Internal Medicine

Data

Official data in SubjectManager for the following academic year: 2023-2024

Topic

Responsible faculty of the course: Professors Kálmán Tóth and István Wittmann.
The aim of the practice is that students of the 6th year, who have already achieved theoretical excellence in significant components of Internal Medicine, synthesize their knowledge during daily bedside practice and use it independently yet under proper supervision. Students work at accredited departments of Medicine of University Hospitals, Teaching Hospitals or at Teaching Divisions, as trainees similarly to residents, ward physicians or doctors in training, they gain empirical, hands-on experiences with patients. Practical requirements for students during and after the practice:
1. Students should take case histories and perform detailed physical examination of patients at the ward. The preparation of a written documentation of each case is expected (at least 2 patients weekly).
2. Students should write a diagnostic and therapeutic plan after the admission of the patient. The preparation of a written documentation of each case is expected (at least 2 patients weekly).
3. Students should summarize diagnostic test results and clinical course as a written discharge summary upon patient?s discharge (at least 2 patients weekly).
4. Students should be prepared to present detailed anonymized patient documentations from each week of the practice (in the end at least 8) at the final examination. The documentations should consist of the above mentioned items, they should indicate the date, the ward specifications, the name of the tutor, the name of the student and they should also be signed by both the student and the tutor. The case history should be composed in the language that was used at the ward, the rest of the documentation in the study language of the student or in English. A patient documentation should be at least one, and a maximum of four typed (A/4) pages long.
5. A regular presence of students is required at medical workshops, consultations, graduate and postgraduate teaching programs of the ward. The practice period is optimally supported by consultations and case presentations.
6. The practice should be performed on regular working days, during usual working hours (6-8 hours a day). Night duties, public/bank holidays, outpatient care, scientific work cannot be accepted as part of the practice.
7. Students should take part in activities of residents, ward doctors and doctors in training under supervision according to the applicable local professional, safety and legal regulations. These should include taking medical history, performing physical examination, admitting new patients, planning diagnostic and therapeutic measures, fulfilling tasks required by the ward-round, regularly reporting to the staff, participating in writing discharge summaries and giving account of their patients during the professorial grand-rounds. They should also accompany their patients to see special examinations and therapies (e.g. endoscopy, biopsy, echocardiography, exercise stress test, operations).
8. Students get certification of the gained clinical skills that they acquire during the practice (at least 4 signatures are required each week). They will be entered into the Booklet of Clinical Skills by the leader of the subject on the basis of the certificate.
http://aok.pte.hu/docs/th/file/GBofCS.pdf
Internal medicine practice can be spent in a foreign country after approval of the Registrars Office at an Internal Medicine Ward in a University Hospital, in a Teaching Hospital or County Hospital with 24-hour patient admission. The student is required to speak the language of the host country. The head of the ward should certify the fulfilment of the practice according to the criteria of the University of Pécs (this should include signature, readable name of head and stamp of the department).

Lectures

Practices

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Seminars

• 1. Heart failure (Dr. Tamás Habon)
• 2. Acid related gastrointestinal diseases (Dr. Áron Vincze / Dr. Imre Szabó)
• 3. Dyslipidemia and obesity (Dr. László Bajnok)
• 4. Chronic liver diseases (Dr. Gabriella Pár)
• 5. Disorders of blood coagulation (Dr. Ágnes Nagy/Dr. Hussain Alizadeh )
• 6. Malignant hematologic diseases (Dr. Hussain Alizadeh /Dr. Árpád Szomor)
• 7. Endocrinology (Dr. Emese Mezősi)
• 8. Clinical immunology (Dr. László Czirják/Dr. Gábor Kumánovics)
• 9. Pulmonology (Dr. Veronika Sárosi)
• 10. Infectology (Dr. Zoltán Péterfi)
• 11. Nephrology (Dr. Judit Nagy, Dr. Tibor Kovács)
• 12. Diabetes (Dr. István Wittmann)
• 13. Hypertension (Dr. Tibor Kovács)
• 14. Case presentation (Dr. Mária Figler/Dr. Gergő Molnár)
• 15. Cardiac arrhythmias (Dr. Kálmán Tóth)
• 16. Coronary artery disease (Dr. László Czopf)

Reading material

Obligatory literature

Literature developed by the Department

Educational resources of 1st Department of Medicine and lecture slides.

Notes

NOTES in diabetology for medical students.
NOTES in nephrology and hypertension for medical students.
(http://aok.pte.hu/en/egyseg/dokumentumok/270)

Recommended literature

- Andreoli, T. E., Carpenter, C. C. J., Griggs, R., Loscalzo, J. (eds.): Cecil Essentials of Medicine, 9th edition, Elsevier 2015,
- Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J.: Harrisons Principles of Internal Medicine, 20th ed., New York: McGraw-Hill Medical Publishing Division, 2018. ISBN 978-0-07-146633-9 or newer
- Kumar and Clarks Clinical Medicine, International Edition with STUDENT CONSULT online access, 8th edition;
- Ballinger: Essentials of Kumar and Clark?s Clinical Medicine, 5th edition;
- Swartz: Textbook of Physical Diagnosis, History and Examination with STUDENT CONSULT Online Access, 7th edition;
- Davidsons Principles and Practice of Medicine with STUDENT CONSULT Online Access, 22nd edition;
- Macleods Clinical Examination with STUDENT CONSULT Online Access, 13th edition;
- Dehn and Asprey: Essential Clinical Procedures Expert Consult - Online and Print, 3rd

Conditions for acceptance of the semester

Exam: Final exam (oral) with a practical part consisting of history taking, physical examination and evaluation of the test results of the patient. At the theoretical part detailed discussion of topics (proposal: 3 topics including cardiology and gastroenterology).
The final exam may contain written or oral entry questions of the most important simple facts relevant in the diagnostics and treatment of internal medicine patients.
15% or more absences are not tolerated during the practice.

Mid-term exams

N/A

Making up for missed classes

It is possible to make up justified absences.
At least 300 hours and at least 8 weeks practice has to be certified.
The certificate of the practice should be accepted by the Registrar's Office 24 hrs before signing up for the exam. No assignment of examination date can be given without accepted certificate.

Exam topics/questions

Exam questions (theses):
1. Supraventricular arrhythmias, diagnosis and therapy
2. Ventricular arrhythmias, diagnosis and therapy
3. Blocks and conduction disorders, diagnosis and drug treatment
4. Preexcitation syndromes, diagnosis and treatment
5. Non-pharmacological therapy of arrhythmias and conduction disorders (cardioversion, pacemakers, automatic implantable cardioverter defibrillator, catheter ablation)
6. Treatment of syncope and sudden cardiac death. Diagnosis and treatment.
Cardiopulmonary resuscitation
7. Epidemiology, risk factors and primary prevention of ischemic heart disease
8. The syndromes of ischemic heart disease and their differential diagnostics
9. The types of acute coronary syndromes, their clinical features, complications, diagnosis and treatment
10. The non-pharmacological treatment of ischemic heart disease (percutaneous coronary interventions, stent implantation, coronary bypass operation)
11. Secondary prevention of ischemic heart disease, medical follow-up of patients after a myocardial infarction or coronary revascularisation
12. Epidemiology, pathophysiological background, types and clinical syndromes of heart failure
13. Diagnosis and therapy of heart failure
14. The importance of essential hypertension, epidemiology, diagnosis and treatment
15. Secondary hypertension, types, differential diagnosis and therapy
16. The cardiomyopathies. Types, pathophysiological background, diagnostics and therapy
17. Inflammatory diseases of the heart (endocarditis, myocarditis, pericarditis) and cardiac tamponade
18. Infective endocarditis. Rheumatic fever and its consequences
19. Valve diseases. Diagnosis and therapy
20. The differential diagnostics and acute management of chest pain
21. Platelet inhibition, anticoagulant and fibrinolytic treatment in internal medicine, methods for monitoring their efficacy
22. Types of anemia. Etiology of iron deficiency anemia, clinical picture and treatment
23. Megaloblastic and other macrocytic anemias. Etiology, types and diagnostics of hemolytic anemias
24. Immune thrombocytopenia. Diagnostics and treatment. Thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome, clinical picture and treatment
25. The aplastic anemia
26. Acute myeloid and lymphoid leukemia. Diagnostics, clinical picture and principles of treatment
27. Classification of myeloproliferative disorders, general characteristics. Polycythemia vera, essential thrombocytemia and osteomyelofibrosis. Clinical picture, possibilities of treatment
28. Chronic myeloid leukemia. Diagnostics, clinical picture and treatment
29. Chronic lymphocytic leukemia. Diagnostics, clinical picture and possibilities of treatment
30. Malignant lymphomas. Classification, diagnostics and clinical features. Hodgkin's disease. Classification, diagnostics, treatment possibilities
31. Non-Hodgkin malignant lymphomas (NHL). Classification, clinical characteristics of indolent and aggressive NHL, possibilities of treatment
32. Multiple myeloma. Diagnostics, symptoms, treatment
33. Deep venous thrombosis and pulmonary embolism. Diagnostics and treatment
34. Inherited and acquired thrombophilias
35. Etiology and types of hemorrhagic disorders
36. Hemophilias. Clinical characteristics, principles of substitution therapy
37. Tumors of the hypophysis. Diabetes insipidus
38. Hyperthyroidism. Hypothyroidism
39. Thyroid tumors. Inflammatory disorders of the thyroid gland
40. Conn's syndrome. Prolactinoma
41. Cushing's disease and syndrome. Addison's disease
42. Hypoparathyroidism. Hyperparathyroidism
43. Pheochromocytoma
44. Acromegaly. Hypopituitarism
45. Congenital adrenal hyperplasia. Osteoporosis
46. Basic symptoms of systemic autoimmune diseases. Primary and secondary Raynaud's syndrome
47. Rheumatoid arthritis (RA). Clinical and laboratory features, treatment
48. Systemic lupus erythematosus (SLE). Characteristics, diagnosis, therapy
49. The antiphospholipid syndrome. Polymyositis, dermatomyositis
50. Main clinical characteristics of Sjögren's syndrome. Extraglandular manifestations
51. Basic features and treatment of systemic sclerosis
52. Systemic vasculitis syndromes. Temporal arteritis
53. Types of vomiting. Diarrhea
54. Gastro-esophageal reflux disease
55. Tumors of the esophagus, stomach and small intestine
56. Peptic ulcer disease. Helicobacter pylori infection
57. Acute and chronic gastritis
58. Functional bowel diseases
59. Celiac disease. Malabsorption syndromes
60. Crohn's disease and ulcerative colitis. Precancerous states of the gastrointestinal tract
61. Colonic polyps and cancer. Diverticulosis and diverticulitis of the colon
62. Appendicitis. Differential diagnostics of abdominal pain
63. Acute and chronic pancreatitis. Functional diagnostics of pancreas insufficiency
64. The ileus. Types of peritonitis. The acute abdomen
65. Classification and differential diagnostics of jaundice. Acute and chronic viral hepatitis
66. Alcoholic liver disease. Liver cirrhosis
67. Autoimmune hepatitis. Primary biliary cirrhosis
68. Primary sclerosing cholangitis
69. Gall stone disease
70. Tumors of the liver and the biliary system. Pancreas cancer
71. Hemochromatosis and Wilson's disease
72. Diagnostics and therapy of gastrointestinal bleeding
73. Differential diagnostics of hematuria
74. Differential diagnostics of proteinuria
75. Differential diagnostics of edema
76. Examination of the kidney (function, morphology, histology)
77. Acute glomerulonephritis
78. Rapidly progressive glomerulonephritis
79. Nephropathies associated to systemic illnesses (SLE nephropathy, vasculitis, atherosclerosis, hemolytic uremic syndrome)
80. Nephrotic syndrome (minimal change, focal segmental glomerulosclerosis, membranous glomerulonephritis)
81. IgA nephropathy
82. Urinary tract infections
83. Acute tubulointerstitial nephritis, analgesic nephropathy
84. Acute renal failure
85. Chronic renal failure
86. Renal replacement therapies
87. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes mellitus. Diagnostics. Treatment of IFG and IGT
88. Clinical picture of type 1 diabetes mellitus in adults. Types of insulin, techniques and regimens of insulin treatment, blood sugar monitoring
89. Gestational, pancreatoprive diabetes and the maturity onset diabetes in the young (MODY). Their clinical picture and treatment, preoperative management of diabetic patients
90. The clinical picture of type 2 diabetes. Dietary, oral antidiabetic and insulin treatment
91. Clinical picture of the metabolic syndrome. Primary prevention of atherosclerosis
92. Hyperglycemia, ketoacidosis, hypoglycemia, diabetic neuropathy, diabetic foot. Their diagnosis and treatment
93. Diabetic nephropathy. Diagnosis and treatment
94. The primary dyslipidemias. Clinical picture and treatment
95. The secondary dyslipidemias. Clinical picture and treatment
96. Treatment of hypertension in patients with metabolic diseases (diabetes mellitus, dyslipidemia, metabolic syndrome)
97. Types of pneumonia, symptoms and therapy
98. Symptoms of bronchial asthma. Its differentiation from chronic obstructive pulmonary disease (COPD) and cardiac asthma. Therapy of bronchial asthma
99. Chronic obstructive pulmonary disease (COPD). Diagnostics, types, therapy
100. Tuberculosis, a differential diagnostic problem
101. Importance of pneumoconiosis and its complications
102. Infectious diseases with bloody stool
103. The anthropozoonoses
104. Lyme's disease
105. Influenza
106. Human immunodeficiency virus (HIV) infection and its consequences

Examiners

• Dr. Alizadeh Hussain
• Dr. Bajnok László Zoltán
• Dr. Cseh Istvánné (Dr. Figler Mária)
• Dr. Csiky Botond
• Dr. Czimmer József
• Dr. Czopf László József
• Dr. Habon Tamás
• Dr. Halmosi Róbert
• Dr. Hunyady Béla
• Dr. Kelényi Gáborné (Dr. Nagy Judit)
• Dr. Késmárky Gábor Róbert
• Dr. Kovács Tibor József
• Dr. Mezősi Emese
• Dr. Molnár Gergő Attila
• Dr. Péterfi Zoltán
• Dr. Sarlós Patricia
• Dr. Sütő Gábor
• Dr. Szabados Eszter
• Dr. Szabó Imre
• Dr. Tóth Kálmán
• Dr. Vincze Áron Endre
• Dr. Wittmann István

Instructor / tutor of practices and seminars

• Dr. Alizadeh Hussain
• Dr. Bajnok László Zoltán
• Dr. Cseh Istvánné (Dr. Figler Mária)
• Dr. Czirják László István
• Dr. Czopf László József
• Dr. Habon Tamás
• Dr. Kovács Tibor József
• Dr. Kumánovics Gábor
• Dr. Laczy Boglárka
• Dr. Márkné Dr. Sárosi Veronika
• Dr. Mezősi Emese
• Dr. Mohás Márton
• Dr. Molnár Gergő Attila
• Dr. Nagy Ágnes
• Dr. Pár Gabriella
• Dr. Péterfi Zoltán
• Dr. Sebők Judit
• Dr. Sütő Gábor
• Dr. Szabó Imre
• Dr. Szomor Árpád
• Dr. Tóth Kálmán
• Dr. Vincze Áron Endre
• Dr. Wittmann István
• Okoriené Dr. Bekő Viktória