Medicine I

Spring 2006

Elements covered by the Medicine I course. (Images adapted by Tufts OCW.)

This course teaches the dental student basic medicine skills, from History Taking to the Physical Examination. It provides concise practical information about patient assessment, symptoms and signs of common diseases, laboratory tests, and pharmacology and prescription writing.

Year one of a three year medical course for dental students, this course focuses on Patient Assessment, History Taking, Physical Examination, and Introduction to Pharmacology and Prescriptions.

This course provides the following competencies:

• To be able to do a complete medical history, dental history, physical examination and intraoral assessment from a dental and a clinical pathology perspective on a patient in the dental setting.
• To have a basic understanding of the "highest priority illnesses" including some of the symptoms and signs associated with those illnesses.
• To have a good understanding of common antibiotics encountered in dentistry and to have some knowledge of local anesthetics and analgesics used in dentistry.
• To learn the details of prescription writing.
• To learn the art of writing SOAP notes in the patient's record.
• To become aware of the special needs patient, very particularly the victims of domestic violence and patients with disabilities.
• To understand the role of Behavioral Medicine in Dentistry.

The course content of Medicine I is taught at a pace that is perceived comfortably by the student body.  The contents per lecture may thus be completed or carried forward depending upon the student body comfort level with the understanding of the material.

• Oral Pathology: Physical Examination: Slide 7
• The Clotting Pathway
• Dental Physical Examination: Oral Diagnosis
• Mycobacterium Tuberculosis (MTB)
• Oral Pathology: Physical Examination: Slide 32

  Syllabus

  Objectives Determine the patient’s chief complaint. Elicit a chronological account of the patient’s problem. Obtain and evaluate the significant aspects of the patient's prior medical history and experience. Elicit a personal, social and family history from the patient, including marital status, occupation, habits, and behavioral consistencies. Determine and record the physiologic and behavioral status of the patient. Perform a systemic and complete examination of the head and neck area, chest, and extremities. Apply all the steps listed above to access a patient with disabilities or a victim of domestic violence. Have knowledge of anesthetics, analgesics, antibiotics, and commonly encountered drugs. Learn the use of Lexi-Comp Online for evaluation of drugs.

  1. Introduction

  Medicine I is the first year of the three year Medicine Course. It is a very clinically-oriented course. Attendance is not mandatory, but the student is completely responsible for information provided during class and the information in the syllabus.

  The art of patient examination and management can only be learned by constant listening, learning, interacting and applying the information appropriately -- in the preclinical setting now and in the clinical setting later. It cannot be gained solely by cramming. This is the time when you will develop the critical thinking skills which are so necessary for patient assessment.

  2. Topics

  The following topics will be discussed extensively during the course:

  1. Goals and objectives
  2. Course overview
  3. Introduction to patient examination
  4. History taking: overview and method
  5. Symptoms and signs associated with common medical conditions encountered and the pathophysiology associated with those disease states
  6. Cardiopulmonary assessment with demonstration
  7. Neurological assessment with demonstration
  8. Head and neck assessment with demonstration
  9. Extremities and abdomen assessment with demonstration
  10. Assessment of victims of violence, the disabled patient and the role of behavioral medicine in patient assessment
  11. Assessment of normal laboratory texts
  12. Medical physical examination overview and method
  13. Dental: History taking and intraoral examination by a General Dentist and an Oral Pathologist
  14. Prescription writing and endocarditis prophylaxis as recommended by the American Heart Association
  15. Using the Physician's Desk Reference (PDR) for evaluation of drugs
  16. Pharmacology: Anesthetics, analgesics and antibodies

  3. Reading

  Recommended reading should serve as a source of additional information. The recommended reading is:

  • A Guide to Physical Examination & History Taking; Barbara Bates. J.B. Lippincott Co., Publishers.
  • The Merck Manual of Diagnosis and Therapy; Robert Berkow, M.D., Editor-in-Chief. Published by Merck Research Laboratories.

  3.1. Additional Suggested Reading

  • Bates B: A Guide to Physical Examination and History Taking
  • DeGowin E., DeGowin, R: Bedside Diagnostic Examination
  • Harrison: Principles of Internal Medicine
  • Kelley WN. (ed.): Textbook of Internal Medicine
  • Rose L, Kaye, D: Internal Medicine for Dentistry

  4. Exams and Grading

  From time to time during the course, you may be randomly examined on short test questions that will not be graded. This will help you in judging the style of clinically oriented questions that you should become familiar with. This in turn will help decide your best style of learning this material.

  • The Medicine Year 01 course is a two credit course.
  • There will be two exams, each contributing 50% towards the final grade.

    Calendar

    Session	Type	Title
    1	Lecture	Patient Interview: Introduction
    2	Lecture	History Taking: Structure and Contents
    3	Lecture	Physical Examination: Structure and Detailed Discussion
    4	Lecture	Additional Signs, Symptoms, and Conditions: Definitions
    5	Lecture	Anemia: Bleeding Disorders
    6	Lecture	Cardiopulmonary Diseases
    7	Lecture	Endocrine Conditions
    8	Lecture	Fits and Faints
    9	Lecture	Gastrointestinal Dysfunctions and Diseases
    10	Examination	Exam I
    11	Lecture	Lab Tests/Signs and Symptoms of Diseases
    12	Lecture	Viral Hepatitis
    13	Lecture	Hospitalizations
    14	Lecture	Infectious Diseases
    15	Lecture	Kidneys and the Urinary Tract
    16	Lecture	Obstetric History; Likelihood of Pregnancy
    17	Lecture	Musculoskeletal System
    18	Lecture	Neurological
    19	Lecture	Ophthalmic
    20	Lecture	Psychiatric Disorders
    21	Lecture	Violence as a Health Issue
    22	Lecture	Behavioral Medicine
    23	Lecture	Dental Assessment: Physical Examination
    24	Lecture	Oral Pathology: Physical Examination
    25	Lecture	Pharmacology Part I (Antibiotics Review Sheet)
    26	Lecture	Pharmacology Part II
    27	Examination	Exam II