Integration Foundation

• Upon completion of this problem, students should be able explain the causes and management of preterm labour. Students should be able to describe the social and health impacts of teen pregnancy for teen parents and their children.
• Upon completion of this problem, students should be able to identify maternal complications of pregnancy with an emphasis on hypertension, and describe resuscitative measures used in hypertensive emergencies (eclampsia). Students should be able to describe the significance of neonatal hypoglycemia and explain the principles surrounding newborn screening for inborn errors of metabolism.
• Describe how vaccines induce immunologic memory to prevent disease.
• Explain the vaccination schedule for infancy and childhood.
• Explain the mathematical/epidemiological concepts of herd immunity.
• Determine the risk/benefit of such treatments as vaccination.
• Explain the roles of primary, secondary and tertiary level care in pregnancy.
• Review screening tests as they apply to low risk and high risk pregnancy.
• Explain the timing and capabilities/limitations of ultrasound in low risk and different high risk pregnancies.
• Describe the risk of preterm labour, predisposing factors and how these might be managed.
• Identify medications, both over-the-counter and prescribed, used in pregnancy and their potential side effects.
• Review placentation, normal histology, structure and function of the placenta in gas exchange, nutrition and waste excretion.
• Describe factors that adversely affect fetal growth and development.
• Describe the tools used to evaluate fetal wellbeing in the third trimester.
• Describe fetal and maternal complications related to the uteroplacental insufficiency.
• Describe the causes and significance of neonatal hypoglycemia.
• Review the concepts of newborn screening and how they are applied in Ontario/Canada.
• Review preconception and antenatal care as it applies to the first and second trimester.
• Differentiate the approach to urinalysis and culture (specifically asymptomatic bacteriuria) in pregnancy.
• Describe normal laboratory variations seen in pregnancy.
• Review the causes and metabolic consequences of acute kidney injury and demonstrate how that manifests clinically.
• Review the role of platelets in hemostasis and thrombosis.
• Explain the clinical presentation of bleeding disorders caused by abnormalities of secondary hemostasis, with emphasis on disseminated intravascular coagulopathy, linking to preeclampsia.
• Upon completion of this problem, students should be able to identify and describe the risks of intimate partner violence, and the obligations of the healthcare team in the assessment and management of a family at risk.
• Describe resources and obligations of medical staff when concerns are noted about Intimate partner violence (IPV), including why recognizing and responding safely to IPV in pregnancy and in the early post-partum period is especially important.
• Describe risk factors associated with IPV.
• Describe common injuries associated with IPV including concussion and fractures.
• Describe the well-baby exam, routine visit timing and Rourke baby record.
• Upon completion of this problem, students should be able to identify and develop an approach to the assessment and management of child maltreatment. Students should also be able to describe an approach to the diagnosis of a child with autism spectrum disorder.
• Describe the responsibility of the treating physician to identify that any child can be at risk of child maltreatment/abuse.
• Describe resources and obligations of medical staff when concerns are noted about child endangerment in a family or other setting, including when to involve child protection professionals.
• Describe risk factors associated with child maltreatment and explain the pitfalls associated with ascribing population-based risk factors to individual children and families.
• Identify the long-term psychosocial, behavioural, emotional and psychiatric morbidities associated with trauma in early childhood.
• Demonstrate an awareness of screening tools for Autism Spectrum Disorder.
• Demonstrate the ability to generate a differential diagnosis for developmental delay.
• Upon completion of this problem, students will be able to review risk factors for cervical cancer and the role of vaccines in decreasing these risks and describe different pathological results for cervical cancer screen and their associated treatments. Students will also examine barriers to successful cervical screening programs and implementation amongst marginalized populations.
• Explain and review the roles of the HPV vaccines in preventing cervical precancers and cancers.
• Differentiate systematic and SES barriers contributing to cervical cancer risk factors and success of screening programs in populations with a higher incidence and mortality of cervical cancer
• Compare different pathological pap smear results and their significance in a cervical screening pathway and treatment.
• Differentiate between stages of low and high grade lesions in cervical cancer subtypes - adenocarcinoma and squamous cell carcinoma.
• Review the treatment modalities for cervical cancer, including radiotherapy, surgery and palliative chemotherapy.