MIAMI DADE COLLEGE
MEDICAL CENTER CAMPUS
RESPIRATORY CARE PROGRAM
COURSE OUTLINE
RET 2503 - RESPIRATORY CARE PATHOPHYSIOLOGY 2
COURSE DESCRIPTION:
This course is designed with an emphasis on specific cardiopulmonary diseases. The focus is on epidemiology, diagnosis and treatment.
Class Day: / Thursday / Class Location: / 2111Class Time: / 10:00am - 12:30am / Instructor: / Phillip Slocum
Office: / 2261 / Phone: / 305-237-4447
Office Hours: / By appointment
REQUIRED TEXTBOOKS/SUPPLIES:
1. Des Jardins, Clinical Manifestations and Assessment of Respiratory Disease, 6th ed., Elsevier.
2. Hess, Respiratory Care: Principles and Practice, 2nd edition, Jones & Bartlett, ISBN: 978-0-7637-6003-8.
Textbooks must be brought for each scheduled class. Be sure to purchase the MOST recent edition available for each text. All required Texts are available in the Campus Bookstore.
Students with documented disabilities should contact the campus ACCESS office in advance for information on appropriate policies and procedures for obtaining assistance. No retroactive accommodations can be provided. The ACCESS office is located in room # 1113 at 305.237.4416. Additional information can be obtained at by email: and http://www.mdc.edu/medical/StudentServices/ACCESS
Any changes to this syllabus, the class schedule, testing, assignments, etc., will be communicated via e-mail or posted on the instructor’s webpage - it is each student’s responsibility to monitor these regularly.
SPECIFIC COURSE OBJECTIVES:
1. The course work will be divided into modules, with specific objectives for each module.
2. You will be responsible for completing all module assignments, lab activities, and quizzes/tests in order to satisfy all course objectives.
3. Quizzes will be given following the completion of the module(s), as well as at any time the instructor deems appropriate.
It is the student’s responsibility to be present for all scheduled examinations. Students who are absent for exams, but provide suitable justification and documentation (physician’s note or other appropriate evidence) will be allowed to take a makeup exam at full credit. If the absence is unexcused, or adequate documentation is not provided, the student may make up the exam but will not receive a grade higher than 80% C. Makeup exams must be scheduled by the student and will be given at the convenience of the instructor. The format of any make-up exam is at the discretion of the instructor, cf. Respiratory Care Program Policies and Procedures, Section Three: Assignments and Tests, #3.
5. The final grade will be computed based on the following:
I. Quizzes 100%
GRADING SCALE
A = 100 - 94
B = 93 - 87
C = 86 - 80
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D = 79 - 73
F = 72 - below
PLEASE NOTE: If a grade of "D" or “F” is earned for any course in the Respiratory Care Program, the course must be repeated successfully (“C” or higher) before the student may continue in the program.
RET 2503
TABLE OF CONTENTS
Module 1 - Clinical Data Obtained From Laboratory Tests and Special Procedures
Module 2 - Asthma
Module 3 - Chronic Obstructive Pulmonary Disease (COPD)
Module 4 - Cystic Fibrosis
Module 5 - Infections of the Lung
Module 6 - Tuberculosis
Module 7 - Interstitial Lung Diseases
Module 8 - Chest Trauma, Smoke Inhalation Injury, Burns & Near Drowning
Module 9 - Pulmonary Edema, Pulmonary Thromboembolism
Module 10 - Acute Respiratory Distress Syndrome
Module 11 - Neuromuscular Disorders and Sleep Disordered Breathing
Module 12 - Cancer of the Lung
MODULE 1 – LABORATORY DATA AND SPECIAL PROCEDURES
General Objective:
This module describes a variety of general and specific tests to help identify the overall health status of the patient. The primary emphasis is on examination of sputum samples to identify potential sources of infection and the levels of red and white blood cells and electrolytes in the blood.
Specific Objectives:
Upon completion of this module, the student should be able to do the following:
· Describe the diagnostic values of the sputum examination, and include common organisms associated with respiratory disorders:
o Gram-negative organisms (Klebsiella, Pseudomonas aeruginosa, Haemophilus influenzae, Legionella pneumophila)
o Gram-positive organisms (Streptococcus and Staphylococcus)
o Viral organisms (Mycoplasma pneumoniae and respiratory syncytial virus)
· Discuss the diagnostic values of the following tests and procedures:
o Skin tests
o Endoscopic examinations (bronchoscopy and mediastinoscopy)
o Lung biopsy
o Video-assisted thoracoscopy (VATS)
o Thoracentesis
o Pleurodesis
· Describe the following components of hematology:
o Complete blood count (CBC)
o Red blood cell (RBC) count (red blood cell indices and types of anemias)
o White blood cell count (WBC), and include granular leukocytes and nongranular leukocytes
· Describe the role of platelet and include:
o Causes of a platelet deficiency
o Clinical significance of a platelet deficiency
· Identify the following blood chemistry tests commonly monitored in respiratory care:
o Glucose
o Lactic dehydrogenase (LDH)
o Serum glutamic oxaloacetic transaminase (SGOT)
o Blood urea nitrogen (BUN)
o Serum creatinine
· Identify the following electrolytes commonly monitored in respiratory care:
o Sodium (Na+)
o Potassium (K+)
o Chloride (Cl−)
o Calcium (Ca++)
MODULE 2 – RADIOGRAPHIC IMAGING
General Objective:
This module describes the language and techniques associated with chest radiography. The student will learn the fundamentals of interpretation of the chest x-ray. The chapter also describes other important radiographic techniques used in assessment of the patient with cardiopulmonary disease.
Specific Objectives:
On completion of module, the student should be able to do the following:
· Describe the fundamentals of radiography
· Differentiate between the following standard positions and techniques of chest radiography:
o Posteroanterior radiograph
o Anteroposterior radiograph
o Lateral radiograph
o Lateral decubitus radiograph
· Define the following radiologic terms commonly used when inspecting the chest radiograph:
o Air cyst
o Bleb
o Bronchogram
o Bulla
o Cavity
o Consolidation
o Homogeneous density
o Honeycombing
o Infiltrate
o Interstitial density
o Lesion
o Opacity
o Pleural density
o Pulmonary mass
o Pulmonary nodule
o Radiodensity
o Radiolucency
o Translucent
· Describe the three steps to evaluate technical quality of the radiograph
· Describe the sequence of examination, and include:
o Mediastinum
o Trachea
o Heart
o Hilar region
o Lung parenchyma (tissue)
o Pleura
o Diaphragm
o Gastric air bubble
o Bony thorax
o Extrathoracic soft tissues
· Describe the diagnostic values of the following radiologic techniques:
o Computed tomography (CT)
o Positron emission tomography (PET)
o Positron emission tomography and computed tomography scan (PET/CT scan)
o Magnetic resonance imaging (MRI)
o Pulmonary angiography
o Ventilation/perfusion scan
o Fluoroscopy
o Bronchography
MODULE 3 - ASTHMA
General Objective:
In this module the student will learn about a very common form of obstructive lung disease known as asthma. The emphasis is placed on assessment and treatment of patients with this disease.
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Specific Objectives:
On completion of module, the student should be able to do the following:
· Describe the role of the following organizations in the management of asthma:
o National Asthma Education and Prevention Program (NAEPP)
o Global Initiative for Asthma (GINA)
· List the anatomic alterations of the lungs associated with asthma
· Describe the epidemiology and risk factors associated with asthma, including:
o Extrinsic asthma
o Intrinsic asthma
· Describe the challenges associated with the diagnosis of asthma, and include the tests used to diagnosis and monitor asthma
· Differentiate the classifications of asthma severity
· Describe the cardiopulmonary clinical manifestations associated with asthma
· Describe the general management of asthma
MODULE 4 - CHRONIC OBSTRUCTIVE PULMONARY DISEASE (CHRONIC BRONCHITIS & EMPHYSEMA))
General Objective:
This module describes the definition, assessment, and treatment for chronic obstructive pulmonary disease. The module also focuses on chronic bronchitis and emphysema and the anatomical differences between the two forms of COPD.
Specific Objectives:
On completion of module, the student should be able to do the following:
· Describe the American Thoracic Society (ATS) guidelines for chronic obstructive pulmonary disease (COPD), chronic bronchitis, and emphysema
· Discuss the Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition of COPD
· List the epidemiology and risk factors associated with COPD
· Describe the Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy for diagnosing COPD
· Describe the key indicators for considering a COPD diagnosis
o Dyspnea
o Chronic cough
o Chronic sputum production
o History of exposure to risk factors
· Describe the three main pulmonary function study measurements used to confirm the clinical suspicion of COPD:
o FVC
o FEV1
o FEV1/FVC ratio
· Differentiate among the following four stages of COPD as outlined by GOLD:
o Stage I: Mild COPD
o Stage II: Moderate COPD
o Stage III: Severe COPD
o Stage IV: Very severe COPD
· Discuss additional diagnostic studies for patients identified as having either Stage II, Stage III, or Stage IV COPD
o Bronchodilator reversibility testing
o Chest x-ray
o Arterial blood gas measurement
o Alpha-1 antitrypsin deficiency screening
· List the anatomic alterations of the lungs caused by both chronic bronchitis and emphysema
· List the cardiopulmonary clinical manifestations caused by the anatomic alterations and pathophysiologic mechanisms associated with chronic bronchitis and emphysema
· Identify the key distinctive differences between chronic bronchitis and emphysema—the “pink puffer” and the “blue bloater”
· Describe the Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy for the management and prevention of chronic obstructive pulmonary diseases
· Describe additional treatment considerations for emphysema, including:
o Alpha1 antitrypsin replacement therapy
o Lung volume reduction surgery
o Lung transplantation
MODULE 5 - CYSTIC FIBROSIS
General Objective:
This module presents the essential information that RTs need to understand the pathologic abnormalities associated with cystic fibrosis. In addition, the typical clinical findings and treatment modalities used to treat patient with CF are presented.
Specific Objectives:
On completion of this module, the student should be able to do the following:
· List the anatomic alterations of the lungs associated with cystic fibrosis
· Describe the causes and classifications of cystic fibrosis
· List the cardiopulmonary clinical manifestations associated with cystic fibrosis
· Describe the general management of cystic fibrosis
MODULE 6 - BRONCHIECTASIS
General Objective:
This module describes the anatomic abnormalities in the lung associated with bronchiectasis. In addition, the module presents the clinical findings and treatment needed for patients with this medical malady.
Specific Objectives:
On completion of this module, the student should be able to do the following:
· Describe the anatomic alterations of the lungs associated with bronchiectasis, including:
o Varicose (fusiform) form of bronchiectasis
o Cylindrical (tubular) form of bronchiectasis
o Cystic (saccular) form of bronchiectasis
· Differentiate between the following possible causes of bronchiectasis:
o Acquired bronchiectasis
o Congenital bronchiectasis
· Describe the cardiopulmonary clinical manifestations associated with bronchiectasis
· Describe the general management of bronchiectasis
MODULE 7 – PNEUMONIA
General Objective:
This module describes the details associated with changes in the lung that occur with pneumonia. The clinical findings and treatment for pneumonia are also presented.
Specific Objectives:
On completion of this module, the student should be able to do the following:
· List the anatomic alterations of the lungs associated with pneumonia
· Describe the causes and classifications of pneumonia
· List the cardiopulmonary clinical manifestations associated with pneumonia
· Describe the general management of pneumonia
MODULE 8 – TUBERCULOSIS
General Objective:
Tuberculosis continues to be a world-wide threat. This module presents the pathology, clinical findings, and treatment associated with tuberculosis. Every RT should be very familiar with the diagnosis and treatment of this medical problem that often leads to a lung infection. Upon completion of this module, the student will understand pulmonary tuberculosis.
Specific Objectives
On completion of this module, the student should be able to do the following:
· List the anatomic alterations of the lungs associated with tuberculosis
· Describe the causes of tuberculosis
· List the cardiopulmonary clinical manifestations associated with tuberculosis
· Describe the general management of tuberculosis
MODULE 9 – INTERSTITIAL LUNG DISEASES
General Objective:
This chapter presents the pathologic changes in the lung associated with interstitial lung diseases. It also addresses the causes, clinical findings, and treatment of these serious lung ailments that come in a large variety of settings.
Specific Objectives
On completion of this module, the student should be able to do the following:
· List the anatomic alterations of the lungs associated with chronic interstitial lung disease
· Describe the causes of chronic interstitial lung disease
· List the cardiopulmonary clinical manifestations associated with chronic interstitial lung disease
· Describe the general management of chronic interstitial lung disease
MODULE 10 – NEAR DROWNING
General Objective:
This module describes the important topic of near drowning. The pathological changes in the lung, causes, clinical findings, and treatment are described in an organized fashion. Every RT should know how to recognize and treat the near drowning victim.
Specific Objectives
On completion of this module, the student should be able to do the following:
· List the anatomic alterations of the lungs associated with near drowning
· Describe the causes of near drowning
· List the cardiopulmonary clinical manifestations associated with near drowning
· Describe the general management of near drowning
MODULE 11 – PULMONARY EDEMA
General Objective:
In this module you will learn the pathological changes in the lung associated with pulmonary edema. The clinical signs and symptoms associated with pulmonary edema are also presented. Finally, the respiratory care given to patients with pulmonary edema will be reviewed.
Specific Objectives:
On completion of this module, the student should be able to do the following:
· List the anatomic alterations of the lungs associated with pulmonary edema
· Describe the causes of pulmonary edema