SEMEIOTICS AND CLINICAL METHODOLOGY
Learning outcomes of the course unit
By the end of the course students will: 1. be able to conduct a general and specific medical history; 2. be able to conduct a general medical examination; 3. be able to measure arterial pressure, take a blood sample from the vein and carry out and interpret a standard electrocardiogram; 4. understand the meaning and general pathophysiology of the most frequent signs and symptoms of disease; 5. be familiar with the normal levels for the main laboratory tests of general medical-surgical interest; 6. be able to detect physical signs of disease, be familiar with the most important variations from laboratory parameters and be familiar with the most common diagnostic tests for studying the major organs and systems that fall within the scope of general medicine/surgery; 7. be acquainted with general aspects of epidemiology and prevention of infectious diseases; 8. be familiar with essential notions of medical statistics and of clinical research methodology. Practical Training Programme (Nursing), 2nd year The main aim of the practical training programme (nursing) that takes place during the 1st and 2nd terms of the 2nd year of the degree course in Medicine and Surgery is to acquaint students with organisational and care aspects that characterise hospital departments in the medical, surgical, specialist and emergency areas. This training programme provides an initial opportunity for students to interact with nursing staff and clinical and organisational issues. Students are assigned to nursing tutors, under the supervision of teachers and coordinators, enabling them to learn about and develop relationships with other professional figures and to familiarise themselves for the first time with the necessary skills for observing and understanding the fundamental clinical and ethical issues that characterise hospital healthcare organisation. Interactive Learning Activity (ADI, Attività Didattica Interattiva), 3rd year The Interactive Learning Activity (ADI) forms an integral part of the Course in Semeiotics and Clinical Methodology. It consists of practical activity in small groups of students conducted by the course teachers in the relevant medical or surgical departments. The fundamental aims of the ADI are to teach students about initial contact with the patient, conducting a medical history, the general physical examination and the most basic semeiological manoeuvres that they must know before taking the exam. The ADI usually takes place during December and January every year. Every year the course coordinator assigns a certain number of students (15-20) to a teacher. They are split into small groups of 3-4 by the teacher him/herself. Students must contact their ADI teacher to arrange times and methods for completing the ADI: the lists of students and their assigned ADI teachers are displayed on the noticeboard of the Department of Clinical Science (Barbieri building) around November 15 every year and can be viewed on the website.
In order to take the exam in Clinical Semeiotics and Methodology students must have passed the exams in Normal Human Anatomy, Physiology and General Pathology.
Course contents summary
Course programme General medical history (anamnesis): family, physiological, occupational, past and recent, pharmacological. General medical examination: nutritional state, skin and appendages, lymph nodes, head and neck, eyes, oropharynx, chest, breast, wrists, abdomen, rectal examination, urogenital system, limbs, joints, muscular system, nervous system, ambulation. General clinical methodology in surgery: anamnesis, physical clinical examination, diagnostic hypotheses, elements of instrumental diagnostics. Signs and symptoms of disease: fever, cough, dyspnoea, cyanosis, asthenia, anorexia, vomiting, diarrhoea, constipation, flatulence, intestinal occlusion, jaundice, oedema, ascites, palpitations, chest pain, abdominal pain, migraine, dizziness, fainting and syncope, stress and shock, coma, stroke, bleeding, dysuria, oliguria, anuria, polyuria, haematuria, itching and dermatosis of interest to internal medicine, malnutrition, hypertension and hypotension. Metabolisms: glucides, lipids, proteins, bile salts, uric acid, iron, water, sodium, potassium, calcium, phosphorus, magnesium, acid – base equilibrium. Blood and haematopoietic organs: red blood cells, white blood cells, platelets, erythrosedimentation rate, haemostasis, haemoculture, physical findings of signs of disease and methods of study of spleen and lymph nodes, bone marrow needle biopsy. Immune system: blood groups, immunoglobulin, autoantibodies, lymphocyte sub-populations, allergic shock, principal allergy tests.
Testi consigliati e bibliografia 1. Materiale didattico sul sito. 2. Semeiotica Medica e Metodologia Clinica. Edizioni Minerva Medica, 2010, autore Ranuccio Nuti. 3. Manuale di Semeiotica Medica. Edizioni Mc Graw-Hill, 1998, autori J.L. Wills, H. Schneiderman, edizione italiana a cura di Giorgio Lambertenghi. 4. Semeiotica e Metodologia Chirurgica. Edizioni Goliardiche, 2005, autore Mariano Cherubini. 5. Dottore ... mi posso fidare?. Manuale di medicina comprensibile. Edizioni Avverbi, 2007 autore Giorgio Dobrilla. 6. Igiene e Medicina Preventiva, Vol. I -4. Edizioni Moruzzi, autori Barbuti - Bellelli. 7. Medici umani, pazienti guerrieri. Editore Baldini Castoldi Dalai, 2008, autore Gianni Bonadonna. 8. Diagnosi infermieristiche. Casa Editrice Ambrosiana, 2006, autore L.J. Carpenito - Moyet, edizione italiana a cura di Carlo Calamandrei e Laura Rasero.
clinical lecture and pratical sessions
Assessment methods and criteria