Course Specification of Internal Medicine University: Assiut Faculty: Medicine Course specifications: Internal Medicine Programme(s) on which the course is given: M. B. B. ch Departments offering the course



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Discuss diagnosis based on clinical and laboratory data mention lines of treatment and possible complications (clinical exam.).

Corriculum

Unit I: Introduction to hepatic and biliary system . This unit introduces the general principles of hepatic and biliary diseases evaluation, specimen collection, and basic laboratory procedures.

Unit II: Various liver diseases including :Jaundice ,hepatitis (acute and chronic),cirrhosis ,hepatic focal lesion ,and liver abscess .

Unit III: Introduction to GIT:this unite introduce the general principles of evaluation of GIT diseases and basic laboratory and radiological procedures ..

Unit IV: Diseases of oesophages:GORD,motility disorder ,hiatus hernia .. 

Unit V: Diseases of stomach and duodenum : h pylori infection ,gastropathy and gastritis.

Unit VI: Gastointestinal bleeding(upper and lower).

Unit VII: Disease of intestine :malabsorbtion ,IBD ,diarrhea and dysentery .

nit VIII: GIT malignancy .

Teaching and Learning Methods

1. Lecture

2. Demonstration

3. Small group clinical teaching, discussion and problem solving

Course schedule:

Topic

teaching methods

coverd ilios

hours

time

by whom

I

1,2, 3

I, II, III, IV

10

1st weak 5th year

Pr.Dr Kilani

Pr.Dr Enas

Dr Hasein

II

1,2, 3

I, II, III, IV

4

2nd weak 5th year

Pr.Dr Kilani


III

1,2, 3

I, II, III, IV

10

3rd weak 5th year

Pr.Dr Enas

Dr. Nabila

Dr Hasein

IV

1,2, 3

I, II, III, IV

2

2nd weak 5th year

Pr.Dr Kilani


V

1,2, 3

I, II, III, IV

3

4th weak 5th year

Pr.Dr Enas

Dr. Hala Mostafa

VI

1,2, 3

I, II, III, IV

6

5th weak 5th year

Pr.Dr Enas

Pr.Dr Kilani

Dr. Nabila


Student assessment:

        • A set of processes, including 3 MCQ or short note examination (written) 8-10 points in different specialties (1.5 hour test).

        • Assessments of students' achievements in clinical rounds by the attending staff then give structured feedback that supports their continuing learning.

Weighting of assessments:

Mid-term examination………………………20%

Mid-term examination………………………80% including:

  • Oral examination…………10% ( 2 groups of examiners)

  • Clinical examination………50% (25% short cases & 25% long case)

  • Written Examination………20%


Recommended Reference readingd:

Hutchinson's Clinical Medicine.

Davidson's Principles and Practice of Medicine.


Unit: Clinical Endocrinology, Diabetes and Metabolism
Overall aims of the course: Medical students should be able to:

1-Mention basic principles of diagnosis and treatment of diabetes mellitus (DM) and other endocrinal glands disorders .

2- Can differentiate between type (1) and type (2) (DM).

3- Mention - causes of hypohalamopituitary disorders goiter and thyroid disorders , parathyroid and suprarenal disorders .

4- Know steps of diagnosis of the previous endocrinal disorders.

5- Have basic information about physiology of different endocrinal glands .

6- Can determine critical cases : diabetic ketoacidosis , hypoglycemia , thyrotoxic crisis, Addisonian crisis and so on.

7- Mention basic principles of diagnosis and treatment of diabetes mellitus.

8- Can differentiate between primary and secondary diabetes.


Intended Learning Outcomes (ILOs)

I-Knowledge and understanding : Medical students should be able to:

1-Mention basic principles of diagnosis and treatment of diabetes mellitus (DM) and other endocrinal glands disorders .

2- Explain differences between type (!) and type (2) (DM).

3- Mention - causes of hypohalamopituitary disorders goiter and thyroid disorders , parathyroid and suprarenal disorders .

4- Mention - steps of diagnosis of the previous endocrinal disorders.

5- Mention - basic information about physiology of different endocrinal glands .

6- Mention – determination of critical cases : diabetic ketoacidosis , hypoglycemia , thyrotoxic crisis, Addisonian crisis and so on .
II- Professional clinical skills: Medical students should be able to:

A- Take proper history from patients with diabetes mellitus and other endocrinal dis orders .

B- Conduct general and abdominal examination for signs of significance in patient endocrinal diseases).

C- Perform simple bed-side laboratory test (urine examination, blood sugar .

III- Intellectual skills: Medical students should be able to:

A- Analyse clinical data to give logic differential diagnosis.

B- Suggest suitable laboratory and other investigations to reach diagnosis in an economic pattern using least possible necessary steps.

C- Interpret clinical data with investigations.

IV- General and transferable skills: Medical students should be able to:

  • Write a good medical report for patients with diabetes mellitus (DM) and other endocrinal glands disorders .

  • Communicate with other medical centre to ask medical service not available in his locality.

  • C-Discuss with the patient his disease about disease etiology, pathogenesis, clinical features, and complications and give proper medical advice principles of prevention and management.

Clinical course 3 hours per week clinical round with staff members alternatively with clinical teaching of physical signs with the help of assistant lecturers).

The student should be able to

Each 2-3 students visit a patient twice per month and take full history and examination to be demonstrated and discussed next day with staff member in front of other students.

Contents

Topic

No. of Hours

Lecture

Practical

Diabetes Mellitus

10

5

5

Hypothalamopituitary disorders

4

2

2

Thyroid Disorders

4

2

2

Parathyroid Disorders & Ca homeostasis

2

1

1

Suprarenal Disorders

2

2

2

Osteoporosis

2

1

1

Obesity

1

1




Short Stature

1

1




Dyslipidemia

1

1




Endocrine Emergency

1

1

1













By the end of the course the student should be able to:

  1. Diagnose diabetes mellitus, know the main clinical presentation, and identify the acute and chronic complications of diabetes and the steps required for controlling hyperglycemia. The indication of insulin use and oral hypoglycemic drugs.

  2. Explain the thyroid disorders, how to suspect hyper and hypothyroidism and the thyroid function test assessment and the different lines of therapy used.

  3. Mention the functions of endocrine disorders (written MCQ exam.).

  4. Give correct differential diagnosis of simple case as a problem-solving type of questions (clinical exam.).

  5. Define causes, diagnosis, treatment and, complications of diabetes, pituitary , thyroid, parathyroid , suprarenal disorders (written and clinical exam.).

  6. Do simple bedside tests as: facial expression, acetone smell , urine examination for sugar , identification of signs of hypo and hyperglycemia .

  7. Take proper history that lead to logic differential diagnosis from patients in the ward of Endocrinology (clinical exam.).

  8. Mention proper laboratory investigations for patients in the ward of Endocrinology and use these data with clinical data to reach diagnosis of simple cases (written and clinical exam.).

  9. Discuss diagnosis based on clinical and laboratory data mention lines of treatment and possible complications (clinical exam.).


Corriculum

  1. Diabetes: Definition , pathophysiology , diagnosis , Clinical features .

Acute complications of DM ; diabetic ketoacidosis , hyperosmolar nonketotic , lactic acidosis ; diagnosis , treatment .

Chronic complications of DM ; diabetic nephropathy , diabetic neuropathy , diabetic retinopathy , diagnosis , including clinical features , laboratory investigation , and treatment .

Treatment of DM including diet , exercise , insulin therapy including indications , types of insulin preparation , methods of administration , doses and complications of insulin therapy . Oral antihyperglycemic drugs including sulphonylurea, Biguanides, Glitazones , Glinides , α glucosidase inhibitors ; indication , pharmacokinetics , and pharmacodynamics .

Hypoglycemia ; definition , causes , clinical features , diagnosis and treatment.

  1. Endocrinology:

Unit I: Introduction to Endocrinology: This unit introduces the general principles of Endocrinology system , anatomy , physiology , pathophysiology , diagnosis and basic laboratory procedures. .

Unit II: Hypothalamo pitutary axis:Anatomy , physiology , clinical presentations , panhypopitutarism , Syndroms of hyperfunctions of anterior pituitary (prolactinoma , Acromegaly , Cushings disease ) and posterior pitutary disorders (DI , SIADH ).

Unit III Throid Disorders Anatomy , physiology , Disorders of thyroid function : Thyrotoxicosis ; Aetiology , pathophysiology , Graves , disease Clinical presentation , diagnosis , treatment . Thyroiditis ; diagnosis and treatment .Hypothyroidism ; causes , clinical features , diagnosis and treatment .

Unit IV Parathyroid Disorders: Anatomy , physiology , Hyperparathyroidism ;causes , clinical features , diagnosis and treatment. Hypoparathyroidism , Calcium homeostasis.

Unit V Suprarenal Gland Disorders : Cushing,s Syndrome, causes , clinical features, diagnosis , localization of the cause of Cushing,s syndrome, and treatment .

Addison,s disease ; causes , clinical features , diagnosis and treatment .

Pheochromocytoma ; causes, clinical features , diagnosis and treatment.

Unit VI Osteoporosis: Definition , causes , pathophysiology , clinical features, diagnosis ; radiological and laboratory investigations , detection of high risk subjects , prevention and treatment .

Unit VII Short stature: Definition , causes , diagnosis and treatment

Unit VIIIObesity: Definition , causes , diagnosis, differential diagnosis , treatment .

Unit XI Dyslipidemia : Definition , causes , diagnosis , differential diagnosis , treatment .

Unit X Endocrine Emergency : causes , diagnosis , differential diagnosis , and treatment .

Teaching and Learning Methods

1. Lecture

2. Demonstration

3. Small group clinical teaching, discussion and problem solving

Teaching and Learning Methods

1. Lecture

2. Demonstration

3. Small group clinical teaching, discussion and problem solving

Course schedule:

Topic

teaching methods

coverd ilios

hours

time

by whom

I

1,2, 3

I, II, III, IV

6

1st weak 6th year

Pr.Dr M.M.Shahwan

II

1,2, 3

I, II, III, IV

6

2nd weak 6th year

Pr.Dr fatheu khalul

III

1,2, 3

I, II, III, IV

10

3rd weak 6th year

Pr.Dr Lubna.F Eltony

IV

1,2, 3

I, II, III, IV

10

4th weak 6th year

Pr.Dr Fatema Abu Baker

V

1,2, 3

I, II, III, IV

7

5th weak 6th year

Dr Thana ElMelgy

VI

1,2, 3

I, II, III, IV

7

6th weak 6th year

Dr Hala El Shreef


5- Student assessment methods:

        1. Case taking in clinical rounds (2-3 times /student) to assess clinical, intellectual and communication skills and interpretation of clinical and investigation data to reach logic differential diagnosis.

        2. Mid-term examination: A set of processes, including 3 MCQ or short note examination (written) to assess knowledge and intellectual skills.

        3. Final-term examination: assess clinical, intellectual and communication skills and interpretation of clinical and investigation data to reach logic differential diagnosis.

Assessment schedule:

  1. Case taking in clinical rounds 2-3 times /student in 5 months/course.

  2. Mid-term examination once/ course after 10 weeks course in the 6th year.

  3. Final-term examination: once/ course at the end of the 6th year.

Weighting of assessments:

Mid-term examination….……………………20%

Final-term examination………………………80% including:

  • Oral examination……10% ( 2 groups of examiners)

  • Clinical examination…50% (25% short cases & 25% long case)

  • Written Examination………20%

Student assessment:

In written examination:

A set of processes, including 3 MCQ or short note examination (written) 8-10 points in different specialties (1.5 hour test).

Assessments of students' achievements in clinical rounds by the attending staff then give structured feedback that supports their continuing learning.

In oral examination:

1. Can give correct differential diagnosis of coma in a diabetic patient.

2. Give an account in management of typa 1and2 diabetis and different endocrinal disorders .

In clinical examination:

student was evaluated about his ability to:

1. Take and write history and detect physical signs and to reach differential diagnosis.

2. Use patient history and physical signs to reach differential diagnosis.

3. Chose proper investigations, lines of treatment of possible diagnosis.

4. Communicate with the patient and give the patient best medical knowledge to prevent complications and approach cure.

Weighting of assessments:

Mid-term examination………………………20%

Mid-term examination………………………80% including:

  • Oral examination…………10% ( 2 groups of examiners)

  • Clinical examination………50% (25% short cases & 25% long case)

  • Written Examination………20%


Recommended Reference readings:

Hutchinson's Clinical Medicine.

Davidson's Principles and Practice of Medicine.

Lectures of Professors and assistant Professors.

Unit: Clinical Rheumatology

Overall aims of the course: Medical students should be able to:

1-Mention basic principles of diagnosis and treatment of various form of arthritis (rhematoid arthritis –systemic lupus erythmatosis-seronegative arthropathy-juvenile rheumatoid arthritis –systemic sclerosis –polymyositis –vasculitis –gout –pseudogout –osteoarthritis-arthritis in eldery)

2- Can differentiate between various form of arthritis.

3- Mention of systemic causes of arthritis.
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