LF:aZLVL7X61c Internal medicine - block 1 - Course Information

aZLVL7X61c Internal Medicine - block 1 - Functional Diagnostics, Occupational Medicine

Extent and Intensity

0/2/0. 1 credit(s). Type of Completion: z (credit).

Teacher(s)

prof. MUDr. Petr Brhel, CSc. (seminar tutor)
MUDr. Petr Malenka, Ph.D. (seminar tutor)
prof. MUDr. Hana Matějovská Kubešová, CSc. (seminar tutor)
Jitka Skládaná (assistant)

Guaranteed by

prof. MUDr. Hana Matějovská Kubešová, CSc.
Department of General Internal Medicine – Joint workplaces with the University Hospital Brno - workplaces of the Bohunice and Mater. Hospital – Faculty of Medicine
Supplier department: Department of General Internal Medicine – Joint workplaces with the University Hospital Brno - workplaces of the Bohunice and Mater. Hospital – Faculty of Medicine

Prerequisites

aZLIP061p Clin.Introd.to Int.Med.-lect. && aZLPA0622c Pathology II - practice && aZLPF0622c Pathophysiol. II - practice && aZLFA0621c Pharmacology I - pract. && ( aZLED061p Restorat. Dent.-Endo.I -lect. || aZLKED061p Preserv. dent.,endo. I -lect. ) && aZLPL0663c Prosthetic Dentistry III-prac. && aZLOC0653c Oral Surgery III -pract. && aZLOR0641c Orthodontics I -pract. && aZLPD0631c Periodontology I - practice
Clinical propaedeutic, Theoretical background of practical medicine, Pathology, Pathophysiology

Course Enrolment Limitations

The course is only offered to the students of the study fields the course is directly associated with.

fields of study / plans the course is directly associated with

• Dentistry (programme LF, M-DENT)
• Dentistry (eng.) (programme LF, M-ZL)

Course objectives

Occupational medicine
This course explains the impact of work and working conditions on the health of workers, the prevention diagnostics, treatment, and medicolegal aspects of diseases caused or exacerbated by working conditions: occupational diseases, accidents at work, work-related diseases, occupational health services in the Czech Republic, aims and functions of an occupational health service, types of service
Functional diagnostics and rehabilitation
This course unit provides detailed information about key diagnostic functional tests in clinical medicine, all of which are conducted inside the lab. Students will be able to apply the basic concepts by conducting self-made examinations and recording their own physiological responses to exercise.
Geriatrics
Students will understand the main differences between seniors and younger patients, especially in disease diagnostics, specificities of objective findings, laboratory parameters and treatment targets as well.

Learning outcomes

Occupational medicine
The student knows occupational preventive measures including the evaluation of working ability, health risks of ionization, physical factors, industrial toxins. Students can describe basic obligatory of employers in relation to an employee, basic rules for evaluation of occupational diseases, risks of occupational diseases or risks of accidents at work. Student is able to describe the duties of attending physician, injured employee and employer in the event of an accident of work.
Functional diagnostics and rehabilitation
After completing the course the student will know: principles of implementation, indications and contraindications of CPX (cardiopulmonary exercise testing) in clinical and outpatient practice (especially spiroergometric testing, basic principles of functional diagnostics of respiratory functions and investigation of autonomic nervous regulations), reactions of the organism to various types of exertion and the differences between the physiological and pathological reactions of the basic functional parameters to the physical load, the importance of prescribing exercise therapy in internal medicine, especially in patients with cardiovascular or respiratory diseases, and metabolic disorders, the importance of different training types for cardiac patients (phase I. - IV. of cardiovascular rehabilitation)
Geriatrics
The student knows complex geriatric assessment Student is able to plan the diagnostics with regard to specific features of older patients The student is able to prepare the therapeutic scheme with regard to specific features of older patients The student is able to formulate the régime and diet measures with regard to specific features of older patients The student is able to plan and assure the aftercare with regard to interdisciplinary syndromes.

Syllabus

• Occupational medicine
• 1 Introduction: The impact of work and working conditions on the health of workers.
• The prevention diagnostics, treatment, and medicolegal aspects of diseases caused or exacerbated by working conditions: occupational diseases, accidents at work, work-related diseases.
• 2 Occupational health services in the Czech Republic. Aims and functions of an occupational health service, types of service
• Occupational health ethics
• Knowledge of the work environment, specific workplace hazards
• Medical examinations: pre-placement, periodic and special medical examinations, occupational history, biological monitoring, medical records
• Rehabilitation and resettlement
• 3 Occupational diseases and toxicology List of occupational diseases (appendix of government decree no. 290/1995)
• Occupational diseases due to chemical agents, poisoning by lead or a compound of lead, poisoning by a nitro- or amino- or chloroderivate of benzene or of a homologue of benzene, poisoning by organophosphates, poisoning by chemical asphyxiants (carbon monoxide, hydrogen cyanide)
• Occupational diseases due to physical agents, work-related cumulative trauma disorders of the hand and arm, hand-arm vibration syndrome, noise-induced hearing loss, non-stochastic and stochastic health effects of ionizing radiation, dysbarism, disorders due to heat
• Occupational lung disorders, pneumoconioses (silicosis, coal workers´ pneumoconiosis, asbestosis), asthma, extrinsic allergic alveolitis- farmer´s lung), acute inflammation, malignancy Occupational dermatoses, primary irritant contact dermatitis, allergic contact dermatitis, neoplasms
• Occupational infections, infections due to exposure to infected humans or their tissues, infections transmitted from animals to humans (zoonoses), travel-associated infectious diseases
• 4 Mental health at work
• 5 The main areas of law relevant to occupational health, workers compensation law
• FUNCTIONAL DIAGNOSTICS AND REHABILITATION
• 1 Introduction
• 2 Reaction and adaptation to physical stress
• Gas transport systém, respiration, circulation, energy metabolism, body fluids and ions, acid-base balance, neuromuscular system
• 3 Stress tests
• Characteristics, indications and contraindications
• Stress testing procedure, criteria of evaluation and interpretation
• Methods, special approaches to stress testing
• 4 Fundamentals of exercise therapy and rehabilitation
• Exercise therapy as a part of rehabilitation
• Definition and division into constituent parts
• Therapeutical rehabilitation
• Prescription of exercise therapy, principles, physiologic efficiency of physical activities, kinds of physical activities, stress intensity, frequency and duration of stress
• 5 Stress testing and exercise therapy in selected diseases
• Cardiovascular and haematologic diseases
• Functional disorders of circulation
• Congenital heart diseases, valvular heart diseases, acute inflammatory diseases. Cardiomyopathy, atherosclerosis, coronary artery diseases, heart failure, arrhythmias, arterial hypertension, chronic ischaemic arterial obstructive disease of lower limbs, respiratory, haematological diseases, diabetes mellitus and other endocrinology diseases
• GERIATRICS
• 1 Specificity of disease symptoms in elderly, diagnostic approach, complex geriatric assessment
• 2 Different disease course in elderly, complications, chronicity
• 3 Immobilization, complication cascade
• 4 Necessarity of emergent approach to elderly to accelerate the healing process and to keep the independency od the elderly
• 5 Giants of geriatrics, multidisciplinary approach
• 6 The social context of diseases in the elderly
• 7 The influence of senzoric, cognitive and motoric deterioration on the independence and abiolita to live in own environment
• 8 Theriatric maldaptation syndrom
• 9 Sleeping disorders in elderly, behavioral disorders in elderly
• 10 Psychical disturbances in elderly, communication basics, stress situation management

Literature

recommended literature
• Geraitrie e-learnigový kurz, Portál LF MU
• The Merck Manual of Geriatrics. http://www.merck.com/mkgr/mmg/search.jsp
• MCARDLE, William D., Frank I. KATCH and Victor L. KATCH. Exercise physiology : nutrition, energy, and human performance. Eighth edition. Philadelphia: Wolters Kluwer Health, 2015, lix, 1028. ISBN 9781451193831. info
• ŠUBRT, Bořivoj and Milan TUČEK. Pracovnělékařské služby : povinnosti zaměstnavatelů a lékařů. 2. doplněné vydání. Olomouc: ANAG, 2015, 351 stran. ISBN 9788072639441. info
• PELCLOVÁ, Daniela. Nemoci z povolání a intoxikace. 3., doplněné vydání. Praha: Karolinum, 2014, 316 stran. ISBN 9788024625973. info
• MATĚJOVSKÁ KUBEŠOVÁ, Hana and Pavel WEBER. Geriatrie (Geriatrics). In Vnitřní lékařství. Praha: Grada, 2011, 30 pp. Vnitřní lékařství 1. ISBN 978-80-247-2110-1. info
• MATĚJOVSKÁ KUBEŠOVÁ, Hana, Pavel WEBER, Pavel ŠEVČÍK, Michal MAŠEK, Zdeněk KADAŇKA, Blanka VEPŘEKOVÁ, Vlasta POLCAROVÁ, Roman GÁL, Dagmar SEIDLOVÁ and Helena ONDRÁŠKOVÁ. Akutní stavy v geriatrii (Emergencies in geriatrics). 1st ed. Praha: Galén, 2009, 233 pp. akutní medicína, geriatrie. ISBN 978-80-7262-620-5. info
• DOBŠÁK, Petr, Jarmila SIEGELOVÁ, Hana SVAČINOVÁ, Pavel HOMOLKA, Leona DUNKLEROVÁ, Michaela SOSÍKOVÁ and Zdeněk PLACHETA. Klinická fyziologie tělesné zátěže (Clinical physiology of body budrden). 2009th ed. Brno: Masarykova univerzita, 2009, 98 pp. <AA-9,10>. ISBN 978-80-210-4965-9. info
• Pracovní lékařství : základy primární pracovnělékařské péče. Edited by Petr Brhel - Marta Manoušková - Evžen Hrnčíř. 1. vyd. Brno: Národní centrum ošetřovatelství a nelékařských zdravotnických oborů, 2005, 338 s. ISBN 8070134143. info
• Textbook of clinical occupational and environmental medicine. Edited by Linda Rosenstock. 2nd ed. Philadelphia: Elsevier Saunders, 2005, xviii, 133. ISBN 0721689744. info
• KALVACH, Zdeněk. Geriatrie a gerontologie. 1. vyd. Praha: Grada, 2004, 861 s. ISBN 8024705486. info
• PLACHETA, Zdeněk, Ilona DOHNALOVÁ, Jan NOVOTNÝ, Břetislav ZATLOUKAL, Karel ČECHOVSKÝ, Vladimír DRAŽIL and Pavel HOMOLKA. Zátěžová funkční diagnostika a preskripce pohybové léčby ve vnitřním lékařství (Stress functional diagnostics and prescription of physical therapy in internal medicine). 2. přepracované vyd. Brno: Masarykova univerzita Brno, 1995, 156 pp. ISBN 80-210-1170-X. info

Teaching methods

Lessons are taking place in blocks. Attendance at the tuition is obligatory. The students work in groups of 6-7 members. Expert seminars and simulation methods are part of education. Practical training (about 20 % of the total volume of teaching) is complemented by a comprehensive range of simulation teaching methods on simulators with varying degrees of fidelity, trainers and virtual patients. Simulation results in subsequent debriefing (feedback to the student). There is also problem-oriented learning in the foreground, where the student is taught by solving the problem presented, as well as team-oriented teaching when small groups of students discuss and choose a solution to the problem. Emphasis is also placed on the development of soft skills, incl. so-called "21st-century skills", particularly communication, decision-making skills, critical thinking, crisis communication and teamwork.

Assessment methods

Test, assay as the case report, colloquium. Traditional methods are complemented by objective clinical evaluation that verifies clinical knowledge and other skills such as communication, physical examination, performance, performance interpretation, etc. This evaluation method provides students with objective and specific feedback.

Language of instruction

English

Further comments (probably available only in Czech)

Information on the extent and intensity of the course: 30.

• Enrolment Statistics (autumn 2019, recent)
  
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