Presentations
- Autoimmune disorders
- Febrile and inflammatory illness
- Occult infections and sepsis
Conditions
- Febrile neutropenia
- Infections:
- bone
- cardiac
- intra-abdominal
- metastatic infection and bacteraemia of unknown origin
- soft-tissue
- vascular
- Inflammatory disorders:
- inflammatory arthritis
- inflammatory bowel disease (IBD)
- large vessel vasculitis
- polymyalgia rheumatica
- sarcoidosis
- Pyrexia of unknown origin (PUO)
- Undifferentiated ‘serious’ disease in adults
PCH
- Infections:
- atypical infections
- bone and soft tissues
- febrile neutropenia
- PUO
- Inflammation:
- inflammatory bowel disease
- vasculitis
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- AIDS-associated or immunocompromised opportunistic infections and malignancy
- Devices or prosthetic infections
- Immune-related adverse events (irAE) associated with immunotherapy treatment for malignancy
- Post-operative infections
- Rare inflammatory disorders
- Tuberculosis
Conditions
- Endocarditis
- Graft-versus-host disease
- Infections of intravascular devices, pacemakers, and prosthetic valves
- Infiltrative disease, such as IgG4 disease and Langerhans cell histiocytosis
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Aetiology of PUO, including secondary to infective, inflammatory, neoplastic, and miscellaneous conditions
- Definition of PUO
- Epidemiological risk factors for infections in immunocompetent and immunocompromised patients, including both medical and non-medical factors, such as cultural, geographic, and socioeconomic factors
- Localised organ involvement in bacteraemia, especially S. aureus and enterobacteria, and disseminated fungal infections
- Pathophysiology of inflammatory conditions, including:
- COVID-19
- inflammatory arthropathies, such as:
- ankylosing spondylitis
- gout
- rheumatoid arthritis
- inflammatory bowel disease (IBD)
- large vessel vasculitis, such as giant cell arteritis and Takayasu arteritis
- mycobacterial infections, including mycobacterium avian complex (MAC)HIV and mycobacterium tuberculosis
- polymyalgia rheumatica
- sarcoidosis
- Physiology of normal healing, and pathological changes of post-surgical interventions
- The pathophysiological mechanisms of acute and chronic inflammation with a focus on cellular-mediated and humoral-mediated immune responses, and their potential application in molecular imaging
PCH
- Basic normal physiology of development in organ systems in infants, children, and adolescents
- Common disorders of the immune system in the paediatric population, including juvenile idiopathic arthritis and vasculitis
Investigations
- Common laboratory investigations for the initial work-up of infection and inflammation, including biochemical, haematological, and serological markers
- Complementary imaging modalities:
- Infection imaging:
- bone marrow scan
- Ga-67 scan
- In-111 or Tc-99m labelled while cell scintigraphy
- PET, including F18-FDG and other novel radiopharmaceuticals
- radiolabelled monoclonal antibodies
- three-phase bone scan
PCH
- Three phase bone scan
- Labelled white cell scintigraphy
- PET including F-18 FDG and other novel radiopharmaceuticals
- Clinical impact of treatment, including antimicrobials and corticosteroids, on image interpretation and test utility
- Patient demographics, including geographic location, socioeconomic status, ethnicity, and cultural background, and the considerations when managing and following up these patients, such as travel from rural to metropolitan areas
- Patient preparation prior to scan, including fasting, dietary modifications, and importance of glycaemic control
- Provide specific instructions to modify patient preparation, and study acquisition protocols tailored to specific inflammatory or infectious conditions of interest
- The limitations and pitfalls of imaging studies in identifying causes of infection and inflammation
