Course contents:

INTRODUCTION TO INTERNAL MEDICINE – 3^RD YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U7

E.U12

E.U14

E.U16

E.U17

E.U18

E.U21

E.U29

E.U30

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

LECTURES

A strategy of history taking and presenting complaints related to the respiratory system.

Cardiovascular complaints.

Gastrointestinal complaints.

Renal, reproductive and musculoskeletal complaints.

General examination.

Examination of the head and neck.

Examination of the respiratory system.

Examination of the cardiovascular system.

Examination of the abdomen.

Examination of the renal, reproductive and musculoskeletal system.

Respiratory diseases.
Cardiovascular diseases.

Gastrointestinal diseases

Diseases of the endocrine system.

Peripheral vascular diseases.

Anaemia and haemorrhagic flaws.

Hematopoietic proliferative diseases.

Renal and osteoarticular diseases.

CLASSES

1. The interview and history taking strategy.
2. Common symptoms.
3. Symptoms of the cardiovascular and respiratory system diseases.
4. Symptoms of the gastrointestinal system diseases
5. Symptoms of the renal, reproductive and musculoskeletal system diseases.
6. General examination. Examination of the head and neck.
7. General examination of the chest, examination of the respiratory system.
8. Examination of the heart and peripheral vessels.
9. General examination of the abdomen, examination of the liver. Examination of the  spleen, intestines, per rectum examination.
10. Examination of the renal and reproductive system.
11. Examination of the musculoskeletal system.
12. Student independent preparation of clinical history – interview and physical examination, suggesting initial diagnosis, suggesting additional examinations, patient observation, differentiation and treatment.
13. Basic electrocardiography, demonstration of typical ECG curves in myocardial infarction, arrhythmias and conduction disorders.
14. Demonstration of clinical cases with particular emphasis on changes in a physical examination.

INTERNAL MEDICINE – ALERGOLOGY – 3^RD YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U7

E.U12

E.U14

E.U16

E.U17

E.U18

E.U21

E.U28

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

1. Respiratory function tests (spirometry, provocation tests). (L, S, C)
2. Allergy diagnostics (allergy tests, immunological diagnosis). (L, S, C)
3. Cough and dyspnoea – main symptoms from respiratory tract. (S, C)
4. Allergy markers in hematopoietic system disorders. (S, C)
5. Allergic and non-allergic asthma, other asthma phenotypes. (L, S, C)
6. Life threatening states caused by allergic reactions: anaphylactic shock, allergic reactions after insect stinging, angioedema. (L, S, C)
7. Non-invasive diagnostics for inflammation in respiratory tract diseases. (C)
8. Practical performance of diagnostics tests used in lung obstructive diseases and allergy-mediated diseases. (C)
9. Coexistence of asthma and chronic obstructive pulmonary disease. (C)
10. Acute and chronic urticaria, coexistence of urticaria and angioedema. (C)
11. Allergic rhinitis and allergic conjunctivitis. (C)
12. Atopic dermatitis. (C)
13. Contact dermatitis. (C)
14. Adverse drug reactions. (C)
15. Occupational allergies. (C)
16. Hypersensitivity pneumonitis. (C)
17. Eosinophilic bronchitis. (C)

INTERNAL MEDICINE – PULMONOLOGY 3^RD YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U7

E.U12

E.U14

E.U16

E.U17

E.U18

E.U21

E.U24.

E.U29

E.U30

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

LECTURES

1. Chronic obstructive pulmonary disease – etiopathogenesis, symptomatology, diagnostics and treatment (2x45min)
2. Pneumonia – etiology, symptoms, diagnostics and treatment (2x45min)
3. Lung cancers – etiology, symptoms, diagnostics and treatment (2x45min)

4. Interstitial lung diseases – etiology, symptoms, diagnostics and treatment (2x45min)
5. Tuberculosis (3x45min)

SEMINARS & CLASSES

1. Physical examination of the respiratory system including special states (lung oedema, atelectasis, pneumothorax, abscess, emphysema)
2. Pulmonary function tests. Classes in the laboratory of spirometry and plethysmography (spirometry, plethysmography, DLCO)
3. Chronic Obstructive Pulmonary Disease (COPD)
4. Pneumonia, methods of taking test material, case study
5. Fluid in pleural cavity, emphysema, participation in thoracocentesis
6. Lung cancer, paraneoplasmatic syndromes, assisting in bronchoscopy, chest radiograms reporting
7. Selected interstitial diseases (sarcoidosis, HP, interstitial lung fibrosis), radiological diagnostics, discussion of BAL and induced sputum examination
8. Chronic respiratory failure, ABH reporting
9. Lung tuberculosis, chest radiograms reporting
10. Final credit test administered in each group after classes completion

INTERNAL MEDICINE – CARDIOLOGY – 4^TH YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U7

E.U12

E.U14

E.U16

E.U17

E.U18

E.U21

E.U29

E.U30

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

LECTURES

1. Introductory lecture. Cardiovascular diseases. Epidemics of the 21st century. (45 min)

The importance of non-invasive tests in the diagnosis of heart disease (45min)

2. Invasive methods of diagnosis and therapy of cardiovascular diseases (2 x 45 min)
3. Acute conditions in cardiology (2 x 45 min)
4. Acquired heart valve diseases. Division, pharmacological treatment. Indications for invasive treatment (2 x 45 min)
5. Congenital heart defects in adults. Diagnosis and treatment. Indications for interventional treatment (45 min). Atrial fibrillation from theory to practice (45 min)
6. Classification and diagnosis of hypertension (45 min). Treatment of hypertension (45 min)
7. Infective endocarditis (45 min). Myocarditis, cardiomyopathies (45 min)

SEMINARS & CLASSES

1. Normal electrocardiogram; examples of ECG records
2. Arrhythmias
3. Conductibility disorders
4. Angina pectoris stable and unstable
5. Myocardial infarction.
6. Electrotherapy of arrhythmias and conductibility disorders
7. Heart failure
8. Prevention of diseases of the cardiovascular system.
9. Examination

INTERNAL MEDICINE – GASTROLOGY – 4^TH YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U7

E.U12

E.U14

E.U16

E.U17

E.U18

E.U21

E.U24

E.U25

E.U29

E.U30

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

LECTURES

1. Gastroesophageal reflux disease
2. Peptic ulcer disease
3. Acute pancreatitis
4. Chronic pancreatitis

SEMINARS

1. Liver cirrhosis

2.     Gastric cancer

3.     Gastrointestinal bleeding

4.     Colorectal cancer

5.     Pancreatic cancer

6.     Ulcerative colitis

7.     Crohn’s disease

CLASSES

I. Medical history and physical examination skills assessment related to internal diseases

II. Topics:            

1. Signs and symptoms of gastrointestinal diseases.
2. Peptic ulcer disease – diagnosis and treatment.
3. Non-alcoholic fatty liver disease and alcoholic liver diseases.
4. Choledocholithiasis – diagnosis and treatment.
5. Acute pancreatitis – pathogenesis, clinical manifestations and treatment.
6. Chronic pancreatitis.
7. Diverticular disease.

III. Written exam on gastroenterology (based on topics covered during lectures and classes).

IV. Final credit test.

INTERNAL MEDICINE – ENDOCRINOLOGY AND DIABETOLOGY – 5^TH YEAR

Learning outcomes

(symbol and number)

Topics

E.W7.

E.U12

E.U16.

E.W1.

E.U24.

E.W1.

E.U32.

E. U30

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

LECTURES

1. Regulation and mechanisms of hormone secretion.
2. Diseases of the pituitary gland.
3. Pathogenesis, diagnosis and treatment of thyroid diseases.
4. Pathogenesis, diagnostics and treatment of adrenal diseases.
5. Regulation of calcium-phosphate homeostasis.
6. Obesity and its consequences.
7. Pathogenesis, diagnosis and treatment of type 1 diabetes.
8. Pathogenesis, diagnosis and treatment of type 2 diabetes.

SEMINARS & CLASESS

1. Clinical picture, management and differential diagnosis in adrenal diseases – part I/II. (S/C)
2. Clinical picture, diagnostics and management of diseases of the hypothalamic-pituitary system. (S/C)
3. Clinical picture, diagnostics and management of thyroid diseases – part I/II. (S)
4. Thyroid ultrasound presentation and fine needle aspiration biopsy (FNA) of the thyroid gland. (C)
5. Diagnostic criteria and glucose control for diabetes mellitus. (S/C)
6. Non-pharmacological and pharmacological treatment of type 2 diabetes. (S/C)
7. Practical insulin therapy – insulin therapy algorithms, presentation of insulin pens, insulin pumps and glucometers – part I/II. (S/C)
8. Discussion of endocrine diseases based on selected clinical cases. (C)

INTERNAL MEDICINE – NEPHROLOGY – 5^TH YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U12

E.U16

E.U17

E.U18

E.U24

E.U29

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

LECTURES

1. Diagnostics of kidney diseases
2. Glomerular diseases
3. Acute kidney injury
4. Interstitial kidney diseases
5. Kidneys and arterial hypertension

SEMINARS & CLASSES

1. Acid-alkaline and water-electrolyte disorders in nephrology
2. Chronic Kidney Disease (CKD)

• causes, symptoms, clinical/physical examination, investigations
• complications of CKD
• management of CKD, renoprotection

3.  Acute kidney injury (AKI)

• prerenal, renal, postrenal
• acute cortical necrosis
• contrast nephropathy
• hepatorenal syndrome

4. Glomerular Diseases

• nephrotic syndrome
• nephritic syndrome
• rapidly progressive glomerulonephritis (RPGN)

5. Renal Replacement Therapy

• hemodialysis
• peritoneal dialysis
• continuous methods

6.  Tubulo-interstitial nephritis

• urinary tract infection
• kidney and hypertension

7. Kidney transplantation

INTERNAL MEDICINE – HEMATOLOGY – 5^TH YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U7

E.U12

E.U14

E.U16

E.U17

E.U18

E.U21

E.U24

E.U29

E.U30

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

LECTURES

1. Anaemia – diagnostics, treatment.
2. Non-Hodgkin's lymphomas – diagnostics, treatment.
3. Acute leukemia – diagnostics, treatment.
4. Congenital and acquired coagulation disorders.
5. Myeloproliferative diseases – diagnostics, treatment.

SEMINARS & CLASSES

1. Multiple myeloma.
2. Non-Hodgkin's lymphomas.
3. Acute leukemia: myeloid and lymphoblastic.
4. Myeloproliferative diseases: chronic myeloid leukemia, polycythemia vera, essential thrombocythosis, idiopathic myelofibrosis.
5. Anaemias.
6. Haemorrhagic diathesis: vascular, plasmatic, and thrombocythopenic.
7. Venous thromboembolism.
8. Anticoagulant, thrombolytic, antiplatelet therapy.

INTERNAL MEDICINE – RHEUMATOLOGY – 5^TH YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U7

E.U12

E.U14

E.U16

E.U17

E.U18

E.U24

E.U29

E.U30

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

SEMINARS & CLASESS

1. Examination of the musculoskeletal system.
2. General characteristics of rheumatic diseases. Clinical-physical picture. Implications of pathogenic changes in the clinical picture.
3. Osteoarthritis. Clinical picture, physical examination, diagnosis, differentiation, prognosis, treatment.
4. Gout, chronic arthritis. Clinical examination, diagnosis, differentiation, prognosis, treatment.
5. Osteoporosis. Clinical examination, diagnosis, differentiation, prognosis
6. Chronic arthritis: Rheumatoid arthritis, Seronegative axial arthritis. Diagnosis, differentiation, therapeutic treatment.

INTERNAL MEDICINE – 6^TH YEAR

Learning outcomes (symbol and number)

Topics

E.W1

E.W7

E.U1

E.U3

E.U7

E.U12

E.U14

E.U16

E.U17

E.U18

E.U21

E.U29

E.U30

E.U32

E.U38

K1, K2, K3, K4, K5, K6, K7, K8, K9, K10, K11

E.W7,

E.U1, E.U3, E.U7, E.U12, E.U13, E.U14, E.U16, E.U24,E.U29, E.U32, E.U38

Diagnosis and treatment in internal medicine – classes at Internist Clinics according to the schedule between 8.00-11.00

1. Patient with dyspnoea – diagnosis and treatment
2. Differential diagnosis of edema
3. Abdominal pains - diagnosis and treatment
4. Chest pains – diagnosis and treatment
5. Patient with fever of unknown origin – differential diagnosis
6. A patient with diarrhea – differential diagnosis and treatment
7. Patient with anaemia – differential diagnosis and treatment

Practical solution of clinical problems – classes according to the schedule between 11.30-13.00

ALLERGOLOGY

1. Diagnostic problems in chronic urticaria
2. Life threatening states in allergology (anaphylactic shock, angioedema)
3. Diagnostic and therapeutic procedures in patients with severe and difficult asthma
4. Hymenoptera and non-hymenoptera venoms allergy

PULMONOLOGY

1. Diagnostic and treatment difficulties in interstitial diseases, in particular interstitial pneumonia and differentiation between sarcoidosis and HP.
2. Recurrent infection of lower airways.
3. Circulatory decompensation and arrhythmias as complications in pneumonology.
4. Non-invasive mechanical ventilation in the treatment of chronic respiratory insufficiency and its exacerbation.
5. Circular shadows in lungs in the chest radiological examination as a diagnostics problem.
6. Shift in the clinical picture of tuberculosis in recent decades and latent tuberculosis.
7. Sleep breathing disorders.

CARDIOLOGY

1. Acute and chronic heart failure.
2. Hypertension.
3. Infective endocarditis.
4. Acquired heart valve defects.
5. Electrotherapy of heart diseases.
6. Invasive treatment of heart diseases.

GASTROENTEROLOGY

1. Causes and treatment strategies of dysphagia in terms of selected disease units.
2. Analysis of endoscopic images of the gastrointestinal tract with regard to certain clinical cases.
3. Anaemia induced by gastrointestinal disorders – analysis of clinical cases.
4. Common causes, diagnostics and treatment of intra- and extrahepatic cholestasis.
5. Clinical manifestations of portal hypertension based on specific clinical cases (ascites, SBP, hepatorenal syndrome).
6. Altered bowel habits in selected clinical conditions (diverticulosis, IBD, IBS).

ENDOCRINOLOGY AND DIABETOLOGY

1. Thyroiditis.
2. Thyroid cancer.
3. Life threatening states in endocrinology
4. Acute complications of diabetes.
5. Thyroid orbitopathy

NEPHROLOGY

1. Cardio-renal syndrome.
2. Diabetic kidney disease.
3. Monoclonal gammopathy of renal significance (MGRS).
4. Lupus nephritis.
5. Polycystic kidney disease.
6. Haemolytic-uremic syndrome.

HEMATOLOGY

1. Differential diagnosis of anaemia.
2. Thrombophilia as an interdisciplinary problem.
3. Suspicion of the proliferative disease – management of the patient.

RHEUMATOLOGY

1. Systemic sclerosis and scleroderma-like syndromes
2. Systemic lupus erythematosus – symptoms, complications, diagnostics, treatment
3. Systemic vasculitis-picture of multiorgan diseases
4. Polymialgia rheumacica and differential diagnosis of fevers of unknown origin
5. Treatment of patients with chronic arthritis refractory to standard therapies
6. Unusual forms of arthritis-Still's disease in adults
7. Sjögren's syndrome
8. Polymyositis and dermatomyositis

METABOLIC DISEASES

1. Eating disorders – anorexia nervosa, bulimia
2. Obesity – clinical aspects
3. Diagnosis and treatment of dyslipidemia
    

DEPARTMENT OF MEDICAL SIMULATIONS – 6^TH YEAR OF MEDICAL FACULTY

1. Acute pancreatitis. Cholelithiasis.
2. Acidosis and ketone coma.
3. Anaphylaxis and anaphylactic shock.
4. Loss of consciousness.
5. Myelosuppression and neutropenic fever.
6. Sepsis and septic shock.
7. Poisonings.

Practical classes are held in the form of high-fidelity medical simulation scenarios in internal medicine with the use of simulators. Students act as members of a multidisciplinary team taking care of the patient. Afterwards, students and their teacher discuss the procedure and draw educational conclusions. Each class consists of a test checking student knowledge, scenario implementation and discussion.

Obligatory textbook:

Textbooks necessary to acquire basic knowledge of the course:

- Harrison’s Internal Medicine

- Macleod’s Clinical Examination

Supplementary literature:

Bates's Guide to Physical Examination and History taking

Criteria for assessing the learning outcomes achieved and the form and conditions for obtaining the credit for the course:

3^RD-6 year

1. Method of passing individual classes – oral (discussion during classes, observation of student work, assessment of activity during classes).
2. Method of passing individual seminars – oral.
3. Method and form of completing all didactic classes in a particular unit – a written test (multiple choice test) and passing the history of the disease (implementation of a specific task, multimedia presentation).
4. The block begins with checking the knowledge of physical examination in the field of Internal Medicine – a form of checking at discretion of the Departments.
5. Preparation to classes is assessed on the ground of active participation in the class (analysis of clinical cases under discussion).
6. Preparation of the medical history during the block of classes.
7. Credit of seminars – based on discussion and participation in the seminar.
8. At the end of the block there is a test of knowledge following the curriculum (the subject matter covers seminars, classes and lectures). The most common form of checking knowledge is a test. In case of failure – a retake test within 14 days after finishing the block.

Absence not confirmed by the sick note – the obligation to make up for the classes after consultation with the teacher. Only the students who participate in all classes can pass the classes. The classes may be made up for if the absences cover less than 30% of the classes.

6^th year

The requirement for receiving credit for Internal Medicine course is:

1. Participation in all courses (classes and practical solutions of clinical problems). A student may have one excused  absence in the classes in a semester (a sick note or Dean’s consent). More absences in the classes require taking up classes with another group. Absence in the classes on ”practical solutions of clinical problems” requires taking up classes with another group or taking a credit with the teacher.
2. Written test.

Rules for the examination in Internal Medicine

A. Initial arrangements

1. Internal Medicine exam on the 6^th year consists of three parts: a written test, practical and oral exam. Passing a test is necessary to take other parts of the exam.
2. The requirement for passing the Internal Medicine exam is to obtain a positive grade for each part of the exam (a test, and practical and oral exam).
3. The exam consists of two parts: a test (50%) and a practical and oral exam (50%). The total grade consists of the average of these two parts.

B. Test exam

1. The test exam consists of 100 questions and lasts 150 minutes.
2. Test questions cover all blocks from Internal Medicine according to the syllabus of Internal Medicine for the years III-VI.
3. Students must take the test by themselves. Contacting other people during the test as well as all forms of using unauthorized support materials, multimedia, mobile phones and electronic means of communication (e.g. smartphones, smartwatches) will result in termination of the test at the moment of the regulations’ violation, which may also result in disqualification of the student taking the exam. Disqualification is equal to an unsatisfactory mark for the test exam.
4. Question sets are prepared in a way that guarantees objectivity and a convenient pursuit of the exam; they are  arranged in such a way that students sitting next to each other have a different order of questions or distractors.
5. Passing the exam means a positive results if the student taking the exam gets at least 60% correct answers (i.e. 60 points). Receiving less than 60 points (i.e. 59 and less) means failing the entire exam, i.e. an unsatisfactory mark in the first term.
6. The test exam can be taken three times.
7. The results of test are available and presented no later than 1 working day from the date of the examination. In the announcement of the test results and all information related to the marks, all standard rules for the protection of personal data are guaranteed.
8. Points and grading system of the test exam are based on the following criteria:

1. 1. <60 failed (2)
   2. 60-67 satisfactory (3)
   3. 68-75 fairly good (3,5)
   4. 76-83 good (4)
   5. 84-92 better than good (4,5)
   6. 93-100 very good (5)

C. Practical exam and oral exam

1. The place of taking oral exams in Internal Medicine and the examiner's name is determined by drawing lots; these data are made available to students ahead of the date of the test.
2. Practical exam and oral exam, constituting an integral part of the Internal Medicine exam, take place after obtaining a positive result of the test. The student receives one mark for the practical and oral exam.
3. The practical and oral examination can take place after the test exam on the next working day; the examination starts at 08:00 A.M.
4. Passing the practical exam requires correct recognition of the so-called "passing diagnoses" in all three electrocardiograms (standardized descriptions for all Departments).
5. Failure of the practical part means that the exam must be retaken (the test remains passed). The practical exam can be taken three times.
6. The oral exam is carried out by the Head of the Department (and/or a second person designated by the Head of the Department – an individual decision made by the Head of the Department). A signature in the student record book (index), examination card and/or the electronic protocol is made by persons conducting the oral examination.
7. The oral exam involves giving correct answers to 3 questions asked (including those based on the differential diagnosis which is a continuation of the practical exam).
8. Failure of the oral part means that the examination has to be retaken (the test and the practical exam remain passed). The oral exam can be taken three times.
9. The final grade in Internal Medicine exam consists of the average of the results obtained for each part of the exam.

D. Retake exam

A retake exam will be carried out in the same way as the exam in the first term.

Exemption from the exam is not applicable.