Team Member Introductions Jessica Smith: I am recently 21 years old and a Junior. I graduated from Lawrence North High School in Indianapolis IN. I'm a pre-medical student majoring in Biology with hopes of attending medical school. I would really like to go to a medical school in Canada, but we'll see. I want to me a pediatrician, and hope to open several free clinics across the US. Ashely Bell: I am from Leesburg, IN which is a little town in northern Indiana. I am a senior and working towards my biology degree with a minor in psychology and human and family development studies. I am planning to apply to a Physician Assistant master's program when I graduate from IU. I have worked at the Bloomington Hospitality House as a CNA for about a year and enjoy the residents there. I also enjoy the outdoors and doing things such as hiking, backpacking, and camping. I grew up on a farm so I also enjoy working with animals. Ashley Ohneck: I am a 21 year old Senior getting my B.S. in Bology. I'm am from Fort Wayne Indiana and I am the oldest child in my family. I currently work at Hobby Lobby and I love arts and crafts. After graduating from IU I hope to get into dental school. so far since I've been here at IU my favorite class as been Genetics with Professor Strome. Whitney Blair Koeppen: I am from Fort Wayne IN, and graduated from Carroll High School. I'm a 3rd year Junior, majoring in Biology. My are of focus is pre-physical therapy and pre-pharmacy. I took Anatomy and Physiology in high school, and have taking Anatomy 215 here at IU. Dan Smith: I am from Milwaukee Wisconsin. Here at IU I am majoring in Biology and receiving a minor in chemistry. I graduate this spring and I'm planning on attending dental school in the fall. I have 4 younger brothers, the youngest being 4, and an older sister who is 31. I am a member of Bloomingkids, and I'm in a college mentor program for Bloomington grade schools.

So, we keep doing not so great on our lab reports/prelabs. We are starting to get frustrated. We put so much time into this class, yet we don't have the grades to show for it. We are starting to get more annoyed. Now we are trying to meet more often, so that we have more time to work on these assignments and make sure that we are forgetting anything. Also at least 1 or 2 of us have been going to office hours, which really helps, because they give you a good idea on what you need to include. Hopefully we will start to see an increase on our assignments.

Near the end of the semester we finally got the hang of the lab assignments. It took us a while, but eventually we developed a strategy for doing well on the assignments. We all started going on to officer hours the night before the assignments were due. This way, if there was something that we my have forgotten, or somethign that we needed more clairfication on, we were able to get it there, and thus improve our performance on these assignments. Although we never got the bonous for our case narrative after the first time, they all turned out really well. We were all excited to see that were were improving. We don't think we could've taken more hard hits with bad grades on the labs; especially since we weren't doing steller on the exams. We need somthing to keep our grades up. Hopefully our final grades will protray our level of understanding of the material.

Grand Rounds Case Here the grand rounds case that we prepared to present to the class on January 25th 2006. This will be our first presentation in front of the class. Initial Observations: -72 year old woman brought in to the ER in a comatose state. -Has been experiencing severe diarrhea -Hypotensive with BP of 80 systolic/ 60 diastolic Hypothesis: -Mrs. Smith is experiencing severe dehydration -Loss of H20 causes individuals to become hypotensive -Diarrhea causes loss of electrolytes(Na ,K ,bicarbonate,Cl-,Fe2 ,Ca2 ) and H20 -Fluid loss results in decreased blood flow to the brain, causing a comatose state Part 2: -Patient has low fluid volume -Hematocrit increases to above 47/B> -Plasma osmolarity is not affected and remains at 300mOsm/L -Interstitial osmolarity is not affected remains at 300mOsm/L Part 3: -An IV is administered containing 1L of distilled H20 -This causes the plasma osmolarity to decrease to <300mOsm/L -This also causes the interstitial osmolarity to decrease to <300mOsm/L Part 4: -After IV is administered we predicted that the Hct would decrease. This is due to rehydration. -The supernatant appears pink due to the initial increase in Hct, thus not all of the heme is being broken down. If Untreated: -Leads to metabolic shock -Seizures -Permanent brain damage -Death -Note: the medical student should not have administered a distilled H20 drip, rather saline which contains electrolytes Definitions: -Hypotension- low blood pressure -Systolic- maximum blood pressure occurs during peak ventricular ejection -Diastolic- minimum blood pressure occurs just before ventricular contraction -Isotonic- a solution that does not change in cell volume (also does not change normal concentration of electrolytes). -Osmolarity- the total solute concentration of a solution -Metabolic shock- excess loss of fluid and electrolytes, due to vomiting, urination, diarrhea. References: -Wibmaer, Eric P, Hershel Raff, and kevin P Strang. Human Physiology: The Mechanisms of Body Function. 10th ed. New York: McGrawHill, 2004. -Nim.nih.gov/medlineplus/ency/article/000982.htm -AAOS, Emergency:Care and Transportation of Sick and Injured. 8th ed. MA: Jones and Bartlett, 2002.

Case Presentation Electric Shock: The story of Darrell Littlejohn I don't think any of use realized how long it was going to take to put this together. It has been an extremely stressful week, but we are glad that it is all over and that it went well. We were kind of bummed that are powerpoint presentation didn't show the pictures during the presentation. We put so much time into it, and didn't realize the files wouldn't convert from a mac to a pc. I guess there is nothing we can do about it now though. Overall we think the presentation went really well, and we're hoping everyone liked it. And even though the video was a headache to put together, I think it really added to our presentation, and it was humorsou (at least we thought so). As for the rest of the class' presentations, we just wanted to say "Good job everyone." It was a tough week, but all the presentations looked really good!!. Case Presentation Plan: Click here to see our initial outline! Case Presentation Summary Case Presentation Handout Case Presentation Powerpoint Sorry if you can't see the pictures in the slides, but it was done on a mac, and the pictures aren't converting.

Final Thoughts: Jessica: Overall this class was an enjoyable experience. It was definitely more work than I was expecting, but I've learned much more than I thought I would. I don't regret taking this class at all. Based on actual material and understanding of a subject, I fell this has been one of my better classes (even if my grades don't totally reflect that). Whitney: I didn't mind the class too much. Although I'm going to have to take P215 I feel that I've left with a new sense of understanding of physiology. I might not be getting the grade that I need in this class, I don't regret taking it. Dan Smith: I think as the semester progressed, I got a better understanding for the class and how things worked. I was glad that my grade steadily increased with evry exam. I feel that I learned a lot in this class. It was an overall good experience. Ashley Bell: I like the class a lot, and my group members. We all worked so well together. I liked how the class was case study based, I feel that it made the material easier to learn. Although I'm no doing as well asI would've like, I really enjoyed the class. Ashley Ohneck: This class was ok. It was a lot of work, but I learned a lot. I just whish my overall performance was better. I felt that I had a good grasp on the topics, but wouldn't do so well on the exam. I'm hoping for better results on the final.

Useful Resources: *Hain, Timothy. "Orthostatic Hypotension." 07 2006. 20 Feb. 2006 <http://www.dizziness-and balance.com/disorders/medical/orthostatic.html>. *Raff, Hershel, Eric P. Widmaier, and Kevin T. Strang. Human Physiology: The Mechanisims of Body Function. 10 ed. Boston: McGrawHill Higher Education, 2004. Pages 393-407 *"Mayoclinic.com." Physical activity plays key role in controlling blood pressure. 12 Aug 2004. 26 Feb.2006 <http://www.mayoclinic.com/health/high-blood-pressure/HI00024>. *Pickering, Thomas G. "Recommendations for Blood Pressure Measurement in Humans and Experimental Animals ." Circulation 111 (2005). 26 Feb 2006 <http://circ.ahajournals.org/cgi/content/full/111/5/697#SEC4>. *Atkins, David L. “Development of Transmembrane Resting Potential.” 21 November 1998. http://sky.bsd.uchicago.edu/lcy_ref/synap/resting.html>. *Diuretic Cartoons. 26 April 2006 <http://www.cartoonstock.com/directory/d/diuretic.asp> *Cooper, Mary Ann. “ Emergent Care of Lightning and Electrical Injuries.” Seminars in Neurology. Vol. 15, No. 3. September 1995. http://www.uic.edu/labs/lightninginjury/treatment.html. “Electrical Injury.” Injuries and Wounds. 2003. AllRefer.com-Health. 25 April 2006 http://health.allrefer.com/health/electrical-injury-pictures-images.html. *Lewis, Sharon, Margaret Heit-Kemper, and Shannon Dirksen. Medical-Surgical Nursing: Assessment and Management of Clinical Problems. 6th ed. St. Louis: Mosby Incorporated, 2004. *Lightning Strikes. 25 April 2006. http://perso.wanadoo.fr/dmtmcham/lightning.htm *Okafor, U. V. “Lightning Injuries and Acute Renal Failure: A Review.” Renal Failure, 27: 129-134. Taylor & Francis Inc. 2005. *Rhoads, Caroline, and Laurence Epstein. “EKG Components and Intervals.” 14 July 2005. Healthwise Incorporated. 26 April 2006. http://www.webmd.com/hw/health_guide_atoz/tu6256abc.asp *Whitcomb, Darren. Jorge A. Martinez, Dayton Daberkow. “Lightning Injuries.” Southern Medical Journal. Vol. 95, No. 11. November 2002. Pg. 1331-1334. *Wright, Ronald K. “Electrical Injuries.” eMedicine. 4 March 2005. Webmd. 25 April 2006. http://www.emedicine.com/EMERG/topic162.htm *AAOS, Emergency:Care and Transportation of Sick and Injured. 8th ed. MA: Jones and Bartlett, 2002. *Grossman, Shamai. "Congestive Heart Failure and Pulmonary Edema." 15 April 2005. 26 Feb 2006 http://www.emedicine.com/emerg/topic108.htm#section~bibliography *Harrison, Bill. "Congestive Heart Failure." Discovery Health Channel. 13 Dec 1999. 26 Feb. 2006 <http://health.discovery.com/encyclopedias/illnesses.html?article=20>. *"ECG configuration." 22 Jan 2006. Fotosearch. 22 Jan. 2006 <http://www.fotosearch.com/LIF139/nu101003/>. *"Testing for a Circulating Problem." The National Forum. The National FDIC Foundation. 30 Mar 2006.<http://www.ncf-net.org/forum/circulatory.htm>. *Fadem, Steve. "MDRD GFR Calculator ." 16 1999. National Kidney Foundation. 29 Mar. 2006 <http://www.kidney.org/professionals/kdoqi/gfr_calculator.cfm>. *Hayes, Jackie. "Respiratory Alkalosis." Instant Access to the Minds of Medicine. 30 2005. Emedicine. 29 Mar. 2006 <http://www.emedicine.com/MED/topic2009.htm>. *"Antidiuretic hormone." Wikipedia. CD_ROM. ed. 2006. <http://www.reference.com/browse/wiki/Antidiuretic_hormone>. *“Diabetes Mellitus.” Medicindnet.com. 26 Oct 2005. Medicinenet.com. 21 Mar. 2006 <http://www.medicinenet.com/diabetes_mellitus/article.htm.>. *Urinalysis." Medicinenet.com. 05 2005. medicinenet, Inc. 26 Mar. 2006 <http://www.medicinenet.com/urinalysis/article.htm>. *Kaufman, David. "Pulmonary function tests." Medline Plus. 17 Apr. 2006 <http://www.nlm.nih.gov/medlineplus/ency/article/003853.htm>. *"Decompression Sickness." 01 Feb. 2003. The Merck Manuals: Online Medical Library. 12 Apr. 2006 <http://www.merck.com/mmhe/sec24/ch295/ch295c.html>. *"Pulmonary Function Testing." Flow Volume Loops in Detection of Pulmonary Disorders . Respiratory Physology. 11 Apr. 2006 <http://www.lib.mcg.edu/edu/eshuphysio/program/section4/4ch8/s4ch8_19.htm>. *Fidel, Marcus James. “Mild Restrictive Lung Disease.” 2 July 2003. 20 April 2006. <www.aamm.unm.edu/show_sheet.php?s_id=116-29k>. *Sharp, Kim A. "Pickwinian Syndrome." HealthAtoZ: Your Family Health Site. Dec. 2002. Gale Encyclopedia of Medicine. 20 Apr. 2006 <http://www.healthatoz.com/healthatoz/Atoz/ency/pickwickian_syndrome.jsp>. **And of course Professor Schlegal

Assignments we've done ECG report Respiratory Report Respiratory Prelab Renal Report Renal Narrative CHF Narrative Renal Prelab Blood Pressure Pre-lab Heart Rate Report MI Case narrative Heart Rate Report Blood Pressure Lab

First Test Blues.... Good job everyone! First of all we want to begin by telling everyone good job. We all made it through our first physiology exam! So that first test was a lot harder than we on Team 4 thought it was going to be. We thought that we did better than we had. Although we didn't do as great as we were expecting, we worked well as a team on this exam. We had developed a strategy the night before so we didn't have to waste time during the exam to figure out everyone's role. We will most likely use the same method on future exams, because it was quick and worked well. Now that we know the layout of the test, and what to expect our hopes our definitely higher for the next exam.

Second Test Shock! So after the second test, we were really bummed. Talk about a low blow to the stomach! Getting the worst grade out of the entire class, ouch. The thing is, we though we did a lot better. We felt a lot more prepared going into this exam than we did for the first one, yet we did worse. Looks like we are just going to have to really put our butts in gear for this third exam, and hopefully it will be better than both of the first exams. It has to be, I don't think any of us can take anymore disappointment.

Exam 3 Jessica: So we did better than we did on the last exam, which is good. I'm still a little bummed because I thought we did better. Mainly I thought I personally did better. Mabye there is something I'm not getting, yet I feel like I have a real grasp on the information and what's going on. I still love my team. We work really well together, and I think are strategies are getting better. We prepared a lot for this last exam, which I think really helped, and we were all able to make it to Thursday office hours, which I also think really helped. At this time I'm not really sure what we could do to improve. I know we've all been keeping up on the readings, and we are always in class, and we do all the cases. I guess we'll just have to see how this next exam goes. Dan: From day one we have worked well together on the group assignments. We have improved in a way that We have each realized our roles in the group and seek to fulfill those and that has improved our group grades for the most part. Personally my test grades have improved as a direct result of studying the text. For the first test I did not complete the reading assignments and I performed poorly. The second test I read the text, but I did not really study it and I improved but my score was still not up to my standards. On this third test I felt I read and analyzed the text sufficiently and my test grade improved greatly. As a group, I think our test preparation has been getting better as well. This can be seen by group members backing up their answers with evidence on a consistent basis. During the group exam we often have a couple people arguing for one answer and a couple arguing for the other answer and those are the questions we often get wrong. We need to make better use of class notes and the textbook so we can get more of these contested questions correct. Ashely B.:After exam III, I feel like our team is really coming together during the exam time. I think that we have all found our roles within the team and know what works and what doesn’t during the team exam. We have found it beneficial to continue through the exam when we come across a question that we are disagreeing on and return to it later. We have also found that when we all do our best to attend study sessions and office hours, while doing individual preparation outside of class, we record our best exam scores. Even if we all can not attend a study session, having at least one group member present has helped our team study sessions. An area that could improve would be our communication with one another during the exam, which will likely only improve over time. I have found that my performance has improved by doing the reading well in advance of the exam, continually reviewing lecture slides and case studies, and by getting plenty of sleep the night before the exam. Ashely O.: I thought this last test was easier than the second test. however I prepared well beforethe exam this time and even typed out notes for all the readings. I felt prepared but mytest score did not show it I think it was hard for me to organize all the information given and often found that more than one answer could be right depending on how one looked at it and I also let my anxiety get in the way. Of course I was thrown off by the last two questions pertaining to the book reading. As a group I think we are contiually improving and I think it helped that we all were able to attendthe review. Whitney: I think that we worked well as a team and i felt that we did really well until we got our grades back. I think for the next test we should look at the questions for face value and not read into them soo much.

Exam 4: The last one!! (well at least until the final) Over all we feel that we wre more prepared for this exam. We did better as a whole than the last exam, so that was nice. Unfortunately it wasn't exactly what we wer hoping for. But we did place higher than ever, and that was exciting. Over all we improved as the semester progressed. I think by the end we finally knew what to expect on the exams, and how to respond to the questions. It was a stressful week for everyone, but overall the results were decent, we just wish we would've scored a little higher as a whole. We can't really develop any more strategies considering this is that last team exam.