Rheumatology

Study Course Description

Course Description Statuss:Approved

Course Description Version:12.00

Study Course Accepted:22.08.2023 09:30:02

Study Course Information
Course Code:		ISK_082		LQF level:		Level 7
Credit Points:		1.00		ECTS:		1.50
Branch of Science:		Clinical Medicine; Internal Medicine		Target Audience:		Medicine
Study Course Supervisor
Course Supervisor:		Anda Kadiša
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)		2	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		4
Classes (count)		6	Class Length (academic hours)		2	Total Contact Hours of Classes		12
Total Contact Hours								16
Study course description
Preliminary Knowledge:
Basic knowledge of propaedeutics, pathology, pharmacology, immunology, dermatology, biochemistry, visual diagnostics.
Objective:
The aim of the course is to study the etiology, pathogenesis, essence of classification criteria, clinical picture, diagnostic principles, diagnostic principles, differential diagnosis and basic principles of rheumatic diseases – arthology, connective tissue diseases and vasculitis.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Differential diagnosis of joint diseases. a. Classification of arthritis, common and different in inflammatory and non-inflammatory arthritis. b. Spondyloarthropathies: ankylosing spondylitis, reactive arthritis, psoriatic arthritis, enteropathic arthritis (etiology, epidemiology, pathogenesis, criteria for classification, clinical, diagnostic, disease activity assessment, basic principles of therapy, differential diagnosis).			Lectures		1.00	clinical base
2	Vasculitis a. Classification of vasculitis. b. Primary systemic vasculitides – etiology, epidemiology, pathogenesis, classification, diagnostic criteria, clinic, diagnostics, assessment of vasculitis activity, basic principles of therapy – Takayasu arteritis, giant cell arteritis and rheumatic polymyalgia, granulomatosis with polyangiitis, eosinophyl granulomatosis with polyangiitis, nodose polyarteritis, cryoglobulinemic vasculitis. Behcet's disease and obliterative thrombangitis.			Lectures		1.00	clinical base
3	a. Osteoarthritis (etiology, epidemiology, pathogenesis, clinic, diagnostics, basic principles of therapy, differential diagnosis). b. Crystal-induced arthropathies: gout, pseudogout. Knowledge of the topic of the lesson is tested with multiple-choice questions and evaluated with a grade.			Classes		0.50	clinical base
4	a. Rheumatoid arthritis (etiology, epidemiology, pathogenesis, classification criteria, clinic, diagnostics, assessment of disease activity, basic principles of therapy, differential diagnosis). b. Infection-induced joint damage: bacterial (septic arthritis), Lyme disease, viral infections. Knowledge of the topic of the lesson is tested with multiple-choice questions and evaluated with a grade.			Classes		0.50	clinical base
5	Spondyloarthropathies: ankylosing spondylitis, reactive arthritis, psoriatic arthritis, enteropathic arthritis (etiology, epidemiology, pathogenesis, calcification criteria, clinic, diagnosis, assessment of disease activity, basic principles of therapy, differential diagnosis). Knowledge of the topic of the lesson is tested with multiple-choice questions and evaluated with a grade.			Classes		1.00	clinical base
6	Diffuse connective tissue diseases (I): etiology, epidemiology, pathogenesis, classification criteria, clinic, diagnostics, assessment of disease activity, basic principles of therapy, differential diagnosis. a. Systemic lupus erythematosus. b. Antiphospholipid syndrome. c. Polymyositis/dermatomyositis. Knowledge of the topic of the lesson is tested with multiple-choice questions and evaluated with a grade.			Classes		1.00	clinical base
7	Diffuse connective tissue diseases (II):etiology, epidemiology, pathogenesis, classification criteria, clinic, diagnostics, assessment of disease activity, basic principles of therapy, differential diagnosis. a. Systemic sclerosis. b. Raynaud phenomenon. c. Sjogren's disease. Knowledge of the topic of the lesson is tested with multiple-choice questions and evaluated with a grade.			Classes		1.00	clinical base
8	Takayasu's arteritis, giant cell arteritis, polymyalgia rheumatica, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, hemorrhagic vasculitis, polyarteritis nodosa, cryoglobulinemic vasculitis, Behçet's disease, thromboangitis obliterans: etiology, epidemiology, pathogenesis, classification, diagnostic criteria, clinic, diagnosis, activity assessment , therapy. Knowledge of the topic of the lesson is tested with multiple-choice questions and evaluated with a grade.			Classes		1.00	clinical base
9	Centrally organized exam • Written response to multiple-choice questions covering arthrology, connective tissue diseases, and vasculitides. Questions include both theoretical knowledge testing and clinical case interpretation. The student's written answer is evaluated with a grade.			Classes		1.00	clinical base
Assessment
Unaided Work:
Individual work with medical literature, with a patient – history collection, interpretation of examinations, preparation of a treatment plan, formulation of a possible diagnosis. 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:
In each lesson, the student's knowledge is evaluated with a grade by answering 10 multiple-choice questions. An average grade is posted at the end of the last lesson. Students take a centrally organized exam and provide a written response to multiple-choice questions that include arthrology, connective tissue diseases, and vasculitis. Questions include both theoretical knowledge testing and clinical case interpretation. Exam questions include disease sections: etiology, pathogenesis, clinical picture, diagnosis or diagnostic criteria, principles of therapy. The student's written answer is evaluated with a grade. The final grade is made up of the average grade from the average grade of the classes and the exam grade. The diseases included in the questions will be fully discussed during the study course (see study course topics). The final grade consists of 50% of the average grade of the class tests and 50% of the exam grade.
Final Examination (Full-Time):		Exam
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		As a result of the study course acquisition students are able to recognize the most important rheumatic diseases, to describe their etiology, pathogenesis, name diagnostic criteria, formulate differential diagnosis, basic principles of treatment and prevention.
Skills:		As a result of the study course acquisition students will be able to identify the diseases listed in the study course description, their severity and course, to differentiate them, to justify the diagnosis, to design the necessary examination plan and evaluate their results, to assign treatment to a specific patient.
Competencies:		As a result of the study course acquisition students will be able to apply the acquired knowledge in the formulation of diagnoses, applying the latest classifications in accordance with accepted clinical guidelines, applying the latest diagnostic and treatment technologies, differentiating clinical symptoms and diagnostic finding results for a particular patient.
Clinical Skills:
No.	Skill					Level
1	Ankle joint mobility test.					A - Beginner level
2	Ballotation symptom in the knee joint					A - Beginner level
3	Determination of the amount of lateral tilt of the spine.					A - Beginner level
4	Determination of the chauffard's triangle					A - Beginner level
5	Determination of thoracolumbal rotation.					A - Beginner level
6	Elbow joint palpation					A - Beginner level
7	Examination of knee flexion.					A - Beginner level
8	Examination of the elbow joint active flexion					A - Beginner level
9	Examination of the elbow joint extension					A - Beginner level
10	Examination of the elbow joint passive flexion					A - Beginner level
11	Examination of the elbow joint pronation					A - Beginner level
12	Examination of the elbow joint supination					A - Beginner level
13	Examination of the extent of knee extension.					A - Beginner level
14	Examination of the hip joint testing active abduction					A - Beginner level
15	Examination of the hip joint testing external rotation					A - Beginner level
16	Examination of the hip joint testing flexion					A - Beginner level
17	Examination of the hip joint testing internal rotation					A - Beginner level
18	Examination of the hip joint testing passive abduction					A - Beginner level
19	Examination of the lumbar and intestinal joints.					A - Beginner level
20	Fallen’s symptom					A - Beginner level
21	Movement test in the subtalar joint.					A - Beginner level
22	Palpation of the ankle joint					A - Beginner level
23	Schober’s symptom					A - Beginner level
24	Shoulder joint examination abduction					A - Beginner level
25	Shoulder joint examination active extension					A - Beginner level
26	Shoulder joint examination active abduction					A - Beginner level
27	Shoulder joint examination active external rotation					A - Beginner level
28	Shoulder joint examination active flexion					A - Beginner level
29	Shoulder joint examination active internal rotation					A - Beginner level
30	Shoulder joint examination passive abduction					A - Beginner level
31	Shoulder joint examination passive extension					A - Beginner level
32	Shoulder joint examination passive external rotation					A - Beginner level
33	Shoulder joint examination passive flexion					A - Beginner level
34	Shoulder joint examination passive internal rotation					A - Beginner level
35	Testing the fist symptom					A - Beginner level
36	Triangle symptom					A - Beginner level
37	Verification of the mobility of the cervical vertebrae.					A - Beginner level
38	Wrist movement test.					A - Beginner level
Bibliography
No.	Reference
Required Reading
1	A. Lejnieks. Klīniskā medicīna. 3. grāmata. SIA Medicīnas apgāds, 2012 (akceptējams izdevums)
2	Current Diagnosis & Treatment in Rheumatology, 4th Edition (LANGE CURRENT Series) eBook: John Imboden, David Hellmann, John Stone. 2021
3	The Merck Manual of diagnosis and therapy, current edition.
4	Harrison`s Rheumatology by Anthony S. Fauci, current edition (akceptējams izdevums)
5	Ārvalstu studentiem/For international students:
6	Current Diagnosis & Treatment in Rheumatology, 4th Edition (LANGE CURRENT Series) eBook: John Imboden, David Hellmann, John Stone. 2021
7	The Merck Manual of diagnosis and therapy, current edition.
Additional Reading
1	Marc C. Hochberg, Rheumatology, current edition.
2	Firestein & Kelley's Textbook of Rheumatology, current Edition.
3	Oxford Textbook of Rheumatology, current edition.
Other Information Sources
1	https://www.rheumatology.org/Practice-Quality/Clinical-Supp…
2	https://www.eular.org/Recommendations_classification_respon…