Week 13 Microbiology II (Virology, HIV, Parasitology)

Transcription

1 Week 13 Microbiology II (Virology, HIV, Parasitology) Welcome to Microbiology Week II This is your second week of microbiology. Hopefully, you have a strong handle of the basic principles of microbiology, bacteriology, mycology, and tuberculosis from your first week of microbiology if not, please review that material and contact us if you have any questions or need clarification. This week, we are changing focus to virology, HIV, and parasitology. The pre-week learning is listed in the order we suggest you view it so that each learning activity builds on the earlier ones. The Monday morning lecture will be used an opportunity to review the pre-week learning material, answer any questions, and apply it to clinical cases. You ll also be applying your preweek learning in this week s case. You ll also have mid-week learning modules and a lecture on Generating Knowledge. You ll get a chance to apply both the per-week learning and the mid-week learning in the What If Scenarios introduced on Thursday during your case-based learning session. In addition to these specific learning opportunities, you ll also have IPE, anatomy, ICE: CPPH, and ICE: Clinical Skills learning opportunities this week. The week will finish off with an integrated summary and application lecture. Please bring your questions to class. If you have any questions at any time, please get in touch with either, Susan Poutanen (Week Lead, Microbiology Weeks), susan.poutanen@sinaihealthsystem.ca, or Lori Albert (Course Director, Concepts, Patients, and Communities 1), lori.albert@uhn.ca or Marcus Law (Director, Foundations) marcus.law@utoronto.ca. And if you have any suggestions for ways to improve your microbiology weeks, please let us know, as we d greatly value your feedback. Looking forward to seeing you all in class again on Monday! Susan M. Poutanen MD MPH FRCPC Week Lead, Microbiology Weeks, Section Lead, Host Defense, Foundation Curriculum Associate Professor, Departments of Laboratory Medicine and Pathobiology and Medicine, U. of Toronto Microbiologist and Infectious Disease Physician, Sinai Health System and University Health Network Lori Albert MD, FRCPC Course Director, Foundations - Concepts, Patients, and Communities 1 Associate Professor of Medicine, University of Toronto Staff Rheumatologist, University Health Network, Toronto Western Hospital Marcus Law MD MBA MEd CCFP FCFP Director of Foundations Associate Professor of Family Medicine, University of Toronto

2 To Complete/Review/Watch Pre-week learning Embedded links/recommended readings (not required) End-of-week Learning Objectives 1. Prepare for Anatomy Lab 8 N/A MIC0200- Identify and describe the relationships between the superficial structures of the neck, including major muscles (sternocleidomastoid, infrahyoid muscles and suprahyoid muscles), the thyroid gland, cranial nerves XI and XII, and the external jugular vein. MIC0205- Identify and describe the relationships between structures of the oral cavity and pharynx, including the hard and soft palate, the tongue, the floor of the mouth, the internal features, folds and muscles of the pharynx, the location of the tonsils, and major nerves of the region MIC0210- Identify and describe the relationships between structures of the nasal cavity and nasal sinuses, the lateral wall of the nasal cavity (conchae, meatuses, foramina), the medial wall of the nasal cavity (bony and cartilaginous nasal septum), and their blood and nerve supply 2. Watch: Fever (15:31) PDF None MIC0015- Define fever and describe the impact of aging on thermoregulation and develop an approach to fever of unknown origin 3. Watch: Fever in the Returned Traveler (17:33) PDF 4. Watch: Viral Hepatitis - Lab Features and Diagnosis (27:12) PDF 5. Watch: Introduction to HIV Infection (7:32) PDF 6. Watch: Post-exposure prophylaxis, Pre-exposure prophylaxis, and Treatment of HIV (12:29) PDF None MIC0183- List a differential diagnosis of fever in the returned traveler and describe an effective strategy regarding the diagnosis and management of patients presenting with fever in a returned traveller. None MIC Describe the etiologic agents, pathogenesis, clinical presentation, diagnostic tests, treatment, modes of transmission, and control measures of viral hepatitis None MIC0181- Describe the epidemiology, pathogenesis, and modes of transmission regarding HIV infection None MIC0182- Describe the role of antiretrovirals for the treatment, post-exposure prophylaxis, and pre-exposure prophylaxis of HIV infection. 2

3 7. Watch: Approach to Needlestick Injuries and Exposures to Blood borne Pathogens (23:19) PDF 8. Prepare for your IPE session on Monday afternoon None MIC0185- Describe the post-exposure management of needle stick injuries in health care workers and high risk exposures in the community to blood borne pathogens MIC0190- Describe the ethical responsibility of health care workers who perform exposure-prone procedures to report infections due to blood-borne pathogens to licensing bodies N/A MIC0228- Describe the roles of different health providers MIC0229- Define the differences between roles vs. scope of practices and consider areas of overlap and collaboration MIC0230- Define how different health professionals are involved with assessment and management MIC0231- Describe how a relational-centred care model can increase collaboration among team members and benefit the patient/client/family 3

4 Lectures 1. Review: Microbiology Fever, Returned Traveller, Hepatitis 2. Review: Microbiology HIV, Needle Sticks None MIC0015- Define fever and describe the impact of aging on thermoregulation and develop an approach to fever of unknown origin MIC0183- List a differential diagnosis and describe an effective strategy regarding the diagnosis and management of patients presenting with fever in a returned traveller. MIC0178- Discuss the responsibility of the medical school/hospital to follow accepted guidelines and to provide counselling (before embarking) regarding appropriate immunizations and chemoprophylaxis for medical students, including those undertaking international electives MIC0180- Describe the etiologic agents, pathogenesis, clinical presentation, diagnostic tests, treatment, modes of transmission, and control measures of viral hepatitis. None MIC0181- Describe the epidemiology, pathogenesis, and modes of transmission regarding HIV infection. MIC0182- Describe the role of antiretrovirals for the treatment, post-exposure prophylaxis, and pre-exposure prophylaxis of HIV infection. MIC0185- Describe the post exposure management of needle stick injuries in health care workers and high risk exposures in the community to blood borne pathogens MIC0190- Describe the ethical responsibility of health care workers who perform exposure-prone procedures to report infections due to blood-borne pathogens to licensing bodies MIC0177- Recognize occupational hazards (particularly biological) that medical students may encounter 4

5 3. Review: Microbiology Virus/Parasite Classification & Treatment, Emerging Infections 4. Review: Creating Knowledge None MIC0174- Describe the classification of viruses and parasites MIC0175- Describe the classification of antiviral, antiretroviral, and antiparasitic agents along with their mechanisms of action, mechanisms of resistance and microbial spectrum of activity MIC0176- Explain the principles behind the emergence of new infectious disease agents None MIC0225- Describe the difference between two research/knowledge paradigms: objectivism and constructivism MIC0226- Describe the key research implications of the two paradigms MIC0227- Recognize the centrality of interests and values in shaping all research 5

6 CBL Review CBL case and complete assignment questions Preparing Medical Students for Electives in Low-Resource Settings: A template for National Guidelines for Pre- Departure Training Fever in the Returning International Traveller Initial Assessment Guidelines HIV Screening and Testing Guide Appendix A: Ethical and Professional Considerations Needle Safety Regulation Occupational Health and Safety Act Guide to Occupational Health and Safety Act Brian Goldman s TED Talk on Making Mistakes in Medicine Brian Goldman s Interview about His TED Talk U. of Toronto MD Program Student Assistance Variety of Hazards in Health Care Workplace Safety and Insurance Board MIC0015- Define fever and describe the impact of aging on thermoregulation and develop an approach to fever of unknown origin MIC0183- List a differential diagnosis and describe an effective strategy regarding the diagnosis and management of patients presenting with fever in a returned traveller. MIC0178- Discuss the responsibility of the medical school/hospital to follow accepted guidelines and to provide counselling (before embarking) regarding appropriate immunizations and chemoprophylaxis for medical students, including those undertaking international electives MIC0180- Describe the etiologic agents, pathogenesis, clinical presentation, diagnostic tests, treatment, modes of transmission, and control measures of viral hepatitis. MIC0181- Describe the epidemiology, pathogenesis, and modes of transmission regarding HIV infection. MIC0185- Describe the post exposure management of needle stick injuries in health care workers and high risk exposures in the community to blood borne pathogens MIC0190- Describe the ethical responsibility of health care workers who perform exposure-prone procedures to report infections due to blood borne pathogens to licencing bodies MIC0177- Recognize occupational hazards (particularly biological) that medical students may encounter MIC0176- Explain the principles behind the emergence of new infectious disease agents MIC0225- Describe the difference between two research/knowledge paradigms: objectivism and constructivism MIC0226- Describe the key research implications of the two paradigms 6

7 List or Reportable Diseases in Ontario Psychiatric consequences of needlestick injury MIC0227- Recognize the centrality of interests and values in shaping all research 7

8 Self-learning module 1. Read: An Introduction to Reading and Appraising Qualitative Research 2. Watch: What Doctors Don't Know about the Drugs they Prescribe (13:21) 3. Watch: Classification of Viruses (25:12) PDF 4. Watch: Classification of Parasites (14:13) PDF MIC0225- Describe the difference between two research/knowledge paradigms: objectivism and constructivism MIC0226- Describe the key research implications of the two paradigms MIC0227- Recognize the centrality of interests and values in shaping all research None MIC0045- Describe the classification of bacteria and fungi None MIC0174- Describe the classification of viruses and parasites 5. Read: Antivirals Overview None MIC0175- Describe the classification of antiviral, antiretroviral, and antiparasitic agents along with their mechanisms of action, mechanisms of resistance and microbial spectrum of activity 6. Read: Antiparasitic Overview 7. Read: Antiretroviral Overview 8. Emerging Infectious Diseases (21:15) PDF None MIC0175- Describe the classification of antiviral, antiretroviral, and antiparasitic agents along with their mechanisms of action, mechanisms of resistance and microbial spectrum of activity None MIC0175- Describe the classification of antiviral, antiretroviral, and antiparasitic agents along with their mechanisms of action, mechanisms of resistance and microbial spectrum of activity Recommended Readings: Engleberg et al (eds.) Schaechter s Mechanisms of Microbial Disease (5th Edition), Lippincott Williams & Wilkins Chapter 57 Recommended Readings: MIC0176- Explain the principles behind the emergence of new infectious disease agents 8

9 Nature 2004;430: & Nature Reviews Microbiology 2013;11: Prepare: ICE: CPPH Community Home Visit/ School Visit Recommended Readings: JAMA Consensus Statements N/A MIC0161- Define a meaningful population for health improvement purposes MIC0162- Measure and record the factors that affect the health status of a population with respect to the principles of causation MIC0163- Be aware of important sources of clinical / population-level health data to describe the health of a population, advantages and disadvantages of each, and the importance of accurate coding and recording of health information MIC0164- Describe the concepts of, and be able to calculate, incidence, prevalence, attack rates, case fatality rates and to understand the principles of standardization MIC0165- Discuss different measures of association including relative risk, odds ratios, attributable risk and correlations FAM0022- Describe the appropriate use of different graphical presentations of data FAM0024- Describe criteria for assessing causation MIC0168- Describe the role of, and work collaboratively with, community and social service agencies (e.g., schools, municipalities, non-governmental and other agencies) regarding the health of individuals and populations in the community MIC0170- Assess individuals in the context of their social and physical environments, including risk and protective factors for illness, and understand how this affects access to health care and adherence to therapeutic recommendations MIC0171- Demonstrate an understanding of ethical issues involved in resource allocation TIS0152- Discuss the importance of the health care team and be able to collaborate effectively with other professionals 9

10 10. Prepare: ICE: Clinical Skills Tutorial 11. Bring any questions you may have to the Nov 25 Integrated Summary and Application lecture N/A MIC0195- Develop an approach to the examination of the lymph nodes of the head and neck N/A N/A 10