Internal Medicine
Study Course Implementer
Residency Speciality
-
About Study Course
Objective
Learning Outcomes
Knowledge
1.Acute and chronic syndromes and diseases: diagnosis, treatment tactics, monitoring and referral to specialists. Has an idea, knowledge and understanding of the following: Respiratory and pulmonary diseases and syndromes: - acute respiratory infections, - acute pneumonia, - chronic obstructive pulmonary diseases, - chronic bronchitis, - pulmonary emphysema, - acute pneumonia, - bronchial asthma, - tuberculosis, - tumours, - acute and chronic respiratory failure, - pneumothorax, - pulmonary haemorrhage, - breathing disorders during sleep. Diseases of the cardiovascular system: - hypertension, - chronic heart failure, - ischemic heart disease, - myocardial infarction, - myocarditis, - pulmocardial insufficiency – cor pulmonale, - cardiomyopathy, - pericarditis, - peripheral vascular diseases. Syndromes and diseases of the digestive tract: - functional dyspepsia, - peptic ulcer, - irritable bowel syndrome, - reflux, - cholelithiasis, - acute and chronic hepatitis, - liver cirrhosis, - bleeding from the digestive tract, - stomach and intestinal tumours, precancerous conditions. Anaemias: - knowledge of differential diagnosis, - iron deficiency anaemia, - haemorrhagic anaemia, - Vitamin B12 deficiency anaemia. Syndromes and diseases of the endocrine system: - diabetes, - thyrotoxicosis, - hypothyroidism, - obesity. Knowledge and understanding of the profession of family doctor characteristic to creative thinking or research and activity at the conjunction of different fields. Understands the aspects of diagnosis (including laboratory, morphological, instrumental, non-instrumental and radiological diagnosis), differential diagnosis, medicinal (clinical pharmacology, pharmacotherapy) and non-medicinal (diet therapy, physiotherapy) treatment, rehabilitation and secondary prevention in the sub-branches of medicine and nosologies. Able to make decisions independently, solve complex situations related to health care, diagnosis and treatment. Able to organise research work in various areas of family medicine.
Skills
1.• evaluation of clinical and biochemical laboratory examination data, • ECG recording, evaluation (rhythm disturbances, conduction disturbances, signs of acute ischemia, overloads), EHO-KG, VEM evaluation, • to establish indications for invasive tactics, urgent and planned (coronarography, percutaneous coronary intervention), • application of treatment algorithms of acute conditions, • able to independently drive the improvement of one’s competences and specialisation, • to take responsibility for results of work of personnel groups and analysis thereof, • to perform work, do research or continue education in complex and unpredictable conditions and to transform them using new approaches, if required. During post-graduate training, the family doctor must learn the indications and contraindications for the following additional methods in the diagnosis of respiratory diseases: • in the assessment of the basic indicators of external respiratory functions, • functional tests (in the assessment of bronchial permeability), • bronchoscopy, • computed tomography, • blood gas test, • chest roentgenogram (must be able to evaluate the results), • aerosol inhalation technique, • peak expiratory flow.
Competences
1.The acquired competences allow to justify decisions, to perform additional analysis if necessary: - Able to explain the impact of environmental changes on the incidence of diseases in the population, to understand the application of preventive, diagnostic and therapeutic methods in this aspect. - Able to assess patient complaints, their connection to the patient’s state of health. Has a broad understanding of diseases and risk factors thereof, the most common diseases in the population, care in case of chronic diseases, diseases that cause disability, and conditions that require emergency care. - Has an understanding of the use of preventive and diagnostic manipulations in primary health care, which covers practically all specialties (i.e. paediatrics, gynaecology, surgery, otolaryngology, dermatovenerology, ophthalmology, neurology, psychiatry, cardiology). - Ability to provide treatment to the patient at the level of primary care, organise rehabilitation if necessary. - Understanding of diagnostic possibilities at the primary and secondary level of health care, the possibilities of referring the patient to a specialist doctor if necessary. - Ability to organise and conduct consultations on issues related to the organisation of health care, especially in matters related to maternal and child health care, family planning. - Understanding of public health issues. - Ability to understand the importance of a positive doctor-patient relationship, to teach the patient to understand their complaints, to learn to live with them. - Ability to work in a team with other members of the primary health care team and other specialists. Able to integrate knowledge from different fields: - Understanding of health care organisation issues in general and primary health care organisation in particular. - Knowledge of legislative acts and directives in health care, ability to participate in the development thereof.
Assessment
Individual work
|
Title
|
% from total grade
|
Grade
|
|---|---|---|
|
1.
Individual work |
-
|
-
|
|
Work in small groups – clinical case analysis. Preparation of a presentation – according to the topic of the rotation cycle.
Educational work with different population groups (development of informative materials, lectures).
|
||
Examination
|
Title
|
% from total grade
|
Grade
|
|---|---|---|
|
1.
Examination |
-
|
-
|
|
2.
Examination |
-
|
-
|
|
Assessment of theoretical knowledge and practical skills at the end of the study course in a 10-point system.
|
||
Study Course Theme Plan
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Differential diagnosis of joint diseases.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Cough. Diseases of the upper respiratory tract in the family doctor practice. Pathogenesis of temperature.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Prevention, therapy, teamwork in the care of patients with type 2 diabetes mellitus.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
More common endocrine diseases in the family doctor's practice. Family doctor tactics.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Arterial hypertension in the family doctor practice.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Gastroenterological diseases. Early diagnosis of tumours of the digestive organs.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Genitourinary infections in the family doctor practice.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Early and timely diagnosis of lung diseases (including oncological) in the practice of a family doctor. Case studies.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Deep respiratory tract diseases in the family doctor practice.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Modern tactics of diagnosis and treatment of chronic heart failure.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Chronic venous insufficiency, principles of diagnosis and treatment
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Differential diagnosis of urinary syndrome. Concept, stages, treatment of chronic kidney disease.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Differential diagnosis of inflammatory kidney diseases in the work of a family doctor.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Cardiac stress tests, indications, methodology, interpretation of results.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Specialized room
|
Topics
|
Anaemia diagnosis and therapeutic principles.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Specialized room
|
Topics
|
Diagnostic principles of haematological diseases.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
-
|
Topics
|
Current development in cardiopulmonary resuscitation
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
On site
|
Auditorium
|
Topics
|
Differential diagnosis of rash and further tactics in GP practice.
|
Bibliography
Required Reading
Practice Guidelines in Primary Care 2021-2022. Jacob A. David. E-book Download Clinical Guidelines in Family Practice Full Online, 2020, Oralee348Ostrander, Format: PDF / EPUB / MOBI
2019. ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). François Mach, Colin Baigent, Alberico L. Catapano, et.al.
2018 ESC/ESH Guidelines for the management of arterial hypertension. Michel Azizi, Michel Burnier, Denis L Clement, et.al. ESC Scientific Document Group
Kalvelis A., Lejnieks A. Galveno kardiovaskulāro slimību un izpausmju klīniskās formas un diagnozes formulējumi. Rīga, 2017.
Jirgensons J., Kalējs O., Lejnieks A. (Sast.). Klīniskā medicīna. Pirmā grāmata, Rīga, 2010.
William J. Bremner, Wellington Hung, C. Ronald Kahn. Family Practice Center, Houston, TX , USA. Medical Diagnosis & Treatment. Stephen McPhee, Maxine Papadakis, Lawrence Tierney, 2007.
Ērglis A., Kalvelis A., Jirgensons J., u.c. Stabila stenokardija. Rīga, 2007.
Kalvelis A., Kalniņš U. Kardiovaskulāro slimību profilakse. Rīga, 2007.
Additional Reading
Family Practice Guidelines. 5th Edition, May 2020. Jill C. Cash, Cheryl A. Glass, Jenny Mullen. ISBN:978-0-8261-3583-4 (Print)
Practice Guidelines in Primary Care 2021-2022. Jacob A. David E-book Download Clinical Guidelines in Family Practice Full Online, 2020, Oralee348Ostrander, Format: PDF / EPUB / MOBI
Medscape. Family Medicine Clinical Practice Guidelines - 2019 Year in Review. Stay current with new guidelines and recommendations.
New: global initiative for asthma 2021 executive summary on asthma management and prevention
Pocket guide to copd diagnosis, management, and prevention. A Guide for Health Care Professionals 2021
2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal. Volume 39, Issue 33, 1 September 2018. Pages 3021–3104
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal (2016) 37,( 2893–2962).
Kamzola G. Ehokardiogrāfijas loma sirds mazspējas difernciāldiagnostikā. Latvijas ārsts. 2016. februāris. (12.-20.lpp.)