GMC Domains

• THE DOCTOR AS A SCHOLAR
  • TD 8: APPLICATION OF BIOMEDICAL SCIENTIFIC PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: ANATOMY (TD 8.1)
    • Medical knowledge: PHYSIOLOGY (TD 8.2)
    • Medical knowledge: BIOCHEMISTRY (inc. Metabolism) (TD 8.3)
    • Medical knowledge: CELL BIOLOGY (TD 8.4)
    • Medical knowledge: MOLECULAR BIOLOGY and GENETICS (TD 8.5, 8.6)
    • Medical knowledge: PATHOLOGY (TD 8.7)
    • Medical knowledge: CANCER
    • Medical knowledge: IMMUNOLOGY and INFLAMMATION (TD 8.8)
    • Medical knowledge: MICROBIOLOGY and INFECTION (TD 8.9)
    • Medical knowledge: PHARMACOLOGY (TD 8.10)
    • Medical knowledge: NUTRITION (TD 8.11)
    • Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
  • TD 9: APPLICATION OF PSYCHOLOGICAL PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: PSYCHOLOGY (TD 9 a-g)
  • TD 10: APPLICATION OF SOCIAL SCIENCE PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: SOCIOLOGY (TD 10 a-e)
  • TD 11. PRINCIPLES, METHODS AND KNOWLEDGE OF POPULATION HEALTH
    • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH (TD 11 a-j)
  • TD 12; APPLICATION OF SCIENTIFIC METHOD AND APPROACHES TO MEDICAL RESEARCH
    • Medical knowledge: EPIDEMIOLOGY
    • Medical Knowledge: SCIENTIFIC METHOD & RESEARCH
• THE DOCTOR AS A PRACTITIONER
  • TD 13: CARRY OUT A CONSULTATION WITH A PATIENT
    • Clinical skills: HISTORY (TD 13 a-b)
    • Clinical skills: PHYSICAL EXAMINATION (TD 13 c)
    • Clinical skills: MENTAL STATE EXAMINATION (TD 13 d)
  • TD 14: DIAGNOSE AND MANAGE CLINICAL PRESENTATIONS
    • Clinical skills: INTERPRETING FINDINGS AND INITIAL ASSESSMENT (TD 14 a-b)
    • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Clinical skills: SURGERY and ANAESTHETICS (TD 14 g)
    • Clinical skills: SUPPORTING PATIENTS and IDENTIFYING ABUSE and NEGLECT (TD 14 h-i)
    • Clinical Skills: CARE OF PATIENTS AND RELATIVES AT END OF LIFE (TD 14 j)
  • TD 15: COMMUNICATE EFFECTIVELY WITH PATIENTS AND COLLEAGUES
    • Clinical skills: INTERACTION WITH PATIENTS (TD 15 a-b)
    • Clinical skills: MANAGING INFORMATION (TD 15 c)
  • TD 16: PROVIDE IMMEDIATE CARE IN MEDICAL EMERGENCIES
    • Emergency Management of Patients (TD 16 b-e)
  • TD 17: PRESCRIBE DRUGS SAFELY, EFFECTIVELY AND ECONOMICALLY
    • Clinical skills: PRESCRIBING DRUGS SAFELY AND EFFECTIVELY (TD 17 a-h)
  • TD 18: CARRY OUT PRACTICAL PROCEDURES SAFELY AND EFFECTIVELY
    • Clinical skills: DIAGNOSTIC PROCEDURES (TD 18 a)
    • Clinical skills: THERAPEUTIC PROCEDURES (TD 18 b)
  • TD 19: USE INFORMATION EFFECTIVELY IN A MEDICAL CONTEXT
    • Clinical skills: EVIDENCE BASED MEDICINE
• THE DOCTOR AS A PROFESSIONAL
  • TD 20: BEHAVE ACCORDING TO ETHICAL AND LEGAL PRINCIPLES
    • Professional issues: ETHICS and LAW (TD 20 a-g)
  • TD 21: REFLECT, LEARN AND TEACH OTHERS
    • Professional Issues: PERSONAL LIMITS OF CARE (TD 21e)
    • Professional issues: LEARNING (TD 21 a-d)
    • Professional issues: TEACHING AND MENTORING (TD 21 f)
  • TD 22: LEARN AND WORK EFFECTIVELY WITHIN A MULT-PROFESSIONAL TEAM
    • Professional issues: WORKING IN TEAMS (TD 22 a-c)
  • TD 23: PROTECT PATIENTS AND IMPROVE CARE
    • Professional issues: DUTIES OF A DOCTOR (TD 23 a-b)
    • Professional issues: MEDICAL FRAMEWORK IN THE UK (TD 23 c)
    • Professional issues: RISK MANAGEMENT and PATIENT SAFETY (TD 23 d)
    • Professional issues: GOVERNANCE, QUALITY MATTERS and AUDIT (TD 23 e)
    • Professional issues: PERSONAL ATTITUDES and SELF CARE (TD 23 f-j)

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TD 14: DIAGNOSE AND MANAGE CLINICAL PRESENTATIONS: Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)

Index

• General Outcomes for Imaging
• General Outcomes for Investigation
• Investigation of Cardiovascular Disorders
• Investigation of Respiratory Disorders
• Investigation of Haematological Disorders

• General Outcomes for Imaging
  • General Outcomes for Imaging
    1. Describe the uses of, and the differences between, the following medical imaging techniques: plain (X-Ray) films; computerised tomography (CT); magnetic resonance imaging (MRI).
    2. Identify components of body systems and structures in several common types of medical images: ultrasound; X-Ray, CT-Scan; MRI-Scan; compared with anatomical pictures and the CAL packages
    3. Discuss why knowledge of anatomy is vital to appreciate the applications of imaging to medicine.
    4. Discuss the use of contrast: Barium, iodine, gadolinium.
    5. Be able to interpret a bone scan with supervision
  • Endocrine Imaging
    1. Principles of diagnostic endocrine and radiological tests for Acromegaly
    2. Outline the laboratory and radiological investigation of suspected Conn's syndrome, phaeochromocytoma and acromegaly
  • Breast Imaging
    1. Appreciate the mammographic appearance of impalpable lesions
    2. Recognise the role of ultrasound, mammography and cytology
    3. Be able to interpret a bone scan with supervision
    4. Be able to interpret mammograms (with supervision)
  • Respiratory Imaging
    1. Describe the basic features of a normal chest X-ray.
    2. Explain the basic anatomical changes in some common lung pathologies and how they are identified in a chest X-ray.
    3. Describe a normal chest x-ray, and compare this with chest x-rays from patients with lung cancer, tuberculosis, Chronic Obstructive Pulmonary Disease and pneumothorax (CR2)
    4. Describe the typical X-ray features of lobar pneumonia, bronchopneumonia and atypical pneumonia
  • Cardiovascular Imaging
    1. Understand the efficacy of cardiac imaging techniques, e.g. echocardiography, coronary angiography. (CR2)
    2. Identify the basic features of a normal mediastinal silhouette and the basic features of cardiac pathologies in chest X-rays (CR2)
    3. Understand the ECG and echocardiography findings in patients with pericardial effusion and constrictive pericarditis/cardiac tamponade (CR3)
  • Renal and Urinary Tract Imaging
    1. Be able to describe the investigations available to establish a diagnosis of renal tract malignancy including urine cytology, endoscopy and imaging
    2. Demonstrate the anatomy of kidneys, ureters and bladder using radiological imaging: CT MRI and IV pyelograms (MET2)
  • Gastrointestinal Imaging
    1. Define endoscopy
    2. Give examples of the use of endoscopy in diagnosis and therapy
    3. Outline requirements for a successful endoscopic system
    4. Be able to understand the appropriate radiological investigations required when diagnosis acute/chronic liver disease
    5. Know the imaging modalities available to interpret cause of large bowel obstruction (MET3A)
    6. Be able to interpret plain abdominal X-Rays showing large bowel obstruction (MET3A)
    7. Know the role of imaging in the diagnosis of appendicitis (MET3A)
    8. Know the role of Ultrasound, CT and ERCP in the management of acute pancreatitis
    9. Understand the role of ultrasound in a patient with obstructive jaundice (MET3A)
    10. Understand the role of ERCP in a patient with obstructive jaundice (MET3A)
    11. Know the appropriate imaging in the investigation of acute abdominal pain including: plain radiography (erect chest X-Ray and abdominal X-Ray), abdominal ultrasound scan, CT scan, contrast studies (MET3A)
    12. Know the radiological investigations available for assessment of a gastrointestinal bleed (MET3A)
    13. Be able to interpret plain abdominal X-Rays showing small bowel obstruction (MET3A)
    14. Be able to recognise the presence of free intra-peritoneal air on plain radiograph and CT Scan (MET3A)
    15. Be able to differentiate between small and large bowel on abdominal X-Ray and CT
    16. Be able to describe radiological tests and findings to confirm diagnosis (MET3A)
    17. Know the role of red cell scanning and interventional radiology in the management of gastrointestinal bleeding (MET3A)
    18. Know the role of computerised tomography (CT) scanning in the management of abdominal trauma
    19. Know the role of focussed abdominal ultrasound in the management of abdominal trauma
    20. Know the role of interventional radiology
  • Neurological Imaging
    1. Demonstrate an ability to distinguish between CT, T1 & T2 weighted images and recognise gross abnormalities (NEURO4, NEURO4)
    2. Describe the different types of neuro-imaging techniques available to investigate the nervous system (GEP/BB)
    3. Define the role of functional imaging in the vegetative state. (BB2)
  • Musculosketetal Imaging
    1. Describe the main features of other imaging modalitites for imaging the skeletal system. (LOC1)
    2. Be able to describe the role of CT and MRI for imaging the soft tissues (LOC1)
    3. Be aware of other imaging modalities for assessing muscle and soft tissue (LOC1)
    4. Understand additional X-Ray based imaging techniques for specialised imaging of the skeletal system (LOC1)
    5. Understand the advantages and disadvantages of X-Rays for imaging the skeletal system (LOC1)
    6. Knows the clinical and radiological features of spondylosis, spondylolisthesis and spondylolysis (MusSkel4)
    7. Can identify the characteristic radiological abnormailities of the common rheumatic diseases including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, pseudogout, psoriatic arthritis and disorders affecting the spine (MusSkel4)
    8. Can describe the main patterns of joint disease in psoriatic arthritis and their radiological features (MusSkel4)
    9. Can identify the characteristic radiological abnormailities, complications and management of the common upper limb fractures, including: Clavicle, Humeral head/neck/shaft, Supracondylar, Olecranon, Radius and Ulnar, and Scaphoid. (MusSkel4)
• General Outcomes for Investigation
  • General
    1. Be able to propose and interpret investigations (based on the results of history taking and physical examination) in the out-patient clinic, emergency room, ward and pre-admission setting
    2. Can propose and interpret appropriate investigations (based on the results of history taking and physical examination) in the out-patient clinic, emergency room and ward setting.
    3. Give examples of the use of endoscopy in diagnosis and therapy
    4. Outline requirements for a successful endoscopic system
    5. Define endoscopy
    6. Be able to request the investigations to establish a diagnosis (MET3A)
    7. Understand the importance of ensuring that investigations proposed are relevant based on the differential diagnosis arrived at through history and examination; fit for purpose and cost-effective for the patient and health service
    8. Be able to understand and interpret the blood tests required to establish a diagnosis
    9. Know how to detect and eradicate H.pylori (MET3A, MET3A)
    10. Know and understand how to investigate a patient presenting with a common malignancy of the elderly, including the ordering and interpretation of relevant (click to see list)
    11. Know and understand how to investigate a patient presenting with common surgical disorders, including the ordering and interpretation of relevant (click to see list)
    12. Know and understand how to investigate a patient presenting with common cardiovascular or respiratory disease, including the ordering and interpretation of relevant (click to see list)
    13. The associated clinical examination and investigations required to complete a clinical assessment of a patient with abdominal disease
    14. Discuss the value of endoscopy and barium examinations in the evaluation of patients with peptic ulcer disease (MET3A)
    15. Know how dysphagia may be investigated.
    16. To understand the investigations for colorectal cancer (MET3A)
    17. Know the diagnostic investigations useful for the diagnosis of acute pancreatitis
    18. Be able to define the triple assessment for colorectal cancer (MET3A)
    19. Outline the investigation of a patient suspected of having inflammatory bowel disease (MET3A)
    20. Know the role of Ultrasound, CT and ERCP in the management of acute pancreatitis
    21. Understand that the diagnosis of a hernia is primarily clinical but certain investigations are available to help delineate the diagnosis
    22. Describe the blood and urine results in appendicitis (MET3A)
    23. Outline the risk of colonic malignancy in IBD; describe the methods used in screening for malignancy in IBD (MET3A)
    24. Know the role laparoscopy in the diagnosis and treatment of appendicitis (MET3A)
    25. Know the available diagnostic investigations in a patient with perforated peptic ulcer (MET3A)
    26. Know the role of laparoscopy in the management of abdominal trauma
    27. Be able to order and interpret relevant investigations for a patient presenting with a fall, including common blood tests, radiology, microbiology,12-lead ECG and rhythm strips.
  • Renal and Urological Investigations
    1. Understand the investigations required to diagnose the underlying predisposition to renal calculi
    2. Understand the investigation of undifferentiated acute uraemia including the place of renal ultrasonography to exlude obstruction and renal biopsy if there is possibility of vasculitis, interstitial nephritis or crescentic glomerulonephritis
    3. Be able to describe the investigations available to establish a diagnosis of renal tract malignancy including urine cytology, endoscopy and imaging
    4. Know the appropriate investigations of patient with nephrotic syndrome
    5. Know the methods for investigating urinary tract infections in children; adult males and females; pregnancy
    6. Understand the importance of proteinuria, how it is measured and its clinical significance
    7. Describe the investigation and management of abnormal renal function in an HIV-infected individual (I&I 4)
  • Endocrine Investigations
    1. Outline the changes in glucose and insulin during an oral glucose tolerance test in normal and diabetic subjects
    2. Use the concept of negative feedback to explain the principles underlying clinical tests for pituitary hormone secretion (GEP/DGM)
    3. To be able to relate diagnostic tests for Cushing's disease to normal physiology
    4. Principles of diagnostic endocrine and radiological tests for Acromegaly
    5. Know the strategy for investigation of endocrine hypertension
    6. List the causes of hypercalcaemia and outline the diagnostic investigations
    7. Distinguish between adrenal failure and pituitary-adrenal failure by means of clinical features assissted by laboratory investigations
    8. Outline the laboratory and radiological investigation of suspected Conn's syndrome, phaeochromocytoma and acromegaly
    9. Describe the initial investigations which help to distinguish cranial and nephrogenic diabetes insipidus and psychogenic polydipsia
    10. Define the role of isotope scanning, ultrasound and fine needle cytology in the investigation of thyroid lesions
    11. Outline the laboratory and radiological investigations which help to distinguish pituitary, adrenal and ectopic causes of Cushing's Syndrome
    12. Understand the difference between fine needle aspiration biopsy, incisional and excisional biopsy and the indications for these. (ENT4)
  • Breast Investigations
    1. Know the relevance and role of tissue diagnosis eg cytology, trucut biopsy of a breast tumour
    2. Recognise the role of ultrasound, mammography and cytology
    3. Recognise the role of biopsy in equivocal cases
  • Sexual Health Investigations
    1. Be able to take microbiological and virological swabs from ano-genital sites which are appropriate to the patient's symptoms and risk factors, and which are appropriate to the medical setting (general practice, A&E, the ward, outpatient clinics)
    2. List the diagnostic tests used (microscopy, culture, urinalysis, pregnancy test) (I&I 4)
    3. List the diagnostic tests used (microscopy, culture, urinalysis) (I&I 4)
    4. List diagnostic tests used (eg microscopy, culture, NAATs) (I&I 4)
    5. Describe what investigations can be performed to establish the causes of subfertility; explain the biological principles involved
    6. List a differential diagnosis for a female patient presenting with vaginal and/or rectal discharge (I&I 4)
    7. List a differential diagnosis patient presenting with urethral or rectal discharge and/or dysuria (including NGU and LGV) (I&I 4)
    8. Identify barriers to testing (from patients and healthcare professionals) (I&I 4)
    9. Describe the tests used in the diagnosis and monitoring of HIV infection including: tests for antibodies to HIV-1 and HIV-2; Tests for the virus itself (viral antigen, viral DNA and RNA, viral subtypes and genetic analysis for resistance mutations); Tests of the immune system (lymphocyte subsets) (I&I 4)
    10. Be able to explain candida infection and bacterial vaginosis (I&I 4)
    11. Describe the investigation of abnormal liver function tests / hepatomegaly in an HIV-infected individual (I&I 4)
    12. Understand a range of testing methods (I&I 4)
    13. Understand treatment options for candida and bacterial vaginosis (I&I 4)
    14. Understand the circumstances in which HIV testing can be performed with out the patient’s consent (I&I 4)
    15. Critically evaluate the utility of individual tests in specific clinical situations including: Diagnosis in chronically infected individual; HIV seroconversion; pregnancy; neonates and children less than 2 years old; patients on antiretroviral therapy (I&I 4)
    16. Describe the range of microbiological/virological tests that are performed at GUM clincis (I&I 4)
  • Obstetric and Gynaecological Investigations
    1. 2. Understand the use of antibodies in analytical methods
    2. Describe what investigations can be performed to establish the causes of infertility (GEP/HD)
    3. Describe what investigations can be performed to diagnose the menopause
    4. Describe what investigations can be performed to diagnose the menopause. (GEP/HD, HD1)
  • Psychiatric Investigations
    1. Know the investigations used in psychiatry and be able to interpret their results. (PSYCH4, PSYCH4)
    2. Substance Abuse and Dependence: Know the investigations undertaken in cases of alcohol and substance misuse (PSYCH4)
  • Neurological Investigations
    1. Describe the role of clinical neurophysiology in the investigation of neurological disease (NEURO4, NEURO4)
    2. Describe the role of clinical neurophysiology in the investigation of neurological disease
    3. Describe the pathology, presentation, investigation and management of peripheral neuropathies
    4. Interpret the following features of CSF – cell count, protein content, glucose content, xanthochromia, oligoclonal bands
    5. Describe the pathology, presentation, investigation and management of motor neuron disease
    6. Interpret the history and examination in order to begin to formulate a differential diagnosis for a patient complaining of dizziness, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate. (NEURO4)
    7. Interpret the presence of oligoclonal bands in CSF (NEURO4)
    8. Interpret the following features of CSF – cell count & xanthochromia (NEURO4)
    9. Interpret the following features of CSF – cell count, protein content, glucose content (NEURO4)
    10. Interpret historical and examination findings in order to begin to formulate a differential diagnosis, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate (NEURO4)
  • Ophthalmological Investigations
  • Musculoskeletal Investigation
    1. List the causes of hypercalcaemia and outline the diagnostic investigations
    2. Understands how to investigate musculoskeletal infection and how to interpret the results including synovial fluid analysis (MusSkel4)
    3. Can describe the diagnositic features of synovial fluid in the common rheumatological disorders (RA, OA, gout) as well infection (MusSkel4)
  • Dermatological Investigations
    1. To interpret and apply results of common investigations employed in dermatological diseases, including skin biopsy, full blood count, ESR, CRP, autoimmune screen, serum biochemistry and skin swab results for mycology and bacteriology. (DERM4)
    2. Describe the relevance of the investigations employed in a patient with Blistering Dermatosis (DERM4)
    3. Describe the relevant investigations required for the following conditions: Erythroderma; Toxic Epidermal Necrosis; Necrotising Fascitiis and Stevens Johnson Syndrome (DERM4)
    4. Describe the relevant investigations for confirmation of the following systemic diseases: Granuloma Annulare; Dermatitis herpetiformis, Necrobiosis lipoidica; Acanthosis nigricans; Splinter haemorrhage; vasculitis, Dermatomyositis; Systemic lupus erythema (DERM4)
    5. Describe the relevant investigations required for the following skin infections: Cellulitis; Impetigo; Fungal infection; Herpes simplex; Herpes zoster; Human papillomavirus and Yeast infections (DERM4)
    6. The above, but also for Erythema nodosum; Erythema multiforme and Pruritus (DERM4)
    7. Describe relevant investigations for a patient presenting with hair loss/gain including: Adrogenetic Alopecia; Hirsutism and Alopecia Areata (DERM4)
• Investigation of Cardiovascular Disorders
  • Cardiovascular Investigations - General
    1. Describe investigations that should be performed in patients with suspected arrhythmias including 24-hour tape and investigation of underlying causes
    2. Describe investigations that can be used to diagnose carotid stenosis (CR3)
    3. Explain how the diagnosis of myocarditis can by confirmed by investigation (CR3)
    4. Describe investigations that can contribute to the diagnosis of rheumatic fever (CR3)
    5. Describe the ECG changes expected in a patient with acute pericarditis and explain how these differ from the changes seen with an MI (CR3)
    6. Describe investigations that can be used to diagnose and monitor an aortic aneurysm (CR3)
    7. Understand the ECG and echocardiography findings in patients with pericardial effusion and constrictive pericarditis/cardiac tamponade (CR3)
    8. Describe investigations that can be used to confirm the diagnosis of angina (CR3)
    9. Describe the relevant investigations to look for causes and complications of hypertension (CR3)
    10. Explain how the diagnosis of infective endocarditis is made and describe the role of investigations including blood cultures and echocardiography in this process (CR3)
    11. Describe investigations that can be used to confirm the diagnosis of congenital heart disease (CR3)
    12. Learn the investigations that should be performed in patients with leg ulcers and explain how these will help with patient management (CR3)
    13. You should have an understanding of the 12-lead ECG, including lead placement and general principles behind what it assesses. (CR2)
    14. Learn the investigations that should be performed in a patient with unstable angina and describe the expected findings (CR3)
    15. Learn about ECG findings expected in patients with these cardiac valve defects (CR3)
    16. Describe the emergency investigation of a patient with acute limb ischaemia (CR3)
    17. Describe the emergency investigations to confirm the diagnosis of MI (CR3)
    18. Describe investigations that can be used to confirm the diagnosis of renal artery stenosis (CR3)
  • Electrocardiograph (ECG)
    1. Set up and record a 12 lead ECG from a normal subject
    2. State which measurements should be made from an ECG trace and how to make them
    3. Perform basic rhythm analysis from an ECG
    4. Recognise the following rhythm disturbances: PAC, atrial flutter, PVC.
    5. Perform basic conduction analysis from an ECG
    6. Describe the significance of the electrical axis of the heart and show qualitatively how to calculate its angle.
    7. Recognise the following conduction abnormalities: 1st degree AV block, 2nd degree AV block, complete AV block.
    8. Recognise ventricular tachycardia and ventricular fibrillation from an ECG record.
    9. Recognise the changes that can occur to the waveforms of an ECG during an MI.
• Investigation of Respiratory Disorders
  • Respiratory Investigations - General
    1. Describe investigations used to confirm the diagnosis of pneumotharax (CR3)
    2. Outline investigations that can be used to confirm the diagnosis of pulmonary hypertension (CR3)
    3. Describe findings on arterial blood gas analysis in Type 1 and 2 respiratory failure
    4. Describe investigations that can be used to confirm the diagnosis of interstitial lung disease
    5. Describe how pleural aspiration is performed and list analyses that should be performed on fluid obtained (CR3)
    6. Describe investigations that can be used to confirm the diagnosis of asthma including the diagnosis of allergy
    7. Describe investigations used in the diagnosis of lung cancer (CR3)
    8. Describe the role of D-Dimer, CXR, ECG, V/Q scanning, Spiral CT scanning and pulmonary angiogram in the diagnosis of pulmonary embolus (CR3)
    9. Describe how investigations are used to confirm or refute the diagnosis of a deep vein thrombosis (CR3)
    10. Describe investigations that can be used to confirm the diagnosis of asbestos-related lung disease (CR3)
    11. Describe the role of spirometry in diagnosing and measuring the severity of COPD (CR3)
    12. Describe investigations that can be used to confirm the diagnosis of a) pulmonary and b) extra-pulmonary sarcoidosis (CR3)
    13. Learn about bronchoscopy in general and its usefulness in the diagnosis of lung cancer and other conditions (CR3)
    14. Describe the purpose and potential abnormal findings of other investigations including chest X-Ray, full blood count and arterial blood gases in a patient with COPD (CR3)
    15. Describe the relevant investigations of a patient with pneumonia (CR3)
    16. Describe the investigations that can be used to confirm diagnosis of bronchiectasis and cystic fibrosis (CR3)
    17. Learn about VATS (video assisted thoracoscopic biopsy) (CR3)
    18. Describe the investigation of a patient with suspected massive pulmonary embolism (CR3)
    19. Describe the investigation of a patient presenting with an acute exacerbation of COPD (CR3)
    20. Review normal lung function tests, and compare them with abnormal lung function tests from a patient with obstructive lung disease and restrictive lung disease (CR2)
    21. Describe how pleural aspiration distinguishes between an exudate and a transudate and explain why this is important (learn Light's criteria)
    22. Describe how investigations including chest X-Ray, pleural tap, pleural biopsy and CT chest can help to differentiate between causes of effusion
  • Lung Function Testing
    1. Discuss the limitations of current tests and how the technique of performing the tests may affect the results, with understanding of how individuals are compared to equivalent populations.
    2. Explain the importance of lung function testing, especially spirometry, in the diagnosis of lung disease.
    3. Discuss the abnormalities seen in asthma and COPD where there is an obstructive defect, and the patterns of obstruction and restriction and their causes.
    4. Describe the tests for gas transfer and their limitations and value, especially in interstitial lung disease.
    5. Discuss other tests of respiratory function, including exercise testing and their use in assessing operative risk.
  • Investigation - Tuberculosis
    1. Describe the tests required for a diagnosis of tuberculosis.
• Investigation of Haematological Disorders
  • Haematological Investigation - General
    1. Outline the clinical manifestations and investigation of a patient with lymphoma
    2. Understand the basic screening tests used to investigate a bleeding disorder (CR3)
    3. Outline the investigation and management of vitamin B12 and folate deficiency (CR3)
    4. Know the relevant blood tests to determine cause of jaundice (MET3A)
  • Anaemia - Investigation
    1. Evaluate a patient with suspected haemolytic anaemia using clinical and laboratory assessment.
    2. Outline the clinical and laboratory aspects of iron deficiency.
    3. Differentiate, by laboratory tests, between the anaemia due to iron deficiency and the other causes of microcytic anaemia.

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