General Pathology and Pathophysiology

A.Y. 2021/2022
11
Max ECTS
88
Overall hours
SSD
MED/04
Language
Italian
Learning objectives
The aim of this course is to provide a detailed description of the etiopathogenetic mechanisms of the main human diseases and to describe the pathophysiological and clinical features of the main organ and system diseases, using the appropriate medical terminology. This approach aims to allow the pharmacist, often the first link in the healthcare structure in contact with the patient, to effectively interact with the other members of the health system and to provide the patient with useful information, advice and indications.
Expected learning outcomes
At the end of the course of General Pathology and Pathophysiology, the student will have acquired basic knowledge of the main pathological mechanisms of the most common human diseases at different ages, with specific reference to pharmacist's professional duties. The knowledge developed within this course will allow the student to build a critical awareness of the pathological risks for human health, with regard to a direct approach of self-medication, as well as for the identification of conditions requiring a prompt evaluation by a physician. Last but not least, the student will have developed the necessary critical view to increase his/her knowledge by moving into the ever-widening world of information regarding human health, starting from the web and from accurate scientific publications.
Course syllabus and organization

Linea AL

Responsible
Lesson period
year
The current COVID-19 pandemic required the prompt adaptation of the teaching activities to an unprecedented setting. The teacher of this course, with the support of UNIMI (see for reference: "Didattica online. Dalla fase 2 al ritorno in aula" (https://work.unimi.it/servizi_insegna/ariel/123737.htm and https://work.unimi.it/servizi_insegna/ariel/119559.htm)), implemented the most effective strategies to overcome the difficulties linked to this situation, in some instances trying to turn a negative condition into a novel opportunity. All the changes listed below are clearly intended to be linked to the contingent emergency situation and, in any case, the maximum effort is done to maintain the best overall quality of the course.
The program of this course is unchanged in terms of topics and number of lessons/hours/credits.
The modality of lesson release will be partially in presence (with direct access also from the Teams platform) and partially online (synchronous) at specific times reported on the timetable. The Teams platform will be preferentially used, although other (i.e., Zoom) may work as backups. All lessons will be also recorded and available on the Ariel platform, along with any additional material. Moreover, some lessons may be delivered only as recorded lectures.
During the emergency time, tests will be conducted online, only orally, using the Teams platform. The positive scores will range from 18/30 to 30/30 with honours.
Prerequisites for admission
Basic knowledge of human anatomy, biology, physiology and biochemistry is required.
Assessment methods and Criteria
The exam is oral and it is aimed at ascertaining a sufficient degree of knowledge of the fundamental concepts concerning general pathology and organ pathophysiology. The exam covers all the topics of the course. The student may choose the topic of the first question. The evaluation is expressed in thirtieths.
At least 7 exam sessions are scheduled per academic year.
General Pathology
Course syllabus
Etiology, Pathogenesis, different aspects of pathologic phenomena

Cellular Pathology
Acute and chronic stress
Cell adaptations to injury: hydropic changes / vacuolar degeneration, atrophy/hypoplasia, hyperplasia, hypertrophy, metaplasia, dysplasia, intracellular accumulations
Morphologic alterations in organs and tissues
Cell death: necrosis and apoptosis
Prion diseases


Cell adaptation to injury
Amyloidosis, hyaline change, fibrosis, mucous degeneration, calcification


Acute inflammation
Vascular changes: microvasculature structure, hyperemia, edema, vasoactive molecules
Inflammatory cells: mastocytes, monocytes / macrophages, lymphocytes
Inflammatory cytokines: chemokines, growth factors, activating factors, the complement system
Systemic effects: fever, acute-phase proteins
Outcomes of Acute inflammation
Resolution, tissue regeneration (restitutio ad integrum), connective tissue replacement /healing (scarring or fibrosis), angiogenesis
Chronic inflammation
Persistent injury: abscess
Primary chronic inflammation: granulomas

Diseases of the immune system
Generalities about natural and acquired immune response: T and B Lymphocytes, antibody reactions, antibodies and genes, T helper e T cytotoxic lymphocytes, mediators of the immune response (stimulatory and suppressor cytokines)
Diseases linked to altered immune responses: congenital or acquired immunodeficiency, hypersensitivity (allergic phenomena, antibodies mediated injury, immunocomplex diseases), autoimmune diseases (rheumatoid arthritis, lupus eritematosus and other connective tissue diseases), AIDS, vaccines

Genetic causes of disease
Mutations
Type of genetic disorders: chromosome diseases, single gene disorders, multifactorial diseases, hereditary diseases, mitochondrial heredity

Prenatal diseases and teratogenesis

Neoplastic diseases
Classification and nomenclature
Tumoral cell growth properties: benign and malignant neoplasms
Carcinogenesis: etiology and evolution, genetic alterations, viral carcinogenesis, chemical carcinogenesis, physical agent carcinogenesis
Epigenetic alterations in cancer
Inflammation, Immunity and cancer
Teaching methods
Active lectures. Attendance is not mandatory, but strongly recommended.
Teaching Resources
- Patologia Generale e Fisiopatologia, F.Celotti, 2013, Edises
- Robbins & Cotran: Le basi patologiche delle malattie. Elsevier 2015
- E. Albi - F.S. Ambesi Impiombato - F. Curcio - B. Moncharmont - A. Palese
Le Basi Cellulari e Molecolari delle Malattie. Idelson Gnocchi
Pathophysiology
Course syllabus
Syllabus
Systemic pathology: diseases of organ systems


The gastrointestinal tract: anatomy and physiology
Esophagus: achalasia, reflux esophagitis, esophageal hernias, esophageal cancers
Stomach: acute and chronic gastritis, peptic ulcer disease, gastric adenocarcinoma
Small intestine and colon: acute enterocolitis (bacteria, virus, parasite), Inflammatory bowel diseases (Crohn disease and ulcerative colitis), diverticular diseases, malabsorption syndromes, acute appendicitis, tumors
Liver: acute viral hepatitis, toxic hepatitis, chronic hepatitis, liver cirrhosis, hepatic adenocarcinoma, gallbladder, acute and chronic cholecystitis
Pancreas: acute and chronic pancreatitis, pancreatic failure, pancreatic cancer, endocrine cancers of the pancreas and of the intestine




Cardiovascular system:
Cardiac pathophysiology, atherosclerosis, ischemic heart disease, heart failure, arrhythmias, hearth disease associated with rheumatologic disorders, arterial and venous thrombotic phenomena, arterial hypertension, pericardites, cardiomyopathies and myocardites




The lung
Anatomy and physiology, pulmonary infections, tuberculosis, sarcoidosis, severe acute respiratory syndrome (adults and children), pleuritis, asthma, obstructive lung diseases, interstitial (restrictive) disease, lung cancer


The endocrine system: anatomy and physiology
hypothalamus/pituitary diseases: diabetes insipidus, hypopituitarism, pituitary adenomas (lactotroph adenoma and GH-secreting)
Thyroid gland: goiter, hyperthyroidism, hypothyroidism, thyroid cancer
Adrenal glands: adrenocortical insufficiency, adrenocortical hyperfunction, hypo- and hyper-aldosteronism
Adrenal medulla diseases: pheochromocytomas
Endocrine pancreas diseases: diabetes mellitus
Reproductive tract diseases
Parathyroid glands
Bone and mineral diseases




Metabolic Diseases
Obesity, metabolic syndrome, hyperuricemia and gout


The kidney
Anatomy and physiology, lower and upper urinary tract infections, glomerular diseases: nephritis e nephrosis, tubulointerstitial diseases, urolithiasis and obstructive urinary tract disease, acute and chronic kidney failure, prostate diseases


Disorders of blood cells and lymphnodes
Anatomy and physiology, anemias - classification and characteristics, the hemoglobinopathies, leukemia, lymphoma, polycythemia and myeloproliferative diseases, multiple myeloma, the blood coagulation system: hemorrhagic and coagulative disorders



The central nervous system
Anatomy and physiology, neurodegeneration (Alzheimer disease, Parkinson disease, triplet diseases), seizures, cerebrovascular disease, CNS neoplasms, amyotrophic lateral sclerosis, multiple sclerosis and demyelinating diseases, neuromuscular disorders, headache and migraine

The main diseases of the skin
Infective disorders (bacteria, viral, mycotic), pigmented and not pigmented tumors
Teaching methods
Active lectures. Attendance is not mandatory, but strongly recommended.
Teaching Resources
- Patologia Generale e Fisiopatologia, F.Celotti, 2013, Edises
- Robbins & Cotran: Le basi patologiche delle malattie. Elsevier 2015
- Harrison's: Principles of Internal Medicine - 20th edition. McGraw-Hill - 2019
General Pathology
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 4
Lessons: 32 hours
Pathophysiology
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 7
Lessons: 56 hours

Linea MZ

Responsible
Lesson period
year
More specific indications concerning the delivery models of training activities for academic year 2021-2022 will be provided over the coming months, based on the evolution of the public health situation.
Prerequisites for admission
Prerequisites for admission:
Basic knowledge of human anatomy, biology, physiology and biochemistry is required
Assessment methods and Criteria
Assessment methods and criteria:
The exam is oral and it is aimed at ascertaining a sufficient degree of knowledge of the fundamental concepts concerning general pathology and organ pathophysiology. The exam covers all the topics of the course. The student may choose the topic of the first question. The evaluation is expressed in thirtieths.
At least 7 exam sessions are scheduled per academic year.
General Pathology
Course syllabus
General Pathology - Course Syllabus:

Etiology, Pathogenesis, different aspects of pathologic phenomena

Cellular Pathology
- Acute and chronic stress
- Cell adaptations to injury: hydropic changes / vacuolar degeneration, atrophy/hypoplasia, hyperplasia, hypertrophy, metaplasia, dysplasia, intracellular accumulations
- Morphologic alterations in organs and tissues
- Cell death: necrosis and apoptosis
- Prion diseases

Cell adaptation to injury
- Amyloidosis, hyaline change, fibrosis, mucous degeneration, calcification

Acute inflammation
- Vascular changes: microvasculature structure, hyperemia, edema, vasoactive molecules
- Inflammatory cells: mastocytes, monocytes / macrophages, lymphocytes
- Inflammatory cytokines: chemokines, growth factors, activating factors, the complement system
- Systemic effects: fever, acute-phase proteins
Outcomes of Acute inflammation
- Resolution, tissue regeneration (restitutio ad integrum), connective tissue replacement /healing (scarring or fibrosis), angiogenesis
Chronic inflammation
- Persistent injury: abscess
- Primary chronic inflammation: granulomas

Diseases of the immune system
- Generalities about natural and acquired immune response: T and B Lymphocytes, antibody reactions, antibodies and genes, T helper e T cytotoxic lymphocytes, mediators of the immune response (stimulatory and suppressor cytokines)
- Diseases linked to altered immune responses: congenital or acquired immunodeficiency, hypersensitivity (allergic phenomena, antibodies mediated injury, immunocomplex diseases), autoimmune diseases (rheumatoid arthritis, lupus eritematosus and other connective tissue diseases), AIDS, vaccines

Genetic causes of disease
- Mutations
- Type of genetic disorders: chromosome diseases, single gene disorders, multifactorial diseases, hereditary diseases, mitochondrial heredity

Prenatal diseases and teratogenesis

Neoplastic diseases
- Classification and nomenclature
- Tumoral cell growth properties: benign and malignant neoplasms
- Carcinogenesis: etiology and evolution, genetic alterations, viral carcinogenesis, chemical carcinogenesis, physical agent carcinogenesis
- Epigenetic alterations in cancer
- Inflammation, Immunity and cancer
Teaching methods
Teaching methods:
Active lectures. Attendance is not mandatory, but strongly recommended.
Teaching Resources
Bibliography:

- Patologia Generale e Fisiopatologia, F.Celotti, 2013, Edises
- Robbins & Cotran: Le basi patologiche delle malattie. Elsevier 2015
- Harrison's: Principles of Internal Medicine - 20th edition. McGraw-Hill - 2019
Pathophysiology
Course syllabus
Pathophysiology - Course Syllabus

Systemic pathology: diseases of organ systems

The gastrointestinal tract: anatomy and physiology
- Esophagus: achalasia, reflux esophagitis, esophageal hernias, esophageal cancers
- Stomach: acute and chronic gastritis, peptic ulcer disease, gastric adenocarcinoma
- Small intestine and colon: acute enterocolitis (bacteria, virus, parasite), Inflammatory bowel diseases (Crohn disease and ulcerative colitis), diverticular diseases, malabsorption syndromes, acute appendicitis, tumors
- Liver: acute viral hepatitis, toxic hepatitis, chronic hepatitis, liver cirrhosis, hepatic adenocarcinoma, gallbladder, acute and chronic cholecystitis
- Pancreas: acute and chronic pancreatitis, pancreatic failure, pancreatic cancer, endocrine cancers of the pancreas and of the intestine
Cardiovascular system:
Cardiac pathophysiology, atherosclerosis, ischemic heart disease, heart failure, arrhythmias, hearth disease associated with rheumatologic disorders, arterial and venous thrombotic phenomena, arterial hypertension, pericardites, cardiomyopathies and myocardites

The lung
Anatomy and physiology, pulmonary infections, tuberculosis, sarcoidosis, severe acute respiratory syndrome (adults and children), pleuritis, asthma, obstructive lung diseases, interstitial (restrictive) disease, lung cancer

The endocrine system: anatomy and physiology
- hypothalamus/pituitary diseases: diabetes insipidus, hypopituitarism, pituitary adenomas (lactotroph adenoma and GH-secreting)
- Thyroid gland: goiter, hyperthyroidism, hypothyroidism, thyroid cancer
- Adrenal glands: adrenocortical insufficiency, adrenocortical hyperfunction, hypo- and hyper-aldosteronism
- Adrenal medulla diseases: pheochromocytomas
- Endocrine pancreas diseases: diabetes mellitus
- Reproductive tract diseases
- Parathyroid glands
- Bone and mineral diseases
Metabolic Diseases
Obesity, metabolic syndrome, hyperuricemia and gout

The kidney
Anatomy and physiology, lower and upper urinary tract infections, glomerular diseases: nephritis e nephrosis, tubulointerstitial diseases, urolithiasis and obstructive urinary tract disease, acute and chronic kidney failure, prostate diseases

Disorders of blood cells and lymphnodes
Anatomy and physiology, anemias - classification and characteristics, the hemoglobinopathies, leukemia, lymphoma, polycythemia and myeloproliferative diseases, multiple myeloma, the blood coagulation system: hemorrhagic and coagulative disorders

The central nervous system
Anatomy and physiology, neurodegeneration (Alzheimer disease, Parkinson disease, triplet diseases), seizures, cerebrovascular disease, CNS neoplasms, amyotrophic lateral sclerosis, multiple sclerosis and demyelinating diseases, neuromuscular disorders, headache and migraine

The main diseases of the skin
Infective disorders (bacteria, viral, mycotic), pigmented and not pigmented tumors, pediculosis
Teaching methods
Teaching methods:
Active lectures. Attendance is not mandatory, but strongly recommended.
Teaching Resources
Bibliography
- Patologia Generale e Fisiopatologia, F.Celotti, 2013, Edises
- Robbins & Cotran: Le basi patologiche delle malattie. Elsevier 2015
- Harrison's: Principles of Internal Medicine - 20th edition. McGraw-Hill - 2019
General Pathology
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 4
Lessons: 32 hours
Pathophysiology
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 7
Lessons: 56 hours
Professor(s)
Reception:
by appointment
Department of Pharmacological and Biomolecular Sciences