Course Introduction

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From the course by Stanford University

Stories of Infection

514 оценки

Stanford University

Stories of Infection

514 оценки

This course introduces learners to a variety of infectious diseases using a patient-centered, story-based approach. Through illustrated, short videos, learners will follow the course of each patient’s illness, from initial presentation to resolution. Integrating the relevant microbiology, pathophysiology and immunology, this course aims to engage and entice the learner towards future studies in microbiology, immunology and infectious diseases. The patient-centered videos included in this course were created as part of the Re-imagining Medical Education initiative, led by Charles Prober MD, Senior Associate Dean of Medical Education at the Stanford School of Medicine. This initiative was the first of its kind to explore the collaborative creation of foundational medical education online content by inter-institutional teams of faculty. The content presented in this course was created by faculty from Stanford University School of Medicine, in collaboration with The University of Washington School of Medicine, Duke University School of Medicine, UCSF School of Medicine, and The University of Michigan Medical School. Support for this initiative was provided by the Robert Wood Johnson Foundation and the Burke Family Foundation. PLEASE NOTE: Information provided in this course is for educational purposes only and is not intended to be used for diagnostic and/or treatment purposes.

From the lesson

Introductory Module

In Module One, we will begin to hear how some microbes cause disease in humans. We will familiarize ourselves with the human immune system, including the cells that make up the innate and adaptive immune responses. We will also examine the relationship between socioeconomic conditions and infectious disease as we explore the story of one person’s experience with cholera. By the end of this module, learners will be more familiar with how the host immune defenses actively defend the body against disease-causing microbes. After each lecture, there is a glossary of terms pertaining to that lecture, which will assist learners in answering the quiz questions. Learners can also find a glossary of all terms from the course, listed alphabetically, under the "Resources" tab.

Course Introduction4:55

Meet the Instructors

Maya Adam, MD
Lecturer
Stanford School of Medicine

As you probably already know, microbiology is the study of microscopic organisms.

And these can be tiny single celled organisms like bacteria or

colonies of cells like fungi, or even non-cellular entities like viruses.

That need to live inside hosts cells in order to replicate.

Microbes live in every ecosystem on earth and

the earliest ones have been around for more than 3 billion years.

The human microbiome is the collection of around 200 trillion

bacteria that live on the skin, inside the mouth, and eyes and

in the gastrointestinal tract of the average adult human.

There are ten times as many microbes as there are cells in the adult human body.

And many of these microbes are commensals, they live in peace with us or

even help us to do things like break down nutrients in the digestive tract or

produce vitamins that keep us healthy.

But obviously, sometimes microbes can cause disease.

And this happens in a variety of ways.

In order to cause disease, microbes need to enter and

colonize a part of the body they're not supposed to inhabit.

Then they have to find ways of persisting there.

Or replicating beyond their usual numbers.

In order for these species to survive, they need to exit the host.

And through all of these activities, microbes will evolve.

Sometimes developing virulence factors that help them survive and

potentially make them more pathogenic than they were before.

The science and practice of immunology tries to understand the host

immune defenses that either keep commensal microbes in check or

actively defend the body against pathogenic ones.

Physical barriers like skin and mucus membranes help keep pathogens out.

And a variety of specialized cells

help to protect the host from disease causing organisms.

The first line cells in the immune system form part of the innate immune system.

They detect and recognize potential pathogens.

Even if they've never encountered them before.

And they can then deploy a cascade of other body defenses.

Including activating the adaptive immune system with the end goal of

either eliminating the pathogen.

Or in the case of commensals, finding a way to tolerate the existence

of certain microbes in ways that don't result in disease.

Through these encounters with microbes,

the adaptive immune system will remember certain pathogens.

And store an arsenal of deterrents in case that pathogen ever gets encountered again.

Most of the time, the microbes in and

on the host are successfully kept in check by the host immune system.

But when this steady state is disturbed or

if the immune system begins to behave inappropriately towards host cells,

the result is a clinical presentation of disease.

If the immune system becomes too weak, or too strong, or

if the microbes become too aggressive, or

go places they're not supposed to be in the body, the equilibrium is disturbed,

and physicians need to figure out what went wrong.

By understanding the characteristics of different microbes, and

how the host immune system usually reacts to them.

Physicians can recognize collections of signs and symptoms and

integrate that with other details from the history and

physical exam, to lead to a list of likely diagnoses.

Which can then be confirmed in many cases,

with the help of things like lab tests and imaging.

Understanding the relevant microbiology and immunology,

as it applies to each patient, helps the physician initiate the right therapy.

For example, choose the right antibiotic for a specific type of bacteria.

Or recognize when the immune system may itself be causing damage to the body,

and the physician can then try to mediate.

Knowing when these diseases are most likely to occur,

how different microbes are spread, and how they cause disease.

This knowledge can help with prevention efforts,

both at the level of the individual patient and on the population level,

when we start thinking about the epidemiology of a disease.

Using a framework of the this kind can help physicians

approach a variety of different diseases in an organized and systematic way.

By trying to understand the clinical presentation of a patient as a result of

the interplay between microbes and the host immune system,

we'll be much more likely to succeed in managing the disease

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