CHECKLIST EOP

INTERNAL MEDICINE

Topic Learning Outcome Remarks

Approach to Chest Pain 1. Outline the blood supply of the heart
(IHD & ACS) 2. Explain the pathophysiology of IHD and identify the risk
Factors
3. Appreciate the Epidemiology - Malaysia
4. Discuss the Clinical presentations of IHD
5. Explain the Investigations with interpretation and justification
6. Discuss the Medical & Surgical principle of treatment of IHD.
7. Outline prevention & prognosis of IHD
8. Discuss the clinical approach to chest pain
Approach to Shortness of 1. Define asthma, COPD, bronchiectasis and explain their
Breath (Asthma, COPD, pathophysiology
Bronchiectasis) 2. List trigger factors and risk factors for asthma, COPD &
Bronchiectasis.
3. Discuss the clinical manifestations and the differential
diagnosis of obstructive lung disease.
4. Discuss the clinical approach to differentiate the obstructive
lung disease.
5. Outline the management of obstructive lung disease including
acute exacerbation.
CASE BASE LEARNING (CBL)

6. Discuss the complications of obstructive lung disease

including the drugs side effects.
Approach to Shortness of 1. Outline the surface anatomy of pleura & the pathophysiology
Breath (Restrictive Lung of the pleural diseases and lung
Disease, Pleural Disease, neoplasm.
Bronchogenic 2. Explain the clinical presentations of pleural diseases &
Carcinoma) Bronchogenic Carcinoma.
3. List down the important Investigations & its interpretation &
justification in pleural disease and B.
carcinoma.
4. Outline the principle of treatment of pleural disease & B.
carcinoma
Approach to Respiratory 1. Explain the indications of ABG.
Failure (type 1 & 2) & 2. Discuss the ABG interpretation with various scenarios to cover
ABG interpretations metabolic and respiratory
acidosis and alkalosis including the mix pH derangement.
3. Interpret the compensated and uncompensated pH
derangement.
4. Explain the differential diagnoses of metabolic and respiratory
alkalosis and acidosis including
the mix pH derangement
1. Differentiate between the types of respiratory failure and their
differential diagnoses
Approach to Palpitation 1. Explain the pathophysiology of arrhythmia and its
and arrythmia classification.
2. Discuss the clinical presentations and the clinical approach to
patient with palpitation including
different investigations.
3. Interpret the ECG finding in common arrhythmia
4. Outline the principle of treatment of common arrythmia
 Topic Learning Outcome Remarks
Approach to Heart 1. Define hypertension according to staging and explain the types
Failure and causes of
(CCF,HPT,VHD) hypertension and VHD.
2. Discuss clinical approach to patient with hypertension, CCF
LECTURE

and VHD including the

complications and risk factors.
3. Explain the differential diagnoses of CCF.
4. Discuss the relevant investigation with justification and in HPT,
CCF & VHD.
5. Outline the principle of management for HPT, CCF and VHD
including hypertensive
emergencies

Topic Learning Outcome Remarks

TEAM BASE LEARNING (TBL)

Chronic Liver Disease 1. Discuss the aetiology and pathophysiology of cirrhosis & its
(Liver Cirrhosis & complication.
complications) 2. Explain the risk factors and clinical manifestations of cirrhosis
& its complications.
3. Outline the management of liver cirrhosis & its complications.
4. Discuss the clinical approach for patient with liver cirrhosis &
its complications.

Topic Learning Outcome Remarks

Lower respiratory Tract 1. Define CAP and HAP
Infection (Pneumonia & 2. Discuss the classification and pathophysiology of CAP, HAP
TB) and Pulm.TB
3. Discuss the predisposing factors, clinical features,
investigation, treatment, and complications of HAP, CAP,
Pulm.TB.
4. Outline the principle of treatment and explain severity
assessment including IC admission criteria.
5. Discuss the prevention aspects and the disease and
treatments complications
SEMINAR

Pulmonary Vascular 1. Discuss the pathophysiology of pulmonary vascular diseases

Disease (Pulmonary (PE)
Hypertension & 2. Discuss the clinical features, investigation, treatment, and
Pulmonary Embolism) prevention
3. Explain the clinical approach to pulmonary vascular diseases
that include their investigations with justification.
Approach to Jaundice 1. Explain the causes and pathophysiology of jaundice
(including hepatitis) 2. Discuss The clinical features of each type of jaundice
3. Discuss the clinical approach to jaundice and hepatitis that
include Investigations and their interpretation.
4. Explain the causes and types of hepatitis.
5. Discuss the clinical features and complications of hepatitis.
6. Outline the principle of treatment including prevention.
Approach to Diarrhoea 1. Differentiate acute and chronic diarrhoea
(Malabsorption, 2. Explain the pathophysiology chronic and acute diarrhoea.
Inflammatory Bowel 3. Discuss the clinical features and complications of IBD &
Disease) Malabsorption
4. Discuss the clinical approach to diarrhoea ( acute & chronic)
including the investigations with their interpretation to
differentiate different causes including IBD & malabsorption.
5. Outline the principle of treatment of acute and chronic
diarrhoea including IBD & malabsorption.

Approach to Fever 1. List the common causes of fever.

(Dengue, Leptospirosis, 2. Explain the pathophysiology of common infectious disease.
Typhoid, Melioidosis, 3. Discuss the clinical approach to formulate differential
Tetanus) diagnoses of fever
4. Discuss the investigations of common infectious disease.
5. Outline the principle of treatment in common infectious
disease including prevention.
Approach to Pyrexia Of 1. Define the PUO
Unknown Origin (PUO) 2. Explain the causes of PUO .
(HIV, Meningitis, 3. Explain the pathophysiology of common infectious disease
Malaria, Infective that present with PUO including HIV, IE, Malaria and Meningitis. 4.
Endocarditis) Discuss the clinical manifestations of causes of PUO including
HIV, IE, Malaria and Meningitis.
5. Discuss the investigations and its interpretation in PUO.
6. Outline the management of the patient with HIV, IE, Malaria
and Meningitis.
Metabolic Syndrome, 1. Define DM & obesity and explain its pathophysiology.
Diabetes, and its 2. Explain the secondary causes of DM & obesity.
Complications 3. Discuss the clinical presentations of the metabolic syndrome
& DM and its complications.
4. List down the important investigations in DM & metabolic
syndrome with their justification and interpretations.
5. Outline the management of obesity, metabolic syndrome, DM
and its acute complications.

Thyroid Disorders & 1. Explain the pathophysiology of thyroid disorders.

Thyroid Examination 2. Discuss the clinical features of different thyroid disorders and
its complications.
3. Interpret the thyroid function test and tests in various thyroid
disorders.
4. Outline the management plan of thyroid disorders.
Approach to bleeding 1. Explain the natural mechanism of haemostasis
tendency. 2. Discuss the differential diagnosis of patient presenting with
bleeding tendency & clinical approach to identify the diagnosis of
bleeding.
3. List relevant investigations and interpret their findings.
4. Outline the management of patients with bleeding tendency
 Approach to patient with 1. Define anaemia and explain its classification and causes.
Pallor (Anemia) 2. Discuss the clinical approach to a case with anaemia including
investigations with their interpretations.
3. Explain the clinical features including the complications of
different types of anaemia.
4. Outline the principle of treatment of patient with anaemia

Approach to patient with 1. Discuss the causes of lymphadenopathy and

Organomegaly / hepatosplenomegaly
Lymphadenopathy 2. Discuss the clinical approach to lymphadenopathy and
hepatosplenomegaly presentation.
3. Identify the clinical features and complications of common
haematological diseases that present with lymphadenopathy
and hepatosplenomegaly.
4. List relevant investigations in lymphadenopathy and
hepatosplenomegaly with justifications.
5. Outline the principle of treatment of common causes of
lymphadenopathy and hepatosplenomegaly.
Introduction to 1. Discuss the anatomy of vascular supply to the brain
Neurological Disorder 2. Explain the types of strokes, predisposing factors and causes.
(CVA, UMNL, LMNL) 3. Discuss the clinical presentation and complication of CVA.
4. Outline the management of CVA.
5. Discuss the clinical approach to UMNL & LMNL).

Approach to patient with 1. Explain the pathophysiology of oedema.

Oedema (Nephrotic 2. Discuss the clinical approach to patient with oedema, identify
syndrome, Heart Failure, the differential diagnoses and justifiable investigations.
Liver disease, CKD) 3. Discuss the pathophysiology of kidney injuries and their
clinical features.
4. Explain the principle of management of patients with kidney
injuries.

Common complaints Remarks

Chest pain,
Oedema,
SOB,
CASE PRESENTATION (CP)

Cough
Palpitations,
Fever,
Diarrhoea (acute & chronic),
Jaundice,
Convulsion,
Pallor,
Bleeding tendency,
Arthritis,
Neurological deficit,
Lymphadenopathy, and hepatosplenomegaly
 Topic Learning Outcome Remarks
Audio-visual 1. Explain the basic physiology of cardiac cycle and the relation
cardiovascular of various heart sounds to cardiac cycle.
examination / Heart 2. Discuss the pathophysiology of abnormal heart sounds and
sound murmurs.
3. Discuss the clinical approach to murmurs.
4. Discuss the clinical approach for cardiovascular physical
examination
Basic ECG interpretation 1. Understand the conduction pathways of the heart
2. Discuss the localization of culprit coronary artery
3. Apply the steps involved in interpreting ECG in orderly way
4. Know the normal limit of the various parts of ECG
5. Able to interpret the ECG
6. Know the overview of performing ECG in patient
Audio-visual respiratory 1. Identify the normal and abnormal breath sounds.
examination / breath 2. Explain the differential diagnosis of abnormal breath sounds.
sound 3. Discuss the clinical approach for respiratory physical
examination.
Pleural tap, biopsy, and 1. Discuss the aseptic technique used to perform pleural tap and
chest tube insertion pleural biopsy.
2.List the indications, contra indication and complications of this
CLINICAL SKILL LAB (CSL)

procedure
3. Demonstrate the technique and sequence of the procedure by
video presentation and on mannequin
4. Calculate and interpret the pleural fluid content weather
transudative and exudative according to the Light’s diagnostic
criteria
5. Learn the post procedure management
6. Apply the procedure technique when observing or assisting in
living patient in the ward
Spirometry 1.Understand the procedure.
2. Acquire the understanding of procedure on real patient in the
ward
3. Differentiate obstructive and restrictive patterns

Audio-visual abdominal 1. Discuss the aseptic technique used to perform abdominal

examination/ Ascitic paracentesis.
tapping 2. List the indications, contra indication and complications of this
procedure
3. Calculate Interpret the SAAG value to identify the cause of
ascites.

lumber puncture and 1. Discuss the aseptic technique used to perform abdominal
CSF analysis paracentesis.
2. List the indications, contra indication and complications of this
procedure
3. Calculate Interpret the SAAG value to identify the cause of
ascites
CNS Examination 1. Cranial Nerve Examination
2. Motor function test
3. Sensory function test
SURGERY

Topic Learning Outcome Remarks

Diseases of Gall Bladder 1. Understand the metabolism of bilirubin, emphasizing its role in
and Obstructive Jaundice obstructive jaundice.
2. Identify and classify common types of gallstones.
3. Explain the clinical presentation and perform a thorough
physical examination in cases of gallbladder diseases.
4. Recognize and list the common causes of surgical jaundice.
5. Discuss various investigations and imaging techniques
relevant to gallbladder and obstructive jaundice.
6. Explain the role of ERCP (Endoscopic Retrograde
Cholangiopancreatography) in diagnosing and managing these
conditions.
7. Outline the management options for surgical jaundice,
including surgical interventions.
8. Analyse and discuss potential postoperative complications in
patients with gallbladder and obstructive jaundice.
Thyroid Diseases 1. Describe the embryology and surgical anatomy of the thyroid
gland.
2. List and categorize diseases of the thyroid gland, emphasizing
prevalence.
3. Define and explain goitre, hyperthyroidism, hypothyroidism,
and solitary thyroid nodules.
4. Detail the pathology, clinical features, investigations,
differential diagnoses, and treatments for common thyroid
LECTURES

diseases.
5. Discuss potential complications associated with thyroid
surgery.

Surgical Disease of 1. Describe the surgical anatomy of parathyroid glands.

Parathyroid Gland 2. List and classify types of parathyroid gland diseases,
highlighting common occurrences.
3. Define hyperparathyroidism and hypoparathyroidism.
4. Explain the pathology, clinical features, investigations, and
treatment for parathyroid diseases

Diseases of Prostate 1. Describe the anatomy of the prostate gland.

2. Discuss various treatment options for different prostate
diseases.
Disease of Kidney and 1. Understand the anatomy of the kidney, emphasizing common
Ureters and Bladder. surgical diseases (stones, malignancy).
2. List symptoms and signs related to each kidney disease.
3. Utilize investigations to differentiate between differential
diagnoses.
4. Analyse findings from diagnostic investigations.
5. Outline the management of common surgical diseases
affecting the kidney, ureters, and bladder.
Abdominal Wall Hernia 1. List criteria for diagnosing patients with hernias.
2. Outline differential diagnoses for hernias.
3. Evaluate the diagnosis and management of hernias,
considering different types.
 Benign Breast Diseases 1. Describe the anatomy of the breast, including blood supply,
venous drainage, and lymphatic drainage.
2. Analyse presenting symptoms and discuss the management of
benign breast diseases.
3. Explain the importance of family history and genetic tests.
4. Define principles of breast surgery.
5. Explain the importance of triple assessment and FNAC (Fine
Needle Aspiration Cytology).

Vascular Diseases Venous Insufficiency:

(Venous Insufficiency and 1. Know lower limb vein anatomy.
LL Ischemia) 2. Understand the pathophysiology of venous insufficiency.
3. Identify clinical presentations of venous insufficiency.
4. Perform and interpret the tourniquet test.
5. Know required investigations for assessing the venous system.
6. Outline treatment plans for patients with venous insufficiency.

Lower Limb Ischemia:

1. List causes of acute limb ischemia.
2. Evaluate clinical presentations of acute limb ischemia.
3. Differentiate between embolus and thrombus as causes.
4. Suggest initial investigations needed.
5. Briefly outline treatment for acute limb ischemia.
6. Identify clinical presentations of chronic limb ischemia.
7. Differentiate between vascular and non-vascular causes of
limb pain.
8. Perform Ankle-Brachial Index (ABSI).

Topic Learning Outcome Remarks

Head Injury 1. List interventions required for head injury.
2. Explain the importance of nerve or vessel injury in trauma.
3. Correlate types of head injury with pathophysiology.
4. Review the Glasgow Coma Scale.
5. Recognize signs in neurologically deteriorating patients.
6. - Demonstrate the ABCDE approach and its relation to avoiding
secondary neurological damage after head injury.
Disease of Scrotum & 1. Describe the surgical anatomy of the testes and scrotum.
CASE BASE LEARNING (CBL)

Testes 2. Recognize various disease presentations.

3. List different management options.
4. Discuss the management of testicular cancer using the TNM
classification.
Acute abdomen, Acute Abdomen & Peritonitis:
peritonitis, and Acute 1. Understand the meaning of acute abdomen.
appendicitis. 2. Recognize signs and symptoms of peritonitis.
3. Correlate symptoms and signs.
4. Produce a list of differential diagnoses.
5. Propose relevant investigations.
6. Interpret findings of investigations in different cases.
7. Outline the management of peritonitis.

Appendicitis:
8. Describe the inflammatory process of the appendix.
9. Know the anatomy of the appendix.
10. Outline the management of appendicitis and its
complications.
 Dysphagia 1. Explain the term dysphagia.
2. Identify different causes, including strictures, malignancy,
achalasia, and neurological causes.
3. Explain 'red flag signs' and the role of blood tests, endoscopy,
and contrast studies in assessing dysphagia.
4. Explain the presentation of and risk factors for oesophageal
cancer.
5. List medical and surgical treatments for oesophageal cancer,
including palliative care.
Breast cancer 1. Understand the anatomy of the breast and lymphatic drainage.
2. Know the risk factors for breast cancer.
3. Recognize symptoms and signs of breast cancer.
4. Analyse the staging of breast cancer.
5. Understand and utilize the triple assessment for approaching
patients.
6. Know radiological studies for breast cancer with interpretation.
7. Outline treatment modalities.

Topic Learning Outcome Remarks

Abdominal and chest 1. Understand different mechanisms of trauma. 2. Realize the
trauma body's response to trauma. 3. Know life-threatening conditions in
chest trauma. 4. Learn management of immediately life-
threatening conditions. 5. Approach a trauma patient using ATLS
(Advanced Trauma Life Support) protocols. 6. Understand
important organ injuries in the abdomen. 7. Outline the
management of organ injury. 8. Understand damage control
surgery
Surgical disease of liver, Liver: 1. List criteria for diagnosing liver diseases. 2. Outline
Spleen, and portal HTN differential diagnoses for liver diseases. 3. Evaluate different liver
diseases. 4. Discuss the management of liver diseases. Spleen &
Portal HTN: 5. Understand the surgical anatomy of the spleen
and portal system. 6. Define and assess portal hypertension. 7.
Explain pathogenesis and classification. 8. Identify causes of
SEMINAR

increased portal flow. 9. Describe variceal bleeding. 10.

Understand the functions of the spleen. 11. List common
complications of splenectomy. 12. Emphasize the importance of
prophylaxis against infection following splenectomy.
Upper GI bleeding 1. Understand the anatomy of the oesophagus, stomach, and
duodenum. 2. Identify different causes of upper GI bleeding,
including duodenal ulcer, gastric ulcer, gastric erosions,
oesophageal varices, MalloryWeiss tear, and oesophageal
cancer. 3. Explain the role of OGDS (Esophago-Gastro-
Duodenoscopy). 4. List factors for upper GI bleeding and the role
of GP (General Practitioner) in its prevention. 5. List options for
treating upper GI bleeding, including endoscopic, surgical, and
pharmacological interventions
Lower GI bleeding 1. Understand the anatomy of the small and large bowel,
including blood supply. 2. Identify different causes of lower GI
bleeding. 3. Explain the role of colonoscopy. 4. Know how to
prepare the patient for colonoscopy. 5. Outline the management
of patients with lower GI bleeding
Burns, skin and soft Burns:
tissue lesions 1. List criteria for admitting burns patients.
2. Outline fluid resuscitation methods for burns.
3. Evaluate definitive and local management of burns.
4. Discuss effects of non-thermal burn injury.

Soft Tissue Lesions:

5. Understand the histology of the skin.
6. List common benign and malignant skin lesions.
7. Develop an understanding of clinical examination for lumps
and bumps.
8. Gather a complete or problem-focused history for common
skin lesions.
9. Discuss presentation, diagnostic strategy, and initial
management of patients with skin and soft tissue lesions.
Shock and metabolic 1. Understand the pathophysiology of shock and ischemia-
response to trauma. perfusion injury.
2. Recognize different patterns of shock and principles of
resuscitation.
3. Know appropriate monitoring and endpoints of resuscitation.
4. Understand classical concepts of homeostasis.
5. Identify mediators of the metabolic response to injury.
6. Understand changes in body composition accompanying
surgical injury.
7. Comprehend concepts behind optimal preoperative care.
Surgical complications of 1. Understand the aetiology and pathogenesis of peptic ulcer
peptic ulcer disease disease.
2. Assess and resuscitate a patient with acute upper GI bleeding.
3. Explain the role of OGDS.
4. List risk factors for peptic ulcer disease.
5. List common complications of peptic ulcer disease and their
management.

Diseases of the colon and 1. Define the anatomy of the colon.

anorectum 2. Understand signs and symptoms of various diseases,
particularly malignancies.
3. Understand the aetiology, clinical features and investigation of
the intestinal obstruction.
4. Generate different treatment plans, considering available
staging systems.

Nutrition in surgery 1. Understand the role of nutrition in surgery for healing and
recovery.
2. Know different ways of delivering nutrition (oral, enteral,
parenteral).
3. Compare pros and cons of different nutrition delivery routes.
4. Assess a patient's nutritional status.
5. Know how to optimize a patient's nutrition prior to surgery.
Principles of wound 1. Develop the ability to present cases and improve self-
healing and its confidence.
complication 2. Gain knowledge of basic anatomy of human skin and its
function.
3. Comprehend the pathological basis of wound healing and its
complications.
4. Develop a general understanding of the basic concept of
dressing a wound.
5. Cultivate the culture of answering queries in public speaking.

Endoscopy & Daycare Endoscopy:

surgery 1. Understand the concept of endoscopy.
2. Know the parts of endoscopy equipment.
3. Know different types of endoscopic procedures in surgery.
4. Know indications and contraindications for endoscopy.
5. Be aware of complications related to endoscopic procedures.

Day-Care Surgery:
6. Define day-care surgery.
7. Understand the criteria for selecting patients for the
procedure.
8. Identify the day-to-day running of a typical day-care ward.
9. Understand the concept of home nursing.
Sepsis, infection and 1. List criteria for managing surgical site infection and antibiotic
antibiotics policy policy.
2. Outline types of surgical site infection and antibiotic policies.
3. Evaluate types of surgical site infection and measures
concerning antibiotic policies.
4. Discuss the management of surgical site infection and the
application of antibiotic policies
Patient’s safety 1. Describe patient safety.
2. List measures for patient safety.
3. State different levels of measures for patient safety.
4. Describe local, regional, and national levels of patient safety
 Topic Remarks
Abdominal Examination

Per Rectal Examination

Urinary Catheterization
CLINICAL SKILL LAB (CSL)

Breast Examination

Sutures & Suturing

technique

Wound management and

dressing

NG Tube Insertion

Hernia Examination

Vascular Examination

Glasgow Coma Score

(GCS)