নেত্রকোণা মেডিকেল কলেজ, নেত্রকোণা

Theoritical Part

Overview of Medicine as a discipline and subject

Learning Clinical Approach 1. Doctor- Patient Relationship, Medical Ethics, Patient’s safety. 2. Communication Skills 3. Behavioural Science

Approach to common symptoms of disease:

 General concept of Pain, chest pain and abdominal pain  Fever  Dyspnoea  Cough, expectoration, and Haemoptysis  Anorexia, Nausea, Vomiting, Weight loss and Weight gain  Haematemesis, Melaena, Haematochezia  Diarrhea, Dysentery and Constipation  Edema and Ascites  Jaundice  Syncope and Seizures  Fainting and Palpitations  Headache and Vertigo  Paralysis, movement disorders & disorders of gait  Coma and other disturbances of consciousness  Common urinary symptoms including anuria, oliguria, nocturia, polyuria, incontinence and enuresis  Anaemia and Bleeding  Enlargement of Lymphnodes, Liver and Spleen  Joint pain, neck pain and back ache

Clinical Teaching

Introduction to clinical ward duties and approach to a patient  Art of Medicine  Doctor patient relationship  Different component of history

 Symptom analysis in relation to diseases of different systems:

 Respiratory System  Shortness of breath  Haemoptysis  Cough  Sputum  Chest pain  Fever .CVS  Palpitation  Chest pain  Leg oedema  Shortness of breath GIT Abdominal pain  Haematemesis and Melaena  Loss of appetite  Diarrhoea & Constipation  Haematochezia  Nausea, Vomiting  Weight loss  Difficulty in swallowing Hepatobiliary  Jaundice  Abdominal swelling  Impaired consciousness Rheumatology  Multiple joint pain  Monoarticular joint pain Nervous System  Loss of consciousness  Fit or convulsion  Syncope  Paralysis  Headache  Vertigo Urinary System  Puffiness of face  Oliguria & anuria, Polyuria  Dysuria  Incontinence  Nocturnal enuresis  Loin pain  Pus per urethra Endocrine System  Swelling of neck  Weight gain  Weight loss Haemopoetic system  Pallor  Bleeding Other  Tropical and infections diseases

• General examination

 Appearance Facies  Built  Nutrition  Hydration status  Decubitus  Anthropometric measurement  Anaemia, Jaundice, Cyanosis  Clubbing, Koilonychia, leukonychia  Oedema, Dehydration, Pulse, BP, Temperature, Respiration  JVP  Lymph node  Thyroid, salivary gland  Skin, Hair, Nail  Skin (Petichae, purpura, echymosis, bruise, haematoma, rashes), pigmentation etc  Hair distribution  Nail  Breast  Eye – Proptosis

• Systemic examination

CVS  Pulse, BP, JVP  Pericardium  Inspection  Palpation  Percussion  Auscultation of heart  Auscultation of lung base  Related G/E of CVS e.g. clubbing, cyanosis,edema. Respiratory System  Respiration rate /Type  Inspection  Palpation  Percussion, Auscultation  Examination of sputum  Lung function test  Pleural fluid aspiration

Nervous System  Higher mental function  Co-operation  Appearance  Level of consciousness  GCS  Memory  Speech  Orientation of time, space, person  Hallucination, Delusion, Illusion  Cranial nerves. (1st -12th )  Motor function  Sensory function  Gait  Signs of meningeal irritation  Examination of peripheral nerves  Involuntary movement

CSF Study

Ophthalmoscopy  Ophthalmoscope

Rheumatology  Joints  (Look & feel)  Inspection  Palpation  Movement

Muscle  Wasting  Swelling

Skeleton  Survey

GIT  Inspection of oral cavity & oropharynx  Abdomen Inspection / Palpation  Test for ascites  Percussion/ auscultation  Per-rectal examination  Examination of stool, vomitus, groin, genitalia, perianal region  Aspiration of peritoneal fluid

Urinary system  Kidneys  Bladder  Uretheral orifice  Urine analysis

Haemopoetic system

Tropical and infectious illness

Animal bite – snakebite, dog bite