Course Structure and Delivery-anatomic pathology

Course Structure and Delivery

 

Degree Program:             Bachelor of Medicine and Bachelor of Surgery (MBChB)

Course Component:       Courses Offered by the Anatomic Pathology Unit

Course

Scheduled Level

Law, Medicine and Ethics (HHP 200)

Level II

General Pathology (HHP 300)

Level III

Systemic Pathology (HHP 400)

Level IV

Forensic Medicine (HHP 604)

Level V

                                                                                                       

These will complement the concurrent courses offered by the Units within the Department of Human Pathology. These are the Units of Clinical Chemistry, Immunology, Haematology and Blood Transfusion. Below are the descriptions of the course:

 

Title with Number

HHP 200: Law, Medicine and Ethics  (Level II)

HHP 300: General Pathology  (Level  III)

HHP 400: Systemic Pathology (Level   IV)

HHP 604: Forensic Medicine  (Level  VI)

Course Summary

HHP 200: Law, Medicine and Ethics.  Introduction to Laws, covenants and policies governing  the practice of medicine

HHP 300: General Pathology:  An introduction to the basis/pathobiology/pathogenesis and morphology of disease processes.

HHP 400: Systemic Pathology:  This course would enable the learner to apply General pathology in entire systems.

HHP 604: Forensic Medicine:

Course Outcomes

HHP 200, Law, Medicine and Ethics:  To understand the basis for the co-functions of law and medicine in society

HHP 300 General Pathology: Recognition and the clinical correlation of common disease process.

HHP 400: Systemic Pathology The learner would develop appropriate system specific terminology of disease description as well as a basis for systemic clinical disease presentation and therapeutics.

HHP 604: Forensic Medicine. This course enables the learner to develop competencies on laws applying to medicine and, to determine and interpret causes of  injury  and processing of sudden unexpected deaths .

Lecturers

Most of the courses involve a wide range of disciplines hence integrated teaching by all academic staff from the various units within the department of human pathology. In addition the Unit has honorary lecturers from other institutions

Course Coordinator/s

 

Course HHP:

Course Time Table Coordinator: Dr E Rogena, Email: rogena_emily@uonbi.ac.ke

 

Course Coordinator: Dr E Rogena, Email: rogena_emily@uonbi.ac.ke

 

Assistant Course Coordinator: Dr E Walong, Email: edwin.walong@uonbi.ac.ke

 

Course Examination Coordinators:  Dr E Rogena, Email: rogena_emily@uonbi.ac.ke

 

Course Content

 HHP 200:            Law, Medicine and Ethics:

 

Introduction to health, medical practice: law and ethics; history of forensic medicine; laws: definition and significance of the ‘state’; national health policy; principles of medical ethics’ origins, basis, conflicts, professional fees, research on human subjects, patency rights, mutual rights and duties; doctor-patient relationship; source of laws: socio-economic, formal sources, division of laws; law and state: judiciary, court systems, judicial processes; civil court procedures: criminal court procedures; law and individual: elements of law of tort; constitution protection; law and individual: elements of criminal, elements of law of contracts; medical/dental practitioners in court: the court, court appearance bond-subpoena, to appear in court, insufficient notice, practitioner as witness and expert witness in court; medical evidence and chain of custody; consent as the basis of medical treatment informed decision-making; confidentiality: medical records and certification, information technology; important laws in medical practice; Medico-legal aspects of therapeutic substances and control of drugs; drug abuse and dependence; alcohol abuse, criminal and civil liabilities; radioactivity, irradiation: hazards, accidents and laws in occupational diseases; births, marriages and deaths registration; definition of death, organ transplantation by living and dead; Introduction: statutory provisions for an autopsy, exhumation laws and procedures, social security act; laws relating to children; mental health act.

 

HHP 300:             General Pathology:

 

 Introduction to principles of pathology; cytopathology; autopsies in clinical practice; genetic basis of disease; cell and tissue injury including drug injury; radiation; iatrogenic disease; amyloidosis; degenerative disorders, pigment disorders; jaundice, melanin, siderosis, anthracosis; acute and suppurative inflammation, chronic inflammation and granulomatous inflammation; healing and repair; pathology of HIV/AIDS; rheumatic fever; infective endocarditis; congestion, oedema, and shock; thrombosis, embolism; ischaemia, infarction, hypertension; diseases of blood vessels; disordered cell growth; environmental/occupational diseases; neoplasia: nomenclature and morphology; Tumour-like conditions: benign and malignant tumours; carcinogenesis: definition and pre-cancerous lesions; carcinogens I: genetic and environmental factors; carcinogens II: physical and chemical; carcinogens III: viruses; spread of tumours and grading of malignant tumours; clinical aspects of tumours, paraneoplastic syndromes; pathologic diagnosis of tumours; immunology of tumours; cause of death in cancer and cancer screening; epidemiology of cancers. Immunology: Introduction to Immunology and immunological concepts, functional organization of the immune system, immunoglobulin structure and function, antibody-antigen interactions, MHC molecules, antigen processing and presentation, immunocompetent cells’ ontogenesis.  Introduction to immune effector mechanisms: cytokine actions and interactions as regulators of the immune responses, cellular collaboration, complement systems, cell mediated effector responses, hypersensitivity reactions.  Immune responses in health and diseases: immune responses to viral, bacterial and protozoa diseases, immunoregulation and immunotherapeutics, immunodeficiency diseases, autoimmunity, transplantation immunology, cancer and the immune system, immunodiagnostics.

HHP 400 Systemic Pathology: 

 

Cardiovascular pathology:  Diseases of blood vessels, hypertensive heart disease, ischaemic heart disease, infective diseases of the heart, rheumatic heart disease, congenital heart diseases, cardiomyopathies.  GIT pathology:  oesophageal diseases, GERD, Esophagitis, Congenital abnormalities and tumours, Gastritis, peptic ulcers disease, tumours of stomach, other gastric lesions, inflammatory bowel disease including TB and Schistosomiasis, Ischaemic bowel disease, Typhoid, Amoebiasis, Appendicitis, malabsorption, Crohn’s disease, ulcerative colitis, Tumours of small and large bowel including appendix.  Liver pathology:  Viral, Bacterial, Parasitic and Fungal infections, Fibrosis, Cirrhosis, Alcoholic liver disease, Neoplasia, Disease of gall bladder, Cholecystitis, Cholelithiasis, Tumours. Diseases of pancreas. Pancreatitis, pancreatic cysts, Tumours. Respiratory pathology:  Pneumonias, Bronchiectasis, Pulmonary Tuberculosis, Chronic obstructive airway disease, Lung abscess Asthma, Tumours of lung and pleura.  Renal pathology:  Gromerulonephritides, Pyelonephritis, Obstructive uropathy, Inflammatory diseases of bladder, Bladder neoplasm, disease of male genital tract including testes, prostate and para-testicular tissues. CNS pathology:  CNS infections, Cerebrovascular disease, CNS tumours`, Peripheral nerve tumours.  Dermatopathology:  Inflammatory skin diseases, Precancerous skin lesions, Tumours of skin including Kaposi’s Sarcoma.  Pathology of breast:  Inflammatory, proliferative and neoplastic process.  Diseases of the female genital tract:  Diseased of vulva, vagina, Diseases of the uterus including cervix, Diseases of the ovaries and fallopian tubes, Tumours of the endocrine glands including pituitary, Thyroid, Adrenal glands and others.  Lymph node pathology:  Lymphadenitis, Lymphomas.  Pathology of bone and cartilage:  Infectious and non-neoplastic diseases of joints, Tumours of bone and cartilage.  Soft tissue tumours and tumour-like conditions: Diseases of muscles including neoplasm.  Pathology of HIV/AIDS:  Perinatal and paediatric pathology, pathology of special organs; diseases of ENT, diseases of the eye.

 

HHP 615: Forensic Medicine

                                                                               

History of Forensic Medicine: Medical and dental board laws related to medical and dental practice. Medical Ethics: Malpractice and criminal acts in the practice of medicine and dentistry. Signs of death and changes after death. Medico-legal autopsy: Autopsy reports and death certification. Medical investigation of course of death. Violent, sudden, unexpected and unexplained deaths in infants, children and adults. Infanticide and cot deaths. Battered child syndrome. Therapeutic and criminal abortion and causes of death. Identification of the living and dead by blood, serology, DNA, trace evidence, odontological and skeletal structures. Firearms:  Firearm identification and ballistics. Medico legal aspects of wounds homicide, traumatic, heat, cold, electricity and firearms. Strangulation and drowning. Hypoxic, anaemic and histotocicanoxia. Surgical operational complications. Transfusion of blood, liquids and thrombo-embolism. Anaesthetic deaths. Role of clinical chemistry in forensic medicine. Medico-legal aspects of alcoholism. Relation with road traffic accidents and crime. Pharmacy and poisons act. Drug abuse, medico-legal aspects of food poisoning. Toxicology. Forensic psychiatry|: rape and other sexual offences. Liability o of hospitals, nursing homes and health workers. Law in relation to industrial personal injuries. Homicide and accidents. Procedures and protocols for exhumations, trace evidence: collection, presentation and admissibility in court. Disaster victim identification (DVI) procedures and protocols; patients’ rights, origins an underpinnings, the health care providers role; transportation injury, death due to self-inflicted injuries.

Formal Lectures

HHP 200: Law, Medicine and Ethics: This will be spread over the year and given by assigned lecturers. The lectures will be delivered on

HHP 300: General Pathology This will be spread over the year and given by assigned lecturers. The lectures will be delivered on

HHP 400: Systemic Pathology This will be spread over the year and given by assigned lecturers. The lectures will be delivered on

HHP 604: Forensic Medicine This will be spread over the year and given by assigned lecturers. The lectures will be delivered on

Clerkship Sessions and Tutorials

HHP 200: Law, Medicine and Ethics  Tutorials will be offered as didactic sessions

HHP 300: General Pathology  Tutorials will be offered as didactic sessions

HHP 400: Systemic Pathology Gross and Microscopic Demonstration of Systemic Pathology on Tuesdays 3pm. 10 day Clerkship consisting of Histopathology and Cytopathology Laboratory Rotations, Cytopathology Clinic, Autopsy sessions involving Prosection and evaluation of gross and microscopic findings.

HHP 604: Forensic Medicine  Tutorials will be offered as didactic sessions

Study Material Including Information to enable Accessibility

HHP 200: Law, Medicine and Ethics. Suggested reading material:  Ethics in Medicine, The Constitution of Kenya, Laws of Kenya, and The Belmont Declaration.

Recommended Reading Style: Continuous and avoid last minute cramming of material, The learner is encouraged to read ahead of the stated classes.

HHP 300: General Pathology.  Suggested reading material: Kumar, Contran and Robbins Pathologic Basis of Disease, Pathology Outlines by Robin Reid, Muir’s Textbook of Pathology

Recommended Reading Style: Continuous and avoid last minute cramming of material, The learner is encouraged to read ahead of the stated classes

HHP 400: Systemic Pathology Suggested reading material: Kumar, Contran and Robbins Pathologic Basis of Disease, Pathology Outlines by Robin Reid, Muir’s Textbook of Pathology

Recommended Reading Style: Continuous and avoid last minute cramming of material, The learner is encouraged to read ahead of the stated classes

HHP 604: Forensic Medicine  Simpson’s Forensic Medicine,

Recommended Reading Style: Continuous and avoid last minute cramming of material, The learner is encouraged to read ahead of the stated classes

Learning Opportunities (including where students can get the materials)

HHP 200: Law, Medicine and Ethics Lectures, Tutorials, Library.

HHP 300: General Pathology Lectures, Tutorials, Library.

HHP 400: Systemic Pathology Lectures, Tutorials, Clerkship in Laboratories, Autopsy, Museum of Potted Gross Specimens, Library.

HHP 604: Forensic Medicine Lectures, Tutorials, Library.

Assessment Methods including rotations and end of year

HHP 200: Law, Medicine and Ethics 

1x3 hour written (MCQ)

1x3 hour written paper (Essay)

HHP 300: General Pathology  

1x3 hour written (MCQ)

1x3 hour written paper (Essay)

HHP 400: Systemic Pathology

1 x 3 hrs. written paper ( essay)

1 x 3 hours written (MCQ)

1 x 2 hours spot/practical paper

1 x 0.25 hours Orals

HHP 604: Forensic Medicine 

1 x 3 hours written (MCQ)

Calculation of CAT

HHP 200, HHP 300, HHP 400, HHP 604

 

Continuous assessment tests which consist of MCQs, Essays and the Log Book all constitute 30% of the overall examination which will be offered at the end of Level III/IV.

 

HHP 200

 

Continuous assessment tests consists of an MCQ which will constitute part of the Internal Medicine Continuous Assessment Test

Calculation of final mark for the course/unit

HHP 200, HHP 300, HHP 400, HHP 604

 

Final exit examinations will be offered at the end of Level III/ IV constitute 70% of the overall assessment.

 

HHP 200

 

The final assessment will constitute part of the Internal Medicine examination which is offered in Level VI.

Examination

HHP 200, HHP 300, HHP 400, HHP 604, HHP 200.

 

In order to sit the examinations, the student must have attended at least two thirds of lectures and all practical rotations offered.  The attendance rate will be calculated for each student and issued after every quarter/semester to enable students to follow their progress.

University of Nairobi regulations related to examinations will apply

Lectures

HHP 200: 2012/2013- Venue: Teaching Laboratory III; Day: Tuesdays; Time: 9.00-11.00am

 

HHP 200: Law, Medicine and : Group A : Venue: School of Dental sciences

Group B: Venue:  Lecture Theater 1,  School of Medicine

Day: Mondays

Time:  8.00-9.00am

HHP 300: General Pathology This will be offered weekly on Wednesday 3pm to 5 pm at the Teaching Laboratory III located at the school of medicine. Lecture schedule as are available at the Department of Human Pathology

HHP 400: Systemic Pathology This will be offered weekly on Tuesday 2pm to 5pm at the Teaching Laboratory III located at the School of Medicine.

HHP 604: Forensic Medicine  (Level VI Human Pathology)

Clinical – Pathological Conferences (CLERKSHIP ROTATION)

The learner is expected to attend the  Kenyatta National Hospital Tumour Board (Wednesday 7am – 8am) and The Neuro-Pathology Clinical-Pathology Conference (Friday 7.30 am – 8.30 am)

External Examiner- 2013-2016

External Examiners for the MBChB programme- General and Systemic  Pathology and LME courses  is Dr Lynnete Tumwine, Head of Department of Anatomic Pathology, Makerere University