Diploma in Clinical Toxicology - Ain Shams Universitymed.asu.edu.eg/uploads/med/toxicology_diploma...experience. This handbook presents information guide and logbook activity of the

FFaaccuullttyy ooff MMeeddiicciinnee AAiinn SShhaammss UUnniivveerrssiittyy

PPoossttggrraadduuaattee SSttuuddiieess

Diploma in Clinical Toxicology السموم األكلينيكيةفى الدبلوم درجة

Program Code: FT910

Program Guide and Logbook

2

C a n d i d a t e C u r r i c u l u m v i t a e

[Name]

Please attach your recent photo photo here.

[telephone no]

[mobile no]

[mailing address]

[email address]

[postcode]

Experience

[organization]

[your present job title]

[start date]

[location]

[responsibilities]

[organization]

[previous job title]

[start and end date]

[location]

[responsibilities]

3

[organization]

[previous job title]


[location]

[responsibilities]

Education

[certificates]


[school or college]

4

Training

[any other training that will be useful in your job]

Filled by post graduate authorities

Date of Registration

First semester _______________________

Second semester _______________________

Third semester _______________________

Fourth semester _______________________

5

TABLE OF CONTENTS: Page

I – Welcome

II - Mission Statement

III – Academic advisor and affiliated departments and Hospitals

IV – Program specifications

1 - Basic Information

2 - Professional Information

3 – Academic standards

4 – Curriculum structure and contents

5 - Program courses.

6. Program admission requirements

7. Regulation for progression and program completion

8. Appendix: course specifications

Pharmacology course specification

Ethics of medical aspects course specification

Internal medicine course specification

Medical Responsibilities and Malpractice in Clinical Toxicology course

specification

General toxicology course specification

Systemic toxicology course specification

Intensive care of poisoned patients course specification

Treatment of Drug Dependence and Practical Program of

Analytical Toxicology course specification

Elective courses

Medical statistics course specification

Computer course specification

Immunology course specification

V - General information

VI – Your log book

1 – Introduction

2 – Supervisors

3 - Tables for training records

4 – Log book preview

VII - Head of department approval for the exam entry

Detachable forms:

VIII – Thesis follow up

IX - Evaluation forms

6

I – Welcome Statement:

The Department of Forensic Medicine and Clinical Toxicology welcomes you to

the Diploma of in Clinical Toxicology. As a department, we are committed to

medical student education and continuously strive to improve your educational

experience.

This handbook presents information guide and logbook activity of the Diploma of

Clinical Toxicology, Faculty of Medicine, Ain Shams University.

II - Mission Statement:

The mission of the Faculty of Medicine, Ain Shams University is

“Preparation of a trained physician, researcher and life long tutor capable of

following standards of medical care and ethics, with managerial and technical

skills in his specialty. Furthermore, promotion outstanding programs of health

care to serve the society, environmental development and targeted scientific

research for continual improvement of health”.

The mission of this degree is to graduate a clinical toxicologist who recognize

the basics, types, mechanisms and varied toxic effects in clinical toxicology.

Furthermore, enough skilled in interpreting diagnostic tools and in management

methods, enough talented to distinguish poisoning from different disease entities,

competent in operating toxicological disasters and developing preventive measures

to protect the community in an ethical way using the current and advanced

guidelines.

III – Senior Supervisor and Affilated Departments and Hospitals

Senior Supervisor

Prof.

-------------------------------

-------------------------------

-------------------------------

E-mail:

Affiliated Departments and Hospitals

Poison Control Center, Ain Shams University Hospitals

Other Hospitals

IV – Program Specifications

A- Basic Information

Program title: Diploma of Clinical Toxicology

Program type: Single

Faculty: Ain Shams University – Faculty of medicine

7

Department: Forensic Medicine and Clinical Toxicology Department

Assistant coordinator: Write the name

Coordinator: Write the name

Last date of program approval:

2 - Professional Information

1. Program aims:

1. Provide learning experiences that promote a broad understanding of the role of

medical toxicology as it relates to other medical disciplines.

2. Develop measurable objectives to assess the progression of the specialist in the

two-year training program.

3. Integrate the sciences applicable to medical toxicology with clinical

experiences in a progressive manner.

4. Provide the specialist in medical toxicology with progressive patient care

responsibilities, commencing with general medical skills and progressing to

complete care of patients in need of toxicological care.

5. Provide training that will enable the specialist in medical toxicology to rapidly

evaluate, initiate treatment, and provide appropriate therapy, and disposition of the

patient.

6. Provide the opportunity to develop the teaching skills of specialists in

emergency medicine in regard to toxicological emergencies.

7. Provide the opportunity to develop the skills necessary for problem solving in

the practice of medical toxicology.

8. Provide the opportunity to develop professional leadership and management

skills.

9. Provide the opportunity to conduct research in medical toxicology.

10. Provide the opportunity to learn to practice clinical toxicology in an ethical

fashion.

2. Intended learning outcomes (ILOs):

1- Knowledge and understanding (K):

By the end of this program the candidate will be able to:

a.1 Demonstrate knowledge in principles of therapeutics; pharmacokinetics,

pharmacodynamics and their application to toxicology, adverse drug reaction and

interactions, principle of drug abuse, drug dependence, drug withdrawal and

tolerance and a practical classification of poisoning

a.2 Demonstrate knowledge in the mechanism of toxicity and usual toxic dose of

common poisons

a.3 Discriminate types of poisoning with the knowledge of the different

toxidromes.

8

a.4 Identify the need for different methods of decontamination and the benefits

and risks of each method.

a.5 Demonstrate knowledge of mechanisms of action ant indications for the

commonly used antidotes

a.6 Recognize and advise patients and their families regarding the general

epidemiology and prevention of poisonings and more specifically inappropriate use

of medications dangerous interactions between medications risks of polypharmacy

and excessive over the counter medications use.

a.7 Demonstrate knowledge in medical, legal, psychiatric and social aspects

of toxicology

a.8 Recognize patient's rights to confidentiality and neutrality in the face of

authorities involvement whilst fulfilling social and legal obligations as per the

medical ethics code and the local regulations.

2- Intellectual skills (IS):

By the end of the program, the candidate will be able to:

b.1. Specify and solve medical dilemmas and complexities.

b.2. Make conclusions and be able to conduct scientific discussion.

b.3. Differentiate different clinical presentations and recognize their emergency

nature.

b.4. Prioritize and tailor the management according to different therapeutic

guidelines to individual situations

b.5. Predict toxicological hazards within a community according to research

studies and cumulated statistics

b.6. Interpret results of investigations for proper diagnosis

3- Professional and practical skills (PS):

By the end of the program, the candidate will be able to:

c.1. Take a focused medical history with proper analysis and conclusions.

c.2. Examine properly and systematically to identify different toxidromes.

c.3. Perform and modify analytical procedures according to given clinical data.

c.4. Interpret toxicological results to reach an accurate diagnosis and design a

treatment plan in reference to therapeutic guidelines and protocols.

c.5. Interpret general medical investigations and use their findings in diagnosis and

therapy.

c.6. Put a diagnosis and differential diagnosis of different cases.

c.7. Write a treatment prescription for a given medical problem within a

multidisciplinary management plan if needed.

c.8. Identify patients needing hospitalization and emergency intervention.

c.9. Identifying patients in need for higher specialization.

9

c.10. Master the different emergency and routine procedures necessary in the

clinical Toxicology specialty.

4- General and transferable skills (GS):

By the end of this program the candidate will be able to:

d.1. Gain communication skills with workers, nurses, juniors, professors, peers,

patients and their care givers.

d.2. Gain communication skills in operating a specialized center for poisoning

treatment and in operating toxicological disasters in cooperation with local

authorities and media

d.3. Master computer skills in research, data base filing and preparation of

presentation.

d.4. Use computer efficiently in solving medical problems.

d.5. Work in team.

d.6. Acquire managerial skills.

3. Academic standards: (Benchmarks)

Programs preparing Board of Medical Toxicology and Diplome d'etudes

superieures de toxicology clinique

4. Curriculum structure and contents:

4 a- Program duration: two years (4 semesters)

4b- Program structure:

اناهح

انكىد انقزراخ انذراسيحانساعاخ

انعتذج

دورج أساسياخ انثحث انعهي يتطهثاخ انكهيح

اندزء األول

FT9101 1 عهى األدويــح

FT9102 1 نطثيـــــحأخالقياخ يارسح انه ا

FT9103 1 انثاطح انعايح

FT9104 1 انسؤنيح انطثيح نحاالخ انتسى و أخطاء األطثاء

FT9105 2 انسىو انعايح

اندزء انثاي

FT9106 6 عهى انسىو انخاصح

FT9107 6 انزعايح انزكزج نحاالخ انتسى

عالج األديا

يحيقزر عهى و تطثيقى نهتحانيم انسFT9108 5

االختياريح انقزراخ

ىاالحصاء انطث يختار انطانة واحذ ي تي: E9009

E9047 استخذاو انكثيىتز 1

E9015 عهى اناعح

6 كزاسح األشطح

36 اندىع

10

5. Program courses:

a. Compulsory

Code Course title No. of hours

L C F SDL

FT9101 Pharmacology course specification

FT9102 Ethics of medical aspects course

specification

FT9103 Internal medicine course specification

FT9104 Medical Responsibilities and Malpractice

in Clinical Toxicology course specification

FT9105 General toxicology course specification

FT9106 Systemic toxicology course specification

FT9107 Intensive care of poisoned patients course

specification

FT9108

Treatment of Drug Dependence and

Practical Program of Analytical

Toxicology course specification

L: Lecture, C: Clinical, F: field and SDL: Self directed learning

b. Elective

Code Course title No. of hours

L C F SDL

E9009 Medical statistics course specification

E9047 Computer course specification

E9015 Immunology course specification

5.1- Program: Diploma in Clinical Toxicology (FT910) : Semester 1

a. Compulsory = 6 CH

6. Program admission requirements:

-: انذتهىو( : يشتزط نقيذ انطانة نهحصىل عهى درخح6) انادج

أ ك زاصال ػه دسخح انثكانسط ف انطة اندشازح ي إزذ خايؼاخ خسح يصش انؼشتح -1

أ ػه دسخح يؼادنح

أ ك لذ أيض عح انرذسة )االيراص( -2

يافمح خح انؼم. -3

(1الن األخضج اعرفاء انغرذاخ انطهتح ف انهسك )ذغذذ انشعو يصاسف انرذسة اعر -4

0انرفشؽ نهذساعح نذج فصه دساع لثم دخل ايرسا اندضء انثا -5

-اناخغرش األساق انرانح :ح مذو طانة اإلنرساق نذسخ ( :1يهحق )

-5انالد أيغرخشج سع. شادج -4شادج اإليراص. -3 0شادج انثكانسط -2 0طهة إنرساق -1

صس فذغشافح 6ػذد -7 0يافمح خح انؼم ػه انرغدم انرفشؽ انطهب -6 0انلف ي انردذ

11

0تانغثح نهافذ مذو انطانة يافمح انغفاسج سذد خح ذسم انفماخ كا مذو شادج صسح -8 0خذذج7. Regulation for progression and program completion

رى انرغدم نهاخغرش يشج ازذج ف انغح ذثذأ ي أل ن زر أخش أغغطظ ػه أ ذثذأ (: 8يادج )

دص لثل ذغدم اناب انؼذ انافذ ف انفرشج ي أل 0انذساعح ف شش أكرتش ي كم ػاو

اندضء األل إال تؼذ إمضاء فرشج انذساعح فثشزر أخش دغثش ػه أال غر نى تذخل إيرسا

.انطهتح

ذصع انذساعح ف كم ػاو خايؼ ػه فصه دساع يذج كم يا خغح ػشش اعثػا . ثذا (: 9يادج )

االل ف أل أكرتش ثذا انثا ف يصف فثشاش. يغ ذظى فصم دساع صف يكثف نذج عرح اعاتغ .

هفصم انذساع لثم اعثػ ي تذار ػه االلم تؼذ إعرفاء انششط زغة انمشساخ رى انرغدم ن

عاػاخ يؼرذج. دص نهطانة ذؼذم 6انغدهح. الثغ أ ضذ انؼةء انذساع ف انفصم انازذ ػ

ساب خالل عر انمشساخ خالل اعثػ ي تذاح انفصم انذساع )تانسزف ا االضافح(. كا دص ن االغ

اعاتغ ي ازذ انمشاسخ د ازرغات ساعثا ف.

: يذج انذساعح نهسصل ػه دسخح انذتهو أ اناخغرش أستؼح ػشش ششا )أستؼح ( 11انادج )

فصل دساعح( ػه خضئ دراص فا انطانة تشايدا ذذسثا يركايال طثما نهغاػاخ انؼرذج انضسح

ال غر ن تذخل اإليرسا لثم األشطح ثاب انشاتغ غرف خالنا انطهب يح ف كرة يراتؼح تان

0إعرفاء ثالثح أستاع انطهب يح ف كم خضء ي انثشايح

دراص تؼذا انطانة ازذ يذج انذساعح ف انذتهو اناخغرش اندضء األل فصم دساع ( :12انادج )

شرشط انداذ ف تانكايم ننإرمال نهذساعح ف اندضء انثا. اندضء انثا رطهة ذفشؽ انطانة إيرساا ال

.تأزذ انغرشفاخ أ انشاكض انؼرذج ي انكهح نذج فصه دساع نهرذسة

مو انذاسط نذسخح اناخغرش ترغدم يضع انشعانح ػه شكم تسث ظش أ ػه تؼذ( : 13يادج )

ػه األلم ػه ي انرغدم إعرفاء فصم دساع ازذ ػه األلم دص أ الش سعانرح تؼذ عرح شس

أ ك لذ در ف يمشساخ اندضء األل تانكايم لثم دخل إيرسا اندضء انثا ال خصص نا

0خ دسخا

م انشعانح يرطهثاخ انكهح لثم مو داسط اناخغرش تإعرفاء يرطهثاخ اندايؼح لثم ذغد( : 14يادج )

يرطهثاخ اندايؼح انسصل ػه شادج انرفم ف انهغح اإلدهضح .دخل إيرسا اندضء انثا

دسخح ػه األلم( يرطهثاخ انكهح زضس دساخ يؼرذج ي ندح انذساعاخ انؼها 450تدع )

انطث أ تإخراص إخرثاساخ خاصح ذسذدا انهدح. اإلزصاء ياح انثسث انؼهتانكهح ف يدال

دص نهساصه ػه دسخح انذتهو إعركال دسخح اناخغرش ترغدم سعانح اناخغرش خالل (: 15يادج )

أستغ عاخ ي انسصل ػه دسخح انذتهو سصم ػه انذسخح تؼذ إعرفاء يرطهثاخ اندايؼح انكهح

يالشح انشعانح تداذ.

انغاػاخ انؼرذج نذساعح انذتهو اناخغرش ثالث عاػح يؼرذج ػه األلم خصص يا (: 16يادج )

ذشم عد عاػاخ ػه األلم نهدضء األل ثا ػششج عاػح ػه يراتؼح األشطح عد عاػاخ نكرة

ضاف إنا عد عاػاخ نهشعانح ف اناخغرش. األلم نهدضء انثا

ذج انمذ نذسخح اناخغرش أستغ عاخ.ي(: 22يادج )

دسخح نهدضء األل. 300دسخح يا 1200يدع دسخاخ االيرسا انائ نهاخغرش (: 24يادج )

دسخح نهاخغرش. 300ه انرشاك تا اص صضاف انا انؼذل انف

ذ إيرسا انذس انثا ف أتشم ؼمذ إيرسا انذس األل ف أكرتش فثش ي كم ػاو ؼم(: 25يادج )

يا ي كم ػاو.

% ي انذسخح 60ك انداذ ف كم يادج ي انذتهو انؼان اناخغرش تؼذ انسصل ػه (: 26يادج )

ك انداذ ف ياد انذكرسا % 50ػه ا ال ذمم دسخح انرسشش ػ انكهح نكم ندا انادج يدرؼح

انشف كم ػه زذج.انرسشش انؼه االكهك % ي دسخح60تؼذ انسصل ػه

12

(: فىى زانىىح إعىىرفار يىىذج انمىىذ كىى نطانىىة انذساعىىاخ انؼهىىا إػىىادج انرغىىدم يىىشج أخىىش ال ؼرىىذ 29)يااادج

تانداذ ف اندضء األل أ انشعانح دة إػادذا.

Assessment Schedule and Weighing of Assessments

Item Mark

Po

ints

GP

A s

core

ةانط

انح

انح

Stu

den

t

sta

te

During

semester

End of

semester Total

First semester (If present) 100 300 400

Second semester 100 100

Third semester 100 100

Fourth

semester

Final exam

Written

900 900

Oral

Practical

/Clinical

Total 300 1200 1500

عهى انىخه انتاني: يهحىظح: تعادل درخاخ انطانة طثقا نهقاط

قاط 4 : % فأكثز 90 -1 A

قاط 3663 : % 90% حتى أقم ي 85ي -2 A-

قاط 3633 : %85% حتى أقم ي 80ي - 3 B+

قاط 3600 : %80% حتى أقم ي 35ي - 4 B

قاط 2663 : %35% حتى أقم ي 30ي - 5 B-

قاط 2633 : %30% حتى أقم ي 65ي - 6 C+

قاط 2600 : %65% حتى أقم ي 62ي -3 C

قاط 1663 : %62% حتى أقم ي 60ي - 8 C-

F صفز : %60أقم ي - 9

( ػهى أعىاط يدىع زاصىم ضىشب مىاط كىم يمىشس يضىشتا فى ػىذد GPAنؼذل انفصه )رى زغاب ا

عاػاذ انؼرذج يمغيا ػه انغاػاخ انؼرذج نهمشساخ انر دسعىا انطانىة فى انفصىم انذساعى. كىا ىرى

( ػهىى أعىىاط يدىىع زاصىىم ضىىشب انمىىاط انرىى زصىىم ػهىىا CGPAانؼىىذل انرشاكىى نهطانىىة ) زغىىاب

ف كم يمشس يضشتا ف ػذد عاػاذ انؼرذج يمغيا ػه يدع انغاػاخ انؼرذج انكهح. انطانة

ىرى اإلػىادج فى أ انىذكرسا اناخغىرش فى انىذتهو أمىشساخ انف زانىح انشعىب فى يىادج أ يدػىح يى

دج فمظ أيا إرا ذكىشس سعىب رى زغاب انرمذش انفؼه انز سصم ػه ف أل إػاانادج أ اندػح فمظ.

ماط ا 1.67% فمظ )ا60فسغة ن ػذ انداذ ذمذش -

C.)

13

C O U R S E S S P E C I F I C A T I O N S

P h a r m a c o l o g y c o u r s e s p e c i f i c a t i o n s University: Ain Shams Faculty: of Medicine

Course specifications

Program on which the course is given: Diploma in Clinical Toxicology (FT910)

Major or minor element of programs: Minor

Department offering the program: Department of Forensic Medicine and clinical

Toxicology

Department offering the course: Department of Pharmacology

Academic level: First year

Date of Specification Approval:


Title: Pharmacology Code: FT9101

Credit Hours: 1 Lectures: 8 h Tutorials:

Clinical: 16 h: Total contact: 24 h

Coordinator:

B - Professional Information

1- Course Aims:

The aim of the course is to assure that the students obtain a thorough

comprehension of the basic pharmacological principles

2- Intended Learning Outcomes (ILOs) from the Course:

a- Knowledge and understanding

By the end of the course the candidate will be able to:

a1. Describe the basic pharmacokinetics of drugs and recognize the bioavailability

and biotransformation of drugs

a2. Describe and explain pharmacodynamic concepts of drug-receptor interaction

to accurately predict drug responses at all levels of biological organization.

a3. Demonstrate the basic mechanisms of drug interactions.

a4. Discuss therapeutic indications and side effects of drugs

b- Intellectual skills


b1. Interpret pharmacological data such as drug levels in the context of

optimizing drug therapy.

14

b2. Apply pharmacological principles in the therapeutic management of

poisoned patients.

b3. Predict the biotransformation and efficacy of metabolites and the

significance of their analysis.

b4. Calculate the area under the curve to estimate the drug concentrations

c- Professional skills


c1- be familiar with the interpretations of drug levels on the basis of absorption,

metabolism and elimination and kinetics

d- General and transferable skills


d.1. Use database to collect material needed for research.

d.2. Gather and organize material on new drugs from various sources

(including library, electronic and online resources).

d.3. Understand the importance of continuing medical education.

3- Course content:

Topics No. of hours

L T C/P SDL

General Pharmacology

Pharmacokinetics 1 1 1

Pharmacodynamics 1 1 1

Mechanism of action of drugs 1 1 1

Routes of drug administration and

Factors modifying drug action

1 1 1

Pharmacological bases of drug

interactions

1 1 1

Adverse drug reactions 1 1 1

Receptor pharmacology 1 1 1

Pharmacogenetic 1 1 1

L: Lecture, T: Tutorial, C/P: Clinical or Practical and SDL: Self directed

learning

. 4 - Student Assessment Methods

4.1 written exam the form of Short essays to assess knowledge and MCQs to

assess knowledge and intellectual skills

Weighing of assessment

4.1 written exam 20

Total 20

15

5 -- List of References

5.1- Course Notes (paper and / or electronic)

5.2- Essential Books (Text Books)

5.3- Recommended Books

5.4- Periodicals, Web Sites, etc

E t h i c s o f M e d i c a l P r a c t i c e c o u r s e s p e c i f i c a t i o n

University Ain Shams Faculty of Medicine

Program on which the course is given Diploma of Clinical Toxicology

(FT910)

Major or minor element of programs Major

Department offering the program Department of Forensic Medicine and

Clinical Toxicology

Department offering the course Department of Forensic Medicine and

Clinical Toxicology

Academic level First year

Date of Specification Approval

A - B A S I C I N F O R M A T I O N

Title Ethics of Medical

Practice Code FT9102

Credit Hours 1 Lectures: 8 h Tutorials: 8 h

Clinical: 8 h Total contact: 24 h

Coordinator

Professional Information

1-Course Aims

The aim of the course is to assure that the students obtain a thorough

comprehension of the basic ethical principles in toxicology practice and in

emergency medicine

2- Intended Learning Outcomes (ILOs)

a- Knowledge and understanding:


c1. Recognize the ethical principles of emergency medicine practice and the

challenges to apply them.

c2. Recognize the ethics rules governing medical practice and issued by the

Egyptian Medical Syndicate.

16

c3. To list different types and limitations of consent in clinical toxicology.

c4. Recognize the medicolegal importance of informed consent and its

limitations.

c5. Describe the confidentiality, fairness and the respect of privacy and dignity

of acutely intoxicated patients and their limitations.

c6. Know how to make full documentations for toxicological patients presented

in emergency room, in-patient unit, intensive care unit and out-patient units.

c7. Describe procedure and limitations to restrain the patients at ICU.

c8. Know the patient rights referring to human rights and lawful legalizations.

2/3 credit hour for knowledge.



b1-Correlate between actions done towards acute intoxicated patients and

malpractice could be done in emergency room, in-patient unit and ICU.

b2- Analyze information given by phone to reach proper decision towards a patient

telephone.

b3- Practice of Emergency and Critical care Medicine in cost conscious manner

b4- Recognize causes of ethical concern in Emergency and critical care

b5- Recognize ethical principles in medical interventions and procedures e.g.

Mechanical Ventilation

This will be achieved by problem oriented sessions.



c1. Demonstrate the procedure and formalities to restrain a patient in ICU.

c2. Write full documentation as regard medical charts; follow up charts for

different intoxicated patients in ER, in-patient unit, out-patient and ICU.

c3. Write a valid consent in different situations and consent needed for discharge a

patient against medical advice.

c4. Write medico-legal reports of acute intoxicated patient.

1/3 credit hour for practical.



d1- Maintain honesty and integrity in all interactions with teachers, colleagues and

others with whom physicians must interact in their professional lives.

d2- Recognize the scope and limits of their role as students as well as the necessity

to seek and apply collaboration with other workers.

d3- Be responsible towards work.

17

III. COURSE CONTENTS:

3- Course content:

Topics No of hours

L T C/P SDL

Medical Ethics 1 Credit Hour

1) Concept of medical ethics 1

2) Ethical principles 2 2 1

3) Ethical principles and limitations in

critical and critical care.

2 2 1

4) Procedures posing special concern in

breaking the ethical principles in emergency

and clinical toxicology practice

1 2

2

5) Rules governing medical ethics in

Egypt

1 1 2

6) Ethical rules in use of drugs and

research

1 1 2

Total 8 8 8


learning.

4- Student Assessment Methods

4.1 Short essays to assess knowledge

4.2 MCQs to assess knowledge and intellectual skills

4.3 Practical/ Clinical exam to assess professional skills and general skills

4.3 Oral exam to assess intellectual, professional and general skills

Weighing of assessments 1 Written examination: 30

2 Practical examination 20

3 Oral examination 10

Total 60






Internal Medicine course specification University Ain Shams Faculty of Medicine


(FT910)


18


Clinical Toxicology

Department offering the course Department of Internal Medicine

Academic level First Year


B- Basic Information

Title Internal Medicine Code FT9103

Credit Hours 1 Lectures: 8 h Tutorials:


Coordinator

C- Professional Information

1- Course Aims

1. Acquire an appropriate background of internal medicine diseases that may

simulate toxicological presentations.

2. Identify and manage medical complications in the context of poisoning

3. Acquire competent practice in general medical examination and develop

skills in differentiating diseases by proper integration of assembled clinical data.

4. Develop the skills to predict and manage possible signs of ominous

system failure and diseases of organs targeted by poisons.

5. Acquire the talent and experience of rapid management of medical

emergencies.


a- Knowledge and understanding (K):


a1. Identify and describe general systemic medical illnesses using the medical

knowledge.

a2. Recognize the elements of evaluation and approach to the patient to

perform proper systemic examination

a3. Identify differentiating clinical points in differentiating metabolic,

structural and toxicological presentations as coma, convulsions, shock, respiratory

failure

a4. Describe the basic investigation tools, their limitations in confirming and

differentiating medical from toxicological illnesses.

a5. Identify differential diagnosis of systemic signs and presentations that

simulate poisoning.

a6. Recognize the medical complications and evolution of general systemic

diseases and follow up guidelines designed in protocols of treatment

19

a7. Identify the therapeutic guidelines and protocols of management of

medical diseases that may concomitantly present in poisoning patient.

a8. Be acquainted with the emergency medical procedures and medications,

their limitations, complications and efficacy in different clinical situations.

b- Intellectual skills (IS):


b.1. Reach clinical diagnosis based on a proper history and general medical

examination to help delineation of toxicological from medical diseases.

b.2. Correlate clinical presentations to pathophysiology of the disease process

b.3. Envisage the evolution of diseases based on the course and detected

prognostic criteria

b.4. Correlate clinical and laboratory findings that differentiate medical and

toxicological illnesses.

b.5. Depict dangerous signs that endanger patient life and correlate them to

medical or toxicological pathology.

b.6. Design rapid and emergency plan of treatment depending on the detailed

presented clinical and laboratory data, especially in critical presentations.

b.7. Design multidisciplinary treatment plan in poisoned patient suffering

medical complication.

c- Professional skills (PS):


c.1. Perform clinical examination especially to the cardiovascular, respiratory,

renal, neurological, and gastrointestinal systems.

c.2. Acquire the skills and perform the procedures necessary for the

evaluation, differentiation, and care of patients with shock and or respiratory

failure

c.3. Acquire the skills to differentiate metabolic, toxicological and structural

brain lesions in cases presenting with coma, convulsions and agitation or altered

behavior

c.4. Acquire the skills necessary for the evaluation, differentiation, and care of

patients with renal, hepatic failure as toxic versus viral fulminant hepatitis, prerenal

versus organic renal failure

c.5. be familiar with the interpretations of imaging: e.g., Plain radiography,

ultrasound, Computed Tomography (CT), Magnetic Resonance Imaging (MRI),

etc.

20

2- General and transferable skills (GS):


d.4. Maintain honesty and integrity in all interactions with teachers, colleagues

and others with whom clinical toxicologist must interact in their professional lives.

d.5. Recognize the limits of their role as toxicologist as well as the necessity to

seek and collaborate with other workers.

d.6. Use database to collect material needed for research.

d.7. Gather and organize material from various sources (including library,

electronic and online resources).

d.8. Understand the importance of continuing professional development.

d.9. Demonstrate ethical medical practice and envisage honesty, fairness and

respect to the patient and families / friends.

d.10. Work cooperatively and show respect for other opinions.

3- Course content

Topics No of hours

L T C/P SDL

Internal Medicine 1 Credit Hour

1) General Clinical Examination 2

2) Neurological diseases:

Cerebrovascular accidents,

Meningoencephalitis, Acute confusional states,

coma, peripheral neuropathy, paralytic states,

2 2 1

3) Cardiovascular Diseases: Shock and

heart failure, hypertension, coronary artery

heart diseases, myocarditis, arrhythmias.

1.5 2 1

4) Respiratory diseases: Acute

bronchospastic conditions, Pneumonitis,

Pulmonary edema, pneumothorax, respiratory

failure,

1.5 2

1

5) Metabolic diseases: Diabetes Mellitus 0.5 0.5 1

6) Gastroenterology: Investigations of

liver disease, acid peptic diseases, hepatitis,

liver cell failure,

1 0.5 1

7) Renal diseases: Glomerulonephritis,

renal failure and ESRD

0.5 0.5 0.5

8) Hematological diseases: Anemia,

neutropenia, DVT, pulmonary

thromboembolism.

1 0.5 0.5

Total 8 8 8

21


learning.






Weighing of assessments 1 Written examination: 30 marks

2 Practical examination ----

3 Oral examination -----

4 Clinical examination 15 marks

Total 45 marks

5- List of References

1- Harrison's textbook of Internal Medicine

2- Oxford Handbook of Clinical Medicine Hope et al

3- Cecil Textbook of Medicine

Medical Responsibilities and Malpractice in Clinical Toxicology course specification



(FT910)



Clinical Toxicology


Clinical Toxicology



Basic Information

Title Medical

Malpractice and

responsibilities

Code FT9104

Credit Hours 1 Lectures: 8 h Tutorials: 10 h


22

Coordinator

Professional Information

1 Course Aims

- Acquire an appropriate background of basics of standards of care in medicine

disease actionable in toxicology.

- Identify and manage medical complications in the context of poisoning

malpractice

- Recognize the inappropriate procedures, drugs, antidotes and other supportive

management

- Acquire the talent and experience of rapid accurate management of medical

emergencies.




a1. Determine malpractice points in reference to therapeutic guidelines and

protocols that could be done for acute intoxicated patients in emergency room, in-

patient unit, ICU, out-patient unit and laboratory.

a2. Know how to write medico-legal report in acute intoxicated patients.

a3. Enumerate the medico-legal responsibilities towards answering a patient

telephone asking a medical advice.

a4. Recognize different forms of negligence in acutely intoxicated patient.

a5. Recognize the medico-legal aspects of transfer and referral

a6. Recognize negligence in providing efforts of diagnosis and management in

toxicology practice

a7. Requirements for Negligence to be Actionable

b- Intellectual skills (IS):


b1. Acquire the skill to avoid malpractice claim in all activities of toxicology

practice.

b2. Express wisdom to negate the elements of a claim.

b3. Express skill to depict inappropriate management and solve it.

b4. Avoid breach of duty by sticking to therapeutic guidelines and protocols that

consider basic standards of care.

b5. Depict dangerous signs that endanger patient life and correlate them to

medical or toxicological pathology.

c- Professional skills (PS):


23

c.1. Acquire Communication skills to harmonize patient toxicologist

interrelation.

c.2. Acquire communication skills with health care providers to achieve the

c.3. goal to cure the patient without commission a breach of duty.

c.4. Arrange teaching sessions aiming at avoiding inappropriate management

from the part of physicians (non toxicologist) and other health care providers

d- General and transferable skills (GS):


d.1. Maintain honesty and integrity in all interactions with patients.

d.2. Assume responsibility towards the patient related to the toxicologist by a

duty

d.3. Work cooperatively and show respect for other opinions.

3- Course content:

Topics No of hours

L C/P C/P SDL

Medical Responsibilities and Malpractice in

Clinical Toxicology

1 Credit Hour

Ideal and basics standards of Care 1 1

Types of malpractice 1 1

Deviation from standards of care by ignorance 2 2 1

Deviation from standards of care by negligence 2 2 1

Elements of negligence claim 1 1

Factors enhancing claim 1

The most common causes of claims and health

care providers

1

Malpractice versus assault 1

Types of informed consent and contribution of

patient in negligence

1

Case studies of common malpractice 4

Total Contact hours = 24 8 10 6

Total Credit hours = 1






24




4 Clinical examination 15 marks

Total 75 marks






General Toxicology course specification University Ain Shams Faculty of Medicine


(FT910)



Clinical Toxicology


Clinical Toxicology




Title General toxicology Code FT9105

Credit Hours 2 Lectures: 21 h Tutorials:

Practical: 18 h Total contact: 39 h

Coordinator


1- Course Aims:

a) To be competent in the clinical evaluation of acute intoxicated patients and

identify those who need life saving procedures.

b) Share in the general management of an acutely intoxicated patient mainly

perform the elimination procedure

b) Diagnose and state the proper management of complications due to acute

intoxication

25

c) To apply background knowledge of the basic toxicology sciences in explaining

special toxicological systemic insults and atypical pictures in extremes of age ,

pregnancy and diseases.




a1. Describes the pathophysiology, toxic causes, clinical picture and

diagnosis of complications of poisoning (respiratory, neurological, cardiovascular

and metabolic)

a2. Describe, in details, the steps of the general management of acutely

intoxicated patients.

a3. Discuss how the different body systems respond to poisoning

a4. Describes the atypical pictures acute poisoning due to pregnancy,

extremes of age and multiple overdoses.



b1. Interpret and diagnose critical life threatening complications of acute

intoxications and identify conditions needing immediate intervention.

b2. Decide promptly the required management procedure and clearly design

the proper pathway of care of and acutely intoxicated patient.

b3. Relate the atypical clinical pictures to special conditions as extremes of

age and pregnancy.



c1. Perform full and informative general and systemic clinical examination of

an intoxicated patient.

c2. Choose the proper required investigational procedure for the general

evaluation of the patient condition

c3. Undergo efficiently all procedures used for detoxification and elimination of

poisoning



d1 –Present cases and discusses clinical data with peers.

d2 – Self education and collect data from the net and other sources

d3 – Communicate properly with patients, peers and seniors ……….

d4 – Work, within a team, in preparing research articles.

26

3- Course content

Topic No. of hours

L C/P C/P SDL

General clinical examination of poisoning

cases and role of the lab.

2 2 4

Toxidromes 1 1 2

Management of acute poisoning

1

Detoxification (Gastric lavage, emesis,

catharsis)

1 2

Elimination procedures (Diuresis, dialysis and

others)

1 2

Toxic causes, diagnosis of specific clinical

complications:

Neurological complications of poisoning and

Management

Coma , Seizures, tremors, fasciculations 2 1

Agitation, Hallucinations and delusions and

Behavioral changes

1 1 1

Encephalopathy, Cranial nerve toxicity -

Peripheral neuropathy

1

Cardiovascular complications

Hypotension, Shock – Hypertensive crises 1

Myocarditis, Myocardial, and peripheral

ischemia

1

Respiratory complications

Respiratory failure - Pneumonitis – ARDS 1

Pulmonary edema (Cardiogenic and non-

cardiogenic)and Acute bronchospastic

conditions

1

Acid Base and Electrolytes imbalance 1 1

Topics No. of hours

L C/P C/P SDL

Poisoning at extreme of ages, pregnancy and

in diseases

1 1

Nephrotoxicity 1

Hepatotoxicity 1

27

Toxicity of hematological system 1

Immunotoxicity 1

Antidotes 1

4 - Student Assessment Methods

4.1 - Essay written … to assess a1, a2, a3 a4

4.2 - Practical exam to assess b5…….……….

4.3 - Clinical exam and check list application to assess c1, c2, c3, c4 and d3

4.4 - MCQ exam to assess a1, a2, a3, a4, c1, c2, c3, c4

4.4 - Research article presentation to assess d1, d2, d4.




Total 90 marks


1. Ellenhorn's Medical Toxicology

2. Dreisbach's handbook of poisoning

SYSTEMIC TOXICOLOGY course specification Course specifications


Program on which the course is given Diploma of Clinical Toxicology (FT910)



Clinical Toxicology


Clinical Toxicology

Academic level (2nd

Year)

Date of Specification Approval 18 -10- 2009


Title Special toxicology. Code FT9106

Credit Hours 6 Lectures: 60 h Tutorials: h

Clinical and Practical: 65h

Total contact hours : 125 h

Coordinator


1- Course Aims:

28

a) To be competent in the clinical evaluation and provide immediate and correct

general and specific emergency management of an acutely intoxicated patient

b) To identify and manage properly all complications due to acute intoxication

c) To apply background knowledge of the basic toxicology sciences in conducting

managerial and professional skill in hospital emergency and outpatient clinics and

provide optimal health services to acute , chronic,occupational and environmetal

intoxications.



By the end of the course the candidate will be able to: a1 Discuss the pathophysiology of common acute intoxications with drugs and

chemicals

a2 Describe acute clinical picture and complications of common drugs and

chemical acute intoxications.

a3 – Outlines the required investigational procedures that help in diagnosis of acute

and chronic intoxications.

a4 –Discusses the details of management of the acute intoxicated patient.



b1- Interpret and diagnose acute intoxications, and identify conditions needing

immediate intervention.

b2 – Decide promptly the required management procedure and clearly design the

proper pathway of care of acute of intoxications.

b3 – Show competency in solving problems revolving around acute intoxications

with referral to medical ethics and medico-legal responsibilities

b4- Apply basic toxicological sciences in the prevention of acute intoxicated cases.

b5 – Formulate questions on research points that require evidence based research.



c1- Perform full and informative general and systemic clinical examination of an

intoxicated patient.

c2 - Choose the proper required investigational procedure that helps in diagnosis

and interpret correctly.

c3 - Undergo efficiently all procedures used for detoxification and elimination of

poisoning

c4 - Show competency in applying protocols for specific and antidotal

management of acute intoxicated cases.

29



d1 –Present cases and discusses clinical data with peers.

d2 – Self education and collect data from the net and other sources

d3 – Communicate properly with patients, peers and seniors ……….

d4 – Work within a team in preparing research articles

3- Course content:

Topics No. of hours

L C/P C/P SDL

Over the Counter drugs

Acetaminophen 1 1 1

Salicylates 1 1 1

Non Steroidal Anti-Inflammatory Drugs 1 1

Vitamins antioxidants and body builders 1 1

Anorexigenic drugs, Obesity Drugs 1 1

Cephalosporins and Penicillins 1 1

Macrolides Quinolones Aminoglycosides 1

Antituberculous drugs 1

Central Nervous System Drugs

Antidepressants 1 1 2

Neuroleptics 1 1

Lithium 1 1

Sedatives hypnotics (Benzodiazepines,

Barbiturates, Meprobamate, Zopiclone,

zolpidem, Melatonin receptor, bromides, plant

origin sedatives.)

1 1 1

Anxiolytics Others (Buspirone…) 1/2 1

Muscle relaxants Others 1/2 1

Antiepileptics 1 1

Respiratory Drugs

Theophylline and Xanthines 1 1 1

Beta2-adrenergic receptor agonist 1

Cardiovascular Drugs

Digitalis preparations 1 1 1

Beta blockers 1 1 1

Diuretics 1

Calcium Channel Blockers 1 1 1

30

Antiarrhytmics 1 1

Antihypertensives 1 1

Nitrates 1 1

Drugs of Abuse(acute intoxication)

Opiates and opioids 1 1 1

Cannabis 1 1 1

Alcohol 1 1 1

Amphetamines 1 1

Cocaine 1 1

Metals and salts

Lead 1

Mercury 1

Arsenic 1

Iron 1 1 1

Corrosives (Acids, Alkalis, chlorine) 3 1 2

Chemicals

Toxic Gases (Carbon monoxide, cyanide,

chlorine, hydrogen sulfide…)

4 1 2

Toxic Alcohols and Glycols 1

Rodenticides (Phosphides, anticoagulants,

Boron, Carbamates)

1 1 1

Insecticides (Organophosphates,

Organochlorines, Carbamates, Pyrethroids,

Others)

1 2 2

Herbicides (Paraquat, diquat, atrazine) 1

Dioxins 1

Petroleum distillates and hydrocarbons 1 1 1

Detergents, Dyes, food colors and preservatives 1

Food Poisoning (Bacterial, viral, chemical,

endogenous…)

1 1 1

Botulism 1 1 1

Ciguatera, Paralytic shellfish. Scombroid 1 1 1 *

Food allergy versus poisoning 1 *

Animal Envenomation

Scorpion 1 1 1

31

Snakes 1 1 1

Spider Bees and wasps and Marine 1

Toxic Plants

Mushrooms 0.5

Mycotoxins, Houseplant 0.5

Atropine, Hyoscine (atropa belladonna &

related plants) Other hallucinogenic

psychoactive plants (Nutmeg, khat, supari,

valerian.)

1

Operating Toxicological Disaster 1

Chemical Warfare (including biological

warfare of toxicological importance)

1

Radiation toxicity 1 1

L: Lecture, T: Tutorial, C/P: Clinical or Practical and SDL: Self directed learning


4.1Essay written … to assess a1, a2, a3 a4

4.2Practical exam to assess b5

4.3Clinical exam and check list application to assess c1, c2, c3, c4 and d3

4.4 MCQ exam to assess a1, a2, a3, a4, b1, b2, b3, b4, b5

4.4 research article presentation to assess b6, d1, d2, d4.




4 Clinical examination 40

Total 300 marks

5 - List of References


…Provided by staff members


Handbook of medical toxicology,Peter Viccellio,Little ,Brown and company


Goldfrank Toxicologic emergencies,

Haddad

Ellenhorn's Medical Toxicology


32

Intensive Care of Poisoned Patients course specification Course specifications



(FT910)



Clinical Toxicology


Clinical Toxicology

Academic level (2nd

Year)

Date of Specification Approval 18 -10- 2009


Title Intensive care of poisoning patient Code FT9107

Credit Hours 6 Lectures: 60 h Tutorials: h

Clinical and Practical: 62h


Coordinator


1- Course Aims:

1) To be competent in the emergency clinical evaluation and management of

an acutely intoxicated patient. acutely ill patient suffering acute intoxications

immediate and correct general and specific emergency management of

2) To identify and manage acute systemic disturbances and failure and

properly manage all complications due to acute intoxication

3) To express skills and competence in dealing with resuscitative measures

as antidotes administration, oxygenation, monitoring, and mechanical ventilation

adjustments suitable for acutely intoxicated patient based on the recognized clinical

toxic effects of poisons.



By the end of the course the candidate will be able to: a1. Describe the resuscitative measures and critical care modalities in patients

with acute or chronic intoxications complicated with system failure.

a2. Explain the usual evolution of poisoning. Depict the prognostic signs and

interpret their significance using the investigative tools and toxicology laboratory

results.

33

a3. Understand the basis of the critical care antidotes and drugs, equipment

and their functioning, use indications, values, complications and limitations

according to type of poisons.

a4. Comprehend the preset parameters of mechanical ventilation, adjustments,

meaning of monitoring value for all types of intoxication, stage of the disease and

circumstances.

a5. Realize the monitoring value of electrocardiographic changes, significance

in different intoxication and emergency management.

a6. Understand the basis of elimination and detoxification procedures, their

potential values and risks and their indications.

a7. Understand the basis and indications of hemodialysis and recommend

specific prescriptions for every poison and other circumstances.

a8. Understand the basis of other procedures helping the eliminations of poison

as peritoneal dialysis, hemofiltration and hemoperfusion.

a9. Outline the required emergency investigational procedures that help in

diagnosis of acute and chronic intoxications.

a10. Discuss the details of management of the acute intoxicated patient.



b1. Provide skills to diagnose acute intoxications and their vital complications

on emergency basis interpret the clinical data and select immediate intervention.

b2. Interpret the monitoring values and significance of clinical changes for rapid

and immediate therapeutic intervention using antidotes, drugs or resuscitative

equipment.

b3. Modify the therapeutic modalities of equipment according to the values and

calculations of clinical and machine data.

b4. Express competence in interpreting arterial blood gas, other laboratory

parameters of significance and monitoring values of cardiac monitor,

electrocardiography, imaging, ventilation, central venous pressure, response of

antidotes and elimination procedures.

b5. Evaluate the patient clinical condition by selecting the proper modality.

b6. Decide promptly the required management procedure and clearly design the

proper pathway of care of acute of intoxications.

b7. Show competency in solving problems related to critical care tools used in

the management of the intoxicated patient. Recognize troubleshooting of every

equipment and express competence in dealing and correcting it

b8. Understand the value of documentation and cumulative critical care

observation for subsequent decision making concerning the management of acute

intoxications

b9. Formulate questions on research points that require evidence based research.

34

b10. Apply basic toxicological sciences in the prevention of acute intoxicated

cases.



c1. Perform full and informative general and systemic clinical examination of

an intoxicated patient.

c2. Select the investigational approach on emergency basis for clarification of

the detailed diagnosis, severity and possible systemic affection.

c3. Choose the required intervention and procedure, and express competence

in performing them, including elimination procedures as emesis, gastric lavage,

assuring airway and endotracheal intubation, AMBU resuscitation and mechanical

ventilation, assessment of central venous pressure, humidification of airway,

oxygenation, nebulizer, use of special modality ventilation, using cardiac

monitoring for starting or terminating antidotes or drugs or for other decision

making therapeutic modality, defibrillation and other minor and major procedures

c4. Undergo efficiently all procedures used for detoxification and elimination

of poisoning

c5. Demonstrate skill in applying protocols for specific and antidotal

management of acute intoxicated cases.

c6. Demonstrate skill in emergency management of acute life threatening

conditions as arrest, treatment of shock, seizures, respiratory failure



d1. Communicate with colleagues and seniors for the sake of a more accurate

diagnosis and effective treatment

d2. Present cases and discuss clinical data with peers.

d3. Practice emergency medicine with referral to medical ethics and medico-

legal responsibilities

d4. Self education and collect data from the net and other sources

d5. Work within a team in preparing research articles

3- Course content

Topics No. of hours

L T C/P SDL

I- General

Criteria for ICU admission of poisoned

patient

1

1

2

4

35

1

1

1

1

3

3

36

II- Respiratory 1- Airway management

2- Pulmonary edema

3- Adult respiratory distress syndrome

4- Respiratory failure

5- Oxygen therapy

6- Mechanical ventilation

III- Cardiovascular 1- Shock and cardiac arrest

2- Acute myocardial infarction

3- Heart failure

4- Common arrhythmias and conduction

disturbance

5- Pulmonary embolism

6- Hypertensive crisis

7- Training in Basic Life Support (BLS),

and Advance Life Support (ALS)

8- ECG interpretation

IV- Neurology

1- Coma, differential diagnosis of

metabolic, structural versus toxic coma.

2- Seizures, agitation, delirium and

confusional states: Causes and management in

Toxicology

3- Cerebrovascular disease

4- Post anoxic brain damage

5- Meningitis and encephalitis

6- Brain death.

V- Renal

Renal failure

VI- Endocrine

1. Diabetic Ketoacidosis

2. Hyperglycemic Hypersomolar

nonketotic Syndrome

3. Diabetes insipidus

4. SIADH

4

1

1

1

1

1

1

2

3

3

2

1

1

1

1

2

1

1

1

1

4

1

2

1

1

4

4

4

4

3

2

4

3

3

3

3

4

2

37

VII- Metabolic & Nutritional 1- Fluid, electrolyte and acid-base disorders

2- Nutritional requirements, monitoring of

nutrition.

3- Enteral and parenteral nutrition

VIII- Haematological 1- Disseminated intravascular coagulation

2- Haemolytic syndromes

3- Acute anaemia

4- Blood component therapy

IX- Infections 1- Severe infection due to aerobic and

anaerobic bacteria, viruses, and fungal

2- Nosocomial infection

3- Aantimicrobial therapy

X- Gastro-intestinal 1- Pancreatitis

2- Acute and chronic liver failure

3- Prevention and treatment of acute G.I.

Bleeding

XI- Common ICU procedures

1. Central venous line and measurement of

CVP

2. Chest tubes

3. Cricothyrotomy and tracheostomy

4. Gastric lavage

1

1

2

1

2

1

2

1

1

1

1

1

1

2

1

1

1

1

TOTAL Contact Hours = 122 hours 60 24 38

TOTAL Credit Hours = 6 hours 4 0.75 1.25


learning

38


4.1Essay written … to assess a1 – a10

4.2Practical exam to assess b1 – b7

4.3Clinical exam and check list application to assess c1 – c6 and d1 - d3

4.4 MCQ exam to assess a1 - a10, b1 - b7

4.4 Research article presentation to assess b8-9, d1, d2, d4.




4 Clinical examination 50

Total 270 marks



…Provided by staff members


Handbook of medical toxicology, Peter Viccellio, Little ,Brown and company


Goldfrank Toxicologic emergencies,

Clinical Toxicology of commercial products

Haddad,

The ICU Book, by Paul L. Marino

Clinical Electrocardiography by Ary L. Goldberger


1. www.americanheart.org

2. http://toxnet.nlm.nih.gov/

A cluster of databases on toxicology, hazardous chemicals and related areas.

3. http://www.uic.edu/com/er/toxikon

Discussions, classes and reviews sponsored by The University of Illinois at

Chicago.

4. http://www.ansci.cornell.edu/plants/index.html

Database of photos, botanical information, and health information on poisonous

plants. Contains links to other related sites

5. http://www.hypertox.com/

Hunter Area Toxicology Service’s modules on approximately 25 common toxic

drugs and environmental agents, including information on pharmacology,

toxicology, and treatment.

6. http://www.aapcc.org/

39

AAPCC is a nationwide organization of poison centers and interested individuals.

7. http://pharminfo.com/phrmlink.html

Very extensive menu of links to data on pharmaceuticals, biotechnology, and

pharmaceutical companies.

8. http://www.ace.orst.edu/info/extoxnet/

Provides a variety of information about pesticides.

9. http://www.foodsafety.gov/~mow/intro.html

This is a site from the US FDA?s Center for Food Safety and Applied Nutrition.

Useful information on mushroom toxidromes.

10. http://www.floridaplants.com/mpois.htm

Information on poisonous plants and mushrooms from around the world.

11. http://www.acep.org/

This site contains the latest news, updates and guidelines for emergency

physicians.

12. http://www.clinicalpharmacology.com/

Search engine for commonly prescribed drugs with; dosages, indications,

interactions, pharmacokinetics, costs and more.

13. http://www.streetdrugs.org/

This is a comprehensive collection of drugs of abuse, although the information is

somewhat basic it is very comprehensive.

14. http://www.martindalecenter.com/Pharmacy.html

Access to Martindale's pharmacy center for drug information.

15. http://www.ecglibrary.com/

ECG library

Treatment of Drug Dependence and Practical Program of Analytical Toxicology course specification

Course specification



(FT910)



Clinical Toxicology


Clinical Toxicology

Academic level Second Year


40

Treatment of Drug Dependence

Basic Information

Title Drug Dependence Code FT9108

Credit Hours: 2.6

Lectures: 24 h Tutorials: h

Clinical and Practical: 30 h

Total contact hours: 54 h

Coordinator

B- Professional Information

1- Course Aims

1. Acquire an appropriate background of drug dependence and methods of

diagnosis using clinical methods, challenge tests and analytical techniques.

2. Identify and manage medical complications of drug dependence including

overdose

3. Acquire competency in detecting drugs of abuse using analytical tools

4. Acquire skills in detoxification maneuvers using internationally approved

techniques and in ethical way

5. Practice in general medical examination and develop skills in

differentiating diseases by proper integration of assembled clinical data.

6. Develop the skills to predict and manage possible signs of ominous

system failure and diseases of organs targeted by poisons.

7. Acquire the talent and experience of rapid management of medical

emergencies.

2- Intended Learning Outcomes (ILOs):



a1. Recognize the drugs used in dependence and drugs in current use.

a2. Describe the pathophysiological changes of drugs of dependence

including central neurotransmitter changes.

a3. Describe the complications of every drug abuse.

a4. Explain the clinical picture of overdose by drugs of abuse and their

complications.

a5. Elucidate the clinical picture of chronic use for every drug and their

complications.

a6. Understand the mechanisms employed for different detoxification

procedures.

41

a7. Specify the rules, including ethical regulations, governing the different

methods of detoxification procedures in different parts of the world.

a8. Recognize the value, dangers and limitations of detoxification in every

drug, multi-drug use, patient's clinical status, chronicity and intensity of addiction.

a9. Describe the role of toxicological analysis in the follow up of ex-addicts

b1- Intellectual skills (IS):

Drug Dependence


b1- Depict the clinical and pathological changes of drug abusers and clarify

them and their correlation.

b2- Acquire a prudent approach to get history and examine patients requesting

treatment.

b3- Apply the rules of ethics to avoid malpractice.

b4- Manifest intellectual conduct and attitude to encourage the patient to submit to

requirements of the examination and subsequently to treatment.

b5- Expresses skills in dealing with patients on follow up and patients hiding their

relapse.

b6- Express skills in diagnosis of multi drug abuse in modified clinical picture.

b7- Design a detailed toxicological analysis and treatment protocol based on

patient's particular factors.

d- Professional and practical skills (PS):

Drug Dependence


a1. Competently carry out clinical examination to accomplish accurate and

detailed diagnosis of drug abuse with its medical complications.

a2. Request investigations and challenge tests pertinent to the clinical data

and preliminary diagnosis.

a3. Perform decontamination procedures in a safe and appropriate technique

according to the standards of care.

a4. Effectively perform procedures and therapeutic actions in accordance of

emerging complications of drug of abuse as special devices oxygenation, special

mode ventilation, arrhythmia correction



d.1. Retrieve the methods and experience through internet contact with other

analytical toxicology centers

42

d.2. Communicate the experience of your results and gain on the other hand

that of other centers

d.3. Achieve the best results through discussion and communication with

colleagues and superiors

d.4. Demonstrate respect, honesty and confidentiality for the patient under

your care and persons for which screening are performed.

d.5. Acquire communication skills with prosecutor, police officers and other

family members or work managers requesting the toxicological test.

3- Course content:

Topics No of hours

L C/P C/P SDL

Mechanisms and theory of drug abuse: receptor

toxicology

2

General basics of drug abuse 2 1

Opiates, narcotics and tramadol 2 2 2

Benzodiazepines and sedatives hypnotics

(Zopiclone, barbiturates, meprobamate and

myorelaxants)

2 2 2

Alcohol abuse 1 1 1

Central stimulants: Cocaine, amphetamine,

designer drugs, sympathomimetic and others

2 1 1

Cannabis 2 1 2

Other drugs of abuse: Research spirit 1 1 1

General examination of dependent patient in

overdose and other dependence emergencies

2 2 2

Tailoring analytical toxicology for diagnosis

and shaping profile of drug abuse

2 1

Detoxification procedures 4 2 4

Monitoring ex drug abuser 2 1

Total 24 15 15


learning.

43





Weighing of assessments

1 Written and MCQ examination: 80 marks

2 Oral examination 20 marks

Total 100 marks


1- Clarke's analysis of drugs and poisons

2- Goldfrank clinical toxicology

Practical Program of Analytical Toxicology course specification

1- Basic Information

Title Analytical

Toxicology Code FT9108

Credit Hours 2.4 Lectures: 22 h Tutorials: h

Clinical and Practical: 30 h


Coordinator

B- Professional Information

1- Course Aims

1- To acquire knowledge of Principles and theories of different analytical

procedures.

2- Acquire an appropriate background of Toxicological sampling, and sample

preservation




a.1 Assimilate the principles of toxicological sampling

a.2 Recognize the preparation steps of samples before analysis

a.3 Assimilate the kinetic and dynamic of different poisons and rules governing

their biotransformation, redistribution and elimination

44

a.4 Understand the principles and theories of each technique used in toxicological

analysis

a.5 Describe the steps of each method of analysis

a.6 Comprehend the mechanism of sample extraction methods

a.7 Recognize the reliability, reproducibility, specificity and sensitivity of each

methodology.

a.8 Understand the basic requirements for each methodology, technique and

procedure.

a.9 Recognize indications, medico-legal implications and cost of each method of

analysis.

d- Intellectual skills (IS):

By the end of the course, the candidate will be able to:

b.1. Reject a sample not valid for toxicological analysis

b.2. Prioritize analytical methods according to the requirement and situation as

emergency, medico-legal or therapeutic; as for the most economic, rapid reliable or

sensitive.

b.3. Preferentially select the plan and sequence of toxicological analysis

according to the given clinical data

b.4. Modify steps according to the required poison to be analyzed, chemicals

availability and cost

b.5. Expect a certain method and selected body fluid for analysis according the

general rules of biotransformation of a given poison with a specific structure.

b.6. Review the literature and references to reach suitable method of

toxicological analysis according to the available resources

b.7. Design a toxicological analysis for an unknown poison of potential

hazards to the community using the basics of research

b.8. Comprehend the values and limitations of poisoning markers

b.9. Comprehend the problems and difficulties of delay, misinterpretation or

ignoring an important step of toxicological analysis

b.10. Accurately interpret results of toxicological analysis according to the used

methods, situation and other factors as timing, body fluid and based on the

toxicological information given by the patient and physician.

b.11. Comprehend the medico-legal aspects and limitations of each result.

45

d- Professional and practical skills (PS):


c.1. Describe and perform simple color tests that may rule out certain

diagnostic possibilities

c.2. Correctly and appropriately report and interpret the results after

confirming the analysis to comply with international standards of toxicological

analysis.



d.6. Retrieve the methods and experience through internet contact with other

analytical toxicology centers

d.7. Communicate the experience of your results and gain on the other hand

that of other centers

d.8. Achieve the best results through discussion and communication with

colleagues and superiors

d.9. Demonstrate respect, honesty and confidentiality for the patient under

your care and persons for which screening are performed.

d.10. Acquire communication skills with prosecutor, police officers and other

family members or work managers requesting the toxicological test.

3- Course content

Topics No of hours

L C/P C/P SDL

Toxicological sampling 2 1

Medico-legal implications in treatment of drug

of abuse and analytical toxicology

1 1

Principles and theories of different analytical

procedures

3 1

Extraction procedures: Principle, methods,

Practical

3 1 3

Color tests 1 1 1

Spectrophotometry in analytical toxicology,

Practical

2 1 1

Thin layer chromatography: Techniques and

procedures for different drug and poison

groups, Practical

3 2 4

Gas chromatography: Description of theory and

Technique, Uses and different methods,

Practical

2 2 2

46

High Performance liquid Chromatography:

Description of theory and Technique, Uses and

different methods, Practical

2 2 2

Immunoassays: Theory, advantages and

limitations, Practical

2 2 2

Other analytical methods : Description of

technique, Atomic absorption, Conway cell,

distillation procedures,

1 1

Total: 22 13 17


4.1 Written and MCQs to assess knowledge and intellectual skills


4.3 Practical exam to assess professional skills

Weighing of assessments

1 Written and MCQ examination: 80 marks

2 Oral examination 20 marks

3 Practical examination 50 marks

Total 150 marks


Clarke's analysis of drugs and poisons

Elective courses Medical statistics course specification University Ain Shams Faculty of Medicine

Program on which the course is given Master of Science in Clinical

Toxicology

Major or minor element of programs Minor


Clinical Toxicology

Department offering the course Community, Environmental and

Occupational Medicine

Academic level



Title: Medical statistics course Code: E7024

Credit Hours: 1 hour Lecture: 0.65 /w. Total: 10

47

Practical: 0.6/2w. Total: 10

A credit hour = one hour lecture or practical weekly for 15 weeks

Coordinator

Community, Environmental and Occupational Medicine Department


Course Aim:

To enable the doctorate candidate to plan, conduct, analyze and interpret the results

of a research in his specific field. This course unit introduces the application of

statistical ideas and methodology to medical research.




a1 - Define medical statistics and identify uses and importance of medical statistics

in medical research

a2 – Define:

Types of variables.

Descriptive statistics.

Presentation and summarization of data.

Measures of central tendency and scatter.

Principles of probability and probability distributions.

Concepts of inferential statistics: confidence interval and hypothesis testing.

Different tests of statistical significance.

Difference between parametric and nonparametric tests of significance.

Correlation and regression

Concept of statistical modeling using multivariable and multivariate

statistical methods.

Combining evidence from different studies and meta-analysis

Importance and methods of sampling and how to determinate the suitable

sample size.

Different types of research methodology:

Observational and intervention studies and the different statistical issues

related to the design, conduct, analysis and interpretation of the results of

each study type.

Ethical aspects of medical research including those specifically applied to

clinical trials.



48

b1 - Interpret correctly the results of statistical analyses and critically evaluate the

use of statistics in the medical literature.

b2 - Integrate and evaluate information from a variety of sources.



c1- Select appropriate study designs to address questions of medical relevance

c2 - Select and apply appropriate statistical methods for analyzing data typically

encountered in medical applications.

c3- Use selected software packages for statistical analysis and data management.



d1 - Work effectively in a group from different backgrounds.

d2 - Respects the role of staff and co-staff members regardless of degree or

occupation.

d3 - Communicate effectively with professional statisticians and the wider medical

community, including the ability to present results of statistical analyses through

written and oral presentations

d4 - Use of computer data bases and other computer skills.

d5 - Handle data appropriately and analyze them through: decision processes,

objective criteria, problem definition, project design and evaluation, risk

management, teamwork and coordination.

d6 - Learn independently with open-mindedness and critical enquiry.

3- Course content:

Topics

T C/P

Introduction to medical statistics and its uses x X

Types of variables and Descriptive statistics x X

Graphic presentation of data x X

Introduction to probability theory and rules x X

Sample and population: sampling distribution of mean and proportion x X

Confidence interval of a mean and a proportion x X

Confidence interval of a difference between two mean /proportion x X

Testing a hypothesis about population mean/proportion x X

Testing a hypothesis about the difference between two

means/proportion

x X

Comparing between more than two means-Introduction to factorial

analysis

x X

Cross-tabulation and introduction to categorical data analysis x X

Simple correlation and simple regression x X

49

Introduction to multivariable and multivariate analysis x X

Study designs: observational studies x X

Study designs: Intervention studies: clinical trials x X

Study designs: Experimental animal studies x X

Study designs: Bias and Confounding x X

Ethical issues in medical research x X

Sample size estimation for continuous and binary outcome measures. x X

Meta-analysis and publication bias. x X

T: Tutorial and C/P: Clinical or Practical and SDL: Self directed learning


4-1 Written exam to assess knowledge and understanding and will concentrate on

problem solving questions

4-2 Weighing of assessment

Written exam 100

Total 100



Student Notes on Medical Statistics and Research Methods. Prof. Mohsen Abdel

Hamid and Dr Moustafa El Houssinie. Department of Community, Environmental

and Occupational Medicine.


Statistics in Clinical Practice. avid Coggon. BMJ Books. 2nd

edition 2003


Handbook of Epidemiology. Springer 2005


www.brettscaife.net/statistics/introstat/

onlinestatbook.com/rvls/

www. Epidemiolog.net

http://www.shef.ac.uk/

Computer Science Course Specification: University Ain Shams Faculty of Medicine


Toxicology



Clinical Toxicology


Clinical Toxicology

50

Academic level

Date of Specification Approval A- Basic Information

Title: Computer Science Code: E6047b Credit Hours: Lecture: 1 h/w (15 h) Total: 15 actual hours Coordinator

A- Professional Information

1 – Overall Aims of Course:

By the end of the course, the student should become aware of computer science

principles and tools, how to do a presentation, how to use internet in

communication and getting knowledge and updated sciences.

2– Intended Learning Outcomes of Course (ILOs):

a. Knowledge and Understanding:

By the end of the course, the candidate should be able to:

a1- Know computer components

a2- Understand principles of computer

a3- Know commonly used softwares

b. Intellectual Skills:


b1- How to get maximum from computer facilities

b2-How to use internet to get knowledge

b3-How to do a presentation with the help of computer

c. Professional and Practical Skills


c1- Use of computer in an optimum way

c2- Use Microsoft office properly

c3- Use of internet

d. General and Transferable Skills


d1- Communicate with collegues through the net.

d2- Communicate with staff through computer

d3- Interchange data with collegues and staff

3. Contents :

Topic No. of hours /week

lectures practical Tutorial

Information Technology 2

Windows 2

Microsoft Office (word, excel, access,

power point)

8

Internet 3

51


4.1 written to assess knowledge

Weighing of Assessments:

Final Examination (written): 50 marks

Total 50 marks



Lecture notes




Basic Immunology course specification University Ain Shams Faculty of Medicine


Toxicology



Clinical Toxicology

Department offering the course Clinical pathology department

Academic level



Title: Basic Immunology course Code: E6015

Credit Hours: 1 hour Lecture: 15 Total: 15

Coordinator

Head of immunology unit clinical pathology dept.


1- Course Aims:

The aims of the course are to provide postgraduate students with an advanced

academic and laboratory research training in modern cellular and molecular

immunology, with emphasis on the interface between the basic and clinical aspects

of the subject.


a) Have a good understanding of the molecular and cellular mechanisms

involved in the development and regulation of the immune response.

b) Understand the way in which the immune system can be manipulated in

the treatment of disease, in particular transplantation and cancer.

52

c) Understand the ways in which defects in the immune system can lead to

disease such as allergy and auto-immunity.

d) Understand the basis of major immunological laboratory investigations

and their clinical use.




a1. Identify major mechanisms involved in the immune response.

a2. Recognize how the immune system can 'go wrong' to cause disease.

a3. Recognize how the immune system can be manipulated to prevent or treat

disease learning'

a4. Know the latest research techniques and approaches, including molecular and

cellular immunology and data handling, data storage and manipulation.



b1 - Analyze & solve immunological problems.

b2 - Integrate and evaluate information from a variety of sources



c1- Analyse experimental results and determine their strength and validity

c2 - Prepare research reports

c3 - Give research presentations Use the scientific literature effectively

c4- Use computational tools and packages



d1 - Work effectively in a group during preparation of seminars.

d2- Respects the role of staff and co-staff members regardless of degree or

occupation.

d3 - Communicate effectively through oral computer processing and written

reports.

d4 - Use of computer data bases and other computer skills.

d5 - Handle data Appropriately and analyze them through: decision processes,

objective criteria, problem definition, project design and evaluation, risk

management, teamwork and coordination.

d6 - Learn independently with open-mindedness and critical enquiry.

3- Course content:

Topics

No. of hours

L T C

/P

S

D

53

L

A. Anatomy and

cellular elements of

the immune system

Anatomy of the immune system

Cells of myelomonocytic

lineage, NK cells and non-specific

defence

Ontogeny, structure, phenotype,

function and activation

Organisation of the lymphoid

system

Primary and secondary

lymphoid organs

Lymphocyte migration

Mucosal and other

compartments of the lymphoid system

Complement

structure, function, control in

defence and in disease

Complement and Fc

receptors, adhesion molecules

Deficiencies

1

1

B. Immune and

inflammatory

mechanisms

Natural or innate immune

response

Antigens and antigen processing

and presentation

Antigens: types, structures,

processing and presentation

Macrophage & Dendritic Cell

Function

APC Regulation of the Immune

Response

Major Histocompatibility

Complexes:

structure, function and

regulation

T Lymphocytes and cell mediated

immunity

Ontogeny, phenotype,

subpopulations

T cell receptors: structure,

function and antigen binding

Receptor/ligand interactions and

1

1

1

1

1

54

cell activation

T cell mediated immune

responses - participating cells

T cell subsets

Regulatory T cells and memory

cells

Effector functions

B Lymphocytes and humoral

immunity

B cell receptors; structure,


Immunogenetics:

polymorphisms, generation of diversity

and rearranging gene families

Immunoglobulins: structure,


Idiotype networks: inhibition

and stimulation

Effector functions

Cytokines, chemokines and

immunomodulators

Cytokines and Chemokines:

origin, structure, effect, site(s) of action

receptors, metabolism, and

regulation

The acute phase response and

inflammation

Inflammatory mediators

(e.g. leukotrienes, prostaglandins and

platelet-activating factor): origin,

structure, effect, site(s) of action

(receptor), metabolism and regulation

1

1

3. Cellular

interactions and

immunomodulation

1. Cellular activation and regulation: for

each cell type, understand mechanisms of

activation and suppression of function

(e.g. T cell:B cell interactions via

CD28:CD80/86)..

3. Immune cell trafficking; adhesion

molecules, chemokines

1

55

4.

Immunoregulation

Immunoregulation

Tolerance: clonal selection,

suppression and antigen paralysis

Oral tolerance

Cell-cell interactions; help and

suppression

1

5. Immune response

mediated tissue

damage

Hypersensitivity mechanisms

IgE-mediated; acute and late phase

reactions

IgA-,IgG and IgM-mediated:

opsonization, complement fixation,

antibody dependent, cell-mediated

cytotoxicity, stimulation and blocking

Immune complex mediated:

physicochemical properties and clearance

Cell-mediated: participating cells,

effector mechanisms and granuloma

formation

Immune Mechanisms of

Autoimmunity and Autoimmune

Disease What is autoimmunity?

Factors [breakdown of functional T

cell anergy, genetics, infection, exposure

to normally hidden antigens, new

epitopes] which give rise to autoimmune

disorders

Mechanisms of tissue damage in

autoimmunity

1

1

6-Autoimune

Diseases:

Laboratory diagnosis of autoimmune

(connective tissue) diseases

Clinical relevance of autoantibodies,

diagnostic specificity and sensitivity for

autoimmune disorders

SLE

Diagnosis of rheumatoid arthritis

and seronegative arthropathies

1

56

Differential diagnosis of rheumatic

diseases

Rare Rheumatic Disorders: diagnosis

Systemic vasculitis including

Cryoglobulinaemia

7-

Immunomodulatory

therapy

Scientific basis of immunosuppressive

and immunomodulatory therapy Drugs

Antibodies

Recombinan molecules

Others

1


learning


4.1written exam to assess knowledge and understanding

Weighing of assessment

4.1 written exam 50

Total 50

57

Your log book

1- Introduction

The aim of this book is to give you a guide to the expectations for each item. It will

be a guide for both you and your teachers to what you should be seeing and doing.

It will give you a list of the important topics that you should think about and should

be covered in:

1. Clinical or practical sessions

2. Tutorials

3. Self-directed learning (SDL)

For each item there is also a list of

1. Clinical conditions or Practical sessions to be seen or attended

2. Practical procedures to be seen and done

Remember

This document is only a guide. It is not an exhaustive list. It is not just a

checklist to score points. It is a guide to encourage you to read and learn more. This

book is for your benefit. It will form a record of your clinical training and

experience.

2 - Supervisors

Nominated Staff members for each unit and activity to sign the logbook items

3–Tables for Training Records

The candidate will record the details and date of each activity, and the authorized

staff member signature.

Candidates are required to fulfill 75% of the listed activities in order to be eligible

for the exam entry. The minimum number required for each activity = 75% (it is

listed for each activity). You are free to attend more and record your extra

attendance.

58

W E E K L Y D E P A R T M E N T P L A N

LECTU

RE

WAR

D

)يزور

انذرس

ي

وانىاب

)

GRAN

D

ROUN

D

)يزور

االساتذج

)

SEMINA

R

TOXICOLO

GY LAB

CASE

PRESENTATI

ON

Saturday 8 – 9

11 - 12

9 – 11 12 -

14

14 -15

Sunday 8 – 9

11 - 12

9 – 11

12-15

Monday 8 – 9

11 - 12

9 – 11 12 - 14 14 - 15

Tuesday 8 – 9

11 - 12

9 – 11 12 -

14

14-15

Wednesd

ay

8 – 9

11 - 12

9 – 11 12 - 14 14 - 15

Thursday 8 – 9

11 - 12

9 – 11

12 - 15

59

Department Seminar attendance

(NB. Minimum number required is 15)

No Date Place Topics Supervisor

signature

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

60

Case Presentation (Special topics are compulsory)


The following case studies are obligatory: Organophosphates, Hydrocarbon,

Corrosives, Scorpion envenomation, snake envenomation, food poisoning,

Opiates overdose, other drug of abuse, and coma of undetermined cause.

No Date Place Topics Supervisor

signature

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

61

Thesis attendance

(NB. Minimum number required is attending 10)

No Date Place Name of the thesis Supervisor

signature

1

2

3

4

5

6

7

8

9

10

62

On the Job Training (24 hours attendance in the Poison Control Center)


No Total Number & / New poisons seen Date Supervisor

signature

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

63

Analytical Toxicology attendance

(Minimum number required for each Lab procedure is 10)

1. Colorimetric analysis (min 5)

No Number & Types of analysis Date Supervisor

signature

1

2

3

4

5

2. Thin Layer Chromatography (min 5)

No Number & Types of cases Date Supervisor

signature

1

2

3

4

5

3. Immunoassay technique

(Minimum number is 10)

No Number of cases Date Supervisor signature

1

2

3

4

5

6

7

8

9

10

64

Airway Management


No Date Type of Management / Poison Supervisor

1

2

3

4

5

6

7

8

9

10

Attendance of Mechanical Ventilation Setting and Follow up and discussion for a

Minimum number of 10 cases

No Toxic cause Date Supervisor

signature

1

2

3

4

5

6

7

8

9

10

Gastric Lavage Procedure

(Minimum number is 10)

No Type of poisons Date Supervisor

signature

1

2

3

4

5

6

7

65

8

9

10

Antidotal Management and Follow Up


No Date Antidote / Poison Supervisor

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

Malpractice – Inappropriate Management Case Study


No Date Type of Management / Poison Supervisor

1

2

3

4

5

66

P R A C T I C A L S K I L L S ( A G R E E M E N T S C A L E )

Requirements

Candidates are required to fulfill 75% of the listed activities in order to be eligible

for the exam entry. The minimum number required for each activity = 75%. You

are free to attend more and record your extra attendance.

a-Poor b- Satisfactory c- Excellent

A. Clinical Procedures and Evaluation

Each of the following procedure should be observed, then assisted then performed

independently

Item

No

Ob

serv

ed

Dat

e an

d s

ign

Ass

iste

d

Dat

e an

d s

ign

Do

ne

ind

epen

den

tly

(A,

B,

C)

Dat

e an

d s

ign

Coma examination

1

2

3

4

5

Control of Toxic seizures

1

2

3

4

5

Intubation

1

2

3

4

5

Challenge tests

(Antidotes)

(5x3)

1

2

3

4

5

Basic general 1

67

neurological examination

(5x3)

2

3

4

5

Respiratory assessment

(imaging, ABG)

1

2

3

4

5

Management and

evaluation of Shock

(5x3)

1

2

3

4

5

TPN prescription

1

2

3

4

5

Management and

evaluation of agitation,

confusion and delirium

(5x3)

1

2

3

4

5

Gastric lavage

1

2

3

4

5

Central Vein

Catheterisation

1

2

3

4

5

Arrhythmia evaluation 1

68

and management

(including DC Shock)

2

3

4

5

Performing and

interpreting abnormal

ECG of toxic etiology

1

2

3

4

5

B. Analytical Procedures

Item

No

Ob

serv

ed

Dat

e an

d s

ign

Ass

iste

d

Dat

e an

d s

ign

Do

ne

ind

epen

den

tly

(A,

B,

C)

Dat

e an

d s

ign

Thin Layer

Chromatography

1

2

3

4

5

Colorimetric analysis

1

2

3

4

5

Immunoassay

(5x3)

1

2

3

4

5

69

5 - Log book preview

The candidate logbook will be reviewed and patients seen/ skills performed

summarized by diagnosis groups during the semester evaluation and at the end of

the course in the table below. This reflects the number of activity done by

category. (According to each degree) The results of this review will be totaled in

the summary chart below.

Semester 1st 2

nd 3

rd 4

th total

Activity

Department Seminar attendance (15)

Case Presentation (Special topics are compulsory)

(24)

Thesis attendance (10)

On the Job Training (24 hours attendance in the

Poison Control Center) (30)

Analytical Toxicology attendance (10)

Colorimetric analysis ( 5)

Thin Layer Chromatography) (5)

Immunoassay technique (10)

Airway Management (10)

Attendance of Mechanical Ventilation Setting and

Follow up and discussion (10)

Gastric Lavage Procedure (10)

Antidotal Management and Follow Up (20)

Malpractice – Inappropriate Management Case Study

(5)

Clinical Procedures and Evaluation

Coma examination(5)

Control of Toxic seizures(5)

Intubation(5)

Challenge tests (Antidotes)(5x3)

Basic general neurological examination (5x3)

Respiratory assessment(imaging, ABG) (5)

Management and evaluation of Shock (5x3)

TPN prescription(5)

Management and evaluation of agitation, confusion

and delirium (5x3)

Gastric lavage(5)

70

Central Vein Catheterisation(5)

Arrhythmia evaluation and management (including

DC Shock) (5)

Performing and interpreting abnormal ECG of toxic

etiology (5)

Analytical Procedures

Thin Layer Chromatography (5)

Colorimetric analysis (5)

Immunoassay (5x3)

Supervisor signature

VII - Head Of Department Approval For The Exam Entry

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

71

72

VIII – Evaluation Forms

To be completed at -------------------------------------

Candidate

Supervisor

Location

Aim of training

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Agreed educational objectives and timescale in which objectives should be

achieved.

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Comments by Candidate

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Comments by Supervisor

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Date of next meeting

Signed by candidate

Signed by Supervisor

Date

73

74



Candidate

Supervisor

Location

Aim of training

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


achieved.

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


Signed by candidate


Date

75

76



Candidate

Supervisor

Location

Aim of training

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


achieved.

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


Signed by candidate


Date

77

78



Candidate

Supervisor

Location

Aim of training

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


achieved.

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


Signed by candidate


Date

79

80



Candidate

Supervisor

Location

Aim of training

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


achieved.

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


Signed by candidate


Date

81

82



Candidate

Supervisor

Location

Aim of training

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


achieved.

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


Signed by candidate


Date

83

84

Degree Program Evaluation Form by The Candidate

To be completed at the end of your degree.

Please consider each pair of statements and decide which most clearly reflects your

view and tick one box or answer the question.

I. Individual Information

1. Are you a graduate of ASU?

yes no to some degree

2. Year and semester when studies began:

II. General Questions

1. What are the advantages/disadvantages of the general study environment at the

University ASU?

2. What were your expectations when you applied to the degree?

3. Do you feel that the degree program prepares you well for your future studies or

employment according to the demands and expectations of those institutions?


4. Has the time limit of the program (two or three academic years) caused you any

difficulties or inconveniences?


III. Structure of Degree Program

1. Did you receive enough guidance in planning your study schedule in the

beginning of the program?


2. What were the main difficulties in the planning of your study schedule?

3. What is your general opinion on the structure of the degree program?

85

4. In your opinion, does the degree program offer a good balance of lectures,

seminars, conferences, and book exams?


a) General Studies

i) Do you feel that you have received enough guidance on academic writing?


ii) Do you feel that you have acquired sufficient knowledge on research skills (eg.

quantitative and qualitative research methods)?


b) Courses

i) Have you had some special difficulties in completing some of the courses?

Please specify.

ii) Has there been a sufficient variety of courses offered for your optional studies?


iii) Have you received enough guidance for the preparation of your thesis?


IV. Concluding Points

1. Did the degree program meet your expectations?


2. What aspects of the degree program do you particularly like?

3. What aspects of the degree program do you particularly dislike?

4. What are your suggestions on how to improve the program?

Thank you!

Documents

Diploma in Clinical Toxicology - Ain Shams Universitymed.asu.edu.eg/uploads/med/toxicology_diploma...experience. This handbook presents information guide and logbook activity of the