Department LEARNING OBJECTIVE

Anatomy and Cell Biology At the end of the block, the student will be
able to :
1. Explain the organogenesis of the
digestive system, which includes :
 Primitive gut: foregut, midgut, and
hindgut.
 The esophagus: foregut
 Stomach: dilatation of the foregut,
rotation of the greater and lesser
curvatures, and pyloric and cardiac
portion.
 Duodenum: portions of intestinal
tract, hepatic diverticulum, and
pancreatic bud.
 Intestinal loop: jejunum, ileum,
caecum, appendix, colon and rectum,
in the process of retraction of
herniated loop, and rotation and
fixation of the intestinal loop.
2. Explain about congenital malformations.
a. Foregut:
 Esophagus: esophageal atresia,
esophageal stenosis, short
esophagus.
 Stomach: Congenital hypertrophic
pyloric stenosis.
 Duodenum: Duodenal stenosis,
duodenal atresia,
 Liver & Biliary Aparatus: anomalies of
the liver, extrahepatic biliary atresia.
 Pancreas: accessory pancreatic
tissue, anular pancreas.
 Spleen: accessory spleen.

b. Midgut:
 Congenital omphalocele
 Umbilical hernia
 Gastroschisis
 Nonrotation of the midgut
 Mixed rotation and volvulus
 Reversed Rotation
 Subhepatic caecum and appendix
 Mobile caecum
 Internal hernia
 Midgut volvulus
 Stenosis and atresia of the intestine
 Ileal diverticulum and other yolk stalk
remnants
 Duplication of the intestine
c. Hindgut :
 Congenital megacolon
 Imperforate anus and anorectal
anomalies
 Anal agenesis, with or without a
fistula
 Anal stenosis
 Membranous atresia of the anus
 Anorectal agenesis, with or without a
fistula
 Rectal atresia

At the end of the block, the student will be

able to :
Define Anatomical terminology (C-1)
Identify the digestive and its associated
organs (C-1)
Discuss the developmental anatomy of the
digestive system (C-2)

At the end of the block, the student will be

able to define the division of the esophagus
(C-1).
Describe the upper & lower esophageal
sphincter. (C-2)
Describe the blood supply and lymphatic
drainage of the esophagus (C-2)

At the end of the block, the student will be

able to :
Describe the surface landmarks of the
anterior abdominal wall (C-2)
Review the abdominal region &
quadrants.(C-2)
Explain the layers of the anterolateral
abdominal wall (i.e. the skin, fascia,
muscle). (C-2)
Explain the blood supply, lymphatic
drainage, and innervation of the anterior
abdominal wall. (C-2)
Explain the inguinal region, including the
descent of testes, inguinal canal, spermatic
cord, nerve of the inguinal region, inguinal
triangle, and femoral ring. (C-2)

At the end of the block, the student will be

able to :
Describe the basic principle of the
abdominopelvic cavity (C-2)
Define the division of the peritoneum and
peritoneal cavity. (C-1)
Explain the developmental anatomy of the
appendix (C-2)
Describe the anatomy of the appendix and
meso appendix (C-2)
Explain the blood supplies and lymphatic
drainage of the appendix (C-2)
Explain the location, position, relationship,
and structures of the gastrointestinal tract.
(C-2)
Explain the blood supply, innervation and
the lymphatic drainage of the
gastrointestinal tract and accessory glands.
(C-2)

Describe the anatomy of the anal canal (C-

2).
Describe the anatomy of internal and
external hemorrhoidal plexus (C-2).

At the end of the block, the student will be

able to:
Describe the anatomical consideration of the
liver, mesenteric attachments, external
surface, position and relationship, structure
of the liver and biliary tree.(C-2)
Describe the blood supply, venous return,
lymphatic drainage and innervation of the
liver, including the portal system. (C-2)
Discuss the hepatic resection, biliary
overload and obstruction. (C-2)

At the end of the block, the student will be

able to describe the developmental
consideration, external structures (1.e.
location, division), internal structures, blood
supply, lymphatic drainage, and innervation
of the pancreas. (C-2)

At the end of the block, the student will be

able to describe the blood supply, venous
return, lymphatic drainage and innervation
of the spleen and its relationship with the
surrounding structures. (C-2)

At the end of the block, the student will be

able to:
Describe the anatomy of external hepatic
tree, including its course, blood supply,
innervation. (C-2)

Physiology of the Digestive System
Describe the gallbladder, including the
position and relationships with the
surrounding structures, external sructures,
blood supply, innervation, and function.(C-2)
At the end of the block, the student will be
able to:
Explain the microscopic structures of the
oesophagus, stomach and small intestines,
including the epithelia, cell types, glands and
the histophysiology. (C-2)
Describe the microstructures of the large
intestine (the caecum, colon, rectum and
anus), including the histophysiology.(C-2)
Describe the microscopic structures of the
rectum and anal canal, including anal
mucosa, submucosa, and muscularis
externa. (C-2)
Describe the microstructures of the
appendix. (C-2)
Describe the microstructures of the
pancreas, including exocrine pancreas,
endocrine pancreas, histophysiology of
endocrine pancreas, cells composing the
islets of Langerhans, the histophysiology of
the endocrine pancreas. (C-2)
Describe the microstructures of the liver,
including the vascular supply, three concepts
of liver lobules, hepatic sinusoid and
hepatocytes plates, hepatic ducts, and
histophysiology of the liver.(C-2)
Describe the microscopic structures of the
gall bladder, including the biliary tract and
its histophysiology. (C-2)
Note : dalam tutorial dapat langsung
dibicarakan secara focus ke arah aspek
pathologinya.
At the end of the block, the student will be
able to:
Explain the mastication and swallowing of
food. (C-2)
Explain the secretion of saliva. (C-2)
Explain the esophageal secretion. (C-2)
Explain the digestion of carbohydrate in the
mouth. (C-2)
At the end of the block, the student will be
able to:
Explain the motor function of the stomach,
including storage function, mixing and
propulsion (the basic electrical rhythm of the
stomach), and emptying of the stomach with
its regulation.(C-2)
Explain the secretion of hydrochloric acid.
(C-2)
Explain the secretion and activation of
pepsinogen. (C-2)
Explain the secretion of other enzymes and
intrinsic factor. (C-2)
Explain the secretion of mucus and gastrin.
(C-2)
Explain the regulation of gastric secretion by
nervous and hormonal mechanisms. (C-2)
Explain phases of gastric secretion. (C-2)
Explain the inhibition of gastric secretion by
post-stomach intestinal factors. (C-2)
Explain the digestion of carbohydrate in the
stomach. (C-2)
Explain the digestion of proteins in the
stomach. (C-2)

At the end of the block, the student will be

able to:
Explain the mixing contraction and
propulsive movements of the small intestine.
(C-2)
Explain the function of ileocecal valve and
feedback control of ileocecal sphincter. (C-2)
Explain the secretion of mucus by Brunner’s
glands in the duodenum. (C-2)
Explain the secretion of the intestinal
digestives juices by the crypts of Lieberkuhn.
(C-2)
Explain the regulation of small intestine
secretion. (C-2)
Explain the secretion of pancreatic digestives
enzymes and bicarbonate ions. (C-2)
Explain the regulation of pancreatic
secretion. (C-2)
Explain the digestion of carbohydrates in the
small intestine. (C-2)
Explain the hydrolysis of dissacharides and
small glucose polymers by intestinal
epithelial enzymes. (C-2)
Explain the digestion of proteins by
pancreatic secretion. (C-2)
Explain the digestion of peptides in the small
intestine. (C-2)
Explain the digestion of fats in the intestine.
(C-2)
Explain the digestion tryglycerides by
pancreatic lipase. (C-2)
Explain the formation of micelles. (C-2)
Explain the digestion of cholesterol ester and
phospholipids. (C-2)

Biochemistry of digestion and
absorption of basic nutritional
constituents
Explain the isosomotic absorption of water in
the small intestine. (C-2)
Explain the absorption of sodium, chloride
and bicarbonate ions in the small intestine.
(C-2)
Explain the absorption of carbohydrates,
proteins and fats in the small intestine. (C-2)
At the end of the block, the student will be
able to :
Explain the mixing and propulsive
movements of the colon. (C-2)
Explain the mechanism of defecation. (C-2)
Explain the mucus secretions of the large
intestine. (C-2)
Explain the absorption and secretion of
water and electrolytes in the large intestine
and formation of feces. (C-2)
At the end of the block, the student will be
able to:
Explain the function of hepatic vascular and
lymph systems.(C-2)
Explain the metabolic functions of the liver.
(C-2)
Explain the secretion of bile by the liver. (C-
2)
Explain the function of bile salts in fat
digestion and absorption.(C-2)
Explain the liver secretion of cholesterol and
gallstone formation. (C-2)
At the end of the block, the student will be
able to:
Describe the digestive enzymes (C-2)
Describe secretion and activation of digestive
enzymes (C-2)
Describe regulation of secretion (C-2)
Describe the role of secretagogues (C-2)
At the end of the block, the student will be
able to:
Describe the solute transport across
epithelial cell layers. (C-2)
Explain trans-epithelial Na+ transport and
the role Na+, K+, ATPase. (C-2)
Describe the secretion of Hcl by gastric
parietal cells. (C-2)
Describe the active transport of nutrients.
(C-2)
At the end of the block, the student will be
 able to:
Describe the gastric and intestinal digestion
of protein.(C-2)
Describe the absorption of free amino acids
and dipeptides by carrier-mediated
transport. (C-2)

At the end of the block, the student will be

able to:
Describe the digestion of carbohydrate in the
intestine. (C-2)
Describe the absorption of monosaccharides
by carrier-mediated transport. (C-2)

At the end of the block, the student will be

able to:
Describe the digestion and absorption of lipid
in the stomach and intestines.(C-2)
Describe the role of bile acids (C-2)
Describe the bile acid metabolism. (C-2)

At the end of the block, the student will be

able to describe the enzymes defects and
malabsorption in carbohydrate digestion.(C-
2)

At the end of the block, the student will be

able to defining the beneficial of dietary
fibers (soluble & insoluble fiber) (C-1)

Related with Amino acid metabolism

Biochemistry of bile acid At the end of the block, the student will be
able to:
Describe the properties of bile (C-2)
Describe the formation of bile acid micelles &
mixed micelles (C-2)
Describe the composition of bile in the liver
& gall bladder (C-2)
Illustrate the biosynthesis and degradation
of bile acids (C-3)
Describe the regulation of bile acid synthesis
(C-2)
Illustrate enterohepatic circulation of bile
acids (C-3)

Biochemistry of bilirubin At the end of the block, the student will be

able to:
Describe the conversion of heme to bilirubin
by microsomal enzyme systems in RES. (C-
 2)
Describe the release of extrahepatic bilirubin
to the blood and bound to serum albumin.
(C-2)

At the end of the block, the student will be

able to:
Describe the carrier mediated uptake of
bilirubin by sinusoidal membrane of liver
parenchymal cells (C-2)
Describe conjugation of bilirubin with
glucuronic acids (C-2).
Describe excretion of conjugated bilirubin
into bile. (C-2)
Describe the degradation of bilirubin to
urobilinogen by bacterial  glucuronidase,
excretion of urobilinogen in the feces and
into urine (C-2).
Describe the enterohepatic circulation. (C-2)
At the end of the block, the student will be
able to:
Describe the definition and pathophysiology
of jaundice. (C-2)
Describe conjugated hyperbilirubinemia. (C-
2)
Describe unconjugated hyperbilirubinemia
(C-2)

Anatomical Pathology At the end of the block, the student will be

able to describe the histopathology of fatty
liver, acute and chronic hepatitis, liver
fibrosis and cirrhosis.

At the end of the block, the student will be

able to:
Explain the histopathological features of
appendicitis, including acute, chronic and
acute exacerbation on chronic appendicitis.
(C-2)
Compare and contrast the histopathological
features and clinical pictures between acute
appendicitis and chronic appendicitis.
Explain the histopathological features of
carcinoid of the appendix. (C-2)

At the end of the block, the student will be

able to:
Describe the oncogenesis of sporadic and
hereditary colorectal cancers.(C-2)
Explain the adenoma-carcinoma sequence of
the large bowel.(C-2)
Describe the pathology of colorectal cancer,

Clinical Pathology
Microbiology of Gastrointestinal System
including histological grading and staging,
and biology of metastasis.(C-2)
At the end of the block, the student will be
able to:
Overview of laboratory testing and diagnosis
of liver and biliary diseases, including:
Blood : Transaminase, Alkaline Phospatase, 
GT, bilirubin, Prothrombine Time, Activated
Partial Thrombine Time, Albumine, Globulin.
Urine : Bilirubine, Urobilin;
Faeces : acholic, stercobilin.
Describe the investigative laboratory
methods for viral hepatitis, including
urinalysis, faeces, blood (haematological)
changes, and serology.
At the end of the block, the student will be
able to describe laboratory diagnosis of
Gastro-intestinal tract and pancreatic
disorders (Lipase&amilase)
After studying this chapter the learner will be
able to :
Describe morphology, structure and
characteristics of bacteria
Describe the specimen for laboratory
examinations and laboratory methods to
identify the bacteria
Describe morphology, structure,
characteristics and the mechanisms of
bacteria that cause the diseases in GIS
Describe the proper specimen collection, and
laboratory methods for isolation and
identification of bacteria
Describe taxonomy, classification,
morphology, structure, characteristics and
replication of virus
Describe laboratory examinations to identify
viruses
Describe taxonomy, classification,
morphology, structure, characteristics and
replication of hepatitis viruses
Describe laboratory examinations to
diagnose the disease
Describe morphology, structure,
characteristics and the mechanisms of
bacteria cause the disease
 Describe the proper specimen collection, and
laboratory methods for isolation and
identification of bacteria
Epidemiology and prevention ?
Parasitic Infection At the end of the block, the student will be
able to:
Define agent, form and characteristic of the
etiology of fasciolopsiasis
Discuss epidemiology of fasciolopsiasis
Describe pathogenesis of fasciolopsiasis
Explain the clinical manifestations of
fasciolopsiasis
Explain the laboratory findings which can be
found on fasciolopsiasis patient
Analyze principle diagnosis and the
differential diagnosis of fasciolopsiasis
Analize the management therapy of
fasciolopsiasis including mechanism of
action, side effects as well as
contraindication of agents in fasciolopsiasis
Explain the complications of fasciolopsiasis
Explain the preventions of fasciolopsiasis

At the end of the block, the student will be

able to:
Define agent, form and characteristic of the
etiology of fascioliasis hepatica
Discuss epidemiology of fascioliasis hepatica
Describe pathogenesis of fascioliasis
hepatica
Explain the clinical manifestions of
fascioliasis hepatica
Explain the laboratory findings which can be
found on fascioliasis patient
Analyze principle diagnosis and the
differential diagnosis of fascioliasis hepatica
Analyze the management therapy of
fascioliasis hepatica including mechanism of
action, side effect as well as contraindication
of agents in fascioliasis
Explain the complications of fascioliasis
hepatica
Explain preventions of fascioliasis hepatica

At the end of the block, the student will be

able to:
Define agent, form and characteristic of the
etiology of Teaniasis
Discuss epidemiology of Teaniasis
Describe pathogenesis of Teaniasis
Explain the clinical manifestations of
Teaniasis
Explain the laboratory findings which can be

Pharmacology and therapy
Radiology of gastrointestinal
system
found on Teaniasis patient
Analyze principle diagnosis and the
differential diagnosis of Teaniasis
Analyze the management therapy of
Teaniasis including mechanism of action,
side effect as well as contraindication of
agents in Teaniasis
Explain the complications of Teaniasis
Explain preventions Teaniasis
At the end of the block, the student will be
able to :
Describe the pharmacological properties of
drugs in GIT disease (antacid, H2 receptor
antagonist, mucosal protective agents,
inhibitors of proton pump and others agents
to antacids) (C-2)
Describe the pharmacological laxatives drugs
(drugs forming laxative, stool surfactant
agent (softener) osmotic laxative, stimulant
laxative) (C-2)
Describe antidiarrheal drugs (opioid agonist,
colloidal bismuth, kaolin, pectin, bile salt,
ocreotide) (C-2)
Describe the pharmacological properties of
antimicrobial in GIT (including sulfasalazine,
aminoglicoside, tetracycline, cotrimoxsazole
At the end of the block, the student will be
able to :
Describe the pharmacological properties of
drugs in GIT disease (antacid, H2 receptor
antagonist, mucosal protective agents,
inhibitors of proton pump and others agents
to antacids) (C-2)
Describe the pharmacological laxatives drugs
(bulks laxative, stool softeners t irritant or
stimulant laxatives) (C-2)
Describe antidiarrheal drugs (loperamide,
kaolin, pectin, to diphenoxylate) (C-2)
Describe the pharmacological properties of
antimicrobial in GIT (including sulfasalazine,
aminoglicoside, tetracycline, cotrimoxsazole)
1. The student will be able to interpret AP &
lateral soft tissue of the neck (C3),
including:
- Nasopharynx
- Oropharynx
- Laryngopharynx
- Retropharyngeal space
- Retrolaryngeal space
- Epiglottis
- Vallecula
- Cricoid & thyroid cartilage

2. The student will be able to interpret

plain films and oesophagograph (C3):
- Oesophageal atresia
- Dilatation of oesophagus (achalasia,
chalasia)
- Cicatrical stenoses or stricture
- Oesophageal spasm
- Presbyesophagus
- Oesophagitis
- Diverticula of the oesophagus
- Oesophageal ulcer
- Oesophageal varices
- Benign tumours and malignant
tumours
- Indentation/displacement of
oesophagus by contiguous structures & by
hiatal hernia

3. The student will be able to describe the

barium meal examination for the
stomach and all of the duodenum (C3)

4. The student will be able to interpret (C3):

Hypertrophic pyloric stenosis
Gastritis
Gastric ulceration
Gastric diverticulum
Benign tumours and malignant tumours of
the stomach
Duodenal atresia
Duodenitis
Duodenal ulcer
Duodenal diverticulum
Benign tumours and malignant tumours of
the duodenum

1. The student will be able to describe the

small-bowel contrast examination (follow-
through examination) (C3)

2. The student will be able to interpret

radiological appearances of small-bowel
disorders , including(C3):
- Crohn’s disease
- Benign tumours and malignant tumours
 - Infectious enteritis
- Miscellaneous conditions (pneumatosis
intestinalis)

1. The student will be able to describe the

largel-bowel contrast examination (barium
enema examination) (C3)

2. The student will be able to interpret

radiological appearances of large-bowel
disorders, including (C3):
- Colorectal tumours
- Diverticular disease
- Colitis
- Miscellaneous conditions (appendicitis,
pneumatosis coli, volvulus)
1. The student will be able to describe
radiopositioning of plain abdominal films for
acute
abdomen (C3):
- Erect chest film
- Supine abdominal film
- Horizontal-ray films (erect & lateral
decubitus)

2. TLWBA to knowledge radiological

appearances of acute abdomen by
interpreting plain abdominal films (C3):
Perforation
Intestinal obstruction
Paralytic ileus
Acute colitis
Intraperitoneal fluid
Inflammatory conditions
Intramural gas
Calcification associated with acute abdominal
conditions

1. TLWBA to knowledge radiological

appearances of abdominal trauma:
- Blunt splenic trauma
- Blunt hepatic trauma
- Blunt pancreatic trauma
by interpreting ultrasound imaging & CT
imaging (C3)

1. TLWBA to knowledge radiological

appearances of liver cirrhosis and
portal hypertension by interpreting
ultrasound imaging (C3)

Psychiatry At the end of the block, the student will be

able to:

Head and Neck
Gastro-enterology (Internal Medicine)
Describe the clinical features and diagnostic
criteria of somatoform autonomic
dysfunction of the upper gastrointestinal
system.
Recall the prevalence of somatoform
autonomic dysfunction of the upper
gastrointestinal system.
Discuss the differential diagnosis of
somatoform autonomic dysfunction of the
upper gastrointestinal system.
Discuss the therapy of somatoform
autonomic dysfunction of the upper
gastrointestinal system.
At the end of the block, the student will be
able to:
Describe the clinical features and diagnostic
criteria of somatoform autonomic
dysfunction of the lower gastrointestinal
tract.(C-2)
Recall the prevalence of somatoform
autonomic dysfunction of the lower
gastrointestinal tract.(C-1)
Discuss the differential diagnosis of
somatoform autonomic dysfunction of the
lower gastrointestinal tract.(C-4)
Discuss the therapy of somatoform
autonomic dysfunction of the lower
gastrointestinal tract. (C-4)
At the end of the block, the student will be
able to
Define dysphagia (C-1)
Describe the accompanying symptoms of
dysphagia (C-2)
Describe the etiology of dysphagia, including
Plummer-Vinson Syndrome, Zenker’s
Diverticulum, achalasia, esophageal webs,
esophageal spasm, Schatzki’sring, burns,
dysphagia lusoria, iatrogenic perforation,
foreign bodies, neoplasms.(C-2)
Explain the steps taken to diagnose the
etiology of dysphagia.(C-2)
Compare and contrast the treatment of
different diseases and disorders that cause
dysphagia.(C-4)
At the end of the block, the student will be
able to:
Describe the definition of gastric and
duodenal ulcer. (C-2)
Explain the etiology, risk factors and
pathogenesis of peptic ulcer, including
aggressive factors and mucosal defence
mechanism. (C-2)
Describe the signs and symptoms of both
ulcers. (C-2)
Describe the physical examination findings in
peptic ulcer patient.
Describe the laboratory results of peptic
ulcer, including Helicobacter pylori
Describe the barium meal findings in peptic
ulcer patient.
Describe the characteristics of endoscopic
findings in peptic ulcer patients.
Appraise the major objectives in pain relief
and accelerating ulcer healing by dietary and
medical therapy, which include antacids, H2
receptor antagonist, and proton pump
inhibitor.
Penekanan pada penggunaan obat-obatan
(risk factors)

At the end of the block the student will be

able to:
Describe the definition and incidence of
ulcerative colitis (C-2)
Describe the etiology and pathogenesis of
ulcerative colitis (C-1)
Explain examination of ulcerative colitis,
including: history taking, physical
examination, and laboratory examination.
(C-2)
Describe the histopathological characteristics
of ulcerative colitis.(C-2)
Describe the imaging examinations of
ulcerative colitis (C-2)
Compare and contrast with crohn’s diseases.
(C-4)
Explain the complication e.g.:Intractable
disease,, Fulminant disease,Bleeding
(Hemato chezia),Toxic megacolon,Peritonitis
& perforation obstruction/stricture (C-2)
Explain the management of ulceraive colitis,
including Dietetic/nutrional theraphy, Drugs:
Sulfasalazine, 5 ASA, Antibiotic, Azathioprine
& 6 Mercaptopurine, and Surgery (C-2)

At the end of the block the student will be

able to:
Explain the definition and etiology and risk
factors (high risk group) of hepatitis
Describe the definition of viral hepatitis
Describe the clinical types of viral hepatitis,
including acute hepatitis, prolonged
 cholestasis, relapses, fulminant hepatitis,
posthepatitis syndrome.
Describe the clinical diagnosis (history and
physical examination) of acute viral hepatitis
Explain the serologic profiles of viral
hepatitis.
Describe the differential diagnosis of viral
hepatitis.
Explain the spesification of hepatitis viruses,
including the epidemiological aspect,
structures, clinical courses, diagnostic
methods, therapy and prophylaxis of :
Hepatitis A, B, C, D, E, G, virus, and TORCH
(Neonatal hepatitis)
Prevention ?

After the end of the block the student will be

able to:
Describe the definition of cirrhosis.
Describe the etiology and clinical
classification of cirrhosis.
Explain the general investigations on
patients with cirrhosis.
Recognize the hepatosellular failure and
portal hypertension
Discuss the prognosis and treatment of
cirrhosis.
Subacute bacterial peritonitis
Hepatorenal syndrome in cirrhosis

Gastroenterology (Pediatrics) At the end of the block, the student will be

able to :
Describe the definition of diarrhoea and
acute diarrhoea in childhood (C-2)
Explain the incidence of acute diarrhoea in
Indonesia and the rest of the world (C-2)
Explain the etiology of Acute diarrhoea in
children (C-2)
Explain the pathophysiology of Invasive
diarrhoea, secretory diarrhoea, Osmotic
diarrhoea
Explain active fluid transport (Na pump) in
the intestine.
Explain the examination of acute diarrhoea
in children, including history, Physical
Examination, and Laboratory Examination
Analyze the differential diagnosis of acute
diarrhoea (C4)
Diagnose acute diarrhoea (C4)
Analyze the complications of acute
diarrhoea, including: dehydration, electrolyte
imbalance, acid base disturbance,
hypovolemic shock, hypoglycaemia (C4)
 Analyze dehydration and its grade.(C4)
Describe the signs and symptoms of
electrolyte imbalance. (C-2)
Explain about the role of stool analysis (C-2)
Discuss the management of of acute
diarrhoea, including :
Rehydration : Plan A , B and C of Treatment.
Dietetic (feeding),
Drugs : indications for antibiotics, and
Antidiarrhoe, as well as the rationale of
avoiding antidiarrhoea for acute diarrhoea.
Health Education (C4)
Discuss the prognosis of acute diarrhoea
(C4)
Discuss the preventive measures of acute
diarrhoea. (C4)

Pediatric Nutrition At the end of the block, the student will be

able to :
Explain about breast and bottle feeding.(C-
2)
Explain about the anatomy of the human
breast, physiology of lactation, immunologic
factors of human milk, and physiologic
binding. (C-2)
Explain the composition of human milk &
infant formula. (C-2)
Explain about weaning, feeding progression,
and baby foods. (C-2)
Explain about balanced nutrition. (C-2)

At the end of the block, the student will be

able to give breast feeding counseling and
supporting skills (P-4)

At the end of the block, the student will be

able to analyse nutritional status in children
using anthropometric indices (C-4)

At the end of the block, the student will be

able to :
Describe the management of protein energy
malnutrition.(C-2)
Describe the management of obesity in
children. (C-2)

Pediatric Surgery At the end of the block, the student will be

able to :
Describe the definition and classification of
invagination (C-2)
 Describe the etiology of invagination in
relation with different age groups (C-2)
Explain the patholophysiology of invagination
(C-2)
Explain the complications of invagination :
Fluid & electrolytes imbalance
Sepsis & peritonitis
Describe the signs and symptoms of
invagination (C-2)
Examine the diagnosis of invagination,
including : (C-4)
History
Physical examination
Compare and contrast between Dysentry
and invagination (C-4)
Discuss the management of invagination
including :
Initial fluid resuscitation,
Antibiotics,
Supportive measures, i.e. : oxygen
theraphy, decompression (NGT), collecting &
measuring urine output.
Discuss different management options :
operative and non operative treatment.
Discuss about early detection and indication
to refer

At the end of the block the student will be

able to :
Describe the embryology of duodenum,
jejunum, ileul and colon (C-2)
Describe the signs and symptoms of
duodenal atresia (C-2)
Compare and contrast between duodenal
atresia against jejunoileal atresia including:
history
physical examination
abdominal x- ray
Describe the management of duodenal
atresia, including (C-2): initial fluid
resuscitation and supportive measures i.e :
oxygenation, protect from cold, Nasogastric
tube
Discuss about early detection and indication
to refer

Digestive surgery At the end of the block, the student will be

able to :
Describe the definition and classification of
ileus (C-2)
Compare and contrast between mechanical
intestinal obstruction against adynamic ileus
(C-4)
Discuss the etiology of intestinal obstruction
in relation with different age groups. (C-2)
Explain the pathophysiology of intestinal
obstruction (C-2)
Discuss the complications of intestinal
obstruction, including : (C-2)
Fluid & electrolyte imbalance
Strangulation
Perforated bowel
Peritonitis and sepsis
Describe the signs and symptoms of
intestinal obstruction with its complications
(C-2)
Appraise the steps taken to diagnose
intestinal obstruction (C-4), including :
History
Physical examination
Laboratory examinations
Imaging : Plain and Erect abdominal X-ray,
Erect Chest X-ray.
Discuss the management of intestinal
obstruction (C-2) , including :
Initial fluid resuscitation and supportive
measures, i.e. Oxygen theraphy,
decompression, urethral catheterization
Operative treatment
Discuss about early detection and indication
to refer

At the end of the block, the student will be

able to:
Explain the concept of peritonitis, Sepsis,
and Systemic Inflammatory Responses
Syndrome ( C-2)
Describe the etiology and classification of
peritonitis (C-2)
Explain the pathophysiology of secondary
peritonitis (C-2)
Discuss the complication of peritonitis (C-2)
Explain the signs and symptoms of primary
and secondary peritonitis (C-2)
Appraise the step takens to diagnose
secondary peritonitis (C-4)
Interpret plain abdominal X-ray of the acute
abdomen (C-4)
Discuss the supportive and definitive
treatments of secondary peritonitis (C-2)
Discuss about early detection and indication
to refer

At the end of the block, the student will be

able to:
Explain the biomechanics of abdominal injury
(C-2)
Define the boundaries of abdominal region
with possible injuries sustained (C-1)
Describe the initial assessment and
resuscitation procedure according to ATLS
principles to manage multiple injury,
including : (C-2)
Primary survey
Secondary survey
Appraise the steps taken to diagnose
abdominal injury, including : (C-4)
History taking
Physical Examinations
Recognize the various diagnostic modalities
available to diagnose abdominal injury,
including :(C-1)
Laboratory examinations
Diagnostic Peritoneal Lavage
Focused Abdominal Ultrasound for Trauma
CT Scan
Abdominal X-rays
Describe the algorithm of abdominal injury
(C-2)
Recognize the indications for surgical
treatment (C-1)
Discuss the various definitive treatment of
abdominal injury (C-2)

At the end of the tutorial, the students will

be able to :
Recall the definition of appendicitis (C-1)
Describe the pathophysiology abdominal
pain (C-2).
Compare and contrast between somatic pain
and visceral abdominal pain (C-4)
Discuss the pathophysiology of appendicitis
(C-2)
Describe the natural courses and
complications of appendicitis. (C-2)
Describe the signs and symptoms of acute
appendicitis (C-2)
Discuss the differential diagnosis of acute
appendicitis (C-2).
Appraise the steps taken to diagnose acute
appendicitis (C-4).
Discuss the management of simple acute
appendicitis, and complicating appendicitis
(C-2).

At the the end of the block, student will be

able to :
Recognize the incidence of colorectal cancer.
(C-1)
Explain the etiology and risk factors of
colorectal cancer, including genetic factor.
(C-2)
Explain the clinical symptoms and signs of
colorectal cancer.(C-2)
Compare and contrast the clinical symptoms
and signs between right colon cancer and
left colon cancer.(C-4)
Explain the complications of advanced
colorectal cancer, including : large bowel
obstruction, perforation and lower GI
bleeding.(C-2)
Appraise the steps taken to diagnose
colorectal cancer including (C-4):
History taking
Physical examination, including : Digital
rectal examination
Specific laboratory findings, including tumor
markers
Abdominal imaging : X-ray, CT Scan.
Endorectal ultrasonography
Explain the methods available for mass
screening. (C-2)
Explain the options of surgical treatment of
colorectal cancer (C-2)
Explain the factors determining the
prognosis of colorectal cancer (C-2)
Discuss about early detection and indication
to refer

At the end of the block, the student will be

able to:
Recognise the definition of hemorrhoidal
diseases (C-1)
Describe the anatomy of the anal canal(C-2).
Describe the anatomy of internal and
external hemorrhoidal plexus (C-2).
Explain the function of hemorrhoidal plexus
(C-2).
Explain the pathogenesis of hemorrhoidal
prolapse (C-2).
Recognise the clinical grades of hemorrhoidal
prolapse (C-1)
Describe the signs and symptoms of the
internal and external hemorrhoidal prolapse
(C-2).
Explain the steps taken to diagnose
hemorrhoidal prolaps (2), including :
History taking
Physical examination : inspection, and
anuscopy.
Discuss the management of hemorrhoidal
prolapse in conjunction with the clinical
grades. (C-2)
Discuss the options and both advantages
and disadvantages of operative treatment
(C-2)
Explain the complications of hemorrhoidal
disease (C-2).

After the completion of the tutorial the

student will be able to :
Define the intraabdominal mass (C-1)
Compare and contrast the signs between
abdominal wall mass against intraabdominal
mass (C-4)
Explain the possible etiologies of
intraabdominal mass in conjunction with
different abdominal regions (C-2)
Decribe the history taking and physical
examination to diagnose the cause of
intrabdominal mass. (C-2)
Describe the diagnostic modalities available
to differentiate causes of abdominal mass,
including (C-2) :
Laboratory examinations
Abdominal imaging : x-ray, CT Scan, MRI.
Explain the differential diagnosis of
abdominal mass in specific abdominal
regions.(C-2)
Discuss about early detection and indication
to refer

At the end of the block the student will be

able to :
Recognize the definition of abdominal hernia.
(C-1)
Recognize the history of hernia surgery (C-
1)
Recall the incidence of abdominal hernia. (C-
1)
Recognize the classification and types of
abdominal hernias.(C-1)
Describe the abdominal wall anatomy, in
conjunction with the pathogenesis of
abdominal hernias.(C-2)
Discuss the etiology and risk factors of
inguinal hernia (C-2).
Discuss clinical manifestions, diagnosis, and
treatment of inguinal hernias. (C-2)
Discuss the differential diagnosis of inguinal
hernia, both in male and female (C-2)
Compare and contrast between direct and
indirect inguinal hernias (C-4).
Compare and contrast between inguinal and
femoral hernia (C-4)
Explain the pathophysiology of complications
of hernia, including : incarceration,
strangulation, perforated bowel, and
peritonitis (C-2)
Distinguish the clinical signs and symptoms
between incarcerated and strangulated
hernia (C-4)
Describe various pathological conditions
related to the complications of hernia,
including Richter hernia, Littre hernia, sliding
hernia, Pantaloon hernia and reduction en
masse (C-2).
Discuss the surgical treatment options of
inguinal and femoral hernias, including
classic open hernia repairs, tension free
hernia repairs, and laparoscopic hernia
repairs (C-2).
Explain factors that determines the
prognosis of inguinal hernia (C-2)
Describe 9 other types of hernia (C-2),
including :
Femoral hernia
Ventral hernia
Umbilical hernia
Obturator hernia
Perineal hernia
Spighelian hernia
Paraumbilical hernia
Epigastric hernia
Lumbar hernias
Discuss about early detection and indication
to refer

At the end of the block, the student will be

able to:
Describe the definition of shock (C-2)
Describe the etiology and classification of
shock (C-2)
Discuss the etiology and pathophysiology of
hemorrhagic shock.(C-2)
Explain the mechanisms of a-v shunting and
irreversible shock (C-2)
Explain the mechanism of the body fluid shift
responses in relation with the degree of
hemorrhagic shock (C-2)
Describe the clinical symptoms and signs of
hemorrhagic shock, including the ATLS
classification of the degree of hemorrhagic
shock. (C-2)
Explain the steps taken to diagnose
hemorrhagic shock (C-2)
Discuss the management of hemorrhagic
shock, including : hemodynamic monitoring,
fluid resuscitation, and supportive measures
and definitive treatments(C-2)

At the end of the tutorial, the student will be

able to :
Explain the pathophysiology of peptic ulcer
complications, including (C-2) :
Upper GI Bleeding
Perforation
Gastric outlet obstruction
Duodeno-gastro-esofagheal reflux
Recognize the signs and symptoms of
bleeding and perforated peptic ulcers (C-1)
Explain the indications of surgery for peptic
ulcer diseases (C-2).
Discuss the all necessary steps taken to
manage upper GI bleeding due to peptic
ulcers (C-2)
Discuss the management of perforated
peptic ulcer diseases (C-2)
Explain the surgical treatment options for
peptic ulcer diseases (C-2).

At the end of the block, the student will be

able to :
Recognise the definition of gastrointestinal
bleeding, including its classification : upper
and lower gastro-intestinal bleeding (C-1).
Discuss the etiology of gastro-intestinal
bleeding (C-2).
Recognize the three most common causes of
upper and lower gastro-intestinal bleeding in
Indonesia (C-1).
Explain the pathophysiology of gastro-
intestinal bleeding (C-2).
Distinguish the clinical signs and symptoms
between upper and lower gastro-intestinal
bleeding (C-4)).
Describe steps taken to diagnose the
etiology of gastro-intestinal bleeding(C-2)
Describe the steps taken to manage patients
with gastrointestinal bleeding including fluid
resuscitation and other supportive
measures.(C-2)
Explain the indications of surgery for gastro-
intestinal bleeding.(C-2) Discuss about early
detection and indication to refer
 At the end of the block, the student will be
able to:
Describe the definition and pathophysiology
of jaundice. (C-2)
Distinguish between obstructive against
medical jaundice.(C-4)
Discuss the common etiologies of obstructive
jaundice, including: gall stones, common bile
duct stones, Parasites (helminthiasis) and
periampullary tumors.(C-2)
Describe the clinical signs and symptoms of
obstructive jaundice. (C-2)
Explain the complications of obstructive
jaundice, including cholangitis, hepato-renal
syndrome, and sepsis.(C-2)
Discuss the steps taken to diagnose
obstructive jaundice with its complications,
including: (C-2)
History taking
Physical examination
Laboratory examinations
Abdominal Imaging
Endoscopic Retrograde Cholangio-
Pancreatography
Explain the surgical management of
obstructive jaundice. (C-2)
Discuss the role of ursodeoxycholic acid and
chenodeoxycholic acid in the management of
gallstones diseases. (C-4)
Discuss about early detection and indication
to refer

Cilinical Nutrition At the end of the block, the student will be

able to :
Overview the effect of macronutrient and
fibre, including carbohydrates, fats, protein,
dietary fibre, nutrient-nutrient interactions in
foods and micronutrients interactions.
Describe the influence of food form and non-
nutrient food, including: components, food
form, enzyme inhibitors, saponins, tannins,
phytates, lectins and rate of food ingestion
and meal frequency.
Describe the differences in digestibility of
foods and physiology, including implication,
glycemic index, colonic absorption, short
chain fatty acid and long-term effects.
 At the end of the block, the student will be
able to explain about nutritional diagnosis
and management in peptic ulcers including:
specific composition, dose, route, and
monitoring. (C-2)

At the end of the block, the student will be

able to describe the effect of intestinal
resection, including motility, absorption of
nutrient, fluid and electrolytes; adaptation of
the intestine, complication; nutritional
treatment and evaluation. (C-2)

At the end of the block, the student will be

able to discuss the management of the
practical nutritional therapy in lactose
intolerance. (C-2)

At the end of the block, the student will be

able to explain about nutritional diagnosis
and management in protein energy
malnutrition, including composition, dose,
route and monitoring. (C-2)

At the end of the block, the student will be

able to explain about nutritional diagnosis
and management in inflammatory bowel
disease, including: rationale for modifying
food intake, special dietary therapies,
treatment of specific deficiencies and
intensive nutritional support. (C-2)

At the end of the block, the student will be

able to explain about nutritional diagnosis
and management in : (C-2)
Acute hepatitis, including specific
composition, dose, and monitoring.
Hepatic encephalopathy/liver failure,
including specific composition, dose, route,
frequency, and monitoring.
Acute pancreatitis, including specific
composition, dose, route, frequency and
monitoring.

Anesthesiology At the end of the block, the student will be

able to:
Explain the mechanism of the body fluid shift
responses in relation with the degree of
hemorrhagic shock (C-2)
Describe the clinical symptoms and signs of
hemorrhagic shock, including the ATLS
 classification of the degree of hemorrhagic
shock. (C-2)
Explain the steps taken to diagnose
hemorrhagic shock (C-2)
Discuss the management of hemorrhagic
shock, including : hemodynamic monitoring,
fluid resuscitation, and supportive measures
and definitive treatments(C-2)
Explain the role and use of blood transfusion
in managing hemorrhagic shock (C-2)

Nuclear Medicine At the end of the block, the student will be

able to :
Describe the indications of GI Bleeding
Scitigraphy
Describe the principle of GI Bleeding
scintigraphy
Describe the positive finding for GI bleeding
Describe the cause of false positive and false
negative results for this kind of scitigraphy

At the end of the block, the student will be

able to :
Describe the principle of scintigraphy for
detection Meckel diverticula’s
Describe the positive finding for this
diverticula’s
Discribe the frequent location of this type of
diverticula’s

At the end of the block, the student will be

able to :
Describe the indications of GET test
Describe the principle of GET test
Describe the normal values of GET for liquid
and solid food, each
Describe what kind of medicine which can be
interfere the test

At the end of the block, the student will be

able to :
Describe the indication of GER test
Describe principle of GER test
Two methods to perform of GER test
Describe the limitations and the advantages
of each methods
Describe the abnormal and normal finding of
Rehabilitation Medicine GER test

At the end of the block, the student will be

 able to : Describe the prescription to prevent
complication of immobilization in post
operative management (C-2)

List of References

No. Reference

1. Langman’s medical embryology. 9th edition 2004

2. The Developing Human, Clinically Oriented Embryology, 6th Edition, 1998

3. Moore K.L., Dalley A.F., Clinically Oriented Anatomy, 5th Edition, 2006

4. Gartner L.P., Hiati J.L., Histology: 2001

5. Junquieira LC.,Carneiro J.,O Kelley R.Basic Histology,Appleton & Lange,2005

6. Guyton AC.Hall E John, Textbook of Medical Physiology 11th ed. Saunder,2006

7. Devlin TM. Textbook of Biochemistry with Clinical Correlations 5th Ed..Wiley Liss 2002

8. Murray R, Graynner DK, Mayes PA, Rodwell VW, Harper’s Illustrated Biochemistry
26th Ed- Mc Graw Hill

9. Robbins, Cotran, Kumar & Colin “Pathology Basic of Disease” 6 th Ed. WB Saunders
Company, 1999

10. Henry JB : Clinical Diagnosis & Management by Laboratory Methods; WB Saunders

Company 2001

11. Brook. Jawetz. Medical microbiology. 5th ed. Lange Medical Books/Mc Graw-Hill 2003

12. Patrick R. Muray, Ken S. Rosenthal, George S. Kobayashi, Michael A. Pfaller, Medical
Microbiology 4th Ed. The CV Mosby Company, St Louis 2002

13. Clinical Parasitology 9th Edition

14. Bertran G. Katzung, Basic & Clinical Pharmacology, 8th Ed. Appleton, Lange Stanford
Connecticut 2001

15. David Sutton, Textbook of Radiology &Imaging 7th Ed. Vol 1

16. The ICD –10 Classification of Mental and Behavioral Disorders

17. Kaplan and Sadock Comprehensive Texbooks of Psychiatry, 7th edition 2000
18. Sadock W, Sadock VA “Synopsis of Psychiatry 9 th Ed. Philadelphia Williams & Wilkens
2003

19. K.J. Lee Essential Otolaryngology, Head And Neck Surgery, 6 th Ed. Appleton and
lange 1995

20. Boies Fundamentals of Otolaryngology 6th Ed. WB Saunder Co. 1997

21. Harrison’s Principles of Internal Medicine 13th ed Mc. Graw-Hill New York, 1994

22. Yamada T, Alpers D.H, Owyang C et al in Handbook of Gastroenterology,

Philladelphia, Pannsylvania, Lippincott-Raven Published, 1998.

23. Dirks, E : Ulcerative Colitis in DR. Falk Pharma Gmbh Freburg, Germany (Product
Presentation 6th ed. 2000)

24. Field M., Fordtran J.S., Schultz G., (Eds) Secretory Diarrhea, American Physiological
Society, Bethesda, Maryland, 1980.

25. Walker W.A.,, Durie P.R., Hamilton J.R., Walter-Smith J.A., Watkins J.B., Pediatric
Gastrointestinal Disease, Volume One, B.C.. Decker Inc. 1991

26. Programme for Control of Diarrhoeal Diseases, WHO, Diarrhoea Management,

Training Course, Guidelines for Conducting Clinical Training Courses at Health
Centres and Small Hospitals, 1992

27. Breast feeding, A Guide for the Medical Profession, Ruth A. Lawrence, page 1- 162

28. Handbook of Nutrition. Patricia M Pediatric. Queen, Carol E. Lang, page 107-144.

29. Breast Feeding Counselling : A Training Course- UNICEF

30. Appropriate Uses of Anthropometric indices in Children- United Nations ACC/SCN

31. Management of Severe Malnutrition , A Manual for Physicians and Other Senior
Health WorkersWHO
32. Textbook of Pediatric Nutrition2nd Edition, Robert M. Suskind, Leslie lewinter
Suskind,
33. Raffensperger J.G (ED), Swensons Pediatric Surgery Fifth Edition, Appleton & Lange,
1990
34. O’ Neill’s Pediatric surgery . 5th ed., Mosby yearbook publisher, St Louis Missoury,
1998

35. Principles of surgery, 7th edition, Mc Graw - Hill, 1999

36. Soybel D I, Ileus and Bowel Obstruction, in Greenfield (Ed), Surgery, Scientific
principles and practice on CD – ROM, Lippincot-Raven, 1997.
37. Surgery, Basic Science and clinical evidence, International Edition, Springer-Verlag ,
2001

38. American College of Surgeons, Committee On Trauma, Advanced Trauma Life

Support, Course Manual, 1997.

39. Sjamsuhidayat R, Ahmadsyah de Jong W (Eds) Edisi Revisi, EGC 1997

40. Clain A., Hamilton Bailey’s, Demonstration of Physical Signs in Clinical Surgery, 16 th
Ed. , ELBS, 1984

41. Shils M.E., Olson J.A., and Shike M., Modern Nutritrion in Health and Disease, Eight
Edition, Lea & Febriger, 1994

42. Hauff, Groff, Advanced Nutrition and Human Metabolism, West Publishing Co., 1990.

43. Tumeh ss, the abdominal contents, In Maisey MN, Britton KE, Collier BD Ed. Clinical
Nuclear Medicine. 3rd Ed. Champman & Hall Medical, London, 1998
44. Malmud LS. Gastrointestinal System In Christian PE, Bernier D, Langan JK Ed.
Nuclear Medicine and PET Technology and techniques. 5th Ed. Mosby Missouri, 2004

45 Halsted and Grabois: in Medical Rehabilitation, chapter 22, Immobilization Syndrome,

Raven Press book, 1985

46 Pedoman Pemberantasan Penyakit Diare, Depkes RI, Direktorat Jenderal PPM & PL,
Jakarta, 2002

47 Buku Kader Posyandu dalam Usaha Perbaikan Gizi Keluarga, Depkes RI

48 Standar Pemantauan Pertumbuhan Balita, Depkes, Direktorat Jenderal Bina

Kesehatan Masyarakat, Jakarta, 2005