Leslie Dan Faculty of Pharmacy University of Toronto Course Outline and Syllabus (2015 2016) Name: Dr. Reina Bendayan Course Number: PHM143H1 Course Title: Pathobiology and Pathology Course Description: This course is designed to introduce pharmacy students to the physiological and biochemical mechanisms which lead to pathological states, and includes the laboratory investigation and follow-up associated with specific diseases. Required: Yes Elective: No 1. Course Learning Objectives: Upon completion of this course, students will be able to have: Knowledge/Skills/Attitudes/Values Intermediate Level: The students will acquire a working knowledge of the basic mechanisms of disease, including the pathophysiology and biochemical changes that occur in specific disease states, and how diagnostic investigations (i.e., laboratory) can confirm the presence of these disease states. Students are expected to integrate knowledge from several sources, such that they can explain and interpret the disease state process present in specific cases to both other health care professionals and patients. 2. Rationale for Inclusion in the Curriculum: Knowledge of the pathophysiology, clinical biochemistry, and other laboratory tests relating to diseases students will eventually encounter as practicing pharmacists is necessary to understand the rationale for pharmacotherapeutic intervention. 3. Pre-requisites: Physiology, Anatomy, Molecular Biochemistry, Immunology 4. Statement of agreement from course coordinators of courses for which your course is a pre-requisite: N.A. 5. Co-requisites (for the current and subsequent year): Physiology, Anatomy, Molecular Biochemistry, Immunology 6. Statement of agreement from course coordinators of courses for which your course is a co-requisite: N.A. 1
7. Course Contact Hours and Teaching Methodologies: Didactic (lecture) Large group problem-based or case-based learning Large Group Size Laboratory or Simulation Tutorial/Seminar/Workshop/Small Group Small Group Size Experiential On-line Other (please specify)* * Other specific information: Total course contact hours 35hours 0 persons 4 hours 0 persons 39hours 8. Estimation and description of student's out-of-class preparation time required: Students will be expected to obtain and read over the notes prior to the lectures. Additional time may be required after the lecture to annotate/complete the notes with material derived from the lecture. 9. Course Coordinator and Teaching Assistant: Dr. Reina Bendayan Tel. #: 416-978-6979 Fax. #: 416-978-8511 Email: r.bendayan@utoronto.ca Camille Alam E-mail: camille.alam@mail.utoronto.ca 10. Course Instructors (including contact information): Course instructors are numerous and are contacted for their participation. 11. Required Resources/Textbooks/Readings: Course notes are available online at Blackboard. 12. Recommended Resources/Textbooks/Readings: Kumar, V., Abbas, A. K., Aster, J. C. (2014). Robbins and Cotran Pathologic Basis of Disease, 9 th ed. Elsevier Saunders. Burtis, C. A., Ashwood, E. R., Bruns, D. E. (2015). Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, 7 th ed. Philadelphia, PA: Saunders. 13. Topic Outline/Schedule: Week 1 Hepatic Pathology - Liver and Biliary Tract Liver Disease (2 hrs): Describe the normal function of the liver. Summarize the purpose and types of liver function tests. Compare and contrast various mechanisms of damage, which lead to cirrhosis or portal hypertension. 2
Week 2 Week 3 Week 4 Week 5 Week 6 Introduction (1 hr): Orientation to the course with an emphasis on the purpose/content, format, and the evaluation methods used. Outline the topics to be covered and lectures to be offered by invited clinicians. Mechanisms of Cell Death (1 hr): Describe the different forms of cell death and the outcomes associated with them. Summarize the various degrees of damage associated with cell death and the diagnostic methods used to evaluate the consequences of cell death. Calcium Disorders (1 hr): Describe the role of Calcium in healthy individuals. Describe how calcium uptake and loss is regulated during a patient s life and how diagnostic tests can be used to monitor bone density and loss. Introduction to Carcinogenesis (2 hrs): Discuss the molecular basis of carcinogenesis. Describe the epidemiology, pathogenesis, diagnosis, and clinical presentation of cancers and potential genetic causes for these conditions. Genetic Disorders (1 hr): Describe the rationale for prenatal screening. Review the factors that lead to neural tube defects and its consequences, the biochemistry and management of PKU, and the potential of gene therapy. Gastrointestinal Pathology (2 hrs): Peptic Ulcer Disease, Inflammatory Bowel Disease, and Ulcerative Colitis. Describe the epidemiology of GI bleeding, ulcers, and inflammatory bowel diseases including the etiology, pathology, diagnosis, clinical presentation, and complications. Describe the factors that lead to GERD, its symptomatology, and complications. Respiratory Pathology - Asthma (1 hr): Describe the prevalence, pathogenesis, clinical presentation, causes, and complications of asthma. Electrolyte Disorders (2 hrs): Discuss the consequences of volume depletion and abnormal sodium/ potassium levels. Interpretation of laboratory tests will be used to allow the students to determine the underlying cause of disorders. Acid/Base Disorders (1 hr): Compare and contrast the underlying basis for respiratory and metabolic acidosis and alkalosis. Integrate the interpretation of laboratory test results and how appropriate interventions can be used to correct these imbalances. Ophthalmology (2 hrs): Describe the structure and function of the eye. Describe common diseases of the eye and their causes. Summarize the diagnosis and symptomatology of these conditions, and discuss the use of dilating agents, anti-bacterial agents, anti-viral agents, steroids, NSAIDS, and anti- VEGF as treatment options. Alcoholic Liver Disease (1 hr): Describe the spectrum of liver toxicities observed in patients, their causality (alcohol induced hepatic toxicity) and prevention, using specific examples and cases. Week 7 Reading Week! Week 8 Tutorial - Midterm Review (2 hrs): Describe the format of the exam, provide suggestions for effective exam preparation, and discuss relevant case studies. Respiratory Pathology - Chronic Obstructive Pulmonary Disease (1 hr): Describe the prevalence, pathogenesis, clinical presentation, causes, and complications of COPD. 3
Week 9 Disorders of the Cardiovascular System (3 hrs): Compare and contrast the pathogenesis that leads to angina, atherosclerosis (i.e., plaque development molecular biology), myocardial infarction, and congestive heart failure. Review the development of the human heart and describe common congenital defects that may result. Summarize the integration and interpretation of diagnostic tests within these conditions. Week 10 Diabetes Mellitus (2 hrs): Summarize the process of glucose homeostasis and how defects can produce hyper or hypo glycaemia or diabetes. Describe diagnostic tests used to monitor glucose levels in diabetic patients. Week 11 Neurophysiology - Epilepsy, Alzheimer s & Parkinson s Disease (3 hrs): Describe the causes of epilepsy and seizures, including triggering factors, diagnosis, pathogenesis, and clinical presentation. Describe the epidemiology, disease progression, diagnosis, biochemical causes, and potential treatment for neurological disorders. Compare and contrast the causes and symptoms of Alzheimer s, Parkinson's, and cerebrovascular diseases. Week 12 Renal Physiology (1 hr): Describe the anatomy and physiology of the kidney. Review the various qualitative and quantitative tests used to evaluate kidney function. Renal Pathology Acute and Chronic Dysfunction (2 hrs): Contrast the etiology, pathogenesis, and clinical presentation and biochemical characteristics of acute and chronic renal failure. Describe the basis of clinical investigation in renal disease. Week 13 Renal Dysfunction - Clinical Investigation and Biochemical Tests (2 hrs): Integrate diagnostic test results with impaired renal function and renal disorders. Discuss several cases illustrating the pathogenesis, clinical presentation, and laboratory data of acute and chronic renal insufficiency. Drug-Induced Renal Toxicity (1 hr): Discuss the mechanisms involved in drug-induced renal injury. Identify which classes of drugs frequently induce renal toxicity and describe the mechanisms whereby this occurs. Week 14 Renal Dysfunction and Drug-Induced Renal Toxicity: (1 hr): Discuss several cases illustrating the pathogenesis, clinical presentation, and laboratory data of acute and chronic renal insufficiency. Discus relevant case studies of drug-induced renal toxicity. Tutorial - Exam review (2 hrs): Describe the format of the exam, provide suggestions for effective exam preparation, and review relevant case studies. 4
14. Assessment Methodologies Used: Learning Objective Addressed Assessment 1: Students are expected to answer factual questions and to be able to apply concepts learned during the lectures. Assessment 2: Students are expected to answer factual questions and to be able to apply concepts learned during the lectures. Assessment Method Used Assessment 1: MCQs Assessment 2: MCQs When Administered Assessment 1: Week 9 Assessment 2: Exam period Percentage of Course Grade Assessment 1: 40% Assessment 2: 60% For Group Work (maximum 10% of course grade) indicate how marks within groups are allocated: Individualized or Same for all Group Members Assessment 1:N.A. Assessment 2: N.A. Remediation Opportunities? Assessment 1: N.A. Assessment 2: N.A. Expectation for pass grades for all Pharmacy courses is 60%. 15. Policy and procedure regarding make-up assignments/examinations/laboratories: In the case of a missed examination, either midterm or final exam, the regulations and policies established by the Faculty of Pharmacy will be applied. When an examination is missed, the student must file with the Faculty Registrar, a petition for consideration in respect to the missed examination. This petition along with supporting documentation must be filed within seven calendar days of the missed examination. For examinations missed during the regularly scheduled examination period (December and April), petitions must be submitted by the end of the examination period. In the case of a missed examination and when a reason deemed valid by the Faculty is presented, the student will be given a make-up examination (written or oral at the instructor s discretion). 16. Policy and procedure regarding supplemental assignments/examinations/laboratories: Provided they have an overall GPA 1.7, students who fail the course will be permitted to write a supplemental examination covering all course material worth 100% of their grade. 17. Policy and procedure regarding course exemptions/prior learning assessment and recognition: N.A. 5
Lecture Schedule (2015-2016) Wk. Date Time (hrs.) Topic Lecturer PB Room 1 MON Jan 4 WED Jan 6 2 MON Jan 11 WED Jan 13 3 MON Jan 18 WED Jan 20 4 MON Jan 25 WED Jan 27 5 MON Feb 1 WED Feb 3 6 MON Feb 8 WED Feb 10 7 MON Feb 15 WED Feb 17 8 MON Feb 22 WED Feb 24 9 MON Feb 29 WED Mar 2 WED Mar 2 1pm 3pm 2:00pm 4:00pm Hepatic Pathology Dr. B. Hoffman Introduction Mechanisms of Cell Death Calcium Disorders Dr. R. Vieth Carcinogenesis Dr. C. Parra- Herran Genetic Disorders Dr. I. Crandall Gastrointestinal Pathology Dr. M. Cino Respiratory Pathology: Asthma Dr. C. Chan Electrolyte Disorders Dr. M. Schreiber Acid Base Disorders Dr. M. Schreiber Ophthalmology Dr. Z. Butty Alcoholic Liver Disease Dr. B. Bartle Family Day & Reading Week Midterm Review TA & Dr. Bendayan Respiratory Pathology: COPD Dr. C. Chan Cardiovascular Disorder Dr. J. Butany Cardiovascular Disorder Dr. J. Butany Midterm Exam EX 100 10 MON Mar 7 WED Mar 9 11 MON Mar 14 WED Mar 16 12 MON Mar 21 WED Mar 23 3pm 6pm (3hrs) 11am 12pm Diabetes Mellitus Dr. B. Hoffman Neurophysiology: Epilepsy, Alzheimer's & Parkinson's Disease and Stroke Renal Physiology & Pathology: Acute and chronic dysfunction Dr. V. Basile 6 Renal Pathology: Acute and chronic dysfunction
13 MON Mar 28 WED Mar 30 14 MON Apr 4 WED Apr 6 MON Apr 11 Case Studies: Clinical investigation/ biochemical Tests Drug-induced renal toxicity Case Studies: Renal Dysfunction and Druginduced renal toxicity Exam Review Part 1 Exam Review Part 2 Final Exam Period TA& Dr. R. Bendayan 7