تفاصيل المقرر

المقدمة


The human body in its normal condition must continually make accommodations to a changing environment, thus maintaining, normal constant internal state achieved through sensitive and finely integrated regulatory mechanisms working at the cellular level. These regulatory mechanisms through which the body adjusts to the changing environment may involve communication by the Central Nervous System or the Endocrine System. The failure of one or more of these mechanisms leads to the metabolic abberations underlying various diseases.
Metabolism is the integrative functioning of many pathways through which fat, carbohydrates, proteins and minerals are ultimately utilized by the livening cell. An understanding of metabolism, requires knowledge of the participating molecules (metabolites), the reactions to which they are subjected, the enzymes involved in these reactions and the hormones that control the rate of sequential reactions that comprise a metabolic pathway.
Endocrinology is the branch of science that deals with hormones, hormonal regulation of metabolism and diseases associated with hormonal abnormalities. It also deals with the hormonal aspects.
Vast amount of information and knowledge are accumulating rapidly concerning metabolism and endocrinology. Their tremendous importance is being increasingly recognized, specially in new medicine, because all diseases including psychiatric disorders, and genetic abnormalities associated with metabolic change. Furthermore, in all body cells hormones influence the metabolism of nucleotides, proteins, lipids, carbohydrates vitamins, water and electrolytes. therefore knowledge of endocrinology and metabolism is important in every branch of medicine.



المحتويات


1 Introduction to the Endocrine system & Mode of action of hormones
2 Overview of endocrine system & metabolism
2 Practical Biochemistry I
4 Functions of pancreas
5 Glycolysis & Pentose Phosphate Pathway
6 D.R. Endocrine system
7 Functions of pancreas
8 Glycolysis & Pentose Phosphate Pathway
9 Anatomy & histology of Pancreas
10 Secretion and control of insulin
11 Pathology of diabetes mellitus
12 Anatomy & histology of hypothalamus & pituitary gland
13 Physiology of hypothalamic & pituitary hormones
14 Pathology of pituitary disorders
15 Biochemistry Laboratory II
16 Fructose & galactose metabolism
17 Pituitary disorders
18 Pituitary tumors
19 Introduction & regulation of CHO metabolism
20 Regulation of blood glucose level
21 Oxidation of fatty acids
22 Lipogenesis and Lipolysis
23 Cholesterol metabolism
24 Formation of ketone bodies
25 Lipoproteins
29 DKA

30 Metabolism of Purines & Pyrimidines
31 Practical Biochemistry III
32 Urea Formation
33 Biosynthesis of amino-acids
34 Amino-acids metabolism
35 Protein Biosynthesis & Genetic code
36 Visit to the Nuclear Medicine Lab.
37 Anatomy of thyroid & parathyroid glands
38 Physiology of thyroid hormones
39 Pathology Thyroid Disorders
40 Metabolism of Purines & Pyrimidines
41 Practical Biochemistry III
42 Thyroid disorders (surgical)
43 Calcium metabolism & common disorders
44 Thyroid disorders
45 Anatomy & Histology of the adrenal gland
46 Physiology of the adrenal hormones
47 Pathology of the adrenal disorders
49 Disorders of the adrenal cortex
50 Disorders of the adrenal medulla
51 Steroid Therapy
52 Principles of Diet Therapy in Endocrine
53 Practical Biochemistry IV
54 Obesity
55 Ward Round
56 Inborn Errors of Metabolism
57 Paediatric Round:



المنسقون


Dr. Mohammed Atta
Dr. Badr Elden Elsuni
Dr. Salah Elamin


المطلوبات


Nutrition & Nutritional Biochemistry
Introduction to the Study of Disease
Man and His Environment
Growth and Development



الأهداف


1) General Objectives:

This course is design to provide an understanding of:
1.1 The major metabolic pathways and their inter-relationships
1.2 The hormonal regulation of metabolism
1.3 The structure and function of endocrine glands
1.4 The commonly occurring endocrine disorders and their management
1.5 Principles governing the design of the therapeutic diets during different metabolic and endocrinological disorders

2) Specific Objectives:

Thus by the end of this course the student should be able to:
2.1 Presented with a case of diabetes mellitus
2.1.1 Describe the shape, position, relations and the histological features of the pancreas
2.1.2 Discuss the factors involved in the control of normal blood sugar level
2.1.3 Discuss the possible aetiological factors in diabetes mellitus
2.1.4 Discuss the clinical presentation and the underlying pathophysiological mechanism in diabetes mellitus
2.1.5 Discuss glucose utilizations
2.1.6 Discuss the mode of action of insulin and its control
2.1.7 Discuss the role of C.A.M.P. in the control of energy metabolism
2.1.8 Describe the processes of glycogenolysis glycolysis and gluconeogenesis with emphasis on rate limiting steps
2.1.9 Discuss the Kreb's cycle as the important terminal point common to the major pathways of energy metabolism
2.1.10 Describe the reactions of the pentose phosphate pathways and discuss its biochemical significance
2.1.11 Perform and interpret Glucose Tolerance Test (GTT) and discuss its abnormalities
2.1.12 Construct a treatment plan for diabetes using dietary and pharmacological approaches

2.2 Presented with case of ketoacidosis the student should be able to:
2.2.1 Recognise the normal blood lipids and factors that regulate their metabolism
2.2.2 Discuss the oxidation of fatty acids
2.2.3 Discuss ketone bodies formation and their metabolism
2.2.4 Outline the reaction involved in lipogenesis

2.2.5 Diagnose and manage the following diabetic complications:
2.2.5.1 Diabetic ketoacidosis
2.2.5.2 Hypoglycaemic coma
2.2.5.3 Diabetic sepsis
2.2.5.4 Non-ketotic hypersmcolar coma

2.3 Presented with a case of obesity the student should be able to:
2.3.1 Discuss the aetiological factors and the social problems associated with it
2.3.2 Discuss the susceptibility of the obese persons to the development of related diseases
2.3.3 Plan a tegim for its management and prevention

2.4 Presented with a case of ischaemic heart disease, the student should be able to:
2.4.1 Define the hyperlipoproteinemias
2.4.2 Discuss the type of lipoproteins and their synthesis
2.4.3 Discuss the synthesis of cholesterol and problems associated with its abnormal levels in the plasma
2.4.4 Recognise the electrophoretic pattern of lipoproteins

2.5 Presented with a case of Kwashiorkor, the student should be able to:
2.5.1 Recognise the relationship between the amino acids pool and the dynamics state of tissue proteins
2.5.2 Describe the mechanisms by which amino acids are utilized for energy and recognise reactions involved in their catabolism (Deamination, Transamination and oxidative deamination)
2.5.3 Describe the biosynthesis of biogenic amines from amino acids

2.6 In argininosuccinase deficiency to student should be able to:
2.6.1 Outline the reactions by which nitrogen produced in amino acids catabolism as converted to urea
2.6.2 Demonstrate how urea production and elimination can affect certain pathological conditions such as portal hypertension
2.6.3 Discuss the excretion of nitrogenous compounds in the urine

2.7 In case of starvation, the student should be able to:
2.7.1 Discuss the inter-relationships between the major metabolic pathway
2.7.2 Discuss the role of liver in metabolism

2.8 Presented with a patient suffering from gout, the student should be able to:
2.8.1 Discuss the metabolism of purine and pyramidine neucleotide
2.8.2 Discuss the aetiological factors of gout
2.8.3 Plan a regime for the management and control of gout
2.8.4 Describe the stops involved in the one-carbon unit metabolism
2.8.5 Illustrate how certain drugs used in gout and cancer chemotherapy may interfere with nucleic acid metabolism

2.9 Given a case of phenylketonuria, the student should be able to:
2.9.1 Describe the process involved in protein biosynthesis and explain how affect these processes
2.9.2 Illustrate how this knowledge explain a whole spectrum of inherited disease
2.9.3 Discuss the possibility of genetic engineering in repair of genetic disease

2.10 Presented with a case of thyroid swelling, the student should be able to:
2.10.1 Describe the development and anatomy of the thyroid and parathyroid gland and their microstructures and relate such knowledge to thyroidectomy
2.10.2 Discuss the formation, secretion, metabolism and the mode of action of thyroid hormones
2.10.3 Describe the influence of the thyroid hormones on growth and other metabolic processes
2.10.4 Discuss the presentation, clinical feature pathology of thyroid swelling and outline the management of simple and nodular goitre
2.10.5 Discuss the formation, secretion metabolism and mode of action of parathyroid hormones
2.10.6 Describe the influence of parathyroid hormones on the metabolic process
2.10.7 Discuss the calcium metabolism and related clinical manifestations

2.11 ADRENAL GLAND
2.11.1 Describe the development and anatomy of adrenal gland and their microstructure
2.11.2 Discuss the formation, secretion, metabolism and mode of action of the adrenal hormone
2.11.3 Describe the influence of adrenal hormones on body metabolic process
2.11.4 Discuss the presentation, clinical features pathology and abnormalities of adrenal hypo and hyperactivity



طرق التدريس


- Clinical rounds
- Problem solving exercises
- Lecturers
- Practical
- Self learning
- Discussion
- Dissection and museum demonstrations



المصادر


1) Human Resources:

1.1. Personnel (Staff):
1.2. Physician
1.3. Surgeon
1.4. Community physician
1.5. Biochemist
1.6. Physiologists
1.7. Anatomists
1.8. Pathologists
1.9. Paediatrician

2) Physical Resources:

2.1 Space a room to accommodate students with slide projectors. Dissection room and museum with specimens and slides (access)
2.2 Library
2.3 Slides (endocrine problems)
2.4 Overhead projector and transparencies



وسائل التقويم


1. A & P and Continuous evaluation in labs --- 10%
2. OSPE --- 10%
3. MCQs --- 40%
4. Short essays --- 40%



المراجع


- Biochemistry (Case-oriented approaches) - Mentgomay
- Harper's Biochemistry
- Review of Medical Physiology W.F Ganong
- Baily and Love (short textbook in surgery)
- Davidson (textbook of Medicine)
- Aids to clinical surgery - (Scott)

N.B.:
GENERAL BOOKS OF ENDOCRINOLOGY, AND SECTIONS CENTRAL TEXTBOOKS:

616.4 Bony, P.K. Med. Ducan's diseases of metabolism
Endocrinology and Nutrition
616.4 Breuer, H. Methods of Hormone analysis
616.4 Recent Advances in endocrinology and metabolism
616.4 Thomson, J.A. An introduction to clinical endocrinology (copies)
616.4 Williams Textbook of Endocrinology, 4th and 5th editions
616.43 Hall Colour Atlas of Endocrinology
616 Macleod, J. Davidson's principles and practice of medicine
Endocrine and Metabolic Diseases. p. 507 Voyd, W. Introduction to the study of diseases.
Endocrine system p. 363 (2 copies)
616 Alstead, S. Textbook of Medical Treatment. Diseases of the Endocrine Glands P. 226.
Stryer Biochemistry

PHYSIOLOGY

616.32 Domline Gastrointestinal Hormones
616.34 Fujita Gastre-entero-pancreatic endocrine system
612.4 Kursomi Functional morphology of endocrine glands
612.4 Villee Humat endocrinology (2 copies)
612.4 Prolactin vol. 5 1977
612.405 Motta Hypothalmic Hormones
612.405 Von Zur Muhien Biochemical Basia of Thyroid Hormone Action
612.62 James the endocrine function of the ovary
612.82 Hess, W.R. Hypothalamus and thalmus

PHARMACOLOGY

615.1 Goth Medical Pharmacology, Section on Pharmacology of Steroids
615.1 P. 481
LAURENCE, Clinical Pharmacology. Sections on insulin, thyroid, adrenal steroids (3 copies)
615.1 Wilson, Applied pharmacology section on pituitary, thyroid and parathyroid, p. 393.
These general pharmacology books will have sections on all the topics.

ANATOMY

1- Cunningham Manual of Anatomy
2- Grays Anatomy
3- Hamilton Textbook of Anatomy



الجدول الزمني

Dr. Badr Elden Elsuni

Introduction to the course

SELF LEARNING

Sun.16/4/2017
8 - 10 a.m.

11 a.m – 1 p.m.
Dr. Mohammed Atta

Dr.Ahmed Maki
Introduction to the Endocrine System & Mode of Action of Hormones

Anatomy of Endocrine System

Mon.17/4/2017
8 - 10 a.m.

11 a.m – 1p.m
Dr. Ghada Elsir

Dr.Ahmed Maki
Glycogen Metabolism

Anatomy & Histology of Pancreas

Tue.18/4/2017
8 - 10 a.m

11 - 2 p.m.
Longitudinal Course
Wed.19/4/2017
Dr. Mohammed Atta

Dr.Ahmed Maki
Gluconeogenesis

Anatomy & Histology of Hypothalamus & Pituitary Gland

Thur.20/4/2017
8 -10 a.m

11a.m -2 p.m
Dr. Ghada Elsir

Dr Isam Mohamed

Dr. Ghada Elsir
Pentose Phosphate Pathway

Physiology of Pancreatic Hormones

Fructose & Galactose Metabolism

Sun 23/4/2017.
8 - 10 a.m.

11a.m - 1 p.m.

2 – 4 p.m
Dr.Nisreen Mohamed

Dr. Mohammed Atta
Physiology of Hypothalamic & Pituitary Hormones I

Regulation of Blood Glucose Level

Mon. 24/4/2017
8 - 10 a.m.

11a.m - 1 p.m
Dr.Nisreen Mohamed

Dr. Salah Elamin
Physiology of Hypothalamic & Pituitary Hormones II

Introduction to Problem 1 & 2

Tue. 25/4/2017
8 - 10 a.m.

11a.m - 1 p.m
Longitudinal Course
Wed. 26/4/2017
Prof. Mohamedani

Dr.Hiba Mahagoub
Pathology of Diabetes Mellitus

Metabolic Pathways of Lipids

Thur 27/4/2017.
8 – 10 a.m

11a.m - 1 pm
Dr.Hiba Mahagoub

Dr.Hiba Mahagoub
Lipogenesis and Lipolysis

Formation of Ketone Bodies

Sun 30/4/2017
8 - 10 a.m.

11 - 1 p.m.
Dr.Hiba Mahagoub

Dr. Mohammed Atta
Biochemistry Dep. Staf
Cholesterol & Lipoproteins Metabolism

GTT Practical Group A

Mon 1/5 /2017.
8 - 10 a.m.

11 - 2 p.m
Dr. Mahmoud Hussein

Dr. Mohammed Atta
Biochemistry Dep. Staf
Introduction to Problem 3&4

GTT Practical Group B

Tue.2 /5/2017
8 - 10 a.m

11a.m - 2 p.m

Longitudinal Course

Wed. 3/5/2017
Dr. Mona Ahmed

Dr. Ahmed Maki
Amino-Acids Metabolism

Anatomy of Thyroid & Parathyroid Glands

Thur .4/5/2017
8 – 10 a.m

11a.m - 1 p.m
Dr. Mona Ahmed

Dr. Mona Ahmed

Dr. Sulafa
Amino-Acids Metabolism

Amino-Acids Metabolism

Pathology of pituitary disorders

Sun 7/5/2017
8 - 10 a.m.

11 - 1 p.m.

2 – 4 p.m
Dr. Salah Elamin

Dr. Isam Mohamed
Obesity

Physiology of Thyroid Hormones

Mon. 8/5/2017
8 - 10 a.m

11 - 1 p.m
Dr. Salah Elamin

Dr. Isam Mohamed
Diabetes Mellitus I

Physiology of Parathyroid Hormones

Tue 9/5/2017
8 - 10 a.m.

11 – 1 p.m

Longitudinal Course

Wed. 10/5/2017
Dr. Salah Elamin

Dr. Ahmed Maki
Diabetes Mellitus II

Anatomy & Histology of the Adrenal Gland

Thur 11/5/2017
8 – 10 a.m

11 - 1 p.m.
Dr. Mohamed Abdraheem

Dr. Mohamed Abdraheem
Biochemistry Dep. Staf
Metabolism of Purines & Pyrimidines I

Biochemistry Practical II - Group A Urine Analysis

Sun. 14/ 5/ 2017
8 - 10

11a.m – 2 P.m
Dr. Mohamed Abdraheem

Dr. Mohamed Abdraheem
Biochemistry Dep. Staf
Metabolism of Purines & Pyrimidines II

Biochemistry Practical II - Group B Urine Analysis

Mon 15/5/2017
8 – 10 a.m

11a.m – 2 p.m
Dr. Salah Elamin

Surgery Dep. Staff
Pituitary disorder

Surgery Round

Tue. 16/5/2017
8 – 10 am

11a.m -2 p.m

Longitudinal Course

Wed. 17/5/2017
Dr. Nada Suliman

Dr. Isam Mohamed
Pathology of Thyroid Disorders

Physiology of the Adrenal Hormones

Thur. 18/5/2017
8 – 10 a.m

11 - 1 p.m
Dr. Isam Mohamed

Dr. Hiba Mahgoup
Biochemistry Dep. Staf
Mechanism of Action Hormones

Biochemistry Practical III – Cholesterol – Group A

Sun. 21/5/2017
8- 10 a.m

11-2 p.m
Dr. Salah Elamin

Dr. Hiba Mahgoup
Biochemistry Dep. Staf
Thyroid Disorders

Biochemistry Practical III – Cholesterol – Group B

Mon 22/5/2017
8 - 10 a.m

11 - 2 p.m
Dr. Ahmed Elamin

Medicine Dep. Staff
(Thyroid disorders (surgical

Medicine Round

Tue. 23/5/2017
8 - 10 a.m

11 - 2 p.m

Longitudinal Course

Wed. 24/5/2017
Dr. Salah Elamin

Dr. Ahmed Elnoor
Calcium metabolism & common disorders

Inborn Errors of Metabolism

Thur.25/ 5/2017
8 - 10 a.m

11 - 1 p.m


26/5/2017
to
1/7/2017
Ramdan & Eid

Dr. Badr Elden Elsuni

Dr. Hind Osman
Integration of CHO, Lipids and Protein Metabolism

Pathology of the adrenal disorders

Sun.2/7/2017
8- 10 a.m

11- 1 p.m
Dr. Salah Elamin

Dr. Mohamed Bushra
Discussion Problem 1& 2

Adrenal Disorders

Mon.3/7/2017
8 - 10 a.m

10- 1p.m
Dr. Salah Elamin

Paediatric Dep. Staff
Discussion Problem 3 & 4

Paediatric Round

Tue.4/7/2017
8 - 10 a.m

11 - 2 p.m

Longitudinal Course

Wed.5/7/2017
Dr. Hani Zaki

National Cancer Institute
Introduction to Molecular Medicine

Visit to the Nuclear Medicine Lab

Thur.6/7/2017
8 - 10

11 - 2 p.m
Dr. Hani Zaki
Biochemistry Dep. Staf
Biochemistry Practical IV – Electrophoresis Group A
Sun.9/7/2017
8- 10 a.m
11- 2 p.m
Dr. Hani Zaki
Biochemistry Dep. Staf
Biochemistry Practical IV - Electrophoresis Group B
Mon.10/7/2017
8 - 10 a.m
11- 2 p.m
Biochemistry Deparments Revision
Tue.11/7/2017
8 - 10 a.m.

Longitudinal Course

Wed.12/7/2017
Biochemistry Deparments Revision
Thur.13/7/2017
8 - 10

WRITTEN EXAMINATION
MCQs
Essays
Tue.18/7/2017

Longitudinal Course

Wed.19/7/2017
O S P E
Thur.20/7/2017

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