Marc Imhotep Cray, M.D.

USMLE WEB MAPS-BMS GENERAL PRINCIPLES

IVMS is the ultimate medical student Web 2.0 companion. This SDL-Face to Face hybrid courseware is a digitally tagged and content enhanced replication of the United States Medical Licensing Examination's Cognitive Learning Objectives (Steps 1, 2 or 3). Including authoritative reusable learning object (RLO) integration and scholarly Web Interactive PowerPoint-driven multimedia shows/PDFs. Comprehensive hypermedia BMS learning outcomes and detailed, General Principles and Organ System USMLE Web Maps content enriched learning objectives.

http://www.imhotepvirtualmedsch.com/

COMPONENT I: BIOCHEMISTRY AND MOLECULAR BIOLOGY delves into gene expression, protein synthesis, energy metabolism and the metabolic pathways associated with diseases.

GENE EXPRESSION: DNA STRUCTURE, REPLICATION AND EXCHANGE 1.1.1 DNA structure: single- and double-stranded DNA, stabilizing forces, supercoiling HGP.pdf DNA and Molecular Genetics DNA Structure and Analysis Gene expression: DNA structure, replication, and exchange 1.1.2 Analysis of DNA: sequencing, restriction analysis, PCR amplification, hybridization DNA Sequence Analysis: Introduction 1.1.3 DNA replication, mutation, repair, degradation, and inactivation DNA Synthesis.ppt DNA Synthesis. notes 1.1.4 Gene Structure and Organization; chromosomes, centromere and telomere Genes and Gene Organization Gene Structure and Genomic Sequence

Marc Imhotep Cray, M.D.

1.1.5 Recombination, insertion sequences, transposons DNA Recombination Insertion Sequences. Notes Transposons: Mobile DNA .notes 1.1.6 Mechanisms of genetic exchange: transformation, transduction, conjugation, cross- over, recombination, linkage Genetic Exchange Mechanisms Slides 4-13 Microbial Genetic Exchange 1.1.7 Plasmids and bacteriophages Cells Alive and T4 Bacteriophages Introduction to the Bacteriophages T4 Virus Inserting a DNA Sample into a Plasmid GENE EXPRESSION: TRANSCRIPTION (INCLUDING DEFECTS) 1.2.1 Transcription of DNA into RNA, enzymatic reactions, RNA, RNA degradation Dr Chromos School: transcription of DNA into RNA Transcription-Synthesis of Messenger RNA (mRNA) 1.2.2 Regulation: cis-regulatory elements, transcription factors, enhancers, promoters, silencers, repressants, splicing Transcription Regulation Gene Regulation: Summary Principles and Overview .PDF GENE EXPRESSION: TRANSLATION INCLUDING DEFECT 1.3.1 The genetic code Introduction to Bioinformatics The Genetic Code The Human Genome Project Genetic Code Table and the 20 Amino Acids DNA-Basics of Structure and Analysis 1.3.2 Structure and function of tRNA Structure and function of transfer RNA Transfer RNA 1.3.3 Structure and function of ribosomes Ribosome Structure and Function Ribosome Structure and Assembly 1.3.4 Protein synthesis Protein Synthesis Comprehensive Protein Synthesis (Animation) Protein Synthesis Summary.ppt

1.3.5 Regulation of translation Regulation of Translation. Illus. notes Translation.ppt

1.3.6 Post-translational modifications (phosphorylation, addition of CHO units) Post-Translational Modifications

1.3.7 Protein degradation Protein Degradation Resource. notes

Marc Imhotep Cray, M.D.

STRUCTURE & FUNCTION OF PROTEINS 1.4.1 Principles of protein structure and folding Protein Structure: The Very Basics .pps 1.4.2 Enzymes: kinetics, reaction mechanisms Symbolism and Terminology in Enzyme Kinetics Enzymes and Enzyme Complexes 1.4.3 Structural and regulatory proteins: ligand binding, self-assembly Regulatory Protein Coordinating Gene Expression 1.4.4 Regulatory properties Regulation of Enzyme Activity.ppt Enzyme Regulatory Mechanisms ENERGY METABOLISM (METABOLIC SEQUENCES & REGULATION) & DISORDERS

1.5.1 Generation of energy from carbohydrates, fatty acids, and essential amino acids; glycolysis, pentose phosphate pathway, tricarboxylic acid cycle, ketogenesis, electron transport and oxidative phosphorylation, glycogenolysis

Step by Step Krebs cycle Metabolic Pathways and Energy Production.ppt Krebs citric acid cycle Energy Production.ppt Summary Diagram of the Krebs cycle Electron Transport and Oxidative Phosphorylation .pps

1.5.2 Storage of energy: gluconeogenesis, glycogenesis, fatty acid and triglyceride synthesis

How Cells Store Energy: ATP. Notes (with Quiz) Metabolism and Energy Balance.ppt 1.5.3 Thermodynamics: free energy, chemical equilibria and group transfer potential, energetics of ATP and other high-energy compounds Energy is conserved: The First Law of Thermodynamics. Notes Laws of Thermodynamics METABOLIC PATHWAY OF SMALL MOLECULES AND ASSOCIATED DISEASES Medical Biochemistry Page IndState-Dr King Inborn Errors of Amino Acid Metabolism.html notes Biochemical Pathways-Metabolic Pathways-Comprehensive Map 1.6.1 Biosynthesis and degradation of amino acids (eg, homocystinuria) 1.6.2 Biosynthesis and degradation of purine and pyrimidine nucleotides (eg, gout, Lesch-Nyhan syndrome) 1.6.3 Biosynthesis and degradation of lipids (eg, dyslipidemias, carnitine deficiency, adrenogenital syndromes) 1.6.4 Biosynthesis and degradation of porphyrins 1.6.5 Biosynthesis and degradation of other macromolecules and associated abnormalities, complex carbohydrates (eg, lysosomal storage disease), glycoproteins, and proteoglycans NetBiochem: Topics, Tables and Still and Animated Graphics Biochemistry Pathways Illustrated Interactive Concepts in Biochemistry - Interactive Animations

Marc Imhotep Cray, M.D.

COMPONENT II: CELLULAR BIOLOGY with emphasis on structure and function of organelles, adaptive mechanisms and apoptosis.

2.1 Signal transduction: second messenger systems - voltage- and ligand-gated channels and receptors Mechanisms of Single Transduction Single Transduction with Link to Vitamin & Coenzymes Notes 2.2 Cell components (eg, endoplasmic reticulum, plasma membrane, nucleus, ribosomes) UTMB- Illustrated Cell Biology Topics Cellular and Molecular Processes-Comprehensive Map Tutorial on Biological Membranes

2.3 Cytoskeleton (including cell movement and intracellular transport) Cytoskeleton Tutorial

2.4 Secretion and exocytosis, endocytosis, transcytosis Eukaryote vs Prokaryote Secretion, Endocytosis and Exocytosis.ppt 2.5 Cell cycle: mitosis, meiosis, structure and regulation of spindle apparatus, control points Mitosis: Labeled Diagram Cell Cycle and Mitosis Tutorial Cell Division and Genetic Consequences Meiosis Tutorial Cell Cycle, Mitosis and Cell Differientation.ppt 2.6 Epithelial cells (including surface specialization, intercellular junctions, gap junctions, and desmosomes) Tissues /e-Histology. Net Membrane Structure and Function: Cell Junction Proteins Cells gap junctions, tight junctions and desmosomes (Slides 37-48) Junctions Between Cells 2.7 Fibroblasts, endothelial cells, and mesenchymal cells: basement membrane, extracellular matrix, proteoglycans, fibronectins, adhesion molecules, annexins Connective Tissues .ppt Cytology and Histology of Connective Tissue 2.8 Muscle cells (cardiac, smooth, skeletal): structure and regulation of contractile elements, excitation-contraction coupling Cardiac and Smooth Muscle Muscle Mechanism of Contraction and Neural Control.ppt Muscle Physiology and Design. Illus. notes 2.9 Adaptive mechanism: cell response to injury (eg, hypertrophy, metaplasia) The Immune Response to Burn Injury

Marc Imhotep Cray, M.D.

Hypertrophy, heart, gross Cell Injury Illustrated Lecture Notes 2.10 Mechanisms of cell injury and necrosis (including free radical mediated cell injury) Cell Injury and Adaptation Mechanisms Inflammation

2.11 Apoptosis (programmed cell death) Apoptosis.html notes Apoptosis.html-Another Look

COMPONENT III: GENETICS & HUMAN DEVELOPMENT with stress on embryogenesis, Mendelian genetics, population genetics, pedigree analysis, genetic abnormalities and counseling.

3.0. Embryology: fertilization, cleavage, blastulation, gastrulation, neurulation, and structures arising out of primary germ cell. Early Development Human Growth and Development The Visible Embryo Project Embryogenesis: programmed gene expression, tissue differentiation and morphogenesis, homeotic genes Embryology-In the Womb Human Embryogenesis

3.1. Congenital abnormalities: principles, patterns of anomalies, dysmorphogenesis Congenital Anomalies

3.2. Principles of pedigree analysis: inheritance patterns, occurrence and recurrence risk General Principles of Medical Genetics

3.3. Population genetics: Hardy-Weinberg law, founder effects, mutation-selection equilibrium

Population Genetics Population Genetics for 1st Year Medical Students

3.4. Genetic mechanisms: chromosomal abnormalities, mendelian inheritance, multifactorial diseases

Terms to Know in Mendelian Genetics Genetic Linkage and Mapping Mendelian genetics Problem Sets and Tutorials Chromosomal Aberrations (simplified lecture notes) General Principles of Medical Genetics (Comprehensive lecture notes) Medical Genetics Comprehensive PDF Notes

3.5. Clinical correlates of genetics: genetic testing, prediagnosis, newborn General Principles of Medical Genetics-Clinical Correlates

Marc Imhotep Cray, M.D.

COMPONENT IV: IMMUNOLOGY: BASIC & APPLIED It explains the functions of the cells involved in immune response, classification of response, genetic regulation of immunogenicity (MHC class molecules), immune impairment and the laboratory techniques in immunologic investigations.

Immune system: goal, division & general function Immune System.html notes Adaptive -Innate Immunity Interplay Animation: Neutralization I Opsonization I Classical complement pathway I Alternate complement pathway

4.1. Histoimmunology: production and function of granulocytes, natural killer cells, macrophages

An Immune System Glossary Granulocytes, Macrophages and Natural Killer Cells.htm notes

4.2. Production and function of T lymphocytes, T lymphocyte receptors The Immune Response System The Adaptive Immune Response -T4 Lymphocytes B lymphocytes- T lymphocyte interactions.ppt

4.3. Production and function of B lymphocytes and plasma cells; immunoglobulin and antibodies: structure and biologic properties

The Immune System-Humoral Development of B-Cells.ppt Immunoglobulin Structure

4.4. Antigenicity and immunogenicity; antigen presentation; cell activation and regulation; tolerance and clonal deletion

Hematopoiesis.htm notes

4.5. Immunologic mediators: chemistry, function, molecular biology, classic and alternative complement pathways, cytokines, chemokines

The Complement System.html Lect Notes The Role of Complement in Elimination of Microorganisms Complement System -Lectin Pathway

4.6. Immunogenetics; MHC structure and function, class I, II molecules; erythrocyte antigens; transplantation

Histocompatability Molecules (Excellent illustration of MHC I & II Molecules) Class I and II MHC

4.7. Immunizations: vaccines, protective immunity http://www.mansfield.ohio-state.edu/~sabedon/black17.htm Epidemiology and Prevention of Vaccine Preventable Diseases

Marc Imhotep Cray, M.D.

4.8. Immunopathology: Alterations in immunologic response & function Immunological Defects 4.8.1 T or B lymphocyte deficiencies B-Cell and T-Cell Screening Test.htm Primary Immune Deficency.htm 4.8.2 Deficiencies of phagocytic cells Phagocytic Cell Defects 4.8.3 Combined immunodeficiency disease Severe Combined Immunodeficency.htm notes Primary Immune Deficiency Disease.html notes 4.8.4 HIV infection/AIDS and other acquired disorders of immune responsiveness HIV/AIDS-What it is -a consumer level overview.html 4.9. Immunopharmacology: drug-induced alterations in immune responses http://cis.nci.nih.gov/fact/7_2.htm 4.10 Immunopathology: immunologically mediated disorders- hypersensitivity (types I-IV) Immunopathology.html Hypersensitivity .htm 4.11.1 Transplant rejection Hypersensitivity Reactions and Tissue Injury 4.11.2 Risks of transplantation, transfusion (eg, graft-versus-host disease) http://www.bioscience.org/news/scientis/gvhd1.htm http://www.cancerbacup.org.uk/info/bone/bone-8.htm Isoimmunization, hemolytic disease of the newborn http://info.med.yale.edu/obgyn/reproimmuno/courses/ReproductiveImmunology/tsld001.htm http://www.emedicine.com/ped/topic959.htm Immunopathogenesis http://hivinsite.ucsf.edu/InSite?page=kb-02-01-04 4.12 IMMUNOLABORATORY: immunologic principles underlying diagnostic laboratory tests (eg, ELISA, complement fixation, RIA, agglutination) http://www.merck.com/mmpe/sec14/ch168/ch168e.html (Great link to commonly utilized immunologic tests) http://www.hhmi.org/biointeractive/vlabs/immunology/index.html

Marc Imhotep Cray, M.D.

COMPONENT V: MICROBIOLOGY & INFECTIOUS DISEASES this component commences with taxonomy, and delves into bacteriology, virology, mycology and parasitology. Throughout the presentation, reference is made to the laboratory diagnosis and the mechanisms of infectivity.

4.0. TAXONOMY: microbial classification and its basis Classification of Microorganisms. PDF Classification of Microorganisms.ppt Prokaryotes.ppt Classification of Microorganisms.html illustrated notes 5.1. BACTERIOLOGY: Bacteria and bacterial diseases Bacterial Structure in Relation to Pathogenicity Microbiology Laboratory Techniques.ppt Bacteriology Tutorials.htm Structure and composition Gram Negative Bacteria.html notes Bacteria Structure and Growth.ppt Structure -Function Pathogenicity Relationship Metabolism, physiology, genetics and regulation Nature and mechanisms of action of virulence factors Bacterial Metabolism Pathophysiology of infection Principles of Pathogenesis Bacterial Infection.ppt Bacterial Pathogenesis Epidemiology and ecology Infectious Disease Epidemololgy Route of infection http://en.wikipedia.org/wiki/Transmission_%28medicine%29 4.17 Principles of cultivation, assay, and laboratory diagnosis http://www.ucc.ie/ucc/depts/path/LN/diagnostic%20tech1-webversion.ppt

5.2. VIROLOGY: Viruses and viral diseases- physical and chemical properties - replication

http://www-micro.msb.le.ac.uk/Tutorials/balti/balti.html Genetics http://gsbs.utmb.edu/microbook/ch043.htm (viral genetics) Principles of cultivation, assay, and laboratory diagnosis

- molecular basis of pathogenesis

Marc Imhotep Cray, M.D.

http://www-micro.msb.le.ac.uk/109/Lectures.html Pathophysiology of infection latent and persistent infections –epidemiology - oncogenic viruses

5.3. MYCOLOGY: Fungi and fungal infections - structure, physiology, cultivation, and laboratory diagnosis - pathogenesis and epidemiology

http://www.nacse.org/ocid/bot461/lectures/lecture1.htm 5.4. PARASITOLOGY: parasites and parasitic diseases

http://www.med.sc.edu:85/book/parasit-sta.htm Structure, physiology, and laboratory diagnosis - pathogenesis and epidemiology http://faculty.uccb.ns.ca/~jfoulds/courses/invertebrate/Powerpoint/Protozoa01.ppt

5.6. LABORATORY TECNIQUES: principles of sterilization and pure culture technique http://www.merck.com/pubs/mmanual/tables/161tb1.htm

COMPONENT VI: GENERAL PATHOLOGY: PATHOGENESIS AND BIOLOGY OF TISSUE RESPONSE TO DISEASE deals with inflammation (cells & mediators), reparative process and the basic concepts in neoplasia including carcinogenesis, tumor immunology and cancer epidemiology, prevention and control.

6.1. INFLAMMATION (CELLS AND MEDIATORS) IVMS-General Pathology- Inflammation PPt. http://ocw.tufts.edu/Course/51/lecturenotes WebPath-Inflammation Index HTML. Page (excellent, most comprehensive pathologic basis of inflammation – highly recommended) http://en.wikipedia.org/wiki/Inflammation Acute inflammation and mediator systems (pharmacologic mediators) IVMS-Anti-Inflammatory and Autacoid Pharmacology- NSAIDs Vascular response to injury (including mediators) Inflammatory cell recruitment (adherence and cell migration) and phagocytosis http://mayoresearch.mayo.edu/vmiller_lab/endothelial.cfm Bactericidal mechanisms and tissue injury Clinical manifestations (including pain, fever, leukocytosis, leukemoid reaction, and chills) http://www.epathoplus.com/inflammation.htm Chronic inflammation CHRONIC INFLAMMATION AND WOUND HEALING IVMS Inflammation Notes

6.2. REPARATIVE PROCESSES Inflammation and Repair Illustrated Lectures

Marc Imhotep Cray, M.D.

Wound healing, hemostasis, and repair: thrombosis, granulation tissue, angiogenesis, fibrosis, and scar/keloid formation http://en.wikipedia.org/wiki/Wound_healing How wounds heal and tumors form Regenerative processes

6.3. NEOPLASIA http://www.pathguy.com/lectures/unknown.htm http://edcenter.med.cornell.edu/CUMC_PathNotes/Neoplasia/Neoplasia_01.html (excellent classification of neoplasm) Classification, histologic diagnosis http://clinlabs.path.queensu.ca/present/dexter/oldneoplasia/ http://www.vet.purdue.edu/vpb/clinpath/vpb555/555cyt3/sld033.htm Grading, and staging of neoplasms http://www.unc.edu/courses/2001fall/biol/008/001/day25/neo5.ppt (Biology & epidemiology of cancer) Cell biology, biochemistry, and molecular biology of neoplastic cells: transformation, oncogenes, altered cell differentiation, and proliferation http://edcenter.med.cornell.edu/CUMC_PathNotes/Neoplasia/Neoplasia_04.html Hereditary neoplastic disorders Invasion and metastasis (mechanism & subtypes) http://www3.mdanderson.org/DEPARTMENTS/liver/images/method.jpg biologic mechanism of metastasis http://www.path.sunysb.edu/courses/im/ Tumor immunology http://www.merck.com/pubs/mmanual/section11/chapter143/143a.htm http://www.mcl.tulane.edu/classware/pathology/medical_pathology/New_for_99/tum_immu/ Paraneoplastic manifestations of cancer IVMS-Gen Tumors, Host and Paraneoplastic Syndromes http://www.urotext.com/pages/PNSs.html http://www.cancernetwork.com/home/frames.htm?http://www.cancernetwork.com/handbook/emergencies.htm&3 Cancer epidemiology, control and prevention http://www.pitt.edu/~super1/lecture/lec0192/

Marc Imhotep Cray, M.D.

COMPONENT VII: BEHAVIORAL SCIENCES with materials covering organic correlates of behavior, life cycle, human behavior in illness, patients’ interview and medical law and ethics. Medical law & ethics is treated with emphasis on patients’ rights, physician-patient relationship, beginning & end of life issues, clinical research & human experimentation and the ethics of managed care.

Gender, ethnic, and behavioral considerations affecting disease treatment and prevention (including psychosocial, cultural, occupational, and environmental) 7.0 BEHAVIORAL CORRELATES: neuroanatomical, neurochemistry, neuropharmacologic, genetic & Psychologic; DSM IV classification of mental illness; Common psychotropic agents American Psychiatric Association - DSM-IV-TR eMedicine - Psychiatry Long - Internet Mental Health http://www.unr.nevada.edu/~goodman/brain/memory_tutorial.html http://www.brainsource.com/amazing brain.htm Neurotramsnitters http://en.wikipedia.org/wiki/Neurotransmitter Brain Neurotransmitters 7.1 LIFE CYCLE: progression through the life cycle (birth through senescence) 7.1.1. Cognitive, language, motor skills, and social and interpersonal development Child and Adolescent Development http://www.med.umich.edu/yourchild/topics/devmile.htm

7.1.2. HUMAN SEXUALITY: sexual development (eg, puberty, menopause) http://www.usu.edu/openshaw/3110/3110ppt/adolescent/ http://www.addison.ac.uk/endocrine_modules/module1/lecturers_material/html_files/END1.19b/

7.1.3. Influence of developmental stage on physician/patient interview http://www.baylorcme.org/adolescent/presentations/middleman/middleman.pdf 7.2 HUMAN BEHAVIOR IN ILLNESS (psychologic and social factors influencing patient behavior) http://www.sciencenetlinks.com/lessons.php?BenchmarkID=6&DocID=281

7.2.1. Personality traits or coping style (coping mechanisms) http://www.alleydog.com/101notes/personality.html International Encyclopedia of Social and Behavioral Science http://www.ship.edu/~cgboeree/perscontents.html (excellent on personality theory) http://en.wikipedia.org/wiki/Defence_mechanism(excellent on defense mechanism)

7.2.2. Psychodynamic and behavioral factors, related past experience http://en.wikipedia.org/wiki/Psychodynamics

7.2.3. Family and cultural factors, including socioeconomic status, ethnicity, and gender

http://www.euteach.com/euteach_module_a5

Marc Imhotep Cray, M.D.

http://www.surgeongeneral.gov/library/mentalhealth/cre/execsummary-6.html Adaptive and maladaptive behavioral responses to stress and illness (eg, drug-seeking behavior, sleep deprivation) http://www.alleydog.com/101notes/stress&health.html

7.2.4. Interactions between the patient and the physician or the health care system (eg, transference)

http://www.oregoncounseling.org/ArticlesPapers/ManagedCare.htm 7.2.5. Patient adherence (general and adolescent)

Patient Adherence /Compliance Assessment Instrument.htm Self-assessment of Personality Theory Guide to Personality Theory with quiz.htm 7.3. PATIENT INTERVIEWING, CONSULTATION & INTERACTIONS WITH FAMILY http://zoey.med.howard.edu/2003/archives/ipc/9-7-99-both-hours.htm 7.3.1 Establishing and maintaining rapport http://www.obgyn.net/medical.asp?page=/english/pubs/articles/rapport01 http://www.obgyn.net/medical.asp?page=/english/pubs/articles/rapport02 7.3.2 Data gathering http://www.columbia.edu/itc/hs/medical/clerkships/peds/Clerkship/Objectives/History.html

7.3.3. Approaches to patient education http://www.ama-assn.org/public/journals/patient/ Doctor-patient relationship

7.3.4. Enticing patients to make life-style changes http://www.nhlbi.nih.gov/chd/lifestyles.htm http://www.mercksharpdohme.com/disease/

7.3.5. Communicating bad news http://www.indiandoctors.com/others/200.php3

7.3.6. “Difficult” interviews (eg, anxious or angry patients) http://xnet.kp.org/permanentejournal/spring03/angry.html

7.3.7. Multicultural ethnic characteristics http://www.statcan.gc.ca/pub/89-593-x/89-593-x2003001-eng.pdf http://www.socialstudies.org/positions/multicultural Culture Clues. Notes Cultural Competency Resources Guidelines/. Html

7.4. MEDICAL LAW & ETHICS 7.4.1. PATIENTS’ RIGHTS: consent and informed consent to treatment

http://www.emedicinehealth.com/patient_rights/article_em.htm 7.4.2. Physician-patient relationships (eg, ethical conduct, confidentiality)

http://www.managedcaremag.com/archives/9708/9708.reducerisk.shtml 7.4.3. END OF LIFE - death and dying, right to die?

http://law.jrank.org/pages/5987/Death-Dying-Right-Die-Individual-Autonomy-State-Interests.html http://www.anabaptists.org/tracts/deathtrc.html

7.4.4. BEGINNING OF LIFE – Legal & Ethical Birth-related issues http://smj.sma.org.sg/3101/3101ra1.pdf http://emedicine.medscape.com/article/978997-overview http://www.commed.uchc.edu/medicalhumanities/weblinks.htm

7.4.5. HUMAN EXPERIMENTATION (issues related to patient participation in research – clinical trials & informed consent)

http://www.nlm.nih.gov/archive//20061214/pubs/cbm/hum_exp.html http://www.nih.gov/sigs/bioethics/casestudies.html - research

Marc Imhotep Cray, M.D.

7.4.6. Interactions with other health professionals (eg, referral)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924173/pdf/canmedaj01268-0043b.pdf 7.4.7. HUMAN SEXUALITY and the profession, other “boundary” issues

http://fampra.oxfordjournals.org/cgi/content/full/18/5/511 http://www.changesurfer.com/Hlth/DPReview.html http://www.ahs.cqu.edu.au/psysoc/units/53270/pdf/m4c11.pdf

7.4.8. Ethics of managed care http://www2.umdnj.edu/omcweb/

7.4.9. Organization and cost of health-care delivery http://en.wikipedia.org/wiki/Health_care_in_the_United_States

COMPONENT VIII: EXTERNAL (EXTRINSIC) FACTORS IN DISEASE This component treats of nutritional issues (nutrients classification, functions of nutrients & nutritional deficiencies), thermoregulation, and adaptation to environment and homeostasis.

MULTI-SYSTEM PROCESSES Environmental Pathology Overview

1. NUTRITION Generation, expenditure, and storage of energy at the whole-body level Glycolysis.html notes Gluconeogenesis.html notes Assessment of nutritional status across the life span (eg, calories, protein, essential nutrients, hypoalimentation Nutrition navigator: http://navigator.tufts.edu American Dietetics Association: http://www.eatright.org Healthy People: http://web.health.gov/healthypeople Functions of nutrients (essential, transfatty acids, cholesterol) Nutrients, Vitamins, Minerals and Dietary Information Cholesterol Management Health Center-WebMD http://en.wikipedia.org/wiki/Trans_fat

Marc Imhotep Cray, M.D.

Protein-calorie malnutrition Nutritional Disorders http://www.xrefer.com/entry/537805 Malnutrition Vitamin deficiencies and/or toxicities DEFICIENCY SYMPTOMS Mineral deficiencies and toxicities http://www.merck.com/mmpe/sec01/ch004/ch004a.html http://bama.ua.edu/~shancock/NHM101/Minerals.PDF Eating disorders (eg, obesity, anorexia, bulimia) http://news.bbc.co.uk/hi/english/health/medical_notes/newsid_1079000/1079435.stm http://coe.west.asu.edu/students/jklein/eatingdisorderwq.html (excellent notes) 2. TEMPERATURE REGULATION http://www.indstate.edu/thcme/mwking/thermodynamics.html 3. ADAPTATION TO ENVIRONMENTAL EXTREMES (including occupational exposures) Physical and associated disorders (eg, temperature; radiation; burns; decreased atmospheric pressure; high altitude sickness; increased water pressure) Trauma and Environmental Injury.html notes http://www.mic.ki.se/Diseases/c23.html Chemical (eg, gases, vapors; smoke inhalation; agricultural hazards, volatile organic solvents, heavy metals; principles of poisoning and therapy) http://www.sas.org/E-Bulletin/2001-09-15/labNotes2/labNotes.html http://www.pepps.fsu.edu/caprm/CAPRM II DraftIND/6-3-9c(chem)HumanHealth.doc http://www.cdc.gov/niosh/elcosh/docs/hazard/chemical.html 4. HOMEOSTASIS: Fluid, electrolyte, and acid-base balance and disorders (eg, dehydration, acidosis, alkalosis) http://www.biology-online.org/4/3_blood_sugar.htm http://www.iacr.bbsrc.ac.uk/notebook/wwwresource/homeostasis319.htm http://www.ags.uci.edu/~bcrourke/Homeostasis/

Marc Imhotep Cray, M.D.

COMPONENT IX: INTRODUCTORY PHARMACOLOGY: PHARMACOKINETIC & PHARMACODYNAMIC PRINCIPLES Pharmacokinetics is the study of what the body does to a drug. Pharmacodynamics is the study of what a drug does to the body. and effect.

9.1. GENERAL PRINCIPLES Medical Pharmacology 2000 General Principles--Introduction Pharmacokinetics Pharmacodynamics General Principles of Medicinal Chemistry.html notes (selected pharmacologic agents notes) Pharmacokinetics: absorption, distribution, metabolism, excretion, dosage intervals Pharmacokinetics Tutorial http://www.cc.nih.gov/training/training/principles/schedule.html http://www.merck.com/pubs/mmanual/section22/chapter299/299a.htm Mechanisms of drug action, structure-activity relationships, receptors, signal transduction http://www.cc.nih.gov/training/training/principles/schedule.html Concentration- and dose-effect relationships (eg, efficacy, potency), types of agonists and antagonists and their actions Drug Receptor Interactions Individual factors altering pharmacokinetics and pharmacodynamics (eg, age, gender, disease, tolerance, compliance, body weight, metabolic proficiency, pharmacogenetics) Absorption, distribution, metabolism and excretion.ppt (excellent on factors influencing absorption, distribution etc.) IVMS-General Principles of Pharmacology-Pharmacokinetics and Pharmacodynamics Drug side effects, overdosage, toxicology http://doublecheckmd.com/EffectsDetail.do?dname=Midrin&sid=1176&eid=4910 Regulatory issues (eg, drug development, approval, scheduling)

2. GENERAL PROPERTIES OF AUTOCOIDS (including peptides and analogs, biogenic amines, prostanoids and their inhibitors, and smooth muscle/endothelial autacoids)

http://www.pharmacology2000.com/Histamine/histamine.htm Renal, Pulmonary and Renal Autocoids .PDF.

3. GENERAL PRINCIPLES OF AUTONOMIC PHARMACOLOGY Autonomic Introduction Autonomic Medicinal Chemistry.htm (neurotransmitters)

4. GENERAL PROPERTIES OF ANTIMICROBIALS (including mechanisms of action and resistance)

Antibacterial Agents

Marc Imhotep Cray, M.D.

5. GENERAL PROPERTIES OF ANTI-NEOPLASTIC AGENTS,

IMMUNOSUPPRESSANTS Chemotherapy: Introduction & General Principles Immunopharmacology

COMPONENT X: BIOSTATISTICS AND EPIDEMIOLOGY (QUANTITATIVE METHODS) This component explains the elements of measures, types of measures and basic epidemiologic concepts & principles namely, risk ratio, relative risk, odds ratio, incidence, prevalence, association, sensitivity, specificity, predictive values etc. Study designs, and hypothesis testing & statistical inference are both discussed in detail, in allowing for adequate interpretation of medical literature.

10.1. ELEMENTS OF MEASUREMENT http://www.health.adelaide.edu.au/icu/files/icu_notes/statistics.pdf http://www.anu.edu.au/nceph/surfstat/surfstat-home/surfstat.html http://www.jerrydallal.com/LHSP/bmj.htm (excellent links) Scales of measurement Distribution, centraltendency, variability, probability http://bmj.com/cgi/content/full/309/6960/996 Disease prevalence and incidence http://bmj.com/epidem/epid.2.html http://www.caregiver.org/brainC.html Disease outcomes (eg, fatality rates) http://courseweb.edteched.uottawa.ca/Medicine_Health/Development/Tutorial1 Notes.htm Associations (correlation or covariance) http://astor.som.jhmi.edu/~esg/assoc_lec2.ppt http://tide.it.bond.edu.au/ianl111/Lectures/week10.ppt http://fisher.osu.edu/mhr/faculty/todor/todorppt/Lecture8.ppt http://www.ccsr.ac.uk/rschproj/chcc/ida/unit10/o10.ppt Health impact (eg, risk differences and ratios) http://bmj.com/cgi/content/full/320/7247/1468 Sensitivity, specificity, predictive values http://www-unix.oit.umass.edu/~bioep540/topics/probdist/probdist-notes-sens-spec.html http://www.sbc.su.se/~per/kth-bioinfo-2001/hmm/sensspec.html http://www.comp.glam.ac.uk/pages/staff/bfjones/ukta/howell/sld021.htm http://bmj.com/cgi/content/full/309/6947/102 (predictive values) http://magix.fri.uni-lj.si/predavanja/uisp/slides/uisp09-Evaluation.ppt

Marc Imhotep Cray, M.D.

10.2. STUDY DESIGNS http://www.bmjpg.com/rct/contents.html http://www.sph.unc.edu/courses/epid168/study_designs.ppt http://anpat.drmm.uniud.it/ctc/resources/STAT.ppt http://ped1.med.uth.tmc.edu/neo/clinepi3.ppt http://www.shef.ac.uk/%7Escharr/triage/docs/systematic/index.htm (discusses meta-analysis) Types of experimental studies (eg, clinical trials, community intervention trials) http://www.nyviaetc.org/slides/Clinical%20Trials.ppt Types of observational studies (eg, cohort, case-control, cross-sectional, case series, community surveys) Sampling and sample size http://artsweb.uwaterloo.ca/~hdailly3/Lecture5.pdf http://www.ssc.wisc.edu/~oliver/SOC357/Lectures%20and%20Notes/SampleTypesBigSlides.pdf http://www.math.virginia.edu/~der/usem170/Chapter09/ (PPT simplified on sampling) http://www.msu.edu/course/prr/475/djslect/sample.ppt http://www.cquest.utoronto.ca/geog/ggr270y/notes/not10a.html Subject selection and exposure allocation (eg, randomization, stratification, self-selection, systematic assignment) Outcome…………assessment http://www.cochrane.dk/nrsmg/docs/nrsmgsymp4.ppt Internal and external validity http://www.asc.upenn.edu/courses/comm522/Review.doc http://carbon.cudenver.edu/~ldeleon/lectr6.html http://artsweb.uwaterloo.ca/~hdailly3/Lecture4.pdf

10.3. HYPOTHESIS TESTING AND STATISTICAL INFERENCE Confidence intervals (95% CI) http://www.esm.ucsb.edu/academics/courses/206/Lectures/Hypothesis%20Testing.ppt http://fisher.osu.edu/mhr/faculty/todor/todorppt/Lecture8.ppt Statistical significance and type I error http://www.ganesha.org/spc/hyptest.html (simplified) http://trochim.human.cornell.edu/kb/hypothes.htm Statistical power and type II error http://davidmlane.com/hyperstat/logic_hypothesis.html (detailed) http://www.stat.lsa.umich.edu/~akapatou/Stat400/lecture_13-16_w02.ppt (simplified) Designed,Developed and Curated by Marc Imhotep Cray,M.D. Please report broken links to drcray@imhotepvirtualmedsch.com