Universitat Internacional de Catalunya
Endocrinology and Nutrition
Teaching staff
ggimenez@uic.es
Introduction
In the case that the sanitary authorities decreed a new period of confinement due to the evolution of the sanitary crisis caused by COVID-19, the professors must communicate in a timely manner the possible affectations to the methodologies and formative activities, also in the d 'system. assessed.
Endocrinology and Nutrition is that medical specialty that deals with the study and treatment of diseases of the endocrine glands, metabolism and all aspects related to nutritional status. It includes the basic and practical knowledge of diagnostic techniques, dietary and therapeutic measures and all aspects of Preventive Medicine related to these fields.
Pre-course requirements
The students must have approved the subject "Structure and function of the endocrine system". As well as, the basic subjects of "Biochemistry", "Cell Biology", "Molecular Biology", "Biophysics", "Histology", "Pathological Anatomy" and "Pharmacology."
Objectives
General objective
During the training period, the student must acquire the ability to recognize the main problems of endocrine pathology, guide their diagnosis (in particular in the most common pathologies), use current diagnostic methods following a logical and rational reasoning and, finally, guide the therapeutic approach. It will also be important to recognize signs of alarm that indicate the need for urgent hospital care.
Specific objectives
Recognize, diagnose and guide the management of the main pathologies of the endocrine system
• Hypothalamic-pituitary pathology.
• Malnutrition and nutritional therapy
• Obesity.
• Disorders of lipoprotein metabolism.
• Diabetes Mellitus. Hyperglycemia. Hypoglycemia
• Thyroid pathology. Inflammatory thyroid disorders: Thyroiditis Alterations of thyroid function: hyperthyroidism and hypothyroidism. Structural pathology of the thyroid: Goiter, thyroid nodule and thyroid cancer.
• Sexual development. Hirsutism and virilization. Gynecomastia.
• Hypercalcemia and Hypocalcemia.
• Diseases of the cortex and adrenal medulla.
• Multiple endocrine neoplasia.
• Tumors of the neuroendocrine lineage.
Competences/Learning outcomes of the degree programme
- 04 - Develop professional practice with respect for patient autonomy, beliefs and culture.
- 10 - To understand and recognise the agents and risk factors which determine health status, and learn how they determine the symptoms and natural development of acute or chronic diseases in individuals and populations.
- 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
- 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
- 16 - Recognize and deal with situations that put life in immediate danger and those that require immediate attention.
- 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
- 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
- 19 - Propose preventive measures appropriate to each clinical situation.
- 25 - Recognize the determinants of public health; genetic and sex-dependent lifestyle, demographic, environmental, social, economic, psychological and cultural determinants.
Learning outcomes of the subject
At the end of the course the student will be able to:
- Identify endocrine-metabolic diseases and know their therapeutic management.
- Know the indications of the determination of hormonal parameters and know how to interpret them.
- Argue for the application of complementary examinations in the common pathologies and to know how to interpret them.
- Know how to perform a differential diagnosis.
- Know the management of the main endocrinological emergencies (severe hypoglycaemia, diabetic ketoacidosis, hyperosmolar coma, hypercalcemia, myxedema coma, acute adrenal crisis…).
- Describe in an understandable way for the patient and / or relative an endocrinological pathology, treatment and prognosis.
Teaching and learning activities
In person
Classes Magistrals
1. Introduction to the endocrine system. Nature of hormones. Hormone receptor families and sites of action. Feedback regulation system. Disorders due to excess, deficit or resistance.
2. Thyroid I. Physiology of the thyroid Inflammatory and functional thyroid pathology.
3. Hypothalamus-Adenohypophysis I. Hypothalamic and adenohypophyseal insufficiency, genetic and acquired causes. Non-tumor lesions of the cell region: vascular, infectious and inflammatory.
4. Phosphate and-calcium metabolism and parathyroid pathology. Physiology of PTH and calcitonin secretion. Hypercalcemia: etiology and clinical manifestations. Hyperparathyroidism. Other causes of hypercalcemia and diagnosis. Hypocalcemia: causes and clinic. Hypoparathyroidism. Pseudohypoparathyroidism. Resistance to PTH action.
5. Adrenal cortex I. Physiology of adrenal hormone secretion. Primary adrenal insufficiency due to autoimmune cause (clinic, diagnosis and treatment). Other causes of primary adrenal insufficiency. Adrenal crisis. Primary and secondary hyperaldosteronism, other hypermineralocorticism and pseudohyperaldosteronism.
6. Adrenal cortex II. Glucocorticoid hypersecretion syndromes. Etiology, clinical manifestations, diagnosis and treatment. Adrenal incidentaloma. Adrenal medulla. Synthesis of catecholamines. Pheochromocytoma: Clinic, diagnosis and treatment.
7. Adult Hyperandrogenism. Definition. Sd. of the polycystic ovary. Other causes of adult hyperandrogenism. Virilizing tumors.
8. Multiple Endocrine Neoplasia. Gastroenteropancreatic endocrine tumors. Carcynoid syndrome. Classification of Multiple Endocrine Neoplasia syndromes. Clinic, genetic study, monitoring and treatment.
9. Diabetes I. Definition, classification of diabetes and diagnosis. Type 1 diabetes. Epidemiology. Pathogenesis of type 1 diabetes Treatment goals. Monitoring and treatment of hyperglycemia.
10. Diabetes II. Type 2 diabetes. Epidemiology. Pathophysiology. Treatment of type 2 diabetes: lifestyle changes, oral treatment, GLP-1 analogues and insulinization.
11. Diabetes III. Chronic complications of diabetes: Microangiopathic complications (nephropathy, retinopathy and neuropathy). Epidemiology, pathogenesis, diagnosis, treatment. Macroangiopathic complications. Epidemiology, Pathogenesis, diagnosis and treatment.
12. Disorders of lipid metabolism. Epidemiology. Diagnosis. Classification. Treatment of dyslipidemias.
13. Obesity. Definition. Etiology. Pathophysiology. Diagnosis. Obese patient assessment and comprehensive treatment.
14. Pathological Anatomy of the Endocrine System.
Split classes
1. Class I: Pituitary tumors I.
2. Part II: Thyroid nodular pathology and thyroid cancer. Clinical cases of thyroid pathology.
3. Part III: Pituitary tumors II. Pathology of the neurohypophysis.
4. Class IV: Acute complications of diabetes (severe hypoglycaemia, diabetic ketoacidosis, hyperosmolar situation
5. Class V: Adrenal pathology. Clinical cases
6. Class VI: Disorders of sexual development. Hypogonadism.
7. Class VI: Endocrine surgery (parathyroid, adrenal, thyroid, bariatric).
Problem Based Learning
ABP I Clinical Nutrition. Nutritional requirements
(macronutrients and micronutrients). Nutritional assessment. Malnutrition: definition, classification, pathophysiology. Treatment. Bases of nutritional support.
ABP II: Dietary treatment of Diabetes Mellitus.
ABP III: Non-insulin pharmacological treatment of type 2 Diabetes Mellitus.
ABP IV: Histopathology of the endocrine system.
Skills Lab
• LH. Diabetes. Insulin treatment in type 1 and 2 diabetes. Monitoring systems.
Evaluation systems and criteria
In person
The final evaluation of the student will be the sum of the evaluation of the different methodologies used. The percentage weight of each of them is detailed below:
- Theoretical evaluation: 60%
Midterm exam. It represents 5% of the note.
Final exam. It represents 55% of the note.
Written tests with 30 and 60 multiple choice questions, respectively, (4 possible answers). In the midterm, 12:25 will be deducted for each incorrect answer. In the final exam, 12:33 will be deducted for each incorrect answer. A score equal to or greater than 5 of the final exam will be required to pass the subject. The examination time will be 1.2 minutes per question.
The midterm exam does not release material.
The subject evaluated in the multiple choice exam includes the content of the divided classes, skills laboratory, virtual learning and problem-based learning sessions, that of the intranet teaching material and the recommended main bibliography.
-Evaluation of the practical methodology
Will represent 40% of the final grade. The final mark of the practical methodology will be obtained from the average of:
Split classes.
Problem-based learning.
Skills lab.
The non-attendance., the non-performance of the activity in any of the practical sessions or the non-performance of the virtual learning supposes a 0 in the score of that session.
The level of knowledge, the application of knowledge in problem solving, synthesis capacity, problem discussion, communication skills, participation and attitude will be evaluated.
- Second call
The second call exam will represent 55% of the grade, the partial exam 5% of the grade and the practical methodology will represent 40%.
In the second call, the final grade for the subject will in no case be eligible for excellent or honors
- Other calls
The qualification in the area of practical methodology will be valid for the calculation of the final grade for the second and third call final evaluation.
- Final grade improvement system
You can improve your grade (1 point maximum) by performing the virtual learning activities available in Moodle, as long as the average grade for the course is higher than 8.
Bibliography and resources
- Jameson, Fauci, Kasper, Hauser, Longo, y Loscalzo, Eds. HARRISON PRINCIPIOS DE MEDICINA INTERNA. 20a edición. McGraw Hill, 2018. ISBN: 978-1-4562-6486-4.
- Rozman y Cardellach, Eds. Farreras-Rozman MEDICINA INTERNA. 19ª edición. Elsevier, 2020. IBSN: 9788491135456.
- Melmed, Polonsky, Reed-Larsen y Kronenberg Eds. WILLIAMS TEXTBOOK OF ENDOCRINOLOGY 13th Edition, 2019. ISBN: 9788491131052.
Pàgines web recomanades
Formació en endocrinologia. www.endotext.org
Formació en patologia tiroidea. www.thyroidmanager.org
Fundación RedGDPS (diabetis a atenció primària). https://www.redgdps.org/publicaciones-redgdps/
Sociedad Española de diabetes. www.sediabetes.org. https://www.sediabetes.org/consensos-guias-y-recomendaciones/
Sociedad Española de endocrinologia y nutrición, www.seen.es. https://www.seen.es/portal/plataforma-formacion
American Association of Clinical Endocrinologists. www.aace.com
Endocrine society. www.endo-society.org. https://www.endocrine.org/clinical-practice-guidelines
Evaluation period
- E1 10/01/2022 15:00h
- E2 06/07/2022 14:00h