Detailed Learning Outcomes for MBChB DIG

1. Demonstrate a detailed understanding of the functional anatomy and histology of the

 Gastrointestinal tract
 Mesentery,
 Blood supply
 Portal system
 Salivary glands
 Pancreas
 Hepatobiliary system
1.2 Demonstrate an understanding of the functional histology of the gastrointestinal tract:

 Smooth muscle
 Nerve plexi
 Secretory glands
 Enterocytes
 APUD cells
1.3 Demonstrate knowledge of the functional anatomy and histology of the salivary glands and
pancreas:

 Salivary glands
 Pancreas
 Exocrine glands
 Acinar cells
 Zymogen
 Duct cells
1.4 Demonstrate knowledge of the functional anatomy and histology of th liver, gall bladder
and biliary tract:

 Liver
 Gall bladder
 Biliary tree
 Portal circulation
 Enterohepatic circulation
 Hepatocytes
 Kupffer cells
1.5 Demonstrate an understanding of the embryological development, maturation of the
digestive system:

 Fore/mid/hind gut
 Blood supply
 Lymph drainage
2. Demonstrate an understanding of the functions of the gastrointestinal tract,
associated organs, and their control.
2.1 Demonstrate an understanding of the biochemical processes involved in the digestion of:

 Carbohydrates,
 Proteins,
 Fats,
 Enzymes,
 Bile acids,
 Chylomicrons
2.2 Demonstrate an understanding of membrane transport and cellular processes that
underlie absorption and secretion Absorption, secretion, membrane transport
2.3 Demonstrate an understanding of the control of secretion of the salivary glands, pancreas
and liver (including bile, mucins, enzymes, bile acids, bile pigments and hormones)
2.4 Demonstrate an understanding of the processes of mastication, swallowing, gut motility
and defecation and their control.
2.5 Demonstrate an understanding of the pharmacological control of digestion, absorption,
secretion and motility (including antiulcer drugs, drugs that act to alter motility, treatments for
constipation, laxatives and diarrhoea)
2.6 Demonstrate an understanding of the role of the liver in digestion, absorption and
assimilation, detoxification and excretion, and the sequence of events of the enterohepatic
circulation (including lipid absorption, bile acids, membrane transport)
2.7 Demonstrate an understanding of how the digestive system is functionally integrated with
other body systems.
3. Demonstrate an understanding of the absorptive and post-absorptive metabolic
states and their control.
3.1 Demonstrate a knowledge of the pathways of carbohydrate, lipid and protein metabolism
and their control during a meal and in fasting.
3.2 Demonstrate an understanding of the general features of the absorptive and post-
absorptive states and their control (including fasting, impact of insulin, glucagon and
adrenaline, in addition to the processes of glycogenolysis, gluconeogenesis, lipolysis)
3.3 Demonstrate an understanding of the metabolic background to starvation, obesity,
diabetes, hyperlipidaemias and atheroma.
4. Demonstrate a comprehension of the role of nutrition in health and disease
4.1 Demonstrate an understanding of the role of vitamins and trace elements in health and
disease.
4.2 Demonstrate a knowledge of how iron is absorbed in the GI tract, how this is regulated
and how deregulation of iron handling can result in several pathologies (anaemia of chronic
disease, iron deficiency anaemia and hereditary haemochromatosis)
4.3 Demonstrate an understanding of the effects of the intestinal microbiome intestinal
processes (including an appreciation of Faecal Microbiome Transplantation and the
microbiomes role in intestinal and extra-intestinal diseases).
4.4 Demonstrate an understanding of the nutritional background to starvation, obesity,
diabetes, hyperlipidaemias, atheroma and gallstone disease and their management.
4.5 Demonstrate an understanding of the role of nitrogen metabolism in health and disease.
4.6 Demonstrate an understanding of the consequences of malabsorptive disease for nutrition
and health (including vitamin deficiency, impaired healing, immunosuppression, coeliac
disease and Crohn’s disease)
5. Demonstrate a knowledge of the basis of pathological conditions of the digestive
system and associated organs
5.1 Demonstrate an appreciation of the common pathological processes that can affect the
digestive system and their manifestations and management (including Gastro-oesophageal
reflux, achalasia, Hirshsprung’s disease, Chaga’s disease inflammatory bowel disease,
malignancy, colitis, steatorrhea and gall stones)
5.2 Demonstrate a knowledge of the appearance of gastro-intestinal pathologies through
radiography, endoscopy and other investigative or imaging techniques: Cross sectional
imaging, CT, MRI, bowel obstruction, contrast enema, endoscopy.
5.3 Demonstrate an understanding of gross and microscopic pathological change in the
gastrointestinal tract in relation to ulceration, inflammation and neoplasia.
5.4 Demonstrate an understanding of the physiological consequences of surgical removal of
parts of the digestive tract.
5.5 Demonstrate an understanding of abnormalities of liver and biliary system function, as
exemplified by jaundice