTa nevrologis stacionarul gundSi,

ambulatoriul klinikaSi, gadaudebel ganyofilebaSi, intensiuri Terapiis ganyofilebaSi, reabilitaciur ganyofilebaSi

monawileoba bavSvTa nevrologisTvis Sesabamis klinikur konferenciebSi

anamnezis Segrovebis, nevrologiuri gasinjvis, diagnostikis da marTvis codnis gamomJRavneba konsiliumebsa da saintereso SemTxvevebis ganxilvebze

procedurebis Sesrulebis Sefaseba kt, mrt, eeg, emg, neirosonografiuli kvlevebis, specifikuri

bioqimiuri/genetikuri testirebis, neirofsiqiatriuli testirebis, antikonvulsantebis da fsiqofarmakologiuri medikamentebis Rirebulebis codnis gamomJRavneba

II. samedicino codna saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier

palatasa da klinikur sesiebze

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saerTo da kompetencia-specifikuri Sefaseba zeda kursis rezidentis da mozrdilTa nevrologiis rotaciaze myofi rezidentis mier

Sefaseba rezidentis yovelwliur gamocdaze monawileoba stacionarul nevrologiur gundSi, konsultaciebSi

gadaudebeli daxmarebis departamentSi, intensiuri Terapiis ganyofilebaSi, reabilitaciis ganyofilebaSi

monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi monawileoba klinikur konferenciebSi (dilis konferencia, bavSvTa

nevrologiuri SemTxvevebis ganxilva, Semovla, bavSvTa nevrologiis qvespecialobebis da Sesabamis neiromecnierebebis konferenciebi)

yovelkvireul nevrologiur da pediatrul Semovlebze daswreba rezidenturis finalur gamocdaze Sefaseba samedicino da mecnieruli, maT Soris biblioTekis da eleqtronuli,

pacientis/ojaxis an daavadebis mixedviT Seqmnili jgufebisa da organizaciebis resursebis codnis demonstrireba diagnostikis, marTvisa da mkurnalobisTvis

III. interpersonuli da komunikaciuri unar-Cvevebi saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier


da mozrdilTa nevrologiis rotaciaze myofi rezidentis mier istoriebis sistematuri mimoxilva pacientTan/ojaxTan interviuebsa da urTierTobebze dakvirveba monawileoba stacionarul nevrologiur gundSi, gadaudebel,

intensiur Terapiis da reabilitaciis ganyofilebaSi konsultaciebSi monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi, maT

Soris eqimTan pacientis prezentacia, referirebul eqimTan, jandacvis sferos sxva personalTan, konsultantebTan, skolis pedagogTan, mSoblebTan/ojaxis wevrebTan komunikacia

klinikur konferenciebze pacientis prezentacia da ganxilva avadoba-letalobis konferenciebis momzadeba da prezentacia bavSvTa nevrologiis SemTxvevebis pediatriul dilis konferenciebze

moxseneba IV. praqtikaze dafuZnebuli swavleba da misi gaumjobeseba saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier


da mozrdilTa nevrologiis rotaciaze myofi rezidentis mier departamentis da ganyofilebis SemTxvevaTa ganxilvis konferenciebSi

monawileoba avadoba-letalobis konferenciebSi monawileoba monawileoba stacionarul nevrologiur gundSi, gadaudebel,

intensiuri Terapiis da reabilitaciis ganyofilebaSi konsultaciebSi, maT Soris mSoblebTan/ojaxis wevrebTan SexvedrebSi, komunikacia pediatriul rezidentebTan, jandacvis sferos sxva personalTan, socialur muSakebTan da sxva konsultantebTan

monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi, maT Soris eqimTan pacientis prezentacia, komunikacia referirebul eqimTan, jandacvis sferos sxva personalTan, konsultantebTan, socialur pedagogTan, mSoblebTan/ojaxis wevrebTan

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pacientis movla/zrunvisas protokolis gamoyeneba gamoqveynebuli praqtikuli parametrebis codnis demonstrireba klinikur konferenciebze SemTxvevaTa prezentacia da ganxilva avadoba-letalobis konferenciis momzadeba, prezentacia da daswreba samedicino da mecnieruli resursebis, maTYSoris biblioTekis,

eleqtronuli biblioTekis da monacemTa bazebis, farmakologiur monacemTa bazis codnis demonstrireba

V. profesionalizmi saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier


da mozrdilTa nevrologiis rotaciaze myofi rezidentis mier monawileoba stacionarul nevrologiur gundSi, gadaudebel,

intensiur Terapiis da reabilitaciis ganyofilebaSi konsultaciebSi, maT Soris mSoblebTan/ojaxis wevrebTan SexvedrebSi, jandacvis sferos sxva personalTan, eqTnebTan da sxva konsultantebTan

monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi, maT Soris eqimTan pacientis prezentacia, komunikacia referirebul eqimTan, jandacvis sferos sxva personalTan, konsultantebTan

avadoba-letalobis konferenciis momzadeba, prezentacia da daswreba eqvsTviani sruli mimoxilva samedicino da mecnieruli resursebis, maTYSoris saerTaSoriso

konferenciebis da kongresebis, biblioTekebis (eleqtronuli da beWdviTi), farmakologiuri da samedicino monacemTa eleqtronuli bazebis codnis demonstrireba

nevrologiis da pediatriis kurikulumSi Semavali eTikuri modulis gavla

VI. sistemaze dafuZnebuli praqtika saerTodakompetencia-

specifikuriSefasebadamswreeqimismierpalatasadaklinikursesiebze saerTodakompetencia-

specifikuriSefasebazedakursisrezidentisdamozrdilTanevrologiisrotaciazemyofirezidentismier

kompetenciebis Sesabamisi samedicino Canawerebis mimoxilva nevrologiur jandacvis gundSi monawileoba monawileobabavSvTanevrologiisambulatoriulklinikaSipacientismarT

visprocesSi, komunikaciadamswredareferirebuleqimTan, jandacvissferossxvapersonalTan

jandacvisgundiskomponentebis, maTSorismovlis, fizikuriTerapiis, okupaciuriTerapiis, metyvelebisTerapiis,socialuriservisis, ganaTlebisdaSemTxvevismarTvis

socialuri servisis da pacientis dacvis hospitalSiga resursebis codnis demonstrireba

Sesabamisi samedicino Canawerebis warmoebis demonstrireba. klinikur konferenciebSi monawileoba

konsensusze damyarebuli praqtikuli gaidlainebis da resursebis codnis demonstrireba.

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pacientTa dacvis lokaluri da saxelmwifo organizaciebis codna da am organizaciebTan dakavSirebis unari

rezidentis pirveli Sefaseba unda moxdes rezidenturis dawyebidan pirvel 6 TveSi. formebi rezidentis kursis ganmavlobaSi SefasebisTvis mocemulia qvemoT. uSualo dakvirvebis forma

forma ivseba rezidentze dakvirvebisas misi klinikuri diagnostikis procesSi

kompet

ent

uri

iviTar

ebs

kompet

enc

ias

Seu

sabamo

an ar

Sef

asda

pacientis movla/zrunva yuradRebas amaxvilebs ojaxis momarTvis mizezze agrovebs dawvrilebiT monacemebs ganviTarebis Sesaxeb, maT Soris:

iyenebs ganmartebul Sesabamis SekiTxvebs “ganviTarebis” mTavari Civilis asaxsnelad

mimoixilavs sistemebs ise, rom SekiTxvebi moicavdes ganviTarebis Sesaxeb monacemebs

krebs informacias ojaxis Sesaxeb ganviTarebasTan kavSirSi

asrulebs srul pediatriul-nevrologiur Sefasebas adekvaturad ganumartavs ojaxs daxmarebebs rTavsojaxsmkurnalobis/moqmedebebisgegmisgansazRvraSi

interpersonuli da komunikaciuri unar-Cvevebi diagnozis da marTvis Sesaxeb informacias awvdis gulisxmierad, damajereblad da ara-ganaCenis saxiT

ganumartavs ojaxs ganviTarebiTi unarSezRudulobis Sedegebs

axorcielebs aqtiur mosmenas Cans manugeSebeli da auCqarebeli SesabamisadafasebsmSoblebiswuxilisxarisxs; vizitisdrosdamoculobasmarTvasadekvaturad

bavSvsganviTarebisetapisSesabamisadrTavsvizitisasgansaxilvelsakiTxebSi

acnobierebsTarjimnissaWiroebas; iyenebsTarjimansefeqturad

------------------------------------------------------------------------ -------------------------------------------------------------------- --------------

rezidentissaxelidagvarixelmoweriTdamswressaxelidagvarixelmoweriTTariRi

komentarebi

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

pediatriuli rezidentis Sefaseba

nevrologiuri gasinjvis Sefasebis forma ki ara

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pre- da postrotaciuli Sefaseba CanawerizogadigasinjvismonacemebisSesaxeb (mag.: dismorfuliniSnebi, yiflibandi, kefisgabrtyeleba, kardialurianomaliebi, hepatosplenomegalia, kanismieridazianebebi)

CanawerimentaluristatusisSesaxeb (mag.: orinetacia, sifxizle, metyvelebadasaWiroebisSemTxvevaSiinteleqtisSefasebisSedegi)

kraniuli nervebi

II – fundoskopia, mxevelobis veli, mxedvelobis simaxvile, quTuTos daxuWvis refleqsi

III, IV, VI – SeuRlebuli moZraobebi, strabizmi, eqstraokuluri moZraobebi, ftozi

V – mgrZnobeloba, kornealuri refleqsi

VII – saxis kunTebis Zala

VIII – smena, nistagmi

IX/XII – mkerd-laviw-dvrilisebri kunTis Zala, ena

motoruli

masa

tonusi (mag.: traqciaze pasuxi, horizontaluri/vertikaluri dakideba, kidurebis tonusi)

Zala

motoruli ganviTareba

siaruli (mag.: sxeulis wonis tareba, TiTebi, quslebi, tandemuri siaruli, rombergis niSani)

koordinacia (mag.: dismetria an saTamaSomde miwvdena, swrafi alternatiuli moZraobebi, muxl-quslis cda, cxvir-TiTis cda)

refleqsebi (mag.: Rrma refleqsebi, martivi refleqsebi, maT Soris moros, kisris tonuri, yrdnobis, paraSutis)

mgrZnobeloba (mag.: tirili, lokalizeba, mizanmimarTuli moSoreba, spinaluri done, dorzaluri svetis – vibraciuli, propriocepcia, temperatura, Sexeba)

gasinjvas eswreboda -----------------------------------------------/xelmowera/

rCevebi/fokusirebis sfero ----------------------------------------------------------

Sefaseba unda moxdes pacientis sawolTan, xelmZRvanelis mier rezidentis muSaobaze dakvirvebiT. is unda grZeldebodes 1 saaTi da Sedgebodes Semdegi nawilebisagan

anamnezis Sekreba - 30 wuTi

nevrologiuri gasinjva, Sefaseba 15 wuTi

Sedegebis interpretacia - 15 wuTi qulebis 50% mogrovebis SemTxvevaSi, barieri daZleulad iTvleba. amave periodSi xdeba dakvirveba unar-Cvevebze da maTi Sesrulebis xarisxze. dgeba CamonaTvali in unarebis, romelTa gaumjobesebaze saWiroa muSaoba. meore Sefaseba igive programiT xdeba rezidenturis pirveli wlis bolos. am SemTxvevaSi barieri daZleulia, Tu rezidentma moagrova qulaTa 80%. rezidentis saboloo Sefaseba xdeba finalur gamocdaze, romelic Sedgeba zepiri da weriTi nawilisgan.rezidenturis zepiri gamocda unda

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Catardes kursis dasrulebamde ramodenime TviT adre, raTa SesaZlebeli iyos arsebuli xarvezebis gamosworeba. zepiri gamocdaunda iTvaliswinebdes Sefasebas 4 sferoSi:

anamnezis Sekreba

nevrologiuri gasinjva

profesionalizmi da konsultirebis unari

prezentacia/formulirebis unari rezidentis mier gasinjuli unda iyos misTvis (da sasurvelia danarCeni rezidentebisTvisac) ucnobi 3 bavSvi an mozardi, romelTagan erTi aucileblad iqneba 2 wlamde asakis da erTi – kritikul mdgomareobaSi myofi. pacientebis SerCevas awarmoebs rezidenturis programis xelmZRvaneli (an komitetis Tavmjdomare). TiToeul rezidents damoukideblad afasebs minimum 3 sertificirebuli (da komitetis wevri) bavSvTa nevrologi Sesabamisi qulebiT (gamocdebis dros gamosayenebeli specialuri Sefasebis formebi warmodgenilia damatebis saxiT). Sefasebis erTi dRe unda gagrZeldes daaxloebiT 1 saaTi. rezidents unda mieces maqsimum 45 wuTi anamnezis Sesagroveblad da nevrologiuri gasinjvisaTvis. damatebiT eZleva 15 wuTi Sedegebis Sesajameblad da prezentaciisTvis.

Sefasebis komponentebi da kriteriumebi

a. anamnezis Sekrebis unari

kompetenciebis RerZs warmoadgens rezidentis mier pacientis daavadebis naTeli, zusti istoriis Sekrebis unari. bavSvTa nevrologi unda flobdes unars istoriis mixedviT moaxdinos daavadebis diagnostika da dazianebis lokalizacia. Semfasebeli akvirdeba am unars da misi gamxorcielebis Tanmimdevrobas.

rezidentma SeiZleba sxvadasxva strategia gamoiyenos anamnezis Sesagroveblad, magram Sedegad unda moagrovos srulyofili informacia qvemoT CamoTvlil sakiTxebze:

daavadebis amJamindeli istoria

daavadebis adreuli istoria

ojaxuri anamnezi

socialuri anamnezi

sxva sistemebis Sesaxeb monacemebi

Sefasebul unda iyos monacemTa xarisxi da maTi amomwuravoba.

garda nevrologiuri anamnezisa rezidentma yuradReba unda gaamaxvilos im sistemebze da faqtorebze, romlebis maprovocirebel an etiologiur faqtorebs SeiZleba warmoadgendnen. mag.: pediatriuli insultis dros unda dazustebul iyos gulis paTologiis arseboba/ ararseboba. Tavis tkivilis dros maprovocirebeli faqtorebi - gadaRla, stresi da a.S.

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pacientis asakis da inteleqtis mixedviT rezidents unda SeeZlos strategiis Secvla. Semfasebeli akvirdeba rezidentis moqnilobasa da komunikaciis unars.

rezidenti ar unda ecnobodes pacientis adreul istorias (Tu arsebobs) Canawerebis mixedviT, aramed TviTon unda SeZlos amomwuravi informaciis Segroveba pacientisa Tu misi ojaxis wevrebisagan.

rezidentma unda moipovos informacia daavadebis xangrZlivobisa da mimdinareobis Sesaxeb. umjobesia rom es procesi qronologiis mixedviT iyos, Tumca sxva strategiac misaRebia Tu saboloo amocana kargad iqneba Sesrulebuli.

daavadebis xangrZlivi mimdinareobis SemTxvevaSi rezidentma unda daafiqsiros axali niSnebi an cvlilebebi niSnebSi, Tu paroqsizmuli daavadebaa zustad unda aRnusxos SetevaTa xasiaTi da raodenoba, aseve xangrZlivoba, maprovocirebeli da Semamsubuqebeli faqtorebi. rezidentma unda SearCios SekiTxvebi da aRmoaCinos rogorc mniSvnelovani “plus” (igulisxmeba axlad ganviTarebuli simptomebi), aseve “minus” (romlebic an ar arian, an aRar arian) simptomebi. es gulisxmobs tkivilis arsebobas, cnobierebis Secvlas, sisustis ganviTarebas da sxva.

rezidentis mier Segrovili samedicino informaciiT Semfaseblisa da rezidentis mier SesaZlebeli unda iyos nevrologiuri daavadebis bunebis dadgena.

b. nevrologiuri gasinjvis unar-Cveva

bavSvTa nevrologisTvis mTavar klinikur unar-Cvevas swored srulyofili nevrologiuri gasinjva warmoadgens.

gasinjva aucileblad unda Seicavdes mentaluri statusis, dgoma-siarulis, motoruli, sensoruli sferos, koordinaciis, kraniuli nervebis da refleqsebis kvleva-Sefasebas. garda zogadi gasinjvisa, TiToeuli sferos gamokvlevisas rezidenti unda iTvaliswinebdes pacientis problemebs da Sesabamis sferos ufro detalur Sefasebas awarmoebdes. mag: mexsierebis problemebis dros mentaluri statusi ufro detalurad unda Seiswavlos, vidre periferiuli nervis parezis SemTxvevaSi.

zogadi gasinjva rezidentis kompetenciaSi ar Sedis, Tumca Tu saWiroa unda SesZlos misi elementebis gamoyeneba.

unda Sefasdes rezidentis urTierToba pacientTan: xom ar iyo uxeSi? tkivilis arsebobisas gaiTvaliswina gasinjvisas es Tu ara? sworad Caatara gasinjva? ama Tu im refleqsis gamowveva sworad iyo Catarebuli Tu ara? xom ar gamotova gasinjvis mniSvnelovani detalebi? amoicno Tu ara mniSvnelovani niSnebi? sworad Seafasa maTi klinikuri Rirebuleba Tu ara? gasinjvisas gaiTvaliswina anamnezi da Civilebi, Tu trafaretulad Caatara gasinjva? gasinjviT miRebuli Sedegebis analizis Semdeg dasva Tu ara damatebiTi kiTxvebi? SeZlo Tu ara gasinjvis Sedegebis mixedviT dazianebis lokalizaciis dadgena?

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gasinjvis damTavrebis Semdeg rezidents da Semfasebels unda hqondes naTeli warmodgena nevrologiuri daavadebis bunebis da paTologiuri procesis lokalizaciis Sesaxeb. miRebuli Sedegebi unda eTanxmebodes pacientis anamnezur monacemebs.

g. profesionalizmi da konsultirebis unari

pacientTan da mis ojaxTan efeqturi komunikaciis unari erT-erT mTavar kompetencias warmoadgens. efeqturi komunikacia aris mkurnalobis procesSi Zalian saWiro pacient-eqimis kavSiris Camoyalibebis safuZveli. Sefasebisas unda dadgindes ramdenad Seiswavla rezidentma es kompetencia.

Sefaseba iwyeba rezidentis pacientTan SexvedriT. komunikacia gulisxmobs rogorc verbalur, aseve araverbalur urTierTobas. unda dadgindes ramdenad moaxerxa rezidentma gasinjvis dros urTierToba pacientTan, gansakuTrebiT sxvadasxva asakis bavSvebTan.

rezidenti sensitiuri unda iyos eTikuri, kulturuli da religiuri sakiTxebis mimarT.

unda Sefasdes rezidentis dialogi pacientsa da mis ojaxTan. ramdenad komfortuli iyo es dialogi ojaxisaTvis? Camoyalibda Tu ara pozitiuri ganwyoba? moeqca Tu ara pativiscemiT pacientsa da mis ojaxs? xom ar iyo uxeSi, imperatiuli? ahyva Tu ara pacientis an ojaxis komentarebs? bolomde moTminebiT moismina kiTxvebze pasuxebi Tu ara? Tu kiTxva gaugebari iyo ojaxisa da pacientisaTvis, gaimeora an Secvala kiTxvis forma ufro gasagebi rom gamxdariyo Tu ara? auxsna gasagebad gasinjvis Sedegebi da SesaZlo daavadeba Tu ara?

d. prezentacia

unda Sefasdes rezidentis mierpacientis SemTxvevis moxsenebis da ganxilvis unari.

e. saboloo Sefaseba

saboloo Sefaseba emyareba zemoT aRwerili oTxi komponentis Sedegebs.

klinikuri unar-Cvevis dadebiTi SefasebisaTvis rezidentma unda daimsaxuros minimum 5 qula TiToeul kompetenciaSi. qvemoT mocemulia Sesafasebeli formebi oTxive sferosTvis.

anamnezis Segrovebis Sesafasebeli forma

qula anamnezis Segrovebis unaris Sefasebis kriteriumebi 8 gansakuTrebuli anamnezi Segrovda unaklod. anamnezi zustad xsnis

nevrologiur daavadebas 7 saukeTeso anamnezSi aris Zalian umniSvnelo defeqtebi an uzustoba 6 Zalian kargi anamnezSi aris mcire defeqtebi an uzustoba 5 kargi anamnezSi aris defeqtebi an uzustoba, magram monacemebi

sakmarisia SemTxvevis formulirebisTvis 4 mosazRvre, magram

miuRebeli anamnezSi aris iseTi defeqtebi an uzustoba, ris gamoc daikarga informacia

3 aradamakmayofilebeli

anamnezSi aris iseTi didi defeqtebi an uzustoba, ris gamoc daikarga mniSvnelovani informacia

65

2 cudi gamotovebulia anamnezis ZiriTadi nawili, ris gamoc SemTxveva Sefasda araadekvaturad

1 Zalian cudi anamnezis Sekreba imdenad cudad moxda, rom rezidentma ver gaacnobiera SemTxveva

nevrologiuri gasinjvis Sesafasebeli forma

qula nevrologiuri gasinjvis Sefasebis kriteriumebi 8 gansakuTrebuli nevrologiuri gasinjva Sesrulda unaklod 7 saukeTeso nevrologiuri gasinjva Sesrulda Zalian umniSvnelo

defeqtebiT an uzustobiT 6 Zalian kargi mcire defeqtebi an uzustoba nevrologiuri gasinjvisas 5 kargi defeqtebi an uzustoba nevrologiuri gasinjvisas, magram inaxa

sakmarisi monacemebi SemTxvevis formulirebisTvis 4 mosazRvre, magram

miuRebeli nevrologiuri gasinjvis iseTi defeqtebi an uzustoba, ris gamoc daikarga informacia


nevrologiuri gasinjvis iseTi didi defeqtebi an uzustoba, ris gamoc daikarga mniSvnelovani informacia

2 cudi gamorCa nevrologiuri gasinjvis ZiriTadi nawili, ris gamoc SemTxveva Sefasda araadekvaturad

1 Zalian cudi nevrologiuri gasinjva imdenad cudad moxda, rom rezidentma ver gaacnobiera SemTxveva

profesionalizmisa da konsultirebis unaris Sesafasebeli forma qula profesionalizmisa da konsultirebis unaris Sefasebis

kriteriumebi 8 gansakuTrebuli efeqturi komunikaciis unar-Cvevebi da pacient-eqimis

urTierToba 7 saukeTeso umniSvnelo problemebi komunikaciasa da pacient-eqimis

urTierTobaSi 6 Zalian kargi mcire problemebi komunikaciasa da pacient-eqimis

urTierTobaSi 5 kargi problemebi komunikaciasa da pacient-eqimis urTierTobaSi,

magram urTierTgagebis SenarCuneba 4 mosazRvre,

magram miuRebeli

problemebi komunikaciasa da pacient-eqimis urTierTobaSi, ris gamoc urTierTgageba mosazRvrea an ar aris kargi


didi problemebi komunikaciasa da pacient-eqimis urTierTobaSi, urTierTgagebis SeuZlebloba

2 cudi didi problemebi komunikaciasa da pacient-eqimis urTierTobaSi, uxeSoba an usiamovneba

1 Zalian cudi komunikacia da pacient-eqimis urTierToba imdenad cudi iyo, rom saWiro gaxda gamomcdelis Careva

prezentacia/formulirebis Sesafasebeli forma

qula prezentacia/formulirebis unaris Sefasebis kriteriumebi 8 gansakuTrebuli ar aris deficiti anamnezis da nevrologiuri gasinjvis

sakvanZo monacemebis aRweraSi 7 saukeTeso erTi mcire (meorexarisxovani) deficiti anamnezis da

nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi 6 Zalian kargi ori mcire (meorexarisxovani) deficiti anamnezis da

nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi 5 kargi ramdenime (cota) mcire an erTi didi deficiti anamnezis da

nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi 4 mosazRvre,

magram miuRebeli

ramdenime (bevri) mcire da ori didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi, gamorCenilia calkeuli sakiTxi

66


ramdenime didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi, gamorCenilia ramdenime sakiTxi

2 cudi ramdenime didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi, monacemTa Sejameba gaugebaria

1 Zalian cudi mravali didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi, monacemTa Sejameba gaugebaria

rezidenturis jamuri Sefasebis forma

rezidenti (saxeli, gvari) -------------------------------------------------------------------------------

gamomcdeli (saxeli, gvari) ----------------------------------------------------------------------------

pacientis asaki -------

qula/ kompetencia

aradamakmayofilebeli damakmayofilebeli 1 2 3 4 5 6 7 8

anamanezis Segrovebis unari nevrologiuri gasinjva profesionalizmisa da konsultirebis unari

prezentacia/formulirebis unari saerTo Sefaseba: aradamakmayofilebeli/damakmayofilebeli (markeriT aRiniSneba Sesabamisi)

gamomcdelis komentari:

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

gamomcdelis xelmowera -------------------------------------------------

rezidentis xelmowera --------------------------------------------------

TariRi ------------------------------------

aucilebeli saxelmZRvaneloebis CamonaTvali:

1. m. janeliZe - klinikuri nevrologia, 2009, 724gv. 2. n. tatiSvili, m. gabunia, i. bokeria - bavSvTa nevrologiur

daavadebaTa mkurnaloba, qarTuli biografiuli centri, 2011, 584gv. 3. J. Aicardi – Deseases of the Nervous system in childhood, 3rd edition, Mac keith

Press, 2009, 965 p. 4. K. Swaiman, S. Ashwal - Pediatric Neurology, Principle and Practice, 4th edition,

Mosby, 2006, 2672 p. 5. G. Fenichel - Clinical Pediatric neurology, Signs and Symptom Approach, 6th

edition, Saunders, 2009, 432 p. 6. J. Volpe - Neurology of Newborn, 5th edition, Saunders, 2008, 1120 p. 7. Д. Гринберг, М. Аминоф - Клиническая Неврология. Медпресс. 2004. 512стр. 8. Д. Феничел - Педиатрическая Неврология. Медина. 2004. 635 стр.

8. kurikulumis marTva kurikulumis Sinaarsi, misi dizaini efuZneba im kompetenciebs da samuSao normativebs, romelic miRebuli da aRiarebulia aSS-sa da evropis ganviTarebuli qveynebis warmatebuli nevrologiuri skolebis mier da romelTa danergvac unda moxdes Cvens qveyanaSi. kurikulumis

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Seqmnis procesSi Sefasda is aucilebeli admianuri da instituciuri resursebi (literatura, samedicino bazebi da sadignostiko-samkurnalo teqnologiebi), romelic SesaZlebels gaxdida programis ganxorcielebas, procesis efeqtur marTvas da sabolo miznebis miRwevas. bavSTa nevrologiis sarezidento programa Sedgeba ori savaldebulo kursisgan - pediatriis kursi da pediatriuli nevrologiis kursi. programa iwyeba pediatriis kursiT, romelic grZeldeba 1 wels, sadac 3 Tve daTmobili aqvs neonatologiis Seswavlas, aseve gadaudebeli da intensiuri Terapiis modulebis savaldebulo gavlas. saswavlo kursi pediatriul nevrologiaSi Sedgeba Semdegi nawilebisgan

1. mwvave pediatriuli nevrologia - minimaluri xangrZlivoba 15 Tve. 2. reabilitacia - minimaluri 5 Tve; 3. mozrdilTa nevrologia - 2 Tve 4. bavSvTa fsiqiatria - minimaluri periodi 1 arasruli dRe/kviraSi 6 Tvis manZilze an Sesabamisi eqvivalenti

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