Annapoorana Medical College & Hospitals, Salem

Department of Chest & TB

Phase III Part I Lesson Plan

Lecture

Competensy

Teaching learning

Topic

Number

methodology

Topic: ANTI-TB drugs and regimen chemoprophylaxis Resistant TB

Describe and discuss the pharmacology of various anti-tuberculous agents, the

Lecture / Small Group

CT 1.14

indications, contraindications, and adverse reactions

Discussion

Objectives

1. Pharmacology of Anti-TB drugs

2. Indiation & Contraindications

3. Interactions & Adverse reaction

Prescribe an appropriate antituberculosis regimen based on the location of disease,

Bedside clinics, / Small

CT 1.15

smear positivity and negativity and co-mobidities based on current national guidelines

Group Discussion /

including directly observed tuberlosis therapy DOTS)

Lecture

Objectives

1. Anti TB regimen based on current National guidelines including DOTS.

Describe the appropriate precautions, screening, testing and indications for

Lecture / Small Group

CT 1.16

chemoprophylaxis for contacts and exposed health care workers

Discussion

Objectives

1. Indications for chemophylexi for contact health

Define criteria for the cure of Tuberculosis; describe and recognise the features of

Lecture / Small Group

CT 1.17

drug resistant ruberculosis, prevention and therapeutic regimens

Discussion

Objectivesc

1. Drug Ressitance Tuberculosis - Prevention & Treatment

Topic: Education of Health Care workers & Educaiton to Patient & Family

Communicate with patients and family in an empathetic manner about the diagnosis,

CT 1.18

DOAP Session

therapy

Objectives

1. Communication to patients & family

Topic :Obstructive Airway Disease Basie, Hypoxia, Hypercapnia

CT 2.1

Define and classify obstructive airway disease

Describeand discuss the epidemiology, risk factors and evolution of obscructive

CT 2.2

airway disease

Enumerate and describe has causes of acute episodes in patients with obstructive

CT 2.3

airway disease

Describe and discuss the Physiology and pathophysiology of hypoxia and

CT 2.4

hypercapneia

Describe and discuss the genetics of alpha 1 antitrypsin deficiency in emphysema

Objective:

1. Epidemiology, risk rfactors, evolution of Obstructive Airway Disease.

2. Cause of acute episodes of obstructive Airway

Topic: Role of Environment in OAD

Describe the role of the environment in the cause and exacerbation of obstructive

Lecture / Small Group

CT 2.6

airway disease.

Discussion

Describe and discuss allergic and non-allergic precipitants of obstructive airway

Lecture / Small Group

CT 2.7

disease.

Discussion

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

Bedside clinics, /DOAP

CT 2.8

obstructive airway disease severity and precipitants.

Session

Objective:

1. Role of environment in the cause and exacerbation of obstructive Airway Disease.

2. Allergic and non allergic precipitants of Obstructive Airway Disease

3. Aetiology of Obstructive Airway Disease.

Topic: Systemic Examination of Respiratory System & Differential Diagnosis

Perform a systematic examination that establishes the diagnosis and severity that

includes measurement of respiratory rate, level of respiratory distress, effort tolerance,

Bes Side Clinic, DOAL

CT 2.9

breath sounds, addes sounds, identification of signs of consolidation pleural effusion

Session

and pneumothorax

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

Bes Side Clinic, DOAL

CT 2.10

a specific aetiology

Session

Objective:

1. Systemic examination including respiratory rate, distress, breath sounds and added

sounds.

2. Identificaiton of signs of consolidation & pleural effusion & Pneumothorax.

3. Generate a differential diagnosis based on clinical features.

Topic: Pulmonary Function Test

Bed Side Clinic, DOAP

CT 2.11

Describe, discuss and interpret pulmonary function test

Session

Bed Side Clinic, DOAP

CT 2.12

Perform and interpret peak expiratory flow reate

Session

Objective:

1. Interpret pulmonary funciton test

2. Perform and interpret peak expiratory flow rate.

Topic: Diagnostic work up & Interpretation of Lab Results & Chest

Bes side Clinic,Small

CT 2.13

Describe the appropriate diagnostic work up based on

group Discussion,

DOAP Session

Bes side Clinic,Small

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

CT 2.14

group Discussion,

Radiograph

DOAP Session

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

CT 2.15

specific aetiology

Objective:

1. ppropriate diagnostic work up based on aetiology

2. Interpretation of results of pulse oximetry ABG

Topic: Therapeutic Plan for OAD

Discuss and describe therapies for Obstructive

Lecture / Small Group

CT 2.16

Airway Disease including bronchodilators, leukotriene inhibitors, mase cell

Discussion

stabilisers, theophylline, inhaled and systemic steroids, oxygen and immunotherapy

Lecture / Small Group

CT 2.17

Describe and discuss the indications for vaccinations

Discussion

Bes side Clinic,Small

CT 2.18

Develop a therapeutic plan including use of bronchodilators

group Discussion,

DOAP Session

Objective

1. Therapies for Obstructive Airway Disease

2. Indication for Vaccination in Obstructive Airway Disease.

3. Therapeutic paln including use of broncodilators

Topic: Management of Acute Exacerbation

Bes side Clinic,Small

Develop a management plan for acute exacerbations including bronchodilators,

CT 2.19

group Discussion,

systemic steroids, antimicrobial therapy

DOAP Session

Describe and discuss the principles and use of oxygen therapy in the hospital and at

CT 2.20

Small Group Discussion

home.

Objective:

1. Management plan for acute exarcerbations

2. Principle of Oxygen therapy

Topic: Counselling on smokers cessation & Cessation & Communication to Patients

Describe discuss and counsel patients appropriately on smoking cessation smoking

CT 2.21

cessation

CT 2.22

Demonstrate and counsel patient on the correct use of inhalers

DOAP Session

CT 2.23

Communicate diagnosis treatment plan and subsequent follow up plan to patients

DOAP Session

Objective:

1. Counselling on smoking cessation

2. Communication to patients on diagnosis, treatment & follow up

Topic: Impact of OAD on Society

Recognise the impact of Obstructive Airway Disease on patient's quality of life, well

Small Group Discussion

CT 2.24

being, work and family

/ Bedside Clinics

Discuss and describe the impact of Obstructive Airway Disease on the society and

Lecture / Small Group

CT 2.25

workplace

Discussion

Objectives:

1. Recognise the impact of Obstructive Airway Disease on Patients and their family's

quality of life.

2. Impact of Obstructive Airway Disease on society

Topic: Preventive measures to Reduce OAD

Discuss and describe prventive measures to reduce Obstructive Airway Disease in

Lecture / Small Group

CT 2.26

workplaces

Discussion

Demonstrate an understanding of patient's inability to change working, living and

Small Gropu

CT 2.27

Discussion, Bedside

environental factors that influence progression of airway disesae

Clinics

Demonstrate an understanding for the difficulties faced by patients during smoking

Small Gropu

CT 2.28

Discussion, Bedside

cessation

Clinics

1. Preventive measures to reduce Obstructive Airway Disease in workplace

Small Group

2. Understanding of patients inability to change working, living and environmental

Discussion, Bedside

factors.

Clinics

3. Understanding the difficulties faced by patient

Topic: Spirometry (Physiology)

PY 6.8

Demonstrate the correct technique to perform & Interior

DOAP Sessions

Objective:

1. To perform and interpret Spirometry

Topic: Drugs in Bronchial Asthma & Couch

Describe the mechanism/s of action, types, doses, sde effects, indications and

PH 1.32

contraindicaitons of drugs used in bronchial asthma and COPD

Describe the mechanism of action, types, doses, side effects, indications and

Lecture / Small Group

PH 1.33

contraindications of the drugs used in cough (antitussives, expectorants/mucolytics)

Discussion

Objective:

1. To know the drugs used in Bronchial Asthma and COPD

2. Drugs used in COUGH (Antitussives expectorants

Topic : First line Anti TB Drugs & MDR & XDR

Desribe the first line antitubercular drugs, their mechanisms of action, side effected

PH 1.44

Lecture

and doses.

PH 1.45

Describe the drugs used in MDR and XDR Tuberculosis

Lecture

Objective:

1. First line anti TB drugs

2. Multi Drug Resistant TB and Extremely Drug resistant TB - Treatment

Topic: C.O.P.D in Elderly

Describe and discuss the eatiopathogenesis, clinical presentation, identification,

IM 24.10

functional changes, acute care, stabilization, management and rehabilittion of COPD

Small Gropu Discussion

in the elderly

Objective:

1. Aetiopathogenesis, clinical presentation, management and rehabilitation of COPD

in the elders

Topic: Asthma in Children (Paediatrics)

Bedside clinics / Small

Describe the etio-pathogenesis, clinical features, diagnosis, management and

PE 28.19

Group Discussion /

prevention of asthma in children

Lecture

Objective:

1. Aetiopathogenesis, clinical features. Diagnosis and treating Asthma in children

Use of inhaler in children.

Topic: Tuberculosis in Children and Adolescent

Discuss the epidemiology, clinical features, clinical types, complications of

Lecture / Small Group

PE 34.1

Tuberculosis in Children and Adolescents

Discussion

Lecture / Small Group

PE 34.2

Discuss the various diagnostic tools for childhood tuberculosis

Discussion

Discuss the various regimens for management of Tuberculosis ad per National

Lecture / Small Group

PE 34.3

Guidelines

Discussion

Objectives:

1. Clinical Features, types & compliations & Diagnosis of TB in Children and

Adolescents.

2. Management of Tuberculosis as per National guidelines.

Topic: Preventive Aspect under National Guidelines & Interpretation of BCG

Discuss the preventive strategies adopted and the objectives and outcome of the

Lecture / Small Group

PE 34.4

National Tuberculosis Control Program

Discussion

Able to elicit, document and present history of contact with tuberculosis in every

Bedside clinics, Skill

PE 34.5

patient encounter

lab

Bedside clinics, Skill

PE 34.6

Identify a BCG scar

lab

Bedside clinics, Skill

PE 34.7

Interpreta Mantoux test

lab

Bedside clinics, Skill

PE 34.8

Interpret a Chest Radiograph

lab

Objectives:

1. Preventive strategies, elicit history of contact with tuberculosis

2.Interpret BCG Scar, Mantoux Test

3. Interpret Chest Radisgraph

Topic: Interpretation of Blood test and Culture test in TB & AFB staining

Bed side Clinic/ Small

PE 34.9

Interpretblood tests in the context of laboratory evidence for tuberculosis

Group Discussion

Discuss the various samples for demonstraing the organism eg Gastric Aspirate,

Bed side Clinic/ Small

PE 34.10

Sputum, CSF, FNAC

Group Discussion

PE 34.11

Perform AFB staining

DOAP session

Enumerate the indications and discuss the limitations of methods of culturing

PE 34.12

Small Group Discussion

M.Tuberculii

Objective:

1. Interpret Blood testes for Tuberculosis

2. Discuss the samples for demonstrating Mycobacterium Tuberculosis

3. Perform AFB staning

4. Discuss the indications and limitations of culturing