Print Version

Effective: Summer 2014
DMS 60BCRITIQUE & PATHOLOGY II2 Unit(s)

Prerequisites: Prerequisite: DMS 60A.
Grade Type: Letter Grade Only
Not Repeatable.
FHGE: Non-GE Transferable: CSU
2 hours lecture. (24 hours total per quarter)

Student Learning Outcomes -
  • Recognize normal and abnormal anatomical structures.
  • List the differential diagnosis that is responsible for sonographic changes.
Description -
Interpretation and critique of normal and abnormal anatomy with correlation of didactic, clinical and image information. Written and oral case presentations with emphasis on abdominal subjects. Intended for students in the diagnostic medical sonography program.

Course Objectives -
The student will be able to:
  1. demonstrate listening, writing, and speaking communication skills through performance and sonographic nomenclature with an emphasis on abdominal structures.
  2. define ethical and professional values related to sonography and medicine and its impact on patient/workers from various cultures, gender, and age populations.
  3. define the data found on the ultrasound examinations including artifacts with an emphasis on abdominal structures..
  4. prepare and present a case study using the criteria provided to conform to quality case studies.
Special Facilities and/or Equipment -
DVD/TV, computer, monitor, viewboxes. Online activities requires internet access.

Course Content (Body of knowledge) -
  1. Communication characteristics for listening, verbal, and written skills.
    1. listen to patients history and write findings using medical nomenclature
    2. interview patients and prepare written reports
  2. Communication using profession specific nomenclature.
    1. Applying described techniques to patients from diverse cultural, emotional, and socioeconomic status with sensitivity to their rights and comforts.
  3. Image Quality Recognition for interpretation, presentation, and technical quality.
    1. Assessing and obtaining pertinent clinical information.
    2. components of the clinical report
    3. assessing relevant from non relevant data
    4. produce quality studies for the physician to interpret
    5. contrast diagnostic quality of examinations from suboptimal studies
    6. Artifacts - determine useful artifacts from other types of artifacts
  4. Components of a Case review and presentation including research.
    1. internet research to develop the Case Review and presentation
    2. internet research for the differential diagnosis
  5. all with an emphasis on abdominal subjects
Methods of Evaluation -
  1. Written quizzes
  2. Case presentations
  3. Comprehensive final exam
Representative Text(s) -
Kawamura, D., Lunsford, B.; Abdomen and Superficial Structure, 3rd ed., Baltimore: Lippincott Williams& Wilkins, Baltimore, MD, 2012.
Kawamura, D., Lunsford, B.;Workbook for DMS: A Guide to Clinical Practice, Abdomen and Superficial Structure, 3rd ed., Baltimore: Lippincott Williams& Wilkins, Baltimore, MD, 2012.
Stephenson, S., Diagnostic Medical Sonography: Obstetrics and Gynecology, 3rd ed., Baltimore: Lippincott, Williams & Wilkins, Baltimore, 2012.
Hall-Terracciano, B., Stephenson, S., Workbook for Diagnostic Medical Sonography: A Guide to Clinical Practice, Obstetrics and Gynecology, 3rd ed., Baltimore: Lippincott, Williams & Wilkins, Baltimore, 2012.

Disciplines -
Diagnostic Medical Technology
 
Method of Instruction -
Lecture presentations, classroom discussions, homework and ETUDES-NG internet.
 
Lab Content -
  1. Participate in online assessments
  2. Testing
  3. Case analysis
 
Types and/or Examples of Required Reading, Writing and Outside of Class Assignments -
  1. Written case reports is to include presenting medical history including signs and symptoms, laboratory findings, a discussion of the examination findings, diagnostic differentials leading to a final diagnosis. It is to include a critique of the studies quality, substance, and depth of findings. Research and citation of reputable medical literature, journals, and publications is to be included.
  2. Case presentation is the oral presentation of the case(s) following the format of the written form and to include substantive research. The medical images and documents is included with well researched comment. The student is to be prepared to answer questions involving the case including the patient history and clinical findings, etiology, laboratory data, image acquisition, post op and prognosis.
  3. Case analysis Case analysis is to include presenting medical history including signs and symptoms, laboratory findings, a discussion of the examination findings, including differentials and leading to a final diagnosis. It is also to include a critique of the study quality, substance, and depth of findings.
EXAMPLE: an 18 y/o female with clinical l symptoms of 2-month abdominal pain, n&v, low –grade fever. Does not take medications. Her abdomen is distended but no guarding or rigidity is noted. No erythema, pallor, or venous distention.

Significant laboratory analyses include a hematocrit of 26.7% (0.267), a platelet count of 51 × 103/μL (51 × 109/L), and a white blood cell (WBC) count of 9.0 × 103/uL (9.0 × 109/L). Her carcinoembryonic antigen (CEA) level is less than 1 ng/mL (1 μg/L; normal range, 0-10 ng/mL), her human chorionic gonadotropin (hCG) value is less than 5 mIU/mL (5 IU/L; normal range for a nonpregnant woman, < 5 mIU/mL), her alpha-fetoprotein (AFP) level is 0.8 ng/mL (0.8 μg/L; normal range, 0-10 ng/mL), her lactate dehydrogenase (LDH) measurement is 534 U/L (normal range, 259-613
U/L), and her cancer antigen (CA) 125 level is 509 U/mL (509 kU/L; normal range, 0-35 U/mL).

Pelvic ultrasonography indicates a normal-sized uterus and endometrial stripe; it also shows a complex, midline pelvic mass of 11 × 9 cm in size, with both solid and cystic components. This is thought to represent either an abscess or ovarian neoplasm.

At laparotomy, a large pelvic abscess is encountered and, subsequently, 1700 mL of turbid fluid is drained from the abscess cavity. The biopsies reveal multiple caseating and noncaseating granulomas with organisms compatible with Mycobacterium tuberculosis on AFB staining.