Basics of Family Medicine

Annotation: The aim of the practical class:  To acquire theoretical and practical knowledge while consulting patients with elevated body temperature in primary care The main tasks:  To study the most often causes of fever in children and adults in primary care (including, upper and lower respiratory tract infections, viral and bacterial infections with rash, uncomplicated urinary tract infections, gastrointestinal infections)  To master consulting of out-patients with elevated body temperature in primary care  To understand the role of clinical, laboratory and visual diagnostic tools in differential diagnosis of acute fever an fever of unknown origin in primary care  To practice management of out-patients with elevated body temperature Topics covered during the class: The list of knowledge and/or skills to be acquired:  Assessment of red flag signs and referral to hospital or further investigations  Differences in body temperature in different measurement sites and using different thermometers  Differential diagnostic steps, tactics during the first 3 days of illness and later.  Consultation specifics regarding elevated body temperature.  Symptomatic treatment indications and options in adults and children.  Indications and preferences for antibiotic use in most common infections.  Cooperation with other primary health care staff and secondary health care specialists. Home tasks: • To read the study guide of the practical class as well as recommended literature To repeat infectious diseases course from previous study years Literature: BOOKS /BOOK CHAPTERS  Harrison’s Principles of Internal Medicine. Part 2: cardinal manifestations and presentation of diseases. Section 2: Alterations in Body Temperature. McGraw-Hill Medical  Nield L, Kamat D. Book chapter: Fever. Nelson Textbook of Pediatrics. Elsevier, 2016. Chapter 176, 1277-1279.e1.  James E. Leggett. Book Chapter: Approach to Fever or Suspected Infection in the Normal Host. Goldman-Cecil Medicine. Elsevier, 2012. Chapter 280, 1849-1854.e2.  Weber R., Fontana A. Chapter 4 Fever. Siegenthaler’s Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis.. Thieme.2007  Nathan W. Mick Book Chapter: Pediatric Fever. Rosen's Emergency Medicine: Concepts and Clinical Practice. Elsevier, 2018. Chapter 166, 2058-2068.e2  Usatine R.P., Smith M.A., Chumley H.S, Mayeaux E.J. The Color Atlas of Family Medicine, 2e. McGraw-Hill Medical. 2013.  Tess A.V. Section II: General Symptoms. Chapter 8: Fever. The Patient History: An Evidence-Based Approach to Differential Diagnosis, 2e. McGraw-Hill Medical, 2012.  The Merck Manual of Diagnosis and Therapy. http://www.merckmanuals.com/professional/infectious_diseases.html  Lecture and workshop materials on infectious diseases of 3rd to 6th study years.  L.Vīksna un līdzautori. Infekcijas slimības. 2011. ARTICLES AND GUIDELINES  Barbi E, Marzuillo P, et al. Fever in Children: Pearls and Pitfalls. Children. 2017;4(9). Available at: https://www.ncbi.nlm.nih.gov/pubmed/28862659  Thompson M, Van den Bruel A, et al. Systematic review and validation of prediction rules for identifying children with serious infections in emergency departments and urgent-access primary care. Health technology assessment (Winchester, England). 2012;16(15):1-100. Available at https://www.ncbi.nlm.nih.gov/pubmed/22452986  Mace SE, Gemme SR, Valente JH, et al. Clinical policy for well-appearing infants and children younger than 2 years of age presenting to the emergency department with fever. Ann Emerg Med. 2016 May;67

Annotation: Aim of the class:  To raise awareness of the management in a family physician’s practice, of the division of responsibilities between the members of a family physician’s team.  To raise awareness of the principles of cooperation: a family physician- a patient- a family.  To introduce with the manipulations carried out in a family physician’s practice and their practical application. Main tasks: ➢ To get acquainted with a functioning of a family physician’s practice ➢ To get acquainted with the equipment of a family physician’s practice ➢ To acquire the application of specific manipulation devices in practice Activities during the class:  Individual and group work on the topic  Introduction to practical manipulations, principles of their application in practice, independent work - mastering of manipulations Topics covered during the class: Homework:  Understanding the structure of GP practice  The general principles of organization of GP practice  Family physician team members, the allocation of responsibilities among team members  Understanding the delegation of responsibilities between GP team members  The concept of a family doctor's practice practicable manipulation The necessary background knowledge: ➢ Understanding about the organization of a family physician’s practice, the principles of action ➢ The idea about the principle of a team work in a family physician’s practice, about the division of responsibilities among the team members ➢ The idea about the delegation of responsibilities among the team members Self-control questions: 1. What are the basic principles of family medicine 2. What is the family doctors working day plan and what it includes 3. What role does the patient play in the decision making process in GP practice 4. What is the optimal family doctor practice team model 5. What are the principles behind the collaboration between a family doctor and his or her team members 6. Optimal number of GPs premises and what it depends on 7. Equipment that should provide the family doctor's premises 8. Information to be placed in GP practice Literature: 1. RSU Library Database: AccessMedicine: http://accessmedicine.mhmedical 2. Chantal Simon, Hazel Everitt, Francoise van Dorp. Oxford Handbook of General Practice, Third Edition, 2010. Section 3, Practice managment.