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2022/2023

Medicine and Surgery II

Code: 102944 ECTS Credits: 13.5
Degree Type Year Semester
2502442 Medicine OB 4 1
The proposed teaching and assessment methodology that appear in the guide may be subject to changes as a result of the restrictions to face-to-face class attendance imposed by the health authorities.

Contact

Name:
José María Ribera Santasusana
Email:
josemaria.ribera@uab.cat

Use of Languages

Principal working language:
catalan (cat)
Some groups entirely in English:
No
Some groups entirely in Catalan:
No
Some groups entirely in Spanish:
No

Teachers

Juan Genesca Ferrer
Jorge Sierra Gil
Christian Domingo Ribas
David Pares Martinez
Sergi Bellmunt Montoya

Prerequisites

In order to take this subject, it is recommended that the students should previously have studied the pathophysiology of cardiovascular system, respiratory system and blood and lymphatic system. Additional knowledge of anatomy, genetics, molecular biology and pharmacology is also recommendable. Knowledge of psychological bases of health status and disease, and adequate knowledge of communication and ethics is also necessary. 

The student will preserve the confidentiality and the professional secret and will maintain an ethical attitude in all the activities of knowledge

Objectives and Contextualisation

Hematology:

 The students will reach the adequate knowledge of the diseases of blood and hematopoietic organs and will learn to interpret the hematologic abnormalities due to non-hematologic diseases. They will achieve knowledge of the hematologic diseases, their classification, risk factors and prevention , clinical picture and laboratory diagnosis, treatment (including stem cell transplantation and immunotherapy/cell therapy), as well as dieseases of the hemostatic system, the transfusion of blood and derivatives and the diseases of the spleen.

 

Cardiology:

 The students will achieve adequate knowledge of the pathophysiology of the diseases of hearth and great vessels. The student will learn to make a differential diagnosis using the adequate complementary tools (electrocardiogram, chest X ray film, echocardiogram, CT scan, MRI, and biochemical markers, among others). The diseases of the cardiovascular system, their risk factors and prevention, the pathophysiology and clinical picture of the diseases of myocardium, cardiac valves, pericardium, aorta and venous and lymphatic system. The principles and clinical use of diagnostic procedures and techniques used in Cardiology and cardiovascular surgery, the adequate treatment (medical, surgical or instrumental) and the rehabilitation procedures of patients with cardiovascular diseases.

 

Pneumology:

 The students will achieve adequate knowledge of respiratory diseases (congenital, acquired, due to dysfunction, toxics drugs, infections, allergy, occupational, ambient, accidental inhalation, neoplastic, traumatism or of unknown origin), their clinical picture, risk factors and prevention , the diagnostic techniques and procedures , their medical, surgical (including the lung transplant) or instrumental therapy, as well as the rehabilitation procedures.

Competences

  • Demonstrate understanding of the manifestations of the illness in the structure and function of the human body.
  • Establish a diagnostic approach and a well thought-out strategy for action, taking account of the results of the anamnesis and the physical examination, and the results of the appropriate complementary tests carried out subsequently.
  • Give the patient and/or accompanying persons the relevant information about the disease process, its bases and consequences, including bad news, in an appropriate way.
  • Indicate the basic diagnosis techniques and procedures and analyse and interpret the results so as to better pinpoint the nature of the problems.
  • Indicate the most suitable treatment for the most prevalent acute and chronic processes, and for the terminally ill.
  • Obtain and prepare a patient record that contains all important information and is structured and patient-centred, taking into account all age and gender groups and cultural, social and ethnic factors.
  • Perform a general and a system-by-system physical examination appropriate to the patient's age and sex, in complete and systematic way, and a mental evaluation.

Learning Outcomes

  1. Describe the effects on all organs and systems of diseases of the blood, the cardiovascular system, the digestive system, the respiratory system, the endocrine system, the nervous system, the genitourinary system, infectious pathologies and diseases of the elderly.
  2. Describe the main pathological situations of the musculoskeletal system, the blood, the cardiovascular system, the digestive system, the respiratory system, the endocrine system, the nervous system, the genitourinary system, infectious pathologies and diseases of the elderly.
  3. Design the treatment for the main infectious diseases, diseases of the blood, of the elderly, and of the hematopoietic system, the cardiovascular system, the digestive system, the respiratory system, the endocrine system, the nervous system, the renal and genitourinary system, the retroperitoneal system and the musculoskeletal system.
  4. Explain the mechanisms by which illness affects the structure and function of the human body.
  5. Give patients the maximum possible information about their health, diagnostic steps, complementary examinations and treatments in an appropriate way.
  6. Identify tumour diseases, and the diagnosis and management of these.
  7. Indicate the complementary examinations for diagnosing the main infectious diseases, diseases of the blood, of the elderly, and of the hematopoietic system, the cardiovascular system, the digestive system, the respiratory system, the endocrine system, the nervous system, the renal and genitourinary system, the retroperitoneal system and the musculoskeletal system.
  8. Perform a suitable physical examination for the main infectious diseases, diseases of the blood, of the elderly, and of the hematopoietic system, the cardiovascular system, the digestive system, the respiratory system, the endocrine system, the nervous system, the renal and genitourinary system, the retroperitoneal system and the musculoskeletal system.
  9. State the most probable diagnosis for the main infectious diseases, diseases of the blood, of the elderly, and of the hematopoietic system, the cardiovascular system, the digestive system, the respiratory system, the endocrine system, the nervous system, the renal and genitourinary system, the retroperitoneal system and the musculoskeletal system.
  10. Write a report giving guidance on diagnosing the main infectious diseases, diseases of the blood, of the elderly, and of the hematopoietic system, the cardiovascular system, the digestive system, the respiratory system, the endocrine system, the nervous system, the renal and genitourinary system, the retroperitoneal system and the musculoskeletal system.

Content

Is highly recommendable to have basic knowledge of pathophysiology of cardiovascular system, respiratory system and blood and lymphatic system.

 Additional knowledge of anatomy, genetics, molecular biology and pharmacology is also recommendable.

 Knowledge of psychological bases of health status and disease, and adequate knowledge of communication and ethics is also necessary.

 The student will preserve the confidentiality and the professional secret and will maintain an ethical attitude in all the activities of knowledge

 

Hematology:

 The students will reach the adequate knowledge of the diseases of blood and hematopoietic organs and will learn to interpret the hematologic abnormalities due to non-hematologic diseases.

The hematologic diseases, their classification, risk factors and prevention , clinical picture and laboratory diagnosis, treatment (including stem cell transplantation and immunotherapy/cell therapy) picture, the disease of the hemostatic system, the transfusion of blood and derivatives and the diseases of the spleen.

 

Cardiology:

The students will achieve adequate knowledge of the pathophysiology of the diseases of hearth and great vessels. The student will learn to make a differential diagnosis using the adequate complementary tools (electrocardiogram, chest X ray film, echocardiogram, CT scan, MRI, and biochemical markers, among others)

The diseases of the cardiovascular system, their risk factors and prevention, the pathophysiology and clinical picture of the diseases of myocardium, cardiac valves, pericardium, aorta and venous and lymphatic system. The principles and clinical use of diagnostic procedures and techniques used in Cardiology and cardiovascular surgery, the adequate treatment (medical, surgical or instrumental) and the rehabilitation procedures of patients with cardiovascular diseases.

 

Pneumology:

 The students will achieve adequate knowledge of respiratory diseases (congenital, acquired, due to dysfunction, toxics drugs, infections, allergy, occupational, ambient, accidental inhalation, neoplastic, traumatism or of unknown origin), their clinical picture, risk factors and prevention , the diagnostic techniques and procedures , their medical, surgical (including the lung transplant) or instrumental therapy, as well as the rehabilitation procedures.

 

 A) HEMATOLOGY

 Theory (20 hours)

 1. Main hematologic syndromes. Hematologic tests and procedures

2. Anemias. Classification.  Iron deficiency  anemia. Anemia of chronic diseases. Megaloblastic and other macrocytic anemias.

3. Congenital and acquired hemolytic anemias

5. Myelodysplastic syndromes

6. Acute leukemias

7. Chronic myeloproliferative neoplasias

8. Benign and malignant diseases of lymph nodes. Diagnosis and staging of lymphomas.

9. Malignant lymphomas

10. Chronic lymphoproliferative diseases.

11. Monoclonal gammopathies

12. Pathology of the spleen.

13. Pathology of mononuclear phagocytic system

14. Diseases of the hemostatic system. Thrombocytopenia and thrombocytopathy.

15. Congenital and acquired coagulopathies.

16. Hypercoagulability. Anticoagulant and thrombolytic therapy.

17. Hemotherapy

18.Hematopoietic stem cell transplantation and cellular therapy

 

Seminars on clinical cases (5 hours)

1. Case 1: anemia

2. Case 2: pancytopenia

3. Case 3: adenopathy

4. Case 4: hemorrhage

5. Case 5: thrombosis

6. Case 6: hematologic abnormalities of extrahematologic disease

7. Case 7: splenomegaly

 Clinical practice

Stay un the hospitalization unit, day/hospital,outpatient area, laboratory of hematology and blood bank

 

B) CARDIOVASCULAR

 

Theory (28 hours)

1. Ischemic cardiopathy

2. Ischemic cardiopathy II  (diagnosis)

3. Ischemic cardiopathy III (stable and unstable angor)

4. Ischemic cardiopathy IV (myocardial infarction)

5. Surgery of ischemic cardiopathy

6. Pericardic diseases

7. Myocardial diseases (myocarditis, dilated cardiomyopathy)

8. Myocardial diseases II (hypertrophic cardiomyopathy)

9. Cardiac failure I (concept, clinical picture and diagnosis)

10. Cardiac failure II (treatment)

11. Arrhythmias I (bradiarrhythmias)

12. Arrhythmias II (supraventricular tachiarrhythmias)

13. Arrhythmias III (ventricular tachiarrythmias)

14. Arrhythmias IV (treatment)

15. Syncope and sudden death

16. Valvulopathies I (mitral)

17. Valvulopathies II (aortic)

18. Infectious endocarditis

19. Valvular surgery. Hearth transplant

20. Arterial hypertension

21. Pulmonary arterial hypertension and pulmonary thromboembolism

22. Diseases of thoracic aorta

23. Congenital cardiopathies in adults

24. Acute ischemia and vascular trauma

25. Chronic ischemia. Diabetic foot.

26. Aneurisms

27. Tumors and angiodysplasia. Arteriovenous fistulas.

28. Arteritis and functional vasculopathies

 

Specialized seminars (6 hours)

1. Normal electrocardiogram

2. Arrhythmias

3. Hearth failure

4. Ischemic cardiopathy. Myocardial infarction

5. Aneurisms

6. Ischemia of extremities

 

Clinical practice

Stay at the inpatient unit, coronary unit, specialzed exploration and outpatient unit

 

C) PNEUMOLOGY AND THORACIC SURGERY

 Theory (23 hours)

 Study of patients with respiratory disease

2. Respiratory failure

3. Disorders of ventilation. Hypoventilation and hyperventilation

4. Respiratory disorders during the sleep

5. Chronic obstructive pulmonary disease

6. Asthma

7. Defensive mechanisms of lung. Bronchiectasis. Cystic fibrosis.

8. Respiratory infections

9. Nosocomial pneumonia

10. Lung tuberculosis

11. Lung infections in immunosuppressed patients

12. Occupational and ambient diseases

13. Pulmonary eosinophilias. Extrinsic allergic alveolitis

14. Interstitial and infiltrative lung diseases

15. Sarcoidosis

16. Lung involvement in systemic diseases and pulmonary vasculitis

17. Lung cancer I; epidemiology, etiology, classification, histology, clinical picture, radiology, diagnosis, paraneoplastic syndromes, medical therapy.

18. Lung cancer II; surgical staging, indications of surgery, surgical techniques, combined therapy, solitary pulmonary nodule.

19. Lung cancer III; lung metastasis, benign lung tumors. Surgical aspects of the treatment of tumors.

20. Pathology of the mediastinum. Diagnosis and therapy of mediastinal tumors. Pleuropericardic and bronchogenic cysts. Neurogenic tumors. Acute and chronic mediastinitis

21. Benign pleural diseases: Etiology. Classification, diagnosis. Tuberculous pleuritis

22. Thoracic traumatisms; management

23. Lung transplant

 

Specialized seminars (3 hours) and seminaries of clinical cases (4 hours)

1. Oxygenotherpy devices

2. Lung function tests. Tobacco

3. Thoracic echography. Pleural drainages

 Seminars on clinical cases

 1. Pneumonia

2. Hemoptisis

3. Interstitial lung disease

4. Asthma. Chronic obstructive airways disease

 D)Clincal practice

Attendance to the Pneumoloy Department  (medical and surgical): hospitalization, day hospital, outpatient area, laboratory, special techniques.

 

Methodology

 The setting, content methodology and general rules of MIC II according to the general study plan are herein described. The final organization of MIC II regarding the number and size of groups, calendar distribution, date of exams, specific criteria for evaluation and review of exams will be specifically indicated at each Docent Unit in their respective web pages, as well as by the responsible professors of MICII at each Docent Unit  

As a general rule for teaching methodology the theoretical classes and seminars should have a practical orientation avoiding when possible the magisterial class. They should be based on practical clinical cases and should be oriented to the training of general physicians, avoiding the concepts belonging to super specialization.

The professors responsible of MIC II for this course are:

Responsible Departments: Medicine and Surgery

Responsible at the Faculty: Josep-Maria Ribera Santasusana, David Pares Martinez        

Responsible at the Teaching Hospital Units (UDH)

Unitat Docent Sant Pau

 

Responsible UDH

Responsible Surgery

Responsible Medicine

MIC II

 Jorge Sierra Gil  
jsierra@santpau.cat

Eduard Targarona

etargarona@santpau.cat

 Eduardo Targarona
etargarona@santpau.cat

Jorge Sierra Gil

jsierra@santpau.cat  

• Cardiovascular diseases

 Jose Mª Guerra Ramos
jguerra@santpau.cat

Jose Roman Escudero Rodriguez 

<palign="center">  J.Guerra Ramos
jguerra@santpau.cat

• Respiratory diseases

 Vicente Plaza Moral  
vplaza@santpau.cat

 Elisabet Martinez Tellez

  V. Plaza Moral  
vplaza@santpau.cat

• Hematologic diseases

 Jorge Sierra Gil  
jsierra@santpau.cat

 Eduardo Targarona
etargarona@santpau.cat

  Jorge Sierra Gil  
jsierra@santpau.cat

 

 Unitat Docent Vall d'Hebron

 

Responsible UDH

Responsible surgery

Responsible medicine

MIC II

Joan Genescà
jgenesca@vhebron.net
Sergi Bellmunt Montoya (sbellmunt@vhebron.net)

Sergi Bellmunt 

 Joan Genesca

• Cardiovascular diseases

Ignacio Ferreira

Sergi Bellmunt Montoya

Sergi Bellmunt Montoya (sbellmunt@vhebron.net)

 

Ignacio Ferreira

Respiratory diseases

Jaume Ferrer

Albert jauregui

 

Albert Jauregui

 Jaume ferrer

• Hematologic diseases

Francesc Bosch Albareda

fbosch@vhebron.net

Nivardo Rodriguez Conde
nirodriguezvhebron.net 

Francesc Bosch Albareda

fbosch@vhebron.net

 

Unitat Docent Germans Trias i Pujol

 

Responsible UDH

Responsible Surgery

Responsible Medicine

MIC II

Josep-Maria Ribera Santasusana
jribera@@iconcologia.net
Jaume Fdez.-Llamazares Rodríguez
jfllamazares.germanstrias@gencat.cat

Jaume Fdez.-Llamazares Rodríguez
jfllamazares.germanstrias@gencat.cat

Josep-Maria Ribera Santasusana
jribera@iconcologia.net

• Cardiovascular diseases

AntoniBayés Genís
abayesgenis@gmail.com
Secundino Llagostera Pujol
sllagostera.germanstrias@gencat.cat

Secundino Llagostera Pujol
sllagostera.germanstrias@gencat.cat

Antoni Bayés Genís
abayesgenis@gmail.com

• Respiratory diseases

Jorge Abad Capa
jabadc.germanstrias@gencat.cat
Pedro Enrique López de Castro
plopezdecastro.germanstrias@gencat.cat

Pedro Enrique López de Castro
plopezdecastro.germanstrias@gencat.cat

Jorge Abad Capa
jabadc.germanstrias@gencat.cat

• Hematologic diseases

Josep Ma. Ribera Santasusana
jribera@iconcologia.net
David Pares Martínez

David.Pares@uab.cat

David Pares Martínez

David.Pares@uab.cat

Josep M. Ribera Santasusana
jribera@iconcologia.net

 

Unitat Docent Parc Taulí

 

Responsible UDH

Responsible Surgery

Responsible Medicine

MICII

Cristian Domingo Ribas
Cdomingo@tauli.cat

Salvador Navarro Soto
snavarro@tauli.cat

Cristian Domingo Ribas
Cdomingo@tauli.cat

• Cardiovascular diseases

Antoni Martinez Rubio
AMartinezR@tauli.cat

Jana Merino

Cristian Domingo Ribas
Cdomingo@tauli.cat

• Respiratory diseases

 Christian Domingo  Manuela Iglesias  Cristian Domingo

• Hematologic diseases

Luz Muñoz Marin
Lmunoz@tauli.cat

SalvadorNavarro Soto
snavarro@tauli.cat

Luz Muñoz Marin

In the current exceptional circumstances, at the discretion of the teachers and also depending onthe resources available and the public health situation, some of the theoretical classes, practicals and seminars organized by the Teaching Units may be taught either inperson or virtually.

Annotation: Within the schedule set by the centre or degree programme, 15 minutes of one class will be reserved for students to evaluate their lecturers and their courses or modules through questionnaires.

Activities

Title Hours ECTS Learning Outcomes
Type: Directed      
CARE PRACTICUM WITHOUT GUIDELINES 62 2.48 1, 2, 3, 8, 4, 9, 6, 7, 5, 10
CLINICAL CASE SEMINARS (SCC) 9 0.36 1, 2, 3, 8, 4, 9, 6, 7, 5, 10
Specialized seminars (SEM) 9 0.36 1, 2, 3, 8, 4, 9, 6, 7, 5, 10
THEORY (TE) 73 2.92 1, 2, 3, 8, 4, 9, 6, 7, 5, 10
Type: Autonomous      
SELF-STUDY /READING ARTICLES /REPORTS OF INTEREST 167.5 6.7 1, 2, 3, 8, 4, 9, 6, 7, 5, 10

Assessment

The evaluation procedure of each matter of MIC II will consist of a written theoretical exam (40% of final score), evaluation through case studies and problem solving (40% of final score), analysis of clinical, cyto or histologic, radiologic EKG, or other image pictures (10% of final scores ) and evaluation of the attendance to the hospital practice (10%). The attendance and active participation in class and seminars will also be taken into account.

 

Theoretical exam (40%)

Restricted question or multiple choice questions can be used according to the criteria of each Hospital Teaching Unit

Case studies and problem solving (40%)

At least two clinical cases.

Pictures (10%)

Will be presented during the exam. A specific answer will be required

Hospital practice (10%)

The attendance is mandatory. A written signature by the professor will be required

 

If the student has not approved the exam of any of the matters of MIC II (minimal score 5) an additional exam with the same structure will be offered

The final score of MIC II will be the wetged mean of scores of the three matters (cardiology, neumology and hematology)

Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
Objective tests 60% 10 0.4 1, 2, 3, 8, 4, 9, 6, 7, 5, 10
Practical evaluations: open and descriptive registries and / or closed registers 40% 7 0.28 1, 2, 3, 8, 4, 9, 6, 7, 5, 10

Bibliography

The biblography of ewach mattter of MIC II will appear in the specific programs  located at the web page of each Teaching Unit  and /or at the virtual campus of MIC II

Hematology

Woessner S, Florensa L. La citología óptica en el diagnóstico hematológico. 5ª ed. Madrid, Fundación Española de Hematología y Hemoterapia FEHH, 2006.

 Sanz MA, Carreras E. Manual práctico de Hematología Clínica. 5ª ed. Sabadell, Ed. Antares, 2020

 Hoffman R, Benz Jr. EJ, Astil SJ, et al. Hematology. Basic principles and practice. 7ª ed. Churchill Livingstone, Philadelphia, 2018.

 Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B.  Wintrobe’s Clinical Hematology 14ª ed. Philadelphia, Lippincott Williams & Wilkins, 2018.

 Lichtman M, Beutler E, Kaushansky K, Kipps TJ, Seligsohn U, Prchal J. Williams Haematology. 9ª ed. McGraw-Hill, 2016.

 Medicina Interna Farreras Rozman. Sección 14 Hematología. 19ª ed. Madrid Elsevier España S.A. 2020

 Harrison’s  Principles of Internal Medicine, 20th Edición, McGraw-Hill, 2018

 http://asheducationbook.hematologylibrary.org/

http://www.ash-sap.org/

http://ashimagebank.hematologylibrary.org/

http://teachingcases.hematology.org/

http://www.hematology.org/Publications/Videos/

http://www.ehaweb.org

http://www.esh.org/

http://www.hematologyatlas.com/

http://www.sehh.es

 

Pneumology

Farreras A y Rozman C. Medicina Interna.1
7ª edición. Elsevier. Barcelona 2012.
Braunwald, Fauci, Kasper, Hauser, Longo, Jameson. Principios de Medicina Interna 17ª Ed.McGraw‐Hill, Interamericana. Madrid 2010.
JL Álvarez-Sala et al,. Neumología Clínica. Elsevier España SL. Barcelona 2010
Recomendaciones SEPAR.  Normativas disponibles en la página Web de la SEPAR
Sabinston. Tratado de cirurgia.  Townsend et al. 19ª ed. 2013. Elsevier.
Tratado de cirurgia torácica SEPAR. Ed SEPAR- EDIMSA Madrid 2010

Societat Catalana de Pneumologia (SOCAP): www.socapnet.org

Sociedad Española de Neumología y Cirugía Torácica (SEPAR): www.separ.es

European Respiratory Society (ERS): www.ersnet.org

American Thoracic Society (ATS): www.thoracic.org

 

Cardiology

Books

  • Harrison Principios de Medicina Intern. Mc Graw Hill.
    • Tratado de Medicina Interna Farreras-Rozman. Elsevier.
    • Braunwald Tratado de Cardiología. Elsevier.
    • Heart disease. A text book of cardiovascular medicine. Braunwald E, Ross R, Topol EJ. Philapdelphia.
    • Mayo Clinic Cardiology Review, Murphy
    • Electrocardiografía clínica, Bayés de Luna, Antoni. Espaxs, S.A
    • La electrocardiografia en la toma de decisiones en urgencias.  H. Wellens. Elsevier.
    • Vascular surgery:  Rutherford   W. B. Saunders Company
    • Tratado de las enfermedades vasculares.  Sociedad  Española de Angiologia y Cirugía Vascular. Viguera editores. Varios autores
    • Guia del residente de  angiología y cirugía vascular  Sociedad Española de Angiología y Cirugía Vascular.
    • Aterosclerosis y enfermedad arterial coronaria. Springer-Verlag Ibérica. Barcelona.

 Journals

  • Circulation
  • Journal of the American College of Cardiology
  • European Heart Journal
  • Revista Española de Cardiología

  Internet resources

 http://www.ncbi.nlm.nih.gov/pubmed

 

Software

Each Unit will develop the program of Hematology, Cardiology and Pneumology with specific adaptations to the particular characteristics, especially regarding the time table for classes, hospital attendance, seminars and dates of exams.