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Compass - 2014 Block Handbook - Respiratory Sciences
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2014 Block Handbook - Respiratory Sciences

Total 126 teaching activities.
3.00 Assessment - Stage 1 Research Methods RFA
3.01 - Not at fault

Lecture 1 - Thorax: thoracic cage wall, boundaries, breast and surface anatomy
Lecture 2 - Thorax: internal organisation and lower respiratory system
Lecture 3 - Overview of emergency medicine
Lecture 4 - Mechanics of breathing 1
Lecture 5 - Mechanics of breathing 2
Lecture 6 - The gas exchange unit: function
Lecture 7 - Psychological effects of trauma
Lecture 8 - Control of breathing and respiratory failure
Lecture 9 - Indigenous Health Education
Lecture 10 - Q and A session: Meet the Expert
Practical 1 - Thorax: thoracic cage wall, boundaries, breast and surface anatomy
Practical 2 - Histology of the Respiratory System
PBL session 1 - Not at fault - 3.01 - PBL 1
Pt-Dr tutorial 1 - Communication Skills - Respiratory History
Pt-Dr tutorial 2 - Physical Exam Skills - Demonstration of examination of the respiratory system
Pt-Dr tutorial 3 - Structured clinical exercises/Attendance sheets/Clinical School Teaching schedule
Procedural skills session 2 - Using a peak flow meter and inhaled medication devices
Seminar 1 - Road trauma: active and passive safety
3.02 - Wheezing and breathless

Lecture 1 - Head and Neck: scalp, face, mastication, neck
Lecture 2 - Normal lung function
Lecture 3 - Mechanisms in asthma
Lecture 4 - Respiratory symptoms and signs
Lecture 5 - Bronchodilators and asthma treatment
Lecture 6 - IgE mediated responses
Lecture 7 - Mechanisms of cutaneous hypersensitivity
Lecture 8 - Normal chest X-ray
Practical 1 - Thorax: internal organisation and structures of the lower respiratory system
Practical 2 - Pathology of airways
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PBL session 1 - Wheezing and breathless - 3.02 - PBL 1

Pt-Dr tutorial 1 - Communication skills - Assessment of the patient with asthma
Pt-Dr tutorial 2 - Physical Exam Skills - Assessing peripheral signs of respiratory disease
Clinical Day 1 - Clinical Day - 3.02
Procedural skills session 2 - Oxygen therapy, pulse oximetry and airway devices
Seminar 1 - Lung function tests: airflow obstruction
Seminar 2 - Prevention and awareness of asthma
3.03 - A nasty cough

Lecture 1 - Head and Neck: nose, sinuses, mouth
Lecture 2 - Advocacy and lobbying for tobacco control
Lecture 3 - Pathophysiology of airways dysfunction in COPD
Lecture 4 - Evidence for tobacco as a cause of disease
Lecture 5 - Pathophysiology of Interstitial Lung Disease 1
Lecture 6 - Mechanisms of symptomatology in COPD
Lecture 7 - Uncertainty in Medical Practice
Lecture 8 - Pathophysiology of Interstitial Lung Disease 2
Practical 1 - Head & Neck: scalp, face, mastication, neck
Practical 2 - Cancer of the lung
PBL session 1 - A nasty cough - 3.03 - PBL 1
Pt-Dr tutorial 1 - Communication Skills - Taking an occupational history
Pt-Dr tutorial 2 - Physical Exam Skills - Chest examination for signs of respiratory disease
Procedural skills session 2 - Spirometry
Seminar 1 - Globalisation and Public Health: One world, one health
Seminar 2 - Honesty in Medical Practice
Assessment 1 - Finding Relevant Information in Health and Medical Databases Workshop
3.04 - Ex-Navy
Lecture 1 - Head and Neck: pharynx, larynx
Lecture 2 - Smoking and anaesthetic risk
Lecture 3 - Smoking related lung disease and smoking cessation
Lecture 4 - Respiratory acid-base disorders
Lecture 5 - Case Conference - Clinical Grand Rounds
Lecture 6 - Biochemical consequences of Oxygen Deficit and Excess
Lecture 7 - Communicating certainty and uncertainty to patients
Practical 1 - Head & Neck: nose, sinuses, mouth
Practical 2 - Pathological lungs
PBL session 1 - Ex-Navy - 3.04 - PBL 1
Pt-Dr tutorial 1 - Communication Skills - Sleep-disordered breathing: including obstructive sleep apnea
Pt-Dr tutorial 2 - Physical Exam Skills - Examination of a patient with COPD (Chronic obstructive pulmonary disease)
Procedural skills session 2 - Ear, Nose and Throat examination
Seminar 1 - Lung function tests: restrictive lung disease
Seminar 2 - Lung Disease Resulting from Occupational Exposures
3.05 - Sleeping on the job

Lecture 1 - Head and Neck: eye
Lecture 2 - Head and Neck: ear
Lecture 3 - Physiology of sleep
Lecture 4 - Sleep disorders
Lecture 5 - Pathophysiology of sleep apnoea
Lecture 6 - Sleepiness in the workplace
Lecture 7 - Pathology related to smoking
Practical 1 - Head & Neck: pharynx, larynx, thyroid gland
Practical 2 - Pathology of chronic airflow limitation
PBL session 1 - Sleeping on the job - 3.05 - PBL 1
Pt-Dr tutorial 1 - Communication Skills - Chronic cough and dyspnoea
Pt-Dr tutorial 2 - Physical Exam Skills - Respiratory examination revision and the role of the chest radiograph in the assessment of a patient with respiratory disease
Seminar 1 - Spirituality and Meaning of Medicine
Seminar 2 - Indigenous Health 3
3.06 - A different cause of cough

Lecture 1 - Head and Neck: cranial nerves
Lecture 2 - Head and Neck: clinical anatomy
Lecture 3 - Exocrine secretion
Lecture 4 - Cystic fibrosis as a multi-system disease
Lecture 5 - Cystic fibrosis as a genetic disorder
Lecture 6 - Support services for patients and families
Lecture 7 - Stress and Coping
Lecture 8 - Infections in Cystic Fibrosis
Lecture 9 - Feedback session with Dean
Practical 1 - Head & Neck: eye and ear
Practical 2 - Epithelial transport
PBL session 1 - A different cause of cough - 3.06 - PBL 1
Pt-Dr tutorial 1 - Communication Skills - History of respiratory tract infection
Pt-Dr tutorial 2 - Clinical Exercises/Revision
Seminar 1 - Physiotherapy in Cystic Fibrosis
Seminar 2 - Critical appraisal of observational studies
3.07 - Difficult circumstances

Lecture
Lecture
Lecture
Lecture
Lecture
1
2
3
4
5
Head and Neck: development

Head and Neck: radiology
Microbiology of pneumonia in Australia
Antimicrobial action in respiratory disease
Aboriginal health: making changes in rural and remote communities
Lecture 6 - Children in hospital

Lecture 7 - Hearing impairment and deafness in the community
Lecture 8 - Immunisation
Practical 1 - Head & Neck: cranial nerves
Practical 2 - Ear: structure and functional testing
Practical 3 - Pathology of pneumonia
PBL session 1 - Difficult circumstances - 3.07 - PBL 1
Pt-Dr tutorial 1 - SHAPE Assessment/Revision
Pt-Dr tutorial 2 - SHAPE Assessment/ Revision
Seminar 1 - Microbiology of pneumonia
Seminar 2 - Taking the Pulse of Indigenous Health 3
Assessment - Stage 1 Required Summative Assessment 1 (1RSA 1)
ASSESSMENT - Stage 1 Research Methods RFA

Principal Teacher
Metadata
Stage: 1
Michael Frommer
michael.frommer@sydney.edu.au
Block: 3: Respiratory Sciences

Week:
PBL/CRS:
Learning Objectives
Sequence No.:
Submitted by: Dominique Briones
TBA
Date Submitted: 2014-01-23

Reviewed by:
Date Reviewed: N/A
Content
RFA 1: Friday 4 July
RFA 2: Monday 14 July
RFA 3: Monday 27 October
Scope:
RFA 1 and 2
These RFAs are designed to test your knowledge and understanding of the material covered in Weeks 1 and 2 of
Research Methods. They consist of 2 online quizzes in the Research Methods site in BlackBoard. The quizzes should
take between 30 - 60 minutes each to complete.
To get to the Research Methods quizzes:
Status: Released
Edit History
#
Created By
Date
Dominique Briones
2014-01-23
1. Log in to the BlackBoard eLearning website: https://elearning.sydney.edu.au/webapps/portal/frameset.jsp

2. Under 'Unit of Study', click on '2014 - Research Methods'
3. On the bar left hand side of the screen, click on 'Quizzes'
Marking and results:
After the due date, the correct answers (for MCQs) and model answers (for the written components) will be provided.
Performance will be considered satisfactory if you have made a genuine attempt to answer each question. Students
who do not make a serious attempt to answer each question, or who do not complete the assessment, will be
contacted by the Research Methods team and may be further contacted by the Faculty for breach of PPD Statement of
Expectations.
For any technical questions about the assessment, please contact Dr. Eszter Kalman (eszter.kalman@sydney.edu.au)
and for any questions about the content, please contact Dr. Phil Clayton (philip.clayton@sydney.edu.au).
RFA 3
Details regarding this assessment will be posted on the SMP Bulletin Board and will be updated on this webpage closer
to the time.
Written/Prepared By:Dominique Briones (Assessment Unit, OME)
LECTURE - Thorax: thoracic cage wall, boundaries, breast and surface anatomy
Principal Teacher
Metadata
Stage: 1
Michelle Barbara Gerke

michelle.gerke@sydney.edu.au

Week: 1
PBL/CRS: Not at fault
Learning Objectives
Sequence No.: 1
Submitted by: Alicia Kaya
To develop an understanding and appreciation of:

Reviewed by:
the structural components and organisation of the lower respiratory system.

the structure-function relationship of the thoracic wall, boundaries and lower respiratory system.
the relationship between the surface anatomy landmarks of the thorax and the underlying respiratory system,
and its relevance in the clinic.
Date Reviewed: N/A

Status: Released
Edit History
Content
Created By
Date
Alicia Kaya
2014-04-01
components of the thoracic cage: sternum, thoracic vertebrae, ribs.

structures of the thoracic wall: muscles, veins, arteries, lymphatics and nerves.
boundaries of the thorax: thoracic inlet, thoracic outlet and their contents.
structure of the diaphragm and associated veins, arteries, lymphatics and nerves.
structure of the breast and associated veins, arteries, lymphatics and nerves.
surface anatomy of the thorax.
clinical relevance of the structure of the thoracic cavity.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Thorax: cage, wall,

boundaries, breast and
surface anatomy - 2014
LECTURE - Thorax: internal organisation and lower respiratory system

Jayne Seward
2013-06-06
Jayne Seward
2013-02-19
Alicia Kaya
2012-07-02
Jayne Seward
2010-05-13
John Mitrofanis
2009-12-07
Metadata
Principal Teacher
Stage: 1


Week: 1
Learning Objectives
Sequence No.: 2
Submitted by: Jayne Seward
the structural components and organisation of the walls and boundaries of the thorax.
the anatomy of the breast and the surface anatomy of the thorax.
the structure-function relationship of the thoracic wall and lower respiratory system.
how the structure of the thoracic cavity relates to its function in a clinical context.
Content
internal organisation and contents of the thorax: pulmonary cavities, mediastinum.
structure and visceral relationships of the lower respiratory system.
trachea, bronchial tree (bronchi, bronchioles, alveoli), lungs, pleura.
veins, arteries, lymphatics and nerves associated with the lower respiratory system.
thoracic mechanisms and muscles of respiration.
clinical relevance of the structure of the respiratory system.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Jayne Seward
2013-07-10
Jayne Seward
2013-06-06
Jayne Seward
2013-02-19
Jayne Seward
2012-03-22
Jayne Seward
2010-05-13
John Mitrofanis
2009-12-07
Thorax: internal
organisation and lower
respiratory system - 2014
LECTURE - Overview of emergency medicine

Principal Teacher
Metadata
Stage: 1
Clare Skinner
clare.skinner@sydney.edu.au

Week: 1
Learning Objectives
Sequence No.: 3
Current Teacher James Brooklyn Edwards
Describe the role of the Emergency Department to stabilise, evaluate, treat and arrange disposition for all patients
presenting.

The wide range of severity of illness and patient complexity mandates the Emergency Department triage patients
needs and priorities.
Life threatening processes must be anticipated and dealt with in an immediate, ordered initial assessment. This
assessment attends first to the most potent life threats of airway, breathing and circulation. When stability is secure
then a more thorough evaluation with history and examination, which can identify processes requiring treatment or
formal investigations. Emergency Department organisation and procedures are essential to deal with both the urgency
and breadth of its role from management of medical and surgical emergencies to the management of trauma, assault,
toxicological problems and pre-hospital care.
Content
Is this a life threatening complaint? - Application of structured approach to Initial Assessment using Primary
Survey of Airway, Breathing, Circulation, with concurrent management. Secondary survey performed when life
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Alicia Kaya
2014-05-28
Alicia Kaya
2014-05-28
Alicia Kaya
2014-04-15
Alicia Kaya
2014-04-14
Jayne Seward
2013-10-08
Jayne Seward
2013-07-11
threatening processes are secure to fully evaluate.

What is the most serious disorder this patient may represent? - Is the patient sick or not sick and what are the
priorities for treatment or further investigative procedures and over what time course.
Breadth of workload in ED representing medical and surgical emergencies, trauma, toxicology and environmental
hazards, pre-hospital retrieval and disaster management.
Team work and organisation required for resuscitation evaluation, disposition and medico-legal aspects of the ED
role. Personal resources required in terms of medical skills, multi-tasking organisation and communication.
Jayne Seward
2012-08-08
John Mitrofanis
2009-12-07
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
LECTURE - Mechanics of breathing 1

Principal Teacher
Metadata
Stage: 1
Gregory George King

gregory.king@sydney.edu.au

Week: 1
Learning Objectives
Sequence No.: 4
Submitted by: John Mitrofanis
Describe the anatomy of the respiratory system and its mechanical properties that allow it to function as a gas
exchanging organ. The respiratory system is a complex elastic structure which has been arranged to function efficiently
with respect to moving air in and out of the lungs and for exchanging oxygen and carbon dioxide. The generation of a
more negative pleural pressure by the contraction of the inspiratory muscles (mainly the diaphragm) draws air through
the conducting airways to the respiratory zone. Relaxation of the inspiratory muscles allows the elastic system to
passively return to its pre-inspiratory state, thus achieving exhalation.

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Content
Created By
Date
John Mitrofanis
2009-12-07
Anatomy of the respiratory system - upper airway, lower airways, lung parenchyma and vessels, respiratory
muscles and chest wall
Anatomy of the branching airways - approximately asymmetric dichotomous branching structure with 23
generations to the alveolar sacs
Individual airways narrow with increasing generation but there is an exponential increase in total airway crosssectional area as they divide so that the major resistance to flow is in the trachea and central airways in health
Concept of convectional gas transport in the larger airways gradually giving way to transport by diffusion
towards the peripheral and gas exchanging airways (respiratory bronchioles and alveolar ducts)
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Mechanics of breathing 1 2014

VIDEO
VIEW
References
Lectures by John B West MD - San Diego
J Clinical Skills - The interview, physical examination and assessment of the patient's problems. Richard Larkins,
Richard Smallwood. Melbourne University Press.
J Respiratory Medicine - 2nd Edition. David C. Flenley. Balliere Tindall.

J Essentials of Respiratory Disease. Cole 1997 Livingston
LECTURE - Mechanics of breathing 2

Principal Teacher
Metadata
Stage: 1
Gregory George King

gregory.king@sydney.edu.au

Week: 1
Learning Objectives
Sequence No.: 5
The anatomy and mechanical properties of the respiratory system dictate how breathing and gas exchange occurs.
Because of the apical to basal gradient of ventilation, blood flow must also match this gradient to allow efficient gas
exchange. Understanding the basic concepts of how disease affects the normal functioning of the lung provides a
sound basis of clinical assessment of respiratory disease.
Content
The mechanical properties of the lung and chest wall result in negative pleural pressures and an apical to basal
gradient of lung distension
Gradient of ventilation to horizontal zones when the lung is in a gravitational field is due to the different pleural

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
John Mitrofanis
2009-12-07
pressure swings during the ventilatory cycle (larger at the bases) leading to a higher ventilation of the lung
bases than the apices
Uneven distribution of ventilation within gravitational zones due to uneven time constants (product of the
resistance of the airway and the compliance of the subtended lung tissue). The mechanism is particularly
important in disease.
The mechanical changes due to common respiratory diseases are described
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
LECTURE - The gas exchange unit: function

Principal Teacher
Iven Young
iyoung@mail.usyd.edu.au
Learning Objectives
Metadata
Stage: 1
Week: 1
Sequence No.: 6
The significance and function of the gas exchange unit

Reviewed by: Iven Young
Date Reviewed: 2012-07-08
Content
Status: Released
Ventilation:
Edit History
alveolar ventilation and CO 2 excretion

anatomical and physiological dead space ventilation
Perfusion/blood flow
Pulmonary vascular pressure/flow relationships
Regional pulmonary blood flows
Zones of the lung
Ventilation/perfusion (V/Q) relationships
V/Q in a single alveolus; V/Q ratios in a lung
V/Q inequality in normal lungs
V/Q inequality as the major cause of gas exchange impairment in disease
Pulmonary shunt: an extreme of V/Q inequality
Diffusion
Equilibration between alveolar gas and capillary blood
Mechanisms of hypoxaemia
Relative importance of V/Q inequality and diffusion impairment
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
The gas exchange unit:

function 2014
References
John West's well known books entitled "Pulmonary Physiology - The Essentials" and "Pulmonary Pathophysiology - The
Essentials"
LECTURE - Psychological effects of trauma

Principal Teacher
Christopher James Ryan
crya7632@mail.usyd.edu.au
Metadata
Stage: 1
Week: 1
Learning Objectives
Sequence No.: 7
Submitted by: Annie Sadowski
A patient who suffers a traumatic injury may suffer a multitude of psychological effects by a number of avenues. This
lecture illuminates a variety of possible psychological effects with special reference to post-traumatic stress disorder
which is described in the Learning Topics.
Content
Life Stress and its effect
Life event stress can have adverse effects on health

The impact of life stress is moderated by psychosocial factors
Trauma is a specific type of life event
Normal responses to trauma and post-traumatic stress disorder
The history of medicine's understanding of post-traumatic stress

Clinical features and epidemiology of post-traumatic stress disorder
Clinical features of acute stress disorder
Post-traumatic features in particular populations (e.g. earthquake survivors)
The effect of acute trauma in children

The effect of chronic trauma in children and its effect on development
Refugees and victims of torture
The effect of trauma on rescue and health workers
Other issues
The importance of empathy in understanding

Classification within psychiatry
Clinical features of brief psychotic disorder
Survivor guilt
Injuries that cause a loss of role definition (e.g. family provider, sportsperson)
The effect of loss of social or cultural structure in a disaster

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Annie Sadowski
2013-07-08
Jayne Seward
2011-03-23
Jayne Seward
2011-03-22
Jayne Seward
2010-05-13
John Mitrofanis
2009-12-07
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Psychological effects of
trauma - 2014
LECTURE - Control of breathing and respiratory failure

Principal Teacher
Colin Sullivan
colin.sullivan@sydney.edu.au
Learning Objectives
The normal physiological regulation of breathing; the disease states that alter normal control of respiration; the acute
Metadata
Stage: 1
Week: 1
Sequence No.: 8
& chronic consequences of respiratory failure
Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
2012Lecture
AUDIO
VIDEO
VIEW
AUDIO
VIDEO
VIEW
2014 (3)Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Control of breathing &

respiratory failure
Control of breathing and

respiratory failure - 203
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-11-24
Jayne Seward
2012-07-27
Jayne Seward
2011-07-27
Jayne Seward
2010-05-13
John Mitrofanis
2009-12-07
LECTURE - Indigenous Health Education

Principal Teacher
Metadata
Stage: 1
Lilon Gretl Bandler

lilon.bandler@sydney.edu.au

Week: 1
Learning Objectives
Sequence No.: 9
TBA

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
#
Created By
Date
Alicia Kaya
2014-05-13
Jayne Seward
2013-11-24
Jayne Seward
2013-11-13
Jayne Seward
2013-04-23
Jayne Seward
2013-02-20
Jayne Seward
2012-12-12
Jayne Seward
2012-07-09
Jayne Seward
2012-07-09
Jayne Seward
2012-07-09
LECTURE - Q and A session: Meet the Expert

Principal Teacher
Peter Smith
psmi1620@sydney.edu.au
Learning Objectives
Metadata
Stage: 1
Week: 1
Sequence No.: 10
Student Group: Year cohort
Revisiting the learning objectives of the week (Meet the Expert).

Reviewed by:
Recordings
Date Reviewed: N/A

Status: Released
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2012 (2)Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Created By
Date
13
Alicia Kaya
2014-04-14
12
Jayne Seward
2013-11-24
11
Jayne Seward
2013-11-13
10
Jennifer Burn
2013-07-03
Jayne Seward
2013-04-23
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2012-12-12
Jayne Seward
2011-08-19
Jayne Seward
2010-11-27
Jayne Seward
2010-10-16
Jayne Seward
2010-07-23
Jayne Seward
2010-07-23
PRACTICAL - Thorax: thoracic cage wall, boundaries, breast and surface anatomy
Principal Teacher
Learning Objectives
the
the
the
the
structural components of the thoracic cage and wall.

mechanical contributions various components of the thorax make to breathing.
structure of the breast.
surface anatomy landmarks present on the thorax.
Metadata
Stage: 1
Week: 1
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A

Status: Released, part of submission
Content
Edit History
The practical class materials are located at various benches around the wet anatomy laboratory in the Anderson Stuart
Building. Students are expected to be appropriately attired to be allowed to enter the practical session. Students
should bring their relevant practical readings to the practical class to identify the underlined structures and to answer
the related questions. The use of an anatomical atlas may be useful to assist in the identification of the relevant
structures during the practical class.
A primer video based on the relevant practical class topic will be available for viewing prior to the practical class along
with a small online spot test. An in-class formative spot test will also be organised to allow students to test their
knowledge of the relevant topic on wet specimens. Answers to the spot test questions will be posted in the practical
rooms.
Students should be able to identify underlined structures outlined in the practical readings and in doing so, aim to
identify, appreciate and understand the:
boundaries and various bones and joints that comprise the thoracic cage.
muscles that make up the thoracic wall and the anatomy of the neurovascular bundle.
relationship between structures of the thoracic cage and respiratory muscles and their role in changing the
dimensions of the thoracic cavity during breathing.
general anatomy of the breast.
thorax radiology and thorax surface anatomy landmarks which will help to delineate the position of organs within
the thorax.
Resources
Practical Readings - 2014
Video: Thorax: cage, wall,

surface anatomy and
structures of the lower
respiratory system.
Practical Quiz
Created By
Date
Alicia Kaya
2014-04-15
Alicia Kaya
2014-02-27
Jayne Seward
2013-06-06
Jayne Seward
2013-06-06
Jayne Seward
2013-05-28
Jayne Seward
2013-02-19
PRACTICAL - Histology of the Respiratory System

Principal Teacher
Metadata
Stage: 1
Suzanne Lea Ollerenshaw

suzanne.ollerenshaw@sydney.edu.au

Week: 1
Learning Objectives
1. Differentiate between olfactory and respiratory epithelium when viewed with the light microscope
2. Recognize and describe the wall of the trachea, bronchus, bronchiole, alveolar duct and alveoli when viewed with
the light microscope
3. Describe the ultrastructure of the alveolar septum when viewed with the electron microscope
4. Apply your knowledge of epithelia to the changes seen in the epithelia lining the conducting versus respiratory
airways
Content
Consideration of the normal histology will concentrate on the respiratory epithelium and the importance of ciliary
movement, mucus secretion by goblet cells and respiratory glands, and the mucociliary elevator in normal function. No
cartilage support in airways smaller than bronchi. Smooth muscle of airway wall. Pulmonary arteries, veins and
bronchial arteries.
Method and Resources
Histology
Students will examine the normal airways and blood vessels in a prepared slide of normal lung
Students will examine ciliary ultrastructure (normal and abnormal) and selected light micrographs of airway histology
by intranet (See also Learning Topic: Structure of respiratory tract).
Resources
Sequence No.: 2
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Jayne Seward
2013-05-29
Jayne Seward
2011-10-31
Jayne Seward
2011-01-18
Stacey Darien Gentilcore
2010-03-25
John Mitrofanis
2009-12-07
Histology of the
Respiratory System - 2014
PBL SESSION - Not at fault - 3.01 - PBL 1

Learning Objectives
Metadata
Stage: 1
See the learning objectives for this problem - PBL Sessions

Week: 1
Content
Sequence No.: 1
Submitted by: Zhigang Jason Xie
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Created By
Date
Zhigang Jason Xie
2010-02-09
Image: Hospital emergency room, with a nurse restraining the patient, an injured cyclist on a stretcher, and forcibly
holding an oxygen mask over his face.
Geoff Turner, aged 38 years, was cycling home from work when he was struck by a car. Geoff swerved to avoid the
car, but was hit in the chest by the cars wing mirror, was knocked off his bike and fell to the road. Geoff did not lose
consciousness and was able, with help, to move to the side of the road. A passing motorist called an ambulance. The
paramedics found Geoff conscious, but uncooperative. Geoff refused to take off his cycling helmet or to lie down in the
ambulance. He told the ambulance officers he did not want to be transported to hospital. His only obvious problems
were pain in his chest, shortness-of-breath, and bruising to his right chest wall. When Geoff arrived in the Emergency
Department about 40 minutes after the accident he was still breathless and in pain, but was able to speak in short
sentences. Soon afterwards, Geoffs mother and younger brother arrived in the Emergency Department. They were
both angry and aggressive. Geoffs brother threatened that he would get even with staff involved if anything
happened to Geoff.
Resources
Medical Humanities
Mechanism
Tutor Guide
Recommended Readings
Results
Student Guide
PT-DR TUTORIAL - Communication Skills - Respiratory History

Learning Objectives
Metadata
Stage: 1
Students should demonstrate:

Week: 1
The ability to elicit a history of a respiratory problem

The ability to communicate with a breathless patient
Awareness of the possible emotional reactions of patients with recurrent or severe breathlessness

Sequence No.: 1
Content
Reviewed by:
Date Reviewed: N/A
Aim
Status: Released
To introduce principles and core requirements of history taking in respiratory disease.

Suggested activities/format
Discuss the essential elements of a respiratory history
Discuss how patients typically describe some of the symptoms mentioned below.
Review the Modified Medical Research Council scale of dyspnoea and the definition of chronic bronchitis.
Patient Interview: one student should elicit a respiratory history from the patient and present the case to the
group for feedback and discussion
Your history should include identifying and assessing the severity and impact of the principal symptoms of dyspnoea,
cough, haemoptysis, sputum, chest pain and wheeze, their triggers and the setting in which they occur. Other
important history on smoking, past history and treatment, medications, occupational and recreational exposures to
Edit History
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Created By
Date
Jayne Seward
2012-06-29
Jayne Seward
2012-06-28
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Celina Aspinall
2010-09-15
inhalants (dusts) and allergens, pets, family history and presence of atopy should also be covered.
John Mitrofanis
Consider other potential causes of breathlessness and how to distinguish between these e.g. anaemia, left ventricular
failure, lack of fitness and musculoskeletal conditions affecting ventilation.
Medical Research Council Definition of Chronic Bronchitis:
Cough productive of sputum for at least three months in two consecutive years.
Medical Research Council Grading of Dyspnoea:
Grade 1I only get breathless with strenuous exercise.
Grade 2I get short of breath when hurrying on the level or up a slight hill
Grade 3I walk slower than people of the same age on the level because of breathlessness or have to stop for breath
when walking at my own pace on the level
Grade 4 I stop for breath after walking 100 yards or after a few minutes on the level
Grade 5I am too breathless to leave the house or I am breathless when dressing
See Occupational Medicine; 2008; 58:226-227; or Thorax 999;54: 581-586
For an alternative classification of dyspnoea, see New York Heart Association classification in Talley and O'Connor.
Between Tutorials
Two students may undertake to interview a patient with respiratory disease. This interview should be presented to the
tutorial group next week.
References
Lloyd M, Bor R. Communication Skills for Medicine, London: Churchill Livingstone, on-line e-book:
Talley NJ, O'Connor S. Clinical Examination, Churchill Livingstone available online using ClinicalKey
PT-DR TUTORIAL - Physical Exam Skills - Demonstration of examination of the respiratory system
Learning Objectives
Metadata
2009-12-07
Stage: 1
Demonstrate ability to carry out a respiratory system examination and report on the findings.

Week: 1
Content
Sequence No.: 2
Aim
Introduce students to the examination of the respiratory system.

Reviewed by:
In this tutorial the tutor will demonstrate a systematic examination of the respiratory system. This standard
examination should demonstrate:
1.
2.
3.
4.
5.
Correct preparation and positioning of the patient.

Important general observations, including assessment of vital signs, use of supplementary oxygen.
Important peripheral signs of respiratory disease
Important elements of the chest examination
Evaluation of other elements which contribute to the clinical assessment e.g. sputum cup and temperature chart
Between Tutorials
Students should practise respiratory examination on each other and each student should arrange to examine a patient
on the wards either by themselves or with a colleague.
Date Reviewed: N/A

Status: Released
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Jayne Seward
2012-06-28
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Please also refer to the Clinical Exercises checklist for respiratory examination.
References
PT-DR TUTORIAL - Structured clinical exercises/Attendance sheets/Clinical School Teaching schedule

Learning Objectives
Structured clinical exercises Block 3
Metadata
Stage: 1
Week: 1
Content

Sequence No.: 3
Clinical Exercises available on the Assessment page.

Reviewed by:
Date Reviewed: N/A
Resources
Status: Released
Edit History
Clinical School Teaching

Schedule - 2014
Record of Attendance Stream A - 2014
Created By
Date
Jayne Seward
2013-05-24
Jayne Seward
2012-06-29
Jayne Seward
2012-06-29
Jayne Seward
2012-06-29
Record of Attendance Stream B - 2014
PROCEDURAL SKILLS SESSION - Using a peak flow meter and inhaled medication devices
Principal Teacher
Metadata
Stage: 1
Procedural Skills Committee

meded_procskills@sydney.edu.au

Week: 1
Learning Objectives
Clinical indications for peak flow
Interpretation of normal values
Perform peak flow
Describe other common tests of respiratory function
Understand the limitations and pitfalls in interpretation of peak flow in children
Be familiar with inhalational devices for the delivery of medications
Content
Sequence No.: 2
Reviewed by:
Date Reviewed: N/A
Status: Released
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Created By
Date
Jayne Seward
2013-06-07
Background
A peak flow measurement is a quick bedside test to assess respiratory function. It does not provide the same degree
of information as full pulmonary function testing and it is insufficient to determine whether the lung condition is
restrictive or obstructive in nature. Peak flow measurements are highly dependent on effort and for this reason it is
an unreliable test with poor reproducibility in young children. In older children (e.g., >8y) peak flows can be a good
indicator of severity of lung disease when the patient produces a maximal effort and the result is reasonably consistent
over three attempts. Peak flow results can be compared against height standardized normal range for the patients
age and gender or compared with their own previous best reading.
Content
Be able to determine expected peak flow for height, gender, ethnicity
Assessment of asthma severity- when the patients normal peak flow is known
Bronchial challenge; exercise spirometry, serial peak flow
1. Clinical indications for peak flow - a bedside test in a patient old enough to make a maximal and reproducible
expiratory effort
2. Interpretation of normal values
3. Perform peak flow- the patient makes a maximal inspiratory effort, ensures a tight seal on the mouthpiece and
makes a maximal expiratory effort (repeat x3 to ensure reproducible maximal effort)
4. Describe other common tests of respiratory function
5. Describe limitations and pitfalls in interpretation of peak flow in children- it is difficult to ensure young children
are making a maximal effort
6. Ask your asthma educator to demonstrate the various inhalational devices used to deliver asthma medications:
for example, turbuhalers, autohalers, accuhalers, dry powder devices and metered dose inhalers.
References
Transplantation Society of Australia and New Zealand (TSANZ) Respiratory Function Tests and Their Application
National Asthma Council of Australia - Spirometry Handbook
National Asthma Council of Australia Asthma Management Handbook
National Asthma Council of Australia Managing Asthma Resources
Sydney Childrens Hospital Network Factsheets
Revised in 2013 by the Procedural Skills Committee
Celina Aspinall
2011-10-17
medkey___jaimec
2011-02-03
Celina Aspinall
2010-09-15
John Mitrofanis
2009-12-07
SEMINAR - Road trauma: active and passive safety

Principal Teacher
Metadata
Stage: 1
Rebecca Quentin Ivers

rebecca.ivers@sydney.edu.au

Week: 1
Learning Objectives
Sequence No.: 1
The contribution of road traffic crashes to injury related death and disability in Australia and internationally, and
prevention strategies.

Reviewed by: Rebecca Quentin Ivers

Status: Released
By the end of this session students should be able to:

describe the extent to which road traffic crashes contribute to injury-related death and disability in Australia and
internationally
describe the trends in injury related death and disability that has occurred globally over the last three decades
understand the respective roles of human and vehicle factors along with physical and social environmental
factors in the causal pathways for motor vehicle crash and injury
use the Haddon Matrix to identify strategies for prevention of motor vehicle crash and injury
identify and discuss the evidence for the effectiveness of these strategies
Content
To present and discuss the following issues
1. Overview:
Road trauma: global patterns of mortality and morbidity, causal pathways for injury and the Haddon matrix for
injury control.
Prevention strategies
2. Pre-crash strategies
Driver factors: reducing alcohol intoxication, random breath testing, medication, illicit drugs, speeding fines/limits,
certification of drivers at licensing.
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Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2011-09-06
Jayne Seward
2011-09-06
Jayne Seward
2011-04-29
John Mitrofanis
2009-12-07
Vehicle factors: increased vehicle safety, design.

Physical environment: improved road structures, traffic controls, traffic calming measures.
Social environment: consumer awareness programmes, advertisements.
3. Crash injury minimization strategies
Driver factors: seat belts, child car seats, booster seats.
Vehicle factors: energy-absorbing frame, air bags, shatterproof windshields, collapsible steering columns, headrests,
anti-lock brakes.
Physical environment: energy-absorbing guard rails.
Social environment: education about child car restraints.
4. Post-crash strategies
Driver factors: medical management at the scene, first aid.
Vehicle factors: design for easier extrication.
Physical environment: emergency field care, careflight.
Social environment: ensure effective 000 service available, rehabilitation services
Case-based illustration of above content delivered by Professor Rebecca Ivers
Web links
www.decadeofaction.org http://www.infrastructure.gov.au/roads/safety/road_fatality_statistics/index.aspx
http://injuries.cochrane.org/
http://www.who.int/violence_injury_prevention/en/
Recordings
2014Lecture
2012Lecture
2013Lecture

AUDIO
VIDEO
VIEW
AUDIO
VIDEO
VIEW
AUDIO
VIDEO
VIEW
Resources
Road trauma: active and

passive safety - 2014
LECTURE - Head and Neck: scalp, face, mastication, neck

Principal Teacher
Metadata
Stage: 1
John Mitrofanis
john.mitrofanis@sydney.edu.au

Week: 2
PBL/CRS: Wheezing and breathless
Learning Objectives
Sequence No.: 1
Detailed anatomical organisation of the scalp, face and neck;the bones, joints (eg temporomandibular) and muscles
(facial expression, neck and mastication) associated with scalp, face and neck

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
Created By
Date
Jayne Seward
2013-07-18
John Mitrofanis
2009-12-07
2014Lecture
2009Lecture
AUDIO
VIDEO
VIEW
Download Audio mp3
Resources
2014 lecture
LECTURE - Normal lung function

Principal Teacher
Norbert Berend
norbert.berend@sydney.edu.au
Learning Objectives
The lung function tests used commonly in the assessment of patients with respiratory disease and the determinants of
Metadata
Stage: 1
Week: 2
Sequence No.: 2
both normal and abnormal lung function
Reviewed by:
Date Reviewed: N/A
Content
Status: Released
The changes of elastic recoil, lung volumes, airway function and gas exchange with height, weight, sex and race
How to measure lung volumes
How to measure airway obstruction
How to measure gas transfer
How to measure airway hyperresponsiveness
How to measure oxygen saturation
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Edit History
#
Created By
Date
John Mitrofanis
2009-12-07
Normal lung function 2014
LECTURE - Mechanisms in asthma

Principal Teacher
Metadata
Stage: 1
Paul Seale
paul.seale@sydney.edu.au

Week: 2
Learning Objectives
Describe the prevalence of asthma in Australia
List the risk factors for asthma
Explain airway hyperresponsiveness (AHR) and list the triggers for AHR
Describe the cells involved in the pathogenesis of asthma
List asthma drugs which act on the pathogenic pathways of asthma
Describe the mechanism of action of these drugs
List the effects of corticosteroids which contribute to efficacy in treating asthma
Content
Theories on development of asthma
Risk factors for asthma
Mechanisms of airway hyperresponsiveness
Airway inflammation in allergic asthma
Theories on T cell subsets in asthma
Cell types involved in asthma
Cytokines and mediators that cause inflammation
Sequence No.: 3
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
John Mitrofanis
2009-12-07
Role of anti-inflammatory corticosteroids
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Mechanisms in Asthma 2014
LECTURE - Respiratory symptoms and signs

Principal Teacher
Paul Hamor
paul.hamor@sydney.edu.au
Metadata
Stage: 1
Week: 2
Learning Objectives
Sequence No.: 4
The principles of taking a history and undertaking an examination of the respiratory system.

Reviewed by:
To discuss the origins of the symptoms (breathlessness, cough, haemoptysis, pain and wheeze) and signs of
respiratory ill health.
Date Reviewed: N/A

Status: Released
Content
Edit History
Concept of breathlessness in health and disease

Taking a history related to breathlessness
Mechanism, types and causes of cough
Mechanisms and causes of haemoptisis
Pain generating structures in the thorax
Wheeze - as a symptom in adults, children and infants
Breathsounds - their origins
Abnormal sounds - how are they generated?
What makes dullness to percussion?
What makes hyper-resonance?
Why the lungs are such friendly organs.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
VIDEO
VIEW
Created By
Date
Alicia Kaya
2014-04-14
John Mitrofanis
2009-12-07
Resources
Respiratory symptoms and

signs - 2013
Respiratory Symptoms &

Signs - 2014
Author
Respiratory Symptoms &

Signs - 2014 (PPT)
Author
LECTURE - Bronchodilators and asthma treatment

Principal Teacher
Metadata
Stage: 1
Paul Seale
paul.seale@sydney.edu.au

Week: 2
Learning Objectives
List the classes of bronchodilators with a couple of examples of drugs in each class
Describe the mechanism of action of adrenoceptor agonists as bronchodilators
List other actions of adrenoceptor agonists which are beneficial in the treatment of asthma
Describe the mechanism of action of muscarinic receptor antagonists
Describe the mechanism of action of phosphodiesterase inhibitors
List the usual drug treatment of asthma
Describe the differences between asthma and COPD
List the usual drug treatment of COPD
Content
1. adrenoceptor agonists
2. anti-cholinergic drugs
Sequence No.: 5
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
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Created By
Date
Jayne Seward
2011-08-19
John Mitrofanis
2009-12-07
3. theophylline and other phosphodiesterase inhibitors
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Bronchodilator drugs
Bronchodilators and
asthma treatment - 2014
VIDEO
VIEW
LECTURE - IgE mediated responses

Metadata
Principal Teacher
Stage: 1
Robert Loblay
dr.loblay@sydney.edu.au

Week: 2
Learning Objectives
Sequence No.: 6
Immunobiology of IgE antibody responses, including their role in protective immunity to parasites and in
hypersensitivity to environmental and other allergens

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
IgE mediated responses
Created By
Date
John Mitrofanis
2009-12-07
LECTURE - Mechanisms of cutaneous hypersensitivity

Metadata
Principal Teacher
Stage: 1
Wolfgang Peter Weninger

wolfgang.weninger@sydney.edu.au

Week: 2
Learning Objectives
Sequence No.: 7
Submitted by: Christiana Katalinic
Diseases caused by hypersensitivity in skin, according to Gell and Coombs classification, their diagnosis and treatment

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
2012Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Created By
Date
Christiana Katalinic
2013-07-05
Jayne Seward
2012-03-28
John Mitrofanis
2009-12-07
Mechanisms of cutaneous
hypersensitivity -2012
LECTURE - Normal chest X-ray

Principal Teacher
Metadata
Stage: 1
Bruno Mario Giuffre

bruno.giuffre@sydney.edu.au

Week: 2
Learning Objectives
Demonstrate an understanding of the anatomy of the basic structures forming the visible thoracic cage on CXR
(ribs, vertebral bodies, diaphragms).
Demonstrate an understanding of the structures forming the visible borders of the mediastinum in the frontal
CXR.
Demonstrate an understanding of the main shadows visible in the lateral CXR (Right ventricle, left atrium, aortic
arch, hilar structures in particular)
Describe the main features which markedly affect the quality of a CXR (with regard to inspiration, rotation and
position of the patient at the time of the CXR)
Explain the main advantages of using CT scan of the chest rather than a CXR (with regard to density differences
and cross sectional demonstration of structures)
Recordings
Sequence No.: 8
Reviewed by:
Date Reviewed: N/A
Edit History
#
Created By
Date
John Mitrofanis
2009-12-07
2010Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Virtual Hospital Diagrams
Normal Chest X-Ray (PPT)

- 2014
Normal Chest X-Ray (PDF)

- 2014
Author
Normal Chest X-Ray
Normal Chest X-Ray - CXR

2014

Metadata
Principal Teacher
Stage: 1
Dominic Adam Fitzgerald

dominic.fitzgerald@sydney.edu.au

Week: 2
Learning Objectives
Sequence No.: 9

Reviewed by:
Recordings
Date Reviewed: N/A

Status: Released
Edit History
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Created By
Date
12
Alicia Kaya
2014-04-14
11
Jayne Seward
2013-07-18
10
Jayne Seward
2013-07-18
Jayne Seward
2013-07-16
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2011-11-07
Jayne Seward
2011-07-20
Jayne Seward
2011-07-20
Jayne Seward
2010-11-27
Jayne Seward
2010-07-23
PRACTICAL - Thorax: internal organisation and structures of the lower respiratory system
Principal Teacher
Metadata
Stage: 1


Week: 2
Learning Objectives
Sequence No.: 1

the structural components and organisation of the walls and boundaries of the thorax.
the anatomy of the breast and the surface anatomy of the thorax.
the structure-function relationship of the thoracic wall and lower respiratory system.
how the structure of the thoracic cavity relates to its function in a clinical context.
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Created By
Date
Alicia Kaya
2014-07-02
Alicia Kaya
2014-02-27
Jayne Seward
2013-06-26
Jayne Seward
2013-06-06
Jayne Seward
2013-02-20
Content
Jayne Seward
2013-02-20
Jayne Seward
2011-04-29
The practical class materials are located at various benches around the wet anatomy laboratory in the Anderson Stuart
Building. Students are expected to be appropriately attired to be allowed to enter the practical session. Students
should bring their relevant practical readings to the practical class to identify the underlined structures and to answer
the related questions. The use of an anatomical atlas may be useful to assist in the identification of the relevant
structures during the practical class.
2010-03-25
John Mitrofanis
2009-12-07

the structure-function relationship of the thoracic wall, boundaries and lower respiratory system.
the relationship between the surface anatomy landmarks of the thorax and the underlying respiratory system,
and its relevance in the clinic.
A primer video based on the relevant practical class topic will be available for viewing prior to the practical class along
with a small online spot test. An in-class formative spot test will also be organised to allow students to test their
knowledge of the relevant topic on wet specimens. Answers to the spot test questions will be posted in the practical
rooms.
Students should be able to identify underlined structures outlined in the practical readings and in doing so, aim to
identify, appreciate and understand the:
boundaries of thoracic inlet, thoracic outlet and mediastinum and their relationships.
structure and features of the diaphragm.
organisation of lower respiratory system, including trachea, bronchi and lungs.
arrangement of parietal and visceral pleura and recesses of the pleural cavity.
basic thorax radiology and how to use thorax surface anatomy landmarks to delineate the relative position of
the lungs and pleura within the thorax.
Recordings
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Thorax: internal
organisation and structures
of the lower respiratory
system - PRACTICAL
READINGS 2014
Quiz: Thorax: cage, wall,

surface anatomy and
respiratory system.
Video: Thorax: cage, wall,

surface anatomy and
respiratory system.
PRACTICAL - Pathology of airways

Principal Teacher
Metadata
Stage: 1
Nicholas King
nicholas.king@sydney.edu.au

Week: 2
Learning Objectives
Sequence No.: 2
The pathology of the airways with particular reference to asthma. The different types of asthma. The macroscopic and
microscopic appearance of the lungs in asthma

Reviewed by: Nicholas King
Content
Aim
To assist students to understand the pathology of the airways, with particular reference to asthma
Content
Consideration will be given to the histological changes that occur associated with asthma and overlapping with other
obstructive airways diseases; the pathophysiology will be related to these changes.
A slide tutorial held in the Pathology Prac Rooms will allow students to examine glass slides showing pathological
changes that occur in asthma and compare them to normal airway histology. Attendance at the Pathology museum to
view the original specimens in bottles and where there are also computers available on the inter and intranet, is also
advocated.
Resources
Status: Released
Edit History
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Date
Alicia Kaya
2011-03-01
John Mitrofanis
2009-12-07
Pathology of airways
Asthma - 2012
Pathology of Asthma 2012
PBL SESSION - Wheezing and breathless - 3.02 - PBL 1

Learning Objectives
Metadata
Stage: 1

Week: 2
Content
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Image: Four year old girl with mother attending GP surgery for review of asthma (receiving medication via a metered
Created By
Date
Zhigang Jason Xie
2010-02-09
dose inhaler and spacer).

Maria Rossini is a four year old girl who has been brought to her GP's surgery because of cough and wheeze which
developed overnight. Mrs Rossini mentions that Maria has had episodes of wheezing since 18 months of age and
recently has also had intermittent cough at night and after exercise. Maria had eczema in the first year of life and was
also allergic to cow's milk but now tolerates this without problem.
Resources
Medical Humanities
Tutor Guide
Mechanism
Results
Student Guide
PT-DR TUTORIAL - Communication skills - Assessment of the patient with asthma

Learning Objectives
Metadata
Stage: 1
Students should learn:

To
To
To
To
To
To
To
To

Week: 2
assess a patient's asthma severity

assess a patient's current degree of asthma control
explain to a patient the nature of asthma
discuss potential triggers to the patient's asthma
discuss with the patient how triggers may be modified
describe the types of medications used to treat asthma (preventers, symptom controllers and relievers)
describe the essential principles of choosing and reviewing optimal use of inhaler devices
describe what an individual asthma plan for a patient involves

Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Content
Aim To introduce students to the management of patients with asthma
Discuss principles of asthma assessment
symptoms of asthma
the importance of objective assessment of lung function by spirometry
how asthma severity and current control can be determined
asthma triggers and how to modify them
Discuss the principles of asthma management
approaches to asthma treatment especially pharmacotherapy: preventers, symptom controllers,
combination medications and relievers; and the modes of drug delivery (p-MDI, DPI, spacers and
nebulisers)
necessity to demonstrate and review inhaler technique
Interview a patient(s) with asthma
Try to include the above areas in the history, such as the patient's understanding of the nature of their
illness, attention to trigger factors, knowledge of medications and the appropriateness of their use, and
whether they have an asthma management plan. The group should observe one student taking a history,
and then discuss the interview afterwards.
Debrief and discuss what an asthma management plan is.
Background information for discussion
Look up www.nationalasthma.org.au for some management guidelines and useful asthma patient information.
Asthma patient education checklist - from the Asthma Management Handbook, 2006 (see
http://www.nationalasthma.org.au).
Inhaler technique videos and printed handouts.
Patient Education Student Handout (linked as Resource)
Templates for written asthma action plans.
Assessing the severity of asthma
Previous ICU admissions, admissions to hospital, speed of deterioration
Edit History
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Created By
Date
Jayne Seward
2012-06-29
Jayne Seward
2012-06-27
Celina Aspinall
2010-09-15
John Mitrofanis
2009-12-07
Frequency of use of oral and IV steroids

Frequency of attacks
Frequency of use of reliever inhalers
Level of preventative inhaled medication used
Nocturnal symptoms
Exercise tolerance and impact on usual daily activities
Peak flow readings and symptoms - how they can be used within the asthma management plan.
Other important related history:
History of atopy (allergic rhinitis, eczema)
Family history of asthma or atopy
Adherence to treatment.
Consider:
What fears do you think asthma sufferers may have?
Do you think the patient you interviewed has good insight into the severity of their illness?
Between Tutorials
Each student should arrange to see a patient with asthma prior to the next tutorial. Suitable patients may be clinic
attendees, or patients with asthma admitted to hospital for another reason. The group should spend the first 20
minutes of next week's tutorial discussing the patients they saw.
Resources
Patient Education - Asthma

- Student Handout
Patient Education Checklist

- Asthma
References
PT-DR TUTORIAL - Physical Exam Skills - Assessing peripheral signs of respiratory disease
Learning Objectives
Metadata
Stage: 1
Learn to recognise peripheral signs of acute and chronic respiratory disease.

Learn to accommodate the difficulty of a physical exam for a breathless patient.

Week: 2
Sequence No.: 2
Content

Aim
Introduce students to the detection and interpretation of normal and abnormal clinical findings in the examination of
the respiratory system.
Students to inspect a patient to check for the signs listed below
The examination for peripheral signs of respiratory disease should include:
Respiratory rate (count)
Ability to speak in sentences, phrases or single words only
Use of accessory muscles of respiration, position and altered breathing patterns of patient
Presence of tachycardia and fever.
Presence of central cyanosis
Inspection of the pharynx
Inspection of the neck veins
Palpation for tracheal position and lymphadenopathy in the cervical/supraclavicular regions
Appreciation of the quality of the patient's voice
Inspection of the sputum and assessment of the cough.
Presence of peripheral oedema
Signs of DVT if pulmonary thromboembolism clinically suggested
There are some rare signs that might suggest the presence of important clinical conditions:
HPOA (hypertrophic pulmonary osteoarthropathy)
Metabolic flap, associated with hypercapnoea or severe liver disease
Horner's syndrome as a sign of Pancoast Tumour
Presence of digital clubbing and peripheral cyanosis.
Between tutorials
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Jayne Seward
2012-06-29
Jayne Seward
2012-06-27
Students should examine a patient with respiratory illness either by themselves, or with a colleague.
References
CLINICAL DAY - Clinical Day - 3.02

Learning Objectives
Metadata
Stage: 1

Week: 2
Sequence No.: 1
Submitted by: Kamal Jaikisan Soni
Reviewed by:
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Status: Released
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#
Created By
Date
Kamal Jaikisan Soni
2010-03-19

Learning Objectives
Metadata
Stage: 1

Week: 2
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
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Created By
Date
Jayne Seward
2011-12-06
Kamal Jaikisan Soni
2010-03-19
PROCEDURAL SKILLS SESSION - Oxygen therapy, pulse oximetry and airway devices
Principal Teacher
Metadata
Stage: 1


Week: 2
Learning Objectives
Sequence No.: 2
Describe normal respiratory physiology.

List common O2 delivery devices and the % O2 delivered to the patient for each.
Fit oxygen mask and nasal prongs.
Fit a pulse oximeter and interpret the % saturation for this device
Identify patients at risk of chronic CO2 retention.
Describe the management of oxygen delivery to these patients.
Demonstrate correct use of oropharyngeal airways and bag and mask.

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Status: Released
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Content
Created By
Date
Jayne Seward
2013-06-07
Background
Celina Aspinall
2011-10-17
Oxygen is required for normal cell metabolism. Inadequate oxygenation results in anaerobic metabolism with harmful
build up of lactic acid and metabolic acidosis with eventual cardio-respiratory failure. Oxygen therapy is required
whenever tissue oxygenation is potentially impaired by injury or illness. However, for some patients increasing in the
inspired percentage of oxygen from 21% (room air) contributes to respiratory failure. It is therefore important for
student doctors to understand what percentage of inspired oxygen is needed and how this is best administered.
Content
1. Normal respiratory physiology
Inspired oxygen: tissue PaO2 (mm Hg); PaCO2 (mm Hg); pH; carrying capacity of Hb; Oxygen dissociation
curve
2. Common oxygen delivery devices:
Variable performance systems
Nasal prongs (low flow: 0-2Lmin-1; high flow can be higher)
Simple semi-rigid plastic masks (Hudson mask) at minimum 4L
Fixed performance system
High flow Venturi type masks, CPAP, BiPAP, mechanical ventilation (via bag, valve mask, and good
seal, endotracheal tube ).
3. Fit oxygen mask and nasal prongs
4. Fit pulse oximeter and interpret % saturation- ensure adequate contact on skin and a good pulse waveform
when reading oxygen saturation. Normal readings are greater than 95%
5. Choice of delivery device and required flow rate
beware of overusing oxygen in patients at risk of CO2 retention (CO2 narcosis) due to chronic lung
disease, and O2 toxicity
6. Correct fitting and use of oropharyngeal airways and bag/valve/mask
7. (Optional) - Use of laryngoscope and endotracheal intubation
References
Faculty notes and publications
Ohs Intensive Care Manual 5th Edition (2003) Chapter 22
Author: Revised in 2013 by the Procedural Skills Committee
SEMINAR - Lung function tests: airflow obstruction

medkey___jaimec
2011-02-03
Celina Aspinall
2011-01-21
Celina Aspinall
2010-09-16
John Mitrofanis
2009-12-07
Metadata
Principal Teacher
Stage: 1
Rebecca Sara Mason

rebecca.mason@sydney.edu.au

Week: 2
Learning Objectives
Sequence No.: 1
Concept of airflow limitation or obstruction. The methods that underpin measurement of airflow limitation

Reviewed by:
Date Reviewed: N/A
Content
Status: Released
Aim
Edit History
To enable students to develop an understanding of the concept of airflow limitation or airflow obstruction.
To enable students to understand the principles which underpin methods of measurement of airflow limitation
To enable students to gain practical experience in the simple methods by which airflow obstruction may be
measured and an appreciation of some of the problems of these measurements
To show that ventilation is stimulated by high alveolar carbon dioxide partial pressures
To show that when high airways resistance is present, ventilation is lower than normal despite a normal
ventilatory drive
Content
The principles of lung volume measurement using standard and electronic spirometers and the measurement of peak
expiratory flow rates will be outlined. Students will be given a demonstration of how to use this equipment and will
have the opportunity to test their own airflow patterns.
One student will be invited to participate, after giving informed consent, in a demonstration of the effect on ventilation
of inhaling a gas mixture with elevated carbon dioxide partial pressure. During this experiment, the effect on
ventilation of an artificial episode of airways obstruction will be demonstrated.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
John Mitrofanis
2009-12-07
Resources
Lung function tests: airflow

obstruction
Lung function tests: airflow

obstruction - 2013
Airflow obstruction
Effects of elevated PCO

and airway obstruction on
ventilation
SEMINAR - Prevention and awareness of asthma

Principal Teacher
Christine Jenkins
christine.jenkins@sydney.edu.au
Learning Objectives
Metadata
Stage: 1
Week: 2
Sequence No.: 2
To acquaint students with:

the importance of preventative measures in the management of asthma

the content and limitations of current preventative strategies
the best means communicating these strategies to the patient and the community.
Reviewed by:
Date Reviewed: N/A
Status: Released
Content
Edit History
Content
Current understanding of the pathophysiology of asthma.
Current evidence for strategies in asthma prevention
Preventative strategies:
primary prevention: late pregnancy and early neonatal measures to reduce asthma and atopy
secondary prevention: early recognition and detection of asthma - especially in children
tertiary prevention: recognition and avoidance of trigger factors, importance of preventative medications,
early recognition and treatment of acute exacerbations, role of patient self management in asthma
prevention, importance of doctor-patient communication in asthma prevention, importance of community
education in asthma prevention
The session will describe the current evidence for the efficacy of strategies in asthma prevention. The practicalities of
asthma prevention in clinical and community settings will then be illustrated through a series of vignettes each
illustrating one or more of the theme session concepts listed above.
Students will be invited, as a group, to read and discuss each of the vignettes and to:
discuss the preventative and management issues raised by each one
suggest possible solutions to the preventative issues raised
A summary of the findings will be presented at the end of the session.
A summary of current preventative guidelines and strategies will be given to students at the end of the session.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2012-11-30
Jayne Seward
2011-08-03
Jayne Seward
2011-01-28
John Mitrofanis
2009-12-07
2013 (2)Lecture
AUDIO
VIDEO
VIEW
Resources
Prevention and awareness

of asthma - 2014
LECTURE - Head and Neck: nose, sinuses, mouth

Principal Teacher
John Mitrofanis
Learning Objectives
Detailed anatomical organisation of the nose, sinuses and mouth; major parts, functions, blood supply and neural
innervartion
Metadata
Stage: 1
Week: 3
PBL/CRS: A nasty cough
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-07-18
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
2014 lecture
LECTURE - Advocacy and lobbying for tobacco control

Principal Teacher
Simon Chapman
simon.chapman@sydney.edu.au
Learning Objectives
Metadata
Stage: 1
Week: 3
Sequence No.: 2
The role and process of public health advocacy in bringing about change in law, regulations, resource allocations and
institutional practices relevant to public health. The key role of mass media in this process

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Advocacy and lobbying for

tobacco control
Advocacy and lobbying for

tobacco control - 2013
LECTURE - Pathophysiology of airways dysfunction in COPD

Principal Teacher
Norbert Berend
norbert.berend@sydney.edu.au
Metadata
Stage: 1
Week: 3
Learning Objectives
Sequence No.: 3
At the end of the lecture students will:
understand the pathology of small airways disease, chronic bronchitis and emphysema
understand the principles of spirometry
understand the reasons for and consequences of loss of elastic recoil in emphysema
appreciate the abnormalities in the lung volume subdivisions and the effects on work of breathing.
understand the concept of flow limitation and its effects on operating lung volumes and exercise limitation
understand the abnormalities of gas transfer in emphysema
Content
To present the underlying physiology of a range of commonly performed lung function tests for the assessment of
COPD and to follow the development of physiological abnormality with disease progression.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
John Mitrofanis
2009-12-07
Pathophysiology of airways
dysfunction in COPD 2014
LECTURE - Evidence for tobacco as a cause of disease

Principal Teacher
Metadata
Stage: 1
Alexandra Barratt
alexandra.barratt@sydney.edu.au

Week: 3
Learning Objectives
Sequence No.: 4
At the end of this teaching session, students should be able to:

Identify diseases for which evidence is sufficient to conclude that smoking causes these diseases
Outline in broad terms the types of epidemiological studies that have been used to investigate the effects of
smoking on the risk of diseases, and limitations of these studies
Explain the principles by which we determine causality
Interpret statistics that are used to quantify the burden of disease from smoking in individuals (Relative Risk,
Attributable Fraction) and in populations (Population Attributable Fraction)
Recordings

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Alicia Kaya
2014-07-01
Alicia Kaya
2014-04-22
John Mitrofanis
2009-12-07
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Evidence for tobacco as a

cause of disease
Evidence for tobacco as a

cause of disease - 2014
LECTURE - Pathophysiology of Interstitial Lung Disease 1

Principal Teacher
Metadata
Stage: 1
Tamera Corte
tamera.corte@sydney.edu.au

Week: 3
Learning Objectives
Sequence No.: 5
The concept of obstructive and restrictive lung disorders. The diagnosis, assessment and monitoring of lung diseases
using lung function tests

Reviewed by:
Date Reviewed: N/A
Content
Aim
To understand the underlying pathophysiology of reduced compliance associated with restrictive lung disease and the
range of common causes of this syndrome
Status: Released
Edit History
#
Created By
Date
Alicia Kaya
2014-04-10
Overview of pathology of restrictive lung disease, including general macroscopic and microscopic features.
Review of responses of the lung to injury causing restrictive lung disease:
responses in acute restrictive lung diseases and common causes (eg Adult respiratory distress syndrome)
responses in chronic restrictive lung diseases and common causes (eg interstitial inflammation with and
without granulomas)
Concepts of lung volumes and lung restriction:
lung compliance
lung-chest wall interactions
pressure volume relationships
surface tension
Abnormalities of gas exchange and gas transfer:
measurement of DLCO
gas transfer in lung disease
mechanisms of hypoxaemia and hypercapnia in restrictive lung disease
Recordings
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Resources
Pathophysiology of
interstitial lung disease 2012
Pathophysiology of
Interstitial Lung Disease
doc.2012
Pathophysiology of
Interstitial Lung Disease 2013
Alicia Kaya
2014-04-01
Jayne Seward
2012-02-28
Jayne Seward
2012-02-28
John Mitrofanis
2009-12-07
LECTURE - Mechanisms of symptomatology in COPD

Metadata
Principal Teacher
Stage: 1
Claude Selim Farah

claude.farah@sydney.edu.au

Week: 3
Learning Objectives
Sequence No.: 6
The major clinical features of chronic obstructive pulmonary disease. The main mechanisms that generate this
condition

Reviewed by:
Date Reviewed: N/A
Content
Status: Released
Edit History
Aim
To understand the mechanisms of breathlessness in patients with COPD
Content
brief overview of definitions/epidemiology of COPD
overview of causes of breathlessness on exertion/ limits to exercise in normals
overview of the different causes of breathlessness in patients with COPD, including impaired lung mechanics,
cardiac disease, deconditioning, peripheral muscle dysfunction etc
brief discussion of treatment options (targeting impaired physiology as described above)
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-04-11
Jayne Seward
2013-04-11
Jayne Seward
2012-02-23
Jayne Seward
2011-08-19
Jayne Seward
2010-11-27
Jayne Seward
2010-06-29
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Mechanisms of
symptomatology in COPD
Mechanisms of
symptomatology in COPD 2014
LECTURE - Uncertainty in Medical Practice

Principal Teacher
Christine Jorm
christine.jorm@sydney.edu.au
Learning Objectives
At the end of this teaching session, students should:
1. Understand the centrality of uncertainty to all medical practice
2. Be aware of the variation in uncertainty tolerance that exists between societies, professions and individuals
Metadata
Stage: 1
Week: 3
Sequence No.: 7
Submitted by: Stacey Darien Gentilcore
Reviewed by:
3. Understand the potential psychological consequences for practitioners of concealing or managing large amounts
of uncertainty
4. Understand what is meant in patient safety systems theory by latent errors
5. Be able to describe the major cognitive errors in diagnostic reasoning and relevant de-biasing strategies
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Uncertainty in Medical
Practice - 2013 - (PDF)
Author
Chapter 6 of
Reconstructing Medical
Practice - C. Jorm (link to
Author
eBook)
Practice (A/Prof Jorm
2012)
Author
Shared Decision Making
Practice (Simon Willcock
2012)
Date Reviewed: N/A

Status: Released
Edit History
#
Created By
Date
2013-07-24
Jayne Seward
2013-02-19
Jayne Seward
2012-03-08
Jayne Seward
2011-11-09
Jayne Seward
2011-10-31
Jayne Seward
2011-03-04
Jayne Seward
2010-12-02
Jayne Seward
2010-11-27
(Barratt)- 2012
Practice - 2014
Author
LECTURE - Pathophysiology of Interstitial Lung Disease 2

Principal Teacher
Metadata
Stage: 1
Tamera Corte

Week: 3
Learning Objectives
Sequence No.: 8
The concept of obstructive and restrictive lung disorders. The diagnosis, assessment and monitoring of lung diseases
using lung function tests

Reviewed by:
Content
Date Reviewed: N/A

Status: Released
Aim
To understand the underlying pathophysiology of reduced compliance associated with restrictive lung disease and the
range of common causes of this syndrome
Overview of pathology of restrictive lung disease, including general macroscopic and microscopic features.
Review of responses of the lung to injury causing restrictive lung disease:
responses in acute restrictive lung diseases and common causes (eg Adult respiratory distress syndrome)
responses in chronic restrictive lung diseases and common causes (eg interstitial inflammation with and
without granulomas)
Concepts of lung volumes and lung restriction:
lung compliance
lung-chest wall interactions
pressure volume relationships
surface tension
Abnormalities of gas exchange and gas transfer:
measurement of DLCO
gas transfer in lung disease
mechanisms of hypoxaemia and hypercapnia in restrictive lung disease
Edit History
#
Created By
Date
Alicia Kaya
2014-04-10
Alicia Kaya
2014-04-01
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
Resources
Pathophysiology of
Interstitial Lung Disease 2
- 2014

Principal Teacher
Claude Selim Farah
claude.farah@sydney.edu.au
Learning Objectives
Metadata
Stage: 1
Week: 3
Sequence No.: 9

Reviewed by:
Recordings
Date Reviewed: N/A

Status: Released
Edit History
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
Created By
Date
13
Alicia Kaya
2014-04-15
12
Jayne Seward
2013-04-04
11
Jayne Seward
2013-04-04
10
Jayne Seward
2013-02-19
Jayne Seward
2012-11-16
Jayne Seward
2012-03-02
Jayne Seward
2011-11-15
Jayne Seward
2011-11-12
Jayne Seward
2011-08-19
Jayne Seward
2010-11-27
Zhigang Jason Xie
2010-10-18
Jayne Seward
2010-07-23
Jayne Seward
2010-07-23
PRACTICAL - Head & Neck: scalp, face, mastication, neck

Principal Teacher
John Mitrofanis
Learning Objectives
Detailed anatomical organisation of the scalp, face and neck;the bones, joints (eg temporomandibular) and muscles
(facial expression, neck and mastication) associated with scalp, face and neck
Resources
Metadata
Stage: 1
Week: 3
Sequence No.: 1
Current Teacher John Mitrofanis
Reviewed by: John Mitrofanis
Status: Released
Edit History
Spot
movie
Created By
Date
Jayne Seward
2013-02-20
John Mitrofanis
2010-11-09
John Mitrofanis
2009-12-07
clinical movie
Practical notes
PRACTICAL - Cancer of the lung

Principal Teacher
Nicholas King
Learning Objectives
TBA
Metadata
Stage: 1
Week: 3
Sequence No.: 2
Reviewed by:
Content
Date Reviewed: N/A

Status: Released
new in 2012 - content to come

Edit History
Resources
Created By
Date
Jayne Seward
2011-10-30
Cancer of the lung - 2012
PBL SESSION - A nasty cough - 3.03 - PBL 1

Learning Objectives
Metadata
Stage: 1

Week: 3
Content

Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Image: Woman coughing into handkerchief.

Joan Donoghue, a 62 year old clerical worker (semi-retired) is brought by ambulance to the Emergency Department
with shortness of breath (unable to walk more than 5m), wheeze and cough productive of yellow sputum for 7 days.
She has a history of hypertension and is a smoker. She usually has a cough productive of a small amount of sputum
most mornings. She has some swollen ankles.
Resources
Medical Humanities
Mechanism
Tutor Guide
Created By
Date
Zhigang Jason Xie
2010-02-09
Results
Student Guide
PT-DR TUTORIAL - Communication Skills - Taking an occupational history

Learning Objectives
Metadata
Stage: 1

Week: 3
To take an occupational history with respect to respiratory illnesses.

To understand the emotional and financial impact of work related diseases on their patients.
To explore the patient's fears, ideas, feelings and expectations regarding an illness that may be related to
occupation.

Sequence No.: 1
Reviewed by:
Content
Aim
To introduce:
The principles of taking a thorough occupational history, with special reference to respiratory disorders.
Some understanding of the emotional reactions experienced by patients with work related disorders.
Some of the medico-legal implications for clinicians in dealing with occupational lung disorders.
Review the between tutorial activity from last week
Discuss important occupational exposures that relate to respiratory illness
Review components of the occupational history (introduced in block 2)
Take an occupational history from any patient with a respiratory illness
Debrief and give feedback on the history
Date Reviewed: N/A

Status: Released
Edit History
#
Created By
Date
Jayne Seward
2012-06-29
Jayne Seward
2012-06-27
Celina Aspinall
2010-09-15
John Mitrofanis
2009-12-07

The occupational history is particularly important in respiratory illness. Occupational dust or other exposure may have
occurred many years before onset of the respiratory condition. Some occupational exposures (e.g. to asbestos) are
well known. It is always worthwhile keeping an open mind regarding a possible occupational component in a disease.
Components of an Occupational History
A complete documentation of all jobs, duration and nature of exposure
Clarification of any work-related technical terms: what did their work involve?
A history of other factors which may contribute towards a possible disease (e.g. smoking, concomitant
medication)
An understanding of potential hazards and the use of control measures (e.g. respiratory protection)
Useful questions include:
What do you/did you work with?
Could you please describe exactly what you do?
What hours do you/did you work?
When did your problem first start?
Describe the physical conditions of your work environment (distance from source of dust and fume
exposures, ventilation, air conditioning)
Has anyone else at work had similar problems?
Do you/did you notice any change in your symptoms at weekends or on holidays?
Have there been any spills or accidents at work recently?
Do you use any protective equipment (mask / gloves / eye shields / earplugs)?
Do you smoke or drink alcohol? (or any other substance use)
Remember the patient may have difficulty in recalling information about jobs many years ago and may find it helpful
to talk to colleagues or his/her spouse to help with details. It may be helpful to suggest that they write down their
work history for review at another visit. Sometimes taking an occupational history can pose challenges to the doctor,
so students should consider the difficulties of obtaining specific information from;
Patients who are convinced before the medical opinion that their disease is due to a particular exposure.
Patients whose disease is due to their work but do not wish to change employment nor inform management, as
they will find difficulty in getting further employment.
Patients who are anxious about potentially toxic exposure
Patients whose symptoms seem disproportionate to the severity of their disease
Patients who do not acknowledge that their symptoms might also be related to some other activity (e.g.
smoking)
Consider how you might best:
Elicit the patient's concerns, anxieties and understanding in the above situations - consider the patient's fears,
ideas, feelings and expectations regarding an illness that may be related to occupation.
Convey information about the exposure, illness etc in a way that the patient will understand and be more
accepting of it.
Verify the presence of occupational asthma if the exposure is ongoing
It is also important to effectively communicate the following information to the patients
Objective facts about effects of occupational exposure
Information about medico legal claims for compensation
The importance of prevention in occupational illness

In NSW the Dust Disease Board under the Workers Compensation (Dust Disease) Act 1942 provides compensation for
occupational lung disease. The diseases covered include; aluminoses, asbestosis, asbestos induced carcinoma,
asbestos-pleural disease, bagassosis, berylliosis, coal workers' pneumoconiosis, farmers' lung, hard metal
pneumoconiosis, mesothelioma, silicosis, silico-tuberculosis and talicosis. Compensation is also available under common
law. Doctors may be requested to provide a written report or attend a court hearing regarding patients whom they
have assessed.
It is important to note that occupational asthma is believed to occur in around 10% adults with asthma either by
initiating asthma or aggravating underlying disease.
Between tutorials
Two students may undertake to interview a patient with respiratory disease. This interview should be presented to the
tutorial group next week.
References
PT-DR TUTORIAL - Physical Exam Skills - Chest examination for signs of respiratory disease
Learning Objectives
Learn
Learn
Learn
Learn
to
to
to
to
recognise normal and abnormal findings on examination of the chest re: percussion and auscultation
detect normal and abnormal airway sounds
recognise signs of reversible airway disease
recognise signs obstructive airway disease
You should become familiar with the following elements of the chest examination:
Inspection of the thorax for scars or deformities
Assessing chest expansion
Percussion of the chest
Assessment of either vocal resonance (or fremitus)
Auscultation of the breath sounds
Metadata
Stage: 1
Week: 3
Sequence No.: 2
Reviewed by:
Date Reviewed: N/A
Status: Released
An adequate examination of the chest includes attention to the anterior chest and axillary regions as well as the
posterior thorax. Recall the surface anatomy of the lungs.
For the auscultatory component of the physical examination, the objective is to learn the characteristics of normal
breath sounds and to gain an introductory understanding of some examples of abnormal breath sounds.
Edit History
#
Created By
Date
Jayne Seward
2012-06-29
Jayne Seward
2012-06-27
Content
Aim
Introduce students to the detection and interpretation of normal and abnormal clinical findings in the examination of
the respiratory system
A brief summary of any significant peripheral signs of respiratory disease
Inspect the chest for scars or deformity
Assess chest expansion
Percuss the chest (side to side, front and back and front)
Auscultate the chest (side to side, back to front, axillae, back) front
Ask patient to cough
Repeat auscultation after patient has coughed
Between Tutorials
Students should practise respiratory examination amongst themselves and each student should arrange to examine a
patient with COPD on the wards either by themselves or with a colleague.
References

Learning Objectives
Metadata
Stage: 1
Week: 3
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Kamal Jaikisan Soni
2010-03-19
PROCEDURAL SKILLS SESSION - Spirometry

Principal Teacher
Metadata
Stage: 1


Week: 3
Learning Objectives
Sequence No.: 2
Clinical indications for spirometry

Revise basic respiratory physiology
Types of curves
Perform spirometry
Understand the limitations and pitfalls in interpretation of spirometry in children
Content
Background
A considerable amount of research has gone into evaluating the relationship between various tests of respiratory
function and respiratory diseases. Spirometry is only one of several tests of respiratory function, but given that it is
cheap and easy to perform, it is considered a good primary test for patients with respiratory symptoms. It is the lung
function test of choice for diagnosing asthma and assessing asthma control, but it is not a gold standard test. The

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Jayne Seward
2013-06-07
Celina Aspinall
2011-10-17
medkey___jaimec
2011-02-03
Celina Aspinall
2011-01-21
Celina Aspinall
2011-01-21
predictive value of spirometry for the diagnosis of asthma depends on many factors such as age, educational level and
pre-test likelihood. The generally accepted values for sensitivity and specificity are 76% and 50% when using
spirometry before and after use of an inhaled bronchodilator.
Content
1.
2.
3.
4.
5.
6.
Clinical indications for spirometry

Revise basic respiratory physiology
Types of curves - flow - volume; time volume
Perform spirometry
Describe limitations and pitfalls in interpretation of spirometry in children
Complete Clinical exercise - Click on the attached to download the resource.
Lung volume subdivisions and other definitions

Tidal volume (TV or Vt) - the volume of gas breathed with each normal breath (in L or ml)
Total lung capacity* (TLC) - the volume of gas in the lungs at the end of a maximal inspiration (in litres, L)
Vital Capacity (VC) - the volume of gas exhaled from maximal inspiration to maximal exhalation; this may be forced
(FVC) or relaxed (in litres, L)
Residual volume (RV) - the gas remaining in the lungs after a maximal expiration (in litres, L)
(this volume of gas cannot be expelled, regardless of the manoeuvre performed)
Functional residual capacity (FRC) - the total volume of gas remaining in the lungs at the end of a tidal exhalation,
equalling the sum of the RV and ERV (in L)
Inspiratory reserve volume (IRV) - the volume of gas that must be inhaled at the end of a tidal inspiration to
reach total lung capacity (in L)
Expiratory reserve volume (ERV) - the volume of gas within the lungs that could still be exhaled after the end of a
tidal exhalation (in L)
Forced expiratory volume in 1 second (FEV1) - the volume of air exhaled in the first second of a forced expiratory
manoeuvre (in L)
Peak expiratory flow rate (PEFR, "peak flow") - the maximal flow rate of exhaled air achieved during a forced
expiratory manoeuvre (L/min or L/sec)
*Note: A "Capacity" is the sum of two or more "Volumes".
Celina Aspinall
2010-09-16
John Mitrofanis
2009-12-07
Figure 1: The lung volumes

Comroe, J.H. et al, (1965). The Lung: Clinical Physiology and Pulmonary Function Tests. 2nd ed. Chicago: Year Book
Medical Publishers
The lung volumes as they appear on a spirogram
Initially, (a) this subject is breathing with a normal tidal volume (TV). At the end of a normal breath out, the subject
takes the largest possible inspiration, demonstrating the inspiratory capacity (IC). The total lung capacity (TLC) is
now reached. The subject now exhales as much as possible, the vital capacity (VC). This manoeuvre leaves the
residual volume (RV) in the lungs. After repeating maximal inspiration and exhalation (ie, breathing at vital capacity),
the subject returns to tidal breathing. The functional residual capacity (FRC) is the volume in the lungs at the end of a
normal breath out, just before the next breath in. The subject takes another maximal inspiration, demonstrating the
inspiratory reserve volume (IRV), and then, after another tidal breath, exhales maximally, demonstrating the
expiratory reserve volume (ERV). The IRV and ERV are both used in exercise, to increase the tidal volume.
The relationship between flow, volume and time
The following figures depict the relationships between lung volumes and flow and lung volumes and time.
Figure 2: The flow-volume curve, which has both inspiratory and expiratory components.
Figure 3: The forced expiratory volume - time curve which is known as spirometry.
Figure 2: Flow-Volume Curve

a) Normal tidal flow-volume loop (see a in Fig 1 also)
b 1) Maximal expiratory flow-volume loop (see b 1 in Fig 1 also)
b 2) Maximal inspiratory flow-volume loop (see b 2 in Fig 1 also)

Note that PEFR (peak expiratory flow rate) occurs very early in the expiratory flow, and represents only one point on
the flow-volume curve).
Spirometry (Forced expiratory volume - time curve)
Figure 3: Normal Spirometry

Expiratory flow (b 1 in fig 2) has been plotted as a volume-time curve.
Note:
Spirometry cannot measure Residual Volume (RV). The zero point commences at Total Lung Capacity (TLC) and
the highest value reflects the lungs at RV.
The Peak Expiratory Flow Rate (PEFR) occurs very early in the forced expiratory manoeuvre. (see Fig 2)
Normal Ranges
Normal values of lung function are based on population samples. For validity, the individual being tested must have
the same characteristics as that population e.g. an Indian migrant to Australia will tend to have relatively smaller lung
volumes when compared with Caucasian normal values, although his lung volumes may be completely normal when
compared with an Indian population sample. Conversely, normal values determined fifty years ago will tend to
overestimate present-day lung volumes, due to the gradual change in population anthropometrics.
The well-recognised differences in lung volume related to height, age, and sex are incorporated into all standard tables
of normal values.
The normal ratio of FEV1 to FVC is 80%.
Abnormal spirometry
Obstructive lung disease is suggested by a reduction in the FVC, and by a disproportionately greater reduction in
the FEV 1 (i.e. the FEV1/ FVC ratio is below 80%), due to the presence of airflow obstruction.
Restrictive lung disease is indicated by a reduction in all lung volumes associated with decreased lung
compliance. The FEV1/FVC ratio is maintained or increased because the decreased lung compliance prevents
dynamic airway closure.
Both Obstructive and Restrictive lung disease have characteristic spirometric and flow-volume curves (see Figures 4
and 5).
Figure 4a: Typical Obstructive Spirometry

Note that full expiration has not yet occurred by six seconds.
Figure 4b: Typical Obstructive Flow - Volume Loop

Note:
Dramatic reduction in the PEFR.
Concave shape of the expiratory curve
Increase in TLC and RV, but decrease in FVC.
Figure 5a: Typical Restrictive Spirometry.

Note that Vital Capacity (VC) is virtually achieved by two seconds.
Figure 5b: Typical Restrictive Flow - Volume Loop.

Note:
Relative preservation of PEFR (cf: Fig 4b)
Reduction in all lung volumes: TLC, RV, FVC.
MEASURING EQUIPMENT
Spirometers
Spirometers may be mechanical (volume-displacement) or electronic (flow-sensing).
Mechanical spirometers include the bell and rolling seal spirometers, both usually found only in the pulmonary function
laboratory, and the wedge bellows spirometer (e.g. the 'Vitalograph'), frequently found on the wards. These machines
depend on the volume of exhaled gas displacing a recording arm which records, on a graph, the expired gas volume
against time.
The standard charts record the gas volume as either:
BTPS (body conditions: body temperature, ambient barometric pressure, saturated with water vapour), or
ATPS ( atmospheric temperature, ambient barometric pressure, saturated with water vapour).
It is assumed that expired gas cools instantaneously to room (atmospheric) temperature as it enters the spirometer,
with associated condensation of water vapour, resulting in the spirometer recording a smaller volume of gas than that
displaced by the lungs.
By convention, the BTPS is always recorded. ATPS is arbitrarily marked as 20C on the common 'Vitalograph'
recording paper, and BTPS volume is calculated accordingly from this. Obviously, the BTPS value is higher (the same
quantity of gas cooled to 20 C would displace less volume).
For general purposes, the derived BTPS value is sufficiently accurate to use (ambient temperature in temperate
Australia is usually close to 20 C). However, for research or epidemiological studies, calculation of the true BTPS
volume, requiring knowledge of the room temperature and barometric pressure, is essential.
Mechanical spirometers have the advantages of being accurate, robust and simple, maintain their calibration for
longer and provide a permanent record of the test; they are disadvantaged by their limited portability and their design
as "collecting bags", which predisposes them to acting as a reservoir for and a source of infection. Thus, the use of
single-use low resistance viral filters is mandatory when patients use this equipment.
Electronic spirometers measure flow by the cooling of a heated wire, or less often, through the rotation of a turbine
blade, or by a pneumotachygraph; this flow signal is then integrated to a volume signal. Thus, they are able to
generate flow-volume curves in addition to standard spirometric values. They are generally smaller and more portable
than mechanical spirometers, and have the advantage of in-built electronic memory, including normal population
values. Additionally, heated flow sensors reduce the error related to cooling and loss of water vapour. At present,
however, they remain less robust and more frequent calibration is required than for mechanical spirometers. It is likely
that the use of electronic spirometers will increase with time, especially as they have less potential as a source of
infection.
Peak-flow meters
Peak-flow meters have evolved from the large and accurate "Wright" peak flow meter to the small, inexpensive,
portable, plastic hand-held "Mini-Wright"style peak flow meters.
Their greatest disadvantage is that they are capable of measuring only the single parameter of peak expiratory flow
rate (i.e. only one data point on the flow volume curve). While not having absolute accuracy, they are reasonably
precise and reproducible. Their greatest utility lies in home self-monitoring, as is necessary in, for example, an asthma
management plan.
PERFORMING BEDSIDE SPIROMETRY - Technique
It is assumed that the machine you will be using has recently been calibrated, and is clean and not a potential source
of infection (one way of confirming calibration is to know one's own STABLE spirometry and to check this with the
machine to be used; obviously, the availability of calibration syringes is preferable).
Due to the chronic nature of their medical conditions, the majority of patients encountered in the hospital setting,
upon whom you will perform spirometry, will have previously performed such testing. This does not necessarily mean
that their technique will be perfect. Thus, for both these patients and patients new to testing, clear instruction on how
to perform the tests and close observation of the testing is paramount for accurate results.
The following instructions apply to the use of a 'Vitalograph' bellows spirometer, but are adaptable for most
spirometers to be encountered in the hospital setting.
1. Setting Up
Wash your hands prior to testing.
Discard used mouthpieces and filters appropriately. Place a fresh filter and unused mouthpiece in the end
of the flexible hose.
Adjust the height of the spirometer to suit the patient.
Preferably the patient should be standing, but in acute illness, seated spirometry will often have to suffice.
Place fresh graph paper in the carriage and return the carriage to the start position, ensuring the pen is at
the zero or 'start' mark indicated on the paper.
The patient's name and Medical Record Number, and the date and time of the test should be recorded on
the graph paper, along with the patient's posture at the time of the test.
The patient's age, height and sex (and racial origin) should be noted for calculation of normal values.
If available, a nasal clip should be placed to occlude the patient's nose; recurrent and inevitable
disappearance of nose clips in the hospital reduces these to "desirable option" status.
2. Inspiration to TLC
First, perform a "dry run" of the entire procedure:
Ask the patient to take as deep a breath as they can.
Advise them that this should NOT be through the mouthpiece, but away from it.
Demonstrate the action of inspiration to TLC to assist your patient's understanding.
3. The Forced Expiratory Manoeuvre

Request the patient to place their mouth around the OUTSIDE of the mouthpiece and to form a tight seal.
Tell the patient to then exhale as forcefully and as long as they can.
Again, mime this action to assist your patient's understanding.
During the actual performance of the forced expiratory manoeuvre, it is traditional to give encouragement
to the patient to ensure they are providing a maximal effort for the entire duration of exhalation.
NOTE: The 'Vitalograph' spirometer is designed to track for 6 seconds; patients with obstructive lung disease may
take well over double this time to completely empty their lungs. Thus, to measure the FVC (and not the FEV6) it is
important to encourage the patient to continue to forcibly exhale beyond the time the carriage has come to rest, if it
is clear that exhalation has not been completed.
4. The Recovery
Patients may develop a range of symptoms while performing spirometry, including dyspnoea, coughing
paroxysms, haemoptysis (coughing up blood), syncope (fainting), or simply light-headedness.
Allow your patient to recover completely before asking them to repeat the manoeuvre (this of course does
NOT apply when haemoptysis or syncope have occurred).
5. Obtaining Satisfactory Results

A minimum of three acceptable tests is required to allow for valid interpretation. The following criteria should be
satisfied before a test is deemed acceptable:
Full inhalation before start of test
Satisfactory start of exhalation - Evidence of maximal effort - No hesitation
No cough or glottal closure during the first second
Satisfactory duration of test - At least 6 seconds, and up to 15 seconds in patients with airflow obstruction
No evidence of leak
No evidence of obstruction of the mouthpiece (by tongue, teeth, dentures etc.)
Results should be reproducible:
For FVC and FEV1, the two largest values should be within 5 % or 0.1 litre (whichever is the larger) of
each other; continue testing until these criteria are met. If criteria are not met after eight trials, stop and
use the best three acceptable tests.
6. Measuring Results and Interpretation
Select from tests of acceptable quality
Select the largest values for FVC and FEV 1 , regardless of the test used
Calculate the following ratios, expressing them as a percentage or as a percentage of the predicted value.
FEV1/FVC
Measured FEV1/Predicted FEV1
Measured FVC/Predicted FVC
From your knowledge of the patient's clinical condition, and the results of these tests, you can then
propose a diagnosis, or move on to the next appropriate test to assist you to reach the diagnosis.
SPIROMETRY - Trouble-Shooting
Most problems will arise from patients not understanding or not following instructions, especially with submaximal
effort at the start of a test, or glottic closure during a test. Be patient and repeat your instructions. The importance of
a demonstration of the required technique cannot be overstated.
With bellows type spirometers, a leak in the system will result in a progressive loss of volume with time. Should this be
noted, ensure that the patient is making a seal around the mouthpiece. If this is satisfactory, the most likely source of
the leak is from a small perforation in the flexible tubing. Identify the leak, discard the tubing and replace it.
If there is a major discrepancy between percent predicted FEV 1 and FVC, check that you have read both results from
the same graph scale (ATPS or BTPS)
When you have completed testing, discard the mouthpiece and filter, and return the spirometer to its home ready for
the next user.
Measurement of the Peak Expiratory Flow Rate
For the peak flow manoeuvre, the patient is requested to blow out as hard as they can (the duration of testing is not
important).
No graphic output is made by portable peak flow meters. Therefore, quality assurance of measurement requires close
observation of the technique.

1. Setting up
If the patient is to be tested on a common departmental peak flow meter, set up as for spirometry with
handwashing and the use of a fresh filter and mouthpiece.
A nose clip is again desirable.
2. Inspiration to TLC
Ask the patient to breathe in to TLC.
A demonstration will be helpful.
3. The Peak-flow manoeuvre
Ask the patient to place their lips around the outside of the mouthpiece before giving a short sharp huff or
blow.
Again, a miming demonstration will be helpful for your patients' understanding.
4. Obtaining satisfactory results
Care should be taken about the following:
The patient should hold the peak flow meter horizontal and stationary throughout the test
The patient should NOT contribute to the expiratory effort by using the tongue or cough to initiate an
expulsive breath, nor contribute to the flow by using the buccal musculature.
5. Results and interpretation
Three satisfactory tests are again required:
The two largest values should be within 5% or 0.5 litres per second of each other. The largest value
should be recorded, and calculated as a percentage of the predicted value found from tables.
Compare with the patient's best known PEFR from their home monitoring.
Preparing the spirometer

1. Ensure that the spirometer is plugged into a power point
2. Turn the spirometer's power on
3. Load the paper face upwards into the carriage guides and position it
4. Adjust the stylus so that the point is positioned on the start point of the paper
5. Attach a one way valve mouth piece to the breathing hose, with the blue valve towards the patient
6. For dynamic testing turn the rocker switch on
Guiding a patient in the use of a spirometer

Demonstrate the desired inspiration and expiration technique
1. Ask the patient to sit erect
2. Explain to the patient each stage: I'd like you to
open your mouth wide and suck in the biggest breath you can
put the mouth piece well into your mouth past your teeth
blow as fast as you can for as long as you can
3. Talk the patient through the inspiration and expiration stages
4. Repeat the test three times
References
Transplantation Society of Australia and New Zealand (TSANZ) Respiratory Function Tests and Their Application
National Asthma Council of Australia - Spirometry Handbook
National Asthma Council of Australia Asthma Management Handbook
National Asthma Council of Australia Managing Asthma Resources
Sydney Childrens Hospital Network Factsheets
Revised in 2013 by the Procedural Skills Committee

SEMINAR - Globalisation and Public Health: One world, one health

Principal Teacher
Metadata
Stage: 1
Kimberley Dale Ivory

kimberley.ivory@sydney.edu.au

Week: 3
Learning Objectives
Aims and Objectives: One World, One Health
Increasing global interconnectedness is challenging our established models and understanding of disease burdens, risks
and controls. Public health is inextricably linked to and informed by the political, cultural and social milieu of the time.
Will our responses to the next anticipated pandemic really be so different as they were to plague or HIV/AIDS? How
does public health negotiate a world in which chronic disease is more threatening than contagion? Can we achieve a
more nuanced response to global health that appreciates health risks in all countries have global causes and
consequences?
This session will be presented by four experts in the field of global health:
Prof Tim Driscoll - Professor, Epidemiology and Occupational Medicine, Sydney School of Public Health
Assoc Prof Ben Marais, Deputy Director, Marie Bashir Institute for Infections Diseases and Biosecurity Institute
(MBI)
Dr Siobhan Mor - Lecturer in Food Security, Faculty of Veterinary Science
Assoc Prof Robyn McConchie - Head of Department, Plant and Food Sciences, Faculty of Agriculture and
Environment
The key questions we will consider in this session are:
What is globalisation?
What is the concept behind 'One Health"
How has globalisation impacted public health practice locally and internationally?
How well are local and international policies and services keeping up?
What are the emerging challenges and opportunities facing public health in an increasingly interconnected world?
What part do future medical practitioners play in addressing those challenges and opportunities?
Recommended Pre-Reading:
Zinsstag, J., Schelling, E., Waltner-Toews, D., & Tanner, M. (2011). From one medicine to one health and systemic
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
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Alicia Kaya
2014-05-09
Jayne Seward
2013-05-09
approaches to health and well-being. Preventive Veterinary Medicine, 101(34), 148-156. doi:
http://dx.doi.org/10.1016/j.prevetmed.2010.07.003
Learning Objectives
By the end of this session, students will be able to
Define globalisation
Define One Health
Demonstrate an understanding of how globalisation impacts on public health by:
Giving examples of how and why the burden of both communicable and non-communicable disease has
changed due to globalisation
Describing public health responses to the changes in the burden of disease
Describing national and international politics and policies that have influence the burden of disease for
better or worse.
Comment on the role of future health practitioners in the control of global disease.
This session will be examinable in the 2013 Stage 1 RSA and the 2014 Stage 2 KFQ exams.
Recordings
2014Lecture
AUDIO
VIDEO
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Resources
Globalisation and Public

Health: Siobhan Mor 2014

Health: Ben Marais 2014

Health: Robyn McConchie
2014

Health: Tim Driscoll 2014
SEMINAR - Honesty in Medical Practice

Principal Teacher
Metadata
Stage: 1
Ian Bruce Marshall

ian.marshall@sydney.edu.au

Week: 3
Christine Jorm
christine.jorm@sydney.edu.au
Sequence No.: 2
Stewart Dunn
stewart.dunn@sydney.edu.au

Reviewed by:
Learning Objectives
Date Reviewed: N/A

Status: Released
By the end of this teaching session, students will:

Be aware of the different types of certificates
Have an understanding of the principles underlying medical certification
Be able to discuss doctor, patient and societal issues regarding certification
Understand why speaking up for safety is hard and why it matters
Know what is meant by whistle blowing
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Created By
Date
Alicia Kaya
2014-03-18
Jayne Seward
2013-12-08
Jayne Seward
2013-11-12
Jayne Seward
2013-04-05
Jayne Seward
2013-04-04
2012-06-18
Content
Jayne Seward
2011-06-02
This seminar consists of 4 presentations:
Jayne Seward
2010-12-02
Jayne Seward
2010-11-27
Articulate the main dimensions of incident disclosure policy

Identify the priorities of patients harmed by incidents and of their relatives
Discuss the main strategies central to effective incident disclosure communication
1. "Medical Certification" (A/Prof Ian Marshall - Director, University Health Service)

2. "Being Open about Clinical Incidents" (Professor Rick Iedema)
3. "Learning Styles and Open Disclosure" (Professor Stewart Dunn)
4. "Failures of the Medical Profession to Speak up for Safety" (A/Prof Christine Jorm)
Bonus Open Disclosure Workshops

On Thursday July 17th, 2014, Professor Stewart Dunn will be facilitating "Open Disclosure" workshops. These
workshops will offer students a unique opportunity to role play with an actor to explore and develop communication
skills around honesty and open disclosure. Attendance is optional.
Location: New Law School Learning Studio 030, New Law Annexe.
There will be three sessions offered, scheduled to dovetail with your lab sessions and PBLs:
Session 1 - 8:30am-10am (for PBL groups 11-21)
Session 2 - 11:15am-12:30pm (for PBL groups 22-31)
Session 3 - 1:00pm-2:30pm (for PBL groups 1-10)
Please Note: In 2013 'Failures of the Medical Profession to Speak up for Safety" will not be delivered live. Cohort 2013 students
are advised to watch the 2012 Echo360 recording of this seminar from 53 minutes to 1 hour 32 minutes.
Written/Prepared By:Stacey Gentilcore
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
2013 (2)Lecture
AUDIO
VIDEO
VIEW
Resources
Honesty in Medical Practice

, Prof Marshall - 2013
Honesty in Medical
Practice, Rick Iedema 2013
Honesty in Medical Practice

- Certificates - 2012
Author
Failures of the Medical

Profession to Speak Up for
Safety - 2012
Author
ASSESSMENT - Finding Relevant Information in Health and Medical Databases Workshop

Metadata
Principal Teacher
Stage: 1
Monica Christina Cooper

monica.cooper@sydney.edu.au

Week: 3
Learning Objectives
Sequence No.: 1
Submitted by: Stacey Darien Gentilcore
The Finding relevant information in health and medical databases workshop is designed to teach students the skills
required to search medical databases.

Reviewed by:
At the end of this session you will be able to:
Date Reviewed: N/A
Understand how medical literature is indexed and how a medical database is organised to help you search more
proficiently and expertly
Find scholarly information quickly and efficiently using some of the major medical databases
Content
ASSESSMENT TYPE: Required Formative
All Stage 1 students are required to attend this 1 hour face-to-face workshop. The workshops will be run over a period
of four weeks - 3.03-3.06 inclusive.
The Workshop Schedule (dates, times and locations) will be added below in the 'Resources' section when it is finalised.
Students will also be able to see the details of workshop they have been allocated in their personal timetable. If
Status: Released
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2014-01-09
2014-01-09
students would like to swap to a different workshop you will need to contact Monica Cooper to request a swap. If
students do not contact Monica to request a swap they will be expected at the session they are allocated to as per the
schedule.
Students are required to ensure their attendance is recorded at the workshop.
After the workshops have all be taught a workbook will be made available to students in the 'Resources' section below.
Written/Prepared By:Stacey Gentilcore
LECTURE - Head and Neck: pharynx, larynx

Metadata
Principal Teacher
Stage: 1
John Mitrofanis

Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 1
Detailed anatomical organisation (cartilages, ligaments and muscle) and function (swallowing and phonation) of the
pharynx and larynx; their blood supply and neural innervations.

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
Resources
VIDEO
VIEW
Created By
Date
Alicia Kaya
2014-04-29
Jayne Seward
2013-07-18
John Mitrofanis
2009-12-07
2014 lecture
LECTURE - Smoking and anaesthetic risk

Metadata
Principal Teacher
Stage: 1
Peter Kam
peter.kam@sydney.edu.au

Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 2
The factors that make tobacco a major identifiable risk factor relating to surgery and the perioperative period

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
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2014 (2)Lecture
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2012Lecture
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Date
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Smoking and anaesthetic

risk
Smoking and anaesthetic

risk - 2014
REVIEW: Predicting
postoperative pulmonary
complications: implications
for outcomes and costs
LECTURE - Smoking related lung disease and smoking cessation

Principal Teacher
Matthew John Peters
matthew.peters@sydney.edu.au
Learning Objectives
Understand the spectrum of smoking-related lung disease
Describe the key behavioural elements that contribute to dependence on tobacco
Comprehend basic pharmacology of nicotine as it relates to dependence and of the treatments used for smoking
cessation
Metadata
Stage: 1
Week: 4
PBL/CRS: Ex-Navy
Sequence No.: 3
Reviewed by:
Date Reviewed: N/A
Explain the complementary nature of behavioural interventions that aid smoking cessation
Discuss at a basic level issues related to e-cigarette use
Edit History
Content
In developed countries smoking causes more avoidable health harms than any other factor. Lung disease is the major
cause of smoking related death and disability.
After this lecture the student will be expected to better understand:
The recent history of tobacco use
The nature of nicotine dependence
Why tobacco smoking causes lung disease
Behavioural strategies to address smoking
The pharmacology of smoking cessation treatments
Recordings
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
2012Lecture
AUDIO
Status: Released
VIDEO
VIEW
Resources
VIDEO
VIEW
Created By
Date
Alicia Kaya
2014-04-10
Jayne Seward
2011-08-19
Jayne Seward
2011-07-26
Alicia Kaya
2011-07-25
Jayne Seward
2011-07-20
Jayne Seward
2011-07-20
Jayne Seward
2011-04-01
Jayne Seward
2010-11-27
Smoking related lung

disease and smoking
cessation - 2014
LECTURE - Respiratory acid-base disorders

Principal Teacher
Metadata
Stage: 1
Iven Young
iyoung@mail.usyd.edu.au

Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 4
The lung's role as a rapid regulator of arterial blood pH, through the control of the partial pressure of carbon dioxide in
the arterial blood; how this is disturbed by disease

Reviewed by: Iven Young
Content
Aim
Acid - base homeostasis is a fundamental requirement for cellular function. In particular, the pH (-log 10 [H + ]) of
the arterial blood is regulated to a narrow range by the normal functioning of the lungs and the kidneys. This lecture
will concentrate on the lung's role as a rapid regulator of arterial blood pH through the control of the partial pressure
of carbon dioxide in the arterial blood (PaCO 2 ), and how this is disturbed by disease.
Content
Definitions and measurement:
pH - difficulties related to the use of this non-linear index
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2011-04-01
John Mitrofanis
2009-12-07
PaCO 2
Base excess
Bicarbonate ion concentration
Henderson-Hasselbach Equation
PaO 2 (oxygen partial pressure) and its smaller effect on acid-base balance
Normal ranges and major disturbances:
Respiratory acidosis and its causes
Respiratory alkalosis and its causes
Metabolic acidosis and respiratory compensation
Metabolic alkalosis and the usual lack of respiratory compensation
The influence of lung disease through causing ventilation-perfusion (VA/Q) inequality
Interpretation of arterial blood gas measurements:
Practical scheme for interpreting pH, PaCO 2 and base excess
Examples of common (and not so common) clinical disorders
Recordings
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
2012Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Respiratory acid - base

disorders - 2014
LECTURE - Case Conference - Clinical Grand Rounds

Principal Teacher
Metadata
Stage: 1
Matthew John Peters

matthew.peters@sydney.edu.au

Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 5
TBA

Reviewed by:
Content
Date Reviewed: N/A

Status: Released
Aim
This session explores a case of a patient with lung disease. The case is used to highlight key aspects of lung structure
and function
Recordings
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Jayne Seward
2010-12-16
Jayne Seward
2010-11-27
2011Lecture
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VIDEO
VIEW
2014Lecture
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VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Resources
Case conference - Clinical

Grand Rounds - 2010
LECTURE - Biochemical consequences of Oxygen Deficit and Excess

Principal Teacher
Arthur Conigrave
arthur.conigrave@sydney.edu.au
Learning Objectives
TBA - new in 2012
Metadata
Stage: 1
Week: 4
PBL/CRS: Ex-Navy
Sequence No.: 6
Content
Reviewed by:
Date Reviewed: N/A

Status: Released
To come.
Edit History
Recordings
2013 recording starts at

7min 30sec.
2014Lecture
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VIDEO
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Date
Jayne Seward
2012-03-13
Jayne Seward
2011-11-07
Jayne Seward
2011-09-09
Jayne Seward
2011-08-25
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Biochemical consequences
of Oxygen Deficit and
Excess - 2014
LECTURE - Communicating certainty and uncertainty to patients

Principal Teacher
Alexandra Barratt
alexandra.barratt@sydney.edu.au
Metadata
Stage: 1
Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 7
At the end of this teaching session, students should:
Current Teacher Heather Shepherd
Be able to describe the features of shared decision making

Be able to describe some major issues in communicating with patients about complex evidence and how decision aids
can assist

Reviewed by:
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Status: Released
Recordings
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Communicating certainty
and uncertainty to patients
- 2014

Created By
Date
Alicia Kaya
2014-04-10
Jayne Seward
2013-07-17
Jayne Seward
2013-07-11
Jayne Seward
2013-07-11
Jayne Seward
2013-02-20
Jayne Seward
2013-02-19
Metadata
Principal Teacher
Stage: 1
Tamera Corte

Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 8

Reviewed by:
Recordings
Date Reviewed: N/A

Status: Released
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2012 (2)Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Created By
Date
11
Alicia Kaya
2014-04-15
10
Alicia Kaya
2014-04-01
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2012-11-16
Jayne Seward
2012-07-27
Jayne Seward
2012-07-24
Jayne Seward
2012-07-24
Jayne Seward
2011-08-25
Jayne Seward
2010-11-27
Jayne Seward
2010-07-23
Meet the Experts 3.04

mp3
PRACTICAL - Head & Neck: nose, sinuses, mouth

Metadata
Principal Teacher
Stage: 1
John Mitrofanis

Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 1
Detailed anatomical organisation of the nose, sinuses and mouth; major parts, functions, blood supply and neural
innervartion

Resources

Status: Released
Edit History
test
movie
clinical movie
Created By
Date
Jayne Seward
2013-02-20
John Mitrofanis
2010-11-09
John Mitrofanis
2009-12-07
Practical notes
Additional notes
PRACTICAL - Pathological lungs

Principal Teacher
Metadata
Stage: 1
Nicholas King

Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 2
The pathological appearance of chronic inflammatory response in the interstitium associated with extrinsic irritation,
using the lung as a prime example

Reviewed by:
Date Reviewed: N/A
Content
Edit History
Aim
To understand the pathological appearance of the chronic inflammatory response in the interstitium associated
with extrinsic irritation, by examining two classic examples.
To assist students understand the ultrastructure and function of the components of the alveoli and the blood-air
barrier.
To assist students understand lung growth and age changes.
Content
A
Status: Released
Lung - Silicosis - Macro

Lung - Silicosis - Close-up of Silicotic Nodules
Created By
Date
Jayne Seward
2011-10-30
John Mitrofanis
2009-12-07
Lung - Asbestosis (micro)

Asbestos Bodies (H&E)
B
The blood-air barrier: type I alveolar epithelial cell, endothelial cell of the capillary, and their shared basal
lamina.
The type II alveolar epithelial cell and surfactant.
Alveolar pores (of Kohn).
Alveolar macrophages (dust cells)
Cells and fibres of the interalveolar interstitium.
Lack of smooth muscle cells, presence of myofibroblasts.
Method
A
To be undertaken in pathology practical rooms using projected slides of macroscopic specimens and viewed
glass slide under a microscope.
As this topic is covered well by textbooks, students will refer to texts for the ultrastructure and function of the
alveolus.
Students will refer to the texts and pathological specimens and discuss the important points relating structure to
function in the lung with particular reference to breathlessness and interstitial lung disease.
Resources
Normal and pathological

lungs
Occupational lung disease

- 2012
Restrictive lung disease 2012
PBL SESSION - Ex-Navy - 3.04 - PBL 1

Learning Objectives
Metadata
Stage: 1

Week: 4
PBL/CRS: Ex-Navy
Content
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Image: A thin man in his fifties, puffing while climbing a flight of stairs.
Ronald James, aged 56, is an ex-navy seaman, who has been referred by his GP to a respiratory physician. He is a
smoker and has a four-year history of increasing breathlessness and cyanosis on exertion. For the past two years he
has noticed a persistent cough sometimes productive of small amounts of greyish-white sputum in the mornings. He
has had vague chest pains which are not connected with breathing or exertion.
Created By
Date
Zhigang Jason Xie
2010-02-09
Resources
Medical Humanities
Mechanism
Tutor Guide
Results
Student Guide
PT-DR TUTORIAL - Communication Skills - Sleep-disordered breathing: including obstructive sleep apnea
Learning Objectives
To elicit a history of symptoms of obstructive sleep apnoea
To elicit a history of sleepiness.
To elicit a history of sleep habits.
Metadata
Stage: 1
Week: 4
PBL/CRS: Ex-Navy
Sequence No.: 1

Content
Reviewed by:
Date Reviewed: N/A
Aim
To learn the principles of taking a sleep history, with special reference to obstructive sleep apnoea and sleepiness
To introduce the features of sleep-disordered breathing
To learn about obstructive sleep apnoea
Discuss common causes of sleepiness in the community. While sleep apnoea is a common medical disorder, the
most common cause of sleepiness in the general population arises from lack of sleep from social and other
demands.
Discuss features of sleep disordered breathing, including hypoventilation syndromes (chest wall dysfunction,
neuromuscular disorders).
Discuss symptoms of obstructive sleep apnoea
Discuss risk factors for obstructive sleep apnoea including obesity, male gender, age and anatomical factors such
as enlarged tonsils, short thick neck and small hypopharynx.
Interview a patient at risk of sleep apnoea (or other sleep disorder).
Present and review history in the group
If the hospital has a sleep laboratory, you may be able to access patients through it, and observe the use of
CPAP/assisted ventilation. A suitable patient might report a history of snoring, poor sleep, daytime sleepiness, or
may have obesity or diagnosed sleep apnoea.
Sleep apnoea symptoms
History from partner of snoring and breathing stops
Poor sleep quality
Nocturnal choking, gasping
Nocturia
Morning headache
Daytime sleepiness (see below)
Difficulties with memory and concentration
Ask about history of coexistent conditions such as hypertension, weight gain, cardiovascular disease,
diabetes mellitus or hyperlipidaemia.
Ask about whether sleep study has been done, and whether there has been treatment for sleep apnoea
(weight loss, CPAP, mandibular splints, surgery), and how well the treatments have been tolerated.
Sleep patterns
Ask about the usual times that the patient gets to bed, and the time they rise in the morning.
How long does it take to fall asleep?
What is the quality of their sleep? Do they feel they are waking often? Is it difficult to fall asleep again
after waking up in the middle of the night?
Do they do any shiftwork?
Symptoms of sleepiness
Ask about the situations in which the patient might have trouble staying awake during the day. It may
Status: Released
Edit History
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Created By
Date
Jayne Seward
2012-06-29
Jayne Seward
2012-06-27
Celina Aspinall
2010-09-15
John Mitrofanis
2009-12-07
help to prompt them about a variety of situations, such as meetings at work, sitting to watch television in
the evening, talking on the telephone or driving. How intrusive or troublesome is sleepiness to the
patient?
Ask specifically about sleepiness while driving, and then if they have had previous motor vehicle accidents
or near misses due to sleepiness.
The Epworth Sleepiness Scale is a commonly used questionnaire enquiring about sleepiness in terms of
likelihood of falling asleep in a variety of situations.
Patients with sleep apnoea may also report difficulties with memory and concentration during the day. This
may be due to the sleepiness they experience, but also a direct effect of hypoxia on the brain.
Sleepiness may arise from sleep disorders such as obstructive sleep apnoea and narcolepsy, however in the general
population sleepiness most commonly arises from lack of sleep owing to social or other demands. It is important to
enquire about the patients sleeping hours, and whether there may be other contributing factors such as medications,
alcohol or shift-work. Insomnia is the most common sleep disorder seen in general practice. Patients with insomnia
often report a feeling of tiredness or fatigue (in the sense of a lack of energy) rather than sleepiness (difficulties
staying awake).
Obesity is an important risk factor for obstructive sleep apnoea. If relevant enquire as to history of weight gain and
any complications of obesity. Also ask about excessive alcohol intake, especially in the evenings.
Epworth Sleepiness Scale (Johns MW. Sleep 1991; 14(6): 540-545.)
How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to
your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how
they would have affected you. Use the following scale to choose the most appropriate number for each situation:
0
1
2
3
=
=
=
=
would never doze

slight chance of dozing
moderate chance of dozing
high chance of dozing
Situations
Sitting and reading
Watching TV
Sitting, inactive in a public place (e.g. a theatre or a meeting)
As a passenger in a car for an hour without break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in traffic
Between tutorials
If the hospital has a sleep laboratory, two students may undertake to interview a patient with obstructive sleep apnoea
References
Kales, A., Soldatos, C. R., & Kales, J. D. (1980). Taking a sleep history. Am Fam Physician, 22(2), 101-107.
PT-DR TUTORIAL - Physical Exam Skills - Examination of a patient with COPD (Chronic obstructive pulmonary disease)
Learning Objectives
Metadata
Stage: 1
Learn to recognise signs of COPD

Learn to assess severity of disease with COPD (including signs of respiratory failure)

Week: 4
PBL/CRS: Ex-Navy
Sequence No.: 2
Content

Aim
Introduce students to the examination of a patient who is breathless and the assessment of respiratory function.
In this tutorial you should practise the systematic examination of the respiratory system. Particular attention should be
paid to:
1. General appearance of the patient
2. Respiratory rate, use of accessory muscles of respiration, positioning and other patient strategies to alleviate
their breathlessness
3. Obesity, cachexia or muscle wasting
4. Nicotine staining of the fingers
5. Use of supplemental oxygen
6. Presence of cyanosis and asterixis
7. Hyperinflation of the chest
8. Quality of the percussion note
9. Quality of the breath sounds
10. Presence or absence of wheeze
Peripheral oedema or signs of pulmonary hypertension may accompany severe COPD.
Patients with COPD frequently do not appear breathless at rest when stable, but readily become breathless with minor
exertion such as undressing or walking short distances.
Additional clinical findings sometimes seen in patients with COPD include:
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Jayne Seward
2013-05-24
Jayne Seward
2012-06-29
Jayne Seward
2012-06-27
1. Signs of treatment side effects eg tremor (beta-2 agonists), bruising (Inhaled or oral corticosteroids)
2. Evidence of co-morbidities, especially heart failure
3. Systemic manifestations of COPD such as low BMI, muscle wasting, osteoporosis (eg thoracic kyphosis may be
due to wedge compression fractures)
Between Tutorials
Students should practise respiratory examination on each other and each student should arrange to examine a patient
with COPD on the wards.
References
ALF website for COPD X http://www.copdx.org.au/

Learning Objectives
Metadata
Stage: 1

Week: 4
PBL/CRS: Ex-Navy
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Created By
Date
Kamal Jaikisan Soni
2010-03-19
PROCEDURAL SKILLS SESSION - Ear, Nose and Throat examination

Principal Teacher
Metadata
Stage: 1


Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Positioning
Performing
Be familiar
Be familiar
Sequence No.: 2
children for ENT examination

otoscopy and pneumatic otoscopy
with tympanogram types (A, B or C)
with Rinne and Weber tests
Content
Background
Middle ear examination is an important component of the examination of any child. Nearly every child will experience
middle ear disease particularly in the pre-school age years. Young children are reluctant to have their ears examined
and it is important to ensure the child is comfortable and not scared and that they are positioned correctly to minimize
movement. The tympanic membrane must be assessed by otoscopy to look for any signs of redness, bulge or
opacity. Pneumatic otoscopy or tympanometry are required to accurately diagnose middle ear effusions as otoscopy
alone often misses middle ear effusions. Children with middle ear effusions may have acute otitis media or otitis media
with effusion (glue ear). A complete view of the tympanic membrane is required to exclude a tympanic membrane
perforation.
Content
1. Positioning children for ENT examination
Legs and arms immobilized by one of the parent/carers arms
Head immobilized by parent/carers other arm
Try not to upset or scare the child
2. Performing otoscopy and pneumatic otoscopy
Ensuring adequate vision of entire tympanic membrane
Looking for perforations and discharge
3. Be familiar with tympanogram types (A, B or C)
What is normal (Type A: peaked), abnormal (Type B: flat) and equivocal (other types, which may indicate
Eustachian tube dysfunction)
4. Be familiar with performing the Rinne and Weber tests- place a tuning fork over the mastoid until the patient
cannot hear the sound and then place next to external auditory canal to ensure the patients air conduction
exceeds bone conduction (normal Rinne). Then place the tuning fork in the midline to ensure the patient hears

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Jayne Seward
2013-06-07
Celina Aspinall
2011-10-17
medkey___jaimec
2011-02-03
Celina Aspinall
2011-01-22
the sound in the midline (normal Weber).
Resources
Ear Nose and Throat Video

clips
References
Takata GS, Chan LS, Morphew T, Manqione-Smith R, Morton SC, Shekelle P. Evidence assessment of the accuracy of
methods of diagnosing middle ear effusion in children with otitis media with effusion. Pediatrics. 2003; 112(6pt1):
1379-87.
Author: Revised in 2013 by the Procedural Skills Committee
SEMINAR - Lung function tests: restrictive lung disease

Principal Teacher
Rebecca Sara Mason
Metadata
Stage: 1
rebecca.mason@sydney.edu.au
Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 1
The principles that underlie a number of lung function tests, including lung volumes (VC, TLC, FRC and RV) and
diffusion capacity (DLCO)

Reviewed by:
Date Reviewed: N/A
Content
Status: Released
Edit History
Aim
To measure how ventilation affects alveolar gas composition.
To outline the principles which underly a number of lung function tests including residual volume and diffusing
capacity.
To practise the interpretation of lung function test results.
Content
With 1 volunteer, the effects of hyperventilation and breath holding on partial pressures of O2 and CO2 in alveolar gas
will be measured. The clinical significance of these effects will be examined using video and interactive questions.
Using interactive discussion, the principles and practice of lung function tests including residual volume and diffusing
capacity will be examined. Effects of restrictive disease on spirometry will be examined.
Interpretation of lung function test results will be discussed and then put into practice in the interpretation of a
number of real lung function reports.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
Resources
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
John Mitrofanis
2009-12-07
Lung function tests:

restrictive lung disease 2014
Author
Lung function tests:

restrictive lung disease results 2014
SEMINAR - Lung Disease Resulting from Occupational Exposures

Principal Teacher
Metadata
Stage: 1
Tim Driscoll
tim.driscoll@sydney.edu.au

Week: 4
PBL/CRS: Ex-Navy
Learning Objectives
Sequence No.: 2
TBA

Reviewed by:
Content
Date Reviewed: N/A

Status: Released
Aim
The aim of the session is to indicate the past and present uses of asbestos in Australia, the history of control
strategies, the occupations and industries in which asbestos exposure was common in the past, and possible sources
of current exposure. Areas of possible environmental exposure will also be described.
Edit History
#
Created By
Date
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2011-05-03
The student should thus be able to recognize the possibility of asbestos related disease from the history, diagnose
asbestos related disease, suggest management and deal with medico legal issues arising.
Jayne Seward
2011-04-29
Jayne Seward
2010-10-28
Content
Jayne Seward
2010-10-28
The world wide asbestos disease problem of the 20th century will be put in context and factors affecting delay in
recognition and control discussed. Issues of compensation, both statutory and common law will be addressed.
Types of asbestos and history of use in Australia

Fibre characteristics and deposition and clearance dynamics for chrysotile, crocidolite and amosite
Quantification of fibres in air and tissue
History of recognition of asbestos related disease.
Compensation for asbestosis, mesothelioma and lung cancer related to asbestos
Control measures - from regulated "safe" exposure levels to total ban on use in Europe, North America and
Australia. Current use in developing countries
Current therapy and supportive management, counselling, psychological support, medico legal issues
Recordings
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
History of asbestos in
Australia
Lung disease resulting

from occupational
VIDEO
VIEW
exposures - 2014
References
References
Leigh J. Driscoll, T. "Malignant Mesothelioma in Australia 1945-2002" Int J Occ Env Health 2003 9(3):206-217.
Henderson, D.W., etal. "The diagnosis and attribution of asbestos-related diseases in an Australian context: Report of
the Adelaide Workshop on Asbestos-related Diseases. October 6-7, 2000." Int J Occ Env Health 2004 10(1): 40-46.
Leigh, James. Malignant mesothelioma in Australia, 1945-2000 - Source: American Journal of Industrial Medicine, 2002
41(3): 188- 201.
Adelaide Workshop on Asbestos Related Diseases. The diagnosis and attribution of asbestos-related diseases in an
Australian context. J Occupational Health and Safety (ANZ) 2002 ; 18(5):443-452.
Leigh, J, Robinson BWS. History of Mesothelioma in Australia 1945-2000" In: Mesothelioma (Robinson BWS, Chahinian
P eds ) London,Martin Dunitz (2002).pp 55-86.
Leigh, J. Editorial. Occupational disease and injury:legal constructs. J Occupational Health and Safety (ANZ) 2002 ;
18(5):395-397.
National Occupational Health & Safety Commission (NOHS) Publication. The Incidence of Mesothelioma in Australia Australian Mesothelioma Register Report Series
Hills B. The James Hardie story: Asbestos Victims' Claims Evaded by Manufacturer. Int J Occ Env Health 2005;
11(2):212-214.
LaDou J . The asbestos cancer epidemic. Env Health Persp. 2004, 112(3):285-290.
Special Issue. Int J Occ Env Health 2003 vol 9 no 3. The Asbestos War. Table of Contents
Leigh J " Long-Latency Disease: The Long-Lasting Epidemics" In: Peterson C, Mayhew C (eds) Occupational health and
safety : International influences and the 'new' epidemics. Amityville, Baywood (2005) pp 75-96.
Henderson, D. etal., "After Helsinki: a multidisciplinary review of the relationship between asbestos exposure and lung
cancer,with emphasis on studies published during 1997-2004." Pathology 36(6): 517-550 (2004).
Leigh J., "Mesothelioma" In:Levy B,Wagner G,Rest K,Weeks J,(eds) Preventing Occupational Diseases and Injury 2nd
ed. Washington DC,American Public Health Association (2005) pp 340-344
Journal of Occupational Health and Safety ANZ
Special Issue: Asbestos: A continuing tragedy in the 21st century. Vol 22(5) October 2006 p387-496.
J.Leigh, D.Henderson. The epidemiology of malignant mesothelioma. J OHS (ANZ) 22(5):441-447 (2006)
J.Leigh, D.Henderson. Lung cancer related to asbestos exposure:causation and compensation . J OHS (ANZ) 22(5):449462(2006)
White, S. Legacy of asbestos : a continuing tragedy in the 21st century (editorial). J OHS (ANZ) 22(5): 387-396
(2006)
Leigh J. History of occupational disease recognition and control , J OHS (ANZ) 23: 519-530 (2007)
D Henderson, J Leigh. Asbestos and Carcinoma of the Lung and Larynx Chapter 6 in Asbestos: Risk
Assessment, Epidemiology, and Health Effects, 2nd Edition ( ed R Dodson, S.Hammar) London,Taylor and Francis
(2010) (in press).
D Henderson , J Leigh The History of Asbestos Utilization and Recognition of Asbestos-induced Diseases
Chapter 1 in Asbestos: Risk Assessment, Epidemiology, and Health Effects, 2nd Edition ( ed R Dodson, S.Hammar)
London,Taylor and Francis (2010) (in press).
M PEACOCK "Killer Company" Sydney,HarperCollins (2009)
D HENDERSON , J LEIGH
Asbestos and Carcinoma of the Lung and Larynx
Chapter 6 in Asbestos: Risk Assessment, Epidemiology,
and Health Effects, 2nd Edition ( ed R Dodson, S.Hammar)
London,Taylor and Francis (2010) (in press). (pdf attached)
D HENDERSON , J LEIGH
The History of Asbestos Utilization and Recognition of
Asbestos-induced Diseases
Chapter 1 in Asbestos: Risk Assessment, Epidemiology,
and Health Effects, 2nd Edition ( ed R Dodson, S.Hammar)
London,Taylor and Francis (2010) (in press).(pdf attached)
M PEACOCK "Killer Company" Sydney,HarperCollins (2009)
LECTURE - Head and Neck: eye

Principal Teacher
John Mitrofanis
Learning Objectives
Detailed anatomical organisation and function of the eye; the different tunics of the globe, blood supply and neural
innervations of the globe and associated structures. The different extraocular eye muscles, their innervations, functions
Metadata
Stage: 1
Week: 5
PBL/CRS: Sleeping on the job
Sequence No.: 1
Reviewed by:
and clinical testing. The bones that make up the cave of the orbit.
Date Reviewed: N/A

Status: Released
Recordings
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2012-07-27
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
2014 lecture
LECTURE - Head and Neck: ear

Principal Teacher
John Mitrofanis
Metadata
Stage: 1
Week: 5
Learning Objectives
Sequence No.: 2
Detailed anatomical organisation and function of the greater ear complex; the internal, middle and external ears. The
bony and cartilagenous frameworks, neural innervations and some clinical applications.

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2012 (2)Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
2014 lecture
VIDEO
VIEW
Created By
Date
Jayne Seward
2012-07-27
John Mitrofanis
2009-12-07
LECTURE - Physiology of sleep

Metadata
Principal Teacher
Stage: 1
Keith Wong
keith.wong@sydney.edu.au

Week: 5
Learning Objectives
Sequence No.: 3
To introduce concepts of normal and abnormal sleep and circadian physiology. The effects of insufficient or disrupted
sleep will be discussed.

Reviewed by:
Date Reviewed: N/A
Content
Status: Released
Sleep is a state which is necessary for normal neural and other body functions and consists of a number of distinct
sleep stages which can be determined electrophysiologically.
Insufficient or disrupted sleep leads to sleepiness, which can be conceived as a body "drive" similar to hunger or thirst.
Sleep and sleepiness are in part controlled by circadian rhythms. In turn, these processes are regulated by
neurotransmitter release including noradrenergic, serotinergic, cholinergic, histaminergic and the newly identified,
orexin-hypocretin system.
Various physiological functions are closely linked to sleep and its stages eg temperature, hormone secretion, erections.
Normal sleep physiology and sleep stages are altered in pathophysiological conditions of sleep such as sleep apnoea,
narcolepsy and night terrors.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Edit History
#
Created By
Date
John Mitrofanis
2009-12-07
2013 (2)Lecture
AUDIO
VIDEO
VIEW
Resources
Physiology of Sleep
Physiology of Sleep - 2014
LECTURE - Sleep disorders

Principal Teacher
Brendon John Yee
brendon.yee@sydney.edu.au
Learning Objectives
The common sleep disorders, their epidemiology and modes of presentation, basic differential diagnosis, consequences
Metadata
Stage: 1
Week: 5
Sequence No.: 4
Reviewed by:
Date Reviewed: N/A
Content
Status: Released
Aim
Edit History
To introduce the common sleep disorders, their epidemiology and modes of presentation, basic differential diagnosis,
consequences and therapies.
Content
There are a number of ways to classify sleep disorders but most will result in the perception of insufficient or disturbed
sleep, daytime sleepiness or unusual movements during sleep.
The commonest specific sleep disorder is insomnia which affects up to 30% of the population, 5% chronically.
Insomnia may be primary or secondary to medical or psychiatric disorders such as depression. Therapies include
various behavioural strategies and sometimes use of short-term hypnotic therapy.
Sleep apnea is part of a continuum of sleep-breathing disorders from snoring to severe hypoventilation during sleep
and occurs in over 5% of the population. Typically it results in fragmentation of normal sleep and daytime sleepiness
and are more frequent in males and the obese. Sleep apnea has long term consequences including hypertension,
increased cardiovascular disease, road accidents, cognitive problems and reduced quality of life. Treatments include
the continuous positive airway pressure, first developed at the University of Sydney, upper airway surgery, dental
splints and weight loss.
Restless legs syndrome is a sensori-motor sleep disorder characterised by an urge to move limbs resulting usually in
sleep disturbances. This condition is typically improved by dopamine agonists.
There are many other less common sleep disorders such as narcolepsy, sleepwalking, night terrors and REM behaviour
disorders.
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
Resources
VIDEO
VIEW
Created By
Date
John Mitrofanis
2009-12-07
Sleep disorders
Sleep disorders - 2014
LECTURE - Pathophysiology of sleep apnoea

Metadata
Principal Teacher
Stage: 1
John Robert Wheatley

john.wheatley@sydney.edu.au

Week: 5
Learning Objectives
Sequence No.: 5
How abnormalities of breathing during sleep lead to the clinical syndrome of obstructive sleep apnoea and its
physiological consequences. The pathophysiological mechanisms contributing to upper airway obstruction and central
apnoea during sleep
VIDEO
Date Reviewed: N/A
Edit History
2014Lecture
Reviewed by:
Status: Released
Recordings
AUDIO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2012-08-08
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Pathophysiology of sleep
apnoea -2014
LECTURE - Sleepiness in the workplace

Principal Teacher
Naomi Rogers
naomi.rogers@sydney.edu.au
Learning Objectives
The effects of shiftwork and extended work hours on neurobehavioural and physiological variables; the occupational
impact of sleep disorders
Metadata
Stage: 1
Week: 5
Sequence No.: 6
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Date Reviewed: N/A
Recordings
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2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-11-24
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Sleepiness in the
workplace
Sleepiness in the
workplace - 2014
LECTURE - Pathology related to smoking

Principal Teacher
Nicholas King
Learning Objectives
The major pathological features related to smoking
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Stage: 1
Week: 5
Sequence No.: 7
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Date Reviewed: N/A
Content
Aim
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Aim
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To illustrate how cigarette smoking affects various organs in the human body. Students will be allowed to focus on the
clinical conditions these patients may present with.
Jayne Seward
2013-11-24
Jayne Seward
2011-10-30
Content
John Mitrofanis
2009-12-07
Students will examine and discuss bottle specimens and microscopic slides.
Discussion will be supplemented by demonstration slides
Methods
Groups will look at glass slides and macro specimens. Each session will be interactive, students will coment on and
discuss their observations under the guidance of a tutor.
Resource materials
Microscopic glass slides:
Squamous metaplasia of bronchus - E4-1, H-11
Bronchogenic carcinoma of the lung - E4-1,E-22
Emphysema lung - H 2
Atherosclerosis - Projection slide only
Bottle specimens from pathology:
Lungs - Emphysema, Bronchogenic carcinoma
Cardiovascular - Atherosclerosis, Myocardial infarction (same bottle)
Brain - Haemorrhage
Discussion will be supplemented by demonstration slides of effect of smoking on other organs - Peptic ulcer, renal and
urinary bladder carcinoma, Oral laryngeal and oesophageal cancers, effects on fetus and Buerger's disease.
Additional pathology resources on the WWW
University of Sydney Pathology Museum
uid: museum
password: stud98
Recordings
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
2012Lecture
AUDIO
VIDEO
VIEW
AUDIO
VIDEO
VIEW
2014 (2)Lecture
2012 (2)Lecture
AUDIO
VIDEO
VIEW
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Pathology related to
smoking
Pathology related to
smoking - 2014

Principal Teacher
Metadata
Stage: 1
Brendon John Yee

brendon.yee@sydney.edu.au

Week: 5
Learning Objectives
Sequence No.: 8

Reviewed by:
Recordings
Date Reviewed: N/A

Status: Released
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2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
PRACTICAL - Head & Neck: pharynx, larynx, thyroid gland

Created By
Date
Alicia Kaya
2014-04-15
Jayne Seward
2013-11-24
Jayne Seward
2013-04-04
Jayne Seward
2011-10-31
Jayne Seward
2010-11-27
Jayne Seward
2010-07-23
Metadata
Principal Teacher
Stage: 1
John Mitrofanis

Week: 5
Learning Objectives
Sequence No.: 1
Detailed anatomical organisation (cartilages, ligaments and muscle) and function (swallowing and phonation) of the
pharynx and larynx; their blood supply and neural innervations.

Resources

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test
clinical movie
movie
Practical notes
Created By
Date
Jayne Seward
2013-02-20
John Mitrofanis
2010-11-09
John Mitrofanis
2009-12-07
PRACTICAL - Pathology of chronic airflow limitation

Principal Teacher
Metadata
Stage: 1
Nicholas King

Week: 5
Learning Objectives
Sequence No.: 2
The disease process associated with chronic airflow limitation; the pathological features associated with chronic airflow
limitation; the microscopic and macroscopic features of chronic bronchitis and emphysema

Reviewed by: Nicholas King
Content
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Aim
To be familiar with the disease processes under this group.
To understand the pathological features of this group of diseases.
The focus will be on correlating the microscopic and macroscopic features with the clinical condition in chronic
bronchitis and emphysema.
Content
Students will be able to examine bottled specimens and glass slides showing the major features of chronic bronchitis
and emphysema.
Method
The class will be divided into groups for each slide session. Each session will be interactive and students will comment
on and discuss their observations under the guidance of a tutor. Discussion will be supplemented by demonstration
slides. As usual, students are encouraged to attend the Pathology Museum to examine bottled specimens in thorough
detail at their leisure.
Resources
Created By
Date
John Mitrofanis
2009-12-07
Pathology of chronic
airflow limitation
airflow limitation 2012 ppt
airflow limitation 2012 doc
PBL SESSION - Sleeping on the job - 3.05 - PBL 1

Learning Objectives
Metadata
Stage: 1

Week: 5
Content
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
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Date
Zhigang Jason Xie
2010-02-09
Image: An obese man in his fifties, seated and looking breathless and weary.
Mohamed Al Ubaidi has been brought to the Emergency Department of the Central Area Hospital by his wife. Mohamed
appears to be confused and breathless and both his ankles are swollen. Mrs Al Ubaidi says that Mohamed has been off
work for about two weeks because he has been too sleepy during the daytime to drive his armoured vehicle.
Mohamed has had an increasing problem with sleepiness over the last ten years or so. Mrs Al Ubaidi says Mohamed
has always been a loud snorer and that sometimes lately, when he is asleep he seems to go silent or have periods of
no breathing. About four days ago Mohamed got a cold and has been coughing up sputum.
Mrs Al Ubaidi says Mohamed seems to have been a bit confused for the last day or so. Over the last two or three
months Mrs Al Ubaidi says that she has noticed Mohamed's ankles swelling, that he has put on weight and is getting
more breathless. His wife and family have noticed a bluish tinge to his lips and fingers.
Resources
Mechanism
Tutor Guide
Results
Medical Humanities
Student Guide
PT-DR TUTORIAL - Communication Skills - Chronic cough and dyspnoea

Learning Objectives
Metadata
Stage: 1

Week: 5
to take a structured history from a patient with COPD (previously used synonyms CAL = chronic airflow
limitation, COAD = chronic obstructive airway disease).
to summarise the main features of the history and present the case concisely and clearly.
possible causes of chronic dyspnoea and cough, and try to distinguish between them.

Sequence No.: 1
Content
Reviewed by:
Date Reviewed: N/A
Aim
Assessment of patients with chronic dyspnoea and cough, with a focus on the problem of chronic obstructive
pulmonary disease (COPD).
Characteristic features of the history that help to distinguish between the possible causes of chronic dyspnoea
and cough.
Principles of case summary and presentation of the history to a medical colleague.
With the group:
Discuss the definitions for chronic obstructive pulmonary disease (for example, the GOLD and COPDX guidelines)
and how it differs from other airway diseases, particularly asthma
Discuss the characteristics of chronic dyspnoea and cough that are typical for common conditions such as
chronic bronchitis, emphysema, bronchiectasis, carcinoma of the bronchus, heart failure, asthma, pulmonary
Status: Released
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Jayne Seward
2012-06-29
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Celina Aspinall
2010-09-16
John Mitrofanis
2009-12-07
fibrosis
Review the Medical Research Council grading of dyspnoea
Discuss the associated symptoms that help to distinguish possible causes of chronic dyspnoea and cough
Take a respiratory history from a patient with COPD. Organise and present the history to the group.
Cough
1. Dry or productive
2. Sputum colour and quantity
The presence of yellow or green sputum, or increasing sputum discolouration, may signify the presence of
infection. The patient may find thick, sticky or copious sputum difficult to clear.Bloodstained or rusty sputum is
most often seen with infection (e.g. pneumonia, TB) but also can be seen with carcinoma or pulmonary
embolism. Pink frothy sputum is sometimes seen in pulmonary oedema.
3. Timing, triggers and relievers
Timing of the cough may also give clues. Nocturnal cough is often associated with asthma, left ventricular
failure, gastro-oesophageal reflux or postnasal drip. Cough that occurs on changing posture may be associated
with bronchiectasis or sinusitis. The cough associated with COPD is often present throughout the day, and is not
usually nocturnal. If cough is present without shortness of breath, then causes to consider would include
smoker's cough, chronic bronchitis without airflow limitation, ACE-inhibitor treatment, inhaled foreign body, postnasal drip, gastro-oesophageal reflux, endobronchial tumour, upper airway irritability and psychogenic cough
(nervous habit). Was the onset of the chronic cough associated with other symptoms of a respiratory tract
infection (sore throat, fever etc)?
4. The character of the cough may point to the causation (e.g. brassy with bronchitis, barking with laryngeal
disorders, paroxysmal with whoops in pertussis)
5. The relievers of the cough often point to its cause (eg relief with bronchodilators suggests asthma, relief with
water or lozenges suggests upper airway irritability, improvement on antibiotics may suggest lower airway
infection)
Dyspnoea
Patients with asthma have dyspnoea that varies from day to day, that improves spontaneously, and has a good
response to bronchodilators. Dyspnoea is often worse at night or the early morning, and with specific types of
exercise.
Patients who have COPD will have dyspnoea that is slowly progressive, persistent (present every day), brought
on by exertion, and relieved by rest. Exacerbations, or an acute worsening of symptoms, are commonly caused
by viral or bacterial respiratory infections.
Patients with heart failure may complain of orthopnoea (breathlessness that is worse on lying flat), paroxysmal
nocturnal dyspnoea, and ankle oedema.
The table below shows a differential diagnosis of chronic dyspnoea and cough based on other aspects of the history.
Asthma
Length of history Variable-often

onset in
childhood
COPD
Bronchiectasis
Variable-onset in mid-life Often but not invariably

longstanding
Ca bronchus
Heart failure
May be recent and Variable

progressive
Associated
symptoms
Wheeze, "tight"
chest
Wheeze, tight chest
Sputum +++, frequently

purulent
Weight loss
Other points in
the history
Allergens may be
triggers. Often
have allergic
rhinitis or
eczema.
Family history
Smoking history.
Recurrent lung infections. Smoking
Only partial relief with
May be associated
bronchodilators.
features of
Allergens and irritants are immunoglobulin
not usually triggers.
deficiency, ear and sinus
infections, or infertility
Ankle swelling
Past history of
ischaemic heart
disease,
hypertension or
valvular heart
disease
NB: Smoking is a risk factor for many respiratory diseases, but you cannot distinguish between them on the strength
of the smoking history.
Airway obstruction that is not fully reversible is a broad definition of COPD, but chronic airflow limitation is a feature
of many overlapping diseases, such as emphysema, chronic bronchitis, bronchiectasis, and asthma. The airflow
limitation associated with COPD is progressive and associated with an inflammatory response of the lungs to noxious
particles or gases. In Australia, by far the most important cause of COPD is cigarette smoking. The definitive test for
COPD is spirometry (presence of a post-bronchodilator FEV1 < 80% of predicted combined with a FEV1 / FVC < 70%
of predicted).
Important points to consider in the COPD history:
The symptoms:Any recent change in symptoms that triggered presentation
A description of the severity of the dyspnoea, in terms of usual exercise tolerance
Impact of the disease on the patient's life
Nutrition (weight loss is often a feature of advanced disease, and associated with significant deconditioning)
Complications of COPD, especially chronic hypoxaemia, right heart failure or polycythaemia
Co-morbidities are frequently associated with COPD. The commonest are ischaemic heart disease, osteoporosis,
pneumonia, skeletal muscle dysfunction, anxiety and depression.
Risk factors:
Amount and duration of smoking, and whether the patient is still smoking. This is essential, as the disease will
progress faster if the patient is still smoking, and continued smoking makes the patient ineligible for home
oxygen therapy. This is an opportunity to discuss the importance of cessation of smoking with the patient.
Chronic asthma - usually when severe and poorly controlled over many years
Family history of emphysema or COPD.
Occupational dusts and chemicals
Outdoor and indoor air pollution (e.g. solid biomass fuel for cooking. In parts of Asia, Middle East and Africa,
this is the reason why COPD is common in women who do not smoke).
Past history:
Any previous respiratory illness such as asthma
Previous hospitalizations and previous need for mechanical ventilation
Co-morbidities (e.g. ischaemic heart disease, sleep disordered breathing, GORD)
Medications:
Any puffers or nebulised drugs

Any drugs that might make breathlessness worse (e.g. beta-blockers)
Need for oral steroids
Need for home oxygen (this implies severe disease)
Between tutorials
Students should start to practise case presentations. The case presentation should be concise, but include all the
relevant positives and negatives. The group should consider how the case can be summarised.
References
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Airway Disease:
NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop Summary. American Journal
of Respiratory and Critical Care Medicine 2007; 176: 532555. www.goldcopd.com
Vestbo J et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary
Disease: GOLD Executive Summary. Am J Respir Crit Care Med 2013, Vol.187: 347-365
http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf
http://www.copdx.org.au/
'General Practice' by John Murtagh. McGraw Hill.
Australian COPD-X website http://www.copdx.org.au/
Lung Foundation of Australia website for further COPD resourceshttp://lungfoundation.com.au/professionalresources/1692-2/guidelines/
COPD-X stepwise management plan http://lungfoundation.com.au/wp-content/uploads/2012/01/Stepwise-V10June-2012.pdf
PT-DR TUTORIAL - Physical Exam Skills - Respiratory examination revision and the role of the chest radiograph in the
assessment of a patient with respiratory disease
Learning Objectives
To perform a comprehensive examination of the respiratory system in a patient with a respiratory disorder
To report the findings of a respiratory examination accurately
Learn to look for and interpret normal and abnormal features of chest x-rays
Metadata
Stage: 1
Week: 5
Sequence No.: 2
Content

Aim
Reviewed by:
Date Reviewed: N/A
To consolidate the performance of respiratory examination and practise presentation of examination findings
Introduce students to the evaluation of radiographic images of the chest
In this tutorial your tutor will ask you to perform a physical examination of the respiratory system in a patient with
respiratory disease. Following the physical examination of the respiratory system, your tutor will review with you the
patient's chest radiograph.
In the second half of the tutorial, discuss an approach to evaluating the CXR and relating the findings to the patient
that has been seen.
This tutorial will cover introductory and general aspects to reading a CXR. It should include discussion of:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Identification of the patient

Identification of the date of the examination
Method of examination (mobile or PA)
Identification of major radiological landmarks
Thoracic skeleton and soft tissue
Cardiac borders
Mediastinal outline and hilar shadows
Lung zones
Diaphragmatic shadows
Normal findings and any diagnostic features
Hidden zones in CXRs; apices, costophrenic angles and behind the heart
Note: Many patients will have other radiographic images of the chest in addition to chest x-rays, including CT scans,
MRIs and nuclear scans. While it is appropriate to review these images if available, the essential objective of this
tutorial relates specifically to chest x-rays.
Between Tutorials
Students should practise respiratory examination amongst themselves and each student should arrange to examine a
patient with COPD on the wards either by themselves or with a colleague. Students should also review the patients
chest xrays, and test each other on chest radiography.
References
Appropriate normal and abnormal chest x-rays
Interpretation of the chest roentgenogram: Raoof et al Chest 2012;141: 545-558.
Patients with respiratory disease
Fundamentals of Lung Auscultation http://www.nejm.org/doi/full/10.1056/NEJMra1302901
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Jayne Seward
2012-06-29
Jayne Seward
2012-06-27

Learning Objectives
Metadata
Stage: 1

Week: 5
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
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Created By
Date
Kamal Jaikisan Soni
2010-03-19
SEMINAR - Spirituality and Meaning of Medicine

Principal Teacher
Louise Baur
louise.baur@sydney.edu.au
Megan Claire Best
megan.best@sydney.edu.au
Ken Howard Curry
ken.curry@sydney.edu.au
Metadata
Stage: 1
Week: 5
Sequence No.: 1
Learning Objectives
Reviewed by:
Date Reviewed: N/A
Status: Released
By the end of this session students will be better able to:

1) Explain the relationships between spirituality, religion and health and their role in the experience of suffering
2) Recognize some of the spiritual issues patients may want to explore in relation to acute or chronic illness and
the place of a spiritual history
3) Appreciate the influence of spirituality on patient decision making in treatment and therapy
4) Understand the role of chaplains/pastoral care workers in the health system and when referral is appropriate
Content
Egan et al (2011) in a study of New Zealand hospice patients stated that "spirituality means different things to
different people. It may include (a search for): one's ultimate beliefs and values; a sense of meaning and purpose in
life; a sense of connectedness; identity and awareness; and for some people, religion. It may be understood at an
individual or population level."
Patients' spirituality influences how they understand health, illness, diagnoses, recovery and loss; strategies they use to
cope with illness; their resilience, resources and sense of support; decision-making about health care; day-to-day
health practices and lifestyle choices; and overall health outcomes. Patients also want clinical hospital staff to respect
and support their beliefs and spiritual practices.
In "Good Medical Practice: A Code of Conduct for Doctors in Australia, 2014", good medical practice involves doctors
having "cultural awareness: being aware of their own culture and beliefs and respectful of the beliefs and cultures of
others, recognising that these cultural differences may impact on the doctor-patient relationship and on the delivery of
health services."
It also involves "avoiding expressing your personal beliefs to your patients in ways that exploit their vulnerability or
that are likely to cause them distress."
In this session we will also look at some case examples and view excerpts from the movie "Wit", starring Emma
Thompson, and then reflect on implications for clinical practice. We will look at practical ways in which patients can be
given spiritual support in hospital settings, including through the role of chaplains and pastoral care workers. During
the session we will also look at the World Health Organization Quality of Life measure for assessment of Spirituality,
Religion and Personal Beliefs which is used in many international studies of spirituality in health care.
Web-link:
ABC 2012 series on Hospital Chaplains. This series looks at the work of several chaplains, of differing faith traditions,
who work in several public hospitals in NSW. There are 6 separate episodes, each of 30 minutes duration. They
originally ran from 15th April to 3rd June 2012, and can be viewed at:
http://www.abc.net.au/compass/episodes/2012.htm
Written/Prepared By:Professor Louise Baur
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Jayne Seward
2013-05-10
12
Jayne Seward
2013-05-10
11
Jayne Seward
2013-04-04
10
Jayne Seward
2013-04-04
Jayne Seward
2012-06-28
Jayne Seward
2012-03-08
Jayne Seward
2011-11-23
Jayne Seward
2011-11-09
Jayne Seward
2011-10-27
2011-03-22
2011-02-22
Jayne Seward
2010-10-25
Jayne Seward
2010-10-19
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
Resources
Spirituality and Meaning in

Medicine 2014 slides
Author
Spirituality and meaning in

medicine - Resource 2014
Spirituality and Meaning in

Medicine 2014 - extra
reading
WHO Quality of Life

Questionnaire
References
Cassell E. The nature of suffering and the goals of medicine. NEJM 1982; 306(11):639-645.
Hassed C. The role of spirituality in medicine. Australian Family Physician 2008; 37 (11):955-957
Additional reading
Hilbers J et al. Spirituality and health: an exploratory study of hospital patients perspectives. Australian Health Review
2010, 34:310. (This article provides information about Australian patients understandings of spirituality and health)
Tuesdays with Morrie by Mitch Albom, 1997 Doubleday, New York.
Spirituality in Patient Care: Why, How, When, and What? Harold G. Koenig. Templeton Foundation Press. (2007)
Frankl V. Man's search for meaning. 1984. New York: Simon and Schuster.
SEMINAR - Indigenous Health 3

Principal Teacher
Metadata
Stage: 1
Lilon Gretl Bandler


Week: 5
Learning Objectives
Sequence No.: 2
Participation in the Indigenous Health Education seminar program will help students increase their understanding of
Indigenous health and the broader context that influences the disparities experienced by Aboriginal and Torres Strait
Islander Australians, and indigenous communities across the world.

Reviewed by:
Date Reviewed: N/A
Please register your interest with Lyn Chick (lyn.chick@sydney.edu.au) or Dr Lilon Bandler
(lilon.bandler@sydney.edu.au). Attendance is not mandatory.
Recordings
Status: Released
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Alicia Kaya
2014-04-04
LECTURE - Head and Neck: cranial nerves

Metadata
Principal Teacher
Stage: 1
John Mitrofanis

Week: 6
PBL/CRS: A different cause of cough
Learning Objectives
Sequence No.: 1
Detailed anatomical organisation of the cranial nerve system; their peripheral distributions including major branches
and patterns of innervations. The functional fibres that each nerve may carry to target structures and the clinical signs
and symptoms after lesion
VIDEO
Date Reviewed: N/A
Edit History
2014Lecture
Reviewed by:
Status: Released
Recordings
AUDIO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2012 (2)Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-07-18
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
2014 lecture
LECTURE - Head and Neck: clinical anatomy

Principal Teacher
Metadata
Stage: 1
Carsten Palme
carsten.palme@sydney.edu.au

Week: 6
Learning Objectives
Sequence No.: 2
Current Teacher Faruque Salahuddin Riffat
The major clinical features of the head and neck; the key anatomical structures and their clinical relevance.

Content
Reviewed by:
Date Reviewed: N/A
Areas to be covered include

Embryology
Neck spaces and their relevance in deep neck space infections
Lymph node levels in the neck and their importance in head and neck oncology
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Overview of the viscera of the neck

Cranial nerves
Pharynx and larynx
Carotid sheath and contents
Alicia Kaya
2014-08-05
Jayne Seward
2013-07-18
John Mitrofanis
2009-12-07
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
LECTURE - Exocrine secretion

Principal Teacher
Metadata
Stage: 1
David Cook
david.cook@sydney.edu.au

Week: 6
Learning Objectives
Sequence No.: 3
The 2-stage hypothesis for function of exocrine glands and its implications for exocrine gland function in cystic fibrosis.
The mechanisms by which sweat ducts, pancreatic ducts, colonic crypts and respiratory epithelium transport ions and
how the function of these affected organs is affected by cystic fibrosis. The various mechanisms by which mutations in
the CF gene lead to abnormal function. The physiological basis of pharmacological therapies for cystic fibrosis
Recordings

Reviewed by:
Date Reviewed: N/A
Status: Released
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Created By
Date
John Mitrofanis
2009-12-07
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Exocrine secretion
LECTURE - Cystic fibrosis as a multi-system disease

Principal Teacher
Peter John Cooper
pcooper@mail.usyd.edu.au
Learning Objectives
The aetiology and pathogenesis of multi-organ damage in cystic fibrosis; the pathogenesis of the clinical features of
cystic fibrosis; the multidisciplinary team approach to management of cystic fibrosis; the impact of chronic disease on
child and family
Metadata
Stage: 1
Week: 6
Sequence No.: 4
Current Teacher Chetan Anand Pandit
Submitted by: Jennifer Burn
Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Resources
Cystic fibrosis as a multisystem disease
Cystic fibrosis as a multisystem disease 2011
Cystic fibrosis as a multisystem disease - 2012
LECTURE - Cystic fibrosis as a genetic disorder

Created By
Date
Jennifer Burn
2013-07-03
Jayne Seward
2012-08-09
Jayne Seward
2012-07-27
John Mitrofanis
2009-12-07
Metadata
Principal Teacher
Stage: 1
Felicity Collins
felicity.collins@sydney.edu.au

Week: 6
Learning Objectives
Sequence No.: 5
The value of DNA genetic diagnosis; describe the significance of the CFTR gene and appreciate the role of family
counselling and DNA mutation scanning

Reviewed by:
Date Reviewed: N/A
Content
Status: Released
Edit History
positional cloning for CF gene

CFTR gene - structure and function
Delta F508 and other CF-related mutations
DNA diagnosis for CF
counselling issues in CF eg carrier testing, prenatal detection
genotype/phenotype correlations in CF
future therapeutic options in CF eg gene therapy
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
VIDEO
VIEW
Created By
Date
John Mitrofanis
2009-12-07

AUDIO
VIDEO
VIEW
Resources
Cystic fibrosis as a genetic

disorder - 2014
LECTURE - Support services for patients and families

Principal Teacher
Metadata
Stage: 1
Miraa Best
mbes8907@mail.usyd.edu.au

Week: 6
Learning Objectives
Sequence No.: 6
The issues involved in living with cystic fibrosis from the time of diagnosis, managing during childhood, adolescence
and adulthood, and finally in the terminal stages

Reviewed by:
Date Reviewed: N/A
Content
Aim
To look at the issues involved in living with cystic fibrosis from the time of diagnosis, managing during childhood,
adolescence and adulthood, and finally in the terminal stages.
Content
Status: Released
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Created By
Date
Jayne Seward
2012-09-04
Jayne Seward
2011-04-01
Jayne Seward
2010-12-16
How parents cope at diagnosis, the techniques they use.

The help and support that families need, the support services provided by Cystic Fibrosis NSW.
How children and young people manage to live meaningful lives while coping with a progressive condition. The
support services they need.
Adults with CF - the challenge of the future. With the majority of young people now surviving into adulthood
many issues have to be addressed to ensure quality of life as well as quantity.
Jayne Seward
2010-12-16
John Mitrofanis
2009-12-07
Recordings
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Support services for

patients and families
Support services for

patients and families 2013
LECTURE - Stress and Coping

Principal Teacher
Metadata
Stage: 1
Simon Willcock
simon.willcock@sydney.edu.au

Week: 6
Learning Objectives
Sequence No.: 7
At the end of this teaching session, students should be able to understand
contemporary models of stress exposure and stress response

the effects of acute and chronic stressors on biopsychosocial health parameters
the difference between appropriate and inappropriate coping behaviours

Reviewed by:
Date Reviewed: N/A
Status: Released
Content
Edit History
Aim
To provide an understanding of the origin of, response to, and outcome of uncertainty in illness. The theory of
uncertainty and more general stress theory will be described. Process models will be discussed and the major elements
of coping theory outlined. Implications from empirical research will be explored.
Content
The multi-dimensional nature of uncertainty and the uncertainty in illness construct.
Stress theory as a parent of the theory of uncertainty in illness
Interactional models of stress incorporating appraisal, coping responses and outcome.
Problem-focussed and emotion - focussed coping.
Direct and defensive coping styles.
Empirical research on uncertainty in illness.
Recordings
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2010-12-16
Jayne Seward
2010-12-16
Jayne Seward
2010-11-27
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Stress and Coping - 2014
LECTURE - Infections in Cystic Fibrosis

Principal Teacher
Jim Manos
jim.manos@sydney.edu.au
Learning Objectives
The main features of cystic fibrosis (CF)
The main microbes associated with CF.
The bacteria showing significant infection in CF patients.
Metadata
Stage: 1
Week: 6
Sequence No.: 8
Reviewed by:
Date Reviewed: N/A
The clinical features and treatment of each bacterial infection

The features of Pseudomonas aeruginosa infection, the main cause of morbidity and mortality in CF.
Status: Released
Edit History
Content
Note regarding 2012 lecture recording:

The 2012 lecture recording contains two lecturers: Prof Peter Bye followed by Dr Jim Manos (55 mins mark). The two
lecturers gave different perspectives: 1. a clinical perspective, and 2. understanding the microbes - genetic approach
and how they operate.
Recordings
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
2012Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Created By
Date
Alicia Kaya
2014-08-22
Jayne Seward
2012-03-06
Jayne Seward
2012-02-28
Jayne Seward
2012-02-28
Jayne Seward
2011-09-28
Infections in Cystic Fibrosis

- 2014 (Dr Jim Manos)
LECTURE - Feedback session with Dean

Metadata
Principal Teacher
Stage: 1
Bruce Robinson
bruce.robinson@sydney.edu.au

Week: 6
Michael Frommer
michael.frommer@sydney.edu.au
Sequence No.: 9
Margot Day
margot.day@sydney.edu.au

Reviewed by:
Date Reviewed: N/A
Learning Objectives
Status: Released
Learning objective information not available.
Recordings
2014Lecture
2012Lecture
Edit History
#
Created By
Date
Alicia Kaya
2014-07-22
Alicia Kaya
2014-07-22
Alicia Kaya
2014-07-22
Alicia Kaya
2014-04-01
Jayne Seward
2012-07-13

AUDIO
VIDEO
VIEW
AUDIO
VIDEO
VIEW

Metadata
Principal Teacher
Stage: 1
Peter Gordon Middleton

peter.middleton@sydney.edu.au

Week: 6
Learning Objectives
Sequence No.: 10

Reviewed by:
Recordings
Date Reviewed: N/A

Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
Resources
VIDEO
VIEW
Created By
Date
Alicia Kaya
2014-04-01
Alicia Kaya
2014-04-01
Jayne Seward
2013-04-04
Jayne Seward
2011-09-27
Jayne Seward
2010-11-27
Jayne Seward
2010-07-23
PRACTICAL - Head & Neck: eye and ear

Metadata
Principal Teacher
Stage: 1
John Mitrofanis

Week: 6
Learning Objectives
Sequence No.: 1

Detailed anatomical organisation and function of the eye; the different tunics of the globe, blood supply and neural
innervations of the globe and associated structures. The different extraocular eye muscles, their innervations, functions
and clinical testing. The bones that make up the cave of the orbit.

Status: Released
Edit History
Resources
test
movie
clinical movie
Created By
Date
Jayne Seward
2013-02-20
Jayne Seward
2011-08-26
John Mitrofanis
2010-11-09
John Mitrofanis
2009-12-07
Practical notes
PRACTICAL - Epithelial transport

Principal Teacher
Metadata
Stage: 1
David Cook
david.cook@sydney.edu.au

Week: 6
Learning Objectives
Sequence No.: 2
The different types of exocrine glands in the body (eg lacrimal glands, sweat glands salivary glands and pancreas); the
functions of the different types of exocrine glands; cystic fibrosis as a defect in epithelial transport

Reviewed by:
Date Reviewed: N/A
Content
Aim
Aim
By the end of this session, students should:
i. understand the 2-stage hypothesis for the function of exocrine glands and its implications for exocrine gland
function in cystic fibrosis
ii. understand the mechanisms by which sweat ducts, pancreatic ducts, colonic crypts and respiratory epithelium
transport ions and how the function of these organs is affected by cystic fibrosis
iii. an appreciation of the various mechanisms by which mutations in the cf gene lead to abnormal function
iv. an understanding of the physiological basis of pharmacological therapies for cystic fibrosis that currently under
development.
Status: Released
Edit History
#
Created By
Date
John Mitrofanis
2009-12-07
Organisation
Students will work through a computer assisted learning package that will enable to fulfill Aims (i) to (iii). At the end
of the session they will then discuss a recent paper on pharmacological treatments of cystic fibrosis (P.L. Zeitlin. Novel
pharmacologic therapies for cystic fibrosis. Journal of Clinical Investigation 103: 447-452, 1999). Those who are
interested, may read this prior to the session, however, copies will be available and time provided to read it during the
session. At the end of the session there will also be opportunity to discuss any of the issues raised by the computer
assisted learning package, or in the lecture on exocrine glands given that morning.
Background Reading
No background reading is required.
Resources
Epithelial transport
PBL SESSION - A different cause of cough - 3.06 - PBL 1

Learning Objectives
Metadata
Stage: 1
Week: 6
Content

Sequence No.: 1

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Image: A man in his late teens, handkerchief at the ready, while waiting to see the doctor.
Barry Edington is an 18-year-old who is referred to the Chest Clinic by his general practitioner with a diagnosis of
difficult-to-treat asthma. Asthma was diagnosed in childhood and initially Barry had a good response to Ventolin.
However, more recently, during the winter months he has developed cough with sputum. Since last year, he has
regularly coughed up half a cup of green sputum daily during winter.
Resources
Mechanism
Tutor Guide
Results
Created By
Date
Zhigang Jason Xie
2010-02-09
Student Guide
Australian Prescriber
article on Cystic Fibrosis
PT-DR TUTORIAL - Communication Skills - History of respiratory tract infection

Learning Objectives
Metadata
Stage: 1

Week: 6
to take a structured history in a patient with a respiratory complaint - in particular an infective illness
to differentiate between infective and non-infective acute respiratory presentations, and between acute/sudden
and subacute/chronic presentations of respiratory infection (e.g. TB, some bacterial and fungal infections)
to summarise the main features and present the case concisely and clearly

Sequence No.: 1
Reviewed by:
Content
Aim
To review and consolidate:
The principles of history taking in respiratory disease with a focus on lung infections / pneumonia
The principles of case summary and presentation of the history to a medical colleague
Suggested Activities/format
Review the components of a medical history
Review the principal symptoms of an infective respiratory illness
Discuss with the group an appropriate structure to the history taking
Interview at least one patient with the group observing and taking notes
Discuss with the group how the case should be summarised and practise presentation skills in the group with
emphasising appropriate use of medical terms without jargon and a logical structure.
Date Reviewed: N/A

Status: Released
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Created By
Date
Jayne Seward
2012-06-29
Jayne Seward
2012-06-27
Jayne Seward
2012-06-27
Students should be familiar with the basic components of a medical history and should be developing a structured
approach.
History of the presenting illness. In the case of pneumonia it is important to know when and where the patient
is likely to have encountered the pathogen - ie community or hospital acquired, as it directs the type of
antibiotic that will be administered. Enquire about prodromal symptoms (e.g. viral symptoms), possible exposure
to infected people (e.g. in an institution) or and overseas travel.
Other features to enquire about include
Fever, rigors and night sweats
Cough and sputum
Haemoptysis
Pain especially pleuritic pain
Wheeze
Dyspnoea
Non-respiratory symptoms e.g. myalgia/arthralgia/rash/sore throat/diarrhoea
Concurrent illness - The presence of comorbid illness is an important predictor of aetiology and prognosis and
may give an indication about the need for hospital admission e.g. HIV/AIDS, immune compromise, cancer,
cardiovascular disease, diabetes etc.
Past History
Enquire about previous respiratory illness including COPD, asthma, pneumonia, tuberculosis, chronic bronchitis,
bronchiectasis or any previously noted chest X-ray abnormalities, which may predispose to respiratory tract
infection. Always enquire about previous hospitalisations including those related to respiratory illness.
Enquire about other risk factors especially swallowing dysfunction, previous stroke, reflux and aspiration
Occupational History
Social History and habits- Smoking increases the severity and frequency of respiratory infections and delays
recovery. Also enquire about alcohol, intravenous drug use, social support and usual activities of daily living
(ADLs).
Medications - Find out whether any antibiotic therapy has been given so far.
Allergies - drug allergies are important when deciding on treatment options.
Between tutorials
Students should begin to practise case presentations. The case presentation should be logical and concise but include
all relevant positive and negative findings. This requires practice!
References
Lim WS, Baudouin SV, George RC et al.Guidelines for Management of Community Acquired pneumonia in adults,
Thorax, 2009, 64, suppl.III, 1-55
Community-acquired pneumonia Garau and Calbo Lancet, 2008; 371; 455 - 458
PT-DR TUTORIAL - Clinical Exercises/Revision

Learning Objectives
Metadata
Stage: 1
Revision

Week: 6
Content
Sequence No.: 2
This tutorial should be Revision of any topic in the current block, The tutorial can also incorporate completing Clinical
Exercises.
Reviewed by:
Date Reviewed: N/A
Status: Released
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#
Created By
Date
Jayne Seward
2013-05-24
Jayne Seward
2013-05-24
Jayne Seward
2012-06-29

Learning Objectives
Metadata
Stage: 1
Week: 6
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Kamal Jaikisan Soni
2010-03-19
SEMINAR - Physiotherapy in Cystic Fibrosis

Principal Teacher
Metadata
Stage: 1
Ruth Luella Dentice

rden9091@uni.sydney.edu.au

Week: 6
Learning Objectives
Sequence No.: 1
The physiological effects of excess secretions and the impact on these on various mucous clearance techniques. The
range of techniques for mucous clearance. The physical effects of some of these techniques.

Reviewed by:
Content
Aim
By the end of the session the student should be able to:
Understand the physiological effects of excess secretions and the impact on these of various mucous clearance
techniques.
Identify a range of techniques available for mucous clearance.
Describe the physical effects of some of the techniques.
Discuss the multisystem management of Cystic Fibrosis
Overview
Introduction (10 minutes)
The role of the physiotherapist within the team managing patients with cystic fibrosis. Discussion of professional
interdependence and the importance of communication, co-operation and collaboration.
Discussion of the reasons why clearance of mucus is important and how techniques may vary according to the
Date Reviewed: N/A

Status: Released
Edit History
#
Created By
Date
Jayne Seward
2013-05-08
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2011-04-01
Jayne Seward
2010-11-01
Jayne Seward
2010-11-01
John Mitrofanis
2009-12-07
patient's sputum volume and the degree to which the patient is debilitated.
Discussion of Specific Techniques (45 minutes)
The following mucous clearance techniques will be discussed in terms of:
Proposed mechanisms of action
Side effects related to the techniques
Choice of technique for an individual patient
Mucous clearance techniques:
Postural drainage with percussion and vibrations
Active cycle of breathing technique
Autogenic drainage
Positive Expiratory Pressure (PEP) valve or mask
Flutter valve
Combination PEP and Flutter - Acapella device
Exercise
Mucoactive Agents: (15 minutes)
Discussion of the roles of the following mucoactive agents in secretion clearance
DNase
Hypertonic saline
Mannitol
Mulisystem Management
Exercise
Posture and Pain
Stress Incontinence
Question Time: (10 minutes)
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
Resources
VIDEO
VIEW
Physiotherapy in Cystic
Fibrosis
Physiotherapy in Cystic
Fibrosis - 2014
SEMINAR - Critical appraisal of observational studies

Principal Teacher
Metadata
Stage: 1
Sharon Elizabeth Reid

sharon.reid@sydney.edu.au

Week: 6
Learning Objectives
Sequence No.: 2
Part 1: Review learning about observational studies in the Research Methods Block
Part 2: Introduction to critical appraisal of observational studies
Submitted by: Annie Sadowski

1. Understand what critical appraisal is

2. Understand how to approach the critical appraisal of observational studies
3. Practise critical appraisal by applying a checklist to:
a) An observational Harm study
b) An observational Prognosis study
Content
Students are required to do some preparation work for this session and also, if possible, bring their own device so
they can read/work on electronic copies of the paper and checklists during the sessions.
Ideally, students should read each of the papers and complete the checklists before the session.
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
#
Created By
Date
Annie Sadowski
2014-02-12
Recordings
2014Lecture
AUDIO
VIDEO
VIEW
Resources
Critical appraisal of
observational studies 2014 PPT
Exercise 1 - checklist
Exercise 2 - checklist
observational studies Answers to exercise 1
observational studies Answers to exercise 2
obsevational studies Links to articles
LECTURE - Head and Neck: development

Metadata
Principal Teacher
Stage: 1
John Mitrofanis

Week: 7
PBL/CRS: Difficult circumstances
Learning Objectives
Sequence No.: 1
The main features of the development of the head and neck: cranium, pharyngeal apparatus, thyroid gland and palate.
Consider some major abnormalities associated with head and neck embryology, for example cleft palate/lip,
holoprosencephaly and acrania

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
2012Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-07-18
John Mitrofanis
2011-08-29
John Mitrofanis
2011-08-28
Jayne Seward
2011-08-25
Jayne Seward
2011-03-24
Zhigang Jason Xie
2010-10-18
Jayne Seward
2010-10-16
2014 lecture
LECTURE - Head and Neck: radiology

Metadata
Principal Teacher
Stage: 1
Lavier Gomes
lavier.gomes@sydney.edu.au

Week: 7
Learning Objectives
Sequence No.: 2
The major radiological features of the head and neck

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2011Lecture
2010Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
Download PDF
Download Powerpoint
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-07-18
Jayne Seward
2010-10-16
John Mitrofanis
2009-12-07
Resources
Head & neck: radiology

Head & neck: radiology 2011
Head & Neck: radiology 2012
LECTURE - Microbiology of pneumonia in Australia

Principal Teacher
Metadata
Stage: 1
Peter McIntyre
peter.mcintyre@sydney.edu.au

Week: 7
Learning Objectives
Sequence No.: 3
The importance of age and underlying disease in predicting the most likely causative organisms in pneumonia. The
methods available for examining specimens, including immunofluorescence, and for viruses, interpretation of sputum
gram stains, use of antigen detection methods, use of blood cultures and serological methods.

Reviewed by:
Date Reviewed: N/A
Content
Status: Released
Edit History
Aim
To highlight the difficulties in obtaining appropriate specimens for diagnosis of the cause of pneumonia eg
unavailability or poor quality of sputum specimens, contamination from upper tract flora
To outline the methods available for examining specimens, including immunofluorescence and for viruses,
interpretation of sputum gram stains, use of antigen detection methods, use of blood cultures and serologic
methods.
Created By
Date
Jayne Seward
2011-03-31
Jayne Seward
2011-03-31
To outline the available data on the causative organisms of community-acquired pneumonia in Australian
populations, including Aboriginal populations
To highlight the importance of age and underlying disease in predicting the most likely causative organisms of
pneumonia
Content
obtaining appropriate specimens for the diagnosis of pneumonia
advantages and disadvantages of various methods of obtaining specimens
viral pathogens and diagnosis
bacterial pathogens and diagnosis
atypical pneumonia agents and diagnosis
tuberculosis diagnosis
representative Australian studies of community acquired pneumonia
pathogens by age and disease state
Recordings
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
2012Lecture
AUDIO
VIDEO
VIEW
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Microbiology of pneumonia
in Australia 2010
in Australia
in Australia - 2014
LECTURE - Antimicrobial action in respiratory disease

Metadata
Principal Teacher
Stage: 1
Thomas Gottlieb
thomas.gottlieb@sydney.edu.au

Week: 7
Learning Objectives
Sequence No.: 4
The mechanisms of anti-microbial action in respiratory disease

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2014 (2)Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2010-10-19
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Antimicrobial action in
respiratory disease - 2014
LECTURE - Aboriginal health: making changes in rural and remote communities

Principal Teacher
Paul John Torzillo
paul.torzillo@sydney.edu.au
Learning Objectives
The state of aboriginal health in rural and remote communities
Metadata
Stage: 1
Week: 7
Sequence No.: 5
Reviewed by:
Recordings
Date Reviewed: N/A
Status: Released
Edit History
2011Lecture
2010Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2012-08-08
Jayne Seward
2010-10-19
John Mitrofanis
2009-12-07
Download Audio mp3
Resources
Aboriginal health: making

changes in rural and
remote communities
LECTURE - Children in hospital

Principal Teacher
Philip Coote
philip.coote@sydney.edu.au
Learning Objectives
Metadata
Stage: 1
Week: 7
Sequence No.: 6
The major reasons for, and issues associated with, the hospitalisation of children

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
Children in hospital - 2013
Impact for children - 2014
VIDEO
VIEW
Created By
Date
Alicia Kaya
2014-08-01
Alicia Kaya
2014-04-15
Jayne Seward
2013-08-07
Jayne Seward
2013-08-07
John Mitrofanis
2010-10-21
Jayne Seward
2010-10-19
John Mitrofanis
2009-12-07
LECTURE - Hearing impairment and deafness in the community

Metadata
Principal Teacher
Stage: 1
William Gibson
william.gibson@sydney.edu.au

Week: 7
Learning Objectives
Sequence No.: 7
The different classifications of hearing loss, together with main cause of hearing loss in children and in adults

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2011Lecture
AUDIO
VIDEO
VIEW
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
2013Lecture
AUDIO
VIDEO
VIEW
Resources
VIDEO
VIEW
Created By
Date
Jayne Seward
2010-11-27
Jayne Seward
2010-10-19
John Mitrofanis
2009-12-07
Hearing Loss in the

Community
Hearing loss in the

community
Hearing impairment and

deafness in the community
- 2014
LECTURE - Immunisation
Metadata
Principal Teacher
Stage: 1
Peter McIntyre
peter.mcintyre@sydney.edu.au

Week: 7
Learning Objectives
Sequence No.: 8
The nature and mechanisms of action of vaccines; the range of vaccines that are used, their effectiveness and impact
on the health of populations

Reviewed by:
Date Reviewed: N/A
Recordings
Status: Released
Edit History
2014Lecture
AUDIO
VIDEO
VIEW
2012Lecture
AUDIO
VIDEO
VIEW
2013Lecture
AUDIO
Resources
VIDEO
VIEW
Created By
Date
Jayne Seward
2010-10-19
John Mitrofanis
2009-12-07
Immunisation
Immunisation - 2014
PRACTICAL - Head & Neck: cranial nerves

Metadata
Principal Teacher
Stage: 1
John Mitrofanis

Week: 7
Learning Objectives
Sequence No.: 1

Resources

Status: Released
Edit History
movie
clinical movie
test
Created By
Date
Jayne Seward
2013-02-20
Jayne Seward
2011-08-26
Jayne Seward
2011-08-26
John Mitrofanis
2010-11-09
John Mitrofanis
2009-12-07
Practical notes
PRACTICAL - Ear: structure and functional testing

Principal Teacher
Metadata
Stage: 1
Simon Carlile
simon.carlile@sydney.edu.au

Week: 7
Learning Objectives
Sequence No.: 2
The methods of testing ear function

Reviewed by:
Date Reviewed: N/A
Content
Aim
Preparation
Students are asked to undertake this short tutorial before they attend this session.
Aim
Status: Released
Edit History
#
Created By
Date
Jayne Seward
2013-11-17
Jayne Seward
2013-02-20
Jayne Seward
2011-10-30
To introduce three methods for testing hearing sensitivity and anatomical structure of the ear.
Objectives
To understand the functional anatomy of the external, middle and inner ear.
To successfully perform a standard audiometric tests using a clinical audiometer and to become familiar with
other means of testing hearing.
Content and Method
Undertake a (CD-ROM) Study Guide on The Ear , using the 'Netter Interactive Atlas', installed on computers in
the Anderson Stuart Building.
Description and operation of the otoscope and clinical audiometer
Students to work in pairs alternating as "patient" and "clinician"
Perform both an air conduction and a bone conduction audiogram on both students
Interpret the measured results and interpret the sample results provided
Become familiar with the Rinne and Weber test of hearing
Become familiar with the Automated Auditory Brainstem response for neonatal screening of hearing.
Resources
F. Netter, Interactive atlas of Human Anatomy (CD-ROM and study guide ). Installed on computers in the
Anderson-Stuart Building; also on loan from Bosch Library
Models of the ear
Clinical Audiometer and sound attenuating chamber
Tuning fork
The equipment to support the theme session is located in Anderson-Stuart class rooms 235 and 236.
Resources
Ear: structure and

functional testing
John Mitrofanis
2009-12-07
PRACTICAL - Pathology of pneumonia

Principal Teacher
Metadata
Stage: 1
Nicholas King

Week: 7
Learning Objectives
Sequence No.: 3
How the molecular events of bacterial pathogenesis in pneumonia are affected by virulence and other factors; to
understand the pathological appearance of bronchopneumonia and lobar pneumonia
To illustrate how the molecular events of bacterial pathogenesis in
pneumonia are due to virulence and other factors.
To emphasise that patient management should include both antibiotic therapy and strategies for prevention and
treatment of septic shock.
To understand the pathological development of bronchopneumonia and lobar pneumonia
To understand the pathological appearance of bronchopneumonia and lobar pneumonia

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Created By
Date
Alicia Kaya
2014-04-15
Jayne Seward
2013-11-27
Content
Jayne Seward
2013-11-17
Case 1
Microbiology - slide photographs
Jayne Seward
2013-06-19
Jayne Seward
2013-06-13
Jayne Seward
2013-02-20
Jayne Seward
2011-10-30
John Mitrofanis
2009-12-07
sputum inoculated on blood agar plus an optochin disk; incubated 37C/18hrs O2/AnO2
Gram stain of sputum
Blood cultures, O2/AnO2
Gram stain of alpha-haemolytic mucoid colony from blood agar.
Pathology
Lung-Lobar Pneumonia (macro) Bottle Number: 24.522.1
Lung-Lobar Pneumonia (micro) Slide H34
Case 2
Microbiology - slide photographs
Gram stain of sputum
Sputum inoculated on blood agar incubated 37C/18 hrs O2/AnO2
Blood cultures O2/AnO2
Gram stain of large mucoid colonies from blood agar
Antibiotic sensitivity tests on isolate.
Flow diagram of interaction of humoral factors and cytokines in the pathogenesis of septic shock.
Pathology
Lung - Bronchopneumonia (macro) Bottle Numbers: 24.511.1 and 24.527.2
Lung - Bronchopneumonia (micro) Slide H40-1
Method
Following the introduction and examination of the clinical patient problem, the class will examine the pathology
associated with these diseases. Two cases will be presented sequentially by members of the Departments of Infectious
Diseases and Pathology. Students will:
interpret
examine
evaluate
examine
examine
sputum examination by microscopy and culture.

the characteristic features of pneumonia caused by two specific bacteria.
factors which predispose the host to infection.
the macroscopic features of pneumonia using bottle specimens
the microscopic features of pneumonia using glass slides
Resources
Microbiology and pathology

of pneumonia
Pathology of pneumonia 2012
Pathology of pneumonia 2012
References
2013 Clinicopathology teaching session with Roger Pamphlett was cancelled due to staff strike.
PBL SESSION - Difficult circumstances - 3.07 - PBL 1

Learning Objectives
Metadata
Stage: 1

Week: 7
Content
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
Image: Small Aboriginal girl in an outback camp.

Rebecca Lawford comes from a remote Aboriginal community about 300 kms from Alice Springs. She is visiting town
with her parents and three other children. They are staying with relatives in a camp on the outskirts of town. The
family are living in a small galvanised iron shelter in the yard area of the relatives' house.
Rebecca was brought to the Emergency Department of the hospital by her mother. Her mother says Rebecca has been
hot and had a cough for about 24 hours. Rebecca has a runny nose and some discharge from her left ear. She has
Created By
Date
Zhigang Jason Xie
2010-02-09
also been breathing fast. Rebecca has continued to drink and eat small amounts of food.
Rebecca's mother says she has been in hospital twice before with this sort of problem. Rebecca was admitted to the
Children's Ward and her mother was told that she should come back tomorrow. Rebecca's mother had still not
returned to the hospital after several days.
Discharge from ear.

Reproduced by permission from
" The National Trachoma and Eye Health Program of the Royal Australian College of
Opthalmologists " 1980
Resources
Medical Humanities
Trigger 1
Tutor Guide
Results
Mechanism
Student Guide
PT-DR TUTORIAL - SHAPE Assessment/Revision

Learning Objectives
Revision Pt-Dr tutorial: respiratory sciences
Metadata
Stage: 1
Week: 7
Content
The acronym SHAPE stands for Structured History and Physical Examination. The aim is to give the students an
opportunity to integrate history taking and physical examination in a formative setting, as these are somewhat
artificially segregated in the tutorials. They should also try to arrive at a problem list and a basic differential diagnosis,
which may be as general early on as a respiratory problem, possibly an infection.

Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
It will take approximately half an hour per student and the process is observed by the tutor. The assessment takes
place on the wards during the usual tutorial time and feedback to students from their peers and from the tutor is a
crucial component.Students will bring along a copy of the form for tutors to complete.
It is useful for students to watch each others assessments. Patients who take part in the SHAPE should have
problems/conditions relating to the any block the students are doing, or to previous blocks.
Suggestions for allocation of time in the half hour assessment:
10 mins - observed history taking-focused on the presenting problem and moving on to other aspects of history, time
permitting
10 mins - observed physical examination- of the system (or systems) identified by history of the presenting illness.
The tutor may dictate this to the student, but it is more useful for them to decide which system is most important to
examine.
5 mins - presentation of case by student
5 mins - feedback.Student to give feedback on him or herself initially followed by constructive feedback from the
tutor.The other students in the group are also encouraged to give feedback.
If a SHAPE assessment is not run at your clinical school, a Revision tutorial will take place.
Resources
SHAPE Form - Formative

Assessment
PT-DR TUTORIAL - SHAPE Assessment/ Revision

Status: Released
Edit History
#
Created By
Date
Jayne Seward
2013-05-24
Jayne Seward
2012-06-29
Celina Aspinall
2010-09-20
Learning Objectives
Metadata
Stage: 1

Week: 7
Revision/Clinical Exercises
This tutorial should be Revision of any topic in the current block, The tutorial can also incorporate completing Clinical Exercises.
Sequence No.: 2
Content
The acronym SHAPE stands for Structured History and Physical Examination. The aim is to give the students an
opportunity to integrate history taking and physical examination in a formative setting, as these are somewhat
artificially segregated in the tutorials. They should also try to arrive at a problem list and a basic differential diagnosis,
which may be as general early on as a respiratory problem, possibly an infection.

Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
It will take approximately half an hour per student and the process is observed by the tutor. The assessment takes
place on the wards during the usual tutorial time and feedback to students from their peers and from the tutor is a
crucial component.Students will bring along a copy of the form for tutors to complete.
Created By
Date
Jayne Seward
2013-05-24
Jayne Seward
2013-05-24
It is useful for students to watch each others assessments. Patients who take part in the SHAPE should have
problems/conditions relating to the any block the students are doing, or to previous blocks.
Jayne Seward
2012-06-29
Suggestions for allocation of time in the half hour assessment:

10 mins - observed history taking-focused on the presenting problem and moving on to other aspects of history, time
permitting
10 mins - observed physical examination- of the system (or systems) identified by history of the presenting illness.
The tutor may dictate this to the student, but it is more useful for them to decide which system is most important to
examine.
5 mins - presentation of case by student
5 mins - feedback.Student to give feedback on him or herself initially followed by constructive feedback from the
tutor.The other students in the group are also encouraged to give feedback.
If a SHAPE assessment is not run at your clinical school, a Revision tutorial will take place.
Resources
SHAPE Form - Formative

Assessment

Learning Objectives
Metadata
Stage: 1

Week: 7
Sequence No.: 1
Reviewed by:
Date Reviewed: N/A
Status: Released
Edit History
SEMINAR - Microbiology of pneumonia

Created By
Date
Kamal Jaikisan Soni
2010-03-19
Metadata
Principal Teacher
Stage: 1
Vitali Sintchenko
vitali.sintchenko@sydney.edu.au

Week: 7
Learning Objectives
Sequence No.: 1
To understand clinical and public health importance of the most common causes of pneumonia and mechanisms of
their transmission

To understand differences in aetiology, clinical significance and methods of laboratory diagnosis of community- and
hospital-acquired pneumonia"
2014Lecture
VIDEO
Status: Released
Edit History
Recordings
AUDIO
Reviewed by:
Date Reviewed: N/A
VIEW
2013Lecture
AUDIO
VIDEO
VIEW
Resources
- 2014
Created By
Date
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2013-02-19
Jayne Seward
2012-10-11
Jayne Seward
2012-09-04
Jayne Seward
2012-08-22
Jayne Seward
2011-10-30
SEMINAR - Taking the Pulse of Indigenous Health 3

Metadata
Principal Teacher
Stage: 1
Lilon Gretl Bandler


Week: 7
Learning Objectives
Sequence No.: 2
Taking the pulse of indigenous health

Reviewed by:
Content
Date Reviewed: N/A

Status: Released
New content to come 2012
Edit History
Recordings
2012Lecture
AUDIO
VIDEO
VIEW
Created By
Date
Jayne Seward
2013-04-04
Jayne Seward
2013-04-04
Jayne Seward
2013-02-19
Jayne Seward
2012-01-31
Jayne Seward
2010-09-01
John Mitrofanis
2009-12-07
2013Lecture
AUDIO
VIDEO
VIEW
ASSESSMENT - Stage 1 Required Summative Assessment 1 (1RSA 1)

Learning Objectives
1.
To assess your mastery of relevant Theme components of the course to this level.
Metadata
Stage: 1
2.
Week: 7
To identify if you do not demonstrate the level of mastery required to progress to Stage 3, and if you require
remediation and reassessment.
The written papers are intended to test your knowledge of normal and abnormal human structure, function and behaviour,
and your ability to apply an understanding of normal and abnormal human structure, function and behaviour to the
diagnosis, management and prevention of health problems. The material assessed will be aligned with the student learning
objectives published on Compass.
Content
Themes: Basic and Clinical Sciences/ Patient and Doctor (including Evidence Based Medicine) / Population
Medicine / Personal and Professional Development
Assessment type: Summative
Date: Friday 15 August 2014
Venues:
Old Teachers College Assembly Hall
Quad Professorial Boardroom
Old Teachers College Room 215
A bulletin with further information about the RSA 1 was posted on 17 July 2014 - please see this bulletin. The seat
number list for this exam is also attached as a resource for this page - please check your name to see your
designated exam venue and seat number.
The written examinations delivered in August and November will both contribute to the Summative Assessment in the Basic and
Clinical Sciences theme with the following weightings:
Required Summative Assessment 1 (RSA 1) - August: 25%

Required Summative Assessment 2 (RSA 2) - November: 65%
Your scores on these two assessments will be combined using the above weighting, and in addition with your weighted
scores from the Required Summative Assessments: Anatomy, will determine whether you have met the overall pass
standard for the BCS Theme in 2014. A 'Not Satisfactory' performance in RSA 1 does not necessarily mean you will not
meet the overall standard for the BCS Theme in the year but does imply the need for substantive improvement in the
final assessment.
Summary of details for the RSA 1:

Format: 1 paper, approx. 75% Single Best Answer (SBA) questions; up to 25% Extended Matching Questions
(EMQ)
Number of items: ~120 items
Duration: 180 minutes
PBL/CRS:
Sequence No.:
Submitted by: Carolyn Saul
Reviewed by:
Date Reviewed: N/A
Edit History
#
Created By
Date
Carolyn Saul
2013-12-09
Theme distribution: ~85% Basic and Clinical Sciences (including Patient-Doctor, Research Methods and EBM);
~10% Population Medicine; ~5% PPD
Scope: ~20% from Block 1a and 1b, ~40% from Block 2, ~40% from Block 3.
Attendance:
Attendance in and completion of the RSA 1 is mandatory. If you do not attend the RSA 1, you are required to
complete and submit a Special Consideration application via the Advocate CARE Notification system, within 7 days of
the assessment.
Marking and script review:
SBA and EMQ answer sheets from all papers will be computer-marked and then forwarded to the Assessment Unit for
processing.
Notification of results:
After the results have been collated, each student will receive an individual feedback sheet with their result and details
of their performance in the assessment. We will notify you via bulletin when the feedback sheets are available to
access online. If your results suggest that you may have experienced difficulties with learning and/or the assessment
will receive an email to attend an interview with a member of Faculty who is knowledgeable about both curriculum
materials and effective study approaches to promote optimal learning. The interview is compulsory and you are
required to take advantage of the opportunity to address any difficulties as early as possible in the Program. The
interview will provide a valuable opportunity for you to review both your understanding of the curriculum content and
your approach to study, and to develop a plan to address any problems identified in time for preparation for the RSA
in November.
Written/Prepared By:Dominique Briones (Assessment Unit, OME)
Resources
Stage 1 RSA 1 2014_Seat

Number List

Copyright 2008 Sydney Medical Program, University of Sydney.

Block - 3 - 2014 Block 3 Book

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Compass - 2014 Block Handbook - Respiratory Sciences

2014 Block Handbook - Respiratory Sciences

3.00 Assessment - Stage 1 Research Methods RFA

3.01 - Not at fault

3.02 - Wheezing and breathless

Compass - 2014 Block Handbook - Respiratory Sciences

PBL session 1 - Wheezing and breathless - 3.02 - PBL 1

3.03 - A nasty cough

Compass - 2014 Block Handbook - Respiratory Sciences

Seminar 2 - Lung Disease Resulting from Occupational Exposures

3.05 - Sleeping on the job

3.06 - A different cause of cough

3.07 - Difficult circumstances

Head and Neck: development

file:///Volumes/curdocuments/SMP/Block%20Books%20/2014%20-%20html/Block3.html[31/10/14 3:29:50 PM]

Compass - 2014 Block Handbook - Respiratory Sciences

Lecture 6 - Children in hospital

ASSESSMENT - Stage 1 Research Methods RFA

Block: 3: Respiratory Sciences

Date Submitted: 2014-01-23

Compass - 2014 Block Handbook - Respiratory Sciences

1. Log in to the BlackBoard eLearning website: https://elearning.sydney.edu.au/webapps/portal/frameset.jsp

Michelle Barbara Gerke

Block: 3: Respiratory Sciences

To develop an understanding and appreciation of:

Date Submitted: 2014-04-01

the structural components and organisation of the lower respiratory system.

Date Reviewed: N/A

Compass - 2014 Block Handbook - Respiratory Sciences

components of the thoracic cage: sternum, thoracic vertebrae, ribs.

Thorax: cage, wall,

LECTURE - Thorax: internal organisation and lower respiratory system

Compass - 2014 Block Handbook - Respiratory Sciences

Michelle Barbara Gerke

Block: 3: Respiratory Sciences

To develop an understanding and appreciation of:

Date Submitted: 2013-07-10

file:///Volumes/curdocuments/SMP/Block%20Books%20/2014%20-%20html/Block3.html[31/10/14 3:29:50 PM]

Compass - 2014 Block Handbook - Respiratory Sciences

LECTURE - Overview of emergency medicine

Block: 3: Respiratory Sciences

Submitted by: Alicia Kaya

Compass - 2014 Block Handbook - Respiratory Sciences

threatening processes are secure to fully evaluate.

LECTURE - Mechanics of breathing 1

Gregory George King

Block: 3: Respiratory Sciences

Date Submitted: 2009-12-07

Compass - 2014 Block Handbook - Respiratory Sciences

Mechanics of breathing 1 2014

Compass - 2014 Block Handbook - Respiratory Sciences

J Respiratory Medicine - 2nd Edition. David C. Flenley. Balliere Tindall.

LECTURE - Mechanics of breathing 2

Gregory George King

Block: 3: Respiratory Sciences

Date Submitted: 2009-12-07

Compass - 2014 Block Handbook - Respiratory Sciences

LECTURE - The gas exchange unit: function

file:///Volumes/curdocuments/SMP/Block%20Books%20/2014%20-%20html/Block3.html[31/10/14 3:29:50 PM]

Compass - 2014 Block Handbook - Respiratory Sciences

The significance and function of the gas exchange unit

Date Submitted: 2009-12-07

alveolar ventilation and CO 2 excretion

file:///Volumes/curdocuments/SMP/Block%20Books%20/2014%20-%20html/Block3.html[31/10/14 3:29:50 PM]