Infectious disease module Study Guide A Course Title INFECTIOUS DISEAESES MODULE B Course Coordinator: Dr. Irfan Ashraf C Course Committee Dr. Irfan Ashraf, Dr. Ali Haider, Dr. Syeda Zarreen Raza, Dr. Rubia Kashif 1. To inform the students how students-learning program has been organized for D the course of Infectious diseases Module (1 st Module of semester V). Objectives of Study 2. To communicate about the process of implementation of redesign module. Guide 3. To help students to organize and manage their study skills throughout the program. This is a 5 week module to develop knowledge skills and attitudes of the students on Introduction infections and infectious diseases and their prevention and control. Furthermore, the module will emphasize on educating the community and especially guiding them in E prevention of infectious diseases F Context The students of semester V having background knowledge of basic sciences will learn to relate it with clinical problems of the infectious diseases. G Target Students Semester V Third year MBBS H Duration 5 WEEKS I Rationale Infectious diseases remain a leading cause of morbidity and mortality worldwide, with HIV, tuberculosis and malaria estimated to cause 10% of all deaths each year This part of world faces much more financial burden than rest of the world because of these preventable diseases. The skills and knowledge imparted in this module will help the students in understanding the etiology, epidemiology of infectious diseases and will help them in identifying and treating the patients with infectious diseases. J Learning Outcomes At the end of this MODULE students will be able to: 1. develop knowledge skills and attitudes on infectious diseases, their prevention and control. 2. State the dynamics of transmission of communicable diseases. 3. describe the principle routes of disease transmission. 4. discuss the epidemiology of some common communicable diseases and their control 1 P a g e
K L measures. 5. define the role of vectors and their control measures. 6. recognize the effects of immunization and programs for its delivery. 7.identify the steps and the rationale for the investigation of disease outbreaks. Teaching strategies 1. Bed Side Teaching 2. Lectures 3. Small group discussion (PBL) 4. Practical session 5. Tutorials 6. Seminar 7. Presentations 8. Skills lab 9. Self-study 10. elearning Clinical Faculty Anatomy Biochemistry Community Medicine Departments Physiology Pathology Pharmacology Forensic medicine DEPARTMENT/SUBJ ECT Week 1 FORENSIC LEARNING OBJECTIVES At the end of the week, the students should be able to: Describe the basic principles of Forensic Medicine in relation to medico/legal cases. Discuss the general principles of toxicology, treatment of poisons and antidotal therapy Describe the relevant legal/court procedures applicable to medico/legal practice Understand the role of forensic medicine in crime detection and TOPICS/METHOD OF TEACHING Introduction of Forensic Medicine & its branches (Lecture) - Basics of Forensic Medicine and Toxicology. - Various branches of Forensic Sciences and their importance and utility in civilized society. - Basics of Legal system in Pakistan - Role of Forensic Medicine in crime detection and other medical, legal 2 P a g e
ethical issues. Discuss the responsibility and power of courts in Pakistan and ethical issues - Courts in Pakistan and their Powers Define a poison. Differentiate between poison and a medicine. Describe the routes of administration of poisons, excretion of poisons. Identify the factors modifying action of poisons Diagnose a case of poisoning in living & dead. Outline the Duties of a doctor in a case of suspected poisoning. Restate the General principles of treatment of poisoning. Explain the procedure of Gastric lavage and the Antidote therapy Recognize the signs and symptoms of different infectious diseases on the basis of history, clinical examination Review the core infectious disease information essential for recognizing the significant attributes of different signs and symptoms Describe the clinical features, differential diagnoses, management and complications of malaria Introduction of Toxicology, classification of poisons (practical) Presenting problem in infectious diseases Clinical examination of Infectious diseases Bacterial infection (Mumps, influenza, infectious, mononucleases, CMV) Clinical Features, diagnosis, management and complication of malaria PEDIATRICS Discuss the importance of integrated management of neonate and child Fever with rash and IMNCI : EPI, MMR 3 P a g e
MICROBIOLOGY with fever and rash State the aims and objectives of EPI program Describe the microorganisms of common infectious diseases. Explain the pathophysiology of inflammation Discuss the pathogenesis, and microbiology of malaria Overview of infectious disease module Acute & chronic inflammation Pathology & microbiology of malaria PHARMACOLOGY COMMUNITY Perform stool DR, urine DR, culture interpret stool DR, urine DR, culture,pcr, serology reports Explain the major action and effects of drugs used to treat infectious diseases Identify criteria, used to select an effective antimicrobial agent review communicable diseases of public health importance; How to perform & interpret stool DR, urine DR, culture,pcr, serology(practical) Antimicrobials Introduction & Definition of communicable and infectious disease Week 2 PATHOLOGY MICROBIOLOGY At the end of the week, the students should be able to: Describe the basic pathophysiology of typhoid fever with emphasis on Typhoid Fever(practical ) laboratory investigations. Describe the microbiology of Typhoid & Para Typhoid(lecture Dengue,VHF and typhoid fever and VHF & Dengue STDs. Micro-organisms causing STDs 4 P a g e
Recognize the presentation and relevant diagnostic tests of typhoid fever and Dengue Identify the appropriate treatment and complication of typhoid fever, Dengue and VHF Clinical features diagnosis and management and complications of Typhoid fever VHF & Dengue PBL DERMATOLOGY PHARMACOLOGY COMMUNITY State the clinical presentation of common skin infections. Discuss management plan of common bacterial and fungal skin infections Describe cutaneous manifestations, diagnosis, and treatment of sexually transmitted diseases Describe the effects, dosage, adverse effects of different anti malarial drugs Discuss the drug treatment of typhoid fever and STDs Review the effects, side effects of medications for management of typhoid and STD Discuss epidemiology and prevention of infectious diseases with special emphasis on measles. discuss the basic principles for communicable disease control discuss simple but effective ways of preventing outbreaks of communicable diseases Skin infection (lecture Clinical features, diagnosis, management and complications of STDs(lecture Anti-malarial Drugs Treatment of typhoid fever(sgd) Drug used for typhoid Fever Drug management of STD s Measles and prevention Measles and prevention (practical) Control of infection and communicable diseases 5 P a g e
FORENSIC Define the terms(summons, warrant, perjury, deposition, exhibit, offence, cognizable offence, non cognizable offence, oath, conduct money, summons case, warrant case, bail, FIR) Discuss the types of medical evidence, documents prepared by medical man, Dying declaration, Dying deposition Explain the importance of legal procedures related to medical man. Discuss the types of witnesses, examination in courts. Legal Procedures- I - Important legal terms such as Summons, warrant, perjury, deposition, exhibit, offence, cognizable offence, non cognizable offence, oath, conduct money, summons case, warrant case, bail, FIR - Medical evidence, types of evidence (oral, documentary, hearsay, circumstantial) - Documents prepared by a medical man(post mortem Reports, Medico Legal Reports, Certificates such as birth certificates, death certificates, sickness certificates, certificates of unsoundness of mind) - Dying declaration, - Dying deposition Legal Procedures II - Types of witnesses - Types of examination in the court - Doctor in the witness box - Procedure of court attendance & recording evidence - Volunteering of a statement by the doctor in court of law - Professional secrecy - Privileged communication Week 3 At the end of the week, the students should be able to: Discuss the presenting features, relevant investigations and Fungal infection 6 P a g e
SURGERY PATHOLOGY management of fungal infections Develop a diagnostic approach to the patient with sepsis and SIRS interpret the investigations relevant to infectious diseases explain the pathophysiology of sepsis and SIRS Discuss acute and chronic inflammation Describe the structure and pathogenesis of HIV List the specific lab tests of HIV to make proper diagnosis Clinical Features, diagnosis management and Complications of Sepsis/ SIRS Diagnosis of pathogens on blood culture(practical) Acute & Chronic inflammation Pathophysiology of Sepsis/ SIRS HIV structure and pathogenesis Specific lab tests of HIV MICROBIOLOGY COMMUNITY PHARMACOLOGY Discuss clostridia and its clinical application Describe leprosy, its types and microorganisms Describe routes of transmission of organism causing diarrhea & its prevention prevention of acute diarrheal diseases and different worms infestation Discuss epidemiology and prevention of infectious diseases Counsel the patient and attendant about measles and scabies Discuss the effects, dosage, adverse effects of drugs used for leprosy Tetanus and Clostridial Infections Leprosy Acute Diarrheal disease & its prevention Worm infestation and its prevention Scabies & its prevention Drug used for Leprosy Leprosy (tutorial) 7 P a g e
FORENSIC PAEDIATRICS Review the classification of Antipyretics & Anti-inflammatory drugs Describe the drug treatment of HIV Recognize importance of forensic medicine, toxicology and its application Diagnose a case of poisoning in living & dead Restate the General principles of treatment of poisoning. Week 4 Diagnose HIV and council the patients about its management and complications Develop a diagnostic approach and management plan of a patient with diarrhea Classify a sick child with Diarrhea, dysentery and worm infestation according to the protocols of IMNCI Assess a sick child with Diarrhea, dysentery and worm infestation according to the protocols of IMNCI Recognize the importance of integrated management plan of a sick child with Diarrhea, dysentery and worm infestation Antipyretics & Anti-inflammatory drugs Drug management of HIV Diagnoses of poisoning in living & dead, general treatment of poisoning (practical) Clinical features, diagnosis, management and complications of HIV( lecture) Acute Diarrhea in adults Assess and Classification of the sick child and management with Diarrhea, dysentery and worm infestation 8 P a g e
PHARMACOLOGY PATHOLOGY Restate all the steps in the treatment of diarrhea according to the protocols of IMNCI Discuss the pharmacological effects of anti-diarrheals and anti-microbial drugs and their complications Drugs treatment of diarrhea(tutorial) Anti-diarrheal and anti-microbial drugs FORENSIC Emphasize the importance of specific lab tests eg. bacterial culture, PCR, Serology and stool D/R Interpret the results of bacterial culture, PCR and stool D/R with relation to specific diseases. Discuss importance of legal procedures and law related to medical man Discuss the criminal justice system in Pakistan Discuss the duties of a doctor In a case of suspected poisoning Apply the forensic knowledge for diagnosis and detection of poisons Practice the principles of treatment of poisons and their antidotal therapy Bacteriology culture techniques PCR, Serology (P-1) / Stool D/R(Practical) Legal Procedures III- IV Criminal Justice system in Pakistan, - Pakistan Penal Code - Criminal Procedure Code - Its execution and Delivery - General presumptions of law - General exemptions of law Duties of a doctor In a case of suspected poisoning General Treatment of poisoning, gastric lavage, antidote therapy(practical General Toxicology MICROBIOLOGY Classify the organisms causing diarrhea and dysentery Discuss in detail classes and pathogenesis of of different worms infesting humans. Diarrhea and dysentery: Agents causing diarrhea Bacterial Parasitic and viruses Worm infestation 9 P a g e
COMMUNITY Week 5 Describe routes of transmission of organism causing diarrhea Describe zoonoses and other health risks associated with pet ownership and its prevention Acute diarrheal diseases II Zoonotic disease & its prevention List the clinically important parasites that infest humans Describe mode of transmission and pathogenesis of diseases caused by worm Describe diagnostic lab tests relevant to worms infestation Discuss the management plan in worm infestation Analyze the clinical features and investigations to reach diagnosis for different worms infestations Discuss the management plan of in worm infestation COMMUNITY Develop ways to improve communication with patients regarding health risks from pets Describe cholera and its routes of spread. identify the correct course of action for treatment and referral of people with watery diarrhea. Demonstrate cholera prevention practices. Nematodes (round worms) clinical features, diagnosis, investigations, Trematodes (flukes) clinical features, diagnosis, investigations, management Cestodes (tape worms) clinical features, diagnosis, investigations, management Emerging & re-emerging disease & its prevention Epidemiology and prevention of Diarrheal diseases (PRACTICAL) 10 P a g e
FORENSIC PHARMACOLOGY outline the duties of doctors as advised by international code of medical ethics Identify obligations of a registered medical practitioner, professional misconduct Recognize the role of consent in medical examination and procedures, types of consent, criteria of valid consent. Express the understanding of Medical negligence, its types and punishments for medical negligence. Summarize core concept of Transplantation of Human Organs and Tissues along With euthanasia and its ethical aspects. Explain the pharmacology of antidiarrhoeal drugs; exploring the classes of drugs used in the typical management strategies of this common condition Cholera & its prevention Acute Diarrheal disease Law in relation to medical man II, III & IV Diarrhea, Dysentery in Adults N O P Q PEDIATRICS MICROBIOLOGY E-Learning WORKSHOPS: Formative assessment Mode of Internal Evaluation: R Schedule Of?????????????? State the integrated case management of the most common childhood problems( IMNCI designed for the management of sick children aged from birth up to five years) classify the rhabdoviruses Rabies Discuss about the structure and replication of these negative strand RNA viruses explain the pathology of rabies 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. Department of medical education will offer optional workshops to improve learning capabilities. 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. 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. 11 P a g e
Examination/s: S Mode of terminal Examination: MCQs + EMQs and OSPE (observed + un observed). T Course Monitoring: Through the Department of Medical Education and Quality Enhancement Cell. U Evaluation of the Through students and faculty feedback and by the analysis of the results. course: V Course Summary: W End Note X Correspondence m.irfan@jsmu.edu.pk Y Message of Vice Chancellor??????????? Z Published On 1-9-2015 Through a combination of lectures, ward visits and practical classes this five weeks module will provide a broad overview including an introduction to the global burden and distribution of infectious diseases, approaches to prevention and control of diseases with respect to our community. This document is prepared by professional development centre and clinical coordination cell in consultation with department of medical education. 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 http://www.jsmu.edu.pk/feedback 12 P a g e