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Endocrine Disorders, Nutrition and Metabolism

Code: MI434     Acronym: DENM

Keywords
Classification Keyword
OFICIAL Medicine

Instance: 2022/2023 - 2S Ícone do Moodle

Active? Yes
Responsible unit: Department of Medicine
Course/CS Responsible: Master Degree in Medicine

Cycles of Study/Courses

Acronym No. of Students Study Plan Curricular Years Credits UCN Credits ECTS Contact hours Total Time
MIMED 135 Plano Oficial 2021 4 - 5 47 135

Teaching Staff - Responsibilities

Teacher Responsibility
Davide Maurício Costa Carvalho

Teaching - Hours

Theoretical classes: 1,07
Theoretical and practical : 0,86
Seminar: 0,21
Traineeship: 1,21
Type Teacher Classes Hour
Theoretical classes Totals 4 4,284
Manuel Celestino da Silva Neves 0,514
António Manuel Ferreira de Gouveia 0,428
Ana Maria Varela Sande 0,30
Paula Isabel Marques Simões de Freitas 0,514
Luís Manuel de Oliveira Sá Vinhas 0,214
Davide Maurício Costa Carvalho 1,371
Maria Elisabete Gonçalves Rodrigues 0,514
João Alberto Capela Alves Rodrigues Costa 0,428
Theoretical and practical Totals 4 3,428
João Alberto Capela Alves Rodrigues Costa 0,571
Ana Maria Varela Sande 0,199
Manuel Celestino da Silva Neves 0,236
Luís Manuel de Oliveira Sá Vinhas 0,571
Maria Elisabete Gonçalves Rodrigues 0,522
Paula Isabel Marques Simões de Freitas 0,236
Davide Maurício Costa Carvalho 0,522
António Manuel Ferreira de Gouveia 0,571
Seminar Totals 8 1,712
José Manuel Pedrosa Baptista Lopes 0,294
Vanessa Alexandra Guerreiro Gonçalves 0,071
Elsa Maria Pereira da Fonseca 0,171
Fernando Miguel da Silva Mendonça 0,071
Juliana Patrícia Ribeiro Gonçalves 0,071
Telma Cid Lopes Moreno 0,071
Cristina de Jesus da Costa Fernandes 0,071
Maria Manuel Faria de Sousa e Silva 0,071
Jorge Manuel Pires Pedro 0,071
Vítor Bruno dos Santos Devezas 0,071
Maria Helena Queiroz Machado Urbano Ferreira 0,071
Maria de Fátima Machado Henriques Carneiro 0,135
Gil Filipe Ramada Faria 0,071
Ana Sara Varela Mendes Ribeiro 0,071
João Manuel Marques Miranda Magalhães 0,086
Fernando Carlos de Landér Schmitt 0,171
João Sérgio de Lima Soares Neves 0,071
Traineeship Totals 32 38,848
Davide Maurício Costa Carvalho 6,761
Fernando Miguel da Silva Mendonça 0,60
Duarte Luís Pignatelli Dias Almeida 0,40
Cristina de Jesus da Costa Fernandes 0,50
Maria Manuel Faria de Sousa e Silva 0,40
Telma Cid Lopes Moreno 0,60
Rosa Maria Monteiro Castro de Araújo Príncipe 2,10
Selma Maria Barbosa Souto 2,10
Paula Isabel Marques Simões de Freitas 3,00
João Sérgio de Lima Soares Neves 0,50
Juliana Patrícia Ribeiro Gonçalves 0,60
Maria Helena Queiroz Machado Urbano Ferreira 0,60
Ana Sara Varela Mendes Ribeiro 0,60
Manuel Celestino da Silva Neves 3,449
Maria Elisabete Gonçalves Rodrigues 3,163
Luís Manuel de Oliveira Sá Vinhas 1,914
Gil Filipe Ramada Faria 0,80
Patrícia Andrea Pinheiro da Silva Sousa Ferreira Bouça Machado 0,002
João Alberto Capela Alves Rodrigues Costa 2,10
Susana Isabel Mourão Domingues 2,40
Vanessa Alexandra Guerreiro Gonçalves 0,40
Vítor Bruno dos Santos Devezas 0,50
Ana Maria Varela Sande 3,70
António Manuel Ferreira de Gouveia 1,059
Jorge Manuel Pires Pedro 0,60

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; 2nd and 3rd 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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