Annapoorana Medical College & Hospitals

GENERAL MEDICINE PHASE III PART 1I MBBS LESSON PLAN

CBME UG CURRICULUM

LECTURE

COMPETENCY

TOPIC NO

TITLES:Topic,Competency,Lesson

TEACHING METHODOLOGY

HEART FAILURE

IM 1.8

OBJECTIVES

2.Definition of atrial fibrillation

3.Types of atrial fibrillation

4.Etiology of atrial fibrillation

5.Pathogeneis of atrial fibrillation

6.Diagnosis of atrial fibrillation

7.Management of atrial fibrillation

ATRIAL FIBRILLATION

LECTURE

Enumerate the indications for and describe the findings of heart

IM 1.19

failure with the following conditions including: 2D echocardiography, brain

natriuretic peptide, exercise testing, nuclear medicine testing

IM 1.19/SLO

1.Brain natriuretic peptide and its role in heart failure

2. 2D ECHO - indications and interpretation

3.Stress resting and its significance

4.Nuclear medcine testing in heart failure

5. Coronary angiogram - Indications

6.Coronary angiogram procedure

INVESTIGATIONS IN HEART FAILURE - ECHO,STRESS TESTING AND

LECTURE

NUCLEAR MEDICINE

CORONARY ANGIOGRAM

LECTURE

Elicit document and present an appropriate history

IM 1.10

the diagnosis, cause and severity of heart failure including:

presenting complaints, precipitating and exacerbating factors, risk

OBJECTIVES

1.History for the diagnosis of heart failure

2.Causes for severity of heart failure

3.History of precipitating and exacerbating factors

4.Risk factors of heart failure

5.History regarding sleeping pattern in heart failure

6.History suggestive of infective endocarditis in heart failure

HISTORY DOCUMENTATION IN HEART FAILURE

SMALL GROUP DISCUSSION

Perform and demonstrate a systematic examination based on the

IM 1.11

history that will help establish the diagnosis and estimate its severity

including: measurement of pulse, blood pressure and respiratory

OBJECTIVES

1.Demonstrate Vital signs in heart failure

2.Measurement of bloodpressure in heart failure and interpretation

3.JVP measurement and wave patterns in heart failure

4.Peripheral pulsations and their quality

5.Examination of apical impulse in heart failure

6.Cardiac murmurs and gallop in heart failure

7.Demonstration of lung signs in heart failure

8.Demonstration of abdominal distension and hepatosplenomegaly

SMALL GROUP

PHYSICAL EXAMINATION IN HEART FAILURE

DISCUSSION/DOAP

Demonstrate peripheral pulse, volume, character, quality and

IM 1.12

variation in various causes of heart failure

OBJECTIVES

1. Peripheral pulse in heart failure

2.Volume and character of pulse forms in heart failure

3.Quality of various pulse forms in heart failure

Measure the blood pressure accurately, recognise and discuss

IM 1.13

alterations in blood pressure in valvular heart disease and other

OBJECTIVES

1.Recording blood pressure

2.Interpretation of Blood pressure alteration in heart failure

3.Blood pressure in valvular heart diseases

4.Blood pressure in cardiac tamponade

SMALL GROUP

PULSE AND BLOOD PRESSURE IN CARDIAC FAILURE AND CARDIAC TAMPON

DISCUSSION/DOAP

Demonstrate and measure jugular venous distension

IM 1.14

OBJECTIVES

1.Definition of JVP

2.Wave pattern in JVP

3.Clinical significance of JVP

4.Measurement of JVP and its interpretation

Identify and describe the timing, pitch quality conduction and significance of

IM 1.15

precordial murmurs and their variations

OBJECTIVES

1.Definition of murmur

2.Various types of murmurs

3.Identification of systolic and diastolic murmurs

4.Interpretation of murmurs

5.Variations in intensity of the murmurs

SMALL GROUP

JVP AND MURMURS IN HEART FAILURE

DISCUSSION/DOAP

Generate a differential diagnosis based on the clinical presentation

IM 1.16

and prioritise it based on the most likely diagnosis

OBJECTIVES

1.Differential diagnosis of heart failure

2. Clinical presentation for the differential diagnosis

Order and interpret diagnostic testing based on the clinical

IM 1.17

diagnosis including 12 lead ECG, Chest radiograph, blood cultures

OBJECTIVES

1.Definition of ECG

3.ECG interpretation in heart failure

4.Chest radiography interpretation in heart failure

5.Blood investigations including culture in heart failure

DIFFERENTIAL DIAGNOSIS AND INVESTIGATIONS IN HEART FAILURE

SMALL GROUP DISCUSSION

IM 1.18

Perform and interpret ECG

OBJECTIVES

1.Definition of ECG

2.Wave pattern in ECG

3.Recording ECG

4.Damping , underdamping and isoelectric line in ECG

5.Interpretation of ECG - Axis ,Heart rate calculation and Rhythm abnormalities

6.Interpretation of ECG - Chamber hypertrophy and conduction abnormalities

7.Interpretation of ECG -ischemia and infarction

ECG

LECTURE /SGD

Describe and discuss and identify the clinical features of acute and

IM 1.21

subacute endocarditis, echocardiographic findings, blood culture

and sensitivity and therapy

OBJECTIVES

1.Definition of acute and subacute endocarditis

2.Etiology

3.Clinical features of infective endocarditis

4.ECHO findings

5.Blood culture and sensitivity

6.Therapy

Assist and demonstrate the proper technique in collecting specimen

IM 1.22

for blood culture

OBJECTIVES

1.Technique of collection of blood sample for endocarditis

INFECTIVE ENDOCARDITIS

LECTURE

Describe, prescribe and communicate non pharmacologic

IM 1.23

management of heart failure including sodium restriction, physical

activity and limitations

OBJECTIVES

1.Dietary advice - salt restricted diet and rich potassium diet

2.Lifestyle modification

Describe and discuss the pharmacology of drugs including

IM 1.24

indications, contraindications in the management of heart failure

including diuretics, ACE inhibitors, Beta blockers, aldosterone

OBJECTIVES

1.Drug therapy - Diuretics,ACE inhibitors,Beta blockers,Aldosterone

anatgonists and cardiac glycosides

2.Drug doses and half life of the drugs

3.Drug side effects

4.Indications and contraindications of drug therapy

Develop document and present a management plan for patients with

IM 1.26

heart failure based on type of failure, underlying aetiology

OBJECTIVES

1.Management plan of heart failure

2.Management based on etiology

PHARMACOLOGICAL AND NON -PHARMACOLOGICAL THERAPY IN HEART F

LECTURE

PHARMACOLOGY

Enumerate the indications for valvuloplasty, valvotomy, coronary

IM 1.25

revascularization and cardiac transplantation

OBJECTIVES

1.Valvuloplasty - Procedure and its indications

2.Valvotomy - Procedure and its indications

3.Coronary revascularisation - Procedure and its indications

4.Cardiac transplantation - Procedure and its indications

INTERVENTIONAL MANAGEMENT OF HEART FAILURE

LECTURE

Enumerate the causes of adult presentations of congenital heart

IM 1.28

disease and describe the distinguishing features between cyanotic

and acyanotic heart disease

OBJECTIVES

1.Adult presentation of congenital heart disease

2.Difference between cyanotic and acyanotic heart disease

Elicit document and present an appropriate history, demonstrate

IM 1.29

correctly general examination, relevant clinical findings and

formulate document and present a management plan for an adult

OBJECTIVES

1.History and examination

2.clinical features

3.Management

CONGENITAL CYANOTIC HEART DISEASES

LECTURE

CONGENITAL ACYANOTIC HEART DISEASES

LECTURE

Administer an intramuscular injection with an appropriate

IM 1.30

explanation to the patient

OBJECTIVES

1. Technique for intramuscular injection

2.Sterile precautions before intramuscular injection

3.Test dosing method

3.Complications of intramuscular injection

4.Early identification of anaphylaxis and its management

INTRAMUSCULAR INJECTION

DOAP SESSION

PHARMACOLOGY

TOPIC

ACUTE MYOCARDIAL INFARCTION/IHD

Discuss and describe the epidemiology, antecedents and risK

IM 2.1`

factors for atherosclerosis and ischemic heart disease

OBJECTIVES

1.Epidemiology

2.Risk factors

Discuss the aetiology of risk factors both modifiable and non modifiable risk

IM 2.2

factors.Discuss the aetiology of risk factors both modifiable and non modifiable

of atherosclerosis and IHD

OBJECTIVES

1.Etiology

2.Modifiable and non modifiable risk factors

ATHEROSCLEROSIS AND IHD- ETIOLOGY AND RISK FACTORS

LECTURE

Discuss and describe the lipid cycle and the role of dyslipidemia in

IM 2.3

the pathogenesis of atherosclerosis

OBJECTIVES

1.Lipid cycle

2.Role of dyslipidemia in atherosclerosis

Discuss and describe the pathogenesis natural history, evolution

IM 2.4

and complications of atherosclerosis and IHD

OBJECTIVES

1.Patholgy and clinical evolution

2.Complications

Choose and interpret a lipid profile and identify the desirable lipid

IM 2.12

pro=ile in the clinical context

OBJECTIVES

1.Interpretation of Lipid profile

Discuss and describe the indications, formulations, doses, side

IM 2.18

effects and monitoring for drugs used in the management of

dyslipidemia

OBJECTIVES

1.Drug dosing,indications

2.Side effects

3.Monitoring of drugs in dyslipidemia

LIPID CYCLE AND DYSLIPIDEMIA - CLINICAL PRESENTATION AND MANAGE

LECTURE/DOAP

Define the various acute coronary syndromes and describe their

IM 2.5

evolution, natural history and outcomes

OBJECTIVES

1.Acute coronary syndrome- types

2.Natural history

3.Outcomes

Elicit document and present an appropriate history that includes onset

IM 2.6

evolution, presentation risk factors, family history, comorbid conditions,

complications, medication, history of atherosclerosis, IHD and coronary

OBJECTIVES

1.History of atherosclerosis

2.Risk factors of CAHD

3. Comorbid conditions and complications

Perform, demonstrate and document a physical examination including a

IM 2.7

vascular and cardiac examination that is appropriate for the clinical

presentation

OBJECTIVES

1.Examination of CVS

2. Clinical findings Interpretation

Generate document and present a differential diagnosis based on the clinical

IM 2.8

presentation and prioritise based on “cannot miss”, most likely diagnosis and

OBJECTIVES

1. Differential diagnosis

2.Final diagnosis and severity

ACUTE CORONARY SYNDROMES - INTRODUCTION AND HISTORY TAKING

LECTURE

ACUTE COROINARY SYNDROMES - EXAMINATION AND DIFFERENTIAL DIAG

LECTURE

Distinguish and differentiate between stable and unstable angina and AMI

IM 2.9

based on the clinical presentation

OBJECTIVES

2.Angina - definition

3. unstable angina

Clinical differentiation between angina and Unstable angina

ANGINA - CLINICAL PRESENTATION

SMALL GROUP DISCUSSION

IM 2.10

Order, perform and interpret an ECG

OBJECTIVES

1. RECORDING ECG

2. Interpretation of ECG in Myocardial infarction

IM 2.11

Order and interpret a Chest X-ray and markers of acute myocardial infarction

OBJECTIVES

1.Interpretation of chest Xray

2.Interpretation of markers in MI

INVESTIGATIONS - MYOCARDIAL INFRACTION

LECTURE

Discuss and enumerate the indications for and findings on echocardiogram,

IM 2.13

stress testing and coronary angiogram

OBJECTIVES

1.Indications for Echocardiogram

2. interpretation of echocardiogram

3. indication for stress testing

4. contraindication for stress testing

5.Indications for coronary angiogram

6.contraindication for coronary angiogram

7.preparation of patient for coronary angiogram

8.interpretation of coronary angiogram report

ECHOCARDIOGRAM STRESS TESTING IN CAD

SGD/ LECTURE

CORONARY ANGIOGRAM IN CAD

SGD/ LECTURE

Discuss and describe the indications for admission to a coronary care unit and

IM 2.14

supportive therapy for a patient with acute coronary syndrome

OBJECTIVES

1.Admission criteria for ACS

2.Supportive therapy in ACS

SMALL GROUP

ACS - ADMISSION CRITERIA ,INVESTIGATIONS AND SUPPORTIVE THERAPY

DISCUSSION/DOAP

Discuss and describe the medications used in patients with an acute coronary

IM 2.15

syndrome based on the clinical presentation

OBJECTIVES

1.drugs used in intensive coronary care unit

2.life saving drugs in the coronary care unit

3.Pharmacological therapy in ACS

MANAGEMENT OF ACS IN INTENSIVE CORONARY CARE UNIT

LECTURE/SGD

IM 2.16

Discuss and describe the indications for acute thrombolysis, PTCA and CABG

OBJECTIVES

1.Thrombolytic therapy - Indications and contraindications

2. drugs used for thrombolytic therapy

3. dose and side effect of drugs in thrombolytic therapy

4. Indications for PTCA

5. indication for CABG

MANAGEMENT OF ACS - THROMBOLYTIC THERAPY , PTCA , CABG

IM 2.17

Discuss and describe the indications and methods of cardiac rehabilitation

Counsel and communicate to patients with empathy lifestyle changes in

IM2.24

atherosclerosis / post coronary syndromes

OBJECTIVES

1.Indications of cardiac rehabilitation

2.Methods of cardiac rehabilitation

3.Dietary advice

4. LIFE STYLE MODIFICATION in ACS

CARDIAC REHABILITATION IN ACS

SGD

IM 2.20

Discuss and describe the assessment and relief of pain in acute coronary syndromes

OBJECTIVES

1.Pain management in ACS

2.Drugs used for relief of pain in ACS

3. indication and contraindication of the drug

1. Pharmacalogical therapy - indications and contraindications

Describe and discuss the indications for nitrates, anti platelet agents,

IM2.23

gpIIb IIIa inhibitors, beta blockers, ACE inhibitors etc in the management

1.indications for nitrates

2.drugs used in acute coronary syndrome - beta blockers, ACE inhibitors

3. uses of antiplatelet drugs and their side effects

PHARMACOLOGICAL MANAGEMENT OF ACS

LECTURE/SGD

PHARMACOLOGY

Discuss and describe the pathogenesis, recognition and management of

IM 2.19

complications of acute coronary syndromes including arrhythmias, shock, LV

dysfunction, papillary muscle rupture and pericarditis

OBJECTIVES

1. acute complication of ACS

2.chronic complication of acs

3.Pathogenesis of complications in ACS

4. clinical findings of complications and management of complications

ACS - COMPLICATIONS AND MANAGEMENT

LECTURE/SGD

Observe and participate in a controlled environment an ACLS program

IM 2.21

OBJECTIVES

1.Current ACLS guidelines 2020

2.Drugs used in ACLS protocol

3. Cardiac arrest Revival

SMALL GROUP

ACS- ACLS PROGRAMME

DISCUSSION/DOAP

Perform and demonstrate in a mannequin BLS

IM 2.22

OBJECTIVES

1.Clinical significance of BLS

2.Steps in BLS

3.Demonstration of BLS

SMALL GROUP

ACS- MANNEQUIN BLS PROGRAMME

DISCUSSION/DOAP

TOPIC

PNEUMONIA

Define, discuss, describe and distinguish community acquired pneumonia,

IM 3.1

nosocomial pneumonia and aspiration pneumonia

OBJECTIVES

1.Difference and clinical presentation of community acquired pneumonia,

nosocomial pneumonia,aspiration pneumonia

Discuss and describe the aetiologies of various kinds of pneumonia and their

IM 3.2

microbiology depending on the setting and immune status of the host

OBJECTIVES

1) Etiology of pneumonia

2)organisms that causes pneumonia

3)Immune status of the host

Discuss and describe the pathogenesis, presentation, natural history and

IM 3.3

complications of pneumonia

OBJECTIVES

1.History of pneumonia

2.Clinical features

3.Pathogenesis

4.Complications OF Pneumonia

PNEUMONIA - CLASSIFICATION ,ETIOLOGY AND PATHOGENESIS

LECTURE

CLINICAL PRESENTATION OF VARIOUS TYPES OF PNEUMONIA

LECTURE

COMPLICATIONS OF PNEUMONIA

Elicit document and present an appropriate history including the evolution,

IM 3.4

risk factors including immune status and occupational risk

OBJECTIVES

1.Evolution of pneumonia

2.Risk factors - immune and occupational

Perform, document and demonstrate a physical examination including general

IM 3.5

examination and appropriate examination of the lungs that establishes the

diagnosis, complications and severity of disease

OBJECTIVES

1.Physical examination and demonstartion of respiratory system

2.Establishing the diagnosis

3.Complication

4.Severity of pneumonia

Generate document and present a differential diagnosis based on the clinical

IM 3.6

features, and prioritise the diagnosis based on the presentation

OBJECTIVES

1.Differential diagnosis

2.Prioritise the diagnosis based on the presentation

PNEUMONIA - HISTORY , EXAMINATION OF RESPIRATORY SYSTEM,

SGD/DOAP

DIAGNOSIS AND DIFFERENRIAL DIAGNOSIS

Order and interpret diagnostic tests based on the clinical presentation

IM 3.7

including: CBC, Chest X ray PA view, Mantoux, sputum gram stain, sputum

culture and sensitivity, pleural fluid examination and culture, HIV testing and

OBJECTIVES

1.Blood investigations- CBC, blood culture interpretation

2.Chest X-Ray PA view

3.Sputum-gram stain , culture and senstivity

4.Pleural fluid- biochemical analysis,culture and senstivity/HIV/ABG

INVESTIGATIONS OF PNEUMONIA

LECTURE /SGD

Demonstrate in a mannequin and interpret results of an arterial blood gas

IM 3.8

examination

OBJECTIVES

1.ABG,mannequin demonstration

2.interpretation of ABG results

BLOOD GAS ANALYSIS

SGD /LECTURE

BIOCHEMISTRY

IM 3.9

Demonstrate in a mannequin and interpret results of a pleural fluid aspiration

OBJECTIVES

1.indications for pleural aspiration

2.contraindication for pleural aspiration

3.Mannequin demonstration of pleural fluid aspiration

4.Interpretation of pleural fluid analysis report

PLEURAL FLUID ASPIRATION TECHNIQUE AND ANALYSIS

LECTURE /DOAP

PATHOLOGY

Demonstrate the correct technique in a mannequin and interpret results of a

IM 3.10

blood culture

OBJECTIVES

1. indications for blood culture

2.sample collection methodology

3. contraindication for blood culture

4.Mannequin demonstration of of blood culture technique

5.Interpretation of blood culture report

PNEUMONIA AND BLOOD CULTURE

LECTURE/DOAP

MICROBIOLOGY

Describe and enumerate the indications for further testing including HRCT,

IM 3.11

Viral cultures, PCR and specialised testing

OBJECTIVES

1. INDICATION FOR HRCT

2.indication for viral culture

3. viral transport media and viral culture media

4. indications of PCR

5. interpretation of PCR

6.Indications for other specialised testing

MICROBIOLOGY/RAD

PNEUMONIA - SPECIAL INVESTIGATIONS

SGD/ LECTURE

IOLOGY

Select, describe and prescribe based on the most likely aetiology, an

IM 3.12

appropriate empirical antimicrobial based on the pharmacology and

antimicrobial spectrum

OBJECTIVES

1.Antimicrobial therapy based on clinical spectrum and investigations

Select, describe and prescribe based on culture and sensitivity appropriate

IM 3.13

empaling antimicrobial based on the pharmacology and antimicrobial spectrum.

OBJECTIVES

1.Drug therapy based on culture and senstivity pattern

2.Appropriate antimicrobial spectrum

IM 3.14

Perform and interpret a sputum gram stain and AFB

OBJECTIVES

1. method of gram staining

2.AFB -zeil neilson technique

3.Interpretation of sputum-gram stain and AFB

Describe and enumerate the indications for hospitalisation in patients with

IM 3.15

pneumonia

OBJECTIVES

1.Indications for hospitalisation and management

MANAGEMENT OF PNEUMONIA - PHARMACOLOGICAL THERAPY

LECTURE/SGD

PHARMACOLOGY

MANAGEMENT OF PNEUMONIA - HOSPITALISATION AND MANAGEMNT

LECTURE/SGD

SPUTUM EXAMINATION FOR AFB AND MANAGEMENT

DOAP

MICROBIOLOGY

Describe and enumerate the indications for isolation and barrier nursing in

IM 3.16

patients with pneumonia

OBJECTIVES

1.Indiactions for isolation

2.Indications for barrier nursing in pneumonia

Describe and discuss the supportive therapy in patients with pneumonia

IM 3.17

including oxygen use and indications for ventilation

OBJECTIVES

1.Indications for oxygen therapy

2.Indications for ventilation

ISOLATION AND BARRIER NURSING OF PNEUMONIA

LECTURE /SGD

OXYGEN THERAPY AND VENTILATION

LECTURE/SGD

ANESTHESIOLOGY

Communicate and counsel patient on family on the diagnosis and therapy of

IM 3.18

pneumonia

OBJECTIVES

1.counselling for the patient's family on the diagnosis

2.Intimation regarding therapy

Discuss, describe, enumerate the indications and communicate to patients on

IM 3.19

pneumococcal and influenza vaccines

OBJECTIVES

1.Indications for pneumococcal vaccines

2.Indications for influenza vaccines

PNEUMONIA-VACCINATION AND COUNSELLING

LECTURE/DOAP

TREATMENT PLAN AND COUNSELLING TO THE FAMILY

SMALL GROUP DISCUSSION

LIVER DISEASES

IM 5.1

Describe and discuss the physiologic and biochemical basis of hyperbilirubinemia

OBJECTIVES

1. Physiological changes in hyperbilirubenemia

2. biological basis of hyperbilirubenemia

IM 5.2

Describe and discuss the aetiology and pathophysiology of liver injury

OBJECTIVES

1. Etiology of liver injury

2. Pathophysiology of liver injury

IM 5.3

Describe and discuss the pathologic changes in various forms of liver disease

OBJECTIVES

1. Pathological changes of liver diseases

2. various forms of liver diseases

IM 5.7

Enumerate and describe the causes and pathophysiology of drug induced liver injury

OBJECTIVES

1. Causes of liver injury

2. Drugs that causes liver injury

3. Pathophysiology of drug induced liver injury

BIOCHEMISTRY/PHY

LIVER FUNCTIONS AND BIOCHEMICAL CHANGES IN LIVER INJURY

LECTURE/SGD

SIOLOGY

PATHOPHYSIOLOGY OF LIVER INJURY

LECTURE/SGD

PATHOLOGY

ETIOLOGY , PATHOPHYSIOLOGY OF DRUG INDUCED LIVER DISEASE

LECTURE/SGD

Pharmacology

Describe and discuss the epidemiology, microbiology, immunology and clinical

IM 5.4

evolution of infective (viral) hepatitis

OBJECTIVES

1. Epidemiology of viral hepatitis

2. Microbiology and immunology

3. Clinical evaluation

Choose and interpret appropriate diagnostic tests including: CBC, bilirubin,

IM 5.12

function tests, Hepatitis serology and ascitic fluid examination in patient with

liver diseases

OBJECTIVES

1. Blood investigations, liver function test, CBC, hepatitis serology

2. Viral markers

3. Ascitic fluid examination

INFECTIVE HEPATITIS, CLINICAL EVALUATION AND INVESTIGATIONS

LECTURE/DOAP

MICROBIOLOGY

Describe and discuss the pathophysiology and clinical evolution of alcoholic

IM 5.5

liver disease

OBJECTIVES

1. Pathophysiology

2. Clinical evaluation of alcholic liver disease

Describe and discuss the pathophysiology, clinical evolution and complications

IM 5.6

of cirrhosis and portal hypertension including ascites, spontaneous bacterial

peritonitis, hepatorenal syndrome and hepatic encephalopathy

OBJECTIVES

1. Etiopathogenesis of cirrhosis

2. Complications of cirrhosis

3. Clinical evaluation

Elicit document and present a medical history that helps delineate the aetiology

IM 5.9

of the current presentation and includes clinical presentation, risk factors, drug

use, sexual history, vaccination history and family history

OBJECTIVES

1. Medical history and etiology

2. Risk factors

3. History of drug exposure, sexual history, vaccination history and family

history

Perform a systematic examination that establishes the diagnosis and severity

IM 5.10

that includes nutritional status, mental status, jaundice, abdominal distension

ascites, features of portosystemic hypertension and hepatic encephalopathy

OBJECTIVES

1. Systemic examination of the abdomen

2. Physical signs of portosystemic hypertension, hepatic encephalopathy

3. Mental status, jaundice and nutritional status

Generate a differential diagnosis and prioritise based on clinical features that

IM 5.11

suggest a specific aetiology for the presenting symptom

OBJECTIVES

1. Differential diagnosis specific to etiology and symptoms

ALCOHOLIC LIVER DISEASE - PATHOPHYSIOLOGY

LECTURE /SGD

CIRRHOSIS OF LIVER - CLINICAL PRESENTATION AND IT'S

LECTURE/SGD

COMPLICATIONS

Describe and discuss the pathophysiology, clinical evolution and complications

IM 5.8

cholelithiasis and cholecystitis

OBJECTIVES

1. Pathophysiology

2. Clinical presentation

3. Complications

CHOLELOLITHIASIS AND CHOLECYSTITIS

LECTURE /SGD

GEBERAL SURGERY

Enumerate the indications for ultrasound and other imaging studies including

IM 5.13

MRCP and ERCP and describe the findings in liver disease

OBJECTIVES

1. Indications for ultrasound

2. Indications for MRCP, ERCP

Outline a diagnostic approach to liver disease based on hyperbilirubinemia,

IM 5.14

liver function changes and hepatitis serology

OBJECTIVES

1. LFT Interpretation

2. Hepatitis serology interpretation

IM 5.15

Assist in the performance and interpret the findings of an ascitic fluid analysis

OBJECTIVES

1. Ascitic fluid analysis - indications and demonstration

2. Interpretation of ascitic fluid analysis

INVESTIGATIONS OF LIVER DISEASE

Describe and discuss the management of hepatitis, cirrhosis, portal

IM 5.16

hypertension, ascites spontaneous, bacterial peritonitis and hepatic

encephalopathy

OBJECTIVES

1. Management of liver cell injury and hepatitis

1. Management of cirrhosis of liver

2. Management of portal hypertension and it's complications

MANAGEMENT OF LIVER CELL INJURY AND HEPATITIS

LECTURE

MANAGEMENT OF CIRRHOSIS

LECTURE

PORTAL HYPERTENSION

SPONTANEOUS BACTERIAL PERITONITIS

HEPATIC ENCEPHALOPATHY

Enumerate the indications, precautions and counsel patients on vaccination for

IM 5.17

hepatitis

OBJECTIVES

1. Indications of hepatitis vaccination

2. Precautions and counselling

IM 5.18

Enumerate the indications for hepatic transplantation

OBJECTIVES

1. Indications of liver transplant

HEPATITIS VACCINATION

LECTURE/SGD

LIVER TRANSPLANTATION

LECTURE/SGD

TOPIC

RHEUMATOLOGICAL PROBLEMS

IM 7.1

Describe the pathophysiology of autoimmune disease

OBJECTIVES

1.Pathophysiology of autoimmune disease

IM 7.2

Describe the genetic basis of autoimmune disease

OBJECTIVES

1.Genetic basis of autoimmune disease

AUTO-IMMUNE DISEASE - PATHOPHYSIOLOGY AND GENETIC BASIS

LECTURE

PATHOLOGY

IM 7.3

Classify cause of joint pain based on the pathophysiology

OBJECTIVES

1. Pathophysiological Causes of joint pain

IM 7.4

Develop a systematic clinical approach to joint pain based on the pathophysiology

OBJECTIVES

1.Clinical approach to joint pain

IM 7.5

Describe and discriminate acute, subacute and chronic causes of joint pain

OBJECTIVES

1.Types of joint pain

2.Various causes of joint pain

JOINT PAIN - CAUSES ,TYPES AND SYSTEMATIC CLINICAL APPROACH

LECTURE/SGD

Discriminate, describe and discuss arthralgia from arthritis and mechanical

IM 7.6

from inflammatory causes of joint pain

OBJECTIVES

1.Difference between arthralgia and arthritis

2.Mechanical and inflammatory causes of joint pain

Discriminate, describe and discuss distinguishing articular from periarticular

IM 7.7

complaints

OBJECTIVES

1. Difference between articular and periarticular complaints

Determine the potential causes of join pain based on the presenting features of

IM 7.8

joint involvement

OBJECTIVES

1.Causes of Joint pain based on joint involvement

2.Arthritis and

3.Arthralgia and

4.Joint pain

RHEUMATOLOGICAL DISEASE- ARTHRITIS,ARTHRALGIA AND JOINT PAIN

LECTURE

Describe the common signs and symptoms of articular and periarticular

IM 7.9

diseases

OBJECTIVES

1.Signs ad symptoms in articular diseases

2.Signs and symptoms in periarticular diseases

IM 7.10

Describe the systemic manifestations of rheumatologic disease

OBJECTIVES

1.Systemic manifestations in Rheumatology

2.SLE - Definition, Etiology, pathogenesis and systematic manifestations

3.Rheumatoid arthritis- Definition, Etiology, pathogenesis and systematic

manifestations

4.Osteoarthritis- Definition, Etiology, pathogenesis and systematic

manifestations

5.Seronegative arthritis - Definition, Etiology, pathogenesis and systematic

manifestations

6.Ankylosing spondylitis - Definition, Etiology, pathogenesis and systematic

manifestations

7.Systemic sclerosis- Definition, Etiology, pathogenesis and systematic

manifestations

8.Sjogren's syndrome and Mixed Connective Tissue Disorder - Definition,

Etiology, pathogenesis and systematic manifestations

9.Polymyositis and dermatomyositis - Definition, Etiology, pathogenesis and

systematic manifestations

11.Osteoporosis - Definition, Etiology, pathogenesis and clinical manifestations

12.Osteomalacia and rickets - Definition, Etiology, pathogenesis and

manifestations

13.Paget's disease of bone - Etiology, pathogenesis and manifestations

SYSTEMIC LUPUS ERTHYEMATOSUS

LECTURE

RHEUMATOID ARTHRITIS

LECTURE

OSTEOARTHRITIS

LECTURE

SERO NEGATIVE ARTHRITIS

LECTURE

ANKYLOSING SPONDYLITIS

LECTURE

SYSTEMIC SCLEROSIS

LECTURE

SJOGREN'S SYNDROME

LECTURE

POLYMYOSITIS

LECTURE

DERMATOMYOSITIS

OSTEOPOROSIS

LECTURE

OSTEOMALACIA AND RICKETS

LECTURE

PAGETS DISEASE OF BONE

LECTURE

Elicit document and present a medical history that will differentiate the

IM 7.11

aetiologies of disease

OBJECTIVES

1.History to differentiate Rheumatological diseaseS

Perform a systematic examination of all joints, muscle and skin that will

IM 7.12

establish the diagnosis and severity of disease

OBJECTIVES

1.Examination of skin in rheumatology

2.Examination of muscle and all joints for diagnosis

RHEUMATOLOGICAL DISEASE - HISTORY AND CLINICAL EXAMINATION

SMALL GROUP DISCUSSION

Generate a differential diagnosis and prioritise based on clinical features that

IM 7.13

suggest a specific aetiology

OBJECTIVES

1.Differential diagnosis based on clinical features

IM 7.14

Describe the appropriate diagnostic work up based on the presumed aetiology

OBJECTIVES

1.Diagnostic plan based on etiology

RHEUMATOLOGICAL DISEASE - DIFFERENTIAL DIAGNOSIS AND

LECTURE/SGD

DIAGNOSTIC PLAN

Enumerate the indications for and interpret the results of : CBC, anti- CCP, RA,

IM 7.15

ANA, DNA and other tests of autoimmunity

OBJECTIVES

1.Indications for tests in Rheumatology

2.Interpretation of test results

IM 7.16

Enumerate the indications for arthrocentesis

OBJECTIVES

1. Indications of arthrocentesis

2.Arthrocentesis procedure

IM 7.17

Enumerate the indications and interpret plain radiographs of joints

OBJECTIVES

1.Indications for Xray joints

2.Interpretation of Xrays

PATHOLOGY AND

RHEUMATOLOGICAL DISEASES- INVESTIGATIONS

LECTURE

RADIOLOGY

Communicate diagnosis, treatment plan and subsequent follow up plan to

IM 7.18

patients

OBJECTIVES

1.Diagnosis and treatment plan

2.Communication of the plan to patients

Develop an appropriate treatment plan for patients with rheumatologic

IM 7.19

diseases

OBJECTIVES

1.Treatment plan for diseases

Select, prescribe and communicate appropriate medications for relief of joint

IM 7.20

pain

OBJECTIVES

1.Selection of appropriate medications for joint pain

2. Prescription and proper communication

Select, prescribe and communicate preventive therapy for crystalline

IM 7.21

arthropathies

OBJECTIVES

1.Selection of preventive therapy for crystalline arthropathies

2.Prescription and proper communication

Select, prescribe and communicate treatment option for systemic

IM 7.22

rheumatologic conditions

OBJECTIVES

1.Selection of drug therapy for systemic rheumatologic conditions

2.Prescription and proper communication

Describe the basis for biologic and disease modifying therapy in rheumatologic

IM 7.23

diseases

OBJECTIVES

1.Basis of Biologic therpay in rheumatology

2.Basis of DMARDS

IM 7.24

Communicate and incorporate patient preferences in the choice of therapy

OBJECTIVES

1.Incorporating patients preferance in choice of therapy

TREATMENT PLAN AND DRUG THERAPY IN RHEUMATOLOGICAL

LECTURE

PHARMACOLOGY

DISEASES

Develop and communicate appropriate follow up and monitoring plans for

IM 7.25

patients with rheumatologic conditions

OBJECTIVES

1.Develop follow up and monitoring plan for Rheumatological conditions

2.Communicate the plan with patients

Demonstrate an understanding of the impact of rheumatologic conditions on

IM 7.26

quality of life, well being, work and family

OBJECTIVES

1.Impact of disease on quality of life

2. Counsel the patients

IM 7.27

Determine the need for specialist consultation

OBJECTIVES

1.To Determine the need for specialist consultation

RHEUMATOLOGICAL DISEASES- FOLLOW UP,COUNSELLING AND REHABILI

LECTURE

COUNSELLING FOR CORRECTION OF NUTRITIONAL ANEMIA AND

LECTURE

SPECIALIST CONSULTATION

TOPIC

Acute Kidney Injury and Chronic renal failure

IM 10.1

Define, describe and differentiate between acute and chronic renal failure

OBJECTIVES

1.Definition of renal failure

2.Difference between acute and chronic renal failure

Classify, describe and differentiate the pathophysiologic causes of acute renal

IM 10.2

failure

OBJECTIVES

1.Classification of acute renal failure(ARF)

2.Pathophysiology

3.Causes

Describe the pathophysiology and causes of pre renal ARF, renal and post renal

IM 10.3

ARF

OBJECTIVES

1.Pathophysiology of Pre-Renal,Renal,Post-Renal ARF

2.Causes of Pre-Renal,Renal,Post-Renal ARF

IM 10.4

Describe the evolution, natural history and treatment of ARF

OBJECTIVES

1.History of ARF

2.Evolution of Renal failure

3.Treatment of ARF

ACUTE RENAL FAILURE - ETIOPATHOGENESIS,CLASSIFICATION AND

LECTURE/SGD

CLINICAL PRESENTATION

ACUTE RENAL FAILURE - PRIMARY GLOMERULAR DISEASES

ACUTE RENAL FAILURE - SECONDARY GLOMERULAR DISEASES

ACUTE RENAL FAILURE - MANAGEMENT

LECTURE/SGD

IM 10.5

Describe and discuss the aetiology of CRF

OBJECTIVES

1.Etiology of Chronic Renal Failure

IM 10.6

Stage Chronic Kidney Disease

OBJECTIVES

1.Various satges of chronic renal failure

IM 10.7

Describe and discuss the pathophysiology and clinical findings of uraemia

OBJECTIVES

1.Pathophysiology of Chronic renal failure

2.Clinical findings of CRF

IM 10.8

Classify, describe and discuss the significance of proteinuria in CKD

OBJECTIVES

1.Classification of proteinurea in CKD

2.Significance of proteinurea in CKD

CHRONIC RENAL FAILURE- ETIOPATHOGENESIS,STAGING AND UREMIA

LECTURE/SGD

CHRONIC RENAL FAILURE - NEPHRITC SYNDROME AND NEPHROTIC SYNDROME

CHRONIC RENAL FAILURE AND PROTEINURIA

LECTURE/SGD

Describe and discuss the pathophysiology of anemia and hyperparathyroidism

IM 10.9

in CKD

OBJECTIVES

1.Pathophysiology of anemia in CKD

2.Hyperparathyroidism in CKD

IM 10.10

Describe and discuss the association between CKD glycemia and hypertension

OBJECTIVES

1.Hypertension in CKD

2.GlyCemia in CKD

Describe and discuss the relationship between CAD risk factors and CKD and in

IM 10.11

dialysis

OBJECTIVES

1.CAD risk factors in CKD

LECTURE/SGD

2.CAD riskfactors in Dialysis

ANEMIA AND HYPERPARATHYROIDISM IN CKD

HYPERTENSION AND HYPERGLYCEMIA IN CKD

CAD RISK FACTORS IN CKD AND DIALYSIS

Elicit document and present a medical history that will differentiate the

IM 10.12

aetiologies of disease, distinguish acute and chronic disease, identify

predisposing conditions, nephrotoxic drugs and systemic causes

OBJECTIVES

1.Medical History for etiology

2.Difference between acute and chronic renal failure

3.Predisposing factors-nephrotoxic drugs and systemic diseases

Perform a systematic examination that establishes the diagnosis and severity

IM 10.13

including determination of volume status, presence of edema and heart failure,

features of uraemia and associated systemic disease

OBJECTIVES

1.Physical examination for establishing the diagnosis

2.To assess the severity of the disease

3.Determination of volume status-edema , cardiac failure

4.Features of uremia

Generate a differential diagnosis and prioritise based on clinical features that

IM 10.14

suggest a specific aetiology

OBJECTIVES

1.Clinical features specific to the etiology

SGD/DOAP

2.Differential diagnosis

SYSTEMIC DISEASES AND NEPHROTOXIC DRUGS IN CKD

CRF CLINICAL PRESENTATION,PREDISPOSING CONDITIONS,DIFFENTIAL DIAGNOSIS

IM 10.15

Describe the appropriate diagnostic work up based on the presumed aetiology

OBJECTIVES

1.Diagnostic workup based on etiology

Enumerate the indications for and interpret the results of : renal function tests,

IM 10.16

calcium, phosphorus, PTH, urine electrolytes, osmolality, Anion gap

OBJECTIVES

1.Indications for renal function test

2.Interpretation of calcium, phosphorus,PTH,serum electrolytes,anion gap

3.Urine osmolality

Describe and calculate indices of renal function based on available laboratories

IM 10.17

including FENa (Fractional Excretion of Sodium) and CrCl (Creatinine

Clearance)

OBJECTIVES

1.Interpretation of FENa

2.Interpretation of creatinine clearence

IM 10.18

Identify the ECG findings in hyperkalemia

OBJECTIVES

1.ECG-hyperkalemia chages-tall T waves

IM 10.19

Enumerate the indications and describe the findings in renal ultrasound

OBJECTIVES

1.Indication for USG- KUB area

2.To assess the kidney size

Describe and discuss the indications to perform arterial blood gas analysis:

IM 10.20

interpret the data

OBJECTIVES

1.Indication to perform ABG analysis

SGD/DOAP

2.Interpretation of ABG

RENAL FAILURE- HEMATOLOGICAL INVESTIGATIONS

RENAL FAILURE- NON-INVASIVE AND SPECIAL INVESTIGATIONS

KIDNEY BIOPSY AND ITS INTERPRETATION

Describe and discuss the indications for and insert a peripheral intravenous

IM 10.21

catheter

OBJECTIVES

1.Indications for Peripheral venous catheter

Describe and discuss the indications, demonstrate in a model and assist in the

IM 10.22

insertion of a central venous or a dialysis catheter

OBJECTIVES

1.Indications for insertion of Central venous catheter

Communicate diagnosis treatment plan and subsequent follow up plan to

IM 10.23

patients

OBJECTIVES

1.Councelling for diagnosis and treatment plan

2.Councelling for followup plan

IM 10.24

Counsel patients on a renal diet

OBJECTIVES

DOAP

1.Councelling for Renal diet

Identify and describe the priorities in the management of ARF including diet,

IM 10.25

volume management, alteration in doses of drugs, monitoring and indications

for dialysis

OBJECTIVES

1.Diet,fluid and drugs management in ARF

2.Indications for dialysis

Describe and discuss supportive therapy in CKD including diet, anti

IM 10.26

hypertensives, glycemic therapy, dyslipidemia, anemia, hyperkalemia,

hyperphosphatemia and secondary hyperparathyroidism

OBJECTIVES

1.Diet,drugs,and supportuve therapy in CKD

IM 10.27

Describe and discuss the indications for renal dialysis

OBJECTIVES

1.Indication of renal dialysis and types of renal dialysis

IM 10.28

Describe and discuss the indications for renal replacement therapy

OBJECTIVES

1.Indication of renal replacement therapy

Describe discuss and communicate the ethical and legal issues involved in renal

IM 10.29

replacement therapy

OBJECTIVES

1.Communicating the ethical and legal issuses in RRT

Recognise the impact of CKD on patient’s quality of life well being work and

IM 10.30

family

OBJECTIVES

1.Advice for quality of life and well being in CKD patients

IM 10.31

Incorporate patient preferences in to the care of CKD

OBJECTIVES

LECTURE/SGD

1.IncorporatIing patient preferences in CKD patients

CONSERVATIVE MANAGEMENT OF CHRONIC RENAL FAILURE

DIALYSIS - RENAL REPLACEMENT THERAPY

100

CENTRAL VENOUS CATHETERISATIONA AND PERIPHERAL ACCESS IN DIALYDOAP

101

DIET AND COUSELLING FOR CHRONIC RENAL FAILURE

102

RENAL TRANSPLANTATION

TOPIC

THYROID DYSFUNCTION

Describe the epidemiology and pathogenesis of hypothyroidism and

IM 12.1

hyperthyroidism including the influence of iodine deficiency and autoimmunity

in the pathogenesis of thyroid disease

Objective

1. Pathogenesis of hypothyroidism

2. Normal iodine requirement of the body

IM 12.2

Describe and discuss the genetic basis of some forms of thyroid dysfunction

Objective

Integrated Teaching

LECTURE/SGD

1.Genetic basis of thyroid disfunction

Physiology

Describe and discuss the physiology of the hypothalamopituitary - thyroid axis,

Integrated Teaching

IM 12.3

LECTURE/SGD

principles of thyroid function testing and alterations in physiologic function

Pathology

Objective

1.Physiology of hypothalamopituitary - thyroid axis

2. Thyroid function and their importants

103

PHYSIOLOGY, EPIDEMIOLOGY, PATHOGENESIS OF THYROID DISORDER

Describe and discuss the principles of radio iodine uptake in the diagnosis of

IM 12.4

thyroid disorders

Objective

1. Principles of Radio iodine uptake

Elicit document and present an appropriate history that will establish the

IM 12.5

diagnosis cause of thyroid dysfunction and its severity

Objective

1. History of thyroid disorder - palpitation, bradycardia

2. History of hypo thyroid

Perform and demonstrate a systematic examination based on the history that

IM 12.6

will help establish the diagnosis and severity including systemic signs of

thyrotoxicosis and hypothyroidism, palpation of the pulse for rate and rhythm

Objective

1. General physical examination

2. Palpation of thyroid gland

IM 12.7

Demonstrate the correct technique to palpate the thyroid

Objective:

Technicque of palpation of thyroid gland

Generate a differential diagnosis based on the clinical presentation and

IM 12.8

LECTURE/SGD

prioritise it based on the most likely diagnosis

Objective:

Differential diagnosis based on clinical features

THYROID DISORDER - HISTORY ,EXAMINATION AND DIFFERENTIAL

104

DIAGNOSIS

Order and interpret diagnostic testing based on the clinical diagnosis including

IM 12.9

CBC, thyroid function tests and ECG and radio iodine uptake and scan

Objective:

1. Blood examination : CBC, thyroid function test

2. ECG - interpretation

IM 12.10

Identify atrial fibrillation, pericardial effusion and bradycardia on ECG

Objective:

1.ECG interpretation for arthymias

2.ECG interpretation of pericardial effusion.

Biochemistry/Radiol

IM 12.11

Interpret thyroid function tests in hypo and hyperthyroidism

LECTURE/SGD

ogy

Objective:

1. Interpretation of thyroid function test

2. Interpretation of hyperthyroidism

105

THYROID DISORDER INVESTIGATIONS

IM 12.12

Describe and discuss the iodisation programs of the government of India

LECTURE

Community Medicine

Objective:

1.National iodisation program

2. National goitore control program

106

NATIONAL IODISATION PROGRAM

Describe the pharmacology, indications, adverse reaction, interactions of

IM 12.13

thyroxine and antithyroid drugs

Objective:

1. Drug therapy of hypothyroidism

Write and communicate to the patient appropriately a prescription for

IM 12.14

LECTURE/SGD

Pharmacology

thyroxine based on age, sex, and clinical and biochemical status

Objective:

1. Counselling the patient for the continuanity of thyroxine drugs

2. Communicate importance of thyroxine drugs

107

HYPOTHYROIDISM MANAGEMENT AND COUNSELLING

Describe and discuss the indications of thionamide therapy, radio iodine

Pharmacology &

IM 12.15

LECTURE/SGD

therapy and surgery in the management of thyrotoxicosis

General Surgery

Objective:

1. Indications of thionamide therapy

2. Indications of radio iodine therapy

108

MANAGEMENT OF HYPERTHYROIDISM AND THYROTOXICOSIS

TOPIC

COMMON MALIGNANCIES

Describe the clinical epidemiology and inherited & modifiable risk factors for

IM 13.1

common malignancies in India

Objective:

1. Common malignancies in India

2. Clinical epidemiology of malignant disorders

IM 13.2

Describe the genetic basis of selected cancers

Objective:

1. Genetic basis of selective malignancies

IM 13.3

Describe the relationship between infection and cancers

LECTURE/SGD

Pathology

Objective:

1. Difference between infection and malignancies

2. Symptoms and signs of infection

109

COMMON MALIGNANCIES AND GENETIC FACTORS

COMMON MALIGNANCIES - EPIDEMIOLOGY, RISKFACTORS AND

110

DIFFERENCE BETWEEN INFECTION AND CANCER

Describe the natural history, presentation, course, complications and cause of

IM 13.4

death for common cancers

Objective:

1.History of cancer

2.Common cancers

3 Presentation, course and complications

4. Cause of death

Describe the common issues encountered in patients at the end of life and

IM 13.5

principles of management

Objective:

1. Common issues of cancer patient

2. Principles of management

Describe and distinguish the difference between curative and palliative care in

IM 13.6

LECTURE/SGD

Pharmacology

patients with cancer

Objective:

1. Curative therapy

2. Palliative therapy care

COMMON MALIGNANCIES -HISTORY ,CLINICAL PRESENTATION AND

111

COMPLICATIONS

112

CURATIVE AND PALLIATIVE CARE IN CANCER THERAPY

Elicit document and present a history that will help establish the aetiology of

IM 13.7

cancer and includes the appropriate risk factors, duration and evolution

Objective:

1. History to establish aetiology of malignan disorder

2. Risk factors of the cancer

Perform and demonstrate a physical examination that includes an appropriate

IM 13.8

general and local examination that excludes the diagnosis, extent spread and

complications of cancer

Objective:

1. General physical examination

2. Local examination for diagnosis

Demonstrate in a mannequin the correct technique for performing breast exam,

IM 13.9

rectal examination and cervical examination and pap smear

Objective:

1. Mannequin technique for breast examination

2. Technique of rectal examination

Generate a differential diagnosis based on the presenting symptoms and

IM 13.10

clinical features and prioritise based on the most likely diagnosis

Objective

1. Differential diagnosis based on symptom

2. Differential diagnosis bases on clinical features

SYMPTOM ANALYSIS AND CLINICAL DEMONSTRATION IN COMMON

113

MALIGNANCIES

PHYSICAL EXAMINATION AND CLINICAL FEATURES OF COMMON

114

MALIGNANCIES

Order and interpret diagnostic testing based on the clinical diagnosis including

IM 13.11

CBC and stool occult blood and prostate specific antigen

Objective:

1. Blood examination CBC and other specific test based on clinical features

2. Stool for occult blood

Describe the indications and interpret the results of Chest X Ray, mammogram,

Radio Diagnosis and

IM 13.12

DOAP

skin and tissue biopsies and tumor markers used in common cancers

Pathology

Objective:

1. Indications for chest x-ray and interpretation

2. Mammogram and interpretation

115

INVESTIGATIONS OF COMMON MALIGNANCIES

IM 13.13

Describe and assess pain and suffering objectively in a patient with cancer

Objective:

1. Pain objective assessment

2. Plan for pain management

Describe the indications for surgery, radiation and chemotherapy for common

IM 13.14

malignancies

Objective:

1. Indications for chemotherapy

2. Indications for radiation

Describe the need, tests involved, their utility in the prevention of common

IM 13.15

DOAP

Pharmacology

malignancies

Objective:

1. Screening for common malignancies prevention

2. Test available for the prevention of malignancies

MANAGEMENT OF COMMON MALIGNANCIES - ASSESSMENT FOR TYPE OF

116

TREATMENT

Demonstrate an understanding and needs and preferences of patients when

IM 13.16

choosing curative and palliative therapy

Objective:

1. Preference for chemotherapy

2. Preference for palliative therapy

Describe and enumerate the indications, use, side effects of narcotics in pain

IM 13.17

alleviation in patients with cancer

Objective:

1. Narcotic therapy in pain alleviation

IM 13.18

Describe and discuss the ethical and the medico legal issues involved in end of life care

Objective:

1. Ethical issues based on common malignancies management

2. Medico legal issues involved in norcatic therapy

Pharmacology

IM 13.19

Describe the therapies used in alleviating suffering in patients at the end of life

DOAP

AETCOM

Objective:

1. Priorities of therapy at end of life

2. Indications for using modalities of treatment for alleviating suffering of the

MANAGEMENT OF COMMON MALIGNANCIES PAIN, END OF LIFE PATIENT

117

CARE

TOPIC

GI bleeding

IM 15.1

Enumerate, describe and discuss the aetiology of upper and lower GI bleeding

OBJECTIVES

1.Common causes for Upper GI bleed

2.Causes for Lower GI Bleed

3.Factors that precipitate GI bleed

Enumerate, describe and discuss the evaluation and steps involved in

IM 15.2

stabilizing a patient who presents with acute volume loss and GI bleed

OBJECTIVES

1.Moniter the vitals to assess the volume loss

2.Identify site and source of blood loss

3.Stabilizing the patient by volume replacements - colloids or crystalloids

IM 15.3

Describe and discuss the physiologic effects of acute blood and volume loss

OBJECTIVES

1.Physiological changes that takes place due to acute blood loss

LECTURE/SGD

2.The effects of acute blood loss changes identified

UPPER AND LOWER GI BLEED- ETIOLOGY,RISK FACTORS AND

118

PATHOGENESIS

119

UPPER AND LOWER GI BLEED-ASSESSMENT AND STABILIZATION

Elicit and document and present an appropriate history that identifies the route

IM 15.4

of bleeding, quantity, grade, volume loss, duration, etiology, comorbid illnesses

and risk factors

OBJECTIVES

1.History of route of bleeding

2.Quantity and grade of volume loss

3.Duration and cause of blood loss

4.Risk factors and co-morbid illness

Perform, demonstrate and document a physical examination based on the

IM 15.5

history that includes general examination, volume assessment and appropriate

abdominal examination

OBJECTIVES

1.General examination-assesing the signs of blood loss-Pulse volume/BP

2.Abdominal examination-Identify source of bleed

Distinguish between upper and lower

IM 15.6

gastrointestinal bleeding based on the clinical features

OBJECTIVES

1.Difference between Upper GI bleed and Lower GI bleed

2.Clinical examination of the upper abdomen

3.Per-Rectal examination to assess lower GI bleed

Demonstrate the correct technique to perform an anal and rectal examination

IM 15.7

in a mannequin or equivalent

OBJECTIVES

1.Technique to perform rectal examination

2.Indications and Contra-indication of rectal examination

3.Interpretation of rectal examination

Generate a differential diagnosis based on the presenting symptoms and

IM 15.8

clinical features and prioritise based on the most likely diagnosis

OBJECTIVES

1.Differential diagnosis based on symptoms and signs

DOAP/SGD

2.Priority of diagnosis based on clinical feature

120

GI BLEED CLINICAL FEATURE AND DIFFERENTIAL DIAGNOSIS

Choose and interpret diagnostic tests based on the clinical diagnosis including

IM 15.9

complete blood count, PT and PTT, stool examination, occult blood, liver

function tests, H.pylori test.

OBJECTIVES

1.Blood investigations-Hb,CBC,PCV,Blood grouping

2.PTT/PT, INR

3.Stool examination for occult blood,Liver function test,H.Pylori test

Enumerate the indications for endoscopy, colonoscopy and other imaging

IM 15.10

procedures in the investigation of Upper GI bleeding

OBJECTIVES

1.Indications and Contra-Indications for upper GI scopy

2.Indications and Contra-indication for colonoscopy

LECTURE/SGD

3.USG abdomen

121

GI BLEED- INVESTIGATIONS

Develop, document and present a treatment plan that includes fluid

IM 15.11

resuscitation, blood and blood component transfusion, and specific therapy for

arresting blood loss

OBJECTIVES

1.Treatment plan for fluid resursitation by assessing volume loss

2.Plan for blood ,blood components transfusion

3.Protocols for blood transfusion and tranfusion related precautions

4.Specific therapy for arresting blood loss

Enumerate the indications for whole blood, component and platelet transfusion

IM 15.12

and describe the clinical features and management of a mismatched transfusion

OBJECTIVES

1.Indications for blood and blood components tranfusion

2.Protocols for blood transfusion and tranfusion related precautions

3.Monitering the clinical features of mismatched transfusion

IM 15.13

Observe cross matching and blood / blood component transfusion

OBJECTIVES

1.Blood and blood components tranfusion- Cross matching procedures

2.Blood collection from the blood bank procedures

LECTURE/SGD

PATHOLOGY

3.Pre-tranfusion and Post-tranfusion precautionary measures

122

MANAGEMENT OF GI BLEED

Describe and enumerate the indications, pharmacology and side effects of

IM 15.14

pharmacotherapy of pressors used in the treatment of Upper GI bleed

OBJECTIVES

1.Indications of drug therapy

2.Side effects of drug therapy

Describe and enumerate the indications, pharmacology and side effects of

IM 15.15

pharmacotherapy of acid peptic disease including Helicobacter pylori

OBJECTIVES

1.Indications of drug therapy in acid peptic disease

2.Drugs used and side effects

3.Drug combination used in Helicobacter Pylori

IM 15.16

Enumerate the indications for endoscopic interventions and Surgery

OBJECTIVES

1.Indications for endoscopic intervention

2.Preperation of patient for endoscopy and interpretation of endoscopic results

3.Indication for surgical procedure in GI Bleed

IM 15.17

Determine appropriate level of specialist consultation

OBJECTIVES

1.Assessing the patient's volume loss

2.Intervention for correcting the volume loss

3.For special procedures to arrest the GI bleed

Counsel the family and patient in an empathetic non-judgmental manner on the

IM 15.18

diagnosis and therapeutic options

OBJECTIVES

1.Councelling the family members

LECTURE/SGD

PHARMOCOLOGY

2.councellimg the patient for diagnostic and therapeutic options

LECTURE/SGD/DOAP

123

MANAGEMENT OF PEPTIC ULCER ,H.PYLORI AND COUNCELLING

TOPIC

Diarrheal disorder

Describe and discuss the aetiology of acute and chronic diarrhea including

IM 16.1

infectious and non infectious causes

OBJECTIVES

1.Etiology of acute and chronic diarrheoa

2.Etiology of infectious and non-infectious diarrheoa

Describe and discuss the acute systemic consequences of diarrhea including its

IM 16.2

impact on fluid balance

OBJECTIVES

1.Systemic consequences of acute diarrheoa

2.Consequences of fluid loss

IM 16.3

Describe and discuss the chronic effects of diarrhea including malabsorption

OBJECTIVES

1.Effects of chronic diarrheoa

LECTURE/SGD

2.Causes of malabsorption

124

ACUTE AND CHRONIC DIARRHEOA-ETIOLOGY AND EFFECTS OF FLUID LOSS

Elicit and document and present an appropriate history that includes the

IM 16.4

natural history, dietary history, travel , sexual history and other concomitant

illnesses

OBJECTIVES

1.Various history for diarrheoa

2.Associated concomitant disease

Perform, document and demonstrate a physical examination based on the

IM 16.5

history that includes general examination, including an appropriate abdominal

examination

OBJECTIVES

1.General physical examination to assess the hydration status

2.Abdominal examination and clinical features of diarrheoa

IM 16.6

Distinguish between diarrheoa and dysentery based on clinical features

OBJECTIVES

1.Difference between diarrheoa and dysentry

2.Clinical features of diarrheoa and dysentry

Generate a differential diagnosis based on the presenting symptoms and

IM 16.7

clinical features and prioritise based on the most likely diagnosis

OBJECTIVES

DOAP

1.Differential diagnosis diarrheoa and dysentry

125

DIARRHEAL DISEASES -CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS

Choose and interpret diagnostic tests based on the clinical diagnosis including

IM 16.8

complete blood count, and stool examination

OBJECTIVES

1.Complete blood examination

2.Stool examination-ova cyst

Identify common parasitic causes of diarrhea under the microscope in a stool

IM 16.9

specimen

OBJECTIVES

1.Microscopic stool examination- procedures and interpretation

IM 16.10

Identify vibrio cholera in a hanging drop specimen

OBJECTIVES

1.Method of hanging drop preparation

2.Interpretation of hanging drop specimen

Enumerate the indications for stool cultures and blood cultures in patients with

IM 16.11

acute diarrhea

OBJECTIVES

1.Stool culture- how and when to do it

2.Blood culture for enteric and non-enteric bacilli

Enumerate and discuss the indications for further investigations including

IM 16.12

antibodies, colonoscopy, diagnostic imaging and biopsy in the diagnosis of

chronic diarrhea

MICROBIOLOGY AND

OBJECTIVES

LECTURE/SGD

BIOCHEMISTRY

1.Indications for special investigations for chronic diarrhea

126

INVESTIGATIONS OF DIARRHOEAL DISEASES

Describe and enumerate the indications, pharmacology and side effects of

IM 16.13

pharmacotherapy for parasitic causes of diarrhea

OBJECTIVES

1.Drug therapy of parasite causing diarrhea

2.Side effects of drug therapy

Describe and enumerate the indications, pharmacology and side effects of

IM 16.14

pharmacotherapy for bacterial and viral diarrhea

OBJECTIVES

1.Drug therapy of bacteria and virus causing diarrhea

LECTURE/SGD

PHARMACOLOGY

2.Side effects of drug therapy

127

MANAGEMENT OF DIARRHEAL DISEASES

Distinguish based on the clinical presentation Crohn’s disease from Ulcerative

IM 16.15

Colitis

OBJECTIVES

1.Clinical features of Crohn's disease

2.Clinical features of Ulcerative Colitis

3.Difference between Crohn's disease and Ulcerative Colitis

Describe and enumerate the indications, pharmacology and side effects of

IM 16.16

pharmacotherapy including immunotherapy

OBJECTIVES

1.Drug therapy of Inflamatory bowel disease

2.Side effects of drug therapy

3.Indications and side effects of immunotherapy

Describe and enumerate the indications for surgery in inflammatory bowel

IM 16.17

disease

OBJECTIVES

LECTURE/SGD

GENERAL SURGERY

1.Indications for surgery in inflammatory bowel disease

ULCERATIVE COLITIS -PATHOPHYSIOLOGY ,CLINICAL FEATURES AND

128

MANAGEMENT

CROHN'S DISEASE - PATHOPHYSIOLOGY, CLINICAL FEATURES AND

129

MANAGEMENT

TOPIC

HEADACHE

Define and classify headache and describe the presenting features,

IM17.1

precipitating factors, aggravating and relieving factors of various kinds of

headache

OBJECTIVES

1.Definition of Headache

2.Classification of headache

3.Clinical features of various forms of heaadche

4.Precipitating factors in headache

5.Aggrevating and relieving factors in different types of headache

LECTURE

6. Define meningitis and various types of meningitis

HEADACHE - DEFINITION ,CLASSIFICATION OF HEADACHE AND

130

MENINGITIS

Elicit and document and present an appropriate history including aura,

IM17.2

precipitating aggravating and relieving factors, associated symptoms that help

identify the cause of headaches

OBJECTIVES

1.Definition of aura

2.History of headache -onset,duration

3.History of headache - aggrevating factors and relieving factors

4.History of headche with associated symptoms like photophobia

Classify migraine and describe the distinguishing features between classical

IM17.3

and non classical forms of migraine

OBJECTIVES

1.Definition of migraine

2.Classification of migraine

LECTURE

3.Difference between Classical and non classical migraine

131

HEADACHE - MIGRAINE

Perform and demonstrate a general neurologic examination and a focused

IM17.4

examination for signs of intracranial tension including neck signs of meningitis

OBJECTIVES

1. Signs of intracranial tension

2. Neck signs in meningitis

3. General neurological examination

4. Demonstration of neck signs in meningitis

Generate document and present a differential diagnosis based on the clinical

IM17.5

features, and prioritise the diagnosis based on the presentation

OBJECTIVES

1. Pathophysiology of meningitis

LECTURE

PATHOLOGY

2.Differential diagnosis of headache

MENINGITIS -PATHOPHYSIOLOGY ,CLNICAL FEATURES AND DIFFRENTIAL

132

DIAGNOSIS

Choose and interpret diagnostic testing based on the clinical diagnosis

IM17.6

including imaging

OBJECTIVES

1.Diagnostic testing in headaches like imaging

2.Interpretation of imaging

Enumerate the indications and describe the findings in the CSF in patients with

IM17.7

meningitis

OBJECTIVES

1.Indications and contraindications of Lumbar puncture

2.Observe Lumbar puncture procedure

3. Interpretation of CSF analysis in meningitis

Demonstrate in a mannequin or equivalent the correct technique for

IM17.8

performing a lumbar puncture

OBJECTIVES

1.Observe lumbar puncture

2.Demonstrate correct technique of lumbar puncture

Interpret the CSF findings when presented with various parameters of CSF fluid

IM17.9

analysis

OBJECTIVES

1.CSF analysis

2.Interpretation of glucose in CSF analysis

3.Interpretation of protein in CSF analysis

LECTURE

4.Interpretation of cell count in CSF analysis

133

INVESTIGATIONS IN HEADACHE AND MENINGITIS

Enumerate the indications for emergency care admission and immediate

IM17.10

supportive care in patients with headache

OBJECTIVES

1.Emergencies in headache

2.Admission criteria of headache in emergency care

LECTURE

3.Management of headache in emergency care

134

ACUTE EMERGENCIES IN HEADACHE AND MANAGEMENT

135

EPILEPSY

136

SUBARACHNOID HEMORRHAGE

137

INCREASED INTRACRANIAL TENSION

Describe the indications, pharmacology, dose, side effects of abortive therapy in

IM17.11

migraine

OBJECTIVES

1.Indications of therapy in migraine

2.Drug therapy and its side effects in megraine

3.Abortive therapy in migraine

4.Adverse effects of abortive therapy

Describe the indications, pharmacology, dose, side effects of prophylactic

IM17.12

therapy in migraine

OBJECTIVES

1.Indications of prophylaxis in migraine

2.Drug prophylaxis in migraine

LECTURE/SGD

PHARMACOLOGY

3.Adverse effects of drug prophylaxis

138

MIGRAINE - MANAGEMENT AND PROPHYLAXIS

Describe the pharmacology, dose, adverse reactions and regimens of drugs

IM17.13

used in the treatment of bacterial, tubercular and viral meningitis

OBJECTIVES

1.Drug therapy in bacterial meningitis and its adverse effects

2.Drug therapy in TB meningitis and its adverse effects

LECTURE

PHARMACOLOGY

3.Drug therapy in Viral meningitis and its adverse effects

139

MENINGITIS - MANAGEMENT

Counsel patients with migraine and tension headache on lifestyle changes and

IM17.14

need for prophylactic therapy

OBJECTIVES

1.Life style modification counselling for patients with migraine

SMALL GROUP DISCUSSION

2.Counselling for prophylaxis for migraine

140

COUNSELLING FOR PROPHYLACTIC THERAPY IN MIGRAINE

TOPIC

CEREBROVASCULAR ACCIDENT

IM18.1

Describe the functional and the vascular anatomy of the brain

OBJECTIVES

1.Functional anatomy of brain

2.Blood supply of brain

3.Physiology of brain

4.Applied aspects in blood supply of brain

BRAIN -FUNCTIONAL ANATOMY,PHYSIOLOGY ,BLOOD SUPPLY AND

141

APPLIED ASPECTS

Classify cerebrovascular accidents and describe the aetiology, predisposing

IM18.2

genetic and risk factors pathogenesis of hemorrhagic and non hemorrhagic

stroke

OBJECTIVES

1.Define CVA

2.Classification of CVA

3.Etiology of CVA

4.Genetic factors and risk factors in CVA

5.Pathogenesis of hemmorhagic stroke

6.Pathogenesis of ischemic and embolic stroke

7.Clionical presentation of ischemic and embolic stroke

8.Clinical presentation of hemorrhagic stroke

142

CVA - DEFINITION ,CLASSIFICATION AND ETIOPATHOGENESIS

143

CVA- CLINICAL FEATURES OF ISCHEMIC AND EMBOLIC STROKE

LECTURE

144

CVA - CLINICAL FEATURES OF HEMMORHAGIC STROKE

Elicit and document and present an appropriate history including onset,

IM18.3

progression, precipitating and aggravating relieving factors, associated

symptoms that help identify the cause of the cerebrovascular accident

OBJECTIVES

1.History taking in CVA

2.History - onset , duration and progression of stroke

3.History - Precipitating,aggrevating and relieving factors in stroke

4.History of associated symptoms in stroke

145

HISTORY AND SYMPTOM ANALYSIS IN STROKE

Identify the nature of the cerebrovascular accident based on the temporal

IM18.4

evolution and resolution of the illness

OBJECTIVES

1.Diagnosis based on history and evolution of stroke

Perform, demonstrate & document physical examination that includes general

IM18.5

and a detailed neurologic examination as appropriate, based on the history

OBJECTIVES

1.Observe general examination and neurological examination

2.Demonstrate neurological examination based on history

146

GENERAL AND NEUROLOGICAL EXAMINATION IN STROKE

SGD

Distinguish the lesion based on upper vs lower motor neuron, side, site and

IM18.6

most probable nature of the lesion

OBJECTIVES

1.Upper motor neuron and lower motor neuron - Anatomy

2.Difference between upper motor neuron and lower motor neuron

3.Identifying the type of leison

4.Localising the site of leison

UPPER MOTOR NEURON, LOWER MOTOR NEURON AND LOCALISATION OF

147

LEISON

Describe the clinical features and distinguish, based on clinical examination, the

IM18.7

various disorders of speech

OBJECTIVES

1.Anatomy and Physiology of speech

2.Discuss the various disorders of speech like aphasia and dysphasia

3.Difference between motor aphasia and sensory aphasia

LECTURE

4.Clinical examination to differentiate disorders of speech

148

SPEECH AND DISORDERS OF SPEECH - AN OVERVIEW

Describe and distinguish, based on the clinical presentation, the types of

IM18.8

bladder dysfunction seen in CNS disease

OBJECTIVES

1.Anatomy and Physiology of bladder

2.Different types of bladder leisons

3.Clinical presentation of neurogenic bladder

LECTURE

4.Clinical presentation of atonic bladder

149

BLADDER - ANATOMY ,PHYSIOLOGY AND DYSFUNCTION IN CNS DISEASES

Choose and interpret the appropriate diagnostic and imaging test that will

IM18.9

delineate the anatomy and underlying cause of the lesion

OBJECTIVES

1.Blood and CSF analysis in brain leisons

2.Imaging like CT brain and MRI in brain leisons

LECTURE

3.Interpretations of the investigations

150

INVESTIGATIONS IN STROKE

Choose and interpret the appropriate diagnostic testing in young patients with

IM18.10

a cerebrovascular accident (CVA)

OBJECTIVES

1.Definition of young stroke

2.Etiology of Young stroke

3.Role of protein -C and protein -S in young stroke

4.Pathophysiology of young stroke

5.Clinical features in young stroke

6.Blood investigations in young stroke

7.Imaging in Young stroke

LECTURE

8.Interpretation of Imaging in Young stroke

151

YOUNG STROKE

Describe the initial supportive management of a patient presenting with a

IM18.11

cerebrovascular accident (CVA)

OBJECTIVES

1.Treatment modalities available for acute stroke

2.Acute stroke protocol

3.Supportive measures in management of acute stroke

Enumerate the indications for and describe acute therapy of non hemorrhagic

IM18.12

stroke including the use of thrombolytic agents

OBJECTIVES

1.Thromolysis in acute non-hemoorhagic stroke

2.Indications and contraindications of thrombolysis

3.Adverse effects of thrombolysis

$.Clinical outcome of thrombolysis.

Enumerate the indications for and describe the role of anti platelet agents in

IM18.13

non hemorrhagic stroke

OBJECTIVES

1.Pharamacological agents used in Non- hemmorhagic stroke

2.Role of antiplatelets in Non- hemmorhagic stroke

3.Indications and contraindications of antiplatelets in stroke

LECTURE

3.Role of statins in Non- hemmorhagic stroke

152

NON-HEMMORHAGIC STROKE MANAGEMENT

IM18.14

Describe the initial management of a hemorrhagic stroke

OBJECTIVES

1.Hemorrhagic stroke and its various presentations

2.Role of mannitol in hemmorhagic stroke

3.Drug therapy in management of hemmorhagic stroke

IM18.15

Enumerate the indications for surgery in a hemorrhagic stroke

OBJECTIVES

1.Surgical procedures in hemorrhagic stroke

2.Indications for surgery in hemorrhagic stroke

LECTURE

3.Contraindications of surgery in hemoorhagic stroke

153

HEMORRHAGIC STROKE - MANAGEMENT

Enumerate the indications describe and observe the multidisciplinary

IM18.16

rehabilitation of patients with a CVA

OBJECTIVES

1.Role of rehabilitation in stroke patients

2.Various methods of rehabilitation

3.Indications for rehabilitation in CVA patients

Counsel patient and family about the diagnosis and therapy in an empathetic

IM18.17

manner

OBJECTIVES

1.Empathising with patient and his/her family

2.Counsel the patient regarding daignosis

SMALL GROUP DISCUSION

3.Counselling the patient on therapy

154

STROKE REHABILITATION AND COUNSELLING

TOPIC

Movement disorders

IM 19.1

Describe the functional anatomy of the locomotor system of the brain

OBJECTIVES

1.Anatomy of locomotor system

2.Components of Musculoskeletal system

Classify movement disorders of the brain based on distribution, rhythm,

IM 19.2

repetition, exacerbating and relieving factors

OBJECTIVES

1.Classification of movement disorders

2.Exacerbating and relieving factors

Elicit and document and present an appropriate history including onset,

IM 19.3

progression precipitating and aggravating relieving factors, associated

symptoms that help identify the cause of the movement disorders

OBJECTIVES

1.Elicitation of history of movement disorders

2.Aggrevating and relieving factors of movement disorders

LECTURE/SGD

3.History that helps to identify the etiology of movement disorder

MOVEMENT DISORDERS-FUNCTIONAL ANATOMY,CLASSIFICATION

155

AGGREVATING RELIEVING FACTORS

Perform, demonstrate and document a physical examination that includes a

IM 19.4

general examination and a detailed neurologic examination using standard

movement rating scales

OBJECTIVES

1.General physical examination

2.Detailed neurological examination examination

3.Standard movement disorder rating scales

Generate document and present a differential diagnosis and prioritise based on

IM 19.5

the history and physical examination

OBJECTIVES

1.Based on physical examination and history types of movement disorder

2.Documentation of movement disorder

3.Differential diagnosis based on demonstration of movement disorders

Make a clinical diagnosis regarding on the anatomical location, nature and

IM 19.6

cause of the lesion based on the clinical presentation and findings

OBJECTIVES

1.Clinicsl features based diagnosis

2.Clinical features based , Anatomical site of lesion

DOAP

3.Nature of the lesion and etiology

156

MOVEMENT DISORDERS CLINICAL FEATURES AND DEMONSTRATION

Choose and interpret diagnostic and imaging tests in the diagnosis of

IM 19.7

movement disorders

OBJECTIVES

1.Imaging interpretation- MRI, CT Brain

Discuss and describe the pharmacology, dose, side effects and interactions used

IM 19.8

in the drug therapy of Parkinson’s syndrome

OBJECTIVES

1.Drug therapy in Parkinson's disorder

2.Side effect,drug interaction of anti-parkinson drugs

3.Other drugs like benzodiazpines, tranquilizers uses in movement disorders

Enumerate the indications for use of surgery and botulinum toxin in the

IM 19.9

treatment of movement disorders

OBJECTIVES

1.Indications for surgical therapy-stereotactic destruction

2.Botulinum toxin in treatment of movement disorder

LECTURE/SGD/DOAP

157

CHOREA - CLASSFICATION AND CLINICAL FEATURES

158

PARKINSON'S DISEASE AND MANAGEMENT

159

INVESTIGATION AND MANAGEMENT OF MOVEMENT DISORDERS

TOPIC

MINERAL ,FLUID ELECTROLYTE AND ACID BASE DISORDER

Enumerate the causes of hypercalcemia and distinguish the features of PTH vs

IM22.1

non PTH mediated hypercalcemia

OBJECTIVES

1.Calcium metabolisim and role of PTH

2.Causes of hpercalcemia

Describe the aetiology, clinical manifestations, diagnosis and clinical approach

IM22.2

to primary hyperparathyroidism

OBJECTIVES

1.Definition of primary hyperparathyroidism

2.Etiology of primary hyperparathyroidism

3.Clinical manifestations of primary hyperparathyroidism

4.Diagnosis of primary hyperparathyroidism

5.Clinical approach in primary hyperparathyroidism

IM22.3

Describe the approach to the management of hypercalcemia

OBJECTIVES

1.Clinical manifestations of hpercalcemia

2.Approach to management of hypercalcemia

CALCIUM METABOLISM, HYPERCALCEMIA,CLINICAL PRESENTATION AND

160

LECTURE

MANAGEMENT

161

HYPERPARATHYROIDISM

LECTURE

Enumerate the components and describe the genetic basis of the multiple

IM22.4

endocrine neoplasia syndrome

OBJECTIVES

1.Definition of MEN

2.Components of MEN syndrome

3.Genetic basis of MEN

162

MULTIPLE ENOCRINE NEOPLASIA

LECTURE

Enumerate the causes and describe the clinical features and the correct

IM22.5

approach to the diagnosis and management of the patient with hyponatremia

OBJECTIVES

1.Definition of Hyponatremia

2.Causes of hyponatremia

3.Clinical features in Hyponatremia

4.Diagnosis of hyponatremia

LECTURE

5.Management of hyponatremia

163

HYPONATREMIA

Enumerate the causes and describe the clinical and laboratory features and the

IM22.6

correct approach to the diagnosis and management of the patient with

hypernatremia

OBJECTIVES

1.Definition of Hypernatremia

2.Causes of hypernatremia

3.Clinical features in Hypernatremia

4.Diagnosis of hypernatremia

LECTURE

5.Management of hypernatremia

164

HYPERNATREMIA

Enumerate the causes and describe the clinical and laboratory features and the

IM22.7

correct approach to the diagnosis and management of the patient with

OBJECTIVES

1.Definition of Hypokalemia

2.Causes of Hypokalemia

3.Clinical features in Hypokalemia

4.Diagnosis of Hypokalemia

LECTURE

5.Management of Hypokalemia

165

HYPOKALEMIA

Enumerate the causes and describe the clinical and laboratory features and the

IM22.8

correct approach to the diagnosis and management of the patient with

hyperkalemia

OBJECTIVES

1.Definition of Hyperkalemia

2.Causes of Hyperkalemia

3.Clinical features in Hyperkalemia

4.Diagnosis of Hyperkalemia

LECTURE

5.Management of Hyperkalemia

166

HYPERKALEMIA

Enumerate the causes and describe the clinical and laboratory features of

IM22.9

metabolic acidosis

OBJECTIVES

1.Definition of metabolic acidosis

2.Causes of metabolic acidosis

3.Clinical features of metabolic acidosis

4.Lab diagnosis of metabolic acidosis

5.Correction of metabolic acidosis

Enumerate the causes of describe the clinical and laboratory features of

IM22.10

metabolic alkalosis

OBJECTIVES

1.Definition of metabolic alkalosis

2.Causes of metabolic alkalosis

3.Clinical features of metabolic alkalosis

4.Lab diagnosis of metabolic alkalosis

LECTURE

5.Correction of metabolic alkalosis

167

METABOLIC ACIDOSIS

168

METABOLIC ALKALOSIS

Enumerate the causes and describe the clinical and laboratory features of

IM22.11

respiratory acidosis

OBJECTIVES

1.Definition of respiratory acidosis

2.Causes of respiratory acidosis

3.Clinical features of respiratory acidosis

4.Lab diagnosis of respiratory acidosis

5.Correction of metabolic alkalosis

Enumerate the causes and describe the clinical and laboratory features of

IM22.12

respiratory alkalosis

OBJECTIVES

1.Definition of respiratory alkalosis

2.Causes of respiratory alkalosis

3.Clinical features of respiratory alkalosis

4.Lab diagnosis of respiratory alkalosis

LECTURE

5.Correction of metabolic alkalosis

169

RESPIRATORY ACIDOSIS

170

RESPIRATORY ALKALOSIS

Identify the underlying acid based disorder based on an ABG report and clinical

IM22.13

situation

OBJECTIVES

1.Arterial blood gas analysis

2.Technique to take arterial blood

3.ABG report analysis

DOAP

4. Interpretation based on ABG report and clinical status

171

ABG - INTERPRETATION

NUTRITIONAL AND VITAMIN DEFICIENCIES

Discuss and describe the methods of nutritional assessment in an adult and

IM23.1

calculation of caloric requirements during illnesses

OBJECTIVES

1. Students should know nutritional value of food materials

2. Nutritional asessment of the food

LECTURE / SGD

3. Calculations of the caloric value and requirement of the patient

172

NUTRITIONAL STATUS AND CALORIC REQUIREMENT ASSESSMENT

Discuss and describe the causes and consequences of protein caloric

IM23.2

malnutrition in the hospital

OBJECTIVES

1. Causes of malnutrition

2. Diffrence between kwashiorkar and marasmus

LECTURE / SGD

3. Normal requirement of protein and clinical presentation of protein loss

(hypoproteinemia)

173

PROTEIN ENERGY MALNUTRITION

Discuss and describe the aetiology, causes, clinical manifestations,

IM23.3

complications, diagnosis and management of common vitamin deficiencies

OBJECTIVES

1. Students should know Fat soluble vitamins

2. Students should know Water soluble vitamins

3. Features of water soluble vitamin defeciencies

4. Features of Fat soluble vitamin defeciencies

5. Daily requirement of vitamin for the body

6. Nutritional or therapeutic supplementation of vitamin in defeciency state

7. Complications of vitamin defeciency

LECTURE / SGD

8. Management of vitamin defeciency and its complications

LECTURE / SGD

174

WATER SOLUBLE VITAMINS

175

FAT SOLUBLE VITAMINS

Enumerate the indications for enteral and parenteral nutrition in critically ill

IM23.4

patients

OBJECTIVES

1. Students should know the routes of nutritional supplementation

2. Indications for enteral nutrition

LECTURE / SGD

3. Indications for parentral nutrition

NUTRITIONAL STATUS IN CLINICALLY ILL PATIENT AND IT'S

176

MANAGEMENT

Counsel and communicate to patients in a simulated environment with illness

IM23.5

on an appropriate balanced diet

OBJECTIVES

1. Balanced diet - carbohydrates,protein, fat and vitamins

2. Nutritional defeciency assessment of ill patients

SGD

3. Supplementation of balanced diet

177

COUNSELLING - NUTRITION AND BALANCED DIET

GERIATRICS

Describe and discuss the epidemiology, pathogenesis, clinical evolution,

IM24.1

presentation and course of common diseases in the elderly

OBJECTIVES

1. Describe five epidemiological risk factors for common diseases in elderly-

ALZHEIMER'S DISASE,OSTEOARTHRITIS, FALLS & BALANCE DISORDERS,

URINARY INCONTINENCE

2.Describe the pathogenesis of common diseases in elderly

3.Identify atleast 5 clinical symptoms & 5 clinical signs regarding common

disease in elderly

4.Discuss course of atleast 3 common disease among elderly

178

COMMON DISEASES IN ELDERLY

Perform multidimensional geriatric assessment that includes medical, psycho-

IM24.2

social and functional components

OBJECTIVES

1.Assess atleast 5 clinically significant anthropometric & physical assessment in

elderly

2.Perform cognitive assessment skills like MMSE in elderly population

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.3

functional changes, acute care, stabilization, management and rehabilitation of

acute confusional states

OBJECTIVES

1.To list atleast 5 common causes of acute confusional states & describe its

pathogenesis

2.To identify atleast 4 clinical presentation & functional changes of acute

confusional states in elderly

3.At the end of lecture should list out the necessary investigations to be done at

acute confusional state

4. Should know the steps to be taken in management of acute confusional state

such as Emergency interventions,stabilisation care

5.Able to describe atleast 5 rehabilitation measures to be done at patient care

179

ACUTE CONFUSIONAL STATE IN GERIATRIC AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.4

functional changes, acute care, stabilization, management and rehabilitation of

vascular events in the elderly

OBJECTIVES

1. Able to list atleast 5 common etiologies & describe its pathogenesis of

vascular events in elderly

2.Should able to list 5 common clinical symptoms & demonstrate common signs

of vascular events in elderly

3. Should be list the necessary investigations & interpret

4.Should demonstarte the important acute interventional skills & stabilisation

care

180

VASCULAR EVENTS IN ELDERLY

Describe and discuss the aetiopathogenesis clinical presentation identification,

IM24 5

functional changes, acute care, stabilization, management and rehabilitation of

depression in the elderly

OBJECTIVES

1. At the end of lecture,student should be able to list atleast 5 etiology &

describe its pathogenesis of deprssion in elderly

2. Able to perform clinical examination of Mental Status Examination &

identify & describe functional status of depression in Elderly

Should know atleast 5 important lab investigations & imaging modalities in

diagnosis of depression in elderly

4. Know the common therapeutic medical interventions in acute care

,stabilisation, management of depression in elderly

5. Should list out 5 ways of rehabilitation measures in management of

depression in elderly

181

DEPRESSIVE DISORDER IN ELDERLY

Describe and discuss the aetiopathogenesis causes, clinical presentation,

IM24.6

difference in discussion presentation identification, functional changes, acute

care, stabilization, management and rehabilitation of dementia in the elderly

OBJECTIVES

1.Should be able to list out atleast 6 neurodegenerative & metabolic causes &

describe its pathogenesis of dementia in elderly

2.Able to discuss various clinical acute, subacute,chronic presentation of

dementia in elderly

3,able to identify & differentiate among varied clinical presentaion of common

neurodegenerative disorders causing dementia in elderly such as

Alzheimer's,Lewy body demtia, Frontotemporal,Parkinsons plus syndrome

4.should know atleast 8 common therapeutic skills in acute care treatment &

stabilisation of depression in elderly

5.Able to enumerate atleast 5 ways of rehabilitaional measures for depression

in elderly

182

DEMENTIA IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.7

functional changes, acute care, stabilization, management and rehabilitation of

personality changes in the elderly

OBJECTIVES

1.should know the common neuroanatomical pathways & its significance , list

the common functions of cerebral cortex responsible for cognitive behaviours

& intellectual functions

2.should be able to list atleast 5 common etiology & describe its pathogenesis

for cognitive behavioural disorders in elderly

3.able to do clinical examination of individual cortical cognitive functions,

behavioural functions & identify specific cognitive dysfunction in elderly

4.should discuss atleast 5 relevant laboratory investigations & imaging

5.should list out 5 ways of rehabilitation measures in management of

personality disorder / cognitive dysfunction in elderly

183

PERSONALITY DISORDER IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.8

functional changes, acute care, stabilization, management and rehabilitation of

osteoporosis in the elderly

OBJECTIVES

1.should be able to describe calcium,phosphate mineral

metabolism,parathormone & sigificance of vitamin D metabolism on bone

architexture

2. Able to describe roles of numerous hormonal factors, influence of ligands,

small molecules over bone remodelling

3. able to list atleast 5 common clinical symptoms& identify clinical signs of

osteoporosis in elderly

4.able to discuss non pharmacological & pharmacological interventional

methods in acute care ,stabilisation of osteoporosis in elderly

5.able to list out 5 common rehabilitational methods for osteoporosis in elderly

184

OSTEOPOROSIS IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.9

functional changes, acute care, stabilization, management and rehabilitation of

OBJECTIVES

1. able to describe & discuss atleast 5 etiopathogenesis of CVA in elderly

2.should be able to clinically diagnose common clinical presentations of CVA in

elderly

3.able to perform common skillful procedures for acute care,stabilisation for

CVA in elderly

4. should know the most common management strategies for ischemic &

hemorrhagic CVA in elderly

5. should know the most common management strategies for ischemic &

hemorrhagic CVA in elderly

185

CEREBROVASCULAR ACCIDENT IN ELDER AGE GROUP

186

POSTERIOR CIRCULATION STROKE

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.10

functional changes, acute care, stabilization, management and rehabilitation of

COPD in the elderly

OBJECTIVES

1. describe & discuss 3 common etiopathogenesis of COPD in elderly

2.should be able to identify clinical signs of COPD in elderly

3.able to discuss pulmonary function test findings as per GOLD classification of

COPD

4.should know common steps of acute xaceberation care & stabilisation -

bronchodilators therapy,steroids,NIV care for COPD in elderly

5. should know pulmonary rehabilitational meaures exercises for COPD in

elderly

187

COPD IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.11

functional changes, acute care, stabilization, management and rehabilitation of

OBJECTIVES

1. should describe common surgical procedures as elderly are subjected to

undergo - CAG,OA KNEE - ARTHROPLASTY,WOUND

DEBRIDEMENT,AMPUTATION

2. discuss etiopathogenesis of factors affecting surgical interventions in elderly

3.should be able to assess physical fitness for elderly patients undergoing

surgeries

4. Know the common therapeutic medical perioperative interventions in acute

care ,stabilisation for elderly patieents undergoing surgery

5.should list 4 rehabilitational strategies for perioperative elderly pts

188

SURGICAL PROCEDURES IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.12

functional changes, acute care, stabilization, management and rehabilitation of

degenerative joint disease

OBJECTIVES

1. describe & discuss 5 etiopathogenesis of osteoarthiritis in elderly

2.should know imaging modalities such as x ray,CT,MRI in evaluation of

osteoarthiritis in elderly

3. should be able to know common pharmacological & non pharmacological

therapeutics in acute care & stabilisation of osteoarthiritis in elderly

4.should know 5 rehabilitationalk measures for degenerative joint disorders in

elderly

189

OSTEOARTHRITIS IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.13

functional changes, acute care, stabilization, management and rehabilitation of

falls in the elderly

OBJECTIVES

1. able to list common neurological , metabolic,polypharmacy causes for falls in

elderly

2. able to identify common clinical significant findings leading to falls in elderly

orthostatic Hypotension,bradycardia,peripheral neuropathy,hypoglycemic

4.should list atleast 5 rehabilitational & ergonomic measures for falls in elderly

190

ACCIDENTAL FALL IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.14

functional changes, acute care, stabilization, management and rehabilitation of

common fractures in the elderly

OBJECTIVES

1. able to list 5 common predisposed anatomical sites for fractures in elderly

2.able to describe & discuss atleast 5 etiopathogenesis for fractures in elderly

3.discuss the importance of stabilisation,immobilisation ,anesthetic

interventions for fractures in elderly

4. should list out 5 common rehabilitational measures for fractures in elderly

5.atleast 5 rehabilitational care for visual loss in elderly

191

COMMON FRACTURES IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.15

functional changes, acute care, stabilization, management and rehabilitation of

vision and visual loss in the elderly

OBJECTIVES

1. should describe visual pathways & its significance

2.describe & discuss etiopathogenesis of common causes of visual impairment

in elderly

3.able to identify visual acuity,color vision,common refractive

problems,cataract,features of glaucoma,fundus findings in elderly

4. should know therapeutics in acute car & management of visual loss in elderly

5.atleast 5 rehabilitational care for visual loss in elderly

192

BLINDNESS IN ELDER AGE GROUP

Describe and discuss the principles of physical and social rehabilitation,

IM24.16

functional assessment, role of physiotherapy and occupational therapy in the

management of disability in the elderly

OBJECTIVES

1. able to describe 5 basic principles of physiotherapy & occupational therapy

for disability in elderly

2.able to perform anthropometric assessment,functional status of older

individuals,quality of life,degree of dependence for daily living among elderly

3.should be able to enumerate rehabilitational interventions of occupational

care,physiotherapy in managing disability in elderly

193

DISABILITY IN ELDER AGE GROUP

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

IM24.17

functional changes, acute care, stabilization, management and rehabilitation of

hearing loss in the elderly

OBJECTIVES

1. able to describe neuro anatomical pathway of vestibulocochlear nerve &

auditory cortex 3.should demonstrate 5 clinical examination tests related to

identification of auditory function in elderly

2.able to discuss atleast 5 common etiopathogenesis of hearing loss in elderly

3.should demonstrate 5 clinical examination tests related to identification of

auditory function in elderly

4.should know the common steps in acute care , stabilisation & management

skills of hearing loss in elderly

5. able to list 3 rehabilitational measures of hearing loss in elderly

194

HEARING LOSS IN ELDER AGE GROUP

IM24.18

Describe the impact of the demographic changes in ageing on the population

OBJECTIVES

1. should list out the current trend of demographagic changes of aged persons

in indian population

2.should list the common 3 social,3 economical, 5 physical & mental health

impacts of ageing in indian population

195

DEMOGRAPHIC CHANGES IN AGEING

Enumerate and describe the social problems in the elderly including isolation,

IM24.19

abuse, change in family structure and their impact on health.

OBJECTIVES

1. Enumerate atleast 5 social problems among elderly - a) Frailty,

b)Retirement, c)loneliness/isolation,physical & mental abuse

d)family environmental changes in elderly

2.Describe socioeconomical,physical, psychological health impacts owing to

above mentioned social problems in elderly

196

SOCIAL ISSUES IN ELDER AGE GROUP

Enumerate and describe social interventions in the care of elderly including

IM24.20

domiciliary discussion services, rehabilitation facilities, old age homes and

state interventions

OBJECTIVES

1. should enumerate 7 common care settings for elderly- Hospital acute care,

Inpatient rehabilitationservices,op clinic,post acute care,chronic disease

care,assisted living, home health care,day care programs

2. should know atleast 5 evidence based model in management for social

problems in elderly

197

ELDER AGE - DOMICILIARY AND OLD AGE HOME SERVICES

IM24.21

Enumerate and describe ethical issues in the care of the elderly

OBJECTIVES

1. should list out 5 common ethical issues in elderly care

2.should be able to describe 3 ethical issues in elderly care

198

ETHICAL ISSUES IN ELDERLY AGE GROUP

Describe and discuss the aetiopathogenesis, clinical presentation,

IM24.22

complications, assessment and management of nutritional disorders in the

elderly

OBJECTIVES

1. should list & discuss 6 etiopathogenesis of common nutritional diorders in

elderly

2.able to assess c3.lincial anthroprometric changes,body composition changes

due to ageing in elderly

3.discuss laboratory , imaging & endocrinological investigations to assess

nutritional disorders in elderly

4. should know common RDA - dietatry requirements / supplements of

vitamins,minerals, carb,proteins, lipids for elderly

5.able to describe basic principles & strategies for nutritional therapeutical

interventions in nutritional disorders in elderly

199

NUTRITIONAL DISORDERS IN ELDER AGE GROUP

TOPIC

THE ROLE OF PHYSICIAN IN COMMUNITY

IM 26.1

Enumerate and describe professional qualities and roles of a physician

OBJECTIVES

1.Professional quality of physician

2.Role of physician in the community

Describe and discuss the commitment to lifelong learning as an important part

IM 26.2

of physician growth

OBJECTIVES

1.Importance of life long learning

Describe and discuss the role of non maleficence as a guiding principle in

IM 26.3

patient care

OBJECTIVES

1.Role of physician in harmless practice

2.Non harmfull approach principles of physician

Describe and discuss the role of autonomy and shared responsibility as a

IM 26.4

guiding principle in patient care

OBJECTIVES

1.Role of physician of independent practice

2.Role of physician of shared responsibility practice

Describe and discuss the role of beneficence of a guiding principle in patient

IM 26.5

care

OBJECTIVES

1.Physician's moral responsibility in patient care

2.Principles of treating the patient with mercy and charity

IM 26.6

Describe and discuss the role of a physician in health care system

OBJECTIVES

1.Responsibility of physician in health care system

SGD

2.Role of physician in health delivery

200

PHYSICIAN- ROLE,PROFESSIONAL QUALITIES AND LIFELONG LEARNING

201

PHYSICIAN - AUTONOMY AND SHARED RESPONSIBILITY

202

RESPONSIBILITIES OF PHYSICIANS IN THE HEALTH CARE SYSTEM

IM 26.7

Describe and discuss the role of justice as a guiding principle in patient care

OBJECTIVES

1.Physician's responsibility of treating the patients equally

2.Physician's responsibility of treating the patients without socioeconomic

discrepency

Identify discuss medicolegal, socioeconomic and ethical issues as it pertains to

IM 26.8

organ donation

OBJECTIVES

1.Medicolegal issue in organ donation

2.Ethical issues in organ donation

3.Socioeconomic status in organ donation

Identify, discuss and defend medicolegal, sociocultural, economic and ethical

IM 26.9

issues as it pertains to rights, equity and justice in access to health care

OBJECTIVES

1.Physicians's responsibility in patient's rights,equity and justice

Identify, discuss and defend medicolegal, socio-cultural and ethical issues as it

IM 26.10

pertains to confidentiality in patient care

OBJECTIVES

1.Confidentiality in patient care based on medicolegal and ethical issues

Identify, discuss and defend medicolegal, socio-cultural and ethical issues as it

IM 26.11

pertains to patient autonomy, patient rights and shared responsibility in health

care

OBJECTIVES

1.Patient to patient autonomy

2.Patient rights and responsiblity of the physicians based on medicolegal and

ethical issues

203

PATIENT RIGHTS AND RESPONSIBILITY OF THE PHYSICIAN

SGD

Identify, discuss and defend medicolegal, socio-cultural and ethical issues as it

IM 26.12

pertains to decision making in health care including advanced directives and

surrogate decision making

OBJECTIVES

1.Physician's decision making in health care delivery

2.Sharing the responsibilty to treat the patient

Identify, discuss and defend medicolegal, socio-cultural and ethical issues as it

IM 26.13

pertains to decision making in emergency care including situations where

patients do not have the capability or capacity to give consent

OBJECTIVES

1.Decision making in the emergency care

2.Decision making in the situtation where the patient is note in the capacity to

give consent

Identify, discuss and defend medicolegal, socio-cultural and ethical issues as it

IM 26.14

pertains to research in human subjects

OBJECTIVES

1.Physician's decision making and ethical issues in human research activities

Identify, discuss and defend, medicolegal,socio-cultural and ethical issues as

IM 26.15

they pertain to consent for surgical procedures

OBJECTIVES

1.Physician's responsibility to get consent for surgical procedures

PHYSICIAN'S ROLE IN TREATING EMERGENCY CARE AND CONSENT FOR

204

SGD

TREATMENT

Identify, discuss and defend medicolegal, socio-cultural, professional and

IM 26.16

ethical issues as it pertains to the physician patient relationship (including

fiduciary duty)

OBJECTIVES

1.Medicolegal professional ethics between patient and physician

Identify, discuss physician’s role and responsibility to society and the

IM 26.17

community that she/ he serves

OBJECTIVES

1.Duty of the physician to serve the society

Identify, discuss and defend medicolegal, socio-cultural, professional and

IM 26.18

ethical issues in physician- industry relationships

OBJECTIVES

1.Physician responsibility of industry relationship

IM 26.19

Demonstrate ability to work in a team of peers and superiors

OBJECTIVES

1.Sharing the responsibility and ability to work with peers and superiors

Demonstrate ability to communicate to patients in a patient, respectful, non

IM 26.20

threatening, non judgemental and empathetic manner

OBJECTIVES

1.Abitilty to communicate to the patients

2.Convey the information about the patient condition in empathetic manner

IM 26.21

Demonstrate respect to patient privacy

OBJECTIVES

1.Physician's role and respect to the patient privacy

205

ROLE OF PHYSICIAN - ETHICAL ISSUES,COMUNICATION AND PRIVACY

SGD

IM 26.22

Demonstrate ability to maintain confidentiality in patient care

OBJECTIVES

1.Maintaining confidentiality in patient care

IM 26.23

Demonstrate a commitment to continued learning

1.Physician's commitement to continued learning

Demonstrate respect in relationship with patients, fellow team members,

IM 26.24

superiors and other health care workers

OBJECTIVES

1.Physician's relationship with team members,superiors and health care workers

Demonstrate responsibility and work ethics while working in the health care

IM 26.25

team

OBJECTIVES

1.Physican responsibility while working in health care team follwing ethics

206

PHYSICIAN ROLE-CONTINUED LEARNING,RESPECT WITH HEALTH CARE TE

DOAP

Demonstrate ability to maintain required documentation in health care

IM 26.26

(including correct use of medical records)

OBJECTIVES

1.Maintianing medical records

2.Carefull medicolegal documentation

Demonstrate personal grooming that is adequate and appropriate for health

IM 26.27

care responsibilities

OBJECTIVES

1.Physician's personal grooming responsibilities

Demonstrate adequate knowledge and use of information technology that

IM 26.28

permits appropriate patient care and continued learning

OBJECTIVES

1.Uses of information technology in patient care and continued learning

207

PHYSICIAN'S RESPONSIBILITY OF INFORMATION TECHNOLOGY OF PATIEN

SGD

Communicate diagnostic and therapeutic opitons to patient and family in a

IM 26.29

simulated environment

OBJECTIVES

1.Physician's role in communicating the diagnostic option to the patient

2.Physician's role in communicating the therapeutic option to the patient and family

Communicate care opitons to patient and family with a terminal illness in a

IM 26.30

simulated environment

OBJECTIVES

1.Physician's responsibility in explaining the terminal care to the patient family

Demonstrate awareness of limitations and seeks help and consultations

IM 26.31

appropriately

OBJECTIVES

1.Awareness of limitation of the illness and consultation of collegues

IM 26.32

Demonstrate appropriate respect to colleagues in the profession

OBJECTIVES

1.Respect to colleagues in the profession

Demonstrate an understanding of the implications and the appropriate

IM 26.33

procedures and response to be followed in the event of medical errors

OBJECTIVES

1.Responsibility of physician in the event of medical errors

PHYSICIAN RESPONSIBILITY ,TREATMENT OPTIONS AND EVENT OF

208

MEDICAL ERROR

Identify conflicts of interest in patient care and professional relationships and

IM 26.34

describe the correct response to these conflicts

OBJECTIVES

1.Declaration odf conflict of interest

2.Correct response of conflict

IM 26.35

Demonstrate empathy in patient encounters

OBJECTIVES

1.Physician's role in patient encounter

IM 26.36

Demonstrate ability to balance personal and professional priorities

OBJECTIVES

1.To balance personal and professional priorities

IM 26.37

Demonstrate ability to manage time appropriately

OBJECTIVES

1.Ability to manage time appropriately

IM 26.38

Demonstrate ability to form and function in appropriate professional networks

OBJECTIVES

1.Physician's responsibility to form and function appropriate function network

IM 26.39

Demonstrate ability to pursue and seek career advancement

OBJECTIVES

1.Ability to pursue and seek career advancement

Demonstrate ability to follow risk management and medical error reduction

IM 26.40

practices where appropriate

OBJECTIVES

1.Physician's role to follow risk management

2.Ability to reduce medical error reduction in practice

IM 26.41

Demonstrate ability to work in a mentoring relationship with junior colleagues

OBJECTIVES

1.To work in a mentoring relationship with junior colleagues

PHYSICIAN RESPONSIBILITY,CONFLICT,MEDICAL ERROR REDUCTION

209

TIME MANAGEMENT

IM 26.42

Demonstrate commitment to learning and scholarship

OBJECTIVES

1.Commitment of learning

2.commitement of scholarship

Identify, discuss and defend medicolegal, sociocultural, economic and ethical

IM 26.43

issues as they pertain to in vitro fertilisation donor insemination and surrogate

motherhood

OBJECTIVES

1.Physician's role in invitro fertilization of donor insemination

2.Physician responsibility in surrogate motherhood

Identify, discuss and defend medicolegal, socio-cultural professional and ethical

IM 26.44

issues pertaining to medical negligence

OBJECTIVES

1.Responsibility in medical negligence

Identify, discuss and defend medicolegal, socio-cultural professional and ethical

IM 26.45

issues pertaining to malpractice

OBJECTIVES

1.Responsibility of the physician to malpractice

Identify, discuss and defend medicolegal, socio-cultural professional and ethical

IM 26.46

issues in dealing with impaired physicians

OBJECTIVES

1.Responsibility of the physician dealing with impaired physicians

Identify, discuss and defend medicolegal, socio-cultural and ethical issues as

IM 26.47

they pertain to refusal of care including do not resuscitate and withdrawal of

life support

OBJECTIVES

1.Responsibility dealing with refusal of care-do not resuscitate

2.Responsibility of physician dealing with withdrawal of life support

IM 26.48

Demonstrate altruism

OBJECTIVES

1.Physician's responsibility of altruism

Administer informed consent and approriately address patient queries to a

IM 26.49

patient being enrolled in a research protocol in a simulated environment

OBJECTIVES

1.Physician's role in addressing patient queries enrolled in research protocol

210

PHYSICIAN'S ROLE- MEDICOLEGAL NEGLIGENCE,ALTRUISM,RESEARCH PROTOCOL