《诊断学》课程教学大纲(五年制英文班临床医学专业)

ofDiagnostics课程名称：Diagnostics授课专业：年制英文班临床医学专业学分与学时：论课66学，见习课学时一

理论课教学内容及基本要求Introduction【and目的要求】．masterbasic掌握诊断学的基本内容．waysoflearning理诊断学学习方法【Instructioncontents教内容】．诊学的定义．importancelearning学诊断学的重要性．Basicof诊学的基本内容．waysoflearning学方法【Thetimes教学时】，0.5小【Teachingmethods教学方法】instruction,multiplemediapresenting,讲多媒体Historycollection【and目的要】．mastercontentsofinquistion掌问诊的内容．skill理解问诊技巧【Instructioncontents教内】

病史采①general②chiefcomplaint,③of④pasthistory,reviewof⑥personal⑦Marital⑧andfamilyhistory.一般项目主诉现史既往史系回顾人史姻史月经和生育史家史【Thetimes教学时】1.5，小时【Teachingmethods教学方法】instruction,multiplemediacase-presenting讲，多媒体，临床实习History病史记录【and目的要】Tomasterhowmakeahistory握怎样记录病史Tounderstandbasicforthehistoryrecord理解病史记录的基本求【Instructioncontents教学内容】（一）ofcase病记录提纲data一资料complaint

主诉Historyofpresent(HPI)现病史Pasthistory(PH)Personalhistory

既往史个人史

婚姻史Menstrualhistory(forpatients)月史Childbearing生史10.Familyhistory(FH)

家族史11.examination

体格检查12.and

实验室检查和仪器检查13.diagnosis

初步诊断（二）case病历示范【Thetimes教时数hours，小时【Teaching教学方法】showing,case-presenting讲授多媒体，临床实习Commonsymptoms常见症状Fever发热【and目的要】．mastertypeandclinical掌发热的类型和临床分类．mechanismoffeverandetiology理发热的机制和病因【Instructioncontents教学内容】．Physiology生理机制．发的机制．病．Clinicalclassification:临分类．Clinical临症状．offever热型（1fever稽热（2Remittent张热（3Intermittent周性发热（4Undulantfever波热（5Relapsing间热（6Irregularfever不则发热．Symptomsandsignsof发热的症状和体征【Thetimes教时数小【Teachingmethods教学方法】multiple讲授多媒体Abdominalpain腹【and目的要】．mastercontentsofpain掌握腹痛的内容．了腹痛的意义【Instructioncontents教学内容】．technique问技巧．Contentsoffor腹问诊的容（1Wherepainlocated?(Site)疼痛的部（2Wheredoesthepain),oritoriginateelsewheretotheabdomen?痛放射到哪里或疼痛原发于别的部位然后转移至腹?

（3wharis(Character)疼痛的性（4Howisit?(Severity)疼的程度（5othersymptomspain?痛伴随哪些症?（6itabout?什原因导致疼痛的发?（7cause什麽原因可减轻疼（8Inchronicabdominalinquire（9Againinchronicpainitinquirepain.慢腹痛的病人问诊疼痛的周期性．ClinicalSignificance临床意义【Thetimes教时数hours2小时【Teachingmethods教学方法】instruction,multiplemedia，讲授，多媒体,sputumdyspnea咳,痰和呼吸困难【and目的要】．masterandmechanismofsputumdyspnea掌握痰液产生和呼吸西困难的机制和原因．clinicalsignificance理解痰液产生和呼吸西困难的临床表现【Instructioncontents教内】．coughanddyspnea咳和呼吸困难的定义．andmechanism病和机制disorders呼疾病胸膜疾病disorders心管疾病centralsystem中神系统疾病．Sputum痰产漏液渗出液黏Dustsaspirated吸灰tissues坏组织．andsignificanceofdyspnea呼困难的病因和临床表现【Thetimes教学时】2hours教时数2小【Teachingmethods教学方法】instruction,pointcase-presenting讲授幻灯片病例分析methods体检的本方法【and目的要】．masterbasicmethodsof掌握体格检查的基本方法．physical理解体格检查的意义【Instructioncontents教内容．Inspection:definitionofgivesomeexamples视:视诊的定义并举例．Palpation:thedefinitionofkindsoftoof

significance.诊:触诊的定义和分掌握触诊的方法和意义．thedefinitionofkindsofmastermaneuverandthedifferentproduced叩诊：叩诊的定义和分类,握叩诊的方法和意义．Auscultation:thesignificanceofto听诊听诊的定义意义掌握怎样使用听诊器．Olfactoryexamination:knowodorscouldcluesinclinic.嗅诊：掌握一些在临床上提供有意义线索的特殊气.【Thetimes教时数2hours小时【Teachingmethods教学方法】instruction,point讲,幻灯片【and目要】

一般检．masterbasicmethodscontentsofgeneral掌握一般检查的基本方法和内容．masterofexaminationandmaneuverof掌握体温测血压测量的方法和淋巴结查的顺序和方法．examinationandthenormalandclinicalsignificance理解体格检查的意义,握正常和异常体征及临床意义【Instructioncontents教内】Vitaltheconditionsofpressure,Respiration.masterofpressure.生命体征：正常范围,温血压脉,吸的异常情掌握体温血压的测量方法：sex-relateddiseaseerythematous.性别：知道哪些性别相关性疾如血友,系统猩红斑狼疮龄andhabitus:thejudgmentsaboutnormaldevelopmentandhabitus.发育和姿势掌正常发育和三种姿势Nutrition:howjudge营养:怎样判定营养状态Stateofconsciousness:the意识状态嗜睡,昏木僵和昏迷的定义andposture:thetypesofactivepassivepositionandposition.体位和体态主体位,动体位强迫体位步Facial(features)characteristics:thesignclinicalsignificanceaboutfacial面容特征:掌异常面容的体征和临床意义如急性面容慢面容,病面容甲腺功能减低面容,满月脸二尖瓣面容suchfacialfeature,ChronicHepaticface,HyperthyroidismMoonface,todefinitionofangiomaanditsclinical

皮肤掌握蜘蛛痣的定义和临床意义definitionkindsofedemasignificance.水肿水肿的定义和意义Subcutaneousnoduleshair皮结节和毛发examinationofandoflymphnode.Significanceofnodeif淋巴结掌淋巴结检查顺序和方,触到的淋巴结的意义【Thetimes教学时】22小时【Teachingmethods教学方法】instruction,point讲,灯片【and目的要】

头颈．mastermethodsandcontentsofneckexamination掌握头颈检查的方法和内容．thesignificanceoftheexamination:ofandmaneuverartery,and掌体检查的意:颈动脉颈静脉甲状腺和气管检查的顺序和方法．examinationsequenceandofhead理解头部检查的顺序和方法【Instructioncontents教内容．Head:contentsofexaminationofthetheofofthetoknowofskull,头部：掌握头部检查的内容和颅部检查的方,知道头颅畸形,如Microcephalus头过skull型颅畸颅Oxycephalia尖颅头过大．：tomasterthenormalandtheirinclinic眼：掌握正常和异常体征及其临床意义（1Eyebrow:毛（2Eyelids眼）Disturbanceof眼关闭异常）Ectropion睑外翻）Entropin睑翻）眼水肿）睑垂（3Conjunctiva结膜（4Eyeball:眼球l：球突出）Enophthalmos眼球内陷）Eyeballmovements眼运动（5Sclerayellowoftenwasinjaundice巩:膜黄染常见于黄疸（6：膜（7Irisand：膜和瞳孔

l）shape瞳孔形状）Pupillarylight:tothecontentsofexamination,瞳孔光反射：掌握检查的内容,法和意义）Convergenceaccommodation集合反射）Functionalocularexaminations,visioncolorsensation:.眼功能检查，包括视力，色觉．耳．Nose：tomastertheexaminationcontents,maneuversinuses鼻：掌握检查内方法和意义．(Oralcavity)腔）Inspectthelips:toknowsignsPallor,Redness,andpigmentation视诊口唇：异常的体征如苍白,绀和色素沉着）InspecttheabnormalsignssuchasPallor,Redness,andpigmentation视诊口黏膜：掌握异常体征如苍红润紫绀和色素沉着）gingivaforcountingteeth检查牙齿和牙龈牙齿的计数方法）tongue:舌）MethodforPharynxandTotheDegreeofthetonsil咽喉：咽喉的检查方掌握扁桃体肿大的程度learnanatomyoftheneckandtheofphysicalexaminations.颈部：掌握颈部的解剖和检查内容）masterdefinitioncervical颈部血管：掌握颈静脉扩张的定义和意义Thyroidthepalpationofthyroidglandanddegreeofenlargement.howdescribethyroidglandwhenpalpateandauscultatethyroidgland甲状腺：掌握甲状腺的触诊方法和肿大程掌握甲状腺触诊和听诊的描述）tomasterthecontentsthemaneuverand气管：掌握检查的内方法的意义【Thetimes教学时】22小【Teachingmethods教学方法】point讲授，幻灯片，临床实习【and目的要】

腹部检．mastermarkersandtheofbodysurface,thethese掌握体表线和体表标志，分区和这些区域的重要内脏器官．masterpalpation,auscultationabdomen.ofliverandspleen.掌握腹部的触,听方法特别是肝脾触诊

．symptomssignscommonabdominaldiseases理解常见腹部疾病的症状和体征【Instructioncontents教内容markersandlinessurface,andvisceraregions.握体表线和体表标志,分区和这些区域的重要内脏器官2.examinationofabdomen腹部检查

掌symmetry,abdominalscars,sinuses,vein,haemorrhages,Visible视诊对称性腹搏动,状瘢痕,道瘘,张的静脉,腹出血，胃肠蠕动波(2)Palpation:andofmuscle,palpationofliver,spleen,gallbladder,kidney,ofmasse,trills,succusionkidneyureter.触诊直接压痛和腹壁紧张反痛肝,脏,胆囊肾脏包块液波震颤音,肾脏和输尿管压痛点(3)Percussion:Traubespace,regionsofliver,bladder叩诊胃泡鼓音区，肝脾，膀胱和肾脏的区域bowelabdominalfriction听诊:鸣音和摩擦音andofcommonabdominaldiseases:Pepticdiseasesandthecomplications,hepaticandintestinalperitonitis,appendicitis.常腹部疾病的症状和体征消化性溃疡和并发症,肝化和门脉高,肠梗阻急性腹膜炎阑炎【Thetimes教学时】hourspractice14小时【Teachingmethods教学方法】instruction,point讲授幻灯片临床实习Physicalexamination【and目的要】

胸部体．mastermethodsandcontentsofthoraxexamination掌握胸部体检的方法和内容．masterclinicalsignificancetactilefremituspercussion掌握触觉语颤的机制和临床意义．physicalpositivesignsofpulmonarydiseases了解常见肺部疾病体格检查和阳性体征【Instructioncontents教内容．themarkerslinesofsurface,imoportanttheseregions.掌握体表线和体表标志，分区和这些区域的重要内脏器官．胸检查（1Inspectionofthelungand肺胸膜的视诊（2Palpationofthelung肺胸膜的触诊（3lungand肺胸膜的叩诊（4Auscultationoftheandpleura肺胸膜的听诊andofcommondiseases:pneumothorax,emphysema,Pleuralpneumonia常见胸部疾病的症状和体征【Thetimes教学时】（Instruction6practicehours）小时（讲授6小时实习时）

【Teachingmethods教学方法】pointshowing,case-presenting.讲授幻灯片临床实习Cardiovascularsystem心血管系统【and目的要】．masterexaminingsequenceandof，palpation,掌握心脏的检查顺序和方法包:视,叩听法masterproducingheartclinicalMasteringkeypointsofofheartmurmursanddifferentialdiagnosisofphysicalandpathologicalheartmurmurs.掌握心脏杂音的产生机制和他们的临床意义掌握杂音听诊的关键点和生理杂音和病理性杂音的鉴别诊断．understandsingscommon理解常见心脏疾病的症状和体征【Instructioncontents教内容．Heart心脏Inspection视诊）Observingprecordium观察心前区）intensitynormalapicalclinicaldisplacement.正常心尖搏动的部位,度和范围,常的临床意义）pulsationsintheotherandtheirclinicalvalues他区域的异常搏动和临床意义Palpation触诊）intensitynormalapicalclinicaldisplacement.正常心尖搏动的部位,度和范围.异的临床意义）precordialpulsation’samplitude,durationintensity.心前区搏动的部强度,持续时间和强）mechanismofthrillsandintensityandthrills.震颤的产生机制和部位强度和性质）frictionrub心包摩擦感叩）percussionofheart.心的叩诊方法）heartbordersandtheirconstituents.心大小）Normalrelativedullnessoftheand心的相对浊音界和对浊音界Auscultation听Itheartmurmurandpericardialfriction包括心率心律心音杂音和心包摩擦音）AuscultatoryValveAreas听瓣膜区producingheartsoundanddifferentialdiagnosisofnormal（心音产生的机制和正常心音的鉴别诊断）Heartrateand心率和节律）mechanismof(Location,timing,quality,radiation,

心脏杂音的产生机制和性(位时,性放射和强度）mechanismclinicalpericardialfriction心包摩擦音的产生机制和临床意义．Blood血）anditsandtension.动脉脉搏和频率,律强度和张力）mechanismofwaveforms(Waterhammerpulse,PulsusDicroticpulse)波形的产生机制和性(冲交替脉重搏波,脉)）measurementofpressureanditssignificance.血压测量的方法和意义）soundDuroziez's枪击音和Duroziez's征．Commonofdiseases:mitralstenosis,mitralstenosis,pericardical心血管疾病的常见症状和体征:二尖瓣狭窄二尖瓣关闭不主动脉瓣狭,主脉瓣关闭不全【Thetimes教学时】（Instructionpractice）14时（讲授小时,习8小时）【Teachingmethods教学方法】powerpointshowingcase-presenting.讲授幻灯片，临床实习Physiologicaland生理病理反【and目的要】．mastermethodsreflex掌生理和病理反射的方法．examination理体格检查的意义【Instructioncontents教内容．Superficial浅射（1角膜反射（2reflex,反射（3abdominalreflex,腹反射（4reflex:提反射（5reflex．Deep深反射（1肱头肌反（2reflex,肱头肌反射（3桡膜反射（4jerk.跟腱反射（5jerk.膝反射．阵挛（1Ankleclonus:踝阵挛（2Patellar髌挛．reflex病理反射（1Babinski'ssign:.巴征

（2Oppenheim's奥本海姆征（3Hoffmann’s霍曼征of脑刺激征（1颈项强直（2克征（3Brudzinski's布征【Thetimes教学时】1.5小时【Teachingmethods教学方法】instruction,pointshowing讲授,幻灯片，实习LaboratoryExamination验室检RoutineTest大便常【and目的要】．mastermethods掌握大便常规的方法．masterpropertyandtheoccultblood掌握大便性状改变的意义和隐血实验的意义．microscopicexamination理解显微镜检查的意义【Instructioncontents教内】．propertyofstool大的一般性状（1watery水便（2mucus黏便（3stool:脓血便（4hematocheziastool:血（5melenastool:黑便或柏油样便．Microscopicexamination微镜检查（1细（2WBC白胞（3RBC红胞（4噬细胞（5肿细胞（6residue:食物残渣（7Ovumofparasite寄生虫卵3.Occoultest隐实验【Thetimes教学时】小【Teachingmethods教学方法】powerpointshowing.讲授幻灯片RoutineTest小便常【and目的要】．methodsurineroutine握尿常规的方法．significanceofurineproperty握尿液性状改变的意义．theofmicroscopicexamination理解显微镜检查的意.【Instructioncontents教内容．Sample’scollectionandsending标本采集和送检

．property般性状（1volume尿（2颜（3Smell气（4尿（5Gravity尿重．化实验（1protein蛋白检测（2糖（3酮体（4胆素（5Urobilinogen尿原（6Blood血（7尿酸盐examination显镜检查（1细（2管形（3Pathogenic病原微物（4Addiscount爱计数（5perhour每小时细胞沉渣【Thetimes教学时】22小【Teachingmethods教学方法】Instruction讲幻片ofBlood血液检【and目的要】mastermethods(RBC)andconcentrationdetermination.掌握红细胞计数和血红蛋白浓度测定的方法．themethodsofwhitebloodcellcount(WBC)differentiatecount(DC).掌握白细胞计数和分类的方法．mastervaluesDC.掌握andDC.参考值changesofRBC,Hb,WBCandDC.掌握变化的意义．andinsomehematological理解常见血液疾病的意义【Instructioncontents教内】．Bloodroutinetest血常规检测（1Redbloodcount(RBC)andHemoglobin(HB)concentration红胞计数血红蛋白浓度测定）functionsRBCHB红胞和血红蛋白的生理功能）RBCHB红胞和血红蛋白的参考值）clinicalsignificanceRBCandHB红细胞和血红蛋白的临床意义（2.Total(WBC)Leukocytedifferential(DC)白细胞计数和分类计数

）morphologyofWBC细胞的形态）白细胞计数和分类计数的参考值）clinicalsignificanceDC白胞计数和分类计临床意义．Specialhematologicaldiseases血病的特殊检查（1Reticulocyte网帜红细胞计数）RC网红细胞参考值）clinicalsignificanceRC网红细胞临床意义（2(Hct)红细胞比容（3Erythrocytesedimentationrate(ESR)细胞沉降率）ESR红胞沉降率参考值）clinicalsignificanceESR红胞沉降率临床意义【Thetimes教时数】hours小时【Teachingmethods教学方法】point讲授,灯片Liver【and目的要】

肝功能．mastercontentsofliverfunctiontest掌肝功能检测的内容．masterliver掌握肝功能检测的意义【Instructioncontents教内】．synthetic肝合成能力的指标（1SerumtotalA,G血蛋白（2Electrophoresisofserum血蛋白电泳（3Prothrombin凝酶原时间．bilirubin胆素代谢的检测．cholestasis胆汁淤积的标志（1Alkalinephosphatase(ALP)性磷酸酶（2Gamma-glutamyl(GGT)谷酐酞转移酶．necrosis肝胞坏死的（1ALT,AST,肝胞酶．forhepaticcarcinoma肝癌检测（1．Detectiionof肝毒检测（1Hepatitis甲（2Hepatitis乙（3HepatitisC:．病分析【Thetimes教学时】小时【Teachingmethods教学方法】point讲幻灯片【and目要】．contentsofrenal握肾功能的内容

肾功能

．significanceoftests掌肾功能检测的意义【Instructioncontents教内容．Reviewfunction肾功能．creatinineclearance内性肌酐清除率．plasmacreatininelevel血浆肌酐水平．β2微蛋白．α1微蛋白．gravity特殊重【Thetimes教时数hours小时【Teaching教学方法】andshowing讲授,幻灯片ofHemorrhagicDisorders【and目的要】

出血疾的检测Tothevaluesandtheclinical（PC（CT）prothrobintime（）掌握血小板计凝血时间和凝血酶原时间的参考值和临床意义Tounderstandand理解止凝和抗凝血的机制和意义【Instructioncontents教内容．hemostasis凝机制（1Bloodvessel血（2血板（3factors凝血因子．凝机制．system抗血系统．forhemorrhagic出疾病（1Testsand(BT),PC出时间（2CTpartialthromboplastintime（（TT（3TestsDIC:Thetests初实确诊实验【Thetimes教学时数】hours2时【Teachingmethods教学方法】point讲幻灯片，实习Examinationof骨髓的检【and目要】．masterofblooddevelopment.掌握血细胞发育规律．mastertheofplasticofcelltheratiooferythroid(G/E).掌握骨髓细胞和粒红比值．clinicalapplicationofexamination.解骨髓检测的临床运用．morphologyofmarrow理解骨髓细胞的形态．contentsandstepsinmarrow理解骨髓检查的步骤和内容【Instructioncontents教内容

．clinicalapplicationofmarrow骨检查的临床运用．developmentofcells血胞的发育．regulationbloodcelldevelopment细胞发育的临床意义（1Thecytobody胞（2Thecytoplasma胞（3The核（4Theratioofnucleusto核比率．morphologyofbonecells骨细胞的形态（1Theoferthrocytic红系列的形态（2Theofseries粒系列的形态（3Theofseries单核系列的形态（4Theofseries巨细胞系列的形态（5Theofseries淋细胞系列的态．contentsandstepsin骨检查的内容和步骤（1骨细胞分类计数的显微镜检查（2Hemogram细胞分类计数．Normalmyelgramhemogram正骨髓细胞分类计数（1Myelogram骨细胞分类计数（2Hemogram细胞分类计数．commonstainsin髓检查的细胞化学染色．ofcommonbloodin常血液病的特征【Thetimes教时数hours小时【Teachingmethods教学方法】point讲授,幻灯片，实习infection【and目要】

临床感的实验室检．mastercontentsoftestinclinicalinfection临感染的实验室检查内容．clinicalsignificancetestsclinical临感染的临床意义【Instructioncontents内容】．Introduction简．Collectionof标采集．Laboratoryinofinfection染诊断的实验室技术）Microscopic显微镜）methods培养方法）Serologicalagglutination,Tubeagglutination血清学方法沉实验,片凝集管凝集ELISA（Western（）酶联免疫试验，蛋白印迹试验．methods:NucleicassayPCRaremainMolecularmethods分子生物学方法核酸分析和是要的分子生物学法．(AST)微生物特异性实验【Thetimes教学时】22小

【Teachingmethods教学方法】point讲幻灯片testsofautoimmune【and目的要】

自身免疾病的免疫断serumimmunoglobulinstest,tests,testtumormarkertest理免疫蛋白实,细胞免疫检肝病毒标志物验,肿瘤标志物实验．masterclinicalsignificanceofthethreeof);severalhepatitistumormarkers掌握血清免疫球蛋白,炎标志物和肿瘤标志物的临床意义【Instructioncontents教内】．twoconceptofimmunology:antibody-mediatedimmunity综免疫学的两个概念抗体介导的免疫和细胞介导的免疫．main主题（1Serumimmunoglobulinstest:Serum(Ig):IgG血清免疫球蛋白实验:血清免疫球蛋白（2CellularimmunityTabdBlymphocyteenumeration,Lymphocyte细胞免疫实:T,B淋细胞计,巴细胞亚群分析（HepatitisHbcAb,.HBV-DNA,HepatitisC,HCV-RNA肝炎标志物实:（4markertest:AFP,CEA,HCG肿标志物实验【Thetimes教学时】22时【Teachingmethods教学方法】pointshowing,讲幻灯片Examinationbiochemictry临床生化检【and目的要】．mastercontentsofexaminationofclinicalbiochemistry掌临床生化检测的内容．clinicalbiochemistry掌临床生化检测的意义【Instructioncontents教内容．ofglucosemetabolism糖谢的检（1Determinationofglucose快血糖检（2test(OGTT)服糖耐量实验（3Glucose-insulintest糖岛素释放实验（4GlycosylatedHemoglobin糖糖蛋白．oflipids血的检测（1ofcholesterol总胆固醇的测量（2of：油三酯的测量（3ofdensity(HDL-C)高密度脂蛋白的测量（4oflowlipoprotein;(LDL-C)密度脂蛋白的测量（5DeterminationofA1脂白（6DeterminationofB脂白．解质的检测（1Determinationof离子（2Determinationofsodium离子

（3Determinationof氯子．Biochemicalmyocardialinjure肌伤的生化指标（1Examinationofcreatinekinase肌酶的检测（2Examinationoflactatedehydrogenase(LDH)乳脱氢酶的检测【Thetimes教时数hours小时【Teachingmethods教学方法】pointshowing,讲授幻灯片Examinationandserousmembranefluid脑脊液浆膜积液的测【and目的要】．mastercontentsofexaminationofcerebrospinalfluidandserousfluid掌握脑脊液和浆膜积液检测的内容mastercerebrospinalfluidmicroscopic掌握脑脊液性状,化学和显微镜检查的意义．masterserousfluidproperty,microscopicchemicalexamination掌浆膜积液性状,学和显微镜检查的意义【Instructioncontents教内】

cerebrospinalfluid脑液检测一般性状CSF正脑脊液status异脑液化检测Protein蛋Chloride氯显微镜检测Total总胞计数,分