Anda di halaman 1dari 112

Faculty of Medicine Ain Shams University Postgraduate Studies

Master of Science in Internal Medicine



Program Code: GIM600

Program Guide and Logbook

Candidate Curriculum vitae


[Name] Please attach your recent photo

[telephone no] [mobile no] [mailing address] [email address] [postcode]

Experience [organization] [your present job title] [start date] [location] [responsibilities] [organization] [previous job title] [start and end date] [location] [responsibilities] 3

photo here.

[organization] [previous job title] [start and end date] [location] [responsibilities]

Education [certificates] [start and end date] [school or college]

Training [any other training that will be useful in your job]

Filled by post graduate authorities


Date of Registration First semester Second semester Third semester Fourth semester _______________________ _______________________ _______________________ _______________________

TABLE OF CONTENTS:
Page I Welcome Statement II - Mission Statement III Senior supervisor and affiliated departments and Hospitals IV Program specifications 1 - Basic Information 2 - Professional Information 3 Academic standards 4 Curriculum structure and contents 5 - Program courses. 6. Program admission requirements 7. Regulation for progression and program completion 8. Appendix: course specifications Physiology course specifications Pathology course specifications Pharmacology course specifications Clinical biochemistry and Molecular biology course specifications Clinical micobiology course specifications Internal Medicine course specifications Hospital management course specifications Infection control course specifications V - General information VI Your log book 1 Introduction 2 Supervisors 3 - Tables for training records 4 Log book preview VII - Head of department approval for the exam entry Detachable forms: VIII Thesis follow up IX - Evaluation forms

I Welcome Statement: The Department of General Internal Medicine department welcomes you to the Degree of Master of science in Internal Medicine. As a department we are committed to medical student education and continuously strive to improve your educational experience. This handbook presents information guide and logbook activity of this master degree administered by the General Internal Medicine department, Faculty of Medicine, Ain Shams University. II - Mission Statement: The mission of the Faculty of Medicine, Ain Shams University is Preparation of a trained physician, researcher and life long tutor capable of following standards of medical care and ethics, with managerial and technical skills in his specialty. Furthermore, promotion outstanding programs of health care to serve the society, environmental development and targeted scientific research for continual improvement of health. The mission of this degree is to provide practicing clinicians in in Internal Medicine with a comprehensive training program both at a basic science and clinical level. Furthermore, to provide extensive training in research design and methodology, to facilitate candidates career development in clinical and basic research of Internal Medicine. III Senior Supervisor and Affilated Departments and Hospitals Senior Supervisor Prof. ------------------------------------------------------------------------------------------E-mail: Affilated Departments and Hospitals Internal medicine departments, Faculty of Medicine, Ain Shams University. -------------------------------

IV Program Specifications A- Basic Information 1. Program title: Master of Science in Internal Medicine 2. Program type: Single Double Multiple 3. Faculty Ain Shams University Faculty of medicine 4. Department General Internal Medicine department. 5. Assistant coordinator . 6. Coordinator .. 7. Last date of program approval: B- Professional Information: 1. Program aims: 1. Program aims: This program should be able to: 1-Facilitate the development of a physician able to function as an independent consultant in General Internal Medicine. A General Physician is a Physician who specialises in the assessment, diagnosis and management of general medical problems; particularly those involving nonspecific symptoms, atypical presentations, multiple problem or system disorder. General physician is skilled in the management of acute unselected medical emergencies and the management of patients in a holistic way, considering all psychosocial as well as medical factors for enhancing quality of life. General physician values the continuing care of all patients irrespective of the nature of the patients complaint. In view of the breadth of experience required to manage acute unselected medical emergencies general physician is trained in common diseases in the following systems or sub-specialities i.e. Cardiology; Respiratory medicine; Gastroenterology and Liver disease; Infectious diseases; Endocrinology and Diabetes; Neurology; Geriatrics; Rheumatology and Rehabilitation; Medical Oncology; Palliative medicine; Genito-urinary and Renal medicine; Dermatology; Clinical Pharmacology, Therapeutics and Toxicology ; Psychological medicine and Intensive care. In addition general physician is trained in some aspects of related specialities

e.g. Haematology and Clinical Biochemistry ;Immunology and Microbiology; Radiology and Nuclear medicine etc. In most cases treatment is non surgical but it is essential that general physician should be able to make a total evaluation of the patient and prioritise treatment which may include surgery. Although triage is one important aspect of the General Physicians role he/she is notsimply a triage officer who transfers patients on to the most appropriate specialistbut continues to co-ordinate the care for all patients involving other specialists as required. General physician will function in a number of roles including clinical, counselling, educating, leading and managing. Thus the aims of training are to develop the necessary competencies to perform these roles. 2- Respond to the educational and research training needs of doctors with a special interest in Internal Medicine. 3- Meet the needs of MSc candidates whilst they are completing their clinical training or working in clinical practice. 4- Provide study modules designed to give candidates a sound understanding of concepts and research. 5- Provide trainees with additional advanced modules, this will allow them to undertake more indepth studies of specific areas in Internal Medicine according to individual interest. 6- Support evidence-based Internal Medicine practice. 7- Give trainees an opportunity to produce a detailed dissertation on a special topic of interest. 8- The program will also provide an opportunity and encouragement for appropriate candidates to apply for a MD Degree in Internal Medicine . 2. Intended learning outcomes (ILOs): a. Knowledge and understanding: By the end of this program the student should be able to: a1- Recognize physiology, pathology, cellular and molecular biology, microbiology and pharmacology relevant to Internal Medicine diseases. a2- Describe different types of Internal Medicine Diseases and emergencies in adult and geriatric age groups. a3- Identify the role of imaging techniques in the investigation of the diseases. a4- Recognize different types laboratory investigations needed for the diagnosis of diseases. a5- Know the place of measurement techniques using imaging (bone densitometry and ultrasonography) in the investigation diseases. a6- List the drugs used in the disease tratment, their indications, actions and monitoring.

a7- Outline the role of allied medical specialties (such as Rehabilitation) a8- Outline the role of patient education. a9- Recognize the socioeconomic and legal aspects diseases. a10- Identify the role of non-conventional medicine in treatment of diseases. a11 Know the basis of hospital management. a12 Understand the basis of infection control. b. Intellectual capabilities: By the end of this program the student should be able to: b1- Classify different medical disorders. b2 Differentiate different medical from each other. b3 - Assess multi-system disease. b4 - Select appropriate laboratory tests. b5 - Interpret appropriate laboratory tests. b6 - Select appropriate imaging technique for diagnosis of different medical disorders. b7 - Interpret radiological imaging. b8 - Select the proper line of treatment. c. Professional and practical skills: By the end of this program the student should be able to: c1- Obtain a proper, reliable history c2- Perform an adequate clinical examination for the patient and elicit abnormal physical signs. c3- Interpret the patient data (history and examination) in an organized and informative manner. c4- Perform Procedural Skills (Central venous line placement, horacentesis, Lumbar puncture, Abdominal paracentesis, Arterial puncture for blood gas analysis and Nasogastric intubation.etc). c5- investigate clinical problems in a prioritised, systematic, well informed and cost effective way c6- Recognize and carry out the treatment of the emergency situations c7- Perform as a either a consultant or a principal care provider when required. c8- Expertise in the ongoing care and management of chronic diseases including preventive and public health medicine and the community aspects of disease. c9- The ability to determine the appropriate time and conditions when referral to another specialist is indicated or transfer to a specialist unit. c10- Manage patients in a holistic way, considering all psycho-social as well as medical factors for improving quality of life. c11- Plan and achieve successful patient discharge from hospital, including knowledge of the various discharge options.

10

c12- Determine when the emphasis of treatment should change from the curative to the palliative in patients whose prognosis is limited. d. General and transferable skills: By the end of this program the student should be able to: d1) Establish Effective Doctor / Patient Relationships 1) Communication Skills d111- Promote trust and cooperation, and to help patients cope with distressing or other emotions. d112- Demonstrate the following skills: - active listening; understanding the need for and enabling the ventilation of feelings; warmth, support and empathy; respect; guidance; partnership. d113- Educate and motivate patients towards co-operating with advice. d114- Demonstrate the following skills: elicitation of existing views/ knowledge; offering clear explanation and instruction; checking understanding; evaluating problems; using positive attribution and praise. d115- Deal with special situations e.g. breaking bad news to patients and relatives; other sensitive issues; preparation for threatening procedures; obtaining informed consent; Conducting family conferences; dealing with complaints etc. 2) Ethical principles d121- demonstrate respect and dignity of patients; their right to privacy and confidentiality; Their right to the best possible care; Their right to autonomy and informed consent; Their right to decline treatment or to take part in teaching or research etc. d2- Demonstrate Leadership and personal management skills 1) Personal achievement d211- Exercise independent judgement and clinical self-confidence. d212- Be self-directed and to achieve objectives. d213- Have high internal standards and a desire to improve. d214- Maintain effective work performance under pressure when appropriate and to cope with ones own emotions. d215- Accept and act on constructive criticism ii) Interpersonal skills --d221- Initiate, build and maintain good relationships, both one to one and in groups. d222- Lead by example. d223- Put oneself in the place of another and correctly interpret their concerns and feelings. d224- Calculate in advance the likely effect of ones words or actions on an individual or group in order to bring about a desired effect. d225- Time ones actions or interventions in order to maximise their effectiveness. iii) Managing others

11

d231- Get others to work effectively by planning and delegating work. d232 - Coach and supervise others and give clear feedback about performance, good or bad. d3) Acquire the following Organisation, Planning and Service Management skills d31 - Conduct and administer a general medical service, including seeing patient referrals, dictating letters, summaries and reports etc. d32- Liaise and work effectively with professional colleagues, particularly general practitioners and members of the multidisciplinary team. d33- Participate in committee work concerned with planning and organising services. d34- Supervise and work with a medical Secretary. d35- Develop a strategic view on the needs and direction of the service. d4) Acquire the following Education and Mentoring Skills i) Being a Role Model d411-The ability to set an example of good practice and be respected as a Physician. ii) Educational Supervision d421- Motivate, demonstrate and explain, particularly the reasons for clinical decisions. d422 - Build relationships with trainees. d423- Use appropriate teaching methods and styles. d424- Assess the performance of trainees d5) Acquire the following Quality Standards, Effectiveness, Research and Development Skills. d51- Present the results of audit or research papers to both small and large audiences. d52- Evaluate research publications to assess their importance. d53- Reflect on clinical practice and plan future educational needs. d54- Maintain an expert knowledge of the diagnosis and treatment of a broad range of common acute disorders through systematic 3. Academic standards: (Benchmarks) Joint Committee on Higher Medical Training, Royal College of Physicians 5 St Andrews Place, Regent's Park, London NW1 4LB http://www.jrcptb.org.uk/Specialty/Documents/2009%20GIM%20curriculum .PDF http://www.jrcptb.org.uk/Specialty/Documents/General%20(internal)%20Me dicine%20Curriculum.pdf 4. Curriculum structure and contents: 4 a- Program duration: two years (4 semesters) 4b- Program structure:

12

: - E6073 E6059

5.1 5.1 5 5 5 6 51 5 6 66

GIM6001 GIM6002 GIM6003 GIM6004 GIM6005

GIM6006 E6073 E6059

5. Program courses: a. Compulsory Code Course title GIM6001 GIM6002 GIM6003 L 22.5 22.5 15

No. of hours C F SDL

Physiology Pathology Pharmacology Clinical biochemistry and Molecular GIM6004 15 biology GIM6005 Clinical microbiology 15 GIM6006 Internal Medicine 90 330 + + L: Lecture, C: Clinical, F: field and SDL: Self directed learning b. Elective No. of hours Code Course title L C F SDL E6004 Hospital management 15 E6002 Infection control 15

13

:6. Program admission requirements (6) : :- 1 - 0 2- () 30- 40- (1) 50- 0 (5) : :- 1- 0 2 - 0 3- 0 4- 0 5 - 0 6 - 0 7 - 6 0 8 - 0 7. Regulation for progression and program completion (8): 0 . (9): . . . . 6 . ( ). . (55) : ( ) 0 (15) : . . (65) : 0 (15) : . (054 ) . (15): . (65): . (11): . (11): 0021 003 . 003 . (11): .

41

(61): 06% . (92): .

Assessment Schedule and Weighing of Assessments GPA score Student state

Item During semester 001 001 001

Mark End of semester 003

Total 004 001 001 009 0051

)First semester (If present Second semester Third semester Written Fourth Oral semester Final exam Practical /Clinical Total

009 003 0021

: : A A+B B B+C C CF

1 16.6 66.6 00.6 16.1 66.1 00.1 16.5

: : : : : : : : :

09 % 18% 09 % 08% 18% 11% 08% 01% 11% 16% 01% 16% 16% 06% 16% 06%

Points

1- 6- 1- 1- 6- 1- 8- 9-

5-

( )GPA . ( )CGPA .

51

. .)C- 06% (76.1 PHYSIOLOGY course specification University: Ain Shams University Faculty: of Medicine Course specifications Program on which the course is given: Master of Science in internal Medicine Major or minor element of programs: Major Department offering the program: General Internal Medicine department. Department offering the course: Physiology department. Academic Level: Master 1st semester Date of specification approval: .. A- Basic Information Title: Physiology course Credit Hours: 1.5 hour Coordinator Physiology department B - Professional Information 1- Course Aims: The aims of this course are to enable students to: 1- Acquire an appropriate functional background of cells, tissues, organs & systems. 2- Integrate physiological data & mechanisms with the ongoing basic sciences: anatomy, histology & biochemistry and clinical applications. 3- Follow the rapidly changing and inflating details about molecular biology & genetics. 4- Explore in detail the functions of the autonomic, the neuromuscular, the respiratory and the cardiovascular systems as well as their integration to achieve homeostasis. 5- Develop the basic scientific research skills as well as effective communication and team work attitudes. II. INTENDED LEARNING OUTCOMES: 2- Intended Learning Outcomes (ILOs) from the Course: a- Knowledge and understanding 1- Describe the cellular functions at the organelle and molecular level. 2- Describe & explain the functions of the nerve cell the nerve and muscle fiber grossly and at the molecular level.

Code: GIM6001 Lecture: 1.5h/week

Total: 22.5 hours

16

3- Describe & explain the functions of the autonomic nervous system, different components of blood, the respiratory and cardiovascular systems both grossly and at the molecular level. 4- Describe some biophysical laws and their relation to physiology. b- Intellectual skills By the end of the course the candidate will be able to: 1- Interpret the most important physiological laboratory results (blood, respiratory, neuromuscular), to distinguish a physiological from a pathological condition. 2- Comment, on some clinical parameters such as: ABP, ECG, nerve conduction velocity & pulmonary functions for a normal individual. 3- Integrate physiology with other basic and clinical sciences. c- Professional skills By the end of the course the candidate will be able to: c1- Perform hematological tests: estimation of blood Hb, bleeding & clotting times, determination of the hematocrite value, the bleeding & clotting times and blood groups. c2- Perform the most important respiratory function tests. c3- Perform the measurement of the arterial blood pressure. c4- Manipulate a stethoscope for hearing heart and respiratory sounds. c5- Record and read an electrocardiogram. c6- Present physiological scientific data in a graphical form. d- General and transferable skills By the end of the course the candidate will be able to: d1- Maintain honesty and integrity in all interactions with teachers, colleagues and others with whom physicians must interact in their professional lives. d2- Recognize the scope and limits of their role as students as well as the necessity to seek and apply collaboration with other workers. d3- Be responsible towards work. III. COURSE CONTENTS: 3- Course content: Topics No of hours L SDL E.C.G & Arrhythmias. 1.5 Venous Circulation, Insufficiency, Syncope. 1.5 Coronary & Cerebral Circulations. 1.5 Pulmonary Circulation (+ Hypertesion, +Oedema, 1.5 +Embolism). Splanchnic Circulation, Portal Hypertesion & Spleen. 1.5 Absorption & Malabsorption. 1.5

17

G.1. T. Hormones. Pituitary gland Adrenal Gland (Cortex & Medulla). . Sensations and Sensory Lesions. VoIuntary Control and Motor Lesions. Muscle Tone (Hypo. & Hypertonia). Resp. Functions Resp. Failure, Hypoxia, Cyanosis & O2 Therapy. Energy Balance & Obesity. L: Lectures and SDL: Self directed learning . 4 - Student Assessment Methods 4.1 written exam to assess knowledge Weighing of assessment 4.1 written exam 75 Total 75

1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5

5 -- List of References 5.1- Course Notes (paper and / or electronic) Lecture notes. 5.2- Essential Books (Text Books) Guyton: Textbook of Medical Physiology. Ganong: Review of Medical Physiology. Illustrated medical physiology 5.3- Recommended Books 5.4- Periodicals, Web Sites, etc Pathology Course Specifications University: Ain Shams University Faculty: of Medicine Course specifications Program on which the course is given: Master of Science in internal Medicine. Major or minor element of programs: Major Department offering the program: General Internal Medicine department Department offering the course: Pathology department. Academic Level: Master 1st semester Date of specification approval: .. A- Basic Information

18

Title: Pathology course Credit Hours: 1.5 hour Coordinator Pathology department

Code: GIM6002 Lecture: 1.5h/week

Total: 22.5 hours

B- Professional Information 1. Overall Aims of Course Pathology is the bridge between the basic science and clinical medicine. The main aim of Pathology course is to provide the candidate with adequate, recognizable and applicable knowledge and skills for common diseases and life threatening illnesses affecting body organs and system. It helps the candidate to understand the causes (aetiology) of disease, the mechanisms of its development (pathogenesis) and the associated alterations of structure (morphologic changes) and function (clinical manifestations and complications) to be able to determine the most likely diagnosis of the disease and management of the patient when provided with the clinical history, the anatomical lesions, and the laboratory data. 2. Intended Learning Outcomes of Course (ILOs) a- Knowledge and Understanding: By the end of the course the candidate will be able to: a1- Recognize and define the basic pathologic processes that disturb the structure and function of the body including cell injury, tissue response to injury (inflammation, healing and repair), haemodynamic disturbances, neoplasia, infections and parasitic diseases. a2- List the causes of common diseases affecting organs or systems. a3- Explain the pathogenesis of common diseases affecting organs or systems a4- Recognize and describe the basic pathologic features (morphologic alterations) including the gross and microscopic pictures of various common diseases affecting organs and systems. a5- Describe how the pathological processes affect the structure and function of the organ systems of the human body a6. Identify the functional consequences and clinical manifestations of common diseases affecting specific organs or systems. a7-Explain the signs and symptoms of disease based on its pathogenesis, thereby demonstrate clinical reasoning. a8- Interpret and identify the complications of common diseases. a9- Describe the effect of environmental factors on causation and geographical variation of disease.

19

a10- Recognize and be fully familiar with the terminology used in the classification, investigation and description of disease, enabling effective communication with professional colleagues and patients. b-Intellectual Skills By the end of the course the candidate will be able to: b1- Correlate the pathologic features of the disease with its clinical presentation, laboratory investigations and complications. b2- Develop skills of observation, interpretation, and integration needed to analyze basic clinical and pathologic data and to diagnose human disease. c- Professional and Practical Skills By the end of the course the candidate will be able to: c1- Recognize and interpret the important pathologic lesions in a pathology report that can provide reliable basis (sound foundation) for rational clinical care and therapy. c2- Select appropriate preservative material necessary for different kind of specimens for different types of pathologic investigations. c3- Select appropriate method of investigation for examination needed to reach a correct diagnosis. c4- Handle and select appropriate tissue from fresh specimen for frozen section examination. d- General and Transferable Skills By the end of the course the candidate will be able to: d1-Use database to collect material needed for research. d2-Gather and organize material from various sources (including library, electronic and online resources). d3- Present a research assignment orally and deliver it in both written and electronic forms. d4- Ensure that request form and specimen identification is accurate and identify and resolve any errors or discordance. d5- Communicate with pathologists promptly and accurately. d6- Understand the importance of continuing professional development. d7- Demonstrate knowledge of the importance of ethical approval and patient consent for clinical research. d8- Work cooperatively and show respect for others opinions. 3- Course content: Topics No of hours L

20

General Pathology Course:

Acute and Chronic Inflammation Cell Injury Adaptation and Death Pathological Calcification and Pigmentation Intracellular accumulations Amyloidosis Tissue Repair and Healing Granulomas Parasitic Diseases Bacterial Infections Haemodynamic Disturbances Disorders of Cellular Growth, Differentiation and Maturation Neoplasia Congestive Heart Failure Ischemic Heart Disease Hypertensive Heart Disease Rheumatic Fever Diseases of Endocardium Primary Myocardial disease Congenital heart Disease Pericardial diseases Diseases of Blood Vessels Congenital anomalies Glomerulonephritis Tubulointerstitial Diseases Vascular Disease of the Kidney Renal Calculi Hydronephrosis Renal Failure Tumours of kidney Bronchitis Bronchial Asthma Bronchiectasis Pneumonia Lung Abscess Lung Gangrene Pulmonary Emphysema Pneumoconiosis Lung Tumours Pleural Diseases

2.5

Systemic Pathology Course Cardiovascular System

Kidneys and Urinary Tract

Respiratory System

21

Gastrointestinal Tract

Liver, Bladder Pancreas Pathology

Gall &

Endocrine System

Oral Pathology Oesophagus (Congenital Anomalies, Inflammatory Diseases & Tumours) Stomach (Congenital Anomalies, Inflammatory Diseases & Tumours) Small Intestine (Congenital Anomalies, Inflammatory Diseases, Malabsorption & Tumours) Large Intestine (Congenital Anomalies, Inflammatory Diseases, Diverticular Disease & Tumours) Intestinal Obstruction Microanatomy of the liver Types of Necrosis Hepatitis Cirrhosis Tumours of Liver Liver Abscess Jaundice Cholecystitis Cholethiasis Pancreatitis Tumours of pancreas Diabetes Mellitus Thyroid Gland Hyperthyroidism Hypothyroidism Graves Disease Diffuse Nontoxic Goiter and Multinodular Goiter Thyroiditis Parathyroid Gland Hyperparathyroidism Hypoparathyroidism Adrenal Cortex Adrenocortical Hyperfunction Adrenal Insufficiency Adrenocortical Neoplasms Adrenal Medulla Pheochromocytoma Neuroblastoma and other neuronal

22

Lymphatic System Spleen

and

Diseases of Blood

Central System

Nervous

Neoplasms Multiple Endocrine Neoplasia Syndromes Inflammatory and Hyperplastic Diseases Tumours of Lymphoid Tissue Hypersplenism Congestive Splenomegaly Tumours Causes of Lymphadenopathy Causes of Enlarged Spleen Diseases of RBCs Diseases of WBCs Leukemia Infections Cerebral aneurysm

2 2

4 - Student Assessment Methods 4.1 written exam to assess knowledge Weighing of assessment 4.1 written exam 75 Total 75 5 -- List of References 5.1- Course Notes (paper and / or electronic) General and Systemic Pathology Notes written by staff members of Pathology Department 5.2- Essential Books (Text Books) Kumar, V. (Ed.), Cotran, R. S., Robbins, S. L. (2007). Basic Pathology 8th edition Philadelphia, PA: W.B. Saunders. 5.3- Recommended Books 5.4- Periodicals, Web Sites, etc http://www.webpath, http://www.pathguy http://www.pathmax.com, http://www.uwo.ca/pathol/resources.html Pharmacology course specification University: Ain Shams University Faculty: of Medicine Course specifications

23

Program on which the course is given: Master of Science in internal Medicine. Major or minor element of programs: Major Department offering the program: General Internal Medicine department Department offering the course: Pharmacology department. Academic Level: Master 1st semester Date of specification approval: .. A- Basic Information Title: pharmacology course Credit Hours: 1 hour Coordinator Pharmacology department B - Professional Information 1- Course Aims: The aim of this course is to provide students with an understanding of the principles of pharmacology. For each medication, understand the dosing, pharmacokinetics, metabolism, mechanisms of action, side effects, drug interactions, compliance issues, costs, and use in specific patient populations, such as renal insufficiency and including fertile, lactating, pregnant women, pediatric and geriatric population. 2- Intended Learning Outcomes (ILOs) from the Course: a- Knowledge and understanding By the end of the course the candidate will be able to: a1- Discuss the pharmacokinetic, pharmacodynamic and pharmacotherapeutic properties of different groups of drugs. a2- Discuss the adverse and toxic effects, and their management of commonly used groups. a3- Give an account on limitations to the use of drugs such as contraindications and drug interactions. a4- Define clinically relevant age, sex and genetic related variations that affect response to drugs. a5- Define the principles, the indications, the relative advantages and disadvantages of various pharmacotherapy modalities. a6- Discuss the role, prevalence and limitations of alternative and complementary therapies commonly in use. a7- Recognize the rational and general guidelines of the use of drugs in the proper dose in special population such as pediatrics, geriatrics, pregnancy and lactation and in cases of liver and kidney impairment.

Code: GIM6502 Lecture: 1/week Total: 15

24

b- Intellectual skills By the end of the course the candidate will be able to: b1- Calculate accurately drugs dosage, bioavailability, plasma half life and volume of distribution in different patient populations. b2- Obtain and record a comprehensive drug history of the patient. b3- Document drug adverse reactions. b4- Observe, record and analyze the effect of drugs on biological tissues b5- Write prescriptions for musculoskeletal diseases. b6- Audit prescriptions citing multiple drugs. c- Professional skills By the end of the course the candidate will be able to: c1- integrate, analyse and summarise information relating to practical aspects or current advances, issues and controversies within the pharmacological sciences from a wide range of sources and evaluate this information to draw reasoned conclusions or sustainable judgements; c2- think independently, evaluate and reflect, set tasks and select appropriate and reasoned approaches to solve problems; c3- use knowledge and understanding of the pharmacological sciences to formulate and apply theprinciples of scientific inquiry to address pharmacologyrelated problems; c4- apply the knowledge and understanding of the pharmacological sciences to plan and undertake hypothesis-driven pharmacological research. c5- demonstrate confidence and competency in understanding, analysing and interpreting pharmacological data d- General and transferable skills By the end of the course the candidate will be able to: d1- Demonstrate respect to all patients irrespective of their socioeconomic levels, culture or religious beliefs and use language appropriate to the patients culture . d2- Provide appropriate basic drug education to the patient and his family. d3- Communicate effectively with other health care professionals to maximize patient benefits and minimize the risk of errors. d4- Understand the importance of life-long self-learning and show a strong commitment to it. d5- Use current IT for appropriate drug database to reach information about a specific medication. d6- Respect patients beliefs, values and privacy.

25

d7- Respect ethics related to drug prescription and use specially to drugs liable to produce abuse. d8- Recognize and effectively deal with unethical behavior of other members of healthcare team. 3- Course content: Topics Drug therapy of heart failure. Diuretics Drug therapy of shock Drug therapy of ischemic heart disease and dyslipidemia Drug therapy of dysrrythmias Drug therapy of hypertension Anemia . Drugs and hemostasis Anti-emetics Drug therapy of acid related disorders Drug therapy of constipation and diarrhea Drug therapy of DM Thyroid disorders. Calcium metabolism Special chemotherapy: Antiviral, antifungal, antiprotozoal & antituberculous Immunomodulators Drug therapy of bronchial asthma. Corticosteriods Cancer chemotherapy Sex hormones antagonists Antihistaminic Analgesics Anti-bacterials L: Lectures and SDL: Self directed learning 4 - Student Assessment Methods 4.1 written exam to assess knowledge, skills Weighing of assessment 4.1 written exam 50 Total 50 5 -- List of References 5.1- Course Notes (paper and / or electronic) None 5.2- Essential Books (Text Books) 5.3- Recommended Books Principles of Clinical Pharmacology 5.4- Periodicals, Web Sites, etc No of hours L 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

26

http://www.centerwatch.com/drug-information/fda-approvals/drugareas.aspx?AreaID=8 http://www.medilexicon.com/drugsearch.php?a=19 http://www.chilanti.com/olbooks/medbooks/Cochrane_Musculoskeletal_Group.ht m medical biochemistry and Molecular biology course specification University: Ain Shams University Faculty: of Medicine Course specifications Program on which the course is given: Master of Science in Internal Medicine. Major or minor element of programs: Major. Department offering the program: General Internal Medicine department. Department offering the course: Medical biochemistry and Molecular biology department. Academic Level: Master 1st semester Date of specification approval: .. A- Basic Information Title: Medical biochemistry and Molecular biology course Credit Hours: 1 hour Lecture: 1/week Coordinator Medical biochemistry and Molecular biology department B - Professional Information 1- Course Aims: 1- To enable students to understand the essential topics of biochemistry including micro- and macromolecules of carbohydrates, lipids, proteins, nucleotides and nucleic acids. 2- To enable the student to describe the biological membrane, the role of free nucleotides in signal transduction control, and macromolecules involved in transmission of information from gene expression to the formation of functioning proteins. 3- To familiarize the students with basic principles of Molecular biology and protein synthesis. 4- To enable the student to be familiar with biotechnology methods and their clinical implications. 5- To make the student oriented with the physico-chemical basis of the biological systems; and the related clinical problems

Code: GIM6004 Total: 15

27

2- Intended Learning Outcomes (ILOs) from the Course: a- Knowledge and understanding By the end of the course the candidate will be able to: a1- Describe the structure and properties of caribodydrates, lipids and proteins of biological importance. a2- Describe the structure of cell membrane and point out its importance. a3- Describe the structure of heme and proteins of the extra-cellular matrix. a4- Demonstrate the structure and importance of immunoglobulins. a5- Describe the chemistry of nucleotides and nucleic acids. a6- Point out the processes of replication, transcription and translation. a7- Describe recombinant DNA biotechniques. a8- Point out the significance of human genome project and the principles of gene therapy. b- Intellectual skills By the end of the course the candidate will be able to: 1- Interpret the observations of chemical tests to identify unknown sugar or protein solutions. 2- Identify electrophoresis bands and comment on them. 3- Interpret the photographs of electrophoresis runs of Polymerase chain reaction (PCR) products. c- Professional skills By the end of the course the candidate will be able to: c1- Select the proper investigation. c2- Read and evaluate scientific literatures. d- General and transferable skills By the end of the course the candidate will be able to: d1- Work effectively in a group during preparation of seminars. d2- Respects the role of staff and co-staff members regardless of degree or occupation. 3- Course content: Topics 1) Carbohydrate metabolism 2) Lipid metabolism 3) Metabolism of protein 4) Hormone biosignaling 5) Fe and heam metabolism

No. of hours L 2 2 2 1 1

28

6) Mineral metabolism 7) Vitamins and diseases 8) Hyperuricemia 9) Diagnostic enzymology 10) Tumour markers 11) Hepatitis markers 12) Molecular biology L: Lecture 4 - Student Assessment Methods 4.1written exam to assess knowledge and understanding Weighing of assessment 4.1 written exam 50 Total 50 5 -- List of References 5.1- Course Notes (paper and / or electronic) Electronic lectures 5.2- Essential Books (Text Books) Lecture notes on molecular medicine 5.3- Recommended Books Harper's Biochemistry. * Lippincott's Illustrated Biochemistry. 5.4- Periodicals, Web Sites, etc

1 1 1 1 1 1 1

Clinical Microbiology course specification University: Ain Shams University Faculty: of Medicine Course specifications Program on which the course is given: Master of Science in Internal Medicine. Major or minor element of programs: Major. Department offering the program: General Internal Medicine department. Department offering the course: Microbiology and Immunology department. Academic Level: Master 1st semester Date of specification approval: .. A- Basic Information Title: Clinical microbiology course Code: GIM6005 Credit Hours: 1 hour Lecture: 1/week Total: 15 Coordinator Microbiology and Immunology department.

29

B - Professional Information 1- Course Aims: 1- To educate students about the basic features of general bacteriology, virology and mycology and to provide students with an understanding of the immune system, its protective functions and its role in the patho-physiology of infectious and non- infectious diseases 2- To familiarize students with the common infections and diseases of medical importance, their microbial causes, as well as laboratory diagnosis, treatment, prevention and control of such diseases 3- To enable the students to practice the principles of sterilization and infection control. 2- Intended Learning Outcomes (ILOs) from the Course: a- Knowledge and understanding By the end of the course the candidate will be able to: a1- Illustrate general bacterial morphology, physiology and genetics. a2- Understand the host parasite relationship and microbial pathogenesis. a3- Explain the physiology of the immune system, its beneficial role, as well as its detrimental role in hypersensitivity, autoimmunity and transplant rejection. a4- Describe the morphology, culture, antigenic structure and virulence factors of microorganisms of medical importance. a5- Recognize the most important infectious clinical conditions and outline the diagnosis, treatment, prevention and control of the most likely organisms causing such diseases. a6- Describe the most important methods of decontamination and principles of infection control a7- Describe recombinant DNA biotechniques. a8- Describe the basics of antimicrobial uses and resistance. b- Intellectual skills By the end of the course the candidate will be able to: b1- Interpret results of microbiological, serological and molecular tests b2- Interpret microbiological, immunological and molecular reports b4- Formulate a systematic approach for laboratory diagnosis of common infectious clinical conditions and select the most appropriate and cost-effective tool leading to the identification of the causative organism b5- Evaluate according to evidence the causal relationship of microbes and diseases b6- Categorize a microorganism as a bacterium, virus or fungus according to standard taxonomy

30

b7- Report and appraise a concise scientific activity according to standard scientific thinking and integrity b8- Appreciate the danger of handling and use of infectious agents on community and environment as a part of their ethical heritage c- Professional skills By the end of the course the candidate will be able to: c1- Identify medically important bacteria based on microscopic examination of stained preparations c2- Perform a Gram stain and a Ziehl-Neelsen stain and identify, according to morphology and characteristics, stained preparations c3- Identify culture media and biochemical tests commonly used for bacterial identification and distinguish positive and negative results c4- Perform hand wash and control of steam sterilization c5- Select the proper investigation. c6- Read and evaluate scientific literatures. d- General and transferable skills By the end of the course the candidate will be able to: d1- Work effectively in a group during preparation of seminars. d2- Respects the role of staff and co-staff members regardless of degree or occupation. 3- Course content: Topics Bacterial structure, physiology, & classification Bacterial genetics, Antibacterial agents, mechanisms of action and resistance Staphylococci, Streptococci & Enterococci Clostridia and other Gram positive bacilli (Corynebacteria, Listeria, bacillus group and actinomyces) Neisseria and Parvobacteria (Haemophilus, Bordetella, Brucella, Legionella, Yersinia & Pasteurella) Enterobacteriaceae Pseudo monads, Vibrios, Campylobacter & Helicobacter Gram negative anaerobic bacteria Spirochetes Mycobacteria Chlamydia, Mycoplasma, Rickettsia Basic Mycology: classification of fungi, antifungal drugs Basic Virology Major Virus Groups Basic immunology: Tissues and cells of immune response, types No. of hours L 1 1

1 1 1 1 1 1 3

31

of immune response, Immunoglobulins, Humoral immune response, complement, Ag-Ab reactions Cell-mediated immunity, Cytokines, immunity to bacterial infection and immunoprophylaxis Hospital-acquired infection and infection Hypersensitivity Autoimmunity and tumor Immunology Immupodeficiency and infections in immunocompromized host L: Lecture 4 - Student Assessment Methods 4.1written exam to assess knowledge and understanding Weighing of assessment 4.1 written exam 50 Total 50 5 -- List of References 5.1- Course Notes (paper and / or electronic) 5.2- Essential Books (Text Books) Jawetz, Melnick and Adelbergs Medical Microbiology 5.3- Recommended Books

1 1 1 1

5.4- Periodicals, Web Sites, etc http://www.phage.org/black09.htm http://www.microbe.org/microbes/virus_or_bacterium.asp http://www.bact.wisc.edu/Bact330/330Lecturetopics http://whyfiles.org/012mad_cow/7.html http://www.microbelibrary.org/ http://www.hepnet.com/hepb.htm http://www.tulane.edu/~dmsander/Big_Virology/BVHomePage.html http://www.mic.ki.se/Diseases/c2.html http://www.med.sc.edu:85/book/welcome.htm http://www.biology.arizona.edu/immunology/microbiology_immunology.html Internal Medicine course specification University: Ain Shams University Faculty: of Medicine Course specifications Program on which the course is given: Master of Science in Internal Medicine. Major or minor element of programs: Major Department offering the program: General Internal Medicine department.

32

Department offering the course: General Internal Medicine department Academic Level: Master 2nd, 3rd and 4th semester. Date of specification approval: .. A- Basic Information Title: Internal Medicine course Code: GIM6006 Credit Hours: 17 hour Lecture: 2/w Total: 90 Clinical: 8/w 2nd and 3rd semesters Clinical: 6/w 4th semester Total: 330 Coordinator General Internal Medicine department B - Professional Information 1- Course Aims: 1-Facilitate the development of a physician able to function as an independent consultant in General Internal Medicine. 2- Respond to the educational and research training needs of doctors with a special interest in Internal Medicine. 3- Meet the needs of MSc candidates whilst they are completing their clinical training or working in clinical practice. 4- Provide study modules designed to give candidates a sound understanding of concepts and research. 5- Provide trainees with additional advanced modules, this will allow them to undertake more indepth studies of specific areas in Internal Medicine according to individual interest. 6- Support evidence-based Internal Medicine practice. 7- Give trainees an opportunity to produce a detailed dissertation on a special topic of interest. 2. Intended learning outcomes (ILOs): a. Knowledge and understanding: By the end of this program the student should be able to: a1- Recognize physiology, pathology, cellular and molecular biology, microbiology and pharmacology relevant to Internal Medicine diseases. a2- Describe different types of Internal Medicine Diseases and emergencies in adult and geriatric age groups. a3- Identify the role of imaging techniques in the investigation of the diseases. a4- Recognize different types laboratory investigations needed for the diagnosis of diseases. a5- Know the place of measurement techniques using imaging (bone densitometry and ultrasonography) in the investigation diseases.

33

a6- List the drugs used in the disease tratment, their indications, actions and monitoring. a7- Outline the role of allied medical specialties (such as Rehabilitation) a8- Outline the role of patient education. a9- Recognize the socioeconomic and legal aspects diseases. a10- Identify the role of non-conventional medicine in treatment of diseases. a11 Know the basis of hospital management. a12 Understand the basis of infection control. b. Intellectual capabilities: By the end of this program the student should be able to: b1- Classify different medical disorders. b2 Differentiate different medical from each other. b3 - Assess multi-system disease. b4 - Select appropriate laboratory tests. b5 - Interpret appropriate laboratory tests. b6 - Select appropriate imaging technique for diagnosis of different medical disorders. b7 - Interpret radiological imaging. b8 - Select the proper line of treatment. c. Professional and practical skills: By the end of this program the student should be able to: c1- Obtain a proper, reliable history c2- Perform an adequate clinical examination for the patient and elicit abnormal physical signs. c3- Interpret the patient data (history and examination) in an organized and informative manner. c4- Perform Procedural Skills (Central venous line placement, horacentesis, Lumbar puncture, Abdominal paracentesis, Arterial puncture for blood gas analysis and Nasogastric intubation.etc). c5- investigate clinical problems in a prioritised, systematic, well informed and cost effective way c6- Recognize and carry out the treatment of the emergency situations c7- Perform as a either a consultant or a principal care provider when required. c8- Expertise in the ongoing care and management of chronic diseases including preventive and public health medicine and the community aspects of disease. c9- The ability to determine the appropriate time and conditions when referral to another specialist is indicated or transfer to a specialist unit. c10- Manage patients in a holistic way, considering all psycho-social as well as medical factors for improving quality of life.

34

c11- Plan and achieve successful patient discharge from hospital, including knowledge of the various discharge options. c12- Determine when the emphasis of treatment should change from the curative to the palliative in patients whose prognosis is limited. d. General and transferable skills: By the end of this program the student should be able to: d1) Establish Effective Doctor / Patient Relationships 1) Communication Skills d111- Promote trust and cooperation, and to help patients cope with distressing or other emotions. d112- Demonstrate the following skills: - active listening; understanding the need for and enabling the ventilation of feelings; warmth, support and empathy; respect; guidance; partnership. d113- Educate and motivate patients towards co-operating with advice. d114- Demonstrate the following skills: elicitation of existing views/ knowledge; offering clear explanation and instruction; checking understanding; evaluating problems; using positive attribution and praise. d115- Deal with special situations e.g. breaking bad news to patients and relatives; other sensitive issues; preparation for threatening procedures; obtaining informed consent; Conducting family conferences; dealing with complaints etc. 2) Ethical principles d121- demonstrate respect and dignity of patients; their right to privacy and confidentiality; Their right to the best possible care; Their right to autonomy and informed consent; Their right to decline treatment or to take part in teaching or research etc. d2- Demonstrate Leadership and personal management skills 1) Personal achievement d211- Exercise independent judgement and clinical self-confidence. d212- Be self-directed and to achieve objectives. d213- Have high internal standards and a desire to improve. d214- Maintain effective work performance under pressure when appropriate and to cope with ones own emotions. d215- Accept and act on constructive criticism ii) Interpersonal skills --d221- Initiate, build and maintain good relationships, both one to one and in groups. d222- Lead by example. d223- Put oneself in the place of another and correctly interpret their concerns and feelings.

35

d224- Calculate in advance the likely effect of ones words or actions on an individual or group in order to bring about a desired effect. d225- Time ones actions or interventions in order to maximise their effectiveness. iii) Managing others d231- Get others to work effectively by planning and delegating work. d232 - Coach and supervise others and give clear feedback about performance, good or bad. d3) Acquire the following Organisation, Planning and Service Management skills d31 - Conduct and administer a general medical service, including seeing patient referrals, dictating letters, summaries and reports etc. d32- Liaise and work effectively with professional colleagues, particularly general practitioners and members of the multidisciplinary team. d33- Participate in committee work concerned with planning and organising services. d34- Supervise and work with a medical Secretary. d35- Develop a strategic view on the needs and direction of the service. d4) Acquire the following Education and Mentoring Skills i) Being a Role Model d411-The ability to set an example of good practice and be respected as a Physician. ii) Educational Supervision d421- Motivate, demonstrate and explain, particularly the reasons for clinical decisions. d422 - Build relationships with trainees. d423- Use appropriate teaching methods and styles. d424- Assess the performance of trainees d5) Acquire the following Quality Standards, Effectiveness, Research and Development Skills. d51- Present the results of audit or research papers to both small and large audiences. d52- Evaluate research publications to assess their importance. d53- Reflect on clinical practice and plan future educational needs. d54- Maintain an expert knowledge of the diagnosis and treatment of a broad range of common acute disorders through systematic

3- Course content:

36

2nd semester Title: Module 1 Credit Hours: 6 Module 1 Topics

Code: GIM6006 a Lecture: 2/w Clinical: 8/w

Total: 30 Total: 120 No of hours L 6 6

Disease of the gastrointestinal tract 1 + 2 Disease of the liver, biliary system, 1 + 2 pancreas and peritoneum Neurology 7 1 + 2 Nephrology 7 Distrurbance in the water, electrolyte and 4 acid base balance 3rd semester Title: Module 2 Code: GIM6006 b Credit Hours: 6 Lecture: 2/w Total: 30 Clinical: 8/w Total: 120 Module 2 Topics No of hours L Hematology and oncology 8 31 Genetics 2 31 Poisoning 2 31 Allergy and immunology 7 6 Diseases due to infection 4 6 Disease of the respiratory system 7 6 4th semester Title: Module 3 Code: GIM6006 c Credit Hours: 5 Lecture: 2/w Total: 30 Clinical: 6/w Total: 90 Module 3 Topics No of hours L Endocrinology and metabolism 8 5 Disease of cardiovascular system 8 5 Nutritional factors in disease 2 5 Rheumatology 8 21 Principle of geriatric medicine 2 21 Diseases of the skin 2 21

37

L: Lecture, T: Tutorial, C: Clinical and SDL: Self directed learning Internal Medicine course Titles and subtitles CARDIOVASCULAR DISEASE STRUCTURE AND FUNCTION OF THE NORMAL HEART AND BLOOD VESSELS Gross Anatomy Electrical Conduction System Microscopic Anatomy Fetal Circulation Myocardial Metabolism Circulatory Physiology Physiology of the Coronary Circulation Physiology of the Systemic Circulation Physiology of the Pulmonary Circulation Cardiovascular Response to Exercise Cardiovascular Physiology During Pregnancy Electrophysiology EVALUATION OF THE PATIENT WITH CARDIOVASCULAR DISEASE History Arterial Pressure and Pulses Examination of the Neck Veins Precordial Examination Cardiac Auscultation Abnormal Heart Sounds Abnormal Murmurs Prosthetic Valve Sounds SPECIAL TESTS AND PROCEDURES IN THE PATIENT WITH CARDIOVASCULAR DISEASE Cardiac Radiography Electrocardiography Abnormal ECG Patterns Long-Term Ambulatory ECG Recording Stress Testing Echocardiography Nuclear Cardiology Other Techniques

38

Cardiac Catheterization Special Techniques CONGESTIVE HEART FAILURE Evaluation and Treatment of Patients with Heart Failure Diuretics Vasodilators Digitalis Sympathomimetic Amines Cardiovascular Assist Devices Acute Pulmonary Edema Diastolic Heart Failure CONGENITAL HEART DISEASE Bicuspid Aortic Valve Coarctation of the Aorta Pulmonic Valve Stenosis Atrial Septal Defect Ventricular Septal Defect Patent Ductus Arteriosus Tetralogy of Fallot General Considerations in the Evaluation and Management of Adults with congenital Heart Disease ACQUIRED VALVULAR HEART General Considerations Aortic Stenosis Aortic Regurgitation Mitral Stenosis Mitral Regurgitation Mitral Valve Prolapse Tricuspid Stenosis Tricuspid Regurgitation Pulmonic Stenosis and Regurgitation Multivalvular Disease Rheumatic Fever Prosthetic Valves CORONARY HEART DISEASE Atherosclerosis Risk Factors

39

Nonatherosclerotic Causes of Coronary Artery Obstruction Nonobstructive Causes of Ischemic Heart Disease Pathophysiology of Ischemic Heart Disease Angina Pectoris Medical Management of Angina Coronary Bypass Surgery and Coronary Angioplasty for Angina Pectoris Variant Angina Acute Myocardial Infarction Treatment of Acute Myocardial Infarction Thrombolytic Therapy and Primary Coronary Angioplasty for Acute Myocardial Infarction Other Measures Non-Q Wave Myocardial Infarction Complications of Myocardial Infarction and Their Management ARRHYTHMIAS Mechanisms of Arrhythmogenesis Approach to the Patient with Suspected or Confirmed Arrhythmias Management of Cardiac Arrhythmias Specific Arrhythmias Principles of Cardiopulmonary Resuscitation MYOCARDIAL AND PERICARDIAl DISEASE Myocardial Disease Pericardial Disease CARDIAC TUMORS AND TRAUMA Cardiac Tumors Nonpenetrating Trauma Penetrating Trauma AORTIC AND PERIPHERAL VASCULAR DISEASE Aortic Aneurysms Aortic Dissection Aortic Arteritis Miscellaneous Aortic Disease Peripheral Vascular Disease Peripheral Aneurysms and Fistulas Arterial Trauma Peripheral Venous Disease Deep Vein Thrombosis

40

OTHER CARDIAC TOPICS A. Transplantation B. Surgery C. Pregnancy RESPIRATORY DISEASE APPROACH TO THE PATIENT WITH RESPIRATORY DISEASE Common Presenting Complaints Physical Examination ANATOMIC AND PHYSIOLOGIC CONSIDERATIONS The Airway Ventilation The Blood Vessels Pulmonary Gas Exchange Nonpulmonary Factors Growth and Aging of the Normal Lung Nonrespiratory Functions of the Lung 125 DIAGNOSTIC TECHNIQUES AND THEIR INDICATIONS Imaging Procedures Pulmonary Function Evaluation OBSTRUCTIVE lUNG DISEASE Pathophysiology of Airway Obstruction Asthma Chronic Obstructive Pulmonary Disease (COPD) Emphysema Small Airway Disease Chronic Bronchitis Bronchiectasis Cystic Fibrosis Treatment Pharmacologic Therapy Oxygen Antibiotics and Vaccines Smoking Cessation Physical Therapy and Rehabilitation Volume Reduction Surgery and Lung Transplantation

41

DIFFUSE INFilTRATIVE DISEASES OF THE lUNG Clinical Manifestations Specific Entities Treatment PULMONARY VASCULAR DISEASE Physiologic Effects of Pulmonary Hypertension Causes of Pulmonary Hypertension Pulmonary Embolism Primary Pulmonary Hypertension DISORDERS OF THE PLEURAL SPACE, MEDIASTINUM, AND CHEST WALL Pleural Disease Mediastinal Disease Chest Wall Disease NEOPLASTIC DISEASES OF THE LUNG Lung Tumor Biology Pathology Clinical Presentation Diagnosis and Evaluation Solitary Pulmonary Nodule Treatment and Prognosis CONTROL OF BREATHING IN DISEASE STATES Sleep Apnea Syndrome Breathing Pattern Abnormalities Associated with Neurologic Disease Neuromuscular Disease INHALATIONAL AND ENVIRONMENTAL INJURY Drowning and Near-Drowning Diseases of Altitude Smoke Inhalation Injury Noxious Gases and Fumes PULMONARY CRITICAL CARE ESSENTIALS OF PULMONARY CRITICAL CARE MEDICINE Shock Acute Respiratory Failure Oxygen Therapy and Mechanical Ventilation

42

Multiple Organ Dysfunction Syndrome, Systemic Inflammatory Response Syndrome, Sepsis, and Adult Respiratory Distress Syndrome RENAL DISEASE ELEMENTS OF RENAL STRUCTURE AND FUNCTION Elements of Renal Structure Elements of Renal Physiology Renal Homeostatic Functions APPROACH TO THE PATIENT WITH RENAL DISEASE Clinical Assessment of the Patient with Renal Disease The Major Renal Syndromes Anatomic Imaging of the Urinary Tract FLUID AND ELECTROLYTE DISORDERS Volume Disorders Osmolality Disorders Hyponatremia Hypernatremic Disorders Disturbances in Potassium Balance Disturbances in Acid-Base Balance GLOMERULAR DISEASES The Glomerulus Mechanisms of Glomerular Injury Clinical Manifestations of Glomerular Disease Approach to the Patient with Glomerular Disease Acute Nephritic Syndrome Rapidly Progressive Glomerulonephritis (RPGN) Nephrotic Syndrome Asymptomatic Urinary Abnormalities Chronic Glomerulonephritis (CGN) MAJOR NONGLOMERULAR DISORDERS Tubulointerstitial Nephropathy Cystic Diseases of the Kidney Urinary Tract Obstruction Nephrolithiasis Renal Tumors

43

HYPERTENSION AND VASCULAR DISORDERS OF THE KIDNEY Arterial Hypertension Vascular Disorders of the Kidney ACUTE RENAL FAILURE Definition and Etiology Differential Diagnosis and Diagnostic Evaluation of the Patient Clinical Presentation, Complications, and Management of Acute Tubular Necrosis Specific Causes of Acute Renal Failure CHRONIC RENAL FAILURE Adaptation to Nephron Loss Clinical Manifestations of Renal Failure Kidney Transplantation GASTROINTESTINAL DISEASE THE COMMON CLINICAL MANIFESTATIONS OF GASTROINTESTINAL DISEASE A. Abdominal Pain B. Gastrointestinal Hemorrhage C. Malabsorption D. Diarrhea RADIOGRAPHIC AND ENDOSCOPIC PROCEDURES IN GASTROENTEROLOGY Radiographic Procedures Endoscopic Procedures DISEASES OF THE ESOPHAGUS Normal Esophageal Physiology Clinical Symptoms of Esophageal Disease Gastroesophageal Reflux Disease Motility Disorders of the Oropharynx and Esophagus Other Esophageal Disorders DISEASES OF THE STOMACH AND DUODENUM Normal Gastric Physiology Gastritis Peptic Ulcer Disease of the Stomach and Duodenum The Zollinger-Ellison Syndrome

44

Abnormalities of Gastric Emptying INFLAMMATORY BOWEL DISEASE Definition Etiology and Pathogenesis Pathology Clinical Manifestations Diagnosis Treatment and Prognosis Complications Ischemic Colitis Diverticulitis NEOPLASMS OF THE GASTROINTESTINAL TRACT Carcinoma of the Esophagus Carcinoma of the Stomach Carcinoma of the Colon Polyps of the Gastrointestinal Tract The Familial Polyposis Syndromes THE PANCREAS Normal Structure and Function Acute Pancreatitis Chronic Pancreatitis Carcinoma of the Pancreas DISEASES OF THE LIVER AND BILIARY SYSTEM LABORATORY TESTS IN LIVER DISEASE Clinical Approach to Liver Disease Laboratory Tests of Liver Function and Disease Tests of Hepatic Function Screening Tests of Hepatobiliary Disease Liver Biopsy JAUNDICE Definition Bilirubin Metabolism Laboratory Tests for Bilirubin Clinical Classification of Jaundice Approach to the Diagnosis of Jaundice

45

ACUTE AND CHRONIC HEPATITIS Definition Acute Hepatitis Chronic Hepatitis FULMINANT HEPATIC FAILURE Diagnosis Treatment Hepatic Transplantation Prognosis CIRRHOSIS OF THE LIVER AND ITS COMPLICATIONS Definition Clinical and Laboratory Features Specific Causes of Cirrhosis Major Complications of Cirrhosis Hepatic Transplantation NEOPLASTIC, INFILTRATIVE, AND VASCULAR DISEASES OF THE LIVER Hepatic Neoplasms Liver Abscess Granulomatous Liver Disease Vascular Disease of the Liver DISORDERS OF THE GALLBLADDER AND BILIARY TRACT Normal Biliary Physiology Pathophysiology of Gallstone Formation (Cholelithiasis) Clinical Manifestations of Gallstones HEMATOLOGIC DISEASE THE BLOOD AND BONE MARROW The Blood The Bone Marrow DISORDERS OF THE HEMATOPOIETIC STEM CELL The Myeloaplastic Disorders The Myelodysplastic Disorders Myeloproliferative Disorders

46

Acute Leukemia DISORDERS OF LYMPHOCYTES Ontology of Lymphocytes Localization of Lymphocytes Disorders of the Lymphatic System Plasma Cell Disorders DISORDERS OF GRANULOCYTES AND MONOCYTES Neutrophil Structure and Function Monocyte Structure and Function Neutropenia Neutrophil Leukocytosis Eosinophilia DISORDERS OF RED CELLS Shape and Structure of Red Cells Birth and Death of Red Cells Anemia TRANSFUSION AND BONE MARROW TRANSPLANTATION Transfusion Allogeneic Bone Marrow Transplantation (BMT) PLATELETS AND PRIMARY HEMOSTASIS Primary Hemostasis Quantitative Platelet Disorders Thrombocytosis Qualitative Platelet Disorders Vascular Purpuras Plasma Protein Disorders Affecting Primary Hemostasis BLOOD COAGULATION AND ITS DISORDERS Secondary Hemostasis and Clot Stabilization Factor Inhibitors Natural Anticoagulants and the Fibrinolytic Pathway Primary Hypercoagulable States Secondary Hypercoagulable States Therapy of Thromboembolic Disease

47

ONCOLOGIC DISEASE GENERAL CONSIDERATIONS IN ONCOLOGY Etiology Screening for Early Cancer Detection Systemic Effects of Cancer PRINCIPLES OF CANCER THERAPY Forming a Treatment Plan 432 Principles of Oncologic Surgery Principles of Radiation Therapy Principles of Chemotherapy Hormonal Therapy ONCOLOGIC EMERGENCIES Hypercalcemia Spinal Cord Compression Increased Intracranial Pressure Superior Vena Cava Syndrome METABOLIC DISEASE INTRODUCTION TO METABOLIC DISEASE EATING DISORDERS Obesity Anorexia Nervosa and Bulimia Nervosa PRINCIPLES OF NUTRITIONAL SUPPORT IN ADULT PATIENTS Nutritional Assessment Route of Nutritional Support Water Calories and Protein Vitamins and Minerals Home Nutritional Support HYPERURICEMIA AND GOUT Mechanisms of Hyperuricemia Pathogenesis of Gout Arthritis Pathogenesis of Renal Disease Pathogenesis of Tophi Clinical Features Treatment

48

DISORDERS OF LIPID METABOLISM Plasma Lipoprotein Physiology Evaluation of Serum Lipoprotein Concentrations Elevated Chylomicrons, VLDL, and IDL Treatment of Hypertriglyceridemia Elevated LDL Treatment of Hypercholesterolemia Lipids and Vascular Disease DISORDERS OF METALS AND METALLOPROTEINS Wilson's Disease Hemochromatosis The Porphyrias DISORDERS OF AMINO ACID METABOLISM Homocystinemia Cystinuria INHERITED DISORDERS OF CONNECTIVE TISSUE Osteogenesis Imperfecta Ehlers-Danlos Syndrome Marfan's Syndrome Mucopolysaccharidoses

ENDOCRINE DISEASE HYPOTHALAMIC-PITUITARY AXIS Anatomy Anterior Pituitary Hormone Physiology and Testing Neuroradiologic Evaluation of the Pituitary Pituitary and Hypothalamic Disorders Hypothalamic Dysfunction Hypopituitarism Empty Sella Syndrome Pituitary Tumors The Posterior Pituitary Gland SIADH THE THYROID GLAND Thyroid Hormone Physiology

49

Thyroid Evaluation Hyperthyroidism Graves' Disease Toxic Adenoma Toxic Multinodular Goiter Thyroiditis Thyrotoxicosis Factitia Rare Causes of Thyrotoxicosis Hypothyroidism Goiter Solitary Thyroid Nodules Thyroid Carcinoma ADRENAL GLAND Physiology Adrenal Insufficiency Hyporeninemic Hypoaldosteronism Congenital Adrenal Hyperplasia Syndromes of Adrenocorticoid Hyperfunction FEMALE REPRODUCTIVE ENDOCRINOLOGY Normal Sexual Development Precocious Puberty Amenorrhea Hirsutism Infertility Dysmenorrhea Premenstrual Syndrome (PMS) Menopause CANCER OF THE BREAST, CERVIX, UTERUS AND OVARY Cancer of the Breast Carcinoma of the Cervix Cancer of the Uterus Ovarian Carcinoma MALE REPRODUCTIVE ENDOCRINOLOGY Hypogonadism Primary Gonadal Abnormalities Defects in Androgen Action Impotence

50

Gynecomastia Testicular Tumors Benign Prostatic Hyperplasia Carcinoma of the Prostate DIABETES MELLITUS Basic Classification Diagnosis Pathogenesis Treatment of Diabetes Complications HYPOGLYCEMIA Definition of a Low Blood Glucose Level Normal Physiology Causes of Hypoglycemia Diagnostic Work-Up for Hypoglycemia Treatment DISEASES OF BONE AND BONE MINERAL METABOLISM NORMAL PHYSIOLOGY OF BONE AND BONE MINERALS Bone Structure and Metabolism Calcium Metabolism Phosphorus Metabolism Magnesium Metabolism Vitamin D Calcitonin THE PARATHYROID GLANDS, HYPERCALCEMIA, AND HYPOCALCEMIA Normal Physiology Hypercalcemia Hypocalcemia OSTEOMALACIA AND RICKETS Pathogenesis Specific Causes Clinical Manifestations Laboratory and Radiographic Features Diagnosis

51

Treatment OSTEOPOROSIS General Considerations Etiology and Pathogenesis Clinical Manifestations Radiographic Findings Diagnosis Treatment Glucocorticoid-Induced Bone Loss PAGET'S DISEASE OF BONE Incidence and Prevalence Etiology Pathology and Pathophysiology Clinical Picture Associated Conditions Laboratory Assessment Treatment MUSCULOSKELETAL AND CONNECTIVE TISSUE DISEASE APPROACH TO THE PATIENT WITH MUSCULOSKELETAL DISEASE Laboratory Tests Radiologic Evaluation RHEUMATOID ARTHRITIS Pathogenesis Clinical Manifestations Treatment SYSTEMIC LUPUS ERYTHEMATOSUS Etiology and Pathogenesis Clinical Features Laboratory Evaluation Treatment SJOGREN'S SYNDROME Clinical Features Diagnosis Treatment

52

IDIOPATHIC INFLAMMATORY MYOPATHIES Clinical Course Diagnostic and Laboratory Findings Treatment SCLERODERMA (SYSTEMIC SCLEROSIS) Localized Scleroderma Limited Systemic Sclerosis (CREST Variant) Diffuse Systemic Sclerosis Scleroderma Sine Scleroderma Clinical Features Differential Diagnosis Treatment MIXED CONNECTIVE TISSUE DISEASE, OVERLAP SYNDROME, AND ANTIPHOSPHOLIPID ANTIBODY SYNDROME Mixed Connective Tissue Disease and Overlap Syndrome Antiphospholipid Antibody Syndrome VASCULITIDES Classification Immunopathogenesis Hypersensitivity Angiitis Polyarteritis Nodosa Allergic Vasculitis of Churg and Strauss Wegener's Granulomatosis Polymyalgia Rheumatica and Giant Cell Arteritis THE SPONDYLOARTHROPATHIES Ankylosing Spondylitis Reiter's Syndrome Psoriatic Arthritis Arthritis Associated with Inflammatory Bowel Disease OSTEOARTHRITIS Classification Etiology and Pathogenesis Clinical Features Differential Diagnosis Treatment

53

THE CRYSTAL-INDUCED ARTHROPATHIES Chondrocalcinosis and Associated Disorders MISCELLANEOUS FORMS OF ARTHRITIS Musculoskeletal Syndromes Associated with Malignancy Arthropathies Associated with Endocrine Diseases Additional Miscellaneous Disorders NONARTICULAR RHEUMATISM Painful Shoulder Bursitis Carpal Tunnel Syndrome Fibromyalgia Syndrome INFECTIOUS DISEASE ORGANISMS THAT INFECT HUMANS Viruses Chlamydiae Rickettsiae Mycoplasmas Bacteria Fungi Protozoans Helminths HOST DEFENSES AGAINST INFECTION Local Barriers to Infection Components of the Immune System Nonspecific Effector Mechanisms Resistance to Extracellular Bacteria Resistance to Obligate Intracellular Parasites: Viruses Resistance to Facultative Intracellular Parasites: Mycobacterium Tuberculosis LABORATORY DIAGNOSIS OF INFECTIOUS DISEASES Diagnosis by Direct Visualization of the Organism Diagnosis by Detection of Microbial Antigens Diagnosis by Examination of Host Immune or Inflammatory Responses Diagnosis by detection of Microbial Nucleotide Sequences Diagnosis by Isolation of the Organism in Culture ANTIMICROBIAL THERAPY

54

The Pathogen Site of Infection Characteristics of the Antimicrobial Route of Administration Monitoring of Antimicrobial Therapy Antiviral Agents Antifungal Agents FEVER AND FEBRILE SYNDROMES Regulation of Body Temperature Fever and Hyperthermia Acute Febrile Syndromes FUO BACTEREMIA Epidemiology Pathogenesis Clinical Manifestations Diagnosis Therapy INFECTIONS OF THE NERVOUS SYSTEM Meningitis Encephalitis Spectrum of Tuberculous, Fungal, and Parasitic Infections INFECTIONS OF THE HEAD AND NECK Infections of the Ear Infections of the Nose and Sinuses Infections of the Mouth and Pharynx INFECTIONS OF THE LOWER RESPIRATORY TRACT Pathogenesis of Pneumonia Epidemiology Diagnostic Approach to the Patient Radiographic Patterns in Patients with Pneumonia Other Laboratory Findings Diagnosis and Management of the Patient with Pneumonia Specific Pathogenic Organisms Treatment and Outcome

55

Prevention INFECTIONS OF THE HEART AND VESSELS Infective Endocarditis (IE) Prosthetic Valve Endocarditis (PVE) prophylaxis of Infective Endocarditis Bacterial Endarteritis and Suppurative Phlebitis SKIN AND SOFT TISSUE INFECTIONS Superficial Infections of the Skin Deeper Infections of the Skin and Soft Tissue INTRA-ABDOMINAL ABSCESS AND PERITONITIS Intra-Abdominal Abscess Abscesses of Solid Organs Extravisceral Abscesses Peritonitis ACUTE INFECTIOUS DIARRHEA Pathogenesis and Pathophysiology General Concepts Types of Microbial Diarrheal Diseases General Epidemiologic Considerations 726 Diagnosis Management: General Principles of Electrolyte Repletion Therapy INFECTIONS INVOLVING BONES AND JOINTS Arthritis Septic Bursitis Osteomyelitis INFECTIONS OF THE URINARY TRACT Urethritis Cystitis and Pyelonephritis Prostatitis NOSOCOMIAL INFECTIONS Approach to the Hospitalized Patient with Suspected Nosocomial Infection Nosocomial Pneumonia Intravascular Catheter- Related Infections Pressure Sores Nosocomial Urinary Tract Infection

56

SEXUALLY TRANSMITTED DISEASES Genital Sores Urethritis, Cervicitis, and Pelvic Inflammatory Disease (PID) HIV INFECTION AND THE ACQUIRED IMMUNODEFICIENCY SYNDROME Epidemiology Pathophysiology Diagnosis and Testing for HIV Infection Sequential Clinical Manifestations of HIV-1 Infection Management of HIV Infection Management of Specific Clinical Manifestations of Immunodeficiency: A Problem-Oriented Approach Mucocutaneous Diseases Nervous System Diseases Pulmonary Diseases Gastrointestinal Diseases Other Complications of HIV Infection Prevention of HIV Infection INFECTIONS IN THE IMMUNOCOMPROMISED HOST Disorders of Cell-Mediated Immunity Disorders of Humoral Immunity Impaired Neutrophil Function Neutropenia Diagnostic Problems in the Compromised Host Prevention and Treatment of Infections in the Neutropenic Patient INFECTIOUS DISEASES OF TRAVELERS;PROTOZOAL AND HELMINTHIC INFECTIONS Preparation of Travelers The Returning Traveler Protozoal and Helminthic Infections NEUROLOGIC DISEASE NEUROLOGIC EVALUATION OF THE PATIENT The Neurologic History The Neurologic Examination Diagnostic Tests: Scope and Limitations

57

DISORDERS OF CONSCIOUSNESS AND HIGHER BRAIN FUNCTION A. Sleep and Its Disorders B. Pathologic Alterations of Consciousness C. Focal Disturbances of Higher Brain Function D. Dementia DISORDERS OF MOOD AND BEHAVIOR A. Psychiatric Disorders B. Drug and Alcohol Abuse DISORDERS OF AUTONOMIC FUNCTION Hypothalamus (HT) Central and Peripheral Autonomic Insufficiencies DISORDERS OF SENSORY FUNCTION A. Pain and Painful Syndromes B. The Special Senses DISORDERS OF THE MOTOR SYSTEM A. Mechanisms of Normal and Abnormal Motor Function B. Movement Disorders C. The Major Cerebellar Ataxias D. Mechanical Lesions of the Spine and Spinal Cord CEREBROVASCULAR DISEASE Anatomy and Pathophysiology of the Cerebral Circulation Epidemiology and Risk Factors Ischemic Stroke Spontaneous Parenchymal Cerebral Hemorrhage Intracranial Aneurysms Arteriovenous Malformations (AVMs) TRAUMA TO THE HEAD AND SPINE Head/Brain Injury Spinal Cord Injury EPILEPSY Incidence and General Etiology Pathophysiology Clinical Seizure Patterns

58

Management INTRACRANIAL NEOPLASMS, CNS COMPLICATIONS OF CANCER, AND STATES OF ALTERED INTRACRANIAL PRESSURE Intracranial Neoplasms Spinal Neoplasms Paraneoplastic Syndromes Non-Neoplastic Alterations of Intracranial Pressure INFECTIOUS AND INFLAMMATORY DISORDERS OF THE NERVOUS SYSTEM Bacterial Infections of the Brain Slow Virus Infections of the Nervous System Demyelinating and Other CNS Inflammatory Disorders of Probable Immune Cause MOTOR NERVE, NERVE ROOT, PERIPHERAL NERVE, AND NEUROCUTANEOUS DISORDERS Peripheral Nerve Disorders Mono- and polyneuropathies Affecting Somatic Cranial Nerve Functions Neurocutaneous Syndromes The Motor Neuron Diseases Focal Radiculopathy and Neuropathy Polyneuropathy DISORDERS OF MYONEURAL JUNCTION AND SKELETAL MUSCLE A. Disorders of Myoneural Junction B. Disorders of Skeletal Muscle THE AGING PATIENT THE BIOLOGY OF AGING The Demographics of Aging and Implications for Health Care Assessment of the Older Patient Common and Often Inadequately Assessed Medical Problems of the Elderly SUBSTANCE ABUSE ALCOHOL AND SUBSTANCE ABUSE Screening Tobacco and Alcohol Abuse Prescription Drug Abuse Illicit Drug Abuse

59

4 - Student Assessment Methods 4.1 written exam to assess knowledge, skills 4.2 Clinical exam to assess practical and professional skills 4.3 oral exam to assess General and transferable skills Weighing of assessment 4.1 written exam 370 4.2 Clinical exam 360 4.3 Oral exam 120 Total 850 End semester exam 300 5 -- List of References 5.1- Course Notes (paper and / or electronic) Clinical learning guide (electronic) Handout of lectures. National books approved by the Internal Medicine Council. 5.2- Essential Books (Text Books) Davidsons textbook of medicine Current textbook of medicine Kumar textbook of medicine Recommended Readings and BOOKS for Students: DAVIDSON'S Principles and Practice of Medicine. Clinical Medicine KUMMAR and CLARK. 1000 MCQs for DAVIDSON'S Principles and Practice of Medicine. MCQs for Clinical Medicine KUMMAR and CLARK. HUTCHISONS Clinical Methods. Clinical Examination, MACLEOD, MUNRO. A Guide to Physical Examination, Barbara Bates. 5.3- Recommended Books Cecil textbook of medicine Harrison textbook of medicine 5.4- Periodicals, Web Sites, etc http://emedicine.medscape.com/ http://casesblog.blogspot.com/2006/08/whats-new-in-general-internalmedicine.html http://www.e-meducation.org/links/internal-medicine/ http://meded.ucsd.edu/clinicalmed/extremities.htm http://cme.medscape.com/internalmedicine http://www.cmelist.com/internal_medicine.htm

60

hospital management course specifications University: Ain Shams University Faculty: of Medicine Course specifications Program on which the course is given: Master of Science in Internal Medicine. Major or minor element of programs: Minor Department offering the program: General Internal Medicine department. Department offering the course: Community, Environmental and Occupational Medicine Academic Level: Master 2nd or 3rd or 4th semester. Date of specification approval: .. A- Basic Information Title: Hospital Management Code: E6073 Credit Hours: 1 hour Lecture: 1/w Total: 15 Coordinator Healthcare Quality Unit at Department of Community Medicine B - Professional Information 1- Course Aims: With the growing importance of hospital industry in providing health care to people across the country, hospital management courses are also becoming popular. The government of India is also paying attention on providing health care in both rural and urban areas. The requirement of professional administrators in the hospitals is growing at a rapid pace primarily because the nature of work in hospitals is quite deferent from other organizations. Hospitals are expected to deliver quality service 24 hours a day at a minimal cost. The urgent nature of its work and the level of efficiency that is expected have increased the need of wellformulated hospital management courses throughout the world providing participants with basic hospital management concepts 2- Intended Learning Outcomes (ILOs) from the Course: a- Knowledge and understanding By the end of the course the candidate will be able to: a1- Put Strategic planning a2- Perform operational planning a3- Manage human resources a4- Manage healthcare quality b- Intellectual skills

61

By the end of the course the candidate will be able to: b1- Create effective management systems which allow hospital management to monitor and observe the performance of key hospital processes, organisation arrangements, people and resources. b2- Understand how to respond positively when performance is inadequate and change becomes necessary. c- Professional skills By the end of the course the candidate will be able to: c1- Manage and lead hospital staff c2- Support quality improvement initiatives. c3- Measure hospital performance d- General and transferable skills By the end of the course the candidate will be able to: d1- Work within the organisational, interpersonal and inter-professional dynamics of the clinical team. d2- Make judgements about their strengths and weaknesses and take responsibility for personal support and professional development 3- Course content: Topics Basic concepts and principles management Strategic planning Operational planning Human resources management Quality management Communication skills of hospital No of hours L 3 3 7 7 3 2

4 - Student Assessment Methods 4.1 written exam to assess knowledge, skills Weighing of assessment 4.1 written exam Total

50 50

62

5 -- List of References 5.1- Course Notes (paper and / or electronic) 5.2- Essential Books (Text Books) 5.3- Recommended Books 5.4- Periodicals, Web Sites, etc infection control course specifications University: Ain Shams University Faculty: of Medicine Course specifications Program on which the course is given: Master of Science in Internal Medicine Major or minor element of programs: Minor Department offering the program: General Internal Medicine department Department offering the course: General Internal Medicine department Academic Level: Master 2nd or 3rd or 4th semester Date of specification approval: .. A- Basic Information Title: Infection Control Code: E6059 Credit Hours: 1 hour Lecture: 1/week Total: 15 Coordinator General Internal Medicine department B - Professional Information 1- Course Aims: 1- Provide Internist with knowledge and skills necessary to apply an active and cost effective Infection Control program (IC) in health care facilities. 1- Enable Internist to comply with infection control measures to prevent spreed of health care associated infection among patients and health care providers and the community. 2- Intended Learning Outcomes (ILOs) from the Course: a- Knowledge and understanding By the end of the course the candidate will be able to: a1- Describe the disease transmission cycle. a2- Describe Strategies to combat nosocomial infection. a3- Recognize necessary vaccines for health care workers a3- Recognize the steps of post exposure management (exposure to blood and infectious diseases. a4- Recognize the notifiable infectious disease according to MOHP regulation. a5- Know elements of standard precaution and transmission based precaution

63

b- Intellectual skills By the end of the course the candidate will be able to: b1- Select the proper transmission based precaution on dealing with different infectious disease . b2- Choose in a cost effective way the new and novel modalities used to reduce risk of health care associated infection (urinary cath, central venous catheters, etc.). b3- Do risk assessment of different medical interventions and choose the proper level of precautions (clean, aseptic, and surgical techniques) b4- Choose proper disinfectant / antiseptics in different indications b5 - Identify, calculate and monitor different hospital acquired infections rates using provided tools. b6 Recognize and notify early outbreaks. c- Professional skills By the end of the course the candidate will be able to: c1- Recognize basic principle of infection control c2 Able to apply aseptic technique

d- General and transferable skills By the end of the course the candidate will be able to: d1- Work effectively as a team member. d2- Respects the role of staff and co-staff members regardless of degree or occupation. 3- Course content: No. of hours Topics L T C/P SDL Basic Epidemiology of nosocomial infection 1 Disease transmission cycle and modes of infection transmission. Standard Precautions 1 hand hygiene Personal protective equipments Transmission based Precautions 1 2 Waste Management Guidelines 1 Disinfection and sterilization 1 Antiseptics Risk Management 1 Aseptic technique 2 Prevention of ICU related infection 1

64

Techniques

Special topics

Prevention of hospital acquired pneumonia and VAP Invasive Procedure Guidelines 1 Indwelling Vascular Devices Guidelines 2 Indwelling Urinary Catheter Guidelines Infectious Diseases Regulations: List of Notifiable Diseases Protocol for Reporting a Notifiable Diseases Staff Health & Post Exposure Guidelines : Staff Immunization Guidelines Management of Blood/Body Fluid Exposure Health Care Worker with Infectious Diseases Prevention of spread of Antibiotic Resistant Micro-organisms Common communicable diseases

1 1

1 1

4 - Student Assessment Methods 4.1Written exam to assess knowledge and understanding Weighing of assessment 4.1 written exam 50 Total 50 5 -- List of References 5.1- Course Notes (paper and / or electronic) Electronic lectures 5.2- Essential Books (Text Books) Lecture notes on infection control 5.3- Recommended Books 5.4- Periodicals, Web Sites, etc V- General Information 1 Monitoring Of Training and Submission Of Training Reports You must keep proper and updated records in your logbook to reflect the activities encountered in your training. Your logbook must be duly endorsed by an authorized signatory at the end of each semester. You will be continuously assessed by your supervisors, in consultation with head of department. An assessment will be submitted within 2 weeks of completion of each semester.

65

2 - Miscellaneous Information: Injury and/or Blood or Body Fluid Exposure: During regular working hours, you should immediately report an exposure incident to infection control unit. If exposure occurs after regular working hours or during a weekend or holiday; please report to the Emergency Department. Please also be sure to inform the supervisors of an exposure incident and/or injury. 3 - Action Completion Of Clinical Training Once all training sessions are completed the log book should be signed by the senior supervisor and the head of the department and then should be submitted to post graduate Secretariat. 4- Reference The Training Guide is available at the post graduate Secretariat and could be downloaded from the following website is ---------------------------------------------------------------

66

Your log book 1- Introduction The aim of this book is to give you a guide to the expectations for each item. It will be a guide for both you and your teachers to what you should be seeing and doing. It will give you a list of the important topics that you should think about and should be covered in: 1. Clinical or practical sessions or 2. Lectures or 3. Self-directed learning (SDL) For each item there is also a list of 1. Clinical conditions or Practical sessions to be seen or attended (According to each degree) 2. Practical procedures to be seen and done Remember This document is only a guide. It is not an exhaustive list. It is not just a checklist to score points. It is a guide to encourage you to read and learn more. This book is for your benefit. It will form a record of your clinical training and experience. 2 - Supervisors 3Tables for Training Records Requirements Candidates are required to fulfill 75% of the listed activities in order to be eligible for the exam entry. The minimum number required for each activity = 75%. You are free to attend more and record your extra attendance.

67

Weekly Department Plan (Gastroenterology and hepatology Division ) 1 2 Saturday Sunday Monday Tuesday Wednesday Thursday 8am9am10am11am 12pm 12pm 8am for 8am for Emergency 24h 24h 9am9am-12pm Hepatology 12pm clinics 9am-1pm 9am-1pm 9am-1pm GIM clinics 9am9amHepatology & 11am 11am gastroenterology Conference 10amHCC conference 12pm Monthly activities: Conference on Updates of Gastroenterology & Hepatology Day /time Grand round Weekly Department Plan (Endocrinology and metabolism division )5 Day /time Grand round Emergency Endoctinology clinic Diabetes clinic GIM clinics Conference Diabetes education Diabetic foot clinic Seminar 8am for 24h 10am-12pm 9am12pm 10am-12pm 10am12pm 9am12pm Saturday Sunday 9am12pm Monday Tuesday Wednesday 9am-12pm Thursday

8am for 24h 9am12pm 9am12pm 9am12pm 9am12pm 9am12pm 9am-12pm 9am12pm

68

Weekly Department Plan (Allergy and immunology division )6 Day /time Grand round Emergency Allery clinics GIM clinics Conference 10am12pm Weekly Department Plan (Nephrology Division ) 9 01 Day /time Bedside education Conference Grand round Emergency attendance Clinic day Monthly activity: Ain shams grand conference Saturday Sunday Monday Tuesday Wednesday 9am -12pm Thursday Saturday Sunday 8am11am Monday Tuesday Wednesday Thursday

8am for 24h 9am12pm 8am for 24h 9am12pm

9 am-2 pm

9am12pm 9am-12 pm 8 am up to 24 hour 9 am-1pm

69

Weekly Department Plan (Rheumatology Division ) 21 Day /time Grand round Rheumatology clinics GIM clinics Rheumatology conference GIM conference Journal club Saturday Sunday 8am11am 9am1pm 9am1pm Monday 9-10 9am1pm Tuesday Wednesday 9-11 9am-1pm Thursday

9am-1pm

9am1pm 9am1pm

9am-1pm

10am11am 11am-12 pm 9am 10.5am

Every other week: Emergency (Thursday) Monthly activity: Radiology conference (Wednesday) Three monthly activities: Grand Rheumatology meeting Weekly Department Plan (Hematology )31 Saturday Sunday Monday Tuesday 10am-12pm 10am10am10am12pm 12pm 12pm 9am12pm 9am-12pm 10am12pm 9am-12pm 9am12pm

Day /time Clinical round Hematology clinics GIM clinics Weekly conference BMT/SCT BMT/SCT conference Conference

Wednesday 10am-12pm 9am-12pm

Thursday 10am12pm

9am-12pm 10am-12pm

10am12pm Every other week: Emergency (Thursday) Three Monthly activities: Grand hematology conference Three Monthly activities: Bone marrow transplantation conference

70

Patients' Case Log Patients Seen with the following emergencies Cardiovascular system Left sided heart failure 5 Acute chest pain 10 Arrhythmias 5 Hypertensive emergencies 10 Syncope 5 Shock Neurology Convulsions and epilepsy 5 Disturbed level of consciousness 5 TIA & Stroke 10 Ascending paralysis 1 Acute paraplegias 1 Subarachnoid hemorrhage 1 Meningitis 2 Encephalitis 2 Kidney Acute renal failure &CRF 10 Electrolytes and acid base imbalance 15 Renal colic 10 Acute pyelonephritis 5 Hemolytic uremic syndrome 1 Blood Haemolytic crisis (jaundice) 3 Haemorrhagic diseases 5 Endocrine Thyrotoxic crisis 1 Myxedema coma 1 Suprarenal emergencies 1 Diabetic emergencies DKA 20 Hypoglycaemia 5 Diabetic foot 10

inflammatory response 5

Respiratory system Status asthmaticus 5 Acute respiratory failure 10 Hemoptysis 2 ARDS 1 Pulmonary embolism 2

GIT Upper GIT bleeding 30 Lower GIT bleeding 10 Hepatic encephalopathy 20 Acute & fulminant hepatitis 1-3 Acute abdomen 5

Autoimmune diseases SLE emergencies 2 Antiphospholipid syndrome 2

Others Jaundice of Pregnancy 1 Hyperthermia 1 Anaphylaxis 1 Angioneurotic edema 2

71

Patients seen / with any of the listed Emergencies PT. INITIALS AGE/SEX MED.RECORD# 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 Supervisor signature

DATE

Diagnosis

72

6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5

73

6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10

74

Non Emergency Medical cases Log And follow up of emergency cases Respiratory system COPDs 30 Upper respiratory infection 20 Lower respiratory infection 10 Suppurative lung disease 3 Pleural effusion 5 Pneumothorax 1 Obstructive sleep apnea 5 Interstitial lung disease 2 Mediastinal syndrome 1 Tumors of lung & pleura 2 Cardiovascular system CHF 10 Valvular heart disease 10 Ischemic heart disease 15 Cardiomyopathy 3 Hypertension 20 Arrythmias; AF & others 10 Infective endocarditis 2 Rheumatic fever 3 Bone diseases Osteomalacia 1 Osteoporosis 5 Neurology TIA 10 Vascular stroke 20 Paraplegia 5 Cranial nerves 5 Ataxias 2 Extrapyramidal syndromes 4 Peripheral neuritis & radiculopathy 5 Myasthenia (1ry and 2ry) 1 Brain tumors 2 Degenerative brain diseases 5 Language disorders 5 Headache 10 Migraine 5 Encephalitis, Meningitis and brain abscess 1 Increased intracranial tension 2 Myopathies & other muscles diseases 1 Kidney Glomerulonephritis 5 Nephrotic syndrome 5 Urinary tract infection 5 ESRD 5 Blood Anemias 10 Leukemias 4 Purpura 5 DVT 5 Multiple myeloma 1 Lymphomas 4 Myeloproliferative disorders 3 Endocrine DM Type1, 2, uncontrolled,, Gestational & complicated 50 Pituitary failure & hypopituitarism 2 Diseases of suprarenal 3 Thyroid diseases 10 Gonadal disorders 1 Nutrition Cachexia 3 Metabolic syndrome & obesity 20 Vitamin deficiencies 10

Infections Salmonellosis 10 Hepatitis 10 Brucellosis 2 Diseases related to travelling to endemic areas Malaria 0-1 Avian flu 0-1 Others Patients seen / with any of the listed Non Emergency Medical cases PT. INITIALS DATE Diagnosis

GIT Functional GIT problems 30 Chronic diarrhea 5 Jaundice 10 Others Skin manifestations of medical diseases 20 Occupational diseases 2 Psychiatric disorders in general practice 5

Supervisor

75

AGE/SEX MED.RECORD# 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8

signature

76

9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8

77

9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8

78

Procedures' Log Level of trainees participation in different procedures 1. Observation of the procedure O 2. Assistance in the procedure A 3. Performance of the Procedure (supervised) Ps 4. Performance of the procedure (independent) P Aseptic Venepuncture No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

infusion and infusion pump No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

No 1 2 3 4 5

Date

Cannula insertion, including large bore PT initials, Indication AGE/SEX

Supervisor signature

79

Arterial blood gas sampling No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

Lumbar Puncture (observed) No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

No 1 2 3 4 5 6

Date

Use oxygen delivery devices and nebulizers PT initials, Indication AGE/SEX

Supervisor signature

80

No 1 2 3 4 5 6

Date

Ascitic tap and Abdominal paracentesis PT initials, Indication AGE/SEX

Supervisor signature

Central venous cannulation No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

Advanced cardiorespiratory resuscitation including DC cardioversion PT Supervisor No Date initials, Indication signature AGE/SEX 1 2 3 4

81

5 6

Urethral catheterization No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

Nasogastric tube placement No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

BM aspiration and teriphine (observed) (NB. Minimum number required is 2) No 1 2 Date PT initials, AGE/SEX Indication Supervisor signature

82

Bmt/sct (observed) (NB. Minimum number required is 1) No 1 Date PT initials, AGE/SEX Indication Supervisor signature

No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Date

Pulmonary function tests interpretation (NB. Minimum number required is 15) PT initials, Supervisor Diagnosis AGE/SEX signature

83

Electrocardiogram (performance and interpretation) (NB. Minimum number required is 20) PT initials, AGE/SEX Supervisor signature

No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Date

Indication

No 1 2 3 4 5 6 7 8

Endo-tracheal Intubation and safe airway protection (NB. Minimum number required is 10) PT Supervisor Date initials, Indication signature AGE/SEX

84

9 10

Sengstaken-Blakemore Tube (NB. Minimum number required is 6) No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

Intercostal drain insertion (NB. Minimum number required is 6) (observed) No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

Knee aspiration (observed) (NB. Minimum number required is 3) No 1 2 Date PT initials, AGE/SEX Indication Supervisor signature

85

Upper GI endoscopy (injection and band ligadtion of bleeding varices) (observed) (NB. Minimum number required is 6) PT Supervisor No Date initials, Indication signature AGE/SEX 1 2 3 4 5 6

Lower GI endoscopy (observed) (NB. Minimum number required is 6) No 1 2 3 4 5 6 Date PT initials, AGE/SEX Indication Supervisor signature

Echocardiography and vascular imaging (observed) (NB. Minimum number required is 6) No 1 Date PT initials, AGE/SEX Indication Supervisor signature

86

2 3 4 5 6

Abdominal ultrasound (observed) (NB. Minimum number required is 6) No 1 2 3 4 5 6 Temporary cardiac pacing (observed) (NB. Minimum number required is 4) PT initials, AGE/SEX Supervisor signature Date PT initials, AGE/SEX Indication Supervisor signature

No 1 2 3 4

Date

Indication

Blood culture (NB. Minimum number required is 6) No 1 2 Date PT initials, AGE/SEX Indication Supervisor signature

87

3 4 5 6

Academic Activities Conferences attendance (NB. Minimum number required is 16) Place Date Topics Supervisor signature No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Thesis attendance (NB. Minimum number required is 10) No 1 2 3 4 Date Place Name of the thesis Supervisor signature

88

5 6 7 8 9 10

Journal club attendance (NB. Minimum number required is 6) Place Date Topics Supervisor signature No 1 2 3 4 5 6

Case presentation with review article (NB. Minimum number required is 6) No 1 2 3 4 5 6 Date Place Diagnosis Supervisor signature

Clinics attendance (NB. Minimum number required is 30) No 1 Date Place Name of the Clinic Supervisor signature

89

2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

90

Emergency attendance (NB. Minimum number required is 20) No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Date Place Department Supervisor signature

Web Cme certificates (NB. Minimum number required is 20) No 1 2 3 4 5 6 7 8 9 10 Date Place Name of the Clinic Supervisor signature

91

11 12 13 14 15 16 17 18 19 20 5 - Log book preview The candidate logbook will be reviewed and patients seen/ skills performed summarized by diagnosis groups during the semester evaluation and at the end of the course in the table below. The results of this review will be totaled in the summary chart below. Summary Patients' Log Semester Activity (Minimum number required) Patients Seen with the following emergencies Cardiovascular system Respiratory system Autoimmune diseases Neurology Kidney Blood Endocrine GIT Others Non Emergency Medical cases Log and follow up of emergency cases Respiratory system Cardiovascular system Bone diseases Infections Neurology 1st No 2nd No 3rd No 4th No Total

92

Kidney Blood Endocrine GIT Others Procedures' Log Semester 1st Activity (Minimum number required) No Aseptic Venepuncture infusion and infusion pump Cannula insertion, including large bore Arterial blood gas sampling Lumbar Puncture Pulmonary function tests interpretation Use oxygen delivery devices and nebulizers Ascitic tap and Abdominal paracentesis Central venous cannulation Advanced cardiorespiratory resuscitation including DC cardioversion Urethral catheterization Nasogastric tube placement BMT/SCT BM aspiration Electrocardiogram (performance and interpretation) Endo-tracheal Intubation and safe airway protection Sengstaken-Blakemore Tube Intercostal drain insertion Knee aspiration Upper GI endoscopy (injection and band ligation of bleeding varices) lower endoscopy Echocardiography and vascular imaging Abdominal ultrasound Temporary cardiac pacing Blood culture Academic Activities Semester 1st Activity (Minimum number required) No 2nd No 3rd No 4th No Total

2nd No

3rd No

4th No

Total

93

Conferences attendance Thesis attendance Journal club attendance Case presentation with review article Clinics attendance Emergency attendance Web CME certificates Supervisor signature VII - Head Of Department Approval For The Exam Entry __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ ______________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ ______________________________________________ _______________________________________________

94

VIII Thesis Follow up

/ / ( ) /

/ /

59

96

/ / ( ) /

/ /

79

98

/ / ( ) /

/ /

99

100

/ / ( ) /

/ /

101

102

VIII Evaluation Forms To be completed at ------------------------------------Candidate Supervisor Location Aim of training __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Agreed educational objectives and timescale in which objectives should be achieved. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Comments by Candidate __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Comments by Supervisor __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

Date of next meeting Signed by candidate Signed by Supervisor Date

103

104

VIII Evaluation Forms To be completed at ------------------------------------Candidate Supervisor Location Aim of training __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Agreed educational objectives and timescale in which objectives should be achieved. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Comments by Candidate __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Comments by Supervisor __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

Date of next meeting Signed by candidate Signed by Supervisor Date

105

106

VIII Evaluation Forms To be completed at ------------------------------------Candidate Supervisor Location Aim of training __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Agreed educational objectives and timescale in which objectives should be achieved. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Comments by Candidate __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Comments by Supervisor __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

Date of next meeting Signed by candidate Signed by Supervisor Date

107

108

VIII Evaluation Forms To be completed at ------------------------------------Candidate Supervisor Location Aim of training __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Agreed educational objectives and timescale in which objectives should be achieved. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Comments by Candidate __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Comments by Supervisor __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

Date of next meeting Signed by candidate Signed by Supervisor Date

109

110

Degree Program Evaluation Form by The Candidate To be completed at the end of your degree. Please consider each pair of statements and decide which most clearly reflects your view and tick one box or answer the question. I. Individual Information 1. Are you a graduate of ASU? yes no to some degree 2. Year and semester when studies began:

II. General Questions 1. What are the advantages/disadvantages of the general study environment at the University ASU?

2.

What

were

your

expectations

when

you

applied

to

the

degree?

3. Do you feel that the degree program prepares you well for your future studies or employment according to the demands and expectations of those institutions? yes no to some degree

4. Has the time limit of the program (two or three academic years) caused you any difficulties or inconveniences? yes no to some degree

III. Structure of Degree Program 1. Did you receive enough guidance in planning your study schedule in the beginning of the program? yes no to some degree

2. What were the main difficulties in the planning of your study schedule? 3. What is your general opinion on the structure of the degree program?

111

4. In your opinion, does the degree program offer a good balance of lectures, seminars, conferences, and book exams? yes no to some degree

a) General Studies i) Do you feel that you have received enough guidance on academic writing? yes no to some degree

ii) Do you feel that you have acquired sufficient knowledge on research skills (eg. quantitative and qualitative research methods)? yes no to some degree

b) Courses i) Have you had some special difficulties in completing some of the courses? Please specify. ii) Has there been a sufficient variety of courses offered for your optional studies? yes no to some degree

iii) Have you received enough guidance for the preparation of your thesis? yes no to some degree

IV. Concluding Points 1. Did the degree 2. yes What no aspects

program

meet do

your you

expectations? like?

to some degree of the degree

program

particularly

3. What aspects of the degree program do you particularly dislike? 4. What are your suggestions on how to improve the program?

Thank you!

112