JINNAH SINDH MEDICAL UNIVERSITY

MODULE TITLE Blood-1

INTRODUCTION Blood is the first system-based integrated module of the MBBS curriculum. It is
designed to provide students with not only knowledge about basics of Blood
but also develop their ability to apply information to solve problems. Blood-1
has a heavy emphasis on Anatomy, Physiology and Biochemistry. The
maximum load of content is from Physiology and Biochemistry. This module is
linked with Blood -2 which will be conducted during 3 rd year MBBS. At that
time the emphasis will be on the details of how blood related diseases occur,
how they can be treated and how common they are in the community.
Forensic and Toxicology related issues will also be considered at that time.
TARGET First year MBBS, March to April 2020
STUDENTS
DURATION Four weeks
OUTCOMES At the end of the module, the students should be able to apply knowledge of
structure and functions of Blood to solve common problems
DEPARTMENTS i. Anatomy
ii. Biochemistry
iii. Physiology
OBJECTIVES By the end of the module, students should be able to:
ANATOMY HISTOLOGY:
Lymphoid tissue, Immune system and Thymus
• Name the components of immune system and lymphoid tissue
• Differentiate between central lymphoid organs and peripheral
lymphoid organs
• Describe the structure of lymph nodes
• Describe the structure and histological appearance of thymus
• Discuss the clinical anatomy of lymphoid organs

Histology of Spleen and Tonsils

• Define the structure and locations of tonsils.
• Describe histological features of tonsils.
• Define the structure and locations of spleen.
• Describe the histological appearance of spleen.

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EMBRYOLOGY
Development of blood
• Define hematopoiesis.
• List the sites and source of hematopoiesis before and after birth
BIOCHEMISTRY Structure and Types of Hemoglobin
• Explain the structure and types of hemoglobin.

Oxygen Dissociation Curve

• Explain the biochemical basis of oxygen dissociation curve.

Hemoglobin abnormalities-1
• Discuss the abnormalities of Hemoglobin synthesis, Porphyrias & its
types.

Hemoglobin abnormalities-2
• Explain the biochemical aspects of Hemoglobinopathies (Thalassemia,
Sickle Cell anemia)

Iron metabolism

• Discuss Iron metabolism in the body with its abnormalities.

Vitamin B12 & Folic acid

• Explain the biochemical importance of Vitamin B12 & folic acid and
associated diseases.

Vitamins E & K
• Explain the importance of vitamin K & E with associated diseases.

Plasma Proteins

• Explain the Biochemical basis for the difference in plasma and serum
• Explain the composition of plasma and plasma proteins.

Immunoglobulins
• Define immunoglobulins
• Describe their chemistry, structure and classification.
PHYSIOLOGY Composition of blood & its cellular components.
• Enumerate the functions of the cellular components of blood.
• State the normal values of RBCs, WBCs & platelets.
• Define hematocrit, normal values & factors affecting hematocrit.

Formation and development of RBCs (erythropoiesis).

• Discuss the different stages of RBCs formation
• List factors necessary for erythropoiesis.
• Discuss the significance of Reticulocyte count

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• Discuss the role of Erythropoietin.

Classification of anemia and significance of red cell indices.

• Describe the morphological & etiological classification of
anemia
• Discuss the significance of red cell indices and their normal
values.

Megaloblastic /iron, B12 folic def. anemia .

• Discuss the etiology & microscopic picture of Megaloblastic and
iron deficiency anemia
• Differentiate between Megaloblastic & Pernicious Anemia based
on microscopic picture and red cell indices.

Hemolysis and hemolytic anemia (hereditary spherocytosis, GGPD def, sickle

cell disease)

Polycythemia.
• Define types of polycythemia
• Explain the effects of polycythemia on human body

Blood groups ABO/RH system.

• Explain the ABO(classical) and Rh system of blood grouping & their
inheritance pattern.
• Define Agglutinogen, agglutinin & agglutination.
• List various Rh antigens & Rh immune response.
• Name the transfusion reactions associated with mismatched blood
transfusion.

Hemostasis & role of Thrombocytes.

• Describe the events in Hemostasis
• Explain the mechanism of formation of platelet plug .
• Describe the role of Prothrombin in blood coagulation and clot
formation.

Clotting cascade & bleeding disorders.

• Explain intrinsic and extrinsic pathway for coagulation.
• Enumerate the clotting factors
• Describe the role of clotting factors in coagulation.

Hemorrhagic & thromboembolic conditions.

• Explain the following hemorrhagic and Thrombo-embolic conditions:
i. Hemophilia
ii. Thrombocytopenia

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iii. Disseminated Intravascular Coagulation.

• Discuss the role of commonly used anticoagulants

Fibrinolytic mechanisms.
• Explain the fibrinolytic mechanism and role of plasmin in lysis of
blood clots.
• Discuss the role of fibrin & anti-thrombin III in anticoagulation.

Genesis and general characteristics of white blood cells.

• Describe the process of leukocyte genesis
• List various types of granulocytes and agranulocytes, their functions &
normal values.

Functions of WBCs: Monocytes macrophage cell system.

• Explain the significance of Reticuloendothelial system in body
defense mechanism
• List various macrophages in different tissues of body.
• Discuss the role of passive immunity against infection.

Types and functions of lymphocytes (Immunity types)

• List the types of lymphocytes and their site of origin.
• Discuss the functions of T and B lymphocytes.
• Enumerate types of T lymphocytes & their functions.

Allergy and hypersensitivity.

• Discuss the following types of hypersensitivity and allergic reactions:
- Urticaria
- Anaphylaxis
- Hay fever
• Discuss the role of Ig E in Immunity.

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PRACTICALS ANATOMY
1. Histology of Lymph Node and Thymus
• Enumerate lymphoid organs
• Briefly describe microscopic structure of lymphoid tissue
• Describe the structure of lymph nodes
• Explain the histological features of lymph nodes
• Describe the structure of thymus
• Explain the histological features of Thymus

2. Histology of Spleen & Tonsil

• Describe the structure and locations of tonsils.
• Identify the histological features of tonsils
• Describe the location and structure of spleen.
• Identify the histological features of spleen

PHYSIOLOGY
1. Demonstrate peripheral blood smear
2. Perform tests for A,B,O, & Rh blood grouping
3. Perform tests of bleeding time and clotting time.
4. DLC
5. Determine Erythrocyte Sedimentation Rate

BIOCHEMISTRY

1. Specimen collection:
collect the blood specimen for biochemical analysis

2. Spectrophotometer:
Demonstrate the use of spectrophotometer.

3. Flame Photometer:
Demonstrate the use of Flame photometer

4. Estimation of Plasma Proteins:

Discuss the role of plasma protein in disease and normal condition and
use of electrophoresis for the detection of plasma proteins.

5. Electrophoresis:
Demonstrate the electrophoresis and its application for the detection
plasma proteins.

6. ELISA:
Demonstrate the biochemical use of ELISA and its application in the
detection of disease.

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INTERNAL • Internal assessment carries 20% weightage in the annual examination.

ASSESSMENT:
FINAL EXAM • Final, Annual exam will consist of One Correct MCQs, One Best MCQs
and OSPE (observed + un observed stations).

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SUGGESTED READINGS

DISCIPLINES RESOURCES
A. HISTOLOGY
1. B. Young J. W. Health Wheather’s Functional Histology
B. EMBRYOLOGY
ANATOMY 1. Keith L. Moore. The Developing Human
2. Langman’s Medical Embryology

1. Harper’s Illustrated Biochemistry

2. Lippincott’s Illustrated reviews of Biochemistry
BIOCHEMISTRY 3. Lehninger’s Principles of Biochemistry
4. Biochemistry by Devlin
A. TEXTBOOKS
1. Textbook of Medical Physiology by Guyton And Hall
2. Ganong’s Review of Medical Physiology
B. REFERENCE BOOKS
1. Human Physiology by Lauralee Sherwood
2. Berne & Levy Physiology
PHYSIOLOGY 3. Best & Taylor Physiological Basis of Medical Practice
4. Guyton & Hall Physiological Review
5. Essentials Of Medical Physiology by Jaypee
6. Textbook Of Medical Physiology by Indu Khurana
7. Short Textbook Of Physiology by Mrthur

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