BMS 291 Pathophysiology and Pharmacology CASE STUDY

Pathophysiology and Pharmacology CASE STUDY

BMS 291

Pathophysiology and Pharmacology CASE STUDY

Assessment No: 1

Weighting: 40%

Due date Part A: midnight Friday 2nd August 2024

Due date Part B: midnight Sunday 29th September 2024

General information

In this assessment, you will develop your skills for analysing, integrating and presenting information for effective evidence-based communication.

Learning Outcomes addressed in this assessment:

  • define common pathophysiological and pharmacological terms
  • outline key pharmacodynamic principles (eg agonist and antagonists, receptor-drug interactions)
  • describe the four pharmacokinetic processes (absorption, distribution, metabolism and elimination)

Detail

This assessment task involves the analysis and interpretation of one patient case study related to material covered in the course before the due date for the item. The Case Study is associated with any or multiple learning objectives from topics 1, 4,6 and 7 inclusive.

  • Various aspects of the patient’s details will be provided including history, signs, symptoms, and

pathology.

  • From this information, the task will involve the formulation of a diagnosis, explanation of the pathology, generation of a treatment regimen and a description of how the treatment works.
  • In this analysis, it is expected that an explanation of the disease and treatment will include details of what is happening at the anatomical, physiological, cellular and molecular levels.
  • Some prompts will be provided to help you construct your answer in such a way that it fulfills the requirements of the marking rubric.

Submission

  • Submission of the case study will be through Brightspace.
  • It is intended that the answers are prepared offline and then cut and pasted into various sections matching the question numbers.
  • A guide length for each question, what it should include and the mark distribution for each section is included for you information.
  • Note also that there are marks allocated for writing clearly and concisely in a scientific style.
  • Each Case Study Part A and B will be marked out of 30 and makes up 40% of the subject.
  • You will submit your Case Study in 2 separate parts, both with different due dates.

Due date Part A: midnight Friday 2nd August 2024

Due date Part B: midnight Sunday 29th September 2024

Students will not be able to access the Interact 2 Assessment after the due date. If you are unable to submit by the due date due to medical/extenuating circumstances, please consult with your subject coordinator as soon as possible. You may also wish to apply for Special Considerations.

Academic Integrity and presentation

  • Your Case Study answers must be pre-prepared by using the document provided, including in text citations and bibliographical references in APA7 format.
  • Before getting started, read the marking criteria in the subject outline or at the end of this document.
  • Use physiology, pathophysiology, and pharmaceutical literature (including MIMS, AMH, drug information sheets, journal articles and textbooks) to understand the case and write your answers IN YOUR OWN WORDS.
  • We recommend that you use a word processor (e.g. Microsoft Word) to write your answers and references, which must be written in academic style and checked for spelling, punctuation and grammar.
  • The answers can then be copied and pasted into the respective answer boxes on the Interact2 Test Tool (test will be made available TWO WEEKS before the due date).
  • Direct quotes are not appropriate. You should present this information in your own words to demonstrate your understanding and writing skills. The use of direct quotes will be penalised because copying information directly does not demonstrate that you understood the information. Answers directly copied from the source document or websites will be awarded zero mark. Lecture slides are NOT appropriate to use as references.
  • Please note that scientific and medical terminology that is in common use can be used without quotation marks. For example, hypertension is a commonly used medical term that you can use without quotation marks, even though that same term may appear in the original journal article you are paraphrasing. Please write in an academic style, paying attention to grammar and spelling, and do not copy directly from the source document.
  • The use of generative A.I tools is not permitted in order to answer this Case Study.
  • DO NOT LEAVE your submission to the last minute as you risk incurring late penalties if you have trouble with the online test in Interact2.

Turnitin

  • You can use the Turnitin plagiarism software to self-check your assignment before submitting into the Online Test tool.

** Student answers will also be checked using standard plagiarism and AI monitoring tools **

Case study

Introduction

Harold is a 70-year-old male. One day, Harold’s girlfriend finds him lying on the floor at home, complaining of shortness of breath and chest pain. She calls 000, but then starts to administer CPR when Harold stops breathing. The paramedics arrive within a few minutes and continue with CPR until he is finally revived and conscious.

Video footage of Harold in the ambulance and paramedic treatment was recorded.

  • View the footage in the YouTube link below, which shows the care and treatment given to George in the ambulance.
    • Write notes and summarise facts you discover about the case from the video recording.

Before leaving the house for the hospital, the paramedics ask Harold’s girlfriend about her boyfriend’s

medical history and she provides the following information: Current symptoms:

Harold has been experiencing shortness of breath, fatigue, and difficulty performing his normal activities for the past few weeks. The girlfriend has also noticed swelling in his legs and ankles, especially towards the end of the day. She reports that he wakes up at night feeling short of breath and must sit up to catch his breath. She also reports that Harold had been experiencing severe chest pain that radiated to his left arm earlier in the day.

Medical history:

Harold has a history of hypertension and hyperlipidaemia, for which he takes medication. He also has family history of heart disease. The girlfriend reports that he has been monitoring his blood pressure and cholesterol levels at home, and they have been well-controlled. However, his recent blood tests revealed a high level of LDL cholesterol.

Case Study Questions – Part A 30 marks

Due date Part A: midnight Friday 2nd August 2024

Part A will assess the following learning outcome/s:

  • define common pathophysiological and pharmacological terms.
    • describe the four pharmacokinetic processes (absorption, distribution, metabolism and elimination).
    • outline key pharmacodynamic principles (eg agonist and antagonists, receptor-drug interactions).
    • demonstrate understanding of the origin and main theories of pain.
    • explain the pharmacological treatment of inflammation and pain.

The paramedics administered 300 mg of aspirin orally and a dose of digoxin orally to Harold in the ambulance.

Answer the following 7 questions in relation to the drugs administered to Harold.

  1. List the therapeutic index (TI) for digoxin and describe the clinical importance in knowing the TI. (2 marks – 100 words)
  2. Considering what you have learnt about pharmacokinetics, create an original flow chart diagram describing the process of drug absorption and distribution for digoxin. Take a photo or screenshot of your diagram and add it to your OneDrive or GoogleDrive (or similar). Copy and paste the LINK into the test centre. Make sure the marker has ACCESS to the link or it will not be marked and awarded zero marks.

(5 marks – 250 words)

  • Considering what you have learnt about pharmacokinetics, describe in detail, the metabolism and elimination of digoxin by the body, explaining the roles of phase I and phase II metabolic reactions and role of the P450 enzyme group. (6 marks – 300 words)
  • Describe the half-life and clearance of digoxin and explain the relevance of these clinically. (3 marks – 150 words)
  • Construct a table to compare the mechanisms of action of NSAIDs and paracetamol. Explain and justify whether aspirin (an NSAID) would have been useful to administer to George. (4 marks – 200 words)
  • George was experiencing severe pain in his chest.

Create an original, labelled diagram/flow chart explaining the neural pathways that determined both the discriminative and emotional aspects of pain for George. Take a photo or screenshot of your diagram and add it to your OneDrive or GoogleDrive (or similar). Copy and paste the LINK into the test centre. Make sure the marker has ACCESS to the link or it will not be marked and awarded zero marks. Keep your original diagram if needed and requested by the marker. (4 marks – 200 words)

  • Describe what type of pain you believe George was experiencing and justify your choice. (3 marks – 150 words)

Referencing (APA 7) and collation of appropriate academic resources. (2 marks)

Case study uses scientific language and style demonstrating research and review of the scientific literature, gathering and compiling relevant scientific evidence. (1 mark)

Marking rubric PART A

Criteria – PART AHigh Distinction (85%+)Distinction (75%-84%)Credit (65%-74%)Pass (50%-64%)Fail (0%-49%)
List the therapeutic index (TI) for digoxiin (0.5 mark) and describe the clinical importance in knowing the TI. (1.5 marks)Correctly listed the TI for digoxin and describes in detail 2 correct clinical applications of knowing the TI. (2 marks)Correctly/incorrectly listed the TI for digoxin (0-0.5 marks) and describes in detail 1 or 2 correct clinical applications of knowing the TI. (1.5 marks)Correctly/incorrectly listed the TI for digoxin (0-0.5 marks) and describes briefly correct clinical applications of knowing the TI. (1 mark)Did/did not provide the correct TI for digoxin and/or describes only one clinical application of knowing the TI. (0.5 – 1 mark)Did not provide the correct TI for digoxin and/or does not describe any clinical applications of knowing the TI. (0 – 0.5 mark)
Create an original flow chart diagram describing the process of drug absorption and distribution for digoxin. (6 marks)Presented a comprehensive and correctly labelled flow chart describing in detail the process of drug absorption and distribution for digoxin occurring at anatomical, physiological, cellular and molecular levels. (5 marks)Presented a clear, detailed and labelled flow chart describing the process of drug absorption and distribution for digoxin occurring at anatomical, physiological, cellular and molecular levels. (4 marks)Presented a simple and labelled flow chart describing the process of drug absorption and distribution for digoxin occurring at anatomical, physiological, cellular and molecular levels. (3 marks)Gave a generic diagram describing most of the process of drug absorption and distribution for digoxin. (2 marks)Gave an incomplete diagram describing the some of the process of drug absorption and distribution for digoxin. (0 – 1 marks)
Describe in detail, the metabolism and elimination of digoxin by the body, explaining pharmacokinetics and the roles of phase I and phase II metabolic reactions and role of the P450 enzyme group. (6 marks)Described concisely and comprehensively both the metabolism and elimination of digoxin by the body, explaining in detail pharmacokinetics and the roles of phase I and phase II metabolic reactions and role of the P450 enzyme group. (5 marks)Described clearly and in detail both the metabolism and elimination of digoxin by the body, explaining pharmacokinetics and the roles of phase I and phase II metabolic reactions and role of the P450 enzyme group. (4 marks)Discussed both the metabolism and elimination of digoxin by the body, describes pharmacokinetics and the roles of phase I and phase II metabolic reactions and role of the P450 enzyme group. (3 marks)Described one or both of the metabolism and elimination of digoxin by the body, simply describes some aspects of pharmacokinetics and the roles of phase I and phase II metabolic reactions and role of the P450 enzyme group. (2 marks)Provided some correct information about the metabolism and elimination of digoxin by the body, and the roles of phase I and phase II metabolic reactions and role of the P450 enzyme group. (0 – 1 marks)
Describe the half-life and clearance of digoxin and explain the relevance of these clinically. (2 marks)Described concisely and comprehensively the half- life and clearance of digoxin and explains the relevance of both of these clinically. (2 marks)Described clearly and in detail the half-life and clearance of digoxin and describes the relevance of both of these clinically. (1.5 marks)Described the half-life and clearance of digoxin simply and outlines the relevance of both of these clinically. (1 mark)Discussed one of the half- life and clearance of digoxin and explains the relevance of one or both of these clinically. (0.5-1 marks)Provided some correct information about the half- life and clearance of digoxin and does not explain the relevance of these clinically. (0 – 0.5 marks)
Construct a table and compare the mechanisms of action (MoA) of NSAIDs and paracetamol. Explain and justify whether paracetamol would have been useful to administer to George. (4 marks)Constructed a table and comprehensively compare the MoA of NSAIDs and paracetamol. Explained and justified whether paracetamol would have been useful to administer to George. (4 marks)Constructed a table and compare the MoA of NSAIDs and paracetamol. Described and justified whether paracetamol would have been useful to administer to George. (3 marks)Constructed a table and describes the MoA of NSAIDs and paracetamol. Explained but didn’t justify whether paracetamol would have been useful to administer to George. (2 marks)Constructed a table describes some of the MoA of NSAIDs and paracetamol. Explained whether paracetamol would have been useful to administer to George. (1 marks)Partially constructed a table and simply describes the MoA of NSAIDs and/or paracetamol. Described simply or incorrectly whether paracetamol would have been useful to administer to George. (0 – 0.5 marks)
Create an original, labelled diagram explaining the neural pathways that determined both the discriminative and emotional aspects of pain for George. (4 marks)Presented a concise, comprehensive and labelled diagram and explains comprehensively the neural pathways that determined both the discriminative and emotional aspects of pain (4 marks)Presented a clear and detailed diagram describing the neural pathways that determined both the discriminative and emotional aspects of pain. (3 marks)Presented a simple diagram describing the neural pathways that determined both the discriminative and emotional aspects of pain. (2 marks)Gave a generic diagram describing the neural pathways that determined both the discriminative and emotional aspects of pain. (1 marks)Gave an incomplete diagram describing the neural pathways that determined both the discriminative and emotional aspects of pain. (0 – 0.5 marks)
Describe what type of pain you believe George was experiencing and justify your choice. (3 marks)Described concisely and comprehensively the correct type of pain and justified with 2 reasons. (3 marks)Described clearly and in detail the correct type of pain and justified with 2 reasons. (2.5 marks)Described the correct type of pain and justified with one reason. (2 marks)Discussed the correct type of pain and justified with one reason. (1.5 marks)Provided some correct information about the type of pain and listed one or two partially correct reasons. (0 – 1 marks)
Referencing (APA 7) and collation of appropriate academic resources. (2 marks)Selected references support statements made in the report and are predominantly derived from peer-reviewed articles, with minimal use of relevant textbooks or internet sources. Consistently accurateSelected references are relevant to statements made in the report and are mainly derived from peer- reviewed articles, with minimal use of relevant textbooks or internet sources. Mostly accurate APA7 referencing style inSelected references are relevant to statements made in the report and are a mix of peer-reviewed articles and relevant textbooks or internet sources. Accurate APA7 referencing style in text and in the reference list,Selected references apply to the report generally but perhaps not directly to the statement it is given in conjunction with. While references from peer- reviewed articles are included, there is a reliance on relevantReferences selected from the literature are not relevant to the topic or credible (including non- peer-reviewed material and commercial websites), or no reference material is provided at all. Where referencing is
 APA7 referencing style in text and in the reference list. (2 marks)text and in the reference list. (1.5 marks)perhaps with some inconsistencies. (1 mark)textbooks or internet sources. Referencing in text and in the reference list follows some APA7 conventions but includes errors and inconsistencies. (0.5 – 1 marks)present, it does not follow APA7 conventions. (0- 0.5 marks)
Write a report using scientific language and style demonstrating research and review of the scientific literature, gathering and compiling relevant scientific evidence. (1 mark)Evidence of extensive literature review through the inclusion of the latest research on disease and treatment options. Writing is consistently clear and outstanding with well- formulated explanations and justifications of claims. (1 mark)Evidence of substantial literature review through the inclusion of data on a variety of research on disease and treatment options. Writing is generally clear with well- formulated explanations and justifications of claims. Explanations and claims are supported by scientific literature. (0.85 marks)Provided an adequate review of disease and treatment options and includes data from the scientific literature. Writing is generally clear with concepts and claims being explained logically. (0.75mark)Provided an overview of disease and treatment options which is supported by references to scientific literature. Writing is generally clear and an attempt is made to explain concepts and claims logically. (0.5 marks)Provided a generic description of the disease and treatment options with little or no reference to credible scientific sources. Information is disorganised and not presented in a logical sequence. (0 – 0.5 marks)

Case Study Questions – Part B 25 marks

Due date Part B: midnight Sunday 29th September 2024

Part B will assess the following learning outcome/s:

  • define common pathophysiological and pharmacological terms.
    • describe the four pharmacokinetic processes (absorption, distribution, metabolism and elimination).
    • outline key pharmacodynamic principles (eg agonist and antagonists, receptor-drug interactions).
    • describe the pathogenesis of major cardiovascular system dysfunction.
    • outline the primary pharmacological interventions used in the treatment of cardiovascular disease.

Questions Part B

  1. Fentanyl (an opioid) was administered to George to modify his pain sensation.

Explain how opioids modify pain sensation in a written answer. Support your answer on how opioids work, by modifying the diagram on the next page; draw additional features and labels onto the diagram to help explain how opioids work. Take a photo or screenshot of your diagram and add it to your OneDrive or GoogleDrive (or similar). Copy and paste the LINK into the test centre. Make sure the marker has ACCESS to the link or it will not be marked and awarded zero marks. Keep your original diagram if needed and requested by the marker. (5 marks – 300 words)

New information related to the case.

After several minutes in hospital, the doctors perform a quick assessment of Harolds vital signs, including blood pressure, heart rate, respiratory rate, oxygen saturation, and temperature (Table 1).

Table 1. Harold’s vital signs

Vital signMeasurement
Systolic blood pressure (mmHg)110
Diastolic blood pressure (mmHg)62
Oral temperature (°C)37.1
Heart rate (beats per minute)120, irregular
Respiratory rate (breaths per minute)33, laboured
Oxygen saturation89%

The doctors also perform a 12-lead ECG on George, which shows abnormalities in the ECG in the inferior leads (Figure 1). They suspect that Harold may be experiencing a myocardial infarction and provide him with more aspirin, glyceryl trinitrate and oxygen therapy.

At the hospital, Harold was found to have a mitral valve prolapse after undergoing an echocardiogram (Figure 2), where laboratory tests (Table 2) revealed the potential damage to the papillary muscles that control the heart’s valves.

Table 2. Harold’s laboratory test results

Laboratory testsJohnNormal
C-reactive protein11 mg/L<5 mg/L
Cardiac troponin0.04 µg/L0.01-0.02 µg/L
Myoglobin95 ng/mL0-85 ng/mL
LDL2.5 mmol/L<2 mmol/L
  • Diagnosis (3 marks) up to 100 words

After his myocardial infarction and damage to his mitral valve, Harold developed further cardiovascular condition or conditions . Name the condition/conditions which is/are now causing respiratory issues? Justify your answer.

  • Description of pathology (6 marks) up to 300 words

Describe the pathophysiology of George’s condition or conditions.

Make sure to cover the following in your answer:

  • Pathophysiology — how did the cardiovascular condition progress from the start (myocardial infarction) to the end (respiratory dysfunction) of the case? (3 marks)
    • How do George’s clinical signs and laboratory tests correlate with his physiological changes?

(3 marks)

  • Recommended treatment or management (1 mark) up to 30 words

List 2 drug groups (not drug names) that could be indicated to manage George’s condition/s (diagnosed in Question 1) by reducing the cardiac afterload in the acute phase of this disease. (0.5 mark each)

  • Treatment rationale and mechanism of action (6 marks) up to 300 words
  1. Justify your selection of treatment by describing the mechanisms of action of the two drug groups listed in Question 3. (4 marks)
  2. Justify why glyceryl trinitrate was used by the paramedics to treat the myocardial infarction. (2 marks)

Referencing (APA 7) and collation of appropriate academic resources. (2 marks)

Case study using scientific language and style demonstrating research and review of the scientific literature, gathering and compiling relevant scientific evidence. (2 marks)

Marking rubric PART B

Criteria – PART BHigh Distinction (85%+)Distinction (75%-84%)Credit (65%-74%)Pass (50%-64%)Fail (0%-49%)
Explain how opioids modify pain sensation in a written answer. Support your answer on how opioids work, by modifying the diagram on the next page; draw additional features and labels onto the diagram to help explain how opioids work. (5 marks)Explained comprehensively how opioids modify pain sensation. Supported answer with a correctly modified diagram, which included additional features and labels onto the diagram to correctly explain how opioids work. (5 marks)Explained clearly and with detail how opioids modify pain sensation. Supported answer with a correctly modified diagram, which included additional features and labels onto the diagram to correctly explain how opioids work. (4 marks)Described simply how opioids modify pain sensation. Supported answer with a simply modified diagram, which included some additional features and labels onto the diagram to correctly explain how opioids work. (3 mark)Listed some statements on how opioids modify pain sensation. Supported answer with a simply modified diagram, which included some additional features and a few labels onto the diagram.(2 marks)Listed a few statements on how opioids modify pain sensation, with some errors. May or may not include an edited diagram with some errors. (0 – 1 marks)
Interpret patient history, signs, symptoms, and pathology to derive a correct diagnosis. (3 marks)Evaluates all aspects of patient history, signs, symptoms, and pathology to derive a correct diagnosis. (3 marks)  Interprets patient manifestations to derive a correct diagnosis. (2.5 marks)  Considers patient manifestations to derive a correct diagnosis. (2 marks)  Derives a diagnosis that is consistent with patient manifestations. (1 mark)  Diagnosis is not consistent with patient manifestations. (0 – 0.5 mark)
      Justify diagnosis and demonstrate an understanding of disease pathology, particularly concerning events occurring at anatomical, physiologica, cellular and molecular levels. (6 marks)Justifies diagnosis by providing strong links between patient manifestations and pathology of a particular disease.   Presents a concise and comprehensive review of disease pathology which incorporates succinct and integrated consideration of events occurring at anatomical, physiological, cellular and molecular levels. (6 marks)  Justifies diagnosis by linking patient manifestations to the pathology of a particular disease.   Presents a clear and detailed review of disease pathology which includes relevant consideration of events occurring at anatomical, physiological, cellular and molecular levels. (4 – 5 marks)    Justifies diagnosis by relating patient manifestations to the pathology of a particular disease.   Explains disease pathology and provides consideration of events occurring at anatomical, physiological, cellular and molecular levels. (3 – 4 marks)    Compares patient manifestations to the pathology of a particular disease.   Describes aspects of disease pathology, including discussion of events occurring at anatomical, physiological, cellular and molecular levels. (2 – 3 marks)      Does not justify the diagnosis.   Gives a generic description of the disease that does not provide critical information on the pathological basis of the disease. (0 – 2 marks)
  Suggest a patient treatment or management strategy based on mechanisms of action of drugs learnt in the subject. (1 mark)  Suggests a concise, comprehensive and current treatment or management strategy and correctly and comprehensively describes drug mechanisms of action. (1 mark)    Suggests an effective treatment or management strategy that addresses correct mechanisms of drug actions (0.75 marks)Suggests an effective treatment or management strategy for the resolution of major issues and describes most of the mechanism of action of suggested drugs. (0.5 marks)  The proposed treatment or management strategy addresses some aspects of pathology with some correct mechanisms of action of proposed drugs. (0.25 marks)The proposed treatment or management strategy is ineffective or incorrect and mechanisms of actions of drugs is incomplete or incorrect. (0 marks)
        Justifies proposed treatment or management strategy by presenting data that explains the mechanism of action (how it works) and supports its effectiveness (proof that it works). (6 marks)For each treatment or management strategy, a clear explanation of the mechanistic basis of the drug action and the influence that this has on the pathological process of disease is provided. Prescription of a particular agent is extensively justified based on of its relative efficacy. Alternative strategies are considered and compared. Claims made are supported by appropriate scientific evidence. (6 marks)  For each treatment or management strategy, information is presented regarding the mechanistic basis of the drug action and the influence that this has on the pathological process of disease. The prescription of a particular agent is justified based on its relative efficacy. Alternative strategies are considered. Claims made are supported by appropriate scientific evidence. (4 – 5 marks)  The prescription of a particular agent is justified through the inclusion of an explanation of the mechanistic basis of the drug action and the influence that this has on the pathological process of disease. Other treatment strategies are identified. Claims made are supported by appropriate scientific evidence. (3 – 4 marks)      The prescription of a particular agent is justified by a discussion of the mechanistic basis of the drug’s action and the influence that this has on the pathological process of disease. Claims made are supported by appropriate scientific evidence. (2 -3 marks)    Little or no linkage between the mechanism of disease pathology and the mechanism of drug action. Poor or no justification is provided as to why an agent is prescribed. Limited or no scientific evidence is provided to support claims. (0 – 2 marks)
          Referencing (APA 7) and collation of appropriate academic resources. (2 marks)    Selected references support statements made in the report and are predominantly derived from peer-reviewed articles, with minimal use of relevant textbooks or internet sources. Consistently accurate APA7 referencing style in text and in the reference list. (2 marks)    Selected references are relevant to statements made in the report and are mainly derived from peer-reviewed articles, with minimal use of relevant textbooks or internet sources. Mostly accurate APA7 referencing style in text and in the reference list. (1.5 marks)    Selected references are relevant to statements made in the report and are a mix of peer-reviewed articles and relevant textbooks or internet sources. Accurate APA7 referencing style in text and in the reference list, perhaps with some inconsistencies. (1 mark)Selected references apply to the report generally but perhaps not directly to the statement it is given in conjunction with. While references from peer- reviewed articles are included, there is a reliance on relevant textbooks or internet sources. Referencing in text and in the reference list follows some APA7 conventions but includes errors and inconsistencies. (0.5-1 marks)  References selected from the literature are not relevant to the topic or credible (including non-peer-reviewed material and commercial websites), or no reference material is provided at all. Where referencing is present, it does not follow APA7 conventions. (0 – 0.5 marks)
    Write a report using scientific language and style demonstrating research and review of the scientific literature, gathering and compiling relevant scientific evidence. (2 marks)    Evidence of extensive literature review through the inclusion of the latest research on disease and treatment options. Writing is consistently clear and outstanding with well- formulated explanations and justifications of claims. (2 marks)Evidence of substantial literature review through the inclusion of data on a variety of research on disease and treatment options. Writing is generally clear with well- formulated explanations and justifications of claims. Explanations and claims are supported by scientific literature. (1.5 marks)    Provides an adequate review of disease and treatment options and includes data from the scientific literature. Writing is generally clear with concepts and claims being explained logically. (1 mark)    Provides an overview of disease and treatment options which is supported by references to scientific literature. Writing is generally clear and an attempt is made to explain concepts and claims logically. (0.5-1 marks)  Provides a generic description of the disease and treatment options with little or no reference to credible scientific sources. Information is disorganised and not presented in a logical sequence. (0 – 0.5 marks)
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