Unit GENERAL PATHOLOGY AND PATHOPHYSIOLOGY 2

GENERAL PATHOLOGY AND PATHOPHYSIOLOGY - MOD. 5

Code	A001241
CFU	2
Learning activities	Caratterizzante
Area	Formazione clinica interdisciplinare e medicina basata sulle evidenze
Academic discipline	MED/04
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

2

Teacher

Giuseppe Servillo

Teachers

• Giuseppe Servillo

Hours

• 25 ore - Giuseppe Servillo

Language of instruction

Italian

Contents

Molecular basis of cellular transformation and oncogenesis.

Reference texts

-PONTIERI FRATI, RUSSO: - Due Volumi- Patologia Generale. Fisiopatologia Generale Ed. PICCIN
-DIANZANI : Istituzioni di Patologia Generale Ed. UTET
ROBBINS & COTRAN Le Basi Patologiche delle Malattie 8a EDIZIONE. Elsevier Italia.

Educational objectives

Il modulo 5 di Patologia Generale rappresenta parte dell’insegnamento di Patologia Generale, del Corso di Laurea in Medicina e Chirurgia, che studia le cause (eziologia) ed i fenomeni patologici, a livello molecolare e cellulare, di malattia rispetto alla biologia e fisiologia della cellula. L’insegnamento permette di acquisire conoscenze riguardo i meccanismi di base che sottendono le malattie più frequenti nell'uomo e la risposta della cellula ad alterazioni dell'ambiente esterno. L'obiettivo principale dell'insegnamento è l'acquisizione di conoscenze riguardo:
Cancerogenesi Chimica, Fisica e Biologica,
Basi molecolari della cellula Neoplastica
Processi cellulari e molecolari dell'invasivita, dell’Angiogenesi e della Metastatizzazione tumorale
La prova finale orale ed i seminari facoltativi sono strumenti per valutare il grado di l’apprendimento e la capacità di comunicare e spiegare, in maniera semplice, ma al tempo stesso rigorosa, immediata ed esaustiva le conoscenze acquisite. Le capacità acquisite nello studio di tale disciplina consente allo studente di raggiungere un'ampia visione d'insieme della correlazione tra il genoma umano, l'ambiente e lo sviluppo di patologie e permette, di ottenere gli strumenti per avere un chiaro quadro delle cause delle patologie ed il loro specifico meccanismo di insorgenza e di sviluppo e della fisiopatologia generale delle malattie più frequenti al fine di proporre comportamenti e trattamenti idonei in qualità di futuro Medico Chirurgo.

Prerequisites

The acquisition of the deep knowledge of main topics in the course of General Pathology, requires relevant knowledge on Biology and Genetics, Biochemistry and Physiology. The skills obtained in these disciplines are essential so that students can understand the concepts of etiopathology of Molecular and Cellular Pathology and Pathophysiology of organs. The student so well prepared in teaching the course will draw a considerable profit.

Teaching methods

To the students are given lectures. Lessons Module 5 make the part of the program of the course of study of General Pathology regarding pathogenetic basis of Diseases for Oncology, with greater reference to Molecular Causes of Diseases for Oncology, the future doctor will face in the course of his profession. Each lesson has a duration of two hours that is given to the specific topic, relating it to others already exposed, to allow the student to have a broad vision of the topics covered. Students are proposed to conduct, at its option, seminars about the arguments in class. The seminars were held in groups of two or three people. The seminars were held in groups of two or three students in the presence of the other students in the course. To this end, the teacher provides students with bibliographical material in English concerning the subject, the subject of the seminar will be presented using computer media (Power-Point and / or similar).

Learning verification modality

The student evaluation consists of an oral exam at the end of the course lessons. The assessment of the preparation of the student lasts an average of thirty minutes depending on the degree of knowledge of the topics covered and the presentation skills of the student. The test consists of three questions regarding the discipline studied related to: molecular and cellular pathology of the intrinsic and extrinsic causes of disease; cellular pathology and molecular oncology and inflammation; general pathophysiology of organs. The questions are administered by different teachers to ensure maximum consistency and objectivity of evaluation. The oral examination is essential for the assessment of the knowledge acquired by the students, exhibition of his skills and mastery of the subject studied with particular reference to the ability to link between different topics.

Extended program

Molecular Oncology
-Classification of the tumors. Characteristics of normal and transformed cell. Metaplasia, Dysplasia, Anaplasia. Benignant and Malignant tumors. Histological classification and morphological features of human tumors.
-In situ carcinoma.
-Carcinogenesis. Epidemiology of tumor. Carcinogenesis: chemical, physical (U.V. and ionizing radiations), viral, environmental.
-Co-carcinogenesis, mechanism of transformation.
-Molecular basis of the transformed cell. Pathogenetic mechanisms. Oncogenes and Tumor Suppressor Genes. Control of DNA replication. Mutations. Hereditary tumor diseases. Karyotype and chromosomal alteration in tumor.
-Role of the apoptosis control in the tumor growth.
-Molecular pathology in DNA repair. Mismatch repair. Lynch syndrome and hereditary colon-recto carcinoma. Excision repair. Xeroderma Pigmetosum and Ataxia-telangiectasia.
-Angiogenesis in cancer.
-Concept of invasive cancer. Metastasis and stage of the cancer. Molecular mechanisms of the metastasis. Metastasis routes.

Cognomi M-Z

CFU

2

Teacher

Francesco Grignani

Teachers

• Francesco Grignani

Hours

• 25 ore - Francesco Grignani

Language of instruction

Italian

Contents

General Oncology: Cancer cell
Carcinogenesis and molecular basis of neoplastic transformation. Angiogenesis. Metastasis. Immunity and tumors

Reference texts

Pontieri, Russo, Frati.
Patologia Generale
Piccin Ed.

Robbins Kumar Cotran
Le basi patologiche delle malattie
Piccin

Educational objectives

Knowledge of the nature of the neoplastic cell and of the molecular and cellular mechanisms of carcinogenesis neoplastic transformation, metastasis and organ damage. Immunity and tumors

Prerequisites

Physics, chemistry and cell biology. Basic genetics. Biochemistry of nucleic acids, proteins and lipids.
Histology. Human anatomy. Elements of Immunology

Teaching methods

Lectures, class discussions, visualization and commentary of images and laboratory procedures. Viewing movies. Work in a group. Inverted classes. Peer to peer teaching. Online teaching

Learning verification modality

In-Itinere verification in the classroom through students interviews

Extended program

GENERAL ONCOLOGY

Classification and nomenclature of tumors. Characteristics of the transformed cell. Metaplasia. Dysplasia. Anaplasia. Benign and malignant tumors. Histological classification and morphological elements of benign and malignant human tumors. In situ carcinoma.

MOLECULAR BASES OF CELL TRANSFORMATION. Oncogene concept. Membrane receptors and signal transduction pathways from the cell surface to the nucleus in the control of cell proliferation. Amplification mutations and translocations as oncogenic mechanisms. Karyotype and chromosomal alterations in tumors. The main oncogenes. Tumor suppressor gene concept. Molecular control of the cell cycle, phases and proteins that regulate the cycle. Cycle checkpoints. Hereditary familial neoplasms. The main tumor suppressors. Epigenetics and cancer.

MOLECULAR PATHOLOGY OF THE CONTROL OF APOPTOSIS. Pro and anti-apoptotic genes in the pathogenesis of tumors

Genomics and tumors: the genetic panorama of tumors and new DNA analysis technologies (outline)

CARCINOGENESIS. Elements of tumor epidemiology. Chemical carcinogenesis. Carcinogenesis from ultraviolet radiation. Carcinogenesis by ionizing radiation. Viral carcinogenesis.

Tumor ANGIOGENESIS.

METASTATIZATION AND STADIATION. Molecular mechanisms underlying the phenomenon of metastasis. Primitive and metastatic tumors. Pathways of metastasization. Graduation and staging of tumors.

IMMUNITY AND CANCER. Role of the immune system in controlling the neoplastic process. Tumor-specific and -associated antigens. Main immunological markers of tumors.

PARANEOPLASTIC SYNDROMES and NEOPLASTIC CACHESSIA

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Health and wellness
Quality education
Gender equality

GENERAL PATHOLOGY AND PATHOPHYSIOLOGY - MOD. 6

Code	A001242
CFU	2
Learning activities	Caratterizzante
Area	Formazione clinica interdisciplinare e medicina basata sulle evidenze
Academic discipline	MED/04
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

2

Teacher

Giuseppe Servillo

Teachers

• Giuseppe Servillo

Hours

• 25 ore - Giuseppe Servillo

Cognomi M-Z

CFU

2

Teacher

Francesco Grignani

Teachers

• Francesco Grignani
• Vasileios Oikonomou (Codocenza)

Hours

• 21 ore - Francesco Grignani
• 4 ore (Codocenza) - Vasileios Oikonomou

Language of instruction

Italian

Contents

General pathophysiology of the cardiovascular, endocrine, digestive, respiratory, kidney and acid-base balance systems, blood

Reference texts

Pontieri, Russo, Frati.
Patologia Generale
Piccin Ed.

Robbins Kumar Cotran
Le basi patologiche delle malattie
Piccin

Educational objectives

Knowledge of the main pictures related to heart, respiratory, renal and liver failure. Alterations of the acid-base and electrolytic balance. Blood crasis disorders Alteration of thermoregulation.
Ability to connect the various pathological situations of different organs, also with the evaluation of laboratory parameters

Prerequisites

Physics, chemistry and cell biology. Basic genetics. Biochemistry of nucleic acids, proteins and lipids.
Histology. Human anatomy. Elements of Immunology. Human Physiology

Teaching methods

Lectures, class discussions, visualization and commentary of images and laboratory procedures. Viewing movies. Work in a group. Inverted classes. Peer to peer teaching. Online teaching

Learning verification modality

Oral and practical exam on the entire program. The exam is aimed at verifying the knowledge regarding the various topics of the program, the ability to connect the topics, the communication skills, the organization of knowledge and the ability to apply knowledge to concrete cases.
The exam is divided into four questions over the course of 20-30 minutes: one question on the causes of disease, two on cellular pathologies, on regressive processes, the basic ones of adaptation and on basic oncology and finally a question on pathophysiology, with exemplification of concrete situations also with reading of a blood gas analysis and other laboratory parameters.
The mark derives from the synthesis of the skills set out above in each of the sections of the exam.

Extended program

PATHOPHYSIOLOGY

THERMOREGULATION AND ALTERATIONS OF THERMOGENESIS. General response of the organism to heat and cold. Causes of fever. Pathological changes in body temperature. Hypothermia and hyperthermia. Morphology of the thermal curve. Organic and metabolic changes in fever.

PATHOPHYSIOLOGY OF THE CARDIOVASCULAR SYSTEM. The atheromasic process. Risk factors for atherosclerosis. Thrombosis. Embolism. Ischemic heart disease and myocardial infarction. Aneurysms. Endocarditis and valvulopathies.
Heart failure and compensation mechanisms.
Hypertension. Hypotension, collapse and syncope. Shock.

BLOOD PATHOPHYSIOLOGY. Plasma proteins: structure, function and study methods. Blood groups: general information, the ABO system. Lymphohematopoietic tumors. Polycythemias and erythremies. Anemias. Pathophysiology of hemostasis and coagulation. Thrombotic and embolic processes. CID.

ENDOCRINE PATHOPHYSIOLOGY AND METABOLISM:
A) HORMONES: nature, effects, synthesis, secretion, mechanisms of action, the negative feed-back system and hypothalamic regulation factors, hormone measurement.
B) ENDOCRINE HYPOTHALAM AND HYPOPHYSIS: The hypothalamic-pituitary axis, hormones of the adenohypophysis, hypopituitarism and hyperpituitarism, the posterior pituitary: oxytocin and vasopressin, diabetes insipidus.
C) THYROID: anatomical and physiological aspects, iodine metabolism, structure and synthesis of thyroid hormones, secretion and blood transport mechanism, regulation of thyroid function, functions of thyroid hormones, mechanism of action of thyroid hormones and their metabolism.
Hypothyroidism and hyperthyroidism.
D) PARATIROIDS AND CALCICOTROPIC HORMONES: generalities, functions and effects of PTH, action mechanism, calcitonin and vitamin D, calcium and the feed-back regulation of the calciumotropic hormones, hypoparathyroidism, pseudohypoparathyroidism-hyperparathyroidism.
E) ENDOCRINE PANCREAS: hormones of the endocrine pancreas, function, effects and action of glucagon, insulin, structure, synthesis, transport and catabolism, the insulin receptor, diabetes mellitus: ethiopathogenetic, metabolic and complications.
F) SURRENE CORTICAL: mineralocorticoids, glucocorticoids and androgens: structure, synthesis and transport, regulation of adrenocortical hormones - biological effects, adrenocortical insufficiency, hypersurrenal syndromes.
G) SURRENE BONE: hormones of the adrenal medulla, biological effects and mechanism of action.
H) GONADI: hypogonadism
I) GASTROINTESTINAL HORMONES

PATHOPHYSIOLOGY OF THE LUNG: Respiratory failure: pathophysiological mechanisms and assessment methods. Atelectasis, pneumothorax, COPD and restrictive pneumopathies as a cause of respiratory failure.

PATHOPHYSIOLOGY OF THE LIVER: Hepatic regeneration. Liver failure. Portal hypertension. Cirrhosis and hepatitis as a cause of liver failure. Jaundices, pathophysiological mechanisms.

PATHOPHYSIOLOGY OF THE KIDNEY: pathology of glomerular filtration and tubular resorption. Proteinurie. Acute and chronic renal failure.

PATHOPHYSIOLOGY OF IONIC AND ACID-BASIC BALANCE

Hyper and hypokalaemia, hyper and hyposodyemia, metabolic and respiratory acidosis and alkalosis

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Health and wellness
Quality education
Gender equality

GENERAL PATHOLOGY AND PATHOPHYSIOLOGY - MOD. 4

Code	A001240
CFU	3
Learning activities	Caratterizzante
Area	Formazione clinica interdisciplinare e medicina basata sulle evidenze
Academic discipline	MED/04
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

3

Teacher

Giuseppe Servillo

Teachers

• Giuseppe Servillo

Hours

• 37.5 ore - Giuseppe Servillo

Language of instruction

Italian

Contents

General Oncology: Cancer cell
Carcinogenesis and molecular basis of neoplastic transformation. Angiogenesis. Metastasis. Immunity and tumors

Reference texts

Pontieri, Russo, Frati.
Patologia Generale
Piccin Ed.

Robbins Kumar Cotran
The pathologic basis of disease
Elsevier

Educational objectives

Knowledge of the nature of the neoplastic cell and of the molecular and cellular mechanisms of carcinogenesis neoplastic transformation, metastasis and organ damage. Immunity and tumors

Prerequisites

Physics, chemistry and cell biology. Basic genetics. Biochemistry of nucleic acids, proteins and lipids.
Histology. Human anatomy. Elements of Immunology

Teaching methods

Lectures, class discussions, visualization and commentary of images and laboratory procedures. Viewing movies. Work in a group. Inverted classes. Peer to peer teaching. Online teaching

Learning verification modality

Examination methods: Oral test lasting approximately 30 minutes with 3 questions. The first is prevalent in Molecular pathology, the second in cellular response and the third in Physiopathology topics. The questions will verify the student's preparation in the subject of General Pathology and Physiopathology.

Extended program

GENERAL ONCOLOGY

Classification and nomenclature of tumors. Characteristics of the transformed cell. Metaplasia. Dysplasia. Anaplasia. Benign and malignant tumors. Histological classification and morphological elements of benign and malignant human tumors. In situ carcinoma.

MOLECULAR BASES OF CELL TRANSFORMATION. Oncogene concept. Membrane receptors and signal transduction pathways from the cell surface to the nucleus in the control of cell proliferation. Amplification mutations and translocations as oncogenic mechanisms. Karyotype and chromosomal alterations in tumors. The main oncogenes. Tumor suppressor gene concept. Molecular control of the cell cycle, phases and proteins that regulate the cycle. Cycle checkpoints. Hereditary familial neoplasms. The main tumor suppressors. Epigenetics and cancer.

MOLECULAR PATHOLOGY OF THE CONTROL OF APOPTOSIS. Pro and anti-apoptotic genes in the pathogenesis of tumors

Genomics and tumors: the genetic panorama of tumors and new DNA analysis technologies (outline)

CARCINOGENESIS. Elements of tumor epidemiology. Chemical carcinogenesis. Carcinogenesis from ultraviolet radiation. Carcinogenesis by ionizing radiation. Viral carcinogenesis.

Tumor ANGIOGENESIS.

METASTATIZATION AND STADIATION. Molecular mechanisms underlying the phenomenon of metastasis. Primitive and metastatic tumors. Pathways of metastasization. Graduation and staging of tumors.

IMMUNITY AND CANCER. Role of the immune system in controlling the neoplastic process. Tumor-specific and -associated antigens. Main immunological markers of tumors.

PARANEOPLASTIC SYNDROMES and NEOPLASTIC CACHESSIA

Cognomi M-Z

CFU

3

Teacher

Francesco Grignani

Teachers

• Francesco Grignani

Hours

• 37.5 ore - Francesco Grignani

Language of instruction

Italian

Contents

Acute and chronic inflammation and its effects.
Low-grade inflammation.
Systemic effects of inflammation
Evolution of inflammation

Reference texts

Pontieri, Russo, Frati.
Patologia Generale
Piccin Ed.

Robbins Kumar Cotran
Le basi patologiche delle malattie
Piccin

Educational objectives

Knowledge of the basic phenomena and signs and symptoms related to inflammation of human tissues, in the context of the organism, with practical examples

Prerequisites

Knowledge of immunology and immunopathology
Knowledge of blood and tissue cytology

Teaching methods

Lectures, viewing of educational films and clinical examples, classroom discussion, student interventions.

Learning verification modality

Classroom interaction and ongoing assessments

Extended program

Acute inflammation

Manifestations, signs and symptoms. Tissue effects of inflammation. Vascular mechanisms of vasodilation and increased permeability. Exudate and its variants. Abscess. Damage from acute inflammation and its repair.
Chemical mediators of inflammation, preformed, synthesized de novo and plasma. Receptors of the different factors, including innate immunity receptors. Inflammasome and its role in cytokine production.
Acute inflammatory cells: Neutrophilic granulocytes and their inflammatory activity. Macrophages and their activities. Different types of macrophages. Role of NK cells and the specific immune system.
Systemic effects of acute inflammation: plasma effects, metabolic effects, fever, hematological effects.

Chronic inflammation

Etiological causes and pathogenesis of chronic inflammation. Cell types in chronic inflammation and their activities, in repair and fibrosis. Relevant growth factors and their receptors.
Types of chronic inflammation: diffuse and granulomatous. Structure of granulomas and their evolution. Causes of chronic granulomatous inflammation.
Chronic low-grade inflammation and its harmful effects on various organs and systems and on aging and the pathogenesis of various cardiovascular and oncological pathologies.

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Health and wellness
Quality education
Gender equality