Endocrine Diseases II
Study Course Implementer
Residency Speciality
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About Study Course
Objective
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
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Title
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% from total grade
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Grade
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1.
Individual work |
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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.
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Examination
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Title
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% from total grade
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Grade
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1.
Examination |
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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.
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Study Course Theme Plan
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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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)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Diabetic sensorimotor neuropathy. Diabetic autonomic neuropathy. (Prof. I. Konrāde)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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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)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Diabetes mellitus and skin, various infections. (Prof. I. Mikažāns)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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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)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Hypothyroidism (primary, secondary, tertiary). (Prof. A. Lejnieks)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Forms of subclinical thyroid disease and their impact on the cardiovascular system. (Prof. A. Lejnieks)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Thyroid pathology and pregnancy. Changes in thyroid function with ageing. (Prof. A. Lejnieks)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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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)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Hyperparathyroidism. Hypoparathyroidism. (Prof. I. Konrāde)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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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)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Metabolic bone diseases. Osteogenesis imperfecta. Paget’s disease. (Prof. A. Lejnieks)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Osteoporosis in men. Glucocorticoid-induced osteoporosis. Osteoporosis in case of other diseases. (Dr I. Rasa)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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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)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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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)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Adrenal examination methods: radiological, scitigraphy, laboratory, etc. Diagnostic tests for adrenal pathology. (Prof. I. Konrāde)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Cushing’s syndrome (hypercortisolism). Hyperaldosteronism. Glucocorticoid-induced hypercorticism. Diagnostic methods with medicinal products. (Prof. I. Konrāde)
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Seminar
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Modality
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Location
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On site
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Specialized room
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Topics
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Pheochromocytoma. Multiple endocrine neoplasia (MEN). Autoimmune polyglandular syndromes. Suprarenal pheochromocytoma. Dopamine, noradrenaline, adrenaline. (Prof. I. Konrāde)
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Bibliography
Required Reading
Handbook of Inpatient Endocrinology, by Rajesh K. Garg (Editor), James V. Hennessey (Editor), & more, 2020
Speroff’s Clinical Gynecologic Endocrinology and Infertility, 9th Edition, 2019
Goldman-Cecil Medicine, 2-Volume Set - 26th Edition, 2019
Williams Textbook of Endocrinology, 14th Edition, 2019
Harrison’s principles of internal medicine. 20th edition, 2018
Harrison's Endocrinology 4th Ed (2017)
THE WASHINGTON MANUAL™ Endocrinology. Endocrinology subspecialty consult. 3rd Edition, 2013
Greenspan Basic and Clinical Endocrinology 5th edition, Appleton & Lange 2011.
Osteoporozes klīniskās vadlīnijas, Rīga, 2011
Andrology - Nieschlag, Eberhard; Behre, Hermann M.; Nieschlag, Susan (Eds.), 3rd ed., 2010.
Klīniskā medicīna Profesora Aivara Lejnieka redakcija, 2010.
Harrison’s principles of internal medicine 17th edition, 2010.
Additional Reading
Gynecological Endocrinology Journal
Diabetes Care
Diabetologie
Endocrinology
Journal of Clinical Endocrinology & Metabolism
Latvijas Ārstu žurnāls
Other Information Sources
UpToDate datubāze (pieejama tiešsaistē Rīgas Austrumu Klīniskajā Universitātes slimnīcā)