Unit SYSTEMIC PATHOLOGY

Course: Medicine and surgery
Study-unit Code: GP004560
Location: PERUGIA
Curriculum: In all curricula
CFU: 11
Course Regulation: Coorte 2019
Offered: 2023/24
Type of study-unit: Obbligatorio (Required)
Type of learning activities: Attività formativa integrata

GASTROENTEROLOGY - MOD. 1

Code	GP005651
Location	PERUGIA
CFU	1
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/12
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Gabrio Bassotti

Teachers

Gabrio Bassotti

Hours

12.5 ore - Gabrio Bassotti

Language of instruction

Italian

Contents

Apprendimento delle procedure per il management di un paziente con malattie dell'apparato digerente.

Reference texts

Manuale dell'apparato digerente. Edizione 2022-2025. A cura di UNIGASTRO

Educational objectives

Inquadramento eziopatologico ed epidemiologico delle patologie, con approfondimento delle tematiche inerenti la sintomatologia ed il flusso diagnostico, e cenni di terapia medica e chirurgica.

Prerequisites

Conoscenza dell'anatomia umana, della fisiologia e della patologia generale.

Teaching methods

Lezioni frontali sugli argomenti in programma.

Learning verification modality

Esame orale. I requisiti minimi per il superamento dell'esame saranno la capacità di collegamenti critici e di sintesi, la qualità dell'esposizione e dell'organizzazione del discorso.

Extended program

Introduzione (cenni di epidemiologia, tecniche diagnostiche in gastroenterologia)
Fisiopatologia esofagea e sintomi correlati (innervazione, fisiologia sensoriale, fisiologia motoria, fisiologia della giunzione gastro-esofagea, pirosi, rigurgito, disfagia, odinofagia, bolo faringeo, dolore toracico simil-anginoso)
Disordini motori esofagei (da alterato rilasciamento sfinteriale, superiore ed inferiore; da alterazioni maggiori della peristalsi; da alterazioni minori della peristalsi)
Malattia da reflusso gastro-esofageo (fisiopatologia, aspetti clinici, diagnosi, terapia)
Esofagiti non associate a malattia da reflusso gastro-esofageo (infettive, da caustici, attinica, eosinofila)
Lesioni precancerose e neoplasie esofagee (epidemiologia, fattori di rischio, caratteristiche cliniche, iter diagnostico, terapia)
Fisiopatologia dello stomaco (motilità, secrezione)
Dispepsia (dfinizione e classificazione, epidemiologia, fisiopatologia, approccio clinico, terapia)
Infezione da Helicobacter pylori e patologie correlate (epidemiologia, vie di trasmissione, meccanismi patogenetici, gastrite crnica, ulcera peptica, neoplasie gastriche, patologie extradigestive, aspetti diagnostici, terapia)
Gastrite cronica e gastropatie da farmaci (aspetti clinici, gastrite cronica jatrogena, altre forme di gastriti croniche)
Lesioni precancerose e neoplasie gastriche (precancerosi gastriche, adenocarcinoma, neoplasie non epiteliali, classificazione neoplasie gastriche, aspetti clinici, diagnosi, terapia)
Fisiopatologia dell’intestino tenue (motilità, dinamica dei fluidi, digestione dei nutrienti, malassorbimento)
Diarree (definizione, epidemiologia, fisiopatologia, aspetti diagnostici)
Malattia celiaca(epidemiologia, fisiopatologia, aspetti diagnostici, complicanze, terapia, follow-up, sensibilità al glutine non celiaca)
Allergie ed intolleranze alimentari (classificazione, allergie IgE-mediate e non-IgE-mediate, intolleranze)
Fisiopatologia del colon (motilità, fisiopatologia)
Sindrome dell’intestino irritabile (definizione, epidemiologia, patofisiologia, aspetti diagnostici, terapia)
Stipsi (definizione, epidemiologia, stipsi acuta e cronica, stipsi funzionale, stipsi secondaria, aspetti diagnostici, terapia)
Morbo di Crohn (epidemiologia, eziopatologia, aspetti anatomo-patologici, presentazione clinica, storia naturale, aspetti diagnostici, terapia)
Colite ulcerosa (epidemiologia, eziopatologia, aspetti anatomo-patologici, presentazione clinica, storia naturale, aspetti diagnostici, terapia)
Altre coliti infiammatorie (coliti microscopiche, colite da diversione, colite segmentaria associata a malattia diverticolare, colite ischemica, colite attinica)
Malattia diverticolare del colon (definizione, epidemiologia, fisiopatologia, aspetti diagnostici, terapia)
Lesioni precancerose e neoplasie del colon-retto (polipi, lesioni non polipoidi, adenomi serrati, poliposi familiari, neoplasie maligne, fisiopatologia, aspetti diagnostici, prevenzione, terapia)
Patologie anorettali (prolasso rettale, ragade anale, ulcera solitaria del retto, proctiti ed infezioni perianali, ascessi e fistole, neoplasie anali)
Funzione epatica e meccanismi di danno epatico acuto e cronico (anatomia micro- e macroscopica, funzione epatica, meccanismi acuti e cronici di danno epatocellulare)
Storia naturale della malattia epatica (epidemiologia, epatite acuta, epatite cronica B,C,D,E, steatosi epatica non alcoolica)
Diagnostica epatologica (test epatici di routine, esami diagnostici)
Epatiti virali (epatiti acute, epatiti croniche, aspetti diagnostici e terapeutici)
Epatopatia alcool-relata (epidemiologia, patofisiologia, aspetti diagnostici, terapia)
Steatosi ed epatopatia non alcool-relata (definizione, aspetti eziopatogenetici, epidemiologia, storia naturale, aspetti genetici, aspetti diagnostici, complicanze epatiche ed extra-epatiche, terapia)
Malattie epatiche autoimmuni (epidemiologia, fisiopatologia, aspetti clinici, aspetti diagnostici, variante colestatica e sindrome da overlap, manifestazioni extraepatiche, terapia)
Malattie epatiche da accumulo (malattia di Wilson, emocromatosi)
Epatopatie da farmaci e da tossici (epidemiologia, fisiopatologia, aspetti clinici, aspetti diagnostici, terapia)
Cirrosi epatica e complicanze (epidemiologia, fisiopatologia, aspetti clinici, complicanze, storia naturale, terapia)
Neoplasie epatocellulari e vascolari (epatocarcinoma, neoplasie benigne)
Trapianto di fegato (indicazoini, selezione dei candidati, considerazioni chirurgiche, rigetto acuto e cronico, terapia immunosoppressiva, complicanze, risultati)
Fisiopatologia delle vie biliari (anatomia, shunt cole-epatico, circolo enteroepatico dei sali biliari, microbiota e recettori nucleari, secrezoine bilare di fosfolipidi e colesterolo, circolazione enteroepatica del colesterolo, secrezione e circolazione enteroepatica della bilirubina)
Ittero e colestasi (definizione, classificazione, fisiopatologia, aspetti eziopatogenetici, approccio clinico, approccio diagnostico)
Malattie colestatiche croniche (colangite biliare primitiva, colangite sclerosante primitiva, colangite associata ad IgG4)
Litiasi biliare e patologie della papilla di Vater (classificazione, fisiopatologia, epidemiologia, aspetti clinici, aspetti diagnostici)
Neoplasie delle vie biliari (classificazoine, neoplasie della colecisti, neoplasie delle vie biliari intra- ed extraepatiche, aspetti clinici, aspetti diagnostici, terapia)
Fisiopatologia pancreatica (anatomia, fisiopatologia della secrezione esocrina ed endoscrina)
Pancreatite acuta (definizione, classificazione, epidemiologia, aspetti eziopatogenetici, fattori di rischio, aspetti clinici, aspetti laboratoristici, ruolo dell’imaging, aspetti diagnostici, storia naturale, complicanze, gestione clinica, terapia)
Pancreatite cronica (definizione, classificazione, epidemiologia, aspetti eziopatogenetici, fattori di rischio, aspetti clinici, aspetti laboratoristici, ruolo dell’imaging, aspetti diagnostici, storia naturale, complicanze, gestione clinica, terapia)
Lesioni precancerose e neoplasie del pancreas (adenocarcinoma, neoplasie cistiche, aspetti epidemiologici, clinici, diagnostici e terapeutici)
Neoplasie neuroendocrine gastrointestinali (diagnosi e definizione anatomo-patologica, distinzione per sede, aspetti clinici e diagnostici, terapia)
Emorragie digestive (definizione, epidemiologia, aspetti ed inquadramento clinico, localizzazione delle sedi di sanguinamento, emorragie superiori ed inferiori acute e croniche, aspetti clinici, aspetti diagnostici, terapia)
Insufficienza epatica acuta (definizione, epidemiologia, fisiopatologia, aspetti ed inquadramento clinico, terapia)
Addome acuto (fisiopatiologia, epidemiologia, inquadramento clinico, aspetti diagnostici)

Cognomi M-Z

CFU

Teacher

Stefano Fiorucci

Teachers

Stefano Fiorucci

Hours

7.5 ore - Stefano Fiorucci

Language of instruction

Italian
slides and educational materials, scientific papers will be provided in English

Contents

The course is devoted to the teaching of clinical diosrders of
of the digestive system, liver and bilio-pancreatic district in terms of laboratory and instrumental diagnostics, clinical and medical therapy, pathophysiology and nutrition and endoscopic therapy of biliodigestive pathologies.

Reference texts

Harrison’s Principles of Internal Medicine, 19-21 Editions
Goldman-Cecil Medicine, 24-26 Editions

Educational objectives

The student must achieve an articulated and organic vision of the main gastrointestinal pathologies, of the physiopathology bases of diseases of the digestive system, liver and biliary-pancreatic system; of the clinical and instrumental semiotics of the digestive system with an overview of the main pathologies, the diagnostic path, and the bases of medical and surgical therapy of gastrointestinal, hepatic and pancreatic pathologies.
Knowledge of endoscopic techniques and other instrumental techniques necessary for the study of the digestive system (ultrasound, x-ray, CT, MRI) is required. The acquisition of basic knowledge of the pathological anatomy of the gastrointestinal pathologies treated is required.
Specific areas of learning include clinical methodology and pharmacological and instrumental therapy of diseases of the digestive system, liver, biliary tract and pancreas, diagnostic and therapeutic digestive endoscopy and abdominal ultrasound (liver, pancreas, bile ducts and upper abdomen). The acquisition of knowledge on the integrated management of digestive system diseases is desirable.

Prerequisites

ANATOMY AND PHYSIOLOGY
General and gastrointetsinal and liver pharmacology
Radiology TC and RMN
Sonography

Teaching methods

LECTURES
Practical clinical activity

Other information

CONTACTS:
Gastroenterology Secretariat: Mrs. Bagianti Chiara 075/58558120
bagianti.chiara@gmail.com

Prof. Fiorucci's address: stefano.fiorucci@unipg.it- Prof. Fiorucci receives, by appointment, every day from 1pm to 2pm.
For information on teaching and lessons, visit the website:
www.gastroenterologia.unipg.it

Learning verification modality

ORAL

Extended program

Presentation of the course: epidemiology of digestive system diseases.

Diseases of the esophagus
Dysphagia
Motor pathologies of the esophagus.
Gastro-oesophageal reflux disease (GERD) and complications.
Stomach diseases.
H. pylori infection.
Peptic disease
Acute and chronic gastritis
Gastric neoplasms: adenocarcinoma
GIST

Small bowel diseases.
Malabsorption syndromes.
Celiac disease.
Small bowel tumors
Chronic intestinal inflammatory diseases (1). Crohn's disease
Chronic intestinal inflammatory diseases 2. Ulcerative colitis.

Colon pathology (3)
Diverticular disease of the colon
Hemorrhoidal pathology
Colorectal cancert and Anal carcinoma

Pathology of the colon and rectum (4)
Colon polyps
Colorectal tumors.
Functional intestinal pathologies
Liver diseases (1)

Clinical approach to patients with liver disease, laboratory and instrumental tests

Jaundice and cholestasis
Alcoholic liver disease
Liver diseases (2)
Steatosis and non-alcoholic steatohepatitis. Acute viral hepatitis
Chronic hepatitis

Liver diseases (3)
Autoimmune liver diseases
Liver cirrhosis and its complications (1)
Liver diseases (4)
Cirrhosis and its complications (2)

Liver diseases (5)
Liver neoplasms
Hepatocarcinoma
Liver transplantation
Biliary tract diseases
Colcolosis of the gallbladder and of
bile ducts.
Biliary tract neoplasms, cholangiocarcinoma
Diseases of the pancreas 1.
Acute pancreatitis
Pancreatic Diseases 2.
Chronic pancreatitis.
Pancreatic adenocarcinoma and other pancreatic neoplasms

Obiettivi Agenda 2030 per lo sviluppo sostenibile

GASTROENTEROLOGY - MOD. 2

Code	GP005652
Location	PERUGIA
CFU	1
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/12
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Olivia Morelli

Teachers

Olivia Morelli

Hours

12.5 ore - Olivia Morelli

Cognomi M-Z

CFU

Teacher

Patrizia Ricci

Teachers

Michele Biagioli

Hours

4 ore - Michele Biagioli

GASTROENTEROLOGY - MOD. 3

Code	GP005653
Location	PERUGIA
CFU	1
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/12
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Gabrio Bassotti

Teachers

Gabrio Bassotti

Hours

12.5 ore - Gabrio Bassotti

Language of instruction

Italian

Contents

Apprendimento delle procedure per il management di un paziente con malattie dell'apparato digerente.

Reference texts

Manuale dell'apparato digerente. Edizione 2022-2025. A cura di UNIGASTRO

Educational objectives

Inquadramento eziopatologico ed epidemiologico delle patologie, con approfondimento delle tematiche inerenti la sintomatologia ed il flusso diagnostico, e cenni di terapia medica e chirurgica.

Prerequisites

Conoscenza dell'anatomia umana, della fisiologia e della patologia generale.

Teaching methods

Lezioni frontali sugli argomenti in programma.

Learning verification modality

Esame orale. I requisiti minimi per il superamento dell'esame saranno la capacità di collegamenti critici e di sintesi, la qualità dell'esposizione e dell'organizzazione del discorso.

Extended program

Cognomi M-Z

CFU

Teacher

Stefano Fiorucci

Teachers

Stefano Fiorucci

Hours

12.5 ore - Stefano Fiorucci

MEDICAL ONCOLOGY

Code	GP004619
Location	PERUGIA
CFU	2
Learning activities	Caratterizzante
Area	Clinica delle specialità medico-chirurgiche
Academic discipline	MED/06
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Fausto Roila

Teachers

Fausto Roila

Hours

25 ore - Fausto Roila

Language of instruction

Italian

Contents

1. Principles of medical cancer therapy
2. Clinical and molecular staging of the main tumors
3. Integrated treatment of the main cancers
4. Target therapy and immunotherapy, chemotherapy, their main mechanisms of activity, evaluation of efficacy and toxicity
5. Principles of supportive care
6. Principles of palliative therapy
7. Treatment of the main toxicities
8. Treatment of oncological emergencies

Reference texts

Frontal lessons with interactive Q&A sessions Textbook written by COMU members
AIOM Guidelines
ESMO Guidelines

Educational objectives

At the end of the course, students will be familiar with theoretical and practical elements that guide the diagnosis and therapy of the main tumors.
Students will have the main elements that guide supportive therapy and major emergencies in oncology.
Finally, students will navigate in clinical cancer management by applying the main knowledge for an integrated cancer approach

Prerequisites

Anatomy, physiology and physiopathology, general pathology, fundamental, main, preliminary principles of pharmacology and internal medicine

Teaching methods

Frontal interactive lessons Clinical cases

Other information

Interactive, additional lessons focusing on the following topics: 1. Pain therapy
2. Intracranial hypertension and spinal cord compression
3. Prophylaxis and therapy of venous thromboembolism
4. Mediastinal syndrome 5. Hypercalcemia
6. Nausea and vomiting 7. Conflict of interest
8. Infectious complications: prevention and therapy
9. Complications of immunotherapy: diagnosis and therapy
10. Practical principles of medical genetics and HPV prophylaxis

Learning verification modality

Written answers to multiple choice questions
Oral exam (if requested)
The average duration of each oral exam is approximately 20 minutes
The final score will be formulated on the basis of the following parameters: score at the written exam and the subsequent oral exam. Parameters for the oral exam: argumentative and evidence-based answers as well as completeness, language property, depth of analysis.

Extended program

1. Principles of medical oncology treatment 2. Melanoma
3. Colangiocarcinoma
4.Hepatocarcinoma
5. Nonmelanoma skin cancers
6. Central nervous system cancers
7. Lung and mediastinal cancers
8. Breast cancers
9. Colorectal cancer
10. Gynecological cancers
11. Prostate cancer
12. Gastric and pancreatic cancer
13. Renal, bladder and testicular cancer

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Promoting Health

Teaching, high quality
Gender balance

Cognomi M-Z

CFU

Teacher

Fausto Roila

Teachers

Fausto Roila

Hours

25 ore - Fausto Roila

Language of instruction

Italian

Contents

Reference texts

Frontal lessons with interactive Q&A sessions Textbook written by COMU members
AIOM Guidelines
ESMO Guidelines

Educational objectives

Prerequisites

Anatomy, physiology and physiopathology, general pathology, fundamental, main, preliminary principles of pharmacology and internal medicine

Teaching methods

Frontal interactive lessons Clinical cases

Other information

Learning verification modality

Extended program

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Promoting Health

Teaching, high quality
Gender balance

PROFESSIONALISING TRAINING IN GASTROENTEROLOGY

Code	GP005655
Location	PERUGIA
CFU	1
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/12
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Gabrio Bassotti

Teachers

Gabrio Bassotti

Hours

25 ore - Gabrio Bassotti

Language of instruction

Italian

Contents

Apprendimento delle procedure per il management di un paziente con malattie dell'apparato digerente.

Reference texts

Manuale dell'apparato digerente. Edizione 2022-2025. A cura di UNIGASTRO

Educational objectives

Inquadramento eziopatologico ed epidemiologico delle patologie, con approfondimento delle tematiche inerenti la sintomatologia ed il flusso diagnostico, e cenni di terapia medica e chirurgica.

Prerequisites

Conoscenza dell'anatomia umana, della fisiologia e della patologia generale.

Teaching methods

Tirocinio pratico in endoscopia, manometria e corsia.

Learning verification modality

Esame orale.

Extended program

Cognomi M-Z

CFU

Teacher

Stefano Fiorucci

Teachers

Stefano Fiorucci

Hours

25 ore - Stefano Fiorucci

PROFESSIONALISING TRAINING IN MEDICAL ONCOLOGY

Code	GP004620
Location	PERUGIA
CFU	1
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/06
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Mario Mandala'

Teachers

Mario Mandala'

Hours

25 ore - Mario Mandala'

Language of instruction

Italian

Contents

Physical examination
Management of cancer patients in ambulatory setting Multidisciplinary discussions: experience with different teams Management of hospitalized cancer patients

Reference texts

Textbook of medical oncology edited by COMU AIOM and NICSO guidelines

Educational objectives

Principles of doctor-patient relationship
Management of cancer patients under treatment and during follow-up in the outpatient setting
Management of hospitalized cancer patients: main notions of supportive and palliative care

Prerequisites

Medical semeiotic
General pathology
Physiopathology
Main, basic notions of internal medicine

Teaching methods

Practical experience with the support by dedicated professors as well as tutors both in the ambulatory and in the ward setting

Other information

Interactions with experts in the field and in-depth discussion of topics that have been addressed during the internship

Learning verification modality

Discussion of Indexed clinical cases
Feedback on specific main issues both in ambulatory and in the ward setting
A Case-based learning process will be adopted in order to prepare students for clinical practice by using and discussing real-life clinical scenarios in a range of contexts. The student should link theory to practice by applying knowledge to real-world scenarios

Extended program

General physical examination
Clinical management of cancer patients
Communication of the diagnosis, prognosis and therapeutic strategy Management of ambulatory cancer patient
Practical experience focusing on the clinical management of patients affected by different solid tumors
Participation in multidisciplinary team discussion
Management of hospitalized patients with a peculiar interest on supportive and palliative care

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Promoting health, supporting prevention and implementation theory into clinical cases

Cognomi M-Z

CFU

Teacher

Mario Mandala'

Teachers

Mario Mandala'

Hours

25 ore - Mario Mandala'

Language of instruction

Italian

Contents

Physical examination
Management of cancer patients in ambulatory setting Multidisciplinary discussions: experience with different teams Management of hospitalized cancer patients

Reference texts

Textbook of medical oncology edited by COMU AIOM and NICSO guidelines

Educational objectives

Prerequisites

Medical semeiotic
General pathology
Physiopathology
Main, basic notions of internal medicine

Teaching methods

Practical experience with the support by dedicated professors as well as tutors both in the ambulatory and in the ward setting

Other information

Interactions with experts in the field and in-depth discussion of topics that have been addressed during the internship

Learning verification modality

Discussion of Indexed clinical cases
Feedback on specific main issues both in ambulatory and in the ward setting
A case-based learning process will be adopted in order to prepare students for clinical practice by using and discussing real-life clinical scenarios in a range of contexts. The student should link theory to practice by applying knowledge to real-world scenarios

Extended program

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Promoting health and supporting primary and secondary prevention
Reduce genere disparities
Promoting high level teaching by discussing challenges clinical cases and implementing theory into clinical cases

PROFESSIONALISING TRAINING IN UROLOGY

Code	GP005654
Location	PERUGIA
CFU	1
Teacher	Ettore Mearini
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/24
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Ettore Mearini

Teachers

Ettore Mearini

Hours

25 ore - Ettore Mearini

Language of instruction

Italian

Contents

The main topics of the urological and andrological semeiotics will be discussed.The main diagnostic and therapeutic instruments used in urological and andrological diseases will also be presented.

Reference texts

"Testo di Chirurgia Specialistica"
Capitoli di Urologia
Editore: Zanichelli CEA
www.zanichelli.it

Educational objectives

AIMS OF INTERACTIVE EDUCATION The interactive education will be carried out in order to transmit the students a methodological approach to the main uro-andrology diseases. Objective will be to develop the ability to recognize the signs and symptoms of various urological diseases, to identify etiopathogenesis and their clinical value in order to formulate the diagnostic hypothesis. We will provide the knowledge needed to identify more suitable diagnostic tests (laboratory and instrumental) to understand the results together with the specialist to improve the diagnostic and therapeutic strategy. A further objective of interactive education is to enable students to critically assess and correlate symptoms, physical signs, any functional alterations, instrumental examinations and hystological features of main andrological and urological diseases. Finally, the student will acquire the knowledge of the basic therapeutic treatments of uro-andrological diseases including also relevant behavior, prevention, rehabilitation and diet. ABILITIES (skills) Aims of gestural skills include: -the bimanual palpation of the kidney and pelvis-ureter points ; -specialist manovre such physical examination of male and female genital identifying their functional and morphological alterations; -digital rectal examination identifying the neurophysiological and morphological features of the pelvic. For this purpose, hand-on training will be organized for the management of urinary catheter and urostomy. RELATIONAL OBJECTIVES (interpersonal skills) Relational purpose include to transmit students the value of the relationship between physician and patient, highlighting the ethical and psychological aspects. Another aim will be to make the student able to evaluate the psychological, sociological and cultural aspects of the patient in order to adapt the language and improve the understanding of the interview. We will also provide the tools to be able to communicate to the patient the clinical diagnosis and prognosis in order to share the therapeutic strategy and to obtain informed consent. Expected outcomes At the end of the course students will have the theoretical and practical bases for suitable clinical management of main urological and andrological diseases, especially in terms of recognition of the pathological state and appropriate therapy.

Prerequisites

We consider as preliminary and acquired the following abilities: • to achieve accurately medical history and symptoms, • to know the most common laboratory tests, to identify biochemical profile’s major alterations and to understand of their clinical significance • to know the main maneuvers of general physical examination (inspection, palpation, percussion and auscultation of the chest and abdomen).

Teaching methods

Attendance at division, (from Monday to Friday, from 8,00 a.m. to 14,00) outpatient services (on Wednesday and Friday from 8.30 am to 14.00) and operating room (on Monday, Tuesday and Thursday from 8.00 am to 14.00) of the S.C. di Chirurgia Urologica, Andrologica e Tecniche Mini-invasive, Terni. These activities are facultative for all students to learn the medical and surgical management of the urologic patient. - Seminar on the management of urostomy and urinary catheterSupporting tutors in: - patient history collection -physical examination of the urinary system, male and female genital -presentation and discussion of clinical cases -presentation of instrumental tests in urologic outpatient services - Presentation of surgical interventions in the operating theater For the hands-on activities, the students are divided into groups including 5 people; each group will go into the operating room at least once from 8.00 to 14.00 only on Wednesday, Thursday and Friday, into the division and outpatient services from Monday to Friday from 8.00 to 14.00

Other information

Attendance:Mandatory. At least 60% of lessons

Learning verification modality

HOW THE UROLOGY EXAM IS CONDUCTED: During the course, the ongoing test agreed with the students is carried out. The test is carried out in a closed written form including 15 multiple choice questions. The result is evaluated during the final exam.
Oral test lasting approximately 15 minutes divided into two questions, one of which relating to Uro-Oncology and one to Functional Urology. The possible discussion of a clinical case on diagnostic material is expected during the exam.
VERIFICATION OF THE SKILLS ACQUIRED DURING THE INTERNSHIP: description of the internship as follows: one day dedicated to morphological diagnostics, one day dedicated to endoscopy, one day dedicated to functional diagnostics, one day reserved for clinical activity in the ward and one day of access to the theater Operation.
METHOD OF ALLOCATION OF THE FINAL MARK: arithmetic mean of the marks obtained in the individual disciplines of Oncology, Gastroenterology and Urology. The Urology exam is usually done last so as to allow the verbalization of Systemic Pathology VI on the same day.

Extended program

- INTRODUCTION AND UROLOGY TERMINOLOGY.
- Semeiotics of the kidney, urinary tract and male genital tract - Bladder catheterization: types of bladder catheter, clinical indications, complications. Instrumental and functional investigations of the Urological Specialty (Urological ultrasound, endoscopy of the urinary tract, urodynamics, invasive instrumental diagnostic endourology)
- Hematuria: etiology and diagnostic-therapeutic work-up.
- High and low obstructive uropathy: etiology, pathogenesis, clinical picture, diagnosis and therapy.
- Malformations of the urinary tract and male genitals: epidemiology, the clinical picture, diagnostic and therapeutic pathways.
- Pathology of the upper excretory tract: epidemiology, etiopathogenesis, clinical and diagnostic framework, pharmacological and surgical therapy of the pyeloureteral joint syndrome and ureteral strictures.
-Kidney cancer: epidemiology, etiology, outline of genomics and pathogenesis, clinical picture, diagnosis, outline of pharmacological therapy, surgical treatment.
- Benign prostatic hyperplasia: epidemiology, etiology, outline of molecular biology, pathogenesis, clinical picture, diagnosis, pharmacological and surgical therapy.
- Prostate cancer: epidemiology, etiology, outline of genomics and pathogenesis, clinical picture, diagnosis, PSA and new markers, pharmacological and surgical therapy.
- Bladder cancer: epidemiology, etiology, outline of genomics and pathogenesis, clinical picture, diagnosis, outline of pharmacological therapy, surgical treatment.
- Urinary diversion: classifications, indications, management and complications Testicular cancer: epidemiology, etiology, pathogenesis, clinical picture, diagnosis, outline of chemotherapy and surgical therapy.
- Penile cancer: epidemiology, etiology, pathogenesis, clinical picture, diagnosis, outline of surgical and physical therapy.
- Traumas of the urogenital system: classifications, main clinical pictures, diagnosis, surgical therapy - Urinary infections: epidemiology, etiology, pathogenesis, diagnosis, outline of pharmacological therapy, management of complications.
-Urinary lithiasis: epidemiology, etiology, pathogenesis, clinical picture, diagnosis, pharmacological, mineral water, dietetic, physical and surgical therapy.
- Neurological bladder: main etiological factors, pathogenesis, main clinical pictures, principles of diagnosis and pharmacological and rehabilitative therapy.

Cognomi M-Z

CFU

Teacher

Ettore Mearini

Teachers

Ettore Mearini

Hours

25 ore - Ettore Mearini

Language of instruction

Italian

Contents

The main topics of the urological and andrological semeiotics will be discussed.The main diagnostic and therapeutic instruments used in urological and andrological diseases will also be presented.

Reference texts

"Testo di Chirurgia Specialistica"
Capitoli di Urologia
Editore: Zanichelli CEA
www.zanichelli.it

Educational objectives

Prerequisites

Teaching methods

Other information

Attendance:Mandatory. At least 60% of lessons

Learning verification modality

Extended program

UROLOGY - MOD. 1

Code	GP004617
Location	PERUGIA
CFU	2
Teacher	Ettore Mearini
Learning activities	Caratterizzante
Area	Discipline ostetrico-ginecologiche, medicina della riproduzione e sessuologia medica
Academic discipline	MED/24
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Ettore Mearini

Teachers

Ettore Mearini

Hours

25 ore - Ettore Mearini

Language of instruction

Italian

Contents

We will debate main urinary and male genital disease related diseases concerning clinical urgency, major urological syndromes (upper and lower urinary tract obstruction), pathology related to the single anatomical district (kidney, urinary tract, prostate and male genitalia) pointing out main infectious, dysfunctional and oncologic problems. We will highlight the most important implications of the pathophysiology, clinical features, the main diagnostic and therapeutic strategies including pharmacology, surgery and / or rehabilitation.

Reference texts

"Testo di Chirurgia Specialistica"
Capitoli di Urologia
Editore: Zanichelli CEA
www.zanichelli.it

Educational objectives

AIMS OF KNOWLEDGE (to know)
To acquire the basic knowledge about the epidemiology, prevention, etiology, pathophysiology, pathological anatomy, the clinical features, clinical, instrumental and differential diagnosis, complications, pharmacologic therapy and surgical treatment of the main urinary and male genital diseases.
Further aim is to achieve essential knowledge of rarer disease, concerning more specialistic field or that will be discussed in following courses.
To know the biotechnological and instrumental innovations, their application in urological clinical practice and the possibilities for development.
Monothematic seminars will also be organized in order to facilitate achievement of these objectives.AIMS OF INTERACTIVE EDUCATION
The interactive education will be carried out in order to transmit the students a methodological approach to the main uro-andrology diseases.
Objective will be to develop the ability to recognize the signs and symptoms of various urological diseases, to identify etiopathogenesis and their clinical value in order to formulate the diagnostic hypothesis.
We will provide the knowledge needed to identify more suitable diagnostic tests (laboratory and instrumental) to understand the results together with the specialist to improve the diagnostic and therapeutic strategy.
A further objective of interactive education is to enable students to critically assess and correlate symptoms, physical signs, any functional alterations, instrumental examinations and hystological features of main andrological and urological diseases.
Finally, the student will acquire the knowledge of the basic therapeutic treatments of uro-andrological diseases including also relevant behavior, prevention, rehabilitation and diet.
ABILITIES (skills)
We consider as preliminary and acquired the following abilities:
• to achieve accurately medical history and symptoms,
• to know the most common laboratory tests, to identify biochemical profile’s major alterations and to understand of their clinical significance
• to know the main maneuvers of general physical examination (inspection, palpation, percussion and auscultation of the chest and abdomen).

Aims of gestural skills include:
-the bimanual palpation of the kidney and pelvis-ureter points ;
-specialist manovre such physical examination of male and female genital identifying
their functional and morphological alterations;
-digital rectal examination identifying the neurophysiological and morphological features of the pelvic.
For this purpose, hand-on training will be organized for the management of urinary catheter and urostomy.

RELATIONAL OBJECTIVES (interpersonal skills)
Relational purpose include to transmit students the value of the relationship between physician and patient, highlighting the ethical and psychological aspects. Another aim will be to make the student able to evaluate the psychological, sociological and cultural aspects of the patient in order to adapt the language and improve the understanding of the interview. We will also provide the tools to be able to communicate to the patient the clinical diagnosis and prognosis in order to share the therapeutic strategy and to obtain informed consent.

Expected outcomes
At the end of the course students will have the theoretical and practical bases for suitable clinical management of main urological and andrological diseases, especially in terms of recognition of the pathological state and appropriate therapy.

Prerequisites

Knowledge of the anatomy and physiology of the urinary and male genital system are indispensable in order to understand the topics of the lessons. Fundamentals of pharmacology and oncology seem very useful to achieve the objectives of the interdisciplinary course.

Teaching methods

Seminar lectures with audiovisual material-Presentation of clinical cases-Presentations of video about the main surgical strategies-Monothematic seminars

Other information

Attendance:Mandatory. At least 60% of lessons

Learning verification modality

Extended program

-Introduction to urological glossary
-Semeiotics of Kidney, urinary tract and the male genitalia
-Vesical catheter: classifications, main types of urinary catheter, clinical indications, complications.
- Urinary tract and male reproductive malformation: epidemiology, etiology, pathogenesis, clinical features, diagnosis, therapy.
-Upper and lower urinary tract obstruction: etiology, pathogenesis, clinical features, diagnosis and therapy.
- Upper urinary tract disease: epidemiology, etiology, clinical features, diagnosis, medical therapy and surgery of stenosis of pelvis-ureter junction, retroperitoneal fibrosis and ureteral stenosis.
-Benign prostatic hyperplasia: epidemiology, etiology, molecular biology and pathogenesis, clinical presentation, diagnosis, pharmacologic therapy and surgery.
-Hematuria: etiology, diagnostic and therapeutic work-up.
-Prostate cancer: epidemiology, etiology, pathogenesis and genomics, clinical features, diagnosis, PSA and new markers, pharmacologic therapy and surgery.
-Kidney cancer: epidemiology, etiology, pathogenesis and genomics, clinical features, diagnosis, pharmacologic therapy and surgery.
-Bladder cancer: epidemiology, etiology, pathogenesis and genomics, clinical features, diagnosis, pharmacologic therapy and surgery.
-Urinary derivations and their management
-Testicular cancer: epidemiology, etiology, pathogenesis, clinical presentation, diagnosis, chemotherapy and surgery.
-Penis cancer: epidemiology, etiology, pathogenesis, clinical presentation, diagnosis, surgery and radiotherapy.
-Urogenital trauma: classifications, etiology, clinical features, diagnosis, surgical therapy
-Urinary Tract Infections: epidemiology, etiology, pathogenesis, diagnosis, pharmacologic therapy, management of complications.
-Litiasi Urinary: epidemiology, etiology, pathogenesis, clinical features, diagnosis, pharmacologic therapy, water therapy, dietary, physical therapy and surgery.
-Neuromuscolar dysfunction of bladder: main etiological factors, pathogenesis, clinical presentation, diagnosis and principles of pharmacologic therapy and rehabilitation.
-Urinary incontinence: epidemiology, classification, etiology, pathogenesis, clinical presentation, diagnosis, pharmacologic therapy and surgery.
-Genitourinary prolapse: epidemiology, classification, etiology, pathogenesis, clinical presentation, diagnosis, rehabilitation therapy and surgery.
- Minimally invasive surgery: indications, advantages and disadvantages, applications in urology

We will also present the main issues about surgical andrology concerning infertility and sexual dysfunction. The concepts of anatomy and physiology of the male genitalia will be necessary to evaluate the morphological aberrations (congenital and acquired penile curvature), functional (erectile dysfunction and priapism). Acute scrotum (testicular torsion and orchi-epididymitis), cryptorchidism, varicocele will be debated both as individual disease and as a clinical entity related to male infertility, paying particular attention to their prevention.
Since 30% of population is involved by an urological or andrological disease, we will highlighted the role of these diseases in determining a worsening of the quality of life of the individual and the couple; we will emphasize the importance of suitable management of urological and andrological disease also for the significant impact on the social and financial costs.

Cognomi M-Z

CFU

Teacher

Ettore Mearini

Teachers

Ettore Mearini

Hours

25 ore - Ettore Mearini

Language of instruction

Italian

Contents

Reference texts

"Testo di Chirurgia Specialistica"
Capitoli di Urologia
Editore: Zanichelli CEA
www.zanichelli.it

Educational objectives

Prerequisites

Teaching methods

Seminar lectures with audiovisual material-Presentation of clinical cases-Presentations of video about the main surgical strategies-Monothematic seminars

Other information

Attendance:Mandatory. At least 60% of lessons

Learning verification modality

Extended program

UROLOGY - MOD. 2

Code	GP004618
Location	PERUGIA
CFU	1
Learning activities	Caratterizzante
Area	Discipline ostetrico-ginecologiche, medicina della riproduzione e sessuologia medica
Academic discipline	MED/24
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Giovanni Cochetti

Teachers

Giovanni Cochetti

Hours

12.5 ore - Giovanni Cochetti

Language of instruction

Italian

Contents

Glossary and urologic semeiotics; hematuria; urinary obstructive syndrome; malformations of the urinary system; Urinary lithiasis; benign prostatic hyperplasia; urinary infections; urologic oncology; urologic disease in the elderly; neurogenic bladder; andrology.

Reference texts

"Testo di Chirurgia Specialistica"
Capitoli di Urologia
Editore: Zanichelli CEA
www.zanichelli.it

Educational objectives

OBJECTIVES OF KNOWLEDGE (Knowledge)
To acquire the basic knowledge about the epidemiology, prevention, pathogenesis, the clinical presentation, clinical and instrumental diagnosis, pharmacologic therapy and surgical strategy of the main diseases of urinary tract and male genitalia.

OBJECTIVES OF INTERACTIVE EDUCATION
The interactive teaching will be carried out in order to transmit the students a methodological approach to the nursing management of the main conditions concerning urologic and andrological disease.
Objective will be to develop the ability to recognize the signs and symptoms of various diseases and their clinical value in order to be able to improve nursing management of the patient.

ABILITIES (skills)
The following abilities are considered preliminary and acquired:
• to collect accurately medical history and symptoms of the patients
• to know the most common laboratory tests, to identify major alterations of biochemical profile and to understand their clinical significance
• the main maneuvers of general physical examination (inspection, palpation, percussion and auscultation of the chest and abdomen).

Aims of gestural skills include:
-Positioning of different types of catheters -management of urostomies
-nursing in diagnostic urologic exam (uroflowmetry, transrectal ultrasound, ultrasound of the urinary tract, scrotal ultrasound, urodynamic examination, urethrocystoscopy, cystography)
-nursing in ESWL
-nursing in patient undergoing urologic surgery

For this purpose hands-on training will be organized for the management of urinary catheter and urostomy.

OBJECTIVES OF RELATIONAL EDUCATION (interpersonal skills)
The objectives are to transmit students the value of the relationship between nurse and patient, highlighting the ethical and psychological aspects; another aim will be to make the student able to evaluate the psychological, sociological and cultural aspects of the patient in order to adapt the language and improve the understanding of the interview. We will also provide the main tools to properly train the care-giver figure.

At the end of the course students will have the theoretical and practical bases for proper nursing management of the urologic and andrological patient.

Prerequisites

Teaching methods

Seminar lectures with audiovisual materialPresentation of clinical casesPresentations of video about the main surgical strategies - Monothematic seminars

Other information

Attendance: Mandatory. At least 60% of lessons

Learning verification modality

Extended program

-Introduction to urological glossary
-Semeiotics of Kidney, urinary tract and the male genitalia
-Vesical catheter: classifications, main types of urinary catheter, clinical indications, complications.
- Fundamentals of urinary tract and male reproductive malformation focusing on epidemiology, etiology, clinical features, diagnosis, therapy.
-Upper and lower urinary tract obstruction: etiology, pathogenesis, clinical features, diagnosis and therapy.
- Upper urinary tract disease: epidemiology, etiology, clinical features, diagnosis, pharmacologic therapy and surgery of stenosis of pelvis-ureter junction and ureteral stenosis.
-Benign prostatic hyperplasia: epidemiology, etiology, molecular biology and pathogenesis, clinical presentation, diagnosis, pharmacologic therapy and surgery.
-Hematuria: etiology, diagnostic and therapeutic work-up.
-Prostate cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, PSA and new markers, pharmacologic therapy and surgery.
-Kidney cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, pharmacologic therapy and surgery.
-Bladder cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, pharmacologic therapy and surgery.
-Urinary derivations and their management
-Testicular cancer: epidemiology, etiology, pathogenesis, clinical presentation, diagnosis, fundamentals of chemotherapy and surgery.
-Penis cancer: epidemiology, etiology, pathogenesis, clinical presentation, diagnosis, fundamentals of surgery and radiotherapy.
-Urinary Tract Infections: epidemiology, etiology, pathogenesis, diagnosis, pharmacologic therapy, management of complications.
-Litiasi Urinary: epidemiology, etiology, pathogenesis, clinical features, diagnosis, pharmacologic therapy, water therapy, dietary, physical therapy and surgery.
-Neuromuscolar dysfunction of bladder: main etiological factors, pathogenesis, clinical presentation, diagnosis and principles of pharmacologic therapy and rehabilitation.
-Urinary incontinence: epidemiology, classification, etiology, pathogenesis, clinical presentation, diagnosis, pharmacologic therapy and surgery.
-Genitourinary prolapse: epidemiology, classification, etiology, pathogenesis, clinical presentation, diagnosis, rehabilitation therapy and surgery.
- Minimally invasive surgery: indications, advantages and disadvantages, applications in urology

We will also present the main issues about surgical andrology concerning infertility and sexual dysfunction. The concepts of anatomy and physiology of the male genitalia will be necessary to evaluate the morphological aberrations (congenital and acquired penile curvature), functional (erectile dysfunction and priapism). Acute scrotum (testicular torsion and orchi-epididymitis), cryptorchidism, varicocele will be debated both as individual disease and as a clinical entity related to male infertility, paying particular attention to their prevention.
Since 30% of population is involved by an urological or andrological disease, we will highlighted the role of these diseases in determining a worsening of the quality of life of the individual and the couple; we will emphasize the importance of suitable management of urological and andrological disease also for the significant impact on the social and financial costs.

Cognomi M-Z

CFU

Teacher

Giovanni Cochetti

Teachers

Giovanni Cochetti

Hours

12.5 ore - Giovanni Cochetti

Language of instruction

Italian

Contents

Reference texts

"Testo di Chirurgia Specialistica"
Capitoli di Urologia
Editore: Zanichelli CEA
www.zanichelli.it

Educational objectives

Prerequisites

Teaching methods

Seminar lectures with audiovisual materialPresentation of clinical casesPresentations of video about the main surgical strategies - Monothematic seminars

Other information

Attendance: Mandatory. At least 60% of lessons

Learning verification modality

Extended program

-Introduction to urological glossary
-Semeiotics of Kidney, urinary tract and the male genitalia
-Vesical catheter: classifications, main types of urinary catheter, clinical indications, complications.
- Fundamentals of urinary tract and male reproductive malformation focusing on epidemiology, etiology, clinical features, diagnosis, therapy.
-Upper and lower urinary tract obstruction: etiology, pathogenesis, clinical features, diagnosis and therapy.
- Upper urinary tract disease: epidemiology, etiology, clinical features, diagnosis, pharmacologic therapy and surgery of stenosis of pelvis-ureter junction and ureteral stenosis.
-Benign prostatic hyperplasia: epidemiology, etiology, molecular biology and pathogenesis, clinical presentation, diagnosis, pharmacologic therapy and surgery.
-Hematuria: etiology, diagnostic and therapeutic work-up.
-Prostate cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, PSA and new markers, pharmacologic therapy and surgery.
-Kidney cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, pharmacologic therapy and surgery.
-Bladder cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, pharmacologic therapy and surgery.
-Urinary derivations and their management
-Testicular cancer: epidemiology, etiology, pathogenesis, clinical presentation, diagnosis, fundamentals of chemotherapy and surgery.
-Penis cancer: epidemiology, etiology, pathogenesis, clinical presentation, diagnosis, fundamentals of surgery and radiotherapy.
-Urinary Tract Infections: epidemiology, etiology, pathogenesis, diagnosis, pharmacologic therapy, management of complications.
-Litiasi Urinary: epidemiology, etiology, pathogenesis, clinical features, diagnosis, pharmacologic therapy, water therapy, dietary, physical therapy and surgery.
-Neuromuscolar dysfunction of bladder: main etiological factors, pathogenesis, clinical presentation, diagnosis and principles of pharmacologic therapy and rehabilitation.
-Urinary incontinence: epidemiology, classification, etiology, pathogenesis, clinical presentation, diagnosis, pharmacologic therapy and surgery.
-Genitourinary prolapse: epidemiology, classification, etiology, pathogenesis, clinical presentation, diagnosis, rehabilitation therapy and surgery.
- Minimally invasive surgery: indications, advantages and disadvantages, applications in urology

We will also present the main issues about surgical andrology concerning infertility and sexual dysfunction. The concepts of anatomy and physiology of the male genitalia will be necessary to evaluate the morphological aberrations (congenital and acquired penile curvature), functional (erectile dysfunction and priapism). Acute scrotum (testicular torsion and orchi-epididymitis), cryptorchidism, varicocele will be debated both as individual disease and as a clinical entity related to male infertility, paying particular attention to their prevention.
Since 30% of population is involved by an urological or andrological disease, we will highlighted the role of these diseases in determining a worsening of the quality of life of the individual and the couple; we will emphasize the importance of suitable management of urological and andrological disease also for the significant impact on the social and financial costs.