Internal Diseases and Propaedeutics

Study Course Description

Course Description Statuss:Approved

Course Description Version:5.00

Study Course Accepted:14.09.2023 08:52:40

Study Course Information
Course Code:		ISK_063		LQF level:		Level 7
Credit Points:		4.00		ECTS:		6.00
Branch of Science:		Clinical Medicine; Internal Medicine		Target Audience:		Dentistry
Study Course Supervisor
Course Supervisor:		Vladimirs Voicehovskis
Study Course Implementer
Structural Unit:		Department of Internal Diseases
The Head of Structural Unit:
Contacts:		Riga, 2 Hipokrata Street, iskrsu[pnkts]lv, +371 67042338
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		6	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		12
Classes (count)		7	Class Length (academic hours)		3	Total Contact Hours of Classes		21
Total Contact Hours								33
Full-Time - Semester No.2
Lectures (count)		5	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		10
Classes (count)		7	Class Length (academic hours)		3	Total Contact Hours of Classes		21
Total Contact Hours								31
Study course description
Preliminary Knowledge:
Basic knowledge of medical ethics, history, legislation, human anatomy and pathological anatomy, physiology, pathological physiology, biochemistry, microbiology, and pharmacology.
Objective:
To develop the students' understanding of professional communication as an essential part of medical practice. To provide knowledge about the principles of propaedeutics, etiology, pathogenesis, clinics, lab tests and other examinations, diagnosis criteria, differential diagnosis, treatment plan and prophylactics of the most important internal diseases. To develop practical skills of patient examination. To introduce basic principles of therapy (main groups of medications), its side effects.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Basic principles of doctor’s professional communication			Lectures		1.00	E-Studies platform
2	Propaedeutics			Lectures		1.00	E-Studies platform
3	Cardiology			Lectures		2.00	E-Studies platform
4	Pulmonology			Lectures		2.00	E-Studies platform
5	Gastroenterology			Lectures		1.00	E-Studies platform
6	Endocrinology			Lectures		1.00	E-Studies platform
7	Nephrology			Lectures		1.00	E-Studies platform
8	Rheumatology			Lectures		1.00	E-Studies platform
9	Hematology			Lectures		1.00	E-Studies platform
10	Introduction to clinic: Definition of communication, clinics and department rules, doctor’s image (a role play). Ethical issues. Deontology. Academic honesty. Doctor-patient relationships, rules, legal issues, doctor’s office design, role of an assistant, medical documentation, Historia morbi (subjective part), “first patient” (a role play).			Classes		1.00	clinical base
11	Basic methods of patient general examination. Blood pressure measurement, pulse measurement, auscultation, percussion, palpation. Practice with patient simulator, group colleagues. Historia morbi (objective part).			Classes		1.00	clinical base
12	Cardiology: principles of propaedeutic, methods of examination. Heart auscultation. Practice with patient simulator, group colleagues.			Classes		1.00	clinical base
13	Cardiology: cardiovascular risks, arterial hypertension, hypertensive crises, acute coronary syndrome, myocardial infarction. Visit to clinic.			Classes		1.00	clinical base
14	Cardiology: arrhythmias, acute and chronic heart failure, infective endocarditis, the role of dental and tonsilar infections in cardiovascular system diseases, the role of medications (anticoagulants, diuretics, etc.) in oral pathology, diseases manifestations in the oral cavity and maxillo-facial region. Visit to clinic.			Classes		1.00	clinical base
15	Pulmonology: principles of propaedeutics, methods of examination. Lung auscultation. Practice with patient simulator, group colleagues.			Classes		1.00	clinical base
16	Pulmonology: functional examination of respiratory system; respiratory failure, bronchial asthma, asthma attack, chronic obstructive pulmonary disease, bronchitis, pneumonias, pleurisy, diseases manifestations in the oral cavity and maxillo-facial region. Visit to clinic.			Classes		1.00	clinical base
17	Gastroenterology: principles of propaedeutic, methods of examination, diseases of the cholangiopancreatic zone, biliary colic, jaundices. Visit to clinic.			Classes		1.00	clinical base
18	Gastroenterology: gastritis, gastric and duodenal ulcer, gastrointestinal bleeding; enterocolitis, Crohn’s disease; manifestations in the oral cavity and maxillo-facial region. Visit to clinic.			Classes		1.00	clinical base
19	Gastroenterology: instrumental methods of examination – videogastro-, videocolonoscopy, US-examination.			Classes		1.00	METC
20	Endocrinology: principles of propedeutics, methods of examination, diabetes mellitus, comas, metabolic syndrome, hypothyroidism, hyperthyroidism, osteoporosis; manifestations in the oral cavity and maxillofacial region. Visit to clinic.			Classes		1.00	clinical base
21	Nephrology: principles of propaedeutic, methods of examination, nephrolithiasis, renal colic, nephrotic syndrome, acute and chronic renal failure, hemodialysis, peritoneal dialysis, kidney transplantation. Visit to clinic.			Classes		1.00	clinical base
22	Rheumatology: principles of propaedeutic, methods of examination, rheumatoid arthritis, systemic lupus erythematosis, systemic sclerosis; vasculitis: Wegener’s granulomatosis, Churg-Strauss syndrome, temporal (giant cell) arteritis, Takayasu’s arteritis, Henoch-Schonlein purpura, Sjögren's syndrome; metabolic arthropathy: gout; manifestations in the oral cavity and maxillo-facial region. Visit to clinic.			Classes		1.00	clinical base
23	Hematology: principles of propaedeutic, methods of examination, acute and chronic leukemias, anemia (B12 and iron-deficiency), coagulopathy, hemorrhagic diathesis, haemophilia, thrombocytopenia, trombocytopenic purpura; manifestations in the oral cavity and maxillo-facial region.			Classes		1.00	clinical base
Assessment
Unaided Work:
To learn reccomended and optional literature for every class. To identify unclear cases (clinical situations) and problems. Standardised “clinical cases” evaluation, diagnostics, treatment ordination (if necessary) – MCQ. In order to evaluate the quality of the study course as a whole, the student must fill out the study course evaluation questionnaire on the Student Portal.
Assessment Criteria:
Standardised and formalised MCQ: • theoretical questions (5 groups of questions) – 60% from the final grade; • practical questions – a “clinical case” evaluation, diagnostics, treatment ordination (if necessary) – 40% from the final grade.
Final Examination (Full-Time):		Exam (OSCE)
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		Students will have acquired the knowledge of the most important cardiac, bronchial, lung diseases, endocrine, hematologic, rheumatologic, renal and gastrointestinal tract diseases, its aetiology, pathogenesis, diagnostic criteria, treatment principles. The students will have acquired knowledge of the hospital and outpatient medical documentation completion.
Skills:		The students will have acquired skills to diagnose the studied diseases, to evaluate severity, pattern, prophylaxis and treatment before the dentistry manipulations.
Competencies:		The students will be able to analyse the situation, to demonstrate individual therapeutical relationship with the patient in every clinical case.
Clinical Skills:
No.	Skill					Level
1	Administration of Insulin Using a Pre-filled Syringe (Pen)					A - Beginner level
2	Auscultation of lungs					A - Beginner level
3	Blumberg's (Shyotkin-Blumberg; rebound tenderness) sign					A - Beginner level
4	Chest comparative percussion on the front and the sides					A - Beginner level
5	Colonoscopy (CS)					A - Beginner level
6	Demonstration of murphy's symptom					A - Beginner level
7	Esophagogastroduodenoscopy (EGD, Upper gastrointestinal endoscopy)					A - Beginner level
8	Gallbladder palpation - examination of Courvoisier's symptom					A - Beginner level
9	Greater curvature of stomach palpation with compression					A - Beginner level
10	Heart auscultation (traditional)					A - Beginner level
11	Liver percussion					A - Beginner level
12	Measurement of arterial pulse					A - Beginner level
13	Measurement of the arterial pressure					A - Beginner level
14	Metered-dose inhaler (MDI) without spacer usage					A - Beginner level
15	Orthner symptom					A - Beginner level
16	Palpation of apex beat					A - Beginner level
17	Palpation of the abdominal surface					A - Beginner level
18	Percussion					A - Beginner level
19	Sigmoid colon (colon sigmoideum) palpation					A - Beginner level
20	Tactile fremitus (fremitus pectoralis) assessment					A - Beginner level
Bibliography
No.	Reference
Required Reading
1	Lejnieks A. Klīniskā medicīna. SIA Medicīnas Apgāds. Rīga 2010, 2012. (akceptējams izdevums)
2	Rudzītis K. Diagnostikas pamati un terapijas preambula. Rīga: Nacionālais apgāds, 2010 (akceptējams izdevums)
3	Bickley L.S., Szilagyi P.G. Bates' Guide to Physical Examination and History Taking. Lippincott Williams&Wilkins, 2017
Additional Reading
1	Allen JF. Health law & medical ethics for healthcare professionals. Boston: Pearson, 2012.
2	Back A, Arnold R, Tulsky J. Mastering communication with seriously ill patients. Cambridge University Press, 2009.
3	Goldman-Cecil Medicine. W.B.Saunders Company, 2020
4	Kumar P, Clark M. Kumar and Clark's Clinical Medicine. A Textbook for Medical Students and Doctors. W.B.Saunders, London. 10th Edition, 2021
5	Lloyd M, Bor R. Clinical Communication Skills for Medicine. 4th Edition. Churchill Livingstone, 2018.
Other Information Sources
1	http://estudijas.rsu.lv/index.php