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Study-Unit Description
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CODE MDS4013

 
TITLE Neurology and Ophthalmology

 
LEVEL 04 - Years 4, 5 in Modular UG or PG Cert Course

 
ECTS CREDITS 6

 
DEPARTMENT Faculty of Medicine and Surgery

 
DESCRIPTION The study-unit builds upon the neurosciences, principally neuroanatomy and neurophysiology (Years 1&2). It assumes a knowledge of basic clinical methods (Y3) and addresses clinical neurology, integrated with pathological and therapeutic correlates.

Structure of the programme: A. teaching methods, B. assessment.

A. Teaching methods.

1. Classroom-based integrated teaching sessions aimed at imparting basic principles of neurology. Most of the sessions are case-based and multidisciplinary. The programme of lecture/seminars is designed to address common clinical problems, disease processes, ancillary investigations and priorities in management/rehabilitation.

2. Tutorials: interactive small group teaching sessions aimed to focus on neurological examination, clinical methods, communication and interpretation of investigative data. Whenever possible real patients are involved in teaching. Separate pathology sessions are also delivered.

3. Clinical attachments: specific consultant physicians.

4. Log-book. The Department of Medicine has a proforma electronic logbook that spans the last three years of the course of studies. The logbook, driven by learning objectives and expected competences, gives precise details for the acquisition of clinical skills.

B. Assessment
General aim: test both presence of knowledge and its practical application.

One two-hour paper divided into two sections: 1: twenty multiple-choice questions (50% weighting) and, 2: two case-based questions addressing commonly encountered clinical scenarios (50% weighting).

Objectives of the written examination are twofold: to assess the ability to think critically about diagnosis, pathology and management, including pharmacological aspects and to ensure that the candidate has a satisfactory base of factual knowledge.

The examiners shall determine and document the correct answers to both sections at the time that the papers are set. The multiple-choice paper shall be marked on the ‘negative-marking’ principle, awarding one mark for every correct answer and deducting one mark for every incorrect answer. The weighting of each section is subdivided proportionately.

Study-unit Aims

1. To introduce clinical neurology to students who have already acquired proficiency in clinical neuroanatomy, clinical neurophysiology, general pathology and basic clinical methods.
2. To present an integrated approach involving the clinical disciplines, pathology and clinical pharmacology as a reflection of actual day-to-day clinical practice.
3. To provide guidance for the acquisition of knowledge of the theory of neurology and its application in a clinical setting.
4. To provide an order of priority and a theoretical complement to the acquisition of clinical skills.
5. Provide details on the mode of action and clinical use of various classes of drugs used in the specific medical conditions in neurology: epilepsy, Parkinson’s, Alzheimer's and other movement disorders.
6. Use formal lectures and tutorials to enhance case based learning and provide an understanding of drug safety.

Learning Outcomes

1. Knowledge & Understanding:

By the end of the study-unit the student will be able to:
1. apply the knowledge gained through the study of neuroanatomy and neurophysiology to clinical neurological practice.
2. access information sources and carry out an appropriate literature search.
3. critically appraise published medical literature.
4. use information technology including hospital based electronic sources such as iSoft, PACS and census databases.
5. show an understanding of the basic principles involved in clinical pharmacology and therapeutics specific classes of drugs specifically neurology: epilepsy, Parkinson’s, Alzheimer's and other movement disorders;
6. describe the various scientific principles underlying the actions and uses of these specific classes of drugs in the clinical setting.
7. recognize the importance of understanding the mode of action and clinical use of these classes of drugs.
8. list the clinical principles involved in the selection of these classes of drugs to the individual patient.
9. predict and outline the concept of individualized drug therapy in use of these classes of drugs.
10. describe the aetiology, risk factors, pathogenesis and morphology of infections and tumours of the central nervous system and eye infections;
11. outline the clinical consequences and complications of infections and tumours of the central nervous system and eye infections;
12. describe the types of laboratory tests available for clinical diagnosis of infections and tumours of the central nervous system and eye infections.

2. Skills:

By the end of the study-unit the student will be able to:
1. communicate with a patient by taking a structured neurological history.
2. carry out a comprehensive neurological examination.
3. perform fundoscopy and interpret the findings in a clinical context.
4. assess a patient’s mental status.
5. plan and interpret appropriate investigations.
6. match appropriate drugs to a specific clinical context.
7. assess psychological and social factors and the impact of illness.
8. devise and discuss the rationale and practicalities of a basic management plan, including rehabilitation.
9. discuss the theoretical aspects of diagnosis, possible complications and management options.
10. show an understanding of the knowledge of the mode of action of drugs to specific clinical scenarios in the use of specific classes of drugs specifically neurology: epilepsy, Parkinson’s, Alzheimer's and other movement disorders; forensic medicine; Drugs and public health: paediatrics.
11. show an understanding of the basic pharmacological principles in prescribing decisions for these classes of drugs
12. predict inter-patient variability with respect to drug response in these classes of drugs
13. explain the selection of differing drug therapies in these drug classes for the individual patient.
14. interpret common symptoms and signs in terms of possible underlying pathology in infections and tumours of the central nervous system and eye infections;
15. correlate the use of simple diagnostic laboratory tests with clinical and morphological features of disease;
16. choose the appropriate laboratory tests to confirm diagnosis and interpret the result;
17. choose the best antibiotic therapy for microbiological infections.

Main Text/s and any supplementary readings

Textbooks as suggested for the whole three-year teaching programme in medicine. No specific books on neurology are suggested:

1. Clinical Medicine. Parveen Kumar & Michael Clark, Saunders, 8th Edition, 2012. Chap 22, Neurological Disease. Jarman P ed.
2. Macleod's Clinical Examination. Graham Douglas, Fiona Nicol, Colin Robertson. Churchill Livingstone. 12th Edition, 2009.
3. Oxford Handbook of Clinical Medicine. Murray Longmore, Ian Wilkinson, Edward Davidson, Alexander Foulkes, OUP. 8th Edition, 2010.

Pathology Text Books as suggested for All Pathology teaching Year 1-5.

Recommended:

Systematic Pathology (and Haematology)

1. Muir’s Textbook of Pathology, Ed by DA Levison, R Reid, AD Burt, DJ Harrison, S Fleming, 14th Edition, ISBN 9780340740620, Hodder Arnold, 2008.
and
2. General and Systematic Pathology, P Bass, S Burroughs, N Carr, C Way, 3erd Ed, Master Medicine, ISBN-10: 0080451292, ISBN-13: 978-0080451299, Churchill Livingstone, 2008.

Microbiology

1. Medical Microbiology and Infection, T Elliott, H Osman, M Gill, T Warthington, 4th Edition, ISBN-10: 1405129328, ISBN-13: 978-1405129329, Blackwell, 2007 [also a Kindle edition, 2012].
and
2. Clinical Oriented Cases in Microbiology, Hilary Humphreys & William Irving, 2nd Ed, ISBN 0198515855, Oxford University Press, 2004.
and
3. Basic Concepts of Infection Control www.theific.org

Alternative texts:

1. General and Systematic Pathology, JCE Underwood, 5eth Edition, ISBN-10: 0443068887, ISBN-13: 0443068881, Churchill Livingstone, 2009.
or
2. Robbins Basic Pathology, V Kumar, A K Abbas, N Fausto, JC Aster, 9eth Edition ISBN-10: 1437717810, ISBN-13: 978-1437717815, Saunders, 2012.
and
3. Notes on Medical Microbiology (Paperback), MC Timbury, C McCartney, B Thakker, KN Ward, ISBN 0443071640 or latest edition, Churchill Livingstone.

Additional Resources:

1. Pathology Illustrated, R Reid, F Roberts, E MacDuff, 7eth Edition, ISBN-10: 0702033766, ISBN-13: 978-0702033766, Churchill Livingstone, 2011.
2. Robbins and Cotran Review of Pathology, EC Klatt, V Kumar, 3rd Edition, ISBN9781416049302, Saunders, Elsevier, 2010.

Reference Texts:

1. Robbins and Cotran Pathologic Basis of Disease, V Kumar, A K Abbas, N Fausto, J C Aster, 8eth Edition ISBN-10 1416031219, ISBN-A3 1416031215, Saunders, Elsevier, 2009.
and
2. Medical Microbiology, Greenwood D, Slack RCB, Peutherer JF, Barer MR, 17eth Edition, ISBN-10: 0443102090, ISBN-13: 978-0443102097, Churchill Livingstone, 2007.

Online resources:

http://emedicine.medscape.com/
http://www.medicalstudent.com/
http://library.med.utah.edu/WebPath/webpath.html

Recommended Clinical Pharmacology text books:

1. Humphrey P. Rang HP, Dale MM, Ritter JM, Flower R. Rang & Dale's Pharmacology. Churchill Livingstone. 6th Ed.
2. Grahame-Smith D, Aronson J. Oxford Textbook of Clinical Pharmacology and Drug Therapy. Oxford University Press. 3rd Ed.
3. Bennett PN, Brown MJ. Clinical Pharmacology. Churchill Livingstone. 10th Ed.
4. British National Formulary. Pharmaceutical Press.

Reference/Additional

1. Brunton L, Lazo J, Parker K. Goodman & Gilman's The Pharmacological Basis of Therapeutics. McGraw-Hill Medical. 11th Ed.
2. Waller DG, Renwick AG, Hillier K. Medical Pharmacology and Therapeutics. Saunders. 3rd Ed.

Lecture notes

1. Reid JL, Rubin PC, Walters MW. Clinical Pharmacology and Therapeutics (Lecture Notes). Blackwell. 7th Ed.
2. Neal MJ. Medical Pharmacology at a Glance. Wiley-Blackwell. 6th Ed.

 
STUDY-UNIT TYPE Lecture, Independent Study & Placement

 
METHOD OF ASSESSMENT
Assessment Component/s Resit Availability Weighting
MCQ & Examination (2 Hours) Yes 100%

 
LECTURER/S Josanne Aquilina
Nicola Aqulina
Christopher Barbara
Charmaine Chircop
Thomas Fenech
Martin Francalanza
Jan Janula
Franco Mercieca
Janet Mifsud
Charles Scerri
Malcolm Vella
Mario Vella
Norbert Vella

 
The University makes every effort to ensure that the published Courses Plans, Programmes of Study and Study-Unit information are complete and up-to-date at the time of publication. The University reserves the right to make changes in case errors are detected after publication.
The availability of optional units may be subject to timetabling constraints.
Units not attracting a sufficient number of registrations may be withdrawn without notice.
It should be noted that all the information in the study-unit description above applies to the academic year 2017/8, if study-unit is available during this academic year, and may be subject to change in subsequent years.
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