Download Year 1 Semester 1 Learning Outcomes

Year 1, Semester 1 Learning Outcomes
WEEK 1: Body basics
• Describe and recognize the anatomical planes and axes of the body, the main components of
the skeleton and describe how they are connected, and the main internal organs and structures
including the nervous system. Describe where each is located and the relations between them.
• Define the concept of a cell and describe the structures and functions of eukaryotic
organelles and other sub-cellular components including the cytoskeletons. Describe the
properties of the three main components of the cytoskeleton, including ancillary proteins
involved, and how a particular cell’s cytoskeleton determines its properties.
• Discuss the concept of a tissue and name the major tissues types, including the different
types of epithelia. Describe the nature and functions of cell-cell interactions, including the
main types of adhesion molecules and cell junctions involved. Describe how cell adhesion is
regulated by the cell, and how cellular adhesions can send signals into and between cells.
• Describe the appearance of secretory cells and the principal methods of secretion. Describe
the major microscopic features of supporting / connective tissues and associated cells in terms
of the cell presents, the components of the matrix and their arrangement relative to each other.
WEEK 2: Human embryology and congenital abnormalities
• Describe the formation and structure of human gametes and the process of fertilization.
• Describe the main methods of assisted conception.
• Describe the processes of normal human development in utero, including, cleavage,
compaction, blastula formation, implantation, gastrulation, neurulation and early
organogenesis.
• Describe the mechanisms that give rise to unusual features or abnormalities of human
development, including twinning (incl. conjoined and transfusion syndrome), axis
duplications, spina bifida, anencephaly, fetus in fetu, cleft palate, phocomelia and intersex
phenotypes.
Week 3: Genetics
• Describe the general features of the human genome (amount of DNA, number of genes,
organisation into chromosomes, repetitive DNA, amount of inter-individual variation).
• Describe random assortment of parental chromosomes and crossing-over. Compare and
contrast mitosis and meiosis.
• Discuss the concept of aneuploidy.
• Describe the basic anatomy of a gene and its controlling regions and understand how DNA
sequence must be interpreted (annotated) experimentally and computationally to identify the
position and function of genes.
• Describe the process of protein synthesis from transcription of the gene to production of
functional protein, and understand why protein synthesis is required.
• Explain and illustrate the mechanisms by which a single gene can encode more than one
possible protein product.
• Compare and contrast pro- and eukaryotic protein synthesis.
• Describe the different ways and mechanisms by which DNA is mutable and explain how
these mutations may either be somatic or affect the germline.
• Describe semi-conservative DNA replication. Explain the need for DNA maintenance
mechanisms. Explain how different classes of mutations have different consequences and
how the phenotype is a complex product of the nature of the mutation, the pattern of gene
expression and (dys) function of the (mutant) gene product.
• Explain the concept of phenotype/genotype correlation and how this may help to predict
severity of a disorder.
• Discuss how genetic differences between individuals can affect the way that they respond to
drugs and evaluate the usefulness of different types of drugs for different genotypes.
• Explain how gene expression array profiling can be used to classify diseases.
• Discuss how most causes of ill health have a genetic and environmental component.
Week 4: Cells: components and communication
• Define the term ‘protein’: explain what is meant by primary, secondary, tertiary and
quaternary structure, contrast the fibrous and globular proteins and explain what is meant by
the phrase ‘conjugated protein’.
• Describe where different types of amino acids are found on and in proteins and protein
clusters, and explain how peptides are coiled into a-helices.
• Define the term ‘enzyme’, describe the general structure of an enzyme and explain how
enzymes are classified and how they work.
• Define the term ‘metabolic pathway’, explain what a controlled enzyme is and describe
different means of controlling an enzyme and an entire metabolic pathway.
• Explain with examples what is meant by ‘hormone’: List the different chemical types of
hormone in mammals and outline with examples the different mechanisms by which
hormones can act.
• Explain the concept of hormone receptors and outline the molecular mechanism of action of
the major classes of hormone receptor. Illustrate how signals are transduced from the
membrane to other compartments of the cell.
• Explain the role of second messengers in the transmission of signals and outline how
concentrations of the major types of second messenger are controlled. Explain the terms
cyclic AMP; cascade and control coefficient
• Explain the function of G-proteins in signal transduction and the roles of protein kinases and
protein phosphatases in regulation.
• Discuss the structure and functions of cell membranes and explain how they control the
transit of molecules and what factors determine the rate at which ions, metabolites and drugs
move across by passive diffusion.
• Describe in outline the structures of membrane proteins. Describe the characteristics of
carrier-mediated permeation and define, with examples, the terms uniporter, symporter and
antiporter.
• Outline the general properties and structures of ion channels. Describe the electrical
equivalent of a plasma membrane containing an ion channel.
Week 5: Electrical excitability and neurotransmission
• Explain what is meant by selective ion permeability. Describe the two major forces acting
on a charged ion across a semi-permeable membrane and explain the major determinant of
resting membrane potential.
• Describe the main electrolyte composition of intra- & extracellular fluid and outline the role
of the Na/K ATPase in maintaining ion gradients.
• Outline the essential features of voltage gated ion channels, with examples. Explain the
membrane permeability changes underlying the action potential, and explain the refractory
period of action potentials and role in action potential frequency.
• Describe the major structural and functional features of neurones and other excitable cells;
Classify neurons by structure and function, and list their histological characteristic.
• Describe the compound action potential and explain how electrical signals are transmitted
along axons. Outline the role of axon diameter and myelination in conduction velocity. State
the modalities carried by each different type of nerve fibre.
• Describe the composition and coverings of a spinal nerve. Describe how disorders of myelin
affect nerve conduction.
• Describe the main features of a chemical synapse. Discuss the quantal hypothesis of
neurotransmission, and describe the main events leading from depolarisation of a nerve
terminal to the postsynaptic response.)
• List the major excitatory and inhibitory neurotransmitters, compare and contrast the features
of ionotropic and metabotropic receptors.
• State the actions of acetylcholine at the neuromuscular junction. Discuss the effects of drugs
that reduce and enhance transmission and state some of the indications for using drugs that
reduce and enhance transmission.
• State the general effects of drugs that are muscarinic cholinoceptor antagonists. Discuss
some of the beneficial effects of muscarinic cholinoceptor agonists and antagonists in human
disease.
• Discuss the roles of the parasympathetic nervous system and sympathetic nervous systems.
• State the key endogenous sympathetic (noradrenergic) neurotransmitters. State some of the
drugs that can influence activity of the sympathetic nervous system and discuss the general
indications for their use. Evaluate the usefulness of different types of drugs for different
applications at this junction.
• Describe the components and connections of a reflex arc and explain how it works.
• Compare and contrast the location, microscopic appearance, nervous control, and function
of the three types of muscle tissue. Explain the relation of blood vessels, nerves and
connective tissue component of skeletal muscles.
• Discuss the microscopic structure of the skeletal muscle sarcomere and explain the slidingfilament mechanism of muscle contraction.
• Describe the structure and importance of the motor unit and explain how it works. Describe
the histochemical features of denervation and reinnervation in skeletal muscle. Explain what
is meant by a neurogenic muscle disorder and describe the main features.
Week 6: Clinical pharmacology and therapeutics
• Define the terms ‘drug’, ‘pharmacology’, ‘clinical pharmacology’, ‘therapeutics’ and
‘adverse drug response’ and explain what is meant by ‘receptors’, ‘agonists’ and
‘antagonists’.
• Discuss the variety of ways by which drugs can produce effects in body systems.
• Discuss the concept of the dose-response curve and its implications for the use of drugs in
man. Discuss the importance of safe and effective drug prescribing in the professional lives of
all doctors, and state the responsibilities of being a prescriber.
• Explain the term pharmacokinetics and discuss its basic concepts. Discuss how interindividual variations in pharmacokinetics lead to variations in the response to drugs and
discuss the advantages and disadvantages of different routes of drug administration.
• Discuss how the handling of drugs is significantly altered in the presence of renal and
hepatic disease and in elderly patients.
• * Discuss the concept of pharmacogenetics.
Week 7: Infection and microorganisms
• Explain why it is useful to identify a microorganism as the cause of a disease. List with
examples the sources, routes of spread, and routes of entry, of microorganisms that can cause
disease, and describe how these routes can be interrupted
• Summarise the role of mechanical barriers, secreted substances and the natural flora in host
defences; describe the nature and distribution of normal commensal organisms around the
body of a healthy adult.
• Describe the structure of a typical bacterial cell, including the structure of Gram-negative
and Gram-positive cell walls. Compare and contract prokaryotic and eukaryotic cells.
• Discuss the principles of bacterial growth, replication and division and explain the selective
action of the main classes of antibiotics.
• Describe the structures and life cycles of fungi, mycoplasma, Rickettsiaceae, Chlamydia and
prions and outline the diseases they cause.
• State the aims of the clinical microbiology laboratory and describe the route from patient to
microbiological diagnosis. Outline the principles of the Gram stain, state when it is
appropriate to use the light microscope and the electron microscope and list culture and nonculture techniques for the diagnosis of infection.
• Describe the principles by which viruses are classified and describe the structure and
function of viral nucleic acids, proteins and glycoproteins.
• Describe stages in the replication cycle of an animal virus (adsorption, penetration,
uncoating, macromolecular synthesis, assembly and release).
• Explain the terms ‘cytopathic effect’ and ‘budding’and what effect viruses have on cells and
the different infection types (acute, persistent, transforming) with examples of each. Give an
overview of poliovirus infection, and describe poliovirus vaccination and world policies for
polio control.
• Describe viral transformation, explain how it differs from productive viral infection, and list
the differences between virally transformed cells and normal cells. Explain what happens
during herpes simplex virus infection and the action of aciclovir (as an example of an antiviral drug).
Week 8: Injury, Inflammation and repair
• State the main types of agent that cause cell injury and death by necrosis and apoptosis and
discuss the mechanisms by which each acts. Describe the main morphological changes by
which cell injury and death may be recognised in tissues, and compare and contrast necrosis,
autophagy and apoptosis.
• Discuss how the body detects injury and describe the roles of the different phases (acute and
chronic inflammation and healing) of the response to injury.
• Describe the basic anatomy of the lymphoid system in terms of the lymph node, primary and
secondary lymphoid tissue and how and why lymphocytes recirculate through the lymphatics.
• Outline the division of the immune response into the humoral and cell mediated response
and discuss the roles of the two types of response.
• Define the terms ‘acute inflammation’, ’exudate’, ‘transudate’, ‘ulcer’, ‘abscess’, ‘pus’, and
‘pyogenic’, ‘serous’, fibrinous’, ‘suppurative’. Give examples of causes of acute
inflammation and describe the sequence of changes that occur in a tissue as it becomes
inflamed. State the name given to inflammation of a given tissue or organ. Discuss how
activation of the body’s innate immune response, both humoral and cellular, including
vascular response, is manifest as acute inflammation. Name the chemical mediators of this
response (kinins, complement etc).
• List the typical signs of acute inflammation and state how they are modified by location or
circumstances. List the cell types typically seen and describe their morphology and what each
does.
• Describe the systemic effects of acute inflammation and discuss the mechanisms by which
these are brought about. Describe the potential outcomes and complications, including key
factors that favour one path or another.
• Describe the possible end results of acute inflammation. Explain why having an acute
inflammatory response may be good or bad for the patient, and how therapeutic modulation of
inflammation may be beneficial or detrimental.
• Define the terms ‘chronic inflammation’ and ‘granuloma’, describe the different types and
implications of chronic inflammation (eg granulomatous, ulceration, abscesses etc) and
describe the main pathways by which chronic inflammation may develop in a tissue.
• List the cell types found in chronic inflammation and describe their morphology and what
they do. Describe how each accumulates in the tissue. Be able to recognize chronic
inflammation when seeing a pathologist’s report.
• State the main systemic effects of chronic inflammation and describe the mechanisms by
which each is brought about.
• Define the following: labile, stable, permanent cell; regeneration, organisation, resolution;
angiogenesis; granulation tissue; healing, repair. Describe how the normal cell cycle relates to
labile, stable and permanent cells and give examples of each.
• Describe the mechanisms involved in the healing and repair of a wound and explain the role
of the various growth factors and systemic factors. State what is meant by the terms primary
union (first intention) and secondary union (second intention).
• Describe the pathway by which collagen is synthesised and secreted and explain its
function, and describe how wound strength changes during the process of healing.
• Explain how the healing process occurs in the following tissues: skin, bone, brain, heart, and
be able to apply your knowledge of the main principles of healing to explain how other
tissues heal.
Week 9: Immunity and defence against infection
• compare and contrast innate and acquired immunity, explain the differences between them
and give examples of each: define the terms antigen, epitope and clonal selection.
• explain the role of the acute phase response. Describe the roles of complement, natural killer
cells, opsonization and phagocytosis, leucocytes, and cytokines in host defences
• explain how leucocytes can be identified
• Describe the structure and function of molecules encoded by the MHC and describe the
functions of B cells, plasma cells, T lymphocytes and the MHC and explain how they interact.
Explain the importance of lymphocyte recirculation
• Describe the basic structure and functions of an antibody, explain how it binds to an antigen
and what is meant by complementary determining regions (CDR) and hypervariable regions.
• Explain the differences between a primary and a secondary immune response
• Explain the role of different antibody isotypes. Compare and contrast passive and active
immunisation, with examples. Explain how antibody crosses the placenta, and describe the
different types of vaccines. Discuss the uses of antibodies as therapeutic and
diagnostic reagents.
Week 10: Neoplasia: mechanisms and effects
• Explain how cell multiplication and tissue growth are normally controlled and how
disorders of these control systems can result in neoplasia. Explain how in vivo cancer growth
rates determine the length of the preclinical growth phase.
• Define the terms neoplasia, metaplasia, dysplasia, carcinoma in situ (intraepithelial
neoplasia) and invasion, and name the benign and malignant neoplasms arising in the main
tissues of the body.
• Compare and contrast the properties of benign and malignant tumours and explain the basis
of the histopathological classification of tumours (grade, stage), including its clinical
significance.
• Describe the principles by which a patient with cancer is investigated clinically. Describe
how immunohistochemistry and/ or array profiling may be used to demonstrate production of
different substances by neoplasms and thereby help in their classification.
• Describe the clinical manifestations of tumours in terms of symptoms and signs which raise
the suspicion of cancer and how these relate to organ-specific effects (eg in lung, colon and
mammary gland), involvement of local structures, metastatic disease and paraneoplastic
effects. Explain how a neoplasm can ultimately kill the patient.
• Define the terms oncogene and onco-suppressor (tumour suppressor) gene, and discuss the
mechanisms of genetic injury leading to oncogenesis.
• Explain how neoplastic phenotypes may be advantageous to cancer cells. Explain why
angiogenesis is important for tumour growth.
• Discuss the development of carcinoma of the colon and cervix as models of oncogenesis and
of tumour progression, in terms of cancer families versus sporadic cancer, intraepithelial
neoplasia and invasion.
• Describe the main routes by which neoplasms spread, and describe the routes of spread and
sites of metastasis of carcinomas of lung, breast and colon.
• Discuss the factors that determine whether metastases occur early or late in the course of
neoplastic disease, including invasion of lymphatics and blood vessels, expression of certain
genes.
• Discuss the mechanisms by which a cancer patient develops weight loss and cachexia.
• Describe the principal methods used to treat cancer and explain how they work in relation to
cell injury and death. Explain why a neoplasm with a fast growth rate may respond well to
management by radiotherapy or chemotherapy. Explain the differences between treatments
that are curative, life-prolonging but not curative, and palliative