Universitat Internacional de Catalunya

Clinical Semiology and Physiopathogenia

Clinical Semiology and Physiopathogenia
11
12066
3
First semester
OB
Main language of instruction: Spanish

Teaching staff

Introduction

We welcome you to thec ourse of Semiotics and Pathophysiology, a key subject in your journey as future health professionals. This coursewill provide you with the essential tools to understand the signs and symptoms of disease, integrating theoretical foundations with clinical practice. Semiotics forms the basis of medical examination, while pathophysiology allows us to understand the internal mechanisms that explain the onset of diseases. Mastering these concepts will not only make you more competent professionals but will also give you a critical and analytical perspective that is essential for making accurate diagnoses and providing quality patient care. I encourage you to make the most of this learning, which will be fundamental throughout your medical career. 

Pre-course requirements

To ensure proper follow-up and achievement of the learning objectives set out, it is essential that students have acquired the knowledge or are enrolled in: 

  • Biochemistry 

  • EiF: Locomotor System 

  • Introduction to Medical Genetics 

  • EiF of the Integration Systems: Nervous and Endocrine 

  • EiF: Skin and Sensory Organs 

  • Molecular Biology 

  • Cell Biology 

  • EiF: Cardiovascular, Respiratory and Renal System 

  • EiF of Blood and the Immune System 

  • EiF: Digestive System and Metabolism 

  • EiF: Reproductive System 

Objectives

The general objective of this course is to understand, through a global and systematic vision, the forms of presentation of diseases, as well as the pathophysiological mechanisms that originate them in order to carryout a correct clinical judgment. 

Specific Objectives: 

  • Acquire a global and integrated view of the mechanismsthat alter the normal functioning of the various organsand systems that make up the human body. 

  • Understand the importance of the clinical history, with special focus on semiotics and propaedeutics. 

  • Identify and interpret the mainc linical manifestations indicative of disease. 

  • Differentiate between signs of normal and pathological organic function in the areas of study. 

  • Know the principles of complementary tests used to study and differentiate normal and pathological functioning and their precise indications in medical pathology. 

Learning outcomes of the subject

At theend of thecourse, thestudentshould be able to: 

Knowledge 

  • Recognize semiology and the importance of medical history and anamnesis, applying ethical principles and respect for the patient, to identify relevant signs and symptoms in the diagnostic process. 

  • Describe the pathophysiological mechanisms that explain the functiona lalterations of the different organs and systems, taking into account biological variability and lifestages to understand the presentation of diseases. 

  • Relate biological, social, and environmental factors with the mechanisms of disease and principles of social justice, adopting an integrative approach to patient care. 

  • Identify therapeutic and preventive resources based on scientific evidence, assessing the need to coordinate with other health professionals for an optimal approach to each clinical case. 

Skills 

  • Apply anamnesis and physical examination techniques to obtain relevant information about the patient's clinical status, demonstrating active listening and empathy in the doctor-patient relationship. 

  • Interpret groupings of signs and symptoms to guide differential diagnosis, using clinical and pathophysiological criteria based on scientific evidence. 

  • Demonstrate skill in performing basic clinical procedures such as thoracocentesis, lumbar puncture, or assessment of vital signs, adapting them to different clinical situations. 

  • Integrate data from the clinical interview, physical examination, and complementary tests to develop a reasoned diagnostic reasoning, considering the patient's biopsychosocial factors. 

Competency 

  • Apply knowledge of pathophysiology ands emiotics to interpret signs and symptoms, guiding clinical diagnosis, differential diagnosis, and developing clinical reasoning based on scientific, ethical, and contextual criteria. 

  • Communicate with empathy and respect with the patient and their environment, adapting language to each clinical situation and demonstrating active listening and emotional support to collect relevant information in anamnesis and physical examination to prepare an accurate and high-quality medical history. 

  • Communicate empathetically and respectfully with the patient and their environment, adapting language to each clinical situation and showing active listening and emotional support during anamnesis and physical examination to write a quality medical history. 

  • Investigate clinical cases using biomedical information sources and scientific reasoning strategies to formulate diagnostic hypotheses and justify the request for complementary tests. 

Syllabus

CM: Lecture   MC: Case Method    ABP: Problem-Based Learning (PBL)     LH: Skills Laboratory


CM   Subject presentation. Medical history LLARGUÉS ROCABRUNA, Esteve  
CM   Pathophysiology of pain CUADRA LLOPART, Leonor  
CM   Respiratory pathophysiology SÁNCHEZ SITJES, Lluís  
CM   Main signs and symptoms of the respiratory system SÁNCHEZ SITJES, Lluís  
CM   Main signs and symptoms of the cardiovascular system SÁNCHEZ SITJES, Lluís  
LH   Respiratory imaging PUYALTO DE PABLO, Paloma  
LH   Physical examination of the respiratory system 1 SÁNCHEZ SITJES, Lluís  
LH   Thoracocentesis LLARGUÉS ROCABRUNA, Esteve  
CM   Obstruction, functional tests LLARGUÉS ROCABRUNA, Esteve  
10  LH   Pathophysiology of arrhythmias BOSQUE CEBOLLA, María Dolores  
11  MC   Dyspnea and cough ZABALZA CERDEIRIÑA, Miguel  
12  CM   Pathophysiology of the cardiocirculatory system ZABALZA CERDEIRIÑA, Miguel  
13  MC   Chest pain BOSQUE CEBOLLA, María Dolores  
14  LH   Arterial and venous pulse ZORRILLA RIVEIRO, José Gregorio  
15  MC   Pleura LLARGUÉS ROCABRUNA, Esteve  
16  LH   Physical examination of the respiratory system 2 SÁNCHEZ SITJES, Lluís  
17  LH   Blood gas analysis POR DETERMINAR-DR , Por Determinar-Dr  
18  CM   Heart failure LLARGUÉS ROCABRUNA, Esteve  
19  CM   Hypertension, arterial syndromes ZORRILLA RIVEIRO, José Gregorio  
20  CM   Pathophysiology of the digestive system ZORRILLA RIVEIRO, José Gregorio  
21  LH   Paracentesis BAS CUTRINA, Francesc  
22  CM   Digestive semiology DE GIORGI , Antonio  
23  LH   Physical examination of the circulatory system ZABALZA CERDEIRIÑA, Miguel  
24  LH   Lumbar puncture POR DETERMINAR-DR , Por Determinar-Dr  
25  LH   Locomotor and neurological examination MALO BARRES, Roger  
26  LH   Physical examination of the circulatory system ZABALZA CERDEIRIÑA, Miguel  
27  CM   Diarrhea DE GIORGI , Antonio  
28  CM   Jaundice DE GIORGI , Antonio  
29  LH   Physical examination of the circulatory system ZABALZA CERDEIRIÑA, Miguel  
30  LH   Physical examination of the circulatory system ZABALZA CERDEIRIÑA, Miguel  
31  LH   Physical examination of the digestive system BAS CUTRINA, Francesc  
32  LH   Physical examination of the circulatory system ZABALZA CERDEIRIÑA, Miguel  
33  MC   Syncope BOSQUE CEBOLLA, María Dolores  
34  CM   Pathophysiology of the nervous system MALO BARRES, Roger  
35  MC   Esophageal dysphagia DE GIORGI , Antonio  
36  CM   Suprarenal H-H axis ESTEVE SIMO, Vicente Juan  
37  CM   Reason for neurology consultation MALO BARRES, Roger  
38  MC   Acid-base balance LLARGUÉS ROCABRUNA, Esteve  
39  MC   Icteric syndrome, portal hypertension DE GIORGI , Antonio  
40  MC   Constitutional syndrome CUADRA LLOPART, Leonor  
41  CM   Diabetes LLARGUÉS ROCABRUNA, Esteve  
42  CM   Pyramidal/extrapyramidal syndrome MALO BARRES, Roger  
43  CM   Spinal cord + PNS (Peripheral Nervous System) MALO BARRES, Roger  
44  MC   Meningeal syndromes MALO BARRES, Roger  
45  MC   Weakness MALO BARRES, Roger  
46  CM   Brainstem + vestibular syndromes MALO BARRES, Roger  
47  LH   Sediment SÁNCHEZ SITJES, Lluís  
48  CM   Topographic and cerebellar syndrome MALO BARRES, Roger  
49  CM   Reason for endocrinology consultation MALO BARRES, Roger  
50  CM   Thyroid and parathyroid disorders MALO BARRES, Roger  
51  CM   Locomotor system examination ZORRILLA RIVEIRO, José Gregorio  
52  MC   Neuro X-ray MALO BARRES, Roger  
53  CM   Geriatric patient evaluation CUADRA LLOPART, Leonor  
54  CM   Semiology and general examination of the hematic system DE GIORGI , Antonio  
55  CM   Anemia and polycythemia DE GIORGI , Antonio  
56  CM   Leukocytosis, leukopenia, lymphadenopathies and splenomegaly DE GIORGI , Antonio  
57  MC   Anemia and lymphadenopathy DE GIORGI , Antonio  
58  CM   Nephrourological syndromes SÁNCHEZ SITJES, Lluís  
59  CM   Nephrourological pain ESTEVE SIMO, Vicente Juan  
60  ABP   Clinical reasoning LASO GUZMÁN, F. Javier 
61  ABP   Dyspnea LLARGUÉS ROCABRUNA, Esteve 

Teaching and learning activities

In person



Lecture: 

The lecture is a teaching modality in which the professor presents the content of a subject to the entire group of students, conveying knowledge in a structured and guided manner. 

CaseMethod: 

The case method consists of the collective analysis and resolution of real situations or problems, usually related to professional practice, encouraging participation and discussion among students and the professor. 

Problem-BasedLearning (PBL): 

PBL is a methodology in which students, organized in groups, are responsible for seeking and proposing solutions to a given problem, with the support of the professor as a tutor who guides and facilitates the learning process. 

Skills LaboratoryPractice: 

The skills laboratory is a practical activity in which students, in small groups, practice and perfect specific competencies and techniques related to their training, under the supervision and guidance of the professor. 

In this subject, therewill be 30 lectures, 12 case method sessions, and 2 problem-based learning activities. 

In the skills laboratory environment, a total of 13 workshops will be held, each lasting two hours: 

  • Physical examination of the respiratory system 1 

  • Physical examination of the respiratory system 2 

  • Imaging tests in respiratory pathology (chest X-ray) 

  • Thoracocentesis 

  • Physical examination of the circulatory system; heart sounds and thei ralterations 

  • Arterial pulse. Venouspulse. Blood pressure. Venous pressure. 

  • Physical examination of the digestive system. Abdominal examination. 

  • Arrhythmias 

  • Paracentesis. Technique andi nterpretation. 

  • Locomotor and neurological examination 

  • Lumbar puncture. Technique and interpretation 

  • Blood gas analysis. Technique and interpretation 

  • Imaging in neurology 

Evaluation systems and criteria

In person



Assessment Systems and Criteria 

Midterm Exam: Multiple-choice test (MIR format). Wrong answers deduct 1/3 of the question's value. No response: not counted. It accounts for 15 % of the final grade. This grade will count to wards the final exam in both the first and second sittings (within the same academic year). 

Final Exam: Multiple-choice test (MIR format). Wrong answers deduct 1/3 of the question's value. No response: not counted. It accounts for 50% of the final grade. If a student sits the exam in two sessions, the final grade will be calculated using the grade obtained in the second exam. 

Objective and Structured Competency Assessment (OSCE): In this test, the student must demonstrate the skills acquired in th eclinical simulation laboratory. Attendance at laboratory practice is mandatory in order to be assessed. This accounts for 20% of the final grade. If a student passes the OSCE but not th esubject, their OSCE gradewill be saved for future exam sessions. 

Problem-Based Learning (PBL):Accounts for 10% of the final grade. This grade will count to wards the final exam in both the first and second sittings (within the same academic year). 

Continuous Assessment: PROMIR platform, multiple-choice test (MIR format). Wrong answers deduct 1/3 of the question's value. It accounts for 15% of the final grade. A 10-question exam is administered for each major topic (cardiovascular, respiratory, digestive, neurological, urological, andendocrine). 

FINAL GRADE 

Weighted sum of Midterm (15%), Final (50%), OSCE (20%), PBL (10%), and Continuous Assessment (15%). 

It is necessary to pass both the final examandthe OSCE separately, with a score equal to or greater than 5, in order to pass the subject. The percentage weights do not apply unless both parts are passed. 

Honors Distinction:

The final grade of the course will be considered, as well as the grades from the OSCEs and the PBL.

The maximum grade for students in the second exam session will be 7. 

Bibliography and resources

 Laso FJ. Introducción a la Medicina Clínica.Fisiopatologia y semiologia5a. Edición. Elsevier Ed.  

 

Laso FJ. Diagnóstico diferencial en Medicina Interna. 5a. Edición. Elsevier Ed. 

 

Argente-Álvarez. SEMIOLOGÍA MÉDICA: FISIOPATOLOGÍA, SEMIOTECNIA Y PROPEDÉUTICA. 2ª Edición. Panamericana, 2013. ISBN: 978-950-06-0600-4 

 

 

Rozman y Cardellach F. Farreras: MEDICINA INTERNA. 17º edición. Elsevier, SL. 2012. ISBN 978-84-8086-896-9 

 

Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, andLoscalzo, Eds. HARRISON PRINCIPIOS DE MEDICINA INTERNA. 18a edición. McGrawHill, 2012. ISBN: 9789701067888 

 

GoldmanandSchafer Ed. Cecil y Goldman. TRATADO DE MEDICINA INTERNA. 24a edición. Elsevier, 2013. ISBN 978-8480869713 

 

Garcia-Conde. PATOLOGIA GENERAL: SEMIOLOGIA CLINICA Y FISIOPATOLOGÍA.McGrawHill, 2003. ISBN: 9788448605506 

 

Swartz. TRATADO DE SEMIOLOGÍA.EdsElsevierSaunders, 2010. Sexta Edición. ISBN 978-1-4160-6203-5 

Steven S. Agabegi y Elizabeth D. Agabegi. INTRODUCCIÓN A LA MEDICINA CLÍNICA. 3ª edición. WoltersKluwer/Lippincott Williams & Wilkins, 2013. ISBN 978-84-15684-00-8 

 

Gutiérrez Isauro. LA FISIOPATOLOGÍA COMO BASE FUNDAMENTAL DEL DIAGNÓSTICO CLÍNICO. Panamericana,  2012. ISBN 978-607-7743-25-5 

 

Noguer-Balcells. EXPLORACIÓN CLÍNICA PRÁCTICA. 28ª edición. Elsevier, 2016. ISBN 978-84-458-2641-6