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Management of the complex patient within the Internal Medicine area

Successful completion of the propaedeutic courses as per decree of the Faculty, i.e., all the exams of the IV year.

Not applicable, as this activity constitutes a clinical internship.

Attendance for 100 hours during TPVES (mandatory)

Constant supervision by the tutor and discussion of selected clinical cases will allow for the assessment of the following competencies: The student is able to apply the principles of the doctor–patient relationship in practice (medical interview, physical and emotional contact, information delivery, clarity, and obtaining informed consent). The student is capable of obtaining a patient history and performing a physical examination in an outpatient setting. The student demonstrates knowledge of, and the ability to apply, clinical reasoning: distinguishing between urgent primary disorders and secondary problems; formulating a diagnostic hypothesis; and identifying the most specific and sensitive diagnostic methods to confirm or refute the hypothesis.

The student is assigned clinical cases or medical records and is expected to discuss the diagnostic and therapeutic pathway with the tutor. In addition, the student will interact with patients under the supervision of the tutor, who will assess the clinical skills and communication abilities acquired during the first four years of the medical program.

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

in internal medicine ward