SEMEIOTICS AND CLINICAL METHODOLOGY
Learning outcomes of the course unit
1. To learn how to conduct a general or specific medical anamnesis.
2 To learn how to perform a full physical examination.
3. To learn how to check blood pressure, take a venous blood sample and perform a standard electrocardiogram.
4. To recognize the significance and general physiopathology of the most frequent signs and symptoms of disease.
5. To learn the normal levels of basic laboratory tests of general medical/surgical interest.
6. To know how to detect objective pathological signs, to learn the most important variations in laboratory analysis parameters, the most common basic tests used for studying the principal organs of the body and other general procedures used in medicine and surgery.
7. To learn the basics of epidemiology and the prophylaxis for infectious diseases.
Course contents summary
Familial, physiological, work-related, past and present pathological, pharmacological.
General medical check-up
Nutritional state, skin, linfonodes, head and neck, eyes, nose, mouth and throat, chest, breasts, pulses, abdomen, rectal exploration, uro-genital apparatus, arms and legs, muscular system, nervous system, deambulation.
General clinical methodology in surgery
Anamnesis, general medical examination, diagnostic hypotheses, elements of instrumental diagnosis.
Signs and symptoms of disease
Fever, cough, dyspnea, cyanosis, asthenia, anorexia, vomiting, diahrrea, constipation, meteorism, intestinal occlusion, jaundice, edema, ascites, cardiopalmo and palpatations, chest pain, abdominal pain, cefalea, dizziness, lipothymia and syncope, stress and shock, coma, cerebral ictus, hemorrhage, dysuria, oliguria, anuria, polyuria, hematuria, pruritus and internal disease related dermatosis, malnutrition, hypertension and hypotension: their detection and significance.
Glucides, lipids, proteins, biliary salts, uric acid, iron, water, sodium, potassium, calcium, phosphorus, magnesium, acid-base balance.
Specific anamnesis, objective observations, basic laboratory and instrumental tests for studying the following organs and systems.
Blood and hematopoietic organs: red blood cells, white blood cells, platelets, erythrosedimentation speed, hemostasis, hemoculture, objective medical reports and methods for studying spleen and linfonodes, bone marrow biopsy.
Immunitary system: blood groups, immunoglobulines, autoantibodies, lymphocyte subpopulations, allergic shock, basic allergy tests.
Heart: specific anamnesis and objective examination of the heart, alterations in cardiac tones, heart murmurs, pericardial fremitus, X-rays of heart and main arteries, laboratory tests in myocardial infarction, characteristics of pulse, normal electrocardiogram and most common alterations (fibrillation and atrial fluttering, ischemia, infarction), cardiological instrumental procedures: the significance and usefulness of ecocardiogram, cardiac catheterization, coronary radiography, myocardial scintigraphy, eco-dopper of the upper aortic trunk, cardiovascular risk factors.
Pulse: pulse characteristics
Lungs and bronchi: current objective findings on thoracic effusion, pneumothorax, atelectasis, pneumonia, pulmonary emphysema, acute and chronic bronchitis, bronchial asthma, acute pulmonary edema, pulmonary embolia and pleuritis, respiratory function exploration, expectorant analysis, thoracentesis and pleural liquid exam, standard chest X-rays, significance and usefulness of computerized axial tomography, pulmonary scintigraphy, bronchoscopy.
Digestive tube: common examination methods for esophagus, stomach, duodenum, jejunum, ileum, colon and rectum, intestinal malabsorption, feces analysis and coproculture, rectal exploration.
Liver, biliary tract and pancreas: objective findings, hepatic, biliary and pancreatic tests, sierological markers for viral hepatitis , ecography and computerized axial tomography, paracentesis, physiopathology of hepatic circulation and of portal hypertension.
Kidneys and urinary tract: objective medical findings, complete urine analysis and uroculture, kidney function evaluation, radiological and endoscopic investigations.
Thyroid and parathyroid: principal changes in their functioning and performance tests.
Arteries and veins: peripheral arterial ischemia, objective signs of upper and lower vena cava obstruction, flebotrombosis and tromboflebitis.
Peritonium: anatomy and physiopathology
Breast: breast semeiotics.
Epidemiology and Prophylaxis:
General Epidemiology: the importance of infectious diseases today, host parasite relation, reservoirs of infection, manner of transmission
Nuti – Caniggia: “Metodologia Clinica” Edizioni Minerva Medica 2002
Novarini: “Argomenti di Semeiotica: basi fisiopatologiche e significato clinico” Edizioni CUSL 1982
Okolicsanyi – Peracchia: “Malattie dell’Apparato Gastro Intestinale” Edizione MCGRAW –HILL 1998
Barbuti – Bellelli: “Igiene e Medicina Preventiva” Vol. I - 4° Edizione, Editore Monduzzi
Didactic activity will consist both in collective formal lectures and in practical exercises for small groups in the medical and surgical wards; in the latter case, Professors of the integrated Course will be the tutors
SSD MED/09 Prof.Loris Borghi (Coordinator), Prof.Paolo Coruzzi, Prof.Tiziana Meschi, Prof.ERminia Ridolo, Prof.Almerina Biggi, Prof.Luisa Musiari, Prof.Giovanna Pelà, Prof.Patrizia Perinotto, Prof.Enrico Fiaccadori, Prof.Nicoletta Ronda, Prof.Aderville Cabassi
SSD MED/06: Prof.Federico Quaini
SSD MED/42: Prof.Maria Luisa Tanzi
SSD MED/18: Prof.Vincenzo Violi, Prof.Roberto Sivelli, Prof.Renato Costi, Prof.Marco Zannoni