GAMSAT Preparation

Topic #1 Cellular Changes in disease

Objectives

1. Explain how the lack of oxygen affects cells
2. Distinguish between hyperplasia & hypertrophy, necrosis, atrophy and apoptosis
3. Indicate what substances may accumulate in cells in disease - coming soon
4. List the main signs of inflammation and relate them to vascular and cellular changes produced by chemical mediators
5. Explain the difference between acute and chronic inflammation
1. What is intrinsic and extrinsic clotting? 

Topic #2 Introduction to Pharmacology

Objectives

1. Describe how the study of toxicology is important when creating treatments
1. Introduction to Toxicology
2. The Discipline of Toxicology and specialty fields
2. Describe treatment options
3. Describe beneficial and adverse effects of each type of treatment
4. Explain how diseases may be prevented 
1. Is it Bird Flu or Human Flu?
5. Describe the science of pharmacology
6. Describe the history of drug development
7. Discuss the various ways drugs are classified
8. Describe how drugs are given their chemical, generic and trade names
9. Describe how drugs are administered. 
10. Describe in general the process of a drug being manufactured and marketed and why tailor made dosing may be necessary
11. Indicate why drugs may lose potency on storage
12. Explain why it is important to develop drugs with specificity of action

Topic #3 Pharmacokinetics

Objectives

1. Define pharmacokinetics
2. Describe what is meant by pharmacokinetics 
3. Define the main process of pharmacokinetics
4. Explain how routes of administration are determined by pharmacokinetics factors
5. Discuss why it is sometimes difficult to achieve effective plasma concentrations of drugs in milk
6. Explain how plasma protein binding affects drug action
7. Distinguish between the two types of metabolism of drugs and where it occurs
8. Explain what is meant by pro-drug
9. Describe enterohepatic recycling of drugs
10. Define what is meant by half-life, therapeutic window and therapeutic index
11. Discuss the factors affecting routes of administration and why certain decisions are made
12. Define the structural and functional roles of cellular membranes
13. Discuss the effects of pH on drug ionization and the clinical implications of altering fluid pH
14. Describe the effects of the blood-brain barrier on drug distribution 
15. Define specific drug targets
16. Describe the difference between receptors and their actions
17. Discuss the lock & key hypothesis and the nature of binding of drugs to receptors
18. Define signal transduction and second messengers
19. Indicate why typing and sub-typing of receptors are important with regard to specificity of drug action
20. Define the terms 'agonist', 'antagonist', 'ligand', 'partial full/against'
21. Define the different types of antagonism
22. Describe the significance of the dose-response curve
23. Describe potency, efficacy, structure-activity relationships and affinity
24. Explain the meaning of up and down regulation of receptors

Topic #4 Hypertension

Objectives

1. Why blood pressure should be decreasing if hypertension is present
2. How mild hypertension should be treated initially by lifestyle changes and what these changes are
3. How a decrease in calcium influx into vascular smooth muscle by Calcium channel blocks a decrease in blood pressure. 
4. Two ways the hypertensive effects of angiotensin, produced in the body can be reduced
5. Why inhibition of the effects of the sympathetic nervous system on blood vessels and the heart can decrease blood pressure
6. How diuretics can decrease blood pressure by decreasing blood volume and dialating arterials (sodium loss)
7. What drugs are used initially to treat an increase in blood pressure?
8. What side effects may be produced by anti-hypertensive drugs

Topic #5 Myocardial Infarction & Stroke

Objectives

1. Explain how most cases of Myocardial Infarction & Stroke are caused by a thrombus blocking an artery
2. Explain how arterial thrombi form, why they develop at sites affected by artheroscerlosis and how they embolise
3. Describe how atherosclerosis is due to hypercholesterolmia, endothelial cell damage and chemical modification of LDL and why these changes occur
4. Give a detailed account of the formation and detrimental effects of an atheroma 
5. Describe how coronary heart disease gives rise to angina pectoris and may lead to Myocardial Infarction
6. Describe how temporary occlusion of arteries supply the brain causes transient ischaemic attacks which may be followed by stroke
7. Distinguish between the two types of stroke
8. Describe the symptoms of Myocardial Infarction and stroke
9. Discuss the role of excitotoxity in ischemic stroke
10. Identify the major drug groups used in the treatment of various cardiovascular disorders
11. State the mechanisms of the actions of the major drug groups
12. Describe how hyperlipidemia can be reduced by dietary and lifestyle changes
13. Describe the mechanisms of the actions of drugs used to decrease blood lipids
14. Describe the use and mechanisms of actions of anti-platelet drugs and fibrinolytic agents
15. Give an account of the mechanism by which aspirin decreases the risk of Myocardial Infarction and thrombotic stroke
16. Describe the clinical uses of anticoagulants
17. Describe the physical and chemical treatments for ischaemic heart disease and the risks associated with their use
18. Describe the emergency treatment of Myocardial Infarction and stroke
19. Describe treatment options after Myocardial Infarction and stroke
20. Describe how angina pectoris can be treated
21. Explain how transient ischaemic attacks and thrombotic stroke can be prevented and treated.

Topic #6 Alzheimer's Disease

Objectives

1. Describe the symptoms of Alzeimers disease
2. Describe the changes that occur in the brain in Alzeimers disease
3. Give an account of possible genetic and environmental causes of Alzeimers disease.

Topic #7 Pulmonary Oedema

Objectives

1. Describe the structures present in the alveolar-cap membrane
2. Explain how Starling Forces apply to movements of H2O between the pulmonary cap and the interstitium (tissue between the alveoli & cap.)
3. Compare and contrast pressures and flow characteristics of the systemic and pulmonary circulations
4. Explain how cardiac and non-cardiac disorders can lead to Pulmonary Oedema
5. Describe the signs and symptoms of Pulmonary Oedema

Topic #8 Rheumatoid Arthritis & Osteoarthritis

Objectives

1. Describe the structure of the synovial joint - coming soon
2. Describe the origin and nature of changes in synovial joints in Rheumatoid Arthritis and Osteoarthritis - coming soon
3. Give an account of the widespread changes which can occur in Rheumatoid Arthritis - coming soon

Topic #9 Hepatitis & Peptic Ulcers

Objectives

1. Give an account of the general structure and functions of the liver as a basis for understanding the causes and implications of liver damage
2. Give an account of viruses that can cause hepatitis, how they are acquired, incubation periods, whether they cause acute or chronic infections and how they can be detected
3. List the types of people who are most at risk of viral induced hepatitis and describe the long-term consequences of viral induced hepatitis
4. Relate alcohol intake to development of liver damage and describe the progressive changes that occur.
5. Describe stimuli for secretion of gastric acid and how prostaglandins exert a protective role in the stomach
6. Explain why non-steroidal anti-inflammatory drugs cause peptic ulcers
7. Give an account of H.Pylori and proof of its role in peptic ulceration
8. Explain the consequences of peptic ulceration
9. Describe how hepatitis can be prevented
10. Describe measures to induce active and passive immunity against HAV and HBV
11. Discuss the roles of anti-viral drugs in viral induced hepatitis
12. Describe how complications of cirrhosis are treated
13. Explain what treatment options are available for the treatment of peptic ulcers due to H.Pylori and NSAIDs and state how effective they are.