MED 272 — الجهاز المكوّن للدم واللمفي
السنة 2 · 28 محاضرة · 6 ساعة معتمدة
العناوين والأهداف منقولة من خطة كلية الطب الرسمية.
1. Introduction to hematopoietic system
Multidisciplinary
- Understand the general outline of the module.
- Be familiar with the modalities of teaching throughout the course.
- Acknowledge the important relation between normal and abnormal structure and function.
- Appreciate the importance of basic sciences in clinical application.
2. Characteristics of blood
Physiology
- Describe the composition of blood.
- Understand the functions of blood.
- Understand factors affecting viscosity of blood.
3. Porphyrins, heme and hemoglobin
Biochemistry
- Describe synthesis of porphyrins.
- Describe regulation of heme synthesis.
- Know types and causes of porphyrias.
- Describe degradation of heme and jaundice.
- Know structural features of human hemoglobin.
- Know different types of human globin genes.
- Know different types of normal hemoglobin.
- Know the developmental expression of globin genes.
- Identify some abnormal hemoglobins.
4. Heme-lymphoid tissue I/II/III
Anatomy
- Describe briefly the microscopic morphology of various blood cell types.
- Discuss the development of various blood cell types.
- Understand the origin and composition of lymphatic fluid.
- Explain the circulation of lymph in the body.
- Describe the major lymph vessels in the body.
- List the major lymph node groups in the body.
- Describe the microscopic structure of lymph node (mucosa and other associated lymphoid tissue).
- Describe the microscopic structure of spleen.
- Describe the microscopic structure of tonsils.
- Describe the microscopic structure of thymus.
5. Hematopoiesis
Physiology
- Understand the concept of hematopoiesis.
- Name organs responsible for hematopoiesis in the fetus and list the developmental stages of hematopoiesis both prenatally and postnatally.
- Understand the concept of pluripotent hematopoietic stem cell, and the growth factors involved.
- Understand the nutritional requirement for hematopoiesis specifically, B12, folic acid and iron.
- Describe cellular stages of hematopoiesis.
6. Hemoglobin structure and function
Biochemistry
- Describe the mechanism of oxygen binding to myoglobin and hemoglobin.
- Describe the conformational differences between deoxygenated and oxygenated hemoglobin.
- Define the concept of cooperativity in oxygen binding to hemoglobin.
- Describe the Bohr effect and its role in modulating the binding of oxygen to hemoglobin.
- Explain how 2,3-bisphosphoglycerate interacts with hemoglobin and influences oxygen binding.
- Summarize the processes by which carbon dioxide is transported from peripheral tissues to the lungs.
7. Physiology of RBCs/WBCs
Physiology
- Describe RBCs structure and its structure-function relationship.
- Understand the different functions of RBCs.
- Understand structure-function relationship of RBCs cell membrane like fluidity.
- Identify the physiological factors that affect RBCs count.
- Understand the life span of RBCs and its relationship to blood donation.
- Recognize the different structural types of WBCs and their physiological functions.
- Define the life span of WBCs and the physiological implication of that. Differentiate between migrating and circulating pools of WBCs.
8. Anemia classification/diagnosis
Pathology
- Name and describe the maturational sequence of erythroid cells in the bone marrow using the terms: proerythroblast, erythroblast, normoblast and reticulocyte.
- Classify anemia according to pathophysiologic criteria.
- Classify anemia according to mean corpuscular volume (MCV) and give three examples of each type.
- Discuss the reticulocyte count, corrected reticulocyte count, and diseases associated with high and low numbers.
9. Drugs used in anemia
Pharmacology
- Describe the normal mechanism of regulation of iron in the body.
- List the major forms of iron used in the therapy of anemias.
- List the anemias for which iron supplementation is indicated and those for which it is contraindicated.
- Describe the acute and chronic toxicity of iron.
- Describe the major hazards involved in the use of folic acid as sole therapy for megaloblastic anemia.
- Describe the major bone marrow colony stimulating factors.
10. Molecular basis of hemoglobin disorders
Biochemistry
- Understand the molecular basis of sickle cell disease and trait.
- Understand the molecular basis of beta thalassemia.
- Know molecular basis of alpha thalassemia and types.
- Know what is hemoglobin Lepore and how it is produced.
- Understand the molecular basis of delta-beta thalassemia.
11. Hemolytic anemia I/II
Pathology
- Identify the different types of hemolytic anemia (intravascular vs. extravascular / intracorpuscular vs. extracorpuscular), their clinical presentation, pathologic findings and relevant laboratory tests and appropriate diagnostic approach.
12. Blood coagulation
Physiology
- Understand the structure, function and life span of platelets.
- Understand the interaction of platelets, blood vessels and plasma coagulation factors in hemostasis.
- Understand the role of the liver in normal hemostasis.
- Understand the process and stages (cascade) of blood coagulation and its significance.
- List and understand the role of factors involved in blood coagulation.
13. Congenital bleeding disorders and DIC
Pathology
- For each of von Willebrand disease, hemophilia A and hemophilia B, describe inheritance, etiology, clinical presentations, laboratory findings and treatment.
- Understand the correct usage and significance of abnormalities of prothrombin time (PT), partial thromboplastin time (PTT), thrombin time (TT), and platelet count.
- For disseminated intravascular coagulation (DIC), describe etiology, clinical presentations and complications.
14. Drugs used in coagulation disorders I/II
Pharmacology
- Compare the oral anticoagulants with heparin in terms of their pharmacokinetics, mechanisms, and toxicities.
- Understand the pharmacological aspects of thrombolytic preparations.
- Understand the pharmacological aspects of antiplatelet drugs.
- List three different drugs used to treat disorders of excessive bleeding.
15. Inherited disorders of platelet function, ITP and TTP
Pathology
- Describe the etiology, pathogenesis, clinical findings, laboratory results and patient management of adult and pediatric ITP.
- Identify the mechanism of neonatal and post-transfusion thrombocytopenia.
- Describe the clinical findings and laboratory results of TTP.
16. Community health aspects of anemia
Community Medicine
- Categorize socio-economic variables that influence community dietary practices with special reference to anemia.
- Describe the major nutritional risk factors in the determination of anemia.
17. Blood grouping and transfusion
Pathology
- Understand the principles of ABH blood group system.
- Understand the principles of Rh blood group system.
- Understand the principles of the HLA system.
18. Non-Hodgkin lymphoma
Pathology
- Understand the general characteristics of NHL, with reference to pathogenesis, classification and procedures used to diagnose them.
- Describe the grading systems of NHL.
- Compare the histopathologic, immunologic and clinical features of NHL.
- List three chromosomal translocations associated with NHL; describe the oncogenes associated with them.
- Describe the morphology of small lymphocytes, small cleaved cells, mantle cells, immunoblasts, prolymphocytes, small non-cleaved cells, and lymphoblasts.
19. Hodgkin lymphoma
Pathology
- Describe the appearance of Reed-Sternberg cells and identify the significance of their presence.
- Define the meaning of “background” appearance of Hodgkin’s disease and how it is used in diagnosis and classification of this disease.
- Describe the staging system of Hodgkin disease.
- List the four types of Hodgkin’s disease; describe their clinical presentations, general guidelines for patient evaluation and management.
20. Bacterial infection I/II [Salmonella typhi (enteric fever), Brucella, and others]
Microbiology
- Understand bacterial classification and characteristic properties.
- Understand bacterial virulence factors and pathogenesis.
- Outline clinical presentation and differential diagnosis.
- Understand laboratory diagnosis including specimen collection, culture techniques, and sensitivity to antibiotics.
- Describe management options including specific therapeutic agents.
- Describe epidemiological aspects including modes of transmission, prevention and control measures.
21. Blood culture
Microbiology
- Understand clinical indications.
- Describe specimen collection including aseptic techniques, timing, volume, and number of bottles.
- Differentiate conventional vs. automated techniques.
- Be able to interpret results and specific identification properties.
- Identify alternative methods.
22. Anti-neoplastic drugs I/II
Pharmacology
- Recognize the general principles of cancer therapy.
- Understand the three main lines of cancer therapy.
- Understand methods of administration of cytotoxic drugs and the rules for combination therapy.
- Understand the terms: adjuvant therapy, growth fraction and cell cycle.
- Understand the mode of drug action either phase-specific or non-specific.
- Classify cytotoxic drugs and explain their mechanisms of action.
- Recognize the major adverse effects of cytotoxic drugs.
23. Clinical management of lymphoma/leukemia
Medicine
- Understand the different modalities of treatment of hemato-lymphoid malignancies: chemotherapy (adjuvant and neoadjuvant), surgery, radiotherapy, monoclonal antibodies, and bone marrow transplantation.
- Identify features that put patients at increased risk of complications of treatment.
- Describe the common complications of chemotherapy and how to prevent and treat such complications.
- Describe the clinical presentations, complications and patient management of acute leukemias.
24. Acute leukemia I/II
Pathology
- Understand the classification of acute leukemias (AML/ALL).
- Define the term “blast”.
- Describe the normal phenotypic changes seen in differentiating myeloblasts and lymphoblasts.
- List chromosomal abnormalities associated with acute leukemias. Identify the oncogenes associated with them and their effects on prognosis.
25. Viral infections [cytomegalovirus (CMV), Epstein-Barr virus (EBV), and parvovirus (B19)]
Microbiology
- Viral classification and characteristics properties.
- Growth, multiplication, and pathogenesis.
- Clinical presentation and differential diagnosis.
- Laboratory diagnosis including specimen collection.
- Management including specific therapeutic agents.
- Epidemiology including modes of transmission, prevention and control measures.
26. Parasitic infections [malaria, babesiosis, trypanosomiasis, visceral leishmaniasis, and filariasis]
Microbiology
- Parasitic classification and characteristic properties.
- Life cycle and pathogenesis.
- Clinical presentation and differential diagnosis.
- Laboratory diagnosis including specimen collection, and microscopic findings.
- Management including specific therapeutic agents.
- Epidemiology including modes of transmission, prevention and control measures.
27. Immunosuppressant agents
Pharmacology
- Recognize the general principles of immunosuppressant therapy.
- List the common drugs which have an immunosuppressive effect.
- Understand the mode of action, pharmacokinetics and toxicities for these agents.
- Understand the new modalities of immunosuppressant therapies.
28. Bone marrow transplantation
Medicine
- Apply the knowledge given in the blood grouping system in blood transfusion.
- Apply the knowledge given in the blood grouping system into organ transplantation.
- Understand how to use this knowledge in the clinical practice.