Semester Six Renal Module Study Guide

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1 Spiral Two Semester Six Renal Module Study Guide A Course Title Renal MODULE B Course Co-ordinator: Dr. Irfan Ashraf C Course Committee Dr.Irfan Ashraf, Dr.Rubia Kashif Objectives of Study 1. To inform the students how studentslearning program has been organized for the Guide course of Renal Module (3 rd Module of semester VI). D 2. To communicate about the process of implementation of redesign module. 3. To help students to organize and manage their study skills throughout the program E F Introduction Context The renal module is structured to provide a review of the renal anatomy and histology, an introduction to kidney diseases and an overview of the common clinical findings that are associated with renal diseases The students of semester VI having background knowledge of basic sciences will learn to relate it with clinical problems of the Renal disorders.

2 G Target Students Semester VI 3 rd year MBBS H Duration 4 weeks I Rationale Renal Systems module focuses on diseases of the renal system including diseases of the urinary tract. These areas focus on the pathology, pathophysiology, signs and symptoms, diagnostic methods, and drugs used for the treatment of urinary tract diseases. The basic science and clinical concepts are expanded to include the pathology and pathophysiology, as well as the pharmacological treatments of diseases of this system. This module emphasizes the molecular and cellular pathology, clinical, pathologic, and laboratory findings, treatment and management of patients with renal and genitourinary disorders. At the end of the module, the students should be able to: Explain the aetiology and diagnosis of the renal diseases Identify common infectious etiologies for upper and J Learning Outcomes lower urinary/renal infections Analyze clinical signs and symptoms of major renal diseases and use these to construct a differential diagnosis using laboratory testing, imaging, endoscopy and results of pathological examination Describe approaches for evaluating and treating renal /urinary diseases. 1. Bed Side Teaching K Teaching and learning strategies: 2. s 3. Small group discussion (PBL) 4. Practical session

3 5. Tutorials 6. Seminar 7. Presentations 8. Skills lab 9. Self-study 10. elearning L Clinical Faculty Anatomy Biochemistry Departments Community Medicine Physiology Pathology Pharmacology M S.No. Week 1 Subject/ departmen t Objective At the end of the module the students should be able to: Topic/method of teaching ANATOMY Describe the structure, development of Kidney and Functional Anatomy (Development,

4 function of the renal system Correlate the anatomic basis of urinary signs & symptoms histology, Variations, Gross of renal system PHYSIOLOGY PATHOLOGY Describe the regulation of GFR and renal blood flow and the factors which affect GFR Correlate the physiological and biochemical basis of renal signs & symptoms Explain physiologic control of fluid, electrolyte and acid-base balance. Describe congenital anomalies of the kidneys Classify cystic and mass lesions of the kidney and urinary tracts Interpret urine analysis Demonstrate proteinuria in a given sample of urine by Lab/Dipstix Method Describe the four main types of renal stones and their pathogenesis GFR and its regulation and its applied physiology Cysts : Congenital and acquired cystic conditions of kidney Urinary Analysis, Protein urea (Lab) Obstructive Uropathy 1 Urinary out flow Obstruction (Urolithiasis, Hydronephrosis) Obstructive Uropathy 2 Urinary out flow Obstruction (Prostate)

5 Discuss the important pathological processes involved in urolithiasis and hydronephrosis. Identify etiologies and pathophysiology for upper and lower urinary/renal infections. Urinary Tract Infections FORENSIC MEDICINE identify sign & symptoms of rape & other sexual offences with their medico-legal importances. describe Procedure of examination of victim or accused Forensic Sexology Sexual offences & Medico Legal aspects of sexual connection Sexual offences- Classification Natural Sexual offences ( Rape, Incest) Classification of sexual offences Legal definition of Rape Procedure of examination of a victim of rape Collection of specimens during examination Examination of accused person

6 Identify the specimens of poisons describe the factors modifying the action of poisons Rape in children Complications following rape with special stress of Post traumatic Stress Disorder Problems in medico legal examination of victim of rape in present scenario Incest and its legal aspects NEPHROLOGY RADIOLOGY UROLOGY Enumerate the renal function tests interpret Renal Function Tests (RFT) Interpret imaging modalities used in the diagnosis of Renal Pathologies. Evaluate a patient with diseases of the kidneys and urinary tract Spinal Poisons Strychnine lab Renal function tests and their interpretation lecture Imaging in renal diseases (IVP/ US/ Renal CT Pyelography, Radio nuclear scan /renal arteriography lecture Approach to the patient with Kidney

7 Analyze clinical signs and symptoms of major renal and urinary tract diseases and Urinary tract diseases COMMUNITY MEDICINE Skills Lab Explain the concept of demography in health system of pakistan Enumerate all the steps of urinary catheterization WEEK 2: Introduction to Demography lecture Urinary Catheterization (skill) Describe the effects and management of urinary tract diseases. Management of Urinary Tract Infections UROLOGY Identify signs and symptoms, treatments and medications used in the management of renal calculus, urolithiasis. describe approaches for evaluating and treating Diseases of Prostate Clinical presentation and Management of Urolithiasis Types & Management of Prostatitis

8 Pathology Classify specific renal diseases according to the three major components: glomerular, vascular and tubulointerstitial describe important pathological processes involved in Glomerular Diseases, Acute tubular necrosis(atn), nephritic syndrome. Identify the etiology, morphology of ATN Relate clinical signs and symptoms of renal disease to underlying pathophysiology and pathology of ATN Pathogenesis of Glomerular Disease (lecture ) Acute tubular necrosis : etiology, pathogenesis, morphology, clinical course () Glomerular conditions: nephrotic syndrome Urine C/S (LAB) NEPHROLOGY Enumerate the procedure of performing urine C/S Describe the diagnosis and management of: acute kidney Acute Kidney Injury (AKI) (pre, intrinsic and post renal)

9 injury, Chronic kidney disease (CKD), Nephrotic syndrome Chronic kidney disease (CKD) FORENSIC Medicine describe different sexual deviations, sexual perversions, artificial insemination with their medico-legal importance describe Procedure of examination of victim or accused Diabetic nephropathy Forensic Sexology Legal aspects of sexual offences & examination of victim of sexual offences Unnatural sexual offences and legal aspects Legal definition of sodomy and its types Examination of a victim of Sodomy Examination of a habitual passive agent (Catamite) Examination of a habitual active agent (Sodomite) Collection of samples from passive and active agent Bestiality with examination Tribadism or female homosexuality and its legal aspects Buccal coitus

10 Identify the specimens of poisons () describe the factors modifying the action of poisons PEDIATRICS PHARMACOLOGY Describe the differences between the Clinical presentation and management nephritic and nephrotic syndrome and relate these to differing types of renal injury. Discuss the sites of action, the mechanisms of action, and the common adverse effects of the six classes of diuretics Cardiac Poison Lab Clinical presentation and management of Glomerular conditions: nephritic and nephrotic syndrome Diuretics I Develop clinical reasoning skills Skills lab Develop self directed study skills Actively participate in the group problem- solving process Problem Based Learning WEEK 3 PATHOLOGY Describe the pathophysiology in Glomerular conditions associated with systemic disease (e.g. diabetes, hypertension), nephritic syndrome, pyelonephritis. Glomerular conditions associated with systemic disorders Glomerular conditions: nephritic

11 UROLOGY Describe symptomatology, diagnostic work-up and therapeutic options of Benign prostatic hyperplasia, Prostatic carcinoma Tumor of ureter and urinary bladder Syndrome Pyelonephritis Benign prostatic hyperplasia Prostatic carcinoma NEPHROLOGY Describe the major characteristics of the renal replacement therapy RRT modalities Identify indications and contraindications for RRT compare RRT to intermittent dialysis therapy. Understand the ethical issues in the management of patients with endstage-renal disease, including issues surrounding resource allocation (such as dialysis and transplantation) Nephritic syndrome Renal replacement therapies - peritoneal dialysis FORENSIC Define a poison. Therapeutic Poisons

12 MEDICINE Describe the factors modifying the action of poisons. Describe different sexual perversions with their medicolegal importance Classify insecticides and Explain the mode of action, S/S, treatment of an insecticide poisoning case Describe post mortem appearances in the dead body of the insecticide posoining cases Paracetamol Benzodiazepine Lab Sexual perversions Insecticide Organophosphate poisoning Classification of organophosphate compounds Mode of action Signs, symptoms and treatment Postmortem findings Medico legal importance PEADS SURGERY COMMUNITY MEDICINE PHARMACOLOGY Describe the development of Urinary system, normal structure, Blood Supply, innervations, lymphatic drainage, functions and its Congenital Anomalies Apply the concept of demography in health system of Pakistan Describe the therapeutic applications of diuretics Congenital disorder of urinary systems Fertility Determination Mortality determination Role of Diuretics in

13 medicine Develop clinical reasoning skills TUTORIAL Skills lab Develop self directed study skills Actively participate in the group problem- solving process Problem Based Learning Week 4 Describe the clinical features, investigations and management of urolethelial tumors Urothelial tumors of upper urinary tract and bladder UROLOGY PEDIATRICS Understand the surgical aspects of renal transplant Describe the evaluation, diagnosis, and management of kidney tumors Identify common infectious etiologies for upper and lower urinary/renal infections. Describe symptomatology, diagnostic work-up and management of Infectious disorders. Surgical aspects of renal transplant Kidney tumor Clinical presentation and management of Infectious disorders

14 FORENSIC MEDICINE COMMUNITY MEDICINE Write report in case of sexual assault Examine a victim in sexual offences Perform swab taking of case of sexual assault. Identify the Post Mortem Findings in case of poisoning Describe post mortem appearances in the dead body of the poisoning cases. Apply the concept of demography in health system of Pakistan Medical legal Report (writing & swab taking of case of sexual assault. Lab Toxicology I & II Measures of Morbidity Population Pyramid Balancing Equation PATHOLOGY Differentiate two major groups of malignant kidney tumors Classify the risk factors, histology and pathophysiology of renal cancers. Tumors of renal system PHARMACOLOGY Describe the conditions and/or drug interactions that interfere with or contraindicate diuretic use Diuretics II

15 Develop clinical reasoning skills Skills lab Develop self directed study skills Actively participate in the group problem- solving process Problem Based Learning N E-Learning A wealth of learning material in the form of presentations and PDF lectures outline are available at JSMU e-learning website. Follow the link from JSMU website. O WORKSHOPS: Department of medical education will offer optional workshops to improve learning capabilities. P Q Formative assessment Formative assessment will be available in digital lab as well as online. This will help in self-assessment of students. (Continuous Assessment): Continuous monitoring of attendance and practical assessment in short groups. Mode of Internal Evaluation: It will be help in the form of BCQs, assignments, stages/sub-stages, projects, quiz or OSPE. Internal evaluation carries 20% weightage in summative semester examination.

16 Schedule Of R Examination/s:?????????????? S Mode of terminal Examination MCQs + EMQs and OSPE (observed + un observed). T How the course will be Monitored Through the Department of Medical Education and Quality Enhancement Cell. U Evaluation of the course: Through students and faculty feedback and by the analysis of the results. V Course Summary Through a combination of lectures, ward visits and practical classes these four weeks module will provide a broad will provide a broad overview of the renal and urinary tract diseases This document is prepared by professional development centre and clinical coordination cell in consultation with department of medical education. W End Note Some parts of the study guide are tentative and may be modified. Any modification will be displayed on website. We need your regular feedback. The hard copies of feedback will be available in your lecture halls. The soft copy is on website

17 X Y Correspondence Message of Vice Chancellor??????????? Z Published On???????????? END NOTE: This document is prepared by the Department of Medical Education in consultation with course director. Some parts of the study guide are tentative and may be modified. Any modification will be displayed on website. We need your regular feedback. The hard copies of feedback will be available in your lecture halls. The soft copy is on website.

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