Medicine and Surgery

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.

Firm and nominal call

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.

1. Introduction to cardiovascular disease 2. Cardiovascular risk factors 3. Vital signs 4. Clinical history 5. Physical examination 6. Cardiac, thoracic and abdominal examination 7. Cardiac examination in detail 8. Arterial and venous pulses 9. Respiratory examination in detail

A thorough working knowledge of cardiovascular anatomy, physiology, pathophysiology and pharmacology is a necessary prerequisite to maximize the learning yield of cardiovascular clinical history and clinical examination.

• Biondi Zoccai G. Malattie Cardiovascolari: Approccio clinico e scientifico. Minerva Medica, 2021. • Camm AJ, Lüscher TF, Maurer G, Serruys PW, The ESC Textbook of Cardiovascular Medicine. Oxford University Press; 2018. • Douglas G, Nicol F, Robertson C. Macleod. Manuale di semeiotica e metodologia medica. Edra; 2014. • Fuster V, Harrington R, Narula J, Eapen Z. Hurst's the Heart. McGraw-Hill Education; 2017. • Griffin BP, Manual of Cardiovascular Medicine. LWW; 2018 • Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Elsevier, 2018.

The course is based on traditional frontal lectures, with oral presentations and additional support via Powerpoint, or remotely using the Google Classroom platform. Additional supporting materials are available on Youtube (https://www.youtube.com/channel/UC2oTNMfSiUjCym7i_6_ZS4A/videos).

Participation to the course is mandatory, with presence check through direct call or signature.

Final exam is based on a written test (multiple choice question with single exact answer) and/or oral exam.

• Andersen S, Davidsen AH, Schirmer H, Melbye H, Spigt M, Aviles-Solis JC. Interrater and intrarater agreement on heart murmurs. Scand J Prim Health Care. 2022 Dec;40(4):491-497. doi: 10.1080/02813432.2022.2159204. Epub 2023 Jan 4. PMID: 36598178; PMCID: PMC9848245. • Davidsen AH, Andersen S, Halvorsen PA, Schirmer H, Reierth E, Melbye H. Diagnostic accuracy of heart auscultation for detecting valve disease: a systematic review. BMJ Open. 2023 Mar 24;13(3):e068121. doi: 10.1136/bmjopen-2022-068121. PMID: 36963797; PMCID: PMC10040065. • Desebbe O, Vallier S, Gergelé L, Alexander B, Marx A, Ben Jaoude E, Kato H, Toubal L, Berna A, Duranteau J, Vincent JL, Joosten A. Diagnostic accuracy of the peripheral venous pressure variation induced by an alveolar recruitment maneuver to predict fluid responsiveness during high-risk abdominal surgery. BMC Anesthesiol. 2023 Jul 22;23(1):249. doi: 10.1186/s12871-023-02194-x. PMID: 37481588; PMCID: PMC10362688. • Dianat B, La Torraca P, Manfredi A, Cassone G, Vacchi C, Sebastiani M, Pancaldi F. Classification of pulmonary sounds through deep learning for the diagnosis of interstitial lung diseases secondary to connective tissue diseases. Comput Biol Med. 2023 Jun;160:106928. doi: 10.1016/j.compbiomed.2023.106928. Epub 2023 Apr 20. PMID: 37156223. • Gardezi SKM, Myerson SG, Chambers J, Coffey S, d'Arcy J, Hobbs FDR, Holt J, Kennedy A, Loudon M, Prendergast A, Prothero A, Wilson J, Prendergast BD. Cardiac auscultation poorly predicts the presence of valvular heart disease in asymptomatic primary care patients. Heart. 2018 Nov;104(22):1832-1835. doi: 10.1136/heartjnl-2018-313082. Epub 2018 May 24. PMID: 29794244. • Seah JJ, Zhao J, Wang Y, Lee HP. Review on the Advancements of Stethoscope Types in Chest Auscultation. Diagnostics (Basel). 2023 Apr 25;13(9):1545. doi: 10.3390/diagnostics13091545. PMID: 37174938; PMCID: PMC10177339. • Thomas SL, Heaton J, Makaryus AN. Physiology, Cardiovascular Murmurs. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30247833. • van der Wall EE. The stethoscope: celebration or cremation after 200 years? Neth Heart J. 2016 May;24(5):303-5. doi: 10.1007/s12471-016-0826-6. PMID: 27052893; PMCID: PMC4840120.

The course is based on traditional frontal lectures, with oral presentations and additional support via Powerpoint, or remotely using the Google Classroom platform. Additional supporting materials are available on Youtube (https://www.youtube.com/channel/UC2oTNMfSiUjCym7i_6_ZS4A/videos).

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

Practice Guidelines

Signature

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