2016 Course Documentation Handbook Vfinal

CLASS OF 2016 COURSE DOCUMENTATION 2013-2014
Welcome from the Dean of Preclinical Medicine

Dear Students, Hello and welcome to the 2013 2014 academic year at Touro College of Osteopathic Medicine. Healthcare today is as exciting as it has ever been. With the political advances in providing health care to those most in need in society to recent developments in technology; being a physician is, in my opinion, the most rewarding and exciting profession of all. You are in the process of taking the first steps in becoming tomorrows physicians congratulations. It is the mission of Touro College of Osteopathic Medicine to ensure that you are one of the best educated of tomorrows doctors. In developing and implementing that mission, we have shaped our curriculum, as detailed in this document, to reflect many of the advancements in Osteopathic Medical education and evidence based medical education curriculum. For example, there has been a concerted approach to integrating Osteopathic principles with the core curriculum courses such as Anatomy, Physiology and Pathology. Another example is the exam schedule. Although the exam schedule is difficult, as you would expect in a medical school curriculum, the exams have been placed in a specific order to maximize learning by structuring the objectives in each course in a linear learning model. Furthermore, our Medical Simulation course is second to none. This course will allow you to experience some of the procedures and pressures of being a doctor while treating a simulated patient. This simulation course coupled with our Objective Structured Clinical Examination course (OSCE) will also allow you to experience the feel of being a doctor. Together, all of these parts of your education will allow you to reach your learning potential and best prepare you for the practice of medicine. This curriculum was developed upon last years and includes the modular courses of Clinical Systems, Pathology, Pharmacology, Immunology and the second year Osteopathic Manipulative Medicine (OMM) course. This will ensure that you will have a detailed understanding on when and where to use manipulative medicine in practice as well as the important question of why OMM is important in maintaining the patients overall health. I am excited to present our faculty and this curriculum to you. Welcome to Touro College of Osteopathic Medicine! Yours,
David V. Lenihan Ph.D., J.D., MCC, CBiol MIBiol, FRSM Dean Preclinical Medicine Professor of Neuroscience and Neuroanatomy Touro College of Osteopathic Medicine
Table of Contents
WELCOME FROM THE DEAN OF PRECLINICAL MEDICINE ...................................................................................................................2 OVERVIEWS AND DOCUMENTATION ............................................................................................................................................... 10 YEAR TWO SCHEDULE OVERVIEW.................................................................................................................................................... 11 ESTIMATED WEEKLY SCHEDULE ....................................................................................................................................................... 12 EXAM SCHEDULE BREAKDOWN ....................................................................................................................................................... 13 SEMESTER ONE ..........................................................................................................................................................................13 SEMESTER ONE FINALS WEEK ........................................................................................................................................................15 SEMESTER TWO ..........................................................................................................................................................................16 SEMESTER TWO FINALS WEEK .......................................................................................................................................................17 FACULTY OFFICE HOURS AND CONTACT INFORMATION.................................................................................................................. 18 COURSE BREAKDOWN ..................................................................................................................................................................... 19 ACADEMIC POLICIES ........................................................................................................................................................................ 20 ACADEMIC POLICIES ....................................................................................................................................................................20 LECTURES ..................................................................................................................................................................................20 E-Lectures ................................................................................................................................................................................ 20 Traditional Lectures ................................................................................................................................................................. 20 ICLICKERS ..................................................................................................................................................................................20 iClicker Policies ........................................................................................................................................................................ 20 ATTENDANCE .............................................................................................................................................................................21 SEATING ASSIGNMENTS ................................................................................................................................................................21 EXAMS .....................................................................................................................................................................................21 Exam Taking Policy .................................................................................................................................................................. 21 ExamSoft and SofTest .............................................................................................................................................................. 22 Prior to Exam Day .................................................................................................................................................................... 22 On Exam Day ........................................................................................................................................................................... 22 SofTest Tips and Tricks ............................................................................................................................................................. 23 ExamSoft Technical Support Resources:.................................................................................................................................... 23 Exam Standardization .............................................................................................................................................................. 23 Exam Reviewing Policy ............................................................................................................................................................. 24 END OF YEAR GRADING POLICY ......................................................................................................................................................24 STUDENT PROMOTION .................................................................................................................................................................25 GLOBAL STUDENT ASSESSMENT TOOLS ............................................................................................................................................25 Early Warning System .............................................................................................................................................................. 25 Cross Course Performance Graph ............................................................................................................................................. 26 COMMUNICATION .......................................................................................................................................................................26 Student Weekly Survey............................................................................................................................................................. 26 Student Town Hall Meetings .................................................................................................................................................... 26 Twitter .................................................................................................................................................................................... 27 Mandatory Evaluation ............................................................................................................................................................. 27 Office Hours and Email Communication ................................................................................................................................... 27 STUDENT RESOURCES ...................................................................................................................................................................27 Resources for Mental Health .................................................................................................................................................... 27 Crises and Emergencies............................................................................................................................................................ 27
*Document is subject to change
Curriculum Specialist................................................................................................................................................................ 27 Student Health Services Clinic................................................................................................................................................... 27 COPYRIGHT FREQUENTLY ASKED QUESTIONS AND ANSWERS.................................................................................................................27 What is the difference between Copyright Infringement and Plagiarism?.................................................................................. 27 What is the purpose of Copyright and Patent in the United States? .......................................................................................... 28 What is Copyright? .................................................................................................................................................................. 28 What types of work are protected by Copyright? ...................................................................................................................... 28 What is Fair Use? ..................................................................................................................................................................... 28 What is the current term of Copyright in the United States? ..................................................................................................... 28 What does Copyright protect?.................................................................................................................................................. 28 What isnt protected by Copyright? .......................................................................................................................................... 28 What is required to have a work be protected by Copyright? .................................................................................................... 28 What is the Public Domain? ..................................................................................................................................................... 28 What is First Sale? ................................................................................................................................................................... 29 What is Copyleft?..................................................................................................................................................................... 29 2016 BOOKLIST ................................................................................................................................................................................ 30 GENERAL REQUIREMENTS .............................................................................................................................................................30 PC Requirements (Windows XP, Vista, 7, 8): ............................................................................................................................. 30 Mac Requirements (OS X 10.6, 10.7, 10.8): ............................................................................................................................... 30 BEHAVIORAL MEDICINE ................................................................................................................................................................30 Required Texts and Materials................................................................................................................................................... 30 Recommended Texts and Materials.......................................................................................................................................... 30 CLINICAL SYSTEMS .......................................................................................................................................................................31 Required Texts and Materials................................................................................................................................................... 31 Supplemental Texts and Materials ........................................................................................................................................... 32 MEDICAL MICROBIOLOGY AND IMMUNOLOGY ...................................................................................................................................33 Required Texts and Materials................................................................................................................................................... 33 Recommended Texts and Materials.......................................................................................................................................... 33 MEDICAL SIMULATION .................................................................................................................................................................34 Required Materials .................................................................................................................................................................. 34 OMM II ...................................................................................................................................................................................34 Required Texts and Materials................................................................................................................................................... 34 Recommended Texts and Materials.......................................................................................................................................... 34 OSCE.......................................................................................................................................................................................34 Required Materials .................................................................................................................................................................. 34 Required Texts ......................................................................................................................................................................... 35 PATHOLOGY...............................................................................................................................................................................35 Required Texts and Materials................................................................................................................................................... 35 Recommended Texts and Materials.......................................................................................................................................... 35 Supplementary Educational Materials ...................................................................................................................................... 36 PHARMACOLOGY ........................................................................................................................................................................37 Required Texts and Materials................................................................................................................................................... 37 Recommended Texts and Materials.......................................................................................................................................... 37 PRIMARY CARE SKILLS ..................................................................................................................................................................37 Required Texts and Materials................................................................................................................................................... 37 PROFESSIONALISM AND MEDICAL ETHICS .........................................................................................................................................38 Required Textbook: .................................................................................................................................................................. 38 SEMESTER ONE SYLLABI .................................................................................................................................................................. 39
BEHAVIORAL MEDICINE SYLLABUS .................................................................................................................................................. 40 COURSE DETAILS .........................................................................................................................................................................40 COURSE DESCRIPTION ..................................................................................................................................................................40 OVERALL COURSE GOALS ..............................................................................................................................................................40 REQUIRED TEXTS AND MATERIALS ..................................................................................................................................................40 RECOMMENDED TEXTS AND MATERIALS ..........................................................................................................................................40 EXAM DATES .............................................................................................................................................................................41 EXAM GRADE COMPUTATION ........................................................................................................................................................41 COURSE GRADE COMPUTATION .....................................................................................................................................................41 COURSE SCHEDULE ......................................................................................................................................................................42 Lectures ................................................................................................................................................................................... 42 CLINICAL SYSTEMS I SYLLABUS ........................................................................................................................................................ 46 COURSE DETAILS .........................................................................................................................................................................46 COURSE DESCRIPTION ..................................................................................................................................................................46 OVERALL COURSE GOALS ..............................................................................................................................................................47 Course Objectives .................................................................................................................................................................... 47 Student Objectives ................................................................................................................................................................... 48 REQUIRED TEXTS AND MATERIALS ..................................................................................................................................................48 SUPPLEMENTAL TEXTS AND MATERIALS ...........................................................................................................................................49 EXAM DATES .............................................................................................................................................................................51 EXAM GRADE COMPUTATION ........................................................................................................................................................51 COURSE GRADE COMPUTATION .....................................................................................................................................................51 ADDITIONAL INFORMATION ...........................................................................................................................................................52 Course Format ......................................................................................................................................................................... 52 Course Presentation ................................................................................................................................................................. 52 Course Specific Attendance and Tardiness Policy ...................................................................................................................... 53 Accessing Up To Date Online Instructions ................................................................................................................................. 53 Cardiac Auscultation Assignment Clinical Systems Cardiology Module ...................................................................................... 53 COURSE SCHEDULE ......................................................................................................................................................................55 Lectures ................................................................................................................................................................................... 55 MEDICAL MICROBIOLOGY AND IMMUNOLOGY I SYLLABUS ............................................................................................................ 85 COURSE DETAILS .........................................................................................................................................................................85 COURSE DESCRIPTION ..................................................................................................................................................................85 OVERALL COURSE GOALS ..............................................................................................................................................................85 REQUIRED TEXTS AND MATERIALS ..................................................................................................................................................86 RECOMMENDED TEXTS AND MATERIALS ..........................................................................................................................................86 EXAM DATES .............................................................................................................................................................................86 EXAM GRADE COMPUTATION ........................................................................................................................................................86 COURSE GRADE COMPUTATION .....................................................................................................................................................87 COURSE SCHEDULE ......................................................................................................................................................................88 Lectures ................................................................................................................................................................................... 88 MEDICAL SIMULATION ELECTIVE FALL SEMESTER SYLLABUS ......................................................................................................... 101 COURSE DETAILS .......................................................................................................................................................................101 COURSE DESCRIPTION ................................................................................................................................................................101 OVERALL COURSE GOALS ............................................................................................................................................................101 REQUIRED MATERIALS ...............................................................................................................................................................101 ASSESSMENT............................................................................................................................................................................101
ADDITIONAL INFORMATION .........................................................................................................................................................102 Course Format ....................................................................................................................................................................... 102 Course Fee ............................................................................................................................................................................. 102 Course Registration................................................................................................................................................................ 102 Attendance, Tardiness & Absences ......................................................................................................................................... 102 Latex Allergies or Latex Hypersensitivities .............................................................................................................................. 102 COURSE SCHEDULE ....................................................................................................................................................................103 Lectures ................................................................................................................................................................................. 103 OSTEOPATHIC MANIPULATIVE MEDICINE II PART 1 SYLLABUS ...................................................................................................... 106 COURSE DETAILS .......................................................................................................................................................................106 COURSE DESCRIPTION ................................................................................................................................................................106 OVERALL COURSE GOALS ............................................................................................................................................................106 REQUIRED TEXTS AND MATERIALS ................................................................................................................................................106 RECOMMENDED TEXTS AND MATERIALS ........................................................................................................................................107 EXAM DATES ...........................................................................................................................................................................107 EXAM GRADE COMPUTATION ......................................................................................................................................................107 COURSE GRADE COMPUTATION ...................................................................................................................................................108 ADDITIONAL INFORMATION .........................................................................................................................................................108 Attendance and Grading Policy .............................................................................................................................................. 108 COURSE SCHEDULE ....................................................................................................................................................................111 Lectures ................................................................................................................................................................................. 111 PATHOLOGY I SYLLABUS ................................................................................................................................................................ 124 COURSE DETAILS .......................................................................................................................................................................124 COURSE DESCRIPTION ................................................................................................................................................................124 OVERALL COURSE GOALS ............................................................................................................................................................124 REQUIRED TEXTS AND MATERIALS ................................................................................................................................................124 RECOMMENDED TEXTS AND MATERIALS ........................................................................................................................................125 SUPPLEMENTARY EDUCATIONAL MATERIALS ...................................................................................................................................125 EXAM DATES ...........................................................................................................................................................................126 EXAM GRADE COMPUTATION ......................................................................................................................................................126 COURSE GRADE COMPUTATION ...................................................................................................................................................127 ADDITIONAL INFORMATION .........................................................................................................................................................127 Laboratory & Small group Session Rules ................................................................................................................................. 127 Participating Faculty .............................................................................................................................................................. 127 COURSE SCHEDULE ....................................................................................................................................................................128 Lectures and Labs .................................................................................................................................................................. 128 PHARMACOLOGY I SYLLABUS ........................................................................................................................................................ 151 COURSE DETAILS .......................................................................................................................................................................151 COURSE DESCRIPTION ................................................................................................................................................................151 OVERALL COURSE GOALS ............................................................................................................................................................151 REQUIRED TEXTS AND MATERIALS ................................................................................................................................................151 RECOMMENDED TEXTS AND MATERIALS ........................................................................................................................................152 EXAM DATES ...........................................................................................................................................................................152 EXAM GRADE COMPUTATION ......................................................................................................................................................152 COURSE GRADE COMPUTATION ...................................................................................................................................................153 COURSE SCHEDULE ....................................................................................................................................................................154 Lectures ................................................................................................................................................................................. 154
PRIMARY CARE SKILLS SYLLABUS................................................................................................................................................... 163 COURSE DETAILS .......................................................................................................................................................................163 COURSE DESCRIPTION ................................................................................................................................................................163 OVERALL COURSE GOALS ............................................................................................................................................................163 REQUIRED TEXTS AND MATERIALS ................................................................................................................................................163 EXAM DATES ...........................................................................................................................................................................164 EXAM GRADE COMPUTATION ......................................................................................................................................................164 COURSE GRADE COMPUTATION ...................................................................................................................................................165 ADDITIONAL INFORMATION .........................................................................................................................................................166 Course Material ..................................................................................................................................................................... 166 Course Format ....................................................................................................................................................................... 166 Course Presentation ............................................................................................................................................................... 166 Course Specific Attendance and Tardiness Policy .................................................................................................................... 167 Latex Allergies or Latex Hypersensitivities .............................................................................................................................. 167 COURSE SCHEDULE ....................................................................................................................................................................168 Lectures ................................................................................................................................................................................. 168 SEMESTER TWO SYLLABI ............................................................................................................................................................... 173 CLINICAL SYSTEMS II SYLLABUS ..................................................................................................................................................... 174 COURSE DETAILS .......................................................................................................................................................................174 COURSE DESCRIPTION ................................................................................................................................................................174 OVERALL COURSE GOALS ............................................................................................................................................................175 Course Objectives .................................................................................................................................................................. 175 Student Objectives ................................................................................................................................................................. 175 REQUIRED TEXTS AND MATERIALS ................................................................................................................................................176 SUPPLEMENTAL TEXTS AND MATERIALS .........................................................................................................................................177 EXAM DATES ...........................................................................................................................................................................178 EXAM GRADE COMPUTATION ......................................................................................................................................................178 COURSE GRADE COMPUTATION ...................................................................................................................................................179 ADDITIONAL INFORMATION .........................................................................................................................................................179 Course Format ....................................................................................................................................................................... 179 Course Presentation ............................................................................................................................................................... 180 Course Specific Attendance and Tardiness Policy .................................................................................................................... 180 Accessing Up to Date Online Instructions................................................................................................................................ 180 HEENT, Ear Assignment.......................................................................................................................................................... 181 COURSE SCHEDULE ....................................................................................................................................................................183 Lectures ................................................................................................................................................................................. 183 MEDICAL MICROBIOLOGY AND IMMUNOLOGY II SYLLABUS ......................................................................................................... 215 COURSE DETAILS .......................................................................................................................................................................215 COURSE DESCRIPTION ................................................................................................................................................................215 OVERALL COURSE GOALS ............................................................................................................................................................215 REQUIRED TEXTS AND MATERIALS ................................................................................................................................................216 RECOMMENDED TEXTS AND MATERIALS ........................................................................................................................................216 EXAM DATES ...........................................................................................................................................................................216 EXAM GRADE COMPUTATION ......................................................................................................................................................216 COURSE GRADE COMPUTATION ...................................................................................................................................................217 COURSE SCHEDULE ....................................................................................................................................................................218 Lectures ................................................................................................................................................................................. 218
MEDICAL SIMULATION ELECTIVE SPRING SEMESTER SYLLABUS..................................................................................................... 229 COURSE DETAILS .......................................................................................................................................................................229 COURSE DESCRIPTION ................................................................................................................................................................229 OVERALL COURSE GOALS ............................................................................................................................................................229 REQUIRED MATERIALS ...............................................................................................................................................................229 ASSESSMENT............................................................................................................................................................................229 ADDITIONAL INFORMATION .........................................................................................................................................................230 Course Format ....................................................................................................................................................................... 230 Course Fee ............................................................................................................................................................................. 230 Course Registration................................................................................................................................................................ 230 Attendance, Tardiness & Absences ......................................................................................................................................... 230 Latex Allergies or Latex Hypersensitivities .............................................................................................................................. 230 COURSE SCHEDULE ....................................................................................................................................................................231 Lectures ................................................................................................................................................................................. 231 OSTEOPATHIC MANIPULATIVE MEDICINE II PART 2 SYLLABUS ...................................................................................................... 235 COURSE DETAILS .......................................................................................................................................................................235 COURSE DESCRIPTION ................................................................................................................................................................235 OVERALL COURSE GOALS ............................................................................................................................................................235 REQUIRED TEXTS AND MATERIALS ................................................................................................................................................235 RECOMMENDED TEXTS AND MATERIALS ........................................................................................................................................236 EXAM DATES ...........................................................................................................................................................................236 EXAM GRADE COMPUTATION ......................................................................................................................................................236 COURSE GRADE COMPUTATION ...................................................................................................................................................237 ADDITIONAL INFORMATION .........................................................................................................................................................237 Attendance and Grading Policy .............................................................................................................................................. 237 COURSE SCHEDULE ....................................................................................................................................................................240 Lectures ................................................................................................................................................................................. 240 OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) SYLLABUS ............................................................................................ 249 COURSE DETAILS .......................................................................................................................................................................249 COURSE DESCRIPTION ................................................................................................................................................................249 OVERALL COURSE GOALS ............................................................................................................................................................249 REQUIRED MATERIALS ...............................................................................................................................................................250 REQUIRED TEXTS.......................................................................................................................................................................250 EXAM GRADE COMPUTATION ......................................................................................................................................................250 COURSE GRADE COMPUTATION ...................................................................................................................................................251 ADDITIONAL INFORMATION .........................................................................................................................................................251 Course Materials.................................................................................................................................................................... 251 Course Format ....................................................................................................................................................................... 251 Course Presentation ............................................................................................................................................................... 252 Course Specific Attendance and Tardiness Policy .................................................................................................................... 252 Latex Allergies or Latex Hypersensitivities .............................................................................................................................. 252 COURSE SCHEDULE ....................................................................................................................................................................253 Lectures ................................................................................................................................................................................. 253 PATHOLOGY II SYLLABUS ............................................................................................................................................................... 259 COURSE DETAILS .......................................................................................................................................................................259 COURSE DESCRIPTION ................................................................................................................................................................259 OVERALL COURSE GOALS ............................................................................................................................................................259
REQUIRED TEXTS AND MATERIALS ................................................................................................................................................259 RECOMMENDED TEXTS AND MATERIALS ........................................................................................................................................260 SUPPLEMENTARY EDUCATIONAL MATERIALS ...................................................................................................................................260 EXAM DATES ...........................................................................................................................................................................261 EXAM GRADE COMPUTATION ......................................................................................................................................................261 COURSE GRADE COMPUTATION ...................................................................................................................................................262 ADDITIONAL INFORMATION .........................................................................................................................................................262 Laboratory & Small group Session Rules ................................................................................................................................. 262 Participating Faculty .............................................................................................................................................................. 262 COURSE SCHEDULE ....................................................................................................................................................................263 Labs & Lectures...................................................................................................................................................................... 263 PHARMACOLOGY II SYLLABUS ....................................................................................................................................................... 275 COURSE DETAILS .......................................................................................................................................................................275 COURSE DESCRIPTION ................................................................................................................................................................275 OVERALL COURSE GOALS ............................................................................................................................................................275 REQUIRED TEXTS AND MATERIALS ................................................................................................................................................275 RECOMMENDED TEXTS AND MATERIALS ........................................................................................................................................276 EXAM DATES ...........................................................................................................................................................................276 EXAM GRADE COMPUTATION ......................................................................................................................................................276 COURSE GRADE COMPUTATION ...................................................................................................................................................277 COURSE SCHEDULE ....................................................................................................................................................................278 Lectures ................................................................................................................................................................................. 278 PROFESSIONALISM IN MEDICINE ................................................................................................................................................... 289 COURSE DETAILS .......................................................................................................................................................................289 COURSE DESCRIPTION ................................................................................................................................................................289 OVERALL COURSE GOALS ............................................................................................................................................................289 COURSE STRUCTURE ..................................................................................................................................................................290 COURSE READINGS ....................................................................................................................................................................290 Required Textbook: ................................................................................................................................................................ 290 iTunes Lectures ...................................................................................................................................................................... 290 FORMAL COURSE ASSIGNMENTS...................................................................................................................................................290 EXAM DATES ...........................................................................................................................................................................290 EXAM GRADE COMPUTATION ......................................................................................................................................................291 COURSE GRADE COMPUTATION ...................................................................................................................................................291 ADDITIONAL INFORMATION .........................................................................................................................................................291 Academic Dishonesty ............................................................................................................................................................. 291 COURSE SCHEDULE ....................................................................................................................................................................292 Lectures ................................................................................................................................................................................. 292
Overviews and Documentation
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Year Two Schedule Overview
11
Estimated Weekly Schedule
12
Exam Schedule Breakdown

Semester One
13
14
Semester One Finals Week Schedule is not finalized subject to change
15
Semester Two
16
Semester Two Finals Week Schedule is not finalized subject to change
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Faculty Office Hours and Contact Information

Professor Dr. Anthony Dr. Bahri Dr. Banihashem Dr. Brown Dr. Capozzi Dr. Delbridge Dr. DiCaprio Dr. Gardere Dr. Grotticelli Dr. Jones Dr. Milani Dr. Pino Dr. Prancan Dr. Sirota Dr. Stern Dr. VasconezPereira Courses Taught OSCE, PCS, MedSim Pathology OMM OSCE, PCS, MedSim, Clinical Systems Clinical Systems, PCS, OSCE Pathology Medical Microbiology & Immunology Behavioral Medicine OSCE, PCS, MedSim Medical Microbiology & Immunology OMM Pharmacology Pharmacology OSCE, MedSim Pathology OMM Room 220 419 420 220 220 427 427 423 220 426 443 426 425 225 419 OSCE (332) E-mail Esquire.Anthony@touro.edu Tipsuda.Bahri@touro.edu Mary.Banihashem@touro.edu Joyce.Brown@touro.edu Barbara.Capozzi@touro.edu Cheryl.Delbridge@touro.edu Kathleen.DiCaprio@touro.edu Jeffrey.Gardere@touro.edu Janet.Grotticelli@touro.edu Stephen.Jones@touro.edu Susan.Milani@touro.edu Maria.Pino@touro.edu Arthur.Prancan@touro.edu Harold.Sirota@touro.edu Robert.Stern@touro.edu Grace.VasconezPereira@touro.edu Phone Number Office Hours x4551 by appt. only x4610 by appt. only x4618 x4506 x4507 x4606 x4608 x4614 x4584 x4609 x4619 x4613 x4612 x4522 x4611 x4581 by appt. only by appt. only by appt. only Tues, by appt. only by appt. only by appt. only by appt. only Tues and Thurs 122pm by appt. only Wed and Thurs at noon or by appt. Wed and Thurs at Noon by appt. only by appt. only by appt. only
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Course Breakdown
Year 2
Courses Behavioral Medicine Clinical Systems Introduction to Clinical Rotations Medical Microbiology and Immunology Medical Simulation Elective OMM II OSCE Pathology Pharmacology Primary Care Skills Professionalism and Medical Ethics Total hours by semester for the second year
(Includes module systems) (Includes module system) (Includes module systems) (Includes module systems)
Subtopics
Semester 1 2 7 2 3 5 4 1 24
Semester 2 7 1 2 3 1 5 4 2 25
(Includes module systems)
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Academic Policies
Academic Policies
All official Touro College of Osteopathic Medicine academic policies can be found in the student handbook. These polices include our attendance policy, our policy on academic integrity, our policy on laboratory accommodations, and more. This handbook is most readily available online, at http://www.touro.edu/med/handbook.html. If there is a conflict in policy between the Course Documentation Handbook and the Student Handbook, the Student Handbook prevails.
Lectures
E-Lectures
Most of your classes will be given using the E-Lecture system. Prerecorded lectures will be available on iTunes for you to download and watch. In-class lectures will be Group Learning sessions that will be structured around Question-Answer sessions using the iClickers. It will be expected that the lecture video is watched before the corresponding Group Learning session. Each courses syllabus will include which lecture videos to watch before the Group Learning session. Some Group Learning sessions will be designated by lab group (A or B). Just like lab sessions, you will only be required to attend Group Learning sessions for your group. Attending alternate Group Learning Sessions will only be permitted in situations when you would be missing your session for a school purpose (attending a conference, work study, etc.). Excused absences will not be sufficient to attend the alternate session. Additionally, any missed Group Learning Sessions will be deducted from your final grade calculation. You can only receive points for a session that you attend. The alternate session is not there for you to attend when you need it.
Traditional Lectures
Courses that are not taught using the E-Lecture system will be taught using the traditional lecture system. Students will attend lectures that are given in class at their scheduled time.
iClickers
iClicker Policies
iClickers with a specific serial number will be assigned to each student at the beginning of the year. They will be used to see how well students understand the course material that is being taught, as well as used for in class quizzes and assignments. Each iClicker has an individual serial number that will be linked to your student ID which will be used to keep track of the answers you input. Scores will be posted on Blackboard under the proper course. Students will be issued an iClicker for the year. You will be expected to bring the iClicker with you to class every day. If you do not bring the iClicker, your presence in the class will not be recorded, you will not receive points for any assignments given that day and you will be marked as absent for the day. Professors will not be accepting handwritten answers to the questions if you forget your iClicker.
20
Students will be responsible for making sure that their iClicker has batteries. If your iClicker is having a technical problem, contact Theodore Thompson (Theodore.thompson7@touro.edu). At the end of the school year, you will return the iClicker. If you do not return the iClicker, you will be charged $50 to replace and reprocess a new one.
Attendance
There will be no global attendance policy this year. Please see individual course syllabi for specific attendance policies.
Seating Assignments
Seating in Lecture Hall 2 will be operating on a First Come/First Serve basis. Saving seats will not be allowed.
Exams
Exam Taking Policy
TouroCOM uses ExamSoft, a computer-based exam program, to write and administer exams. For each exam, students download a password protected exam file and at exam time are given the password to begin the exam. Once the exam is finished, students upload their answer file to be graded. Exams are given on Mondays during the semester. Exam dates and times are listed in the Course Documentation Handbook on page 13 and in each individual class syllabus. Exams can be taken in either Lecture Halls 1 or 2. Exam times are subject to change; please refer to the Google calendar for the most accurate version of the schedule. Students will use their own computer to take exams. Students who do not have a computer that fits the specifications to use ExamSoft can use the computers in the Histology lab. This room will also be available to students who have issues with their computers during the exam. The Histology lab is not available to students who have their own computer but would like a different environment. All students who are able to take the exam in one of the Lecture Halls are required to do so. If you miss an exam or know that you will miss an exam in the future, contact Dr. Cammarata, Dean of Student Affairs, regarding an excused absence and Jennifer Engeleit to schedule a makeup exam. Makeup exams are held within one week after the exam date (the following Monday) and makeup exam grades are posted one week after the makeup exam is taken. Once you schedule a makeup exam with Ms. Engeleit, you are required to show up for your makeup exam. Rescheduling the makeup exam will necessitate another excused absence from Dr. Cammarata. Failure to do so or failure to attend your makeup exam will result in a 0% test grade. The exam time listed in the syllabus is the time that the exam is scheduled to begin. Students should arrive in the lecture hall to take the exam thirty minutes before the exam is scheduled to begin to ensure enough time to get seated and download the exam. Students who arrive after the exam password has been released or after the exam has begun will not receive extra time to make up for what they have lost. If an exam begins at 10am, it is your responsibility to arrive before 10am so that you can start on time. Students who are more than 15 minutes late to an exam will not be allowed to sit for the exam at that time. If this happens, contact Dr. Cammarata and Jennifer Engeleit to schedule a makeup exam. All exams are proctored. Proctors will observe the exam takers to ensure there is no cheating or other academic dishonesty. Proctors have authority in an exam situation and can ask you to show them your scrap paper, your computer or any other items that you are using. If a proctor chooses to do so, they can ask for your name and ID number and submit a report on student behavior to the Deans office. This may result in a meeting with the Dean of Preclinical Medicine and a note in your file. *Document is subject to change 21
The following items are not allowed in an exam room: Written notes or textbooks Cellphones iPods, or any other portable audio device Loud or distracting food or drink Headphones
Once all students have their personal items cleared from the room, the password will be posted for students to begin the exam. Students will follow the prompts until they get to a screen that requires them to type in the word Begin, where they will stop and wait for further instruction. Once students are at the begin screen, they will receive their scrap paper. When every student has scrap paper, the proctors will give the room the instruction to begin together. If a student needs to go to the bathroom or anywhere outside the test room during the exam, they should raise their hands and wait for the proctors for further instruction. Students will get a 10 minute warning before the end of the exam. Once the proctors tell all students to close out of the exam, students must do so. If any conflict arises, do not argue with the proctors; instead request to have Jennifer Engeleit called and wait for her to arrive to have the matter resolved. Arguing with the proctors will result in a report on your behavior issued to the Dean. After students have closed out of the exam, students must wait for their exam file to upload before leaving the room. Be sure to make sure your exam file uploads or else your answers will not be available to grade, which will result in there being no grade for the exam when grades are posted.
ExamSoft and SofTest

At the start of the academic year you will receive an email with your user name and password. You will use this user name and password to log onto our personal ExamSoft webpage at https://www.examsoft.com/dotnet/Default.aspx?f=tourocomny. From there you will download SofTest.
Prior to Exam Day

Once you have downloaded SofTest you will be ready to download your exam files as they are released to you. Generally exams will be released a few days before you are scheduled to take the exam. To download your exam you will open SofTest and select the icon Download Exam Files ( ). You will then log in with your User ID and Password. From there you will select which exam you wish to download and press Download.
On Exam Day
On exam day you will open up SofTest and click the icon Take an Exam ( ). You will then select your exam from the drop-down and enter the password that the proctor gives you. At this point your computer will switch into a secure mode and you will be brought into your exam. After agreeing to the honor code and reading the instructions you will be able to begin the exam. When you are finished you will submit your exam, the computer will revert back to the normal mode, and your answers will be automatically uploaded to ExamSoft for grading. *Document is subject to change 22
SofTest Tips and Tricks

1. ExamSoft recommends disabling antivirus program before taking the test. The detailed instructions can be found at http://www.examsoft.com/dotnet/faqs/guides/kaspersky.html 2. Question Navigator enables you to see what questions you have not yet answered, mark any questions you want to go back to, and skip around to various questions 3. You can open and close any images by checking the show image box for applicable questions 4. You can view the exam instructions at any time by clicking Exam Instructions so that normal values and other information are never missing. 5. Your answers will automatically save when you go to the next question 6. You can cross out answer choices by right clicking 7. You can set a timer to automatically notify you when a set amount of time has passed 8. You can resume a test independently if your computer restarts or battery dies 9. Your receive a confirmation when your answers are submitted 10. Safeguards exist to ensure that you do not mistakenly submit and incomplete exam 11. Constant backups are made of your answers to protect against lost exams 12. You will have access to a built in calculator during some exams 13. And more!
ExamSoft Technical Support Resources:

Live Chat: Available Monday-Friday, 8:30am to 5:30pm through the ExamSoft website under (link can be found under Technical Support) Email Support: support@examsoft.com Student Hotline: (866) 429-8889 (option #3)
Exam Standardization
TouroCOM exams are standardized using a formula that is customized for each course. This formula compares the students raw percentages to the average of all successful students exam grades over the past three years in that course while controlling for the standard deviation of all successful students exam grades over the past three years in that course. Additionally faculty set a Faculty Adjustment value at the beginning of the year to ensure that the standard of their course is met. By comparing students grades for each course to the grades of students who succeeded in the past in that course we are able to standardize grades to ensure that we measure students ability to succeed at TouroCOM. Additionally, this method of standardization encourages within class cooperation as it allows the curve to be set by the performance of previous TouroCOM students instead of by within class competition. The formula used to calculate your standardized grade (Z-Score) from your raw percent is: %
Though the raw percentage required to obtain a specific Z-Score changes from course to course (depending on the Mean, Standardization and Faculty Adjustment of the specific course), the Z-Scores required to obtain each final grade are standardized across all classes. The breakdown of what z-score is required to each final grade is as follows: *Document is subject to change 23
A B C U
0.75 Z-Score -0.45 Z-Score < -0.75 -1.35 Z-Score < -0.45 Z-Score < -1.35
The breakdown of what is required to obtain these cutoffs is specified in each courses syllabus. Below please find a graph depicting the range of percentages required for each cutoffs.
Exam Reviewing Policy

Exam grades are posted to Blackboard seven days after the exam is taken (usually the following Monday). Exam reports from ExamSoft are also released seven days after an exam is taken. Students wishing to challenge a question on the exam will have 14 days after the exam is given to contact their professor and challenge the question. Any challenges that have been accepted will be considered when grading the exam. If a challenge is accepted after the grades are posted, the exam will be regraded and new scores will be posted after the 14 day challenge period ends. After the 14 day period ends, grades are final and question challenges will not be accepted. Generally students will not be allowed to review exam questions for security purposes. If a faculty member wishes to allow students to review their exam questions it is up to their discretion, however any review must occur under the faculty members supervision.
End of Year Grading Policy

Students will receive a final letter grade (A, B, C, or U) that corresponds to their final Z-Score at the end of the semester. Final course grades will be computed using the computation method specified in the course syllabus. However professors have the ability to, at the end of the semester, curve their course grades up to one standard deviation up or down.
24
Student Promotion
Student Promotion is the ability of a student to move to the next year of their medical education and is decided by the Student Promotions Committee. The subject of Student Promotion is detailed in the Student Handbook, which is available online at http://www.touro.edu/med/handbook.html.
Global Student Assessment Tools

Early Warning System
In order to help ensure our students success, TouroCOM has created an Early Warning system which helps us monitor student performance and will alert us if a students grades begin to drop. This system takes into account a number of factors, including if your average exam score up to the present date, your rank and current GPA. Three times each semester an Early Warning report is run and the students with the highest Concern Levels are contacted. These students will meet with Dr. Lenihan to discuss their situation and their study habits and to ensure that *Document is subject to change 25
they have all the resources that they need. These emails and meetings are not indicative that you are doing poorly or are in danger of failing, just that we are concerned about the trending of your performance and would like to talk to you about maximizing your education and getting you any help that you need.
Cross Course Performance Graph
After an Early Warning quarter, your faculty advisor might ask to meet with you regarding your performance. Advisors will be issued the above graph for their advisees. This graph shows your performance in each course (the blue bars) compared to the class average (the red line). It is up to your advisors discretion to show or give you your graph if they have them, but Performance Graphs will not be generated for students at their request. If you would like to compare your performance to your peers on your own, please refer to the exam statistics released with the ExamSoft answer keys and the class distribution graphs that are released after each exam. If you would like to compare your performance to your peers on your own, please reference the exam statistics released with the ExamSoft answer keys and the class distribution released after each exam.
Communication
Student Weekly Survey
During the semester, TouroCOM distributes a short weekly survey to the first and second year students. This survey helps us monitor the pulse of student satisfaction with the faculty, administration and the SGA. The survey can be taken through your email account and takes about 3 minutes to complete.
Student Town Hall Meetings

During the semester, the Preclinical Dean will hold Student Town Hall meetings to discuss any pertinent topics that may need clarification and to get feedback on any issues that the students feel warrant discussion. Students attending the meeting will have the chance to ask questions about school policies and raise concerns on any other issues that they deem necessary. *Document is subject to change 26
Twitter
Dr. Lenihan, Dean of Preclinical Medicine, has set up a twitter account, @PreclinicalDean, to write about TouroCOM and its students. Feel free to follow, @reply or retweet anything posted on his Twitter.
Mandatory Evaluation
At the end of each semester, online faculty evaluations will be available for you to complete about your professors. The answers you select will be anonymous, but your participation will be recorded to ensure that all students complete an evaluation for each faculty member. Until all evaluations are submitted, final course grades will not be posted on TCWeb.
Office Hours and Email Communication

Faculty office hours are posted on page 18 of this book. Additionally, any member of the TouroCOM faculty, staff or administration can be contacted by their Touro email, (First Name).(Last Name)@touro.edu.
Student Resources
Resources for Mental Health
Ms. Kari Tabag, LCSW 646-981-4562, Room 312 Kari.Tabag@touro.edu All services are free and confidential
Crises and Emergencies

Dr. Cammarata, Dean of Students 917-597-9362 Jerry.Cammarata@touro.edu
Curriculum Specialist
Dr. Gray Frank.Gray@touro.edu
Student Health Services Clinic

Dr. Patel Medical Office Hemant Patel MD PC 33 West 125 Street New York, NY 10027 212-289-5795
Copyright Frequently Asked Questions and Answers

What is the difference between Copyright Infringement and Plagiarism?
Infringement is an illegal act where one has exercised one of the exclusive rights of a copyright owner beyond the exemptions permitted under law and without permission. Plagiarism is the unethical act of using someone elses expression or ideas without giving that person credit. If you copy a work beyond the amount permitted by fair use it is infringement even if you cite the author. If you take an idea from some else and do NOT cite the author it is plagiarism, even if the work is in the public domain or you did not copy protected expression. *Document is subject to change 27
What is the purpose of Copyright and Patent in the United States?

To promote the progress of science and the useful arts.
What is Copyright?
Copyright is a bundle of rights that grants the copyright owner of a work the exclusive right to: reproduce; prepare derivative works; distribute copies to the public by sale, other transfer of ownership, rental, lease or lending; perform the work publicly, or display the work publicly. Authors of certain works of visual art also have the right of attribution (to be recognized as the creator of the work) and the right of integrity (not to have a work changed without their permission). In the United States the Copyright Office is part of the Library of Congress. More information can be found at http://www.copyright.gov/. Of particular interest of librarians and educators is circular 21 at http://www.copyright.gov/circs/circ21.pdf .
What types of work are protected by Copyright?

Original works of authorship fixed in a tangible medium of expression readable by the unaided human eye or via machines. This includes: literary works; musical works, including any accompanying words; dramatic works, including any accompanying music; pantomimes and choreographic works; pictorial, graphic, and sculptural works; motion pictures and other audiovisual works; sound recordings; architectural works, software, and vessel hulls.
What is Fair Use?

Fair Use is a general exemption to the exclusive rights of the owner. It allows anyone to use a limited portion of a work for criticism, comment, news reporting, teaching, scholarship, or research. There are no bright line guidelines as to whether any particular use is fair. For this reason fair use is often referred to as an equitable rule of reason. Fair use was first created as a judicial doctrine then incorporated into copyright law in the 1978 revision. Fair Use does not necessarily apply to works that are licensed. To determine whether a particular use is fair four factors need to be considered: 1) the purpose of the use, 2) the nature of the work (highly creative works are generally more protected than factual works), 3) amount taken, and 4) effect on the market value of the work.
What is the current term of Copyright in the United States?

Works by an identified author(s) - life of author plus 70 years, Anonymous, pseudonymous works and works for hire - 95 years from first publication or 120 years from creation, whichever expires first (see Laura Gasaways site http://www.unc.edu/~unclng/public-d.htm for a complete chart of when works pass into the public domain.)
What does Copyright protect?

Copyright protects the expression embedded in the work (the actual words, images, notes, etc.).
What isnt protected by Copyright?

Facts, concepts, ideas, processes, procedures, works by the United States government
What is required to have a work be protected by Copyright?

There is currently no requirement for registration or for a copyright notice for a work to be protected. Once a work is fixed it is covered by copyright. However, in order to sue someone for copyright infringement in the United States the work must be registered, even if the registration takes place after the infringement took place.
What is the Public Domain?

If a work is no longer protected by copyright or not eligible to be protected by copyright it is in the public domain. That means there is no copyright owner authorized to exercise exclusive rights, so anyone can create a derivate version of the work, or reproduce, sell, distribute, display and perform the work without permission or fee. *Document is subject to change 28
What is First Sale?

Once an individual buys an object in which copyright expression is embedded the buyer has the right to control that object, this includes lending, selling, and destroying anything in fact but making a copy. It is the right of first sale that permits libraries to buy materials and circulate them. First sale does not necessarily apply to works that are licensed rather than purchased.
What is Copyleft?
This is a movement to release works with only a few specified restrictions. Where copyright takes the stance that all uses not permitted are restricted, Copyleft takes the approach all uses not restricted are permitted. See The Creative Commons at http://creativecommons.org/.
29
2016 Booklist
General Requirements
1 laptop computer or iPad that fits the following minimum requirements (to take exams with SofTest): Note: these requirements are as of May 15, 2013. Hardware compatibility may change by Fall 2013. Please check http://support.examsoft.com/link/portal/15157/15194/Article/162/What-are-the-minimum-system-requirements-torun-SofTest for the most recent requirements.
PC Requirements (Windows XP, Vista, 7, 8):

CPU = 2GHz Intel Core/Celeron or equivalent x86 processor (CPU Info) RAM = highest recommended for the operating system or 2GB Hard Drive = highest recommended for the operating system or 1GB of free space Operating System = English 32-bit Versions of Windows XP, 32-bit and 64-bit Versions of Windows Vista, Windows 7, and Windows 8 SofTest cannot be used on virtual operating systems such as Microsoft's Virtual Machine, Parallels or VMware, VMware Fusion or any other virtual environments, unless approved for the institution. Software = Internet Explorer 7.0 or later Internet connection for SofTest Installation, Exam Download and Upload Screen Resolution must be 1024x768 or higher Administrator level account permissions
Mac Requirements (OS X 10.6, 10.7, 10.8):

CPU = Intel processor RAM = 2 GB Hard Drive = 1 GB of free disk space Operating System = MAC OS X 10.6 (Snow Leopard), 10.7 (Lion), or 10.8 (Mountain Lion) Server version of Mac OS X is not supported SofTest may not be used in a virtual operating systems Software = Internet connection for SofTest installation, Exam Download and Upload Administrator account
Behavioral Medicine
Required Texts and Materials
COMLEX Level 1 Lecture Notes Behavioral Sciences and OMM by Kaplan Medical *This will be distributed by the school.
Recommended Texts and Materials

1. Kaplan and Sadocks Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry by Benjamin J. Sadock and Virginia A. Sadock (ISBN: 9978-0-7817-7327-0, 0-7817-7327-X
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Clinical Systems
1. Title: Cecil Medicine 24th Edition a. By: Lee Goldman (editor) b. Publisher: Saunders; 24th edition (July 25, 2011) c. ISBN: 978-1-4160-2805-5 2. Title: Nelson Essentials of Pediatrics 6th Edition a. By: Robert Kliegman(Author) b. Publisher: Saunders; 6 edition (March 31, 2010) c. ISBN: 978-1-4377-0643-7 3. Title: Rapid Interpretation of EKGs, Sixth Edition a. By: Dale Dubin (Author) b. Publisher: Cover Publishing Company; 6 edition (October 15, 2000) c. ISBN: 978-0-9129-1206-6 4. Title: Hacker & Moore's Essentials of Obstetrics and Gynecology a. By: Neville F. Hacker MD b. Publisher: Saunders; 5 edition (February 4, 2009) c. ISBN: 978-1-4160-5940-0 5. Title: Bates Guide to Physical Examination and History Taking 10th Edition a. By: Lynn S. Bickley b. Publisher: Lippincott Williams & Wilkins; 10th edition (December 10, 2008) c. ISBN: 978-1-6054-7803-6 6. Title: Pathophysiology a. By: Ivan Damjanov MD PhD b. Publisher: Saunders; 1 Pap/Psc edition (April 30, 2008) c. ISBN: 978-1-4160-0229-1 7. Title: Primer on the Rheumatic Diseases a. By: John H. Klippel b. Publisher: Springer; 13th ed. 2008 c. ISBN: 978-0-387356648 8. Title: Bates' Visual Guide to Physical Examination a. By: Barbara Bates, Lynn S Bickley b. Imprint: Philadelphia, Pa. : Lippincott Williams & Wilkins, c2005, c2007 c. ISBN: 978-0-7817-5861-1 d. Call # (for Touro-Harlem Medical Library): WB 205 B329 2007 9. Title: Physical Examination of the Spine and Extremities a. By: Stanley Hoppenfeld b. Publisher: Prentice Hall; 1st Edition (June 5, 1976) c. ISBN: 978-0-838578537 10. Title: Renal Notebook* a. By: James Agresti, DO b. Will be posted on Blackboard prior to the Renal Module.
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Supplemental Texts and Materials

1. Title: Harrisons Principles of Internal Medicine 18 Th. Edition a. By: Anthony S.Fauci b. Publisher: McGraw-Hill c. ISBN: 978-0-0714-6633-2 2. Title: Rakel Textbook of Family Medicine a. By: Robert E. Rakel b. Publisher: Saunders; 8 Th. Edition (April 25, 2007) c. ISBN: 978-1-4160-2467-5 3. Title: Rakel Essential Family Medicine: Fundamentals and Case Studies, Third edition a. By: Robert E. Rakel b. Publisher: Saunders, Elsevir c. ISBN: 978-1-4160-2377-7 4. Title: Kochars Clinical Medicine for Students: Fifth Edition a. By: Dario Torre b. Publisher: Lippincott Williams and Wilkins, Fifth Edition (2009) c. ISBN: 978-0-7817-6699-9 5. Title: Nelson Textbook of Pediatrics 18 Th. Edition a. By: Robert M. Kliegman b. Publisher:Elsevier Science Health Science Division c. ISBN: 978-1-4160-2450-7 6. Title: Minor Emergencies: Splinters to Fractures a. By: Philip Buttaravoli b. Publisher: Mosby; 2 nd. Edition c. ISBN: 978-0-323-04026-6. 7. Title: ENT Secrets, Third Edition a. By: Bruce W. Jafek, M.D. b. Publisher: Mosby; 3 rd. Edition c. ISBN: 978-1560536178 8. Title: Obstetrics and Gynecology a. By: Charles RB Beckmann (Editor) b. Publisher: Lippincott Williams & Wilkins; 6 Edition (May 1, 2009) c. ISBN: 978-0-7817-8807-6 9. Title: Williams Obstetrics a. By: F. Gary Cunningham b. Publisher: McGraw- Hill; 23rd Edition c. ISBN: 978-0-0714-9701-5 10. Title: Learning Radiology: Recognizing the Basics a. By: William Herring MD (Author) b. Publisher: Mosby; 1 Pap/Pas edition (May 1, 2007) c. ISBN: 978-0-3230-4317-5 11. Title: A Practical Approach to Radiology a. By: Nancy M. Major, M.D. b. Publisher: Saunders; 1 edition (August 25, 2006) c. ISBN: 978-1-4160-2341-8 *Document is subject to change 32
12. Title: Ferri's Best Test: A Practical Guide to Laboratory Medicine and Diagnostic Imaging a. By: Fred F. Ferri MD FACP (Author) b. Publisher: Mosby; 2 edition (April 7, 2009) c. ISBN: 978-0-3230-5759-2 13. Title: Primary Care Geriatrics, 5th Edition: A Case Based Approach a. By: Ellen Flaherty, PhD APRN BC (Author) b. Publisher: Mosby; 5 edition (September 18, 2006) c. ISBN-13: 978-0-3230-3930-7 14. Title: Essentials of Surgery a. By: James M. Becker, M.D., FACS b. Publisher: Saunders c. ISBN: 978-0-7216-8186-3 15. Title: The Complete Guide to Nutrition in Primary Care a. By: Darwin Deen , Lisa Hark b. Publisher: Blackwell c. ISBN: 978-1-4051-0474-6
Medical Microbiology and Immunology

1. Microbiology: A Clinical Approach a. ISBN#: 978-0-815-36514-3 b. Edition: 1st c. Publisher: Garland science d. Year: 2010 2. Essentials of Clinical Immunology a. ISBN#: 978-1-4051-2761-5 b. Edition: 5th c. Publisher: John Wiley and Sons Inc d. Year: 2006

1. Rubins Pathology: Clinicopathologic foundations of medicine a. ISBN#: 0-7817-9516-8 b. Edition: 5th c. Publisher: Lippincott Williams and Wilkins d. Year: 2008 2. Schaechters Mechanisms of Microbial Disease a. ISBN#: 978-0-7817-53425 b. Edition: 4th c. Publisher: Lippincott Williams and Wilkins d. Year: 2006 3. Lippincotts Illustrated Q&A Review of Microbiology and Immunology a. ISBN#: 987-1-58255-857-8 b. Publisher: Lippincott Williams and Wilkins c. Year: 2010 *Document is subject to change 33
Medical Simulation
Required Materials
Stethoscope Scrubs White lab coat
OMM II
1. Osteopathic Considerations in Systemic Dysfunction, Revised 2nd Edition, a. Author - Kuchera, M. b. ISBN -1-57074-154-9 2. Foundations of Osteopathic Medicine, 3rd Edition a. Editor -Chila, Anthony b. ISBN -978-0-7817-6671-5 3. An Osteopathic Approach to Diagnosis & Treatment a. Author-DiGiovanna et al b. ISBN -978-0-7817-6671-5 4. Physical Examination of the Spine & Extremities a. Author-HoppenfeldI S. b. ISBN -0-8385-7853-5

1. Somatic Dysfunction in Osteopathic Family Medicine a. Editor -Nelson, Kenneth b. ISBN-13 =978-1-4051-0475-3 2. Teachings in the Science of Osteopathy a. Author-Sutherland, William b. ISBN-0-930298-00-5 3. A Pocket Manual of OMT a. Author- Steele, Karen M. b. ISBN-13 978-1405104807 4. The 5-Minute Osteopathic Manipulative Medicine Consult a. Author-Channel,Millicent King b. ISBN 13: 978-0781779531
OSCE
Required Materials
Stethoscope with a dual head (separate diaphragm and bell) Adult blood pressure cuff (latex free) Ophthalmoscope with a coaxial head. A panoptic head is not acceptable. Otoscope with a pneumatic bulb. Otoscope head must be compatible with plastic disposable specula. Reflex hammer Two tuning forks (one that is between 512-1024 Hz and that is 128 Hz) 34
Penlight Student length/consultation white laboratory coat
Required Texts
1. Bates Guide to Physical Examination and History Taking, 10th Edition a. Author=Lynn S. Bickley b. Editor =Bickley c. Publisher =Lippincott Williams & Wilkins d. Publisher Webpage=http://www.lww.com e. Publication Date =2009 f. ISBN =978-0-7817-8058-2 2. Physical Examination of the Spine and Extremities a. Author=Stanley Hoppenfeld b. Editor =Hoppenfeld c. Publisher =Prentice Hall d. Publisher Webpage=http://www.prenticehall.com e. Publication Date = 1976 f. ISBN = 0-8385-7853-5 3. Bates Visual Guide to Physical Examination DVD Series Volumes 1-19, 4th Edition* a. Author = Lynn S. Bickely b. ISBN = 9780781757645 *This is available on via streaming video through the TouroCOM library. Instructions for access and viewing are posted on Blackboard.
Pathology
If you have purchased the Robbins Basic, Big Robbins, or Rubins and do not want to change textbooks, then that is fine. The required reading will be based upon Robbins Basic Pathology (see schedule). 1. Robbins Basic Pathology, 9th Edition (2012) [8th edition (2007) will also suffice] a. Kumar, Abbas, Fausto, and Mitchell b. ISBN-13: 978-1-4160-2973-7 from Elsevier (Saunders) --OR-2. Rubins Pathology: Clinicopathologic foundations of medicine, 5th or 6th edition (2011) a. Rubin and Strayer b. 5th edition: ISBN: 0-7817-9516-8; 6th edition ISBN: 9781605479682 from Lippincott Williams & Wilkins 3. Blueprints Medicine, 5th edition (2010) [For Clinico-pharmacologic correlation] a. Young, Chick, Kormos, & Goroll b. ISBN: 4. Rapid Review Laboratory Testing in Clinical Medicine (2008) [For Lab medicine correlation] a. Goljan and Sloka b. ISBN: 978-0-323-03646-7 from Elsevier (Mosby)

Listed in order of highly recommended to least recommended: *Document is subject to change 35
1. Rapid Review Pathology, 3rd edition 2011 a. Goljan b. ISBN 9780323068628 from Elsevier (Mosby) 2. First Aid of the USMLE Step1, 2013 edition a. Bhusan & Le b. ISBN: 9780071475310 McGraw-Hill 3. Pathophysiology 2009 a. Damjanov b. ISBN-13: 978-1-4160-0229-1 from Elsevier (Saunders) 4. Robbins & Cotran Review of Pathology, 3rd edition a. Klatt, Vinay, & Kumar b. ISBN: 9781416049302 from Elsevier (Saunders) 5. Lippincott's Review of Pathology (2006) a. Fenderson and Rubin b. ISBN: 9781416049302 from Elsevier (Saunders)
Supplementary Educational Materials

Textbooks: 1. Robbins and Cotran, 8th edition a. Kumar, Abbas, Fausto, Aster b. ISBN: 9781437707922 from Elsevier (Saunders) 2. Essentials of Rubins pathology, 5th edition a. Rubin and Reisner b. ISBN-10: 0-7817-7324-5 from Lippincott Williams & Wilkins 3. Renal Pathophysiology: the Essentials 3rd edition a. Rennke and Denker b. ISBN: 0781799953 4. Pathology Flash cards 2009 a. Baron and Lee b. 0071613056 McGraw-Hill 5. Andreoli and Carpenters Cecil Essentials of Medicine, 7th edition a. Andreoli b. ISBN-10: 1-4160-2933-8 from Elsevier (Saunders) Websites: Pathology: 1. http://library.med.utah.edu/WebPath/webpath.html {Great images, tutorials, and review questions} Histology/Pathology: 1. http://zoomify.lumc.edu/path/virtualpath.htm {Virtual pathology: Online glass slide review} 2. http://www.meddean.luc.edu/lumen/gme.htm {Interesting multi-disciplinary case studies} 3. http://www.medicine.virginia.edu/clinical/departments/pathology/Case%20Studies/known-pathologycases Radiology: *Document is subject to change 36
1. http://www.med-ed.virginia.edu/courses/rad/ {Great source on reading XRays, CT scans, etc}
Pharmacology
1. Study Guide and Lecture Notes a. Arthur Prancan, Ph.D; Maria A. Pino, Ph.D. b. Posted on Blackboard

1. Basic and Clinical Pharmacology, 12th edition a. Editor = Bertram Katzung b. Publisher = McGraw-Hill Companies c. Publication Date = 2011 d. ISBN = 978-0-07-160405-5
Primary Care Skills

1. 2. 3. 4. 5. 6. 7. 8. 9. Stethoscope with a dual head (separate diaphragm and bell) Adult blood pressure cuff (latex free is recommended) Ophthalmoscope with a coaxial head. A panoptic head is not acceptable. Otoscope with a pneumatic bulb. Otoscope head must be compatible with plastic disposable specula. Reflex hammer Two tuning forks (512-1024 Hz and 128 Hz) Penlight Student/consultation length white laboratory coat Bates Guide to Physical Examination and History Taking, 10th Edition a. Author=Lynn S. Bickley b. Editor =Bickley c. Publisher =Lippincott Williams & Wilkins d. Publisher Webpage=http://www.lww.com e. Publication Date =2009 f. ISBN =978-0-7817-8058-2 10. Physical Examination of the Spine and Extremities a. Author=Stanley Hoppenfeld b. Editor =Hoppenfeld c. Publisher =Prentice Hall d. Publisher Webpage=http://www.prenticehall.com e. Publication Date = 1976 f. ISBN = 0-8385-7853-5 11. Bates Visual Guide to Physical Examination DVD Series Volumes 1-19, 4th Edition* a. Author = Lynn S. Bickely b. ISBN = 9780781757645 *This is available on via streaming video through the TouroCOM library. Instructions for access and viewing are posted on Blackboard. *Document is subject to change 37
Professionalism and Medical Ethics

Required Textbook:
1. Medical Ethics: A Very Short Introduction by Tony Hope 2. Master the Boards USMLE Medical Ethics: The Only USMLE Ethics High-Yield Review by Conrad Fischer
38
Semester One Syllabi
39
Behavioral Medicine Syllabus

Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Course Coordinator Directors Campus Phone Directors Email Office Hours Behavioral Medicine I PRCR-626-E Basic Sciences 2 18 weeks Letter Dr. Jeff Gardere, PhD Dr. Jeff Gardere, PhD 917-312-4497 Jeffrey.gardere@touro.edu By appointment only
Course Description
This course explores behavioral aspects of medicine and psychopathology. This is a challenging field in that it requires integration across multiple frames of reference: biological, psychological, and sociocultural and dealing with irrational ideas. Students learn the basics of normal and abnormal patterns of psychological and social development and their effect on the health of individuals. Students learn about signs, symptoms, diagnostic testing, and treatments of mental illness and management plans. The epidemiology, descriptive psychopathology, etiology, and prognosis of the major child and adult mental disorders are presented. The focus is both on common problems encountered by primary care physicians and on the chronic, severe mental disorders; schizophrenia, bipolar disorder, depression and alcoholism, which affect as much as 20 percent of the population.
Overall Course Goals

1. Describe the basics of normal and abnormal patterns of psychological and social development and their effect on the health of individuals. 2. Learn about signs, symptoms, diagnostic testing, and treatments of mental illness and management plans. 3. Learn the value of integrating psychiatry in medicine. Mentally ill are underserved, and treating them reduces health disparities. 4. Understand the public health and policy consequences of the global burden of mental illness and issues in health care reform. 5. Ensure that the elements of the Core Competencies are met.

COMLEX Level 1 Lecture Notes Behavioral Sciences and OMM by Kaplan Medical *This will be distributed by the school.

1. Kaplan and Sadocks Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry by Benjamin J. Sadock and Virginia A. Sadock (ISBN: 9978-0-7817-7327-0, 0-7817-7327-X 2. Kaplan and Sadocks Study Guide and Self-Examination Review in Psychiatry, Eighth Edition, Wolters Kluver/Lippincott Williams & Wilkins, 2007. Behavioral Medicine 40 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Exam Dates
These dates are subject to change. Exam I 10/7/2013 Exam II 12/11/2013
Exam Grade Computation

For this course the following breakdown will be used, where exam Z-Scores greater than and equal to 0.75 are an A, exam Z-Scores less than 0.75 and greater than and equal to -0.45 and are a B, exam Z-Scores less than -0.45 and greater than and equal to -1.35 are a C and exam Z-Scores below -1.35 are an F. For the raw percentages required to achieve these Z-Scores for this course, please see the chart below. Letter Grade A B C F Z-Score 0.75 Z -0.45 Z < 0.75 -1.35 Z < -0.45 Z < -1.35 Percent 88.91% % 79.96% % < 88.91% 73.25% % < 79.96% % < 73.25%
Z-Scores are calculated using the following formula: %
The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation Behavioral Medicine 15.00% 84.44% 7.46%
Course Grade Computation

Quizzes Exam I Exam II Total 10% 45% 45% 100%
Behavioral Medicine 41 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Schedule
Lectures
Sem: Week Date Lect. # 1-1 Lecture Topic Epidemiology 1 Readings 1. 2. 3. 4. 5. 6. 1. 2. 3. 4. 5. 1:2 8/8 2-2 Biostatistics 2 Chapter 2 (Pg 15-38) 6. 7. 8. 1. 1:3 8/15 3 Life in the United States Chapter 3 (Pg 39-48) Course Objectives Know the definitions and use of rates Know incidence and prevalence Know standardized rates Know use and computations for screening tests Know how to identify bias in research Know common study designs Know the rules governing join probability Know types of central tendency Know measures of variation Know constant percentages under the normal curve Know computing and using confidence intervals, including standard errors and Zscores Know the logical statistics including p-values and Type I and Type II errors Know type of scales Know how to choose among very basic statistical tests Know some basic facts about life in United States included family life, suicide, use of health care and AIDS. (General patterns and trends are more important than specific numbers). Know susceptibility to alcohol problems and the most common interventions Know presenting signs and symptoms for intoxication and withdrawal reactions for commonly abused substances Know basic factions about substance abuse and health status Lecturer
1:1
8/1
1-2
Epidemiology 2
Chapter 1 (Pg 1-14)
Dr. Gardere
2-1
Biostatistics 1
Dr. Gardere
Dr. Gardere
1. 2. 1:4 8/22 4 Substance Abuse Chapter 4 (Pg 49-60) 3.
Dr. Gardere
Behavioral Medicine *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
42
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 1. Know sexual behavior in the United States 2. Know paraphilias 3. Know differential diagnosis among sexual dysfunctions 4. Know facts about sexual practices 1. Know the differences between classical and operant conditioning 2. Know types of reinforcement 3. Know the effect of difference reinforcement schedules 4. Know applications of Behavioral principles in clinical situations 5. Know the behavioral substrate of depression 6. Know the curvilinear relationship between arousal and performance 7. Know behavioral approaches to pain management 1. Know how to recognize the presence of defense mechanisms and the impact they have on human behaviors and perceptions. Special attention should paid to the impact these defenses mechanisms may have on medical practice. 2. Know which defense mechanisms are commonly associated with specific psychiatric diagnoses. Review Exam I 1. Understand Type A behavior pattern, how stress impacts physical health, and what intelligence is and the basic tests for measuring it. 2. Know the difference between objective and projective tests and common examples of each
Lecturer
1:5
8/29
Human Sexuality
Chapter 5 (Pg 61-72)
Dr. Gardere
1:7
9/12
Learning and Behavior Modification
Dr. Gardere
1:8b
9/24
Defense Mechanism
Dr. Gardere
1:9
10/3 10/7
1:10
10/10
Psychological Health Testing
Dr. Gardere
43
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 3. Know commonly used neuropsychological tests 4. Knows how to compute and understand IQ 1. Know capacities and preferences of infants 2. Know basic developmental patterns, including reproducing shapes and learning movements 3. Know Common ages corresponding to physical milestones 4. Know the basic issues in Personality Development 5. Know how social capacities change with age 6. Know the sequence of cognitive development 7. Know how languages skills develop with age. 8. Know characteristics patterns of play at given ages 9. Know how to discipline children 10. Know how to cope with attachment and loss 11. Know how to differentiate grief and depression and childrens conceptions of death and illness 12. Know how to deal with abuse 1. Know sleep architecture, including how to read sleep diagrams and EEG tracings 2. Know developmental changes in sleep patterns, including sleep for infants and the elderly 3. Know the effect of sleep deprivation 4. Understand the diagnosis and treatment of sleep disorders 5. Know clinical correlates of sleep patterns with psychiatric conditions and pharmacology 6. Know the biochemistry of sleep 1. Understand what constitutes the best Physician-Patient Relationship and be able to apply this understanding to current medical
Lecturer
1:11
10/17
Human Development
Dr. Gardere
1:12
10/24
10
Sleep and Sleep Disorders
Chapter 10 (Pg 121-130)
Dr. Gardere
1:13
10/31
11
Physician-Patient Relationship
Chapter 11 (Pg 131-142)
Dr. Gardere
44
Sem: Week
Date
Lect. #
Lecture Topic Diagnostic and Statistical Manual IV (DSM IV) 1 Diagnostic and Statistical Manual IV (DSM IV) 2
Readings 1.
Course Objectives practice. Recognize and offer differential diagnosis of Axis I and Axis II diagnoses, including common treatment interventions. Be able to apply information in the form of clinical vignettes Pay special attention to: mental retardation, eating disorders, stress disorders, the relationship between biological markers and behavior patterns for schizophrenia and affective disorders, the preferred treatments for each of the separate anxiety disorders, and the differential diagnosis of personality disorders. Know the signs and symptoms of common organic conditions Understand the differential diagnosis among related disorders and between organic disorders and psychiatric disorders
Lecturer
12-1 12-2
2. 3.
1:14
11/7 12-3 Diagnostic and Statistical Manual IV (DSM IV) 3
Chapter 12 (Pg 143-174)
Dr. Gardere
14-1 1:15 11/14 14-2
Organic Disorders 1 Organic Disorders 2 Chapter 13 (Pg 175-188)
1. 2.
Dr. Gardere
1:16 1:17
11/21 11/28
13
Neurotransmitters & Their Receptor Actions Psychopharmacology 1 Psychopharmacology 2 Thanksgiving Closure 1. Know when different types of drugs are used 2. Know the side effects of different types of the Chapter 14 (Pg 189-204) drugs 3. Know how to manage the side effects of different types of drugs. 1. Know the best response to common ethical and legal dilemmas. Chapter 15 (Pg 205-218) 2. Be able to determine the best response by applying the standards of ideal ethical professional conduct Exam 2
Dr. Prancan Dr. Pino Dr. Gardere
16-1 16-2 1:18 12/5 15
Dr. Gardere Dr. Prancan Dr. Pino
Ethical and Legal Issues
Dr. Gardere
Finals
12/11
45
Clinical Systems I Syllabus

Course Details
Course Title Course Number: Department: Credit Hours: Duration: Grading Type: Course Director: Course Coordinator Directors Campus Phone: Directors E-mail: Office days/Hours: Clinical Systems I PRCR-627 Primary Care 7 18 weeks Letter Barbara Capozzi, DO Barbara Capozzi, DO (646)981-4507 barbara.capozzi@touro.edu By appointment
Course Description
The Clinical Systems I Course is composed of 7 Modules. Note that this year iTunes will be the main source for delivery of material. Class will correspond with this material and reading assignments. The course will be presented in chronological order as follows: 1. 2. 3. 4. 5. 6. 7. Pediatrics Geriatrics Cardiology Pulmonary Endocrinology Renal Gastroenterology (GI) 2 weeks 1 week 4 weeks 3 weeks 2 weeks 3 weeks 3 weeks
The Clinical Systems course will provide a foundation for clinical medicine. The course will cover the clinical aspect of medicine relative to the pediatric, adolescent, adult and geriatric population. The first two modules, Pediatrics and Geriatrics, will constitute Life Cycle Medicine. In addition, the course will divide clinical medicine into major organ systems (presented in modules), and will incorporate, (but will not be limited to), Infectious Diseases, Radiology/Diagnostic Imaging, Laboratory Values and Surgery. At the same time the Clinical Systems Course will have a vertical thread with the Basic Sciences: Pathology, Pharmacology, Immunology and Microbiology, and Osteopathic Manipulative Medicine, so that students will have a complete presentation of each of the disciplines of medicine. The Clinical Systems course will also be integrated with the Primary Care Skills course (case-based learning) and the OSCE course (experiential learning). Select topics will be reinforced utilizing Medical Simulation. Clinical Systems course content will include: etiology, risk factors (genetic, racial, ethnic, environmental), presenting signs and symptoms, physical examination findings, assessment, appropriate differential diagnosis, ordering and interpretation of appropriate diagnostic and laboratory tests, and current standard of care including: pharmacological and non-pharmacological management, nutrition, preventive medical care, rehabilitation, osteopathic manipulative medicine, and surgical considerations. Clinical Systems I 46 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
While the Clinical Systems course places emphasis on the basic sciences, it includes how diseases manifest, present, and also differ with regard to gender, age and lifecycle. The course provides the student with knowledge necessary for developing diagnostic skills and prepares students to answer questions based on a clinical scenario, to diagnose specific medical conditions, thereby enabling the student to have a greater understanding of proper patient assessment. In the Pediatrics module, students will learn about human development throughout the life cycle from the first year of life, childhood, adolescence and through adulthood. Students will learn how to assess a pediatric patient from the perspective of a primary care physician, for both a healthy child well-visit and for acute and chronic conditions. Emphasis will be placed on: transition to extrauterine life, common pulmonary and cardiac conditions at birth, developmental milestones, nutrition, gastroenterological and neurologic complications, infectious diseases, and musculoskeletal disorders. General medical and surgical conditions common to the pediatric population will be covered; Pediatrics will also be addressed in subsequent modules. As in all modules, students will be expected to review the relevant Physical Diagnosis lecture and laboratory material from year one. Students will have an opportunity to assess APGAR score will utilizing Medical Simulation. In the Geriatrics module, students will learn about the heterogeneity of the geriatric population and the unique approach to the geriatric patient. The overall objective is to provide a foundation for geriatrics and to help prepare the students to provide quality health care to older adults. The module will emphasize age-related changes, functional assessment of the geriatric patient, the physical examination, common chronic conditions, prevalent geriatric syndromes, co-morbidity and how these interact with each other. Students will learn about common medical and nutritional problems for this population and will also have an appreciation of the importance of the social and psychosocial component of the history and its role in deciding treatment options. Students will become familiar with screening tools and learn how to identify dementia, delirium and fall risk. The role of the geriatric team, identifying proper treatment including non-pharmacological therapy, physical therapy and various living facilities will be discussed. Geriatrics will also be addressed in subsequent modules. In each system module, the classic symptoms of specific diseases and their clinical relevance as they relate to physical findings are discussed. The diagnostic work up, its importance and limitations are discussed. In addition to appropriate medical management, other therapeutic treatment options (in addition to osteopathic manipulative medicine) and surgical considerations are covered. At the end of the course, students will have a better understanding of the clinical manifestations, pathophysiology of disease and mechanisms of treatment. Simultaneous instruction in the Primary Care Skills course reinforces the clinical skills necessary for interviewing, examining, diagnosing and treating patients. The overall goal is to provide a comprehensive presentation of clinical medicine relevant for second year medical students, as well as to help prepare students for clinical rotations. Multiple faculty members will be utilized in their areas of expertise to ensure the best possible exposure for the student.

Course Objectives
1. To provide the clinical aspect of medicine for pediatric, adult and the geriatric population. 2. To present clinical medicine as separate organ systems with a focus on presenting signs and symptoms; to have an appreciation for racial and ethnic disparities in evaluating risk factors for diseases. 3. To identify relevant physical exam findings associated with common diagnoses.
Clinical Systems I 47 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
4. To enable the student to formulate an accurate differential diagnosis and make a definitive diagnosis and treatment plan based on: presenting signs and symptoms, physical findings, laboratory values and diagnostic studies. 5. To prepare students with fundamental clinical knowledge necessary for medical case presentation discussion; thereby facilitating integration of the Clinical Systems course with the Primary Care Skills and OSCE Labs. 6. To provide students with a basic foundation in clinical medicine.
Student Objectives
1. To recognize the classic clinical presentation, signs, symptoms, associated physical exam findings for common diagnoses. 2. To formulate an appropriate differential diagnosis. 3. To state and discuss the appropriate work up. 4. To review and interpret laboratory results. 5. To recognize classic diagnostic imaging results. 6. To state the definitive diagnosis. 7. To identify and explain appropriate treatment. 8. To state associated complications. 9. To identify associated risk factors. 10. To recognize associated pathology and/or histopathology, pathophysiology, microbiology and/or immunology. 11. To recognize the importance of individualization when selecting treatment. 12. To appreciate the importance of communication and patient education. 13. To recognize the unique approach to the pediatric and geriatric population. 14. To assimilate information learned in this course with Primary Care Skills, and OSCE courses, thereby facilitating competency and adequate preparation for clinical clerkships. 15. To integrate the information learned in this course with osteopathic physical examination enabling better diagnostic and therapeutic management of patients.

These books will be referenced throughout the course. Students are expected to read prior to attending class. 1. Title: Cecil Medicine 24th Edition a. By: Lee Goldman (editor) b. Publisher: Saunders; 24th edition (July 25, 2011) c. ISBN: 978-1-4160-2805-5 2. Title: Nelson Essentials of Pediatrics 6th Edition a. By: Robert Kliegman(Author) b. Publisher: Saunders; 6 edition (March 31, 2010) c. ISBN: 978-1-4377-0643-7 3. Title: Rapid Interpretation of EKGs, Sixth Edition a. By: Dale Dubin (Author) b. Publisher: Cover Publishing Company; 6 edition (October 15, 2000) c. ISBN: 978-0-9129-1206-6 4. Title: Hacker & Moore's Essentials of Obstetrics and Gynecology a. By: Neville F. Hacker MD Clinical Systems I 48 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
5.
6.
7.
8.
9.
10.
b. Publisher: Saunders; 5 edition (February 4, 2009) c. ISBN: 978-1-4160-5940-0 Title: Bates Guide to Physical Examination and History Taking 10th Edition a. By: Lynn S. Bickley b. Publisher: Lippincott Williams & Wilkins; 10th edition (December 11, 2008) c. ISBN: 978-0-7817-8058-2 Title: Pathophysiology a. By: Ivan Damjanov MD PhD b. Publisher: Saunders; 1 Pap/Psc edition (April 30, 2008) c. ISBN: 978-1-4160-0229-1 Title: Primer on the Rheumatic Diseases a. By: John H. Klippel b. Publisher: Springer; 13th ed. 2008 c. ISBN: 978-0-387356648 Title: Bates' Visual Guide to Physical Examination a. By: Barbara Bates, Lynn S Bickley b. Imprint: Philadelphia, Pa. : Lippincott Williams & Wilkins, c2005, c2007 c. ISBN: 978-0-7817-5861-1 d. Call # (for Touro-Harlem Medical Library): WB 205 B329 2007 Title: Physical Examination of the Spine and Extremities a. By: Stanley Hoppenfeld b. Publisher: Prentice Hall; 1st Edition (June 5, 1976) c. ISBN: 978-0-838578537 Title: Renal Notebook* a. By: James Agresti, DO b. Will be posted on Blackboard prior to the Renal Module.

1. Title: Harrisons Principles of Internal Medicine 18 Th. Edition a. By: Anthony S.Fauci b. Publisher: McGraw-Hill c. ISBN: 978-0-0714-6633-2 2. Title: Rakel Textbook of Family Medicine a. By: Robert E. Rakel b. Publisher: Saunders; 8 Th. Edition (April 25, 2007) c. ISBN: 978-1-4160-2467-5 3. Title: Rakel Essential Family Medicine: Fundamentals and Case Studies, Third edition a. By: Robert E. Rakel b. Publisher: Saunders, Elsevir c. ISBN: 978-1-4160-2377-7 4. Title: Kochars Clinical Medicine for Students: Fifth Edition a. By: Dario Torre b. Publisher: Lippincott Williams and Wilkins, Fifth Edition (2009) Clinical Systems I 49 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
c. ISBN: 978-0-7817-6699-9 Title: Nelson Textbook of Pediatrics 18 Th. Edition a. By: Robert M. Kliegman b. Publisher:Elsevier Science Health Science Division c. ISBN: 978-1-4160-2450-7 Title: Minor Emergencies: Splinters to Fractures a. By: Philip Buttaravoli b. Publisher: Mosby; 2 nd. Edition c. ISBN: 978-0-323-04026-6. Title: ENT Secrets, Third Edition a. By: Bruce W. Jafek, M.D. b. Publisher: Mosby; 3 rd. Edition c. ISBN: 978-1560536178 Title: Obstetrics and Gynecology a. By: Charles RB Beckmann (Editor) b. Publisher: Lippincott Williams & Wilkins; 6 Edition (May 1, 2009) c. ISBN: 978-0-7817-8807-6 Title: Williams Obstetrics a. By: F. Gary Cunningham b. Publisher: McGraw- Hill; 23rd Edition c. ISBN: 978-0-0714-9701-5 Title: Learning Radiology: Recognizing the Basics a. By: William Herring MD (Author) b. Publisher: Mosby; 1 Pap/Pas edition (May 1, 2007) c. ISBN: 978-0-3230-4317-5 Title: A Practical Approach to Radiology a. By: Nancy M. Major, M.D. b. Publisher: Saunders; 1 edition (August 25, 2006) c. ISBN: 978-1-4160-2341-8 Title: Ferri's Best Test: A Practical Guide to Laboratory Medicine and Diagnostic Imaging a. By: Fred F. Ferri MD FACP (Author) b. Publisher: Mosby; 2 edition (April 7, 2009) c. ISBN: 978-0-3230-5759-2 Title: Primary Care Geriatrics, 5th Edition: A Case Based Approach a. By: Ellen Flaherty, PhD APRN BC (Author) b. Publisher: Mosby; 5 edition (September 18, 2006) c. ISBN-13: 978-0-3230-3930-7 Title: Essentials of Surgery a. By: James M. Becker, M.D., FACS b. Publisher: Saunders c. ISBN: 978-0-7216-8186-3 Title: The Complete Guide to Nutrition in Primary Care a. By : Darwin Deen , Lisa Hark
b. Publisher: Blackwell c. ISBN: 978-1-4051-0474-6 16. Title: Electrocardiography a. By : Kathryn Booth b. Publisher: McGraw-Hill Science/Engineering/Math; 3 edition (January 27, 2011) c. ISBN: 978-0-0774-8527-6
Exam Dates
These dates are subject to change. NB Lifecycle Medicine exam will include both Pediatrics and Geriatrics. Lifecycle Medicine Exam (Pediatrics and Geriatrics) Cardiology Exam Pulmonary Exam Endocrine Exam Renal/GU Exam Gastroenterology Exam 8/19/13 9/16/13 10/14/13 10/28/13 11/18/13 12/9/13

The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation CS I -17.00% 74.39% 9.66%

Each module exam will be weighted for a total of 90% of the semester grade. Case Presentations and Q and A Sessions will be 10% of the semester grade. All Class Case Presentation Sessions 10%
All Module Exams Module 1 Module 2 Module 3 Module 4 Module 5 Module 6 Module 7 Total
90% 10% 5% 20% 15% 10% 15% 15% 100%
Additional Information
Course Format
The Clinical Systems course content will be delivered via iTunes recorded by faculty. A live interactive clicker session that utilizes multiple choice core questions, vignettes and cases with relevant multiple choice questions will occur each Wednesday at the scheduled time. These clicker sessions will focus on the material for a given week. Core Concept Questions will precede the Case Presentations. The Course Director will use Blackboard to provide the students with the iTunes lecture titles and the corresponding PowerPoint presentations (required reading included) for the week, in advance. The students are responsible for listening to iTunes, reading PowerPoint and for completing reading in text(s) and other sources prior to attending the clicker sessions. Medical Simulation will be utilized for some iClicker sessions. Resources to include but are not limited to Up to Date Online, journal articles and the Renal Notebook. Additional sessions may meet on Friday from 9am-11am; therefore, students are advised to keep their schedule free at this time. Students are expected to be prepared for iClicker sessions and discussions. Tools for preparation to achieve course objectives include reading assignments from texts and online, iTunes lectures, PowerPoint presentations and attending class sessions.
Course Presentation
1. Module format iTunes Lectures and in class Case Presentation and Question & Answer iClicker Sessions including Core Concept Questions. 2. iTunes (independent viewing to be completed before each Wednesdays Case Presentation and Question & Answer iClicker Sessions.) 3. Case Presentation and Question & Answer iClicker Sessions Wednesday @ 10 am -12 pm; attendance required. 4. Faculty Overview of the weeks iTunes is Wednesday @ 9 am -10 am. 5. For several modules Physiology Review iTunes by Dr. Conrad Fischer will be available and will focus on relevant material for that module. 6. There is an optional live session for the Department of Primary Care on Fridays, from 9 am - 11 am each week. Students are advised to keep their schedule free at this time. *Schedule is subject to change. 7. Full-time faculty, adjunct faculty, and guest lecturers will give iTunes and/or Case Presentation and Question & Answer iClicker Sessions. 8. Clinical scenarios and case presentations will be incorporated into the curriculum. 9. The Clinical Systems course director may give a review before final exams, if time allows. 10. Self-Assessments may be given. Clinical Systems I 52 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
11. 12. 13. 14.
Independent directed study will be assigned for heart sounds. UpToDate Online will be used frequently throughout the semester. Exams will be given on the first Monday following the last day of each module. High yield topics will be emphasized throughout multiple modules.
Course Specific Attendance and Tardiness Policy

If an absence is anticipated or occurs, the student must notify the Dean of Students and the Course Director as soon as possible. Excused absences must be obtained from the Dean of Students and submitted to the Course Director. Make-up for lectures and Case Presentation and Question & Answer iClicker Sessions will not be offered. Each unexcused absence will result in a zero (0) for each missed clicker session. Students are required to be aware of the course schedule and to check their e-mail and Blackboard for updates. Holiday and personal travel must be planned accordingly. No excused absences will be granted for holiday travel.
Accessing Up To Date Online Instructions

1. 2. 3. 4. 5. 6. 7. To access Up To Date Online, go to http://www.touro.edu/med and click on LIBRARY Scroll down to list of proprietary databases (in orange) and click on the link. On the next screen, scroll down on right to the bottom of the page and you will see in blue, Up To Date Online Click on to Up To Date Online Accept the agreement. Under NEW SEARCH type in your topic. On left scroll down to more specifics about your topic.
Cardiac Auscultation Assignment Clinical Systems Cardiology Module

Must be completed on the library computers Allow 1-2 hours for the assignment Bring your headphones Assignment must be completed by: TBA Your assignment is to complete the computer based HARVEY learning module. During this learning session you will have the opportunity to review and listen to cardiac auscultation of the normal patient and few of the most common heart murmurs and sounds. All of the computers in the library have been equipped with the computer program. You will need to bring headphones to listen to the audio portion of the learning module. On the desktop, open the program Essential Cardiac Auscultation (NOT the program entitled HARVEY curriculum). Click on the option on the bottom left that says skip introduction/credits. You will be given several options for navigating through the program. I recommend that you chose the review the lesson from the beginning option, however you may also use the menu to select the order in which you want to utilize the module. You must complete the following lessons: 1. Orientation 2. Heart Sounds (all portions) 3. Murmurs-Mitral regurgitation, aortic stenosis, aortic regurgitation, tricuspid regurgitation, mitral stenosis and pericardial frictions rub Clinical Systems I 53 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
4. Big 12 Practice 5. Self-Testing
Course Schedule
Lectures
Sem: Week 1:1 Date 7/31/13 Lecture Topic Growth and Development Readings Bates, 10th Edition Ch 18, Tables 6-1, 6-2, 612, Pgs 762-764, 770, 772, 774, Tables 18-2 to 14, pgs 794-795, 797, Table 7-23, pg 781-782, 840, Table 18-10, pg 786, Table 18-13, 831 Bates DVD on PE PD II lecture and lab Nelson Pgs: 15-24, 42348 Nelson Chapter 27 pp131-142. Bates 10th edition: Tables 4-5,4-6, 18-6 and 18-8, and pages 749,755-757. www.aap.org 1. 2. 3. 4. 5. 6. Course Objectives Discuss normal growth and development in children and adolescents Discuss timing for normal infant reflexes Recognize common normal developmental milestones in ages: First year, 15-60 months, childhood, adolescence for: gross motor, fine motor, language and social/cognitive skills Discuss how physical and mental development grow together and help with anticipatory guidance Describe Tanner staging Demonstrate how to plot a growth curve Lecturer Dr. Wilkins
1:1
7/31/13
Nutrition in Infant, Newborn and Adolescent
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.
Discuss the AAP recommendations for breastfeeding Describe the nutritional requirements of the newborn infant Explain the benefits and protective outcomes of breastfeeding for the infant and the mother Identify contraindications to breastfeeding List components of colostrum and breast milk Explain the benefits of breast milk vs. cows milk-based formulas Discuss the difference between cows milk based formulas, soy formulas and therapeutic formulas Describe the nutritional needs and dietary recommendations for infants and toddlers Explain appropriate timing for introducing complementary foods List foods that are choking hazards Recognize cultural differences List common food allergens
Dr. Capozzi
Clinical Systems I *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
55
Sem: Week 1:1
Date 7/31/13
Lecture Topic Anemia
Readings Damjanov Nelson anemia Pgs: 313-316 Bates 10th Edition Tables 18-9 Laboratory Medicine 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 1. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3. 4. 5. 6. 7. 8.
Course Objectives Define and discuss types of anemia Discuss the clinical presentation of newborn anemia Review the role of fetal Hemoglobin Explain the importance of cord clamping time Discuss the differential diagnosis Review the pathophysiology Differentiate hemaglobinopathies, hemolytic disease of newborn, sickle cell, Erythroblastosis Fetalis Review microcytic- thalassemia and Iron deficiency Review the clinical presentation and consequences of lead poisoning Review the etiology and presentation of macrocytic anemias (B12, folic acid, G6PD) Review appropriate labs to order and their interpretation Discuss the appropriate treatment List complications Discuss the clinical presentation and definition of jaundice Review the pathophysiology of newborn jaundice , breast fed jaundice and breast milk jaundice Recognize risk factors Explain the use of nomogram Discuss kernicterus Discuss the differential diagnosis Discuss appropriate labs to order Discuss treatments and role of phototherapy Recognize the complications of treatment Define fever, bacteremia, sepsis and fever of unknown origin Discuss the significance of fever and sepsis in newborn, infant and child Discuss common pathogens associated with fever in specific ages groups Review the significance of history, physical exam findings and clinical presentation Formulate a differential diagnosis in the case of fever with or without a source Explain the appropriate workup Discusses causes of fever with a rash Distinguish classic rashes: characteristic onset, associated signs & symptoms, diagnosis, treatment and complications of: Measles (Rubeola), German Measles (Rubella), Human Herpes virus 6 (Roseola) exanthem subitum, Parvovirus B19 (erythema infectiosum) fifth disease, Varicella (chicken pox) Discuss types of vaccines and how they work Recognize the importance of guidelines/ schedules for vaccination Describe the clinical presentation and complications of: Diphtheria, Tetanus, Polio, Pertussis, Hep A & B, Measles, Mumps, Rubella, Varicella , HIB, Streptococcus pneumonia, Meningococcus, Rotavirus, HPV, Influenza Recognize the importance of education
Lecturer Dr. Wilkins
1:1
7/31/13
Jaundice
Nelson Pgs: 316-319 Damjanov Bates 10th edition, pp. 761-762
Dr. Wilkins
1:1
7/31/13
Fever
Nelson Pgs: 459-467 Bates 10th edition, Table 6-12, Viral Exanthems and Table 18-14
Dr. Wilkins
1:1
7/31/13
Immunizations
Nelson pgs, 449-452 Bates 10th edition, Table 6-12, 18-14 and pp.275
1. 2. 3.
Dr. Wilkins
4.
56
Sem: Week 1:1
Date 7/31/13
Lecture Topic Exanthems and Enanthems
Readings Nelson Essentials of Pediatrics Bates 10th Edition, Table 6-12 and 18-14, Tables 7-23, 8-1, 8-2, 83, 8-7 1. 2. 3. 4. 5.
Course Objectives Discuss basic rashes Apply appropriate nomenclature Define enanthem and exanthem Discuss the clinical presentation Distinguish: Measles (Rubeola), German Measles (Rubella), Erythema Infectiosum Fifths Disease, Exanthem Subitum ( Roseola), Varicella, Scarlet Fever, Coxsackie (Herpangina), Staph Scalded Skin, Erythema Multiforme, Meningococcemia, Henoch Schonlein Purpura, Kawasaki Disease Discuss the work-up and treatment List complications Review mechanisms of diarrhea in gastroenteritis Discuss the etiology/specific GI pathogens, and their common clinical presentations (viruses, bacteria, parasites) Review the significance of history, physical exam findings and clinical presentation Discuss the differential diagnosis Discuss the appropriate workup and treatment Recognize complications Discuss prevention Discuss the etiology, presentation, appropriate work-up, diagnosis, and treatment of the following: Epiglottitis, Peritonsillar abscess, Foreign body in esophagus, Croup, Epistaxis, Otitis Media, Otitis Externa, Nasal Foreign Body, Sinusitis, Acute pharyngitis Differentiate otitis media and externa Identify the most common organisms associated with each ENT infection Identify appropriate antibiotic treatment Discuss cough , wheezing and stridor Discuss the clinical presentation of bronchitis, bronchiolitis, pneumonia (viral and bacterial), and atypical pneumonia Identify and discuss typical pathogens associated with each Discuss disorders of the trachea and esophagus Discuss radiographic evidence and other studies in helping to formulate a plan Discuss complications Discuss Cystic Fibrosis Discuss chronic lower airway disease Discuss the unique physiological characteristics of fetal life: fetal oxygen supply and demand the fetal circulation Discuss the key physiological adaptations required at birth: Onset of breathing, Transition from fetal to postnatal circulation, Thermoregulation, Glucose homeostasis Discuss some of the clinical conditions which may result Explain use of the APGAR score Discuss signs and symptoms and significance of respiratory distress in the newborn
Lecturer Dr. Wilkins
1:1
7/31/13
Gastroenteritis
Nelson Pgs: 512-518
6. 7. 1. 2. 3. 4. 5. 6.
Dr. Wilkins
7.
1:1 7/31/13 Pediatric ENT Nelson pp. 488499,598-599,407. Bates 10th edition. Cecil Medicine 1.
Dr. Kernis
2. 3.
4.
1:1 7/31/13 Pediatrics Lower Airway Disease : Acute Bronchitis, Bronchiolitis, Pneumonia, Cystic Fibrosis Nelson. Lower airway 501-508, 642-650 Bates 10th edition. 1. 2. 3. 4. 5. 6. 7. 8. 1. 2. 3. 4. 5.
Dr. Wilkins
1:2
8/7/13
Transition to Extrauterine Life, Respiratory Distress in the Newborn
Nelson Hacker and Moore, Essentials of OBGYN, pp. 63-67 Bates 10th edition. Table 18-9 Damjanov PD II lecture and lab
Dr. Schulman
57
Sem: Week 1:2
Date 8/7/13
Lecture Topic Basics of Newborn Evaluation and Care
Readings Bates 10th Edition Review PD II lecture and lab Nelson 1. 2. 3.
Course Objectives Review the physiological challenges faced by every newborn Explain the basics of observation and care in the newborn nursery Discuss the elements of the newborn physical examination, including the assessment of gestational age and intrauterine growth 4. Recognize the most common signs of distress in the newborn 5. Discuss the use of laboratory testing in the normal newborn 6. Discuss basic understanding of newborn feeding 7. Discuss evaluation of discharge readiness, including evaluation of bilirubin levels 1. Discuss cyanotic and noncyanotic congenital heart disease 2. Discuss etiology, epidemiology and clinical manifestations 3. Distinguish Acyanotic (VSD,ASD, endocardial cushing defect, pulmonary stenosis, aortic stenosis, coarctation of the aorta; and Cyanotic heart disease ( tetralogy of Fallot, transposition of the great arteries, truncus arteriosis, anomalous pulmonary venous return, hypoplastic left heart disease) 4. Discuss treatment and complications 5. Describe congenital malformation syndromes associated with: Endocardial Cushing defect, VSD, ASD, PDA, coarctation of the aorta, transposition of the great vessels 6. Distinguish the pathophysiologic groups for congenital heart defects: Left-to-right shunts, right-to-left shunts, and obstructive stenotic lesions 1. Discuss Failure to Thrive 2. Discuss the possible presentations 3. Identify risk factors 4. Discuss treatment 5. State complications 6. Discuss management 7. Define child abuse /neglect 8. Be aware of when to suspect abuse 9. Recognize common physical findings 10. Discuss physical and behavioral indicators of sexual abuse 11. Describe evaluation approaches and the purpose for multidisciplinary team 12. Describe mandated reporting 1. Review normal growth hormone physiology and bone growth 2. Discuss endocrine factors affecting growth, clinical manifestations, diagnosis and treatment of Short Stature 3. Discuss Short stature of non-endocrine causes: define short stature, growth failure and constitutional delay 4. Discuss Short stature caused by growth hormone deficiency epidemiology and etiology, clinical manifestations, diagnosis 5. Review the differential diagnosis, presentation, pathophysiology, and treatment of disorders causing short stature 6. Differentiate: Growth Hormone Deficiency, Hypothyroidism, Type I Vitamin D Resistant Rickets, Type II, Turner Syndrome.
Lecturer Dr. Schulman
1:2
8/7/13
Congenital Heart Disease
1:2
8/7/13
Failure to Thrive, Abuse and Neglect
Nelson. Chapter XIX, The Cardiovascular System; Acyanotic and Cyanotic Congenital Heart Disease. Bates 10th edition, Pp. 781-782, 840, Table 1810 rd Cecil Medicine, 23 edition Damjanov Physiology Nelson pp 105-108 Bates 10th edition, Table 18-11
Dr. Levchuck
Dr. Wilkins
1:2
8/7/13
Short Stature
Cecil Medicine 23rd edition Pathophysiology, Damjanov Nelson. Pp 789-796, 108, 234. Endotext.org
Dr. Paras
58
Sem: Week 1:2
Date 8/7/13
Lecture Topic Overweight and Obesity
Readings Nelson Essentials of Pediatrics, Fifth Edition. Saunders Chapter 27 pp131-142, 143-156. Bates, 10th edition: Tables 4-1 to 4-7, and pp. 346 www.aap.org www.cdc.gov www.aha.org www.mypyramid.gov 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 1.
Course Objectives Explain the use of BMI as a screening tool in children Recognize the significance of BMI % ile and demonstrate how to use charts Discuss recommended nutritional guidelines for children > 2 years old State AAP recommendations for TV and physical activity Identify nutritional needs for teens Explain the role of food and activity in prevention of chronic disease and obesity Demonstrate the approach to obtaining a nutrition /diet history Recognize cultural and ethnic differences and cultural food preferences Identify the risk factors for Diabetes Mellitus type 2 List consequence of DM 2 Discuss the AAP recommendations for assessment, prevention and treatment of childhood overweight and obesity Discuss the long term consequences of overweight and obesity Recognize the importance of patient/family education Discuss the characteristic clinical presentation, risk factors, and appropriate management of: Colic, temper tantrums, breath holding spells, poor behavior, picky eating, stranger anxiety, sleep disorders, AD / ADHD, Oppositional Defiant Disorder, Conduct Disorder, PDD, Autism, Rett syndrome, risk-taking behaviors, fetal alcohol syndrome and mental retardation. Discuss appropriate timing for toileting and difficulty with toileting Discuss the classic presentation, etiology, and treatment of Lesch Nyam Review demography and epidemiology of aging Recognize the heterogeneity of the elderly population and the importance of recognizing each person as an individual Recognize cultural differences in the elderly and attitudes toward aging Identify the effects of aging on specific organ systems :skin, eye, ear, olfaction; nervous: sleep, age-related memory loss; musculoskeletal; immune, renal, hematology, endocrine, respiratory, GI, GU/reproductive Describe common changes that occur: presbyopia, cataracts, presbycusis, ARMD, body composition Discuss common musculoskeletal diseases: Osteoporosis, Rheumatoid arthritis and Osteoarthritis Discuss common problems: constipation, obstruction, diverticular disease, dehydration, BP changes and regulation, Atrial fibrillation, hyperthyroidism,dementia Discuss nonspecific signs and symptoms List the recommended vaccinations Discuss cognitive impairment
Lecturer Dr. Capozzi
1:2
8/7/13
Behavioral Disorders
Nelson Essentials of Pediatrics Pgs: 59-75
Dr. Wilkins
1:3
8/14/13
Intro to Geriatrics
Bates, 10th Edition Ch 20 Cecil Medicine, 23rd edition
2. 3. 1. 2. 3. 4.
Dr. Capozzi
5. 6. 7. 8. 9. 10.
59
Sem: Week 1:3
Date 8/14/13
Lecture Topic Functional Assessment
Readings Bates, 10th Edition Ch 20 Cecil Medicine, 23rd edition 1. 2. 3. 4. 5. 6. 7. 8. 9.
Course Objectives Describe how to approach the geriatric patient Identify components of the Geriatric Assessment Perform a Geriatric Assessment Explain and recognize the importance of Functional Assessment Identify and discuss ADLs and IADLs Identify various tests and tools for patient evaluation Identify elements of the CAGE questionnaire Identify and recognize the importance of a multidisciplinary approach Recognize the emphasis on improving and optimizing function , rather than just focusing on disease 10. Discuss living facilities 1. Discuss normal metabolic changes associated with aging 2. Discuss nutrient needs in the older adult 3. Explain how to assess appropriate intake and how to incorporate assessment into office practice 4. Discuss malnutrition and identify risk factors 5. Review nutritional deficiencies and osteoporosis 6. Identify common drug-nutrient interactions 1. Identify and discuss atypical presentations of common disease in the older adult 2. Discuss common concerns: dizziness, tremors, inappropriate body temperature ,WBC, low Hb, GI symptoms 3. Recognize the impact of polypharmancy 1. Define polypharmacy 2. Identify and discuss strategies to reduce polypharmacy 3. Identify reasons for noncompliance and methods to improve noncompliance 4. Recognize the importance of identifying drug induced functional impairment 5. Discuss the importance of patient education 6. Discuss the importance of recognize cultural differences 1. List age-related changes in urology 2. Define and discuss 4 types of urinary incontinence: (stress, urge, overflow, functional) 3. Discuss patient presentation, evaluation and consequences 4. Discuss the significance of Overactive Bladder 5. Discuss the clinical presentation of benign prostatic hyperplasia, BPH 1. Define stages of pressure ulcers 2. Identify common sites for pressure ulcers 3. Discuss causes and risk factors 4. Identify methods of prevention 5. Discuss the significance of underlying nutritional status 6. List complications
1:3
8/14/13
Nutrition in Older Adults
Bates, 10th Edition Ch 20 rd Cecil Medicine, 23 edition
Dr. Capozzi
1:3
8/14/13
1:3
8/14/13
Atypical Presentation of Common Diseases Polypharmacy
Bates, 10th Edition Ch 20 Cecil Medicine, 23rd edition Bates, 10th Edition Ch 20 Cecil Medicine, 23rd edition
Dr. Capozzi
Dr. Capozzi
1:3
8/14/13
Urology
Bates, 10th Edition Ch 20 Cecil Medicine, 23rd edition Bates, 10th Edition Ch 20 Cecil Medicine, 23rd edition
Dr. Capozzi
1:3
8/14/13
Pressure Ulcers
Dr. Capozzi
60
Sem: Week 1:3
Date 8/14/13
Lecture Topic Osteoporosis
Readings Bates, 10th Edition Ch 20 Cecil Medicine, 23rd edition 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 8.
Course Objectives Define osteoporosis Identify risk factors Identify changes in posture Discuss how diagnose Discuss the use of FRAX Identify the most common fracture sites and consequences of each Discuss Calcium and Vitamin D recommendations Discuss prevention including nutrition , exercise and lifestyle Identify appropriate treatment Recognize that HVLA is contraindicated in osteoporosis and osteopenia Recognize the impact of falls on older adults Review aging changes Identify risk factors for falls Idenitfy consequence of falls Explain how to assess balance,gait and mobility on physical exam Be able to perform the Chair Rise and Timed Get Up and Go Tests to assess functional status Discuss how to evaluate a patient for falling problem Review the Fall Risk Assessment Tool Identify strategies to prevent future falls Idenitfy and discuss changes in gait , balance and mobility Distinguish normal aging, Mild Cognitive Impairment and Alzheimers dementia Discuss and distinguish the clinical presentation of delirium, dementia and depression Identify causes of each Demonstrate how to administer a cognitive screen Differentiate 4 types of dementia: Alzheimers, Lewy Body, Vascular, Frontotemporal Discuss and explain how to evaluate a patient for dementia, delirium and depression Identify common behavioral issues in Alzheimers Discuss assessment tools for evaluating dementia :MMSE, MiniCog, Clock Drawing test, neurological exam 9. Discuss assessment tool for evaluating confusion: Confusion Assessment Method 10. Discuss assessment tools for evaluating depression : GDS, PHQ2 11. Discuss Caregiver Stress and Elder Mistreatment 1. Define and describe the core components of the geriatric history and physical examination 2. Recognize the importance of the approach to the geriatric patient and important areas of concern, health promotion, counseling, and screening, as well as accurate history taking 3. Appreciate the role of functional assessment and the 10 Minute Geriatric Screener 4. Identify and describe each of the components of the geriatric history including the chief complaint, the history of the present illness, past medical history, past surgical history, social history, family history, allergies, medications, and review of systems 5. Define and discuss the geriatric physical examination 6. Identify the key differences in the history and physical examination between the adult population and the geriatric population
1:3
8/14/13
Falls
Dr. Capozzi
1:3
8/14/13
Cognitive Impairment and the 3 Ds: Delirium, Dementia, Depression
Dr. Capozzi
1:3
8/14/13
Physical Exam
Dr. Capozzi
61
Sem: Week 1:4 1:4
Date 8/19/13 8/21/13
Lecture Topic
Readings
Course Objectives
Lecturer
Lifecycle Medicine Exam (Pediatrics and Geriatrics) EKG Dubin, Rapid 1. 2. Arryth Interpretation of EKGs 3. mia Recognition Pathophysiology Bates 10th edition, Pp. and 331, Table 9-1, 9-2. 4. Interpretation Cecil Essentials of 5. Part I & II 6. EKG Examples Medicine Emergency Digitalis 7. Part I & II Toxicity,AJN 8. CS ,Dr. Kobern Arrhythmias lecture
9. 10. 11. 12. 13. 14. 1. 2. 3. 4. 5. 6. 7. 8.
1:5
8/28/13
Cardiac Auscultation Murmurs
Cecil Medicine; Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition. pp 361- 369, Table 95,through 9-12 Assignments: Cardiac Auscultation Assignment PD Lecture and Lab, Cardiac Examination
Discuss the basic principles behind the formation of the surface EKG Discuss lead placement and various wave formations Discuss the meaning and physiologic significance of various wave forms generated by the EKG. Follow a systematic approach to interpret an EKG Evaluate EKGs and determine: axis, rate, rhythm, wave formations and calculate intervals Identify electrolyte abnormalities Recognize immediate evaluation and treatment of electrolyte abnormalities Recognize normal sinus rhythm and common arrhythmias on the EKG: NSR, sinus tachycardia, sinus bradycardia, sinus arrest, Wolf-Parkinson White, Atrial flutter and fibrillation, MAT, PAC, PSVT, Ventricular tachycardia ventricular fibrillation, Torsades de Pointes; first, second and third degree AV block; right and left bundle branch block, sick sinus syndrome ,PVC, pulseless VT, asystole, pacemaker rhythm Identify ischemia on the EKG Identify Myocardial Infarctions: AMI, IWMI, Lateral, and Posterior on EKG Identify the anatomical correlate associated with each Myocardial Infarction: AMI, IWMI, Lateral, and Posterior Identify Pericarditis on EKG Identify first, second, third degree heart block, LBBB, RBBB Identify LVH, RVH Discuss the pathophysiology of murmurs Identify and describe heart sounds: S1, S2, S3, S4 and timing of murmurs (Open-snap, MVP) Identify elements of cardiac cycle Describe and identify common murmurs Differentiate and identify Systolic- aortic stenosis and mitral regurgitation; Diastolic murmurs -aortic insufficiency and mitral stenosis Discuss and identify pericardial friction rub Discuss valsalva maneuver Identify murmurs by auscultation on Harvey
Dr. Colbourne
Dr. Kobren
62
Sem: Week 1:5
Date 8/28/13
Lecture Topic Valvular Heart Disease
Readings Cecil Medicine Pathophysiology Bates Guide to Physical Examination, 10th edition.pp. 362-370, 379-387 Assignments: Cardiac Auscultation Assignment Readings: Cecil Medicine Pathophysiology Bates Guide to Physical Examination, 10th edition. Tables 9-1 ,92,pp. 331, 121, 265 Readings: Cecil Medicine Pathophysiology Damjanov Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition, pp. 385,716,717 Cecil Medicine Pathophysiology Damjanov Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition, pp. 385,716,717 1. 2. 3.
Course Objectives Describe types of valves: Semilunar-Aortic,Pulmonic,Bicuspid-Mitral,Tricuspid- Tricuspid Discuss the pathophysiology of valvular heart disease : Stenotic, Regurgitant,Combined Stenotic/Regurgitant , Subvalvular ,Supravalvular Discuss the clinical manifestations, physical exam findings, diagnostic modalities and interpretation, and complications of each: Aortic stenosis, senile calcifications, Rheumatic Aortic Stenosis, LVH , Aortic Insufficiency, Mitral Stenosis, Rheumatic Mitral Valve disease, Mitral Regurgitation, Tricuspid Regurgitation, Tricuspid Stenosis Discuss treatment Discuss the mechanisms of arrhythmias Identify common arrhythmias :NSR, sinus tachycardia, sinus bradycardia, sinus arrest, Wolf-Parkinson White, Atrial flutter and fibrillation, MAT, PAC, PSVT, Ventricular tachycardia ventricular fibrillation, Torsades de Pointes; first, second and third degree AV block; right and left bundle branch block, sick sinus syndrome Discuss approach to the patient and basic treatment modalities Define and discuss the pathophysiology of different types of cardiomyopathies Discuss the classification of cardiomyopathies Differentiate: Dilated (systolic dysfunction), Hypertrophic (diastolic dysfunction), Restrictive (diastolic dysfunction) Discuss the etiology, risk factors and clinical manifestations of each Discuss diagnostic modalities Discuss the treatment goals of different types of cardiomyopathies
Lecturer Dr. Kobren
4. 1. 2.
1:5
8/28/13
Arrhythmias
Dr. Kobren
3. 1. 2. 3. 4. 5. 6.
1:5
8/28/13
Cardiomyopathy
Dr. Kobren
1:5
8/28/13
Pericarditis and Myocarditis
1. 2. 3.
Discuss the pathophysiology, etiology, and clinical features of myocarditis and pericarditis Discuss diagnostic studies and identify EKG findings Discuss treatment goals
Dr. Kobren
63
Sem: Week 1:5
Date 8/28/13
Lecture Topic Heart Failure
Readings Cecil Medicine Pathophysiology Physical Diagnosis Lecture & Lab Material 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 1. 2. 3. 4. 5.
Course Objectives Discuss the basic pathophysiology of heart failure Differentiate between Left and Right heart failure, systolic dysfunction and diastolic dysfunction Identify the causes of heart failure Discuss the treatment goals for acute and chronic heart failure Identify and discuss the clinical manifestations ,symptoms and physical exam findings Discuss how to diagnose and manage Define and distinguish: dyspnea, orthopnea and paroxysmal nocturnal dyspnea, JVD Review the etiology, pathophysiology and consequences of clinical hypertension Define hypertension and pre-hypertension Identify modifiable and non-modifiable risk factors for hypertension (HTN) Define essential, secondary , White Coat and labile hypertension Identify causes and clinical manifestations of secondary HTN Discuss the Joint National Committee VII - Prevention and Treatment of High Blood Pressure Recognize clinical symptoms of hypertension Discuss the significance of chief complaint and various presentations Review how to take an appropriate history, review of systems, and assess risk factors Review physical exam and identify associated physical findings Discuss the appropriate evaluation and how to diagnose Identify the BP goals for patients with and without Diabetes Mellitus (DM) Discuss lifestyle and dietary modifications including the DASH Diet Discuss Hypertensive Urgency and Emergency Discuss the effects of long standing hypertension Recognize the importance of individualizing pharmacologic management Recognize the importance of patient education Identify the JNC 7 classification of Hypertension and Prehypertension Identify BP goals in patients with DM Identify modifiable and non-modifiable risk factors for HTN Identify populations at risk Recognize the importance of lifestyle modifications: weight reduction in overweight or obese, healthy diet, physical activity, and moderation of alcohol consumption in prevention and treatment Identify high sodium foods to limit Identify foods low in sodium and high in potassium Describe the DASH diet and how to implement dietary changes Recognize the need to continue diet and healthy lifestyle modification in patients on antihypertensive medications Identify the importance of patient education Discuss the 4 As for Smoking Cessation
Lecturer Dr. Kobren
1:6
9/4/13
Hypertension
Bates 10 Edition, Pgs 334-347, 114-119, 659, 670, Tables 4-7 Cecil Medicine Pathophysiology PD Lecture and Lab, Vital Signs www.aha.org http://www.nhlbi.nih.g ov/health/public/heart/ hbp/dash/new_dash.pd f
TH
Dr. Schwarzwald
1:6
9/4/13
Hypertension and Nutrition
Bates 10TH Edition, Pgs 334-347, 114-119, 659, 670, Tables 4-7 Cecil Medicine Pathophysiology PD Lecture and Lab, Vital Signs www.aha.org http://www.nhlbi.nih.g ov/health/public/heart/ hbp/dash/new_dash.pd f
Dr. Capozzi
6. 7. 8. 9. 10. 11.
64
Sem: Week 1:6
Date 9/4/13
Lecture Topic Hyperlipidemia
Readings Readings: Cecil Medicine Pathophysiology Bates 10TH edition: Pgs 334-347, 114-119, 659, 670, Tables 4-7 www.nhlbi.nih.gov/guid elines/cholesterol/atgla nce.pdf 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. 2. 3. 4. 5. 6. 7. 8.
Course Objectives Discuss lipoprotein metabolism and the pathogenesis of atherosclerosis Identify and discuss laboratory tests and interpretation for plaques ruptureDiscuss clinical atherosclerosis Identify the major factors for atherosclerosis Discuss primary and secondary prevention of CHD Review NCEP ATP III Guidelines for Cholesterol Discuss high risk and very high risk populations and treatment goals Explain how to interpret a lipid profile (total, HDL, LDL, non-HDL, Triglycerides) State how to calculate non-HDL and its significance Discuss the Framingham Risk calculator Identify the signs and symptoms of CHD Describe silent CHD Discuss pharmacologic treatment Identify the role of nutrition and lifestyle modifications Review pathophysiology and clinical manifestations of Monckeberg medial calcific sclerosis, arteriolosclerosis and atherosclerosis Identify the major risk factors for Coronary Heart Disease ,CHD Discuss the ATP III Therapeutic Lifestyle Changes Program (TLC )program including diet, physical activity and weight management Identify the dietary recommendations and food sources for saturated, poly and monounsaturated fats and trans fats, cholesterol, sodium ,and sugar Identify indications for and benefit of plant sterol and stanols Identify sources and benefits of soluble and insoluble fiber Identify common food sources of each of the macronutrients Identify soy foods and the benefits Identify the components of Metabolic Syndrome and dietary recommendations Describe key elements of a nutrition history Recognize the importance of patient education and communication skills Describe NCEP ATP III Guidelines for Cholesterol Define Coronary Artery Disease Discuss the pathophysiology Identify the major risk factors Recognize the impact of CAD on the US population Identify the symptoms and clinical features Recognize that angina is a symptom of CHD Distinguish stable and unstable angina ( discussed here and in subsequent lectures) Discuss diagnostic tools and treatment options
Lecturer Dr. Schwarzwald
1:6
9/4/13
Cardio Nutrition
Readings: Cecil Medicine Pathophysiology Bates 10TH edition: Pgs 334-347, 114-119, 659, 670, Tables 4-7 www.nhlbi.nih.gov/guid elines/cholesterol/atgla nce.pdf
Dr. Capozzi
1:6
9/4/13
Coronary Artery Disease
Readings: Cecil Medicine Pathophysiology Bates Guide to Physical Examination, 10th edition Table 8-1, Pgs 121, 265, Pgs 336-347
Dr. Schwarzwald
65
Sem: Week 1:6
Date 9/4/13
Lecture Topic Chest Pain
Readings Readings: Cecil MedicineP Pathophysiology Bates Guide to Physical Examination, 10th edition Table 8-1, Pgs 121, 265, Pgs 336-347 Assignments: Up to Date Online 1.
Course Objectives Discuss the pathophysiology and clinical presentation of different chest pain syndromes: stable angina, unstable angina, MI , cardiac tamponade, pericardial effusion, dissecting aortic aneurysm, anxiety, pneumonia, pulmonary embolus, chest wall pain, GERD, esophageal reflux, esophageal spasm Acute Coronary Syndromes ( ACS), ischemia, thrombosis, STEMI, Prinzmetal's angina, pericarditis. Discuss how to evaluate patients: appropriate history, physical and diagnostic testing Discuss the characteristics of cardiac and non-cardiac chest pain Define stable and unstable angina Discuss diagnostic testing: EKG, echocardiography, stress testing, stress echo, angiography, cardiac catheterization ,cardiac CT Discuss procedures: stenting and coronary artery bypass Classify chest pain accordingly and formulate an appropriate differential diagnosis Discuss basic pharmacotherpay Identify the characteristics of chest wall pain and non-cardiac causes of chest pain Discuss the terminology acute coronary syndromes, ACS Discuss the pathophysiology of acute coronary syndromes Define and differentiate unstable angina, NSTEMI (non -st segment Myocardial infarction), and STEMI ( st segment elevation MI) Discuss the clinical manifestations , appropriate history and physical exam, risk factors, and appropriate evaluation and treatment: of acute coronary syndromes, ischemic heart disease, myocardial infarction (MI) and Prinzmetals angina Recognize atypical presentation in females and patients with DM Discuss and recognize EKG changes Identify and discuss biochemical markers (CPK, MB, Troponin) Discuss the pharmacological treatment approach to STEMI and NSTEMI Identify contraindications to fibrinolytics Discuss the pathophysiology, clinical manifestations, appropriate evaluation and treatment of complications of MI (LV aneurysm, LV rupture ,RV infarct, ruptured papillary muscle, arrhythmias, Dressler's syndrome, stroke) Define Peripheral Arterial Disease and review the pathophysiology Discuss risk factors, signs and symptoms, and clinical manifestations, and appropriate workup Identify the co-morbidities associated with PAD Discuss prevention, treatment and complications Discuss ankle brachial index, ABI Identify the anatomical correlates associated with the site of leg ischemia Discuss critical leg ischemia Discuss the differential diagnosis: Buerger s disease, chronic venous insufficiency, compartment syndrome Discuss varicose veins
Lecturer Dr. Schwarzwald
2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3. 4.
1:6
9/4/13
Myocardial Infarction
Readings: Cecil Medicine Pathophysiology Bates Guide to Physical Examination, 10th edition Table 8-1, Pgs 121, 265, Pgs 336-347 Up to Date Online
Dr. Schwarzwald
5. 6. 7. 8. 9. 10.
1:7
9/11/13
PVD, Peripheral Vascular Disease
Readings: Cecil Medicine Pathophysiology Dubin Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition Ch 12, Table 12-1 to 125, 12-7, Pgs 471-492
1. 2. 3. 4. 5. 6. 7. 8. 9.
Dr. Mintz
66
Sem: Week 1:7
Date 9/11/13
Lecture Topic Aortic Disease and Aneurysms
Readings Readings: Cecil Medicine Pathophysiology Dubin Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition Ch 12, Table 12-1 to 125, 12-7, Pgs 471-492 Cecils Pathophysiology, Damjanov: Pages 77-80 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5.
Course Objectives Define aneurysm and pseudoaneurysm Discuss the pathophysiology of aneurysm and pseudoaneurysm Discuss the risk factors and clinical manifestations of aortic disease and aneurysms Discuss the symptoms thoracic and abdominal aneurysms Define aortic aneurysm, dissection and rupture Discuss indications for surgery Discuss physical exam findings Discuss how to diagnose aortic aneurysm Discuss types of aneurysm: atherosclerotic, syphilitic, dissecting aortic aneurysms, Berry aneurysm, micro aneurysms, mycotic, and AV fistula Discuss the complications of aneurysms Define shock Differentiate between hypotension and shock Define the different classifications of shock Define stages of shock Compare and contrast the different types of shock
Lecturer Dr. Mintz
1:7
9/11/13
Shock
Dr. Brown
1:8a 1:8b
9/16/13 9/23/13
Pathophysiology Review Cardiology Cardiology Module Exam The Pulmonary Cecil, Text of Medicine, Evaluation Bates Guide to Physical Examination and History Taking, 10th edition, chapter 8 See PowerPoint from PD1 , Thorax and Lung Exam See PD1, Thorax and Lungs Lab sheet.
Dr. Fischer
1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
Review how to take an appropriate history and perform a pulmonary physical exam Discuss the 3 common chief pulmonary complaints Understand how to elicit an appropriate history Understand the relevance of the chief complaint and the patients complete history Review the sequence and components of the history Explain the proper sequence of the pulmonary physical exam Differentiate Crepitus, Pleural friction rub, and Tactile fremitus Identify and describe normal breath sounds Identify and describe adventitious breath sounds Apply terminology
Dr. Steier
67
Sem: Week 1:8b
Date 9/23/13
Lecture Topic Community Acquired Pneumonia
Readings Cecil Medicine Pathophysiology Pneumonia pp170172,table 5-9,5-10,fig 523,5-24 Bates Guide to Physical examination and History Taking, 10th edition Tables 7-23, 8-1 to 8-7 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 1. 2. 3. 4. 5. 6. 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. 7.
Course Objectives Distinguish community acquired pneumonia from hospital-acquired or health careassociated pneumonia Review the pathobiology of pneumonia Differentiate the potential causative organisms Discuss treatment and prevention Differentiate epidemiology and causes based on: clinical presentation, symptoms, signs and physical exam findings. Discuss the work up and interpretation of laboratory values, pulse oximetry, and diagnostic imaging for the following types of pneumonia Differentiate Strep. Pneumonia, Mycoplasma, viruses, H. influenza, Legionella, varicella, Staph. Aureus, M. Tuberculosis, endemic fungi, anaerobic Gram negative bacilli Discuss appropriate pharmacologic treatment Discuss aspiration pneumonia Differentiate each of the atypical pneumonias : Legionella ,Mycoplasma, Chlamydia, CMV, RSV, Influenza Discuss bioterrorism Discuss Pneumocystis carini / jiroveci pneumonia Discuss the background and clinical presentation Discuss history, symptoms, signs, CXR, lab tests, workup and treatment Describe the characteristic clinical and radiographic findings Recognize importance of early diagnosis and treatment Review pathophysiology and etiology Identify acute, subacute and chronic alveolitis Identify histological groups Discuss common risk factors Recognize the importance of patient history/evaluation Recognize the possible clinical presentation(s) and physical findings Discuss signs and symptoms of: primary tumor, intra and extrathoracic spread, and Paraneoplastic syndromes Discuss Pancoast tumor Recognize the importance of having high index of suspicion Discuss the etiology, genetics and various clinical presentations Discuss the clinical signs, symptoms and physical exam findings Discuss the appropriate diagnostic workup and limitations Discuss the role of sputum cytology, fiberoptic flexible bronchoscopy Discuss the indications and contraindications for various procedure Review staging and treatment Review diagnostic imaging
Lecturer Dr. Steier
1:8b
9/23/13
Interstitial lung disease, ILD
Cecil Medicine Readings: Cecil Medicine Pathophysiology Pp183-185 Readings: Cecil Medicine Pathophysiology Pg 8790 Bates Guide to Physical examination and History Taking, 10th edition Tables 8-1 to 8-7 Cecil Medicine Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition Tables 8-1 to 8-7
Dr. Steier
1:8b
9/23/13
Introduction to Lung Cancer
Dr. Capozzi
1:8b
9/23/13
Lung Cancer and Nodule
Dr. Steier
68
Sem: Week 1:8b
Date 9/23/13
Lecture Topic Sleep Apnea
Readings Cecil Medicine Pathophysiology 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 1. 2. 3. 4.
Course Objectives Define types of :Apnea, Obstructive Apnea, Central Apnea, Mixed Apnea, Pickwickian Describe the clinical characteristics of obstructive vs. central apnea Discuss the etiology, characteristics, clinical presentation, , risk factors, pathogenesis, consequences, Discuss and how to diagnose and treat Discuss sleep studies Discuss the role of CPAP Discuss narcolepsy Define Acute Respiratory Failure and identify causes Describe the use of respirators Discuss : Acute Respiratory Failure, ventilatory pump failure, respiratory muscle dysfunction, inefficient gas exchange Identify the types of ventilators Recognize complications Discuss blunt and penetrating chest trauma Discuss mechanisms of injury Review anatomy Discuss the clinical presentation, symptoms and physical exam findings in rib fractures, sternal fractures, flail chest, simple pneumothorax, tension pneumothorax and hemopneumothorax Discuss appropriate work up and treatment Discuss cardiac injuries: myocardial contusion, pericardial tamponade, aortic tear, ruptured myocardium, Commotio cordisuss Discuss appropriate work up and treatment Define influenza Review antigenic variation Describe the characteristics clinical manifestations of influenza syndrome Identify how to diagnoses Discuss immunization Discuss respiratory complications Describe nonpulmonary complications Discuss prevention Discuss treatment Be able to interpret arterial blood gases Determine the primary acid base disturbance Review pH, PCO2, HCO3 Determine a secondary acid base disorder Measure anion gap and explain the significance Determine whether the compensation is appropriate Identify conditions associated with each ABG disturbance
Lecturer Dr. Steier
1:8b
9/23/13
Ventilators and Respiratory Failure
Cecil Medicine Pathophysiology
Dr. Steier
1:8b
9/23/13
Chest Trauma
Dr. Steier
5. 6. 7. 1. 2. 3. 4. 5. 6. 7. 8.
1:8b
9/23/13
Influenza
Cecil Medicine
Dr. Steier
9.
1:9 10/2/13 ABG Cecil Medicine Pathophysiology 1. 2. 3. 4. 5. 6. 7.
Dr. Genovese
69
Sem: Week 1:9
Date 10/2/13
Lecture Topic DVT, deep vein thrombosis
Readings Cecil Medicine Pathophysiology 1. 2. 3. 4. 5. 6. 7. 8. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. 7.
Course Objectives Define DVT Discuss the risk factors, clinical manifestations, physical exam findings and appropriate testing Discuss diagnostic testing and interpretation of results Discuss prophylaxis and treatment Identify complications of DVT Discuss symptomatic vs. asymptomatic disease Discuss Thrombophilia and hypercoaugulable states Discuss arterial vs. venous thrombosis Define pulmonary embolus, (PE) Discuss the etiology and pathophysiology Discuss acquired and inherited risk factors Discuss the relevant history Discuss the signs, symptoms and clinical features Discuss ventilation-perfusion mismatch Discuss the appropriate diagnostic tests for PE and how to interpret results of diagnostic tests Discuss the D-dimer marker and its role in evaluating patients Discuss inherited defects of coagulation and appropriate testing Discuss appropriate treatment Discuss the use of thrombolytics -Streptokinase and TPA Discuss use of IVC filter Discuss other emboli Discuss the pathophysiology and treatment of arterial and venous thrombosis Discuss venous insufficiency Define cough Distinguish acute, subacute and chronic cough Discus the appropriate differential diagnosis of cough Discuss the treatment of cough Define hemoptysis Explain the presentation and causes of hemoptysis Discuss the evaluation and treatment of hemoptysis Identify fundamentals of pulmonary function tests, (PFT ) Describe how PFTs are administered Explain the clinical relevance of PFTs Discuss air flow rates Discuss lung volumes and capacity Discuss the clinical significance of results Identify patterns in obstructive and restrictive lung disorders
Lecturer Dr. Genovese
1:9
10/2/13
Pulmonary Embolus and other Emboli
Dr. Genovese
1:10
10/9/13
Overview of Cough, Dyspnea and Hemoptysis
Readings: Cecil Medicine Pathophysiology
TBD
1:10
10/9/13
Pulmonary Function Tests
Cecil Medicine Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition. Tables 4-8, 8-1 to 8-7, Pgs 119, 302-309, 338339
Dr. Colbourne
70
Sem: Week 1:10
Date 10/9/13
Lecture Topic COPD
Readings Cecil Medicine Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition. Tables 4-8, 8-1 to 8-7, Pgs 119, 302-309, 338339 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 1. 2. 3. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
Course Objectives Define COPD Differentiate restrictive and obstructive lung disease Differentiate chronic bronchitis and emphysema Discuss the pathophysiology Identify the risk factors Discuss the clinical presentation and physical exam findings Discuss appropriate diagnostic testing and interpretation: spirometry, lung volumes, CO2 diffusing capacity, pulse ox, PFTs, ABGs and CXR findings Discuss treatment and recommendations for patients with COPD Discuss complications Differentiate Asthma and COPD Define asthma Discuss the etiology, pathogenesis and triggers Differentiate extrinsic vs. intrinsic Describe the clinical presentation Discuss the significance of past medical history and family history Describe and interpret physical exam findings Discuss the appropriate work up Discuss peak flow, pulse ox, ABGs and interpretation of PFTS Describe the methacholine challenge Discuss pharmacologic management of chronic and acute exacerbation of asthma Discuss status asthmaticus Recognize the importance of patient education Review pathophysiology Recognize clinical presentation Identify treatment Review anatomy Define pleural effusion Discuss the pathophysiology and clinical significance of transudative and exudative pleural effusions Differentiate transudative and exudative pleural effusion Identify the clinical conditions associated with each Recognize the clinical presentation including signs, symptoms and associated physical findings Discuss how to diagnose Recognize characteristic X ray findings Discuss the consequences of exudative effusions Discuss thoracocentesis and evaluation of fluid Discuss basic treatment
Lecturer Dr. Colbourne
1:10
10/9/13
Asthma
Cecil Medicine Bates Guide to Physical Examination and History Taking, 10th edition.: chapter 8: Page 289, 296,306307,314,416,319,2321 Damjanov, Pathophysiology
Dr. Colbourne
1:10
10/9/13
Pulmonary Edema Pleural Effusions
1:10
10/9/13
Readings: Cecil Medicine Pathophysiology Readings: Cecil Medicine Pathophysiology Pp183-185 Bates Guide to Physical examination and History Taking, 10th edition.
Dr. Colbourne
Dr. Colbourne
71
Sem: Week 1:10
Date 10/9/13
Lecture Topic Primary Pulmonary Hypertension
Readings Readings: Cecil Medicine Pathophysiology Pp183-185 Bates Guide to Physical examination and History Taking, 10th edition. Readings: Cecil Medicine Pathophysiology TB Testing PowerPoint 1. 2. 3. 4. 5. 6. 7. 8. 1. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5.
Course Objectives Define primary pulmonary hypertension Discuss pathophysiology and etiology Identify populations at risk Discuss the clinical presentation, signs ,symptoms, and physical exam findings Recognize characteristic Xray findings Discuss how to diagnose Discuss consequences Discuss how to confirm diagnosis Define Describe and discuss the clinical presentation, characteristic features, and pathobiology Identify populations at risk Discuss the appropriate diagnostic workup, complications, and treatment Differentiate primary, latent, reactivation/secondary, disseminated and miliary Describe treatment Recognize characteristic CXR findings Discuss he presentation and treatment of TB in the HIV+ patient Differentiate the granuloma of tuberculosis and sarcoidosis Define sarcoidosis , granulomatous and nongranulomatous disease Discuss the epidemiology Describe the characteristics Identify populations at risk Discuss the histopathology of sarcoidosis Discuss the pulmonary and extrapulmonary clinical manifestations Discuss the diagnostic workup , management and prognosis of sarcoidosis Review pathophysiology Differentiate between left heart failure, right heart failure, biventricular failure, high output failure and low output failure Distinguish acute and chronic heart failure Differentiate heart failure without congestion and heart failure with congestion (CHF) Explain how to diagnose and treat heart failure
Lecturer Dr. Colbourne
1:10
10/9/13
Tuberculosis
Dr. Colbourne
1:10
10/9/13
Sarcoid
Dr. Colbourne
1:10
10/9/13
Review Heart Failure
1:10
10/9/13
Occupational Lung Disease and Fungal Infections
Readings: Cecil Medicine Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition. Tables 4-8, 8-1 to 8-7, Pgs 119, 302-309, 338339 Cecil Medicine Pathophysiology
Dr. Colbourne
1. 2. 3. 4. 5.
Discuss common occupational lung diseases Identify risk factors for each Discuss complications Review pathology/histopathology Review radiographic findings
TBD
72
Sem: Week
Date
Lecture Topic
Readings
Course Objectives
Lecturer Dr. Fischer
1:11 1:11
10/14/13 10/16/13
1:11
10/16/13
Pathophysiology Review Pulmonary Pulmonary Exam Hypothalamus; Cecils Textbook of Pituitary Medicine,23rd Ed: Disorders Principles of Endocrinology Neuroendocrinology Anterior Pituitary Posterior Pituitary Damjanov, Pathophysiology Bates Guide to Physical examination and th History Taking, 10 edition. Table 7-4 and 7-5 Adrenal Cecil, 24rd edition Disorders I & II Damjanov, Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition. Table 7-4 and 7-5
1. 2. 3. 4. 5. 6. 7. 8. 9.
Review general principles of neuroendocrine function, including common feedback loops Discuss principles of neuroendocrine evaluation, including laboratory and radiologic testing Describe pituitary anatomy Recognize syndromes of underproduction of a variety of pituitary hormones Recognize syndromes of overproduction of a variety of pituitary hormones Explain how to correctly evaluate a pituitary incidentaloma Identify disorders involving the posterior pituitary hormone vasopressin State the gene responsible for and hormones involved in Multiple Endocrine Neoplasia Type 1 Select appropriate therapies for pituitary dysfunction
Dr. Rosenfeld
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
1:11
10/16/13
Hyper & Hypothyroid; Thyroid Nodules & Cancer
Cecils Textbook of Medicine Damjanov, Pathophysiology, pp. 366, 376-381 Bates Guide to Physical examination and History Taking, 10th edition. Tables 7-4 , 7-6, 7-26, 7-27
Explain the process of steroid synthesis and metabolism Review adrenal hormone regulation and action Discuss and select appropriate testing to evaluate adrenal structure and function Recognize syndromes of adrenal hyperfunction Recognize syndromes of adrenal hypofunction Identify causes of endocrine hypertension Identify the glands involved in polyglandular autoimmune syndromes State the gene responsible for and hormones involved in Multiple Endocrine Neoplasia Type 2 Explain how to correctly evaluate an adrenal incidentaloma Select appropriate therapies for adrenal dysfunction Describe thyroid anatomy and relationship of surrounding structures Review thyroid hormone synthesis, secretion and metabolism Select appropriate testing to evaluate thyroid structure and function Recognize syndromes of thyroid hypofunction Recognize syndromes of thyroid hyperfunction Select appropriate therapies for thyroid dysfunction Identify effects of binding abnormalities, severe illness and medications on thyroid testing and function Correctly evaluate a thyroid nodule Describe the pathologic subtypes of thyroid cancer Select initial appropriate therapies for thyroid cancer
Dr. Rosenfeld
Dr. Rosenfeld
73
Sem: Week 1:12
Date 10/23/13
Lecture Topic Diabetes Mellitus 1 & 2; Diabetic Management; Complications
Readings Cecil Medicine, 24rd edition Damjanov, Pathophysiology ADA Guideline 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3.
Course Objectives Review the principles of insulin synthesis, secretion, and action Explain the interaction of multiple hormones and substances involved in glucose metabolism Describe the pathophysiology of the various forms of diabetes mellitus List the components of metabolic syndrome Select appropriate testing for screening and diagnosis of diabetes mellitus Select appropriate therapies for diabetes mellitus based upon clinical practice guidelines and consideration of concurrent medical conditions Identify and treat acute complications of diabetes mellitus Identify and treat chronic complications of diabetes mellitus Evaluate the patient with a hypoglycemic syndrome Discuss evaluation and management of hyperglycemia and hypoglycemia Differentiate DKA (diabetic ketoacidosis) and HHS (Hyperosmolar hyperglycemic state) Define overweight and obesity based upon standard parameters Review the physiologic regulation of energy balance Identify hormones involved in hunger and satiety Explain the function of leptin as it relates to animal vs. human obesity Identify rare genetic mutations and syndromes involved in human obesity State the etiology of most cases of human obesity Identify the disease states associated with and consequences of human obesity Identify medications which may cause weight gain Explain how to evaluate the obese patient Select appropriate therapies for obesity Review calcium homeostasis and normal parathyroid physiology Discuss the differential diagnosis, presentation, pathophysiology, and treatment of disorders of hypercalcemia and hypocalcaemia Discuss pathophysiology, etiology, signs, symptoms, clinical presentation, lab testing, and treatment of the parathyroid disorders: primary Hyperparathyroid, Hypercalcemia of Malignancy, Hereditary Hyperparathyroid disorders: Multiple Endocrine Neoplasia Type 1 (MEN1), Type 2 (MEN2); Hyperparathyroidism-Jaw Tumor Syndrome (HPT-JT); Neonatal sever hyperparathyroidism; Familial hypocalciuric Hypercalcemia (FHH); Hypocalcaemia, hypoparathyroidism, autoimmune polyglandular syndrome, pseudo ohypoparathyroidism; Abnormal parathyroid development (DiGeorge Syndrome)
Lecturer Dr. Rosenfeld
1:12
10/23/13
Obesity; Inherited Disorders
As per Instructor
Dr. Rosenfeld
1:12
10/23/13
Disorders of Calcium and Parathyroid
Cecil Medicine 24rd edition Pathophysiology, Damjanov, pp. 22-26, 364, 381-386, 414-418, 440 Bates Guide to Physical examination and History Taking, 10th edition. pp. 767Chvostek sign
Dr. Paras
74
Sem: Week 1:12
Date 10/23/13
Lecture Topic Reproductive Endocrinology
Readings Cecil Medicine 24rd edition Pathophysiology, Damjanov, pp. 22-26, 364, 381-386, 414-418, 440 Bates Guide to Physical examination and History Taking, 10th edition. 1. 2. 3. 4. 5. 6.
Course Objectives Define infertility Review the female gonadal cycle Review spermatogenesis in males Review the basic physiology of fertilization and implantation Discuss how to interpret an infertility work up in a woman Discuss to how to interpret an infertility work up in a man
Lecturer Dr. Paras
1:13 1:13
10/28/13 10/30/13
Pathophysiology Review Endocrine Endocrine Exam Water Balance
Dr. Fischer
1:13
10/30/13
ECF Volume: Clinical Disorders
1:13
10/30/13
ECF Fluid Expansion
Readings: Cecil Medicine Damjanov Pathophysiology. Chapter 1, Laboratory Medicine and Chapter 12, The Kidneys Renal Notebook, J.Agresti Readings: Cecil Medicine Damjanov Pathophysiology. Chapter 1, Laboratory Medicine and Chapter 12, The Kidneys Renal Notebook, J.Agresti Readings: Cecil Medicine Damjanov Pathophysiology. Chapter 1, Laboratory Medicine and Chapter 12, The Kidneys Renal Notebook, J.Agresti
1. 2. 3.
Review Notebook physiology concepts Recognize the clinical presentation of both dehydration and fluid overloaded states Discuss the laboratory abnormalities associated with these disorders including urinary electrolytes
Dr. Agresti
1. 2.
Discuss the clinical presentation of both dehydration and fluid overloaded states Discuss the laboratory abnormalities associated with these disorders including urinary electrolytes
Dr. Agresti
1. 2. 3. 4. 5. 6. 7.
Define fluid overload Define edema and recognize the significance of edema Recognize that fluid expansion /overload is characterized by an increase in total body water, accompanied by an increase in total body Na+ Discuss the clinical manifestations Discuss heart failure, hepatic cirrhosis, nephritic syndrome and edema Discuss appropriate treatment Discuss the role of diuretics
Dr. Agresti
75
Sem: Week 1:13
Date 10/30/13
Lecture Topic Hyponatremia
Readings Readings: Cecil Medicine Damjanov Pathophysiology Renal Notebook Physiology and Physiology Review 1. 2. 3. 4.
Course Objectives Define hyponatremia Define pseudohyponatremia Differentiate: hypovolemic hyponatremia, hypervolemic hyponatremia and euvolemic hyponatremia Discuss the pathophysiology, symptoms, causes , how to diagnose and treat: Acute symptomatic hyponatremia, chronic symptomatic hyponatremia and chronic asymptomatic Discuss the clinical presentation, how to diagnose and treat/ or prevent: SIADH, Cerebral Salt Wasting, Osmotic Demyelinating Syndrome/ Central Pontine Myelenosis (CPM) or Extra (EPM) Pontine Myelinosis Discuss potassium intake, distribution ,excretion, regulation ,redistribution and acid base effects Discuss the causes of hyperkalemia Describe the clinical manifestations including cardiac, skeletal and GI Identify and recognize EKG changes associated with electrolyte disturbances Describe the appropriate treatment/management
Lecturer Dr. Agresti
5.
1:13
10/30/13
Hyperkalemia
1:13
10/30/13
Calcium, Magnesium, Phosphorus
1:13
10/30/13
Metabolic Acidosis
Readings: Cecil Medicine Damjanov Pathophysiology Renal Notebook Dubin CS Cardiology EKG lectures Readings: Cecil Medicine Damjanov Pathophysiology Renal Notebook Dubin Bates Guide to Physical examination and History Taking, 10th edition. pp. 767Chvostek sign Dubin Readings: Cecil Medicine Damjanov Pathophysiology Renal Notebook
1. 2. 3. 4. 5.
Dr. Agresti
1. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3. 4. 5. 6. 7. 8.
Discuss pathophysiology Identify the most common causes of disorders of calcium, phosphorus and magnesium Discuss hypo and hypercalcemia : causes, clinical presentation, patient evaluation and treatment Identify EKG changes for hyper and hypocalcemia Discuss the relationship of albumin and calcium with regard to lab testing Discuss how to calculate corrected calcium Discuss phosphorus homeostasis Discuss hyper and hypophosphatemia: causes, clinical presentation, patient evaluation and treatment Discuss disorders of magnesium balance: causes, clinical presentation, patient evaluation and treatment Define metabolic acidosis and Identify how to diagnose Describe the common causes of metabolic acidosis Describe the different types of metabolic acidosis including anion gap and nonanion gap acidosis. Identify clinical manifestations Define serum anion gap Identify causes of normal (hyperchloremic) gap , anion gap and high-anion gap acidosis Describe Type A and B Lactic acidosis Describe treatment
Dr. Agresti
Dr. Agresti
76
Sem: Week 1:13
Date 10/30/13
Lecture Topic Metabolic Alkalosis
Readings Readings: Cecil Medicine Damjanov Pathophysiology Renal Notebook Readings: Cecil Medicine Damjanov Pathophysiology Renal Notebook 1. 2. 3. 4. 5. 6. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
Course Objectives Define metabolic alkalosis Describe the common causes of metabolic alkalosis. Discuss pathophysiology Identify clinical manifestations Describe chloride responsive and chloride resistant metabolic alkalosis Describe treatment Discuss acute renal failure, ARF : pre-renal, renal and post-renal causes Describe urine electrolytes with regards to the differential diagnosis of acute renal failure Describe the basic treatments associated with acute renal failure Discuss etiologies Discuss pathophysiology Identify classification and causes of prerenal failure Identify the clinical manifestations of volume overload and depletion; recognize lab abnormalities (BUN and Creatinine) Discuss ultrasound findings associated with ARF ATN (acute tubular necrosis): define and discuss pathology, pathogenesis, causes, clinical course and pharmacological therapy Post Renal failure: identify cause and treatment HRS(hepatorenal syndrome): define and discuss pathology, pathophysiology, renal consequences, clinical pattern Type I and Type II, clinical manifestations, triggers, lab oratory diagnosis, prevention and treatment Define Discuss etiology and pathophysiology Discuss the clinical presentation and appropriate lab work-up Discuss how to diagnose, prevent and treat Define Discuss etiology Identify patients at risk Discuss the clinical manifestations Discuss the appropriate recommendations/ prophylactic therapy Discuss etiology Identify patients at risk Discuss the clinical manifestations Discuss the appropriate recommendations/ prophylactic therapy Define Discuss the causes of tubulointerstitial nephritis and its presentation Discuss the lab associated with tubulointerstitial nephritis Discuss how to differentiate from other causes of acute renal failure Identify the population at risk for renal artery stenosis and its clinical presentation
1:13
10/30/13
Acute Renal Failure, ARF
Dr. Agresti
1:14
11/6/13
Rhabdomyolysis
Readings: Cecil Medicine Pathophysiology Readings: Cecil Medicine Pathophysiology
1:14
11/6/13
Contrast Nephrotoxicity
1:14
11/6/13
1:14
11/6/13
Nephrogenic Systemic Fibrosis:(MRI studies Gadolidium) Tubulointerstitia l Nephritis
1. 2. 3. 4. 1. 2. 3. 4. 5. 1. 2. 3. 4. 1. 2. 3. 4. 5.
Dr. Agresti
Dr. Agresti
Dr. Agresti
Dr. Agresti
77
Sem: Week 1:14
Date 11/6/13
Lecture Topic Glomerular Disease
Readings Readings: Cecil Medicine Pathophysiology 1. 2. 3. 4. 1. 2. 3.
Course Objectives Define proteinuria Discuss hematuria: glomerular and non-glomerular Nephrotic Syndrome: Discuss the clinical presentation, characteristics, causes, laboratory abnormalities and consequences Differentiate Nephrotic and Nephritic syndrome Identify the most common causes of primary glomerulonephritis and their pathologic distinctions Identify populations at risk for primary glomerulonephritis and common causes Discuss the clinical presentation, lab abnormalities, pathology and treatment of: Minimal Change Disease, Focal Segmental Glomerulosclerosis, Membranous Nephropathy,Membranoproliferative Glomerulonephritis ,Rapidly Progressive Glomerulonephritis, IgA Nephropathy Discuss the common causes of secondary glomerulonephritis: Systemic Lupus Erythematosus Goodpastures Syndrome, ANCA associated Vasculities (Wegeners Granulomatosis, Churg-Strauss Syndrome), Microscopic Polyangiitis, Polyarteritis Nodosa, Sarcoidosis, Amyloidosis ,Multiple Myeloma Discuss the clinical presentation, lab abnormalities, and appropriate treatment Define stages Identify signs and symptoms Discuss the clinical manifestations and lab abnormalities Identify factors effecting disease progression Discuss treatment Describe diabetic nephropathy Identify populations/ ethnicity at risk Describe patient evaluation Describe the clinical presentation, hallmarks, and course of Diabetes Mellitus, DM , clinical presentation and course Describe the clinical course of Type1 and Type2 Explain the significance of GFR , glycemic control, microabluminuria , blood pressure control and LDL goal Identify screening tests and interpret results Identify risk factors for progression of microabluminuria Identify goals and therapy in proteinuric patients Discuss the appropriate therapy, prevention and treatment including pharmacologic management Discuss the recommended dietary protein intake
1:14
11/6/13
Primary Glomerular Disease
Dr. Agresti
1:14
11/6/13
Secondary Glomerular Disease
1.
Dr. Agresti
1:14
11/6/13
Chronic Kidney Disease
1:14
11/6/13
Diabetic Nephropathy
2. 1. 2. 3. 4. 5. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
Dr. Agresti
Dr. Agresti
78
Sem: Week 1:14
Date 11/6/13
Lecture Topic Aging Kidney and Obesity
Readings Readings: Cecil Medicine Pathophysiology 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. 2. 3. 4. 5. 6. 7. 1. 2. 3.
Course Objectives Describe structural and functional changes in the aging kidney Describe changes in GFR Describe how to interpret creatinine in the elderly Identify the consequences of renal tubule function Describe the changes in endocrine function Discuss the significance of microalbuminuria Identify the components of Metabolic Syndrome and the risk for CKD Define and identify obesity Describe the clinical presentation of nephropathy associated with obesity Identify the independent risk factors for CKD Describe treatment for patients with obesity Identify the 5 broad categories Describe the clinical manifestations ,epidemiology, prognosis and treatment of HIV associate nephropathy Recognize coincidental renal disorders Identify drug-induced electrolyte disorders in HIV Describe acute renal failure Identify causes of rhabdomyolysis Describe glomerular syndromes and Crystalluria syndromes in HIV Identify and define the most common signs and symptoms of urinary tract infections, BPH, and each of the urological and renal cancers Review anatomy Discuss the clinical presentation, etiology , risk factors , and how to diagnose and treat urinary tract infection in males vs. females, including urethritis, urethral strictures, cystitis and pyelonephritis Discuss the risk factors, clinical manifestations, etiology, and how to diagnose and treat disorders of the bladder including incontinence Describe the presentation, clinical significance, diagnostic work-up of microscopic and macroscopic hematuria Discuss the clinical presentation, physical exam findings , risk factors, etiology and how to diagnose and treat benign prostatic hyperplasia (BPH), prostatitis, nodules, and cancer Discuss the clinical presentation, risk factors, etiology and how to diagnose and treat cancer of the bladder and renal cell cancer Identify and define the most common signs and symptoms of prostate , bladder and renal cancers Discuss the clinical presentation, physical exam findings , risk factors, etiology and how to diagnose and treat prostate cancer Discuss the clinical presentation, risk factors, etiology and how to diagnose and treat cancer of the bladder and renal cell cancer
1:14
11/6/13
AIDS
Dr. Agresti
1:15
11/13/13
Clinical Urology
Readings: Cecil Medicine Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition, pp. 427-429, pp.445-447
Dr. Cheuck
4. 5. 6. 7.
1:15
11/13/13
Clinical Urology and Oncology
Readings: Cecil Medicine Pathophysiology Bates Guide to Physical examination and History Taking, 10th edition, pp. 427-429, pp.445-447
1. 2.
Dr. Cheuck
3.
79
Sem: Week 1:15
Date 11/13/13
Lecture Topic Calculi
Readings Readings: Cecil Medicine Pathophysiology Bates Guide to Physical Examination,10th edition : Pgs 427-428 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.
Course Objectives Review the relevant anatomy, etiology and epidemiology Define calculi Describe types of calculi and characteristics of each and findings Discuss the pathophysiology Discuss risk factors, etiology, signs and symptoms, and common physical exam findings Differentiate renal/flank pain from ureteral pain Describe the appropriate workup and interpret results Discuss management and prevention Identify complications of calculi Discuss the differential diagnosis of renal colic Recognize the importance of a comprehensive history Identify radiographic findings Discuss medical and surgical treatment
Lecturer Dr. Marks
1:16 1:16
11/18/13 11/20/13
Pathophysiology Review Renal Renal/GU Exam Disorders of the Esophagus
Dr. Fischer
Readings: Cecil Medicine Pathophysiology Bates Guide to Physical Examination, 10th edition. Ch 11, Table 11-2, 6-8, 8-1, Tables 11-1, 7-22, Tables 11-1, 11-5, 11-8, 11-10, 1111, Pg 467 Readings: Cecil Medicine Pathophysiology Bates
1. 2.
1:16
11/20/13
Disorders of Stomach
1. 2.
1:16
11/20/13
Disorders of Duodenum
Readings: Cecil Medicine Pathophysiology Bates
3. 1.
Define and discuss esophageal symptoms Discuss the etiology, pathophysiology, risks, clinical manifestation, diagnostic modalities, differential diagnosis, treatment and complications for each disorder: Disorders of Motility: Achalasia (Chagas disease), GERD Disorders of Structure: diverticulae (Zenkers, midesophageal, distal esophageal) Mucosal disease: esophagitis, esophageal erosions, esophageal ulcer, Barrets Disorders of Structure: Boerhaves syndrome, Mallory-Weiss tear,Varices Strictures- benign and malignant Esophageal webs (Shatski Web, Plummer-Vinson Syndrome) and rings Identify etiology and risks for esophageal carcinoma Describe Congenital disorders: Tracheoesophageal fistula Define gastric symptoms dyspepsia, hematemesis, melena Discuss the etiology, pathophysiology ,risks, clinical manifestation, diagnostic modality, differential diagnosis, treatment and complications for each: Disorders of Function: delayed gastric emptying (DM, post-operative atony) and accelerated gastric emptying (Dumping syndrome) Disorders of Structure: PUD, gastric ulcer, duodenal ulcer , H.pylori, ; hemorrhagic gastritis, stress ulcers, chronic gastritis, erosions, gastritis, tumors, polyps, carcinoma, hypertrophic gastropathy (Menetier disease),Zollinger Ellison syndrome, carcinoid, lymphoma, stromal tumor. Discuss congenital disorders: pyloric stenosis, diaphragmatic hernia Discuss the etiology, pathophysiology ,risks, clinical manifestation, diagnostic modality, differential diagnosis, treatment and complications for each : Duodenal tumors, adenoma, adenocarcinomas, Hamartomatous polyps, Peutz Jaegers, carcinoid and lymphoma
Dr. Ganjhu
Dr. Ganjhu
Dr. Ganjhu
80
Sem: Week 1:16
Date 11/20/13
Lecture Topic Gallbladder
Readings Readings: Cecil Medicine Pathophysiology Bates: Tables 11-1, 1111, Pg 451 Review Pediatrics Jaundice lecture Readings: Cecil Medicine Damjanov Pathophysiology, chapter 9, Fig. 9-2 through 9- 11 Bates, Guide to Physical th Examination,10 edition, Tables 11-1, 11-11 Readings: Cecil Medicine Pathophysiology Ch 8, Pgs 74-76 Bates Guide to Physical Examination 10th edition ,Pp. 429-433, 448-451 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. 7.
Course Objectives Define: Cholelithiasis, cholecystitis, Choledocholithiasis, biliary colic Discuss types of stones, clinical presentation, physical exam findings Discuss appropriate workup and treatment List complications of cholecystitis and cholelithias Differentiate acute and chronic cholecystitis Discuss ascending cholangitis, cholesterolosis, and hydrops of the gall bladder Discuss risk factors ,clinical presentation , physical exam findings, work up, and treatment of gall bladder cholangiocarcinoma (bile duct cancer ) Review pathophysiology Define pancreatitis List Ranson criteria Discuss and differentiate acute and chronic pancreatitis Discuss the etiology, presentation, physical exam findings, appropriate diagnostic work up, treatment and complications Discuss prognosis and management Discuss tumors of the pancreas
Lecturer Dr. Ganjhu
1:16
11/20/13
Pancreas
Dr. Ganjhu
1:16
11/20/13
Approach to Liver Disease
1. 2. 3. 4. 5. 6.
1:16
11/20/13
Hyperbilirubine mia
Readings: Cecil Medicine Pathophysiology Bates: Tables 11-1, 1111, Pg 451 Review Pediatrics Jaundice lecture
1. 2. 3. 4. 5. 6. 7.
Discuss the evaluation and management of patients with liver disease Identify liver chemistry tests and the clinical implication of abnormalities Discuss diagnostic imaging findings Review pathology Review laboratory tests for viral hepatitis Discuss and differentiate the clinical presentation, physical exam findings, appropriate diagnostic workup, pathophysiology, management and complications of each: Viral: Hepatitis A,B,C, D, and E Metabolic: Hemochromatosis, Alpha 1 antitrypsin deficiency, Wilsons Disease, NASH Autoimmune: Autoimmune hepatitis, Sclerosing Cholangitis, Primary Biliary Cirrhosis Alcohol Toxic and Drug induced hepatitis Define hyperbilirubinemia Differentiate unconjugated and conjugated bilirubinemia Identify causes Discuss the differential diagnosis Identify common physical findings Discuss the laboratory and imaging studies Differentiate : Gilbert syndrome, Crigler-Najjar, Dubin-Johnson, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis
Dr. Ga njhu
Dr. Ganjhu
81
Sem: Week 1:17
Date 11/27/13
Lecture Topic Irritable Bowel Syndrome
Readings Readings: Cecil Medicine Pathophysiology Damjanov chapter 7, *Table 7-7 Bates Guide to Physical th Examination, 10 edition Tables 11-4, 11-5, Table 11-4, 7-24, 7-25 Readings: Cecil Medicine Pathophysiology Damjanov, chapter 7, *Table 7-7 Bates Guide to Physical Examination, 10th edition Tables 11-4, 11-5, Table 11-4, 7-24, 7-25 Readings: Cecil Medicine23rd edition, 1019 - 1042 Pathophysiology 1. 2. 3. 4.
Course Objectives Define irritable bowel syndrome Discuss the etiology, clinical manifestations, relevant history, physical findings Discuss the differential diagnosis Discuss the diagnostic workup, and treatment of Irritable Bowel Syndrome
Lecturer Dr. Ganjhu
1:17
11/27/13
Inflammatory Bowel Disease
1. 2. 3. 4. 5. 6. 7. 8.
Discuss the etiology and clinical manifestations Discuss relevant history and physical findings Explain the diagnostic workup Discuss treatment Review pathophysiology and histopathology Identify complications Differentiate Crohns Disease and Ulcerative Colitis Distinguish IBS from IBD
Dr. Ganjhu
1:17
11/27/13
Malabsorption
1. 2. 3. 4. 5. 6.
7. 8.
Review the physiology of fat, protein and carbohydrate malabsorption Review pathophysiology and mechanism for each disease Identify and discuss the signs, symptoms and clinical features of malabsorption Review phases of malabsorption Identify and interpret appropriate laboratory screening and diagnostic tests Differentiate and discuss management, mechanism, and treatment of malabsorption disease states :chronic pancreatitis, Zollinger Ellison syndrome, Post-Bilroth II, cirrhosis, bacterial overgrowth, ileal disease/resection; vitamin B 12 deficiency (atrophic gastritis, pernicious anemia, bacterial overgrowth); deficiency states ( sucrose-isomaltase deficiency, lactase deficiency, Hartnups disease, Celiac Sprue, abetalipoproteinemia, intestinal lymphangectasia), a CVID Common Variable Immunodeficiency and Tropical Sprue Identify the work up and treatment of malabsorption disease states: diarrhea, Whipples disease, steatorrhea Review iron deficiency, zinc deficiency and osteomalacia
Dr. Pasternak
82
Sem: Week 1:17
Date 11/27/13
Lecture Topic Diverticular Disease
Readings Readings: Cecil Medicine Pathophysiology Bates Guide to Physical Examination, 10th edition, chapter 11 pp. 505, Tables 11-3, 114,11-5, 15-2 1. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3.
Course Objectives Define diverticulitis and diverticulosis Identify the risk factors for each Discuss the clinical presentation Indicate key elements in the history Discuss the appropriate physical exam and interpret clinical findings Identify and describe appropriate screening and diagnostic tests Review the pathogenesis and pathophysiology Identify and discuss the complications of each Discuss the treatment and prevention including diet, lifestyle modifications, pharmacologic management and indications for surgery Identify risk factors for hereditary and nonhereditary colon cancer Discuss the clinical presentation of colon cancer, Pseudomembranous colitis and other colon diseases Differentiate Hereditary Polyposis syndromes :Familial Adenomatous Polyposis (FAP), Gardners syndrome, Turcots syndrome and Hereditary non-polyposis colorectal cancer (HNPCC) Lynch Syndrome Differentiate Hamartomatous Polyposis: Peutz Jeghers syndrome and Juvenile polyposis Discuss Angiodysplasia Review the pathophysiology of colonic diseases Identify and discuss the appropriate tests to diagnose colon conditions Identify advantages and disadvantages of colonoscopy Discuss treatment of colonic conditions including diet and lifestyle modifications, pharmacologic management Discuss indications for surgery Define angiodysplasia Describe pathophysiology Identify associated conditions Discuss clinical manifestations and work up Identify complications and treatment Discuss Gastric Antral Vascular Ectasias Discuss mesenteric ischemia Discuss the clinical presentation and evaluation of abdominal pain Identify associated physical exam findings Discuss the clinical presentation and causes of upper GI bleeds (distinguish: PUD , gastric and duodenal ulcers) Review the clinical presentation and evaluation of Mallory Weiss tear Discuss the clinical presentation and causes of lower GI bleeds (distinguish: diverticulosis, angiodysplasia, neoplasm, inflammatory disease, ischemic colitis and SMA syndrome) Discuss appropriate work up and management Discuss types of hernias Discuss types hemorrhoids
Lecturer Dr. Pasternak
1:17
11/27/13
Colorectal Disorders; Cancer
Dr. Pasternak
4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. 7. 8.
1:17
11/27/13
Vascular Disorders
Dr. Pasternak
1:18
12/4/13
Surgical Abdomen
TBD
83
Sem: Week 1:18
Date 12/4/13
Lecture Topic Pediatric surgery
Readings Readings: Cecil Medicine Pathophysiology 1. 2. 3. 4. 5. 6. 7. 8.
Course Objectives Discuss fluids and electrolytes Discuss the appropriate evaluation and management of a child with trauma Explain when to suspect child abuse Describe common findings on the physical exam that suggest child abuse Describe abdominal wall defects in the newborn Discuss pyloric stenosis, duodenal atresia and duodenal stenosis Discuss common disorders of the esophagus Discuss common disorders of the intestine: malrotation, meconium ileus, Meckels diverticulum 9. Describe the classic presentation of appendicitis 10. Describe Hirschprungs disease 11. Discuss common biliary tract disorders 12. Discuss inguinal hernia and hydrocele TBD
Lecturer
Finals
12/9/13
GI Exam
84
Medical Microbiology and Immunology I Syllabus

Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Course Coordinator Directors Campus Phone Directors Email Office Hours Medical Microbiology and Immunology I BSCI-624-E Basic Science, Microbiology and Immunology 2 20 weeks Letter Stephen Jones, PhD Kathleen DiCaprio, PhD 646-981-4609 Stephen.jones@touro.edu Posted
Course Description
This purpose of this course will be to apply the foundation of knowledge gained from the basic immunology and microbiology course in the first year to our understanding of the pathogenesis of infectious disease, the role of the immune system in protection from infections, and the immunopathological mechanisms responsible for inflammatory injury in both infectious and noninfectious situations. Our focus will be on the most clinically relevant information and will be guided by those topics that are important to the organ system module under study. Because infectious disease and the inflammatory mechanisms of the immune system are primarily responsible for a great number of pathological conditions, topics covered in this course will overlap with those covered in the Pathology and Clinical Systems courses. Our focus, however, will be to develop an understanding of the different microbiological and immunopathological mechanisms that are at the very heart of these pathologies, and how these mechanisms relate to the diagnosis and treatment of disease.

1. To relate basic immunological concepts to the mechanisms of inflammatory disease and immunologically mediated protection from infection. 2. To appraise the contribution of the different mechanisms of hypersensitivity to the development of both systemic and tissue specific inflammatory diseases. 3. To integrate ones knowledge of the immunopathological mechanisms of inflammatory disease with the most appropriate clinical testing approach and treatment philosophy. 4. To understand the roll of the immune system in recovery from and resistance to infectious pathogens. 5. To appraise the known or hypothesized environmental, genetic, and socio-economical factors that contribute to trends in infectious and immune mediated disease. 6. To understand the unique aspects of physiology, transmission, replication, pathogenesis, and laboratory identification of bacteria, viruses, fungi, protozoa, and helminthes. 7. To understand host-pathogen interactions and their role in the etiology, pathogenesis, treatment and diagnosis of infectious disease.
Medical Microbiology and Immunology I 85 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.

1. Microbiology: A Clinical Approach a) ISBN#: 978-0-815-36514-3 b) Edition: 1st c) Publisher: Garland science d) Year: 2010 2. Essentials of Clinical Immunology a) ISBN#: 978-1-4051-2761-5 b) Edition: 5th c) Publisher: John Wiley and Sons Inc d) Year: 2006

1. Rubins Pathology: Clinicopathologic foundations of medicine a. ISBN#: 0-7817-9516-8 b. Edition: 5th c. Publisher: Lippincott Williams and Wilkins d. Year: 2008 2. Schaechters Mechanisms of Microbial Disease a. ISBN#: 978-0-7817-53425 b. Edition: 4th c. Publisher: Lippincott Williams and Wilkins d. Year: 2006 3. Lippincotts Illustrated Q&A Review of Microbiology and Immunology a. ISBN#: 987-1-58255-857-8 b. Publisher: Lippincott Williams and Wilkins c. Year: 2010
Exam Dates
These dates are subject to change. Module I Pediatrics Module II Geriatrics Module III Cardiology Module IV Pulmonary Module V Endocrinology Module VI Renal Module VII GI
8/19/13 (Combined Module I and II exam) 9/16/13 10/14/13 10/28/13 11/18/13 12/9/13

For this course the following breakdown will be used, where exam Z-Scores greater than and equal to 0.75 are an A, exam Z-Scores less than 0.75 and greater than and equal to -0.45 and are a B, exam Z-Scores less than -0.45 and greater than and equal to -1.35 are a C and exam Z-Scores below -1.35 are an F. For the raw percentages required to achieve these Z-Scores for this course, please see the chart below. Medical Microbiology and Immunology I 86 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Letter Grade A B C F
Z-Score 0.75 Z -0.45 Z < 0.75 -1.35 Z < -0.45 Z < -1.35
Percent 90.00% % 75.69% % < 90.00% 64.96% % < 75.69% % < 64.96%
The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation MMI I -16.50% 79.09% 11.92%

Quizzes/iClickers Module I Module II Module III Module IV Module V Module VI Module VII Total 10% 10% 5% 20% 15% 10% 15% 15% 100%
Medical Microbiology and Immunology I 87 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Schedule
Lectures
Sem: Week Date Lect. # Lecture Topic Readings Course Objectives 1. Describe the physiological immunodeficiencies associated with newborn and pediatric patients and appraise their relationship to protective immunity. 2. Summarize the kinetics of maternal Ab appearance and disappearance in the fetus and newborn, and relate this to risk of infection in the premature and immunocompromised. 3. Describe in general the different types of infections that occur as a result of various forms of immunodeficiency disease. 4. Discuss the special considerations that must be taken into account when investigating, testing and diagnosing pediatric patients for an immunodeficiency disease. 5. Describe the Primary Features, Mechanism of Defects, Functional Defects, Clinical Outcome, Testing and Diagnosis, and treatment for the most common congenital immunodeficiencies found in pediatric patients. 1. Describe the mechanisms behind the 4 types of hyper-sensitivity diseases. 2. Describe the central role of th2 CD4 T cells, B cells, IgE, and mast cells in the sensitization and effector phases of the type 1 hyper sensitivity response. 3. List the early and late phase mediators of Lecturer
Peds_1
Pediatrics: Immunological Status of the Newborn. Congenital immunodeficiencies in pediatric patients.
Chapel Ch. 3, provided reading
Jones
1:1
August 1
Peds_2
Pediatrics: childhood allergies
Chapel Ch. 4, provided reading
Jones
Medical Microbiology and Immunology I *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
88
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives type 1 hypersensitivity response and describe their physiological effects. Identify the type-1 hypersensitivity diseases that commonly occur in children and describe their immune-pathogenesis. Describe the application and interpretation of the clinical tests used for the diagnosis of these allergic diseases. Describe the factors that influence the development of allergies in the pediatric population. Compare and contrast passive versus active immunization and describe a situation when you would use passive immunization over active. Describe the interactions between a dendritic cell, a T cell and a B cell in the development of an immune response to vaccination. Describe the significance of costimulation, Th1 versus a Th2 maturation, affinity maturation, and isotype switching during the response to a vaccination. Describe the concepts of immunological memory as it applies to vaccination. Describe how you would use the indirect ELISA to determine the response to a vaccine. List the properties of an effective vaccine and identify the different kinds of vaccine preparations. Describe the roll of an adjuvant and the general mechanism of its action.
Lecturer
4.
5.
6.
1.
2.
3. Pediatrics: Immunological memory and vaccines Chapel Ch. 7, provided reading 4. 5.
1:2
August 8
Peds_3
Jones
7.
8.
89
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 9. Discuss the most common side effects to the MMR vaccine and describe in general the data from the first studying linking autism and the MMR vaccine. 10. List the basic deficiencies in the newborns immune response that limit vaccine efficacy. 1. Describe the basic pathogen characteristics, transmission, disease pathogenesis, host response, lab identification, treatment, and prevention of pathogens associated with acute otitis media 2. Discuss the classic childhood exanthems and describe the biology and pathogenesis of each causative pathogen. 1. Know the risk factors associated with the increased susceptibility of elderly patients to certain types of infection and why. 2. Describe the most common etiologies and risk factors of UTIs. Pneumonia, pressure ulcers, and infectious diarrhea in elderly patients. 3. Describe the basic pathogen characteristics, transmission, disease pathologies, host response, lab identification, and treatment and prevention of the common infectious in geriatric populations. 1. Appraise the roll of the age-associated decline of immune system function with health outcomes in the elderly population 2. Describe the changes seen in the thymus
Lecturer
Peds_4
Pediatrics: Pediatric infectious diseases
Mims: p207-208 (Strep), p209-210 (Otitis Media), p355361 (exanthems)
DiCaprio
Geriatrics 1 1:3 August 15
Geriatrics: Infectious Disease
DiCaprio
Geriatrics 2
Geriatrics: Immune Defenses of the aging hose
Jones
90
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives with increasing age, and relate these changes to the phenotypic and function age-related changes in the T cell compartment. Contrast the ratio of nave:memory T cells in the young and aged, and describe the significance of this ratio to protection from infection. Appraise the functionality of the aged memory T cell compartment. Describe the relationship between the CD4:CD8 T cell ratio, CD8+CD28- cells, CMV infection, protective immunity, the IRP, and life expectancy. Relate the function of the aged immune system with the success of vaccination in the elderly. Describe the concept of herd immunity, and give known clinical examples of how it can be demonstrated within this population. Describe the etiology and mechanisms of pathogenesis of the most common inflammatory diseases in the elderly.
Lecturer
3.
4. 5.
6.
7.
8.
1:4
August 22
Cardio_1
Cardiology: Inflammatory diseases of the vasculature I
Robbins Ch.11
1. Describe the pathological features/ mechanisms of inflammatory (noninfectious) vasculitis. 2. Differentiate the vasculitic diseases based upon their immunopathological mechanism. 3. Describe the different treatments commonly used for the inflammatory vasculitic diseases.
Jones
91
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 4. Describe the diagnostic value of ANCAs and their proposed immune-pathological mechanism of action in vasculitic disease. 5. Compare and contrast the immunopathological features of WG, MP and CSS. 6. Contrast the classical activation of a T cell via engagement of a peptide/ MHC complex, with activation by a superantigen. 7. Appraise the role of superantigen stimulation in the development of Kawasaki disease. 1. Describe the basic pathological features/ mechanisms of inflammatory (noninfectious) vasculitis. 2. Differentiate the vasculitic diseases based upon their immunopathological mechanism. 3. Describe the different treatments commonly used for the inflammatory vasculitic diseases. 4. Describe the diagnostic value of ANCA and their proposed immune-pathological mechanism of action in vasculitic disease. 5. Compare and contrast the immunopathological features of WG, MP and CSS. 6. Contrast the classical activation of a T cell via engagement of a peptide/ MHC complex, with activation by a superantigen. 7. Appraise the role of superantigen stimulation in the development of
Lecturer
Cardio_2
Cardiology: inflammatory diseases of the vasculature II
Robbins Ch. 11
Jones
92
Sem: Week
Date
Lect. #
Lecture Topic
Readings 1.
Course Objectives Kawasaki disease. Explain the sequence of inflammatory events leading to the formation of the atherosclerotic lesion, emboli and discuss the factors driving this inflammatory process. Appraise the role of regulatory cells/cytokines/ molecules in controlling atherosclerosis. Describe the role of eosinophilia in the development of cholesterol emboli. Relate the clinical testing and basic treatment to the mechanism of disease. Describe the immune-pathogenesis of rheumatic fever, myocarditis, endocarditis (including dresslers syndrome), and endomyocardial fibrosis. Discuss the mechanistic basis for diagnosis and basic treatment of the inflammatory diseases in the heart. List the signs and symptoms of viral myocarditis and infectious endocarditis. List typical organisms causing myocarditis and endocarditis and relate the infective properties of the organism to the characteristics of the pathology Compare the typical course of infection for viral myocarditis and infective endocarditis. Relate the etiology and progression of these infectious diseases to predisposing conditions or risk behaviors
Lecturer
Cardio_3
Cardiology: immunology of atherosclerosis
2.
Jones
3. 1:5 August 29 4. 1. Cardiology: inflammatory diseases affecting the heart Chapel Ch.13, Robbins Ch. 12
Cardio_4
Jones
2.
1. 2.
1:7
September 12
Cardio_5
Cardiology: Myocarditisi
Mims: 379 (Chagas)
3.
DiCaprio
4.
93
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 1. List the signs and symptoms of viral myocarditis and infectious endocarditis. 2. List typical organisms causing myocarditis and endocarditis and relate the infective properties of the organism to the characteristics of the pathology 3. Compare the typical course of infection for viral myocarditis and infective endocarditis. 4. Relate the etiology and progression of these infectious diseases to predisposing conditions or risk behaviors 1. List the hallmark signs and symptoms of the common cold, pharyngitis, epiglotittis, sinusitis, laryngitis, and laryngotracheobronchitis 2. List the typical organisms causing the above mentioned diseases and relate the infective properties of the organism to the characteristics of the pathology. 3. Identify the diagnostic properties of each organism in the context of the disease in which the organism is presented. 1. List the hallmark signs and symptoms of pertussis, tuberculosis, pneumonias, and aspergillosis. 2. List typical organisms causing the above mentioned disease and relate the infective properties of the organism to the characteristics of the pathology. 3. Identify the diagnostic properties of each organism in the context of the disease in
Lecturer
Cardio_6
Cardiology: Infective Endocardititis
Mims: 400-401 (infective endocarditis)
DiCaprio
Pulm_1
Pulmonology: Upper Respiratory Infections
Mims: Ch 18
DiCaprio
1:8b
September 24
Pulm_2
Pulmonology: Lower Respiratory Infections
Mims: Ch 19
DiCaprio
94
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives which it is presented. 1. Describe the immunopathogenic mechanism of ARDS. 2. Sketch out the mechanism of granuloma formation and describe the immunepathogenesis of Tb infection. 3. Describe the immune-pathogenesis of hypersensitivity pneumonitis. 4. Understand the potential role of ANCAS in the development of Wegeners granulomatosis. 5. Describe the pathogenesis of Goodpastures syndrome and describe the relationship between autoimmunity and HLA haplotype 1. Identify the immunological mediators of the asthmatic response. 2. Describe the immunological events that occur during allergen sensitization and reexposure. 3. Describe the physiological and anatomical changes to the lung that occur as a result of the acute and chronic asthma condition. 4. Discuss the scientific basis for diagnosis and treatment. 1. Describe the mechanisms of immunity to infectious pathogens in the lung. 2. Appraise the immune response to pathogens as a mediator of tissue injury during the course of fighting an infection. 3. Discuss the mechanisms of healing in the
Lecturer
Pulm_3
Pulmonology: inflammatory diseases of the lungs
Chapel Ch. 13, Robbins Ch. 15
Jones
1:9
October 3
Pulm_4
Pulmonology: Asthma
Chapel Ch. 4, Robbins Ch. 15
Jones
1:10
October 10
Pulm_5
Pulmonology: Immunity and Healing in the lung
Jones
95
Sem: Week
Date
Lect. #
Lecture Topic Pulmonology: Immune manipulation
Readings
Course Objectives lung following an infection.
Lecturer
Pulm_6
Endo 1
Endocrine: the neuroendocrine-immune connection
1:11
October 17
Endo_2
Endocrine: autoimmunity of the thyroid gland
Endo_3 1:12 October 24
Endocrine: type I diabetes/insulin autoimmune syndrome
Required: Chapel Ch 15, Robbins Ch 24
Endo_4
Endocrine : Polyglandular syndrome/autoimmune
1. Describe the neuronal/ hormonal pathways known to connect the neuroendocrine system and immune system. 2. Describe the functional consequences of communication between the neuronendocrine system and the immune system. 3. Describe the immunological consequences of disrupted or imbalanced neuroendocrine function. 1. Describe the immune-pathology of Grave's disease and Hashimoto's thyroiditis. 2. Appraise the role of genetics and heredity in the development of thyroid autoimmune disease. 3. Relate clinical testing and treatment to the mechanism of the disease. 1. Describe the immunopathogenesis of T1D. 2. Appraise the clinical and experiment al data that have contributed to our understanding T1D. 3. Relate clinical testing and treatment to the mechanism of disease. 4. Describe the immune-pathology of insulin autoimmune syndrome. 1. Describe the role of AIRE gene expression in the thymus, and to appraise the affects of its mutation on the development
Jones
Jones
Jones
Jones
96
Sem: Week
Date
Lect. #
Lecture Topic adrenalitis
Readings 2.
Course Objectives autoimmunity. Describe the immune-pathology of polyglandular syndrome/autoimmune adrenalitis Recall the mechanism of pathogenesis by which Streptococcus pyogenes causes glomerulonephritis. Identify organisms associated with nosocomial and community-acquired UTI. List virulence factors associated with organisms that cause UTIs. List typical organisms causing the highlighted urinary system infection and other renal infections and relate the infective properties of the organism to the characteristics of disease pathologies. Identify the diagnostic properties of each organism in the context of the disease in which it is presented.
Lecturer
1.
2. 3. Renal/UTIs Renal_1 Mims: CH 20 4.
DiCaprio
5. 1:13 October 31
Renal_2
Renal/GU Infections II
TBD
1. Recall the mechanisms of pathogenesis associated with Toxic Shock Syndrome 2. Know mechanisms of actions associated with Staphylococcus aureus toxins and the contributions these toxins make to Toxic Shock Syndrome 3. Identify pathogens and their associated virulence factors that cause urethritis, pelvic inflammatory disease, orchitis, and vaginitis. 4. Identify pathogens based on diagnostic
DiCaprio
97
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives properties.
Lecturer
Renal_3
Renal/GU: Inflammatory diseases of the kidney I
Required: Chapel Ch 9, Robbins Ch. 20
1:14
November 7
Renal_4
Renal/GU: Inflammatory diseases of the kidney II
1. Discuss the general mechanisms of inflammatory injury to the kidney and the reasons why the kidney's structure and function favor involvement in systemic autoimmune/ inflammatory diseases. 2. Describe the 5 major glomerular syndromes. Jones 3. Compare and contrast the general inflammatory mechanisms responsible for inflammatory glomerular disease. 4. Describe the contributing immunopath, clinical diagnosis and treatment of antiglomerular basement membrane antibody mediated glomerulonephritis. 1. Describe the development and immunopathological mechanisms of glomerular diseases caused by immune complex formation in situ (anti-GBM Ab mediated disease and membranous nephropathy). 2. Discuss the general mechanisms of inflammatory injury to the kidney caused by the deposition of circulating immune Jones complexes. 3. Describe the development, immunopathological mechanisms, morphology and clinical features of poststreptococcal glomerulonephritis, lupus glomerulonephritis, type I and II membranoproliferative glomerulonephritis, and IgA nephropathy. 4. Describe the development, 98
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives immunopathological mechanisms, morphology and clinical features of the ANCA assoc. glomerulonephritis. 1. Describe the development, immunopathological mechanisms, morphology and clinical features of of the GU inflammatory diseases. 1. List the hallmark signs and symptoms of diarrheal gastrointestinal infectious diseases. 2. Be able to identify and differentiate organisms that cause bloody and/or watery diarrhea. 3. List typical organisms causing the highlighted diseases and relate the infective properties of the organism to the characteristics of disease pathologies. 4. Identify the diagnostic properties of each organism in the context of the disease in which it is presented. 5. Know pathogenic mechanisms associated with toxins 1. Identify organisms associated with different types of food poisoning. 2. List virulence factors associated with organisms that cause food poisoning. 3. Identify symptoms associated with different types of food poisoning. 4. List typical organisms causing the highlighted hepatic diseases and relate the infective properties of the organism to the characteristics of disease pathologies.
Lecturer
1:15
November 14
Renal_5 Renal_6
Renal/gu: GU inflammatory diseases Review
Jones
GI_1
GI: Normal flora/GI infections
Mims: Ch 22
DiCaprio
1:16
November 21
GI_2
GI: GI infections II
Mims: Ch 22
DiCaprio
99
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 5. Identify the diagnostic properties of each organism in the context of the disease in which it is presented. 1. Describe the specialized anatomical and physiological features of the mucosal immune system in the gut. 2. Describe the function of the cellular components of the gut mucosal immune system. 3. Appraise the balance in the gut between protection and tolerance. 4. Describe the immune-pathogenic mechanism of celiac disease and autoimmune gastritis. 5. Discuss the scientific basis for diagnosis and treatment. 1. Describe the immunopathogenic mechanisms of the IBDs. 2. Appraise the role of enteric flora and dietary antigens in the development of IBD. 3. Appraise the role of genetics and society in the development of IBD. 4. Describe the scientific basis for the diagnosis and treatment of IBDs. 5. Discuss the immunologic mediators of the auto-immune diseases affecting the GI accessory organs.
Lecturer
GI_3
GI: Immunity in the gut; the immunopathology of celiac disease and autoimmune gastritis
Chapel Ch 14, Robbins Ch. 17
Joness
1:18
December 5
GI_4
GI: immunopathology of the inflammatory bowel diseases, and inflammatory diseases of the GI accessory organs
Chapel Ch 14, Robbins Ch. 17, 18
Jones
100
Medical Simulation Elective Fall Semester Syllabus

Course Details
Course Title: Course Number: Department: Credit Hours: Duration: Grading Type: Course Director: Directors E-mail: Asst. Coordinator: Asst. Coordinators E-mail: Office Days/Hours: Department Phone: Medical Simulation Elective PRCR-616-E Primary Care None 1 Semester N/A Joyce Brown, DO Joyce.Brown@touro.edu Janet Grotticelli, DO Janet.Grotticelli@touro.edu By appointment 646-981-4508
Course Description
The use of medical simulation is a highly effective method to enhance learning, improve patient care, decrease medical errors and improve patient safety. In this hands-on course, simulators will be utilized to provide students with opportunities to develop patient care, critical thinking, clinical decision making, communication and procedural skills. Students will work with a variety of simulators (including low, mid and high fidelity simulators, task trainers and cadavers) in small groups led by trained faculty. This is a non-credit elective course offered to second year osteopathic medical students.

1. 2. 3. 4. 5. 6. Develop competence in fundamental clinical and procedural skills. Demonstrate and apply fundamental pathophysiologic and pharmacologic principles to clinical case scenarios. Understand and practice basic lifesaving assessment and management skills. Develop the ability to work as an effective part of a medical team. Develop effective communication skills. Gain hands-on clinical experience in a safe learning environment without posing risks to actual patients.
Required Materials
1. Stethoscope 2. Scrubs 3. White lab coat
Assessment
Students performance will be evaluated and feedback will be given during each class. As this is an elective course, there will be no formal grade given.
Medical Simulation Elective Fall 101 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Format
This course will be delivered during 2 hour blocks on select Tuesdays (during students free blocks). An additional course delivery time and/or format will be considered if the Tuesday sections become filled.
Course Fee
The fee for this course is $600.00. The course fee will be used for maintenance of equipment, materials, training and staffing. The course fee and deposit are non-refundable.
Course Registration
This course has limited space. Deposit is required at the time of registration to secure a spot in the course. Full payment is required prior to the start of the class. Specific details of registration and payment deadlines will be announced.
Attendance, Tardiness & Absences

***Attendance Policy for this course differs from most TouroCOM courses*** 1. This is an elective course; therefore, attendance is not mandatory. 2. There may be no make-up sessions for missed or cancelled classes.
Latex Allergies or Latex Hypersensitivities

Latex containing products will likely be used during this course. Individuals with latex allergies and/or hypersensitivities must notify the Course Director in writing within one week of the start of the course. Individuals with latex allergies and/or sensitivities may be requested to obtain medical clearance prior to interacting with latex containing products.
Medical Simulation Elective Fall 102 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Schedule
Lectures
Sem: Week 1:5 Date 8/27/13 Topic. # 1, 2 & 3
Lecture Topic Primary Survey Introduction to Airway Nasogastric tubes
Readings TBA
1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 1. 2. 3. 4. 5. 6.
1:6
9/3/13
Peripheral IV Insertion
TBA
1:7
9/10/13
Breathing Medical Scenario
TBA
1:8a
9/17/13
Advanced Airway (Intubation)
TBA
1. 2. 3. 1. 2. 3. 4.
1:9
10/1/13
Circulation 1 Medical Scenario
TBA
Course Objectives Define the Primary Survey Define the Airway Identify open, closed and insecure airways Demonstrate the ability to open an airway using a variety of tools and techniques Define nasogastric intubation Discuss techniques of nasogastic intubation Correctly perform nasogastric intubation Define intravenous access Describe basic and advanced intravenous access procedures Perform peripheral IV insertion Define and discuss breathing List and discuss immediately life threatening problems with breathing Discuss multiple modalities for managing a patient with breathing problems Correctly assess and treat a patient with breathing problems Identify and manage acute breathing problems Assess and manage a patient with a medical problem Define endotracheal intubation Discuss some key steps of orotracheal intubation Perform orotracheal intubation Define circulation List and define immediately life threatening problems with circulation Correctly assess a patients circulation Identify and manage immediately life
Lecturer TBA
TBA
TBA
TBA
TBA
Medical Simulation Elective Fall Semester 103 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Sem: Week
Date
Topic. #
Lecture Topic
Readings
5. 1:10 10/8/13 8
TBA
1. 2. 3. 4. 5. 6.
1:11
10/15/13
Casting and Splinting Suturing (Cadaver Lab) Dextrose and Deficits Lumbar Puncture Discussion
TBA
1. 2. 1. 2. 1. 2. 3. 4.
1:12 1:13
10/22/13 10/29/13
10 11 & 12
TBA TBA
5. 6.
Course Objectives threatening problems with circulation Identify and manage acute circulation problems Assess and manage a patient with a medical problem Discuss advanced circulation management List and define immediately life threatening problems with circulation Correctly assess a patients circulation Identify and manage immediately life threatening problems with circulation Identify and manage acute circulation problems Assess and manage a patient with a medical problem Define and discuss basic casting and splinting techniques Perform basic casting and splinting Discuss skin closure techniques Perform basic suturing techniques Define dextrose and deficits List and define immediately life threatening problems with dextrose and deficits Correctly assess a patients dextrose and deficits Identify and manage immediately life threatening problems with dextrose and deficits Identify and manage acute dextrose and/or deficit problems Define and discuss the lumbar puncture
Lecturer
TBA
TBA
TBA TBA
Sem: Week 1:14
Date 11/5/13
Topic. # 13
Lecture Topic Obstetric Delivery Obstetrics [Group 1] Lumbar Puncture {Group 2&3] Orotracheal Intubation review and Practice
Readings TBA
1:15
11/12/13
14
1:16
11/19/13
15 & 16
Obstetrics [Groups 2 & 3] Lumbar Puncture [Group 1] Orotracheal Intubation review and Practice Trauma & E Advanced Simulation Scenarios
TBA
Course Objectives 1. Define and discuss an obstetric delivery 2. Discuss management of normal delivery 3. Discuss initial assessment of the laboring patient 4. Describe the stages and mechanism of normal labor and delivery 5. Perform on uncomplicated obstetric delivery 6. Provide care for mother and neonate 7. Correctly perform lumbar puncture 8. Practice orotracheal intubation 1. Perform obstetric delivery 2. Provide care for mother and neonate 3. Define and discuss lumbar puncture 4. Perform lumbar puncture 5. Practice orotracheal intubation
Lecturer TBA
TBA
TBA
1. Define ATLS 2. Identify and describe some key steps of the ATLS primary survey 3. Correctly perform some key steps of the ATLS primary survey 4. Identify and manage a trauma patient using a patient simulator 5. Define and discuss immediately life threatening Environmental problems
TBA
Osteopathic Manipulative Medicine II Part 1 Syllabus

Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Directors Campus Phone Directors Email Office Hours Osteopathic Manipulative Medicine II Part 1 OMM-625-E Osteopathic Manipulative Medicine (OMM) Department 3 Entire Semester Letter Susan Milani, D.O. (646) 981-4619 Susan.Milani@touro.edu By Appointment
Course Description
The second course in Osteopathic Manipulative Medicine (OMM) is designed to continue to develop the philosophy, principles, and skills of osteopathic health care. Emphasis is on the sequential development of the palpatory examination, as well as, the diagnostic and therapeutic skills of osteopathic manipulative medicine. These skills are now applied to the structural and functional relationships of the musculoskeletal system as they relate to the other organ systems of the body. The biomechanical, respiratory-circulatory, neurological, metabolic energy, and behavioral models will be used to provide the context for the diagnosis and treatment of a large variety of clinical scenarios. This material is presented in the context of the modular systems so that specifically osteopathic considerations are well-integrated into all the courses in the second year. The course will cover osteopathic approaches to problem solving and patient management, incorporating multiple osteopathic manipulative treatments as appropriate, including: soft tissue, myofascial release, balanced ligamentous tension, articulatory, counterstrain, muscle energy, high velocity low amplitude, and Osteopathy in the Cranial Field treatment modalities.

1. Describe the role of osteopathic history, philosophy, principles and current professional challenges for osteopathic medicine. 2. Identify, differentiate, explain, and interpret palpatory findings in an examination of a surrogate patient. 3. Identify and interpret somatic dysfunction, including its anatomical and physiological basis and its impact on the health of the patient. 4. Define, explain and successfully demonstrate appropriate diagnostics and the aforementioned techniques to restore and optimal function of all body regions and reduce somatic dysfunctions. 5. Define and demonstrate the structural and functional models: biomechanical, respiratory-circulatory, neurological, metabolic energy, and behavioral for each of the systems that are covered. 6. Demonstrate the treatment plans based on the presented clinical scenarios.

1. Osteopathic Considerations in Systemic Dysfunction, Revised 3nd Edition, a. Author-Kuchera, M. b. ISBN -1-57074-154-9 2. Foundations of Osteopathic Medicine, 3rd Edition OMM I Part 1 106 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
a. Editor -Chila, Anthony b. ISBN -978-0-7817-6671-5 3. An Osteopathic Approach to Diagnosis & Treatment a. Author-DiGiovanna et al b. ISBN -978-0-7817-6671-5 4. Physical Examination of the Spine & Extremities a. Author-Hoppenfeld S. b. ISBN -0-8385-7853-5

1. Somatic Dysfunction in Osteopathic Family Medicine a. Editor -Nelson, Kenneth b. ISBN-13 =978-1-4051-0475-3 2. Teachings in the Science of Osteopathy a. Author-Sutherland, William b. ISBN-0-930298-00-5 3. A Pocket Manual of OMT a. Author- Steele, Karen M. b. ISBN-13 978-1405104807 4. The 5-Minute Osteopathic Manipulative Medicine Consult a. Author-Channel, Millicent King b. ISBN 13: 978-0781779531
Exam Dates
These dates are subject to change. Written Exams Pediatrics and Geriatrics Exam Cardiology Exam Pulmonary Exam Endocrine Exam Renal/GU Exam GI Exam Practical Exams Practical I Practical II 10/15/2013 12/3/2013 8/19/2013 9/16/2013 10/14/2013 10/28/2013 11/18/2013 12/9/2013

For this course the following breakdown will be used, where exam Z-Scores greater than and equal to 0.75 are an A, exam Z-Scores less than 0.75 and greater than and equal to -0.45 and are a B, exam Z-Scores less than -0.45 and greater than and equal to -1.35 are a C and exam Z-Scores below -1.35 are an F. For the raw percentages required to achieve these Z-Scores for this course, please see the chart below. OMM I Part 1 107 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Z-Score 0.75 Z -0.45 Z < 0.75 -1.35 Z < -0.45 Z < -1.35
Percent 91.10% % 77.47% % < 91.10% 67.24% % < 77.47% % < 67.24%
The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation OMM I Part 1 -10.00% 81.44% 11.36%

Quizzes Module I Module II Module III Module IV Module V Module VI Module VII Practical I Practical II Total 10.0% 6.7% 3.3% 13.3% 10.0% 6.7% 10.0% 10.0% 15.0% 15.0% 100%
Attendance and Grading Policy
Exams In-Class Clicker Questions: The lecturer can administer in-class questions via the clicker system. The mean of the clicker quiz scores will constitute 10% of the final course grade. Since clicker quiz answers will be reviewed in class, clicker grades will not be sent to students. Lab Practical Exams: Please note that practical exams are for evaluation purposes only and are not designed as teaching tools therefore, students will not be permitted to view their grading sheets. Failure: There will be no re-take practical exams. Students who score below 70% will be given the opportunity to review areas of weakness with a member of the faculty. OMM I Part 1 108 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Absence: Students who miss a practical exam will receive a zero for that practical exam. An excused absence from the Dean of Student Affairs, will allow the student to take the practical exam a later date with a maximum attainable grade of 70%. OMM Lab Attendance Due to the nature of the psychomotor skills associated with the lab content, 100% attendance and punctuality is required. If an absence is anticipated or occurs, the student must notify the department. Excused absences must be obtained from the Dean of Student Affairs. For each unexcused absence, 10 percentage points will be deducted from the overall practical score. OMM Lab Dress Policy (The following is a nationally accepted Dress Code for OMM Labs.) The dress requirement in the clinical skills training sessions is designed to promote learning by providing optimal access to diagnostic observation and palpatory experience. Wearing inappropriate clothing interferes with a partners experience of diagnosis and treatment. Appropriate attire must be clean and includes: Shorts that are above the knee. o (No jean shorts, cut-offs, thick-seamed shorts, spandex, short shorts or knee length shorts.) T-shirts. o Both sexes will be asked to remove t-shirts while acting as patients. Sports bras or bathing suit tops for women. o These should expose the spine and ribs (not wide T-back styles). Student doctors may wear sweats or scrubs (or other apparel approved by the Course Director) over laboratory attire when not in the role of the patient o Please note that scrubs worn in anatomy lab are NOT appropriate outside of the anatomy lab. OMM lab does not have the same ventilation system as is required by law for the anatomy lab and the chemicals can affect the table coverings. Please bring and wear only clean non-fragrant scrubs to OMM lab. Remove shoes when you are the patient (no shoes are permitted on the tables). Hats or head coverings (other than for religious purposes) are not permitted in OMM lab. Religious head coverings are to be removed when you would obscure the immediate area to be examined or treated (e.g., head, neck, and upper back). The head covering can then be immediately replaced after this portion of clinical skills training. Please note that jewelry, especially large rings, may damage the tables. Please secure rings and other jewelry before the lab. If a student is not properly dressed, inappropriate attire will be recorded, and 5% points deducted from the next practical exam grade.
Limitation/Exclusion from Participation in the OMM Lab for Medical Reasons Any student doctor with a pre-existing health problem that may preclude examination and/or treatment is required to submit a written request for limitation and/or exclusion to the Department Chair and present appropriate medical documentation. A physician member of the department will review this information on a case-by-case basis, and may OMM I Part 1 109 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
require additional diagnostic measures. The department member reviewing the case will determine any limitation or exclusion from participation, and the student doctor will be notified in writing of the decision.
OMM I Part 1 110 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Schedule
Lectures
Sem: Week Date Lect. # Lecture Topic Readings Course Objectives Lab Objectives 1. Describe and demonstrate the preparatory exercises for cranial palpation: grounding and centering. 2. Palpate the cranial rhythmic impulse (CRI) using the following contacts: cranium, sacrum and paired bones. 3. Identify flexion and extension and internal & external rotation within the cranial rhythmic impulse (CRI). 4. Identify; landmarks: asterion, pterion, bregma, lambda, sutures: coronal, lambdoidal, sagittal, occipitomastoid, mastoid process as they relate to the vault hold. 5. Demonstrate the vault hold, and identify location of each finger position [sphenoid, temporal, temporal, occiput]. 6. Demonstrate venous sinus drainage and identify contraindications. 7. Demonstrate the hand models for flexion/extension and the strain patterns (torsion, side-bending rotation, lateral & vertical). 8. Identify strain patterns with palpation and exaggeration using the vault hold. 9. List the clinical correlations related to cranial treatment. 1. Describe the approach to the osteopathic structural exam (OSE) in infants and children including the 111
Pediatrics I: Osteopathy in the Cranial Field AD 1:1 7/30 1 Posted: Cranial Nerves Lecture (OMM1) DA Foundationsp. 728-748 Digiovanna: p.109-112, 549584
1. Discuss the historical contribution of William G. Sutherland to Osteopathy in the Cranial Field (OCF) 2. Define the Primary Respiratory Mechanism and its five anatomicphysiologic components or phenomena 3. Give examples of research that support each of the five phenomena 4. Define the mechanisms of cranial motion: flexion and extension of midline bones and rotation of the paired bones 5. Demonstrate the contact points for the vault hold 6. Demonstrate the physiological and nonphysiological strain patterns related to the cranial bones (flexion, extension, lateral and vertical strains, and torsions)
1:2
8/6
Pediatrics II: Pediatric Patient/Otitis
Kuchera: p. 171-178 DiGiovanna: p.
1. Describe the Osteopathic Structural Examination of the Newborn. 2. Describe the occipital bone at birth.
OMM I Part 1 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Sem: Week
Date
Lect. #
Lecture Topic Media AD
Readings 615-617 Foundationsp. 918-930
Course Objectives 3. Discuss clinical components and osteopathic considerations of the following conditions arising from severe forces of labor and delivery: a. excessive molding, b. ridges and over-riding sutures, c. difficulty with sucking and swallowing, d. condylar compression and OM suture compression e. vomiting and hypotonia. f. plagiocephaly/torticollis 4. Discuss the osteopathic research related to otitis media. 5. Discuss the anatomical considerations and the osteopathic treatment and management associated with otitis media and Eustachian tube dysfunction based on the biomechanical, respiratory-circulatory, and neurological models. 2. 3. 4. 5. 6.
Lab Objectives assessment of CRI. Evaluate the occiput and sacrum for cranial flexion and extension. Discuss the goals of treatment for otitis media. Demonstrate temporal decompression. Demonstrate OM suture V spread technique (apply to any suture). Demonstrate the Galbreath technique.
1:3
8/13
Geriatrics: End Of Life BT
1. List the stages of grief as they pertain to the end of life. 2. List some of the common physiological processes that occur during the end of life. 3. List the osteopathic contributions to end of life care. 4. Develop of self-awareness and comfort discussing the issues related the dying with both patients and their loved one
1. Describe the approach to the osteopathic structural exam in the geriatric patient including changes in range of motion, gait, and joint barrier findings. 2. Demonstrate palpation of the CRI in the vault, the fronto-occipital and the Becker holds. 3. Demonstrate the following treatments; a) Exaggeration b) Parietal lift c) Frontal lift d) CV4 e) EV4 112
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives
Lab Objectives 4. Discuss the concepts, indications and contraindications of the above treatments.
Cardiovascular I: Clinical Thoracic Spine and Ribs SM
Foundationsp. 528-541 DiGiovanna: p. 175-189, 226232 OMM 1 Manual T-spine p. 45-56
1:4
8/20
The Clinical Application of Osteopathic Manipulative Treatment Modalities AD
Foundations p. 669-727 p. 749-785 p. 809-819
1. Discuss the clinical implications of the thoracic region in terms of the five-point structure function model: biomechanical, respiratory-circulatory(lymphatics), neurological, metabolic energy, and behavioral 2. Describe the physiology of the viscerosomatic reflex and the associated sympathetic and parasympathetic segmental levels 3. List the levels of the VSR and the corresponding nerves 4. Discuss the clinical implications of the thoracic region in terms of the five-point structure function model: biomechanical, respiratory-circulatory, neurological, metabolic energy, and behavioral 5. Discuss the treatment plans based on the above models for Shermans, compressions fractures and cord compression costocondritis 1. Define and explain the theory of counterstrain, muscle energy, myofascial, HVLA, BLT and FPR manipulative techniques including the proposed mechanisms and physiology. 2. Discuss the applications, safety and efficacy of each modality. 3. Discuss the clinical applications of the above treatment modalities indicating treatment duration and frequency.
1. Demonstrate the evaluation and diagnosis of somatic dysfunctions for the patient with pain in the thoracic area in terms of thoracic spine (type I & II), ribs and diaphragm. 2. Diagnosis the following rib dysfunctions: structural rib, inhalation/exhalation, subluxation, compression and anterior/posterior. (Review rib handout.) 3. Diagnosis the VSR and restrictions in the abdominal ganglia. 4. Locate the Chapmans points for gallbladder, stomach acid, myocardium, and esophagus. 5. List the principles and protocols for counterstrain. 6. Demonstrate thoracic counterstrain.
113
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 4. Discuss the indications and contraindications related to treatment modality in terms of patient age, overall condition, acute versus chronic disease processes, and pain level. 5. Differentiate between direct versus indirect and active versus passive techniques. 6. Discuss the considerations relevant to the choices of treatment modalities a patients treatment plan. 1. Discuss chest pain in relation to VSR and autonomics 2. List the differential diagnosis of chest pain including referral pain patterns. 3. List causes of chest pain that are emergencies vs. less emergent causes 4. Discuss biomechanical musculoskeletal pain vs. visceral pain 5. Discuss anterior vs. posterior chest pain 6. Describe the types of mechanisms and causes that result in chest pain in terms of the biomechanical (costochondritis/Tietze syndrome), respiratory-circulatory, neurological, metabolic, and behavior models. 7. Describe how to differentiate cardiac from non-cardiac chest pain including the clinical presentation of GERD. 8. Discuss the osteopathic treatment and management plan for non-cardiac chest pain. List the considerations of the ribs in chest pain including the neural, visceral, and
Lab Objectives
1:5
8/27
Cardiovascular II: Chest Pain KS
Kuchera: p. 5759 Foundationsp. 529-541 DiGiovanna: p. 624-7
1. List a differential diagnosis for noncardiac chest pain (intercostal neuralgia, shingles, costo-chondritis and Tietze syndrome). 2. Demonstrate the evaluation of the patient with chest pain focusing on the palpation of the following muscles: scalene, pectoralis major and minor, intercostals, iliocostalis, serratus anterior, tranversus thoracis and the costo-chondral junction of the ribs. 3. Identify the viscerosomatic levels that are related to the differential diagnosis for chest pain. 4. Demonstrate counterstrain treatment of the ribs. 5. Mastery: Demonstrate thoracic spine myofascial and HVLA.
114
Sem: Week
Date
Lect. #
Lecture Topic
Readings 1. Foundationsp. 1021-4 p. 1027-28, p. 1053-6 p. 1065-6 DiGiovanna: p. 624-7 Kuchera: p. 53-76 2. 3. 4. 5. 6.
Course Objectives biomechanical influences. Describe the strategies for approaching clinical research. Describe the models for clinical research. Discuss the impact of the osteopathic research on the MI patient. Discuss Irwin Korrs research on the autonomics. Discuss Louisa Burnss research on cardiac tissue. Discuss the impact of osteopathic research and its implication to current medical practice. Describe osteopathic diagnosis and treatment in the overall management plan of the patient who presents with myocardial infarction.
Lab Objectives
1:6
9/3
Cardiovascular III: Cardiac OMM Research/Myoc ardial Infarction MB
Posted material: Patient with 7. Myocardial Infarction
1. Demonstrate the evaluation and treatment plan for the postmyocardial infarction patient including the management of tachy and brady arrhythmias. 2. Demonstrate rib raising related to cardiac findings. 3. Demonstrate seated articulatory/HVLA technique for the ribs. 4. Mastery: Demonstrate muscle energy for the thoracic spine and ribs.
1:7
9/10
Cardiovascular IV: CHF/HTN/ Arrhythmias DD
Foundationsp. 889-902 Kuchera: p. 5378 DiGiovanna: p. 624-7 Posted material: Patient with Congestive Heart Failure
1. Describe the pathophysiology of congestive heart failure, hypertension, and arrhythmias based on the autonomic, lymphatic, and somatic systems. 2. Describe the osteopathic treatment management of CHF, HTN, and arrhythmias in terms of the following pathophysiological models: biomechanical, respiratory-circulatory, neurological, metabolic-energy and behavioral. 3. State research studies related to HTN.
1. Demonstrate the evaluation of the cardiac patient. 2. Discuss the treatment goals for the cardiac patient related to the sympathetic, parasympathetic, and lymphatic systems. 3. Diagnose the thoracic inlet including T1, rib 1 and scalene. 4. Demonstrate the lymphatic treatments: a. re-doming the thoracic diaphragm, b. pelvic floor release (prone), c. popliteal fossa release, d. pectoral traction, e. indirect release of the thoracic inlet by treating the first rib with FPR (discuss the effect on T1), 115
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives f.
Lab Objectives thoracic and pedal pumps (review). 5. Locate the pectoralis trigger point related to arrhythmia. 6. Mastery; Demonstrate lymphatic techniques.
1:8a
9/17
Pulmonary I: Clinical Considerations of the Cervical spine MB
Foundations p. 513-527 979989 DiGiovanna: p. 125-137, p. 160172 Review first year Functional and Clinical Cervical Spine Lectures Posted material: Patient with Inertial Injury and Patient with Torticollis Kuchera: p. 33-52 DiGiovanna: 618-619 Foundationsp.20 6-214
1:9
10/1
Pulmonary II: Introduction to the Respiratory Patient/Pneumo nia Posted material: Patient with MB Bacterial Lobar Pneumonia
1. List the differential diagnosis of neck pain for the based on the findings of local pathology 2. Describe the mechanism of injury in the whiplash injury as well as the findings that may be present throughout the body. 3. Describe the presentation and findings for the patient with torticollis. 4. Describe the osteopathic patient management based on the biomechanical, respiratory-circulatory, neurological, metabolic energy, and behavioral models 5. List the contraindications and cautions regarding the OMT for somatic dysfunctions in the patient with acute neck pain. 1. Demonstrate an osteopathic approach to the lower respiratory patient. 2. Describe what types of restrictions are found with pulmonary disease. 3. Describe pump handle, bucket handle, caliper motion of the rib cage with breathing. 4. Discuss how cervical and upper thoracic somatic dysfunctions relate to the pulmonary function. 5. Describe the role of the scalene muscles in respiration.
1. Demonstrate the diagnosis of the OA, AA and cervical spine correlating cervical counterstrain tender points with cervical spine somatic dysfunctions. 2. Discuss the evaluation and treatment consideration of the patient with a whiplash injury. 3. Locate and palpate the trigger points and associated referral patterns for SCM and scalene. 4. Demonstrate the treatment of OA, AA, and cervical spine using counterstrain. 1. Demonstrate the evaluation of the respiratory patient. 2. Demonstrate the Chapmans points related to the lungs. 3. List the treatment protocol for the patient with pneumonia. a) Thoracic inlet evaluation and treatment with BLT. b) Thoracic spinal muscle inhibition/Chapmans point treatment for lungs c) Rib-raising; seated and supine 116
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 6. Understand the role of that respiration has on the lymphatic flow and how myofascial restrictions may impair lymphatic drainage. 7. Integrate osteopathic diagnosis and treatment into the overall medical management of the patient who presents with lower respiratory disease (pneumonia).
Lab Objectives d) Evaluate rib/chest compliance e) Evaluate and re-dome the diaphragm (seated) f) Condylar decompression & Cervical spine myofascial release g) Thoracic lymphatic pump h) Pedal pump 4. Demonstrate rib-raising. 5. List the principles and protocols of facilitated positional release (FPR). 6. Demonstrate FPR to the cervical and thoracic spine. 1. List the differential diagnosis for the patient with dyspnea. 2. Describe the management and treatment plan for the respiratory patient including the autonomic nervous system and lymphatic effects. 3. Describe the steps of cervical and sinus effleurage for the treatment of sinusitis. 4. Demonstrate the screening assessment for the pulmonary patient including; observational findings associated with pneumonia, asthma, sinusitis and COPD. 5. Demonstrate the treatment plan for asthma: Seated myofascial inhibition at costo-vertebral joints to reduce sympathetic tone. Springing of costovertebral joints to increase sympathetic tone to facilitate bronchial dilatation. 117
1:10
10/8
10
Pulmonary III: Upper Respiratory Conditions: Asthma, COPD, and Sinusitis, DD
Kuchera: p. 2352 Foundationsp. 206-214, 931938 DiGiovanna: p. 620-621 Posted material: Pediatric Asthma Patient
1. Discuss the pathophysiology of respiratory disorders in terms of reflex action during infection, autonomic, musculoskeletal, and lymphatic responses. 2. List the differential diagnosis of dyspnea. 3. Describe the osteopathic management plan that includes the biomechanical, respiratory-circulatory, neurological, metabolic-energy and behavioral models for asthma, COPD, bronchitis, and sinusitis 4. List the suggested OMT protocol for the patient with COPD.
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives
Lab Objectives 6. Lab review: Demonstrate FPR & ME of the cervical & thoracic spine and CS of the cervical, thoracic spine & ribs. 7. Mastery: Demonstrate cervical spine myofascial, ME & HVLA
Endocrine I: HPA and Cranial III Foundationsp 258,728-48 SM
1:11
10/15
11
Endocrine II: Thyroid BGC
Foundationsp 253-9
1. Describe the anatomy and physiology of the Hypothalamus-Pituitary-Adrenal axis 2. Describe the blood supply to the pituitary gland 3. Describe the indications for and treatment implications of the CV4 4. Describe the significance of parietal and frontal bone compression on cranial physiology 5. Describe the relevant history taking for the cranial patient (trauma, birth history) 6. Describe the clinical research in the cranial field 7. Describe the observational diagnosis relevant to the cranial patient. 8. Describe the goals of treatment that one would have with the cranial patient. 1. Describe the systemic effects, from an Osteopathic perspective, of thyroid disease 2. Manipulative treatment for thyroid disease states 3. Describe the clinical manifestations of thyroid disease. 4. Describe the sequence to treat Chapmans points 5. Describe the endocrine considerations in chronic pain (including the effect of circulation hormones and circulating
Practical 1
118
Sem: Week
Date
Lect. #
Lecture Topic
Readings 6. 7. 8.
Course Objectives cytokines) Describe the interconnection between the endocrine and autonomic nervous system. Describe the effect of adrenal compromise on musculoskeletal function. Describe how one would screen for these in the workup of musculoskeletal complaints Describe the mechanism whereby the stress response can lead to hyperventilation and TMJ problems Describe the clinical presentation of hyperventilation, including the biochemistry and palpatory musculoskeletal findings. Describe the osteopathic treatment plan for hyperventilation syndrome. Describe the osteopathic perspective to dysfunctions of the temporo-mandibular joint, including the clinical history, physical exam, laboratory studies. Describe the relationship of the temporomandibular joint to the cranial mechanism. Describe the differential diagnosis that are generated by the above clinical findings, including differentiation of acute and chronic TMJ dysfunction Describe the entrapment of the buccal nerve in relation to the lateral pterygoid muscle Describe the local, postural, and systemic implications of structural pathologies of the lower extremities
Lab Objectives
1.
2.
1:12
10/22
12
Endocrine III: Musculoskeletal Ramifications of Stress Syndromes (Hyperventilatio n and TMJ) MB
Foundationsp. 510-511 DiGiovanna: p. 607-611 Posted material: Patient with TMJ
3. 4.
5.
6.
1. Describe the observation and palpatory findings relevant to TMJ dysfunction, including; palpation of the temporalis, masseter, medial and lateral pterygoid muscles, temporal bones and cranial strain patterns. 2. Demonstrate the treatment plan for TMJ, including; myofascial release, muscle energy and patient selftreatment. 3. Demonstrate inhibition to the medial & lateral pterygoids and masseter muscles.
7.
1:13
10/29
13
Renal/GU I: Osteopathic Considerations
Foundationsp. 602-639, 809813.
1.
1. Demonstrate the examination of the hip, knee, foot and ankle, with concentration on foot and ankle exam. 119
Sem: Week
Date
Lect. #
Lecture Topic of the Lower Extremities MT
Readings DiGiovanna: p. 475-505, 537548 Teachings in the Science of Osteopathy p. 269-70
Course Objectives
Lab Objectives
1:14
11/5
14
Renal/GU II: Upper GU SM
Kuchera: pp 123-9, 134-5 DiGiovanna: p. 639-645
2. Describe the structure-function 2. Demonstrate counterstrain for the relationships of the lower extremities as following tender points of the lower they relate to the biomechanical, extremity: medial and lateral meniscus, neuromusculoskeletal, and circulatory anterior and posterior cruciates, ankle, function. medial and lateral ankle, and calcaneal. 3. Discuss the capsular patterns of the lower 3. List the principles and protocols of extremity in terms of the restriction of balanced ligamentous tension (BLT). range of motion and the palpated end-feel 4. Demonstrate treatment of the fibular of the joint. head with BLT. 4. Discuss the findings and treatment objectives for the following cases: transient synovitis, trochanteric bursitis, meralgia paresthetica, chondromalacia patella, pes anserine bursitis, tibial torsion in a young child, March fracture, medical collateral ligament sprain, plantar fascial strain. 5. List the clinical goals for treatment of the lower extremities. 1. Differentiate visceral vs. musculoskeletal 1. Demonstrate the evaluation of the low back pain. lumbar spine including multifidus 2. Describe the connections of the kidney triangle, piriformis and quadratus with the: colon, liver, stomach, spleen lumborum trigger points. 3. Describe the connections of the kidneys 2. Describe the differential diagnosis of with the: renal fascia, psoas, diaphragm flank pain, differentiating between 4. Describe neuropathic pain caused by visceral and structural etiologies. kidney malposition 3. List the clinical presentation and 5. Describe the viscerosomatic reflexes for expected somatic dysfunctions related the kidneys and upper ureters. to psoas syndrome & disc herniation. 6. List the 3 locations where the ureter 4. Demonstrate lumbar FPR: hypertonic narrows. muscles, flexion SD, extension SD and 7. Describe the consequences of kidney discogenic. ptosis including effect on ureteral patency 5. Mastery: Demonstrate lumbar spine 8. Describe the Osteopathic treatment ME. 120
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives approach to hypertension, nephrolithiasis/ureterolithiasis and renal disease 1. Describe the anatomical relationships of lower ureters and bladder. 2. Describe the superior, lateral, and inferior support for the bladder. 3. Describe the effect of delivery, surgery, and trauma to support of the bladder. 4. Describe the effect of the pelvic and respiratory diaphragms on the function the bladder. 5. Describe the neurologic control of micturition, and the pathways of the relevant nerves 6. Describe the pelvic structures that drain via the renal veins 7. Describe the Osteopathic approach to prostatitis and urinary tract infections 1. Discuss the differential diagnosis of shoulder pain that includes the muscular/tendinous, osseous, capsular, biomechanical, neurovascular, and referred pain patterns (cervical, MI, pleurisy, irritation of the diaphragm by gall bladder). 2. Discuss the diagnosis and treatment of the following clinical cases: infection in the hand, rotator cuff tendonitis, tennis elbow, impingement syndromes. 3. Discuss the common somatic dysfunctions
Lab Objectives
1:15
11/12
15
Renal/GU III: Lower GU and Pelvic Floor Dysfunctions KS
Kuchera: pp 123-29, 136-39 DiGiovanna: p. 639-645
1:16
11/19
16
Gastrointestinal I: Clinical Considerations of the Upper Extremities MB
Foundationsp. 640-659, 946951 DiGiovanna: 409-432, 463470 Posted material: Patient with Carpal Tunnel Syndrome
1. Describe the evaluation of the patient with dysuria. 2. List the observation and palpatory findings in the patient with dysuria. 3. List treatment, management, and contraindications for the patient with dysuria. 4. List and locate the VSR and Chapman points to the kidneys, ureter, prostate & bladder. 5. Describe the parasympathetic innervations of the kidney (vagus), proximal ureter (vagus), bladder (pelvic splanchnics) 6. Demonstrate the evaluation and treatment of the lumbar spine counterstrain tenderpoints. 7. Demonstrate location and treatment of celiac, superior and inferior ganglia. 1. Demonstrate the evaluation and diagnosis of the upper extremities, including the clavicle. 2. Demonstrate clavicle muscle energy. 3. Locate and demonstrate the treatment for the following counterstrain points; long and short head of the biceps, supraspinatus, radial head-lateral and medical epicondyle, coranoid, olecranon, and the dorsal and ventral points of the wrist. 4. Correlate counterstrain points to 121
Sem: Week
Date
Lect. #
Lecture Topic
Readings OMM 1 Lab Manual p. 197215, UE
Course Objectives of the UE and the corresponding structural-function relationship to the respiratory-circulatory, biomechanical, neurological, musculoskeletal, and behavioral models.
Lab Objectives associated SD and postural changes. 5. Demonstrate the treatment of carpal tunnel including; opponens role, direct HVLA flexion SD, direct HVLA extension SD, direct HVLA adduction SD and articulatory technique (Squeeze with circumduction for intercarpal SD).
Gastrointestinal II: Upper GI: (Stomach, GERD, Hiatal Hernia, Pancreatitis Cholecystitis) TS 1:17 11/26 17
Foundations p. 999-1005 DiGiovanna: p. 631-8 Kuchera: p. 7994
Gastrointestinal III: Colon & Liver KS
Foundationsp. 999-1005 Kuchera: p. 95-122 DiGiovanna: p. 631-8 Posted material: Patient with Ileus who has had Abdominal Surgery
1. Describe the clinical presentation of GERD, especially how to differentiate it from cardiac and pulmonary causes of chest pain. 2. Describe the anatomy of the GE junction and highlight the muscular and bony structures that influence the lower esophageal sphincter 3. Discuss pain patterns, structural findings, and osteopathic treatment of pancreatitis. 4. Discuss pain patterns, structural findings, and osteopathic treatment of cholecystitis. 1. Describe the effects of thoracic diaphragmatic excursion on liver function and circulation. 2. Review the ligamentous attachment of the liver. 3. Describe the autonomic innervations of the liver. 4. Describe the neural control systems of the bowel. 5. Describe the effects of the autonomic nervous system on intestinal function. 6. Describe the suspensory system of the
1. Describe the evaluation of the patient with post-op ileus or constipation. 2. List the observation and palpatory findings in the patient with post-op ileus or constipation. 3. List treatment, management and contraindications for the post-op ileus patient or constipation. 4. Perform the mesenteric lift. 5. Describe the direct myofascial release of the colon. 6. List and locate GI viscerosomatic reflexes T5-L2. 7. List the Chapmans reflexes for ilieus constipation and appendicitis. 8. Demonstrate visceral techniques of the GE junction and trans-abdominal stimulation. 9. Demonstrate BLT of the 12th rib. 10. Demonstrate lumbar para-inhibition.
122
Sem: Week
Date
Lect. #
Lecture Topic
Readings 7.
Course Objectives intestines. Describe the role of the posterior abdominal wall, thoracic and pelvic diaphragms on intestinal function. Describe the structural exam and findings in post-op ileus Describe the effects of abdominal surgery on intestinal function. Describe the presentation of irritable bowel syndrome Describe the physiology underlying Osteopathic manipulative treatment of irritable bowel syndrome
Lab Objectives
8. 9. 10. 11.
1:18
12/3
18
Practical 2
123
Pathology I Syllabus
Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Directors Campus Phone Directors Email Office Hours Pathology I BSCI-633-E Pathology 5 18 weeks total Letter Grade Tipsuda Junsanto-Bahri MD 646-981-4610 tipsuda.bahri@touro.edu By appointment ONLY
Course Description
Pathology is the study of disease. This course will provide students with 1) the understanding of basic patho-physiologic mechanisms that contribute to disease processes, and 2) the introduction of clinical correlations (i.e. symptoms, physical diagnosis, diagnostic procedures, and laboratory tests) that are important in the diagnosis of a disorder. The course also compliments and integrates topics with other second year courses: Clinical Systems, Medical Microbiology and Immunology, and Pharmacology. The course is covered over two semesters (Pathology I and Pathology II) and is divided into separate systems-based modules with didactic lectures. Student interaction and participation are required. There is a weekly 2 hour laboratory session which revolves around case studies and review questions that coincide with the module theme and incorporate histo-pathologic examination of digital images. The case studies will provide students with the ability to 1) understand certain patho-physiologic mechanisms of disease, 2) associate how certain mechanisms contribute to clinical presentations, symptoms, and disease patterns, 3) recognize key morphologic features and changes seen in organs associated with certain disorders, and 4) recognize and interpret certain ancillary diagnostic procedures and tests. In addition to the lab activities, the small group discussion/review sessions will aid in concept comprehension, promote teamwork, encourage peer evaluation, and strengthen the students role as educator.

After completion of the course, the student should be able to: 1. Understand pathology terminology and use them in proper context 2. Recognize general patho-physiologic mechanisms of disease (i.e. genetic/biochemichal disorders, cell injury, inflammation, infection, and neoplasia) 3. Evaluate and assess certain disorders regarding their patho-physiologic mechanisms, morphologic features, and clinical manifestations, and 4. Analyze and interpret certain procedures and tests as an aid in disease diagnosis.

If you have purchased the Robbins Basic, Big Robbins, or Rubins and do not want to change textbooks, then that is fine. The required reading will be based upon Robbins Basic Pathology (see schedule). Pathology I *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
1. Robbins Basic Pathology, 9th Edition (2012) [8th edition (2007) will also suffice] a. Kumar, Abbas, Fausto, and Mitchell b. ISBN-13: 978-1-4160-2973-7 from Elsevier (Saunders) --OR-2. Rubins Pathology: Clinicopathologic foundations of medicine, 5th or 6th edition (2011) a. Rubin and Strayer b. 5th edition: ISBN: 0-7817-9516-8; 6th edition ISBN: 9781605479682 from Lippincott Williams & Wilkins 3. Blueprints Medicine, 5th edition (2010) [For Clinico-pharmacologic correlation] a. Young, Chick, Kormos, & Goroll b. ISBN: 4. Rapid Review Laboratory Testing in Clinical Medicine (2008) [For Lab medicine correlation] a. Goljan and Sloka b. ISBN: 978-0-323-03646-7 from Elsevier (Mosby)

Listed in order of highly recommended to least recommended: 1. Rapid Review Pathology, 3rd edition 2011 a. Goljan b. ISBN 9780323068628 from Elsevier (Mosby) 2. First Aid of the USMLE Step1, 2013 edition a. Bhusan & Le b. ISBN: 9780071475310 McGraw-Hill 3. Pathophysiology 2009 a. Damjanov b. ISBN-13: 978-1-4160-0229-1 from Elsevier (Saunders) 4. Robbins & Cotran Review of Pathology, 3rd edition a. Klatt, Vinay, & Kumar b. ISBN: 9781416049302 from Elsevier (Saunders) 5. Lippincott's Review of Pathology (2006) a. Fenderson and Rubin b. ISBN: 9781416049302 from Elsevier (Saunders)

Textbooks: 1. Robbins and Cotran, 8th edition a. Kumar, Abbas, Fausto, Aster b. ISBN: 9781437707922 from Elsevier (Saunders) 2. Essentials of Rubins pathology, 5th edition a. Rubin and Reisner b. ISBN-10: 0-7817-7324-5 from Lippincott Williams & Wilkins 3. Renal Pathophysiology: the Essentials 3rd edition a. Rennke and Denker b. ISBN: 0781799953 4. Pathology Flash cards 2009 a. Baron and Lee b. 0071613056 McGraw-Hill 5. Andreoli and Carpenters Cecil Essentials of Medicine, 7th edition a. Andreoli Pathology I *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
b. ISBN-10: 1-4160-2933-8 from Elsevier (Saunders) Websites: Pathology: http://library.med.utah.edu/WebPath/webpath.html {Great images, tutorials, and review questions} Histology/Pathology: http://zoomify.lumc.edu/path/virtualpath.htm {Virtual pathology: Online glass slide review} http://www.meddean.luc.edu/lumen/gme.htm {Interesting multi-disciplinary case studies} http://www.medicine.virginia.edu/clinical/departments/pathology/Case%20Studies/known-pathologycases Radiology: http://www.med-ed.virginia.edu/courses/rad/ {Great source on reading XRays, CT scans, etc}
Exam Dates

The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation Path I -50.00% 78.86% 11.45%
Pathology I *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.

Quizzes /Clicker session Module I Module II Module III Module IV Module V Module VI Module VII Total 10% 10% 5% 20% 15% 10% 15% 15% 100%
Laboratory & Small group Session Rules
Professionalism should be maintained in mannerisms and attire. Cells phones are to be turned off during laboratory sessions. Texting is not allowed. If you need to have your cell phone on for an important call, please notify a faculty member and make sure it is on vibrate mode. Students access to the internet and electronic books are for study inquiry only. Students should not access non-study-related websites (i.e. social networking, online shopping, or other sites). If students are not participating in the laboratory or session activity and are spending time on these non-related study sites, then these incidents will be taken into account for student evaluations and grade assessments. Laboratory attendance is MANDATORY. Excused absences are granted only by Dr Cammarata. Dr. Bahri must be notified of ANY absences verbally or in writing prior to, on the day of, or after the absence. Please submit documentation, Dr. Cammaratas written approval, or a doctors note the following day.
Participating Faculty
Tipsuda Bahri MD Robert Stern MD
Course Schedule
Lectures and Labs
Sem: Week Date Topic # Lecture Topic Objectives 1. Interpret chromosomal karyotypes and pedigree charts Contrast Mendelian vs non-Mendelian inheritance patterns Explain Monosomy, Disomy, Trisomy, and Trinucleotide repeats, and recognize medical conditions associated with these chromosomal abnormalities 2. Discuss the etiology, pathogenic mechanism, clinical manifestations, and related tests (if applicable) of Turner syndrome, Klinefelter syndrome, Fragile X syndrome, Tay-Sachs disease, and Phenylketonuria (PKU) 1. Explain why trinucleotide repeat expansion, mitochondrial DNA inheritance, and genomic imprinting are considered under nonMendelian inheritance pattern 2. Compare and contrast the etiology, pathogenic mechanism, clinical manifestations, and related test (if applicable) of PraderWilli and Angelman syndromes Define genomic imprinting and uniparental disomy and understand their pathogenic role in Prader-Willi & Angelman syndromes 3. Discuss the etiology, pathogenic mechanism, clinical manifestations, and related tests (if applicable) of Fragile X syndrome and Huntington disease Distinguish genetic anticipation effect of Fragile X syndrome from Huntington disease 4. Discuss the etiology, pathogenic mechanism, clinical manifestations, and related tests (if applicable) of Tay-Sachs disease, Duchenne muscular dystrophy, Becker muscular dystrophy, Osteogenesis imperfecta, Marfan syndrome, and Ehlers-Danlos syndrome Recognize certain groups/populations with an increased prevalence of some conditions listed above Distinguish Tay-Sachs disease from Phenylketonuria (PKU) Lecturer Readings
1:1
7/30/13
Lab1: Intro to course; Pediatric genetics disorders part1
Dr Bahri/ Dr Stern
1:1
8/1/13
Pediatric genetic disorders part2
Dr. Bahri
Robbins Basic 8th ed. Chap 7: pp 22552 [Rubins Chap 6: pp 185-219] Supplemental readings: Jorde, Medical genetics 4th edition Chap 4, 5, 6, 7 [related topics]
128
Sem: Week
Date
Topic #
Lecture Topic
Objectives Identify which condition is associated with mutations of dystrophin, collagen, and fibrillin
Lecturer
Readings
Environmental, Nutritional disorders {No new Electure- Review Dr Sterns Spring General Pathology lecture: Environmental/ Nutritional disorders}
8/1/12
1. Discuss the pathogenic mechanisms, morphology, and clinical manifestations of some common environmental toxicities and nutritional disorders Environmental toxins, pollutants Carbon monoxide, lead, mercury , arsenic, cadmium poisoning Tobacco smoke, Alcoholism Vitamin deficiency and toxicity states Obesity and eating disorders 2. Examine the effects of the above conditions and their impact on the human body and society
Robbins Basic 8th ed. Chap 8: pp 30313 [Rubins Chap 8: pp 277-84] Dr. Stern Dr Sterns Spring Intro to Pathology lecture on Environmental/ Nutritional disorders
Module Exam will cover this material
8/1/12
SGA Picnic (1-5PM)

1. Define hyperbilirubinemia, jaundice, icterus, cholestasis, and hemolysis 2. Distinguish between the causes of conjugated and unconjugated hyperbilirubinemia Explain the pathway of bilirubin conjugation, bile production, and bile excretion through the biliary tract Compare & contrast the causes and pathogenic mechanisms of Crigler-Najjar types I & II, Gilberts disease, & Dubin-Johnson syndrome 3. Interpret liver function tests, direct and indirect Coombst test as an aid to diagnose hyperbilirubinemia 4. Distinguish between physiologic and pathologic neonatal jaundice Robbins Basic 8th ed. Chap 7: pp 26163, Chap 16: pp 637-39 [Rubins Chap 14: pp 620-28] Supplemental reading: Damjanov Chap 8: pp 285-92
1:2
8/6/13
Lab2: Pathophysiology of jaundice/ hemolytic anemia
Dr. Bahri/ Dr. Stern
129
Sem: Week
Date
Topic #
Lecture Topic
Objectives 5. Discuss the etiology, pathophysiologic mechanisms, morphology, laboratory diagnosis, and clinical manifestations of hemolytic anemia/ erythroblastosis fetalis (i.e. ABO/Rh incompatibility, hereditary spherocytosis) in the neonate, and G6PD deficiency 1. Discuss the pathogenic mechanisms, morphology, and clinical manifestations of some common pediatric tumors (i.e. Wilms tumor, retinoblastoma, neuroblastoma, medulloblastoma, and astrocytoma) 2. Compare and contrast pediatric CNS tumors with adult CNS tumors, (i.e. glioblatoma multiforme) regarding their age predisposition, location, and prognosis 1. Review the normal anatomy of the eye and the region around the eye 2. Distinguish the etiology, pathogenic mechanism, and fundoscopic features of hypertensive and diabetic retinopathy 3. Discuss how increased intraocular pressure and vascular occlusions can affect the vessels of the eye 4. Discuss age related eye disorders (i.e. age-related macular degeneration and cataracts) regarding their etiology, pathogenic mechanism, clinical manifestations, and fundoscopic features 1. Classify the types of congenital heart disorders with left to right shunt 2. Categorize congenital heart disorders into cyanotic, cyanosis tardive, and cyanotic groups 3. Compare and contrast Atrial septal defect (ASD), Ventricular septal defect (VSD), Endocardial cushion defect, Patent ductus arteriosus (PDA), and Persistent truncus arteriosus in terms of embryologic defect, hemodynamic abnormality, and clinical manifestation 4. Distinguish between Patent foramen ovale and Ostium primum vs secundum types of ASDs 5. Discuss the development of Eisenmenger syndrome/complex
Lecturer
Readings
Pediatric tumors
Dr. Bahri
Robbins Basic 8th ed. Chap 7: pp 26873 Chap 23: pp 882-884 [Rubins Chap 6: pp 227-8] Supplemental reading in Big Robbins or Big Rubins Chap 29: Eye disorders Material tested on exam is based upon lecture notes
1:2
8/8/13
Eye disorders
Dr Bahri
1:3
8/13/13
Lab3: Congenital heart disorders
Robbins Basic 8th ed. Chap 11: pp 382-88 [Rubins Chap 11: pp 435-45]
130
Sem: Week
Date
Topic #
Lecture Topic 6.
Objectives as a complication of left to right shunt Associate certain cardiac congenital anomalies with certain genetic defects (trisomy 13, 18, 21, Turners syndrome) and maternal conditions (Diabetes mellitus, Lupus) Discuss the types of congenital heart disorders that contribute to right to left shunt Compare and contrast Tetralogy of Fallot and Tricuspid atresia in terms of embryologic defect, hemodynamic abnormality, and clinical manifestations Compare and contrast Transposition of the great arteries, Coarctation of aorta, Pulmonary stenosis, Congenital aortic stenosis, Ebstein malformation, Endocardial fibroelastosis, and Dextrocardia in terms of embryologic defect, hemodynamic abnormality, and clinical manifestations Discuss the pathogenic mechanisms of the aging process Discuss progeria and compare and contrast with the regular aging process Discuss the etiology, morphology, and clinical manifestations of common age-related disorders (i.e. osteoarthritis, arcus senilis, skin changes,cardiovascular disease, etc) Review the normal anatomy of the eye and the region around the eye Distinguish the etiology, pathogenic mechanism, and fundoscopic features of hypertensive and diabetic retinopathy Discuss how increased intraocular pressure and vascular occlusions can affect the vessels of the eye
Lecturer
Readings
7. 8.
9.
1. 2. 3. 1:3 8/15/13 7 The aging process
5. 6. 7.
Dr. Stern
Big Robbins Chap 29 Eye disorders; Rubins Chap 29: Eye disorders Supplemental reading: http://www.therub ins.com/aging/proc ess1.htm (parts 112) Rubins Chap1: Aging pp 31-35]
1:4
8/19/13
Module exam I
Covers materials from weeks 1-3
131
Sem: Week
Date
Topic #
Lecture Topic
Objectives 1. Review Starling mechanism and the role of hydrostatic pressure, osmotic pressure, interstitial pressure, and lymphatic channels in maintain fluid balance Identify conditions that alter the Starling mechanism and how edema occurs in these conditions 2. Review the concept of effusions: transudate vs exudates, serous, sanguinous, purulent, and fibrinous, and malignant types 3. Outline the hemostatic mechanisms involved in endothelial injury 4. Explain Virchows triad and altered hemostasis 5. Distinguish between the pathogenesis, morphology, and clinical manifestation of thrombosis and embolism 6. List the types of embolisms and recognize their etiologies 1. Distinguish between the morphology of atherosclerosis and arteriosclerosis (vascular hypertensive changes) 2. Compare and contrast the pathogenesis of essential, malignant, renovascular, and secondary hypertension 3. Assess the effects and complications of Systemic hypertension on the heart, brain, and kidneys 1. Assess the effects and complications of Systemic hypertension on the aorta and the risk of developing aortic dissection 2. Explain the patho-physiology and adaptive response of the myocardium in Hypertensive heart disease 3. Discuss Pulmonary hypertension in terms of the etiologies, morphologic changes, clinical manifestations, and grading system 1. Discuss the epidemiology, risk factors, pathogenesis, morphology, and complications of atherosclerosis and ischemic heart disease 2. Compare and contrast the patho-physiology, and clinical manifestations of Angina pectoris and Acute myocardial infarction (AMI) Distinguish between stable, unstable, and Prinzmetal
Lecturer
Readings
8/20/13
Lab4: Disorders of hemodynamics
Basic Robbins 8th ed. Chap 4: pp 81100; Chap 10: pp 339-42 [Rubins Chap 7: pp 230-41; Chap 10: pp 388-413]
1:4
Systemic hypertension
Basic Robbins 8th ed. Chap 10: pp 353-56, Chap 11: pp 398-400, Chap 13: pp 506-7 Dr. Bahri [Rubins Chap 10: pp 409-12; Chap 11: pp 454-55; Chap 12: pp 53638] Basic Robbins 8th ed. Chap 10: pp 341-53; Chap 11: pp 388-98 [Rubins Chap 10: pp 396-41; Chap 11: pp 445-54] 132
8/22/13
9 Complications of systemic HTN; Pulmonary hypertension
1:5
8/27/13
10,11
Lab5: Atherosclerosis; Ischemic heart disease
Dr. Stern
Sem: Week
Date
Topic #
Lecture Topic
Objectives angina Recognize the ECG changes seen with acute MI (STEMI) Recognize elevated Troponin I and CK-MB as part of workup and diagnosis of acute MI Illustrate how the location of coronary artery thrombosis will affect which area of the heart (i.e. LAD vs RCA vs LCA) Recognize the clinical presentation of an LAD vs RCA occlusion acute MI Distinguish subendocardial and transmural infarction by their cause and morphology Outline the timeline of the sequence of changes seen in Acute myocardial infarction, from acute onset to healed phase (gross and histo-morphology changes) Recognize the complications of acute MI: arrhythmia, papillary muscle/free wall/septal wall rupture, cardiac tamponade, fibrinous pericarditis (includes Dressler syndrome), ventricular aneurysm, mural thrombus formation Discuss the causes, morphology , and clinical manifestations of infectious and non-infectious myocarditis Discuss the genetic defects and the interactions of mutant proteins involved in the pathogenesis of Dilated and Hypertrophic cardiomyopathy Associate which cardiac protein mutations correspond to dilated or hypertrophic cardiomyopathy Compare and contrast the etiology, pathogenesis, morphology, and clinical manifestations of Dilated, Hypertrophic, and Restrictive cardiomyopathy Review your Intro to Path concepts of normal hemodynamics and causes of altered hemodynamic conditions Define the terms hyperemia and congestion and describe the vascular changes associated with these conditions (arterial vs venous) Organize conditions that causes edema by: Causes of vascular permeability
Lecturer
Readings
3.
4.
5.
1. 2. 12 Myocarditis; Cardiomyopathy 3. 8/29/13 1.
Dr. Bahri
Basic Robbins 8th ed. Chap 11: pp 409-16 [Rubins Chap 11: pp 465-75]
13
Heart failure
Dr. Bahri
133
Sem: Week
Date
Topic #
Lecture Topic
Objectives Causes of altered hydrostatic pressure Causes of altered oncotic pressure Causes of altered lymphatic function Discuss the Frank-Starling mechanism and myocardial hypertrophy in heart failure 2. Compare and contrast the pathogenesis, compensatory mechanisms, morphology, clinical manifestations, and complications of Left-sided heart failure and Right-sided heart failure 3. Recognize the causes of Left-sided and Right-sided heart failure 4. Define Cardiogenic shock and explain some causes
Lecturer
Readings
9/2/13
Labor Day Holiday

1. Discuss the etiology, morphology, and clinical manifestations of certain vascular conditions Vein disorders: varicose veins, venous thrombosis, thrombophlebitis Benign tumors of blood vessels; hemangioma, telangiectasia Malignant tumors of blood vessels: angiosarcoma, Kaposi sarcoma Associate congenital telangiectasias, hemangiomas, hemangioblastomas with conditions such as Port-wine stain, Klippel-Trenaunay syndrome, Mafucci syndrome, Osler-Weber-Rendu disease, Sturge-Weber syndrome, and von Hippel-Lindau disease 2. Compare and contrast varicose veins and deep vein thrombosis 3. Discuss the etiology, morphology, and clinical manifestations of benign and malignant conditions of the lymphatic system: Lymphangitis, Lymphedema, and Lymphangioma (Associated with Turner synd) 4. Recognize unusual circulatory problems that reflect other systemic pathology: Raynaud disease vs phenomenon (autoimmune disorder)
1:6 9/3/13 14 Lab5: Disorders of blood vessels I
Dr. Stern
Basic Robbins 8th ed. Chap 7 p 267, Chap 10: pp 369-78 [Rubins Chap 10: pp 422-26]
134
Sem: Week
Date
Topic #
Lecture Topic
Objectives Migratory thrombophlebitis & Trousseas sign (cancer) Hemorrhoids and esophageal varices (liver disease) Vena cava syndrome (cancer) Recognize specific vasculitides by their pathogenesis, morphology, clinical manifestations, and ancillary diagnostic tests Associate certain vasculitides by their vessel size predilection Identify the ANCA-associated vasculitides Distinguish Polyarteritis nodosa (PAN) from Microscopic arteritis Distinguis Wegener granulomatosis fromChurg-Strauss syndrome Distinguish between the morphology of necrotizing vasculitis and granulomatous vasculitis and list disorders exhibiting such features Identify the various types of Aneurysms by their etiology, patho-physiology, location, and clinical manifestation Compare saccular vs aortic aneurysms vs aortic dissection Distinguish aortic aneurysms from syphilitic aortitis Compare and contrast the patho-physiology and clinical manifestations Buerger disease and Raynauds phenomenon
Lecturer
Readings
1.
15
Lab5: Disorders of blood vessels II
Dr. Bahri
2.
3.
4. 9/5/13 9/6/13
1:6
Rosh Hashana Holiday

1. Distinguish between acute rheumatic fever and chronic rheumatic heart disease 2. Discuss the epidemiology, patho-physiologic mechanism, morphology, and clinical manifestations of Bacterial endocarditis, Nonbacterial thrombotic endocarditis (NBTE), and Libman-Sacks endocarditis 3. Compare and contrast the epidemiology, patho-physiologic mechanism, morphology, and clinical manifestations of the various forms of valvular (aortic and mitral) stenosis and
1:7
9/10/13
16
Lab6: Valvular & endocardial disorders; Valve replacement
135
Sem: Week
Date
Topic #
Lecture Topic
Objectives insufficiency (regurgitation) 4. Discuss the types of valve replacement and their associated complications 1. Distinguish between fibrinous and serous pericarditis 2. Explain and recognize the causes of fibrinous pericarditis Discuss the pathogenesis and morphology of primary and secondary cardiac neoplasms (i.e. Myxoma, Rhabdomyoma, Rhabdomyosarcoma, and Metastatic tumor) Interpret the use of immunohistochemical stains for the identification of intermediate filaments in various tumors Identify the use of desmin as the intermediate filament present in cardiac rhabdomyoma and rhabdomyosarcoma
Lecturer
Readings
9/10/13
17
Lab6: Cardiac tumors; Pericarditis
Dr. Bahri/ Dr Stern
9/12/13 1:7 9/13/13
Module Review Clicker questions will still count towards your grade Yom Kippur Holiday
Dr. Bahri/ Dr Stern
9/16/13
Module exam II

1. Distinguish between the etiology, location, and clinical manifestation epiglottitis and croup 2. Discuss the etiology of infection and inflammation in the nasal cavity, paranasal sinuses, pharynx, and larynx Recognize nasal polyps as a complication of allergic sinusitis/rhinitis Recognize pathogenic mechanism and morphology of Aspergillus infection in the upper respiratory tract 3. Compare and contrast the pathogenesis and morphology of vocal cord nodule, squamous papilloma, and squamous cell carcinoma of the larynx
1:8a 9/17/13 18
Lab7: Upper respiratory tract disorders; Mediastinal lesions
136
Sem: Week
Date
Topic # 19
Lecture Topic Lab7: Mediastinal lesions
Objectives 1. Discuss the etiology, location, clinical manifestation (if applicable), and morphology of mediastinal masses
Lecturer Dr. Bahri/ Dr. Stern
Readings Robbins Basic 8th ed. [Rubins] Pertinent topics
9/17/13 9/18/13 9/19/13 9/20/13
Sukkot Holiday
1. Outline bacterial pneumonia and discuss the various etiologic agents, pathogenesis, and clinical manifestations 2. Distinguish between community-acquired, nosocomial, aspiration, and chronic pneumonias 3. Discuss the various etiologic agents, pathogenesis, and clinical manifestations of fungal and viral pneumonia 4. Discuss the etiology, transmission, pathogenic mechanism, morphology, diagnosis, and clinical manifestation of tuberculosis (TB) Compare primary, secondary, and military TB Recognize the morphology of caseous granuloma, Ghon complex, Simon focus, and military TB Recognize Potts disease 5. Describe the types of pulmonary infections seen in the immunosuppressed patient 1. Categorize and distinguish between the various forms of atelectasis (i.e resorption, compression, micro-, and contraction) 2. Discuss the injuries that can lead to Acute respiratory distress syndrome (ARDS) 3. Distinguish ARDS from hyaline membrane disease 4. Distinguish the morphology, and clinical manifestations of acute respiratory distress syndrome (ARDS), chronic bronchitis, bronchiectasis, emphysema, and asthma (extrinsic and intrinsic types) 5. Compare the environmentally and genetically-derived forms of emphysema Distinguish between the types of emphysema (centriacinar,
1:8b
9/24/13 (Tues)
20A& B
Pulmonary infections; Tuberculosis
Dr. Stern
Robbins Basic 8th ed. Chap 13: pp 481, 492-4, 508-28 [Rubin's Chap 12: pp 489-503]
1:9
10/1/13
21
Lab8: Obstructive lung disease
Dr. Stern
Robbins Basic 8th ed. Chap 13: pp 481-93 [Rubins Chap 12: pp 503-7, 510-19]
137
Sem: Week
Date
Topic #
Lecture Topic
Objectives panacinar, and distal acinar) and recognize the etiologic conditions that contribute to these types Discuss the etiology, pathogenic mechanism, morphology, and clinical manifestations of alpha-1-antitrypsin deficiency Illustrate and examine the consequences of heavy tobacco smoking in the lung Define diffuse interstitial lung disease and honey-comb lung Categorize the conditions associated with restrictive lung disorders Compare and contrast the pathogenesis, morphology, and clinical manifestation of fibrosing, granulomatous, and smoking-related types of interstitial lung disease Discuss the morphology and clinical manifestations of sarcoidosis, usual interstitial pneumonia (UIP), desqaumative interstitial pneumonia (DIP), and lymphoid interstitial pneumonia (LIP) Distinguish between the epidemiology, pathogenic mechanism, morphology, and clinical manifestation of sarcoidosis and hypersensitivy pneumonitis Distinguish between the epidemiology, pathogenic mechanism, morphology, and clinical manifestations of hypersensitivity pneumonitis and pneumoconioses Appraise silicosis, coal worker pneumoconiosis, and asbestosis as important occupational hazards Distinguish the morphology and pulmonary complications of silica and asbestos exposure Discuss the pathogenesis, morphology, and prognosis of malignant mesothelioma Recognize specific disorders that can present with pulmonary hemorrhage and/or hemoptysis Distinguish between the pathogenesis, morphology, and clinical manifestations of Goodpasture syndrome, Wegener granulomatosis, and Churg-Strauss syndrome Recognize how these disorders can present with
Lecturer
Readings
1. 2.
1:9
10/3/13
22
Interstitial lung diseases
3.
4.
Dr. Bahri
1.
Robbins Basic 8th ed. Chap: pp 494504 [Rubins Chap 12: pp 524-33]
1:9
10/3/13
23
Pneumoconioses
1. 1:10 10/8/13 24 Lab9: Pulmonary vascular disorders 2.
Dr. Bahri
Robbins Basic 8th ed. Chap 10: pp 367-8 Chap 13: pp 507-8 [Rubins Chap 1: pp 534-36] 138
Sem: Week
Date
Topic #
Lecture Topic
Objectives hemorrhage and/or hemoptysis Recognize the morphologic features of acute pulmonary hemorrhage and distinguish from pulmonary congestion (heart failure) Discuss the significance of the serum ANCA test with Wegeners granulomatosis and Churg-Strauss syndrome Discuss the mechanism and morphology of Aspergillus infection of the lung Recognize that Aspergillus infection can occur in immunocompetent and immunosuprressed hosts Recognize that Aspergillus can invade blood vessels and spread hematogenously Discuss the etiology and epidemiology of lung cancers Classify the major lung cancers as non-small cell cancers(NSCLC) and small cell lung cancers (SCLC) Categorize the various types of non-small cell carcinoma and discuss the pathogenesis, morphology, and clinical manifestation (i.e. squamous cell, adenocarcinoma, large cell carcinoma, etc) Discuss the etiology, pathogenesis, morphology, diagnostic tests, clinical manifestation, and prognosis of small cell carcinoma Describe Horners syndrome and other paraneoplastic syndrome presentation of lung cancer (i.e. hypercalcemia, PTHrp, SIADH, ACTH) Distinguish the location predilection of primary and metastatic lung tumors (central vs peripheral) Recognize benign tumors of the lung (i.e. hamartoma, carcinoid tumor)
Lecturer
Readings
3. 4.
1. 2.
10/8/13 1:10
25
Lab9: Pulmonary tumors 3.
Dr. Stern
4. 5.
10/10/13
Module Review Clicker questions will still count towards your grade
Dr. Bahri/ Dr Stern
139
Sem: Week
Date 10/14/13
Topic #
Lecture Topic
Objectives
Lecturer
Readings
Module exam III

1. Define hormone and its endocrine role 2. Review the anatomy and physiology of the pituitary gland and the hypothalamic-pituitary axis 3. List disorders associated with a pituitary insufficiency (i.e. Sheehan syndrome, Empty sella syndrome, Pituitary dwarfism) 4. Discuss the etiology, pathogenic mechanism, and clinical manifestations of pituitary hormone hyperfunction Correlate the cell type with various pituitary adenomas Distinguish between a functioning and nonfunctioning pituitary adenoma Recognize conditions such as Gigantism, Acromegaly, Pituitary hyperthyroidism, and Pituitary Cushing disease) 5. Distinguish between the etiology, pathogenic mechanism, and clinical manifestations of central diabetes insipidus and SIADH 1. Outline the normal regulation, production, and function of thyroid hormone and insulin 2. Recognize and interpret tests for thyroid function and diabetes mellitus 3. Understand the indications for ordering thyroid function and blood glucose studies 4. Identify certain variables that can affect the above test results 1. Evaluate the clinical profile and laboratory values found in hyper- and hypothyroidism Distinguish primary, secondary & tertiary hyperthyroidism 2. Compare and contrast the etiology, pathogenesis and clinical manifestation of nonendemic and endemic cretinism 3. Compare and contrast the pathogenesis, morphology, and clinical manifestation of toxic goiter and Graves disease 4. Describe the various forms of thyroiditis (i.e. acute, deQuervains, Hashimotos, and Reidels types ) regarding their etiology, clinical manifestation, and morphology
Robbins Basic 8th ed. Chap 20: pp 752-57 Dr. Stern [Rubins Chap 21: pp 934-49] Goljan Chap 10: pp 342-50
10/15/13 1:11
26
Lab10: Pituitary disorders
10/15/13
27
Lab10: Lab Medicine: Thyroid & glucose studies
Dr. Bahri
Goljan & Slojka Rapid review lab medicine pp 291-97, 345-47
1:11
10/17/13
28
Thyroid disorders
Dr. Stern
140
Sem: Week
Date
Topic #
Lecture Topic
Objectives 5. Differentiate the epidemiology, laboratory diagnosis, and clinical manifestations of benign and malignant thyroid tumors 1. Summarize the mechanism of calcium homeostasis 2. Evaluate laboratory tests used for diagnosis of parathyroid disorders 3. Distinguish the etiology, clinical presentation, and laboratory findings of hypo- and hypercalcemia Associate osteitis cystica with hyperparathyroidism and recognize its morphology 4. Identify the histologic morphology of parathyroid hyperplasia and adenoma 5. Compare and contrast the pathogenesis and clinical manifestation of primary, secondary, and tertiary hyperparathyroidism, hypercalcemia of malignancy, and hypoparathyroidism 1. Review the normal anatomy, histology, and physiology of the adrenal gland Review the general production and function of cortisol and aldosterone Identify which conditions are associated with adrenal cortical hyperfunction and insufficiency Distinguish between adrenal hyperplasia, adenoma, and atrophy 2. Distinguish between the pathogenesis and clinical manifestation of Cushing syndrome and Cushing disease Understand the use of lab tests for the diagnosis of hypercortisolism: 24hr urine cortisol, serum ACTH, overnight dexamethasone, low and high dose dexamethasone suppression test, late night salivary gland cortisol Understand how the high dose dexamethasone suppression test is used to distinguish Cushing disease from an adrenal or ectopic Cushing syndrome 3. Appraise the concept of exogenous-type Cushing syndrome, the
Lecturer
Readings
29
Parathyroid disorders
Dr. Bahri
Robbins Basic 8th ed. Chap 20: pp 771-75 Goljan Chap 9: pp 286-90 [Rubins Chap 21: pp 955-58]
Robbins Basic 8th ed. Chap 20: pp 789-98 Dr. Bahri Goljan Rapid Review of Lab Med Chap 10: pp 350-58 [Rubins Chap 21: pp 958-72]
1:12
10/22/13
30
Lab11: Adrenal disorders
141
Sem: Week
Date
Topic #
Lecture Topic
Objectives effects on the adrenal gland with chronic steroid use, and the importance of weaning and tapering doses on discontinuation Discuss the patho-physiologic mechanism, morphology, and clinical manifestation of congenital adrenal hyperplasia Compare and contrast the pathogenesis, morphology, and clinical manifestation of Addison disease and Conn syndrome Evaluate the metyrapone and cosyntropin tests used to aid in the diagnosis of Addisons disease Discuss etiology, pathogenic mechanism, morphology, and clinical manifestation of Waterhouse-Friedrichsen syndrome Associate the complications and development of DIC with this condition FYI: Discuss the pathogenesis, morphology, and clinical manifestation of adrenal cortical carcinoma Understand certain disorders that are of neural crest origin. Distinguish between pheochromocytoma and extra-adrenal paraganglioma Associate pheochromocytoma with certain types of MEN syndrome Recognize the morphology and clinical manifestations of carcinoid tumors and carcinoid syndrome Discuss the pathogenesis, laboratory evaluation, clinical manifestation, and prognosis of neuroblastoma Review the normal function of the pineal gland and its significance in the production of melatonin List the common pineal gland neoplasms and their clinical manifestations Discuss the history and overview of MEN syndrome Identify the endocrine tumors and their morphology, associated with MEN syndrome pituitary adenoma parathyroid adenoma pancreatic islet cell tumors medullary thyroid carcinoma
Lecturer
Readings
4. 5.
6.
7. 1. 2.
Robbins Basic 8th ed. Dr. Bahri Refer to corresponding chaps [Rubins]
10/22/13
31
Neural crest tumors
3. 4. 5. 6. 1. 2.
1:12
Robbins Basic 8th ed. Chap20: pp 798-99 Dr Bahri Goljan Rapid Review of Lab Med Chap 10: pp 350-58 142
10/22/13
32
MEN syndrome
Sem: Week
Date
Topic #
Lecture Topic
Objectives pheochromocytoma 3. Distinguish the genetic mutations and clinical manifestations of MEN types 1, 2A (II), and 3A (III) Discuss MEN1 tumor suppressor gene mutation associated with MEN1 Discuss the RET oncogene mutation associated with MEN2A & 2B 4. Discuss familial medullary thyroid carcinoma and the association with Ret proto-oncogene
Lecturer
Readings [Rubins Chap 21: pp 958-72]
10/28/13
Module exam V

1. Review the normal anatomy and histology of the kidney tubules and glomeruli 2. Discuss special stains and diagnostic techniques (immunofluorescence and electron microscopy) used to identify glomerular diseases 3. Review the components of the urine analysis (dipstick) and urine microscopic examination 4. Distinguish between the causes, morphology, and clinical manifestation of Alport syndrome 5. Discuss the basic criteria for the diagnosis of nephritic and nephritic syndrome Recognize lipiduria and Maltese crosses in urine microscopy as a component of nephritic syndrome Recognize key cases typical of nephritic and nephritic syndrome, ie. Minimal change disease and Poststreptococcal glomerulonephritis 6. Discuss the etiology, pathogenic mechanism, morphology, clinical manifestations, and lab test associated with hemolytic uremic syndrome (HUS) 1. Recognize which glomerular conditions present with nephritic or nephrotic syndrome, Distinguish conditions that present with gross or
1:13
10/29/13
33
Lab12: Intro to renal pathology
Dr. Bahri/ Dr Stern
Robbins Basic 8th ed. Chap 14 [Rubins Chap 16: pp 692-94, 698700]
10/31/13
34
Glomerulonephritis
Dr Stern
Robbins Basic 8th ed. Chap 14: pp 542-59 143
Sem: Week
Date
Topic #
Lecture Topic
Objectives microscopic which are included under the category of nephritic syndrome Distinguish between the causes, morphology, and clinical manifestation of focal segmental glomerulosclerosis and membranous glomerulopathy Distinguish between the pathogenesis, morphology, and clinical manifestation of type I and type II membranoproliferative glomerulonephritis Discuss the pathogenesis, morphology, and clinical manifestation of crescentic/rapidly progressive glomerulonephritis Recognize glomerular conditions that can progress to Crescentic GN Distinguish between the causes, morphology, and clinical manifestation of IgA nephropathy and Henoch-Schonlein purpura Discuss the pathogenesis, morphology, and clinical manifestation of anti-glomerular basement membrane disease and the association with Goodpasture disease Compare and contrast the pathogenesis, morphology, and clinical manifestation of diabetes and amyloidosis affects on the kidneys Classify renal conditions as 1) inflammatory involvement of tubules and interstitium or 2) acute tubular injury (tubular necrosis) Discuss the etiology, pathogenic mechanism, morphology, clinical manifestation, laboratory diagnosis, and complications of acute pyelonephritis Discuss the etiology, pathogenic mechanism, morphology, and complications of chronic pyelonephritis and reflux nephropathy Discuss the etiology, pathogenic mechanism, morphology, clinical manifestation, and laboratory diagnosis of drug-induced interstitial nephritis Distinguish from acute drug-induced interstitial nephritis vs
Lecturer
Readings [Big Rubins Chap 16: pp 698-714]
2.
3.
4.
5.
6.
7.
1.
2. 1:14 11/5/13 35 Lab13: Renal tubular and interstitial disorders
3. 4.
Dr Stern
144
Sem: Week
Date
Topic #
Lecture Topic 5.
Objectives analgesic nephropathy Discuss the etiology, pathogenic mechanism, morphology, clinical manifestation, and laboratory diagnosis of acute tubular necrosis Review and classify the types of small vessels vasculitic that affects the kidneys (i.e. HSP, cryoglobulinemia, Good pasture syndrome, & ANCA-associated vasculitis) and correlate their corresponding renal clinical manifestations Discuss the significance of anti-neutrophilic cytoplasmic antibody (ANCA) as related to renal vasculitis. Review the causes and consequences of renovascular stenosis and occlusion Associate Potter sequence with oligo-hydramnios and recognize key clinical manifestations (Potter complex) Define renal agenesis, hypoplasia, dysplasia, ectopia, and fusion, and understand the corresponding morphology Compare and contrast the pathogenesis, morphology, and clinical manifestation of autosomal dominant (ADPKD), autosomal recessive polycystic kidney disease (ARPKD), and acquired cystic kidney disease (i.e. dialysis-associated) Recognize the extra-renal manifestations associated with ADPKD and ARPKD Distinguish between the pathogenesis and morphology of nephronophthisis and medullary sponge kidney List the most common causes of ureteral obstuction Discuss the pathogenesis, location, and clinical manifestation of renal and bladder lithiasis Discuss the malignant neoplasms of the kidney and urinary bladder Discuss the pathogenesis, location, and clinical manifestation of end stage renal disease and amyloidosis Evaluate penile lesions and distinguish their etiology, morphology, and clinical manifestation Distinguish between hypospadius, epispadius, and phimosis
Lecturer
Readings
1. Lab13: Renal vascular disorders
36
Dr. Bahri
2. 3. 1. 2. 3.
37
Congenital, Cystic Renal disorders
Dr. Bahri
1:14
11/7/13 4. 1. 2. 38 Renal pelvis, ureter, & urinary bladder 3. 4. Lab14: Scrotal/penile disorders 1.
Dr Stern
1:15
11/12/13
39
Dr. Bahri/ Dr Stern
Robbins Basic 8th ed. Chap 18: pp 689-690 145
Sem: Week
Date
Topic #
Lecture Topic
Objectives 2. Discuss the pathogenesis, morphology, common locations, clinical manifestation, and complications of cryptorchidism 3. Classify the etiologies and morphology of scrotal masses Distinguish varicocele, hydrocele, spermatocele, hematocele, and chylocele Recognize the use of scrotal illumination in evaluating scrotal masses, and distinguishing a fluid filled lesion from a solid lesion 4. Review inflammatory lesions of the testis and testicular torsion 1. Categorize testicular tumors into germ cell tumors and sex cord stromal tumors and provide some examples 2. Explain the clinical significance of distinguishing seminomas from nonseminomatous germ cell tumors Distinguish the etiology, morphology, and clinical manifestations of seminomas and nonseminomatous testicular tumors Discuss the clinical significance of alpha fetoprotein (AFP) and human chorionic gonadotropin (hCG) associated with nonseminomatous germ cell tumors 3. List tumors that can metastasize to the testes 4. Discuss the epidemiology, morphology, and clinical manifestations of penile squamous cell carcinoma 1. Distinguish between benign and malignant renal neoplasms 2. Distinguish between the pathogenesis, morphology, and location of renal cell carcinoma and transitional cell carcinoma of the kidney Recognize the increased risk of invasive renal cell carcinoma embolism into the venous route/ inferior vena cava Appraise the various morphologies of transitional cell carcinoma (i.e. papillary, flat, invasive types) 3. Discuss Gleasons grading system for prostate carcinoma and its clinical correlations 4. Distinguish between pathogenesis, morphology, and clinical manifestation of benign and malignant prostatic neoplasms
Lecturer
Readings [Rubins Chap 17: pp 758, 761-765, 766-79]
40
Lab14: Testicular/ Penile tumors
Robbins Basic 8th ed. Chap 18: pp 689-700 Dr Stern [Rubins Chap 17: pp 758, 761-765, 766-79]
1:15
11/14/13
41
Tumors: Kidney, prostate
Dr Stern
Robbins Basic 8th ed. Chap 14: pp 573-75, Chap 18: pp 695-700 [Rubins Chap 16: pp 741-44, Chap 17: 773-778]
146
Sem: Week
Date
Topic #
Lecture Topic
Objectives 5. Discuss the urinary complications of benign nodular hyperplasia
Lecturer
Readings
11/18/13
Module exam VI

1. Categorize the pathogenesis, morphology, and clinical manifestation of benign and malignant salivary gland neoplasms 2. Associate the pathogenesis of Barrett esophagus and esophageal adenocarcinoma 3. List the etiology and pathogenesis of intestinal malabsorption Discuss the pathogenesis, morphology, and clinical manifestation of celiac disease, cystic fibrosis, and lactose intolerance Recognize and evaluate laboratory tests that detect specific forms of malabsorption 1. Differentiate the etiology, morphology, and clinical manifestations of oral disorders: Aphthous ulcers, Behcets disease, Herpetic stomatitis, Oral candidiasis, Leukoplakia/oral cancer, Measles, and Methamphetamine abuse 2. Distinguish between the etiology and clinical manifestations of salivary gland disorders: Sialadenitis, Sjogrens syndrome, Mumps, and Tumors 3. Categorize the various types of esophageal disorders in terms of their pathogenesis, morphology, and clinical manifestation (i.e. Esophagitis, Hiatal hernia, Achalasia, Esophageal varices, Mallory-Weiss syndrome, GERD/Reflux esophagitis, Barretts esophagus, and Carcinoma) 4. Discuss morphology and clinical manifestations of congenital gastric anomalies (i.e. pyloric stenosis, diaphragmatic hernia, and gastric heterotopias 5. Categorize the various types of gastritis (acute and chronic) in terms of their pathogenesis, morphology, and clinical manifestation Distinguish stress ulcers from peptic ulcer disease 6. Discuss the environmental, genetic, and physiologic causes, morphology, and complications of peptic ulcers
11/19/13
42
Lab15: Intro to upper GI disorders; The floating stool
1:16
11/21/13
43
Upper GI disorders
Robbins Basic 8th ed. Chap 15: pp 580-600 Dr. Stern [Rubins Chap 13: pp 550-55, pp 55872]
147
Sem: Week
Date
Topic #
Lecture Topic 7.
Objectives Explain the role of H. pylori in the pathogenesis of chronic gastritis and peptic ulcers Discuss the association of atrophic gastritis with pernicious anemia and vitamin B12 deficiency Categorize the different causes of vitamin B12 deficiency and megaloblastic anemia Discuss the role of Intrinsic factor in vitamin B12 absorption Discuss the risk factors, pathogenesis, morphology, and clinical manifestations of gastric tumors (i.e. adenocarcinoma and MALToma) Discuss the morphology and clinical manifestation of Meckel diverticulum Compare and contrast the pathogenesis, morphology, laboratory evaluation, and clinical manifestation of Celiac disease, Whipple disease, and Tropical sprue Distinguish between the pathogenesis, morphology, and clinical manifestation of Hirschsprung disease and acquired megacolon Discuss the pathogenic mechanism, laboratory tests, and morphology of Crohns disease and Ulcerative colitis Recognize the complications of Crohns disease and Ulcerative colitis Recognize the association of Dermatitis herpetiformis with Crohns disease; Increased colon cancer & ankylosing spondylitis with Ulcerative colitis Distinguish between morphology and clinical manifestation of diverticulosis and diverticulitis
Lecturer
Readings
8.
1. 2.
3. 11/26/13 1:17 44 Lab16: Lower GI disorders 4.
Dr. Stern
Basic Robbins 8th ed. Chap 15: pp 600-4, 609-16 [Rubins Chap 13: pp 576-78]
5. 11/22/12 11/23/12
Thanksgiving Holiday
Lab17: Hepatobiliary disorders 1. Discuss the causes, pathophysiologic mechanism, clinical manifestations, and complications of hepatic failure 2. Distinguish between the pathogenesis, morphology, and clinical manifestation of drug/toxin-induced, alcoholic and viral hepatitis 3. Discuss the pathogenesis, morphology, and clinical Robbins Basic 8th ed. Chap16: pp 637-60, 664-70, [Rubins Chap 14: pp 620-28, 635-45, 148
1:18
12/3/13
45
Sem: Week
Date
Topic #
Lecture Topic 3.
Objectives manifestations of portal hypertension and cirrhosis Discuss the systemic sequelae of liver disease (i.e. hepato-renal syndrome, hepatic encephalopathy, telangiectasia, spider angioma, gynecomastia, palmar erythema, etc) Compare and contrast the pathogenesis and morphology of alcoholic liver disease and non-alcoholic fatty liver disease Discuss the pathogenic mechanism, involved anatomic structure(s), and clinical manifestations of Budd-Chiari syndrome Distinguish the clinical manifestations of Portal vein obstruction from Budd-Chiari syndrome Review the patho-physiologic mechanism of hyperbilirubinemia and jaundice Recognize and evaluate laboratory liver function tests and radiographic images utilized for hyperbilirubinemia and pancreatitis Explain the patho-physiologic mechanism, morphology, and clinical manifestations, associated with gallstone pancreatitis and hepatitis Discuss the risk factors, pathogenesis, morphology, and clinical manifestations of cholelithiasis and cholecystitis Compare and contrast the morphology and clinical manifestations of acute and chronic cholecystitis Compare and contrast the etiology, morphology, and clinical manifestations of Primary biliary cirrhosis from Primary sclerosing cholangitis Recognize the significance of anti-mitochondrial antibodies Recognize the radiographic findings associated with PSC
Lecturer
Readings 649-57, 667-72] Goljan & Slojka Chap 9: pp 300-12
4. 5.
6. 7. 8.
9.
10. 11. 12.
1:18
12/5/13
46
Exocrine pancreas; Appendicitis; Peritonitis
1. Discuss the etiology, pathogenesis, morphology, and laboratory evaluation of acute pancreatitis 2. Compare and contrast the morphology and clinical manifestations of acute and chronic pancreatitis Recognize pseudocyst formation as a complication of chronic pancreatitis
Dr. Bahri
Basic Robbins 8th ed. Chap 15: p 628; Chap 17 pp 676-85 Goljan & SlojkaChap 11: pp 149
Sem: Week
Date
Topic #
Lecture Topic
Objectives 3. Discuss the epidemiology, pathogenesis, morphology, and clinical manifestation of benign and malignant pancreatic neoplasms (i.e. cystadenoma, ductal adenocarcinoma, islet cell tumors) Associate Courvosier sign (Dilated palpable gallbladder) with a pancreatic tumor located in the head of the pancreas 4. Explain the causes and pathogenic mechanism of appendicitis and peritonitis Differentiate the condition of ascites from peritonitis Recognize the use of paracentesis as a diagnostic test for evaluation of ascites Differentiate the pathogenic mechanism of acute bacterial from spontaneous bacterial peritonitis 1. Compare and contrast the pathogenesis, morphology, and clinical manifestations of gastric polyps and gastric carcinoma 2. Discuss the epidemiology, risk factors, morphology of colon polyps, adenoma, and carcinoma 3. Distinguish between the biologic behavior and morphology of villous and tubular adenoma, and their risk for developing adenocarcinoma 4. Explain the risk of colon carcinoma arising in ulcerative colitis 5. Distinguish between the gross morphology and clinical presentation of colon tumors arising in the ascending from the descending colon 6. Discuss the pathogenesis and clinical manifestation of PeutzJeghers syndrome, familial adenomatous polyposis (FAP) and nonhereditary polyposis colon carcinoma (NHPCC) 7. Distinguish the pathogenesis, morphology, location, and clinical manifestation of gastrointestinal stromal tumor (GIST), carcinoid tumor, and lymphoma
Lecturer
Readings 396-98 [Rubins Chap 13: p 615; Chap 15: pp 676-85]
Robbins Basic 8th ed. Chap 15: pp 597-600, 617-27 Dr. Stern [Rubins Chap 15: pp 568-72, pp 58689, pp 601-10]
1:18
12/5/13
47
GI tumors
12/9/13
Module exam VII
150
Pharmacology I Syllabus
Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Assistant Professor Directors Campus Phone Assistant Professors Phone Directors Email Assistant Professors Email Office Hours Pharmacology I BSCI 647-E Basic Biomedical Sciences 4 18 weeks Letter Arthur Prancan, PhD Maria A. Pino, PhD (646) 981-4612 (646) 981-4613 Arthur.Prancan@touro.edu maria.pino@touro.edu Noon Wednesday and Thursday
Course Description
Pharmacology is the comprehensive understanding of how a single chemical mechanism can stop or reverse a disease process and restore normal biochemical and physiological function. This course will emphasize that the basis for safe and effective drug therapy is a clear awareness of the following: 1. 2. 3. 4. A precise expectation of the therapeutic goal. The mechanistic cause of dysfunction or disease. The mechanism of action which a drug must apply in order to prevent, stop or reverse a disease or dysfunction. The limits to safe and effective drug action.

The student will incorporate information attained in lecture, textbooks, quizzes and exams into a body of knowledge which will support the practice of safe and effective application of drug therapy. The student should learn to: 1. Describe the general principles which define the application of a drug to a patient. 2. Identify which drug class or classes are indicated for the prevention or relief of a medical condition or disease. 3. Describe the precise mechanism of action for each drug class and be able to give an example using a specific member of the drug class. 4. Identify the generic name of the prototype for each drug class with specific attention to the unique characteristics that define specific members of each drug family. 5. Describe the adverse effects uniquely associated with a class of drugs, and special problems associated with individual members of the group. 6. Predict adverse drug-drug, drug-food and drug-disease interactions.

Study Guide and Lecture Notes a. Arthur Prancan, Ph.D; Maria A. Pino, Ph.D. b. Posted on Blackboard Pharmacology I 151 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.

1. Basic and Clinical Pharmacology, 12th edition a. Editor = Bertram Katzung b. Publisher = McGraw-Hill Companies c. Publication Date = 2011 d. ISBN = 978-0-07-160405-5 2. First Aid of the USMLE Step1, 2013 edition a. Editor = Bhusan & Le b. Publisher = McGraw-Hill c. Publication Date = 2013 d. ISBN = 9780071475310 3. Katzung and Trevors Pharmacology with Examination and Board Review, 10th edition a. Editor = Trevor and Katzung b. Publisher = McGraw-Hill Companies c. Publication Date = 2013 d. ISBN = 978-0-07-178923-3 4. Pharmacology, 4th edition a. Editor= Brenner and Stevens b. Publishe r= Elsevier c. Publication Date = 2013 d. ISBN = 978-1-4557-0282-4
Exam Dates

Pharmacology I 152 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation Pharm I -10.00% 80.84% 12.05%

Quizzes Module I Module II Module III Module IV Module V Module VI Module VII Total 10% (no quizzes will be dropped) 10% 5% 20% 15% 10% 15% 15% 100%
Pharmacology I 153 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Schedule
Lectures
Sem: Week Date Topic. # Lecture Topic Readings Course Objectives 1. Overview the classes of antimicrobial agents. 2. Focus on MOA, spectrum of activity, bacteriocidal and bacteriostatic action 3. Define major toxicities and mechanisms of resistance. 1. Define MOA of drugs used to inhibit cell wall synthesis. 2. Describe mechanisms for microbial resistance 3. Describe spectrum of action, toxicity and resistance of cell wall inhibitors including penicillins, cephalosporins, carbapenams and vancomycin. 1. Describe MOA of folic acid antagonists 2. Describe MOA of the quinolones 3. Identify mechanisms for resistance, toxicities, and drug interactions associated with these drugs 1. Describe the MOA of macrolides, tetracyclines, clindamycin, and aminoglycosides. 2. Define mechanisms of microbial resistance. 3. Describe toxicities and significant drug interactions associated with these agents. 1. Describe the MOA of antiviral drugs and associated toxicities. 2. Define mechanisms of viral resistance. 1. Understand classifications and MOA of anti-HIV drugs 2. Define mechanisms of viral resistance 3. Characterize usefulness and toxicity 1. Describe the MOA of antifungals used for topical and systemic applications 2. Identify common toxicities and drug interactions Lecturer
Module I and II: Pediatric and Geriatric Concepts Introduction to Antimicrobials
Study Guide
Prancan
2 1:1 8/1 3
Cell Wall Inhibitors
Ch. 43
Prancan
Nucleic Acid Inhibitors
Ch. 46
Pino
Protein Synthesis Inhibitors
Ch. 44, 45
Pino
Antivirals I
Ch. 49
Pino
1:2
8/8
Antivirals II (anti-HIV Drugs)
Ch. 49
Prancan
Antifungals
Ch. 48
Prancan
Pharmacology I *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
154
Sem: Week
Date
Topic. # 8
Lecture Topic Alzheimers Disease
Readings Ch 60, Study Guide 1. 2. 3. 1. 2. 3.
Course Objectives
Lecturer
1:3
8/15
Drugs for Prostate 4. 5.
1. 10 Glaucoma Module I and II Exam (Pediatrics and Geriatrics) Ch. 9, 10, Study Guide Lectures 110 1. 2. 3. 4. 2.
Define the disorder. Apply drugs used in this disorder. Identify toxicities. Pino Compare drugs on the basis of toxicities and MOA. Describe the use of selective alpha-1 antagonists in the treatment of BPH. Identify toxicities. Describe the MOA, toxicity, and warnings associated with inhibitors of 5-alpha reductase. Describe the use of the herbal supplement saw palmetto in BPH. Describe the similarities to Pino finasteride. Identify 5-phosphodiesterase inhibitors, including their use and specific drug interactions. Describe the treatments used for prostatitis, including the use of NSAIDs and antibiotics. Identify the specific toxicities of these classes of drugs. Describe the MOA and toxicities of drugs used in the treatment of glaucoma Prancan Describe the MOA of drugs contraindicated to the glaucoma patient
8/19
Module III: Cardiovascular Pharmacology

11,12 1:4 8/22 Diuretics, Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARBs) Vasodilators and Calcium Channel Blockers Ch. 11, 15
Describe the MOA of all available diuretics. Understand usefulness of diuretics. Define diuretic toxicities. Identify classes of drugs used to inhibit ReninAngiotensin- Aldosterone 5. Define the relative toxicities, drug interactions and usefulness of the ACEI and ARBs. 1. Describe the MOA of drugs used to relax arteriolar vascular smooth muscle and thereby reduce blood pressure. 2. Identify toxicities and significant drug interactions associated with these drugs.
Prancan
13
Ch. 11, 12
Pino
155
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 3. Characterize their usefulness and safety. 1. Define Typical and Atypical Angina Pectoris. 2. Identify the three drug classes which treat/prevent angina. 3. Define the MOA for each drug class. 4. Identify toxicities which may or may not limit usefulness of each drug class. 1. Define the specific mechanisms which promote onset of arrhythmias. 2. Identify the drug targets which they present. 3. Predict the application of the four antiarrhythmic drug classes to the known mechanisms for generation of arrhythmias. 1. Name the drugs in Drug Classes I IV. 2. Identify MOA, uses, toxicities for each class. 3. Correlate actions of the drugs in each class with mechanisms identified above. 1. Identify the various drug classes which are used to treat and prevent MI. 2. Identify MOA, usefulness and toxicity 1. Define the etiology of heart failure. 2. Describe the MOA of drugs used to treat heart failure including cardiac glycosides, ACE inhibitors, ARBs, naturetic peptides, diuretics, beta-blockers and PDE3 inhibitors. 3. Identify drugs which are life-saving. 1. Describe the therapeutic strategies according to JNC7. 2. Identify the safest drugs for initial therapy. 3. Identify non-drug measures which are antihypertensive. 1. Describe the many ways the Sympathetic System is suppressed by drugs. 2. Define the usefulness and toxicity of each sympatholytic drug class.
Lecturer
14
Drugs for Chest Pain
Ch. 12
Prancan
1:5
8/29
15
Cardiac Arrhythmias
Ch. 14
Prancan
16
Antiarrhythmic Drug Actions
Ch. 14
Prancan
17
Drugs which treat and prevent Myocardial Infarction (MI)
Ch. 12
18
Heart Failure
Ch. 13
Prancan
1:7
9/12 19 Hypertension Ch. 11
Prancan
20
Antihypertensive Drugs: Sympatholytics
Ch. 11
Prancan
156
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 1. Describe the various agents used in the treatment of dyslipidemia. What does each class of drug specifically treat with respect to LDL, HDL, or triglycerides? 2. Describe the toxicities of these agents 3. Identify significant drug interactions
Lecturer
21
Hyperlipidemia
Ch. 35
Pino
9/16
Module III Exam (Cardiovascular Pharmacology)
Lecture 1121 1. Overview respiratory disease conditions which are responsive to drug therapy. 2. Describe airway muscle contraction. 3. Define the role of these mediators on inflammation and bronchoconstriction. 4. Identify targets for drug therapy against inflammation. 5. Identify targets for reversing or preventing bronchoconstriction. 6. Describe the role of these mediators on inflammation and bronchoconstriction. 7. Identify targets for drug therapy against inflammation. 8. Identify targets for reversing or preventing bronchoconstriction. 1. Identify Drug Classes and Drug MOA as they apply to episodic broncho-obstructive disease. 2. Identify Drug Classes and Drug MOA as they apply to the underlying inflammation of broncho-obstructive disease. 3. Define toxicities of all drug classes. 1. Identify the Drug Classes and Drug MOA as they apply to chronicbroncho-obstructive disease. 2. Define requirements for disease suppression before drugs are introduced. 3. Describe toxicities associated with these agents 4. Describe drugs used for pulmonary artery hypertension. 1. Define the etiology and antibiotic pharmacology of this
Module IV: Respiratory Introduction to Respiratory Pharmacology

22 Cytokines, Histamine, Bradykinin, Prostaglandins and Leukotrienes and drugs which manage these cytokines 1:8b 9/24 Study Guide
Prancan
23
Asthma
Ch. 20
Prancan
24
Bronchitis, Emphysema and COPD
Ch. 20
Pino
1:9
10/3
25
Endocarditis
Study Guide
Prancan 157
Sem: Week
Date
Topic. # 26
Lecture Topic Respiratory Infection: Tuberculosis
Readings 1. 1.
Course Objectives cardiac infection Describe the Drug Classes, MOA, and toxicities as they apply to TB infections. Describe the Drug Classes, MOA, and toxicities as they apply to infections of the airway. Associate the infective organism with the clinical respiratory condition. Describe the use of vaccines for the prevention of specific respiratory infections. Describe the MOA and indications for the drugs used for cough, cold, and allergy. . Describe the toxicities associated with the use of these agents. Describe special considerations associated with the use of these drugs including age, other disease states, and drug interactions. Identify drugs used for cystic fibrosis
Lecturer
Ch. 47
Prancan
27
Respiratory Infection: URI and Pneumonia
Study Guide
2. 3.
Pino
1:10
10/10
1. 2. 28 Drugs for Cough, Cold, and Allergy Study Guide 3.
Pino
4. 10/14 Module IV Exam (Respiratory Pharmacology) Lectures 2228
Module V: Endocrine
29 1:11 10/17 30
Introduction to Endocrine Pharmacology

Hormones of the Pituitary Gland Thyroid Gland
Ch. 37
1. Identify hormones of the pituitary gland which may act as drugs. 2. Identify drugs which are used to modify pituitary gland hormone action.
Prancan
Ch. 38
31
Insulin
Ch. 41
1. Describe drug actions which are appropriate for treatment of hypothyroidism and hyperthyroidism. 2. Identify disease conditions and other drugs which lead to hypothyroidism orhyperthyroidism. 1. Describe the MOA for the various insulin preparations, including their usefulness and duration of action. 2. Describe insulin resistance.
Pino
Pino
158
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 3. Define mechanisms in the Beta-Islet Cell which lead to insulin retention and release. 4. Describe how diuretics, calcium channel blockers, and vasodilators play a role in insulinrelease and blood glucose. 1. Identify drugs which modify dietary glucose absorption. 2. Describe the MOA, use, and toxicities associated with these agents. 3. Describe the role of glucagon in hypoglycemia. 1. Define the mechanisms for improving or decreasing plasma calcium concentration. 2. Characterize the common diseases of bone mineralization. 3. Identify drugs which may prevent loss of mineralization in bone disease. 4. Identify drugs which may replace missing bone structure. 5. Describe the role of calcium and vitamin D 6. Describe toxicities and significant drug interactions associated with the use of these specific agents. 7. Identify diet drugs. 1. Understand the common syntheticsites in synthesis of steroids. 2. Identify drugs and site of action which may interrupt steroid synthesis. 3. Identify corticosteroids, MOA, actions, toxicities.
Lecturer
32
Type II diabetes
Ch. 41
Pino
1:12
10/24
33
Bone metabolism and drugs for bone disease
Ch. 42
Pino
34
Adrenocorticosteroids
Ch. 39
Pino
10/28 1:13 10/31 35
ModuleV Exam (Endocrine Pharmacology)
Lectures 2934 1. Overview Renal Physiology and Disease Conditions. 2. Focus on sites for drug action.
Module VI: Renal Introduction to Renal Pharmacology

Study Guide Prancan
159
Sem: Week
Date
Topic. # 36
Lecture Topic
Readings Ch. 15, pp. 637-638
Course Objectives 1. Identify sites for renal drug action. 2. Define mechanisms for hyperuricemia. 3. Identify drugs, their MOA and toxicity as they are used to prevent or reverse hyperuricemia. 1. Describe individual diuretic drug action (MOA), toxicity and drug interactions. 2. Identify Vasopressin Receptor agonists and antagonists and define their respective usefulness. 1. Understand control of renal function and BP by R-AIIAldo 2. Define the stimuli for renin release. 3. Describe the metabolic pathways for synthesis and degradation of angiotensin and bradykinin. 4. Describe the impact of Angiotensin II, Aldosterone and Bradykinin on hypertension and congestive heart disease. 1. Describe the MOA and toxicity for Angiotensin Converting Enzyme Inhibitors (ACEI). 2. Describe the MOA and toxicity for Angiotensin Receptor Blocking drugs (ARBs). 3. Identify significant drug interactions associated with their use. 1. Identify drug classes which are known to cause nephrotoxicity. 2. Describe the mechanism of toxicity and specific ways to manage nephrotoxicity. 1. Identify drugs which have a role in resolving the causes of glomerulonephritis. 2. Identify drugs which are used to treat bacterial nephritis, cystitis and prostatitis. 3. For each drug identify MOA, any mechanism of resistance, and toxicity. 1. Describe why it is important to determine renal function before dosing renally excreted drugs.
Lecturer
Nephron/Uric Acid
Prancan
37
Diuretics
Ch. 15
Prancan
38
Renin-AngiotensinAldosterone
Ch. 11
Prancan
39
ACE Inhibitors, Angiotensin Receptor Blockers (ARBs)
Ch. 11
Pino
1:14
11/7
40
Nephrotoxic Drugs
Study Guide
Pino
41
Drugs used for glomerulonephritis, bacterial nephritis, cystitis and prostatitis
Study Guide
Pino
1:15
11/14
42
Pharmacokinetic Renal Dosing
Study Guide
Prancan 160
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 2. Identify drugs which must be dosed based on renal function. 1. Describe the origin, sites of action and MOA for nitric oxide. 2. Describe the physiologic and toxic actions of nitric oxide. 3. Identify the nitrates and know their usefulness and toxicity. 4. Describe 5-PDE inhibitors, use and toxicity.
Lecturer
43
Nitric Oxide, Nitrates and 5-PDE Inhibitors
Ch. 19
Prancan
11/18
Module VI Exam (Renal Pharmacology)
Lectures 3543 1. Overview Gastrointestinal Physiology and Disease Conditions. 2. Focus on sites for drug action. 3. Describe the GI mechanisms for acidity, cytoprotection and smooth muscle contractility 4. Identify drug actions which are developed to reduce GI acidity. 5. Identify drug actions which are cytoprotective 6. Define the prokinetic mechanisms and their applications 1. Describe the drugs which are used to suppress symptoms of IBD. 2. Identify MOA, usefu and toxicity for each drug and class. 3. Describe the conditions which require stimulation of GI components and the Drugs. 4. Identify drugs and products which stimulate the bowel. 5. Describe the limits to usefulness of these products. 1. Define the mechanisms for nausea and vomiting (N/V). 2. Identify the drugs which suppress N/V
44
Module VII: GI Introduction to GI Pharmacology: PUD, Peptic Ulcer Disease
Study Guide Ch. 62
Prancan
1:16 11/21
45
Inflammatory bowel Disease (IBD) Prokinetic Drugs; Laxatives
Ch. 62
Prancan
46
Emesis and antiemetic drugs
Ch. 62
Prancan
161
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 1. Describe mechanisms for GI hyperactivity and diarrhea. 2. Identify drugs which suppress GI hyperactivity and diarrhea, including MOA and toxicities. 1. Describe common GI infections: Enterobacteriacae, GI parasites, viral gastroenteritis, hepatitis viruses, campylobacter and helicobacter. 2. Identify appropriate antimicrobial drugs, MOA and toxicity. 3. Describe the contraindication of metronidazole and alcohol. 1. Describe the drugs used for infections due to protozoans, worms, and malaria 2. Describe the MOA of these drugs 3. Identify toxicities and contraindications associated with the use of these drugs
Lecturer
47
Diarrhea and Irritable Bowel Syndrome
Ch, 62
Pino
1:18
12/5
48
Infections of the GI tract
Study Guide
Pino
49
Anti-malarials, Parasites, and Helminths
Ch. 52,53
Pino
Finals
12/9
50
Module VII Exam (GI Pharmacology)
Lectures 4449
162
Primary Care Skills Syllabus

Course Details
Course Title: Course Number: Department: Credit Hours: Duration: Grading Type: Course Director: Directors E-mail: Assistant Coordinator: Coordinators E-mail: Course Assistant: Course Assistants Email: Office Days/Hours: Department Phone: Primary Care Skills PCR-632-E Primary Care 1 1 Semester Letter Joyce Brown, DO Joyce.Brown@touro.edu Amber Brody, DO Esquire Anthony, DO Esquire.Anthony@touro.edu By appointment 646-981-4508
Course Description
The second year Primary Care Skills (PCS) course is a one semester course which is taught in a variety of formats. The skills taught in this course will serve as a bridge between didactic information and the clinical arena. The course will develop the students skills with particular emphasis on clinical decision making and the osteopathic history and physical examination. The clinical content will place emphasis on primary care medicine as it relates to the maintenance of health and treatment of disease. The concepts learned in this course will be further developed and put into practice during the second semester Objective Structured Clinical Examination (OSCE) course.

Acquire the skills necessary to analyze clinical situations Enhance and demonstrate osteopathic history taking and physical examination skills Enhance the ability to conduct patient centered interviews Develop differential diagnoses appropriate to the context of the patient settings and findings Develop patient centered, evidence based assessments and management plans including those with an emphasis on preventive medicine and health promotion 6. Enhance the ability to utilize diagnostic studies 7. Enhance and demonstrate medical interpersonal and communication skills 8. Develop and demonstrate the ability to document a comprehensive patient encounter in the primary care setting in an accurate, organized and logical manner via the H&P note 1. 2. 3. 4. 5.

1. 2. 3. 4. Stethoscope with a dual head (separate diaphragm and bell) Adult blood pressure cuff (latex free is required) Ophthalmoscope with a coaxial head. A panoptic head is not acceptable. Otoscope with a pneumatic bulb. Otoscope head must be compatible with plastic disposable specula.
Primary Care Skills 163 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
5. 6. 7. 8. 9.
Reflex hammer Two tuning forks (one that is 512-1024 Hz and one that is 128 Hz) Penlight Student/consultation length white laboratory coat Bates Guide to Physical Examination and History Taking, 10th Edition a. Author = Lynn S. Bickley b. ISBN = 978-0-7817-8058-2 Listed on schedule under Readings as: BG 10. Physical Examination of the Spine and Extremities a. Author = Stanley Hoppenfeld b. ISBN = 0-8385-7853-5 Listed on schedule under Readings as: H 11. Bates Visual Guide to Physical Examination DVD Series Volumes 1-19, 4th Edition* a. Author = Lynn S. Bickely b. ISBN = 9780781757645 Listed on schedule under Readings as: BV *This is available via streaming video through the TouroCOM library. Instructions for access and viewing are posted on Blackboard.
Exam Dates
These dates are subject to change. OSCE I (Standardized Patient Encounter): October 2nd, October 9th and October 16th, 2013 OSCE II (Practical Examination): November 20th, 2013

The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course PCS
Faculty Adjustment Mean Standard Deviation
20.00% 87.91% 7.58%

Note: Student attendance may affect course grade. See under Course Specific Attendance and Tardiness Policy. Interactive Clicker Sessions Small Group Performance OSCE I OSCE II Total 10% 35% 35% 20% 100%
Small Group Performance Points (semester total) 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 0
% Score 100 98.3 96.6 94.9 93.1 91.4 89.7 88.0 86.3 84.6 82.9 81.1 79.4 77.7 76.0 74.3 72.6 70.9 69.1 67.4 65.7 64.0
Course Material
Course material including lectures, interactive learning sessions, examinations and OSCEs will include content from the required and recommended textbooks and other required and recommended materials. Students are responsible for all covered and for all assigned material.
Course Format
The content of this course is multifaceted and utilizes multiple delivery formats. The majority of the course material will be delivered through weekly 1 hour, topic specific, small group learning sessions. These faculty led sessions will be predominantly case based. The topics will be integrated with those being taught in the other second year courses. A significant amount of student preparation and participation will be required each week. The small group learning sessions may be recorded. There will be a limited number of live lectures, skills sessions, iTunes lectures and/or interactive learning sessions which will take the place of the weekly small group sessions. For select topics, students will be directed to view pre-recorded lectures via iTunes. When topics are delivered via iTunes, students may be required to attend interactive, learning sessions based on the iTunes lectures. The iTunes lectures are to be viewed prior to the class for which they are assigned. Portions of the course, including the OSCEs may be recorded. Recordings are for Department use and may be used in subsequent lectures. Students are encouraged to watch their recorded OSCE encounters. Recordings may not be used for student requested grading purposes. The term OSCE is an acronym for the Objective Structured Clinical Examination. It is a simulated student doctor-patient encounter designed to develop and assess clinical skills. An OSCE is: Objective, because examiners use a checklist for evaluating students and each student is evaluated in the same manner, using the same type of criteria. Structured, because every student is presented with similar clinical scenarios and is expected to perform similar tasks, in the same time frame. A clinical examination, because the tasks are representative of those faced in clinical situations.
Course material including weekly schedule, assignments, and announcements will be posted on Blackboard. Students will be required to utilize Blackboard daily.
Course Presentation
1. Scheduled time is Wednesdays from 1pm-5pm. Variations may occur and will be posted on Blackboard. 2. The specific weekly schedule for each student will vary based on the weekly format and will be posted on Blackboard. 3. Students must attend the sessions to which they have been assigned. 4. Lectures, skills sessions and/or interactive learning sessions will occasionally take the place of the weekly sessions. 5. Lectures are streamed or recorded at the Departments discretion. 6. The schedule is subject to change at the Departments discretion.

Due to the unique nature of this course, 100% attendance and punctuality is required. If an absence is anticipated or occurs, the student must notify the Dean of Students and the Course Director as soon as possible. Excused absences must be obtained from the Dean of Students and submitted to the Course Director within 1 week of the absence. Failure to attend will result in a deduction from the students overall course grade. One (1) unexcused absence will result in a five (5) point deduction. Two (2) unexcused absences will result in a ten (10) point deduction. Three (3) unexcused absences will result in course failure. An unexcused absence from an OSCE will result in a grade of zero. Students are required to be aware of the course schedule. Holiday and personal travel must be planned accordingly. No excused absences will be granted for holiday travel.

Latex containing products will be used during this course. Individuals with latex allergies and/or hypersensitivities must notify the Course Director in writing within one week of the start of the course. Individuals with latex allergies and/or sensitivities may be requested to obtain medical clearance prior to interacting with latex containing products
Course Schedule
Lectures
Sem: Week 1:1 Date Lect. # Lecture Topic Course Introduction & Guidelines for Working with Standardized Patients (Live Lecture) Readings/Assignments 1. 2. 1. 2. Introduction to the Comprehensive History & Physical Examination in the Primary Care Setting. Note: This is a review from the Physical Diagnosis Course (iTunes and interactive clicker session) 3. Course Objectives Describe and discuss course objectives, format, schedule and policies. Define Standardized Patient encounter procedures and guidelines. Recognize the importance of accurate history taking. Define the subjective and objective components of a patient encounter. Identify and describe each of the components of the comprehensive patient history in the primary care setting including the chief complaint, the history of the present illness, past medical history, past surgical history, medications, allergies, social history, family history, review of systems and routine health maintenance & immunizations. Identify and describe each of the components of the comprehensive physical examination in the primary care setting. Identify and describe Assessments. Define and describe the components of a Plan. Describe and discuss the comprehensive verbal presentation in the primar care setting. Identify the components of the comprehensive verbal presentation in the priamr care setting. Identify and discuss tips for effective verbal patient presentations. Deliver an effective verbal presentation using the provided format. Lecturer
7/31/13
Dr. Brown
1:2
8/7/13
BG: Chapter 3
Dr. Brown
4.
5. 6. 1. The Comprehensive Verbal Case Presentation (iTunes and Interactive clicker session) 2. TBA 3. 4.
1:2
8/7/13
Dr. Grotticelli
Primary Care Skills *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
168
Sem: Week
Date
Lect. #
Lecture Topic
Readings/Assignments 1.
Course Objectives Identify the components of the comprehensive patient history in the outpatient primary care setting. 2. Define and describe each of the components of the comprehensive patient history in the primary care outpatient setting. 3. Elicit a comprehensive patient history in the primary care outpatient setting. 4. Describe and discuss the comprehensive physical examination in the primary care outpatient setting. See blackboard for additional objectives and assignments 1. Deliver a verbal presentation of the patient history and physical examination from the previous weeks case. 2. Identify and discuss the appropriate diagnostic studies, assessments and plans for the patient in this case. See blackboard for additional objectives & assignments 1. Define the focused patient encounter. 2. Define and discuss the adult focused history in the outpatient primary care setting. 3. Define and discuss the adult focused physical examination in the outpatient primary care setting. 4. Define and describe the focused assessment and plan in the outpatient primary care setting. 5. Differentiate between the focused and comprehensive patent encounter. 6. Perform an adult focused patient encounter in the outpatient primary care setting. 1. 2. 3. Identify and describe the approach to a patient complaint. Discuss clinical reasoning and decision making. Use an accepted clinical reasoning schematic to evaluate a patient complaint, perform a history & physical examination, determine appropriate diagnostic testing and to develop an appropriate assessment and management plan.
Lecturer
1:3
8/14/13
Small Group Case 1: Part 1
TBA
TBA
1:4
8/21/13
TBA
TBA
1:5
8/28/13
Focused Patient Evaluation in the Primary Care Setting (ITunes and Interactive Clicker Session)
TBA
TBA
1:5
8/28/13
Clinical Reasoning (ITunes and Interactive Clicker Session)
TBA
TBA
169
Sem: Week
Date
Lect. #
Lecture Topic
Readings/Assignments 1.
Course Objectives Identify the purposes of a focused verbal patient presentation. 2. Define and describe the components of the focused verbal patient presentation. 3. Differentiate between the focused and comprehensive verbal presentation. 4. Deliver a focused verbal patient presentation. 1. Elicit a focused patient history and physical examination in the primary care outpatient setting. 2. Develop a differential diagnosis. 3. Identify and interpret relevant diagnostic studies. 4. Develop appropriate assessments and plans. See blackboard for additional objectives and assignments
Lecturer
1:6
9/4/13
Focused Verbal Presentation in the Primary Care Setting (iTunes & Interactive Clicker Session) 1-1:50pm
TBA
TBA
1:7
9/11/13
Small Group Case 2:
TBA
TBA
1:8b
9/23/13
OSCE & Standardized Patient Encounter Preparation (Live Lecture and Interactive Clicker Session) Note:1-1:50pm
Review the following ITunes lectures from the Physical Diagnosis Course prior to class (ITunes can be found under the 2012 Fall Physical Diagnosis Course Introduction to the Patient Interview The Approach to the Patient The Advanced Patient Interview
1. 2. 3.
Discuss the OSCE goals, procesudres, expectatons and preparation strategies. Review key interview and patient encounter techniques. Discuss preparation strategies and tips for the OSCE.
TBA
1:8b
9/23/13
Documentation of the Comprehensive Patient Encounter (iTunes & Interactive Clicker Session) Note:2-2:50pm Skills Session: Group 1 Note:3-5pm
TBA
1. 2. 3. 4.
Discuss the main purposes of documentation. List key some of the types of documentation. Identify general documentation strategies. Define and discuss the format of the comprehensive History and Physical (aka H & P) note in the primary care outpatient setting. Practice history and physical examination skills prepare for the OSCE I and OSCE II. TBA
1:8b
9/23/13
TBA
1.
170
Sem: Week
Date
Lect. #
Lecture Topic
Readings/Assignments
1.
Course Objectives
Lecturer
1:9
10/2/13
Group 1: OSCE I Groups 2 & 3: Skills Sessions
TBA
1:10
10/9/13
Group 2: OSCE I Groups 1 & 3: Skills Sessions
TBA
1:11
10/16/13
Group 3: OSCE I Group 2: Skills Sessions
TBA
1:12
10/23/13 9
OSCE Encounter and Note Review (Live lecture and Interactive Clicker Session)
TBA
1:13
10/30/13
TBA
Demonstrate competence in performing and documenting an osteopathic history and/or physical examination. 2. Practice history and physical examination skills. See blackboard for additional objectives and assignments. 1. Demonstrate competence in performing and documenting an osteopathic history and/or physical examination. 2. Practice history and physical examination skills. See blackboard for additional objectives and assignments. 1. Demonstrate competence in performing and documenting an osteopathic history and/or physical examination. 2. Practice history and physical examination skills. See blackboard for additional objectives and assignments. 1. Discuss the previous OSCE case encounter and strategies for improvement. 2. Discuss the H&P note from the previous OSCE encounter and strategies for improvement. 1. Elicit a focused patient history and physical examination in the primary care outpatient setting. 2. Develop a differential diagnosis. 3. Deliver a verbal presentation of the previous patient case. See blackboard for additional objectives and assignments.
TBA
TBA
TBA
Dr. Brown
171
Sem: Week
Date
Lect. #
Lecture Topic
Readings/Assignments
Course Objectives
Lecturer
1:14
11/6/13
TBA
1. 2. 3. 4.
Discuss the differential diagnosis. Identify and interpret relevant diagnostic studies. Develop appropriate assessments and plans. Deliver a verbal presentation of the patient case from the previous week. 5. See blackboard for additional objectives and assignments.
TBA
1:15 1:16
11/13/13 11/20/13
Skills Session OSCE II
TBA TBA 1. Elicit a focused patient history and physical examination in the primary care outpatient setting. 2. Develop a differential diagnosis 3. Deliver a verbal presenation of the previous patient case. 4. See blackboard for additional objectives and assignments. 1. Discuss the differential diagnosis. 2. Identify and interpret relevant diagnostic studies. 3. Develop appropriate assessments and plans. 4. Deliver a verbal presentation of the patient case from the previous week. 5. See blackboard for additional objectives and assignments.
TBA TBA
1:17
11/27/13
TBA
TBA
1:18
12/4/13
TBA
TBA
172
Semester Two Syllabi
173
Clinical Systems II Syllabus

Course Details
Course Title Course Number: Department: Credit Hours: Duration: Grading Type: Course Director: Course Coordinator Directors Campus Phone: Directors E-mail: Office days/Hours: Clinical Systems II PRCR-646-E Primary Care 7 Credit Hours 14 weeks Letter Barbara Capozzi, DO Barbara Capozzi, DO (646)981-4507 barbara.capozzi@touro.edu By appointment
Course Description
The Clinical Systems II Course is composed of 6 Modules. Note that this year iTunes will be the main source for delivery of material. Class will correspond with this material and reading assignments. The course will be presented in chronological order as follows: 8. 9. 10. 11. 12. 13. Dermatology Rheumatology/Immunology Hematology Oncology Neuromuscular Obstetrics/Gynecology 1 week 2 weeks 2 weeks 2 weeks 4 weeks 3 weeks
The Clinical Systems course will provide a foundation for clinical medicine. The course will cover the clinical aspect of medicine relative to the pediatric, adolescent, adult, obstetrics, and geriatric population. In addition, the course will divide clinical medicine into major organ systems (presented in modules), and will incorporate, (but will not be limited to), Infectious Diseases, Radiology/Diagnostic Imaging, Laboratory Values and Surgery. At the same time the Clinical Systems Course will have a vertical thread with the Basic Sciences: Pathology, Pharmacology, Immunology and Microbiology, and Osteopathic Manipulative Medicine, so that students will have a complete presentation of each of the disciplines of medicine. The Clinical Systems course will also be integrated with the Primary Care Skills course (casebased learning) and the OSCE course (experiential learning). Select topics will be reinforced utilizing Medical Simulation. Clinical Systems content will include: etiology, risk factors (genetic, racial, ethnic, environmental), presenting signs and symptoms, physical examination findings, assessment, appropriate differential diagnosis, ordering and interpretation of appropriate diagnostic and laboratory testing, and current standard of care including: pharmacological and nonpharmacological management, nutrition, preventive medical care, rehabilitation, osteopathic manipulative medicine, and surgical considerations. While the Clinical Systems course places emphasis on the basic sciences, it includes how diseases manifest, present, and also differ with regard to gender, age and lifecycle. The course provides the student with knowledge necessary for
Clinical Systems II 174 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
developing diagnostic skills and prepares students to answer questions based on a clinical scenario, to diagnose specific medical conditions, thereby enabling the student to have a greater understanding of proper patient assessment. The HEENT section will emphasize common presenting problems of the head, ear, eye, nose and throat, including symptoms, associated physical findings, differential diagnosis, appropriate laboratory/diagnostic testing and interpretation, etiology, risk factors, treatment, complications, and common surgical procedures. Particular attention will be placed on neuro-opthamology in the Neuromuscular Medicine Module. This will focus on ophthalmologic manifestations seen in various neurological conditions. As in all modules, students will be expected to review the relevant Physical Diagnosis lecture(s) and lab(s) from year one. In each system module, the classic symptoms of specific diseases and their clinical relevance as they relate to physical findings are discussed. The diagnostic work up, its importance and limitations are discussed. In addition to appropriate medical management, other therapeutic treatment options (in addition to osteopathic manipulative medicine) and surgical considerations are covered. At the end of the course students will have a better understanding of the clinical manifestations, pathophysiology of disease, and mechanisms of treatment. Simultaneous instruction in the Primary Care Skills and OSCE courses reinforce the clinical skills necessary for interviewing, examining, diagnosing and treating patients. The overall goal is to provide a comprehensive presentation of clinical medicine relevant for second year medical students, as well as to prepare students for clinical rotations. Multiple faculty members will be utilized in their areas of expertise to ensure the best possible exposure for the student.

Course Objectives
1. To provide the clinical aspect of medicine for pediatric, adult and the geriatric population. 2. To present clinical medicine as separate organ systems with a focus on presenting signs and symptoms; to have an appreciation for racial and ethnic disparities in evaluating risk factors for diseases. 3. To identify relevant physical exam findings associated with common diagnoses. 4. To enable the student to formulate an accurate differential diagnosis, work-up, and treatment plan based on: presenting signs and symptoms, physical findings, laboratory values, and diagnostic studies. 5. To prepare students with fundamental clinical knowledge necessary for medical case presentation discussion; thereby facilitating integration of the Clinical Systems course with the Primary Care Skills and OSCE Lab. 6. To provide students with a foundation in clinical medicine relevant for clinical rotations.
Student Objectives
1. To recognize the classic clinical presentation, signs, symptoms, associated physical exam findings for common diagnoses. 2. To formulate an appropriate differential diagnosis. 3. To state and discuss the appropriate work up. 4. To review and interpret laboratory results. 5. To recognize classic diagnostic imaging results. 6. To state the definitive diagnosis. 7. To identify and explain appropriate treatment. 8. To state associated complications. Clinical Systems II 175 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
9. 10. 11. 12. 13. 14.
To identify associated risk factors. To recognize associated pathology and/or histopathology, pathophysiology, microbiology and/or immunology. To recognize the importance individualization when selecting treatment. To appreciate the importance of communication and patient education. To recognize the unique approach to the pediatric and geriatric population. To assimilate information learned in this course with Primary Care Skills, and OSCE courses, thereby facilitating competency and adequate preparation for clinical clerkships. 15. To integrate the information learned in this course with osteopathic physical examination enabling better diagnostic and therapeutic management of patients.

These books will be referenced throughout the course. Students are expected to read prior to attending class. 1. Title: Cecil Medicine 24th Edition a. By: Lee Goldman (editor) b. Publisher: Saunders; 24th edition (July 25, 2011) c. ISBN: 978-1-4160-2805-5 2. Title: Nelson Essentials of Pediatrics 6th Edition a. By: Robert Kliegman(Author) b. Publisher: Saunders; 6 edition (March 31, 2010) c. ISBN: 978-1-4377-0643-7 3. Title: Rapid Interpretation of EKGs, Sixth Edition a. By: Dale Dubin (Author) b. Publisher: Cover Publishing Company; 6 edition (October 15, 2000) c. ISBN: 978-0-9129-1206-6 4. Title: Hacker & Moore's Essentials of Obstetrics and Gynecology a. By: Neville F. Hacker MD b. Publisher: Saunders; 5 edition (February 4, 2009) c. ISBN: 978-1-4160-5940-0 5. Title: Bates Guide to Physical Examination and History Taking 10th Edition a. By: Lynn S. Bickley b. Publisher: Lippincott Williams & Wilkins; 10th edition (December 10, 2008) c. ISBN: 978-1-6054-7803-6 6. Title: Pathophysiology a. By: Ivan Damjanov MD PhD b. Publisher: Saunders; 1 Pap/Psc edition (April 30, 2008) c. ISBN: 978-1-4160-0229-1 7. Title: Primer on the Rheumatic Diseases a. By: John H. Klippel b. Publisher: Springer; 13th ed. 2008 c. ISBN: 978-0-387356648 8. Title: Bates' Visual Guide to Physical Examination a. By: Barbara Bates, Lynn S Bickley b. Imprint: Philadelphia, Pa. : Lippincott Williams & Wilkins, c2005, c2007 Clinical Systems II 176 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
c. ISBN: 978-0-7817-5861-1 d. Call # (for Touro-Harlem Medical Library): WB 205 B329 2007 9. Title: Physical Examination of the Spine and Extremities a. By: Stanley Hoppenfeld b. Publisher: Prentice Hall; 1st Edition (June 5, 1976) c. ISBN: 978-0-838578537 10. Title: Renal Notebook* a. By: James Agresti, DO b. Will be posted on Blackboard prior to the Renal Module.

1. Title: Harrisons Principles of Internal Medicine 18 Th. Edition a. By: Anthony S.Fauci b. Publisher: McGraw-Hill c. ISBN: 978-0-0714-6633-2 2. Title: Rakel Textbook of Family Medicine a. By: Robert E. Rakel b. Publisher: Saunders; 8 Th. Edition (April 25, 2007) c. ISBN: 978-1-4160-2467-5 3. Title: Rakel Essential Family Medicine: Fundamentals and Case Studies, Third edition a. By: Robert E. Rakel b. Publisher: Saunders, Elsevir c. ISBN: 978-1-4160-2377-7 4. Title: Kochars Clinical Medicine for Students: Fifth Edition a. By: Dario Torre b. Publisher: Lippincott Williams and Wilkins, Fifth Edition (2009) c. ISBN: 978-0-7817-6699-9 5. Title: Nelson Textbook of Pediatrics 18 Th. Edition a. By: Robert M. Kliegman b. Publisher:Elsevier Science Health Science Division c. ISBN: 978-1-4160-2450-7 6. Title: Minor Emergencies: Splinters to Fractures a. By: Philip Buttaravoli b. Publisher: Mosby; 2 nd. Edition c. ISBN: 978-0-323-04026-6. 7. Title: ENT Secrets, Third Edition a. By: Bruce W. Jafek, M.D. b. Publisher: Mosby; 3 rd. Edition c. ISBN: 978-1560536178 8. Title: Obstetrics and Gynecology a. By: Charles RB Beckmann (Editor) b. Publisher: Lippincott Williams & Wilkins; 6 Edition (May 1, 2009) c. ISBN: 978-0-7817-8807-6 Clinical Systems II 177 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
9. Title: Williams Obstetrics a. By: F. Gary Cunningham b. Publisher: McGraw- Hill; 23rd Edition c. ISBN: 978-0-0714-9701-5 10. Title: Learning Radiology: Recognizing the Basics a. By: William Herring MD (Author) b. Publisher: Mosby; 1 Pap/Pas edition (May 1, 2007) c. ISBN: 978-0-3230-4317-5 11. Title: A Practical Approach to Radiology a. By: Nancy M. Major, M.D. b. Publisher: Saunders; 1 edition (August 25, 2006) c. ISBN: 978-1-4160-2341-8 12. Title: Ferri's Best Test: A Practical Guide to Laboratory Medicine and Diagnostic Imaging a. By: Fred F. Ferri MD FACP (Author) b. Publisher: Mosby; 2 edition (April 7, 2009) c. ISBN: 978-0-3230-5759-2 13. Title: Primary Care Geriatrics, 5th Edition: A Case Based Approach a. By: Ellen Flaherty, PhD APRN BC (Author) b. Publisher: Mosby; 5 edition (September 18, 2006) c. ISBN-13: 978-0-3230-3930-7 14. Title: Essentials of Surgery a. By: James M. Becker, M.D., FACS b. Publisher: Saunders c. ISBN: 978-0-7216-8186-3 15. Title: The Complete Guide to Nutrition in Primary Care a. By : Darwin Deen , Lisa Hark b. Publisher: Blackwell c. ISBN: 978-1-4051-0474-6
Exam Dates
These dates are subject to change. Dermatology + Rheumatology/Immunology Hematology Oncology Neuromuscular Obstetrics/Gynecology 2/3/14 2/10/14 3/3/14 3/31/14 5/5/14

For this course the following breakdown will be used, where exam Z-Scores greater than and equal to 0.75 are an A, exam Z-Scores less than 0.75 and greater than and equal to -0.45 and are a B, exam Z-Scores less than -0.45 and greater than and equal to -1.35 are a C and exam Z-Scores below -1.35 are an F. For the raw percentages required to achieve these Z-Scores for this course, please see the chart below. Letter Grade Z-Score Percent
A B C F
0.75 Z -0.45 Z < 0.75 -1.35 Z < -0.45 Z < -1.35
82.44% % 70.06% % < 82.44% 60.77% % < 70.06% % < 60.77%
The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation CS II 0.00% 74.70% 10.32%

Each module exam will be weighted for a total of 90% of the semester grade. All iClicker Sessions will be 10% of the semester grade. All iClicker Sessions All Module Exams Module 7 Module 8 Module 9 Module 10 Module 11 Module 12 Total 10% 90% 6.4% 12.9% 12.9% 12.9% 25.7% 12.3% 100%
Course Format
The Clinical Systems course content will be delivered via iTunes recorded by faculty. A live interactive clicker session that utilizes multiple choice questions, vignettes and cases with relevant multiple choice questions will occur each Wednesday at the scheduled time. These clicker sessions will focus on the material for a given week. Core Concept Questions will precede the Case Presentations. The Course Director will use Blackboard to provide the students with the iTunes lecture titles and the corresponding PowerPoint presentations (required reading included) for the week, in advance. The students are responsible for listening to ITunes, reading PowerPoint and for completing reading in text(s) prior to attending the clicker sessions. Medical Simulation will be utilized for some iClicker sessions. Resources include but are not limited to: Up to Date Online, Journal articles, and the Renal Notebook. Additional sessions may meet on Friday from 9am-11am; therefore, students are advised to keep their schedule free at this time.
Students are expected to be prepared for iClicker sessions and discussions. Tools for preparation to achieve course objectives include reading assignments from texts and online, iTunes lectures, PowerPoint presentations and attending class sessions.
Course Presentation
1. Module format iTunes Lectures and in class Case Presentation and Question & Answer iClicker Sessions. Including Core Concept Questions. 2. iTunes (independent viewing to be completed before each Wednesdays Case Presentation and Question & Answer iClicker Sessions.) 3. Case Presentation and Question & Answer iClicker Sessions Wednesday @ 10 am -12 pm; attendance required. 4. Faculty Overview of the weeks iTunes is Wednesday @ 9 am -10 am. 5. For several modules Physiology Review iTunes by Dr. Conrad Fischer will be available and will focus on relevant material for that module. 6. There is an optional live session for the Department of Primary Care on Fridays, from 9 am - 11 am each week. Students are advised to keep their schedule free at this time. *Schedule is subject to change. 7. Full-time faculty, adjunct faculty, and guest lecturers will give iTunes and/or Case Presentation and Question & Answer iClicker Sessions. 8. Clinical scenarios and case presentations will be incorporated into the curriculum. 9. The Clinical Systems course director may give a review before final exams, if time allows. 10. Self-Assessments may be given. 11. Independent directed study will be assigned for heart sounds. 12. UpToDate Online will be used frequently throughout the semester. 13. Exams will be given on the first Monday following the last day of each module. 14. High yield topics will be emphasized throughout multiple modules.

If an absence is anticipated or occurs, the student must notify the Dean of Students and Course Director as soon as possible. Excused absences must be obtained from the Dean of Students and submitted to the Course Director. Make-up for lectures and Case Presentation and Question & Answer iClicker Sessions will not be offered. Each unexcused absence will result in a zero (0) for each missed clicker session. Students are required to be aware of the course schedule and to check their e-mail and Blackboard for updates. Holiday and personal travel must be planned accordingly. No excused absences will be granted for holiday travel.
Accessing Up to Date Online Instructions

1. 2. 3. 4. 5. 6. 7. To access Up To Date Online, go to http://www.touro.edu/med and click on LIBRARY Scroll down to list of proprietary databases (in orange) and click on the link. On the next screen, scroll down on right to the bottom of the page and you will see in blue, Up To Date Online Click on to Up To Date Online Accept the agreement. Under NEW SEARCH type in your topic. On left scroll down to more specifics about your topic.
HEENT, Ear Assignment

To reinforce topics covered in the didactic Ear lecture students will be given assignments to complete. This is assignment #1. 1. Access Up To Date Online using the instructions above. 2. Under NEW SEARCH type in Ear 3. On left scroll down: Acute Otitis Media in Adults Complete this section first. 4. Under RELATED TOPICS (on left), click onto Acute Otitis Media in Adults (Suppurative and Serous) Complete this section for: Acute otitis media Otitis media with effusion Acute mastoiditis Chronic otitis media LEARNING OBJECTIVES: For these diagnoses students should know: Characteristics of each Etiology Eustachian tube dysfunction, most common organism etc. Common presentation of the patient How to diagnose- (expected otoscope and pneumatic otoscope findings) Complications Evaluation for hearing loss (Weber test). Read about treatment and understand when to refer to specialist. BE SURE TO CLICK ON PICTURES FOR: Acute otitis media Pneumatic otoscope Normal tympanic membrane Retracted tympanic membrane
TOPICS FOR PART 2: GO TO TOP OF PAGE AND WHERE IS SAYS SEARCH type in: Bacterial otitis externa- (Swimmers ear) READ this section. Then type in, Etiology of hearing loss in adults READ: Classification; infection, trauma, tumor, exostosis, osteoma, Eustachian tube dysfunction, tympanic membrane perforation, Cholesteatoma, otosclerosis, barotraumas, Presbycusis, Meniere's disease , noise exposure, ototoxic medications
LEARNING OBJECTIVES: For these diagnoses students should know:
Definitions, characteristics of each diagnosis, risks, etiology, symptoms, diagnosis
Course Schedule
Lectures
Sem: Week
2:1
Date
Lecture Topic
Bacterial and Fungal Infections; Common Skin Disorders, Viral
Readings
1.
Cecil, Bates: Chapter 6; Damjanov: pp 59-66; Review PD Lecture & Lab Material
Course Objectives
Discuss the characteristic presentations of common bacterial, viral, fungal infections and common skin disorders Recognize the dermatological manifestations of each Discuss the differential diagnosis Discuss treatment Discuss the characteristic presentations of: Contact, Atopic, Seborrhea, Nummular, Exfoliative , Lichen Simplex Recognize the dermatological manifestations of each Discuss the differential diagnosis Discuss treatment Discuss the clinical presentation and etiology: Impetigo, Ecthyma, Cellulitis and erysipelas, Necrotizing fasciitis, Folliculitis, Keratosis Pilaris, Pseudofolliculitis barbae, Furuncle and Carbuncles, Staphylococcal Scalded Skin Syndrome Recognize the dermatological manifestations of each Discuss the clinical presentation and etiology : Tinea pedis, corpora, capitis, cruris, tinea versicolor, barbae, Candida intertrigo, oral Candida, Onychomycosis (Tinea Unguium) Recognize the dermatological manifestations of each Discuss treatment Discuss the clinical presentation and organism: Scabies, Pediculosis Capitis (Head Lice), Pediculosis Pubis (Crab Lice), Pediculosis Corporis (Body Lice), Warts (Verrucae), Molloscum Contagiosum, Verruca Plana, Vulgaris, Condyloma Acuminata, Ance vulgaris, Rosacea , Hypertrichosis, alopecia Recognize the dermatological manifestations of each Discuss treatment Discuss the clinical presentation, risk factors and characteristic rash of : Condyloma/Warts, Herpes simplex 1 and 2,oral, Herpetic Gladiatorum, Herpes zoster/varicella, EBV, CMV, HSV 6 ,7; Molluscum Contagiosum; Coxsackie A 16; hand, foot and mouth, Measles, Rubella, 5th disease, Roseola Infantum /6th disease Recognize the dermatological manifestations of each Discuss treatment
Lecturer
1/15/14
2. 3. 4. 1. 2. 3. 4. 1.
Dr. Rozenberg
2:1
1/15/14
Dermatitis
Dr. Rozenberg
2:1
1/15/14
Bacterial Infections
Dr. Rozenberg
2. 1.
2:1
1/15/14
Fungal and Yeast Infections
Dr. Rozenberg
2. 3. 1.
2:1
1/15/14
Common Skin Disorders
Dr. Rozenberg
2. 3. 1.
2:1
1/15/14
Viral Skin Diseases
Dr. Rozenberg
2. 3.
Clinical Systems II *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
183
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Differentiate common papulosquamous and inflammatory skin disorders 2. Discuss the clinical presentation, characteristics and associated symptoms: Psoriasis, Pityriasis Rosea, Lichen Planus 3. Recognize the dermatological manifestations of each 4. Discuss treatment 1. Discuss the clinical presentation, risk factors, epidemiology, diagnosis, and complications of:, Erythema Multiforme (EM), Toxic Epidermal Necrolysis, Stevens-Johnson Syndrome, Granuloma Annulare, Erythema Migrans, Erythema Nodosum 2. Recognize the dermatological manifestations of each 3. Discuss treatment 1. Discuss the clinical presentations ,characteristics and histopathology of common blistering disorders: Pemphigus Vulgaris, Bullous Pemphigoid, Dermatitis Herpetiformis 2. Recognize the dermatological manifestations of each 3. Discuss treatment 1. Discuss nevi and skin cancer 2. Identify basal cell, squamous cell and melamona, Seborrheic Keratosis ,actinic keratosis (squamous cell precursor 3. Discuss the characteristics of each 4. Identify the risk factors associated with each 1. Explain how to classify an immune reaction 2. Discuss Gel Coombs classification 3. Review cellular mechanism 4. Discuss how pharmacologic intervention works 5. Discuss and differentiate the clinical presentation of : Anaphylaxis, Asthma, Serum Sickness, Contact Dermatitis, and Immune Hemolytic Anemia 6. Describe diagnostics tests and treatment 7. Explain the adaptive immune response 8. Differentiate allergy and anaphylaxis 9. Discuss and differentiate the 4 major types of immunologically mediated Hypersensitivity Reactions 10. Explain how to assess a patient 1. Identify the different clinical presentations of atopic dermatitis, AD 2. Identify the major and minor criteria to make the diagnosis 3. Discuss the immunology 4. Discuss treatment 5. Identify risk factors and associated conditions
Lecturer
2:1
1/15/14
Papulosquamous; Inflammatory Disorders
Dr. Rozenberg
2:1
1/15/14
Inflammatory Disorders
Dr. Rozenberg
2:1
1/15/14
Blistering Diseases
Dr. Rozenberg
2:1
1/15/14
Cancer and Nevi
Dr. Rozenberg
2:2
1/22/14
Intro to Hypersensitivity Reactions
Cecil; Pathophysiology; Primer of RD, Bates Damjanov
Dr. Mitchell
2:2
1/22/14
Atopic Dermatitis
Cecil; pp. 29372938.Pathophysiology;, Bates Clinical Systems Dermatology lectures Clinical Systems Pediatrics module
Dr. Mitchell
184
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3. 4.
Course Objectives
Review basic immunology of complement pathways Differentiate urticaria vs. angioedema Discuss types of Hereditary Angioedema (HAE) Discuss clinical syndromes of Angioedema and complement deficiencies 5. Identify the diagnostic laboratory tests 6. Identify and discuss new treatments for Hereditary Angioedema (HAE) 7. Discuss and distinguish causes of angioedema: Type I/II HAE, Type III HAE, Acquired C1INH deficiency, anaphylaxis and idiopathic AE, ACE-1 associated angioedema 8. Discuss the complement profile in various types of angioedema 9. Discuss how to recognize acute attack 10. Discuss prophylaxis 1. Identify the infections associated with Immunodeficiency diseases 2. Identify the Immune defect that gives rise to the pathogen 3. Discuss specific immunodeficiency diseases and iIdentify screening tests for these disorders 4. Discuss and differentiate : B-cell immunodeficiency: X-linked (Brutons) aggamaglobulinemia , Hyper IgM immunodeficiency, Common Variable Immunodeficiency ,IgA deficiency ,IgG Subclass deficiency 5. Discuss and differentiate Abnormal T cell activation and Infections: Fungi: Candida, Cryptococcus, Pneumocystitis; Viruses: CMV, H.simplex, Varicella; Mycobacterium, HIV and AIDS 6. Discuss and differentiae Primary Immune Deficiency : X-linked Agammaglobulinemia, Common Variable, Di George Syndrome, SCID, Wiskott-Adrich , Ataxia-Telangiectasia, Chediak-Higashi Syndrome, Hyper-IgE syndrome(Jobs syndrome), IFN gamma Receptor Deficiency 7. Identify phagocytic cell dysfunction infections and diseases
Lecturer
2:2
1/22/14
Angioedema Syndromes and Complement Deficiencies
Cecil; Pathophysiology; Primer of RD, Bates
Dr. Mitchell
2:2
1/22/14
Primary Immune Deficiency
Cecil; Pathophysiology; Primer of RD, Bates
Dr. Mitchell
185
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Review clinical presentation, pathophysiology, etiology and epidemiology 2. Discuss the clinical presentation, signs, symptoms, and physical exam findings 3. Identify triggers 4. Discuss the appropriate workup 5. Review pharmacologic treatment 6. Discuss the role of patient education and prevention guidelines 7. Review status asthmaticus 8. Discuss common allergies in the pediatric population 9. Recognize common physical findings 10. Discuss and differentiate allergic conjunctivitis, allergic sinusitis, and urticaria 1. Discuss the epidemiology of HIV in the world & USA 2. Review the HIV virus and how drugs work in HIV 3. Discuss HIV: signs, symptoms and risk factors for transmission 4. Discuss diagnosis and testing 5. Discuss how to prevent transmission 6. Differentiate HIV-infection and AIDS: acute infection, perinatal infection and infection in children 7. Identify the Aids Defining Conditions 1. Review principles of treatment 2. Identify appropriate treatment and markers 3. Discuss clinical presentation of Immunoreconstitution Inflammatory Syndrome in HIV 4. Discuss the Hyperallergic state in HIV 5. List HIV related malignancies 6. Discuss Wasting syndrome 7. Identify and review common opportunistic infections 8. Discuss prophylaxis and treatment of common opportunistic infections
Lecturer
2:2
1/22/14
Pediatric Asthma and Allergies
Cecil Pathophysiology Bates
Dr. Tahzib
2:2
1/22/14
HIV/AIDS (Part 1)
Cecil Pathophysiology Primer of RD Bates
Dr. Tahzib
2:2
1/22/14
HIV/AIDS (Part 2): Treatment and Opportunistic Infections
Damjanov, pp 80-84 Primer on Allergic and Immunologic Diseases, JACI Volume 111, no.2, Feb 2003 www.mosby.com/jaci CDC website NIH website Mayo Clinic website
Dr. Tahzib
186
Sem: Week
Date
Lecture Topic
Readings
Cecil Primer of RD Damjanov, pp 80-84 Primer on Allergic and Immunologic Diseases: the Journal of Allergy & Clinical Immunology Volume 111, No.2, February 2003 Textbook Immunobiology by Janeway (reference to immunologi concepts
Course Objectives
Lecturer
1. 2. 3. 4. 5.
2:2
1/22/14
Secondary Immune Deficiency
Discuss what constitutes Secondary Immuno-deficiencies, (SID) Identify the most common causes of SID Identify the most common clinical manifestations Discuss risk factors, prevention, diagnosis, and treatment Identify populations at risk
Dr. Tahzib
2:2
1/22/14
Inherited Disorders of Connective Tissue
Cecil, Primer of RD; Bates: Ch. 16, Table 16-1 to 10, Table 6-12; Damjanov, pp 228-229
1. 2. 3. 4. 5. 6. 7. 8.
1. 2.
2:3
1/29/14
Categorizing Arthritis: Intro to Rheumatology
Cecil Rheumatic Diseases Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 6-12
3. 4. 5. 6. 1. 2. 3. 4. 5. 6.
2:3
1/29/14
Osteoarthritis
Cecil; Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 6-12 Hoppenfeld
Discuss the characteristics and typical clinical features Review the pathophysiologic mechanisms Discuss diagnostic criteria Discuss treatment Differentiate: Marfans, Pseudoxanthoma elasticum, Ehlers Danlos Syndromes,Cutis laxa Differentiate: Osteogenesis Imperfecta, osteochondrosysplasia Discuss Primary & Secondary Amyloidosis Differentiate: Glycosaminoglycan Storage, Gaucher, TaySachs, Fabry, Primary & Secondary Amyloidosis, Mucopolysaccharidosis Discuss nomenclature and define terminology Explain how to take an appropriate history and identify classic physical exam findings Discuss pathobiology Discuss laboratory evaluation Differentiate characteristics of Rheumatoid Arthritis and Osteoarthritis Discuss Connective Tissue Disease spectrums Define Osteoarthritis ,OA Discuss epidemiology and pathobiology Discuss the symptoms, clinical manifestations and physical exam findings Identify radiologic findings Discuss how to diagnose Discuss management
Dr. Paras
Dr. Forman
Dr. Forman Dr. Harris
187
Sem: Week
Date
Lecture Topic
Readings
1. CecilMedicine,23 edition, chapter 293, 342,343,313. Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 6-12
rd
Course Objectives
Discuss the presentation, evaluation and treatment of septic arthritis Identify and discuss the Jones Criteria for Rheumatic Fever Discuss the presentation, evaluation and treatment of Lyme disease Discuss the presentation, evaluation and treatment of Discitis and Osteomyelitis
Lecturer
2:3
1/29/14
Septic Arthritis
2. 3. 4.
Dr. Harris
2:3
1/29/14
Septic Arthritis and Reactive Arthritis Due to Infection 1. 2. 3. 4. 5. 6. Discuss definitions and disease spectrum Discuss risk factors, epidemiology and pathobiology Discuss the clinical manifestations and physical exam findings Discuss laboratory findings and diagnosis Discuss complications, prognosis and management Differentiate: SLE, Drug induced Lupus, Neonatal Lupus, Raynauds phenomenon, Scleroderma, Limited Scleroderma, Dermatomyositis, Polymyositis, Sjogrens Syndrome ; Undifferentiated Connective Tissue Diseases vs. Mixed Connective Tissue Diseases Define rheumatoid arthritis ,RA Discuss epidemiology, etiology ,pathogenesis and immunopathogenesis Discuss the classification criteria Discuss the symptoms, clinical manifestations and classic physical exam findings Differentiate osteoarthritis and RA Discuss laboratory tests and radiographic findings Review extra-articular manifestations Discuss prognosis and management Review DMARDS and biologic agents Discuss nomenclature, synonyms and terminology Discuss the ACR Classification for the diagnosis of JIA Review the differential diagnosis Identify the characteristics of chronic arthritis by onset Discuss the JIA subtypes: Systemic Onset, Pauciarticular (oligoarticular), Subtype I, Pauciarticular Disease II (older, Juvenile Spondyloarthropathy) , Pauciarticular Subtype III (Psoriatic Arthritis ), Polyarticular Onset Juvenile Spondylitis (RF negative) and Polyarticular onset ( RF positive ) Discuss the clinical presentation and physical exam finings Discuss laboratory tests Discuss course, prognosis and management
Dr. Harris
2:3
1/29/14
Connective Tissue Diseases
Cecil Medicine, 23rd edition Chapter 280, 288,289; Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 6-12
Dr. Forman
1. 2. 3. 4. 5. 6. 7. 8. 9.
1. 2. 3. 4. 5.
2:3
1/29/14
Rheumatoid Arthritis
Cecil; Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 6-12 Hoppenfeld
Dr. Forman
2:3
1/29/14
Juvenile Idiopathic Arthritis
Cecil; Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 6-12
Dr. Forman
6. 7. 8.
188
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3. 4. 5. 6.
Course Objectives
Define and discuss spondyloarthropathies Review the pathophysiology, etiology and genetics Discuss the clinical manifestations and physical exam findings Discuss the major characteristics Discuss laboratory evaluation and imaging findings Differentiate Ankylosing Spondylitis ,Psoriatic Arthritis, Reactive Arthritis, Enteropathic Arthritis, Juvenile Ankylosing Spondylitis 7. Discuss management 1. Discuss hyperuricemia, pathogenesis and Gout 2. Discuss the clinical course of classical gout and its management 3. Discuss Calcium Pyrophosphate Deposition Disease (CPPD, chondrocalcinosis, Psuedogout) 4. Differentiate gout, pseudogout and septic joint 5. Identify populations at risk for each 6. Discuss the clinical manifestations and physical exam findings 7. Discuss laboratory evaluation and clinical diagnosis 8. Discuss prognosis and prevention 9. Discuss the principles of pharmacological management 10. Discuss pathogenesis of other crystals 1. Discuss the general pathophysiology of vasculitis 2. Identify the major classification of vasculitis syndromes 3. Discuss the major clinical features of the vasculitis syndromes 4. Discuss the general treatment guidelines for the major clinical vasculitis syndromes 5. Differentiate: Large vessel: Takayasus arteritis, Temporal arteritis /Giant Cell; Medium/small vessel: Polyarteritis Nodosa, Churg-Strauss Syndrome, Wegeners. 6. Differentiate Small vessel: Granulomatosis, Microscopic polyarteritis, , Henoch-Schonlein Purpura, Cutaneous Leukocytoclastic Angitis, Urticarial Vasculitis, Cryoglobulinemia 7. Discuss Panniculitis,Erythema Nodosum ,Behcets disease 1. Recognize FM as a syndrome 2. Recognize the concomitant symptoms and conditions 3. Review the physiologic basis of central sensitization in processing pain 4. Discuss the diagnostic criteria 5. Discuss pharmacologic and non-pharmacologic treatment strategies
Lecturer
2:3
1/29/14
Seronegative Arthritis: Ankylosing Spondylitis, Reactive Arthritis, Psoriatic Arthritis
Cecil chapter 286 Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 6-12
Dr. Forman
2:3
1/29/14
Crystal Diseases
Cecil; Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 612
Dr. Forman
2:3
1/29/14
Systemic Vasculitides
Cecil chaoter 291, 292, Primer of RD; Bates: Ch. 16, Table 16-1 to 16-10, Table 6-12
Dr. Forman
2:3
1/29/14
Fibromyalgia: TUNevada on iTunes
Cecil, Primer of RD; Bates: Ch. 16, Table 16-1 to 10, Table 6-12; Damjanov, pp 228-229
Dr. Forman
2:4
2/3/14
Dermatology and Rheumatology/Immunology Exam
189
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3.
Course Objectives
Review the process of erythropoiesis and the production and function of erythropoietin (EPO) Review the growth and differetnitaion factors for the development of red and white blood cell lineages Understand the indications for ordering a complete blood cell count (CBC), white cell differential, peripheral blood smear (PBS), iron studies and hemoglobin electrophoresis Identify certain variables that can affect certain hematologic test results Discuss the significance of the reticulocyte count and the corrected reticulocyte count Evaluate and interpret complete blood cell count (CBC), white cell differential, and peripheral blood smear (PBS) associated with certain red cell disorders Illustrate the physiologic compensatory mechanisms that enhance oxygen delivery to tissues and associate some of these mechanisms with the clinical signs and symptoms of anemia Distinguish extramedullary and accelerated forms of hematopoiesis Review normal and abnormal bone marrow biopsies & peripheral blood smears Recognize the etiologies and underlying pathophysiologic mechanisms of anemia Define & distinguish intrinsic and extrinsic anemia Define & distinguish intravascular and extravascular hemolysis Distinguish anemia based upon morphologic and etiologic classifications and provide examples Recognize and analyze diagnostic lab tests for anemia workup Discuss the role of the spleen in the removal of old/abnormal red blood cells Discuss the pathophysiology and morphology of aplastic anemia
Lecturer
2:4
2/5/14
Intro to Lab Medicine
Cecil; Pathophysiology: Ch1 and Ch6; Lecture material from PD II
4. 5.
Dr. Bahri
1.
2. 3.
2:4
2/5/14
Overview Of Anemias
Dr. Bahri
4. 5.
190
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Classify the etiology of hemolytic anemia into red cell hemoglobin, membrane, and metabolic disorders 2. Compare and contrast the pathogenic mechanisms, clinical manifestations, and laboratory findings of 3. intravascular and extravascular hemolysis 4. Recognize and analyze diagnostic laboratory tests for hemolytic anemia work-up Evaluate the utilization of the Coombs (anti-globulin) test in the work-up of hemolytic anemia Distinguish between direct and indirect Coombs test 1. Understand the pathogenic mechanism of immune hemolytic anemias Recognize the role of IgG and IgM antibodies in hemolytic anemia 2. Distinguish between the etiology, lab work-up, and clinical manifestations of warm and cold antibody immune hemolytic anemias 3. Distinguish between the pathogenic mechanisms of inherited and acquired hemolytic anemia (HA) Among the acquired HAs, distinguish from immune vs non-immune-mediated hemolytic anemias Evaluate the utilization of the direct and indirect Coombs test in the diagnosis of hemolytic anemias 1. Review the normal production of a- and b-globin chains 2. Define hemoglobinopathy and recognize the various types 3. Understand the genetic mutation of sickle cell disease and other hemoglobinopathies 4. Identify the mode of inheritance and the population(s) affected by sickle cell disease. 5. Distinguish between sickle cell disease and sickle cell trait 6. Recognize the screening and diagnostic tests for sickle cell disease 7. Recognize the signs, symptoms, complications, and treatment of sickle cell disease 1. Associate mutations in globin chain synthesis with a- and bthalassemia 2. Recognize and analyze diagnostic tests for thalassemia workup 3. Discuss the genetic mutation, laboratory diagnosis, and clinical features of alpha-, beta-thalassemia and trait 4. Distinguish between the pathogenesis and clinical features of hemoglobin Bart and hemoglobin H
Lecturer
2:4
2/5/14
Hemolytic Anemias
Dr. Bahri
2:4
2/5/14
Immune Hemolytic Anemias
Dr. Bahri
2:4
2/5/14
Sickle Cell Anemia
Dr. Bahri
2:4
2/5/14
Thalassemia
Dr. Bahri
191
Sem: Week
Date
Lecture Topic
Readings
1. G6PD, PK deficiencies: Chap165 pp 1208-1; Sideroblastic anemia: Chap 163 pp 1191-93l; Cecils Chap 170 pp 1231 (megaloblastic anemia). Damjanov: Pathophysiology Chap 6 pp 211-16 2. 3. 4. 5.
Course Objectives
Discuss the pathogenesis, epidemiology, laboratory findings, and clinical features of glucose-6-phosphate dehydrogenase deficiency (G6PD) Distinguish G6PD from pyruvate kinase deficiency Review the heme synthetic pathway and the role of the mitochondria in heme prophyrin synthesis and iron metabolism Discuss the pathogenesis, laboratory findings, and clinical features of sideroblastic anemia Distinguish between the etiology and lab evaluation of megaloblastic and non-megaloblastic types of macrocytic anemia Review the mechanism of folate and B12 absorption Evaluate the etiology and pathophysiologic mechanisms of megaloblastic anemia Recognize and analyze diagnostic tests for megaloblastic anemia work-up Distinguish between the clinical features and treatment of folate and B12 deficiency Review normal iron metabolism Discuss the pathogenesis, epidemiology, and clinical features of iron deficiency anemia Evaluate the criteria used for the diagnosis of iron deficiency anemia Discuss the pathogenesis and clinical features of lead poisoning Discuss the pathogenesis and clinical features of porphyria, anemia of chronic disease, and paroxysmal nocturnal hemoglobinuria Provide examples of underlying diseases associated with anemia of chronic disease Recognize and analyze diagnostic tests for iron deficiency anemia, anemia of chronic disease, paroxysmal nocturnal hemoglobinuria, and lead poisoning Discuss the pathogenesis and clinical features of anemia of chronic disease Provide examples of underlying diseases associated with anemia of chronic disease Recognize and analyze diagnostic tests for anemia of chronic disease
Lecturer
2:4
2/5/14
Glucose-6-Phosphate Deficiency, Sideroblastic Anemia
Dr. Bahri
1.
2:4
2/5/14
Megaloblastic Anemia
Cecil; Pathophysiology Chap 6 pp 211-216
2. 3. 4. 5. 1. 2. 3. 4.
Dr. Bahri
2:4
2/5/14
Iron Deficiency Anemia
Cecil; Pathophysiology Chap 6 pp 211-216
5.
Dr. Bahri
6. 7.
1.
2:4
2/5/14
Anemia of Chronic Disease
Cecil
2. 3.
Dr. Bahri
192
Sem: Week
Date
Lecture Topic
Readings
1. 2.
Course Objectives
Discuss the association of glycosylphosatidylinositol (GPI)anchoring proteins and complement-mediated lysis Discuss the genetic, clinical features, and complications of paroxysmal nocturnal hemoglobinuria (PNH) Evaluate the utilization of the serum haptoglobin, urobilinogen, serum lactase dehydrogenase, Ham test, and sucrose hemolysis test in the assessment of paroxysmal nocturnal hemoglobinuria Discuss the etiology of DIC and provide examples of common underlying causes Evaluate the pathophysiology of bleeding, thrombosis, and ischemia and associate the with clinical manifestations of DIC Recognize and analyze diagnostic tests for DIC work-up and diagnosis Discuss the treatment of DIC Review the process of hemostasis and the production and function of platelets Evaluate the utilization of the complete blood count (CBC) and peripheral blood smear (PBS) in assessment of platelet disorders Understand the indications for ordering hemostatic, coagulation, and fibrinolytic system tests Recognize and interpret laboratory findings associated with certain hemostatic disorders: Hemophilia, ITP, TTP, Thrombocytopenia Discuss the etiology/ pathogenesis, clinical manifestations, and diagnostic lab work-up of Hemophilia, von Willebrand disease, ITP, and TTP Explain the causes of thrombocytopenia and platelet dysfunction Discuss the etiology of leukocytosis and provide examples Distinguish between neutrophilia, monocytosis, eosinophilia, and lymphocytosis Discuss the etiology of lymphadenopathy and provide examples List factors/considerations important in the evaluation of lymphadenopathy Describe methods of lymph node evaluation Apply lymph node evaluation in Hodgkin disease and Cat scratch disease Describe the patient management and therapy for Cat scratch disease
Lecturer
2:5
2/12/14
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Cecil
3.
Dr. Bahri
1. Disseminated Intravascular Coagulopathy (DIC) Cecil Damjanov, pp 80, 230 Damjanov Lecture material from PD II 2. 3. 4. 1. 2.
2:5
2/12/14
Dr. Bahri
2:5
2/12/14
Lab Medicine :Bleeding Disorders
Cecil Damjanov chapter 1 and chapter 6 Lecture material from PD II
3. 4. 5. 1.
Dr. Bahri
2:5
2/12/14
Bleeding Disorders
Cecil Damjanov chapter 1 and chapter 6 Lecture material from PD II
Dr. Bahri
2. 1. 2. 3.
2:5
2/12/14
Leukocytosis, Lymphadenopathy
Cecil
4. 5. 6.
Dr. Bahri
193
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Discuss the genetics, epidemiology, risk factors, pathogenesis, and clinical features of acute myelogenous leukemia (AML) 2. Recognize some common cytogenetic abnormalities associated with AML 3. Review the classifications of AML 4. Discuss the treatment and prognosis of certain AML types 1. Discuss major subtypes of T and B cell and NK/ NK-T cell neoplasms in lymph nodes 2. Differentiate :Follicular, Diffuse Large B cell, Mantle Cell, Burkitts , Peripheral T-cell, Anaplastic Large Cell, Myosis Fungoides 3. Discuss etiology and exposures associated with increased risk 4. Discuss the clinical presentation 5. Identify and discuss the appropriate evaluation including biopsy, markers, immunohistochemical staining 6. Discuss treatment and prognosis 1. Discuss Hodgkins Disease, HD-classification, features and workup 2. Review staging and diagnosis 3. Review the clinical presentation 4. Discuss principles of treatment 5. Identify secondary malignancies and other complications 6. Discuss Multiple Myeloma, MM 7. Distinguish clinical forms (MM, solitary plasmacytoma, plasma cell leukemia) 8. Discuss the clinical manifestations and symptoms 9. Discuss workup and diagnostic criteria 10. Discuss treatment and supportive therapy 11. Discuss prognosis 12. Discuss Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia ,SLL/CLL
Lecturer
2:5
2/12/14
Intro to Acute Myelogenous Leukemia (AML)
Cecil
Dr. Bahri
2:6
2/19/14
Lymphoid Malignancies Part 1
Cecil Damjanov, Chapter 6
Dr. Zain
2:6
2/19/14
Lymphoid Malignancies Part 2
Dr. Zain
194
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3.
Course Objectives
Discuss the classification of myeloid neoplasms Review how to identify acute leukemias Discuss Acute Myeloid Leukemia ,AML- the clinical presentation, characteristics and workup 4. Discuss AML -classification, surface markers, subtypes, and predisposing causes 5. Discuss AML -management, treatment, relapse and prognosis 6. Discuss Acute Lymphoblastic Leukemia, ALL-FAB and WHO classification, subtypes and immunologic classification of BALL and T-ALL 7. Discuss the clinical presentation and evaluation 8. Discuss ALL -principles of therapy, CNS prophylaxis and prognostic features 1. Discuss Myelodysplastic Syndrome, MDS- etiology, diagnostic criteria, and work-up 2. Identify cytogenetics and blood and marrow findings 3. Identify risks 4. Discuss management goals and treatment options 5. Discuss 5 q- syndrome 6. Discuss Myeloproliferative Syndromes ,MPS- classic and nonclassic: discuss the clinical features, symptoms and mutations 7. Discuss Chronic Myeloid Leukemia ,CML- clinical presentation and course 8. Discuss CML workup and treatment 9. Discuss stem cell transplant and complications 10. Discuss Polycythemia Vera, PCV- clinical presentation, workup and treatment 11. Discuss Essential Thrombocythemia, ET-clinical presentation, diagnostic algorithm and treatment 12. Discuss Primary Myelofibrosis - diagnostic algorithm, characteristics and treatment
Lecturer
2:6
2/19/14
Myeloid Malignancies Part 1
Dr. Zain
2:6
2/19/14
Myeloid Malignancies Part 2 (MDS,MPS ,CML, PCV)
Dr. Zain
195
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3. 4.
Course Objectives
Recognize basic principles of cancerogenesis of cancers of head and neck Identify the risk factors for the development of head and neck cancers Recognize the presenting signs, symptoms and expected physical exam findings of specific head and neck cancers Discuss the approach and workup for specific head and neck cancers Discuss the appropriate treatment of each specific head and neck cancer Discuss the complications of cancers of the head and neck Review esophageal cancers- risk factors, etiology, presentation, workup, treatment and complications Review thyroid cancers -risk factors, etiology, presentation, workup, treatment and follow up management Discuss the symptoms, causes, clinical presentation, work up and basic management of Superior Vena Cava syndrome Identify malignancies associated with SVC Discuss the symptoms, clinical presentation, work up and basic management of Hypercalcemia of malignancy Identify the types of hypercalcemia associated with malignancies Discuss the symptoms, clinical presentation, cause, work up and basic management of Cord compression Identify malignancies associated with Cord compression Discuss the symptoms, clinical presentation, symptoms, work up and basic management of Tumor lysis syndrome Identify malignancies and complications associated with TLS
Lecturer
2:6
2/19/14
Head & Neck Cancer
Cecil
5. 6. 7. 8. 1. 2. 3. 4.
Dr. Krichmar
2:6
2/19/14
Oncologic Emergencies
Cecil
5. 6. 7. 8.
Dr. Krichmar
2:7
2/24/14
Hematology Exam
196
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Cancer intro & statistics: Review the epidemiology, incidence, mortality, and survival of cancers among adults and children in the US and the world Cancer genetics: Discuss cancer as an inherited or acquired from a somatic cell disorder Review the significance of cell cycle, apoptosis, tumor suppressor genes, oncogenes, DNA repair genes Review some common cytogenetic changes in cells (i.e. translocations, gain, deletion, amplification) Review inherited familial cancer disorders (i.e. FPC, HNPCC, BRCA1/BRCA2) Oncologic diagnosis & therapy: Discuss the translation of medical knowledge gained in cancer genetics research in the clinical diagnosis and the utilization of cancer therapy Recognize the use of cytogenetic studies, FISH, Immunohistochemical stain, Her2-neu, and BRCA1/BRCA2 Recognize the genetic etiology and clinical manifestations of childhood tumors: Retinoblastoma, Burkitts Evaluate the patients family history, risk factors, and screening for breast, prostate, and testicular cancer Discuss the diagnostic tests and techniques for breast, prostate, and testicular cancer Understand the use of BRCA1 & BRCA2, serum PSA , AFP and HCG, ultrasound, and biopsies Recognize tumor types/morphology Understand progression of hyperplastic /dysplastic epithelium as precursors to malignant lesion (breast, prostate) Distinguish between ductal and lobular types of breast carcinoma, insitu vs. infiltrating types, inflammatory type vs. Pagets disease Discuss tumor staging, prognosis, and therapy of breast, prostate, and testicular cancer Review key prognostic factors (Her2/neu, and ER/PR positivity) in breast cancer Understand Gleasons grade for prostate carcinoma (prognosis & Tx) Prognosis of seminomatous vs. nonseminomatous testicular cancer
Lecturer
2.
2:7
2/26/14
Intro to Cancer Genetics and Childhood Cancers
Cecil 3.
Dr. Bahri
4. 1. 2.
3.
2:7
2/26/14
Breast & Prostate and Testicular Cancers
Cecil
Dr. Bahri
4.
5.
197
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Discuss the epidemiology, risk factors, pathogenesis, and some clinical manifestations of inherited and acquired colorectal carcinomas Discuss the epidemiology, risk factors, pathogenesis, and clinical manifestations of lung and bronchial carcinomas, and lung metastasis Explain the clinical significance of grouping lung carcinomas as small versus non-small cell carcinomas Distinguish the clinical features of local spread and paraneoplastic syndrome associated with lung carcinomas Review the staging of colorectal and lung carcinomas Recognize premalignant and malignant squamous cell carcinoma Recognize key tumors of the vulva, vaginal, cervix, uterus, and ovary Understand precursor lesions of squamous cell carcinoma and adenocarcinoma (intraepithelial lesions) Discuss cancers: vulva, vaginal, cervix, uterus (endometrial cancer), ovary: cystadenocarcinoma, dysgerminoma; metastatic to ovary, choriocarcinoma; penis- squamous cell carcinoma; testicular: seminoma, embryonal, choriocarcinoma, yolk-sac tumor teratoma; sex chord: Leydig cell tumor; testicular lymphoma, scrotal squmaous cell carcinoma; prostate Discuss the approach to the headache patient Distinguish primary from secondary headaches List and distinguish the 3 most common types of primary headache List and discuss causes of secondary headaches Discuss and recognize the importance of identifying red flags in the history and physical exam in patients with secondary headaches Discuss common, evidence-based treatments Discuss other types of headaches Discuss and differentiate the clinical presentation of: acute migraine, cluster, tension headache, temporal arteritis, chronic daily headache, Trigeminal neuralgia, atypical facial pain, temporomandibular disorders, pseudotumor cerebri, subarachnoid hemorrhage, low ICP, infectious, intracranial tumors, meningiomas
Lecturer
2.
2:7
2/26/14
GI and Lung Cancers
Cecil 3. 4. 5. 1. 2. 3.
Dr. Bahri
2:7
2/26/14
Gyn Cancers; Penile Testicular
Cecil
Dr. Bahri
2:8
3/3/14
Oncology Exam 1. 2. 3. 4. 5.
2:8
3/5/14
Headache
Cecil; Bates: Tables 7-1 and 7-2; Pathophysiology, headache pp 4648
6. 7. 8.
Dr. Carcione
198
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3. 4. 5. 6.
Course Objectives
Define syncope Discuss the classification and causes of True syncope Review the history and physical exam and initial evaluation Discuss the work up Discuss management /treatment Discuss the importance of recognizing Carotid sinus syndrome and Carotid Sinus Hypersensitivity related to falls in the elderly Discuss specific conditions: cardiac arrhythmias, structural cardiopulmonary problems, Vasovagal syncope (VVS), Carotid sinus syndrome (CSS), orthostatic hypotension, and situational syncope Discuss dizziness Define vertigo Describe the differences between central & peripheral vertigo Discuss key elements of the clinical examination Discuss the relevance of specific elements in the history Discuss treatment options Review the pathophysiology of MS Discuss risk factors Discuss the clinical manifestations, presentation and common symptoms Discuss the diagnostic criteria Discuss treatment Discuss common hypo and hyperkinetic movement disorders Describe the characteristic clinical presentation of each: Parkinsons, Parkinsons Plus syndromes, Tremor, Dystonia, Myoclonus, Chorea, Tics, Akathisia, Stereotypy, Restless Leg Syndrome Review pathophsyiology Discuss the differential diagnosis and workup Discuss treatment
Lecturer
2:8
3/5/14
Syncope
Cecil Bates: Table 17-2 Damjanov pp55-58
Dr. Carcione
7.
2:8
3/5/14
Dizziness and Vertigo
Cecil Bates: Table 17-2 Damjanov pp55-58
2:8
3/5/14
Multiple Sclerosis
Cecil .Damjanov, Bates: Table 17-410, 17-8 to 17-10, pg. 702, 672
1. 2. 3. 4. 5. 6. 1. 2. 3. 4. 5. 1. 2.
Dr. Carcione
Dr. Carcione
2:8
3/5/14
Movement Disorders
Cecil Bates: Tables 17-4, 17-5 Damjanov, pp 52-54
Dr. Carcione
3. 4. 5.
199
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Discuss a rational approach to a patient with altered mental status 2. Describe levels of arousal 3. Review pathophysiology 4. Discuss signs and symptoms of increased intracranial pressure ,ICP 5. Be aware of the importance of identifying increased IPC 6. List and describe the components of the neurological exam in a comatose patient 7. Review significance of specific findings on the neurological exam 8. Discuss herniation syndromes 9. Discuss decorticate and decerebrate posturing 10. Discuss various etiologies for altered mental status 1. Define coma 2. Discuss classification 3. Discuss the differential diagnosis , evaluation , management and treatment 4. Review pupil abnormalities 5. Discuss decorticate and decerebrite posture 6. Discuss infratentorial lesions, metabolic vs. structural causes, and differentiating features 7. Discuss increased intracranial pressure 8. Discuss Glasgow Coma 1. Discuss clinical presentation, risk factors, work up and management of Acute CNS infections 2. Review the clinical presentation, differential diagnosis, pathophysiology, and treatment of Meningitis , Encephalitis and Brain Abscess 3. Distinguish Bacterial , viral and fungal meningitis 4. Describe the clinical presentation of encephalitis and meningitis 5. Discuss etiology 6. Discuss how to interpret lumbar puncture fluid analysis 7. Discuss diagnosis and identify appropriate treatment 1. Differentiate seizure , epilepsy , and status epilepticus 2. Review the classification and types of seizures 3. Discuss characteristics and clinical presentation of each 4. Discuss the diagnostic evaluation 5. Identify treatment
Lecturer
2:8
3/5/14
Altered Mental Status
Cecil; Bates Guide to Physical TH Examination, 10 edition. Ch 17, Tables 17-5, 17-11 metabolic and structural coma, 17-12 pupils in comatose, 17-13 abnormal posture in comatose; Pgs 702-710; Damjanov ,pp. 57-58
Dr. Carcione
2:8
3/5/14
Coma
Cecil; Bates Guide to Physical TH Examination, 10 edition. Ch 17, Tables 17-5, 17-11 metabolic and structural coma, 17-12 pupils in comatose, 17-13 abnormal posture in comatose; Pgs 702-710; Damjanov ,pp. 57-58
Dr. Carcione
2:9
3/12/14
CNS Infections
Cecil Bates:
Pg. 702
Dr. Carcione Dr. Paras
2:9
3/12/14
Adult Seizures
Cecil Bates: Table 17-3
Dr. Carcione
200
Sem: Week
Date
Lecture Topic
Readings
2. 3. 4. 5. 6. 7. 8. 1. 2. 3. 4. 5. 6.
Course Objectives
1. Discuss stroke Review the pathological process Define the different types of stroke Describe how stroke manifests Discuss the distributions of stroke Discuss the classification and diagnosis of stroke Identify stroke treatments Identify stroke prevention Review cerebrovascular anatomy Define stroke, TIA, Stroke in evolution Review types: Ischemic (thrombosis and emboli) and Hemorrhagic (intracerebral and subarachnoid) Identify risk factors for stroke Identify the clinical anatomical correlate Distinguish effects of stroke for each vessel :Middle Cerebral Artery (Superior, Inferior, Lenticulostriate, right vs. left side); Anterior Cerebral Artery, Posterior Cerebral Artery, Internal Carotid ; Vertebral-basilar (Anterior Cerebellar, Posterior Inferior Cerebellar Artery, anterior, posterior ); Hemorrhagic Review the physical exam Discuss the appropriate diagnostic work up Discuss common neuromuscular disorders Review sensory and motor signs and symptoms Review reflexes Discuss nerve pathologies and causes of nerve injuries Review anatomy Identify diagnostic modalities Identify and describe each of the components of the Neurologic exam Discuss upper and lower motor neuron lesions Review segmental reflex innervation Discuss abnormal findings Identify and discuss pain and sensory and motor deficits with nerve root involvement
Lecturer
2:9
3/12/14
Stroke Part I
Cecil Bates
Dr. Carcione
2:9
3/12/14
Stroke Part II
Cecil Bates
TBD
2:9
3/12/14
Neuromuscular Disease Part 1: Introductory Concepts
Cecil, Bates: Tables 17-8, 17-9, pgs. 678, -704, Ch 6 Hoppenfeld Damjanov, pp 50-54 Physical Diagnosis Lecture & Lab
7. 8. 1. 2. 3. 4. 5. 6. 1. 2. 3. 4. 5.
Dr. Carcione
2:9
3/12/14
The Neurologic Exam Review
Dr. Carcione
201
Sem: Week
Date
Lecture Topic
Readings
Cecil Bates: Tables 17-8, 17-9, pgs. 678, -704, Ch 6 Hoppenfeld Damjanov, pp 50-54 Physical Diagnosis Lecture and Lab: Geriatrics 1. 2. 3.
Course Objectives
List and describe how to evaluate patients for dementia Discuss changes in vital signs Describe normal and abnormal changes in gait in the geriatric patient 4. Describe normal and abnormal findings on the neurologic exam of the geriatric patient 5. Explain how to evaluate for balance in the geriatric patient 6. List motor and sensory changes in the geriatric patient 7. Discuss differential diagnosis of abnormal gait and abnormal balance 1. Discuss common motor neuron diseases 2. Distinguish : Amyotrophic Lateral Sclerosis (ALS),Progressive bulbar palsy (PBP),Progressive muscular atrophy PMA), Spinal muscular atrophy (SMA), Primary lateral sclerosis 3. Discuss polyneuropathies 4. Discuss Guillain-Barrre syndrome 5. Distinguish common peripheral neuropathies acute, subacte and chronic 6. Discuss Diabetic Polyneuropathy 7. Review the clinical presentation and course 8. Discuss the diagnostic approach 9. Review etiology and pathophsyiology 10. Review anatomy 11. Discuss treatment 1. Discuss chronic inflammatory demyelinating neuropathy 2. Discuss the clinical presentations and etiology of polyneuropathies (nutritional, vascultitc neuropathies , toxic, organophosphate ,drug induced, anti-neoplastic agents ) 3. Discuss Leprosy 4. Discuss neuropathies in HIV 5. Discuss hereditary neuropathies 1. Discuss common myopathies 2. Discuss the clinical manifestations, etiology, evaluation and classification 3. Distinguish Polymyositis vs. Dermatomyositis 4. Discuss parasitic myopathies and Polymyalgia rheumatica (PMR) 5. Distinguish Duchennes Muscular Dystrophy, Facioscapulohumeral, Scapuloperoneal, Limb Girdle, Congenital
Lecturer
2:9
3/12/14
The Neuromuscular Exam for Geriatrics
TBD
2:9
3/12/14
Neuromuscular Disease Part 2
Dr. Carcione
2:9
3/12/14
Neuromuscular Disease Part 3: Demyelinating diseases
Dr. Carcione
2:9
3/12/14
Neuromuscular Disease Part 4: Myopathies and Focal Entrapment Syndromes
Dr. Carcione
202
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Review functional anatomy of the Facial nerve/ cranial nerve VII Discuss Bells palsy Distinguish central vs. peripheral palsy Review clinical features and etiology Discuss the differential diagnosis and investigational work up Discuss management and complications Discuss neuromuscular junction disorders Distinguish Pre-synaptic (Lambert Eaton myasthenic syndrome and Botulism) and Post-synaptic (Myasthenia Gravis) neuromuscular junction disorders Discuss the clinical presentation, etiology, work up and treatment Review pathophysiology Discuss myasthenic crisis and cholinergic crisis Review normal sleep cycle Discuss changes in sleep that occur in older adults Discuss narcolepsy Review sleep apnea Review basic bone physiology Discuss the definition, epidemiology, pathobiology, and clinical manifestations of Pagets Disease Discuss the definition, epidemiology, pathobiology, and clinical manifestations of Osteoporosis Identify risk factors Discuss the diagnostic work up Identify treatment Review primary and secondary causes of osteoporosis Discuss prevention and treatment of osteoporosis Define and identify types of fractures: simple, comminuted, closed, open/ compound displaced, non-displaced, transverse, Greenstick, buckle, stress, Healing fractures, Nonunion fractures Discuss the symptoms of fractures Discuss causes of fractures Review diagnostic imaging Discuss treatment Discuss common complications Discuss the presentation, differential diagnosis, pathophysiology and treatment of Osteomalacia and Renal osteodystrophy
Lecturer
2:9
3/12/14
Neuromuscular Disease Part 5: Facial Pain
2. 3. 4. 5. 6. 1. 2.
2:9
3/12/14
Neuromuscular Disease Part 6: Neuromuscular junction disorders
3. 4. 5. 1. 2. 3. 4. 1. 2. 3.
Dr. Carcione
2:9
3/12/14
Sleep Disorders
Cecil;Bates:Tables 17-4, 17-5; Damjanov, pp 52-54
Dr. Carcione
2:10
3/19/14
Disorders of Bone Structure
4. 5. 6. 7. 8. 1.
Dr. Paras
2:10
3/19/14
Fractures
Cecil
2. 3. 4. 5. 6. 7.
TBD
203
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3. 4. 5.
Course Objectives
Discuss the characteristics and clinical presentation of common sports related injuries Review anatomy and pathophysiology Discuss physical exam findings, appropriate evaluation and diagnostic imaging Discuss treatment Discuss the following: Common spine problmes : spondylosis, spondylolisthesis, and herniated discs Common shoulder injuries : Erbs Palsy, Rotator Cuff Tear, Bursitis, Tendonitis, Adhesive capsulitis Common elbow injuries: Medial epicondylitis, lateral epicondylitis Common hip injuries: Avascular Necrosis of the Hip, Legs-Calves-Perthes Disease, Trochanteric Bursitis, SCFE Common knee injuries: Anterior Cruciate Ligament (ACL) tear , Medial meniscus tear , Pre-Patellar Bursitis, Chondromalacia Patella Common ankle injuries : Ankle-sprain, ATF tear Common wrist injuries: carpal tunnel syndrome, Dupuytrens contracture Discuss head trauma, loss of consciousness and concussion Review the categories of ankle/foot disorders Review the diagnostic approach including physical exam, anatomy, and radiographic assistance Discuss the various treatment modalities Discuss suturing and types of sutures Discuss simple incision and drainage Discuss joint aspiration: hip, knee, shoulder Discuss treatment of common fractures Discuss common joint replacements: hip, knee, shoulder List and discuss common upper extremity fractures List and discuss common lower extremity fractures Discuss spine fractures
Lecturer
2:10
3/19/14
Common Sports Related Injuries
Cecil Bates Hoppenfeld OMM
Dr. Paras
2:10
3/19/14
Disorders of the Foot and Ankle
6. 1. 2. 3. 1. 2. 3. 4. 5. 6. 7. 8.
Dr. Harris
2:10
3/19/14
General Surgery/Orthopedics
TBD
204
Sem: Week
Date
Lecture Topic
Readings
1. 2.
Course Objectives
Define List and discuss types of head injuries : concussion, loss of consciousness, brain contusion , skull fracture, intracranial hematoma, scalp and facial hematoma Discuss symptoms Discuss appropriate evaluation and work up Discuss treatment Identify complications Discuss prevention Review types, location , etiology and risk factors Discuss the clinical presentation Define and discuss generalized symptoms and lateralizing symptoms Discuss the appropriate evaluation Identify management and complications Discuss and distinguish: Meningioma, Acoustic neuromas, Vestibular Schwannoma, Pituitary adenoma, Craniopharyngiomas, Cerebellar hemangioblastomas, Gliomas, Glioblastoma, Malignant astrocytoma Medulloblastomas, Oligodendroglioma Discuss CNS lymphoma and metastatic disease Discuss common pediatric brain tumors Medulloblastomas, Neuroblastomas Describe the classification of pediatric seizures Discuss how to obtain an appropriate history Review physical exam findings Discuss the clinical presentation, differential diagnosis and work up Differentiate the presentation of Generalized seizures: Convulsive: tonic-clonic seizures and Non-convulsive: absence seizures, Partial seizures: Simple: no impaired consciousness and Complex: impaired consciousness Differentiate :Neonatal seizures, Benign childhood epilepsy (Rolandic), Infantile spasms (West syndrome) Lennox-Gastaut syndrome, Atonic seizures, Febrile seizures, Status Epilepticus Identify treatment
Lecturer
2:10
3/19/14
Traumatic Brain Injury
3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6.
TBD
2:10
3/19/14
Brain Tumors
Cecil Pathology lectures
TBD
7. 8. 1. 2. 3. 4. Cecil Bates: Table 17-3 Nelsons 5.
2:11
3/26/14
Pediatric Seizures
Dr. OheneFianko
6.
7.
205
Sem: Week
Date
Lecture Topic
Readings
1. Cecil Bates: Table 17-3 Nelsons Hoppenfeld 2. 3. 4. 1. 2. 3. 4. 5.
Course Objectives
Review autism: classic presentation, possible risk factors, prognosis and treatment Review ADHD: classic presentation, possible risk factors ,prognosis and treatment Review Lesch Nyhan :classic presentation, etiology and treatment Discuss childhood headaches :clinical presentation, causes and treatment Review the normal growth and development of pediatric bone growth Define terminologies for deviations of bone growth Discuss the evaluation-history and physical exam of pediatric orthopedic problems Differentiate common types of fractures Discuss the etiology, clinical presentation, and how to diagnose and treat: Torticollis, Developmental Dysplasia of the hip, Common fractures in children, Toxic synovitis, Osteomyelitis, Osgood-Schlatter disease, Nursemaids elbow,Talipes equinovarus (club foot), Rickets,Genu varus (bow legged),Slipped capital femoral epiphysis Discuss the neuro-ophthalmic history and physical Differentiate pupil abnormalities: Marcus Gunn, Argyll Robertson, Aidie's, Horners syndrome etc. Review extraocular muscles Differentiate cranial nerve 3,4,6 palsies Discuss visual fields in bitemporal hemianopia, homonymous hemianopia, glaucoma Discuss the clinical presentations of thyroid eye disease and Myasthenia Gravis Discuss and differentiate causes of sudden vision lossAmorosis Fugax, Carotid disease, ocular ischemia Discuss the differential diagnosis of the Red Eye: trauma, chemical, - viral conjunctivitis, bacterial conjunctivitis, Herpes, allergic, uveitis, acute narrow angle glaucoma, corneal abrasion, thyroid disease, subconjunctival hemorrhage and pterygium
Lecturer
2:11
3/26/14
Pediatric Neurology, Behavior, and Headaches
Dr. OheneFianko
2:11
3/26/14
Pediatric Orthopedic Problems
Cecil Bates: Table 17-3 Nelsons Hoppenfeld
Dr. Kernis
1. 2. 3. 4. 5. 6. 7. Bates Guide to Physical Examination, 10th edition. Tables 7-5 to 7-18, 17-6, 17-7, Pgs 659, 672-678, 243-244 1.
2:11
3/26/14
Neuro ophthalmology Part I & II
Cecil Bates: Tables 7-5 to 7-18, 17-6, 17-7, Pgs 659, 672-678, 243-244
Dr. Sherman
2:11
3/26/14
General Ophthalmology Part 1
Dr. Sherman
206
Sem: Week
Date
Lecture Topic
Readings
1. 2. Bates Guide to Physical Examination, 10th edition. Tables 7-5 to 7-18, 17-6, 17-7, Pgs 659, 672-678, 243-244 3. 4. 5. 6. 7. 1.
Course Objectives
Differentiate scleritis, episcleritis and iritis Discuss and distinguish types of glaucoma : open angle and acute angle closure Recognize populations at risk for glaucoma Review the physical exam findings and visual field defects Describe the clinical presentation and causes of visual field defects Discuss treatment of glaucoma Describe the clinical presentation and causes of visual feild defects Discuss and differentiate the ophthalmologic manifestation of : Giant Cell Arteritis, optic neuritis, Multiple Sclerosis, papilledema, and migraines Discuss evaluation and treatment Discuss common pediatric ophthalmologic problems: strabismus and exotropia Discuss diabetic retinopathy and physical exam findings Discuss complications Review screening guidelines and goals Review changes in the aging eye: cataracts, ARMD Review risk factors and symptoms of ARMD Describe physical exam findings in ARMD Discuss treatment Discuss cataracts Review symptoms, risk factors and treatment Discuss common eye emergencies and injuries: corneal abrasion, foreign body, ruptured globe, hyphema, corneal ulcer and orbital fractures Review the clinical presentation Discuss the evaluation and treatment Discuss common nonsurgical and surgical conditions of the neck and throat Discuss how to evaluate and treat hoarseness, gastroesophageal reflux and laryngitis Discuss how to evaluate and treat recurrent tonsillitis Discuss laryngeal trauma , vocal cord paralysis and vocal cord nodules Discuss how to evaluate common neck masses Review how to evaluate and treat thyroid masses Discuss how to evaluate and treat parotid neoplasm Discuss disorders of the salivary glands
Lecturer
2:11
3/26/14
Dr. Sherman
2:11
3/26/14
Bates Guide to Physical Examination, 10th edition. Tables 7-5 to 7-18, 17-6, 17-7, Pgs 659, 672-678, 243-244
2. 3. 1. 2. 3. 4. 5. 6. 7. 8. 9. 1.
Dr. Sherman
2:11
3/26/14
Bates Guide to Physical Examination, 10th edition. Tables 7-5 to 7-18, 17-6, 17-7, Pgs 659, 672-678, 243-244 CS Endocrine Module Lecture: Diabetes
Dr. Sherman
2:11
3/26/14
Bates Guide to Physical Examination, 10th edition. Tables 7-5 to 7-18, 17-6, 17-7, Pgs 659, 672-678, 243-244
Dr. Sherman
2. 3. 1. 2.
2:11
3/26/14
Neck And Throat
Cecil; Bates Guide to Physical Examination, 10th edition CS Thyroid Endocrine Lecture
3. 4. 5. 6. 7. 8.
TBD
207
Sem: Week
Date
Lecture Topic
Readings
1.
Course Objectives
Discuss common nasal problems :epistaxis, obstruction, adenoid hypertrophy, foreign body, Choanal atresia, nasal polyps, deviated septum, hypertrophied turbinates 2. Discuss types of rhinitis: allergic, vasomotor, idiopathic, medicamentosa and atrophic 3. Discuss acute, chronic and recurrent sinusitis 4. Review the appropriate antibiotic treatment for each 5. List complications of sinusitis 6. Discuss pediatric sinusitis 7. Discuss the clinical presentation and management of nasal polyps and sinonasal tumors 8. Discuss surgical options 9. Discuss nasal trauma, fracture and complications 10. Discuss facial trauma and orbital fracture 1. Discuss initial survey 2. Discuss airway and cervical stabilization 3. Review level of consciousness 4. Discuss secondary survey 5. Discuss burns and fluid replacement 6. Discuss bites 1. 2. Review the normal menstrual cycle Define menstrual abnormalities , amenorrhea (Primary and Secondary), dysmenorrhea and dysfunctional uterine bleeding Discuss how to evaluate and manage these conditions Discuss the hormonal changes associated with both normal and abnormal menstrual bleeding Discuss amenorrhea and oligomenorrhea Differentiate: PCOS, Ashermans syndrome, Premature ovarian failure, dysfunctional uterine bleeding, Polymenorrhea, Menorrhagia , Metrorrhagia, Menometrorrhagia, Intermenstrual bleeding Discuss the manifestations of Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) Discuss the how to diagnose and magnate PMS and PMDD Define and discuss menopause, perimenopause and postmenopause Identify signs and symptoms Discuss common problmes in the postmenopausal patient Discuss current treatment options
Lecturer
2:11
3/26/14
Nose and Paranasal Sinuses
Cecil; Bates Guide to Physical Examination, 10th edition
TBD
2:11
3/26/14
Emergency Medicine Serious Injury
Cecil; Bates Guide to Physical Examination, 10th edition
TBD
2:12
3/31/14
Neuromuscular Medicine Exam
2:12
4/2/14
Menstrual Cycle
Cecil Hacker and Moore 5TH Ed. pp 34-42,256-258,355-370
3. 4. 5. 6.
Dr. Haynes
1. 2. 3. 4. 5. 6.
2:12
4/2/14
PMS, PMDD, Menopause and HRT
Cecil Hacker and Moore
Dr. Haynes
208
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3. 4. 5. 6. 7.
Course Objectives
Review the pathogenesis of endometriosis Discuss the clinical presentation, signs and symptoms of endometriosis Discuss appropriate evaluation and diagnostic imaging Discuss management /treatment options Discuss causes of acute and chronic pelvic pain Discuss the appropriate assessment and management of patients with chronic pelvic pain Discuss the clinical presentation and work up for the following causes of pelvic pain: Mittelschmerz, P.I.D., DysmenorrheaPrimary/Secondary; Adnexal mass/bleeding/growth/torsion, Ectopic pregnancy, Endometriosis/Adenomyosis, Uterine fibroids/growth/degeneration Review the basic embryologic development of female genital organs Describe how anomalies of the genital organs develop Discuss some of the basic abnormal clinical conditions: Urethral diverticula, Inclusion cysts, Bartholins cyst Differentiate the presentation of: Cystocele/rectocele/enterocele,Fistulas, Vaginismus, Infections Describe uterine anomalies Discuss Uterine fibroids Discuss Imperforate hymen Discuss the clinical presentation of common vulvar diseases and lesions Review the definition, causes, evaluation and management of couples with infertility Identify the types of contraception and their specific mechanisms of action Discuss the risk and benefit of each type of contraceptive Discuss the indications and contraindications for various contraceptive methods Discuss emergency contraception Discuss types of sterilization Define and discuss infertility Review female gonadal cycle Review spermatogenesis Discuss common causes of infertility Review the basic physiology of fertilization and implantation Discuss infertility workup
Lecturer
2:12
4/2/14
Pelvic Pain and Endometriosis
Dr. Haynes
1. 2. 3. Disorders of the Vulva, Vagina and Uterus
2:12
4/2/14
Cecil Hacker and Moore Bates
4.
Dr. Haynes
5. 6. 7. 8. 1. 2.
2:12
4/2/14
Infertility and Contraception
Cecil Hacker and Moore Bates
3. 4. 5. 6. 1. 2. 3. 4. 5. 6.
Dr. Haynes
2:12
4/2/14
Reproductive Endocrinology
Cecil Medicine 24 edition Pathophysiology, Damjanov Endotext.org Endocrine module e lectures
rd
209
Sem: Week
Date
Lecture Topic
Readings
1. 2.
Course Objectives
Discuss the common sexually transmitted Infections (STIs) Discuss the clinical presentation and signs and symptoms of cervicitis: Chlamydia and Gonorrhea 3. Discuss and distinguish the clinical presentation , signs and symptoms of ulcerative genital lesions 4. Discuss and distinguish the clinical presentation and signs and symptoms of Vulvovaginitis : (monilia), bacteria (bacterial vaginosis, BV), and trichomads (trichomoniasis). 5. Discuss how to differentiate, diagnose and treat each 6. Discuss Pelvic Inflammatory Disease (PID): the clinical presentation , causes , evaluation and complications 7. Discuss the etiology, pathology ,clinical presentation and evaluation Fitz-Hugh Kurtis syndrome 8. Differentiate Lyphogranuloma Venerum (LGV), Chancroid, Granuloma Inguinale, Donoviasis 9. Discuss treatment 10. Discuss the importance of history and patient education 1. Review normal breast anatomy 2. Discuss common causes of breast lumps 3. Discuss the clinical manifestations and characteristic physical findings of : fibroadenoma, phylloides tumors, intraductal papilloma, carcinoma (histologic variants), inflammatory carcinoma, Paget disease of the nipple, acute mastitis and fat necrosis 4. Discuss fibrocystic changes, benign and malignant neoplasms of the breasts 5. Discuss the risk factors, etiology, and clinical presentation 6. Discuss appropriate workup for each 7. Review management and prognosis of breast cancer 8. Review genetic mutations: BRCA 1 and BRCA 2 1. Discuss the major causes of bleeding from the upper and lower genital tract 2. Discuss how to evaluate pregnant, non-pregnant, premenarchal and post-menopausal patients with vaginal bleeding 3. Discuss the causes of bleeding in: newborn, pre-pubertal, menstruating, pregnant, non-pregnant, and post-menopausal patients 4. Discuss how to manage patients with vaginal bleeding 5. Review spontaneous abortions and molar pregnancy 1. Discuss uterine atony and causes of post partum hemorrhage
Lecturer
2:12
4/2/14
Sexually Transmitted Infections, STD, PID
Cecil Hacker and Moore Bates PD lecture and lab :GYN exam Urology lectures
Dr. Haynes Dr. Cheuck
2:12
4/2/14
Disorders of the Breast
Cecil Hacker and Moore Bates PD lecture and Lab material Oncology module lectures
Dr. Haynes
2:13
4/9/14
Abnormal Vaginal Bleeding
Dr. Haynes
210
Sem: Week
Date
Lecture Topic
Readings
2.
Course Objectives
Review basic anatomic, physiologic and pathologic processes of the ovary 3. Review the pathophysiology, clinical presentation, workup, risk factors and consequences of polycystic ovarian syndrome, PCOS 4. Discuss types of ovarian cysts 5. Review common benign and malignant neoplasms of the ovary: epithelial , stromal and germ cell and metastatic tumors 6. Identify risk factors 7. Discuss screening, diagnosis and management of benign and malignant tumors of the ovary 1. Discuss terminology and definitions 2. Explain how to diagnose normal and ectopic pregnancy 3. Discuss how to conduct a thorough obstetrical history 4. List the symptoms and signs of pregnancy 5. Discuss the appropriate lab tests and interpretation of results 6. Discuss how to initiate prenatal care 7. Identify risks factors for ectopic pregnancy 8. Discuss the clinical presentation of ectopic pregnancy 9. Discuss evaluation and diagnostic tests 10. Discuss treatment and management of an ectopic pregnancy 11. Distinguish types of ectopic pregnancies 1. Discuss antepartum care and fetal well-being 2. Identify and discuss first and second trimester screening 3. Discuss screening for gestational DM 4. Discuss non-stress test and contraction stress test 1. Discuss appropriate weight gain in pregnancy for normal, underweight and overweight women 2. Identify population at risk for nutritional problems 3. Discuss vitamin and mineral recommendations 4. List dietary recommendations for common problems in pregnancy 5. List substances to avoid in pregnancy 6. Identify how to avoid food borne illness 7. Recognize the importance of encouraging breast feeding 8. Identify nutritional needs for lactating women
Lecturer
2:13
4/9/14
Disorders of the Ovary
Cecil Hacker and Moore Endocrine Module lectures Oncology module lectures
Dr. Haynes
2:13
4/9/14
Obstetric History, Ectopic and Normal Pregnancy
Cecil Hacker and Moore Bates Physical Diagnosis lecture
2:13
4/9/14
Antepartum Care
Dr. Haynes
2:13
4/9/14
Nutrition in Pregnancy and Lactation
Bates Guide to Physical Examination and History Taking , 10th edition, pages 875-888. Pediatric module lectureNutrition in Newborn and Infant Hacker and Moore
Dr. Capozzi
211
Sem: Week
Date
Lecture Topic
Readings
1. 2.
Course Objectives
Define spontaneous and elective abortion Define and differentiate the clinical presentation of spontaneous abortions: threatened, inevitable, incomplete, complete, missed, recurrent 3. Explain how to diagnose and manage spontaneous abortions 4. Distinguish complete and partial/incomplete molar pregnancies 5. Review the etiology, risks , and clinical presentation 6. Discuss how to diagnose and manage 7. Identify complications and discuss follow up care 8. Discuss imaging studies in the pregnant patient 1. Discuss common complications that can occur during pregnancy 2. Define and discuss preterm labor, premature rupture of membranes, IUGR, and fetal demise 3. Discuss diabetes mellitus in pregnancy 4. Define and distinguish hypertensive disorders of pregnancy 5. List risk factors 6. Explain the characteristics and management of Preeclampsia, eclampsia and severe eclpamsia 7. Discuss HEELP syndrome 8. Discuss how to diagnosis and manage: preterm labor, PROM, IUGR, post-term pregnancy , intrauterine fetal demise ,diabetes, and hypertensive disorders 1. Discuss how to assess fetal wellbeing during a normal pregnancy 2. Discuss how to monitor the fetus during labor and delivery 3. Discuss how the fetus responds during a normal and abnormal labor and delivery 4. Discuss the non-stress test 5. Explain the importance of fetal heart rate monitoring 6. Discuss FHR decelerations and significance of scalp pH 7. Discuss how to identify abnormal fetal heart rate patterns during labor and delivery 8. Discuss management 9. Discuss uteroplacental insufficiency 10. Discuss meconium 11. Review Apgar score
Lecturer
2:13
4/9/14
Pregnancy Loss and Molar Pregnancy, Imaging
Dr. Haynes
2:13
4/9/14
Obstetric Complications
Dr. Haynes
2:13
4/9/14
Fetal Assessment and Complications
Dr. Haynes
212
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 1. 2. Cecil Hacker and Moore Pulmonary module lecture 3. 4. 5. 6. 7.
Course Objectives
Discuss abnormal fetal development List and discuss screening tests in pregnancy Explain how to diagnose abnormal fetal development Discuss intrauterine growth abnormality Review risks and etiology Discuss symmetric and asymmetric IUGR Discuss how to evaluate IUGR Discuss fetal macrosomia Review Rh isoimmunization Discuss multifetal gestation Discuss and distinguish various breech presentations Identify the normal events of labor Distinguish true labor and false labor Discuss the pelvic exam List the 4 Stages of labor and explain what occurs in each stage Define latent and active labor Discuss the mechanisms of labor and normal delivery List and discuss Cardinal Movements of Labor Discuss the mechanisms of labor Discuss management of labor Discuss fetal heart rate during labor Discuss dysfunctional labor Discuss causes and management of dysfunctional labor Explain stages of delivery Discuss the risk factors and causes of ante-partum and postpartum hemorrhage Discuss and differentiate: placenta previa, abruptio placenta and placenta acreta, increta, percreta Discuss uterine rupture and fetal bleeding Discuss uterine atony, retained placental tissue, low implantation and uterine inversion Review amniotic fluid embolism, DIC and shock Discuss the common obstetric hemorrhagic and infectious emergencies Discuss how to diagnose and manage common ante-partum and post-partum emergencies
Lecturer
2:13
4/9/14
Abnormal Fetal Development and Multifetal Gestation
Cecil Hacker and Moore Pediatrics module lectures Laboratory Medicine lectures
Dr. Haynes
2:14
4/30/14
Normal and Dysfunctional Labor, Normal Delivery
Dr. Haynes
2:14
4/30/14
OB Hemorrhage and Postpartum Emergencies
Dr. Haynes
213
Sem: Week
Date
Lecture Topic
Readings
1. 2. 3. 4. Cecil Hacker and Moore
Course Objectives
Discuss the common infections in pregnancy Describe the impact on mother and fetus Discuss HIV, TORCHES and Hepatitis: Toxoplasmosis, others, rubella, CMV, herpes simplex. Distinguish the clininal presentation and complications of : HIV, rubella, CMV, varicella, herpes simplex, UTI, Group Bstrep, TB, Syphilis, Toxoplasmosis Explain how to diagnose and treat common infections during pregnancy Discuss Postpartum infections, endometritis, and post op infections Discuss how to diagnose and manage infectious emergencies that may occur during pregnancy Review UTI :appropriate workup and management of asymptotic and symptomatic patients
Lecturer
2:14
4/30/14
Perinatal Infections
5. 6. 7. 8.
Dr. Haynes
2:15
5/5/14
OB-Gyn Exam
214
Medical Microbiology and Immunology II Syllabus

Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Course Coordinator Directors Campus Phone Directors Email Office Hours Medical Microbiology and Immunology I BSCI-624-E Basic Science, Microbiology and Immunology 2 14 weeks Letter Stephen Jones, PhD Kathleen DiCaprio, PhD 646-981-4609 Stephen.jones@touro.edu Posted
Course Description
This purpose of this course will be to apply the foundation of knowledge gained from the basic immunology and microbiology course in the first year to our understanding of the pathogenesis of infectious disease, the role of the immune system in protection from infections, and the immunopathological mechanisms responsible for inflammatory injury in both infectious and noninfectious situations. Our focus will be on the most clinically relevant information and will be guided by those topics that are important to the organ system module under study. Because infectious disease and the inflammatory mechanisms of the immune system are primarily responsible for a great number of pathological conditions, topics covered in this course will overlap with those covered in the Pathology and Clinical Systems courses. Our focus, however, will be to develop an understanding of the different microbiological and immunopathological mechanisms that are at the very heart of these pathologies, and how these mechanisms relate to the diagnosis and treatment of disease.

1. To relate basic immunological concepts to the mechanisms of inflammatory disease and immunologically mediated protection from infection. 2. To appraise the contribution of the different mechanisms of hypersensitivity to the development of both systemic and tissue specific inflammatory diseases. 3. To integrate ones knowledge of the immunopathological mechanisms of inflammatory disease with the most appropriate clinical testing approach and treatment philosophy. 4. To understand the roll of the immune system in recovery from and resistance to infectious pathogens. 5. To appraise the known or hypothesized environmental, genetic, and socio-economical factors that contribute to trends in infectious and immune mediated disease. 6. To understand the unique aspects of physiology, transmission, replication, pathogenesis, and laboratory identification of bacteria, viruses, fungi, protozoa, and helminthes. 7. To understand host-pathogen interactions and their role in the etiology, pathogenesis, treatment and diagnosis of infectious disease.
Medical Microbiology and Immunology II 215 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.

1. Microbiology: A Clinical Approach a) ISBN#: 978-0-815-36514-3 b) Edition: 1st c) Publisher: Garland science d) Year: 2010 2. Essentials of Clinical Immunology a) ISBN#: 978-1-4051-2761-5 b) Edition: 5th c) Publisher: John Wiley and Sons Inc d) Year: 2006

1. Rubins Pathology: Clinicopathologic foundations of medicine a. ISBN#: 0-7817-9516-8 b. Edition: 5th c. Publisher: Lippincott Williams and Wilkins d. Year: 2008 2. Schaechters Mechanisms of Microbial Disease a. ISBN#: 978-0-7817-53425 b. Edition: 4th c. Publisher: Lippincott Williams and Wilkins d. Year: 2006 3. Lippincotts Illustrated Q&A Review of Microbiology and Immunology a. ISBN#: 987-1-58255-857-8 b. Publisher: Lippincott Williams and Wilkins c. Year: 2010
Exam Dates
These dates are subject to change. Module VIII Dermatology Module IX Rheumatology/Immunology Module X Hematology Module XI Oncology Module XII Neuromuscular Medicine Module XIII Obstetrics/Gynecology
2/3/14 (Combined Module VIII and IX exams) 2/24/14 3/3/14 3/31/14 5/5/14

For this course the following breakdown will be used, where exam Z-Scores greater than and equal to 0.75 are an A, exam Z-Scores less than 0.75 and greater than and equal to -0.45 and are a B, exam Z-Scores less than -0.45 and greater than and equal to -1.35 are a C and exam Z-Scores below -1.35 are an F. For the raw percentages required to achieve these Z-Scores for this course, please see the chart below.
Z-Score 0.75 Z -0.45 Z < 0.75 -1.35 Z < -0.45 Z < -1.35
Percent 90.86% % 78.24% % < 90.86% 68.78% % < 78.24% % < 68.78%
The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation MMI II -5.00% 82.45% 10.51%

Quizzes Module VIII Module IX Module X Module XI Module XII Module XIII Total 10% 6.4% 12.9% 12.9% 12.9% 25.7% 19.3% 100%
Course Schedule
Lectures
Sem: Week Date Lect. # Lecture Topic Inflammatory Diseases of the skin Readings Course Objectives 1. Describe the immune-pathogenesis of common inflammatory dermatoses. 2. Relate clinical testing and treatment to the mechanism of disease. 1. Know the biology, pathogenesis, clinical manifestations, and diagnostic tests associated with the pathogens discussed. 2. Know the common modes of transmission of the discussed pathogens. 3. Know the clinical characteristics that differentiate smallpox from chickenpox. 4. Know the morphological classifications of the dermatophytes. 1. Describe the tests commonly used to assess function of the humoral and cellular immune responses. 2. Describe those clinical observations that would indicate the need for such tests. 3. Differentiate the mechanism of disorder for each of the primary immunodeficiency diseases. 4. Appraise the relationship between specific immune-deficiency syndromes and the predisposition to particular Lecturer
Derm 1
Chapel 11
Jones
2:1
January 16 Derm 2 Infectious Diseases of the skin Mims Ch 26
DiCaprio
2:2
January 23
Rheum_1
Rheum/Immuno: Evaluation of Clinical Immune Status and Immunodeficiency Disease
Abbas, Chapters 1-9
Jones
Medical Microbiology and Immunology II *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
218
Sem: Week
Date
Lect. #
Lecture Topic
Readings 5.
Course Objectives infections. Employ the appropriate clinical tests required to differentiate particular immunodeficiency syndromes and formulate diagnoses of particular immune-deficiency syndromes based upon clinical test results. Devise treatment options to address the unique deficiencies of particular immunodeficiency syndromes. Compare and contrast the mechanisms of the four different hypersensitivity reactions. Discuss the role of T cells, B cells, mast cells and eosinophils in type I hypersensitivity reactions. Describe the mechanism of anaphylactic shock. Distinguish the nature of the inciting antigens and the route of exposure that leads to the different type I hypersensitivity diseases. Relate clinical testing and treatment to the mechanism of atopic disease; describe the application of the skin prick test and the RAST test. Appraise the role of environmental and genetic factors in the development of allergic disease. Compare and contrast type II and III hypersensitivity reactions. Differentiate between the mechanisms and clinical outcomes of the different types of type II hypersensitivity
Lecturer
6.
1.
2.
3. 4. Rheum/Immuno: Immunopathology of hypersensitivity disease
Rheum_2
Chapel Ch. 4 and 5
5.
Jones
6.
7. 8.
219
Sem: Week
Date
Lect. #
Lecture Topic
Readings 9.
Course Objectives reactions. Define the term hapten, and appraise the role of haptens in the pathogenesis of hypersensitivity disease. Describe the mechanism of hemolytic anemia as it relates to drug sensitivity. Describe the mechanism of the arthrus reaction, and appraise its clinical significance. Describe the mechanism of allergic contact dermatitis. Appraise the roll of T cells, and T cell derived cytokines, and the innate immune system in the pathogenesis of DTH reactions. Explain the clinical features and immune-pathogenesis of the abnormal immune response in SLE, sleroderma, Sjogrens syndrome and antiphospholid syndrome, rheumatoid arthritis, seronegative spondyloarthropathies, and relapsing polychondritis . Describe the tissue specific and systemic effects of each disease. Relate the clinical testing and treatment to the mechanism of disease. Describe the role of donor MHC and host lymphocytes during the rejection of a transplanted organ. Describe the immunological effector mechanisms during hyperacute, acute
Lecturer
10. 11.
12. 13.
1. Rheum/Immuno: Rheumatic Disease SLE, Scleroderma, Sjogrens syndrome, antiphospholipid syndrome Rheumatoid Arthritis, seronegative spondyloarthropathies, relapsing polychondritis
Rheum_3 2:3 January 30
Chapel Ch. 10 2. 3.
Jones
1. Rheum_4 Rheum/Immuno: Transplantation Immunology Chapel Ch. 8 2.
Jones
220
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives and chronic organ rejection, including the ABO system. Relate common immune-suppressive treatments, as well as experimental treatment modalities, to the mechanism of rejection. Recognize clinical manifestations of sepsis and septic shock. Identify microorganisms and associated virulence factors that are of special relevance to sepsis and septic shock. Recall Hepatitis B serology and be able to identify the HBV status of a patient. Recall the biology, epidemiology, and clinical manifestations of malaria. Identify the 2 common parasites of filarisis. Know the clinical course and complications of Diphyllobothrium latum infections. Know the biology, pathogenesis, epidemiology, clinical manifestations, and diagnostic properties associated with Yersinia pestis, Francisella tularensis, Brucella, and Borrelia bugdorferi. Know the epidemiology and clinical manifestations of relapsing fever. Diagram the immunological mechanisms responsible for immune mediated hematological disorders (Autoimmune/ drug induced
Lecturer
3.
1. Hem_1 Hematology: Pathogenesis of Sepsis Mims: p183-187 2.
Brown/DiCaprio
1. 2. 3. 2:4 February 6 4. Hem_2 Hematology: Bloodborne Pathogens TBD 5.
DiCaprio
6. 1. 2:5 February 13 Hem_3 Heme: Immunologically mediated hematological disease Chapel Ch 16
Jones
221
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives haemolytic anaemia, autoimmune thrombocytopenia, autoimmune neutropenia, alloimmune diseases of the blood). 2. Explain the use of Coombs antiglobulin test and interpret results. 3. Discuss relationship between autoimmune gastritis and megaloblastic anemia.
Lecturer
Hem_4
Review 1. Describe the basic pathogen characteristics, transmission, disease pathogenesis, host response, lab identification, treatment, and prevention of HBV, HCV, EBV, HPV, HTLV-1, and HHV-8. 2. Describe how these viruses causes neoplasia. 3. Know the clinical manifestations associated with these viruses. 4. Know the common cancers associated with each of these viruses. 1. Describe the known etiology and pathogenesis of Multiple myeloma, Waldenstroms macroglobulinaemia, heavy chain disease, amyloidosis, chronic lymphocytic leukemia and nonHodgkins lymphoma 1. Compare and contrast the ability of the
Jones
Onc_1
Oncology : Lymphotropic viruses
Mims: p192-195
DiCaprio
2:6
February 20
Onc_2
Oncology: Lymphoproliferative disorders Oncology: Tumor
Chapel Ch 6
Jones
2:7
February 27
Onc_3
Jones 222
Sem: Week
Date
Lect. #
Lecture Topic Immunology
Readings
Course Objectives immune system to prevent the growth of tumors induced by oncogenic viruses versus spontaneous tumors. Discuss the characteristics of the different types of tumor antigens. Diagram the multiple potential mechanisms used by the immune system to kill tumor cells and indicate where tumor evasion mechanisms allow it to resist/evade the host immune response. Appraise the characteristics associated with successful immune mediated tumor rejection. Appraise strategies that enhance the immune response to tumors.
Lecturer
2. 3.
4.
5.
Onc_4
Graft-versus-Host Disease and Graft-versusLeukemia
2:8
March 6
Neuro_1
Neuro/Musc: Bacterial CNSInfections
Mims CH 24
1. Describe the immune-pathogenesis of graft-versus-host disease. 2. Discuss the relationship between the development of graft-versus-host disease, graft-versus-leukemia and cancer relapse. 1. Know the general clinical features of meningitis 2. Know CSF profiles for all CNS infections. For the following bacterial organsms: H. influenzae type b, Neisseria meningitidis, Streptococcus pneumonia,
Jones
DiCaprio
223
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives Listeria, Mycobacterium, E. coli, and Streptococcus agalactiae 3. Describe the biological characteristics of each 4. Explain the pathogenic mechanisms of the most common virulence factors of these organisms 5. Describe the epidemiology and route of transmission 6. Describe the most common diseases and associated clinical manifestation in conjunction with meningitis 7. Describe the common lab tests and treatments 1. Know the general clinical features of meningitis 2. Know CSF profiles for all CNS infections. For the following bacterial organsms: Herpesviruses, Enteroviruses, Arboviruses, Rabies, and JC virus
Lecturer
Neuro_2
Neuro/Musc: Viral CNS infections
Mims CH 24
3. Describe the biological characteristics of each 4. Explain the pathogenic mechanisms of the most common virulence factors of these organisms 5. Describe the epidemiology and route of transmission 6. Describe the most common diseases and associated clinical manifestation in
DiCaprio
224
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives conjunction with meningitis 7. Describe the common lab tests and treatments 1. Know the general clinical features of meningitis 2. Know CSF profiles for all CNS infections. For the following bacterial organsms: Naegleria, Acanthamoeba, Balamuthia, Toxoplasma, Taenia, Cryptococcus
Lecturer
2:9
March 13
Neuro_3
Neuro/Musc: Fungal, Parasitic, and CNS infections
Mims CH 24
3. Describe the biological characteristics of each 4. Explain the pathogenic mechanisms of the most common virulence factors of these organisms 5. Describe the epidemiology and route of transmission 6. Describe the most common diseases and associated clinical manifestation in conjunction with meningitis 7. Describe the common lab tests and treatments
DiCaprio
Neuro_4
Review 1. Discuss the mechanisms of immunologically mediated protection from infection in the brain. 2. Describe the mechanisms in the brain responsible for regulation of the
DiCaprio
2:10
March 20
Neuro_5
Neuro/Musc: Immunology on the brain
Provided reading
Jones
225
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives immune/inflammatory response. 1. To discuss the immune-pathogenesis of multiple sclerosis, and Guillain-Barre syndrome in its acute and chronic form. 2. To describe the basic immunopathogenic mechanisms of the different subtypes of MS. 3. To relate clinical testing and treatment to the mechanism of disease. 3. To discuss factors that influence susceptibility to autoimmune disease. 1. To discuss the immune-pathogenic mechanisms of myathenia gravis and LEMS. 2. To recall the auto-immune targets and be able to relate this to the development of clinical disease. 3. To relate clinical testing and treatment to the mechanism of disease. 4. To compare and contrast the etiology and imunopath of the different noninfectious inflammatory myopathies.
Lecturer
Neuro_6
Neuro/Musc: Multiple sclerosis , Guillain-Barre syndrome
Chapel Ch 17, Rubins Ch 28
Jones
Neuro_7
Neuro/Musc: Autoimmune disease of the neuro-muscular junction
Chapel Ch 17, Rubins Ch 27
Jones
2:11
March 27
Neuro_8
Review For the following pathogens: Neisseria, Chlamydia, HSV, HPV, Pubic Lice, Scabies, Trponema pallidum, Haemophilus ducreyi, Trichomonas
Jones
2:12
April 3
OBGYN_1
Ob/Gyn: STDs
Mims: CH 23
DiCaprio
226
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives Vaginatis. 1. Describe the biological characteristics of each. 2. Describe the pathogenic mechanisms of the most common virulence factors of these organisms. 3. Describe the epidemiology and routes of transmission. 4. Describe the most common diseases and associated clinical manifestations. 5. Describe the common laboratory tests and testing algorithms used to identify these organisms. 6. Know the common therapies to treat infections caused by these organisms. 1. Know the biology, transmission, pathogenesis, clinical manifestations, diagnostic tests, prevention, and treatment of the pathogens discussed. 2. Be able to describe ToRCH infections. 3. Be able to describe the maternal and neonate clinical manifestations of ToRCH infections. 4. Describe the routes of infection for a fetus and neonate and the common pathogens associated with each. 5. Describe ophthalmia neomatorum and know the biology, transmission, pathogenesis, and diagnostic tests of the causative pathogens.
Lecturer
OBGYN_2
Ob/Gyn: Congenital and Perinatal Infections
Mims: CH 23
DiCaprio
227
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 1. Compare the rate of occurrence of the most common autoimmune diseases in women vs. men. 2. Appraise the proposed role of sex hormones in the increased frequency of autoimmune diseases in women. 3. Appraise the proposed role of x chromosome abnormalities and microchimerism in the increased frequency of autoimmune diseases in women. 1. Describe the protocols to be followed when an SLE patient is considering becoming pregnant. 2. Describe the basic mechanisms of pathogenesis in SLE and describe the significance of anti-phospholipid antibodies in the pathogenesis of SLE. 3. Describe the risk of anti-phospholipid antibodies to the developing placenta/fetus. 4. Describe the known risks during pregnancy that are associated with maternal Ro/SS-A and anti-platelet Abs.
Lecturer
OBGYN_3
Ob/Gyn: The autoimmune gender gap
provided
Jones
2:13
April 10
OBGYN_4
Ob/Gyn: Autoimmunity and adverse pregnancy outcomes
provided
Jones
228
Medical Simulation Elective Spring Semester Syllabus

Course Details
Course Title: Course Number: Department: Credit Hours: Duration: Grading Type: Course Director: Directors E-mail: Asst. Coordinator: Asst. Coordinators E-mail: Office Days/Hours: Department Phone: Medical Simulation Elective PRCR-616-E Primary Care None 1 Semester N/A Joyce Brown, DO Joyce.Brown@touro.edu Janet Grotticelli, DO Janet.Grotticelli@touro.edu By appointment 646-981-4508
Course Description
The use of medical simulation is a highly effective method to enhance learning, improve patient care, decrease medical errors and improve patient safety. In this hands-on course, simulators will be utilized to provide students with opportunities to develop patient care, critical thinking, clinical decision making, communication and procedural skills. Students will work with a variety of simulators (including low, mid and high fidelity simulators, task trainers and cadavers) in small groups led by trained faculty. This is a non-credit elective course offered to second year osteopathic medical students.

1. 2. 3. 4. 5. 6. Develop competence in fundamental clinical and procedural skills. Demonstrate and apply fundamental pathophysiologic and pharmacologic principles to clinical case scenarios. Understand and practice basic lifesaving assessment and management skills. Develop the ability to work as an effective part of a medical team. Develop effective communication skills. Gain hands-on clinical experience in a safe learning environment without posing actual risks to patients.
Required Materials
1. Stethoscope 2. Scrubs 3. White lab coat
Assessment
Students performance will be evaluated and feedback will be given during each class. As this is an elective course, there will be no formal grade given.
Medical Simulation Elective Spring 229 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Format
This course will be delivered during 2 hour blocks on select Tuesdays (during students free blocks). An additional course delivery time and/or format will be considered if the Tuesday sections become filled.
Course Fee
The fee for this course is $600.00. The course fee will be used for maintenance of equipment, materials, training and staffing. The course fee and deposit are non-refundable.
Course Registration
This course has limited space. Deposit is required at the time of registration to secure a spot in the course. Full payment is required prior to the start of the class. Specific details of registration and payment deadlines will be announced.
Attendance, Tardiness & Absences

***Attendance Policy for this course differs from most TouroCOM courses*** 1. This is an elective course; therefore, attendance is not mandatory. 2. There may be no make-up sessions for missed or cancelled classes.

Latex containing products will likely be used during this course. Individuals with latex allergies and/or hypersensitivities must notify the Course Director in writing within one week of the start of the course. Individuals with latex allergies and/or sensitivities may be requested to obtain medical clearance prior to interacting with latex containing products.
Medical Simulation Elective Spring 230 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Schedule
Lectures
Sem: Week 2:1 Date 1/14/14 Topic. # 1 Lecture Topic
Peripheral IV
Readings TBA
Insertion
2:2
1/21/14
2, 3 & 4
Primary survey Introduction to Airway Nasogastric tubes
TBA
2:3
1/28/14
Breathing Medical Scenario
TBA
2:4
2/4/14
Advanced Airway (Intubation)
TBA
Course Objectives 1. Define intravenous access 2. Describe basic and advanced intravenous access procedures 3. Perform peripheral IV insertion 1. Define the Primary Survey 2. Define the Airway 3. Identify open, closed and insecure airways 4. Demonstrate the ability to open an airway using a variety of tools and techniques 5. Define nasogastric intubation 6. Discuss techniques of nasogastic intubation 7. Correctly perform nasogastric intubation 1. Define and discuss breathing 2. List and discuss immediately life threatening problems with breathing 3. Discuss multiple modalities for managing a patient with breathing problems 4. Correctly assess and treat a patient with breathing problems 5. Identify and manage acute breathing problems 6. Assess and manage a medical patient 1. Define endotracheal intubation 2. Discuss some key steps of orotracheal intubation 3. Perform orotracheal intubation
Lecturer TBA
TBA
TBA
TBA
Medical Simulation Elective Spring Semester *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
231
Sem: Week 2:5
Date 2/11/14
Topic. # 7
Lecture Topic Circulation Medical Scenario
Readings TBA
2:6
2/18/14
TBA
2:7 2:8
2/25/14 3/4/14
9 10
Suturing (Cadaver Lab) Casting and Splinting
TBA TBA
Course Objectives 1. Define circulation 2. List and define immediately life threatening problems with circulation 3. Correctly assess a patients circulation 4. Identify and manage immediately life threatening problems with circulation 5. Identify and manage acute circulation problems 6. Assess and manage a medical patient 1. Discuss advanced circulation management 2. List and define immediately life threatening problems with circulation 3. Correctly assess a patients circulation 4. Identify and manage immediately life threatening problems with circulation 5. Identify and manage acute circulation problems 6. Assess and manage a medical patient 1. Discuss skin closure techniques 2. Perform basic suturing techniques 1. Define and discuss basic casting and splinting techniques 2. Perform basic casting and splinting
Lecturer
TBA
TBA
TBA TBA
232
Sem: Week 2:9
Date 3/11/14
Topic. # 11 & 12
Lecture Topic Dextrose and Deficits Lumbar Puncture Discussion
Readings TBA
2:10
3/18/14
13
Obstetric Delivery Obstetrics [Group 1] Lumbar Puncture {Group 2&3] Orotracheal Intubation review and Practice
TBA
2:11
3/25/14
14
Obstetrics [Groups 2 & 3] Lumbar Puncture [Group 1] Orotracheal Intubation review and Practice
TBA
Course Objectives 1. Define dextrose and deficits 2. List and define immediately life threatening problems with dextrose and deficits 3. Correctly assess a patients dextrose and deficits 4. Identify and manage immediately life threatening problems with dextrose and deficits 5. Identify and manage acute dextrose and/or deficit problems 6. Define and discuss the lumbar puncture 1. Define and discuss an obstetric delivery 2. Discuss management of normal delivery 3. Discuss initial assessment of the laboring patient 4. Describe the stages and mechanism of normal labor and delivery 5. Perform an obstetric delivery 6. Provide care for mother and neonate 7. Correctly perform lumbar puncture 8. Practice orotracheal intubation 1. Perform obstetric delivery 2. Provide care for mother and neonate 3. Define and discuss lumbar puncture 4. Perform lumbar puncture 5. Practice orotracheal intubation
Lecturer
TBA
TBA
TBA
233
Sem: Week 2:12
Date 4/1/14
Topic. # 15 & 16
Lecture Topic Trauma & E Advanced Simulation Scenarios
Readings TBA
Course Objectives 1. Define ATLS 2. Identify and describe some key steps of the ATLS primary survey 3. Correctly perform some key steps of the ATLS primary survey 4. Identify and manage a trauma patient using a patient simulator 5. Define and discuss immediately life threatening Environmental problems 6. Assess and manage a medical patient
Lecturer
TBA
234
Osteopathic Manipulative Medicine II Part 2 Syllabus

Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Directors Campus Phone Directors Email Office Hours Osteopathic Manipulative Medicine II Part 1 OMM-637-E Osteopathic Manipulative Medicine (OMM) Department 3 Entire Semester Letter Susan Milani, D.O. (646) 981-4619 Susan.Milani@touro.edu By Appointment
Course Description
The second course in Osteopathic Manipulative Medicine (OMM) is designed to continue to develop the philosophy, principles, and skills of osteopathic health care. Emphasis is on the sequential development of the palpatory examination, as well as, the diagnostic and therapeutic skills of osteopathic manipulative medicine. These skills are now applied to the structural and functional relationships of the musculoskeletal system to the other organ systems of the body. The biomechanical, respiratory-circulatory, neurological, metabolic energy and behavioral models will be used to provide the context for the diagnosis and treatment of a large variety of clinical scenarios. This material is presented in the context of the modular systems so that specifically osteopathic considerations are well-integrated into all the courses in the second year. The course will cover osteopathic approaches to problem solving and patient management, incorporating multiple osteopathic manipulative treatments as appropriate, including: soft tissue, myofascial release, balanced ligamentous tension, articulatory, counterstrain, muscle energy, high velocity low amplitude, and osteopathy in the cranial field treatment modalities.

1. Describe the role of osteopathic history, philosophy, principles and current professional challenges for osteopathic medicine. 2. Identify, differentiate, explain, and interpret palpatory findings in an examination of a surrogate patient. 3. Identify and interpret somatic dysfunction, including its anatomical and physiological basis and its impact on the health of the patient. 4. Define, explain and successfully demonstrate appropriate diagnostics and the aforementioned techniques to restore and optimize function of all body regions and reduce somatic dysfunctions. 5. Define and demonstrate the structural and functional models: biomechanical, respiratory-circulatory, neurological, metabolic energy, and behavioral for each of the systems that are covered. 6. Demonstrate the treatment plans based on the presented clinical scenarios.

1. Osteopathic Considerations in Systemic Dysfunction, Revised 3nd Edition, a. Author-Kuchera, M. b. ISBN -1-57074-154-9 2. Foundations of Osteopathic Medicine, 3rd Edition OMM II Part 2 235 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
a. Editor -Chila, Anthony b. ISBN -978-0-7817-6671-5 3. An Osteopathic Approach to Diagnosis & Treatment a. Author-DiGiovanna et al b. ISBN -978-0-7817-6671-5 4. Physical Examination of the Spine & Extremities a. Author-Hoppenfeld S. b. ISBN -0-8385-7853-5

1. Somatic Dysfunction in Osteopathic Family Medicine a. Editor -Nelson, Kenneth b. ISBN-13 =978-1-4051-0475-3 2. Teachings in the Science of Osteopathy a. Author-Sutherland, William b. ISBN-0-930298-00-5 3. A Pocket Manual of OMT a. Author- Steele, Karen M. b. ISBN-13 978-1405104807 4. The 5-Minute Osteopathic Manipulative Medicine Consult a. Author-Channel, Millicent King b. ISBN 13: 978-0781779531
Exam Dates
These dates are subject to change. Written Exams Dermatology and Rheumatology/Immunology Hematology Oncology Neuromuscular Obstetrics/Gynecology Practical Exams Practical I Practical II 2/25/2014 4/29/2014 2/3/14 2/24/14 3/3/14 3/31/14 5/5/14

For this course the following breakdown will be used, where exam Z-Scores greater than and equal to 0.75 are an A, exam Z-Scores less than 0.75 and greater than and equal to -0.45 and are a B, exam Z-Scores less than -0.45 and greater than and equal to -1.35 are a C and exam Z-Scores below -1.35 are an F. For the raw percentages required to achieve these Z-Scores for this course, please see the chart below. Letter Grade Z-Score Percent
OMM II Part 2 236 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
A B C F
0.75 Z -0.45 Z < 0.75 -1.35 Z < -0.45 Z < -1.35
90.45% % 76.01% % < 90.45% 65.17% % < 76.01% % < 65.17%
The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation OMM II Part 2 -20.00% 79.01% 12.04%

Quizzes Module VIII Module IX Module X Module XI Module XII Module XIII Practical I Practical II Total 10% 4.3% 8.6% 8.6% 8.6% 17.1% 12.3% 10% 20% 100%
Attendance and Grading Policy
Exams In-Class Clicker Questions: The lecturer can administer in-class questions via the clicker system. The mean of the clicker quiz scores will constitute 10% of the final course grade. Since clicker quiz answers will be reviewed in class, clicker grades will not be sent to students. Lab Practical Exams: Please note that practical exams are for evaluation purposes only and are not designed as teaching tools therefore, students will not be permitted to view their grading sheets. Failure: There will be no re-take practical exams. Students who score below 70% will be given the opportunity to review areas of weakness with a member of the faculty.
Absence: Students who miss a practical exam will receive a zero for that practical exam. An excused absence from the Dean of Student Affairs, will allow the student to take the practical exam a later date with a maximum attainable grade of 70%. OMM Lab Attendance Due to the nature of the psychomotor skills associated with the lab content, 100% attendance and punctuality is required. If an absence is anticipated or occurs, the student must notify the department. Excused absences must be obtained from the Dean of Student Affairs. For each unexcused absence, 10 percentage points will be deducted from the overall practical score. OMM Lab Dress Policy (The following is a nationally accepted Dress Code for OMM Labs.) The dress requirement in the clinical skills training sessions is designed to promote learning by providing optimal access to diagnostic observation and palpatory experience. Wearing inappropriate clothing interferes with a partners experience of diagnosis and treatment. Appropriate attire must be clean and includes: Shorts that are above the knee. o (No jean shorts, cut-offs, thick-seamed shorts, spandex, short shorts or knee length shorts.) T-shirts. o Both sexes will be asked to remove t-shirts while acting as patients. Sports bras or bathing suit tops for women. o These should expose the spine and ribs (not wide T-back styles). Student doctors may wear sweats or scrubs (or other apparel approved by the Course Director) over laboratory attire when not in the role of the patient o Please note that scrubs worn in anatomy lab are NOT appropriate outside of the anatomy lab. OMM lab does not have the same ventilation system as is required by law for the anatomy lab and the chemicals can affect the table coverings. Please bring and wear only clean non-fragrant scrubs to OMM lab. Remove shoes when you are the patient (no shoes are permitted on the tables). Hats or head coverings (other than for religious purposes) are not permitted in OMM lab. Religious head coverings are to be removed when you would obscure the immediate area to be examined or treated (e.g., head, neck, and upper back). The head covering can then be immediately replaced after this portion of clinical skills training. Please note that jewelry, especially large rings, may damage the tables. Please secure rings and other jewelry before the lab. If a student is not properly dressed, inappropriate attire will be recorded, and 5% points deducted from the next practical exam grade.
Limitation/Exclusion from Participation in the OMM Lab for Medical Reasons Any student doctor with a pre-existing health problem that may preclude examination and/or treatment is required to submit a written request for limitation and/or exclusion to the Department Chair and present appropriate medical documentation. A physician member of the department will review this information on a case-by-case basis, and may OMM II Part 2 238 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
require additional diagnostic measures. The department member reviewing the case will determine any limitation or exclusion from participation, and the student doctor will be notified in writing of the decision.
Course Schedule
Lectures
Sem: Week Date Lect. # Lecture Topic Readings Course Objectives 1. Discuss the relationship of the Osteopathic structural exam to the dermatologic evaluation. 2. Understand and apply the holistic Osteopathic approach to the dermatological patient. 3. Discuss the dermatologic manifestations of systemic disease. 4. Discuss how Osteopathic techniques can affect patient outcome on controlling dermatological cases. 5. Understand how the holistic osteopathic approach and considerations of stress and diet will affect your patients outcome. 6. Describe the Osteopathic approach to: stasis dermatitis and atopic dermatitis, considering the psycho-endocrineimmunologic model. 1. Discuss the osteopathic structural exam of the hospitalized patient that is directed toward the underlying pathophyiology of the disease process as it relates to the major organ systems. 2. Describe reflex facilitation in terms of mechanism of action, palpatory findings and interpretation of these findings. 3. Describe the examination of the thorax, abdomen and pelvis in the hospitalized patient. 4. Describe the treatment approach in the case of segmental facilitation and Lab Objectives
Dermatology I 2:1 1/14 1 MB
1. Demonstrate the principles and protocol for balanced ligamentous tension (BLT). 2. Demonstrate BLT to the cervical spine. 3. Mastery: Demonstrate C-spine MF, FPR & HVLA.
Rheumatology /Immunology I: 2:2 1/21 2 The Hospitalized Patient KS Foundations 2nd ed: p. 1115-1142 (will be posted)
1. Demonstrate the osteopathic structural exam for the hospitalized patient including palpation of the CRI at the paired bones (ankles). 2. Demonstrate the documentation of findings on the hospital structural exam form. 3. Perform the hospitalized exam on multiple partners and record those findings. 4. Demonstrate BLT of the ribs, thoracic spine and SI joint (with 240
OMM II Part 2 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives inflammation. 5. Describe the treatment approach to aid the patient in the resolution of inflammation. 1. Describe the pathophysiology of rheumatologic disorders (Osteoarthritis (OA), Rheumatoid Arthritis (RA), fibromyalgia) in terms of the autonomics, musculoskeletal, and respiratorycirculatory systems. 2. Describe the treatment approach to osteoarthritis, rheumatoid arthritis, and fibromyalgia based on the biomechanical, respiratory-circulatory, neurological, metabolic energy and behavioral models. 3. List the differential diagnosis for myalgias that include mechanical/degenerative, infectious, inflammatory, and metabolic conditions. 4. Compare and contrast the expected physical exam findings for OA and RA 5. Describe the common clinical presentations of RA, OA and fibromyalgia and how to differentiate from other myofascial pain. 6. State the OMT technique that is contraindicated in RA and why.
Lab Objectives traction).
Rheum/ Immuno II Osteopathic Approach to the Rheumatologi c Patient: Fibromyalgia, Osteoarthritis, Rheumatoid Arthritis AD Kuchera: p. 159167 Foundations: p. 952-960,974-8 Posted material: Patient with Osteoarthritis
2:3
1/28
2:4
2/4
Hematology I: Lumbar Mechanics and Clinical Applications MB
Foundations: p. 542-574, 1006-1020
1. Demonstrate the osteopathic diagnosis of the lumbar spine. 2. List the differential for low back pain based on mechanical, non-mechanical, DiGiovanna: p. vasculogenic, and infectious causes. 233-242, 275- 3. List the differential diagnosis of low back 284 pain based on the localized low back/ non-
1. Demonstrate the exam for OA of the hip and knee. 2. List the exam findings for cervical osteoarthritis. 3. Demonstrate cervical spine traction with rotation articulation. 4. Demonstrate hip myofascial with traction. 5. Demonstrate the counterstrain treatment of the following tenderpoints; the lateral trochanter (associated with piriformis), inguinal ligament, (review iliacus/ psoas), low ilium sacroiliac, midpole sacral, high flare-out. 6. Compare and contrast palpable findings associated with osteoarthritis and rheumatoid arthritis. 7. Correlate the appropriate treatment models and rational for osteoarthritis vs. rheumatoid arthritis. 1. Describe the evaluation of the lumbar spine in relation to a patient with disc disease. 2. Diagnose the lumbar spine. 3. Demonstrate counterstrain for the lumbar spine. 4. Demonstrate the disc reduction 241
Sem: Week
Date
Lect. #
Lecture Topic
Readings Review first year lumbar 4. spine lectures. Posted material: Lumbar Degenerative Disc Disease 5. 6.
Course Objectives mechanical causes and the referral sites/causes of low back pain. List the differential diagnosis of low back pain that is based on the structural/ functional model. List the somatic dysfunctions associated with low back pain. List the diagnostic observational and palpatory findings as well as osteopathic treatment approaches for stenosis, OA, disc herniation, claudications, spondylolisthesis/spondyolysis, iliolumbar syndrome, lumbar compression fractures and visceral causes of low pain. List the osteopathic patient management of low back pain based on the biomechanical, respiratory-circulatory, neurological, metabolic energy and behavioral models. Identify the red flags for low back pain. Describe the pathology and clinical presentation of the various neuropathic pain syndromes that cause headaches, in cranial and non-cranial locations. Describe the pathology and clinical presentation of metastatic epidural spinal cord compression. Describe the trigger points that cause head pain. Describe the urgent pathologies that present as head pain. Describe the differential diagnosis of the cervical spine in relation to head and neck pain. List the contraindications for OMT in the
Lab Objectives technique. 5. Demonstrate the FPR discogenic technique. 6. Describe the treatment and management plan for disc disease including exercise recommendations. 7. Mastery: Demonstrate Lumbar MF, ME & HVLA.
7.
8. 1.
Foundations: 93945 Hematology II: DiGiovanna: p. Headaches 606-607 SM Posted material: Patient with a Headache
2.
2:5
2/11
3. 4. 5.
6.
1. Evaluate the seated and standing posture in relation to the etiology of tension headache. 2. Diagnose the cervical spine on multiple partners and record findings. 3. Demonstrate OA decompression and BLT of the OA. 4. Demonstrate ME of the cervical spine utilizing the occulocephalic reflex. 5. Demonstrate OA HVLA with sidebending. 6. Demonstrate treatment for upper trapezius trigger points. 242
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives patient with head and/or neck pain
Lab Objectives 7. Demonstrate exercises for a patient with tension headaches. 1. Demonstrate the evaluation of the patient with lower extremity pain and dysfunction (review lab from previous semester). 2. List the observation and palpatory findings in the patient with lower extremity pain and dysfunction (including chondromalacia patellae, meralgia paresthetica, fibular head dysfunction; subtalar, talar, and plantar fascia somatic dysfunction). 4. List treatment, management, and contraindications for the patient with lower extremity pain and dysfunction. 5. Review and demonstrate the special tests of the lower extremity, including sensory, motor, and orthopedic tests (on your own). 6. Demonstrate treatment of quadriceps ME & MF for meralgia paresthetica. 7. Demonstrate treatment of foot drop and fibular head dysfunction (anterior and posterior) with ME and long and short lever HVLA. 8. Demonstrate patellar distraction with BLT. 9. Demonstrate treatment of the talus with BLT, HVLA & 243
Oncology I Lower Extremity Peripheral Pain MB
2:6
2/18
1. Describe the presentation and radiologic findings of bone tumors of the lower extremity DSD p. 537-45 2. Understand and be able to apply an osteopathic approach to patients with Review lower compression entrapment neuropathies of extremity lectures the lower extremity. and lab from 3. Analyze the relevant anatomy of these previous semester neuropathies 4. Review possible Osteopathic treatments for these neuropathies
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives
Lab Objectives articulatory. 10. Demonstrate MF & exercises plantar fascia.
2:7
2/25
Oncology II Metastasis to Bone ML
1. Describe the history taking, palpatory exam, and symptomology that would identify metastatic cancer as a cause of musculoskeletal pain. 2. Describe the contribution of osteopathic manipulation in the cancer patient in terms of the biomechanical, respiratorycirculatory, neurological, metabolic energy, and behavioral models. 3. List contraindications in the use of osteopathic manipulation in the cancer patient. 4. Describe history-taking that helps differentiate the different causes of pain in the cancer patient. 5. Name the most frequent sites of metastasis and their presentation pain in tumor patients. 6. Describe history-taking and palpatory findings that helps differentiate the different causes of pain in the cancer patient. 7. Describe the role of trigger point treatment in the cancer patient. 8. Name the most frequent carcinoma sites from which bone metastases arise. 9. Name and describe the characteristics and the source of the 3 types of bone metastases. 10. Describe how to spot pain from metastatic bone disease in common locations and
Practical 1
244
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives common pain complaints 11. Characterize the radiologic presentation of common bone tumors (including Ewing Sarcoma, chondrosarcoma, osteosarcoma). 12. Describe laboratory values that would suggest a bone tumor
Lab Objectives
Neuromusculo skeletal I: Thoracic Spine, Scoliosis, Leg Length KS Foundations: p. 437-483
2:8
3/4
1. Understand the biomechanics of scoliosis. 2. Describe the terminology associated with scoliosis 3. Describe the scope of causes of scoliosis 4. Understand the natural history of idiopathic scoliosis 5. Describe the diagnostic and screening testing 6. Describe the approach to the scoliotic patient. 7. Describe the management and osteopathic treatment of scoliosis. 8. Describe the long term consequences of scoliosis 9. Understand the individualized goals of treatment. 10. Describe scoliosis in relation to lateral curves and leg length discrepancies
2:9
3/11
Neuromusculo skeletal II: Upper Extremity
Posted material: Patient with Thoracic Outlet Syndrome
1. Discuss the overview of the differential diagnosis of the upper extremity. 2. Recognize and understand clinical presentations that cause referred pain to
1. Demonstrate the thoracic spine evaluation and somatic dysfunction diagnosis. 2. Describe the osteopathic treatment plan for scoliosis and leg length discrepancy. 3. Demonstrate the evaluation of scoliosis and leg length and treatment considerations of leg length. 4. Demonstrate BLT of the thoracic spine. 5. Demonstrate seated thoracic articulatory techniques. 6. Demonstrate thoracic HVLATexas Twist. 7. Demonstrate supine innominate muscle energy. 8. Mastery: Demonstrate HVLA for an anterior and posterior innominate. 9. Demonstrate exercise for scoliosis: lazy person side lying & figure 8 mobilizations. 1. Demonstrate the evaluation and examination of the cervical spine and the shoulder complex. 2. Discuss the differential diagnosis 245
Sem: Week
Date
Lect. #
Lecture Topic Peripheral Pain MB
Readings
Course Objectives the shoulder area. 3. Discuss case presentations for cervical radiculitis and pain referral patterns to the upper extremity. 4. Describe the clinical presentation and treatment concepts for scapulo-thoracic syndrome that encompasses: (1) cervical rib (2) scalene anterior syndrome (3) claviculo-scapular syndrome (4) pectoralis minor syndrome.
Lab Objectives for the shoulder, including musculoskeletal pain from cervical referred pain (cervical spondylosis and cervical disc herniation) and the relationship of these diagnoses to the osteopathic examination. 3. Describe the presentation, osteopathic examination and treatment of the following syndromes; scapulocostal, costoclavicular, pectoralis minor, anterior scalene, cervical rib and 1st rib. 4. Demonstrate the following techniques; treatment of the brachial plexus & posterior cervical roots, brachial plexusbehind the clavicle, treatment of the median nerve in the subpectoralis tunnel, Spencer technique, upper extremity integrated NMS and fascial release of the scapular fascia. 5. Demonstrate exercises for adhesive capsulitis and scalene muscle tension. NO CLASS 1. Demonstrate the osteopathic evaluation of the sacrum and pelvis. 2. Demonstrate diagnosis of the Lspine, sacrum and pelvis. 3. Discuss and demonstrate the 246
2:10
3/18 Neuromusculo skeletal III:
2:11
3/25
10
Clinical Consideration of the Sacrum
Foundations: p. 575-601
American Academy of Osteopathy Convocation 1. Demonstrate the diagnosis of the sacrum. 2. List the ten most common causes of sacroiliac dysfunction 3. Describe the Mitchell model of sacral diagnosis related to the forward torsion with L5 neutral mechanics and the
Sem: Week
Date
Lect. #
Lecture Topic AD
Readings
Course Objectives backward torsion with non-neutral mechanics. 4. Describe the somatic dysfunctions and their characteristics: Unilateral flexion, unilateral extension, left on left torsion, right on right torsion, Right on left torsion, left on right torsion, bilateral flexion and bilateral extension. 5. Describe the presentation and treatment plan for sacroilitis (ankylosing spondylitis) and coccygodynia.
Lab Objectives clinical findings associated with psoas syndrome, quadratus lumborum hypertonia and piriformis syndrome. Discuss the viscerosomatic reflexes mediated through the sacrum and pelvis. Demonstrate treatment to the sacrum and pelvis, using muscle energy and myofascial release. Demonstrate standing BLT of the innominate. Mastery: Demonstrate sacrumME, HVLA (sacral C). Demonstrate the osteopathic examination of the pregnant patient. Discuss adaptations of sacral and pelvic technique for the pregnant patient. Discuss the treatment approach that addresses gynecological concerns, such as; dysmenorrhea, premenstrual symptoms, infection and mechanical dysfunctions. Demonstrate the treatment of morning sickness: Chapmans point for liver and stomach. List the treatment for postmastectomy patient. List VSR and Chapmans points for female reproductive organs. Demonstrate seated rib raising. Demonstrate uterine lift 247
4.
5.
6. 7. 1.
2. DiGiovanna: pp. 651-59 OB/Gyn I: Pregnancy SM Foundations: pp. 451-61, 961-66, 967-73 Kuchera: p. 149158 1. Describe the anatomical and physiological changes of pregnancy. 2. Describe the osteopathic approach to the different stages of pregnancy and the postpartum period. 3. Discuss the treatment of morning sickness, carpal tunnel and low back pain in the pregnant patient. 4. Describe the osteopathic management of the pregnant t patient. 5. List the contraindications and indications for OMT in the pregnant patient.
3.
2:12
4/1
11
4.
5. 6. 7. 8.
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives
Lab Objectives technique. 9. Demonstrate sacral rock & sacral inhibition (prone & lateral recumbent). 10. Demonstrate self-treatment for sacral inhibition. 11. Demonstrate iliacus counterstrain for dysmenorrhea.
2:13
4/8
12
OB/Gyn II: Gynecology SM
Foundations: pp. 451-61 DiGiovanna: pp. 651-59
1. Demonstrate understanding of gynecological issues related to hormonal changes and reproduction in terms of signs & symptoms, pathophysiology, mechanics, and treatment with an osteopathic medical approach 2. Osteopathic diagnosis and treatment approach of dysmenorrhea, premenstrual syndrome, infection, and mechanical dysfunctions, cyclical pelvic pain and noncyclic pelvic pain SPRING BREAK
1. Practical Review 2. Demonstrate observation, palpation, range of motion, special tests and technique modalities for areas covered this semester.
4/124/27 2:14 4/29 13
Practical 2 Final-includes entire semester
248
Objective Structured Clinical Examination (OSCE) Syllabus

Course Details
Course Title: Course Number: Department: Credit Hours: Duration: Grading Type: Course Director: Directors E-mail: Assistant Coordinator Assistant Coordinators Email: Course Assistant: Course Assistants Email: Office Days/Hours: Department Phone: Objective Structured Clinical Examination (OSCE) PCR-601-E Primary Care 1 1 Semester Letter Joyce Brown, DO Joyce.Brown@touro.edu Amber Brody, DO Esquire Anthony, DO Esquire.Anthony@touro.edu By appointment 646-981-4508
Course Description
The one semester Objective Structured Clinical Examination (OSCE) course is given during the second semester of the second year. The OSCE course serves to enhance and assess the students clinical competency in areas such as history taking, physical examination, communication, interpersonal skills, professionalism and clinical decision making. The student physician will participate in a series of encounters with standardized patients in simulated medical scenarios. The skills developed and assessed during the OSCE course will include those that were taught and emphasized during the Physical Diagnosis and Primary Care Skills courses. The clinical content will place emphasis on primary care medicine as it relates to the maintenance of health and treatment of disease. The medical conditions presented in the OSCE scenarios will correlate with the concepts taught in the Clinical Systems course. The term OSCE is an acronym for the Objective Structured Clinical Examination. It is a simulated student doctor-patient encounter designed to develop and assess clinical skills. An OSCE is: Objective, because examiners use a checklist for evaluating the students and each student is evaluated in the same manner, using the same type of criteria. Structured, because every student is presented with the same type of predesigned clinical scenario and is expected to perform the same type of tasks, in the same time frame. A clinical examination, because the tasks are representative of those that will be experienced in real clinical situations.

1. Enhance and demonstrate osteopathic history taking and physical examination skills 2. Conduct patient centered interviews 3. Gather accurate data related to the patient encounter
Objective Structured Clinical Examination 249 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
4. Demonstrate and enhance the ability to generate differential diagnoses appropriate to the context of the patient setting and findings 5. Demonstrate and enhance the ability to develop patient centered, evidence based assessments and management plans particularly those with an emphasis on preventive medicine and health promotion 6. Demonstrate and enhance the ability to document clinical encounters in the outpatient primary care setting in an accurate, organized and logical manner via the post encounter note 7. Demonstrate and enhance advanced communication and interpersonal skills
Required Materials
1. 2. 3. 4. 5. 6. 7. 8. Stethoscope with a dual head (separate diaphragm and bell) Adult blood pressure cuff (latex free) Ophthalmoscope with a coaxial head. A panoptic head is not acceptable. Otoscope with a pneumatic bulb. Otoscope head must be compatible with plastic disposable specula. Reflex hammer Two tuning forks (one that is between 512-1024 Hz and that is 128 Hz) Penlight Student length/consultation white laboratory coat
Required Texts
1. Bates Guide to Physical Examination and History Taking, 10th Edition a. Author = Lynn S. Bickley b. ISBN = 978-0-7817-8058-2 c. Listed on schedule under Readings as: BG 2. Physical Examination of the Spine and Extremities a. Author = Stanley Hoppenfeld b. ISBN = 0-8385-7853-5 Listed on schedule under Readings as: H 3. Bates Visual Guide to Physical Examination DVD Series Volumes 1-19, 4th Edition* a. Author = Lynn S. Bickely b. ISBN = 9780781757645 Listed on schedule under Readings as: BV *This is available via streaming video through the TouroCOM library. Instructions for access and viewing are posted on Blackboard.

The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation OSCE 0.00% 86.83% 8.73%

Note: Student attendance may affect course grade. See under Course Specific Attendance and Tardiness Policy. Clicker Session(s) OSCE #1 (Patient Encounter & Post Encounter Note) OSCE #2 (Patient Encounter & Post Encounter Note) OSCE #3 (Patient Encounter & Post Encounter Note) OSCE #4 (Patient Encounter Only) OSCE #4 (Post Encounter Note) Total 2% 10% 23% 15% 20% 30% 100%
Course Materials
Course material will include content from the recommended textbooks and other recommended materials. Students are responsible for all covered and for all assigned material.
Course Format
The OSCE course will take place on Wednesday afternoons from 1pm to 5pm. Course material will be delivered through a variety of modalities including topic specific lectures, ITunes lectures, OSCEs and skills sessions. For each OSCE encounter, students will be assigned to a faculty member and simulated patient. During each OSCE encounter, the student will be responsible for performing tasks such as taking a history and/or performing a physical examination. The assigned faculty member will serve as a silent observer and evaluator during the session. Following the session, the student will develop and submit a post encounter note. Each students performance will be evaluated and discussed with the student during an individual student-faculty review session. Course material including (but not limited to) weekly schedule, assignments and announcements will be posted on Blackboard. Students are expected to utilize Blackboard daily.
The OSCE sessions may be recorded. Recordings may be used in subsequent lectures. Students are encouraged to watch their recorded encounters for learning purposes. Recordings may not be used for student requested re-grading purposes. For select topics, students will be directed to view pre-taped lectures via iTunes. When topics are delivered via iTunes, students may be required to attend interactive, clinically based learning sessions based on the ITunes lectures. The ITunes lectures are to be viewed prior to the class for which they are assigned.
Course Presentation
1. Scheduled times are Wednesday afternoons from 1pm-5pm. 2. Each student will be assigned to standardized patient encounters, individual faculty review sessions and lecture based review sessions. Individual student schedules will be posted on Blackboard. 3. Students must attend the sessions to which they are assigned. 4. Individual student schedules are subject to change at any time. Students are responsible for being aware of their own schedule. 5. Course materials will be posted on Blackboard. 6. Lectures are streamed or recorded at the Departments discretion. 7. The schedule is subject to change at the Departments discretion.

Due to the unique nature of this class, 100% attendance and punctuality is required. If a student is more than 5 minutes late, it will be considered an absence and that individual may not be allowed to participate and will be referred to the Dean of Students. If an absence is anticipated or occurs, the student must notify the Course Director as soon as possible. Failure to attend lectures and/or group review sessions will result in a deduction from the students overall course grade. One (1) unexcused absence will result in a five (5) point deduction. Two (2) unexcused absences will result in a ten (10) point deduction. Three (3) unexcused absences will result in course failure. Any unexcused absence from an OSCE will result in a grade of zero.

Latex containing products may be used during this course. Individuals with latex allergies and/or hypersensitivities must notify the Course Director in writing within one week of the start of the course. Individuals with latex allergies and/or sensitivities may be requested to obtain medical clearance prior to interacting with latex containing products.
Course Schedule
Lectures
Sem: Week Date Lect. # 1 Lecture Topic Course Introduction (Live Lecture) Working with Standardized Patients (Note: This is a review. See posted Powerpoint from Primary Care Skills Course) OSCE Case 1 Preparation (Live Lecture) TBA Readings Course Objectives 1. Discuss course objectives, format, requirements and schedule. Lecturer Dr. Brown
TBA
1. Discuss and define standardized patient encounter procedures and guidelines.
Dr. Brown
TBA
2:1
1/15/14 The Focused Patient Evaluation in the Primary Care Setting (ITunes-see TBA under Primary Care Skills Course as this is a review)
Documentation of the SOAP Note in the Primary Care Setting (ITunes & Interactive Clicker Session)
TBA
1. Discuss how to prepare for and approach the first OSCE case. See blackboard for additional objectives and assignments 1. Define the focused patient encounter. 2. Define and discuss the adult focused history in the outpatient primary care setting. 3. Define and discuss the adult focused physical examination in the outpatient primary care setting. 4. Define and describe the focused assessment and plan in the outpatient primary care setting. 5. Differentiate between the focused and comprehensive patent encounter. 6. Perform an adult focused patient encounter in the outpatient primary care setting. 1. Define and discuss the SOAP note in the primary care outpatient setting. 2. Differentiate the H&P note from the SOAP note. 3. List and describe the components fo the SOAP note in the primary care, outpatient
Dr. Brown
Dr. Brown
TBA
Objective Structured Clinical Examination *Document is subject to change, please refer to Outlook or Blackboard for the most current version
253
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives setting. 4. Demonstrate the ability to write a SOAP note. 1. Practice history taking and physical examination skills. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Practice history taking and physical examination skills. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Practice history taking and physical examination skills. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient.
Lecturer
Skills Session
TBA
TBA
OSCE Case #1 2:2 1/22/14
TBA
TBA
Skills Session
TBA
TBA
OSCE Case #1 2:3 1/29/14
TBA
TBA
Skills Session
TBA
TBA
2:4
2/5/14
OSCE Case #1
TBA
TBA
254
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Discuss key elements of the previous OSCE Case. 2. Discuss the appropriate SOAP note for the previous OSCE Case. 3. Identify and discuss objectives, assignments and key strategies for the next OSCE case. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Discuss key elements of the previous OSCE Case. 2. Discuss the appropriate SOAP note for the previous OSCE Case. 3. Identify and discuss objectives, assignments and key strategies for the next OSCE case. 1. Practice history taking and physical examination skills. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific
Lecturer
Review Lecture & Case #2 Preparation (Live Lecture)
TBA
Dr. Brown
OSCE Case #2
TBA
TBA
2:5
2/12/14 Review Lecture & Case #2 Preparation (Live Lecture)
TBA
Dr. Brown
Skills Session
TBA
TBA
2:6
2/19/14
OSCE Case #2
TBA
TBA
255
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives objectives. 1. Practice history taking and physical examination skills. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Discuss key elements of the previous OSCE Case. 2. Discuss the appropriate SOAP note for the previous OSCE Case. 3. Identify and discuss objectives, assignments and key strategies for the next OSCE case. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Discuss key elements of the previous OSCE Case. 2. Discuss the appropriate SOAP note for the previous OSCE Case. 3. Identify and discuss objectives, assignments and key strategies for the next OSCE case.
Lecturer
Skills Session
TBA
TBA
OSCE Case #2
TBA
TBA
2:7
2/26/14
TBA
Dr. Brown
OSCE Case #3
TBA
TBA
2:8
3/5/14
TBA
Dr. Brown
256
Sem: Week
Date
Lect. #
Lecture Topic Skills Session TBA
Readings
Course Objectives 1. Practice history taking and physical examination skills. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Practice history taking and physical examination skills. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Discuss key elements of the previous OSCE Case. 2. Discuss the appropriate SOAP note for the previous OSCE Case. 3. Identify and discuss objectives, assignments and key strategies for the next OSCE case. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. TBA
Lecturer
OSCE Case #3 2:9 3/12/14
TBA
TBA
Skills Session
TBA
TBA
OSCE Case #3
TBA
TBA
2:10
3/19/14
TBA
Dr. Brown
2:11
3/26/14
OSCE Case #4
TBA
TBA
257
Sem: Week
Date
Lect. #
Lecture Topic
Readings
Course Objectives 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Discuss key elements of the previous OSCE Case. 2. Discuss the appropriate SOAP note for the previous OSCE Case. 3. Identify and discuss objectives, assignments and key strategies for the next OSCE case. 1. Practice history taking and physical examination skills. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives. 1. Elicit a focused history. 2. Perform a focused physical examination. 3. Demonstrate correct interviewing and patient communication techniques. 4. Identify the correct Assessments and Plans for the patient. 5. Construct a post encounter SOAP note. See Blackboard for additional case specific objectives.
Lecturer
TBA
Dr. Brown
Skills Session
TBA
TBA
2:12
4/2/14
OSCE Case #4
TBA
TBA
2:13
4/9/14
OSCE Case #4
TBA
TBA
2:14
4/30/14
Course Conclusion
TBA
TBA
258
Pathology II Syllabus
Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Directors Campus Phone Directors Email Office Hours Pathology II BSCI-633-E Basic Biomedical Sciences 5 14 weeks Letter grade Tipsuda Bahri, MD 646-981-4610 tipsuda.bahri@touro.edu By appointment only
Course Description
Pathology is the study of disease. This course will provide students with 1) the understanding of basic patho-physiologic mechanisms that contribute to disease processes, and 2) the introduction of clinical correlations (i.e. symptoms, physical diagnosis, diagnostic procedures, and laboratory tests) that are important in the diagnosis of a disorder. The course also compliments and integrates topics with other second year courses: Clinical Systems, Medical Microbiology and Immunology, and Pharmacology. The course is covered over two semesters (Pathology I and Pathology II) and is divided into separate systems-based modules with didactic lectures. Student interaction and participation are required. There is a weekly 2 hour laboratory session which revolves around case studies and review questions that coincide with the module theme and incorporate histo-pathologic examination of digital images. The case studies will provide students with the ability to 1) understand certain patho-physiologic mechanisms of disease, 2) associate how certain mechanisms contribute to clinical presentations, symptoms, and disease patterns, 3) recognize key morphologic features and changes seen in organs associated with certain disorders, and 4) recognize and interpret certain ancillary diagnostic procedures and tests. In addition to the lab activities, the small group discussion/review sessions will aid in concept comprehension, promote teamwork, encourage peer evaluation, and strengthen the students role as educator.

After completion of the course, the student should be able to: 1. Understand pathology terminology and use them in proper context 2. Recognize general patho-physiologic mechanisms of disease (i.e. genetic/biochemichal disorders, cell injury, inflammation, infection, and neoplasia) 3. Evaluate and assess certain disorders regarding their patho-physiologic mechanisms, morphologic features, and clinical manifestations, and 4. Analyze and interpret certain procedures and tests as an aid in disease diagnosis.

If you have purchased the Robbins Basic, Big Robbins, or Rubins and do not want to change textbooks, then that is fine. The required reading will be based upon Robbins Basic Pathology (see schedule). Pathology II 259 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
1. Robbins Basic Pathology, 9th Edition (2012) [8th edition (2007) will also suffice] a. Kumar, Abbas, Fausto, and Mitchell b. ISBN-13: 978-1-4160-2973-7 from Elsevier (Saunders) --OR-2. Rubins Pathology: Clinicopathologic foundations of medicine, 5th or 6th edition (2011) a. Rubin and Strayer b. 5th edition: ISBN: 0-7817-9516-8; 6th edition ISBN: 9781605479682 from Lippincott Williams & Wilkins 3. Blueprints Medicine, 5th edition (2010) [For Clinico-pharmacologic correlation] a. Young, Chick, Kormos, & Goroll b. ISBN: 4. Rapid Review Laboratory Testing in Clinical Medicine (2008) [For Lab medicine correlation] a. Goljan and Sloka b. ISBN: 978-0-323-03646-7 from Elsevier (Mosby)

Listed in order of highly recommended to least recommended: 1. Rapid Review Pathology, 3rd edition 2011 a. Goljan b. ISBN 9780323068628 from Elsevier (Mosby) 2. First Aid of the USMLE Step1, 2013 edition a. Bhusan & Le b. ISBN: 9780071475310 McGraw-Hill 3. Pathophysiology 2009 a. Damjanov b. ISBN-13: 978-1-4160-0229-1 from Elsevier (Saunders) 4. Robbins & Cotran Review of Pathology, 3rd edition a. Klatt, Vinay, & Kumar b. ISBN: 9781416049302 from Elsevier (Saunders) 5. Lippincott's Review of Pathology (2006) a. Fenderson and Rubin b. ISBN: 9781416049302 from Elsevier (Saunders)

Textbooks:
1. Robbins and Cotran, 8th edition a. Kumar, Abbas, Fausto, Aster b. ISBN: 9781437707922 from Elsevier (Saunders) 2. Essentials of Rubins pathology, 5th edition a. Rubin and Reisner b. ISBN-10: 0-7817-7324-5 from Lippincott Williams & Wilkins 3. Renal Pathophysiology: the Essentials 3rd edition a. Rennke and Denker b. ISBN: 0781799953 4. Pathology Flash cards 2009 a. Baron and Lee b. 0071613056 McGraw-Hill 5. Andreoli and Carpenters Cecil Essentials of Medicine, 7th edition Pathology II 260 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
a. Andreoli b. ISBN-10: 1-4160-2933-8 from Elsevier (Saunders) Websites: Pathology: http://library.med.utah.edu/WebPath/webpath.html {Great images, tutorials, and review questions} Histology/Pathology: http://zoomify.lumc.edu/path/virtualpath.htm {Virtual pathology: Online glass slide review} http://www.meddean.luc.edu/lumen/gme.htm {Interesting multi-disciplinary case studies} http://www.medicine.virginia.edu/clinical/departments/pathology/Case%20Studies/known-pathologycases Radiology: http://www.med-ed.virginia.edu/courses/rad/ {Great source on reading XRays, CT scans, etc}
Exam Dates

The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation Path II -25.00% 81.55% 10.32%
Pathology II 261 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.

Quizzes /clicker sessions Module VIII Module IX Module X Module XI Module XII Module XIII Total 10% 6.4% 12.9% 12.9% 12.9% 25.7% 19.3% 100%
Laboratory & Small group Session Rules
Professionalism should be maintained in mannerisms and attire. Cells phones are to be turned off during laboratory sessions. Texting is not allowed. If you need to have your cell phone on for an important call, please notify a faculty member and make sure it is on vibrate mode. Students access to the internet and electronic books are for study inquiry only. Students should not access non-study-related websites (i.e. social networking, online shopping, or other sites). If students are not participating in the laboratory or session activity and are spending time on these non-related study sites, then these incidents will be taken into account for student evaluations and grade assessments. Laboratory attendance is MANDATORY. Excused absences are granted only by Dr Cammarata. Dr. Bahri must be notified of ANY absences verbally or in writing prior to, on the day of, or after the absence. Please submit documentation, Dr. Cammaratas written approval, or a doctors note the following day.
Participating Faculty
Tipsuda Bahri MD Robert Stern MD
Pathology II 262 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Schedule
Labs & Lectures
Sem: Week Date Lect. # Lecture Topic 1. 2. Course Objectives Distinguish the difference between a scrape, shave biopsy, punch biopsy, and excisional biopsy Recognize and categorize skin lesions as infectious, inflammatory, benign neoplasm, or malignant neoplasm by their clinical presentation and morphology Formulate a differential diagnosis for a rash, melanotic lesion, and blistering lesion based upon selected clinical case studies Evaluate special stains (histochemical/immunohistochemical) as diagnostic aids Discuss the pathogenesis, morphology, and clinical manifestation of ichthyoses, erythema multiform, lichen planus, and psoriasis Compare and contrast the pathogenesis, morphology, and clinical manifestation of pemphigus vulgaris, bullous phemphigoid, and dermatitis herpetiformis Explain the cutaneous involvement by cutaneous and systemic lupus erythematosis List the inflammatory disorders of the superficial and deep vascular bed and explain their pathogenesis Compare and contrast the pathogenesis, morphology, and clinical manifestation of panniculitis, erythema nodosum, and erythema induratum Discuss the pathogenesis and clinical manifestation of acne vulgaris List the infections and infestations of the skin and describe the corresponding clinical manifestation Compare and contrast the morphology of benign nevus, dysplastic nevus, and malignant melanoma Classify the types of malignant melanoma and describe the morphology and clinical manifestation Compare and contrast the pathogenesis, morphology, and Lecturer Readings
1/14/14
Lab1: Intro to Dermpath; Epidermal & Dermo-epidermal disorders
3. 4. 5.
Robbins Basic Chap 22 [Rubins Chap 24: pp 1006-25, pp 1027-31, pp 103437, pp 1037-56]
6.
2:1
7. 1. 2. 2 1/16/14 Infectious & Inflammatory dermatoses
Dr. Bahri
3. 4. 1.
Robbins Basic Chap 22 [Rubins Chap 24: pp 1027-37]
Benign & Malignant skin tumors
2. 3.
Dr. Stern
Robbins Basic Chap 22 [Rubins Chap 24: pp 1037-56] 263
Pathology II *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Sem: Week
Date
Lect. #
Lecture Topic
Course Objectives clinical manifestation of benign keratoses, squamous cell carcinoma, and basal cell carcinoma Distinguish between the morphology, clinical manifestation, and prognosis of adnexal cell tumors, dermatofibroma, and dermatofibrosarcoma protuberans
Lecturer
Readings
4.
1/20/14 1.
Holiday- Martin Luther King Jr Birthday

Identify the normal histology and function of immune systemorgans (Lymph node, Thymus, Spleen, MALT/GALT: Tonsils,and Appendix) Explain their role in certain conditions (i.e. increasing age,inflammation/infection, tumor metastasis, myastheniagravis) Recognize the common CD markers for lymphocyticidentification and how it is used to distinguish B & Tlymphocytes Recognize abnormal, pathologic architectural changes Define the terms Atrophy, Effacement, Follicularhyperplasia, and Sinus histiocytosis Discuss acute phase reaction and the significance of certain involved reactants Evaluate serum and urine protein electrophoresis in acute phase reaction, chronic inflammation, nephritic syndrome, and monoclonoal vs polyclonal gammopathy conditions Evaluate CSF protein electrophoresis and the presence of oligoclonal bands present in multiple sclerosis Explain the mechanisms by which immune tolerance is lost in the general pathogenesis of autoimmune disease Discuss the pathogenesis, laboratory diagnosis, morphology, and clinical manifestation of systemic lupus erythematosus (SLE) Recognize the organs in the body affected by SLE and describe the corresponding clinical manifestation
1/21/13 2:2
Lab2: Evaluation of immune system organs
2.
3. 4.
Supplemental reading: Review these organs from the chapters of your histology textbook
5. 1. Autoimmune diseases I 2.
1/23/14
Dr. Bahri
3.
Robbins Basic Chap 5: pp 135-51 [Rubins: Chap 4 pp 123-29]
264
Sem: Week
Date
Lect. #
Lecture Topic 4.
Course Objectives Identify and compare and contrast the pathogenesis, laboratory diagnosis, and clinical manifestation of types of lupus-like diseases Discuss the pathogenesis, laboratory diagnosis, and morphology of Sjogren syndrome, Scleroderma, and Mixed connective tissue disease Describe the organs in the body affected by Sjogren syndrome and Scleroderma Discuss the incidence and clinical manifestation of Mixed connective tissue disease and compare and contrast with SLE and Scleroderma Review the pathophysiology of transplant immunology Identify the morphology and clinical manifestation of the types of transplant rejection reactions Discuss the pathophysiology, morphology, and clinical manifestation of graft versus host disease (GVHD) Compare and contrast the patho-physiologic mechanism, morphology, and clinical manifestation of acute and chronic graft versus host disease Compare and contrast the pathogenesis, morphology, and clinical manifestation of disorders of primary antibody deficiency disease Compare and contrast the pathogenesis, morphology, and clinical manifestation of disorders of T cell immunodeficiency disease Discuss the pathogenesis, morphology, and clinical manifestation of disorders of combined immunodeficiency disease List the etiology of secondary immune deficiency syndrome Discuss pathogenesis, laboratory diagnosis, morphology, and clinical manifestation of acquired immune deficiency syndrome (AIDS) List the infections and neoplasms associated with AIDS Compare and contrast the epidemiology of HIV-1 and HIV2
Lecturer
Readings
1.
Autoimmune diseases II
2. 3.
Dr. Stern
Robbins Basic Chap 5: pp 135-51 [Rubins: Chap 4 pp 127-29, Chap 24 pp 1031-32, Chap 25 pp 1074-75]
1. 2. 2:3 1/28/14 6 Lab3: Transplantation 3. 4.
Dr. Bahri
Robbins Basic Chap 5: pp 152-55 [Rubins: Chap 4 pp 118-23, 129-31]
1.
Immune deficiency diseases
2.
Dr. Bahri
3. 2:3 1/30/14 1. 2.
Secondary immune deficiency syndrome
Dr. Stern
3. 4.
265
Sem: Week
Date
Lect. #
Lecture Topic infection
Course Objectives
Lecturer
Readings
2/3/14
Module exams VIII & IX

1.

Compare and contrast the etiology, pathogenesis, morphology, and clinical manifestation of various types of anemia and hemostatic disorders Utilize peripheral blood smears, laboratory tests, and bone marrow biopsy to assess red blood cell, platelet, and bone marrow disorders Distinguish on the peripheral blood smears, the morphologic features of anemia, spherocytosis, rouleaux formation, thrombocytopenia, and platelet dysmorphology
2:4 2/4/14 Lab4: Anemia work-up
2.
3.
Robbins basic Chap 12 [Rubins: Chap 20 pp 861-93, pp 92829]
NOTE: Path discussion sessions in the Heme module are based upon Dr Bahris Clinical Systems E-lectures. [No separate E-Lectures for Pathology Heme section. Pathology sessions are an extension of Clinical Systems]
1. CS ELecture Anemias I; Polycythemia 2. 1. Discuss the pathogenesis, morphology, laboratory evaluation, and clinical manifestation of polycythemia Distinguish from normocytic, microcytic, and macrocytic anemia by the peripheral blood smear morphology and etiology Distinguish between the pathogenesis, morphology, laboratory evaluation, and clinical manifestation of autoimmune hemolytic anemia, hemolytic transfusion reaction, hemolytic disease of the newborn, and paroxysmal nocturnal hemoglobinuria Recognize the utility of the direct antiglobulin test (direct Coomb's test) in the diagnosis of immune hermolytic anemia Distinguish between intravascular and extravascular hemolysis in hemolytic anemia, and provide examples of disorders associated with each type Discuss the role of the spleen in the removal of aged/damaged erythrocytes and in extravascular hemolysis Discuss the pathogenesis, morphology, laboratory evaluation of mechanical red cell fragmentation syndrome (micro- or macro angiopathic hemolytic anemia) Explain the association of severe thermal burns with hemolytic Dr. Bahri Robbins basic Chap 12 [Rubins Chap 20: pp 862-70, 880]
2:4 2. 2/6/14 CS ELecture 3. Anemias II 4. 5.
Dr. Bahri
Robbins basic Chap 12 [Rubins Chap 20: pp 870-72, 874-77]
6.
266
Sem: Week
Date
Lect. #
Lecture Topic 1. 2. Lab5: Immunohematology 3. 4. 5.
Course Objectives anemia Describe the formation of ABO, Rh antigens and their genetic basics Describe the laboratory tests used to determine blood type, blood compatibility, and transfusion reactions Identify the types of blood components available for transfusion Compare and contrast the pathogenesis and clinical manifestations of certain types of transfusion reactions Compare and contrast the IgG and IgM alloantibodies produced in response to red blood cell transfusion in terms of ability to cross the placenta, and likelihood of causing intravascular or extravascular hemolysis Discuss the pathogenesis, laboratory findings, and clinical manifestation of hemolytic disease of the newborn Compare and contrast the pathogenesis, morphology, laboratory evaluation, and clinical manifestation of thalassemia and sickle cell disease Discuss the laboratory evaluation for abnormal hemoglobin disorders, Hereditary spherocytosis, and Paroxysmal nocturnal hemoglobinuria Recognize some causes, clinical manifestations, and lab diagnosis of vitamin B 12 and folate deficiencies Classify hemostatic disorders by vascular abnormality, platelet abnormality, or coagulation factor deficiency Recognize laboratory tests used for the evaluation of hemostatic disorders Compare and contrast the pathogenesis, laboratory evaluation, and clinical manifestation of hemophilia A, von Willebrand disease, and vitamin K deficiency Distinguish between disorders of coagulation factor deficiency and inhibitors of coagulation factor Explain Virchow's triad and provide examples of disorders associated with each triad component Distinguish between inherited and acquired hypercoagulability
Lecturer
Readings
2/11/14
{Separately designated Pathology ELecture}
Goljan Rapid Review Laboratory testing Chap 8 pp 266-76
6. 1. 2:5 2/13/14 CS ELecture
Anemias III
2.
Dr. Bahri
Robbins basic Chap 12 [Rubins Chap 20: pp 877-80]
3. 1. 2. CS ELecture Disorders of Hemostasis & thrombosis 3.
2/13/14
Dr. Bahri
4. 5. 6.
Robbins basic Chap 12 [Rubins Chap 10: pp 393-96, Chap 20: pp pp 862-70, 880, 88390]
267
Sem: Week
Date
Lect. #
Lecture Topic 7. 8.
Course Objectives and provide examples associated with each Describe the pathogenesis, laboratory evaluation, and clinical manifestation of coagulation factor inhibitors Compare and contrast the pathogenesis, morphology, laboratory evaluation, and clinical manifestation of disseminated intravascular coagulation (DIC), idiopathic thrombocytopenic purpura (ITP), and thrombotic thrombocytopenic purpura (TTP)
Lecturer
Readings
2/17/14 1.
Holiday- Presidents Day

Compare and contrast the pathogenesis, morphology, molecular genetics, and clinical manifestation of disorders associated with myelodysplastic syndrome Evaluate the WHO classification of acute myeloid leukemia (AML) and classify associated disorders by their pathogenesis, morphology, molecular genetics, and clinical manifestation Compare and contrast the French-American-British (FAB) classification with the WHO classification of acute myeloid leukemia (AML) Distinguish between the morphology and immunophenotype of the types of acute myeloid leukemia (AML) Distinguish between lymphcytopenia, lymphocytosis, plasmacytosis, histiocytosis, and lymphoid hyperplasia Evaluate the classification of B-cell neoplasms and classify disorders by their pathogenesis, morphology, and molecular genetics Distinguish between B-acute lymphoblastic leukemia/lymphoma, small lymphocytic lymphoma, and lymphoplasmacytic lymphoma Compare and contrast the morphology, immunophenotype, and clinical manifestation of mantle cell lymphoma, diffuse large Bcell lymphoma, follicular lymphoma, Burkitt lymphoma, hairy cell leukemia, and MALT lymphoma
2:6 2/18/14 CS ELecture
Lab6: Myelodysplastic syndrome; Leukemia
2.
Dr. Bahri
3.
4. 1. 2. Disorders of lymphopoietic system I
2:6
2/20/14
10
3.
Dr. Stern
4.
268
Sem: Week
Date 2/24/14
Lect. #
Lecture Topic
Course Objectives
Lecturer
Readings
Module exam X
1.

Compare and contrast the morphology , immunophenotype, and clinical manifestation of adult T-cell leukemia/lymphoma, mycosis fungioides, and anaplastic large cell lymphoma Discuss the epidemiology, pathogenesis, histologic classification, and clinical manifestation of Hodgkin lymphoma Summarize the prognosis and staging system for Hodgkin disease Discuss the epidemiology, pathogenesis, morphology, and clinical manifestation of post-transplant lymphoproliferative disorder Distinguish multiple myeloma, MGUS, Waldenstrom macroglobulinemia by their pathogenic mechanism, morphology, clinical manifestation, and laboratory diagnosis Review and discuss some common solid organ tumors regarding their epidemiology, morphology, clinical manifestations, and diagnostic tests Discuss the epidemiology, risk factors, pathogenic mechanisms, and morphology of breast, pulmonary, and colorectal carcinoma Discuss the molecular genetics associated with certain solid tumors Identify prognostic factors associated with each cancer type Interpret the effects of local spread and metastasis associated with each cancer type
2/25/14
11
Lab: Disorders of lymphopoietic system II; Plasma cell dyscrasia
2. 3. 4.
Dr Bahri/ Dr. Stern
2:7
5.
1.
2. 2/27/14 12 Solid Tumors 3. 4. 5. 3/3/14
Dr. Stern
Robbins Basic Chap 13,15,19 [Rubins: Chap 20 pp 893-94, pp 902-10, pp 92226]
Module exam XI
1. Lab: CNS infections; CSF examination

Recognize the morphology, diagnostic tests, and clinical manifestations of agents that can infect the CNS parenchyma Identify infectious agents that are commonly associated with HIV/AIDS Discuss the normal cellular, protein, sugar, and electrolyte component of CSF Dr Bahri/ Dr. Stern Robbins Basic Chap 23: pp 873-81 [Rubins: Chap 28 pp 1195-1209] 269
2:8 3/4/14 13
2. 3.
Sem: Week
Date
Lect. #
Lecture Topic 4.
Course Objectives Compare and contrast examples of normal, reactive, and abnormal cell morphology, and foreign material in CSF examination and associate the cytologic findings with the corresponding disorder Compare and contrast the pathogenesis, morphology, and clinical manifestation of bacterial and viral CNS infections Review cerebral edema and the resulting brain herniations Distinguish between the location, morphology, and clinical manifestion of subfalcine, transtentorial (uncinate), and tonsillar herniation Review head injuries and the development of coup-coutre coup Distinguish the etiology, morphology, and clinical presentation of epidural, subdural, and subarachnoid hemorrhages Distinguish the etiology, pathogenic mechanism, and morphology of hemorrhagic ,and ischemic stroke Recognize neuronal changes seen in neuronal injury and ischemic infarct Associate liquefactive necrosis with ischemic infarct Evaluate the utility of creatinine kinase, electromyography, aspartate aminotransferase, and muscle biopsy in the diagnosis of muscular disorders Distinguish between the morphology and clinical manifestation of Duchenne and Becker muscular dystrophy Discuss the pathogenesis, morphology, and clinical manifestation of myotonic dystrophy Identify the pathogenic mechanism, morphology and clinical manifestations of Alzheimers, Parkinsons, Picks, Huntingtons disease, and ALS Recognize congenital malformations of the brain & spinal cord Discuss the pathogenesis, morphology, and clinical manifestations of Multiple sclerosis (MS) and Guillian-Barre syndrome (GBS) Be able to distinguish MS as a CNS demyelination vs GBS as a PNS demyelination
Lecturer
Readings
5. 1.
2:8
3/6/14
14
CNS trauma; Cerebrovascular disease;
2. 3. 4.
Dr. Bahri
Robbins Basic Chap 23: pp 86171, 891-97 [Rubins: Chap 28 pp 1188-98, pp 1211-12]
5. 1. Lab: Neuromuscular disorders
3/11/14
15
2. 3.
Dr. Bahri/ Dr.Stern
Robbins Basic Chap 21: pp 827-30 [Rubins: Chap 27 pp 1156-59, pp 1167-70]
2:9
3/11/14
16
Lab: Degenerative disease Demyelinating, congenital and metabolic disorders
1.
Dr. Stern
1. 2.
3/13/14
17
Robbins Basic Chap 23: pp 887-89 [Rubins: Chap 28 pp 1209-1212, 1239-43] 270
Sem: Week
Date
Lect. #
Lecture Topic 3.
Course Objectives Distinguish primary demyelinating disorders from acquired demyelinating disorders (i.e central pontine myelinolysis and progressive multifocal leukoencephalopathy) Distinguish between the pathogenesis, morphology, and clinical manifestations of leukodystrophic disorders Review some metabolic disturbances of the CNS (thiamine deficiency, vitamin B12 deficiency, hyper/hypoglycemia, and hepatic encephalopathy) Classify the CNS tumors according to their cell of origin Discuss the distribution, age, and clinical manifestation of common intracranial tumors Distinguish the morphology of CNS tumors and discuss their prognosis Distinguish between the pathogenesis, morphology, and clinical manifestation of primary PNS tumors (Schwannoma, neurofibroma, and malignant peripheral nerve sheath tumor ) Discuss the pathogenesis, morphology, clinical manifestation, and complications of avascular necrosis and osteomyelitis Compare and contrast the pathogenesis, morphology and clinical manifestation of osteoporosis, osteomalacia, primary hyper-parathyroidism, and renal osteodystrophy Distinguish between osteomalacia and rickets Describe the clinical and radiographic features of various fractures: open, closed, comminuted, impacted, transverse, spiral, oblique, Greenstick, compression, pathologic, etc Summarize the phases of fracture healing Review the morphology and clinical manifestations of rheumatoid arthritis, gout, pseudogout, and osteoarthritis Distinguish between the morphology and clinical manifestation of benign and malignant tumors of the bone, cartilage, and soft tissue List common locations of primary bone tumors Correlate the radiographic features associated with osteosarcoma (i.e. Codmans triangle and Sunburst sighn)
Lecturer
Readings
4. 5.
1. 2. 3/18/14 18 Lab: CNS & PNS tumors 3. 4. 2:10 1. 3/20/14 19 Benign disorders of bone 2.
Dr.Stern
Robbins Basic Chap 23: pp 882-87 [Rubins: Chap 28 pp 1225-36, 124445]
Dr.Stern
3. 1. 3/25/14 20 Lab: Bone, cartilage, and soft tissue disorders
2. 3. 1.
Dr. Bahri
2:11 Tumors of bone and soft tissue
3/27/14
21
Dr.Stern
2. 3.
271
Sem: Week
Date
Lect. #
Lecture Topic 4.
Course Objectives Distinguish between primary tumors and metastasis to bone
Lecturer
Readings
3/31/14
Module exam XII

1.

Discuss the pathogenesis, morphology, and clinical manifestation of gynecomastia Distinguish between the pathogenesis, morphology, and clinical manifestation of fibroadenoma, fibrocystic change Discuss the pathogenesis, morphology, and clinical manifestation of phyllodes tumor Distinguish between morphology and clinical manifestations of in-situ and invasive ductal and lobular carcinoma Discuss the significance of mammography for breast cancer screening Discuss the significance of BRCA1 and BRCA2 in breast cancer genetics Recognize other types of carcinoma (tubular, inflammatory) Discuss the congenital anomalies of the uterus Compare and contrast the histologic features of the reproductive, menopausal, and postmenopausal periods List the etiology of menopausal and postmenopausal dysfunctional uterine bleeding, and infertility Distinguish between acute and chronic endometritis, endometriosis, adenomyosis, and intrauterine adhesions List the causes of abnormal uterine bleeding associated with the reproductive, menopausal, and postmenopausal ages Explain the indications for endomyometrial biopsy Distinguish between the pathogenesis, morphology, and clinical manifestation of endometrial hyperplasia, endometrial polyp, and adenocarcinoma Classify the morphologic types of endometrial adenocarcinoma Discuss the pathogenesis, morphology, and clinical manifestation of endometrial smooth muscle tumors (i.e. leiomyoma, leiomyosarcoma)
4/1/14
22
Lab: Breast disorders
2. 3. 1. 2.
Dr. Bahri/ Dr.Stern

23
Breast disorders 3. 4. 1. 2. 3.
Dr.Stern
2:12
4/3/14
4. Disorders of the uterus 5. 6. 7.
24
Dr. Bahri
8. 9.
272
Sem: Week
Date
Lect. #
Lecture Topic
Course Objectives 10. Discuss the morphology and clinical manifestations of malignant mixed mullerian tumor (MMMT) 1. Distinguish between the pathogenesis, morphology, and clinical manifestation of complete and partial hydatidiform mole, and the association with choriocarcinoma 2. Compare and contrast the pathogenesis, morphology, and clinical manifestation of placental abruption, previa, and accreta 3. Distinguish the placental morphology of dizygotic and monozygotic twins 4. Discuss the etiology and morphology of spontaneous abortion 5. Review of Lecture 22 (above) 1. Classify ovarian tumors by the cell of origin 2. Distinguish between the pathogenesis, morphology, and clinical manifestation of benign, borderline, and malignant epithelial ovarian tumors 3. Discuss the pathogenesis, morphology, and clinical manifestation of ovarian germ cell and sex cord/stromal tumors 4. Explain the clinical significance of Krukenberg tumors, Struma ovarii, and Pseudomyxoma peritonei 5. Discuss the pathogenesis, morphology, and clinical manifestation of salpingitis and distinguish from pyosalpinx, hydrosalpinx, and tubo-ovarian abscess 6. Discuss the pathogenesis, morphology, and clinical manifestation of ectopic pregnancy 7. 6. Discuss the pathogenesis, morphology, and clinical manifestation of benign ovarian cysts, and polycystic ovarian syndrome 1. Discuss etiology of acute cervicitis and distiguish acute cervicitis from chronic cervicitis 2. Discuss HPV infection and the pathogenesis of cervical dysplasia and carcinoma and list HPV strains that are high risk 3. Compare and contrast the pathogenesis, morphology, and clinical manifestation of cervical adenocarcinoma and
Lecturer
Readings
2:13
4/8/14
25
Lab: Placental/ Gestational disorders
Dr. Bahri
4/8/14
26
Lab: Disorders of the ovaries & fallopian tubes
Dr.Stern
Robbins Basic Chap 19 [Rubins: Chap 18 pp 805-11, pp 814-23, pp 828-29]
2:13
4/10/14
27
Disorders of the cervix, vulva, and vagina
Dr. Bahri
273
Sem: Week
Date
Lect. #
Lecture Topic
Course Objectives squamous cell carcinoma
Lecturer
Readings
4/14/14 to 4/24/14 2:14 Finals 4/29/14 5/1/14 5/5/14
Spring break- No classes No Pathology Lab due to OMM practical

Dr Bahri & Dr Stern available for office hours
Module review Module exam XIII
Clicker session score will still count towards course grade Covers materials from weeks 12-14
274
Pharmacology II Syllabus
Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Assistant Professor Directors Campus Phone Assistant Professors Phone Directors Email Assistant Professors Email Office Hours Pharmacology II BSCI 647-E Basic Biomedical Sciences 4 14 weeks Letter Arthur Prancan, PhD Maria A. Pino, PhD (646) 981-4612 (646) 981-4613 Arthur.Prancan@touro.edu maria.pino@touro.edu Noon Wednesday and Thursday
Course Description
Pharmacology is the comprehensive understanding of how a single chemical mechanism can stop or reverse a disease process and restore normal biochemical and physiological function. This course will emphasize that the basis for safe and effective drug therapy is a clear awareness of the following: 1. A precise expectation of the therapeutic goal. 2. The mechanistic cause of dysfunction or disease. 3. The mechanism of action which a drug must apply in order to prevent, stop or reverse a disease or dysfunction. 4. The limits to safe and effective drug action.

The student will incorporate information attained in lecture, textbooks, quizzes and exams into a body of knowledge which will support the practice of safe and effective application of drug therapy. The student should learn to: 1. Describe the general principles which define the application of a drug to a patient. 2. Identify which drug class or classes are indicated for the prevention or relief of a medical condition or disease. 3. Describe the precise mechanism of action for each drug class and be able to give an example using a specific member of the drug class. 4. Identify the generic name of the prototype for each drug class with specific attention to the unique characteristics that define specific members of each drug family. 5. Describe the adverse effects uniquely associated with a class of drugs, and special problems associated with individual members of the group. 6. Predict adverse drug-drug, drug-food and drug-disease interactions.

Study Guide and Lecture Notes
Pharmacology II 275 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
a. Arthur Prancan, Ph.D; Maria A. Pino, Ph.D. b. Posted on Blackboard

1. Basic and Clinical Pharmacology, 12th edition a. Editor = Bertram Katzung b. Publisher = McGraw-Hill Companies c. Publication Date = 2011 d. ISBN = 978-0-07-160405-5 2. First Aid of the USMLE Step1, 2013 edition a. Editor = Bhusan & Le b. Publisher = McGraw-Hill c. Publication Date = 2013 d. ISBN = 9780071475310 3. Katzung and Trevors Pharmacology with Examination and Board Review, 10th edition a. Editor = Trevor and Katzung b. Publisher = McGraw-Hill Companies c. Publication Date = 2013 d. ISBN = 978-0-07-178923-3 4. Pharmacology, 4th edition a. Editor= Brenner and Stevens b. Publishe r= Elsevier c. Publication Date = 2013 d. ISBN = 978-1-4557-0282-4
Exam Dates

For this course the following breakdown will be used, where exam Z-Scores greater than and equal to 0.75 are an A, exam Z-Scores less than 0.75 and greater than and equal to -0.45 and are a B, exam Z-Scores less than -0.45 and greater than and equal to -1.35 are a C and exam Z-Scores below -1.35 are an F. For the raw percentages required to achieve these Z-Scores for this course, please see the chart below. Letter Grade A B C Z-Score 0.75 Z -0.45 Z < 0.75 -1.35 Z < -0.45 Percent 90.63% % 77.24% % < 90.63% 67.21% % < 77.24%
Z < -1.35
% < 67.21%
The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation Pharm II -5.00% 81.70% 11.15%

Quizzes Module VIII Module IX Module X Module XI Module XII Module XIII Total 10% (no quizzes will be dropped) 6.4% 12.9% 12.9% 12.9% 25.7% 19.3% 100%
Course Schedule
Lectures
Sem: Week Date Topic. # Lecture Topic Readings Course Objectives 1. Describe the role of corticosteroids in skin disorders (useful, MOA, and toxicities). 2. Identify drugs used in hair growth, theirMOA, and toxicities 3. Describe the MOA of botox and associated toxicities 4. Describe the treatments (oral and topical) used in acne, including their action in the skin and toxicity. 5. Describe the contraindications and toxicities associated with isotretinoin. 1. Describe the use of immune modulators in skin disorders, including MOA and toxicities. 2. Identify drugs used in psoriasis. 3. Review the MOA of biological agents and their toxicities. 4. Describe the agents used in the treatment of skin cancer including MOA, and toxicities, 1. Describe the MOA, clinical use, and clinically significant drug interactions for drugs used to treat bacterial, fungal, and viral skin infections. 2. Identify the toxicities for all classes of drugs 3. Identify drugs used for lice.Describe their MOA and toxicity. 1. Identify prostaglandins which exert inflammatory action. Lecturer
Module VIII: Dermatology

1 Topical Corticosteroids, Hair Growth, Botox, and Acne Ch. 36,61
Pino
2:1
1/16/14 2 Immune-Modulators and Drugs used in Psoriasis and Skin Cancer Ch. 61
Pino
Skin Infections
Ch. 61
Pino
2:2
1/23
Module IX
Ch. 18
Prancan 278
Pharmacology II *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 2. Identify leukotrienes which exert proinflammatory action. 3. Identify drugs which may block prostaglandin and leukotriene action.
Lecturer
Introduction to Immunology:
The Proinflammatory Prostaglandin and Leukotriene Actions
Aspirin and Acetaminophen
Ch. 36
Non-Steroidal Antiinflammatory Drugs (NSAIDs)
Ch. 36
Corticosteroids as AntiInflammatory Drugs
Ch. 39
1. Describe the MOA for aspirin. 2. Describe the MOA for acetaminophen. 3. Identify the analgesic, antipyretic and anti-inflammatory usefulness for aspirin. How does aspirin differ from acetaminophen.. 4. Determine the toxicities of aspirin and the method of decontamination in the event of an overdose. 5. Describe the basis for low-dose aspirin prophylaxis against cardiac and cerebral vascular events. 6. Describe the MOA N-acetylcysteine as the antidote for acetaminophen overdose 1. Define the MOA for these drugs 2. Identify individual drugs and their usefulness and toxicity. 3. Identify COX-2 selective NSAIDs. 4. Describe the basis for COX-2 selective NSAID toxicity leading to MI and stroke. 1. Determine the synthesis, MOA and physiologic role for cortisol. 2. Identify drugs with glucocorticoid and mineralcorticoid activity. 3. Identify the anti-inflammatory benefits of glucocorticoids.
Pino
Pino
Pino
279
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 4. Determine the toxic outcomes of longterm therapy with glucocorticoids, including the possibility of osteoporosis 1. Identify DMARDs. 2. Describe their MOA, usefulness and toxicity. 1. Define the role of serotonin in disease. 2. Identify drugs which support serotonin action or oppose it. 3. Define the serotonin syndrome and describe drug-drug interactions which will produce it. 4. Define the role of histamine in disease. 5. Identify drugs which block histamine action. 6. Define the serotonin syndrome and describe drug-drug interactions which will produce it. Describe mechanisms for immune-mediated allograft rejection. 1. Identify immunosuppressive drugs by class. 2. Define the strategy for drug combinations in immunosuppression. 3. Characterize drugs by MOA, usefulness and toxicity.
Lecturer
Disease Modifying AntiRheumatoid Drugs (DMARDs)
Ch. 36
Prancan
9 2:3 1/30
Serotonin Agonists and Antagonists and Histamine Blockers
Ch. 16
Prancan
10
Transplant Rejection
iTunes lecture
Jones
11
Immunosuppressive Drugs
Ch. 55
Pino
2/3
2:4
Module VIII and IX Exam (Derm and Rheum) Pharmacology Lectures 1-11 1. Identify mechanisms of platelet Module X: activation which are targets for drug Hematology action.
12 Platelets and Antiplatelet Drugs 13 Blood Coagulation and Ch. 34 Ch. 34 2. Describe the MOA and toxicities of antiplatelet drugs. 3. Understand the Low-Dose Aspirin Story 1. Identify coagulation mechanisms which Prancan
2/6
Prancan 280
Sem: Week
Date
Topic. #
Lecture Topic Anticoagulants
Readings 2. 3. 1. 2.
Course Objectives are targets for drug action. Characterize the drug classes which act to suppress coagulation Characterize drugs which promote clot retraction Define the daily requirements for iron for certain populations Identify the signs and symptoms of iron deficiency Identify iron replacements Define neutropenia and Thrombocytopenia Identify factors which stimulate cell growth. What are the toxicities of these growth factors? Describe deferoxamines role in iron intoxication Describe the folate pathway with an emphasis on the role of Vitamin B12. Define the outcomes of the two deficiencies. Compare the symptoms of these two deficiencies Describe methods for recovery Describe drugs known to induce anemias; including the MOA and toxicities of these drugs. Describe the MOA for this class of drugs, including cisplatin and related drugs. Identify individual drugs by indication. Define the specific organ toxicity of this class of drug. Describe the role of MESNA in cyclophosphamide toxicity.5.Describe
Lecturer
14
The Anemias I Iron Deficiency Neutropenia Thrombocytopenia
Ch. 33
3. 4. 5.
Pino
2:5
2/13
6. 1. 2. 15 The Anemias II Vit B12 Deficiency Folate Deficiency Ch. 33 3. 4. 5.
Pino
1.
Module XI: Oncology

2:6 2/20 16 Alkylating Agents Ch. 54
2. 3. 4.
Pino
281
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives how the toxicities of chemotherapeutic drugs can be clinically managed. Describe the MOA for this class of drugs. Identify individual drugs by usefulness and toxicity. Define SERM and which drugs are included Define SERD and which drugs are included Describe the outcome of aromatase blocking drugs Describe drugs indicated for use in Estrogen Receptor (ER) positive breast cancer Describe the advantages of Raloxifene and Fulvestrant over Tamoxifen Describe the advantages of aromatase inhibitors over tamoxifen Describe the MOA and toxicity for diethylstilbesterol (DES) and flutamide Describe the use for flutamide in early treatment with leuprolide or goserelin
Lecturer
17
Antimetabolites
Ch. 54
1. 2. 1. 2. 3. 4.
Degenhardt
18
Hormonal Cancer Management
Ch. 54 5. 6. 7. 8.
Degenhardt
2/24
Module X Exam (Hematology). Lectures 12-15

1. Define the MOA and specific organ toxicities associated with doxorubicin, bleomycin, actinomycin-d, and mitomycin 2. Define the MOA.,different drugs included and toxicity for the Vinca alkaloids 3. Define the specific toxicities and warnings of vincristine and vinblastine. 5. Describe the MOA and toxicities of the taxane class of chemotherapeutics
2:7
2/27
19
Antibiotics and Vinca Alkaloids
Ch. 54
Degenhardt
282
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 6. Describe the indications for the use of this class of drugs 7. Describe how drug toxicities can be clinically managed 1. Identify the drug targets. 2. Identify individual drugs by usefulness at specific targets. 3. Identify drug toxicities 2. Identify the drug targets. 3. Identify individual drugs by usefulness at specific targets. 4. Identify drug toxicities 1. Identify analgesic drug classes; including full, weak and partial agonists. What are the indications of specific agonists? 2. Describe drugs and correlate to MOA. 3. Identify drug usefulness and toxicity. 4. Recognize the signs of an opioid overdose. 5. Describe the critical use of opioid antagonists in overdose situations. 1. Describe the concepts of gas induction and elimination. 2. Identify the MOA for anesthetics. 3. Define the usefulness and toxicity of each anesthetic. 4. Classify anesthetics according to safety and useful characteristics. 1. Describe the clinical use of anesthetics. 2. Identify the MOA of anesthetics. 3. Identify local anesthetics. 4. Characterize the MOA, usefulness and
Lecturer
20
Monoclonal Antibodies
Ch. 54
Degenhardt
21 3/3
Molecular Targets
Ch. 54
Degenhardt
Module XI Exam (Oncology). Lectures 16-21 Module XII:Introduction to Neuropharmacology and 22 Psychopharmacology
Analgesia: Opioids and NonNarcotics
Pino
2:8
3/6 General Inhalation Anesthetics
23
Ch. 25
Prancan
24
Injectable and Local Anesthetics
Ch. 26
Pino
283
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives toxicity for each anesthetic agent and class. Describe why certain LA induce allergic reactions and what can be done to avoid this in those patients. Describe the role of sodium bicarbonate and vasoconstrictors in LA administration. Define MOA and toxicities of drugs for sedation and sleep. Describe advantages and indications among the drug classes. Describe the benefit of using benzodiazepines over barbiturates Describe the drug interactions associated with use of these classes of drugs Describe the antidote for benzodiazepine toxicity. Describe the difference in use and MOA between benzodiazepine and buspirone in anxiety disorders. Define the disorder. Apply drugs. Identify toxicities. Compare drugs on the basis of toxicities and MOA. Describe the classes of drugs which improve mood. Indicate MOA. Define advantages on toxicities and efficacy. Describe the early and late drug interventions in migraine. Define the drugs according to MOA. Describe toxicities associated with
Lecturer
5.
6.
1. 2. 3. 25 Anxiety, Sleep and SedativeHypnotics Ch. 22 4.
Pino
5. 2:9 3/13 6.
26
Psychosis and Antipsychotic Drugs Depression and Antidepressant Drugs
Ch. 29
1. 2. 3. 1.
Prancan
27
Ch. 30
2. 1.
Prancan
2:10
3/20
28
Headache
Study Guide
2. 3.
Pino
284
Sem: Week
Date
Topic. #
Lecture Topic
Readings 4. 5. 1. 2. 3.
Course Objectives headache medication use Describe the contraindications of 5HT1/D agonists Describe the role of muscle relaxants in headache therapy. Identify anticonvulsants. Characterize each drug according to MOA, use and specific toxicity. Describe the toxicities that may manifest in the developing embryo when being treated with specific anticonvulsants Describe drug interactions common to these drugs Describe other uses for these anticonvulsant drugs in other neurological disorders. Describe the specific treatment options for CNS infections. Describe the MOA and toxicity of specific drug treatments Understand the role of dopamine and acetylcholine in control of movement. Apply specific drugs to these disorders. Describe the mechanism and toxicities of the drugs used in Parkinsons disease Define the etiology of Myasthenia Gravis (MG). Determine appropriate diagnosis. Identify drug classes used in MG. Define drug related toxicities Identify neuromuscular blockers which are non-depolarizing and which are depolarizing in mechanism of action. Characterize the neuromuscular blockers
Lecturer
29
Anticonvulsants
Ch. 24 4. 5.
Pino
1. 30 CNS infections Lecture and Study guide 2. 2. 31 Movement Disorders Ch. 28 3. 4. 1. 2:11 3/27 32 Autoimmune Disease of the Neuro-Muscular Junction Ch. 7 2. 3. 4. 1.
Pino
Prancan
Prancan
33
Neuromuscular Blockers
Ch. 27 2.
Prancan
285
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives according to duration of action. 3. Identify natural toxins and define the MOA.
Lecturer
3/31
Module XII Exam (Neuro-Psychopharmacology). Lectures 22-33 Module XIII: Obstetrics/Gynecolog y and Applied 1. Define the MOA of tocolytic agents. 2. Describe the MOA of drugs used to Pharmacology Topics
34 Study Guide
Introduction to OB/GYN
Tocolytics: Drugs used to Induce Labor
induce labor. 3. Describe the MOA of drugs used to overcome the toxicities of drugs in items 1 and 2.
Prancan
2:12
4/3 Fertility Drugs Contraceptives Abortifacients
35
Ch. 40
36
Drugs and Teratogenicity
Study Guide
1. Identify the clinical uses for oral contraceptives (OC). 2. Explain the MOA, toxicities, contraindications, and significant drug interactions of OC use. 3. Describe the benefits and risks of progestin only and post-coital formulations. 4. Describe the role of clomiphene in fertility treatment. What is the MOA and toxicity of this drug? 5. Describe mifepristone and its antipregnancy effects. 1. Define the term teratogen 2. Explain some pharmacokinetic principles in regards to teratogens. 3. Describe the FDAs method of categorizing the use of a drug in the
Pino
Pino
286
Sem: Week
Date
Topic. #
Lecture Topic
Readings 4. 1.
Course Objectives pregnant female. Describe the MOA and fetal effects of known teratogens. Identify the specific treatment for specific STDs. Describe the MOA of drugs used in the treatment of STDs. Describe drugs for STDs that are considered safe in the pregnant female. Describe the basic elements of a valid prescription. Identify the five controlled drug classes and which drugs belong to each specific class. Identify the common abbreviations used in prescriptions and chart orders. Describe the laws that govern the use of control drugs, faxed, written, and telephoned prescriptions. Describe the important metric conversions in prescription dosing. Describe the stages, timing and terminology of the drug approval process. Define: IND, NDA, ORPHAN DRUGS, COMPASSIONATE USE Describe the Food and Drug Administration (FDA) and investigator/practitioner requirements before, during and following investigation. Define the roles of two drugs in an interaction. Describe possible interactive situations.
Lecturer
37
Sexually Transmitted Disease
Ch. 51
2. 3. 1. 2.
Pino
38
Drug schedules and prescription writing
Ch. 65
3. 4.
Pino
5. 2:13 4/10 1.
2. 39 Drug Development Study Guide 3.
Prancan
40
Drug Interactions and Adverse Events
1. Ch. 66 2.
Prancan
287
Sem: Week
Date
Topic. #
Lecture Topic
Readings
Course Objectives 3. Describe common interactions and their potential outcomes. 1. Describe the role of government in control of information and supplements. 2. Describe where to go for information regarding supplements. 3. Define your role in maintaining patient safety regarding supplements. 4. Describe the actions, toxicites and drug interactions of popular supplements. 1. Describe the clinical management of a poisoned patient and all parameters that need to be considered. 2. Identify the decontamination procedures: Ipecac syrup, Activated Charcoal, Gastric lavage, Cathartics, dialysis, and Urinary pH manipulation. 3. Describe common toxic syndromes (Toxidromes) and specific antidotes. 4. Describe the MOA, clinical manifestations, and specific antidotes used in heavy metal poisoning.
Lecturer
41 Nutritional Supplements Ch. 64
Pino
2:14
5/1
42
Toxicology
Ch. 56, 57,58, Study Guide
Pino
Finals
5/5
Module XIII Exam (Oby-gyn) Lectures 34-42.
288
Professionalism in Medicine
Course Details
Course Title Course Number Department Credit Hours Duration Grading Type Course Director Course Coordinator Directors Campus Phone Directors Email Office Hours Professionalism and Medical Ethics Basic Sciences 2 14 weeks Letter Niket Sonpal MD Niket Sonpal MD 646-981-4747 niket.sonpal@touro.edu By appointment in room 436
Course Description
Professionalism: Its NOT the job you DO, Its HOW you DO the job. Anonymous While many people claim to be professional or to act in professional ways, there is a growing demand for moral behavior amongst professionals. This course will provide a values-based approach to ethical professionalism and provide a method of thinking about and dealing with ethical issues that will be encountered in the education, work and medical environments. Essentially, the course will provide a discussion of what professionalism is and what it means to constantly and consistently act professionally. We will focus on an in-depth analysis of the ethical principles that are fundamental to any professional: integrity, respect for persons, justice, compassion, beneficence and nonmaleficence, and responsibility. In addition, the course will focus on some of the ethical and moral issues facing people in the profession of medicine. Lastly, students will be informed of expected behaviors for their clinical rotation years.

...to learn and not to do is really not to learn. To know and not to do is really not to know. (Stephen R. Covey). knowledge without application is like a book that is never read. (Christopher Crawford) The main objective of this course is for you to not only learn the course material but most important for you to APPLY the information. Consequently, at the end of this course, you should be able to: Adhere to high ethical and moral standards in your daily practice of medicine. Display fundamental humanistic values such as honesty and integrity, respect for others, altruism and empathy, compassion, and trustworthiness. Exercise accountability to yourself, colleagues, patients, society, and profession. Adhere to the American Medical Association Principles of Medical Ethics such as providing competent medical care, with compassion and respect for human dignity and rights. Develop and demonstrates competency in interpersonal communication. Consider and embed multicultural issues not only in medical practice but in all aspects of your thinking/behavior.
Professionalism and Medical Ethics 289 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Recognize the importance of maintaining good personal health and well-being by balancing personal, family, and career goals. Ruminate on your actions, behaviors and decisions as you encounter high levels of complexity and uncertainty in your medical profession. Develop strategies/skills to maintain self-awareness and act professionally when faced with micro-ethical challenges within the informal curriculum. To self-reflect (introspection) on your learning experience in this class in order to identify challenges to professional development and develop an awareness of your perspective on professionalism.
Course Structure
In a community of learners, all participants are active: no one has all the responsibility and no one is passive. (Rogoff, 1996). The class is designed to teach you how to: (a) act professional even when you do not feel like doing it, and (b) critically read, evaluate, and apply the learning material. Therefore, to the extent possible, the course will be conducted as a seminar class - the vast majority of class time will consist of discussion, case analysis, class activity and collaborative group work. All these activities are geared toward engaging students as active participants in their learning by focusing their attention on critical elements, encouraging abstraction of common themes or principles, and evaluating their own progress toward understanding. Therefore it is vital that you are prepared for class and complete the weekly readings before attending class each week.
Course Readings
Approach the readings in an active, systematic, and deliberate way. Read to understand, not to memorize. You are expected to read the assigned readings before each class unless otherwise indicated. This will give you time to formulate questions that you may have about the readings and allow you to ask these questions and engage in discussions during that class.
Required Textbook:
3. Medical Ethics: A Very Short Introduction by Tony Hope 4. Master the Boards USMLE Medical Ethics: The Only USMLE Ethics High-Yield Review by Conrad Fischer
iTunes Lectures
Lectures 5-9 will be based on information from iTunes created lectures.
Formal Course Assignments

1. Midterm Examination on Ethics This multiple choice exam will assess your understanding of the American Medical Association Code of Ethics, and material covered in lectures 1-9. 2. Group Project You will be assigned to a group with 4 other students. Your assignment will be to write a narrative of your thoughts on the film.
Exam Dates
These dates are subject to change. Exam I 5/5/2014 Professionalism and Medical Ethics 290 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.

The mean, standard deviation and faculty adjustment used to calculate your Z-Score is listed below. Course Faculty Adjustment Mean Standard Deviation Professionalism -15.00% 82.58% 8.40%

Exam Group Project Total 40% 60% 100%
Academic Dishonesty
Academic honesty is fundamental to the activities and principles of a university. All members of the academic community must be confident that each person's work has been responsibly and honorably acquired, developed, and presented. Any effort to gain an advantage not given to all students is dishonest whether or not the effort is successful. The academic community regards breaches of the academic integrity rules as extremely serious matters. Sanctions for such a breach may include academic sanctions from the instructor, including failing the course for any violation, to disciplinary sanctions ranging from probation to expulsion. When in doubt about plagiarism, paraphrasing, quoting, or collaboration, consult the course instructor.
Professionalism and Medical Ethics 291 *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
Course Schedule
Lectures
Sem: Week 2:1 Date 1/16 1 Lect. # Topic Introduction to Professionalism and Ethics Instructor Whole Team Readings to be Discussed Readings TBA via Blackboard Objectives 1. Demonstrate the goals and purpose of this class 2. Discuss professionalism as set forth by the AMA guidelines 3. Discuss OMM etiquette and behaviors 1. Demonstrate effective listening skills when communicating with others. 2. Integrate and apply empathy building skills into their current communication skills. 3. Modify their current behavioral patterns when responding to situations involving negative feedback and conflict. 4. Communicate in a professional manner when composing professional emails and documents 1. To identify the role of non-verbal communication in the speech chain and as part of the feedback loop of comprehension. 2. To identify non-verbal communication techniques as tools of a physician in providing patient care. 3. To identify micro-expressions of non-verbal communication in patients. 1. Define Malpractice and deviations from local standards of care 2. Demonstrate informed consent protection against liability 3. Discussion based QA on medical mal. 1. Define Autonomy, competence and capacity as it relates to patient care 292
2:2
1/23
OMS2DO - Professionalism in the school environment
Kari Tabag LCSW-R
Readings TBA via Blackboard
2:3
1/30
Non-verbal communication
Dr. Jerry Cammarata
2:4
2/6
Law and Medicine
Dr. David Lenihan
2:5
2/13
Medicine and Ethics Clicker sessions
Dr. Niket Sonpal
ITunes lecture
Professionalism and Medical Ethics *Document is subject to change; please refer to Blackboard or the Google Calendar for the most current version.
2:6
2/20
Dr. Niket Sonpal
ITunes lecture
2:7
2/27
Dr. Niket Sonpal
ITunes lecture
2:8
3/6
Dr. Niket Sonpal
ITunes lecture
2:9
3/13
Dr. Niket Sonpal Kari Tabag LCSW-R
ITunes lecture
2:10 2:11
3/20 3/27
10 11
FILM Clinical Dilemmas and Rotations an OMS3/OMS4 Dr. Kenneth Steir Readings TBA via Blackboard
2:12
4/3
12
End of life Discussion and Medical Mistakes
Dr. Conrad Fischer
2. Define informed consent in the setting of emergency, pregnant patients, nevercompetent persons, and minors 3. Demonstrate adverse effects and the need for communication of them prior to treatment in the medical setting 1. Integrate the idea confidentiality through case based presentations 2. Discuss correcting medical record errors 3. Demonstrate when it is allowable to release information to 3rd parties 1. Discuss the current medical paradigms and define abortion, contraception, sterilization, minors, and the donation of sperm and eggs and the ethical issues surrounding them. 1. Define patient specific issues regarding reportable diseases and STDS 2. Demonstrate through case HIV related issues , confidentiality, testing, and partner notification 3. Discuss HIV positive health care workers and its ethical impact on the COMLEX 1. Define the parameters of Child abuse, elder abuse, impaired drivers, spousal abuse 2. Discuss Gifts and industry funding and its ethical paradigms 3. Discuss impaired physicians and physician disagreements 1. Students are to watch the film in class and in their groups come up with a narrative 1. Top scenarios a OMS student should be aware when entering the clinical setting (objectives subject to change as per Dr. Steier) 1. Define DNR, DNI and advance directives 2. Demonstrate through cases the Law of 293
2:13
4/10
13
Engaging the difficult patient
TEAM
2:14
5/1
14
Issues involved in gaming the system
Dr. Niket Sonpal
double effect 3. Discuss and illustrate futile care, palliative care, and determination of brain death 4. Illustrate through current events medical errors and the correct and incorrect ways of addressing them as set forth by the AMA 5. Define the process through the Johns Hpkins 3 step method 1. Discuss medical reasons for difficult patients 2. Illustrate three tasks in communicating with difficult patients 3. Student participation in mock difficult patients 1. Through case illustrate cases on insurance fraud and doctor pharmaceutical relationship 2. Identify the reasons for financial disclosures in practice and research with your patients 3. Identify and discuss the Hidden Curriculum in training medical residents
Finals
5/5
Final Exam
294

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CLASS OF 2016 COURSE DOCUMENTATION 2013-2014

Welcome from the Dean of Preclinical Medicine

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Overviews and Documentation

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Year Two Schedule Overview

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Estimated Weekly Schedule

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Exam Schedule Breakdown

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Semester One Finals Week Schedule is not finalized subject to change

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Semester Two Finals Week Schedule is not finalized subject to change

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Faculty Office Hours and Contact Information

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(Includes module systems)

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ExamSoft and SofTest

Prior to Exam Day

SofTest Tips and Tricks

ExamSoft Technical Support Resources:

Exam Reviewing Policy

End of Year Grading Policy

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Global Student Assessment Tools

Cross Course Performance Graph

Student Town Hall Meetings

Office Hours and Email Communication

Crises and Emergencies

Student Health Services Clinic

Copyright Frequently Asked Questions and Answers

What is the purpose of Copyright and Patent in the United States?

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What is Fair Use?

What is the current term of Copyright in the United States?

What does Copyright protect?

What isnt protected by Copyright?

What is required to have a work be protected by Copyright?

What is the Public Domain?

What is First Sale?

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PC Requirements (Windows XP, Vista, 7, 8):

Mac Requirements (OS X 10.6, 10.7, 10.8):

Recommended Texts and Materials

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Supplemental Texts and Materials

Medical Microbiology and Immunology

Recommended Texts and Materials

Recommended Texts and Materials

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Penlight Student length/consultation white laboratory coat