اساسيات الصحة والمرض

Principles of Health & Diseases
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A Message from the Dean
It is my pleasure to welcome you once again, now being for the second module of the first
semester. As you have seen that the first module has been quite interesting and it has led to
a good foundation for your further Medical education. The second module basically deals
with Principles of Health and Disease.
Faculty members are continually striving to update and improve the curriculum and
teaching methodologies, along with assessment tools. Like in the previous module the
curriculum involves classroom didactics; problem based small group learning sessions,
interactive classroom technology, small group tutorials, and structured self-study modules.
Our purpose is to make learning not only timely, effective and efficient, but also enjoyable.
Your interest, involvement and feedback would reflect on our processes and successes in
medical education, and will help us in our continuing effort for improving the system.
I hope that this module too would be interesting and would lay a solid foundation for
further medical education and future goals in medicine.
Dr. Mohammed O. Al-Rukban
Dean of the College of Medicine
Majmaah University


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Dear student..............
We are delighted to welcome you in your
second exciting and important module
"Principles of Health & Diseases" that will
inform and update you about the concepts of
health & disease and how the human body
and its systems are affected.
We have a big list of interesting and
involving teaching and learning materials &
methods to complement the highly relevant
line up of content topics that will be
introduced to you during this module.
Best wishes from
Your module committee
members


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Table of Contents

Contents
Page Number
A Message from the Dean 2
A Message from the Members of the Module Committee 3
Table of Contents 4
General Module Information 5
Module Description 6
General Module Objectives 6
List of Teaching & Learning Contents 7
Detailed Objectives of the Learning Contents 10
Problem-based Learning (PBL) 22
Field Visits 23
Seminars 24
Case- Discussion 26
Practical Sessions Objectives 30
Weekly Time Table 31
Distribution of tasks for Faculty 40
Teaching & Learning Methods in Details 41
Assessment 45
Evaluation & Quality Assurance Process 46
Resource Material 47
Tutors Emails 48

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General Module Information

Module Title : Principles of Health & Disease

Module Code & Number : PATH 110

Credit Hour : 6 hours

Module Duration : 8 Weeks

Module Starting Dates :4
th
Dhul-Hijjah, 1432 H (30
th
October, 2011G)

Module Coordinator : Dr. Mohammed Alimullah Fawaz

Module Committee Members
Prof. Mazin Al-Qato
Dr. Fahim Haider Jafari
Dr. Sherif Aly Saleh
Dr. Mohammed Ashraf

Module Tutors

Prof. Mazen Al-Qato
Dr. Fahim Haider Jafari
Dr. Qazi Imtiaz Rasool
Dr. Mohammed Alimullah Fawaz
Dr. Sherif Aly Saleh
Dr. Mohammed Ashraf
Dr. Mohammed Rehan Asad
Dr. Mohammed Elenazy
Dr. Raed Alzahrani


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Module Description
The course focuses on the principle of health and diseases. It starts with an orientation
to the concepts of health and disease with an emphasis that these two entities are a
continuum rather than distinct entities. It also illustrates role of prevention and concept
of bio-psychosocial model of illness and disease.
The course is divided into four main themes:
1. Concepts of health and diseases
2. Mechanism of disease
3. Human and microorganism
4. Bodys Immune Response.

General Module Objectives
By the end of this course, students are expected to:
Recognize the current concepts of health and disease.
Recognize the basic mechanisms of disease.
Identify how the structural alterations of disease correlate with the clinical
manifestations of disease and with the psychosocial effects of disease.
Recognize the natural body defense mechanism.
Identify how to gather clinical and laboratory data to make clinical decisions
regarding diagnosis and treatment.
Evaluate clinical decision making in the framework of the multi-disciplinary team
and to know the roles of other members of the healthcare team.
Explain the concepts behind the optimum use of laboratory testing in health and
disease.
Analyze the preventive system, how disease may be prevented and how programs of
prevention can be implemented in a way that can have maximal benefit.
Describe the Saudi Health system


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List of Teaching & Learning Contents
Theme 1: Concepts of Health & Diseases (week 1 & 2)
1. Concepts of health and disease
2. Social determinants of health
3. Common health problems in Saudi Arabia
4. Health system in Saudi Arabia
5. National & International Health Organizations
6. Health beliefs of individuals
7. Utilization and barriers to health care
8. Bio-psychosocial approach to health and disease
9. Overview of epidemiology
10. Introduction to health education and health promotion

Theme 2: Mechanisms of Diseases (Weeks 3 & 4)
1. Overview of mechanism of diseases
2. Genetic basis of disease(and inborn errors of metabolism)
3. Cell injury and cell response
4. Cell adaptation
5. Cell-growth
6. Environmental factors that cause cell injury(heat, dehydration, chemical injury)
7. Pathology of Tumors
8. Effects of cancer on host
9. Cancer: definition, classification, and overview
10. Oncogenes
11. Mechanism of cancer: Genetic
12. Mechanism of cancer: Environmental
13. Mechanisms of cancer: Microorganisms
14. Medical Errors and patient safety

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Theme 3: Human and Microorganism (Weeks 5 & 6)
1. Introduction to microorganisms
2. Classification and structures of bacteria
3. Growth and replication of bacteria
4. Normal microbial Flora of human body.
5. How microorganisms cause diseases (virulence)
6. Survival and spread of bacteria
7. Combating the bacteria (e.g., sterilization, prophylaxis and curative)
8. Overview of antibacterials (major classes of antibacterials and their
mechanism)
9. Mechanism of antibacterial resistance
10. Structure and classification of viruses
11. Overview of anti-viral (major classes and mechanism)
12. Major Fungi
13. Major parasites
14. Nosocomial infection
15. Detection of pathogens (diagnostic bacteriology and virology)
16. Bio-Medical waste management

Theme 4: Bodys Immune Response (Weeks 7 & 8)
1. Innate versus adaptive Immunity
2. Immune organs
3. Antigens and antibody
4. Antigen-antibody Interactions
5. Complement
6. Antigen Processing and presentation / T-cell Function
7. Acute inflammation
8. Chronic inflammation
9. Healing and repair
10. Autoimmunity
11. Body response to microorganisms

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12. Vaccination
13. Immunodeficiency
14. Hypersensitivity
15. Foetal maternal immunological barrier, interactions
16. Immunity in vulnerable age-groups (neonates & elderly)
17. Transplantation Immunology
-----------------------------------------------------------------------------------------


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Details of Objectives of the Learning
Contents
Theme 1: Concepts of Health & Disease
1. Concepts of health and disease:

Define health, dimensions of health, holistic concepts of health
including determinants of health.
Define disease, illness, and related concept
Recognize that health and disease states are not dichotomous they
exist in a continuum
Describe multi-factorial etiologies of diseases including biomedical
and social, environmental factors
Explain the natural history common disease and application of
principles of interventions and prevention
Determine the health profile in Saudi Arabia

2. Social determinants of health:

Discuss the social determinants of health
Identify modifiable and non-modifiable factors in social determinants
Explain how social determinants of health can be modified to improve
the health of the individual and community
Describe the action on the social determinants of health to improve
overall population health, improve the distribution of health,

3. Common health problems in Saudi Arabia:

Define the common communicable and non communicable diseases in
Saudi Arabia
Predict the future trends of common health problems with special
reference to life-style related diseases in Saudi Arabia.
Explain how the burden of diseases in Saudi Arabia affects the health
care delivery in Saudi Arabia.

4. Health system in Saudi Arabia:

Explain the Primary Health Care and Comprehensive Health Care in
the country
Discuss the health care delivery system in the country and
infrastructure at peripheral, primary, secondary and tertiary care level
Describe the roles of different components of health systems in Saudi
Arabia

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5. National and international health organizations:

Describe the national and international health organizations and their
programmes
Cite examples of specific roles of national and international health
organization in the country
Recognize the relationship of different organizations and how they
interact together to improve countrys health

6. Health beliefs of an individual:

Explain the concept of health belief model, individual perception and
its modifying factors
Describe how the health beliefs of an individual can affect the
management of health and disease
Describe how the health beliefs of an individual can be changed to
improve health

7. Utilizations and barriers to health care:

Explain the concept of universal health coverage for the entire
population
Explain the reasons for delaying care, perceptions and experiences of
services, and health-care expenditure.
Explain the factors (such as socio-economic status, health beliefs,
perceptions) that can be modified to improve health.

8. Bio-psychosocial approach to health and diseases:

Explain the concept of holistic or bio-psychosocial model of health
care
Recognize the importance of basic needs such as nutrition, sleep,
exercise, social, emotional, education, community life, and equal
opportunity in maintenance of health
Explain how biological, psychological and social factors can be
integrated in the assessment, prevention and treatment of diseases.

9. Overview of epidemiology, prevention and control:

Define epidemiology, prevention and control
Define the terms used in describing disease transmission and control.
Cite examples of the basic epidemiological tools to make a community
diagnosis of the diseases
Briefly describe the common modes of transmission of communicable
diseases
Briefly describe the principles of prevention and control of communicable
and non-communicable disease

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10. Introduction to health education and health promotion

Describe the concepts of health education and health promotion
Recognize the importance of health education and health promotion in
holistic management of health and disease
Integrate features of health education and health promotion in daily
patient management
Develop a model of health education and health promotion in the local
community


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Theme 2: Mechanisms of Disease

1. Overview of mechanism of disease:

Explain the etiology of disease
Discuss the various mechanism of the disease
Cite illustrative examples from each major category of mechanisms of
diseases

2. Genetic basis of disease:

Discuss the role of genetics in causing of disease
Describe common modes of genetic disorders such as single gene
defect, polygenic inheritance
Describe how gene-gene interaction, gene-environment interactions,
and complex traits and diseases predispose and modify common
diseases
Define inborn errors of metabolism
Describe the common characteristic features of inborn errors of
metabolism
Correlate the pathophysiological basis of prototypical and common
inborn errors of metabolism with biochemical abnormalities

3. Cell injury and response:

Describe cell injury
Cite examples of common types of cell injuries
Describe the pathology of injury

4. Cell adaptation:

Define and classify adaptation
Discuss the basic mechanism
Explain the clinical significance of cell adaptation

5. Cell Growth:

Discuss cellular and molecular events in growth of cell
Identify growth promoting and inhibiting factors

6. Environmental factors causing cell injury:

Describe the common environmental factors causing cell injury
Discuss their underlying mechanisms


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7. Pathology of tumors;

Define and classify neoplasms
Identify the methods of cell differentiation
Discuss local spread and metastasis

8. Cancer:

Define cancer
Identify the features of cancers
Discuss the etiology and epidemiology of cancer including top five
commonest cancers in male and female in Saudi Arabia

9. Oncogenes:

Discuss the concept of oncogenes and their role in cancer biology
Explain the role of cancer suppressor genes in the prevention of
cancer

10. Mechanism of cancerGenetic:
Describe the role of genetics in the etiology of cancers
Cite examples of prototypical genetic cancer including mechanism of
cancer in these vulnerable groups

11. Mechanism of cancer Environmental:

Discuss the common environmental factors in causing cancer
List common carcinogens with special emphasis of smoking
Explain how smoking causes cancer
Discuss the mechanism of action of common carcinogens

12. Mechanism of cancerMicroorganism:

Discuss the etiology ,
Discuss the mechanism of viral oncogenesis
Discuss prevention strategies against cancers caused by
microorganism

13. Effect of cancer on host:

Discuss the effects of cancer on host


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14. Medical error and patient safety:

Recognize medical error is one of the commonest cause of preventable
morbidity and mortality
Discuss, with help of illustrative real-life examples, various types of
medical errors
Analyze the role of human factors in prevention of medical errors
Discuss the strategies to prevent medical error


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Theme 3: Human and Microorganisms:

1.Introduction to microorganisms:

Explain the fundamentals of microbiology and its medical importance
Describe the basic characteristics of bacteria, viruses, fungi and
parasites
Describe the microorganisms of medical importance.
Recall the contributions of Robert Koch and Louis Pasteur in
development of microbiology

2.Classification and structure of bacteria:

Classify bacteria
Identify the unicellular nature of bacterial cell
Review the selective toxicity of antibiotics

3.Growth and replication of bacteria:

Explain the growth requirements of bacteria
Relate the bacterial growth curve to survival and spread of bacteria
Identify the bacterial method of replication and its clinical significance

4.Normal microbial flora:

Define and classify normal microbial flora of human body
Explain the beneficial role of microbial flora
Explain the disease causing ability and clinical importance of microbial
flora.

5.How microorganisms cause diseases (virulence):

Name the methods of transmission of infection
Describe the process of infection
List the bacterial virulence factors.
Cite examples of instances where bacterial virulence factors play
important role in virulence, antibiotic susceptibility and host defense

6.Survival and spread of bacteria:

Identify the methods of bacterial spread
Discuss the mechanism of bacterial pathogenicity for survival and
spread
Explain factors influencing microbial pathogenicity

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7.Combating bacteriaSterilization:

Define the process of sterilization
Classify the methods of sterilization
Validate the methods of sterilization

8.Overview of antibacterials:

Classify the antibacterials
Identify the mechanism of action
Recall the use of common/routine antibacterials

9.Mechanism of antibacterial resistance:

Define drug resistance
Classify drug resistance
Discuss the mechanism of drug resistance
Explain the clinical importance of drug resistance

10.Structure and classification of viruses:

Classify viruses
Describe the structure and shape of viruses

11.Overview of antivirals:

Classify anti virals
Describe the mechanism of action of antivirals
List the uses and side effects of common anti-virals

12.Major fungi:

Classify fungi
Identify the clinical significance of fungal infections
List the common diseases caused by fungi
Explain the importance of opportunistic fungal infections in human

13.Major parasites:

Define parasitism
Classify parasites
Describe the concept of life cycle of a parasite
List the common parasitic diseases


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14.Nosocomial infections:

Define nosocomial infections
Identify the epidiemology of nosocomial infections
Explain the causes and importance of nosocomial infection
List the common pathogens in hospital environment
Identify the methods of prevention

15.Detection of pathogens (bacteriology and virology):

Explain the basic concepts of diagnostic microbiology including
classical bacteriology and newer techniques
Identify the available diagnostic methods.

16.Biochemical waste management:

Define and classify biochemical waste
List the methods of segregation of waste
Identify the methods to manage the biomedical waste


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Theme 4: Bodys Immune Response

1. Innate versus adaptive immunity:

Define and classify immunity
Distinguish innate and adaptive immunity
Explain the mechanism of innate and adaptive immunity
Discuss the clinical importance of immunity

2. Immune organs:

Name the basic immune organs
Describe the basic role of these organs in immunity
Discuss the production of lymphocytes

3. Antigens and antibody:

Define antigen and antibody
Explain the structure of antigen and antibody
Discuss the factors determining antibody production
Define monoclonal antibody and give its clinical uses

4. Antigen Antibody interactions:

Explain the basis of immunoserological reactions
Define and compare the clinical application of various antigen
antibody reactions---immunoserological reactions

5. Complement:

Define complement and give its clinical importance
Explain the biological effects of complement
Review the diseases due to complement deficiency

6. Antigen processing and presentation/T- cell function:

Explain the process of antigen presentation
Discuss the significance and importance of antigen processing

7. Acute inflammation:

Define and classify inflammation
Explain the causes of acute inflammation
Discuss the mechanism of inflammation
List the features of acute inflammation

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8. Chronic inflammation:

Define the chronic inflammation
Identify causes of inflammation
Discuss the basic mechanism involved
List the features of chronic inflammation

9. Healing and repair:

Review of cell proliferation, cell growth, cell cycle, and cell
differentiation
Describe the basic factors of tissue regeneration
Identify factors promoting healing

10. Autoimmunity:

Define and classify auto-immunity
Discuss causes and mechanism
Describe pathogenesis of common auto-immune disorders.

11. Body response:

Define immune response
Explain the concept of cell mediated and antibody mediated immune
response
Identify the mechanism of tolerance
Describe the clinical importance

12. Vaccination:

Explain passive and active immunity
Define and explain basic concept of vaccination
Classify common vaccines and describe the features of common
vaccines category
List common vaccine preventable diseases.

13. Immunodeficiency:

Define immunodeficiency
Classify various immunodeficiency disorders such as congenital and
acquired immunodeficiency.
Explain briefly the mechanism of prototypical and common
immunodeficiency diseases.


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14. Hypersensitivity:

Define and classify hypersensitivity.
Discuss mechanism and clinical importance of hypersensitivity.
Describe the clinical significance of anaphylaxis.

15. Foetal maternal immunological barrier, interactions:

Define foetomaternal immunological barrier.
Describe interaction between the antibodies in the mother and fetus.
Explain the mechanism of erythroblastosis fetalis.

16. Immunity in vulnerable age-groups (neonates &
elderly):

Discuss the immune status of a neonate and elderly.
Identify the common infections in these two age groups.
Describe some of the preventive strategies

17. Transplantation immunology
Discuss the concept of transplantation
Classify the different types of transplant
Explain histocompatibility antigens
Explain the Importance of histocompatibility testing in transplantation
immunology
Explain the graft versus host reaction


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Problem-Based Learning (PBL)

1- PBL-1:
A student from the Sharia College.

2- PBL-2:

A health conscious lady wants to maintain healthy life

3- PBL-3:

Elementary school pupils who developed skin rash .


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Field Visits
I. Guidelines for field visits:

1- Students should follow instruction given to them prior to the visit.
2- A handout is given to students before every visit illustrating program,
objectives and other details concerning the visit. Students are required to
read handouts carefully.
3- Students are encouraged to go to hospital utilizing transportation which
is secured by the College Administration. Transportation will be available
half an hour prior to visit.
4- Students are expected to behave as future doctors.
However, any misconduct by any student will be reported to the College
Administration for appropriate measures according to University Rules.
5- At the end of each field visit, students are required to give their feedback
regarding fulfillment of the objectives of the visit and clarify any
comments and suggestions they may have. Feedback will be discussed in
a scheduled session that will be held after the visit in the College.

II. Objectives of field visits:

1. Primary Health Centre:
At the end of the visit, the student should be able to:
Discuss the primary health care system in Saudi Arabia
Discuss the role of medical, paramedical and supporting staff in PHCs
Identify different services provided at PHC level
Discuss the process of utilization of health care services available in
PHCs
Report on the quality of health care services delivered by PHC

2. Visit to King Khaled Hospital, Majmaah:
At the end of the visit, the student should be able to:
Discuss the common medical errors in the hospital.
Discuss the strategies for prevention of medical errors.
Discuss the related issues with hospital staff.

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Seminars
I. Guidelines for Seminar Sessions:
1- Three seminars are scheduled during the block. Duration of each
seminar is 2 hours.

2- The whole patch of year-2 students of the College of Medicine are divided
into four groups, A,B, C & D (11-12 students for each group).

3- Groups are recommended to assign a group leader chosen by students.
Each group leader will be in charge for contacting the Module
Coordinator, Dr. M. A.Fawaz.

4- A staff member will be assigned as a Seminar Supervisor for each
group.
The Seminar Supervisor will be take care of his group regarding:
assigning students for giving presentations in coordination with the
group leader.
assigning of topics of seminars in coordination with group leader.
direct helping and advising students during preparation of
presentations
leading and supervising of seminars regarding securing convenient
venue, managing timing for each presentations and keeping order
during seminars sessions.
facilitating group discussion after each presentation.
Assessing students (those who give presentations and also who do
not give presentations.

5- Three to four students are assigned for giving presentations in each
seminar.

6- Each of the assigned students has to prepare a presentation for his
assigned topic.
The presentation should be formatted by Microsoft office
PowerPoint program.
Only 5-8 slides are required for each presentation.
Presentation should last for 7-10 minutes only. 5 minutes will be
allowed for whole group discussion.
5-10 minutes are devoted for the tutor for giving feedback and
comments.

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7- Other students (not giving presentations) have to properly prepare
themselves for active collaboration & discussion by reading topics related
to seminars prior to attending (NOT JUST PASSIVE LISTENING).

8- All students should consider that they are assessed by the assigned
tutor (not only presenters of the seminar)

9- Topics discussed during seminars can be examined in the module
written exams in the form of scenario based questions and/or SEQs.

II. Topics & Objectives of Seminars:

1- Medical errors & patient safety
(4 presenters):

A. Discuss the frequency and severity of medical errors
B. Discuss the impact of medical errors on patient safety
C. Identify situations and processes that impact the incidence of medical
errors
D. Define the processes for analysis of medical errors
E. Identify special safety needs of specific patient populations
F. Identify the role of healthcare providers in the prevention of medical
errors

2. Humanimmunodeficiency virus (HIV)/ AIDS
(3 presenters)

A. Define the mode of transmission for HIV
B. Describe the response of the immune system to viral infections
C. Identify means of infection control for HIV
D. Discuss specific HIV testing
E. Discuss the ethical issues related to HIV patients

3. Reactive Oxygen Species (ROS) (Free Radicals)
(3 presenters):

A. Concept of ROS & mechanisms of their production in cells.
B. Pathological effects of ROS on human body.
C. Important anti oxidants and their role in combating ROS


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Case- Discussion
I. Guidelines for Case Discussion Sessions:

1- Three scheduled sessions will be held during the module of the Principle of
Health & Disease.

2- Instructional method: Team based learning

3- Students preparation for the sessions:

One week before each scheduled Case discussion session, students will be
given the full scenario of the case to be discussed. All students are asked and
highly encouraged to read the scenario carefully and try to prepare
themselves for the team-based learning discussion by trying to answer
questions provided. Utilizing textbooks in the Medical Library and useful
websites are of profound help in achieving convenient preparation in
advance.

4- Case discussion Sessions:

On the day of every session, the whole batch of students will gather with a
few number of faculty in the Main Lecture Hall. During each session, the case
will be presented and discussed by the students in collaboration with the
faculty. The faculty will be in charge for facilitating discussions and clarifying
points issued by students. The faculty also may give some critical questions
related to the topic during the discussion. Active collaboration of all the
students in discussion and response to faculty questions is highly motivated.

5. Assessment of students for Case Discussion sessions:

Topics discussed during sessions can be examined in the module written
exams in the form of scenario based questions and/or SEQs.


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II. Cases for Discussion:
Case 1:
On April 19, 2011, the Local Health Supervisor in the village in Jazan Province,
reported the occurrence of an outbreak of acute gastrointestinal illness to the
District Health Manager. Dr. Mohammed, epidemiologist-in-training, was
assigned to conduct an investigation. When Dr. Mohammed, arrived in the field,
he learned from the health Supervisor that all persons known to be ill had
attended a marriage party held on the previous evening. Family members who
did not attend the event did not become ill. Accordingly, Dr. Mohammed focused
the investigation on the marriage dinner suspecting a case of mass food
poisoning. He completed Interviews with 75 of the 80 persons known to have
attended, collecting information about the occurrence, time of onset of
symptoms and foods consumed. Of the 75 persons interviewed, 46 persons
reported gastrointestinal illness. The onset of illness in all cases was acute,
characterized chiefly by nausea, vomiting, diarrhea, and abdominal pain. None of
the ill persons reported an elevation in temperature and all showed marked
disappearance of symptoms within 24 to 30 hours. No fecal specimens were
obtained for bacteriologic examination.

Questions for discussion:

1. Would you call this an epidemic? Would you call it an outbreak?
2. Review the steps of an outbreak investigation?
3. What are other modes of transmission of food poisoning?
4. What are the most common organisms causing food poisoning?
5. What are the laboratory methods for diagnosis of food poisoning?


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Case- 2:

A 24-year-old previously health adult male comes to the clinic with the
complaints of fever and sore throat. The attending doctor considers the
diagnosis of pharyngitis and prescribed oral ampicillin. Approximately one hour
after intake of antibiotic by the patient, he complained of tightness of chest,
breathing difficulty, and wheezing. He rushed to the emergency department. The
attending doctor found him to be in great distress. His blood pressure was 86/45
mm of Hg, heart rate 124/minute, and oxygen saturation 94% of room air. There
was diminished air entry bilaterally in the lungs with both inspiratory and
expiratory rhonchi. The patient developed following skin rash soon after

1. What are the possible causes of his symptoms?
2. What history would you like to find out from his relatives?
3. Can you explain the basis of his symptoms?

Anesthesia team was called immediately. Oxygen was administered through a
mask with improvement of his oxygenation. Intravenous adrenaline was
administered, followed by methylprednisolone, diphenhydramine, and
cimetidine. Medication resulted in gradual improvement of patients condition.


1. What is the primary mechanism underlying the patients condition?
2. What is the basis of administering the medication?
3. How his condition could have been prevented?
4. What advice do you have for him?
5. Would you do any further test to confirm ampicillin allergy?


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Case - 3:
The patient was a 74-year-old man with a history of diabetes mellitus and
coronary artery disease. He was admitted for a coronary bypass graft.
Postoperatively, his foot remained ischemic and he was treated with antibiotics
(cephalosporin). Three days later he developed tachypnoea, diarrhoea, and
abdominal distension. On abdominal X-ray, his colon was markedly dilated. His
full blood count shows leucocytosis. He was diagnosed as having colonic
ischemia and subsequently underwent an operation where parts of his small and
large intestines were removed. He required further two weeks of hospitalization
and then eventually was discharged home.
Explain the key terms
a. Ischemia
b. Tachypnoea
c. Leucocytosis
Gross description of colon and illeum
The surgical specimen consisted of an 11 cm segment of terminal ileum, a 7 cm
appendix, and 23 cm of cecum and colon. The cecum and colon were diffusely
covered by pseudomembranes consisting of yellow, raised, exudative plaques.
Question for discussion:
Explain the following terms:
a. Gross descriptions
b. Pseudomembrane
c. Exudates
What is the relevance of antibiotic to his presenting symptoms?
Microscopic
Histologically, the colonic mucosa was largely ulcerated and necrotic. The normal
mucosa was replaced by pseudomembranous plaques of fibrin, cellular debris,
and neutrophils. Relatively normal mucosa with preserved glandular
architecture was seen adjacent to mushroom-shaped necrotic plaques.
Perforation of the mucosa muscularis.

Objectives of discussion:
a) Explain the basis of microscopic findings
Immunoserology
The patient's stool was positive for Clostridium difficile toxin.


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Practical Sessions Objectives
A. Microbiology:

1. Microscopy

Describe parts and principles of using microscope
Explain the different types of microscopes

2. Gram Staining & Bacterial Slides
Describe the reagents used in the Gram stain and state the purpose of
each reagent.
State the color expected for Gram positive and Gram negative cells
after performing the Gram stain
Describe why Gram positive and negative cells stain the way they do
with the Gram Stain.
Describe the cell wall structure of Gram positive and negative
organisms.
Explain what Gram variable means.
Explain specific findings of different slides illustrating different
bacteria.

3. Sterilization

Define disinfection and sterilization
Describe the common substances and processes used to achieve these
outcomes
Evaluate issues influencing choice of method

4. Immunoserology

Explain the basic procedures of immunoserology,

B. Pathology

Discus basic techniques of gross and microscopic interpretation of tissue
specimens.
Identify various diagnostic techniques in Pathology.- Venous thrombosis,
Inflammation

P a g e | 31

Weekly Time Plan

Week-1
Starting Date: Sunday: 3/12/1432 H (30/10/2011 G)
Theme: Concepts of Health & Diseases
Day: Saturday Sunday Monday Tuesday Wednesday
Date: 29/10/2011 30/10/2011 31/10/2011 1/11/2011 2/11/2011

8-9 am

Revision
Human
Body
Module

Concepts of
Health & Disease
Dr. Ashraf

Social Determinants of
Health & Disease
Dr. Ashraf

Eid Al-Adha Vacation

9-10 am

Health for All
Dr. Ashraf

Common
Health Problems in
Saudi Arabia
Dr. Ashraf

10-11 am

Critical Lateral
Thinking
Dr. Fahim

Attitudes
Dr. Kamran

11-12 pm

IGL

Salam

12-1 pm Prayer & Prayer Break

1-3 pm

Revision

IGL

IGL

Principles of Health & Disease PBL CD IGL Psychological & Behavioral Sciences Medical Learning Skills

Salam

P a g e | 32

Week-2
Starting Date: Saturday: 16/12/1432 H (12/11/2011 G)
Theme: Concepts of Health & Diseases
Date: 12/11/2011 13/11/2011 14/11/2011 15/11/2011 16/11/2011

8-9 am

Health System in
Saudi Arabia
Dr. Ashraf

Final Exam
Human Body Module

Health Beliefs of
Individuals
Dr. Ashraf

Bio-psychosocial Approach to
Health & Disease
Dr. Ashraf

Introduction to
Health Education
& Health Promotion
Dr. Ashraf

9-10 am

National & International
Health Organizations
Dr. Ashraf

IGL

IGL

IGL

10-11 am

IGL

IGL

Overview of Epidemiology
Dr. Ashraf

11-12 pm

Salam

Psychosocial Factors Affecting
Physical Illnesses
Dr. A. Rahman

Overview of
Mechanism of Disease
Dr. Ashraf
12-1 pm Prayer & Lunch Break

1-3 pm

IGL

Final Exam
Human Body Module

Utilizations & Barriers
to Health Care
Dr. Ashraf

CBD
Psychosocial Factors Affecting
Physical Illnesses
Dr. A. Rahman

Role-play
Interpersonl Skills
Dr. Ashraf

Salam

P a g e | 33

Week-3
Theme: Mechanism of Diseases
Date: 19/11/2011 20/11/2011 21/11/2011 22/11/2011 23/11/2011

8-9 am

Genetic Basis of Diseases
Dr. Sherif

Cell Injury &
Cell Response
Dr. Fawaz

Cell Growth
Dr. Rehan

Pathology of Tumors
Dr. Ashraf

Mechanism of Cancer:
Environment
Dr. Rehan

9-10 am

IGL

Cell Adaptation
Dr. Qazi

Environmental Factors:
Dehydration,
Chemical Injury
Dr. Fawaz

IGL

IGL

10-11 am

Stereotype & Prejudice
Dr. A. Rahman

IGL

11-12 pm

Inborn Errors of
Metabolism
Dr. Sherif

Salam

Cancer:
Definition, Classification,
Overview
Dr. Ashraf

Microorganism
Dr. Fawaz

1-3 pm

PBL - 1 a

CBD
Dr. A. Rahman

Role- play
Interpersonal Skills
Dr. Ashraf

CD 1

PBL - 1b

Salam

P a g e | 34

Week-4
Starting Date: Saturday:1/1/1432 H (26/11/2011 G)
Theme: Mechanism of Diseases
Date: 26/11/2011 27/11/2011 28/11/2011 29/11/2011 30/11/2011

8-9 am

Oncogenes
Dr. Sherif

Genetic
Dr. Sherif

Effect of Cancer
on Host
Dr. Qazi

Medical Errors &
Patient Safety
Dr. Ashraf

Classification & Structure of
Bacteria
Dr. Fawaz

9-10 am
Working in Teams
Dr. Ashraf

IGL

IGL

IGL

IGL

10-11 am
IGL

How to Excel in Examination:
Answering Written Examination
Dr. Waqas

11-12 pm

Leadership
Dr. Ashraf

Salam

Introduction
to Microorganisms
Dr. Fawaz


1-3 pm

PBL 1 Panel

Seminar-1

Practical

Histopathology-1

Practical

Histopathology- 2

PBL 2 a

Salam

P a g e | 35

Week-5
Theme: Humans & Microorganisms
Date: 3/12/2011 4/12/2011 5/12/2011 6/12/2011 7/12/2011

8-9 am

Growth & Replication of
Bacteria
Dr. Fawaz

Survival & Spread
of Bacteria
Dr. Fawaz

Overview of
Anti-bacterials
Prof. Mazen

Recent Advances
in Medicine
Prof. Mazen

Mechanism
of Antibacterial
Resistance
Prof. Mazen

9-10 am

How Microorganisms
Cause Diseases
(Virulence)
Dr. Fawaz

IGL

IGL

Illness Behavior
Dr. Kamran

PBL 2: Panel
10-11 am

IGL

IGL
11-12 pm

Professionalism
of Students
Dr. Rukban

Combating
the Bacteria:
Prophylaxis, Curative
Dr. Ashraf

Salam

1-3 pm

CD 2

Practical
Pathology
Specimens

Seminar-2

PBL 2 b

Practical
Microscopy

Salam

P a g e | 36

Week-6
Theme: Humans & Microorganisms
Date: 10/12/2011 11/12/2011 12/12/2011 13/12/2011 14/12/2011

8-9 am

Mid Module Exam

Major Parasites
Dr. Fahim

Major Fungi
Dr. Qazi

Detection of Pathogens
(Diagnostic Bacteriology &
Virology
Dr. Ashraf

Nosocomial
Infection
Dr. Ashraf

9-10 am

Role- play
Interpersonal Skills
Dr. Ashraf

Anti-fungals
Prof. Mazen

Biomedical Waste Management
Dr. Fawaz

IGL

10-11 am

Structure & Classification
of Viruses
Dr. Fawaz

Evidenced Based Practice
Dr. Ashraf

Feedback of the Field
Visit to PHC

IGL

Normal Microbial Flora of
Human Body
Dr. Fawaz

11-12 pm

Overview of Anti-virals
(Major Classification &
Mechanism)
Prof. Mazen

Salam

Changing Behavior
Dr. Kamran

IGL

1-3 pm

PBL 3 a

Field Visit
(PHC)

Practical
Bacterial Staining &
Slides

CBD
Changing Behavior
Dr. Kamran

PBL 3 b

Salam

P a g e | 37

Week-7
Starting Date: Saturday:22/1/1433 H (17/12/2011 G)
Theme: Body`s Immune Response
Date: 17/12/2011 18/11/2011 19/12/2011 20/11/2011 21/11/2011

8-9 am

Innate Versus Adaptive
Immunity
Dr. Fawaz

Antigen & Antibody
Dr. Ashraf

Immunity in Vulnerable
Age Groups
(Neonates & Elders)
Dr. Qazi

Antigen- antibody Interaction
Dr. Fawaz

Antigen Processing &
Presentation/T cell
Function
Dr. Kamran

9-10 am

Immune Organs
Dr. Fahim

Motivation & Compliance
Dr. Kamran

Fetal Maternal
Immunological
Barriers
Dr. Rehan

IGL

IGL

10-11 am

IGL

IGL

IGL

11-12 pm

Psychological &
Behavioral Problems
in the Kingdom
Dr.A.Rahman

Salam

Complement
Dr. Fawaz

1-3 pm

PBL 3 Panel

Seminar - 3

Clinical Learning
Dr. Ashraf

CD - 3

Practical
Immunoserology

Salam

P a g e | 38

Week-8
Theme: Body`s Immune Response
Date: 24/12/2011 25/12/2011 26/12/2011 27/12/2011 28/11/2011

8-9 am

Acute Inflammation
Dr. Kamran

Field Visit to the Hospital

Vaccination
Dr. ashraf

Immune Deficiency
Dr. fawaz

Hypersensitivity
Dr. Fawaz

9-10 am

Chronic Inflammation
Dr. ashraf

Autoimmunity
Dr. Fawaz

Continuous Professional
Development
Dr. Hamza

Transplantation Immunology
Dr. ashraf
10-11 am

IGL

Body Response to
Microorganisms
Dr. Fawaz

IGL

IGL
11-12 pm
Healing & Repair
Dr. Fawaz

Salam
1-3 pm
Practical
Slides in Bacteriology

Feedback of the Field Visit to
the Hospital

Health System
Management
Dr. Ashraf

Introduction to Medical Ethics &
Professionalism
Dr. Ashraf

Graft Versus Host Reaction
Dr. Fawaz

Salam

P a g e | 39

Week-9
Theme: Revisions & Examinations
Date: 31/12/2011 1/1/2012 2/1/2011 3/1/2011 4/1/2011

8-9 am

Revisions

Written
Examination

Practical
Examination

9-10 am

10-11 am

11-12 pm

12-1 pm

1-3 pm


P a g e | 40

Distribution of Tasks for the Faculty

Week

Faculty
member

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

PBL-1 a

SAT
19
Nov

CD-1

TUE
22
Nov

PBL-1 b

WED
23
Nov

PBL-1
Panel

SAT
26
Nov

Sem-1

SUN
27
Nov

PBL-2a

WED
30
Nov

CD-2

SAT
3
Dec

Sem-2

MON
5
Dec

PBL-2b

TUE
6
Dec

PBL-2
Panel

WED
7
Dec

PBL-3a

SAT
10
Dec

Field
Visit
PHC
SUN
11
Dec

PBL-3b

WED
14
Dec

PBL-3
Panel

SAT
17
Dec

Sem-3

SUN
18
Dec

CD-3

TUE
20
Dec

Field
Visit
HOSP.
SUN
25
Dec
Prof. Mazen A ALL A ALL C B ALL D B ALL ALL C ALL
Dr. Fahim ALL D D ALL D ALL
Dr. Qazi C ALL C ALL A D ALL D ALL ALL ALL
Dr. Fawaz ALL ALL B ALL B ALL B A/B B ALL ALL A/B
Dr. Sherif D ALL D ALL ALL A ALL C C ALL B ALL
Dr. Ashraf ALL ALL D C ALL C ALL C/D ALL ALL C/D
Dr. Rehan B ALL B ALL A ALL C A ALL ALL ALL
Dr. Kamran ALL A A ALL A ALL

Principles of Health & Disease PBL CD

P a g e | 41

Teaching & Learning Methods

This section provides an elaboration of the teaching and learning methods that
will be used to deliver this block. Thus, there will be a detailed description and a
step-wise guide as to how the about the following methods should be applied
will be given below.
A. Interactive lectures
B. Small group learning sessions (PBL)
C. Large group learning sessions (seminars)
D. Practical sessions
E. Skills lab sessions
F. Clinical teaching and learning sessions

A. Interactive lectures:
Introduction:
Interactive lectures are similar to the lectures used in all other parts of the
curriculum, or anywhere else. They are, however, not the didactic lectures used
in the past.
Process:
The lecturer will involve the students in active discussion, and may provide brief
learning activities during the lecture to achieve the learning objectives stated
under each topic. Occasionally, there will be more than one lecture/lecturer to
achieve all the learning objectives given under one topic. As much as possible,
where applicable, the lectures will highlight clinical application of the content
material. Students could take notes during a lecture, but the lecture slides will be
available on Blackboard (i.e. the learning management system of the university).


P a g e | 42

B. Problem-Bases Learning (PBL)
Introduction:
These are activities where students are divided in a small group of about 10
under the supervision of a tutor/facilitator. One of the important methods of
small group learning is PBL, where the students first will be trained how to work
in a PBL.
Process:
A detailed guide as to how a PBL is conducted provided separately. Please go
through this guide, carefully before taking on PBL learning.

C. Large group learning sessions :
Introduction:
In this method students will prepare for a relevant topic on a given curriculum
facet. The curriculum facet for discussion will be selected by the tutor. The
topics related to a given curriculum facet could be either selected by the tutor or
by the student, but pre-agreed with the tutor. The student will prepare for a 30-
minute presentation on the topic and deliver it to the whole batch. There will be
at approximately one large group learning session every two to three weeks.
Process:
1. Tutor selects a curriculum facet relevant to the module/theme that is being
learned at that time.
2. Tutor asks for three student volunteers who are willing to prepare for three,
30-minute presentations.
3. The three volunteer students will discuss with the tutor and agree on three
topics under a given curriculum facet. For example, if the curriculum facet
selected by the tutor is the contribution of tissues to the organization of the
body, students can make presentations on topics such as structure of
different tissues in the body, functions of tissues, and how the tissue
structure has been adapted to its function. These topics will be either
selected by the tutor or selected by the students with the concurrence of the
tutor.
4. For a given learning session, 2 hours in duration, three students will deliver
three, 30-minute presentations on a particular theme, selected by the tutor.
After each 30-minute presentation there will be a 10-minute discussion.
5. Finally, the tutor will summarize the presentations of the session in the last
10 minutes.

P a g e | 43

D. Practical sessions:
Introduction:
Practical sessions are designed to practically illustrate the concepts and
principles introduced to the student in the lectures. Thus, the practicals will
provide an opportunity for the students to acquire hands-on experience on an
abstract concept or a principle they learned in the lectures; i.e. the students will
experience for themselves how an abstract concept or a principle practically
operates. Every theme that is studied within each module will have several
practical sessions. These practicals will range from studying microscope to
viewing slides using the light microscope. The topics of the practical sessions will
be determined by the tutor as appropriate. A practical will be held for 2 hours in
the newly built system-based laboratories under the guidance of a tutor.
Depending on the nature of the subject matter taught within a module, a given
module may or may not contain practical sessions.
Process:
1. Tutors who teach in a particular theme, in collaboration with each other will
determine an appropriate number of practicals for a given theme.
2. Objectives of a given practical session will be developed and given to the
students by the tutor before the practical.
3. Students will be pre-informed about a given practical topic. Depending on
the type of practical and facilities available, 25 to 50 students will take part
in a given practical session.
4. Students will record findings of the practical in a separate Practical Record
Book.
5. At the end of the session the tutor will summarize the main learning points
illustrated during the practical.

E. Skills lab sessions:
Introduction:
Students will use the newly built, state-of-the-art skills lab to train the students
in certain important practical, clinical skills from year 2; i.e. phase 2. An example
for a skills lab session would be blood pressure measurement. Depending on the
nature of the module, there may or may not be skills lab sessions for a given
module.


P a g e | 44

Process
1. The tutors who teach within a module in collaboration with each other will
determine the number of skills lab sessions per module.
2. The tutors will then draw up the objectives for each session and inform the
students about the objectives of the session prior to the skills lab session.
3. Depending on the nature of the skills lab session, students will either
participate in small groups or as the whole batch. For example, for blood
pressure measurement they will measure the blood pressure of each other in
small groups.
4. Depending on the skill, the students will perform the skill either on
themselves, on each other or on a simulator.
5. The students will record the findings of the skills lab session in a separate
Skills Lab Record Book.
6. The tutor will at the end of the session summarize the main learning points.

F. Clinical teaching and learning sessions:
Introduction
Where relevant the students in small groups of 10, will visit a clinical setting (e.g.
a ward, a clinic, or a surgical theatre, central sterilization unit) observe (e.g.
observing the sterilization process in the central sterilization unit of the hospital)
or experience (e.g. speaking with a patient who has a disease related to
smoking)how a given concept or principle is clinically applied. Depending on the
nature of the subject matter being taught, there may or may not be clinical
teaching and learning sessions within a given module.
Process
1. The tutors responsible for teaching and learning for a given module will
determine the topics for which there will be clinical teaching and learning
sessions.
2. The tutors will then draw up the objectives of a given session and
communicate it to the student prior to the session.
3. The students will be divided into groups of 10.
4. A tutor will accompany the students to the clinical setting or a clinician (who
is aware of the objectives of the session) from the relevant clinical setting will
be assigned to show the students the relevant procedures that they need to
observe or do.
5. Students will record their experience or observations in a Clinical Teaching
and Learning Record Book.

P a g e | 45

Assessment of the Module
This block comprises two types of assessment.
A. Continuous assessment:

These assessments will take place throughout the course.
They are mostly based the PBL sessions, skill lab, practical and
clinical activities.
Also there will be MCQ as mid module examination.
A proportion of marks (40%) from these assessments will
contribute to the final summative module assessment.

B. Final assessment:

The eligibility criterion for sitting the final examination will be the
completion of 75% of attendance.
This exam is held the end of the module assessment, and will be
held under formal examination conditions, including MCQ, OSPE,
OSCE and so forth.
A proportion of marks (60%) from this assessment will contribute
to the final summative mark of the module assessment.


P a g e | 46

Quality Assurance & Evaluation Process
Any new course, or for that matter any old course, needs constant reviewing and
monitoring to ensure that it meets the demands placed on it by the overall
curriculum. This curriculum is no exception. Hence, there will be a number of
evaluation strategies employed by the module.
They are as follows:
1. Student feedback at the end of the module, seeking student comments on
both teaching and learning, and assessment, along with views on the
general course organization and implementation
2. Student feedback of a sample of teaching and learning activities
3. Tutor feedback
4. Examiner feedback
5. Peer evaluation, where a staff member may visit a particular teaching and
learning activity and provide formative feedback about its conduct
6. Analysis of the students examination results
7. External reviews.


P a g e | 47

Resource Material
Parks Text Book of Preventive and Social Medicine. 18
th
Edition
Robbins Basic Pathology. 8
th
Edition
Muirs Text book of Pathology. 14
th
Edition
Medical Microbiology by Jawetz, Melnick, Adelbergs. 25
th
Edition
Text Book of Microbiology. Green Wood
Essential Immunology. Roitt. 11
th
Edition
Basic and Clinical Pharmacology. Katzung 10
th
Edition
Study Skills and Test Taking Strategies For Medical Students.
Deborah D. Shain
Professionalism in Medicine A Case Based Guide for Medical
Students.John Spandorfer, 2009
Ayers, De Visser 2011. Psychology for Medicine. Sage Publications
ltd, London


P a g e | 48

Tutors Emails
Prof. Mazen Al-Qato: [email protected]
Dr. Fahim Haider Jafari: [email protected]
Dr. Qazi Imtiaz Rasol: [email protected]
Dr. Mohammed Alimullah Fawaz: [email protected]
Dr. Mohammed Ashraf: [email protected]
Dr. Sherif Aly Saleh: [email protected]
Dr. Mohammed Rehan Asad: [email protected]

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