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Course, academic year 2023/2024
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Internal Medicine I - DA0108369
Title: Internal Medicine I
Guaranteed by: Department of Internal Medicine (13-341)
Faculty: Second Faculty of Medicine
Actual: from 2023 to 2023
Semester: winter
Points: 3
E-Credits: 3
Examination process: winter s.:
Hours per week, examination: winter s.:0/30, C [HT]
Extent per academic year: 5 [weeks]
Capacity: unknown / unlimited (unknown)
Min. number of students: unlimited
4EU+: no
Virtual mobility / capacity: no
Key competences:  
State of the course: taught
Language: English
Teaching methods: full-time
Teaching methods: full-time
Level:  
Guarantor: prof. MUDr. Radan Keil, Ph.D.
Classification: Medicine > Clinical Disciplines
Pre-requisite : DA0105044, DA0105341, DA0105439, DA0105454
Is co-requisite for: DA0108107, DA0108104
Is pre-requisite for: DA0110002, DA0108103, DA0110313, DA0110036, DA0112029, DA0110369
Annotation
Last update: Dita Strnadová (02.02.2024)
Information about Internal Medicine I The subject is composed from theoretical lectures, seminars and clinical practicals. Practicals are run on wards of Internal Clinic. Start of lectures and practicals is specified in time schedule. Students may check which meeting room/ward is assigned to their class: • SIS • on a noticeboard on the floor 4D (in front of secretariat of Internal clinic) The education of 5 blocks will end with a credit test, the dates will be announced in SIS. The test has open-ended questions for free writting. To successfully completed test must have more than 75% of the answers correct, i.e. more than 7.5 points. The results will be written in SIS.
Course completion requirements
Last update: PALACKAJ (31.07.2019)

All practical classes and seminars are compulsory and the attendance is checked.

The lectures are optional but you are requested to attend them if possible.

The student is allowed to miss up to 4 practical classes and seminars during all 5 weeks, but there is necessary to replace them. About substitution of practicals ask your teacher.

For obtaining credit the student must meet following criteria:

  • to complete attendance at practicals and seminars, replace all missed
  • to complete 1 case study report
  • to pass the credit examination successfully

Credit examination finishes the object.

The terms for credit examination will be available in SIS and the examination will take place after finishing the practicals

Literature
Last update: Bc. Daniela Polanecká (08.07.2020)

INTERNAL MEDICINE I.:

Faunci A.: Harrison´s principles of internal medicine : Mc Graw-Hill (B) (2015 - available as ebook)

Andreoli, T. E.: Andreoli and Carpenter's Cecil essentials of medicine : Saunders Elsevier, 2010 (B)

(available as ebook)

Kumar, P.: Kumar & Clark's clinical medicine. Elsevier 2012 (B) (available as ebook)

Khan, M.G.: Rapid ECG interpretation. Springer 2008 (B)

Requirements to the exam
Last update: PALACKAJ (19.10.2018)

4TH YEAR – INTERNATIONAL STUDENTS – CREDIT

(valid from October 1st, 2018)

1. Acute heart failure

2. Chronic heart failure and its complex therapy

3. Aortic valvular disorders

4. Mitral valvular disorders

5. Coronary artery disease – acute forms

6. Chronic coronary artery disease – classification, etiology

7. Chronic coronary artery disease – diagnostics, therapy

8. Acute myocardial infarction

9. Complications of myocardial infarction

10. Shock

11. Arterial hypertension

12. Secondary hypertension

13. Pulmonary embolism

14. Congenital heart defects in adults

15. Inflammatory disorders of the heart (myocarditis, pericarditis…)

16. Infective endocarditis

17. Cardiomyopathies

18. Cardiac tamponade

19. Supraventricular arrhythmias

20. Ventricular arrhythmias

21. Atrial fibrillation – symptomatology, diagnosis and therapy

22. Cor pulmonale

23. Circulatory and breathing arrest, cardiopulmonary resuscitation

24. Disorders of aorta

25. Disorders of brain arteries, stroke

26. Acute and chronic disorders of peripheral arteries

27. Acute and chronic disorders of peripheral veins

28. Type 1 Diabetes mellitus – patophysiology, clinical presentation, diagnostics

29. Type 2 Diabetes mellitus – patophysiology, clinical presentation, diagnostics

30. Basic principles of treatment of type 1 and type 2 diabetes

31. Acute complications of diabetes mellitus

32. Chronic complications of diabetes mellitus

33. Obesity, syndrome of insulin resistance

34. Community-acquired pneumonia

35. Hospital-acquired pneumonia

36. Pulmonary tuberculosis

37. Bronchial asthma – classification, therapy and prevention

38. Acute bronchial asthma

39. Chronic bronchitis, bronchiectasis

40. Chronic obstructive pulmonary disease (COPD) – diagnosis and therapy in a stable patient

41. Acute exacerbation of the chronic obstructive pulmonary disease

42. Idiopathic pulmonary fibrosis

43. Lung cancer

44. Pleural effusions

45. Pneumothorax

46. Acute and chronic respiratory insufficiency

47. Disturbances of lipid metabolism

48. Atherosclerosis

49. Gastrointestinal bleeding

50. Disorders of esophagus

51. Peptic ulcer disease

52. Tumors of stomach

53. Inflammatory bowel disease

54. Colonic polyps and colorectal cancer

55. Non-neoplasmatic disorders of bowel – diverticulosis, diverticulitis

56. Functional gastrointestinal disorders, coeliac disease

57. Cholelithiasis and its complication

58. Acute and chronic pancreatitis

59. Acute hepatitis

60. Chronic hepatitis

61. Liver cirrhosis

62. Portal hypertension – classification, complication, therapy and prognosis

63. Acute and chronic liver failure

64. Tumors of liver, bile duct, gallbladder and pancreas

Syllabus
Last update: PALACKAJ (31.07.2019)

Syllabus of lectures and seminars of Internal Medicine I

Pulmonology:

1. Emergency in pulmonology

The presentation gives an overview of emergency situations in pneumology, their etiology, pathogenesis, clinical features, diagnosis, and treatment. Attention is paid to imaging methods.

Required knowledge: anatomy, physiology of lungs and ventilation

2. Bronchoscopy

Overview of indications, types, complications, and benefits of this important examination.

Required knowledge: anatomy, physiology of lungs and ventilation

3. Acute and chronic respiratory insufficiency

The lecture deals with the definition, pathophysiology, clinical presentation, diagnostic approaches, and therapeutic measures in conditions associated with respiratory insufficiency.

Required knowledge: anatomy, physiology of lungs and ventilation

4. COPD

Etiology, pathophysiology, risk factors. Clinical presentation, physical examination, functional testing, imaging methods. Therapy and importance of non-smoking.

Required knowledge: anatomy, physiology of lungs and ventilation

5. Dyspnea

The presentation gives an overview of the etiology, pathogenesis, clinical features, differential diagnosis, and treatment of dyspnea. Attention is paid to imaging methods.

Required knowledge: anatomy, physiology of lungs and ventilation

6. Asthma bronchiale

The presentation gives an overview of the definition, etiology, pathogenesis, clinical features, diagnosis, classification, and treatment of bronchial asthma. The latest international guidelines are considered (GINA).

Required knowledge: anatomy, physiology of lungs and ventilation

7. Interstitial lung diseases

The lecture deals with the definition, pathophysiology, clinical presentation, diagnostic approaches, and therapeutic measures in interstitial pulmonary processes, as disease model is discussed sarcoidosis in detail. Idiopathic pulmonary fibrosis - the presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment of idiopathic pulmonary fibrosis. Attention is paid to imaging methods.

Required knowledge: anatomy, physiology of lungs and ventilation

8. Hemoptysis

The presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, differential diagnosis, and treatment of hemoptysis. Attention is paid to imaging methods.

Required knowledge: anatomy, physiology of lungs and ventilation

9. Pneumonias

The presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment of community acquired and hospital acquired pneumonia and pneumonia in immunocompromised host. Attention is paid to imaging methods.

Required knowledge: anatomy, physiology of lungs and ventilation

10. Pleural effusion

The presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment of pleural effusion. Attention is paid to imaging methods.

Required knowledge: anatomy, physiology of lungs and ventilation

11. Tuberculosis

The presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment of tuberculosis. Attention is paid to new methods of diagnosis of latent tuberculosis, vaccination, and other measures of control of tuberculosis.

Required knowledge: anatomy, physiology of lungs and ventilation, microbiology of tbc

12. Lung cancer

The presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment of lung cancer. Attention is paid to imaging methods and prevention of this disease.

Required knowledge: anatomy, physiology of lungs and ventilation

Gastroenterology:

1. Examination methods in gastroenterology and hematology

History, common complaints. Physical examination. Ultrasound, X-ray, CT, and MR imaging. Endoscopic and biochemical methods.

Required knowledge: anatomy, physiology of gastrointestinal tract

2. Gastroesophageal reflux disease. Peptic ulcer of stomach and duodenum. Tumors of stomach. The presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, diagnosis and treatment of gastroesophageal reflux disease, peptic ulcers, and stomach tumors. Attention is paid to imaging methods and prevention of this disease.

Required knowledge: anatomy, physiology of gastrointestinal tract

3. Inflammatory bowel disease

The presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment of inflammatory bowel disease. Attention is paid to imaging methods.

Required knowledge: anatomy, physiology of gastrointestinal tract

4. Intestinal polyps, cancer of large intestine and rectum

The presentation gives an overview of the epidemiology, etiology, pathogenesis, clinical features, diagnosis and treatment of intestinal polyps and cancer. Attention is paid to imaging methods, screening and prevention of this disease.

Required knowledge: anatomy, physiology of gastrointestinal tract

5. Gastrointestinal bleeding, chronic pancreatitis

Acute bleeding to the gastrointestinal tract, main clinical symptoms, differences in clinical symptomatology dependent on etiology of the bleeding. Importance of circulation stabilization, endoscopy methods for examination and treatment. Chronic pancreatitis - definition, pathogenesis, etiology. Risk factors, clinical presentation, physical examination, lab results and imaging methods. Treatment.

Required knowledge: anatomy, physiology of gastrointestinal tract

6. Cholelithiasis and its complications

Definition: Cholecystolithiasis - biliary stones in the gallbladder, choledocholithiasis - biliary stones in the common bile duct and hepatic duct. Incidence, etiology, clinical presentation, laboratory results, imaging methods, therapy.

Required knowledge: anatomy, physiology of hepatobiliary area

7. Chronic hepatitis, cirrhosis of the liver

Definition, etiology, and pathophysiology. Viral, autoimmune, and other chronic hepatitis. Diagnosis, imaging methods, treatment, and complications of this disease. Liver cirrhosis - etiology, pathophysiology, clinical presentation, lab, and imaging methods. Treatment and complications.

Required knowledge: anatomy, physiology of liver

8. Portal hypertension, hepatic failure

Definition, anatomy, and pathophysiology of portal hypertension. Etiology, diagnostics, clinical presentation, complications, and therapy. Definition and incidence of liver failure, etiology and pathophysiology, complications, diagnosis, and treatment.

Required knowledge: anatomy, physiology of liver

9. Differential diagnosis of jaundice

Review of basic types of icterus, (prehepatic, hepatic, posthepatic), clinical presentation, lab results, imaging methods. Case reports.

Required knowledge: anatomy, physiology of liver

10. Differential diagnosis of fever states

Pathophysiological of temperature, types of temperature, diagnostic methods. Febrile states by etiology: infection, tumors, systematic disease. Sub febrile states, invasive methods as febrile source.

Required knowledge: physiological and pathophysiological knowledge of thermoregulation

11. Disturbances of GI tract passage. Required knowledge: anatomy, physiology of gastrointestinal tract

Diabetology a metabolism:

1. Diabetes mellitus part I

Etiology, pathogenesis, clinical presentation, diagnostic. Classification and differential diagnostics of diabetes.

Required knowledge: physiology and pathophysiology of metabolism

2. Diabetes mellitus part II

Chronic diabetes complication. Clinical presentation, diagnostics, and treatment.

Required knowledge: physiology and pathophysiology of metabolism

3. Acute complication of diabetes. Differential diagnosis of hypoglycemia. Required knowledge: physiology and pathophysiology of metabolism

4. Treatment of diabetes mellitus

Treatment with oral antidiabetic agents and insulin treatment. Differences in treatment of type 1 and 2 diabetes. Diet and physical exercise.

Required knowledge: physiology and pathophysiology of metabolism

5. Nutritional disorders (obesity, cachexia)

Definition, measurement, classification of obesity. Examination of an obese patient (history, specifics in obesity), function and distribution of adipose tissue, complication of obesity. Therapy (behavior modification, diet, exercise, psychotherapy, drugs, surgery). Definition, etiology of malnutrition, diagnostic and types, laboratory parameters, complications. Required knowledge: physiology and pathophysiology of metabolism

6. Disorders of lipid metabolism

Dyslipidemia - risks and classification. Goals for treatment, recommended targets for dyslipidemia treatment. Lab results. Required knowledge: physiology and pathophysiology of metabolism

7. Atherosclerosis and endothelial dysfunction

Required knowledge: physiology and pathophysiology of metabolism

Cardiology:

1. Acute coronary syndromes

Etiology, pathophysiology, risk factors. Clinical presentation, examination, diagnostics, treatment.

Required knowledge: physiology and pathophysiology of circulation

2. Atherosclerosis and chronic coronary heart disease

Introductory lecture to clinical aspects of coronary heart disease (CHD) defining clinical forms of CHD. It defines principles of coronary circulation in a heathy individual, as well as normal functions of endothelium. Endothelial dysfunction is presented in relation to atherogenesis together with main risk factors of CHD. Of clinical forms of CHD, effort angina pectoris and silent ischemia are presented (clinical symptomatology, examinations, non-invasive and invasive treatment).

Required knowledge: physiology and pathophysiology of circulation

3. Valvular heart disease

Etiology, pathophysiology, risk factors. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

4. Arrhythmias

Etiology, pathophysiology, risk factors. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

5. Congestive heart failure

Etiology, pathophysiology, risk factors. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

6. Cor pulmonale, pulmonary embolism

Etiology, pathophysiology, risk factors. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

7. Hypertension

Etiology, pathophysiology, risk factors. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

8. Shock

Presentation composed of two parts. The general one defines symptoms and signs of shock, diagnostic principles, as well as general therapeutic possibilities. The second part presents cardiogenic shock in myocardial infarction, in pulmonary embolism and in cardiac tamponade. Oligemic shock is presented mainly in connections important for internal medicine. Distributary shock, septic and anaphylactic shock are presented.

Required knowledge: physiology and pathophysiology of circulation

9. Cardiomyopathies

Etiology, pathophysiology, risk factors. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

10. Myocarditis, pericarditis, endocarditis

Etiology, pathophysiology, risk factors. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

11. Differential diagnosis of chest pains

Etiology, pathophysiology, risk factors. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

12. Differential diagnosis of syncope. Required knowledge: physiology and pathophysiology of circulation.

13. Differential diagnosis of dyspnea. Required knowledge: physiology and pathophysiology of circulation

14. Basic ECG records

Clinical presentation, basic ECG records of most important dysrhythmias.

Required knowledge: physiology and pathophysiology of circulation

15. Disorders of limb arteries and veins

Etiology, pathophysiology, risk factors of arterial and venous disease of peripheral vessels. Clinical presentation, imaging methods, treatment.

Required knowledge: physiology and pathophysiology of circulation

Head supervisor of teaching of Internal Medicine I is:

prof. MUDr. Milan Kvapil, CSc., MBA

Responsible person: as. MUDr. Pavlína Piťhová, Ph.D., tel. 22443 4014, 4067

 
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