SYLLABUS – EUROPEAN GROUP

Labs 60 h, lectures 35 h

All labs and lectures are conducted by prof. Kinga Borowicz

FALL SEMESTER: labs 30 h, lectures 15 h

Lab. 1 (4-8.10.2010)
Introduction to endocrinology. Chemical structure and synthesis of hormones, hormones
secretion, transport and clearance from the blood. Mechanism of actions of hormones.

Lecture 1
Hypothalamus and pituitary. Pituitary hormones and their control by the hypothalamus.
Pituitary adenomas and hyperpituitarism: prolactinomas, growth hormone adenomas,
corticotroph cell adenomas. Hypopituitarism. Posterior pituitary syndromes. Pineal gland.

Lab. 2 (11-15.10.2010)
Thyroid gland. Thyroid hormones: synthesis and secretion, physiologic functions, regulation
of thyroid hormone secretion. Hyperthyroidism.

Lecture 2
Hypothyroidism. Thyroiditis: Hashimoto thyroiditis. Graves disease. Diffuse and
multinodular goiter.

Lab. 3 (18-22.10.2010)
Parathyroid glands. Calcium – phosphate balance. Calcium and phosphate metabolism.
Parathyroid hormone. Vitamin D. Calcitonin. Hyperparathyroidism – primary and secondary.
Hypoparathyroidism. Pseudohypoparathyroidism.

Lecture 3
Diabetes. Insulin and its metabolic effect. Glucagon and its function. Blood glucose
regulation. Diabetes mellitus: pathogenesis of type I and II diabetes.

Lab. 4 (25-29.10.2010)
Acute and chronic complications of diabetes. Pancreatis endocrine neoplasms: Insulinoma,
Zollinger-Ellison syndrome

Lecture 4
Adrenal glands Synthesis and secretion of adrenocortical hormones: aldosterone,
glucocorticoids, adrenal androgens. Adrenocortical hyperfunction: Cushing syndrome,
primary hyperaldosteronism (Conn’s disease), adrenogenitalsyndromes. Adrenal
insufficiency: acute adrenal insufficiency, primary chronic adrenal insufficiency, secondary
adrenal insufficiency. Adrenal medulla, multiple endocrine neoplasia, type I and II.
Pheochromocytoma. Tumors of extra-adrenal paraganglia. Neuroblastoma. MEN, type 1 and
type 2.

Lab. 5 (1-5.11.2010)
Pathology of ovaries. Reproductive and hormonal functions of female.
Female hormonal system. Monthly ovarian cycle, functions of the gonadotrophic hormones
and ovarian hormones. Feedback oscillation of the hypothalamic-pituitary-ovarian system.
Puberty and menarche. Menopause. Abnormalities of secretion by the ovaries. Non-
neoplastic and functional cysts: follicular and lutel cysts, pCOS, stromal hyperthecosis.
Hirsutismus.

Lecture 5
Pathology of testes. Testosteron and other male sex hormones – secretion, metabolism,
function and basic intracellular mechanism of action. Abnormalities of male sexual functions
– hypogonadism in the male, abnormalities of prostate gland.

Lab. 6 (8-12.11.2010)
Partial exam - endocrinology

Lecture 6
Pathophysiology of migraine. Huntington’s disease.

Lab 7. (15-19.11.2010)
Inflammation - part 1. General features of inflammation. Stimuli for inflammation. Vascular
changes. Leukocyte extravasation. Chemotaxis. Phagocytosis.

Lecture 7.
Central nervous system: epilepsy. Parkinson’s disease. Alzheimer’s disease.

Lab. 8. (22-26.11.2010)
Inflammation - part 2. Mediators of inflammation (vasoactive amines, arachidonic acid
metabolites, platelet-activating factor, reactive oxygen species and their scavengers,
lysosomal constituents of leucocytes, plasma proteins: complement system, kinin system,
clotting system, acute phase proteins)

Lecture 8.
Inflammation -part 3. Systemic effects of inflammation. Outcomes of acute inflammation.
Causes and morphologic features of chronic inflammation. Consequences of defective or
excessive inflammation. Repair responses after injury and inflammation.

Lab 9. (29.11.-3.12. 2010)

Antibody-mediated (type II) hypersensitivity. Antibody-dependent cellular cytotoxity.
Immune complex- mediated (type III) hypersensitivity. Arthus reaction and acute serum
sickness. Cell-mediated (type IV) hypersensitivity. T cell-mediated cytotoxity.

Lab 10. (6-10.12.2010)

Innate and adaptive immunity. Allergy. Cells and tissues of immune system. Structure and
function of MHC. Classification of allergy. Pathophysiology of allergic reactions. Mediators
of allergic reactions. Immediate (type I) hypersensitivity -anaphylaxis, atopic diseases.
Lab 11. (13-17.12.2010)
Connective tissue disease. Systemic Lupus Erythematosus. Sjögren Syndrome, Systemic
Sclerosis. Immunologic deficiency syndromes. Primary immunodeficencies. AIDS.
Amyloidosis.

Lab. 12. (3-7.01.2011)

Autoimmune diseases. Immunologic tolerance, mechanism of autoimmune diseases.
Rheumatoid Arthritis. Inflammatory Myopathies.

Lab 13. (10-14.01.2011)

Partial exam – inflammation and immunology

Lab 14. (17-21.01.2011)

Regulation of body temperature. The major mechanism of heat exchange between the skin
and environment. The thermoregulatory system. Pathophysiology of fever. Phases of fever.
Heat balance. Apoptosis. Neoplasm. Oncogenesis

Lab. 15. (24-28.01.2011)

Red and white cell disorders. Anemias. Polycythemia. Leukopenia. Splenomegaly.
SPRING SEMESTER
Labs: 30h, lectures 20h

Lab 1. (14-18.02.2011)
Bleeding disorders. Disseminated intravascular coagulation (DIC).

Lecture 1.
 Biological functions of body fluids and normal water balance.
 Distribution of water - fluid compartments.
 Composition of body fluids and transport of water and solutes between fluid
compartments.
 Regulation of water electrolyte balance
 Dehydration and hyperhydration– etiology, classification, signs and symptoms.
 Mechanisms of edema formation.
 Physiology of potassium balance. Hypokalemia and hyperkalemia – etiology, signs
and symptoms.

Lab 2. Renal pathophysiology (21-25.02.2011)

 Acute renal failure.

 Inherited and acquired abnormalities of tubular transport.
 Chronic renal failure.
 Disorders of calcium-phosphate metabolism and metabolic diseases of bones
associated with renal pathology.

Lecture 2.

 Definition, classification and diagnosis of hypertension.

 Regulation of blood pressure.
 Pathogenesis of hypertension – role of peripheral resistance and pressure natriuresis.
 Etiology of essential hypertension: role of RAA, SNS, oxidative stress, salt intake.
 Hypertension associated with the metabolic syndrome.
 Renovascular hypertension.
 Primary hyperaldosteronism.

Lab.3. Partial exam – hematology, thermoregulation, water-electrolyte balance

(28.02-4.03.2011)

Lecture 3. Arterial hypertension – part 2

 Monogenic forms of hypertension: Liddle syndrome, apparent mineralocorticoid
excess, glucocorticoid-remediable aldosteronism, congenital adrenal hyperplasia,
hypertension exacerbated by pregnancy, Gordon syndrome.
 Obstructive sleep apnea.
  Hormonal causes of hypertension: pheochromocytoma, Cushing syndrome, thyroid
diseases, hyperparathyroidism, acromegaly.
 Hypertension associated with aortic coarctation.
 Neurogenic hypertension.
 Preeclampsia.
 Secondary hypertension induced by drugs.
 Complications of hypertension.

Lab 4. Physiology and disorders of plasma lipoproteins – part I. (7-11.03.2011)

 Classification of lipoprotein fractions and their physiological role.
 Digestion and absorption of alimentary lipids.
 Metabolism of chylomicrons.
 Synthesis and metabolism of VLDL and LDL.
 Synthesis and metabolism of HDL.
 Divergent roles of HDL.
 Cholesterol balance.
 Classification of dyslipidemias.
 Friedewald’s formula.
 Consequences of hyperlipidemia.
 Normal values of plasma lipid profile.
 Monogenic familial hypercholesterolemia.

Lecture 4. Physiology and disorders of plasma lipoproteins – part II

 Hypercholesterolemia associated with defective apo-B100.
 Autosomal recessive hypercholesterolemia.
 Autosomal dominant hypercholesterolemia.
 Familial polygenic hypercholesterolemia.
 Sitosterolemia.
 Cerebrotendinous xanthomatosis.
 Familial hypertriglyceridemia.
 Lipoprotein lipase deficiency.
 Familial apo C-II deficiency.

Lab 5. Physiology and disorders of plasma lipoproteins – part III (14-18.03.2011)

 Familial type III hyperlipidemia.
 Familial combined hyperlipidemia.
 Secondary hyperlipoproteinemia.
 Hyperlipoproteinemia associated with the metabolic syndrome.
 Abetalipoproteinemia.
 Hypobetalipoproteinemia.
 Hypolipoproteinemia associated with PCSK9 deficiency.
 Secondary hypolipoproteinemia.
 Primary HDL deficiency: apo A-I deficiency, Tangier disease, LCAT deficiency,
familial hypoalphalipoproteinemia.
 Secondary HDL deficiency.
 Hyperaphalipoproteinemia.
Atherosclerosis
 Definition.
 Evolution of lesions.
 Pathogenesis.
 Risk factors.
 Consequences of atherosclerosis.

Lecture 5. Heart failure

 Physiology of myocardial contraction and relaxation
 Factors affecting cardiac performance
 Causes of circulatory failure and heart failure
 Systolic and diastolic dysfunction
 Pathogenesis of systolic dysfunction of the left ventricle
 Compensatory mechanisms in heart failure
 Hypertrophy and remodeling of myocardium – molecular mechanisms and
consequences
 Symptoms and signs of heart failure

Lab 6. Ischemic heart disease (21-25.03.2011)

 Factors affecting myocardial oxygen supply
 Anatomy and physiology of coronary circulation
 Etiology of IHD
 Nonatherosclerotic causes of ischemic heart disease
 Degrees of myocardial ischemia
 Classification of IHD
 Consequences of myocardial ischemia
 Stable angina
 Unstable angina and acute coronary syndromes
 Myocardial infarction: mechanisms, classification, factors affecting area and time-
course of necrosis
 Symptoms and signs of MI
 Localization of MI in correlation with changes in specific ECG leads and site of
occlusion
 Biochemical markers of myocardial necrosis
 Reperfusion injury
 Complications of MI
 Myocardial hibernation and stunning
 Ischemic preconditioning

Lecture 6. Cardiac arrhythmias

 Structure of cardiac conductive system
 Action potential of myocardial cells
 Features of conductive cells: automaticity, conductivity, refractoriness
 Factors affecting rate of discharge and velocity of conduction
 Mechanisms of arrhythmias
 Classification of ectopic rhythms: escape rhythm, accelerated rhythm, ectopic
tachycardia
  Classification of arrhythmias
 Normal cardiac rhythm
 Abnormalities of the sinus rhythm: sinus tachycardia, sinus bradycardia, sinus
arrhythmia, sinus pause, sinoatrial exit block, sick sinus syndrome
 Supraventricular tachyarrhythmias: premature supraventricular complexes, atrial
fibrillation and flutter, paroxysmal supraventricular tachycardia, accelerated AV
junctional rhythm, AV junctional escape rhythm
 Ventricular tachyarrhythmias: premature ventricular complexes, ventricular
tachycardia, ventricular fibrillation and flutter, accelerated ventricular rhythm,
ventricular escape rhythm
 Atrioventricular blocks
 Preexcitation syndromes

Lab 7. Partial exam – cardiology (28.03.-01.04.2011)

Lecture 7. Gastrointestinal pathophysiology

 Normal gastric physiology – control of gastric secretion
 Pathogenesis of peptic ulcer disease
 Acute stress - induced and drug - induced ulcers
Studies of pancreatic structure and function
 Zollinger- Ellison syndrome
 Acute pancreatitis
a/ definitions
b/ etiology and pathogenesis
 Pathophysiology of chronic pancreatitis
Malabsorption. Diarrhea
 Disorders associated with malabsorption
 Clinical tests of digestion and absorption
 Definition
 Classification and pathophysiology of diarrhea
 Evaluation of acute and chronic diarrhea
 Etiology and pathogenesis of ulcerative colitis and Crohn’s disease

Lab. 8. Disorders of the esophagus. Liver and biliary tract (4-8.04.2011)

 Gastroesophageal reflux disease
A. Mechanisms preventing reflux
B. Etiology and pathogenesis
 Motility disorders of the oropharynx and esophagus
 Complications of Cholelithiasis
 Other Disorders of the Biliary Tree
 Major function of the liver
 Bilirubin metabolism and jaundice
 Pathophysiologic mechanisms in jaundice states
- excess bilirubin production
- impaired uptake of bilirubin
- impaired conjugation of bilirubin
- impaired conjugation of bilirubin
 Laboratory tests for bilirubin

Lecture 8. Cirrhosis of the liver

 Etiology and pathogenesis
 Clinical and laboratory features of cirrhosis
 Major complication of cirrhosis
a/ portal hypertension
b/ liver failure
c/ ascites
d/ the hepatorenal syndrome
e/ hepatic encephalopathy
f/ hepatocellular carcinoma

Lab. 9. Partial exam - gastrointestinal tract (11-15.04.2011)

Lecture 9.
Physiology and pathology of sleep

Lab. 10. Acid-Base Disorders (18-28.04.2011)

General principles
Renal hydrogen ion excretion
Primary acid-base disorders
 Metabolic acidosis and alkalosis
 Respiratory acidosis and alkalosis
Mixed acid-base disorders
Assessment of acid-base homeostasis
 Pathogenesis
 General clinical features
 Biological diagnosis and management

Lab 11. Pathology of respiratory system (2-6.05.2011)

Normal respiratory and nonrespiratory functions of the lung

Control of respiration
 The respiratory centers
 Respiratory sensors
 Effectors of the respiratory system
Physiologic methods: pulmonary function tests
 Spirometry
 Flow volume loops
 Assessing the efficiency of pulmonary gas exchange
Lab 12. Obstructive patterns of respiratory diseases (9-13.05.2011)

 Pathophysiology of airways obstruction

 Chronic obstructive pulmonary diseases (COPD)
A. Asthma
B. Chronic bronchitis and emphysema
The sleep apnea syndrome

Lab 13. Disorders of the Pleural Space, Mediastinum and Chest Wall (16-20.05.2011)

Blood gases and oxygen delivery

Acute respiratory failure
A. Pathogenesis and etiology
- Shunt
- Ventilation-perfusion mismatch
- Altered diffusion capacity
B. Evaluation of patients
C. Treatment of acute respiratory failure
The Adult Respiratory Distress Syndrome (ARDS)

 Pleural effusions
 Pneumothorax
 Mediastinal diseases
 Chest wall diseases

Lab. 14. Pulmonary hypertension (23-27.05.2011)

 Physiologic effect of pulmonary hypertension

 Pulmonary embolism
 Primary pulmonary hypertension
 Pulmonary edema

Lab. 15. Partial exam – respiratory system (30.05.-3.06.2011)

Lecture 10 FINAL EXAM – 7.06.2011