37223 - Internal Medicine I (A)

Learning outcomes

By the end of the course, students will have acquired the general principles of pathophysiology necessary for interpreting clinical findings in their future medical practice. Specifically, this knowledge provides a comprehensive understanding of the mechanisms underlying organ and system dysfunction, which give rise to both clinical and semiological manifestations. Furthermore, students will be able to properly approach patient care concerning the physical examination. They will develop the ability to independently evaluate various body systems by applying the investigative procedures fundamental to clinical methodology. The integration of clinical pathophysiology and medical semiotics will empower students to understand the fundamental basis of diseases, serving as a preparatory foundation for their subsequent medical studies.

Course contents

The 16 hours of the module included within the integrated course will cover the following topics:

1. Fundamentals of Clinical Methodology:
- General approach to the patient and clinical interview
- Family, physiological, and occupational history
- Past medical history and pharmacological profile (current medications)
- History of present illness and characterization of the chief complaint
- Measurement and interpretation of vital signs (body temperature, blood pressure, heart and respiratory rate, oxygen saturation)
- Clinical reasoning: from sign/symptom to diagnostic hypothesis

2. Approach to Respiratory Semiotics:
- Inspection, palpation, percussion, and auscultation
- Tactile vocal fremitus
- Vesicular breath sounds and adventitious breath sounds (wet and dry)
- Semiological overview of major respiratory diseases (asthma, pulmonary emphysema, lobar pneumonia, pleural effusion, pneumothorax)

3. Approach to Cardiovascular Semiotics:
- Inspection, palpation, percussion, and auscultation
- Cardiac auscultation areas
- Heart sounds: physiology and pathological aspects
- Extra heart sounds: S3 and S4
- Systolic clicks
- Heart murmurs: physiology and pathological aspects
- General overview of signs and symptoms of cardiac diseases

4. Approach to Peripheral Vascular Semiotics:
- Inspection, palpation, and auscultation
- Arterial pulses
- Signs and symptoms of lower limb arterial ischemia
- Signs and symptoms of lower limb chronic venous insufficiency


Practical Laboratory (17 hours)

The Practical Laboratory aims at the theoretical-practical integration of the acquired knowledge and the provision of experiential learning preparatory to clinical ward clerkships.
Teaching methodology: guided exercises, clinical simulations, and interactive group activities.
Target competencies and educational activities:
- Data collection: practical execution of the medical interview and history taking.
- Clinical examination: execution of the general and systemic physical examination.
- Instrumentation: critical and correct use of basic clinical examination instruments.
- Doctor-Patient relationship and communication: development of effective communication skills, management of interviews in difficult clinical situations, and techniques for breaking bad news.

Readings/Bibliography

• G Fradà e G. Fradà. Semeiotica medica nell’adulto e nell’anziano.VI edizione. Piccin editore. 2018
• A Amoroso e F Rossi Fanelli. Semeiotica Medica e Metodologia Clinica. II edizione. Delfino editore. 2018
• GE Gerunda. Metodologia Medica e Chirurgica. I edizione. Idselson Gnocchi editore. 2020
• G Sesti. Metodologia Medica e Chirurgica. La Semeiotica Medica. Il metodo clinico passo dopo passo. I edizione. EDRA editore. 2022
• MacLeod’s Clinical Examination. XV edizione. Elesevier editore. 2023
• eBook: Bates’ guide to physical examination and history taking. Lynn S Bikley. 12th Edition. Wolter Kluwers Edition. 2018. Disponibile su Amazon.com come versione per Kindle o libro stampato

Teaching methods

Lectures and student interactions supported by educational materials, including PowerPoint slides and video resources, which are available to all students via the JoVE digital platform.

Assessment methods

The final assessment for the integrated course consists of an oral examination covering the four constituent disciplines. The final grade is determined by the weighted average of the scores achieved in each respective module.

Teaching tools

Educational materials presented during lectures (PowerPoint slides) are made available to students. When provided in advance, students may bring these materials to the lectures. Access to the video resources in the Clinical Skills section of the JoVE platform () is free of charge for all faculty and students of the University of Bologna. Instructions on how to access the platform will be provided to students at the beginning of the course.

Office hours

See the website of Giacomo Zaccherini