biomedical science

BIOMEDICAL SCIENCE

Prof Agus BagiadaBMS team leader

Learning outcomes

1. Define medical and allied sciences2. Clarify the relationship between medical

competency and the contribution of medical and allied sciences, professional skills and attitude.

Enabling outcomes

1. Be able to knows what is BS2. Be able to describe that BS is concerned to

integration of a wide range of subject to understand the biology of disease.

3. Be able to describe the role of BS as science of causes, diagnoses and treatment of disease.

Lecture

• Introduction: including enabling outcomes 1 and 2

• The role of BS in supporting to know the causes, diagnose and treatment of diseases scientifically (Anatomi/Histology, Biochemistry, Physiology and Farmacy/Pharmacology) (Enabling outcomes 3)

Learning activities

1. Lecture (presented by one of the team members) All lecturers in the team are order to make an abstract of their lecture (no more than 2 pages), completed by essential reference (learning resources), and learning task, in order to support the role of each department as the part of BS team.

2. SGD (Learning task and cases discussion )3. Plenary session

Learning taskCase for discussed.

1. 55 years woman visited her family physician , complain chest pain in left part oh her chest, specially when she exercised. She is also complain lost her weight more than 8 kg in a month. She eat and drink more than usual. On laboratory examination found FBS 150 mg%, lipid profile increase (total cholesterol 240 mg%, LDL chol 200 mg%, HDL chol 175 mg% and tri glyceride 300 mg% blood pressure 150/90 mmHg. Her family doctor diagnose as DM with hypertension and hyperlipidemiea with TIA. Her doctor treat her with glycasid, for DM, captopril and statin for hypertention and dislipidemia.

Learning task

1. Where is the normal location of the heart in our body; heart border; What is heart rate and heart function.

2. Why does she lost her body weight, while she eat and drink more than usual.

3. Are the Laboratory finding is normal?. If not where are the disorder.

4. Are sign and symptom lead you to diagnose the disease. What it is ?

5.

Introduction Medical curriculum in Udayana Fac of Medicine. 1. Traditional C, Depart. Based approach C (preclinical

and clinical years) Criticized – lacking in the skill and attitude required to practice their profession.

2. In the response of these challenges Out come-based C for biomedical sciences

3. After introduction of “National Competency-Based C for the primary Care Physician” The New integrated Competency based undergraduate C”.

BMS

• BMS is concerned with the integration of a wide range of subjects to understand the biology of disease.

• Biology in this sense means predominantly anatomy/histology, physiology, biochemistry, genetic, immunology, microbiology, pharmacology and molecular biology related to human disease

• More specific knowledge of disease process comes from the study of specialized biology : cellular pathology, clinical biochemistry, clinical immunology, medical microbiology, hematology, transfusion science .

• This enables a BM scientist to understand the science of causes, diagnosis and treatment of disease.

• Clinical sciences is the science you need in your private practice to diagnose and treated and preventions of patients problem through history of disease/anamnesis, and physical examination.

• Its have to be support by BMS and allied sciences.

Allied sciences

• Sciences which is important in supporting the management of preventing, diagnosis and treatment of disease.

• Together with BMS and clinical sciences, physician will manage the disease holistically and scientifically

• Example : communication, psychological science and other behavioral sciences.

Characteristic of BMSThe important characteristic of BMS:1. Always change life long education2. Tights inter relationship one another3. Are always in the forefront of modern science

rapidly evolving subject and highly relevant to investigating and understanding current controversies.

4. Tight relationship to clinical and allied sciences on solving medical cases

5. Graduate will have a wide range of employment.

Advantages of learning BMS

• BMS involve a multidisciplinary approach to the study of human disease.

• Graduates must have knowledge of how disease develop and how they affect the normal function of the human body.

• They will have awareness of the development of new methods for diagnosis, treatment and prevention of disease.

Attributes of Graduates

Think creatively and critically.Able to problem-solve.Communicate effectively.Have professional conduct.Able to work in teams.Understand how scientific research is conducted, applied, and funded.

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Case study• A forty years old patient attend his family doctor with

complain of reduce body weight in six month later. She has drinking a lot of water, but also pass a lot of water. His appetite increase. He is also complaining about head ache. On the laboratory examination found, fasting blood sugar 180 mg%, and 300 mg% 2 hours after meal. Keton bodies of urine increase and HbA-1c = 7.5 His blood pressure 170/100 mmHg.He is also complain palpitation especially when exercise His doctor diagnosed him as Diabetic and hypertension. The doctor cured him with gliclazide for his diabetic and Captopril for his hypertension and medicine for her heart.

• Please learned the case by yourself (independent learning) using interdisciplinary approach of BMS

• Secondly discussed on your SGD. Use the learning tasks as guide lines on your discussion. Debate if there are any difference opinion in solving the problem.

• Finally report the result of your SGD in plenary session.

1.Here is the normal value of fasting blood sugara. 45 mg%b. 80 -120 mg% by glucose oxidase technique.c. 60 – 100 mg% by o-Toluidin techniqued. 170 mg%e. all above are wrong

• 2. Patient with high blood pressure (170 mmHg). Its might be cause by, except: a. increase of peripheral resistance b. hypercholesterolemiac. hyperlipidemiad. hyperproteinemiae. all above are right

3.Normal urine volume in 24 hours of human being is:a. 400 mlb. 170 mlc. 1440 mld. 2500 mle. More than 2500 ml

4. HbA-1C isa. Conjugated Hbb. Oxidize Hbc. Glicated Hbd. Reduce Hbe. Mutated Hb

BIOCHEMICAL VIEWOF BMS

Biochemical view of BMS

1. Metabolism of CH, Lipid, protein and xenobiotic

2. Energy production

3. Normal value of body chemistry

Metabolism.

• Metabolism is all enzymatic reaction that occur in the cells

• Divided into 2 catagories anabolism and catabolism

• Anabolism is energy required reaction• Catabolism is energy yielding reaction

• Metabolism of Carbohydrate including:glycolysisconversion of pyruvate to acetyl CO-AKreb-cycle/TCA cycleOxidation phosphorylationEnergy production

• Lipid metabolism• Lipid break to glycerol and fatty acid• Fatty acid beta, alpha and omega oxidation

to produce acetyl-CoA Kreb cycle Oxidation phosphoryration energy.

• Protein amino acid. (glucogenic, ketogenic, gluco-ketogenic) Kreb cycle Oxid phosp energy

Overview of Metabolism

acetyl-CoA

pyruvate ATP

ADP + Pi

polysaccharides

hexosespentoses

ADP + Pi

ATP

ADP + Pi

ATP

ADP + Pi

ATPATP

ADP + Pi

ADP + Pi

ATP

lipids

fatty acids

ATP

ADP + Pi

protein

amino acids

citric acidcycle

ureacycle ATP

ADP + Pi

urea

CO2

electron transportchain

oxidative phosphorylation

O2

ATP

e-

Energy yielding in catabolism

• Catabolism of C-H, lipids, aa to a simpler end-product such as CO2, H2O and amonia is accompanied by the synthesis of ATP.

• ATP is utilized for various cellular functions such as :

• synthesis of protein,RNA,DNA for growth, adaptation and repair,• synthesis of fat and glycogen,• performance of mechanical work,• active ion transport, • absorptions of nutrients against the gradient.

Eat to Live!

Live to Eat!

“EAT TO LIVE”

Intake = Expenditure

Weight Stable

“LIVE TO EAT”

Intake > Expenditure

Obese

Normal value of body biochemistry

• Glucose 60-100 mg% (o-toluidin)• Protein 6-8 gr% (A/G ratio 1,2/1)• Total cholesterol, LDL, HDL, Triglyceride• Urine 24 hours about 1500 cc• Specific gravity 1.003-1030• Total solid in urine last two decimal x

Koeficient Long