2nd Year Basic Science Curriculum

 

Brain and Behavior

Course Chair:	Marcella Pascualy; macella.pascuale@med.va.gov
Credits:	3

Major psychiatric disorders are defined and described and a systematic approach to differential diagnosis is presented. Conceptual development, pathogenesis, epidemiology, nomenclature and the terminology used in psychiatry are discussed.

Objectives

At the conclusion of this course, students should be able to:

• List the components of the Mental Status Exam
• Begin to develop skills on how to conduct a psychiatric interview.
• Discuss how to assess and manage a suicidal patient.
• Define and distinguish affective disorders.
• Define and distinguish psychotic disorders.
• Define and distinguish anxiety disorders.
• Define and distinguish personality disorders.
• Demonstrate an understanding of the principles of psychotherapy.
• Demonstrate a general understanding of the biological basis of psychiatry.

Cardiovascular System

Course Chair:	Eric Feigl, efeigl@u.washington.edu
Credits:	6

An interdisciplinary approach to cardiovascular medicine, including anatomy, physiology, radiology, pathology, medicine and surgery. The central theme of this course is the function of the cardiovascular system in health and disease.

Objectives

At the conclusion of this course, students should be able to:

• Identify and describe heart failure based on an understanding of cardiac preload and afterload.
• Identify and describe valvular heart disease based on an understanding of the events of cardiac cycle.
• Identify and describe ischemic heart disease based on an understanding of the underlying pathophysiology.
• Interpret simple ECG’s based on an understanding of membrane potentials and electrical wave propagation in the heart.

Clinical Epidemiology and Evidence-Based Medicine

Course Chair:	Bryan Kestenbaum; brk@u.washington.edu
Credits:	2

Introduction to principles of epidemiology and biostatistics, emphasizing application to clinical medicine. Three broad topics: 1) Health and disease in the community, including assessment of disease risk and mechanisms of epidemic detection, spread, and control; 2) Interpretation of research results, including fundamentals of research design, data analysis and sources of bias; 3) Clinical epidemiology, including evaluation and application of diagnostic tests, natural history of disease, and quantitative aids for clinical decision making.

Objectives

At the conclusion of this course, students should be able to:

• Learn fundamental concepts of epidemiology and biostatistics and apply these concepts to the interpretation of modern clinical research articles
• Understand general principles of epidemiology: study design, misclassification, confounding, and effect modification
• Understand general principles of biostatistics: inference, hypothesis testing, regression, and survival data
• Understand general principles of screening and diagnostic testing

Clinical Nutrition

Course Chair:	Ed Lipkin; ewl@u.washington.edu
Credits:	1

Provides students with insights into the principles and practice of clinical nutrition. An appreciation of the role of nutrients in normal growth and development, the pathogenesis of chronic disease, and nutrition in the management of certain disease states is covered.

Objectives

At the conclusion of this course, students should be able to:

• Describe the role of nutrients in normal growth and development.
• Describe the role of nutrients in normal growth and development.
• Give examples of the use of nutrition in the management of chronic diseases.
• Give examples of how diet and nutrient therapies can be incorporated into their clinical practices.
• Introduce how to promote health and wellness in their patients through dietary advice.
• Illustrate how nutrient intakes are compromised in illness.
• Illustrate how to use diet to therapeutic advantage.

Endocrine System

Course Chair:	Brad Anawalt; bradley.anawalt@med.va.gov
Credits:	3

Normal, gross, and microscopic anatomy and physiology of the endocrine system. Illustrations examining the clinical relevance of homeostasis, feedback, and other controlling mechanisms previously learned. The endocrine integration of metabolism. Clinically important endocrine pathophysiology.

Objectives

At the conclusion of this course, students should be able to:

• In the small group sessions and the mid-term and final exams, the student will be able to recite the anatomy of major endocrine organs and the normal physiological effects of the major classes of hormones.
• In the small group sessions and the mid-term and final exams, the student will be able to describe the regulation (including the principal negative and positive feedback loops) of hormone production and secretion from the major endocrine organs.
• In the small group sessions and the mid-term and final exams, the student will be able to identify and describe the pathology and pathophysiology of the major endocrine diseases including the common endocrine tumors and the syndromes of hormone deficiency and excess.
• In small group sessions and the mid-term and final exams, the student will be able to describe the basic epidemiology and clinical manifestations of the major endocrine diseases.
• On the website practice exam, mid-term and final exam, the student will determine the best (e.g, most accurate, safest or least expensive) method of diagnosing and treating specific endocrine diseases in hypothetical patient cases.
• On the website practice exam, mid-term and final exam, the student will demonstrate the ability to solve hypothetical patient cases; these solutions may include the design of novel diagnostic tools or therapies for endocrine diseases.

Gastrointestinal System

Course Chair:	Bruce Silverstein; bruce@docsilverstein.com
Credits:	4

Anatomy of gastrointestinal system; physiology and pathology of digestion and hepatic function; physical and laboratory examination.

Objectives

At the conclusion of this course, students should be able to:

• Outline an algorithm for the differential diagnosis of difficulty with swallowing.
• Explain the regulation of gastric acid secretion and how your explanation relates to the treatment of peptic ulcer disease.
• Describe the autoregulation of pancreatic endocrine, and exocrine secretion during the digestion of a meal.
• Give a description of normal fat absorption, and the derangements, which lead to fat malabsorption.
• Identify the principles of water and electrolyte absorption so that you can describe the abnormalities in normal absorption, which leads to diarrhea.
• Explain how cirrhosis of the liver can lead to esophageal variceal bleeding, ascites, and encephalopathy.
• Formulate a differential diagnosis of jaundice.
• Explain how cholesterol gallstones form.
  

Genetics

Course Chair:	Michael Raff; mraff@u.washington.edu
	Mark Hannibal, mhanni@u.washington.edu
Credits:	2

The primary aim of the course is to review basic genetic principles in the context of their applications in clinical medicine. Topics include human chromosomal disorders, pathogenesis of hereditary disease, patterns of inheritance, genetic counseling, amniocentesis, monogenic and multifactorial pathogenesis, role of genetics in common diseases, behavioral genetics, drug-gene interactions (pharmacogenetics), and prevention and treatment of genetic diseases including prenatal diagnosis and population screening.

Objectives

At the conclusion of this course, students should be able to:

• Describe what genes are, how they are organized and controlled, what they do and how they segregate.
• Describe the nature of mutations and permutations and how they contribute to human variability and to disease.
• Identify and describe the patterns of inheritance characteristics of autosomal dominant, autosomal recess, sex-linked recessive traits, and mitochondrial inheritance.
• Describe how genes are organized into chromosomes, how chromosomes replicate in mitosis and meiosis, and how they are transmitted from parent to child.
• Identify and describe the clinical manifestations of common numeric, structural, and mosaic chromosomal anomalies.
• Describe how polymorphism, gene linkage, and human gene mapping are used in medicine.
• Describe the multifactorial nature of most human traits, both normal and abnormal, and how multifactorial inheritance works.
• Describe the role of genetics in the pathogenesis of neoplasms and in the predisposition of malignancies.
• Identify common molecular and cytogenetic diagnostic techniques and how they are applied to genetic disorders.
• Describe the procedures available for prenatal genetic diagnosis and the kind soft diseases that can be detected prenatally.
• Identify and describe the approaches to treatment of genetic diseases.
• Describe the procedures available for prenatal genetic diagnosis and the kind soft diseases that can be detected prenatally.
• Identify and describe the approaches to treatment of genetic diseases.
• Students will be able to elicit a comprehensive medical genetic history and construct an appropriate pedigree.
• Students will be able to demonstrate sympathy, a non-judgmental and non-directive attitude, recognize their own limitations, seek consultation whenever necessary, and become life-long self-motivated learners.

Hematology

Course Chair:	Pam Becker; pbecker@u.washington.edu
Credits:	3

Familiarizes students with the basic pathophysiologic mechanisms leading to disturbances of red cell, white cell and platelet production as well as abnormalities of hemostasis presenting clinical problems. Pathophysiology, rather than minute details of individual disease, is stressed. Problem-based learning sessions are a significant portion of this course as well as in the musculoskeletal course.

Objectives

At the conclusion of this course, students should be able to:

• Describe the normal development, function and turnover of red blood cells, white blood cells, and platelets.
• Describe the pathophysiology of the different types of disorders of red blood cells and iron homeostasis.
• Describe the cellular and biochemical mechanisms of blood clotting and testing of these systems.
• Describe the pathophysiology of disorders of hemostasis and thrombosis.
• Describe the pathophysiology of benign and malignant disorders of white blood cells.
• Perform appropriate diagnostic evaluation of patients with blood disorders.
• Propose possible treatment options for patients with different types of blood disorders.
• Describe blood typing, blood component preparation, indications, and potential risks and complications of transfusions.

Introduction to Clinical Medicine

Course Chair:	Karen McDonough; kmcdonou.washington.edu
	Erika Goldstein, erika@u.washington.edu
Credits:	AUT/WIN/SPR: 4/4/5 Total: 13

Advanced instruction in interview techniques, history taking and physical examination, with emphasis upon detection of abnormalities. The ICM teaching in this year focuses on the history and physical exam of the specific areas of the body such as heart, lung, abdomen, mental status, etc. Topics such as human sexuality, geriatrics, and death and dying are covered in the small group format. Emphasis upon identification of problems and correlation of findings with pathophysiological mechanisms, and introduction to clinical and laboratory diagnosis will also be covered.

Objectives

At the conclusion of this course, students should be able to:

Medical Interviewing

• Review basic interviewing skills
• Learn advanced interviewing skills
• Alcohol and substance use history
• Interviewing with an interpreter
• Sexual history
• Problem-focused interviewing

Physical Exam

• Review the basic physical exam
• Learn the advanced physical exam for:
• Vital Signs
• Skin (in Dermatology)
• HEENT and neck
• Chest and lungs
• Breast
• Cardiovascular
• Abdomen
• Pelvic
• Musculoskeletal
• Neurologic
• Psychiatric
• Male genital and rectal

Documentation

• Review format for recording the medical database
• Problem list
• Complete medical database – complete H & P
• Focused (SOAP) notes
• Review the organization of the inpatient and outpatient medical record

Clinical Reasoning

• Review principles of clinical reasoning
• Learn clinical reasoning tools
• Differential diagnosis
• Branching diagrams
• Application of clinical epidemiology
• Learn to integrate clinical reasoning with data gathering and case presentation

Oral Case Presentations

• Learn the organization and content of the full oral case presentation
• Learn other types of case presentations
• Problem focused case presentation (e.g. clinic visit)
• Very brief case presentation (e.g. consultation request)

Professional Development

• Review core professional values
• Altruism
• Reliability
• Excellence, scholarship, and commitment to self directed learning
• Honor and integrity
• Compassion
• Leadership
• Respect for patients and for colleagues
• Learn about the impact of uncertainty and mistakes in medical practice
• Review the principles of medical ethics Review the professional boundaries between patients and physicians
• Learn how to care for yourself as you care for patients

Special Topics

Learn about:

• Care of patients with disabilities
• Care of patients of different cultural and ethnic backgrounds
• Complementary and alternative medicine
• Health issues related to human sexuality
• Caring for patients with life-threatening and terminal illness
• Pediatric communication

Continued