The Surgical Semiotics (Signs and Symptoms) module aims to impart the following knowledge and skills to students:

Knowledge and Understanding:

- Understanding etiology, epidemiology, risk factors, and pathophysiology:

Students will gain an in-depth understanding of the etiology, epidemiology, risk factors, and pathophysiology of surgical diseases, for proper diagnostic-differential orientation.

- Recognizing clinical manifestations:

Students will learn to recognize the clinical manifestations of surgical diseases through appropriate collection of medical history and proper application of physical examination.

- Critical interpretation of findings:

Skills will be developed to critically interpret the results of laboratory, radiological, and instrumental diagnostics, analyzing them from a pathophysiological perspective.

- Surgical and non-surgical management:

Students will understand the principles of surgical and non-surgical management of clinical cases, including planning interventions and postoperative management.

- Setting prognosis:

Students will be trained to set an accurate prognosis for surgical therapy and to prevent possible complications.

Applying Knowledge and Understanding:

- Detection of clinical findings:

Students will apply advanced methodologies to detect clinical findings during examinations, developing essential practical skills for diagnosis.

- Diagnostic analysis:

The importance of functional, instrumental, and laboratory analyses in evaluating patient conditions will be emphasized, with practical exercises to enhance analytical skills.

- Formulation of differential diagnoses:

Students will be trained to formulate accurate differential diagnoses, distinguishing between clinical conditions with similar symptoms but different etiologies.

- Diagnostic pathway proposals:

The course will teach how to develop and propose appropriate diagnostic pathways, integrating all collected information to plan diagnostic and general assessment interventions.

- Adapting clinical decisions:

Students will learn to adapt clinical decisions to the patient's specific conditions, with particular attention to elderly patients and complex situations.

- Use of clinical guidelines:

Tools will be provided for the critical use of clinical guidelines, with particular attention to their practical application in patient management.

The effective acquisition of these knowledge and skills will be verified through theoretical and practical exams simulating real clinical scenarios, ensuring that students have achieved an adequate level of competence.

The course content will be delivered through theoretical lectures, case analysis, practical exercises at the Advanced Simulation Center (SIMAV), and attendance in medical and surgical wards, for a total number of hours as specified in the teaching module. Attendance is mandatory, with verification carried out according to the methods defined by the School.

Any Student with documented Specific Learning Disorders (SLD), or with any special needs, shall reach out to the Lecturer(s) and to the dedicated SLD Representative in the Department before class begins, in order to liase and arrange the specific teaching methods and ensure proper achievement of the learning aims and outcomes.

General Semiotics (Signs and Symptoms)

- The role and importance of semiotics, dialogue with the patient, reasons for hospitalization

- Medical history: subdivision and terminology, common hereditary conditions

- General physical examination: classical conduction of the physical examination (observation, auscultation, palpation, percussion), developmental and stature alterations

- Semiotics of the skin and mucous membranes

- Syndromes and signs of hydroelectrolytic metabolism disorders

- Semiotics of adipose tissue and lymph nodes

- Fever and febrile syndromes

- Pain

- Introduction to clinical case presentation

- Errors in medicine

 Semiotics of the Digestive System

- Oropharyngeal cavity: symptoms and signs of alterations of the lips, tongue, oral cavity, and pharynx

- Semiotics of the esophagus

- Clinical and instrumental semiotics of the abdomen: inspection, palpation, percussion, auscultation, radiological examination, ultrasound, and main ultrasound findings

- Semiotics of the stomach: symptoms, signs, and main disorders (pain, heartburn, regurgitation, nausea, vomiting, melena, appetite disturbances, etc.); instrumental analyses pertinent to gastroesophageal pathology (EGDS, pH-metry, EUS)

- Concept and etiology of dyspepsia (dyspepsia, ulcer, gastritis), dumping syndrome, gastroparesis: main signs, symptoms, and etiologies

- Intestinal semiotics: main symptoms and disorders (pain, transit, meteorism, etc.), constipation, and diarrhea, instrumental investigations

- Clinical cases of the digestive system

 Semiotics of the Endocrine System

- Thyroid and parathyroids

- Adrenal glands and pituitary gland

- Main acute and chronic syndromes of the endocrine system: signs and symptoms of excess or deficiency of function, main anatomical alterations, instrumental investigations

- Diabetes

- Clinical cases of the endocrine system

 Exocrine Glands

- Semiotics of the mammary gland

 Semiotics of the Liver, Biliary Tracts, and Gallbladder

- Anamnestic elements peculiar to liver diseases, main symptoms

- Physical examination of the liver, biliary tracts, and gallbladder

- Jaundice and liver failure

- Portal hypertension, cirrhosis, and ascites: instrumental investigations

- Clinical cases of the liver/biliary tracts

 Semiotics of the Spleen

- Anamnestic elements peculiar to diseases involving the spleen, main symptoms

- Physical examination of the spleen, instrumental investigations

- Clinical cases of the spleen

 Semiotics of the Respiratory System

- Anamnestic elements peculiar to diseases involving the respiratory system

- Physical examination of the respiratory system: main symptoms and signs (cough, sputum, cyanosis, pathological breathing)

- Pleural and mediastinal syndromes

- Chronic obstructive bronchitis, asthma, occupational diseases: instrumental investigations

- Clinical cases of the respiratory system

 Semiotics of the Cardiovascular System

- Anamnestic peculiarities of cardiovascular diseases: symptoms (pain, palpitations, dyspnea, cough, pre-syncope, syncope, shock, collapse, etc.)

- Inspection, palpation, percussion, and auscultation of the precordial region

- Semiotics of arteries, veins, and lymphatic vessels: main symptoms (acute and chronic peripheral ischemia syndromes, venous and lymphatic insufficiency, arterial hypertension and hypotension, stenosis, and aneurysms), instrumental investigations

- Rhythm and conduction disorders

- Semiotics of valvular diseases

- Coronary syndromes

- Heart failure

- The pericardium and associated syndromes

- Clinical cases of the cardiovascular system

 Semiotics of the Urinary and Gynecological Systems

- Anamnestic peculiarities in diseases of the urinary and gynecological systems: symptoms (pain, urinary and micturition disorders, hematuria, pyuria, edema, extrarenal manifestations of urinary diseases, etc.)

- Inspection, palpation, percussion, and auscultation of the abdomen and lumbar region

- Semiotics of urine examination, instrumental investigations of the urinary system

- Glomerulopathies and nephrotic syndrome, interstitial nephropathies, vascular nephropathies

- Acute and chronic renal failure

- Clinical cases of the urinary system

Semiotics of the Musculoskeletal System

- Semiotics of degenerative and inflammatory arthropathies of the musculoskeletal system

- Main systemic syndromes with implications for the musculoskeletal system

- Spinal alterations, low back pain

 Semiotics of the Hematopoietic System

- Anemia, polycythemia, platelet count and coagulation disorders: main symptoms and signs

- Acute and chronic alterations of the white blood cell count and differential

- Main pathologies of the hematopoietic system (myeloproliferative, myelodysplastic, and lymphoproliferative syndromes): signs and symptoms, instrumental investigations

- Clinical cases of the hematopoietic system

Neurological Semiotics

- Physical examination: signs and symptoms, gait alterations, main syndromes, most frequent metabolic causes of neurological alterations, instrumental investigations

Introduction to Instrumental Semiotics

- Exploration of advanced imaging techniques (CT, MRI, PET) and their role in clinical diagnosis, with particular emphasis on ultrasound

Semiotics of the Immune System

- Discussion of autoimmune and inflammatory diseases, with emphasis on clinical signs and instrumental investigations

Advances in Diagnostic Methods

- Emerging and innovative diagnostic methodologies, such as genomics and proteomics

TEXTBOOKS / BIBLIOGRAPHY

EVALUATION METHODS

FURTHER INFORMATION

Non-attending students will be able to communicate their possible requirements concerning only the General Surgery part of Teaching, at the following email address: campisi@unige.it

Reception and Counselling Mode for Students:

Wednesday / Friday, from 11.00 am  to noon,

at the Chair of Director Prof. Corradino Campisi,

“Pad. Ex. Isolamento, I° piano / ponente, IRCCS AOU San Martino – IST”

National Institute for Cancer Research, Genoa, with a prior phone advisement to one of the following numbers:

010- 555 4292 / Cell. 338 1 71 80 67