examination history taking and physicalphysics.mef.hr/spisak/mse/msenapl100828.pdf · history...

UNIVERSITY OF ZAGREB SCHOOL OF MEDICINE

Plan of the course

History Taking and PhysicalExamination

Academic year 2015/2016

izv. prof. dr. sc. Željko Krznarić

I. COURSE AIMS

History taking and physical examination represents the introduction to clinical medicine. The aims of the course are:introducing the student with the terminology, ethics, the way of collecting relevant information and the generic skills ofphysical examination.

The complexity of the course manifests within the collecting data and contacting with the non-English speaking patients. Forthis reason, it is necessary for students to learn basics of Croatian language, especially the terminology regardingsymptoms and signs of diseases. The course consists of the standard lectures and seminars. Seminars are characterized byinteraction, which enables the students to approach issues and problems more elaborately, as well as to clarify theambiguous terminology.

Practicals make the most important part of this course and they last throughout the whole academic year enabling thestudents and the teaching staff to prepare more adequately, emphasizing the importance of relevant clinical examples.

At the end of the course the student must be trained for independent and logical data collecting, as well as for standardphysical examination. Successful completion of the course is a prerequisite for enrolment into «Internal Medicine» course.

To learn the meaningful approach to the case history, physical examination and clinical way of making a decision inclinical medicine.To learn how to interview the patient and take the health history.To learn how to carry out the status and how to differentiate normal findings and disturbances.To learn the typical findings and special techniques of assessment in specific instances.To learn how to present patients verbally.To prepare concise and clear medical findings in propedeutics.To learn how to formulate the differential diagnosis.To learn how to order and interpret findings of usual examinations which are being used in diagnostics of commondiseases.To understand the principles of treatment of more frequent diseases.To encourage the independent gaining of knowledge.

II. COURSE STRUCTURE

Course hours:

Lectures: 29

Seminar: 25

Clinical practicals: 81

Total hours: 135

Lectures (L): 29 hours (clinical 25 hours+surgical 4 hours)

Seminars (S): 25 hours (clinical 25 hours)

Practicals (P): 81 hours (clinical 75 hours+surgical 6 hours)

Total: 135 (clinical 125+surgical 10)

Lectures and seminars will take place in educational centers of the University Hospital Centre Zagreb, Kišpatićeva 12 andpracticals will be held in the departments of the University Hospital Centre Zagreb, Kišpatićeva 12 and Clinical hospitalDubrava, Avenija Gojka Šuška 6.

III. PLAN OF THE COURSE AND COURSE SCHEDULE

BLOCKS OF THE COURSE

Number of blocks: 1Blocknumber Start End

1. 1.10.2015 22.4.2016

BLOCKS OF THE COURSE SHEME

Block 1

Date Time Group Coursehours type Theme Teasching staff

Thursday1.10.2015.

10:00-10:45;Edukacijski istok -1

All Lectures Introduction to the clinical medicine prof. dr. sc. ŽeljkoReiner


All Seminar History taking and physical examination-yesterday and today

prof. dr. sc. ŽeljkoReiner


All Lectures Comprehensive history prof. dr. sc. ŽeljkoReiner


All Seminar Discussion about history taking prof. dr. sc. ŽeljkoReiner

Friday2.10.2015.

08:30-10:45;Klinička bolnicaDubrava

Group 7 Clinicalpracticals Practical del Marija Crnčević Urek

08:30-10:45;KB Dubrava,dnevna bolnica,klinika P-6

Group 10 Clinicalpracticals Practical del Zdravko Mitrović

11:00-13:15;KAO II Group 1 Clinical

practicals Practical cardiology izv. prof. dr. sc. MajaStrozzi

11:00-13:15;Zavod zagastroenterologiju ihepatologiju I

Group 3 Clinicalpracticals Practical Gastroenterology izv. prof. dr. sc.

Željko Krznarić

11:00-13:15;Zavod zaintenzivnumedicinu I

Group 5 Clinicalpracticals Practical Intensive care izv. prof. dr. sc.

Radovan Radonić

11:00-13:15;Zavod zanefrologiju,arterijskuhipertenziju idijalizu

Group 4 Clinicalpracticals Practical Nephrology doc. dr. sc. Nikolina

Bašić-Jukić

11:00-13:15;Zavod zahematologiju

Group 6 Clinicalpracticals Practical Hematology dr. sc. Nadira

Duraković

11:00-13:15;Zavod za bolestimetabolizma

Group 2 Clinicalpracticals Practical Metabolism dr. sc. Ivan Pećin


Group 9 Clinicalpracticals Practical Gastroenterology - KB Dubrava Marija Crnčević Urek







Friday9.10.2015.









Željko Krznarić



Radovan Radonić



Bašić-Jukić



Duraković











Thursday15.10.2015.


All Lectures Basics of medical deontology and ethics. akademik DavorMiličić


All Seminar Ethical issues in medial medicine akademik DavorMiličić

Friday16.10.2015.







11:00-13:15;Koronarna Group 2 Clinical

practicals Practical Cardiology doc. dr. sc. Maja Čikeš



Group 3 Clinicalpracticals Practical Gastroenterology dr. sc. Marko Brinar



Radovan Radonić



Duraković











Thursday22.10.2015.


All Lectures Medical terminology akademik DavorMiličić


All Seminar Croatian medical terminology and contactwith patients

akademik DavorMiličić

Friday23.10.2015.






practicals Practical cardiology doc. dr. sc. JoškoBulum







Radovan Radonić



Duraković












Thursday29.10.2015.


All Lectures Basic of physical examination (PE) izv. prof. dr. sc.Radovan Radonić


All Seminar 1. Basic of physical examination (PE) izv. prof. dr. sc.Radovan Radonić

Friday30.10.2015.











Željko Krznarić

11:00-13:15;Zavod zagastroenterologiju ihepatologiju II

Group 4 Clinicalpracticals Practical Gastroenterology doc. dr. sc. Mirjana

Kalauz

11:00-13:15;Zavod zaintenzivnumedicinu II

Group 3 Clinicalpracticals Practical Intensive care doc. dr. sc. Ivan

Gornik



Duraković










Thursday5.11.2015.


All Lectures Physical examination – General survey doc. dr. sc. IvanGornik


All Seminar 2. Vital signs doc. dr. sc. IvanGornik

Friday6.11.2015.








practicals Practical Cardiology doc. dr. sc. BoškoSkorić



Željko Krznarić



Kalauz



Gornik



Duraković









Thursday12.11.2015.


All Lectures Physical status- Haematologic system izv. prof. dr. sc.Radovan Vrhovac


All Seminar 3. Limphatics izv. prof. dr. sc.Radovan Vrhovac

Friday13.11.2015.












Kalauz



Gornik

11:00-13:15;Odjel Group 1 Clinical

practicals Practical Pulmology izv. prof. dr. sc. SanjaPopović-Grle



Bašić-Jukić









Thursday19.11.2015.


All Lectures The head izv. prof. dr. sc.Drago Prgomet

13:45-14:30;Edukacijski istok -1 All Seminar

4. Selected faces-acromegaly,myxoedema, nephrotic sy, Cushing’s sy,parotid gland enlargement, Parkinson’sdisease

doc. dr. sc. ZlatkoGiljević

Friday20.11.2015.











Kalauz




Gornik





Bašić-Jukić









Thursday26.11.2015.


All Lectures The neck izv. prof. dr. sc.Drago Prgomet


All Seminar 5. Lumps and swellings, thyroidenlargement

izv. prof. dr. sc.Drago Prgomet

Friday27.11.2015.

11:00-13:15;Rebro, KlinikaORL, Ambulanta 1

Group 1,2 Clinicalpracticals Practical ENT izv. prof. dr. sc.

Drago Prgomet


Group 3,4 Clinicalpracticals Practical ENT dr. sc. Krsto

Dawidowsky


Group 5,6 Clinicalpracticals Practical ENT Lana Kovač Bilić, dr.

med.


Group 7,8 Clinicalpracticals Practical ENT Marcel Marjanović

Kavanagh

11:00-13:15;Rebro, KlinikaORL, Hitna služba

Group 9,10 Clinicalpracticals Practical ENT Juraj Lukinović

11:00-13:15;Rebro, KlinikaORL, OutpatientCare

Group 11,12 Clinicalpracticals Practical ENT mr. sc. Gorazd Poje

Thursday3.12.2015.


All Lectures The thorax and lungs izv. prof. dr. sc. SanjaPopović-Grle


All Seminar 6. General approach to the patient withdisease of respiratory system

izv. prof. dr. sc. SanjaPopović-Grle

Friday4.12.2015.










Kalauz



Radovan Radonić





Bašić-Jukić











Thursday10.12.2015.


All Lectures The thorax and lungs – clinical examples doc. dr. sc. MarkoJakopović


All Seminar 7. Abnormal auscultatory lungsphenomena

doc. dr. sc. MarkoJakopović

Friday11.12.2015.









Kalauz




Radovan Radonić





Bašić-Jukić











Thursday7.1.2016.


All Lectures The cardiovascular system –Clinicalanatomy and physiology

izv. prof. dr. sc.Martina Lovrić-Benčić


All Seminar 8. Praecordium examination; Chestdeformity

izv. prof. dr. sc.Martina Lovrić-Benčić

Friday8.1.2016.











Kalauz



Radovan Radonić



Gornik












Thursday14.1.2016.


All Lectures The heart – Blood pressure and pulse doc. dr. sc. NikolinaBašić-Jukić


All Seminar 9. The arterial pulse doc. dr. sc. NikolinaBašić-Jukić

Friday15.1.2016.











Kalauz



Radovan Radonić



Gornik












Thursday21.1.2016.


All Lectures The heart – Auscultation doc. dr. sc. BoškoSkorić


All Seminar 10. Surface projections of the heart andgreat vessels

doc. dr. sc. BoškoSkorić

Friday22.1.2016.











Kalauz



Radovan Radonić



Gornik



Bašić-Jukić









Thursday28.1.2016.


All Lectures The heart – Murmurs and clinical meaning izv. prof. dr. sc. MajaStrozzi


All Seminar 11. Abnormal heart sounds and murmurs izv. prof. dr. sc. MajaStrozzi


Friday29.1.2016.











Kalauz



Radovan Radonić



Gornik



Bašić-Jukić









Thursday4.2.2016.


All Lectures The peripheral vascular system doc. dr. sc. LjiljanaBanfić


All Seminar 12. Vascular insuffiency - symptoms andsigns

doc. dr. sc. LjiljanaBanfić

Friday5.2.2016.










Željko Krznarić



Kalauz



Radovan Radonić





Bašić-Jukić









Thursday11.2.2016.


All Lectures The abdomen – Clinical anatomy andtopography.

izv. prof. dr. sc.Željko Krznarić


All Seminar13. Techniques of examination;Inspection and auscultation - practicalissues

Marija Crnčević Urek

Friday12.2.2016.









Željko Krznarić



Kalauz



Radovan Radonić






Bašić-Jukić









Thursday18.2.2016.


All Lectures The abdomen –Abdominal diagnosticsbased on the HT & PE

doc. dr. sc. MirjanaKalauz


All Seminar 14. Percuting and palpating abdomen-practical issues

doc. dr. sc. MirjanaKalauz

Friday19.2.2016.











Gornik





Duraković












Thursday25.2.2016.


All Lectures Anus, rectum and prostate izv. prof. dr. sc.Nadan Rustemović


All Seminar 15. Rectal examination - normal andpathological findings

izv. prof. dr. sc.Nadan Rustemović

Friday26.2.2016.











Gornik





Duraković











Thursday3.3.2016.


All Lectures Urological symptoms and examination izv. prof. dr. sc.Željko Kaštelan


All Seminar 16. Differentiation of hernias in the groin izv. prof. dr. sc.Željko Kaštelan

Friday4.3.2016.










Gornik





Duraković













Thursday10.3.2016.


All Lectures The musculosceletal system prof. dr. sc. JasenkaMarkeljević


All Seminar 17. General approach to HT & PE ofmusculoskeletal system

prof. dr. sc. JasenkaMarkeljević

Friday11.3.2016.









Gornik





Duraković














Thursday17.3.2016.


All Lectures The nervous system izv. prof. dr. sc. FranBorovečki


All Seminar 18. III, IV, VI &VII nerve palsy izv. prof. dr. sc. FranBorovečki

Friday18.3.2016.

11:00-13:15;REBRO Klinika zaneurologiju

Group1,2,3,4,5,6,7,8,9,10,11,12

Clinicalpracticals Practical Neurology

dr. sc. Marina Boban,Barbara Barun, doc.dr. sc. Nataša Klepac,izv. prof. dr. sc. SanjaPropadalo-Hajnšek,prof. dr. sc. MajaRelja, izv. prof. dr. sc.Marija Žagar, doc. dr.sc. Mario Habek, doc.dr. sc. Darija MahovićLakušić, doc. dr. sc.Branko Malojčić, doc.dr. sc. Željka PetelinGadže, izv. prof. dr.sc. Damir Petravić,izv. prof. dr. sc.Srđana Telarović

Thursday24.3.2016.


All Lectures History taking and physical examinationin oncology

prof. dr. sc. StjepkoPleština


All Seminar 19. History taking and physicalexamination in endocrinology

doc. dr. sc. ZlatkoGiljević

Friday25.3.2016. 11:00-13:15;

NEPOZNATO!!Group1,2,3,4,5,6,7,8,9,10,11,12

Clinicalpracticals Practical Oncology

prof. dr. sc. StjepkoPleština, mr. sc. IvanBilić

Thursday31.3.2016.


All Lectures The breasts and axillae prof. dr. sc. StjepkoPleština


All Seminar 20. General approach to HT & PE inoncology

prof. dr. sc. StjepkoPleština

Friday1.4.2016.











Group 2 Clinicalpracticals Practical Nephrology dr. sc. Živka Dika


Group 3 Clinicalpracticals Practical Hematology dr. sc. Josip Batinić


Group 1 Clinicalpracticals Practical Metabolism prof. dr. sc. Željko

Reiner











Thursday7.4.2016.


All Lectures Nutritional status doc. dr. sc. DarijaVranešić Bender


All Seminar 21. Nutritional status doc. dr. sc. DarijaVranešić Bender

Friday8.4.2016.










Group 2 Clinicalpracticals Practical Nephrology dr. sc. Živka Dika



Group 3 Clinicalpracticals Practical Hematology dr. sc. Josip Batinić













Friday15.4.2016.


All Lectures The injury of musculosceletal system dr. sc. Ivan Dobrić


All Lectures Skin, breast, hands and wrists izv. prof. dr. sc.Davor Mijatović

12:45-15:00;Zavod 1 Group 1 Clinical

practicals Practical Surgery dr. sc. Ivan Dobrić


practicals Practical Surgery Igor Petrović


practicals Practical Surgery Petar Matošević


practicals Practical Surgery dr. sc. TomislavMeštrović


practicals Practical Surgery dr. sc. Marko Bogović


practicals Practical Surgery Mladen Duduković

12:45-15:00;Sala 6 Group 7 Clinical

practicals Practical Surgery dr. sc. Krešimir Bulić


practicals Practical Surgery Stanko Ćavar


practicals Practical Surgery dr. sc. TonisavAntoljak


practicals Practical Surgery dr. sc. Hrvoje Silovski


practicals Practical Surgery Ognjan Deban


practicals Practical Surgery Damir Halužan

Friday22.4.2016.


All Lectures The thoracic injuries, Pneumothoraxizv. prof. dr. sc.Dinko Stančić-Rokotov


All Lectures Examination of acute abdomen dr. sc. Goran Augustin



practicals Practical Surgery dr. sc. Ivan Dobrić


practicals Practical Surgery Igor Petrović


practicals Practical Surgery Petar Matošević


practicals Practical Surgery dr. sc. Marko Bogović


practicals Practical Surgery Mladen Duduković


practicals Practical Surgery Stanko Ćavar


practicals Practical Surgery dr. sc. Krešimir Bulić


practicals Practical Surgery dr. sc. Goran Augustin


practicals Practical Surgery dr. sc. TonisavAntoljak


practicals Practical Surgery dr. sc. Hrvoje Silovski


practicals Practical Surgery Ognjan Deban


practicals Practical Surgery dr. sc. TomislavMeštrović


For practical classes students rotate through diferent departments to learn specifics in history taking and physicalexamination from the best experts in their field. In total students will spend roughly around 6 practicals in cardiology, 4practicals in both gastroeneterology and critical care unit, 2 practicals in pulmology, metabolic disorders, hematology,nephrology and Department for surgery and 1 practical in Department for oncology, Department for Neurology and ENTdepartment. (Changes may happen because of specific of each clinic)

IV. EXAMINATIONS

Students can take the exam only after they have ALL their student obligations fulfilled (attendance for lectures and seminar,possible make up colloquia, attendance to practical).

NOTE: Students are allowed to miss 2 school hours of lectures, 2 school hours of seminars and 6 school hours of practical(at the clinical wards) with corresponding documentation provided by the student (proof of exam, doctor’s note if sick...)without having to make-up classes. If students do not provide the requested documentation, make-up will be necessary.Students who miss more than 2 school hours of lecture and 2 school hours of seminars and 6 school hours of practical willhave to make-up for theoretical part of the course via colloquium and the practical part by organizing the make-uppractical. Students who miss 20 or more percent (27 school hours) will not receive the necessary attendance signatureallowing them to proceed to the final exam and will have to retake the course. In case that less than 80% of the course isattended student will need to re-take the entire course in next academic year.

Types of examination and examination dates

The exam includes a written test and an oral/practical exam. Written test consists of multiple-choice questions. Passing thewritten test is a requirement for approaching the oral/ practical exam.

Course grades: 5 = excellent (A)

4 = very good (B)

3 = good (C)

2 = satisfactory (D)

1 = fail (F)

Final grade of the course is calculated as an average grade from written and oral/practical exam grades.

V./I. LIST OF LECTURERS AND TEACHING STAFF

1. izv. prof. dr. sc. Željko Krznarić

2. prof. dr. sc. Željko Reiner

3. akademik Davor Miličić

4. dr. sc. Krsto Dawidowsky

5. izv. prof. dr. sc. Radovan Radonić

6. izv. prof. dr. sc. Željko Kaštelan

7. izv. prof. dr. sc. Radovan Vrhovac

8. izv. prof. dr. sc. Drago Prgomet

9. doc. dr. sc. Zlatko Giljević

10. doc. dr. sc. Marko Jakopović

11. prof. dr. sc. Stjepko Pleština

12. izv. prof. dr. sc. Martina Lovrić-Benčić

13. doc. dr. sc. Boško Skorić

14. prof. dr. sc. Anton Šmalcelj

15. izv. prof. dr. sc. Bojan Jelaković

16. dr. sc. Živka Dika

17. doc. dr. sc. Joško Bulum

18. mr. sc. Gorazd Poje

19. prof. dr. sc. Rajko Ostojić

20. doc. dr. sc. Silvija Čuković-Čavka

21. izv. prof. dr. sc. Fran Borovečki

22. doc. dr. sc. Ljiljana Banfić

23. doc. dr. sc. Maja Čikeš

24. izv. prof. dr. sc. Davor Mijatović

25. izv. prof. dr. sc. Dinko Stančić-Rokotov

26. dr. sc. Goran Augustin

27. prof. dr. sc. Igor Aurer

28. prof. dr. sc. Nada Čikeš

29. prof. dr. sc. Vladimir Gašparović

30. prof. dr. sc. Petar Kes

31. izv. prof. dr. sc. Ivana Pavlić-Renar

32. doc. dr. sc. Ivan Gornik

33. izv. prof. dr. sc. Darko Kaštelan

34. doc. dr. sc. Robert Likić

35. doc. dr. sc. Iveta Šimić

36. dr. sc. Nadira Duraković

37. doc. dr. sc. Tina Dušek

38. dr. sc. Ivan Pećin

39. dr. sc. Josip Batinić

40. dr. sc. Luka Bielen

41. dr. sc. Ana Boban

42. dr. sc. Marko Brinar

43. prof. dr. sc. Jadranka Šeparović Hanževački

44. dr. sc. Karlo Golubić

45. dr. sc. Mislav Puljević

46. dr. sc. Jure Samardžić

47. prof. dr. sc. Lea Smirčić Duvnjak

48. prof. dr. sc. Jasenka Markeljević

49. dr. sc. Krešimir Bulić

50. dr. sc. Ivan Dobrić

51. dr. sc. Hrvoje Silovski

52. dr. sc. Tomislav Meštrović

53. dr. sc. Marko Bogović

54. izv. prof. dr. sc. Zdravka Poljaković

55. prof. dr. sc. Maja Relja

56. izv. prof. dr. sc. Marija Žagar

57. izv. prof. dr. sc. Ervina Bilić

58. doc. dr. sc. Mario Habek

59. doc. dr. sc. Darija Mahović Lakušić

60. doc. dr. sc. Branko Malojčić

61. doc. dr. sc. Željka Petelin Gadže

62. izv. prof. dr. sc. Damir Petravić

63. izv. prof. dr. sc. Srđana Telarović

64. dr. sc. Marina Boban

65. mr. sc. Ivan Bilić

66. izv. prof. dr. sc. Sanja Propadalo-Hajnšek

V./II EXTERNAL ASSOCIATES:

1. Zdravko Mitrović

2. Marija Crnčević Urek

3. prof. dr. sc. Igor Francetić

4. prof. dr. sc. Boris Vucelić

5. doc. dr. sc. Darija Vranešić Bender

6. dr. sc. Tonisav Antoljak

7. Stanko Ćavar

8. Ognjan Deban

9. Mladen Duduković

10. Anto Dujmović

11. Damir Halužan

12. Petar Matošević

13. Igor Petrović

14. Suzana Sršen-Medančić

15. Irena Šnajdar

16. Tomislav Žigman

17. Barbara Barun

18. Tereza Gabelić

19. Magdalena Krbot Skorić

20. Tanja Badovinac Črnjević

21. Marcel Marjanović Kavanagh

22. Juraj Lukinović

V./III UNTENURED LECTURERS:

1. doc. dr. sc. Silva Zupančić-Šalek

2. izv. prof. dr. sc. Sanja Popović-Grle

3. izv. prof. dr. sc. Maja Strozzi

4. doc. dr. sc. Mirjana Kalauz

5. izv. prof. dr. sc. Nadan Rustemović

6. doc. dr. sc. Nikolina Bašić-Jukić

7. izv. prof. dr. sc. Anko Antabak

8. Emil Kinda, dr. med.

9. Tihomir Kekez, dr. med.

10. doc. dr. sc. Nataša Klepac

11. Ivana Zadro, dr. med.

12. Lana Kovač Bilić, dr. med.

VI. LITERATURE

A. Mandatory

1. Bates' Pocket Guide to Physical Examination and History Taking. by Bickley, Lynn S.; Szilagyi, Peter G.; Bates,Barbara. LIPPINCOTT WILLIAMS & WILKINS Philadelphia 2003-

B. Additional

1. Pocket Companion for Physical Examination and Health Assessment. Jarvis, C. Elsevier Science Health Science, 20032. A Guide to Physical Examination and History Taking. Bates B.; J. B. Lippincott, Philadelphia: 5th Edition, 19913. Anamneza i fizikalni pregled. Čustović, F. Školska knjiga, Zagreb 2000.4. Internistička propedeutika i osnove fizikalne dijagnostike. Metelko Ž, Harambašić H. i sur. Medicinska naklada 1999.

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