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 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).
Sufficient bases of anatomy, biochemistry, microbiology, immunology and physiology are required.
Course contents summary
Concepts of health, disease, and homeostasis. Aetiology and pathogenesis of molecular alterations. Intrinsic factors of disease: monogenic diseases (mendelian and non mendelian), polygenic multifactorial diseases, chromosomal diseases. Extrinsic factors of disease: physical, chemical and biologic causes of disease. Environmental diseases. Nutritional diseases: malnutrition, nutrition excess, carential diseases. Alterations of DNA, RNA and proteins. DNA repair. Mutations. Diseases due to RNA alterations. Protein damage: structural bases and functional consequences. Genotype and phenotype. Selecte examples of protein alterations: alterations in structural proteins, hemoglobinopathies, channelopaties, alterations in transporters and receptors, intracellular and extracellular protein depositions.
Cellular pathology. Reversibile and irreversible cell injury. Adaptive mechanisms to cell injury: hypertrophy, hyperplasia, atrophy, metaplasia, dysplasia. Tesaurismosis, steatosis, and other storage diseases. Biotransformations: Phases of xenobiotic metabolism; Cytochromes P450, Metabolism of ethanol. Free radicals and disease: Production of ROS; Molecular and cellular targets of the oxidative stress; Scavenger enzymes and antioxidants. The ischemic-hypoxic stress: Mechanisms; Metabolic consequences; Reperfusion injury; The response to ischemic-hypoxic stress; Mechanisms of ischemic damage in myocardium and central nervous system. Cell aging and its relationships with human disease. Progeroid syndromes. Cell death: Accidental cell death (oncosis); Programmed cell death (apoptosis and other types). Necrosis and post-necrotic changes.
Oncology. Definitions, nomenclature, epidemiology. Tumor etiology: Chemical carcinogenesis; Radiation cancerogenesis; DNA and RNA oncogenic viruses; Nonviral cancerogenesis from biological agents; Heredity and tumors. Molecular oncology: The cell cycle and its control;; Protooncogenes, oncogenes and oncoproteins; Oncosuppressor genes and their products; Altered DNA repair mechanisms and tumors; Defects of apoptosis and cancer; Karyotipic alterations in tumors. The natural history of cancer: Stem cells and cancer; Intiation and promotion; Multiphasic cancerogenesis; Tumor progression. The neoplastic cell: Cytological and metabolic alterations; Tumor angiogenesis; Invasivity; Metastasis
Pathophysiology of tissue injury and repair. Hemostasis: Phases and mechanisms; Hemorrhagic diseases due do defects in primary or secondary hemostasis. Consumption coagulopathies. Thrombosis, embolism, infarction. Innate immunity: The inflammatory process: Signals and Activating mechanisms; Events, types and evolution of inflammatory processes; Resolution; Chemical mediators of inflammation; Inflammatory lesions: abscesses, ulcers, granulomas; Systemic effects of inflammation: fever, acute phase response; Derangements of the inflammatory response. Tissue repair and regeneration: Stem cells and tissue regeneration; Tissue repair and its alterations; Wound healing; Fibrosis. Atherosclerosis.
Pathophysiology of the homeostatic networks. Thermoregulation and its alterations. Metabolic disorders: Disorders of lipoproteins and of lipid circulation; Disorders of purine metabolism; Metabolic alterations in diabetes; Disorders of porphirine metabolism (porphyrias, jaundice). Pathophysiology of blood cells and disorders of hematopoiesis; Anemias; Leukocyte disorders. Edema. Shock. Disorders of iron and copper metabolism. Eating disorders and obesity. Pathophysiology of endocrine disorders.
General Pathology subjects to be treated in other Courses:
Fluid and Ion Balance Physiopathology (Hyper- and Hyponatremia; Dehydration and hyperhydration; Hyper- and Hypo-kalemia; Acidosis and alcalosi; disorders of calcium, Phosphorus and Magnesium)
Cancer pathogenesis (Host-tumor relationships; Cachexia; Paraneoplastic sindrome; Tumor immunology; Biological bases of cancer therapy)
- Kumar, Abbas, Fausto, Aster (Eds). Robbins e Cotran – Le Basi Patologiche delle Malattie. 8 Edizione italiana, Elsevier Masson, 2010.
- Pontieri, Russo, Frati. Patologia Generale. 4° Edizione, Piccin, 2010.
Additional references will be suggested during the lectures.
Interactive oral lectures, laboratory practice (optional), slides on line.
Assessment methods and criteria