Introduction to Clinical Medicine

Study Course Description

Course Description Statuss:Approved

Course Description Version:9.00

Study Course Accepted:11.04.2024 08:33:18

Study Course Information
Course Code:		ISK_199		LQF level:		Level 7
Credit Points:		2.00		ECTS:		3.00
Branch of Science:		Clinical Medicine; Internal Medicine		Target Audience:		Medicine
Study Course Supervisor
Course Supervisor:		Valdis Ģībietis
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)		1	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		2
Classes (count)		10	Class Length (academic hours)		3	Total Contact Hours of Classes		30
Total Contact Hours								32
Study course description
Preliminary Knowledge:
Student has attended at least 5 Medical Communication classes before starting current course. Normal anatomy, histology, normal physiology, biochemistry and principles of medical physics, biology and basics of genetics. Normal hematopoesis. Normal blood counts. Normal blood coagulation/hemostasis.
Objective:
Introduction to Clinical Medicine: 1. Instruct students on medical history documentation – chief complaint, history of present illness, past medical history. 2. Develop bedside physical examination skills according to the clinical case – the interview, inspection, palpation, percussion, auscultation. 3. Teach the ways of combining patient subjective experience in an illness with the data from physical examination and come to a possible diagnosis. Hematology: 1. Learn about hematological patients examination methods. Learn to recognise and define changes in red blood cells, white blood cells and platelets. 2. Learn to define anemia, recognise symptoms and signs of anemia. Learn laboratory diagnostic of anemia, laboratory classification of anemia. 3. Learn types of bleeding disorders, symptoms and signs, laboratory diagnostic methods.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Introduction to clinical medicine. From symptom to syndrome.			Lectures		1.00	E-Studies platform
2	General medical examination. Basic clinical skills.			Classes		1.00	clinical base
3	Extremities: peripheral vascular system and lymph nodes.			Classes		1.00	clinical base
4	Thorax and the lungs. Hands-on examination.			Classes		1.00	clinical base
5	Clinical cases with pulmonary function tests.			Classes		1.00	clinical base
6	Upper abdominal examination: hands-on at the RUQ and LUQ.			Classes		1.00	clinical base
7	Clinical Reasoning and Instrumental Examinations			Classes		1.00	clinical base
8	Assessment of the patient. Group work.			Classes		1.00	clinical base
9	Symptoms and signs of hematological diseases. Examination methods of hematological patients. Changes in blood counts.			Classes		1.00	clinical base
10	Symptoms and signs of anemia. Laboratory diagnostic and laboratory clasification of anemia.			Classes		1.00	clinical base
11	Types of bleeding disorders. Symptoms and signs of bleeding disorders. Laboratory analyses for bleeding disorders.			Classes		1.00	clinical base
Assessment
Unaided Work:
Students independently familiarize themselves with the requirements in each lesson and learn clinical manipulations from a source understandable to the student (at their own discretion). Students individually search for and learn the most up-to-date information about the methods of physical examination of patients from materials recommended by the department or other sources. 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:
Introduction to Clinical Medicine: 1. Successfully completed a test for each videolecture – 30% of total grade; 2. Physical examination technique demonstration at bedside/simulator – 70% of total grade. Haematology cycle: 1. Tests during the lessons; 2. Situation tasks during the lessons; 3. Written examination (test questions, at least 75% are correct).
Final Examination (Full-Time):		Exam
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		On course completion, the students will know how to: • structurally interview and record patient medical history; • perform clinical examination according to presented disease/condition; • objectivize pacient's subjective experience with a condition; • explain terminology used in the clinical setting.
Skills:		Upon successful completion of the course, students will be able to: • communicate with patients, their relatives, colleagues, other persons involved in the process of health care; • specify the complaints, medical history, structurally interviewing and recording history data; • perform components of physical examination – inspection, palpation, percussion, auscultation; • interpret lung functional testing – spirometry.
Competencies:		1. Evaluate symptoms, reveal interconnections between pathologies. 2. Analyse situations, substantiate, logically formulate and explain their opinion. 3. Evaluate lung functional examination data, relate it to the certain clinical case. 4. Evaluate blood test results, recognise main hematology disorders, attribute to a specific clinical case and general examination data.
Clinical Skills:
No.	Skill					Level
1	Anterior and lateral comparative percussion of lungs					A - Beginner level
2	Anterior and lateral fremitus pectoralis					A - Beginner level
3	Auscultation of lungs					A - Beginner level
4	Demonstration of murphy's symptom					A - Beginner level
5	Detection of ascites					A - Beginner level
6	Detection of gallbladder projection site					A - Beginner level
7	Examination of muscle-induced rigidity of the abdominal wall					A - Beginner level
8	Liver percussion					A - Beginner level
9	Measurement of arterial pulse					A - Beginner level
10	Measurement of the arterial pressure					A - Beginner level
11	Measurement of the radial pulse tension					A - Beginner level
12	Palpation of the abdominal surface					A - Beginner level
13	Palpation of the liver					A - Beginner level
14	Percussion of the kidneys					A - Beginner level
15	Pleural and intercostal pains					A - Beginner level
16	Posterior fremitus pectoralis					A - Beginner level
17	Posterior lungs comparative percussion					A - Beginner level
Bibliography
No.	Reference
Required Reading
1	Bates’ guide to physical examination and history taking / Lynn S. Bickley, Peter G. Szilagyi. 2017
2	The Merck Manual of Patient Symptoms: A Concise, Practical Guide to Etiology, Evaluation, and Treatment 1st edition. 2008. (akceptējams izdevums)
3	Hutchison’s clinical methods: an integrated approach to clinical practice. 2017.
4	Macleod’s clinical examination / edited by Graham Douglas, Fiona Nicol, Colin Robertson ; illustrated by Robert Britton, Ethan Danielson. 2018.
5	Klīniskā hematoloģija / Sandra Lejniece. 2020
6	Ārvalstu studentiem/For international students:
7	Bates’ guide to physical examination and history taking / Lynn S. Bickley, Peter G. Szilagyi. 2017
8	The Merck Manual of Patient Symptoms: A Concise, Practical Guide to Etiology, Evaluation, and Treatment 1st edition. 2008. (akceptējams izdevums)
9	Macleod’s clinical examination / edited by Graham Douglas, Fiona Nicol, Colin Robertson ; illustrated by Robert Britton, Ethan Danielson. 2018.
Additional Reading
1	Propedeitika. G.Orļikova un Pičkura redakcijā. RSU, 2014.
2	Oxford Handbook of Clinical Haematology. Oxford University Press, 2015.
3	Wintrobe’s Atlas of Clinical Hematology. Douglas C. Tkachuk, Jan Hirschmann. Lippincott Williams& Wilkins, 2017.
4	Disorders of Iron Homeostasis, Erythrocytes, Erythropoiesis. Handbook. European School of Haematology, 2006.
5	Scott H. Goodnight, William E. Hathaway. Disorders of Hemostasis and Thrombosis. A Clinical Guide. The McGraw-Hill Companies, 2001, p.1-314.
6	Williams Manual of Hematology. Sixth edition, McGraw-Hill Medical Publishing Division, 2003.
7	Bleeding Disorders by D.Green, C.A.Ludlam. Health Press, 2006
8	Marshall A.Lichtman, Ernest Beutler, Thomas J.Kipps, Uri Seligsohn, Kenneth Kaushansky, Josef T. Prchal. Williams Hematology. 7th edition. 2021.
9	S.M. Lewis, B.J. Bain, I. Bates. Dacie and Lewis Practical Haematology. Churchill Livingstone, 2017
10	Hoffman A.V., Moss P.A.H. Essential Haematology. 6th edition. Wuiley- Blackwell, 2020.
11	Ārvalstu studentiem/For international students:
12	Oxford Handbook of Clinical Haematology. Oxford University Press, 2015
13	Wintrobe’s Atlas of Clinical Hematology. Douglas C. Tkachuk, Jan Hirschmann. Lippincott Williams& Wilkins, 2017.
14	Disorders of Iron Homeostasis, Erythrocytes, Erythropoiesis. Handbook. European School of Haematology, 2006.