Gastrointestinal and Genitourinary System

At the end of this course, students should be able to: 1. describe the epidemiology and aetiology of diarrhoea; 2. explain the pathophysiology of watery diarrhoea dehydration and rehydration; 3. describe the assessment of the patient with diarrhoea; 4. list complications of diarrhoea diseases; 5. discuss treatment of dehydration in patients (iso, hypo, hyper natraemic), hypo kalaemia and base deficit /acidosis; 6. explain the association between diarrhoea and malnutrition; 7. enumerate the strategies for control and prevention of diarrhoea; 8. describe review of physiology of fluid distribution and electrolytes in children; 9. list the fluid types and uses in paediatrics; 10. describe the principle of fluid therapy in paediatrics; 11. differentiate dehydration and other disorders of fluid in paediatrics; 12. enumerate the common electrolyte disorders in children and how to correct them; 13. differentiate acid base balance and disorders; 14. define UTIs; 15. enumerate the aetiology, risk factors, and different forms of presentation of UTIs; 16. discuss the pathogenesis of UTIs; and 17. describe the diagnosis and management of UTIs.

Gastrointestinal system. Diarrhoea, definition, mechanisms of diarrhoea, classification of diarrhoea. Aetiology, clinical features, evaluation, complications, treatment and prevention. Vomiting in children, causes, evaluation of a child with vomiting, complications, treatment. Fluid imbalance, peculiarities of fluid and electrolyte homeostasis in children. Dehydration, types of dehydration, severity of dehydration. Assessment of hydration status of children. Complications of dehydration. Management. Electrolyte imbalance, causes of electrolyte imbalance in children. Clinical features and management of various types of electrolyte imbalance- hyponatraemia, hypernatremia, hypokalaemia, hyperkalaemia, acidosis, alkalosis, hypochloraemia, hyperchloremia. Oral rehydration therapy, what is ORT, mechanism of action of ORT, types of ORT. Composition of ORS and its uses. Jaundice, definition, causes. Evaluation of a child with jaundice. Hepatitis, definition, aetiology, acute and chronic hepatitis. Hepatic encephalopathy, clinical manifestations, interpreting laboratory features, complications, treatment and prevention. Intestinal parasites, types, life cycle, modes of transmission, clinical features, impact of intestinal parasites on child health, complications, treatment and prevention. Abdominal pain. Acute abdomen. Chronic abdominal pain, aetiology, evaluation of a child with abdominal pain. Interpreting laboratory and imaging studies, Treatment. Malabsorption, definition, classification, diseases associated with malabsorption, consequences of malabsorption, evaluation, investigating children with malabsorption of carbohydrates, fats, proteins and other nutrients, treatment. GIT bleeding, classification, upper and lower GI bleeding. Evaluation and resuscitation of a child with GI bleeding, treatment. Oedema and ascites, pathophysiology, aetiology, evaluation, management. Genitourinary, evaluation of urogenital system, brief anatomy and physiology of the urogenital system, history suggestive of disorders of the system, examination of the urogenital system, examination of the urine, investigations required in evaluating urinary 117 system disorders. Evaluation of the glomerular filtration rate. Nephritic and nephritic syndrome, definition of nephrotic syndrome, Pathogenesis of nephrotic syndrome. Aetiology of nephrotic syndrome, clinical features. Work up of suspected cases, management, Complications of nephrotic syndrome, outcome/prognosis. Acute glomerulonephritis (AGN); Introduction with definitions. aetiology of acute glomerulonephritis. Prototype-post- streptococcal AGN, pathophysiology of AGN. Clinical features. work up of suspected cases, Management. Outcome/prognosis. Acute kidney injury and end stage renal disease. Definition of AKI, aetiology and classification of AKI, pathophysiology of AKI, clinical presentation, investigation, management. Chronic kidney disease (CKD) definition, aetiology and classification of CKD, pathophysiology of CKD, clinical presentations. Work up of suspected cases, management. Urinary tract anomalies and infections. Introduction and levels of CAKUTs. Types of CAKUTs, pathogenesis, clinical presentation. Specific types, posterior urethral valves (PUVs) and vesicoureteric reflux (VUR), types, clinical presentations, management. Urinary tract infections (UTIs), definition, aetiology and risk factors for UTIs, forms of presentation. Pathogenesis. Diagnosis of UTI. Management. Haematuria and proteinuria. Pathophysiology, causes, evaluation, management.