NRDNP 838 Advanced Pathophysiology
Fall 2013
Medical University of South Carolina
College of Nursing Syllabus
Course Number:
NRDNP 838 W 01
Course Title:
Advanced Pathophysiology
Semester and year:
Fall 2013
Credit:
Three (3) Semester Hours — 3 sh (45:0:0)
Placement in curriculum:
(ONLINE) Fall 2013 from Friday 8/20/2013 to
Friday 12/6/2013. All coursework & exams (which
are in the online course) must be completed online
by the end of the day on Monday, 12/9/2013.
According to MUSC policy, if coursework is not
completed by the end date of the course, the
student will receive either a grade of “Incomplete”
or an “F” grade due to zero credit on required
assignments. If an “Incomplete” is granted, the
student must then complete all coursework
according to the MUSC policy (by posted date prior
to the following term) to receive a numeric grade,
or automatically receive an “F” grade. The
“incomplete” option may be used only once per
course and is NOT automatically granted (must be
arranged in advance with instructor permission).
Academic progress will be reviewed periodically
throughout the term and warnings given as
needed. This is a core MSN course, a grade of
85% (3.0) in clinical tracks is required.
Pre-and co-requisites:
Graduate Standing
Faculty:
Name: Claire DeCristofaro, MD
MUSC Email: decristc@musc.edu
Room: No on-campus office or phone
Phone: (828) 545-9406 (cell for calls & texts)
Fax: n/a
Skype name: n/a
Instructor: C. DeCristofaro, MD
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NRDNP 838 Advanced Pathophysiology
Fall 2013
Instructor availability:
Office hours: You may contact instructor 24/7 using MUSC email or her cell phone (see above). Dr. D
is happy to communicate with students outside of regular business hours. Her MUSC email and
online course messages will be checked at least once daily (usually more often), including holidays
and weekends. If she is not available for a specific segment of time, students will be notified within
the online course. For regular communications, use MUSC email. For urgent communications, do not
hesitate to use the provided instructor’s cell phone number (if no answer, leave your name, course,
return numbers/times, reason for call; you can also text).
Course description:
In-depth study of normal physiologic and pathologic mechanisms of disease across the lifespan
providing a foundation for advanced clinical assessment, diagnostic reasoning, and management of
common, episodic and chronic conditions. Emphasis on the interpretation of diagnostic laboratory
data as it reflects both normal function and pathological changes that result in signs and symptoms of
disease. Prerequisite: Graduate standing. Fall
Course objectives:
At the end of the course, the student will be able to:
1. Comprehend physiologic changes over the life span.
2. Apply knowledge of developmental physiology, etiology, and pathogenesis of common diseases
to the presentation, interpretation, and analysis of diverse symptom complexes.
3. Analyze select diagnostic and laboratory studies from a physiological or pathophysiological
perspective.
Instructor: C. DeCristofaro, MD
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NRDNP 838 Advanced Pathophysiology
Fall 2013
Teaching strategies:
Online course lecture notes, independent readings, clinical pathophysiological correlates (case
studies), enhanced online content (audio, images, links) & instructor communications.
 This class is totally online (Web-Based). All exams, course notes, course calendar, and
communications are within the online course shell in the educational software used for online
courses at MUSC.
 This course is “asynchronous” – meaning you will not be obligated to attend class online at a
specific date/time for learning activities. Assignments and assessments will have specific due
dates in the course calendar.
 There are instructor-created notes to supplement text readings as well as optional audio files in
MP3 format to accompany the notes. Within the notes there may be internet links that you should
follow as directed.
 NOTES FILES:
o The notes are in “PDF” format and are read using Adobe Acrobat Reader, a free software
that you can download from the internet (see below). Your computer probably already has
this installed, but you want to be sure that you have the latest version. This is also a
program (application) that you will need to view other files such as Clinical Practice
Guidelines (e.g. from the CDC, National Institutes of Health) and many online files from the
clinical literature. The filename extension for these files is “.pdf” In order to obtain this free
program (application), go to http://get.adobe.com/reader/
o UNCHECK the box that says “McAfee” (unless you want this antivirus software).
Download it to your desktop or another location in your computer that you will remember.
Then, find the file after it has downloaded, double-click on it, and it will “self-install.” Be
sure you do this at the start of this term to get the latest version or many PDF files won’t
work for you.
 AUDIO FILES:
o There are available AUDIO (MP3) files for this course. They are optional and designed to
enrich the online learning environment. Most students find them very helpful. They can be
played over the internet, downloaded to your computer and played using your computer, or
any MP3 (music) player.
o They are available via weblink in the course for download.
o Audio files will be uploaded as the course progresses.
o Instructions for downloading these files are within the course.
Instructor: C. DeCristofaro, MD
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NRDNP 838 Advanced Pathophysiology
Fall 2013
Course materials:
Required:
1. Course notes will be available online: You will need the latest version of Adobe Acrobat Reader
(free) available ONLINE. In order to obtain this free program (application), go to
http://get.adobe.com/reader/
UNCHECK the box that says “McAfee” (unless you want this antivirus software). Download it to
your desktop or another location in your computer that you will remember. Then, find the file
after it has downloaded, double-click on it, and it will “self-install.” Be sure you do this at the start
of this term to get the latest version or many PDF files won’t work for you.
2. Optional audio files: MP3 audio files will be available to accompany most course notes.
Instructions on the location of these files and how to download them will be provided in the online
course. They can be played over the internet, or downloaded to be played on your computer or
MP3 (music) player.
3. Assigned text readings from: McCance, K.L. & Huether, S.E. (2010) Pathophysiology: The
Biologic Basis for Disease In Adults and Children. St. Louis: Mosby. ISBN: 978-0-323-06584-9
(Sixth Edition) Internet site for book:
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323065849
Beware of similar titles by the same author.
Recommended:
1. Despopoulos, A. (2009) Color Atlas of Physiology. New York: Thieme Medical Publishers. ISBN
9783135450063 (Sixth Edition) Softcover:
http://www.thieme.com/index.php?page=shop.product_details&flypage=flypage.tpl&product_id=85
5&category_id=15&keyword=silbernagl&option=com_virtuemart&Itemid=53http://www.thieme.com
/SID2478098062330/productsubpages/pubid2055675596.html
2. Silbernagl & Lang. (2010) Color Atlas of Pathophysiology (2nd edition). Thieme Medical
Publishers. ISBN: 9783131165527 Softcover:
http://www.thieme.com/index.php?page=shop.product_details&flypage=flypage.tpl&product_id=88
9&category_id=15&option=com_virtuemart&Itemid=53
3. Ganong, WF. Review of Medical Physiology. Appleton & Lange. Paperback, companion to text
below. Physiology only (no pathophysiology).
4. McPhee, SJ, et. al. Pathophysiology of Disease: An Introduction to Clinical Medicine. Latest
paperback edition. Does not contain info on Maternal/Fetal.
5. Guyton, A. Textbook of Medical Physiology. This is the "standard" hardcover text for physiology,
but very little pathophysiology and no maternal/fetal medicine. Saunders.
Instructor: C. DeCristofaro, MD
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NRDNP 838 Advanced Pathophysiology
Fall 2013
Topical outline:
Basic concepts presented earlier in the course provide the basis for learning complex processes, with
an eventual appreciation of the integration of physiologic functions across organ systems. This is the
basis for the clinician's ability to analyze presenting signs and symptoms within a framework of health
and disease. Clinical laboratory correlates are integrated into course content by organ system.
Topics are covered in thematically related Learning Modules:
1.
Cell Structure & Function (genetics, receptors, metabolism, immunity, neoplasm)
2.
Nervous System
3.
Muscle, Bone & Integumentary
4.
Hematologic System
5.
Cardiovascular & Lymphatic Systems
6.
Pulmonary (Respiratory) Systems
7.
Renal & Urologic Systems
8.
Acid-Base & Fluid-Electrolyte Balance
9.
Digestive System, Accessory Organs of Digestion, Liver, Lipoprotein Physiology
10.
Endocrine System
11.
Reproductive System, Fetal & Neonatal Physiology
12.
Special Sense Organs & Clinical Laboratory Correlates
See topical outline below with course calendar by WEEK
Instructor: C. DeCristofaro, MD
Page 5 of 13
NRDNP 838 Advanced Pathophysiology
Fall 2013
Fall 2013 Course Calendar – weeks are “Monday to Sunday” (except Finals Week):
Week/Date
Week 1
8/20-8/25
Week 2
8/26-9/1
Week 3
9/2-9/8
Week 4
9/9-9/15
Week 5
9/16-9/22
Learning Module
Start Module 1
Continue Module 1
Start Module 2
(Labor Day 9/2 – CON
closed)
Complete Module 2
Complete Module 3
Module Topic Contents
Pathophysiology Basics
(Start)
Pathophysiology Basics
(Finish)
Nervous System
(Start)
Nervous System
(Finish)
Muscle/Bone/Skin
(Complete)
Complete
Module 4
Complete
Module 5
Complete Module 6
Hematology
Review Modules 4, 5 & 6
Review these modules
Week 10
10/21-10/27
Week 11
10/28-11/3
Week 12
11/4-11/10
Complete Module 7
Renal/Urologic
Complete Module 8
Acid/Base/Electrolytes
Review Modules 7 & 8
GI & Accessory Organs
Lipoproteins
Week 13
11/11-11/17
Complete Module 9
GI & Accessory Organs
Lipoproteins
Week 14
11/18-11/24
Week 15
11/25-12/1
Complete Module 10
Endocrine
Week 16
12/2-12/8
Self-study Module 11 &
Module 12 (not tested)
Cardiovascular
Pulmonary/Thorax
Take Exam 3 (content from
Modules 4, 5 & 6) Completion
Deadline: Sunday 10/27
Review Modules 9 & 10
(Thanksgiving 11/28 &
11/29 – CON closed)
Instructor: C. DeCristofaro, MD
Take Exam 1 (content from
Module 1) Completion
Deadline: Sun 9/9
Take Exam 2 (content from
Modules 2 & 3) Completion
Deadline: Sunday 9/29
Week 6
9/23-9/29
Week 7
9/30-10/6
Week 8
10/7-10/13
Week 9
10/14-10/20
Finals Week
12/9-12/11
Exams & Tasks Schedule
Email have read Syllabus
Computer Readiness
Reproductive
Special Senses
Optional Final Exam
covers Modules 1-11;
must take & submit for
grading Exams 1-5 first
Take Exam 4 (content from
Modules 7 & 8) Completion
Deadline: Sunday 11/17
Study for and take Exam 5
(covers content from Modules 9
& 10) Completion Deadline:
Sunday 12/8
Take Optional Final Exam
(content from Modules 1 – 11)
Completion Deadline:
Monday 12/9
Optional Final Exam has
completion deadline of
Monday 12/9
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NRDNP 838 Advanced Pathophysiology
Fall 2013
Assessments:
Below is a list of activities that are graded in this course, their due dates and
percent of total grade for each. Below the grid is a brief description of each
assessment including how it will be evaluated.
 There are five (5) required course examinations, with objective-type
questions, spaced throughout the course covering specific segments of
course material; final grade is the average of all 5 exams.
 All five required course exams (Exams 1 – 5 inclusive) must be taken and
submitted for grading before the end of the semester to obtain course credit.
 There is an optional final exam that is comprehensive; if taken, the five best
exam grades are averaged to obtain your final grade (one worst grade of 6 is
dropped). All of the required five course exams must be taken BEFORE
attempting/submitting the final exam.
 Exams cover specific segments of course material, but it is expected that the
student remain responsible for prior knowledge learned earlier in the course.
 THESE EXAMS ARE NOT "OPEN BOOK," THEY ARE ON THE HONOR
SYSTEM, completed through INDIVIDUAL effort, without access to learning
resources; they must be completed at one sitting. Any time limits for
completion of an exam will be posted in the course.
#
Assessments
1
2
3
4
5
6
Online Exam 1
Online Exam 2
Online Exam 3
Online Exam 4
Online Exam 5
Optional Final Exam (may
replace one worst grade
from required exams above)
Date due
Sunday, 9 September 2013
Sunday, 29 September 2013
Sunday, 27 October 2013
Sunday, 17 November 2013
Sunday, 8 December 2013
Monday, 9 December 2013
% final
grade
20%
20%
20%
20%
20%
n/a (see
above)
Assessment details: all exams cover BOTH pathophysiology AND diagnostics
content
1. Exam 1: Module 1 content (course notes & directed resources, text readings)
2. Exam 2: Modules 2 & 3 content (course notes & directed resources, text
readings)
3. Exam 3: Modules 4, 5 & 6 content (course notes & directed resources, text
readings)
4. Exam 4: Modules 7 & 8 content (course notes & directed resources, text
readings)
5. Exam 5: Modules 9 & 10 content (course notes & directed resources, text
readings)
6. Optional Final Exam: Modules 1-11 content inclusive (course notes, directed
resources, text readings (optional and grade may replace one worse previous
exam grade from exams 1-5; all exams 1-5 must have been taken and
submitted for grading before attempting/submitting the optional final exam
Instructor: C. DeCristofaro, MD
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NRDNP 838 Advanced Pathophysiology
Fall 2013
Assignments:
First Week Readiness Tasks:
 Read all links at the top of the page in Moodle
 Read the Syllabus (this document) in entirety and email Dr. D that you
have read it and have no questions
 Computer Readiness – Update Adobe Reader
 Computer Readiness – Download/install LockDown Browser
 Computer Readiness – Take Fake Exam (in Moodle)
Reading Assignments:
 Reading assignments are from the required text for each module/unit
(note that the chapter assignments may not be in order!)
 For every module, there are extensive COURSE NOTES from the
instructor, which are ALSO part of the REQUIRED READING
 Assessment assignments follow on next page
Module 1: course notes & text chapters 1, 2, 4, 5, 6, 7, 8, 9, 10, 11,12, 13
(NOT Ch. 3)
Module 2: course notes & text chapters 14, 15 (not Special Senses section),
16, 17, 18, 19.
Module 3: course notes & text chapters 41, 42, 43, 44, 45.
Module 4: course notes & text chapters 25, 26, 27, 28.
Module 5: course notes & text chapters 29, 30, 31.
Module 6: course notes & text chapters 32, 33, 34.
Module 7: course notes & text chapters 35, 36, 37.
Module 8: course notes & text chapters 3, 46, 47.
Module 9: course notes & text chapters 38, 39, 40.
Module 10: course notes & text chapters 20, 21.
Module 11: course notes & text chapters 22, 23, 24.
Module 12: course notes & text chapter 15 (section on Special Senses).
Instructor: C. DeCristofaro, MD
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NRDNP 838 Advanced Pathophysiology
Fall 2013
Grading Scale: The grading scale from the current MUSC College of Nursing
Student Handbook can be found by clicking on the link below and finding
“grades” in the table of contents.
Grading scale (at:
http://academicdepartments.musc.edu/bulletin/acad_policies/grading.html )
Late assignment policy:




Students may request the instructor, in ADVANCE of posted deadlines, if a
deadline extension may be granted. This may be granted at the discretion of
the instructor. At instructor discretion, a “zero” grade may be assigned (or
points taken off the numeric exam grade) if an exam is not taken by the
posted completion deadline. No deadline extensions are possible beyond the
posted end date of the course.
Accessing ALL course materials, demonstrating academic progress in the
course throughout the term, and responding to instructor emails or other
notices as directed are all part of the requirements for successful completion
of this course. The student “tracking” function in the online course will be
utilized as needed to demonstrate continued participation as per course
calendar dates.
If all coursework and assignents/exams are not completed by the posted end
date of the course, the student’s course grade is based on the available
grades from completed assignments. The “Incomplete” grade option is NOT
automatic and may be used only once per course. This option must be
arranged well in advance of the end of the semester, and is only given with
instructor and advisor permission. The student should be in good academic
standing, with every expectation that coursework can be successfully
completed before the beginning of the subsequent term, with all remaining
work to be completed by specified dates to be determined by the instructor, or
an “F” grade is assigned.
Student academic progress will be reviewed periodically throughout the term
and academic warnings given as needed and copied to the student services
department of the College of Nursing. This is a core course and a final grade
of 85% (3.0) for those in clinical tracks is required.
CON participation policy:
A student who does not participate in a class for three consecutive weeks will be
automatically dropped from the course. Participation is defined as your presence
in class and active participation as evidenced by class preparation and
discussion regarding the class topic
Instructor: C. DeCristofaro, MD
Page 9 of 13
NRDNP 838 Advanced Pathophysiology
Fall 2013
Additional course-specific participation policies:
 The online course calendar and course information packet will have a timeline
for completion of course materials, learning activities, exams and/or other
assignments. Any updates or changes will be made via course messaging
(email), the course calendar, and/or course announcements.
 You are expected to log in and check for course messages/emails and/or
calendar updates and/or announcements at least three times per week
during the active semester, and provide a response to instructor emails
as requested within two business days.
 You can expect the instructor to return student email within 24-48 hours. For
urgent communications, use the instructor’s cell phone (provided); you may
call or text any time. If you have not heard back from the instructor within the
time frame expected, please RESEND your message.
 Throughout the term, accessing all course materials and demonstrating
appropriate academic progress, as well as completing assignments/exams on
time, are additional requirements for successful completion of this course.
 All five required course exams (Exams 1-5 inclusive) must be taken and
submitted for grading before the end of the semester to obtain course credit.
At instructor discretion, a “zero” grade may be assigned (or points taken off
the numeric exam grade) if an exam is not taken by the posted deadline. See
above policy on late assignment (deadline extensions) and late submissions.
 Before the end of the term, the College of Nursing will make available an
online anonymous evaluation that will allow you to evaluate the course and
the instructor. Please complete this, student feedback is appreciated. You
are also welcome to provide feedback on the course to the instructor at any
time.
Resources:
Technology support:
A support hierarchy is in place to assist students enrolled in online courses. If
you need assistance, please see below.
1. Nursing Technology Center, Monday - Friday, 8am-5pm
a. Email ntc@musc.edu first. This is the best way to set up an
appointment or request non-urgent help.
b. If you cannot proceed with your work until you get assistance, call
Bernie Jansen (843) 792-0213
2. 24/7 support: OCIO-IS Support Desk is available Monday - Sunday, 24
hours, (843) 792-9700, or helpdesk@musc.edu to send an email. If you
have forgotten your username and password, only OCIO-IS can help you.
3. For content-specific issues, remember to look in the syllabus. The
answers to many of your questions can be found in the syllabus. Contact
course faculty with course-specific questions.
Instructor: C. DeCristofaro, MD
Page 10 of 13
NRDNP 838 Advanced Pathophysiology
Fall 2013
Required technology:
Computer use at MUSC: Please read and understand the university’s computer
use policy. It can be located by clicking below.
Computer Use Policy:
Prerequisite computer competencies:
This information can be found in Section III of the current MUSC College of
Nursing Student Handbook, which is posted on the website and can be accessed
by clicking below.
Computer Competencies
Honor Code:
The faculty of the MUSC College of Nursing endorse the campus Honor Code
and expect students to be familiar with and abide by its provisions. The Honor
Code policy applies to all tests, written assignments, clinical behavior, clinical
logs, medical record entries, and verbal and electronic communication. The
Honor Code document can be viewed by clicking below.
Honor Code
Plagiarism statement:
Plagiarism is a form of academic misconduct and is the use of another person’s
words or ideas without providing credit to that person. It is the theft of another
person’s words or ideas to give the impression that you created them. These
words and ideas may be from a variety of sources including printed works,
speeches, presentations, and/or Internet sites and documents. Appropriate and
complete referencing of words and ideas obtained from others is a requirement in
ALL courses. If a work is anonymous, as may be the case with some Internet
documents, it still must be fully referenced.
Course Evaluation:
The practice of professional nursing involves internalizing values of altruism,
autonomy, human dignity, and integrity (The essentials of baccalaureate
education for professional nursing practice, 2008). While few would argue this
occurs in caring for patients, it often does not translate into professional
relationships. At the end of this course, you will be asked to evaluate the course
and faculty. We ask that you do so with these values in mind. We value your
honest opinions, but please be respectful.
Accommodation for disabilities:
Section 504 of the Rehabilitation Act of and the Americans with Disabilities Act of
1990 requires MUSC to provide academic adjustments or accommodations for
students with documented disabilities. Students seeking academic adjustments
or accommodations must self-identify with the Associate Dean for Academics in
the College of Nursing. The Disability Accommodation Request form may be
found in the Office of Student services. After consulting with the Associate Dean
for Academics, students are encouraged to meet with instructors to discuss their
needs and, if applicable, any clinical safety concerns related to their disabilities.
Instructor: C. DeCristofaro, MD
Page 11 of 13
NRDNP 838 Advanced Pathophysiology
Fall 2013
FREE STUFF!!!
US Public Service Task Force: Guide to Clinical Preventive Services at
http://www.ahrq.gov/clinic/pocketgd.htm (scroll down to the Online Store)
Join the NIH, FDA, CDC and other listservs (free):
 A listserv subscribes you to receive email updates; can unsubscribe any time
 CDC: http://www.cdc.gov/subscribe.html
 FDA:
http://www.fda.gov/AboutFDA/ContactFDA/StayInformed/GetEmailUpdates/d
efault.htm
 NIH listserv signup: https://list.nih.gov/cgi-bin/wa.exe?A0=nihpress
 FDA Med-Watch: http://www.fda.gov/Safety/MedWatch/ucm228488.htm
 Be sure to check your email within 24 hours – they will want you to confirm
that you have joined the list in order to establish your membership in the list
The Merck Manual Professional Online:
http://www.merckmanuals.com/professional/index.html and smartphone apps at
http://www.merckmedicus.com/pp/jsp/home.jsp http://www.merck.com/
Monthly Prescribing Reference (MPR) online:

Drug database resource: http://www.empr.com/ register for free email
newsletter on new drugs

Downloadable app for smartphone/PDA: http://www.empr.com/downloadempr/section/753/
Diagnosaurus: free “app” for PDA/smartphone. Google “diagnosaurus” or find
using your app store on your device. This app allows you to generate a
differential diagnosis list!!
Morbidity & Mortality Weekly Report MMWR): weekly with periodic
summaries, CDC guidelines and advice for screening & intervention strategies,
travel recommendations. You may request to be put on their listserv email
notification system so you will know when new issues are available and can link
to them via email: http://www.cdc.gov/mmwr/mmwrsubscribe.html
Physician's Desk Reference (PDR): can register for free newsletters and also
use their searchable drug information database at http://www.pdr.net/
Order free monofilaments for neuropathy testing:
http://www.ask.hrsa.gov/detail_materials.cfm?ProdID=3465
Instructor: C. DeCristofaro, MD
Page 12 of 13
NRDNP 838 Advanced Pathophysiology
Fall 2013
THINGS THAT COST MONEY
LexiComp Smartphone/PDA database: databases for drug interaction, drug
database and more. Much of this is now available at the MUSC library. You will
also purchase a discounted student subscription for your smart phone before we
begin Advanced Pharmacology – if questions, ask Dr. D.
Pharmacology Continuing Education: (print, smartphone, online)
The Medical Letter on Drugs & Therapeutics: http://secure.medicalletter.org/
The Prescriber’s Letter:
http://prescribersletter.therapeuticresearch.com/home.aspx?cs=&s=PRL
Lippincott Manual Series: http://www.lww.com
Washington University Manual on Medical Therapeutics – hospital diagnosis &
therapeutics
Problem Oriented Medical Diagnosis – great for beginning clinical students
(symptom-based diagnosis)
Many other “manuals” in this series (orthopedics, ophthalmology, etc.) – usually
available as print manual and/or PDA/smartphone app.
Harriet Lane Handbook (Johns Hopkins Hospital), Pub: Mosby, new edition
updated every 2 years. Pediatric handbook & reference values; carry size
handbook with PDA link (be sure to purchase the book that also gives you the
PDA link for download).
Dermatology: Fitzpatrick. Color Atlas and Synopsis of Clinical Dermatology.
McGraw –Hill
Red Book, Report of The Committee on Infectious Disease, American
Academy of Pediatrics, published every 2 - 3 years. Latest recommendations for
topics relating to infectious disease, including vaccinations & infectious and/or
pediatric care issues. Can be purchased online as PDA download, or text, or
computer download. URL: http://aapredbook.aappublications.org/
Instructor: C. DeCristofaro, MD
Page 13 of 13