MEDSCI 203 : Mechanisms of Disease

Medical and Health Sciences

2023 Semester One (1233) (15 POINTS)

Course Prescription

Outlines the basic mechanisms, operating at the molecular, cellular and tissue levels, by which human disease develops. These include genetic factors, cell injury, inflammation, repair, circulatory disturbances, and neoplastic change. These mechanisms are illustrated by descriptions of the pathogenesis of specific diseases that are relevant to the New Zealand situation, or are the focus of current biomedical research.

Course Overview

The course commences with a consideration of the nature of pathology, especially its underlying disease processes, and its implications for clinical and laboratory science. Diseases develop as the outcome of interacting genetic and environmental factors. 
In summary, modules comprising this course address the following topics (and are further described under 'Course Outcomes'):
1. Genetic disease
2. Cell injury, acute inflammation, repair and chronic inflammation (exemplified by fatty liver disease, allergy and autoimmunity)
3. Mechanisms of bacterial infection 
4. Metabolic and cardiovascular disease
5. Abnormalities of growth and tumours

Consideration of pathological mechanisms commences with the causes and consequences of cell injury. Cell and tissue responses to such injury include the reversible processes of adaptation and recovery, but if injury to cells is too severe, cell death by any of several recognisable processes may occur. Cell breakdown by necrotic mechanisms leads to inflammation and repair. Such acute inflammation is vital in reparative processes, but if it fails to resolve and becomes chronic, a host of diseases, typical of modern, affluent civilisation may result. Runaway inflammation is seen in autoimmune conditions, as exemplified by rheumatoid arthritis. Inflammation is also associated with microbial invasion. Infectious disease is the theme of our sister course, MEDSCI 202, but a module on mechanisms of infectious disease is included in MEDSCI 203. Diseases that illustrate acute and chronic inflammatory processes following infection are described.
Metabolic and cardiovascular considerations include obesity, type-2 diabetes and fatty liver disease. Blood vessel damage (atherosclerosis, thrombosis and embolism), the loss of blood supply (ischaemia) and tissue destruction (infarction) are covered.
Neoplasia, ‘new’ or uncontrolled growth of cells as seen in cancer, is an important class of human disease. The final lectures will introduce the scientific basis of disordered cell growth and cell death, tumour development, and cancer invasion. Cancers that metastasize (colonise distant sites) are responsible for most of the mortality of tumours, and mechanisms of metastasis will be conclude the course. Interestingly, metastatic processes tend to overlap widely with mechanisms of inflammation.   

Mechanisms of Disease provides an introduction to opportunities for future undergraduate and postgraduate study in the Department of Molecular Medicine and Pathology. Further information may be obtained from any of the lecturers involved in this course. At third year level, for example, MEDSCI 301 is a natural sequel, and MEDSCI 302 (in conjunction with the Auckland Cancer Society Research Centre) is a focused look at cancer biology. MEDSCI 314 considers immunology. 

Course Requirements

Prerequisite: BIOSCI 107, MEDSCI 142

Course Contacts

For 2023, the Course Director is Dr Cherie Blenkiron, c.blenkiron@auckland.ac.nz.
The course coordinator is Dr Rachelle Singleton, r.singleton@auckland.ac.nz, who should be consulted on all issues relating to laboratory attendance. 

Capabilities Developed in this Course

Capability 1: Disciplinary Knowledge and Practice
Capability 2: Critical Thinking
Capability 3: Solution Seeking
Capability 4: Communication and Engagement
Capability 5: Independence and Integrity
Capability 6: Social and Environmental Responsibilities
Graduate Profile: Bachelor of Science

Learning Outcomes

By the end of this course, students will be able to:
  1. Understand the origins (aetiologies) and developmental mechanisms (pathogenesis) of diseases, including chronic inflammation (fatty liver disease), abnormalities of immunity (allergies, autoimmunity), bacterial infections, obesity and the loss of insulin efficacy, cardiovascular disease, and tumours. (Capability 1)
  2. Develop the ability to hold competing theories in mind, and to evaluate their relative merits in accounting for disease development, as exemplified by ongoing controversies over the origins of arterial disease (atheroma and atherosclerosis), and (in cancer) multiple ways by which tumours gain a blood supply and colonise sites remote from the primary tumour. (Capability 2)
  3. Apply integrative thinking to develop models and hypotheses as to how complex, multifactorial disease conditions may evolve, and how they may be diagnosed (as with genomic and transcriptomic analyses of genetic disease) and treated (as with therapies developed to target proteins specifically altered in cancers ). (Capability 3)
  4. Develop connections between genetics, relevant environmental conditions, and emerging disease phenotypes, recognising that gene-environment interactions are involved in inflammatory, metabolic and cardiovascular abnormalities (Capability 4)
  5. Evaluate scientific literature to identify key points and link them together critically in mechanistically illuminating and credible flow diagrams or mind maps. This will be achieved in part by assignments requiring analysis of articles on fatty liver disease, inflammation, heart disease and cancer. (Capability 5)
  6. Demonstrate the ability to engage in self directed learning when novel concepts require further explanation or elucidation (although staff are available to help with students' difficulties, it is anticipated that students will use resources available to resolve issues arising). (Capability 5)
  7. Apply knowledge learned in this course to living wisely: theory should relate to lifestyle applications in terms of diet, exercise, stress, cultural and other inputs that ultimately impact on health (such as mediating effects of chronic inflammation, metabolic disease and cardiovascular function). (Capability 6)

Assessments

Assessment Type Percentage Classification
Assignments - online 14% Individual Coursework
Mid-semester Test 20% Individual Test
Final Exam 50% Individual Examination
Laboratories - reports 16% Individual Coursework
Assessment Type Learning Outcome Addressed
1 2 3 4 5 6 7
Assignments - online
Mid-semester Test
Final Exam
Laboratories - reports
To pass the course as a whole you will need to achieve a satisfactory performance in your coursework assignments AND at least 35/70 in the mid-semester test and final exam combined weighting (70%).

The Assignments will consist of three online modules designed for students to critically assess scientific review articles and three practical pathology laboratory-based reports.

Workload Expectations

This course is a standard 15 point course and students are expected to spend 10 hours per week involved in each 15 point course that they are enrolled in.

For this course, you can expect 32 hours of lectures with tutorials arranged as required, 72 hours of reading, thinking about the content and test/exam preparation, and 45 hours of laboratory work and assignments. The mid-term test is held during a scheduled lecture time.  

Delivery Mode

Campus Experience

Attendance is expected at scheduled practical labs to complete coursework components of the course. 

We expect lecture attendance in person which is an opportunity to engage with your peers and lecturers. Lecture recordings will be provided as an adjunct to support revision but these should not be relied on as the only method of learning. Other learning activities including labs and tutorials will NOT be available as recordings. 
The course will NOT include live online events including group discussions/tutorials. 
Attendance on campus is required for the Mid-Semester test. 
The activities for the course are scheduled as a standard weekly timetable.

Learning Resources

Course materials are made available in a learning and collaboration tool called Canvas which also includes reading lists and lecture recordings (where available).

Please remember that the recording of any class on a personal device requires the permission of the instructor.

Important course administration information and detailed laboratory information is provided in a coursebook (free of charge), which is to be picked up at the start of the semester and brought to all in-person laboratories. Lecture material, slides and recordings will be available on Canvas. Students are strongly advised to familiarise themselves with, and routinely use,  the resources of the University e-library system. These include e-journals and search engines, of which PubMed is strongly recommended. PubMed provides the periodical biomedical literature in abstract form, and in most cases, permits access to articles (reviews and research publications). We expect students to consult this literature, and so do not prescribe a textbook. However for students who prefer to have a textbook, an appropriate volume is the latest edition of Lakhani et al, Basic Pathology (CRC Press). More comprehensive, bulky and expensive pathology reference texts are listed in the course manual and are available on short-term loan or online via the library. 

Student Feedback

At the end of every semester students will be invited to give feedback on the course and teaching through a tool called SET or Qualtrics. The lecturers and course co-ordinators will consider all feedback and respond with summaries and actions.

Your feedback helps teachers to improve the course and its delivery for future students.

Class Representatives in each class can take feedback to the department and faculty staff-student consultative committees.

Overall course satisfaction in 2022 was high with respondents stating that the resources provided complimented lectures and labs. Throughout 2022 we actively worked with class representatives to resolve immediate and longer-term issues. Some students felt that the learning environment did not provide enough opportunities to communicate and/or collaborate with peers. This was no-doubt exacerbated by pandemic restrictions and the need for us to work remotely for the first half of the semester. We encourage students to attend our lectures and engage with peers / lecturers. This will help students to feel more connected to a community of learners and stay motivated and engaged with their learning.

Academic Integrity

The University of Auckland will not tolerate cheating, or assisting others to cheat, and views cheating in coursework as a serious academic offence. The work that a student submits for grading must be the student's own work, reflecting their learning. Where work from other sources is used, it must be properly acknowledged and referenced. This requirement also applies to sources on the internet. A student's assessed work may be reviewed against online source material using computerised detection mechanisms.

Class Representatives

Class representatives are students tasked with representing student issues to departments, faculties, and the wider university. If you have a complaint about this course, please contact your class rep who will know how to raise it in the right channels. See your departmental noticeboard for contact details for your class reps.

Inclusive Learning

All students are asked to discuss any impairment related requirements privately, face to face and/or in written form with the course coordinator, lecturer or tutor.

Student Disability Services also provides support for students with a wide range of impairments, both visible and invisible, to succeed and excel at the University. For more information and contact details, please visit the Student Disability Services’ website http://disability.auckland.ac.nz

Special Circumstances

If your ability to complete assessed coursework is affected by illness or other personal circumstances outside of your control, contact a member of teaching staff as soon as possible before the assessment is due.

If your personal circumstances significantly affect your performance, or preparation, for an exam or eligible written test, refer to the University’s aegrotat or compassionate consideration page https://www.auckland.ac.nz/en/students/academic-information/exams-and-final-results/during-exams/aegrotat-and-compassionate-consideration.html.

This should be done as soon as possible and no later than seven days after the affected test or exam date.

Completing assignments and texts/exams is an essential part of this course to support learning. No more than one major in-course assessment may be awarded with an aegrotat or compassionate assessment. If you apply for more than one aegrotat for major assessments, aegrotat can only be applied to one of these. Once exam marking has been completed, we will perform an analysis and apply the most favourable outcome possible to one of those assessments.

Learning Continuity

In the event of an unexpected disruption, we undertake to maintain the continuity and standard of teaching and learning in all your courses throughout the year. If there are unexpected disruptions the University has contingency plans to ensure that access to your course continues and course assessment continues to meet the principles of the University’s assessment policy. Some adjustments may need to be made in emergencies. You will be kept fully informed by your course co-ordinator/director, and if disruption occurs you should refer to the university website for information about how to proceed.

The delivery mode may change depending on COVID restrictions. Any changes will be communicated through Canvas.

Student Charter and Responsibilities

The Student Charter assumes and acknowledges that students are active participants in the learning process and that they have responsibilities to the institution and the international community of scholars. The University expects that students will act at all times in a way that demonstrates respect for the rights of other students and staff so that the learning environment is both safe and productive. For further information visit Student Charter https://www.auckland.ac.nz/en/students/forms-policies-and-guidelines/student-policies-and-guidelines/student-charter.html.

Disclaimer

Elements of this outline may be subject to change. The latest information about the course will be available for enrolled students in Canvas.

In this course students may be asked to submit coursework assessments digitally. The University reserves the right to conduct scheduled tests and examinations for this course online or through the use of computers or other electronic devices. Where tests or examinations are conducted online remote invigilation arrangements may be used. In exceptional circumstances changes to elements of this course may be necessary at short notice. Students enrolled in this course will be informed of any such changes and the reasons for them, as soon as possible, through Canvas.