Problem Based Learning

Problem based learning (PBL) is a popular method of learning, currently used by most health professional courses in the UK.

The aim of PBL is for you to read through a complex and broad series of information, to identify areas of interest and areas you would like to explore further, in order to further your knowledge of specific topics, through self-directed learning.

 The questions our mentors have provided offer ideas of topics to explore and are written in three streams for aspiring medics, dentists and veterinarians; focus on all three or simply what interests you!

  • Remeber you can leave a comment if you have any questions and we will be sure to answer them.
  • We will  be discussing and answering the PBL cases in the Dental meeting at 5:45pm – 6:45pm, the Vet meeting at 7pm – 8pm and the Medics meeting at 7pm – 8pm on 7th November 2021.

Sensory Afflictions

THE Dental PBL Case

Systematically go through the function and structure of the tongue labelling the images in for each question in the Appendix. Think about the role the tongue has in relation to oral health and dentistry. 

Question:

1) What are the main functions of the tongue?

2) Label the following diagram with the names of the extrinsic and intrinsic muscles of the tongue (A to I)

3) What movements are made by the extrinsic and intrinsic muscles of the tongue?

4) What nerve(s) innervate the muscles of the tongue?

5) Label the following papillae (A to D)

6) What nerve(s) innervate the taste buds on the anterior 2/3rds of the tongue?

7) Label the following blood vessels (A to C)

8) Mrs Salt Tee is a new patient and comes in for a dental check-up appointment. She is 58 years old, a smoker and allergic to bananas and nuts. You are carrying out an oral examination and notice some lesions on her tongue.

What do you think this is, what may have caused it and what would be the treatment?

Appendix 1

Appendix 2

Appendix 3

Appendix 4

The answers will be covered during the Virtual Society Meetings November 2021.

And after available to re-watch HERE

THE Medic PBL Case

 Duncan is a 55-year-old man who presents to the ophthalmology (eye) clinic after referral from the opticians. He mentions that his vision has slowly been deteriorating in both eyes over the course of a year, and he no longer sees colours as vividly as he used to. He also admits to seeing halos around bright lights, which he notices most often from streetlamps and cars during his nightly runs. He denies any increase in floaters. On examination of his eye using a slit lamp, the doctor notes opacities in both lenses. He also lets the attending medical student examine Duncan’s optic disk with an ophthalmoscope for practice! Their view is shown in the picture. As Duncan is now having trouble reading, which he needs for his job, he is referred for cataract surgery in both eyes. This not only corrects his vision but also cures his myopia (short-sightedness).

Three years later, Duncan attends the eye casualty clinic complaining of severe pain in his right eye. He also mentions a severe headache, and he has been vomiting. On examination, the eye appears bloodshot, and the pupil is dilated and unresponsive to light. The doctor measures his intraocular pressure using tonometry, finds it to be very raised, and diagnoses acute angle-closure glaucoma. Duncan is given immediate eye drops and tablets to bring down the pressure in his eye and is then referred for laser peripheral iridotomy a day later when the pressure is brought under control for a more permanent solution. 

Fundoscopy image credits: University of Iowa, ophthalmology and visual sciences department 

 Questions

  1. Describe the anatomy of the eye in terms of its structures and functions.
  2. What are floaters and cataracts?
  3. What does cataract surgery involve? 
  4. What are red flag symptoms?
  5. What are some other conditions that can result in a red eye? 
  6. What are some questions that you would want to ask someone with a red eye? 
  7. What is glaucoma, and what causes it? 
  8. What are the two types of glaucoma, and what are the differences in their presentation? 
  9. What is laser peripheral iridotomy? 
  10. Identify the optic disk and macula in the fundoscopy picture provided. What are these, and why would you be worried if the optic disk was swollen? 
The answers will be covered during the Virtual Society Meetings November 2021. 

And after available to re-watch HERE

THE Vet PBL Case

Case 1:

You are an ambulatory equine vet and are called to see a horse with a ‘nose bleed’. You arrived and are presented with Poppy, a 6yo thoroughbred horse see Appendix 1. 

After obtaining a thorough history from the owner, you find out that Poppy has been having nose bleeds every time she finishes her exercise session at the training school.

Case 2:

You are presented with a 6 year old, FN Domestic Short Hair called Ginger with a lesion around the nose. See Appendix 2. The owner adopted her from Spain a couple of months ago, where she spent most of her time roaming the sunny streets outdoors. Upon completing your thorough clinical examination, you could not find any other abnormalities, besides a few tiny bumps around the tip of her ears.

Case 3:

You were called to investigate an outbreak of ‘wonky noses’ in a herd of 4 week old pigs. See Appendix 4. Unfortunately, a number of pigs did not survive and the post mortem report revealed a condition shown in Appendix 5 (The left specimen is from the pig with the ‘wonky nose’ and the right specimen is from a normal healthy pig). You collect samples and diagnose the condition called atrophic rhinitis. 

Case 1:

  1. What questions should you ask the owner to get more information?
  2. Putting the history of the animal aside, what other conditions can cause a nose bleed (epistaxis) in horses? 
  3. What treatment options are available for Poppy?
  4. When can Poppy go back to competing in the next race?

Case 2:

  1. This condition is also predisposed in what coloured cats?
  2. How can we further investigate this problem?
  3. What do you think is causing this condition?
  4. What treatment options are available for Ginger?
  5. Do you think this condition is very serious in cats?

Case 3:

  1. What are the two main bacteria involved in this condition, and what damage do they cause to the pig’s nasal structures?
  2. Appendix 3 shows you the structure of cilia in a pig’s nasal epithelium. What is the importance of this cilia in preventing respiratory disease in the pig?
  3. What are the options of treatment for this animal?
  4. Do you have any advice for the farmer to control this disease in future herds?

Apendix 1

Apendix 2

Apendix 3

Apendix 4

Apendix 5

Answers will be covered in the Virtual Veterinary  Society Meeting in November 2021.

And will be available to re-watch HERE

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