Often, the medical student will cringe at the “drudgery” of the basic science courses and see little connection between a field such as physiology and clinical situations. Clinicians, however, often wish they knew more about the basic sciences, because it is through the science that we can begin to understand the complexities of the human body and thus have rational methods of diagnosis and treatment.

Mastering the knowledge in a discipline such as physiology is a formidable task. It is even more difficult to retain this information and to recall it when the clinical setting is encountered. To accomplish this synthesis, physiology is optimally taught in the context of medical situations, and this is reinforced later during the clinical rotations. The gulf between the basic sciences and the patient arena is wide. Perhaps one way to bridge this gulf is with carefully constructed clinical cases that ask basic science-oriented questions. In an attempt to achieve this goal, we have designed a collection of patient cases to teach physiology-related points. More important, the explanations for these cases emphasize the underlying mechanisms and relate the clinical setting to the basic science data. We explore the principles rather than emphasize rote memorization.

This book is organized for versatility: to allow the student “in a rush” to go quickly through the scenarios and check the corresponding answers and to provide more detailed information for the student who wants thought-provoking explanations. The answers are arranged from simple to complex: a summary of the pertinent points, the bare answers, a clinical correlation, an approach to the physiology topic, a comprehension test at the end for reinforcement or emphasis, and a list of references for further reading. The clinical cases are arranged by system to better reflect the organization within the basic science. Finally, to encourage thinking about mechanisms and relationships, we intentionally used open-ended questions in the cases. Nevertheless, several multiple-choice questions are included at the end of each scenario to reinforce concepts or introduce related topics.

We appreciate the good feedback from the various medical students from across the country. We have adopted many of these suggestions. In this second edition, there have been 30 cases that were substantially rewritten and 16 new figures to improve the readability and explanations. We think this second edition is an even better product.

HOW TO GET THE MOST OUT OF THIS BOOK

Each case is designed to introduce a clinically related issue and includes open-ended questions usually asking a basic science question, but at times, to break up the monotony, there will be a clinical question. The answers are organized into four different parts:

PART I

1. Summary

2. A straightforward answer is given for each open-ended question.

3. Clinical Correlation—A discussion of the relevant points relating the basic science to the clinical manifestations, and perhaps introducing the student to issues such as diagnosis and treatment.

PART II

An approach to the basic science concept consisting of two parts

1. Objectives—A listing of the two to four main principles that are critical for understanding the underlying physiology to answer the question and relate to the clinical situation.

2. Discussion of the physiologic principles.

PART III

Comprehension Questions—Each case includes several multiple-choice questions that reinforce the material or introduce new and related concepts. Questions about the material not found in the text are explained in the answers.

PART IV

Physiology Pearls—A listing of several important points, many clinically relevant, reiterated as a summation of the text and to allow for easy review, such as before an examination.