The
Gastrointestinal and Nutritional
Health Problems

FOLDER 4

LEARNING OBJECTIVES

General Learning Objectives
Clinical Competency
Biological Foundation and Basis of Clinical Management

GENERAL LEARNING OBJECTIVES

At the end of the course, the student must be able to:

1. Write an overview and a personal perspective on Gastrointestinal and Nutritional Disorders in general and specific Gastrointestinal and Nutritional Disorder in particular, as a global, national and local health problem.

2. Manage any patient presenting with a Gastrointestinal and Nutritional Disorder.

2.1 Demonstrate skills in

2.1.1 Establishing rapport
2.1.2 Clinical diagnostic process
2.1.3 Paraclinical diagnostic process
2.1.4 Treatment process
2.1.5 Giving advice
2.1.6 Making referrals

2.2 Demonstrate qualities of an effective, efficient, and humane physician.

2.3 Discuss/explain the biological foundation and basis of the clinical management of a patient with a Gastrointestinal and Nutritional Disorder.

3. Discuss the following issues on Gastrointestinal and Nutritional Disorders:

3.1 Clinical management issues
3.2 Psychosocial or behavioral issues
3.3 Bioethical issues
3.4 Medicolegal issues

4. Conduct a public health education program on the prevention and early detection of Gastrointestinal and Nutritional Disorders.

5. Perform a research activity on Gastrointestinal and Nutritional Disorders.

6. Formulate a community health plan on the Gastrointestinal and Nutritional Disorders.

7. Pass examinations on Gastrointestinal and Nutritional Disorders.

CLINICAL COMPETENCY

General Clinical Competencies:

A primary health care physician must be able to manage any patient with a Gastrointestinal and Nutritional Disorder.

He/She must be able to:

1. Outline the goals in the management.

2. Demonstrate skills in:

2.1 Establishing rapport.
2.2 Clinical diagnostic process.
2.3 Paraclinical diagnostic process.
2.4 Treatment process
2.5 Giving advice.
2.6 Making referrals.

3. Demonstrate qualities of an effective, efficient, and humane physician.

Specific clinical competencies:

Given actual and simulated patients with a Gastrointestinal and Nutritional Disorder, a primary health care physician must be able to:

1. Diagnose the presence of the Gastrointestinal and Nutritional Disorder (and its kinds and causes) through interviewing and examining.

2. Decide on how to stop the Gastrointestinal and Nutritional Disorder process, if possible.

3. Determine the severity of the Gastrointestinal and Nutritional Disorder and how it will affect management.

4. Determine indications for cardiopulmonary resuscitation. If indicated, perform.

5. Determine indications for ventilatory therapy (oxygen, endotracheal intubation, tracheostomy). If indicated, prescribe.

6. Determine indications for intravenous fluid therapy. If indicated, prescribe the type of fluids, amount, and rate of administration during the first 24 hours after decision.

7. Determine indications for blood therapy. If indicated, prescribe the type of blood, amount, and rate of administration during the first 24 hours after decision.

8. Determine indications for analgesic therapy. If indicated, prescribe the type, dosage, and route of administration.

9. Determine indications for tetanus prophylaxis. If indicated, prescribe the type, dosage, and route of administration.

10. Determine indications for antibiotic therapy. If indicated, prescribe the type, dosage, and route of administration.

11. Determine indications for paraclinical diagnostic procedures. If indicated, advice on selection.

12. Advice on treatment, on options, and selection.

13. Determine indications for hospitalization. If indicated, write an admitting order.

14. Determine indications for referrals. If indicated, write a letter of referral.

15. Prescribe an outpatient/clinic/home treatment.

16. Advice on prognosis and recovery.

17. Advice on preventive and promotive health measure.

18. Perform the following procedures:

1. Establish rapport with the patient and her relatives
2. Interview
3. Perform a physical examination
4. Perform cardiopulmonary resuscitation
5. Establish an intravenous line
6. Administer parenteral medications
7. Prescribe a drug
8. Write an admitting order
9. Write a letter of referral
10. Write a medical certificate
11. Fill up a death certificate

General Learning Objectives
Clinical Competency
Biological Foundation and Basis of Clinical Management

BIOLOGICAL FOUNDATION AND BASIS OF
CLINICAL MANAGEMENT

General Learning Objectives:

A primary health care physician must be able to discuss/explain the biological foundation and basis in the clinical management of a patient with Gastrointestinal and Nutritional Disorders.

Enabling objectives:

A primary health care physician must be able to answer the questions and accomplish the tasks listed below:

Epidemiology

1a. What is a Gastrointestinal and Nutritional Disorders?

1b. How common are Gastrointestinal and Nutritional Disorders as a health problem in the community? Support your answer.

Common/uncommon

Global

National

Local

2a. What are the different types/causes of Gastrointestinal and Nutritional Disorders?

2b. What are the 2 more common types/causes of Gastrointestinal and Nutritional Disorders in the community?

3a. What type(s) of persons (based on age groups, occupations, behaviors, and other factors) are at higher risk for Gastrointestinal and Nutritional Disorders?

3b. What type(s) of social environment (cultural practices, folk beliefs) predispose persons to Gastrointestinal and Nutritional Disorders?

3c. What type(s) of occupations and physical environment predispose persons to Gastrointestinal and Nutritional Disorders?

Pathophysiology

1. Make a diagram of a conceptual framework on the general pathophysiology of Gastrointestinal and Nutritional Disorders.

1.1 Make a diagram of a conceptual framework on the pathophysiology of the different types/causes of Gastrointestinal and Nutritional Disorders.

2. What systems, organs, tissues, and cells are usually involved in Gastrointestinal and Nutritional Disorders (in general and in particular types)? Draw the organs involved.

3. What are the usual functions of the different systems, organs, tissues, and cells that are usually involved in Gastrointestinal and Nutritional Disorders?

4. What are the usual changes in structure that may occur after the different systems, organs, tissues, and cells are involved in Gastrointestinal and Nutritional Disorders (in general and in particular types)?

Usual Changes in Structure (in general terms)

System

Organ

Tissue

Cell

5. What are the usual changes in structure that may occur after the different systems, organs, tissues, and cells are involved in Gastrointestinal and Nutritional Disorders (in general and in particular types)?

Usual Changes in Function (in general terms)

System

Organ

Tissue

Cell

6. How does the human body respond to the Gastrointestinal and Nutritional Disorders, specifically, what are the endocrine, metabolic, and psychologic responses?

7a. Name three possible outcomes that may happen after a person is involved in Gastrointestinal and Nutritional Disorders (in general and in particular types) in the absence of a physician's intervention.

7b. Name three possible outcomes that may happen after a person is involved in Gastrointestinal and Nutritional Disorders (in general and in particular types) in the presence of a physician's intervention.

7c. What are the usual causes of disability in patients with Gastrointestinal and Nutritional Disorders (in general and in particular types)?

7d. What are the usual causes of death in patients with Gastrointestinal and Nutritional Disorders (in general and in particular types)?

CAUSES

DISABILITY

DEATH

Diagnosis

1. What are the usual presenting signs and symptoms of patients with Gastrointestinal and Nutritional Disorders?

2. What are the paraclinical diagnostic procedures (PCD) that are known to be done for patients with Gastrointestinal and Nutritional Disorders (in general and in particular types)? If there are, name at least three. Briefly describe how they are being done. Then, compare them in terms of benefit- risk-cost-availability in the community. Identify an indication for each procedure.

BENEFIT

RISK

COST

AVAILABILITY

PCD1

PCD2

PCD3

Treatment

1a. What are the indications for nonoperative treatment in patients with Gastrointestinal and Nutritional Disorders?

1b. Name at least three forms of nonoperative treatment in patients with Gastrointestinal and Nutritional Disorders.

Briefly describe them and give an indication for each.

2a. What are the indications for operative treatment in patients with Gastrointestinal and Nutritional Disorders?

2b. Name at least three forms of operative treatment in patients with Gastrointestinal and Nutritional Disorders.

Briefly describe them and give an indication for each.

2c. For a particular Gastrointestinal and Nutritional Disorder, enumerate at least three possible treatment procedures (T) or options (both operative and nonoperative). Then compare them in terms of benefit-risk-cost-availability in the community.

BENEFIT

RISK

COST

AVAILABILITY

T1

T2

T3

 

Management Plan, Algorithm, or Protocol

1. Outline the goals in the management of patients with Gastrointestinal and Nutritional Disorders.

2. Write a plan, algorithm, or protocol illustrating the general steps in the management of patients with Gastrointestinal and Nutritional Disorders in general.

3. Write a plan, algorithm, or protocol illustrating the general steps in the management of patients with specific kinds of Gastrointestinal and Nutritional Disorders.

Preventive and Promotive Health Program

1. Based on known risk factors, suggest ways to prevent Gastrointestinal and Nutritional Disorders.

2. Formulate (outline) a preventive and promotive health program on Gastrointestinal and Nutritional Disorders for yourself.

3. Formulate (outline) a preventive and promotive health program on Gastrointestinal and Nutritional Disorders for your community.

Identification of Issues

1. Identify at least one psychosocial factor that may promote occurrence of Gastrointestinal and Nutritional Disorders or that may affect recovery of patients with Gastrointestinal and Nutritional Disorders.

2. Identify at least one bioethical issue that may be encountered in the management of patients with Gastrointestinal and Nutritional Disorders.

3. Identify kinds/causes of Gastrointestinal and Nutritional Disorders that usually have legal implications and then briefly describe the legal implications.

4. Identify at least one medicolegal issue that may be encountered in the management of patients with Gastrointestinal and Nutritional Disorders.

5. Identify at least one personal research question in Gastrointestinal and Nutritional Disorders and briefly state the reasons why you consider it as such.

General Learning Objectives
Clinical Competency
Biological Foundation and Basis of Clinical Management

Course Content