Learning objectives
By the end of the course students will: 1. be able to conduct a general
and specific medical history; 2. be able to conduct a general medical
examination; 3. be able to measure arterial pressure, take a blood
sample from the vein and carry out and interpret a standard
electrocardiogram; 4. understand the meaning and general
pathophysiology of the most frequent signs and symptoms of disease; 5.
be familiar with the normal levels for the main laboratory tests of general
medical-surgical interest; 6. be able to detect physical signs of disease,
be familiar with the most important variations from laboratory
parameters and be familiar with the most common diagnostic tests for
studying the major organs and systems that fall within the scope of
general medicine/surgery; 7. be acquainted with general aspects of
epidemiology and prevention of infectious diseases; 8. be familiar with
essential notions of medical statistics and of clinical research
methodology. Practical Training Programme (Nursing), 2nd year The main
aim of the practical training programme (nursing) that takes place during
the 1st and 2nd terms of the 2nd year of the degree course in Medicine
and Surgery is to acquaint students with organisational and care aspects
that characterise hospital departments in the medical, surgical, specialist
and emergency areas. This training programme provides an initial
opportunity for students to interact with nursing staff and clinical and
organisational issues. Students are assigned to nursing tutors, under the
supervision of teachers and coordinators, enabling them to learn about
and develop relationships with other professional figures and to
familiarise themselves for the first time with the necessary skills for
observing and understanding the fundamental clinical and ethical issues
that characterise hospital healthcare organisation. Interactive Learning
Activity (ADI, Attività Didattica Interattiva), 3rd year The Interactive
Learning Activity (ADI) forms an integral part of the Course in Semeiotics
and Clinical Methodology. It consists of practical activity in small groups
of students conducted by the course teachers in the relevant medical or
surgical departments. The fundamental aims of the ADI are to teach
students about initial contact with the patient, conducting a medical
history, the general physical examination and the most basic
semeiological manoeuvres that they must know before taking the exam.
The ADI usually takes place during December and January every year.
Every year the course coordinator assigns a certain number of students
(15-20) to a teacher. They are split into small groups of 3-4 by the
teacher him/herself. Students must contact their ADI teacher to arrange
times and methods for completing the ADI: the lists of students and their
assigned ADI teachers are displayed on the noticeboard of the
Department of Clinical Science (Barbieri building) around November 15
every year and can be viewed on the website.
Prerequisites
Preparation In order to take the exam in Clinical Semeiotics and
Methodology students must have passed the exams in Normal Human
Anatomy, Physiology and General Pathology
Course unit content
Course programme General medical history (anamnesis): family,
physiological, occupational, past and recent, pharmacological. General
medical examination: nutritional state, skin and appendages, lymph
nodes, head and neck, eyes, oropharynx, chest, breast, wrists, abdomen,
rectal examination, urogenital system, limbs, joints, muscular system,
nervous system, ambulation. General clinical methodology in surgery:
anamnesis, physical clinical examination, diagnostic hypotheses,
elements of instrumental diagnostics. Signs and symptoms of disease:
fever, cough, dyspnoea, cyanosis, asthenia, anorexia, vomiting,
diarrhoea, constipation, flatulence, intestinal occlusion, jaundice, oedema, ascites, palpitations, chest pain, abdominal pain, migraine,
dizziness, fainting and syncope, stress and shock, coma, stroke, bleeding,
dysuria, oliguria, anuria, polyuria, haematuria, itching and dermatosis of
interest to internal medicine, malnutrition, hypertension and hypotension.
Metabolisms: glucides, lipids, proteins, bile salts, uric acid, iron, water,
sodium, potassium, calcium, phosphorus, magnesium, acid – base
equilibrium. Blood and haematopoietic organs: red blood cells, white
blood cells, platelets, erythrosedimentation rate, haemostasis,
haemoculture, physical findings of signs of disease and methods of study
of spleen and lymph nodes, bone marrow needle biopsy. Immune system:
blood groups, immunoglobulin, autoantibodies, lymphocyte sub-
populations, allergic shock, principal allergy tests.
Full programme
General medical history (anamnesis): family, physiological, occupational,
past and recent, pharmacological. General medical examination:
nutritional state, skin and appendages, lymph nodes, head and neck,
eyes, oropharynx, chest, breast, wrists, abdomen, rectal examination,
urogenital system, limbs, joints, muscular system, nervous system,
ambulation. General clinical methodology in surgery: anamnesis, physical
clinical examination, diagnostic hypotheses, elements of instrumental
diagnostics. Signs and symptoms of disease: fever, cough, dyspnoea,
cyanosis, asthenia, anorexia, vomiting, diarrhoea, constipation,
flatulence, intestinal occlusion, jaundice, oedema, ascites, palpitations,
chest pain, abdominal pain, migraine, dizziness, fainting and syncope,
stress and shock, coma, stroke, bleeding, dysuria, oliguria, anuria,
polyuria, haematuria, itching and dermatosis of interest to internal
medicine, malnutrition, hypertension and hypotension. Metabolisms:
glucides, lipids, proteins, bile salts, uric acid, iron, water, sodium,
potassium, calcium, phosphorus, magnesium, acid – base equilibrium.
Blood and haematopoietic organs: red blood cells, white blood cells,
platelets, erythrosedimentation rate, haemostasis, haemoculture,
physical findings of signs of disease and methods of study of spleen and
lymph nodes, bone marrow needle biopsy. Immune system: blood groups,
immunoglobulin, autoantibodies, lymphocyte sub-populations, allergic
shock, principal allergy tests.
Bibliography
Recommended texts and reading list 1. Course material on website. 2.
Semeiotica Medica e Metodologia Clinica. Edizioni Minerva Medica, 2010,
author: Ranuccio Nuti. 3. Manuale di Semeiotica Medica. Edizioni McGraw-
Hill, 1998, authors: J.L. Wills, H. Schneiderman, edizione italiana a cura di
Giorgio Lambertenghi. 4. Semeiotica e Metodologia Chirurgica. Edizioni
Goliardiche, 2005, author: Mariano Cherubini. 5. Dottore ... mi posso
fidare? Manuale di medicina comprensibile. Edizioni Avverbi, 2007,
author: Giorgio Dobrilla. 6. Igiene e Medicina Preventiva, Vols. I -4.
Edizioni Moruzzi, authors: Barbuti & Bellelli. 7. Medici umani, pazienti
guerrieri. Editore Baldini Castoldi Dalai, 2008, author: Gianni Bonadonna.
8. Diagnosi infermieristiche. Casa Editrice Ambrosiana, 2006, author: L.J.
Carpenito-Moyet, Italian edition edited by Carlo Calamandrei & Laura
Rasero
Teaching methods
Learning activities The learning activities relating to the teaching of
Semeiotics and Clinical Methodology as a whole are structured and
developed during the 2nd and 3rd year of the degree course in Medicine
and Surgery as follows: - 2nd year, 1st term: practical training
programme in “preparatory medical-surgical clinical methodology” with
medical and surgical nursing and emergency treatment, concluding with
a certificate of attendance. Coordinator: Prof. Aderville Cabassi. - 2nd
year, 2nd term: practical training programme in “preparatory specialised
clinical methodology” with pediatric, obstetric/gynaecological and
neuropsychiatric rehabilitation nursing, concluding with a certificate of
attendance. Coordinator: Prof. Aldo Agnetti. - 3rd year, 1st and 2nd
terms: “lectures in semeiotics and clinical methodology” (coordinator:
Prof. Loris Borghi) and Interactive Learning Activity (ADI, Attività Didattica
Interattiva) in small groups at the patient’s bedside (coordinator: Prof.
Loris Borghi), concluding with a certificate of attendance and exam. The
course activities overall are worth 23 learning credits which are gained
upon passing the exam in Semeiotics and Clinical methodology held
during the 3rd year. The exam is oral.
Assessment methods and criteria
Oral examination
Other information
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