Syllabus Information

1.3. Context and importance of this course in the degree

INFECTIOUS DISEASES

GERIATRICS

Learning of Geriatrics within the disciplines of the Degree is needed for scientific and social reasons. The ultimate goal is that physicians can, in their social environment, provide better service for elderly patients and doing so from scientific basis.
 Knowing the content of the specialty of Geriatrics, the usefulness of geriatric comprehensive assessment and the more common assessment scales.
 Geriatric care levels meet the criteria for hospital admission in both emergency and other units, and the composition and performance of interdisciplinary teams, to ensure continuity of care and care for the elderly and their caregivers

EMERGENCIES

Emergencies take part in the group of medical-surgical specialties in the Medicine degree and they aim to:

      1.- Initiate in the knowledge of the diseases which are accompanied by any vital organ failure, facilitating the relation and multidisciplinary work with other areas and subjects.

      2.- Provide the necessary medical knowledge in order to evaluate the severity of a patient vital urgency and their initial assistance

2.1. Learning goals

ENFERMEDADES INFECCIOSAS

GERIATRIA

Successfully pass the subject of Geriatrics must involve achieving the following results:

Knowing the main physical, psychological and social peculiarities of the elderly.

Address personal circumstances of the environment in which of the elderly person’s life develops.

To know the main geriatrics syndromes and the etiopathogenic, pathophysiological and clinical features that the most common adult diseases occur with ageing.

  Get used to including in the assesment of the elderly, in addition to the syndrome, disease and etiology, social and demographic data (family, social, environmental environment, etc ...) that may influence the recovery, maintenance and improvement of their health.

Knowing the nuances necessary for indications of treatment in relation to age.

Knowing the most common preventive measures for the elderly in relation to their health.

Acquire habits for a comprehensive approach and empathic relationship with the elderly

Know most adequate facilities for caring the elderly, establish criteria for hospital admission, emergency referral and stay in other units. Manage interdisciplinary teams, to ensure the continuity of care and care for the elderly and their caregivers

 Geriatrics learning within the disciplines of the Degree is justified for scientific and social reasons. Professional will acquire, in their social environment, skills to provide better service as a physician as well as to be able for working in multidisplinary teams.

The application of scientific methodology at this stage of life (taking into account the changes brought about by age) has revealed the benefit of refine diagnostic, therapeutic and preventive measures, as well as the doctor-patient relationship in terms of the elderly .

Social Motivation: The growing proportion of the elderly population and the fact that the disease is more frequent in general at this stage of life, leads to the fact that, in the normal activity of modern medical, demand of care from elderly groups is increasingly steadily.

URGENCIAS

2.2. Importance of learning goals

INFECTIOUS DISEASES

GERIATRICS

The practice of medicine in any of their especialities a deep knowledge of aging process and the morphological, functional, psychological and social changes experienced by the elderly, as well as different health care resources available.

EMERGENCIES

The knowledge in emergencies will qualify the student for the global assistance of the most frequent clinical pictures which are acompanied by vital risk and it will establish the basis for a proper utilization of the available resources and the relation with other specialties.

Multidisciplinary assistance will encourage teamwork and facilitate the integral formation of the student.

3.1. Aims of the course

INFECTIOUS DISEASES

GERIATRICS

Knowing the aging process and the most common physical, psychological, social and environmental context of their specifity.
Know the main geriatric syndromes.
Acquiring the ability to recognize the most frequent changes in symptoms and signs of disease (those commonly studied in General Medical Practice) as they happen durin geriatric age.

Acquiring skills for clinical reasoning based on symptoms and signs in order to request additional tests to formulate accurate diagnoses.
Acquiring skills to adapt clinical and terapeutical decissions to frail and ill elderly population.
Learn the main preventive indications of geriatric syndromes and the most common diseases, taking into account the reality of the old man or woman and his or her environment, history and life expectancies.
Encourage inclusives strategies of treatment for the elderly, their families and people around them.

EMERGENCIES

Emergencies provide the student with the necessary resources to recognize the symptoms and failure signs of our organism vital systems (circulatory, respiratory, kidney, neurological and metabolic) which accompany the most frequent serious diseases. They also provide training to monitor essential physiological variables and clinical data in order to assess the evolution and the response to the treatment.

General objectives:

        1.- To dianose and adequately treat cardiopulmonary arrest.

        2.- To recognize and guide the therapeutic management of severe clinical pictures which most frequently occur in practice.

        3.- To know the importance of the monitoring in the evaluation of the severity and control of the patients.

        4.- To know the usefulness of ECG, Chest X-ray, chest and brain CT Scan, blood gas test and analytical data to the urgent evaluation of the severe patient.

4.1. Assessment tasks (description of tasks, marking system and assessment criteria)

INFECTIOUS DISEASES

GERIATRICS

1. Multiple choice questions from the theoretical program, taught in lectures and seminars. This examination consists of 25 multiple choice questions with four distractors, with only one true answer. This part accounts for 60% of the final mark.
    The questions can be asked in clinical format regardless of the clinical cases of the following section (see below). Failures do not detract points.
    2) Resolution of clinical cases assessed by several tests:
    - First, attendance at seminars and practices is mandatory and must reach a minimum of 80%.
    - Secondly, by resolution of 5 clinical cases, in a format similar to test that evaluates the theoretical and held in conjunction with the 25 questions the theoretical test.
    - Thirdly, it is also taken in consideration oral presentation and / or active participation in the discussion of clinical cases during the seminars, in small groups throughout the semester.
    The weight of the evaluation of these three sections, altogether accounts for 40% of the final mark.

EMERGENCIES

Complete evaluation is done by:

1. Theoretical themes evaluation: it will be carried out by means of a multiple-choice test regarding the issues explained in the theoretical lectures and group activities. Such exam will consist of 40 multiple-choice questions with 4 options and only one correct answer. The result will constitute 85% of the final grade.

2. Worksshop evaluation: they will be evaluated by the resolution of 3 practical cases. Its weighting in the final grade will be 10%

3. Mentored works: they will constitute 5% of the final range and will be made from the clinical cases incluided in the digital course of the subject included in the Anillo Digital Docente (ADD), Moodle 2 platform. Assistace to Workshops and Seminars is mandatory, a minimum assistance of 80% being required, in order to be authorized to take exam in the June call.

5.3. Syllabus

INFECTIOUS DISEASES

Topics in infectious diseases   (theory)

 1.Sepsis

2. FUO

3. Infection in immunosuppressed

4. HIV infection I

5. HIV infection II

6. Central nervous system infections

7. Mycobacterium infections

8. Infections clostridium

9.Rickettsial infections and borrelia 

10. Flu

11. Use of antimicrobial I

12. Use of antimicrobial II

13. Hospital-acquired infections

14.Pasmodium infections  

15. Other tropical infections

 Workshops

 Patient HIV. patient ETS

Pathology and commuter

Orientation to consultation clinic for infectious diseases

 Mycobacterium infection

Rational use of antibiotic

 Seminars

 Assignment of a clinical case for each

GERIATRICS 

Topics in Geriatrics (theoretical agenda)

1. Aging: definition epidemiology, etiology and cell biology. Syndromes of premature aging.

2. Typology of elderly. Fragility and dependence.
3. Presentation forms of the disease in the elderly.
4. Diagnosis and treatment of the elderly. Functional assessment.

5. Instability and falls.

6. Immobility and its complications. Pressure ulcers.

7. Urinary and fecal incontinence. Constipation. 

8. Geriatric Psychiatry.
9. Nutrition in the elderly.
10. Iatrogenic and polypharmacy in the elderly.
11. Model for Social Care in Aragon. Resources for the elderly.
12. Ethical issues: Responsibility of health and non-health workers around seniors. Rights of    dependent elderly and the sick. Geriatric care at the end of life.
13. Engineering in helping the elderly.
14. Preventing loss of independence in the elderly. Occupational therapy. Functional recovery.
15. Retirement, socioeconomic conditions. The Depdence law
Seminars based in clinical problem solving:
   1. Hip fracture
    2. Agitation
    3. Memory loss
    4. Pluripathology
    5. Enteral feeding
    6. Hyperosmolar coma

EMERGENCIES

THEORETICAL LESSONS
 1.       Emergency and Critical Care. Organization and triage in the emergency department
 2.       Monitoring
 3.       Attitude facing major disasters
 4.       Severity score systems in the critical ill patients 
5.       Acute coronary syndrome
6.       Acute heart failure
7.       Thromboembolic disease
8.       Acute respiratory infection
9.       Patient with neurologic focus
10.   Brain death and organ donation
11.   Septic patient in the emergency department
12.   Acute kidney failure
13.   Evaluation of the patient with gastrointestinal bleeding
14.   Patient with traumatic brain injury
15.   Polytraumatized patient 

 SEMINARS (1 hour/seminar)
1.       Patient with chest pain
2.       The patient in shock
3.       Syncope in the emergency department
4.       Patient with headache
5.       Evaluation of a comatose patient
6.       Evaluation of acute abdominal pain
7.       Febrile syndrome in the emergency department

 WORKSHOPS (2 hours/workshop)
1.       Basic cardiopulmonary resuscitation (CPR)
2.       ECG and Arrhythmia I
3.       ECG and Arrhythmia II
4.       Oxygen therapy and ventilatory support

5.5. Bibliography and recommended resources

• [Geriatría] - Principios de medicina interna [18ª ed.] / editores, Dan L. Longo... [et al.] . 18ª ed. México ; Madrid [etc.] : McGraw-Hill, cop. 2012
• [Geriatría y Patología Infecciosa] - Medicina interna [17ª ed.] / fundado por A. von Domarus ; continuado por P. Farreras Valentí ; director (desde 1968) C. Rozman ; subdirector (desde 2003), F. Cardellach López . 17ª ed. Ámsterdam ; Barcelona ; Madrid [etc.] : Elsevier, 201
• [Geriatría] - Tratado de geriatría para residentes / [autores, Abellán Van Kan, Gabor ... (et al.)] . Madrid : Sociedad Española de Geriatría y Gerontología, D.L.2006
• [Geriatría y Patología infecciosa] - Geriatría en atención primaria / editores, José Manuel Ribera Casado, Alfonso J. Cruz-Jentoft . 4ª ed. Madrid : Aula Médica, D.L. 2008
• [Patología infecciosa] - Mensa Pueyo, Josep. Guía de terapéutica antimicrobiana 2014 / Josep Mensa Pueyo, Josep Mª Gatell Artigas, José Elías García Sánchez . [Molins de Rei (Barcelona)] : Antares, D.L. 2013
• [Patología infecciosa] - Guía práctica del SIDA : clínica, diagnóstico y tratamiento / directores, Josep M. Gatell Artigas ... [et al.] ; secretario de redacción, Josep Mallolas Masferrer . 12ª ed. [Molins de Rei, Barcelona] : Antares, 2013
• [Patología infecciosa] - Enfermedades infecciosas : principios y práctica / [editores], John E. Bennett, Raphael Dolin, Martin J. Blaser ; [revisores de la ed. española, Carlos Barros Aguado... (et al.)]. 8ª ed. Ámsterdam ; Barcelona ; Madrid [etc.] : Elsevier, D.L. 2015
• [Urgencias] - Manual de urgencias [3ª ed.] / Miguel Rivas Jiménez [coordinador] . 3ª ed. Buenos Aires ; Madrid [etc.] : Editorial Médica Panamericana, D.L. 2013
• [Urgencias] - Medicina de urgencias y emergencias : guía diagnóstica y protocolos de actuación / [directores], Luis Jiménez Murillo, F. Javier Montero Pérez . 5ª ed. Ámsterdam ; Barcelona ; Madrid [etc.] : Elsevier, D.L. 2014
• [Urgencias] - Normas de actuación en urgencias / Manuel S. Moya Mir, [editor] . 5ª ed. Buenos Aires ; Madrid [etc.] : Editorial Médica Panamericana, 2011
• [Urgencias] - Manual de medicina intensiva del Massachusetts General Hospital / senior editor, Luca M. Bigatello ; associate editors, Hasan B. Alam... [et al.] ; [traducción, M. Jesús del Sol Jaquotot ; revisión científica, Pedro Castro Rebollo, José Millà  Santos, Marcos Peraza Sánchez] . 5ª ed. L'Hospitalet de Llobregat, Barcelona : Wolters Kluwer Health/Lippincott Williams & Wilkins, cop. 2011
• [Urgencias] - Frendl, Gyorgy. Cuidados intensivos de bolsillo / Gyorgy Frendl, Richard D. Urman ; [traducción, Bardo Andrés Lira Mendoza ; revisión científica, Víctor Manuel López Raya, Pedro Manuel Ramírez Ambriz, Daniel Osvaldo Villaseñor Trujillo]. L'Hospitalet de Llobregat, Barcelona : Wolters Kluwer Health/Lippincott Williams & Wilkins, D.L. 2013
• [Urgencias] - Whiteley, Simon M.. Cuidados intensivos / Simon M. Whiteley, Andrew Bodenham, Mark C. Bellamy ; [revisión científica, José A. Lorente] . 3ª ed. Ámsterdam ; Barcelona ; Madrid [etc.] : Elsevier, cop. 2011

http://psfunizar7.unizar.es/br13/eBuscar.php?tipo=a