Unit SYSTEMIC PATHOLOGY V

BLOOD DISEASES - MOD. 1

Code	GP004821
Location	TERNI
CFU	2
Teacher	Antonio Pierini
Teachers	Antonio Pierini
Hours	25 ore - Antonio Pierini
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	GP004822
Location	TERNI
CFU	1
Teacher	Cristina Mecucci
Teachers	Cristina Mecucci
Hours	12.5 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	Classification of thrombocytopenias; Idiopathic Thrombocytopenic Purpura; Thrombotic Thrombocytopenic Purpura; Myelodysplastic Syndromes; Chronic Myeloproliferative Diseases
Reference texts	HARRISON’S PRINCIPLES OF MEDICINE - TURA-ZINZANI
Educational objectives	Differential diagnosis of main thrombocytopenic syndromes. Knowledge of main pathological, clinical e prognostic aspects of myelodysplastic and myeloproliferative syndromes.
Prerequisites	Physiology, Anatomy, Molecular Medicine, General Pathology.
Teaching methods	Teaching in class
Learning verification modality	Oral exam
Extended program	Classification of thrombocytopenias; Idiopathic Thrombocytopenic Purpura; Thrombotic Thrombocytopenic Purpura; Myelodysplastic Syndromes; Chronic Myeloproliferative Diseases

DISEASES OF THE IMMUNE SYSTEM

Code	GP005900
Location	TERNI
CFU	2
Teacher	Antonio Pierini
Teachers	Antonio Pierini
Hours	25 ore - Antonio Pierini
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	Physiology of the human immune system. The immunodeficiencies: Pathogenetic mechanisms of infectious risk and diagnostics of immunodeficiencies. Primary immunodeficiencies: Severe Combined Immunodeficiencies. Antibody deficiency diseases. Complement deficiency diseases Immunodeficiencies due to granulocyte function deficit New pathogenetic mechanisms of immune deficiencies and cytopenias Secondary immunodeficiencies: AIDS: immuno-pathogenesis, natural history of the disease, main clinical pictures. Immunodeficiencies due to immunosuppressive and cytostatic drugs Splenectomy Immunodeficiencies due to neoplastic diseases Hematopoietic cell transplantation: basic principles, donor choice, infectious complications, tolerance and engraftment, graft versus host disease Antibody and cellular immunotherapy Principles of immunotherapy of neoplastic and autoimmune diseases Checkpoint inhibitors Cellular immunotherapy Hypersensitivity diseases Pathophysiology of allergic diseases: hypersensitivity types I, II, III, IV Immediate hypersensitivity clinical syndromes: Urticaria and angiodema, Food allergies, Allergic rhinitis, asthma, anaphylactic shock. Immunological pathogenesis and clinical pictures of the main organ autoimmune diseases specifications Hashimoto's thyroiditis Multiple sclerosis, autoimmune cytopenias, aplastic anemia, Celiac disease Immune complex diseases and vasculitis: Purple of the Schonlein-Henoch, serum sickness, Cryoglobulinemias Clinical Immunology of Vaccines
Reference texts	HARRISON " Principles of Internal Medicine"
Educational objectives	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 hospital warm
Learning verification modality	The exam includes a 3 questions. Questions will cover all program 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	Physiology of the human immune system. The immunodeficiencies: Pathogenetic mechanisms of infectious risk and diagnostics of immunodeficiencies. Primary immunodeficiencies: Severe Combined Immunodeficiencies. Antibody deficiency diseases. Complement deficiency diseases Immunodeficiencies due to granulocyte function deficit New pathogenetic mechanisms of immune deficiencies and cytopenias Secondary immunodeficiencies: AIDS: immuno-pathogenesis, natural history of the disease, main clinical pictures. Immunodeficiencies due to immunosuppressive and cytostatic drugs Splenectomy Immunodeficiencies due to neoplastic diseases Hematopoietic cell transplantation: basic principles, donor choice, infectious complications, tolerance and engraftment, graft versus host disease Antibody and cellular immunotherapy Principles of immunotherapy of neoplastic and autoimmune diseases Checkpoint inhibitors Cellular immunotherapy Hypersensitivity diseases Pathophysiology of allergic diseases: hypersensitivity types I, II, III, IV Immediate hypersensitivity clinical syndromes: Urticaria and angiodema, Food allergies, Allergic rhinitis, asthma, anaphylactic shock. Immunological pathogenesis and clinical pictures of the main organ autoimmune diseases specifications Hashimoto's thyroiditis Multiple sclerosis, autoimmune cytopenias, aplastic anemia, Celiac disease Immune complex diseases and vasculitis: Purple of the Schonlein-Henoch, serum sickness, Cryoglobulinemias Clinical Immunology of Vaccines

MOLECULAR MEDICINE

Code	GP004823
Location	TERNI
CFU	1
Teacher	Cristina Mecucci
Teachers	Cristina Mecucci
Hours	12.5 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. Clonal hematopoiesis and leukemia pathogenesis. 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 or oral exam
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	GP005901
Location	TERNI
CFU	2
Teacher	Elena Bartoloni Bocci
Teachers	Elena Bartoloni Bocci
Hours	25 ore - Elena Bartoloni Bocci
Learning activities	Caratterizzante
Area	Clinica delle specialità medico-chirurgiche
Academic discipline	MED/16
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Definition, classification and epidemiology of rheumatic diseases. Etiopathogenesis and clinical manifestations of rheumatic diseases. Chronic inflammatory rheumatic diseases. Connective tissue diseases. Vasculitides. Gout and pseudo-gout. Extra-articular localized and generalized rheumatic diseases.
Reference texts	REUMATOLOGIA per studenti e medici di Medicina Generale- III edizione; a cura di UNIREUMA. IDELSON GNOCCHI Ed. 2019 Fauci A.S., Braunwald E. HARRISON- Principi di Medicina Interna - Edizione XX - McGraw-Hill Eds 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	Knowledge of anatomy and symptoms of the most common diseases of internal medicine. Ability to read and interpret routine laboratory exams.
Teaching methods	Face-to face lessons on all the subjects of the course Practical training in Rheumatology clinic. Students will be divided in groups (maximum 3 students per group) and will be involved in the clincal evaluation of patients with rheumatologic diseases
Other information	Compulsory frequency (at least 75% of lessons) Teaching methods: power-point, radiographic images, clinical picture
Learning verification modality	The oral exam 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. Osteoarticular system anatomy 3. Etiopathogenesis of rheumatic diseases 4. Signs and simpthoms of rheumatic diseases 5. Laboratory exams and imaging of rheumatic diseases. Synovial fluid analysis 6. Chronic inflammatory rheumatic diseases: Rheumatoid arthritis Spondyloarthopaties (ankylosing spondylitis, psoriasic arthritis, reactive arthritis, enteropathic arthritis) 7. Connective tissue diseases Systemic lupus erythematosus Antiphospholipid antibodies syndrome Systemic sclerosis Polimyositis/Dermatomyositis Sjogren's syndrome Mixed connective tissue disease Undifferentiated connective tissue disease 8. Systemic vasculitides Takayasu arteritis/ Horton arteritis Panarteritis nodosa ANCA-associated vasculitides 9. Secondary systemic vasculitides 10. Bechet disease 11. IgG4-related disease 12. Rheumatic polymyalgia 13. Septic arthritis. Post-infection arthritis 14. Gout and pseudo-gout 15. Osteoarthritis 16. Extra-articular localized and generalized rheumatic diseases 17. Neurologic and neurovascular syndrome (algodystrophy, Raynaud's phenomenon) 18. Sarcoidosis

PROFESSIONALISING TRAINING IN BLOOD DISEASES

Code	GP004824
Location	TERNI
CFU	1
Teacher	Angelo Genua
Teachers	Angelo Genua
Hours	25 ore - Angelo Genua
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	GP005902
Location	TERNI
CFU	1
Teacher	Antonio Pierini
Teachers	Antonio Pierini
Hours	25 ore - Antonio Pierini
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)

PROFESSIONALISING TRAINING IN MOLECULAR MEDICINE

Code	GP004825
Location	TERNI
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	Tutor system in working groups.
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	GP005903
Location	TERNI
CFU	1
Teacher	Elena Bartoloni Bocci
Teachers	Elena Bartoloni Bocci
Hours	25 ore - Elena Bartoloni Bocci
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 and practical activity in clinic with Rheumatologists: clinical history, physical examination, diagnosis and therapeutic prescription of all chronic inflammatory and autoimmune diseases and degenerative articular diseases. Evaluation of patients treated with infusion of biologic agents. Opportunity to assist at instrumental activity by ultrasound evaluation of muscle-skeletal diseases and ultrasound-driven arthrocentesis and infiltration of joints, tendons and bursas. Diagnosis of microcirculation disorders by capillaroscopic examination. Evaluation of patients with foot and posture disorders.
Reference texts	REUMATOLOGIA per studenti e medici di Medicina Generale- III edizione; a cura di UNIREUMA. IDELSON GNOCCHI Ed. 2019. ¿ Fauci A.S., Braunwald E. HARRISON- Principi di Medicina Interna - Edizione XX - McGraw-Hill Eds 2018.
Educational objectives	Differential diagnosis of chronic inflammatory joint diseases and systemic autoimmune diseases.
Prerequisites	Knowledge of anatomy and semiotics
Teaching methods	Partecipation to the above described activities with a specialist physician
Other information	Training can be carried out over the whole academic year. Days to be defined with professor by email.
Learning verification modality	Results based on check of the acquired ability, behaviour and interaction degree of the student.
Extended program	See above