study guide - universiti kebangsaan malaysia · 1 study guide year 2 semester 1 2016/2017. 2...
TRANSCRIPT
1
STUDY GUIDE
YEAR 2 SEMESTER 1
2016/2017
2
PREFACE
There are four major strands involved in the first semester second year of the Medical Program which are the Biomedical (BM), Medicine and Society (MS), Clinical Science (CS) and Personal and Professional Development (PPD) strands. There are four modules in the BM strand and each module is covered in four weeks. Activities of the MS, CS and PPD strands will be incorporated throughout the semester. Credit unit of each module in semester 2 is shown below. The methodology of teaching is similar as in Year 1. Other than the concept lectures, students will learn independently with self learning packages, problem-based learning (PBL), computer-aided learning and practical.
MODULE
CODE
CREDIT UNIT
Blood and lymph
FFFF2113
3
Cardiovascular
FFFF2214
4
Respiratory
FFFF2313
3
Urinary
FFFF2433
3
Clinical Science
FFFF2511
1
Medicine & Society
FFFF2613
3
Personal & Professional Development
FFFF2712
2
Contents Page
Preface 2 Blood and Lymph 6 Cardiovascular 14 Respiratory 25 Urinary 32 Clinical Science 39 Personal & Professional Development (PPD) 42 Medicine &Society 47
3
VENUE FOR TEACHING-LEARNING ACTIVITIES
ACTIVITES
VENUE / PLACE
Lecture
Dewan Kuliah 2 (DK2), Level 2, Pre-Clinical Building
Practical
Makmal Pelbagai Guna (MPG), Level 7&8 Dewan Diseksi, Anatomi (DD), Level 1
SGD / PBL
Bilik Pengajian Kecil (BPK).
Clinical Science
Makmal Skill Klinikal
4
Assessment consists of Continuous Assessment (CA) and End of Semester Examinations (ESE). Types of CA vary depending on the module. For the Biomedical Strand, CA is based on the end of module examination and the PBL sessions. ESE comprises of theory and practical papers. The types of questions in the theory papers are:
One Best Answer (OBA)
Extended Matching Items (EMI)
Modified Essay Questions (MEQ) There will be one practical paper that is the objective structured practical examination (OSPE) or objective structured clinical examination (OSCE) which includes all modules except Medicine & Society. Overall methods of assessment in Semester 3 are outlined below:
MODULE
METHODS OF ASSESSMENT
CA
END OF SEMESTER EXAMINATION LOG BOOK
OBA
EMI
MEQ
OSPE
Bld & lymph
CVS
Respiratory
Urinary
CS
MS
PPD
Attendance in all teaching-learning activities will be considered in allowing a student to sit for the end of Semester 3 examination.
At the end of semester 3, students should be able to :
1. explain the structures and functions, the pathological process, effect and complication of common diseases in blood and lymph, cardiovascular, respiratory, gastrointestinal, urinary, and the principle of drug action.
2. perform history taking, physical examination and basic clinical procedures. 3. interpret results of basic laboratory investigations in the diagnosis of common
diseases. 4. compare and contrast the approaches used in the health care services, in the
provision of comprehensive and holistic care to patients, families and the community, as well as groups with special needs and those related to occupational and environmental problems.
5
5. apply critical thinking, leadership quality, effective communication, basic principles of religious and cultural values in dealing with patients, colleagues and the community.
6. demonstrate ability to utilize various resources to obtain the relevant current information in the quest to become a life long learner.
Summary of teaching learning methodology and number of sessions.
MODULE/STRAND
LECTURE & TBL
SLP/ CAL
PRACTICAL/ MES/CSL/SGD PROJECT
PBL
Total Hours
BLOOD AND LYMPH
16
2
10
12
39
CARDIOVASCULAR
19
4
12
12
47
RESPIRATORY
15
5
12
12
44
URINARY
16
1
6
2
37
CLINICAL SCIENCE
4
-
8
-
20
MEDICINE AND SOCIETY
16
2
10
1
44
PROFESSIONAL AND PERSONAL DEVELOPMENT
3
2
8
30
6
BLOOD AND LYMPH (FFFF2113)
I. DIRECTORY OF TEACHING STAFF
Name of lectures Phone no.
E-mail address
1. Dr. Hafiza Alauddin (Module Coordinator)
9145 9518 [email protected]
2. Prof. Datin Dr. Noor Hamidah Hussin 9145 5339 [email protected]
3 Prof. Dr. Noraidah Masir
9145 5367 [email protected]
4 Prof. Madya Dr. Leong Chooi Fun 9145 5842 [email protected]
5 Prof Madya Dr. Nurismah Md Isa 9145 5827
6 Prof. Madya Dr. Raja Zahratul Azma Raja Sabudin
9145 9493 [email protected]
7 Dr. Hanita Othman 9145 5378 [email protected]
8 Dr. Nurasyikin Yusof 9145 9516 [email protected]
9 Dr. Azlin Ithnin 9145 9495 [email protected]
10 Dr Suria Hayati Md Pauzi 9145 9503 [email protected]
11 Dr Wong Yin Ping 9145 9608
12 Dr Tang Yee Loong 9145 9509
13
Dr Fazarina Mohammed 9145 5357 [email protected]
14 Dr Dashima Abd Shukor 9145 9502 [email protected]
15.
Dr Azyani Yahaya 9145 5357 [email protected]
16. Puan Farah Hanan Fathihah Jaffar
91458614 [email protected]
17. Dr Anisah Nordin 9145 9592 [email protected]
18. Prof. Madya Dr. Norzana Abd. Ghafar
9145 8605 [email protected]
19. Dr Siti Norlia Othman
9145 9582 [email protected]
20. Prof Madya Datin Dr. Noor Zetti Zainol Rashid
9145 9533
21. Dr Goon Jo Aan 91459558 [email protected]
7
INTRODUCTION TO BLOOD AND LYMPH
The module aims to enable the students to acquire basic knowledge on the normal blood cells production and also the mechanisms and pathophysiology of common blood and lymphoreticular disorders. It will also facilitate students to understand the signs and symptoms of these common blood disorders and enable them to interpret the relevant investigation results for the diagnosis of these disorders. The module will also cover the principles of blood grouping and transfusion and the basic principles of stem cell transplantation. In this module student shall learn through concept lectures, practicals, Problem-Based Learning packages (PBL) and Directed Student Learning packages (DSL). The scope of learning is outlined in the guidebook as shown in the content and specific objectives of the topics. Students are expected to further acquire their knowledge through reading suggested textbooks and websites.
PRE-REQUISITES The students should have prior knowledge of:
the blood constituents, basic structure/morphology and function of blood cells; (leucocytes, erythrocytes and platelets), haemostasis, (Tissues of Body Module).
haemoglobin synthesis and degradation (Tissues of Body Module).
the basic biochemistry of biological molecules (Metabolism and Endocrine Module)
normal immune system, immune response and abnormalities of the immune system (Infection and Immunity Module)
host-parasite relationship (Infection and Immunity Module)
II. MODULE OBJECTIVES
By the end of this module, students should be able to:
explain normal haemopoiesis,
describe iron, folate, vitamin B12 metabolism.
explain the common terminologies used in the common blood and lymphoreticular disorders.
explain the pathogenesis of the common blood and lymphoreticular disorders
correlate the pathological process of the common blood and lymphoreticular disorders with clinical features
interpret relevant laboratory tests, identify and describe the morphology of abnormal cells in the common blood and lymphoreticular disorders
explain the principles of blood grouping, transfusion and basic principles of stem cell transplantation
discuss the infections of immunocompromised host
discuss the common blood infections.
8
III. METHODS OF ASSESSMENT
Continuous assessment (PBL 10%)
End of Module Exam (20% which includes OBA, EMI and MEQ)
End of Semester Examination: o Theory paper in the forms of OBA, EMI and MEQ (60%) o Practical paper in the form of OSPE (10%)
IV. RESOURCE MATERIALS
Ramzy S. Cotran, Vijay Kumar, Stanley L. Robbins. 2003. Robbins Pathologic Basis of Disease 7th edition. Saunders, Philadelphia.
Parakrama Chandrasoma, Clive R. Taylor. 2002. Concise Pathology 4th edition. Appleton and Lange.
Hoffbrand, A.V., Pettit, J.E., Moss, P.A.H. 2011 Essential Haematology 6th edition. Blackwell Science.
Martin R Howard, Peter J Hamilton, 2002. Haematology, an Illustrated Colour Text. Churchill Livingstone
Hoffbrand, A.V., Pettit, J.E., 2002. Clinical Haematology Illustrated. Churchill Livingstone
Lewis S.M., Baon B.J., Bates I. 2006. Dacie and Lewis Practical Haematology 10th edition. Churchill Livingstone.
Katzung BG. Basic and Clinical Pharmacology. 9th Edition 2004. Appleton & Lange, McGraw Hill, Norwalk. Connecticut/Los Altos California.
CK Jayaram Paniker. Textbook of Medical Parasitology. 5th Edition, 2004.Jaypee Brothers Medical Publishers, New Delhi,
Arora DR and Arora B. Medical Parasitology. 2001. CBS Publishers and Distributers, New Delhi.
Noor Hayati Md Isa. Atlas Berwarna Parasitologi Perubatan. Edisi Kedua, 2004, NHMIKBM Enterprise, Kuala Lumpur.
Sallehuddin Sulaiman. Entomologi Perubatan. 1999. Penerbit Universiti Kebangsaan Malaysia Bangi.
Roitt I, Brostoff J and Male D. Immunology. 6th Edition, 2001. Gower Medical Publishing, London.
Kenneth J Ryan and C George Ray. Sherries Medical Microbiology. An Introduction to Infectious Diseases. 4th Edition, 2004. Mc Graw Hill
www.BloodMed.com
V. TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES
Lectures
At the end of the lecture/practical/demonstration/MES sessions, students should be able to: CL1 Haemopoiesis
describe normal haemopoiesis
relate the properties of pluripotent bone marrow stem cells to its function
explain the regulation of haemopoiesis
9
CL2 Normal Metabolism of Iron, Folate and Vitamin B12
explain the digestion, absorbtion and transport of iron, folate and vitamin B12
explain the function of iron, folate and vitamin B12 in relation to haemoglobin synthesis
discuss the effect of iron, folate and vitamin B12 in deficiency and factors affecting it.
CL 3, P1. Malaria
define malaria and describe the types
name the causative species and the vector
outline the life cycle of Plasmodium and identify its various stages
explain the pathogenesis and state the clinical features
outline the method of diagnosis and differentiate the use of thin and thick blood films
outline the general epidemiology in Malaysia
state the principles of treatment, prevention and control in Malaysia CL4, P2 Bleeding disorders – Approach to Diagnosis and Laboratory Investigations.
define abnormal bleeding
discuss briefly the mechanism and causes of abnormal bleeding
describe the complications of abnormal bleeding
discuss briefly the causes of inherited and acquired bleeding disorders
discuss the inheritance, clinical features, complications and laboratory investigations of Haemophillia A
discuss the pathogenesis, causes, effects, complications and laboratory investigations of disseminated intravascular coagulation (DIVC)
CL5, P2.Anaemia
define anaemia
classify anaemia
discuss the aetiology, pathogenesis and complications of anaemia
describe briefly the clinical features of the different types of anaemias
interpret the laboratory results in the investigations of common anaemias (iron deficiency, megaloblastic and haemolytic anaemias, thalassaemias, G6PD deficiency)
describe the abnormal morphology of blood cells in the various types of anaemia
CL6 Arboviruses and Haemorrhagic Fever Viruses
define and state examples of arboviruses
describe the general characteristics and clinical manifestations of arboviral diseases
outline the laboratory diagnosis and principles of treatment and prevention of aboviral diseases
describe the general characteristics and clinical manifestations of haemorrhagic fever viruses
10
outline the laboratory diagnosis and principles of treatment and prevention of haemorrhagic fever viruses
CL7 Infections In The Immunocompromised
discuss briefly the causes of immunodeficiency
categorize the degree of risk towards infection
describe the types of infections common to immunocompromised patients
state the clinical features of infections in immunocompromised patients
state the relevant laboratory investigations for diagnosis
state the principles of management of immunocompromised patients
CL8, P3 Rhesus and ABO Blood Groups and Principles of Blood Transfusion.
state the common and important blood groups
explain the principles of blood grouping and cross-matching
state the various of blood component production
outline the principles of blood and blood component usage
CL9 Lymphoid Tissues
outline the pathway of lymph circulation from tissues to the circulatory system
describe the structure and function of lymph nodes
discuss the function of the spleen, tonsils and thymus glands
describe the factors that maintain steady lymph flow
describe the function of valves within the lymphatics CL10, P5 Bone Marrow Failure/Aplastic Anaemia
explain the concept of bone marrow failure
define ineffective haemopoiesis
list the causes of bone marrow failure
discuss the effects and complications of bone marrow failure
classify aplastic anaemia
explain the pathogenesis of aplastic anaemia
describe the effects and complications of aplastic anaemia
CL11, P5 Leukaemias – Classification and Approach to Diagnosis
define leukemia and leukaemoid reaction
classify leukaemias
outline the known aetiology/pathogenesis of leukaemias
discuss the effects and complications of leukaemias
describe the laboratory investigations of leukaemias and identify the abnormal cells
outline the principles of management of leukaemias
11
CL12, P5 Myeloproliferative Neoplasms (MPN)
define myeloproliferative neoplasms (MPN) and state the diseases in MPN.
discuss the the pathogenesis, effects and complications of common MPN such as CML and polycythaemia rubra vera (PRV).
Explain the mechanisms of secondary polycythaemia.
List the causes of secondary polycythaemia.
outline the laboratory investigations and principles of management of CML and PRV
CL 13., P5 Paraproteinaemia
define paraproteinaemia
discuss the causes of paraproteinaemia
define multiple myeloma
describe the effects and complications of multiple myeloma
interpret the laboratory investigations in the diagnosis of multiple myeloma
CL14, P4 Filariasis
define filariasis
list the causative agents and related vectors
outline the life cycle of the parasite and identify its general morphology
explain the pathogenesis and state the clinical features of lymphatic filariasis
outline the methods of diagnosis and interpret the laboratory results
outline the general epidemiology in Malaysia
state the principles of treatment, prevention and control in Malaysia
CL15 Stem Cells and Transplantation
define stem cells
list the different types and sources of stem cells
relate the properties of stem cells to its potential applications
explain autologous, allogeneic and syngenic transplantation
explain the principles of stem cell transplantation
discuss briefly the effects and complications of stem cell transplantation
CL 16 Lymphoma
define lymphoma
classify lymphomas
describe the effects and complications of lymphomas
describe the ‘Reed-Sternberg’ cell in Hodgkin’s lymphoma
describe the relevant laboratory investigations of lymphomas
12
MES / Practicals / Demonstrations
At the end of the sessions, the students should be able to: P1 Malaria parasites
To perform blood smear for the detection of malarial parasites
Identify the malarial parasites by species and stages
P2 Anaemia and bleeding disorders
Identify the abnormal morphology of blood cells
Interpret the laboratory investigation results to diagnose the various types of anaemia
Interpret the laboratory investigation results to diagnose acquired and inherited bleeding disorders.
P3 Blood grouping
Determinine haemoglobin concentration
Determine haematocrit level
Determine ABO and Rhesus blood group
P4 Filariasis
Identify microfilaria found in blood by species.
P5 Haematological Malignancies and Bone Marrow Failure
Identify the leukaemiac cells.
Interpret the laboratory investigation results to diagnose leukaemias.
Describe the effects and complications of bone marrow failure
Identify ‘Reed-Sternberg’ cells in Hodgkin’s lymphoma
Identify abnormal plasma cells
Interpret laboratory investigation results to diagnose multiple myeloma and polycythaemia rubra vera
13
Self-Learning Packages (SLP)
At the end of the DSL topics, students should be able to:
SLP1 - Different types of leucocytes abnormalities:
define leucocytes, state the normal leucocytes in the circulation and describe its function
define the terminologies used to describe the various leucocytes abnormalities
list the causes of leucocytes abnormalities
relate the leucocytes abnormalities to the body response to injury, exercise, and infections (bacteria, parasite, and viral infections).
SLP 2 - Complications of blood transfusion
List the various blood components
Discuss the effects and complications of blood transfusion
Outline the investigations of immediate transfusion reactions. Problem-Based Learning (PBL) Topics
There are three (3) PBL topics in this module, each requiring two sessions
1. Tired and Yellow
2. Bleeding All Over
3. Kissing Fever
14
C. CARDIOVASCULAR MODULE (FFFF 2214)
I. DIRECTORY OF TEACHING STAFF
NO.
NAME OF LECTURERS
PHONE NO.
E-MAIL ADDRESS
1.
Dr Norliza Muhammad (Module Coordinator)
03-91459572
2.
Dr Norliana Masbah (Assistant Coordinator)
03-91459567
3.
Prof Dato’ Dr Ruszymah Hj Idrus
05-91458617
4.
Prof To’ Puan Dr Nordiah Hj. Awang Jalil
03-91459568
5.
Prof Dr Zaiton Zakaria
03- 91458614
6.
Prof Dr Srijit Das
03-
7.
Assoc Prof Dr Leong Chooi Fun
03-91455842
8.
Assoc Prof Dr Qodriyah Hj Mohd Saad
03-91459565
9.
Dr Tang Yee Loong
03-91459509
15
II. INTRODUCTION TO CARDIOVASCULAR MODULE
The aim of this module is to enable the student to acquire the knowledge of the structure and functions of the cardiovascular system. This module provides an introduction to common cardiovascular diseases and to describe the pathophysiological changes that occur with the disease process. It also enables the student to acquire knowledge on the underlying mechanisms and the principles of management of common diseases of the cardiovascular system.
PRE-REQUISITES
For this module the students should have basic knowledge in:
Histological structure of the major tissues of the body, such as epithelium, endothelium and smooth muscle (tissues of the body module).
Composition of blood and basic principles of haemostasis (blood and lymph module)
Basis of ischaemia/infarction, atherosclerosis, and thromboembolic disorders (mechanism of disease module).
III. MODULE OBJECTIVES
At the end of the module, the students should be able to:
1. Relate the structure and relations of the heart and major blood vessels of the body with the functions in the circulation.
2. Describe the operation of the heart as a pump, including the origin of the heartbeat, characteristics of the cardiac specialized conduction system and impulse transmission.
3. Interpret normal and abnormal electrocardiogram in some common clinical conditions and relate to the electrical events in the heart.
4. Describe the pressure, blood flow and volume changes in one cardiac cycle, the basis of normal and abnormal heart sounds and the jugular venous pulsation.
5. Apply the understanding of the cardiac cycle as a basis for physical examination of the heart.
6. Explain the mechanisms that control cardiac output in the normal individual, and how they operate in common situations such as exercise.
7. Differentiate flow, pressure and resistance in systemic and pulmonary circulation.
8. Describe the local and systemic (neural and chemical) mechanisms that control blood flow through the systemic and individual tissues (cerebral, skin and splanchnic circulations).
9. Discuss the factors that determine systolic and diastolic blood pressure as well as the short and long term regulatory mechanisms during changes in posture and in shock.
10. Explain the causes of hypertension, pathophysiology, complications and management of hypertension and the principles involved.
11. Describe the development of the heart, some common congenital defects, and the pathology of valvular problems.
12. Define shock; explain the mechanisms, the compensatory mechanisms in shock and causes of different types of shock.
16
13. Describe the pathophysiological changes, complication and the clinical features in the different stages of shock
14. Describe the types of infective endocarditis(acute and subacute). List the common etiological agents, the predisposing factors, pathogenesis and complications of infective endocarditis
15. Describe the structure and properties of the coronary circulation, and the pathology and effects of ischaemic heart disease and management of angina pectoris and the principles involved.
16. Describe some common causes, major effects and treatment of heart failure and the principles involved.
17. Describe the different types of cardiomyopathies, their aetiology,
pathogenesis, effects and complications (dilated cardiomyopathy,
hypertrophic cardiomyopathy and restrictive cardiomyopathy); Discuss the
causes, pathogenesis and morphology of myocarditis and pericarditis.
IV. METHOD OF ASSESSMENTS
Continuous assessment (PBL) - 10%
Formative (End of module) Assessment in the form of OBA, EMI and MEQ – 20%
End of Semester Examination: o Theory paper in the form of OBA, EMI and MEQ – 60% o Practical paper in the form of OSPE - 10%
V. RESOURCE MATERIAL
1. Basic and Clinical Pharmacology 13th Edition. Katzung and Masters. 2015. Lange/ Mc Graw Hill.
2. Rang & Dale’s pharmacology. 8th Edition. 2015. Churchill Livingstone London.
3. Robbins Pathologic Basis of Disease. Cotran, Kumar, Collins. 9 th edition 2015. WB Saunders Company,
4. Pathology Illustrated. Reid et al. 7th edition. 2011. Churchill Livingstone.
5. Human Physiology, from cells to Systems. Lauralee Sherwood. 2015. 9 th Ed. Brookes/Cole. Thompson Learning
6. Ganong’s Review of Medical physiology. Barret et al. 25 th Ed. 2016. Lange Medical Books/McGraw-Hill, Medical Publishing Division, NY.
7. Clinical Electrocardiography. B L Chia. 4th edition. 2016. World Scientific
8. Clinically Oriented Anatomy. Keith L Moore, Arthur F Dalley. 7 th Ed. 2013. Lippincot Williams & Wilkins.
17
9. Clinical Anatomy for Medical Students. Richard Snell. 7th. Ed. Lippincott Williams & Wilkins.
10. Wheater’s Functional Histology-A Text and Colour Atlas. Young et al. 6th. Ed. 2014. Churchill Livingstone Publication.
11. Langman’s Medical Embryology. TW Sadler. 13th. Ed. 2014. Lippincott Williams & Wilkins.
VI. TEACHING LEARNING TOPICS AND SPECIFIC OBJECTIVES
Concept Lectures
At the end of the lectures, student should be able to:
CL1. Heart
Identify the four chambers, relate the important structures and explain the blood flow through these chambers.
Describe the salient features of each chamber and their significances sulcus / crista terminalis, musculi pectinati, limbus & fossa ovalis, openings in the atrial papillary muscles including moderater band,chordae tendinae, openings in the ventricles and cusps of the valves.
CL2. Development of the heart.
Identify the Germ layer from where the C.V.S. derives.
Describe the formation of and changes in the position of the heart tube.
Correlate the three layers of the Heart tube and their development origins.
Describe the different parts of the Heart tube and identify their derivatives.
Correlate the folding of the Heart tube and formation of dextrocardia.
Describe the formation of the Interatrial septum and its significances.
Explain how septum/ostium primum and secundum are formed and how the foramen ovale is closed.
Describe the septa formations (together with their significances) in a).Atrio-ventricular canal and the role of endocardial cushions b).Trunco-conal region c)Ventricle
CL3. Electrical activity of the heart and ECG
Explain the origin of the heartbeat.
Explain the ionic basis of the pacemaker potential.
Explain the characteristics of the sinoatrial node and the conductive tissues.
Explain the roles of autonomic innervation of the heart.
Describe the spread of cardiac excitation.
18
CL4. Development of major blood vessels
List the great vessels of thorax.
Describe the development and anomalies of the great vessel of thorax.
Describe the origin, course, relations and termination of large arteries
Explain the formation and drainage of large veins.
CL5. Cardiac cycle
Describe the pressure, blood flow and volume changes in the atrium, ventricle and aorta in one cardiac cycle.
Relate the mechanical events during the cardiac cycle with the ECG.
Explain the formation and the characteristics of the heart sounds.
Explain the pressure changes in the jugular veins during one cardiac cycle.
CL6. Cardiac Output
Define cardiac output.
Explain the factors determining cardiac output.
Discuss the various factors influencing the cardiac output.
CL7. Hypertension
Explain the causes of hypertension, pathophysiology, and complications CL8. Treatment for hypertension
Classify antihypertensive drugs into 4 groups : symphatolytic agents, vasodilators, ACE inhibitors and diuretics.
Explain the mechanism of action and side effects of various antihypertensive agents
CL9. Heart Failure
Define cardiac failure.
Classify causes of cardiac failure and differentiate between the high output failure from the low output failure.
Describe the compensatory mechanism involve in cardiac failure.
Describe the features and pathogenesis of left & right cardiac failure.
List out the signs & symptoms of cardiac failure and describe its pathogenesis.
CL10. Drugs for heart failure
State two or three common factors that can adversely affect cardiac preload and afterload.
Explain the rationale for pharmacological intervention in heart failure.
State the drugs used to treat heart failure.
19
Describe the cellular mechanism(s) of action by which digoxin exerts it “beneficial” effects in CHF.
State the normal half-life of digoxin and how it is eliminated, usefulness of loading dose.
State the main (dose-dependent) effects of digoxin on (1) atrial, ventricular automaticity and impulse conduction rates; and (2) A-V nodal conduction rates
State the limitations of digoxin and why it is not used much in the treatment of heart failure nowadays.
State the common cardiac and extracardiac signs and symptoms of digoxin toxicity, and steps you would take to assess for and correct it..
State the general indication(s) for therapy with phosphodiesterase inhibitors (e.g., amrinone, milrinone), and the main adverse effects of these drugs.
Explain the use of the following drugs in the treatment of heart failure: diuretics (including high-ceiling diuretics and spironolactone), vasodilators and angiotensin “modifiers,” e.g. angiotensin converting enzyme inhibitors and angiotensin receptor blockers.
CL11. Ischaemic Heart Disease
Define ischaemia, angina and infarction.
List the causes and predisposing factors of IHD and explain atherosclerosis as the main cause of IHD.
Explain the factors that influence the effects of ischaemia.
Describe the pathogenesis, effects and complications of myocardial infarction.
Explain the serum enzyme changes specific for acute myocardial infarction
CL12. Drugs for angina
State the main groups of antianginal drugs and their administration. Identify the routes suitable (efficacious) for managing acute angina against prophylaxis.
Explain the biochemical mechanism by which organic nitrates exert their antianginal effects (NO; EDRF) and the physiologic consequences on the nitrates in terms of the oxygen supply-demand equation. Identify the main/common side effects of organic nitrates and specify which is pro-
ischemic or pro-anginal.
Describe the pros and cons of using long-acting (e.g., oral) nitrovasodilators in terms of long-term symptom control; tolerance; and probable impact on the efficacy of sublingual nitroglycerin if/when used for acute angina.
Compare and contrast the effects of different types of calcium antagonists: verapamil, diltiazem, and nifedipine in terms of their antianginal actions and in terms of their effects on the myocardium (e.g., contractility) and peripheral vasculature.
State the drugs that interact adversely with verapamil (or diltiazem) by enhancing the hypotensive and/or cardiac depressant effects of the calcium channel blocker.
Identify the main effects by which ß-adrenergic blockers exert their antianginal effects and explain why ß-blockers are suitable as prophylaxis
20
CL13. Valvular heart disease
Describe the pathogenesis of acute rheumatic fever.
List out the Jone’s Criteria for the diagnosis of acute rheumatic fever.
Name the common valvular abnormalities involved in rheumatic heart disease.
Describe the pathophysiology, effects and complications of chronic rheumatic heart disease
CL14. Microbiological Aspect of Infective Endocarditis
Describe the epidemiology and pathogenesis of infective endocarditis.
List the sources of infection, predisposing factors and aetiological agents of infective endocarditis.
Describe the clinical presentations of infective endocarditis.
List the relevant laboratory investigations for infective endocarditis.
Outline the principle of management of infective endocarditis.
List the indications for surgical intervention.
Outline the prevention of infective endocarditis.
CL15. Congenital Heart Disease
Define congenital heart diseases
Classify congenital heart disease into cyanotic and acynotic
Explain the mechanism of cyanosis
Explain the pathophysiology, the clinical features, natural history and complications of the common forms of congenital heart diseases – Fallot’s Tetralogy, Ventricular septum defect, atrial septum defect, patent ductus arteriosus, coarctation of aorta
Team-based Learning 1: Microcirculation, Haemodynamics, Coronary and Cerebral circulation
Describe the differences in the structure and functions of arteries, arterioles, capillary, venules and veins.
Describe the pressure that causes movement of fluid and interstitial spaces.
Explain the relationship between flow, pressure and resistance.
Explain the relationship between velocity of flow and the total cross-sectional area of a vessel.
Desribe the factors that influence resistance to blood flow.
Differentiate blood flow, pressure and resistance in the systemic and and pulmonary circulation
Explain the regulation of cerebral blood flow.
Discuss the factors affecting cerebral blood flow.
Relate the coronary blood flow with the phases of cardiac cycle.
Explain the regulation of coronary blood flow.
Explain the regulation of splanchnic blood flow.
21
Team-based Learning 2: Regulation of cardiovascular system and Cardiovascular Adaptation
Discuss the regulation of regional blood flow – intrinsic control.
Discuss the regulation of regional blood flow – extrinsic control.
Describe the factors that determine systolic and diastolic blood pressure.
Discuss the factors affecting blood pressure
Discuss the short term and long-term regulation of blood pressure.
Explain the local CVS control mechanisms.
Explain the systemic CVS control mechanisms
Practicals
At the end of the practical session, the students should be able to:
P1. Major contents of the mediastinum & gross anatomy of the
heart
Draw the surface marking of the heart on the chest wall of a Volunteer / simulator.
Demonstrate the normal orientation of the heart and identify the : Borders, surfaces and the chambers. Identify the special features of each chamber(both external
and internal) and correlate their significances e.g. sulcus terminalis,crista terminalis,musculi pectinati, venacaval openings,atrio-ventricular orifices and valves, interatrial septum and interventricular septum, papillary muscles,septo-marginal band,chordae tendinae,infundibulum of the right ventricle, pulmonary orifice,
Aortic vestibule and Aortic orifice.
Identify the congenital abnormality of the heart (gross / picture) Ventricular septum defect Defect at the interventricular region Atrial septum defect Defect at the interatrial wall Tetralogy of Fallot Right ventricular hypertrophy Ventricular septum defect Overiding aorta Subpulmonic stenosis Coarctation of aorta Preductal Postductal Patent ductus arteriosus
Identify cyanosis in relation to PaO2 level in arterial blood gases.
Describe the hemodynamic changes in congenital heart disease.
Demonstrate the clinical findings of congenital heart disease.
Signs of heart failure – raised JVP, ankle oedema
22
Clubbing
Polycythemia
Heart murmur
Major contents of Mediastinum
Identify and correlate the different parts of the Aorta and important
structures closely related to it (especially around the Arch, including
Ligamentum arteriosum) Identify the Pulmonary trunk and its branches and important
structures closely related to it Identify the Superior venacava and its main tributaries
(eg.Brachiocephalic and Azygos vein)
Identify the Trachea and primary Bronchi and closely related structures(e.g. sternum, apex of the Lung, Arch of Aorta, Recurrent laryngeal nerve).
Identify the oesophagus and relate with the important structures lying close to it(e.g. Arch of aorta, Left bronchus)
P2. Histology of heart & blood vessels
Differentiate between the Artery and the Vein.
Explain the characteristic features and significances of -Elastic artery, Muscular artery, Arteriole, Veins and Capillaries.
Describe the main features of lymphatic vessel/duct.
Identify the characteristic features of cardiac muscle (eg. its branching pattern, position of the nucleus, Intercalated disc).
Identify the heart valve and Purkinje cells.
Identify the three layers of the blood vessel and differentiate the artery and the vein.
Differentiate and identify the elastic artery, muscular artery and arterioles.
Identify the capillaries and the veins.
P3. Pathology Practical I
Discuss the classification, pathophysiology of congenital heart disease.
Discuss the aetiology, pathology, effects and complications of hypertension.
Identify the gross abnormality of ventricular hypertrophy.
Define shock and list the different types of shock, describe the stages of shock.
Discuss the causes of myocarditis and identify the histopathological abnormality of myocarditis.
Discuss the pathogenesis of acute rheumatic fever.
Describe the effects and complications and the Jones diagnostic criteria for acute rheumatic fever.
Identify the gross abnormality of mitral valve stenosis
Briefly discuss about chronic rheumatic heart disease.
23
P4. CVS responses in physiological conditions
Explain the principle in the measurement of blood pressure
Determine blood pressure using the palpation and auscultatory techniques
Calculate mean arterial blood pressure
Determine the postural mean blood pressure index
Explain the regulation of blood pressure on change in posture
Explain the effect of prolonged standing on blood pressure & heart rate
Describe the response of superficial blood vessels towards injury.
P5. Blood culture technique and processing
Perform blood culture under sterile technique.
Perform blood culture in a case of Infective endocarditis.
Identify the various types of blood culture medium.
Perform a gram staining.
Identify the streptococcus and staphylococcus.
P6. Objectives for Pathology Practical II
Identify the gross picture of myocardial infarction
Identify the histopathological features of acute myocardial infarction
Identify the vegetations on the valve leaflet in a case of infective endocarditis
Macroscopically : bulky, friable mass Microscopically: numerous clumps of bacteria (stained blue)
covered by layers of fibrin and platelets, thus making the eradication of bacteria in IE very difficult.
Discuss the causes and pathogenesis, effects and complications of aneurysm.
Define heart failure and list the causes of heart failure.
Describe the effects and complications of heart failure
Self-learning package (SLP)
SLP1. Great vessels of thorax
Describe the origin, course, important relations and branches of aorta (especially the arch of aorta).
Describe briefly the course, termination and significances of -brachio-cephalic trunk, carotid arteries & subclavian arteries.
Describe the development of aortic arches and formation of major arteries and correlate the significances.
24
SLP2. Regional circulation
Describe splanchnic circulation and its regulation.
Describe cutaneous circulation.
Describe fetal circulation
Compare fetal circulation and adult circulation SLP3. Cardimyopathy and myocardial diseases
Define cardiomyopathy
Describe the aetiology, pathogenesis, morphology and effects and
complications of the 3 patterns of cardiomyopathies – dilated
cardiomyopathy, hypertrophic cardiomyopathy and restrictive cardiomyopathy
Describe the aetiology, pathogenesis and morphology of myocarditis.
Describe the causes, pathology and clinical features and complications of
acute pericarditis.
SLP4. Shock
Define shock.
Explain the mechanisms and causes of different types of shock.
Explain the compensatory mechanisms in shock.
Describe the pathophysiological changes and the clinical features in the different stages of shock.
Discuss the effects and complications of shock.
Problem-Based Learning (PBL) Topics
PBL1. Restart My Heart PBL2. Blue Baby PBL3. My achy leaky heart
25
RESPIRATORY MODULE (FFFF2313)
DIRECTORY OF TEACHING STAFF
NO. NAME OF LECTURERS PHONE NO. E-MAIL ADDRESS
1. Assoc. Prof Dr Chua Kien Hui
(Module Coordinator) 91458613 [email protected]
2. Prof. Dr. Farihah Hj. Suhaimi 91458639 [email protected]
3. Assoc. Prof. Dr. Nur Azlina Mohd
Fahami 91459574 [email protected]
5. Dr. Wong Yin Ping 91459608 [email protected]
6. Dr. Fazarina Mohammed 91455357 [email protected]
7. Dr. Norliza Muhammad 91459572 [email protected]
8. Dr. Zalina Ismail 9145 5930 [email protected]
9. Dr. Umi Kalsom Ali 9145 5924 [email protected]
10. Datin Dr. Anita Sulong 9145 5402 [email protected]
AIMS The aim of this module is that the students should be able to understand the structure of the respiratory system and relate the structure to its functions. The knowledge of basic sciences obtained in year 1 such as infection and immunity, the mechanism of diseases and the pharmacokinetics of drugs will help students to understand the diseases commonly affecting the respiratory system and the drugs used in respiratory diseases. PRE-REQUISITES
The students should have prior knowledge of: i. biochemistry of haemoglobin and properties of blood.
ii. structure and functions of the cardiovascular system.
iii. classification of microorganisms.
iv. pharmacokinetics and pharmacodynamics of drugs.
v. mechanisms of diseases such as inflammation and neoplasm.
MODULE OBJECTIVES
By the end of the module, students should be able to: i. Describe the normal development, structure and histology of the respiratory
system.
26
ii. Explain the mechanisms of respiration.
iii. Interpret lung function tests.
iv. Explain gas exchange and gas transport in the respiratory system.
v. Explain the control of respiration.
vi. Explain signs and symptoms associated with respiratory system.
vii. Explain the aetiology and pathophysiology of pneumonia, bronchial asthma,
chronic obstructive airway diseases, pulmonary tuberculosis, and tumours of the
lungs.
viii. Explain the pathogenesis of adult respiratory distress syndrome, restrictive lung
disease and pleural lung disease.
ix. Classify the drugs used for treatment of cough.
x. Identify the antibiotics used for respiratory tract infection.
xi. Explain the pharmacology of the anti-asthma and anti-TB drugs.
METHODS OF ASSESSMENT
Continuous assessment (30%):
o End module assessment in the form of OBA, EMI and MEQ (20%).
o Problem-based learning (PBL) (10%).
End of Semester Examination (70%):
o Theory – in the form of OBA, EMI and MEQ (60%).
o Practical paper in the form of OSPE (10%).
RESOURCE MATERIALS 1. Cotran, Kumar, Collins, Colins. 1999. Robbins Pathologic Basis of Disease. 6th
Edition. USA: WB Saunders Company.
2. Barrett, K.E., Barman, S.M., Boitano, S. & Brooks, H. 2010. Ganong’s Review of
Medical Physiology. 23rd Edition. USA: McGraw Hill Lange.
3. Katzung, B.G. 2004. Basic and Clinical Pharmacology. 9th Edition. Norwalk:
McGraw Hill.
4. Lauralee Sherwood. 2001. Human Physiology: From Cells to System, 4th Edition.
USA: Brooks/Cole Thomson Learning.
5. Murray P.R., Rosenthal K.S., Kobayashi G.S., PFaller M.A. 2002. Medical
Microbiology. 4th Edition. USA: Mosby.
6. Murray R.K., Granner D.K., Mayes P.A. & Rodwell, V.W. 1996. A Lange Medical
Book Harper’s Biochemistry, 24th Edition. USA: Prentice Hall International Inc.
7. Nabishah Mohamad. 2006. Fisiologi Pernafasan: Pendekatan Berasaskan Masalah.
Bangi: UKM.
8. Richard Snell. Clinical Anatomy for Medical Students. 7th Edition. USA: Lippincot
Williams & Wilkins.
9. Walter and Israel. 1996. General Pathology, 7th Edition. Connecticut: Appleton &
Lange.
10. Young B & Health J.W. Wheater’s Functional Histolgy, 5th Edition. Churchill
Livingstone. 11. Sadler TW. Langman’s Medical Embryology. 9th Edition. Lippincot Williams &
Wilkins.
27
TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES At the end of the lectures, students should be able to: CL 1: Thoracic wall and diaphragm
Name the bones forming the thoracic cage.
Differentiate between the typical and atypical ribs.
Describe the intercostal spaces and its contents.
Describe in general the attachment, action and innervation of the muscles of the intercostal space.
Explain thoracocentesis.
Describe the structure of the diaphragm, its innervation and blood supply.
Describe the structures that pass through the openings in the diaphragm. .
CL 2: Structures of the upper and lower respiratory tracts
Name the components of the upper and lower respiratory tracts.
Describe the airway from the trachea, bronchus to alveolus.
Explain the visceral and parietal pleurae.
Describe the pleural cavities and pleural membranes.
Explain the importance of the pleural cavity during breathing.
Explain the clinical application as in pneumothorax or pleural effusion.
Describe the structure of the lungs.
Explain the differences between the right and the left lung.
Draw the surface anatomy of the lung and the pleura.
Explain the importance of the bronchopulmonary segments. CL 3: The mechanics of respiration
Explain the general functions of the respiratory system.
Explain the mechanics of breathing in relations to intrapleural and alveolar pressure.
Explain pulmonary compliance and factors affecting it.
Explain the role of surfactant and factors influencing it.
Discuss the work of breathing.
CL 4: Development of the respiratory system
Describe the development of the larynx, trachea, bronchi and lungs.
Describe the stages of lung maturation.
Describe the development of the diaphragm. CL 5: Ventilation and perfusion
Define ventilation and perfusion.
Explain dead space and alveolar ventilation.
Explain pulmonary blood circulation and its regulation.
Define the gravitational effects on ventilation/perfusion inequality.
Discuss ventilation/perfusion mismatch.
28
CL 6: Gas transport
Explain partial pressure of gases.
Explain diffusion capacities of gases and the factors influencing them.
Describe the transportation and release of oxygen.
Explain the significance of the oxygen-haemoglobin saturation curve and factors affecting it.
Describe transportation of carbon dioxide in the blood. CL 7: Control of respiration
Discuss the chemical and neural control of respiration.
Discuss the influence of various reflexes on the activities of respiratory centre.
Discuss different conditions affecting ventilation.
Explain the different types of hypoxia and their effects on ventilation. CL 8: Viral infections of the respiratory tract
List the viral agents of respiratory tract infections.
Describe the epidemiology and pathogenesis of viral respiratory tract infections.
Describe the clinical manifestations of respiratory tract infections.
Describe the laboratory diagnosis of viral respiratory tract infections.
Describe the principles of treatment and prevention of viral respiratory tract infections.
CL 9: Infections of the upper respiratory tract
List the bacterial causes of upper respiratory tract infections.
Describe the epidemiology and pathogenesis of bacterial upper respiratory tract infections.
Describe the clinical manifestations of bacterial upper respiratory tract infections.
Describe the laboratory diagnosis of bacterial upper respiratory tract infections.
Describe the principles of treatment and prevention of bacterial upper respiratory tract infections.
CL 10: Infections of the lower respiratory tract
List the bacterial causes of lower respiratory tract infections.
Describe the epidemiology and pathogenesis of bacterial lower respiratory tract infections.
Describe the clinical manifestations of bacterial lower respiratory tract infections.
Describe the laboratory diagnosis of bacterial lower respiratory tract infections.
Describe the principles of treatment and prevention of bacterial lower respiratory tract infections.
CL 11: Lung infections
Explain pneumonia in general terms based on aetiology, morphological features and predisposing factors.
Describe lobar and bronchopneumonia based on aetiology, pathological changes and complications.
Describe the aetiology and pathological changes of interstitial pneumonia caused by virus and mycoplasma.
List the causes of pneumonia in immuno-compromised patients.
Describe the aetiology and complications of lung abscess.
29
Describe tuberculosis in terms of the causative agent, pathogenesis, and features of primary (the TB granuloma, Ghon focus and Ghon complex) and secondary TB, sequelae and complications including military TB.
Describe the laboratory diagnosis of TB. CL 12: Antituberculous agents
Classify the anti-TB agents into the first-line and second-line drugs.
Describe the mechanism of action and adverse effects of each of the drugs in the first-line and second-line groups.
Name the first-line drugs used in the preferred regiment and alternative regiment.
Explain the rationale behind each regiment.
Explain the rationale of using combination therapy for treatment of TB.
Justify the indications for using the second-line drugs and explain the precautions that should be taken when using second-line drugs.
CL 13: Lung and upper respiratory tract neoplasms
Classify carcinoma of the lung into primary (four main histological types, small cell vs non-small cell) and secondary neoplasms.
Explain the risk factors and pathogenesis and describe the pathological features, clinical manifestations and complications of lung carcinoma.
Describe the diagnosis and principles of treatment of lung carcinoma.
Explain the aetiology and pathogenesis and describe the pathological features, clinical manifestations and spread of nasopharyngeal carcinoma.
Explain the predisposing factors and describe the pathological and clinical features of carcinoma of larynx.
CL 14: Chronic obstructive airway diseases
Identify the chronic obstructive airway diseases namely asthma, chronic bronchitis, emphysema and bronchiectasis.
Explain asthma in terms of its definition, types, and pathogenesis, and describe the pathological changes and complications.
Explain chronic bronchitis in terms of its definition, aetiology, pathogenesis and complications.
Explain emphysema in terms of its definition, types, pathogenesis and the complications.
Explain bronchiectasis in terms of its definition, aetiology, pathogenesis and complications.
CL 15: Drugs used for treatment of asthma and COPD
Classify the anti-asthmatic agents into agents used in acute treatment and prophylaxis of asthma.
Classify the bronchodilators and describe the mechanism of action, clinical uses and side-effects of each group.
Describe the mechanism of action, clinical uses and adverse effects of the prophylactic agents.
Explain the use of corticosteroids in asthma, including the route of administration and potential toxicity.
Explain the therapeutic approach in selecting a suitable anti-asthmatic agent, based on severity and duration of symptoms.
30
P 1: Gross anatomy of the respiratory system
Identify the thoracic vertebra from the other vertebral bones.
Identify typical ribs from the atypical ribs.
Identify the sternum.
Identify the important reference lines on the chest wall.
Identify and explain the attachments, innervations and action of the muscles of the intercostal space and the neurovascular bundle.
Identify the position of the neurovascular bundle and the arrangement of its components.
Identify the diaphragm.
Identify all the openings in the diaphragm as well as the structures that pass through them.
Identify the trachea and primary/main bronchus.
Identify the structures forming the root of the lung.
Identify the lung and differentiate between the right and left lung.
Identify the impressions made on the left and right lung. P 2: Histology of the respiratory system
Identify the respiratory epithelium.
Identify the trachea.
Identify the bronchus.
Identify the lung with the bronchiole, respiratory bronchiole, alveolar duct, alveolar sac and alveolus.
Identify the interalveolar septum.
Explain the change along the respiratory tract.
Explain the importance of surfactant in maintaining surface tension of the alveolus.
Describe the blood-air barrier. P 3: Lung volumes and capacities
Describe lung volumes and capacities.
Describe the technique of measuring lung volumes and capacities.
Interpret lung function test and explain its clinical importance. P 4: Laboratory diagnosis of respiratory tract infections
Describe the laboratory diagnosis of viral respiratory tract infections.
Describe the laboratory diagnosis of bacterial respiratory tract infections. P 5: Lung infections
Gross description and histology of the bacterial bronchopneumonia and lobar pneumonia.
Gross morphology and histology of TB. P 6: Lung carcinoma
Describe gross and histology of the main types of lung carcinoma – squamos cell carcinoma, adenocarcinoma and small cell carcinoma of lung.
31
SLP 1: Pulmonary vascular diseases
Define pulmonary oedema and describe the causes, pathogenesis and effects on lung function.
Define pulmonary hypertension and describe the causes, pathogenesis and effects on the right ventricle of the heart.
Define pulmonary embolism and describe the causes, pathogenesis, predisposing factors, effects and complications.
SLP 2: The effects of hypo- and hyperbaric conditions on the body
Explain the effects of high altitude on the body.
Explain the effects of acclimatization in high altitude on the body.
Explain the effects of deep-sea diving.
Explain the mechanism of nitrogen narcosis and decompression sickness. SLP 3: Mucolytics and Expectorants
Classify the agents used for treatment of cough.
Define antitussives, mucolytics and expectorants.
Explain the mechanism of action, clinical uses and adverse effects of the three groups of drugs.
Explain the potential risk of codeine containing antitussive mixtures. SLP 4: Interstitial lung diseases
List the major categories of interstitial lung diseases (restrictive lung diseases).
Describe the general features and effects of interstitial lung diseases.
Describe briefly the pathological features of the common pneumoconioses – coal workers’ pneumoconiosis, silicosis and asbestosis.
Define ARDS and explain the aetiology, pathogenesis, pathological and clinical features and complications.
PROBLEM-BASED LEARNING (PBL) TITLES
1. Mom, I Can’t Breathe 2. Singing Nightingale 3. Light Up Your Lung
32
URINARY MODULE (FF2433)
I. DIRECTORY OF TEACHING STAFF
NO.
NAME OF LECTURERS
PHONE NO.
E-MAIL ADDRESS
Pathology
1. Khalidah Mazlan Bador
(Head of Module)
03-9145 9510
016 6143905
2. Prof. Dr. Noraidah Masir 03-9145 5367
019-3202605
3. Dr Dian Nasriana
Nasuruddin
03-9145 9501
013-3068338
Pharmacology
4. AP Dr. Qodriyah bt Hj
Mohd Saad
03-9145 9565
019-3344383
5. Dr Norliana Masbah 03-9145 9567
du.my
Physiology
6. AP Dr Norfilza Mohd Mokhtar
03-9145 8611
Anatomy
7. AP Dr. Faizah Othman 03-9145 8637
019-2597379
019-3324192
Microbiology
8. Dr. Siti Norlia Othman 03-9145 5944
019-3245644
Biochemistry
9. Dr. Mohd. Hanafi Ahmad
Damanhuri Ismail
03-9145 9551
019-2177307
hanafi.damanhuri @gmail.com
edu.my
II. INTRODUCTION TO URINARY SYSTEM
The aims of this module are, first, the students should have sufficient knowledge of macroscopic and microscopic structure of the urinary tract system in order to understand the normal function and common clinical problems. Second, that the students should appreciate the role of the kidney in controlling the volume and composition of body fluid and the way in which they respond to abnormal volume, electrolyte concentration and systemic haemodynamics. Third, students should understand as much detail of renal cellular function as well as allow them to appreciate the basis of relevant therapeutics. Fourth, students should be able to describe normal micturition, the reasons for oliguria and such common conditions
33
as glomerulonephritis, pyelonephritis, urinary tract infection, urinary calculi, haematuria, proteinuria, and acute and chronic renal failure.
PRE-REQUISITES
Before starting this module the student should have prior knowledge of the following subjects: i) The classification of tissue and its basic histology. ii) The physical chemistry pf osmotic forces, pH and buffers. iii) The factors affecting the movement of substances across cell membranes
including the distinction between active and passive movement and the role of ion pumps, transporters and channels.
iv) The effects of changes in blood volumes upon the cardiovascular system. v) The basic classification of micro-organisms. vi) The basic classification, pharmacokinetics and pharmocodynamics of
drugs.
III. MODULE OBJECTIVES
At the end of this module, the students should be able to: i) discuss surface anatomy, structure and relations of the kidney, ureters,
bladder and urethra in the male and female ii) discuss fluid compartment of the body, their electrolytes composition and
state the normal concentrations of major electrolytes in the extracellular fluid, blood and urine
iii) discuss gross anatomy and histology of the kidney and other urinary tract lining epithelium and identify the component parts of the nephron
iv) discuss structure of glomerulus and explain the process of glomerular ultrafiltration, the processes underlying the formation of diluted and concentrated urine
v) discuss renal responses to extracellular fluid volume depletion and other common alterations in systemic haemodynamics
vi) explain the mechanisms controlling sodium and potassium balance and discuss the common causes and consequences of low and high extracellular concentration of both electrolytes
vii) explain the role of kidney in maintaining acid base balance and interpret uncomplicated cases of acid base disturbances
viii) classify diuretics and explain their mode of action ix) explain control of micturition x) discuss common urinary tract infections and the principles of their
assessment and treatment xi) discuss common pathological changes in the urinary tract, including
glomerulonephritis, tubulointerstitial disease, pyelonephritis, neoplasia, renal calculi and explain their clinical consequences
xii) discuss the causes, features, effects/complications and principle of management of acute and chronic renal failure
34
IV. METHODS OF ASSESSMENT
Continuous assessment (30%): PBL plus End of Module Exam
End of Semester Examination (70%): Theory paper in the forms of OBA, EMI and MEQ Practical paper in the form of OSPE
V. RESOURCE MATERIALS
1) Review of Medical Physiology 21st Edition. Ganong WF; Appleton-Lange Medical Books / McGraw Hill, Medical Publishing Division, NY
2) Clinical Anatomy for Medical Students 7th Edition. Richard Snell; Lippincot Williams & Wilkins
3) Harpes Biochemistry. Murray RK, Granner RK, Mayers PA, Rodwell VW. 25th Edition. Prentice Hall International. USA.
4) Wheather’s Functional Histology 4th Edition. B. Young, JW Heath; Churchill Livingstone
5) Langman’s Medical Embryology 12th Edition. TW Sadler; Lippincot William & Wilkins
6) Robbins Basic Patology (Edited by) Vinay Kumar. Ramzi S Cotran, Stanley L Robbins with illustrations by James A Perkins 7 th Edition. Saunders 2003.
7) Pathology Illustrated 5th Edition. Govan et al. Churchill Livingstone 1999 8) Concise Pathology by Parakrama Chandrasoma. 3rd Edition. Stamford,
Appleton and Lange 9) Clinical Chemistry 6st Edition. William J Marshall & Stephen K Bangert.
Churchill Livingstone 10) Sherris Medical Microbiology 3rd Edition. Keneth LN et al; Appleton &
Lange 11) Medical Immunology 10th Edition. Stites et al; Langen 12) Basic and Clinical Pharmacology 7th Edition. BG Katzung; Appleton &
Lange 13) The Pharmacological Basis of Therapeutics. 10th Edition. Goodman &
Gilman MacMillan 14) Kumar ad Clark Clinical Medicine 5th Edition. WB Saunders; 2002 15) Devlin, TM. Textbook of Biochemistry with Clinical Correlations. 4 th
Edition. A John and Wiley and Sons, Inc. Publication. New York, USA 16) Mim’s Medical Microbiology 4th Edition. Goering et al. Elsevier. 17) http://www.bartleby.com/107/253.html 18) http://www-medlib.med.utah.edu/WebPath/webpath.html 19) http://www.med/uiuc.edu/PathAtlasf/framer3/path3.html
VI. TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES Concept Lectures At the end of the lecture/practical/demonstration/MES sessions, students should be able to:
35
CL1 – Anatomy of Urinary System
describe the gross structure of the kidney, ureter and urinary bladder
describe the anterior and posterior relations of the kidneys
explain the important relations of the ureter and bladder
list the parts of the urethra in the male and female
describe the blood supply, innervation and lymphatic drainage of the urinary organs
CL2 – Histology of the Urinary System
describe the structures found in the cortex (renal corpuscle, proximal and distal convoluted tubules and juxtaglomerular apparatus) and medulla of the kidney
describe the ureter
describe the urethra
CL3 – Renal functions and its basic processes
explain the general functions of the urinary system
describe the basic processes occurring in the nephron
CL4 – Development of Urinary System
describe the development of the kidneys and ureters
explain the positional changes of the kidneys during the developmental process
describe the congenital malformations of the kidneys and ureters
describe the development of the urinary bladder and urethra
describe the congenital malformations of the urachus and urinary bladder
CL5 – Renal clearance, blood flow and filtration
define clearance
describe general principles of clearance and its application
describe renal blood flow and plasma flow
explain factors that can affect renal blood flow
define glomerular filtration rate (GFR)
describe the factors that affect GFR
CL6 – Concentrating and diluting mechanism
describe the mechanism of counter multiplier and exchanger
explain the regulation of urine volume and concentration
explain the significance of concentrating and diluting mechanism
describe factors that affect urine concentration
describe types of dieresis
explain process of micturition
36
CL7 – Renal control of acid-base homeostasis
describe the sources of acids and bases in the body
describe the relationship between pH, HCO3- & PCO2 in Henderson-
Hasselbach’s equation
describe renal acid secretion and urine acidification
explain intracellular and extracellular buffering system
describe bicarbonate ion production and reabsorption
explain renal response to acidosis and alkalosis
CL8 – Regulation of extracellular fluid (ECF)
describe normal fluid compartment and electrolyte compositions
describe intake and output of body fluid and electrolytes
explain the regulation of body fluid and electrolytes
explain the factors that can influence the secretion of ADH, aldosterone, angiotensin II and ANP
CL9 – Principles of acid base disorders
list the classification of acid base imbalance (metabolic acidosis and alkalosis, respiratory acidosis and alkalosis)
identify the classification/type from the laboratory arterial blood gas results
list causes of acid base imbalance
explain the compensatory mechanism in uncomplicated acid base disturbances
CL10 – Acute and chronic renal failure
classify kidney failure and give definition for each class
explain and classify the causes of acute renal failure
list the causes of chronic renal failure
explain the biochemical changes in acute and chronic renal failure
discuss the effects and complications of acute and chronic renal failure and outline the principles of management of acute and chronic renal failure
list the relevant investigation and tests which are used to diagnose and manage acute and chronic renal failure
CL11 – Urinary tract infection
differentiate between community-acquired UTI and hospital-acquired UTI
explain the pathogenesis of UTI
explain the terms - significant bacteriuria - asymptomatic bacteriuria
identify the predisposing factors of UTI
37
describe the investigations for UTI and interpret the laboratory results
explain the principle of antibiotic therapy of UTI
CL12 – Glomerular diseases: GN, NS, haematuria and diabetic nephropathy
explain the syndrome of glomerular diseases – nephritic and nephrotic syndrome
classify glomerular diseases
explain the pathogenesis, clinicopathologic features of each glomerulonephritis
CL13 – Tubulointerstitial diseases: ATN, AIN and drug induced nephropathy and renovascular diseases
explain the cause, pathogenesis, effects and complications of acute tubular necrosis, acute interstitial nephritis and acute and chronic pyelonephritis
describe the effects of systemic diseases on renal vessels
CL14 – Principles of diuretic use
define diuresis and diuretic agents
explain the mechanism of action of diuretic agents with regards to the effects on electrolyte absorption in the kidney tubules
classify diuretic agents according to its action sites in the kidney tubules
explain the mechanism of action and the side effects of each group of the diuretics
CL15 – Antibiotics in urinary tract infection
classify the antibiotics that are commonly used in the treatment of urinary tract infection and name the commonly used drugs in each class
explain the mechanism of action and its antibacterial activity of each class of antibiotics
describe the pharmacokinetics of each class of antibiotics
list the adverse effects of the antibiotics and its contraindications
CL16 – Neoplasms: renal and bladder
briefly classify the tumours of the urinary tract
explain the clinicopathological features of renal cell carcinoma and Wilms tumour
explain the clinicopathological features of bladder tumour
explain the clinicopathological features of polycystic disease of the kidney
38
Practicals / Demonstrations / MES
1. Anatomy of kidney and urinary tract
2. Histology slides of normal kidney and urinary tract & radiological imaging of urinary tract – KUB (abdominal X-ray) and IVP
3. UFEME (Normal and abnormal urine content – sugar, protein, blood,
bacteria, ketones) 4. Renal function (MES) 5. Urinary tract infection
role play on instruction of urine collection for culture interpretation of urine culture and sensitivity results illustration with 2 cases of UTI
6. Acid base imbalance & Renal pathology (MES)
Glomerulonephritis
Hydronephrotic kidney
Renal stones and obstructive bladder disease
Polycystic kidneys
Flea-bitten kidney
Interpret laboratory arterial blood gas & electrolyte results.
Self-Learning Package Topics SLP 1: Tubular transport Problem-Based Learning (PBL) Topics
There are two topics in this module, each requiring two sessions. PBL 1. Puffy Face PBL 2. Curse of stone
39
CLINICAL SCIENCE MODULE (FF2511)
I. DIRECTORY OF TEACHING STAFF
No NAME OF LECTURERS PHONE NO. E-MAIL ADDRESS
1 Dr Amilia Aminuddin (Module coordinator)
0391458620 [email protected]
2. Dr. Mohamad Fairuz Bin Yahaya (Assisstant Module Coordinator)
03-91458605 [email protected]
3. Dr Soo Chun Ian (General examination)
0192244721 [email protected]
4. Dr.Andrea Ban Ling (Respiratory) 03-91457924 [email protected]
5. Dr. Hamat Hamdi CH (Cardiovascular)
0197295759 [email protected]
6. Dr.Tan Guan Hee (genitourinary) 019-262 2621 [email protected]
II. INTRODUCTION TO CLINICAL SCIENCE
This module is to provide the students with a complete approach to history taking and physical examination of the cardiovascular and respiratory system. The students will revise history taking which they have learnt in the first year, focusing on features and presentations which are typical to cardiovascular and respiratory systems. This will be commenced by learning to perform physical examination systematically. The students will also learn some basic clinical procedures related to cardiovascular and respiratory systems which will enhance their learning during the year and in subsequent clinical years. Their learning will be further reinforced by learning how to interpret normal radiographic image of the two systems.
PRE-REQUISITES
The students should have acquired the basic generic skills of history-taking which was learnt in 1st year.
III. MODULE OBJECTIVES
By the end of the module, the students should be able to
obtain history- taking relevant to the cardiovascular and respiratory systems
perform general as well as systematic physical examination of the cardiovascular and respiratory systems
perform basic clinical procedures relevant to the cardiovascular and respiratory systems
IV. ASSESSMENT
40
Continuous assessment, log book, reflective writing and Objective Structured Clinical Assessment (OSCA) which comprises 30% of the semester’s marks.
Summative assessment in the form of OSCE which makes up 70% of the semester’s evaluation.
V. RESOURCE MATERIALS
References:
1. Douglas G, Nicol F and Robertson C. Macleod’s Clinical Examination, 13th edition. Churchill Livingstone 2009 2. Talley N and O’Connor S. Clinical Examination: A systemic
Guide to Physical Diagnosis, 6th edition. Elsevier 2010 3. Glynn M, Drake WM. Hutchinson’s Clinical Methods: An Integrated
Approach to Clinical Practice, 23rd edition. WB Saunders 2012 4. CD ‘Physical Examination of the Cardiovascular System’ (FPUKM) 5. CD ‘Physical Examination of the Respiratory system’ (FPUKM) 6. CD ‘General Examination’ (FPUKM)
VI. TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES
Lectures At the end of the lectures, students should be able to: CL1 General Examination
Describe the systematic general examination of a patient CL2. History- taking and physical examination of the Cardiovascular system
List symptoms related to cardiovascular illness
Describe cardiac surface markings and other body landmarks in relation to the cardiovascular system
Describe systematic cardiovascular system examination
CL3. History taking and Physical Examination of the Respiratory system
List symptoms related to respiratory illness
Describe lung surface markings and other body structures in relation to the respiratory system
Describe systematic respiratory system examination CL 4 History- taking and Physical examination of the Genitourinary system
List symptoms related to the genito-urinary system
Describe kidney surface markings and other body structures in relation to the genito-urinary system
41
VII. Clinical Skill Learning Sessions (CSL)
The session will be held every Tuesday or Thursday afternoon (2.00pm – 5.00 pm) at the Makmal Skill Klinikal Tingkat 4 Blok Pra Klinikal PPUKM
At the end of these clinical skill learning sessions, students should be able to: CSL 1 & 2 Introduction to General Examination, CVS 1 & 2
Identify cardiac surface markings and other body landmarks in relation to the cardiovascular system
Perform systematic general examination of the body
Perform systematic cardiovascular system examination
Identify normal general and cardiovascular examination findings
CSL 3 Procedures
Perform venepuncture on arm model
Identify normal and abnormal heart and lungs sounds
Read normal chest radiograph and identify heart silhouette and major vascular markings
CSL 4 CVS 3 History-taking (Role Play)
Obtain history of typical problems related to the cardiovascular system
CSL 5 & 6 Respiratory 1 & 2
Identify lung surface markings and other body structures in relation to the respiratory system
Perform systematic respiratory system examination
Identify normal and abnormal breath sounds
CSL 7 Respiratory 3 History-taking (Role Play)
Obtain relevant history of typical problems related to the respiratory system
CSL 8 CVS & Respiratory History-taking & Physical examination assessment (OSCA)
Obtain a history of typical problems related to the cardiovascular and respiratory systems
Perform CVS and Respiratory physical examination
Demonstrate good communication skills
42
PERSONAL AND PROFESSIONAL DEVELOPMENT FF2712
I DIRECTORY OF TEACHING STAFF
NO NAME OF LECTURERS PHONE NO DEPARTMENT/EMAIL ADDRESS
1. Prof Dr Norazlina Mohamed (Module coordinator)
91459577
Pharmacology [email protected]
2 Prof Dr Yasmin Anum Mohd Yusof
91459556 Biochemistry
3. Assoc Prof Dr Chua Kien Hui
91458613 Physiology
4. Pn Raynuha Mahadevan
91456155 Psychiatry
5 Assoc Prof. Dr. Azmi Mohd Tamil
91456879 Community Health
II INTRODUCTION
The aims of this module are to further develop the students’ total approach towards learning and practice of medicine which includes information technology. Student's ability to adapt to life as a medical student in terms of healthy lifestyle is emphasized, and issues related to stress management are also revisited and discussed. In addition, there will be more emphasis on issues involving the community's health. Student's communication skills, as well as critical thinking are further developed in this module particularly in terms of issues concerning peers and community.
PRE-REQUISTES
The pre-requisite of this module is that the students had successfully undergone the modules in Year 1 (FF 1712 and FF 1722) and has achieved a satisfactory level of understanding on the important aspects of the Personal & Professional Development strand.
43
III MODULE OBJECTIVES
By the end of the module, students should be able to:
1. Discuss on healthy and unhealthy lifestyle and relate it to the life of a medical student and extend it to the community.
2. Apply skills in critical thinking, interpersonal communication in learning and daily life activities.
3. Apply web tools to manage learning. 4. Assess self management and coping skills in university environment. 5. Apply teamwork skills and leadership skills.
IV METHODS OF ASSESSMENT
Continuous assessment
-Attendance (5%)
-Specific activities eg SGD (25%)
-Reflective writing (10%)
-Seminar (10%)
-Supervisor’s report (10%)
End of semester examination
-OSCE (40%)
V RESOURCE MATERIALS
1. Scott B. 1995. The skills of communication. Jaico Publishing. Mumbai. 2. Lazarus RS, & Folkman S. 1984. Stress, Appraisal, and Coping. New York:
Springer Publishing Company Inc. 3. Brookfield SD. 1987. Developing critical thinkers: Challenging adults to explore
alternative ways of thinking and acting. Jossey-Bass. San Francisco. 4. Donald J. 2002. Learning to think: Disciplinary perspective. Jossey-Bass. San
Francisco.
44
VI TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES
Lectures
Lecture 1: Healthy lifestyle
At the end of the lecture, students should be able to:
1. Differentiate between healthy lifestyle and unhealthy lifestyle.
Lecture 2: New Tools for Learning
At the end of the lecture, students should be able to:
1. Use selected web tools for managing learning.
Lecture 3: Reflective Writing on Communication Skill
At the end of the lecture, students should be able to:
1. Reflect and write reflection on experience in relation to communication skills.
Video: Pursuit of Happyness
At the end of the video session, students should be able to:
1. Demonstrate critical thinking on the video shown.
Small Group Discussion (SGD)
SGD 1: Critical Thinking (Reflective Writing)
At the end of the SGD session, students should be able to:
1. Demonstrate critical thinking skills by reflection on specific events 2. Perform constructive feedback among friends
45
SGD 2: Stress Management – Revisit
At the end of the SGD session, students should be able to:
1. Explain the meaning of stress 2. Identify the causes of stress 3. Explain how stress could cause changes to the thinking process, emotions and
behaviour 4. Identify the steps to solve problems associated with stress 5. Apply the steps to overcome stress / problem
SGD3: Adaptation Skill (Healthy Lifestyle)
At the end of the SGD session, students should be able to:
1. Discuss components of healthy lifestyle 2. Differentiate healthy and unhealthy lifestyle 3. Identify the current status of their lifestyle including risk factors that may
jeopardize their health 4. Formulate an action plan to maintain a healthy lifestyle as a medical student
SGD 4: Video Session
At the end of the SGD session, students should be able to:
1. discuss the challenges that contribute to self-development. 2. identify and discuss positive attitudes and attributes towards life that can
enhance personal development 3. identify and discuss negative attitudes that will impede personal development. 4. recognize and discuss important values that contribute to coping with real life
challenges.
SGD5: Communication Skills
At the end of the SGD session, students should be able to:
1. Demonstrate good interpersonal skills when communicating with peers and authority in difficult situation.
SGD 6: Feedback on Reflective Writing & Supervisor Report
At the end of the SGD session, students should be able to:
1. Assess reflective journal. 2. Acquire feedback from peers and facilitator. 3. Give feedback to peers.
46
Seminar: Healthy Lifestyle
Pre-requisites:
1. Students have gone through a lecture and SGD on Healthy Lifestyle in relation to
a medical student.
At the end of the seminar, students should be able to:
1. Extend the aspects of healthy lifestyle to the community.
2. Create a poster based on a theme to promote healthy lifestyle to the community.
Self-Learning Package (SLP) 1: Briefing on Healthy Lifestyle Seminar
At the end of the SLP, students should be able to:
1. Plan and delegate tasks in conducting a seminar. 2. Work as a team to create a poster based on a theme to promote healthy lifestyle
to the community.
Self-Learning Package (SLP) 2: Preparation of Reflective Writing on Communication Skills
At the end of the SLP, students should be able to:
1. Write reflection on experience in relation to communication skills.
Group Task: Preparation of Healthy Lifestyle Seminar
At the end of the group task, students should be able to:
1. Discuss on a theme of promoting healthy lifestyle to the community. 2. Create a poster relating to the theme.
CONTENTS SUMMARY
Lecture : 4 hours
Video : 3 hours
SGD/Reflective writing : 12 hours
Self-Learning Package/Group Task : 5 hours
Seminar : 6 hours
47
MEDICINE AND SOCIETY MODULE (FF2613) SESSION 2016/2017
I. DIRECTORY OF TEACHING STAFF (Tel: 03- 9145…..)
NO. NAME OF LECTURERS PHONE NO. E-MAIL ADDRESS
1 Assc. Prof. Dr. Azmi Mohd Tamil (Module Coordinator)
5890 019-3207073
2. Prof. Dr. Khadijah Shamsuddin 5894 [email protected]
3 Assc. Prof. Dr. Zaleha Md Isa 5902 [email protected]
4 Assc. Prof. Dr. Rosnah Sutan 5896 [email protected]
5 Assc. Prof. Dr Mohd Hasni Jaafar
5720 [email protected]
6 Dr. Ahmad Taufik Jamil 8793 [email protected]
7 Dr. Nazarudin Safian 8786 [email protected]
8 Dr. Rosnah Ismail 5900 [email protected]
9 Dr. Faiz Daud 5903 [email protected]
II. INTRODUCTION TO MEDICINE AND SOCIETY II
The module discusses the concept of control and prevention of communicable and non-communicable diseases. Attention is specifically given to the programs and services of disease control that has become the public health problem in Malaysia. This module also introduces basic demography including important statistics, fertility data, population expansion and life table. Basic knowledge on occupational safety and health, as well as hazard assessment and control measures at workplace are also explored. The students will be exposed to the existing occupational safety and health acts and regulations in Malaysia, as well as the occupational accident prevention programs and the occupational injury compensation legislation. This module also introduces the students to the technique of conducting research from proposal preparation and data collection until data analysis and report writing. Basic statistical techniques such as descriptive statistics and inferential statistics will be introduced to the students as they conduct their research. PRE-REQUISITES
The students should have basic knowledge of medicine and society in Year 1, Semester 2. III. MODULE OBJECTIVES
By the end of this module, students should be able to:
recognise basic tools of public health specifically epidemiology, statistics, demography and occupational health.
recognise basic principles of health services for specific groups of population such as workers, children and mothers.
conduct research and analyse a data set.
48
IV. METHODS OF ASSESSMENT
1. Continuous assessment (40%)
i. Mini Test I (20 MCQ-OBA questions) – 10% ii. Mini Test II (20 MCQ-OBA questions) – 10% iii. Research Project Presentation and Written Report – 5% + 5% iv. Online practical sessions via Google Forms – 10%
2. End of Semester Examination (60%)
i. 30 MCQ-OBA Questions ii. 6 Extended Matching Item Questions (Each theme contain 5 item stems)
iii. 2 Modified Essay Questions V. RESOURCE MATERIALS
1. Mausner, J.S. & Bahn. 1985. Epidemiology – An Introduction Text. W.B. Saunders Company, Philadelphia.
2. Osman Ali. 1990. Kaedah Epidemiologi, Dewan Bahasa dan Pustaka, Kuala Lumpur.
3. Md. Idris Mohd. Noor. 1997. Asas Statistik Dan Penyelidikan Perubatan. 2nd. Ed. Dewan Bahasa dan Pustaka, Kuala Lumpur. https://drtamil.me/2010/08/27/fk6163-ff2613-buku-asas-statistik-penyelidikan-perubatan/
4. Chan Y.H., 2003-2005. Basic Statistics For Doctors Series. Singapore Medical Journal. Available from http://drtamil.me/ (password yhchan)
o 101: Data Presentation (June 2003) o 102: Quantitative Data - Parametric & Non-Parametric Tests (August
2003) o 103: Qualitative Data - Tests of Independence (October 2003) o 104: Correlational Analysis (December 2003) o 201: Linear Regression Analysis (Feb 2004)
5. Swinscow, T. D. V. 1997. Statistics at Square One. BMJ Publishing Group; 9th edition. Freely available from http://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one
6. Blog at https://drtamil.me/ffff2613/ 7. Facebook Group at https://www.facebook.com/groups/ezrabridger/ 8. Slideshare at http://www.slideshare.net/drtamil/
9. ifolio at http://ifolio.ukm.my
49
TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES Concept Lectures
At the end of the lectures, students should be able to: CL1 Epidemiology in Medicine
comprehend the concept and definition of epidemiology.
know the scope and usefulness of epidemiology.
recognise the development of epidemiology and its role in medicine.
describe the relationship between agent, host, environment and human in diseases transmission.
CL2 Principles in Control and Prevention of Diseases
comprehend the definition of diseases prevention, control, elimination and surveillance.
explain isolation and quarantine.
discuss the principles of diseases prevention.
describe methods of control and prevention used for communicable and non-communicable diseases.
define descriptive epidemiology.
recognise disease distribution according to people, place and time.
explain disease distribution by giving certain examples. CL3 Epidemic Investigation
differentiate between epidemic and endemic.
discuss the methods used in epidemic investigation.
identify the epidemic curve and calculate the attack rate.
describe the steps in epidemic control measures. CL4 Disease Surveillance
comprehend the definition and concept of disease surveillance.
discuss diseases under the Ministry of Health Surveillance Program.
outline the International Health Surveillance and role of WHO. CL5 Disease Epidemiology in Malaysia
recognise the common diseases in Malaysia.
explain the trend of communicable and non-communicable diseases in Malaysia.
identify factors that may influence the trend of communicable and non-communicable diseases occurrence.
identify the incidence of communicable and non-communicable diseases among multi-racial population in Malaysia.
50
CL6 Control and Prevention of Non-Communicable Diseases
describe the principles of non-communicable disease prevention and control.
outline the prevention programmes carried out by the Ministry of Health, Malaysia.
CL7 Health Statistics and Indicators
describe health statistics and indicators used by the Ministry of Health, Malaysia.
explain and suggest mitigation measures that are appropriate according to the indicators.
CL8 Research Methodology – Study Designs
know how studies are designed, methodology and appropriate statistics methods that can be used in presenting the results of the study.
CL9 Research Methodology – Data Collection
know different methods of sampling data
know different methods of data collection
understand the need for data exploration. CL10 Principles of Demography
define the demography, health statistics and important database.
relate demography and health.
illustrate the usefulness of demography.
know the notification system in Malaysia.
differentiate between fertility and fecundity.
discuss factors involved in fertility.
discuss the effect of fertility on population changes.
measure fertility and problems in measuring it. CL11 Descriptive Analysis
identify types of descriptive statistics commonly used in research.
Able to conduct descriptive analysis.
differentiate between descriptive and analytic statistics.
CL12 Analysis of Quantitative Data – T-test
distinguish different types of analysis of quantitative data commonly used in medical research.
Able to analyse quantitative data using T- test
51
CL13 Analysis of Quantitative Data – Correlation & Regression
distinguish different types of analysis of quantitative data commonly used in medical research.
Able to analyse quantitative data using Correlation & Regression. CL14 Analysis of Qualitative Data – Chi-Square & Proportionate Test
distinguish different types of analysis of qualitative data commonly used in medical research.
Able to analyse qualitative data using Chi-Square & Proportionate Test. CL 15 Non-Parametric Analysis
Able to decide when to use parametric and non-parametric analysis
Able to analyse using different types of non-parametric analysis commonly used in medical research.
CL16 Principles of Occupational Safety and Health
define occupational safety and health.
recognise the concept of man and machine interface.
recognise hazard assessment and control measures at workplace. Self-Learning Package (SLP)
At the end of the SLP topics, students should be able to: SLP1. Vaccines and Immunity
recognise the concept of immunity and immunisation.
outline the history and type of vaccines.
identify vaccination programs in Malaysia. SLP2. Occupational Safety and Health Legislations
recognise the existing occupational safety and health acts and regulations in Malaysia.
define occupational safety and accident.
discuss the occupational accident prevention programs.
explain the occupational injury compensation legislation.
52
Practicals
PE1 Control and Prevention of Communicable Diseases
explain the stages involved in prevention of diseases based on natural history of the disease.
explain the concept of multi-factorial causes of a disease.
describe the principle of communicable diseases prevention.
define isolation, quarantine, prevention and control.
describe characteristics of prevention and control of certain diseases. PE2. Screening Test
define sensitivity, specificity and predictive values.
explain what is a good screening test. PS1 Descriptive Statistics
Preceded by CL 10 Descriptive Analysis.
identify types of descriptive statistics commonly used in research.
differentiate between descriptive and analytic statistics. PS2 Analysis of Quantitative Data – T-test
Preceded by CL 11 T-test
identify different types of analysis of quantitative data commonly used in medical research.
Able to analyse quantitative data using T- test PS3 Analysis of Quantitative Data – Correlation & Regression
Preceded by CL12 Correlation & Regression
identify different types of analysis of quantitative data commonly used in medical research.
Able to analyse quantitative data using correlation and linear regression. PS4 Non-Parametric Analysis
• Preceded by CL 13 Analysis of Qualitative Data & CL 14 Non-Parametric
Analysis • Able to analyse qualitative data using Chi-Square & Proportionate Test • Able to use non-parametric analysis in analyzing data.
PS5 Presentation of Research Findings
Using software such as Camtasia Studio, students record their presentation and submit it to YouTube prior to the scheduled sessions.
https://ppukm.org/2014/06/03/e-learning-installing-camtasia-studio-8/
https://ppukm.org/2016/03/05/sharing-videos-on-the-ifolio/
53
Mini Tests
Mini Test 1
Epidemiology & Demography Mini Test 2
Statistics & Occupational Health Problem-Based Learning (PBL) PBL1. Occupational Injury – A wildlife officer (Pegawai Perhilitan) with
Leptospirosis infection due to work exposure.
At the end of the PBL topics, students should be able to:
recognise the importance of epidemiological surveillance activity in prevention of communicable diseases.
describe the universal precaution practice at workplace.
recognise the importance of early notification in disease control. Research Project At the end of practical and research project sessions, students should be able to:
develop basic concept of asking and thinking in scientific way.
gain, manage and analyse research data in such scientific method. Research Project 1
determine title, objective, hypothesis and references. Draft research proposal and questionnaire
Research Project 2
present research proposal to the group and finalise the questionnaire. Research Project 3
conduct data collection and key-in data in statistical software. Research Project 4
conduct data analysis and prepare for presentation. Research Project 5 a & b
present research results and write report.
54
CONTENT SUMMARY
Teaching-Learning Method
Number of sessions
Duration per session (hours)
Total Contact Hours
Concept Lecture 16 16 sessions X 1 hour 16
Self-Learning Package 2 2 sessions X 1 hour 2
Practical and Research Project
8 6 sessions X 2 hours 14
2 sessions X 1 hours
Mini Tests 2 2 sessions X 2 hours 4
Problem-Based Learning
1 1 sessions X 4 hours 4
Total 29 40