- Teacher: Dr Asif Ali
- Teacher: Kinza Ayaz
- Teacher: Dr Yasar Yousafzai
- Teacher: Kinza Ayaz
- Teacher: Dr Yasar Yousafzai
- Teacher: Kinza Ayaz
- Teacher: Asfand Roghani
- Teacher: Dr Yasar Yousafzai
- Teacher: Kinza Ayaz
- Teacher: Ihtesham Khan
- Teacher: Dr Yasar Yousafzai
- Teacher: Kinza Ayaz
- Teacher: Saima Hashim
- Teacher: Dr Yasar Yousafzai
Title: Effects of drugs on blood Code: BMS 755 Credit Hours: 2hrs
Lectures: 32
Tutorial:
B.PROFESSIONAL INFORMATION
1.OVERALL AIMS OF COURSE
The overall aim of the course is to furnish the students with the core scientific knowledge of drugs their effects and side effects on blood and controversies about them.
2. INTENDED LEARNING OUTCOMES OF COURSE (ILOS)
A. KNOWLEDGE AND UNDERSTANDING:
After completion of this course the students of MPhil leading to PhD program will be able to:
1. Discuss the basic principles of iron and vitamins replacement therapy.
2. Enlist different types of coagulopathies,and discuss its management in detail.
3. Enlist different classes of anti-thrombotics and discuss its pharmacodynamics and pharmacokinetics in detail.
4. Classify antiplatelet agents and its management and complications.
5. Discuss the types of anti-fibrinolytic agents, its indications for therapy.
6. Discuss the management of hemorrhagic complications of anti coagulation agents.
7. Explain in detail the agents used to treat haematological malignancies.
B.INTELLECTUAL SKILLS:
1. Students should be able to identify the normal outcome of the treatment and well as the complications of the treatment.
2. Students should be able to identify and interpret the lab. Tests.
3. They should be able to differentiate between normal and abnormal reports for that specific age and sex, etc,
4. Students should be able to identify the complications of the disease due to drugs.
5. Students should have enough knowledge about all the drugs,indications and side effects.
C.GENERAL AND TRANSFERABLE SKILLS:
After completion of this course, the students of MPhil leading to PhD program will be able to:
i. Prepare a Microsoft PowerPoint presentation
ii. Use Microsoft Word for writing assignments
iii. Use Endnote/Reference Manager to cite published literature
iv. Be able to explain disease system to scientific and non-scientific audience.
|
Replacement therapies |
Types of anemias resulting from iron and vitamin deficiencies. |
1, Classification of anemia. 2, Signs and symptoms of anemia. 3, Diagnostic tests 4,Appropriate treatment accordingly. |
Route of administration. Dose . Drug/drug interaction. Drug/ food interaction. Hypervitaminosis. Failure of therapy. Combination therapy.
|
Presentations/assignments |
|
Coagulopathies |
Understanding and knowledge of different types of coagulation disorders. |
1, Types of coagulation disorders. 2, Presenting symptoms. 3, Coagulation profile and factor assay etc, 4,Management. |
Ffps :dosage. Cryoprecipitate. Immunoglobulin. Recombinant factors. Transfusion reactions and risks. Follow up investigations. |
Presentations/assignments |
|
Antithrombotic Agents |
1, Heparin 2, Warfarin 3, FXa 4, Direct thrombin inhibitors
|
Composition Site of Action MOA Indications/ contraindications Side effects Treatment of complications |
Indications for LMWH and Unfractionated heparin and warfarin. |
Presentations/assignments |
|
Anti-platelet agents |
1,Aspirin 2, Clopidogrel 3,Abciximab 4,Dipyradamol
|
Composition Representative agents MOA Indications/ Contraindications sSide effects Management of complications
|
Therapeutic uses Complications Toxicities |
Presentations/assignments |
|
Anti-fibrinolytic agents |
1, Amino caproic acid 2, fibrinogen 3,transemic acid |
Composition MOA Indications/ contraindications Toxicity Management of complications
|
Route of administration Tolerance,common side effects and complications.
|
Presentations/assignments |
2.Management Of Haemorrhagic Complications Of Anti Coagulation:
|
Intracranial haemorrhages |
Causative agents: Warfarin Heparin Antiplatelet drugs Direct thrombin inhibitors |
Management: Pharmacokinetics Pharmacodynamics Antidote for drugs Surgical approach |
2hrs |
Investigations Treatment and dosage |
Presentations/assignments |
3. Agents Used To Treat Haematological Malignancies:
|
Myeloproliferative disorders |
Hydroxyurea Anagrelide BCR-ABL TKi
|
Pt. selection MOA,side effects |
2hr |
Presentations/assignments |
|
Myelodysplasias |
DNA-methyl transferase inhibitors |
Pt. selection MOA,side effects |
2hr |
Presentations/assignment |
|
Leukemia,Lymphomas, Multiple Myeloma |
1.Chemotherapeutic agents
2.Targeted therapies a. Monoclonal antibodies b. Radioimmunotherapy c. Immunomodulatory drugs d. Proteosome inhibitors |
:-Pt. selection MOA,side effects (additional haematological malignancies)
:-a, combination therapy,disease specific, side effects. b, new adjuvant therapy,side effects c,MOA, side effects. d,MOA, side effects.
|
3hr |
presentations/ |
4. Teaching and Learning Methods:
a. Lectures.
b. Presentations.
c. Assignments.
5. Student Assessment Methods
a. Class Tests to assess continuous learning process.
b. Terminal Examination to assess learning out comes.
c. Presentations to assess communication skills.
d. Assignments to assess writing skills.
Assessment Schedule
Assessment: 1 Class Test I Week: 5th week
Assessment: 2 Class Test II Week: 10th week
Assessment: 3 Presentations Week:7th week onwards
Assessment: 4 Assignments Week:10th weekonwards
Weighting of assessments
Class assessment 40%
Terminal examination 50%
Oral examination 0%
Practical examination 0%
Semester work (presentations) 5%
Other types of assessment (assignments) 5%
Total 100 %
Any formative only assessments
6. Lists of references
a. Course notes: Class lectures (PPT)
b. Essential books (text books): Postgraduate Haematology by Victor Hoffbrand, 5th edition
c. Recommended books:
i. A beginner’s guide to blood cells by Barbera J Bain, 2nd edition
ii. Colour atlas of hematology –Practical, microscopic and clinical diagnosis by Herald Theml
iii. Wintrobe’s clinical haematology
d. Periodicals, Websites,..etc:
1. Pathology
2. Histopathology
4. Pathology and Pathobiology
5. Journal of Clinical Pathology
6. Analytical Cellular Pathology
7. Annals of Diagnostic Pathology
8. Experimental and Molecular Pathology
9. Experimental and Toxicologic Pathology
7. Facilities required for teaching and learning: Multimedia, availability of Text and recommended books, online access to the journals
The course is taught to the M. Phil Haematology and M. Phil Histopathology students. The overall aim of the course is to furnish the students with the core scientific knowledge of general pathology of disease, and the controversies in the field.
Intended Learning outcomes:
After completion
of this course the students of MPhil leading to PhD program will be able to: 1. Discuss the basic principles
of cellular responses to toxic stimuli 2. Discuss the mechanisms of cell injury 3. Discuss in detail the
principles of apoptosis 4. Describe briefly
intracellular accumulation and pathologic calcification 5. Trace the process of acute
inflammation 6. Discuss the process of
leukocyte migration 7. List the mediators of
inflammation and briefly describe their role 8. Discuss briefly the
morphologic patterns of acute inflammation 9.
Discuss the principles
and process of chronic inflammation 10. Discuss in brief
Granulomatous inflammation 11. Discuss in brief the
systemic effects and consequences of inflammation 12. Discuss the processes involved in normal
cellular proliferation and tissue growth 13. Explain the term stem
cells and describe the different types of stem cells. Discuss the controversies
surrounding stem cell research 14. Discuss in detail cell
cycle. Explain how abnormal cell cycle relates to disease 15. Discuss the mechanisms of
tissue regeneration 16. Discus the extracellular
matrix and cell matrix interactions and their role in normal homeostasis and
disease 17. Discuss the mechanism of
wound healing by repair, scar formation and fibrosis 18. Discuss the etiology and
pathogenesis of different types of edema. 19. Discuss morphologic
features of haemorrhage. Compare and contrast hyperemia and congestion 20. Discuss the process of
normal homeostasis. List the pro-thrombotic and anti-thrombotic factors. 21. Trace the process of
coagulation. Explain disseminated intravascular coagulation 22. Discuss the processes
involved in thrombosis and embolism 23. Briefly discuss infarction.
Discuss the role of biomarkers in diagnosis of infarction. Discuss the
sensitivity and specificity of biomarkers and why sensitivity and specificity
of tests is clinically significant. 24. Briefly describe shock 25. Describe the main features
of the human genetic architecture 26. Describe genetic
mutations. List the various types of mutations. Explain how genetic mutations
can lead to a particular clinical phenotype with examples 27. Discuss the Mendelian
pattern of inheritance and single gene disorders. Discuss the basic principles
of single gene disorders (Proteins, enzymes) 28. Discuss the normal immune
response of the body 29. Discuss the Human
Leukocyte Antigen system 30. Discuss the basic
principles of hypersensitivity reaction 31. Discuss the basic
principles of autoimmune disorders 32. Discuss the principles of
transplant rejection 33. Discuss the basic
principles of immunodeficiency disorders. Classify immunodeficiency disorders 34. Describe the
classification of neoplasia 35. Discuss the process of
oncogenesis 36. Molecular basis of cancer 37. Describe carcinogens and
discuss their cellular interactions 38. Discuss the role of immune
system in protection from cancers 39. Discuss the clinical
aspects of neoplasia 40. Discuss in detail the
principles of apoptosis b.
General and transferable skills After completion of this course, the students of MPhil leading to PhD
program will be able to: i.
Prepare a Microsoft PowerPoint presentation ii.
Use Microsoft Word for writing assignments iii.
Use Endnote/Reference Manager to cite published
literature iv.
Be able to explain disease system to scientific and
non-scientific audience
Course breakdown:
Learning outcome (LO) Content Time
(Hours) Mode
of teaching Assessment
of LOs Discuss the basic principles of
cellular responses to toxic stimuli 1. Types
of toxic stimuli 2. Cellular
responses - Hypertrophy - Hyperplasia - Atrophy - Metaplasia
- Dysplasia 3. Differentiate
between reversible and irreversible cell injury 1 hours Lecture MCQ, SEQ,
essay questions Discuss the mechanisms of cell injury 1. ATP
depletion 2. Mitochondrial
damage 3. Loss
of Ca++ homeostasis 4. Accumulation
of reactive oxygen species 5. Defects
in membrane permeability 6. Damage
to DNA and proteins 7. Examples
of cell injury and necrosis -Ischemic
cell injury -Ischemia-reperfusion
injury -Chemical
(toxic injury) 2 hours Lecture MCQ, SEQ,
essay questions Discuss in
detail the principles of apoptosis 1. Overview
of apoptosis 2. Causes
of apoptosis 3. Apoptosis
in pathologic conditions 4. Morphologic
and biochemical changes in apoptosis 5. Mechanism
of apoptosis 6. Apoptosis
in health and disease 2 hours Lecture +
presentation MCQ, SEQ,
essay questions Describe briefly intracellular accumulation and
pathologic calcification 1. Intracellular
accumulation -Lipids -Cholesterol
and cholesterol esters -proteins -glycogen -pigments 2.
Calcifications -Dystrophic
calcification -Metastatic
calcification 1 hour Lecture MCQ, EMQ,
essay questions Trace the process of acute inflammation 1. Causes
of acute inflammation 2. Vascular
changes -Vasoconstriction -Vasodilation
and capillary permeability 3. Leukocyte
changes -Leukocyte
recruitment -Leukocyte
induced damage 3.
Outcomes of acute inflammation 2 hours Lecture MCQ, SEQ,
essay questions Discuss the process of leukocyte migration 1. Steps
of leukocyte migration -Leukocyte
recruitment -Leukocyte
adhesion -Transmigration -extravascular
chemotaxis 1 hour Lecture MCQ, SEQ,
essay questions List the mediators of inflammation and briefly
describe their role 1. Cell
derived 2. Plasma
derived 1 hour Lecture MCQ, SEQ,
essay questions Discuss briefly the morphologic patterns of acute
inflammation 1. Serous
inflammation 2. Fibrinous
inflammation 3. Suppurative
inflammation 4. Ulcers 1 hour Lectures MCQ, SEQ,
essay questions Discuss the principles and
process of chronic inflammation 1. Causes
of chronic inflammation 2. Morphologic
features of chronic inflammation 3. Acute-chronic
inflammation relationship 4. Cells
of the chronic inflammation -Macrophages -Lymphocytes -Plasma
cells -Eosinophils -Mast
cells 2 hours Lecture +
assignment MCQ, SEQ,
essay questions Discuss in brief Granulomatous
inflammation 1. Causative
factors of granulomatous inflammation 2. Morphologic
features of granulomatous inflammation 3. Cells
involved in granulomatous inflammation 1 hour Lecture MCQ, SEQ,
essay questions Discuss in brief the systemic effects and
consequences of inflammation 1. Systemic
effects of acute inflammation 2. Systemic
effects of chronic inflammation 3. Consequences
of inflammation -Consequences
of acute inflammation -Consequences
of chronic inflammation -Consequences
of defective or excessive inflammation 1 hour Lecture MCQ, SEQ,
essay questions Discuss the processes involved in normal cellular
proliferation and tissue growth 1. Normal
cell homeostasis 2. Control
of normal cell proliferation and tissue growth 2 hours Lecture MCQ, SEQ,
essay questions Explain the term stem cells and describe the different
types of stem cells. Discuss the controversies surrounding stem cell research 1. Features
of stem cells 2. Embryonic
stem cells 3. Adult
stem cells 4. Induced
pluoripotent stem cells 5. Principles
of cloning 3 hours Lecture MCQ, SEQ,
essay questions Discuss in detail cell cycle. Explain how abnormal
cell cycle relates to disease 1. Cell
cycle and regulation of growth factors 2. Brief
overview of the growth factors 3. Signalling
mechanism in cell growth 4. Classification
of cell receptors 2 hours Lecture MCQ, SEQ,
essay questions Discuss the mechanisms of tissue regeneration 1. Overview
of regeneration process 2. Liver
regeneration 1 hours Lecture MCQ, SEQ,
essay questions Discus the extracellular matrix and cell matrix
interactions and their role in normal homeostasis and disease 1. Composition
of extracellular matrix 2. Fibres
of the matrix 3. Cell
adhesion molecules 4. GAGs 5. Role
of cell interaction in disease (eg cancer metastasis) 1 hours Lecture MCQ, SEQ,
essay questions Discuss the mechanism of wound healing by repair,
scar formation and fibrosis 1. Overview
of healing 2. Mechanisms
of angiogenesis 3. Cutaneous
wound healing 4. Local
and systemic factors affecting wound healing 5. Pathologic
aspects of repair 6. Fibrosis 2 hours Lecture MCQ, SEQ,
essay questions Discuss the etiology and pathogenesis of different
types of edema. 1. Edema
overview 2. Causes
of edema 3. Pathogenesis
of edema 4. Types
of edema and their significance 5. Hyperemia
and congestion 1 hour Lecture MCQ, SEQ,
essay questions Discuss morphologic features of haemorrhage. Compare
and contrast hyperemia and congestion 1. Haemorrhage 2. Hyperemia 3. Congestion 1 Hour Lecture MCQ, EMQ,
essay questions Discuss the process of normal homeostasis. List the
pro-thrombotic and anti-thrombotic factors. 1. Normal
homeostasis 2. Endothelium -antithrombotic
properties -prothrombotic
properties 3.
Plateletes 2 hours Lecture MCQ, SEQ,
essay questions Trace the process of coagulation. Explain
disseminated intravascular coagulation 1. Coagulation
cascade 2. Disseminated
intravascular coagulation 2 hours Lecture MCQ, SEQ, essay
questions Discuss the processes involved in thrombosis and
embolism 1. Thrombosis 2. Embolism 1 hour Lecture MCQ, SEQ,
essay questions Briefly discuss infarction. Discuss the role of
biomarkers in diagnosis of infarction. Discuss the sensitivity and specificity
of biomarkers and why sensitivity and specificity of tests is clinically
significant. 1. Overview
of infarction and necrosis 2. Biomarkers
of infarction 1 Lecture Lecture MCQ, SEQ,
essay questions Briefly describe shock 1. Shock
overview 2. Types
of shock 3. Clinical
features associated with shock syndromes 1 hour Lecture MCQ, SEQ,
essay questions Describe the main features of the human genetic
architecture 1. Human
genetic architecture - The
genome - Genes,
exons, introns - Single
nucleotide variants - The
human genome project 1 hour Lecture MCQ, SEQ,
essay questions Describe genetic mutations. List the various types
of mutations. Explain how genetic mutations can lead to a particular clinical
phenotype with examples 1. Genetic
mutations 2. Types
of genetic mutations 3. Genotype-phenotype
relationship 2 hours Lecture MCQ, SEQ,
essay questions Discuss the Mendelian pattern of inheritance and
single gene disorders. Discuss the basic principles of single gene disorders
(Proteins, enzymes) 1. Mendelian
disorders 2. Transmission
of single gene disorders 3. Common
disorders according to classification - Disorders
associated with defects in structural proteins - Disorders
of enzymes 2 hours Lecture MCQ, SEQ,
essay questions Discuss the normal immune response of the body 1. Composition
of the immune system 2. Innate
immunity 3. Adaptive
immunity 4. Cells
of the immune system -Lymphocytes
(B, T and NK) -Macrophage 5.
Organs of the lymphoid system 2 hours Lecture MCQ, SEQ,
essay questions Discuss the Human Leukocyte Antigen system 1. HLA
molecules 2. Transplantation
and the HLA system 1 hour Lecture MCQ, SEQ,
essay questions Discuss the basic principles of hypersensitivity
reaction 1. Mechanism
of hypersensitivity reactions 2. Types
of hypersensitivity reactions 3. Mediators
of hypersensitivity 4. Local
and systemic hypersensitivity 5. Mechanism
of tissue injury in hypersensitivity 2 hours Lecture MCQ, SEQ,
essay questions Discuss the basic principles of autoimmune disorders 1. General
principles of autoimmune diseases 2. Immunological
tolerance 3. Mechanisms
of tissue injury in autoimmune diseases 2 hours Lecture MCQ, SEQ,
essay questions Discuss the principles of transplant rejection 1. Mechanisms
of recognition and rejection of allografts - T-cell
mediated reaction - Antibody
mediated reaction - Methods
of increasing graft survival 2 hours Lecture MCQ, SEQ,
essay questions Discuss the basic principles of immunodeficiency
disorders. Classify immunodeficiency disorders 1. Immunodeficiency
disorders overview 2. Primary
and secondary immunodeficiency 3. Mechanisms
of tissue injury, morbidity and mortality in immunodeficiency disorders 1 hour Lecture MCQ, SEQ,
essay questions Describe the classification of neoplasia 1. Nomenclature 2. Characteristics
of benign and malignant neoplasia 1 hour Lecture MCQ, SEQ,
essay questions Discuss the process of oncogenesis 1. Genetic
mutations and oncogenesis 2. Multi-hit
hypothesis 3. Tumour
cell heterogeneity 4. Cancer
stem cells 5. Preleukaemia
and in-utero acquisition of leukaemia 2 hours Lecture MCQ, SEQ,
essay questions Molecular basis of cancer 1. Essential
features of malignant cancer cells -self
sufficiency -Insensitivity
to growth inhibition -Evasion
of apoptosis -Limitless
replicative potential -Sustained
angiogenesis -Ability
to invade and metastasise -Defects
in DNA repair 2.
Oncogenes -Ras -Myc 3.
Tumour suppressor genes 3 hours Lecture MCQ, SEQ,
essay questions Describe carcinogens and discuss their cellular
interactions 1. Chemical
carcinogenesis 2. Radiation
carcinogenesis 3. Microbial
carcinogenesis 2 hours Lecture MCQ, SEQ,
essay questions Discuss the role of immune system in protection from
cancers 1. Tumour
immunity 2. Tumour
antigens 3. Antitumour
effector mechanisms 4. Immune
surveillance and escape 2 hours Lecture MCQ, SEQ,
essay questions Discuss the clinical aspects of neoplasia 1. Local
and hormonal effects 2. Cancer
cachexia 3. Paraneoplastic
syndromes 4. Grading
and staging 5. Laboratory
diagnosis of cancer 1 hour Lecture MCQ, SEQ,
essay questions
Overall aims of course
The overall aim of the course is to furnish the students with the core scientific knowledge of red blood cells, erythropoiesis and red cell disorders, and the controversies in the field.
Intended learning outcomes of course (ILOs)
Knowledge and understanding:
After completion of this course the students of MPhil leading to PhD program will be able to:
1. Discuss the basic principles of haemopoiesis. Discuss in detail the process of erythropoiesis
2. Trace the processes of Iron absorption, storage and transport
3. Discuss in detail the causes, pathology and treatment options in iron deficiency anaemia
4. Discuss briefly the disorders of Haeme synthesis
5. Discuss the pathology and the haematologic manifestation of sideroblastic anaemia
6. Discuss the causes and pathological consequences of iron overload. Explain the principles of iron chelation therapy
7. Discuss the causes of megalobastic anaemias. Explain the processes leading to anaemia in Cobalamine and Folic acid deficiencies
8. Discuss the physiological and biochemical characteristics of haemoglobin molecule. Discuss the genetic basis of thalassaemia syndromes. Classify disorders of haemoglobin synthesis
9. Discuss the genetic and molecular basis of sickle cell disease. Describe the clinical outcome of sickle cell anaemia
10. Classify hereditary disorders of red cell membrane. Discuss the structural and biochemical features of the red cell membrane. Explain the process of haemolysis in red cell membrane disorders
Intellectual skills
After completion of this course the students of MPhil leading to PhD program will be able to:
i. Identify normal and the various types of abnormal red blood cells in a peripheral blood smear
ii. Identify the maturing erythroid cells in a bone marrow smear
iii. Interpret the findings of normal and abnormal parameters on haematology analyser report for different ages and sexes
iv. Discriminate between thalassaemia trait and iron deficiency from haematology analyser reports
v. Interpret osmotic fragility tests
vi. Interpret bone marrow smear stained with iron stain
vii. Interpret peripheral blood and bone marrow smears with megaloblasts
viii. Interpret reticulocyte count
Professional and Practical Skills
After completion of this course the students of MPhil leading to PhD program will be able to:
i. Sample blood from a peripheral vain and transfer to EDTA/Gel tubes
ii. Separate plasma from haematocrit
iii. Prepare peripheral blood smear from blood taken in EDTA tubes/ thumb prick
iv. Perform Giemsa staining on peripheral blood smear slides
v. Set up, calibrate and focus a compound microscope
vi. Set up and calibrate a haematology analyser
General and transferable skills
After completion of this course, the students of MPhil leading to PhD program will be able to:
i. Prepare a Microsoft PowerPoint presentation
ii. Use Microsoft Word for writing assignments
iii. Use Endnote/Reference Manager to cite published literature
iv. Be able to explain disease system to scientific and non-scientific audience