Unit SYSTEMIC PATHOLOGY V

BLOOD DISEASES - MOD. 1

Code	GP004621
Location	PERUGIA
CFU	2
Teacher	Brunangelo Falini
Teachers	Andrea Velardi (Codocenza) Brunangelo Falini
Hours	4 ore (Codocenza) - Andrea Velardi 20 ore - Brunangelo Falini
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/15
Type of study-unit	Obbligatorio (Required)

BLOOD DISEASES - MOD. 2

Code	GP004622
Location	PERUGIA
CFU	1
Teacher	Maria Paola Martelli
Teachers	Antonio Pierini (Codocenza) Maria Paola Martelli
Hours	2 ore (Codocenza) - Antonio Pierini 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	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).
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	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 examination
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	GP005656
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	Immunodeficiencies: pathogenic mechanisms and risk nfettivo diagnosis of primary immunodeficienze.Immunodeficienze; Severe Combined Immunodeficiency; Immunodeficiency by defective granulocyte function; immunideficienze The secondary; Secondary immunodeficiencies (not AIDS); After splenectomy Immediate hypersensitivity diseases, autoimmune diseases; Immune diseases (vasculitis); immunopathogenesis and clinical; The systemic vasculitinecrotizzanti; immunopathogenesis and clinical; Systemic autoimmune diseases; immunopathogenesis and clinical
Reference texts	HARRISON " Principles of Internal Medicine"
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. The verification of the real acquisizioneis of the student will be carried out during examination.
Prerequisites	In order to start Diseases of the Immune System lessons, the student should have good knowledge of anatomy and physiopatology and good skill in general phisical examonation of the patient.
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). Score: + 1 for correct answer, - 0.25 for wrong answer, 0 points for not done answer. 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 (with a score of at least 18/30) and includes wider questions aimed at evaluating theoretical and practical skills as well as deductive processes and communication. The average examination time is 20-25 minutes.
Extended program	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	GP004623
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 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	GP005657
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	REUMATOLOGIA per studenti e Medici di a cura di UNIREUMA. IDELSON GNOCCHI III Ed. 2019. ¿ HARRISON et al. Principles of Internal Medicin 19th McGraw Hill Edizione XX, 2018
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.
Prerequisites	In order to start Rheumatology lessons, the student should have good knowledge of anatomy and physiopathology and good skill in general phisical examination of the patient.
Teaching methods	The Course includes 16 theoretical hours, 8 practical hours and practical training or seminars.
Learning verification modality	The exam includes a multiple choice written test (30 questions with up to 5 possible answers of which only 1 correct). Score: + 1 for correct answer, - 0.25 for wrong answer, 0 points for not done answer. 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 (with a score of at least 18/30) and includes wider questions aimed at evaluating theoretical and practical skills as well as deductive processes and communication. The average examination time is 20-25 minutes.
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	GP004624
Location	PERUGIA
CFU	1
Teacher	Brunangelo Falini
Teachers	Brunangelo Falini
Hours	25 ore - Brunangelo Falini
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/15
Type of study-unit	Obbligatorio (Required)

PROFESSIONALISING TRAINING IN DISEASES OF THE IMMUNE SYSTEM

Code	GP005658
Location	PERUGIA
CFU	1
Teacher	Andrea Velardi
Teachers	Andrea Velardi
Hours	25 ore - Andrea Velardi
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian

PROFESSIONALISING TRAINING IN MOLECULAR MEDICINE

Code	GP004625
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)
Language of instruction	Italian
Contents	Technological approaches to genome surveys. Protocols and their applications.
Educational objectives	Ability to address diagnostic investigations and optimize procedures.
Prerequisites	Knowledge of the genetic basis of tumors.
Teaching methods	Sistema di tutor in gruppi di lavoro.
Learning verification modality	during the exam
Extended program	Conventional cytogenetics. FISH, PCR, sequencing. Telomeres, Chromosomal instability test. Test on paraffin sections. Nucleic acids, separation. Microarrays.

PROFESSIONALISING TRAINING IN REUMATHOLOGY

Code	GP005659
Location	PERUGIA
CFU	1
Teacher	Roberto Gerli
Teachers	Roberto Gerli
Hours	25 ore - Roberto Gerli
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/16
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Clinical activity with Rheumatologist, included clinical history, physical examination, diagnosis and therapeutic intervention; infusion of biotechnological agents; instrumental diagnosis by ultrasound evaluation of muscle-skeletal areas and ultrasound-driven interventions for joints, tendons, ...; diagnosis of microcirculation disorders by videocapillaroscopic examination; evaluations of foot and posture disorders.
Reference texts	REUMATOLOGIA per studenti e Medici di a cura di UNIREUMA. IDELSON GNOCCHI III Ed. 2019. ¿ HARRISON et al. Principles of Internal Medicin 19th McGraw Hill Edizione XX, 2018
Educational objectives	Results based on check of the acquired ability, behavior and interaction degree of the student.
Prerequisites	For the purpose of learning, the student should have good knowledge of anatomy and physiopathology and good skill in general phisical examination of the patient.
Teaching methods	Partecipation to the above described activities
Learning verification modality	The exam includes a multiple choice written test (30 questions with up to 5 possible answers of which only 1 correct). Score: + 1 for correct answer, - 0.25 for wrong answer, 0 points for not done answer. 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 (with a score of at least 18/30) and includes wider questions aimed at evaluating theoretical and practical skills as well as deductive processes and communication. The average examination time is 20-25 minutes.
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