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Internal Medicine II - DA0110369

Title:	Internal Medicine II
Guaranteed by:	Department of Internal Medicine (13-341)
Faculty:	Second Faculty of Medicine
Actual:	from 2023
Semester:	winter
Points:	6
E-Credits:	6
Examination process:	winter s.:
Hours per week, examination:	winter s.:0/30, C [HT]
Extent per academic year:	5 [weeks]
Capacity:	unknown / unlimited (unknown)
Min. number of students:	unlimited
4EU+:	no
Virtual mobility / capacity:	no
Key competences:
State of the course:	taught
Language:	English
Teaching methods:	full-time
Teaching methods:	full-time
Level:

Guarantor:	prof. MUDr. Radan Keil, Ph.D.
Classification:	Medicine > Clinical Disciplines
Pre-requisite :	DA0108056, DA0108363, DA0108369, DA0108390
Is pre-requisite for:	DA0112303

Examination dates WS schedule Noticeboard

Annotation

Last update: PALACKAJ (31.07.2019)

Information about Internal Medicine II The subject is composed from theoretical lectures, seminars and clinical practicals. Practicals are run on wards of Internal Clinic. Start of lectures and practicals is specified in time schedule. Students may check which meeting room/ward is assigned to their class: • SIS • on a noticeboard on the floor 4D (in front of the secretariat of Internal clinic)

Course completion requirements

Last update: PALACKAJ (31.07.2019)

All practical classes and seminars are compulsory and the attendance is checked.

The lectures are optional but you are requested to attend them if possible.

The student is allowed to miss up to 4 practical classes and seminars during all 5 weeks, but there is necessary to replace them. About substitution of practicals ask your teacher.

Credit examination finishes the object.

For obtaining credit the student must meet following criteria:

to complete attendance at practicals and seminars, replace all missed

to complete 1 case study report

to pass the credit examination successfully

The terms for credit examination will be available in SIS and the examination will take place after finishing the practicals

Literature

Last update: Bc. Daniela Polanecká (08.07.2020)

INTERNAL MEDICINE II.:

Goldman, L.: Cecil medicine : W. B. Saunders company, 2008 (B)

Conaway, D. C.: Geriatrics : Williams and Wilkins, 1988 (B)

Forciea, Lavizzo-Mourey: Geriatric secrets, Elsevier, 2004 (B)

Chrobák, L.: Physical examination in internal medicine (B)

And basic literature for the 4th year

Requirements to the exam

Last update: Dita Strnadová (16.01.2024)

5TH YEAR – INTERNATIONAL STUDENTS – CREDIT

(valid from October 1st, 2021)

1. Acute heart failure

2. Chronic heart failure and its complex therapy

3. Aortic valvular disorders

4. Mitral valvular disorders

5. Coronary artery disease – acute forms

6. Chronic coronary artery disease – classification, etiology

7. Chronic coronary artery disease - diagnostics, therapy

8. Acute myocardial infarction

9. Complications of myocardial infarction

10. Shock

11. Arterial hypertension

12. Secondary hypertension

13. Pulmonary embolism

14. Congenital heart defects in adults

15. Inflammatory disorders of the heart (myocarditis, pericarditis…)

16. Infective endocarditis

17. Cardiomyopathies

18. Cardiac tamponade

19. Supraventricular arrhythmias

20. Ventricular arrhythmias

21. Atrial fibrillation – symptomatology, diagnosis and therapy

22. Cor pulmonale

23. Circulatory and breathing arrest, cardiopulmonary resuscitation

24. Disorders of aorta

25. Disorders of brain arteries, stroke

26. Acute and chronic disorders of peripheral arteries

27. Acute and chronic disorders of peripheral veins

28. Vasculatis - related kidney disease – affections of kidney caused by connective tissue diseases and vasculitis

29. Vasculitis

30. Nephrotic syndrome (definition and differential diagnosis)

31. Serious affections of kidneys in relation to internal diseases (diabetes

mellitus, hypertension, poisoning, malignancies)

32. Urinary tract infections

33. Urolithiasis

34. Acute and rapidly progressive glomerulonephritis

35. Chronic glomerulonephritis

36. Tubulointerstitial nephritis and pyelonephritis. Cystic disease of the kidney

37. Staging of chronic nephropathies (regardless of etiology)

38. Acute kidney failure

39. Chronic kidney failure

40. Acid-base balance and its disturbances

41. The most frequently observed disturbances of fluid and electrolyte balance

42. Organ transplantation, elimination methods

43. Vascular nephropathy

44. Benign disorders of the thyroid gland (including inflammatory); goiter

45. Hyperthyroidism and its complications

46. Hypothyroidism and its complications

47. Tumors of the thyroid gland

48. Parathyroid gland disorders

49. Basic hypothalamic and pituitary disorders

50. Hyporfunction of adrenal cortex, diagnostics, treatment, signficance

51. Hyperfunction of adrenal cortex, diagnostics, treatment, signficance

52. Primary hyperaldosteronism, diagnostics, treatment, signficance

53. Treatment by corticosteroids (acute and chronic), indication and complications

54. Disorders of adrenal medulla

55. Type 1 Diabetes mellitus – patophysiology, clinical presentation, diagnostics

56. Type 2 Diabetes mellitus - patophysiology, clinical presentation, diagnostics

57. Basic principles of treatment of type 1 and type 2 diabetes

58. Acute complications of diabetes mellitus

59. Chronic complications of diabetes mellitus

60. Obesity, syndrome of insulin resistance

61. Autoimmune polyglandular syndrome

62. Community-acquired pneumonia

63. Hospital-acquired pneumonia

64. Pulmonary tuberculosis

65. Extrapulmonary tuberculosis

66. Bronchial asthma – classification, therapy and prevention

67. Acute bronchial asthma

68. Chronic bronchitis, bronchiectasis

69. Chronic obstructive pulmonary disease (COPD) – diagnosis and therapy in a stable patient

70. Acute exacerbation of the chronic obstructive pulmonary disease

71. Idiopathic pulmonary fibrosis

72. Lung cancer

73. Pleural effusions

74. Pneumothorax

75. Acute and chronic respiratory insufficiency

76. Anemia – classification, etiology, symptomatology

77. Principles of transfusion medicine

78. Iron deficiency anemia

79. Megaloblastic anemia

80. Hemolytic anemia and anemia of chronic disease

81. Myelodysplastic syndrome

82. Myeloproliferative disorders

83. Plasmacytoma and plasma cell disorders

84. Disturbances in coagulation – bleeding disorders

85. Disturbances in coagulation – hypercoagulation state

86. Disseminated intravascular coagulopathy

87. Degenerative disorders of joints and spine

88. Chronic inflammatory arthropathies; rheumatoid arthritis

89. Acute rheumatic fever

90. Ankylosing spondylitis and spondylarthropathies

91. Systemic rheumatic disease (scleroderma, polymyositis, dermatomyositis)

92. Systemic lupus erythematosus

93. Osteoporosis and osteomalacia

94. Uric acid, gout, and porphyria

95. Disturbances of lipid metabolism

96. Atherosclerosis

97. Gastrointestinal bleeding

98. Disorders of esophagus

99. Peptic ulcer disease

100. Tumors of stomach

101. Inflammatory bowel disease

102. Colonic polyps and colorectal cancer

103. Non-neoplasmatic disorders of bowel – diverticulosis, diverticulitis

104. Functional gastrointestinal disorders, coeliac disease

105. Malabsorption syndrome

106. Cholelithiasis and its complication

107. Acute and chronic pancreatitis

108. Acute hepatitis

109. Chronic hepatitis

110. Liver cirrhosis

111. Portal hypertension – classification, complication, therapy and prognosis

112. Acute and chronic liver failure

113. Tumors of liver, bile duct, gallbladder and pancreas

114. Principles of parenteral nutrition

115. Principles of enteral nutrition

116. Differences in the course, clinical presentation, diagnostics, and therapy of internal diseases in elderly; functional geriatric examination

117. Geriatric frailty syndrome and rational pharmacotherapy in elderly

STATE EXAM QUESTIONS – 5TH YEAR – INTERNATIONAL STUDENTS - ERASMUS

(valid from October 1st, 2021)

CARDIOLOGY

1. Acute heart failure

2. Chronic heart failure – etiopathogenesis and symptomatology

3. Chronic heart failure – diagnostics and complex therapy

4. Aortic valvular disorders

5. Mitral valvular disorders

6. Coronary artery disease – acute forms

7. Chronic coronary artery disease – classification, etiology, symptomatology

8. Chronic coronary artery disease - diagnostics, therapy

9. Acute myocardial infarction

10. Complications of myocardial infarction

11. Shock

12. Arterial hypertension

13. Secondary hypertension

14. Pulmonary embolism

15. Congenital heart defects in adults

16. Inflammatory disorders of the heart (myocarditis, pericarditis…)

17. Infective endocarditis

18. Cardiomyopathies

19. Cardiac tamponade

20. Supraventricular arrhythmias

21. Ventricular arrhythmias

22. Atrial fibrillation – symptomatology, diagnosis, and therapy

23. Cor pulmonale

24. Circulatory and breathing arrest, cardiopulmonary resuscitation

25. Disorders of aorta

26. Disorders of brain arteries, stroke

27. Acute disorders of peripheral arteries

28. Chronic disorders of peripheral arteries

29. Acute disorders of peripheral veins

30. Chronic disorders of peripheral veins

31. Atherosclerosis

NEPHROLOGY

32. Vasculitis-related kidney disease – affections of kidney caused by connective tissue diseases and vasculitis

33. Vasculitis

34. Nephrotic syndrome (definition and differential diagnosis)

35. Serious affections of kidneys in relation to internal diseases (diabetes

mellitus, hypertension, poisoning, malignancies)

36. Urinary tract infections

37. Urolithiasis

38. Acute and rapidly progressive glomerulonephritis

39. Chronic glomerulonephritis

40. Tubulointerstitial nephritis and pyelonephritis. Cystic disease of the kidney

41. Staging of chronic nephropathies (regardless of etiology)

42. Acute kidney failure (classification and differential diagnostics)

43. Chronic kidney failure

44. Organ transplantation. Elimination methods.

45. Vascular nephropathy

METABOLISM

46. Acid-base balance and it´s disturbances

47. The most frequently observed disturbances of fluid balance

48. The most frequently observed disturbances of electrolyte balance

49. Disturbances of lipid metabolism

50. Parenteral nutrition – basic principles

51. Enteral nutrition – basic principles

52. Obesity

53. Osteoporosis and osteomalatia

54. Uric acid, hyperuricemia and gout

55. Porphyrias

ENDOCRINOLOGY

56. Benign disorders of the thyroid gland (including inflammatory); goiter

57. Hyperthyroidism and it´s complications

58. Hypothyroidism and it´s complications

59. Tumors of the thyroid gland

60. Parathyroid gland disorders

61. Basic hypothalamic and pituitary disorders

62. Hyporfunction of adrenal cortex, diagnostics, treatment, signficance

63. Hyperfunction of adrenal cortex, diagnostics, treatment, signficance

64. Primary hyperaldosteronism, diagnostics, treatment, signficance

65. Treatment by corticosteroids (acute and chronic), indication and complications

66. Disorders of adrenal medulla

67. Osteoporosis and osteomalatia

DIABETOLOGY

68. Type 1 Diabetes mellitus – pathophysiology, clinical presentation, diagnostics

69. Type 2 Diabetes mellitus - pathophysiology, clinical presentation, diagnostics

70. Basic treatment principles of type 1 diabetes

71. Basic treatment principles of type 2 diabetes

72. Acute complications of diabetes mellitus

73. Chronic complications of diabetes mellitus

74. Syndrome of insulin resistance

75. Autoimmune polyglandular syndrome

PULMOLOGY

76. Community-acquired pneumonia

77. Hospital-acquired pneumonia

78. Pulmonary tuberculosis

79. Extrapulmonary tuberculosis

80. Bronchial asthma – classification, therapy, and prevention

81. Acute bronchial asthma

82. Chronic bronchitis, bronchiectasis

83. Chronic obstructive pulmonary disease (COPD) – diagnosis and therapy in a stable patient

84. Acute exacerbation of the chronic obstructive pulmonary disease

85. Idiopathic pulmonary fibrosis

86. Lung cancer

87. Pleural effusions

88. Acute and chronic respiratory insufficiency

89. Diseases of mediastinum

HEMATOLOGY

90. Anemia – classification, ethiology, symptomatology

91. Principles of transfusion medicine

92. Iron deficiency anemia

93. Megaloblastic anemia

94. Hemolytic anemia and anemia of chronic disease

95. Myelodysplastic syndrome

96. Myeloproliferative disorders

97. Plasmacytoma and plasma cell disorders

98. Disturbances in coagulation – bleeding disorders

99. Disturbances in coagulation – hypercoagulation state

100. Disseminated intravascular coagulopathy

RHEUMATOLOGY

101. Degenerative disorders of joints and spine

102. Chronic inflammatory arthropathies; rheumatoid arthritis

103. Acute rheumatic fever

104. Ankylosing spondylitis and spondylarthropathies

105. Systemic rheumatic disease (scleroderma, polymyositis, dermatomyositis)

106. Systemic lupus erythematosus

107. Vasculitis

108. ANCA associated vasculitis

GASTROENTEROLOGY

109. Gastrointestinal bleeding

110. Disorders of esophagus

111. Peptic ulcer disease

112. Tumors of stomach

113. Inflammatory bowel disease

114. Colonic polyps and colorectal cancer

115. Non-neoplasmatic disorders of bowel – diverticulosis, diverticulitis

116. Functional gastrointestinal disorders, coeliac disease

117. Malabsorption syndrome

118. Cholelithiasis and its complication

119. Acute pancreatitis

120. Chronic pancreatitis

121. Acute hepatitis

122. Chronic hepatitis

123. Liver cirrhosis

124. Portal hypertension – classification, complication, therapy, and prognosis

125. Acute and chronic liver failure

126. Tumors of liver, bile duct, gallbladder, and pancreas

GERIATRICS

127. Differences in the course, clinical presentation, diagnostics, and therapy of internal diseases in elderly

128. Functional geriatric examination

129. Geriatric frailty syndrome

130. Rational pharmacotherapy in elderly

131. Aging theories

132. Organ changes during ageing

133. Cardiovascular system in elderly

134. Gastrointestinal system in elderly

135. Diabetes mellitus in elderly

Syllabus

Last update: Dita Strnadová (16.01.2024)

Klinika nukleární medicíny a endokrinologie
odkaz na přednášky v Moodle - https://dl1.cuni.cz/course/view.php?id=6781 (vstup pro studenty až po zadání hesla)

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Syllabus of lectures and seminars of Internal Medicine II

Nephrology:

1. Introduction to nephrology.

History of nephrology. Kidney anatomy, nephron, loop of Henle, blood supply. Kidney physiology and pathophysiology. Hormone secretion by the kidneys: renin-angiotensin-aldosterone system, vasodilators and their significance, the kidney and vitamin D, erythropoietin. History taken in the renal patient. Physical examination in patients with the renal disease. Blood pressure and the kidney, the kidney and blood pressure. How to collect the urine for laboratory assays. Urinalysis and microscopy. The urine pH and its interpretation. Proteinuria: quantitative and qualitative classification. Erythrocyturia and hematuria: classification. Casts: typology and significance. Urine culture. The glomerular function, glomerular filtration rate, clearance methods. SNGFR - single nephron glomerular filtration rate, its clinical and pathophysiologic significance. The tubular function. The urine concentration and acidification, tubular syndromes. Ions and other substances fraction excretion and their significance. Imaging methods in nephrology. Radionuclides in nephrology. Molecular biology in nephrology. Renal biopsy. Specific clinical syndromes (asymptomatic proteinuria, the nephrotic syndrome, acute nephritic syndrome, microscopic hematuria, recurrent hematuria, hypertension, acute renal failure, chronic renal failure).

Required knowledge: renal, ureter and urinary bladder anatomy and physiology; renal pathophysiology

2. Glomerulonephritis.

Richard Bright, Bright´s disease. Glomerulonephritis and glomerulopathy. Glomerular capillary structure, light microscopy, electron microscopy, immunofluorescent microscopy. Size selectivity and charge selectivity of the glomerular capillary wall. Prevalence and incidence of glomerulonephritis, pathogenesis, acute serum sickness, circulating immune complexes, in situ immune complex formation, most common autoantigens of the glomerular capillary. Etiology of glomerulonephritis: bacteria, viruses, other microorganisms, tumors, drugs, ANCA, infection and glomerulonephritis. Laboratory signs of glomerulonephritis: proteinuria, erythrocyteuria and hematuria, casts, glomerular filtration rate, complement components, anti-GBM. Renal biopsy: technique, significance, complication. Urinary syndromes in glomerulonephritis (predominant proteinuria, predominant hematuria, combined proteinuria, and hematuria). Differential diagnosis of glomerulopathies according to urinary findings. Classification of glomerulonephritis: primary, secondary, systemic. Acute glomerulonephritis. Rapidly progressive glomerulonephritis: anti-GBM, pauci immune (ANCA), immune complex glomerulonephritis. Minimal change nephrotic syndrome. Focal and segmental glomerulosclerosis. Membranous, mesangial proliferative (IgA nephropathy), membranoproliferative glomerulonephritis (mesangiocapillary). Symptomatic treatment of glomerulonephritis, immunosuppressive (‘specific’) treatment of glomerulonephritis, ‘biologic’ treatment of glomerulonephritis. Pregnancy and glomerulonephritis. Transplantation and glomerulonephritis, recurrence in the graft.

Required knowledge: the nephron structure; acute and chronic serum sickness; structure and physiological role of immune globulins; antiidiotopic antibodies; pathogenesis of immune mediated inflammation

3. Acute and chronic renal failure.

Renal insufficiency and renal failure. Differential diagnosis between acute and chronic renal failure. Causes of acute renal failure (ARF), classification, oliguric and non-oliguric ARF. Water handling, protein handling, DNA metabolites in ARF. Ion disorders, acid-base balance disturbance in ARF. Differential diagnosis of prerenal, Reno parenchymatous and postrenal ARF. Fraction excretion of sodium and urea, sodium urine concentration, urine osmolality in ARF. Monitoring of ARF patient. ‘Pitfalls’ in patient with ARF. Treatment of ion, nitrogen, and proton disturbances in ARF. Nutrition of the patient with ARF. ARF prognosis. CVVH in treatment of ARF. Chronic renal failure (CRF) - definition, prevalence and causes, experimental models, pathogenesis, uremic ‘toxins’. Disorders of water, electrolytes, and nitrogen metabolism in CRF, acid-base balance disorders in CRF. Central and peripheral nervous system disorders, cardiac disorders, respiration system disorders, gastrointestinal system disorders, endocrine system disorders in CRF. Blood count, uremic bone disease. Pharmacological treatment of CRF. Protein and salt intake in CRF. Adjustment of drug dosage in patients with CRF.

Required knowledge: renal, ureter and urinary bladder anatomy and physiology; renal pathophysiology

4. Urinary tract infections. Some other kidney diseases.

Definition. Pathogenesis. Causative agents of UTI. Clinical symptomatology. Differential diagnosis. Clinical course. Predisposing factors for complicated UTI. Diagnosis. Therapeutical regiment.

Required knowledge: renal, ureter and urinary bladder anatomy and physiology; renal pathophysiology

5. Fluid and electrolyte disorders.

Body water content. Body fluid compartments (intracellular, extracellular, interstitial, intravascular, EABV - effective arterial blood volume. Body fluids regulation, high- and low- pressure receptors, renin a-angiotensin-aldosterone system, other hormones. Ionic composition of extra- and intracellular fluids. Ionic composition of other body fluids. Low of electroneutrality. Estimation of body fluid volumes in the organisms: history, physical exam, laboratory exam. Extracellular fluid composition in body fluid volume disturbances. Disturbances of the urine ionic composition in dehydration. Hypovolemia and hypervolemia, differential diagnosis. Dehydration - its classification. Water and sodium - osmotically inactive sodium. Hyponatremia and hypernatremia. Hypochloremia and hyperchloremia. Hypokalemia and hyperkalemia. Hypophosphatemia and hyperphosphatemia. ECG in ion composition disturbances. Commonly used substitutive solutions, their composition. Calculation of water, sodium, and bicarbonate deficit. Routinely used concentrations of substitutive solutions. Ionic content of common p.o. administered salts. Which solution to use in common disturbances of ion and water body composition.

Required knowledge the role of water, sodium, potassium, calcium, phosphorus in the organism; mechanisms of water and electrolyte balance; Starling Law

6. Acid-base balance disturbances

7. Nephrotic syndrome, hypertension and kidney, urolithiasis.

Nephrotic syndrome - definition, theory of edema development. Nephropathies that could cause nephrotic syndrome, differences between nephrotic and nephritic syndrome. Corticosteroids and immunosuppressive treatment used in the treatment. Hypertension and kidneys - secondary renal and renovascular hypertension, vascular nefrosclerosis. Urolithiasis - etiology, types of urolithiasis, risk factors, basic examination and treatment.

Required knowledge: renal, ureter and urinary bladder anatomy and physiology; renal pathophysiology

8. Tubulointerstitial nephropathy.

Definition. Histology. Pathogenesis. Trigger factors. Clinical course. Diagnosis. Therapy.

Required knowledge: renal, ureter and urinary bladder anatomy and physiology; renal pathophysiology

9. Kidney disorders in diabetic patients. Dif. diagnosis of proteinuria.

Definition. Epidemiology. Etiopathogenesis. Clinical course. Frequent events of acute kidney injury on diabetic kidney disease. Diabetic kidney disease screening. Definition and Classification of microalbuminuria/proteinuria. Measurement and estimation of GFR. Diagnosis of vascular nephropathy. Diabetic kidney disease therapy.

Required knowledge: renal, ureter and urinary bladder anatomy and physiology; renal pathophysiology

10. Elimination methods in nephrology. Transplantation treatment.

Hemodialysis, peritoneal dialysis. Renal transplant, immunosuppressive therapy.

Required knowledge: renal, ureter and urinary bladder anatomy and physiology; renal pathophysiology

Hematology:

10. Differential diagnosis of anemias.

Short revision of clinically relevant information on hematopoiesis and basic laboratory tests in anemia diagnosis. Clinical presentation of anemias (signs and symptoms). Classifications used in differential diagnostics of anemias in clinical practice. Clinically most important types of anemia: iron deficiency anemia, anemia of chronic disease and megaloblastic anemias. Pathophysiology, differential diagnostics of causes and modern treatment of these diseases. Basic characteristics of hemolytic and aplastic anemias and principles of their diagnostic approach and treatment.

Required knowledge: pathology and pathophysiology of hematopoiesis

11. Principles of hemotherapy, transfusion

12. Multiple myeloma and monoclonal gammopathies

13. CLL, myeloprolipherative and myelodysplastic syndromes.

Definition, etiology, pathogenesis of chronic leukemia and myeloproliferative disorders. Laboratory and imaging methods, treatment.

Required knowledge: pathology and pathophysiology of hematopoiesis

14. Differential diagnosis of lymphadenopathies.

Definition, etiopathogenesis, diagnostics, clinical presentation.

Required knowledge: pathology and pathophysiology of hematopoiesis

15. Disorders of coagulation. Definition, etiology, pathogenesis and clinical presentation of bleeding disorders and thrombophilia states. Laboratory and imaging methods, treatment. Required knowledge: pathology and pathophysiology of coagulation

Rheumatology:

13. Diagnosis of systemic inflammatory diseases.

etiology, pathogenesis, diagnostics, and therapy of systemic inflammatory diseases. Clinical presentation and complications.

Required knowledge: pathology and pathophysiology of connective tissues and joints

14. Vasculitis.

Basic classification of vasculitis. Primary and secondary vasculitis. Vasculitis of large vessels (Takayasu and Horton´s arteritis), vasculitis of medium size vessels (polyarteritis nodosa and Kawasaki disease) and vasculitis of small vessels (Wegener´s granulomatosis, Churg-Strauss, ETA). Clinical presentation - systemic (febrility, fatigue, inflammation) and local. Treatment of vasculitis.

Required knowledge: pathology and pathophysiology of vasculitis

15. Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis – etiopathogenesis, clinical presentation, diagnostics, and therapy. Required knowledge: pathology and pathophysiology of connective tissues and joints

16. Systemic lupus erythematosus, scleroderma, dermato/polymyositis, polymyalgia rheumatica – etiopathogenesis, clinical presentation, diagnostics, and treatment. Required knowledge: pathology and pathophysiology of connective tissues and joints.

17. Osteoporosis – diagnosis and treatment. Required knowledge: pathology and pathophysiology of connective tissues and joints.

Endocrinology:

18. Diseases of parathyroid glands and disorders of calcium-phosphate metabolism.

Calcium, its´ role and content in the body. Homeostasis of calcium-phosphate metabolism. Parathormone, calcitonin and vitamin D and their role in calcium level regulation. Hyper and hypoparathyroidism. Osteoporosis, diff dg of hypocalcemia states.

Required knowledge: pathology and pathophysiology of endocrine glands

19. Diseases of the thyroid gland, endemic goiter.

Thyreopaties, ethiology. Metabolism of iodium and its role in thyroid gland function Thyroidal hormones and thein role in the body. Diagnostics and treatment of thyreopathies.

Required knowledge: pathology and pathophysiology of endocrine glands

20. Diseases of adrenal glands.

Adrenal glands and their hormones, role of adrenal hormones in metabolism regulation. Clinical presentation and syndromes connected to disturbances in hormonal secretion.

Required knowledge: pathology and pathophysiology of endocrine glands

21. Diseases of pituitary gland and hypothalamus.

Hormones of pituitary gland and hypothalamus, their role in metabolism. Clinical syndromes connected to disturbances in hormonal secretion, diagnostics, and treatment.

Required knowledge: pathology and pathophysiology of endocrine glands

Metabolism and varia:

22. Nutrition and its importance in health and illness, nutritional status assessment, malabsorption

23. Enteral and parenteral nutrition.

The most important information about clinical nutrition are given. The necessity of the special nutrition support in some diseases are explained.

Required knowledge: pathology and pathophysiology of metabolism

24. Practical application of nutritional evidence into clinical practice.

The most important information about clinical nutrition are given. The necessity of the special nutrition support in some diseases are explained.

Required knowledge: pathology and pathophysiology of metabolism

25. Syndrome of insulin resistance.

Insulin resistance, hyperinsulinemia. Syndrome of insulin resistance - ethiology, diagnostics, complications, treatment, and prevention possibilities.

Required knowledge: pathology and pathophysiology of diabetes

26. Diabetic foot syndrome.

Ethiology and pathogenesis od diabetic foot syndrome, diabetic neuropathy, and tissue ischemia. Influence of infection on the healing. Classification, diagnostics, treatment, and prevention.

Required knowledge: pathology and pathophysiology of diabetes

27. Hyperuricemia, gout, porphyria. Definition, pathogenesis, clinical features of hyperuricemia, arthritis uratica, chronic gout, therapy. Definition, classification, clinical features of porphyria. Required knowledge: physiology and pathophysiology of metabolism

28. Pre-operative examination and peri- and post-operative medical care in seriously ill patients (diabetes, hypertension, cardiac diseases...).

Preparation for surgery, ability of patients for surgery.

Required knowledge: pathology and pathophysiology

29. Functional disorders of the gastrointestinal tract. Coeliakia. Ethiology and classification of functional gastrointestinal disorders, clinical presentation, and diagnostic possibilities. Basic principles of therapy of functional disorders. Celiakia - clinical presentation, dispenzarization of the patients.

Required knowledge: pathology and pathophysiology of GIT

30. Therapy of infections in internal medicine.

Basic terminology connected to infectious diseases. Strategy of antimicrobial therapy, basic principles, and side effects of the treatment.

Required knowledge: pharmacology of antimicrobial agents

31. Primary and secondary prevention of cardiovascular diseases.

The principle risk factors and the complications of atherosclerosis are mentioned. The modalities that can decrease the risks and complications of atherosclerosis are underlined.

Required knowledge: pathology and pathophysiology of circulation

32. The importance of genetic examination in internal medicine. Genetically conditioned diseases, theirs´ screening and importance of genetic examination. Required knowledge: basic principles of genetics.

Lectures on Geriatrics, pharmacotherapy, and differential diagnostics with respect of the patient´s age:

31. Introduction to clinical geriatrics.

Definition of geriatric patients, differences of clinical presentation in elderly patients, involution changing of aging. Functional examination of geriatric patient. Frailty syndrome. Rational pharmacotherapy in elderly people.