Nephrology
1655-Lek4NEFR-J
Classes in nephrology are conducted in the form of seminars and exercises. The aim of the seminars is to familiarize students with the issues of epidemiology, pathophysiology as well as diagnostics and pharmacotherapy of nephrological syndromes such as: acute kidney injury, chronic kidney disease, primary and secondary glomerulonephritis, as well as tubulointerstitial nephritis, nephrolithiasis and complications of these entities sickness. The curriculum also covers the diagnosis and treatment of arterial hypertension and basic disorders of water, electrolyte and acid-base balance. The exercises are devoted to improving the practical skills of an internal medical history and physical examination of a patient, with particular attention to systemic symptoms occurring in the course of kidney diseases, including the assessment of the body's water balance, correct blood pressure measurement and the interpretation of additional laboratory and imaging tests. The problems of diagnosis, differential diagnosis and treatment of: nephrotic and nephritic syndromes, acute kidney damage, chronic kidney disease and arterial hypertension are also discussed during the exercises. Students learn to interpret the results of additional tests in relation to the listed disease entities. They assist in diagnostic and therapeutic procedures, such as kidney biopsy,
and central venous hemodialysis catheter implantation. During the exercises, dialysis techniques (hemodialysis, peritoneal dialysis) and vascular accesses for renal replacement treatment (temporary and tunneled catheter) are presented and discussed. Students are
acquainted with the issues of renal replacement therapy for urgent and chronic indications and with the assessment of the adequacy of
dialysis therapy.
Seminar topics:
1. Basics of nephrological diagnostics
2. Primary hypertension and the most common forms of secondary hypertension
3. Antihypertensive drugs and principles of hypertension treatment
4. Acute and rapidly progressive glomerulonephritis
5. Chronic glomerulonephritis
6. Nephrotoxicity of drugs
7. Fluid balance, water and sodium metabolism disorders
8. Potassium metabolism disorders
9. Acid-base disorders
10. Acute kidney injury
11. Urinary tract infections
12. Interstitial nephropathy
13. Polycystic kidney disease
14. Chronic kidney disease
15. Nephroprotective measures
16. Anemia in the course of chronic kidney disease
17. Mineral and bone disorders in chronic kidney disease
18. Hemodialysis
19. Vascular access for hemodialysis
20. Peritoneal dialysis and peritoneal access
Exercise topics:
Exercise topics include the following topics:
1. Patient with acute kidney injury.
2. A patient with chronic kidney disease.
3. Patient with nephrotic/nephritic syndrome.
4. Patient undergoing renal replacement therapy with hemodialysis
5. Patient undergoing renal replacement therapy with peritoneal dialysis.
6. A patient with a urinary tract infection.
7. A patient with hypertension.
8. A patient with fluid, electrolyte and acid-base disorders.
Total student workload
1.Workload associated with direct participation of academic teachers:
- tutorials: 20 h
- clinical classes 30 h
- final test: 1 h
Total workload involving the direct participation of academic teachers: 49 h, which equals 1,63 of an ECTS point.
2.Total student workload:
- tutorials: 20 h
- clinical classes 30 h
- preparation for tutorials (including reading of the selected literature and written tasks completion): 16 h
- preparation for final test and final test: 5 + 1 = 6 h
Total student workload: 70 h, which equals 2,33 ECTS point.
3. Time required to prepare for and participate in the assessment process:
- preparation for and passing the exam: 16+5+1 = 22 hours, which corresponds to 0.73 ECTS points (22/30)
4. The student's total practical workload
– participation in classes (including practical examination) is 30 hours, which corresponds to 1 ECTS point (30/30)
5. Balance of workload related to the implementation of learning outcomes in medical simulation conditions (group of 6 people):
- participation in exercises – 4 hours
The total workload related to the implementation of learning outcomes in medical simulation conditions is 4 hours, which corresponds to 0.13 ECTS points; percentage of activities enabling the achievement of learning outcomes: 8.3%.
Learning outcomes - knowledge
W1: the student lists the environmental and epidemiological conditions, causes, symptoms, explains the principles of diagnosis and therapeutic procedures in the case of the most common internal diseases occurring in adults and their complications: 1) hypertension (primary and secondary) 2) diseases of the kidneys and urinary tract, including acute kidney injury and chronic kidney disease in all stages and their complications, glomerular diseases (primary and secondary, including diabetic nephropathy and systemic) and interstitial renal diseases, renal hypertension, renal cysts, nephrolithiasis, urinary tract infections (upper and lower sections), kidney diseases during pregnancy 3) water-electrolyte and acid-base disorders (states of dehydration, states of overhydration, electrolyte disorders, acidosis and alkalosis) (E.W7)
W2: student discusses the principles of pharmacotherapy in patients with renal failure and renal replacement therapy (E.W8)
Learning outcomes - skills
U1: the student is able to associate images of tissue and organ damage with clinical symptoms of the disease, history and laboratory test results in order to establish the diagnosis of the most common adult diseases (C.U7);
U2: the student is able to select drugs in appropriate doses to correct pathological phenomena in the human body and individual organs (C.U9)
U3: the student is able to estimate toxicological danger in specific age groups and in states of liver and kidney failure and prevent drug poisoning (C.U13).
U4: the student is able to conduct an interview with an adult, including an elderly person, using skills related to the content, process and perception of communication, taking into account the biomedical perspective and the patient's perspective (E.U1).
U5: the student is able to perform a complete and focused physical examination of an adult adapted to a specific clinical situation, including a general internal medicine examination (E.U5);
U6: the student is able to recognize the most common symptoms of the disease in adults, apply diagnostic tests and interpret their results, conduct differential diagnosis, implement therapy, monitor the effects of treatment and assess indications for specialist consultation, in particular in the case of symptoms such as: 1) swelling; 2) shortness of breath; 3) urination disorders; 4) hematuria and proteinuria; 5) dehydration and overhydration (E.U9)
U7: the student is able to perform medical procedures and treatments, including: 1) measurement and assessment of basic vital functions (temperature, heart rate, blood pressure) and monitoring them using a cardiomonitor (E.U14);
U8: the student is able to keep patient medical records, including in electronic form, in accordance with the law (E.U18);
Learning outcomes - social competencies
K1: establishing and maintaining deep and respectful contact with the patient, as well as showing understanding for ideological and cultural differences (K_K01)
K2: being guided by the good of the patient (K_K02)
K3: compliance with medical confidentiality and patient rights (K_K03)
K4: noticing and recognizing one's own limitations and self-assessing educational deficits and needs (K_K05)
K5: using objective sources of information (K_K07)
K6: accepting responsibility related to decisions made as part of professional activity, including in terms of one's own safety and that of other people (K_K11)
Teaching methods
Seminars:
- presentation
- problem discussion
- questions and answers session
Exercises:
- clinical case study
- observation
- demonstration of taking history and physical examination
- simulated case
Expository teaching methods
- participatory lecture
- discussion
- narration
Exploratory teaching methods
- practical
- observation
- brainstorming
- seminar
- case study
- experimental
Prerequisites
A student starting training in the subject "Nephrology" should have basic knowledge of the anatomy, physiology, pathophysiology and pathology of the kidneys and urinary tract. The student should have knowledge and skills in conducting interviews and physical examinations. The student should have basic knowledge of pharmacology.
Course coordinators
Assessment criteria
Seminars: Final test 0-15 points; ≥60%= passed): W1-W2, U1-U6.
<9 points - FAILED;9 points and more – PASSED
Exercises:
Practical assessment - interpretation of laboratory and imaging tests used in nephrology (W1, U1-U6): (0-failed, 1 passed)
Social competences (K1-K6): extended observation (0-failed, 1 passed).
Practical placement
Additional information
Additional information (registration calendar, class conductors,
localization and schedules of classes), might be available in the USOSweb system: