Medicine and Surgery

Activity type

Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica, Tirocini formativi e di orientamento

SSD

MED/18, MED/18

Year

3rd year

Semester

1st semester

CFU

3

Hours distribution

25 classroom hours, 25 training hours

Lecturers

LAURA GIACOMELLI

Activity type

Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica, Tirocini formativi e di orientamento

SSD

MED/09, MED/09

Year

3rd year

Semester

1st semester

CFU

4

Hours distribution

38 classroom hours, 25 training hours

Lecturers

MARCELLO ARCA
GIORGIO GRANI

Activity type

Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica

SSD

M-PSI/08

Year

3rd year

Semester

1st semester

CFU

1

Hours distribution

13 classroom hours

Lecturers

GIUSEPPINA PORCIELLO

Activity type

Clinica generale medica e chirurgica, Tirocini formativi e di orientamento

SSD

MED/09, MED/09

Year

3rd year

Semester

2nd semester

CFU

2

Hours distribution

13 classroom hours, 25 training hours

Lecturers

MARCELLO ARCA

Activity type

Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica

SSD

MED/12

Year

3rd year

Semester

2nd semester

CFU

1

Hours distribution

13 classroom hours

Lecturers

MARCELLO ARCA

Activity type

Inglese scientifico e abilità linguistiche, informatiche e relazionali, pedagogia medica, tecnologie avanzate e a distanza di informazione e comunicazione, Attività formative affini o integrative

SSD

MED/01, MED/01

Year

3rd year

Semester

2nd semester

CFU

2

Hours distribution

26 classroom hours

Lecturers

MARIA IRENE BELLINI
LAURA GIACOMELLI

Activity type

Inglese scientifico e abilità linguistiche, informatiche e relazionali, pedagogia medica, tecnologie avanzate e a distanza di informazione e comunicazione

SSD

L-LIN/12

Year

3rd year

Semester

2nd semester

CFU

4

Hours distribution

50 classroom hours

Lecturers

MIKIKO WATANABE

Activity type

Clinica generale medica e chirurgica, Tirocini formativi e di orientamento

SSD

MED/18, MED/18

Year

3rd year

Semester

2nd semester

CFU

3

Hours distribution

25 classroom hours, 25 training hours

Lecturers

LAURA GIACOMELLI
MARIA IRENE BELLINI

Main teaching objectives:
The course aims to develop the theoretical and practical skills necessary to allow a correct medical-patient interaction, to develop a method of collecting information and clinical data as well as the ability to accurately collect, recognize and interpret the main normal and pathological physical signs for all organs and systems.
At the end of the course, the student must be able /or have:
to perform patient’s interviewing and health history taking (Adapting Interviewing Techniques to Specific Situations)
to perform physical examination of major organs including collection of vital signs
to collect blood pressure
to perform basic surgical maneuvers
to perform a basic interpretation of ECG
basic knowledge of clinical reasoning
to perform the main Basic Life Support maneuvers (licenzed by American Heart Association).

Students will acquire the ability to perform basic physical examinations of the major organs and systems (cardiovascular, respiratory, abdominal, neurological, and musculoskeletal).
They will acquire the ability to perform and interpret the fundamentals of an ECG.
They will be able to perform a venous blood draw and an intramuscular injection.
They will understand the basics and main applications of bedside ultrasound techniques, useful for performing physical examinations.
They will acquire and develop clinical reasoning skills.
Improve their ability to read scientific papers in English

Knowledge of anatomy and physiology.

Module: CLINICAL SCIENTIFIC METHODS - GENERAL SURGERY
Contents:
history taking and physical exam of the abdomen and thyroid.


Module: CLINICAL SCIENTIFIC METHODS I - INTERNAL MEDICINE
Contents:
Lessons on the theoretical bases for the execution of the physical examination of the respiratory and cardiovascular system; lessons for the description of simple maneuvers for the execution of the neurological examination and of the musculoskeletal system. Practical exercises to learn how perform, in patients and in a clinical setting, the examination of the chest and heart. Execution and basic interpretation of the ECG. These practical activities are always accompanied by the collection of medical history.



Module: CLINICAL SCIENTIFIC METHODS I - GENERAL PSYCHOLOGY
The course will be structured into the following thematic blocks:
• Principles for Doctor–Patient Communication
• Promoting and Supporting Changes in Health Behaviors
• The methodological foundations of research in clinical psychology
• Evaluation of the effectiveness of clinical interventions



Module: CLINICAL SCIENTIFIC METHODS II - GENERAL SURGERY
Module Outline:
Lectures to acquire the theoretical and practical foundations for assessing the chest and lungs.
Lectures to acquire the theoretical foundations for assessing the musculoskeletal system, with particular reference to the impact of neurological injuries.
Use of medical vocabulary.
Lectures on the theory of interpreting clinical signs.
Small-group exercises for taking the medical history and performing the main semiological maneuvers for assessing the chest, lungs, and musculoskeletal system





Module: CLINICAL SCIENTIFIC METHODS II - GASTROENTEROLOGY
Contents:
Practical exercises to learn how to perform abdomen examination in patients. Exercises with patients in the classification and interpretation of simple clinical findings. These practical activities are always accompanied by the collection of the medical hystory.



Module: CLINICAL SCIENTIFIC METHODS II - MEDICAL STATISTICS
Contents:
history taking and physical exam of the abdomen



Module: CLINICAL SCIENTIFIC METHODS II - SCIENTIFIC ENGLISH
1. Abstract Writing for Scientists: Students will be trained in the art of condensing complex scientific articles into concise, yet comprehensive abstracts tailored for a scientific audience. Lectures will cover the essential elements of an abstract, the importance of keywords, and how to maintain scientific rigor while summarizing research findings.
2. Lay Summaries for the Public: Students will learn how to translate scientific jargon into language that is easily understandable by the general public. This skill is crucial for patient education and public health initiatives. Lectures will focus on identifying key takeaways from scientific articles and presenting them in a manner that is engaging and informative for laypeople.
3. Peer Review Workshops: Students will engage in peer review exercises to critically evaluate the abstracts and lay summaries written by their classmates. They will learn how to provide constructive feedback and how to assess the quality of scientific writing.
4. Editorial Role-Play: In a simulated editorial setting, students will act as editors to judge both the peer reviews and the original articles. This will help them understand the editorial process and the criteria used for scientific publishing.
5. Presentations for Laypeople: Students will be paired to give oral presentations explaining scientific articles to a lay audience. This will be supported by visual aids and will focus on simplifying complex scientific concepts without losing their essence.



Module: CLINICAL SCIENTIFIC METHODS II - INTERNAL MEDICINE
Contents:
history taking and physical exam of the abdomen, perineum and anus, breast

Module: CLINICAL SCIENTIFIC METHODS - GENERAL SURGERY
Suggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition



Module: CLINICAL SCIENTIFIC METHODS I - INTERNAL MEDICINE
Suggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition



Module: CLINICAL SCIENTIFIC METHODS I - GENERAL PSYCHOLOGY
Slides and materials provided by the professor on e-learning


Module: CLINICAL SCIENTIFIC METHODS II - GENERAL SURGERY
Suggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition




Module: CLINICAL SCIENTIFIC METHODS II - GASTROENTEROLOGY
Suggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition


Module: CLINICAL SCIENTIFIC METHODS II - MEDICAL STATISTICS
uggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition


Module: CLINICAL SCIENTIFIC METHODS II - SCIENTIFIC ENGLISH
No text is required. Lesson, articles and additional material will be provided by the teacher digitally.




Module: CLINICAL SCIENTIFIC METHODS II - INTERNAL MEDICINE
Suggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition

Module: CLINICAL SCIENTIFIC METHODS - GENERAL SURGERY
N/D
Module: CLINICAL SCIENTIFIC METHODS I - INTERNAL MEDICINE
N/D
Module: CLINICAL SCIENTIFIC METHODS I - GENERAL PSYCHOLOGY
N/D
Module: CLINICAL SCIENTIFIC METHODS II - GENERAL SURGERY
N/D
Module: CLINICAL SCIENTIFIC METHODS II - GASTROENTEROLOGY
N/D
Module: CLINICAL SCIENTIFIC METHODS II - MEDICAL STATISTICS
N/D
Module: CLINICAL SCIENTIFIC METHODS II - SCIENTIFIC ENGLISH
N/D
Module: CLINICAL SCIENTIFIC METHODS II - INTERNAL MEDICINE
N/D

Students will attend lectures and participate in small-group sessions of practical activities with real or simulated patients. They will perform practical activities in the skill lab on mannequins.

Students must attend at least 75% of the lectures and practical activities foreseen in the course calendar. Classroom attendance tracking

Students will have to complete a multiple choice questionnaire and take a practical test in performing the objective examination (on an indicated organ or system) which also includes the collection of vital signs and the execution/interpretation of the ECG in a real or simulated patient.

Examples of questions included in the MCQ

During the first consultation interviews with a slightly confused or old patient it is recommended to
a. adopt a precise and pressing interrogation method
b. acquire information through closed questionnaires with few simple alternative answers
c. re-propose the patients’ answers heard reformulating them in clear terms
d. interpret the answers based on the diagnostic hypothesis and clinical experience

The presence of blood around shaped stools could be interpreted more likely as:
a. constipation
b. the presence of a lesion of sigmoid colon or rectum
c. the presence of a lesion of the stomach or duodenum
d. the presence of a lesion of the small bowel or right colon
e. the presence of diverticula of the sigmoid colon

Light palpation of the abdomen is mainly useful to
a. detect spider nevi
b. detect enlarged veins
c. feel the distribution of hair
d. feel the normal introversion of the umbilicus
e. detect an abdominal wall hernia

If you suspect the presence of a small amount of ascitis, the best manoeuvre is
a. a careful deep palpation
b. a careful auscultation while gently shaking the abdomen
c. percussion with the patient seated on the border of bed
d. percussion with the patient lying on a flank
e. inspection with the patient standing

Module: CLINICAL SCIENTIFIC METHODS - GENERAL SURGERY

• Endocrine System
  Medical History and Physical Examination
  
  Thyroid gland
  
  Adrenal glands
  
  Pituitary gland
  
  Parathyroid glands
  
  Endocrine pancreas
  
  Testis
  
  Ovary
  
  Main signs and symptoms
  
  Polydipsia / Polyuria (excessive thirst and urination)
  
  Hirsutism / Hypertrichosis (excessive hair growth)
  • Books: Thomas et
    
    al. Oxford Handbook of Clinical Examination and
    
    Practical Skills


• General and specific clinical and instrumental semiology of breast diseases.

• Practical activity sessions (3 hours), in small groups with real and simulated patients
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition

• ·        
  Principles for Doctor–Patient Communication
  • Books: Slides on e-learning


• ·        
  Promoting and
  Supporting Changes in Health Behaviors
  • Books: Slides on e-learning


• ·        
  The methodological
  foundations of research in clinical psychology
  • Books: Slides on e-learning


• ·        
  Evaluation of the
  effectiveness of clinical interventions
  • Books: Slides on e-learning

•   Elements of anamnesis of pulmonary pathologies. The main symptoms
  • Books: Bates'
    
    Guide to Physical Examination and History-Taking - Lippincott Williams &
    
    Wilkins -  Lynn Bickley MD (Author),  Goldman’s
    
    Cecil medicine 24th edition


• Examination
  of the posterior chest (inspection, palpation, percussion, auscultation);
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  Goldman’s Cecil medicine 24th edition


• Examination of the Anterior Chest (Inspection,
  Palpation, Percussion, Auscultation)
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  Goldman’s Cecil medicine 24th edition


• Special Techniques (clinical assessment of
  pulmonary function, forced expiratory time, identification of a fractured rib).
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  Goldman’s Cecil medicine 24th edition


• Principles
  of clinical reasoning (Identifying problems and making diagnoses: a stepwise
  process. Sensitivity, specificity, predictive value of signs and symptoms) 
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  Goldman’s Cecil medicine 24th edition


• Principles
  of doctor–patient relationship . Communication within a patient centered approach
  . Promoting and supporting changes in health behaviors
  • Books: Slide set


• Elements of theory and practice for the physical examination of the musculoskeletal system, with particular reference to neurological damage (Part I)
  • Books: ates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  Goldman’s Cecil medicine 24th edition


• Elements of theory and practice for the physical examination of the musculoskeletal system, with particular reference to neurological damage (Part II)
  • Books: ates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  Goldman’s Cecil medicine 24th edition


• Practical activity sessions (3 hours), in small groups with real and simulated patients

• Practical activity sessions (3 hours), in small groups with real and simulated patients

• Abstract Writing for Scientists: Students
  will be trained in the art of condensing complex scientific articles into
  concise, yet comprehensive abstracts tailored for a scientific audience.
  Lectures will cover the essential elements of an abstract, the importance
  of keywords, and how to maintain scientific rigor while summarizing
  research findings.Lay Summaries for the Public: Students
  will learn how to translate scientific jargon into language that is easily
  understandable by the general public. This skill is crucial for patient
  education and public health initiatives. Lectures will focus on
  identifying key takeaways from scientific articles and presenting them in
  a manner that is engaging and informative for laypeople.Peer Review Workshops: Students will
  engage in peer review exercises to critically evaluate the abstracts and
  lay summaries written by their classmates. They will learn how to provide
  constructive feedback and how to assess the quality of scientific writing.Editorial Role-Play: In a simulated
  editorial setting, students will act as editors to judge both the peer
  reviews and the original articles. This will help them understand the
  editorial process and the criteria used for scientific publishing.Presentations for Laypeople: Students
  will be paired to give oral presentations explaining scientific articles
  to a lay audience. This will be supported by visual aids and will focus on
  simplifying complex scientific concepts without losing their essence.
  • Books: No text is required. Lesson, articles and additional material will be provided by the teacher digitally.

• Digestive System
  Medical History and Physical Examination
  
  Oral cavity
  
  Breath odor (halitosis)
  
  Salivary glands
  
  Physical examination of the abdomen (general and physical semiology of the abdomen)
  
  Palpability and tenderness of the abdomen
  
  Umbilical scar inspection
  
  Abdominal masses
  
  Hernias
  
  Ascitic fluid (ascites)
  
  Liver
  
  Spleen
  
  Inguinal canal
  
  Rectum Symptoms and signs
  
  Xerostomia (dry mouth)
  
  Sialorrhea (excessive salivation)
  
  Halitosis (bad breath)
  
  Nausea / Vomiting
  
  Belching / Bloating / Flatulence
  
  Hematemesis (vomiting of blood)
  
  Dysphagia (difficulty swallowing)
  
  Odynophagia (painful swallowing)
  
  Dyspepsia (indigestion)
  
  Pyrosis (heartburn)
  
  Epigastralgia (epigastric pain)
  
  Bowel habit disturbances
  
  Tenesmus
  
  Melena (black tarry stools)
  
  Rectorrhagia (rectal bleeding)
  • Books: Thomas et
    
    al. Oxford Handbook of Clinical Examination and
    
    Practical Skills


• Medical History and Physical Examination
  Physical and functional semiology of the kidneys and urinary tract
  
  Renal and ureteral anatomical landmarks
  
  Bladder examination
  
  Polyuria
  
  Pollakiuria (frequent urination)
  
  Dysuria / Stranguria (painful or difficult urination)
  
  Oliguria – Anuria
  
  Nocturia
  
  Enuresis (involuntary urination)
  
  Hematuria (blood in the urine)
  
  Tenesmus and urinary incontinence
  
  Urine discolorations and urinalysis


• Pathophysiology and Surgical Semiology
  Medical History (Anamnesis)
  
  General physical examination of the surgical patient and postoperative patient.
  
  Alterations in bowel and urinary function: disturbances of intestinal transit, basic clinical anatomy, and pain in major acute abdominal syndromes.
  
  Local physical examination of: swellings, discontinuities of tissues, neck and head, chest, abdomen and genitals, limbs.
  
  Clinical and instrumental semiology of diaphragmatic disorders
  
  General and instrumental semiology of diaphragmatic pathology.
  
  Non-traumatic diaphragmatic hernias: hiatal, sliding, and paraesophageal hernias; gastroesophageal reflux.
  
  Traumatic diaphragmatic hernias.
  
  Breast semiology
  
  General and specific clinical and instrumental semiology of breast diseases.
  
  Abdominal wall hernias
  
  General and specific clinical and instrumental semiology of abdominal visceral hernias and their complications: inguinal, femoral, umbilical, epigastric (linea alba), and internal hernias.
  
  Esophageal and gastric pathology
  
  General and specific clinical and instrumental semiology of esophageal and gastric disorders: gastric ulcer, Zollinger–Ellison syndrome, malignant tumors, gastroesophageal reflux disease (GERD).
  
  Duodenal and small intestinal pathology
  
  General and specific clinical and instrumental semiology of duodenal and small intestinal diseases: duodenal ulcer, intestinal infarction, intestinal intussusception, Meckel’s diverticulum.
  
  Large bowel pathology
  
  General and specific clinical and instrumental semiology of large bowel diseases: acute appendicitis, colonic diverticulosis, hemorrhoids, rectal prolapse, anal fissures, abscesses, anorectal fistulas, benign and malignant tumors.
  
  Gastrointestinal bleeding
  
  Clinical and instrumental semiology of digestive hemorrhages (upper and lower gastrointestinal tract).
  
  Diverticulosis and diverticulitis
  
  Physical and instrumental semiology of diverticular disease.
  
  Peritonitis and related conditions
  
  Pathophysiological basis of semiology, clinical and instrumental semiology of peritonitis: acute diffuse, chronic, and localized forms. Clinical forms of peritonitis. Subphrenic abscesses. Pelvi-peritonitis.
  
  Intestinal obstruction
  
  General and specific clinical and instrumental semiology of intestinal obstruction: definition, etiopathogenetic classification, pathophysiology. Differential semiology of the various types of ileus and other abdominal syndromes.
  
  Constipation and fecal incontinence
  
  Physical and instrumental semiology of constipation of surgical interest.
  
  Physical and instrumental semiology of fecal incontinence.
  
  Proctologic disorders
  
  Physical and instrumental semiology of proctologic conditions: hemorrhoids, anal fissures, perianal fistulas.
  
  Liver and biliary tract pathology
  
  General and specific clinical and instrumental semiology of hepatic and biliary tract diseases: acute and chronic cholecystitis, choledocholithiasis, surgically relevant jaundices and their classification, bilio-digestive fistulas, biliary tract tumors.
  
  Pancreatic pathology
  
  General and specific clinical and instrumental semiology of pancreatic diseases: tumors, acute and chronic pancreatitis.
  
  Portal hypertension
  
  Physical and instrumental semiology of portal hypertension.
  
  Nephro–uro–genital surgical pathology
  
  Physical and instrumental semiology of surgical diseases of the nephro–uro–genital system: disorders of micturition, terminology of qualitative and quantitative urinary alterations, renal, pelvic, ureteral, and bladder pain, and their differential diagnosis.
  
  Vascular pathology
  
  Clinical, instrumental, and differential semiology of vascular diseases: acute and chronic ischemic syndromes, aneurysms, arteriovenous fistulas, thrombophlebitis, varicose veins.
  
  Endocrine pathology
  
  Physical and instrumental semiology of thyroid diseases.
  
  Physical and instrumental semiology of adrenal diseases.
  
  Shock
  
  Physical and instrumental semiology of shock.