Learning outcomes of the course unit
The course will enable the student to gain in-depth knowledge of the pathogenesis and molecular mechanisms of cell and tissue damage in relation to the various etiologies of disease, of cell and tissue adaptation and cell death; This will allow the student to fully understand how to these pathological processes evolve as well as how the processes of the defensive response of the organism and tissue develop with particular reference to the inflammation, the tissue repair and regeneration, the acute phase reaction, the innate and acquired immune defensive response against biological patogens.The students will also acquire basic concepts and mechanisms of immune-mediated pathologies in animals focusing on hypersensitivity, autoimmune diseases and immunedepression (Immunopathology)as well as on the main physiopathological aspects and the changes of immune response during viral and bacterial infection.The students have to acquire knowledge on the physiopathological mechanisms at mean organs and apparatus aiming at understanding the functional local implications and the systemic connections during the organ's failure (Physiopathology).
During the lab activity of histopathology the students will acquire the abiliy to identify and evaluate the cell damage and types of inflammation by means of the microscopic observation of pathological tissue samples for a diagnostic application.During laboratory activity of immunopathology the students will acquire the ability to treat blood sample for cytometry for lymphocyte characterization by cytometry and their use for a functional evaluation of the efficiency of the immune response.In the lab of blood physiopathology, the students will learn to prepare cytologic samples for the observation and diagnostic description of cases of anaemia. During the practice on joint physiopatholgy, the students will acquire the knowledge on the main macroscopic aspect of osteoarthritis and ostecondrosis for a differential evaluation.
During "Classroom practice" the students will learn to apply the knowledge and understandings in physiopatology of the immune response to infection and of organ failure to solve some problems of practical application.
Propedeutics to: Pathological Anatomy – Internal Medicine – Pathologoicaol Surgery and Radiology – Infectious Diseases – Ostetrics
Propedeutics done: Microbiology and Iiia e Immunologia - Epidemiologia, Fisiologia II - Endocrinologia
Course contents summary
The contents of General Pathology are the etiology and pathogenesis of diseases, the cellular and molecular mechanisms of the tissutal and cellular damage, the cell and tissue adaptation and the cell death, as well as the processes of the defensive response (the inflammation and the innate immunity, the regenerative and reparative responses, the acute phase reaction and the defensive response against the biological pathogens). Moreover, the etiology, pathogenesis and physiopathology of the neoplastic diseases are treated. The main arguments treated in the immunopathology, are the hypersensitivity and the autoimmune diseases with reference to the specific spontaneous disease, the causes of immunosuppression as well as the pathophysiological aspects and the modulation of the immune response during viral and bacterial infections. The part of Pathophysiology provides the detailed knowledge on the pathophysiologic mechanisms of the functional insufficiency at the level of major organs and systems.
CONTENTS OF THEORETICAL LESSONS
Homeostasis, health and disease : basic concepts of causes and pathogenesis of the diseases.
Etiopathogenesis (causes of cell and tissue pathology)of the diseases: - Infectious agents (the main mechanisms of injury by virus e bacteria); - the main mechanisms of chemical injury, of physical agents (radiation injury, thermal injuries, mechanical forces); - the general aspects of nutritional deficiencies.
Cell, tissue and systemic adaptive response:
-Molecular aspects of cell (heat shock proteins, anti-oxidants, response to DNA damage) and tissue adaptation (hypertrophy, hyperplasia, atrophy, metaplasia).
Reversible and irreversible cell injury:The models of cell damage by hypoxia and free radicals.
Cellular and extracellular degenerations: cloudy swelling, hydropic and vacuolar degeneration, steatosis, intracellular protein accumulation disorders, fibrinoid necrosis, sclerosis, pathological calcification.
The cell Death:
- Necrosis: biochemical and morphologic aspects, types of necrosis;
- Apoptosis: causes (physiologic and pathologic apoptosis), morphologic and biochemical features and mechanisms.
-General features: etiology, classification and development
The Acute inflammation and immune innate response
- vascular and cellular events of acute inflammation;
- inflammatory and innate immune cells;
- chemical mediators of inflammation outcomes of acute inflammation;
- Cellular events and regulation;
- the mechanisms of connection to acquired immune response.
The primary chronic inflammation and granulomatous inflammation (causes and pathogenetic mechanisms).
Acute Phase Reactions.
Tissue renewal and repair: regeneration; repair by healing; cutaneous wound healing; factors influencing wound healing.
Neoplasia: definition, general features and nomenclature; molecular basis of cancer (oncogenes, tumor suppressor genes, apoptosis genes); biology of the neoplastic cell (transformation and progression, heterogeneity); etiology and epidemiology (chemical, radiation and microbial carcinogenesis); differential aspects between benign and malignant neoplasms and classification; invasion and metastasis; immune response against neoplastic cells; paraneoplastic syndromes.
Hypersensitivity: etiology, pathogenesis and examples of immune-mediated diseases ( Type I, Type II, Type III and Type IV hypersensitivity).
Autoimmunity : mechanisms of immunologic tolerance, general concepts and pathogenetic mechanisms, mechanisms of immune-mediated damage, examples of autoimmune diseases.
Immunosuppression: hereditary and acquired immunodeficiency.
Infection and immunity: damage by hypersensitivity, by autoreactivity and immunesuppressive effects.
Physiopathology o the infection: damage by virus and bacteria, endotoxic and septic shock, the innate and adaptive immune response to virus and bacteria.
Physiopathology of joints: pathogenesis and gross lesions of osteoarthritits and osteochondrosis.
Bone physiopathology: calcium/phosphorus imbalances and metabolic bone diseases.
Physiopathology of blood: leukocytosis, leukopenia, anaemia, polycvthemia, haemostasis and thrombosis.
Hemodynamic disorders. edema, hyperaemia, , embolism, infarction, hemorrhagic disorders, shock.
Physiopathology of kidney: acute and chronic failure, nephrotic and uremic syndromes.
Physiopathology of water and acido-base imbalances: dehydration, acidosis and alkalosis.
Hepatic physiopathology: jaundice, steatosis, liver failure.
Basics of lung and cardiac physiopathology the respiratory failure, edema, emphysema, the hearth failure.
PREPARATORY BOOKS FOR EXAMINATION:
1) V Kumar, A. Abbas, N. Fausto: “Robbins e Cotran: Le basi patologiche delle malattie. vol. 1 Patologia Generale” (2010), Elsevier Italia, Srl, Milano.
2) McGavin M.D., Zachary J.F. Patologia generale veterinaria. (2008). Elsevier Masson, Milano.
3) M.A. Russo, L. Frati, G.M. Pontieri. Patologia Generale vol. I e II (2009) Piccin, Padova. Piccin, Padova.
REFERENCE BOOKS: 1) Tizard I.R. Veterinary Immunology. Saunders (USA)(2011). 2) Marcato P.S. Patologia Sistematica Veterinaria (2002). Edagricole, Bologna. 3) Marcato P.S. Anatomia e istologia patologica generale veterinaria. (2000) Eusculapio, Bologna.
REVIEWS ON SPECIFIC TOPICS OF PHYSIOPATHOLOGY.
TEACHING MATERIAL AVAILABLE ON-LINE: 1)SLIDES OF LECTURES provided for SINGLE TOPIC; 2) SCHEMATIC DISPENSA ON ALL THE TOPICS COVERED DURING THE COURSE: The dispensa should be only an INTEGRATION and COMPLETION of the study on one of the TEXT recommended; at the end of the exam MAY BE USEFUL as they provide an overview and summary of the arguments in condensed form and by schemes for a general review on the contents of the course.
The lectures (classroom teaching: 72 hours) were carried out the topics of the program by presenting Power Point slide.
Practicals (20 hours) is carried out in multi-seat laboratories of histopathology and immunopathology/ pathophysiology as well as through the activities of "Class room practice" in which students will face problems on the practical aspects of pathophysiology ("solving problems"). Test of self-assessment tests with open discussion with the teacher on argomentoi being examined were also included.
Assessment methods and criteria
The student may choice between:
1) Written examination 15 multichoice questions with a open explanations and a brief oral question for final evaluation.
The final evaluation was determined considering a maximum of 2 points each response.
2) Oral examination: 3 questions on theoretical contents and 1 question on practicals contents
Oral examination was globally evaluated by all the responses on both theoretical and practical questions.
A mid-term (“in itinere”) written examination can be performed on the contents of general pathology, oncology and immune-pathology before the end of the lessons and the first official exam’s session.Then, the students must complete the examination on the contents of physiopathology at the official session within the examination’s session of September. Self-evaluation tests simulating a written examination will be carried around the end of the course.
The teacher is at students disposal for further explanations on the contents, during the course and for exam's preparation, and tutorial assistance. For this purpose, the reception is possible for students from Monday to Friday prior agreements via-email. In the event of notice not given the best days (compatibly with other commitments) are: Tuesday 9.30 to 11.30, Wednesday 10.30 to 12.30 or 15-17, or 15-17 Thursday 10,30-12,30.