Hi, Thank you for agreeing to do the countdown to finals lectures!

We have produced a quick guide to the sort of things to cover in your lectures. We thought this may be useful, especially for the people who didnt come to Leeds. The Leeds Syllabus Fifth year at Leeds is based around six clinical placements. In our experience there is a definite emphasis on topics which are commonly seen by FY1s and can be applied to your first year at work, along with ABC management of the more common emergencies. As a rule, there isnt a lot of theory and basic science covered in either the course materials or exams. The written exams are made up of two multiple choice papers (MCQs and EMCQs) and a slide show. The slideshow is made up of a series of pictures on which the candidates must answer two to three questions in their own words. There is no multiple choice element in this section of the exam. The OSCE is run over two days, with a mixture of examination and diagnosis of patients with pathology, history taking, clinical reasoning, and procedure type stations. Some examples of the stations on last years exams are; Respiratory and cardiac exam C. Diff. history Fainting patient history Cannula and fluid prescribing Death certification Discussing DNAR with a family member The syllabus is based around a long list of clinical conditions that 5th years should be familiar with. They are divided into; Core Clinical Conditions These make up the majority of the conditions listed. Candidates should know the following about them; underpinning basic scientific principles aetiology and epidemiology pathology presenting features appropriate investigations differential diagnosis principles of management complications and outcome prevention of disease Act Conditions For these conditions, candidates should know all of the above, along with how to; initiate appropriate action prescribe appropriately

recognise the limits of your own competence and know how to whom to refer.

Know Of Conditions These are not covered in detail. All candidates need to do is; be able to define and recognise a clinical image of the condition consider in a differential diagnosis (if appropriate) know when and where to find out more about if necessary. The list of conditions is included at the end of this handout. Your Lecture Top Tips We have included some handy tips for how to structure your lectures, from being C2F guinea pigs last year. 1. Keep it clinical- Leeds finals are massively oriented towards practical medicine and your job as an FY1, so put a clinical slant on what you are doing. Which leads to 2. Chill out on the basic science- The amount of basic science included in Leeds exams is comedically small. Unless it relates to the risk factors for or the management of a condition fairly directly (think Virchows triad in thromboembolism) then there isnt any need to include it in a huge amount of detail. 3. Common things are common- Try to concentrate on the common things, especially the stuff you see every day on the ward. 4. Keep it swift- Keep your lecture to 30 minutes at the absolute most. The arrythmias lecture lasted two hours last year and everyone nearly cried. 5. Keep it simple- The C2F lectures are meant to be an overview of the topic. It isnt possible to fit everything in, especially if you have a huge topic. 6. Drugs and doses- You are only expected to know the doses for very common things (like analgesia) and very important things in the core conditions (like adrenaline in a crash). No need to go into detail with every medication other than that. 7. Eponymous syndromes and mega rare things- Leeds do not care for such things, so dont worry about trying to cover them. 8. Slides and sample questions- If you have some time spare at the end, sample questions and slideshow questions always went down very well. The Practical Stuff Your lecture needs to be a thirty minute summary of your topic, with a powerpoint slides to present from and a handout that summarises your talk that people can take away at the end. We recommend you use the titles of the core clinical conditions competencies as your lecture slides. Your lecture and handout need to be emailed to the C2F account (countdown2finals@gmail.com) a minimum of one week before you present so we can upload it and put the C2F front page on it and sort out the handouts. If you include pictures, make sure they are credited fully with the website you got them from. Set out the page how you want- but bear in mind people will probably want to print

them. Also, include your references at the end. There is no need to do them in the proper Harvard style, but people may want to read a bit further.

Thank you for agreeing to take part in the Countdown to Finals lectures. Big love, The C2F Team x

Clinical Conditions
CORE CLINICAL CONDITIONS (List 1) BLOOD Anaemia iron deficiency* Acute non-haemolytic reactions during transfusion* Haemolytic anaemias Myeloma Lymphomas Macrocytic anaemia

CARDIOVASCULAR SYSTEM Cardiac arrest* Acute left ventricular failure* Stable angina Atrial flutter Heart block (all degrees) Re-entrant supra-ventricular tachycardia Mitral regurgitation & stenosis Chronic cardiac failure Pulmonary embolism Deep vein thrombosis* Superficial thrombophlebitis* Varicose veins Myocardial infarction* Unstable angina* Hypertension* Atrial fibrillation Ischaemic heart disease Ventricular tachycardia Aortic regurgitation & stenosis Infective endocarditis Aneurysms Acute limb ischaemia* Cannula-related phlebitis* Chronic lower limb ischaemia

EMERGENCY CONDITIONS Anaphylaxis* Cardiogenic shock* Acute respiratory failure* Septic shock* Hypovolaemic shock* Cardiac arrest*

Overdose* (paracetamol, salicylate, TCADs and Iron)

ENDOCRINE SYSTEM Hypoglycaemia* Type 1 diabetes Severe acute diabetic foot infection/ischaemia Adrenocortical insufficiency (Addisons Disease) Hyperparathyroidism Hyperlipidaemia Diabetic ketoacidosis* Type 2 diabetes Gravess disease Hypothyroidism Hypercalcaemia of malignancy

GASTROINTESTINAL SYSTEM Upper GI Tract Upper GI bleeding* Oesophagitis and reflux Hiatus hernia Gastric carcinoma Coeliac disease Peritonitis Femoral hernia Umbilical hernia Cholecystitis Viral hepatitis Ascites

Malnutrition Oesophageal carcinoma Peptic ulcer Carcinoma of pancreas Acute pancreatitis Inguinal hernia Incisional hernia Gallstones Portal hypertension Cirrhosis

Lower GI Tract Inflammatory bowel disease Appendicitis Ileus

Diverticular disease Intestinal obstruction Colorectal carcinoma

Irritable bowel syndrome Haemorrhoids Anal fissure

Rectal prolapse Perianal abscess Sigmoid volvulus

INFECTION (not classified elsewhere)

Infection in surgical patients* Severe sepsis* Human immunodeficiency virus (HIV) Measles Rubella Whooping cough Malaria Febrile traveller

Infectious mononucleosis* Pyrexia of undetermined origin Influenza Mumps Chicken-pox Infective gastro-enteritis

*Hospital acquired infection including Clostridium difficile enteritis/colitis (antibiotic induced)

MUSCULOSKELETAL Osteoarthritis Rheumatoid arthritis Septic arthritis* Temporal arteritis* Spinal cord compression* Fragility fractures Reactive arthritis NERVOUS SYSTEM Stroke* Meningitis* Osteoporosis Polymyalgia rheumatica Gout/ Pseudogout Vasculitis Low back pain Ankylosing Spondylitis

Acute confusional state* Cranial nerve lesions Subarachnoid haemorrhage* Extradural haematoma Parkinsons disease Epilepsy Migraine

Status epilepticus Peripheral nerve lesions Subdural haematoma Multiple sclerosis Dementia Tension headache

ORGANS OF SPECIAL SENSE Ear Otitis media* Ear wax Labyrinthitis (and the causes of dizziness)

Otitis externa Deafness

Eye Cataracts Acute glaucoma* Conjunctivitis allergic and infective Episcleritis/scleritis Corneal ulcers Stye Ocular foreign bodies/trauma

Nose Epistaxis Rhinitis

Nose trauma and foreign bodies Sinusitis

Skin Acne Psoriasis Basal cell carcinoma Melanoma

Eczema Warts Squamous carcinoma Leg ulcers

Throat and Mouth Acute tonsillitis* Upper respiratory tract infection

Acute pharyngitis* Acute epiglottitis

PSYCHIATRY & MENTAL HEALTH Adjustment disorders (acute and chronic), bereavement Alcohol & substance misuse/dependency Anxiety/panic attacks (assessment and initial management) Phobic anxiety disorders (such as agoraphobia, social phobia, simple phobias) Bipolar affective disorders (manic and hypomanic states) Dementia (common causes e.g. Alzheimers, multi-infarct, alcohol-induced); risk assessment of confused older adults* Pseudodementia Acute & chronic confusion

Depressive disorders recognition and distinguish from dementia) Eating disorders (bulimia and anorexia nervosa) Health anxiety (hypochondriasis) and excessive/inappropriate health presentations Mental Health Act principles of use Obsessional compulsive disorder Personality disorders Schizophrenia and paranoid disorders including drug-induced psychosis Somatisation Suicide and parasuicide assessment and management* Sleep disturbance (assessment and management of insomnia)

REPRODUCTIVE SYSTEM Genital warts Genital herpes HIV all manifestations Gonorrhoea Syphilis

Breast Fibroadenoma Breast cancer Breast abscess

Torsion of the testis* Balanitis Phimosis/paraphimosis

Gynaecological causes of: Abdominal pain Vaginal discharge Vaginal bleeding Erectile dysfunction Epididymo-orchitis Urethritis Testicular cancer

RESPIRATORY SYSTEM

Hyperventilation (panic attack)* Acute asthma attack* COPD Tension pneumothorax* Pleural effusion Metastatic cancer lung Cystic fibrosis Inhaled foreign body Sleep disorders obstructive sleep apnoea SUBSTANCE ABUSE Opiate overdose Paracetamol overdose* Alcohol intoxication withdrawal Recreational drug abuse

Asthma Acute exacerbation of COPD* Acute bronchitis* Non-tension-pneumothorax Bronchial carcinoma Sarcoidosis Pneumonia Tuberculosis

Aspirin overdose Alcohol Cigarettes Solvent abuse

TRAUMA Sprained ankle Long bone fracture Head injury Multi system trauma Assessing the injured limb Colles fracture Hip fracture Hand sepsis

URINARY SYSTEM Urinary tract infection* Acute pyelonephritis*

Acute cystitis* Prostatic acute urinary obstruction*

Chronic renal failure Nephrotic syndrome Acute renal failure Severe hyperkalaemia* Hydronephrosis Renal carcinoma Urethritis Urinary stones

Stress/other causes of incontinence Detrusor instability Bladder cancer Prostatic cancer

ACT CORE CLINICAL CONDITIONS (Summary of those marked * in List I)

In relation to these conditions, you should be competent to:

initiate appropriate action

prescribe appropriately

recognise the limits of your own competence and know how, when and to whom to refer.

BLOOD Anaemia iron deficiency Acute non-haemolytic reactions during transfusion

CARDIOVASCULAR SYSTEM Cardiac arrest Acute left ventricular failure Hypertension Acute limb ischaemia Cannula-related phlebitis Postural hypotension (not limited to CV causes) Myocardial infarction Unstable angina Deep vein thrombosis Superficial thrombophlebitis Complete Heart Block

EMERGENCY CONDITIONS Anaphylaxis Cardiogenic shock Acute respiratory failure Overdose Septic shock Hypovolaemic shock Cardiac arrest Falls in the elderly (all causes)

ENDOCRINE SYSTEM Hypoglycaemia Diabetic ketoacidosis

GASTROINTESTINAL SYSTEM Upper GI bleeding Constipation & diarrhoea

INFECTION (not classified elsewhere)

Infection in surgical patients Severe sepsis Pyrexia of unknown origin Hospital acquired infection.

Infectious mononucleosis Hospital acquired infection Gastroenteritis

MUSCULOSKELETAL Septic arthritis Spinal cord compression Temporal arteritis

NERVOUS SYSTEM Stroke Acute confusional state Spinal cord compression Meningitis

ORGANS OF SPECIAL SENSE Ear Otitis media Throat & Mouth Acute Tonsillitis Acute pharyngitis REPRODUCTIVE SYSTEM Torsion of the testis Suspected ectopic pregnancy

RESPIRATORY SYSTEM Hyperventilation (panic attack) Acute bronchitis Pulmonary embolism Acute asthma attack Tension pneumothorax Pneumonia

Acute exacerbation of COPD (chronic obstructive pulmonary disease)

URINARY SYSTEM Urinary tract infection/acute cystitis Severe hyperkalaemia Acute pyelonephritis Prostatic acute urinary obstruction

TRAUMA Compartment syndrome LESS COMMON KNOW OF CORE CLINICAL CONDITIONS (List II)

The following list indicates less common conditions and topics that you should:

have an awareness of and have heard about be able to define and recognise a clinical image of the condition consider in a differential diagnosis (if appropriate) know when and where to find out more about if necessary.

You are not expected to have an in-depth knowledge of these conditions.

BLOOD Disseminated intravascular coagulation Sickle cell disease Thalassaemia Haemophilia Thrombophilia Thrombocytopenia obstruction Pancytopenia Neutropenia Bone marrow replacement Acute leukaemia Chronic myeloid leukaemia Chronic lymphocytic leukaemia

CARDIOVASCULAR SYSTEM Accelerated Hypertension Pericarditis/Pericardial Effusion Cardiomyopathy Aortic Dissection Mesenteric Ischaemia Superior Vena Cava thrombosis / Raynauds syndrome Lymphoedema

EMERGENCY CONDITIONS Spinal shock Complications of shock

ENDOCRINE SYSTEM Hypoparathyroidism Thyroid Cancer

Acute renal failure

Multinodular goitre Toxic nodule Simple goitre Thyroiditis Hypopituitarism Pituitary tumours Suppressed hypothalamo-pit-adrenal axis Phaechromocytoma

Cushings syndrome Adrenogenital syndrome Hyperaldosteronism Hypoaldosteronism Hirsuitism Hyperosmolar hyperglycaemic non ketotic coma Diabetes insipidus GASTROINTESTINAL SYSTEM Upper GI Tract Achalasia Gastritis Chronic pancreatitis Chronic hepatitis Subphrenic abscess Liver abscess Primary liver tumours Hepatic failure Epigastric hernia Lower GI Tract Meckels Diverticulum Colonic polyposis Anal Carcinoma Perianal Haematoma Fistula-in-ano

MUSCULOSKELETAL SYSTEM Seronegative arthritis Pagets and osteomalacia Fibromylagia

NERVOUS SYSTEM Brain Tumours Encephalitis Hydrocephalus Myasthenia Gravis

Connective tissue diseases eg SLE, scleroderma, Soft tissue conditions e.g. rotator cuff tears, lateral epicondylitis

ORGANS OF SPECIAL SENSE Ear Cholesteatoma Acoustic neuroma Nose Nasal Polyps

Eye Acute anterior uveitis Iritis Uveitis Ectropion Entropion Blepharitis

Skin Solar Keratosis Keloid scar Ganglion Vascular lesions of the skin Kaposis Sarcoma

Throat and Mouth Oral tumours Trigeminal neuralgia

PSYCHIATRY & MENTAL HEALTH Rarer dementias Picks disease Creutzfeld Jakob Spongiform encephalopathies AIDS related dementia

REPRODUCTIVE SYSTEM Female Breast Fat Necrosis Fibrocystic disease

Learning disability Post-traumatic stress disorder

Male Hypospadias Undescended testis Prostatitis

RESPIRATORY SYSTEM Bronchiectasis Cryptogenic fibrosing alveolitis Coalworkers pneumoconiosis Mesothelioma and asbestosis Lung abscess empyema

SUBSTANCE ABUSE/POISONING Carbon Monoxide Poisoning Other drug/substance abuse

TRAUMA

Facial Injury Shoulder fractures The injured hand Soft tissue knee injuries Foot and ankle fractures Pelvic and acetabular fractures Ilizarov frame surgery URINARY SYSTEM Adult polycystic disease Urethral stricture Vesico-ureteric reflux Glomerulonephritis Orthostatic proteinuria

CORE CLINICAL PROBLEMS FOR THE STUDENT AND NEW DOCTOR (List III)

As a student and newly qualified junior doctor you will encounter patients with a variety of Presenting Complaints. The following list indicates common presenting problems for which the newly qualified doctor is expected to understand the underlying biological science (anatomical, physiological, biochemical, psychological and pathological). Although they are listed using systems and topic headings, each problem can relate to a number of body systems. You may find it useful when using this list to refer back to the Core Clinical Conditions. CARDIOVASCULAR SYSTEM Chest pain Palpitations Collapse Painful limb Peripheral oedema EMERGENCY CONDITIONS Collapse Coma Respiratory Arrest Cardiac Arrest Haemorrhage internal and external Hypothermia

ENDOCRINE SYSTEM Gynaecomastia Weight change Urinary frequency

GASTROINTESTINAL SYSTEM Weight Loss Dysphagia Dyspepsia Vomiting

INFECTION

Haematemesis Diarrhoea

Febrile patient

Constipation Change in bowel habit

MENTAL STATE

Faecal incontinence Melaena

Confusion/Delirium Aggression/Violence

Rectal bleeding Acute abdominal pain

Depression Sleep Disturbance MUSCULOSKELETAL SYSTEM Back and /or neck pain Painful swollen and /or stiff joints Peripheral joint /joint region pains Painful limbs Difficulty walking The limping child Limb weakness

Abdominal swelling Jaundice NERVOUS SYSTEM Pain Headache Fits Faints Collapse Coma Difficulty walking Hemiparesis/ Hemip

ORGANS OF SPECIAL SENSE Ear Earache Tinnitus Hearing loss Dizziness Eye Acute Red Eye Loss of Vision Visual Failure Squint

Skin Rash Lump in the groin Lump in the neck Lump in the skin

Throat/Mouth Oral Ulceration Hoarseness Globus Cervical Lump Stridor

Nose Epistaxis

REPRODUCTIVE SYSTEM Female Vaginal discharge Discharging nipple Breast lump RESPIRATORY SYSTEM Chest pain Breathlessness Wheeze Cough Haemoptysis Cyanosis TRAUMA The severely injured patient Assessment of the injured limb Spinal cord compression URINARY SYSTEM Loin Pain Dysuria Oliguria/Anuria Acute Retention of Urine Incontinence Male Testicular Swelling/pain