Introductory Chemical Pathology

At the end of the course, students should be able to: 1. describe chemical pathology; 2. demonstrate knowledge of the bio-chemical basis of disease states; 3. select relevant biochemical tests that will confirm or refute provisional clinical diagnosis of disease states; and 4. interpret and apply these results in deciding therapy and follow up of these disease states.

What is Chemical Pathology? Objectives of the course; Instruments used in Chemical Pathology; Collection of Specimens; Interpretation of Results; Point of Care Testing (PCT)- Side-room Tests; Sodium Metabolism: hyponatraemia, hypernatraemia- cause, effects, clinical situations and features. Clinical significance. Potassium metabolism. Water deficiency and excess. Aldosteronism. Diabetes insipidus. Acid-base Balance. Respiratory and metabolic disturbances. Acidosis; Alkalosis. Principles of treatment of acid-base disturbances and many others. Renal Function: Glomerular dysfunction. Tubular dysfunction. Proteinuria. Nephrotic syndrome. Renal failure Investigation. Renal calculi. Gastrointestinal Tract: Gastric function, peptic ulcer, Zollinger- Ellison syndrome, carcinoma of the stomach. Malabsorption Syndromes. Differential diagnosis of generalised intestinal and pancreatic malabsorption. Pernicious anaemia. The Pancreas: acute pancreatitis, diagnosis, tests of function. The Liver: Disorders of bile pigment metabolism, Classification of jaundice, Basic processes in liver disease, cholestasis. Acute hepatitis and chronic hepatitis. Cirrhosis. Haemolytic jaundice. Congenital hyperbilirubinemia. Neonatal jaundice (and drugs). Gallstones - formation and consequence of gallstones. Disorders of Carbohydrate Metabolism: Blood glucose, glycosuria, ketonuria, ketosis, lactic acidosis. Diabetes mellitus: clinical and laboratory features, diagnosis, glucose tolerance test, types of glucose tolerance curves. Diagnosis of diabetes; acute metabolic complications - diabetic comas; keto-acidosis, hyperosmolar non-ketotic coma, hypogIycaemic coma. Investigation of a diabetic presenting in coma. Hypoglycaemia: causes, insulinoma. hypoglycaemia in children.