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Medicine Final Year MBBS Learning Objectives: Clinical and Lectures

Method · August 2020

DOI: 10.13140/RG.2.2.11125.19682

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Muhammad Khurram Sara Mustafa

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 2020

Medicine Final Year

MBBS
Learning Objectives: Clinical and Lectures

Dean Medicine & Allied

RAWALPINDI MEDICAL UNIVERSITY
 LEARNING OBJECTIVES CLINICALS
APPROACH TO PATIENT WITH ANEMIA

Define anemia and its various types (nutritional, anemia of chronic illness, hemolytic and aplastic)
Explain pathophysiology of different types of anemia including hemolytic anemia (intravascular
v/s extravascular, congenital v/s acquired)
Recognize various clinical features of anemia including hemolytic anemia (congenital, acquired,
autoimmune v/s non immune)
Differentiate between various types of anemia on the basis of history and clinical examination
Enlist and interpret various hematological investigations in evaluating a case of anemia including
various red cell indices and specialized tests
Formulate differential diagnosis on the basis of available investigations
Outline principles of management of various types of anemia
Counsel regarding different types of anemia especially hemolytic anemia

APPROACH TO PATIENTS WITH LYMPHADENOPATHY

Formulate differential diagnosis on the basis of history and clinical examination in a patient
with lymphadenopathy
Define and differentiate between various lymphoproliferative disorders/ plasma cell disorders
Define various modes of presentations of lymphoproliferative disorders /plasma cell disorders
Explainpathogenesis of lymphoproliferative disorders / plasma cell disorders
Outline and interpret investigations for lymphoproliferative disorders/ plasma cell disorders
Define importance of cytogenetics of lymphoma / plasma cell disorders
Outline principles of management of lymphoma / plasma cell disorders
Counsel the patients regarding prognosis in lymphoproliferative disorders / plasma cell order

APPROACH TO PATIENTS WITH MASSIVE SPLENOMEGALY

Formulate differential diagnosis on the basis of history and clinical examination in a patient with
splenomegaly
Define and differentiate between various myeloproliferative disorders
Define various modes of presentations of myeloproliferative disorders
Define and differentiate between various types of acute leukemias
Explainpathogenesis of myeloproliferative disorders
 Outline and interpret investigations myeloproliferative disorders
Define importance of cytogenetic / molecular aspects of CML
Outline principles of management of various phases of CML
Enlist indications and complications of Bone marrow transplantation
Counsel the patients regarding prognosis in myeloproliferative disorders

APPROACH TO A PATIENT WITH BLEEDING / CLOTTING DISORDERS

Enumerate signs and symptoms of bleeding /clotting disorders

Explain pathophysiology of bleeding and clotting disorders
Outline and interpret investigations for bleeding and clotting disorders
Outline management of different bleeding/ clotting disorders including indications of blood
products
Counsel the patients regarding prognosis of bleeding / clotting disorders

APPROACH TO A PATIENT WITH UPPER GASTROINTESTINAL BLEED

Distinguish between upper and lower GI bleed

Distinguish between hematemesis, hematochezia and malena
Enlist causes of upper gastrointestinal bleed
Discuss different clinical features pertinent to different causes
Outline investigations in a patient with upper GI bleed
Enlist risk factors for the outcome of upper GI bleed
Outline management for acute upper GI bleed including variceal bleed
Counsel the patients in relation to management and prognosis

APPROACH TO A PATIENT WITH DYSPEPSIA / DYSPHAGIA

Define dyspepsia and dysphagia

Enumerate causes of dyspepsia / dysphagia
Enlist alarmingfeatures of dyspepsia
Elucidate clinical features of dyspepsia /dysphagia
Outline investigations of dyspepsia /dysphagia
Enlist indications for barium studies and endoscopies
Explainpathophysiology of H. pylori, GERD/APD
Enlist investigations for diagnosis of H. pylori infection
Outline treatment of dyspepsia including H. pylori, GERD/APD
Approach to a patient with Acute Diarrhea
Define acute diarrhea and distinguish it from chronic diarrhea
Define pathophysiology of absorption of different nutrients and concepts of osmotic, secretory,
inflammatory, infective, factitious
Differentiate between small bowel and large bowel diarrhea including dysentry
Enumerate the causes of acute diarrhea
Explain pathogenesis of different acute diarrhea
Enlist clinical features of dehydration including red flag signs
Outline steps of management
Enumerate complications of acute diarrhea

APPROACH TO A PATIENT WITH CHRONIC DIARRHEA

Define chronic diarrhea

Enlist different causes of chronic diarrhea / Malabsorption
Enlist clinical features of Malabsorption
Explain pathophysiology of Malabsorption
Enumerate relevant investigations including serologies, endoscopies
Elucidate principles of management in relation to the different etiologies

APPROACH TO A PATIENT WITH JAUNDICE INCLUDING ACUTE VIRAL

HEPATITIS

Differentiate between pre hepatic, hepatic and post hepatic jaundice

Enlist causes of acute hepatitis including viruses
Explain pathophysiology of acute hepatitis
Enlist clinical features of acute viral hepatitis
Outline and interpret investigations for acute hepatitis
Enlist complications of acute viral hepatitis
Outline management of acute viral hepatitis
Counsel Patients regarding prevention (including role of vaccination for hepatitis A and B) and
prognosis

CHRONIC LIVER DISEASE

Define chronic liver disease and differentiate it from acute liver injury
Enlist signs and symptoms of chronic liver disease
Enlist various causes of chronic liver disease including viral and non-viral causes
 Enumerate and diagnose different complications of chronic liver disease including portal
hypertension, ascites and SBP, upper GI bleed, hepatic encephalopathy, hepato-renal syndrome,
hepatocellular carcinoma
Outline general and specific management of chronic liver disease and its complications
Counsel Patient regarding prognosis of chronic liver disease

APPROACH TO A PATIENT WITH PROTIENURIA (GLOMERULONEPHRITIS /

NEPHROTIC SYNDROME)

Define Micro, Macro and Nephrotic range protienuria

Enlist common causes of micro, macro and nephrotic range protienuria
Define nephrotic and Nephritic syndromes
Enumerate causes of nephrotic and nephritic syndrome
Elucidate clinical features of nephrotic and nephritic syndromes
Differentiate between nephrotic and nephritic syndromes on the basis of history, examination
and investigations
Outline management of nephritic / nephrotic syndrome
Enlist complications of nephrotic and nephritic syndromes
Enlist different causes of microscopic and macroscopic hematuria
Outline investigation of a patient with hematuria

ACUTE RENAL FAILURE / ACUTE KIDNEY INJURY

Define Acute Renal Failure / Acute Kidney Injury (ARF/AKI)

Define types of Acute Renal Failure including pre renal, renal, post renal azotemia
Enumerate causes of Acute Renal Failure
Elucidate clinical presentations of Acute Kidney Injury
Outline investigations of Acute Renal Failure
Differentiate causes of Acute Renal Failure in relation to history and examination
Outline management of Acute Renal Failure
Enlist indications for Dialysis
Diagnose and treat different metabolic abnormalities in ARF
Decide when to refer/admit the patient
Counsel the patients regarding prognosis

CHRONIC RENAL FAILURE / CHRONIC KIDNEY DISEASE

Define chronic Kidney Disease (CKD)

Enlist major causes of chronic Kidney Disease including glomerular, tubulointerstitial nephritis,
vascular, congenital, and obstructive
 Define Stages of chronic Kidney Disease
Elucidate clinical presentations (Symptoms & Signs) of chronic Kidney Disease
Outline Investigations pertinent to the cause
Enlist complications of chronic Kidney Disease
Outline treatment of Chronic Kidney Disease and complications
Decide when to refer for dialysis and transplantation
Counsel regarding the prognosis of CKD/ESRD

ELECTROLYTE IMBALANCE

Define normal ranges of serum osmolality and serum levels of common electrolytes (Na, K, Cl,
HCO3, Ca, Mg,PO4)
Define the calculation of serum osmolality, total body water, free water deficit, Sodium deficit,
corrected calcium level
Explain compositions of commonly used IV fluids
Enlist causes of Hypo & Hypernatremia, Hypo & hyperkalemia, Hypo &hypercalcemia
Enumerate the clinical features of Hypo & Hypernatremia, Hypo & hyperkalemia, Hypo
&hypercalcemia
Outline other relevant investigations to reach the cause
Outline management Hypo & Hypernatremia, Hypo & hyperkalemia, Hypo &hypercalcemia
Enlist complications of drugs/fluids used for the treatment of electrolyte imbalance

APPROACH TO PATIENT WITH ACUTE DYSPNEA

Enlist causes of acute Dyspnea

Define and classify respiratory failure
Assess severity of dyspnea (NYHA, asthma)
Explain pathophysiology of acute asthma
Enlist clinical features of acute asthma
Enlist clinical features of tension pneumothorax
Enlist & interpret investigations to reach to a diagnosis including acute pulmonary oedema, acute
pulmonary embolism, pneumothorax, acute severe asthma / COPD / respiratory failure
Outline principles of management of each conditions
Outline management of acute severe asthma
Outline management of tension pneumothorax
Enlist indications for ventilatory support including invasive and non invasive modes of ventilation
Counsel patient about the disease
APPROACH TO PATIENT WITH CHRONIC DYSPNEA

Enlist and differentiate between different causes of chronic dyspnea including chronic asthma,
COPD, interstitial lung disease, occupational lung diseases
Explain pathophysiology of COPD
Enlist risk factors associated with COPD
Outline investigations to confirm the diagnosis of chronic dyspnea according to the cause
Differentiate between restrictive and obstructive patterns of PFT’s
Outline management of chronic dyspnea
Enlist indications for long term O2 therapy
Counsel the patients regarding smoking cessation

APPROACH TO A PATIENT WITH PNEUMONIA / PLEURAL EFFUSION

Define and classify pneumonia

Differentiate between community acquired & hospital acquired pneumonia
Enlist causative organism of pneumonia
Explain pathogenesis of pneumonia
Enumerate clinical features of pneumonia including typical and atypical pneumonia
Outline investigations of pneumonia
Read X-Ray chest for findings of pneumonia
Decide criteria for admission in general Medical ward as well as Intensive Care Unit
Formulate treatment plan
Enlist complications of pneumonia including pleural effusion
Explain pathophysiology of pleural effusion
Enlist causes and clinical features of pleural effusion
Outline investigations and treatment plan in pleural effusion
Enlist indications for chest tube intubation

DIABETES MELLITUS

Define diagnostic criteria for diabetes mellitus (WHO)

Define different types of diabetes mellitus
Explain pathogenesis of diabetes mellitus (type 1 and 2)
Enlist symptoms and signs of diabetes mellitus
Outline management of diabetes mellitus (type1 and 2)
Explain diet and life style modification
Enumerate anti-diabetic drugs including oral hypoglycemic along with modes of action, and
insulin
 Enlist side effects of oral hypoglycemic and insulin
Enlist complications of diabetes mellitus
Educate patient regarding treatment and life style modification
Counsel the patient regarding the illness

ACUTE COMPLICATIONS OF DIABETES MELLITUS

Enlist important acute metabolic complications in type 1 & 2 diabetes mellitus (DKA, HHS,
Hypoglycemia)
Differentiate various diabetic metabolic emergency on the basis of clinical signs and symptoms
Explain pathogenesis of DKA, HHS
Understand all possible precipitants of acute metabolic complications
Outline and interpret the investigations for diagnosis of DKA, HHS, hypoglycemia
Outline management plan in a patient with DKA, HHS, hypoglycemia
Enlist complications of the illness
Educate the patient to prevent these complications

CHRONIC COMPLICATIONS OF DIABETES MELLITUS&DIABETIC

NEPHROPATHY

Suspect diabetic nephropathy on the basis of clinical features

Classify stages of diabetic nephropathy (CKD), clinical and histopathological
Outline and interpret investigations in diabetic nephropathy including micro and macro
albuminuria
Explain prevention of nephropathy in a diabetic patient with and without microalbumin
Outline management plan in diabetic nephropathy including early intervention, late intervention
in terms of ESRD

DIABETIC NEUROPATHY / RETINOPATHY

Suspect neuropathy in a diabetic patient on the basis of negative and positive sensory symptoms
Classify various types of diabetic neuropathy
Enlist clinical features of diabetic neuropathy (clinical presentations)
Outline investigations to confirm neuropathy
Outline management of diabetic neuropathy
Enlist complications of diabetic neuropathy
Enlist all ocular complications of DM (cataract, retinopathy and glaucoma)
Classify various stages of diabetic retinopathy (background versus proliferative)
DIABETIC FOOT
Define diabetic foot
Enlist risk factors for diabetic foot
Classify diabetic foot ulcers
differentiate between ischemic versus neuropathic ulcers
Enlist common pathogens leading to diabetic foot
Explain preventive measures for diabetic foot
Outline investigations in a diabetic foot
Outline management of diabetic foot
Enlist indications for amputation

HYPOTHYROIDISM AND HYPERTHYROIDISM

Explain pathophysiology of hypo and hyperthyroidism

Enumerate causes of these conditions
Enlist clinical presentations and physical signs
Outline pertinent investigation of hypo and hyperthyroidism
Interpret thyroid function test
Diagnose and manage acute emergency situations
Outline treatment options of both conditions
Enlist side effects of drugs used in these diseases

CUSHING’S SYNDROME

Explain pathophysiology and its relation with pituitary gland

Differentiate between Cushing’s syndrome and Cushing’s disease
Understand the drug Induced Cushing, iatrogenic Cushing
Enumerate clinical features and physical signs
Enlist side effects of corticosteroids

ADRENAL INSUFFICIENCY

Explain pathophysiology of the illness

Enumerate etiology of adrenal insufficiency
Enlist different clinical presentations according to etiology
Enumerate pertinent physical signs
Outline investigative approach to diagnose adrenal insufficiency
 Explain treatment options and how to educate a patient
Deal with an acute adrenal crisis

APPROACH TO PATIENT WITH ARTHRITIS

Differentiate between mono- oligo- and polyarthritis
Enlist causes of mono- oligo- and polyarthritis
Elicit clinical signs in a patient with joint pain
Explain pathogenesis of arthritis in RA, Gout, sero-negative arthritis
Investigate and interpret various laboratory and radiological investigations in an arthritis patient
Outline principles of management of RA, Gout, sero-negative arthritis
Enumerate various complications of RA, Gout, sero-negative arthritis itself and its treatment
Counsel patient about disease and its prognosis

APPROACH TO PATIENT WITH CONNECTIVE TISSUE DISEASE

Define Overlap Syndrome / MCTD
Explain pathogenesis of SLE / Scleroderma / Polymyositis
Enumerate signs and symptoms of SLE / Scleroderma / Polymyositis
Enlist various modes of presentations of SLE/ Scleroderma / Polymyositis
Enlist diagnostic criteria of SLE / Scleroderma / Polymyositis
Elucidate and interpret serological Investigations (ANA, Anti ds DNA, ENA)
Outline principles of management of SLE / Scleroderma / Polymyositis
Counsel patients of connective tissue diseases regarding treatment, complications and
rehabilitation
Enlist drugs causing Lupus
Enlist stages of Lupus Nephritis

APPROACH TO PATIENTS WITH FEVER AND ALTERED LEVEL OF

CONSCIOUSNESS

Enlist causes of fever with PUO

Enlist differential diagnosis in patients having fever with altered level of consciousness
Define and differentiate meningoencephalitis / cerebral malaria
Enlist organisms involved in meningoencephalitis including bacterial both acute and chronic, viral,
fungal
Enlist clinical features of meningoenchephalitis /cerebral malaria
Enlist complications of meningoencephalitis / cerebral malaria
Outline investigations in a patient with meningoencephalitis / cerebral malaria
 Interpret CSF analysis in different types of CNS infections including bacterial, viral, fungal and
protozoal
Outline management plan in a patient with meningoencephalitis / cerebral malaria
Counsel the patient regarding long term sequelae especially in chronic meningitis / partially
treated cases

APPROACH TO PATIENTS WITH PULMONARY AND EXTRA

PULMONARY TUBERCULOSIS

Explain pathogenesis of pulmonary and extrapulmonary tuberculosis

Suspect and diagnose pulmonary & extra pulmonary tuberculosis
Suspect and diagnose atypical tuberculosis especially in immunocompromised individuals
Outline investigations to diagnose pulmonary and extra pulmonary tuberculosis
Outline management plan for pulmonary and extra pulmonary tuberculosis, considering CAT I and
CAT II Therapy
Explain radiology of different patterns of pulmonary tuberculosis
Identify ATT induced side effects
Treat tuberculosis in specific circumstances including liver disease, pregnancy, AIDS
Define, diagnose and treat drug resistant tuberculosis including MDR, XDR
Counsel patient with tuberculosis including adherence to treatment, drugs side effect, and
interaction with the family/isolation

APPROACH TO PATIENTS WITH HIV

Define AIDS and HIV

Explain modes of transmission and epidemiology of HIV
Explain virology and immunology in HIV
Explain natural history and staging of HIV
Enlist clinical features of acute HIV
Enumerate different modes of presentation in HIV
Enumerate different diseases in relation to CD4 cell count
Outline investigations to make a diagnosis and evaluate complications
Outline management regarding treatment of primary illness and complications of the disease
Counsel the patient regarding primary illness, complications, social relationships, rehabilitation
and prevention

INFECTIVE ENDOCARDITIS

Give definition of infective endocarditis

Classify different types of infective endocarditis
Enumerate the common organisms causing infective endocarditis
Explain pathogenesis and risk factors associated with infective endocarditis
Enlist clinical features suggestive of infective endocarditis
Outline investigations to establish a diagnosis
Formulate treatment strategy along with duration and response to therapy
Explain requirement of prophylaxis in different surgical procedures
Enlist complications of infective endocarditis
Counsel the patients regarding treatment / surgery and prophylaxis
 LECTURES

OVERVIEW OF DYSLIPIDEMIA / METABOLIC SYNDROME/ OBESITY

Define and classify dyslipidemia, obesity and metabolic syndrome.
Discuss their pathogenesis.
Recognize and differentiate between various causes and clinical features of secondary
dyslipidemia, obesity and metabolic syndrome.
Enlist and interpret various laboratory investigations in evaluating a case of dyslipidemia.
Identify various risk factors and risk stratification of various factors in the management
Discuss the principles of management of dyslipidemia/ metabolic syndrome/ obesity.
Discuss the counseling for different types of dyslipidemia, obesity and metabolic syndrome.

OVERVIEW OF HEMOLYTIC ANEMIA

Define hemolytic anemia and its various types

Discuss the pathogenesis of different types of hemolytic anemia( intravascular v/s extravascular,
congenital v/s acquired).
Recognize various clinical features of hemolytic anemia (congenital, acquired, autoimmune v/s
non immune).
Enlist and interpret various haematological investigations (including various red cell indices) in
evaluating a case of hemolytic anemia.
Formulate the differential diagnosis on the basis of available investigations.
Discuss the principles of management of various types of hemolytic
Discuss the counseling for different types of hemolytic anemia.

OVERVIEW OF HIV
Define AIDS and HIV
Explain modes of transmission and epidemiology of HIV
Explain virology and immunology in HIV
Explain natural history and staging of HIV
 Enlist clinical features of acute HIV
Enumerate different modes of presentation in HIV
Enumerate different diseases in relation to CD4 cell count
Outline investigations to make a diagnosis and evaluate complications
Outline management regarding treatment of primary illness and complications of the disease
Counsel the patient regarding primary illness, complications, social relationships, rehabilitation
and preventio

BONE MARROW TRANSPLANTATION

Enlist the indications of bone marrow transplantation

Discuss various types of bone marrow transplantation( allogeneic ,autologous)
Identify Complications of bone marrow transplantation (both early and late)
Discuss graft-versus-host disease (GVHD)
Discuss principles of management of a transplant patient

OSTEOPOROSIS / OSTEOMALACIA

Define osteoporosis/ osteomalacia

Discuss various clinical manifestations of osteoporosis/ osteomalacia
Discuss pathophysiology of osteoporosis/ osteomalacia
Identify various risk factors of osteoporosis/ osteomalacia
Identify screening protocol for osteoporosis/ osteomalacia
Diagnose osteoporosis/ osteomalacia
Discuss the principles of management including counseling of osteoporosis/ osteomalacia

OVERVIEW OF CHRONIC DIARRHEA/ MALABSORPTION

SYNDROME
1. Define chronic diarrhea and malabsorption syndrome.
2. Enlist the causes of chronic diarrhea and malabsorption syndrome.
3. Discuss the pathophysiology of important malabsorption syndromes like Celiac Disease, Tropical
Sprue, Wipple's Disease.
4. Discuss the pathophysiology of inflammatory bowel disease.
5. Discuss the signs and symptoms of malabsorption syndrome.
6. Enumerate and discuss the various malabsorption tests.
7. Outline the management of chronic diarrhea and important malabsorption syndromes.
8. Discuss the signs and symptoms of inflammatory bowel disease.
9. Enlist the investigations needed for the diagnosis of inflammatory bowel disease.
10. Outline the management of inflammatory bowel disease.
APPROACH TO RENAL FAILURE

Define acute and chronic renal failure.

Enumerate the causes of acute and chronic renal failure.
Discuss the pathophysiology of renal failure.
Enlist the signs and symptoms of renal failure.
Enlist and interpret the investigations for renal failure.
Outline the management plan.
Discuss the complications of renal failure.
Enumerate the indications for dialysis.
Discuss briefly the concept of hemodialysis and peritoneal dialysis.

OVERVIEW OF ARTHRITIS

Classify arthritis according to the onset and number of joint involvement.

Classify arthritis according to the etiology.
Discuss the pathophysiology of rheumatoid, osteoarthritis, gout and seronegative arthritis.
Enlist the investigations needed for different arthritis.
Discuss the radiological findings in different arthritis.
Interpret the synovial fluid analysis.
Outline the management plan.

SEPSIS & DIC

Define SIRS & Sepsis
Discuss the Pathophysiology of Sepsis
Discuss the Signs & Symptoms of Sepsis
Discuss the management of Sepsis
Define DIC
Discuss Pathophysiology of DIC
Enlist the Causes of DIC
Enlist the Investigation needed to diagnose DIC
Discuss the Management of DIC

COAGULOPATHY / DVT / EMBOLISM

Define the Coagulation disorders
Discuss the defect in coagulation cascade
Enumerate the Signs & Symptoms of Coagulation disorders
Outline the management of coagulation disorders
Define DVT
 Enlist the causes of DVT
Discuss the pathophysiology of DVT
Enlist the signs & symptoms of DVT
Define the embolism (Air, Amniotic, Fat, Clot)
Enlist the predisposing conditions of Embolism
Outline the management of DVT with emphasis on anticoagulation therapy
Discuss the anticoagulants and their mode of action

OVERVIEW OF DIABETES MELLITUS

Describe the pathophysiology of diabetes mellitus

Enlist the different types of DM
Enumerate the clinical features of DM
Outline the basics of management of DM
Enlist the microvascular and macrovascular complications of DM

INTERPRETATION OF ABG’S
Understand the basics of arterial blood gases
Know the normal values of ABG’S
Know when to order the test
Enumerate different types of ABG’s
Differentiate between acidosis and alkalosis
Enlist causes of all 4 basic varieties of ABG’s
Understand the change in hemoglobin dissociation curve in relation to ABG’S

RESPIRATORY FAILURE AND MECHANICAL VENTILATION

Understand type I and II respiratory failure

Enumerate the causes of type I and II respiratory failure
Discuss different methods of oxygen therapy and use of different devices
Understand the oxygen therapy in both types of respiratory failure
Management of type II respiratory failure in relation to oxygen therapy and mechanical
ventilation
Enumerate different modes of mechanical ventilation including CMV, SIMV, CPAP
Understand the role of PEEP in type I respiratory failure
Enlist the indications for mechanical ventilation

FLUID AND ELECTROLYTES BALANCE

Enlist different types of derangements in electrolytes

 Enlist the causes of these electrolytes imbalances
Enlist the salient clinical features of these electrolytes disturbances
Discuss methods for calculating different electrolytes deficit and how to replace them
Discuss different fluids available in market like 0.9% saline, 0.45% saline, 3% saline, 5% D/w,
0.45% D/Saline, 0.9% D/Saline, ringer lactate,20 mEq potassium solution, 25% D/W
Discuss use of these solutions at appropriate deficiencies

OVERVIEW OF POISONING

Enlist common types of poisoning including organophosphorous compounds, atropine, halothane,

benzodiazepams, narcotics, alcohol, corrosives, carbon monoxide
Enumerate clinical presentations of these poisoning
Discuss the immediate management of these poisoning
Enlist the complications of these poisoning
Discuss the long term management including rehabilitation if required
Counsel the patient and family regarding the consequences of these poisoning

BLOOD TRANSFUSION METHODS

Discuss different types of blood transfusion methods

Enlist different blood products available like whole blood, packed cell, platelets, white cell, fresh
frozen plasma
Enlist indications for use of these blood products
Discuss complications associated with blood product transfusion itself and of different varieties of
blood

EMERGENCY LIFE SAVING SKILLS FOR MEDICINE

TITLE OF SKILL:
Introduction to Defibrillation.

INTRODUCTION:

Defibrillation by Automated External Defibrillators or Manual Defibrillators is a life-saving skill

during cardiac arrest. Learning proper technique of defibrillation is essential for every healthcare
professional working in emergency and intensive care settings.

LEARNING OBJECTIVES:
After this session students should be able to:
 List the equipment required for this procedure.
Demonstrate correct technique of defibrillation by a manual defibrillator.

TITLE OF SKILL: Management of Respiratory Arrest.

INTRODUCTION:

Airway management is an essential part of any emergency medical intervention in cases of cardiac
or respiratory arrest. Proper use of basic and advanced airway adjuncts is a fundamental skill for all
tiers of health care professionals.

LEARNING OBJECTIVES:
After this session students should be able to:

List the equipment required for this procedure.

Demonstrate correct technique of insertion of basic and advanced airways with precautions.

CARDIOLOGY
PATIENT WITH CHEST PAIN

Analyze history and examination of the patient with ischemic heart diseases.
Able to differentiate the clinical presentation of various ischemic presentations.
Able to predict risk score for management plane.
Read ECG and laboratory test investigation Troponin and CK-MB.
Correlate the clinical presentation with reports of the advanced investigation like ECHO and
Coronary Angio and Thallium Spect.
Describe the management plane of specific ischemic disorders.

PATIENT WITH CARDIAC FAILURE

Analyze the history and examination of cardiac failure presentation.

On the clinical presentation try to find the cause of cardiac failure.
Read ECG and X-Ray finding.
Correlate the clinical presentation with echocardiography reports finding.
Describe the management.

PATIENT WITH HYPERTENSION

 Analyze and the history and examination specially BP taking procedure in a patient with
hypertension.
Able to Grade the level of blood pressure.
On the clinical presentation try to identify the secondary cause end-organ damage.
Assess cardiovascular risk factors.
Analyze the appropriate test for secondary cause e.g. ultrasound abdomen KUB thyroid profile
etc.
Analyze the appropriate test for end-organ damage documented on clinical presentation. (U &Es,
urinalysis, creatnine, ECG, Fundascopy, ECHO).
Describe the management.

PATIENTS WITH VALVULAR DISEASES

Analyze history and examination of the rheumatic valvular heart diseases presentation.
On the clinical presentation try to find diagnosis of the specific valular involvement.
Read the ECG Chest X-Ray finding.
Correlate clinical finding with the reports of Echocardiography finding.
Describe the management and prophylaxis.

PATIENTS WITH ARRHYTHMIAS

Analyze the history and examination of patient with arrhythmias.

On the clinical presentation try to clarify the nature of arrhythmias
Try to find the cause of arrhythmias.
Know the importance of advance investigation for the management plain 24 hours Ambulatory
ECG, ECHOCARDIOGRAPHY, EP studies, Laboratory test.
Describe the management plane of specific arrhythmias.

PATIENT WITH ADULT CHD:

Analyze the history and examination of Cyanotic Heart disease presentation.

On the clinical presentation try to find the diagnosis of the congenital heart diseases.
Read ECG, Chest, X-Ray finding.
Correlate the echocardiography findings with clinical presentation.
Describe management plane.
 NEUROLOGY
APPROACH TO PATIENT WITH HEADACHE:

Record accurate neurological history.

Perform complete as well as customized neurological examination
Able to perform fundoscopic examination
Able to recognize red flags signs related to headache.
Able to differentiate between different types of primary headache disorders.

APPROACH TO PATIENT WITH EPILEPSY:

Record accurate neurological history.

Perform complete as well as customized neurological examination
Able to differentiate between different types of epilepsies.
To know the indications ,contraindications and side effects of different antiepileptic drugs
Able to know different treatment options for refractory /resistant epilepsy

APPROACH TO PATIENT WITH STROKE/MOTOR WEAKNESS:

Record accurate neurological history.
Perform complete as well as customized neurological examination
Localize the lesion indifferent parts of nervous system on the basis of history and examination in
patients with motor weakness.
Able to perform immediate and routine investigations in patient with weakness.
Able to perform immediate management in patient with stroke
Able to know usage, indication and contraindication of TPA

APPROACH TO PATIENT WITH PARKINSON’S DISEASE:

Record accurate neurological history.

Perform complete as well as customized neurological examination
Able to know the differential diagnosis of patients with Parkinsonism
Able to know the different management plans of patient with Parkinson disease

APPROACH TO PATIENT WITH MULTIPLE SCLEROSIS:

Record accurate neurological history.
Perform complete as well as customized neurological examination
Localize the lesion indifferent parts of nervous system on the basis of history and examination.
Able to know different types and management of patients with multiple sclerosis
 APPROACH TO PATIENT WITH NUMBNESS AND GBS:

Record accurate neurological history.

Perform complete as well as customized neurological examination
Able to know differential diagnosis in patients with numbness
Able to differentiate demyelinating and axonal diseases on EMG/NCVs
Able to recognize and manage patients with acute neuropathy e.g. GBS

APPROACH TO PATIENT WITH ATAXIA:

Record accurate neurological history.

Perform complete as well as customized neurological examination in patients with ataxia
Able to know the differential diagnosis of ataxia
Able to investigate the treatable causes of ataxia

APPROACH TO COMATOSE PATIENT:

Record brief history and tailored neurological examination

Able to know the neurological and non-neurological causes of coma
Able to know the immediate investigations in patients with coma
Able to know the immediate management plans in patients with coma.

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