1) 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/she must demonstrate understanding of the basic principles of semeiotics.
2) APPLIED KNOWLEDGE AND UNDERSTANDING. At the end of the course, the student must be able to take a family, physiological, remote pathological and proximate pathological history. The student must be able to conduct an objective examination by applying the basic principles of semeiotics: inspection, palpation, percussion and auscultation.
3) AUTONOMY OF JUDGEMENT.
At the end of the course, the student must demonstrate that he/she has not only acquired knowledge and concepts, but also that he/she is able to recognise signs and symptoms by means of correct examination methodology and that he/she is able to make appropriate judgements.
4. COMMUNICATION SKILLS.
At the end of the course, the student should be able to express and argue appropriately through correct use of the glossary acquired from the lectures delivered, the teaching material and the reference texts.
5. LEARNING ABILITY.
At the end of the course the student must demonstrate that he/she is able to apply the knowledge, skills and competences described in this Syllabus.

The candidate shall have passed the exam of general pathology

SEMEIOTIC AND CLINICAL METHODOLOGY
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 semiotics 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 large 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

SEMEIOTIC AND SURGICAL METHODOLOGY
1) Continuous tissue solutions;
2) Medical record;
3) Anamnesis;
4) Fever;
5) Chest pain of non-cardiac origin;
6) Breast;
7) Abdominal pain;
8) General objective examination;
9) Objective examination of tumefactions;
10) Objective abdominal examination:
acute occlusive and peritonitic abdomen;
11) Proctological objective examination;
12) Haematemesis and melena;
13) Enterorrhagia and rectorrhagia;
14) Kidney and urinary tract;
15) Ernie;
16) Lower limb varices;
17) Objective examination of the lymphatic system.

BIOCHEMISTRY AND CLINICAL BIOCHEMISTRY
1) Introduction to clinical biochemistry
2) Laboratory tests in inflammation
3) Laboratory tests in haematology
4) Laboratory tests in haemostasis
5) Serum markers of acute myocardial infarction
6) Laboratory tests in extra-hepatic gastrointestinal pathologies
7) Laboratory tests of liver function
8) Laboratory tests in the diagnosis and monitoring of the diabetic patient
9) Description of the main tumour markers
10) Protidogram
11) Serum electrolytes dosage
12) Laboratory tests of renal function
13) Laboratory tests of thyroid function
14) Laboratory tests of adrenal function
15) Laboratory tests in the diagnosis of COVID 19

SEMEIOTIC AND CLINICAL METHODOLOGY
Fradà - Semeiotica Medica
Harrison's Principles of Internal Medicine

SEMEIOTIC AND SURGICAL METHODOLOGY
EMSI Editore. Cirenei, Stipa, seconda edizione - Metodologia Clinica
L. Gallone - Casa Editrice Ambrosiana - Semeiotica Chirurgica e Metodologia Clinica.

SEMEIOTIC AND CLINICAL METHODOLOGY
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).
SEMEIOTIC and SURGICAL METHODOLOGY
See attached document
CLINICAL BIOCHEMISTRY
See attached docume

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

The learning assessment includes a practical test on a dummy in a simulation room and an oral test. In the practical test on a dummy, the student must be able to recognise 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 mark will be added to the mark the student will receive in the oral medical semeiotics test.
The oral test, which takes the form of an interview, includes up to three medical semeiotics questions (among which there is always a cardiology semeiotics question), three surgical semeiotics questions and one laboratory medicine question. The interview lasts on average about 30 minutes and is designed to test the level of knowledge of the programme topics, the level of mastery of specialist language and the ability to develop an argument by applying theoretical knowledge. The examination is based on the entire course programme.
The evaluation grid adopted is as follows:
EXCELLENT (30-30 cum laude): excellent knowledge of the topics, excellent command of language, excellent analytical ability; the student is able to apply theoretical knowledge brilliantly to concrete cases.
VERY GOOD (27-29): good knowledge of the main topics, considerable ownership of language, good analytical ability; the student is able to apply theoretical knowledge correctly to concrete cases.
GOOD (24-26): good knowledge of the main topics, fair command of language; the student shows an adequate ability to apply theoretical knowledge to concrete cases.
SATISFACTIVE (21-23): the student does not show full mastery of the main topics of the course, although he/she possesses the fundamental knowledge; however, he/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 apply theoretical knowledge adequately to concrete cases.
INSUFFICIENT: the student does not possess an acceptable knowledge of the content of the different topics of the syllabus.

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