System diseases 1

A.Y. 2019/2020
11
Max ECTS
132
Overall hours
SSD
BIO/12 MED/07 MED/08 MED/11 MED/14 MED/36
Language
English
Learning objectives
The System Diseases 1 course takes the students into clinical medicine with the study of the "Diseases of the Kidney and Urinary System" (Nephrology) and the "Diseases of the Heart and Vessels" (Cardiology). Such studies will be dealt on a comprehensive basis, i.e. including Diagnostic Imaging, Pathology, Clinical Biochemistry and Microbiology, in relation to the diseases of the organ.
CARDIOVASCULAR DISEASES
This module will focus on some relevant aspects of cardiology, which shall be discussed with a predominantly pathophysiological approach. A more clinical and therapy oriented approach will be in place at 5th year, in the exam of Translational Cariovascular Medicine and Surgery.
NEPHROLOGY
The purpose of this module is to provide essential knowledge of the kidney role in maintaining the body homeostasis, both in patients with renal diseases and in patients with other conditions, such as arterial hypertension and diabetes mellitus, in which kidneys play a pivotal role in the genesis and the response of the organism to the disease process. The module offers the unique opportunity to systematically explore specific renal disorders, like the glomerulopathies, and an introduction to very relevant clinical syndromes, such as acute and chronic kidney disease.
Course Relevance: The knowledge of signs and symptoms (semeiotics) in nephrology and the ability to identify the clinical presentation of renal diseases represent an essential part of the medical heritage and practice. It is of utmost importance in the everyday clinical and surgical practice, if we consider the high incidence of both acute (mostly in surgical setting) and chronic kidney injury (mostly in internal medicine). Also, the ability to detect the first signs and symptoms of a specific renal disease is crucial for an early nephrology referral. Despite the intended field of specialization in medicine, we believe that this module is very important both for the future physician and the future surgeon.
MICROBIOLOGY
The main purpose of the module is the understanding of the role of microorganisms, as etiological agents or cofactors, in the pathogenesis of myocardial/cardiac (cardiology module) and urinary tract diseases (nephrology module).
Every lecture will focus on four main aspects: the epidemiology of the involved microorganisms, the mechanisms of pathogenesis employed by the microorganisms, the diagnostic approaches for the detection of the microorganisms, and, when available, the antimicrobial therapies.
PATHOLOGY
The first part of the course will focus on the definition of Anatomic Pathology and on its contribution in modern medicine. The organization of the work flow at a Pathology Department, with particular focus on its three major sections (histology, cytology and autopsy) will be described, together with the structure and the contents of a modern pathological report. Principles, applications and clinical implications of some ancillary techniques of the anatomic pathology such as immunohistochemistry and molecular pathology will also be considered in detail.
The second part of the course will deal with the anatomic pathology of the heart. In particular, lectures will be focused on the pathogenetic mechanisms, morphologic changes, evolution and complications of the diseases involving the most important structures of the heart (myocardium, endocardium and valves, pericardium) and the blood vessels.
DIAGNOSTIC IMAGING
The module is focused on explaining the different interactions between iodizing and non iodizing radiation and matter in order to obtain diagnostic images (i.e. x rays, sonography and magnetic resonance imaging) and the use of radiopharmaceuticals in Nuclear Medicine. The course is also designed to highlight the different diagnostic capabilities of imaging techniques in detecting and characterizing pathologic conditions in the cardiovascular and urinary systems.
In particular, the course will focus on conditions such as ischemic heart disease, valvular heart disease, urinary tract stones, infections and tumors.
Expected learning outcomes
Students are expected to achieve general and specific requirements. General requirements:
-Recognize the most relevant signs and symptoms of renal and cardiovascular disease.
-Learn how to conduct a medical and anamnestic interview.
-Plan the best approach to the patient.
-Apply the correct steps of a medical examination.
-Understand the pathophysiological features of acute and chronic renal and cardiovascular diseases.
-Develop a deep knowledge of the principal renal and cardiac syndromes.
-Understand the main etiologies and the clinical features of acute injury of the kidney and the cardiovascular system.
-Understand the main etiologies and the clinical features of chronic injury of the kidney and the cardiovascular system.
-Develop a broad understanding of the role of kidneys in the pathogenesis of electrolyte disturbances
-Develop a broad knowledge of genetic abnormalities determining renal diseases
Specific requirements :
-Understand how to collect critical information about renal and cardiovascular diseases from the patient's clinical history.
-Demonstrate the ability to grade a cardiovascular disease
-Understand how to stage kidney injury upon the creatinine serum levels and the corresponding glomerular filtration rate.
-Understand how proteinuria affects severity of kidney disease and its progression.
-Understand how to put together clinical and laboratory data in order to identify: nephritic syndrome, nephrotic syndrome, urinary tract infections, acute kidney injury, chronic kidney injury.
-Demonstrate the ability in detecting the condition of body fluid overload.
Course syllabus and organization

Single session

Responsible
Prerequisites for admission
To take the System Diseases 1 exam, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Assessment methods and Criteria
Student assessment is based on a combination of written and oral examinations.
The written exam is a multiple choice test focused on the topics of the modules: Clinical Biochemistry, Microbiology, Pathology (10 questions for each subject). Only students who successfully pass the written tests of all subjects (threshold 7/10) are allowed to take the oral examination, focused on the modules: Diagnostic Imaging, Cardiovascular Diseases, Nephrology.
The oral examination must be passed in the same session as the written examination.
The students must undergo both written and oral examination on the same day. If the student does not pass successfully the oral examination, the positive result at the written test is valid only within the same session.
The final mark is the average of the marks obtained in the three oral examinations weighted for the number of credits of each discipline.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (lode) may be granted with the consent of all the professors.
Registration to the exam through SIFA is mandatory.
Cardiovascular diseases
Course syllabus
Lecture 1 - Cardiology. Cardiovascular risk
Lecture 2 - Cardiology. Grading the severity of cardiovascular diseases
Lecture 3 - Nephrology. Management of the patient with renal disease
Lecture 4 - Diagnostic Imaging. Ionizing and non-iodizing radiation used in diagnostic imaging
Lecture 4b - Nuclear Medicine
Lecture 5 - Diagnostic Imaging. Sonography
Lecture 6 - Pathology. Introduction to Anatomic Pathology part I
Lecture 7 - Pathology: Introduction to Anatomic Pathology part II
Lecture 8 - Pathology. Ancillary techniques in Anatomic Pathology
Lecture 9 - Clinical Biochemistry. Specimen collection and storage; point of care testing and automation
Lecture 10 - Clinical Biochemistry. The quality control in clinical laboratory
Lecture 11 - Clinical Biochemistry. Biobanks and their importance in clinical and scientific fields related to biomedical research
Lecture 12 - Clinical Biochemistry. Preanalytical variables affecting the Integrity of human biospecimens in laboratory tests and in biobanking
Lecture 13 - Cardiology. Resting ECG
Lecture 14 - Cardiology. Arrhythmias
Lecture 15 - Diagnostic Imaging. Computerized Tomography - CT
Lecture 16 - Cardiology. Heart-lung interaction
Lecture 17 - Cardiology. O2 consumption
Lecture 18 - Diagnostic Imaging. Magnetic Resonance Imaging - MRI
Lecture 19 - Pathology. Atherosclerosis and Ischemic heart disease
Lecture 20 - Non neoplastic and neoplastic diseases of great vessels and heart
Lecture 21 - Cardiology. Ischemic heart disease
Lecture 22 - Nuclear Cardiology. Imaging of ischemia and cardiac function
Lecture 23 - Pathology. Pathology of the endocardium, myocardium and cardiac valves
Lecture 24 - Cardiology. Valvular heart disease
Lecture 25 - Cardiology. Pericarditis and endocarditis
Lecture 26 - Diagnostic Imaging. Cardiac imaging
Lecture 27 - Diagnostic Imaging. Cardiovascular imaging
Lecture 28 - Diagnostic Imaging. Cardiovascular imaging
Lecture 29 - Cardiology. Heart failure part 1
Lecture 30 - Cardiology. Heart failure part 2
Lecture 31 - Microbiology. Viruses and myocardial diseases
Lecture 32 - Microbiology. Bacteria and cardiac diseases
Lecture 33 - Microbiology. The role of microbes in atherosclerosis and other chronic cardiac diseases
Lecture 34 - Cardiology. Pulmonary hypertension
Lecture 35 - Clinical Biochemistry. Cardiac monitoring in clinical laboratory and biological fluids profiling: a new challenge in clinical laboratory
Lecture 36 - Nephrology. The body fluid imbalance and the pathophysiology of the edema
Lecture 37 - Nephrology. Glomerular disorders
Lecture 38 - Microbiology. Microbes and urinary tract infection
Lecture 39 - Nephrology. Management of patients with tubulo-interstitial nephritis
Lecture 40 - Nephrology. Approach to patients with urinary tract and renal infection
Lecture 41 - Cardiology. Congenital heart diseases
Lecture 42 - Nephrology. Acute kidney injury / acute renal failure
Lecture 43 - Nephrology. Chronic kidney disease - CKD
Lecture 44 - Nephrology. Introduction to artificial kidney
Lecture 45 - Nephrology. Renal vascular diseases
Lecture 46 - Diagnostic Imaging. Kidney imaging
Lecture 47 - Nuclear Medicine. Imaging of renal
Lecture 48 - Nephrology. Case studies
Lecture 49 - Diagnostic Imaging. Kidney imaging part 1
Lecture 50 - Diagnostic Imaging. Kidney imaging part 2
Lecture 51 - Nephrology. Principles of renal transplantation
Lecture 52 - Microbiology. Infectious agents and renal transplant
Lecture 53 - Nephrology. Management of patients with diabetes
Lecture 54 - Clinical Biochemistry. Diabetes diagnosis and monitoring in laboratory medicine
Lecture 55 - Nephrology. Management of patients with hereditary nephropathies
Lecture 56 - Microbiology. Urinary tract infection and microbe associate renal diseases
Lecture 57 - Pathology. Non neoplastic diseases of the kidney
Lecture 58 - Nephrology. Analysis of the urinary sediment
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· Goldman's Cecil Medicine L. Goldman, A. I. Schafer, 25th ed., Elsevier, 2015
· Making Sense of Exercise Texting, R. B. Schoene, H. T. Robertson, CRC Press, 2019
· Bates' Guide to Physical Examination and History Taking, Lynn S. Bickley
· Robbins and Cotran. Pathologic Basis Of Disease (9th Edition)
· Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders. (e book)
· Core Radiology. J. Mandell. Cambrige University Press. (ebook)
· Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
· Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
· Nephrology textbooks and resources:
o Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
o Robert W. Schrier. Manual of Nephrology. Wolters Kluwer Health, 2014
· JOVE Clinical Skills - Digital library of the University of Milano
Nephrology
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Cardiovascular diseases
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· Goldman's Cecil Medicine L. Goldman, A. I. Schafer, 25th ed., Elsevier, 2015
· Making Sense of Exercise Texting, R. B. Schoene, H. T. Robertson, CRC Press, 2019
· Bates' Guide to Physical Examination and History Taking, Lynn S. Bickley
· Robbins and Cotran. Pathologic Basis Of Disease (9th Edition)
· Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders. (e book)
· Core Radiology. J. Mandell. Cambrige University Press. (ebook)
· Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
· Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
· Nephrology textbooks and resources:
o Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
o Robert W. Schrier. Manual of Nephrology. Wolters Kluwer Health, 2014
· JOVE Clinical Skills - Digital library of the University of Milano
Pathology
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Cardiovascular diseases
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· Goldman's Cecil Medicine L. Goldman, A. I. Schafer, 25th ed., Elsevier, 2015
· Making Sense of Exercise Texting, R. B. Schoene, H. T. Robertson, CRC Press, 2019
· Bates' Guide to Physical Examination and History Taking, Lynn S. Bickley
· Robbins and Cotran. Pathologic Basis Of Disease (9th Edition)
· Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders. (e book)
· Core Radiology. J. Mandell. Cambrige University Press. (ebook)
· Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
· Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
· Nephrology textbooks and resources:
o Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
o Robert W. Schrier. Manual of Nephrology. Wolters Kluwer Health, 2014
· JOVE Clinical Skills - Digital library of the University of Milano
Radiology
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Cardiovascular diseases
Teaching methods
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· Goldman's Cecil Medicine L. Goldman, A. I. Schafer, 25th ed., Elsevier, 2015
· Making Sense of Exercise Texting, R. B. Schoene, H. T. Robertson, CRC Press, 2019
· Bates' Guide to Physical Examination and History Taking, Lynn S. Bickley
· Robbins and Cotran. Pathologic Basis Of Disease (9th Edition)
· Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders. (e book)
· Core Radiology. J. Mandell. Cambrige University Press. (ebook)
· Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
· Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
· Nephrology textbooks and resources:
o Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
o Robert W. Schrier. Manual of Nephrology. Wolters Kluwer Health, 2014
· JOVE Clinical Skills - Digital library of the University of Milano
Teaching Resources
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· Goldman's Cecil Medicine L. Goldman, A. I. Schafer, 25th ed., Elsevier, 2015
· Making Sense of Exercise Texting, R. B. Schoene, H. T. Robertson, CRC Press, 2019
· Bates' Guide to Physical Examination and History Taking, Lynn S. Bickley
· Robbins and Cotran. Pathologic Basis Of Disease (9th Edition)
· Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders. (e book)
· Core Radiology. J. Mandell. Cambrige University Press. (ebook)
· Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
· Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
· Nephrology textbooks and resources:
o Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
o Robert W. Schrier. Manual of Nephrology. Wolters Kluwer Health, 2014
· JOVE Clinical Skills - Digital library of the University of Milano
Microbiology
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Cardiovascular diseases
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· Goldman's Cecil Medicine L. Goldman, A. I. Schafer, 25th ed., Elsevier, 2015
· Making Sense of Exercise Texting, R. B. Schoene, H. T. Robertson, CRC Press, 2019
· Bates' Guide to Physical Examination and History Taking, Lynn S. Bickley
· Robbins and Cotran. Pathologic Basis Of Disease (9th Edition)
· Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders. (e book)
· Core Radiology. J. Mandell. Cambrige University Press. (ebook)
· Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
· Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
· Nephrology textbooks and resources:
o Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
o Robert W. Schrier. Manual of Nephrology. Wolters Kluwer Health, 2014
· JOVE Clinical Skills - Digital library of the University of Milano
Clinical Biochemistry
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Cardiovascular diseases
Teaching methods
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· Goldman's Cecil Medicine L. Goldman, A. I. Schafer, 25th ed., Elsevier, 2015
· Making Sense of Exercise Texting, R. B. Schoene, H. T. Robertson, CRC Press, 2019
· Bates' Guide to Physical Examination and History Taking, Lynn S. Bickley
· Robbins and Cotran. Pathologic Basis Of Disease (9th Edition)
· Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders. (e book)
· Core Radiology. J. Mandell. Cambrige University Press. (ebook)
· Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
· Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
· Nephrology textbooks and resources:
o Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
o Robert W. Schrier. Manual of Nephrology. Wolters Kluwer Health, 2014
· JOVE Clinical Skills - Digital library of the University of Milano
Teaching Resources
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· Goldman's Cecil Medicine L. Goldman, A. I. Schafer, 25th ed., Elsevier, 2015
· Making Sense of Exercise Texting, R. B. Schoene, H. T. Robertson, CRC Press, 2019
· Bates' Guide to Physical Examination and History Taking, Lynn S. Bickley
· Robbins and Cotran. Pathologic Basis Of Disease (9th Edition)
· Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders. (e book)
· Core Radiology. J. Mandell. Cambrige University Press. (ebook)
· Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
· Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
· Nephrology textbooks and resources:
o Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
o Robert W. Schrier. Manual of Nephrology. Wolters Kluwer Health, 2014
· JOVE Clinical Skills - Digital library of the University of Milano
Cardiovascular diseases
MED/11 - CARDIOVASCULAR DISEASES - University credits: 2
Lessons: 24 hours
Professors: Agostoni Piergiuseppe, Vignati Carlo
Clinical Biochemistry
BIO/12 - CLINICAL BIOCHEMISTRY AND MOLECULAR BIOLOGY - University credits: 1
Lessons: 12 hours
Professor: Gelfi Cecilia
Microbiology
MED/07 - MICROBIOLOGY AND CLINICAL MICROBIOLOGY - University credits: 1
Lessons: 12 hours
Professor: Ferrante Pasquale
Nephrology
MED/14 - NEPHROLOGY - University credits: 4
Lessons: 48 hours
Pathology
MED/08 - PATHOLOGY - University credits: 1
Lessons: 12 hours
Radiology
MED/36 - IMAGING AND RADIOTHERAPY - University credits: 2
Lessons: 24 hours
Professor(s)
Reception:
For an appointment please send an email
Nephrology and Dialysis Units of Sacco hospital or Fatebenefratelli hospital
Reception:
Monday 10am-13pm
LITA Segrate
Reception:
Upon email contact
IRCCS Istituto Ortopedico Galeazzi, Radiology Unit, floor -2