MEDICINE

 

 

Course Number: Internal Medicine II 18122600, Internal Medicine III 18122570

Prerequisites: Anatomy, Biochemistry, Physiology, Microbiology, Pathology, Pharmacology, Community Medicine

Credits (hours per week, lecture/practical): 6（4-4/32）

Year: 4^th year semester

 

OBJECTIVES:

The goal of the undergraduate training in general medicine is to provide such knowledge, skills and

behavioral attribute that may enable the graduating physician to function effectively as a Primary Care Physician in a community setting. At the end of training, each student must be able to:

1. Understand the various manifestations of infectious and non-infectious diseases.

2. Understand the basic principle of history taking and clinical examinations.

3. Elicit a detailed history, perform a thorough physical examination including mental status.

4. Examination and examination of an unconscious patient.

5. Correlate the clinical symptoms and physical signs to make a provisional anatomical, physiological,

etiopathological diagnosis along with the functional disability and suggest relevant investigation.

6. Interpret reasonably the relevant investigations.

7. Professionally present and discuss the principles involved in the management of the patient, initiate

first line management and outline short-term and long term management.

8. Manage acute medical emergencies like acute myocardial infarction, acute pulmonary oedema,

acute anaphylactic and hypovolumic shock, status asthmaticus, tension pneumothorax, status

epilepticus, hyperpyrexia, haemoptysis, gastro-intestinal bleeding, diabetic coma, electric shock,

drowning, snake bites, common poisoning etc.

9. Acquire the skills to perform minor procedure under supervision like – IV cannulation, insertion of

nasogastric tube, urinary bladder catherisation, use of peak flow meter, doing an ECG etc.

 

COURSE CONTENT:

The lectures content is organized around the textbook, Cecil Textbook of Medicine.

1、Cardiovascular Disease

Lectures

--Introduction of cardiology                                              2 hr

      Impact of cardiovascular disease

      cardinal symptom of cardiovascular disease

      Physical examination and investigation of cardiovascular disease

--Valvular heart disease                                                 2 hr

      Causes

      Pathology

Clinical manifestation

      Laboratory examinations 

      Diagnosis and differential diagnosis

      Treatments

--Hypertension                                                         4 hr

      Epidemiology     

Etiology

      Pathogenesis and Pathology

      Diagnosis

      Treatments

--Heart failure                                                          4 hr

Causes

      Pathology

Clinical manifestation

      Laboratory examinations

      Diagnosis and differential diagnosis

      Treatments

--Infective endocarditis                                                  2 hr

Causes

      Pathology

Clinical manifestation

      Laboratory examinations

      Diagnosis and differential diagnosis

      Treatments

--Coronary atherosclerotic heart disease                                    4 hr

Classification

Etiology

Diagnosis and differential diagnosis

Major clinical manifestations

 -Treatment

-Angina pectoris

   Classification

Etiology

Diagnosis and differential diagnosis

Major clinical manifestations

Treatment

-Myocardial infarction

Classification

Etiology

Diagnosis and differential diagnosis

Major clinical manifestations

Treatment

--Cardiac arrhythmia                                                   4 hr

Classification

Etiology

Diagnosis and differential diagnosis

Major clinical manifestations

Treatment

--Cardiomyopathies                                                    2 hr

Classification

Etiology

Diagnosis and differential diagnosis

Major clinical manifestations

Treatment

 

Practicals

--Physical examination of normal heart                                          

--Medical history taking and physical examinations of patients with valvular heart disease, heart failure or cardiac arrhythmia

--Physical examine signs of other diseases (including hypertension, coronary atherosclerotic heart disease and infective endocarditis)

--Acquire the skills to do ECG and the ability to read ECG of typical example of the above disease

 

2、Respiratory Disease

Lectures

--General introduction:                                                           2 hr

Clinical examination of the respiratory system

Functional anatomy, physiology and investigations

Major manifestations of lung disease

--Asthma                                                            2 hr

--Chronic obstructive pulmonary disease                                    2 hr

--Community-acquired pneumonia                                            2 hr

--Pulmonary tuberculosis                                                        2 hr

--Tumors of the bronchus and lung                                            2 hr

--Interstitial and infiltrative lung diseases                                        2 hr

--Obstructive sleep apnoea                                                         2 hr

--Suppurative lung diseases                                              2 hr

Bronchiectasis

Lung abscess                                

--Respiratory failure                                                   2 hr

Pulmonary vascular diseases

Pulmonary hypertension

Pulmonary thromboembolism

--Pleural effusion and empyema                                           2 hr

 

Practicals

--Practicals are designed to complement the lectures as follows:

---Physical examination of the normal pulmonale and diseased lung;                                          

--Medical history taking and physical examination of 2 or 3 patients with asthma and lung cancer;

--Physical examination for signs of typical diseases (such as wheezing, Velcro sound and bulb finger).

 

3、Gastrointestinal Disease

Lectures

--General introduction

Clinical examination of the gastrointestinal system

Functional anatomy, physiology and investigations

Major manifestations of gastrointestinal disease

--Peptic ulcer                                                        3 hr

      Classification

Etiology

      Clinical manifestation

      Laboratory examinations 

      Diagnosis and differential diagnosis

      Treatments

--Gastroesophageal reflux disease (GERD)                                 3 hr

 Etiology

      Clinical manifestation

      Laboratory examinations 

      Diagnosis and differential diagnosis

      Treatments

--Gastric cancer                                                      2 hr

Etiology

      Pathology

Classification

Clinical manifestation

      Laboratory examinations 

      Diagnosis and differential diagnosis

      Treatments

--IBD (Ulcerative colitis and Crohn’s Disease)                              3 hr

Etiology

Pathology

Classification

Clinical manifestation

      Laboratory examinations 

      Diagnosis and differential diagnosis

      Treatments

--Intestinal Tuberculosis & Tuberculous Peritonitis                           3 hr

Etiology

      Clinical manifestation

      Laboratory examinations

      Diagnosis and differential diagnosis

      Treatments

--Irritable bowel syndrome (IBS)                                         2 hr

Etiology

      Clinical manifestation

      Laboratory examinations

      Diagnosis and differential diagnosis

      Treatments

--Liver cirrhosis                                                       3 hr

Classification

Etiology

Pathology

      Clinical manifestation

      Laboratory examinations 

      Diagnosis and differential diagnosis

      Treatments

--Acute pancreatitis                                                    3 hr

Classification

Etiology

      Clinical manifestation

      Laboratory examinations 

      Diagnosis and differential diagnosis

      Treatments

--Primary liver carcinoma                                               2 hr

Classification

Etiology

Pathology

      Clinical manifestation

      Laboratory examinations 

      Diagnosis and differential diagnosis

      Treatments

 

Practicals

--Physical examination of abdomen                                              

--Medical history taking and physical examinations of 2 or 3 patients with each disease

 

4、Hematologic Disease

Lectures

--Principles of anemia                                                  1 hr

Basic concept

Classification

Clinical presentations

Diagnosis

Treatment principles

--Iron deficiency anemia                                                2 hr

Concept of IDA

Metabolism of iron

Etiology and pathogenesis

Clinical presentations

Laboratory finding

Diagnosis and differential diagnosis

Treatment

Prophylactic measure

--Aplastic Anemia.                                                     1 hr

Type of aplastic anemia(AA)

Etiology and pathogenesis

Clinical manifestations and laboratory finding

Diagnosis and differential diagnosis

Treatment principle

--Hemolytic anemia                                                    3 hr

Pathogeneses

Clinical manifestations and laboratory finding of HA.

Diagnostic procedure

Type of autoimmune hemolytic anemia (AIHA)

Diagnosis and treatment of AIHA.

Indication of splenectomy for HA.

--Leukemia                                                          4 hr

Concept, classification and etiology 

Clinical presentation, diagnosis and differential diagnosis, treatment, prognosis

Chronic myeloid leukemia

--Lymphoma                                                          1 hr

Overview

Etiology

Pathology and classification

Clinical presentation

Laboratory and special examination

Diagnosis and differential diagnosis

Treatment

Prognosis

--Overview of hemorrhagic diseases                                       3 hr

Overview

Pathogenesis and etiology

Classification

Clinical presentation

Diagnosis

Treatment and prophylactic principles

--Thrombocytopenic purpura                                             1 hr

Concept

Pathogenesis

Clinical presentations

Diagnosis and differential diagnosis

Treatment

 

Practicals

--Medical history taking and physical examinations of 2 or 3 patients with Leukemia or Anemia

--Physical examine signs of other diseases (such as Lymphoma, ITP et al )

 

5、Endocrine Disease

Lectures

--Introduction of endocrinology                                           2 hr

     Endocrine regulation             

     Principle in diagnosing and treating endocrinopathy

--Hypercortisolism                                                     2 hr

     Causes

     Clinical manifestations

     Laboratory and anixillary tests

     Diagnosis and differential diagnosis

     Treatments

--Endocrine hypertension (hypertension and hypokallemia)                     2 hr

     Causes

     Clinical manifestations

     Laboratory and anixillary tests

     Diagnosis and differential diagnosis

     Treatments

--Hyperthyroidism                                                     4 hr

     Causes of hyperthyroidism

     Etiology

     Clinical manifestations

     Special types of hyperthyroidism

     Diagnosis and differential diagnosis

     Treatment

--Diabetes mellitus                                                    6 hr

Classification

Etiology

Diagnosis and differential diagnosis

Major clinical manifestations

Chronic complications

     -Diabetic neuropathy

     -Diabetic retinopathy

     -Diabetic nephropathy

     -Atherosclerosis

Acute metabolic complications    

-DKA

         -Hyperglycemic non-ketotic coma

Treatment

 

Practicals

--Physical examination of normal thyroid and disease of thyroid                                          

--Medical history taking and physical examinations of 2 or 3 patients with diabetes or hyperthyroidism

--Physical examine signs of other diseases (such as diseases of pituitary gland, adrenal, et al )

 

6、Renal Disease

Lectures

--Introduction of kidney diseases                                          2 hr

Structure and function of the kidneys

Epidemiology

Pathophysiology

Classifications and clinical manifestations

--Glomerulonephritis and nephrotic syndrome                               4 hr

     Glomerulonerphritis: definition, classifications, pathological and clinical manifestations

     Nephrotic syndrome: definition, clinical manifestations and pathophysiology, pathological types, diagnosis, treatment, comorbidities.

--Tubulointerstitial diseases                                              2 hr

 Definition, causes and diagnosis of acute and chronic interstitial nephritis

     Definition, classification and diagnosis of renal tubular acidosis.

--Acute kidney injury                                                   2 hr 

Definition and epidemiology

Classification and pathophysiology

Clinical manifestations and laboratory tests

Diagnosis

Treatment and prevention

--Chronic renal failure and renal replacement therapy                           2 hr 

Definition, causes and epidemiology

Pathophysiology

Clinical manifestations and laboratory tests

Diagnosis

Treatment and prevention

Classification and principles of renal replacement therapy

--Renal vascular diseases (renal artery stenosis and ischemic renal disease)         2 hr

Definition and causes

Clinical manifestations and laboratory tests

Diagnosis

Treatment and prevention

--Infections of the kidney and urinary tract                                   1 hr

Definition, classifications and causes

Clinical manifestations and laboratory tests

Diagnosis

Treatment and prevention

--Nephrolithiasis                                                       1 hr

Classifications and risk factors

Clinical manifestations and laboratory tests

Diagnosis

Treatment and prevention

Practical

Medical history taking and physical examinations of 2 or 3 patients with nephrotic syndrome, nephritis or acute renal failure.

 

7、Rheumatology

Lectures

--Introduction of rheumatology                                           1 hr

Concept

      Principle in diagnosing and treating rheumatology

--Rheumatoid arthritis                                                  3 hr                                           

      Causes

      Clinical manifestations

      Laboratory and anixillary tests

      Diagnosis and differential diagnosis

      Treatments

--Systemic lupus erythematosus                                           4 hr                    

      Causes

      Clinical manifestations

      Laboratory and anixillary tests

      Diagnosis and differential diagnosis

      Treatments

 

Practicals

--Major manifestations of musculoskeletal disease

Joint pains

Bone pain

Muscle pain and weakness

Regional periarticular pain

Back and neck pain

Approach to articular and musculoskeletal disorders

Inflammatory joint disease

Infectious arthritis

Inflammatory muscle disease

Osteoarthritis

--Medical history taking and physical examinations of 2 or 3 patients with rheumatoid arthritis or systemic lupus erythematosus.

STRUCTURE:

The course comprises 128 hr of lectures and 128 hr of practicals (16 weeks in autumn & winter semester, 2010-2011; another 16 weeks in spring & summer semester, 2010-2011)

A lecture session will be held every week on Wednesday mornings from 8:50 to 12:15.One weekly 4 hr practical session will be held on Thursday and Friday mornings from 8:50 to 12:15.

One test (1 hr) will be given before medical students leaving the concerned department. At the end of each semester, final examination (2 hr) will be held.

 

ORGANIZATION:

Each session will be offered to the entire class.

An assistant of the different system will act as liaison between students and teachers, and will be responsible for taking attendance, collecting exam papers and related matters.

 

EVALUATION: (PATTERN AND MARK DISTRIBUTION)

Students’ performance will be evaluated on the basis of attendance at lectures and participation in practicals (10%), scores on the test (30%) and final examination (60%).

 

RECOMMENDED TEXTBOOK:

1. Cecil Essentials of Medicine (7^th edition),Saunders Publications

2. Harrison's Principles of Internal Medicine (Hardcover),

3. Brenner & Rector’s THE KIDNEY, 7^th edition.

4. Williams Textbook of Respirology.

SUPPLEMENTARY READING:

 

TEACHING TEAM:

Faculty:

1. Tutors of Cardiovascular System

Prof. Wang Jianan

Department of Cardiology, 2^nd Affiliated Hospital

Tel: 87784677, 13805786328

Email: wang_jian_an@tom.com

Prof. Hu Shenjiang

Dean of Medicine Teaching Office, 1^st Affiliated Hospital

Tel: 87236578

Email: S0hu0001@126.com

 

Prof. Fu Guosheng

Department of Cardiology, Sir Run Run Shaw Hospital

Tel: 86006242.
E-mail: fugs@medmail.com.cn

 

Prof. Zhu Jianhua

Department of Cardiology, 1^st Affiliated Hospital

Tel: 87236794

Email: zhujianhua2006@hotmail.com

 

Dr.. Pang Xiaohong

Department of Cardiology, 2^nd Affiliated Hospital

Tel: 87784677, 13857116993

Email: heartpanxh@hotmail.com

 

Dr. Chen Shan

Department of Cardiology, 2^nd Affiliated Hospital

Tel: 87784677, 13868130609

Email: chenshan_zju@hotmail.com

 

Dr. Hu Xinyang

Department of Cardiology, 2^nd Affiliated Hospital

Tel: 87784677, 13857166372

Email: hxy0507@hotmail.com

 

Assistant:

Dr. Hu Chunyan

Assistant of Medicine Teaching Office,1^st Affiliated Hospital

Tel: 13758250838

Email: hzhcy@163.com

.

2. Tutors of Respiratory System

Prof. Shen Huahao

Director of Respiratory Department, 2^nd Affiliated Hospital

Tel: 13857189288

Email: hh_shen@yahoo.com.cn

 

Dr. Wang Kai

Associate chief physician, Respiratory Department, 2^nd Affiliated Hospital

Tel: 13957158572

Email: doctorhuxi@hotmail.com

 

Dr. Ding Liren

Attending, Respiratory Department, 2^nd Affiliated Hospital

Tel: 13906535702

Email: lirending@zju.edu.cn

 

Dr. Shen Yihong

Attending, Respiratory Department,1^st Affiliated Hospital

Tel: 13958106605

Email: drsyh@163.com

 

Dr. Pan Zhijie

Attending, Respiratory Department, 1^st Affiliated Hospital

Tel: 13805741181

Email: panzhijie73@hotmail.com

 

Dr. Wu Xiaohong

Associate Director of Respiratory department, Sir Run Run Shaw Hospital

Tel: 13588706901

Email: gina68831@yahoo.com.cn

 

Dr. Chen Enguo

Attending, Respiratory Department, Sir Run Run Shaw Hospital

Tel:13588706779

Email:georgechen100@googlemail.com

 

Assistant:

Dr. Ding Liren

Attending, Respiratory Department, 2^nd Affiliated Hospital

Tel: 13906535702

Email: lirending@zju.edu.cn

 

3. Tutors of Gastrointestinal Tract

Dr. Chen Yan

Associate chief physician, 2^nd Affiliated Hospital

Tel: 13757118653

Email: chenyang72_72@hotmail.com

 

Dr. Han Yaohua

Associate chief physician, 2^nd Affiliated Hospital

Tel: 13858126927

Email: hanyaohua770826@sohu.com

 

Dr. Lu Xinliang

Associate chief physician, 2^nd Affiliated Hospital

Tel: 13600515015

Email: luxl_zju@126.com

 

Dr. Yue Ming

Associate chief physician, 2^nd Affiliated Hospital

Tel: 13456779976

Email: yuemin2001@yahoo.com.cn

 

Dr. Liu Youshi

Associate chief physician, 2^nd Affiliated Hospital

Tel: 13757191669

Email: liuyoushi@zju.edu.cn

 

4. Tutors of Hematological Disorders

Prof. Jin Jie 

Director of department of Hematology, 1^st Affiliated Hospital

Tel: 87236702               

Email: Jiej@hzcnc.com

 

Associate Prof. Xie Wanzhuo

Attending, Department of Hematology, 1^st Affiliated Hospital

Tel: 87236703

Email: xiewanz@163.com

 

Associate Prof. Meng Xiaojian

Associate chief physician, Department of Hematology, 1^st Affiliated Hospital

Tel: 87236703

Email: rgyybzd@yahoo.com.cn

 

Associate Prof. Tong Yin

Associate chief physician, Department of Hematology, 1^st Affiliated Hospital

Tel: 87236896

Email: tongyin_cn2@yahoo.com

 

Associate Prof. Huang Jian

Attending, Department of Hematology, 1^st Affiliated Hospital

Tel: 87236896

Email: househuang@hotmail.com

 

Associate Prof. Xu Yang

Associate chief physician, Department of Hematology, 1^st Affiliated Hospital

Tel: 15988132164

Email: yxu@zju.edu.cn

 

Dr. Lou Yinjun

Attending, Department of Hematology, 1^st Affiliated Hospital

Tel: 87236896

Email: louyinjun@yahoo.com.cn

 

Dr. Wei Guoqing

Attending, Department of Hematology, 1^st Affiliated Hospital

Tel: 87236703

Email: weiguoqing2000@sina.com

Dr. Yu Wenjun

Associate chief physician, Department of Hematology, 1^st Affiliated Hospital

Tel: 87236896

Email: drwjyu@163.com

 

Dr. Ye Xueshi

Attending, Department of Hematology, Sir Run Run Shaw Hospital

Tel: 13606618381

Email: april-2@163.com

 

5. Tutors of Endocrinology and Metabolism

Prof. Li Hong 

Director of Department of Endocrinology, Sir Run Run Shaw Hospital

Tel: 86006975

Email: lihongheyi@126.com

 

Associate Prof. Wang Qingqing 

Director of department of science and education, Sir Run Run Shaw Hospital

Tel: 86006641

Email: wangqq@zju.edu.cn

 

Associate Prof. Wang Zhou

Associate Director of Endocrinology Department, Sir Run Run Shaw Hospital

Tel: 86006977

Email: wwgl@medmail.com.cn

 

Associate Prof. Zhou Jiaqiang

Department of Endocrinology, Sir Run Run Shaw Hospital

Tel:

Email: zhoujq27@yahoo.com

 

Dr. Zhan Nan

Department of Endocrinology, Sir Run Run Shaw Hospital

Tel:13588708503

Email: doczkm@yahoo.com.cn

 

Dr. Wang Guoxing

Department of Endocrinology, Sir Run Run Shaw Hospital

Tel: 13588706776

Email: Wangguoxing1969@yahoo.com.cn

 

Dr. Zheng Fengping

Department of endocrinology, Sir Run Run Shaw Hospital

Tel:

Email: zhengfenping@tom.com

 

Dr. Wu Fang

Department of endocrinology, Sir Run Run Shaw Hospital

Tel:

Email: wf8056@163.com

 

Dr. Dong Xuehong

Department of endocrinology, Sir Run Run Shaw Hospital

Tel:

Email: doreen_china@hotmail.com

 

Assistant:

Dr. Wang Guoxing

Department of Endocrinology, Sir Run Run Shaw Hospital

Tel: 13588706776

Email: Wangguoxing1969@yahoo.com.cn

 

6. Tutors of Kidney and Genitourinary System

Prof. Chen Jianghua 

Director of Kidney Disease Center,1^st Affiliated Hospital

Tel: 87236189

Email: Chenjianghua@zju.edu.cn

 

Associate Prof. He Qiang 

Kidney Disease Center,1^st Affiliated Hospital

Tel: 87236871

Email: strong_he@163.com

Prof. Li Yiwen

Kidney Disease Center,1^st Affiliated Hospital

Tel: 13456779525

Email: yiwen1962@yahoo.com

 

Associate Prof. Tian Jiong

Kidney Disease Center,1^st Affiliated Hospital

Tel:13858059251

Email: tusaj@medmail.com.cn

 

Dr. Han Fei

Kidney Disease Center,1^st Affiliated Hospital

Tel: 13968193317

Email: hanf8876@hz.cn

 

Dr. Jiang Xinxin

Department of nephrology, Sir Run Run Shaw Hospital

Tel: 13588706759

Email: jiangxin0413@yahoo.com.cn

 

Dr. Hu Weimin

Department of nephrology, Sir Run Run Shaw Hospital

Tel: 13867198585

Email: huwm@sohu.com

 

Dr. Feng Jian

Department of nephrology, Sir Run Run Shaw Hospital

Tel: 13588706758

Email: Feng_jian_2004@yahoo.com

 

Dr. Lu Mingxi

Department of nephrology, Sir Run Run Shaw Hospital

Tel: 13958181994

Email: qvqv915@hotmail.com

 

Assistant:

Dr. Han Fei

Kidney Disease Center, 1^st Affiliated Hospital

Tel: 13968193317

Email: hanf8876@hz.cn

 

7. Tutors of Disorders of the Immune System, Connective Tissue and Joints

Prof. Wu Huaxiang

Director of department of rheumatology, 2^nd Affiliated Hospital

Tel: 0571-87783562

Email: wuhx8855@sina.com

 

Associate Prof. Lin Jin

Director of department of rheumatology, 1^st Affiliated Hospital

Tel: 13906539996

Email: linjzj@yahoo.com.cn

 

Associate Prof. Xue Jing

Associate chief physician, Department of rheumatology, 2^nd Affiliated Hospital

Tel: 13858121751

Email: jingxue77@hotmail.com

 

Dr. Lu Xiaoyong

Attending of department of rheumatology, 2^nd Affiliated Hospital

Tel: 13857170840

Email: lxy@126.com

 

Dr. Xu Liqin

Attending of department of rheumatology, 1^st Affiliated Hospital

Tel: 13777826206

Email: liqinx@yahoo.com.cn

 

Assistant:

Associate Prof. Xue Jing

Associate chief physician, Department of rheumatology, 2^nd Affiliated Hospital

Tel: 13858121751

Email: jingxue77@hotmail.com