MC/0536 - CLINICAL METHODOLOGY 2
Academic Year 2021/2022
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QUIRICO MELA (Tit.)
- Teaching style
- Lingua Insegnamento
|[40/39] MEDICINE AND SURGERY||[39/00 - Ord. 2015] PERCORSO COMUNE||13||160|
BASIC KNOWLEDGE AND COMPREHENSION CAPACITY: The student is required to acquire the methodologies aimed at collecting the clinical history and the physical examination of the patient. The student will learn how to perform the general objective examination, the physical examination of head and neck and cardiovascular, respiratory and gastroenteric systems, as well as kidney and urinary tract and skin. The clinical evaluation will be integrated with the main functional and instrumental methods of diagnostic imaging (ultrasound, echodoppler, MRI, CT, Nuclear Medicine) of the following organs and apparatus: cardiovascular, respiratory, thyroid, breast, oesophagus, stomach, small intestines, colon, liver and biliary tract, pancreas, kidney and urinary tract, arteries and veins, bone. The main pathophysiological mechanisms of the following diseases will be analyzed: portal hypertension, acid-base balance and hydro-electrolytic imbalances, clotting disorders as well as disorders of sodium, potassium, calcium and phosphorus metabolism. The clinical consequences of infections, trauma, shock, burns, digestive bleeding, intestinal occlusion, peritonitis and organ transplantation will be examined. The following topics will also be addressed: somatic and visceral pain, bronchial asthma, chronic obstructive pulmonary disease, pulmonary emphysema, pulmonary edema, acute and chronic heart failure and respiratory failure. It will also address the pathophysiology of hydro-electrolytic balance (homeostasis of sodium, potassium, calcium, phosphorus, magnesium) and alterations in the acid-base balance: respiratory and metabolic acidosis and alkalosis, shock, burns, the pathophysiology of intestinal occlusion, peritonitis and digestive hemorrhages, transplantation.
AUTONOMY JUDGEMENT: The student will learn to acquire anamnestic and physical data in order to formulate a basic diagnostic judgement in the context of gastrointestinal, cardiologic, and thoraco-pulmonary diseases.
APPLICATION CAPACITIES: The student should be able to combine the recognition of the signs of medical and surgical semeiotic with the correct request for diagnostic tests to confirm the clinical suspicion of a pathology following a correct radiological flow chart.
COMMUNICATION CAPACITY: The student will learn to present relevant data regarding a specific clinical case and to properly expose the development of diagnostic pathways and the results of therapeutic interventions.
COMPREHENSION CAPACITY: The student will learn to acquire new information and to enforce his cultural background in a critical way through the consultation and interpretation of recent scientific literature.
Knowledge of human anatomy, physiology, biochemistry.
Family history, physiological, past and recent pathological, history
General physical examination
Respiratory system: inspection, palpation, percussion, auscultation
Cough, Pneumonia, Bronchopneumonia, Chronic obstructive pulmonary disease, Pulmonary emphysema, Bronchial asthma, Pleuritis, Pneumothorax
Cardiovascular system: anamnesis, risk factors
Dyspnea. Thoracic pain (angina pectoris, myocardial infarction, aortic dissection, pulmonary embolism, esophagitis, musculo-tendinous pain, pneumothorax, pleuritis, ganglio-radiculitis)
Cardiovascular system: inspection, palpation, percussion, auscultation (auscultation areas). heart sounds, murmurs, clicks. Valvular defects: aortic stenosis and insufficiency, mitral stenosis and insufficiency, pulmunary stenosis and insufficiency, tricuspid stenosis and insufficiency, interatrial and interventricular defect, Botallo's duct patency. Acute pericarditis, cardiac tamponade. Arterial pulse and Venous pulse
Blood pressure measurement
Abdomen: inspection, palpation, percussion, auscultation Hepatomegaly, portal hypertension, Ascites
Alteration of skin color: jaundice, cyanosis, purple. Spleen: inspection, palpation, percussion; Splenomegalie
Kidney: physical and functional semeiology
Urination Disorders, Urine Examination
Hints of Osteoarticular Semeiology
Notes on Electrocardiography: sinus rhythm
Calculation of heart rate,QR axis,SECG Holter
Respiratory system: Asthma, COPD, Emphysema, Pulmonary edema, Acute and chronic pulmonary heart, Respiratory insufficiency, Spirometry, Haemogasanalysis, Cyanosis
Family history, physiological, past and recent pathological, history
General physical examination
Physical examination by inspection, palpation, percussion and auscultation. Examination of swellings and wounds. Examination of the neck: congenital pathologies, thyroid, salivary glands, lymph node stations. Examination of the chest: trauma, bronchial carcinoma, pleural effusion, pulmonary embolism, mediastinal syndromes.Examination of the breast. Examination of the abdomen: Evaluation of abdominal swelling; symptoms and signs of the most frequent abdominal diseases. Rectal examination. Abdominal trauma.
Examination of the liver and biliary tract; cholestatic jaundice Examination of abdominal hernias and genitals
Acute abdominal syndromes: Examination of bowel obstruction, peritonitis, acute pancreatitis, hemoperitoneum. Evaluation of digestive haemorrhages. Medical history and physical examination of chronic obliterative arteriopathies and venous insufficiency. Acute Ischemias of the limbs. Diuresis and urination disorders; hematuria.
Functional Surgical Semeiotics
Instrumental Methods, Ultrasound, Radiology, Angiography, CT, Endoscopy and Laparoscopy
Functional and instrumental thyroid semeiotics
Functional and instrumental breast semeiotics
c. Cytology and Biopsy.
Chest and mediastinum instrumental semiotics
Instrumental semiotics of esophagus, stomach, small intestine and colon. Functional and instrumental semiotics of liver and biliary tract:
Instrumental semiotics of the pancreas. Functional and instrumental semiotics of the kidney and urinary tract
a. Urography and Ascending Pyelography
Instrumental semiotics of arteries and veins
a. Doppler and Ultrasound
The program of the Radiological Semeiotics course includes the study of Flow Chart of Diagnostic Imaging, drawn up according to international guidelines, concerning the signs of clinical and surgical semeiotic pathologies
The entire course will include both frontal lectures presented thought PowerPoint presentations and clinical practice though the attendance of clinical ward, day hospital, clinic and endoscopy unit. The frontal lecture may be integrated by innovative teaching routes (active learning) through the analysis and interpretation of clinical cases. In agreement with the Manifesto degli Studi for the AA 2020-2021 (pag.12): “teaching will be contemporary held both by frontal lesson and online, delineating a joint teaching that could be held both in university classrooms or through online education activities. Each student is required to choose between frontal or distance lessons at the beginning of the semester. This will be a binding choice for the entire semester. If the number of the students exceeds the maximum classroom seating capacity, determined by the state sanitary regulations to fight the Covid-19 pandemics, the access to the didactic units will be regulated though a rounding system that will be communicated in time to the interested students.
Verification of learning
The final exam will be based on a written or oral test.
The written exam will be composed of multiple-choice questions.
The oral exam will include open questions on different topics present on the program that could be also presented as clinical cases.
In both cases, the maximum final grade that could be achieved is 30. The exam will be considered as passed if at least a grade of 18/30 has been achieved.
The comprehension of course covered topics, as well as the ability to formulate valid diagnostic hypothesis and to verify them through an opportune and valuable diagnostic planning, will be evaluated. The knowledge of non specialistic therapies for the examinated pathologies will also be evaluated. Finally, the expression capacity, the use of appropriate scientific language and the ability to synthetize information will be assessed.
The final grade will take into account:
Manifested quality of the knowledge, capacities and competences:
a) Knowledge pertinence, accuracy and consistency
b) Capacity pertinence, accuracy and consistency
c) Competences pertinence, accuracy and consistency
a) Expressive capacity.
b) Appropriate and correct use of specific discipline-related language.
c) Logic reasoning capabilities in contents connection.
e) Ability to create links between different topics focusing on common points, and to make a general coherent speech, taking care of the structure, organization and logic connections of the speech.
f) Ability to synthetize information.
The final grade can be:
a) Sufficient (18 to 20/30)
Scarcity of acquired notions, superficial level of knowledge with numerous gaps, simple expressive capacities but sufficient to sustain a coherent speech. The capacity to link different topics lays at an elementary level. Scarce ability to synthetize and to interact with the professor during the interview.
b) Decent (21 to 23)
Reasonable quantity of acquired notions, but scarce in-depth analysis. Few knowledge gaps. Expressive capacities adequate to sustain a coherent speech and acceptable scientific language fluency. The ability to logically link different topics lays at a moderate complexity level. Adequate ability to synthetize and to interact with the professor during the interview.
c) Good (24 to 26)
Wide knowledge, moderate in-depth analysis, with little gaps; satisfying expressive capacities and significative scientific language fluency; well recognizable ability to dialog and acceptable critical sensibility. Good ability to synthetize and to interact with the professor during the interview.
d) Very good (27 to 29)
Extensive and deeply analyzed knowledge, with only negligible gaps; notable expressive capacities and high scientific language fluency; remarkable ability to dialog and inclination to synthetize and to interact with the professor during the interview.
e) Excellent (30)
Exceptionally extensive and deeply analyzed knowledge, eventually with irrelevant gaps. Very high expressive capacities and scientific language fluency, excellent ability to dialog, exceptional inclination to create links between different topics, outstanding ability to synthetize and to interact with the professor during the interview.
The laude will be awarded to the candidates that demonstrate to be remarkably above the average, whose eventual expressional, conceptual, logical and notional limits result to be mainly irrelevant.
• - Moderni aspetti di Semeiotica Medica. Sanna e Dioguardi
• - Il nuovo Rasario - Semeiotica e Metodologia Clinica. B. Tarquini - Idelson editore
• - Metodologia clinica. Nuti e Caniggia
• - Metodologia Chirurgica. W. Montorsi, A. Peracchia, P. Pietri - Ed Minerva Medica.
• - Semeiotica e Metodologia Chirurgica. E. Berti Riboli, M. Gipponi - ECIG
• - Semeiotica Chirurgica e Metodologia Clinica. L. Gallone - Casa Editrice Ambrosiana.
• - Corazza, Ziparo. Manuale di Fisiopatologia medica e chirurgica. Il pensiero scientifico editore.
• - D’Amico. Chirurgia Generale. Fisiopatologia clinica e terapia. Piccin
• - F. Basile, R. Bellantone, A. Biondi, G. Di Candio, G. Dionigi, L. Decimo, C.P. Lombardi. Manuale di Semeiotica e Metodologia Chirurgica. EDRA
The exam registrations will take place through ESSE3 platform.
The exam could be sustained by all the students who attended at least 70% of the total frontal lectures hours and at least 50% of each lesson module and after a complete attendance of all hours required for the practical professionalizing activity.
Location of interactive teaching and pratical training:
AOU of Cagliari
"Duilio Casula" University Hospital at the Department of Internal Medicine, Department of Surgery and Department of Diagnostic Imaging
Student reception: Tuesday from 1pm to 2pm at the "Duilio Casula" University Hospital (Department of Internal Medicine, Department of Surgery, Department of Diagnostic Imaging)
Prof. Quirico Mela mail: firstname.lastname@example.org
Prof. Angelo Restivo mail: email@example.com
Prof.ssa Carola Politi mail: firstname.lastname@example.org