Learning outcomes of the course unit
To provide scientific fundaments to the practice of medicine, defined as the capability to identify clinical conditions affecting human beings and to promote preventive or therapeutic to implement individual and community health. Once completed the Course, the Student will have a thorough knowledge and understanding of the etio-pathogenetic factors underlying the basic structural and functional alterations in humans, and the relative response mechanisms, at the different levels of integration (molecule, cells, tissues, organism).
Students should also be able to apply this knowledge, integrated with information from previous Courses, to he understanding of the pathophysiology of common human pathologies.
Sufficient bases of histology, anatomy, biochemistry, microbiology, immunology, oncology and physiology are required.
Course contents summary
The Course will concern:
- Cell Pathology
- Tissue responses to cell injury: inflammation, hemostasis, repair
- General pathophysiology
1)Etiology and pathogenesis of molecular injury
- Intrinsic factors of damage:
- Monogenic Mendelian disease (autosomic dominant, autosomic recessive, X-linked)
- Monogenic non-mendelian diseases
- Polygenic multifactorial diseases
- Chromosomal alterations
- Nutritional disorders:
- Hypovitaminosis and hypervitaminosis
- Disorders of gene expression:
- Phenotypic effects of mutations
- Disorders of RNA
- Protein disorders (structural proteins, hemoglobinopathies and thalassemias, channels and transporters, hormones and receptors)
2) Cellular pathology.
- Cell damage: reversible vs. irreversible
- Protein misfolding: ER stress and UPR
- Intracellular protein aggregates
- Oxidative stress
- Cell response to oxidative stress
- Ethanol metabolism
- Lysosomal diseases
- Hypoxic-ischemic stress
- Cell and tissue adaptation to hypoxic-ischemic stress
- Cell aging
- Organism aging and progeroid syndromes
3) The response to tissue damage
- Hemostasis and its mechanisms
- Hemorrhagic disease
- Thrombosis (mechanisms, Virchow's factors, consequences)
- Embolia (concept, types, consequences)
- Innate immunity and inflammation triggering
- Acute inflammation: phenomena, cells, mediators, types
- The inflammatory exudate (mechanism of formation, types)
- Mediators of the inflammatory response (exogenous vs. endogenous; cellular vs. plasmatic; preformed vs. neosynthesized; the complement system; the kinine system; histamine; eicosanoids; the cytokines; nitric oxide; antiinflammtory mediators)
- Chronic inflammation (the infiltrate, mechanisms, cells, evolution)
- The resolution of the acute inflammatory response
- Inflammatory lesions: ascesses, ulcerae, granulomas
- Systemic phenomena in inflammation (leukocytosis, acute phase response, the inflammatory stress, metabolic changes)
- Defects of the inflammatory response
- Autoinflammatory diseases
- Mechanisms of tissue repair
- Derangements of tissue repair mechanisms
- Endocrine disorders:
- Endocrine defects (hormone deficits, receptor defects, post-receptorial defects)
- Endocrine hyperactivities (hormone excess, receptor hyperactivity, excess of signal transduction)
- Pathophysiology of metabolism (alterations of purine metabolism, alterations of lipid metabolism, Type I and Type II Diabetes Mellitus (etiologic factors, pathogenesis, metabolic alterations, complications)
- Porphirias and itteri
- Iron and copper homeostasis(Sideropenic anemia, primary and secondary hemochromatosis, Wilson disease)
- Pathophysiology of nutrition. Obesity.
- Kumar, Abbas, Fausto, Aster (Eds). Robbins e Cotran – Le Basi Patologiche delle Malattie. 8 Edizione italiana, Elsevier Masson, 2010.
(new edition from the 9th edition expected in 2015)
- Pontieri, Russo, Frati. Patologia Generale. 5° Edizione, Piccin, 2015.
Additional references will be suggested during the lectures.
Interactive oral lectures, based on the explanation of the main conceptual frame of each subject, supported by Powerpoint slides available to the students. Examples taken from the medical practice will be provided together with bibliographic references so as to stimulate students' questions. The course will be integrated with optional laboratory practice.
Assessment methods and criteria
No interim evaluation is programmed.
The final evaluation will consist in an oral examination.
Questions/student: 2 (from different examiners).
Questions will concern subjects listed in the detailed program.
Failure to answer to one question, or verified uncapability to define
correctly the subject, will prevent the successful completion of the exam.
The outcome will be also negative if, during the discussion, the student will exhibit severe pitfalls, not compatible with an adequate understanding of the subject.
After each question, the examiner will give an evalaution expressed in marks:
A. Very good knowledge and understanding. Very good capability of
applying knowledge to bio-medical problems. Corresponding to 30/30.
B. Good knowledge and understanding. Good capability to apply knowledge to biomedical problems. Corresponding to 27-29/30.
C. Average knowledge and understanding. Average capability of applying knowledge to bio-medical problems. Corresponding to 24-26/30
D. Sufficient knowledge and understanding. Sufficient capability of
applying information to bio-medical problems. Corresponding to 21-23/30.
E. Barely sufficient knowledge and understanding (with evident pitfalls).
Scarce capability of applying knowledge to bio-medical problems.
Corresponding to 18-20/30.
Full marks with laude will be reserved to students exhibiting, together an
overal evaluation of 30/30, capability of making judgments and good
communication ability and autonomous learning skills.
The final vote will be decided jointly by the examiners, who will have the
possibility to decide a vote not higher or lower than three grades from the best or the worst vote derived from the mean of the two individual votes.