Medicine

Code:

MI501

Acronym:

MED

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2012/2013 - SP

Active?	Yes
Responsible unit:	Kidney, Urologic and Infectious Diseases Departement
Course/CS Responsible:	Integrated Master in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIMED	252	Mestrado Integrado em Medicina 2007	5	-	13,5	146	364,5

Teaching language

Portuguese

Objectives

To enable the student to collect, to register and to transmit clinical information (by means of disease history, objective exam and complementary exams). To use the collected information by means of setting out a list of problems and to propose the research and resolution of clinically selected problems (diagnosis strategy). To acquire a core of theoretical knowledge that allows the resolution of the main common medical situations (resolution of clinical problems). To propose an appropriate therapeutic strategy and enable the seeking of information to make decisions.

Gastroenterology:
To obtain the clinical information through the history of disease and objective examination of the patient; to establish a diagnosis strategy; to obtain the core knowledge in the area of clinical Gastroenterology; To enhance the solving capability of clinical problems with therapeutics proposal in patients at the clinic, ward and emergency; To develop the attitudes of permanent ethic and scientific demand.

Infeccious Diseases:
The students will be integrated in clinical activities of the Department during the morning. In the afternoon they will participate in clinical rounds and in the discussion of clinical cases.

Nephrology:
Transmission of the core knowledge of nephrology that should be demanded in undergraduation, for all medical students based on the aspects that must be embraced by all the new physicians (nephrologic syndromes). Optimising a two-week period objective attributed to each block of Nephrology, knowing which are the areas of knowledge of unquestionable importance, that medical students and new physicians have greater difficulty in handling.

Program

Gastroenterology:
Clinical assessment, diagnosis and therapeutics methods in Gastroenterology; Helicobacter Pylori and peptic ulcer; Acute and chronic gastrointestinal bleeding; Crohn’s Disease and ulcerative colitis; Therapeutic strategy in intestinal inflammatory disease; Chronic diarrhea and malabsorption; GI motility disease; Maligment neoplasias of the GI tract; Acute and chronic viral hepatitis; Alcholic liver disease and non alcoholic fatty liver disease; Metabolic liver disease; Acute and chronic pancreatitis.
Practical program: Work integrated in the clinical activity of the Service under the professor's orientation.

Infeccious Diseases:
Infections of the Central Nervous System; Influenza; Tuberculosis; Acute gastroenteritis; Typhoid fever; Viral Hepatitis; HIV infection / AIDS and its complications; Community viral infections: Herpetic infections / Cytomegalovirus infections / Infectious mononucleosis / Chickenpox / Herpes zoster; Mumps; Scarlet fever; Tetanus; Botulism; Brucellosis; Rickettsial infections; Leptospirosis; Malaria; Sepsis / Septic shock / Toxic shock; Endocarditis;- Fever of unknown origin.
Theoretical-practical seminars: Maternal transmitted infections, with emphasis to Hepatitis B and HIV infections; Acute fever: clinical approach; CNS infectious diseases: diagnostic evaluation, treatment and prevention; Traveller's diseases; Infections in injection drug-addicts; Hepatitis B and hepatitis C: diagnostic evaluation, treatment and prevention; Community acquired pneumonia: diagnosis and treatment; Co-infection HIV-tuberculosis: therapeutic strategy; Prevention of the infectious diseases: attitudes.
Practical programs: Supervised clinical activities in the Infectious Diseases Department. Clinical rounds and clinical cases presentations between 14,30 and 16,30h.

Nephrology:
Lectures: I: Renal semiology; II. Water, sodium and potassium metabolism disturbances; III. Acid-base balance disturbances; IV. Acute renal failure; V. Chronic renal failure; VI. Primary glomerular diseases; VII. Secondary systemic glomerular diseases; VIII. Arterial hypertension; IX. Nephrolitiasis.
Theoretical-practical sessions: I: The approach to the patient with hematuria; II. The approach of the patient with proteinuria; III. The approach to the patient with azotemia; IV. The approach to the patient with acid-base unbalance; V. The approach to the patient with disturbance of the water, sodium and potassium metabolism.
Practical sessions: Analysis and study centred in the following clinical cases: I. The patient with acute or chronic renal dysfunction in the surgery service or in the intensive care units; II. The patient with hydro-electrolitic or acid-base balance disturbances in the surgery service or in intensive care units; III. The patient with acute renal dysfunction in the internal medicine service; IV. The patient with chronic renal dysfunction in the internal medicine service; V. The patient with nephrology pathology in the external consultation of Nephrology; VI. The patient with chronic renal failure in the regular dialysis program.

Teaching methods and learning activities

Lectures, theoretical-practical and practical sessions.

Gastroenterology:
The workload is of 25h/week: 8.30-13.00h everyday and 14.00 - 17.15h once a week.
Prelections and seminars will take place at 8.30 and 12.00 according to the established plan.
The practical sessions are included in the work integrated in the clinical activity of the Service. Each group of students is distributed into 8 educational groups, each one with 3 to 4 students, that rotate in different sections of the Service: external consultation, wards, complementary exams and emergency service.

Infeccious Diseases:
The total workload of the discipline is 66 hours (daily from 8.30h-13.00h and 14.30h-16.30h.

Nephrology:Lectures, practical sessions, seminars, group sessions, etc. Formally, the lectures of Nephrology consist of ten sessions with a medium 90 minutes duration, total of 15 hours: Semiology (90 minutes); Water, sodium and potassium metabolism disturbances (120 minutes); Disturbances of the acid-base metabolism (120 minutes); Acute renal failure (90 minutes); Chronic renal failure (90 minutes); Hypertension (60 minutes); Nephrolitiasis (60 minutes); Primary glomerulopathies (90 minutes), secondary glomerulopathies (120 minutes). The theoretical-practical sessions occupy 6 to 8 hours in each block and they are aimed at the analysis of six themes. In two of these themes (approach to the patient with hematuria and approach to the patient with proteinuria), the sessions are organized in the following way: the first part it is constituted by a theoretical revision of the subject, during which the outline is delineated to proceed a systematic assessment, diagnostic and therapeutic, of each one of the clinical data. A second part proceeds to the analysis of concrete clinical cases exemplifying clinical practice type situations. In that analysis, it is expected that the debate be centred on the students, while the professor assumes a moderating and advisory role of the study process, in agreement with the outline of clinical and diagnostic assessment previously presented.
In the four remaining themes (approach to the patient with azotemia; approach to the patient with sodium, water and potassium metabolism disturbances; approach to the patient with balance acid-base disturbances and approach to the patient with urinary infection), already treated in the theoretical sessions, the theoretic-practical sessions are exclusively devoted to the analysis of concrete clinical cases, in an attempt to approach the model of the problem analysis. The practical sessions guarantee the students' contact with the clinical situations that constitute models of the main nephrology syndromes. The practical teaching is organized, in each block, through the distribution of the students into 7-9 groups, each one with 3 to 4 students. The students are responsible for the elaboration of clinical reports which are discussed with the professors during the two week period. The students' attendance is the responsibility of the doctors responsible for each sector.

Evaluation Type

Evaluation with final exam

Assessment Components

Description	Type	Time (hours)	Weight (%)	End date
Attendance (estimated)	Participação presencial	0,00
	Total:	-	0,00

Eligibility for exams

The assessment is made at the end of the frequency (documents of each area), during the ninth week of each block. Theorical assessment exam with multiple choice and essay with 64 questions (60 multiple choice and 4 essays). Practical exam with the observation of the one patient. Ponderation of assiduity and participation.

Gastroenterology:
Assessment: Integrated in the Final Exam of Medicine.
Theorical Exam - 15 questions (14 multiple choice and 1 Essay).
Practical Exam – Activity Report; assesment; patient observation and oral discussion with 2 Professors.

Infeccious Diseases:
Continuous assessment
Professionalism and report of clinical daily activities (discussed at the end of the fellowship).
Written Exam: multiple choice questions.
Mandatory the attendance of 2/3 of the sessions.
The final classification corresponds to ¼ of the 5th year Medicine discipline.

Nephrology:
The assessment of the course of Nephrology consists of a multiple choice question test consisting of 15 questions with five hypotheses and a true statement, that approaches the extension of the themes and a practical exam. The minimum requirement for a pass is a mark of 9.5, including all the areas of medicine. The relative weight of the area of Nephrology is 25%.

Calculation formula of final grade

The final classification will be calculated according to the formula 3T+P/4 - T: Theorical exame and P - Practical exam.

Observations

BIBLIOGRAPHY

Gastroenterology:
Doenças do Aparelho Digestivo Semiologia e Laboratório. Ed. Diniz de Freitas, 2005, Edição do autor; Cecil Essentials of Medicine - Ed. TE Andreoli et al., 2001, Saunders; Harrison’s Principle of Internal Medicine, 16th Ed. Mc Graw-Hill, 2005 – Disponibilidade de CD e actualização “on-line” na Biblioteca do Serviço de Gastrenterologia; Diseases of the Liver and Biliaey System Sheila Sherlock, 9th edition 2001; Tratado de Hepatologia, Permaneyer Portugal, Coord. J. Areias, 2006.

Infeccious Diseases:
Principles and Practice of Infectious Diseases - Mandell, Douglas, and Bennett’s – Edited by Gerald L. Mandell, John E. Bennett, Raphael Dolin. 6th Edition - 2005; Infectious Diseases – Cohen J. Powderly W. - 2th Editon - 2004; Maladies Infectieuses et Parasitaires – Encyclopédie Médico-Chirurgicale; Principles of Internal Medicine - Harrison´s - 16th Edition – 2005.

Nephrology:
Primer on Kidney Diseases – (4th Edition) National Kidney Foundation, 2001; Harrison’s Principles of Internal Medicine - (16th Edition) MacGraw-Hill, 2005; Clinical Physiology of Acid-Base and Electrolyte Disorders Burton David Rose. (5th Edition) MacGraw-Hill, 2001. Cecil- Essencials of Medicine – (6th Edition) Suanders, 2004.