Gastrointestinal Nutrition Block Overview

GASTROINTESTINAL & NUTRITION BLOCK INTRODUCTION Ali M Somily MD

OBJECTIVES By the end of the gastrointestinal and haematology block, students should be able to: Correlate Correlate between between the the anatomical anatomical structures structures and and their their functions functions. . Use Use the the basic basic sciences sciences to to interpret interpret symptoms, symptoms, signs signs and and investigation investigation results results Understand Understand the the pathology, pathology, microbiology microbiology and and pathogenesis pathogenesis of of the the common common disorders disorders Discuss Discuss the the pharmacological pharmacological basis basis of of drugs drugs Epidemiology Epidemiology and and preventive preventive approaches approaches

OBJECTIVES Revisit Revisit epidemiological epidemiological parameters body body mass mass index index Macro Macro and and micro parameters such such as as micro nutritional nutritional requirements requirements of of a a population population. . Normal Normal haemopoiesis haemopoiesis and and the the functions functions of of different different haemopoietic haemopoietic cells cells. . Disorders Disorders affecting affecting the the haemopoietic haemopoietic system, system, with with particular particular emphasis emphasis on on anaemia anaemia. . Role Role of of haemoglobin haemoglobin and and its its types types of of and and iron iron metabolism metabolism. . Develop Develop communication communication and and professional professional skills skills at at the the level level of of a a medical medical student student. .

TEACHING & LEARNUNG MODES Small Small group group discussion discussion Lectures Lectures Student Student- -led led seminars seminars Practical Practical classes classes Clinical Clinical skills skills Self Self- -directed directed learning learning Writing Writing an an essay essay or or mini mini thesis thesis E E- -learning learning sessions sessions

LECTURES & EXAMINATIONS Esophagus and Stomach. Esophagus and Stomach. Pancreas. Pancreas. Small Intestine. Small Intestine. Colon. Colon. Liver & Liver & hematopoietic hematopoietic system. Spleen & hematopoietic Spleen & hematopoietic system. Gallbladder & Gallbladder & Biliary System. Biliary System. Seven Seven Weeks Weeks Week 5: Week 5: Midblock Examination Midblock Examination 25 December 2016 December 2016 25 Week Week 8: Consolidation week from 15 8: Consolidation week from 15 January 2017 to 19 January 2017 January 2017 to 19 January 2017 system. system. Week 9: Examination week from 22 Week 9: Examination week from 22 January 2017 to 26 January 2017 January 2017 to 26 January 2017 Total Total 88 lectures 88 lectures 7 7 practicals practicals

OESOPHAGUS AND STOMACH Week (1) Specialty Specialty Practical Practical Lecture (16) Lecture (16) Week (1) Anatomy Anatomy 1 1- -Anatomy of the oral cavity Anatomy of the oral cavity oseophagus oseophagus and stomach and stomach Anatomy, histology and Anatomy, histology and radiology of radiology of eosophagus stomach stomach eosophagus & & 2 2- -Histology of the esophagus and stomach Histology of the esophagus and stomach 3 3- -Anatomy and histology of the salivary glands Anatomy and histology of the salivary glands 4 4- -Introduction to Introduction to Pleuripotent Pleuripotent stem cell stem cell Physiology Physiology 1 1- -General principles of GIT physiology General principles of GIT physiology 2 2- -Oesophageal motility and pathophysiology of reflux disease Oesophageal motility and pathophysiology of reflux disease 3 3- -Physiology of the stomach and regulation of gastric secretions Physiology of the stomach and regulation of gastric secretions Biochemistry Biochemistry 1 1- -Role of salivary gland and Role of salivary gland and stomach in digestion stomach in digestion 2 2- -Structure and function of Structure and function of haemoglobin haemoglobin Pathology Pathology 1 1- -Gastro Esophageal Reflux Disease (GERD) Gastro Esophageal Reflux Disease (GERD) 2 2- -Pathology and pathophysiology of peptic ulcer Pathology and pathophysiology of peptic ulcer Microbiology Microbiology 1 1- -H pylori H pylori and drugs used in treatment and drugs used in treatment Hematology Hematology 1 1- -Anemia Anemia 2 2- -Hemoglobinopathies Hemoglobinopathies 3 3- -Transfusion & Cross Transfusion & Cross- -matching matching Pharmacology Pharmacology 1 1- -H2 blockers and proton pump inhibitors H2 blockers and proton pump inhibitors 2 2- -Antiemetic drugs Antiemetic drugs

PANCREAS PANCREAS Lecture (9) Lecture (9) Week (2) Week (2) Specialty Specialty Practical Practical Anatomy Anatomy 1 1- -Embryology of the Embryology of the pancreas and small pancreas and small intestine intestine 2 2- -Anatomy and histology Anatomy and histology of pancreas and biliary of pancreas and biliary system system Physiology Physiology 1 1- -Physiology of pancreas Physiology of pancreas Biochemistry Biochemistry 1 1- -Biochemical aspects of Biochemical aspects of digestion of lipids digestion of lipids 2 2- -Biochemical aspects of Biochemical aspects of digestion of proteins and digestion of proteins and carbohydrates carbohydrates 3 3- -Nutritional Nutritional requirements requirements 4 4- -Plasma proteins Plasma proteins 5 5- -Macro and micro Macro and micro nutrients nutrients Pathology Pathology GERD & Peptic ulcer GERD & Peptic ulcer 1 1- -Pathology and pathogenesis of acute and chronic Pathology and pathogenesis of acute and chronic pancreatitis pancreatitis

SMALL INTESTINE SMALL INTESTINE Specialty Specialty Practical Practical Lecture (11) Lecture (11) Week (3) Week (3) 1-Anatomy and histology of the small intestine Anatomy Anatomy Physiology Physiology 1 1- -Physiology of the small intestine: motility and Physiology of the small intestine: motility and secretion secretion Biochemistry Biochemistry Clinical chemistry and Clinical chemistry and pathology practical about pathology practical about malabsorption, acute and malabsorption, acute and chronic pancreatitis chronic pancreatitis Pathology Pathology 1 1- -Pathology and mechanisms of malabsorption Pathology and mechanisms of malabsorption 2-Pathophysiology and mechanisms of diarrhea Microbiology Microbiology 1 1- -Normal flora and introduction to infectious diarrhea Normal flora and introduction to infectious diarrhea 2 2- -Intestinal helminthes Intestinal helminthes 3 3- -Intestinal protozoa Intestinal protozoa 4 4- -Viral gastroenteritis Viral gastroenteritis 5 5- -Shigella and salmonella Shigella and salmonella 6 6- -Cholera Cholera 1 1- -Radiology of the abdomen Radiology Radiology

COLON COLON Specialty Specialty Practical Practical Lecture (12) Lecture (12) Week (4) Week (4) Anatomy Anatomy 1 1- -Anatomy and histology of the large intestine Anatomy and histology of the large intestine 2 2- -Anatomy of the Anatomy of the omentum omentum Anatomy, histology and Anatomy, histology and radiology of the small and radiology of the small and large intestine large intestine Physiology Physiology 1 1- -Physiology of the colon: motility Physiology of the colon: motility Pathology Pathology 1 1- -Colonic Colonic tumours 2 2- -Colonic tumors and polyps Colonic tumors and polyps- -2 2 3 3- -Crohn s disease Crohn s disease 4 4- -ulcerative colitis ulcerative colitis tumours and polyps and polyps- -1 1 Microbiology Microbiology 1 1- -Schistosomiasis Schistosomiasis Pharmacology Pharmacology 1 1- -Treatment of dysentery and Treatment of dysentery and amoebiasis 2 2- -Drugs used in treating constipation and IBS Drugs used in treating constipation and IBS 3 3- -Drugs used in IBD and biological and immune Drugs used in IBD and biological and immune therapy of IB therapy of IB amoebiasis Medicine Medicine 1 1- -Irritable bowel syndrome Irritable bowel syndrome

LIVER & HEMATOPOIETIC SYSTEM LIVER & HEMATOPOIETIC SYSTEM Specialty Specialty Practical Practical Lecture (18) Lecture (18) Week (5) Week (5) Anatomy Anatomy 1 1- -Anatomy of the liver and spleen Anatomy of the liver and spleen Physiology Physiology 1 1- -Bilirubin metabolism Bilirubin metabolism 2 2- -Reticuloendothelial system and function of the Reticuloendothelial system and function of the spleen spleen 3 3- -Coagulation mechanisms Coagulation mechanisms 4 4- -Platelets structure and functions Platelets structure and functions 1-Liver function test 2-Biochemical aspects of bile acids and salts 3-Urea cycle 4-Biochemistry of vitamin K Biochemistry Biochemistry test Pathology Pathology 1 1- -Pathology and pathogenesis of liver Cirrhosis Pathology and pathogenesis of liver Cirrhosis 2 2- -Complication of liver cirrhosis Complication of liver cirrhosis 3 3- -Cancer of the liver and pancreas Cancer of the liver and pancreas 1-Trypanosomiasis Microbiology Microbiology 2-Leishmaniosis 3-Viral hepatitis B, C, D and G Hematology Hematology 1 1- -Approach to bleeding disorders Approach to bleeding disorders Pharmacology Pharmacology 1 1- -Cytochrome system and drug metabolism Cytochrome system and drug metabolism 2 2- -Hepatotoxic drugs Hepatotoxic drugs

SPLEEN & HEMATOPOIETIC SYSTEM SPLEEN & HEMATOPOIETIC SYSTEM Specialty Specialty Practical Practical Lecture (14) Lecture (14) Week Week ( (6) 6) Anatomy Anatomy 1 1- -Histology of the liver and Histology of the liver and spleen spleen 1-G6PD Biochemistry Biochemistry Pathology Pathology Liver function test(Integrated Liver function test(Integrated Biochemistry & Pathology) Biochemistry & Pathology) 1-Malaria 2-Viral hepatitis A and E Microbiology Microbiology Hematology Hematology 1 1- -Acute leukemia I Acute leukemia I 2 2- -Acute leukemia II Acute leukemia II 3 3- -Megaloblastic anemia Megaloblastic anemia 4 4- -Chronic Leukemia Chronic Leukemia 5 5- -Polycythemia Polycythemia 6 6- -Lymphoproliferative Lymphoproliferative disorder disorder 7 7- -Approach to Hemolysis Approach to Hemolysis Hemoglobinopathies Hemoglobinopathies Pharmacology Pharmacology 1 1- -Anti Anti- -coagulant drugs coagulant drugs 2 2- -Anti Anti- -Malarial Drugs Malarial Drugs 3 3- -Anti Anti- -Platelet Drugs Platelet Drugs

GALLBLADDER & GALLBLADDER & BILIARY BILIARY SYSTEM SYSTEM Specialty Specialty Practical Practical Lecture (8) Lecture (8) Week (7) Week (7) Physiology Physiology 1 1- -Physiology of bile salts and enterohepatic Physiology of bile salts and enterohepatic Circulation Circulation Biochemistry Biochemistry Pathology Pathology 1 1- -Pathology and pathogenesis of gallstones and Pathology and pathogenesis of gallstones and cholecystitis cholecystitis 2 2- -Liver, biliary system and pancreas Liver, biliary system and pancreas Microbiology Microbiology 1 1- -Hepatitis Hepatitis 2 2- -Blood Parasites Blood Parasites Hematology Hematology 1 1- -Bleeding disorders Bleeding disorders Radiology Radiology 1 1- -Ultrasound of the liver and gallstones Ultrasound of the liver and gallstones Anatomy, histology and Anatomy, histology and radiology of liver, spleen, radiology of liver, spleen, pancreas and biliary system pancreas and biliary system Medicine Medicine 1 1- -Pathophysiology of ascites Pathophysiology of ascites

EVALUATION SI. SI. No No Item Item Marks Marks 1 Small Group 5 2 Midterm MCQs 20 3 Short Answer Question (SAQs) 20 4 Final MCQs 30 5 OSPE 20 6 Clinical Skills 5 TOTAL 100

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