System diseases 1

A.Y. 2021/2022
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
BLOCK 1
Adaptation of cellular growth and differentiation
Mechanisms of cellular injury and cell death (necrosis, apoptosis, autophagy, pyroptosis, necroptosis)
Reactive oxygen species (ROS): types, source, effects
Balance between ROS and antioxidants in human health and unbalance in human disease
Intracellular accumulations of endogenous and exogenous substances
Molecular and cellular aspects of protein misfolding and mechanisms of protein-folding diseases
The stem cell and the concept of pluripotency
Main properties of embryonic and adult stem cells
The hematopoietic stem cell as a paradigm of adult stem cells
Reprogrammed cells and induced pluripotency
Somatic cell reprogramming by nuclear transfer ("therapeutic cloning")
Hallmarks of aging
Genetic and biochemical changes in aging
Cellular senescence
Stem cell exhaustion
Altered intercellular communication
Sources, biochemical functions, and health benefits of energy-releasing and energy-converting vitamins (B1, B2, B3, B5, B6, B7), and deficiency-related diseases
Sources, biochemical functions, and health benefits of hematopoietic vitamins (B9, B12), vitamin C, and deficiency-related diseases
Lipid-soluble vitamins (A, D, E, K), and deficiency/excess-related diseases

BLOCK 2
Effect of mutations on protein function
Mechanism linking mutations to disease
Same gene, different phenotypes; different genes, same phenotype
Mutation not affecting coding gene sequences
Molecular basis of reduced penetrance in human inherited diseases
Identification of genetic risk factors in complex diseases
Common versus rare variant hypothesis in neurodegenerative disorders
Lessons from studying monogenic disease for common disease: the genetics of Alzheimer disease and mellitus diabetes
Epigenetic mechanisms
Epigenetic modifications and environment
Role of epigenetics in human diseases
Mechanisms of action of miRNA and lncRNA
Role of miRNA and lncRNA in human diseases
Genetic variation and drug response
Genetic variation and personalized medicine

BLOCK 3
Microbiota in health and disease
Basics of bacterial cell structure
Properties of bacterial cell walls (Gram staining, structure of peptidoglycan, LPS structure and role in human pathogenesis, target sites for antibiotics)
The genetic makeup of bacteria
Mechanisms of bacterial virulence: secretory, membrane-associated, and cytosolic factors. Structure, regulation, expression and their contribution to pathogenesis and immune evasion.
The eukaryotic nature of fungi and their classification
The fungal relationships with humans: basic pathogenic mechanisms for opportunistic and invasive infections.
Structure, morphology, genome organization and virulence factors of parasites
Pathogenesis of Giardia, Trichomonas, Plasmodii, and intestinal nematodes
Structure, morphology, genome organization and evolution theories of viruses
Classification of the viruses infecting humans Replication's strategies
Mechanisms of viral pathogenesis Determinants of communicable diseases

BLOCK 4
Structures, genome organization, replication properties and pathogenesis of clinical relevant human picornaviruses.
Structures, genome organization, replication properties and pathogenesis of clinical relevant human flaviviruses.
Structures, genome organization, replication properties and pathogenesis of the human viruses belonging to the viral families: togaviridae, coronaviridae, rhabdoviridae
Structures, genome organization, replication properties and pathogenesis of the viruses belonging to the viral families: orthomixoviridae, paramixoviridae, and pneumoviridae.
Structures, genome organization, replication properties and pathogenesis of the viruses belonging to the viral families: filoviridae, arenaviridae, bunyaviridae.
Structures, genome organization, replication and pathogenesis of the major viruses causing hepatitis.
Structures, genome organization, replication and pathogenesis of the major viruses causing hepatitis (II).
Structures, genome organization, replication properties and pathogenesis of the human herpesviruses.
Structures, genome organization, replication properties and pathogenesis of the viruses belonging to the viral families: parvoviridae, adenoviridae, papillomaviridae.
Structures, genome organization, replication properties and pathogenesis of the human polyomaviruses.
Structures, genome organization, and replication properties of HIV.
Pathogenesis of HIV.
Structures, genome organization, replication properties and pathogenesis of the human delta retroviruses (HTLV-I and II). Structures and pathogenesis of the prions.


BLOCK 5
Classification, pathogenetic mechanisms and diagnostic aspects of most clinically relevant bacteria.
Staphylococcus, Streptococcus, Enterococcus.
Corynebacterium diphtheriae.
Listeria monocytogenes, Legionella pneumophila, Chlamydiae, Neisseriae.
Haemophilus influenzae.
Bordetella pertussis.
Campylobacter, Helicobacter pylori, Vibrio cholerae, Pseudomonas aeruginosa, Acinetobacter.
Clostridia and bacilli
Mycobacteria
Fungi (Candida, Cryptococcus, Aspergillus, dermatophytes, Blastomyces, Coccidioides, Histoplasma, Pneumocystis).
The burden of nosocomial infections
Anti-microbial resistance
Superbugs (MRSA, VRE, KPC)

BLOCK 6
The hematopoietic niche and hematopoietic stem cells
Hematopoietic lineages and cytokines
The normal and altered blood counts
Biological and physical barriers of innate immunity
Cardinal signs of acute inflammation
Blood flow alterations and vascular permeability
The endothelium as a reactive biological structure
Mast cells, phagocytes and NK cells
Molecular mediators active on vessels
Molecular mediators active on leukocytes
Primary inflammatory cytokines
Eicosanoids
Cell adhesion: adhesion molecules and cell migration, the chemokine system
Pathogen-Associated Molecular Patterns (PAMPs) and Pathogen Recognition Receptors (PRRs)
Danger-Associated Molecular Patterns (DAMPs) and their receptors
The TLR system
Intracellular PRR
Opsonic receptors
Genetic defects in pathogen recognition
Complement system: Activation pathways, functions, regulatory mechanisms, genetic defects in the complement system
Mechanisms of cell-mediated cytotoxicity: phagocytosis and degranulation
Oxygen-dependent mechanisms, oxygen independent mechanisms, opsonic agents
Genetic defects in pathogen killing mechanisms
Energy for immunity
Metabolic signatures and profiles of key immune cells
Metabolic control of immune responses
Neutrophils metabolism and bioenergetics of anti-microbial action
Metabolism of macrophages
Metabolic shifts in macrophage activation and polarization
Negative regulators of the inflammatory response
The hypothalamic-pituitary-adrenal axis
Anti-inflammatory cytokines and eicosanoids
Stem cells and growth factors in tissue renewal
Multistep process of tissue repair, fibrosis, anomalies in wound healing
Distinct types of chronic inflammation
Cellular and molecular effectors of chronic inflammation
Macrophage polarization in chronic inflammatory responses
Systemic inflammation: Fever, leukocytosis, acute phase proteins

BLOCK 7
Key features of acquired immunity: specificity, memory, tolerance
The lymphoid system
Primary and secondary lymphoid tissues, lymphatic vessels
The antigen: source, structure, processing
Thymus-dependent and thymus-independent antigens
Structure and function of Major Histocompatibility Complex I and II
MHC-I and MHC-II loci organization
Superantigens
Professional and non-professional antigen presenting cells
Dendritic cells origin and subsets
Dendritic cells maturation and migration
Costimulatory molecules
Intrathymic development
Positive and negative selection of T lymphocytes
TCR structure and repertoire generation
Central and peripheral tolerance
The TCR/CD3 signalling complex and transduction pathways
Helper and cytotoxic T lymphocytes
BCR signalling and B cell activation
Antibody classes: structure and functions Isotype switch
Antibody classes in primary and secondary immune responses
Affinity maturation
T helper subsets and polarized immune responses
Differentiation and signalling in T helper cells
Immune response polarization in pathology
T cell / macrophage crosstalk in chronic inflammatory responses
Impact on effector cells
Immune granulomata: an immune perspective
Regulatory T cells
Myeloid regulatory cells
Metabolic differences between innate and adaptive immunity
Metabolism of specific T cell lineages
T cell metabolism changes during immune response
Vaccines and their development

BLOCK 8
Recognition of viral infection by the immune system
Effector mechanisms against viral infections
Viral strategies for evading antiviral immune responses
Recognition of intracellular infection by the immune system
Microbial strategies for evading immune responses
The mucosal immune system
Mucosal immunity and commensal microorganisms
Mucosal immunity to pathogenic microbes
General issues on hypersensitivity reactions
Type I hypersensitivity
Type II hypersensitivity
Type III hypersensitivity
Type IV hypersensitivity
The multifactorial pathogenesis of autoimmune diseases
Failure mechanisms of the central and peripheral tolerance
Effector mechanisms of autoimmune reactions
Immune mechanisms of the most common autoimmune diseases
Differential features of autoimmune vs autoinflammatory diseases
Immune deficiency caused by defects in innate immunity
Immune deficiency caused by defects in B and T maturation
Iatrogenic immunodeficiencies
HIV infection and immune response
Acquired immune deficiency syndrome (AIDS) pathogenesis
Animal models to assess HIV-1 infection and AIDS pathogenesis
Immunological basis of allograft rejection
Major and minor histocompatibility antigens
Molecular basis of direct and indirect allorecognition
Mechanisms of hyperacute, acute and chronic rejection graft-versus-host disease
Age-related changes in the innate immune system
Age-related changes in the adaptive immune system
Impact of immunosenescence on diseases and vaccination
Tissue immunometabolism: relationships in the gastrointestinal tract, liver, and adipose tissue
Relationships between systemic metabolism and immunity
Vitamins in the control of immunity
Obesity as a multifactorial disease
Immunological implications of obesity

BLOCK 9
Definition of cancer and epidemiology
Tumor nomenclature, TNM classification
Differentiation and cell grading, rate of growth
Local invasion
Metastasis, pathways of spread
Oncogenic signaling and tumor microenvironment as drivers of cancer metabolism
Tumor sensing and metabolic adaptations to hypoxia and nutrient deprivation
Signals and targets of metabolic reprogramming in cancer cells
Advantages and liabilities of tumor cell metabolism
Genes in which mutations cause cancer: oncogenes, tumor suppressor genes (gatekeepers and caretakers genes)
Type of genetic alterations responsible for initiating cancer
Activating or gain of function mutations
Ectopic or heterochronic mutations
Chromosome translocations
Loss of function mutations
Genomic instability and tumor progression
Activated oncogenes in hereditary cancer syndrome: MEN2
Gatekeeper tumor suppressor genes in AD cancer syndromes
The two-hit origin of cancer: the hereditary and sporadic forms of retinoblastoma
The Li-Fraumeni syndrome
Caretaker gene in autosomal dominant cancer syndromes
BRCA1 and BRCA2 mutations in familial breast cancer
Familial colon cancer
Counselling and germline mutation testing
The hallmarks of cancer
The cancer-associated genes involved in the hallmarks of cancer
Genomic instability and multistep carcinogenesis
Cancer stem cells
UV and ionizing radiations
Chemical carcinogenesis: initiation, promotion and progression
Metabolic activation of chemical compounds in vivo
Factors that control chemical carcinogenesis
Genotoxic and non-genotoxic effects of carcinogens
Oncogenic DNA and RNA viruses
Genetic mechanisms underlying the oncogenic process
Host interaction with oncogenic viruses
Pathogenic role of viruses into the oncogenic process
Role of bacteria into the oncogenic process: the H. pylori case
The immunosurveillance hypothesis
Determinants of tumor antigenicity
Defensive mechanisms against tumors
Mechanisms of cancer immune evasion
Cancer immunoediting
Principles of cancer immunotherapy
Epidemiologic evidence
Myeloid-derived suppressor cells
Tumor-associated macrophages and neutrophils
Mechanisms of angiogenesis and vasculogenesis
Endothelial progenitors and other pro-angiogenetic bone marrow-derived cells
Angiogenetic cytokines and their receptors
Common and distinctive features of blood and lymphatic vessels
Role of angiogenesis to tumor survival and growth
The role of the tumor microenvironment
Cancer-related anorexia and cachexia
Metabolic mechanisms of neoplastic cachexia
Molecular mediators of neoplastic cachexia
Tumor factors contributing to cancer cachexia
Clinical characteristics of neoplastic cachexia
Paraneoplastic syndromes

BLOCK 10
Platelets
Primary and secondary hemostasis and coagulation cascade
Fibrinolytic system
Mechanisms of atherosclerotic plaque generation: risk factors, clinical manifestations and complications
Thrombus formation and evolution
Thromboembolism and immunothrombosis
Pathogenesis and stages of shock
Disseminated intravascular coagulopathy
Biology of the red blood cell and classification of anemias

BLOCK 11
iPCs-technology as a tool to investigate pathogenesis and therapy of human diseases
Modern translational approaches in immunologic disorders
Bio-informatics approaches in the diagnosis of a new primary immune deficiencies
Regulatory agencies and policies of physicians facing new challenges and technologies
Flow cytometry in diagnosis and therapy of hematologic malignancies
Bone marrow reconstitution
Course syllabus and organization

Single session

Responsible
More specific information on the delivery modes of training activities for academic year 2021/22 will be provided over the coming months, based on the evolution of the public health situation.
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. 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 weighted average of the marks obtained in the oral examinations.
Cardiovascular diseases
Course syllabus
PROGRAM (INTEGRATED):
Lecture 1 - CARDIOLOGY. Cardiovascular risk
Understand the approaches used to identify the genetic predisposition and environmental factors to cardiovascular diseases
To be able to define monogenic vs. multifactorial cardiovascular diseases: description of examples
Understand the clinical impact of risk stratification
Evaluation of the role as cardiovascular risk factors of race and economical condition
Lecture 2 - CARDIOLOGY. Grading the severity of cardiovascular diseases
Perform a medical interview and a general examination of the cardiac patient
Recognize cardiac sounds and the severity of the cardiovascular disease
Capability to define the severity of heart failure
Lecture 3 - NEPHROLOGY. Management of the patient with renal disease
How to identify renal syndromes from the patient's clinical presentation (nephrotic syndrome, nephritic syndrome, positive uranalysis examination, rapidly progressive renal failure, chronic kidney disease) and through specific laboratory investigations, including microscopic urinary sediment analysis
How to measure kidney function (glomerular filtration rate, tubular and endocrine renal function)
The renal biopsy
Lecture 4 - DIAGNOSTIC IMAGING. Ionizing and non-iodizing radiation used in diagnostic imaging
Understand the different radiation used in medical imaging
Describe interactions of different radiations with matter
Describe the possible harmful effects of ionizing radiations
Lecture 4b - DIAGNOSTIC IMAGING: Nuclear Medicine
Understand the basic principles of nuclear image formation
Understand the use of radiopharmaceuticals in diagnostic imaging and therapy
Describe the role of hybrid imaging
Lecture 5 - DIAGNOSTIC IMAGING. Sonography
Describe interaction of mechanical waves with tissues
Describe monographic probes and image genesis for diagnostic purposes
Describe image patterns of different anatomic and pathologic structures
Lecture 6 - PATHOLOGY. Introduction to Anatomic Pathology part I
Define goals and roles of Anatomic and Surgical Pathology in the modern medicine
Describe activities and the work flow at the Pathology Department: histology
Focus on the structure and contents of the pathology report (histological diagnosis, grading, staging, prognostic and predictive parameters)
Lecture 7 - PATHOLOGY - Introduction to Anatomic Pathology part II
Describe activities and the work flow at the Pathology Department: cytology and autopsies
Cytology: Aspitation cytology and exfoliative cytology (pros and cons)
Autopsies: Who, why and when
Lecture 8 - PATHOLOGY. Ancillary techniques in Anatomic Pathology
Describe principles, applications and clinical implication of immunohistochemistry
Describe principles, applications and clinical implication of molecular pathology (PCR-based techniques, FISH)
Lecture 9 - CLINICAL BIOCHEMISTRY. Specimen collection and storage; point of care testing and automation
Recognize the importance of correct blood collection in managing total patient care
Describe what the correct specimen for the requested test is
Differentiate between whole blood, plasma and serum
Describe the collection of serum samples
Describe the collection of the urine sample
Describe the collection of CSF
Illustrate the stability of biological samples
Understand and illustrate the core lab and the point of care testing
Lecture 10 - CLINICAL BIOCHEMISTRY. The quality control in clinical laboratory
Define the relevance of quality control
Define the type and rate of error in laboratory medicine
Define methods for the analytical quality control
Define accuracy and precision in laboratory medicine
Define the analytical goal for precision
Define the biological variability and reference intervals
Lecture 11 - CLINICAL BIOCHEMISTRY. Biobanks and their importance in clinical and scientific fields related to biomedical research
Define a biobank and define a private collection highlighting the differences
Define the relevance of biobanks in clinical research
The role of the informed consent.
Define the different types of collected specimen.
Define the possible clinical and scientific use of different specimen
Define the relevance of right operating procedures of specimen collection
Lecture 12 - CLINICAL BIOCHEMISTRY. Preanalytical variables affecting the Integrity of human biospecimens in laboratory tests and in biobanking
Define preanalytical variables
Define the role of preanalytical variables in laboratory tests
Define the impact of preanalytical variables in NGS and mass spectrometry analytical procedures
Define the impact of preanalytical variables in clinical studies.
Lecture 13 - CARDIOLOGY. Resting ECG
Understanding of the cellular and molecular mechanisms involved in the electrical activity of the heart; the anatomy and physiology of the conduction system; and the electrical vectors throughout the cardiac cycle
Understanding the philosophy behind ECG
Understanding the normal ECG and learning to recognize the characteristic appearances of, and the explanation for, the ECG in the main pathological conditions
Lecture 14 - CARDIOLOGY. Arrhythmias
Understanding the epidemiology, pathophysiology, diagnosis and clinical features of arrhythmias and conduction disturbances
Understanding of the classification and definition of bradycardias, tachycardias, supraventricular arrhythmias (including atrial fibrillation and flutter) and ventricular arrhythmias
Lecture 15 - DIAGNOSTIC IMAGING. Computed Tomography - CT
Describe the technical aspects of a CT scanner
Describe the different acquisitions protocols (axial acquisition, volumetric acquisition, High Resolution acquisition)
Describe image-processing capabilities (multiplanar reconstructions, MIP, Virtual reality reconstructions)
Describe the use of contrast media
Lecture 16 - CARDIOLOGY. Heart-lung interaction
Discuss of the pathophysiology of lung-heart interactions
Discuss of the clinical and physiological modifications that occur during exercise
Evaluate exercise tolerance and differentiate between cardiovascular and pulmonary aetiology of exercise intolerance
Discuss the difference between cardiac and lung dyspnea
Lecture 17 - CARDIOLOGY. O2 consumption
Discuss of Wasserman plots, CPET parameters and their correlation with prognosis
Discuss the use of VO2 to determine heart failure prognosis
Discuss exercise ventilator efficiency for cardiac, pulmonary and cardiopulmonary diseases
Lecture 18 - DIAGNOSTIC IMAGING. Magnetic Resonance Imaging - MRI
Describe the technical aspects of a MRI scanner
Describe the different acquisitions protocols (T1w, T2w, Fat Sat, DWI. Contrast enhanced)
Lecture 19 - PATHOLOGY. Atherosclerosis and Ischemic heart disease
Describe the pathogenesis, morphologic changes and the evolution of the atherosclerotic plaque
Define aneurysms and aortic dissection
Describe the pathogenesis of myocardial infarction (MI), macroscopic and microscopic changes and their temporal evolution; morphologic changes of the MI after reperfusion; the complications of MI
Define Sudden Cardiac Death in adults and describe its causes
Lecture 20 - PATHOLOGY. Non neoplastic and neoplastic diseases of great vessels and heart.
Define aneurysms and aortic dissection
Define vasculitis
Describe neoplastic lesions of the vessels and heart
Lecture 21 - CARDIOLOGY. Ischemic heart disease
Understand myocardial ischemia: from pathophysiology to the clinical spectrum (angina, myocardial infarction)
Comprehend the diagnostic tools for assessing myocardial ischemia
Define the basis of the therapeutic approaches
Lecture 22 - DIAGNOSTIC IMAGING. Nuclear Cardiology. Imaging of ischemia and cardiac function
Describe the role of nuclear medicine in the evaluation of ischemic heart disease and cardiac function
Lecture 23 - PATHOLOGY. Pathology of the endocardium, myocardium and cardiac valves
Define pathogenesis and morphologic changes of endocarditis
Define pathogenesis of cardiomyopathies and their morphologic changes (dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy)
Define pathogenesis and morphologic changes in myocarditis
Define Rheumatic Fever and rheumatic heart disease
Define valvular heart diseases (calcific valvular degeneration and valve prolapse)
Lecture 24 - CARDIOLOGY. Valvular heart disease
Learning the definition of mitral valve diseases
Learning the definition of aortic valve diseases
Learning the definition of tricuspid valve diseases
Learning the definition of pulmonary valve diseases
Hemodynamics of valvular heart diseases
Lecture 25 - CARDIOLOGY. Pericarditis and endocarditis
Myocarditis and pericarditis: understanding of the mechanisms underlying the disease, the pathophysiology of the disease and diagnostic and therapeutic approaches
Endocarditis: understanding of the epidemiology, aetiopathogenesis, pathophysiology, diagnosis and therapeutic approaches
Lecture 26 - DIAGNOSTIC IMAGING. Cardiac imaging
Describe the capabilities and clinical applications of cardiac sonography
Describe the capabilities and clinical applications of cardiac CT
Lecture 27 - DIAGNOSTIC IMAGING. Cardiovascular imaging
Describe the capabilities and clinical applications of cardiac MRI
Describe the different imaging aspects of cardiac failure, ischemic heart disease
Myocarditis and pericarditis
Lecture 28 - DIAGNOSTIC IMAGING. Cardiovascular imaging
Clinical cases
Lecture 29 - CARDIOLOGY. Heart failure part 1
Understanding the evolution of concept of HF
Understanding of the epidemiology and prognosis of heart failure with reduced and preserved ejection fraction
Understand the definition of heart failure and recognize the different underlying causes and the precipitating factors of heart failure
Understanding of the pathophysiology of heart failure and systolic and diastolic dysfunction
Lecture 30 - CARDIOLOGY. Heart failure part 2
To be able to evaluate the prognosis of the heart failure patient
To be able to manage acute and chronic HF
Understanding of the role of exercise training programmes in HF patients
Understand the complications of HF
Understanding the therapy approach of HF
Lecture 31 - MICROBIOLOGY. Viruses and myocardial diseases
Understand the role of viruses in inducing myocardial diseases
To learn the epidemiology and pathogenesis of virus-induced myocarditis and pericarditis
To be able to define the diagnostic approach and the laboratory monitoring or viral cardiac diseases
Lecture 32 - MICROBIOLOGY. Bacteria and cardiac diseases
Understand the epidemiology and etiology bacterial cardiac diseases
Understand the pathogenesis of bacterial cardiac diseases
To be able to define the diagnostic approach, and to learn basic aspects of antimicrobial therapy
Lecture 33 - MICROBIOLOGY. The role of microbes in atherosclerosis and other chronic cardiac diseases
Understand the main epidemiological aspects of microbes possibly involved in chronic cardiovascular diseases
Understand the pathogenesis of microbe - related chronic cardiovascular diseases
Lecture 34 - CARDIOLOGY. Pulmonary hypertension
Understanding of the pathophysiological classification of pulmonary hypertension and the type of investigations used for diagnosing pulmonary hypertension and recognizing the etiology
Understanding of the medical, surgical and interventional management of pulmonary hypertension
Lecture 35 - CLINICAL BIOCHEMISTRY. Cardiac monitoring in clinical laboratory and biological fluids profiling: a new challenge in clinical laboratory
Describe an ideal marker
Discuss their kinetic of release, sensitivity and specificity
Define biochemical markers for AMI
Discuss the use of troponin in AMI management and define its limitations
Define future markers
Define why biological fluids should be profiled
Describe the most innovative technologies for profiling biological fluids
Discuss the significance and relevance of profiling results
Lecture 36 - NEPHROLOGY. The body fluid imbalance and the pathophysiology of the edema
Evaluation of hypovolemia and volume overload in patients with normal and altered renal function
Clinical management and diagnostic algorithm of hyponatremia and hypernatremia
Clinical management and diagnostic algorithm of hypokalemia and hyperkalemia
Clinical management and diagnostic algorithm of acid-base disorders
Lecture 37 - NEPHROLOGY. Glomerular disorders
Clinical presentation and management of most frequent primary and secondary glomerulonephritis, microscopic urinary sediment analysis, follow up of chronic glomerulonephritis
Lecture 38 - MICROBIOLOGY. Microbes and urinary tract infection
Understand the epidemiology of urinary upper and lower urinary tract infection (UTI)
Understand the etiology and pathogenesis of bacterial and viral UTI
To be able to define the diagnostic approach, from the sample collection to the laboratory result evaluation
Lecture 39 - NEPHROLOGY. Management of patients with tubulo-interstitial nephritis
Common etiologies, clinical presentation, diagnostic algorithm for both acute nephritis and chronic interstitial nephritis
Lecture 40 - NEPHROLOGY. Approach to patients with urinary tract and renal infection
Common etiologies and clinical presentation of cystitis, acute and chronic pyelonephritis, reflux nephropathy, CAKUT syndrome
Lecture 41 - CARDIOLOGY. Congenital heart diseases
Discuss the anatomy of the heart, veins and great vessels, their major congenital malformations and the principles of nomenclature
Discuss the physiology of the foetal and transitional circulations; aetiology of congenital heart disease, including the developmental anatomy of the heart and vasculature
Discuss the pathophysiology, natural history and complications of: valve and outflow tract lesions; septal defects; patent ductus arteriosus; Eisenmenger syndrome; coarctation of the aorta; Ebsteins's anomaly; aortic and pulmonary artery malformations; venous anomalies; transposition of the great arteries (complete and congenitally corrected); tetralogy of Fallot; congenital malformations of coronary arteries; cyanotic congenital heart disease and secondary erythrocytosis; and pulmonary hypertension in congenital heart disease
Evaluate adolescent and adult patients with simple congenital heart defects (grown-up congenital heart disease - GUCH), including those who have undergone cardiac surgery
Describe and recognize physical signs of congenital heart disease and its complications
Lecture 42 - NEPHROLOGY. Acute kidney injury / acute renal failure
Common etiologies and clinical presentation of acute kidney injury in the hospital and community settings
Differential diagnosis of the various clinical presentations (pre-renal, parenchymal, obstructive renal injury)
Lecture 43 - NEPHROLOGY. Chronic kidney disease - CKD
Common etiologies and clinical presentation of CKD
Systemic consequences of CKD, based on loss of physiologic functions of the kidneys
Endocrine abnormalities linked to CKD. Introduction to the artificial kidney
Lecture 44 - NEPHROLOGY. Introduction to artificial kidney
Lecture 45 - NEPHROLOGY. Renal vascular diseases
Vascular injury to the kidney
Hypertensive vascular disease
Lecture 46 - DIAGNOSTIC IMAGING. Kidney imaging
Describe imaging aspects of acute renal failure
Describe imaging aspects of chronic renal failure
Understand imaging of nephrovascular hypertension
Lecture 47 - DIAGNOSTIC IMAGING. Nuclear Medicine. Imaging of renal function
Understand the role of radiopharmaceutical in the evaluation of renal function
Lecture 48 - NEPHROLOGY. Case studies
Four hours of non-formal teaching will be devoted to case studies, where students will be challenged to understand and explain pathophysiological mechanisms of kidney diseases based on a simulated clinical case and on information derived from published articles
Lecture 49 - DIAGNOSTIC IMAGING. Kidney imaging
Describe imaging aspects of urinary tract stones and infections
Describe diagnostic imaging in renal and urinary tract tumors
Lecture 50 - DIAGNOSTIC IMAGING. Kidney imaging
Clinical cases discussion
Lecture 51 - NEPHROLOGY. Principles of renal transplantation
How to get on the transplant waiting list, selection of the recipients, management of the waiting list, different types of donors, early and late complications of renal transplantation
Lecture 52 - MICROBIOLOGY. Infectious agents and renal transplant
Understand the role of infectious agents in the outcome of renal transplant
Understand the pathogenesis of viral induced organ rejection
To be able to define the diagnostic approach and the laboratory monitoring or viral replication
Lecture 53 - NEPHROLOGY. Management of patients with diabetes
When to suspect a renal involvement and how to detect an early diabetic nephropathy (signs, symptoms and specific laboratory investigations)
The stages of diabetic nephropathy: microalbuminuria, nephrotic syndrome, renal failure and uremia
Treatment and follow-up of diabetic patients
Lecture 54 - CINICAL BIOCHEMISTRY. Diabetes diagnosis and monitoring in laboratory medicine
Diabetic nephropathy micro and macro albuminuria
Define renal clearance
Urine analyses
Glycated proteins assessment
Define additional tests
Lecture 55 - NEPHROLOGY. Management of patients with hereditary nephropathies
When to suspect a hereditary nephropathy and how to conduct a clinical interview in such conditions (autosomic dominant polycystic kidney disease, Alport Syndrome, benign familial hematuria, Fabry disease)
Inherited renal tubular disorders : Bartter, Gitelman, RTA etc
When to suspect a hereditary nephropathy and how to conduct a clinical interview in such conditions (autosomic dominant polycystic kidney disease, Alport Syndrome, benign familial hematuria, Fabry disease)
Lecture 56 - MICROBIOLOGY. Urinary tract infection and microbe associate renal diseases
To learn basic aspects of antimicrobial therapy
Understand the impact of viruses and other agents in acute and chronic renal diseases
To learn the role of infectious agents in kidney, prostate and urinary tract cancer
Lecture 57 - PATHOLOGY. Non neoplastic diseases of the kidney
Glomerular diseases: pathogenesis and mechanisms of progression; diseases associated with nephritic and nephrotic syndromes.
Tubular and Interstitial Diseases
Vascular Disease
Lecture 58 - NEPHROLOGY. Analysis of the urinary sediment
To learn how to recognize diseases based on the characteristics of the urine composition and microscopic analysis
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills
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:
Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
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
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:
Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
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
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:
Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
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
Lectures, Clinical cases, Case studies and Laboratory skills
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:
Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
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
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:
Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
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
Lectures, Clinical cases, Case studies and Laboratory skills
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:
Edinburgh Renal Education Pages Textbook. Free textbook available at http://www.edrep.org/pages/textbook.php
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
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: Alteri Claudia
Nephrology
MED/14 - NEPHROLOGY - University credits: 4
Lessons: 48 hours
Pathology
MED/08 - PATHOLOGY - University credits: 1
Lessons: 12 hours
Professor: Fusco Nicola
Radiology
MED/36 - IMAGING AND RADIOTHERAPY - University credits: 2
Lessons: 24 hours
Professor(s)
Reception:
By appointment
Zoom/Teams/Skype
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