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Předmět, akademický rok 2023/2024
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Clinical Examination in Internal Medicine - FGP031
Anglický název: Clinical Examination in Internal Medicine
Zajišťuje: Katedra interních oborů (15-400)
Fakulta: Lékařská fakulta v Hradci Králové
Platnost: od 2023
Semestr: zimní
Body: 0
E-Kredity: 7
Způsob provedení zkoušky: zimní s.:
Rozsah, examinace: zimní s.:25/67, Z+Zk [HS]
Počet míst: neomezen
Minimální obsazenost: neomezen
4EU+: ne
Virtuální mobilita / počet míst pro virtuální mobilitu: ne
Kompetence:  
Stav předmětu: vyučován
Jazyk výuky: angličtina
Způsob výuky: prezenční
Způsob výuky: prezenční
Úroveň:  
Poznámka: odhlásit z termínu zkoušky při nesplněné rekvizitě
Garant: prof. MUDr. Petr Dulíček, Ph.D.
Prerekvizity : {General Medicine 1st year}, FGP016
Neslučitelnost : FV10025
Záměnnost : FA0105050, FA0105051, FV10025
Ve slož. prerekvizitě: FG10050, FG10051, FG10052, FG10054, FG10055, FG10056, FG10057, FG10058, FG10059, FG10060, FG10061, FG10062, FG10063, FG10064, FG10065, FG10066, FG10067, FG10068, FG10076, FG10077, FG10078, FG10079, FG10080, FG10081, FG10092, FG10093, FG10094, FG10095, FG10097, FV057
Anotace - angličtina
Poslední úprava: Bc. Tereza Bartáková (17.07.2023)
During the course Physical Examination in Internal Medicine students will learn the basics of history taking and physical examination with a focus on internal medicine disorders. Entry requirements: successful completion of Physiology II. Expected outcomes (knowledge and clinical skills): 1. Knowledge of clinical picture of the most common internal diseases. 2. Clinical examination of the patient.
Vstupní požadavky - angličtina
Poslední úprava: Bc. Tereza Bartáková (13.09.2023)
Entry requirements: successful completion of Physiology II 
Cíl předmětu - angličtina
Poslední úprava: Bc. Tereza Bartáková (13.09.2023)

Expected outcomes (knowledge and clinical skills):  

  1. Knowledge of clinical picture of the most common internal diseases. 

  1. Clinical examination of the patient. 

Požadavky ke zkoušce - angličtina
Poslední úprava: Patricie Mrkvičková (18.09.2023)

Requirements for credit 

 

Participation in seminars and practicals 

No more than two excused absences are allowed; excuses must be sent only in advance by e-mailto the Academic Department of Internal Medicine. In case of a higher number of absences the situation will be delt individually with the Head of the Academic Department of Internal Medicine. 

 

Credit 

Credit will be awarded based on successful completion of all the tests before the seminars (History taking in patients with respiratory diseases, History taking in patients with cardiac disorders, History taking in hepatogastroenterology, Rheumatology: case presentation, Physical examination in cardiology, Physical examination in pneumology, General assessment of the patient) - required success rate 70 %. If all tests are not passed before the seminars no credit will be given for the course. 

 

Exam 

Theoretical part: 

The theoretical part of the exam will assess knowledge of the symptoms of internal diseases, principles of physical examination and clinical cases of the most common internal diseases. 

First and second attempt: Test inMoodle, 50 questions, grade: 90 % excellent, ≥ 80 % very good, 70 % good. 

Third attempt: commissional oral exam 

Practical part: 

Clinical examination of the patient. - Evaluation by OSCE method, required success rate > 70%.

Sylabus - angličtina
Poslední úprava: Patricie Mrkvičková (18.09.2023)

Lectures 

The lectures are aimed at introducing the basic principles of clinical examination of the patient. 

 

Lecturers: 

Assoc. Prof. Miroslav Solař, M.D., Ph.D.

Róbert Bánszky, M.D.

Assoc. Prof. Petr Bradna, M.D., Ph.D.

Assoc. Prof. Jiří Ceral, M.D., Ph.D.

Tomáš Fejfar, M.D., Ph.D.

Assoc. Prof. Vladimír Koblížek, M.D., Ph.D.

Vratislav Sedlák, M.D., Ph.D.

Assoc. Prof. Roman Šafránek, M.D., Ph.D.

Štěpán Šembera, M.D., Ph.D.

Prof. Pavel Žák, M.D., Ph.D.

 

Topics: 

Introduction into Clinical Medicine 

Introduction into cardiac exam (briefing before practising with cardiac aucultation simulator)

General Assessment of the Patient 

Clinical Examination in Pneumology I-IV 

Clinical Examination in Cardiology I-V 

Clinical Examination in Hepatogastroenterology I-IV 

Clinical Examination in Rheumatology I-II 

Clinical Examination in Hematology 

Clinical Examination in Nephrology I 

Clinical Examination in Angiology I-II 

wrap up of clinical examination in cardiology 

wrap up of clinical examination in pneumology 

wrap up of clinical examination in hepatogastroenterology 

 

E-learning - Introduction into lung exam (briefing before practising with lung aucultation simulator)

 

Seminars 

The seminars focus on the practical aspects of the clinical examination of the patient. 

 

Lecturers: 

Prof. Petr Dulíček, M.D., Ph.D.

Assoc. Prof. Vladimír Koblížek, M.D., Ph.D.

Michal Kopecký, M.D.

Prof. Radek Pudil, M.D., Ph.D.

Assoc. Prof. Miroslav Solař, M.D., Ph.D.

Šembera Štěpán, M.D., Ph.D.

Tomš Jan, M.D., Ph.D.


Topics: 

Communication with the patient 

General Assessment of the Patient

History taking in patients with cardiac disorders

History taking in hepatogastroenterology

Physical examination of the cardiovascular system

Physical examination of the respiratory tract

Rheumatology: case presentations

History taking in patients with respiratory diseases

wrap up of physical examinationhistory taking, QA 

wrap up of history taking, QA 

 

Practicals

During practical classes of physical examination the students will master the following knowledge and skills.   

Medical history 

Family history: occupational history and social background, allergy, atopy, smoking history, alcohol and illicit drug abuse, previous medical history (assessment of individua organ systems, surgery, major injury), gynaecological history, pharmacotherapy (n. of drugs and indications) 

Current complaints (detailed assessment of the most frequent symptoms): Pain assessment (SOCRATES), Chest pain (cardiac and non-cardiac chest pain, angina pectoris, chest pain in acute myocardial infarction), Dyspnoea (NYHA a mMRC scoring, typical features of of dyspnoea in heart failure, pulmonary disease, anemia), Short lasting unconsciousness (clinical picture of cardiogenic, ortostatic and reflex syncope, epilepsy), Palpitace (to know the accompanying symptoms that may correspond to serious arrhythmias: chest pain, dyspnoea, weakness, syncope), Leg pain (to know the symptom related to the peripheral artery disease), Leg oedema (to know the characteristics of oedema in deep vein thrombosis, heart failure, chronic venous insufficiency, hypoproteinemia), Cough, Dysphagia , Upper dyspepsia, Lower dyspepsia, Sing of gastrointestinal bleeding, Acute abdominal pain (to know the signs of peritonitis), Arthalgia (inflammatory and non-inflammatory), Signs of infection, Signs of malignant disorders, Signs associated with kidney and urinary tract disease.   

Physical exam  

General assessment  

Vital signs: State of consciousness and cooperation (AVPU, GCS), Respiration (respiratory rate, abnormal respiratory patterns), Capillary refill time, Heart rate, Blood pressure, SpO2 measurement,  

Other: Skin (colour, and major abnormalities), Hydration (signs of dehydration and hyperhydration), Position and mobility,  

Head exam  

Common pathologies of the face (eg. uremic face), Nose and ears, N. V a n. VII 

Eye exam: Position and movement of eyeballs, Pupils, Scleras and irises, Conjuctivas  

Mouth exam: Oral mucosa, Dentice, Tongue  

Neck exam: Neck spine mobility, Neck (jugular) vein filling (normal, increase, decreased, not accessible for examination), Carotid arteries, Lymph nodes, Thyroid gland.  

Chest exam  

Shape, Brest exam (on a model), Skin abnormalities, Scars.  

Cardiac exam  

Inspection, Palpation, Auscultation: heart rate, sounds and murmurs (systolic murmur in a patient must be heard by every student) 

Pulmonary exam  

Inspection (to know signs of respiratory distress, paradoxical breathing, normal and pathological breathing patterns), Percussion, Palpation and bronchophony 

Auscultation (every student must examine a patient with abnormal breathing sounds: crackles, wheezing, prolonged expiration) 

Abdominal exam  

Inspection (Constitution, respiration, hernias, scars, caput medusae, skin abnormalities), Auscultation (peristalsis, vascular murmurs), Percussion, Palpation, Liver exam (every student must examine patient with hepatomegaly), Splenic exam, Per rectum exam (on a model), Examination of a patient with ascites.   

Examination of the kidney exam and urinary tract 

Tapotement, Bimanual palpation 

Examination of the extremities 

Examination of arteries, Examination of the veins (varices, signs of dep vein thrombosis), Oedema,  

Examination of typical patients with   

Acute coronary syndrome, Heart failure, Chronic obstructive pulmonary disease, Pneumonia, Liver cirrhosis 

 

Necessary equipement: stethoscope 

Required clothing: white coat

 

 

Literatura - angličtina
Poslední úprava: Bc. Tereza Bartáková (19.07.2023)

Rocommended sources:

Literature: 

Adam Feather, David Randall, Mona Waterhouse, Kumar and Clark´s Clinical Medicine E-Book

Ian B. Wilkinson, Tim Raine, Kate Wiles, Anna Goodhart, Catriona Hall and Harriet O´Neil, Oxford Handbook of Clinical Medicine 

Češka et. al., Interna

Sčudla et. al. Základy diferenciální diagnostiky ve vnitřním lékařství

Bureš et. al Vnitřní lékařství

Bureš J, Horáček J, Malý J (eds): Vnitřní lékařství I a II. 2. vydání. Praha, Galén, 2014; ISBN 978-80-7492-145-2

Websites:

1. www.medscape.com

2. www.amboss.com

3. wikidoc.org

 

 
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