Unit GENERAL PATHOLOGY

Course

Pharmacy

Study-unit Code

65001409

Location

PERUGIA

Curriculum

In all curricula

Teacher

Giuseppe Servillo

Teachers

Giuseppe Servillo

Hours

63 ore - Giuseppe Servillo

CFU

Course Regulation

Coorte 2016

Offered

2018/19

Learning activities

Base

Area

Discipline mediche

Academic discipline

MED/04

Type of study-unit

Obbligatorio (Required)

Type of learning activities

Attività formativa monodisciplinare

Language of instruction

Italian

Contents

Intrinsic and Extrinsic Causes of Disease. Regressive and Progressive processes. Oncology. Classification of the tumors. Carcinogenesis. Oncogenes and Tumor Suppressor Genes. Invasive cancer and metastasis. Acute and Chronic inflammation. Physiopathology of Human Apparatuses

Reference texts

Patologia Generale Fisiopatologia Generale; PONTIERI-RUSSO-FRATI: Ed. PICCIN
Istituzioni di Patologia Generale; DIANZANI: Ed. UTET
ROBBINS & COTRAN Le Basi Patologiche delle Malattie 8a EDIZIONE. Elsevier Italia.

Educational objectives

The lesson of General Pathology is a teaching of the Degree in Pharmacy, which studies the causes (etiology) and pathological phenomena at the molecular and cellular disease than the biology and physiology of the cell. The course intends to acquire knowledge about the basic mechanisms underlying the most common diseases in humans and the cell response to changes in the external environment. The main objective of the course is to acquire knowledge about:

• intrinsic molecular pathology

• physical, chemical and biological causes of disease

• molecular mechanisms of cell death

• carcinogenesis, molecular oncology

• cellular and molecular processes of inflammation

• General pathophysiology of tissues and organs in humans

The oral examination and optional seminars are tools to assess the degree of learning and the ability to communicate and explain, in a simple, yet rigorous, immediate and thorough knowledge gained. The skills acquired in the study of this discipline allows the student to achieve a broad overview of the relationship between the human genome, the environment and the development of diseases and allows to obtain the means to have a clear picture of the causes of pathologies and their specific mechanism of occurrence and development and general pathophysiology of the most common diseases in order to propose behaviors and appropriate treatment as a future Pharmacist

Prerequisites

The acquisition of relevant knowledge in the course of General Pathology, requires the achievement of relevant knowledge Biology and Genetics, Biochemistry and Physiology. The skills obtained in these disciplines are essential so that students can understand the concepts of etiopathology of Molecular and Cellular Pathology and Pathophysiology of organs. The student so well prepared in teaching the course will draw a considerable profit.

Teaching methods

Students are given lectures. The lectures deal with the whole program of the course of study and are also treated subjects concerning some issues of disorders more frequent that the future Pharmacist will face in the course of his profession. Each lesson has a duration of two hours that is given to the specific topic, relating it to others already exposed, to allow the student to have a broad vision of the topics covered. Students are proposed to conduct, at its option, seminars about the arguments in class. The seminars were held in groups of two or three people. The seminars were held in groups of two or three students in the presence of the other students in the course. To this end, the teacher provides students with bibliographical material in English concerning the subject, the subject of the seminar will be presented using computer media (Power-Point and / or the like).

Learning verification modality

The student evaluation consists of an oral exam at the end of the course lessons. The assessment of the preparation of the student lasts an average of thirty minutes depending on the degree of knowledge of the topics covered and the presentation skills of the student. The test consists of three questions regarding the discipline studied related to: molecular and cellular pathology of the intrinsic and extrinsic causes of disease; cellular pathology and molecular oncology and inflammatory; general physiopathology organ. The oral examination is essential for the assessment of the knowledge acquired by the students, exhibition of his skills and mastery of the subject studied with particular reference to the ability to link between different topics.

Extended program

Intrinsic Causes of Disease

Genetic Pathology
-Instrumental genetical analysis in diagnostic human diseases.
-Experimental model of genetic diseases.
-Monogenic autosomic and heterochromosomic diseases. Heterogenetic interaction between genes and their products, interaction genes-environment, dynamic and somatic mutations, epigenetic modification.
-DNA mutation, mechanisms of DNA repair.
-Mitochondrial DNA mutations.
-Genetic susceptibility of human diseases. Concept of genetic penetrance.
-Blood genetic diseases: Thalassemia, Spherocytosis, Depranocytosis, Hemophilia.
-Muscular Dystrophya.
-Chromosomal Alteration. Numerical and structural alteration of the chromosomes (Down, Turner and Klinefelter syndromes).

Extrinsic Causes of Disease
-Physical agents. Non ionizing and ionizing radiation. Low and high temperature: freezing and burn. Electric and electromagnetic energy.
-Chemical and Environmental agents. Environment pollution, Drugs.
-Alimentary causes. Vitamins: A, D, E, K, B and C group.
-Free Radical: Oxidative stress.
-Causes of Embryopathy and Fetopathy: physical, infective, endocrine and toxic.

Cellular Pathology
-The cell: structure and principal functions. Phases and proteins regulating cell cycle. Membrane receptors and principal pathways in mitogenic signalling.
-Elementary injury of the cell. Pathology of nucleus, mitochondria, endoplasmic reticulum, lysosomes, cytoskeleton, peroxisome, Golgi apparatus and cell membrane.

Regressive processes
-Physiological and pathological Atrophy.
-Vacuolar, hydropic and turbid degeneration. Hyaline and Mucoid degenerations. Steatosis.
-Extracellular Regressive processes. Amiloidosis, Hyaline, Mucoid and Fibrinoid degenerations.
-Pathology of extracellular matrix, fibrosis, cirrhosis and sclerosis.
-Cell death. Necrosis. Gangrene. Outcome of necrotic process. Autolysis post-mortem. Apoptosis.
-Ageing. Theory of senescence. Molecular analysis of senescence. Ageing of organism, cell and subcellular fractions. Pathology of ageing.
Concept of Immunopathology and autoimmune diseases.
Progressive processes.
-Physiological and pathological hypertrophy and hyperplasia, regenerative process in labile, stable and perennial cells. Liver regeneration, reconstitution process.

Molecular Oncology
-Classification of the tumors. Characteristics of normal and transformed cell. Metaplasia, Dysplasia, Anaplasia. Benignant and Malignant tumors. Histological classification and morphological features of human tumors.
-In situ carcinoma.
-Carcinogenesis. Epidemiology of tumor. Carcinogenesis: chemical, physical (U.V. and ionizing radiations), viral, environmental.
-Co-carcinogenesis, mechanism of transformation.
-Molecular basis of the transformed cell. Pathogenetic mechanisms. Oncogenes and Tumor Suppressor Genes. Control of DNA replication. Mutations. Hereditary tumor diseases. Karyotype and chromosomal alteration in tumor.
-Role of the apoptosis control in the tumor growth..
-Molecular pathology in DNA repair. Mismatch repair. Lynch syndrome and hereditary colon-recto carcinoma. Excision repair. Xeroderma Pigmetosum and Ataxia-telangiectasia.
-Angiogenesis in cancer.
-Concept of invasive cancer. Metastasis and stage of the cancer. Molecular mechanisms of the metastasis. Metastasis routes.

Inflammation
-General characteristic and definition of inflammation. Recognition mechanisms of pathogens. Distinctive characters between acute and chronic phlogosis.
-Acute exudative phlogosis (Angiophlogosis) The inflammation phases. Plasmatic and tissutal mediators of inflammation. The exudation: different types of exudate. Acute phase proteins. Acute phase cells. The diapedesis, the chemotaxis, and phagocytosis. Different types of acute inflammation: serous, serous-fibrinous, fibrinous, catarrhal, purulent, hemorrhagic, necrotic- hemorrhagic and allergic.
-Chronic phlogosis. The cells of chronic inflammation.
-Chronic inflammation: granulomatosis and interstitial. Structure of granuloma: tuberculoma, syphiloma, rheumatic nodule, leprous, viral granuloma and foreign body granuloma.
-Outcome of inflammatory process. The repair processes and granulation tissue.

Physiopathology

Physiopathology of the blood

- Alteration of the mass. The erytrocytes: Polycythemia and erythremia. Hemoglobinopathy. Anaemia. White blood cells and leukocytosis. Lympho-hematopoietic tumor. Acute and Chronic leukaemia. Lymphomas. Plasmacytoma. The platelet, the hemostasis and coagulation. Haemorrhage. Thrombotic and embolic processes. Disseminated intravascular coagulation (DIC).

Physiopathology of the heart and the blood vessel

- Congenital and acquired heart defects. Endocarditis and valvulopathy. Ischemic heart disease. Heart attack. Myocardiopathy. Heart failure. Hypertension and hypotension.

- Pathogenesis of atherosclerosis and its complications.

- Shock: cause of shock, evolution and phases, compensatory mechanisms. Edema.

Physiopathology of respiratory apparatus

- Alterations in gas exchange and pulmonary perfusion. Pathogenesis of respiratory insufficiency: Inflammatory processes; Bronchial asthma; Obstructive pneumopathy (COPD); Interstitial lung diseases; Atelectasis; pneumothorax. Acute and chronic Pulmonary Edema. Hypoxia, cyanosis.

Physiopathology of the liver

- Liver primitive pathology; Inflammatory and degenerative processes. Hepatitis, Cirrhosis. Secondary Pathology: Hemosiderosis and Hemochromatosis; Jaundice. Liver Failure. Portal hypertension. Ascites.

Physiopathology of the kidney

- Alteration in glomerular filtration rate andtubular reabsorption. Proteinuria. Tubular hereditary pathology. Renal diabetes. Vascular nephropathy. Interstitial nephrites. Pyelonephrites and cystitis. Renal failure. Acute and chronic uraemia.

Physiopathology of endocrine system

- Mechanisms of hormones action, feed-back system, hypothalamus and hypophysis (hypothalamus-hypophysis axe), hypo and hyperpituitarism. Posterior pituitary hormones, oxytocin and vasopressin. Diabetes insipidus.

- Thyroid: hypo- and hyper-thyroidism. Thyroid goiter. Thyroiditis.

- Parathyroid and calcitotropic hormones. Hypoparathyroidism, Pseudo-hypoparathyroidism and hyper-parathyroidism.

- Endocrine pancreas, Glucagon and Insulin. Diabetes Mellitus: etiopathogenetic and metabolic aspects, complications.

- Adrenal cortex: mineralcorticoid, glucocorticoid and androgen, structures and biological effects. Adrenal failure, hyper-adrenal function syndromes.

Alteration of the thermoregulation

- Fever, Hypothermia and Hyperthermia.