Clinical Methodology

Academic/Subject Sector
MED/09-Internal Medicine;
MED/18-General Surgery
Year III
Semester 2
Total number of credits 11
Integrated Course coordinator Prof. Giue!!e Piano "g!iano#unica.it)
Integrated Course lecturers
Even student numbers:
Prof. $al% PG "!gcalo#unica.it)
&orcolo '. "(orcolo#!ac.unica.it)
)arci MG "a*gfa#ticali.it)
Erda E. "erdaenrico#li+ero.it,
'oddo M. "*loddo#!ac.unica.it,.
dd student numbers:
Prof. Piano G. "g!iano#unica.it)
Pianu -. "adolfo.!ianu#tin.it)
Manda -. "a*anda#!ac.unica.it,
Multineddu ..
Aims of the course
Aims of the Integrated/!oined Course of Clinical Methodology
/0i coure ai* at !ro1iding tudent 2it0 internal *edicine and urgical 3ill. $oure
content include teac0ing 0o2 to ta3e clinical 0itory and 0o2 to !erfor* !0yical
e4a*ination.
)ro* t0e a!!raial of General $linical E4a*ination5 tudent 2ill +e taug0t 0o2 to !erfor*
!0yical e4a*ination of t0e 0ead and nec35 cardio1acular5 re!iratory and gatro enteric
yte* a 2ell a t0e 3idney5 urinary tract and 3in a!!aratu.
$linical e1aluation 2ill +e integrated 2it0 t0e *ain *et0od of functional and intru*ental
tudy of t0e follo2ing organ and a!!aratu6 cardio1acular5 re!iratory5 t0yroid5 +reat5
oeo!0agu5 to*ac05 *all and large +o2el5 li1er and +iliary tract5 !ancrea5 3idney and
urinary tract5 arterie and 1ein.
Main !0yio!at0ologic *ec0ani* of t0e follo2ing dieae 2ill +e analyed6 !ortal
0y!ertenion5 acid-+ae and 0ydroelettrolitic i*+alance5 coagulation diorder a 2ell a
ditur+ance of odiu*5 !otaiu*5 calciu* and !0o!0orou *eta+oli*. $linical
cone7uence follo2ing infection5 in8urie5 0oc35 +urn5 digeti1e +leeding5 +o2el
o+truction5 !eritoniti and organ tran!lantation 2ill +e e4a*ined. $oure content alo
include6 So*atic and 1iceral !ain5 +ronc0ial at0*a5 c0ronic o+tructi1e !ul*onary
dieae5 !ul*onary e*!0ye*a5 !ul*onary oede*a5 acute and c0ronic 0eart failure and
re!iratory failure.
"rofessional training
Profeional training 2ill ta3e !lace at t0e de!art*ent of Medicine and Surgery of t0e
9o!ital :San Gio1anni di Dio; in $agliari and at t0e Policlinico in Monerrato. /0e ai* of
t0e training i to ena+le tudent to !erfor*6
- $linical 0itory
- General !0yical e4a*ination
- -rterial !ule e1aluation
- <lood !reure e4a*ination
- $oncience tatu a!!raial
- =ec3 e4a*ination
- $0et 2all and re!iratory e4a*ination
- $ardio1acular yte* e4a*ination
- $ardio1acular yte* e4a*ination
- >idney and urinary tract e4a*ination
- ?teoarticular yte* e4a*ination
- Main 3in dieae e4a*ination
- ?ede*a e1aluation
/0e training 2ill alo !ro1ide tudent 2it0 a +aic 3no2ledge of t0e follo2ing intru*ental
diagnotic tool6
E>G
@ltraonogra!0y
Do!!ler ultraound
/raditional radiology and co*!uteri(ed to*ogra!0y
S!iro*etry
Gatrointetinal endoco!y and 'a!aroco!y
Syllabus
Medical Semeiotics #"rof$ AM% &arci and "rof$ A$ Mandas'
1. )a*ilial ana*nei5 !eronal ana*nei5 !at !at0ological ana*nei5 i**ediate
!at !at0ological ana*nei
2. General e4a*ination
A. .e!iratory yte*6 e4a*ination5 !al!ation
B. .e!iratory yte*6 !ercuion5 aucultation
C. $oug0ing5 !neu*onia5 +ronc0o!neu*onia5 c0ronic o+tructi1e +ronc0o!at0y5
!ul*onary e*!0ye*a5 +ronc0ial at0*a5 !leuriti5 !neu*ot0ora4
D. $ardio1acular yte*6 ana*nei5 ri3 factor
E. Dy!noea
8. /0oracic !ain "angina5 *yocardial infarction5 aortic diection5 !ul*onary e*+oli*5
eo!0agiti5 *ucle/tendon !ain5 !neu*ot0ora45 !leuriti5 ganglion radiculiti5 etc,
9. $ardio1acular yte*6 e4a*ination5 !al!ation "0eart+eat5 fre*iti,
10. $ardio1acular yte*6 !ercuion5 aucultation "aucultation area,
11. 9eart tone5 *ur*ur5 clic3
12. Fal1ular dieae6 aortic tenoi5 aortic inufficiency5 *itral tenoi5 *itral
inufficiency5 !ul*onary tenoi5 !ul*onary inufficiency5 tricu!id tenoi5
tricu!id inufficiency5 interatrial defect5 inter1entricular defect5 !er*ea+ility of
<otalloG duct
1A. -cute !ericarditi5 cardiac ta*!onade
1B. -rterial !ule6 feature. Fenou !ule
1C. -rterial !reure *eaure*ent
1D. -+do*en6 e4a*ination5 !al!ation5 !ercuion5 aucultation
1E. 9e!ato*egalie6 acute and c0ronic 0e!atiti5 cirr0oi of t0e li1er5
0e*oc0ro*atoi5 HilonG dieae
18. Portal 0y!ertenion5 acite
19. S3in colour 1ariation6 icteru5 cyanoi5 !ur!ura
20. S!leen6 e4a*ination5 !al!ation5 !ercuion; S!leno*egaly
21. >idney6 !0yical e*iology
22. Micturition trou+le5 urine e4a*ination
2A. -n outline of t0e oteoarticular e*iology
&unctional semeiotics (ecturer: "rof$ M (oddo e ) Multineddu
1. Electrocardiogra* "E$G,6 inu r0yt0* inter!retation
2. $ardiac fre7uency and I.S a4i *eaure*ent
A. -n outline of P-2a1e !at0ology5 -F conduction and I.S
B. Pre*ature 1entricular contraction "PF$,
C. )i+rillation and atrial flutter
D. =ecroi 2a1e
E. 9olterG dyna*ic E$G
8. .e!iratory yte*6 -n outline of !0yiology
9. Fentilation inufficiency
10. S!iro*etry
11. -t0*a
12. $?PD
1A. E*!0ye*a
1B. Pul*onary oede*a
1C. -cute and c0ronic !ul*onary 0eart
1D. .e!iratory inufficiency
1E. 9e*ogaanalyi
18. $yanoi
19. /0ora4 J-ray
Surgical semeiotics (ecturer: "rof$ "% Cal* e % "isano
1. Diagnotic !rocedure6 doctor-!atient relation0i!. )a*ilial ana*nei5 !eronal
ana*nei5 !at !at0ological ana*nei5 i**ediate !at !at0ological ana*nei
cae 0itory.
2. General e4a*ination and o+8ecti1e e4a*ination6 !0yical e4a*ination of t0e !atient
+y in!ection5 !al!ation5 !ercuion and aucultation.
A. P0yical e4a*ination of t0e tu*efaction and in8urie "an outline of e7ui!*ent
*et0od,.
B. $linical nec3 e4a*ination in relation to t0e congenital !at0ology5 t0yroid5 ali1ary
gland5 ly*!0 node tation.
C. $linical t0ora4 e4a*ination in relation to urgical !at0ologie6 /0oracic trau*a5
+ronc0ial carcino*a5 !leuric effuion5 !ul*onary e*+oli*5 *ediatinic yndro*e.
D. $linical +reat e4a*ination
E. $linical a+do*en e4a*ination in election condition6 clinical e1aluation of t0e
a+do*inal tu*efaction; y*!to* and ign of t0e *ot fre7uent a+do*inal
!at0ologie. .ectal e4a*ination. -+do*inal trau*a.
8. $linical e4a*ination of t0e li1er and gall duct; c0oletatic icteru; !ortal
0y!ertenion
9. $linical e4a*ination of 0ernia and e4ternal genitalia
10. -cute a+do*inal yndro*e6 !0yical e4a*ination of intetinal occluion5
!eritoniti5 acute !ancreatiti5 0e*o!eritoneu*. -n outline of intru*ental
e*eiotic.
11. $linical e1aluation of digeti1e 0ae*orr0age5 0oc3 e*eiotic.
12. $linical 0itory and !0yical e4a*ination of c0ronic o+tructi1e arterio!at0ie and
1enou inufficiency. -cute li*+ ic0e*ia. -n outline of e7ui!*ent *et0od.
1A. Diurei and *icturition trou+le; 0e*aturia
&unctional surgical semeiotics (ecturers: "rof$ A "isanu e ( +orcolo
1. E7ui!*ent *et0od
a. Ec0ogra!0y
+. .adiological *et0od
2. -ngiogra!0y
a. $-/
+. Endoco!y
c. 'a!aroco!y
A. )unctional and intru*ental e*eiotic of t0e t0yroid
4. Intru*ental e*eiotic of t0e +reat
a. .adiology
+. Ecogra!0y
c. $ytology
d. <io!y
5. Intru*ental e*eiotic of t0e t0ora4
a. .adiology
+. Endoco!y
c. 9e*ogaanalyi
D. Intru*ental e*eiotic of t0e *ediatinu*
E. Intru*ental e*eiotic of t0e oeo!0agu
8. Intru*ental e*eiotic of t0e to*ac0
9. Intru*ental e*eiotic of t0e *all intetine
10. Intru*ental e*eiotic of t0e colon
11. )unctional and intru*ental e*eiotic of t0e li1er and gall duct
a. Ecogra!0y
+. $/
c. -go+io!y
d. ?ral 0olecytogra!0y5 endo1enou c0olangiogra!0y
e. E.$P
12. )unctional and intru*ental e*eiotic of t0e !ortal 0y!ertenion
1A. Intru*ental e*eiotic of t0e !ancrea
14. )unctional and intru*ental e*eiotic of t0e del 3idney and urinary tract
a. $learance
+. @rinanalyi
c. @rogra!0y e acending !yelogra!0y
d. >idney cintigra!0y and .=G
e. $ytoco!y
f. @rodyna*ic e4a*ination
15. Intru*ental e*eiotic of arterie and 1ein
a. Do!!ler ultraound
+. Ecogra!0y
c. -ngiogra!0y
Surgical ,hysio,athology (ecturers: "rof$ E Erdas e A "isanu
1. P0yio!at0ology of t0e 0ydroelectrolytic +alance and odiu* 0o*eotai
2. Potaiu*5 calciu*5 !0o!0oru5 *agneiu* 0o*eotai and alteration
A. -cid-+ae +alance6 re!iratory acidoi and al3aloi
B. -cid-+ae +alance6 *eta+olic acidoi and al3aloi
C. S0oc36 general !rinci!le
D. S0oc36 claification5 yte*atic5 clinical correlation
E. <urn I
8. <urn II
9. Intetinal occluion !0yio!at0ology
10. Peritoniti !0yio!at0ology
11. Digeti1e 0ae*orr0age !0yio!at0ology
12. General !rinci!le on graft
)eference te-ts
Il nuo1o .aario - Se*eiotica e Metodologia $linica
<. /ar7uini - Idelon editore
Metodologia clinica
=uti e $aniggia
Moderni a!etti di Se*eiotica Medica
Sanna e Dioguardi
Metodologia $0irurgica
H. Montori5 -. Pernacc0ia5 P. Pietri - Ed Miner1a Medica.
Se*eiotica e Metodologia $0irurgica
E. <erti .i+oli5 M. Gi!!oni - E$IG
Se*eiotica $0irurgica e Metodologia $linica
'. Gallone - $aa Editrice -*+roiana
Teaching Methods
Assessment methods
)inal 8oint oral e4a*
)e.uirements to ta/e the e-am
(anguage of instruction
0here 1e are
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&urther information