CBME UG CURRICULUM

GENERAL MEDICINE MBBS LESSON PLAN

LECTURE NO

COMPETENCY NO

TITLES:Topic,Competency,Lesson

TEACHING METHODOLOGY

INTEGRATED TEACHING

TOPIC

HEART FAILURE

Describe and discuss the epidemiology, pathogenesis clinical

evolution and course of common causes of heart disease including:

IM 1.1

rheuma c/ valvular, ischemic, hypertrophic , inflammatory

IM 1.1 /SLO

1.Epidemiology and causes of rheumatic fever

2.Etiopathogeneisis of valvular heart disease

3. Causes for ishemic heart disease and epidemiology

4. various types of cardiomyopathies , etiopathogenesis and epidimiology

5. various types of inflammatory cardiac diseases and etipathogenesis

IM1.2

Describe and discuss the gene c basis of some forms of heart failure

IM 1.2/SLO

1.Genetic basis of heart failure

RHEUMATIC VALVULAR HEART DISEASE - EPIDEMIOLOGY AND ETIOPATHOGENESIS

LECTURE

PATHOLOGY

ISCHEMIC HEART DISEASE -EPIDEMIOLOGY,CAUSES AND PATHOGENESIS

LECTURE

PATHOLOGY

CARDIOMYOPATHIES- EPIDEMIOLOGY ,TYPES AND ETIOPATHOGENESIS

LECTURE

PATHOLOGY

Describe and discuss the ae ology microbiology pathogenies and

clinical evolution of rheumatic fever, criteria, degree of rheumatic

activity and rheumatic valvular heart disease and its complications

IM 1.3

including infective endocarditis

IM 1.3/SLO

1.Etiopatogenesis , microbiology of rheumatic fever

2.criteria for rheumatic fever

3.sequelae of rheumatic fever

4.causes for mitral stenosis , etipathogenesis ,clinical evaluation and management

5.causes for mitral regurgitation , etipathogenesis ,clinical evaluation and management

6.causes for aortic stenosis , etipathogenesis ,clinical evaluation and management

7.causes for aortic regurgitation , etipathogenesis ,clinical evaluation and management

MITRAL STENOSIS

LECTURE

MITRAL REGURGITATION

LECTURE

AORTIC STENOSIS

LECTURE

AORTIC REGURGITATION

LECTURE

Describe and discuss the clinical presenta on and features,

IM 1.9

diagnosis, recogni on and management of acute rheuma c fever

IM 1.9 /SLO

1.Clinical presentation of rheumatic fever

2.diagnostic criteria for rheumatic fever

3. investigations for rheumatic fever - ASO titre , throat swab , culture and sensitivity , ecg

, echo evaluation

4. treatment for rheumatic fever

Describe and discuss the role of penicillin prophylaxis in the

preven on of rheuma c heart disease

IM 1.27

IM 1.27 / SLO

1.penicillin classification

2. therapeutic uses of penicillin in rheumatic fever

3. penicillin prophylaxis - dose , duration.

4. drug prophylaxis in penicillin hypersensitivity patients

MICRO AND

RHEUMATIC FEVER AND PENICILLIN PROPHYLAXIS

LECTURE

PAHRMACOLOGY

Stage heart failure

IM 1.4

IM 1.4 / SLO

1. definition of heart failure

2.Staging in heart failure

Describe ,discuss and differen ate the processes involved in R Vs L

heart failure, systolic vs diastolic failure

IM 1.5

IM 1.5 /SLO

1. definition of right heart failure

2. definition of left heart failure

3. definition of systolic heart failure

4. definition of diastolic heart failure

5.Difference between right and left heart failure

6.systolic vs diastolic heart failure

Describe and discuss the compensatory mechanisms involved in

heart failure including cardiac remodelling and neurohormonal

adapta ons

IM 1.6

IM 1.6 /SLO

1.Mechanisms in heart failure

2.Neurohormonal mechanism and cardiac remodelling

HEART FAILURE - CLASSIFICATION AND STAGING

LECTURE

PATHOLOGY AND

MECHANISMS OF HEART FAILURE

LECTURE

PHYSIOLOGY

Enumerate, describe and discuss the factors that exacerbate heart

failure including ischemia, arrythmias, anemia, thyrotoxicosis, discussion discussion

dietary factors drugs etc.

IM 1.7

IM 1.7 /SLO

1. Role of ishemia in heart failure

2. Exacerbating factors of heart failure

3. Dietary factors in heart failure

4. Drugs exacerbating heart failure

5. Hyperdynamic circulatory state exacerbating heart failure

Describe and discuss the pathogenesis and development of

common arrythmias involved in heart failure particularly atrial

fibrilla on

IM 1.8

IM 1.8 /SLO

1.Tachyarrythmias and its types in heart failure

2.Bradyarrthymias and its types in heart failure

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

FACTORS EXACERBATING HEART FAILURE AND BRADYARRYTHMIAS IN HEART FAILURE

LECTURE

TACHYARRTHYMIAS IN HEART FAILURE

LECTURE

ATRIAL FIBRILLATION

LECTURE

Enumerate the indica ons for and describe the findings of heart

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

peptide, exercise testing, nuclear medicine testing

IM 1.19

and coronary angiogram

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 NUCLEAR MEDICINE

LECTURE

RADIOLOGY

CORONARY ANGIOGRAM

LECTURE

RADIOLOGY

Elicit document and present an appropriate history

the diagnosis, cause and severity of heart failure including:

presenting complaints, precipitating and exacerbating factors, risk

factors exercise tolerance, changes in sleep patterns, features

IM 1.10

suggestive of infective endocarditis

IM 1.10

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 systema c examina on based on the

history that will help establish the diagnosis and estimate its severity

including: measurement of pulse, blood pressure and respiratory

rate, jugular venous forms and pulses, peripheral pulses,

conjunctiva and fundus, lung, cardiac examination including

palpation and auscultation with identification of heart sounds and

IM 1.11

murmurs, abdominal distension and splenic palpa on

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

PHYSICAL EXAMINATION IN HEART FAILURE

SMALL GROUP DISCUSSION

Demonstrate peripheral pulse, volume, character, quality and

IM 1.12

varia on 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

alterations in blood pressure in valvular heart disease and other

IM 1.13

causes of heart failure and cardiac tamponade

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

PULSE AND BLOOD PRESSURE IN CARDIAC FAILURE AND CARDIAC TAMPONADE

SMALL GROUP DISCUSSION

IM 1.14

Demonstrate and measure jugular venous distension

OBJECTIVES

1.Definition of JVP

2.Wave pattern in JVP

3.Clinical significance of JVP

4.Measurement of JVP and its interpretation

Iden fy and describe the ming, pitch quality conduc on and significance of precordial

IM 1.15

murmurs and their varia ons

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

JVP AND MURMURS IN HEART FAILURE

LECTURE

Generate a differen al diagnosis based on the clinical presenta on

IM 1.16

and priori se 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

SGD

Describe and discuss and iden fy the clinical features of acute and

subacute endocarditis, echocardiographic findings, blood culture

and sensitivity and therapy

IM 1.21

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 collec ng specimen

IM 1.22

for blood culture

OBJECTIVES

1.Technique of collection of blood sample for endocarditis

INFECTIVE ENDOCARDITIS

LECTURE

MICROBIOLOGY

Describe, prescribe and communicate non pharmacologic

management of heart failure including sodium restriction, physical

activity and limitations

IM 1.23

OBJECTIVES

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

2.Lifestyle modification

Describe and discuss the pharmacology of drugs including

indications, contraindications in the management of heart failure

including diuretics, ACE inhibitors, Beta blockers, aldosterone

IM 1.24

antagonists and cardiac glycosides

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 pa ents with

IM 1.26

heart failure based on type of failure, underlying ae ology

OBJECTIVES

1.Management plan of heart failure

2.Management based on etiology

PHARMACOLOGICAL AND NON -PHARMACOLOGICAL THERAPY IN HEART FAILURE

LECTURE

PHARMACOLOGY

Enumerate the indica ons for valvuloplasty, valvotomy, coronary

IM 1.25

revasculariza on and cardiac transplanta on

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 presenta ons of congenital heart

disease and describe the distinguishing features between cyanotic

IM 1.28

and acyano c 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

correctly general examination, relevant clinical findings and

formulate document and present a management plan for an adult

IM 1.29

pa ent presen ng with a common form of congenital heart disease

OBJECTIVES

1.History and examination

2.clinical features

3.Management

CONGENITAL CYANOTIC HEART DISEASES

LECTURE

CONGENITAL ACYANOTIC HEART DISEASES

LECTURE

Administer an intramuscular injec on 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 ae ology of risk factors both modifiable and non modifiable risk

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

IM 2.2

atherosclerosis and IHD

OBJECTIVES

1.Etiology

2.Modifiable and non modifiable risk factors

PATHOLOGY ,

PHYSIOLOGY AND

ATHEROSCLEROSIS AND IHD- ETIOLOGY AND RISK FACTORS

LECTURE

COMMUNITY MEDICINE

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, evolu on

IM 2.4

and complica ons of atherosclerosis and IHD

OBJECTIVES

1.Patholgy and clinical evolution

2.Complications

Choose and interpret a lipid profile and iden fy the desirable lipid

IM 2.12

profile in the clinical context

OBJECTIVES

1.Interpretation of Lipid profile

Discuss and describe the indica ons, formula ons, doses, side

effects and monitoring for drugs used in the management of

IM 2.18

dyslipidemia

OBJECTIVES

1.Drug dosing,indications

2.Side effects

3.Monitoring of drugs in dyslipidemia

LIPID CYCLE AND DYSLIPIDEMIA - CLINICAL PRESENTATION AND MANAGEMENT

LECTURE

BIOCHEMISTRY

Define the various acute coronary syndromes and describe their

IM 2.5

evolu on, 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 evolution,

presentation risk factors, family history, comorbid conditions, complications, medication,

IM 2.6

history of atherosclerosis, IHD and coronary syndromes

OBJECTIVES

1.History of atherosclerosis

2.Risk factors of CAHD

3. Comorbid conditions and complications

Perform, demonstrate and document a physical examination including a vascular and

IM 2.7

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 presentation

IM 2.8

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

OBJECTIVES

1. Differential diagnosis

2.Final diagnosis and severity

ACUTE CORONARY SYNDROMES - INTRODUCTION AND HISTORY TAKING

LECTURE

ACUTE COROINARY SYNDROMES - EXAMINATION AND DIFFERENTIAL DIAGNOSIS

LECTURE

Distinguish and differentiate between stable and unstable angina and AMI based on the

IM 2.9

clinical presenta on

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 infarc on

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, stress testing

and coronary angiogram

IM 2.13

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

CORONARY ANGIOGRAM IN CAD

SGD

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

IM 2.14

therapy for a pa ent with acute coronary syndrome

OBJECTIVES

1.Admission criteria for ACS

2.Supportive therapy in ACS

ACS - ADMISSION CRITERIA ,INVESTIGATIONS AND SUPPORTIVE THERAPY

SGD

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

IM 2.15

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

PHARMACOLOGY

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

SGD

IM 2.17

Discuss and describe the indica ons and methods of cardiac rehabilita on

Counsel and communicate to patients with empathy lifestyle changes in atherosclerosis /

IM2.24

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 indica>ons for nitrates, an> platelet agents, gpIIb IIIa inhibitors,

IM2.23

beta blockers, ACE inhibitors etc in the management of coronary syndromes

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

SGD

PHARMACOLOGY

Discuss and describe the pathogenesis, recognition and management of complications of

acute coronary syndromes including arrhythmias, shock, LV dysfunction, papillary muscle

rupture and pericarditis

IM 2.19

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

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

ACS- ACLS PROGRAMME

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

ACS- MANNEQUIN BLS PROGRAMME

DOAP

TOPIC

PNEUMONIA

Define, discuss, describe and dis nguish community acquired pneumonia, nosocomial

IM 3.1

pneumonia and aspira on pneumonia

OBJECTIVES

1.Difference and clinical presentation of community acquired pneumonia,

nosocomial pneumonia,aspiration pneumonia

Discuss and describe the ae ologies of various kinds of pneumonia and their microbiology

IM 3.2

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 complications of

IM 3.3

pneumonia

OBJECTIVES

1.History of pneumonia

2.Clinical features

3.Pathogenesis

4.Complications OF Pneumonia

PNEUMONIA - CLASSIFICATION ,ETIOLOGY AND PATHOGENESIS

LECTURE

PATHOLOGY

CLINICAL PRESENTATION OF VARIOUS TYPES OF PNEUMONIA

LECTURE

PATHOLOGY

Elicit document and present an appropriate history including the evolution, risk factors

IM 3.4

including immune status and occupational risk

OBJECTIVES

1.Evolution of pneumonia

2.Risk factors - immune and occupational

Perform, document and demonstrate a physical examina on including general

examination and appropriate examination of the lungs that establishes the diagnosis,

complications and severity of disease

IM 3.5

OBJECTIVES

1.Physical examination and demonstartion of respiratory system

2.Establishing the diagnosis

3.Complication

4.Severity of pneumonia

Generate document and present a differen al diagnosis based on the clinical features, and

prioritise the diagnosis based on the presentation

IM 3.6

OBJECTIVES

1.Differential diagnosis

2.Prioritise the diagnosis based on the presentation

PNEUMONIA - HISTORY , EXAMINATION OF RESPIRATORY SYSTEM, DIAGNOSIS AND

DIFFERENRIAL DIAGNOSIS

SGD

Order and interpret diagnostic tests based on the clinical presentation including: CBC,

Chest X ray PA view, Mantoux, sputum gram stain, sputum culture and sensitivity, pleural

IM 3.7

fluid examination and culture, HIV testing and ABG

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

SGD

MICROBIOLOGY

IM 3.8

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

OBJECTIVES

1.ABG,mannequin demonstration

2.interpretation of ABG results

BLOOD GAS ANALYSIS

SGD

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

SGD

PATHOLOGY

IM 3.10

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

SGD

MICROBIOLOGY

Describe and enumerate the indications for further testing including HRCT, Viral cultures,

IM 3.11

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/RADIOL

PNEUMONIA - SPECIAL INVESTIGATIONS

SGD

OGY

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

IM 3.12

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 empaling

IM 3.13

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

IM 3.15

Describe and enumerate the indications for hospitalisation in patients with pneumonia

OBJECTIVES

1.Indications for hospitalisation and management

MANAGEMENT OF PNEUMONIA - PHARMACOLOGICAL THERAPY

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 patients with

IM 3.16

pneumonia

OBJECTIVES

1.Indiactions for isolation

2.Indications for barrier nursing in pneumonia

Describe and discuss the supportive therapy in patients with pneumonia including oxygen

IM 3.17

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

IM 3.18

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

SGD/DOAP

MICROBIOLOGY

TOPIC

FEVER AND FEBRILE SYNDROMES

Describe and discuss the febrile response and the influence of host immune status, risk

IM 4.1

factors and comorbidities on the febrile response

OBJECTIVES

1.Definition of febrile response

2.Host immune status and risk factors

3.Comorbidities in febrile reponse

Describe and discuss the influence of special populations on the febrile response

IM 4.2

including: the elderly, immune suppression, malignancy and neutropenia, HIV and travel

OBJECTIVES

1.Febrile response in elderly and immunosupressed

2.Febrile response in in malignancy and neutropenia

3.Febrilke response in HIV and travel

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

that includes the evolution and pattern of fever, associated symptoms, immune status,

comorbidities, risk factors, exposure through occupation, travel and environment and

IM 4.9

medication use

OBJECTIVES

1.History and pattern of fever

2.Risk factors and associated symptoms

FEVER - FEBRILE RESPONSE,HISTORY, RISKFACTORS ,IMMUNE STATUS AND ASSOCIATED

SYMPTOMS

LECTURE/SGD

MICROBIOLOGY

Discuss and describe the common causes, pathophysiology and manifestations of fever in

various regions in India including bacterial, parasitic and viral causes (e.g.Dengue,

IM 4.3

Chikungunya, Typhus)

OBJECTIVES

1. Comon causes of fever

2.Pathophysiology of fever

3.Manifestations of fever in various regions in India

Describe and discuss the pathophysiology and manifestations of inflammatory causes of

IM 4.4

fever

OBJECTIVES

1.Inflammatory causes of fever

2.Pathophysiology

Describe and discuss the pathophysiology and manifestations of malignant causes of fever

IM 4.5

including hematologic and lymph node malignancies

OBJECTIVES

1.Malignant cause of fever

2.Pathophysiology and manifestations

DENGUE FEVER

LECTURE

MICROBIOLOGY

CHIKUNGUNYA

LECTURE

MICROBIOLOGY

TYPHUS

LECTURE

MICROBIOLOGY

ENTERIC FEVER

LECTURE

MICROBIOLOGY

FEVER IN MALIGNANCIES

LECTURE

PATHOLOGY

IM 4.6

Discuss and describe the pathophysiology and manifestations of malaria

OBJECTIVES

1.PATHOPHYSIOLOGY

2.Clinical Manifestations of malaria

IM 4.7

Discuss and describe the pathophysiology and manifestations of the sepsis syndrome

OBJECTIVES

1. Clinical manifestations of sepsis syndrome

2.Various causes of sepsis

3.Pathophysiology

IM 4.15

Perform and interpret a malarial smear

OBJECTIVES

1.Preparartion of Malarial smear

2.Staining pattern

3.Identification of malarial parasite

Describe and discuss the pharmacology, indications, adverse reactions, interactions of

IM 4.22

antimalarial drugs and basis of resistance

OBJECTIVES

1. Indications and interaction of anti-malarial drugs

2.Adverse reactions

3.Drug resistance

Prescribe drugs for malaria based on the species identified, prevalence of drug

IM 4.23

resistance and national programs

OBJECTIVES

1.Drug therapy based on species identification

2.Prevalence of drug resistance in India

3.National malaria Programmes

IM 4.26

Counsel the patient on malarial prevention

OBJECTIVES

1.Counselling of malarial prevention

MALARIA - PATHOPHYSIOLOGY , CLINICAL FEATURES , MANAGEMENT AND NATIONAL

MICROBIOLOGY AND

PROGRAMMES

LECTURE

COMMUNITY MEDICINE

SEPSIS SYNDROME - MANIFESTATIONS AND MANAGEMENT

LECTURE

Discuss and describe the pathophysiology, aetiology and clinical manifestations of

fever of unknown origin (FUO) including in a normal host, neutropenic host,

IM 4.8

nosocomial host and a host with HIV disease

OBJECTIVES

1.Etiology and clinical manifestations of FUO

2.Pathophysiology of FUO

3. Various manifestations in special situations like nosocomial host/ HIV

FEVER OF UNKNOWN ORIGIN

LECTURE

Perform a systematic examination that establishes the diagnosis and severity of

presentation that includes: general skin mucosal and lymph node examination, chest and

IM 4.10

abdominal examination (including examination of the liver and spleen)

OBJECTIVES

1.General Examination/lymphnode

2.Systemic examination - chest,liver and spleen

Generate a differential diagnosis and prioritise based on clinical features that help

IM 4.11

distinguish between infective, inflammatory, malignant and rheumatologic causes

OBJECTIVES

1.Differential diagnosis of fever

2. Clinical features of various fevers

CLINICAL EXAMINATION AND DIFFERENTIAL DIAGNOSIS OF FEVER

SMALL GROUP DISCUSSION

Order and interpret diagnostic tests based on the differential diagnosis including: CBC

with differential, peripheral smear, urinary analysis with sediment, Chest X ray, blood and

urine cultures, sputum gram stain and cultures, sputum AFB and cultures, CSF analysis,

IM 4.12pleural and body fluid analysis, stool routine and culture and QBC

OBJECTIVES

1.CBC,peripheral smear study

2.Urine analysis

3.Chest X-ray

4.Blood and urine cultures

5.AFB,Gram stain culture

6.CSF analysis and culture

7.Pleural fluid analysis and culture

8.Stool routine and culture

IM 4.13

Perform and interpret a sputum gram stain

OBJECTIVES

1.Preparation of sputum smear gram staining

2.Interpretation

IM 4.14

Perform and interpret a sputum AFB

OBJECTIVES

1.Preparation of sputum AFB technique

2.Interpretation of sputum AFB

INVESTIGATIONS BASED ON DIFFERENTIAL DIAGNOSIS IN FEVER

LECTURE

Enumerate the indications and describe the findings in tests of inflammation and

specific rheumatologic tests, serologic testing for pathogens including HIV, bone

IM 4.16

marrow aspiration and biopsy

OBJECTIVES

1.Specific serology for HIV

2.Specific testing for Rheumatological disease,bone marrow biopsy and culture

Observe and assist in the performance of a bone marrow aspiration and biopsy in

IM 4.17

a simulated environment

OBJECTIVES

1.Preparation of bone marrow aspirations

2.Indications and contra-indications

3.Observe bone marrow biopsy procedure

Enumerate the indications for use of imaging in the diagnosis of febrile syndromes

IM 4.18

OBJECTIVES

1.Imaging modalities like USG,CT/MRI Brain and spine

IM 4.19

Assist in the collection of blood and wound cultures

OBJECTIVES

1.Collection of blood sample and wound secretions for culture

IM 4.20

Interpret a PPD (Mantoux)

OBJECTIVES

1. Indications for mantoux

2.Interpretation of mantoux

SPECIAL INVESTIGATIONS AND IMAGING IN FEVER

LECTURE/SGD

RADIOLOGY

Develop and present an appropriate diagnostic plan based on the clinical

IM 4.21

presentation, most likely diagnosis in a prioritised and cost effective manner

OBJECTIVES

1.Diagnosis based on clinical findings and investigations

2. Cost effective management

IM 4.25

Communicate to the patient and family the diagnosis and treatment

OBJECTIVES

1.Communication regarding the disease to family

2. Treatment plan and prognosis

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/PHYSIOL

LIVER FUNCTIONS AND BIOCHEMICAL CHANGES IN LIVER INJURY

LECTURE/SGD

OGY

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,

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

IM 5.12

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

MICROBIOLOGY

Describe and discuss the pathophysiology and clinical evolution of alcoholic liver

IM 5.5

disease

OBJECTIVES

1. Pathophysiology

2. Clinical evaluation of alcholic liver disease

Describe and discuss the pathophysiology, clinical evolution and complications of

cirrhosis and portal hypertension including ascites, spontaneous bacterial

IM 5.6

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 of

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

IM 5.9

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 that

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

IM 5.10

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 COMPLICATIONS

LECTURE/SGD

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

GENERAL 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, liver

IM 5.14

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

SGD

RADIODIAGNOSIS

Describe and discuss the management of hepatitis, cirrhosis, portal hypertension,

IM 5.16

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 AND IT'S COMPLICATIONS

LECTURE

PHARMACOLOGY

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

MICROBIOLOGY

LIVER TRANSPLANTATION

LECTURE/SGD

TOPIC

HIV

IM 6.1

Describe and discuss the symptoms and signs of acute HIV seroconversion

OBJECTIVES

1.Symptoms and signs of acute HIV

2.seroconversion of HIV

IM 6.2

Define and classify HIV AIDS based on the CDC criteria

OBJECTIVES

1.Defininition of HIV-AIDS

2.Classification of HIV AIDS based on CDC CRITERIA

DEFINITION OF HIV AND CLASSIFICATION

LECTURE/SGD

Describe and discuss the relationship between CDC count and the risk of opportunistic

IM 6.3

infections

OBJECTIVES

1.CDC count and risk of oppurtunistic infection

2.Types of oppurtunistic infections

Describe and discuss the pathogenesis, evolution and clinical features of common HIV

IM 6.4

related opportunistic infections

OBJECTIVES

1.Pathogenesis of oppurtunistic infections

2.Clinical features of oppurtunistic infections

HIV AND OPPURTUNISTIC INFECTIONS

LECTURE/SGD

MICROBIOLOGY

Describe and discuss the pathogenesis, evolution and clinical features of common HIV

IM 6.5

related malignancies

OBJECTIVES

1.Pathogenesis of HIV related Malignancies

2.Clinical features of HIV related Malignancies

4.severity of pneumonia

HIV AND MALIGNANCIES

LECTURE /SGD

PATHOLOGY

Describe and discuss the pathogenesis, evolution and clinical features of common HIV

IM 6.6

related skin and oral lesions

OBJECTIVES

1.Pathogenesis of HIV related Skin diseases

2.Clinical features of Skin and Oral lesions

HIV - SKIN AND ORAL DISEASES

LECTURE/SGD

DERMATOLOGY

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

current presentation and includes risk factors for HIV, mode of infection, other sexually

IM 6.7

transmitted diseases, risks for opportunistic infections and nutritional status

OBJECTIVES

1.Medical history elicitation

2.Etiology

3.Risk factors

4.Mode of transmission

5.Opportunistic infection and nutritional status

Generate a differential diagnosis and prioritise based on clinical features that suggest a

IM 6.8

specific aetiology for the presenting symptom

OBJECTIVES

1.Differential diagnosis based on symotoms and clinical features

HIV-HISTORY,ETIOLOGY,CLINICAL FEATURES,MODE OF TRANSMISSION/DD

SGD/DOAP

Choose and interpret appropriate diagnostic tests to diagnose and classify the severity of

IM 6.9

HIV-AIDS including specific tests of HIV, CDC

OBJECTIVES

1.HIV specific test

Choose and interpret appropriate diagnostic tests to diagnose opportunistic infections

including CBC, sputum examination and cultures, blood cultures, stool analysis, CSF

IM 6.10

analysis and Chest radiographs

OBJECTIVES

1.Blood Investigations-CBC,Blood culture

2.Sputum examination-Culture,AFB

3.CSF analysis and culture

4.Chest X-ray

5.Stool examination

IM 6.11

Enumerate the indications and describe the findings for CT of the chest and brain and MRI

OBJECTIVES

1.Indication for CT-Brain/Chest and MRI

Enumerate the indications for and interpret the results of: pulse oximetry, ABG, Chest

IM 6.12

Radiograph

OBJECTIVES

1.Indication for ABG, chest X-Ray

2.Interpretation of pulsoxymetry

IM 6.14

Perform and interpret AFB sputum

OBJECTIVES

1.Sputum,staining for AFB and interpretation

HIV INVESTIGATIONS

SGD/DOAP

MICROBIOLOGY

Describe and enumerate the indications and side effects of drugs for bacterial, viral and

IM 6.13

other types of diarrhea

OBJECTIVES

1.Types of diarrheoa

2.Indications and side effects of the drugs for diarrheoa

HIV AND DIARRHOEAL DISEASE

LECTURE/SGD

OBJECTIVES

1.Indications for hospitalisation and management

IM 6.15

Demonstrate in a model the correct technique to perform a lumbar puncture

OBJECTIVES

1.Indiactions for lumbar puncture

2.Diagnostic use of CSF analysis in HIV

HIV - CSF EXAMINATION

DOAP

Discuss and describe the principles of HAART, the classes of antiretrovirals used, adverse

IM 6.16

reactions and interactions

OBJECTIVES

1 Principles of HAART

2.Anti-retroviral drugs

3.Drug adverse reaction and interactions

IM 6.17

Discuss and describe the principles and regimens used in post exposure prophylaxis

OBJECTIVES

1.Post- exposure prophylaxis regimens

2.Principles of drug regime

Enumerate the indications and discuss prophylactic drugs used to prevent HIV related

IM 6.18

opportunistic infections

OBJECTIVES

1.Prophylactic drugs to prevent opportunistic infections

HIV - MANAGEMENT

LECTURE/SGD

PHARMACOLOGY

IM 6.19

Counsel patients on prevention of HIV transmission

OBJECTIVES

1.Counselling the patient for HIV transmission prevention

2.Explaining the importance of prevention of the disease

IM 6.20

Communicate diagnosis, treatment plan and subsequent follow up plan to patients

OBJECTIVES

1.Explaing the importance of the treatment plan

2.Importance of follow up to control the infection

IM 6.21

Communicate with patients on the importance of medication adherence

OBJECTIVES

1.Explaing the importance of taking regular medications

COUNSELLING TO THE HIV PATIENT AND FOLLOW UP THERAPY

DOAP

AETCOM

Demonstrate understanding of ethical and legal issues regarding patient confidentiality

IM 6.22

and disclosure in patients with HIV

OBJECTIVES

1.Explaining the ethical issues

2.Creating awarness for legal issues regarding patient's confidentiality

IM 6.23

Demonstrate a non-judgemental attitude to patients with HIV and to their lifestyles

OBJECTIVES

1.Demonstrating the life style of the patient

2.Non-judgemental attitude to patients

HIV-ETHICAL AND LEGAL ISSUES AND CREATING AWARENESS OF LIFESTYLE

SGD/DOAP

AETCOM

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 from

IM 7.6

inflammatory causes of joint pain

OBJECTIVES

1.Difference between arthralgia and arthritis

2.Mechanical and inflammatory causes of joint pain

IM 7.7

Discriminate, describe and discuss distinguishing articular from periarticular complaints

OBJECTIVES

1. Difference between articular and periarticular complaints

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

IM 7.8

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

ORTHOPAEDICS

IM 7.9

Describe the common signs and symptoms of articular and periarticular 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.Osteoposrosis- 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

10.Osteomalacia and rickets - Definition, Etiology, pathogenesis and manifestations

SYSTEMIC LUPUS ERTHYEMATOSUS

LECTURE

RHEUMATOID ARTHRITIS

LECTURE

OSTEOPOROSIS

LECTURE

ORTHOPAEDICS

100

SERO NEGATIVE ARTHRITIS

LECTURE

101

ANKYLOSING SPONDYLITIS

LECTURE

102

SYSTEMIC SCLEROSIS

LECTURE

103

SJOGREN'S SYNDROME

LECTURE

104

POLYMYOSITIS AND DERMATOMYOSITIS

LECTURE

105

OSTEOMALACIA AND RICKETS

LECTURE

Elicit document and present a medical history that will differentiate the aetiologies of

IM 7.11

disease

OBJECTIVES

1.History to differentiate Rheumatological diseaseS

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

IM 7.12

diagnosis and severity of disease

OBJECTIVES

1.Examination of skin in rheumatology

2.Examination of muscle and all joints for diagnosis

106

RHEUMATOLOGICAL DISEASE - HISTORY AND CLINICAL EXAMINATION

SMALL GROUP DISCUSSION

Generate a differential diagnosis and prioritise based on clinical features that suggest a

IM 7.13

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

107

RHEUMATOLOGICAL DISEASE - DIFFERENTIAL DIAGNOSIS AND DIAGNOSTIC PLAN

LECTURE/SGD

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

IM 7.15

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

108

RHEUMATOLOGICAL DISEASES- INVESTIGATIONS

LECTURE

RADIOLOGY

IM 7.18

Communicate diagnosis, treatment plan and subsequent follow up plan to patients

OBJECTIVES

1.Diagnosis and treatment plan

2.Communication of the plan to patients

IM 7.19

Develop an appropriate treatment plan for patients with rheumatologic diseases

OBJECTIVES

1.Treatment plan for diseases

IM 7.20

Select, prescribe and communicate appropriate medications for relief of joint pain

OBJECTIVES

1.Selection of appropriate medications for joint pain

2. Prescription and proper communication

IM 7.21

Select, prescribe and communicate preventive therapy for crystalline arthropathies

OBJECTIVES

1.Selection of preventive therapy for crystalline arthropathies

2.Prescription and proper communication

Select, prescribe and communicate treatment option for systemic rheumatologic

IM 7.22

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

109

TREATMENT PLAN AND DRUG THERAPY IN RHEUMATOLOGICAL DISEASES

LECTURE

PHARMACOLOGY

Develop and communicate appropriate follow up and monitoring plans for patients

IM 7.25

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 quality of

IM 7.26

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

110

RHEUMATOLOGICAL DISEASES- FOLLOW UP,COUNSELLING AND REHABILITATION

LECTURE

TOPIC

HYPERTENSION

Describe and discuss the epidemiology, aetiology and the prevalence of primary

IM 8.1

and secondary hypertension

OBJECTIVES

1. Primary / Secondary Hyper tension Epidemiology

2. Aetiology of Hyper tension

3. Prevalence of Hyper tension

IM 8.2

Describe and discuss the pathophysiology of hypertension

OBJECTIVES

Pathophysiology of hypertension

IM 8.3

Describe and discuss the genetic basis of hypertension

OBJECTIVES

Genetic basis of hypertension

PATHOLOGY AND

111

HYPERTENSION - EPIDEMIOLOGY, PATHO PHYSIOLOGY, GENETIC BASIS

LECTURE/SGD

PHYSIOLOGY

IM 8.4

Define and classify hypertension

OBJECTIVES

1. Definition of hypertension

2. Classification of hypertension

Describe and discuss the differences between primary and secondary hypertension

IM 8.5

OBJECTIVES

1. Difference between primary and secondary hypertension

HYPERTENSION CLASSIFICATION, DIFFERENCE BETWEEN PRIMARY AND SECONDARY

112

HYPERTENSION

LECTURE/SGD

PATHOLOGY

Define, describe and discuss and recognise hypertensive urgency and emergency

IM8.6

OBJECTIVES

1. Emergencies of uncontrolled hypertension

2. Urgency of uncontrolled hypertension

IM8.8

Describe, discuss and identify target organ damage due to hypertension

OBJECTIVES

1. Identify target organ damage

2. Etiopatho genis

Describe and discuss the clinical manifestations of the various aetiologies of

IM 8.7

secondary causes of hypertension

OBJECTIVES

1. Aetiologies of secondary hypertension

2. Clinical Presentation

113

HYPERTENSIVE EMERGENCY , URGENCY AND SECONDARY HYPERTENSION

LECTURE/SGD

PATHOLOGY

Elicit document and present a medical history that includes: duration and levels,

symptoms, comorbidities, lifestyle, risk factors, family history, psychosocial and

environmental factors, dietary assessment, previous and concomitant therapy

IM8.9

OBJECTIVES

1. History of hypertension

2. Symptoms of hypertension

3. Risk factors of hypertension

4. Comorbidities of hypertension

5. Dietary Assessment

Perform a systematic examination that includes : an accurate measurement of

blood pressure, fundus examination, examination of vasculature and heart

IM 8.10

OBJECTIVES

1. Measurement of blood pressure

2. Physical Examination of Vascular System and Heart

3. Fundus examination

Generate a differential diagnosis and prioritise based on clinical features that

IM 8.11

suggest a specific aetiology

OBJECTIVES

1. Differential diagnosis of hypertension

2. Specific Aetiology for DD

HYPERTENSION-HISTORY , RISK FACTORS, CLINICAL FEATURES AND DIFFERNTIAL

114

DIAGNOSIS .

LECTURE/SGD

Describe the appropriate diagnostic work up based on the presumed aetiology

IM 8.12

OBJECTIVES

1. Investigation based on aetiology

Enumerate the indications for and interpret the results of : CBC, Urine routine,

IM 8.13

BUN, Cr, Electrolytes, Uric acid, ECG

OBJECTIVES

1. Blood investigation - CBC, BUN, Cr, Electrolytes, Uric acid

2. ECG - Recording and interpretation

3. Urine Routine

IM 8.17

Perform and interpret a 12 lead ECG

Objective:

1. ECG - Recording and interpretation

115

HYPERTENSION - INVESTIGATIONS

SGD

IM 8.14

Develop an appropriate treatment plan for essential hypertension

OBJECTIVES

1. Treatment plan for Primary Hypertension

2. Drug therapy and dieatry advice

IM 8.15

Recognise, prioritise and manage hypertensive emergencies

OBJECTIVES

1. Hypertensive emergency - effective Management

Develop and communicate to the patient lifestyle modification including weight

reduction, moderation of alcohol intake, physical activity and sodium intake

IM 8.16

OBJECTIVES

1. Life style modification - weight reduction, moderate alchohol intake

2. Increasing physical activity, decrease sodium intake

IM 8.17

Incorporate patient preferences in the management of HTN

OBJECTIVES

1. Priority and preferrences in treatment of hypertension

116

HYPERTENSION MANAGEMENT

LECTURE

PHARMACOLOGY

Demonstrate understanding of the impact of Hypertension on quality of life, well

IM 8.19

being, work and family

OBJECTIVES

1. Impact of Hypertension on quality of life

2. Importance of following drug therapy and advise to the family

IM 8.20

Determine the need for specialist consultation

OBJECTIVES

1. Importance of specialist consultation

2. To reduce morbidity and mortality

HYPERTENSION ADVISE TO REDUCE MORBIDITY AND MORTALITY

117

DOAP/SGD

TOPIC

ANEMIAS

Define, describe and classify anemia based on red blood cell size and reticulocyte

IM9.1

count

OBJECTIVES

1.Definition for anemia

2.Classification based on morphology of RBC and reticulocyte

Describe and discuss the morphological characteristics, aetiology and prevalence

IM9.2

of each of the causes of anemia

OBJECTIVES

1.Description of morphology of blood cells

2.Etiological classification of anemia

3.Nutritional deficiency anemias - Etiology and pathogenesis

4.Hemoglobinopathies and Hemolytic anemias - Etiology and pathogenesis

5.Anemia of blood loss -Etiology and pathogenesis

Elicit document and present a medical history that includes symptoms, risk factors

including GI bleeding, prior history, medications, menstrual history, and family

IM9.3

history

OBJECTIVES

1.Medical history relate to anemia

2.Symptom analysis and risk factors

Perform a systematic examination that includes : general examination for pallor,

oral examination, DOAP session of hyper dynamic circulation, lymph node and

IM9.4

splenic examination

OBJECTIVES

1.General Physical examination

2.Examination of abdomen and lymphnodes and abdomen

Generate a differential diagnosis and prioritise based on clinical features that

IM9.5

suggest a specific aetiology

OBJECTIVES

1.Clinical features based on etiology

2.Differential diagnosis

118

ANEMIA - CLASSIFICATION , ETIOLOGY AND HISTORY

LECTURE/DOAP

ANEMIA - HISTORY,PHYSICAL EXAMINATION AND DIFFERENTIAL

119

SGD/DOAP

120

NUTRITIONAL ANEMIAS - IRON DEFICIENCY ANEMIA

LECTURE/DOAP

PATHOLOGY

121

NUTRITIONAL ANEMIAS - MEGALOBLASTIC ANEMIA

LECTURE/DOAP

PATHOLOGY

122

HEMOGLOBINOPATHIES

LECTURE/DOAP

PATHOLOGY

123

HEMOLYTIC ANEMIA

LECTURE/DOAP

PATHOLOGY

124

SECONDARY ANEMIAS

LECTURE/DOAP

PATHOLOGY

Describe the appropriate diagnostic work up based on the presumed aetiology

IM9.6

OBJECTIVES

1.Diagnostic plan based on etiology

Describe and discuss the meaning and utility of various components of the

IM9.7

hemogram

OBJECTIVES

1.interpretation of peripheral blood smear study

Describe and discuss the various tests for iron deficiency

IM9.8

OBJECTIVES

1.Biochemical analysis - serum iron,serum ferritin,TIBC

2.Peripheral blood smear

Order and interpret tests for anemia including hemogram, red cell indices,

IM9.9

reticulocyte count, iron studies, B12 and folate

OBJECTIVES

1.Hematological indices interpretation

2.Iron,B12 and folate assay

Describe, perform and interpret a peripheral smear and stool occult blood

IM9.10

OBJECTIVES

1.Preparation of peripheral blood smear

2.PS study and interpretation

3.Stool examination for occult blood

Describe the indications and interpret the results of a bone marrow aspirations and

IM9.11

biopsy

OBJECTIVES

1.Indicattions and contraindications for bone marrow study

2.Permforming bone marrow biopsy

3.Interpretation of bone marrow study

IM9.12

Describe, develop a diagnostic plan to determine the aetiology of anemia

OBJECTIVES

1.Diagnostic plan based on etiology

ANEMIA INVESTIGATIONS- HEMOGRAM, AND PERIPHERAL BLOOD SMEAR

PATHOLOGY

125

LECTURE /DOAP

/BIOCHEMISTRY

126

BONE MARROW BIOPSY

LECTURE /DOAP

PATHOLOGY

ANEMIA INVESTIGATIONS - SPECIAL INVESTIGATIONS BASED ON

ETIOLOGY

127

LECTURE /DOAP

BIOCHEMISTRY

IM9.13

Prescribe replacement therapy with iron, B12, folate

OBJECTIVES

1.Iron replacement therapy

2.B12 and folate replacement therapy

IM9.14

Describe the national programs for anemia prevention

OBJECTIVES

1.National anemia programmes

IM9.15

Communicate the diagnosis and the treatment appropriately to patients

OBJECTIVES

1.Counsel the patient regarding diagnosis

2.Counsel the patient regarding therapy

IM9.16

Incorporate patient preferences in the management of anemia

OBJECTIVES

1.Incorporating patients preferance in therapy

NUTRITIONAL DEFICIENCY ANEMIA- MANAGEMENT AND NATIONAL

128

ANEMIA PROGRAMMES

LECTURE

COMMUNITY MEDICINE

Describe the indications for blood transfusion and the appropriate use of blood

IM9.17

components

OBJECTIVES

1.Indications for blood transfusion

2.Componenets of blood transfusion

Describe the precautions required necessary when performing a blood transfusion

IM9.18

OBJECTIVES

1.Preparation of the patient for blood transfusion

2.Observation of Tranfusion reactions

IM9.19

Assist in a blood transfusion

OBJECTIVES

1.Monitoring the vitals

2.Maintenance of blood transfusion chart

129

ANEMIA - BLOOD COMPONENTS TRANSFUSION

LECTURE

PATHOLOGY

Communicate and counsel patients with methods to prevent nutritional anemia

IM9.20

OBJECTIVES

1.Counselling to correct nutritional anemia

2.Dietary advice

3.Personal hygiene

IM9.21

Determine the need for specialist consultation

OBJECTIVES

1.Early detection of anemia to prevent complications

2.Management of complicated anemia

COUNSELLING FOR CORRECTION OF NUTRITIONAL ANEMIA AND SPECIALIST

130

CONSULTATION

DOAP

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

IM 10.2

Classify, describe and differentiate the pathophysiologic causes of acute renal failure

OBJECTIVES

1.Classification of acute renal failure(ARF)

2.Pathophysiology

3.Causes

IM 10.3

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

131

PRESENTATION

LECTURE/SGD

PATHOLOGY

132

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

133

CHRONIC RENAL FAILURE- ETIOPATHOGENESIS,STAGING AND UREMIA

LECTURE/SGD

PATHOLOGY

134

CHRONIC RENAL FAILURE AND PROTEINURIA

LECTURE/SGD

PATHOLOGY

IM 10.9

Describe and discuss the pathophysiology of anemia and hyperparathyroidism 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

IM 10.11

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

OBJECTIVES

1.CAD risk factors in CKD

2.CAD riskfactors in Dialysis

135

ANEMIA AND HYPERPARATHYROIDISM IN CKD

LECTURE

136

HYPERTENSION AND HYPERGLYCEMIA IN CKD

LECTURE

137

CAD RISK FACTORS IN CKD IN DIALYSIS

LECTURE/SGD

Elicit document and present a medical history that will differentiate the aetiologies of

disease, distinguish acute and chronic disease, identify predisposing conditions,

IM 10.12

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 including

determination of volume status, presence of edema and heart failure, features of uraemia

IM 10.13

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 suggest a

IM 10.14

specific aetiology

OBJECTIVES

1.Clinical features specific to the etiology

2.Differential diagnosis

138

SYSTEMIC DISEASES AND NEPHROTOXIC DRUGS IN CKD

LECTURE/SGD

139

CRF CLINICAL PRESENTATION,PREDISPOSING CONDITIONS,DIFFENTIAL DIAGNOSIS

LECTURE/SGD

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, calcium,

IM 10.16

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 including

IM 10.17

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: interpret the

IM 10.20

data

OBJECTIVES

1.Indication to perform ABG analysis

2.Interpretation of ABG

140

RENAL FAILURE- HEMATOLOGICAL INVESTIGATIONS

SGD

PATHOLOGY

141

RENAL FAILURE- NON-INVASIVE AND SPECIAL INVESTIGATIONS

SGD

RADIOLOGY

142

KIDNEY BIOPSY AND ITS INTERPRETATION

DOAP

IM 10.21

Describe and discuss the indications for and insert a peripheral intravenous catheter

OBJECTIVES

1.Indications for Peripheral venous catheter

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

IM 10.22

a central venous or a dialysis catheter

OBJECTIVES

1.Indications for insertion of Central venous catheter

IM 10.23

Communicate diagnosis treatment plan and subsequent follow up plan to patients

OBJECTIVES

1.Councelling for diagnosis and treatment plan

2.Councelling for followup plan

IM 10.24

Counsel patients on a renal diet

OBJECTIVES

1.Councelling for Renal diet

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

IM 10.25

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 hypertensives,

glycemic therapy, dyslipidemia, anemia, hyperkalemia, hyperphosphatemia and

IM 10.26

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

IM 10.30

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

1.IncorporatIing patient preferences in CKD patients

143

CONSERVATIVE MANAGEMENT OF CHRONIC RENAL FAILURE

LECTURE/SGD

PHARMACOLOGY

144

DIALYSIS - RENAL REPLACEMENT THERAPY

SGD

145

CENTRAL VENOUS CATHETERISATIONA AND PERIPHERAL ACCESS IN DIALYSIS

DOAP

146

DIET AND COUSELLING FOR CHRONIC RENAL FAILURE

DOAP

147

RENAL TRANSPLANTATION

LECTURE

TOPIC

DIABETES MELLITUS

IM11.1

Define and classify diabetes

OBJECTIVES

1.Definition of Diabetes Mellitus

2.Classification of diabetes mellitus

Describe and discuss the epidemiology and pathogenesis and risk factors and

clinical evolution of type 1 diabetes

IM11.2

OBJECTIVES

1.Epidemiology of Type 1 Diabetes

2.Pathogenesis and risk factors

3.Clinical evolution

DIABETES MELLITUS - DEFINITION ,CLASSIFICATION AND TYPE 1 DM

148

LECTURE

PATHOLOGY

Describe and discuss the epidemiology and pathogenesis and risk factors

IM11.3

economic impact and clinical evolution of type 2 diabetes

OBJECTIVES

1.Epidemiology of Type 2 Diabetes

2.Pathogenesis and risk factors

3.Clinical evolution

Describe and discuss the genetic background and the influence of the environment

IM11.4

on diabetes

OBJECTIVES

1.Genetic basis in Diabetes

2.Influence of environment on diabetes

TYPE 2 DIABETES MELLITUS -EPIDEMIOLOGY,PATHOGENESIS AND

149

GENETIC BASIS

LECTURE

PATHOLOGY

TYPE 2 DIABETES MELLITUS -RISK FACTORS AND CLINICAL EVOLUTION

150

LECTURE

PATHOLOGY

Describe and discuss the pathogenesis and temporal evolution of microvascular

IM11.5

and macrovascular complications of diabetes

OBJECTIVES

1.Pathogenesis and evolution of microvascular complications in DM

2.Pathogenesis ans evolution of macrovascular complications in DM

MICRO AND MACRO VASCULAR COMPLICATIONS IN DIABETES MELLITUS

151

LECTURE

PATHOLOGY

Describe and discuss the pathogenesis and precipitating factors, recognition and

IM11.6

management of diabetic emergencies

OBJECTIVES

1.Enumerate the various diabetic emergencies

2.Pathogenesis of diabetic emergencies

3.Precipitating factors in Diabetic emergencies

4.Management of Diabetic emergencies

Describe and recognise the clinical features of patients who present with a diabetic

IM11.9

emergency

OBJECTIVES

1.Clinical features of Diabetic keto acidosis

2.Clinical features of HHS

Recognise the presentation of hypoglycaemia and outline the principles on its

IM11.14

therapy

OBJECTIVES

1.Definition of hypoglycemia

2.Presentation of hypoglycemia

3.Management of hypoglycemia

Recognise the presentation of diabetic emergencies and outline the principles of

IM11.15

therapy

OBJECTIVES

1.Presentation and management of Diabetic keto acidosis

2.Presentation and management of HHS

152

DIABETIC EMERGENCIES - AN OVERVIEW

LECTURE

Elicit document and present a medical history that will differentiate the aetiologies

of diabetes including risk factors, precipitating factors, lifestyle, nutritional history,

family history, medication history, co-morbidities and target organ disease

IM11.7

OBJECTIVES

1.Medical history in diabetes mellitus

2.Family history

3.Life style and nutritional history

Perform a systematic examination that establishes the diagnosis and severity that

includes skin, peripheral pulses, blood pressure measurement, fundus

examination, detailed examination of the foot (pulses, nervous and deformities and

IM11.8

injuries)

OBJECTIVES

1.Examination of skin in diabetes

2.Examination of vitals

3.Examination of fundus

4.Examination of foot

Generate a differential diagnosis and prioritise based on clinical features that

IM11.10

suggest a specific aetiology

OBJECTIVES

1.Differential diagnosis based on clinical features

HISTORY AND EXAMINATION IN DIABETES MELLITUS AND DIFFERENTIAL

153

DIAGNOSIS

SGD

Order and interpret laboratory tests to diagnose diabetes and its complications

including: glucoses, glucose tolerance test, glycosylated hemoglobin, urinary micro

albumin, ECG, electrolytes, ABG, ketones, renal function tests and lipid profile

IM11.11

OBJECTIVES

1.Glucose and GTT significance

2.HbA1C significance

3.Urinary microalbumin significance

4.ECG significance

5.RFT and electrolytes in Diabetes

6.ABG and lipid profile significance

IM11.12

Perform and interpret a capillary blood glucose test

OBJECTIVES

1.Observe and perform capillary blood glucose test

2.Interpretation of CBG

IM11.13

Perform and interpret a urinary ketone estimation with a dipstick

OBJECTIVES

1.Observe and perform urine dipstick test for ketones

2.Interpretatation of dipstick test

154

DIABETES MELLITUS - INVESTIGATIONS

LECTURE / SGD

BIOCHEMISTRY

Discuss and describe the pharmacologic therapies for diabetes their indications,

IM11.16

contraindications, adverse reactions and interactions

OBJECTIVES

1.Drug therapy- indications and contraindications in diabetes

2.Drug interactions

3.Drug adverse reaction

Outline a therapeutic approach to therapy of T2Diabetes based on presentation,

IM11.17

severity and complications in a cost effective manner

OBJECTIVES

1.Therapy based on presentation in diabetes

2.Therapy based on severity and complications in diabetes

Describe and discuss the pharmacology, indications, adverse reactions and

interactions of drugs used in the prevention and treatment of target organ damage

and complications of Type II Diabetes including neuropathy, nephropathy,

retinopathy, hypertension, dyslipidemia and cardiovascular disease

IM11.18

OBJECTIVES

1.Drug therapy in treatment of Target organ damage

2.Micro vascular and macrovascular complications in DM

155

DRUG THERAPY IN DIABETES MELLITUS

LECTURE

PHARMACOLOGY

Demonstrate and counsel patients on the correct technique to administer insulin

IM11.19

OBJECTIVES

1.Insulin therapy in diabetes

2.Observe correct technique to administer insulin

3.Perform and counsel correct technique to administer insulin

Demonstrate to and counsel patients on the correct technique of self monitoring of

IM11.20

blood glucoses

OBJECTIVES

1.Demonstrating the correct technique of self monitoring of CBG

2.Counselling

Recognise the importance of patient preference while selecting therapy for diabetes

IM11.21

OBJECTIVES

1.Selection of drug therapy for patients

156

INSULIN THERAPY AND COUNSELLING

LECTURE

PHARMACOLOGY

Enumerate the causes of hypoglycaemia and describe the counter hormone

IM11.22

response and the initial approach and treatment

OBJECTIVES

1.Causes of Hypoglycemia

2.Counter hormone response in hypoglycemia

3.Treatment of Hypoglycemia

157

HYPOGLYCEMIA - AN OVERVIEW

LECTURE

Describe the precipitating causes,pathophysiology, recognition, clinical features,

IM11.23

diagnosis, stabilisation and management of diabetic ketoacidosis

OBJECTIVES

1.Definition of DKA

2.Precipitating factors in DKA

3.Pathophysiology and clinical features in DKA

4.Diagnosis of DKA

5.Management of DKA

158

DIABETIC KETO-ACIDOSIS

LECTURE

Describe the precipitating causes, pathophysiology, recognition, clinical features,

diagnosis, stabilisation and management of Hyperosmolar non ketotic state

IM11.24

OBJECTIVES

1.Definition of HHS

2.Precipitating factors of HHS

3.Pathophysiology and clinical features in HHS

4.Diagnosis of HHS

5.Management of HHS

159

HYPEROSMOLAR HYPERGLYCEMIC NON KETOTIC STATE

LECTURE

TOPIC

THYROID DYSFUNCTION

Describe the epidemiology and pathogenesis of hypothyroidism and

hyperthyroidism including the influence of iodine deficiency and autoimmunity in

IM 12.1

the pathogenesis of thyroid disease

Objective

1. Pathogenesis of hypothyroidism

2. Normal iodine requirement of the body

3. Iodine autoimmunity in the pathogenesis of thyroid disease.

4. Role of iodine deficience in thyroid disease

IM 12.2

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

Objective

1.Genetic basis of thyroid disfunction

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

principles of thyroid function testing and alterations in physiologic function

IM 12.3

Objective

1.Physiology of hypothalamopituitary - thyroid axis

2. Thyroid function and their importants

3. Functional Anatomy of thyroid gland

160

PHYSIOLOGY, EPIDEMIOLOGY, PATHOGENESIS OF THYROID DISORDER

LECTURE/SGD

PHYSIOLOGY

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 diagnosis

IM 12.5

cause of thyroid dysfunction and its severity

Objective

1. History of thyroid disorder - palpitation, bradycardia

2. History of hypo thyroid

3. History of thyrotoxic disorder

Perform and demonstrate a systematic examination based on the history that will

help establish the diagnosis and severity including systemic signs of thyrotoxicosis

and hypothyroidism, palpation of the pulse for rate and rhythm abnormalities, neck

IM 12.6

palpation of the thyroid and lymph nodes and cardiovascular findings

Objective

1. General physical examination

2. Palpation of thyroid gland

3. Palpation of limb nodes

4. Importance of examination of cardio vascular system

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 prioritise it

IM 12.8

based on the most likely diagnosis

Objective:

Differential diagnosis based on clinical features

161

THYROID DISORDER - HISTORY ,EXAMINATION AND DIFFERENTIAL DIAGNOSIS

LECTURE/SGD

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

3. Interpretation of thyroid function test and blood analysis

4. Radio iodine uptake interpretation

5. Thyroid scan 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.

3. Interpration of bradycardia and tachycardia

IM 12.11

Interpret thyroid function tests in hypo and hyperthyroidism

Objective:

1. Interpretation of thyroid function test

2. Interpretation of hyperthyroidism

3. Interpretation of hypothyroidism

162

THYROID DISORDER INVESTIGATIONS

LECTURE

IM 12.12

Describe and discuss the iodisation programs of the government of India

Objective:

1.National iodisation program

2. National goitore control program

163

NATIONAL IODISATION PROGRAM

SGD

COMMUNITY MEDICINE

Describe the pharmacology, indications, adverse reaction, interactions of thyroxine

IM 12.13

and antithyroid drugs

Objective:

1. Drug therapy of hypothyroidism

2. Interaction of thyroxine

3. Adverse reaction of antithyroid drugs

Write and communicate to the patient appropriately a prescription for thyroxine

IM 12.14

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

3. Observing follow of therapy based on clinical features

164

HYPOTHYROIDISM MANAGEMENT AND COUNSELLING

LECTURE/SGD

PHARMACOLOGY

Describe and discuss the indications of thionamide therapy, radio iodine therapy

IM 12.15

and surgery in the management of thyrotoxicosis

Objective:

1. Indications of thionamide therapy

2. Indications of radio iodine therapy

3. Medical management of thyrotoxicosis

4. Surgical management of thyrotoxicosis

5. Post operative care of thyroidectomy

165

MANAGEMENT OF HYPERTHYROIDISM AND THYROTOXICOSIS

LECTURE/SGD

PHARMACOLOGY

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

3. Risk factors - modifiable and inheritable

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

Objective:

1. Difference between infection and malignancies

2. Symptoms and signs of infection

3. Creteria to rule out malignan disorders

166

COMMON MALIGNANCIES AND GENETIC FACTORS

LECTURE/SGD

PATHOLOGY

COMMON MALIGNANCIES - EPIDEMIOLOGY, RISKFACTORS AND DIFFERENCE BETWEEN

PATHOLOGY AND

167

INFECTION AND CANCER

LECTURE/SGD

MICOBIOLOGY

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

patients with cancer

Objective:

1. Curative therapy

2. Palliative therapy care

3. Difference between curative and palliative therapy

168

COMMON MALIGNANCIES -HISTORY ,CLINICAL PRESENTATION AND COMPLICATIONS

SGD

169

CURATIVE AND PALLIATIVE CARE IN CANCER THERAPY

LECTURE/SGD

PHARMACOLOGY

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

3. Duration and evaluation of malignancy

Perform and demonstrate a physical examination that includes an appropriate

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

IM 13.8

complications of cancer

Objective:

1. General physical examination

2. Local examination for diagnosis

3. Assessment of extent of the disease

4. Complications of cancer

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

3. Technique for cervical examination

4. Pap smear technique

Generate a differential diagnosis based on the presenting symptoms and clinical

IM 13.10

features and prioritise based on the most likely diagnosis

Objective

1. Differential diagnosis based on symptom

2. Differential diagnosis bases on clinical features

3. Most likely diagnosis priority based symptoms and signs

170

SYMPTOM ANALYSIS AND CLINICAL DEMONSTRATION IN COMMON MALIGNANCIES

SGD

171

PHYSICAL EXAMINATION AND CLINICAL FEATURES OF COMMON MALIGNANCIES

SGD

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

3. Prostate specific antigen Assessment

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

IM 13.12

skin and tissue biopsies and tumor markers used in common cancers

Objective:

1. Indications for chest x-ray and interpretation

2. Mammogram and interpretation

3. Skin and tissue biopsies - histo pathological correlation

4. Tumor markers interpretation

172

INVESTIGATIONS OF COMMON MALIGNANCIES

LECTURE/SGD

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

3. Indications for surgery

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

IM 13.15

malignancies

Objective:

1. Screening for common malignancies prevention

2. Test available for the prevention of malignancies

173

MANAGEMENT OF COMMON MALIGNANCIES - ASSESSMENT FOR TYPE OF TREATMENT

LECTURE

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

2. Indications and uses of narcotic therapy

3. Side effect of narcotic therapy

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

3. Legal issues involved in end of life care

IM 13.19

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

Objective:

1. Priorities of therapy at end of life

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

the end of life

PHARMACOLOGY ,

MANAGEMENT OF COMMON MALIGNANCIES PAIN AND ETHICAL ISSUES IN END OF LIFE

ANESTHISIOLOGY AND

PATIENT CARE

174

SGD

AETCOM

TOPIC

OBESITY

IM14.1

Define and measure obesity as it relates to the Indian population

OBESITY

1.Definition of obesity

2.Body mass index(BMI)

3.Various methods to measure BMI

4.Measurents in obesity

Describe and discuss the aetiology of obesity including modifiable and non-

IM14.2

modifiable risk factors and secondary causes

OBESITY

1.Etiology of obesity

2.Modifiable risk factors

3.Non-modifiable risk factors

4.Secondary causes of obesity

IM14.3

Describe and discuss the monogenic forms of obesity

OBJECTIVES

1.Monogenic forms of obesity

175

BODY MASS INDEX AND OBESITY - DEFINITION AND ETIOLOGY

LECTURE

Describe and discuss the impact of environmental factors including eating habits,

food, work, environment and physical activity on the incidence of obesity

IM14.4

OBJECTIVES

1.Influence of food habits

2.Environmental factors in obesity

3.Role of Physical activity

IM14.5

Describe and discuss the natural history of obesity and its complications

OBJECTIVES

1.Natural history of obesity

2.Complications of obesity

OBESITY - PATHOPHYSIOLOGY,NATURAL HISTORY AND COMPLICATIONS

176

LECTURE

PATHOLOGY

Elicit and document and present an appropriate history that includes the natural

history, dietary history, modifiable risk factors, family history, clues for secondary

IM14.6

causes and motivation to lose weight

OBJECTIVES

1.Natural history of obesity

2.Dietary history in obesity

3.Modifiable risk factors in obesity

4.Family history in obesity

5.Secondary causes of obesity

6. Motivating the patient to lose weight

Perform, document and demonstrate a physical examination based on the history

that includes general examination, measurement of abdominal obesity, signs of

IM14.7

secondary causes and comorbidities

OBJECTIVES

1.General Clinical examination in obesity

2.Anthropometric measurements

3.Measurement of abdominal obesity

4.Signs in obesity

5.Comorbidities in obesity

Generate a differential diagnosis based on the presenting symptoms and clinical

IM14.8

features and prioritise based on the most likely diagnosis

OBJECTIVES

1.Differential diagnosis based on symptoms

2.Differential diagnosis based on clinical features

OBESITY -HISTORY,CLINICAL EXAMINATION AND DIFFERENTIAL

177

DIAGNOSIS

SGD

Order and interpret diagnostic tests based on the clinical diagnosis including blood

IM14.9

glucose, lipids, thyroid function tests etc.

OBJECTIVES

1.Blood glucose level in obesity

2.Fasting lipid profile in obesity

3.Throid function tests in obesity

4.Hormonal assays in obesity

178

INVESTIGATIONS IN OBESITY

SGD

Communicate and counsel patient on behavioural, dietary and lifestyle

IM14.11

modifications

OBJECTIVES

1.Dietary advice counselling

2.Lifestyle modifications counselling

3.Significance of physical activity

Demonstrate an understanding of patient’s inability to adhere to lifestyle

IM14.12

instructions and counsel them in a non - judgemental way

OBJECTIVES

1.Empathising with patients lifestyle difficulties

2.Counselling the patients on adhering to healthy lifestyle

Describe and enumerate the indications, pharmacology and side effects of

IM14.13

pharmacotherapy for obesity

OBJECTIVES

1.Indications of drugs in obesity

2.Pharmacology of drugs in obesity

3.Adverse effect of drug therapy

OBESITY- PHARMACOLOGICAL MANAGEMENT AND LIFE STYLE

179

MODIFICATIONS

LECTURE

PHARMACOLOGY

IM14.14

Describe and enumerate the indications and side effects of bariatric surgery

OBJECTIVES

1.Types of bariatric surgery

2.Indications of bariatric surgery

3.Contraindications of bariatric surgery

Describe and enumerate and educate patients, health care workers and the public

IM14.15

on measures to prevent obesity and promote a healthy lifestyle

OBJECTIVES

1.Various health measures for prevention of obesity

2.Creating awareness about obesity among health care workers

3.Educating the public about adverse outcomes of obesity

5.Counselling the public to promote healthy life style

180

OBESITY - SURGICAL MANAGEMENT AND COUNSELLING PREVENTIVE MEASURES

LECTURE/SGD

GENERAL SURGERY

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 stabilizing a patient

IM 15.2

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

2.The effects of acute blood loss changes identified

PATHOLOGY AND

181

UPPER AND LOWER GI BLEED- ETIOLOGY,RISK FACTORS AND PATHOGENESIS

LECTURE/SGD

GENERAL SURGERY

182

UPPER AND LOWER GI BLEED-ASSESSMENT AND STABILIZATION

LECTURE/SGD

GENERAL SURGERY

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

bleeding, quantity, grade, volume loss, duration, etiology, comorbid illnesses and risk

IM 15.4

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 history that

IM 15.5

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

gastrointestinal bleeding based on the clinical features

IM 15.6

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 in a

IM 15.7

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 clinical features

IM 15.8

and prioritise based on the most likely diagnosis

OBJECTIVES

1.Differential diagnosis based on symptoms and signs

2.Priority of diagnosis based on clinical feature

183

GI BLEED CLINICAL FEATURE AND DIFFERENTIAL DIAGNOSIS

LECTURE/SGD

Choose and interpret diagnostic tests based on the clinical diagnosis including complete

IM 15.9

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 procedures in

IM 15.10

the investigation of Upper GI bleeding

OBJECTIVES

1.Indications and Contra-Indications for upper GI scopy

2.Indications and Contra-indication for colonoscopy

3.USG abdomen

184

GI BLEED- INVESTIGATIONS

LECTURE/SGD

Develop, document and present a treatment plan that includes fluid resuscitation, blood

IM 15.11

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 and

IM 15.12

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

3.Pre-tranfusion and Post-tranfusion precautionary measures

185

MANAGEMENT OF GI BLEED

LECTURE/SGD

GENERAL SURGERY

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 diagnosis

IM 15.18

and therapeutic options

OBJECTIVES

1.Councelling the family members

2.councellimg the patient for diagnostic and therapeutic options

PHARMACOLOGY AND

186

MANAGEMENT OF PEPTIC ULCER ,H.PYLORI AND COUNCELLING

LECTURE/SGD

MICROBIOLOGY

TOPIC

Diarrheal disorder

Describe and discuss the aetiology of acute and chronic diarrhea including infectious and

IM 16.1

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 impact on

IM 16.2

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

2.Causes of malabsorption

187

ACUTE AND CHRONIC DIARRHEOA-ETIOLOGY AND EFFECTS OF FLUID LOSS

LECTURE/SGD

MICROBIOLOGY

Elicit and document and present an appropriate history that includes the natural history,

IM 16.4

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 history that

IM 16.5

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 clinical features

IM 16.7

and prioritise based on the most likely diagnosis

OBJECTIVES

1.Differential diagnosis diarrheoa and dysentry

188

DIARRHEAL DISEASES -CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS

SGD

Choose and interpret diagnostic tests based on the clinical diagnosis including complete

IM 16.8

blood count, and stool examination

OBJECTIVES

1.Complete blood examination

2.Stool examination-ova cyst

IM 16.9

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

IM 16.11

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 antibodies,

IM 16.12

colonoscopy, diagnostic imaging and biopsy in the diagnosis of chronic diarrhea

OBJECTIVES

1.Indications for special investigations for chronic diarrhea

189

INVESTIGATIONS OF DIARRHOEAL DISEASES

SGD

MICROBIOLOGY

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

2.Side effects of drug therapy

190

MANAGEMENT OF DIARRHEAL DISEASES

LECTURE/SGD

PHARMACOLOGY

IM 16.15

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

IM 16.17

Describe and enumerate the indications for surgery in inflammatory bowel disease

OBJECTIVES

1.Indications for surgery in inflammatory bowel disease

191

ULCERATIVE COLITIS -PATHOPHYSIOLOGY ,CLINICAL FEATURES AND MANAGEMENT

LECTURE

PATHOLOGY

192

CROHN'S DISEASE - PATHOPHYSIOLOGY, CLINICAL FEATURES AND MANAGEMENT

LECTURE

PATHOLOGY

TOPIC

HEADACHE

Define and classify headache and describe the presenting features, precipitating

factors, aggravating and relieving factors of various kinds of headache

IM17.1

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

6. Define meningitis and various types of meningitis

HEADACHE - DEFINITION ,CLASSIFICATION OF HEADACHE AND

193

MENINGITIS

LECTURE/SGD

Elicit and document and present an appropriate history including aura, precipitating

aggravating and relieving factors, associated symptoms that help identify the

IM17.2

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 and

IM17.3

non classical forms of migraine

OBJECTIVES

1.Definition of migraine

2.Classification of migraine

3.Difference between Classical and non classical migraine

194

HEADACHE - MIGRAINE

LECTURE/SGD

Perform and demonstrate a general neurologic examination and a focused

examination for signs of intracranial tension including neck signs of meningitis

IM17.4

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

2.Differential diagnosis of headache

MENINGITIS -PATHOPHYSIOLOGY ,CLNICAL FEATURES AND DIFFRENTIAL

MICROBIOLOGY AND

195

DIAGNOSIS

LECTURE

PATHOLOGY

Choose and interpret diagnostic testing based on the clinical diagnosis including

IM17.6

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 performing a

IM17.8

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

4.Interpretation of cell count in CSF analysis

INVESTIGATIONS IN HEADACHE AND MENINGITIS

MICROBIOLGY AND

196

LECTURE/SGD

PATHOLOGY

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

3.Management of headache in emergency care

197

ACUTE EMERGENCIES IN HEADACHE AND MANAGEMENT

LECTURE/SGD

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 therapy

IM17.12

in migraine

OBJECTIVES

1.Indications of prophylaxis in migraine

2.Drug prophylaxis in migraine

3.Adverse effects of drug prophylaxis

198

MIGRAINE - MANAGEMENT AND PROPHYLAXIS

LECTURE/SGD

PHARMACOLOGY

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

IM17.13

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

3.Drug therapy in Viral meningitis and its adverse effects

199

MENINGITIS - MANAGEMENT

LECTURE/SGD

PHARMACOLOGY

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

2.Counselling for prophylaxis for migraine

200

COUNSELLING FOR PROPHYLACTIC THERAPY IN MIGRAINE

DOAP

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

ANATOMY AND

201

APPLIED ASPECTS

LECTURE

PHYSIOLOGY

Classify cerebrovascular accidents and describe the aetiology, predisposing

genetic and risk factors pathogenesis of hemorrhagic and non hemorrhagic stroke

IM18.2

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

202

CVA - DEFINITION ,CLASSIFICATION AND ETIOPATHOGENESIS

LECTURE

CVA- CLINICAL FEATURES OF ISCHEMIC AND EMBOLIC STROKE

203

LECTURE

CVA - CLINICAL FEATURES OF HEMMORHAGIC STROKE

204

LECTURE

Elicit and document and present an appropriate history including onset,

progression, precipitating and aggravating relieving factors, associated symptoms

IM18.3

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

205

HISTORY AND SYMPTOM ANALYSIS IN STROKE

SGD

Identify the nature of the cerebrovascular accident based on the temporal evolution

IM18.4

and resolution of the illness

OBJECTIVES

1.Diagnosis based on history and evolution of stroke

Perform, demonstrate & document physical examination that includes general and

a detailed neurologic examination as appropriate, based on the history

IM18.5

OBJECTIVES

1.Observe general examination and neurological examination

2.Demonstrate neurological examination based on history

206

GENERAL AND NEUROLOGICAL EXAMINATION IN STROKE

SGD

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

IM18.6

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

207

OF LEISON

SGD

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

4.Clinical examination to differentiate disorders of speech

208

SPEECH AND DISORDERS OF SPEECH - AN OVERVIEW

SGD

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

IM18.8

dysfunction seen in CNS disease

OBJECTIVES

1.Anatomy and Physiology of bladder

2.Different types of bladder leisons

3.Clinical presentation of neurogenic bladder

4.Clinical presentation of atonic bladder

BLADDER - ANATOMY ,PHYSIOLOGY AND DYSFUNCTION IN CNS DISEASES

209

LECTURE/SGD

Choose and interpret the appropriate diagnostic and imaging test that will delineate

IM18.9

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

3.Interpretations of the investigations

210

INVESTIGATIONS IN STROKE

LECTURE/SGD

RADIOLOGY

Choose and interpret the appropriate diagnostic testing in young patients with a

IM18.10

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

8.Interpretation of Imaging in Young stroke

211

YOUNG STROKE

LECTURE

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 non

IM18.13

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

3.Role of statins in Non- hemmorhagic stroke

212

NON-HEMMORHAGIC STROKE MANAGEMENT

LECTURE/SGD

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

3.Contraindications of surgery in hemoorhagic stroke

213

HEMORRHAGIC STROKE - MANAGEMENT

LECTURE/SGD

Enumerate the indications describe and observe the multidisciplinary rehabilitation

IM18.16

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

3.Counselling the patient on therapy

214

STROKE REHABILITATION AND COUNSELLING

SGD

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, repetition,

IM 19.2

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, progression

precipitating and aggravating relieving factors, associated symptoms that help identify the

IM 19.3

cause of the movement disorders

OBJECTIVES

1.Elicitation of history of movement disorders

2.Aggrevating and relieving factors of movement disorders

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

MOVEMENT DISORDERS-FUNCTIONAL ANATOMY,CLASSIFICATION AGGREVATING

ANATOMY AND

215

RELIEVING FACTORS

LECTURE/SGD

PHYSIOLOGY

Perform, demonstrate and document a physical examination that includes a general

IM 19.4

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 the

IM 19.5

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 cause of the

IM 19.6

lesion based on the clinical presentation and findings

OBJECTIVES

1.Clinicsl features based diagnosis

2.Clinical features based , Anatomical site of lesion

3.Nature of the lesion and etiology

216

MOVEMENT DISORDERS CLINICAL FEATURES AND DEMONSTRATION

DOAP

IM 19.7

Choose and interpret diagnostic and imaging tests in the diagnosis of movement disorders

OBJECTIVES

1.Imaging interpretation- MRI, CT Brain

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

IM 19.8

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 treatment of

IM 19.9

movement disorders

OBJECTIVES

1.Indications for surgical therapy-stereotactic destruction

2.Botulinum toxin in treatment of movement disorder

217

CHOREA - CLASSFICATION AND CLINICAL FEATURES

LECTURE

218

PARKINSON'S DISEASE AND MANAGEMENT

LECTURE

PHARMOCOLOGY

219

INVESTIGATION AND MANAGEMENT OF MOVEMENT DISORDERS

SGD

RADIOLOGY

TOPIC

Envenomation

Enumerate the local poisonous snakes

and describe the distinguishing marks of each

IM 20.1

OBJECTIVES

1.Various types of poisonous snakes

2.Distinguish poisonous snake from non-poisonous snakes

3.Difference between various types of poisonuous snakes

Describe, demonstrate in a volunteer or a mannequin and educate (to other health care

IM 20.2

workers / patients) the correct initial management of patient with a snake bite in the field

OBJECTIVES

1.Educating the initial management of snake envenomation patient

2.Educating Do's and Don'ts in initial managements

3.Educate to identify the poisonous snakes

Describe the initial approach to the stabilisation of the patient who presents with snake

IM 20.3

bite

OBJECTIVES

1.Monitering the vital signs

2.Identifing the type of snake envenomation

3.Assessing the nature of toxins-cardiotoxic/neurotoxic

4.Identifying the systemic envenomation

5.Stabilizing the patient with ASV and parenteral IV fluids

Elicit and document and present an appropriate history, the circumstance, time, kind of

IM 20.4

snake, evolution of symptoms in a patient with snake bite

OBJECTIVES

1.History regarding kind of snake , time and circumstances

2.Assessing the symptoms related system envenomation

Perform a systematic examination, document and present a physical examination that

includes general examination, local examination, appropriate cardiac and neurologic

IM 20.5

examination

OBJECTIVES

1.General physical examination

2.Local examination at the site of bite

3.Examination of neurological and cardiovascular system to assess systemic

envenomation

220

SNAKE ENVENOMATION AND CLINICAL ASSESSMENT

LECTURE/SGD

FORENSIC MEDICINE

IM 20.6

Choose and interpret the appropriate diagnostic testing in patients with snake bites

OBJECTIVES

1.Blood investigations-Bleeding time,clotting time,PT

2.ECG for cardiotoxic

Enumerate the indications and describe the pharmacology, dose, adverse reactions,

IM 20.7

hypersensitivity reactions of anti snake venom

OBJECTIVES

1.Indications for ASV

2.Test dose of ASV to assess hypersensitivity

3.Dose of ASV

4.Adverse reaction of ASV

221

SNAKE ENVENOMATION MANAGEMENT

LECTURE/SGD

PHARMOCOLOGY

Describe the diagnosis, initial approach stabilisation and therapy of scorpion

IM 20.8

envenomation

OBJECTIVES

1.History of scorpion sting

2.Assessment of local toxic effect

3.Assessment of systemic toxin

4.Stabilization by IV fluids,antihistamine,cocktail therapy

IM 20.9

Describe the diagnosis initial approach stabilisation and therapy of bee sting allergy

OBJECTIVES

1.History of bee sting

2.Assessment of local and systemic toxic effect

3.Initial approach by monitering the vitals and pain managment

4.Stabilization by antihistamine and other drug therapy

222

MANAGEMENT OF SCORPION STING AND BEE STING

LECTURE/SGD

TOPIC

Poisoning

Describe the initial approach to the

stabilisation of the patient who presents with poisoning

IM 21.1

OBJECTIVES

1.History to identify the nature and type of poison

2.Registering AR entry

3.Initiation of stomach wash

4.Stabilizing the patient with universal antidote after assessing the vitals

223

POISONING- GENERAL APPROACH

LECTURE/SGD

Enumerate the common plant poisons seen in your area and describe their toxicology,

IM 21.2

clinical features, prognosis and specific approach to detoxification

OBJECTIVES

1.Common plant poisons

2.Toxic effects of the particular poisons

3.Clinical manifestations of plant poisons

4.Universal antidote and specific detoxification drugs

5.Organophosphorous compunds poisoning - Etiopathogenesis ,clinical features

224

PLANT POISONS AND MANAGEMENTS

LECTURE/SGD

225

ORGANOPHOSPHOROUS POISONING AND ITS MANAGEMENT

LECTURE/SGD

PHARMOCOLOGY

Enumerate the common corrosives used in your area and describe their toxicology, clinical

IM 21.3

features, prognosis and approach to therapy

OBJECTIVES

1.Common corrosive poisons

2.Toxic effects of each poison

3.Clinical presentation of each poison

4.Indication and contraindications for stomach wash

5.Stablisation approach and specific antidote therapy

6.Common non corrosive poisons

7.Clinical presentation of non-corosive poisons

8.Management of non-corrosive poisons

226

CORROSIVE POISONS AND MANAGEMENT

LECTURE/SGD

227

NON CORROSIVE POISONING AND ITS MANAGEMENT

LECTURE/SGD

Enumerate the commonly observed drug overdose in your area and describe their

IM 21.4

toxicology, clinical features, prognosis and approach to therapy

OBJECTIVES

1.History to identify overdose drug

2.Identify the normal therapeutic dose of the drug

3.Identify the toxic dose of the drug

4.Clinical presentation of the overdose of the drug

5.Stabilising the general condition and specific antidote of the drug

228

DRUGS OVERDOSE AND MANAGEMENT

LECTURE

PHARMOCOLOGY

IM 21.5

Observe and describe the functions and role of a poison center in suspected poisoning

OBJECTIVES

1.Locating the nearby poison centre

2.National poison centre functions

3.Collecting the information regarding Antidote of specific poison

4.Functions of Institutional pharmacovigliance committee

229

POISON CENTRES /PHARMACOVIGILANCE COMMITTEE

SGD

FORENSIC MEDICINE

Describe the medico legal aspects of suspected suicidal or homicidal poisoning and

demonstrate the correct procedure to write a medico legal report on a suspected

IM 21.6

poisoning

OBJECTIVES

1.Medicolegal registration at casuality

2.Intimation of poison and copy of medicolegal registration to police station

3.Monitoring the vitals

4.Collecting the detailed information regarding the poison consumption

Counsel family members of a patient with suspected poisoning about the clinical and

IM 21.7

medico legal aspects with empathy

OBJECTIVES

1.Councelling the family members of the patient regarding the nature of the poison

2.Exaplain the clinical nature and medicolegal aspect

MEDICOLEGAL REGISTRATION OF POISONING AND COUNsELLING THE FAMILY MEMBERS

230

SGD

FORENSIC MEDICINE

Enumerate the indications for psychiatric consultation and describe the precautions to be

IM 21.8

taken in a patient with suspected suicidal ideation / gesture

OBJECTIVES

1.Indications for psychiatric consultation

2.Precaution ot moniter suicidal attempted patients

231

PSYCHIATRIC COUNSELLING - SUICIDAL ATTEMPTED PATIENTS

DOAP

PSYCHIATRY

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 to

IM22.2

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

232

MANAGEMENT

LECTURE

233

HYPERPARATHYROIDISM

LECTURE

GENERAL SURGERY

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

234

MULTIPLE ENDOCRINE NEOPLASIA

LECTURE

PATHOLOGY

Enumerate the causes and describe the clinical features and the correct approach

to the diagnosis and management of the patient with hyponatremia

IM22.5

OBJECTIVES

1.Definition of Hyponatremia

2.Causes of hyponatremia

3.Clinical features in Hyponatremia

4.Diagnosis of hyponatremia

5.Management of hyponatremia

235

HYPONATREMIA

LECTURE

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

correct approach to the diagnosis and management of the patient with

IM22.6

hypernatremia

OBJECTIVES

1.Definition of Hypernatremia

2.Causes of hypernatremia

3.Clinical features in Hypernatremia

4.Diagnosis of hypernatremia

5.Management of hypernatremia

236

HYPERNATREMIA

LECTURE

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

correct approach to the diagnosis and management of the patient with hypokalemia

IM22.7

OBJECTIVES

1.Definition of Hypokalemia

2.Causes of Hypokalemia

3.Clinical features in Hypokalemia

4.Diagnosis of Hypokalemia

5.Management of Hypokalemia

237

HYPOKALEMIA

LECTURE

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

correct approach to the diagnosis and management of the patient with

IM22.8

hyperkalemia

OBJECTIVES

1.Definition of Hyperkalemia

2.Causes of Hyperkalemia

3.Clinical features in Hyperkalemia

4.Diagnosis of Hyperkalemia

5.Management of Hyperkalemia

238

HYPERKALEMIA

LECTURE

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 metabolic

IM22.10

alkalosis

OBJECTIVES

1.Definition of metabolic alkalosis

2.Causes of metabolic alkalosis

3.Clinical features of metabolic alkalosis

4.Lab diagnosis of metabolic alkalosis

5.Correction of metabolic alkalosis

239

METABOLIC ACIDOSIS AND ALKALOSIS

SGD

PHYSIOLOGY

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

5.Correction of metabolic alkalosis

240

RESPIRATORY ACIDOSIS AND ALKALOSIS

SGD

PHYSIOLOGY

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

4. Interpretation based on ABG report and clinical status

241

ABG - INTERPRETATION

DOAP

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

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

NUTRITIONAL STATUS AND CALORIC REQUIREMENT ASSESSMENT

242

LECTURE/SGD

Discuss and describe the causes and consequences of protein caloric malnutrition

IM23.2

in the hospital

OBJECTIVES

1. Causes of malnutrition

2. Diffrence between kwashiorkar and marasmus

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

(hypoproteinemia)

243

PROTEIN ENERGY MALNUTRITION

LECTURE/SGD

PEDIATRICS

Discuss and describe the aetiology, causes, clinical manifestations, complications,

IM23.3

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

8. Management of vitamin defeciency and its complications

244

WATER SOLUBLE VITAMINS

LECTURE/SGD

BIOCHEMISTRY

245

FAT SOLUBLE VITAMINS

LECTURE/SGD

BIOCHEMISTRY

Enumerate the indications for enteral and parenteral nutrition in critically ill patients

IM23.4

OBJECTIVES

1. Students should know the routes of nutritional supplementation

2. Indications for enteral nutrition

3. Indications for parentral nutrition

NUTRITIONAL STATUS IN CLINICALLY ILL PATIENT AND IT'S MANAGEMENT

246

LECTURE/SGD

Counsel and communicate to patients in a simulated environment with illness on

IM23.5

an appropriate balanced diet

OBJECTIVES

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

2. Nutritional defeciency assessment of ill patients

3. Supplementation of balanced diet

247

COUNSELLING - NUTRITION AND BALANCED DIET

DOAP

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

248

COMMON DISEASES IN ELDERLY

LECTURE/SGD

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,

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

IM24.3

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

249

ACUTE CONFUSIONAL STATE IN GERIATRIC AGE GROUP

LECTURE/SGD

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.4

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

250

VASCULAR EVENTS IN ELDERLY

LECTURE/SGD

Describe and discuss the aetiopathogenesis clinical presentation identification,

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

IM24 5

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

251

DEPRESSIVE DISORDER IN ELDERLY

LECTURE/SGD

PYSCHIATRY

Describe and discuss the aetiopathogenesis causes, clinical presentation,

difference in discussion presentation identification, functional changes, acute care,

stabilization, management and rehabilitation of dementia in the elderly

IM24.6

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

252

DEMENTIA IN ELDER AGE GROUP

LECTURE/SGD

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.7

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 modalities in

daignosis of cognitive dysfunction

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

disorder / cognitive dysfunction in elderly

253

PERSONALITY DISORDER IN ELDER AGE GROUP

LECTURE/SGD

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.8

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

254

OSTEOPOROSIS IN ELDER AGE GROUP

LECTURE/SGD

ORTHOPAEDICS

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.9

CVA in the elderly

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

255

CEREBROVASCULAR ACCIDENT IN ELDER AGE GROUP

LECTURE/SGD

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.10

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

COPD IN ELDER AGE GROUP

256

LECTURE/SGD

RESPIRATORY MEDICINE

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.11

elderly undergoing surgery

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

SURGICAL PROCEDURES IN ELDER AGE GROUP

GENERAL SURGERY AND

257

LECTURE/SGD

ORTHOPAEDICS

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.12

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

258

OSTEOARTHRITIS IN ELDER AGE GROUP

LECTURE/SGD

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.13

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 episodes,cerebellar &

parkinsonian fatures 3.should know common skillful interventions for acute care &

stabilisation for falls in elderly

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

259

ACCIDENTAL FALL IN ELDER AGE GROUP

LECTURE/SGD

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.14

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

COMMON FRACTURES IN ELDER AGE GROUP

ORTHOPAEDICS ,

PHYSICAL MEDICINE AND

260

LECTURE/SGD

REHABILITATION

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.15

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

261

BLINDNESS IN ELDER AGE GROUP

LECTURE/SGD

OPHTHALMOLOGY

Describe and discuss the principles of physical and social rehabilitation, functional

assessment, role of physiotherapy and occupational therapy in the management of

IM24.16

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

ORTHOPAEDICS ,

PHYSICAL MEDICINE AND

262

DISABILITY IN ELDER AGE GROUP

LECTURE/SGD

REHABILITATION

Describe and discuss the aetiopathogenesis,clinical presentation, identification,

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

IM24.17

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

263

HEARING LOSS IN ELDER AGE GROUP

LECTURE/SGD

ENT

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

IM24.18

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

264

DEMOGRAPHIC CHANGES IN AGEING

LECTURE/SGD

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

265

SOCIAL ISSUES IN ELDER AGE GROUP

LECTURE/SGD

Enumerate and describe social interventions in the care of elderly including

domiciliary discussion services, rehabilitation facilities, old age homes and state

IM24.20

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

266

ELDER AGE - DOMICILIARY AND OLD AGE HOME SERVICES

SGD

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

267

ETHICAL ISSUES IN ELDERLY AGE GROUP

SGD

AETCOM

Describe and discuss the aetiopathogenesis, clinical presentation, complications,

assessment and management of nutritional disorders in the elderly

IM24.22

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

PHYSIOLOGY AND

268

NUTRITIONAL DISORDERS IN ELDER AGE GROUP

LECTURE/SGD

BIOOCHEMISTRY

MISCELLANEOUS INFECTIONS

Describe and discuss the response and the influence of host immune status, risk

factors and comorbidities on zoonotic diseases (e.g. Leptospirosis, Rabies) and

IM25.1

non-febrile infectious disease (e.g. Tetanus)

OBJECTIVES

1. To describe the host immune status on zoonotic and non febrile infectious disease

2. To discuss the list of risk factors and comorbidities on zoonotic and non febrile

infectious disease

Discuss and describe the common causes, pathophysiology and manifestations of

IM25.2

these diseases

OBJECTIVES

1.To describe the mode of transmission and incubation period

2.To describe the morphological characteritics and pathophysiology of leptospirosis

3.To discuss the list of triad of clinical features and ateast 5 common clinical features of

leptospirosis

4.Teatnus - Etiopathogenis and clinical presentation

5.Anthrax- Etiopathogenis and clinical presentation

Describe and discuss the pathophysiology and manifestations of these diseases

IM25.3

OBJECTIVES

1.To describe the mode of transmission and incubation period

2.To describe the structure and pathophysiology of rabies

3. To list the early,additional and late clinical features of rabies

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

these diseases that includes the evolution and pattern of symptoms, risk factors,

IM25.4

exposure through occupation and travel

OBJECTIVES

1.History to rule out etiology based on symptoms

1.History - Related to travellers infection

2.History - Related to occupation exposure

Perform a systematic examination that establishes the diagnosis and severity of

presentation that includes: general skin, mucosal and lymph node examination,

chest and abdominal examination (including examination of the liver and spleen)

IM25.5

OBJECTIVES

1.General physical examination - lymph nodes, mucous membrane

2. Systemic examination including abdomen - liver, spleen

3. Respiratory system examination - breath sounds and abnormal breath sounds

Generate a differential diagnosis and prioritise based on clinical features that help

distinguish between infective, inflammatory, malignant and rheumatologic causes

IM25.6

OBJECTIVES

1. Difference between infective diseases and inflammatory , malignant and

rheumatological diseases

2. Etiology of infectious diseases

3. Various etiology of rheumatological diseases

4. Causes for malignant diseases

5. Inflammatory signs

269

LEPTOSPIROSIS - ETIPATHOGENESIS AND CLINICAL FEATURES

LECTURE/SGD

MICROBIOLOGY

270

RABIES - ETIOPATHOGENESIS AND CLINICAL FEATURES

LECTURE/SGD

MICROBIOLOGY

271

TETANUS -ETIOPATHOGENESIS AND CLINICAL FEATURES

LECTURE/SGD

MICROBIOLOGY

272

ANTHRAX- ETIOPATHOGENESIS AND CLINICAL FEATURES

LECTURE/SGD

MICROBIOLOGY

Order and interpret diagnostic tests based on the differential diagnosis including:

CBC with differential, blood biochemistry, peripheral smear, urinary analysis with

sediment, Chest X ray, blood and urine cultures, sputum gram stain and cultures,

sputum AFB and cultures, CSF analysis, pleural and body fluid analysis, stool

IM25.7

routine and culture and QBC

OBJECTIVES

1. Interpretation of complete blood count - TC, DC, ESR, Platelet, Hb, rbc, pcv

2. Interpretation of peripheral bloodn smear study - morphology of blood cells and

premature cells

3. Interpretation of biochemical tests - sugar, urea, creatinine, LFT, lipid profile

4. Interpretation of urine analysis

5. Interpretation of chest X-ray, Images

6. Interpretation of blood culture and sensitivity

7. Interpretation of CSF culture and sensitivity

273

INVESTIGATIONS IN ZOONOTIC DISEASES

LECTURE/SGD

MICROBIOLOGY

Enumerate the indications for use of newer techniques in the diagnosis of these

IM25.8

infections

OBJECTIVES

1.Enumerate Common indications for use of newer techniques in diagnosis of zoonotic

disease - Leptospirosis, Rabies,Anthrax

IM25.9

Assist in the collection of blood and other specimen cultures

OBJECTIVES

1. Blood collection for dark field examination of spirochetes

2. Blood culture and peripheral blood smear study

3. CSF analysis

Develop and present an appropriate diagnostic plan based on the clinical

IM25.10

presentation, most likely diagnosis in a prioritised and cost effective manner

OBJECTIVES

1. Investigation plan based on history for leptospirosis

2. Investigation plan based on history for rabies

274

SPECIMEN COLLECTION OF ZOONOTIC DISEASES

DOAP

Develop an appropriate empiric treatment plan based on the patient’s clinical and

IM25.11

immune status pending definitive diagnosis

OBJECTIVES

1. Treatment plan for leptospirosis

2. Treatment plan for rabies

3. Treatment plan for tetanus

4.Treatment of Anthrax

275

MANAGEMENT OF ZOONOTIC DISEASES

LECTURE/SGD

Communicate to the patient and family the diagnosis and treatment of identified

IM25.12

infection

OBJECTIVES

1. Communicate and councelling the patient and the family members about the

diagnosis

2. Communicate and councelling the patient and the family members regarding the

treatment

Counsel the patient and family on prevention of various infections due to

IM25.13

environmental issues

OBJECTIVES

1. Counselling the patient for the prevention of the infectious disease

2. Counselling the patient relatives regarding the prevention of disease

276

COUNsELLING OF ZOONOTIC DISEASES AND ITS PREVENTION

DOAP

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 of

IM 26.2

physician growth

OBJECTIVES

1.Importance of life long learning

IM 26.3

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

IM 26.4

in patient care

OBJECTIVES

1.Role of physician of independent practice

2.Role of physician of shared responsibility practice

IM 26.5

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

2.Role of physician in health delivery

277

PHYSICIAN- ROLE,PROFESSIONAL QUALITIES AND LIFELONG LEARNING

SGD

278

PHYSICIAN - AUTONOMY AND SHARED RESPONSIBILITY

SGD

279

RESPONSIBILITIES OF PHYSICIANS IN THE HEALTH CARE SYSTEM

SGD

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 organ

IM 26.8

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 issues as it

IM 26.9

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 pertains to

IM 26.10

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 pertains to

IM 26.11

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

280

PATIENT RIGHTS AND RESPONSIBILITY OF THE PHYSICIAN

SGD

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

decision making in health care including advanced directives and surrogate decision

IM 26.12

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 pertains to

decision making in emergency care including situations where patients do not have the

IM 26.13

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 pertains to

IM 26.14

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 they pertain

IM 26.15

to consent for surgical procedures

OBJECTIVES

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

281

PHYSICIAN'S ROLE IN TREATING EMERGENCY CARE AND CONSENT FOR TREATMENT

SGD

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

IM 26.16

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 community that she/

IM 26.17

he serves

OBJECTIVES

1.Duty of the physician to serve the society

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

IM 26.18

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 threatening,

IM 26.20

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

282

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, superiors and

IM 26.24

other health care workers

OBJECTIVES

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

IM 26.25

Demonstrate responsibility and work ethics while working in the health care team

OBJECTIVES

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

283

PHYSICIAN ROLE-CONTINUED LEARNING,RESPECT WITH HEALTH CARE TEAM

DOAP

Demonstrate ability to maintain required documentation in health care (including correct

IM 26.26

use of medical records)

OBJECTIVES

1.Maintianing medical records

2.Carefull medicolegal documentation

Demonstrate personal grooming that is adequate and appropriate for health care

IM 26.27

responsibilities

OBJECTIVES

1.Physician's personal grooming responsibilities

Demonstrate adequate knowledge and use of information technology that permits

IM 26.28

appropriate patient care and continued learning

OBJECTIVES

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

284

PHYSICIAN'S RESPONSIBILITY OF INFORMATION TECHNOLOGY OF PATIENT CARE

SGD

Communicate diagnostic and therapeutic opitons to patient and family in a simulated

IM 26.29

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 simulated

IM 26.30

environment

OBJECTIVES

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

IM 26.31

Demonstrate awareness of limitations and seeks help and consultations 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 procedures and

IM 26.33

response to be followed in the event of medical errors

OBJECTIVES

1.Responsibility of physician in the event of medical errors

285

PHYSICIAN RESPONSIBILITY ,TREATMENT OPTIONS AND EVENT OF MEDICAL ERROR

SGD

Identify conflicts of interest in patient care and professional relationships and describe the

IM 26.34

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 practices

IM 26.40

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

286

PHYSICIAN RESPONSIBILITY,CONFLICT,MEDICAL ERROR REDUCTION TIME MANAGEMENT

SGD

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 issues as

IM 26.43

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 issues

IM 26.44

pertaining to medical negligence

OBJECTIVES

1.Responsibility in medical negligence

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

IM 26.45

pertaining to malpractice

OBJECTIVES

1.Responsibility of the physician to malpractice

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

IM 26.46

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 they pertain

IM 26.47

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 patient being

IM 26.49

enrolled in a research protocol in a simulated environment

OBJECTIVES

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

287

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

DOAP