Learning objectives
The student will have to correctly address the main internal medicine clinical scenarios in an Emergency-urgency setting, and will have to know the basics of therapeutics.
Prerequisites
Knowledge of physiopathology, semeiotics and clinical methodology, basics of clinical pharmacology.
Course unit content
The "Internal Medicine" module is integrated within the course of "Urgency Medicine and First Aid" with the aim of giving medical students knowledge of the approach to the main medical emergencies in both a territorial and hospital context, with particular focus on the management of these conditions in an hospital Emergency Department. Students will have to be able to orient themselves in the differential diagnosis of the main acute symptoms, know the main diseases of interest in the context of emergency-urgency medicine, know the main life-saving manoeuvres and know the basics of therapeutics that are used in territorial and intra-hospital emergencies. They will also have to get knowledge of the main alterations of instrumental examinations and laboratory tests of interest in a context of emergency/urgency medicine. The organization of an Emergency Department and its impact on the healthcare need satisfaction of the population will be particularly focused during the course.
Full programme
1) Alarm Symptoms (coma, cardiopalm, headache, motor deficiency, diarrhea, dyspnoea, pain, bleeding, fever, back pain, vomiting, etc.).
2) Cardiovascular emergencies (arrhythmias, acute coronary syndrome, pulmonary embolism, acute pulmonary edema, pericarditis, aneurysms, critical ischemia, hypertensive crises).
3) Pulmonary emergencies (bronchospasm, pneumonia, pneumothorax, respiratory failure).
4) Emergencies of the digestive system (digestive bleeding, perforation, acute appendicitis, intestinal occlusion, acute pancreatitis, acute diverticulitis, biliary colic).
5) Neurological and psychiatric emergencies (epilepsy, TIA, stroke, intracranial hemorrhage, delirium, acute psychosis, drug and / or narcotic abuse).
6) Infective illnesses (meningitis, sepsis, endocarditis).
7) Endocrinological emergencies (diabetic ketoacidosis, hyperosmolar syndromes, Addison's disease, thyrotoxicosis).
8) Hematological emergencies (coagulopathy, acute anemia, acute leukemia, acute piastrinopenia).
9) Nephro-urologic emergencies (renal colic, acute renal failure, nephritic syndrome).
10) Acute acid-base and hydro-electrolyte balance alterations.
11) Internistic polyrauma complications (Crush syndrome, compartmental syndrome, rhabdomyolysis).
12) Shock: definition, classification, clinical and therapeutic approach.
13) Healthcare Principles (triage, overcrowding in Emergency Departments: Causes, Consequences and Remedies).
Bibliography
Casagranda-Ghiselli. Medicina d'Emergenza-Urgenza. Ed Idelson-Gnocchi 2017
Teaching material published on the Elly Medicina site, which is accessible to all the course students
Teaching methods
Frontal lessons with a strong interactive component, possibly organized as seminars also with the partecipation of clinicians and Emergency Medicine residents. These seminars will be structured as collegial discussion of simulated clinical cases, in which students will be interactively involved.
Due to the COVID-19 pandemic, in compliance with Italian law and local regulations, lessons will be delivered with 30% of students in classroom and 70% connected with online streaming. In case of emergency clinical situations due to the COVID-19 pandemic, part of the lessons may be delivered in pre-recorded online streaming.
Assessment methods and criteria
Oral examination. Students will be asked to discuss the clinical approach to a simulated clinical case, a disease or an acute symptom in the context of territorial emergency services or hospital Emergency Department. They will also be asked to outline general principles of therapeutics in the proposed clinical case or disease.
