Faculty of Medicine



DEPARTMENT OF MEDICINE

5th YEAR STUDY GUIDE

Table of Contents

|Topic | |Page |

|THE OUTCOMES OF THE UNDERGRADUATE CURRICULUM | | |

|CURRICULUM MAP | | |

|STRUCTURE OF 5TH YEAR – INTERNAL MEDICINE | | |

|INTRODUCTION | | |

|AIMS & OBJECTIVES | | |

|TEACHERS CONTACTS | | |

|ASSESSMENT | | |

|ICONS | | |

|TOPIC OUTLINES | | |

Outcomes of the 5Th year Medical Curriculum

1) Knowledge

The main purposes of the clinical course in the 5th year are as follows:

1. Students develop the ability to take and report a full history

2. Acquire skills in performing a complete physical examination

3. Discuss cases at bed side teaching / clinical rounds to emphasize pathophysiology of symptoms and signs.

4. Students should be familiar with the usual instruments in clinical practice; i.e. stethoscope, sphygmomanometer, reflex hammer, ophthalmoscope, etc.

5. Students should be familiar with x-rays, pathology jars, slides and instruments

6. Students develops the ability to outline management

2) Skills

1. To clerk at least two patients on clerking days.

2. On the day of the clinical teaching session, students should have prepared at least one fully clerked patient.

3. Participate in the discussion of one or more cases. The cases discussed should be looked up in the recommended or any other appropriate textbooks

4. Be prepared to present a case of a clerked patient during any teaching round.

3) Other Activities

The clinical teaching sessions are run 5 days a week from Saturday to Wednesday. Academic staff will teach on Saturdays – Wednesdays. During which, 2 half-days of the week, students will conduct their self teaching (clerking). During their rotation for 5 weeks in Medicine, they should learn and acquire the clinical skills of history taking and physical exam.

No. of Days per Week: 5 days teaching with academic staff

2 half-days clerking days

No. of week per posting: 5 weeks

Total clinical sessions: 25 clinical sessions for the entire rotation

The leader of each sub-group will distribute all beds in the ward equally among the group (e.g. 2-3 beds per student)

Attendance during all sessions (clerking and teaching rounds) is mandatory. Any missed session will result in mark deduction. Students who are absent more than 10% of the sessions are not illegible to sit for the end of posting exam.

Attendance card/slip should be signed by the teacher during each session. Teachers should reschedule missed sessions if any.

4) Attitude

Student should have the attitude of

a. Respect for every human being and abide by relevant Islamic ethics

b. A desire to ease pain and suffering

c. Willingness to work in a team with other health professionals

d. Responsibility to remain a life-long learner and maintain the highest ethical and professional standards

e. Referring patients to other health professional when needed

f. A realization that it is not always in the interest of patients to pursue every diagnostic or therapeutic possibility

Curriculum Map

LECTURES:

Content Titles No. of Lecture

Cardiovascular System 8

Respiratory System 2

Gastroenterology (GIT) 4

Neurology 5

Endocrinology & Metabolic 2

Nephrology 2

Rheumatology 3

Oncology 2

Therapeutics 22

Psychiatry 17

Lectures (TITLES)

A. General Medicine Lectures' Title:

Curriculum for 5th Year

Extra Pyramidal Disorders

Oncological Emergencies

Rheumatoid Arthritis

Epilepsies

Pulmonary Tuberculosis

Introduction to Electrocardiography

Bronchogenic Carcinoma

Peripheral Neuropathy

Extrapulmonary TB:- CNS + Intestinal + Lymph Node

Gastrointestinal Bleeding

Malabsorption Syndrome

Adrenal Gland Disorders

Systemic Lupus Erythematosus

ECG Interpretation

Inflammatory Bowel Disease

Sero-Negative Arthritis

Cardiomyopathies

Esophageal Disorders

Metabolic Syndrome

Pericardial Diseases

Cerebrovascular Accident and Intracranial Bleeding I

Cerebrovascular Accident and Intracranial Bleeding II

Chronic Liver Disease I

Chronic Liver Disease II

Ischemic Heart Disease I

Ischemic Heart Disease II

Acute and Chronic Renal Failure I

Acute and Chronic Renal Failure II

B. Therapeutic Lectures' Title:

From Department of Medicine:

Lipids Disorders

Cancer Chemotherapy

Anti-Tuberculosis Therapy

Drugs in Heart Failure

Thyphoid Fever and Brucellosis

Anti-Hypertensive Therapy

Drugs and the Kidney

Drugs and Liver

Anti-Malaria Therapy

Drugs and the Kidney

From Department of Haematology:

Bleeding Disorders Including Anticoagulants

Lympho-Proliferative Disorders / Lymphomas

Multiple Myeloma and Amyloidosis

Lectures (TITLES) – continued:

From Department of Pharmacology:

Principle of Antimicrobial Therapy

Mechanism of Drug Interaction

Adverse Drug Reaction

Paediatric and Geriatric Pharmacology

Clinical Pharmacokinetics

Anti-Viral Therapy

Corticosteroids

Anti-Rheumatic Therapy

Analgesics

C. Psychiatry Lectures' Title:

Psychopathology: Part I

Psychopathology: Part II

Cognitive Disorders I

Cognitive Disorders II

Psychotic Disorders I

Psychotic Disorders II

Moods Disorders I

Moods Disorders II

Anxiety Disorders I

Anxiety Disorders II

Childhood Disorders I

Childhood Disorders II

Personality Disorders I

Personality Disorders II

Somastisation Disorders

Psychopharmacology Overview

Psychotherapy Overview

Conversion Disorders

D. Forensic Medicine Lectures

Lectures Title arranged by the VDCA

E. Others

Bedside Clinical Teaching

The clinical teaching sessions are run 5 days a week from Saturday to Wednesday. Academic staff will teach on Saturdays – Wednesdays. During which, 2 half-days of the week, students will conduct their self teaching (clerking). During their rotation for 5 weeks in Medicine, they should learn and acquire the clinical skills of history taking and physical exam.

No. of Days per Week: 5 days teaching with academic staff

2 half-days clerking days

No. of week per posting: 5 weeks

Total clinical sessions: 25 clinical sessions for the entire rotation

The leader of each sub-group will distribute all beds in the ward equally among the group (e.g. 2-3 beds per student)

Attendance during all sessions (clerking and teaching rounds) is mandatory. Any missed session will result in mark deduction. Students who are absent more than 10% of the sessions are not illegible to sit for the end of posting exam.

Attendance card/slip should be signed by the teacher during each session. Teachers should reschedule missed sessions if any.

STRUCTURE OF 5TH YEAR - INTERNAL MEDICINE

Introduction

During the 5th year rotation, students are expected to continue to gain clinical experience from what they have achieved in the 4th year. They will be given lectures as well as having clinical teaching sessions.

The lecturer, due to the limitation of allocated time, will put emphasis on certain parts of the topic concerned. However, the students are urged to study on their own to cover the whole subject. This will be achieved through reading from the reference books chosen by the Department. Lecturers will also provide the students, whenever needed, further readings. During the clinical teaching, the 5th year students should master the physical exam of the normal systems and start to acquire knowledge and skills about their diseases and subsequent physical changes and important investigations to be performed. They will also be expected to have minimal knowledge about management of various diseases. Male and female students are taught separately in small sub-groups

❖ Student needs:

Lectures

Clinical teaching session including clerking and teaching rounds

Aims & Objectives

On completion of the course, the 5th year students will be able to:

1. Understand the lectures’ content and answer properly the related questions.

2. Take proper history from the patient.

3. Elicit all physical signs of organs in their normal state.

4. Elicit major physical signs of various systems in their disease state (e.g., changes of vital signs, organomegaly, etc…)

5. Interpret physical signs, order appropriate investigations and suggest a diagnosis.

6. Have a minimal knowledge of management of various diseases

Teachers Contacts

NAME/STATUS PHONE # E-mail

medconf@

Male Section

Prof. Hassan Fatani, Professor 640-8245

Prof. Mohd Kassimi, Professor 640-8273

Dr. Abdullah Al-Fares, Assistant 640-8344

Prof. Siraj Mira, Associate Professor 640.8279

Prof. Mohamad Al-Hadramy, Professor 640-8278

Dr. Hussein Malibary Assistant Professor 640-8280

Prof. Tarif Zawawi, Professor 640-8277

Prof. Khalid Marzouki, Professor 640-8276

Dr. Sami Hamdi, Associate Professor 640-8249

Dr. Sameer Zimmo, Associate Professor 640-8251

Dr. Adil Khazindar, Assistant Professor 640-8257

Dr. Saad Al-Shohaib, Associate Professor 640-8247

Dr. Omer Al-Amoudi, Associate Professor 640-8246

Prof. Mahmoud Al-Ahwal, Professor 640-8253

Dr. Hisham Akbar, Associate Professor 640-8266

Dr. Nabil Al-Ama, Assistant Professor 640-8258

Dr. Yousif Qari, Assistant Professor 640-8265

Dr. Omar Fathaldin, Assistant Professor 640-8274

Dr. Emad Koshak, Associate Professor 640-8261

Dr. Saeed Al-Ghamdi, Associate Professor 640-8248

Dr. Tariq Madani, Associate Professor 640-8348

Dr. Turki Al Turki, Assistant Professor 640-

Dr. Sami Bahlas 640-8265

Dr. Abdulraheem Al-Shehri 640-

Female Section

Dr. Aisha Siddiqui, Associate Professor 640-8380

Dr. Abeer Kawthar, Assistant Professor 640-8378

Dr. Faiza Qari, Associate Professor 640-8371

Prof. Daad Akbar, Professor 640-8374

Dr. Aisha Al-Ghamdi, Associate Professor 640-8383

Dr. Haifa Marzouki, Assistant Professor 640-8372

Dr. Nawal Al-Ghamdi, Assistant Professor 640-8364

Dr. Suzan Attar, Assistant Professor 640-

Dr. Maimoona Mushtaq, Assistant Professor 640-8367

Dr. Hind Fallatah, Consultant Physician 640-

Dr. Fatma Al-Beladi, Consultant Physician 640-

Assessment

TYPE OF EXAMS:

a) End of Posting Exam 50 %

b) Final exam 100 % (50 % for Written

+ 50 % Clinical)

End of Posting Exam comprising of:

Written Exam:-

40 Multiple Choice Questions (MCQ) = 20 %

1 Problems solving = 5 %

1 Data Interpretation = 5 %

Practical Exam:-

1. Long Case for the Clinical Exam = 20 %

Final exam comprising of:

Written Exam:-

80 Multiple Choice Questions (MCQ) = 40 %

2 Problems solving = 5 %

2 Data Interpretation = 5 %

Practical Exam:-

Objective Structured Clinical Exam (OSCE)

• 10 INACTIVE CASES IN SLIDES = 25 %

• 6 ACTIVE CASES (PATIENTS) = 25 %

Icons (standards)

The following icons have been used to help you identify the various experiences you will be exposed to.

[pic] Learning objectives

[pic] Content of the lecture

[pic] Independent learning from textbooks

[pic] Independent learning from the CD-ROM.

The computer cluster is in the 2nd floor of the medical library, building No. 7.

[pic] Independent learning from the Internet

[pic]

[pic] Problem-Based Learning

[pic] Self- Assessment (the answer to self-assessment exercises will be discussed in tutorial sessions)

[pic] The main concepts

LECTURE / TOPIC OUTLINES

|Lecture 1: Extra Pyramidal Disorders |

| | Student Notes: . |

|Lecturer: Prof. Tarif H. Zawawi | |

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|At the end of the lecture you should be able to: | |

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|Develop an understanding of the various causes of extra pyramidal disorders | |

|with special emphasis on Parkinson's disease | |

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|Content: | |

|Introduction | |

|Outline of various extra pyramidal disorders with causes and associated | |

|diseases | |

|Parkinson's disease | |

|Discussion:- Pathology, clinical features including new added features such | |

|as depression and dementia; established and new management strategies with the| |

|most common complications | |

|Summary | |

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|[pic] | |

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|Lecture 2: Epilepsies |

| |Student Notes: |

|Lecturer: Dr. Hussein M. Malibary | |

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|At the end of the lecture you should be able to: | |

|understand the pathophysiology of epilepsies and to differentiate the various | |

|clinical types | |

|know the appropriate investigations required | |

|know the therapeutic options according to the type and cause of different | |

|epileptic syndrome | |

|know the basic treatment of status epilepticus | |

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|Content: | |

|Definition | |

|Epidemiology | |

|Classification and description of major types | |

|Investigations: EEG, Brain Mapping, Neuroimaging | |

|Treatment: Antiepileptic Drugs (aed), Dose side effects, Drug monitoring, | |

|Surgical treatment | |

|Intractable seizures | |

|Status Epilepticus | |

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|[pic] | |

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|Lecture 3: Peripheral Neuropathy |

| |Student Notes: |

|Lecturer: Dr. Hussein M. Malibary | |

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|At the end of the lecture you should be able to: | |

|know the basic anatomy and physiology of the peripheral nerves | |

|differentiate the clinical features of peripheral nerves disorders | |

|know the classifications and the causes of peripheral neuropathy | |

|know the basic investigations and treatment of peripheral neuropathy | |

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|Content: | |

|Definition | |

|Brief review of anatomy and physiology of the peripheral nervous system | |

|Causes | |

|Clinical Features: motor and sensory | |

|Classifications: Mono, multi and polyneuropathy, axonal, demyelinating, | |

|acute, Subacute and chronic | |

|Investigations: EMG, motor and sensory nerve conduction, nerve biopsy and | |

|sensory biopsy | |

|Treatment | |

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|Lecture 4: Bronchogenic Carcinoma |

| |Student Notes: |

|Lecturer: Prof. Mahmoud Shaheen Al-Ahwal | |

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|At the end of the lecture you should be able to: | |

|know the different types of lung cancer and its epidemiology andits relation | |

|to different causative agents | |

|appreciate the different presentations of lung cancer | |

|know the mode of screening and diagnosing lung cancer | |

|know fair and good ideas about the management of lung cancer with its staging | |

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|Content: | |

|Epidemiology | |

|Aetiology: | |

|Smoking | |

|Occupational Factors | |

|3. The 4 histological diagnosis of bronchial carcinoma: | |

|Squamous cell | |

|Small cells | |

|Adenocarcinoma | |

|Large cell carcinoma | |

|4. Screening Procedures: | |

|X-ray | |

|Sputum cytoloyg | |

|Antibody raised to human lung cancer cells | |

|Tumour markers | |

|5. Clinical Features: | |

|Local symptoms | |

|Metastatic symptoms | |

|Non-metastatic extrapulmonary symptoms | |

|6. Diagnosis of Bronchial Asthma: | |

|History taking | |

|Physical examination | |

|Radiological exam and all diagnoses of radiological findings | |

|Other investigations, such as: | |

|Sputum cytology | |

|Bronchoscopy and biopsies | |

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|Lecture 4: Bronchogenic Carcinoma (continuation): |

| |Student Notes: |

|Lecturer: Prof. Mahmoud Shaheen Al-Ahwal | |

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|Content: | |

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|7. Management: | |

|Medical: Chemotherapy + radiotherapy | |

|Surgical intervention | |

|Combined treatment | |

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|8. Prognosis in differential diagnosis of Lung Carcinoma | |

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|Lecture 5: Introduction to Electrocardiography |

| |Student Notes: |

|Lecturer: Prof. Khalid Marzouki | |

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|At the end of the lecture you should be able to: | |

|read a normal ECG tracing and pick up major abnormalities in the ECG. | |

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|Content: | |

|CG tracing is to be introduced to students and students were guided as to| |

|read a normal ECG by looking at: | |

|rate | |

|rhythm | |

|P-wave | |

|PR interval | |

|Q-wave | |

|R-wave | |

|ST segments | |

|T-wave changes. | |

|Illustrations are given of normal ECG tracing as well as various ECG | |

|abnormalities. | |

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|[pic] | |

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|Lecture 6: Pericardial Diseases |

| |Student Notes: |

|Lecturer: Prof. Khalid Marzouki | |

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|At the end of the lecture you should be able to: | |

|differentiate ischemic from pericardial pain. | |

|recognize the electrographic feature of acute pericarditis | |

|understand the pathophysiology of cardiac tamponade and its clinical correlates at the | |

|bedside | |

|understand the role of echocardiography in the diagnosis of pericardial disease | |

|understand the role of other imaging/diagnostic modalities in the diagnosis of | |

|pericardial pathology | |

|recognize the clinical presentations associated with disease of the pericardium | |

|recognize that the etiology of many of the disease of the pericardium can manifest in a | |

|variety of ways in individual patients and in the same patient at different stages of the| |

|disease process | |

|understand the pathophysiology of constrictive pericarditis and its clinical correlates | |

|at the bedside | |

|understand the similarities and differences between tamponade physiology and constrictive| |

|physiology | |

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|Content: | |

|Definition | |

|Signs and symptoms | |

|Aetiology | |

|Clinical presentations | |

|Pathophysiology | |

|Clinical recognition | |

|Diagnosis | |

|Confirmatory diagnosis | |

|Treatment | |

|Reading assignment | |

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|[pic] | |

|Lecture 7: Malabsorption Syndrome |

| |Student Notes: |

|Lecturer: Dr. Yousif Qari | |

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|At the end of the lecture you should be able to: | |

|understand the definition | |

|understand the symptoms and signs | |

|know the diagnostic work up for malabsorption | |

|diagnose and treat the particular underlying cause of malabsorption | |

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|Content: | |

|Definition:- intraluminal, mucosal, post-mucosa | |

|Causes | |

|Screening method | |

|Diagnosis:- importance of small bowel biopsy | |

|Treatment | |

|Special note on Lactose intolerance | |

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|Lecture 8: Pulmonary Tuberculosis |

| |Student Notes: |

|Lecturer: Dr. Omar Al-Amoudi / | |

|Dr. Aisha Siddiqui | |

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|At the end of the lecture you should be able to: | |

|be familiar with the different presentation of pulmonary TB | |

|know how to diagnose pulmonary TB | |

|know how to manage it | |

|be aware for the complication of TB and side effects of anti-TB therapy | |

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|Content: | |

|Epidemiology | |

|Pathology | |

|Clinical Features | |

|Investigations | |

|Prevention: BCG | |

|Contact tracing | |

|Different regimens, duration & side effects | |

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|[pic] | |

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|Lecture 9: Extrapulmonary Tuberculosis (CNS, Intestinal, Lymph Node) |

| |Student Notes: |

|Lecturer: Dr. Adil Khazindar | |

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|At the end of the lecture you should be able to: | |

|think of the possibility of this disease | |

|importance of this disease | |

|know the ways how to diagnose and treat this disease | |

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|Content: | |

|Definition of TB and epidemiology of the disease | |

|Transmission and possibility of morbidity | |

|Tuberculo-meningitis: | |

|Symptoms and physical examination (more neurological) | |

|Course, diagnostic steps and treatment | |

|Intestinal TB: pathogens and transmission: | |

|Clinical symptoms | |

|Diagnostic steps | |

|Differential diagnosis | |

|Treatment | |

|Tuberculos lymhphadenopathy: | |

|History | |

|Signs and symptoms | |

|Biopsy, as most important diagnostic investigations | |

|Treatment like pulmonary TB treatment | |

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|Lecture 10: ACUTE AND CHRONIC RENAL FAILURE – (ACUTE Phase) |

| |Student Notes: |

|Lecturer: DR. Saeed M. G. Al-Ghamdi | |

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|At the end of the lecture you should be able to: | |

|approach patient with acute renal failure | |

|know the major categories and common causes of acute renal failure (pre-renal, renal, | |

|post renal) | |

|assess volume status (dehydrate or volume depletion and euvolemia | |

|utilize different diagnostic tests to enable to reach to the diagnosis, such as: | |

|urinalysis, urine sodium and ultrasound kidneys and bladder | |

|distinguish between acute renal and chronic renal failure | |

|know the different treatment to acute renal failure according to the cause | |

|be prompt in treating this potentially reversible disease | |

|know the nephrotoxic medications causing acute renal failure | |

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|Content: | |

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|Definition | |

|Causes according to the site of ailment (i.e., pre-renal, renal, post-renal) | |

|Presentation and volume status | |

|Investigations: | |

|urine analysis and microscopy | |

|urine sodium, sodium excretion, sodium fractional excretion | |

|ultrasound kidneys and bladder | |

|urine creatinine and electolytes | |

|serological tests in glomerulonephritis | |

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|Lecture 10: ACUTE AND CHRONIC RENAL FAILURE – (ACUTE Phase) - continuation |

| |Student Notes: |

|Lecturer: DR. Saeed M. G. Al-Ghamdi | |

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|Content (continuation): | |

|Treatment: | |

|Pre-renal:- hydrate | |

|Renal:- according to causes | |

|Post-renal:- relieve obstruction | |

|Conservative treatment of established acute renal failure | |

|Indications for dialysis | |

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|Lecture 11: ACUTE AND CHRONIC RENAL FAILURE – (CHRONIC Phase) |

| |Student Notes: |

|Lecturer: DR. Saeed M. G. Al-Ghamdi | |

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|At the end of the lecture you should be able to: | |

|approach causes of chronic renal failure | |

|distinguish between chronic and acute renal failure | |

|know the natural history of the disease | |

|know the common causes and pathophysiological mechanisms | |

|know the clinical presentation | |

|know the complications of chronic renal failure | |

|know the diagnostic tests in chronic renal failure | |

|know the treatment of complications of chronic renal failure: bone disease, etc. | |

|know how to ameliorate the disease and postpone the inevitable | |

|know how to prepare patient for renal replacement therapy | |

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|Content: | |

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|Definition | |

|Causes according to the site of ailment (i.e., pre-renal, renal, post-renal) | |

|Pathophysiology of the presression of the disease: hyperfiltration therapy | |

|Clinical presentation | |

|Diagnostic tests: | |

|ultrasound | |

|urine analysis | |

|CBC | |

|Ca, PO4, Alp, Urea, Creatinine, Potassium, etc. | |

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|Lecture 11: ACUTE AND CHRONIC RENAL FAILURE – (CHRONIC Phase) |

| |Student Notes: |

|Lecturer: DR. Saeed M. G. Al-Ghamdi | |

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|Content (continuation): | |

|Pre-requisites to diagnose chronic renal failure | |

|Complications of chronic renal failure and its treatment: | |

|Uremic bone disease and to pathophysiology | |

|Anaemia | |

|Follow-up patients with chronic renal failure | |

|Preparing patient for renal replacement therapy | |

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|Lecture 12: CEREBROVASCULAR ACCIDENT AND INTRACRANIAL BLEEDING 1 and 2 |

| |Student Notes: |

|Lecturer: Dr. Hussein M. Malibary and | |

|Dr. Abeer Kawthar | |

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|At the end of the lecture you should be able to: | |

|know the basic anatomy and physiology of the cerebral circulation | |

|recognize the risk factors of CVA | |

|know and differentiate the various types of ischemic and haemorrhagic CVA | |

|know the specific feature of occlusion of each gross artery of the brain | |

|choose the appropriate investigations | |

|outline the basic management | |

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|Content: | |

|Definition | |

|Review of blood supply to the brain: | |

|Internal and external carotids system | |

|Vertebrobasilar system | |

|Circle of Willis and other anastomotic system | |

|Types of stroke in CVA: | |

|Ischaemic:- TIA, RIND, Stroke in evolution and Completed stroke | |

|Haemorrhagic:- intracerebral; subarachnoid, subdural, epidural and cerebellar| |

|Specific features of cerebral arteries occlusion: | |

|ACA | |

|MCA | |

|PCA | |

|Internal carotid | |

|PICA | |

|Vertebrobasilar | |

|Lecture 12: CEREBROVASCULAR ACCIDENT AND INTRACRANIAL BLEEDING 1 and 2 |

| |Student Notes: |

|Lecturer: Dr. Hussein M. Malibary and | |

|Dr. Abeer Kawthar | |

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|Content: (continuation) | |

|Venous and sinuses thromboses: | |

|Superior sagittal sinus | |

|Cavernous sinus | |

|Investigations: | |

|CBC | |

|CT, MRI, MRA | |

|Angiography | |

|Isotope scanning SPECT | |

|Specific tests according to clinical presentation | |

|Treatment: | |

|Symptomatic | |

|Anticoagulation and antiplatelet | |

|Physiotherapy | |

|Rehabilitation speech therapy | |

|Surgery | |

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|Lecture 13: INFLAMMATORY BOWEL DISEASE (IBD) |

| |Student Notes: |

|Lecturer: DR. Yousif A. Qari | |

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|At the end of the lecture you should be able to: | |

|think of the possibility of inflammatory bowel disease (IBD) | |

|know the importance of IBD | |

|know the ways how to diagnose and treat IBD | |

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|Content: | |

|Introduction about the epidemiology of the disease and short historical | |

|background to Dr. Crohn who discover the disease for the first time. | |

|Etiology:- discussion for some etiological factors assumed like:- viral | |

|infection, genetic predisposition and autoimmune mechanism. | |

|Definition:- emphasis on both ulcerative colitis and Crohn's disease might be| |

|the same disorder with different clinical manifestations. To make clinical | |

|symptoms of both disorders understandable, pathological background with | |

|possible anatomical changes of each disease was given in particular difference| |

|in the localization and nature of pathology of ulcerative colitis and Crohn's | |

|disease. | |

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|Lecture 13: INFLAMMATORY BOWEL DISEASE (IBD) |

| |Student Notes: |

|Lecturer: DR. Yousif A. Qari | |

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| | |

| | |

|Content: - continuation: | |

|Clinical Presentation:- discussion in depth for each disease at the same time| |

|so as to differentiate easily between the two disorders. | |

|Laboratory and Diagnostic Steps:- to reach the diagnosis and the role of CBC,| |

|ESR, barium meal follow through and colonoscopy. | |

|Differential Diagnosis:- explained as extra intestinal manifestation can give| |

|rise to confusion with rheumatoid arthritis, SLE, malabsorption syndrome, | |

|malignancy in gastrointestinal tract, etc. | |

|Prognosis:- discussed and the point is stressed that the earlier the disease | |

|is recognized, the better the prognosis will be. | |

|Treatment:- including steroids – treatment is discussed in details and side | |

|effects of drugs is mentioned. The importance of follow-up and the | |

|psychological support of the patient with such disease is stressed. | |

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|Lecture 14: RHEUMATOID ARTHRITIS |

| |Student Notes: |

|Lecturer: Dr. Omar Fathaldin and | |

|Dr. Suzan Attar | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|know how to approach the diagnosis of rheumatoid arthritis | |

|stress the importance of rheumatological history | |

|know how to demonstrate the joints examination | |

|discuss the articular and extra-articular manifestations | |

|know the investigations required to diagnose | |

|know the differential diagnoses | |

|outline the general line of management of the disease | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Approach to diagnose rheumatoid arthritis:- | |

|Stress on the importance of rheumatological history | |

|Demonstrate how to do joint examination | |

|Discuss the criteria to diagnose rheumatoid arthritis. | |

|Discuss the articular and extra-articular manifestations of the disease | |

|Investigations required to diagnose the disease:- | |

|Laboratory test | |

|Radiological test | |

|Differential diagnosis | |

|General line of management of the disease | |

|[pic] | |

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| | |

|Lecture 15: ONCOLOGICAL EMERGENCIES |

| |Student Notes: |

|Lecturer: Prof. Mahmoud Shaheen Al-Ahwal | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|differentiate types of Oncologic Emergencies | |

|diagnose and deal with different types of Oncologic emergencies | |

|attend with emergency cases | |

|see and know how to treat immediately | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Types of the Oncologic Emergencies | |

|Diagnostic tools for each type | |

|Management of the disease:- neutropenic patient after chemotherapy | |

|Treatment of acute complications of chemotherapy | |

|Treatment of patients with hypercalcemia caused by malignancy | |

|Treatment of obstruction in ducts compressed by malignant mass or lymphnoid | |

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|Lecture 16: GASTROINTESTINAL BLEEDING |

| |Student Notes: |

|Lecturer: Dr. Yousif A. Qari | |

| | |

| | |

| | |

|At the end of the lecture you should be able to know: | |

|the causes of GI bleeding | |

|the diagnostic tools to diagnose patients with GI bleeding | |

|the ABC resuscitation for patients with GI bleeding | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Differential diagnosis of the causes of Upper GI bleeding | |

|Symptoms and Signs of GI blood loss | |

|Assessment of the blood loss | |

|Diagnostic approach to patients with Upper GI bleeding | |

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|Lecture 17: METABOLIC SYNDROME |

| |Student Notes: |

|Lecturer: Prof. Mohamad S. Al-Hadramy and | |

|Dr. Faiza A. Qari | |

| | |

| | |

| | |

|At the end of the lecture you should be able to know: | |

|how to define Metabolic Syndrome | |

|the signs of insulin resistance | |

|how to approach the diagnosis of Metabolic Syndrome | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Symptoms and Signs | |

|Criteria to come up with the diagnosis | |

|Complications | |

|Prevention and treatment of the disease | |

|Treatment of other components of Metabolic Syndrome | |

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|[pic] | |

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|Lecture 18: CHRONIC LIVER DISEASES 1 and 2 |

| |Student Notes: |

|Lecturer: Dr. Hisham Akbar and | |

|Dr. Hind Fallatah | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|know the causes of Chronic Liver Diseases | |

|know the complications of the disease | |

|know how to approach the patient with decompensated CLD:- ascites, | |

|encephalopathy, variceal bleeding | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Definition | |

|Causes:- | |

|Infections:- HBV, HCV, Bilharziasis | |

|Autoimmune:- AIH, BPC, PSC | |

|Metabolic:- Henoch, Wilson's, etc. | |

|NASH | |

|Alcoholic liver disease | |

|Vascular, Budd Chiari Syndrome | |

|Decompensated CLD | |

|Ascites | |

|Encephalopathy | |

|GI bleeding | |

|Diagnostic tools for each decompensated CLD | |

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|[pic] | |

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|Lecture 19: ESOPHAGEAL DISORDERS |

| |Student Notes: |

|Lecturer: Dr. Hisham Akbar | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|understand the definition of various Esophageal Disorders with special | |

|emphasis on the two commonest forms. 1) Irritable Bowel Syndrome (IBS) and | |

|(2) Functional Dyspepsia | |

|understand the current theories that pertains to the underlying | |

|pathophysiological mechanisms involved in IBS and functional dyspepsia | |

|understand the diagnostic criteria in diagnosing IBS and functional dyspepsia | |

|know how to diagnose the disease based on good history, physical examination | |

|and simple investigations | |

|know how to treat patients with this kind of disease in a step wise approach | |

|starting with the non-pharmaceutical modalities followed by pharmaceutical | |

|elements to most predominant symptoms. | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Definition | |

|Functional dyspepsia:- | |

|definition | |

|types according to the predominant symptoms | |

|pathophysiology | |

|diagnostic work up | |

|relation to H. pylori | |

|therapeutic options | |

| | |

|[pic] | |

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| | |

|Lecture 19: ESOPHAGEAL DISORDERS (continuation) |

| |Student Notes: |

|Lecturer: Dr. Hisham Akbar | |

| | |

| | |

| | |

| | |

| | |

|Content: (continuation: | |

|Irritable Bowel Syndrome (IBS):- | |

|definition | |

|epidemiological data | |

|pathophysiological mechanisms and theories behind it with special emphasis on | |

|the influence of the psychosocial element on the symptomatology and the vice | |

|versa | |

|Diagnostic criteria: Rome criteria | |

|Diagnostic approach, strengthening the positive attitude for the diagnosis | |

|rather than considering it as a diagnosis of exclusion. | |

|Treatment:- | |

|the importance of listening to the patient and understanding their concerns | |

|stressing on the importance of reassurance and explaining the syndrome to the | |

|patient | |

|the use of natural bran | |

|step form approach to the treatment | |

|to discuss different classes of medications used to treat the predominant | |

|symptoms in patients with IBS with special emphasis on careful use of these | |

|drugs to avoid placebo effect and abuse medications that are ineffective to | |

|begin with except for their placebo action | |

|brief discussion of psychotherapy | |

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|[pic] | |

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| | |

|Lecture 20: SYSTEMIC LUPUS ERYTHEMATOSUS |

| |Student Notes: |

|Lecturer: Dr. Omar Fathaldin | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|know what is Systemic Lupus Erythematosus (SLE) | |

|approach the patient | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Criteria of SLE | |

|Diagnosis | |

|Differential diagnosis | |

|Investigations | |

|Complications | |

|Treatment | |

|Prognosis | |

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|[pic] | |

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| | |

|Lecture 21: ADRENAL GLAND DISORDERS |

| |Student Notes: |

|Lecturer: Prof. Daad Akbar and | |

|Dr. Khalid Al-Shali | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|suspect the diagnosis from proper history and examination of the patient | |

|perform the appropriate investigations | |

|interpret the results | |

|manage the patient properly from all aspects | |

|follow-up the patient | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Anatomy:- center, medullar | |

|Physiology:- | |

|Cortex:- cortical hormone: excess or deficiency; Cushing's Syndrome, Addison's| |

|Disease, Aldosteronism (Conn's Disease), Sex hormones: congenital adrenal | |

|hyperplesia (mechanisms and features) | |

|Medulla:- Pheochromocytoma:- Features, Diagnosis, Management | |

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|[pic] | |

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| | |

|Lecture 22: ECG INTERPRETATION |

| |Student Notes: |

|Lecturer: Prof. Khalid Marzouki | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|know the basic normal ECG | |

|know time activation of each ECG wave | |

|read the 12 leads of ECG | |

|know the anatomical position of each bed | |

|know how to diagnose the abnormalities of each wave | |

|know how to diagnose left and right atrial hypertrophy | |

|know how to diagnose left and right ventricular hypertrophy | |

|know how to diagnose atrial and ventricular arrythmias | |

|know how to diagnose atrio-ventricular block | |

|know how to diagnose ischaemic heart disease and myocardial infarction | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Definition | |

|Signs and symptoms | |

|Clinical Features | |

|Diagnosis | |

| | |

|[pic] | |

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| | |

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| | |

| | |

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| | |

|Lecture 23: CARDIOMYOPATHIES |

| |Student Notes: |

|Lecturer: Dr. Nabil Al Ama | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|know the types of cardiomyopathies (CMP) | |

|know the causes of CMP | |

|know how to define CMP | |

|know the ways how to diagnose CMP | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Introduction about CMP | |

|Definition of CMP | |

|Types of CMP | |

|Causes of CMP | |

|Management of CMP: | |

|Symptoms of each type of CMP | |

|Signs of each type of CMP | |

|Investigations of each type of CMP | |

|Differential diagnosis of each type of CMP | |

|Medical treatment of each type of CMP | |

|Complications of CMP | |

|Prognosis | |

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|[pic] | |

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| | |

|Lecture 24: SERO-NEGATIVE ARTHRITIS |

| |Student Notes: |

|Lecturer: Dr. Sami Bahlas and | |

|Dr. Susan Attar | |

| | |

| | |

| | |

|At the end of the lecture you should be able to know the: | |

|aetiology | |

|classification | |

|clinical presentation | |

|prognosis | |

|treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Ankylosing spondylitis | |

|Enteropathic arthritis | |

|Psoriatic arthritis | |

|Reactive arthritis | |

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|[pic] | |

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| | |

|Lecture 25: ISCHAEMIC HEART DISEASES 1 and 2 |

| |Student Notes: |

|Lecturer: Dr. Nabil Al-Ama | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|identify patients with ischaemic heart disease | |

|know the magnitude of the problem | |

|know how to diagnose patients with ischaemic heart disease | |

|know how to treat and manage patients with ischaemic heart disease | |

|know the risk factors and prevention of ischaemic heart disease | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Definition | |

|Prevalence | |

|Risk factors | |

|Categories: | |

|Angina | |

|Unstable angina | |

|Myocardial Infarction | |

|Sudden Death | |

|Silent ischaemia | |

|Pringe metal angina | |

|Each categories: | |

|History | |

|Examination | |

|Investigations | |

|Treatment | |

|Complications | |

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|[pic] | |

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|Lecture 26: CANCER CHEMOTHERAPY |

| |Student Notes: |

|Lecturer: Prof. Mahmoud Shaheen Al-Ahwal | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|___ | |

|____ | |

|_____ | |

|___ | |

|_ | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|___ | |

|___ | |

|----- | |

|------ | |

|---- | |

|----- | |

| | |

|[pic] | |

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| | |

| | |

|Lecture 27: DRUGS IN HEART FAILURE |

| |Student Notes: |

|Lecturer: Dr. Nabil Al-Ama | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|___ | |

|____ | |

|_____ | |

|___ | |

|_ | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|___ | |

|___ | |

|----- | |

|------ | |

|---- | |

|----- | |

| | |

|[pic] | |

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| | |

|Lecture 28: TYPHOID FEVER AND BRUCELLOSIS |

| |Student Notes: |

|Lecturer: Dr. Tariq Madani | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

| | |

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|[pic] | |

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|Lecture 29: ANTI-MALARIA THERAPY |

| |Student Notes: |

|Lecturer: Dr. Tariq Madani | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|___ | |

|____ | |

|_____ | |

|___ | |

|_ | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|___ | |

|___ | |

|----- | |

|------ | |

|---- | |

|----- | |

| | |

|[pic] | |

| | |

| | |

| | |

| | |

| | |

| | |

|Lecture 30: CANCER CHEMOTHERAPY |

| |Student Notes: |

|Lecturer: Prof. Mahmoud Shaheen Al-Ahwal | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|___ | |

|____ | |

|_____ | |

|___ | |

|_ | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|___ | |

|___ | |

|----- | |

|------ | |

|---- | |

|----- | |

| | |

|[pic] | |

| | |

| | |

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| | |

| | |

| | |

|Lecture 27: DRUGS IN HEART FAILURE |

| |Student Notes: |

|Lecturer: Dr. Nabil Al-Ama | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|___ | |

|____ | |

|_____ | |

|___ | |

|_ | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|___ | |

|___ | |

|----- | |

|------ | |

|---- | |

|----- | |

| | |

|[pic] | |

| | |

| | |

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| | |

| | |

| | |

|Lecture 28: THYPHOID FEVER AND BRUCELLOSIS |

| |Student Notes: |

|Lecturer: Dr. Tariq Madani | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

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|[pic] | |

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| | |

|Lecture 29: ANTI-MALARIA THERAPY |

| |Student Notes: |

|Lecturer: Dr. Tariq Madani | |

| | |

| | |

| | |

|At the end of the lecture you should be able to: | |

|___ | |

|____ | |

|_____ | |

|___ | |

|_ | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|___ | |

|___ | |

|----- | |

|------ | |

|---- | |

|----- | |

| | |

|[pic] | |

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| | |

Independent learning

“Independent learning is a very essential skill for tomorrow’s doctors. We will train you to gain this important skill by asking you to read independently about specific topics in medical diseases ”

PBL (Problem-Based Learning)

❖ PBL process

• The clinical scenario

• Key information

• Explore the problem

• What you know

• What you need to know

• Identify learning issues

• Self/group study

• Share the knowledge

• Solve the problem

• Give feedback & reflect

RECOMMENDED TEXTBOOKS

Davidson’s Principles of Internal Medicine

Concise Middle Eastern Clinical Medicine

Harrison’s Principles of Internal Medicine

Medicine by John Axford - First edition

RECOMMENDED WEBSITE





Tutors: Dr. Faiza A. Qari / Dr. Emad Koshak

-----------------------

Faculty of Medicine

King Abdulaziz University

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