KNOWLEDGE AND UNDERSTANDING. At the end of the course the student must demonstrate knowledge of the symptoms and signs of the main organ failures and pathologies. He must demonstrate the ability to understand the fundamental principles of semiotics.
APPLIED KNOWLEDGE AND UNDERSTANDING. At the end of the course the student must be able to collect the family, physiological, remote pathological and proximate pathological anamnesis. The student must be able to conduct an objective examination by applying the fundamental principles of semiotics: inspection, palpation, percussion and auscultation.
AUTONOMY OF JUDGMENT. At the end of the course the student must demonstrate that he has not only acquired knowledge and concepts, but also that he knows how to recognize the signs and symptoms through a correct examination methodology and that he is able to provide appropriate judgments.
COMMUNICATION SKILLS. At the end of the course the student must be able to express and argue appropriately through the correct use of the glossary acquired with the lessons provided, the teaching material and the reference texts.
LEARNING ABILITY. At the end of the course the student must demonstrate that he is able to apply the knowledge, skills and competences described in this syllabus.

The candidate shall have passed the exam of general pathology.

1)INTRODUCTION to semeiotics
2) MEETING THE PATIENT: anamnesis and general objective examination
3) GENERAL OBJECTIVE EXAMINATION
4) VITAL SIGNS: breathing, fever, blood pressure, arterial pulse
5) PULSE WAVE ANALYSIS
6) GENERAL SEMEIOTICS OF PAIN
7) SIGNS AND SYMPTOMS of major organ disorders
8) OBJECTIVE EXAMINATION OF HEAD AND NECK: external eye, internal eye, thyroid and oral cavity
9) OBJECTIVE EXAMINATION OF THE THORAX
10) OBJECTIVE EXAMINATION OF THE HEART AND LARGEV^ VESSELS
11) OBJECTIVE EXAMINATION OF LIVER AND SPLEEN
12) OBJECTIVE EXAMINATION OF THE UROGENITAL SYSTEM
13) OBJECTIVE EXAMINATION OF THE NERVOUS SYSTEM
14) OBJECTIVE EXAMINATION OF THE MUSCULOSKELETAL SYSTEM
15) OBJECTIVE EXAMINATION OF THE OSTEOARTICULAR SYSTEM and major rheumatological diseases.

Fradà - Semeiotica Medica;
Harrison's Principles of Internal Medicine.

INTRODUCTION TO SEMEIOTICS: knowing, knowing how to do, knowing how to be.
ANAMNESIS: anamnesis at the first visit (family medical history, remote pathological history, proximate pathological anamnesis); anamnesis at the follow-up visit; clinical diary.
VITAL SIGNS: a) characteristics of the arterial pulse (frequency, rhythm, amplitude, equality, duration, strength, tension, consistency, symmetry and synchrony) and study of the pulse wave; b) arterial pressure and methods of detection; c) characteristics of breathing and pathological breathing; d) fever: accompanying signs, mode of onset and disappearance, temperature curve, differences between hyperthermia and hyperpyrexia.
GENERAL PHYSICAL EXAMINATION: a) age; b) sex; c) psyche and sensorium; d) facies; e) somatic conformation; f) constitutional biotype and anthropometric measurements; g) decubitus; h) hydration status; i) skin and skin annexes; l) arthroskeletal system; m) superficial lymph nodes.
OBJECTIVE EXAMINATION OF THE THORAX: a) lines and landmarks; b) inspection: shape and size of the thorax, symmetry, skin and subcutaneous venous circles; c) palpation: thoracic expansion, search for thoracic pain (Valleix points, phrenic points, spinous apophyses), tactile thoracic-vocal tremor; d) percussion: topographic or delimiting (base expansion and comparative; e) auscultation: physiological respiratory noises; continuous and discontinuous added noises.
SIGNS AND SYMPTOMS OF RESPIRATORY ORIGIN: dyspnoea; cough; cyanosis of pulmonary origin; haemoptysis and haemoptoe; non-cardiac chest pain.
SEMEIOLOGICAL FEATURES (signs and symptoms) OF THE PATIENT WITH RESPIRATORY DIEASES: a) chronic bronchitis; b) pleural effusion; c) bronchial asthma; d) pulmonary emphysema; e) pneumonia and bronchopneumonia; f) pulmonary fibrosis; g) lung cavern; h) atelectasis.
OBJECTIVE EXAMINATION OF THE HEART: a) inspection: appearance of the precordial region, tip yttus; b) palpation: characteristics of tip yttus; other pulsations; heart thrills and pericardial frictions; c) percussion: absolute and relative obtuseness; Ebstein's hepatocardiac angle; d) auscultation: physiological and pathological heart tones, systolic and pathological murmurs.
SIGNS AND SYMPTOMS OF CARDIAC ORIGIN: a) orthopnoea; paroxysmal nocturnal dyspnoea; cardiac asthma; acute pulmonary oedema; PVC and jugular pulse; cyanosis; digital hippocratism; b) semeiological features and signs of heart failure: signs of hypoperfusion and signs of congestion; c) signs and symptoms of major valvulopathies (aortic stenosis and insufficiency, mitral stenosis and insufficiency, mitral prolapse, pervious foramen ovale of Botallo; d) chest pain: angina pectoris and myocardial infarction.
SIGNS AND SYMPTOMS OF LIVER CIRRHOSIS. SIGNS OF PORTAL HYPERTENSION.
JAUNDICE AND PSEUDOHYTTERUS.
OBJECTIVE EXAMINATION OF THE THYROID GLAND: a) role of inspection, palpation, percussion and auscultation in thyroid pathology; b) goitre and thyroid nodules; c) signs and symptoms of hyperthyroidism and hypothyroidism.
OBJECTIVE EXAMINATION OF THE OUTER AND INNER EYE (eyelids, conjunctiva, lacrimal glands, cornea, sclera, uvea, pupil, lens, retina).
OBJECTIVE EXAMINATION OF THE CENTRAL NERVOUS SYSTEM: examination of speech; examination of the motor system (muscle tone, trophism, muscle strength reflexes); examination of sensitivity; pyramidal syndromes; examination of cerebellar function; examination of cranial nerve function; examination of posture and gait; signs of meningeal irritation.
OBJECTIVE EXAMINATION OF THE MUSCULOSKELETAL AND OSTEOARTICULAR SYSTEM (rheumatoid arthritis, spondyloiditis, psoriatic arthritis, gout).

Lectures, videos (general physical examination, thorax, heart, and abdomen examination), meetings (glossary, fever, jaundice, and chest pain), practical trainings (peer physical examination, bed-side physical examination, cardiopulmonary auscultation on mankins).

Bruno Fabris, Professore Associato, Dipartimento di Scienze mediche, chirurgiche e della salute, Medicina Clinica, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste
Tel: 040/3994320
Office hours: by appointment
https://moodle2.units.it

The final exam includes a practical test on a dummy in the simulation classroom and an oral test. In the practical test on the dummy, the student must be able to recognize and graph a cardiac and pulmonary auscultatory finding. The outcome of the test will be evaluated with a score of 0.5 (recognition of one auscultatory finding) or 1 (recognition of both auscultatory findings). This score will be added to the score that the student will receive in the medical semeiotics oral exam.
The oral test, organized in the form of an interview, includes up to three medical semeiotics questions (among which there is always a cardiological semeiotics question), three surgical semeiotics questions and a laboratory medicine question. The interview has an average duration of about 30 minutes and involves verifying the level of knowledge of the topics of the program, the level of mastery of the specialized language and the ability to develop reasoning by applying theoretical knowledge. The exam is based on the whole program of the course.
The evaluation grid adopted is the following:
EXCELLENT (30–30 cum laude): excellent knowledge of the topics, excellent language skills, excellent analytical skills; the student is able to brilliantly apply theoretical knowledge to concrete cases.
VERY GOOD (27–29): good knowledge of the subjects, remarkable fluency, good analytical skills; the student is able to correctly apply theoretical knowledge to concrete cases.
GOOD (24–26): good knowledge of the main topics, good command of the language; the student shows an adequate ability to apply theoretical knowledge to concrete cases.
SATISFACTORY (21–23): the student does not show full command of the main topics of the teaching, although he/she possesses the fundamental knowledge; however, she shows satisfactory language skills and sufficient ability to apply theoretical knowledge to concrete cases.
SUFFICIENT (18-20): minimal knowledge of the main teaching topics and technical language, limited ability to adequately apply theoretical knowledge to concrete cases.
INSUFFICIENT: the student does not have an acceptable knowledge of the contents of the different topics of the program.

This teaching explores topics closely related to one or more objectives of the 2030 Agenda for Sustainable Development of the United Nations.