Key presentations and conditions
Basic Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Presentations
- Diarrhoea
- Dysuria
- Fever without a focus
Conditions
- Bacteraemia
- Common skin infections, such as:
- cellulitis, and other streptococcal and staphylococcal skin manifestations
- fungal infections
- parasitic infections, such as head lice and scabies
- Epstein-Barr virus (EBV)
- Febrile neutropenia
- Infective endocarditis
- Line and prosthetic infections
- Lower respiratory tract infections, such as pneumonia
- Meningitis and encephalitis
- Ophthalmological infections, such as blepharitis, conjunctivitis, and orbital or periorbital cellulitis
- Septic arthritis
- Septicaemia and septic shock
- Upper respiratory tract infections, such as otitis media and tonsillitis
- Urinary tract infections
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - 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
Less common or more complex presentations and conditions
Basic Trainees will understand these presentations and conditions. Basic Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Presentations
- Fever in the returning traveller
- Males presenting with acute testicular pain and swelling
- Patients presenting following recent sexual assault
- Vaginal discharge
Conditions
- Abscesses
- Emerging or less common infections, such as:
- cytomegalovirus (CMV)
- toxoplasmosis
- Genito-urinary conditions:
- anogenital ulcers
- epididymo-orchitis
- human papillomavirus - associated conditions, including anogenital warts
- pelvic inflammatory disease
- sexually transmitted infections (STIs)
- candidiasis
- vaginosis
- Hepatitis viruses
- HIV
- Infections in the immunocompromised host, such as those with diabetes mellitus, HIV, and those receiving immunosuppressive therapies
- Infections in the returning traveller, such as dengue fever, malaria, and parasitic infections
- Necrotising fasciitis
- Osteomyelitis
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - 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
Epidemiology, pathophysiology and clinical sciences
Basic Trainees will describe the principles of the foundational sciences.
- Antimicrobial resistance and strategies for management and prevention, including antimicrobial stewardship
- Biology of common and important pathogens
- High risk groups for the different categories of infectious diseases
- Host response to infection
- Modes and sites of transmission, incubation periods, symptoms, possible complications, and occupational hazards of the common infectious diseases, such as STIs
- Occupational exposure-related infections
- Pathophysiology of HIV, and the different groups and common side effects of anti-retroviral medications
- Pharmacology of major antimicrobial (bacterial, fungal, and viral) medication classes used
- Principles of infection control, including hand hygiene
- Principles of innate and adaptive immune responses
- Principles of passive and active immunisation
- Principles underlying laboratory testing for infectious diseases
- Role of immunisation in preventing infectious diseases, including for STIs
Investigations, procedures and clinical assessment tools
Basic Trainees will know the indications for, and how to interpret the results of these investigations, procedures, and clinical assessments tools. Basic Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Investigations
- Basic imaging:
- chest X-ray (CXR)
- CT of the head
- CT of the abdomen and pelvis
- MRI
- nuclear scans
- ultrasound scan, including echocardiography for the evaluation of endocarditis
- X-ray of bone and joints
- Faecal parasite detection
- Investigations for the common STIs, such as chlamydia, gonorrhoea, herpes, HIV, syphilis, and trichomoniasis, including culture, nucleic acid amplification tests (NAAT), and serology
- Laboratory tests:
- full blood count (FBC)
- inflammatory markers
- microbiology
- serology
- virology
- Lumbar puncture
- Malaria detection
- Microbiology and culture of blood, broncho-alveolar lavage (BAL), cerebrospinal fluid (CSF), joint aspirate (synovial fluid), peritoneal fluid, pus, sputum, and urine
- Mycobacterium tuberculosis detection
- Respiratory and gastrointestinal polymerase chain reactions (PCR)
- Serologic testing for CMV, EBV, hepatitis viral infection, HIV, and syphilis
- Skin biopsy
- Viral load assessment for:
- CMV
- hepatitis viruses
- HIV
Procedures
- Common vaccine administration, including consent and delivery
Important specific issues
Basic Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
- Antibiotic use in patients with a history of antibiotic allergy, including anaphylaxis
- Assessment for and provision of emergency contraception
- Assessment of potential routes of infection, routes of transmission, and secondary sites of infection
- Contact tracing and partner notification in STI management
- Cultural beliefs of communities and the effect these have on the management of contact tracing
- Global health impact and distribution of infectious diseases, including neglected tropical diseases
- Infection control including hand hygiene, aseptic technique, and procedures for donning and doffing personal protective equipment (PPE)
- Management of STIs in pregnant patients
- Multidisciplinary approach to the management of complicated or chronic infections
- Planning for isolation of patients with infectious diseases
- Post-exposure prophylaxis in emergency situations
- Principles of immunisation in the immunocompromised host
- Principles of investigating infections, and initiating and monitoring treatment response in immunocompromised patients
- Principles of investigating and treating prosthetic joint, artificial heart valve, pacemaker, and central line infections in normal and immunocompromised patients
- Requirements for public health notification of infectious diseases, including local guidelines
- Risks of needle-stick injuries and non-occupational exposure, including local guidelines, and post-exposure prophylaxis and follow up
- Symptoms of syphilis that can mimic other conditions and how this can be considered in the differential diagnosis
- References to patients in the remainder of this document may include their families or carers.