The course consists of the presentation of clinical cases concerning the main hematological pathologies of internal medicine interest in order to acquire the ability to design differential diagnosis paths and to set up appropriate pharmacological and non-pharmacological therapies taking into account the gender differences in the various pathologies.
KNOWLEDGE AND UNDERSTANDING. At the end of the course, students will have to demonstrate knowledge and ability to understand the fundamental concepts and principles on which the differential diagnosis and therapy of the main hematological pathologies of internal medicine interest is based.
ABILITY TO APPLY KNOWLEDGE AND UNDERSTANDING. At the end of the course the student must be able to apply the knowledge acquired in the previous point in order to apply the appropriate methodologies for the practical management of the patient's clinical problem. You must also know how to prescribe and appropriately interpret laboratory tests (chemical, microbiological and genetic) and instrumental tests (diagnostic imaging and pathophysiological tests) aimed at differential diagnosis. You must know how to plan the appropriate therapy by evaluating the risk-benefit ratio of drugs and non-pharmacological therapies. At the end of the course, students should be able to manage patients' clinical internal problems.
MAKING JUDGEMENTS. At the end of the course, students will have to demonstrate that they have not only acquired knowledge and concepts, but also that they are able to provide appropriate judgments in relation to the setting of the diagnostic-therapeutic process, patient safety and management of the clinical risk.
COMMUNICATION SKILLS. At the end of the course, students must be able to express themselves and argue appropriately through the specific terminology acquired through the lessons provided, the teaching material and/or the reference text. Students must also be able to communicate with patients and family members in a clear and empathetic way using simple terminology and avoiding technical terms.
LEARNING ABILITY. At the end of the course, students will have to demonstrate that they are able to apply the minimum knowledge, skills and competences described in this Syllabus.

Pathophysiology of endocrine, metabolic and liver diseases and methods of clinical examination. Pharmacology of endocrine, metabolic and liver disease therapies.

Clinical cases of hematology with analysis of gender differences in various pathologies. Asthenia and conjunctival pallor. Chronic diarrhea with weight loss and side opening anemia. Epistaxis and purpura. splenomegaly. Cervical lymphadenopathy and cyclic fever. Hemothysis and weight loss in smokers. Fever of unknown origin. Malnutrition in a patient with chronic alcoholism. Epigastric pyrosis.

Oxford Manuale di Medicina Clinica Decima Edizione. Current Medical Diagnosis & Treatment 2024. McGraw Hill LANGE. SIMI HANDBOOK Terapia Medica. Seconda edizione 2022. EDRA Ed.

Clinical cases in hematology. ASTHENIA AND CONJUNCTIVAL PALLOR. Differential diagnosis of anemia based on erythrocyte volume and number of reticulocytes. Identification of iron deficiency anemia. Causes of chronic bleeding. Indications for blood transfusion in acute and chronic hemorrhages and in patients with cardiovascular comorbidities. Oral and intravenous martial therapy. Macrocytic anemias and B12 deficiency syndrome. Thalassemias and sickle cell anemia. Hemolytic anemias. Iron metabolism: serum iron, transferrin, ferritin, calculation of transferrin saturation, hepcidin. Martial overload syndromes. CHRONIC DIARRHEA WITH WEIGHT LOSS AND SIDE OPENING ANEMIA. Differential diagnosis of chronic diarrhea and malabsorption syndromes. Celiac disease in adults. Non-celiac hypersensitivity to gluten. Bacterial overgrowth syndrome, chronic pancreatitis, irritable bowel syndrome. Identify B12 deficiency syndrome. Crohn's disease and ulcerative rectoclitis. Extraintestinal manifestations. Principles of therapy of chronic intestinal inflammatory diseases. EPISTAXIS AND PURPURA. Hemorrhagic syndromes. Differential diagnosis of thrombocytopenia. Autoimmune thrombocytopenic purpura. Thrombopoietin. Heparin-induced thrombocythemia. Thrombotic microangiopathies. Coagulation factor deficiency. Congenital and acquired coagulation defects. Disseminated intravascular coagulation. Therapy of hemorrhagic diathesis. Indications for platelet transfusion. SPLENOMEGALY. Differential diagnosis of splenomegaly. Hypersplenism. Massive splenomegaly: malaria, leishmaniasis, chronic myelogenous leukemia, myelofibrosis, Gaucher disease. Clinical presentation of acute leukemias. Neutropenic syndromes. Myelopoiesis growth factors. States of immunosuppression due to neutropenia (e.g. leukemia), hypogammaglobulinemia (e.g. myeloma) and reduced cell-mediated immunity (e.g. HIV infections). Infections in the immunocompromised patient. Shingles. Lymphocytosis. Chronic lymphocytic leukemia. Myeloproliferative syndromes. Identify macrocytic anemias due to myelodysplastic syndromes. CERVICAL LYMPHADENOPATHY AND CYCLIC FEVER. Differential diagnosis of lymphadenopathy. Identify Hodgkin's and non-Hodgkin's lymphomas. Infectious mononucleosis and other infectious diseases that can manifest with localized or generalized lymphadenopathy. HEMOTHYSIS AND WEIGHT LOSS IN SMOKERS. Differential diagnosis of hemoptysis. Definition and differential diagnosis of involuntary weight loss. Differential diagnosis of dysphagia. Recognizing lung cancer. Paraneoplastic syndromes. Syndrome of inappropriate ADH secretion. Differential diagnosis and therapy of hyponatremia. Differential diagnosis and therapy of hypernatremia. Recognize tuberculosis and HIV infection. FEVER OF UNKNOWN ORIGIN. Recognize and establish the differential diagnosis of fever of unknown origin. Differentiate fevers of infectious, rheumatic and oncological origin. MALNUTRITION IN A PATIENT WITH CHRONIC ALCOHOLISM. Identify and manage refeeding syndrome in anorexia and alcoholism. Recognize acid-base balance disorders. Differential diagnosis of metabolic acidosis. Anion gap. Ketoacidosis and lactic acidosis. EPIGASTRIC PYROSIS. Identify the causes and clinical manifestations of gastroduodenal peptic disease. Differential diagnosis of dyspepsia. Principles of Helicobacter pylori eradication therapy. Gastro-esophageal reflux disease (GERD). Stomach cancer. Esophageal carcinoma. Clinical manifestations, complications and therapy of acute pancreatitis. Carcinoid.

Lectures and clinical case studies on real or simulated patient. Attendance of a two-week internship in an internal medicine department (UCO Clinica Medica, Cattinara Hospital, Trieste, ASUGI) is required. The teaching material is made available to students via the Moodle and MS-Teams platforms.

Course coordinator
Prof. Gianni Biolo
Dipartimento di Scienze mediche, Chirurgiche e della Salute
Clinica Medica - Ospedale di Cattinara - ASUITs
Strada di Fiume 447, 34100 Trieste
e-mail: biolo@units.it
tel. 040-3994433
Orario di ricevimento: su appuntamento

Evaluation of clinical skills through an oral exam, which includes discussion of clinical cases and topics included in the program. Score 29-30 cum laude: the student has an IN-DEPTH knowledge of the subject, has excellent communication skills and masters medical-scientific language. Score 26-28: the student has a GOOD knowledge of the subject and explains the topics clearly using appropriate medical-scientific language; Score 22-25: the student has a DISCRETE knowledge of the subject, even if limited to the main topics and explains the topics quite clearly with a reasonable command of language; Score 18-21: the student has the MINIMUM knowledge of the subject and explains the topics clearly enough although the language skills are poorly developed; Exam not passed: the student DOES NOT HAVE THE MINIMUM KNOWLEDGE required of the main contents of the course. The ability to use specific language is very poor or non-existent and he is unable to apply the knowledge acquired independently.

This course explores topics closely related to one or more goals of the United Nations 2030 Agenda for Sustainable Development (SDGs)