Training Programme in Respiratory Diseases

Syllabus
Each student is required to know and cover the following five domains during the period of training.
1. Theoretical Knowledge
2. Clinical Skills
3. Practical skills
4. Management of Medical Emergencies
5. Preparation of a dissertation
Unit
1. Historical Perspectives
2. Lung Functions
a. Anatomy
5Anatomy of respiratory system Functional design of the lung for gas exchange.
Respiratory muscles
Development and growth of the lung
Bronchopulmonary anatomy
Blood supply, lymphatics and nerve supply
Surfactant and associated proteins
Non-respiratory function of the lungs
b. Physiology
Pulmonary mechanics
Respiration and its control ventilation, perfusion, Diffusion Assessment of pulmonary function.
Blood gas transport
Inhalation kinetics and its implication in aerosol therapy Aterical blood gases.
Acid-Base Balance.
C. Lungs in different Physiological states
Sleep
Exercise
Pregnancy
Ageing
d. Lung immunology
Pulmonary defense
Lymphocytes & Macrophages in inflammation
Mast cells and eosinophils
Mechanisms of hypersensitivity reactions
e. Lung injury and repair
Cytokines & Chemokines
Nitric oxide
Inflammatory reactions
Reactions to acute and chronic injury
Pulmonary fibrosis
3. Clinical features
a. Symptomatology: Breathlessness, Cough, Haemoptysis, chest pain
b. Physical signs
c. Dermatological manifestations of lung diseases.
6
d. Pulmonary-systemic interactions
e. Pulmonary-renal syndrome
f. Pulmonary complications of pancreatitis and liver diseases.
g. Menstruation-related respiratory diseases.
4. Diagnosis procedures
a. Sputum examination
b. Culture
c. Radiographic and imaging students. CT, MRI ultrasinography
d. Pulmonary function studies and their interpretations in determining
the disability.
e. Cardiopulmonary exercise testing
f. Blood gas analysis
h. Bronchoscopy, Bronchial lavage, Biopsy.
I. Transthoracic needle aspiration and biopsy
j. Pleural fluid studies
k. Thoracoscopy
l. Pulmonary scintigraphy
m. Pulmonary arteriography
n. Skin test: tuberculin, allergen
o. Bronchoprovocation tests
p. ECG and ECHO studies
q. Mediastinscopy and VAT
5. Epidemiology
Epidemiological terms
Epidemiological techniques
Epidemiology of Tuberculosis, pneumoconiosis, Bronchial asthma COPD and lung cancer
National Tuberculosis Control Programme and RNTCP
Research methods and study designs cohort, case control, randomized Clinical trials, observative
and cross-sectional studies.
Common statistical methods for analysis of research.
7
6. Development and Genetic abnormalities
Dimorphic lung, Tracheal agenesis Tracheal stenosis, Tracheomalacia.
Vascular ring anomalies, Bronchial cvst, Agenesis of the lung, Congenital lobar emphysema,
Cystic adenomatoid malformation, Bronchopulmonary sequestration, Azygos lobe, Horse shoe
lung, Scimitar syndrome, Diaphragmatic hernia, Congenital eventration of the diaphragm,
primary ciliary dyskinesia.
7. Infection
· Microbial flora and colonization of the respiratory tract
· Pulmonary clearance of infectious agents
· Approach to the patient with pulmonary infections
· Community acquired pneumonia
· Pneumonias:
· Gram-positive bacteria
· Gram-negative bacteria
· Legionellosis
· Rickettsial Pneumonia
· Myscoplasmal Pneumonia
· Chlamydia Pneumonia
· Radiation Pneumonia
· Lipoid pneumonia
· Varicella Pneumonia
· Pulmonary melidosis
· Tuberculosis
· Primary tuberculosis: Pathogenesis, Clinical features, Tuberculin test.
· Diagnosis, Milliary, tuberculosis, treatment, BCG vaccination
· Non-primary tuberculosis: Pathogenesis, clinical features investigation.
· Complications, antituberculosis drugs, chemotherapy, DOTS, fixed.
· Dose combinations, drug-resistant tuberculosis Extrapulmonary tuberculosis Lymph-node,
abdominal hepatobiliary, neruo, osteoarticular, cutaneous, renal, pericardial, ocular, otologic,
endocrine, and genital tuberculosis.
· Non-tuberculosis mycobacaterial infections.
· Opportunistic infections
8
· Anaerobic bacterial infections
· Pulmonary infections in AIDS
· Pulmonary infections in neutropenia and caner
· Pneumonia in organ transplant patient
· Pulmonary infections in patient with primary immune defects.
· Postoperative pneumonia
· Hantavirus Pulmonary Syndrome
· Ventilator-associated pneumonia
· Pulmonary ehrlichiosis
· Rhodcoccus equi infections
· Actinomysis
8. Fungal infection
· Histoplasmosis
· Coccidioidomycosis
· Aspergillosis
· Candidiasis
· Cryptococcosis
· Nocardiosis
· Blastomycosis
9. Parasitic pulmonary diseases
· Plueropulmonary amoebiasis
· Malarial lung disease
· Toxoplasmosis
· Pnemumocystis pneumonia Nematodes
· Pulmonary dirofilarais
· Pulmonary echinococcosis
· Schistomiasis
· Paragonimiasis
· Pulmonary eosinophil syndrome
910. Zoonotic pulmonary diseases
· Plague
· Q fever
· Tularemia
· Pasteurellosis
· Rhodococcus pneumonia
· Leptospiral Pneumonia
· Hantavirus pulmonary syndrome
· Acute equine respiratory syndrome
11. Suppuration
· Suppurative pneumonia
· Ling abscess
· Bronchiectasis
· Gangrene of the lung12. Pleural diseases
· Pleural dynamics and effusion
· Pleurisy and effusion
· Non-neoplastic and neoplastic effusions
· Pulmonary lymphangioleiomyomatosis
· Pneumothorax
· Empyema thoracis
· Bronchopleural fistula and its complications
· Pleural thickening
· Primary pleural tumours
· Malignant mesothelioma
13. Immunology
· Pulmonary hypersensitivity
· Extrinsic allergic alveolitis
· Goodpasture’s syndrome
14. Airflow obstruction
· Air pollution
· Chronic obstructive pulmonary disease
· Chronic cor pulmonale
· Unilateral hyperradiancy of the lung
· Broinchial asthma
· Bronchiolar disease
· Reactive airways dysfunction syndrome
· Small airway disease
· Upper airway obstruction
· Cystic fibrosis
· Bronchiolitis
· Bullous diseases of the lungs
15. Occupational and environmental disorders
· Silicosis
· Coal workers’ pneumonosis
· Asbestos-related lung disease
· Berylliosis
· Hard-metal lung disease
· Byssinosis
· Bagassosis
· Hypersensitivity Pneumonitis
· Industrial bronchitis
· Toxic inhalations
· Air pollution
· High altitude
· Diving injuries
· Thermal lung injury
16. Disorders of Pulmonary Circulation
· Pulmonary hypertension & cor pulmonable
· Pulmonary oedema
11
· Pulmonary infarction
· Pulmonary embolism
· Pulmonary vasculitis
· Pulmonary arteriovenous malformations
· Cardiac problems in pulmonary Patient
· Pulmonary diseases produced in cardiac patients
· Diffuse alveolar haemorrhage
17. Respiratory failure
· Types
· Hypoxemia and Hypercarbia
· Clinical features, diagnosis & treatment
· Respiratory problems in neuromuscular disorders
· Respiratory failure in patient with obstructive airway disease
· Respiratory distress syndrome of newborn
· Acute respiratory distress syndrome
· Systemic inflammatory response syndrome & multiple organ dysfunction
· Syndrome
· Respiratory failure in the surgical patient.
18. Diseases of undetermined origin
· Sarcoidosis
· Idiopathic pulmonary fibrosis
· Bronchiolitis obliterans organizing pneumonia
· Lungs in collagen vascular diseases
· Pulmonary angiitis and granulomatosis
· Wegener’s granulomatosis
· Pulmonary lymphocytic angiitis and granulomatosis
· Honeycomb lungs
· Histiocytosis
· Pulmonary tuberous sclerosis
· Pulmonary amyloidosis
· Idiopathic pulmonary hemosiderosis
· Pulmonary alveolar proteinosis
· Pulmonary alveolar microlithiasis
· Broncholithasis
19. Sleep and sleep disorders
· Breathing and sleep
· Sleep related respiratory disorders
· Sleep apnoea syndrome
· Obesity hypoventilation syndrome


Syllabus
Each student is required to know and cover the following five domains during the period of training.
1. Theoretical Knowledge
2. Clinical Skills
3. Practical skills
4. Management of Medical Emergencies
5. Preparation of a dissertation
Unit
1. Historical Perspectives
2. Lung Functions
a. Anatomy
5Anatomy of respiratory system Functional design of the lung for gas exchange.
Respiratory muscles
Development and growth of the lung
Bronchopulmonary anatomy
Blood supply, lymphatics and nerve supply
Surfactant and associated proteins
Non-respiratory function of the lungs
b. Physiology
Pulmonary mechanics
Respiration and its control ventilation, perfusion, Diffusion Assessment of pulmonary function.
Blood gas transport
Inhalation kinetics and its implication in aerosol therapy Aterical blood gases.
Acid-Base Balance.
C. Lungs in different Physiological states
Sleep
Exercise
Pregnancy
Ageing
d. Lung immunology
Pulmonary defense
Lymphocytes & Macrophages in inflammation
Mast cells and eosinophils
Mechanisms of hypersensitivity reactions
e. Lung injury and repair
Cytokines & Chemokines
Nitric oxide
Inflammatory reactions
Reactions to acute and chronic injury
Pulmonary fibrosis
3. Clinical features
a. Symptomatology: Breathlessness, Cough, Haemoptysis, chest pain
b. Physical signs
c. Dermatological manifestations of lung diseases.
6
d. Pulmonary-systemic interactions
e. Pulmonary-renal syndrome
f. Pulmonary complications of pancreatitis and liver diseases.
g. Menstruation-related respiratory diseases.
4. Diagnosis procedures
a. Sputum examination
b. Culture
c. Radiographic and imaging students. CT, MRI ultrasinography
d. Pulmonary function studies and their interpretations in determining
the disability.
e. Cardiopulmonary exercise testing
f. Blood gas analysis
h. Bronchoscopy, Bronchial lavage, Biopsy.
I. Transthoracic needle aspiration and biopsy
j. Pleural fluid studies
k. Thoracoscopy
l. Pulmonary scintigraphy
m. Pulmonary arteriography
n. Skin test: tuberculin, allergen
o. Bronchoprovocation tests
p. ECG and ECHO studies
q. Mediastinscopy and VAT
5. Epidemiology
Epidemiological terms
Epidemiological techniques
Epidemiology of Tuberculosis, pneumoconiosis, Bronchial asthma COPD and lung cancer
National Tuberculosis Control Programme and RNTCP
Research methods and study designs cohort, case control, randomized Clinical trials, observative
and cross-sectional studies.
Common statistical methods for analysis of research.
7
6. Development and Genetic abnormalities
Dimorphic lung, Tracheal agenesis Tracheal stenosis, Tracheomalacia.
Vascular ring anomalies, Bronchial cvst, Agenesis of the lung, Congenital lobar emphysema,
Cystic adenomatoid malformation, Bronchopulmonary sequestration, Azygos lobe, Horse shoe
lung, Scimitar syndrome, Diaphragmatic hernia, Congenital eventration of the diaphragm,
primary ciliary dyskinesia.
7. Infection
· Microbial flora and colonization of the respiratory tract
· Pulmonary clearance of infectious agents
· Approach to the patient with pulmonary infections
· Community acquired pneumonia
· Pneumonias:
· Gram-positive bacteria
· Gram-negative bacteria
· Legionellosis
· Rickettsial Pneumonia
· Myscoplasmal Pneumonia
· Chlamydia Pneumonia
· Radiation Pneumonia
· Lipoid pneumonia
· Varicella Pneumonia
· Pulmonary melidosis
· Tuberculosis
· Primary tuberculosis: Pathogenesis, Clinical features, Tuberculin test.
· Diagnosis, Milliary, tuberculosis, treatment, BCG vaccination
· Non-primary tuberculosis: Pathogenesis, clinical features investigation.
· Complications, antituberculosis drugs, chemotherapy, DOTS, fixed.
· Dose combinations, drug-resistant tuberculosis Extrapulmonary tuberculosis Lymph-node,
abdominal hepatobiliary, neruo, osteoarticular, cutaneous, renal, pericardial, ocular, otologic,
endocrine, and genital tuberculosis.
· Non-tuberculosis mycobacaterial infections.
· Opportunistic infections
8
· Anaerobic bacterial infections
· Pulmonary infections in AIDS
· Pulmonary infections in neutropenia and caner
· Pneumonia in organ transplant patient
· Pulmonary infections in patient with primary immune defects.
· Postoperative pneumonia
· Hantavirus Pulmonary Syndrome
· Ventilator-associated pneumonia
· Pulmonary ehrlichiosis
· Rhodcoccus equi infections
· Actinomysis
8. Fungal infection
· Histoplasmosis
· Coccidioidomycosis
· Aspergillosis
· Candidiasis
· Cryptococcosis
· Nocardiosis
· Blastomycosis
9. Parasitic pulmonary diseases
· Plueropulmonary amoebiasis
· Malarial lung disease
· Toxoplasmosis
· Pnemumocystis pneumonia Nematodes
· Pulmonary dirofilarais
· Pulmonary echinococcosis
· Schistomiasis
· Paragonimiasis
· Pulmonary eosinophil syndrome
910. Zoonotic pulmonary diseases
· Plague
· Q fever
· Tularemia
· Pasteurellosis
· Rhodococcus pneumonia
· Leptospiral Pneumonia
· Hantavirus pulmonary syndrome
· Acute equine respiratory syndrome
11. Suppuration
· Suppurative pneumonia
· Ling abscess
· Bronchiectasis
· Gangrene of the lung12. Pleural diseases
· Pleural dynamics and effusion
· Pleurisy and effusion
· Non-neoplastic and neoplastic effusions
· Pulmonary lymphangioleiomyomatosis
· Pneumothorax
· Empyema thoracis
· Bronchopleural fistula and its complications
· Pleural thickening
· Primary pleural tumours
· Malignant mesothelioma
13. Immunology
· Pulmonary hypersensitivity
· Extrinsic allergic alveolitis
· Goodpasture’s syndrome
14. Airflow obstruction
· Air pollution
· Chronic obstructive pulmonary disease
· Chronic cor pulmonale
· Unilateral hyperradiancy of the lung
· Broinchial asthma
· Bronchiolar disease
· Reactive airways dysfunction syndrome
· Small airway disease
· Upper airway obstruction
· Cystic fibrosis
· Bronchiolitis
· Bullous diseases of the lungs
15. Occupational and environmental disorders
· Silicosis
· Coal workers’ pneumonosis
· Asbestos-related lung disease
· Berylliosis
· Hard-metal lung disease
· Byssinosis
· Bagassosis
· Hypersensitivity Pneumonitis
· Industrial bronchitis
· Toxic inhalations
· Air pollution
· High altitude
· Diving injuries
· Thermal lung injury
16. Disorders of Pulmonary Circulation
· Pulmonary hypertension & cor pulmonable
· Pulmonary oedema
11
· Pulmonary infarction
· Pulmonary embolism
· Pulmonary vasculitis
· Pulmonary arteriovenous malformations
· Cardiac problems in pulmonary Patient
· Pulmonary diseases produced in cardiac patients
· Diffuse alveolar haemorrhage
17. Respiratory failure
· Types
· Hypoxemia and Hypercarbia
· Clinical features, diagnosis & treatment
· Respiratory problems in neuromuscular disorders
· Respiratory failure in patient with obstructive airway disease
· Respiratory distress syndrome of newborn
· Acute respiratory distress syndrome
· Systemic inflammatory response syndrome & multiple organ dysfunction
· Syndrome
· Respiratory failure in the surgical patient.
18. Diseases of undetermined origin
· Sarcoidosis
· Idiopathic pulmonary fibrosis
· Bronchiolitis obliterans organizing pneumonia
· Lungs in collagen vascular diseases
· Pulmonary angiitis and granulomatosis
· Wegener’s granulomatosis
· Pulmonary lymphocytic angiitis and granulomatosis
· Honeycomb lungs
· Histiocytosis
· Pulmonary tuberous sclerosis
· Pulmonary amyloidosis
· Idiopathic pulmonary hemosiderosis
· Pulmonary alveolar proteinosis
· Pulmonary alveolar microlithiasis
· Broncholithasis
19. Sleep and sleep disorders
· Breathing and sleep
· Sleep related respiratory disorders
· Sleep apnoea syndrome
· Obesity hypoventilation syndrome