|
Learning Objectives:
During this month fellows will:
-
Gain awareness of the indications,
spectrum of activity and side effects of commonly used antibiotics.
-
Learn the epidemiology, diagnosis and
management of common infectious diseases requiring hospitalization
including tuberculosis, complicated skin and soft tissue infections,
endocarditis, meningitis, encephalitis, osteomyelitis, pyelonephritis,
pneumonia, and fever of unknown origin.
-
Understand the pathogenesis and
natural history of HIV infection.
-
Understand the principles of
antiretroviral therapy including indications for HAART, and side
effects and drug interactions of commonly used agents.
-
Gain awareness of the common
opportunistic infections associated with HIV infection, including
presentation, prophylaxis and therapy. Common opportunistic infections
include Pneumocytis carinii pneumonia, Mycobacterium avium complex
infections cytomegalovirus infections, cryptococcus, candida, and
toxoplasmosis.
-
Understand the presentation, natural
history and management of non-infectious complications of HIV
infection, including Kaposi's sarcoma, lymphoma, renal disease.
-
Following this rotation residents
should be able to develop a diagnostic evaluation for the common
complications of HIV infection (such as pneumonia, diarrhea, change in
mental status).
-
Gain practical experience in the
performance and interpretation of the Gram's stain.
Methods:
-
Fellows will have daily bedside rounds
with the Infectious Disease attending and participate in the diagnosis and
daily management of acutely ill HIV patients with a variety of
complications.
-
Didactic discussions based around
patients but planned to cover major HIV and Infectious Disease syndromes
over the month led by the Infectious Disease attending and fellows. Topics
covered include pathophysiology of HIV and its complications, as well as
diagnosis and therapy.
-
Patients are mainly those followed in
the Special Immunology Unit (outpatient HIV clinic providing primary care
to 700 HIV infected persons). Additional patients include newly diagnosed
HIV and infectious diseases patients from the Emergency Room, patients
followed by Infectious Diseases attendings, Infectious Diseases referrals
from outside hospitals. Additionally, general medicine patients may also
be followed, depending on the Infectious Diseases case load.
-
Fellows supervise residents in the
execution of commonly performed bedside procedures including lumbar
puncture, thoracentesis, paracentesis and central line placement.
-
The principle ancillary educational
material is a compendium of articles from the most recent medical
literature covering commonly encountered infectious diseases, HIV
pathogenesis and therapy, diagnosis, pathophysiology and treatment of the
major opportunistic infections and malignancies.
Evaluation:
- Fellows will receive verbal and written
feedback at the end of the rotation.
Patient Population:
- Patients with HIV followed in the John
Carey Special Immunology Unit or presenting to the emergency room will be
admitted to the inpatient Infectious Diseases unit. Patients with
infectious disease problems referred from outside hospitals or presenting
to the emergency room and requiring hospitalization will be preferentially
admitted to the team.
References:
- This is present in a binder on the floor
at all times. In addition, pertinent articles related to specific patients
are provided.
|
