NBE CME programme for DNB consultants - National Board Of ...

NBE CME programme for DNB consultantsShould be able to identify-RT V/s LT sided Valve Lesions, Stenotic V/s Regurgitant LesionsClinical examination- Detailed ESP, GPE-Pulse(especially for)- BP, Signs of IE, Evidence of RF, Ifsuspected AR-Look for features of MARFAN’S, Syndrome,JVP, EDEMA; CVS – Detailed, thoroughexam of CVS-all areas; Abdomen; Fundus Exam; CNSInvestigations– ECG, Discuss Findings; CXR—Discuss Findings; ECHO—What all can be seenIf IE – Blood c/s— How many/when; RF – ASLO/CRP, other anti strept AbDifferential diagnosis- To give diagnosis as Which all valves are involved list in order of severity;Etiology (?Rheumatic ?MARFANS etc.); Presence/Absence of-Pulmonary A hypertension,Congestive cardiac failure, Arrythmias/Normal Sinus Rhythm, Rheumatic Aaivety, Infective EndoCarditis.Management - Discuss M/m in relation of; Valve involvement- Conservative, Surgical, Others ofBMV; CHF; IE; RF; Emborisation; AF; Special Simulation eg. In Pregnancy discuss prognosis andoutcomeAny other – Discuss-Prophylaxis for RF; IE Prophylaxis; Anticoagulation; Digoxcin-Role andToxicity; M/m of Embolisation in setting of IE; Fungal EndocarditisCerebellar diseaseHistory- Detailed History of Onsent, Progression of complaints; Family History – should traceinvolvement in family for inherited forms of cerebellar disease; Drugs/Toxics – History especially of; Other Neoplasms – Paraneoplastic involvementClinical examination - Detailed neurological exam Especially of – CNS and also spine; Othersystems-To be able to identify cause of cerebellar involvement.Investigations - Role of MR/CT; Discuss findingsDifferential diagnosis-Acuteonset-Chroniconset;Symmetrical - Symmetrical;Asymmetrical –Asymmetrical.To discuss D/D according to individual situations.Management -To identify the involvement as; Degenerative; Inherited; Drug/Toxin related; Infective;Vascular involvement; Paraneoplastic; M/m of individual situationAny other -To discuss D/D appropriate IE clinical situation eg. Age.Congenital Heart DiseaseHistory - Onset of Symptoms – childhood, adolescence, adults; Discuss the symptoms; Cynosis– if yes cyanotic spells feeding; Growth and milestones in children; Respiratory infectionClinical examination-Any compiler eg. Stroke, etc.,Detailed Cardiovascular- Exam, GPE – Sxanosis,Cuilbbing, JVP, EDEMA; Evaluate for other inherited/congenital malformation/disorders.Investigations – ECG; CXR; ECHO; Polycythemia/Hci; ABGDifferential diagnosis - To reach diagnosis as congenital HD. Cyanotic, Acynotic and then furtherdiscuss the individual differential thesis according to the case in hand; Eisenmenger – to discussin detail.Management - ISSUEO regarding; M/m of cyanotic spells(in children); M/m of CHF; M/m relating to;Operability; Surgery; Prognosis and OutcomeShort CaseMyopathy - Disease of Muscle/NerveHistory-History of symptoms,weakness especially, Onset, Progress, Prox V/s Distae, Severity,Fasciculations, Atrosphy, MSI Fatigue; To identify cause if possible on history; ParaneoplasticinvolvementClinical examination - Complete physical exam including; Detailed neurological examination;Focus on demonstration of (focus on LMN signs); Refrences-Planter response, Atrophy of MSIS;Skin Exam; Spine Exam121