COLLEGE OF MEDICINE

HMIM 224 BLOCK

The Intended Learning Outcomes (ILO’s) and

Lecture objectives

1433-1434 [2012-2013]

HMIM 224 Block (Week 1)

The intended learning outcomes / Requirement to achieve the ILO’s
(Lecture objectives)
§  Discuss the structural anatomy of lymphatic system.
§  Describe the arrangement and drainage of different types of lymph nodes.
§  Describe the gross anatomy of spleen, thymus, and tonsils. /
Enlist the structures forming lymphatic system.
• Differentiate between superficial and deep lymphatic vessels.
• Describe the lymph node and enlist its functions.
• Discuss the formation of the right lymphatic duct.
• List the parts drained by the right lymphatic trunk
• Describe thoracic duct and its origin and relation.
• List the parts drained by the thoracic duct
• Explain the arrangement and drainage of different groups of axillary lymph nodes.
• Describe the gross anatomical features of spleen.
• Understand the peritoneal relations of spleen.
• Enlist the contents of gastrosplenic and lienorenal ligaments.
• Discuss the blood supply of spleen.
• Define the terms splenomegaly and spleenectomy.
• Explain the arrangement and drainage of superficial and deep inguinal lymph nodes
• Describe the arrangement of the thoracic wall and mediastinal lymph nodes
• Discuss the lymph drainage of the pelvis and abdomen
§  Enlist plasma proteins and the clinical features associated with their abnormal values.
§  Correlate the normal ranges of Red blood cells and hemoglobin with their functions.
§  Enumerate the stages of erythropoiesis. / §  Summarize the plasma proteins and their function.
§  Predict the clinical features if there is change in the plasma proteins.
§  Write the functions of hemoglobin.
§  Write the normal range of RBCs and hemoglobin in male & females.
§  Write the steps of RBCs development and cell types present in bone marrow and peripheral blood.
§  Describe the microscopic features of the primary and secondary lymphoid organs.
§  Explain the differentiation of myeloid and lymphoid stem cells. / §  Describe the location of lymphatic organs.
§  Describe different types of tonsils
§  Understand the arrangement of Waldeyer’s ring.
§  Explain the microscopic features of Lymph Node.
§  Define the direction of flow of lymph in the lymph node.
§  Explain the microscopic features of spleen.
§  Differentiate between the mechanism of Open and Closed Circulation in Spleen.
§  Explain the microscopic features of thymus
§  Explain the composition of whole blood.
§  List the steps used in preparing a blood smear.
§  Describe the structure of Erythrocyte.
§  Enlist different types of leucocytes.
§  Differentiate between different types of leucocytes
§  Enlist the different functions of leucocytes
§  Understand the terms used to describe increased and decreased number of different types of leucocytes
§  Explain the differentiation of myeloid and lymphoid stem cells.
§  Describe the development of red blood cells in red bone marrow.
§  Describe the development of granulocytes
§  Describe the development of agranulocytes
§  Describe the development of platelets
§  Understand the following terms: leukemia, stem cells, bone marrow transplantation
§  Identify the main metabolic pathways occur in RBCs and some diseases associated with metabolic disorders. / §  Understand the general structural & functional features of red blood cells (RBCs).
§  Recognize the main metabolic pathways occurring in RBCs with reference to their relations to functions of RBCs.
§  Identify some of the main & common diseases of RBCs as implication of defects of RBCs metabolism.
§  Understand the relation of characteristic features of structure of membrane of RBCs.
§  Recognize changes occurring in aging of RBCs.

HMIM 224 Block (Week 2)

The intended learning outcomes / Requirement to achieve the ILO’s
§  Describe the structural and functional criteria of hemoglobin and the clinical significance of Glycosylated hemoglobin (HBA1c).
§  Identify the genetic factors and biochemical- structural defects occurs in both thalassemia and sickle cell anemia. / §  Understand the main structural & functional details of hemoglobin as one of the hemoproteins.
§  Identify types & relative concentrations of normal adult hemoglobin with reference to HBA1c with its clinical application.
§  Recognize some of the main genetic & biochemical aspects of hemoglobinopathies with some implications on clinical features (with focusing on thalassemias and sickle cell anemia).
§  Discuss different types of anemia and their effect on the body.
§  Enlist the types and functions of WBCs, and their role in cellular immunity.
§  Recognize different blood group systems and their relationship with the blood transfusion process. / §  Differentiate between different types of anemia.
§  Summarize the effect of anemia on the body.
§  Recognize the different types of WBCs and their normal values.
§  Summarize the functions of each WBC and its clinical significant associated with different abnormal conditions.
§  List different types of blood group systems
§  Explain the mechanism of blood group inheritance
§  Use the knowledge of blood groups in blood transfusion.
§  Summarize the pathophysiology of Hemolytic disease of newborn.
§  Identify the general structure of porphyrin and types of porphyrias associated with metabolic defects.
§  Recognize the main steps of Heme synthesis and degradation. / §  Understand the general structure of the porphyrin.
§  Discuss the main steps of synthesis of heme with reference to clinical implications.
§  Verify the types of porphyrias with explaining the biochemical bases of clinical manifestations.
§  Recognize the main steps for heme degradation.
§  Define hyperemia and its pathological effects.
§  Know the types, causes, and complications of thrombosis.
§  Recognize the types and causes of embolism and ischemia respectively. / §  Understand the terminology and pathological effects of hyperemia.
§  Recognize the causes, morphological features, types and complications of thrombosis.
§  Know the definition and types of embolism.
§  Understand the causes of acute ischemia and the concept of infarction.

HMIM 224 Block (Week 3)

The intended learning outcomes / Requirement to achieve the ILO’s
§  Define the biochemical role of folic acid and vitamin B12 in production of normal Red blood cells.
§  Correlate the folic acid and/or vitamin B12 deficiency with pernicious anemia.
§  Identify the role of vitamin K in blood coagulation process.
§  Correlate the vitamin K deficiency with some types of hemorrhagic diseases. / §  Recognize the general biochemical aspects of water and fat soluble vitamins.
§  Understand the biochemical roles of folic acid, vitamin B12 (cobalamine), vitamin C and vitamin K in heme system.
§  Discuss biochemical and clinical aspects of folic acid deficiency and pernicious anemia.
§  Explain the relationship between vitamin K deficiency and the pathogenesis of some hemorrhagic diseases with reference to treatment.
§  Correlate the abnormalities of hemostasis with platelet and clotting factors. / §  Write normal range of platelets
§  Summarize the functions of platelets.
§  Enlist the clotting factors.
§  Define the abnormalities of hemostasis.
§  Explain the mechanism of action and adverse effects of anticoagulants. / §  Define anticoagulation
§  Understand iindications of anticoagulant therapy
§  Explain blood coagulation cascade
§  Describe mechanism of action of heparin and its complication.
§  Know about heparin induced thrombocytopenia and its management
§  Compare and contrast the heparin and low molecular weight heparins
§  5-understand the differnces between oral and parenteral anticoagulants
§  List the drug interaction with warfarin
§  Explain mechanism of action and adverse effects of oral anticoagulants
§  Correlate the viral window period with the risk of transmission of infection by blood transfusion.
§  Enlist the infectious agents transmitted by blood transfusion.
§  Identify the relationship between Plasmodium infection and hemolytic and hepatic jaundice. / §  Define the viral window period and genetic vertical transmission.
§  Enlist the factors that play a role in transmission of virus by blood transfusion.
§  Name the infectious diseases that could be transmitted by blood transfusion.
§  Identify the microbes that infect white and Red Blood cells.
§  Identify the viral latent infection within white blood cells.
§  Describe the microbiological characteristics of Retroviruses, Herpes viruses, Parvovirus B19, HIV, Hepatitis B and C, Treponema pallidium, and Plasmodium species.
§  Identify the life cycle of Plasmodium species.
§  Define hemorrhage and edema, and their causes and pathological effects.
§  Classify shock according to its causes. / §  Enlist the causes, types and pathological effects of hemorrhage.
§  Define edema, and their causes.
§  Understand the causes and classification of shock.

HMIM 224 Block (Week 4)

The intended learning outcomes / Requirement to achieve the ILO’s
§  Recognize types, pathological features, stages, and diagnostic procedure of lymphoma. / §  Define lymphoma.
§  Enlist the classes of lymphoma.
§  Understand the pathological features of non-Hodgkin's and Hodgkin's lymphoma.
§  Understand the diagnosis and staging of lymphoma.
§  Enlist the antiplatelet drugs according to mechanism of action and their properties.
§  Explain the mechanism of action and major indications for fibrinolytics and antifibrinolytics. / §  Explain the role of platelets in in thromboembolic diseases.
§  List the mechanism of action, pharmacokinetics, adverse effects and major indications of aspirin.
§  Enumerate the mechanism of action, pharmacokinetic, major uses and adverse effects of ADP receptor antagonist.
§  Explain the mechanism of action and major uses of GPIIb/IIIa-receptor antagonist.
§  List the commonly used antiplatelet.
§  Describe the mechanism of action of athrombolytic drugs such as streptokinase and tissue plasminogen activator (tPA).
§  Explain the role of platelets in in thromboembolic diseases.
§  List the mechanism of action, pharmacokinetics, adverse effects and major indications of aspirin.
§  Enumerate the mechanism of action, pharmacokinetic, major uses and adverse effects of ADP receptor antagonist.
§  Explain the mechanism of action and major uses of GPIIb/IIIa-receptor antagonist.
§  List other commonly used antiplatelet.
§  Enumerate the commonly used anti-fibrinolytics with their mode of action and common indications.
§  Classify anemia according to morphological variations in Red blood cells and causes.
§  Differentiate between types of anemia according to laboratory findings and results interpretation. / §  Identify the red blood cells indices.
§  Explain the morphological classification of anemia.
§  List the different types of anemia.
§  Differentiate between types of microcytic hypochromic anemia.
§  Explain the laboratory findings of iron deficiency anemia and thalassemia.
§  Discriminate between hemoglobin electrophoresis of different types of thalassemia.
§  Identify the types of macrocytic normochromic anemia and the laboratory findings of megaloblastic anemia.
§  Describe the cause and laboratory features of aplastic anemia.
§  Summarize the different types and mechanisms of hemolytic anemia.
§  Explain the hereditary causes and hemoglobin electrophoresis of sickle cell anemia.
§  Recognize the relationship between pentose phosphate pathway, the coenzyme NADPH and G6PD enzymatic activity.
§  Correlate the G6PD deficiency with hemolytic anemia. / §  Understand the main functional concepts for pentose phosphate pathway ( hexose monophosphate pathway).
§  Identify the main general uses of NADPH for normal cellular metabolism with special focus on its role in antioxidant mechanisms.
§  Describe the genetic & biochemical basis of glucose 6 phosphate dehydrogenase deficiency (G6PD deficiency).
§  Recognize the precipitating factors for G6PD deficiency anemia.
§  Recall classes of G6PD deficiency anemia (as indicated by variants of G6P dehydrogenase enzyme).
§  Discuss the biochemical & clinical rationale for lines of diagnosis of G6PD deficiency anemia.
§  Define natural barriers to infection.
§  Identify the role of defense mechanism of natural barriers in preventing of infection. / §  Enlist the physical and chemical barriers of innate immunity.
§  Identify the role of natural barriers in protection of human body.
§  Discuss the inhibitory mechanism by which normal flora prevent pathogenic colonization of exogenous microbes.
§  Identify the factors that play a role in establishment of infection.

HMIM 224 Block (Week 5)

The intended learning outcomes / Requirement to achieve the ILO’s
§  Recognize the mechanism of iron absorption, distribution, and excretion in the body.
§  Discuss iron deficiency and toxicity, and the laboratory investigations required for evaluation of iron status.
§  Identify plasma proteins, their metabolism and function.
§  Define the methods of plasma proteins measurement, and its clinical significance in diagnosis of some diseases of white blood cells and immunity. / §  Recall sources and requirements of dietary iron.
§  Explain factors affecting absorption of iron from GIT.
§  Discuss iron distribution and excretion in the body.
§  Recognize laboratory assessment investigations for iron status.
§  Understand causes of iron deficiencies and iron overload with reference to clinical consequences.
§  Review the general physiological functions & metabolism of plasma proteins.
§  Understand main lines of plasma protein measurement.
§  Discuss the main concepts of plasma protein electrophoresis as a semi-quantitative method for protein measurement in clinical labs.
§  Recognize the main biochemical, pathological & clinical aspects of some of the plasma proteins as prealbumin, albumin, gamma globulins & acute phase proteins.
§  Define humoral and cellular immunity.
§  Recognize the role of lymphocytes in natural defense and different clinical conditions. / §  Define humoral and cell-mediated immunity
§  Summarize the function of lymphocytes.
§  Write types and functions of T lymphocytes
§  Discuss the role of lymphocytes in different clinical conditions.
§  Enumerate the classes, causes, and types of leukemia.
§  Know the clinical picture, prognosis, and laboratory diagnostic methods of different types of leukemia. / §  Define acute and chronic leukemia.
§  Classify acute and chronic leukemia.
§  Enumerate causes and types of acute leukemia.
§  Apply the clinical features and investigations of acute lymphoblastic leukemia (ALL).
§  Explain the morphological classification and prognosis of ALL.
§  Identify the clinical picture and laboratory diagnosis of acute myeloid leukemia (AML).
§  Summarize the clinical features and laboratory characteristics of B-cell chronic lymphocytic leukemia (B-cell CLL)
§  Recognize the clinical picture and laboratory findings of chronic myeloid leukemia (CML).
§  Define the self-recognition, antigens, and Hapten.
§  Recognize the components of innate immunity, and its activity during inflammation. / §  Define self-recognition, antigen, immunogen, Superantigen, and Hapten.
§  Identify the role of cell receptors in self-recognition and epitope interaction.
§  Describe the importance of Land-Steiner’s experiment in identification of immunogen and Hapten.
§  Compare between T-cell dependent and T-cell independent antigens.
§  Define innate immunity.
§  Enlist the soluble inflammatory mediators of innate immunity.
§  Recognize the type and mechanism of cellular interaction during innate immune response.
§  Recognize the causes, pathogenesis, clinical features, and diagnostic criteria of systemic lupus erythematosus. / §  Identify the terminology and causes of Systemic lupus erythematosus (SLE).
§  Understand the pathogenesis of SLE.
§  Know the clinical presentation and features of SLE.
§  Discuss the pathological changes of SLE on different body organs.
§  Understand the diagnostic criteria for SLE.

HMIM 224 Block (Week 6)