Leslie Dan Faculty of Pharmacy University of Toronto Course Outline and Syllabus (2012 2013) Name: Professor 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 student 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 (i.e., laboratory) investigations 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 and Immunology. 4. Statement of agreement from course coordinators of courses for which your course is a pre requisite: N.A. 1
5. Co requisites: (for the current and subsequent year) Physiology, Anatomy, Molecular Biochemistry and Immunology. 6. Statement of agreement from course coordinators of courses for which your course is a co requisite: N.A. 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 35 hours 0 hours 0 persons 0 hours 4 hours 0 persons 0 hours 0 hours 0 hours 39 hours 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 (including contact information): Dr. Reina Bendayan Tel. #: 416 978 6979 Fax. #: 416 978 8511 Email: r.bendayan@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 AK, Fausto N, Aster JC, eds. Robbins and Cotran: Pathologic Basis of Disease, 8th ed., Saunders WB, Philadelphia, PA 2010. 2
Tietz s Textbook of Clinical Chemistry, Ed.: C.A. Burtis, E.R. Ashwood, 4th ed., WB Saunders, Philadelphia, PA 2005 13. Topic Outline/Schedule: Week 1 Introduction (1 hour): Orientation to the course with an emphasis on the purpose/content of the course, format of the course and the evaluation methods used. Outline the topics to be covered and lectures to be offered by invited clinicians. Mechanisms of Cell Death (1): 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. Genetic Disorders (1): 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. Week 2 Electrolyte Disorders (2): Discuss the consequences of volume depletion and abnormal sodium and potassium levels. Interpretation of laboratory tests will be used to allow the students to determine the underlying cause of disorders. Acid/Base Disorders (1): 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. Week 3 Hepatic Pathology: Liver and Biliary tract Liver disease (2): 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. Drug and Alcohol induced hepatoxicity (1): Describe the spectrum of liver toxicities observed in patients, their causality (alcohol induced hepatic toxicity) and prevention using specific examples and cases. 3
Week 4 Disorders of Glucose (2): 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 5 Tutorial Midterm exam review (2): Describe the format of the exam, provide suggestions for effective exam preparation and discuss relevant case studies. Week 6 Neurophysiology and Epilepsy (2): Describe the causes of epilepsy and seizures, including triggering factors, diagnosis, pathogenesis and clinical presentation. Gastrointestinal Pathology (2): 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. Alzheimers, Parkinson's, Cerebrovascular disease (1): Describe the epidemiology, disease progression, diagnosis, biochemical causes and potential treatment for neurological disorders. Compare and contrast the causes and symptoms of Alzheimers, Parkinson's, and cerebrovascular diseases. Week 7 Disorders of the Cardiovascular system (3): 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. 4
Week 8 Respiratory Pathology: Asthma and COPD (2): Describe the prevalence, pathogenesis, clinical presentation, causes, and complications of asthma and COPD. Week 9 Renal Physiology (1): 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): Contrast the etiology, pathogenesis, clinical presentation and biochemical characteristics of acute and chronic renal failure. Describe the basis of clinical investigation in renal disease. Week 10 Renal Dysfunction Clinical Investigation and Biochemical Tests (2): 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). Discuss the mechanisms involved in drug induced renal injury. Identify which classes of drugs frequently induce renal toxicity, describe the mechanisms whereby this occurs. Week 11 Renal Dysfunction and Drug Induced Renal Toxicity: (2): 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. Week 12 5
Calcium Metabolism (2): 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. Ophthalmology (2): 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. Tutorial Exam review (1): Describe the format of the exam, provide suggestions for effective exam preparation and review relevant case studies. Week 13 Introduction to Carcinogenesis (2): Discuss the molecular basis of carcinogenesis. Describe the epidemiology, pathogenesis, diagnosis, and clinical presentation of cancers and potential genetic causes for these conditions. Tutorial Exam review (1): Describe the format of the exam, provide suggestions for effective exam preparation and discuss relevant case studies. 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 6 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? 6
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. Lecture Schedule (2012-2013) 7
Week Topic Lecturer Date H Time PB Room 1 Introduction Dr. R. Bendayan (Tue) 8 th Jan 1 9:00 10:00 a.m. B 150 Mechanisms of Cell Death Dr. R. Bendayan (Tue) 8 th Jan 1 10:00 11:00 a.m. B 150 Genetic Disorders Dr. Ian Crandall (Fri) 11 th Jan 1 9:00 10:00 a.m. B 150 2 Electrolyte & Acid/Base Disorders Dr. M. Schreiber (Tue) 15 th Jan 2 9:00 11:00 a.m. B 150 Electrolyte & Acid/Base Disorders Dr. M. Schreiber (Fri) 18 th Jan 1 9:00 10:00 a.m. B 150 3 Hepatic Pathology Dr. B. Hoffman (Tue) 22 nd Jan 2 9:00 11:00 a.m. B 150 Drug/Alcohol induced hepatic toxicity Dr. B. Bartle. (Fri) 25 th Jan 1 9:00 10:00 a.m. B 150 4 Diabetes Mellitus Dr. B. Hoffman (Tue) 29 th Jan 2 9:00 11:00 a.m. B 150 No Class (Fri) 1 st Feb 5 Tutorial TAs and Dr. R. Bendayan (Tue) 5 th Feb 2 9:00 11:00 a.m. B 150 No Class (Fri) 8 th Feb 6 Midterm Examination (Mon) 11 th Feb 10:00 12:00 a.m. EX200 8
Neurophysiology Dr. V. Basile (Tue) 12 th Feb 1 9:00 10:00 a.m. B 150 Epilepsy Dr. V. Basile 1 10:00 11:00 a.m. Gastrointestinal Pathology Dr. M. Cino (Wed) 13 th Feb 2 11:30 1:30 p.m. OI G162 Alzheimer's and Parkinson's Disease and stroke TBA (Fri) 15 th Feb 1 9:00 10:00 a.m. B 150 No Class Reading Week (Tue) 19 th Feb No Class Reading Week (Fri) 22 nd Feb 7 Cardiovascular Disorders Dr. J. Butany (Tue) 26 th Feb 2 9:00 11:00 a.m. B 150 Cardiovascular Disorders Dr. J. Butany (Fri) 1 st Mar 1 9:00 10:00 a.m. B 150 8 Respiratory Pathology Dr. C. Chan (Tue) 5 th Mar 2 9:00 11:00 a.m. B 150 No class (Fri) 8 th Mar B 150 9 Renal Physiology Dr. R. Bendayan (Tue) 12 th Mar 1 9:00 10:00 a.m. B 150 Renal Pathology: Acute and chronic dysfunction Dr. R. Bendayan (Tue) 12 th Mar 1 10:00 11:00 a.m. B 150 9
Renal Pathology: Acute and chronic dysfunction Dr. R. Bendayan (Fri) 15 th Mar 1 9:00 10:00 a.m. B 150 10 Clinical Investigation/ Biochemical Tests (Case Studies) Dr. R. Bendayan (Tue) 19 th Mar 2 9:00 11:00 a.m. B 150 Drug induced toxicity renal Dr. R. Bendayan (Fri) 22 nd Mar 1 9:00 10:00 a.m. B 150 11 Renal Dysfunction and Drug induced renal toxicity (Case Studies) Dr. R. Bendayan (Tue) 26 th Mar 2 9:00 11:00 a.m. B 150 No Class Good Friday (Fri) 29 th Mar B 150 12 Calcium Disorders Dr. R. Vieth (Tue) 2 nd Apr 2 9:00 11:00 a.m. B 150 Ophthalmology Dr. K. Cao (Wed) 3 rd Apr 2 11:30 1:30 p.m. OI G162 Tutorial Final Exam Preparation Review TAs and Dr. R. Bendayan (Fri) 5 th Apr 1 9:00 10:00 a.m. B 150 13 Carcinogenesis Dr. V. Dube (Tue) 9 th Apr 2 9:00 11:00 a.m. B 150 Tutorial Final Exam Preparation Review TAs and Dr. R. Bendayan (Fri) 12 th Apr 1 9:00 10:00 a.m. B 150 Final Exam Period 15 th 30 th Apr 10