DEPARTMENT OF MEDICAL MICROBIOLOGY
ACADEMIC STAFF

S/N NAMES STATUS QUALIFICATIONS
1 Prof. (Mrs.) L. U. Airauhi Professor A/Dip., PGD, M.Sc, Ph.D
2 Dr. E. O. Yusuf Senior Lecturer MBBS, FMCPath, M.Sc.
3 Dr. O. Iyoha Associate Professor MBBS, FMCPath, M.Sc., MPA, NIM
4 Dr. P. V. O. Lofor Senior Lecturer MBBS, FMCPath
5 Dr. I. I. Osaigbovo Lecturer I MBBS, FMCPath, NMA, ASSOPON, ESCMID
LABORATORY STAFF

S/N NAMES STATUS QUALIFICATIONS

  1. P. I. Otaigbe (Mr) Med. Lab. Scientist I AMILT, FMLS,
  2. O. Edogun Med. Lab. Tech. II AMILT
  3. A. Aimufua (Mrs) Lab. Assistant O/L GCE
    ADMINISTRATIVE STAFF

S/N NAMES STATUS QUALIFICATIONS

  1. E.L. Ekhator (Mrs.) Chief data entry personnel B.Sc.
  2. I. E. J. Ogbeide (Mrs.) Administrative Officer B.Sc (Ed), MPA
  3. Mary-Jane Olowu(Mrs.) Administrative Assistant B.Sc
  4. A. Onubogu (Ms.) Executive Officer NCE, B.Sc, (Ed)
  5. O.I. Ediagbonya (Mrs) Higher Executive Officer SSCE, B.Sc.

REVIEWED ACADEMIC CURRICULUM

INTRODUCTION
Medical microbiology is the study of Micro-organisms as agents of human disease. Subspecialties of medical Microbiology include: Bacteriology, Immunology, Mycology, Parasitology and Virology. Medical microbiology provides the scientific basis for understanding health and disease in the practice of Medicine as it relates to infectious diseases. It provides the necessary linkage between the basic services or bench work and clinical approach to the patient.

VISION:
To train and be self-sufficient in medical workforce and to maintain a high quality health care service locally and internationally, with the capacity to cope with rapid technological advances in microbiology and the ability to organize and operate a primary health care medical microbiology laboratory.

MISSION:
To train medical practitioners who are competent to practise independently in any setting and contribute to the health and professional educational need of Nigeria with the capacity to operate the primary health care laboratory services and meet the millennium development goals.

HISTORY:
The Department of Medical Microbiology in University of Benin had its pioneer Head of Department in the person of Prof. Simon Nkeadinma Chukwunwike Wemambu, MD, FMC path, FWACP, Consultant and Professor of Clinical Microbiology, (1931-2010) who with colleagues demonstrated for the first time ever to the medical world that leprosy has an Immunological basis. He transferred his services to UNIBEN in 1974 as Lecturer I and rose to the position of Professor in 1990. He delivered his inaugural lecture titled “leprosy Scourge of ages, whither do we go?” in August 2001. Other Heads of Department since inception include Dr (Mrs). C. I. Emokpare, Prof (Mrs). E. Offor,Dr. P. V. O. Lofor, Dr. E. O. Yusuf and Dr. O. Iyoha (Current Head of Department). Other Academic staff includes Prof. L. U. Airauhi.

GOALS:
To teach the students the principles and practice of Medical Microbiology as ideally practised by the medical officers. The objective is to obtain at the end of the programme a well rounded orientation, clearly defined and ready with relevant concept to apply the student to clinical training. The trainee must be able:
To organize and manage a microbiology laboratory in a primary health care centre including being conversant with the requisite safety procedures of the laboratory.
To learn the basic principles underlying all the laboratory diagnostic techniques as well as practically carry them out.
To undertake accurate statistics and periodic clinical audit in medical microbiology.
To interpret laboratory results and situate them in the appropriate context.
To make diagnosis or summaries based on the results of laboratory tests or procedures to the management of disease processes.
To organize and supervise the primary health care laboratories
To advise on antibiotic use for communicable diseases based on the result of the appropriate laboratory procedures.
Clinical management of infectious diseases
A clear understanding of agents of infectious disease and how it brings about functional changes in cells, tissues and organs is imperative for excellence in research endeavours, diagnostic techniques and therapeutic management of diseases.
The study of Medical Microbiology involves the identification of microscopic and quantifiable changes which characterize any abnormal state observable in patients which is referred to as microbial disease.

SPECIFIC OBJECTIVES:
To produce medical doctors who are able to:
To understand basic taxonomy of agents of infectious disease.
To understand epidemiology and clinical classification of agents of infectious diseases.
To understand the basic disease process with emphasis on etiology and pathogenesis
To become conversant in the terminology used to describe microbial diseases and their characteristics.
To develop an understanding of characteristic morphological patterns for the interpretation of laboratory findings relevant in disease processes, the evolution of these processes and their effect upon the patient in the clinical setting.

COURSE DESCRIPTION:
The three course runs from 2nd semester of 300L to the 2nd semester of 400L. There are five sections; Bacteriology, Immunology, Parasitology and Virology

CURRICULUM
To achieve the departmental objectives undergraduate medical microbiology course is divided into the following section:

INTRODUCTORY POSTING
COURSE CODE: MMB321 16 HRS (1Credit)
Introductory Lecture 2nd semester 300L
Introduction to medical microbiology 2 hrs
Criteria for classification of microorgansm 1hr
Transmission of infections disease agent 2hrs
Biology and principles of microbiology 2hrs
Properties of microorganisms 2hrs
Principles of immunology 4hrs

FIRST SEMESTER
SECTION ONE: PRINCIPLES/FUNDAMENTALS MMB411 48 HRS (3 Credits)
Fundamentals of Mycology
Superficial mycosis
Subcutaneous mycosis.
Classification of parasites of medical importance
Introduction & classification of Arthropods of medical importance.(medical Entomiology)
Ectoparasitic scabies mites, myiasis causing larvae etc.
Venomous Arthropods
Arthropods: Intermediate hosts and vectors of diseases
Principles of life cycle pattern of parasites
Epidemiology of parasitic diseases
Epidemiology of mycoses
General properties and cultivation of Bacteria(growth nutrition growth curve
Bacteria phages
Sterilization & disinfection
Morphology of bacterial cell
Antibacterial agents
Culture media
Infection and resistance to infection
Normal microbial flora
General properties/classification of the viruses

SECTION TWO: SYSTEMIC MICROBIOLOGY: MMB421   74hrs     (3Credits)
Mycology:
Opportunistic mycoses
Systemic mycoses
Superficial mycoses
Antifungal agents
Medical helminthology:
Classification of helminthic diseases
Nematodes
Cestodes
Trematodes
Lumen dwelling helminthes
Blood and tissue nematodes
Arthropods of medical importance (medical Entomology).
Medical protozoalogy:
Sporozoa: Malaria and Babesia
Toxoplasma
Cryptosporidium
Pneumocystis
Flagellate:
Trypanosomes
Leishmania
Trichomornas
Giardia
Amoebae
Ciliates
Antiparasitic drugs.
Bacteriology:
Gram positive cocci: streptococci/staphylococci and infections
Gram negative bacilli nitrobacteria ceae eg. Escherichia, salmonellae, shigellae etc.
Non- fermentative gram negative bacteria :-
Pseudomonades, pseudomonas Spp, Acinetobacter, alcaligenes
Corynebacteria, vibrios, campylobacter, Helicobacter, Lysteria, haemophilllus spp.
Bacillaceae e.g. anthracis clinical significant mechanism of pathogenicity
Clostridia Cl perfringens, Cl. Tetani, Cl. botulinum
Mycobacteriaceae, Actinomycetes, Nocardia
Spirochetes
Niesseria
Gram negative coccobacilli
Pasteurella
Brucella
Bordertella
Franciscella.
Mycoplasma & ureaplasma
Chlamydia & Richettsiae
Hospital infection
Food poisoning
Urinary tract infection
Diseases of the central nervous system: Meningitis
Diseases of the respiratory system: Pneumonias, tuberculosis.
Virology:
Adenoviruses
Papovaviridae
Herpesviridae
Poxviridae
Hepadnaviridae
Picornaviridae
Orthomyxoviridae
Paramyxoviridae
Flaviviridae
Rhadoviridae
Arenaviridae
Filoviridae
Bunyaviridae
Retroviridae
Coronaviridae
Caliciviridae
Astroviridae
Prions.

SECTION THREE: PRACTICALS MMB 420 51hrs (2Credits)
GENERAL LABORATORY PROCEDURES
The microscope; adjustment and use
Disposal of specimens and infected material
Specimen containers etc.
Safety precautions in laboratory
Preparation of films for various stains. Common stains e.g. (a) giemsa (b) ziehl-neelson (c) spore staining etc.
Preparation of smears to show pus cells, shape of bacteria motility etc.
Preparation of smears to show parasites and fungi
Quality Assurance

PARASITOLOGY 13hrs
examination of samples e.g. blood, urine CSF etc. for parasites
Concentration methods
Charts/photomicrographs

BACTEROLOGY 15hrs
Innoculation of agar plates
Media formulations and relevarance clinical practice
Morphological characteristics of bacteria species
Microorganisms found by direct film examination
Water sampling
Demonstration of bacteria flora
Interpretations of sensitivity test etc.

MYCOLOGY 10hrs
Examination of specimen for fungi
Study of charts/photomicrographs.

IMMUNOLOGY/SEROLOGY: 2hrs
Observation and performance of serological procedures
Antibodies – structure & function
Cytokines
Immune responses: Cell mediated and humoral, Hypersensitivity, Immuno-suppression diseases
Immunology of transplantation
Immunodiagnostic methods

SECOND SEMESTER

SECTION ONE: SYNDROMIC MICROBIOLOGY MMB 511 15 HRS (1 Credit)
Hospital infection. Epidemic and endemic infections. Food poisoning. Urinary tract infections. Sepsis syndrome, Cerebrospinal fluid infection- meningitis. Diphtheria, tetanus, botulinism, diseases of the respiratory tact. Bacterial endocarditis.Introduction to molecular diagnosis

SECTION FOUR: PRACTICALS MMB 520 18 HRS (1 Credit)
PARASITOLOGY:
Making of thick & thin blood films for malaria parasites.
Giemsa staining technique for thick & thin blood films.
Examination of blood films for malaria parasites.
Interpretation of malaria parasite blood results.
Examination of photomicrograph of malaria parasites species.
Making of wet blood film for microfilaria .
Photomicrograph showing some microfilaria
Making of wet blood films for trypanosomes
Photomicrograph showing morphology of trypanosome sp.
Techniques for the examination of faeces:
Saline preparation
Iodine preparation

B. MYCOLOGY:
1. Specimens
Skin specimen
Nail “
Hair “
Sputum “
Blood etc

  1. Examination samples
    (a) Direct examination
    (b) Culture of the specimens
    (c) Methods of examining the cultures
    3. Photomicrograph/charts:
    M. canis growth colony on culture plate
    M. canis macroconidia
    Multiple lesiong of tinea of smooth skin
    Symmetrical tinea of groin extending to skin of scrotum
    Candidal onychomycosis of toes
    Condidiasis of tonque
    4.
    Candida infection of the tumbs
    Aspergillosis of the lungs
    Indian ink demonstration of C. neaformans capsule
    Wood lamb demonstration of tinea of the scalp
    Actinomycosis and Norcadiosis
    VIROLOGY:
    Introduction to specimen collection.
    (a) Throat swab or Nasophanyngeal swab or Nasal wash for e.g. Polio virus, coxsackie virus, Adenovirus. Influenza & parainfluenza virus & RSV.
    (b) Stood/Rectal swab for Rota virus, Cox ECHO, Polio etc.
    (c) C.S. F. for mumps, Herpes simplex, Enterovirus etc.
    (d) Sputum for influenza & parasinfluenza virus
    (e) Fluid from vesicles in variola, varicella, H. zoster etc.
    (f) Smears on slide in Herpes simplex, vaccinia, infected sides in
    Rabies.
    (g) Blood specimen in cases of: Yellow fever, Rabies, measles, mumps, Psittacosis, variola etc.
  2. Processing of the specimens.
    (a) staining of smears to demonstrate viral CPE
    (b) Serodiagnosis on blood specimens
    (c) Culture techniques using
    Tissue culture
    (ii) Growth in fertile eggs
    (iii) Animal inoculation
    4 Exhibition of slides and photomicrographs of viral CPE & morphology
    (a) Rota virus morphology
    (b) Hepatitis B antigen with its 3 morphological structures.
    (c) Multinucleated giant cell in cell culture infected
    (d) Cell aggregation or rounding of cell in Rabbit kidney cell culture
    Haemadsorption on monkey kidney cells infected with Para influenza virus.
    D BACTERIOLOGY:
    Methods for collection of specimen for stool cultures
    Procedures of plating out of cultures and incubation
    formulation of cultures media e.g.
    Selective media
    Differential media
    Procedures for plate reading
    Interpretation of stool culture results
    Biochemical identification procedures
    Antibiotic sensitivity procedures
    Serological identification of bacterial species
    Bacterial infections of blood and implicating organisms
    Pre-requisites for blood specimen collection
    Methods of blood specimen collections for cultures
    Plating of blood culture, plate reading and interpretation of results
    Incubation techniques and sub-culturing procedures e.g.
    Aerobic cultures
    Anaerobic cultures
    Antibiotic sensitivity procedures
    Biochemical identification procedures
    Methods of examination of stool for parasites
    Macroscopic examination
    Microscopic examination
    saline preparation
    Iodine preparation
    19 Concentration method of examination
    (a) Zine sulphate method
    (b) Fomol – ether method
    (c) Saturated Na chloride method
    20 Methods for estimating parasitic eggs
    Common intestinal parasites
    Identification of parasitic
    General microbiological procedures
    Introduction to medical microbiology
    Staining techniques
    Safety precutions
    Sterilization techniques
    Making and fixing of spears
    Method of examination of stained & wet smears

SECTION THREE MMB 521: IMMUNOLOY / IMMUNOLOGICAL BASES OF DX 22 HRS (2 Credits)
Antigens, antibodies, immune response. Antibody-antigen reactions. Abnormalities of antibody production. Immunity and infectious diseases. Tissue reactions due to homoral antibodies. Tissue reactions due to cell-mediated immune response. Vaccination immunology. Immunosuppressive agents. Transplantation immunology. T and B-lymphocytes. Immunodeficiency states.

TUTORIALS : (4 Credits)
Involves teachings, demonstrations and clinicals during Bench Rounds, Consults and outpatients clinics as well as organized group/class tutorials.

SCHEDULE OF LECTURES
SECTION ONE 2nd SEMESTER YEAR 3 IDP MBB 321 13WKS

S/N TIME TOPIC
1 2 – 3pm Introduction to Medical Microbiology
2 3 – 4pm Host-Microorganism interaction
3 2 – 3pm Normal Microbial Flora
4 3 – 4pm Mechanism of Pathogenicity
5 2 – 3pm The Microscope
6 3 – 4pm Culture Media
7 2 – 3pm Safety in the Lab.
8 3 – 4pm Collection of Specimen in Microbiology
9 2 – 3pm Basic principles of Immunology
10 3 – 4pm Basic principles and fundamentals of microbes
11 2 – 3pm Transmission of infections
12 3 – 4pm Basic definitions in Microbiology
13 2 – 3pm An overview of superficial mycoses
14 3 – 4pm Properties of Micro-organisms
15 2 – 3pm Anti-microbial chemotherapy
16 3 – 4pm Anti-microbial resistance

SECTION TWO: 1ST SEMESTER YEAR 4: MMB 411

S/N DAY TIME COURSE
259 Wednesday 2 – 3pm General Properties
& classification Bacteria
2 Wednesday 3 –4pm Classification of molds and Yeasts
3 Wednesday 2-3pm General properties & classification of viruses
4 Wednesday 3-4pm Yeast infections
5 Wednesday 2-3pm Entero bacteriaceae
6 Wednesday 3-4pm Dermatophytes, dermatophytosis and other Superficial mycoses
7 Wednesday 2-3pm Campy lobactes I
8 Wednesday 3-4pm Helicobacter pylor I
9 Wednesday 2-3pm Genus: Baccillus I
10 Wednesday 3-4pm Classification of Helminthiasis and Intestinal Helminthiasis
11 Wednesday 2-3pm Classification of Helminthiasis and Intestinal Helminthiasis
12 Wednesday 3-4pm Aspergillosis and other opportunistic mycosis.
13 Wednesday 2-3pm Orthomyxoviridae
14 Wednesday 34pm Urinary tract infection
15 Wednesday 2-3pm Immunoglobins
16 Wednesday 3-4pm Antigen/Antibody
17 Wednesday 2-3pm Paramyxoviridae
18 Wednesday 3-4pm Staphylococci
19 Wednesday 2-3pm Enterobacteriaceae 1
20 Wednesday 3-4pm Campylobacter spp II
21 Wednesday 2-3pm Introduct. to molecular diagnosis 1
22 Wednesday 3-4pm Haemophilus spp
23 Wednesday 2-3pm Leishmaniasis and other flagellates
24 Wednesday 3-4pm Malaria I
25 Wednesday 2-3pm Malaria II
26 Wednesday 3-4pm Trematode infections
27 Wednesday 2-3pm Stroptococcus spp
28 Wednesday 3-4pm Enterobacteriaecae II
29 Wednesday 2-3pm Septicaemia
30 Wednesday 3-4pm Baccillus 11
31 Wednesday 2-3pm Immunoglobulins
32 Wednesday 3-4pm Chromoblastomycosis and other Subcutaneous mycosis I
33 Wednesday 2-3pm Chromoblastomycosis and other Subcutaneous mycosis II
34 Wednesday 3-4pm Super-antigens
35 Wednesday 2-3pm Immune responses to infection
36 Wednesday 3-4p m Arenaviridae
37 Wednesday 2-3pm Filariasis
38 Wednesday 3-4pm Guinea worm disease and other tissue nematodes
39 Wednesday 2-3pm Rhabdoviridae
40 Wednesday 3-4pm Hepadnaviridae I
41 Wednesday 2-3pm Hydatid disease and other tape worms
42 Wednesday 3-4pm Hepadnaviridae II
43 Wednesday 2-3pm Herpesviridae I
44 Wednesday 3-4pm Laboratory methods
45 Wednesday 2-3pm Herpesviridae II
46 Wednesday 3-4pm Introduct. to molecular diagnosis 11
47 Wednesday 2-3pm Bunyaviridae
48 Wednesday 3-4pm Laboratory methods

FIRST CONTINOUS ASSESSMENT TEST.
SECTION THREE 2ND SEMESTER YEAR 4 MBB 511

S/N TIME TOPIC
1 10am-11am Staphylococci
2 9am-10am Introduction to human Flagellates
3 8am-10am Trypanosomiasis; Sleeping sickness Chagas diseases
4 2pm-5pm PRACTICALS
5 10am-11am Classification of Helminths and Helminthology
V6 9am-10am Quality control
7 8am-10am Opportunistic Mycosis
8 2pm-5pm PRACTICALS
9 10am-11am Chromoblastomycosis and other Subcutaneous Mycosis
10 9am-10am Testing water supplies
11 8am-10am Arthropods of medical importance
12 2pm-5pm PRACTICALS
13 10am-11am Diagnostic principles in microbiology
14 9am-10am Systemic Mycosis: Histoplasmosis and Blastomycosis
15 8am-10am Prions
16 2pm-5pm PRACTICALS
17 10am-11am Antiviral agents
18 9am-10am Hydatid disease and other tape worms
19 8am-10am Review of Bactriology
20 2pm-5pm PRACTICALS
21 10am-11am Practical Review Bactriology
22 9am-10am Practical Review Virology
23 8am-10am Practical Review Immunology
24 2pm-5pm PRACTICALS
25 10am-11am Arthropods of medical importance
26 9am-10am Zygomycosis
27 8am-10am Control of microbial infections
28 2pm-5pm PRACTICALS
29 10am-11am Laboratory methods in Parasitology and Mycology
30 9am-10am Anti parasitic drugs
31 8am-10am Rabies
32 2pm-5pm PRACTICALS
33 10am-11am Antifungals
34 9am-10am Antifungals
35 8am-10am Laboratory methods
36 2pm-5pm PRACTICALS
37 10am-11am Laboratory methods
38 9am-10am Laboratory methods
39 8am-10am Review of viral diseases
40 2pm-5pm PRACTICALS
41 10am-11am Aspergillosis
42 9am-10am Zygomycosis
43 8am-10am Systemic Mycosis: Paracoccidiodomycosis and Coccidiodomycosis
44 2pm-5pm PRACTICALS
45 10am-11am Aspergillosis
46 9am-10am Aspergillosis
47 8am-10am Revision Virology
48 1pm-3pm Revision immunology
49 3pm-5pm Revision Bacteriology

EXAMINATION
Assignment one: Specimen collection as observed during clinical postings.
Assignment two: Essay on preventing the spread of Diseases.
Marking scheme below for grading Assignments

Assignment one:
Marking scheme:
Ability to present a calendar Showing 2 weeks which the indicate posting for the period ——————————————————————- 2 points.
Recognition of specimen containers by a simple description with no reference to any book ——————————————————– 2 points
Recognition of possible destination of samples collected————- 1 point.

Assignment two:
Marking Scheme
Only Original essays are graded, all copied assignments are disqualified and no marks given.
Basic definition of disease without use of text book——————– 1point
Listing of at least 3 methods of preventing spread of disease ——–2points.
Highlighting the benefits of disease free environment —————-2points

END OF SECTION EXAMINATION
Examination include questions are set from the sub specially areas of medical microbiology
Essay: ………5 question are compulsory with max 20 marks each
Multiple choice questions:………………………..50 questions
Every correct answer attracts +1 while every incorrect answer is – 1.

  1. Practical —————— 14 questions with max 10 marks each.

Method of Computing Scores
Assignment One: ————————————————–20 marks
Assignment Two: ————————————————-20 marks
1St Continuous Assessment test:——————————–50 marks
2nd Continuous Assessment test ——————————-50 marks
Posting/ practical scores:—————————————-20 marks
Total……………………………………………………… 160 marks.
Scores are scaled to 30% of the overall score for medical microbiology for pathology Examination (MBBS 111) examination.

Method of computing Final Grades:
ESSAY: ————————————————————–100 marks
Multiple choice Questions (MCQS) ————————- 50 marks
Practicals: ———————————————————140 marks
Scores are scaled to 70% of the overall score for medical microbiology for
Pathology Examination (MBBS III)
75% attendance at lectures, practicals and postings is mandatory to qualify to write pathology examination.

MARKING SCHEME
Q 1: Write an essay on the pathogenesis of falciparum malaria…(10 marks)
Plasmodium falciparum is one of the 4 species of plasmodium infective for humans and it causes the most severe form of malaria. Plasmodium falciparum sporozotes inoculated by the bite of a female Anopheles mosquitoe infect liver cells by the binding of the sporozoite surface thrombospondin into the receptor on hepatocytes to begin exo erythrocytic schizogony.
At the end of the liver phase (exo erythrocytic schizogony) merozotes are produced that invade the red blood cells begining erythrocytic schizogomy
Merozoites attach by means of the parasite lectin to glycophorin molecule on the surface of the rbc to begin erythrocytic schizogony.
Red cell lysis following the rupture of mature schizonts with the release cytoplamic contents & haermozoin pigments producing anemia & fever.
Falciperum infected rbcs are sequestered in the visceral interstitial fluid with the flow of blood through microvessels . Hyperparasiteamia and severe anemia results from multiple parasitism of a single red cells and invasion of all rbc irrespective of the age of rbcs.
Q2. Write an essay on Beta- haemolytic streptococcus group B. (S. agalactiae), dwelling clearing on the early phase and late phase of infections. (10 marks).
The most serious form of group B. streptococcal disease is neonatal sepsis. This condition is classified as early or late disease on the basis of several features, including the time of onset. Early on-set disease occurs at birth or within 7 days of birth, and late onset disease is the more common form and has the greater mortality (up to 75%) 3 marks.
Babies who develop early – onset disease become infected in utero or at birth. The degree of colonization of the vagina and cervix of the mother is directly related to the development and severity of the disease of the baby. Several risk factors, such as prematurity, prolonged rupture of membranes and other obstertric complications, are associated with early – onset disease. The most important risk factors, prematurity is responsible for the diminished immunocompetence of the neonate and the resulting inability to handle the large numbers of organisms that are introduced by the presence of other obstetric problems ————————————–(3marks)
Early – onset disease is associated with group B streptococci of genotypes I , II and III. The portal of entry for early- onset disease is probably the upper respiratory tract. Infected neonates usually display some type of respiratory disease plus bacteremia with or without meningitis may also be seen in the absence of respiratory disease ………………………….(1 mark)
The cause of late onset disease is unknown, but potential sources of infection include the hands or other contacts of colonized mothers or infants – to – infant cross – colonization by the display either meningitis or osteomyelitis, both with and without bacteraenia. The mortality here is 14% to 18% however the morbidity secondary to meningitis may as high as 50%. Type III group B. streptococci is associated with 90% of the cases of late onset disease….3 marks)
Q3. Write short notes on
Amoebiasis
Aspergillosis
Candidiasis

. (a) Amoebisis
Etiology is Entamoeba hystolytica which is a protozoan parasitic amoeba. Infection is by ingesting four nucleated infective cyst in food or drink contaminated with human faeces.
Infection may also be sexually contracted among homosexual through anal sex. ……………….. 1 mark
It presents with pathologic and clinical manifestations with intestinal and extra intestinal lesions. Intestinal lesions manifest as amebic dysentery with bloody mucoid stool. Abscesses can be formed in other extraintestinal sites e.g liver and other organs.
…………1 mark
Diagnosis is by microscopic demonstration of characteristic cyst in iodine stained stool smears.
Diarrhoea stool examined microscopically reveals characteristic trophozoites which contain ingested red blood cells.
Histological sections reveal characteristic flask shaped ulcers
Metronidazole is useful for the management.
Prevention is by improved hygiene………………………..………………..……2marks
Aspergillosis is an example of opportunitic mycosis. Etiology is Aspergillus species e.g. A. fumigatus which is a filamentous fungus
Aspergillus species growing on the surface of peanuts secrete aflatoxin which is a carcinogen and may predispose to liver cancer…….…… 1 mark
Aspergillosis presents with a variety of signs and syndromes
Allergic bronchopulmonary aspergillosis, Inhalation of Aspergillus spores in subjects sensitized to the organism exposes the airways and alveoli to Aspergillus antigen which initiates an allergic response.
Aspergilloma occurs when inhaled spores germinate producing masses of hyphae in a previously existing cavity created by a primary infection e.g TB. It presents with persistent haemoptysis.
Invasive aspergillosis is disseminated aspergillosis to various organs e.g. brain, kidney, etc from the lungs. Presents with fever and resembles any other opportunistic infection.
Diagnosis: Examination of sputum reveals Aspergillus conidia. Special stains e.g. Silver impregnation reveals Aspergillus in tissue section. Treatment is with systemic antifungal agents……………..……3marks
Candidiasis is mycosis which may be confined to the superficial layers of the skin or mucous membranes presenting clinically as superficial mycosis e.g. Oral thrush, vulvovagintis, onychomycosis etc. Haematogenous disemination (systemic candidiasis) produces lesions in any organ
……… 1 mark
Predisposition to opportunitic candidiasis include damage to skin barriers e.g. maceration, wounds, hormonal inbalance, use of corticosteroid, prolonged used of broad spectrum antibiotics etc…………………..1 mark
Diagnosis of is based on demonstration of the budding yeast cells characteristic of Candida albicans by microscopy.
Examination of cultures and germ tube test
Antifungal agents include topical and systemic agents.
Ameliorating the underlying causes of candidiasis is necessary to facilitate cure
…………….1 mark
Q4. Write an essay on the classification of mycoses:
Marking Scheme:
Recognizing morphological characteristics of pathogenic fungi as
1 Moulds;
The organism grow as filaments and produce spores which are characteristic and diagnostic
2 Yeast – like;
These organisms grow singly or in colonies with pseudohyphae which are oval shaped. The colonial appearance on agar and biochemical profile are useful in diagnosis.
3 Yeast;
These organisms grow singly or in colonies and so do not produce hyphae. Colonial appearance and biochemical profiles are useful in diagnosis.
4 Dimorphic (5 marks)
Dimorphic organisms grow as moulds at temperature room (25oC) and as yeasts at 37oC.
Recognising clinical manifestations of mycoses as
Superficial
Subcutaneous
Opportunistic
Systemic mycoses (5 marks)
A. Mycoses are fungal infections classified based on clinical presentation as follows:

  1. Superficial mycoses which are transmitted by direct contact and involve the outer keratinized tissues of the skin, hair and nails e.g. Dermatophytosis, Pityriasis versicolor.
  2. Subcutaneous mycoses also known as mycoses of implantation. Infection is transmitted via traumatic implantation of the etiologic agent into the skin. Infection affects the deep layers of the skin. e.g. Mycetoma and sporotrichosis
  3. Systemic mycoses affect various organs, the etiologic agents are dimorphic fungi. The mode of transmission is inhalation of spores and the infection is non-communicable. e.g. Histoplasmosis and blastomycosis.
  4. Opportunistic mycoses occur when the host is immunologically
    Compromised. predisposing factors must be identified and managed before treating the infection e.g. candidiasis
    Q5. Discuss briefly the classification of viruses of medical importance. Give examples to illustrate your answer. ………………………………………….(10 marks)
    Each characteristic with the appropriate example-…………………….— 2 marks)
    The characteristics used in the classification of viruses of medical importance are as follows
  5. Morphology and composition
    .a Type of genome: The type of nucleic acid.
    Viruses consist of either RNA or DNA which may be single stranded or double stranded.
    Examples of DNA viruses
    Herpes virus
    Pox virus
    Papova virus A
    Papova virus B etc etc
    Example of RNA viruses
    Enterovirus
    Rhino virus
    Rota virus
    Arena virus etc etc.
    b. Type of capsid symmetry whether Icosahedral, helical or complex
    Example of Icosahedral virus
    Papova virus A
    Papova virus B
    Entero virus
    Example of Helical virus
    Influenza virus
    Complex type capsid
    e.g Pox viridae
    c. Presence or absence of envelope hence sensitivity to solvents e.g. ether
    Examples of enveloped virus
    Herpes viruses
    Rota virus etc etc
    Example of non enveloped virus
    Polio virus
    Adeno virus etc etc.
    d. Classification base on size: viruses are the smallest infecting microorganism measuring between 10 – 400mm and cannot be seen with the light microscope of measurement in monometer
    Examples viruses and sizes
    orthopoxvirus 23 x 300nm
    Parovirus 18 – 26nm
  6. Classification based on infections caused
    e.g Enterovirus that causes polio is polio virus
    Lyssavirus that causes Rabies is Rabies virus etc etc
  7. Classification based on the history and geographical location of the virus.
    e.g. Ebola virus named after a river in Zaire where an epidemic of Ebola haemorhagic fever occurred in the mid-seventies.
  8. Mode of transmission of the virus may be a characteristic used in classifying the virus e.g. sexually transmitted, arthropod – borne.
  9. Site of capsid assembly in the nucleic or cybplasm e.g nucleus
    (papovarus Herpes) cyboplasm [pox virus influenza virus]
    6 Virus may be classified based on the pathology of disease
    e.g. menigitis associated with Echo viruses, coxsackie viruses, mumps virus, Herpes simplex virus – II
    Encephalitis associated with togavirus, bunya viruses, measles etc Haemorhagic fever associated with Ebola, Marburg, lassa, yellow fever etc etc.
  10. Based on Taxonomic classification into families and general

Examples of taxonomic classification

Family Genium virus
Papoviridae paporaviridae Papova A & B
Parovoviridae Parvovirus
Adenoviridae Mastadenovirus
Herpeviridae Alphaherpesvirinae
Piconaviridae Enterovirus
Orthomyxoviridae Influenzavirus
Rhabdoviridae Rabiesvirus

Q6. Discuss the life cycle and laboratory diagnosis of a named protozoan disease.
A. Correct example of a protozoan disease and etiologic agent —-1 mark
The correct listing of life cycle events as they occur during the life cycle of the example listed above–4 marks
The procedures carried out for the diagnosis of the example given above using the following heading
(macroscopic examination and findings(s)
(microscopic examination and finding(s)
Useful serological tests if necessary. —————-5 marks

DEPARTMENT OF MEDICINE
ACADEMIC STAFF

S/N NAMES STATUS QUALIFICATIONS

  1. Prof. L. I. Ojogwu Professor Emeritus MBBS, MRCP, FWACP, FRCP
  2. Prof. A. Obasohan Professor MBBS, FWACP, FMCP, FESC, FACC
  3. Prof. Efosa Oviasu Professor MBBS, FMCP, FWACP
  4. Prof. E. I. Unuigbe Professor MBBS, FMCP,FWACP
  5. Prof. A. N. Onunu Professor MBBS, FWACP
  6. Prof. E. E. Egbagbe Professor MBBS, FWACP
  7. Prof. A. O. Ogunrin Professor MBChB, FWACP
  8. Prof. V. A. Josephs Professor MBBS, FWACP
  9. Prof. A.E. Edo Professor MBBS, FMCP
  10. Prof. A. Eregie Professor MBBS, FMCP
  11. Prof. C. E. Omuemu Professor MBBS, FWACP, MPH
  12. Prof. O. Akoria Professor MBBS, FMCP, PG Dip, MPH, Certificate Geriatrics
  13. Prof. F. A. Imarhiagbe Associate Professor MBChB, FMCP
  14. Dr. (Mrs) E. I. Okaka Associate Professor MBBS, FWACP
    15 Dr. (Mrs) E. J. Ogbemudia Senior Lecturer MBBS, FMCP
  15. Dr. O. T. Ehondor Lecturer I MBBS, FMCP
  16. Dr F.E. Odiase Lecturer I MBBS, FMCP
  17. Dr. A. Olowofela Lecturer I MBBS, FWACP, FMCP
  18. Dr. A.B. Olokor Lecturer I MBBS, FMCP,FWACP
  19. Dr. R.A.Ugiagbe Lecturer I MBBS, FMCP
  20. Dr. S.A. Ayinbuomwan Lecturer I MBBS, FMCP
  21. Dr. C. R. Madubuko Lecturer I MBBS, MWACP, FWACP
  22. Dr. P. N. Ekhator Lecturer I MBBS, FWACP
  23. Dr. O. I. Iyawe Lecturer I MBBS, MWACP, FMCP

ADMINISTRATIVE STAFF

S/N NAMES STATUS QUALIFICATIONS

  1. A. W. A. Anenih (Mr) Senior Executive Officer B.Sc, Cert. in Computer Application
  2. G. Egharevba (Mr) Office Assistant II FSLC
  3. F. Awaritoma (Mrs.) Chief Clerical Officer WAEC
  4. Izobo Moses (Mrs) Computer Operator NECO/OND
  5. B. Legemah Senior Clerical Officer SSCE
    BACKGROUND
    The Department of Medicine was established in 1973 as one of the core clinical departments of the College of Medical Sciences (then faculty of Medicine and Pharmacy).
    The first Head of Department was late Professor D.R.W. Haddock (MD, FRCP; died 1985), who was on secondment from the Liverpool School of Tropical Medicine from 1973 – 1976. With the departure of Professor Haddock, Dr V.O.Oviasu (then Senior Lecturer) became Head of Department. Since then (i.e. in the last 42 years), the department has had various heads.
    The pioneer academic staff members were Professor D.W. Haddock, Dr. V.O. Oviasu and Dr. C.O.Anah. The present staff disposition consists of 11 professors, 4 associate professors, 2 senior lecturers and 10 lecturers.
    The department conducted its first final examinations for undergraduate medical students in 1976 for 17 students. The numbers of students have grown tremendously with the final class approaching (and at times exceeding) 200.
    From the 1980s the department became actively involved in the training of post graduate doctors with the establishment of the Nigerian and West African post graduate medical colleges. This development gave impetus to an articulate staff development programme which produced the new generation of academic staff from the mid-80s.
    From 1998, the basic infrastructure housing the departmental offices was the College Building, located in the University of Benin Teaching Hospital premises. With the completion of the new College Building (the Oba Akenzua Complex) in 2008, standard office accommodation for all academic staff has been available.
    The clinical facilities which can be found mainly on the grounds of the teaching hospital started with 2 wards of 30 beds each for male and female patients, respectively. There has been expansion of the bed spaces over the years because of the high bed occupancy. There are now 4 medical wards, providing 107 dedicated medical beds. In addition, medical patients are also admitted into the New Emergency Ward (20-bedded), the Intensive Care Unit – ICU (7-bedded) and the Renal Unit (6-bedded). The department also has access to the male surgical ward for overflow patients.
    The cardiology unit commenced electrocardiography with the inception of the department and echocardiography services were included later.
    The renal unit of the department commenced haemodialysis in 1999 with the opening of the dialysis unit which currently houses dialysis machines.
    Facilities in the ICU have recently been upgraded.
    The department also has an endoscopy suite for diagnostic and therapeutic endoscopy.
    The Clinical Pharmacology & Therapeutics Unit, in collaboration with the hospital’s Department of Pharmacy set up an Adverse Drug Reaction Registry and a Drugs & Poisons Information Centre (DPIC) in 1997.
    There is a 12-room outpatient facility which accommodates morning and afternoon consultant clinics on all working days. In addition there is a 3-room facility dedicated to HIV/AIDS clinics (PEPFAR Clinic). There is also a dedicated Dermatology clinic as well as a Direct Observation Therapy Short course (DOTS) facility for TB outpatient care.
    The Geriatrics Unit was established in October, 2013. An inter-disciplinary geriatrics team comprising 19 nurses, 4 doctors, 1 pharmacist, 1 physiotherapist, and 1 occupational therapist was trained between February 14 and March 12, 2014, following which the Geriatrics Unit admitted her first patient in the dedicated Geriatric Ward on March 19, 2014. The Unit admits older adults with multi-morbidities and geriatric syndromes. The unit also runs weekly academic Continuing Professional Development Programmes (CPD).

Medicine

MED 401: Junior Medical Posting (5 Credits)
Identification of normal physiological mechanisms in HUMANS Identification of abnormal physiological mechanisms in HUMANS. Interpretation of (b) against (a) to diagnose disease

MED 402: Lectures & Tutorials (3 Credits)

MED 403: Primary Medical Care (2 Credits)
Exposure to general practice clinic . Exposure to specialist practice outside teaching hospital . Visit to leprosy settlement.

MED 504: Dermatology and Venereology (2 Credits)
Dermatology posting, Lectures

MED 621: Lectures, Tutorials and Senior Posting in Medicine (10 Credits)
Lectures, interpretation of symptoms and signs to diagnose disease. Investigation of patients to diagnose disease. General management techniques in disease including therapeutics.

COURSE DESCRIPTION
This course is given in periods of clinical postings
(i) The introductory Course of 10 days is at the end of the 300-level after the pre-clinical examination in Anatomy Physiology & Biochemistry. During the period, the student learns history taking, eliciting symptoms and physical signs in clinical medicine and case documentation.
(ii) The first clinical posting is undertaken at the 400-level of the course following immediately after the introductory course. This period which aims at laying the foundations of medicine lasts for 8 weeks
(iii) The second clinical posting in medicine is undertaken during the fourth year of the course. The posting includes general medicine,4 weeks of primary health care, 4 weeks of Radiology Posting and 2 weeks of Dermatology and Venereology. This posting lasts for 8 weeks.
(iv) The third clinical posting in Medicine is undertaken during the final posting, the student receives lectures, tutorials and clinical training. He is assigned to assist the residents in their routine duties.
(v) The final period ends with a final comprehensive examination but each posting period ends with an assessment, and the results of these are taken into account in the total assessment of the student.
(vi) Teaching of medicine embodies liberal reference to the basic medical science background of diseases, an active review of pathology therapeutics and community health aspects relevant to the medical subjects.
(vii) There will be a number of assessment tests, posting tests and reports. The grades of all these are to be computed for the final evaluation of the student at the final examination taken at the end of the final year.

TYPES OF CASES IN WARDS
Cardiovascular System- Dr. Ogbemudia
Congestive heart failure, left ventricular failure due to hypertension, valvular disease, anaemia, thyrotoxicosis,
Heart failure of unknown cause of association e.g endomyocardial fibrosis, congestive cardiomyopathy, Hypertension, arrhythmias etc.
Respiratory System
Pneumonia
Suppurative lung diseases e.g. bronchiectasis, lung abscess, empyema, Lung Function Test,
Sarcoidosis
HIV related lung disorder
Respiratory failure
Lung cancer
Tuberculosis
Asthma
Chronic obstructive airway disease e.g chronic bronchitis and emphysema
Gastrointestinal System
Peptic ulcer
Amoebic liver abscess
Infective hepatitis
Chronic liver disease
Primary liver cell carcinoma
Dysentries
Gastroentreritis
Tb Abdomen
Gastro-intestinal neoplasm
Endocrine System
Diabetes mellitus
Thyroid disorders
Thyrotoxicosis
Pituitary disorders
Adrenal disorders
Obesity, Metabolic syndrome
Parathyroid disorders
Disorders of calcium metabolism
Clinical Pharmacology and Therapeutics
Adverse Drug Reactions e. g TENS, SJS
Envenomations e. g Snake bite, Bee stings, Dog bite
Poisonings e. g Carbon Monoxide and Organophosphorous poising
Fevers
Neurology
Cerebrovascular accident due to haemorrhage, embolism,
Thrombosis, infarction
Primary subarachnoid haemorrhage
Meningitis – pyogenic, tuberculous
Paraplegia
Epilepsy
Intracranial tumours
Peripheral neuropathies
Tetanus
NEHPROLOGY
Acute nephritic syndrome
Nephrotic Syndrome
Acute renal failure
Chronic renal failure
Pylonephritis

DERMATOLOGY/VENEROLOGY
Dermatitis
Scabies
Drug reactions
Lichen planus
Herpes simplex, Herpes Zoster

GENERAL
Fevers
Pyrexia of Unknown Origin (P.U.O.)
Snake bite, Dog bite (Bites & stings)
Acquired Immune Deficiency Syndrome (AIDS)

FORMAT OF THE FINAL DEGREE EXAMINATION
The final degree examination in medicine consists of
(a) (Paper I – Section A: I hour of multiple choice questions – 50, in number, each consisting of (i) to (v)
Paper I-Section B: Consists of 5 short response questions in general medicine and therapeutics.
Paper II: 3 hours written paper in medicine and therapeutics.
This is made up of 7 or 8 short response questions and one essay
(b) Clinical Examination: consists of
(i) One long case during which a candidate is left with the patient for 60 minutes, after which he/she is examined for 15 minutes by a pair of examiners.
(ii) The candidate is examined by another pair of examiners for three short cases for a total of 15 minutes.
(iii) An oral examination (15 minutes)
In the long case marks are awarded for history taking, demonstration of signs, discussion, knowledge of clinical side room tests and management of cases; while for short cases marks are awarded for technique of examination, correct elicitation of physical signs and interpretation of findings.
The minimum Pass Murk for the Final Degree Examination is 50%. A Pass in Clinical Medicine is mandatory in order to pass in the whole examination.
The end of posting assessment examination marks and the marks awarded for practical work during the posting are taken into cognizance in the final grade evaluation.
The Geriatrics Unit was established in October, 2013. An inter-disciplinary geriatrics team comprising 19 nurses, 4 doctors, 1 pharmacist, 1 physiotherapist, and 1 occupational therapist was trained between February 14 and March 12, 2014, following which the Geriatrics Unit admitted her first patient in the dedicated Geriatric Ward on March 19, 2014. The Unit admits older adults with multi-morbidities and geriatric syndromes. The unit also runs weekly academic Continuing Professional Development Programmes (CPD).