Learning objectives
D1 - KNOWLEDGE AND UNDERSTANDING
At the end of the training activity the student will be able to:
1. Know and understand the methodology for the physical examination to be applied at the clinical problem;
2. Know and understand the diagnostic pathway based on the physical examination and clinical pathology;
3. Know, understand and remember the definition of symptoms;
4. Know and understand fundamentals of etiology, pathophysiology, symptomatology, diagnosis and guidelines for the treatment of major internal medical problems of small and large pets;
5. Know and understand the methods of clinical and instrumental diagnosis of the main internistic medical problems of small and large domestic animals.
D2 - CAPACITY TO APPLY KNOWLEDGE AND UNDERSTANDING
At the end of the training activity the student will be able to:
1. Perform a physical examination and complete a clinical record;
2. Set up a diagnostic plan based on physical examination, laboratory findings ;
3. Interpret evidences from clinical pathology ;
4. Perform and interpret an electrocardiographic examination;
5. Perform a basic cardiological, neurological, dermatological examination;
6. Know how to handle, in collaboration with other professionals, a case of internal medicine;
7. Know how to apply the knowledge and understanding acquired in interpreting the patient's problems, recognizing the causes and the clinical consequences.
D3 - MAKING JUDGEMENTS
At the end of the training activity the student will be able to:
1. Evaluate and critically choose the most relevant instrumental and laboratory diagnostic tools to formulate diagnosis and prognosis;
2. Analyze the diagnostic elements to formulate the clinical problem;
3. Analyze a diagnostic plan;
4. Set up an appropriate therapy and patient monitoring plan.
D4 - COMMUNICATION SKILLS
At the end of the training activity the student will be able to:
1. Communicate clearly and with appropriate terms a clinical case
2. Communicate with the owner or driver of the animal about the clinical problem;
3. Relate correctly to the patient, the animal owner, and the work colleagues
D5 - LEARNING SKILLS
At the end of the training activity the student will be able to:
1. Modify the approach to the patient according to what was learned;
2. Critically consult scientific texts and papers;
3. Make a bibliographic research autonomously;
4. Have a mastery of clinical disciplines that will stimulate continued lifelong learning.
Prerequisites
Competences on physiology, general pathology and physio-pathology are needed.
Course unit content
The course in Physical Examination and Clinical Pathology aims at giving the basis for the physical examination of the animals. Thanks to the physical examination and clinical pathology the student must be able to design the clinical approach to the sick animal.
The course in Medical Pathology provides fundamental knowledge on the etiology, pathophysiology, diagnosis, prognosis and treatment of the most common internal medicine diseases of domestic small and large animals.
Full programme
Medical pathology of the cardiovascular system:
Pericardial diseases. Myocardial disease. Endocardial diseases. Cardiac rhythm abnormalities. Acute and chronic cardiocirculatory failure.
Medical pathology of the respiratory system:
Diseases of the upper respiratory tract (nasal and paranasal cavity, larynx). Diseases of the trachea and bronchi. Diseases of the lungs and pleura. Diaphragm diseases.
Medical pathology of the urinary system:
Kidney diseases. Diseases of the bladder, urethers and urethra. Acute and chronic renal failure.
Madical pathology of the gastrointestinal system:
Diseases of the oral cavity. Diseases of the pharynx. Diseases of the esophagus. Diseases of the stomach. Diseases of rumen, reticulum, omasum and abomasum. Diseases of intestines. Colics. Diaseas of liver and gall bladder. Diseases of pancreas. Diseases of the peritoneum.
Medical pathology of the endocrine system:
Diseases of thyroid and parathyroid. Diseases of the adrenal glands. Diabetes mellitus.
Medical pathology of muscle-skeletal system:
Diseases of muscles. Diseases of bones.
Medical pathology of the nervous system:
Diseases of the central nervous system. Diseases of the peripheral system. Epilepsy.
Medical pathology of hemopoietic system
Disorders of red blood cells. Disorders of platelets. Disorders of white blood cells. Coagulopathies.
General Semeiology
Definition of semeiology; brief history on the evolution of the semeiologic technique; direct or physical semeiological processes: inspection, palpation, percussion, auscultation, measurement, thermometry, polls, catheterizations, exploratory bites. indirect or instrumental semeiological processes: urine, feces, blood, transudate, exudate, gastric and ruminal juice, microbiological tests, allergy tests and serological tests.
Semiological test scheme. History: environmental, collective, individual, remote, proximate, physiological, pathological. Signaling and identification of the subject.
Examinations (present state): skeletal development and constitution; nutritional status and muscle tone, sensory status, attitudes, and distinguishing features; skin and subcutaneous connective tissue, mucosal membranes; lymphnodes, temperature, pulse, breathing, major organ functions .
Special Semiology: examination of the body systems in the species of veterinary interest.
Examination of the digestive system
Appetite, thirst, degeneration of taste; intake of food and beverages; alterations of mastication, swallowing disorders, rumination, belching, vomiting, defecation. Examination of the oral cavity: inspection of the labial (size and appearance of salivary flow, lesions of the lips, mobility of the lower jaw); examination of the buccal vestibule and mouth (temperature, salivary secretion, smell, feel, appearance); review the language. Examination of the teeth. Examination of the pharynx and esophagus. Examination of the abdomen in horses and small animals: inspection, palpation, percussion, auscultation. Examination of the perineum. Rectal examination in horses, cattles and dogs. Rhino-esophageal intubation in the horse; gastric intubation in small animals. Examination of stomachs of cattle: inspection, palpation, percussion, auscultation of the rumen; collection and examination of rumen content; e Evidence of diaphragmatic and peritoneal pain in cattle: compression, percussion with heavy hammer, and Kalchschmidt test. Examination of the intestine in cattle; intraperitoneal exploration in cattle; exploration endoruminoreticolare in cattle; rectal examination in cattle; survey rhino-esophageal in cattle; survey in the bovine rumen. Puncture of the abdomen (paracentesis) in the horse, in cattle, in small animals. Examination of the payment of the serous cavities: physical examination, chemical, microscopic, bacteriological. Stool examination: macroscopic examination, microscopic examination, bacteriological examination and culture, blood research. Examination of the liver: physical examination, functional tests, liver biopsy. Examination of the spleen.
Examination of the respiratory system
Semeiologic examination of the upper respiratory tract: examination of the nostrils and the nasal mucosa; examination of the breasts; examination of the larynx; provocation, characters and genesis of cough; examination of the trachea. Inspection, palpation, percussion, auscultation of the chest; functional examination of the breath.
Examination of the cardiovascular system
Capillaries Arteries: inspection, palpation (arterial pulse), auscultation. Veins, swelling and increase in volume, decrease or disappearance; venous pulsations. Heart: inspection, palpation, percussion, auscultation of the heart region; outbreaks of auscultation, heart sounds and tones; extracardiac noise. Laboratory Tests of cardiovascular function: measurement of blood pressure, phonocardiographs, electrocardiography.
Examination of the blood and blood-forming organs. Blood-forming organs: lymph nodes, spleen, bone marrow and laboratory evaluation semeiologic of homeostasis.
Examination of the urinary tract
Supplement medical history. Direct physical examination: inspection, palpation, rectal examination. Functional examination: urine test chemical and physical blood tests, renal function tests.
Examination of the integumentary system. Direct physical examination: inspection, Smelling, palpation, percussion. Microscopic examination of material obtained by cutaneous scarification.
Examination of the endocrine glands
Semeiological direct and functional examination of pituitary, thyroid, parathyroid, adrenal glands and pancreas.
Examination of the neuro-muscular system
State of the sensorium, standing and gait; Postural reactions. Sensory examination. Examination of cranial and spinal reflexes. EMG and EEG investigations.
Methodological principles of decision-making procedure in veterinary medicine
Symptoms, signs and clinical data; Causes of errors in the detection of symptoms, Normality and Pathology; Measurement of symptoms, The clinical explanation; Programming the diagnosis, The minimization of errors and costs of the diagnosis, The diagnostic choice ; Medical practice and practice of clinical research.
CLINICAL PATHOLOGY:
Haematology: Blood cell count; Enzymes and substrates; Laboratory investigations for the evaluation of: liver function; Kidney and urinary tract function + urinalyses; disorders associated with cardiopathy; gastrointestinal disorders; endocrin disorders; muscular and skeleton diseases; autoimmune disorders; metabolic disorders; acid-base balance. Biological fluid examination.
Bibliography
Patologia medica: CONSTABLE, HINCHCLIFF-DONE-GRUNBERG:Veterinary medicine. A textbook of the diseases of cattle, horses, sheep, pigs and goats - 2017; SMITH: Large animal internal medicine - Edizioni varie; REED - BAYLY: Equine Internal Medicine, Saunders Co, 2018; ETTINGER : Textbook of veterinary internal medicine - Edizioni varie; NELSON-COUTO: Small animal internal medicine - Edizioni varie
Physical examination and Clinical Pathology: Paolo Ciaramella. Semeiologia Clinica Veterinaria. Poletto Editore, 2014, Vermezzo (MI); Paltrinieri -Bertazzolo-Giordano: Patologia clinica del cane e del gatto. Approccio pratico alla diagnostica di laboratorio,1° ed., Elsevier-Masson, 2010
Teaching methods
The didactic activities will be conducted with frontal lessons. Practicals include lab and desk activities, pre-clinical work on simulators and healthy animals, discussion of clinical cases with POA method. The didactic material (guide contents for lectures as PowerPoint presentations) are uploaded to the Elly platform at the beginning of the course. The same material can be requested directly to the teacher. This didactic material is not exhaustive and therefore needs to be supplemented by infomation given by the teacher during lectures and practical training. Additionally, the student is required to integrate the arguments with the contents of the suggested texts.
Assessment methods and criteria
For the module of Physical Examination and Clinical Pathology, the assessment of the expected learning outcomes described by the indicators D1, D2 and D3 is based on an oral examination (oral test) consisting of three questions mainly focused on the critical discussion of clinical methodology, physical and clinical pathology, and a practical exam on healthy animals or simulators. With the same questions, it will be ensured that the achievement of the objectives will enable the student to apply what is acquired in terms of knowledge. Each of the three questions has an equal weight for the mark definition that is expressed in thirty. The outcome of the test is communicated at the end of the examination. No partial or on-going (in itinere) tests are provided.
For the Medical Pathology module, the assessment of the achievement of the expected learning and comprehension objectives involves an oral examination consisting of three questions strictly related to the content discussed in the course. With such questions will be determined the achievement of the objectives that will allow the student to apply the acquired knowledge. Each answer will receive a score from 0 to 10. The final mark is expressed in thirty.
The final mark of the course of Medical Semeiology and Medical Pathology , expressed in 30ths, is the mean of the marks obtained in the two modules of the course.
