Touro University – California

Joint MSPAS/MPH Program

PASC 602E: Clinical Pathophysiology and Diagnostic

Studies
Spring 2018

Course Syllabus
Semester I
Class of 2020
Course Coordinator
Kathy Clift, MSPAS, PA-C
(707) 638-5876
Kathy.clift@tu.edu

I. Course Description & Structure

The Clinical Pathophysiology and Diagnostic Studies course is one of several cornerstone
courses in the MSPAS curriculum. This course will span through each of the 3 didactic sessions
of the first year and will focus on the pathophysiology related to specific organ systems as well
as how to order and interpret diagnostic studies such as labs and x-rays to assist in diagnosis
of illness. The focus of the course is specifically is to provide physician assistant students with
core knowledge and concepts for effectively and appropriately approaching and managing
patients with common illnesses, diseases and conditions seen in the following systems:

Renal
Hematology
Endocrine
Cardiovascular

This course will introduce PA students to commonly used diagnostic studies and laboratory
investigations to help them build a conceptual framework for understanding how laboratory
testing and imaging studies aid in diagnosis and monitoring of common disorders. It includes
a review of collection techniques, universal precautions, reference ranges and factors affecting
results. It covers clinical significance of normal/abnormal and critical results for renal and
electrolyte tests, urinalysis, the complete blood count, calcium, parathyroid hormone, cortisol,
thyroid and lipid panels. Discussing results with patients will also be incorporated. In keeping
with the TUC PA program emphasis on integration of public health knowledge and practice with
clinical medicine, the concepts of sensitivity, specificity and predictive value will be explored.
The course is not an exhaustive review of all blood tests or diagnostic studies used in clinical
medicine, but rather a building block in the development of the complex cognitive skill set
required for the practice of medicine.

TEXTS:

Mosby’s Manual of Diagnostic and Laboratory Tests, Pagana and Pagana 5th Edition (Required)

Pathophysiology of Heart Disease, Leonard S. Lilly, 5th Edition (Required)

Essentials of Pathophysiology, Porth, 4th Edition (Required)
Essentials of Radiology, Mettler, 3rd Edition, 2013 (available online via Touro’s electronic library)
 I. ARC-PA Standards

The ARC-PA Standards, 4th ed. that are relevant to this course are listed below.
B1 CURRICULUM
B1.01 The curriculum must be consistent with the mission and goals of the program.
B1.02 The curriculum must include core knowledge about established and evolving biomedical
and clinical sciences and the application of this knowledge to patient care.
B1.03 The curriculum must be of sufficient breadth and depth to prepare the student for the
clinical practice of medicine.
B1.04 The curriculum design must reflect sequencing that enables students to develop the
competencies necessary for current and evolving clinical practice.
B1.06 The curriculum must include instruction to prepare students to provide medical care to
patients from diverse populations.
B1.07 The curriculum must include instruction related to the development of problem solving
and medical decision-making skills.
B1.08 The curriculum must include instruction to prepare students to work collaboratively in
interprofessional patient centered teams.
B1.09 For each didactic and clinical course, the program must define and publish instructional
objectives that guide student acquisition of required competencies.
B1.10 The program should orient instructional faculty to the specific learning outcomes it
requires of students.

B2 CLINICAL PREPARATORY INSTRUCTION

B2.01 While programs may require specific course(s) as prerequisites to enrollment, those
prerequisites must not substitute for more advanced applied content within the professional
component of the program.
B2.02 The program curriculum must include instruction in the following areas of applied
medical sciences and their application in clinical practice:
a) physiology,
b) pathophysiology,
c) the genetic and molecular mechanisms of health and disease.
B2.03 The program curriculum must include instruction in clinical medicine covering all organ
systems.
B2.05 The program curriculum must include instruction in patient evaluation, diagnosis and
management.
B2.06 The program curriculum must include instruction in the provision of clinical medical care
across the life span.
IA. Grading Policy
This is a pass-fail course. In order to pass the class the students need to maintain a
70% on all quizzes, in class discussions, as well as group case studies. If a student gets
<70% on a quiz, he/she will have the opportunity to do a remediation quiz to bring the
score up to a 70%. If there is failure of more than 3 quizzes (including remediation
quizzes) or 2 failures in the group assignments the student will need to remediate the
course.

Grading will be as follows:

Group Assignments 50%

In-class quizzes 40 %
In-class participation 10 %
Total 100%

*Student Responsibilities*
Students are expected to read the text chapters relevant to the scheduled lecture as
outlined in the assigned reading prior to class. This will facilitate comprehension of
the material presented in lecture.

Students are responsible for the course learning objectives whether or not they are
covered in lectures. Exam questions may be from the text, lectures and/or handouts.
All questions will be based on both the general and specific course learning objectives.

Assignments:
Students will be assigned to a small group. With each system studied, the groups will
be given case studies to work on outside of class and then present to the class at an
assigned time. The cases will prompt the students to identify concerning symptoms or
signs on the H&P, to come up with an initial diagnosis and then order appropriate
clinical studies to rule-in or rule-out the diagnosis. Students will not be responsible to
initiate a treatment plan but will have to include follow-up labs/imaging in order to
follow or manage the disease. The grade for the assignments will be determined by the
quality of the case as well as the quality of the presentation. A grading rubric will be
supplied to the class.
Quizzes
There will a total of 4 in-class quizzes that will test on the basics of pathophysiology
of the system that is being studied, as well as the specifics related to individual
diagnostic studies.

In-class participation:
The students are expected to be actively engaged in class discussions. When the class
meets for the review of the appropriate labs related to a system, a short lecture will be
given and then a case will be presented by the instructor. The students are expected to
answer questions posed by the course instructor during the case.

II. Professional Conduct

1. Lectures
Visiting lecturers have been chosen for their medical expertise in the specific topic
being presented. Since they include practicing clinicians, lectures may have to be
postponed and rescheduled because lecturers may not be able to leave their clinical
work sites. Every attempt will be made to reschedule postponed lectures. The
information and experience provided by lecturers is extremely valuable; students
must provide full attention and respect to all in-house and guest lecturers.
Completing assignments for other courses or studying for other course exams will not
be permitted during lectures. Students conducting tasks unrelated to the lecture
topic and/or displaying behavior that is disruptive or disrespectful to any person will
be asked to leave the classroom and notified that this behavior is equivalent to an
unexcused absence. Continued abuse of this policy will result in disciplinary
procedures. In addition, any student needing to remove themselves from the
classroom during lecture must do so quietly………no slamming doors!
Finally, any food consumed during lecture must not be disruptive to the speaker or to
any other students.

Participation & Attendance

Attendance is mandatory. Formal attendance will be taken at each lecture. Students will
be granted one unexcused absence without penalty. Any additional absences require
that the student notify the course coordinator in advance by telephone and email.
Students who seek excused absences are also required to notify the course coordinator
in advance. The course coordinator will determine if the student is granted an excused
absence. Failure to properly notify the course coordinator as stated in the
aforementioned will result in an unexcused absence. More than one unexcused absence
will be addressed in a meeting with the course coordinator, documented in the student’s
academic file as an incident of unprofessional behavior, and a lowering of the student’s
final course grade by 5 percent. Any additional unexcused absences will result in the
aforementioned penalty, placement on probation, and referral to the MSPAS Student
Promotions Committee.

2. Objectives
Specific learning objectives will be provided for each major topic in each system.
Objectives help to prioritize, organize and focus one’s reading and study of a subject.
It is essential that the reading assignments be completed in their entirety before each
lecture for best understanding of the medical concepts presented. Information
provided by lecturers should be used to supplement the reading material as objectives
may not always be fully covered within the context of their presentations. Exam
questions will come from both lectures and all reading assignments.

3. Student guests
A student who wishes to bring a guest to class must receive formal permission from
the University (refer to the Student Handbook for further details). Immediately upon
receiving University permission, the course coordinator must be informed that the
guest will be present at least 24 hours prior to the scheduled lecture he/she plans to
attend. In addition, this guest must not be a distraction to the student or fellow
classmates. Students who have an unforeseen temporary need to bring a child into
the classroom must also receive prior approval from the University; however the
maturity of the child and their ability to avoid distracting behavior must be
considered as well as the nature of the topics being presented, as some topics may
not be appropriate for children. Under no circumstances are pets allowed in class.

4. Academic Integrity
Academic integrity is expected of all faculty, staff and students. Key components of
academic integrity are communication and mutual respect. Faculty, staff and
students are expected to abide by the code of ethics of their respective professions
(see MSPAS/MPH Student Handbook). Lack of academic integrity includes, but is not
limited to, plagiarizing, cheating, deception, falsifying assignments (making up or
handing in someone else’s work), discussing exam questions, and failure to confront
and/or report misconduct of others.

5. Disability Accommodations
 If you are eligible for course adaptations or accommodations because of a
documented learning, physical, or psychological disability, please make an
appointment with Dr. James Binkerd, Associate Dean of Student Services. Students
eligible for accommodations must provide appropriate documentation prior to the
start of the course to receive an accommodation. (Refer to MSPAS/MPH Student
Handbook).

6. Internet connectivity
Students are expected to communicate with the course coordinator and lecturers
through their tu.edu email accounts and to check email regularly (preferably daily).
Note that Blackboard is considered an integral part of this course and will be used to
convey messages, to post course materials, and to post exam grades. Students are
therefore advised to check Blackboard daily. Students will also be expected to utilize
our Library’s electronic media for purposes of study.

7. Cell phones must be turned put away during class. Students found to be repeatedly
leaving class during lecture to make phone calls will be called into the course
coordinators office and be written up for professionalism. Any student caught using
their phone and/or laptop during class for anything other than taking notes or
following the lecture will result in a professionalism violation. Students are also not
to leave the class frequently to use their phones.

8. Course evaluations
Constructive student feedback is an integral part of the ongoing success of this
course. It is expected that all students will complete the online course evaluations
for each session.

9. Dress code
Students are NOT to arrive to class wearing their pajamas, bedroom slippers, pants
with words written across their buttock, or midriffs.

III. Course Coordinator’s Objectives

1. Explain course objectives and logistics for each course session.
2. Provide a syllabus and schedule for each system presented within the course.
3. Help students identify useful and available learning resources.
4. Develop self-study assignments to enhance understanding of course topics and
common patient presentations.
5. Be available for appointments during hours outside of scheduled class time.
 6. Notify students, via blackboard or initiation of the phone tree, when significant course
changes are expected.

IV. General Course Objectives

Upon completion of this course of study of renal, hematology, endocrine and cardiovascular
systems, the student will be able to:

1. Describe the pathophysiology of common disease entities encountered in a primary care

setting.
2. Identify the appropriate laboratory and diagnostic work-up for common disease entities.
3. Develop a differential diagnosis and identify diagnostic modalities most appropriate for
common presenting symptoms in primary care.
4. Describe the appropriate health screening labs and disease prevention methods utilized
in primary care.
5. Explain the appropriate follow-up labs and diagnostic studies for chronic medical
conditions encountered in primary care, including monitoring of pharmacologic and
non-pharmacologic therapies.

V. Specific Learning Objectives

Specific learning objectives for each system covered in this course will be posted to
Blackboard separately.