Advanced Pathophysiology for College Credit Web Course

COURSE DESCRIPTION:  This course presents an orientation to disease as disordered physiology.  It is intended to enable advanced practice nurses to understand how and why the symptoms and signs of various conditions appear.  In approaching disease as disordered physiology, this course analyzes the mechanism(s) of production of the symptoms and signs of different disease syndromes.  In doing so, it recognizes the student’s and practitioner’s need to understand the mechanism(s) underlying the disease and its clinical manifestations so that rational therapies can be devised.  Appropriate screening and diagnostic laboratory evaluative methods will also be included. 

COURSE OBJECTIVES:  The advanced practice nurse should possess a well-grounded understanding of normal physiologic and pathologic mechanisms of disease that serves as one primary component of the foundation for clinical assessment, decision-making and management. The graduate should be able to relate this knowledge to interpreting changes in normal function that result in symptoms indicative of illness and in assessing an individual’s response to pharmacologic management of illness. At the completion of this course, students will have the knowledge and skills to:

• compare and contrast physiologic changes over the life span;     

• analyze the relationship between normal physiologic and pathological phenomena produced by altered states across the life span;

• synthesize and apply current research-based knowledge regarding pathological changes in selected disease states;

• describe the developmental physiology, normal etiology, pathogenesis, and clinical manifestations of commonly found/seen altered health states;

• analyze physiologic responses to illness and treatment modalities; and

• analyze data with respect to diagnosing client problems.

TEACHING/LEARNING METHODS: This course will be taught using a combination of 10 modules and specific Web sites. The assumption is made that all students have access to computer facilities, the Internet, a web browser that is equivalent to Netscape 5 or higher or Internet Explorer 5 or higher, and an e-mail address. Since active learning is required, students are expected to complete all assignments in a timely manner. However, this is student-directed and no time limits are set within the technology.

VIDEOS: Where applicable, clinical videos will be available for viewing. The link for the videos can be found in appropriate modules. These are intended to reinforce pathophysiological concepts that are applicable to individual systems (see course schedule).  This unique series of videos utilizes two- and three-dimensional graphics and animations to illustrate concepts of a specific disease or disorder.  They illustrate how the body reacts and adapts from early disease states through acute illness and through subacute stages. Videos resources are made available in the related modules.  

WEB SITES: The Internet offers a broad array of academic-related resources:

• professional and governmental archives and databases

• online journals

• access to commercial databases and abstract services

• professional discussion via news groups, mailing lists, and discussion groups

• academic and public library catalogs

• grant listings and deadlines

• directories of researchers and research projects funded by the federal government

• conference announcements and calls for papers

• academic, government and industry job announcements

• faculty biographies and university course descriptions

• educational and other software

The module activities (assignments) will come from two major Web sites: 

1.  http://library.med.utah.edu/

The Internet Pathophysiology Laboratory for Medical Education

This Web-based resource includes over 1900 images along with text, tutorials, laboratory exercises, and examination items for self-assessment that demonstrates pathophysiologic concepts

       2.   http://www.medicinenet.com

MedicineNet.com

This web-based resource lists pathophysiological conditions alphabetically, related terms, a main article, related medical procedures/tests, related news and updates, and related diseases and treatments.

 For ease, please bookmark these two sites.

Evaluation: There is one posttest for each module which consists of questions from the modules and the two Web sites. Each posttest is designed to test your understanding of the material in the module. By completing all of the modules and the final exam with an 80 percent or higher, you will get 3 hours of credit certified by the University of Kentucky. You can only take each posttest twice. The modules are worth 80 percent of the course grade and the final exam 20 percent.

There are 600 points possible in the course. The final letter grade will be computed from a percentage of correct answers. The percentage grade will be sent to your school and your letter grade will be computed based on the policy of your school.

For example:

600 points = 100%

540 points =   90%

480 points =   80%

WEB-BASED LEARNING:  

To take this course, each student must:

1.  have Internet access

2. register for the course

3.  follow instruction

4. set up an account

5. receive an enrollment key for the course

REFERENCE LIST:

The New England Journal of Medicine is one of the most widely circulated journals in the United States. Most hospitals, clinics, university libraries, physicians, etc., subscribe to it; thus the journal is widely available to students.  Approximately every other week, there is a special section in the journal titled, "Clinical Problem Solving."  In this journal feature, information about a real patient is presented in stages (including all of the pathophysiology) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader. This is followed by the author’s commentary. To better appreciate the value of pathophysiology in one’s clinical training, we strongly suggest you read these articles every other week.  It only takes about 15 minutes to obtain a wealth of useful information.
Chowdry, P. (1993). Pathophysiology with practical applications.  Dubuque, Iowa: Wm. C. Brown Publishers.
Copstead, L.C. & Banasik, J.L. (eds.) (2005). Perspectives on pathophysiology, 3^rd Ed. Elsevier/Saunders Publishing Company.
Corwin, E. (1999). Handbook of pathophysiology, 2^nd ed. (1999). Philadelphia: Lippincott, Williams & Wilkins.
Crowley, L.V. ( 2001). An introduction to human disease: Pathology and pathophysiology correlations, 5^th ed . Boston, MA: Jones and Bartlett Publishers.
Damjanov, I. (2000). Pathology for the health related professions, 2^nd ed. Philadelphia: W.B. Saunders Publishing Co.
Guyton, A.C., and Hall, J.E. (1996). Human physiology and mechanisms of disease, 6^th ed. Philadelphia: W. B. Saunders Co.
Kaufman, C., and McKee, P. (1996). Essentials of pathophysiology (Essentials of basic science). Philadelphia: Lippincott, Williams & Wilkins.  ISBN 0-316-48405-9.

Kent, T.H. and Hart, M.N. (1998). Introduction to human disease. Upper Saddle River, NJ: Prentice Hall.
Kumar, V., Fausto, N. and Abbas, A. (eds.). (2004). Robbins & Cotran Pathologic basis of disease, 7^th ed. Philadelphia: W.B. Saunders.
McCance, K.L. and Huether, S.E. (2002). Pathophysiology: The biologic basis for disease in adults and children, 4^th ed .  Elsevier/Mosby Co. 
McPhee, S.J., Lingappa, V.R., Ganong, W.F. & Lange, J.D. (2002). Pathophysiology of disease: An introduction to clinical medicine, 4^th ed. McGraw-Hill Medical. 
Nowak, T.J. and Handord, A.G. (1994).Essentials of pathophysiology: Concepts and applications for health care professionals.  Dubuque, Iowa: Wm. C. Brown Publishers.
Porth, C.M. (2005). Pathophysiology: Concepts of altered health states, 7^th ed.  Lippincott, Williams & Wilkins.
Stephens, G.J. (1980). Pathophysiology for health practitioners.  New York: Macmillan Publishing Company.

SUGGESTED JOURNAL READINGS:

Modules 1-3

Caroll, P. 1997. Clarifying the CBC. Registered Nurse, September, pp 29-33.
Garavito. 1999. Working Knowledge of Aspirin. Scientific American. May 1999.
George-Gay B. (2003). Understanding the complete blood count with differential. J Perianesth Nurs, 18 (2), pp. 96-114; quiz 115-7.
Grimm, D. (2004). Disease Backs Cancer Origin Theory. Science, 306(5695), p389, 2/3p, 1c-389.
Gupta S. (2005).  Molecular mechanisms of apoptosis in the cells of the immune system in human aging. Immunol Rev, 205, pp. 114-29.
Shute. (2000). Why Do We Age. USNWR. 55-57.
Tefferi, A. (2005). How to interpret and pursue an abnormal complete blood cell count in adults. Mayo Clin Proc, 80 (7), pp. 923-36.
Weinberg, R. 1996. How Cancer Arises. Scientific American, September, pp 63-67.

Modules 4-6
Cohn, J.1996. The Management of Chronic Heart Failure, New England Journal of Medicine, pp 490-497.
Dávila, D.; Núńez, T.; Odreman, R.; et al. (2005). Mechanisms of neurohormonal activation in chronic congestive heart failure: Pathophysiology and therapeutic implications. International Journal of Cardiology, 101(3), p343-346.
Doherty, D.E. (2004). The pathophysiology of airway dysfunction. Am J Med, 117 (Suppl 12A), pp. 11S-23S.
Frieri, M. (2005). New concepts in asthma pathophysiology. Curr Allergy Asthma Rep, 5(5), pp. 339-40.
Grossman, S.; Grossman, L.C. (2005). Pathophysiology of cystic fibrosis implications for critical care nurses. Critical Care Nurse, 25(4), p46.
Hogg, J. C. (2004). Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet, 364(9435), p709.
Lameire, N. (2005). The pathophysiology of acute renal failure. Crit Care Clin, 21(2), pp. 197-210.
Lilly, C.M. (2005). Diversity of asthma: evolving concepts of pathophysiology and lessons from genetics. J Allergy Clin Immunol, 115 (4 Suppl), pp. S526-31.
Molitoris, B.A. (2005). Renal blood flow in sepsis: a complex issue. Crit Care, 9(4), pp. 327-8.
Nicholas, M. (2004). Heart failure: Pathophysiology, treatment and nursing care. Nursing Standard, 19 (11), p46-51.
Russell, T.A. (2005). Acute renal failure related to rhabdomyolysis: Pathophysiology, diagnosis, and collaborative management. Nephrology Nursing Journal, 32(4), p409.
Tenenbaum, A.; Fisman, E. (2004). Impaired glucose metabolism in patients with heart failure: Pathophysiology and possible treatment strategies. American Journal of Cardiovascular Drugs, 4 (5), p269.
Thandhani,, R. 1996. Acute Renal Failure, New England Journal of Medicine, May 30, pp 1448.

Vogel, M. 1997. New Clues to Asthma Therapy. Science, vol 276, 13 June, pp 1643-1646.

Welsh, M. 1995. Cystic Fibrosis. Scientific American, December, pp 52-59.

Modules 7-9
Evans, K.J. (2005). Hyperkalemia: a review. J Intensive Care Med, 20(5), pp. 272-90.
Gennari, F. (1998). Hypokalemia. New England Journal of Medicine, August 13, pp 451-457.
Lamberts, S. (1997). The Endocrinology of Aging. Science, vol 278, 17 October, pp 419-23.
Lamberts, S.W. (2002). The endocrinology of aging and the brain. Arch Neurol, 59(11), pp. 1709-11.
Sherman, F.T. (2005). The 3 "Hypo's" of hospitalization. Geriatrics, 60(5), pp9-10.
Smith. (1999). The Timing of Birth. Scientific American, March.

Module 10
Blanchard, T.G.; Drakes, M.L.; Czinn, S.J. (2004). Helicobacter infection: pathogenesis. Current Opinion in Gastroenterology, 20(1), pp10-15.
Blaser, M. 1998. The Bacteria Behind Ulcers, Scientific American, February, pp 104-125.
Suzuki, H.K. (2003). Current consensus on the diagnosis and treatment of H. pylori-associated gastroduodenal disease. J Med, 52(3), pp. 163-73.
Wekerle, H. (2002). Immune Protection of the Brain--Efficient and Delicate. Journal of Infectious Diseases, 186(11), pp S140-144.
Wolfgang, J. 1995. The Brain’s Immune System. Scientific American, November, pp 54-61.

MODULE TOPICS AND ASSIGNMENTS

MODULE                  MAJOR TOPIC

Module 1                    Introduction to General Pathology: Mechanisms of Disease

Pathophysiological conditions from Web Sites 1 & 2, Postest 1
Module 2                    Hematologic Disorders

Pathophysiological conditions from Web Sites 1 & 2, Postest 2

Module 3                    Cardiovascular Physiology

Pathophysiological conditions from Web Sites 1 & 2, Postest 3

Module 4                    Renal Pathophysiology

Pathophysiological conditions from Web Sites 1 & 2, Postest 4

Module 5                    Respiratory Pathophysiology

Pathophysiological conditions from Web Sites 1 & 2, Postest 5

Module 6                    Endocrine and Metabolic Disorders

Pathophysiological conditions from Web Sites 1 & 2, Postest 6

Module 7                    Disorders of the reproductive Systems

Pathophysiological conditions from Web Sites 1 & 2, Postest 7

Module 8                    Fluid and Electrolyte Disorders

Pathophysiological conditions from Web Sites 1 & 2, Postest 8

Module 9                    Gastrointestinal Pathophysiology

Pathophysiological conditions from Web Sites 1 & 2, Postest 9

Module 10                  Neurological Disorders

Pathophysiological conditions from Web Sites 1 & 2, Postest 10

Final Examination

Syllabus for Web-based pathophysiology course.

Contact: Melissa Bolin (859) 323-3851 or melissa.bolin@uky.edu