Course book

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The summary of all the lectures given to the 5th stage students in 2010-2011 | College of Medicine, University of Sulaymaniyah

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Course book

  1. 1. COURSE BOOK | Course coordinator and list of teachers | Two Lectures on Introduction & COURSE BOOK RADIOLOGY page 7 UROLOGY page 15 ANESTHESIA page 23 OTOLARYNGOLOGY page 26 DERMATOLOGY page 37 GYNECOLOGY page 42 MEDICINE page 57 OPHTHALMOLOGY page 60 PEDIATRICS page 70 SURGERY page 75 PRACTICAL SESSIONS page 782011 1 Fifth stage Course Book
  2. 2. COURSE BOOK | Course coordinator and list of teachers | Two Lectures on Introduction & Extended Contents COURSE BOOK .............................................................................................................................1 RADIOLOGY .................................................................................................................................7 Course coordinator and list of teachers ............................................................................................ 7 Course Overview ................................................................................................................................ 7 Reading lists: ...................................................................................................................................... 7 Syllabus .............................................................................................................................................. 8 Detail of Syllabus................................................................................................................................ 8  Two Lectures on Introduction & Technical Considerations: given by Dr. Ameer .................................... 8  Spine: Two Lectures given by Dr. Ameer ................................................................................................. 9  Skull & brain; 2 Lectures given by Dr. Ameer .......................................................................................... 9  Sinuses, Orbits & Neck one lecture by Dr. Ameer: ................................................................................ 10  Interventional Radiology: one Lecture by Dr. Ameer. ........................................................................... 10  Plain abdominal radiographs: One lecture given by Dr. kawa Abdulla ................................................. 10  GIT Contrast examination & other imaging modalities: Five Lectures by Dr. kawa .............................. 10  Hepato - biliary system; three Lectures given by Dr. kawa ................................................................... 11  Peritoneal cavity & retroperitoneum; two Lectures given by Dr. kawa ................................................ 11  Chest: Seven lectures given by Dr. Abeer Kadum Abass ....................................................................... 11  Cardiovascular system (CVS) : Four lectures given by Dr. Abeer Kadum Abass. ................................... 12  Bone & Joint diseases: Four Lectures by Dr. Salah Kalary ..................................................................... 13  Bone Trauma: One Lecture by Dr.Salah Kalary. ..................................................................................... 14 UROLOGY .................................................................................................................................. 15 Course coordinator and list of teachers .......................................................................................... 15 Course Overview .............................................................................................................................. 15 Course Objectives ............................................................................................................................ 15 Course Reading List .......................................................................................................................... 16 Syllabus ............................................................................................................................................ 16 Detail of Syllabus.............................................................................................................................. 17  Lectures titles (the kidney) .................................................................................................................... 17  Lectures titles (the Prostate) ................................................................................................................. 17  Lectures title: (Urinary bladder) ............................................................................................................ 18  Lectures titles (the penis and urethra) .................................................................................................. 18  Lectures titles (the testis) ...................................................................................................................... 19 Student feedback for the subject of a lecture ................................................................................. 19 Examinations.................................................................................................................................... 20  Types of questions: ................................................................................................................................ 20  The number of questions and marks are divided as follows: ................................................................ 20  Advices and directions for all students before and during exams. ....................................................... 20  Sample Questions .................................................................................................................................. 20 Student feedback on the course ...................................................................................................... 222011 2 Fifth stage Course Book
  3. 3. COURSE BOOK | Course coordinator and list of teachers | Two Lectures on Introduction & ANESTHESIA ............................................................................................................................... 23 Anesthesia Lectures ......................................................................................................................... 23 Detailed Syllabus .............................................................................................................................. 23  Introduction to anesthesia 5 Hrs ........................................................................................................... 23  Types of Anesthesia 1Hr ........................................................................................................................ 23  Drugs used in anesthesia 4hrs ............................................................................................................... 23  Post operative complications 3hrs ........................................................................................................ 24  Pain management 2hrs .......................................................................................................................... 24  Airway Management 5hr ....................................................................................................................... 24  Monitoring 1hr....................................................................................................................................... 24  Cardiopulmonary resuscitation 2hr ....................................................................................................... 24  Intensive Care Unite 4hrs ...................................................................................................................... 24  References ............................................................................................................................................. 24 Question Examples .......................................................................................................................... 24 OTOLARYNGOLOGY.................................................................................................................... 26 Course coordinator and list of teachers on this course................................................................... 26 Course Overview .............................................................................................................................. 26 Course Objectives ............................................................................................................................ 26 Course Reading List .......................................................................................................................... 27 Syllabus ............................................................................................................................................ 27 Detailed Syllabus .............................................................................................................................. 28 Student feedback for the subject of a lecture ................................................................................. 33 Examinations.................................................................................................................................... 34  Types of questions: ................................................................................................................................ 34  Time of exam. ........................................................................................................................................ 34  Advices and directions for all students before and during exams. ....................................................... 34  Samples of MCQ, Single choice, long and short essays ......................................................................... 34  External examiner .................................................................................................................................. 36 DERMATOLOGY ......................................................................................................................... 37 Contents ........................................................................................................................................... 37 1 - Course coordinator and list of teachers on this course ............................................................. 37 2 - Course Overview ......................................................................................................................... 37 3 - Course objectives ........................................................................................................................ 38 4 - Course Reading list ..................................................................................................................... 38 5 - Syllabus ....................................................................................................................................... 38 6 - The Scientific contents:............................................................................................................... 39 7 - Exams .......................................................................................................................................... 39 8 - Samples of the expected questions and their answers .............................................................. 39  Example for Compositional questions ................................................................................................... 39  MCQs: .................................................................................................................................................... 39 GYNECOLOGY ............................................................................................................................ 422011 3 Fifth stage Course Book
  4. 4. COURSE BOOK | Course coordinator and list of teachers | Two Lectures on Introduction & Course coordinator and list of teachers on this course................................................................... 42 Course Overview .............................................................................................................................. 42 Course objectives ............................................................................................................................. 42 Course Reading list........................................................................................................................... 43 Syllabus ............................................................................................................................................ 43 Detail of Syllabus.............................................................................................................................. 44  Family Planning: ..................................................................................................................................... 44  Early pregnancy problems: .................................................................................................................... 44  Benign tumours of the uterus................................................................................................................ 45  Menopause and HRT.............................................................................................................................. 46  Operative Gynaecology ......................................................................................................................... 46  Normal and abnormal sexual development .......................................................................................... 46  Gynaecological disorders of childhood and adolescence ...................................................................... 47  Infertility ................................................................................................................................................ 47  Genital tuberculosis ............................................................................................................................... 47  Premalignant conditions of the cervix. .................................................................................................. 48  Cervical cancer ....................................................................................................................................... 48  Hyperandrogenism, hirsutism and polycystic ovary s ........................................................................... 48  Secondary amenorrhea ......................................................................................................................... 49  Vaginal discharge ................................................................................................................................... 49  Diseases of the vulva and vagina ........................................................................................................... 49  Subject name: pelvic inflammatory disease. ......................................................................................... 49  Endometriosis: ....................................................................................................................................... 50  Ovarian tumours: ................................................................................................................................... 50  Genital prolapse:.................................................................................................................................... 50  Dysmenorrhoea ..................................................................................................................................... 51  Sexually transmitted infections (2 hours) .............................................................................................. 51  Primary amenorrhoea............................................................................................................................ 51  Disorders of the menstrual cycle/ abnormal vaginal bleeding ............................................................. 52  Post menopausal bleeding (PMB).......................................................................................................... 52  Operative gyneacology/ laparoscopy .................................................................................................... 52  Premalignant and malignant disorders of the uterine corpus .............................................................. 52 Students feedback on the subject .................................................................................................. 53 Exams ............................................................................................................................................... 54 Types of questions: .......................................................................................................................... 54 Samples of the expected questions and their answers ................................................................... 54  Long essay question:.............................................................................................................................. 54  Short essays questions: ......................................................................................................................... 54  Multiple choice questions...................................................................................................................... 55  Single choice questions:......................................................................................................................... 55 External Examiner ............................................................................................................................ 56 MEDICINE .................................................................................................................................. 57 Course coordinator and list of teachers .......................................................................................... 572011 4 Fifth stage Course Book
  5. 5. COURSE BOOK | Course coordinator and list of teachers | Two Lectures on Introduction & Course Overview .............................................................................................................................. 57 Course objectives ............................................................................................................................. 58 Course Reading List .......................................................................................................................... 58 Exams ............................................................................................................................................... 58  Composition (Essay) ;............................................................................................................................. 58  MCQs ..................................................................................................................................................... 59 OPHTHALMOLOGY ..................................................................................................................... 60 Course Information: ......................................................................................................................... 60 Course Description........................................................................................................................... 61 Class objectives: ............................................................................................................................... 61 Materials and Resources.................................................................................................................. 61 Expectations and Policies................................................................................................................. 61 Instruction methodology: ................................................................................................................ 62 Theoretical Lectures Outline............................................................................................................ 62 Practical Course Outline .................................................................................................................. 63 Grading............................................................................................................................................. 64 Detail of Syllabus.............................................................................................................................. 64  Introduction to ophthalmology ............................................................................................................. 64  The Ocular Examination......................................................................................................................... 65 Examinations.................................................................................................................................... 67  Types of questions: ................................................................................................................................ 67  The number of questions and marks are divided as follows: ................................................................ 67  Advices and directions for all students before and during exams. ....................................................... 67  Sample of MCQ and long and short essays ........................................................................................... 67 Student feedback for the subject of a lecture ................................................................................. 68 PEDIATRICS ................................................................................................................................ 70 Course Book Content ....................................................................................................................... 70 Course objectives ............................................................................................................................. 70 Course overview .............................................................................................................................. 70 Course Reading list; ......................................................................................................................... 70 Syllabus ............................................................................................................................................ 71 Exams ............................................................................................................................................... 71  Multiple choice questions: .................................................................................................................... 72  True and false questions:....................................................................................................................... 72  Problem solving questions ..................................................................................................................... 72  Data questions; ...................................................................................................................................... 72  Short assay questions ............................................................................................................................ 73  Enumerate questions;............................................................................................................................ 73  Exam’s duration: .................................................................................................................................... 74  Clinical exams; ....................................................................................................................................... 74 SURGERY ................................................................................................................................... 752011 5 Fifth stage Course Book
  6. 6. COURSE BOOK | Course coordinator and list of teachers | Two Lectures on Introduction & Course coordinator and list of teachers on this course................................................................... 75 Course Overview .............................................................................................................................. 75 Course Reading List .......................................................................................................................... 75 Syllabus ............................................................................................................................................ 75 Student feedback for the subject of a lecture ................................................................................. 76 Examinations.................................................................................................................................... 76 Examples: ......................................................................................................................................... 76 PRACTICAL SESSIONS ................................................................................................................. 78 Medicine .......................................................................................................................................... 78 Neurosurgery ................................................................................................................................... 79 Thoracic and Cardiovascular Surgery............................................................................................... 812011 6 Fifth stage Course Book
  7. 7. RADIOLOGY | Course coordinator and list of teachers | Two Lectures on Introduction & RADIOLOGY Radiology for 5th Year Students of College of Medicine/ University of Sulaimani: 45 Lectures Course coordinator and list of teachers 1 - Name of the Course: Radiology. 2 - Lecturer tutor in charge: Dr. Ameer Ahmad 3 - Department Branch and the college: Dept. Surgery/ college of medicine/ University of Sulaimani 4 - Contacts: - Address: University of Sulaimani/ College of medicine/ Dept. of Surgery. E - Mail: amirkurda@yahoo.com U U - Website Link: - Other participant Lecturers: 1 - Dr. Kawa Abdulla 2 - Dr.Abeer Kadhum. 3 - Dr.Salal Fatih Tel no. 07701473771 salahkalary@yahoo.com U U 4 - Dr. Nasreen Atrooshi Course Overview The student will be taught how to use the different imaging modalities properly & which imaging modality fits particular situation. The student should also learn how to read the radiographs of common clinical problems e.g. he or she should learn how to diagnose different fractures, pneumothorax, pneumonia, intestinal obstruction, pneumoperitoneum etc….. Not only that the graduated doctor should also learn how to read CT scan in patients with Stroke & head injury. Lastly the student should be taught about the update of Radiology & that radiology is no more used for diagnosis only, it is taking part in the therapy as well i.e. Interventional Radiology. Reading lists: 1 - Diagnostic Imaging …Peter Armstrong & Martin Wastie….. Sixth edition ……2009 2 - Textbook of Radiology & Imaging …….David Sutton Seventh Edition….2003 3 - Bailey & Loves Short Practice of Surgery 24th Edition…2004 2nd Chapter 4 - WWW.LearningRadiology U U2011 7 Fifth stage Course Book
  8. 8. RADIOLOGY | Syllabus | Two Lectures on Introduction & Technical Considerations: given b Syllabus No. Title of the Subject Lecturers/Tutors Name 2 Introduction Dr.Ameer 7 Chest diseases Dr.Abeer 4 Cardio - vascular diseases Dr.Abeer 1 Plain abdomen Dr.Kawa 5 GIT Dr.Kawa Hepato - biliary system 3 Dr.Kawa Pancreas & spleen Peritoneal cavity and 2 Dr.Kawa Retroperitoneum 7 Urinary tract Dr.Nasreen 3 OBGYN Dr.Nasreen 4 Bone & joint diseases Dr.Salah 1 Bone Trauma Dr.Salah 2 Spine Dr.Ameer 2 Skull & Brain Dr.Ameer 1 Sinuses, orbits & Neck Dr.Ameer 1 Interventional Radiology Dr.Ameer 45 Total Detail of Syllabus Two Lectures on Introduction & Technical Considerations: given by Dr. Ameer Objectives: - Proper use of imaging department. - How X - rays are produced in Conventional Radiography.2011 8 Fifth stage Course Book
  9. 9. RADIOLOGY | Detail of Syllabus | Spine: Two Lectures given by Dr. Ameer Syllabus: - The basic radiographic densities. - Projections in conventional radiology:…PA. AP. Lateral, Horizontal X - ray beam, Lateral decubitus - CT Scan, Ultrasound, MRI, Radionuclide imaging & PET, Basic principles - Contrast agents in Conventional Radiography & CT.. Definition & side effects - PACS - Radiation Hazards Spine: Two Lectures given by Dr. Ameer Objectives: - Role of different imaging modalities in the diseases of the spine. (Plain radiographs, MRI, CT, Myelography) Syllabus: - Signs of abnormality on plain films. - How metastases/ myeloma/ lymphoma appear on different imaging modalities and which one is the best. - Infection of spine; Pyogenic & TB spondylodiscitis. - Spinal Trauma. - Degenerative disc disease (DDD) ; plain film & MRI findings. - Disc herniation. - Failed back syndrome. - Spinal canal stenosis. - Ankylosing Spondylitis. - Spinal dysraphism. - Spondylolisthesis. - Spinal cord compression. - Intrinsic disorders of the spinal cord.. Skull & brain; 2 Lectures given by Dr. Ameer Objectives: - Role of different imaging modalities in head injury, Stroke, Brain tumors. Syllabus: - Plain film; normal & abnormal intra - cranial calcification. - Signs of raised intra - cranial pressure on Plain films. - Normal & abnormal Brain CT. - Cardinal signs of abnormal CT brain. - CT angiography. - MRI of the brain. - MRA. - US of the Brain in neonates. - Brain Tumors; How common brain tumors appear by CT & MRI? e.g. glioma, meningioma, acoustic neuroma, pituitary tumors & metastases. - Stroke; Role of CT to exclude hemorrhage initially. - CT in subarachnoid hemorrhage...2011 9 Fifth stage Course Book
  10. 10. RADIOLOGY | Detail of Syllabus | Sinuses, Orbits & Neck one lecture by Dr. Ameer: - Role of CT in infarction. - Role of MRI in infarction. DWI - AVM in MRI & MRA. - Infection & brain abscesses. - MS. - Head injury; Role of CT to show epidural, subdural & parenchymal hemorrhage. Contusion & fractures. Sinuses, Orbits & Neck one lecture by Dr. Ameer: Objectives - Role of Plain film & CT in sinusitis. - Different causes of opaque sinuses. - Role of CT in blow out fracture. - Exophthalmus. - Diseases of Salivary glands & Role of plain radiograph, Sialography, CT & MRI. - Thyroid nodules; Role of US & radionuclide scan. Interventional Radiology: one Lecture by Dr. Ameer. Objectives To let the student know that Imaging has not only the role in diagnosis of diseases, but it can be of great help in treatment & may replace surgical procedures.: How can imaging guide biopsy? Draining abscesses? putting stents & e.g biliary drainage ?. Different interventional procedures via angiography; e.g. embolisation, thrombolysis. Plain abdominal radiographs: One lecture given by Dr. kawa Abdulla Objectives: Proper analysis of plain films Illustration of causes of abnormal plain films Syllabus: - The basic plain abdominal radiographs. - illustration of normal & abnormal plain films - analysis of GIT dilatation - analysis of extraluminal air. - analysis of GIT opacities & calcification on plain films - analysis of hepatic & splenic abnormalities on plain films - analysis of ascites; abdomino - pelvic masses on plain films GIT Contrast examination & other imaging modalities: Five Lectures by Dr. kawa Objectives: Analysis of role & findings of contrast studies & different imaging modalities in the GIT including US; CT; MRI; isotope studies & angiography Syllabus: - proper technique; limitations & hazards of contrast examinations - proper technique; limitations & hazards of other imaging modalities2011 10 Fifth stage Course Book
  11. 11. RADIOLOGY | Detail of Syllabus | Hepato - biliary system; three Lectures given by Dr. kawa - analysis of causes & findings of barium study abnormalities; including strictures; filling defects & ulcerations - dedicated evaluation of major topics: GIT malignancies; peptic ulcer; malabsorption syndrome; ulcerative colitis & Crohns disease with diverticular disease. - emphasis on the role & findings on US; CT; MRI - emphasis on the role & findings of isotope studies& angiography especially in GI bleeding Hepato - biliary system; three Lectures given by Dr. kawa Objectives: - analysis of role & findings of US; CT; MRI; isotope studies & angiography in Hepatic; biliary; splenic & pancreatic problems - analysis of role; findings; limitation& hazards of biliary contras examinations & isotope studies. Syllabus: - normal imaging appearances of liver; spleen; pancreas & biliary system with the gall bladder. - analysis of causes & findings of liver masses; cysts & abscesses. - analysis of findings in cirrhosis & portal hypertension and in liver trauma. - analysis of role; findings; limitation& hazards of ERCP; PTC – - analysis of imaging findings & limitations in cholecystitis ; GB & bile duct stones - analysis of imaging evaluation of jaundice starting with non invasive studies US, CT; MRI & MRCP with occasional isotope studies then to diagnostic & therapeutic ERCP & PTC - dedicated evaluation of causes & findings in splenomegaly - emphasis on the imaging findings in splenic trauma - analysis of imaging role & findings in pancreatic tumors and in acute & chronic pancreatitis. Peritoneal cavity & retroperitoneum; two Lectures given by Dr. kawa Objectives: - analysis of imaging role & findings in ascites; peritoneal tumors & intra - peritoneal abscesses - analysis of imaging role; findings & limitation in evaluation of the adrenal glands; abdominal aorta; para - aortic lymphadenopathy & retroperitoneal tumors and abscesses Syllabus: - analysis of imaging role & findings in ascites - analysis of role & findings of US; CT & isotope studies in intra - peritoneal abscesses - analysis of findings on US & CT in peritoneal tumors - US; CT & MRI appearance of normal retroperitoneal structures - US & CT evaluation of para - aortic lymphadenopathy. - imaging evaluation of adrenal adenoma - functioning, cons, Cushings and non functioning adenomas - US; CT; MRI & isotope studies evaluation of pheochromocytoma & adrenal metastases - Aortic aneurysms US; CT; MRI & angiographic evaluation. - imaging evaluation of retroperitoneal abscesses & tumors Chest: Seven lectures given by Dr. Abeer Kadum Abass Objectives: Role of different imaging modalities in the evaluation of different chest diseases.2011 11 Fifth stage Course Book
  12. 12. RADIOLOGY | Detail of Syllabus | Cardiovascular system (CVS) : Four lectures given by Dr. Proper reading of normal CXR. Correlation between clinical & CXR findings for accurate way of achieving diagnosis. Syllabus: Normal CXR interpretation. Abnormal chest radiograph; Silhouette sign & radiological signs of lung diseases: air space filling (pul. Odema & pul. consolidation), pul. collapse, spherical pul. Shadows, band like pul. Shadow, wide spread small shadows. Pleura; CXR findings, & causes in pleural effusion (free & loculated). Pleural thickening. Pleural tumors. Pneumo thorax (diagnosis, causes & types). Mediastinum; compartment, plain chest film findings in mediastinal masses & complementary CT. Pneumo - mediastium (causes & CXR findings). Hilar enlargement; unilateral & bilateral; causes & CXR findings. Diaphragm: Normal anatomy, variant & causes of marked unilateral elevation of hemi diaphragm. Specific diseases : Infection : Bacterial pneumonia, viral & mycoplasma pneumonia, lung abscess, pulmonary TB (Primary & post primary), fungal & parasitic disease, pneumonia in immunocompromised host, Sarcoidosis, diffuse pulmonary fibrosis ; CXR findings & try to determine the cause of the abnormal CXR findings. Diseases of air way passages (Asthma, bronchiolitis, acute bronchitis, chronic obstructive air way diseases, cystic fibrosis) ; definition, & CXR findings). Respiratory distress in the new born (Meconium aspiration & hyaline membranes disease) CXR findings & complications of therapy. ARDS; causes & CXR findings. Pulmonary embolism & infarction (CXR diagnosis, role of CT angiography & Radionuclide scanning). Trauma to the chest (CXR & CT) findings. CA Bronchus (CXR findings in peripheral & central), spread. Metastatic neoplasm to the chest (lung, chest wall, pleura, & mediastium). Lymphoma in the chest. Mammography; indications, plain radiograph & US findings in benign & malignant focal lesions. Cardiovascular system (CVS) : Four lectures given by Dr. Abeer Kadum Abass. Objectives: 1 - Role of imaging techniques in evaluation of cardiovascular disease. 2 - Proper interpretation of the CXR; regarding normal & cardiac diseases emphasized that CXR is useful for looking at the effects of cardiac diseases on the lung & pleural cavity, but provide only limited information about the heart itself. Syllabus: Evaluation of the CVS, with CXR, Echo & Doppler, CT & CT angiography, MRI & MRA, Radionuclide techniques, cardiac catheterization & angiography. Cardiac disease; size (common causes of chamber enlargement), Chamber hypertrophy & dilatation. Valve movement deformity & calcification. Ventricular contractility. Pericardial diseases (effusion & calcification).2011 12 Fifth stage Course Book
  13. 13. RADIOLOGY | Detail of Syllabus | Bone & Joint diseases: Four Lectures by Dr. Salah Kalary Pulmonary vessels: increased flow (CXR appearance & causes), decreased flow (CXR appearance & causes). Pulmonary arterial hypertension causes & CXR appearance. Pulmonary venous hypertension causes & CXR appearance. Pulmonary odema: Types, causes & CXR findings. Specific cardiac disorders; Heart failure, valvular heart disease, LT – atrial myxoma & other intracardiac tumors. Common Congenital heart diseases; LT –RT shunt, coarctation of aorta, Tetrology of Fallot. Bone & Joint diseases: Four Lectures by Dr. Salah Kalary Objectives: First: principal of reading of bone images in different modalities specially plain X - ray Second: how student can approach focal bone lesion & steps of imaging consequences Third: principles of differentiation between aggressive & benign bone lesions Fourth: principles of differentiation between joint degenerative changes like OA & inflammatory joint diseases like RA Fifth: information about criteria of differentiation between most common types of polyarticular joint diseases. Syllabus: Imaging techniques used in Dx of bone disease (role of different imaging modalities in approaching the bone disease Signs of bone disease in plain X - ray Types of bone diseases; focal, generalized & alteration in the trabecular pattern or changes in the shape Radiological approach for diagnosis of solitary bone lesions Bone tumors, including primary (benign & malignant) & secondaries Bone infection: Pyogenic (acute & chronic) & TB Generalize decreased bone density (osteopenia) Osteoporosis. Rickets & Osteomalacia. Hyperparathyroidism. Multiple myeloma. Generalized increase in bone density 1 - Paget’s disease 2 - Thalassemia 3 - Radiation induced bone diseases Changes in bone shapes Diaphyseal aclasia Joints diseases (2 lectures each of 1 hr) Imaging technique (roles of each modalities in Dx of joint disease) Approach in Dx of arthritis & radiological features of deferent type of arthritis including OA, inflammatory & metabolic arthritis & principle differentiating radiological points between them Osteochondritis including Perthe’s, Kienbock’s disease Freiberg’s disease Kohler’s disease Slipped femoral epiphysis Developmental dysplasia of the hips (DDH or CDH)2011 13 Fifth stage Course Book
  14. 14. RADIOLOGY | Detail of Syllabus | Bone Trauma: One Lecture by Dr.Salah Kalary. Internal derangement of the knee joint Shoulder Rotator cuff tear Bone Trauma: One Lecture by Dr.Salah Kalary. Objectives: Role of plain radiograph in bone trauma. Signs of Fracture & dislocation. Role of nuclear medicine, CT & MRI in bone trauma, Stress fracture. Insufficiency fracture. Pathological fracture. Salter Harris classification. Non - accidental trauma.2011 14 Fifth stage Course Book
  15. 15. UROLOGY | Course coordinator and list of teachers | Bone Trauma: One Lecture by Dr.Sala UROLOGY Fifth Stage Department of Surgery College of Medicine 2010 - 2011 Course coordinator and list of teachers Course: urology Course coordinator: Dr. Ali Kamal Department: surgery College: Medicine Course coordinator link: alikamal22@yahoo.com Tel. +9647705449905 List of teachers on this course: Dr. Ismaeel Hama Ameen Dr. Aso Omer Rasheed Dr. Sarwar Noore Mahmoud Dr. Ali Kamal M.Sami Dr. Ahmed Abdulhameed Course Overview The course of urology is dedicated to deal with undergraduate level to know the importance of urology in the daily activities of the junior doctors and the sessions and the lectures are overall based on simple principles and standards for the juniors in urology to understand the physiology and pathology and management of these problems in simple and qualified methods in 16 lectures. The subjects should enable the students to understand the procedures of intervention in urology and the justification of such intervention and when to decide to treat conservatively and when to interfere with the disease process with a wide base of knowledge that will help the students to widen their experiences through journals and textbooks after understanding the basics of urology. Course Objectives At the end of the course of urology, the students should be able to master and perform the basic skills that are considered fundamentals in urology and to have basic urological experience needed for doctors in urology department or in case of urological emergency, and some of these objectives include: 1. Insertion of urethral Foley’s catheter. 2. Performing suprapubic cystostomy2011 15 Fifth stage Course Book
  16. 16. UROLOGY | Course Reading List | Bone Trauma: One Lecture by Dr.Salah Kalary. 3. Diagnosing urine retention with its management. 4. Suspecting urethral injury and urethral rupture. 5. Diagnosing and treatment of urological diseases. 6. Suspecting malignancy and differentiating from benign lesions. Course Reading List 1. 1 - Baily and Love, short practice of surgery 2. 2 - Smith’s urology 3. 3 - Journal of Urology. American Urological Association. 4. 4 - European association of urology, clinical guidelines. Syllabus No. Title of subject Lecturer/Tuttor’s name 1 kidney and urinary symptoms Dr. Aso Omer Rasheed 2 Investigation in urology Dr. Aso Omer Rasheed 3 Congenital anomalies of UT Dr. Aso Omer Rasheed 4 infection Dr. Aso Omer Rasheed 5 Anuria Dr. Aso Omer Rasheed 6 hydronephrosis Dr. Aso Omer Rasheed 7 Urolithiasis Dr. Aso Omer Rasheed 8 renal truma Dr. Aso Omer Rasheed 9 renal tumor Dr. Aso Omer Rasheed 10 Prostate infections 1 Dr. Sarwar Noore 11 Prostate inferctions 2 Dr. Sarwar Noore BPH 1 12 Dr. Sarwar Noore 13 BPH 2 Dr. Sarwar Noore 14 Carcinoma of prostate 1 Dr. Sarwar Noore 15 Carcinoma of prostate 2 Dr. Sarwar Noore No. Title of subject Lecturer/Tuttor’s name 16 Urinary bladder anatomy, physiology and pathology Dr. Ali Kamal 17 Rupture of urinary bladder, urine retention Dr. Ali Kamal 18 Neuropathic bladder + urinary incontinence Dr. Ali Kamal 19 Urinary bladder stones, vesical fistula, bladder diverticulum Dr. Ali Kamal 20 Bladder tumors Dr. Ali Kamal2011 16 Fifth stage Course Book
  17. 17. UROLOGY | Detail of Syllabus | Lectures titles (the kidney) 21 Urinary bladder schistosomiasis, Dr. Ali Kamal 22 Urethra and penis, anatomy and congenital anomalies Dr. Ahmed Abdulhamed 23 Hypospadias Dr. Ahmed Abdulhamed 24 Acquired urethral stricture Dr. Ahmed Abdulhamed 25 Disorders of female urethra Dr. Ahmed Abdulhamed Ectopic testis and cryptorchidism 26 Dr.Ismaeel Hama amen Dr.Ismaeel Hama amen 27 Hydrocele 28 Orchitis Dr.Ismaeel Hama amen 29 Torsion of the spermatic cord Dr.Ismaeel Hama amen 30 Tumors of the testis Dr.Ismaeel Hama amen Detail of Syllabus Lectures titles (the kidney) Lecturer (dr. Aso Omer) Objectives: these lectures are dedicated to help the medical students understand the importance of the kidneys in daily practice as a common problem that they will face every day in the hospital and urinary emergency of renal trauma or renal stones or anuria or infection of the kidneys, the objectives are: a. The function of kidneys. b. The investigations needed to diagnose and define renal problems. c. To differentiate between anuria and urine retention. d. To be clinically capable of differentiation between renal colic and acute abdomen. e. Management of renal colic. f. The lines of treatment of renal colic and renal pain. g. Surgical treatment of renal tumor. The lectures include: a. Introduction to kidney function and physiology of urine formation. b. Causes of renal colic, renal tumor, hydronephrosis, anuria, renal trauma and their managment Lectures titles (the Prostate) Lecturer (dr. Sarwar Noore) Objectives: these lectures are dedicated to help the medical students understand the importance of the prostate as a common problem that they will face every day in the hospital and urinary emergency of hematuria or urine retention or infection of the prostate, the objectives are: 1. To understand the function of prostate.2011 17 Fifth stage Course Book
  18. 18. UROLOGY | Detail of Syllabus | Lectures title: (Urinary bladder) 2. The investigations needed to diagnose and define prostate infections and relation to LUTS. 3. To differentiate between benign prostatic hyperplasia and prostatic carcinoma. 4. To be clinically capable of performing rectal examination. 5. Management of BPH. 6. Surgical treatment of prostatic carcinoma. The lectures include: a. Introduction to prostate anatomy and physiology. b. Presentation, diagnosis and treatment of prostatic problems. Lectures title: (Urinary bladder) Lecturer name: Dr. Ali kamal Objectives: Theses lectures are directed to dedicated to help the medical students understand the functions and anatomy and micturition process and the mechanism of urinary retention in daily practice as a common problem that they will encounter while dealing with patients suffering from urinary frequency and hematuria or urinary bladder carcinoma, also the rupture of bladder.the objectives are: 1. The causes of urinary retention, also the causes of urinary bladder rupture. 2. The difference between the urinary retention and anuria 3. To differentiate between acute and chronic retention. 4. To be clinically capable of differentiate between intraperitoneal and extraperitoneal rupture of bladder. 5. Management of retention. 6. The contraindications to catheterization in cases of urine retention with urethral injury. 7. Surgical treatment of rupture of urinary bladder, , vesical fistula. The lectures include: a. Introduction to urinary bladder function and physiology of micturition. and meaning of urine retention. b. presentation and management of bladder stones, infections, and malignancy, fistulas, congenital anomalies. c. Causes of urine retention and classification of urine retention acute and chronic, neurogenic and obstructive and presentation of patients. d. What is difference between intraperitoneal and extraperitoneal bladder rupture, how to diagnose both and treatment of both types. References: 1. Baily and Love short practice of surgery 2. Journal of urology. Lectures titles (the penis and urethra) Lecturer (dr. Ahmed abdulhameed)2011 18 Fifth stage Course Book
  19. 19. UROLOGY | Student feedback for the subject of a lecture | Lectures titles (the testis) Objectives: These lectures are dealing with the penis and urethra and are intending to introduce the penis and urethral problems as congenital and acquired diseases. the objectives are: 1. To understand the anatomy of penis and urethra. 2. The investigations needed to diagnose and treat urethral diseases. 3. To differentiate between hypospadias and epispadius. 4. To be clinically capable of catheterizing the urethra in female and male. 5. Management of urethral injury. 6. The lines of diagnosing female urethral problems. 7. Surgical treatment of urethral strictures. The lectures include: a. Introduction to penis and urethral anatomy. b. presentation and treatment of congenital and acquired urethral problems in male and in females. Lectures titles (the testis) Lecturer (dr. Ismaeel Hama Ameen) Objectives: these lectures are dealing with the testes and the congenital abnormalities as well as the acquired problems of the testis, and a the emergency of testicular and spermatic conditions. the objectives are: 1. The function, anatomy and physiology of testes. 2. The investigations needed to diagnose and define testicular problems. 3. To diagnose the emergency of testicular torsion and infection of testes. 4. To be clinically capable of diagnosing hydrocele and varicocele. 5. Management of renal colic. 6. The lines of treatment of renal colic and renal pain. 7. Surgical treatment of renal tumor. The lectures include: a. Introduction to testis anatomy, function and physiology, b. presentation and treatment of testicular torsion and hydrocele and varicocele and ect Causes of renal colic, renal tumor, hydronephrosis, and ectopic testis, also infection. Student feedback for the subject of a lecture Date: course: year: lecturer: title: NO. EVALUATION QUESTIONS SCORE (1 - 5) SUBJECTIVE REMARKS The objectives and key messages of the subject 1 were clear The contents of the subject were useful and 2 related to the main objectives of the course 3 The materials were prepared carefully as needed 4 The lecturer/ tutor while lecturing tried to analyze2011 19 Fifth stage Course Book
  20. 20. UROLOGY | Examinations | Types of questions: the principles, contents and the important points of the subject simply and properly. The lecturer/ tutor while lecturing kept my 5 attention. The lecturer/ tutor came into the classroom on 6 time and was committed to the duration of the lecture. The lecturers behavior in the classroom was calm 7 and respectful The slides used in the lecture were clear and 8 attractive. At the end of the lecture, the lecturer gave the 9 students a chance for questions and comments. His/ her answers were complete. The reading sources are new and compatible with 10 the subject. Total score 1 - very bad 2–bad 3–medium 4 - good 5 - verygood Examinations Time of exam. 3 Three hours. Types of questions: 1 - short essay. 2 - long essay. 3 - multiple choice questions. The number of questions and marks are divided as follows: 30 Marks for long essays. 30 Marks for short essays. 60 Marks for MCQs. The methods of correction of answers depend on key answers and key for multiple choice questions and correction and marks are given accordingly. Advices and directions for all students before and during exams. 1. Read the question twice before answering. 2. Think of the answer before writing. 3. Plan your answer in a separate page before writing it down on the answer paper. 4. Arrange the answer in the form of introduction, contents and the final part so that the student organizes his/her answer Sample Questions MCQ Regarding the penis all are true except: a. has a fixed root and a body that hangs free. b. the bulb of the penis is traversed by the urethra and covered on its outer surface by bulbospongiosus muscle.2011 20 Fifth stage Course Book
  21. 21. UROLOGY | Examinations | Sample Questions c. the corpora cavernosa supplied by branches from the external femoral arteries. d. the corpus spongiosum at its end expands to form the glans penis. e. nerve supply is from the pudendal nerve and the pelvic plexus the correct answer is (c) Which of the following is correct regarding urethrorectal and vesicorectal fistula: a. they are very common congenital abnormality. b. they are almost always associated with imperforate anus. c. urorectal septum has developed completely. d. the fistula opens on the anterior abdominal wall. e. cystoscopy and panendoscopy can not show the fistulous opening. The correct answer is (d) Classification of hypospadias according to location include all the following except: a. perineal. b. glandular. c. suprapubic. d. coronal. e. penoscrotal. The correct answer is (c) Which of the following is not a clinical finding in Peyronie’s disease: a. painful erection. b. curvature of the penis. c. poor erection distal to the involved area. d. the patient has moderate to severe pain when the penis is in nonerect state. e. Examination of the penile shaft reveals a palpable dense, fibrous plaque involving the tunica albuginea. The correct answer is (d) Treatment of acquired urethral stricture and its complications, all are correct but one: a. dilation of urethral stricture is not usually curative. b. urethrotomy under endoscopic direct vision. c. short strictures (≤2 cm) of the anterior urethra should be completely excised and primary anastomosis done. d. strictures >2 cm in length can be managed by patch graft urethroplasty. e. periurethral abscess self - limited and will heal spontaneously. The correct answer is (e) long and short essays Question: Enumerate the causes of priapism Answer: a. Idiopathic in 60% of cases. b. Secondary in 40% of cases due to the following diseases: 1. Leukemia. 2. Sickle cell disease.2011 21 Fifth stage Course Book
  22. 22. UROLOGY | Student feedback on the course | Sample Questions 3. Pelvic tumors. 4. Pelvic infections. 5. Penile trauma. 6. Spinal cord trauma. 7. Medications (trazodone). Currently, intracavernous injection therapy for impotence may be the most common cause Question: write short assay on the diagnosis of urethral diverticulum. Answer : Diagnosis: 1. feeling a rounded cystic mass in the anterior wall of the vagina that leaks pus from the urethral orifice when pressure is applied. 2. Endoscopy may reveal the urethral opening. 3. The postvoiding film of an IVU series may demonstrate the lesion. 4. Transvaginal ultrasonography. Student feedback on the course Date : course: year lecturer: SCORE SUBJECTIVE NO. EVALUATION QUESTIONS (1 - 5) REMARKS 1 The objectives and key messages of the subject were clear The contents of the subject were useful and were related to the main 2 objectives of the course 3 The coordinator teacher had worked hard to prepare the materials The coordinator teacher had worked hard to cooperate and prepare the 4 course 5 The lecturers were carefully selected and were expert in their fields The coordinator teacher gave a good attention to the students 6 criticisms and claims 7 Information on the Examination process was well provided 8 The questions of the exams were related to the contents of the course There is a potential to promote and develop the course in the following 9 areas: 10 Total of the levels 1 - very bad 2 - bad 3 - medium 4 - good 5 - very good2011 22 Fifth stage Course Book
  23. 23. ANESTHESIA | Anesthesia Lectures | Introduction to anesthesia 5 Hrs ANESTHESIA Fifth Stage Department of Surgery College of Medicine 2010 - 2011 Anesthesia Lectures Dr. Amir Boujan Dr. Gona Ahmed Detailed Syllabus Introduction to anesthesia 5 Hrs Objectives: the student will learn about History of anesthesia. Preoperative preparation of a patient to anesthesia which includes preoperative visit of the anesthetist to the patient. History (including drug history and its effect on anesthesia) clinical examination Interpretation of laboratory data Consent Planned management of anesthesia Methods available for relief of post operative pain Fasting guidelines Assignment the physical status classification Premedication and Types of Anesthesia 1Hr Objectives: The student should know the aim of anesthesia, the definition of general anesthesia and the meaning of induction maintenance and recovery. Also the student will learn about local anesthesia and the types of local anesthesia procedures (e.g. regional anesthesia) Drugs used in anesthesia 4hrs Objectives: The student will learn about different groups of anesthesia drugs, there effects, side effects also drug interaction.2011 23 Fifth stage Course Book
  24. 24. ANESTHESIA | Question Examples | Post operative complications 3hrs Post operative complications 3hrs Objectives: The student should know the postoperative anesthesia complications and how to manage them Pain management 2hrs Objectives: The student will learn about pain, types of pain and the methods available to control acute pain and the methods to control chronic pain Airway Management 5hr Objectives: the student will learn about: Anatomy of the airway Airway assessment and difficult airway Endotracheal intubation, it’s indications and complications Surgical intervention to control the airway Monitoring 1hr Objective: The student will learn about patient monitoring in the operation room or in the ICU. Cardiopulmonary resuscitation 2hr Objectives: The student should know the ABC of Cardiopulmonary resuscitation and how to deal with patient developed cardiac arrest Intensive Care Unite 4hrs Objectives: The Student will learn about: ICU and the instrument available in it (e.g. respiratory support instruments) Criteria for admission to ICU Criteria for patient to discharge from ICU Care to critical ill patient Dealing with specific conditions in ICU (e.g. Salicylic acid poisoning) Total parenteral nutrition References Robert K.stoetling, Ronald D.Miller, Basics of anesthesia 2004 Kith G.Allman, Iain Wilson, Oxford Handbook of Anaesthesia 2007 A.R. Aitkenhead, G.Smith, Textbook of Anaesthesia Question Examples Q1/ Enumerate the Important aspects of the preoperative evaluation. Answer/ Important aspects of the preoperative evaluation includes the followings:2011 24 Fifth stage Course Book
  25. 25. ANESTHESIA | Question Examples | References History Review of current drug therapy Physical examination Interpretation of laboratory data Consent Planned management of anesthesia Methods available for relief of post operative pain Fasting Assignment the physical status classification Premedication Q2/ Write short notes on the causes of post operative hypertension. Answer/ the causes are: Arterial hypoxemia. Enhanced sympathetic nervous system activity (pain, bladder distension). Preoperative hypertension. Hypervolemia. Hypercarbia Q2/ Match items in table A (1 - 12) with the appropriate items in table B (a - t) : (each items in table B should be used once only) (answer on this paper) (1mark/each) Table A Halothane J, O Atracurium H, R Thiopenton L Fentanyl Pentazocine T Ketamine I, Q, S Remifentanil P Propofol B Bupivacaine D, F, N Succinylcholine A, E, G, K, M Neostigmine C Pethidine Q/choose the most approperiat answer The sources of blood clot embolization in the arteries are all except: U U a. Mural thrombus b. Following myocardial infarction c. Mitral stenosis d. Aortic stenosis e. Atrial fibrillation Answer/c2011 25 Fifth stage Course Book
  26. 26. OTOLARYNGOLOGY | Course coordinator and list of teachers on this course | References OTOLARYNGOLOGY Fifth Stage Department of Surgery College of Medicine 2010 - 2011 Course coordinator and list of teachers on this course Course: otolaryngology Course coordinator: Dr. Hewa Asad Department: surgery - otolaryngology College: Medicine Course coordinator link: hewa_ent@yahoo.com Tel. +9647701580087 List of teachers on this course: Dr. Hewa Asad Abdelkareem Dr. Yousif Ibrahim chalabi Dr. Muaid Ismaiel Aziz Dr. Sherko Saeed Fathullah Course Overview The course of otolaryngology – head & neck surgery is dedicated to deal with undergraduate level to know the importance of otolaryngology in the daily activities of the junior doctors and the sessions and the lectures are overall based on simple principles and standards for the juniors in otolaryngology to understand the physiology and pathology and management of common diseases & how to deal with emergency situations that they may be faced in their practical work, these lectures given in simple and qualified methods in 28 lectures. Course Objectives At the end of the course of otolaryngology, the students should be able to master and perform the basic otolaryngology assessment & examinations that are considered fundamentals and learn how to be able to deal with emergency situations. some of these objectives include: Performing ENT examination. Deal with a patient complaining of nasal bleeding. How to manage a patients with foreign bodies inhalations or ingestion. How to manage a patients with an obstructed upper airway obstruction (stridor). Diagnosing and treatment of common otolaryngological diseases.2011 26 Fifth stage Course Book
  27. 27. OTOLARYNGOLOGY | Course Reading List | References Course Reading List 1 - Scott - Brown otolaryngology 2 - Logans Turners diseases of ear, nose, throat 3 - Synopsis otolaryngology 4 - Makhbool otolaryngology 5 - Essential Otolaryngology 6 - Oxford handbook of ENT emergences 7 - American journal of otolaryngology - head & neck Surgery 8 - journal of laryngoscope 9 - www.emedicine.com Syllabus NO TITLE OF SUBJECT LECTURER/TUTTOR’S NAME 1 Anatomy and physiology of the larynx Dr.Hewa asaad 2 Traumatic conditions of the larynx. Dr.Hewa asaad 3 Inflammations of the larynx: Acute laryngitis. Dr.Hewa asaad 4 Inflammations of the larynx: Chronic laryngitis. Dr.Hewa asaad Neoplasms of the larynx: Benign tumors and 5 Dr.Hewa asaad cysts 6 Neoplasms of the larynx: Malignant tumors. Dr.Hewa asaad 7 Hoarseness Dr.Hewa asaad Anatomy, Embryology & physiology of the nose 8 Dr Yousif Chalabi & PNS 9 congenital anomalies and trauma to the nose Dr Yousif Chalabi 10 Acute & Chronic nasal &PNS sinus inflammation Dr Yousif Chalabi 11 Epistaxis Dr Yousif Chalabi 12 Allergic rhinitis & nasal polyposis Dr Yousif Chalabi 13 The deformed nose & nasal obstruction Dr Yousif Chalabi 14 Tumors of nose & paranasal sinuses Dr Yousif Chalabi 15 Anatomy, physiology of the ear Dr. Muaid Ismaiel Aziz Physical& radiological assessment of the ear 16 Dr. Muaid Ismaiel Aziz diseases 17 Symptomatology in ear diseases Dr. Muaid Ismaiel Aziz Diseases of the external ear (cong.anomalies, 18 Dr. Muaid Ismaiel Aziz infections, tumors) 19 Diseases of the middle ear (acute otitis media) Dr. Muaid Ismaiel Aziz 20 Diseases of the middle ear (chronic otitis media) Dr. Muaid Ismaiel Aziz2011 27 Fifth stage Course Book
  28. 28. OTOLARYNGOLOGY | Detailed Syllabus | References 21 Diseases of the inner ear, ear surgeries Dr. Muaid Ismaiel Aziz 22 Anatomy and physiology of the pharynx Dr. Sherko Saeed Fathullah 23 Common diseases of the buccal cavity Dr. Sherko Saeed Fathullah 24 Pharyngitis and pharyngeal abscesses Dr. Sherko Saeed Fathullah 25 Tonsillitis and adenoids Dr. Sherko Saeed Fathullah 26 Tumors of the pharynx Dr. Sherko Saeed Fathullah Miscellaneous conditions of the pharynx and 27 Dr. Sherko Saeed Fathullah throat 28 Neck masses and salivary glands Dr. Sherko Saeed Fathullah Detailed Syllabus Lecture title: Anatomy and physiology of the larynx. Lecturer name: Dr. Hiwa Asad Objectives: This lecture is dedicated to help medical students understand anatomy and physiology of the larynx and their clinical importance, the lecture includes: a. Introduction to laryngeal structure. b. Description of laryngeal structure (laryngeal cartilages and membranes, muscles of the larynx and their actions) demonstrated by figures c. Description of surface anatomy of the larynx. d. Blood supply, nerve supply, and lymphatic drainage of larynx and their clinical importance. e. Description of functions of larynx. Lecture title: Traumatic conditions of the larynx Lecturer: Dr. Hiwa Asad Objectives: This lecture is dedicated to help medical students understand management of trauma of larynx and neck which is a common clinical condition that they will face frequently in their practice in hospital and emergency department, the lecture includes: a. Introduction to laryngeal and neck trauma. b. Description of mechanism of injury (blunt trauma injury and penetrating trauma). c. Initial evaluation, clinical assessment, endoscopic assessment and imaging of the larynx. d. Classification of laryngeal injury according to extent of damage. e. Management of laryngeal trauma, goals of laryngeal exploration, laryngeal repair, and management of associated vascular and esophageal injuries. f. Outcome of management of this condition. Lecture title: Inflammations of the larynx: Acute laryngitis Lecturer name: Dr. Hiwa Asad Objectives: This lecture is dedicated to help medical students understand this common problem that they will face in their practice in outpatient clinic, emergency department or if they work in otolaryngology or pediatric departments, the lecture includes: a. Introduction to acute laryngitis and its etiological factors.2011 28 Fifth stage Course Book
  29. 29. OTOLARYNGOLOGY | Detailed Syllabus | References b. Description of clinical types of acute laryngitis. c. Comparison between pediatric patients and adult patients and relative clinical points to be considered. d. Treatment options and outcome. Lecturer title: Inflammations of the larynx: Chronic laryngitis Lecturer name: Dr. Hiwa asad Objectives: This lecture is dedicated to understand this troublesome condition caused by various etiological factors, and its types (specific and non specific), the lecture includes: a. Definition and etiological factors of chronic laryngitis. b. Clinical classification of chronic laryngitis into specific and non - specific, and subgroups of each type. c. Pathology, clinical features, and treatment modality for each type. Lecture title: Tumors of the larynx: Benign tumors Lecturer name: Dr. Hiwa Asad Objectives: This lecture is dedicated to help medical students understand this important conditions that might affect respiration and voice of patients that needs specific management, the lecture includes : a. Introduction. b. Classification of benign tumors. c. Clinical features, diagnosis and treatment of each type. d. Pseudotumors types, clinical features and management of each type. Lecture title: Tumors of the larynx: Malignant tumors Lecturer name: Dr. Hiwa Asad Objectives: This lecture is dedicated to help medical students understand this serious condition and develop high sense of suspicious for early diagnosis. It also demonstrates treatment options of this condition, the lecture includes: a. Introduction. b. Classification of carcinoma of larynx. c. Demonstration of etiological factors. d. Clinical features, examination of the larynx and the neck. e. Radiological investigations and other relevant investigations to assess tumor extension and spread. f. Staging and grading of Ca larynx. g. Demonstration of strategy of treatment and the options available for this condition. Lecture title: Hoarseness Lecturer name: Dr. Hiwa Asad Objectives: to understand the students the meaning of the hoarseness & its causes &its treatment, were all objectives included in the lecture. Lecture title: Anatomy & Physiology of nose & paranasal sinus Lecturer : Dr. Yousif Chalabi Objective: To emphasize the importance of anatomy &its variations especially the osteomeatal complex in the clinical managements of common nose &sinus chronic diseases & correction of nose & nasal septum both for physiological & cosmetic purposes, the lecture includes an embyrological introduction to explain some congenital variation of nose like choanal atresia anatomy of external nose &its skeleton to explain the anatomical dangerous region of nose &anatomical & physiological background of cosmetic nasal surgery. anatomy &physiology of nasal fossae & its wall, their role in respiration2011 29 Fifth stage Course Book
  30. 30. OTOLARYNGOLOGY | Detailed Syllabus | References anatomy of paranasal sinuses &their variation with its impact on pathogenesis of chronic sinus diseases & facial pain Lecture title: congenital anomalies and trauma to the nose Lecturer: Dr Yousif Chalabi Objectives : to emphasize the importance of early diagnosis of some congenital anomalies as a cause of embarrassed respiration in neonates & infants for urgent interference &to explain the clinical managements of broken nose &face both medically &legally in addition to its impact on possible intra cranial, base of skull, cosmetic & respiratory complications to guarantee early proper detection &management to prevent subsequent sequels. The lecture includes a quick review of embryological formation of nose. its openings & anatomy of nasal skeleton, Choanal atresia, fracture nasal bone &facial bones (Leforts) fractures, Foreign bodies in nose & their managements. Lecture title : Acute & Chronic nasal &paranasal sinus inflammation Lecturer: Dr Yousif Chalabi Objectives: To consider the predisposing factors& their prevention in the etiology of acute nasal & paranasal sinus (PNS) infections & to emphasize the effects of prompt & early treatments in prevention of persistence of infections & changing to chronic state. And how to manage whether medically or surgically the chronic state. The lecture includes A quick review of key points of previous lecture Acute viral &bacterial infections of nose &PNS Chronic non - specific nasal &PNS inflammation Chronic specific nasal & PNS infection Managements including the medical & surgical way of treatments Lecture title: Epistaxis Lecturer: Dr Yousif Chalabi Objectives : This lecture is dedicated to emphasize the importance of epistaxis as one of common acute emergencies in medicine in general & to teach the students how to manage it as first - aid, general &specific ENT managements. How to identify its causes as a local nasal causes or general systemic causes especially the blood dyscriasis causes. How to be treated specifically, generally & how to prevent & guard against it. The lecture includes A quick review of key points of previous lecture an introduction to epistaxis Causes as a local nasal causes &general systemic causes Management including the lab hematological., radiological & endoscopical way to find the cause as local nasal or general systemic. how to be treated whether medically or surgically conservatively or radically &how to be followed up properly. Lecture title: Allergic Rhinitis & Nasal polyposis Lecturer: Dr Yousif Chalabi Objectives: to emphasize the role of preventative measures especially the avoidance of allergens.proper use of immunization & medical treatments In reducing the complaint & severity of allergic patients. How to differentiate the different causes of wet nose including infections allergy & intrinsic vasomotor rhinitis &how to be treated properly.The lecture is dedicated to make the students understand the nature of common nasal problem of polyposis & how to differentiate it from normal or hypertrophied turbinates. To emphasize the role of medical treatment as an effective measures in the early & small polypi or as a preliminary measures for effective radical treatment or follow up for those treated surgically.2011 30 Fifth stage Course Book
  31. 31. OTOLARYNGOLOGY | Detailed Syllabus | References The lecture includes A quick review of key points of previous lecture An introduction to the types of hypersensitivity reactions &nature of nasal allergy Etiology of allergy &types of allergens Management including the differentiation &how to diagnose different types of wet nose. Allergy dermatological & hematological test in addition to proper way of prevention &treatments Nasal polyposis as a pathogenesis, diagnosis & treatments whether medically emphasizing the role of proper use of cortisone in a non contra - indicated patients or surgically whether conservatively or radically by FEES or conventionally by traditional surgical way Lecture title : The deformed nose & nasal obstruction Lecturer: Dr Yousif Chalabi Objectives: This lecture is dedicated to emphasize the role of cosmetic nasal surgery with consideration of nasal passage for proper respiratory functions which so frequently threatened by some surgeon not considering the physiological aspect of nasal function &how to deal with nose surgically both for physiological & cosmetic purposes. It also aims to make the students understanding the causes of nasal obstruction &to differentiate the pathological from normal physiological obstructions of nasal cycle.The lecture includes A quick review of the key points of previous lecture A review of the nasal respiratory physiology &anatomy of the nasal skeleton Causes of deformed nose &nasal obstruction Management including the requested examination whether endoscopically or by imaging (CT SCAN) to determine the causes &sites of obstructions & how to be treated whether medically or surgically whether for cosmetic or physiological purpose separately or in combinations. Lecture title : Tumors of nose & paranasal sinuses Lecturer: Dr Yousif Chalabi Objectives: The lecture is dedicated to make the students understanding the nature of tumors &how the malignant tumors present with specific signs & symptoms to be differentiated from benign one.What are the predisposing factor & the definite causes to be diagnosed early before extension to nearby vital & dangerous area of eye & intracranially. Although generally they are rare tumors but they carry a great morbidity & mortality necessating a special considerations by the juniors &the surgeon. Also to teach the students how these tumors presents with different signs & symptoms making the patients wandering among different specialty until diagnosed too late as a nasal or paranasal malignant tumors. The lecture includes: A quick reviews of key points of previous lecture classifications of tumors as benign & malignant with their different types. Histological classification & staging of tumors predisposing & etiological factor for tumor causation Managements including the diagnosis of tumors whether benign or malignant &the best selected way of treatments whether surgically or by DXRT or combined in addition to their prognosis Lecture title : Embryology, anatomy, physiology of the ear Lecturer name: Dr. Muaid Ismaiel Aziz Objectives: This lecture is dedicated to help medical students understand embryology, anatomy and physiology of the ear and their clinical importance, the lecture will deal with followings : Embryological development of the ear Anatomical parts of the ear Anatomical landmarks of the ear2011 31 Fifth stage Course Book
  32. 32. OTOLARYNGOLOGY | Detailed Syllabus | References Functions of the ear Lecture title: Physical & radiological assessment of the ear diseases Lecturer name: Dr. Muaid Ismaiel Aziz Objectives: in this lecture the students will learn how to examine & get diagnosis of the ear diseases as its includes; The different ways of ear examination What you will see in normal ear examination to make differentiation from disease ear Audio logical assessment & its interpretation Role of plain x - ray & ct scan in ear disease & their indications. Lecture title: Symptomatology in ear diseases Lecturer name: Dr. Muaid Ismaiel Aziz Objectives: to know different ear disease symptoms as deafness (hearing loss), tinnitus (perceptive noisy sound), vertigo (rotating movement of the surrounding or the patient himself with fixed environment), otalgia (pain in the ear). So you will get information about above topics shortly including their classifications, differential diagnosis, diagnosis & treatments. Lecture title: Diseases of the external ear (cong. anomalies, infections, tumors) Lecturer name: Dr. Muaid Ismaiel Aziz Objectives: to make the student oriented with the different ear diseases starting from external ear diseases, in this lecture will discuss the congenital diseases like auricle deformity (bat ear), preauricular sinus, otitis externa & its most common causes & types & its treatment, also will concentrate on benign & malignant tumors like osteoma, basal cell carcinoma. Lecture title : Diseases of the middle ear (acute otitis media) Lecturer name: Dr. Muaid Ismaiel Aziz Objectives: in this lecture the student will face the most important & commonest pathology which is middle ear infection (otitis media), pathology, types, causes, diagnosis & treatment. Lecture title : Diseases of the middle ear (chronic otitis media) Lecturer name: Dr. Muaid Ismaiel Aziz Objectives: chronic OM classified into safe & unsafe disease, so its important to know both types & its pathology & treatment, also will discuss different classifications for CSOM & which of them is useful. Lecture title : Diseases of the inner ear, ear surgeries Lecturer name: Dr. Muaid Ismaiel Aziz Objectives: in this lecture some of the inner ear disease which is more common than other inner ear disease like otosclerosis, meniers disease will discussed briefly in addition the students will get good & sufficient information about the common ear surgeries like myringotomy, myringoplasty. Lecture title : Anatomy and physiology of the pharynx Lecturer name: Dr. Sherko Saeed Fathullah Objectives: in this lecture the students will get enough information Concentrating on boundaries and parts of the pharynx including naso, oro and laryngopharynx, as well as muscles, nerve supplies with short notes on the anatomy of soft palate. In physiology, function of pharyngeal lymphoid tissue and deglutition are discussed Lecture title : Common diseases of the buccal cavity Lecturer name: Dr. Sherko Saeed Fathullah Objectives: Some of the common diseases of otolarygologist interest are described including : stomatitis, aphthous ulcers, Behcet’s syndrome tongue ulcers and AIDS, notes on cysts of mouth, carcinoma of the toungue, ludwing’s angina and tumours of the oral cavity2011 32 Fifth stage Course Book
  33. 33. OTOLARYNGOLOGY | Student feedback for the subject of a lecture | References Lecture title : Pharyngitis and pharyngeal abscesses Lecturer name: Dr. Sherko Saeed Fathullah Objectives: in this lecture the students will know about common disease in the community (pharyngitis) Acute and chronic specific and non specific pharyngitis as well as acute and chronic pharyngeal abscesses, Pharyngitis and pharyngeal abscesses, & how these conditions can be dealt with. Lecture title : Tonsillitis and adenoids Lecturer name: Dr. Sherko Saeed Fathullah Objectives: Concentrating on acute and chronic tonsillitis with their complications.Tonsillectomy and post operative cares, Peritonsillar abscess, Clinical features of nasopharyngeal tonsillitis, its complication and adenoidectomy, Pharyngitis and pharyngeal abscesses Lecture title : Tumors of the pharynx Lecturer name: Dr. Sherko Saeed Fathullah Objectives: in this lecture will deal with important subject which is tumors of pharynx & its include Tumors of the nasopharynx Tumors of the oropharynx Tumors of the laryngopharynx Lecture title : Misceleneous conditions of the pharynx and throat Lecturer name: Dr. Sherko Saeed Fathullah Objectives: including Globus hysterics, palate and pharyngeal palsy, pharyngeal spasm, pharyngeal pouch, trismus, cleft palate and elongated styloid process Lecture title : Neck masses and salivary glands Lecturer name: Dr. Sherko Saeed Fathullah Objectives: in this lecture will discuss Thyroglossal cyst and fistula, branchial cyst, cystic hygroma sternomastoid tumor as well as mumps, submandibular gland calculus and sialography. Student feedback for the subject of a lecture Date: course: year: lecturer: title: No. Evaluation Questions Score (1 - 5) Subjective Remarks The objectives and key messages of the subject were 1 clear The contents of the subject were useful and related 2 to the main objectives of the course 3 The materials were prepared carefully as needed The lecturer/ tutor while lecturing tried to analyze 4 the principles, contents and the important points of the subject simply and properly. 5 The lecturer/ tutor while lecturing kept my attention. The lecturer/ tutor came into the classroom on time 6 and was committed to the duration of the lecture. The lecturers behavior in the classroom was calm 7 and respectful The slides used in the lecture were clear and 8 attractive. At the end of the lecture, the lecturer gave the 9 students a chance for questions and comments. His/2011 33 Fifth stage Course Book
  34. 34. OTOLARYNGOLOGY | Examinations. | Types of questions: her answers were complete. The reading sources are new and compatible with 10 the subject. Total score 1 - very bad 2–bad 3–medium 4 - good 5 - verygood Examinations. Types of questions: 1 - short essay. 2 - long essay. 3 - multiple choice questions. 4 - Single choice questions Time of exam. 3 Three hours. The number of questions and marks are variables : The methods of correction of answers depend on key answers of single choice and key for multiple choice questions & its usually that false answer will council the true answer in MCQ (either one for one or two for one) and correction and marks are given accordingly. Advices and directions for all students before and during exams. Read the question twice before answering. Think of the answer before writing. Plan your answer in a separate page before writing it down on the answer paper. Arrange the answer in the form of introduction, contents and the final part so that the student organizes his/her answer Samples of MCQ, Single choice, long and short essays Single choice question middle turbinate is formed by: (….) A. vomer bone (….) B. Ethmoid bone (….) C. Maxilla bone (….) D. All of the above (….) E. none of the above the correct answer is (B) MULTIPLE CHOICE QUESTIONS Regarding carcinoma of the larynx: SCC is the most common pathology Smoking has no any role in incidence Neck mass (lymph node invasion) is more incident with glottis carcinoma Surgery always curative The answers as fallow a. T, b. F, c. F, d. F SHORT ASSAY ON TREATMENT OF ALLERGIC RHIINITIS2011 34 Fifth stage Course Book
  35. 35. OTOLARYNGOLOGY | Examinations. | Samples of MCQ, Single choice, long and short essay ANSWER Treatment: includes allergen avoidance, pharmacotherapy, immunotherapy & surgery which is rarely needed when there is local pathology affecting the regress of the symptoms like septal deviation, turbinate hypertrophy, nasal polyp. Medication include : Antihistamines : these rapidly relieve running, itching, & sneezing, but have little effect on blockage. 1st generation antihistamines (chlorphenramine & diphenhydramine) should be avoided because of sedation effect, its better to use non - sedative 2nd generation like (loratidine, fexofenadine). Topical corticosteroids: these are most effective for treatment of rhinitis especially if started prior to allergen exposure, it reduces inflammation, nasal, eye symptoms & improve sense of smell e.g (mometasone, beclomethasone, fluticasone). Sodium cromoglicate: its weak effective against all rhinitis symptoms but useful for children aged less than 4 years. Decongestant : topically used for reducing nasal obstruction, but increase rhinorroea. Systemic decongestant not effective with systemic side effects. Ipratropium bromide : this atropine –like nasal spray is useful against rhinorrhoea. Systemic corticosteroids : oral steroids used for very sever symptoms during hay fever season. Antileukotrienes : effective against congestion & mucous Production. 8. Nasal douching : Its effective in seasonal rhinitis. 9. Immunotherapy : Indicated in patients with sever symptoms not get response to routine medical treatments. write long assay on an intrinsic rhinitis Answer : Is a non - infective, non allergic condition. Like many diseases whose etiology is obscure, its also termed as perennial rhinitis or vasomotor rhinitis which is still perhaps the commonest term. The term (non allergic rhinitis) is commonly applied to a diagnosis of any nasal condition in which the symptoms are identical to those seen in allergic rhinitis but an allergic etiology has been excluded.These non allergic entities can be broadly be classified as : Idiopathic rhinitis (vasomotor rhinitis, or non allergic non infectious perennial rhinitis) Non allergic occupational rhinitis Hormonal rhinitis Drug - induced rhinitis Other forms (non allergic rhinitis with esinophilia syndrome, rhinitis due to physical & chemical factors, food - induced rhinitis, emotional rhinitis, atrophic rhinitis). unlike allergic rhinitis there are no specific diagnostic tests for non allergic rhinitis & diagnosis is made on the basis of rhinitis symptoms in the absence of identifiable allergy (by allergy skin test), structural abnormality, immune deficiency, sinus disease or other causes. Clinical presentation : there are 6 main symptoms of rhinitis, these are nasal congestion, sneezing, nasal itching, rhinorrhoea, hyposmia & postnasal discharge, of these nasal symptoms significant sneezing & itching are highly suggestive of allergic rhinitis & tend not to occur with intrinsic rhinitis, very marked nasal congestion & significant hyposmia tend to be symptoms of non allergic rhinitis. Rhinitis presenting in childhood is almost invariably of allergic etiology, whereas adult onset rhinitis is more likely to be due to intrinsic rhinitis.2011 35 Fifth stage Course Book
  36. 36. OTOLARYNGOLOGY | Examinations. | External examiner Allergic rhinitis is always associated with nasal eosinophilia (more than 25% of nasal smear cells are eosinophils), whereas non allergic rhinitis (intrinsic rhinitis) may or may not associated with eosinophilia, approximately 1/3 of intrinsic rhinitis patients have nasal secretion eosinophilia, so clinically IR classified into Eosinophilic (obstruction syndrome) & Non - eosinophilic (rhinorrhoea syndrome) groups. The eosinophilic variety of (IR) was characterized by marked nasal congestion, profuse rhinorrhoea, hyposmia, marked inferior turbinate hypertrophy which is mild in the other group& mucoid nasal secretion, also nasal polyposis is more frequent in eosinophilic groups. Rhinorrhoea is profuse in both groups but more in non - eosinophilic group which is a predominant feature. The rhinorhoea group tend to occur in relatively advanced age whereas the nasal obstruction group tend to occur in middle age. Other clinical differences between the 2 groups are marked mucosal thickening frequently occurs in the eosinophlic group which is evident on plain radiological examination of the sinuses, also noted that patient with eosinophilic (IR) frequently have asthma & occasionally aspirin sensitivety, neither of which occurs in the non - eosinophilic (IR) group. One of the most clinically obvious differences is dramatic response of the eosinophilic group to intranasal steroids & poor response of the other group to any therapy apart from anticholinergic agents. ---------------------------------------------------------------------------- --------------------------------------------------------------- External examiner From now on every course should have its own external examiner with identified roles. The one who can play the role of an external examiner should: Have an academic post with the scientific rank of assistant Professor and higher. He/she should be an active, reputable and experienced academic staff in his field or a related field to the course. He/she should have not participated in lecturing or administering of the course. The roles of the external examiner are: Evaluating the contents and the program of the course. Prior to the exam, he /she should contribute to choosing the questions and looking at the ideal answers. Evaluating the process of the examinations: he/she should see all the marked exam papers, then choose randomly nine marked papers: three with high marks, three with medium and three with low marks. Evaluating the students feedbacks He/she should participate in the final meeting of the first round examinations committee and give his assessment on the entire course and the examination process, then to give his opinion about the final results. He/she should participate in the final meeting of the second round examinations committee and should have a main vote on those problems that may face them. Then the lecturer/ tutor in charge will respond to the external examiners questions and will reply officially to all the questions and clarify the reasons.2011 36 Fifth stage Course Book

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