Thalassemia is a blood disorder where the body cannot make normal haemoglobin needed to

produce healthy red blood cells.

This results in excessive destruction of red blood cells which leads to anaemia. Hereditary not
infection and contagious cause by genetic mutation or deletion of certain key genes.
Thalasemia major is the most severe form of anemia which if left untreated can lead to heart
failure or liver problems. Death usually results within a few years. Regular blood transfusion is
the only treatment available. Most thalassemia major patients require blood transfusion every
2-4 weeks. Those with thalassemia encounter the trouble of finding compatible blood to sustain
their lives.

DNA replication https://www.youtube.com/watch?v=TNKWgcFPHqw

Helicase unzips. Separate strand act as template. Primase makes a small piece of rna called a
primer. DNA polymerase binds to the primer and add bases from the 5’ end to 3’ end. Leading
strand. 3’ end to 5’ end can only make with okazaki fragments. Exonuclease remove all the rna
primer from both strand of DNA. Dna polymerase fill in the blank with dna bases. Ligase seals
up to form a continuous strand.

From DNA to protein https://www.youtube.com/watch?v=gG7uCskUOrA

Transcription https://www.youtube.com/watch?v=WsofH466lqk

DNA mutation https://www.youtube.com/watch?v=MOtRqBs0jxE

CFTR mutation https://www.youtube.com/watch?v=_j99-xgOIaw

Gene therapy for beta thalassemia https://www.youtube.com/watch?v=uv86NLamS6c

Gastrulation

https://nm-panopto.ncl.edu.my/Panopto/Pages/Viewer.aspx?id=c01ffe3a-d383-4437-ab34-
a7297facab3c

https://nm-panopto.ncl.edu.my/Panopto/Pages/Viewer.aspx?id=c9babd9f-0890-4d90-82f1-
f5df2db2ad95

Endoplasmic reticulum and golgi body role in protein secretion

https://www.youtube.com/watch?v=6UqtgH_Zy1Y

protein synthesis and interaction with RER

https://www.youtube.com/watch?v=XaoTtCj4r3U
Basic histological terms
http://www.bu.edu/histology/m/glossary.htm

foundation 2

CASE STUDY: JUST A VIRUS?

GP visit
Jamie Stewart was a 13 year old boy. He went to see the GP with his mother. He had begun with a cold
four days previously. He had had a runny nose, sore throat and dry cough. He was off his food, and
running a fever. The evening before the appointment he had had started to bring up some clear sputum.
His mother had been quite worried.

The GP, Dr Barker, was relieved to have a straightforward problem to solve, as it had been a trying
morning. He established that there had been no other symptoms and began his examination.

Jamie looked reasonably well, despite his cold. His throat was a bit red, and he had mild cervical
lymphadenopathy. His ears were fine. His chest sounded clear.

Dr Barker thought that Jamie had an upper respiratory tract infection that was likely to be viral rather than
bacterial. He decided it was unlikely to be glandular fever. Aware of the evidence base in this area, he
proceeded to explain to Mrs Stewart about the nature of viral infections. He explained that antibiotics
were of no use in treating viral infections. Furthermore, he explained, antibiotics sometimes caused
problems and this risk had to be weighed against their very unlikely benefit.

Mrs Stewart was far from pleased. She explained to the doctor that a similar thing had happened to her
youngest about a year previously, and he had eventually needed antibiotics because the infection had
moved onto his chest. She did not want that to happen again. Furthermore they were due to go on
holiday to France that weekend, and she didn’t want that to be spoilt for the whole family. Also, there
were plenty of occasions in the past where people she knew had taken antibiotics with no problems
whatsoever.

Dr Barker thought for a while. He could understand the mother’s concerns, even if they were probably
erroneous. Furthermore, not prescribing might make him vulnerable to criticism if Jamie subsequently
became worse, and it was possible that the infection was bacterial. He wondered about taking a sputum
sample for laboratory analysis, but then dismissed the idea.

He reasoned that, if it was bacterial, the most likely causative organisms were either Streptococcus
pneumonia or Haemophilus influenzae. He considered prescribing the new antibiotic he had seen
mentioned at a recent educational meeting he had attended, but then he remembered that the company
who make the drug sponsored the meeting. He therefore prescribed amoxicillin.

Hospital admission
At nine o’clock that evening Jamie awoke suddenly. His mother rushed into his bedroom to find him
gasping for air, and looking blue around his lips. His lips and tongue appeared swollen and he made a
strange noise as he tried to breathe. She rang for an ambulance.

On arrival in casualty the doctor quickly assessed Jamie’s pulse, blood pressure and respiration, while
taking a rapid focussed history from the mother. He diagnosed an acute allergic reaction and
administered adrenaline IM into the anterolateral aspect of his thigh, followed by IV fluids. Hydrocortisone
and chlorpheniramine were given intravenously. Jamie made a rapid recovery.

The doctor advised Jamie and his mother that he was allergic to penicillins and that he should never have
them again.

GP reflection
A few days later Dr Barker was looking through the morning mail and came across the casualty slip. His
heart sank. He immediately got the notes out to have a close look, and to his horror found a vague,
illegible reference to a previous rash coming on after a course of penicillin that Jamie had had at the age
of 3. This had not been highlighted anywhere on the front of the notes or the computer file.

He took this to a partners’ meeting the next day. Their response was sympathetic but was mainly of the
‘these things happen’ variety, which Dr Barker didn’t find very helpful.

For some weeks he expected to receive a call or a letter from the parents, complaining about what had
happened. He felt undecided about whether he should arrange to speak with the parents. However, no
contact came, although the family did remove themselves from his patient list.

After a few weeks and further reflection he decided to seek some professional counselling.

Peripheral and autonomic nervous system

https://nm-panopto.ncl.edu.my/Panopto/Pages/Viewer.aspx?id=9686e599-47a3-40dc-8673-
7ba0b743b07e

Endocrine System
https://www.youtube.com/watch?v=gjmS4_7kvDM&t=2s

Homeostasis: positive and negative feedback

https://www.youtube.com/watch?v=KkxDWeaKRow

foundation 3 (microbiology)

https://www.youtube.com/watch?v=0PUsdv1kDTc
Links:
1. Severe Dengue Fever with Haemolytic Anaemia – A Case Study
Trop. Med. Infect. Dis. 2016, 1, 6; doi:10.3390/tropicalmed1010006
http://www.mdpi.com/2414-6366/1/1/6

2. Dengue definition
https://www.cdc.gov/dengue/clinicallab/casedef.html

3. WHO Dengue Fact Sheet

http://www.who.int/mediacentre/factsheets/fs117/en/

4. Dengue Epidemiology
https://www.cdc.gov/dengue/epidemiology/index.html

5. Dengue Prevention
https://www.cdc.gov/dengue/prevention/index.html

6. Dengue Diagnosis, Management, Prevention and Control

http://apps.who.int/iris/bitstream/10665/44188/1/9789241547871_eng.pdf

7. Patient Education Materials

https://www.cdc.gov/dengue/resources/CS_205910-A.Dengue-patient-Ed-Eng.FINAL.pdf

virus
https://www.youtube.com/watch?v=7KXHwhTghWI

gram stain
https://www.youtube.com/watch?v=L9batS-vGDY&t=117s