SURGERY III AND MEDICAL/SURGICAL EMERGENCIES - NO EXAM
Academic year and teacher
If you can't find the course description that you're looking for in the above list,
please see the following instructions >>
- Versione italiana
- Academic year
- 2019/2020
- Teacher
- PAOLO CARCOFORO
- Credits
- 8
- Didactic period
- Primo Semestre
Training objectives
- GENERAL SURGERY
The aim of the course is to provide the basis of surgical anatomy and pathophysiology, that are the basis of diseases of surgical relevance. The main surgical diseases will be introduced starting from epidemiology to the presentations of clinical history, examination of symptoms, the basis of diagnostic techniques both clinical and instrumental which need to reach the diagnosis and to reach surgical and parasurgical therapies. Particular emphasis will be given to the evaluation of emergencies, the use of imaging and technology both diagnostic and therapeutic, about how and when to use it. It will stimulate the attitude to reasoning, deduction and synthesis.
ANESTHESIA and INTERNAL MEDICINE
At the end of the course the student will:
Learn how to apply the decision making process and the differential diagnosis and treatment of diseases and syndromes that affect the vital functions, even in complex clinical situations, even in relation to gender in emergency situations.
Knowing how to explain to the patient the goals of anesthesia, indications and drawbacks of general anesthesia and that loco-regional. Prerequisites
- GENERAL SURGERY
Good knowledge of the surgical anatomy, pathophysiology, pathology.
ANESTHESIA and INTERNAL MEDICINE
Knowledge of the pathophysiology of the most relevant diseases and syndromes associated with a compromised vital sings. Course programme
- GENERAL SURGERY
Symptoms and warning signs in the surgical patient:
Pain and swelling in the lower limbs. Bleeding of uncertain nature and anemia. Jaundice: surgical and non-surgical. Peritonitis: genesis, signs, symptoms. Vomiting. Swallowing difficult. Neck stiff, sore and reddened.
Breast reddened and other morphological alterations. Nevo flushed and other changes. Loss of consciousness, even temporarily
Acute abdominal pain: decision making. Acute Abdomen: clinical and therapeutic approach
Management of polytraumatized patient
Advanced Trauma Life Support - ATLS
Thoracic, abdominal, head trauma. Pelvic and musculoskeletar trauma. Spine and Spinal Cord trauma
Pediatric, geriatric trauma and t. in pregnancy
Nonoperative management of traumatic splenic and liver injury
Abdominal hypertension, ACS and laparostomy. Esophagus perforation
First aid
Surgery of the liver and of the pancreas (History, anatomical bases, procedures). Acute pancreatitis (Guidelines and role of surgery)
Abdominal surgery complications
Oncological patient: surgical urgency
Relaparotomy in abdominal surgery
Clinical cases: simulation
Decision-making in complex and "end-stage disease" patient. Multidisciplinary seminar.
Abdominal wall and inguinal surgery
Colorectal and gastric cancer: the laparoscopic approach
Skin melanoma. Haemorrhoidal diseas. Emergency in proctology
ANESTHESIOLOGY
Methodology of emergency medicine
Cardiac arrest; Etiology, consequences, chain of survival
Cardiopulmonary resuscitation: BLS, BLSD, ALS, ACLS
Electrolyte imbalances and acid-base; interpretation of arterial blood gases
Different types of shock. Septic shock and SIRS, sepsis, severe sepsis. Anaphylactic shock. Hypovolemic shock. Cardiogenic shock.
Volume replacement therapy: how to do it, why, and by using what.
Correct use of blood, fresh frozen plasma and platelets
Cardiac failure; cardiac arrhythmias, coronary syndromes, heart failure, pulmonary edema, hypertensive crisis, vascular emergencies
Pulmonary embolism: TEP, fat embolism, air embolism
Acute respiratory failure (ARF): physiopathology, ARDS, airway obstruction, laryngospasm, near fatal asthma, exacerbation of chronic obstructive lung disease, ARF and neuromuscular disease
Acute Neurological disease: syncope, different types of coma, seizures and status epilepticus, urgencies and cerebrovascular emergencies; psychiatric emergencies
Poisoning: approach to acute poisoning.
Major trauma - ATLS. Approach to trauma patient with trauma: prehospital and inhospital management
Mechanisms of injury and different types of trauma: head, spine, chest, abdomen, pelvis and limbs
Emergency physical agents: burns, electric shock, drowning, heat stroke, hypothermia
Principles of parenteral and enteral nutrition.
Principles of analgesic therapy
Emergencies due to burns, electric shock, drowning, heat stroke, hypothermia.
General and regional anesthesia.
INSTRUMENTS AND PROCEDURES
Airway: pharyngeal cannula, tracheal intubation, tracheostomy, pharyngeal and tracheal aspiration, bronchoscopy
Respiratory monitoring: pulse oximetry, capnometry, blood gas analysis, spirometry.
Respiratory support: oxygen therapy, positive pressure ventilation (CPAP), mechanical ventilation, pleural decompression and chest drainage
Cardiovascular monitoring: ECG, non-invasive and invasive arterial pressure, Central Venous Pressure, Swan Ganz catheter
Peripheral venous catheterization, central venous catheterization.
Defibrillation, cardioversion, electrostimulation
Different reactions and behaviors in relation to gender in emergency situations.
INTERNAL MEDICINE
Methodology of clinical approach to urgency/emergency as for: acute coronary syndrome, dyspnea, hypertension, metabolic coma, kidney disease. Didactic methods
Learning assessment procedures
- The following partial tests are foreseen:
GENERAL SURGERY
The exam will be held orally and will last between half and three quarters an hour.
ANESTHESIOLOGY and INTERNAL MEDICINE
Oral exam based on two questions relating to various aspects of the program topic. The third question is the analysis of a blood gas and thus on the recognition of changes in acid-base balance
THE FINAL VOTE WILL BE ACQUIRED AT THE END OF THE SECOND SEMESTER AND WILL BE THE RESULT OF THE EVALUATION OF THE PARTIAL TESTS AND THE PERFORMANCE OF THE TRAINING SCHEDULES Reference texts
- GENERAL SURGERY
D'Amico Davide, Chirurgia Generale - Fisiopatologia - Clinica e Terapia, Piccin Ed., 2006
Schwartz Seymour I., Principles of Surgery, McGraw-Hill Professional, 2004, 8a Ed.
Sabiston, Trattato di Chirurgia. Le basi biologiche della moderna pratica chirurgica, Ed. Delfino, 2002
ANESTHESIOLOGY
Text Reference:
Maurizio Chiaranda, Urgenze ed Emergenze - Istituzioni, Piccin Ed. Padova 2007
For deepening:
Harrison, Principi di Medicina Interna, McGraw-Hill 2005
M. Chiaranda, Guida illustrata delle Emergenze, Piccin Ed. 2005
Olson K.R., Intossicazioni acute, Springer 1999
Oh, Manuale di Terapia Intensiva, Elsevier 2004
Manuali BLSD, ALS, ACLS: Centro Scientifico Editore
Italian Resuscitation Council ( www.ircouncil.it/ )
American Heart Association (www.americanheart.org )
INTERNAL MEDICINE
Harrison’s Principles of Internal Medicine, 18th ed, McGraw-Hill, 2011
Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed, Elsevier, 2014
American Heart Association (www.americanheart.org)
European Society of Cardiology (http://www.escardio.org/Pages/index.aspx)
Italian Society of Cardiology (http://www.sicardiologia.it/Sito/)
Italian Society of Internal Medicine (http://www.simi.it/)
Italian Society of Emergency Medicine (http://www.simeu.it/)
