Endocrine Disorders, Nutrition and Metabolism

Code:

MI427

Acronym:

DENM

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2018/2019 - 1S (of 10-09-2018 to 08-02-2019)

Active?	Yes
Responsible unit:	Department of Medicine
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	151	Mestrado Integrado em Medicina- Plano oficial 2013 (Reforma Curricular)	4	-	6	58	162

Modules

Code	Name
MI427_B
MI427_A

Teaching language

Suitable for English-speaking students

Objectives

Main objective: To acquire the theoretical and clinical practice skills on endocrine, metabolic and nutritional pathology.
Specifc objectives: To identify the most common endocrine, metabolic and nutritional disorders underlying mechanisms. To develop skills in the collection, recording and reporting of clinical information (clinical history and physical examination of endocrine, metabolic and nutritional disorders); To use the information obtained to prepare a list of problems and propose the research to differentiate the main diagnoses and resolve persistent doubts by rational use of complementary diagnostic tools (diagnostic strategy). Acquire a core of theoretical knowledge that allows the resolution of the most frequent endocrine, metabolic and nutritional conditions (resolution of clinical problems). Building a therapeutic strategy using all available means, from the non-pharmacological, such as life style changes, to drugs, surgery and others means of complementary therapy, and be enable to look for information to make decisions.

Learning outcomes and competences

The course contents were designed to allow the student to progress in the acquisition of knowledge, skills and understanding to be able to evaluete, a proposed diagnostic , therapeutic and define a stratagy envolving the various options available. The various diseases and conditions were included in this plan.

Working method

Presencial

Pre-requirements (prior knowledge) and co-requirements (common knowledge)

Students should be able to establish a dialogue with the patient, to obtain a medical history, perform a physical examination and discuss the differential diagnosis.

Program

Introductory Themes (26): 1. Semiology clinical and laboratory of endocrine diseases; 2. Basis of Clinical anatomic or functional abnormalities of the various endocrine glands and breast with surgical implications or consequences of either benign or malignant; 3. Breast male and female breast benign; 4. Breast Tumor Pathology; 5. Obesety and medical treatment; 6. Surgical treatment of obesity; 7. Diabetes type 1 and 2; 8. Complications of diabetes (neuropathy, nephropathy, retinopathy diabetic and cardiovascular complications); 9. Endocrine Hypertension; 10. Atherosclerosis and dyslipidemia; 11. Thyroid dysfunction; 12. Gonadal dysfunction (hypogonadism male, female and erectile dysfunction); 13. Diseases of the pituitary gland (acromegaly, Cushing's Disease, Prolactinoma, non functioning adenomas, Diabetes Insipidus); 14. Adrenal Diseases (Addison's disease, Congenital Adrenal Hyperplasia); 15. Metabolism phospho-calcium (hypercalcemia, hypocalcemia, metabolic bone disease); 16. Thyroid Nodule; 17. Pancreas and Neuroendocrine tumors; 18. Additional Methods of diagnosis of endocrine glands; 19. Surgery of the Adrenal Tumors.
Course of clinical Nutrition: 20. Food - general principles; 21. Nutritional Status; 22. Nutrition and feeding of obese patients; 23. Nutrition and feeding of dyslipidemic patients; 24. Nutrition and feeding of the diabetic patients; 25. Nutritional Support in crtically patients; 26. Nutrition and feeding the patient has renal impairment.
Seminars discussion of clinical cases (13): Duration - 90 minutes.
Method - Clinical cases distributed to the students to prepare a presentation and discussion.
1. Clinical Case - Thyrotoxicosis and Leukopenia. Faculty: Endocrinology, Hematology Clinic.
2. Clinical Case - Cardiovascular disease in diabetic patient. Faculty: Endocrinology, Cardiology.
3. Clinical case - Morbid Obesity, sleep apnea and metabolic syndrome. Faculty: Endocrinology, Surgery, Pulmonology.
4. Clinical case - Hypercalcemia. Faculty: Endocrinology, Surgery, Pathology.
5. Clinical case - Cushing's syndrome. Faculty: Endocrinology, Surgery, Pathology.
6. Clinical case of Diabetes (Acute complications of diabetes). Faculty: Endocrine Therapy.
7. Clinical case of diabetes (Insulin and glycemic self-monitoring). Faculty: Endocrinology, Therapeutics.
8. Clinical cases of Adrenal Diseases (hyperaldosteronism, pheochromocytoma). Faculty: Endocrinology, Surgery, radiology, Pathology.
9. Clinical case - Goiter and nodular thyroid disease. Faculty: Endocrinology, Surgery, Radiology, Pathology.
10. Seminar Thyroid Cancer. Faculty: Endocrinology, Surgery, Radiology, Pathology.
11. Breast Cancer Seminar. Faculty: Surgery, Radiology, Pathology, Oncology.
12. Seminar breast surgery reconstruction. Faculty: Surgery, Radiology, Pathology.
13. Seminar of Obesity Surgical Treatment: Bariatric surgery to plastic surgery. Faculty: Surgery.

Mandatory literature

Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo; Harrison´s Principle of Internal Medicine, Mc Graw Hill 12ª Edição
Shlomo Melmed & Kenneth S. Polonsky & P. Reed Larsen & Henry M. Kronenberg; Williams Textbook of Endocrinology, 13th Edition, elsevier
David Gardner, Dolores Shoback ; Greenspan's Basic and Clinical Endocrinology, Ninth Edition, McGraw-Hill Education
Kathleen Mahan L, Escott- Stump S; Krause's Food & the Nutrition Care Process, 13th Edition , edition Saunders, 2008
Townsend, CM, Beauchamp, RD, Evers, Mark & Mattox, KL ; Sabiston Textbook of Surgery, 19th Edition, Saunders, 2012
Williams NS, Bulstrode CJK, O´Connell PR ; Bailey & Love's Short Practice of Surgery 27th Ed , Hodder Arnold, 2013
Brunicardi FC et al ; Schwartz's Principles of Surgery, 9th Edition, The McGraw-Hill Companies, 2010
Doherty GM ; Current Diagnosis & Treatment: Surgery, 13th Ed, The McGraw-Hill Companies, Inc., 2010

Teaching methods and learning activities

Introductory Themes - 26 lessons of 45 minutes (19.5 hours); 2 classes of 45 minutes/week
Seminars - 13 seminars of 90 minutes (19.5 hours); 1 seminar/week
Clinical practice (ward consultation, support and other services to urgent); 1,5 hors practice/week x 13 weeks - 19 hours.

Evaluation Type

Distributed evaluation with final exam

Assessment Components

Designation	Weight (%)
Exame	25,00
Participação presencial	15,00
Teste	60,00
Total:	100,00

Amount of time allocated to each course unit

Designation	Time (hours)
Apresentação/discussão de um trabalho científico	19,50
Estudo autónomo	104,00
Frequência das aulas	19,50
Realização de Estágio	19,00
Total:	162,00

Eligibility for exams

Students must attend at least 75% of theoretical classes, theoretical practices and seminars.

Calculation formula of final grade

The classification obtained at each evaluation has to be higher than 10.

Calculation formula = (15% continuous evaluation) + (60% theoretical evaluation) + (25% practical evaluation)

Examinations or Special Assignments

The Theoretical Assessment consists of a multiple-choice test with 60 questions, with 5 items, being each sentence valued with 0,33, for a total of 20 values