Medicine and Surgery

Gastrointestinal, hepatic and pancreatic diseases Jaundice and cholestasis: diagnostic approach in the patient with hepatocellular jaundice (acute viral, toxic, iatrogenic hepatitis) and with extrahepatic jaundice (lithiasis of the gallbladder and biliary tract, neoplasms of the biliary and pancreatic pathways). Chronic elevation of transaminases: diagnostic pathways (steatosis, non-alcoholic steatohepatitis, chronic viral hepatitis, alcoholic liver disease, metabolic diseases). Acute and chronic hepatic failure, fulminant hepatitis and liver cirrhosis, complications of cirrhosis of the liver (portal hypertension, esophageal variceal hemorrhage, ascites, hepatic encephalopathy, hepatocarcinoma). Esophageal disease as a frequent cause of chest pain: gastro-oesophageal reflux disease, esophageal motility disorders. Digestive hemorrhages (hematemesis and melena) diagnostic pathway, clinical pictures, prognostic factors, principles of medical and endoscopic therapy. NSAID gastropathy. Acute abdominal pain: clinical pictures (peptic ulcer disease, cholecystitis, acute pancreatitis, biliary colic, intestinal obstruction, abdominal vascular pathology, appendicitis) and diagnostic approach. Functional dyspepsia. Acute and chronic gastritis. Peptic disease. The relationships between gastroduodenal pathology and HP infection. Tumors of the esophagus and stomach. Acute and chronic pancreatitis. Weight loss: pathophysiology, clinical pictures and diagnostic approach (malabsorption, chronic pancreatitis, celiac disease). Chronic intestinal inflammatory diseases (ulcerative colitis and Crohn's disease). Bowel modifications: clinical pictures and diagnostic pathways in chronic acute diarrhea; irritable bowel syndrome; constipation. Diverticular disease and diverticulitis. Epidemiology and colorectal cancer screening strategies in the population. Colorectal cancers. Indication to the main investigations in gastroenterology: EDGS, colonoscopy, liver biopsy, ultrasound. Professionalizing activity Colloquium and anamnesis in the gastroenterological patient. Diagnostic maneuvers in the objective examination of the gastroenterological patient. Biochemical and instrumental examinations in the gastroenterological patient (indications and appropriateness in the diagnostic procedure, interpretation in clinical reasoning). To be able to identify the active problems of the gastroenterological patient from the interview and the objective examination and to be able to set up an appropriate diagnostic procedure.

Knowledge on anatomy, physiology, methodology on gatrointestinal tract. Knowledge on statistics and clinical epidemiology are

Specific guidelines will be provided during lectures and will be available on e-learning

Lectures with slides, exercises in the classroom, seminars on specific topic.ing Professional activity in hospital according to the bedside teaching methodology (small group activity on history taking followed by a debriefing to the large group). The following practical skills will be shown in the skill lab: naso-gastric tube positioning, rectal examination, venous and arterial sampling. On Moodle 2 relevant participating clinical cases will be discussed and a feedback will be obtained by each student.

Signature and nominal call.

Written examination by means of MCQ of different types (knowledge, interpretation skill and decision making) To Pass the test student must obtain a note of 18/30 for each subject of the integrated teach. Student must possess a sufficient knowledge of the program To obtain a note of 30/30 with distinction student must possess an excellent knowledge of the whole program using a correct terminology to expose the topics

Lectures with slides, exercises in the classroom, seminars on specific topic.ing Professional activity in hospital according to the bedside teaching methodology (small group activity on history taking followed by a debriefing to the large group). The following practical skills will be shown in the skill lab: naso-gastric tube positioning, rectal examination, venous and arterial sampling. On Moodle 2 relevant participating clinical cases will be discussed and a feedback will be obtained by each student.

The courses of Clinical methodology II and III takes place in the first and second semester of the third year and ends directly with the final exam. The aim is to learn: knowledge terminology, subjective symptoms, objective signs, laboratory investigations and instrumental investigations of the apparatuses: Cardiovascular, Respiratory, Endocrine, Digestive, Hematopoietic, Nephro-Urological, and alterations of the acid-base and hydro-electrolyte balance ABILITY 1) to conduct a correct (not problem-oriented) systematic anamnesis and to write it in a terminologically appropriate way. 2) to conduct the general physical examination (EO) in the normal subject correctly (excluding specialist dermatological, neurological, gynecological, proctological, rheumatological, ophthalmological maneuvers) and to dictate it in a terminologically appropriate way using a pre-established scheme. The dictation will also allow the assessment of the EO's inspection documents. and to introduce students to some SKILLS of pathophysiological reasoning, intended as the ability to know how to interpret signs and symptoms as an expression of morpho-functional alterations and to identify the problem from which to start the diagnostic procedure, with reference to some great syndromic examples.

Anatomy and physiology

Fradà Semeiotica Medica Amoroso Rossi Fanelli: Semeiotica Medica e Metodologia Clinica Amoroso, Riggio: Semeiotica Pratica Bates Esame obiettivo e anamnesis

The activity will take place through classroom lectures, classroom seminars and small group exercises based on the “peer physical examination” method. SKILLS: ANAMNESIS collected through an empty medical record: to be used to practice collecting the anamnesis in its various parts and a medical record for full anamnesis: to be used to learn the correct terminology. The student is required to carry out at least 15 anamnesis and to present the medical records compiled for the practical exam. The EO will be learned through an empty EO Clinical Record: to be used to write the objective findings highlighted using correct terminology and the correct sequence of gestures and a full EO Clinical Record: to be used to learn the correct terminology. A Checklist will also be used for how to perform the EO maneuvers The student is required to perform at least 15 EO (to friends, relatives, etc). The completed medical records must be presented at the time of the practical exam.

MCQ; performance evaluation on anamnesis and per physical examination. Practical examination which is necessary to be admitted to the written examination is based on a history taking in a simulated patients and on a physical examination on one of the following part: general, head and neck, thorax, abdomen and nervous system. A standardized check list will be used to check the student ability. To Pass the test student must obtain a note of 18/30 for each subject of the integrated teach. Student must possess a sufficient knowledge of the program To obtain a note of 30/30 with distinction student must possess an excellent knowledge of the whole program using a correct terminology to expose the topics

The activity will take place through classroom lectures, classroom seminars and small group exercises based on the “peer physical examination” method. SKILLS: ANAMNESIS collected through an empty medical record: to be used to practice collecting the anamnesis in its various parts and a medical record for full anamnesis: to be used to learn the correct terminology. The student is required to carry out at least 15 anamnesis and to present the medical records compiled for the practical exam. The EO will be learned through an empty EO Clinical Record: to be used to write the objective findings highlighted using correct terminology and the correct sequence of gestures and a full EO Clinical Record: to be used to learn the correct terminology. A Checklist will also be used for how to perform the EO maneuvers The student is required to perform at least 15 EO (to friends, relatives, etc). The completed medical records must be presented at the time of the practical exam.