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Endocrine Disorders, Nutrition and Metabolism

Code:

MI434

Acronym:

DENM

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2022/2023 - 1S

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	147	Plano Oficial 2021	4	-	5	47	135

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 lifestyle changes, to drugs, surgery and others means of complementary therapy, and be enable to look for information to make decisions.

Learning outcomes and competences

Syllabus and teaching methodologies were designed to allow the student to progress in the acquisition of knowledge and skills to achieve the defined learning objectives.

Evaluation methods will seek to determine whether learning objectives have been achieved and, therefore, will include a knowledge

Working method

Presencial

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

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

Students should be aware of the possible complementary diagnostic methods to use: laboratory tests, imaging tests, and other complementary diagnostic tests.

Program

Introductory Themes: 45 minutes duration; Method - Exposure.
1. Clinical and laboratory semiology of endocrine diseases;
2. Pituitary diseases (Acromegaly, Cushing's Disease, Prolactinoma, Non-functioning Adenoma, Diabetes insipidus);
3. Obesity and non-surgical treatment (nutrition, physical activity, and pharmacological treatment)
4.Surgical treatment of obesity; metabolic surgery;
5. Diabetes mellitus: Diagnosis, classification and diabetes types;
6. Late Complications of Diabetes (Neuropathy, Nephropathy, Diabetic Retinopathy and Cardiovascular Complications);
7. Endocrine Hypertension;
8. Atherosclerosis and dyslipidemia;
9. Thyroid dysfunction;
10. Thyroid nodular pathology;
11. Surgical treatment of thyroid disease;
12. Gonadal dysfunction (Male and Female Hypogonadism and Erectile Dysfunction);
13. Adrenal diseases (Addison's Disease, Congenital Adrenal Hyperplasia);
14. Surgical treatment of Adrenal diseases;
15. Disorders of phospho-calcium metabolism (Hypercalcemia, Hypocalcemia, Metabolic bone disorders);
16. Surgical treatment of parathyroid diseases;
17. Pancreas and neuroendocrine tumors (NET's); surgical treatment;
18. Food: general principles;
19. Nutritional status assessment;
20. Nutrition and nutrition for diabetic and dyslipidemic patients;

Clinical case discussion Seminars (10):

Duration 90 minutes.
Method - Clinical cases: presentation and discussion.
1. Pituitary Tumors. Faculty: Endocrinology;
2. Obesity: From prevention to therapeutics. Faculty: Endocrinology, Surgery.
3. Morbid obesity: Surgical and endoscopic treatment. Faculty: Surgery, Endocrinology.
4. Diabetes: Insulin therapy and glycemic self-monitoring). Faculty: Endocrinology;
5. Diabetes: Acute complications. Faculty: Endocrinology;
6. Cardiovascular disease in a diabetic patient. Faculty: Endocrinology;
7. Hypercalcemia. Faculty: Endocrinology, Surgery;
8. Suprarenal diseases (Hyperaldosteronism, Pheochromocytoma). Faculty: Endocrinology, Surgery and Pathological Anatomy;
9. Thyroid nodular pathology; thyroid dysfunction. Faculty: Endocrinology, Surgery, Pathological Anatomy;
10. Thyroid cancer. Faculty: Endocrinology, Surgery, Pathological Anatomy.

Practice – 7 practical lessons in 3 weeks: 4 lessons of Medical Endocrinology and 3 of Surgical Endocrinology.

Total: First week, 8 hours; 2^nd and 3^rd weeks, 4.5 hours.

Mandatory literature

Vários; Endocrinologia Clínica, Vilar L, Kater C, Naves L, Freitas MC, Albuquerque L, Diniz ET; Carvalho D, 2021. ISBN: 9788527736664
Fauci A, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo; Harrison´s Principle of Internal Medicine, Mc Graw Hill 20ª Edition, 2018. ISBN: 9781259644030

Complementary Bibliography

Shlomo Melmed & Kenneth S. Polonsky & P. Reed Larsen & Henry M. Kronenberg; Williams Textbook of Endocrinology, 13th Edition, elsevier
Townsend, CM, Beauchamp, RD, Evers, Mark & Mattox, KL ; Sabiston Textbook of Surgery, 19th Edition, Saunders, 2012
Doherty GM ; Current Diagnosis & Treatment: Surgery, 13th Ed, The McGraw-Hill Companies, Inc., 2010
Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo; Harrison´s Principle of Internal Medicine, Mc Graw Hill 12ª Edição
Kathleen Mahan L, Escott- Stump S; Krause's Food & the Nutrition Care Process, 13th Edition , edition Saunders, 2008
Williams NS, Bulstrode CJK, O´Connell PR ; Bailey & Love's Short Practice of Surgery 27th Ed , Hodder Arnold, 2013
Ivor B, Giggs R, Wing E and Fitz J; Andreoli and Carpenters's Cecil Essential of Medicine. , Elsevier Health Science, 2015

Teaching methods and learning activities

Introductory Themes - 20 lessons of 45 minutes (15 hours); 2 classes of 45 minutes/week
Seminars - 10 seminars of 90 minutes (15 hours); 1 seminar/week
Clinical practice (ward consultation, support to other departments and emergency room)17 hours; 8 hours clinical practice/1st week; 4.5 hours in the 2nd and 3rd week.

Evaluation Type

Distributed evaluation with final exam

Assessment Components

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

Amount of time allocated to each course unit

Designation	Time (hours)
Estudo autónomo	88,00
Frequência das aulas	27,50
Realização de Estágio	19,50
Total:	135,00

Eligibility for exams

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

Calculation formula of final grade

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

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

Examinations or Special Assignments

The Theoretical Assessment consists of a multiple choice test with 60 questions, with 5 items, of which one sentence, with a value of 0.33 / each, for a total of 20 values (60%).

Practical evaluation: two teachers 1 Endocrinology and 1 of Surgery (25%).

The main objective is the evaluation of general and cross-cutting competencies necessary for all physicians, regardless of their future specialty:

Medical-patient and medical-other health professionals interaction

Ability to develop a clinical history expeditiously, organized and coherently

Ability to perform simple but relevant physical examination gestures

Ability to analyze some simple complementary diagnostic tests

Ability to integrate information into coherent diagnostic hypotheses

Ability to develop a summary therapeutic plan.

1 - General impression and posture of the student. Identification of the patient and collection of the clinical history - 6 values.

1.1 - do you have an appropriate posture in contact with the patient and know how to collect the patient's identification?

1. 2 - do you know why you have recourse to medical care and/or hospitalization?

1.3 – Do you know how to adequately reap a clinical history, including personal, family and other anamnesis factors?

2 - Physical Examination - 4 values.

2.1 - do you know how to perform simple and basic gestures of the physical examination?

2.2 – the student must perform 3 practical maneuvers that are part of the UC(s) program.

3 - Request and interpretation of Complementary Exams - 4 values.

3.1 – the student must be able to choose appropriate complementary diagnostic tests and/or interpret some of the specimens presented (analyses, Rx, Echo, Scintigraphy, CT, EDA, etc.).

4 - Correct interpretation of the information obtained and ability to integrate in diagnostic hypotheses and therapeutic plans - 6 values.

4.1 – the student should know how to integrate the information into coherent diagnostic hypotheses (regardless of the diagnosis of the specific patient).

4.2 - it should be able to elaborate a summary therapeutic plan according to the diagnostic hypotheses.

Continuous evaluation - evaluation carried out by the assistants regarding the performance and quality of knowledge, the skills demonstrated in the performance of gestures, commitment and attitudes (15%).

Ability to integrate knowledge and skills into clinical practice; Performance in the execution of procedures and gestures; Quality of communication with patients and health professionals; Trainee's personal commitment to his learning.

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

The classification obtained in each evaluation component must be equal to or greater than 50% (10).

Validity of the classification of continuous and practical evaluation

The continuous evaluation is valid for 2 years, except for the 2nd half of 2019-2020, because it concerns only 1 month. Similarly, the practical evaluation will be valid for 2 years (except for the 2nd half of 2019-2020).

Internship work/project

The Curricular Unity does not require the elaboration of a project.

Special assessment (TE, DA, ...)

For student workers, association leaders and other special situations (with the impossibility of attending practical classes), continuous evaluation may be replaced by a 60-minute practical examination with 2 teachers.

Classification improvement

Students who already approve who wish to improve the qualification obtained, must register for it and inform the uc coordination for scheduling their practical exam.

The improvement of classification requires the repetition of the theoretical examination and the practical examination, and the continuous evaluation is valid for 2 years (except that of the 2nd semester of 2019-2020).

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