PATHOLOGY

Microsoft software (Power Point) is used to deliver the lessons.

The Library has the necessary textbooks for the course. Students also have access to international scientific databases (PubMed), which the Library has.

All course deliveries are via computer presentation using Power Point. The above lectures of the courses are posted on the websites of the School of Medicine and the University Pathology Clinic with free access by the students of the School of Medicine. Finally, the email of the person in charge of the course as well as the other teachers can be used for communication between students and teachers and students are encouraged to use this method of communication as well. Also, information or announcements regarding the course are posted on the websites of the Medical School and the University Pathology Clinic with free access by the students of the Medical School.

1. Grading at the end of the exercise by the responsible faculty member regarding his performance in the clinical exercise. This rating is graded as follows: insufficient, average, good, very good.
2. During the daily visit, an examination is carried out on a specific patient (history taking, objective examination, identification of the patient's main problems, differential diagnosis based on the problems and a general investigation plan)
3. During the examination period with an oral examination in Pathology by the course instructor and Faculty members of the Clinic.

The exams are particularly demanding and it is usually necessary to answer at least 70% of the questions correctly, so that the student receives a passable grade. The score is determined based on the above three evaluations.

From the above it is concluded that the workload of the students for the Pathology Degree course is the maximum possible and the requirements are comparatively the highest of all the courses of the Medical Department of the Faculty of Medicine.

Finally, a special questionnaire is available (online from academic year 2018-2019) to the students at the end of the Clinical Exercise of (11+3)=14 weeks of the course, so that there is an evaluation by the students of each of the teachers, on the one hand for each of the Lectures of the lessons and on the other hand for the everyday Clinical Practice throughout the 14-week training. Students are also encouraged to express their opinion on the overall educational process of the course and any proposed changes.

The results of the above answers to the questionnaire are used appropriately with the aim of improving the educational process for the specific course.

The practice is done in groups under the supervision of a person in charge (faculty member) for each group of teachers. Usually 4-8 students are allocated per group. Each student attends at least 4-6 inpatients.

Goals 

The clinical practice in Pathology of the 6th year aims to acquire clinical skills, knowledge and professional behavior necessary in the study and care of adult patients under the careful supervision of the medical staff of the clinic.

Objective purposes

Course objectives may be specialized in clinical skills, knowledge and professional behavior.

CLINICAL SKILLS: During the internship students will acquire and be able to apply the clinical skills necessary to assess and care for adult patients with frequent pathological problems (with appropriate supervision).

In particular, students should acquire skills in the following:

• Obtain from the patient an accurate, complete and focused medical history, based on the symptoms he is experiencing.
• To perform an accurate, complete and focused medical examination.
• Be able to evaluate simple laboratory tests, such as complete blood count, complete urinalysis, routine biochemical laboratory findings and chest X-ray.
• Identify the main problems of the patient and based on them formulate the diagnostic possibilities.
• To plan the necessary laboratory, imaging and other paraclinical tests required for the differential diagnosis, the documentation of the diagnosis and the treatment of the patient.
• Be able to record the history, the findings of the objective examination, the course of the disease, the findings of the tests and the treatment in appropriate forms (in parallel and independently of the official records performed by the doctors of the clinic).
• To communicate with the other members of the team and in particular to present incidents during the visit and to communicate with the nursing and auxiliary staff of the clinic.
• To become familiar with the ways in which the diagnosis, prognosis and therapeutic approach are communicated to patients and their families by participating in the relevant process of the responsible doctors.
• Be familiar with and be able to perform simple medical procedures, such as venipuncture, drawing arterial blood, catheterizing the bladder, placing venous catheters, performing an EKG, and placing nasogastric tubes.
• To become familiar with the use of sterilization and the application of general rules for the prevention of the transmission of infectious agents.
• Familiarize yourself by assisting in the performance of more complex medical procedures such as pleural fluid, peritoneal fluid, synovial fluid puncture and collection, as well as lumbar puncture, bone marrow smears and bone marrow biopsy.

PROFESSIONAL CONDUCT: Students must understand and become familiar with behavioral attitudes necessary to provide proper care. In particular:

• Independent and self-directed learning
• Reliability
• Integrity, honesty, altruism
• Respect for the patient's personal data and rights
• Professional appearance and image in manners and attire
• Recognition of personal limitations in knowledge and skills and a constant will to improve them
• Providing medical care without the interference of personal biases
• Respect for the role of other health professions

Conditions 

In order for the student to attend the 6th year Pathology clinical practice effectively, they will need to have knowledge of many subjects, which have been taught on the basis of the curriculum. Of particular importance are the knowledge of the preclinical courses: Anatomy, Histology, Physiology, Biology, Biochemistry, Pharmacology and Microbiology. Knowledge in Pathological Anatomy, Pathological Physiology, Imaging Diagnostics, Pre-educational Pathology and Pathology I and II is particularly important.

Structure of Education 

Clinical practice in Pathology takes place in the 6th year according to the Study Guide of the Medical Department. The training lasts 14 weeks (11 weeks in the Pathology Clinic and 3 weeks in the selected Clinics of the related specialties of the Pathology Department or in the Neurology Clinic).

During the internship, the students are compulsorily trained as follows:

1) They attend the clinic on working days every day from 08.00 to 15.00.

• Each student personally monitors at least 4-6 patients for whom he records in parallel with the official records the history, the findings of the objective examination on a daily basis, the findings of the tests, the course of the disease and the treatment of the patient (in total he monitors 70 approximately patients). At discharge, a review is recorded with a summary of history and findings and an analysis of the rationale for the differential diagnosis, documentation of the diagnosis, and medication.
• Performs and monitors the performance of paraclinical interventions described in "CLINICAL SKILLS".
• He carries out instructions assigned to him by the medical staff of the clinic.

2) Every student during the term attends the internal on-calls from 16.00 to 23.00 for at least 20 days. There he has the opportunity to familiarize himself with problems that arise in emergency situations in hospitalized patients.

3) Each student during the term participates in nine general shifts from 08.00 to 23.00. With this participation, he becomes familiar with acute cases and especially with abdominal pain, precardial pain, fevers, the various forms of coma, digestive bleeding, acute renal failure, asthma, heart failure, the clinical appearance of lungs, hypertensive seizures, in acute neoplastic syndromes, in venous thrombosis and pulmonary embolism and other acute conditions.

4) During the term, the student attends mandatory all Clinic events based on the Clinic's annual post-educational program:

– Analysis of patient cases and lectures in nosological entities

– Lectures by guest speakers

– Conferences – Conferences, Symposia and Seminars organized by the Clinic or other Clinics

of the Pathological sector

– Bibliographic information

– Interclinical scientific meetings

- He's watching compulsory the lectures made specifically for students (see below)

LECTURES DURING THE PRACTICE OF THE 6TH YEAR STUDENTS IN PATHOLOGY

1. Coma: Definitions, etiological classification, diagnostic approach at the patient's arrival and etiological management.
2. Perceptual disorders: Confusion, delirium and acute confusional states, amnesia, dementia: Definitions, etiology and diagnostic approach.
3. Febrile conditions: Diagnostic approach to fever during the first week and fever of unknown etiology.
4. Chemotherapy of Infections: Drug Groups, Mode of Action, Common Side Effects by Drug Groups, and Treatment of Common Bacterial Infections
5. Arterial Hypertension: Definition of arterial hypertension and treatment (groups of antihypertensive drugs, mode of action, side effects) and strategy of medication treatment of hypertension.
6. Bronchial asthma: Groups of antiasthmatic drugs, mode of action, side effects by group. Treatment of acute episodes and chronic treatment.
7. Pneumonia: Community-acquired pneumonia, nosocomial pneumonia, pneumonia in the immunocompromised, lung abscess. Diagnostic approach and treatment.
8. Abdominal pain: Types of abdominal pain, possible causes and diagnostic approach.
9. Peptic ulcer: Clinical manifestations, importance of Helicobacter pylori and therapeutic management.
10. Upper gastrointestinal bleeding: Definition, etiology, methods of investigation and treatment.
11. Interpretation of laboratory findings of liver diseases
12. Anemias: Differential diagnosis of the main groups of anemias (iron deficiency anemias, anemias of chronic disorders, megaloblastic anemias, hemolytic anemias).
13. Anticoagulation treatment: Heparin therapy (forms of heparin, their mechanisms of action, indications for their administration, methods of administration and monitoring, major side effects). Dicoumarin derivatives (mechanism of action, methods of administration, monitoring and major side effects). Newer oral anticoagulants (Dabigatran, Rivaroxaban, Apixaban - mechanism of action, routes of administration, monitoring and major side effects).
14. Transfusions of blood and blood derivatives.
15. Acute & Chronic Renal Failure: Definition, etiological classification, diagnosis and treatment.
16. Electrolyte homeostasis disorders (Sodium, Potassium, Calcium, etc.): Main pathophysiological groups, etiology classification, investigation and treatment.
17. Acid-base balance disorders
18. Arthritic syndromes: Clinical forms, differential diagnosis based on clinical and laboratory evidence.
19. Autoantibodies: Classification and clinical applications in diagnostics.
20. Non-steroid anti-inflammatory drugs: Mode of action, clinical applications and adverse effects.
21. Hyperthyroidism and hypothyroidism: Definition, etiological classification, clinical laboratory manifestations and treatment.
22. Diabetes mellitus: Definition, major complications and treatment with antidiabetic tablets and insulin.
23. Dyslipidemias: Major lipid disorders, clinical implications and management.
24. Paraneoplastic syndromes: Endocrine, neurological, dermatological and hematological.
25. Acute neoplastic syndromes: Superior cavity syndrome, spinal cord compression, gastrointestinal obstructions, urological emergencies.
26. Investigation of ascitic collection
27. Emergencies in Pathology: Airway Obstruction-Pneumothorax-Heatstroke-Coldstroke-Poisoning-Seizures-Rhabdomyolysis-Anaphylactic shock-Cardiopulmonary resuscitation

General Skills

The course aims to:

• Search, analysis and synthesis of data and information, using the necessary technologies
• Decision making
• Autonomous work
• Teamwork
• Work in an international environment
• Work in an interdisciplinary environment
• Generating new research ideas
• Exercise criticism and self-criticism
• Promotion of free, creative and inductive thinking

1. Cecil Basic Pathology

(Andreoli Thomas, Carpenter Charles, Griggs Robert)

ISBN 978960372176-5 K. & N. LITSAS OE.

2. Essential diagnostic and therapeutic guide

(Tierney Lawrence M., Saint Sanjay, Thompson Clinton E., Whooley Mary A.)

ISBN 9789603998099 BROKEN HILL PUBLISHERS LTD

3. Interior Pathology Mayo clinic

(Thomas Habermann)

4. Pathology, The Johns Hopkins (Ashar, Miller, Sisson)

978-618-5296-03-2 LAGOS DIMITRIOS

5. Internal Pathology (Gerd Herold)

9789609553315 PARISIAN KING OF JOHN

6. DIFFERENTIAL DIAGNOSIS (THEODOROS D. MOUNDOKALAKIS)

9789606656453 STEFANAKIS EMM. AND CO. EE

7. HARRISON Internal Pathology

(D. KASPER, E. BRAUNWALD, A. FAUCI, S. HAUSER, D. LONGO L. JAMESON)

ISBN 978-960-394 684-7 PARISIANOU PUBLISHING

8. Medical Bibliography on the Internet (PubMed and other bibliographic sources)

–Related scientifically periodically:

1. The New England Journal of Medicine
2. The Lancet
3. European Journal of Internal Medicine
4. Annals of Internal Medicine
5. JAMA Internal Medicine