Applied Science for Medicine Pathogenesis of psoriasis and psoriatic arthritis (predominantly genetic basis with environmental aggravators) Explain that: psoriasis can be associated with inflammatory psoriatic arthritis; severe early-onset chronic large-plaque psoriasis is an independent risk factor for cardiovascular disease Pharmacology of topical steroids, calcipotriol (vitamin D analogue) and coal tar; systemic methotrexate, ciclosporin, acitretin, biologics (tumour necrosis factor-alpha antagonists - adalimumab, etanercept, infliximab; interleukin 12/23 inhibitor - ustekinemab) Understand the mechanism of action of phototherapy in treating inflammatory skin disorders
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Clinical and Communication Skills History of psoriasis, related conditions and previous management (how treatments were used, efficacy and side effects) Skin examination to determine the extent and severity of psoriasis Describe the cutaneous features using dermatological terminology Establish a provisional treatment plan appropriate for the patient, the nature and extent of his psoriasis and his lifestyle Undertake a general health review including medical and drug history, examination and appropriate investigations. Address any reversible cardiovascular risk factors Provide the patient with verbal and written information about chronic plaque psoriasis and the chosen treatment Establish the psychosocial effect of psoriasis for this patient and his family/whānau
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Personal and Professional Skills Establish a multidisciplinary treatment programme, which may involve a GP, dermatologist, rheumatologist and general physician Establish a therapeutic relationship with the patient and realistic treatment goals in the management of a chronic disorder, including addressing physical and psychological aspects
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Hauora Māori Engage appropriately with whānau as well as the patient for management of chronic skin disease Understanding of inequities in access to health services and quality of medical care for Māori, and application of this to clinical decision making and management
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Population Health Epidemiology of psoriasis
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