COLLEGE OF MEDICINE

HMIM 224 BLOCK

The Intended Learning Outcomes (ILO’s) and Lecture objectives

1433-1434[ 2012-2013 ]

HMIM 224 Block (Week 1)1

The intended learning outcomesRequirement 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

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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.

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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.

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HMIM 224 Block (Week 2)

The intended learning outcomesRequirement 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.

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

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Recognize different blood group systems and their relationship with the blood transfusion process.

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.

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HMIM 224 Block (Week 3)

The intended learning outcomesRequirement 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.

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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.

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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 outcomesRequirement 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.

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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.

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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).

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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 outcomesRequirement 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.

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.

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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.

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

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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.

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HMIM 224 Block (Week 6)

The intended learning outcomesRequirement to achieve the ILO’s

Recognize the components of adaptive immunity, and its clinical significance in resistance of tumor and infections.

Define adaptive immunity. Enlist the soluble inflammatory mediators of adaptive immunity.

Recognize the type and mechanism of cellular interaction during adaptive

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immune response.

Identify self-tolerance, and its importance in recognition of self-proteins.

Define self-tolerance

Enumerate the examples of self-tolerance

Explain the mechanism of self-tolerance

Recognize the pathophysiology, the diagnostic criteria, and the methods of investigation of rheumatoid arthritis.

Understand the pathophysiology of rheumatoid arthritis.

Identify the diagnostic criteria of rheumatoid arthritis.

Identify the methods of investigations of a case of rheumatoid arthritis.

Recognize the differential diagnosis of rheumatoid arthritis.

Enumerate immunosuppressive drugs with their mechanism of action, pharmacokinetics, adverse effects, clinical uses and contra-indications.

Understand the general features of immunosuppressive drugs.

Explain the mechanism of action, pharmacokinetic, therapeutic uses and mode of action of immunosuppressive drugs.

Be familiar with various immune-stimulants with their clinical indications.

Recognize immune cells and receptors, and their importance in activation of innate or adaptive immune response.

Enlist immune cells. Classify immune cells according to its original progenitor cells and

function. Know the immune cells receptors and their importance in innate and

adaptive immunity. Write different immune cells markers, and their importance as a cluster of

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cell differentiation.

Identify the mechanism of hypersensitivity I and II, and the effect of its inflammatory mediators on human health.

Define hypersensitivity. Write the causes of hypersensitivity. Explain the mechanism of hypersensitivity I and II. Recognize different clinical examples on hypersensitivity I and II.

HMIM 224 Block (Week 7)

The intended learning outcomesRequirement to achieve the ILO’s

Identify the mechanism of hypersensitivity III and IV, and the most common clinical examples on each type.

Explain the mechanism of hypersensitivity III and IV. Recognize different clinical examples on hypersensitivity III, and IV. Write the diagnostic tests of serology that depend on these

hypersensitivity types.

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Recognize vaccine, types, classes, and its clinical significance in improvement of humoral and cellular immunity.

Define vaccine. Enlist the properties of vaccine, types, and the factors that control

immunization procedure. Classify vaccine according to its nature. Enlist the most common example on each class. Define adjuvants, and its importance in vaccination process.

Identify the mechanisms of loss of tolerance, and the most common clinical examples on each type.

Define autoimmunity, tolerance, anergy, and suppression. Recognize the mechanisms of loss of tolerance. Enlist the most common clinical examples on autoimmunity.

Enumerate immunosuppressive drugs with their mechanism of action, pharmacokinetics, adverse effects, clinical uses and contra-indications.

Understand the general features of immunosuppressive drugs. Explain the mechanism of action, pharmacokinetic, therapeutic uses and

mode of action of immunosuppressive drugs. Be familiar with various immune-stimulants with their clinical

indications.

Recognize different types of primary immunodeficiency, and their genetic defective mutation.

Identify acquired immunodeficiency, and its causative agents focusing on HIV.

Enlist the most common types of primary immunodeficiency. Identify the genetic defects associated with each type of congenital

immunodeficiency. Recognize the most common feature of each type of intrinsic

immunodeficiency. Classify acquired immunodeficiency according to causative

environmental factors. Enlist the most common microbes that associated with acquired

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immunodeficiency due to specific escape mechanism. Identify the tropism of Human immunodeficiency virus (HIV). Recognize the effect of HIV on immune cells and immune response. Define the stages of HIV infection. Write the effect of HIV infection on CD4:CD8 cell ratio.

HMIM 224 Block (Week 8)

The intended learning outcomesRequirement to achieve the ILO’s

Correlate the genetic basis of tissue

Define the genetic basis of tissue transplantation.

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transplantation and types of tissue rejection.

Define the clinical significance of tissue

transplantation.

Recognize the clinical significance of major histocompatibility complex.

Classify grafts according to donor-recipient genetic relationship.

Identify the mechanism of tissue rejection.

Differentiate between acute, chronic, and hyper-acute rejection according

to immunologic aspects.

Recognize the most important serologic

methods, and their clinical significance in

diagnosis of different diseases.

Enlist the serologic methods used for detection of antigen or antibodies in

vitro.

Identify the principle of serologic methods.

Write the most common laboratory test that depends on each serologic

method.

Define haemagglutination, antibody titer, and prozone phenomena.

Recognize the clinical significance of ELISA test in diagnosis of viral

infections.

Enlist the methods used for measurement of cellular immunity.

Know the clinical application of these methods.

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