تفاصيل المقرر

المقدمة


The clerkship period is meant to be a consolidation and re-organization phase to your knowledge acquired in the previous courses, as well as reinforcement of various competences and skills learnt in handling patients. It is also meant to refine a compassionate, and professional attitude towards patients
This booklet is meant to act as a guide both to students and staff. It helps to tell what has been covered and what has not. It is a guide to the staff on what to teach and to the student on what to learn
Objectives are set into problems, conditions and statements. Problems are usually the common presenting complaints of patients when first seen. The student is expected to develop the discipline, the attitude and competences necessary to collect data, formulate alternative hypothesis and reach a likely working diagnosis and outline management

:Objectives have been divided into two levels

:Level I

Includes all conditions which are common (and/or) serious (and/or) preventable, which the student is expected to discuss, diagnose and manage. It also includes statements or situations which the student is expected to recognize, discuss and interpret

:Level II

Includes division conditions which are less common (and/or) serious (and/or) preventable compared to Level I

This division is by no means concrete or absolute. It is liable to change. But it is a guide to the student about the importance and significance of the different conditions and situations which he will meet on graduation. It does not mean that conditions not appearing in these levels should be completely ignored there is no limit to what the student can learn
Some of the objectives appearing in this clerkship would have been covered in previous courses, their appearance here does not mean that these will be taught again. The student will be referred to the respective course
Another important point is that not all objectives appearing in this clerkship will be taught by direct student/staff learning experience, but the student should consult other resources e.g. textbooks, library, audio visual materials and staff. Self learning is very important. The learning experience is the responsibility of the student as well as the staff
It needs to be stressed that this booklet is a guide to students and staff, it does not cover every aspect but tries to level conditions and situation. Medicine is an ever expanding subject and new discoveries will continue to be made and so learning is a dynamic process and all have to keep pace

:JUSTIFICATION

In the past the child was looked on as a minture adult and paediatrics was studied as part of internal medicine. In the last few decades the importance of paediatrics and child health as separate entity was realized. The main reasons for this especially in the developing countries were as follows
Firstly, by share number children make the majority of the population; children under the age of 15 years make about 50% of the total population and children under the age of five years make ab out 20%
Secondly infants by virtue of being the 'front' of life they are more prone to diseases especially through infectious agents. This leads to higher mortality among them. In the Sudan infant mortality is around 60-80 per thousand - as compared to 9 per thousand in Sweden. Deaths among children less than five years make around 50% of the total deaths. These reduce the average life expectancy. In Sudan it is about 45 years as compared to over 70 years in Sweden. This would mean shorter productive years and waste of human life
Thirdly, about 80% of this high mortality is due to infectious diseases, malnutrition and diarrhoea. These are preventable diseases. Good antenatal care, immunization, breast feeding, right supplementation oral rehydration and health education will be paid back in reduction of infant morbidity and mortality. So evaluation of efforts based on cost-and-benefit-analysis will always be favorable. The effort is not wasted
Lastly, most of the seeds of diseases of adult life are shown in infancy and childhood - e.g. atherosclerosis tuberculosis, rheumatic heart diseases, mental sub normality etc.. etc. In addition, infants and children suffer from the other diseases which the adult might get - but the effects among infants and children are worse because they are growing and developing
Diseases affect the rate and quality of growth and development and the effects might be permanent. Again because of growth and development the nutritional requirements are great so much so that a child of two years would need 50% of the adult requirements



المحتويات


Specific Objectives and Contents:

Some of the objectives of this block have been studied before in the previous blocks, some of these will be restated so as to reinforce or expand on them. New objectives will be added. On finishing the clerkship the student is expected to:

General:

 Develop an attitude to child care which is a blend of scientific and humanitarian approach
 Communicate in a friendly manner with infants, children and their families
 Treat children sympathetically, honestly and kindly without any discrimination, show interest, compassion respect and dignity
 Aware himself of the psychological, social, economical religious and traditional background in the assessment of children and in dealings with their families
 4.1.5 Realize that child care is dynamic process and that he has to adapt to changing situations
 Involve the family in child health care both in hospital and at home, realize their worry ever if it seems exaggerated, show sympathy and understanding
 Establish cooperative good relationship with colleagues health auxiliaries and all those involved in the provision of child care
 Continually educate oneself and promote his skills and knowledge utilizing books, journals, teachers, peers, available clinical resources and other any means
 Realize the advantages and disadvantages and the involved inconvenience and cost of child care in different settings-home, community centre, dressing station, dispensary health centers and hospitals.

 Take comprehensive and relevant history from the parents or the child and record it. It should include:
- Identifying information about the child and the family
- The complaint(s) which made the parents or child seek
- medical help
- Other associated problems and presentations
- Detailed history of the present illness with review of other systems
- Previous illness(es) or events including history of pregnancy,
- delivery, nutrition and immunization
- Family history and socio economic factors

 Understand the general normal body structure and normal functions and understand the departure from normal
 4.1.12 Perform a comprehensive and complete physical examination covering all the systems and to the satisfaction of an attending member of the staff
 Present and discuss the case in a clinical round, seminar or conference.  4.1.14 Discuss and share in the program of IMCI & EPI

SKILLS

The skills are arranged in two levels:
Level I: Those to be done by the student himself
Level II: Those to be demonstrated by a member of staff

Level I Skills

• Weighing of infants and children using different types of scales
• Measurement of height, head circumference and midarm circumference
• Intramuscular, intradermal, subcutaneous and intravenous injections
• Setting an intravenous drip and blood transfusion
• Venesection in the leg (Saphenous vein)
• Finger, ear lobe and heal prick
• Lumbar puncture
• Putting a stomach tube for feeding and for stomach wash
• Putting a rectal tube
• Measuring haemoglobin
• Examination of urine for specific gravity, sugars, proteins, cells and casts
• Making sickling test
• Giving oxygen
• Mouth to mouth breathing
• Artificial respiration
• External cardiac massage
• Preparation of thin and thick blood film for malaria
• Peritoneal drip
• Staining use Field and Gemsa stains
• Taking swab for culture from throat and pustular lesions
• Identify different containers used for common investigations
• Resuscitate newborn
• Calculate an Apgar score at one and five inutes
• Rectal examination
• General examination of stools
• Measure blood pressure
• Fundal examination
• Calculate the amount of fluids and electrolytes need in newborn, infants and children
• Obtain urine for culture by U-bags and catheterization

Level II skills

 Venipuncture from femoral, external jugular and scalp veins
 Peritoneal paracentesis
 Thoracocentesis
 Bone marrow aspiration
 Obtaining pustular and vesicular fluids from mucocutaneous lesion and making gram stain
 Tracheal intubation
 Suprapubic tap
 Exchange transfusion
 Application of photo therapy
 Proctoscopy including taking snip
 Use the incubator
 Laryngoscopy
 Make an ECG
 Venisection in the arm (radial vein)
 Measuring white cells
 --------------------------------------------------------------------
The following conditions and statements are levelled into two levels:
Level I :

Includes all conditions which are common (and/or) serious (and/or) preventable, which the student is expected to discuss, diagnose and manage. It also includes statements or situations which the student is expected to recognize , discuss and interpret

Level I :

Includes conditions which are common (and/or) serious (and/or) preventable compared to Level I.
------------------------------------------------------------------------

4.2 Genetic and Teratology

Problems commonly encountered
1. Congenital malformation
2. Recurrent abnormality in the pedigree
Level I : statement and conditions :
 4.2.1 Recognize the common drugs and diseases which are tetratogenic
 4.2.2 Discuss the different modes of inheritance and their genertic basis and intrauterine diagnosis of common inherited diseases

 Recognize the abnormal chromosomal appearance of :
• Mongolism
• Turner syndrome
• Kleinfelter syndrome

 Construct pedigree and be able to interpret :
- Autosomal recessive inheritance
- Autosomal dominant inheritance
- Sex linked recessive inheritance
- Sex linked dominant inheritance

 Provide genetic counseling on common problems
 Recognize the general physical features which are suggestive of genetic diseases and chromosomal abnormality

 Discuss the genetic abnormalities, physical and functional disturbances, diagnoses and outline management of the common genetic chromosomal, and teratogenic diagnoses especially:
- Hemophilia
- Mongolism
- Sickle anaemia
- Familial goiter
- Hair lip and Clift palate
- Congenital pyloric stenosis
- Rubella syndrome

Level II :

 Discuss the embryological and environmental basis of congenital malformations and fetal development (Refer to growth and development course)
 Discuss the application of cytogenetics in medicine especially during intrauterine life
 Recognize normal chromosomal arrangement and how it is prepared
 Discuss the importance methods and the limitations of screening programmes for common genetic disease taking phenylketonuria as an example

 Discuss the genetic abnormalities, clinical features and diagnosis of the following :
- Phenylketonuria
- Muscular dystrophies
- Thalassaemia
- Albinism

* Intrauterine and Neonatal

Problems commonly encountered :
1. Breathlessness
2. Convulsions
3. Jaundice
4. Vomiting
5. Apnoea
6. Paleness
7. Cyanosis
8. Bleeding
9. Congenital abnormality

Specific statements and conditions :
Level I :

 Discuss fertilization, implantation, development and growth in utero and the role of the placenta
 Discuss the effect of maternal nutrition and maternal diseases on the development and growth on the foetus
 Describe the special features which would suggest illness of the newborn
 Discuss the special aspects of drug therapy in foetus and newborn
 Take good history including consanguinity, pregnancy, labour and delivery
 Carry out complete physical examination and rule out manifestation of illness
 Advise mother on proper breast feeding and against artificial feeding and use of bottle
 Realize the importance of early contact between baby and mother

 Diagnose and manage the following conditions in the newborn :
- Respiratory distress syndrome
- Convulsions
- Prematurity
- Light for dates
- Jaundice
- Cyanosis
- Vomiting
- Apnea
- Bleeding
- Hypoglycaemia
- Hypocalcaemia
- Hypokalaemia
- Hypothermia

* Congenital anomalies
- Imperforate anus
- Congenital pyloric stenosis
- Oesophageal atresia and tracheo-osphageal fistula
- Hydrocephalus
- Cleft palate and hair lip
- Congenital dislocation of the hip
- Erb's palsy

 Discuss the factors which lead to abortions, still-birth and neonatal deaths and how these can be reduced (Refer to Obs & Gynae)
 Describe the process of labour and how the newborn can be affected during this process (Refer to Obs & Gynae)

Level II :

 Diagnose and outline manage the following conditions in the newborn :
- Cephalohaematoma
- Dundeal atresia
- Meningomyelocele
- Talipes
- Microcephaly

* Nutrition

Problems commonly encountered :
1. Failure to thrive
2. Oedema
3. Paleness
4. Loss of appetite and apathy
5. Stomatitis
6. Skin ulcerations
7. Bleeding gums
8. Swelling of the neck
9. Obesity

Specific statements & conditions :
Level I :

 Discuss and advise on the importance of maternal nutrition during pregnancy and lactation (refer to 4.3.2)
 Discuss and advise on the importance and means of proper breast feeding
 Discuss and advise on nutritional requirements during infancy, childhood and adolescence
 Discuss the contents, nutritional value costing and availability of different foods and when to use these for infants and children feeding
 Realize the importance of home made weaning foods and proper education to insure optimal sanitary conditions
 Discuss the disadvantages of artificial feeding and the harmful effects of bottle feeding
 Take a proper nutritional history from the mother

 Diagnose and manage the following nutritional diseases:
- Protein energy malnutrition
- Iron deficiency anaemia
- Vitamin C deficiency
- Vitamin A deficiency
- Vitamin D deficiency
- Vitamin B deficiency
- Folic acid deficiency
- Endemic goitre (Iodine deficiency)
- Obesity
- Realize the importance of involving the home and the community in the diagnosis, management and prevention of diseases in
- Discuss the interaction of nutrition and infection
- Realize the long range consequences of malnutrition
- Investigate the etiological factors of malnutrition and proper means to compact them
- Educate auxiliaries on simple ways of detection of protein energy malnutrition in the community using the weight and growth charts and shakir strip

- Infectious diseases and Immunology

Problems commonly encountered :
1. Fever
2. Rash
3. Breathlessness
4. Diarrhoea
5. Headache
6. Convulsions
7. Neck rigidity
8. Vomiting
9. Rigors
10. Sweating
11. Repeated infections
12. Pus discharge

Specific statements & conditions :
Level I :

- Discuss nature of infectious agents and the mechanism of infections and host defense mechanisms
- 4.5.2 Discuss immunity - natural and artificial, passive and acquired
- Discuss the pharmacology and actions of commonly used antimicrobial agents especially sulphonamides, penicillins, streptomycin, tetracycline, and chloromyctin, antimalarial, antibilharzial

- Diagnose, investigate, manage and discuss the epidemiology, pathology, natural history and prevention of the following commonly encountered diseases:
- Measles
- Diphtheria
- Tuberculosis
- Malaria
- Bilharziasis
- Meningitis
- Whooping cough
- Poliomyelitis
- Tetanus
- Typhoid, paratyphoid and Brucellosis
- Infective hepatitis
- Gastroenteritis and cholera
- Amoebic and Bacillary dysentery
- Urinary tract infections
- Respiratory tract infections
- Chickenpox
- Mumps

- Discuss the principles and practical applications of the following vaccines:
- Pentavalent vaccine
- Polio vaccine
- Measles vaccine
- BCG
- Meningococcal vaccine
- Pneumoccal vaccine
- Rota virus vaccine

Level II :

-Discuss the principles of the following vaccines
- Yellow fever vaccine
- Typhoid vaccine & Cholera vaccine
- Rubella vaccine

- Discuss the clinical features of :
- Infectious mononucleosis
- Herpes labialis
- Herpes zoster
- Dengue fever
- Steven-Johnson's syndrome

- - Gastrointestinal, Liver and Biliary System

Problems commonly encountered :
1. Diarrhoea
2. Vomiting
3. Jaundice
4. Distended abdomen
5. Abdominal mass
6. Constipation
7. Bleeding

Specific statements & conditions "
 Demonstrate using drawing and diagrams digestion, absorption, transport and execratory functions (Refer to Gastroenterology Course)
 Discuss the epidemiology, aetiology, diagnosis, pathophysiology and prevention of diarrhea in the different age groups
 Discuss the use of different fluids for oral, intraperitoneal and intravenous rehydration
 Educate auxiliaries and mothers on home based oral rehydration

 Discuss the diagnosis and management of :
- Vomiting
- Constipation
- Distended abdomen
- Jaundice
- Enlargement of liver
- Abdominal pain
- Intestinal bleeding
- Portal hypertension
- Intestinal parasites and worms
- Malabsorption
- Abdominal mass

- Discuss the differential diagnosis of acute abdomen including acute appendicitis and intestinal obstruction (Refer to Gastroenterology Course)
- Discuss the importance of the following liver function tests:
- Serum bilirubin
- Plasma proteins
- Alkaline Phosphatase
- SGOT, SGPT

- Discuss the following radiological investigations :
- Plain X-ray abdomen
- Barium swollow
- Barium meal
- Barium enema
- Cholecystogram

Level II:

- Discuss the clinical features of:
- Celiac disease
- Crohn's disease
- Hirschsprung's disease
- Megacolon
- Cystic fibrosis

4.6.10 Discuss the indications and limitations of :
- Intestinal biopsy
- Xylose test (blood and urine)

- Respiratory System

Problems commonly encountered :
1. Stridor
2. Breathlessness
3. Wheeze
4. Cough
5. Haemoptysis
6. Sore throat
7. Discharging ear
8. Chest pain

Specific statements & conditions
Level I:

- Discuss the pulmonary physiology (Refer to Respiratory Course)
- Control of respiration
- Pulmonary volume
- Alveolar ventilation
- Gas exchange
- Ventilation/perfusion ratio

- Discuss the diagnosis management and complications of
- Tuberculosis
- Bronchopneumonia
- Asthma
- Tonsillitis
- Laryngitis
- Bronchiolitis
- Aspiration of chemical agents
- Aspiration of foreign bodies
- Discharging ear
- Pneumothorax
- Tuberculosis
- Adenoids
- Recurrent upper respiratory tract infection

- Discuss the presentation, diagnosis and management of respiratory failure
- Interpret the followings :
- Plain chest X-ray
- Mantoux Test
- B.C.G.
- PCR ,ICT ,ELISA tests

Level II:

 Discuss the diagnosis, management and complication at different ages for :
- Bronchiectasis
- Hearing problems
 Discuss the indications of bronchogram
 Discuss the clinical features of the following congenital abnormalities related to the respiratory system
- Choanal atresia
- Hypoplasia of the lungs
- Diaphragmatic Harnia
- Laryngomalacia

 Cardiovascular System
Problems commonly encountered :
1. Arthritis
2. Breathlessness
3. Cyanosis
4. Palpitation
5. Oedema
6. Chest pain
7. Failure to thrive
8. Feeding difficulty

Specific statements & conditions
Level I:

 Discuss the embryology and the development of the heart and great vessels and related congenital abnormalities (Refer to CVS course)
 Discuss and draw diagrammatically the fetal circulation and physiological and anatomical changes that takes place after delivery

 Discuss the anatomical changes and circulatory disturbances diagnoses and outline management of the following common congenital abnormalities
- Fallot's Tetrology
- Transposition of the great vessels
- Patent Ductus arteriosus
- Ventricular Septal defects
- Eisemenger's syndrome

 Discuss the importance of Rheumatic fever, aetiology, presentation, diagnosis, complications management and prevention
 Diagnose and discuss the management of the cardiac complications of Rheumatic fever
 Diagnose and manage congestive heart failure discuss the causes and mechanisms
 Diagnose and discuss the management of myocarditis

 Discuss the actions of the commonly used drugs :
- Diueretics
- Digoxin preparations
- Antihypertensives
 Diagnose and manage subacute bacterial endocarditis
 Student should be able to read X-ray chest related to the conditions mentioned in objective 4.8.3

Level II:

 Discuss the clinical features of the following congenital abnormalities:
- Atrial Septal defect
- Tricuspid atresia
- Pulmonary Stenosis
- Aortic Stenosis
- Anomalous pulmonary venous drainage
- Heart block
- Coarcitation of the aorta

* Genito-urinary Systems
Problems commonly encountered :
1. Burning micturition
2. Hematuria
3. Turbid urine
4. Oedema
5. Oliguria
6. Enuersis
7. Polyuria
8. Abdominal pain
9. Vaginal discharge

* Specific statements & conditions
Level I:

 Discuss the water and electrolyte requirements of newborn, infant and children
 Discuss the mechanisms of acid-base control, PH, and treatment of these disturbances (Refer to course 205)

 Diagnose and outline management of the following conditions and realize their short and long term complications:
- Urinary tract infections
- Acute glomerulonephritis
- Nephrotic syndrome
- Haematuria
- Bilharzia haematobium
- Proteinuria
- Obstructuve uropathy
- Vesicoureteric reflux (VUR)
- Enuersis
- Chronic glomerulonephritis
- Renal failure (Acute kidney injury & chronic kidney disease)
• Discuss the etiological factors, the diagnosis and management of hypertension
• Read a plain X-ray (KUB) and L.V.P.

Level II:

 Discuss the diagnosis and clinical features of:
- Wilm's tumour
- Vaginal bleeding and discharge in neonate & young girls
- Posterior urethral valves
- Undesended testicle
- Hypercalcuria
- Polycystic kidney disease
- Haemolytic uraemic syndrome
- Anaphlactoid nephritis
- Fanconi syndrome

* Discuss the following tests, their indications, and interpretations:
- Creatinine clearance
- Urine selectivity test
- Esbach test.
- I.V.P.
- Micturating cystourethrogram and Retrograde I.V.P.
- Renogram
- CT scan ,DMSA ,DPTA

* Metabolism and Endocrine System

Problems commonly encountered :
1. Short stature
2. Polyuria
3. Polydepsia
4. Coma
5. Ambiguous genitalia
6. Thyroid enlargement
7. Hyperpigmentation
8. Precocious Puberty
9. Obese child

Specific statements & conditions
Level I:

* Discuss the embryology and development of the thyroid gland (Refer to Endocrine course)
* Draw diagrammatically and discuss the synthesis transport, biochemical actions and control of Section of the thyroid hormone (Refer to Endocrine course)
* Diagnose and outline manage and discuss the complications of the following problems:
- Growth retardation
- Hyperglycaemia
- Hypoglycaemia
- Goitre
- Hypothyroidism
- Hyperthyroidism
- Steroids administration
- Hypoadrenalism
- Polyuria

- Discuss the actions of the following:
- Insulin
- Thyroxine
- Anti-thyroid drugs
- Steroids
- Discuss the metabolic problems associated with:
- Diabetes mellitus
- Hepatic failure
- Heart failure
- Respiratory failure
- Renal failure (acute and chronic)

Level II:

- Discuss the diagnosis and clinical features of:
- Early and delayed sexual development and puberty
- Ambiguous genitalia
- Hypercalaemia
- Hypocalaemia
- Adrenogenital syndrome
- Discuss the actions of the following drugs:
- Testosterone
- A.C.T.H.
- Adrenaline
- Growth Hormone
- Ant diuretic Hormone
- Discuss the indications and interpretations of the common thyroid function tests

- Nervous System

Problems commonly encountered :
- Coma
- Spasticity
- Hypotonia
- Delayed milestones
- Muscle pain and tenderness
- Abnormal movements
- Fits
- Headache
- Paralysis
- Mental retardation
- Cerebral palsy

Specific statements & conditions
Level I:

 Discuss the embryology and development of the related gross congenital abnormalities (Refer to CNS Course)
 Draw diagrammatically the flow of the CSF and discuss its formation absorption and functions
 Discuss the functions of the blood brain barrier
 Draw diagrammatically the major sites of obstruction of the flow of CSF and discuss the presentation diagnosis complications and managements
 Diagnose, manage and prevent common infections
- Meningitis
- Encephalitis
- Poliomyelitis
- Cerebral Malaria
- Cerebral abscess

* Diagnose and discuss the aetiology, complications and outline management of :
- Cerebral palsy
- Hypotonia (Flobby baby)
- Spasticity
- Delay in motor and intellectual development
- Fits and seizures
- Impaired consciousness and coma
- Space occupying lesions and raised intracranial pressure
- Persistent headache
- Muscle pain and tenderness
- Read a plain X-ray of skull including diagnosis of raised intracranial pressure
- Interpretation of CSF tests results

Level II:

- Diagnose and discuss the aetiology, complication and management:
- Episodic disorder, tics breath holding attacks, Hysteria
- Muscle pain and tenderness
* Discuss the following radiological investigations and their indications:
- Myelography
- Subdural puncture and aspiration
- CSF analysis
- Angiography
- Brain Scan
- E.E.G.
- G.A.T. Scan

* Discuss the clinical features of:
- Cytomegalovirus
- Toxoplasmosis
- Rubella
- Phenylketonuria
- Migraine
- Infantile hemiplegia
- Carinopharyngioma
- Medulloblastoma
- Neuro-cutanens disorder
* Blood

Problems commonly encountered :
1. Paleness
2. Bleeding

Specific statements & conditions
Level I:

 Discuss the development, functions, sites of production and factors which influence the formation of different blood elements. (Refer to Haematology Course)
 Discuss the factors and the mechanism of haemostasis and the diagnosis, aetiology and outline management of:
- Hemophilia A,B
- Platelet deficiency
- Hypoprothrombinaemia
 Diagnose and manage different types of anaemia
 Discuss blood groups and principles of transfusion limitations, indications and hazards (Refer to Blood Course)
 Diagnose and manage incompatibility in the newborn
 Diagnose and explain management of :
 Acute lymphoblastic leukemia
 Lymph node enlargement
 Chronic myeloid leukemia
 Hepatosplenomegaly
 Bleeding
 Chronic lymphatic leukemia
- Discuss the clinical features of :
- Von Will brand disease
- Fibrinogen deficiency
- Spasticity
- Discuss the indications, hazards and interpretations of:
- Bone marrow
- Radioactive chromium studies

- Skin Diseases Allergic Diseases

Problems commonly encountered :
1. Itching
2. Rash
3. Ulceration

Specific statements & conditions
Level I:

 Discuss pigmentary, allergic and inflammatory responses of skin
 Discuss the common skin manifestations of systemic diseases
 Discuss the clinical features of :
- Eczema
- Diaper rash
- Drug eruptions
- Leprosy
- Fungal infection
- Bacterial skin infection
- Insect bites
- Scabies
- Onchocerciasis
- Candida infection

Level II:

* Discuss the clinical features of:
- Psoriasis
- Viral skin infections
- Muco-cutaneous Leishmaniasis
- Contact dermatitis
- Acne
- Falling hair
- Syphilis
* Disease of Bone, Joints and Connective tissue
Problems commonly encountered :
1. Joint pain
2. Skeletal deformity

Specific statements & conditions
Level I:
* Diagnose and discuss the management of :
- Rheumatoid arthritis
- Club foot
- Congenital hip dislocation
- Osteomyelitis
- Joint disease secondary to bacterial infections, tuberculosis, typhoid and dysentry

Level II:

* Describe the clinical features of:
- Osteogeneses imperfecta
- Achondroplasia
- Scoliosis
- Dermatomyositis

* Eye Diseases

Problems commonly encountered :
1. Cataract
2. Squint
3. Red discharging eye
4. Diminshed in vision (Blindness)

Specific statements & conditions
Level I:

* Draw the visual pathways showing points of possible abnormalities (Refer to CNS Course)
* Diagnose and outline management of the following conditions:
- Cataract
- Squint
- Onchocerciasis
- Xerophthalmia
* Diagnose and discuss management and prevention of :
- Trachoma
- Bacterial infections
4.15.4 Discuss the ocular manifestations of systemic diseases
- Hypertension
- Diabetes mellitus
- Increased intracranial pressure
- Tuberculus meningitis

Level II:

- Discuss the anatomy of the eye using simple diagrams and the actions of ocular muscles (Refer to Anatomy Course)
- Discuss the following conditions :
- Night blindness
- Colour blindness
- Glucoma
- Horner's syndrome
- Steroid therapy
- Retinitis pigmentosa
- Optic atrophy
- Exophthalmos

- Accidents and Poisoning
Problems commonly encountered :
Level I:

- Discuss the common poisoning and accidents occurring in infants and children, the manifestation, management and prevention
- Kerosine inhalation
- Salicylates
- Phenobarbitone
- Organophosphorous compounds
- Food poisoning
-Discuss methods of calculation of doses of drugs in infants and children

Level II:

- Discuss the clinical features and describe management of:
- Battered baby syndrome
- Iron poisoning

- Emergency Pediatrics
Statements and conditions
Level I:

- Deal effectively with the following conditions:
- Hyperglycaemia
- Hypoglycemia
- Shock and electrolyte disturbance
- Convulsive disorders
- Disturbed consciousness
- Status asthmaticus
- Acute abdomen
- Respiratory obstruction, diphtheria, foreign body, croup
- Hypertensive encephalopathy
- Heart failure
- Acute renal failure
- Hepatic failure

- Endemic Diseases
Statements and conditions Level I:

- Diagnose, manage and discuss complications, community diagnosis effect and prevention of :
- Bilharziasis
- Malaria
- Kalazar
- Leprosy
- Common Heliminthic diseases
- Onchocerciasis
- Filariasis

- Health Education
4.19.1 Educate and seek cooperation of mothers, parents and the community in:
- Sanitation
- Antenatal care
- Breast feeding
- Nutrition
- Immunization
- Oral rehydration

-Research
Cultivate in himself the habits of asking questions and trying to find an answer. To realize that research should be directed to help solve problems which will improve service; and to realize that research does not always need sophisticated equipments, but can be simple and realistic.

- PLACES OF LEARNING AND RESOURCES

- Each student will be given beds in each of the general, neonatal, malnutrition, gastrointestinal, quarantine and surgical wards. The student will be responsible of the patients in these beds. To each patient he is expected to do the following, keeping his own records:
- Take and record history
- Carry out and record clinical examination
- Ensure that the required investigations are done and recorded
- Record the treatment and discuss it with the staff
- Follow up the patient and record progress
- Attend special investigations, operation or other procedures which the patient has to go through
- Be ready to present and discuss the patient
- When warranted and where possible, to follow up patient at home, school etc.
- In case of death console parents and discuss with the staff the cause of death and be ready to evaluate the case in the discharge and death clinic



المنسقون


Dr. ElfadilEisa
Dr. George Zarif



المطلوبات



الأهداف


:General Objectives

It is of paramount important for all doctors to be well trained in pediatrics and child health. This will reduce sufferings and deaths among infants, and children and would lead to more healthy productive adults the required investigations are done and recorded



طرق التدريس


1 Emergency and referred clinics
The student will be attending in small groups working with the staff. (see timetable)
2 Health Centers
The student will be going in small groups to work with the staff (see timetable)
3 Comprehensive child care clinics
The student will also go to the villages in small groups to work with the staff (see timetable).
4 Night duty
The student will spend nights in the hospital working in the emergency out-patient and the ward (see timetable).
5 Paediatric Side-ward Laboratory
The student should do simple tests mentioned int he specific objectives.
6 Tutorials and seminars will be conducted in the paediatric side-room.
7 Ward rounds and field work including rural or village comprehensive paediatric work
8 Conversances, medical, histopathological and sociomedical
9 Seminars
10 Tutorials
11 Peer teaching
12 Discharge and death clinic
13 Journal clubs
14 Guest lectures



المصادر


1 Human resources : pediatricians
2 Physical resources
2.1 Lecture room
2.2 Training sites
2.3 Audio-visual. aids



وسائل التقويم


1 ndance to the ward, teaching sessions and interest in patients under student's care - reports by members of staff. 15%
2 written clerkship records of patients under student's care and performing the skills mentioned in the specific objectives. 15%
13 entations and taking active part in discussions during rounds, seminars tutorial, seminars and with staff reports by members of staff. 15%
14 MCQs & Single best answer 25%
5 Written 15%
6 Clinical (PACES) 40%
7 OSCE 10%
8 Attendance &performance 10%



المراجع


1 Medical care in developing countries
M. King
2 Priorities in paediatric care in developing countries
D. Morley
3 Nelson Text Book of Pediatrics
4 A Companion to Medical Studies
Passmore and Robson
5 Diseases of the Newborn Schaffer Avery
6 Primary Child Care
King and F. King
7 Paterson Side Children Light Wood, Brimble combe and Barltrop
8 Diseases of Children Jolly
9 clinical Pharmacology Laurance
10 Child Health and Development Ellis
11 Paediatric Journals



الجدول الزمني


Department Members

Dr. A.SalamEltayeb

Prof. Huda Haroun

Dr. Musa Mustafa

Introduction

History taking and clinical examination

Breast feeding and infant feeding

Introduction to IMCI

Sunday09/4/2017
08:00AM- 09:30AM

09:30AM- 10:30AM

11:00AM- 12:30PM

01:00PM- 02:30PM

Dr. ElfadilEisa

Dr. Omaima Salah

Dr. Musa Mustafa

Birth Asphyxia

(Respiratory distress syndrome (RDS

Neonatal jaundice


Monday10/4/2017
08:00AM- 09:30AM

10:30AM- 12:00PM

12:30PM- 02:00PM

Prof.Ali Haboor

Dr. George Zarif

Dr. HushamElomda

(Iron Deficiency Anemia(IDA

Genetics

Acute poststrepto-coccal Nephritis


Tuesday11/4/2017
08:00AM- 09:30AM

10:30AM- 12:00PM

12:30PM- 02:00PM

Optional


Wednesday12/4/2017

Dr. FawziaHammad

Prof.Huda Haroun

Dr. HushamElomda

(Protein Energy Malnutrition (PEM) (1

(Hemolytic Anemia(1

Nephrotic syndrome


Thursday13/4/2017
08:00AM- 09:30AM

10:30AM- 12:00PM

12:30PM- 02:00PM

Dr. A.SalamEltayeb

Dr. George Zarif

Dr. George Zarif

(Intra uterine infections (TORCH

(Diarrheal diseases(1

(Diarrheal diseases(2


Sunday16/4/2017
08:00AM- 09:30AM

10:30AM- 12:00PM

01:00PM- 02:30PM

Prof. Ali Haboor

Childhood TB


Monday17/4/2017
08:00AM- 09:30AM

Group A
Neonatal Round
Group 1 -----------Prof. Huda Haroun
Group 2---------- Dr. HushamOmda
Group 3------------ Dr. Omaima Salah
Group 4 ----------Dr. FawziaHmmad
Group 5 -----------Dr. Mona Ibrahim


Group B
Neonatal Round
Group 1 -----------Dr. Nasr Eldin
Group 2--------- Dr. ElfadilEisa
Group 3 ---------Dr. George
Group 4 ------------Dr. Musa Mustafa
Group 5--------------- Dr. A. Salam


11:00PM- 02:00PM
















Dr. HayderElhadi

Dr.M. Alamin

Dr.M.Alamin

growth monitoring& Psychomotor Development

(Congenital Heart Diseases(1) (CHD1

Childhood Asthma


Tuesday18/4/2017
08:00AM- 09:30AM

10:30AM- 12:00PM

01:00PM- 02:30PM

Dr. FawziaHmmad

(Protein Energy Malnutrition (PEM) (2


Wednesday19/4/2017
08:00AM- 09:30AM

Prof.HudaHaroun

(Hemolytic Anemia(2


Thursday20/4/2017
08:00AM- 09:30AM

Group A
ClinicalRound
Group 1-------------- Dr. Mona Ibrahim
Group 2---------- Dr. FawziaHmmad
Group 3--------- Dr. ElfadilEisa
Group 4 ---------Dr. HushamOmda
Group 5 ---------Dr. Omaima Salah


Group B
ClinicalRound
Group 1--------- Prof. Ali Haboor
Group 2-------- Dr. A. Salam
Group 3--------- Dr. Musa Mustafa
Group 4---------- Dr. Nasr Eldin
Group 5--------- Dr. George


11:00PM- 02:00PM
















Dr. HayderElhadi

Epilepsy and Convulsions


Sunday23/4/2017
08:00AM- 09:30AM

Group A
Case Presentation
PEM Dr. FawziaHmmad

Group B
Clinical Round
Group 1 -----------Prof. Ali Haboor
Group 2---------- Dr. ElfadilEisa
Group 3---------- Dr. George
Group 4-------------- Dr. Musa Mustafa
Group 5-------------- Dr. A. Salam


11:00AM- 02:00PM












Dr. A. Salam

Tetanus


Monday24/4/2017
08:00AM- 10:00AM

Group A
Clinical Round
Group 1------------ Prof. Huda Haroun
Group 2------------ Dr. HushamOmda
Group 3------------- Dr. Omaima Salah
Group 4--------------- Dr. NsrEldin
Group 5--------- Dr. Mona Ibrahim


Group B
Case Presentation
PEM Dr. FawziaHmmad


11:00AM- 02:00PM












Prof. Ali Haboor

Dr.M. Alamin

Seminar: Diabetes and Hypoglycemia

(Congenital Heart Diseases(2) (CHD2


Tuesday25/4/2017
08:00AM- 10:00AM

11:00AM- 12:30PM

Dr. HushamOmda

(Urinary Tract Infection (UTI


Wednesday26/4/2017
08:00AM- 09:30AM

Group A
IMCI
1wk – <2month---------- Dr. Kamil Saeed
Dr. ElfadilEisa


Group B
Clinical Round
Group 1--------------- Dr. Omaima Salah
Group 2------------- Prof. Ali Haboor
Group 3---------- Dr. Mona Ibrahim
Group 4----------- Prof. Huda Haroun
Group 5------------- Dr. Nada Othman


11:00AM- 02:00PM












Dr. Musa Mustafa

Meningitis and Encephalitis


Thursday27/4/2017
08:00AM- 09:30AM

Group A
ClinicalRound
Group 1---------- Dr. George
Group 2 ----------Dr. NsrEldin
Group 3----------- Dr. A. Salam
Group 4----------- Dr. FawziaHmmad
Group 5 ------------Dr. ElfadilEisa


Group B
IMCI
1wk – <2month---------- Dr. Kamil Saeed
Dr. Omaima Salah


11:00PM- 02:00PM












Dr.M.Alamin

Rheumatic Fever


Sunday30/4/2017
08:00AM- 09:30AM

Group A
Clinical Round
Group 1----------- Prof. Huda Haroun
Group 2 ----------Dr. HushamOmda
Group 3---------- Dr. Omaima Salah
Group 4 -----------Dr. FawziaHmmad
Group 5----------- Dr. Mona Ibrahim


Group B
Case Presentation
Diabetes
Dr. Nasr Eldin


11:00AM- 02:00PM












Dr. George

Dr. George

Whooping Cough

Diphtheria


Monday01/5/2017
08:00AM- 09:00AM

09:00AM- 10:00AM


Group A
Case Presentation
Diabetes
Dr. Nasr Eldin


Group B
Clinical Round
Group 1 ---------Prof. Ali Haboor
Group 2 ----------Dr. ElfadilEisa
Group 3 ----------Dr. George
Group 4 ----------Dr. Musa Mustafa
Group 5 ---------Dr. A. Salam


11:00AM- 02:00PM












Dr. ElfadilEisa

Dr.M.Alamin

(Seminar: (upper respiratory tract obstruction

Heart Failure in Children


Tuesday02/5/2017
08:00AM- 10:00AM

11:00AM- 12:30PM

Dr. A. Salam

Rickets


Wednesday03/5/2017
08:00AM- 09:30AM


Group A
Clinical Round
Group 1---------- Dr. HushamOmda
Group 2---------- Dr. Nada Othman
Group 3 ---------Dr. FawziaHmmad
Group 4 ------------Dr. Mona Ibrahim
Group 5---------- Prof. Huda Haroun


Group B
IMCI: Danger signs and difficulty breathing
IMCI ----------Dr. Kamil Saeed
Dr. George


11:00AM- 02:00PM












Dr. Omaima Salah

Viral Hepatitis


Thursday04/5/2017
08:00AM- 09:30AM


Group A
IMCI: Danger signs and difficulty breathing
IMCI ----------Dr. Kamil Saeed
Dr. HushamOmda


Group B
Clinical Round
Group 1------------- Dr. ElfadilEisa
Group 2-------------- Dr. Omaima Salah
Group 3------------ Dr. Musa Mustafa
Group 4------------ Dr. A. Salam
Group 5 -----------Prof. Ali Haboor


11:00AM- 02:00PM












Dr. HushamOmda

Seminar: Renal Failure


Sunday 07/5/2017
08:00AM- 09:30AM

Group A
Case Presentation
Respiratory------------ Dr. Musa Mustafa


Group B
Clinical Round
Group 1---------- Prof. Ali Haboor
Group 2 ----------Dr. ElfadilEisa
Group 3 ----------Dr. George
Group 4----------- Dr. Dr. NsrEldin
Group 5------------- Dr. A. Salam


11:00AM- 02:00PM












Dr. George

(Juvenile Rheumatoid Arthritis( JRA


Monday 08/5/2017
08:00AM- 09:30AM


Group A
Clinical Round
Group 1 ------------Prof. Huda Haroun
Group 2 -----------Dr. HushamOmda
Group 3 ----------Dr. Omaima Salah
Group 4--------------- Dr. FawziaHmmad
Group 5------------- Dr. Mona Ibrahim


Group B
Case Presentation
Respiratory------------ Dr. Musa Mustafa


11:00AM- 02:00PM












Dr. HayderElhadi

Measles


Tuesday 09/5/2017
08:00AM- 10:00AM

Mid Term Exam


Wednesday 10/5/2017
08:00AM- 09:30AM


Group A
Optional

Group B
Clinical Round
Group 1-------------- Prof. Huda Haroun
Group 2 ----------Dr. Nada Othman
Group 3 ----------Dr. Omaima Salah
Group 4-------------- Dr. Musa Mustafa
Group 5 -----------Dr. Mona Ibrahim


11:00AM- 02:00PM












Optional


Thursday11/5/2017
08:00AM- 09:30AM


Group A
ClinicalRound
Group 1------------ Prof. Ali Haboor
Group 2---------- Dr. ElfadilEisa
Group 3---------- Dr. George
Group 4 ----------Dr. Fawzia
Group 5 -----------Dr. NsrEldin


Group B
(Case presentation(Cardiac Center
CVS ----------Dr. M. Alamin


11:00AM- 02:00PM












Dr. Musa Mustafa

Bleeding Disorders


Sunday14/5/2017
08:00AM- 09:30AM


Group A
Clinical Round
Group 1----------- Dr. Nada Othman
Group 2------------- Dr. HushamOmda
Group 3-------------- Dr. Omaima Salah
Group 4-------------- Dr. FawziaHmmad
Group 5------------ Dr. Mona Ibrahim


Group B
Case Presentation
Hematology ----------Prof. Huda Haroun


11:00AM- 02:00PM












Prof. HyderElhadi

(Seminar: (Acute flaccid Paralysis and Cerebral Palsy


Monday15/5/2017
08:00AM- 10:00AM


Group A
Case Presentation
Renal-------------- Dr. HushamOmda


Group B
Clinical Round
Group 1 ----------Prof. Ali Haboor
Group 2--------- Dr. ElfadilEisa
Group 3 -------------Dr. George
Group 4-------------- Dr. Musa Mustafa
Group 5-------------- Dr. A. Salam


11:00AM- 02:00PM












Dr. Nada Othman

Malignancy in Children


Tuesday 16/5/2017
08:00AM- 09:30AM


Group A
Optional

Group B
Case presentation
CNS -----------Prof. HyderElhadi


11:00AM- 02:00PM






Dr. A. Salam

(Inborn Error of Metabolism(IEM


Wednesday 17/5/2017
08:00AM- 09:30AM


Group A
Clinical Round
Group 1 ---------Prof. Huda Haroun
Group 2 ----------Dr. Mona Ibrahim
Group 3 ---------Dr. HushamOmda
Group 4 ---------Dr. Omaima Salah
Group 5 ------------Dr. FawziaHmmad


Group B
Optional


11:00AM- 02:00PM










Optional


Thursday 18/5/2017
08:00AM- 09:30AM


Group A
(Case presentation(Cardiac Center
CVS------- Dr. M. Alamin


Group B
Clinical Round
Group 1 ----------Dr. A. Salam
Group 2--------- Prof. Ali haboor
Group 3----------- Dr. ElfadilEisa
Group 4 -----------Dr. George
Group 5---------- Dr. Musa Mustafa


11:00AM- 02:00PM












Dr. George Zarif

Thyroid Gland Disorders


Sunday21/5/2017
08:00AM- 09:30AM


Group A
Case Presentation
Hematology -------Prof. Huda Haroun


Group B
Clinical Round
Group 1--------- Prof. Ali Haboor
Group 2---------- Dr. ElfadilEisa
Group 3 -----------Dr. Nada Othman
Group 4 -----------Dr. Musa Mustafa
Group 5 ----------Dr. A. Salam


11:00AM- 02:00PM












Prof. Ali Habour

Malaria


Monday22/5/2017
08:00AM- 09:30AM


Group A
Clinical Round
Group 1-------- Prof. Huda Haroun
Group 2 -----------Dr. A. Salam
Group 3--------------- Dr. Omaima Salah
Group 4------------ Dr. Musa Mustafa
Group 5----------- Dr. Mona Ibrahim


Group B
Case Presentation
Renal------------- Dr. HushamOmda


11:00AM- 02:00PM












Dr. Omaima Salah

AIDS


Tuesday 23/5/2017
08:00AM- 09:30AM


Group A
Case presentation
CNS------ Prof. HyderElhadi


Group B
Optional


11:00AM- 02:00PM








Optional


Wednesday 24/5/2017
08:00AM- 09:30AM


Group A
IMCI: Diarrhea
IMCI ---------Dr. Kamil Saeed
Dr. Mona Ibrahim


Group B
Clinical Round
Group 1----------- Dr. FawziaHmmad
Group 2-------------- Dr. NsrEldin
Group 3--------- Prof. Huda Haroun
Group 4 ------------Dr. Nada Othman
Group 5-------------- Dr. Omaima Salah


11:00AM- 02:00PM












Optional


Thursday 25/5/2017
08:00AM- 09:30AM


Group A
Clinical Round
Group 1 -----------Dr. Musa Mustafa
Group 2----------- Dr. HushamOmda
Group 3 ---------Prof. Ali Haboor
Group 4 ----------Dr. ElfadilEisa
Group 5------------- Dr. NsrEldin


Group B
IMCI: Diarrhea
IMCI----------- Dr. Kamil Saeed
Dr. FawziaHmmad


11:00AM- 02:00PM













Ramadan Vacation till 2/7/2017


Optional


Sunday02/7/2017
08:00AM- 09:30AM


Group A
Clinical Round
Group 1------------- Prof. Huda Haroun
Group 2------------ Dr. HushamOmda
Group 3------------- Dr. Omaima Salah
Group 4------------- Dr. FawziaHmmad
Group 5 -----------Dr. Mona Ibrahim


Group B
IMCI
Fever----------- Dr. Kamil Saeed
Dr. A. Salam


11:00AM- 01:00PM












Optional


Monday 03/7/2017
08:00AM- 09:00AM


Group A
IMCI
Fever----------- Dr. Kamil Saeed
Dr. NsrEldin


Group B
Clinical Round
Group 1--------- Prof. Ali Haboor
Group 2------------ Dr. ElfadilEisa
Group 3---------- Dr. George
Group 4---------- Dr. Musa Mustafa
Group 5--------- Dr. A. Salam


11:00PM- 02:00PM















Group A
Case presentation
Dr. Nada Othman
Group B
Optional


Group A
Optional
Group B
Case presentation
Dr. Nada Othman


Tuesday 04/7/2017
09:30AM- 11:00AM









11:30AM- 01:00PM


Optional


Wednesday 05/7/2017
08:00AM- 09:00AM


Group A
Clinical Round
Group 1 --------Dr. Omaima Salah
Group 2----------- Dr. FawziaHmmad
Group 3 ------------Dr. Mona Ibrahim
Group 4---------- Prof. Huda Haroun
Group 5-------- Dr. HushamOmda


Group B
IMCI:
Nutrition and Dr. Kamil Saeed
Anemia----------- Prof. Haboor


11:00PM- 02:00PM












Prof. Huda Haroun

Seminar: Children Toxicology


Thursday 06/7/2017
08:00AM- 09:30AM


Group A
IMCI: Diarrhea
Nutrition and Dr. Kamil Saeed
Anemia------------ Prof. Huda Haroun


Group B Clinical Round
Group 1 -----------Dr. George
Group 2------------- Dr. Musa Mustafa
Group 3--------- Dr. A. Salam
Group 4----------- Dr. Nada Othman
Group 5 -----------Dr. ElfadilEisa


11:00AM- 02:00PM












Optional


Sunday 09/7/2017
08:00AM- 09:30AM


Group A
Clinical Round
Group 1----------- Prof. Huda Haroun
Group 2----------- Dr. HushamOmda
Group 3------------ Dr. Omaima Salah
Group 4---------- Dr. FawziaHmmad
Group 5 ---------Dr. Mona Ibrahim


Group B
Clinical Round
Group 1------------ Prof. Ali Haboor
Group 2-------- Dr. ElfadilEisa
Group 3 -----------Dr. George
Group 4---------- Dr. Musa Mustafa
Group 5----------- Dr. A. Salam


11:00AM- 02:00PM
















(Written Exam (MCQs and Essays


Thursday 13/7/2017
08:00AM- 09:30AM

OSCE


Monday 17/7/2017
08:00AM- 10:30AM

Clinical Examination


Wednesday19/7/2017
08:00AM- 03:00PM

Clinical Examination


Thursday 20/7/2017
08:00AM- 03:00PM

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