Learning objectives
At the end of this integrated Course students should:
- have understood the fundamental principles of immunological pathogenesis of diseases
- be able to apply immunological knowledge to diagnose specific clinical conditions
- have learnt the classification of the rheumatic diseases and the main manifestations of rheumatic disorders
- have acquired basic knowledge of targeted pharmacological treatment of autoimmune diseases
- have developed clinical reasoning and problem-solving skills in clinical immunology and rheumatology
Course unit content
The term “rheumatic diseases” encompasses a large number of pathologic conditions characterized by pain and musculo-skeletal involvement. Rheumatic diseases are very heterogeneous, including inflammatory or degenerative, inherited or acquired, mechanic or immune-mediated conditions.
In the last years, rheumatology showed many progresses in the knowledge of pathogenesis, treatment, and classifications of rheumatic diseases, including new pathologic entities, such as anti-synthetasessyndromes, iper-IgG4 diseases and autoinflammatory conditions.
Full programme
The course and the final test include:
- Classification and definition of rheumatic diseases
- Pain, definition, physiopathology and clinical pictures.
- Role and significance of autoimmunity
- Analysis and interpretation of synovial fluid
- Osteoarthritis, pathogenesis, diagnosis, clinical and radiologic pictures, treatment
- Fibromyalgia, pathogenesis, diagnosis, clinical picture, treatment
- Gout, pathogenesis, diagnosis, clinical picture, treatment
- Chondrocalcinosis e microcrystalline arthropathies, pathogenesis, diagnosis, clinical and radiologic pictures, treatment
- Panniculitis and erythema nodosum, diagnosis, clinical picture, treatment
- Chronic inflammatory diseases: Rheumatoid arthritis, pathogenesis, diagnosis, clinical and radiologic pictures, treatment. Seronegative spondylarthritis: ankylosing spondylitis, entero-arthritis, non-radiographic spondylarthritis, pathogenesis, diagnosis, clinical and radiologic pictures, treatment. Psoriatic arthritis, pathogenesis, diagnosis, clinical and radiologic pictures, treatment. Reactive and infectious arthritis, diagnosis, clinical picture, treatment
- Connective tissue diseases: Systemic lupus erythematosus, diagnosis, clinical picture, treatment. Anti-phospholipid antibody syndrome, diagnosis, clinical picture, treatment. Systemic sclerosis, Raynaud’s phenomenon and capillaroscopy, diagnosis, clinical picture, treatment. Sjogren’s syndrome, diagnosis, clinical picture, treatment. Inflammatory idiopathic myopathies: dermatomyositis, polymyositis, anti-synthetase antibodies syndrome, diagnosis, clinical picture, treatment. Mixed connective tissue disease. Undifferentiated connective tissue disease.
- Systemic vasculitides: Giant cell arteritis and polymyalgia rheumatica, diagnosis, clinical picture, treatment. Takayasu’s arteritis, diagnosis, clinical picture, treatment. Polyarteritis nodosa, diagnosis, clinical picture, treatment. ANCA associated vasculitis: granulomatosis with polyangiitis, micro-polyangiitis, eosinophilic granulomatosis with polyangiitis, diagnosis, clinical picture, treatment. Cryoglobulinaemic vasculitis, diagnosis, clinical picture, treatment. IgA vasculitis (Henoch-Schoenlein’s vasculitis), diagnosis, clinical picture, treatment. Hypocomplementemic urticarial vasculitis, diagnosis, clinical picture, treatment
- Autoinflammatory diseases, definition and classification: Behcet’s disease, diagnosis, clinical picture, treatment. Familial mediterranean fever, diagnosis, clinical picture, treatment. TNF Receptor-Associated Periodic Syndrome (TRAPS), diagnosis, clinical picture. Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome, diagnosis, clinical picture.
- Bone diseases: Osteoporosis, diagnosis, clinical picture, treatment. Osteonecrosis and complex regional pain syndrome, diagnosis, clinical picture, treatment. Paget’s disease, diagnosis, clinical picture, treatment.
Bibliography
Harrison’s Principles of Internal Medicine (Loscalzo, Fauci, Kasper, Hauser, Longo, Jameson Eds.), 21st Edition, McGraw-Hill 2022
UpToDate, Wolters Kluver, accessible for free through the link: http://www.uptodate.com from computers connected to the web network of the University of Parma
Teaching methods
Frontal lessons, discussion of clinical cases and clinical vignettes
Assessment methods and criteria
The final exam will be performed by the administration of a multiple-choice test, consisting of 50 questions (20 questions covering topics of the section of Clinical Immunology and 30 questions covering topics of the section of Rheumatology) with 4 possible answers. Correct answers will receive a score of 1. Wrong answers will receive a score of -0.5 and unanswered questions will receive a score of 0. A minimum of 70% of success, corresponding to 35 correct answers will be required to pass the exam.
Thirty-five correct answers will correspond to a final score of 18/30. The number of correct answers exceeding the minimum of 35 will be scaled to progressively increasing scores up to a maximum of 30/30 cum laude, corresponding to 50 correct answers.
A time interval of 75 minutes will be allowed to answer 50 questions. Supplemental time will be allowed only upon previous exhibition of a formal certification of special needs.
The use of textbooks or written notes, as well the use of cellular phones or tablets will not be allowed during the exam, pending the invalidation of the test.
Simulation tests will be administered in the last hour of the last lesson at the end of each section of the integrated Course.
