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    Aldo MARRONE

    Insegnamento di INTERNAL MEDICINE

    Corso di laurea magistrale a ciclo unico in MEDICINA E CHIRURGIA

    SSD: MED/09

    CFU: 6,00

    ORE PER UNITÀ DIDATTICA: 60,00

    Periodo di Erogazione: Annualità Singola

    Italiano

    Lingua di insegnamento

    Inglese

    English

    Teaching language

    English

    Contents

    Clinical history taking–Medical and Surgical approach
    General clinical exam. First impressions: complexion, decubitus, skin colour; odour, tongue, hands; body composition, temperature, hydration; edema, lumps, swellings.
    The neck: history and examination of swellings in the neck, cervical lymphadenotpathy
    Thyroid gland examination: different forms of goitre, thyroid dysfunctions, thyrotoxicosis
    The breast: examination, presentation of breast disease, benign and malignant breast lumps
    Skin exam
    Fever
    Abdomen: examination and types of abdominal pain. Intestinal obstruction and perforation. Acute lower abdominal pain: appendicitis, diverticulitis. Upper GI tract bleeding. Biliary colic, cholecystitis, gallbladder carcinoma. Pancreatitis, pancreatic tumors. Jaundice and portal hypertension.
    Respiratory system exam.
    Arterial blood pressure
    Cardiovascular exam: dyspnea, chest pain; palpitations, syncope, ECG (basics); history and general evaluation in CV patient; evaluation of the precordium; cardiac auscultation
    Alteration of bowel habits (constipation, diarrhea). Dyspahgia, dyspepsia. Vomiting. Abdominal masses. Abdominal hernias: inguinal, umbilical, femoral. Rectum and anal canal: anorectal diseases, rectal bleeding, anal lump, prolapse
    Gastrointestinal clinical examination
    Endocrine system: general principles, pituitary gland, adrenal gland; thyroid and parathyroids; the endocrine pancreas.
    Renal system: signs and symptoms, history physical exam and diagnostic investigations. Kidney, urinary tract and prostate: dysuria, hematuria, ureteric colic. Urine retention, BPH
    The Nervous system examination
    Osteoarticular system exam
    Intraabdominal hemorrages (ruptured AAA); mesenteric ischemia. Peripheral arterial vessel and vein exam. Lymphatic system exam
    Patient with trauma and shock
    Biopsychosocial model in medicine Value of communication in medicine. Verbal and non-verbal communication. Communication skills: competence, empathy, trust. Comm. in critical situations.

    Textbook and course materials

    Personal notes taken at lessons (essential).

    As an aid to personal study, students can use the ‘Macleod’s Clinical Examination’, Churchill Livingstone and the ‘Browse’s Introduction to The Symptoms and Signs of Surgical Disease’, Taylor & Francis

    Course objectives

    To introduce the 3rd year student into Clinical Medicine. Teach the students how to come into contact with the patient, how to collect clinical history, how to interpret symptoms of disease and how to look for and recognize signs of disease. Explain the relationship between pathophysiology of diseases and their clinical presentation. Show the students how to perform the physical examination of each organ system and body region, and recognize the major abnormalities. Teach how to utilize the basic diagnostic investigations and interpret the most important findings.

    Prerequisites

    Have an extensive knowledge of macroscopic anatomy, physiology and pathophysiology of major disorders.

    Teaching methods

    Class lectures given in 3 overlapping modules: Medicine, Surgery, Clinical psychology

    Evaluation methods

    This is an oral exam with multiple professors and solely based on topics addressed at lessons. There will be several questions with at least one question regarding the medical part, one the surgical part and one the clinical psychology part. The questions usually refer to a specific symptom or sign, or ask for the description of a specific organ/system exam and mostly coincides with a topic addressed at a single lesson/series of lessons. Multiple topics will be reviewed.

    At the end of the course and the relevant exam, the student has to show the ability to approach the patient under supervision, know which relevant questions should be answered according to the clinical setting, and describe how to perform clinical exam as well as the most important findings in the major medical and surgical disease conditions.

    Other information

    The formal teaching activity of this Course is strictly integrated with practical teaching sessions that will be held in Medicine and Surgery Units during the I and II term.

    Course Syllabus

    Clinical history taking–Medical and Surgical approach
    General clinical exam. First impressions: complexion, decubitus, skin colour; odour, tongue, hands; body composition, temperature, hydration; edema, lumps, swellings.
    The neck: history and examination of swellings in the neck, cervical lymphadenotpathy
    Thyroid gland examination: different forms of goitre, thyroid dysfunctions, thyrotoxicosis
    The breast: examination, presentation of breast disease, benign and malignant breast lumps
    Skin exam
    Fever
    Abdomen: examination and types of abdominal pain. Intestinal obstruction and perforation. Acute lower abdominal pain: appendicitis, diverticulitis. Upper GI tract bleeding. Biliary colic, cholecystitis, gallbladder carcinoma. Pancreatitis, pancreatic tumors. Jaundice and portal hypertension.
    Respiratory system exam.
    Arterial blood pressure
    Cardiovascular exam: dyspnea, chest pain; palpitations, syncope, ECG (basics); history and general evaluation in CV patient; evaluation of the precordium; cardiac auscultation
    Alteration of bowel habits (constipation, diarrhea). Dyspahgia, dyspepsia. Vomiting. Abdominal masses. Abdominal hernias: inguinal, umbilical, femoral. Rectum and anal canal: anorectal diseases, rectal bleeding, anal lump, prolapse
    Gastrointestinal clinical examination
    Endocrine system: general principles, pituitary gland, adrenal gland; thyroid and parathyroids; the endocrine pancreas.
    Renal system: signs and symptoms, history physical exam and diagnostic investigations. Kidney, urinary tract and prostate: dysuria, hematuria, ureteric colic. Urine retention, BPH
    The Nervous system examination
    Osteoarticular system exam
    Intraabdominal hemorrages (ruptured AAA); mesenteric ischemia. Peripheral arterial vessel and vein exam. Lymphatic system exam
    Patient with trauma and shock
    Biopsychosocial model in medicine Value of communication in medicine. Verbal and non-verbal communication. Communication skills: competence, empathy, trust. Comm. in critical situations.

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