Faculty of Medicine



DEPARTMENT OF MEDICINE

4th YEAR STUDY GUIDE

Table of Contents

|Topic | |Page |

|THE OUTCOMES OF THE UNDERGRADUATE CURRICULUM | | |

|CURRICULUM MAP | | |

|STRUCTURE OF 4TH YEAR – INTERNAL MEDICINE | | |

|INTRODUCTION | | |

|AIMS & OBJECTIVES | | |

|TEACHERS CONTACTS | | |

|ASSESSMENT | | |

|ICONS | | |

|TOPIC OUTLINES | | |

Outcomes of the 4Th year Medical Curriculum

1) Knowledge

The main purposes of the clinical course in the 4th 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 9 weeks in Medicine, they should learn and acquire the clinical skills of history taking and physical exam.

No. of Days per Week: 3 days teaching with academic staff

2 days clerking days

No. of week per posting: 9 weeks

Total clinical sessions: 27 clinical sessions for the entire rotation

The leader of each 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 one mark deduction. Students who are absent more than 10% of the sessions are not illegible to sit for 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

Respiratory System

Gastroenterology (GIT)

Neurology

Endocrinology & Metabolic

Infectious Diseases

Nephrology

Lectures (TITLES)

A. General Medicine Lectures' Title:

1. Curriculum of Medicine

2. History Taking

3. General Examination

4. Examination of the Cardiovascular System

5. Examination of the Respiratory System

6. Examination of the Cranial Nervous System

7. Signs and Symptoms in Cardiovascular System

8. Signs and Symptoms in Cranial Nervous System

9. Signs and Symptoms in Respiratory System

10. Signs and Symptoms in Gastrointestinal Tract

11. Signs and Symptoms in Endocrine System

12. Signs and Symptoms in Rheumatology

13. Headaches

14. Chronic Bronchitis and Emphysema

15. Pneumonias and Atypical Pneumonia

16. Pleural Effusion (Empyema + Lung Abscess)

17. Valvular Heart Disease I

18. Valvular Heart Disease II

19. Heart Failure

20. Infective Endocarditis

21. Hypertension

22. Glomerulonephritis & Nephrotic Syndrome

23. Peptic Ulcers Disorders

24. Acute Hepatitis

25. Hypothalamus & Pituitary Disorders I

26. Hypothalamus & Pituitary Disorders II

27. Thyroid Disorders (Excluding Management)

28. Diabetes Mellitus (Excluding Management)

29. Bronchial Asthma

30. Urinary Tract Infection + Pyelonephritis

B. Others

CLINICAL TEACHING:

Students are distributed in small sub-groups. They will be assigned to one hospital (University hospital or affiliated MOH hospitals). The clinical sessions have a duration of 3 hours each. 9:00-12:00 in the morning session and 1:00-4:00 in the afternoon session. Clinical teaching is conducted by an academic staff member.

The clinical teaching sessions are run 5 days a week from Saturday to Wednesday. Academic staff will teach on Saturdays - Mondays - Wednesdays, while on Sundays and Tuesdays, students will conduct their self teaching (clerking days), during which, they learn and acquire the clinical skills of history taking and physical exam.

No. of Days per Week: 3 days teaching with academic staff

2 days clerking days

No. of week per posting: 9 weeks

STRUCTURE OF 4TH YEAR - INTERNAL MEDICINE

Introduction

Students should start this year with the clinical sciences including the introductory course, the lectures and the clinical bedside teaching. The introductory course includes the methods of history taking and physical exam related to the major branches of Internal Medicine as well as the common symptoms and signs. The lecturer, due to the limitation of allocated time, will put emphasis on certain parts of the topic. 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, with further readings. During the clinical teaching, the 4th 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. 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 4th 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

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 640-8477

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

Dr. Sami Bahlas 640-8265

Dr. Abdulraheem Al-Shehri None

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. Nawal Al-Ghamdi, Assistant Professor 640-8364

Dr. Suzan Attar, Assistant Professor 640-8235

Dr. Maimoona Mushtaq, Consultant Physician 640-8367

Dr. Hind Fallatah, Consultant Physician/Gastroenterologist None

Dr. Fatma Al-Beladi, Consultant Physician/Nephrologist None

Assessment

TYPE OF EXAMS:

a) End of Posting Exam 50 %

b) Final exam 80 %

End of Posting Exam comprising of:

Written Exam:-

40 Multiple Choice Questions (MCQ) = 40 %

1 Problems solving = 5 %

1 Data Interpretation = 5 %

Final exam comprising of:

Written Exam:-

60 Multiple Choice Questions (MCQ) = 60 %

2 Problems solving = 10 %

2 Data Interpretation = 10 %

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: Curriculum of Medicine |

| | Student Notes: . |

|Lecturer: Dr. Abdulrahman Al Shaikh | |

| | |

| | |

| | |

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

| | |

|1. catch the importance of the clinical science with medical practice | |

|2. know what are the components of the curriculum | |

|3. prepare him/her self for looking for clinical knowledge and skills | |

|4. by the end of the 4th year student, should master the clinical exam of | |

|the normal human being | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. briefing about the lectures | |

|2. briefing about the clinical sessions including the clerking and clinical | |

|teaching sessions | |

|3. introduction of the exam system with its various types: i.e. | |

|- MCQ | |

|- Short Notes | |

|- Assay | |

|- Data Interpretation | |

|- Problem Solving | |

|- Clinical Exams | |

| | |

|[pic] | |

|Lecture 2: History Taking |

| |Student Notes: |

|Lecturer: Dr. Adil Khazindar and | |

|Dr. Faiza Qari | |

| | |

| | |

| | |

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

| | |

|know what is meant by history taking | |

|know the significance of history taking | |

|know the responsibility of history taking | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. Complaint(s) of the patient (Chief complaint) | |

|2. History of present complaint(s) present illness | |

|3. Past medical history | |

|4. Systematic Question on all systems: (Review of Systems) | |

|Cardiovascular System | |

|Respiratory System | |

|Urinary Genital System | |

|Musculoskeletal System | |

|Haematological System | |

|Gastrointestinal System | |

|CentralNervous System | |

|5. Social history | |

|6. Family history | |

|7. Drug history | |

|8. Allergy history | |

|9. Summary | |

| | |

|[pic] | |

| | |

| | |

| | |

| | |

|Lecture 3: General Examination |

| |Student Notes: |

|Lecturer: Dr. Abeer Kawthar and | |

|Dr. Khalid Al Shali | |

| | |

| | |

| | |

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

|1. recognize in situ each normal anatomical part of the human body | |

|2. use the different techniques of clinical exam starting by:- | |

|inspection, palpation, percussion and auscultation of the different parts of | |

|the body | |

|3. observe politeness and courtesy to patients and avoid unnecessary hassle | |

|to patients | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. General appearance of illness | |

|2. Facial expression | |

|3. The attitude, mental state | |

|4. Build and Nutritional status | |

|5. Head and Face: | |

|- Hair | |

|- Eyes | |

|- Parotid glands | |

|- Cheeks | |

|- Lips | |

|- Teeth and Gums | |

|- Tongue | |

|- Buccal mucosa | |

|6. Neck swelling, lymph nodes, thyroid gland, trachea | |

|7. Skin colour and temperature | |

|8. Upper limbs | |

|9. Chest and breast | |

|10. Abdomen | |

|11. Lower limbs | |

|12. Deformities | |

|13. Abnormal: | |

|- posture | |

|- behaviour | |

|- movements | |

| | |

|Lecture 4: Examination of Cardiovascular System |

| |Student Notes: |

|Lecturer: Dr. Aisha Al Ghamdi and | |

|Dr. Hassan Badahman | |

| | |

| | |

| | |

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

| | |

|understand the mechanism of symptoms and signs through the anatomy and | |

|physiology of the cardiovascular system | |

|recognize the anatomical landmarks of the heart and vessels | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. History: chest pain, palpitation, etc. | |

|2. Physical Examination | |

|3. arterial pulses | |

|4. venous pulses | |

|5. blood pressure | |

|6. exam of the heart by: | |

|- inspection, - apex beat | |

|- palpation | |

|- percussion | |

|- auscultation: | |

|* normal heart sounds | |

|* added sounds | |

|* murmurs | |

|7. signs and symptoms of major cardiac diseases | |

| | |

|[pic] | |

|Lecture 5: Examination of Respiratory System |

|Lecturer: Dr. Emad Koshak and |Student Notes: |

|Dr. Maimoona Mushtaq | |

| | |

| | |

| | |

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

|recognize the anatomical landmark of the respiratory system | |

|understand the mechanism of symptoms and signs in normal and pathological | |

|conditions | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|History of chest symptoms (breathlessness, chest pain, cough, ….) | |

| | |

|Examination: | |

| | |

|A. Chest examination: | |

|1. Inspection: | |

|- appearance of chest wall (normal shape, deformities) | |

|- breathing rate and pattern | |

|- chest wall movements, expansion | |

|- parodoxical movements | |

|- abdominal movements | |

|- uses of accessory muscles | |

|2. Palpation: | |

|- trachea | |

|- tactile vocal fremitus | |

|3. Percussion: | |

|- normal | |

|- hyperresonant | |

|- dull | |

|- stony dull | |

|4. Auscultation: | |

|- breath sounds: | |

|- normal | |

|- reduced | |

|- absent | |

| - added sounds: | |

|- wheezes | |

|- crackles - crepitation | |

|- pleural rub | |

|Lecture 5: Examination of Respiratory System |

| |Student Notes: |

|Lecturer: Dr. Emad Koshak and | |

|Dr. Maimoona Mushtaq | |

| | |

| | |

| | |

| | |

| | |

| | |

|Content: (continuation) | |

| | |

|B. Extra Thoracic Signs: | |

|1. clubbing | |

|2. cyanosis | |

|3. hypertrophic pulmonary osteoarthropathy | |

| | |

| | |

| | |

|[pic] | |

| | |

| | |

| | |

|Lecture 6: Examination of Cranial Nervous System |

| |Student Notes: |

|Lecturer: Dr. Abdulraheem Al Shehri and | |

|Dr. Aisha Al Shareef | |

| | |

| | |

| | |

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

| | |

|familiar with the function of the different parts of the central and peripheral nervous | |

|system | |

|able to conduct a methodical and logical neurological exam of the patient with and | |

|without neurological disorder | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. Proper history taking with emphasis to the nervous system | |

| | |

|2. Steps of the neurological exam with explanation on how to examine and elicit signs | |

|I. Higher functions (mental status) | |

|- consciousness and its disorders drowziness, stupor, coma, brain death | |

|- speech: | |

|- normal speech: motor (fluency) and sensory (comprehension) and speech centres | |

|- central disorders: aphasia dysphasia | |

|- peripheral disorders: dysarthria, dysphonia | |

|- Memory: | |

|- recent | |

|- remote and anatomical localization | |

|- Orientation to time, place and person | |

|- Brief overview of other higher functions | |

| | |

|II. Examination of the 12 cranial nerves | |

| | |

| | |

|Lecture 6: Examination of Cranial Nervous System |

| |Student Notes: |

|Lecturer: Dr. Abdulraheem Al Shehri and | |

|Dr. Aisha Al Shareef | |

| | |

| | |

| | |

| | |

| | |

|Content: (continuation) | |

| | |

|III. Examination of the motor system: | |

|- bulk of muscles, normal wasting, hypertrophy | |

|- abnormal movements (tremor, chorea, fasciculation,…) | |

|- muscle power through muscle grading (grades 0-5) | |

|- tone: normal, hypertoma, hypotoma | |

|- coordination (cerebellar function) | |

|- reflexes: DTR + superficial reflexes | |

|- gait | |

| | |

|IV. Sensory examination: | |

|- superficial sensations: touch, pain, thermic, pressure, … | |

|- deep sensations (position sense, vibration sense) | |

|- loss of sensation: peripheral, cortical, … | |

| | |

|[pic] | |

|Lecture 7: Signs and Symptoms in Cardiovascular System |

| |Student Notes: |

|Lecturer: Prof. Khalid Marzouki and | |

|Dr. Aisha Siddiqui | |

| | |

| | |

| | |

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

|recognize the different signs and symptoms of the cardiovascular system | |

|understand their mechanisms | |

|properly examine the cardiovascular system | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

| | |

|Symptoms: | |

|shortness of breath + dyspnoea | |

|palpitation | |

|chest pain | |

|hemoptysis | |

|cyanosis | |

|edema | |

| | |

|Signs: | |

|1. inspection, palpation, percussion, auscultation, heart sounds normal + | |

|added | |

|2. pulses, arterial, mucous, venous (JVP) | |

|3. clubbing | |

|4. funduscopy in hypertension | |

|5. edema | |

|6. cyanosis | |

|[pic] | |

| | |

|Lecture 8: Signs and Symptoms Cranial Nervous System |

| |Student Notes: |

|Lecturer: Dr. Hussein Malibary and | |

|Dr. Aisha Al Shareef | |

| | |

| | |

| | |

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

|The student should understand the mechanisms of symptoms and signs through the anatomy and| |

|physiology of the nervous system. | |

|The student should be able to relate the symptoms and signs to the different structures of| |

|the Nervous System. | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|I. Brief review of the anatomy and physiology of the central and peripheral nervous | |

|systems as well as the autonomic system. | |

| | |

|II. II. Follow the steps of the neurological exam with explanation of the symptoms and | |

|signs related to each step and how to get and elicit the signs: | |

| | |

|A. A. Higher Functions: | |

|Consciousness and its disorders: | |

|Dizziness, confusion, stupor, lethargy, coma and brain death. | |

|Speech: Review of the speech centres | |

|(Broca, Wernicke); Normal speech; Abnormal speech: aphasia-dysphasia (central), | |

|dysarthria (peripheral), dysphonia, mutism | |

|Memory: recent and remote memory | |

|Orientation in time, space and to person: | |

|B. Cranial Nerves: | |

|- Common disorders affecting each cranial nerve with common symptoms and signs | |

|explained | |

|C. C. The motor system: | |

|- Brief review of the motor function, motor unit, myotome | |

| | |

|Lecture 8: Signs and Symptoms Cranial Nervous System |

| |Student Notes: |

|Lecturer: Dr. Hussein Malibary and | |

|Dr. Aisha Al Shareef | |

| | |

| | |

| | |

| | |

| | |

|Content: (continuation) | |

|- Reflexes deep tendon reflexes and superficial reflexes | |

|- Power, muscle grading (0/5 ---> 5/5) | |

|- Tone, Dystonia, hypertoma, hypotonia | |

|Association in syndromes of upper or lower motor neuron lesion. The student | |

|should | |

|master the differentiation between these 2 entities. | |

|- Incoordinaion, ataxia | |

|- Abnormal movements: tremor, chorea, fasciculation, hemiballesmus – TICS | |

| | |

|D. The sensory system: | |

|- Sensory modalities: | |

|Superficial and deep sensations: pain, touch, thermic, cortical sensations: | |

|stereognosis, dermatome | |

|- Sensory symptoms: | |

|Paresthesia (numbness), causalgia, anaesthesia, sensory ataxia | |

| | |

|- Syndromic associations: | |

|Posterior column, lateral column, thalamic syndrome, cortical deficit | |

| | |

| | |

|[pic] | |

| | |

| | |

| | |

|Lecture 9: Signs and Symptoms in Respiratory System |

|Lecturer: Dr. Omer Alamoudi and |Student Notes: |

|Dr. Abeer Kawthar | |

| | |

| | |

| | |

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

|recognize the signs and symptoms of respiratory diseases | |

|understand their pathophysiology | |

|elicit the signs by proper physical exaM | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|I. Symptoms: | |

|Full description of the following symptoms with mechanism, pathophysiology, | |

|complication and diagnostic value: | |

|cough | |

|chest pain | |

|sputum: color, amount | |

|haemoptysis | |

|clubbing | |

|cyanosis | |

|dyspnoea | |

|wheezes | |

|stridor | |

|II. Signs: | |

|Inspection - chest deformities, respiratory movements | |

|Palpation - position of the trachea, tactile vocal fremitus | |

|Percussion - dullness, resonance | |

|Auscultation: | |

|- air entry | |

|- bronchial breathing | |

|- rhonchi | |

|- crepitation | |

|- pleural rub | |

|- vocal resonance | |

|Extra thoracic manifestation of the respiratory diseases: | |

|- clubbing | |

|- cyanosis | |

|- hypertrophic osteoarthropathy | |

| | |

|Lecture 10: Signs and Symptoms in Gastrointestinal Tract |

|Lecturer: Dr. Hisham Akbar and |Student Notes: |

|Dr. Hind Fallatah | |

| | |

| | |

| | |

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

|know how to take detailed history of different complaints related to the | |

|gastrointestinal tract. | |

|know how to analyze pain regarding the site, character, radiation, severity, duration,| |

|frequency and periodicity, aggravating and relieving factors and associated phenomena.| |

|be able to relate pain at different sites to the underlying structure. | |

|be able to analyze other gastrointestinal complaints and to list possible causes as | |

|changes in appetite and weight, dysphagia, heart burn, vomiting, changes in bowel | |

|habit. | |

|know how to perform a complete physical examination and to detect all physical | |

|findings related to the gastrointestinal diseases. | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. Introduction | |

|2. Pain analysis: | |

|site, nature, duration, radiation, aggravating factors and relieving factors, | |

|severity, frequency and periodicity and associated phenomena | |

|3. Retrosternal pain: esophageal pain | |

|4. Upper abdominal pain: | |

|hiatus hernia pain, peptic ulcer pain, billiary pain, hepatic pain and pancreatic | |

|pain | |

|5. Central abdominal pain: small intestinal pain, colonic pain | |

|6. Lower abdominal pain: colonic pain, urinary bladder and uterine pain | |

|7. Lateralized pain: renal pain | |

|8. Other symptoms analysis as changes of appetite and weight, dysphagia, heart burn,| |

|vomiting, bowel habits | |

| | |

|Lecture 10: Signs and Symptoms in Gastrointestinal Tract |

|Lecturer: Dr. Hisham Akbar and |

|Dr. Hind Fallatah |

| |

| |

| |

| |

| |

|Content: (continuation) |

|9. General examination: |

|- general appearance |

|- state of nutrition |

|- skin color |

|- skin eruption |

|- body hair |

|- xanthelasma |

|10. Hand examination: |

|- clubbing |

|- leuconychia |

|- Dupuytren’s contracture, palmar erythema, flapping tremor |

|- scratch mark, muscle wasting & tattoos |

|11. Eyes examination: anaemia, jaundice, xanthelasma |

|12. Lips examination: cyanosis, swollen lips, patches of pigmentation, mouth |

|ulcer |

|13. Neck examination: cervical lymph nodes |

|14. Chest examination: looking to signs related to gastrointestinal diseases, |

|gynaecomastia, spider naevi, scratch mark, paucity of hair |

|15. Abdominal examination: inspection, palpation, percussion, auscultation |

|16. The students will be shown slides showing signs srelated to gastrointestinal |

|diseases. |

| |

|Lecture 11: Signs and Symptoms in Endocrine System |

| |Student Notes: |

|Lecturer: Dr. Faiza Qari and | |

|Dr. Khalid Al Shali | |

| | |

| | |

| | |

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

|recognize the signs and symptoms of various endocrine disorders | |

|understand their pathophysiology | |

|elicit the signs by proper physical exam | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

| | |

|Important signs and symptoms with proper history regarding: | |

| | |

|- duration | |

|- frequency | |

|- periodicity | |

|- severity | |

|- aggravating and relieving factors | |

|- typical endocrine causes | |

| | |

|Symptoms include: | |

| | |

|- tiredness and fatigue | |

|- weight gain | |

|- weight loss | |

|- syncope and queer turns | |

|- polyuria | |

|- amenorrhea and other menstrual abnormalities | |

|- galactorrhea | |

|- hyperpigmentation | |

|- hypopigmentation | |

| | |

|[pic] | |

| | |

|Lecture 12: Signs and Symptoms in Rheumatology |

|Lecturer: Dr. Sami Bahlas and |Student Notes: |

|Dr. Suzan Attar | |

| | |

| | |

| | |

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

|1. recognize the signs and symptoms of various rheumatological disorders | |

|2. understand their pathophysiology | |

|3. elicit the signs by proper physical exam | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Full description and mechanism of symptoms and signs | |

| | |

|Symptoms: | |

|pain | |

|immobility - stiffness | |

|loss of function | |

|swelling | |

|changed in color | |

| | |

|Signs: | |

|tenderness | |

|range of movement of joints | |

|swelling, fluctuation, effusion | |

|deformities | |

|redness | |

|crepitus | |

|skin lesions: | |

|- psoriasis | |

|- butterfly rash | |

|- erythema nodosum | |

|- Raynaud phenomenon | |

|- nodules | |

|- ulcers | |

|- dryness | |

|- vasculitis | |

|- subcutaneous tophi | |

| | |

|[pic] | |

|Lecture 13: Headaches |

| |Student Notes: |

|Lecturer: Dr. Tariq Madani and | |

|Dr. Aisha Al Shareef | |

| | |

| | |

| | |

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

|1. know the pathophysiology of the headache | |

|2. know how to take proper history in case of headache | |

|3. know the different types and causes of headache and their management | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

| | |

|1. Definition, epidemiology | |

| | |

|II. 2. Pathophysiology: | |

|Extra and intracranial pain sensitive structures. | |

| | |

|III. 3. Types of pain (Headache): | |

|Throbbing, stabing, dull ... | |

| | |

|IV. 4. Distribution of Headache: | |

|Unilateral, bilateral (holocranial), frontal, occipital, temporal | |

|Alternating | |

| | |

|V. 5. Radiation of pain to neck, to face and eyes | |

| | |

|VI. 6. Associated symptoms: | |

|Nausea, vomiting, blurred vision, irritability, depression | |

| | |

|VII. 7. Classification (Causes): | |

|Seriousness of the headache depends on the cause | |

|Non-neurological causes: | |

|Hypertension +++ | |

|ENT: Sinusitis | |

|Ophthalmo: Refractory errors | |

|Dental | |

|Infections | |

| | |

|Lecture 13: Headaches |

| |Student Notes: |

|Lecturer: Dr. Tariq Madani and | |

|Dr. Aisha Al Shareef | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

| | |

|Neurological causes: | |

|A. A. Serious : Tumours | |

|Infections (meningitis, ...) | |

|Intracranial bleeding | |

|Temporal arteritis | |

|B. Benign : Migraines | |

|Neuralgias (Trigeminal) | |

|Muscle contraction | |

|Common cause of headache: Psychogenic: tension-type headache | |

| | |

|VII. 8. Outline of Management: | |

|Important investigations: CT, MRI, LP | |

|Pain relief | |

| | |

|[pic] | |

|Lecture 14: Chronic Bronchitis and Emphysema |

| |Student Notes: |

|Lecturer: Dr. Omer Alamoudi and | |

|Dr. Aisha Siddiqui | |

| | |

| | |

| | |

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

|1. recognize the clinical features of chronic bronchitis, emphysema and | |

|COAD | |

|2. elicit their physical signs | |

|3. choose the appropriate diagnostic methods and | |

|know the basic treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. Definition of chronic bronchitis and emphysema | |

| | |

|2. Epidemiology of COAD | |

|- Tobacco smoking | |

|- Occupation | |

|- Natural history | |

|- Genetics factors | |

| | |

|3. Pathology of emphysema and chronic bronchitis including | |

|- Role of protease, anti protease inhibitor | |

|- Raid index | |

| | |

|4. 4. Clinical presentation of COAD and characteristic feature of each type | |

| | |

|- Pink puffer (emphysematous) | |

|- Blue bloater (bronchiectatic) | |

| | |

|5. Features differentiating COAD from Asthma | |

| | |

|6. Diagnosis | |

|- History | |

|- Clinical examination | |

|- Sputum | |

|- Radiology | |

|- Pulmonary Function Test | |

|- Arterial blood gases | |

| | |

|Lecture 14: Chronic Bronchitis and Emphysema |

| |Student Notes: |

|Lecturer: Dr. Omer Alamoudi and | |

|Dr. Aisha Siddiqui | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|7. Management (outline) | |

|- General measures | |

|b. - Specific (antibiotics, bronchodilator, steroids, | |

|and oxygen) | |

|[pic] | |

|Lecture 15: Pneumonias and Atypical Pneumonias |

| |Student Notes: |

|Lecturer: Dr. Adil Khazindar and | |

|Dr. Aisha Siddiqui | |

| | |

| | |

| | |

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

|1. understand the pathophysiology of the chest | |

|infection and its clinical features | |

|2. elicit the physical signs | |

|3. understand the basis of its management | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|I. Definition | |

| | |

|II. Pathophysiology | |

| | |

|III. Classification: | |

|community-acquired | |

|hospital-acquired | |

|aspiration pneumonia | |

|pneumonia in the immunocompromised | |

|patients | |

| | |

|IV. Causative agents | |

| | |

|V. Clinical features: | |

|- symptoms | |

|- signs | |

| | |

|VI. Differential diagnosis | |

| | |

|VII. Investigations | |

| | |

|VIII. Treatment | |

| | |

|IX. Prognosis and recovery | |

| | |

|[pic] | |

| | |

|Lecture 16: Pleural Effusion (Empyema + Lung Abscess) |

|Lecturer: Dr. Emad Koshak and |Student Notes: |

|Dr. Aisha Al Ghamdi | |

| | |

| | |

| | |

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

|Since pleural effusion is a common disease and it accounts for a good number | |

|of admissions to the medical ward, the students should: | |

|1. be able to define pleural effusion | |

|2. have a clear idea about the normal physiology of fluid accumulation in | |

|the pleural space | |

|3. know the different causes of pleural effusion, both transudate and | |

|exudate | |

|be able to describe the clinical presentation and finding on physical | |

|examination | |

|know how to investigate patient with pleural effusion | |

|have an idea about the lines of treatment of the disease | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. Introduction | |

|2. Definition | |

|3. Physiology | |

|4. Types: Transudate and Exudate | |

|5. Causes of transudate pleural effusion: | |

|heart failure, liver cirrhosis, nephrotic syndrome, | |

|malnutrition | |

|6. Causes of exudate pleural effusion: infection, malignany, pulmonary | |

|embolism, Collagen’s vascular diseases, intra-abdominal abscesses, | |

|trauma, miscellaneous | |

|7. Clinical manifestations: | |

|Symptoms: related to the effusion, related to | |

|the primary cause | |

|Signs: inspection, palpation, percussion, | |

|auscultation | |

|8. Investigations: radiological examinations, pleural aspiration and biopsy | |

|9. Treatment: pleural tapping, treat the underlying cause | |

| | |

|Lecture 16: Pleural Effusion (Empyema + Lung Abscess) |

| |Student Notes: |

|Lecturer: Dr. Emad Koshak and | |

|Dr. Aisha Al Ghamdi | |

| | |

| | |

| | |

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

|A. EMPYEMA | |

| | |

|1. know what is the meaning of empyema | |

|2. know the causes of empyema | |

|3. be able to describe the symptoms, the patient | |

|might come with and know the findings on physical examination | |

|4. be able to outline the way of diagnosis empyema | |

|5. have an idea about the lines of treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. Definition | |

|2. Types: total, loculate | |

|3. Causes: secondary to lung infection, infection of haemothorax, rupture of| |

|subphrenic abscess | |

|4. Clinical presentations | |

|5. Investigations: radiological, aspiration | |

|6. Treatment: | |

|Acute: intercostal tube drainage, antibiotics | |

|Chronic: decortication | |

|[pic] | |

| | |

|Lecture 16: Pleural Effusion (Empyema + Lung Abscess) |

| |Student Notes: |

|Lecturer: Dr. Emad Koshak and | |

|Dr. Aisha Al Ghamdi | |

| | |

| | |

| | |

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

|B. LUNG ABSCESS | |

| | |

|1. be able to define lung abscess | |

|2. have a clear idea about the different causes | |

|of lung abscess | |

|3. know the clinical presentation and physical | |

|finding | |

|4. be able to diagnose lung abscess | |

|5. be able to outline the ways of treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. Definition | |

|2. Causes | |

|3. Clinical manifestation | |

|4. Investigations:radiological, bronchoscopy | |

|5. Treatment: antibiotics, surgical intervention | |

| | |

|[pic] | |

| | |

|Lecture 17& 18 : Valvular Heart Disease I & II |

|Lecturer: Prof. Khalid Marzouki |Student Notes: |

|Dr. Nabil Alama | |

| | |

| | |

| | |

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

|The students should know the pathophysiology of Valvular Heart Diseases and | |

|understand the clinical presentation of valvular change: stenosis, | |

|incompetence | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Mitral Regurgitation: | |

|- Anatomy of the Mitral Valve in Mitral Regurgitation | |

|- Etiology of Acute Mitral Regurgitation | |

|- Natural history of Mitral Regurgitation | |

|- Clinical Presentation of Acute Mitral | |

|Regurgitation | |

|- Evaluation of Mitral Regurgitation | |

|- Treatment of Acute Mitral Regurgitation | |

|Chronic Mitral Regurgitaton: | |

|- Etiologies of Chronic Mitral Regurgitation | |

|- Natural History of Chronic Mitral | |

|Regurgitation | |

|- Cardiac Exam in Chronic Mitral Regurgitation | |

|- Treatment of Chronic Mitral Regurgitation | |

|Acute Aortic Regurgitation: | |

|- Anatomy of Aortic Regurgitation | |

|- Pathophysiology of Acute Aortic Regurgitation | |

|- Natural History of Aortic Regurgitation | |

|- Clinical Presentation of Acute Aortic | |

|Regurgitation | |

|- Making the Diagnosis | |

|- Treatment of Acute Aortic Regurgitation | |

|Chronic Aortic Regurgitation: | |

|- Symptoms of Chronic Aortic Regurgitation | |

|- Signs of Chronic Aortic Regurgitation | |

|- Evaluation and diagnosis of Chronic Aortic Regurgitation | |

|- Treatment of Chronic Aortic Regurgitation | |

|Lecture 17 & 18: Valvular Heart Disease I & II |

|Lecturer: Prof. Khalid Marzouki |Student Notes: |

|Dr. Nabil Alama | |

| | |

| | |

| | |

| | |

| | |

| | |

|Content: (continuation) | |

| | |

|Mitral Stenosis: | |

|- Etiology of mitral stenosis | |

|- Pathology of mitral stenosis | |

|- Pathophysiology of mitral stenosis | |

|- Clinical presentation of mitral stenosis | |

|- Examination of mitral stenosis | |

|- Diagnosing mitral stenosis | |

|- Treatment of mitral stenosis | |

| | |

|Aortic Stenosis: | |

|- Etiology of aortic stenosis: valvular, subvalvular (uncommon), | |

|supravalvular (rare) | |

|- Pathophysiology of aortic stenosis | |

|- Clinical presentation of aortic stenosis | |

|- Natural history of severe aortic stenosis | |

|- Examination of aortic stenosis | |

|- Making the diagnosis | |

|- Differential diagnostic evaluation of aortic stenosis | |

|- Role of cardiac catheterization in aortic stenosis | |

|- Treatment of severe aortic stenosis | |

| | |

|[pic] | |

| | |

|Lecture 19: Heart Failure |

|Lecturer: Dr. Nabil Alama and |Student Notes: |

|Dr. Maimoona Mushtaq | |

| | |

| | |

| | |

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

|- understand the pathophysiology of heart failure | |

|- understand the etiology of heart failure | |

|- know how to reach the diagnosis of heart failure | |

|- know how to manage patients with heart failure | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|I. Definition of heart failure; | |

| | |

|II. Clinical approach to a patient with heart failure; | |

| | |

|III. Uncommon symptoms of heart failure; | |

| | |

|IV. N. Y. Classification of heart failure; Types of heart failure. | |

| | |

|Treatment of heart failure; | |

|General considerations; Weight; salt intake; smoking; physical activity; | |

|underlying causes; treatment failure; diuretics; vasodilators with special | |

|emphasis on ACE inhibitors; positive inotropic drugs: Dopamine, dobutamine, | |

|Digoxin and controversy of clinical use. | |

| | |

|Prognosis, surgical management: cardiomyoplasty, heart transplantation. | |

| | |

|[pic] | |

|Lecture 20: Infective Endocarditis |

| |Student Notes: |

|Lecturer: Dr. Tariq Madani | |

| | |

| | |

| | |

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

|- know the importance and definition of infective endocarditis | |

|- know the classification of the disease | |

|- know the different cardiac lesions that are exposed to infection | |

|- have a brief idea about the pathology of the disease | |

|- be able to describe the clinical presentation and findings on physical | |

|examination in a patient with infective endocarditis | |

|- know the different complications of the disease | |

|- be able to diagnose infective endocarditis | |

|- have a brief idea about the treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|I. Introduction | |

|II. Definition | |

|III. Classification: native valve, prosthetic valve, endocarditis in drug | |

|abusers | |

|IV. Pathology | |

|V. Clinical manifestations: symptoms, signs | |

|VI. Investigations: diagnostic investigation (blood culture + echo), Other | |

|laboratory findings (anaemia, leukocytosis, proteinurea, microscopic | |

|haematuria, elevated serum creatinine level, elevated ESR, rheumatoid factor, | |

|decreased serum complement level) | |

|VII. Treatment | |

|VIII. Prophylaxis - list of cardiac lesions for which prophylaxis is given | |

|IX. Slides showing different signs of infective endocarditis | |

|[pic] | |

|Lecture 21: Hypertension |

| |Student Notes: |

|Lecturer: Dr. Saad Shohaib | |

| | |

| | |

| | |

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

|- understand the magnitude of the hypertension | |

|- properly examine the patient | |

|- understand the basic ancillary tests and treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|I. Definition and Classification | |

|II. Epidemiology | |

|III.Physical Exam | |

|IV. Laboratory Investigations: | |

|U/E, CBC, ECG, Chest x-ray, Urine analysis | |

|V. Aetiology | |

|VI. Special Groups: | |

|Hyperuresis, Aetiology, Treatment | |

|VII. Symptoms: | |

|head ache, dizziness, chest pain/shortness of breath/Palpitation, ankle | |

|swelling syncope cyanosis, haemoptysis, etc… | |

|VIII. Signs: | |

|General appearance, face, pulse, types, BP, JVP, carotid A, PMI, S1 + S2 + S3| |

|+ S4, murmur, added sounds, funduscopy | |

|IX. Treatment | |

| | |

|[pic] | |

| | |

|Lecture 22: Glomerulonephritis & Nephrotic Syndrome |

|Lecturer: Dr. Saeed Al Ghamdi and |Student Notes: |

|Dr. Fatma Beladi | |

| | |

| | |

| | |

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

|A. GLOMERULONEPHRITIS | |

| | |

|- recognize the clinical presentation of a patient with glomerulonephrotic | |

|syndrome | |

|- properly examine the patient | |

|- understand the basic ancillary tests and treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|- Clinical classification: acute and chronic glomerulonephritis | |

|- Causes: (Acute) post infection, mixed essential cryoglobulinemia, SLE, | |

|polyarteritis nodosa, Goodpasture’s syndrome, Wegener’s ganulomatosis, | |

|anaphylactoid purpura | |

|- Pathological classifications: | |

|focal proliferative, diffuse proliferative, | |

|membranoproliferative, crescentic, IgA | |

|nephropathy | |

|- Management | |

|- Prognosis | |

| | |

|[pic] | |

| | |

|Lecture 22: Glomerulonephritis & Nephrotic Syndrome |

|Lecturer: Dr. Saeed Al Ghamdi and |Student Notes: |

|Dr. Fatma Beladi | |

| | |

| | |

| | |

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

|B. NEPHROTIC SYNDROME | |

| | |

|- recognize the clinical presentation of a patient with nephrotic syndrome | |

|- properly examine the patient | |

|- understand the basic ancillary tests and treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|- Causes of nephrotic syndromes based on histopathology | |

|- Symptoms and signs | |

|- Investigations | |

|- Treatment | |

|- Complications: | |

|High susceptibility to infections | |

|High susceptibility to thrombosis | |

|Low effective circulatory volume | |

|Enhanced atherosclerosis if hyperlipidemia is severe and prolonged | |

| | |

|[pic] | |

| | |

|Lecture 23: Peptic Ulcers Disorders |

|Lecturer: Dr. Hisham Akbar and |Student Notes: |

|Dr. Hind Fallatah | |

| | |

| | |

| | |

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

|- understand the magnitude of peptic ulcers in terms of epidemiology and | |

|aetiology | |

|- recognize the clinical features and pay particular attention to the | |

|characteristics of the pain, its precipitating and relieving factors | |

|- understand the pathology and be familiar with the | |

|important diagnostic methods | |

|- outline the treatment of the peptic ulcers and their complications | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|- Definition, epidemiology | |

|- Aetiological factors | |

|- Pathology | |

|- Symptoms and signs with particular emphasis on the pain | |

|- Investigations stressing the role of endoscopy and H. pylori | |

|- Complications | |

|- Treatment | |

| | |

|[pic] | |

| | |

|Lecture 24: Acute Hepatitis |

|Lecturer: Dr. Hisham Akbar and |Student Notes: |

|Dr. Hind Fallatah | |

| | |

| | |

| | |

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

|- be familiar with the different virus types of hepatitis and their | |

|epidemiology | |

|- recognize the clinical features of acute hepatitis | |

|- understand the basic ancillary tests and treatment as well as preventive | |

|measures | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Causes: | |

|Viral A B C D E | |

|Post viral | |

|Non-viral | |

|Drugs | |

|Toxins | |

|Metabolic | |

|Ischemic | |

|Epidemiology (High risk groups) | |

|Clinical features | |

|Laboratory | |

|Complications | |

|Management: | |

|Bed rest | |

|Diet | |

|Drugs | |

|Prevention | |

| | |

|[pic] | |

|Lecture 25 & 26: Hypothalamus & Pituitary Disorders I & II |

|Lecturer: Prof. Mohammad Al Hadramy and |Student Notes: |

|Dr. Abeer Kawthar | |

| | |

| | |

| | |

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

|- know the physiology of the hypothalamus and | |

|pituitary glands | |

|- know their functional disorders on the clinical side | |

|- understand the basic ancillary tests and treatment | |

|of various disorders | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|I. Introduction | |

|II. Normal physiology | |

|III. Pituitary Hyperfunction | |

|1. Acromegaly : clinical features, diagnosis, treatment | |

|2. Cushing’s disease: | |

|clinical features, diagnosis, treatment | |

|3. Hyperprolactinoma | |

|causes | |

|clinical features | |

|diagnosis | |

|treatment | |

|Pituitary Hypofunction: | |

|causes, clinical features, diagnosis, treatment | |

|Posterior pituitary hypofunction - Diabetes insipidus | |

|clinical features, diagnosis, treatment | |

| | |

|[pic] | |

|Lecture 25 & 26: Hypothalamus & Pituitary Disorders I & II |

|Lecturer: Prof. Mohammad Al Hadramy and |Student Notes: |

|Dr. Abeer Kawthar | |

| | |

| | |

| | |

| | |

| | |

|Content: (continuation) | |

| | |

|Posterior pituitary hyperfunction - SIADH | |

|causes, clinical features, treatment | |

|Adrenal hyperfunction: | |

|Cushing’s syndrome: | |

|clinical features, diagnosis, treatment | |

|Conn’s syndrome: | |

|clinical features, diagnosis, treatment | |

|Adrenal hypofunction: | |

|causes | |

|clinical features | |

|investigations | |

|treatment | |

| | |

|[pic] | |

|Lecture 27: Thyroid Disorders (Excluding Management) |

|Lecturer: Dr. Faiza Qari and |Student Notes: |

|Dr. Abdulrahman Al Shaikh | |

| | |

| | |

| | |

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

| | |

|- know the physiology of the thyroid gland and | |

|anatomical landmarks | |

|- recognize the clinical features of malfunction | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|- Definition | |

|- Anatomy and physiology | |

|- Epidemiology | |

|- Causes | |

|- Classification: hyperthyroidism- thyrotoxicosis, | |

|hypothyroidism-myxoedema, goitre, thyroiditis | |

|- Investigations | |

|- Treatment | |

| | |

|[pic] | |

|Lecture 28: Diabetes Mellitus (Excluding Management) |

|Lecturer: Prof. Daad Akbar and |Student Notes: |

|Dr. Khalid Al Shali | |

| | |

| | |

| | |

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

|- to have background knowledge about the pathophysiology and aetiology | |

|of diabetes mellitus | |

|- to know the types of diabetes mellitus | |

|- to know the clinical features of Type I diabetes | |

|mellitus | |

|- to know the clinical features of Type II diabetes | |

|mellitus | |

|- to diagnose diabetes mellitus | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|A. Prevalence of Diabetes Mellitus in Saudi Arabia and the rest of the world | |

|is discussed in detail | |

|B. Classification of Diabetes Mellitus into various types is explained and | |

|updated according to latest W.H.O. guidance. | |

|C. Type I diabetes is discussed outlining the important aspects of: | |

|- pathophysiology | |

|- aetiological factors such as viral, autoimmune and genetic | |

|- clinical features | |

|D. Type II diabetes is also discussed outlining the important aspects of: | |

|- pathophysiology | |

|- aetiological factors such as genetic, | |

|familial and environmental | |

|E. The latest diagnostic criteria is discussed and outlined. | |

|F. A final overview summary is made of the lecture and questions by the | |

|students are encouraged | |

| | |

|Methods: | |

|Slide projections | |

|Interactive discussion | |

|[pic] | |

|Lecture 29: Bronchial Asthma |

|Lecturer: Dr. Emad Koshak and |Student Notes: |

|Dr. Maimoona Mushtaq | |

| | |

| | |

| | |

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

|- understand the pathophysiology | |

|- recognize the symptomatology of bronchial asthma | |

|- deal acute emergency cases of bronchial asthma | |

|- reach the diagnosis and differential diagnosis of asthma | |

|- treat and manage patients with bronchial asthma | |

|- differentiate between the different types of | |

|bronchial asthma and treat accordingly | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|1. Definition: | |

|Definition for Status Asthmaticus | |

|2. Prevalence and Aetiology | |

|3. Types of Asthma: | |

|A. Allergic (Extrinsic) with Definition | |

|B. Idiosyncratic (Intrinsic) with Definition | |

|and explaining the difference between the 2 types of asthma | |

|4. Pathogenesis of Asthma | |

|Discussing the postulated cascade of reaction that takes place to result in | |

|bronchial asthma and explaining the difference between the acute and the | |

|chronic reaction. | |

|5. 5. The different stimuli that interact with the airways to include the | |

|responsiveness of the bronchial wall: | |

|A. Allergic | |

|B. Pharmacologic | |

|C. Environmental | |

|D. Occupational | |

|E. Infectious | |

|F. Exercise-Related | |

|G. Emotional | |

|6. Pathology | |

|7. Patho-Physiology | |

| | |

|Lecture 29: Bronchial Asthma |

|Lecturer: Dr. Emad Koshak and |Student Notes: |

|Dr. Maimoona Mushtaq | |

| | |

| | |

| | |

| | |

| | |

|Content: (continuation) | |

|Discussing the step that takes place to explain the changes in the bronchial | |

|wall and the level of associated clinical features. | |

|8. Clinical Features | |

|9. Differential Diagnosis | |

|10. Diagnoses: Clinical as well as using Respiratory Tools | |

|11. Therapy: General and Specific | |

|Specific: Four (4) groups used: | |

|A. Beta-adrenergic agonist | |

|B. Methylxanthines | |

|C. Glococorticoids | |

|D. Mast cell stabilizing agents | |

|E. Anticholinergics | |

|12. Prognosis and Clinical Course | |

| | |

|[pic] | |

|Lecture 30: Urinary Tract Infection |

|Lecturer: Dr. Saad Shohaib and |Student Notes: |

|Dr. Fatma Beladi | |

| | |

| | |

| | |

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

|- know the basic morphology of the urinary tract | |

|- know the clinical features of its infection | |

|- understand the basic diagnostic methods and treatment | |

| | |

| | |

| | |

| | |

| | |

|Content: | |

|Classifications | |

|Predisposing Factors for UTI | |

|Causes | |

|Clinical Presentation | |

|Diagnosis | |

|Treatment | |

| | |

| | |

|[pic] | |

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. SAAD SHOHAIB /

Dr. AISHA ALGHAMDI

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

Faculty of Medicine

King Abdulaziz University

[pic]

[pic]

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download