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Class of 2017
Session Information


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Session Title:
SURG: Biliary Tract Disease
Description:
Keywords:
Learning Objectives
Blueprint ID Learning Objectives
1072 Explain the differential diagnosis of a patient with jaundice: (a) Discuss pre-hepatic, intrahepatic (both non-obstructive) and post-hepatic (obstructive) etiologies, (b) Discuss painful vs. non-painful, (c) Discuss benign vs. malignant, and (d) Discuss inflammatory vs. non-inflammatory.
1073 List and explain the justification for the diagnostic modalities used in the examination of a patient with jaundice, including limitations, relative costs, and potential risks. (a) Explain the importance of the patient’s history: estimated duration of illness, associated symptoms (pain and its characteristics), and risk factors. (b) Discuss important physical exam findings: (i) hepatomegaly (ii) palpable mass (iii) Courvoisier’s sign (iv) Murphy’s sign (v) scleral icterus (vi) abdominal tenderness (vii) lymphadenopathy (viii) Charcot’s triad (ix) Reynold’s pentad
1074 Explain the rationale for using these diagnostic tests in the evaluation of a patient with jaundice: (a) liver function test, (b) other laboratory tests and their indications (hepatitis profile, peripheral blood smear, Coombs tests, etc.), and (c) hepatobiliary imaging procedures (ultrasound, CT scan, ERCP, PTHC, HIDA scan)
1075 Discuss the management principles, including initial treatment; role and timing of surgery; and, if necessary, timing of appropriate consultation of the following: (a) cholecystitis (b) choledocholithiasis (c) cholangitis (d) cholangiocarcinoma (e) pancreatic cancer (f) periampullary cancer (g) hepatic cancer (h) hepatitis
1076 Complete a focused history and physical examination that includes abdominal and rectal exam, palpating liver and spleen, Courvoisier’s sign and Murphy’s sign.
1077 Confirm physical findings of jaundice.
1078 Discuss alcohol abuse.
1079 Explain the importance of hepatitis vaccination.
1080 Explain the importance of appropriate transfusion practices.

Linked Course Goal(s) to Session
Blueprint ID Course Goals
10387 EPA 1 (AAMC): Gather a history and perform a physical examination
Linked Program Competencies
To This Course Goal:
me-1 me-2 me-6 cm-1 cm-2 ha-1 pr-1
10388 EPA 2 (AAMC): Prioritize a differential diagnosis following a clinical encounter
Linked Program Competencies
To This Course Goal:
me-4 me-6 cm-1 cm-2 cm-6 co-2 ha-1 ha-2 sc-1 sc-2 sc-3 pr-1
10393 EPA 7 (AAMC): Form clinical questions and retrieve evidence to advance patient care
Linked Program Competencies
To This Course Goal:
me-6 cm-3 cm-5 cm-6 ld-2 ld-3 sc-1 sc-2 sc-3 pr-1
10395 EPA 9 (AAMC): Collaborate as a member of an interprofessional team
Linked Program Competencies
To This Course Goal:
me-6 cm-5 co-1 co-2 co-3 co-4 ld-3 ha-1 ha-2 pr-1
10396 EPA 10 (AAMC): Recognize a patient requiring urgent or emergent care and initiate evaluation
Linked Program Competencies
To This Course Goal:
me-1 me-2 me-3 me-4 me-5 me-6 cm-1 cm-2 cm-3 cm-4 cm-5 cm-6 co-1 co-2 co-3 ld-1 ld-2 ld-3 ha-3 sc-1 sc-2 pr-1
10397 EPA 11 (AAMC): Obtain informed consent for tests and/or procedures
Linked Program Competencies
To This Course Goal:
me-3 me-5 me-6 cm-1 cm-3 cm-4 cm-5 ld-2 ld-3 ha-1 ha-3 sc-2 sc-3 pr-1
10398 EPA 12 (AAMC): Perform general procedures of a physician
Linked Program Competencies
To This Course Goal:
me-3 me-5 me-6 cm-1 cm-3 cm-4 cm-5 cm-6 co-1 co-3 ld-2 sc-1 sc-2 pr-1
10399 EPA 13 (AAMC): Identify system failures and contribute to a culture of safety and improvement
Linked Program Competencies
To This Course Goal:
me-6 cm-6 co-1 ld-1 ld-3 ha-3 sc-1 sc-2 sc-3 pr-1
Linked Program Competencies To Course Goal(s)
me-1 Medical Expert
Perform a complete and accurate patient-centred history appropriate to the patient’s presentation.
me-2 Medical Expert
Perform a complete and accurate physical examination appropriate to the patient’s presentation.
me-6 Medical Expert
Apply knowledge of the clinical, socio-behavioural, and fundamental biomedical sciences relevant to a clinical problem.
cm-1 Communicator
Develop and maintain appropriate ethical and therapeutic relationships, rapport and trust with patients and their families.
cm-2 Communicator
Collect and synthesize accurate and relevant information, incorporating perspectives from patients and their families, colleagues and other health care professionals.
ha-1 Health Advocate
Identify the important determinants of health, risk factors for illness, interaction between the population and their physical, biological and social environment, and personal attributes.
pr-1 Professional
Demonstrate accountability to patients by applying best practices and adhering to high ethical standards.
me-4 Medical Expert
Develop a differential diagnosis and key clinical problem list following assessment of a patient.
cm-6 Communicator
Discuss effective strategies for communicating with third parties other than health care professionals.
co-2 Collaborator
Demonstrate effective consultation with other health care professionals to provide care for individuals, communities, and populations.
ha-2 Health Advocate
Identify public policies and trends that affect health locally, nationally, and globally, and barriers to access for populations, including persons with disabilities, the underserved and the marginalized.
sc-1 Scholar
Develop a plan for personal continued education.
sc-2 Scholar
Apply the principles of research, critical appraisal and evidence-based medicine to learning and practice.
sc-3 Scholar
Demonstrate facilitation of learning for health care professionals, patients and society as part of the professional responsibility.
cm-3 Communicator
Discuss relevant health care information and management plans with patients and their families.
cm-5 Communicator
Demonstrate effective oral and written communication of information associated with a medical encounter.
ld-2 Leader
Apply evidence and management processes to effectively allocate health care resources.
ld-3 Leader
Describe the roles and responsibilities of physicians and governing bodies in the development and support of the health care system.
co-1 Collaborator
Demonstrate effective collaboration skills within the health care system.
co-3 Collaborator
Demonstrate respect for health care team members without bias (e.g., bias related to gender, ethnicity, cultural background or health care role).
co-4 Collaborator
Demonstrate effective strategies to promote understanding, manage differences and resolve conflicts through negotiation and collaboration.
me-3 Medical Expert
Formulate an initial plan of appropriate diagnostic and therapeutic procedures relevant to the patient’s presentation.
me-5 Medical Expert
Develop a management plan for key clinical problems following assessment of a patient.
cm-4 Communicator
Develop a shared plan of care with patients, their families, and other health care professionals.
ld-1 Leader
Identify strategies to effectively manage practice and career.
ha-3 Health Advocate
Assess and respond to issues in the Canadian health care system and advocate for patients at all levels.

Linked MCC Medical Expert Objectives
(015-1) BLEEDING, BRUISING
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(003-2) ACUTE ABDOMINAL PAIN
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(003-3) CHRONIC ABDOMINAL PAIN
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(049) JAUNDICE
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(052) ABNORMAL LIVER FUNCTION TESTS
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(002) ABDOMINAL / PELVIC MASS
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