MERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE II PULMONOLOGY COMPONENT. PULMONOLOGY COMPONENT Component Description: This is an intensive study of the presentation of disorders of the respiratory tract. The course will emphasize appreciation of normal respiratory and non-respiratory pulmonary functions in order 10 appreciate the pathogenesis of disease. Evaluation and management of patients with respiratory disease will be stressed. Required Reading: Harrison’s Principles of Internal Medicine Current Medical Diagnosis and Treatment 2014 Component Outline: Topic Unit 1 - Overview of Respiratory Diseases | Unit 2 - Obstructive Airway Disease Unit 3— Asthma Unit 4 - Interstitial Lung Diseases Unit §- Environmental Lung Injury Exam #1 - Units 1-5 Unit 6 — Pulmonary Vascular Disease; Acute Respiratory Distress Syndrome (ARDS) Unit 6 — Continued Unit 7 - Disease of the Pleura, Mediastinum, and Chest Wall | Unie 8 - Pneumonia Unit 9 - Tuberculosis Unit 10 Pulmonary Neoplasms ‘Comprehensive Pulmonary ExaminationMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE II PULMONOLOGY COMPONENT UNIT 1: OVERVIEW OF PULMONARY MEDICINE UNIT OBJECTIVES: Afier completion of this component unit, the student will be able “ @) © 1. Discuss the anatomical structures of the lungs and the physiology of pulmonary function; briefly describe the function of the lungs related to vocal cord! function (A) Outline a pertinent pulmonary assessment (A) History and review of systems, Physical examination techniques, General management considerations 3. Describe the clinical significance of respiratory symptoms and physical examination findings and the differential diagnosis of: (A) ont Dyspnea Stridor “SP/29T Sputum production Wheeze Hemoptsis alee smsereaen Cyanosis Rhonchi - explRaTaN Clubbing Absent breath sounds 4, Enumerate the indications, and know the interpretation of significant findings of the following pulmonary diagnostic tests (A) Chest x-ray Blood gas. Pulse Oximetry Lung biopsy Bronchoscopy _Bronchioalveolar lavage Pulmonary function tests: Spirometry, Bronchial provocation, Peak flow Total lung capacity (TLC) , Functional residual capacity (FRC), Residual volume (RV), Forced Expiratory volume in the first second (FEV1), FVC foreed vital eapacity 5. Enumerate the various routes of pathogenic transmission of pulmonary diseases. Denotes care knowledge - essential to appropriately recognize the presentation, perform the assessment, derive the iagnosis, and Wat the disorder asa primary’ care provider Denotes kev knowledge - important to appropriately recognize the presentation, porform the assessment, and disgnose the Aisorder asa primary ere referral Denotes important knowledge -heipfol to appropriately recognine to en ateas of medical pratioe sce and augment knowledge inthe core and keyMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES, PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE IL PU LOGY COMPO! UNIT 2: OBSTRUCTIVE AIRWAY DISEASE, UNIT OBJECTIVES: After completion of this component unit, the student will be able to: 1, Discuss the risk factors, prevalence, pathophysiology, pathogenesis, pathological findings, signs and symptoms, diagnostic assessment, differential diagnosis, management and treatment, and complications of obstructive airway disorders (A) -Chronic obstructive pulmonary disease (COPD): Emphysema, Chronic bronchitis (with chronic airflow obstruction) -Bronchiectasis, 2. Deseribe the pathophysiology, diagnosis, and management of the respiratory tract manifestations of cystic fibrosis (A) 4. Briefly outline other organ involvement of cystic fibrosis and know the pathophys and the clinical presentations (A) logy 5. Describe therapeutic approaches to managing patients with obstru (A) airway disorders Pharmacological therapy Antibiotics Vaccines Supplemental oxygen Risk factor reduction Physical therapy (A) Denotes core knowledge - essential to appropriately recognize the presentation, perform the assessmem, derive the siagnosis, and teat the disorder asa primary’ care provider (B) Denotes kev knowledge - important to appropriately recognize the presentation, perform the assessment, ad diagnose the disorder as a primary ete refer (©) Denotes impartant knowledge -helpfil to appropriately recognize to enhance and augment knowledge in the core and key sas of medical prtMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE IL PULMONOLOGY COMPONENT. IT 3: ASTHMA UNIT OBJECTIVES: After completion of this component unit, the student will be able to: 1. Define asthma (A) 2. Identify key historical questions to ask a patient with asthma (A) 3. Discuss the epidemiology, prevalence, and pathogenesis of asthma (A) 4, Know the pathology of the reactive airway response and physiologic changes associated with asthma (A) -Tachypnea Wheezing, 5, Enumerate the bronchoscopic findings in asthma (A) 6. Discuss the clinical presentation, diagnostic findings, and differential diagnosis of asthma (A) 7. Know the severity classifications of asthma(A) 8. Discuss the assessment of response to the therapeutic management of asthma (A) 9. Know the mechanism of actions of drugs commonly used in the treatment of asthma (A) 10. Define status asthmaticus (B) 11. Discuss the presentation and management of status asthmaticus (B) (A) Denotes core knowledge = essential 10 appropriately recognize the presentation, perform the assessment, derive the diagnosis, and teat the disorder as a primary eae provider (B) Denotes kev knowledge - important to appropriately recognize the presentation, perform the assessment, and diggnose the disorder as «primary care referral (€) Denotes important knowledge - help to appropriately recognize enhance areas of medical practice 1yzment knowledge inthe core and keyMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE II PULMONOLOGY PONENT UNIT 4: INTERSTITIAL PULMONARY DISEASE UNIT OBJECTIVES: After completion of this component unit, the student will be able to: 1. Describe the epidemiology, pathogenesis, and clinical presentations of interstitial lung, disease (diffuse parenchymal lung disease) (A) 2. Discuss the epidemiology, pathogenesis, clinical manifestations, diagnosis, management, and prognosis of hypersensitivity pneumonitis (extrinsic allergic alveolitis) (B) 3. Discuss the epidemiology, pathogenesis, clinical manifestations, diagnosis, management, and prognosis of disorders of unknown etiology @) é Sarcoidosis * Idiopathic pulmonary fibrosis Disorders associated with systemic collagen vascular disorders Pulmonary vasculitis (Churge-Strauss, Granulomatous with polyangitis) Alveolar hemorrhage syndromes (Goodpasture, Hemosiderosis) (A) Denotes sore knowledge - essential 10 appropriately recognize the presentation, perform the assessment, derive the diagnosis, and reat tho disorder as a primary eee prover (B) Denotes key knowledge - important to appropriately rsagnize the presentation, perform dhe assessment, and diagnose the disorder asa primary ere referral (©) Denotes important knowledge -helpol to appropriately recognize to enhance snd augment knowledge inthe core and key areas of medical practiceMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE IT PULMONOLOGY COMPONENT UNIT 5: ENVIRONMENTAL LUNG INJURY UNIT OBJECTIVES: ‘After completion of this component unit, the student will be abl 3. Discuss the epidemiology, pathogenesis, clinical manifestations, diagnos and prognosis of environmental and occupational interstitial lung disease (pneumoconiosis) (A) management, Asbestos Lead Poisoning Coal Silica/ Fiberglass 2. Discuss the epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, management, and complications of drug induced and radiation lung disease (B) Discuss the pathogenesis signs and symptoms, and management of drowning and near drowning (fresh water) accident vietims (A) 3. Discuss the pathogenesis and mai (B) \gement of thermal Lung injury and smoke inhalation 4, Discuss the pathogenesis and management of noxious fume inhalation (B) (A) Denotes core knowledge - essential 10 appropriately recognize the presentation, perform the assessment, derive the diagnosis, and teat the disorder as a primary care provider (8) Denotes kev knowledge - important to appropriately recogni Aisorder as a primary are referral (©) Denotes important knowtedze -helpil to appropsiately recognize to enhance and augment knowiedge inthe core and key areas of medical practice c the presentation, perform the asessmt, and diagnose dheMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE II PULMONOLOGY COMPONENT UNr PULMONARY VASCULAR DISORDERS; ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS); MECHANICAL VENTILATORY SUPPORT UNIT OBJECTIVES: After completion of this component unit, the student will be able to: 1, Define the pathogenesis, incidence, pathophysiology, clinical manifestations, diagnostic evaluation, of pulmonary embolism (A) 2. Know the management of pulmonary embolism in general and recurrent pulmonary embolism in particular (A) “ Define Adult Respiratory Distress Syndrome (ARDS) and the disorders associated with ARDS (A) 4, Describe the principles of mechanical ventilatory support (C) 5. Define acute respiratory failure, describe the characteristics and circumstances associated with respiratory failure (B) 6. Differentiate the features of hypoxic and hypercapnic-hypoxic acute respiratory failure ey zie 7. Discuss the indications for lung transplantation. Describe post-operative infections, rejection risk and long term outcome of lung transplantation (B) (A) Denotes gore knowledge - essential 10 appropriacly recognize the presentation, perform the assessment, derive the diagnosis, and iret the disorder asa primary care provider (8) Denotes kev knawtedge «important 1 appropriately recognize the presentation, perform the assessment and diagnose the Aliso as a primary eare referral (©) Denotes impartant knowledge - helpful to appropiatly recognize to enhance and augment knowledge inthe core and key seas of medical preticeMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE II PULMONOLOGY COMPONENT UNIT 7: DISEASES OF THE PLEURA, MEDIASTINUM, AND CHEST WALL UNIT OBJECTIVES: After completion of this component unit, the student will be able to: 2 Discuss disorders of diaphragmatic motion (B) Describe the etiology, pathophysiology, presentation and management of thoracic derangements (B) Kyphoscoliosis Scoliosis Ankylosing spondylitis Pectus excavatum and carinatum (Marfan Syndrome) Discuss the etiology, signs and symptoms, pathophysiology, diagnosis, and management of pneumothorax (A) Discuss some clinical manifestations of pneumothorax (B) Blebs, Bullae, Bronchogenic cysts Differentiate between spontancous, tension, and secondary pneumothorax (B) Discuss frequent causes of anterior, middle and posterior medi Describe the anatomy and physiology of the pleura (B) Define the etiology, signs and symptoms, diagnostic tests and findings ,and management of pleural effusion (A) -transudate -exudate List the clinical entities that can present with exudative and transudative pleural 10. Differentiate transudative effusion from exudative effusions, hemothorax from chylothorax (A) (A) Denotes sore knowledge - essential 10 appropriately recognize the presentation, perform the assessment, derive the diagnosis, and eat the disorder asa primary care provider (B) Denotes ev knowledge - important to appropriately recognize the presentation, perform the assessment, and diagnose the disorder asa primary eae referral (©) Denotes important knowlege - helpful to appropriately recognize to enhance and augment knowledge inthe core and key areas of modical practiceMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES. PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE IT PULMONOLOGY PONENT UNIT 8: LOWER AIRWAY DISORDERS UNIT OBJECTIVES: After completion of this component unit, the student will be able to: 1, Discuss the epidemiology, pathogenesis, host defenses, risk factors, immunoglobulins involved in the development of pneumonia (A) - Bacterial - Viral 2. Discuss the clinical manifestations, diagnosis, management and drug of choice, and complications of pneumonia (A) - _ Klebsiela pneumonia, Streptococcus pneumonia, Mycoplasma pneumonia, = Pneumocystis carinii pneumonia, Legionella pneumonia (Legionnaires' di - Hnfluenza pneumonia, Staphylococcus aureus pneumonia 4. List the clinical conditions in which polyvalent pneumococcal vaccination is recommended (A) (A) Denotes core knowledge - essential 10 appropriately recognize the presenti derive the iagnosis, and wet the disorder as a primary’ care provider (B) Denotes Kev knowledge - important to appropriately recognize the presentation, perform the assessment, and diagnose the sisorder as a primary ete referral (©) Denotes impartant knossledge = help o appropriately reeognize to enhance and augment knowledge in the core and key areas of medical pritice perform tho assessmenGRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE II PULMONOLOGY COMPONE! UNIT 9: LOWER AIRWAY DISORDERS UNIT OBJECTIVES: Afier completion of this component unit, the student will be able to: - Discuss the epidemiology, screening test, diagnosis, management, and sequela of pulmonary tuberculosis (A) . Describe the clinical manifestations and management of abscesses and empyema (B) Discuss the etiology, clinical manifestations, diagnosis, treatment and outcome of Atelectasis (B) Briefly outline ventilatory disorders (C) “ Denotes gore knowledge ~ essential to appropriately recognize the presentation, perform the assessment, derive the agnosis, and reat the disorder as primary eae provider (B) Denotes kev knowledge - important to appropriately recognize the presentation, perform the assessten, and dignose the isorde asa primary eae referral (©) Denotes important knowted = helpful to sppropriately recognize wo enance and augment knowledge inthe core and key axeas of medical practiceMERCY COLLEGE GRADUATE PROGRAM IN PHYSICIAN ASSISTANT STUDIES PHAS 504 - FUNDAMENTALS OF CLINICAL MEDICINE II PULMONOLOGY COMPONENT UNIT 10; PULMONARY NEOPLASMS UNIT OBJECTIVES: After completion of this component unit, the student will be able to: 1, Define the epidemiology, prevalence, incidence, risk factors and pathogenesis of pulmonary neoplasia (A) 2. Distinguish modifiable from non-modifiable risk factors for pulmonary neoplasia (A) 3. Discuss the clinical presentation and diagnostic evaluation of pulmonary neoplasia (A) 4. Discuss the types and staging of pulmonary neoplasia (A) 5. Describe common paraneoplastic syndromes associated with pulmonary neoplasia and management of pulmonary neoplasia (B) 6. Discuss the etiology, presentation, and management of malignant pleural effusions and malignant mesothelioma (B) (A) Denotes core knowledge - essential 10 appropriately recognize the presentation, perform the assessment, derive the ‘gnosis, and weat he disorder as a primary eae provider (B) Denotes kev knowledge «important to appropriately recognize the presentation, perform the assessment and diagnose the disorder asa primary cae refeeal (©) Denotes important knowledge - helpful to appropriately recognize to enhance and augment knowledge in the eave and key areas of medical practicePEN, [PVC teases RNOND —TOAL VOLUN & Awour (900 1200 OmL pesipuay Vou4e Laie URE T WN Lunas ARTES evEerthNG dhe een expiezo > wi200mL VITAL caaury Ardounre of ex CHANGABLE B12, TW + e2N “VN —Funcnions Resiousl CA pacity RN +EUNIT2* OpsreucTIVE JiR AY Asease tecopp — GENERAL aoe EsENse OF Agaad omsrevemont DUE > cdeowte BoeoNtdhnS o@ aewipinse® we ilper ne CaeeneatTss We peepueniotl of eovlahal -Excesst sea . 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