Medicine and Surgery

1. Main Clinical Manifestations and Scenarios of Diseases of Internal Medicine Interest:: Pain, fever, syncope, altered states of consciousness, impaired respiratory and circulatory function (e.g., dyspnea, cough, hypoxia, edema, etc.), impaired gastrointestinal function (e.g., dysphagia, jaundice, diarrhea/constipation, ascites, unintentional weight loss, etc.), altered renal and urinary tract function (e.g., fluid-electrolyte imbalances, dysnatremias, nephrotic and nephritic syndromes, etc.), and hematological abnormalities (e.g., anemia, hemorrhages, thrombosis, etc.). 2. Clinical Complexity, Medical Uncertainty, and Its Management.

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National and International Guidelines

Main Teaching Objectives: The course is organised in professional activity, aimed towards the student acquiring a diagnostic methodology (clinical, in the laboratory and instrumental) and subsequently to recognize therapeutic indications. Bearing this in mind the discussion of clinical cases and video projections are fundamental in the student’spractical professional activity. The following principal clinical symptoms of interest to doctors and surgeons are dealt with: dysfagia, vomiting, abdominal pain , thoracic pain, alterations of the alvus, icteri, arterial hypertension, tumefaction, anemic syndromes, dyspnea. During the course particular attention is paid to the main geriatric syndromes and the evaluation of surgical risk in geriatrics. Multi Dimensional evaluation (VMD) and predictive medicine will be dealt with. Common symptoms in geriatric practice will be dealt with, such as the following: bedsores, senile malnutrition, osteoporosis, urinary incontinence, dementia, acute confusional states and the “case management” of the healthy elderly patient and risk of disability. At the end of the course the student must be able to make a decision aimed towards therapeutic ends in pathologies of statistical importance. The student will also have acquired general knowledge about intensive therapy, enteral and parenteral nutrition, transfusions, obvious and concealed hemorrhage, and, as far as the surgical patient is concerned, to prepare him for the operation, and to deal with post-operative complications, paying particular attention to infection and antibiotic treatment.

The student must have completed integrated clinics and internal medicine 1-2 as well as pharmacology, pathological anatomy and laboratory medicine

-Malattie del cuore di Braunwald - Trattato di medicina cardiovascolare Autori: Braunwald - Zipes - Libby - Bonow ISBN: 9788821430497 Editore: Elsevier - Masson -Harrison - Manuale di Medicina interna - Edizione 2017 Autori: Fauci - Kasper - Hauser - Longo - Jameson - Loscalzo - Harrison ISBN: 9788808680006

mandatory attendance

objective examination with the compilation of a medical record, clinical reasoning and therapeutic approach

Oral and written exam in the classroom.

1. Primary and secondary cardiovascular prevention: therapeutic options 2. Atrial fibrillation as an example of complex cardiovascular pathology in the elderly 3. Arterial hypertension: diagnosis and treatment 4. Heart failure: diagnosis and treatment 5. Liver cirrhosis: diagnosis and treatment 6. Deep vein thrombosis and pulmonary embolism: diagnosis and treatment 7. Liver cirrhosis: diagnosis and treatment 8. Appropriate use of antiplatelet and anticoagulant drugs

The main purpose of the Internal Medicine course (within the broader scope of Internal Medicine and Surgery II) is to provide students with the fundamental knowledge necessary to perform clinical assessment, differential diagnosis, and formulate treatment plans for the most common conditions in Internal Medicine. These skills should also include the ability to conduct comprehensive health assessments and evaluate the risks associated with various treatments in patients with multiple pathologies. The course, taught by the instructor, includes professional activities in hospital wards or outpatient clinics, which should be considered indispensable for achieving the course objectives.

Harrison: Principles of Internal Medicine (last edition) ESC National Cardiac Societies; ESC Scientific Document Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021 Sep 7;42(34):3227-3337. doi: 10.1093/eurheartj/ehab484 ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-3726. doi: 10.1093/eurheartj/ehab368. ESC Scientific Document Group. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021 Feb 1;42(5):373-498. doi: 10.1093/eurheartj/ehaa612.

The students will have to attend practical professionalizing sessions in small groups with the undersigned in the internal medicine wards.

The general assessment of the exam consists of knowledge of the topics covered in class. The assessment of internships will be based on the student's ability to evaluate a complex clinical situation, work in a team, handle communication between physician and patient, propose a diagnostic-therapeutic strategy, discuss it with colleagues, and make collective decisions.

Practical professionalizing sessions in small groups in the wards and outpatient clinics of internal medicine.