تفاصيل المقرر

المقدمة


The GIT system is probably one of the most ill-treated systems of the human body, yet it has the remarkable capability of with-standing a great deal of punishment, usually without serious consequences. Day in, day out, two, three or more times a day was send down a variety of things (from food to different drugs) feeling fairly sure that ``Old irongut`` will somehow withstand the invasion and emerge victorious once again.
Many diseases prevalent in this community like gastroenteritis and other diarrhoeal diseases, malnutrition, parasitic infestations, liver diseases and bilharziasis which all together contribute a great deal to the mortality and morbidity in this country.



المحتويات


1 various GIT organs from the duodenum to the anal verge in a human body or a diagram
2 the disorders of motility as in diarrhoea,constipation, paralytic ileus and mechanical bowl obstruction.
3 the common gastrointestinal secretions and discuss their physiological role in digestion and absorption.
4 the various GIT hormones and enzymes .
5 clinical presentation, pathology, investigations and management and complications of the common primary tumours of the stomach large bowl, rectum, liver and pancrease.
6 psychosocial factors that are related to the gastrointestinal diseases and their complications.
7 treating and preventing the gastrointestinal diseases and to deliver counselling to both the patients and those who look after them.
8 dyspepsia
9 upper or lower GIT bleeding.
10 bowel obstruction
11 malabsorption
12 life cycle, pathogenesis, diagnosis and management of infection with the helminths
13 epidemiology of schistomiasis in Sudan, mode of infestation, pathology
14 acute abdominal symptoms.
15 acute & chronic liver disease
16 hepatomegaly.
17 the aetiology, pathogenesis, clinical manifestations and management of liver cirrhosis
18 aetiology, metabolic disturbances and management of hepatic coma



المنسقون



المطلوبات


ALL PRE-SET COURSES


الأهداف


1) General Objectives:

The ultimate goal of this of this course is to make the student properly understands and efficiently handle and manage the common problems of the GIT system in this country, based on sound scientific knowledge of basic structure, functions, malfunctions and diseases of the Gastrointestinal system and the related psychosocial factors.

2) Spesific Objectives

the student should be able to :
2.1 Identify the various GIT organs from the duodenum to the anal verge in a human body or a diagram and describe their:
- surface anatomy, gross appearance and major features
- relations within the human body and their microstructures

2.2 To discuss the disorders of motility as in diarrhoea,constipation, paralytic ileus and mechanical bowl obstruction.
2.3 Enumerate the common gastrointestinal secretions and discuss their physiological role in digestion and absorption.

2.4 Enumerate the various GIT hormones and enzymes and discuss their:-
- sites of secretion.
- functions.
- role in motility, digestion and absorption.

2.5 Discuss the clinical presentation, pathology, investigations and outline management and complications of the common primary tumours of the stomach large bowl, rectum, liver and pancrease.
2.6 Discuss the psychosocial factors that are related to the gastrointestinal diseases and their complications.
2.7 To determine the means of treating and preventing the gastrointestinal diseases and to deliver counselling to both the patients and those who look after them.

2.8 Given a patient with dyspepsia the student should be able to:
- take a good history.
- conduct a comprehensive clinical examination.
- request laboratory and radiological investigation which would help in diagnosis.
- Construct a differential diagnosis including:
- peptic ulcer, hiatus hernia and gall bladder disease.
- Discuss the treatment [;including both the medical and the surgical treatment)and to deliver counselling to both patients and their families.
- Discuss complications and outline their management and prevention

2.9 Faced with a case of upper or lower GIT bleeding, the student should be able to:
- take a good history and elicit physical findings
- list emergency and elective investigations.
- discuss the aetiological factors.
- differentiate between bleeding oesphageal varices and other causes of upper GIT bleeding.
- differentiate between bloody diarrhoea, frank bleeding per-rectum and melaena.
- Discuss emergency management and outline definitive management and methods of prevention and to deliver counselling to both patients and their families..

2.10 Given an adult or a child with bowel obstruction
- Take a good history and elicit the associated physical findings.
- List relevant investigations.
- Discuss the pathophysiological changes of acute and chronic bowl obstruction.
- Discuss the differential diagnosis including: volvulus, intussception, obstructed hernia,adhesions, carcinomas and neonatal bowel obstruction.
- Outline the principles of management and to deliver counselling .

2.11 Faced with a problem of malabsorption
- Discuss the pathophysiology
- List the possible aetiological factor including:

- Tuberculosis of small bowl
- Steatorrhoea
- Coeliac disease & tropical sprue
- Parasitic infestations.
- Crohn`s disease
- Surgical causes.
Discuss the investigation for each cause and outline the management and to deliver counselling to both patients and their families

2.12 Discuss the life cycle, pathogenesis, diagnosis and management of infection with the following helminths (ascaris, T.saginata, H.nana, Hookworms, strongyloids entrobius vermicubris)
-discuss their portal of entery and infestation.
-describe their general appearance,the microscopic appearance larval stages
-determine briefly their signs,symptoms,pathology and outline managment

2.13 Faced with a case of portal hypertension.
- take a good history including history of e.g. jaundice, bilharziasis, alcoholism etc.
- elicit physical associated clinical findings, demonstrating other signs of liver disease
- outline principles of management of protal hypertension and deliver counselling to both patients and their families.
- discuss the socioeconomic consequences of portal hypertension at the level of individuals and family

2.14 Describe epidemiology of schistomiasis in Sudan, mode of infestation, pathology and pathogenesis:
- outline prevention and control measures with special reference to the protocols and guidlines of the Federal Ministry of Health
discuss the socioeconomic impact of bilharziasis at the level of - List symptoms, singns and relevant investigations.
- Construct a differential diagnosis including:-

- acute appendincitis.
- acute bowl obstruction.
- perforated viscus.acute cholecystitis and biliary colic
- acute pancreatitis
- renal colic
- peritonitis.
- - Outline the individual, family and the whole community
- discuss the drug treatment of bilharziasis

2.15 Faced with a patient in the emergency department with acute abdominal symptoms.
- Define acute abdomen
priciples for evaluation, diagnosis and emergency management.
- Outline definitive management.

2.16 Given a patient with acute or chronic liver disease:
- discuss pathophysiology and clinical presentation of liver disease
- to elicit the associated physical signs
- outline relevant investigation

- discuss the differential diagnosis including:
* liver cirrhosis(all types)
* periportal fibrosis
* amoebic hepatitis,

-discuss the aggravating factors of the disease
-outline the management and prevention of hepatic coma.

2.17 Given a patient with hepatomegaly. Outline possible causes and pathogenesis including:
* amoebic hepatitis
* amoebic liver abscess
- * primary and secondary hepatic neoplastic
conditions
* hydatid disease
* other metabolic and storage disease of the liver
- outline a plan of investigation
- discuss management and prevention and counselling of patients and their families

2.18 Discuss the aetiology, pathogenesis, clinical manifestations and management of liver cirrhosis
2.19 Discuss aetiology, metabolic disturbances and management of hepatic coma
2.20 Perform the following :
- general and microscopic examination of stools
- identify pus cells, RBCs, amoeba, helminths eggs, bile



طرق التدريس


1 Lectures, tutorial, seminars, problem based learning
2 Practical classes.
3 Clinical rounds.
4 Audiovisual aids.
5 Assignments.
6 Internet



المصادر


1) Human Resources:

1.1 Anatomists.
1.2 Physiologist.
1.3 Biochemist.
1.4 Community Medicine.
1.5 Physicians
1.6 Surgeon
11.7 Paediatrician.
1.8 Pathologist and medical imaging
1.9 Bacteriologist
1.10 Radiologist
1.11 Tutors(PBL)

2) Physical Resources:

2.12 Rooms for clinical training
2.13 Room for students
2.14 Buses for transport



وسائل التقويم


- MCQs 30%
- Essays 25%
- Clinical Examination (PACES) 25%
- OSPE 10%
- A&P 10%



المراجع


1 Davidson - Principles of Medicine.
2 Baiely & Love - short practice of surgery.
3 Co,panion Medical Studies
4 Hutchinson Clinical Methods
5 A guide to Human Parasitology
6 BDS Biochemistry
7 Laurence- Clinical Phrmacology.
8 Gunningham Manual of Anatomy
9 Atlas of Microscopic anatomy by Bergman
10 Muire Textbook of Pathology
11Clinical Signs in Surgery-Hamilton Bailay.
12 Paediatric Gastro-enterology
13 Lecture notes acute diarrhoeal diseases
14 Text book of Paediatrics-Jolly.
15 Diseases of Children in the Tropical and Subtropics Jelliffee and Standfie



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