45533 - Internal Medicine 2 (A-K)

Learning outcomes

Upon completion of the course, students will have acquired the fundamental knowledge and clinical approach necessary to:

• recognize and assess true emergency conditions based on clinical evaluation and first-line laboratory and instrumental investigations;
• formulate the main differential diagnoses and initiate appropriate early therapeutic interventions;
• plan subsequent management strategies and appropriately refer patients to specialist care pathways.

Course contents

The course provides students with the fundamental knowledge and clinical methodology required for the initial assessment and management of major medical emergencies.

Particular emphasis will be placed on:

• recognizing whether a patient's presentation represents a true medical emergency based on clinical findings and first-line laboratory and instrumental investigations;
• formulating the main differential diagnoses and implementing appropriate initial therapeutic measures;
• planning the medium-term management strategy and identifying the most appropriate specialist referral pathway.

The course will focus on selected major emergency conditions frequently encountered in clinical practice:

1. General principles of emergency medicine

• Definition of urgency and emergency.
• Systematic approach to the critically ill patient (ABCDE approach).
• Assessment of vital signs and recognition of clinical instability.
• Interpretation of first-line laboratory and instrumental investigations.

2. Syncope

• Definition and classification.
• Differential diagnosis of transient loss of consciousness.
• Identification of high-risk features.
• Initial management and indications for specialist referral.

3. Acute pulmonary oedema

• Pathophysiology and main causes.
• Clinical presentation and differential diagnosis of acute dyspnoea.
• Principles of initial treatment and monitoring.

4. Hyperosmolar hyperglycaemic state

• Pathophysiology and diagnostic criteria.
• Differential diagnosis with diabetic ketoacidosis.
• Principles of initial management, including fluid replacement and metabolic correction.

5. Sepsis and septic shock

• Current definitions and diagnostic criteria.
• Early recognition of sepsis.
• Principles of initial treatment, including fluid resuscitation, antimicrobial therapy and haemodynamic support.
• Indications for intensive care referral.

6. Head trauma

• Initial clinical assessment and Glasgow Coma Scale.
• Recognition of red flags and severe injury.
• Indications for imaging studies.
• Initial management and specialist referral pathways.

Clinical cases and interactive discussions will be used to foster clinical reasoning and decision-making skills.

Readings/Bibliography

Recommended textbooks

• Harrison's Principles of Internal Medicine.
• Selected chapters from Emergency Medicine and Internal Medicine textbooks.

Guidelines and additional references

• European Society of Cardiology (ESC) Guidelines on Syncope.
• Surviving Sepsis Campaign Guidelines.
• American Diabetes Association (ADA) Standards of Care.
• European Resuscitation Council (ERC) Guidelines.

Additional educational material, lecture slides and selected scientific articles will be made available through the University e-learning platform

Teaching methods

Teaching activities include:

• frontal lectures;
• discussion of clinical cases;
• guided interpretation of clinical, laboratory and instrumental findings;
• interactive sessions aimed at developing clinical reasoning and decision-making skills in emergency settings.

Given the short duration of the course (8 hours), teaching activities will focus primarily on practical aspects of early recognition and initial management of emergency conditions.

Assessment methods

Final Examination
The final exam will assess the student’s knowledge of the topics covered in the course program. The exam consists of a written test with multiple-choice questions, graded on a 30-point scale.

Any negative evaluation (either “withdrawn” or “failed”) will be recorded in AlmaEsami, as required by the teaching regulations, without affecting the student’s academic record, and the exam may be retaken. A “refusal”of the grade will also be registered in AlmaEsami according to the regulations.

Students must register for the exam through AlmaEsami online within the established deadlines. Examination sessions are scheduled at the end of the lecture period. The recording of the grade obtained in the written test will be carried out in AlmaEsami by the examiner.

Students are reminded that they must present themselves at the exam with their university ID card and a valid identification document. For reasons of privacy protection, students are requested to use only the authenticated institutional email address (nome.cognome@studio.unibo.it ) for all communications regarding their academic record.

Exam dates:
To be defined.

Grading criteria
Assessment will be based on a written test consisting of multiple-choice questions and open-ended questions.

• Multiple-choice questions (15): +2 points for a correct answer; −1 point for an incorrect answer; 0 points if unanswered.

• Open-ended questions (3): +3 points for a correct answer; −3 points for an incorrect or incomplete answer; −1 point if unanswered.

The total time allowed for the written test is 60 minutes. The use of any supporting material (textbooks, notes, electronic devices) is not permitted during the exam.

The maximum achievable score, if all answers are correct and complete, is 30/30 with honors (cum laude).
The minimum passing grade is 18/30.

Use of Artificial Intelligence

The use of generative artificial intelligence tools during the examination is not permitted. Any unauthorized use will be considered a violation of academic integrity (Scenario 1).

Teaching tools

Lectures with video projection. The teaching materials presented during the lessons will be made available to students in electronic format via the internet.

Office hours

See the website of Davide Agnoletti