Internal Diseases I (Gastroenterology, Nephrology, Endocrinology)

Title	% from total grade	Grade
1. Individual work	-	-
Work with a patient, i.e. medical history data, simulations, work with literature, including the e-environment, resulting in a protocol for patient screening with a diagnosis, its rationale, key examinations, and specific treatment for the patient being examined.

Title	% from total grade	Grade
1. Examination	-	10 points
The exam takes place in writing, covering the fourth year of study in gastroenterology, nephrology and endocrinology, which is included in the tickets (available in e-studies). After the invitation, the student draws 3 tickets (one from each discipline) and receives an exam sheet, where the full text of the exam ticket question must be written before writing the answer. The exam is passed if the answers to all ticket questions are marked "4" or higher. If any of the answers are rated below, then the exam must be taken again. The mark is enhanced not only by the breadth and accuracy of the student's knowledge, but also by references to modern classifications and the latest guidelines. Schemes, drawings and algorithms are positively evaluated. The description of treatment should include all therapies, lifestyle, medicines starting with the "gold standard", including surgery (endotherapy, invasive radiology) and possible alternative approaches. The final grade is a cumulative grade (average grade): 1) the average grade of practical classes (the teacher will assess the student's knowledge and activity in each practical class with a grade); 2) examination mark.

Classification of esophageal diseases. Functional esophageal diseases. Esophageal Achalasia. Non-reflux oesophagites, esophageal lesions due to infections, systemic diseases, medications, radiation injuries, esophageal tumors. Gastroesophageal reflux disease. Definition, diagnosis, complications. Typical and atypical presentation. Principles of treatment. Barrett’s esophagus. Mallory-Weiss syndrome. Foreign bodies in the esophagus.

Gastroduodenal Diseases I. Classification. Functional dyspepsia (definition, classification (Rome IV), diagnostic criteria, principles of therapy). The concept of gastropathies. Type of gastrites. Sydney classification of gastritis. Clinical relevance of chronic gastritis (atrophy, metaplasia, OLGA and OLGIM systems, cancer).The concept of duodenitis (peptic, non-peptic). Diagnostic capabilities.

Gastric and duodenal diseases II. Peptic gastric and duodenal ulcer (aetiology, pathogenesis, diagnostics, principles of treatment, complications). H.pylori infection (diagnosis, clinical relevance, Maastricht / Florence consensus, eradication principles). Non-helicobacter and/or non-NSAIDs associated ulcers.

Liver diseases I. Symptoms and syndromes of liver diseases. Bile acids and its metabolism. Compensated and decompensated liver cirrhosis and its complications. Acute-on-Chronic Liver Failure. Portal hypertension and variceal gastrointestinal bleeding. Ascites and spontaneous bacterial peritonitis. Hepatorenal syndrome. Hepatic encephalopathy. Liver failure. Drug-induced liver injury. Liver transplantation.

Liver Diseases II. Acute and chronic viral hepatites. Hepatic parasitosis. Alcohol and non-alcohol liver damage. Non-alcoholic steatohepatitis. Liver tumors and cysts.

Liver Diseases III. Congenital hepatic metabolism disorders, rare liver diseases: haemochromatosis, Gilbert's syndrome, Wilson's disease, primary biliary cholangitis, autoimmune hepatitis, primary sclerosing cholangitis, α1-antitrypsin deficiency.

Diseases of the gallbladder and biliary tract. Gallbladder and sphincter Oddi dysfunction. Bile litogenity clinical manifestations (sludge, gallstone microlithiasis, lithiasis) and therapeutical options. Holangites (clinical signs and principles of treatment). Tumors of biliary tract. Primary sclerosing cholangitis. Endoscopic and radiologic treatment of biliary disease.

Diseases of the pancreas. Classification of pancreatic diseases. Pancreatic insufficiency (cause, clinic, diagnostics, principles of therapy). Gastroenteropancreatic endocrine system and neuroendocrine tumors. Chronic pancreatitis (classification, diagnostic and treatment). Pancreatic carcinoma risk factors.

Small bowel diseases. Classification of small bowel diseases. Maldigestion and malabsorption. Microbiota and dysbiosis. Short bowel syndrome. Celiac Disease. Enterocolites: E. coli and its pathogenic strains; other infections, travelers' diarrhea. Intestinal parasites. Lactase deficiency.

Colon Diseases. Diverticulosis. Diverticulitis. Inflammatory bowel disease (Ulcerative colitis, Crohn's disease). Ischemic colitis. Risk factors of colorectal cancer. Prevention. Irritable Bowel Syndrome.

Nutrition in gastroenterological patients. Nutritional assessment techniques (incl. MUST, SNAQ, NRS scales). Harris Benedict equation (determination of basal metabolic rate). The main types of feeding. Indications and contraindications for enteral and parenteral nutrition).

Digestive endoscopy. METC. Upper gastrointestinal endoscopy (indications for immediate and planned use, contraindications). Colonoscopy (indications, bowel cleansing, contraindications). Endoscopic retrograde holangiopancreatography (options, indications). Echoendoscopy (options, indications). Small intestine endoscopy (intestinoscopy, capsule endoscopy). Recent trends in endoscopy (robotic, computerized). Bleeding from the digestive tract.

Functional dyspepsia. Gastropathies.

Comprehensive examination of the kidney patient.

Urinary tract infection (cystitis, pyelonephritis, acute urethral syndrome).

Biological mechanisms of hormone activity in norm and pathology. Diagnostic and therapeutic principles in modern endocrinology.

Irritable bowel syndrome.

Examination of kidney patient.

Chronic renal failure.

Acute renal failure.

Acute allergic bacterial nephritis, HRS, etc. specific causes of acute renal failure.

Glomerulonephritis with predominantly nephritic syndrome (IgAN, post-infectious GN, MPGN).

Glomerulonephritis with predominantly nephrotic syndrome (MPG, FSGS, MGN).

Fast progressive glomerulonephritis.

Chronic tubulointerstitial nephropathy (reflux NP, OU, nephrocalcinosis, toxins).

Cystic kidney disease (ADNP, ARNP, MCNS), kidney stone disease.

Diabetic nephropathy, amyloidosis, systemic lupus erythematosus (kidney aspects).

Chronic renal failure – classification (chronic kidney disease), syndromes, cardiovascular risk, staging.

Basics of Kidney Replacement Therapy (HD, PD, Tx).

Common disorders of water and electrolyte metabolism.

Thrombotic microangiopathy, preeclampsia, a. renal stenosis.

Principal mechanisms and regulation of hormone activity. Hypothalamus – normal physiology of pituitary hormones and basics of pathology. Acromegaly, Diabetes mellitus – pathogenesis, diagnostics and principles of therapy.

Adrenal hormones and major diseases. Concept of endocrine arterial hypertension (diagnosis, differential diagnosis and principles of therapy).

Basic carbohydrate metabolism. Diagnosis, classification, differential diagnosis of diabetes mellitus. Pathogenesis of type 2 diabetes. Principles of therapy and standards of care. Oral antidiabetic agents.

Pathogenesis of type 1 diabetes. Principles of insulin therapy. Concept of acute (hypoglycaemia, diabetic ketoacidosis) and chronic complications (nephropathy, retinopathy, polyneuropathy) of diabetes mellitus.

Role of thyroid hormones in physiological processes. Struma. Hypothyroidism and hyperthyroidism (diagnosis, principles of therapy). Characterisation of thyroid nodules, malignancy criterion.

Regulation of calcium homeostasis. The concept of hyperparathyroidism and hypoparathyroidism.

Principles of diagnosis and therapy of osteoporosis and bone metabolic diseases.

Adiposity and appetite control. Aspects of reproductive endocrinology.