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INTERNAL MEDICINE 2

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INTERNAL MEDICINE 2

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Academic year 2022/2023

Course ID
SCB0227
Teaching staff
Marco De Gobbi (Lecturer)
Alessandro Morotti (Lecturer)
Massimo Terzolo (Coordinator)
Soraya Puglisi (Lecturer)
Year
6th year
Teaching period
First semester
Type
Basic
Credits/Recognition
6 (6 hours of lectures, 72 hours of exercises)
Course disciplinary sector (SSD)
MED/09 - internal medicine
Delivery
Formal authority
Language
English
Attendance
Mandatory
Type of examination
Written and oral
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Sommario del corso

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Course objectives

  • Patient-centered clinical reasoning with special focus on quality of life and patient-reported outcomes
  • Approach to a patient with multiple comorbidities of which one is prevailing and causing the search for care
  • Approach to a patient presenting with acute decompensation or worsening of known, chronic diseases and to a patient with multiple comorbidities presenting a with a new disease
  • Understanding the complexity of clinics and care and defining a priority of intervention
  • Application in clinical practice of the clinical reasoning and methodology to complex and usually elder patients
  • Balanced use of resources for diagnosis and treatment; avoid defensive medicine
  • Decision making founded on reasoned application of evidence-based medicine
  • Organization of follow-up focusing on clinical and laboratory parameters useful to control clinical balance and leading to prompt detection of instability and decompensation
  • Multidimensional assessment of elder patients to approach frailty

Being able to work in a complex system, with inherent multi-disciplinary and multi-operative characteristics and being able to interact with many health-workers in different capacities.

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Results of learning outcomes

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To reach the above-mentioned learning objectives.
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Course delivery

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Frontal teaching and exercises on simulated clinical cases
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Learning assessment methods

 

The examination includes a written and an oral test. The written test consists of two brief clinical cases pertaining to the topics addressed during the course. Positive results in both tests allow to sustain the oral test, while two negative results, or a severe insufficiency in one test, preclude the oral test. Both written and oral tests should be passed at the same session.

The oral test consists in the presentation of a clinical case pertaining to Internal Medicine made by the candidate with a few slides addressing the diagnostic and therapeutic issues of the case and providing a clinical reasoning of the decision-making process. The case should be real: i.e., a case seen during internship. A discussion of the written test could take place as other questions on the presented case with the aim to check the global knowledge of the candidate. The candidate may try the examination for a maximum of 4 times year: every reject count as a try, while a withdrawal after attaining a positive evaluation (willing a better grade) does not count.

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Program

  • Complexity in clinics and care of Internal Medicine and Geriatrics
  • Discussion of the different types of presentation of a clinical case in internal medicine
  • Principles of therapy of the following diseases:
    • Arterial hypertension
    • Heart failure
    • Dyslipidemia
    • Electrolytic disturbances
    • Liver cirrhosis
    • Endocrine diseases and diabetes mellitus
    • Asthma and COPD
    • Anemia in elder subjects and myelodysplastic syndromes
    • Monoclonal gammopathy
    • Diverticulosis & Diverticulitis
    • Thrombocytopenia
    • Delirium and cognitive impairment in elderly
  • Principles of steroid therapy
  • Principles of anti-platelet and anti-coagulant therapy
  • Principles of antibiotic, antiviral and antifungal therapy
  • Principles of immunosuppressive therapy
  • Principles of treatment of coagulation disorders

Suggested readings and bibliography



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Book
Title:  
Harrison's Principles of Internal Medicine, 21e
Year of publication:  
2022
Publisher:  
McGraw Hill
Author:  
Joseph Loscalzo, Anthony Fauci, Dennis Kasper, Stephen Hauser, Dan Longo, J. Larry Jameson
ISBN  
Permalink:  
Required:  
Yes


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Book
Title:  
Harrison's Manual of Medicine, 20e
Year of publication:  
2020
Publisher:  
McGraw-Hill
Author:  
J. Larry Jameson, Antony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo, Joseph Loscalzo
ISBN  
Permalink:  
Required:  
Yes
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