Adult MedicineIntended Learning Objectives 4th Year ExaminationCardiology Coronary Artery DiseaseUnderstand the pathology o coronary artery disease!escribe the ris" actors or atherosclerosis in the coronary arteries !escribe the pathophysiology o acute coronary syndromes and myocardial inarction#ecognise the clinical presentations o coronary artery disease !escribe the investigation o a patient $ith chest pain and suspected coronary artery diseaseOutline the diagnosis o acute myocardial inarction !iscuss treatment options or optimal reperusion !escribe the complications o acute myocardial inarction Outline management ollo$ing an acute MI including secondary drug treatments and rehabilitation!iscuss the management o stable coronary artery disease Hypertension!escribe the role o hypertension in the pathogenesis o cardiovascular disease Outline the common causes o hypertension %including secondary causes&Outline the diagnosis o hypertension#ecognise the clinical presentations o hypertension!escribe the investigation o a patient $ith hypertensionOutline the management o hypertension!iscuss the mechanisms o actions o drugs used to treat hypertension!iscuss non'pharmacological treatments or hypertensionDyslipidaemia!escribe the normal physiology o blood lipidsOutline the role o lipids in the pathogenesis o atheroma !escribe the mechanisms o actions o lipid'lo$ering drugs#evie$ the evidence o bene(t rom trial evidence o reducing ris" actorsOutline treatment strategies to lo$er blood lipidsArrhythmias !escribe the clinical presentations o bradyarrythmias and tachyarrythmias)Outline the investigation and diagnosis o common bradyarrthymias and tachyarrythmiasOutline the common causes o atrial (brillation!escribe the rationale underlying the various therapeutic approaches to atrial (brillation* including rate control and rhythm control* using anti'arrhythmic drugs!escribe the ris" o stro"e associated $ith atrial (brillation* the indications or anti'coagulation* and the importance and mechanism o drug interactions in patients on anti'coagulants %e)g) $ararin&!escribe the arrhythmias that cause cardiac arrest and sudden cardiac death!iscuss the basic concepts o a pacema"er in the management o bradyarrythmiasElectrocardiography!escribe the physics underlying the recording o a +,'lead E-.!emonstrate the recording o a +,'lead E-. Outline a systematic approach to the interpretation o the E-.!iscuss ho$ to recognise normal and abnormal cardiac rhythms#ecognise common abnormalities on E-.* including acute MI!iscuss the role o exercise E-. in the investigation o cardiovascular disease!iscuss the role o ambulatory E-. monitoring in the investigation o arrhythmiasHeart failure !escribe the pathophysiology o heart ailureOutline the common causes o heart ailure#ecognise the clinical presentations o heart ailure!escribe and understand radiology signs o heart ailure on a chest x'rayOutline the management o acute and chronic heart ailure!iscuss the mechanisms o actions o drugs used to treat heart ailure Outline the evidence o bene(t o drug treatments or heart ailure!iscuss non'pharmacological treatments or heart ailureCardiac ImagingUnderstand the commonly used imaging techni/ues in cardiologyOutline clinical indications or di0erent imaging techni/uesIllustrate the clinical use o cardiac imaging using clinical casesValvular heart diseaseUnderstand the origins o heart valve murmurs* due to stenosis and1or regurgitation!escribe the aetiology and pathology o aortic and mitral valve diseaseExplain the symptoms and signs o aortic and mitral valve disease %stenosis1regurgitation&Explain the complications o aortic and mitral valve disease %stenosis1regurgitation&*including the e0ects on the let and right ventricle!escribe the investigation o aortic and mitral valve disease and outline the management* in particular the indications or surgeryInfective Endocarditis#evie$ the clinical eatures o inective endocarditis Outline the diagnosis o inective endocarditis and describe diagnostic criteria!iscuss the microbiology o the inective organisms in inective endocarditis!iscuss the treatment o inective endocarditisCardiomyopathy!escribe the de(nitions o cardiomyopathies %in particular !ilated -ardiomyopathy and 2ypertrophic -ardiomyopathy&Outline the potential cardiac complications o cardiomyopathyCongenital Heart Diseases!escribe the common causes o congenital heart diseaseAdult MedicineIntended Learning Objectives 4th Year ExaminationRespiratory Medicine Chronic Obstructive Airways Disease!escribe the de(nition o -O3!#evie$ the pathological changes in the air$ays and the distal air spaces that result in -O3!List the major ris" actors or the development o -O3!#ecognise the clinical presentations o -O3!!escribe the clinical syndromes that are covered by the term -O3!)Outline an appropriate plan o investigation to diagnose -O3!!escribe and understand radiology signs o -O3! on a chest x'rayExplain the eatures o spirometry in obstructive lung diseases such as -O3Understand ho$ spirometry is used to classiy the severity o the conditionOutline the management o -O3! in acute exacerbations and chronic disease!iscuss the management o acute exacerbations o -O3!Outline the pharmacological and non'pharmacological treatments o chronic -O3!!escribe the indications or the use o non'invasive ventilation and long'term oxygen therapy in -O3!Asthma Understand the underlying in4ammatory mechanisms in the air$ays in asthma)Outline the cell types and in4ammatory mediators involved in the development o asthma!escribe the changes that occur in the air$ays as a result o asthmatic in4ammation List extrinsic actors that may exacerbate asthma#ecognise the clinical presentations o asthmaOutline a plan o investigation to diagnose asthma!iscuss the management o acute asthmaOutline the step'$ise management o chronic asthma !escribe ho$ pharmacological therapies target in4ammatory mechanisms in acute and chronic asthmaPneumonia #ecognise the clinical presentations o pneumonia!escribe the causes and di0erences bet$een typical and atypical pneumonia!escribe the use o -U#567 to assess severity o -A3Outline an appropriate plan o investigation to diagnose pneumonia) !emonstrate the silhouette sign to detect lung consolidation and collapseIdentiy consolidation1 pneumonia and correlate $ith clinical presentations Outline the management o -A3 including empirical choices o antibiotics!iscuss the complications o -A3ronchiectasisOutline the common causes o bronchiectasis!escribe the de(nition o bronchiectasis !escribe the pathogenesis o bronchiectasis %not cystic (brosis& Explain the e0ect o chronic inection in the lung#ecognise the clinical presentations o bronchiectasis %not cystic (brosis&Outline a plan o investigation to diagnose bronchiectasis!iscuss the management o bronchiectasis in acute exacerbations and chronic disease !ung CancerOutline the pathogenesis o lung cancer!escribe the main histological sub'classi(cations o lung cancer and ho$ this in4uences prognosis!escribe the pathological conse/uences o lung cancer %local and distant&List the clinical presentations that are suspicious o a diagnosis o lung cancerList the common sites o metastases rom lung cancer and problems they may cause!escribe common non'metastatic maniestations o lung cancer Outline a plan o investigations to diagnose lung cancer!escribe the investigations used in the staging systems or lung cancerIdentiy lobar collapse on a chest x'ray and discuss the implications#ecognise intrapulmonary masses on a chest x'ray and describe the di0erential diagnosis %including tumours %primary and secondary&* abscess and 85)Understand ho$ the results o all these tests are used to de(ne a management planor the patient!escribe the treatments modalities used in the management o lung cancer"espiratory failure !escribe the classi(cation o respiratory ailure!escribe some eatures o end'stage respiratory diseaseOutline a systematic approach to blood gases analysis in clinical practiceExplain the serum biochemical adaptation to acute and chronic respiratory ailure!iscuss the clinical application o the alveolar'air e/uationPneumothora# $and tension pneumothora#%!escribe the causes o pneumothorax %primary and secondaryecognise the clinical presentation o pneumothoraxOutline an appropriate plan o investigation to diagnose pneumothorax!escribe and understand radiology signs o pneumothorax on a chest x'rayOutline the management o pneumothorax including indications or aspiration andchest drain insertion!iscuss the complications o pneumothorax Pulmonary embolism !escribe the de(nition o pulmonary embolism!escribe the causes o pulmonary embolism #ecognise the clinical presentations o pulmonary embolism!escribe the use o the Modi(ed'.eneva 9core to assess the li"elihood opulmonary embolism Outline an appropriate plan o investigation to diagnose pulmonary embolismOutline thepharmacological and non'pharmacologicalmanagement o acutepulmonary embolism Pleural e&usion !escribe the pathogenesis o pleural e0usionsList the common causes o pleural e0usions!escribe a strategy or the investigation o pleural disease!escribe the classi(cation o pleural e0usions as either transudates or exudatesExplain the management o pleural e0usions based on the aetiologyOutline the radiological and pathological eatures o mesotheliomaInterstitial and 'brotic lung diseases!escribe the pathogenic changes in the lungs that result in the development o pulmonary (brosis)Explain ho$ these histological eatures alter lung unction and lead to respiratory ailure in some types o interstitial lung disease!escribe the histological and radiological changes seen in idiopathic pulmonary (brosis %usual interstitial pneumonia&!escribe the classi(cation system or interstitial lung diseaseList drug and environmental agents that may cause pulmonary (brosis !escribe other medical conditions that are associated $ith the development o interstitial lung disease9peciy the investigations used to ma"e a diagnosis o interstitial lung disease!escribe the blood tests used to try to de(ne an underlying aetiology!escribe the pattern o change in arterial blood gases caused by idiopathic pulmonary (brosis !escribe and understand radiology signs o interstitial lung disease on a chest x'rayExplain the eatures o spirometry in restrictive lung diseases such as -O3!!iscuss the basic principles o the management o interstitial lung disease(ranulomatous !ung Disease!escribe the conditions other than 85 $hich cause granulomatous lung in4ammation!escribe common clinical presentations o sarcoidosis!iscuss the basic principles o the management o sarcoidosisList some rarer conditions that cause pulmonary granulomasObstructive sleep apnoea syndrome!escribe the de(nition o obstructive sleep apnoea syndrome %O9A9ecognise the clinical presentations o O9A9!iscuss the conse/uences o O9A9!escribe actors that predispose to the development o O9A9!iscuss the investigation re/uired to ma"e a diagnosis o O9A9Outline possible treatments or O9A9Cor pulmonaleOutline the basic pathophysiology o cor pulmonaleOutline the common causes o cor pulmonale!escribe common clinical presentations o cor pulmonale!iscuss the basic principles o the management o cor pulmonaleAdult MedicineIntended Learning Objectives 4th Year ExaminationGastroenterology )ymptoms of (I Disorders* +ausea, Vomiting, Dysphagia, Dyspepsia, Diarrhoea, Constipation leeding, -aundice and .eight loss9peciy the common causes o each symptomExplain the importance o history and examination in assessing a patient $ith these symptomsOutline a logical approach to investigation o each symptom /pper gastrointestinal disease !escribe normal structures and signi(cant developmental abnormalities involving the oesophagus and stomach !iscuss the causes* clinical presentations* investigation* management and complications o gastro'oesphageal re4ux disease %.O#!& and hiatus hernia3rovide an account o 5arrett:s oesophagus* including its epidemiology* aetiology* pathogenesis and complications!iscuss the causes* clinical presentations* investigation* management* complications o gastritis1duodenitis and gastric1duodenal ulcers !escribe the role o 2elicobacter pylori inection in mucosal ulceration o the stomach and duodenumO0er a practical classi(cation o gastritis %acute versus chronic; autoimmune* bacterial and chemical&Account or pathophysiological conse/uences o parietal'cell loss in atrophic gastritis!emonstrate the lin" bet$een 2elicobacter pylori inection and lymphomaExplain ho$ ulcers* varices and other causes o upper .I bleeding arise and discuss ho$ these pathologies can lead to the clinical presentation o upper .I bleeding!escribe the important steps in managing a patient $ith acute gastrointestinal bleeding Outline the long'term management o oesophageal varices!iver DiseaseList the causes o jaundice and1or abnormal liver unction testsOutline the classi(cation o jaundice9tate that in the diagnosis and management o liver disease* it is important to distinguish bet$een space occupying lesions or masses* and di0use liver disease List these common histological patterns o di0use liver disease< acute hepatitis* acute cholestasis1 cholestatic hepatitis* atty liver disease* chronic hepatitis* chronicbiliary disease and hepatic vascular disease) =or each* brie4y describe their clinical and1or histological appearances* and their most common causes and1or underlying disease processes %this list should include primary biliary cirrhosis* autoimmune* >+'antitrypsin deiciency* haemochromatosis* ?ilson@s disease* alcohol* viral hepatitis& Explain ris" actors or certain aetiologies o liver diseaseExplain* $ith examples that drug'induced liver disease is common and may present as almost any pattern o liver disease =or space occupying %mass& lesions* explain that the main di0erential diagnosis is bet$een in4ammatory lesions e)g) abscesses* and neoplasms List and describe commonly encountered hepatic neoplasms including primary liver tumours and metastases Understand the di0erence bet$een acute and chronic hepatitis !escribe the viral causes o hepatitis< epidemiology* virology* clinical eatures* treatment and outcome !e(ne cirrhosis !escribe the common clinical maniestation o liver disease and understand the mechanisms by $hich liver disease leads to these Outline a logical approach o investigation o raised liver unction tests and1or liver disease!escribe the common management strategies or patients $ith acute liver ailure and chronic liver disease1cirrhosisIn0ammatory bowel disease including /C and Crohn1s disease !escribe "no$n pathophysiology o in4ammatory bo$el disease including ulcerativecolitis and -rohn:s disease #ecognise the clinical re/uired in suspected in4ammatory bo$el disease Outline the common investigations re/uired to con(rm a diagnosis o in4ammatory bo$el diseaseOutline the common investigations re/uired disease during acute exacerbations o in4ammatory bo$el disease !escribe commonly used maintenance treatments or in4ammatory bo$el disease !escribe commonly used treatments or acute exacerbations o in4ammatory bo$eldisease 3rovide an understanding o the potential roles o surgical treatment or in4ammatory bo$el diseaseOutline the potential complications o in4ammatory bo$el disease 2alabsorption syndromes including coeliac disease!escribe the clinical syndromes associated $ith nutritional de(ciencies!iscuss the management and potential complications o a patient $ith coeliac disease!iscuss the pathophysiology* clinical presentations* investigation and diagnosis o coeliac disease !iscuss the basic principles o the management and potential complications o coeliac disease Irritable bowel syndrome $I)% and +on3/lcer dyspepsiaOutline brie4y the clinical presentations and approach to investigation* diagnosis and management Adult MedicineIntended Learning Objectives 4th Year ExaminationNeurologyClinical +euroanatomyExplain basic neuroanatomy and provide examples o ho$ lesions $ithin the nervous system give rise to clinical signs)!escribe the structure o nervous system 9peciy examples o $hat clinical signs might be seen $ith lesions at the ollo$ing levels