Learning objectives
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 (molecules, cells, tissues, organisms).
Students are also expected to be able to apply this knowledge, integrated with information from previous Courses, to the comprehension of the pathophysiology of common human pathologies.
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Prerequisites
Adequate bases of cytology/histology, anatomy, biochemistry, microbiology, immunology, oncology and physiology are required.
Course unit content
The Course will provide scientific bases 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. The Course will concern:
- Cell Pathology
- Molecular Pathology
- Tissue responses to cell injury: inflammation, hemostasis, repair
- General pathophysiology
Full programme
1)Molecular pathology
- Monogenic Mendelian disease (with relevant examples)
* autosomic dominant
* autosomic recessive
* X-linked
- Monogenic non-mendelian diseases (with examples)
- Polygenic multifactorial diseases (with examples)
- Chromosomal alterations
- Disorders of gene expression and phenotypic effects of mutations
- Examples of 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 accumulations: protein accumulation, steatosis, glycogenosis, lysosomal diseases
- Extracellular accumulations: amyloidosis
- Oxidative stress and the cell response
- Biotransformations and ethanol toxicity
- Ischemic and hypoxic stress. Cell and tissue adaptation to hypoxic-ischemic stress
- Types, biological significance and mechanisms of cell death
- Cell aging, organism aging and progeroid syndromes
3) The response to tissue damage
- Hemostasis and its mechanisms
- Hemorrhagic disease
- DIC
- Thrombosis (mechanisms, Virchow's factors, evolution and consequences)
- Embolia (concept, types, consequences)
- Infarction
- 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; antiinflammatory mediators)
- The resolution of the acute inflammatory response
- Chronic inflammation (the infiltrate, mechanisms, cells, evolution)
- Inflammatory lesions: abscesses, ulcerae, granulomas
- Systemic phenomena in inflammation (leukocytosis, acute phase response, the inflammatory stress, metabolic changes)
- Fever
- Defects of the inflammatory response
- SIRS
- Autoinflammatory diseases
- Mechanisms of tissue repair
- Derangements of tissue repair mechanisms
- Fibrosis
- Atherosclerosis
4) Pathophysiology
- Edema: exudates and trasuìdates
- Shock
- Thermoregulation
- 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
* Diabetes Mellitus: etiologic factors, types, pathophysiology of metabolic alterations and complications
* Porphiries and jaundice
* Iron and copper. Iron deficiency and overload.
- Pathophysiology of nutrition.
*Obesity
* PEM
* Hypovitaminosis and hypervitaminosis
Bibliography
- Kumar, Abbas, Fausto, Aster (Eds). Robbins e Cotran – Pathologic Basis of Disease - Elsevier Masson, 2015
- Mainiero, Misasi, Sorice (Eds.) Patologia Generale e Fisiopatologia Generale,
2 vol. VI edizione
Piccin, 2019.
Altucci, Berton, Moncharmont, Stivala (Eds.)
Patologia e Fisiopatologia Generale, 2 vol.
Ildeson-Gnocchi, 2018
Additional references will be suggested during the lectures.
Teaching methods
Interactive oral lectures, based on the explanation of the main conceptual frame of each subject, supported by graphical presentations which will be available to the students on the Elly platform. This material will be useful to support the individual learning process but, by no means, should be considered sufficient for the preparation of the exam. Examples taken from the medical practice will be provided together with bibliographic references so as to stimulate students to raise questions, to go in depth in subjects of interest or to provide answers to simple problems presented by the teacher. The course will be integrated with optional laboratory practice.
Assessment methods and criteria
No interim summative evaluation is programmed, while valutative or diagnostic evaluations will be possible.
The final summative evaluation will consist in the oral examination of the Integrated Course.
For further information see the Integrated Course.
Other information
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