MDSC 3313 Applied Para-Clinical Sciences III 2014/15

COURSE OBJECTIVES


ANATOMICAL PATHOLOGY

I Pathology of Central Nervous System

A. Common Pathophysiologic complications
1. Define cerebral edema and list the types. Distinguish interstitial, intercellular and intracellular edema in
terms of aetiology and morphology.
2. List the types of brain herniation and explain the causes of mass shifts in the brain, and the
consequences of herniation.
3. Outline the differences between communicating, non-communicating hydrocephalus, and
hydrocephalus ex vacuo.

B. Cranio-cerebral injuries
4. List the various types of cranial trauma.
5. Discuss in detail about skull fractures.
6. Outline the differences between concussion, contusion, and laceration. Describe coup and contrecoup
injuries, and of traumatic axonal injury.
7. Describe epidural and subdural hematomas, distinguish how they occur and how they impact on the
patient and describe the autopsy findings

C. Infections
8. Outline the differences between encephalitis, meningitis, and cerebritis.
9. Discuss in detail about common bacterial meningitis. State the most common bacteria causing
meningitis in patients in various ages and situations. Describe the common complications and sequelae.
10. Outline the differences between Bacterial and Viral meningitis.
11. Describe in detail tuberculous and cryptococcal meningitis.
12. Discuss the aetiology, pathogenesis, morphology and complications of brain abscess.
13. Briefly describe common infections of the brain parenchyma - Viral Encephalitis, Fungal and parasitic
infections
14. Describe the key pathological feature of HIV encephalitis.
15. Outline the types of human prion diseases. Describe the key pathological finding in CJD.

D. Tumours of the brain
16. Classify brain tumours. Describe the important features distinctive of brain tumours.
17. Discuss aetiology and risk factors. Describe the clinical features of Intracranial space occupying lesion.
18. List the paraneoplastic CNS syndromes.
19. Describe the following tumours listed below under: Age distribution, location, gross and microscopic
morphology and prognosis.

Astrocytoma (Include grading)

Glioblastoma

MDSC 3313 Applied Para-Clinical Sciences III 2014/15

Ependymoma

Oligodendroglioma

Subependymoma

Medulloblastoma

Meningioma

Lymphoma

Metastases

Vascular Disease of the CNS
20. Define cerebro-vascular disease.
21. Describe the clinical and pathological types of cerebro-vascular disease.
22. Discuss the pathophysiology of cerebro-vascular disease.
23. Describe the types of acute ischaemic injury in the brain and the morphology of each type.
24. Describe the aetiology and pathogenesis of cerebral infarcts and the morphology of the different types.
25. Outline the causes of intracranial haemorrhage, including hypertension. Describe the pathogenesis of
hypertensive cerebro-vascular disease.
26. Describe the effects of hypertensive cerebro-vascular disease.
27. List the causes of subarachnoid haemorrhage. Describe the aetiology, pathogenesis, morphology,
clinical features and prognosis of berry aneurysms. Know the prognosis of berry aneurysm.
28. Outline three main types of vascular malformations in the CNS, including the morphology of
arteriovenous malformations.
29. Classify traumatic vascular intracranial injury according to compartments. Describe the morphology of
each, including the relevant clinical features.
30. Describe the sequelae of brain trauma.

II Pathology of Bones

31. Review the anatomy of the bones whether long or flat including the histologic structure of the different
types of bone.

Bone fracture and repair
32. Differentiate between the different types of bone fractures (simple, compound, fissure or
comminuted).
33. Explain whether the fractured bone is already healthy or diseased (pathologic fracture).
34. Discuss in detail the various steps involved in healing of bone fracture.
35. Describe the factors that affect healing of bone fracture.
36. Describe the complications of healing of bone fracture
Inflammation of the bone
37. Definition of osteomyelitis.
38. Classify osteomyelitis depending upon the aetiological agent (non-specific, tuberculosis, sarcoidosis
and syphilis )and the duration (acute and chronic ).
39. Describe the morphology, clinical features and complications of acute osteomyelitis.
40. Discuss in detail about Chronic suppurative osteomyelitis (sources of infection, course with special
reference to Brodies abscess).

MDSC 3313 Applied Para-Clinical Sciences III 2014/15

Tumours of bone
41. Classify bone tumours. Explain the significance of age, location and radiological findings in the study of
bone tumours.
42. Describe the common bone tumours: Aetiology, clinical features, morphology and prognosis.
43. Study the specimen and histology of the bone tumour in the pathology museum.

III Lymph Node Pathology

44. Classify and discuss the clinical features, morphology, staging and prognosis of Hodgkins Lymphoma.
45. Outline the most recent classification of Non-Hodgkins Lymphoma.

Endocrine System
46. List the causes of hyperpituitarism and hypopituitarism.
47. Classify the different types of pituitary adenoma and know the morphology of adenomas of the
pituitary.
48. Describe the clinical features, general and specific, of pituitary adenomas.
49. Outline the main causes of hyperthyroidism, including Graves disease.
50. Discuss the pathogenesis, clinical features and extra-thyroidal manifestations of Graves disease.
51. Describe briefly morphology of the thyroid gland in Graves disease.
52. Describe the aetiology, epidemiology and morphology of goitre.
53. List the various types of thyroiditis.
54. Outline the causes and clinical features of hypothyroidism.
55. Describe the pathogenesis, morphology and complication of Hashimotos thyroiditis. Know the
pathogenesis and complications of Hashimotos thyroiditis.
56. Classify the benign and malignant neoplasms of the thyroid. Describe the morphology of follicular
adenoma and the four main carcinomas of the thyroid and describe how the various cancers spread
beyond the thyroid.
57. List the causes of hyper- and hypoparathyroidism, including the morphology of parathyroid hyperplasia
and parathyroid adenoma.
58. Outline the causes of adrenocortical dysfunction including adrenal atrophy, Cushings syndrome,
Addisons disease and Conns syndrome.
59. Describe the morphology, clinical features and complications of Cushings syndrome. Know the
morphology of the adrenals in Cushings syndrome.
60. Describe the morphology of adrenal neoplasms including adrenocortical carcinoma,
pheochromocytoma and neuroblastoma.
61. Classify different types of congenital adrenal hyperplasia.
62. Discuss in detail about Multiple Endocrine Neoplasia (MEN) syndromes.
63. Describe the morphology of the kidney in diabetes mellitus (diabetic nephropathy) and the
complications resulting from these changes.

CHEMICAL PATHOLOGY
1. Review lipid and lipoprotein metabolism.
2. Discuss the pattern of plasma lipid and lipoprotein in atherosclerosis.
3. Discuss the cholesterol transport capacities of HDL and LDL in relation to heart disease.

MDSC 3313 Applied Para-Clinical Sciences III 2014/15

4. Discuss the approach to management of hypercalcemia.
5. Describe the blood brain barrier and the circulation of CSF.
6. Discuss normal and abnormal constituents of CSF in disease states, viral, bacterial meningitis, trauma,
SAH subarachnoid bleed, spinal tumours
7. List causes of xanthochromia.
8. List precautions taken when doing a lumbar puncture.
9. Review of structure and function of bone
10. Explain the biochemical changes in bone disease osteoporosis, multiple myeloma, Pagets disease,
osteomalacia, rickets
11. Describe the hypothalamus-pituitary-thyroid axis.
12. Discuss the importance of iodine in the pathogenesis of thyroid diseases.
13. Explain the difference between hyperthyroidism and T3-toxicosis.
14. Discuss thyroid function tests.
15. List the hormones of the hypothalamus and pituitary glands.
16. Explain the biochemical changes in Hypopituitarism.
17. Explain the control of pituitary hormone secretion.
18. Review of endocrine control.
19. Describe functional test of disturbance of hormone secretion.
20. Describe the synthesis and regulation of thyroid hormones.
21. Explain Thyroid function test.
22. Explain Hyper and Hypothyroidism.
23. Describe the synthesis, regulation and metabolism of hormones of the adrenal cortex and medulla.
24. Explain the biochemical abnormalities in disorders of adrenal cortex Cushings Syndrome, Addisons
Disease, Hyperaldosteronism.
25. Explain the use of tumour markers.
26. Describe the following, carcinoid tumours, pheochromocytoma, neuroblastoma.
27. Describe the various types of tumour markers hormones, enzymes, proteins and amines.

HAEMATOLOGY
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Review normal haemopoiesis

Review the normal haemoglobin for age and sex.
Outline the main causes of erythrocytosis under the headings primary and secondary causes.
List the important points in the clinical history, examination and investigation of erythrocytosis.
Discuss the diagnosis of Polycythemia Rubra Vera.
Discuss the Chronic myeloproliferative disorders
Describe the causes of thrombocytopenia under the headings: impaired production, increased
consumption/destruction.
Define pancytopenia. Describe the causes under the headings

a) bone marrow problem

b) peripheral problem.
Discuss oncogenesis
Define clonality.
Discuss the risk factors, clinical presentation, complications and prognostic indicators in acute leukemia
Discuss the laboratory investigations involved in the diagnosis of acute leukemia.
Describe the diagnostic criteria and clinical staging for multiple myeloma.

MDSC 3313 Applied Para-Clinical Sciences III 2014/15

14. Describe the basis for rouleaux formation and a raised ESR in myeloma.
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Discuss the value of Beta () 2 microglobulin in managing a patient with multiple myeloma.
Describe the morphologic changes seen in the bone marrow in a patient with multiple myeloma.
Discuss the clinical presentation and complications and prognostic indicators of multiple myeloma.
Define amyloidosis. Discuss the causes, diagnosis and complications of amyloidosis.
Discuss the approach to management of hypercalcaemia in patient with myeloma.
Discuss the differential diagnosis of lymphadenopathy.
Describe the features in the clinical examination which would distinguish between an infective/reactive
cause and a malignant cause of lymphadenopathy.
Differentiate between Hodgkin and Non Hodgkin lymphoma
Outline the clinical staging system for lymphoma.
Discuss the value of non specific tests like the ESR and LDH in lymphoma evaluation.
List the different treatment modalities in haematological malignancies
Discuss the principles and complications of a) chemotherapy, b) radiotherapy in treating haematologic
malignancies.
Discuss the haematologic manifestations of systemic disease.

27.

IMMUNOLOGY
1. Define the following terms: autologous grafting; isogeneic grafting; allogeneic grafting; heterologous or
xenogeneic grafting, human leukocyte antigens; haplotype.
2. List the different tissues and organs that have been successfully transplanted between humans
3. Discuss the rational for HLA typing of donor and recipient prior to organ and/or bone marrow
transplantation.
4. Outline some of the techniques used in HLA typing and the determination of the best graft for a
recipient.
5. Discuss the immunopathogenesis of hyperacute, acute and chronic graft rejection. State the ways in
which graft rejection can be prevented and treated
6. Outline the immunopathogenesis and major clinical features of graft versus host disease as seen in
bone marrow transplantation

7. Describe the immunopathogenesis, clinical features and laboratory diagnosis of Hashimotos thyroiditis,
Graves disease and primary myxoedema,
8. Compare and contrast with examples active and passive forms of immunity,
9. Explain the aims of immunization and discuss with examples the advantages and disadvantages of the
following types of vaccines; whole killed organisms, live attenuated organisms, inactivated toxin
(toxoid) vaccines, subunit vaccines, and recombinant vaccines.
10. Outline the role of adjuvants and give examples of commonly used adjuvants.
11. Outline the recommended immunization schedule for infants and children in Trinidad and Tobago.
12. Outline the immunization requirements for the following groups of persons; Healthcare workers,
elderly patients over 65 years of age, persons with chronic lung and heart disease, animal workers,
asplenic patients, young persons living in institutions.
13. Outline the rationale for limited immunization, if any, in immunocompromised patients.

MDSC 3313 Applied Para-Clinical Sciences III 2014/15

MICROBIOLOGY

Diphtheria - Corynebacterium diphtheriae
1. Discuss the morphology and identification of Corynebacterium diphtheriae.
2. Outline the pathogenesis, pathology and clinical findings in diphtheria infection.
3. Discuss the diagnostic laboratory tests and cite the special culture conditions required for the isolation
of Corynebacterium diphtheriae from clinical material.
4. Outline the treatment of diphtheric infection.
5. Discuss the epidemiology, prevention & control of diphtheria..

Meningitis - Neisseria meningitidis
6. Discuss the aetiology of meningoencephalitis.
7. Discuss the morphology and identification of Neisseriae meningitidis.
8. Outline the pathogenesis, pathology and clinical findings in Neisseriae meningitidis infection.
9. Discuss the diagnostic laboratory tests required for the isolation of Neisseriae meningitidis from clinical
material.
10. Outline the treatment of Neisseriae meningitidis infection.
11. Discuss the epidemiology, prevention & control of meningitis.

Tetanus & Botulism - Clostridium tetani & Clostridium botulinum
12. Discuss the morphology and identification of clostridium species.
13. Outline the pathogenesis, pathology and clinical findings of Clostridium tetani.
14. Outline the diagnosis of tetanus and discuss the prevention, treatment & control of tetanus.
15. Describe the pathogenesis and clinical findings in of Clostridium botulinum.
16. Outline the diagnostic laboratory tests for Clostridium botulinum.
17. Outline the treatment of botulism and discuss the epidemiology, prevention & control.

Rabies:
18. Recognise the structural properties, classification, replication, growth and antigenic properties of rabies
virus.
19. Describe pathogenesis, pathology and clinical findings of rabies.
20. Outline the lab diagnosis and treatment of rabies.
21. Discuss the immunity, prevention & epidemiology of rabies.

Arthropod-Borne (Arbo) viral infection:
22. Recognise the properties, classification and antigenic properties of arbovirus.
23. Describe pathogenesis, pathology and clinical findings of arthropod-borne & rodent-borne viral
diseases.
24. Outline the lab diagnosis and treatment of rabies.
25. Discuss the immunity, prevention & epidemiology of rabies.
26. Outline the Arbovirus Host-vector transmission cycles & treatment and control.
27. Describe the pathogenesis, pathology & clinical findings of Yellow fever.
28. Discuss the lab diagnosis of yellow fever.
29. Outline the treatment, prevention & control of yellow fever.

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30. Discuss the clinical findings, lab diagnosis and treatment of Dengue (break bone fever).
31. Discuss the clinical findings, lab diagnosis and treatment of Chikungunya virus.
32. Compare and contrast Dengue fever virus and Chikungunya virus infections.
33. Discuss the sandfly fever.
34. Discuss the Rodent-borne hemorrhagic fevers.

Herpes viral infection:
35. Discuss the properties, classification & replication of Herpes virus.
36. Describe pathogenesis, pathology, clinical findings, lab diagnosis, epidemiology, treatment and
prevention of Herpes simplex virus.
37. Describe pathogenesis, pathology, clinical findings, lab diagnosis, epidemiology, treatment and
prevention of Varicella Zoster virus.
38. Describe pathogenesis, pathology, clinical findings, lab diagnosis, epidemiology, treatment and
prevention of Cytomegalovirus.
39. Describe pathogenesis, pathology, clinical findings, lab diagnosis, epidemiology, treatment and
prevention of Epstein- Barr virus.

Bone & joint Infections:
40. Discuss the aetiopathogenesis, clinical features and laboratory diagnosis and treatment of Infectious
(Septic) Arthritis, Osteomyelitis and Infections associated with Prostheses of Bones and Joints
(Staphylococci, streptococci, Micrococci & Enterococci).

Congenital infection:
41. Discuss the aetiopathogenesis, clinical findings and laboratory diagnosis and treatment of congenitally
acquired infections.

Anaerobic & nosocomial infection:
42. Understand anaerobic bacteria including their sensitivity to oxygen and where they may be found in the
environment and the human body.
43. Describe how anaerobes, as part of endogenous microbiota, initiate and establish infection.
44. Name the endogenous anaerobes commonly involved in human infection and their lab diagnosis with
special reference to specimens that are acceptable and unacceptable for anaerobic culture.
45. Discuss the clinical symptoms suggestive of anaerobic infections.
46. List the principal sites and forms of Anaerobic infection.
47. List anaerobic pathogens, their specific virulent factors and pathogenesis.
48. List specific anaerobic infections, their epidemiology and clinical features.
49. Discuss the predisposing factors of Actinomycosis infections.
50. Discuss the laboratory diagnosis, treatment, prognosis and prevention of specific anaerobic infections.
51. Discuss the treatment, complications and prognosis of Clostridium tetani, Clostridium botulinum and
Clostridium difficile associated diarrhoeal infections.
52. Know the epidemiology of nosocomial infections.
53. Discuss the various modes of transmission of nosocomial infections.
54. Outline the strategies to prevent and control the nosocomial infections.
55. Discuss the lab diagnosis and treatment strategy of nosocomial infections.

MDSC 3313 Applied Para-Clinical Sciences III 2014/15

Tissue parasites:
56. Enlist the tissue parasites, their morphology, life cycle, pathogenesis, clinical manifestation, lab diagnosis,
treatment and prevention of tissue parasites.
57. Discuss the classification of the tissue parasites of medical importance to man.
58. Describe the life cycle, pathogenesis and clinical manifestation of specific parasites e.g. Onchocerca
volvulus, Trypanosoma cruzi, Loa Loa, Toxoplasmosis gondii, Toxocara canis, Taenia solium, Drancunculus
medinensis, Trichinella spiralis, Angiostrogylus cantonensis.
59. Discuss the lab diagnosis, treatment and prevention of tissue parasites.

Fever of unknown origin:
60. Describe the aetiology, pathogenesis, lab diagnosis, and treatment of pyrexia of unknown origin. Know
the prevention of PUO.
61. Describe the Major subtypes of PUO.
62. Discuss the main aetiological categories of PUO.
63. Describe the characteristics of these aetiological categories definitions, location, main clinical features
in terms of symptoms and signs
64. Describe the major investigations in identify the subtypes of PUO.
65. Describe the treatment and preventive measures of PUO.


PHARMACOLOGY

Drugs used in the treatment of schizophrenia (Neuroleptics)
1. Recognise, in clinical case study problems the main diagnostic criteria of schizophrenia.
2. Describe the dopamine theory of schizophrenia, data supporting and refuting.
3. Describe dopamine, how it is synthesized and the various dopaminergic pathways.
4. Describe the serotonin theory of schizophrenia, data supporting and refuting.
5. Describe serotonin, how it is synthesized and the various serotonergic pathways.
6. Recognise differences between typical and atypical antipsychotics in clinical case study problems
particularly with regard to strength of binding to dopamine and serotonin receptors and adverse effects.
7. When choosing an antipsychotic drug what are the implications of these being high or low potency
antipsychotics.
8. Recognise signs and symptoms of extrapyramidal side effects (acute and chronic) and explain how
antipsychotic drugs may lead to their appearance.
9. Explain the pharmacological basis for the treatment of antipsychotic-induced acute and chronic
extrapyramidal side effects.
10. When prophylactic treatment for extrapyramidal side effects should be considered and what are the
medications available?
11. Describe the neuroleptic malignant syndrome and how it should be managed.
12. Recognise other relevant typical antipsychotic side effects in clinical case study problems including
seizures, galactorrhea and oligomenorrhea, weight gain, and effects on sexual function and explain their
occurrence based on their effects mediated by different receptors types.

MDSC 3313 Applied Para-Clinical Sciences III 2014/15

13. Choose atypical antipsychotics in clinical case study problems based on strength of binding to dopamine,
serotonin and autonomic receptors and their relation to adverse effects.
14. Describe the effects of clozapine and olanzapine on glucose and triglyceride levels.
15. State the routes of administration of antipsychotic drugs.

Drugs used in the treatment of Parkinsons Disease
16. Describe the negrostriatal pathway and explain the interplay of neurotransmitters in the extrapyramidal
control of motion.
17. Explain how degeneration of the nigrostriatal pathway results in Parkinsonism.
18. Recognise signs and symptoms of Parkinsons Disease in clinical case study problems.
19. Based on the knowledge of the synthesis of dopamine explain how levodopa works to relieve the
symptoms in Parkinsonism.
20. Explain the basis for the pharmacological advantage of L-DOPA administration vs. dopamine
administration.
21. Explain the rationale for the addition of carbidopa and benseraside to levodopa.
22. Explain the nature of the drug interaction between L-DOPA and vitamin B6. Discuss other clinically
relevant drug interactions with levodopa.
23. Explain why may the best therapeutic results with L-DOPA be obtainable often during the first few years
of treatment (honey moon period).
24. Recognise clinical manifestations of dyskinesias during the wearing of and the on off fluctuations in
clinical case study problems. Explain the rationale for the addition of entacapone to carbidopa and
levodopa in the management of the wearing of fluctuation.
25. Based on the knowledge of the different dopamine receptor subtypes and their locations explain the
actions of dopamine receptor agonists.
26. What are the advantages and disadvantages of dopamine receptor agonists compared to levodopa in
the treatment of Parkinsons Disease.
27. Recognise signs and symptoms of dopamine receptor agonists in clinical case study problems and
explain their occurrence based on the effects mediated by the dopamine receptors with whom they
interact.
28. Explain the role of the centrally active anticholinergic drugs in the treatment of Parkinsons Disease and
describe how do they exert their actions.
29. In clinical case study problems Recognise signs and symptoms of anticholinergic side effects and identify
contraindications to their use.
30. Explain the role of the monoamine oxidase B inhibitor (MAOB) selegiline in the therapy of Parkinsons
Disease?
31. Explain the role of apomorphine in the treatment of Parkinsons Disease.
32. What drug classes may induce Parkinsonism?

Drugs used in the treatment of thyroid disorders
33. Recognise, in clinical case study problems, signs and symptoms of the most common thyroid
dysfunctions and explain the physiological basis of their appearance.
34. Explain the mechanism of action of antithyroid drugs based on your knowledge of thyroid hormone
biosynthesis
35. Recognise when to use antithyroid drugs.

MDSC 3313 Applied Para-Clinical Sciences III 2014/15

36. Recognise, in clinical case study problems, signs and symptoms of the most relevant side effects of
thioamide drugs and how to correct it.
37. Identify reasons for therapy failure with thioamide drugs in clinical case study problems
38. Know what advice to give a patient before and after receiving treatment with radioactive iodide
39. Know when to contraindicate the use of radioactive iodine
40. Recognise what are the signs and symptoms that are improved by propranolol and why.
41. Recognise signs and symptoms of thyroid storm
42. Identify events that may trigger a thyroid storm and how to avoid it.
43. Explain how to treat a thyroid storm and the pharmacological rational for choosing the drugs and their
sequence of administration (include the explanation about when iodides should be given in a thyroid
storm as well as the reason for its use before a thyroidectomy)
44. Recognise signs and symptoms of iodide toxicity and how to avoid it.
45. Know when to contraindicate the use of iodide
46. Apply your knowledge of the thyroid-pituitary relationships, thyroid gland autoregulation and thyroid
hormones biological half-life to monitor thyroid replacement hormone therapy.
47. Identify in clinical case study problems conditions that may affect thyroid hormone replacement therapy
efficiency.
48. Explain why levothyroxine is the drug of choice to treat hypothyroidism.
49. Know the route of administration of thyroid and antithyroid drugs.

Antiseizure Drugs
50. Differentiate a seizure from epilepsy.
51. Recognise, in clinical case study problems, the various clinical types of epilepsy.
52. Discuss the events that lead to the onset of a seizure.
53. Explain the basic mechanisms underlying seizures and epilepsy as well as how they relate to the
mechanisms of action of the different classes of antiseizure drugs.
54. Choose the drugs of choice according to the different types of seizures.
55. Describe and explain the clinical relevance of phenytoin metabolism.
56. Recognise in clinical case studies, potential drug interactions with antiseizure drugs.
57. Recognise in clinical case studies, signs and symptoms of antiseizure side effects.
58. Describe principles of antiepileptic drugs therapy indicating the role of therapeutic drug monitoring in
the management of epilepsy.
59. Discuss the pharmacokinetic changes of antiepileptic drugs during pregnancy, risks of having a seizure
during pregnancy versus risk of antiepileptic drug use during pregnancy.
60. Discuss the role of phenytoin, carbamazepine and valproate in conditions other than epilepsy.

Antidepressant Drugs
61. Describe the most common therapeutic indication for antidepressant drugs.
62. List the toxic effects that occur during chronic therapy and with an acute overdose of tricyclic
antidepressants.
63. Identify the selective serotonin reuptake inhibitors, list their major characteristics, and explain how they
differ from the tricyclics in mechanism of action.
64. Describe the major drug interactions associated with SSRIs.

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65. List two of the commonly prescribed dual mechanism designer antidepressants & explain how they
differ from SSRIs in terms of side effects & indications.
66. List the primary indication for MAOIs in treating depression, their side effects and their predicted drug
interactions.
67. Discuss the speed of onset of antidepressant effect that occurs after initiating drug therapy in relation to
the onset of their effects on neurotransmitter levels.
68. Discuss the indications, primary mechanism of action & side effects/toxicity for lithium in the treatment
of mood disorders.

Anoxiolytic Drugs
69. Describe the stages of CNS depression.
70. Recognise the differences between sedation, hypnosis, anesthesia and anxiolysis.
71. Explain the rationale of barbiturates classification based on their duration of action.
72. Understand the concept of physical redistribution as it pertains to the action of barbiturates.
73. Understand the concept of endogenous benzodiazepines.
74. Explain the cellular mechanisms by which benzodiazepines & barbiturates exert their sedative-hypnotic
effects.
75. Describe the differences in the dose-depression relationships for benzodiazepines and barbiturates.
76. Recognise the advantages and disadvantages of each class relative to the others.
77. Recognise and explain the effects of these agents on the cardiovascular, respiratory and central nervous
systems.
78. Describe the major clinical indications, side effects & toxicity for the benzodiazepines & barbiturates.
79. Explain the distinctive properties of buspirone, zolpidem & zaleplon.