STUDY GUIDE - Liaquat National GUIDE...STUDY GUIDE FOR RESPIRATORY II MODULE S.No Pa ... [ assume responsibilities of their own learning through individual study, ... The Respiratory System II ...

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  • LIAQUAT NATIONAL HOSPITAL

    & MEDICAL COLLEGE

    RESPIRATORY II MODULE

    THIRD YEAR MBBS SEMESTER 5

    STUDY GUIDE

    2017

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 2

    STUDY GUIDE FOR RESPIRATORY II MODULE

    S.No

    CONTENTS Page No.

    1 Overview 3 2 Introduction to Study Guide 4

    3 Learning Methodologies 5 4 Module 3: Respiratory II 7

    4.1 Introduction 7

    4.2 Objectives and Strategies 8

    5 Learning Resources 14 6 Assessment Methods 16 7 Semester Examination Rules and Regulations of JSMU 18

    8 Modular Examination Rules and Regulations (LNMC) 20

    9 Schedule 22

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 3

    Module name: Respiratory II

    Semester: Five Year: Three Duration: 4 weeks (Jan - Feb 2017)

    Timetable hours: Lectures, Case-Based Integrated Learning (CBIL), Clinical Rotations, learning

    experience in LNH outreach centers, Laboratory, Practical, Demonstrations, Skills, Self-Study

    Credit hours: 3 credit hours in theory and 1.5 credit hours in practical

    MODULE INTEGRATED COMMITTEE

    DEPARTMENTS & RESOURCE PERSONS FACILITATING LEARNING

    MODULE COORDINATOR: Dr. Zafar Ahmed (Pulmonology)

    CO-COORDINATORS: Professor Nighat Huda (DHCE) Dr. Sheeba Mahjabeen (Pulmonology) Dr. Amna Khursheed (Pathology)

    BASIC HEALTH SCIENCES CLINICAL AND ANCILLARY DEPARTMENTS ANATOMY

    Professor Zia-ul-Islam

    CHEMICAL PATHOLOGY Dr. Howrah Ali

    COMMUNITY MEDICINE Professor Rafiq Soomro

    PEDIATRICS Prof. Samina Shamim

    FORENSIC MEDICINE Professor Murad Zafar

    PULMONOLOGY Professor Ali Arsalan Dr. Ali Abbas Dr. Zafar Ahmed Dr. Sheeba Mahjabeen

    PATHOLOGY

    Professor Naveen Faridi Dr. Amna Khursheed

    RADIOLOGY Dr. Muhammad Ayub Mansoor Dr. Roomi Mahmud

    PHARMACOLOGY Professor Nazir Ahmad Solangi

    RESEARCH & SKILLS DEVELOPMENT CENTER Dr Kahkashan Tahir

    PHYSIOLOGY

    Professor Syed Hafeez-ul-Hassan RESEARCH

    Dr. Shaheena Akbani

    DEPARTMENT of HEALTH CARE EDUCATION Professor Nighat Huda Dr. Mirza Aroosa Beg

    LNH&MC MANAGEMENT

    Professor Amir Ali Shoro, Dean & Principal, Director FHS LNH&MC Dr. Shaheena Akbani, Controller A.A & R.T LNH&MC

    STUDY GUIDE COMPILED BY: Department of Health Care Education

    Dr. Muhammad Suleman Sadiq

    Dr. Rabia Mahmood

    Dr. Afifa Tabassum

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 4

    INTRODUCTION

    WHAT IS A STUDY GUIDE?

    It is an aid to:

    Inform students how student learning program of the semester-wise module has been

    organized

    Help students organize and manage their studies throughout the module

    Guide students on assessment methods, rules and regulations

    THE STUDY GUIDE:

    Communicates information on organization and management of the module.

    This will help the student to contact the right person in case of any difficulty.

    Defines the objectives which are expected to be achieved at the end of the module.

    Identifies the learning strategies such as lectures, small group teachings, clinical skills,

    demonstration, tutorial and case based learning that will be implemented to achieve the

    module objectives.

    Provides a list of learning resources such as books, computer assisted learning programs,

    web- links, journals, for students to consult in order to maximize their learning.

    Highlights information on the contribution of continuous and semester examinations on the

    students overall performance.

    Includes information on the assessment methods that will be held to determine every students

    achievement of objectives.

    Focuses on information pertaining to examination policy, rules and regulations.

    CURRICULUM FRAMEWORK

    Students will experience integrated curriculum similar to previous modules of all 4 semesters.

    INTEGRATED CURRICULUM comprises of system-based modules such as Infectious Diseases,

    Hematology, Respiratory system and CVS which links basic science knowledge to clinical problems.

    Integrated teaching means that subjects are presented as a meaningful whole. Students will be

    able to have better understanding of basic sciences when they repeatedly learn in relation to clinical

    examples.

    LEARNING EXPERIENCES: Case based Integrated discussions, skills acquisition in skills lab. computer-

    based assignments, learning experiences in clinics, wards, and outreach centers

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 5

    LEARNING METHODOLOGIES

    The following teaching / learning methods are used to promote better understanding:

    Interactive Lectures

    Small Group Discussion

    Case- Based Integrated Learning (CBIL)

    Clinical Experiences o Clinical Rotations o Experience in LNH outreach centers

    Practicals

    Skills session

    Self-Directed Study

    INTERACTIVE LECTURES: In large group, the lecturer introduces a topic or common clinical conditions and

    explains the underlying phenomena through questions, pictures, videos of patients interviews,

    exercises, etc. Students are actively involved in the learning process.

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 6

    SMALL GROUP SESSION: This format helps students to clarify concepts, acquire skills or desired

    attitudes. Sessions are structured with the help of specific exercises such as patient case, interviews or

    discussion topics. Students exchange opinions and apply knowledge gained from lectures, tutorials and

    self study. The facilitator role is to ask probing questions, summarize, or rephrase to help clarify concepts.

    CASE- BASED INTEGRATED LEARNING (CBIL): A small group discussion format where learning is focused

    around a series of questions based on a clinical scenario. Students discuss and answer the questions

    applying relevant knowledge gained previously in clinical and basic health sciences during the module and

    construct new knowledge. The CBIL will be provided by the concern department.

    CLINICAL LEARNING EXPERIENCES: In small groups, students observe patients with signs and symptoms

    in hospital wards, clinics and outreach centers. This helps students to relate knowledge of basic and

    clinical sciences of the module and prepare for future practice.

    o CLINICAL ROTATIONS: In small groups, students rotate in different wards like Medicine, Pediatrics,

    Surgery, Obs & Gyne, ENT, Eye, Family Medicine clinics, outreach centers & Community Medicine

    experiences. Here students observe patients, take histories and perform supervised clinical

    examinations in outpatient and inpatient settings. They also get an opportunity to observe medical

    personnel working as a team. These rotations help students relate basic medical and clinical

    knowledge in diverse clinical areas.

    o EXPERIENCE IN LNH OUTREACH CENTERS: Learning at outreach centers of LNH have been

    organized and incorporated as part of training of third year medicinal students. The objective of

    these visits is to provide clinical training experiences for students in primary care settings.

    PRACTICAL: Basic science practicals related to pharmacology, microbiology, forensic medicine, and

    community medicine have been schedule for student learning.

    SKILLS SESSION: Skills relevant to respective module are observed and practiced where applicable in

    skills laboratory.

    SELF-DIRECTED STUDY: Students assume responsibilities of their own learning through individual study,

    sharing and discussing with peers, seeking information from Learning Resource Center, teachers and

    resource persons within and outside the college. Students can utilize the time within the college

    scheduled hours of self-study.

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 7

    SEMESTER 5 MODULE 3 : RESPIRATORY II

    INTRODUCTION

    The Respiratory System II (RES II) module is designed to consolidate, and build on the Semester OneRES1

    module which covered basic medical sciences concepts for understanding the causes and treatment of

    diseases.

    RES (II) will focus on the respiratory system, its associated diseases, treatment options, and prevention of the

    diseases such as obstructive lung diseases, hypersensitivity related diseases, pulmonary infections, respiratory

    failure and restrictive lung diseases. The community medicine learning will aim at sessions on preventive

    medicine and various program such as TB DOTS and national tuberculosis control program of Pakistan. The

    module will enable students to relate their theoretical learning through common clinical presentations, case-

    based learning, interactive lectures, patient, simulated-based experiences and video-based learning.

    Forensic Medicine, family medicine clinics and research will run parallel with the module.

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 8

    COURSE OBJECTIVES AND STRATEGIES

    At the end of the module the students will be able to:

    OBJECTIVES FACULTY LEARNING

    STRATEGY

    OBSTRUCTIVE LUNG DISEASES (COPD)

    Perform Respiratory System Examination Skills Lab

    Group Learning,

    Simulation Based

    Hands-on Practice

    Discuss overview of clinical anatomy of Thorax including thoracic wall, lungs and trachea-bronchial tree

    Anatomy

    Small Group

    Discussion

    Explain the different Stages of development of Lung and its congenital anomalies

    Interactive

    Lecture/Small Group

    Discussion

    Enlist and describe the different volumes and capacities of lungs

    Physiology

    Interactive

    Lecture/Small Group

    Discussion

    Take focused history

    Perform examinations in Respiratory Diseases

    Discuss abnormal assessment findings associated with pulmonary diseases

    Pulmonology

    Interactive

    Lecture/Small Group

    Discussion

    Discuss the investigations relevant to respiratory diseases Interactive Lecture

    Discuss the epidemiology, patho-physiology and etiology related to the development of COPD

    Explain the signs and symptoms of the disease

    Discuss the investigations & diagnostic strategies for COPD

    Explain the management of COPD

    Pulmonology Interactive Lecture

    Discuss the differential diagnosis of granulomatous inflammation including TB

    Pathology

    Small Group

    Discussion

    Analyze histopathological changes in given slide of a patient suffering from chronic obstructive pulmonary disease

    Small Group

    Discussion

    Explain the etiology and pathogenesis of obstructive lung disease including chronic bronchitis, bronchiectasis, asthma and emphysema

    Interactive Lecture

    Discuss pathogenesis of Anaphylaxsis

    Interactive Lecture

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 9

    HYPERSENSITIVITY RELATED DISEASES (Asthma)

    Explain the different types of asthma

    Explain the role of histamine and antihistamine in bronchial asthma

    Discuss the drugs used in preventive therapy

    Describe drugs used in acute attack of asthma

    Discuss the treatment of status asthmatics

    Discuss drugs used in COPD

    Explain the adverse effect of different drugs

    Pharmacology Interactive Lecture

    Discuss the epidemiology, pathophysiology, etiology, and contributing factors related to the development of asthma

    Describe the clinical presentation, diagnostic process and assessment of asthma

    Review the pharmacologic treatments for different types of asthma

    Identify the elements of long-term asthma management

    Discuss the roles of respiratory, physical, and occupational therapy in the long-term management of asthma

    Pulmonology Interactive Lecture

    Discuss the etiology, pathogenesis, clinical presentation and management of asthma in children

    Pediatrics Interactive Lecture

    Describe the prevalence, causes and strategies of primary prevention of asthma

    Community

    Medicine Interactive Lecture

    Discuss the treatment approach of bronchial asthma

    Demonstrate the methods of administration of drugs used in asthma including nebulizer and inhaler

    Pharmacology Practical

    PULMONARY INFECTIONS (Tuberculosis)

    Identify the common causative agents, modes of transmission and risk factors for the common acute respiratory tract infections in pediatric age group

    Explain the management of acute respiratory tract infections in children

    Explain the most effective ways to prevent and control ARIs

    Describe the clinical presentations and complications of ARIs, and the danger signs of severe pneumonia

    Pediatrics Interactive Lecture

    Explain the different types of cough

    Explain the treatment strategy of cough

    Discuss the adverse effect of anti-tussive drugs

    Describe allergic rhinitis and its triggering factor

    Explain the drugs used in the treatment of allergic rhinitis and its treatment strategy

    Pharmacology

    Small Group

    Discussion

    Discuss the first line drugs used in treatment of tuberculosis, mechanism of action and adverse effects

    Discuss the second line drugs used in treatment of tuberculosis, indications for use and adverse effects

    Describe WHO guidelines for treatment of tuberculosis

    Interactive Lecture

  • 3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

    2017 Page | 10

    The DOTS Regimen

    Explain monitoring of Anti-Tuberculosis (AT) therapy

    Explain Multiple Resistance Drugs (MRD) TB, causes of resistance and prevention of resistance

    Discuss drugs for prevention of TB in exposed patients

    List the immunological differences of TB in child and adult

    Explain the signs and symptoms of various forms of TB presenting in children

    Recall the diagnostic criteria for TB in pediatric age group

    Discuss the treatment protocol for TB

    Pediatrics Interactive Lecture

    Discuss the clinical diagnosis, investigation and management protocol for TB and MDR TB

    Pulmonology Interactive Lecture

    Explain tuberculosis as a public health problem globally including Pakistan

    Discuss the mode of transmission such as droplets, dust, physical contact etc

    Describe the various screening tests of tuberculosis

    Discuss the preventive strategies at primary level and the National Tuberculosis Control Program of Pakistan

    Community

    Medicine Interactive Lecture

    Pneumonia

    Explain the community acquired pneumonia with special emphasis on its general features and causative agents

    Pulmonology Interactive Lecture

    Discuss the causative organisms of pneumonia Pathology Interactive Lecture

    Disucss community acquired pneumonia along with its pathogens

    Discuss the clinical features of disease

    Discuss the investigations required for diagnosis

    Discuss the drugs used in community acquired pneumonia, atypical and suppurative pneumonia

    Discuss Penicillin in detail along with pharmacokinetic and pharmacodynamic profile

    Pharmacology

    Case-Based

    Learning/Small

    Group Discussion

    RESPIRATORY FAILURE (Pneumothorax)

    Distinguish between inflammatory and non-i...

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