Course
Study programs
Medical Studies in EnglishYear of study
3ISVU ID
ECTS
6
The course Clinical propedeutics is a compulsory course in the third year of the Integrated Undergraduate and Graduate Study of Medicine in English, which takes place in II. (summer) semester. It consists of 50 hours of lectures and 70 hours of exercises, a total of 120 hours (6 ECTS credits).
Course objective: Course Clinical Propedeutics is an introduction to clinical medicine, in which the student acquires the knowledge and skills necessary for the examination of patients and is introduced to leading signs and syndromes in the field of internal medicine. Introducing the student to the basics of clinical medicine; acquisition of theoretical knowledge and practical skills required for clinical examination of patients (medical history taking and physical examination); interpretation of the etiology and pathogenesis of the leading symptoms and signs of internal organ disease (by organ systems); acquaintance with basic laboratory and instrumental examinations and correct interpretation of their results in the diagnostic procedure; acquisition of specific competencies: blood sampling, injection, infusion placement, swab collection, urine sampling, ascites puncture, pleural puncture, lumbar puncture, bladder catheterization, nasogastric placement, etc. the skills that the student must master are the content of the course. The list of skills that a student needs to acquire is shared with the list of skills in the course Internal Medicine - the student will need to master the entire list of skills during both courses.
Contents of the course: Introduction to clinical medicine and basic concepts of the disease presentation; history taking; physical examination - inspection, palpation, percussion, auscultation; general patient status assessment; inspection of the head, neck and the chest; examination of the lungs and heart; examination of the abdomen and extremities; leading symptoms and signs of diseases of certain organ systems (chest pain, abdominal pain, cough and hemoptysis, dyspnea, hypoxia, polycythemia, cyanosis, edema, shock,
cardiovascular collapse, cardiac arrest, sudden death, gastrointestinal bleeding, icterus, abdominal swelling, meteorism, ascites, urinary disorders); the role of the basic laboratory and instrumental examinations in clinical medicine; quantitative aspects of critical clinical judgment.
Teaching: Classes are organised in the form of lectures and exercises, with no seminars. Exercises are coordinated with the lectures, and after the topic is elaborated at the lecture, it should be demonstrated and practised during the consecutive exercise. Students are required to attend regularly and actively participate in all forms of teaching.
- Bates B. ed. Bate's Guide to Physical Examination and History Taking 11th Edition. Wolters Kluwer Lippincott Williams & Wilkins, Philladelphia, 2018.
- Metelko Ž, Harambašić H. i sur. Internistička propedeutika i osnove fizikalne dijagnotike, Medicinska naklada, Zagreb, 1999.
- Antonin B. Propedeutika interne medicine, Jumena, Zagreb, 1989.
- Vrhovac B. i sur. Udžbenik interne medicine, Naprijed, Zagreb, 1991.
- Jameson JL. et. al ed. Harrison’s Principles of Internal Medicine (hrvatski prijevod), McGraw-Hill Education, Philladelphia, 2018.
The student did not fulfil the obligations if did not attend more than 30% of teaching hours (lectures, exercises). All relevant students' activities are evaluated (commitment, regular attendance). During the classes every student may collect 50% of the final course evaluation (maximum 50 points out of a total of 100 possible points). The rest 50 % of the final evaluation is generated from the final exam.
Student assessment is carried out in accordance with the current University of Rijeka Study Regulations and the Student Student Regulations at the Faculty of Medicine Rijeka (adopted by the Faculty Council of the Faculty of Medicine Rijeka).
Students' performance will be evaluated during the course and at the final exam. Out of a total of 100 credits, a student can earn 50 credits during the course, and 50 points at the final exam.
Assessment will be performed in accordance with the Rulebook on Student Assessment at the Faculty of Medicine in Rijeka, as follows:
1. After the first part of the class (the first of the two Clinical Hospital Centre Rijeka localities), the first oral / practical midterm exam (colloquium) will be held in the area of ANALYSIS, GENERAL STATUS, HEAD AND NECK EXAMINATION, BREAST, LUNG AND HEART EXAMINATION. If the student fail this exam, the remedial exam cannot be before the expiration of 30 days.
2. At the end of the second part of the class (the second of the two teaching sites), the second oral / practical midterm exam (colloquium) will be held covering the entire PRACTICAL PART (history taking and physical examination). In the event that the student fail this exam, the remedial exam also cannot take place before the expiration of 30 days.
3. The written midterm exam (colloquium) shall cover all theoretical material and shall be held after the end of all classes, according to the term defined in the performance plan. A student who, for justifiable reasons, could not attend the written exam, there will be just one more written exam organised in the time defined at the course performance plan.
4. The final exam has an oral and practical part, and includes the entire THEORETICAL (GENERAL AND SPECIAL PROPEDEUTICS) and PRACTICAL PART (CLINICAL EXAMINATION and HISTORY TAKING). All three midterm exams (two oral / practical and one written) must be passed in order to take the final exam. Before the final examination, the clinical skills booklet should be properly filled.
Learning outcomes
Define why clinical propedeutics is important - explain the fact that history taking and clinical examination of patients is the basis of all branches of clinical medicine. Describe the elements of history taking, define what is essential when approaching to the patient, and list the basic communication skills in clinical medicine. Describe essential and irrelevant information. Define the meaning of trust between physician and patient as one of the preconditions for good diagnostics and therapy.
Learning outcomes
Define, describe and analyse the key ethical and legislative principles in approaching patient and his family
Learning outcomes
List and describe the methods of physical examination. Describe and explain the theoretical basics of inspection, palpation, percussion, and auscultation.
Learning outcomes
Analyse relevant changes in the general status of the patient – the body height, body weight, changes in musculoskeletal structure, changes in skin and mucous membranes, mobility of the patients, the consciousness. Describe the recognition and assessment vital signs - pulse, arterial pressure, breathing, body temperature.
Learning outcomes
Describe the technique of head and neck examination. Define the most common pathological changes in the status of the head and neck with special review to the organs and structures of this region (eyes, ears, nose, oral cavity and pharynx, thyroid gland, lymph nodes, neck veins).
Learning outcomes
Define the topography of the chest and explain how to indicate the precise localisation of changes that are observed. Describe the most common changes in the chest wall, changes of the spine, and of the breast.
Learning outcomes
Define the technique of lung examination (percussion, auscultation). Describe the mechanisms of percutaneous sound changes, respiratory noise and associated audible phenomena (continuous musical noises, intermittent non-muscular noises, pleural friction).
Learning outcomes
Define the most common changes that can be detected by percusion and auscultation, and explain their meaning. Describe the theoretical part of the physical examination of the heart (changes in cardiac ictus, percussion techniques and basics of the auscultation of the heart).
Learning outcomes
Describe the mechanisms of heart tones and heart murmurs. Define the audible elements by mechanism of origin, temporal localization, volume, quality of the sounds and changes during dynamic auscultation. Define how to describe the pathological findings of heart tones and murmurs, and explain the key differences between them. Describe the physical findings of the most common heart valve diseases and other haemodynamic hart changes. Describe the most common changes in the carotid artery pulse that can be detected by physical examination.
Learning outcomes
Define the topography of the abdomen and how to describe the precise localisation of changes observed. Describe the technique of physical examination of the abdomen and how to indicate / report the changes. Define the recognition of enlargement of individual abdominal organs, the presence of ascites and tumours by physical examination.
Learning outcomes
Define the technique of physical examination of the extremities. Describe clinically significant changes in the peripheral arterial pulse, compare them with each other and argue for their meaning.
Learning outcomes
Explain how to approach to the patient with chest pain, describe the specifics of the anamnesis and physical examination. Distinguish between the most common diseases that may have the chest pain as a leading symptom and describe their differential diagnosis.
Learning outcomes
Define access to the patient with abdominal pain, and explain the most important elements of medical history taking and physical examination. Describe the key clinical elements of the most common diseases that may be presented with abdominal pain, and describe their differential diagnosis.
Learning outcomes
Explain what is the clinical importance of cough and hemoptysis, and what are the key elements of medical history and physical examination in those patients. List the most common causes of cough and hemoptysis. Compare the leading clinical determinants of bleeding from the respiratory system and indicate the differences in hemoptysis from bleeding from other sources (nose, gastrointestinal tract).
Learning outcomes
List the most common causes of dyspnea and explain the specifics of the diagnostic approach to these patients. Define differential diagnosis of dyspnoea that are based on clinical examination (history and physical findings).
Learning outcomes
Define the mechanisms, origin causes, consequences and clinical significance of hypoxia. Describe the approach to these patients and the possibilities of differential diagnosis.
Learning outcomes
Describe the mechanisms of edema formation and compare the clinical contexts in which they may occur. Define how based on clinical examination edema may be differentiated depending on the cause (heart, liver, kidney, peripheral venous insufficiency, hypoproteinaemia, lymphedema, iatrogenic edema).
Learning outcomes
Explain what are the manifestations of gastrointestinal bleeding (haematemesis, melena, occult bleeding). Define the most common causes of gastrointestinal bleeding, list and explain the differential diagnosis options. Explain what is icterus, differentiate and argue the differential diagnosis. Describe how to identify ascites using physical examination methods and how to distinguish the ascites from other causes of abdominal enlargement (obesity, flatulence, tumours).
Learning outcomes
Describe what shock and cardiovascular collapse are. Define forms of shock and explain their recognition, and list their key similarities and differences. Define cardiac arrest (access to a patient with a sudden loss of consciousness) and explain how to distinguish it from sudden cardiac death.
Learning outcomes
Define the most common causes of lymphadenopathy and splenomegaly, explain methods of their identification by physical examination, argue the importance of certain details of physical status and describe the possibilities of differential diagnosis.
Learning outcomes
Define the most common symptoms and signs of rheumatologic and autoimmune diseases (general symptoms, changes in general status, changes in joints, skin and internal organs). Describe the most common mechanisms of these disorders, compare leading clinical imaging features and define differential diagnosis options.
Learning outcomes
Define the most common urinary disorders (polyuria, oliguria, anuria, polacysuria, dysuria, nocturia, enuresis, incontinence). Distinguish the most common causes of these particular disorders, explain and argue the possibilities of their differential diagnosis.
Learning outcomes
Define the value of findings from the history and physical examination according to their sensitivity, specificity and predictive value. Explain what evidence-based medicine is, describe how it is generated, and define how clinical guidelines should be used.
| Academic year | |
|---|---|
| 2023/2024 | [Download] |