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Internal Diseases I (Gastroenterology, Nephrology, Endocrinology)
Study Course Description
Course Description Statuss:Approved
Course Description Version:5.00
Study Course Accepted:04.07.2022 09:52:37
| Study Course Information | |||||||||
| Course Code: | ISK_213 | LQF level: | Level 7 | ||||||
| Credit Points: | 7.00 | ECTS: | 10.50 | ||||||
| Branch of Science: | Clinical Medicine; Internal Medicine | Target Audience: | Medicine | ||||||
| Study Course Supervisor | |||||||||
| Course Supervisor: | Juris Pokrotnieks | ||||||||
| Study Course Implementer | |||||||||
| Structural Unit: | Department of Internal Diseases | ||||||||
| The Head of Structural Unit: | |||||||||
| Contacts: | Riga, 2 Hipokrata Street, isk rsu[pnkts]lv, +371 67042338 | ||||||||
| Study Course Planning | |||||||||
| Full-Time - Semester No.1 | |||||||||
| Lectures (count) | 5 | Lecture Length (academic hours) | 2 | Total Contact Hours of Lectures | 10 | ||||
| Classes (count) | 14 | Class Length (academic hours) | 3 | Total Contact Hours of Classes | 42 | ||||
| Total Contact Hours | 52 | ||||||||
| Full-Time - Semester No.2 | |||||||||
| Lectures (count) | Lecture Length (academic hours) | Total Contact Hours of Lectures | 0 | ||||||
| Classes (count) | 20 | Class Length (academic hours) | 3 | Total Contact Hours of Classes | 60 | ||||
| Total Contact Hours | 60 | ||||||||
| Study course description | |||||||||
| Preliminary Knowledge: | Normal and pathological anatomy and physiology of the digestive tract, kidneys and endocrine system; examination possibilities, including propaedeutics, laboratory and image diagnostics and pharmacotherapy. | ||||||||
| Objective: | Acquire knowledge of the aetiology, pathogenesis, classification and examination methods, diagnosis and differential diagnosis of the digestive tract, kidney and endocrine diseases; learn the principles of treatment, prognosis and prevention. | ||||||||
| Topic Layout (Full-Time) | |||||||||
| No. | Topic | Type of Implementation | Number | Venue | |||||
| 1 | Classification of esophageal diseases. Functional esophageal diseases. Esophageal Achalasia. Non-reflux oesophagites, esophageal lesions due to infections, systemic diseases, medications, radiation injuries, esophageal tumors. Gastroesophageal reflux disease. Definition, diagnosis, complications. Typical and atypical presentation. Principles of treatment. Barrett’s esophagus. Mallory-Weiss syndrome. Foreign bodies in the esophagus. | Classes | 1.00 | clinical base | |||||
| 2 | Gastroduodenal Diseases I. Classification. Functional dyspepsia (definition, classification (Rome IV), diagnostic criteria, principles of therapy). The concept of gastropathies. Type of gastrites. Sydney classification of gastritis. Clinical relevance of chronic gastritis (atrophy, metaplasia, OLGA and OLGIM systems, cancer).The concept of duodenitis (peptic, non-peptic). Diagnostic capabilities. | Classes | 1.00 | clinical base | |||||
| 3 | Gastric and duodenal diseases II. Peptic gastric and duodenal ulcer (aetiology, pathogenesis, diagnostics, principles of treatment, complications). H.pylori infection (diagnosis, clinical relevance, Maastricht / Florence consensus, eradication principles). Non-helicobacter and/or non-NSAIDs associated ulcers. | Classes | 1.00 | clinical base | |||||
| 4 | Liver diseases I. Symptoms and syndromes of liver diseases. Bile acids and its metabolism. Compensated and decompensated liver cirrhosis and its complications. Acute-on-Chronic Liver Failure. Portal hypertension and variceal gastrointestinal bleeding. Ascites and spontaneous bacterial peritonitis. Hepatorenal syndrome. Hepatic encephalopathy. Liver failure. Drug-induced liver injury. Liver transplantation. | Classes | 1.00 | clinical base | |||||
| 5 | Liver Diseases II. Acute and chronic viral hepatites. Hepatic parasitosis. Alcohol and non-alcohol liver damage. Non-alcoholic steatohepatitis. Liver tumors and cysts. | Classes | 1.00 | clinical base | |||||
| 6 | Liver Diseases III. Congenital hepatic metabolism disorders, rare liver diseases: haemochromatosis, Gilbert's syndrome, Wilson's disease, primary biliary cholangitis, autoimmune hepatitis, primary sclerosing cholangitis, α1-antitrypsin deficiency. | Classes | 1.00 | clinical base | |||||
| 7 | Diseases of the gallbladder and biliary tract. Gallbladder and sphincter Oddi dysfunction. Bile litogenity clinical manifestations (sludge, gallstone microlithiasis, lithiasis) and therapeutical options. Holangites (clinical signs and principles of treatment). Tumors of biliary tract. Primary sclerosing cholangitis. Endoscopic and radiologic treatment of biliary disease. | Classes | 1.00 | clinical base | |||||
| 8 | Diseases of the pancreas. Classification of pancreatic diseases. Pancreatic insufficiency (cause, clinic, diagnostics, principles of therapy). Gastroenteropancreatic endocrine system and neuroendocrine tumors. Chronic pancreatitis (classification, diagnostic and treatment). Pancreatic carcinoma risk factors. | Classes | 1.00 | clinical base | |||||
| 9 | Small bowel diseases. Classification of small bowel diseases. Maldigestion and malabsorption. Microbiota and dysbiosis. Short bowel syndrome. Celiac Disease. Enterocolites: E. coli and its pathogenic strains; other infections, travelers' diarrhea. Intestinal parasites. Lactase deficiency. | Classes | 1.00 | clinical base | |||||
| 10 | Colon Diseases. Diverticulosis. Diverticulitis. Inflammatory bowel disease (Ulcerative colitis, Crohn's disease). Ischemic colitis. Risk factors of colorectal cancer. Prevention. Irritable Bowel Syndrome. | Classes | 1.00 | clinical base | |||||
| 11 | Nutrition in gastroenterological patients. Nutritional assessment techniques (incl. MUST, SNAQ, NRS scales). Harris Benedict equation (determination of basal metabolic rate). The main types of feeding. Indications and contraindications for enteral and parenteral nutrition). | Classes | 1.00 | clinical base | |||||
| 12 | Digestive endoscopy. METC. Upper gastrointestinal endoscopy (indications for immediate and planned use, contraindications). Colonoscopy (indications, bowel cleansing, contraindications). Endoscopic retrograde holangiopancreatography (options, indications). Echoendoscopy (options, indications). Small intestine endoscopy (intestinoscopy, capsule endoscopy). Recent trends in endoscopy (robotic, computerized). Bleeding from the digestive tract. | Classes | 1.00 | clinical base | |||||
| 13 | Functional dyspepsia. Gastropathies. | Lectures | 1.00 | E-Studies platform | |||||
| 14 | Comprehensive examination of the kidney patient. | Classes | 1.00 | clinical base | |||||
| 15 | Urinary tract infection (cystitis, pyelonephritis, acute urethral syndrome). | Classes | 1.00 | clinical base | |||||
| 16 | Acute renal failure. | Classes | 1.00 | clinical base | |||||
| 17 | Acute allergic bacterial nephritis, HRS, etc. specific causes of acute renal failure. | Classes | 1.00 | clinical base | |||||
| 18 | Glomerulonephritis with predominantly nephritic syndrome (IgAN, post-infectious GN, MPGN). | Classes | 1.00 | clinical base | |||||
| 19 | Glomerulonephritis with predominantly nephrotic syndrome (MPG, FSGS, MGN). | Classes | 1.00 | clinical base | |||||
| 20 | Fast progressive glomerulonephritis. | Classes | 1.00 | clinical base | |||||
| 21 | Chronic tubulointerstitial nephropathy (reflux NP, OU, nephrocalcinosis, toxins). | Classes | 1.00 | clinical base | |||||
| 22 | Cystic kidney disease (ADNP, ARNP, MCNS), kidney stone disease. | Classes | 1.00 | clinical base | |||||
| 23 | Diabetic nephropathy, amyloidosis, systemic lupus erythematosus (kidney aspects). | Classes | 1.00 | clinical base | |||||
| 24 | Chronic renal failure – classification (chronic kidney disease), syndromes, cardiovascular risk, staging. | Classes | 1.00 | clinical base | |||||
| 25 | Basics of Kidney Replacement Therapy (HD, PD, Tx). | Classes | 1.00 | clinical base | |||||
| 26 | Common disorders of water and electrolyte metabolism. | Classes | 1.00 | clinical base | |||||
| 27 | Thrombotic microangiopathy, preeclampsia, a. renal stenosis. | Classes | 1.00 | clinical base | |||||
| 28 | Principal mechanisms and regulation of hormone activity. Hypothalamus – normal physiology of pituitary hormones and basics of pathology. Acromegaly, Diabetes mellitus – pathogenesis, diagnostics and principles of therapy. | Classes | 1.00 | clinical base | |||||
| 29 | Adrenal hormones and major diseases. Concept of endocrine arterial hypertension (diagnosis, differential diagnosis and principles of therapy). | Classes | 1.00 | clinical base | |||||
| 30 | Basic carbohydrate metabolism. Diagnosis, classification, differential diagnosis of diabetes mellitus. Pathogenesis of type 2 diabetes. Principles of therapy and standards of care. Oral antidiabetic agents. | Classes | 1.00 | clinical base | |||||
| 31 | Pathogenesis of type 1 diabetes. Principles of insulin therapy. Concept of acute (hypoglycaemia, diabetic ketoacidosis) and chronic complications (nephropathy, retinopathy, polyneuropathy) of diabetes mellitus. | Classes | 1.00 | clinical base | |||||
| 32 | Role of thyroid hormones in physiological processes. Struma. Hypothyroidism and hyperthyroidism (diagnosis, principles of therapy). Characterisation of thyroid nodules, malignancy criterion. | Classes | 1.00 | clinical base | |||||
| 33 | Regulation of calcium homeostasis. The concept of hyperparathyroidism and hypoparathyroidism. | Classes | 1.00 | clinical base | |||||
| 34 | Principles of diagnosis and therapy of osteoporosis and bone metabolic diseases. | Classes | 1.00 | clinical base | |||||
| 35 | Adiposity and appetite control. Aspects of reproductive endocrinology. | Classes | 1.00 | clinical base | |||||
| 36 | Biological mechanisms of hormone activity in norm and pathology. Diagnostic and therapeutic principles in modern endocrinology. | Lectures | 1.00 | E-Studies platform | |||||
| 37 | Irritable bowel syndrome. | Lectures | 1.00 | E-Studies platform | |||||
| 38 | Examination of kidney patient. | Lectures | 1.00 | E-Studies platform | |||||
| 39 | Chronic renal failure. | Lectures | 1.00 | E-Studies platform | |||||
| Assessment | |||||||||
| Unaided Work: | Work with a patient, i.e. medical history data, simulations, work with literature, including the e-environment, resulting in a protocol for patient screening with a diagnosis, its rationale, key examinations, and specific treatment for the patient being examined. | ||||||||
| Assessment Criteria: | The exam takes place in writing, covering the fourth year of study in gastroenterology, nephrology and endocrinology, which is included in the tickets (available in e-studies). After the invitation, the student draws 3 tickets (one from each discipline) and receives an exam sheet, where the full text of the exam ticket question must be written before writing the answer. The exam is passed if the answers to all ticket questions are marked "4" or higher. If any of the answers are rated below, then the exam must be taken again. The mark is enhanced not only by the breadth and accuracy of the student's knowledge, but also by references to modern classifications and the latest guidelines. Schemes, drawings and algorithms are positively evaluated. The description of treatment should include all therapies, lifestyle, medicines starting with the "gold standard", including surgery (endotherapy, invasive radiology) and possible alternative approaches. The final grade is a cumulative grade (average grade): 1) the average grade of practical classes (the teacher will assess the student's knowledge and activity in each practical class with a grade); 2) examination mark. | ||||||||
| Final Examination (Full-Time): | Exam (Written) | ||||||||
| Final Examination (Part-Time): | |||||||||
| Learning Outcomes | |||||||||
| Knowledge: | On completion of the study course, the student will be able to name and describe the digestive tract, kidney and endocrine diseases mentioned in the study course description, to formulate the definition of these diseases, key classification (-s), symptoms, the course of the disease, diagnostic criteria, examination plan, principles of treatment including non-medical, prognosis and prevention options. | ||||||||
| Skills: | Students will be able to formulate the most probable diagnosis of the above-mentioned internal diseases using the examination data, to select the confirmatory data as well as the additional information / examinations required, to choose the principles of treatment and to apply the treatment specifically to the given situation. | ||||||||
| Competencies: | Independently plan the cognitive process to balance the existing knowledge gained from previous courses with the new subject; be able to organise patient examination, working alone or in a group of two to three students; be able to use literature, e-environment, peer and teacher knowledge; take responsibility for presenting the work of the group of students. | ||||||||
| Clinical Skills: | |||||||||
| No. | Skill | Level | |||||||
| 1 | Colonoscopy (CS) | A - Beginner level | |||||||
| 2 | Esophagogastroduodenoscopy (EGD, Upper gastrointestinal endoscopy) | A - Beginner level | |||||||
| 3 | Liver percussion | A - Beginner level | |||||||
| 4 | Palpation of the kidneys | A - Beginner level | |||||||
| 5 | Palpation of the liver | A - Beginner level | |||||||
| 6 | Percussion of the kidneys | A - Beginner level | |||||||
| Bibliography | |||||||||
| No. | Reference | ||||||||
| Required Reading | |||||||||
| 1 | Klīniskā medicīna. Prof. A.Lejnieka red. 1-3.grāmata, 2010-2012 | ||||||||
| 2 | Goldman-Cecil Medicine. 26th edition. Elsevier, 2020 | ||||||||
| 3 | Ārvalstu studentiem/For international students: | ||||||||
| 4 | Goldman-Cecil Medicine. 26th edition. Elsevier, 2020 | ||||||||
| Additional Reading | |||||||||
| 1 | Ferri’s Clinical Advisor. Elsevier, 2023 | ||||||||
| Other Information Sources | |||||||||
| 1 | Zāļu Valsts aģentūra | ||||||||
| 2 | www.uptodate.com | ||||||||
| 3 | www.medscape.com | ||||||||
| 4 | Ārvalstu studentiem/For International students: | ||||||||
| 5 | www.uptodate.com | ||||||||
| 6 | www.medscape.com | ||||||||
