ITALIANO

I contenuti del programma saranno inseriti in un contesto clinico integrato, fornendo basi fisiopatologiche per interpretarne i meccanismi, al fine di consentire l’inserimento degli elementi semeiotici nei principali quadri patologici di interesse medico e chirurgico.

AMOROSO – FANELLI: Semeiotica Medica e Metodologia Clinica, Editore: Antonio Delfini. Edizione 2a/2017

Obiettivo del Corso integrato è il conseguimento delle seguenti conoscenze e skills :
- Utilizzando in modo integrato le nozioni precliniche già acquisite durante il CDL (in particolare anatomia, biochimica, fisiologia, patologia generale), apprendere la metodologia dell’approccio clinico al paziente, attraverso gli strumenti dell’anamnesi, della semeiotica fisica, laboratoristica e strumentale.
- conoscere la metodologia di un corretto ed efficace colloquio con il paziente, in accordo con i principi fondamentali della deontologia medica; conoscere e saper affrontare la problematica del consenso informato delle indagini diagnostiche e dei procedimenti terapeutici;
- apprendere la terminologia semeiotica necessaria ad una valida interazione all’interno dell’equipe sanitaria;
- saper interpretare il razionale fisiopatologico dei segni e sintomi della semeiotica fisica
- acquisire le tecniche e le manovre della semeiotica fisica e saperle utilizzare correttamente
secondo i criteri e la logica “consecutio” della metodologia clinica, al fine di un corretto esame obiettivo generale e per organi ed apparati
- conoscere nelle linee generali le indagini strumentali di più comune impiego;
- saper riconoscere le principali alterazioni degli esami di laboratorio, inquadrandole in un percorso diagnostico metodologicamente corretto
- saper identificare i segni e sintomi in modo integrato tra loro e con i principali quadri della semeiotica di laboratorio e strumentale
- apprendere i principi della metodologia clinica che guidano nel cammino diagnostico

Esami propedeutici: esame di anatomia, fisiologia, patologia generale

Didattica frontale

La verifica dell’apprendimento è finalizzata a valutare il livello di acquisizione delle conoscenze teoriche, delle capacità di ragionamento clinico e delle competenze pratiche nell’ambito della semeiotica e della metodologia clinica in Medicina Interna. Il processo valutativo mira a garantire l’integrazione tra sapere scientifico e applicazione clinico-assistenziale, in linea con le competenze professionali richieste al laureato in Infermieristica.

1. Tipologie di verifica
a) Prova scritta

La prova scritta può comprendere:

Quesiti a scelta multipla (MCQ)
Domande a risposta breve
Quesiti basati su casi clinici

Questa modalità consente di valutare:

Le conoscenze di fisiopatologia e semeiotica
La capacità di riconoscere segni e sintomi
L’interpretazione dei dati laboratoristici e strumentali
b) Prova orale

La prova orale è finalizzata a valutare:

La profondità delle conoscenze teoriche
La capacità di organizzare un ragionamento clinico
L’uso appropriato della terminologia medico-infermieristica
L’integrazione tra anamnesi, esame obiettivo e dati diagnostici

Allo studente può essere richiesto di:

Discutere argomenti del programma
Analizzare scenari clinici
Illustrare percorsi diagnostico-assistenziali

Italian

The contents of the program will be inserted in an integrated clinical context, providing pathophysiological bases to interpret the mechanisms, in order to allow the insertion of semeiotic elements in the main pathological conditions of medical and surgical interest.

AMOROSO – FANELLI: Semeiotica Medica e Metodologia Clinica, Editore: Antonio Delfini. Edizione 2a/2017

The objective of the integrated course is to achieve the following knowledge and skills:
- using in an integrated way the preclinical notions already acquired during the CDL (in particular anatomy, biochemistry, physiology, general pathology), learning the methodology of the clinical approach to the patient, through the tools of the anamnesis, of the physical, laboratory and instrumental semeiotics .
- know the basics of the biopsychosocial approach to medical pathology; acquire the methodology for a correct and effective conversation with the user, in accordance with the fundamental principles of medical ethics and the "partnership" with the same; know and know how to deal with the issue of informed consent, respect for privacy and the right to the agreed choice of care;
- learn the semeiotic terminology necessary for a valid interaction within the health team;
- being able to interpret the physiopathological rationale of the signs and symptoms of physical semeiotics
- acquire the techniques and maneuvers of physical semiotics and know how to use them correctly
according to the criteria and the "consecutive" logic of the clinical methodology, for the purpose of a correct general objective examination and for organs and systems
- to know in general the instrumental investigations of the most common use;
- be able to recognize the main alterations of the laboratory tests, framing them in a methodologically correct diagnostic path
- know how to identify the signs and symptoms in an integrated way with each other and with the main pictures of laboratory and instrumental semeiotics
- learn the principles of clinical methodology that guide you in the diagnostic journey

the exams of anatomy, physiology, pathophysiology

Frontal teaching

Oral Examination

The oral examination is aimed at assessing:

Depth of theoretical knowledge
Ability to organize clinical reasoning
Appropriate use of medical and nursing terminology
Integration of medical history, physical examination, and diagnostic data

Students may be required to:

Discuss topics included in the program
Analyze clinical scenarios
Describe diagnostic and care pathways

The contents of this program are embedded within an integrated clinical framework aimed at providing solid pathophysiological foundations for interpreting disease mechanisms. The goal is to enable students to integrate anamnestic, physical (semiotic), laboratory, and instrumental findings in order to correctly identify and interpret the main clinical conditions encountered in Internal Medicine.

1. Stages of Medical Practice and Timing of Clinical Examination

Systematic analysis of the diagnostic process:

Medical history (anamnesis)
Family history (hereditary diseases, predispositions)
Personal physiological history (lifestyle, habits)
Past medical history and recent history
Physical examination
General principles
Techniques: inspection, palpation, percussion, auscultation
Laboratory and instrumental diagnostics
Integration of clinical findings with laboratory and imaging data
2. General Physical Examination

Global patient assessment:

Facial appearance (“facies”), posture, and decubitus
Standing position and gait
Body constitution and nutritional status
Fluid and electrolyte balance
Mental status and sensorium
Alterations of consciousness:
Presyncope (lipothymia)
Syncope
Coma (classification and clinical approach)
3. Skin and Skin Appendages
Clinical examination of the skin
Nevi and skin neoplasms
Dermatological conditions of internal medicine relevance
Burns: classification, extent, and systemic implications
4. Nervous System
Functional neurological symptoms
General neurological examination
Reflexes and meningeal signs
Alterations of:
Sensation
Motor function (pyramidal and extrapyramidal disorders)
Speech
Cognitive functions
Balance and coordination
Vision
Involuntary movements
Overview of peripheral nerve lesions
5. Body Temperature and Infections
Alterations of body temperature
Fever and chills: pathophysiological mechanisms
Clinical and laboratory diagnosis of systemic infections
6. Vital Signs and Clinical Monitoring
Heart rate
Respiratory rate
Blood pressure
Oxygen saturation
7. Head, Neck, and Oral Cavity
Complete physical examination
Lymph node evaluation
Thyroid assessment (clinical aspects)
Oral cavity diseases of systemic relevance
8. Respiratory System – Symptoms
Cough
Hemoptysis
Dyspnea
Vomica
Pulmonary edema
Chest pain: differential diagnosis
9. Respiratory System – Diagnostic Methodology
Physical examination of the chest:
Normal conditions
Pathological conditions (pneumonia, pleuritis, emphysema, bronchial obstruction)
Instrumental diagnostics:
Chest X-ray
Computed tomography (CT)
Bronchoscopy
Spirometry
Arterial blood gas analysis
CT-guided lung biopsy
10. Cardiovascular System
Cardiac physical examination:
Heart sounds
Murmurs
Gallop rhythm
Coronary chest pain: clinical and diagnostic approach
Blood pressure measurement
Arterial hypertension
Instrumental diagnostics:
Electrocardiogram (ECG)
Echocardiography
Cardiac scintigraphy
Cardiac catheterization
Cardiovascular risk factors
11. Breast Examination
Clinical examination
Self-examination
Basics of imaging diagnostics (mammography, ultrasound)
12. Arterial, Venous, and Lymphatic Circulation
Clinical signs:
Peripheral arterial disease
Lymphedema
Diagnostic maneuvers:
Trendelenburg test
Perthes test
13. Digestive System – Symptoms
Appetite disorders
Dyspepsia
Dysphagia
Vomiting, regurgitation, rumination
Diarrhea
Abdominal pain
Rectal tenesmus
Gastrointestinal bleeding:
Hematemesis
Melena
Enterorrhagia
Rectorrhagia
14. Abdominal Examination
Inspection, palpation, percussion, auscultation
Clinical anatomy and anatomical landmarks
Abdominal tender points
Abdominal wall alterations (scars, hernias)
15. Stomach and Intestines
Clinical and diagnostic methodology
Investigations:
Endoscopy
Radiology
Microbiology
16. Acute Abdomen
Ileus:
Functional (paralytic)
Mechanical
Intestinal perforation
Hemoperitoneum
Emergency clinical approach
17. Liver, Biliary Tract, and Pancreas
Clinical examination
Jaundice
Ascites
Pancreatic pain
Hepatitis
Laboratory and imaging diagnostics
18. Urinary System – Symptoms
Urinary disorders:
Anuria, polyuria, pollakiuria
Nocturia, stranguria
Hematuria, proteinuria
Urinary incontinence and enuresis
19. Urinary System – Methodology
Clinical and laboratory evaluation
Microbiological diagnostics
Renal and ureteral tender points
Bladder retention and distension
20. Fluid and Electrolyte Disorders
Edema
Acidosis and alkalosis
Fluid balance
Third-space concept
21–22. Male Genital System
Clinical examination
Scrotum and inguinal canal
Microbiological diagnostics
23. Endocrine System
Thyroid disorders (goiter, hyper- and hypothyroidism)
Diabetes mellitus
Dyslipidemias
Adrenal, parathyroid, and pituitary disorders
Hypoglycemia
24. Musculoskeletal System
Clinical examination of joints
Connective tissue disorders
Signs of rheumatologic disease
25. Hematologic and Coagulation System
Anemias and hematologic disorders
Hemorrhagic syndromes
Thrombosis
26. Lymphatic System and Spleen
Lymphadenopathies
Splenomegaly
27. Immune System
Immunodeficiencies
Defects in defense mechanisms
Clinical and laboratory evaluation