INTRODUCTION
CHAIR PERSON: DR. MALAK EL-HAZMI
CO-CHAIR: DR. SAMI AL-NASSAR
RESPIRATORY BLOCK COMMITTEE
General objectives of RESPIRATORY
block
The block is for 4 week. The major learning objectives.
1. Understand normal structure and function of the Respiratory
system.
2.Describe the etiology and the pathogenesis of common
respiratory disorders (Bronchial asthma, Allergy, COPD,
respiratory tract infections and pulmonary tuberculosis).
3. Correlate clinical features to the pathophysiology of the
disease.
4. Take a relevant history and perform a clinical examination to
diagnose respiratory tract disorders.
5. Plan out investigations to diagnose and manage respiratory
disorders.
General objectives of RESPIRATORY
block
6. Describe principles of the pharmacological basis in the
treatment of
respiratory disorders (Bronchial asthma,
Allergy, COPD, respiratory tract infections and pulmonary
tuberculosis).
8. Describe cigarette smoking problems and their solution .
9. Describe the basic management of the respiratory disorders
10. Be able to diagnose, manage and counsel patients with
respiratory disorders
Modes of teaching
Teaching of this block contents will be in the form of :
 Lectures
 Problem based learning
 Practical.
ANATOMY: TEACHING STAFF
1.
2.
3.
4.
5.
6.
7.
8.
9.
Dr. Jamilah Al Medany
Dr. Sanaa Shaarawy
Dr. Raeesa Mohammad
Prof. Saeed Abumakarem
Prof. Ahmed Fathalla
Dr. Essam Salama
Dr. Aly Mohammad
Dr. Saeed Vohra
Additional Team of Doctors and technicians for the
practical
ANATOMY’S LECTURES:
1.
2.
3.
4.
5.
6.
7.
Anatomy and histology of the Nasal cavity & pharynx
Muscles involved in Normal Respiration
Embryology of the Respiratory System
Anatomy of Larynx, Trachea & bronchi
Anatomy of lungs and pleura
Radiological anatomy of the chest
Mediastinum
HISTOLOGY'S LECTURE:
1. Histology of the lung and bronchial tree
 ANATOMY & HISTOLOGY OF NASAL CAVITY & PHARYNX
 Nasal cavity: boundaries, lateral wall.
 Paranasal sinuses: names, functions, openings.
 Pharynx: parts.
 Microscopic structures of: vestibule of nose, respiratory & olfactory
mucosa, nasal septum, mucosa of paranasal sinuses, larynx..
 MUSCLES INVOLVED IN NORMAL RESPIRATION
- Bones and joints of thoracic cage.
- Respiratory movements
- Inspiratory & expiratory muscles.
 ANATOMY OF LARYNX, TRACHEA & BRONCHI
- Larynx & trachea: extent, structure & functions.
- Bronchial tree: structure, subdivisions & functions.
 EMBRYOLOGY OF RESPIRATORY SYSTEM
- Important notes in development of larynx, trachea & lung.
 ANATOMY OF PLEURA & LUNG
- Pleura: subdivisions, recesses, surface anatomy, supply.
- Lungs: shape, relations, supply.
- Difference between right & left lungs.
 HISTOLOGY OF LUNG & BRONCHIAL TREE
- Microscopic structures of the wall of: trachea, bronchi,
bronchioles, pleura.
 RADIOLOGICAL ANATOMY OF CHEST
 Postero-anterior radiograph of chest.
 Postero-anterior bronchogram .
 Lateral radiograph of chest, after barium swallow.
 Coronary angiogram.
 MEDIASTINUM
- Definition, subdivisions, boundaries & contents of each
mediastinum.
PHARMACOLOGY: TEACHING STAFF
1.
2.
3.
4.
5.
6.
Prof. Hanan Hagar
Prof. Yieldez Basioni
Prof. Al Humayyd
Dr. Osama Yousef
Dr. Ishfaq Bukhari
Dr. Saeed Sheikh
PHARMACOLOGY’S LECTURES:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Anti cholinergic drugs
Adrenergic agonist
Drugs used in anaphylaxis
Pharmacology of drugs used in bronchial asthma
Pharmacology of drugs used in COPD
Antibiotics
Treatment of acute and chronic rhinitis and cough
Pharmacology of drugs used in tuberculosis
Treatment of respiratory tract infection
Pharmacology In Focus
 Pharmacotherapeutic profile of anticholinergic and




agrenergic drugs
Pharmacology of various classes of drugs used in the
management of Asthma and COIPD.
Drugs used in the management of anaphylaxis, cough and
rhinitis.
General concept of antibiotics and rational of the use of
antibiotics in respiratory tract infections.
Pharmacotherapy of Tubercolosis , mechasim, selection and
safety profile of Anti-TB drugs.
BIOCHEMISTRY’S TEACHING STAFF
1.
2.
3.
4.
5.
6.
Dr. Rana Hasanato
Dr. Reem Sallam
Dr. Sumbul Fatma
Dr. Amr Moustafa
Dr. Usman Ghani
Dr. Ahmed Mujamammi
BIOCHEMISTRY’S LECTURES
1. Globular proteins
2. Phospholipids of clinical significance
3. Respiratory chain
Respiratory Block
Biochemistry
2012-2013
Lec 1: Globular Proteins
Upon completion of this
lecture, students should
be able to:
 understand what are
globular proteins; their
types & functions; with
special emphasis on
hemoglobin,
myoglobin, & globulins
 be familiar with
Diseases associated
with globular proteins
Lec 2: Phospholipid (PL)
Compounds
of Physiological
Importance
In this lecture, students will
be introduced to the
following:
• Selected members of
PLs
• Physiological
importance of PLs
• Lung surfactant:
structure, function, &
clinical application.
• Types and functions of
Plospholipases
Lec 3: Respiratory
Chain
Upon completion of
this lecture, students
should be able to:
•understand how
Energy-rich molecules
are metabolized by a
series of oxidation
reactions.
•be familiar with the
process of electron
transport chain and
the relevant reactions
taking place in
mitochondria.
PHYSIOLOGY’S TEACHING STAFF
1. Dr. Aida Korish
2. Dr. Abdulrahman Al Howaikan
PHYSIOLOGY’S LECTURES
1. Functions and Organization of the Respiratory System
2. Mechanics of breathing
3. Respiratory ventilation
4. Lung Function in Health and disease
5. Gas Exchange and Gas Transfer
6. Oxygen and Carbon dioxide Transport
7. Hypoxia and cyanosis
8. Control of breathing
9. Effects of low and high gas pressure on the body
10.Effects of exercise on the respiratory system
PATHOLOGY’S TEACHING STAFF
1.
2.
3.
4.
Dr. Ammar Al Rikabi ammar_rikabi@hotmail.com
Dr. Maha Arafah marafah@hotmail.com
Dr. Marie (male practicals)
Dr. Shaesta Zaidi (female practicals) snz24@yahoo.com
Number of Lectures: 6
Number of Practicals: 2
PATHOLOGY’S LECTURES
1. Pathology of bronchial asthma
2. Pathology of restrictive lung disease including allergic
alveolitis
3. Introduction to COPD including bronchiectasis,
chronic bronchitis & emphysema.
4. Pathology of Tuberculosis
5. Pathology of Lobar pneumonia& broncho pneumonia
6. Tumours of the lung
LECTURE ONE : Pathology and pathogenesis of bronchial asthma.
OBJECTIVES:
At the end of this lecture, the student should be capable of:
A]
Understanding asthma as an episodic, reversible
bronchoconstriction caused by increased responsiveness of the
tracheobronchial tree to various stimuli.
B]
Knowing that asthma is divided into two basic types: extrinsic or
atopic allergic and intrinsic asthma.
C]
Understanding the morphological changes seen in the lungs in
cases of severe asthma.
CONTENTS:
1]
Definitions of asthma as one of the chronic obstruction airway
diseases.
2]
Types and pathogenesis of extrinsic (immune) asthma and
extrinsic (non-immune) asthma.
3]
Clinical presentation and pathological changes seen in the
bronchial tree in cases of asthma.
4]
Complications of asthma: superimposed infection, chronic
bronchitis and pulmonary emphysema.
5]
Definition and manifestations of status asthmaticus.
LECTURE TWO: : Chronic obstructive airway diseases: chronic bronchitis,
emphysema and bronchiectasis.
OBJECTIVES:
At the end of this lecture, the students should be able to:
A]
Understand that this group of disorders is characterized by an increase
in resistance to airflow, owing to partial or complete obstruction at any level of
the bronchial/bronchiolar.
B]
Know that the major obstructive disorders are chronic bronchitis,
emphysema, asthma and bronchiectasis.
C]
Is aware that the symptom common to all these disorders is "dyspnea"
(difficulty in breathing) but each have their own clinical and anatomical
characteristics.
D]
Chronic bronchitis and emphysema almost always coexists.
CONTENTS:
1]
Chronic bronchitis: definition, clinical presentation, role of cigarette
smoking and air pollution, pathological changes and complications with special
emphasis on cor pulmonale.
2]
Emphysema: definition and clinical characteristics. Types of
emphysema including centrilobular emphysema, panacinar emphysema
(deficiency of alpha one antitrypsin), paraseptal and irregular emphysema.
3]
Complications of emphysema with special emphasis on interstitial
emphysema and pneumothorax.
4]
Bronchiectasis: definition, predisposing factors, kartagener's syndrome
(primary ciliary dyskinesia) and pathological features of bronchiectasis.
LECTURE THREE: Restrictive lung diseases.
OBJECTIVES:
At the end of this lecture, the student should be able to:
A]
Understand the structure and constituents of the lung interstitium as
well as the restrictive changes which occur in these diseases and lead to the
development of symptoms of progressive breathlessness and cough in affected
patients.
B]
Appreciate the pathogenesis of interstitial lung diseases regardless of
their type. This pathogenesis include the influx of inflammatory cells into the
alveoli and alveolar walls, distortion of the normal structure of alveoli, release of
chemical mediators and promotion of fibrosis (honey-comb lung).
C]
Become aware of the classification of interstitial lung diseases.
CONTENTS:
1]
Definition and causes of restrictive pulmonary diseases.
2]
Pathogenesis of restrictive pulmonary diseases which include abnormalities in the
chest wall or neuromuscular diseases that restrict lung expansion or conditions leading to
interstitial accumulations of cells or non-cellular substances.
3]
Brief account on the clinicopathological features of:
Adult and neonatal respiratory distress syndromes.
Anthracosis and coal worker's pneumoconiosis.
Silicosis and asbestosis.
Hypersensitivity pneumonitis (extrinsic allergic alveolitis).
Goodpasture syndrome.
Eosinophilic granuloma.
Idiopathic pulmonary fibrosis.
Sarcoidosis.
LECTURE FOUR: TUBERCULOSIS
OBJECTIVES
At the end of this lecture, the student should be able to:
A] Define tuberculosis.
B] List organs that are commonly affected by tuberculosis.
C] Epidemiology of Tuberculosis.
D] Recognize the morphology of Mycobacteria.
E] Recognize different phases of tuberculosis
F] Know the basis and use of tuberculin skin (Mantoux) test.
G] List the common clinical presentations, complications and prognosis of
tuberculosis.
CONTENTS:
1] Definition and causes of Tuberculosis including its epidemiology.
2] Pathogenesis of granuloma formation and its morphology.
3] In regard to Mycobacterial lung infection: Compare and contrast the
following in relation to their gross and histologic lung pathology:
primary tuberculosis (include a definition of the Ghon complex).
secondary or reactivation tuberculosis.
miliary tuberculosis.
4] Brief account on the clinicopathological features of tuberculosis.
5] Diagnosis and the basis of tuberculin skin (Mantoux) test.
6] Brief account on the complications and prognosis of tuberculosis.
LECTURE FIVE: Pathology of lobar pneumonia and bronchopneumonia.
OBJECTIVES:
At the end of this lecture, the student should be able to:
A]
Understand that pneumonia is an inflammatory condition of the lung
characterized by consolidation (solidification) of the pulmonary tissue.
B]
Is aware of the pathogenesis of pneumonia and its classification which
principally include bronchopneumoniae, lobar pneumonia and atypical
pneumonia.
C]
Is able to appreciate the aetiology and pathogenesis of lung abscess.
CONTENTS:
1]
General considerations and clinical characteristics of pneumonia.
2]
Morphologic types of pneumonias including lobar pneumonia,
bronchopneumonia and interstitial pneumonia (atypical pneumonia) with special
emphasis on mycoplasma pneumonia, viral pneumonia and ornithosis (Chlamydia
induced).
3]
Pneumocystis carinii pneumonia as the most common opportunistic
infection in patients with AIDS.
4]
Hospital acquired gram negative pneumonias.
5]
Lung abscess: causes and manifestations.
LECTURE SIX: TUMOURS OF THE LUNG
OBJECTIVES:
At the end of this lecture, the student should be able to:
A]
Understand the incidence, age group of affected patients and predisposing
factors of bronchogenic carcinoma.
B]
Is aware of the classification of bronchogenic carcinoma which include:
squamous carcinoma, adenocarcinoma, small cell and large cell (anaplastic)
carcinomas.
C]
Understands the clinical features and gross pathology of bronchogenic
carcinoma.
D]
Have a basic knowledge about neuroendocrine tumours with special
emphasis on small cell carcinoma and bronchial carcinoid.
E]
Is aware that the lung is a frequent site for metastatic neoplasms.
CONTENTS:
1]
Bronchogenic carcinoma: aetiology, epidemiology, clinical features
including superior Vena Cava syndrome, pancoast tumour, hoarseness, pleural
effusion and paraneoplastic endocrine syndromes.
2]
Types, location and clinicopathological characteristics of squamous cell
carcinoma, adenocarcinoma, bronchioloalveolar carcinoma, small cell carcinoma,
large cell carcinoma, carcinoid tumour and metastatic carcinoma to the lung.
3]
Primary and secondary tumours of the pleura.
IMMUNOLOGY’S TEACHING STAFF
1. Dr. Hend Al-Otaibi
2. Prof. Zahid Shakoor
3. Dr. Adel Al Mogren
IMMUNOLOGY’S LECTURES
1. Immunology of bronchial asthma
2. Immunology of T.B
Immunology Unit
Immunology of bronchial asthma
Allergens in induction of allergic inflammation
Cytokines in pathogenesis of asthma
Airway remodeling in asthma
Immunology of tuberculosis
Immune handling of M. tuberculosis
Cytokines and TB
Tuberculin test
MICROBIOLOGY’S TEACHING STAFF
1.
2.
3.
4.
5.
6.
7.
8.
Prof. Hanan Habib
Dr. Fawzia Al Otaibi
Prof. Kambal
Dr. Ali Somily
Dr. Mona Badr
Dr. Al Hetheel
Dr. Maha Al Muhaizea
Dr. Ahmed Al Barrag
MICROBIOLOGY’S LECTURES
1.
2.
3.
4.
Bacteria causing upper respiratory tract infection
Community acquired pneumonia
Tuberculosis
Viral infection of respiratory tract “influenza and
adenoviruses
5. Respiratory fungal infection and aspergelosis
6. Hospital acquired pneumonia
7. MERS-Cov and other viral infections
Microbiology
Tuberculosis
Causative agents mycobacterium tuberculosis complex (MTBC)
Non tuberculosis mycobacterium (NTM)
Difference between MTBC & NTM
Morphology differences
Culture methods
Susceptibility Testing
Importance of tuberculosis as a mainly respiratory diseases
Cause of Upper Respiratory Tract Infection
Importance of sore throat by group A and its complications.
Viral causes of Respiratory Tract Infection - Influenza, Rhinoviruses
etc.
Fungal causes of Respiratory Infection.
Commonly acquired pneumonia (bacterial cause).
Hospital acquired pneumonia caused by multidrug resistant bacteria.
FAMILY MEDICINE’S TEACHING STAFF
1. Dr. Nada Al Yousefi
2. Dr. Ali AlHazmi
FAMILY MEDICINE'S LECTURE
1. Tobacco consumption, problems and solutions.
TIME:
Final MCQ: 15 February 2016
OSPE & SAQs: 18 February 2016
CONTENTS: Assessment for the subjects covered
in the ALL the weeks of the block.
GOOD LUCK FOR ALL!