Year 3 CR3: Cardiovascular, Respiratory and Haematology (CR3)

Lecture: Chest Pain & Atheroma

Introduction to Cardiorespiratory

Lecture: Interpretation of ECG

1. Understand the basics of cardiac electrophysiology (including origin of each wave form)
2. Know the basic anatomy of the heart
3. Understand the ECG changes of cardiac ischaemia and MI
4. Learn about the ECG changes due to common electrolyte disturbances
5. Learn ECG changes in cardiac arrhythmias
6. Learn ECG changes in cardiac conduction defects
7. Understand the ECG changes in common cardio-respiratory conditions as per the learning outcomes for the individual condition

Lecture: Stable Angina

Lecture: Acute Coronary Syndrome & MI

Lecture: How to Look at a CXR?

Lecture: Valvular Heart Disease and Endocarditis

Lecture: Airways Disease (Asthma & COPD)

Lecture: Management of Asthma/COPD

Lecture: Respiratory Infections

Lecture: Tuberculosis/Sarcoidosis

Lecture: Interpretation of Lung Function

Lecture: Hypertension

Lecture: Commonly used Cardiac Medications

1. Describe the mechanism and speed of onset of action, place in therapy and major side effects of adenosine, digoxin, amiodarone, verapamil, beta blockers, lignocaine, flecainide, magnesium and atropine.
2. Learn the role of anticoagulation in cardiac arrhythmias, particularly in atrial fibrillation

Lecture: Pleural Disease ( Effusion and Mesothelioma)

Lecture: Cardiac Arrhythmias

Lecture: Respiratory Emergencies

Lecture: Heart Failure

Lecture: Oxygen Therapy

1. Describe methods of oxygen delivery for patients
2. Describe how the decision is made on the amount of oxygen to prescribe
3. Describe oxygen delivery methods in a hospital
4. Describe the role of controlled versus high flow oxygen in patients with COPS and Asthma
5. Describe the arrangements for the supply of oxygen in the community

Lecture: Blood transfusion reactions

Lecture: Malaria

Lecture: Respiratory Failure/Sleep Apnoea

Lecture: Endocarditis

CE & SDL RS: Lung function & pulmonary anatomy/physiology

1. Learn the basic anatomy of the lungs
2. Describe the use of lung function in the diagnosis of respiratory diseases
3. Be able to interpret spirometry, lung volumes and gas transfer
4. Be able to differentiate obstructive and restrictive patterns
5. Learn about peak expiratory flow measurement and its usefulness
6. Describe the roles of peak flow and spirometry in the diagnosis and monitoring of respiratory diseases
7. Be able to explain to a patient how to perform spirometry and peak flow and, in the case of peak flow, record the results
8. Be able to interpret acid-base balance results

CE & SDL HAEM: Benign White Cell (Leucocyte)

1. Recall the basic structure and function of circulating leucocytes
2. Draw the proliferation and differentiation pathways of the different white cell lines
3. Learn the common causes of increases and reductions in the numbers of various leucocytes
4. Define neutropenia and describe the causes and consequences of this condition
5. Describe the management of a patient with neutropenia on the ward

CE & SDL HAEM: Haemoglobinopathies (Sickle Cell Thalassaemia)

1. Understand how the genetic alterations affect the normal physiology of haemoglobin and the red cell and what the clinical consequences
2. Understand the genetics of sickle cell disease and thalassaemia; define sickle cell disease and sickle cell trait
3. Outline the laboratory diagnosis of sickle cell disease and thalassaemia
4. Outline the management of sickle cell disease and thalassaemia
5. Recognise the symptoms and signs of the different types of sickle cell crisis
6. Account for the vulnerability to infection that affects people with sickle cell disease

Lecture: Lipids in Heart Disease

Lecture: Cardio-vascular Pathology

Lecture: Pulmonary Pathology

H10: Venous Thromboembolism (VTE) - Prevention & Thromboprophylaxis (Priority 2)

1. Describe the differences, including pressure differences, between the systemic and pulmonary circulation, and left and right sides of the heart
2. Understand the significance of venous thromboembolism (VTE) morbidity and mortality in the whole hospital setting and to appreciate that much of this is preventable
3. Understand the process and justification for VTE risk assessment of hospitalised patients and alternative policy approaches to thromboprophylaxis
4. Describe methods and effectiveness of VTE prevention strategies along with their contraindications

Lecture: Lung Cancer

CE & SDL CV: Hypertension (Priority 1)

NOTE:  A virtual patient is available for this condition. Please sign into Blackboard to view.

1. Learn the patho-physiology of atherosclerosis and other mechanisms of hypertension
2. Define hypertension (essential and secondary) and learn British Hypertension Society targets for blood pressure control
3. Describe symptoms and signs of hypertension
4. Learn secondary causes of hypertension and give symptoms and signs that may be found in each condition
5. Learn about the associated cardiovascular risk factors that should be looked for in patients with hypertension
6. Describe the relevant investigations to look for causes and complications of hypertension
7. Discuss the non-pharmacological management of cardiovascular risk factors
8. Advise patients with hypertension on the risks and benefits of drugs and non-therapeutic treatment options.
9. Learn those classes of drugs that can be used to control blood pressure and describe the mechanism of action, place in therapy and major side effects of each.
10. Learn the definition of accelerated hypertension
11. Learn about the pathology of target organ damage caused by accelerated hypertension
12. Discuss the principles of emergency blood pressure control in hypertension

CE & SDL CV : Angina (Priority 1)

1. Learn patho-physiology of atherosclerosis and explain how this leads to angina
2. Identify a patient with ischaemic heart disease
3. Describe symptoms and signs of angina
4. Learn about differential diagnosis for retrosternal chest pain
5. Learn about risk factors for the development of atheroma and outline how each should be controlled in a patient with angina
6. Describe investigations that can be used to confirm the diagnosis of angina
7. Learn those classes of drugs used for angina and describe the mechanism of action, place in therapy (i.e. whether they reduce the risk of a CV event or just control the symptoms) and major side effects of each
8. Explain to a patient how to take sublingual GTN spray in the event of chest pain
9. Learn about the indications for referral of a patient with angina to a specialist cardiology service
10. Define unstable angina and the risk of progression of this to myocardial infarction
11. Describe symptoms and signs of unstable angina
12. Learn the investigations that should be performed in a patient with unstable angina and describe the expected findings
13. Define unstable angina and the risk of progression of this to myocardial infarction
14. Describe the management of unstable angina
15. Give mechanism(s) of action and major side effects of drugs used in unstable angina
16. Learn the indications for urgent cardiological intervention
17. Describe the processes of coronary angiography, angioplasty and stenting to a patient
18. Learn the complications of these procedures and discuss their prevention and management
19. Discuss indications for coronary artery bypass surgery
20. Describe some details about the process of putting a patient onto cardiopulmonary bypass
21. Learn the common complications of cardiopulmonary bypass and explain why these occur
22. Describe the process of coronary artery bypass and the risk of complications to a patient

CE & SDL CV : Acute Coronary Syndrome & Myocardial Infarction (Priority 1*)

NOTE: A virtual patient is available for this condition. Please log in to QMplus (Curriculum links > Virtual Patients on the right side of screen).

1. Learn the coronary circulation, particularly the vascular supply to various myocardial regions
2. Learn the basic anatomy of the heart
3. Explain how an ECG can be used to determine the site of myocardial infarction and indicate which vessel is occluded
4. Identify a patient with ischaemic heart disease
5. Learn the ECG changes (including evolutional changes) in Acute Coronary Syndrome.
6. Describe the changes in cardiac enzymes including troponin and creatinine kinase that occur from hours to weeks following MI
7. Learn the common complications of myocardial infarction
8. Explain how and why complications may differ between anterior and inferior myocardial infarction
9. Describe symptoms and signs of complications of MI including a) arrhythmias and b) cardiac failure
10. Learn the drugs which are proven to improve prognosis / survival following MI and give evidence supporting their use including number need to be treated (NNT) values
11. Organise the long term care of a patient with ischaemic heart disease
12. Advise patients with ischaemic heart disease on non therapeutic methods of improving their condition
13. Prescribe for a patient with ischaemic heart disease with a view to improving prognosis
14. Evaluate the most appropriate treatment for patients with ischaemic heart disease
15. Advise patients with ischaemic heart disease on the risks and benefits of drugs and non therapeutic treatment options.
16. Describe the role of cardiac rehabilitation in recovery from ACS
17. Describe the pathogenesis of an acute MI
18. Describe the symptoms and signs of acute MI
19. Describe the emergency investigations to confirm the diagnosis of MI
20. Describe the criteria for the diagnosis of myocardial infarction
21. Describe the immediate management of a patient with myocardial infarction
22. Describe the mechanism of action, role in therapy and major side effects of aspirin, other anti-platelet therapies, diamorphine and oxygen in acute MI
23. Learn the role of primary coronary intervention (PCI) as an emergency therapy
24. Learn the role of thrombolysis in MI
25. Describe mechanism of actions, indications and contraindications and major side effects of thrombolytic agents
26. Learn about the indications, pros and cons on the use of Primary Coronary Intervention (PCI) versus thrombolysis
27. Define "arrival-to-ECG" and "door-to-needle" times for suspected MI and explain why these are important
28. Give indications for urgent cardiological referral in MI

CE & SDL CV: Arrhythmias and Conduction Defects

1. Learn about cardiac cycle and cardiac electrophysiology and learn how this relates to the ECG waveform
2. Identify common arrhythmias on an ECG
3. Using history (symptoms), signs and ECG findings be able to diagnose and distinguish between the following: cardiac arrest; atrial flutter and atrial fibrillation (AF); respiratory arrest; ventricular tachycardia; pulse; Peri-arrest; ventricular fibrillation; supraventricular tachycardia; 1st, 2nd & 3rd degree heart block
4. Describe the symptoms by a patient experiencing cardiac arrhythmias
5. Learn how to distinguish between neurological and cardiological causes of collapse
6. Learn cardiological causes of collapse
7. Learn the causes of each type of pathological tachycardia and bradycardia
8. Describe how abnormalities of cardiac electrophysiology lead to the arrhythmias listed above
9. Learn about the ECG changes in common electrolyte disturbances, particularly potassium abnormalities
10. Describe the relevant investigations that should be performed in patients with suspected arrhythmias including 24 hour cardiac monitoring and investigation of underlying causes
11. Describe the mechanism and speed of onset of action, place in therapy and major side effects of adenosine, digoxin, amiodarone, verapamil, beta blockers, lignocaine, flecainide, magnesium and atropine
12. Learn the role of anticoagulation in cardiac arrhythmias, particularly in atrial fibrillation
13. Discuss indications for "electrical treatment" of arrhythmias (cardioversion, pacemaker and ablation) and describe how each procedure is done
14. Describe methods that can be used to reduce recurrence of arrhythmias including treatment of underlying cause, drug treatment and radiofrequency ablation
15. Summarise the management of arrhythmias listed including termination of arrhythmias, control of heart rate and prevention of recurrence
16. Know how to manage a patient with a cardiac arrest in line with the current UK Resuscitation Council Guidelines

CE & SDL CV: Cardiac Failure / Pulmonary Oedema (Priority 1)

1. Learn about the physiological mechanisms of cardiac contractility and learn about cardiac output and starling’s law
2. Explain how preload, after-load and cardiac contractility determine cardiac output
3. Describe symptoms and signs of left, right and biventricular cardiac failure
4. Learn the causes of left, right and biventricular cardiac failure and the underlying pathogenesis.
5. Learn about the differential diagnosis for breathlessness (cardiac, respiratory and haematological)
6. Describe investigations that can be used to confirm the diagnosis of cardiac failure
7. Learn about the drugs which alter a) preload, b) after-load and c) cardiac contractility and explain how each of these can be used to treat cardiac failure
8. Learn about drugs which a) improve symptoms b) prolong survival in heart failure and give evidence for the latter
9. Discuss the role of non-pharmacological treatments in heart failure including exercise and diet, revascularisation and cardiac transplantation
10. Be aware of new advancements in the treatment of heart failure
11. Compare the prognosis of congestive cardiac failure (CCF) to other common conditions.
12. Discuss the role of the primary care team in the management of chronic cardiac failure and in the avoidance of re-admissions
13. Describe the emergency management of a patient presenting with cardiac failure, particularly pulmonary oedema.
14. Describe the macroscopic and histological changes in the lungs and liver in heart failure
15. Be able to distinguish between the following terms and conditions: Left Ventricular Failure; Right Ventricular Failure; Congestive Cardiac Failure / Bi-ventricular Failure; Diastolic and Systolic Failure; Cardiogenic Shock; Low Output Failure; High Output Failure; Decompensated Failure
16. Learn about the CXR changes in pulmonary oedema

CE & SDL CV: Acute Circulatory Failure / Shock

1. Learn about the mechanisms of shock
2. Describe how hypovolaemia, cardiac failure or obstruction (cardiac tamponade, pulmonary embolism), sepsis and anaphylaxis can each cause shock
3. Describe how clinical examination can be used to distinguish between the causes of shock listed
4. Describe how central venous pressure measurement can be used to give an indication of the cause of shock
5. Learn to distinguish between bronchial and “cardiac asthma”
6. Describe how a patient in shock should be monitored and managed
7. Explain the patho-physiological consequences / complications of shock
8. Outline the measures that should be taken to prevent these complications of shock
9. Learn the causes of cardiogenic shock
10. Describe how preload, cardiac contractility and after load could be optimised to maximise cardiac function
11. Describe the mechanism of action, place in therapy and major side effects of adrenaline, noradrenaline, dopamine and dobutamine
12. Learn about the prognosis of cardiogenic shock

CE & SDL CV: Cardio-respiratory Arrest

1. Learn how to recognise cardiorespiratory arrest
2. Learn UK resuscitation council (UK) guidelines in cardio-respiratory arrest.
3. Know how to perform basic life support including a) assessment and maintenance of the airway; b) respiratory support; c) cardiac massage
4. Explain the role and details about the cardiac arrest team and describe how to contact them
5. Recognise cardiac rhythm problems, particularly ventricular fibrillation (VF) and ventricular tachycardia (VT) on an ECG trace
6. Explain the importance of rapid defibrillation in a patient with VF or pulseless VT
7. Demonstrate the positioning of defibrillator gel pads and safe use of a defibrillator
8. Describe how you would administer defibrillation to a patient in ventricular fibrillation
9. Describe the mechanism of action and role of adrenaline, lignocaine, amiodarone and magnesium in the management of a cardiac arrest
10. Learn about the reversible causes of a cardiorespiratory arrest and explain how you would look for and correct these rapidly
11. Describe the prognosis of a patient in hospital who has a cardio-respiratory arrest and explain how underlying illnesses (acute and chronic), such as cancer influences this prognosis
12. Explain why the cardiac arrest team is NOT called for all patients that have cardiorespiratory arrest.
13. Discuss how the decision not to call the arrest team is made and describe how the patient and their family should be involved in this process

CE & SDL CV: Vascular Disease in other sites including CVA

1. Learn the patho-physiology of atherosclerosis
2. Describe symptoms and signs of carotid stenosis
3. Describe investigations that can be used to diagnose carotid stenosis
4. Discuss the main indications for end-arterectomy in patient with carotid stenosis
5. Identify a patient with cerebro-vascular accident
6. Describe the symptoms and signs associated with stroke and its complications
7. Know the general mechanisms which cause cerebral vascular disease
8. Describe the role of aspirin, other anti-platelet drugs, thrombolysis and anticoagulation in the treatment of stroke
9. Demonstrate examination of the relevant neurological system following stroke
10. Know the medical management of transient ischaemic attacks (TIA) and completed stroke
11. Know about the rehabilitation of patients with completed stroke
12. Demonstrate competency in use of an ophthalmoscope to recognise retinal vascular abnormalities
13. Outline the management options in primary care for a patient who has residual disabililty following stroke
14. Describe the importance of appropriate disease treatment and life style changes in stroke prevention
15. Explain how blood supply to the bowel may be compromised and how this might present acutely/chronically
16. Learn the common symptoms and signs of mesenteric ischaemia
17. Learn the management of mesenteric ischaemia
18. Describe symptoms and signs of renal artery stenosis
19. Learn the different pathological types of renal artery stenosis and describe people who might typically be affected by each
20. Describe investigations that can be used to confirm the diagnosis of renal artery stenosis
21. Outline the management of renal artery stenosis
22. Explain why ACE Inhibitors are contra-indicated in patients with renal artery stenosis
23. Describe measures you would take to ensure ACE inhibitors are used safely in a patient with possible vascular disease
24. Give an outline of a simple classification of vasculitis
25. Give an account of polyarteritis nodosa

CE & SDL CV: Infective Endocarditis

1. Describe the signs and symptoms of infective endocarditis
2. Give a differential diagnosis for an unexplained fever
3. Learn about the organisms that cause infective endocarditis and explain how cardiac infection with each may be acquired
4. Describe the pathogenesis of infective endocarditis and its complications
5. Explain how the diagnosis of infective endocarditis is made and describe the role of investigations including blood cultures and echocardiography in this process
6. Learn about the antibiotics effective against each organism that commonly causes infective endocarditis and describe the mechanism of action, place in therapy and major side effects of each
7. Learn NICE guidelines on antibiotic prophylaxis for endocarditis
8. Give indications for the surgical treatment of infective endocarditis and discuss the timing of surgery in patients with this condtion
9. Be able to define minimum inhibitory concentration (MIC), minimal bactericidal concentration (MBC) and antimicrobial synergy
10. Be able to explain why liaison between the microbiologist, cardiologist and cardiac surgeon is important
11. Be able to list host factors predisposing to the development of endocarditis
12. Be able to list the common bacterial causes of endocarditis in people with normal valves, abnormal native valves and prosthetic valves
13. Discuss the link between rheumatic fever and infective endocarditis

CE & SDL CV: Valvular Heart Disease

1. Learn the anatomy of the heart and the structure of the semi-lunar and AV valves
2. Explain the cardiac cycle, particularly the valvular functions during this cycle
3. Explain how the first and second heart sounds are generated and relate these to the cardiac cycle and valve openings and closures
4. Learn the mechanisms of 3rd and 4th heart sounds and their clinical significance
5. Recognise the first and second heart sounds on cardiac auscultation and identify systolic and diastolic murmurs
6. Be able to describe the haemodynamic consequences of atrial and ventricular septal defects
7. Describe symptoms and signs of aortic stenosis, aortic sclerosis, mitral regurgitation, tricuspid regurgitation and pulmonary stenosis
8. Distinguish between the causes of systolic murmurs using characteristics of the murmur (site, radiation, character, pitch) and associated clinical features, mainly to differentiate ejection systolic murmur of aortic stenosis, aortic sclerosis, mitral regurgitation, tricuspid regurgitation and pulmonary stenosis from that of pan systolic murmur.
9. Describe symptoms and signs of aortic/pulmonary regurgitation and mitral stenosis
10. Distinguish between the causes of diastolic murmurs using characteristics of the murmur (site, radiation, character, pitch) and associated clinical features
11. Learn the causes of aortic regurgitation and mitral stenosis; describe the pathological effect that each type of valve lesion has on the heart and circulation
12. Learn about ECG findings expected in patients with these cardiac valve defects
13. Discuss the management of a patient with a cardiac valve defect including a) treatment of the underlying cause b) prevention of complications, c) valve replacement surgery
14. Describe different types of prosthetic heart valve that may be used to replace defective valves and discuss the advantages and disadvantages of each

CE & SDL CV : Atherosclerosis & Arteriosclerosis / Lipid Disorders

1. Learn the patho-physiology of atherosclerosis
2. Learn basic biochemistry about lipids, particularly chylomicrons, cholesterol, VLDL, HDL
3. Describe the relationship between lipoprotein concentrations, atheroma and cardiovascular risk
4. Describe clinical features and investigations of hyperlipidaemia
5. Describe the management of hyperlipidaemia including diet, exercise and drugs
6. Describe primary and secondary prevention of hyperlipidaemia and benefits
7. Learn about commonly prescribed drugs in hyperlipidaemia
8. Describe the role of screening for hyperlipidaemia

CE & SDL CV: Acute and Chronic Limb Ischaemia / Peripheral Vascular Disease

1. Describe the symptoms and signs of chronic limb ischaemia
2. Learn about the differential diagnosis for calf pain
3. Describe the pathogenesis of peripheral vascular disease
4. Learn the risk factors for the development of peripheral vascular disease and describe how each of these can be looked for and controlled
5. Describe the investigations that should be performed to determine the presence and severity of peripheral vascular disease, including ABPI and duplex Doppler
6. Counsel a patient on improving symptoms, slowing progression and preventing complications of peripheral vascular disease
7. Give indications for percutaneous transluminal angioplasty and arterial reconstruction surgery
8. Describe percutaneous transluminal angioplasty and arterial reconstruction surgery to a patient, including risk of complications
9. Discuss indications for limb amputation
10. Describe types and the process of limb amputation and list possible complications
11. Discuss rehabilitation for patients following limb amputation and list mobility aids available
12. Explain the options available for pain control and palliative support in a patient with intractable limb ischaemia
13. Describe the symptoms and signs of acute limb ischaemia
14. Discuss mechanisms which may lead to the development of acute limb ischaemia
15. Describe the nature and timing of pathological changes that will occur in an acutely ischaemic limb if the ischaemia is not relieved
16. Describe the emergency investigation of a patient with acute limb ischaemia
17. Recognise the urgency of management of the acutely ischaemic limb
18. Discuss the options available for emergency management of acute limb ischaemia including anticoagulation, thrombolysis, angioplasty and embolectomy

CE & SDL CV: Limb Ulceration and Gangrene

1. Learn the causes of chronic leg ulcers and describe the different appearances
2. List the causes of chronic leg ulcers and describe the different appearances
3. Learn the types of gangrene e.g. wet, dry, gas, Fournier’s scrotal gangrene and explain the pathogenesis and appearance of each and outline its management
4. Compare and contrast the presentation of venous and arterial leg ulcers
5. Describe the pathogenesis of ischaemic, venous and diabetic ulcers
6. Describe the features of decubitus ulcers (pressure sores)
7. Describe the risk factors for decubitus ulcers
8. Describe measures for the primary and secondary prevention of leg ulcers
9. Learn the investigations that should be performed in patients with leg ulcers and explain how these will help with patient management
10. Discuss the treatment options for a patient with chronic leg ulcers including a) management of the underlying cause b) dressings and bandaging and c) skin grafting
11. Describe the role of the multidisciplinary team in the prevention and treatment of pressure sores
12. Explain how you would recognise gangrene clinically
13. Describe the gangrene associated with chronic ischaemia
14. Describe the management of each type of gangrene
15. Describe how skin ulceration can be prevented

CE & SDL CV: Arterial Aneurysms

1. Describe how arterial aneurysms develop and give common anatomical sites at which they occur
2. Explain the difference between true and false aneurysms
3. Describe symptoms and signs of an aortic aneurysm
4. Describe the potential complications of aneurysms
5. Describe investigations that can be used to diagnose and monitor an aortic aneurysm
6. Know the indications for surgical intervention in aortic aneurysm disease
7. Explain the difference between an open and endovascular repair
8. Describe the potential complications of aortic aneurysm surgery including mortality figures for elective and emergency aneurysm surgery
9. Give a differential diagnosis for an epigastric mass
10. Learn the risk factors for arterial aneurysm and describe how these should be assessed and controlled
11. Describe complications of arterial surgery and explain how these should be managed
12. Describe the symptoms and signs of a patient presenting with a leak or rupture of an aneurysm of : a) the abdominal aorta; b) the thoracic aorta
13. Describe the emergency management of a patient presenting with a leaking or ruptured aortic aneurysm

CE & SDL CV: Pericardial Disease

1. Describe the characteristics of pain caused by pericardial inflammation
2. Describe the clinical signs and causes of pericarditis, pericardial effusion and constrictive pericarditis/cardiac tamponade
3. Describe the ECG changes expected in a patient with acute pericarditis and explain how these differ from the changes seen with an MI
4. Understand the ECG and echocardiography findings in patients with pericardial effusion and constrictive pericarditis/cardiac tamponade
5. Describe the management of acute pericarditis
6. Outline the use of pericardiocentesis and surgery in the diagnosis and treatment of patients with pericardial effusion or constriction

CE & SDL CV: Myocardial Disease/Cardiomyopathy

1. Describe symptoms and signs of myocarditis
2. Learn the major causes of myocarditis
3. Explain how the diagnosis of myocarditis can by confirmed by investigation
4. Define cardiomyopathy and learn the types of cardiomyopathy
5. Describe symptoms and signs of dilated, hypertrophic and restrictive cardiomyopathy and explain why these differ between types
6. Give causes of dilated, hypertrophic and restrictive cardiomyopathy
7. Discuss the advantages and disadvantages of screening in families with cardiomyopathy
8. Describe the management options for patients with dilated, hypertrophic and restrictive cardiomyopathies
9. Outline the main pathological features of cardiomyopathy

CE & SDL CV: Congenital Cardiovascular Disease

1. Describe symptoms and clinical signs of the cardiac malformations: atrial and ventricular septal defects, patent ductus arteriosus, Fallot’s tetralogy, coarctation of the aorta
2. Give a differential diagnosis for central cyanosis
3. Learn the factors that cause congenital heart disease
4. Describe the pathology and cardiac consequences of these cardiac malformations
5. Define and explain the Eisenmenger reaction / syndrome and explain why this worsens prognosis
6. Know the complications of congenital heart disease and explain how these may be prevented
7. Describe investigations that can be used to confirm the diagnosis of congenital heart disease
8. Discuss the role and timing of surgery in the management of congenital cardiac disease
9. Discuss the particular difficulties that may be faced by adolescents and young adults with chronic cardiac disease

CE & SDL CV: Rheumatic Fever and Rheumatic Heart Disease

1. Describe symptoms and signs of rheumatic fever
2. Describe how the Duckett-Jones criteria are used to make the diagnosis of rheumatic fever
3. Explain how Group A streptococcal pharyngeal infection can lead to heart, skin, joint and CNS involvement and describe the pathological changes in these tissues.
4. Describe investigations that can contribute to the diagnosis of rheumatic fever
5. Discuss the management of rheumatic fever including the choice of antibiotics for streptococcal infection
6. Discuss the cardiac complications of rheumatic fever
7. Discuss the epidemiology of rheumatic fever in the UK and worldwide

CE & SDL CV: Varicose Veins

1. Describe the symptoms and signs associated with varicose veins and their complications
2. Demonstrate examination of varicose veins including distribution, communication with deep veins and complications
3. Discuss the pathophysiology of varicose veins
4. Give risk factors for the development of varicose veins
5. Outline the management options for a patient with varicose veins including indications for surgery
6. Describe the surgical options for treatment of varicose veins to a patient

CE & SDL CV: Vasculitis (Priority 2)

1. Understand the classification of vasculitis
2. Understand the pathology of common vasculitis conditions
3. Understand the importance of anti-nuclear cytoplasmic antibody (ANCA)
4. Understand the signs and symptoms and pathology of Polyarteritis nodosa, Granulomatosis with polyangiitis (Wegener's granulomatosis) and ANCA related vasculitis.
5. Give a differential diagnosis of conditions presenting like vasculitis

CE & SDL RS: Asthma

1. Learn the basic anatomy of the larger and smaller airways
2. Describe the aetiology and pathophysiology of asthma
3. Give a differential diagnosis for a wheeze
4. Describe investigations that can be used to confirm the diagnosis of asthma including the diagnosis of atopy
5. Describe the mechanism of action, place in therapy and major side effects of asthma treatments including short and long acting beta2 agonists, corticosteroids, leukotriene antagonists and anti-IgE.
6. Explain the rationale behind the stepwise approach used in asthma management and demonstrate use of the British Thoracic Society (BTS) and Scottish Intercollegiate Network (SIGN) guidelines to choose treatments for asthma
7. Explain the role of specialist nurse practitioners and self management plans in the management of asthma
8. Explain to a patient the difference between a reliever and preventer inhaler and the use of each in asthma management
9. Demonstrate the use of a metered dose inhaler with and without a spacer to a patient
10. Be able to recognise differences and similarities in the management of asthma and COPD
11. Learn the precipitating factors for an asthma attack
12. Describe symptoms and signs of different severities of asthma exacerbations (as per the BTS guideline)
13. Describe the emergency management of asthma in a person presenting to Emergency Department and indications for admission
14. Discuss the role of intensive care in managing an acute asthma attack
15. Describe how a patient with acute asthma should be monitored following admission to hospital
16. Describe measures that should be taken prior to hospital discharge to prevent asthma recurrence
17. Discuss the role of pharmacological and non-pharmacological interventions in preventing asthma exacerbations

CE & SDL RS: Chronic Obstructive Pulmonary Disease (COPD)

1. Describe symptoms and signs in patients with COPD
2. Give a differential diagnosis for exertional breathlessness and cough
3. Describe the pathology and causes of COPD
4. Describe how a patient's 'pack years' are calculated
5. Describe the role of spirometry in diagnosing and measuring the severity of COPD
6. Describe the purpose and potential abnormal findings of other investigations including chest X-Ray, full blood count and arterial blood gases in a patient with COPD
7. Explain the rationale behind the stepwise approach to COPD management and demonstrate use of the British Thoracic Society and NICE guidelines on COPD to choose drugs for COPD
8. Learn the drugs that can be used to aid smoking cessation and give evidence for their effectiveness and be aware of their contraindications
9. Give smoking cessation advice to a patient
10. Explain the mechanism of action and major side effects of bronchodilators, corticosteroids and theophylline in the management of COPD.
11. Describe the roles of specialist nursing, physiotherapy and pulmonary rehabilitation in the management of COPD
12. Learn the role of community services in the management of COPD
13. Learn complications of COPD and describe their investigation and management
14. Understand the indications and rationale for long term oxygen therapy (LTOT)
15. Describe the clinical features (symptoms and signs) of an acute exacerbation of COPD
16. Give a differential diagnosis for increased breathlessness in a patient with COPD
17. Describe the investigation of a patient presenting with an acute exacerbation of COPD
18. Describe the emergency management of a patient with an acute exacerbation of COPD
19. List organisms that may cause pulmonary infection in patients with COPD
20. Discuss the role and choice of antibiotics for treatment of an acute exacerbation of COPD
21. Discuss the role of pharmacological and non-pharmacological interventions in preventing COPD exacerbations
22. Learn the role of community services in the management of COPD exacerbation

CE & SDL RS: Respiratory Failure

1. Learn the oxygen dissociation curve and its importance in oxygen delivery
2. Describe the pathological consequences of hypoxia and hypercapnoea
3. Define type 1 and type 2 respiratory failures and interpretation of arterial blood gas results in these conditions and be able to differentiate these from other (metabolic) blood gas derangements
4. Explain the importance of correcting hypoxia in respiratory failure
5. Explain why oxygen replacement can cause deterioration as well as improvement in a patient with respiratory failure
6. Be aware of the treatment options for patients with ventilatory failure including: (a) non-invasive ventilation (NIV or BIPAP) & (b) continuous positive airways pressure (CPAP)
7. Discuss situations in which treatment may not be appropriate for ventilatory failure and describe palliative measures that could be used to relieve symptoms in these patients
8. Be able to interpret arterial blood gases and pH in order to assist making a diagnosis
9. Explain how matching of ventilation and perfusion is achieved in the normal lung
10. Describe the pathogenesis of Type 1 respiratory failure
11. Learn causes of Type 1 respiratory failure
12. Describe symptoms and signs of Type 1 respiratory failure
13. Describe the normal mechanical process of ventilation
14. Describe the normal process of control of breathing
15. Describe the pathogenesis of Type 2 respiratory failure
16. Learn causes of Type 2 respiratory failure
17. Describe symptoms and signs of Type 2 respiratory failure

CE & SDL RS: Pneumonia

1. Describe symptoms and signs of pneumonia
2. Describe the physiological processes important for normal lung defence from infection
3. Learn pulmonary, immunological or other conditions which predispose patients to pulmonary infection
4. Learn about the principal organisms that cause pneumonia in those patients who are (a) immuno-competent, (b) immuno-compromised and (c) in hospitals/institutions
5. Learn about the “atypical pathogens” and the clinical, pathological and microbiological features that differentiate them from ‘typical’ pathogens.
6. Describe the relevant investigations of a patient with pneumonia
7. Explain how organisms causing lower respiratory tract infections are differentiated and identified by microbiological investigations
8. Name antibiotics likely to be effective against each of the major respiratory pathogens
9. Explain how the correct drug is chosen for lower respiratory tract infections
10. Describe routes of administration by which antibiotics can be given and state when each route should be used
11. Describe the major adverse consequences of antibiotics used in the treatment of LRTI a) for the individual, and b) for society
12. Know the indications for vaccination against the following: a) influenza b) pneumococcus
13. Recognise chest radiograph changes consistent with pneumonia (consolidation, lobar collapse and pleural effusion).
14. Identify and describe the histopathological changes in the lung in a patient with pneumonia
15. Describe clinical features that differentiate mild, moderate and severe pneumonia; know about the use of CURB 65
16. Identify patients who are likely to have poor outcomes with community acquired pneumonia
17. Explain how and why management differs in those with mild, moderate and severe pneumonia
18. Give reasons for hospital admission with pneumonia

CE & SDL RS: Pulmonary Embolism

1. Learn pathophysiology of venous thrombo-embolism.
2. Describe symptoms and signs of pulmonary embolism
3. Give a differential diagnosis for pleuritic chest pain
4. Explain how clinical history and examination can be used to distinguish between causes of pleuritic chest pain
5. Describe the role of D-Dimer, CXR, ECG, V/Q scanning, Spiral CT scanning and pulmonary angiogram in the diagnosis of pulmonary embolus
6. Learn about the usefulness of Well’s and other PE probability scoring systems
7. Describe the mechanism of action, place in therapy and major side effects of heparin and warfarin in the treatment of DVT and pulmonary embolus
8. Be aware of the new classes of anticoagulation treatments and the indications for choosing between them.
9. Learn about prevention of venous thrombo-embolism.
10. Describe the clinical features of massive pulmonary embolism
11. Describe the investigation of a patient with suspected massive pulmonary embolism
12. Outline the management of a patient with a suspected massive pulmonary embolism
13. Be aware of the indications for thrombolysis in massive PE
14. Discuss the advantages and disadvantages of thrombolysis and surgery in a patient with a massive pulmonary embolus

CE & SDL RS: Deep Vein Thrombosis

1. Describe the anatomy of the lower limb venous system
2. Describe the symptoms and signs of deep venous thrombosis (DVT)
3. Give the differential diagnosis for calf swelling / tenderness
4. Learn the risk factors for deep venous thrombosis and pulmonary embolism
5. Describe how investigations are used to confirm or refute the diagnosis of a deep vein thrombosis
6. Describe the mechanism of action, place in therapy and major side effects of heparin and warfarin in the treatment of DVT and pulmonary embolus
7. Counsel a patient regarding avoidance of drugs, foods and alcohol whilst taking Warfarin
8. Describe the physiological and pathological processes that occur in a post-thrombotic limb; explain how these may lead to venous insufficiency and ulceration
9. Describe the management of a post-thrombotic limb and of venous ulceration
10. Learn about the indications for thrombo-prophylaxis for hospital in-patients and describe how this is done
11. Advise a patient on DVT / PE prophylaxis during travel e.g. a long haul flight
12. Be aware of the new classes of anticoagulation treatments and the indications for choosing between them.

CE & SDL RS: Oxygen Therapy

1. Learn about oxygen transport and the oxygen dissociation curve
2. Describe methods of oxygen delivery for patients both in hospital and in the community
3. Be aware of the concept of prescribing oxygen to achieve target saturations
4. Be able to identify conditions which should have oxygen prescribed to achieve saturations in each of the two common target saturation ranges.
5. Learn about conditions and situations where prescribing oxygen to target saturations does not apply and be able to explain why
6. Be able to prescribe oxygen on a standard drug chart.
7. Explain how you would determine what concentration of oxygen to administer to a patient with COPD
8. Describe different devices used to enrich the oxygen content of inspired air, including nasal prongs, venturi-masks, reservoir masks

CE & SDL RS: Carcinoma of the Bronchus

1. Learn about the risk factors for lung cancer and the usefulness of screening program
2. Learn about and be able to apply the histological classification and staging of lung cancer
3. Explain why it is important to differentiate between small cell and non-small cell forms of lung cancer
4. Describe clinical (including metastatic) manifestations of lung cancer
5. Describe investigations used in the diagnosis of lung cancer
6. Learn about bronchoscopy in general and its usefulness in the diagnosis of lung cancer and other conditions
7. Be able to break the news that the patient has lung cancer
8. Discuss the role of the multi-disciplinary team in the diagnosis, treatment and support of a patient diagnosed with lung cancer
9. Be aware of the potential paraneoplastic presentations of lung cancer and their pathogenesis, where known.
10. Understand the role of surgery, chemotherapy, radiotherapy and palliative care in the management of bronchial carcinoma
11. Describe specific clinical features and likelihood and common sites of metastasis of non-small cell cancer
12. Describe the clinical course and prognosis of patients with non-small cell lung cancer
13. Describe the management of non-small cell lung cancer based on the TNM classification
14. Understand adjuvant, neo-adjuvant and palliative treatments
15. Discuss the side effects and expected benefits of each treatment for non-small cell cancer
16. Describe specific clinical features and likelihood and common sites of metastasis of small cell lung cancer
17. Describe the clinical course and prognosis of patients with small cell lung cancer
18. Describe the management of small cell lung cancer if (a) locally advanced and (b) metastatic
19. Discuss the side effects and expected benefits of the treatment for small cell cancer
20. Explain how treatment may result in either improvement or deterioration in quality of life and discuss how treatment decisions are made
21. Learn symptoms experienced by patients dying of lung cancer and describe palliative measures which may be used to relieve each one
22. Describe the role of the palliative care home team in supporting patients dying at home and their families
23. Describe the role of primary care team in the palliative care of terminal respiratory disease
24. Explain the role of the hospice in providing care for patients with lung cancer
25. Explain the role of care of the dying pathways in the management of the dying patient

CE & SDL RS: Pulmonary Tuberculosis

1. Define tuberculosis
2. Describe the epidemiology of tuberculosis; global, UK and risk factors
3. Be aware of the DOTS strategy
4. Review the symptoms of tuberculosis (see lung cancer for differential diagnosis of haemoptysis)
5. Differentiate between primary and post-primary tuberculosis
6. List the investigations for active tuberculosis
7. Explain why contact tracing is important
8. Understand the standard treatment of tuberculosis
9. Understand the role of BCG vaccination.

CE & SDL RS: Pleural Effusion and Pleural Disease

1. Learn the physiological mechanisms of pleural effusion
2. Describe symptoms and signs of a pleural effusion
3. Differentiate clinical signs of a pleural effusion from those of pulmonary consolidation, collapse, pneumothorax and lung fibrosis
4. Describe how pleural aspiration is performed and list analyses that should be performed on fluid obtained
5. Describe how these tests distinguish between an exudate and a transudate and explain why this is important (learn Light's criteria
6. List causes of an exudate and a transudate
7. Describe how investigations including chest X-ray, pleural aspiration, pleural biopsy, thoracic ultrasound and CT chest can help to differentiate between causes of effusion and the indications for each investigation.
8. Describe (in general) how pleural effusions are managed medically and surgically
9. Learn about chest drain insertion
10. Learn about VATS (video assisted thoracoscopic biopsy)

CE & SDL RS: Chest Trauma / Haemothorax

1. Learn pulmonary and pleural complications of blunt, sharp and explosion related chest trauma
2. Describe how chest trauma is assessed as part of the Advanced Trauma Life Support (ATLS) protocol
3. Describe the diagnosis and management of haemothorax

CE & SDL RS Pneumothorax

1. Describe symptoms and signs of pneumothorax
2. Learn the risk factors and describe the pathogenesis of pneumothorax
3. Describe investigations used to confirm the diagnosis of pneumotharax
4. Describe conservative, medical and surgical management of pneumothorax and when each should be considered
5. Describe how an underwater chest drain is managed on a day to day basis on the ward
6. Describe the criteria used in order to remove a chest drain in a patient
7. Explain the chances of pneumothorax recurrence and activities to avoid to a young patient with a simple pneumothorax
8. Describe the role of smoking cessation in patients with pneumothorax
9. Describe the clinical features of a tension pneumotherax
10. Explain why a tension pneumothorax is life threatening
11. Describe the emergency management of a tension pneumothorax

CE & SDL RS: Bronchiectasis and Cystic Fibrosis

1. Give a differential diagnosis for cough with productive of sputum
2. Describe the pathology of bronchiectasis
3. Learn the common causes of bronchiectasis
4. Describe the symptoms and signs of bronchiectasis and Cystic fibrosis
5. Describe the genetic mutation of cystic fibrosis and explain current theories as to how this leads to lung disease
6. Describe the pathological effect and clinical consequences of cystic fibrosis in non-pulmonary organs
7. Describe the investigations that can be used to confirm diagnosis of bronchiectasis and cystic fibrosis
8. Learn the role of lung function and understand that bronchiectasis is one of the causes of COPD.
9. Learn about the organisms that exacerbate bronchiectasis and cystic fibrosis and explain how you would choose an antibiotic for patients with exacerbations
10. Discuss the significance of isolation of bacterial organisms like pseudomonas in sputum of those patients with bronchiectasis
11. Learn about the role of antibiotic prophylaxis in bronchiectasis
12. Describe the role of chest physiotherapy in the management of bronchiectasis
13. Describe nutritional problems and their management in cystic fibrosis
14. Describe the potential impact of chronic disease, such as cystic fibrosis, on the lives of young people

CE & SDL RS: Sarcoidosis

1. Describe symptoms and signs of sarcoidosis
2. Describe the pathological features of sarcoidosis
3. Describe how sarcoidosis affects a) the lungs and b) other tissues and organs
4. Describe clinical conditions which closely resemble sarcoidosis
5. Describe investigations that can be used to confirm the diagnosis of a) pulmonary and b) extra-pulmonary sarcoidosis
6. Describe the treatment options for patients with sarcoidosis and the indications for commencing treatment
7. Learn about the prognosis for patients with different presentations of sarcoidosis

CE & SDL RS: Interstitial Lung Disease

CE & SDL RS: Interstitial Pneumonias

1. Describe the symptoms and signs of interstitial pneumonias
2. Give a differential diagnosis for finger clubbing
3. Describe those investigations which are used towards making the diagnosis
4. Understand the overall classification of interstitial pneumonias
5. Summarise the other causes of lung fibrosis including occupational dusts, sarcoidosis, extrinsic alveolitis, TB, connective tissue diseases, drugs
6. Describe which patients with interstitial pneumonias should be referred for specialist management
7. Describe the role of steroids and immune-modulating drugs in the therapy of interstitial pneumonias.
8. Describe the symptoms and signs characteristic of a restrictive lung defect including the changes in lung function.
9. Discuss the indications for single lung or heart-lung transplant.

CE & SDL RS: Obstructive Sleep Apnoea

1. Describe the clinical features of sleep apnoea in a child
2. Identify patients who may be suitable for referral to a sleep service
3. Discuss the difference between obstructive and central sleep apnoea
4. Learn the basic components of a sleep study and changes in sleep apnoea
5. Explain to a patient what they can expect when undergoing a sleep study
6. Describe the treatments available for obstructive sleep apnoea including conservative measures, Continuous Positive Airways Pressure (CPAP) therapy and surgery and when they are indicated
7. Discuss the complications of untreated sleep apnoea and describe the implications of driving with this condition
8. Outline the causes of sleep apnoea in children and adults

CE & SDL RS: Pulmonary Hypertension

1. Describe differences, including pressure differences, between the systemic and pulmonary circulation and left and right sides of the heart
2. Learn about the common causes of pulmonary hypertension, particularly other systemic conditions
3. Outline investigations that can be used to confirm the diagnosis of pulmonary hypertension
4. Describe which patients with pulmonary hypertension should be referred for specialist management
5. Learn the outcomes of those patients having pulmonary hypertension secondary to underlying lung diseases

CE & SDL RS: Occupational Lung Disease

1. Give examples of occupational exposures that predispose to a) asthma, b) extrinsic allergic alveolitis, c) lung fibrosis, and d) pulmonary malignancy
2. Describe measures that can be taken to prevent occupational lung disease
3. Learn about those occupations that have a high chance of asbestos exposure
4. Describe the pulmonary consequences of asbestos exposure
5. Describe investigations that can be used to confirm the diagnosis of asbestos-related lung disease
6. Learn about the patient categories with asbestos-related lung disease who are entitled to compensation
7. Learn about the clinical symptoms and signs of mesothelioma
8. Learn about how mesothelioma is diagnosed
9. Understand the role of the MDT in the diagnosis and management of mesothelioma
10. Understand the role of surgery, chemotherapy and radiotherapy in the management of mesothelioma

CE & SDL HAEM: Anaemia (General)

1. Recall the process of erythropoiesis and the function of erythropoietin
2. Recall the structure and function of the red cell and haemoglobin
3. Recall the normal process of red cell breakdown with recycling of components
4. Recall the basic causes of anaemia and the morphological classification of anaemia ie, microcytic, normocytic and macrocytic
5. Describe the symptoms and signs of anaemia and the compensatory physiological responses to anaemia
6. Describe an approach to the investigation and management of a patient with anaemia

CE & SDL HAEM: Microcytic Anaemia (Iron Deficiency) (Priority 1)

1. Outline the nutritional and metabolic aspects of iron (including dietary iron, iron absorption, body iron distribution and transport)
2. Outline the common causes of iron deficiency anaemia
3. Identify questions which, on history taking, help elucidate likely causes of iron deficiency anaemia
4. Describe the symptoms and signs of iron deficiency anaemia and diseases associated with this anaemia
5. Outline the investigation and management of a patient with iron deficiency anaemia
6. Differentiate, by laboratory tests, anaemia due to iron deficiency from other causes of microcytic anaemia

CE & SDL HAEM: Macrocytic Anaemia (B12 and Folate Deficiency) and Macrocytosis (Priority 1)

1. Learn the common causes of macrocytic anaemia and macrocytosis without anaemia
2. Outline the nutritional and metabolic aspects of vitamin B12 and folate metabolism (including dietary aspects, absorption, body distribution and transport)
3. Understand the concept of megaloblastic anaemia and the effect of vitamin B12 and folate deficiency or inhibition on DNA synthesis
4. Outline the common causes of vitamin B12 and folate deficiency
5. Identify questions which, on history taking, help elucidate likely causes of macrocytic anaemia
6. Describe the symptoms, signs and laboratory diagnosis of megaloblastic anaemia
7. Outline the investigation and management of vitamin B12 and folate deficiency

CE & SDL HAEM: Normocytic Anaemia (Priority 2)

1. Give a differential diagnosis for normocytic anaemia (anaemia of chronic disease)
2. Discuss investigation and management of normocytic anaemia
3. Understand the concept of the anaemia of chronic disorder/inflammation
4. Be able to discuss which chronic diseases can cause anaemia, the mechanism for the anaemia and the types of anaemia

CE & SDL HAEM: Tropical Haematological Disorders

1. Draw the life cycle of malarial species in man and the mosquito
2. Know how to seek expert advice on the prevention and treatment of malaria
3. Learn about the different species of Plasmodium that cause malaria in humans
4. Understand the treatment of malaria
5. Know about the measures to be taken to prevent malaria

CE & SDL HAEM: Platelet Disorders

1. Recall normal platelet structure and function
2. Learn the common causes of thrombocytopenia (low platelet count)
3. Describe the symptoms and signs of a patient with thrombocytopenia
4. Outline the investigation and management of immune thrombocytopenia
5. Learn the differential diagnoses for thrombocytosis (raised platelet count)
6. Give examples of drugs that inhibit platelet function and explain when these are used

CE & SDL HAEM: Haemostasis

1. Recall the key elements of the haemostatic mechanism
2. Understand how a balance is maintained between the opposing mechanisms of coagulation
3. Describe the symptoms and signs associated with bleeding disorders
4. Understand the basic screening tests used to investigate a bleeding disorder
5. Learn about some bleeding disorders which are inherited and acquired
6. Be aware of the therapeutic approaches used to manage bleeding disorders
7. Outline the action of anti-thrombotic drugs
8. Identify the various treatment options for patients with haemophillia and Von Willebrand's Disease, and be aware of their complications
9. Learn about how haemophilia can be managed in the community with specialist help from a wide range of health care professionals

CE & SDL HAEM: Venous Thromboembolism

1. Recall the pathological and physiological mechanisms leading to VTE
2. Understand the significance of VTE (morbidity and mortality) in the whole hospital setting and to appreciate that much of this is preventable
3. Understand the process and justification for VTE risk assessment of hospitalised patients and alternative policy approaches to thromboprophylaxis
4. Describe methods and effectiveness of VTE prevention strategies along with their contraindications

CE & SDL HAEM: Blood Transfusion (as applied to Clinical Medicine)

1. Recognise the importance of the Blood Transfusion Service and identify the various blood components available for transfusion.
2. Recall the indications for blood transfusion
3. Summarise the precautions and testing donated blood undergoes
4. Recall the ward procedures required for safe blood transfusion practice
5. Summarise the complications of blood transfusion
6. Develop a plan to investigate and manage a patient suspected of receiving an incompatible transfusion
7. Be able to identify the various blood components available for transfusion and their clinical indications
8. Learn about the most important blood groups and their associated antibodies and antigens and their clinical importance
9. Apply the necessary benefits, risks, adverse effects, interactions, monitoring when using the following medications: Whole Blood; Packed Red Cells; Platelet Concentrate; Fresh Frozen Plasma; Cryoprecipitate; Human Albumin solution; Clotting Factor Concentrates; Immunoglobulins

CE & SDL HAEM: Leukaemias (myeloproliferative Disorders and Myelodysplasia)

1. Understand the nature of the malignant process and the concept of clonality; relate this to haematological malignancy - abnormal growth, differentiation, apoptosis
2. Be able to classify leukaemia into acute (AML and ALL) and chronic (CML and CLL) based on the clinical and laboratory findings
3. Compare and contrast the main differences between acute and chronic leukaemia
4. Explain the clinical features of leukaemia
5. Describe the diagnostic pathway required to confirm the diagnosis of leukaemia
6. Outline the basic principles of the management and treatment of leukaemia
7. Understand the concept of the myeloproliferative disorders
8. Understand the concept of myelodysplasia

CE & SDL HAEM: Myeloma (Priority 3)

1. Understand the structure and function of the immunoglobulins
2. Define the term paraproteinaemia
3. Understand the pathology and clinical manifestations of myeloma
4. Describe the biochemical and haematological abnormalities common in myeloma and their significance
5. Outline the diagnosis, investigation and management of myeloma
6. Distinguish myeloma from benign paraproteinaemia
7. Be aware of the complications of myeloma and their treatment
8. Discuss the management of myeloma

CE & SDL HAEM: Haemolytic Anaemia (Priority 2)

1. Recall normal red cell metabolism and red cell breakdown
2. Construct a simplified classification for the haemolytic anaemias
3. Describe additional clinical signs in a patient with haemolytic anaemia and explain how these may differ from those of anaemia due to other causes
4. Outline the laboratory diagnosis of a haemolytic process and understand the concept of extra-vascular and intravascular haemolysis
5. Describe the investigation and management of a patient with haemolytic anaemia
6. List common drugs which may induce haemolytic anaemia

CE & SDL HAEM: Lymphoma (Priority 3)

1. Define the term lymphoma
2. Be able to recall a simplified classification of lymphoma
3. Outline the clinical manifestations and investigation of a patient with lymphoma
4. Understand the staging of lymphoma; list the criteria used for staging
5. Discuss the pathology of lymphoma including Hodgkin's and non-Hodgkin's lymphoma.
6. Understand the approach to the management and treatment of lymphoma

CE & SDL HAEM: Polycythaemia (Priority 3)

1. Define polycythaemia
2. Learn the basic mechanisms leading to the development of erythrocytosis
3. Give a differential diagnosis for polycythaemia
4. Describe the management of polycythaemia
5. Be able to make a diagnosis of polycythaemia from history and investigations

Review of Haematology SDL Cases

Review of Cardio-vascular SDL Cases

CR3 PBL1: Chest Pain

CR3 PBL2: Cardiac Murmur

CR3 PBL3: Cough and Shortness of Breath

CR3 - PBL 4: Right Sided Chest Pain

CR3 PBL 5: The City Trader

CR3 PBL 6: The Ex-Docker

CR3 PBL 7: Seafood Restaurant

CR3 PBL8: A Visit to the GP

CR3 PBL8: A Visit to the GP