Homeostasis

Homeostasis is one of the fundamental properties of any living organism. The heart, lungs, and kidneys work in concert to provide oxygen to and remove toxins from our cells, and they do so continuously from our first breath to our last. The goal therefore of the Homeostasis course is to elucidate the complex biological communication and feedback, mediated via mechanical, soluble and cellular mechanisms, between the heart, the lungs, and the kidneys. Although crosstalk between these organ systems is essential to maintain body homeostasis, pathological states in one or more organs can lead to functional and structural dysfunction in the other organs.

Homeostasis is roughly divided into thirds, with the first portion focused on cardiology, the second on pulmonology, and the third on nephrology. However, content is integrated throughout the course where appropriate; for example, renal physiology and regulation of blood pressure is introduced in the first few weeks given relevance to cardiovascular content.

Formative

• Optional weekly quizzes
• Two mandatory, mid-course self-assessments

Summative

• End-of-course, pass/fail qualifier

• Explain how the heart and kidneys work together to maintain intravascular volume and blood pressure despite shifts in fluid status, and apply knowledge of pharmacology to select appropriate agents to correct volume status and optimize vascular resistance.
• Identify the variety of risk factors (both modifiable and nonmodifiable) that predispose to the development of atherosclerosis through lipid deposition and inflammation, discuss lifestyle and pharmacologic options to reduce atherosclerosis progression.
• Recognize the most common bradyarrhythmias and tachyarrhythmias, and review the different options of pharmacologic and electrical treatment. •
• Discuss how the heart and lungs work together to ensure adequate tissue oxygenation and recognize different causes of hypoxia and how to diagnose and treat appropriately.
• Compare and contrast pulmonary and systemic circulations with respect to pressures, resistance, and response to hypoxia.
• Describe principles of blood oxygen content and explain their disturbances in different shock states, including an understanding of the alveolar gas equation and its role in determining causes of hypoxia.
• Compare and contrast pulmonary function tests in obstructive and restrictive lung diseases. • Describe the kidney’s role in maintaining homeostasis via regulation of electrolyte balance and excretion of bodily toxins in addition to maintaining volume and acid-base status as described above.
• Describe the kidney’s role in maintaining homeostasis via regulation of electrolyte balance and excretion of bodily toxins in addition to maintaining volume and acid-base status as described above.
• Understand the spectrum of disease states in which renal function is compromised, including glomerular, interstitial, and oncologic processes, as well as understanding the challenges in managing patients with compromised renal function.