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SURGERY III AND MEDICAL/SURGICAL EMERGENCIES

Academic year and teacher
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Versione italiana
Academic year
2022/2023
Teacher
PAOLO CARCOFORO
Credits
9
Didactic period
Primo Semestre

Training objectives

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Modulo: 005987 - CHIRURGIA GENERALE
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Training objectives
GENERAL SURGERY
The course of Chirurgia III ed emergenze medico-chirurgiche consists of three modules. The general surgery module aims to provide theoretical and practical knowledges to prepare students to recognize emergency surgery pathologies and to define the appropriate pathway for diagnosis and treatment.

ANESTHESIA and INTERNAL MEDICINE
The Anesthesia module aims to provide the knowledge for being able to recognize and deal with emergency, both in the pre-hospital and intra-hospital phase; for being able to evaluate different reactions and behaviors in relation to gender in emergency. At the end of the course the student will know how to apply the differential-diagnostic decision-making process and the treatment of diseases and syndromes that compromise vital functions, even in complex clinical situations. Finally, he / she must know how to illustrate to the patient the objectives of anesthesia, indications and drawbacks of general and loco-regional anesthesia.
Regarding PAIN THERAPY:
The student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.


------------------------------------------------------------
Modulo: 46467 - ANESTESIOLOGIA
------------------------------------------------------------
Training objectives
GENERAL SURGERY
The course of Chirurgia III ed emergenze medico-chirurgiche consists of three modules.

ANESTHESIA and INTERNAL MEDICINE
The Anesthesia module aims to provide the knowledge for being able to recognize and deal with emergency, both in the pre-hospital and intra-hospital phase; for being able to evaluate different reactions and behaviors in relation to gender in emergency. At the end of the course the student will know how to apply the differential-diagnostic decision-making process and the treatment of diseases and syndromes that compromise vital functions, even in complex clinical situations. Finally, he / she must know how to illustrate to the patient the objectives of anesthesia, indications and drawbacks of general and loco-regional anesthesia.
Regarding PAIN THERAPY:
The student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.

------------------------------------------------------------
Modulo: 47781 - MEDICINA INTERNA
------------------------------------------------------------
Training objectives
GENERAL SURGERY
The course of Chirurgia III ed emergenze medico-chirurgiche consists of three modules. The general surgery module aims to provide theoretical and practical knowledges to prepare students to recognize emergency surgery pathologies and to define the appropriate pathway for diagnosis and treatment.

ANESTHESIA and INTERNAL MEDICINE
The Anesthesia module aims to provide the knowledge for being able to recognize and deal with emergency, both in the pre-hospital and intra-hospital phase; for being able to evaluate different reactions and behaviors in relation to gender in emergency. At the end of the course the student will know how to apply the differential-diagnostic decision-making process and the treatment of diseases and syndromes that compromise vital functions, even in complex clinical situations. Finally, he / she must know how to illustrate to the patient the objectives of anesthesia, indications and drawbacks of general and loco-regional anesthesia.
Regarding PAIN THERAPY:
The student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.

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Modulo: 65383 - TERAPIA DEL DOLORE
------------------------------------------------------------
Training objectives
GENERAL SURGERY
The course of Chirurgia III ed emergenze medico-chirurgiche consists of three modules. The general surgery module aims to provide theoretical and practical knowledges to prepare students to recognize emergency surgery pathologies and to define the appropriate pathway for diagnosis and treatment.

ANESTHESIA and INTERNAL MEDICINE
The Anesthesia module aims to provide the knowledge for being able to recognize and deal with emergency, both in the pre-hospital and intra-hospital phase; for being able to evaluate different reactions and behaviors in relation to gender in emergency. At the end of the course the student will know how to apply the differential-diagnostic decision-making process and the treatment of diseases and syndromes that compromise vital functions, even in complex clinical situations. Finally, he / she must know how to illustrate to the patient the objectives of anesthesia, indications and drawbacks of general and loco-regional anesthesia.
Regarding PAIN THERAPY:
The student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.

Prerequisites

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Modulo: 005987 - CHIRURGIA GENERALE
------------------------------------------------------------
GENERAL SURGERY
Knowledge of Human Anatomy, Pathology, Physiology, Clinical Methodology, Radiology, Surgery I and II.
ANESTHESIA and INTERNAL MEDICINE
Knowledge of the pathophysiological bases of the main diseases and medical syndromes, which involve an impairment of vital functions


------------------------------------------------------------
Modulo: 46467 - ANESTESIOLOGIA
------------------------------------------------------------
ANESTHESIA and INTERNAL MEDICINE
Knowledge of the pathophysiological bases of the main diseases and medical syndromes, which involve an impairment of vital functions

------------------------------------------------------------
Modulo: 47781 - MEDICINA INTERNA
------------------------------------------------------------
GENERAL SURGERY
Knowledge of Human Anatomy, Pathology, Physiology, Clinical Methodology, Radiology, Surgery I and II.
ANESTHESIA and INTERNAL MEDICINE
Knowledge of the pathophysiological bases of the main diseases and medical syndromes, which involve an impairment of vital functions


------------------------------------------------------------
Modulo: 65383 - TERAPIA DEL DOLORE
------------------------------------------------------------
GENERAL SURGERY
Knowledge of Human Anatomy, Pathology, Physiology, Clinical Methodology, Radiology, Surgery I and II.
ANESTHESIA and INTERNAL MEDICINE
Knowledge of the pathophysiological bases of the main diseases and medical syndromes, which involve an impairment of vital functions

Course programme

------------------------------------------------------------
Modulo: 005987 - CHIRURGIA GENERALE
------------------------------------------------------------
GENERAL SURGERY

• Initial approach to the emergency surgery patient
• Primary and secondary evaluation in thoraco-abdominal trauma
• Peri-operative evaluation of the emergency surgery patient and prevention of peri-operative complications through a multimodal evidence-based approach
• Management of peri-operative complications
• Abdominal emergencies (Acute appendicitis, Acute diverticulitis, Biliary colic and Acute cholecystitis, Jaundice and cholangitis, Peptic ulcer, Mesenteric ischemia, Gastrointestinal bleeding, Acute pancreatitis, Bowel obstruction, Bowel perforation, liver rupture, splenic rupture, Abdominal Compartment Syndrome)
• Thoracic emergencies (pneumothorax, hemothorax, esophageal rupture, mediastinitis)
• Soft tissue infection, necrotizing fasciitis, compartment syndrome of the upper and lower limbs
•Vascular emergencies (Abdominal aortic aneurysm rupture, Critical limb ischemia)
ANESTHESIOLOGY
• Initial approach to the patient with emergencies
• Approach to the patient with acute respiratory failure
• Approach to the patient with septic shock
• Approach to the patient with anaphylactic shock
• Approach to the patient with cardiogenic shock
• Approach to volume replacement therapy in different clinical situations
• Approach to the traumatized patient
• Approach to the patient with severe electrolyte disturbances
• Approach to the patient with multiple organ failure

INTERNAL MEDICINE
Clinical approach to emergency conditions: acute coronary syndromes, hypertensive crisis, hydro-electrolytic unbalance, high and low temperature diseases, drowning syndrome, dizziness (symptoms and causes), chronobiology of cardiovascular emergencies.
PAIN THERAPY
At the end of the course the student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.


------------------------------------------------------------
Modulo: 46467 - ANESTESIOLOGIA
------------------------------------------------------------
ANESTHESIOLOGY
• Initial approach to the patient with emergencies
• Approach to the patient with acute respiratory failure
• Approach to the patient with septic shock
• Approach to the patient with anaphylactic shock
• Approach to the patient with cardiogenic shock
• Approach to volume replacement therapy in different clinical situations
• Approach to the traumatized patient
• Approach to the patient with severe electrolyte disturbances
• Approach to the patient with multiple organ failure

INTERNAL MEDICINE
Clinical approach to emergency conditions: acute coronary syndromes, hypertensive crisis, hydro-electrolytic unbalance, high and low temperature diseases, drowning syndrome, dizziness (symptoms and causes), chronobiology of cardiovascular emergencies.
PAIN THERAPY
At the end of the course the student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.

------------------------------------------------------------
Modulo: 47781 - MEDICINA INTERNA
------------------------------------------------------------
GENERAL SURGERY

• Initial approach to the emergency surgery patient
• Primary and secondary evaluation in thoraco-abdominal trauma
• Peri-operative evaluation of the emergency surgery patient and prevention of peri-operative complications through a multimodal evidence-based approach
• Management of peri-operative complications
• Abdominal emergencies (Acute appendicitis, Acute diverticulitis, Biliary colic and Acute cholecystitis, Jaundice and cholangitis, Peptic ulcer, Mesenteric ischemia, Gastrointestinal bleeding, Acute pancreatitis, Bowel obstruction, Bowel perforation, liver rupture, splenic rupture, Abdominal Compartment Syndrome)
• Thoracic emergencies (pneumothorax, hemothorax, esophageal rupture, mediastinitis)
• Soft tissue infection, necrotizing fasciitis, compartment syndrome of the upper and lower limbs
•Vascular emergencies (Abdominal aortic aneurysm rupture, Critical limb ischemia)
ANESTHESIOLOGY
• Initial approach to the patient with emergencies
• Approach to the patient with acute respiratory failure
• Approach to the patient with septic shock
• Approach to the patient with anaphylactic shock
• Approach to the patient with cardiogenic shock
• Approach to volume replacement therapy in different clinical situations
• Approach to the traumatized patient
• Approach to the patient with severe electrolyte disturbances
• Approach to the patient with multiple organ failure

INTERNAL MEDICINE
Clinical approach to emergency conditions: acute coronary syndromes, hypertensive crisis, hydro-electrolytic unbalance, high and low temperature diseases, drowning syndrome, dizziness (symptoms and causes), chronobiology of cardiovascular emergencies.
PAIN THERAPY
At the end of the course the student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.


------------------------------------------------------------
Modulo: 65383 - TERAPIA DEL DOLORE
------------------------------------------------------------
GENERAL SURGERY

• Initial approach to the emergency surgery patient
• Primary and secondary evaluation in thoraco-abdominal trauma
• Peri-operative evaluation of the emergency surgery patient and prevention of peri-operative complications through a multimodal evidence-based approach
• Management of peri-operative complications
• Abdominal emergencies (Acute appendicitis, Acute diverticulitis, Biliary colic and Acute cholecystitis, Jaundice and cholangitis, Peptic ulcer, Mesenteric ischemia, Gastrointestinal bleeding, Acute pancreatitis, Bowel obstruction, Bowel perforation, liver rupture, splenic rupture, Abdominal Compartment Syndrome)
• Thoracic emergencies (pneumothorax, hemothorax, esophageal rupture, mediastinitis)
• Soft tissue infection, necrotizing fasciitis, compartment syndrome of the upper and lower limbs
•Vascular emergencies (Abdominal aortic aneurysm rupture, Critical limb ischemia)
ANESTHESIOLOGY
• Initial approach to the patient with emergencies
• Approach to the patient with acute respiratory failure
• Approach to the patient with septic shock
• Approach to the patient with anaphylactic shock
• Approach to the patient with cardiogenic shock
• Approach to volume replacement therapy in different clinical situations
• Approach to the traumatized patient
• Approach to the patient with severe electrolyte disturbances
• Approach to the patient with multiple organ failure

INTERNAL MEDICINE
Clinical approach to emergency conditions: acute coronary syndromes, hypertensive crisis, hydro-electrolytic unbalance, high and low temperature diseases, drowning syndrome, dizziness (symptoms and causes), chronobiology of cardiovascular emergencies.
PAIN THERAPY
At the end of the course the student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.

Didactic methods

------------------------------------------------------------
Modulo: 005987 - CHIRURGIA GENERALE
------------------------------------------------------------
GENERAL SURGERY
The module of general surgery provides:
• frontal lessons with analysis of the diagnostic/therapeutic pathways for different emergency surgery pathologies and discussion of clinical cases;
• attendance at the surgical ward and the operating room.


The module of ANESTHESIOLOGY and INTERNAL MEDICINE include frontal lessons, discussion of clinical cases, exercitations



------------------------------------------------------------
Modulo: 46467 - ANESTESIOLOGIA
------------------------------------------------------------
The module provides:
• frontal lessons with analysis of the diagnostic/therapeutic pathways for different pathologies and discussion of clinical cases;



The module of ANESTHESIOLOGY and INTERNAL MEDICINE include frontal lessons, discussion of clinical cases, exercitations

------------------------------------------------------------
Modulo: 47781 - MEDICINA INTERNA
------------------------------------------------------------
GENERAL SURGERY
The module of general surgery provides:
• frontal lessons with analysis of the diagnostic/therapeutic pathways for different emergency surgery pathologies and discussion of clinical cases;
• attendance at the surgical ward and the operating room.


The module of ANESTHESIOLOGY and INTERNAL MEDICINE include frontal lessons, discussion of clinical cases, exercitations



------------------------------------------------------------
Modulo: 65383 - TERAPIA DEL DOLORE
------------------------------------------------------------
GENERAL SURGERY
The module of general surgery provides:
• frontal lessons with analysis of the diagnostic/therapeutic pathways for different emergency surgery pathologies and discussion of clinical cases;
• attendance at the surgical ward and the operating room.


The module of ANESTHESIOLOGY and INTERNAL MEDICINE include frontal lessons, discussion of clinical cases, exercitations


Learning assessment procedures

GENERAL SURGERY
Verification of learning will be carried out by oral examination with discussion of a clinical case. A clinical case will be presented to the student, with laboratory and/or instrumental investigations (e.g. abdomen x-ray, abdomen CT scan, etc ...) with the aim to determine the student's ability to establish a diagnostic hypothesis and the adequate diagnostic/therapeutic path.
A minimum score of 18 out of 30 will be required to pass the exam. The grade will depend on the student's ability to: 1) conduct the initial assessment of the emergency surgery patient; 2) request and interpret the investigations useful to reach the diagnosis; 3) define a differential diagnosis and know the diagnosed pathology; and 4) choose the appropriate surgical or conservative treatment based on the diagnosed disease.
ANESTHESIOLOGY
Verification of learning will be carried out by means of a written exam with 60 multiple choice questions with 4 possible answers. Evaluation: 0.5 points for correct answer, 0 points for not given or wrong answer.
The final mark will derive from a weighted average between the mark of the modules of Surgery III, Internal Medicine and Anesthesiology.
INTERNAL MEDICINE
The assessment of the learning will be carried out (see Anesthesiology).
The final grade will derive from a weighted average of the Chirurgia III,pain Therapy and Anestesiology and internal medicine modules. the final verbalization will be made only following the completion of the TPV Internship in the second semester, and the attendance of the Pain Therapy seminar.
The exam will take place on a single date at the end of the first semester.

Reference texts

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Modulo: 005987 - CHIRURGIA GENERALE
------------------------------------------------------------
GENERAL SURGERY
“Chirurgia Generale” a cura di Francesco Minni. Edizione CEA - Casa Editrice Ambrosiana. 2019 ISBN 978-88-08-32049-0
“Emergency Surgery” edited by Adam Brooks, Bryan A. Cotton, Nigel Tai, Peter F. Mahoney, David J. Humes. Blackwell Publishing Ltd. 2010 ISBN: 978-1-405-17025-3
“Emergency Surgery Manual” edited by Massimo Sartelli e Fausto Catena. Alpes Italia 2008 ISBN: 8889923326
“Urgenze ed Emergenze” a cura di Maurizio Chiaranda. Edizione Piccin. 2016 ISBN: 978-88-299-2783-8
ANESTHESIOLOGY
Maurizio Chiaranda, Urgenze ed Emergenze - Istituzioni, Piccin Ed. Padova, Quarta edizione
Harrison, Principi di Medicina Interna, McGraw-Hill Ultima edizione
INTERNAL MEDICINE
Harrison’s Principles of Internal Medicine, McGraw-Hill
Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, Elsevier
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/)
PAIN THERAPY
Teacher notes


------------------------------------------------------------
Modulo: 46467 - ANESTESIOLOGIA
------------------------------------------------------------
ANESTHESIOLOGY
Maurizio Chiaranda, Urgenze ed Emergenze - Istituzioni, Piccin Ed. Padova, Quinta edizione
Harrison, Principi di Medicina Interna, McGraw-Hill Ultima edizione
PAIN THERAPY
Teacher notes

------------------------------------------------------------
Modulo: 47781 - MEDICINA INTERNA
------------------------------------------------------------
GENERAL SURGERY
“Chirurgia Generale” a cura di Francesco Minni. Edizione CEA - Casa Editrice Ambrosiana. 2019 ISBN 978-88-08-32049-0
“Emergency Surgery” edited by Adam Brooks, Bryan A. Cotton, Nigel Tai, Peter F. Mahoney, David J. Humes. Blackwell Publishing Ltd. 2010 ISBN: 978-1-405-17025-3
“Emergency Surgery Manual” edited by Massimo Sartelli e Fausto Catena. Alpes Italia 2008 ISBN: 8889923326
“Urgenze ed Emergenze” a cura di Maurizio Chiaranda. Piccin Ed., Fifth Edition 2022.
ANESTHESIOLOGY
Maurizio Chiaranda,
INTERNAL MEDICINE
Harrison’s Principles of Internal Medicine, McGraw-Hill
Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, Elsevier
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/)
PAIN THERAPY
Teacher notes

------------------------------------------------------------
Modulo: 65383 - TERAPIA DEL DOLORE
------------------------------------------------------------
GENERAL SURGERY
“Chirurgia Generale” a cura di Francesco Minni. Edizione CEA - Casa Editrice Ambrosiana. 2019 ISBN 978-88-08-32049-0
“Emergency Surgery” edited by Adam Brooks, Bryan A. Cotton, Nigel Tai, Peter F. Mahoney, David J. Humes. Blackwell Publishing Ltd. 2010 ISBN: 978-1-405-17025-3
“Emergency Surgery Manual” edited by Massimo Sartelli e Fausto Catena. Alpes Italia 2008 ISBN: 8889923326
“Urgenze ed Emergenze” a cura di Maurizio Chiaranda. Edizione Piccin. 2016 ISBN: 978-88-299-2783-8
ANESTHESIOLOGY
Maurizio Chiaranda, Urgenze ed Emergenze - Istituzioni, Piccin Ed. Padova, Quarta edizione
Harrison, Principi di Medicina Interna, McGraw-Hill Ultima edizione
INTERNAL MEDICINE
Harrison’s Principles of Internal Medicine, McGraw-Hill
Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, Elsevier
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/)
PAIN THERAPY
Teacher notes