Veidlapa Nr. M-3 (8)
Study Course Description

Endocrine Diseases II

Main Study Course Information

Course Code
REN_016
Branch of Science
Clinical medicine; Internal medicine
ECTS
36.00
Target Audience
Medicine
LQF
Level 8

Study Course Implementer

Course Supervisor

Residency Speciality

Speciality
Supervisor of Medical Speciality
Contacts

-

About Study Course

Objective

To ensure acquisition of theoretical knowledge and practical skills in the diagnosis of endocrine diseases, differential diagnosis, recognition of various congenital and acquired endocrine syndromes. To deepen the knowledge acquired in the Endocrine Diseases I study course, as well as to supplement it, paying special attention to diabetes mellitus complications, bone metabolic diseases and adrenal diseases.

Learning Outcomes

Knowledge

1.Curriculum of the Endocrine Diseases II study course acquired in the intended scope; During the training, the medical resident worked in a specialised endocrinology department and in an outpatient endocrinologist’s office under the guidance of endocrinologists entitled to teach; Regularly participated in medical resident seminars and lectures, prepared speeches for clinic morning sessions and participated in the student training process; Understands in depth and is able to analyse the importance of hormones in the normal development and ageing of an organism, knows the pathology of various endocrine glands, knows the relevant diagnostic, treatment and prevention techniques; To accurately evaluate and choose the specific treatment tactics, especially for patients with diabetes mellitus and thyroid problems.

Skills

1.To recognise and describe different endocrine problems in humans, to define possible endocrine pathology, systematise diagnostic examinations and organise specific treatment. To independently apply acquired knowledge in solving medical problems, prevention of endocrine diseases, diagnosis, treatment, care. To perform practical manipulations skilfully, has acquired the skills to work in the organisation of Health Care, as well as in education and research; To evaluate, detect and prevent possible risk factors for the development of various endocrine diseases; To be competent in the pharmacokinetics and pharmacodynamics of endocrine preparations, especially in insulin therapy. To understand and interpret the results of various examinations (laboratory, radiological, morphological), know and practically apply the methods of conservative treatment and prevention of endocrine diseases. To know how to perform dynamic care of diabetes patients and training of patients (their relatives), know how to diagnose chronic complications of diabetes early and learn techniques for their prevention. To diagnose bone metabolic diseases and adrenal diseases. To know how to initiate adequate therapy in cases of these diseases. To critically evaluate specialised literature and base one’s clinical decisions on the foundations of evidence-based medicine.

Competences

1.Ability to independently apply acquired knowledge in solving medical problems, diagnosis, treatment, care and prevention of endocrine diseases. Ability to perform practical manipulations with skill. The medical resident has gained skills in working in a healthcare organisation as well as in education and research.

Assessment

Individual work

Title
% from total grade
Grade
1.

Individual work

-
-
The medical resident shall participate in the care of endocrine patients, acquiring knowledge and skills in specialised departments, diagnostic and training rooms and outpatient endocrinology practices. To participate in the planned seminars. To prepare clinical presentations for seminars, to get acquainted with the latest literature and prepare literature reviews. To understand the diagnostic and treatment features of endocrine diseases. Preparation for the examination test.

Examination

Title
% from total grade
Grade
1.

Examination

-
-
Successfully completed seminar test works; The types and extent of intended manipulations have been learned; Demonstrated ability to independently diagnose, examine and prescribe therapy for patients with endocrine diseases, emphasising chronic complications of diabetes mellitus, thyroid pathology, bone metabolic diseases and adrenal diseases.

Study Course Theme Plan

FULL-TIME
Part 1
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Risk factors for cardiovascular diseases, early detection and possible prevention thereof. Primary and secondary prevention. Diabetes and arterial hypertension. Cardiovascular problems in diabetic patients. (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Diabetic sensorimotor neuropathy. Diabetic autonomic neuropathy. (Prof. I. Konrāde)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Diabetic macroangiopathy. Diabetic foot. Charcot foot. Principles of foot examination and possibilities of symptom objectification. Treatment of various wounds of the diabetic foot. Medical pedicure. Orthopaedic shoes. (Prof. I. Konrāde / Dr I. Ūdris)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Diabetes mellitus and skin, various infections. (Prof. I. Mikažāns)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Physiology of the thyroid gland. Iodine as a trace element, iodine in the diet, the required amount of iodine. The principle of thyroid hormone formation. Thyrocyte, thyroglobulin. Iodine peroxidase. TSH, bT4, bT3, reverse T3. The feedback principle. Pathogenesis and diagnosis of diffuse toxic goiter. Treatment of toxic goiter. Non-toxic goiter. Thyroid nodules. Thyroiditis: autoimmune, acute, subacute, fibrotic. (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Hypothyroidism (primary, secondary, tertiary). (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Forms of subclinical thyroid disease and their impact on the cardiovascular system. (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Thyroid pathology and pregnancy. Changes in thyroid function with ageing. (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Calcium, calcium metabolism, vitamin D, calcitonin, PTH, vitamin K. Importance of vitamin D, effects on various body systems, normal limits, concentration in the population (+ review of the latest literature). (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Hyperparathyroidism. Hypoparathyroidism. (Prof. I. Konrāde)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Bone structure and physiology. Importance of bones. Bone remodelling: osteoblasts, osteoclasts, osteocytes, mast cells. Modern theoretical principles of bone remodelling (RANK, RANKL, OPG, IL-1, IL-6, IL-11, TNF alpha, etc. substances). (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Metabolic bone diseases. Osteogenesis imperfecta. Paget’s disease. (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Osteoporosis in men. Glucocorticoid-induced osteoporosis. Osteoporosis in case of other diseases. (Dr I. Rasa)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Guidelines for diagnosis and treatment of osteoporosis. Analysis of various studies on osteoporosis and the medicinal products used (literature review and research analysis). (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Physiology and morphology of the adrenal gland: zona glomerulosa, zona retucularis, zona fasciculata. Cholesterol hormones. Acute adrenal failure. Mineralocorticoids. Chronic adrenal failure (Addison’s disease): hyperpigmentation, orthostasis, electrolyte imbalance. (Prof. A. Lejnieks)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Adrenal examination methods: radiological, scitigraphy, laboratory, etc. Diagnostic tests for adrenal pathology. (Prof. I. Konrāde)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Cushing’s syndrome (hypercortisolism). Hyperaldosteronism. Glucocorticoid-induced hypercorticism. Diagnostic methods with medicinal products. (Prof. I. Konrāde)
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Pheochromocytoma. Multiple endocrine neoplasia (MEN). Autoimmune polyglandular syndromes. Suprarenal pheochromocytoma. Dopamine, noradrenaline, adrenaline. (Prof. I. Konrāde)
Total ECTS (Creditpoints):
36.00
Number of Residency Seminars:
18
Length (weeks):
27
Final Examination:
Residency exam (Theory and practice)

Bibliography

Required Reading

1.

Handbook of Inpatient Endocrinology, by Rajesh K. Garg (Editor), James V. Hennessey (Editor), & more, 2020

2.

Speroff’s Clinical Gynecologic Endocrinology and Infertility, 9th Edition, 2019

3.

Goldman-Cecil Medicine, 2-Volume Set - 26th Edition, 2019

4.

Williams Textbook of Endocrinology, 14th Edition, 2019

5.

Harrison’s principles of internal medicine. 20th edition, 2018

6.

Harrison's Endocrinology 4th Ed (2017)

7.

THE WASHINGTON MANUAL™ Endocrinology. Endocrinology subspecialty consult. 3rd Edition, 2013

8.

Greenspan Basic and Clinical Endocrinology 5th edition, Appleton & Lange 2011.

9.

Osteoporozes klīniskās vadlīnijas, Rīga, 2011

10.

Andrology - Nieschlag, Eberhard; Behre, Hermann M.; Nieschlag, Susan (Eds.), 3rd ed., 2010.

11.

Klīniskā medicīna Profesora Aivara Lejnieka redakcija, 2010.

12.

Harrison’s principles of internal medicine 17th edition, 2010.

Additional Reading

1.

Gynecological Endocrinology Journal

2.

Diabetes Care

3.

Diabetologie

4.

Endocrinology

5.

Journal of Clinical Endocrinology & Metabolism

6.

Latvijas Ārstu žurnāls

Other Information Sources

1.

Acromegaly. 2021

2.

Leslie DeGroot, MD - Endotext Founder 1928-2018

3.

www.endotext.org

5.

www.netwibes.com/info_med

8.

UpToDate datubāze (pieejama tiešsaistē Rīgas Austrumu Klīniskajā Universitātes slimnīcā)