Unit PHYSIO-PATHOLOGICAL BASES OF DISEASE

PHYSIOLOGY II

Code	GP003951
CFU	2
Teacher	Aldo Ferraresi
Teachers	Aldo Ferraresi
Hours	30 ore - Aldo Ferraresi
Learning activities	Base
Area	Scienze biomediche
Academic discipline	BIO/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Physiology of the cardiocirculatory, respiratory, renal and digestive systems
Reference texts	Elementi di Fisiologia di Roberto Poltronieri Editore: Edises Anno di Pubblicazione: 2018 ISBN: 8833190072 Pagine: 500 Fisiologia dell'uomo di Autori Vari Editore: Edi. Ermes Anno di Pubblicazione: 2002 ISBN: 8870512517 Pagine: XVI-600 Principi di Fisiologia di Luciano Zocchi Editore: Edises Anno di Pubblicazione: 2012 ISBN: 8870512517 Pagine: 464 / 4 colori
Educational objectives	Knowledge and understanding of the cardiovascular, respiratory, renal and digestive systems
Prerequisites	Basic knowledge of chemistry and physics. Adequate knowledge of anatomy.
Teaching methods	Frontal lessons
Other information	None
Learning verification modality	Multiple choice written test
Extended program	Cardiovascular system. • Anatomical and functional characteristics. Large and small circle, vessel wall structure, vessel compliance. • Principles of hemodynamics. Flow equation, pressure gradient, vessel elasticity, flow and velocity, Bernulli's principle, laminar and turbulent motion, viscosity, Poisseuille's law, series and parallel resistances, Laplace's law, effects of gravity. • Cardiac conduction system. Functions of nodal, conduction and working tissues, nodal tissue self-regression, functions of the atrioventricular node and Purkinje network, refractory period and re-entry. Electrocardiogram. • Cardiac mechanics. Control of the contraction and role of calcium, inotropic effect, isometric and isotonic contraction, cardiac cycle, differences between Dx and Sn ventricles, length-tension, preload and afterload relation, Frank-Starling law. • Cardiac output. Measurement according to the Fick principle, determinants of GC, heart-lung preparation, homeometric regulation, heart rate / range relationship. • Blood pressure. Determinants of BP, dicrote wave, time constant, sphygmic wave, pulse pressure and flow pulse, pulsatility, measurement with the Riva-Rocci method, oscillations of the PA. • Capillary circle. Capillary and capillary circulation structure, diffusion and filtration, Starling model, filtration coefficient, lymphatic circulation. • PA regulation. Organization of regulatory mechanisms, baroreceptors and baroceptive reflexes, voloceptors and Bainbridge reflex, chemoreceptors, central ischemic response. Relationship volemia pressure, endocrine mechanisms (ADH, PNA, Angiotensin, Aldosterone), pressure diuresis, effects of Angiotensin on the renal function curve. • Venous return. Pressures and resistance in venous return, venous return curve, venous compliance, venous return and cardiac function curves, muscle pump, thoraco-abdominal pump, valve plane mechanism. Renal system. • Glomerular filtration. Functional anatomy of the kidney, urine formation mechanisms, glomerulus filtering structure, Starling model applied to the glomerulus, afferent and efferent arterioles, VFG and filtration fraction. • VFG control. Myogenic autoregulation, tubulo-glomerular feedback (juxta-glomerular apparatus, role of Sodium). • Tubular reabsorption. Transport mechanisms involved, reabsorption of sodium, water, cotransport and against transport, maximum transport, glomerulo-tubular balance. • Renal clearance. Definition of clearance, inulin clearance, creatinine clearance, PAI clearance, osmolar clearance and free water. • Regulation of osmolarity. Water reabsorption in the various segments of the nephron, hyperosmolarity of the interstitium, multiplication mechanism against the current, the role of ADH, control of ADH secretion. • Regulation of Sodium and Potassium. Control of Sodium reabsorption, Renin Angiotensin Aldosterone system, PNA; balance of potassium, mechanisms of elimination of potassium. • Urine elimination. Bladder, detrusor muscle and internal and external sphincters, urination reflex, pontine and cortical control, urination disorders. Respiratory system. • Respiratory mechanics. Events involved in respiration, functional anatomy of the respiratory system, lung volumes and capacities, anatomical and functional dead space, pulmonary and alveolar ventilation, role of pleurae, residual functional capacity, inspiratory and expiratory muscles. • Elastic resistances. Thoraco-pulmonary, pulmonary and thoracic relaxation (compliance) curve, surface tension and surfactant, alveolar stability. • Flow resistance. Resistance distribution, lung strength / volume relationship, resistance to forced expiration, flow-volume diagram and FEV1, restrictive and obstructive pathologies, pressure-volume relationship and respiratory work. • Ventilation and perfusion. Characteristics of the pulmonary circulation, vessel-alveoli ratios, effects of pressure variation in pulmonary vessels, Starling model, hypoxic vasoconstriction, regional distribution of ventilation and blood, areas of West, ventilation-perfusion ratio. • Honeycomb exchanges. Dalton's law, composition of atmospheric, inspired and alveolar air, alveolar air equation, solubilization and diffusion, Fick's law, diffusion of oxygen in particular conditions. • O2 and CO2 transport. O2 transport mode, hemoglobin and relative saturation curve, Bohr effect, determinants of O2 transport and hypoxia; CO2 transport mode, role of bicarbonate, Haldane effect. • Nervous control of ventilation. Requirements to be met, bulbar and pontine control centers, discharge characteristics of respiratory neurons, pulmonary receptors, anticipatory responses. • Chemical control of ventilation. Central chemoreceptors, peripheral chemoreceptors, sensitivity to O2 and CO2. and pH, adaptation to altitude. • Acid-base balance. Blood buffer systems, effects of ventilation on bicarbonate swab, renal bicarbonate reabsorption, elimination of H + ions, urinary swabs. • Alterations in the acid-base balance. Respiratory and metabolic acidosis, respiratory and metabolic alkalosis, alkaline and bicarbonate reserve, anion gap, acid-base nomogram, diagnostic criteria. Digestive system • Control of the digestive system. Structure of the digestive canal (muscle layers, nerve plexuses), characteristics of smooth muscles, control of smooth muscles, organization of innervation, hormonal controls. • Motility and secretions of the mouth. teeth, masticatory muscles, swallowing, saliva, control of salivary secretion. • Motility of the digestive system. Motility of the esophagus, upper and lower esophageal sphincters, stomach motility, control of gastric motility, bowel motility, defecation. • Gastric secretion. Oximation glands, components of gastric secretion, HCl production mechanism, gastric mucosal barrier, control of gastric secretion. • Pancreatic secretions. Components of exocrine pancreatic secretion, bicarbonate production, control of bicarbonate secretion, control of enzymatic secretion. • Bile. Bile components, bile acids, bilirubin, cholangiocyte secretions, control of bile secretion. • Digestion and absorption. Starch digestion, digestion and absorption of oligosaccharides, protein digestion, absorption of amino acids and oligopeptides, lipid digestion, absorption of fatty acids and monoglycerides, lipid management, calcium, iron, vitamin B12. • Feeding control. Mechanisms of control of hunger and satiety, factors that alter physiological controls, control of long-term nutrition.

MICROBIOLOGY

Code	GP003952
CFU	2
Teacher	Claudia Monari
Teachers	Claudia Monari
Hours	30 ore - Claudia Monari
Learning activities	Base
Area	Scienze biomediche
Academic discipline	MED/07
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Structure and physiology of bacteria, viruses, fungi, parasites. Host-microorganism interaction. Mechanisms of microbial pathogenicity. Main pathogenic microorganisms for humans. Infections of the apparatus of the human body Hospital infections
Reference texts	Microbiologia e microbiologia clinica. Per le professioni sanitarie e Odontoiatria. Seconda Edizione- Con MyLab. Simona De Grazia, Donatella Ferraro, Giovanni Giammanco. (Casa Editrice Pearson) Microbiologia Clinica. Quarta Edizione. Eudes Lanciotti. (Casa Editrice Ambrosiana) Principi di Microbiologia Medica. La Placa Michele
Educational objectives	Overview of processes and agents that cause infection in humans.
Prerequisites	The knowledge that the student must possess at the beginning of the lessons in order to understand the contents treated and the learning objectives are: anatomy - important immunology - indispensable biology - useful general pathology - useful
Teaching methods	Frontal lessons.
Other information
Learning verification modality	Written exam with multiple choice questions. For information on support services for students with disabilities and / or DSA visit the page:http://www.unipg.it/disabilita-e-dsa
Extended program	Introduction to medical microbiology. Commensal and pathogenic microbial flora in humans. Sterilization, disinfection, asepsis. Bacteria Bacterial cell. Metabolism. Replication. Genetics of bacteria. Mechanisms of bacterial pathogenicity. Bacteria cultivation. Antibacterial drugs. Main pathogenic bacteria for humans. Virus Structure and replication of viruses. Mechanisms of viral pathogenity. Cultivation and titration of viruses. Antiviral drugs Main pathogenic viruses for humans. Fungi General characteristics of mycetes Mechanisms of fungal pathogenicity Antifungal drugs Main pathogenic fungi for humans. Parasitology General characteristics of pathogenic human parasites. Mechanisms of pathogenicity of parasites. Overview of the main pathogenic parasites for humans. Infections of the apparatus of the human body. Hospital infections.

GENERAL PATHOLOGY AND PATHOPHYSIOLOGY

Code	GP003950
CFU	3
Teacher	Stefano Brancorsini
Teachers	Stefano Brancorsini
Hours	45 ore - Stefano Brancorsini
Learning activities	Base
Area	Scienze biomediche
Academic discipline	MED/04
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Causes of Hereditary Disease  Necrosis, Apoptosis  Cancer  Acute and chronic inflammation  Pathophysiology of the red cells and platelets Pathophysiology of heart and circulation  Pathophysiologyof liver cirrhosis, hepatitis
Reference texts	Pontieri G.M. "Patologia generale & Fisiopatologia - Per i corsi di Laurea in Professioni sanitarie" II Edizione - Editore: PICCIN  Barrera G. et al. "Patologia e Fisiopatologia Generale" - Editore: Monduzzi Editore Maier J.A.M., Mariotti M. "Elementi di Patologia generale e Fisiopatologia" - Editore: McGraw-Hill
Educational objectives	Specific goal is to understand the fundamental causes and mechanisms responsible for the altered state of health. To this end, the effects will be examined at molecular and cellular levels of endogenous and exogenous pathogens. Description of local reaction after systemic tissue damage thorough examination inflammatory process and subsequent tissue repair.
Prerequisites	In order to be able to understand and apply efficently the majority of the arguments described within the course, you must have successfully passed the Basi Anatomo-Fisiologiche del Corpo Umano. Moreover, deep knowledge of Biology and Biochemistry are determinant as precondition for the student planning to follow this course with profit.
Teaching methods	Face-to-face and seminar lectures with audiovisual material on all subjects of the Course
Other information	No additional information
Learning verification modality	The exam consist of at least a multiple choice test during the course for every single module and a joined final test. The test during the course consists of a minimum number of 15 questions with a duration calculated as 2 minutes for a single question (For example, a test with 30 questions has a duration of no more than 60 minutes). The test is designed on arguments proposed by the professor and aims to ascertain the understanding capability and knovledge levels of students. The test is considered passed with minimum mark of 18/30. The final test is a multiple choice test including questions from all modules and considers that the students should have positively passed the test during the course. The final test consists of a minimum of 15 questions for every module with a duration calculated as 1 minutes for a single question. Final mark will be calculated as average of marks from all tests. Overall, this procedure allow to verify specifically the both the ability of knowledge and understanding and the ability to apply the acquired skills on all theoretical topics and methodologies reported in all teachings.
Extended program	Causative agents and pathogenesis. Homeostasis and adaptation.  Genetic Diseases, Multigenic and monogenic hereditary diseases. Point mutations and chromosomal mutations. Examples of genetic diseases (Tay-Sachs disease; Hungtinton disease, Duchenne dystrophy, Klinefelter syndrome, Turner syndrome).  Immune System. Cells of the immune system. Differences between innate immunity and acquired immunity. Humoral and cellular immune response. Immunoglobulins. Cytokines. Autoimmune diseases.  General features of inflammation. The acute inflammation and morphological types. Alterations in vascular caliber and blood flow. Leukocyte recruitment. Chemical mediators of acute inflammation. Chronic inflammation: causes and characteristics.  Necrosis: morphology and classification. Physiological and pathological apoptosis. Intrinsic and extrinsic pathway of apoptosis.  Mechanical trauma. Superficial and deep trauma. Skeletal Trauma. Types of wounds and their healing. Granulation tissue.  Injuries caused by thermal agents and their classification. Hyperthermia, hypothermia, frostbite and freezing.  Ionizing radiation and exciting.  Electric currents: thermal effect, electrochemical and biological. The electric shock.  Pollution. The industrial exposures and effects of toxic metals.  Disorders caused by a wrong diet. Inadequate food, overeating and ipoalimentazione. Protein malnutrition: kwashiorkor. Hypovitaminosis.  Physiological and pathological atrophy. Abnormal growth. Ipetrofia. Hyperplasia.  Carcinogenesis. Induced mutations and spontaneous mutations. DNA repair mechanisms. Etiology of cancer.  Proto-oncogenes, oncogenes and tumor suppressor genes. Differentiation and anaplasia. Benign and malignant tumors and their characteristics. Carcinoma in situ.  Concept of invasiveness and angiogenesis. Metastatic mechanisms.  Elements of interaction between the immune system and cancer.  Classification of tumors.  Hematopoiesis  Basics of hematopoiesis. Definition of stem cells.  The erythropoiesis.  Hemoglobin types and structure. Transport capacity and oxygen dissociation curves.  Heart and liver physiopathology. Basics of physiopathology of kidney