Course Study Guide SECOND YEAR FACULTY OF MEDICINE PADJADJARAN UNIVERSITY ACADEMIC YEAR 2014-2015 Course Study Guide DermatoMusculoSkeletal System SECOND YEAR FACULTY OF MEDICINE PADJADJARAN UNIVERSITY ACADEMIC YEAR 2014-2015 1. Rational / Synopsis In this system the students will learn the basic science and clinical aspect in Skin, Muscular and Skeletal diseases. 2. Intended Competency Fulfilled SKDI 1-4 3. Number of SCU and length of week 8 SCU in 8 weeks 4. General learning outcome After completing this system the students should be able to review the embryology, anatomy, physiology, biochemistry that related to the Dermatomuscularskeletal system and the epidemiology, pathogenesis, pathophysiology, diagnosis and management of diseases in the Dermatomuscularskeletal system. 1 5. Specific Learning Objective No Department Specific Learning Objective Delivery method Assessment methods Reference Relation to the rule as a doctors 1. Anatomy 1.1 Integument system & bone Lab act : Structure and function of skin appendages 1.1.1. Explain the anatomy of skin MDE, SOCA Clinically Oriented Anatomy : Moore &Dalley, Tutorial : 1.2 The scalp and face 1.2.1. Describe the layers of the scalp Lab Act : Structure and function of skin appendages MDE Clinically Oriented Anatomy : Moore &Dalley, 1.2.2. Describe the blood supply, innervation and lymphatic drainage of the scalp Lab act : Structure and function of skin appendages MDE Clinically Oriented Anatomy : Moore &Dalley, 1.2.3. Relate the anatomical knowledge to common clinical conditions involving the scalp e.g. due to trauma or infections Tutorial : MDE, OSCE Clinically Oriented Anatomy : Moore &Dalley, 1.2.4. Describe briefly the facial muscles Tutorial : MDE Clinically Oriented Anatomy : Moore &Dalley, MDE Clinically Oriented Anatomy Lab Act : Structure and function of skin appendages 1.2.5. Illustrate territories of the face supplied by the divisions of the trigeminal nerve Tutorial : Lab Act : Structure and function of skin appendages 1.2.6. Describe the extracranial division of the facial nerve Tutorial : 1.2.7. Describe the blood supply and lymphatic drainage of the face Tutorial : : Moore &Dalley, MDE, SOCA Clinically Oriented Anatomy : Moore &Dalley, MDE Clinically Oriented Anatomy : Moore &Dalley, MDE Clinically Oriented Anatomy : Moore &Dalley MDE Clinically Oriented Anatomy : Moore &Dalley MDE Clinically Oriented Anatomy : Moore &Dalley MDE Clinically Oriented Anatomy Lab Act : Structure and function of skin appendages Lab Act : Fascia of the neck, vascularization head&neck 1.3. The neck 1.3.1. Illustrate the subdivisions of the fasciae of the neck Tutorial : 1.3.2. Describe the boundaries of the anterior and posterior triangles of the neck Tutorial : 1.3.3. State the contents of the anterior and posterior triangles of the neck Tutorial : 1.3.4. Describe the location of the lymph nodes in the neck and their areas of drainage Tutorial : Lab Act : Fascia of the neck, vascularization head&neck Lab Act : Fascia of the neck, vascularization head&neck Lab Act : Fascia of the neck, vascularization head&neck Lab Act : Fascia of the neck, vascularization head&neck 1.4. The oral, maxillofacial and neck region 1. 4.1 Explain the oral (include teeth), maxillofacial Lab act :Basic anatomy of maxillofacial, orbita, skull base & and neck region cranial fossa : Moore &Dalley, Tutor : 1.5. Muscular tissue and muscular system 1.5.1. Overview of muscular tissue Tutorial : MDE, SOCA Clinically Oriented Anatomy : Moore &Dalley, MDE Clinically Oriented Anatomy : Moore &Dalley MDE, SOCA Clinically Oriented Anatomy : Moore &Dalley MDE, SOCA Clinically Oriented Anatomy : Moore &Dalley, MDE, SOCA Clinically Oriented Anatomy : Moore &Dalley, Lab act : Basic anatomy and kinesiology of trunk, pelvis & hip joint 1.5.2. Naming of skeletal muscle Tutorial : Lab act : Basic anatomy and kinesiology of trunk, pelvis & hip joint 1.5.3. Relationship of structure (upper limb and lower limb) which close to the bone pertaining certain lession such as trauma and injury Tutorial : Lab act : Basic anatomy and kinesiology of trunk, pelvis & hip joint 1.6. Spine 1.6.1. Explain anatomy of spine (parts, joint, physiological curve, special structure and muscle) 1.6.2 Explain the Scapular anastomosis Tutorial : Lab act : Basic anatomy and kinesiology of trunk, pelvis & hip joint 1.7 Musculoskeletal System 1.7.1 Explain the Anatomy of the bone on the upper limb and lower limb Tutorial : Lab act : Skeleton of the body ( axial & appendicular) 1.7.2 Explain the vascularization, innervations of upper arm : brachial pleksus 1.7.3 Explain about Relationship of structure (upper limb and lower limb) which close to the bone pertaining certain lession such as trauma and injury brachial nerve injury 1.7.4 Explain the anatomy of lower limb : muscular system, vascularization & innervation 17.5. Explain about Foot, muscle, bonen nerve and arches of the foot Lab Act : Axillary space ( wall & content), muscular system of the upper arm, vascularization and innervations MDE Clinically Oriented Anatomy : Moore &Dalley, MDE Clinically Oriented Anatomy : Moore &Dalley, Tutorial : Lab Act : popliteal space, musculoskeletal system, vascularization and innervations of the lower limb incl. Foot ( lumbosacral pleksus ,) 1.8 Bone and Joint 2 Cell Biology SOCA, MDE Explain the anatomy of the knee Joint including bone formation (X-ray), muscles group and kinesiology. Tutorial : " 2.1 Embryology of Integument system & bone Tutorial : Clinically Oriented Anatomy : Moore &Dalley, SOCA, MDE Moore and Persaud. The developing human. 7th ed. 2003,p.485-491. SOCA, MDE Luiz carlos Junquerra. Basic Histology, 11th ed. 2003. P 360-370. Lab Act : Structure and function of skin appendages 2.2 Histology of the skin & bone Tutorial : Lab Act : Structure and function of skin appendages 2.3 The oral, maxillofacial and neck region The embryology and histology of the oral (include teeth), maxillofacial and neck region. Tutorial : SOCA, MDE Lab Act : Fascia of the neck, vascularization head&neck Moore and Persaud. The developing human. 7th ed. 2003,p.485-491 Luiz carlos Junquerra. Basic Histology, 11th ed. 2003. P 360-370. 2.4 Muscular tissue and muscular system • Skeletal muscle tissue Cardiac muscle tissue Smooth muscle tissue Development of muscle 2.5 Spine Explain embryogenic development process of bodyform 2.6 Musculoskeletal System: Explain Embryology and histology of bone and cartilage 3 Physiology 3.1 The Skin Function Explain the The skin as an organ protection, thermoregulator 3.2 The oral, maxillofacial and neck: Explain The physiology of the oral Tutorial : SOCA, MDE Lab act : Basic anatomy and kinesiology of trunk, pelvis & hip joint Tutorial : Luiz carlos Junquerra. Basic Histology, 11th ed. 2003. P 360-370. MDE, SOCA Moore and Persaud. Human development MDE Lab Act : Embryology & Histology of bone and cartilage ( include teeth ) Tutorial : Tutorial : Moore and Persaud. The developing human. 7th ed. 2003,p. p.485-491 1. Junqueira. Basic histology 2. Moore and Persaud. Human development MDE, SOCA Guyton AC. Textbook of medical physiology. WB Saunders Co. London, 1991. SOOCA/MDE Guyton AC. Textbook of medical physiology. WB (include teeth), maxillofacial and neck region. Explain the Physiology of mastication, swallowing, and voice formation. 3.3. The Muscular tissue and muscular system Explain Contraction and relaxation of skeletal muscle fibers Explain Muscle metabolism Explain Control of muscle tension Explain Types of skeletal muscle fibers Explain Exercise and skeletal muscle tissue Explain Regeneration of muscular tissue Explain Aging of muscular tissue Explain Contribution of muscular system to our body movement systems 4. Plastic Surgery 4.1 The Skin problem 1. Explain related to degree / depth of burn. 2. Explain etiology of burn. 3. Explain pathophysiology of burn. 4. Explain Total Body Surface area (TBSA) and estimate burn extent. 5. Explain classification of burn and criteria of hospitalization. 6. Explain complication of burn. 7. Explain management of burn patient: resuscitation position surgical management rehabilitation Saunders Co. London, 1991. Tutorial : SOOCA/MDE Guyton AC. Textbook of medical physiology. WB Saunders Co. London, 1991. Tutorial : Mini Lecture: Current Issues Management on Burn 1. Schwartz SI. Principles of Surgery. Sixth Edition..Mc Graw Hill Inc. New York, 1994. Page 225 – 278. 2. Settle JAD. Principles and practice of burns Management. Churchill Livingstone. New York, 1996 SOOCA/MDE Overview of skin disorders related to the structure: Impetigo, folliculitis, carbunkel Fat layer: cellulitis Muscle : pyomyositis 5 Microbiology 5.1 Microbiology of The Skin Overview of Skin infection related structure and its causative agent, incl : Impetigo, folliculitis, Carbunkel 6.1 Skin Diseases Mini Lecture : Microbiology of the Skin SOOCA, MDE TUTORIAL : MDE LAB. ACTIVITY : Microbiology spore forming bacteria aero-anaerobfungi Mini Lecture : 6 Dentistry 6.1 Infection disorders of Oral, Maxillofacial and Neck The pathogenesis of tissue inflammatory of the mouth due to infection of dental origin. Infection due to Clostridium tetani infection The microbiology of the oral cavity. The etiology, epidemiology, characteristics and route of infection in the oral, maxillofacial and neck region. The predisposition factors of a progressive acute cellulities (Angina Von Ludwig) due to dental origin. The infection management of dental origin Parasite infection: Scabies Bacterial infection: Leprae Tutorial MDE Pharmacology of drug of choice for causative organism. Oral hygiene. Prognosis Complication. 7. Dermatology 7.1 Dermatitis The etiology of exfoliative dermatitis The complication of exfoliative dermatitis The principle management of exfoliative dermatitis Mini Lecture : 1. Overview of Dermatological Emergencie 2. Dermatotherapy MDE Tutorial: 8. Pathology Anatomy 8.1 Pathology of the skin Pathology of the skin tumor and pathology of skin adnexa and skin healing Lab Activity: MDE Week II Mini Lecture: Overview of skin tumors Molecular Basis of Skin Tumor (PA) 9 Orthopaedic 9.1 Explain the Spine Problem define HNP is degenerative disorder Explain etiology, histopathology, and pathofisiology of HNP analyze anamnesis, pathogenesis and physical diagnosis of HNP Explain electro-diagnostic test & neuroimaging test Tutorial: Skill Lab; Orthopedic Physical Examination MDE,SOOCA, OSCE Freedberg IM, Katz IS, Wolf K, Goldsmith LA, Frank AK. Fitzpatrick`s dermatology in th general medicine. 6 ed. 2003. Explain the management of HNP Explain complication of HNP 9.2 Trauma of Musculoskeletal System. Explain Complication of bone fracture and its healing (avascular necrosis). Explain General principles of trauma (emergency priority B1- B6, and ATLS) Explain Principles of bone fracture management. Explain Classification of fractures on extremity and skull. Explain Normal bone healing of fractures, Explain Abnormal healing of fractures, Explain Clinical and radiographic features of extremity and skull Explain The general principles of fracture management of head injury. Explain Trauma management according to ATLS (Advanced Trauma Life Support) standard Explain Hand related abnormality: Carpal Tunnel Syndrome, Tenosinovitis, Ganglion Explain Nerve lessions injury: sciatic nerve, abduction injury Tutorial: MDE,SOOCA Skill Lab; Splinting Traction and Mini Lecture: ATLS Bandaging, Skin Salter RB. Textbook of Disorders of the Musculoskeletal System. Apley’s System of Orthopaedics Fractures. 9.3 Degenerative Disorders of Bone and Joint Explain the pathology of knee osteoarthritis Explain the management of knee osteoarthritis related to the basic science Explain of degenerative disorders of bone and joint Explain etiology, pathophyisiology and clinical features of degenerative disorders of bone and joint Analyze anamnesis and physical diagnostic of degenerative disorders of bone and joint Explain laboratory test for degenerative disorders of bone and joint Summarize diagnosis and differential diagnosis of degenerative disorders of bone and joint Explain drugs of degenerative disorders of bone and joint Explain the management of degenerative disorders of bone and joint SOOCA, MDE Tutorial: 1. Salter RB. Textbook of Disorders of the Musculoskeletal System. 2. Apley’s System of Orthopaedics Fractures 1. Salter RB. Textbook of Disorders of the Musculoskeletal System. Mini Lecture : Diagnostic Approach and Principles of Management in Dislocation Cases Clinical Aspects Abnormality TUTORIAL : 9.4 Fracture and Joint Injury (Upper extremity) Explain classification of fracture and dislocation Describe the normal healing of fracture and dislocation Describe the abnormal healing of fracture and dislocation of Spine SOOCA, MDE 2. Apley’s System of Orthopaedics Fractures 1. Explain complication of fracture and dislocation Summarize clinical and radiographic features of fracture and dislocation Explain the general treatment principles of fracture and dislocation Course Study Guide Endocrine and Metabolism System SECOND YEAR TWINNING PROGRAMME FACULTY OF MEDICINE PADJADJARAN UNIVERSITY ACADEMIC YEAR 2014 – 2015 1. Rational / Synopsis In this system the students will learn the basic science and clinical aspect in endocrine and metabolism diseases. 2. Intended Competency Fulfilled SKDI 1-4 3. Number of SCU and length of week 7 SCU in 6 weeks 4. General learning outcome After completing this system the students should be able to review the embryology, anatomy, physiology, biochemistry that related to the endocrine and metabolism system and the epidemiology, pathogenesis, pathophysiology, diagnosis and management of diseases in the endocrine and metabolism system. 14 5. Specific Learning Objectives CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Anatomy Specific Learning Objectives Mini Lecture Assessment Method Reference Tutorial Lab Activity Evaluate macroanatomy, topography and vascularisation of hypophysis and hypothalamus √ √ MDE, SOCA 6 Analyze macro anatomy, topography and vascularisation of thyroid gland √ √ MDE, SOCA 6 Apply macro anatomy, topography and vascularisation the concept of parathyroid gland √ √ MDE, SOCA 6 Analyze macro anatomy, topography and vascularisation the concept of adrenal gland √ √ MDE, SOCA 6 Analyze macro anatomy, topography and vascularisation the concept of pancreas gland √ √ MDE, SOCA 6 15 CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Biochemistry Specific Learning Objectives Mini Lecture Tutorial Lab Activity Assessment Method Reference Evaluate action of hormone based on its structure (lipid, protein, amino acid) √ MDE, SOCA 2 Analyze the structure, synthesis secretation of thyroid hormone √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 Apply the mechanism of action (receptor & 2nd messenger), & regulation (HPO axis) of parathyroid hormone √ MDE, SOCA 1.2 Analyze the structure, synthesis &secretation of Adrenal hormone √ MDE, SOCA 1.2 Analyze the mechanism of action (receptor & 2nd messenger), & regulation (HPO axis) of Adrenal hormone √ MDE, SOCA 1.2 & Analyze the mechanism of action (receptor & 2nd messenger), & regulation (HPO axis) of thyroid hormone Explain the structure, synthesis &secretation of parathyroid hormone 16 Analyze structure, synthesis, secretion, of insulin & glucagon √ MDE, SOCA 1.2 Analyze receptor, mechanism of action & regulation (HPO axis) of pancreatic hormone √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 Understand the genetic background of DM Apply the metabolism of calcium, phosphate, &vitamine D Explain the factors contribute to calcium & phosphate metabolism Analyze the metabolism of lipid, lipoprotein, lipid transport Analyze the metabolism of keton bodies Analyze the metabolism of protein and degradation products such as ammonia Analyze interrelational metabolism carbohidrate, lipid and protein of Analyze the carbohydrate metabolism and its relation to lipid and protein metabolism in various cells (liver, muscle, lipocyte) Analyze of Amino acid metabolisms Analyze Glucose-6-Phosphate dehydrogenase (G6PD) and the disturbance in its metabolism pathways √ √ √ 17 CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Specific Learning Objectives Explain the origin (embryology) Hypothalamus and Hypophysis Mini Lecture of Evaluate histological parts and cell type of Hypophysis, hypothalamo-hypophyseal system Cell Biology Analyze the embryology of thyroid gland Analyze the embryology of the parathyroid gland Explain the embryology of Adrenal Gland Analyze histological parts and cell type of thyroid gland Explain the embryology of Pancreas Gland Analyze histological parts and cell type of Adrenal Gland (glomerulosa, fasiculata, reticularis) Assessment Method Reference Tutorial Lab Activity √ √ MDE, SOCA 5 √ √ MDE, SOCA 4 √ MDE, SOCA 5 √ MDE, SOCA 5 √ MDE, SOCA 5 MDE, SOCA 4 MDE, SOCA 5 MDE, SOCA 4 √ √ √ √ √ 18 Explain histological parts and cell type of Pancreas Gland √ √ MDE, SOCA 4 Assessment Method Reference CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Internal Medicine Specific Learning Objectives Mini Lecture Tutorial √ √ MDE, SOCA 7 √ MDE, SOCA 7 Explain the pathophysiology& pathogenesis of Grave's Disease √ MDE, SOCA 7 Explain the patophysiology& pathogenesis of hypoparathyroidism and hypocalcemia √ MDE, SOCA 7 Explain the patophysiology& pathogenesis of hypoparathyroidism and hypocalcemia √ MDE, SOCA 7 Evaluate general concept of endocrine glands and hormones, specific on concept of hormonal disorder (hypo &hyperfunction) Explain disorders of thyroid hormone (difference between hypo & hyperthyroid) Lab Activity 19 Explain the general concept of endocrine system/hormone disorder & disorders of adrenocortical insufficiency (primary & secondary) √ MDE, SOCA 7 Explain the patophysiology& pathogenesis of Cushing's Syndrome √ MDE, SOCA 7 √ MDE, SOCA 7 √ MDE, SOCA 7 √ MDE, SOCA 7 √ MDE, SOCA 7 √ MDE, SOCA 7 Explain the problem of metabolic syndrome √ Analyze the patophysiology& pathogenesis of Type 2 DM, including its complication Explain the clinical aspects of diabetes in pregnancy Analyze the non pharmacological management of DM Explain the pathophysiology management of DKA and √ 20 CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Specific Learning Objectives Mini Lecture Understand the physiology of normal growth and puberty Explain factors influence growth and puberty Explain the regulation of growth hormone and sex steroid hormone secretion (FHS, LH) Pediatrics Describe disorders of growth and puberty Explain Congenital Hypothyroidism in relation with Human Development Index Explain congenital metabolism disorders eq. galactosemia, phenylketonuria. Analyze the definition, pathogenesis, and pathophysiology of Type 1 DM √ Assessment Method Reference √ MDE, SOCA 1.8 √ MDE, SOCA 1.8 √ MDE, SOCA 1.8 √ MDE, SOCA 1.8 √ MDE, SOCA 1.8 MDE 1.8 MDE, SOCA 1.8 Tutorial √ √ Lab Activity 21 CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Assessment Method Reference √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 Analysis regulation of hormone (hypothalamus, pituitary, organ axis) √ MDE, SOCA 1.2 Analyze the functions of growth hormone (GH) and its physiological actions √ MDE, SOCA 1.2 Explain the physiological changes due to excess of GH (example: Acromegaly) and deficiency of GH √ MDE, SOCA 1.2 Specific Learning Objectives Evaluate general concept of hormone and endocrine glands, specific on embryology of the glands, autocrine, paracrine, endocrine & exocrine concepts Physiology Analyze the physiological hypothalamus hormone effect of Analyze the physiological hypophysis hormone effect of Mini Lecture Tutorial √ Lab Activity 22 Analyze mechanism effect of the thyroid hormone √ MDE, SOCA 1.2 Explain the physiology of the parathyroid hormone √ MDE, SOCA 1.2 Analyze the physiology effect of adrenal hormone √ MDE, SOCA 1.2 Apply the function of calcium, phosphate, &vitamine D √ MDE, SOCA 1.2 Explain the physiological effect of hypocalcemia and hypercalcemia Analyze the physiological effect of pancreatic hormone (insulin & glucagon) √ MDE, SOCA 1.2 √ MDE, SOCA 1.2 23 CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Specific Learning Objectives Assessment Method Reference MDE, SOCA 3 √ MDE, SOCA 3 √ MDE, SOCA 3 MDE, SOCA 3 MDE, SOCA 3 Tutorial Lab Activity Explain how hormonal substitution could overcome the problems √ √ Analyze the pharmacological aspects of propylthiouracil and other antithyroid agents Analyze the pharmacological properties of Pharmacology steroid hormone Analyze pharmacological properties of the antidiabetic drugs, including oral & parenteral drugs Apply the pharmacological aspects of Calcium, Phosphate, & vitamine D Mini Lecture √ √ √ 24 CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Specific Learning Objectives Assessment Method Reference MDE, SOCA 17 √ MDE 17 √ MDE 17 MDE, SOCA 17 Mini Lecture Explain the examination the thyroid function (TSH, TRH, T3, T4, fT4, rT4) Explain laboratory test related to endocrine & metabolism disorder Clinical Pathology Explain the specimen collection & preparation related to endocrine & metabolism disorder Practice to identify metabolism disorder: Glucose in blood and urine, Keton bodies in urine, Blood Glucose Home Monitoring and Blood Gas Analysis in Metabolic Acidosis State Tutorial Lab Activity √ √ √ 25 CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Specific Learning Objectives Mini Lecture Explain the histopathologic disorder of the thyroid glands Explain the pathogenesis and histopathologic changes of endocrine neoplasia(MEN 1, parathyroid tumor, gulonoma, insulinoma, pineal gland) Pathology Anatomy Apply the pathogenesis and histopathologic changes of pituitary diseases: pituitary adenoma and hyperpituitarism (akromegali, gigantisme), hypopituitarism, posterior pituitary syndromes (diabetes insipidus) and hypothalamic suprasellar tumors (diabetes insipidus). List of microscopic feature of pituitary adenoma, craniopharyngioma. Tutorial Lab Activity √ √ √ √ √ Assessment Method Reference MDE, SOCA 10 MDE 10 MDE, SOCA 10 MDE 10 26 Apply the pathogenesis and histopathologic changes of thyroid diseases: hyperthyroidism, hypothyroidism, thyroiditis, diffuse and multinodular goiters, neoplasm of thyroid and congenital anomalies. √ List of microscopic feature of Hashimoto thyroiditis, Graves disease, adenomatous goiter, follicular adenoma, follicular carcinoma,papillary carcinoma of thyroid and thyroglossal cyst. √ MDE, SOCA 10 MDE 10 Apply the pathogenesis of parathyroid diseases: hyperparathyroid (primary and secondary hyperparathyroidism),hypoparathyroid and pseudo hypoparathyroidism. √ MDE, SOCA 10 Explain the pathogenesis of pancreas diseases: diabetes mellitus (diagnosis, klasifikasi,glucose homeostasis), type 1 diabetes mellitus (genetic susceptibility, environmental factor, mechanism of B-cell destruction), type 2 diabetes mellitus ( insulin resistance,B-cell dysfunction), monogenic forms of diabetes, complication of diabetes mellitus, morphology of diabetes and its late complications, clinical feature of diabetes and pancreatic endocrine neoplasm. √ MDE, SOCA 10 27 Explain the pathogenesis and histopathologic changes of adrenal diseases: adrenocortical hyperfunction (Cushing syndrome, primary hyperaldosteronism,adrenogenital syndrome), adrenocortical insufficiency (primary acute adrenocortical insufficiency, primary chronic adrenocortical insufficiency, secondary adrenocortical insufficiency), adrenocortical neoplasm and adrenal medulla lesion (pheochromocytoma). √ List microscopic feature of adrenocortical adenoma and pheocromocytoma. √ MDE, SOCA 10 MDE 10 Assessment Method Reference CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Specific Learning Objectives Nuclear Medicine Indicate the role of nuclear medicine in hormonal problem Mini Lecture √ Tutorial Lab Activity MDE 28 Analyze the nutritional aspect of diabetes mellitus (Diabetic Medical Nutrition) Nutrition Radiology √ Apply dietary considerations as nonpharmacological interventions for patients with type 2 Diabetes Describe radiology structure of endocrine gland √ MDE, SOCA 9 √ MDE, SOCA 9 MDE 11 Assessment Method Reference √ SOCA 12 √ SOCA 12 √ CSG Second Year Programme Endocrine and Metabolism Year Academic : System: Delivery Method Department Specific Learning Objectives BHP Evaluate the duty of a doctor to explain the risk honestly Apply the concept of the difference between the occurrence of foreseen risk, unforeseen risk and malpractice case Mini Lecture Tutorial Lab Activity 29 Evaluate doctor’s duty to be able to communicate properly with patients from various social and educational background √ SOCA 12 Evaluate relationship between colleagues in multidisciplinary team approach in patient management √ SOCA 12 Evaluate the responsibility of medical professionals to ensure the patient received proper therapy √ SOCA 12 √ SOCA Evaluate the community research and public CRP & PHOP health aspect in the case 30 6. Specific Learning Objectives of Clinical Skills CSG Year Academic : System: Second Year Programme Endocrine and Metabolism Learning objective Delivery Method Assessment Method Reference The students will be able to performe measurements of weight, height and body proportion in children Skills Laboratory OSCE 13 The students will be able to perform History Taking in Thyroid history taking related to thyroid Disease disease Skills Laboratory OSCE 14 The students will be able to perform physical examination related to thyroid disease Skills Laboratory OSCE 14 The student will be able to write prescription order properly Skills Laboratory OSCE 3 The students will be able to perform Diabetic Foot Care in diabetic foot care to support Diabetes Mellitus patients management in diabetic patients. Skills Laboratory OSCE 16 The students will be able to perform Administering intramuscular, intramuscular, subcutaneous and subcutaneous and intracutaneous injection in a good intracutaneous injection manner Skills Laboratory OSCE 15 Topic Assessment of Anthropometry Growth Physical Examination Thyroid Disease Drug Prescription in 31 7. References 1.Guyton and Hall, 2011, Textbook of Medical Physiology, 12th Edition, Elsevier. 2. Harper's Illustrated Biochemistry,29th edition, Lange & McGraw Hill. 3. Katzung, Masters and Trevor, Basic and Clinical Pharmacology,12th edition, Lange & McGraw Hill. 4. Mescher, Junqueira's Basic Histology: Text and Atlas, 12th edition, 2009, Lange & McGraw Hill. 5. Sadler,TW, Langman's Medical Embryology, 12th edition, Lippincott Williams & Wilkins. 6.Moore Clinically Oriented Anatomy, 2013, 7th edition, Lippincott Williams & Wilkins. 7. Gardner & Shoback, Greenspan's Basic & Clinical Endocrinology, 9th edition, 2011, Lange & McGraw Hill. 8. Kleigman, Stanton, et al. Nelson's Textbook of Pediatrics, 19th edition, Elsevier. 9. Insel&Ross, Nutrition, 5th edition. 10. Robbins & Cotran Pathologic Basis of Disease, 8th edition, 2009, Saunders. 11. Herring, W, Learning Radiology, 2nd edition, 2011, Elsevier. 12. Vaughn, L, Bioethics: Principles, Issues and Cases, 2nd edition, 2012, Oxford University Press. 13. Sawyer, S. Pediatric Physical Examination & Health Assessment. 14. Guide to Physical Examination and History Taking, 11th edition, 2012, Lippincott Williams & Wilkins. 15. Perry and Potter, Clinical Nursing Skills & Techniques,7th edition, 2009. 16. O'Sullivan, Physical Rehabilitation, 6th edition. 17. Henry's Clinical Diagnosis and Management by Laboratory Methods, 2011. 32 Course Study Guide Hematology and Immunology System SECOND YEAR TWINNING PROGRAMME FACULTY OF MEDICINE PADJADJARAN UNIVERSITY ACADEMIC YEAR 2014 – 2015 33 1. Rational / Synopsis In this system the students will learn the basic science and clinical aspect in hematology and immunology diseases. 2. Intended Competency Fulfilled SKDI 1-4 3. Number of SCU and length of week 8 SCU in 8 weeks 4. General learning outcome After completing this system the students should be able to review the embryology, anatomy, physiology, biochemistry that related to the hematology and immunology system and the epidemiology, pathogenesis, pathophysiology, diagnosis and management of diseases in the hematology and immunology system. This module is designed to provide basic and core understanding of biomedical program especially for hemato-immunology system. Basic principle of hemato-immunology system will serve as fundamental basic science for further clinical application. 5. Specific Learning Objectives No. Department Specific Learning Objectives Delivery Method 1. Explain the anatomy of spleen & liver and their related organs Lab Act: Lymphoid MDE, SOCA organ Anatomy Identify and describe the gross anatomy of the organs and tissues of the lymphatic system Assessment Method Tutorial: Identify the major lymphatic vessels, lymph nodes, and organs of the lymphatic system 2. Histology Explain the histology of the organs and tissues of the lymphatic system including lymph node, spleen and tonsils Lab Act: Week 7 Physiology Explain the structure function of RBC and Mescher, Junqueira's Basic Histology: Text and Atlas, 12th edition, 2009, Lange & McGraw Hill. MDE, SOCA Guyton and Hall, 2011, Textbook of Tutorial: Tutorial: Moore KL and Dalley AF. Clinically Oriented Anatomy. 5th Edition. Lippincott Williams & Wilkins. 2006 pp 44-45 MDE, SOCA Explain the structure and function from organs and tissues of the lymphatic system including lymph node, spleen and tonsils 3. Reference Relation to the rule as doctors List organs producing the RBCs Explain the erythropoiesis (including normal and abnormal maturation) Explain the role of erythropoietin and tissue oxygenation in the regulation of RBC production Explain the role of several factors involved in the maturation of RBC Explain the development, structure and function of haemoglobin. Explain the mechanism of RBC destruction Explain the erythropoiesis dependent on age (including normal and abnormal maturation) Describe the condition cause tissues hypoxia Medical Physiology, 12th Edition, Elsevier. Lab Act: Hematopoeisis Mini Lecture: Hematopoeisis Normal abnormal maturation blood cells and of Skill Lab: Blood Smear 4. Biochemistry Explain the role of iron, vit Tutorial: B12 and folic acid for RBCs production Explain the metabolism of iron, vit B12 and folic acid 5. Cellular Biology Explain Genetics of cell antibodies. Explain Genetics of HLA MDE, SOCA Harper's Illustrated Biochemistry,29th edition, Lange & McGraw Hill. Gardner, E.J. 1983. Human Heredity. John Wiley and Sons Inc. system. Explain Genetics of ABO Blood Groups and RH system. Explain Genetics of Serum Proteins: Haptoglobins and transferring. 6. Clinical Pathology Explain Antigen and Antigenicity of the semen. Explain Antisperm antibodies in women and in men. Explain Antibody against seminal components . Explain Immunoglobulins in the fluid of male reproductive tracts. Explain Sperm agglutination and immobilization which is not by antibody. Analyze the laboratory assessment of RBC (number, Hb content, Hct, Erythrocyte Index, Red Cell Distribution Width Reticulocyte, Peripheral blood smear Explain the development and morphology of Erythropoietic system Tutorial: Harmening DM. Clinical Hematology and Fundamentals of Hemostasis. 4th edition. Philadelphia. FA Davis Company. 2002 Lab Act: Morphology of Normal Blood Cells Wintrobe’s Clinical Hematology. Tenth Edition. Philadelphia, Lippincott Williams&Wilkins. 1999 Explain the development and morphology of Granulopoietic system Explain the development and morphology of Megakaryopoietic system Explain the development and morphology of the Lymphopoietic system Explain maturation changes in all blood cells, such as: size, chromatin, shape, and cytoplasm. Mini Lecture: Explain the hemostasis physiology of Hemostasis, Thrombosis Infection and Apply Diagnostic approach to bleeding disorder (hemorrhagic and thrombotic diseases) Classify vascular disorders Mini Lecture: Trombosis Explain the etiology, disorders patophysiology, sign and Laboratory aspects symptoms, management, of homeostasis prognosis of vascular disorders. Explain the definition of platelet disorders. Explain the platelet function in hemostasis and thrombosis. distinguish the types of platelet disorders. Explain the etiology of platelet disorders. Explain the pathogenesis of platelet disorders. Explain the signs and symptoms of platelet disorders. Apply the laboratory findings of platelet disorders. Explain the differential diagnosis of platelet disorders. Explain the management of platelet disorders. Explain the course and prognosis of platelet disorders (C4). Explain the course of platelet disorders due to infection (Dengue fever). Explain basic concept of blood transfusion, reaction of blood transfusion and stem cell transplantation disorders Tutorial: Lab activity: Torniquette test Bleeding time test Wintrobe’s Clinical Hematology. Tenth Edition. Philadelphia, Lippincott Williams&Wilkins. 1999 Mini Lecture: Explain the principle Immunodiagnostic. of Explain the definition, mechanism and classification of immunodeficiency. Immunodiagnostic Parslow TG, Stites DP, Terr AI, Imboden JB. Medical immunology. Tenth edition. McGraw-Hill Co. Appleton & Lange. 2003 Mini Lecture: Immunodeficiency Explain immunotolerance, immunostimulance, and immunosupression. Apply laboratory assays establish the diagnosis Rheumatoid Arthritis 8. Internal Medicine to of Explain the definition of anemia. Assess the symptoms of anemia in adult and children. Identify physical signs of anemia in adult and children. Evaluate the laboratory findings of anemia. Classify RBC disorders into 3 categories. Henry's Clinical Diagnosis and Management by Laboratory Methods, 2011 Tutorial: Beutler E, Coller BS, Lichtman MA, Kipps TJ, Seligsohn U. Williams Hematology. Sixth edition. New York. McGraw-Hill. 2001 Explain the definition of iron deficiency anemia. Explain the etiology of iron deficiency anemia in adult and children. Explain the pathogenesis of iron deficiency anemia including the stages in the development of iron deficiency. Explain signs and symptoms of iron deficiency anemia in adult and children. Evaluate the laboratory findings of iron deficiency anemia (C6). List the differential diagnosis of iron deficiency anemia (C6). Explain evaluate the management of iron deficiency anemia (C6). Explain the course and prognosis of iron deficiency anemia Explain the definition of hemolysis and hemolytic anemia. Classify the types of hemolytic anemia into 2 categories. Explain the etiology, pathogenesis and pathophysiology of hemolytic anemia. Skill Lab: History Taking Anemia Physical Examination of anemia Lawlor Fischer Manual of Allergic and Immunology. Diagnosis and Theraphy. 1st ed Boston. LITTLE, Brown and company. 1981 Explain the signs and symptoms of hemolytic anemia. Evaluate the laboratory findings of hemolytic anemia. Explain the differential diagnosis of hemolytic anemia. Explain the complications of hemolytic anemia including 2 types of crisis in hemolytic anemia. Explain the management of hemolytic anemia including the indication of splenectomy. Explain the course and prognosis of hemolytic anemia. Explain the course of hemolytic anemia due to infection (Malaria).(TropMed) Explain the definition of aplastic anemia. Explain the etiology of aplastic anemia .. Explain the pathogenesis and pathophysiology of aplastic anemia .. Explain the signs and symptoms of aplastic anemia. Explain the laboratory findings of aplastic anemia. Explain the severity of aplastic anemia. Explain the differential diagnostic of peripheral pancytopenia. Explain the management of aplastic anemia. Explain outline the course and prognosis of aplastic anemia Explain the definition of aplastic anemia. Explain the etiology of aplastic anemia. Explain the pathogenesis and pathophysiology of aplastic anemia. Explain the signs and symptoms of aplastic anemia. Apply the laboratory findings of aplastic anemia. differentiate the severity of aplastic anemia. Explain the differential diagnostic of peripheral pancytopenia. Explain the management of aplastic anemia. Explain the course and prognosis of aplastic anemia. Explain the definition of megaloblastic anemia. Explain the etiology of megaloblastic anemia. Explain the pathogenesis and pathophysiology of megaloblastic anemia. Explain the etiology of folic acid and cobalamin (vitamin B12) deficiency. Explain the pathogenesis of folic acid and cobalamin deficiency. Explain the signs and symptoms of folic acid and cobalamin deficiency. examine the laboratory findings of folic acid and cobalamin deficiency. Explain the differential diagnosis of folic acid and cobalamin deficiency. Explain the treatment of folic acid and cobalamin deficiency. Explain the course and prognosis of folic acid and cobalamin deficiency. Explain the structure and maturation of leucocytes (normal and abnormal). Explain the function of leucocytes. Explain the definition of MDS and acute leukemia. Explain the types of acute leukemia into 2 categories. Explain the etiology of MDS, acute myelogenous leukemia (AML) and acute lymphoblastic leukemia (ALL). Explain the pathogenesis of, Tutorial: Skill Lab: History taking of hematological malignancy Physical examination of MDS, AML, and ALL. explain the classification of MDS, AML, and ALL. Explain the signs and symptoms of MDS, AML , and ALL. examine the laboratory findings of MDS, AML, and ALL. Explain the differential diagnosis of MDS, AML, and ALL. Explain the management of MDS, AML, and ALL. Explain the course and prognosis of MDS, AML, and ALL Explain the definition of chronic leukemia. Classify the types of chronic leukemia into 2 categories . Explain the etiology of clinic myelogenous leukemia (CML) and chronic lymphocytic leukemia (CLL). Explain the signs and symptoms of CML and CLL. examine the laboratory findings of CML and CLL. Explain the differential diagnosis of CML and CLL. Explain the management of CML and CLL. Explain the course and prognosis of CML and CLL. Explain morphology, structure, taxonomy, hematological malignancy Differential Count Lab activity: Abnormal maturation blood cell of Mini Lecture: Immune Response in replication and cell response to HIV infections . Explain pathogenesis and pathology of HIV infection . Explain immunologic process in immunodeficiency of HIV infection . Explain opportunistic infection due to HIV infection such as Cryptococcus infection, Pneumonitis carinii, Candida infection, etc. . TropMed Explain transmission of infection, the prevention and features of HIV infection . Explain laboratory diagnostic of HIV infection Explain the definition of polycythemia vera and myelofibrosis Explain the etiology of polycythemia vera and myelofibrosis Explain the pathogenesis of polycythemia vera and myelofibrosis Explain the signs and symptoms of polycythemia vera and myelofibrosis Explain the laboratory findings of polycythemia vera and myelofibrosis Explain the differential diagnosis of polycythemia vera and myelofibrosis Explain the management of Infection Skill lab: Infectious disease corpse management Mini Lecture: Leukocyte Disorder polycythemia vera and myelofibrosis Explain the course and prognosis of polycythemia vera and myelofibrosis Describe the structure of plasmocyte . Explain the definition of multiple myeloma . Explain the etiology of multiple myeloma . Explain the pathogenesis of multiple myeloma . Explain the signs and symptoms of multiple myeloma . Explain the laboratory findings of multiple myeloma. Explain the differential diagnosis of multiple myeloma . Explain the management of multiple myeloma . Explain the course and prognosis of multiple myeloma . Explain the definition of lymphadenopathy (lymph nodes enlargement) .. Explain the etiology of lymphadenopathy . Explain the definition of malignant lymphoma .. Classify the types of malignant lymphoma into 2 Tutorial: categories . Describe the classification of Non-Hodgkin Malignant Lymphoma (NHML) (Rappaport, Lukes-Collin, Working Formulation, REAL/WHO) . Describe the classification of Hodgkin’s disease (Rye classification) . Explain the etiology of malignant lymphoma including its relation with HIV Explain the pathogenesis of malignant lymphoma. Explain the signs and symptoms of malignant lymphoma. Explain the differential diagnosis of malignant lymphoma. Explain the management of malignant lymphoma. Explain the course and prognosis of malignant lymphoma. Explain the etiology, clinical manifestations, patophysiology, differential diagnosis, management, lab support, prevention and prognosis of vasculitis LA : Histology of Lymphoid Organ Lymph node Hiperplasia,Malig nan Lymphoma and Thymoma Explain the etiology, clinical Tutorial: manifestations, patophysiology, differential diagnosis, management, lab support, prevention and prognosis of Lupus erytematosus Klippel, Primer on the Rheumatic Diseases, 2003 Explain the etiology, clinical manifestations, patophysiology, differential diagnosis, management, lab support, and prognosis of Rheumatoid arthritis 9. Pediatrics Explain the mechanism of coagulation in hemostatic mechanism. Explain the definition of hemophilia. Classify the types of hemophilia. Explain the etiology of hemophilia A, B and C. Explain the etiology of Hemophilia A, B and C. Explain the signs and symptoms of Hemophilia. explain the laboratory findings of Hemophilia A, B and C. Explain the differential diagnosis of Hemophilia A, B Tutorial: Kleigman, Stanton, et al. Nelson's Textbook of Pediatrics, 19th edition, Elsevier. and C. Explain the management of Hemophilia A, B and C. Explain the course and prognosis of Hemophilia A, B and C. Explain the definition of von Willebrand disease. Explain the function of von Willebrand factor. distinguish the types of von Willebrand disease. Explain the etiology of von Willebrand disease. Explain the pathogenesis of von Willebrand disease. Explain the signs and symptoms of von Willebrand disease. Apply the laboratory findings of von Willebrand disease. Explain the differential diagnosis of von Willebrand disease. Explain the treatment (management) of von Willebrand disease. Explain the course and prognosis of von Willebrand disease. Explain the patophysiology, etiology, sign and Tutorial: symptoms, prognosis management, of Coagulation disorders (Haemorrhagic Diseases of the Newborn/ HDN) Explain the etiology, patophysiology, sign and symptoms, management, prognosis of Fibrinolysis disorders Explain the etiology, patophysiology, sign and symptoms, management, prognosis of Thrombotic disorders 10. Microbiology Apply basic immunology concept of Mini lecture: Basic immunology The Recognition of Antigen Mini Lecture: and Antibody : Complement The structure and function of system antibodies Major Histocompatibility Complex Antigen processing and presentation Immunity and Immune MHC and immune response Jawetz Medical Microbiology Response : Explain : Active immune response Passive immune response Innate immunity Adaptive immunity AIDS and Lentivirus : Classification of HIV Replication Route of transmission Laboratory diagnosis Treatment. Explain the mechanism of inflammation reaction and structure of immuno competent cells which happened. 11. Pharmacology Explain classification hemopoeitic agents of Tutorial: Explain pharmacological Mini Lecture: properties of hemopoeitic Immunomodulator agents and Immunosupresive Explain classification immunosupressant Explain Properties of Pharmacological of Katzung, B.G. et al. in Basic and Clinical Pharmacology 11th edition. Singapore: McGraw-Hill Companies.2009. Immunosupressant Explain classification immunosupressant of Explain Pharmacological Properties of Immunosupressant 12. Pathology Anatomy Explain the pathogenesis type Tutorial: I to IV hypersensitivity and its diseases Explain the pathogenesis and Mini lecture: microscopic feature of chronic allergic rhinitis (nasal polyp), and urticaria Describe the diseases of Lab activity: autoimmune and its general Histopathology of pathogenesis Lymph Node Hyperplasia Malignant Lymphoma Explain the pathogenesis of several autoimmune diseases and its microscopic feature: systemic lupus erythematosus, polymialgia rheumatic, anafilactic reaction, rheumatic Robbins & Cotran Pathologic Basis of Disease, 8th edition, 2009, Saunders. fever, rheumathoid artritis Explain the pathogenesis of acquired immunodeficiency syndrome Explain the disorders of white blood cells ( acute and chronic leukemia), lymph node (lymphoma hodgkin and non Hodgkin lymphadenopathy, lymphadenitis), spleen and thymus (timoma) Explain the pathogenesis and microscopic appearance of reactive hyperplasia of the lymph node and sinus histiocytosis Explain the pathogenesis and microscopic appearance of hodgkin’s and non hodgkin’s lymphoma Explain the basic concept of tumor imunity 13. Dermatology Explain structure and function of the skin and appendages. Explain definition of atopy and atopic dermatitis . Mini Lecture: Atopy Freedberg IM, et al. Fitzpatrick’s Dermatology in General Medicine. Sixth Edition. Explain etiopathogenesis of atopic dermatitis, especially itch and environment factors. Explain clinical manifestation and classification of atopic dermatitis. Apply laboratory assays to establish the diagnosis of atopic dermatitis . Explain differential diagnosis of atopic dermatitis . Explain the management of atopic dermatitis . McGraw York. Hill. New Tutorial: Skill lab: History Taking in Allergic & Immunologic Disease Skill lab: Physical examination in pediatric allergy & immunology Explain the etiology, sign & symptoms, patophysiology, differential diagnosis, management, lab support and prognosis of urticaria and angioedema Explain the etiology, clinical manifestations, patophysiology, differential diagnosis, management, lab Odom RB, James WD, Berger TG. Andrew’s diseases of the skin. 9th ed. Philadelphia, WB Saunders Company. support, prognosis shock prevention and of anaphylactic Explain the etiology, clinical Tutorial: manifestations, patophysiology, differential diagnosis, management, lab support, prevention and prognosis of drug eruption Explain the etiology, clinical Tutorial: manifestations, patophysiology, differential diagnosis, management, lab support, prevention and prognosis of allergic contact dermatitis Explain the etiology, clinical manifestations, patophysiology, differential diagnosis, management, lab support, prevention and prognosis of chronic bullous disease 14. ENT Explain definition and etiology of Skill lab: allergic rhinitis Physical examination special and Scott-Browns Otolaryngology, Allan G. Kerr. 6th ed editor Ian S. Mackey. And T.R. investigation ENT Explain pathophysiology, differential diagnosis,treatment and prognosis of non allergic rhinitis Explain non allergenic etiology of allergic rhinitis Explain the classical pathophysiology of hypersensitivity type I of allergic rhinitis Explain sign and symptoms, management and prognosis of allergic rhinitis in Bull. Vol. 4 Rhinology, 1997 Butterworths London Boston Durban Singapore, Sidney Toronto, Wellington Course Study Guide Neurobehavior System SECOND YEAR FACULTY OF MEDICINE PADJADJARAN UNIVERSITY ACADEMIC YEAR 2014 – 2015 1. Rational / Synopsis In this system the students will learn the basic science and clinical aspect in neurobehavior and special sense diseases. 2. Intended Competency Fulfilled SKDI 1-4 3. Number of SCU and length of week 8 SCU in 9 weeks 4. General learning outcome After completing this system the students should be able to review the embryology, anatomy, physiology, biochemistry that related to the cardiovascular system and the epidemiology, pathogenesis, pathophysiology, diagnosis and management of diseases in the neurobehavior and special sense system. 5. Specific Learning Objective No Department Specific Learning Objective Delivery method Assessme nt methods Reference Relation to the rule as a doctors 1. Anatomy 1.1 Peripheral Nerve 1.1.1. General concept of peripheral nerve (motor, sensory, otonom) : Root, dorsal root ganglion, plexus, peripheral nerve, neuromuscular junction 1.1.2. Anatomy, embriology, and physiology : posterior (dorsal) and anterior (ventral) root; dorsal root ganglion; brachial and lumbar plexus; peripheral nerve (median, ulnar, radial, musculocutaneus, sciatic, femoral, tibial, sural and peroneal nerve 1.2 Spinal Cord LA : Basic Anatomy & Embryology of CNS, Anatomy of Peripheral Nerves & connection to Spinal Cord (Week I) 1.2.3. Explain Axial section of Cervical, Thoracal, Lumbar, Sacral. 1.2.4. Explain spinal cord vascularization (artery and venous) Clinically Oriented Anatomy : Moore &Dalley MDE, SOCA Clinically Oriented Anatomy : Moore &Dalley TR : TR : 1.2.1. Embryologi,Anatomy,Histology,Physiol ogy of Spinal Cord LA : 1.2.2. Explain Descending and Ascending pathway of Spinal Cord MDE, SOCA Anatomy of Cranial Nerves &Brain; Basic concept of Somatosensory System, Dermatome & Myotome 1.2.5. Explain meningeal layer of spinal cord. 1.3. Brain 1.3.1. Explain the Cerebral vascularization and autoregulation TR: 1.3.2. Explain the structure of Motor and sensory LA : Neuro-Anatomy Motor System ; Physiology of Posture & Movement; Basic concept of UMN & LMN pathway 1.3.3. Explain the structure of Cortical and Subcortical function, Cranial nerves, Limbic system and Brain Stem MDE, SOOCA Clinically Oriented Anatomy : Moore &Dalley MDE, SOOCA Clinically Oriented Anatomy : Moore &Dalley, p. 180181 TR : 1.3.4. Explain and Evaluate Anatomy of Meningeal layer of Brain, Brain Hemisphere, Cerebral fluid system, Brain stem and Cranial Nerve (CN.I, III-IV-VI, V, VII, IX-X, XI, XII). 1.3.5. Explain and Evaluate Anatomy of Brain Vascularization, Circle of Willis, Cerebral blood flow, Blood Brain Barrier and Descending tract of brain : Corticospinal tract, corticobulber tract 1.4. High Cortical Function 1.4.1. Explain the anatomy of cerebral cortex 1.4.2. Explain anatomy of the organ that related to Epilepsy and Shizophrenia (limbic system and cerebral lobes) TR : TR: LA : Neuro-Anatomy of Brainstem, Cerebellum & Basal Ganglia ; Basic concept of attention & wakefulness 1.5. Special Sense 1.5.1. Explain anatomy of vestibular system and visual system correlated with case, and proprioception TR: MDE, SOCA LA: Anatomy and Physiology of AudioVestibular Organ Learning objectives: • describe the external, middle and inner ear 1.5.2. Explain anatomy of the eye list the contents of the middle ear relate the anatomical structures with common clinical conditions involving the ear TR: LA: Anatomy and Physiology of the Eye Learning objectives: • enumerate the bones forming the orbit • describe the contents of the Clinically Oriented Anatomy : Moore &Dalley, p. 40-43 orbit (extraocular muscles, vessels and nerves) • describe the eyeball, list the structures passing through the superior orbital fissure, optic canal and common tendinous ring 2. Cell Biology 2.1 Peripheral Nerve 2.1.1. Histology of peripheral nerve : the fascicles (schwann cells and fibrocytes, axons, myelin sheats, collagen fibrils of endoneurium), connective tissue sheats (endoneurium, perineurium and epineurium), structure of neuron, dendrit, axon, morphologic type of neuron, nodes of ranvier and internodal segment of schwann cells, type of synaptic cleft 2.1.2 Histology and neuromuscular junction embriology MDE, SOCA TR : of 2.2 Spinal Cord 2.2.1.Explain Embryology and Histology of Spinal Cord TR : MDE, SOCA 2.3 Brain 2.3.1.Explain Histology of Meningeal layer, Brain Hemisphere of Brain and Cerebral fluid system. TR: SOOCA, MDE 2.4 High Cortical Function TR : 2.3.1.Explain the histology of cerebral cortex SOOCA, MDE ML: Life Cycles of Human Being 2.5 Development of brain 2.5.1. Explain the development of human brain TR: SOOCA, MDE 2.5.2. Explain the histology of human brain 2.6 Special Sense 2.6.1. Explain the histology of vestibular system and visual system correlated with case 2.6.2. Explain histology of the eye TR: SOOCA, MDE TR: SOOCA, MDE 3. Physiology 3.1 Peripheral Nerve 3.1.1. Physiology of peripheral nerve : nerve impuls potential (resting potential, action potensial : depolarization and repolarization), conduction impulses. 3.1.2. Classification of nerve fiber (Myelinated and non-myelinated; somatic and autonomic; motoric and sensoric; based on conduction velocity, diameter and function).. 3.1.3. Physiology of peripheral nerve : nerve impuls potential (resting potential, action potensial : depolarization and repolarization), conduction impulses. 3.1.4. General concept of lower motor neuron (sensoric, motoric and reflexes). 3.2 Spinal Cord 3.1.1. Explain the Physiology of Spinal Cord TR : ML: Myelinization Neuronal Transmission SOOCA, MDE, Guyton AC. Textbook of medical physiology. WB Saunders Co. London & TR : MDE, SOCA 3.1.2. Explain Otonomic Function of Spinal Cord ( Simpatis, parasimpatis, miction, defecation) 3.1.4. Explain Motoric pathway and function of spinal cord (Myotome) 3.1.4. Explain Sensoric pathway, type and function of spinal cord (Dermatome) 3.1.4. Explain reflex arch in spinal cord 3.3 Brain 3.3.1. Explain the Cerebral vascularization and autoregulation TR: MDE,SOOCA Guyton AC. Textbook of medical physiology. WB Saunders Co. London Guyton AC. Textbook of medical physiology. WB Saunders Co. London 3.3.2 Explain the Structure and function of Motor and sensory pathway 3.3.3 Explain the Signal transduction and the Signal Communication mediated by neurotransmitter, cytokines and eicosanoids 3.3.4 Explain the Physiology of Meningeal layer of Brain, Brain Hemisphere, Cerebral fluid system and Brain stem. 3.3.5 Explain and Evaluate the Physiology of Consciousness and Cranial Nerve (CN.I, III-IV-VI, V, VII, IX-X, XI, XII) 3.3.6 Explain and Evaluate the Physiology of the descending tract of brain : Corticospinal tract, corticobulber tract, Brain Vascularization, Circle of Willi, Blood Brain Barrier and Cerebral blood flow 3.3.7 Explain physiology of neurotransmitter related to movement regulation (basall ganglia and extrapyramidal system) TR : LA : Physiology of Posture & Movement; Basic concept of UMN & LMN MDE,SOOCA Guyton AC. Textbook of medical physiology. WB Saunders Co. London ML : 1.Brain Plasticity 2.Physiology Equilibrium of 3.4 High Cortical Function 3.4.1 Explain the physiology of cerebral cortex 3.4.2 Explain the the concepts of cognition and memory and higher cortical function. TR : MDE Guyton AC. Textbook of medical physiology. WB Saunders Co. London 3.4.3 Explain physiology of the organ that related to Epilepsy (limbic system and cerebral lobes) TR: MDE,SOOCA Guyton AC. Textbook of medical physiology. WB Saunders Co. London ML: 1. Life Cycles of Human Being 2. Brain Death 3.5 Development 3.5.1 Explain the brain function regarding : Consciousness, Emotion, Motor behavior (Conation), Thinking, Speech, Perception, Memory, Intelligence, Insight, and Judgment TR: MDE LA: The Limbic SOCA System : Emotion & Guyton AC. Textbook of medical physiology. WB Saunders Co. Personality; Memory Learning London & 3.6 Special Sense 3.6.1 Explain the physiology of vestibular system, visual system correlated with case, and proprioception TR: MDE ML : SOCA Physiology of Equilibrium 3.6.2 Explain the pathophysiology of decreased visual acuity 3.6.3 Explain the visual pathway and physiology of vision 4. Neurology TR: MDE SOCA Guyton AC. Textbook of medical physiology. WB Saunders Co. London Guyton AC. Textbook of medical physiology. WB Saunders Co. London 4.1 Peripheral Nerve 4.1.1 Explain the Topography of sensoric distribution (dermatomes, myotomes and sclerotomes) 4.1.2 Explain the Pathomechanism degeneration of peripheral nerve disease (pathologic reaction of neuron : wallerian degeneration, axonal degeneration and demyelinating degeneration; remyelinitation) 4.1.3 Explain the Patophysiology of peripheral nerve disease (neurotmesis, axonotmesis, avulsion) TR : MDE SOCA SL : MOTOR AND OSCE SENSORY EXAMINATION ML: Basic Concept of Pain Mechanism focusing on Adams R. D., et al : principal of neurology vol.1, VI at McGrawHill, New York, 1997, p.13461445. 4.1.4 Explain the Pathomechanism of neuro muscular junction disease. 4.1.5 Explain the Positive and negative symptom of peripheral nerve disease. 4.1.6 Explain the Classification of peripheral nerve disease, based on location : radiculopathy, plexopathy, neuropathy (mononeuropathy, polineuropathy, mononeuropathy multiplex). 4.1.7 Explain the Etiology, clinical characteristic, diagnostic, differential diagnostic, management, prognosis of peripheral nerve disease. 4.1.8 Explain the Definition, classification, precipitating factor, Patophysiology and patomechanism, Clinical manifestation, differential diagnostic, and diagnostic tools, Management, complication and prognosis of Guillain barre syndrome 4.1.9 Explain the BHP, PHOP, and medicolegal aspect of Guillain barre syndrome. 4.2 Spinal Cord neuropathic pain 4.2.1 Explain the definition and incidence and pathogenesis, complication and management of spinal cord disease 4.2.2 Explain the classification of spinal cord disease (Neoplasm, Vasculer, Inflamation, Infection, Trauma,Degenerative) 4.2.3 Explain the complete (transvere) lesion in spinal cord and the incomplete lesion in spinal cord : Hemilesion (Brown TR : MDE 1. SOCA OSCE SL : REFLEXES AND MENINGEAL SIGN EXAMINATION 2. Adams RD, Maurice V, Ropper AH. Principles of Neurology, 6th ed, 1997:766775; 874-901 Rowland LP. Head Injury in Rowland LP (Ed). Sequard, Anterior cord syndrome, Central cord syndrome, Posterior cord syndrome). 4.2.4 Explain the Physical Examination in spinal cord disease 3. Merritt’s textbook of neurology 9th ed. Williams and Wilkins, Baltimore,19 95:350-335; 417-440 NarayanRK, Wilberger JE. Povlisshock JT, Neurotrauma, McGrawHill, New York, 1996 4.3 Brain TR: 4.3.1 Explain pathophysiology of cerebral vascular damage i.e., stenosis/occlusion, Intracerebral hemorrhage, sub arachnoids hemorrhage (aneurysm, avm, cavernous angioma, cavernoma, etc), lacunar. SL: 4.3.2 Explain Explain pathology of cerebral vascularization i.e., stenosis/occlusion, Intracerebral hemorrhage, sub arachnoids hemorrhage (aneurysm, avm, cavernous angioma, cavernoma, etc), lacunar. 4.3.3 Understand the definition of stroke Analyze the classification of carotid system stroke and vertebro-basiler system MDE 1. Gilman S. Manter and Gatz’s Essentials of Clinical Neuroanato my and Neurophysiol th ogy, 8 ed. FA Davis Company, USA,1992 2. DeMyer W. Neuroanato nd my 2 ed. Williams and Wilkins-A. Waverl Co, SOCA CRANIAL NERVE EXAMINATION USA,1998 stroke 4.3.4 Explain the definition, incidence, classification, differential diagnosis, Mechanism, Pathogenesis, sign and symptom, Complication (Neurological, non-neurological, psychososial, principle management by type of stroke and principle rehabilitation and prognosis of stroke of Stroke 4.3.5 Explain the Risk Factors, Prevention (Primary and secondary) and BHP, PHOP, CRP aspect of stroke 4.3.6 Explain the incidence, definition, pathophysiology, clinical & etiological classification, the signs and symptoms, of Parkinson 4.3.7 Understand the neuroimmunoendocrinology of Parkinson 4.3.8 Analyze of the anamnesis, the general examination, the neurological examination, the neuro-imaging, the clinical pathology, diagnosis, complication and prognosis of Parkinson 4.3.9 Explain the management of Parkinson, include promoting, preventing, curative and rehabilitative, the pharmacological properties of cholinergic agonist and antagonist and the medicolegal aspect of Parkinson 4.4 High Cortical Function 3. TR : MDE SOOCA SL : MMSE & GCS EXAMINATION OSCE Victor M, Ropper AH. Adams and Victor’s Principles of th Neurology 7 ed. USA. McGraw-Hill, 2001:821924 Victor M, Ropper AH. Adams and Victor’s Principles th of Neurology 7 ed. USA. McGrawHill, 2001:99-120 4.4.1 Explain the definition, epidemiology and the classification of epilepsy and seizure (ILAE) of epilepsy and seizure 4.4.2 Explain the brain neurotransmiter in epilepsy and schizophrenia (pathogenesis and phatophysiology). 4.4.3 Explain the principle management of epilepsy and schizophrenia i.e. medication, operative, life style, dietary for epilepsy and social aspect, rehabilitation of epilepsy /Psychosocial in epilepsy. 4.4.4 Explain supported lab. examination for epilepsy : Neurophysiologic/ EEG and the differential diagnosis of seizure and epilepsy. 4.5 Special Sense TR: 4.5.1 Explain the incidence, sign and symptoms, general examinations, and neurological examinations of vertigo TR: MDE SOOCA MDE SOOCA 4.5.2 Analyze classification, pathogenesis and pathophysiology of vertigo 4.5.3 Explaining treatment of vertigo 5. Radiology 5.1 Spinal cord injury (Trauma) 5.1.1 Explain Supporting Examination in spinal disease (plain x-ray, CT-Scan, MRI) MDE Victor M, Ropper AH. Adams and Victor’s Principles th of Neurology 7 ed. USA. McGrawHill, 2001:99-120 Victor M, Ropper AH. Adams and Victor’s Principles th of Neurology 7 ed. USA. McGrawHill, 2001:99-120 5.2 Epilepsy 5.2.1 Explain supported lab. examination for epilepsy : Neuroimaging of choice for epilepsy TR: MDE, TR: 5.3 Benign Paroxismal Vertigo 5.3.1 Explaining the laboratory findings and neuroimaging of vertigo 6. Psychiatry TR: MDE, ML : MDE 6.1 Post Traumatic Stress Disorder (PTSD) 6.1.1 Explain the differentiation of normal and abnormal Anxiety 1. Basic Concept OSCE of Mental 6.1.2 Explain the distinction between fear and Health anxiety 2. Psycho pharmacology 6.1.3 Explain the classification and peripheral and manifestations of anxiety disorders. Neurotransmit (DSM-IV-TR and PPDGJ-III) ter 6.1.4 Explain the criteria diagnosis, clinical feature, comorbidity, epidemiology and etiology (stressor, risk factors, predisposing vulnerability factors) of Post Traumatic Stress Disorder (PTSD). (DSM-IV-TR and PPDGJ-III) 6.1.5 Explain the psycho-pathogenesis (psychodynamic and CognitiveBehavioral factors) and psychopathology (symptomatology) of PTSD Sadock BJ, Sadock VA. Kaplan & Sadock’s Synopsis of Psychiatry, Behavioural Science/Clinical Psychiatry, 9th ed. Lippincott Wilkins&Wilkins, Hpiladelphia, 2003 6.1.6 Explain the biological factors of PTSD (norepinephrine, dopamine, endogenous opioids, and benzodiazepine receptors and the hypothalamic-pituitary-adrenalHPA axis) 6.1.7 Explain the precipitating factor, principle of PTSD management (psychopharmacology and psychotherapy), Course and Prognosis, and the indication for case referral of PTSD 6.1.8 Explain the traumatic event, trauma type, and trauma severity and the difference between PTSD and acute stress disorder 6.1.9 Evaluate the BHP, PHOP, and CRP aspect of the case. 6.2 Delirium and Dementia 6.2.1 Differentiate normal age-associated forgetfulness, mild cognitive impairment, dementia, delirium, and depression 6.2.2 Explain the definition, incidence, etiology, diagnostic criteria, differential diagnosis, management, course and prognosis of delirium 6.2.3 Explain the definition, incidence, etiology, diagnostic criteria, differential diagnosis, management, course and prognosis of dementia 6.2.4 Explain the pathophysiology and Neuropathology of Dementia TR : MDE SL : SOCA PSYCHIATRIC EXAM : Non Psychotic Disorder OSCE Sadock BJ, Sadock VA. Kaplan & Sadock’s Synopsis of Psychiatry, Behavioural Science/Clinical Psychiatry, 9th ed. Lippincott Wilkins&Wilkins, Hpiladelphia, 2003 6.2.5 Explain the neurotransmitter involvement in memory process and cognition 6.2.6 Evaluate the Medico-legal, BHP, PHOP, and CRP aspect of the case. 6.3 High Cortical Function 6.3.1 Explain the personality disorder and personality changes in epilepsy. 6.3.2 Explain the classification of psychotic disorder 6.3.3 Explain differential diagnosis of schizophrenia 6.3.4 Explain the prognosis of epilepsy and schizophrenia TR: MDE SL: SOCA PSYCHIATRIC EXAM : Psychotic Disorder OSCE Kaplan & Sadock’s Comphrehensive Textbook of Psychiatry, 8th ed., 2005, Kaplan & Sadock’s Synopsis of Psychiatry 10th ed., 2007, 467 497 6.4 Mood and Panic Disorders 6.4.1 Explain the definition, classification , TR: epidemiology, etiology , ML: psychopathology and psychodynamic, signs and symptoms, management , Coping course and prognosis, and the mechanism medicolegal aspects of mood disorders 6.4.2 Explain the definition, classification , Brain Plasticity epidemiology, etiology , psychopathology and psychodynamic, signs and symptoms, management , course and prognosis, and the medicolegal aspects of dependent personality disorder 6.4.3 Explain the neurotransmitter involved in mood disorder MDE SOCA OSCE 1. Kaplan & Sadocks :Comprehe nsive Textbook of Psychiatry 9th Ed Lippincott, Williams &Wilkins2 006,p. 2. Kaplan & Sadocks : Synopsis of Psychiatry 10 th Ed.Wolters Kluwer,Lip pincott,Will iams &Wilkins2 007, p.527568.. 3. Kaplan & Sadocks :Comprehe nsive Textbook of Psychiatry 9 th Ed Lippincott, Williams &Wilkins2 006, 6.5 Mental Redardation 7. Biochemistry 6.5.1 Explain definition and classification, sign and symptoms, neurological and psychiatric examination and the management of Mental Retardation 7.1 Mental Redardation TR: 7.1.1 Explain the normal brain neurotransmiter 7.1.2 Explain the brain neurotransmiter in epilepsy and schizophrenia (pathogenesis and phatophysiology). TR: ML: MDE Basic Concept of SOCA Devlin. Biochemistry and clinical 7.1.3 8. ClinPath CLP (Consultation Liaison Psychiatry) Explain metabolism of the lens correlation. 5 ed. 2002 8.1 Brain Patophysiology LA : MDE CSF Examination : Clinical Pathology & Microbiology 10 Microbiology 9.1 Brain Patophysiology Pediatric 9.1.1 Explain the causative agents of infections of the central nervous system 9.1.2 Explain the epidemiology and pathogenesis of infections of the central nervous system 9.1.3 Explain the clinical manifestation of infections of the central nervous system 9.1.4 Explain the clinical manifestation of infections of the central nervous system 9.1.5 Explain the clinical manifestation of infections of the central nervous system 9.1.6 Explain the laboratory diagnosis and interpret laboratory results of cerebrospinal fluid examination 9.1.7 Explain the principle of treatment and preventive of infections of the central nervous system 10.1 Cerebral Palsy LA: (Tropmed) ML : 1. Aging process of the brain 2. Drug of Abuse 3. Infection of CNS MDE th 11 Pathology Anatomy 10.1.1 Explain definition of growth and development 10.1.2 Explain basic principle of child growth and development 10.1.3 Explain period of growth and development 10.1.4 Describe factors influencing child growth and development 10.1.5 Describe normal pattern of child growth and development 10.1.6 Describe aspect/domain of child development 10.1.7. Explain milestone of child development 10.1.8. Recognize screening and monitoring of child growth and development 10.1.9. Describe normal child behavior and milestone 10.1.10.Explain definition of cerebral palsy (CP) 11. Describe etiology of CP 12. Explain the sign and symptoms of CP 13. Explain neurological examination of CP 14. Describe radiology findings of CP 15. Explain management of CP 11.1 Understanding the pathogenesis of hypoxia, ischemia, infarction, hypertension cerebrovascular disease and intracranial haemorrage 11.2 Understanding the pathogenesis of acute meningitis, acute focal suppurativa infection, chronic bacterial meningoencephalitis and viral meningoencephalitis 11.3 understanding pathogenesis of alzheimer disease, dementia and parkinson 11.4 Understanding the pathogenesis and it”s microscopic features of degenerative disease TR: MDE SL: Pediatric Primitive Reflex Examination SOOCA LA: Pharmacological Properties of Epileptic Drugs ML: 1. Addiction Concept Child Growth & Development LAB Act 11.5 Understanding the pathogenesis and it”s microscopis features of astrocytoma, medullablastoma, meningioma, and schwannoma. 11.6Understanding the pathogenesis of carpal tunnel syndrone, GBS, Myastenia gravis, and neuropathy 11.7 Understanding pathogenesis and microscopic appearance of neurofibroma 11.8 Understanding the pathogenesis of inflamation in eye ( conjungtivitis, blefaristis, screitis, dacroadenitis, keratitis, and endopthalmitis ) 11.9 Explain kind and type of accular neoplasma
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