Cardiovascular system

COURSE OBJECTIVES

Students will be able to

identify and explain the nature of abnormalities seen in common cardiovascular system in relation to normal structure and functions.

outline the principles of therapeutic and behavioural management of patient and families.

correlate the normal structure and functions of cardiovascular system to the signs, symptoms patho-physiological states, diagnosis and management of the following common conditions:

chest pain; dyspnoea; swelling of legs; palpitation; cyanosis; rheumatic fever/ rheumatic heart disease; infective endocarditis; ischaemic heart disease; hypertension; shock; varicose veins; haemorrhoids; filariasis; anaemia; thromboembolism

ANATOMY

Students will be able to

recall the divisions, boundaries and contents of mediastinum if not discussed in respiratory system.

mention

parts of cvs

different types of circulation

different types of blood vessels their structure and blood and nerve supply,

anastomoses, collateral circulation & end arteries.

mention the different parts of developing heart tube, their fate and main anomalies.

explain the development and fate of the arches of aorta; correlate with developmental anomalies.
explain the size, shape, position, parts and important relations of heart.
describe the blood supply of heart and correlate with the ischaemia of heart.
describe the conductive system and nervous supply of the heart.
mention the extent and branches of the following arteries:

arch of aorta

descending and abdominal aorta

subclavian a., axillary a., brachial a., radial a., ulnar a., superficial and deep palmar arches.

common iliac a., external iliac a., internal iliac a., femoral a., popliteal a., anterior tibial a., posterior tibial a., dorsalis pedis a.
common carotid a., external carotid a., internal carotid a.,
mention the extent and tributaries of the following veins
external and internal jugular
dural venous sinuses
branchiocephalic
subclavian
axillary
brachial, cephalic & basilic
azygos and hemiazygos
internal and external iliac
femoral
poplilial
long and short saphenous
mention the course, relations and tributaries of portal vein
describe porto-systemic anastomoses
enumerate lymphatic organs
mention structure and location of different important groups of lymphnodes and their area of drainage.
identify inguinal and axillary lymphnodes , their subgroups and their area if drainage
describe the size, shape, structure, position, blood supply of spleen and thymus.
mention course, extent, relations and tributaries of thoracic duct and right lymphatic duct.
mention the position and tributaries of cisterna chyli.

CLINICAL PHYSIOLOGY

Students will be able to

describe functional Anatomy of the Heart

describe properties of Cardiac muscle
describe cardiac cycle / Heart Rate
describe electrocardiography
describe cardiac output and venous return
describe haemodynamics of Circulation
describe regulation of cardiovascular functions
describe arterial Blood Pressure and its Regulation
describe regional Circulations
describe Lymphatic Circulation
describe cardiovascular changes during Exercise
describe applied physiology of CVS e.g.

Pathophysiology of Hypertension
Pathophysiology of Edema
Pathophysiology of Circulatory Shock
Pathophysiology of Heart Failure and syncope

CLINICAL BIOCHEMISTRY

Blood

Students will be able to

describe metabolism in reticulocytes, erythrocytes, leucocytes and platelets;

list the blood coagulation factors and describe their properties;
explain extrinsic and intrinsic pathways of coagulation;

explain how oxalate, fluoride, EDTA inhibit clotting;

explain the function of plasminogen and lysis of clot;
list the defects in platelets, plasma, vessels wall;
describe the biochemical explanation of haemorrhagic disease.

Iron metabolism

Students will be able to

list the iron containing haeme and non haeme proteins and describe their functions;
describe intestinal absorption of iron and distribution kinetics in the body;
describe the process of haeme biosynthesis and catabolism;
describe iron deficiency anaemia and acute intermittent porphyria;
describe the diagnostic test for iron deficiency states (serum-iron, serum iron binding capacity nd serum ferritin);
describe classificatin of prophyria;
describe the causes, diagnosis and management of porphyria.

Lipoprotein

Students will be able to

define lipoproteins and list major classes of lipoproteins of plasma.

draw the structure of lipoproteins and list their composition.

describe metabolism of lipoproteins.
classify hyperlipoproteinaemia according to WHO specification (type I to V).
show the relation between atherosclerosis and plasma lipoprotein level.
describe the molecular basis, diagnosis and biochemical investigations of:
myocardial infarction, rheumatic carditis and hypertension;
primary hyperlipoproteinaemia
familial dysbetalipoproteinaemia (broad beta-diseases);
familial chyiomicronaemia;
hyperchclesieraiaernia,
a beta lipoproteinemia
Tangier disease
Secondary hyperlipoproteinaemia

PATHOLOGY

Cardiovascular system

Students will be able to

define hypertension and list its causes.
list different types of hypertension.
describe the aetiology, mechanism and complications of hypertension.
explain the pathological changes in the heart and blood vessels in hypertension.

define ischemic heart diseases. List different types of IHD.

describe different types of angina.
describe the etiopathogenesis of different types of ischemic heart disease.
describe the etiopathogenesis, gross and microscopic features of acute myocardial infarction and its complications.
define pancarditis, endocarditis, pericarditis, and myocarditis.
describe etiopathogenesis, gross and microscopic features of rheumatic heart disease and its complications.
describe the etiology and morphology of myocarditis and pericarditis.
enumerate different types of endocarditis.
describe the etiology, gross and microscopic features, and complications of bacterial endocarditis.
list common types of congenital cardiac anomalies and describe their etiologies.
describe different types of cardiomyopathies.
define atherosclerosis, arteriosclerosis, vasculitis and arteritis.
describe the etiopathogensis, gross and microscopic features and complications of atherosclerosis.
define vasculitis; list different types of vasculitis and arteritis.

describe etiology, gross and microscopic features of polyarteritis nodosa.

describe the etiology and pathological features of thromboangitis obliterans. (Buerger’s disease) and its complications.

mention aneurysm under following headings- definition, types, etiopathogenesis,
morphology and complications.
discuss cardiac failure under following headings- definition, types, causes, pathogenesis, morphology and complications.

Hematology

Students will be able to

define and classify anemia.
discuss the etiology, morphological features and complications of iron deficiency anemia.
describe the etiology, morphological features and complications of megaloblastic anemia
define pancytopenia and describe its etiology.
define leukocytosis and leucopenia.
describe the etiology, morphological features and complications of aplastic anemia.

list different types of hemolytic anemia.

describe the etiopathogenesis and morphology of hereditary spherocytosis.
define hemoglobinopathies.
mention thalassemia and sickle cell anemia under following headings- types, hematological and radiological findings, clinical features and complications.

define leukemia and myeloproliferative disorders.

list FAB classification of leukemias.
describe the morphological features of acute myeloid leukemia, acute lymphoid leukemia, chronic myeloid leukemia and chronic lymphocytic leukemia.
differentiate between leukemia and leukemoid reaction.
describe different types of lymphadenitis.
describe the classification and morphology of different types of lymphoma (Hodgkin’s lymphoma and common types of non-Hodgkin lymphoma).
list the etiology and morphology of polycythemia and myelofibrosis.
define and describe the morphologic features of multiple myeloma.
list laboratory investigations of multiple myeloma.
define and list the hemorrhagic (bleeding) disorders.
describe the etiopathogenesis of hemorrhagic (bleeding) disorders.
describe etiopathogenesis, morphology and laboratory findings of idiopathic thrombocytopenic purpura.
describe the etiopathogenesis and complications of Hemophilia A and Hemophilia B
define disseminated intravascular coagulation; describe the etiopathogenesis, laboratory findings and complications of DIC.
list different types of clinically important blood groups.
explain ABO and Rh incompatibility.
List the indications and complications of blood transfusion.

CLINICAL MICROBIOLOGY

Students will be able to

list and describe the important pathogens affecting Cardiovascular system;

describe the morphology, pathogenesis, laboratory diagnosis, transmission & prevention of the following organisms:

Bacteria:

Brucella

Ricketsiae
Streptococcus viridans
Staphylococci

Gram negative bacilli including HACEK group of organisms

Blood parasites

Plasmodium species
Leishmania donovani
Wuchereria bancrofti

CLINICAL PHARMACOLOGY

Drugs used in treatment of cardiac failure

Students will be able to

define the objectives of treatment of cardiac failure.
describe the mechanism of action and indications of cardiac glycosides (digoxin).
list the adverse effects of digoxin and their management.
enumerate drug-interactions of digoxin.
describe the mechanism of action and adverse reactions of other drugs used in cardiac failure.

Drugs for cardiac arrhythmia

Students will be able to

define the objectives of treatment of cardiac arrhythmias.
list the common anti-arrhythmic drugs.
describe the mechanisms of action and the cardiovascular actions of each drug.
describe the specificity of each drug for indication in a particular type of arrhythmia.
list the adverse reactions of anti-arrhythmic drugs.
explain how these reactions can be managed.

Drugs for angina pectoris

Students will be able to

define the objectives of treatment of angina pectoris.
list the drugs used in angina pectoris.
describe the mechanism of action and adverse reactions of these drugs.

Drugs for hypertension

Students will be able to

define the objectives of treatment of hypertension.
state the mechanism of action, ability to promote salt and water retention, adverse reactions and contraindications of each class of drugs.
describe the advantages and type of the patient for using combination of beta- blocker, ACE inhibitor, thiazide-diuretics and calcium channel blockers.
describe the drugs used in treatment of hypertensive crisis/emergencies.
describe the importance of non-pharmacological agents in hypertension.

Drugs used in the treatment of shock

Students will be able to

define the objectives of treatment of shock.

name the drugs used in treatment of hypotension and shock.
define hypovolemic shock, cardiogenic shock, septic shock and neurogenic shock.
select correct treatment for the above conditions when a list of correct and incorrect treatments are presented.
describe the usefulness of dobutamine in therapy of shock.
discuss the usefulness of dopamine in the management of cardiogenic shock.

Drugs used in thromboembolic disorders

Students will be able to

define the objectives of treatment of thromboembolic disorders.
name the agents used as anticoagulants.
state their routes of administration, mechanism of action, indications and antidote for overdose.
describe the drugs used for the prevention and treatment of arterial thrombosis.

Drugs used in anaemias

Students will be able to

define the objectives of treatment of anaemias.
state the normal absorption of iron from the gastrointestinal tract and mention the factors inhibiting or facilitating the absorption.
list the drugs effective in the treatment of iron deficiency anaemia.
state the routes of administration of therapeutic agents for iron deficiency anaemia.
mention adverse effects and contraindications.
describe the main haematopoietic and neurological effects of Vitamin-B-12 deficiency.
name the drug of choice for the treatment of pernicious anaemia and state its route of administration and duration of therapy.

Drugs used in treatment of myocardial infarction and hyperlipidemia

Students will be able to

define the objectives of treatment of myocardial infarction.
explain the principles of therapeutic management of a case of myocardial infarction.
describe the role of thrombolytics and antiplatelet drugs in Ml.
list the drugs effective for the prevention and treatment of hyperlipidemia and atherosclerosis.