Denumirea disciplinei FIŞA DISCIPLINEI (english series) Numărul total de ore (pe semestru) din planul de învăţământ (84) NEPHROLOGY Anul de studiu 5 Semestrul * I Tipul de evaluare finală (E / V / C) E Regimul disciplinei (Ob obligatorie, Op opţională, F - facultativă) Ob Numărul de credite 6 Total ore din planul de învăţământ 84 Titularul disciplinei Facultatea Total ore de studiu individual 120 Prof. Dr. Adrian Covic Total ore pe semestru * Dacă disciplina are mai multe semestre de studiu, se completează câte o fişă pentru fiecare semestru Medicina Total C** S L P 84 24 60 204 Departamentul Medicale 1 Profilul Medicina Specializarea Medicina ** C curs, L activităţi de laborator, P proiect sau lucrări practice Minimum knowledge needed by students attending the course: Minimal knowledge: Assessment of renal function urine examination diagnosis of hematuria interpretation of proteinuria Hypo / hypersodemia Hypo / hyperkalemia kidney role in acid-base balance Renin angiotensin aldosterone system and medication which addresses it Nephrotic syndrome Nephritic syndrome Hypertension and its relation to renal function Diabetic nephropathy: diagnosis, staging, prevention, treatment Diagnosis and treatment in urinary infection ARF - classification Etiologic diagnosis of acute renal failure Diagnosis and treatment of complications of acute renal failure Chronic kidney disease - diagnosis, staging Complications of chronic kidney disease Progression factors in chronic kidney disease Principles of treatment in chronic kidney disease Cardiovascular damage in chronic kidney disease
Course objectives: Recognizing aggression factors on renal function and their control Prevention of acute kidney injury and chronic kidney disease Identifying kidney as target organ in infectious, immunological, hematological, metabolic, cardiovascular and genetic diseases. Learning a correct diagnosis algorithm in kidney disease. Recognition and prevention of drug nephrotoxicity. Information regarding the correct dosage of drugs in patients with acute or chronic renal impairment Recognition and prevention of cardiovascular involvement in chronic kidney disease Learning some basic notions about renal replacement therapy: alternatives, indications, complications, patient supervision. Lecture schedule: Electrolyte imbalances Acid-base disorders Primitive glomerulonephritis Renovascular hypertension, ischemic nephropathy, diabetic nephropathy Secondary glomerulonephritis Acute and chronic interstitial nephropathies; urinary tract infections Autosomal dominant polycystic kidney disease ARF (acute renal failure) Chronic kidney disease Renal replacement therapies (HD, PD, Kidney Transplant) Practical activities during the semester: Case presentations: Fluid and electrolyte disorders 1 hour Nephrotic Syndrome 1 hour Acute interstitial nephritis 1 hour Lupus nephropathy 1 hour Rapidly progressive glomerulonephritis 1 hour ARF 1 hour Chronic Kidney Disease ours Hematuria 1 hour Obstructive acute renal failure 1 hour Diagnostic algorithm in renal disease (evaluation and interpretation): -increased blood creatinine -hematuria -lower limb edema -proteinuria and nephrotic syndrome -anomalies of water and sodium balance: dehydration, hyponatremia -hypokalaemia -hyperkalemia No. hours 1 h 10 hours
Primitive and secondary glomerular nephropathies: -syndromes glomerular and non-renal associated signs -diagnostic investigation before a glomerular syndrome, renal biopsy -signs of severity, prognosis, principles of treatment in chronic glomerular nephropathies, rapidly progressive glomerulonephritis, ANCA associated glomerulonephritis and Good Pasture Syndrome -minimal lesions nephrotic syndrome - IgA nephropathy with- - membranous nephropathy - focal and segmental glomerulonephritis - membrano-proliferative glomerulonephritis Secondary nephropathies: -diabetic nephropathy -nephropathy in viral hepatitis -nephropathy in multiple mioloma Sistemic lupus eritematous; lupic nephropathy Tubulo-interstitial nephropathies: - urinary tract infections - analgesic nephropathy - immuno-allergic interstitial nephritis Special renal involvment (pregnancy, elderly people, heart failure) Vascular diseases of the kidney Acid-base imbalance Acute renal failure Chronic kidney disease: - definition, epidemiology, classification, diagnosis - CKD consequences: anemia, cardiovascular, bone disease, disorders of acid-base and electrolyte balance, metabolic disorders - progression factors in CKD - predialysis treatment of CKD - uremic syndrome - renal replacement therapies (hemodialysis, peritoneal dialysis) - renal transplantation ours ours Practical skills acquired at the end of the year / semester: - Recognition and interpretation of acute nephritic syndrome - Recognition and interpretation of nephrotic syndrome - Recognition and interpretation of rapidly progressive glomerulonephritis - Interpretation of urine examination (urinary dipstick and urinary sediment); interpretation of urinary indices - Collection and interpretation urine culture - Clinical and paraclinical diagnosis of dehydration and pre-renal acute renal failure - Clinical and ECG signs in electrolyte imbalances - Acid-base disorders - Renal colic: clinical diagnosis, laboratory findings, treatment - Diagnosis of peritonitis associated with peritoneal dialysis - Hyperosmolarity : clinical signs, etiology, serum ionogram interpretation - Insertion of central venous catheters and performing renal biopsy puncture (optional).
The final mark is composed of: - writen exam: 20 MCQs - oral exam (2 subjects) - practical exam (clinical case, ECG, radiography, virtual case) Procent of final mark: (Total = 100 %) 20 % 40 % 30 % - continuous testing during the semester 10 % Final examination consists of: Written examination (MCQ), practical exam and oral examination Estimated individual study hours needed: 1. Reading of lecture notes 20 7. Oral presentations 5 2. Studying of recomended readings 10 8. Preparing for the final exam 40 3. Studying of mandatory bibliography 10 4. Suplimentary reading at UMF library 10 9. Studying from internet resources, e- learning platform 5 5. Written assignments. 5 6. Preparing for periodic tests 10 10. Other activities (on call in the hospital) 5 Total individual study hours = 120 hours Mandatory references: - Nefrologie. Principii teoretice şi practice. Adrian Covic. Editura Demiurg 2011 - Nefrologie. Manual de buzunar pentru medicul de familie. Adrian Covic (coord.). Editura Demiurg 2012 - Le Book des ECN. Editia in limba romana. Laurent Karila (coord) Editura Medicala Universitara Iuliu Hateganu 2011 - Hemodializa. Principii teoretice şi practice. Adrian Covic (coord.). Editura Demiurg 2011, 18 Sep 2009 ISBN-10: 1405184728
Supplimentary readings: - Brenner and Rector's The Kidney, 9th Edition, By Maarten W. Taal, MD, FCP(SA), ISBN: 978-1-4160-6193-9, Copyright: 2012 - Comprehensive Clinical Nephrology, 4th Edition, Jurgen Floege, Richard J. Johnson, MD and John Feehally, MA, DM, FRCP, ISBN: 978-0-323-05876-6, Copyright: 2011 -The Renal System at a Glance, Chris O'Callaghan, Publication Date: 18 Sep 2009, ISBN-10: 1405184728 - Terapeutica Medicala Editia a II-a. G. Ungureanu. Maria Covic. Editura Polirom 2000 Date: 2012 Head of discipline, Prof. Dr. Adrian Covic