Fundamentals of Clinical Medicine 2

The Fundamentals of Clinical Medicine 2 course takes the students into clinical medicine with the study of Hematology, Rheumatology and Internal Medicine. Such studies will be dealt on a comprehensive basis, i.e. including diagnostic imaging, pathology, laboratory medicine, to guide the student through a comprehensive path. This will help the student to acquire notions on clinical conditions in a systematic basis, as well as to understand the clinical reasoning that leads to diagnosis starting from symptoms and signs.
The students will acquire knowledge on non-neoplastic hematological conditions with particular focus on anemia, bleeding and thrombotic conditions and transfusion medicine. In rheumatology the students will study the etiopathogenic mechanisms and clinical presentation of inflammatory arthritides, microcristalline arthropathies, non inflammatory musculoskeletal disorders, connective tissue diseases and systemic vasculitides.
The module tackles the multidisciplinary clinical approach to patients with a rheumatological disease, combining history collection, physical examination, laboratory tests, and imaging. The featuresof autoimmunity and chronic inflammation will be discussed, along with a general approach to the main complaints of patients with these conditions.
In internal medicine, lectures will complement what presented in hematology and rheumatology classes. Some topics will be presented more in depth, for some others special emphasis will be put on the semeiology and on the interpretation of blood tests. Principles of management, adjusted for the seniority of the students will be discusses.

Students are expected to achieve general and specific requirements:
- provide a systematic description of the disease and clinical conditions described in the program above
- comment on the main diagnostic modalities used to evaluate these conditions
- provide principles of treatment when discussed in class.
For hematology, the students will be required to comment on the differential diagnosis of anemias based on morphology and rate of production, navigating through different conditions using clinical and laboratory features. To provide a clinical and laboratory approach to hemorragic and thrombophilic conditions. In each case, the examination will be conducted either/both as a systemic description of conditions and reasoning along case vignettes.
For rheumatology, the students will be required to comment on the differential diagnosis of articular and extra-articular manifestations of inflammatory arthropathies, systemic vasculitis and connective tissue diseases, to interpret positivity for lab tests in rheumatology and to delineate a diagnostic approach to a patient with suspected rheumatological disease.
For internal medicine students will have to demonstrate knowledge of the physical examination in the field of immuno-rheumatological diseases, to know basic notions on the pathogenesis of autoimmunity including the interaction between the intestinal microbiota and the immune system, the interaction between the autonomic nervous system and innate and adaptive immunity as well as knowledge of laboratory tests such as autoantibodies and others, which characterize the basic screening in the suspicion of systemic autoimmune diseases. They will have to be proficient in commenting abnormalities in the full blood count, especially regarding red cell indexes, and coagulation tests. Bleeding/thrombotic episodes will be discussed in terms of clinical presentation, laboratory findings and basic principles of management.