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FACULTAD DE MEDICINA Y ODONTOLOGA

COURSE GUIDE OF
MEDICINE AND
SURGERY OF THE
NEPHROUROLOGICAL
SYSTEM
Medical degree

Academic year 2013-2014

COURSE GUIDE OF
MEDICINE AND SURGERY OF THE NEPHROUROLOGICAL SYSTEM

ECTS

COURSE: MEDICINE AND SURGERY OF THE


NEPHROUROLOGICAL SYSTEM

Subject: Human pathology

102

Module: Human clinical training

114

Type:

Year: Fifth

On campus classes

Semester: First

Responsible teacher:
Julio Hernndez Jaras
julio.hernandez@ucv.es
Faculty:
Pedro Navaln Verdejo
Pedro.navalon@ucv.es

Department:
Human clinical training

Module organization
HUMAN CLINICAL TRAINING

114 ECTS

Duration and temporal location within the curriculum:


Subjects and courses
Subject

ECTS

Course/
Semester

General pathology

3 / 5

General pathology II: Problem analysis

3 / 6

Medical psychology and


psychopathology

3 / 6

Obstetrics and Gynecology

4 / 7 y 8

Oftalmology

3 / 6

4 / 7 y 8

3 / 6

Otolaryngology

4 / 8

Infectious pathology

3 / 6

Hematology

3 / 6

Dermatology

5 / 9

Pediatrics

5 / 9 y 10

Psychiatry

5 / 9

Medicine and surgery of the digestive


system

4 / 7 y 8

Endocrinology and nutrition

5 / 9 y 10

Medicine and surgery of the nephrourological system

5 / 9

Palliative medicine

6 / 11

Oncology

5 / 10

Medicine and surgery of the locomotor

4 / 7 y 8

Medicine and surgery of the nervous


system

5 / 9 y 10

Allergology and clinical immunology

3 / 6

Rheumatology

4 / 8

ECTS

Bases of human
pathology

Psychology

COURSE

Medicine and surgery of the cardiocirculatory system


Medicine and surgery of the respiratory
system

Human pathology

102

COURSE GUIDE OF:


MEDICINE AND SURGERY OF THE NEPHROUROLOGICAL
SYSTEM
Prerequisite: Having passed module 1

GENERAL GOALS
At the end of this course, the student will:

Know how the normal nephro-urological system works.

Know the clinical manifestations and the clinical syndromes which are a part of this area.

Know the main diseases of the kidney and genitourinary tract in a surgical and medical

aspect.

Know how to indicate and interprete the main analytical, functional, morphological and

imaging tests.

Know and indicate therapeutic, medical and surgical procedures of the aforementioned

organs and systems.

Knowing the main preventive measures that lead to stop or slow the progression of chronic

kidney disease, avoiding as far as possible the need for renal replacement therapy.

Knowing the prognosis of kidney disease and its possible modification by applying different

therapies.

Competence
weighting
0

TRANSVERSAL COMPETENCES
1.

Instrumental

1. Capacity to analyze and summarize.

2. Ability to organize and plan.

3. Oral and written communication in the native language

4. Knowledge of a foreign language

5. Computer skills

6. Ability to manage information

7. Problem solving

8. Decision making

2.

Personal

9. Teamwork

10. Interdisciplinary teamwork

11. Working in an international context

12. Interpersonal skills


13. Acknowledge the diversity and multiculturalism

X
X

14. Critical thinking

15. Ethical commitment

3.

Systemic competences

16. Independent learning

17. Adapting to new situations

18. Creativity

19. Leadership
20. Knowledge of other cultures and traditions

X
X

21. Initiative and entrepreneurship

22. Motivation for quality


23. Sensitivity to environmental and sociosanitary issues

4.

X
X

Other skills

24. Ability to assume responsibilities

25. Ability for self criticism

26. Know to evaluate personal perfomance and to know their own skills and
limitations.

27. Ability to express one's feelings

28. Show sensitivity to the problems of Humanity

29. Know how to interpret the intentions of others

30. Social engagement

31. Show sensitivity to personal, environmental and institutional injustice

32. Be able to establish and maintain relationships with other professionals and
institutions.
33. Know how to obtain relevant information from personal interviews

X
X

SPECIFIC COMPETENCES
1.

Professional values, attitudes, behavior and ethics

34. Recognize the essential elements of the medical profession, including ethical
and legal responsibilities.

35. Understand the importance of such principles for the benefit of patients, society
and the profession, with an emphasis on secrecy and the protection of the patient's
life.

36. Know how to apply the principles of social justice in professional practice.

37. Develop professional practice with respect for the patient's autonomy, beliefs
and culture.

38. Recognize your limitations and the need to maintain and upgrade their
professional expertise.

39. Develop professional practice with respect to other health professionals.

2.

Scientific basis of Medicine

40. To understand and appreciate the normal structure and functions of the human
body on a molecular, cellular, tissular, and organic levels systems in all stages of life
41. Recognize the basis of normal human behavior and its disorders

X
X

42. Understand and recognize the effects, mechanisms and manifestations of the
disease on structures and functions of the human body.

43. Understand and recognize causing agents and risk factors that determine health
conditions and disease development.
44. Understand and recognize the effects of growth, development and aging on the
individual and his social environment.

X
X

45. Understanding the basics of action, indications, and efficacy of therapeutic


interventions based on scientific evidence.

46. Acquire adequate clinical experience in hospitals, health centers, and other
health institutions under supervision, as well as basic knowledge, clinical management
and appropriate use of tests, medications and other health system resources.

3.

Clinical skills

46b. Obtain and develop a health record that contains all relevant information of the
patient.

47. Perform a physical examination and a mental evaluation.

48. Ability to develop an initial diagnosis and establish a rational diagnostic strategy.

49. Recognize and deal with situations which put the patient's life in danger and
other situations that require immediate attention.

50. Establish a diagnosis, prognosis and treatment applying principles based on the
best information possible.

51. Indicate the most appropriate treatment of the most prevalent acute, chronic and
terminal diseases.

52. Establish and suggest preventive measures appropriate to each clinical


situation.

4.

Communication skills

53. Listen carefully, obtain and synthesize relevant information about the problems
of the patient, and understand the contents of this information.

54. Compose medical records and other health records in an understandable way.

55. Communicate effectively, in oral and written form, with patients, families, the
media and other professionals.

56. Establish good interpersonal communication, which enables the student to


contact the patient, family and other professionals with efficiency and empathy.

5.

Public Health and health Systems

57. Recognize the determinants of health in the population, both genetic and lifestyle
determinants such as demographic, environmental, social, economic, psychological
and cultural determinants.
58. Assume the role in the prevention and protection against illness, injury or
accidents and maintenance and health promotion on a individual and community level.

59. Recognize your role in multidisciplinary teams, providing leadership when


necessary, both for the provision of care as well as in interventions for health
promotion.

60. Obtain and use epidemiological data and evaluate trends and risks for decision
making in regards to the patient's health.
61. Know international health organizations, and the environments and conditions of
different health systems.

X
X

62. Basic knowledge of the NHS and health legislation.

6.

Information Management

62b. Understand, evaluate critically and learn to use sources of clinical and
biomedical information to obtain, organize, interpret and communicate scientific and
health information.

63. Know how to use information technology and communication in clinical,


therapeutic, preventive and research activities.

64. Maintain and use records with the patient's information for its later analysis,
preserving the confidentiality of the data.

7.

Critical analysis and research

65. Have a critical, creative and constructive point of view in the professional activity,
as well as constructive skepticism that is research oriented.

66. Understand the importance and limitations of scientific thinking in the study,
prevention and disease management.

67. Being able to formulate hypotheses, collect and critically evaluate information to
solve problems using the scientific method.

68. Maintaining ethical principles also in the development of any research project.

Note: There are skills that are not included in this course weighted as zero..

LEARNING OUTCOMES
R1 Recognize the causes and progression mecasnisms of nephrourological
diseases.

COMPETENCES
1,2,3,4,9,10,12,42,43,44,62,63

R2 Grouping the recognized signs and symptoms in one big group of main
nephrourological syndromes.

1,2,3,4,5,6,7,8,9,10,12,14,15,16,
19,22,25,32,33,38,43,

R3 Identify clinical problems and request additional tests to confirm the initial
diagnosis.

1,2,3,4,5,6,7,8,9,10,12,14,15,16,
19,22,25,32,33,38,45,46b,48,49,
50,52,55, 56,62,63,64

R4 Identify the most appropriate treatment options for the patient, taking into
account the risks and limitations.

1,2,3,7,8,14,15,16,22,25,26,32,3
3,37,38,39,

R5 Perform an appropriate prognosis on the severity of the disease.

2,3,7,8,14,15,16,22,25,26,32,33,
37,38,39,

PRACTICAL LEARNING OUTCOMES

COMPETENCES

RP1 Adequately perform a medical examination in order to resolve


nephrourological diseases.

1,2,3,4,9,10,12,42,43,44,62,63

RP2 Perform a complete physical examination with special attention to the


genitourinary system (abdominal scan, lumbar fist percussion, testicular
examination).

1,2,3,4,9,10,12,42,43,44,62,63

RP3 Know how to interpret a basic urine analysis and sediment:


Know the technique.

1,2,3,4,9,10,12,42,43,44,62,63

Assess: Density, pH, glucose, hematuria, proteinuria, presence of formed


elements in the sediment.
RP4 Indicate and interpret basic analytics related to renal function, electrolyte
pH and
balance and acid-base: Urea, creatinine, ions (Na, K, Cl),
bicarbonate.

1,2,3,4,9,10,12,42,43,44,62,63

RP5 Calculate glomerular filtration with formulas and estimate the appropriate
stage of chronic kidney disease of the patient according to this calculation.

1,2,3,4,9,10,12,42,43,44,62,63

RP6 Having practiced under supervision:


Digital rectal prostate scan.
Catheterization (male and female).

1,2,3,4,9,10,12,42,43,44,62,63

PH
Adequately perform a medical examination in order to resolve
nephrourological diseases.

Perform a complete physical examination with special attention to the


genitourinary system (abdominal scan, lumbar fist percussion, testicular
examination).

Know how to interpret a basic urine analysis and sediment:


Assess: Density, pH, glucose, hematuria, proteinuria, presence of formed
elements in the sediment.

Indicate and interpret basic analytics related to renal function, electrolyte


pH and
balance and acid-base: Urea, creatinine, ions (Na, K, Cl),
bicarbonate.

Calculate glomerular filtration with formulas and estimate the appropriate


stage of chronic kidney disease of the patient according to this calculation.

Having practiced under supervision:


Digital rectal prostate scan.
Catheterization (male and female).
PH: Hospital practice
TS: Simulation workshops
TE: Specific workshops
SL: Seminars in the laboratory
EP: Personal study

TS

TE

SP

EP

ON-CAMPUS EDUCATIONAL ACTIVITIES


ACTIVITY

Methodology of Teaching-Learning

Relationship to Learning
Outcomes of the subject

ECTS

ON-CAMPUS
CLASS

Lecture. Resolution problems. Virtual


simulators. Exhibition content by the
teacher. Explanation of knowledge and
skills.

R1, R2, R3, R4, R5.

30%

SEMINAR AND
PRACTICE
GROUP

Laboratory
practices
(virtual
simulators, anatomical models). Oral
presentation of the student. Group
activities:
group
work
sessions
supervised by the teacher. Knowledge
construction through interaction and
student activity. It includes anatomical
dissection practices.

R1, R2, R3, R4, R5.

4%

SMALL GROUP
PRACTICE

Resolution problems and cases. Field


practices.

RP1, RP2, RP3, RP4, RP5,


RP6

12%

TUTORING

Personalized attention in small groups.


A period of instruction and / or
guidance by a tutor aimed to review
and discuss the material and themes
presented in the lectures, seminars,
readings, performance of works, etc.

R1, R2, R3, R4, R5.

1,5%

Joint oral tests and / or written


employed in the initial t, formative or
additive student assessmen.

R1, R2, R3, R4, R5.

2%

EVALUATION

Total

49,5%

INDEPENDENT STUDENT WORK


ACTIVITY

Teaching-Learning Methology

Relationship with Learning


Outcomes for the subject

ECTS

INDEPENDE
NT WORK

Resolution problems and cases. Papers.


Activity on-line e-learning platform.
Study. Searching for information and
documentation.

R1, R2, R3, R4, R5.

43,5% -

R1, R2, R3, R4, R5.

7%

GROUP
WORK

Discussion and problem solving.


Performing works or memoirs. Search
group work, discussion and filter
information on the subjects.

Total

50,5%

SYSTEM FOR ASSESSING THE ACQUISITION OF THE COMPETENCES:


GRADING

Assesment Tool

LEARNING OUTCOMES
ASSESSED

Allocated
Percentage

R-1, R-2, R-3, R-4, R-5

5%

RP1, RP2, RP3, RP4, RP5,


RP6.

5%

R-1, R-2, R-3, R-4, R-5

10%

R-1, R-2, R-3, R-4, R-5

20%

R-1, R-2, R-3, R-4, R-5

60%

Attendance and participation


The teacher assesses the participation, involvement and progression of
acquiring knowledge and skills of students during lectures and
curricular practices.

Practice evaluation
Your instructor (PAAP) assesses the participation, involvement and
progression of the practices and in achieving practical results.

Simulations, OSCE
The goal of these simulations is the reproduction of
similar situation in real life with standardizedconditions,
which allow the teacher to analyze the clinical skills of the
student in specific situations. The teacher can also use
the test known as Objective Structured Clinical
Evaluation (OSCE). Evaluation and interpretation of structured
renal biopsies. Clinical cases of classification and staging of
chronic kidney disease. Throughout the semester, the teacher will
upload 5 -10 clinical cases with several questions that the student
has to solve.

Open question exam: 4 short questions.


Written test that assesses knowledge and primarily the student's ability
to relate, integrate, and express coherently in written language. Case
studies.

Multiple choice exam: 60 questions.


Multiple choice exam with only one correct answer out of five possible.
Examination rating: correctly-wrong / 3. Blank questions will not be
evaluated.

The assignment and simulations must be presented 24 hours before the date of the first
exam
(09/12/2013 13:00). After this date, it will not be possible to present the
aforementioned works. It is not possible for students which only attend the second taking of
the exam to present their works after the aforementioned date.

Minimum requirements:
The student is not able to attend any course from module 3 ( cursar ninguna asignatura del mdulo
3 (Human clinical training) without having passed all the courses from module 1 (Morphology,
structure and function of the human body).
Criteria for granting honours:
Honours may be granted to the best students, who must have obtained a minimum grade of 9.
In certain cases, the teacher may establish a special test in order to determine those students which
deserve the honour, given the limitation of 5% of the students enrolled.
In the second and subsequent exams, honours may only be granted if there are any honours left to
be granted.

Course evolution in the second and subsequent course attendances:


There will be a class for people who have failed the first exam, in case that the number of students
exceeds the occupancy limit of the classroom and there will be a teacher for the aforementioned
class.
The teacher in charge of this group will teach six follow-up sessions and tutoring for 2 hours each.
The competences to acquire the skills and abilities of the subject are made through all the practices
provided for the subject. Each session of the course will develop the course so as to reinforce the
work of the competences that each student needs in order to pass the course.
The evaluation of the content and abilities for the course will be performed through an official exam.

CONTENT DESCRIPTION

COMPETENCES

NEPHROLOGY AND UROLOGY: OVERVIEW AND SEMIOLOGY

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

RENAL FAILURE

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

PRIMARY AND SECONDARY GLOMERULAR DISEASES

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

RENAL INVOLVEMENT IN SYSTEMIC DISEASES

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

CONGENITAL AND HEREDITARY NEPHROPATHIES

INTERSTITIAL NEPHROPATHIES AND TUBULOPATHIES

VASCULAR NEPHROPATHIES

KIDNEY AND ARTERIAL HYPERTENSION

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64
1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64
1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64
1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

DISORDERS OF ELECTROLYTE BALANCE AND ACID-BASE

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

CONGENITAL ANOMALIES AND UROGENITAL INJURIES

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

UPPER AND LOWER OBSTRUCTIVE UROPATHY

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

GENITOURINARY INFECTIONS

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

UROLOGIC ONCOLOGY

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

UROANDROLOGY

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49

,50,51,52,55,56,62,63,64

PATHOLOGY OF THE RETROPERITONEAL SPACE

1,2,3,4,5,6,7,8,9,10,12,14,15,16,1
9,22,26,32,33,38,43,46b,47,48,49
,50,51,52,55,56,62,63,64

PCA-27-F-01
Gua Docente. Grado de Medicina
[MEDICINA Y CIRUGIA DEL APARATO NEFROUROLOGICO]. Curso [2013-2014]

TEMPORAL ORGANIZATION OF LEARNING


TEACHING UNIT

General concepts. Renal anatomy. Kidney function. Semiology.


Measurement of glomerular filtration.
Goals:
Know the macro and microscopic structure of the kidney
Knowing the basics of normal renal function: Purifying
function, regulating electrolyte balance, regulating the
acid-base balance and metabolic endocrine function.
Know how to describe the functions of filtration,
reabsorption and secretion.
Understand the mechanisms of renal concentration and
dilution
Renal Semiology and diagnostic methods in nephrology.
Major syndromes in Nephrology.
Goals:

Number of
sessions

Know and identify the 10 basic nephrologic syndromes:


nonspecific urinary abnormalities (proteinuria,
hematuria), nephrotic syndrome, nephritic syndrome,
acute kidney injury, chronic renal failure, tubular
disorders, hypertension, kidney stones, urinary tract
infection and urinary tract obstruction.
Acute kidney failure.
Goals:
Know the diagnostic criteria for ARF (RIFLE criteria).
Knowing the major pathophysiologic groups and list the
most common causes that can lead to ARF in each of
the groups.
Describe the clinical phases of acute tubular necrosis
(ATN).
Know the clinical, laboratory and imaging tests that are
based on the diagnosis of ARF.
Know the differential diagnosis of ARF
Describe the most common complications of ARF.
Knowing the course and prognosis of ARF and ATN.
Evaluate both treatment and substitutes for ARF

1,5

PCA-27-F-01
Gua Docente. Grado de Medicina.

CKD: concept, pathogenesis and clinical symptoms.


Goals:

Know the definition and stages of chronic kidney


disease (CKD).
Know that renal processes frequently lead to chronic
renal failure (CRF).
Knowing the pathogenetic mechanisms (toxic, endocrine
and renal adaptive) leading to the appearance of the
CKD.
Know the major pathophysiological changes that occur
in CKD.
Describe the major clinical manifestations due to
involvement of different organ systems.
Diagnose the CKD and meet the most basic criteria for
differentiating between CKD and ARF.
Know the medical treatment for nonterminal CKD
Know about renal replacement therapy by dialysis and
kidney transplantation.
Glomerulonephritis: Concept, pathogenesis and classification.
Goals:
Know the etiology of primary glomerulonephritis.
Describe the immunological mechanisms involved in its
development.
Know how to classify different types of
glomerulonephritis by evolution, histology and clinical
manifestations.
Correlating semiology, morphology and pathogenesis.
Knowing the value of renal biopsy in the diagnosis of
glomerulonephritis.
Diagnosis and treatment of glomerulonephritis that present more
frequently with nephrotic syndrome: minimal change Hyalinosis
Focal membranous Glomerulonifritis.
Goals:
Know the main glomerulonephritis.
Define important clinical manifestations.
Distinguishing between its morphology.
Know their prognosis and treatment.
Diagnosis and treatment of glomerulonephritis that present itself
more frequently with nephritic syndrome and nonspecific urinary
abnormalities: Mesangial glomerulonifritis,
membranoproliferative glomerulonephritis, acute and
extracapillary glomerulonephritis.
Goals:
Know the main glomerulonephritis and syndromes
associated with them.
Define important clinical manifestations.
Distinguish between morphology.
Know their prognosis and treatment.

Universidad Catlica de Valencia San Vicente Mrtir

1,5

0,5

Pgina 19 de 26

PCA-27-F-01
Gua Docente. Grado de Medicina.
[MEDICINA Y CIRUGIA DEL APARATO NEFROUROLOGICO]. Curso [2013-2014]

10

11

12

Lupus nephritis:
Goals:
Know the clinical-biological semiotics of lupus nephritis.
Expose the utility of renal biopsy in the diagnosis of
lupus nephropathy.
List the most important diagnostic tests.
Describe the morphological bases of the different types
of lupus nephritis.
Know the clinical types of lupus nephritis.
Know what types of lupus nephritis require treatment
and what type of treatment (induction and maintenance).
Know the prognosis of lupus nephritis.
Renal involvement in systemic vasculitis and other autoimmune
diseases: ANCA + vasculitis, Goodpasture, HenochSchnlein
purpura, cryoglobulinemia, Sjogren, Rheumatoid arthritis.
Goals:
List vasculitis and other autoimmune diseases that can
cause kidney damage.
Know pathogenetic mechanisms of vascular and renal
injuries.
Describe the microscopic morphological renal disorders.
State clinical renal manifestations of these pathologies.
Learn the basics of immunological diagnosis.
Describe the prognosis and treatment of vasculitis and
other autoimmune diseases with renal involvement.
Diabetic nephropathy. Kidney and uric acid.
Goals:
Knowing the various mechanisms by which diabetes
mellitus produces kidney involvement.
Describe the various stages of diabetic nephropathy.
Knowing semiology of diabetic nephropathy.
List the most important morphological changes of a
diabetic kidney.
State the evolution and prognosis of diabetic
nephropathy.
Establish the prevention of diabetic nephropathy.
Knowing the treatment of diabetic nephropathy and its
complications.
Define the different forms of affection by uric acid.
The kidney in plasma dyscrasias: Myeloma, primary and
secondary amyloidosis and disease by heavy and light chains.
Goals:
Knowing the most common kidney pathology derived
from dysproteinemias and amyloidosis.
State the kidney manifestations of these diseases.
Know their prognosis and treatment.
Congenital and hereditary nephropathies.
Goals:
Knowing the most common inherited diseases in our
environment (Alport disease, polycystic disease and
Fabry).

Pgina 20 de 26

0,5

Universidad Catlica de Valencia San Vicente Mrtir

PCA-27-F-01
Gua Docente. Grado de Medicina.

Describe the main clinical kidney and non-kidney


diseases.
Know its pathogenesis and gene regulation: ciliopathies,
collagen disorders, alpha-galactosidase deficiency.
Understand the transmission between adult polycystic
kidney disease and hereditary nephropathies.
Outline the differences between polycystic disease of
the adult and the child.
Know the most appropriate means of diagnosis in cystic
diseases.
Know the importance of genetic counseling in carriers of
these processes.
Establish the prognosis and treatment of the most
common hereditary diseases.
Interstitial tubulopathies and nephropathy: Acute and chronic.
Kidney glycosuria, Fanconi syndrome, tubular kidney acidosis
and Bartter syndrome.
Goals:

Defining and classifying toxic interstitial nephropathies.


List the most important nephropathies with isolated
tubular defect.
Know basic semiology to help suspect renal glycosuria.
Describe basic semiology to suspect the existence of
the Fanconi syndrome.
State the types of renal tubular acidosis (RTA),
pathophysiology and clinical symptoms.
Describe functional tests and analytical studies
performed for the diagnosis of each of the types of RTA.
Know the differential diagnosis of RTA
Understand the physiopathology and symptoms of the
Bartter syndrome.
Vascular nephropathies: Nephroangioesclerosis, ischemic
nephropathy, atherosclerotic disease. thrombotic
microangiopathy.
Goals:
Define and classify the different vascular nephropathies.
State the renal manifestations of these diseases.
Evaluate the different diagnostic methods including
kidney biopsy
Know the prognosis and treatment.
Kidney and Hypertension.
Goals:
Describe the renal mechanisms involved in the
regulation of blood pressure.
Know the most common causes of hypertension of renal
origin.
Know the pathophysiological mechanisms through which
organ affection leads to renal hypertension.
State the types of vascular-renal hypertension.

13

14

15

Universidad Catlica de Valencia San Vicente Mrtir

1,5

1,5

Pgina 21 de 26

PCA-27-F-01
Gua Docente. Grado de Medicina.
[MEDICINA Y CIRUGIA DEL APARATO NEFROUROLOGICO]. Curso [2013-2014]

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Reasoning the pathophysiology of the various forms of


vascular-kidney hypertension.
Evaluate clinical features of hypertension to suspect that
the origin may be vascular or renal.
Know biological diagnostic methods and imaging
methods of these processes.
Know the mechanism of action and complications of
drugs used in the treatment of this type of hypertension
The kidney in pregnancy and heart and liver diseases.
Goals:
Define normal kidney changes in pregnancy.
Know preeclampsia: definition, pathophysiology,
symptoms and clinical treatment.
State types of cardiorenal syndromes.
Understand the role of the kidney in liver diseases with
special attention to hepatorenal syndrome.
Electrolyte metabolism disorders (disorders of sodium and
potassium).
Goals:
Understanding the factors that determine the
concentration of these ions in plasma.
Reasoning the central role of deteriorating water
regulation in the genesis of hypo and hypernatremia.
Relation between hypo and hypernatremia with plasma
hyperosmolarity.
Understanding the factors regulating potassium
homeostasis.
Know the main causes of these disorders.
Evaluate the diagnostic algorithm of these disorders.
State the basic principles of treatment.
Disorders of acid-base balance.
Goals:
Learn the basic principles of the physiology of acid-base
balance.
State the characteristics of the different acid-base
disorders and compensation mechanisms.
Know the utility of anion gap in the differential diagnosis
of metabolic acidosis.
Evaluate the factors responsible for the generation and
maintenance of metabolic alkalosis.
State the general principles involved in the treatment of
different types of alterations in acid-base balance.
General semiology of the urinary tract.
Goals:
Know and identify correctly the different signs and
symptoms that result in diseases affecting the urinary
tract.
Recognize the organic substrate and the
neurophysiological bases that give that produce these
symptoms.

Learn to clinically differentiate main symptoms and

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PCA-27-F-01
Gua Docente. Grado de Medicina.

courtship of secondary symptoms associated with


urogenital system diseases.

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Congenital anomalies of the urinary system.


Goals:
Know basic epidemiological aspects of congenital
anomalies of the urinary tract.
Know the different chronological stages that interfere
with normal embryonic development of the urinary
system, and its relationship with the processes of
differentiation of the genital tract in both sexes.
Recognize the most characteristic clinical and
morphological features of malformation syndromes
affecting the urogenital system.
Have sufficient knowledge about the various manual
exploratory and instrumental methods and the most
characteristic signs provided by the different diagnostic
procedures.
Have a broad range of therapeutic possibilities for the
most significant malformations.
Urogenital trauma.
Goals:
Know the different mechanisms which can produce open
or blunt traumas of the urogenital area.
Perform an initial clinical evaluation of a patient with
suspected trauma of the urogenital area.
Establish the diagnosis and clinical severity of blunt
renal trauma and take immediate remedial measures.
Differential diagnosis between intraperitoneal bladder
rupture and extraperitoneal rupture and adopt urgent
therapeutic standards.
Know the basic rules for finding the differential diagnosis
of blunt injuries of the bladder and blunt trauma of the
urethra and initial therapeutic measures to be taken.
Recognize and evaluate the degree of importance of
genital trauma and know how to adopt standards that
are more appropriate for initial treatment.
Know how to appropriately evaluate the criteria of the
limits of direct clinical action in a case of this study area
and know how to establish when the patients is attended
by a specialist.
Obstructive uropathy of the lower urinary tract.
Goals:
Having knowledge about the concept of obstructive
uropathy and pathophysiological mechanisms
associated with acute and chronic obstruction of the
lower urinary tract.
Know the different entities capable of constraining
anatomoclinical obstructive uropathy lower urinary tract.
Knowing how to interpret the various accompanying
clinical symptoms and signs, as well as different

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exploratory techniques used to establish the differential


diagnosis between the different processes and their
differential diagnosis with functional obstruction of
neurogenic origin.
Know the general rules of therapeutic management of
obstructive uropathy of the lower urinary tract, both from
the medical and the surgical side.
Obstructive uropathy of the upper urinary tract.
Goals:
Know the pathophysiological mechanisms triggered by
acute or chronic obstruction of the upper urinary tract.
Know the different entities capable of constraining
anatomoclinical urinary outflow obstruction at that level.
Know the differential characteristics between acute and
chronic obstruction of the upper urinary tract. Know the
different techniques and explorations used to delimit the
different etiologies and differential diagnosis with
misleading obstructions.
Have a general understanding of the different treatment
regimens according to the etiology of the disease.
Specific and nonspecific infections of the genitourinary area.
Goals:
Know the nosological concept and general epidemiology
of urinary tract infections and detailing its impact on the
basis of age and sex.
Know the pathogenesis of urinary tract infections and
the defense mechanisms of the urinary tract before the
invasion of pathogens.
Know the different clinical syndromes and their
diagnosis and therapeutic management.
Knowledge of basic prophylactic rules to minimize the
incidence of urinary tract infections in both outpatients
and hospital patients.
Urologic oncology.
Goals:
Knowing the general epidemiology and pathogenesis of
benign and malignant tumors of the renal parenchyma,
renal pelvis, ureter, bladder, prostate, urethra, penis and
scrotum.
Know how to interpret the images and histopathologic
and morphological features for each tumor grade.
Recognize the signs and symptoms that occur with each
tumor and the strategy to adopt in these patients.
Know the different analytical and exploratory techniques
used to establish the maximum reliability for
preoperative diagnosis.
Know the different therapeutic alternatives currently
used for the treatment of each of the different tumors,
and the morbidity and prognosis associated with each of
these treatment regimens.

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Uroandrology.
Goals:
Know from the embryological point of view, the different
variants of clinical abnormalities observed in
differentiation of the male external genitalia.
Knowing the etiologic classification and therapeutic
possibilities of male infertility.
Know the most common developmental anomalies of
the testicle and in a particular, the clinical, diagnostic
and therapeutic cryptorchidism and testicular ectopia.
Recognize acute testicular torsion and testicular
appendages and differential diagnosis with other
inflammatory processes and tumor of the testicle and
scrotum.
Know how to clinically diagnose a varicocele and know
the impact it may have on fertility. Know basic clinical
criteria for differential diagnosis of various forms of
erectile dysfunction. Know how to diagnose phimosis
and know the steps to follow to reduce paraphimosis.
Know how to recognize and diagnose the most common
pathology of the penis, especially the different nature of
balanoposthitis, priapism and plastic induration of the
corpora cavernosa.
Pathology of the retroperitoneal space.
Goals:
Know the different histological types of retroperitoneal
tumors, its clinical manifestations and the different
methods used for the differential diagnosis with other
pathological conditions of the retroperitoneum.
Know tumors which are derived from cortical and
medullary portion of the adrenal gland, along with their
accompanying clinical syndromes, diagnostic
procedures and general treatment guidelines.

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PCA-27-F-01
Gua Docente. Grado de Medicina.
[MEDICINA Y CIRUGIA DEL APARATO NEFROUROLOGICO]. Curso [2013-2014]

BIBLIOGRAPHY

Nefrologa Clnica, 3 Ed. L. Hernando Avendao. Ed. Panamericana. Madrid 2008.


ISBN: 978-84-9835-186-6
Nefrologa al da. 1Ed. V.Lorenzo Sellars, JM Lpez Gmez. Plus Medical. 2010.
ISBN: 978- 84- 96727-97-7. (Disponible en descarga libre en www.senefro.org )
Urologa General. DR Smith 14 Ed. El Manual Moderno SA. 2009.
Libro del Residente de Urologa. J.Castieiras. Grficas Marte. 2007.

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