Learning objectives
The course is part of General Medicine Teaching or integrated course of Medicine I. The course aims to enable the student to know and to understand the essential elements of etiology, pathogenesis, diagnosis and treatment of major diseases of internal medicine general interest, also in order to allow the student the ability to use knowledge and understanding acquired in identifying the patient's problems related to the condition of the person suffering from the disease to internal medicine and general preparation of a plan of care appropriately.
Prerequisites
of physiologKnowledgey, general pathology, semiotics
Course unit content
clinical approach to the patient's internist. Acceptance, clinical examination, laboratory and instrumental setting of examinations and their proper use; diagnostic and therapeutic. Setting the follow-up. Relations with the paziente and the family. Integration and coordination in the hospital.
Full programme
Course program of General Medicine General symptoms:
• The sensory
• The facies
• The decubitus
• The skin and its alterations
• Fever and the changes induced by fever on the various organs and systems.
Diseases of various organs and systems: Diseases of the respiratory system:
• Clinical Manifestations: disordered breathing, chest pain, acute and chronic cough, sputum, hemoptysis, and hemoptysis, cyanosis.
• Survey methods: laboratory, diagnostic imaging, functional assessment, endoscopy, techniques to obtain biological material.
• Pleural and pneumothorax
• Middle Clinical Overview: COPD, pneumonia.
Diseases of the cardiovascular system:
• General Symptoms of diseases of the heart: fatigue and lack of energy, difficulty breathing, cyanosis, palpitations, chest pain, edema, changes in urination, syncope. • Instrumental investigations: ECG, chest X-ray, ECG, ECG dynamic, transthoracic and transesophageal echocardiography, CT, MRI, PET, cardiac catheterization.
• primary and secondary arterial hypertension: diagnostic evaluation.
• Middle Clinical Overview: ischemic heart disease, arrhythmias, valvular disease, pericardial effusion, heart failure, shock.
Diseases of the digestive system
General Symptoms of diseases of the digestive symptoms (nausea and vomiting, constipation, diarrhea, malabsorption, dyspepsia, dysphagia, odynophagia, heartburn, esophageal pain, abdominal pain, gastrointestinal bleeding).
• Investigations in gastroenterology (endoscopy, diagnostic imaging radiology, ultrasound, endoscopic ultrasound, CT, MRI, scintigraphic examinations; manometry)
• Major symptoms: gastritis, peptic ulcer disease, chronic inflammatory disease. Diseases of the liver
• General Symptoms: Jaundice, ascites, edema, rash, foetor hepaticus, altered state of consciousness.
• Semiotics functional liver: laboratory (parenchymal function indexes, cytolysis, cholestasis, of inflammation).
• Investigations in hepatology: ultrasound, CT, MRI, scintigraphy, laparoscopy and biopsy.
• Major symptoms: acute and chronic hepatitis, liver cirrhosis
Diseases of the exocrine pancreas
• Symptoms of general acute and chronic diseases of the pancreas.
• Evaluation of laboratory, instrumental and imaging.
• Major symptoms: acute and chronic pancreatitis.
Diseases of the blood, lymphatic system and spleen:
• General Symptoms: The major hematologic syndromes: anemic, poliglobulica, neutropenic hemorrhagic thrombocytopenia, splenomegaly, linfoadenopathies.
• Evaluation of clinical, laboratory and instrumental.
• Major symptoms: anemia, myeloproliferative and lymphoproliferative disorders, thrombocytopenia .
Diseases of the immune system, connective tissue, allergies
• General concepts
Bone diseases:
• General concepts of the main metabolic bone diseases.
• Diagnostic laboratory and instrumental evaluation of bone diseases.
Endocrine diseases
• Semiotics physical and clinical signs of major diseases of the hypothalamic- pituitary axis, anterior and posterior pituitary, thyroid, adrenal cortex and medulla, testes and ovary.
• Semiotics physical and clinical signs of major diseases of metabolism, dyslipidemia, diabetes mellitus, gout.
• Major symptoms: Acromegaly, Diabetes insipidus, hyper-and hypothyroidism, goiter, thyroiditis, thyroid nodule syndrome and Cushing's disease, pheochromocytoma, Diabetes Mellitus, Dyslipidemia
Diseases of the kidney and urinary tract
• Main clinical signs of disease of the kidneys.
• Evaluation of laboratory, radiological and instrumental (urinalysis, renal function tests, diagnostic imaging, renal biopsy).
• Major symptoms: glomerular nephropathy, tubulointerstitial and vascular disorders. Urinary tract infections and kidney stones. Acute and chronic renal failure.
Bibliography
Medicina Interna - Renato Massini - 3^ Edizione - McGraw - Hill
Manuale di Medicina Interna - Ranuccio Nuti - Edizioni Minerva Medica
Teaching methods
The lectures will include the etiopathogenesis, the clinical pathophysiology and the diagnosis of the main pathologies of the various organs and systems. In addition, clinical activities will be carried out on the hospitalized patient's bed.
Assessment methods and criteria
The oral examination will focus on the main pathological and clinical aspects of the main pathologies of the various organs and systems. Moreover, the student will do it in a critical and finalized way to reach a diagnosis and a therapy. This is the responsibility of the acquisition of the student and his capacity for clinical reasoning.
