Unit SYSTEMIC PATHOLOGY V

BLOOD DISEASES - MOD. 1

Code	GP004672
Location	PERUGIA
CFU	2
Teacher	Brunangelo Falini
Teachers	Brunangelo Falini Andrea Velardi (Codocenza)
Hours	20 ore - Brunangelo Falini 4 ore (Codocenza) - Andrea Velardi
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/15
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Blood Diseases
Reference texts	Harrison's - Principles of Internal Medicine Hoffbrand/Moss - Essential Haematology Bosi, De Stefano, Di Raimondo, La Nasa - Manuale di Malattie del sangue Avvisati - Ematologia di Mandelli Hoffman - Hematology basic priniples and practice
Educational objectives	The general objective of education is to provide students with the foundation to address the study of blood diseases (either malignant or not). The main skills that will be acquired: - Analyze a CBC - Identify the diagnostic procedure for alterations in the numbers of blood elements - Identify the diagnostic procedure in case of lymphadenopathy - Identify the diagnostic procedure in case of splenomegaly
Teaching methods	The course is organized as follows: - Lectures on the main topics of the course - Discussion of clinical cases to completion of the main topics
Learning verification modality	ORAL EXAM
Extended program	The myeloproliferative syndromes: - Chronic myeloid leukemia - Idiopathic myelofibrosis - Polycythemia Vera - Essential thrombocythemia The myelodysplastic syndromes The acute leukemias - Acute myeloid and lymphoid leukemias - Classification and clinical presentation. - Key molecular alterations associated - Examples of 'target' therapy Chronic lymphoproliferative disorders: - Chronic lymphocytic leukemia - The hairy cell leukemia The malignant lymphomas - Hodgkin's disease - Non-Hodgkin's Lymphoma The monoclonal gammopathy - MGUS - Multiple Myeloma - Waldenstrom's Macroglobulinemia Transfusion therapy: treatment with blood components or blood components

BLOOD DISEASES - MOD. 2

Code	GP004673
Location	PERUGIA
CFU	1
Teacher	Maria Paola Martelli
Teachers	Maria Paola Martelli
Hours	12 ore - Maria Paola Martelli
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/15
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	The anemias The thrombocytopenia Issues of general haematological interest
Reference texts	Harrison's - Principles of Internal Medicine Hoffbrand/Moss - Essential Haematology Bosi, De Stefano, Di Raimondo, La Nasa – Manuale di Malattie del Sangue Avvisati – Ematologia di Mandelli Hoffman - Hematology basic principles and practice
Educational objectives	Acquisition of knowledge on the main causes of changes in blood count and in particular of anemias and platelets. Differential diagnostic capacity within the various morbid conditions.
Prerequisites	In order to understand and know how to tackle the course, students must have the basic understanding on: - Physiology of blood, features and functions of the elements of blood (leukocytes, erythrocytes and platelets) - Anatomy, organization and functions of the lymphatic system - Cellular and humoral immunity - Structure of the bone marrow and hematopoiesis - The blood count - Principles of Serum protein electrophoresis - The monoclonal antibodies
Teaching methods	- Lectures on the main topics of the course - Discussion of clinical cases to completion of the main topics
Other information	None
Learning verification modality	The assessment method includes an oral test which will assess the acquired knowledge and the ability of the student to communicate and reason in front of a specific question. The oral exam consists of a discussion-interview related to the topics covered during the course or otherwise provided for by the program and in-depth on the recommended texts. For the teaching of Blood Diseases will be addressed a topic of oncohematological pathology and one of non-oncohematological pathology.
Extended program	The anemias: - General aspects of anemia and erythropoiesis - Classification of anemia: a. etiopathogenetic; b. morphological - Morphological alterations of red blood cells. The smear of peripheral venous blood - Iron deficiency anemia - Megaloblastic Anemia and other macrocytic anemias - Anemia of chronic disorders - Hemolytic anemias Hemolytic hereditary disorders Extraglobular causes of hemolytic disorders - Thalassemias - Aplastic anemia and other selective cytopenias (erythroblastopenia isolated, neutropenia and thrombocytopenia) - Differential diagnosis of anemic syndromes. Discussion of clinical cases and diagnostic work. The thrombocytopenia. - Idiopathic Thrombocytopenia Purpura - Thrombotic thrombocytopenia purpura Issues of general haematological interest: - Numerical changes of blood elements: a. differential diagnosis of erythrocytosis b. leukopenia and leukocytosis (lymphopenia and lymphocytosis, neutropenia and neutrophilia) c. thrombocytopenia and thrombocytosis - Splenomegaly. - Splenectomy. Indications in hematology and complications - Lymphadenopathy: Differential Diagnosis - Hematological alterations in systemic diseases

DISEASES OF THE IMMUNE SYSTEM

Code	GP005730
Location	PERUGIA
CFU	2
Teacher	Andrea Velardi
Teachers	Andrea Velardi
Hours	24 ore - Andrea Velardi
Learning activities	Caratterizzante
Area	Medicina delle attività motorie e del benessere
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Diseases of the Immune System
Reference texts	HARRISON " MEDICINE INTERNAL"
Educational objectives	At the end of the course the student will have to be able to know and to frame, from a clinical and diagnostic point of view , the main diseases of the immunity system., pimary and secondary systemic autoimmunities and immunodeficiency.
Prerequisites	It is mandatory that students already passed the exams of physiology and general pathology to allow a global comprehension of the topics included in the course.
Teaching methods	the course is organized in the following way: lecture on all subjects of the course practices that the students, divided in small groups, they will hold both in ambulatory that in department
Learning verification modality	The exam includes a multiple choice written test (30 questions with up to 5 possible answers of which only 1 correct). Questions will cover all rheumatology topics and can be afforded with a basic knowledge of such topics. The oral exam is open to students who passed the first written test and includes wider questions aimed at evaluating theoretical and practical skills as well as deductive processes and communication.
Extended program	The immunodeficiencies: pathogenic mechanisms and risk nfettivo diagnosis of immunodeficiencies. Primary immunodeficiencies: Antibody deficiency diseases: X-linked agammaglobulinemia, Camune Variable immunodeficiency, IgA deficiency. Severe Combined Immunodeficiency: Interleukin receptor gamma chain deficiency, recombinase activating gene deficiency. Immunodeficiencies deficit granulocyte function: Chronic Granulomatous Disease The immunideficienze secondary AIDS: immunopatogeensi, natural history of the disease, the main clinical features. Secondary immunodeficiencies (not AIDS): after splenectomy In the course of lymphoproliferative disorders In the course of immunosuppressive and cytostatic After transplantation of hematopoietic cells, etc.. Immediate hypersensitivity diseases: Urticaria and angioedema, food Allergies Allergic rhinitis, Asthma. Autoimmune diseases: Immunological pathogenesis of organ-specific autoimmune diseases principalei: Hashimoto's thyroiditis, diabetes mellitus, multiple sclerosis, aplastic anemia, and autoimmune pistrinipenie, etc.. Immune diseases (vasculitis): immunopathogenesis and clinical pictures: From genes Infected: Schonlein-Henoch purpura, hepatitis .. The malettia serum drug and vasculitis. Sindromei clinical immune complex amlattie associated with systemic autoimmune (SLE, RA etc;) with cancer. the crioglobulinemie The systemic vasculitinecrotizzanti: immunopathogenesis and clinical pictures: Panarteritis Gnarled, microscipica polyangiitis, Churg-Strauss disease Wegener's granulomatosis Aterite time Disease Behce Systemic autoimmune diseases: immunopathogenesis and clinical Systemic lupus erythematosus Scleroderma and overlap syndromes sarcoidosis

MOLECULAR MEDICINE

Code	GP004674
Location	PERUGIA
CFU	1
Teacher	Cristina Mecucci
Teachers	Cristina Mecucci
Hours	12 ore - Cristina Mecucci
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/15
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Technological approaches for the study of the genome. - Leukemic and tumor stem cells, multistep process of oncogenesis, mechanisms of alteration of oncogenes, tumor suppressors, shelter genes and check-point genes. - Models of pathogenesis of congenital and acquired medullary insufficiencies. - Models of pathogenesis of Acute Leukemia. - Tyrosinchinase. - Pathogenesis models of lymphoproliferative disorders. - Myeloma pathogenesis models. - Models of pathogenesis of solid tumors (lung, breast, colon).
Reference texts	The material will be provided by the professor
Teaching methods	Frontal lessons Seminars
Learning verification modality	Multiple choice quiz
Extended program	Technological approaches for the study of the genome. - Leukemic and tumor stem cells, multistep process of oncogenesis, mechanisms of alteration of oncogenes, tumor suppressors, shelter genes and check-point genes. - Models of pathogenesis of congenital and acquired medullary insufficiencies. - Models of pathogenesis of Acute Leukemia. - Tyrosinchinase. - Pathogenesis models of lymphoproliferative disorders. - Myeloma pathogenesis models. - Models of pathogenesis of solid tumors (lung, breast, colon).

REUMATHOLOGY

Code	GP005731
Location	PERUGIA
CFU	2
Teacher	Roberto Gerli
Teachers	Roberto Gerli
Hours	24 ore - Roberto Gerli
Learning activities	Caratterizzante
Area	Clinica delle specialità medico-chirurgiche
Academic discipline	MED/16
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Classification, epidemiology and pathogenesis of rheumatic disease. Clinical features of most common acute and chronic osteoarticular disease, inflammatory and not, of extra-articular rheumatism, of systemic autoimmunitary disease and of systemic vasculitides.
Reference texts	UNIREUMA - REUMATOLOGIA per studenti e Medici di Medicina Generale; edizioni IDELSON-GNOCCHI III ed. 2018. HARRISON et al. - Principi di Medicina Interna - McGraw Hill Edizione XIX, 2016
Educational objectives	At the end of the Course students are expected to recognize and define the peculiar features of most common chronic articular conditions, both inflammatory and degenerative, extra-articular rheumatic diseases, systemic autoimmune diseases and systemic vasculitis, from an etiologic, pathogenic and, most importantly, clinical point of view. In addition, the students are asked to prove the ability to recognize and interpret the laboratory tests specific for the aforementioned conditions and the most common instrumental procedures employed in rheumatology clinics. The students’ diagnostic approach based on signs and symptoms will also be evaluated.
Teaching methods	16 theoretical hours, 8 practical hours and practical training or seminars.
Learning verification modality	Oral testing after passing written tests.
Extended program	1. Definition, classification and epidemiology of rheumatic diseases 2. The musculoskeletal system: anatomic- functional elements (signs) 3. Etiopathogenetic mechanism of rheumatic diseases 4. Signs and syntoms of rheumatic diseases 5. Laboratory and imaging diagnosis and synovial liquid analysis 6. Articular inflammatory reumatism i. Rheumatoid arthritis and other arthritis ii. Spondyloarthropathies (overview) iii. Ankylosing Spondylitis iv. Reactive arthritis v. Psoriatic arthritis vi. Enteropathic arthropaties 7. Connective tissue disease i. Systemic Lupus erythematosus ii. Antiphospholipid syndrome iii. Systemic Sclerosis iv. Polymyositis/ Dermatomyositis v. Sjögren syndrome vi. Overlap syndrome vii. Undifferentiated connective tissue diseases (UCTD) 8. Primitive systemic vasculitides i. Large sized-arteries: Takayasu arteritis, temporal arteritis ii. Medium -sized arteries: polyarteritis nodosa iii. Medium and small-sized arteries ANCA-associated ( Wegener's granulomatosis, Churg-Strauss syndrome, micropolyangiitis) iv. Small- sized arteries (Schönlein-Henoch purpura, cryoglobulinemia) 9. Secondary systemic vasculitides 10. Behçet's syndrome 11. Polymyalgia rheumatica 12. Septic and post-infective arthritis (rheumatic fever) 13. Microcrystal arthropaties (Gout, Calcium pyrophosphate dihydrate and hydroxyapatite deposition disorders) 14. Osteoarthrosis 15. Localized extra-articular rheumatic diseases and fibromyalgia 16. Neurovascular and neurologic syndrome i. Algodystrophi syndrome ii. Raynaud 's phenomenon 17. Miscellaneous disorders associated with articular manifestations i. Sarcoidosis ii. Amyloidosis

PROFESSIONALISING TRAINING IN BLOOD DISEASES

Code	GP004675
Location	PERUGIA
CFU	1
Teacher	Maria Paola Martelli
Teachers	Maria Paola Martelli
Hours	25 ore - Maria Paola Martelli
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/15
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	- Activities in the outpatient and clinic department with the specialist: General approach to the patient with alteration of CBC Discussion of normal and abnormal blood counts: anemia and erythrocytosis leucopenie and leukocytosis thrombocytopenia and thrombocytosis pancytopenia General approach to the patient with lymphadenopathy General approach to the patient with splenomegaly - Execution, staining and reading the smear of peripheral venous blood (SVP) - Vision and participation in the examination of the bone marrow: bone marrow aspiration and biopsy procedures
Reference texts	Harrison's - Principles of Internal Medicine Hoffbrand/Moss - Essential Haematology Bosi, De Stefano, Di Raimondo, La Nasa – Manuale di Malattie del Sangue Avvisati – Ematologia di Mandelli Hoffman - Hematology basic principles and practice
Educational objectives	The learning outcomes are compliant with the provisions in the didactic published at: http: //www.med.unipg.it/ccl (http://www.med.unipg.it/ccl) In detail, the general objective of education is to provide students with the foundation to address the study of blood diseases (either malignant or not). The main skills that will be acquired: - Analyze a CBC - Identify the diagnostic procedure for alterations in the numbers of blood elements - Identify the diagnostic procedure in case of lymphadenopathy - Identify the diagnostic procedure in case of splenomegaly
Prerequisites	Basic knowledge on hematological diseases
Teaching methods	Clinic department and laboratory attendance
Other information	None
Learning verification modality	Oral
Extended program	- Activities in the outpatient and clinic department with the specialist: General approach to the patient with alteration of CBC Discussion of normal and abnormal blood counts: anemia and erythrocytosis leucopenie and leukocytosis thrombocytopenia and thrombocytosis pancytopenia General approach to the patient with lymphadenopathy General approach to the patient with splenomegaly - Execution, staining and reading the smear of peripheral venous blood (SVP) - Vision and participation in the examination of the bone marrow: bone marrow aspiration and biopsy procedures

PROFESSIONALISING TRAINING IN DISEASES OF THE IMMUNE SYSTEM

Code	GP005732
Location	PERUGIA
CFU	1
Teacher	Andrea Velardi
Teachers	Antonio Pierini (Codocenza)
Hours	25 ore (Codocenza) - Antonio Pierini
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Professionalising Training in Diseases of the Immune System
Reference texts	HARRISON " MEDICINE INTERNAL"
Educational objectives	The results of the learning are based on the verification of acquired ability,on the verification of knowledge from a clinical and diagnostic point of view of the main infectious complications caused by Immunodeficiency States.
Prerequisites	It is mandatory that students already passed the exams of physiology and general pathology to allow a global comprehension of the topics included in the training.
Teaching methods	Departmental activities frequency
Extended program	The training program provides the stake amount to clinical activity, with the specialist, in the unit allogeneic marrow transplantation, and gives you a nearly complete vision of infectious complications caused by Immunodeficiency States.

PROFESSIONALISING TRAINING IN MOLECULAR MEDICINE

Code	GP004676
Location	PERUGIA
CFU	1
Teacher	Cristina Mecucci
Teachers	Cristina Mecucci
Hours	25 ore - Cristina Mecucci
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/15
Type of study-unit	Obbligatorio (Required)

PROFESSIONALISING TRAINING IN REUMATHOLOGY

Code	GP005733
Location	PERUGIA
CFU	1
Teacher	Alessia Alunno
Teachers	Alessia Alunno
Hours	25 ore - Alessia Alunno
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/16
Type of study-unit	Obbligatorio (Required)