Internal Medicine
A.Y. 2023/2024
Learning objectives
The objectives of the sixth year are unified with those of the fifth, the various topics concerning the main diseases, their differential diagnosis and therapies will be distributed in the two semesters of the fifth year and in the first semester of the sixth year
Expected learning outcomes
At the end of the course, which includes the 5th and 6th year, the exam will be carried out in which the candidate will have to perform a practical part and answer questions.
Lesson period: First semester
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Single course
This course cannot be attended as a single course. Please check our list of single courses to find the ones available for enrolment.
Course syllabus and organization
Linea: Policlinico
Course syllabus
The main topics covered during the course are:
Cardiovascular diseases
Respiratory diseases
Hematopoietic disorders
Disorders of hemostasis and thrombosis
Hepato-gastro-intestinal diseases
Disorders of metabolism (diabetes)
General approach to autoimmune based disorders
General approach to oncological problems in medicine (most common neoplasms, treatment and adverse effects...)
Main approach to complex disorders (confusion, frailty in elederly, weight disorders, electrolyte imbalance, non-typical abdominal pain, nocosomial infections )
Statistical and epidemiological evaluation in the most common diseases
Cardiovascular diseases
Respiratory diseases
Hematopoietic disorders
Disorders of hemostasis and thrombosis
Hepato-gastro-intestinal diseases
Disorders of metabolism (diabetes)
General approach to autoimmune based disorders
General approach to oncological problems in medicine (most common neoplasms, treatment and adverse effects...)
Main approach to complex disorders (confusion, frailty in elederly, weight disorders, electrolyte imbalance, non-typical abdominal pain, nocosomial infections )
Statistical and epidemiological evaluation in the most common diseases
Prerequisites for admission
The student needs to know the pathogenesis and pathophysiological bases, the risk factors and the prognostic factors of the diseases; their epidemiology and pathology, physical, laboratory and instrumental characterization of the diseases; the pharmacological basis of the therapies; how to evaluate the evidence in medicine
Teaching methods
The course uses the teaching tools listed below in relation to the diversified teaching activities foreseen during the course.
· Frontal lessons - Presentation of clinical cases aimed at promoting the discussion of methodological aspects (clinical epidemiology, medical reasoning); specific pathological conditions which, due to their prevalence, exemplarity and complexity, require a more in-depth treatment, or have recently been updated or reviewed (guidelines, reviews according to EBM); analysis of the ethical dimensions of clinical decisions.
· Tutorial professional activities "Medical Clinical Practice Skills" - Training course carried out at the Hospital Medicine Departments following dedicated tutors, oriented towards the acquisition of Elementary Teaching Units relating to specific practical skills (ETU). This part is defined by a section of the skills booklet for the 3 last years which will be delivered to the students and signed by the tutor chosen to acquire each of the UDE.
·Professionalizing tutorial activities "Clinical reasoning: Making Thinking Visible (MTV)" - Teaching module dedicated to the guided discussion, on: strategies for critical collection of clinical evidence and their interpretation; disease severity assessment in terms of severity thresholds or alteration intensity; formulation of rational pathways of diagnosis and therapy; analysis of the critical aspects that influence diagnostic and therapeutic decisions; definition of the risk-benefit ratio using "threshold approach" models for clinical decisions; drug therapy management (choice of drugs and their dosage in relation to the patient's characteristics; criteria for monitoring therapeutic efficacy and side effects; criteria for establishing success or failure of therapy, duration and suspension of therapy ). These activities are dedicated to 5th year.
- "General Medicine" professional tutoring activities Attendance at a general practitioner's clinic
- Attendance in the wards of Internal Medicine (internship elective and preparation of degree thesis) on individual student request, following one of the tutors of the course as part of the assistance activities carried out in the department of belonging, the Day Hospital.
· Frontal lessons - Presentation of clinical cases aimed at promoting the discussion of methodological aspects (clinical epidemiology, medical reasoning); specific pathological conditions which, due to their prevalence, exemplarity and complexity, require a more in-depth treatment, or have recently been updated or reviewed (guidelines, reviews according to EBM); analysis of the ethical dimensions of clinical decisions.
· Tutorial professional activities "Medical Clinical Practice Skills" - Training course carried out at the Hospital Medicine Departments following dedicated tutors, oriented towards the acquisition of Elementary Teaching Units relating to specific practical skills (ETU). This part is defined by a section of the skills booklet for the 3 last years which will be delivered to the students and signed by the tutor chosen to acquire each of the UDE.
·Professionalizing tutorial activities "Clinical reasoning: Making Thinking Visible (MTV)" - Teaching module dedicated to the guided discussion, on: strategies for critical collection of clinical evidence and their interpretation; disease severity assessment in terms of severity thresholds or alteration intensity; formulation of rational pathways of diagnosis and therapy; analysis of the critical aspects that influence diagnostic and therapeutic decisions; definition of the risk-benefit ratio using "threshold approach" models for clinical decisions; drug therapy management (choice of drugs and their dosage in relation to the patient's characteristics; criteria for monitoring therapeutic efficacy and side effects; criteria for establishing success or failure of therapy, duration and suspension of therapy ). These activities are dedicated to 5th year.
- "General Medicine" professional tutoring activities Attendance at a general practitioner's clinic
- Attendance in the wards of Internal Medicine (internship elective and preparation of degree thesis) on individual student request, following one of the tutors of the course as part of the assistance activities carried out in the department of belonging, the Day Hospital.
Teaching Resources
Books proposed are the following: Harrison Principles of Internal Medicine, 21 th edition (McGraw Hill education), Current Medical Diagnosis and Treatment 2023 edition (Editore: McGraw Hill education); Step Up Medicine (Editore: Piccin).
During the teaching activities, Professors will provide references for the consultation of the update literature available online, with particular attention to the New England Journal of Medicine, Lancet, British Medical Journal-BMJ; journals published by the American College of Physicians; Cochrane Library, and the most recent guidelines
During the teaching activities, Professors will provide references for the consultation of the update literature available online, with particular attention to the New England Journal of Medicine, Lancet, British Medical Journal-BMJ; journals published by the American College of Physicians; Cochrane Library, and the most recent guidelines
Assessment methods and Criteria
At the end of the 6th year course, the exam of Internal Medicine will evaluate the student's skills to collect and interpret the data from patients interview and physical examination and plan rational diagnostic procedure to reach a correct diagnosis and to define the most appropriate therapy. The following contents will be specifically evaluated during an oral exam:
(a) Ability to perform the approach to the patient both in terms of history collection and evaluation of the physical examination
(b) Ability of the interpretation of laboratory or instrumental tests and discussion of their meaning in the context of the patient under examination and as differential diagnosis with other clinical pictures.
(c) Discussion of a clinical case with particular attention to differential diagnosis
(d) Definition of a rational diagnostic procedure based on: epidemiological criteria, rational use of diagnostic resources, optimal risk-benefit and cost-effectiveness ratio, expected prognosis
(e) Discussion of the criteria for setting the therapy in the treatment of the various conditions with particular attention to the exposure of:
- methods of clinical use of the main drugs and their therapeutic efficacy
- main contraindications and side effects in the use of the most used drugs.
The evaluation of each of the two parts will constitute the overall mark out of 30
(a) Ability to perform the approach to the patient both in terms of history collection and evaluation of the physical examination
(b) Ability of the interpretation of laboratory or instrumental tests and discussion of their meaning in the context of the patient under examination and as differential diagnosis with other clinical pictures.
(c) Discussion of a clinical case with particular attention to differential diagnosis
(d) Definition of a rational diagnostic procedure based on: epidemiological criteria, rational use of diagnostic resources, optimal risk-benefit and cost-effectiveness ratio, expected prognosis
(e) Discussion of the criteria for setting the therapy in the treatment of the various conditions with particular attention to the exposure of:
- methods of clinical use of the main drugs and their therapeutic efficacy
- main contraindications and side effects in the use of the most used drugs.
The evaluation of each of the two parts will constitute the overall mark out of 30
MED/09 - INTERNAL MEDICINE - University credits: 5
Lessons: 60 hours
Linea: San Donato
Course syllabus
Hypertension
- Approach to autoimmune diseases
- Urgent ultrasound and bedside ultrasound
- Urinary tract infections
- Acute and chronic renal failure
- Dehydration and hypovolemia, electrolyte imbalances (K +, Ca ++)
- Anemia
- Alterations of state of consciousness, confusional states
- Acute non-surgical abdomen
- Fragility in the elderly and evaluation in geriatrics
- Polytherapy and deprescribing
- Approach to autoimmune diseases
- Urgent ultrasound and bedside ultrasound
- Urinary tract infections
- Acute and chronic renal failure
- Dehydration and hypovolemia, electrolyte imbalances (K +, Ca ++)
- Anemia
- Alterations of state of consciousness, confusional states
- Acute non-surgical abdomen
- Fragility in the elderly and evaluation in geriatrics
- Polytherapy and deprescribing
Prerequisites for admission
The student need to know the pathogenesis and pathophysiological bases, the risk factors and the prognostic factors of the diseases; their epidemiology and pathology, physical, laboratory and instrumental characterization of the diseases; the pharmacological basis of the therapies; how to evaluate the evidence in medicine
Teaching methods
· Frontal lessons - Presentation of clinical cases aimed at promoting the discussion of methodological aspects (clinical epidemiology, medical reasoning); specific pathological conditions which, due to their prevalence, exemplarity and complexity, require a more in-depth treatment, or have recently been updated or reviewed (guidelines, reviews according to EBM); analysis of the ethical dimensions of clinical decisions.
Teaching Resources
Il libro di testo proposto è: Harrison Principles of Internal Medicine, 20th edition
Durante le lezioni l'attenzione è rivolta a fornire riferimenti per la consultazione della letteratura di aggiornamento disponibile online, con particolare attenzione alle riviste New England Journal of Medicine, Lancet, British Medical Journal-BMJ; riviste edite dall'American College of Physicians; Cochrane Library.
Per le tematiche trattate nelle lezioni fontali verranno forniti le referenze delle più recenti linee guida internazionali.
Ogni lezione del corso presenta i riferimenti bibliografici essenziali circa gli argomenti trattati.
Durante le lezioni l'attenzione è rivolta a fornire riferimenti per la consultazione della letteratura di aggiornamento disponibile online, con particolare attenzione alle riviste New England Journal of Medicine, Lancet, British Medical Journal-BMJ; riviste edite dall'American College of Physicians; Cochrane Library.
Per le tematiche trattate nelle lezioni fontali verranno forniti le referenze delle più recenti linee guida internazionali.
Ogni lezione del corso presenta i riferimenti bibliografici essenziali circa gli argomenti trattati.
Assessment methods and Criteria
The exam of Internal Medicine will evaluate the student's skills to collect and interpret the data from patients interview and physical examination and plan rational diagnostic procedure to reach a correct diagnosis and to define the most appropriate therapy. The following contents will be specifically evaluated:
1) practice exam: (a) Ability to perform the approach to the patient both in terms of history collection and evaluation of the physical examination (b) Ability of the interpretation of laboratory or instrumental tests and discussion of their meaning in the context of the patient under examination and as differential diagnosis with other clinical pictures.
2) Oral exam
(a) Discussion of a clinical case with particular attention:
- to differential diagnosis
- the definition of a rational diagnostic procedure based on: epidemiological criteria, rational use of diagnostic resources, optimal risk-benefit and cost-effectiveness ratio, expected prognosis
(b) Discussion of the criteria for setting the therapy in the treatment of the various conditions with particular attention to the exposure of:
- methods of clinical use of the main drugs and their therapeutic efficacy
- main contraindications and side effects in the use of the most used drugs.
The evaluation of each of the two parts will constitute the overall mark out of 30
If the health conditions do not allow this procedure to be carried out, the exam will take place only in oral form.
1) practice exam: (a) Ability to perform the approach to the patient both in terms of history collection and evaluation of the physical examination (b) Ability of the interpretation of laboratory or instrumental tests and discussion of their meaning in the context of the patient under examination and as differential diagnosis with other clinical pictures.
2) Oral exam
(a) Discussion of a clinical case with particular attention:
- to differential diagnosis
- the definition of a rational diagnostic procedure based on: epidemiological criteria, rational use of diagnostic resources, optimal risk-benefit and cost-effectiveness ratio, expected prognosis
(b) Discussion of the criteria for setting the therapy in the treatment of the various conditions with particular attention to the exposure of:
- methods of clinical use of the main drugs and their therapeutic efficacy
- main contraindications and side effects in the use of the most used drugs.
The evaluation of each of the two parts will constitute the overall mark out of 30
If the health conditions do not allow this procedure to be carried out, the exam will take place only in oral form.
MED/09 - INTERNAL MEDICINE - University credits: 5
Lessons: 60 hours
Shifts:
Linea: San Giuseppe
Course syllabus
- Hypertension
- Approach to autoimmune diseases
- Urgent ultrasound and bedside ultrasound
- Urinary tract infections
- Acute and chronic renal failure
- Dehydration and hypovolemia, electrolyte imbalances (K +, Ca ++)
- Anemia
- Alterations of state of consciousness, confusional states
- Acute non-surgical abdomen
- Fragility in the elderly and evaluation in geriatrics
- Polytherapy and deprescribing
- Approach to autoimmune diseases
- Urgent ultrasound and bedside ultrasound
- Urinary tract infections
- Acute and chronic renal failure
- Dehydration and hypovolemia, electrolyte imbalances (K +, Ca ++)
- Anemia
- Alterations of state of consciousness, confusional states
- Acute non-surgical abdomen
- Fragility in the elderly and evaluation in geriatrics
- Polytherapy and deprescribing
Prerequisites for admission
The student need to know the pathogenesis and pathophysiological bases, the risk factors and the prognostic factors of the diseases; their epidemiology and pathology, physical, laboratory and instrumental characterization of the diseases; the pharmacological basis of the therapies; how to evaluate the evidence in medicine
Teaching methods
· Frontal lessons - Presentation of clinical cases aimed at promoting the discussion of methodological aspects (clinical epidemiology, medical reasoning); specific pathological conditions which, due to their prevalence, exemplarity and complexity, require a more in-depth treatment, or have recently been updated or reviewed (guidelines, reviews according to EBM); analysis of the ethical dimensions of clinical decisions.
Teaching Resources
Il libro di testo proposto è: Harrison Principles of Internal Medicine, 20th edition
Durante le lezioni l'attenzione è rivolta a fornire riferimenti per la consultazione della letteratura di aggiornamento disponibile online, con particolare attenzione alle riviste New England Journal of Medicine, Lancet, British Medical Journal-BMJ; riviste edite dall'American College of Physicians; Cochrane Library.
Per le tematiche trattate nelle lezioni fontali verranno forniti le referenze delle più recenti linee guida internazionali.
Ogni lezione del corso presenta i riferimenti bibliografici essenziali circa gli argomenti trattati.
Durante le lezioni l'attenzione è rivolta a fornire riferimenti per la consultazione della letteratura di aggiornamento disponibile online, con particolare attenzione alle riviste New England Journal of Medicine, Lancet, British Medical Journal-BMJ; riviste edite dall'American College of Physicians; Cochrane Library.
Per le tematiche trattate nelle lezioni fontali verranno forniti le referenze delle più recenti linee guida internazionali.
Ogni lezione del corso presenta i riferimenti bibliografici essenziali circa gli argomenti trattati.
Assessment methods and Criteria
The exam of Internal Medicine will evaluate the student's skills to collect and interpret the data from patients interview and physical examination and plan rational diagnostic procedure to reach a correct diagnosis and to define the most appropriate therapy. The following contents will be specifically evaluated:
1) practice exam: (a) Ability to perform the approach to the patient both in terms of history collection and evaluation of the physical examination (b) Ability of the interpretation of laboratory or instrumental tests and discussion of their meaning in the context of the patient under examination and as differential diagnosis with other clinical pictures.
2) Oral exam
(a) Discussion of a clinical case with particular attention:
- to differential diagnosis
- the definition of a rational diagnostic procedure based on: epidemiological criteria, rational use of diagnostic resources, optimal risk-benefit and cost-effectiveness ratio, expected prognosis
(b) Discussion of the criteria for setting the therapy in the treatment of the various conditions with particular attention to the exposure of:
- methods of clinical use of the main drugs and their therapeutic efficacy
- main contraindications and side effects in the use of the most used drugs.
The evaluation of each of the two parts will constitute the overall mark out of 30
If the health conditions do not allow this procedure to be carried out, the exam will take place only in oral form.
1) practice exam: (a) Ability to perform the approach to the patient both in terms of history collection and evaluation of the physical examination (b) Ability of the interpretation of laboratory or instrumental tests and discussion of their meaning in the context of the patient under examination and as differential diagnosis with other clinical pictures.
2) Oral exam
(a) Discussion of a clinical case with particular attention:
- to differential diagnosis
- the definition of a rational diagnostic procedure based on: epidemiological criteria, rational use of diagnostic resources, optimal risk-benefit and cost-effectiveness ratio, expected prognosis
(b) Discussion of the criteria for setting the therapy in the treatment of the various conditions with particular attention to the exposure of:
- methods of clinical use of the main drugs and their therapeutic efficacy
- main contraindications and side effects in the use of the most used drugs.
The evaluation of each of the two parts will constitute the overall mark out of 30
If the health conditions do not allow this procedure to be carried out, the exam will take place only in oral form.
MED/09 - INTERNAL MEDICINE - University credits: 5
Lessons: 60 hours
Professor(s)
Reception:
On Thursdays, at 3 p.m.
CET, via Pace 9 Milano, Pad 2, first floor
Reception:
by appointment (e-mail request)
Marangoni pavilion, Policlinico IRCCS hospital, via F Sforza 35, Milan