Human Health and Disease: A Clinical Approach Section G, Spring 2017 Instructors: Marie Deen Christensen & Sabrina Khan Hospital, Tuesdays and Fridays 15:30-17:30

Learning objectives The objective of the course is to introduce students to the most important human diseases, their diagnosis and treatment, and to the clinical working methods of physicians as practiced at a large, Danish referral University Hospital (Glostrup Hospital) in . Upon completion of this course, students will be able to: 1. Write a structured medical report 2. Explain the rationale for choice of tests and treatments in clinical practice 3. Copy basic manual skills (suture, IV, catheters) and give a basic explanation of the techniques 4. Discuss knowledge of human anatomy, physiology, and scientific context 5. Describe medical practice in a social, international, and scientific context 6. Outline the epidemiology of major diseases in both the industrialized world and the developing world.

Content The clinical approach of the course implies studying symptoms, signs, diagnostic methods and treatment of the most important human diseases, writing patient case reviews based upon medical records, and patient interviews, visiting various clinical and diagnostic hospital departments, and performing physical examinations on phantoms or other students.

The course, however, does not provide regular medical training corresponding to that of medical students and does not include shadowing of doctors or physical examination of patients. Patient demonstrations are included in some, but not all, lectures.

Instructors Marie Deen Christensen M.D. (Aarhus University, 2014). PhD student in Neuroscience, . Main research includes pathophysiology of migraine without aura, human migraine models, and neuroimaging. Affiliated with the Human Migraine Research Unit, Danish Headache Center since 2014. Dept. of , Rigshospitalet and Glostrup Hospital, (Copenhagen University Hospital), 2014. With DIS since 2014.

Sabrina Khan M.D. (University of Copenhagen, 2013). PhD student in Neurology at Rigshospitalet Glostrup, University of Copenhagen. Research in migraine and underlying pathophysiological mechanisms. Affiliated with the Human Migraine Research Unit, Dept. of Neurology at Rigshospitalet Glostrup since 2012. With DIS since 2015.

Guest Instructor

Samaira Younis M.D. (University of Copenhagen, 2015). PhD student in Neurology at Rigshospitalet Glostrup, University of Copenhagen. Research in migraine and neuroimaging. Affiliated with the Human Migraine Research Unit, Danish Headache Center, Dept. of Neurology at Rigshospitalet Glostrup since 2015.

Course Assistant

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Lasse Fjordside 11th semester medical student at the University of Copenhagen. B.Sc. Medicine, University of Copenhagen, 2014. Junior Doctor, Department of Abdominal Surgery, Rigshospitalet. Research assistant in the DALI-project at Center for Gestational Diabetes, Rigshospitalet. Nurse's substitute, FADL (Association of Danish Medical Students). With DIS since 2015.

DIS Contacts Lisbeth Borbye, Program Director Stephanie Clemente, Project Manager, Ryan Polito, Program Assistant, Science & Health Program Office, Vestergade 10-B12

Prerequisites At least one year of biology and one year of chemistry at the university level. The course is oriented towards serious students with a documented academic interest in medicine.

Evaluation Students will be evaluated based on participation, 2 written theoretical case reviews, 1 clinical case review, two small tests and final examination. There will also be a small assignment related to the study tours. The grade on this assignment will contribute to your participation grade.

Tests (2 at 10%) 20% Participation 10% Patient cases (3 at 10%) 30% Study Tour Assignment 10% Final examination 30%

Participation covers the following areas 1. Attendance 2. Level of preparation and ability to answer questions asked in class 3. Involvement in class and group discussions 4. Level of individual research and contribution to discussions

Electronics Computer and cell phone usage is not allowed in class. It is distracting to both your classmates and your instructors, so please keep them off and out of sight during class!

Policy on late papers: Late papers will be accepted, but your grade for the paper will be reduced by half a point for each day that it is late.

Disability resources: Any student who has a need for disability accommodations should contact the office of academic support ([email protected]) to coordinate this. Upon DIS approval, students should inform the instructor of accommodations within the first two weeks of class.

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Academic Honesty: DIS expects that students abide by the highest standards of intellectual honesty in all academic work. DIS assumes that all students do their own work and credit all work or thought taken from others. Academic dishonesty will result in a final course grade of “F” and can result in dismissal. The students’ home universities will be notified. DIS reserves the right to request that written student assignments be turned in electronic form for submission to plagiarism detection software. See the Academic Handbook for more information, or ask your instructor if you have questions.

Academic Excellence Award Each semester we recognize one outstanding student from the Medical Practice & Policy Program with an Award of Academic Excellence. It is reserved for a student who has distinguished him- or herself through diligence, commitment, academic performance, and ideally a student who contributes to a good, collaborative learning environment in class.

Short Schedule Tests  Test I: Friday, March 17  Test II: Friday, April 21  Final Exam: Tuesday, May 9

Clinical Case Reviews  Friday, February 24, due Friday, March 10

Theoretical Patient Case Review  Friday, February 10, due Friday, February 17  Tuesday, March 28, due Tuesday, April 4

DIS Clinical Skill Course Date:  Tuesday, March 7 15:30-19:00

Practical Information Medical Practice & Policy faculty and staff have put many hours into selecting and organizing the readings for this course. Please make sure to read all the material assigned; the reading material has been carefully chosen and all of it is pertinent to your success in Human Health and Disease: A Clinical Approach. You have an obligation to your fellow classmates and yourself to come prepared to class. Lectures will not cover all of the readings; however, you are still responsible for the information. If you have questions, need clarification about a reading, or lecture material do not hesitate to speak up and/or contact the course assistant. This is very important. The professors for this course have no office hours, as such; please feel free to set up appointments with them via email. The faculty’s e-mails have been provided; please feel free to email them or the course assistant, Ryan Polito () to set up an appointment or simply ask a question.

Tests and Final There will be two tests and a final throughout the semester. These tests will consist of a mix of short answer questions and essay questions. Tests may be given at the beginning of class or at the end. If the latter, the material covered in lecture that day may be on the test; so, make sure to pay close attention to the information discussed in lecture that day. Tests in class will generally last a maximum of 30 minutes depending on the amount of information covered. The final for this course will be cumulative and will be written in the same manner as tests. The final will be two hours in duration.

Clinical and Theoretical Patient Cases

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During the semester, each student will be presented with a real patient (Clinical Case Review) and two theoretical patient cases and everyone will write up their own case history about the signs, symptoms, ailments and treatments for the specific patients that are introduced to the students in class. It is important to note that, on these dates, attendance is mandatory. Skipping class for travel or other reasons will not be accepted. More details will be given on this activity as the time approaches.

Important information: It is mandatory to attend classes in which clinical and theoretical case reviews are presented. Missing a class would result in a ‘fail’ in that paper. More information about these case reviews will be given on the first day of class.

Core Course Week From Monday, February 6 until Friday, February 10 you will be working solely with your core course instructor(s) and fellow students in your core course section. You will be participating in activities, lectures and events, which will broaden your perspective in relation to the topics covered in your core course. In this way, you will be able to focus primarily on your program and get the opportunity to take an in depth look at relevant topics related to human health and disease.

Study Tours: One of the learning objectives of Human Health and Disease: A Clinical Approach is for you, the student, to be able to describe medical practice in a social, international, and scientific context. The study tours are a way to achieve this learning objective.

Core Course Week and Study Tours Core Course week and study tours are an integral part of the core course as we take the classroom on the road and see how theory presented in the classroom is translated to practice in the field. You will travel with your classmates and DIS faculty/staff on two study tours: a short study tour during Core Course Week and a long study tour to relevant European destinations.

Expectations for study tours  Participate in all activities  Engage in discussions, ask questions, and contribute to achieving the learning objectives  Respect the destination, the speakers, DIS staff, and your fellow classmates  Represent yourself, your home university and DIS in a positive light One of the learning objectives of Human Health and Disease: A Clinical Approach is for you, the student, to be able to describe medical practice in a social, international, and scientific context. The study tours are a way to achieve this learning objective.

Learning Objectives: The objectives of both the short study tour and the long study tour are:  to showcase examples of clinical practice and health care systems in different sectors and countries  to broaden the students’ view of the challenges that health care providers face  to show examples of research with clinical relevance  to explore and learn more about and other societies in Europe While on a program study tour DIS will provide hostel/hotel accommodation, transportation to/from the destination(s), approx. 2 meals per day and entrances, guides, and visits relevant to your area of study or the destination. You will receive a more detailed itinerary prior to departure.

Travel policies: You are required to travel with your group to the destination. If you have to deviate from the group travel plans, you need approval from the program director and the study tours office.

Core Course Week – February 6 – February 10

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Short Tour: Ebeltoft/Århus: Monday, February 6 – Wednesday, February 8 Copenhagen Portion: Thursday, February 9 – Friday, February 10

Long Study Tour: Poznan, Poland & Berlin, Germany: Sunday, February 26 – Friday, March 3

Study Tour Assignment: Before going on the short study tour, you will be divided into groups of 3 people and be given a specific subject to focus on in your study tour assignment. An observation booklet will be used on both trips for notes, which will be used as a basis for discussion within your group. A more in depth description of the study tour assignment will be provided closer to the short study tour. The study tour assignment is due Friday, March 17 by 16:00, upload to Canvas

Required readings Textbooks • Hole JW: Essentials of Human Anatomy & Physiology, 10th Edition. WC Brown Publishers, London 2004: Hole’s.  O'Neill P, Dornan T, Denning DW: Medicine. A Core Text with Self-Assessment. Churchill Livingstone, 3rd Edition, 2008: O'Neill.  Ford MJ, Hennessey, I, and Japp, A: Introduction to Clinical Examination, 8th Edition. Churchill Livingstone, London 2005: Ford.

*NOTE: Not all reading assignments will be covered in class, but all reading assignments are absolutely necessary in order to follow what is actually covered in class. In some cases, where noted, skimming the reading and picking out important points will be sufficient.

Useful Links and Online Medical Dictionaries 1. Medline Plus Medical Dictionary http://www.nlm.nih.gov/medlineplus/mplusdictionary.html 2. Medical Dictionary http://www.medical-dictionary.com/ 3. Medicine Net http://www.medicinenet.com/ 4. Inteli Health http://www.intelihealth.com/IH/ihtIH/WSIHW000/408/408.html 5. UK Medical Search Engine & Health Guide http://www.medic8.com/index.htm

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Meeting locations: Classroom: Entrance 7, First Floor, Auditorium B & Blå Stue Transportation to Glostrup Hospital: You will be taking public transportation to Glostrup Hospital on days that you have class and your transportation pass provided by DIS will cover you from DIS to class.

To get to Glostrup, the following route is recommended: Take S-train B towards Høje st and get off at Glostrup St. Take bus 500S towards Kokkedal st or 300S towards Nærum st.and get off at Glostrup Hospital.

Detailed Map of Glostrup Hospital:

Auditorium D

To DIS

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Course Overview Class Day / Date Time, Title Read Lecturers Room Wednesday, January 18 14:50-16:10 Location: DIS, Metroanneks on Fiolstræde (See Arrival Booklet) Medical Practice & Policy Program Orientation

1 Friday, 15.30- Lecture 1 Ford 1-55 (skim) Marie, January 20 17.30 Introduction and Course Overview + lecture notes on Sabrina, Aud D - Presentation of the course and the Canvas Samaira introduction of faculty and students *Meet CA - Introduction to Theoretical Patient at 14.35 at - Cases (TPC) DIS, V7 Courtyard* 2 Tuesday, 15.30- Lecture 2 Ford chapter 1 & Sabrina January 24 17.30 Clinical signs and symptoms, 3 + pages 15-18 Aud D paramedical tests - Physical examination, understanding signs and symptoms, structure of medical records.

3 Friday, 15.30- Lecture 3 Ford: page 30 Samaira January 27 17.30 Headache Aud D

Tuesday, Reserved for make-up class if January 31 necessary

Wednesday, 17.30- Mandatory Study Tour Orientation The Danish DIS Staff February 1 19.00 Healthcare System (On DIS Canvas), What V23-301 Can We Learn From Denmark (On Canvas) Friday, Reserved for make-up class if February 3 necessary **Note Details Below: Medical Practice & Policy Program Social**

Medical Practice & Policy Program Social Friday, February 3, 18:00-20:00 Café Klaptræet

Short Study Tour Ebeltoft/Århus Monday, February 6 – Wednesday, February 8

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4 Friday, 15.30- Lecture 4 Ford: pp. 19-20, Sabrina February 10 17.30 GI System I 25-26, 28-29, 32, Aud D - Anatomy & Physiology 34, 98-116 - Diagnostic and treatment methods O'Neil 117-120, 151-152, Holes Theoretical patient case 1 chapter 15

5 Tuesday, 15.30- Lecture 5 O'Neil: 122-134 Sabrina February 14 17.30 GI System II Aud D - Gastric and duodenal ulcers - Inflammatory bowel disease Colorectal cancer

Friday, Reserved for make-up class if February 17 necessary

Theoretical Patient Case 1 due via Canvas 6 Tuesday, 15.30- Lecture 6 Hole’s: Chapter 9 Samaira February 21 17.30 CNS 1 Ford: Chapter 7 Aud D -Anatomy and physiology -Most frequent disease entities - -Diagnostic and treatment methods 7 Friday, 15.30- Lecture 7 Ford: Chapter 7 Samaira February 24 17.30 CNS II O’Neill: Chapter

Clinical Patient Case

Long Study Tour Poznan, Poland & Berlin, Germany Sunday, February 26 – Friday, March 3

8 Tuesday, 16.00- Lecture 8 On Canvas CAMES March 7 19.30 Introductory DIS Clinical Course staff - IV Insertion, Suture, Catheters Simulation og Træning Center (Gentofte Hospital) **Meet Course Assistant in DIS V7 courtyard at 15.00** *NOTE TIME and LOCATION CHANGE*

9 Friday, 15.30- Lecture 9 Davidson’s Samaira March 10 17.30 Psychiatry Principles and Aud D - Affective mood disorders Practice of - Suicide Medicine, chapter - Eating disorders 8, pgs. 246-269 - Schizophrenia and delusional (Medical disorders Psychiatry)

Clinical Patient Case due via Canvas

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10 Tuesday, 15:30- Lecture 18 On Canvas Ditte March 14 20:30 Emergency Medicine Andersen - The management of the stopped Herlev heart - diagnosing and treating Hospital cardiac arrest - Practical training in resuscitation *NOTE - Team Training using Simulation TIME Center Rooms in various patient and case scenarios LOCATION CHANGE* More information regarding meeting

time/place will be provided

11 Friday 15.30- Lecture 10 Ford 169-171, Marie March, 17 17.30 ER I O'Neil 7-11, 69- Aud D 74, 98 Test I

Break Monday, March 20 – Friday, March 24

12 Tuesday, 15.30- Lecture 11 Ford 169-171, Marie March 28 17.30 ER II O'Neil 7-11, 85- Aud D 89, 225-227 Theoretical patient case 2

Friday, Reserved for make-up class if March 31 necessary

13 Tuesday, 15.30- Lecture 12 Hole’s: Chapter Marie April 4 17.30 Cardiovascular system I 13 Aud D O’Neill: pages 7- Theoretical patient case 2 due via 36 Canvas

14 Friday, 15:30- Lecture 13 Hole’s: Chapter April 7 17:30 Cardiovascular system II 13 Marie Aud D O’Neill: pages 7- 36 Tuesday, 15.30- Reserved for make-up class if April 11 17.30 necessary Aud D

Travel break Wednesday, April 12 – Monday, April 17

15 Tuesday, 15.30- Lecture 14 O'Neil: 77, 408- Sabrina April 18 17.30 Infections I 410, 425-426, Aud D 429-431

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16 Friday, 15.30- Lecture 15 O'Neil: 78-79, Sabrina April 21 17.30 Infections II 219-220, 418, Aud D 421, 421-425 Test II

17 Tuesday, 15.30- Lecture 16 Hole's chapter 16 Marie April 25 17.30 Respiratory System I O’Neill pgs. 69- Aud D -Anatomy and physiology 93, 98-99 - Clinical examination of the lungs 18 Friday, 15.30- Lecture 17 Hole's chapter 16 Marie April 28 17.30 Respiratory system II O’Neill pgs. 69- Aud D 93, 98-99

19 Tuesday 15.30- Lecture 19 May 2 17.30 Course wrap up Aud D Preparation for the final

Tuesday, 15.00- May 9 17.00 Final Exam

DIS TBA

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