PHYSIOLOGY AND PATHOPHYSIOLOGY II is a compulsory course in the second year of the Integrated Undergraduate and Graduate University Study of Medicine in English, taking place in the IV semester. It consists of 45 hours of lectures, 35 hours of seminars, and 40 hours of laboratory practicals, which overalls in 120 hours (11 ECTS). Lectures and seminars are held in lecture halls of the Faculty of Medicine according to the course schedule.
The aim of the integrated course is to enable the student to, by applying previously acquired knowledge of physics, chemistry, biology, biochemistry, and normal morphology (anatomy and histology), primarily acquires knowledge of the normal function of the organism, and then to acquire knowledge of pathophysiological mechanisms that lead to disease. This is followed by a review of a clinical correlation, i.e. a computer simulation of different pathophysiological conditions, which prepares the student for an independent troubleshooting of a health care problem. There is an attempt to explain individual functions at a molecular level, as well as at a level of an organism as a whole, and to analyze it in the processes of an organism adapting to changing external environmental conditions. The emphasis of the course is on learning basic and "applicable" physiology, i.e. on the vertical upgrade of the knowledge acquired during the explanation of basic physiological functions.
Content of the course Physiology and Pathophysiology II:
Physiology and Pathophysiologies of the Heart and the Circulation: Heart – structure and function. Creating and spreading impulses. Creating a normal electrocardiogram. Cardiac arrhythmias and their electrocardiographic interpretation. Heart sounds. Overview of the circulation. Cardiac output regulation. Arterial pressure regulation. Arterial and venous pulse. Microcirculation and lymphatic system. Hypertension and hypotension. Coronary circulation and ischemic heart disease. Cardiac failure. Syncope. Circulatory shock and the basics of its treatment. Physiology and Pathophysiology of the Kidney: Kidney – structure and function. Filtration and reabsorption.Creating concentrated and diluted urine. Prerenal, renal, and postrenal kidney disorders. Disorders of water and electrolytes turnover. Acute and chronic renal insufficiency. Physiology and Pathophysiology of Respiration: Respiratory system – structure and function. Pressures and volumes. Pulmonary ventilation. Gas exchange through the respiratory membrane. Regulation of respiration. Pulmonary function tests. Obstructive and restrictive respiration disorders. Acid-base Balance Regulation and Disorders: Pathophysiological factors of acid-base balance disorders. Metabolic and respiratory acidosis and alkalosis. Compensation mechanisms and consequences of acid-base balance disorders.
LEARNING OUTCOMES FOR THE COURSE:
I. COGNITIVE DOMAIN - KNOWLEDGE
1. to describe and explain a normal function of the cardiovascular, uropoetic, and respiratory organic system, and to describe and explain interrelations of certain organic systems in a healthy human
2. to describe control mechanisms responsible for a normal function and maintenance of homeostasis of the cardiovascular, uropoetic, and respiratory system, to analyze it according to the activation rate, strength, and duration of action, to match its effects in maintaining homeostasis, to analyze the principles of the feedback mechanism
3. to describe and classify the most important etiologic factors that cause disorders in the cardiovascular, uropoetic, and respiratory system, and to analyze mechanisms of its harmful effects on organs and organic systems, to describe and explain general patterns of organism’s reactions to noxious stimuli, and to describe and analyze branching of basic pathophysiological processes in an organism’s systemic reaction
4. to describe and analyze pathogenetic mechanisms of principal systemic and organ-specific diseases, and to match it with etiologic factors and basic clinical signs of a disease, to classify diseases of the cardiovascular, uropoetic, and respiratory system according to etiopathogenesis
5. to explain and define the functional reserve of the organic system and to describe tests for the detection of latent organ insufficiency, to explain mechanisms of organ decompensation
6. to describe principles of basic functional and laboratory tests and to distinguish deviations from normal values, to analyze it within individual pathophysiological conditions in these organic systems
7. to describe and interpret the mechanisms of the most important clinical signs in the most common disorders in the function of the cardiovascular, uropoetic, and respiratory system
II. PSYCHOMOTOR DOMAIN - SKILLS
1. to record a normal ECG by means of the simulation system, to read and to interpret a normal ECG, to analyze basic heart rhythm disturbances, to perform vectorial analysis, and to analyze disturbances of a mean electrical axis in the most common disorders of electrical activity or the heart structure
2. to measure arterial blood pressure and to analyze the causes of blood pressure disorders, to palpate the arterial pulse and to explain the reasons for possible pulse changes,
3. to analyze the composition of normal urine, to determine the presence of pathological components in the urine by applying basic qualitative and quantitative methods, to calculate clearances according to the given parameters
4. to determine individual pulmonary volumes and capacities, to compare the given values with the expected ones, to perform basic static and dynamic pulmonary function tests, to interpret pathogenic mechanisms that cause its changes,
5. to elaborate pathogenesis algorithmically in certain examples of diseases of the cardiovascular, uropoetic, and respiratory system (according to the problem-solving assignments from the additional literature)
Class organization:
Teaching is performed in the form of lectures, seminars, and laboratory practicals. Active participation of the student within the curriculum may be achieved by performing practicals on computer programs (Biopack), as well as by the application of computer Physio-ex programs that simulate pathological conditions and provide clinical correlates of certain diseases. Part of the seminars is conducted as problem-based classes so that students can, based on typical anamnestic and diagnostic data, solve complex physiological and pathophysiological problems with the help of the teacher. At seminars and practicals, the student actively discusses with the teacher about the physiological and pathophysiological mechanisms. During the course classes, the student obtains credits/grade points, which make up 50% of the final grade on the exam. A student who obtains 25 grade points or more may access the final exam that is organized immediately after the completion of the classes.