Study Guide Semester 7

Transcription

1 Study Guide Semester 7 Lund / Malmö / Helsingborg 1 April 2015 Contents 1 Neuroscience 2 3 Ophthalmology 6 4 Otorhinolaryngology 8 5 Infectious diseases 10 6 Dermatology and venereology 12 7 Rheumatology 14 1

2 1 Neuroscience 1.1 Knowledge and understanding Cerebrovascular diseases diagnose and initially manage transient ischemic attacks (TIA) and stroke including subarachnoid haemorrhage further investigate and treat TIA/cerebral infarction and intracerebral haemorrhage (including the risk factors and secondary prophylaxis) investigate and treat sinus thrombosis and arterial dissection describe the rehabilitation process after a stroke, and the work procedure at the stroke ward Headache diagnose and initially process acute headaches diagnose and manage migraines, tension-type headaches and medication-induced headaches describe the clinical characteristics of secondary (symptomatic) headaches describe the diagnosis and initial management of patients with temporal arthritis, cluster headaches and trigeminal neuralgia Epilepsy acutely manage first-time as well as reoccurring epileptic seizures diagnose and initially manage status epilepticus diagnose and initially manage patients that have recently been diagnosed with epilepsy, including drug treatment and driver s license issues describe the specific problems related to fertile women with epilepsy Neurotrauma diagnose and initially manage severe head trauma/spinal trauma. Adopt the appropriate measures for transport manage patients with mild head trauma diagnose and initially manage conditions of intracranial hypertension. diagnose chronic subdural hematoma explain the intracranial pressure-volume curve Hydrocephalus diagnose and initially manage acute non-communicating (obstructive) hydrocephalus acutely diagnose and manage complications from treatment with cerebrospinal fluid shunts describe the development of symptoms when diagnosing communicating (normal pressure) hydrocephalus 2

3 Decreased alertness/coma diagnose and initially manage decreased alertness/coma describe the common causes of metabolic or structural conditions of decreased alertness describe the principles and legal criteria for determining total cerebral infarction Somnipathy diagnose narcolepsy and other common hypersomnia Movement disorders diagnose and initially manage uncomplicated cases of Parkinson s disease, secondary parkinsonism, essential tremor, and restless legs initially examine patients with ataxia and tremor Multiple sclerosis diagnose and initially manage patients with MS initially manage patients with acutely worsening MS describe the long-term treatment and disease progression of MS Dementia and delirium diagnose and manage patients suffering from an acute confused state, including Wernicke encephalopathy, and transient global amnesia describe the diagnosis and treatment of Alzheimer s disease and the other most common dementia diseases: Vascular dementia, Lewy body dementia/parkinson s disease dementia and frontotemporal dementia describe how risk factors and ageing affect the brain cognitively. Vertigo diagnose and manage patients with acute vertigo from a peripheral or central origin diagnose and initially manage chronic dizziness Tumours diagnose and initially manage patients with primary and secondary tumours in the nervous system describe the growth, prognosis and treatments for common primary and secondary tumours in the nervous system Infection diagnose and initially manage patients with encephalitis, bacterial and serous meningitis and cerebral abscess diagnose and manage patients with neuroborreliosis 3

4 Spinal cord disease and nerve root disease diagnose and initially manage patients with acute or slowly developing spinal cord disease, especially spinal cord compression diagnose and acutely manage patients suffering from nerve root disease Neuromuscular disease and peripheral neuropathy diagnose and manage patients with polyneuropathy diagnose and initially manage patients with Guillain-Barre syndrome, myasthenia gravis and motor neurone disease, including respiratory failure from neuromuscular disease diagnose and initially manage peripheral facial palsy and common mononeuropathies describe the symptoms of acquired and hereditary myopathies and polymyositis Pain and functional symptoms describe the diagnosis and management procedure for neurogenic and nociceptive pain. describe the differential diagnosis of functional states 1.2 Competence and skills Complete and assess the outcomes of the medical history of a patient with a suspected or known neurological disorder routine neurological examinations basic cognitive examinations, especially mini mental state examinations in cases of suspected dementia supplementary neurological examinations with sensibility testing, neurological examination of cauda equina syndrome, sphincter function and of patients with decreased alertness Correctly and in a structured manner independently conduct lumbar punctures, issue referrals for analysis of cerebrospinal fluid and interpret the results issue referrals for and assess referral responses from electroneurography (ENeG), electromyography (EMG), and electroencephalogram (EEC) issue referrals for and assess referral responses from computed tomography (CT) and magnetic resonance tomography (MRT) of the brain and spinal cord identify relevant neuroanatomical structures and clear pathological findings in CT and MRT images based on the medical history and status examination conduct a discussion of anatomical damage levels 1.3 Judgement and approach 4

5 approach patients with neurological disabilities, as well as their relatives approach and appropriately treat patients with acute and life-threatening neurological diseases including consciousness disorders describe and assess ethical issues in neurological diseases communicate well and collaborate with healthcare personnel of all categories 5

6 2 Ophthalmology 2.1 Knowledge and understanding demonstrate specialised knowledge of the pathophysiology, methods of diagnosis, treatment and relevant social aspects of the following conditions, and account for the principles of referral to specialist care: red eye eye injuries acute visual disorders slow visual deterioration disrupted visual development the impact of general diseases on the eye/visual function explain the general principles of pharmacological treatment of the following conditions: red eye eye injuries acute visual disorders slow visual deterioration the impact of general diseases on the eyes/visual function account for ophthalmological requirements in legislation for the issue of a driving licence 2.2 Competence and skills demonstrate a specialised ability to independently diagnose and manage common disorders in conjunction with red eye eye injuries acute visual disorders slow visual deterioration the impact of general diseases on the eyes/visual function obtain the medical history and perform a targeted physical examination of a patient with red eye eye injuries acute visual disorders slow visual deterioration disrupted visual development general diseases having an impact on the eyes/visual function 2.3 Judgement and approach 6

7 approach patients and their relatives in a professional manner discuss ethical issues in relation to severe eye diseases collaborate and communicate with relevant clinical eye care personnel discuss social aspects of eye diseases/visual impairment independently and supported by fellow students, take responsibility for their theoretical and practical training 7

8 3 Otorhinolaryngology 3.1 Knowledge and understanding manage common otorhinolaryngological diseases of both children and adults with acute or chronic symptoms identify and assess the seriousness of the following conditions, and initiate primary treatment: upper respiratory tract infection breathing difficulty and upper airway obstruction nasal congestion/rhinorrhoea loss of smell and taste symptoms of the oral cavity/salivary glands hearing impairment vertigo and balance disorders speech and language disorders hoarseness dysphagia facial pain and headache epistaxis facial trauma tumours of the head and neck account for the etiology and pathogenesis of the conditions listed above and describe appropriate audiological, laboratory, imaging and function investigations 3.2 Competence and skills perform a complete ENT examination with an otomicroscope and fibre laryngoscope and a basic otoneurological examination of both children and adults obtain a targeted medical history and assess what ENT examination is required on the basis of the medical history treat anterior epistaxis, external otitis and benign paroxysmal positional vertigo obtain indications for acute or elective referral to an ENT specialist 3.3 Judgement and approach On completion of the course, students shall demonstrate the ability to approach patients and their relatives respectfully communicate and collaborate with healthcare personnel of all categories in a good way examine ethical aspects of different ENT conditions 8

9 understand how otorhinolaryngological impairments affect the interaction between patients and their environment 9

10 4 Infectious diseases 4.1 Knowledge and understanding explain the spectra of activity, mechanisms of action, indications, contraindications and side effects of antibiotics and the mechanisms of bacterial resistance identify and assess the seriousness of the following conditions and initiate treatment: respiratory tract infections, community- or hospital-acquired urinary tract infections, community- or hospital-acquired gastrointestinal infections caused by bacteria, viruses or parasites skin or soft tissue infections bone and joint infections not caused by exogenous organisms meningoencephalitis, community-acquired septicaemia and endocarditis acute viral hepatitis herpes simplex domestic zoonoses in the presence of these infections, also be able to account for their epidemiology and pathogenesis account for investigation principles, clinical and chemical analyses, imaging and function diagnosis and microbiological diagnosis demonstrate knowledge of the epidemiology, pathogenesis, investigation and treatment of infections caused by foreign bodies infections in individuals suffering from immunosuppression or immunodeficiency chronic viral hepatitis domestic worm infestations cases of fever of unknown origin HIV infection malaria tuberculosis cerebral and spinal abscesses 4.2 Competence and skills assess microbiological test results account for infection routes and apply the Infectious Diseases Act apply hygiene principles perform lumbar puncture on a manikin independently perform initial management and initiate investigation and treatment of patients with acute infections and to keep medical records present patient cases to colleagues 10

11 4.3 Judgement and approach approach patients and their relatives respectfully communicate and collaborate with healthcare personnel of all categories in a good way describe and discuss ethical issues in conjunction with infectious diseases 11

12 5 Dermatology and venereology 5.1 Knowledge and understanding manage common dermatological and venereal diseases to enable them to manage these conditions as a foundation doctor and establish a good foundation for further acquisition of knowledge in the field. Eczema (both endogenous and exogenous) Skin infections (bacterial, viral, fungal and as result of parasitic infestation) Psoriasis and other papulosquamous disorders Hair and sebaceous gland diseases Venous ulcers Skin tumours Skin manifestations of internal diseases Drug reactions Bullous dermatoses Pigmentation disorders Granulomatous diseases Hair loss Light-induced skin diseases Psychodermatology Work-related skin diseases Sexually transmitted diseases in the presence of these conditions also be able to account for their epidemiology and pathogenesis account for investigation principles 5.2 Competence and skills Onn completion of the course, students shall be able to obtain and report an appropriate dermatological and venereological medical history and describe the results of examination with dermatological terminology know and apply the principles of dermatological local treatment using corticosteroids and other substances demonstrate knowledge of the techniques for obtaining venereological samples and the methods of tracking and reporting communicable diseases demonstrate knowledge of the techniques for obtaining skin biopsies for microscopic and immunofluorescence examination demonstrate knowledge of the techniques for establishing bacterial cultures and obtaining virus samples demonstrate knowledge of the techniques for direct microscopy and mycosis cultivation demonstrate knowledge of the techniques for compression treatment of the lower leg present patient cases to colleagues 12

13 On completion of the course, students shall demonstrate knowledge of techniques for patch testing in investigations of contact dermatitis techniques for the diagnosis of scabies light therapy options ( UVB, UVA, PUVA, Bucky, lasers and PDT) techniques for cryotherapy, curettage and simple skin excisions 5.3 Judgement and approach approach patients and their relatives respectfully communicate and collaborate with healthcare personnel of all categories in a good way describe and discuss ethical aspects in conjunction with skin diseases adapt the approach on the basis of the patient s situation and ethnicity 13

14 6 Rheumatology 6.1 Knowledge and understanding account for the epidemiology and fundamental theories of the etiology and pathogenesis of rheumatoid arthritis make a diagnosis of mono- and oligo/polyarthritis and initiate appropriate acute investigation and treatment correctly identify clinical symptoms and signs indicating rheumatoid arthritis, spondyloarthropathy and osteoarthritis correctly identify clinical symptoms and signs indicating temporal arteritis and/or polymyalgia rheumatica and initiate investigation and treatment On completion of the course, students shall demonstrate knowledge of the diagnosis and treatment of inflammatory system diseases such as SLE and systemic vasculitis long-term treatment of rheumatoid arthritis and inflammatory spondyloarthritis serious complications of rheumatoid arthritis such as extra-articular manifestations and atlantoaxial instability with medullary compression non-inflammatory muscle pain such as fibromyalgia and chronic pain syndrome the most important serological tests of relevance to rheumatology and how they are used 6.2 Competence and skills obtain a rheumatological medical history and correctly perform a joint examination and analyse the medical history and examination results obtain indications for acute and non-acute referral to a rheumatology specialist identify typical X-ray signs of rheumatoid arthritis and osteoarthritis On completion of the course, students shall demonstrate knowledge of how to assess disease activity and identify relapses in arthritis and inflammatory system diseases how to perform joint puncture, obtain indications for intra-articular steroid injection and use a crystal microscope 6.3 Judgement and approach approach patients with chronic rheumatic diseases and their relatives respectfully communicate and collaborate with healthcare personnel of all categories 14

15 account for and understand the importance of long-term team treatment of patients with rheumatic diseases 15