SCHOOL OF MEDICINE

HUMAN MEDICINE EAP

MEDIC SYLLABUS INTERNAL INA I

(CODE 4101)
ACADEMIC YEAR: 2013- I
FOURTH YEAR

CONTENT:

1. GENERAL DATA
2. SUMILLA
3. COURSE COMPETENCES
4. CONTENT
5. SPECIFIC COMPETENCES OF THE DIDACTIC UNITS .
6. PROGRAMMING BY UNITS
7. TEACHING METHODOLOGY
8. AUXILIARY TEACHING MEDIA
9. EVALUATION SYSTEM
10. BIBLIOGRAPHY
11. ANNEX (EVALUATION INSTRUMENTS, MODULE)

HUÁNUCO, MARCH 2013

 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

1.- GENERAL DATA .

 Name : INTERNAL MEDICINE I
 Code : 4101
 Cycle : FIRST SEMESTER
 Year of Studies : FOURTH YEAR
 Credit : 15 credits
 Pre requirements :
Introduction to the Clinic.
Clinical laboratory.
Diagnostic Imaging.
Investigation methodology.
Advanced English II
 Start date : March 18, 2013
 End date : July 22, 2013
 Duration : 18 weeks
 Class schedule : Theory 5:00 p.m. to 8:00 p.m.
Practice 08:00 to 13:00 hrs.

 Chief coordinator :
Med. Jimmy Curo Niquén AXTP – 20 hrs.

 Theory and Practice Teachers :

Med. Bernardo Damaso Mata ASTP-20 hr
Med. Rosa Guzmán Díaz AXTP-20 hr
Med. Heriberto Hidalgo Carrasco ASTP-20 hr
Med. Juan Nájera Gómez AXTP-20 hr
Med. Carlos Navarro Manchego PPTP-20 hr
Med. Hector Rodriguez Arroyo AXTP-20 hr
Mèd Hugo Sànchez Cerna AXTP-20hr
 Hired and invited teachers
Med. Luis Chuquihuanga Chambilla 20 hrs
Med. Luis Alberto Bracamonte Ferrel 20 hrs
Med. Daniel Delgado Cornejo 20 hrs.
Med. Mauro Molleapaza Tito 20 hrs
Med. Jaime Quispe Marocho 20 hrs
Med. Patricia Karen Paucar Lescano 20 hrs
Med. José Ernesto Velit Besada 20 hrs
Med. Abel José Ponce Hurtado 20 hrs
Med. Juan Mena Parco guest
Med. Amilcar Tinoco Solòrzano guest

2.- SUMILLA .
The subject of Internal Medicine aims to train a GENERAL PHYSICIAN, the subject being of
a THEORETICAL-PRACTICAL nature: with the purpose of achieving a professional-medical
profile in the skills:

Cognitive: The processes for acquiring knowledge of Peruvian and world pathology, with its
phases, which begin with the preparation of the clinical history until the diagnosis and
therapeutic management.

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Communication : The teaching-learning-dialogue and debate act, for the selection of

Syndromes or Problems, individualizing the main one, based on its severity, or strategic
location, to induce reasoning, diagnosis, preventive and therapeutic actions.

Technical – Instrumental : Teaching techniques for the detection of symptoms, signs of

the patient and the appropriate request for diagnostic support, through interconsultations,
imaging, and laboratory.
Ethics – axiological – deontological – new knowledge and technological advances raise new
ethical and deontological dilemmas. The medical professional in training will be instilled with
ethical attitudes of human relationship with patients, supportive action, respecting their
autonomy, regarding their opinion, and the request for informed consent.
Correct interpersonal relationships, performance, insertion or
Labor intervention, and incentives for creation and autonomy.

The subject of Internal Medicine I has a value of 15 credits, lasting 18 weeks, with seven
teaching units: Toxicology, Medical Oncology and Introduction to the aging process,
Neurology, Gastroenterology, Dermatology, Hematology and Rheumatology-Immunology.

3.- COURSE COMPETENCE .

The subject of Internal Medicine trains students of the 4th year of EAP Studies of Human
Medicine in the basic competencies that include: COGNITIVE – PROCEDIMENTAL AND
ATTITUDINAL field, using SEVEN UNITS, which make up this subject, so that your
performance as a 1st level doctor is satisfactory.
The subject, whose course is THEORETICAL – PRACTICAL, is developed in TWO
healthcare teaching centers: Hospital II ESSALUD Huánuco and Hospital Hermilio Valdizán
Medrano, in addition to a rotation at the Carlos Showin Hospital.

At the end of the Course the student will be able to:

- Correctly structure the CLINICAL HISTORY of patients, outpatients, inpatients, and the
Emergency Service, according to existing guidelines.

Based on the learning of the Introduction to Clinical subject, detects and extracts the
symptoms and performs the comprehensive physical examination, describing the
normal or pathological findings.
- Of the symptoms and signs detected, forms SYNDROMES OR PROBLEMS, of which the
most important will be selected, based on severity, or on its location, strategy for the
reasoned elaboration that leads to the PRESUMPTIVE DIAGNOSIS.
- Based on the knowledge previously acquired in the basic subjects of Clinical Laboratory
and Imaging. A WORK PLAN will be scheduled requesting diagnostic support tests to
confirm or rule out the presumptive clinical diagnosis.
PRESCRIBE medications rationally, taking into account adverse or collateral effects.
- Locate the nosological entity in the epidemiological spectrum of Peru and the world,
recommending PREVENTION measures.
- Recognize the critical patient and reference and/or counter-reference criteria for patients.
- Request informed consent from the patient in your care.
- Know and apply biosafety standards, to protect your health and the people around you.

4.- CONTENTS .

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Didactic Unit 1: - Molecular Biology

- Toxicology.

Didactic Unit 2: - Medical Oncology.

- Introduction to the Aging Process.

Didactic Unit 3: - Neurology .

Didactic Unit 4: - Hematology.

Didactic Unit 5: - Gastroenterology .

Didactic Unit 6: - Dermatology

Didactic Unit 7: - Rheumatology- Immunology.

5.- SPECIFIC COMPETENCES OF THE DIDACTIC UNITS .

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

UNIT: GASTRENTEROLOGY
(Duration: 03 weeks)

CONTENTS
CONCEPTUAL PROCEDURAL ATTITUDINAL
Learn about gastroenterological Preparation of clinical history of outpatient consultation, Supportive and respectful of the sick.
pathology: hospitalization and emergency service.
Inflammatory–infectious, Explains his illness while maintaining
Inflammatory, neoplastic-metabolic, Correctly execute the comprehensive physical examination. discretion
degenerative, congenital, common in
Peru and the world. Appropriately request diagnostic aid tests. Request informed consent, if the
case requires it.
Identify risk factors and epidemiologicalApplication of the knowledge and skills acquired in:
aspects. Biochemistry, physiology, pathophysiology, microbiology, Demonstrates discipline, interest,
clinical laboratory, imaging, for the interpretation of diagnostic and excitement for learning.
Observe and follow the teachings aid tests.
regarding endoscopic examinations As a consequence, instructions will
and biopsies of the digestive system. Integrating the symptoms, signs and findings of diagnostic be given on how to start the
help, it forms the Syndromes or Problems. INVESTIGATION.
Indicates the appropriate medication,
knowing its indications and Select the most important Syndrome or Problem, based on Solidarity and respect for their
contraindications. severity, or location, to begin diagnostic reasoning. teachers, classmates and medical
staff.
Recognizes critical patients through the Prescribe appropriate medications.
detection of symptoms and signs. Locate the frequency and incidence of the entity in Peru.
Apply prevention measures.
Establishes the prognosis of diseases and their
complications.

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

UNIT: NEUROLOGY
(Duration: 03 weeks)

CONTENTS
CONCEPTUAL PROCEDURAL ATTITUDINAL
Synthetic knowledge of diseases of Preparation of clinical history in outpatient consultation, Shows discipline, interest and
the NERVOUS SYSTEM, of etiology: hospitalization and Emergency service. excitement in learning
infectious, parasitic, traumatic,
cerebrovascular, neoplastic, Application of the knowledge acquired in anatomy, As a consequence, you will be
metabolic, degenerative, congenital, biochemistry, physiology-pathophysiology, microbiology, INSTRUCTED how to START the
frequent and uncommon in Peru and clinical laboratory, imaging, for the request and INVESTIGATION
in the world interpretation of diagnostic aid tests.
Supportive and respectful of the sick.
Observe and pay attention to the By applying the knowledge acquired in the Introduction to
teachings regarding the indications Clinical subject, the syndromes are formed, selecting the Explains his illness while maintaining
and contraindications of the most important one, based on its severity, or strategic discretion
procedures. location, and the diagnostic reasoning begins.
Request informed consent, if the
Identify risk factors and They prescribe the appropriate medications. case requires it.
epidemiological aspects.
Recognize critical patients through Locate the frequency of the Entity in Peru. Refers the patient in a timely and
symptoms and signs. effective manner
Apply prevention measures.
Supportive relationship and respect
Establishes the prognosis of diseases of the nervous for their teachers, classmates and
system and their complications paramedical staff.

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

UNIT: DERMATOLOGY
(Duration: 02 weeks)

CONTENTS
CONCEPTUAL PROCEDURAL ATTITUDINAL
Synthetic knowledge of common and Preparation of the Clinical History in outpatient Shows discipline, interest and excitement in
uncommon dermatological diseases in consultation, hospitalization and Emergency learning.
Peru and the World: service.
* Of the skin As a consequence, you will be
* From the annexes Correctly perform the comprehensive physical INSTRUCTED how to START the
* Sexually transmitted examination, preferably of the skin. INVESTIGATION.
* Systematic diseases
with dermatological lesion Application of the knowledge acquired in anatomy Supportive and respectful of the sick.
and physiology, and introduction to the clinic, for
Observe and pay attention to the the detection of signs and consequently, formation Explains his illness while maintaining
teachings regarding invasive of Dermatological SYNDROMES that, through discretion
examinations: biopsies, therapy, surgery. clinical reasoning, makes the final diagnosis
possible. Request informed consent, if the case
Defines what are the indications and requires it.
against indications of the procedures. Request diagnostic aid procedures - Interpret - the
results of the requested diagnostic aid tests. Refers the patient in a timely and effective
Identify risk factors and epidemiological manner
aspects. They prescribe the appropriate medications.
Supportive relationship and respect for their
List emergencies, recognizing alarm Locate the frequency and incidence of teachers, classmates and paramedical
manifestations. dermatological disease in Peru. staff.

Establishes the prognosis of skin diseases and

their complications.

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

RHEUMATOLOGY
(Duration: 02 weeks)

CONTENTS
CONCEPTUAL PROCEDURAL ATTITUDINAL
Knowledge of the most frequent diseases Development of clinical records that meet Maintaining interest and constant motivation
that compromise the device the characteristics of clarity and towards the study and research on
Locomotor caused by immunological, readability; chronology in the description rheumatic ailments.
degenerative, metabolic and infectious and execution of systematic physical
alterations. examination. Adequate knowledge of rheumatic diseases
that allows you to have a human approach
Training in the rational request for auxiliary Adequate interpretation of all the auxiliary to the patient, respecting their beliefs and
examinations that help us diagnose and elements used in the nosographic values.
monitor diseases that compromise the diagnosis.
musculoskeletal system. They provide emotional support that
Participation in the procedures used for facilitates a better relationship between
Knowledge of the therapeutic schemes the diagnosis and/or treatment of health personnel and the patient and their
appropriate to each particular situation, musculoskeletal diseases. families.
taking into account the different socio-
economic realities Choosing the most appropriate therapeutic Supportive relationship and respect for their
scheme for the rheumatic patient teachers, classmates and paramedical staff.
according to his medical condition and
socio-economic situation.

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

HEMATOLOGY
(Duration: 03 weeks)

CONTENTS
CONCEPTUAL PROCEDURAL ATTITUDINAL
Knowledge of frequent and uncommon Preparation of clinical history of Shows discipline, interest and excitement
hematological diseases: diagnosis, therapy outpatient consultation, hospitalization in learning.
and prevention of deficiency anemias, and emergency service.
anemias due to bone marrow disease and As a consequence, instructions will be
hemolytic diseases. Correctly execute the anamnesis, given on how to start the
comprehensive physical examination INVESTIGATION.
Diagnosis, therapy and prevention of
hemostasis disorders. Application of the knowledge and skills The relationship with the patient must be
acquired in Physiology, pathophysiology warm. Recognize your rights to information
Recognizes, diagnoses and treats and Clinical Laboratory, for the and informed consent.
hematological neoplasms: leukemia - interpretation of requested diagnostic aid
lymphomas - myeloma. tests. Refer the patient in a timely and effective
manner.
Observe and pay attention to the teachings Appropriately request diagnostic aid
regarding invasive bone marrow tests. Solidarity and respect for their teachers,
examinations. classmates and paramedical staff.

Recognizes critical patients through

symptoms and signs.

Identify risk factors and epidemiological

aspects.

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

6.- PROGRAMMING BY UNITS .

DIDACTIC UNIT 1: 03.18.13 - 03.31.13

MOLECULAR BIOLOGY.
Coordinator: Méd. Juan Carlos Nájera Gómez
1. Molecular Biology Techniques: DNA Isolation. recombinant DNA. Polymerase
chain reaction (PCR). Cell cultures.
2. The Human Genome Project. Molecular biology technology in the treatment of
genetic and non-genetic diseases.
3. Introduction to Immunology: Adaptive and innate immunity
4. Mother cells . Stem cell transplant.

TOXICOLOGY.
Coordinator: Méd. Carlos Navarro Manchego
1. Toxicology. Intoxications. Syndromes in toxicology and their identification in the
Emergency.
2. Intoxication by organophosphates , coumarins and household agents . Mèd Luis
Bracamonte F.
3. Intoxication by caustics, corrosives , industrial solvents.
4. Oxygen, carbon monoxide , lead and iron poisoning . . Mèd Luis Bracamonte F.
5. Salicylate poisoning . Opiate poisoning .
6. Adverse reactions from the use of antibiotics.
7. poisoning by benzodiazepines , alcohol . Botulism. . Mèd Luis Bracamonte F.

Exam : 03.04.13 . Medical Manager Carlos Navarro M.

DIDACTIC UNIT 2: 01.04.13 - 14.04.13

INTRODUCTION TO THE AGING PROCESS.
Coordinator: Méd. Juan Mena Parco
1. The elderly patient: demographics and epidemiology. Anatomical and physiological
changes of aging.
2. Comprehensive Geriatric Assessment.
3. Geriatric Syndromes I.
4. Geriatric Syndromes II.

MEDICAL ONCOLOGY.
Coordinator: Méd. Rosa Guzmán Díaz
1. Cancer epidemiology. Molecular biology and genetic relationship with cancer.
2. Drugs for cancer treatment.
3. Role of surgery in cancer treatment . Dr Helard Romàn.
4. Cancer treatment with radiotherapy.
5. Oncological emergencies.

Exam: 04/17/13. Medical Manager Rosa Guzmán Díaz.

DIDACTIC UNIT 3 : 04.15.13 – 05.05.13

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

NEUROLOGY .
Coordinator: Méd. Hector Rodriguez Arroyo
1. Headache, Migraine and other craniofacial pain.
2. Epilepsy.
3. Neuroinfections: acute and chronic meningitis, granulomas and abscesses, viral
encephalitis.
4. NeuroInfections in the patient with HIV.
5. Ischemic cerebral vascular diseases.
6. Hemorrhagic cerebral vascular diseases.
7. Demyelinating diseases. Multiple sclerosis. Encephalomyelitis, myelinolysis.
8. Movement Disorders
9. Tumors of the central nervous system. Brain tumors. Med. Mauro Mollepaza Tito
10. Diseases of the Spinal Cord: Spinal cord compression, Myelopathy due to
spondylosis, Transverse myelitis, PET, ALS, etc. Med. Mauro Mollepaza Tito
11. Degenerative and Hereditary Diseases. Med. Mauro Mollepaza Tito
12. Peripheral neuropathies. Med. Mauro Mollepaza Tito
13. Myopathies. Neuromuscular transmission disorders. Myasthenia. Botulism. Med.
Mauro Mollepaza Tito
14. Vertigo Med. Mauro Mollepaza Tito
15. Dementias Med. Mauro Mollepaza Tito

Exam: 05/08/13. Medical Manager Héctor Rodríguez Arroyo.

DIDACTIC UNIT 4 : 05.06.13 – 05.26.13

HEMATOLOGY
Coordinator: Méd . Jimmy Curo Niquén
1. Introduction to Hematology. Hematology in the elderly. Med. Juan Mena.
2. Iron deficiency anemias.
3. Megaloblastic anemias.
4. Aplastic anemia . Med. Rosa Guzman
5. Hereditary hemolytic anemias.
6. Acquired hemolytic anemias.
7. Acute Purples. Med. Rosa Guzman
8. Hemostasis diseases. Hemophilia. Med. Rosa Guzman
9. Thrombophilic states.
10. Polycythemia: primary and secondary . Doctor Luis Chuquihuanga.
11. Acute lymphocytic leukemia. Med. Bernardo Damaso
12. Acute non-lymphocytic (myeloid) leukemia. Med. Bernardo Damaso
13. Chronic leukemias: Chronic Lymphocytic and Myeloid Leukemia. Med. Bernardo
Damaso
14. Hodgkin lymphoma. Non-Hodgkin lymphoma. Med. Bernardo Damaso
15. Multiple myeloma. Waldestrom's disease

Exam: 05/29/13. Medical Manager Jimmy Curo Niquén

DIDACTIC UNIT 5 : 05.27.13 – 06.16.13

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

GASTROENTEROLOGY .
Coordinator: Méd. Heriberto Hidalgo Carrasco
1. Gastroesophageal reflux disease and complications.
2. Motor disorders of the esophagus. Doctor Jaime Quispe M.
3. Dyspepsia.
4. Peptic ulcer and complications. Helicobacter pylori infection.
5. Intestinal and Peritoneal Tuberculosis.
6. Acute and chronic diarrhea.
7. Inflammatory Bowel Disease: Crohn's Disease, Ulcerative Rectocolitis. Doctor
Jaime Quispe M.
8. Cholecystitis, gallbladder lithiasis. Choledocholithiasis. Acute cholangitis.
9. Acute and Chronic Pancreatitis. Doctor Jaime Quispe M.
10 . Irritable bowel syndrome. Irritable Colon. Colon diverticular disease.
11.Anorectal pathology. Méd Jaime Quispe M.
12.Viral Hepatitis: A - G. Chronic Hepatitis.
13.Liver Cirrhosis and Complications.
14.Autoimmune hepatitis. Primary biliary cirrhosis. Sclerosing cholangitis. Doctor
Jaime Quispe M.
15. Liver abscess.
16. Esophageal Cancer. Gastric cancer.
17. Pancreatic Cancer. Bile duct tumors. Doctor Jaime Quispe M.
18. Intestinal Lymphoma. Adenocarcinoma of the Small Intestine. Doctor Jaime
Quispe M.
19. Colorectal cancer. Doctor Jaime Quispe M.
20. Liver Tumors. Hepatocarcinoma. Liver Cyst.

Exam: 06/19/13. Medical Manager Heriberto Hidalgo Carrasco.

DIDACTIC UNIT 6: 06/17/13 – 06/30/13

DERMATOLOGY
Coordinator: Méd. Patricia Paucar.
1. Anatomical-physiological and semiological bases of the skin.
2. Bacterial skin diseases.
3. Parasitic and Viral Skin Diseases. Mèd José Velit
4. Fungal skin diseases .
5. Sexually transmitted diseases. Mèd José Velit
6. Actinic dermopathies. Skin aging . Mèd José Velit
7. Adnexal skin diseases. Mèd José Velit
8. Dyschromic skin diseases.
9. Reactive and immunological skin diseases.
10. Erythematous-Desquamative Diseases. Mèd José Velit
11. Blistering diseases. Mèd José Velit
12. Acute and chronic urticaria. Erythema nodosum. Erythema multiforme.
13. Skin cancer.

Exam: 07/03/13. Medical Manager Patricia Paucar.

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

DIDACTIC UNIT 7 : 01.07.13 – 14.07.13

RHEUMATOLOGY AND IMMUNOLOGY.
Coordinator: Méd . Jimmy Curo Niquén
1. Immunogenetics. Immune system. Mechanism of tissue immune damage. Med.
Abel Ponce.
2. Rheumatoid arthritis. Med. Rosa Guzman.
3. Systemic lupus erythematosus. Med. Daniel Delgado.
4. Inflammatory Muscle Disease. Polymyositis/Dermatomyositis. Med. Luis
Chuquihuanga Ch.
5. Vasculitis. Med. Bernardo Damaso
6. Systemic Sclerosis. . Med. Rosa Guzman
7. Seronegative spondyloarthropathies. Med. Jimmy Curo
8. Arthritis due to microcrystal deposition. Med. Jimmy Curo
9. Osteoarthrosis or degenerative joint disease. Osteoporosis . Med. Jimmy Curo
10 . Non-joint injuries. Soft parts. Med. Jose Rios.
eleven . Infectious arthritis. Med. Jimmy Curo

Exam: 07/16/13. Medical Manager Jimmy Curo Niquén

SEMINARS:
DIDACTIC UNIT 1: Electrolyte and Acid Base Disorder.
DIDACTIC UNIT 2: Cardiorespiratory Arrest and CardioPulmonary Resuscitation.
DIDACTIC UNIT 3: Emergency Management of Ischemic and Hemorrhagic VCD
DIDACTIC UNIT 4: Neuroimaging.
DIDACTIC UNIT 5: Septic Shock.
DIDACTIC UNIT 6: Management of the jaundiced patient
DIDACTIC UNIT 7: Transfusion therapy.

SINGLE SUBSTITUTE EXAM: 07/19/13. Medical Manager Jimmy Curo Niquén

DELIVERY OF NOTES : 22.07.13

7.- TEACHING METHODOLOGY

 Expository-participatory theoretical classes, following teaching strategies and
techniques, presented by the teacher and students.
 Presentation of a clinical therapeutic or clinical pathological discussion in each unit
by the Course Coordinator. Their respective qualification will be the responsibility of
the course coordinator.
 Presentation of a report or booklet for each rotation to the Practice Teacher. Their
respective qualification will be in charge of the Practice Teacher.
 The evaluation and qualification of the Magazine of Magazines will be the
responsibility of the Course Coordinator.
 Seminars to be developed by students under the supervision of the teacher, on
frequent situations in the Emergency
 Activity not presented will be graded 00 (ZERO).

ACADEMIC ACTIVITIES

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

 Theoretical Classes.
 Hospital clinical practice.
 Hospital guards.
 Clinical-Pathological Conversation.
 Clinical-Therapeutic Conversation.
 magazine magazine
 Seminars.

 MEDICAL CLINIC PRACTICES.

This is where teachers should place emphasis on the ACQUISITION OF
STUDENTS' SKILLS.
It is carried out in medical assistance services, emergency services, outpatient
clinics and hospitalization, an activity aimed at the development of KNOW-HOW,
that is, the creation of skills, abilities and experience in the diagnostic and
treatment approach through anamnesis and physical examination, according to an
appropriate model. to the objectives. At the end of each rotation, the student must
personally write medical histories and may propose diagnoses, problems and
respective treatment.
8 clinical rotations have been scheduled with an average duration of 2 weeks each.

The student will enter clinical practice, with the minimum necessary instruments
and a clean white apron with the respective card - credential.
At the end of each rotation, the student must present his or her booklet within a
period of no more than 2 days after the end of the rotation.

In the case of Emergency practice, the student is required to attend TWO guards
in each rotation, outside the usual Practice hours. Attendance and qualification
must be corroborated in the respective format to be taken into account when
grading practices.

 THEORETICAL CLASSES.
The dictation of the 7 didactic units must be synthetic, schematic and updated.
Teachers will be able to develop teaching strategies and techniques to develop the
respective competencies in the student. The active intervention of students must
be encouraged, seeking to integrate knowledge of basic sciences with that
provided by clinical sciences. THE STUDENT SHOULD MAKE A
BIBLIOGRAPHICAL CONSULTATION BEFORE AND AFTER in order to improve
their understanding of the topic to be presented.

It is recommended that at the beginning of class, the teacher motivates students

with questions that lead to cognitive imbalance for a few minutes. Then the teacher
will develop his scheduled class, restoring cognitive balance. At the end of the
presentation, there will be an additional period of questions from the teacher to the
students and vice versa to ensure that a minimum of necessary knowledge has
been imparted.

The development of each nosography must include definition, epidemiology,

etiopathogenesis, pathological anatomy, clinical picture, clinical forms, diagnoses,
differential diagnosis, prognosis, evaluation, treatment and primary prevention of
the main risk factors. The therapeutic approach must also provide the student with
criteria for the appropriate selection of drugs according to criteria of Evidence-

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Based Medicine and other options, taking into consideration the concepts of
effectiveness, safety, risk, cost-benefit, drug interactions and side effects.

 CLINICAL – PATHOLOGICAL CONVERSATORIES and/or CLINICAL –

THERAPEUTIC CONVERSATORIES.
The topics selected for the Clinical-Pathological case correspond to a clinical
history extracted from the hospital itself or another medium, by the course
coordinator, (the participation of the Pathological Anatomy teacher can be
requested), preferably in relation to the topic of the chapter that is being dictated.
The summary will be delivered to the student days in advance, for study,
discussion and diagnostic proposals. On the scheduled day, students will submit
their diagnostic disquisition in writing to the teacher for subsequent grading.
The presentation will be carried out by the assigned students, 03 of the 06
scheduled students, analyzing and considering diagnostic possibilities in 20 to 30
minutes. Next, the professor assigned to the clinical discussion will intervene, using
15 to 30 minutes, promoting the participation of all students. . Patients can be
presented if possible.
Finally, if applicable, the assigned pathologist or teacher will discuss the findings,
reopening the debate and establishing new correlations.
All students must have a grade for this activity.

In the Clinical-Therapeutic case activity, clinical histories of patients who suffer

from a disease related to the chapter in development will be presented. The stories
will be chosen by the course or chapter coordinator, with students being assigned
in advance. The students designated by the professor responsible for the
discussion and adequately guided by him, will present the clinical case: anamnesis,
physical examination, auxiliary tests, diagnosis, differential diagnosis,
etiopathogenic and therapeutic interpretation. During the presentation, special
emphasis will be placed on the diagnosis of the disease and its therapy.
Once the presentation is over, the other students will participate with clarifying
contributions to the concepts presented. All students and participants in the clinical
case presentation will be graded. During the presentation, students must have
audio-visual aid material.
Total clinical cases: seven.

 MAGAZINE OF MAGAZINES .
A review of magazines will be presented in two sessions per unit (total 14), where
the Course Coordinator will be the facilitator. Each student will prepare, using some
audiovisual means, a critical synthesis of an ORIGINAL ARTICLE, analyzing the
methodology used and the clinical value of the article. They will take no more than
10 minutes per student. There are at least eight students per session CHOSEN AT
RANDOM, the rest will present their analysis in writing on the scheduled day.

 SEMINARS
A seminar to be developed per unit (total 7). The 6 designated students under the
supervision of the teacher will prepare the seminar, on frequent situations in the
Emergency. Each seminar will be graded with each student having a grade at the
end of it.

8.- AUXILIARY TEACHING MEDIA

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

The teacher and students have at their disposal an overhead projector, multimedia
equipment and a slide projector, to carry out all academic activities, in the facilities of the
EAP of Human Medicine.

9.- EVALUATION SYSTEM

a. The regulations for the evaluation of students adhere to what is stipulated in
Resolution: No. 006 – 2008 – UNHEVAL – AU (July 30, 2008).
b. The 07 partial theoretical tests are taken on the dates stipulated in this syllable. In
total 7 theoretical notes of the teaching units. . The first partial average includes the
first four teaching units and the second partial average includes the last three units.
In the case of the clinical practices themselves, the first 4 rotations will be
considered in the first partial average and the last 3 rotations in the second partial
average. The theory grade corresponds to 45% and the practice grade to 55%
(includes practice itself and complementary activities) of the final grade. The
weights are shown below (art. 25°).

PARTIAL AVERAGE:
45% Theory exam
05% Clinical Discussions
05% Seminars
40% Clinical practice (proper)
05% Magazine of Magazines

c. Theoretical exams must be objective tests, including clinical problems. Its

preparation is in charge of the coordinators of each chapter, in agreement with the
course coordinator.
d. The grades for all theoretical and practical activities range from zero (0) to twenty
(20)
e. The decimal fractions of the theoretical tests remain unchanged and have a
cumulative effect. Only in the final averages does the fraction of 0.5 and more
become the next higher unit (rounding). THE MINIMUM FINAL APPROVING
GRADE IS 11 (art. 20°).
f. The results of the theoretical evaluation must be communicated to the students
within 72 hours after the date of the theoretical exam, stipulated in the syllable (art.
21°). Students have the right to request a review of the test up to a maximum of 24
hours after knowing the results (art. 43°.e).
g. Tests not taken (NSP) are graded 0 (zero), a grade that must be averaged with the
grades of the remaining chapters (art. 32°).
h. Students have the right to a make-up exam only due to justified absences, given in
the resolution mentioned above (art. 43.f).
i. THERE WILL BE ONLY ONE SUBSTITUTE EXAM FOR THE ENTIRE COURSE
that will replace the lowest theoretical grade.
j. It is a requirement to PASS the Internal Medicine I course that the student must
obtain AT LEAST FOUR THEORETICAL EXAMS WITH GRADE EQUAL OR
GREATER than 10.5, including the substituted grade.
In the end, by having four or more failed theoretical exams, the student
automatically fails the course and their partial and final averages will not
exceed 10 (supported in art. 6°,7°,8°, 9°,13°,43°,47°).
k. The practice grade (55%) is made up of : the notes from the rotations with the
practice teacher, the on-call grade, the seminar grade (5%), the journal grade (5%),

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

the clinical discussion grade (5%). %). An average (40%) is extracted from the
actual practice and guard notes.
l. Attendance at clinical practices and related activities is mandatory. Unjustified
absence from 30% or more of them (each one of them) invalidates the right to have
the practice grade and take the theoretical exam (art. 30°). The evaluation of the
practices is continuous throughout the entire course. In the evaluation of the
practices, the teacher will take into consideration punctuality, responsibility, active
participation, cooperation, the student's initiative and the quality of the preparation
of the clinical history.
m. Students who have not shown up at any time to class or to any scheduled
evaluation during the course of the subject will be recorded in the Promotional
Record NO SHOW (NSP), equivalent to a grade of ZERO.
n. Practice starts at 08:00 am and ends at 1:00 p.m. Attendance will be signed by the
respective internship teacher.

10.- BIBLIOGRAPHY

INTERNAL MEDICINE:
HARRISON, ANTHONY Principles of Internal Medicine Ed. McGraw Hill
FAUCI AND OTHERS
WILLIAM N. KELLEY Textbook of Internal Medicine, Ed. JB: Lippinctott,
New York.
ALLEN R. MYERS NMS National Medical Serves for Independent Study,
Medicine. 3rd Edition. Ed. Williams & Willkins.
WEB PAGES (free access for Latin America):
www.nejm.org
www.bmjjournals.com

EXOGENOUS INTOXICATIONS:
AGG from FERNÍCOLA;
JAUGE, Pedro. “Basic Notions of Toxicology.” Pan American Center
for Human Ecology and Health. PAHO.WHO.

GOODMAN GILMAN, Alfred;

GOODMAN, Lous S.;
RALL, Theodore W.; and others. “The Pharmacological Bases of Therapeutics” 7th
Edition. Edit Panamericana Medical, Buenos Aires.

RHEUMATOLOGY AND IMMUNOLOGY:

CLARK MABSC.FREP.TJH “Asthma.” Published by Chapman and may Medical
London.

MARGHI, RICARDO A. “Immunology and Immunochemistry”. 4th. Edition,

Editorial Panamericana Bogotá, Caracas, Madrid,
Mexico and Sao Paulo.

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

GASTROENTEROLOGY:
HARRISON Principles of Internal Medicine.- Ed. in Spanish KJ
Isseelbacher, E. Braunwald, JD Wilson, EDS. 14th Ed.
Inter-American. Mc. Graw-Hill, New York.

HARRISON`S Principals of Internal Medicine, Ed. In English.

CECIL Treatise on Internal Medicine; Ed. In Spanish.

HEMATOLOGY:
WILLIAMS Hematology.

WINTROBE Hematology Treatise.

SANS-SABRAFEN Clinical Hematology-3rd Edition.

NEUROLOGY:
ADAMS, R.D. and VICTOR . “Principles of Neurology” Mc. Graw Hill, New York.

DERMATOLOGY:
FITZPATRICKA “Dermatology in Medicine”. Edit Panamericana.

FEWRRANDIZ. c. “Visual Clinical Scheme in Dermatology.” Edit

Doyma. Barcelona. Madrid.

11.- ANNEX

 Coordinators by Didactic Units:

Didactic Unit 1 : - Molecular Biology (Méd. Carlos Nájera Gómez).

- Toxicology. (Med. Carlos Navarro Manchego).

Didactic Unit 2: - Medical Oncology. (Med. Rosa Guzmán Díaz)

- Introduction to the Aging Process (Med. Juan Mena Parco).

Didactic Unit 3: - Neurology (Med. Héctor Rodríguez Arroyo).

Didactic Unit 4: - Hematology (Med. Jimmy Curo Niquén)

Didactic Unit 5: - Gastroenterology (Med. Heriberto Hidalgo Carrasco).

Didactic Unit 6: - Dermatology (Méd . Patricia Paucar).

Didactic Unit 7: - Rheumatology and Immunology (Med. Jimmy Curo Niquén).

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HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

LIST OF INTERNAL MEDICINE I STUDENTS

No. SURNAMES AND NAMES

1 Acosta Sobrado, Roy Edson
2 Agüero Vega, Ader
3 Allazo Bejar, Ingrid
4 Baldeón Chávez, Ivan
5 Bazán Álvarez, Johannes Kendall
6 Agurto Boxes, Fabio Eduardo
7 Calero Huamalí, Jhenny
8 Campos Gonzales, Roel Kenyo
9 Chávez García, Abel Yefferson
10 Condor Cisneros, Julio
11 Cori Valverde, Victor Rossini
12 Díaz Rivera, Wilmer Saturnino
13 Espinoza Dávila, Samantha Noelia
14 Figueroa Arquiñigo, José Ronald
15 Gonzales Amancio, Gemeneza Lidia
16 Grández Graus, Juan Carlos
17 Guerra Alvarado, Liliana Jackeline
18 Gutiérrez Cáriga, Miryam Katherine
19 Hilario Barreto, Katherin Luz
20 Meza Copello, Williams Alberto
21 Meza Villaneda, Xi-Omara Wilda
22 Ospino Martin, Luis Pedro
23 Panduro Arroyo, Ivan Yhersino
24 Santiago Tweezers, Michael Kory
25 Pollo Briceño, Leidith Darmelly
26 Ramos Bermudez, Gerson
27 Ramos Pando, Wilfredo
28 Ramos Velasquez, Fredy Alcides
29 Raraz Vidal, Harvis
30 Rivera Illatopa, Gean Carlos Nilo
31 Rubio Degrees, Dumer Gary
32 Salazar Borja, Juan Carlos
33 Sarmiento Ponciano, Cati
34 Solórzano Gómez, Diana Soledad
35 Sullca Ccopa, Franklin
36 Tarazona Luna, Gaby Carmen
37 Tolentino Hinojosa, Lennin José
38 Trinidad Guzmán, Heiddy Jeanette
39 Velasquez Pimentel, Vanesa Tatiana
40 Zárate Casachahua, Yojhaida Catty

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

ROTATION SCHEDULE

GROUP 1
Acosta Sobrado, Roy Edson
Allazo Bejar, Ingrid A1 Med. Jimmy Curo Niquén
Bazán Álvarez, Johannes Kendall
Calero Huamalí, Jhenny
Chávez García, Abel Yefferson B1 Med. Bernardo Damaso Mata
Cori Valverde, Victor Rossini
Espinoza Dávila, Samantha Noelia
Gonzales Amancio, Gemeneza Lidia C1 Med. Luis Chuquihuanga Chambilla
Guerra Alvarado, Liliana Jackeline
Hilario Barreto, Katherin Luz
Meza Villaneda, Xi-Omara Wilda D1 Med. Jaime Quispe Marocho
Panduro Arroyo, Ivan Yhersino
Pollo Briceño, Leidith Darmelly
Ramos Pando, Wilfredo E1 Med. Hector Rodriguez Arroyo
Raraz Vidal, Harvis
Rubio Degrees, Dumer Gary
Sarmiento Ponciano, Cati F1 Med. Patricia Paucar Lescano
Sullca Ccopa, Franklin
Tolentino Hinojosa, Lennin José
Velasquez Pimentel, Vanesa Tatiana G1 Med. Luis Bracamonte Ferrel
Zárate Casachahua, Yojhaida Catty
*Med. Hugo Sánchez Cerna (Free for replacement)
GROUP 2
Agüero Vega, Ader
Baldeón Chávez, Ivan A2 Med. Rosa Guzmán Díaz
Agurto Boxes, Fabio
Campos Gonzales, Roel K.
Condor Cisneros, Julio B2 Med. Daniel Delgado Cornejo
Diaz Rivera, Wilmer
Figueroa Arquiñigo, José R.
Grandes Graus, Juan Carlos C2 Med. Abel Ponce Hurtado
Gutiérrez Cariga, Myriam
Meza Copello, Williams
Med. Heriberto Hidalgo
Ospino Martin, Luis D2
Carrasco
Santiago Tweezers, Michael
Ramos Bermúdez, Gerson
Ramos Velásquez, Fredy E2 Med. Mauro Molleapaza Tito
Rivera Illatopa, Gean Carlos N.
Salazar Borja, Juan Carlos
Solorzano Gómez, Diana
F2 Med. José Velit Besada
Tarazona Luna, Gaby
Trinidad Guzmán, Heiddy J.
Med. Carlos Navarro Manchego
*Med. Juan C. Najera Gómez (Free for replacement)

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

03/25/13 to 04/08/13 to 04/22/13 to 05/06/13 to 05/20/13 to 06/03/13 to 06/17/13 to

TEACHERS GROUP 1 04/07/13 04/21/13 05/05/13 05/19/13 06/02/13 06/16/13 06/30/13

1 Med. Jimmy Curo Niquén A1 G1 F1 E1 D1 C1 B1

2 Med. Bernardo Damaso Mata B1 A1 G1 F1 E1 D1 C1
3 Med. Luis Chuquihuanga Chambilla C1 B1 A1 G1 F1 E1 D1
4 Med. Jaime Quispe Marocho D1 C1 B1 A1 G1 F1 E1
5 Med. Hector Rodriguez Arroyo E1 D1 C1 B1 A1 G1 F1
6 Med. Patricia Paucar Lescano F1 E1 D1 C1 B1 A1 G1
7 Med. Luis Bracamonte Ferrel G1 F1 E1 D1 C1 B1 A1
*Med. Hugo Sánchez Cerna (Free for replacement)

03/25/13 to 04/08/13 to 04/22/13 to 05/06/13 to 05/20/13 to 06/03/13 to 06/17/13 to

TEACHERS GROUP 2 04/07/13 04/21/13 05/05/13 05/19/13 06/02/13 06/16/13 06/30/13

1 Med. Rosa Guzmán Díaz A2 Free F2 E2 D2 C2 B2

2 Med. Daniel Delgado Cornejo B2 A2 Free F2 E2 D2 C2
3 Med. Abel Ponce Hurtado C2 B2 A2 Free F2 E2 D2
4 Med. Heriberto Hidalgo Carrasco D2 C2 B2 A2 Free F2 E2
5 Med. Mauro Molleapaza Tito E2 D2 C2 B2 A2 Free F2
6 Med. José Velit Besada F2 E2 D2 C2 B2 A2 Free
7 Med. Carlos Navarro Manchego Free F2 E2 D2 C2 B2 A2

*Med. Juan C. Najera Gómez (Free for replacement)

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

PROOF OF EXECUTION OF GUARDS.

INTERNAL MEDICINE COURSE I
Student: __________________________________________________________

NOTE
DOCTOR
No. PLACE DATE (Number and
(Signature and stamp)
Letters)
1

10

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

PROOF OF EXECUTION OF GUARDS.

INTERNAL MEDICINE COURSE I
Student: __________________________________________________________

NOTE
No. DOCTOR
PLACE DATE (Number and
(Signature and stamp)
Letters)

11

12

13

14

15

16

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

PROOF OF EXECUTION OF PRACTICES.

INTERNAL MEDICINE COURSE I

Student: ____________________________________________________________

ROTATION START FINAL

Med. Jimmy Curo Niquén

Med. Bernardo Damaso Mata

Med. Luis Chuquihuanga Chambilla

Med. Jaime Quispe Marocho

Med. Hector Rodriguez Arroyo

Med. Patricia Paucar Lescano

Med. Luis Bracamonte Ferrel

Med. Hugo Sánchez Cerna

Med. Rosa Guzmán Díaz

Med. Daniel Delgado Cornejo

Med. Abel Ponce Hurtado

Med. Heriberto Hidalgo Carrasco

Med. Mauro Molleapaza Tito

Med. José Velit Besada

Med. Carlos Navarro Manchego

Med. Juan C. Najera Gomez

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

SEMINAR DOCTOR CLINICAL CONVERSATORY

FROM 1 TO 6 1 DR A. TINOCO 7 DR CURO
FROM 7 TO 2 DR A. TINOCO 6 DR CURO
12
FROM 13 TO 3 DR A. TINOCO 4 DR CURO
18
FROM 19 TO 4 DR H. RODRIGUEZ 5 DR CURO
24
FROM 25 TO 5 DR A. TINOCO 3 DR CURO
30
FROM 31 TO 6 DR J. QUISPE 2 DR CURO
35
FROM 36 TO 7 DR A. TINOCO 1 DR CURO
40

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

EVALUATION OF CLINICAL SKILLS

STUDENT (A):
____________________________________________________

NOTE NOTE NOTE

_______________________ __________________________ ________________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
1 (03/25/13 TO 04/07/13) 2 (04/08/13 TO 04/21/13) 3 (04/22/13 TO 05/05/13)

NOTE NOTE NOTE

_______________________ __________________________ ________________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
4 (05/06/13 TO 05/19/13) 5 (05/20/13 TO 06/02/13) 6 (06/03/13 TO 06/16/13)

NOTE NOTE NOTE

_______________________ __________________________ _______________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
7 ( 06/17/13 TO 06/30/13)

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

CLINICAL HISTORY EVALUATION

STUDENT
(A):______________________________________________________________
___

NOTE NOTE NOTE

_______________________ __________________________ ________________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
1 (03/25/13 TO 04/07/13) 2 (04/08/13 TO 04/21/13) 3 (04/22/13 TO 05/05/13)

NOTE NOTE NOTE

_______________________ __________________________ ________________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
4 (05/06/13 TO 05/19/13) 5 (05/20/13 TO 06/02/13) 6 (06/03/13 TO 06/16/13)

NOTE NOTE NOTE

_______________________ __________________________ _______________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
7 ( 06/17/13 TO 06/30/13)

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

EVALUATION OF THE PRACTICE BOOKLET

STUDENT
(A):_______________________________________________________

NOTE NOTE NOTE

_______________________ __________________________ ________________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
1 (03/25/13 TO 04/07/13) 2 (04/08/13 TO 04/21/13) 3 (04/22/13 TO 05/05/13)

NOTE NOTE NOTE

_______________________ __________________________ ________________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
4 (05/06/13 TO 05/19/13) 5 (05/20/13 TO 06/02/13) 6 (06/03/13 TO 06/16/13)

NOTE NOTE NOTE

_______________________ __________________________ _______________________

SIGNATURE AND STAMP SIGNATURE AND STAMP SIGNATURE AND STAMP
7 ( 06/17/13 TO 06/30/13)

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACIÓN DE LAS APTITUDES CLÍNICAS

CONOCIMIENTOS
Cumplimiento de las tareas solicitadas 1 0
Respuesta de conocimiento a las preguntas durante la visita medica, consultorio externo y emergencia. 1 0
Juicio adecuado respecto a los diagnósticos 1 0
Juicio adecuado respecto a la terapéutica 1 0
Conocimiento del uso e interpretación de los exámenes auxiliares ( EKG, Radiografías y de laboratorio ). 1 0

PROCEDIMIENTOS
Técnica adecuada para el examen físico 1 0
Toma de funciones vitales con las técnicas adecuadas 1 0
Observación por los detalles durante el examen fisico 1 0
Emplea con el paciente un tono confiado y cortez 1 0
Explica al paciente los procedimientos antes de realizarlos, en forma clara 1 0
Escucha atentamente al paciente 1 0
Aplica medidas de bio-seguridad ( lavado de manos, uso de guantes, uso de mandil, uso de anteojos, uso de mascarillas ). 1 0

ACTITUD
Puntualidad a sus prácticas 2 1 0
Trae sus materiales para el examen ( estetoscopio, tensiómetro, linterna, martillo ) 2 1 0
Entrega oportuna de sus historias clínicas 1 0
Tiene iniciativas durante la evaluación medica 1 0
Trae bibliografía relacionada a su paciente 1 0
Uso de libreta de anotaciones y de resumen 1 0

NOTA DE PRACTICA :

Anexar asistencia de los alumnos :

Responsible Teacher

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACIÓN DE LA HISTORIA CLINICA

CONOCIMIENTOS
Diagnostico sindromico coherente y justificado (evaluar comentarios) 2 0
Diagnostico etiologico coherente y justificado (evaluar comentarios) 2 0
Plan de Trabajo coherente y justificado (evaluar comentarios) 2 0
Tratamiento coherente y justificado (evaluar comentarios) 2 0
Pronostico y medidas preventivas coherentes y justificadas (evaluar comentarios) 1 0

PROCEDIMIENTOS
Historia Clinica escrita manualmente con letra legible 2 0
Cumple con todas las partes de la Historia Clinica Modelo. 2 0
Cumple con todas las partes de la Evolucion diaria 1 0
Anexa los resultados de la evaluacion del Mini-mental test de Folstein 1 0

ACTITUD
Entrega PUNTUAL de acuerdo a lo programado (no hay prorrogas) 2 0
Anexa cuatro bibliografias de los cuatro ultimos años (de preferencia idioma extranjero). 2 1 0
Explica cada una de las bibliografias 1 0

NOTA DE HISTORIA CLINICA

Importante : El alumno cuenta con dos semanas para confeccionar la historia clinica, con la evaluacion geriatrica y evaluacion mental al ingreso y alta (o ultimo dia de la rotacion) del paciente.
La entrega de la Historia Clinica es el ultimo de rotacion al coordinador general y al docente de practica.
La nota de calificacion es realizado por el docente de practica.

Responsible Teacher
Delegate

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Issue:
Rotation No.: ________________________________________________
Date:
Responsible professor:

INSTRUMENTO DE EVALUACIÓN DEL CUADERNILLO DE LA GUIA DE PRACTICA (HOSPITALIZACION)

CONOCIMIENTOS
Diagnostico sindromico coherente y justificado (evaluar comentarios) 2 0
Diagnostico etiologico coherente y justificado (evaluar comentarios) 2 0
Diagnostico diferencial coherente y justificado (evaluar comentarios) 2 0
Pruebas auxiliares coherente y justificado (evaluar comentarios) 2 0
Tratamientos coherentes y justificadas (evaluar comentarios) 1 0

PROCEDIMIENTOS
Cuadernillo escrito manualmente con letra legible 3 0
Cumple con todas las partes de lo solicitado 3 0

ACTITUD
Entrega PUNTUAL de acuerdo a lo programado (no hay prorrogas) 2 0
Anexa cuatro bibliografias de los cuatro ultimos años (de preferencia idioma extranjero). 2 1 0
Explica cada una de las bibliografias 1 0

NO TA DE CUADERNILLO

Importante : El alumno cuenta con una semana para confeccionar el cuadernillo.

La entrega del cuadernillo se realizará cada v iernes al coordinador general y al docente de practica.
La nota de calificacion es realizado por el docente de practica.

Responsible Teacher
Delegate

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student: ___________________________________________________________
Rotation No.: _____________________________________________________
Date: __________________________________________________________
Responsible professor: ______________________________________________

INTERCONSULTATION RESOLUTION EVALUATION INSTRUMENT

KNOWLEDGE
(9 points)
Appropriate judgment regarding diagnosis
Substantiate with valid arguments regarding the suggested therapy.
Substantiate the request for auxiliary examinations with valid arguments.

PROCEDURES
(6 points)
You have an order for the resolution of the interconsultation
Thoroughly reviews the medical history and ancillary imaging examinations.
Preparation of the appropriate anamnesis
Preparation of the appropriate clinical examination

ATTITUDE
(5 points)
Explain to the patient the reason for the requested interconsultation
Has initiative for the resolution of the interconsultation
Appropriate behavior towards patients.

NOTE:

__________________
Responsible Teacher

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

REFERENCE CRITERIA EVALUATION INSTRUMENT

Appropriat inappropriat
e e
Supports diagnosis and treatment
Supports differential diagnoses
Justify the reason for the reference
Justify the destination service of the reference
Justify the destination hospital of the referral
Fill out the reference form
Initiative to make the reference
Explain to the patient or family the reason for
referral

___________________
Responsible teacher

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACION DE LA PRESCRIPCION MEDICA

Adecuado Inadecuado
Diagnóstico
Nombre genérico del producto (denominación común internacional, DCI)
Nombre (s) comercial del producto
Presentacion (forma farmacéutica)
Posología (dosis total por día)
Dosis fraccionada por día
Vias de administración
Periodo total de administración
Fecha de expedición de la receta
Fecha de la próxima cita

Nota: al termino de la rotacion de practica, el alumno debe realizar todos los indicadores del instrumento, SIN
EXCEPCION. Ante la carencia de uno de ellos, el alumno no aprobara la rotacion de practica, sin excepcion.
El docente de practica debe asegurar que el alumno cumpla con la COMPETENCIA.

Responsible Teacher
Delegate

35
 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACION DE LA ORIENTACION DIAGNOSTICA AL PACIENTE

Adecuado Inadecuado
Informa el diagnóstico mas probable al paciente
Explica acerca de otros probables diagnósticos al paciente
Explica la evolución a corto y/o largo plazo del diagnóstico probable
Explica la evolución a corto y/o largo plazo de otros diagnósticos probables
Explica el pronóstico del diagnóstico probable
Explica el pronóstico de otros diagnósticos probables
Explica el tratamiento del diagnóstico probable
Explica el tratamiento de otros diagnósticos probables
Explica tratamientos alternativos del diagnóstico probable
Explica tratamientos alternativos de los otros diagnósticos probables

Nota: al termino de la rotacion de practica, el alumno debe realizar todos los indicadores del instru-
mento, SIN EXCEPCION. Ante la carencia de uno de ellos, el alumno no aprobara la rotacion de
practica, sin excepcion.
El docente de practica debe asegurar que el alumno cumpla con la COMPETENCIA.

Responsible Teacher
Delegate

36
 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACION DE LA ORIENTACION FARMACOLOGICA AL PACIENTE

Adecuado Inadecuado
Informa el diagnóstico mas probable al paciente
Explica la via de administración de los medicamentos a ser empleados
Explica la posología de administración de los medicamentos a ser empleados
Explica el tiempo de administración de los medicamentos a ser empleados
Explica los riesgos a corto y/o largo plazo durante la administración de los medicamentos
Explica las contraindicaciones absolutas y relativas de la medicación elegida
Explica las reacciones adversas que se pueden presentar durante la administración
Explica las principales interacciones farmacológicas
Realiza una demostración, frente al paciente, de la administración del medicamento
Observa y corrige el procedimiento de administración por el paciente

Nota: al termino de la rotacion de practica, el alumno debe realizar todos los indicadores del instrumento, SIN
EXCEPCION. Ante la carencia de uno de ellos, el alumno no aprobara la rotacion de practica, sin excepcion.
El docente de practica debe asegurar que el alumno cumpla con la COMPETENCIA.

Responsible Teacher

37
 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACION DE LA PRESERVACION DE LOS DERECHOS

DEL PACIENTE AL TRATAMIENTO

Adecuado Inadecuado
Saluda cordialmente al paciente
Se identifica adecuada y completamente
Explica el motivo de la entrevista, solicitándole permiso
Informa el diagnóstico al paciente
Explica las posibilidades diagnósticas probables
Explica las ventajas de elegir un tratamiento médico o quirúrgico
Explica los efectos colaterales a corto y largo plazo del tratamiento médico o quirúrgico
Explica las interacciones medicamentosas que se pueden presentar
Explica los beneficios y riesgos al elegir un tratamiento médico o quirúrgico
Conjuntamente con el paciente, elijen una opcion terapeutica

Nota: al termino de la rotacion de practica, el alumno debe realizar todos los indicadores del instrumento, SIN
EXCEPCION. Ante la carencia de uno de ellos, el alumno no aprobara la rotacion de practica, sin excepcion.
El docente de practica debe asegurar que el alumno cumpla con la COMPETENCIA.

Responsible Teacher

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACION DE ACTITUDES FRENTE AL PACIENTE

Adecuado Inadecuado
Saluda cordialmente al paciente
Se identifica adecuada y completamente
Explica el motivo de la entrevista, solicitándole permiso
Informa el diagnóstico al paciente
No emite juicios de valor frente al paciente, respecto a la decisión terapéutica
Adopta una actitud expectante ante las respuestas del paciente
Explica los procedimientos del examen físico, antes de realizarlo (EN PRIVADO)
Explica los procedimientos de los examenes auxiliares, antes de su realizacion
No interrumpe cuando el paciente explica su dolencia
Se despide cordialmente, agradecido por la entrevista ofrecida

Nota: al termino de la rotacion de practica, el alumno debe realizar todos los indicadores del instrumento, SIN
EXCEPCION. Ante la carencia de uno de ellos, el alumno no aprobara la rotacion de practica, sin excepcion.
El docente de practica debe asegurar que el alumno cumpla con la COMPETENCIA.

Responsible Teacher

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Student:
Rotation No.:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACION DE RESERVA DE INFORMACION

Adecuado Inadecuado
Saluda cordialmente al paciente
Se identifica adecuada y completamente
Explica el motivo de la entrevista, solicitándole permiso
Informa al paciente la confidencialidad de la entrevista y el examen físico
Elaboración de la Historia Clínica, con códigos (NO NOMBRES)
Realiza el examen físico en forma confidencial
Mantiene en forma reservada sus apuntes respecto a la Historia Clínica
Los hallazgos son comunicados directamente al médico tratante y el docente
No comentar los hallazgos con personal no autorizado por el paciente
Recalcar al paciente sobre la confidencialidad de la entrevistas, al término de la misma

Nota: al termino de la rotacion de practica, el alumno debe realizar todos los indicadores del instrumento, SIN
EXCEPCION. Ante la carencia de uno de ellos, el alumno no aprobara la rotacion de practica, sin excepcion.
El docente de practica debe asegurar que el alumno cumpla con la COMPETENCIA.

Responsible Teacher

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

Issue:
Date:
Responsible professor:

INSTRUMENTO DE EVALUACIÓN DE CONVERSATORIO CLINICO PATOLOGICO

CRITERIOS
Uso de materiales Presentacion de Conocimiento Desenvolmiento Empleo del tiempo
Nota
Alumno Audiovisuales Revisiones actualizadas del Tema programado
(0-5) (0-5) (0-4) (0-4) (0-2)
1.-
2.-
3.-
4.-
5.-

Uso de materiales audiovisuales : Papelografo, Retroproyector, Multimedia.

Revisiones actualizadas : Cinco articulos de los dos ultimos años, idioma extranjero.
Conocimiento del tema : Respuesta a cuatro preguntas del docente
Desenvolvimiento : con empleo de tarjetas de resumenes, no olvidos, respuesta a 04 preguntas del publico.
Empleo del tiempo programado : Inicio puntual en el tiempo programado.

Responsible Teacher

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

FORMATO DE ASISTENCIA A PRACTICAS y ROTACIÓN POR EMERGENCIA

Docente :

Fecha :

Alumno :

Fecha de Rotacion :

L M M J V S L M M J V S
Fecha

P : presente Guardia :
F : falta
T : tarde

Fecha
Establecimiento

Docente Delegado

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

INSTRUMENTO DE EVALUACIÓN DE CONVERSATORIO CLINICO TERAPEUTICO

CRITERIOS
Uso de materiales Presentacion de Conocimiento Desenvolmiento Empleo del tiempo
Nota
Alumno Audiovisuales Revisiones actualizadas del Tema programado
(0-5) (0-5) (0-4) (0-4) (0-2)
1.-
2.-
3.-
4.-
5.-

Uso de materiales audiovisuales : Papelografo, Retroproyector, Multimedia.

Revisiones actualizadas : Cinco articulos de los dos ultimos años, idioma extranjero.
Conocimiento del tema : Respuesta a cuatro preguntas del docente
Desenvolvimiento : con empleo de tarjetas de resumenes, no olvidos, respuesta a 04 preguntas del publico.
Empleo del tiempo programado : Inicio puntual en el tiempo programado.

Responsible Teacher

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

EVALUATION INSTRUMENT OF THE THERAPEUTIC

CLINICAL CONVERSATORY
NON-EXHIBITORS
Name:................................................ .................................................. .....................
Issue:................................................ .................................................. .........................
Responsible professor:............................................... ..................................................
Date:.................................

Y
Criterion 0 1 2 3 4 score o

Initiative, spontaneity No Yeah

Knowledge of the subject No Bad Regular Well Very good

Oral input No Bad Regular Well Very good

Bibiographical contribution No Bad Regular Well Very good

Attitude during the conversation No Bad Regular Well Very good

Score Final grade

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

EVALUATION INSTRUMENT OF THE CLINICAL

PATHOLOGICAL CONVERSATORY
NON-EXHIBITORS
Name:................................................ .................................................. .....................
Issue:................................................ .................................................. .........................
Responsible professor:............................................... ..................................................
Date:.................................

Criterion 0 1 2 3 4 score

Diagnostic examination No Bad Regular Well Very good

Knowledge of the subject No Bad Regular Well Very good

Diagnostic support No Bad Regular Well Very good

Quality of Contribution No Bad Regular Well Very good

Bibliographic support No Bad Regular Well Very good

Score Final grade

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

MAGAZINE OF MAGAZINES

FACULTY OF HUMAN MEDICINE. UNHEVAL

INTERNAL MEDICINE I

CHAPTER: …………………………………………DATE:…………………….
STUDENT:……………………………………………………………………………

SECTION A

1. Name of scientific article:

2. Published in: (use Vancouver format).

3. Summary of objectives and method:

4. Most important results:

5. Critical appreciation of the methodological design:

SECTION B
Appreciation of the clinical contribution of the article (attach article).

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

CLINICAL HISTORY IN INTERNAL MEDICINE

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

HERMILIO VALDIZAN NATIONAL UNIVERSITY

EAP HUMAN MEDICINE
INTERNAL MEDICINE

CLINICAL HISTORY MODEL

ECTOSCOPY : (Apparent age, Apparent sex, Facie, severity status)

ANAMNESIS : Direct or Indirect

FILIATION
Name
Age
Sex
Race
Occupation
Civil status
Instruction level
Religion
Language
Birthdate
Place of birth
Place of origin
Time at Place of residence
Home
Person in charge
Date of admission
Entry mode
Date of Medical History

CURRENT ILLNESS.
Sick Time
Start Form
Course of the disease
Main Symptoms
Story

RASA
HEAD: headache, trauma
EYES: vision, lenses, diplopia, scotomas, pain and inflammation
EARS: hearing, tinnitus, pain, secretions
NOSE: olfaction, anterior or posterior discharge, epistaxis, obstruction, itching, sneezing
MOUTH: taste disorders, symptoms and signs referring to lips, teeth, gums and tongue
PHARYNX – LARYNX: pain, swallowing disorders, hoarse voice, laryngeal stridor. Tonsils
NECK: pain, stiffness, goiter and tumors
MAMMARY GLANDS: lumps, pain, secretions and retractions
RESPIRATORY SYSTEM: cough, expectoration, hemoptysis, dyspnea, chest pain,
pleurisy, bronchial asthma and vomiting

CARDIOVASCULAR SYSTEM: palpitations, dyspnea on exertion, at rest and paroxysmal.

Precordial and substernal pain, edema, cyanosis, arterial hypertension, intermittent
claudication
GASTROINTESTINAL SYSTEM: dysphagia, odynophagia, heartburn, regurgitation.
Epigastric heaviness, ballooning, burning and pain: their relationship with food. Nausea,
vomiting, hematemesis and melena. Abdominal pain and distension. Diarrhea,
constipation, laxatives. Jaundice, choluria, hypocolia, acholia. Diet.

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

URINARY SYSTEM: dysuria, stranguria, frequency, nocturia, urinary incontinence,

urgency and urgency. Decreased urinary stream caliber. Polyuria, oliguria and anuria.
Aspects of urine: color, foam, turbidity and sediment. Hematuria. Elimination of stones.
Lumbar pain. renal colic

NEUROPSYCHIATRIC: dizziness, vertigo, syncope and lipothymia. Paresis, paralysis,

neuralgia, radicular pain, paresthesia, anesthesia and incoordination. Tremors. Seizures.
Word disorders. Emotions. Character. Memory. Adaptation. History of psychiatric illnesses
LOCOMOTOR SYSTEM: functional limitation, rigidity, duration. Muscle weakness:
proximal, distal. Signs of joint phlogosis. Distribution (asymmetric, symmetrical).
Presentation (migratory, additive). Number: monoarthritis (1), oligoarthritis (2 – 4),
polyarthritis (> 4)

SKIN AND ANNEXES: rashes, changes in color and temperature, itching, ecchymosis,
petechiae. Seborrhea and dry skin. Hair system: hair loss, dryness and fragility,
hypertrichosis and hirsutism. Nails: fragility and deformation

LYMPHATIC SYSTEM: lymphadenomegaly, phlogosis and distribution

BIOLOGICAL FUNCTIONS
Appetite
Thirst
Urine
Deposition
Dream
Weight

BACKGROUND
GENERAL PERSONAL BACKGROUND
living place
Feeding
Outfit
Bad Habits
Socio-economic situation
Trips
Previous Residences
Occupation and Previous Occupations
Immunizations
Allergies
Blood Transfusions

PHYSIOLOGICAL PERSONAL HISTORY

Prenatal
Natales
Breastfeeding and Ablation
Psychomotor Development (holding head, sitting, crawling, standing, walking, first
word, etc.)
Obstetric History
Menarche
Catamenial Regime
Last Rule Date
Sexual Activity
Number of Sexual Partners
G to P bcdef

a: number of pregnancies
b: number of births at term
c: number of premature births

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

d: number of abortions
e: number of children currently alive
Menopause

PATHOLOGICAL PERSONAL HISTORY

Diseases in Childhood
Diseases in Adolescence
Diseases in Youth
Diseases in Adulthood
Diseases in old age
Previous hospitalizations
Surgical interventions
Accidents
Diabetes mellitus, TB, HBP, Bronchial Asthma, Typhoid Fever, Brucellosis,
Hepatitis.

FAMILY BACKGROUND
Parents
Wife or Partner
Children
Siblings
Coworkers
Neighbors

PHYSICAL EXAM

VITAL FUNCTIONS (Temperature, Heart Rate, Pulse Rate, Respiratory Rate, Blood
Pressure, Weight, Height, Body Mass Index).
FACIE
OVERALL STATUS
NUTRITIONAL CONDITION
HYDRATION STATUS
MORPHOLOGICAL TYPE
ATTITUDE
MARCH

SKIN AND FANERALS

Color, Temperature, Humidity, Consistency, Primary and secondary lesions.
Hair, armpit and pubic hair, distribution, TANNER scale.

SUBCUTANEOUS CELLULAR TISSUE

Quantity, Distribution, Abnormal Findings.

LYMPHATIC TISSUE
Ganglia (location, number, size, pain, degree of fixation to deep planes, consistency),
axillary, cervical, supraclavicular, occipital, inguinal, epitrocheal, popliteal regions.

MAMMARY REGION
Inspection-Palpation.
Moms.

Areola.
Nipple.
Axillary and supraclavicular lymph nodes.
Tanner scale.

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

OSTEOARTICULAR SYSTEM AND VERTEBRAL COLUMN.

Attitude, Clinical Axes, Shape-Size, Painful points, Mobility, Measurements.

MUSCULAR SYSTEM
Tone, Trophism, Muscle Contractures, Muscle Strength.

REGIONAL EXAM
HEAD
SKULL: position, movements, shape, size.
ORBITAL REGION: Superciliary region, eyelids, eyeballs (FUNDO DE EYE), cornea,
anterior chamber, iris.
AURICULAR AND MASTOID REGION: Pinnae, external auditory canal, tympanic
membrane, preauricular area, mastoid region.
NASAL REGION: Nasal pyramid, nasal mucosa, inferior turbinates.
ORAL REGION: lips, buccal mucosa, gums, teeth, sublingual mucosa, tongue, hard palate,
soft palate.
OROPHARYNX REGION: soft palate, uvula, pillars, tonsils.

NECK
Cervical spine
Trachea and Thyroid Cartilage
Thyroid gland
Blood vessels
Ganglia

THORAX AND LUNGS

INSPECTION: static and dynamic.
PALPATION: sensitivity, amplexation, vocal vibrations.
PERCUSSION: sonority.
AUSCULTATION: vesicular murmur, rales, murmurs, pleural sounds, voice auscultation

CARDIOVASCULAR SYSTEM
EXTREMITIES: Presence of Cyanosis, edema. Pulse . Blood pressure.
NECK: Jugular venous pulse, Carotid pulse
PRECORDIAL REGION:
INSPECTION
PALPATION: apical region, left sternal border, pulmonary area, aortic area.
Left and right ventricular impulse. Fremito.
PERCUSSION: cardiac dullness.
AUSCULTATION: mitral focus, tricuspid focus, pulmonary focus, aortic focus.
Heart rate, first, second, third and fourth sounds, murmur, pericardial rub.
EPIGASTRIUM: right ventricular beat, aortic beat. Hepatojugular reflux.

ABDOMEN EXAMINATION
INSPECTION
AUSCULTATION: Hydroaerial sounds, murmurs, borborygmi, gastric bazuqueo.
PERCUSSION: dullness, subdullness or tympany. Liver, spleen, bladder
Superficial and deep PALPATION. Painful points, retro abdominal or peritoneal masses.
Liver, Spleen.
INGUINAL REGION: nodes, neurovascular bundle, hernias.

RECTAL TOUCH:
Anal and Perianal INSPECTION.
PALPATION: anal sphincter, rectum, prostate."Glove finger"

GENITOURINARY SYSTEM
URINARY SYSTEM
INSPECTION

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

PALPATION: anterior and posterior PRU. Renal. Bladder.

PERCUSSION: Renal. Bladder.
AUSCULTATION.

MALE GENITALS
Axillary and Pubic Hair.
Penis. Scrotum. Testicles. Epididymis. spermatic cord.
Prostate. Size, consistency, mobility.
Tanner scale (penis, pubic hair).

FEMALE GENITALS
INSPECTION: Mons venus, vulva, perineum.
PALPATION: Vaginal, adnexa and rectal touch.
Tanner scale (pubic hair).

NEUROLOGICAL EXAM
CONSCIOUSNESS STATE
GLASGOW SCORE SCORE (describe)
CRANIAL PAIRS
I Nasal passages, olfaction.
II Optical. Visual acuity, Campimetry, Color recognition, Fundus of the eye.
III oculomotor (superior rectus, levator palpebrae superioris, medial rectus
inferior rectus, minor oblique), pupils.
IV Pathetic (major oblique muscle).
V Trigeminal (ophthalmic, upper and lower jaw, and motor sensitivity).
VI External ocular motor.
VII Facial (motor, sensitive and sensory)
VIII Cochleovestibular (Clock Test, Weber Test, Rinne Test, Barany Index,
Babinsky Star, Acaloric Test)
IX - X Voice, swallowing, soft palate, uvula, gag reflex, sense of taste
XI Sternocleidomastoid and trapezius muscle.
XII language exam (trophism, movements)

MOTOR FUNCTION: Muscle strength and tone (involuntary movements), tests

balance-coordination, reflexes (osteotendinous reflex, cutaneous mucosal,
pathological).
SENSITIVE FUNCTION: superficial sensitivity (tactile, thermal, painful), deep,
gnosis (object recognition, somatognosia).
HIGHER FUNCTIONS: Gnosis (tactile, visual, auditory), Praxis (ideatory, ideomotor,
dressing, constructive), language (oral, written), memory (anterograde and retrograde).

SYNDROME DIAGNOSTIC IMPRESSION (four):

Bibliographic commentary of each one

ETIOLOGICAL DIAGNOSTIC IMPRESSION (four):

Bibliographic commentary of each one

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

DIFFERENTIAL DIAGNOSIS (four):

Bibliographic commentary of each one

WORKPLAN
Auxiliary exams: Hematological
Biochemicals
Serological
Microbiological
Hormonal
Immunological
Ultrasounds (conventional, specialized -cardiological-).
Radiological (conventional radiology, CT, MRI).
Scintigraphy.
Endoscopy

Diagnostic Procedures (Biopsies).

Therapeutic Procedures
Evaluation by other specialties
Surgical procedures
Rehabilitation
Bibliographic commentary of each one

TREATMENT
Diet type
Hydration type
Antibiotic treatment
Etiological treatment
Prophylactic treatment
Treatment suggested by other specialists.
Supportive treatment (oxygen, nursing procedures).
Bibliographic commentary of each one

FORECAST
Short term
Long-term

PRECAUTIONARY MEASURES
Primary
high schools
Tertiary

DAILY CLINICAL EVOLUTION

SUBJECTIVE:
Symptoms related to the disease
Medication compliance
Symptoms not related to the disease
biological functions

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

GOALS:
Vital functions
Diuresis (volume).
General physical examination
Preferential physical examination

APPRECIATION:
Diagnostic impression
New diagnoses
Opinion on diagnoses

WORKPLAN:
Therapeutic proposals
Diagnostic test proposals
Bibliography

Final Comment of the evolution day

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 HERMILIO VALDIZAN NATIONAL UNIVERSITY
PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

HISTORIA GERIATRICA : ADDENDUM A HISTORIA CLINICA

I. FILIACIÓN
NOMBRE EDAD
ESTADO CIVIL SOLTERO CASADO VIUDO DIVORCIADO SEXO M F
GRADO DE INSTRUCCIÓN ANALFABETO PRIMARIA SECUNDARIA SUPERIOR

DOMICILIO TELEFONO
(REFERENCIA) (paciente)
RESPONSABLE DEL PACIENTE TELEFONO
TIPO DE ANAMNESIS DIRECTA INDIRECTA DIRECTA + INDIRECTA
FECHA DE INGRESO

II. HISTORIA FARMACOLÓGICA

NOMBRE DOSIS/ DIA INTERVALO RP. MEDICA AUTO RP. TIEMPO DE USO CUMPLIMIENTO
1
2
3
4
5

III. SINDROMES GERIATRICOS ACTUALES

SI NO SI NO
1. CONFUSIÓN AGUDA 6. INMOVILIZACION
2. DEPRIVACION VISUAL 7. INCONTINENCIA URINARIA
SENSORIAL AUDITIVA FECAL
3. SINCOPE 8. CONSTIPACION
4. CAIDAS 9 ULCERAS DE PRESION
5. INSOMNIO

IV. EVALUACIÓN FUNCIOANL: ACTIVIDADES DE LA VIDA DIARIA

ACTIVIDAD DEPENDIENTE INDEPENDIENTE CALIFICACION Independiente en todas la
Bañarse actividades (ningun item positivo
Vestirse de dependencia )
Ir al baño Dependiente parcial ( 1 a 5 items
Levantarse positivos de dependencia
Continencia Dependencia total ( 5 items
Alimentación PUNTOS positivos de dependencia)

V. PROBLEMAS GERIATRICOS ACTUALES

SI NO 4. EVALUACIÓN NUTRICIONAL 5. EVALUACIÓN BUCAL
1. ORTOSTATISMO Desnutrición(IMC < 24) Dentición completa
2. MAREOS Eutrofico (IMC 24-26.9) Edentulo (parcial y total)
3. PROSTATISMO Sobrepeso (IMC 27 - 29.9) Portador de prótesis
Obesidad (IMC 30 a más)

6. EVALUACIÓN SOCIAL 7. EVALUACIÓN COGNTIVA 8. EVALUACIÓN AFECTIVA

( Prueba de Pfeiffer) (Prueba reducida de Yesavage)
CALIFICACIÓN CALIFICACIÓN CALIFICACIÓN
Entorno socal adecuado (< 10 puntos) No evidncia de deterioro cognitivo No evidencia de manifestaciónes
Riesgo y problema social( 10 puntos y más) (< 5 puntos) depresivas ( < 5 puntos )
Deterioro cognitivo ( 5 puntos y más) Estado depresivo leve ( 5-8 puntos )
Depresión establecida ( 9 puntos y más)

PUNTOS PUNTOS PUNTOS

Commentary on the Geriatric Clinical History (Addenda).

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

ESTADO MINI - MENTAL DE FOLSTEIN

ORIENTACIÓN
5 ( ) ¿Qué (dia) (mes) (estación) (año) (fecha) es ?
5 ( ) ¿Dónde estamos? (provincia ) ( comunidad) ( ciudad) (hospital) ( suelo)

REGISTRO
3 ( ) Nombre tres objetos: 1 segundo para decir cada uno. Pida entonces al paciente que los
vuelva a repetir los 3 después de usted. Déle 1 punto por cada
respuesta correcta. Sígalos repitiendo hasta que el paciente aprenda
los 3. Cuente los intentos y regístrelos
INTENTOS

ATENCIÓN Y CÁLCULO
5 ( ) Serie de 7. 1 punto por cada respuesta correcta. Parar después de 5 respuestas.
Como alternativa, haga que el paciente deletree una palabra al revés

RECUERDO
3 ( ) Pida que repita los tres objetos repetidos anteriormente. Un punto por respuesta correcta

LENGUAJE
9 ( ) Nombre un lápiz y un reloj (2 puntos )
Repita lo siguiente "No usar si condicional, y ni pero" (1 punto)
Realice una orden con tres pasos
"Coja un papel con la mano derecha, dóblelo por la mitady déjelo en el suelo" (3 puntos)
Lea y siga las instrucciones siguientes
Cierre los ojos (1 punto)
Escriba una frase (1 punto)
Copie una figura (1 punto)

Puntuación máxima PUNTUACIÓN TOTAL

Valoracion del nivel de connsciencia como en continuo

Alerta Somnoliento Estupor Coma

INSTRUCCIONES PARA LA REALIZACIÓN DEL EXAMEN DEL ESTADO MENTAL MINI- MENTAL
ORIENTACIÓN
(1) Pregunte la fecha. Después pregunte algo omitido, p. ej: "Puede decirme además la estación en
la que estámos". Un punto por cada respuesta correcta
(2) Pregunte por orden datos sobre el hospital (ciudad, distriti, barrio). Un punto por cada respuesta correcta.

REGISTRO
Pregunte al paciente si puede comprobar su memoria. Diga entonces en nombre de tres objetos sin relación
clara y lentamente (emplee aproximadamente 1 segundo por cada uno). Una vez dichos, pida al paciente que
los repita. La primera repetición determina su puntiación (0 a 3 ), pero haga que los repita 6 veces.
Si no se ha aprendido bien los tres objetos, el recuerdo no es valorable.

ATENCIÓN Y CÁLCULO
Pida al paciente que, comenzando en el 100, vaya restando de 7 en 7. Deténgase despues de las 5
primeras restas (93, 86, 79, 65). Puntúe el núemro de respuestas correctas.
Si el paciente no puede realizar esta prueba, pídale que deletree una palabra al revés (p. ej. PABLO).
La puntuación es el número de letras en el orden solicitado: OLBAP = 5 puntos; OBLAP = 3 puntos.

RECUERDO
Pregunte al paciente las tres palabras que repitió anteriormente.

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PROFESSIONAL ACADEMIC SCHOOL OF HUMAN MEDICINE

LENGUAJE
NOMBRAR: Muestre al paciente un reloj de pulsera y pregúntele qué es. Repítalo con un lápiz. Puntos 0 a 2
REPETIR: Pida al paciente que repita un frase después de decirla usted. Sólo un intento. Puntos 0 a1.
ÓRDENES: En tres frases, entrege al paciente un papel blanco y repita la orden. U punto por
cada fase ejecutada correctamente.
LEER: Escriba en un paple: "CIERRE LOS OJOS", en letras lo suficientemente grandes como para que el
paciente pueda leerlos. Pidale que haga lo que se indica en el papel. Puntúe un punto solo
si el paciente cierra realmente los ojos.
ESCRIBIR: Entrege al paciente un papel en blanco y haga que escriba un frase. No le dicte, que
la escriba espontáneamente. Debe tener al menos u sujeto y un verbo. No es necesaria una correcta gramática.
COPIAR: En un papel en blanco, dibuje dos pentágonos que se crúzan, cada uno de unos 3 cm de lado, y pida
al paciente que los copie exáctamente como están. Para obtener un punto debe dibujar los 10 ánguolos y la
intersección de dos de ellos. No cuenta el temblor ni la rotación,
Estime el nivel sensorial del paciente mostrado durante el examen d froma continua : desde aleta (a la izquierda)
hasta el como (a la derecha).

Mental Evaluation Commentary.

DAILY CLINICAL EVOLUTION

Subjective:
 Symptoms related to the disease
 Medication compliance
 Symptoms not related to the disease
 biological functions

Goals:
 Vital functions
 Diuresis (volume).
 General physical examination
 Preferential physical examination

Appreciation:
 Diagnostic impression
 New diagnoses
 Opinion on diagnoses

Workplan:
 Therapeutic proposal
 Proposal for diagnostic tests
 Bibliography

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