Rajiv Gandhi University of Health Sciences, Karnataka

CLINICAL MICROBIOLOGY 80 Hours

1. General aspects.

The investigation of biological samples in infectious diseases is different from the other branches in that it requires general knowledge of pathogenic agents (bacteria or viruses) and of host reaction.

1.1 Definition of infection and infectious disease: natural bacteriological ecosystem.

1.2 Pathogenicity of bacteria and viruses.

1.3 General epidemiology of infection and infectious diseases.

1.4 Sterilization & Disinfection

1.5 Culture media and preparation

1.6 Bacteriology of Milk, Water and Air

2. Diagnostic procedures.

2.1 Specimen selection and collection (blood, urine, sputum, faeces, others).

2.2 Specimen processing: smears, staining, cultures including cell cultures, susceptibility testing, antigen detection.

2.3 Preservation of cultures

2.4 Usual techniques for microbe and virus identification (including principal differential characteristics).

2.5 Molecular biology techniques for characterization of microbes and viral agents.

2.6 Bacteriological and viral serology.

3. Bacterial and viruses.

Succinct description of responsible bacterial and viruses in bacteriological and viral syndromes or diseases (including principal differential characteristics).

3.1 Bacterial: Neisseria gonorrhoeae and N. meningitidis, Staphylococcus aureus, Coagulase Negative Staphylococcus, Streptococcus pyogenes (especially S. agalactiae and S. pneumonia), Escherichia coli, Salmonella, Shigella and other Enterobacteriaceae,

Vibrio cholerae, Pseudomonas aeruginosa, Haemophilus influenzae, Clostridium perfringens, C. tetani, Bacteroides spp, Lister monocytogenes, Legionella, Mycobacterium tuberculosis and others, Treponema pallidum, Chlamydia, Mycoplasma, etc.Corynebacterium diphtheriae, Bacillus anthracis, B.cereus, Non sporing Anaerobes, Bordetella, Brucella, Yersinia, Actinomyces, Pasteurella, Franciesella,

3.2 Viruses: herpes (herpes simplex, herpes varicellae, cytomegalovirus, Epstein Barr virus); hepatitis A, B, C, D, E; human immunodeficiency virus; enteroviruses (poliovirus); rubella, mumps, measles, parvovirus B19, RSV, myxovirus, rhinovirus, coronavirus, adenovirus, rotavirus, papillomavirus, rabies, Arboviruses, Poxviruses, Oncogenic Viruses,etc.

4. Antibiotics and antiviral agents

5.1 Basic knowledge of antibiotics and antimicrobial therapy.

5.2 Antibiotic and antiviral sensitivity test.

5.3 Antibiotic and antiviral resistant mechanisms.


Medical Parasitology & Mycology

5. Epidemiology, main clinical signs, basis for biological diagnosis (including a succinct description of parasites and fungi without biochemical characteristics),treatment.

5.1 Amoebiasis: Entamoeba histolytica.

5.2 Giardsis, cryptosporidiosis and uro-genital trichomoniases.

5.3 Malaria.

5.4 Toxoplasmosis.

5.5 Intestinal, hepatic and urinary helminthiasis: strongyloidiasis, ancylostomiasis, enterobiasis, ascariasis, schistosomiasis (Schistosoma mansoni and S haematobium), fascioliasis (Fasciola hepatica) and taeniasis (Taenia saginata).

5.6 Fungal infections (Candida albicans, Cryptococcus neoformans, etc.).

5.7 Aspergillus infections (Aspergillus fumigatus).

5.8 Dermatophyte infections (Microsporum canis, Epidermophyton

floccosum, Trichophyton rubrum, Trichophyton mentagrophytes).

5.9 Leishmaniosis.

5.10 Echinococcosis.

5.11 Pneumocystosis.

5.12 Filariasis.

5.13 Leptospirosis

6. Usual techniques for parasite and fungus identification.

7. 
   Immunological and molecular diagnosis of parasitic and mycological diseases.
   

8. Bio-Medical waste: Types, potential risks and their safe management.

MICROBIOLOGY PRACTICALS 100 Hours

1. Collection of clinical materials like blood, urine, stool, sputum,

swabs, CSF etc.

2. Parasitology - collection, preservation and transportation of faecal material for examination of parasites. Concentration techniques of stool for ova and cyst. Wet preparation of faecal sample for ova and cyst. Identification of ova and cyst in stool sample.

3. Procedure of techniques of sputum for AFB.

4. Procedure of skin clipping of Leprae Bacilli.

5. Identification of organisms with Biochemical reactions of common organism like - Staphylococus, E.coli - Klebsiella, shigella, Salmonella, Proteus, Pseudomonas.

6. Antibiotic Sensitivity tests

7. Preservation of stock culture

8. Bacteriology of water

9. Collection of specimen for fungal examination like skin scrapings, swabs, CSF.

10. Fungal examination by wet preparation

11. Fungal culture

12. ELISA HIV & HBsAg test (Demonstration only)

13. Western blot test ( Demonstration Only)

14. Incubation of fertile eggs and inoculation by various routes. (Demonstration only)

Section B:-IMMUNOLOGY AND MOLECULAR BIOLOGY
IMMUNOLOGY 40 Hours
Immune System
Basic immunology

A. Characteristics of the Immune System

1. Define CD antigens.

2. Define primary and secondary lymphoid tissues.

3. Define mucosal-associated lymphoid tissues.

3.1 oral

3.2 nasopharyngeal

3.3 gut-associated

3.4 reproductive

4. Describe blood-lymph circulation and lymphatics.

5. Organization of lymph nodes

5.1 Explain hematopoietic cell distribution in lymph nodes.

5.2 Provide examples and locations of lymph nodes in head and neck.

Innate and Adaptive Immunity

1. Define concepts of specificity and memory.

2. Describe basic properties of innate immune cells.

3. Describe basic properties of adaptive immune cells.

Physiochemical properties of innate immunity

1. Physiological barriers

2. Anatomical barriers

3. Phagocytic/endocytic barriers

4. Inflammatory barriers
Adaptive Immunity

1. Define humoral immunity.

2. Define cell-mediated immunity.

3. Define T cells, T cell subsets, B cells, and plasma cells.

Antigens and Immunogens

1. Define antigen and immunogen.

2. Define relative antigenicity of macromolecules.

3. Define and give example of antigenic determinants and epitopes.

4. List types of antigens with examples.

5. Define ‘Hapten’ and explain how they function in the immune system

Immunoglobulins (Igs)/Antibodies (Abs):

1. source from B cells and plasma cells

2. B cell/antibody/specificity relationship

3. Describe structure of immunoglobulins:

3.1. Molecular components of Igs

3.2 heavy and light chains

3.3 variable and constant regions

3.4 Define allotype, isotype, idiotype.

Classification of immunoglobulins

1. Explain differences based on heavy and light chains.

2. Describe functional properties of Ig classes.

3. Describe evidence for number of antigenic determinants recognized by Igs.

T cells

1. Describe classification of T cells (Th1, Th2, αβ and γδ T cells).

2. Compare and contrast molecular and cellular features of T cell receptor (TCR) to B cells receptor (Ig molecule).

3. Describe development of T cells in the thymus.

4. Describe the genes’ rearrangement in TCR development.

5. T cell-associated molecule - the TCR complex

5.1 CD3 molecules

5.2 T cell signaling by CD3

6. Define αβ and γδ T cells, including

6.1 tissue distribution

6.2 differential functions of αβ and γδ T cell.
The Complement System

1. Define the complement system and describe when and how it is used.

2. Provide step-by-step examples of how complement works:

2.1 the classical complement pathway

2.2 the alternate complement pathway

3. List representative infectious agents and products that activate complement.

4. Describe biological effects mediated by complement.

5. Describe the effects of complement on the immune system.

6. Describe the significance of complement at oral mucosal surfaces.
Antigen Processing and Presentation

1. Describe use as a function of T cell activation.

2. Describe cells involved in antigen processing and presentation.
The Major Histocompatibility Complex (MHC)

1. Describe gene nomenclature for MHC antigens.

2. List the numbers of human MHC genes.

3. Explain the tissue distribution of MHC antigens.

4. Describe the structure of MHC Class-I and Class-II molecules.

5. Describe, with examples, how peptide antigens are processed.

Cell-Mediated Immunity (CMI)

1. Describe the cells involved in CMI and the role played in the immune response.

2. Describe the mechanisms of tissue cell destruction by T cells.

3. Describe concept of ‘Memory T Cell’.

4. Define Natural Killer (NK) cell.

5. Define ‘Super Antigen’ and give examples in disease.

Bio-Medical waste: Types, potential risks and their safe management.

IMMUNOLOGY PRACTICALS 40 Hours

1. 
   VDRL Tests
   
2. 
   Brucella Agglutination test
   
3. 
   Weil felix test (Demonstration only)
   
3. 
   Paul Bunnel test (Demonstration only)
   
4. 
   RA test
   
5. 
   CRP test
   
6. 
   TPHA
   
7. 
   ELISA
   
8. 
   ASLO
   
9. 
   WIDAL
   

MOLECULAR BIOLOGY

MOLECULAR BIOLOGY 40 Hours

1. DNA: the support of hereditary information

Structure, types, coiling and supercoiling, topoisomerases, replication, satellite DNA. Organisation of Prokaryotic and Eukaryotic genome, chromosomes structure, number, sex chromosomes, human karyotype, methods for chromosome analysis, chromosome banding, FISH, CGH, Flow cytometry, Cell cycle, mitosis and meiosis.

2. Transcription and translation factors involved, RNA processing, types of RNA, genetic code, Lac operon, Tryptophan operon, regulation in eukaryotes, gene dosage and gene amplification, generation of antibody diversity.
3.Mutation spontaneous, induced, point mutation and silent mutation, frameshift mutation, physical and chemical mutagents, molecular basis, site directed mutagenesis, significance of mutagenesis, DNA repair, isolating mutants, Ames test.
4. Recombinant DNA technology: necessary elements – enzymes and vectors – plasmids, cosmids, bacteriophages, shuttle vectors, expression vectors, construction of rDNA and cloning strategies – various methods, genomic libraries (e.g. using phage vectors), cDNA libraries, introduction of rDNA into host – methods, restriction maps and sequencing.
5. Genetics in medicine: Hemoglobin and hemoglobinopathies, phenylketonuria, alkaptonuria, homocystinuria, Lesch-Nyhan syndrome, genetics of cancer, Down’s syndrome, Di-George syndrome, Kleinfelters syndrome, Turner’s syndrome, hermaphroditism, cystic Fibrosis, hemophilia, prenatal diagnosis of genetic diseases, application of recombinant DNA Technology in medicine – PCR, RFLP, DNA finger printing, therapeutic proteins, vaccines, antibodies, transgenic organisms, gene therapy, human genome project.
MOLECULAR BIOLOGY PRACTICALS 20 Hours
PCR- Side Directed Mutagenesis

DNA Isoltation

DNA Cloning, Bacteriall Transformation and Fusion Protein Purification

(Demonstration only)

Plasmid Analysis by Restriction Digestion and Protein Gel Electrophoresis

DNA Gel Electrophoresis.

SCHEME OF EXAMINATION

Theory: - Their shall be one paper of 3 hrs duration, carrying 100 marks each.

PAPER II:- MICROBIOLOGY-I
Sec A: - Clinical Microbiology -50 marks

Sec B: - Immunology and Molecular Biology -50 marks