Second-Year Medicine

Block 3: Gastrointestinal System

The interdisciplinary course is intended to provide an understanding of the biological basis of the common and important disorders of the gastrointestinal tract, liver, biliary tree and pancreas. The course encompasses the disciplines of Microbiology and Immunology, Pathology and Pharmacology and is presented in an integrated manner illustrating pathophysiologic principles. The course is taught through small-group sessions [case-based learning (CBL), laboratory exercises, interdisciplinary conferences] with the supplemental lectures preceding or following the relevant small- group sessions. The course includes epidemiology and pathophysiology of gastrointestinal disorders, diagnostic approaches including microbial culture, endoscopy, relevant radiology and histopathology.

Chemotherapeutic approaches for both infectious and non-infectious conditions are incorporated highlighting the mechanisms of action. The course is designed to emphasize clinical relevance and foster independent thinking.

Gastrointestinal System

Epidemiology of gastrointestinal infections
Diseases of the oral cavity [developmental anomalies; non-neoplastic and neoplastic conditions]
Microbiology of the gastrointestinal tract [normal flora in health and disease; gut-associated lymphoid tissue; spectrum of gastrointestinal infections; pathogen-host-cell interaction; contact secretion systems; agents of diarrhea and dysentery; bacterial toxins and their modes of action; food poisoning; laboratory identification of bacterial pathogens]
Esophageal and gastric disorders [achalasia; gastroesophageal reflux disease; acute and chronic gastritis; gastric and duodenal ulcers; hypertrophic gastropathy; benign and malignant tumors]
Gastrointestinal hormones [hormone-receptor interaction; gastrin-cholecystokinin family; secretin family; glucagon and glucagon-like peptides; somatostatin family; pancreatic polypeptide family; tachykinins; motilin; tyrosine kinase receptor family]
Disorders of the small intestine including diarrhea and malabsorption [congenital anomalies; malabsorption syndromes; intestinal obstruction; diagnosis and treatment]
Disorders of the large intestine [inflammatory bowel disease (ulcerative colitis, Crohn’s disease); megacolon; diverticular disease; irritable bowel syndrome; non-neoplastic and neoplastic disorders]
Drugs for gastrointestinal disorders [peptic ulcer disease (antisecretory agents: H2 blockers, proton pump inhibitors, anticholinergics; antacids; cytoprotective agents: prostaglandins, sucralfate, bismuth compounds; antimicrobials); constipation (bulk-forming agents, osmotic laxatives, stimulant laxatives, lubricants); diarrhea; antiemetics; prokinetics]
Protozoal and helminth infections [life cycles of protozoa, nematodes, cestodes and trematodes that infect the gastrointestinal tract; mechanisms of pathogenesis; laboratory diagnosis; prevention; chemotherapy]
Liver and biliary tract disease [drug-induced liver disease; primary biliary cirrhosis; primary sclerosing cholangitis; hemochromatosis; Wilson’s disease; alcoholic liver disease; viral hepatitis; vascular disorders, neoplasms; cholestasis; cholelithiasis; cholecystitis, α₁-antitrypsin deficiency]
Disorders of the pancreas [congenital anomalies; macroamylasemia; cystic fibrosis; hereditary hemochromatosis; acute and chronic pancreatitis; neoplasia]