Medicine and Surgery

Activity type

Clinica generale medica e chirurgica, Tirocini formativi e di orientamento

SSD

MED/09, MED/09

Year

6th year

Semester

2nd semester

CFU

3

Hours distribution

25 classroom hours, 25 others hours

Lecturers

MARCELLO ARCA
COSIMO DURANTE
MARIANNA MARANGHI

Activity type

Clinica generale medica e chirurgica

SSD

MED/18

Year

6th year

Semester

2nd semester

CFU

1

Hours distribution

13 classroom hours

Lecturers

MARIA IRENE BELLINI

At the end of the course, the student will be able to:

• Collect, analyze, and integrate anamnestic, clinical, laboratory, and instrumental data to formulate an appropriate diagnostic reasoning process.
• Manage complex clinical cases and patients with multiple comorbidities, applying the PICO methodology to solve diagnostic and therapeutic problems.
• Recognize and manage the main internal medicine conditions commonly encountered in clinical practice, including community-acquired pneumonia, acute kidney injury, and type 2 diabetes mellitus.
• Identify the main risks associated with polypharmacy (drug interactions, drug-related adverse events, lack of therapeutic benefit, use of potentially inappropriate medications, poor adherence).
• Recognize and manage the main surgical conditions commonly encountered in clinical practice, including acute and chronic abdominal pain, cholelithiasis, complications in patients undergoing gastric or colorectal surgery, and surgical causes of hematuria.
• Identify the main pharmacological interactions, recognize patients at higher risk of adverse drug events, and make appropriate dosage adjustments based on the patient’s clinical profile.
• Discuss and present clinical cases in a structured and reasoned manner, integrating clinical and pharmacological knowledge.
• Read and interpret arterial blood gas analysis and other laboratory tests in relation to the clinical context.
• Accurately interpret a normal electrocardiogram and recognize the main clinically relevant abnormalities.

The student must have passed the ongoing exam of Intern Medicine and Surgery II. A basic knowledge of medicine, pharmacology and physiopathology is required.

Internal Medicine
• Drug interactions
• Drug-related adverse events
• Identification of patients at higher risk of adverse drug reactions
• Management of polypharmacy
• Management of patients with community-acquired pneumonia
• Management of patients with acute kidney injury
• Management of patients with type 2 diabetes mellitus
• Reading and interpretation of arterial blood gas analysis
• Reading and interpretation of a normal electrocardiogram
• Presentation and discussion of clinical cases
• Application of the PICO methodology for solving diagnostic and therapeutic problems

General Surgery
• Acute and chronic abdominal pain
• Pathophysiology of patients undergoing gastric and colorectal surgery
• Cholelithiasis: pathophysiology, diagnosis, and treatment
• Hematuria: clinical evaluation and diagnostic work-up
• Discussion of clinical cases and management of complex surgical patients

● Harrison’s Principles of Internal Medicine, 19th Edition, McGraw Hill
● Sabiston Textbook of Surgery, Elsevier/Saunders

Module: INTERNAL MEDICINE AND GENERAL SURGERY III Chirurgia Generale
N/D
Module: INTERNAL MEDICINE AND GENERAL SURGERY III Medicina Interna
N/D

Lectures, flipped classroom, training sessions, homework with class revision. To foster interaction with students during classroom lessons, digital platforms will be used to create interactive presentations and lectures, enabling active participation through real-time polls, quizzes, and word clouds

Mandatory, attendance tracking through the University’s ‘Prodigit’ application

The examination will consist of a guided discussion of clinical cases representative of the main syndromes covered during the course. Through case-based presentation, students will be required to:

- Develop a structured diagnostic reasoning process, identifying the most appropriate first- and second-level investigations.
- Propose a therapeutic plan, with particular focus on core principles of clinical pharmacology: mechanisms of action, indications, adverse effects, and drug interactions.
- Justify clinical decisions on the basis of available evidence and current guidelines.

Assessment will take into account: the ability to integrate knowledge from different areas, clarity of communication, appropriateness of clinical reasoning, and mastery of medical-scientific terminology.

“You are evaluating a patient with epigastric pain radiating to the back and elevated pancreatic enzymes. What are the possible causes? How would you assess disease severity, and what initial therapeutic approach would you implement?”

“A 70-year-old woman presents with fever, productive cough, and shortness of breath for 48 hours. Which criteria would you use to diagnose community-acquired pneumonia and to assess the need for hospitalization? Which empiric antibiotic therapy would you choose based on the presence or absence of comorbidities and the most likely pathogens?”

• Clinical case(s): choosing the right treatment for type 2 diabetes mellitus (1)
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Clinical case(s): lower limb problem
  • Books: Sabiston Textbook of Surgery, Elsevier/Saunders


• Clinical case (s): choosing the right treatment for type 2 diabetes mellitus (2)
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Clinical case(s): managing a patient with multiple comorbidities
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Interpreting ECG: methods (1)
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Interpreting ECG (2): methods
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Clinical case(s): postoperative care
  • Books: Sabiston Textbook of Surgery, Elsevier/Saunders


• Interpreting ABG: methods
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Clinical case(s): the PICO approach (students presenting) (1)
  • Books: Pubmed, Cochrane database


• Clinical case(s): the PICO approach (students presenting) (2)
  • Books: Pubmed, Cochrane database


• Clinical case: managing a patient with abdominal pain
  • Books: Sabiston Textbook of Surgery, Elsevier/Saunders


• Clinical case(s): managing a patient with dyspnea (1)
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Clinical case(s): managing a patient with dyspnea (2)
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Role of bedside ultrasound
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Clinical case(s): managing a patient with kidney failure
  • Books: Harrison’s Principles of Internal Medicine, McGraw Hill


• Clinical case(s): the PICO approach (students presenting) (3)
  • Books: Pubmed, Cochrane database


• Clinical case(s): the PICO approach (students presenting) (4)
  • Books: Pubmed, Cochrane database