News & NoticesDEPARTMENT OF CHEMICAL PATHOLOGY AND IMMUNOLOGY FACULTY OF BASIC MEDICAL SCIENCES UNIVERSITY OF ILORIN, ILORIN
ANNUAL REPORT FOR THE 2009/2010 ACADEMIC SESSION The official account of the operation of the Department of Chemical Pathology and Immunology in the 2009/2010 Academic session is provided as follows: Public Lectures held by the Department: Nil Research niche area/research activities (ongoing, completed, patented, commercialized etc) There are many researches going on both internally and in collaboration with other units/department of the University. Individual researches are internal and presently the department in collaboration with Faculty of Business Administration and Social sciences, Engineering and Science through the Centre for Hydropower Research and Development (University of Ilorin) is involved in the Health Impact Assessment component of the Environmental Impact Assessment of Shiroro, Niger and Jebba Dams operation. The department has also formed an Obesity and Eating disorder research group with other departments in the college of Health Sciences. It is hoped that the group would have a metamorphic growth into a center. This is with a view to tackle the health burden of this epidermis. The department has also submitted a research proposal to ETF funding on the Hypoglycaemic and Lipid profile effect of commonly eaten dietary leaves in albino rats’
Conferences organized by (faculty/department): Nil Workshops hosted by the Faculty/Department: Nil Seminars organized by the Department: Nil Staff offered external appointments (to include names, Institution, agency, date and type) Dr Akande A.A.: Visiting Lecturer, University of Maiduguri - April, 2010 Examiner to the National Postgraduate Medical College Fellowship examinations - April, 2010 External Examiner to College of Medicine, University of Lagos, Department of Clinical Chemistry – April, 2010 Professor A.B. Okesina – on leave of Absence Dr. S.A. Adebisi – on Sabbatical/Accumulated Annual Leave Professor G.O. Oyeyinka served as both Internal and External Examiner to other departments in the University during the period (Departments of Medical Microbiology, Epidemiology and Community Health. He remains the Pathology Programme Coordinator for the College of Health Sciences, University of Ilorin. He is also currently serving as a representative of Faculty of BMS on the Boards of Postgraduate School and the Technical and Entrepreneurship Centre. g. Grants attracted by the Department and individual staff: Grants attracted by the Department and individual staff:Dr. Akande A.A. NACHRED research fund N5.8 Million, HAF/KWASACA grant worth N1.9Million Scholarships/Fellowships; Research and Merit awards to the staff and Students of the Department: NIL Number of the University Scholars in the department during the period: NIL Percentage of students’ enrollment and Graduation pass rate [undergraduate and
Percentage of students’ enrollment and Graduation pass rate [undergraduate and postgraduate] Set Number Undergraduate 2010 – 13 280 2009 – 12 216
COURSE TITLE AND CODE: CHEMICAL PATHOLOGY MODULE: - consisting of 80% of the course content.COURSE DURATION: One year COURSE CONTENT: General Chemical Pathology, Carbonhdyrate metabolism and disorders, Plasma Proteins, Metabolism of lipids and its disorders, Endocrine biochemistry, Uric aicd metabolism, Renal biochemistry, Hepatic biochemistry, Investigation of Gastrointestinal tract, Plasma enzymes, Water and electrolytes homeostasis, Hydrogen ion homeostasis, Calcium and Phosphate metabolism and disorder, Laboratory computer, Vitamins, Biochemical effect of tumors, Chemistry of Cerebrospinal fluid, Nutritional chemistry and therapeutic drug monitoring. COURSE DESCRIPTION: The modules operate a three block posting within the 400 level year. Each posting last between six and eight weeks and this provides opportunity for integrated learning. The course provides a clear understanding of Chemical Pathology and clinical diseases. The first posting deals with lectures on introductory Chemical Pathology and consist of ten hours of lectures and sixty five hours of practical instruction. The second posting consist of twenty two hours of lectures and fifteen hours of practical mainly on principles of Chemical Pathology. The last posting of twenty two hours is on clinical application of Chemical Pathology. COURSE JUSTIFICATION: Chemical pathology and its clinical application is fundamental tools for basis of the diagnosis, treatment, follow –up, screening and research of biochemical related pathology. This course would enable a student to order for appropriate biochemical tests, interpret and apply such to clinical outcome of diseases. COURSE OBJECTIVE: To introduce students to the clinical application of the principles in confirmation of provisional diagnosis, treatment and monitoring of disease state with particular reference to those common in Nigeria COURSE REQUIREMENT: A candidate must have completed the prescribe courses of Anatomy, Physiology, Biochemistry and Integrated subjects with a grade of not less than 50% in each subject. COURSE ASSESSMENT: There is a progressive assessment at the end of each posting. This is made of two papers – Multiple choice and Short answer essay. The final assessment shall be as prescribed the University regulations. This consist of two papers – Multiple choice and short answer types, Practical and oral examinations. The weighing shall be the total of all progressive assessment as 50% and the final professional examination as 50%. The pass grade is 50%. INSTRUCTIONAL OBJECTIVE: At the end of the course, a student should be able to demonstrate the knowledge of the biochemical basis of disease state and select relevant biochemical tests that will confirm clinical diagnosis. They must also be able to interpret and apply the report in the treatment and follow up of illment. They will be able to perform simple tests such urinalysis and CSF analysis. INSTRUCTIONAL METHODS: Instructions shall be delivered by lectures, tutorials, seminars and demonstration and participation in practical LECTURES LECTURE 1: GENERAL CHEMICAL PATHOLGY Objectives of Lecture: This is to introduce the scope of the subject in-relation to clinical application. At the end of this lecture, students are expected to know the various tests profile, the Chemical Pathology specimens and how to interpret results of biochemical analysis Description of Lecture: The lecture will cover the following: Overview and uses of Chemical Pathology in medical Practice, constituents of blood, use of anticoagulants, reference values, quality control, units in chemical Pathology, importance of side-room testing, laboratory computer s, automation, concept of homeostasis in Chemical pathology and uses of laboratory data. Duration of Lecture: Six (06) Hours Study Questions: Write an essay on the types, limitations, and relevance of anticoagulants available in Chemical Pathology. List and Classify into test profile twenty tests used in Chemical Pathology. Discuss the uses of laboratory Data. Discuss the application of computer in laboratory practice Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 1-19. Essential Pathology for Clinical students in the tropics by Olusegun Ojo. Pg 1-8 Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.173-182 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 58-91 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 1-7 LECTURE 2: Carbohydrates Metabolism and Disorders Objectives of Lecture: This is to introduce the metabolic pathways of Carbonhydrate – Glucose, Galactose etc, the enzymes involved and the effect of the absence of such enzyme activities. Hormones of Glucose homeostasis and to study the various diseases – pathology, causes, investigation, and treatment Description of Lecture: The lecture will cover the following: Introduction to Carbonhydrate metabolism, Biochemical abnormalities of Diabetes Mellitus, Biochemical monitoring of Diabetes Mellitus and Hypoglycemia. Duration of Lecture: Four (04) Hours Study Questions: Write an essay on Glucose Homeostasis List hormones of Glucose Hormones and discuss one in details. Discuss the laboratory investigations to monitor Diabetes Mellitus List and classify the causes of Hypoglycemia Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 71-97. Essential Pathology for Clinical students in the tropics by Olusegun Ojo. Pg 486-500 Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.1-22 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 928-1000 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 1174-198 LECTURE 3: Plasma Proteins Objectives of Lecture: Total Protein and Albumin are routine tests in chemical Pathology. This is to introduce the other plasma proteins of diagnostic importance and the their value in clinical practice Description of Lecture: The lecture will cover the following: Classification and metabolism of plasma Proteins, Functions of plasma proteins, Aminoacidurias, Electrophoresis and its clinical applications Duration of Lecture: Four (04) Hours Study Questions: Write short notes on Acute Phase proteins- Classification and functions. List biochemical tests available for the diagnosis of Multiple Myeloma. Define aminoaciduria. Classify and discuss one in detilas. Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 123-140. Essential Pathology for Clinical students in the tropics by Olusegun Ojo. Pg 499-500 Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.110-124 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 5625-671 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 280-301 LECTURE 4: Plasma Lipids and Disorders of Lipid Metabolism Objectives of Lecture: This is to introduce the metabolism of the lipoproteins and the clinical disorder associated with the metabolism. At the end of this lecture, students are expected to define Lipid, Lipoprotein and Apoprotein. Know the metabolism of Lipoproteins and the classification of hypercholesterolemia and hypertriglyceridemia as well as how to investigate the disorders. Description of Lecture: The lecture will cover the following: Introduction to Lipid metabolism, Classification of hyperlipidemias, Investigation and Management of Hyperlipidemias. Duration of Lecture: Four (04) Hours Study Questions: Define Lipid and classify the plasma Lipids. What is a Lipoprotein? Classify Lipoproteins and discuss the role of the apoprotein component of one. Classify Hypercholesterolemia. Discuss one in details Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 111-123 Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.53-69 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1000-1081 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 198-214 LECTURE 5: Endocrinology Objectives of Lecture: This is to introduce the students to the various clinical conditions associated with the Hypothalamus-pituitary-end organ aixs. At the end of the instructions student would be to investigate these clinical conditions as well as perform simple diagnostic tests. Description of Lecture: The lecture will cover the following: Physiology and disorders of Pituitary gland, Hypothalamus-Pituitary- Gonadal axis and the investigation of infertile couple, Physiology and disorders of Hypothalamus-Pituitary-Adrenal axis, Hypothalamus-Pituitary-Thyroid-axis, Endocrine emergencies and Biochemical investigation of Coma and stupor. Duration of Lecture: Six (06) Hours Study Questions: List the endocrine emergencies in a medical emergency unit and discuss one in details. Enumerate the causes and biochemical investigation of coma and stupor. List the available dynamic tests of Hypothalamic pituitary adrenal axis. List and classify biochemical tests for a patient suspected of having heat intolerance and neck swelling. Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 277-319. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.32, 124-136. Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1645-1878 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 115-162 LECTURE 6: Uric acid metabolism and disorder Objectives of Lecture: This is to introduce Uric acid metabolism in-relation to clinical application. At the end of this lecture, students are expected to know the various tests profile, the Chemical Pathology specimens and how to interpret results of biochemical analysis. Description of Lecture: The lecture will cover the following: Uric acid Metabolism and disorder Duration of Lecture: One (01) Hour Study Questions: Discuss Uric acid metabolism. What is Gout? Discuss the enzymes deficiencies Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 199-205 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1559-1568 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 301-308 LECTURE 7: Renal Biochemistry Objectives of Lecture: At the end of this lecture, students are expected to know the various renal tests profile. The Chemical Pathology specimens and how to interpret results of biochemical analysis Description of Lecture: The lecture will cover the following: Biochemical concepts of renal function, Biochemical features and investigation of acute and renal failure, Renal tubular acidosis and Renal calculi Duration of Lecture: Three (03) Hours Study Questions: Write an essay on renal function tests. List and Classify into renal tubular acidosis. Compare and contrast the biochemical features of acute and chronic renal failure Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 215-237. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.80-95 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1513-1568 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 36-58 LECTURE 8: Hepatic Biochemistry Objectives of Lecture: At the end of this lecture, students are expected to know the various hepatic tests profile, the Chemical Pathology specimens and how to interpret results of biochemical analysis Description of Lecture: The lecture will cover the following: Liver function tests, Hyperbilirubinemia – Classification and management, Bile acid metabolism and disorder Duration of Lecture: Three (03) Hours Study Questions: Write an essay on Liver function tests in Chemical Pathology. List and Classify liver enzymes in-relation to hepatic pathology Classify hyperbilirubinemias. Discuss the causes in one classification Discuss the clinical significance of Bile acid metabolism. Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 237-253 Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.69-80 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1449-1505 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 250-268 LECTURE TOPIC 9: Gastrointestinal biochemistry Objectives of Lecture: At the end of this lecture, students are expected to know the various GIT tests profile, the Chemical Pathology specimens and how to interpret results of biochemical analysis Description of Lecture: The lecture will cover the following: GIT functions and assessment. Duration of Lecture: One (01) Hour Study Questions: List five biochemical tests of GIT function and describe any one of them Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg.233-250. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.173-182 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1576-1620 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 233-250 LECTURE 10: Plasma Enzymes and Enzyme markers of Diseases Objectives of Lecture: This is to introduce the enzymatic basis of clinical diseases and the application of plasma enzymes to diagnosis. At the end of this lecture, students are expected to know the various enzymes tests profile, the Chemical Pathology specimens and how to interpret results of biochemical analysis to make diagnosis Description of Lecture: The lecture will cover the following: Chemistry of enzymes, Plasma enzymes of clinical interest, application of enzymology to diagnosis and enzymes as markers of diseases. Duration of Lecture: Three (03) Hours Study Questions: List ten enzymes of clinical interest and write an essay on one stating the chemistry, sources, activity and clinical significance List the enzymes of clinical interest in the diagnosis of prostate disease, Myocardiac infarction and discuss its use. Discuss the enzyme markers of cardiac diseases Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg.205-215 Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.193-204 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 735-888 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 268-280 LECTURE 11: Water and Electrolytes Objectives of Lecture: This is to introduce water distribution, homeostasis and disorders. At the end of this lecture, students are expected to know causes, laboratory investigation and treatment of hypo/hypervolumia, Hypo/hypernatrimia, Hypo/hyperkalaemia, the Chemical Pathology specimens and how to interpret results of biochemical analysis Description of Lecture: The lecture will cover the following: Water distribution, Water homeostasis, Hypo/Hypervolumia, Hypo/hypernatremia, Hypo/hyperkalamia. Duration of Lecture: Two (02) Hours Study Questions: List the hormones of water homeostasis and discuss the role of one. List the disorders of water and Electrolyte homeostasis and discuss the causes, investigation and treatment of any one. Classify Hyponatremia and list causes of each class Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 19-53. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.136-157 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1375-1409 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 7-36 LECTURE 12: Hydrogen ion Homeostasis and Disorders Objectives of Lecture: This is to introduce the sources of hydrogen ions, the homeostasis mechanisms and the clinical disorders and compensatory mechanisms associated with the disorders. At the end of this lecture, students are expected to know the causes, presentation , biochemical picture, and treatment of Metabolic acidosis/alkalosis and Respiratory acidosis/alkalosis Description of Lecture: The lecture will cover the following: Hydrogen ion buffer system, Respiratory mechanism, renal mechanisms, Disorders – Metabolic acidosis/alkalosis, Respiratory acidosis/alkalosis Duration of Lecture: One (01) Hour Study Questions: Write an essay on the Buffer systems or the renal mechanisms of hydrogen ion homeostasis. List and Classify hydrogen ion disorders. Discuss Respiratory Acidosis in detials Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg.53-71. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.22-32 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1375-1409 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 58-82 LECTURE 13: Calcium and Phosphate Homeostasis and Disorders Objectives of Lecture: This is to introduce the metabolism of Calcium and Phosphate, causes of Hypo/Hypercalcemia and phosphatemia as well as metabolic bone diseases. At the end of this lecture, students are expected to know the causes of disorders, various tests profile interpretations, the Chemical Pathology specimens and treatment and diagnosis of metabolic bone diseases Description of Lecture: The lecture will cover the following: calcium and Phosphate homeostasis, Causes and treatment of disorders, Metabolic bone diseases. Duration of Lecture: Two (02) Hours Study Questions: Write an essay on the hormones of Calcium and Phosphate Homeostasis. List the causes of Hypercalcemia. List the metabolic bone Diseases and discuss one in details. Discuss the term renal Osteodystrophy Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 97-111. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.95-110 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1887-1953 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 94-115 LECTURE 14: Vitamins Objectives of Lecture: This is to introduce the classification of Vitamins, metabolism, sources and deficiencies of Vitamins At the end of this lecture, students are expected to know the classification, sources and clinical implication of deficiencies Description of Lecture: The lecture will cover the following: Clssification, metabolism and clinical disorders of deficiencies Duration of Lecture: One (01) Hour Study Questions: Write an essay on the causes of Vitamin deficiencies. Discuss the biochemical investigations of Vitamin deficiency disease Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 1-19. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.182 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg.1275-1276 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 222-233 LECTURE 15: Biochemical effect of tumors and tumor markers Objectives of Lecture: This is to introduce the scope of biochemical presentation of tumors and its uses as a marker. At the end of this lecture, students are expected to know the biochemical effects, biochemical markers and their applications as well as uses. Description of Lecture: The lecture will cover the following: Definitions, classification, uses and application of tumor markers. Duration of Lecture: Two (02) Hours Study Questions: Classify Tumor markers with two examples each List and Classify the biochemical effects of tumors and discuss the treatment of one Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 335-339. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.163-173 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 897-904 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 335-344 LECTURE 16: Cerebrospinal fluid Objectives of Lecture: This is to introduce the synthesis, biochemical composition and its application to clinical. At the end of this lecture, students are expected to know the biochemical composition application in the diagnosis of Bacterial, Viral and Tuberculous meningitis. Description of Lecture: The lecture will cover the following: Synthesis, Biochemical composition, CSF biochemical picture in Bacterial, Viral and Tuberculous meningitis Duration of Lecture: One (01) Hour Study Questions: Discuss the biochemical findings in the CSF specimen of a Meningitis patient Compare the biochemical findings in the CSF specimen of Bacterial, Viral and Tuberculous Meningitis Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 339-345. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg.173 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 897-904 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 329 LECTURE 16: Nutritional Assessment and Feeding Objectives of Lecture: This is to introduce the scope of biochemical support in Nutrition and the way to monitor and assess. At the end of this lecture, students are expected to know the composition of various biochemical fluids and their clinical uses as well as know how to monitor patients on nutritional support Description of Lecture: The lecture will cover the following: Indications and types of Nutritional support and composition. Monitoring of intravenous feeding, Nutritional assessment Duration of Lecture: One (01) Hour Study Questions: List the biochemical monitors of Nutrition Reading Text: Essential Clinical Biochemistry by Hassan S. Isah. Pg. 141-177. Clinical Chemistry by Zilva and Pannall Critical Chemical Pathology MCQ by Gadzama AA, Mshelia DS, Akande AA. Pg. 204 Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1236-1267 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 214-222 LECTURE 17: Therapeutic Drug Monitoring Objectives of Lecture: This is to introduce the scope of drug classification used for biochemical monitoring. At the end of this lecture, students are expected to know the class of drugs to be monitored Description of Lecture: The lecture will cover the following: Classification of drugs and analysis of monitoring. Duration of Lecture: One (01) Hour Study Questions: What are clinical uses of therapeutic drug monitoring? List four drug groups under therapeutic drug monitoring and name one example of drug in each group Reference Text: Teitz textbook of clinical chemistry (2nd Edition) by Teitz. Pg. 1094-1150 Clinical Chemistry and Metabolic Medicine (7th Edition) by Martin A Crook. Pg. 344-355 COURSEWARE FOR IMMUNOLOGY MODULE FOR 400 LEVEL MB; BS Course Title: Immunology (20% of Chemical Pathology and Immunology programme); Compulsory Lecturer’s Name: Gabriel Olujide OYEYINKA Qualifications and Title: Ph.D., M.Sc., PGD (Immunol.), AIMLT; Professor E-mail Addresses:
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Office Location: Extreme left-end room, Department of Chemical Pathology and Immunology Office Block, Mini-Campus. Consultation Hours: 2.00 pm to 4.00 pm; Wednesdays and Thursdays
Course Content: The course defines Immunology, classifies immunity and elucidates immune mechanisms of the humoral and cellular compartments. Immunogens and antigens, immuno-globulins, complement system and antigen-antibody interactions will be studied. Also to be studied are: the major histocompatibility complex, cellular interactions in adaptive immune responses, hypersensitivity, immunodiagnosis, immunodeficiency, evaluation of immune status and the immunology of transplantation. Course Description: The module provides a clear understanding of basic immunology. The knowledge of basic mechanisms will be used to classify inappropriate immune responses directed against host tissues. Congenital and acquired states of immunodeficiency will be studied. Also to be studied is the immunologic basis of transplant rejection and its prevention. Course Justification: Immunology holds the key to a rational understanding of the mechanisms of host protection from infection and explains pathogenic mechanisms in many human diseases. A good grasp of immunologic principles is therefore an essential component of the medical training programme. Course Objectives: It is expected that at the end of this module, students will have a clear understanding of the immune system and how it functions. It is also expected that they will be able to logically interprete results of immunology laboratory techniques and apply them to effective diagnosis of infection and diseases. Course Requirements: At least 75% attendance at lectures, practicals and tutorials is required to qualify to write the final examination in Pathology. Methods of Grading: The course will be assessed along with other courses in Pathology: progressive assessment (50%) and final examination (50%). Course Delivery Strategies and Practical Schedules: This will be done face-to-face. Prepared lecture notes will be provided after every lecture. The practical sessions will demonstrate immunological methods based on precipitation and agglutination reactions. Preparative techniques for the separation of leucocytes and lymphocytes from blood and the identification of T and B lymphocytes will also be demonstrated. The course will be delivered 11/2 hours per lecture and 3 hours per practical session. There will be 2 weeks of revision: at the middle and at the end of the programme. LECTURE TOPIC 1: THE IMMUNE SYSTEM – INTRODUCTORY CONCEPTS Objectives of Topic: This is to introduce the immune system and its component parts and mechanisms as a baseline upon which the more detailed picture of the subject can subsequently be painted. At the end of this lecture, students are expected to have a general understanding of the immune system and its operations. Description of Topic: The lecture will cover the following: definition, classification, introductory broad-base of Immunology, kinetics of the immune response and proliferative cycles, the normal immune response pathway, Burnet’s clonal selection theory, functional state of immunologic mechanisms in neonatal life, and interaction of nutrition, immunity and infection. Study Questions: Explain the relationships between innate and adaptive immune mechanisms. Trace the basis of specificity in immune responses. What is immunologic “memory”? Discuss the timing of children vaccination programmes. Describe how nutrition, immunity and infection interact. Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p. 1-13. Available in the Department. LECTURE TOPIC 2: ANTIGENS AND IMMUNOGENS Objectives of Topic: This is to explain the terms: antigen, immunogen, hapten and mitogen; and also to elaborate on factors that influence immunogenicity. Description of Topic: The lecture will cover the following: definition of antigen, immunogen, hapten and mitogen; requirements for immunogenicity, and sources, classification and fate of antigens in the body. Study Questions: Explain the difference between antigens and immunogens. Write short notes on haptens and mitogens. What is immunodominance? Discuss the factors that influence immunogenicity. Give an account of the different types of antigens. Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p. 14-23. Available in the Department. LECTURE TOPIC 3: STRUCTURE AND FUNCTIONS OF IMMUNOGLOBULINS Objective of Topic: This is to reveal the basis for the heterogeneity of antibody molecules, and assemble the functions the different immunoglobulin isotypes perform. At the end of this lecture, students will be expected to be familiar with the basic structure of the immunoglobulins. Description of Topic: The lecture will cover the following: basic immunoglobulin structure, effect of digestion with papain, pepsin and 2-mercaptoethanol, immunoglobulin allotypes, , idiotypes and isotypes including a consideration of light-chain and heavy-chain types, immunoglobulin subclasses, secretory component, J-chain and carbohydrate moieties, and functions of IgG, IgA, IgM, IgD and IgE. Study Questions: Describe the actions of immunoglobulin splitting enzymes and reducing agents. Identify the immunoglobulin isotypes. Describe the secretory immunoglobulin. Discuss the basis for heterogeneity of immunoglobulin structures. What functions do Immunoglobulins perform? Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p.56-76. Available in the Department. Essential immunology by Ivan Roitt. Available in the Medical Library. LECTURE TOPIC 4: THE COMPLEMENT SYSTEM Objectives of Topic: This assembles the several proteins comprising the complement system and explains their interaction in the generation of the inflammatory response. The physiologic control mechanisms and biologic consequences of their activation will be considered. Description of Topic: The lecture will cover the following: complement activation pathways including the effect of cobra venom protein, control mechanisms of complement system activation, and biologic consequences and significance of complement system activation. Study Questions: Explain the classical pathway of complement activation. Explain the alternative pathway of complement activation. Describe what happens immunologically following a bite by cobra. What are the control points of complement system activation? Discuss the biologic consequences of complement activation. Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p. 84-91. Available in the Department. Essential immunology by Ivan Roitt. Available in the Medical Library. LECTURE TOPIC 5: ANTIGEN-ANTIBODY INTERACTIONS Objectives of Topic: This is to show the features of the reaction of antigen with corresponding antibody. The lecture will also define antibody affinity, avidity and cross-reactions. Description of Topic: The lecture will cover the following: features of antigen-antibody reaction, forces responsible for the union of antigen and antibody, antibody affinity and avidity, mechanisms of protection by antigen-antibody reaction in the body, and harmful effects of antigen-antibody reaction in the body. Study Questions: State the factors involved in the formation of immune complexes. Identify the forces responsible for the integrity of immune complexes. Differentiate between antibody affinity and avidity. Describe how cross-reactions occur in antigen-antibody interactions. List and discuss the mechanisms of protection by immune complex formation in the body. Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p. 24-31. Available in the Department. Essential immunology by Ivan Roitt. Available in the Medical Library. LECTURE TOPIC 6: THE MAJOR HISTOCOMPATIBILITY COMPLEX AND ANTIGEN PRESENTATION Objectives of the Topic: This lecture aims to give a clear understanding of the genetic organization of the HLA complex, the structure and functions of MHC proteins, and their role in antigen presentation during the induction of an immune response. Description of Topic: The lecture will cover the following: organization of HLA complex, HLA proteins, antigen presentation by MHC proteins, and functions of the major histocompatibility complex and their association with certain diseases. Study Questions: Describe the genetic organization of the HLA complex. Draw the structures of HLA Class I and Class II proteins and label them. What are the functions of the major histocompatibility complex? Write a note on the role of Class I and Class II HLA proteins in antigen presentation. Discuss the possible role of the major histocompatibility complex in determinant selection. Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p. 92-98. Available in the Department. Essential immunology by Ivan Roitt. Available in the Medical Library. LECTURE TOPIC 7: CELLULAR INTERACTIONS IN IMMUNE RESPONSES Objectives of Topic: The objective of this lecture is to explain the mechanisms of cell mediated immunity and to show how lymphoid cells interact to enable the synthesis of antibodies. Description of Topic: The lecture will cover the following: T cell receptor and activation, the two effector arms of the cell mediated immune response, and cellular interactions involved in antibody production. Study Questions: Describe the T cell receptor. Trace the pathway of cell mediated immune response from antigen recognition. Elaborate on the two effector arms of the cell mediated immune response. Write a note on lymphokines that sub-classify T cells. How do T and B lymphocytes interact to synthesise antibodies? Reading List: Essential immunology by Ivan Roitt. Available in the Medical Library. LECTURE TOPIC 8: HYPERSENSITIVITY Objectives of Topic: The purpose here is to assemble and classify the aberrant immune responses that are directed at, and thus injures, host tissues. Description of Topic: This lecture will explain, with examples, the pathogenic mechanisms of Type I, Type II, Type III, Type IV and Type V hypersensitivity states. Study Questions: Write a note on atopy. Elaborate the immuno-pathogenic mechanisms in cytotoxic hypersensitivity. Explain the immuno-pathogenic mechanisms at play in Mycobacterium leprae infection. What is serum sickness? Describe the cellular and molecular events that lead to cell-mediated hypersensitivity. Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p. 114-127. Available in the Department. Essential immunology by Ivan Roitt. Available in the Medical Library. Immunology of Medicine in the tropics by B.M. Greenwood and H.C. Whittle, p. 87-135. Available in the Medical Library. LECTURE TOPIC 9: IMMUNODIAGNOSIS Objectives of Topic: The objective here is to equip students with knowledge to enable them to critically appraise the results of immunology laboratory investigations and determine their limits of usefulness in diagnosis. Description of Topic: This lecture will discuss immunodiagnostic methods based on: antigen detection, detection of non-specific immunologic changes induced by infection, and detection of specific humoral and cellular immune responses to infection. Study Questions: What are the advantages of antigen detection methods in immunodiagnosis? How would you establish the diagnostic success rate of a laboratory technique? Explain some situations when non-specific immunologic changes induced by infection becomes important in immunodiagnosis. In what ways may the effectiveness of antibody detection methods in immunodiagnosis be enhanced? Discuss the use of delayed hypersensitivity skin tests in immuno-diagnosis. Reading List: Immunology of medicine in the tropics by B.M. Greenwood and H.C. Whittle, p. 136-177. Available in the Medical ibrary. LECTURE TOPIC 10: IMMUNODEFICIENCY Objectives of Topic: The objective of this topic is to reveal general features associated with deficiency in immunologic capacity, classify the congenital immunodeficiency states, and discuss conditions that lead to secondary immunodeficiency. Description of Topic: This lecture will cover the following: phagocytic disorders, complement abnormalities, B cell deficiency, T cell deficiency, stem cell deficiency, and secondary immunodeficiency. Study Questions: List the general features of immunodeficiency. Discuss extrinsic factors that may lead to neutrophil immuno-incompetence List five complement immunodeficiency states and discuss one of them. Write a note on Bruton’s disease or on Di-George syndrome. What is the problem in severe combined immunodeficiency? Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p.142-153.Available in the Department. Essential immunology by Ivan Roitt. Available in the Medical Library. LECTURE TOPIC 11: EVALUATION OF IMMUNE STATUS Objectives of Topic: The objective here is to harness the knowledge of the components of the immune system and subject their capacity to immunology laboratory tests. Description of Topic: This lecture will cover nominal and functional assays of humoral and cellular functions in the innate and adaptive arms of the immune system. Study Questions: How may the adaptive humoral immunologic capacity be assessed? How may the innate cell mediated immunity be evaluated for competence? Describe in detail the characterization of proteins in the laboratory. Write a note on lymphocyte transformation test and its advantages. Discuss the use of cell surface markers in the enumeration of lymphocytes and its subsets. Reading List: Basic and clinical immunology by D.P. Stites, A.I. Terr and T.G. Parslow, p. 256-262. Available in the Medical Library. LECTURE TOPIC 12: IMMUNOLOGY OF TRANSPLANTATION Objectives of Topic: The objective is to explain the immunological basis for transplant rejection and for graft versus host reaction, and to show how to prevent rejection of transplanted tissues. Description of Topic: The lecture will cover the following: definition of terms used in transplantation, evidence for graft rejection as an immunologic process, mechanisms of graft rejection, and prevention of tissue transplant rejection. Study Questions: Explain the different forms of tissue exchanges possible within and among species. Discuss the available evidence for an immunologic basis of transplant rejection. Write a note on the immunologic mechanisms involved in tissue graft rejection. Explain the role of tissue typing in the prevention of transplant rejection. Discuss the choice of donor for an effective transplantation. Reading List: Basic immunology for students of medicine and biology by L.S. Salimonu et al., p. 99-107.Available in the Department. 2. Essential immunology by Ivan Roitt. Available in the Medical Library
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