Obstetrics, gynecology and pediatrics

A.A. 2021/2022
10
Crediti massimi
120
Ore totali
SSD
MED/38 MED/40
Lingua
Inglese
Obiettivi formativi
The course of Obstetrics, Gynecology and Pediatrics aims at living students the fundamental notions for the care of women, mothers and infants and children. In particular, the course of Obstetrics and Gynecology aims at acquainting the student with the varied aspects of medical care for women, with emphasis on acquiring the basic skills of gynecology and obstetrics. The course of Pediatrics course aims at training students about common conditions of newborns, children and adolescents as well as less common but important chronic conditions in these age groups.
Risultati apprendimento attesi
Students are expected to gain knowledge on:
-the physiology of the woman in the various phases of life
-the physiopathology of the main diseases of the various phases of women's life, including pregnancy
At the end of the course, the student should have gained experience in many aspects of pediatric clinical specialties, including, but not limited to:
-neonatology;
-pediatric infectious diseases, gastroenterology, hepatology, allergology, pneumology; neurology, rheumatology, endocrinology, nephrology, hematology and oncology
- pediatric nutrition; genetics and metabolic diseases.
Programma e organizzazione didattica

Edizione unica

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.
Prerequisiti
To take the Obstetrics Gynecology and Pediatrics 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).
OBSTETRICS AND GYNECOLOGY: students must review the reproductive physiology from the Functions course
PEDIATRICS: students must review the physiology of growth from the Functions course
Modalità di verifica dell’apprendimento e criteri di valutazione
Students' evaluation will be assessed with oral examinations focused on the topics developed during the course. The "Obstetric & Gynecology" and the "Pediatrics" modules of the exam will be organized in different dates. Once passed, the mark obtained in one module is valid until the students complete the exam with the other module. The final mark is the average of mark obtained in the two modules.
Obstetrics, gynecology
Programma
GYNECOLOGY
Session 1. Pelvic anatomy
The bony pelvic
The external genitalia & pelvic viscera
The pelvic support (muscles and fascia)
Vascularization and innervation
Session 2. The female physiology
the normal menstrual cycle
primary and secondary amenorrhea: diagnostic algorithm and principles of treatment
menstrual cycles abnormalities: diagnostic algorithm and principles of treatment
contraceptive methods: efficacy, side effects, contraindications, counseling
Session 3. Abnormal uterine (genital) bleeding
Definition
Most common causes (by age)
Fibroids
Endometrial Polyps
Hyperplasia
Diagnostic algorithm and treatment strategy
Session 4. Inflammatory diseases
Vaginal discharge: differential diagnosis
Sexually transmitted diseases (STDs)
Most common causes
Diagnosis
Treatment
Complications -> PID
PID
Criteria for hospitalization, principles of therapy
Complications
Session 5. Reproductive endocrinology
How to diagnose, investigate and treat couples with infertility
Session 6. Acute and chronic pelvic pain
Clinical Presentation
Diagnostic algorithm most common causes
Endometriosis: principles of diagnosis and treatment
Session 7. Pelvic masses
Definition
Most common causes (by age)
Diagnostic algorithm and treatment strategy
Session 8. Menopause
Definition
Counseling
Prevention of complications
Session 9. Urogynecology
Pelvic prolapse: definition, diagnosis and treatment strategies
Urinary incontinence: definition, diagnosis and treatment strategies
Session 10. Cervical cancer
Etiopathogenesis: HPV
Primary and secondary prevention strategies
Vaccination
Screening
Invasive cancer: diagnosis, staging, and principles of treatment
Session 11. Endometrial cancer
Pathogenesis and risk factors
Clinical presentation and diagnosis
Principles of treatment
Session 12. Ovarian cancer
Epidemiology by different age and histologic subtypes
Pathogenesis
The tubal origin -> BRCA mutations and implications
Clinical presentation and diagnosis (by histology)
Principles of treatment (by histology)

OBSTETRICS
Session 1. Antenatal care
Maternal adaptation to pregnancy
Assessment of maternal wellbeing
Fetal and placental development
Congenital infections: prevention, counselling, assessment, treatment
Prenatal diagnosis of congenital anomalies
Session 2. Early pregnancy assessment
Bleeding in early pregnancy [pregnancy of unknown location; pregnancy of unknown viability; ectopic pregnancy; gestational recurrent miscarriage] trophoblastic disease;
Legal abortion
Nausea and vomiting in pregnancy
Nutrition in pregnancy; safe behaviors in pregnancy
Medications; vaccinations; diagnostic radiology
Rh immunization
Session 3. Maternal-fetal medicine 1
Preterm birth and pPROM
Abnormalities of fetal growth
Gestational hypertension
Gestational diabetes and obesity
Session 4. Maternal-fetal medicine 2
Bleeding in the third trimester
Twin pregnancy
Trombophilias and VTE
Intrahepatic cholestasis of pregnancy
Urinary tract infections
Session 5. Physiology of labor and delivery:
Mechanisms of labor and delivery; intrapartum care
Assessment and treatment of abnormal labor progression [dystocia in I and II stage]
Fetal heart rate tracings
Epidural analgesia
Puerperium
Session 6. Abnormal labor and delivery:
Induction of labor
Obstetric emergencies [umbilical cord prolapse; shoulder dystocia; post partum hemorrhage]
Operative vaginal delivery
Cesarean delivery and vaginal birth after cesarean
Metodi didattici
Lectures, Case studies, Clinical examination
Materiale di riferimento
Beckmann and Ling's Obstetrics and Gynecology, Wolters Kluwer
Pediatrics
Programma
PEDIATRIC HEALTH:
Lecture - Introduction to pediatric medicine (1)
To know and understand growth and development in neonates, children and adolescents;
To understand the impact that illness may have on growth and development.
Lecture - Introduction to pediatric medicine (2)
To know how to record infants and children's medical history
To know how to perform a physical examination in children
Lecture - Vaccine-preventable diseases
To know recommended vaccination in pediatric age in Italy and other countries;
To describe epidemiology and clinical aspects of vaccine-preventable diseases;
To describe immunogenicity, efficacy and safety of vaccines recommended in pediatric age;
To understand the indirect benefits of vaccine prevention.
Lecture - Breastfeeding and nutrition in pediatric age
To know the importance of breastfeeding;
To describe alternative methods of feeding;
To describe when, how and why complementary feeding is recommended;
To describe principles of nutrition in different pediatric ages;
To know the long-term effect of an appropriate nutrition in the first years of life.

NEONATAL PHYSIOLOGY AND PATHOLOGY:
Lecture - Approach to the newborn and neonatal screening
To describe neonatal adaptation to extrauterine life;
To summarize physiologic disorders in neonatal age (e.g., neonatal jaundice);
To describe main diseases in the newborn (e.g., respiratory failure and indication to invasive and non-invasive ventilation, main infectious risks, including sepsis);
To know screening tests recommended in neonatal age.
Lecture - Approach to premature newborn
To summarize main disorders associated with premature birth
To know different patterns of perinatal brain damage
To describe nutritional management in premature newborns
To describe neurodevelopmental deficits associated with premature birth
Lecture - Congenital Infections
To know how to diagnose, manage and follow up congenital TORCH infections

PEDIATRIC PATHOLOGY:
Lecture - Infantile Viral Exanthems
To know how to recognize and manage viral exanthems in pediatric age: measles, rubella, chickenpox, fifth disease, rubeola
Lecture - Pediatric nephrology
To know when to suspect urinary tract infection in pediatric age and how to manage it;
To describe approach to nephrotic syndrome in the first years of life;
To summarize etiopathogenesis of glomerulonephritis and its possible complications in childhood.
Lecture - Upper respiratory tract infections
To know how to manage pediatric pharyngotonsillitis;
To describe etiology as well as diagnostic and therapeutic approach to acute otitis media;
To summarize clinical aspects of rhinosinusitis in the first years of life.
Lecture - Allergic diseases
To summarize main causes of food allergy in the first years of life and principles of management;
To describe how to diagnose and treat atopic dermatitis in pediatric age;
To know main causes of urticaria in childhood;
To summarize asthma etiology and pathogenesis in the first years of life, how to diagnose and to treat as well as its outcome.
Lecture - Congenital cardiopathies
To describe when to suspect congenital cardiopathies;
To summarize characteristics and complications of congenital cardiopathies.
Seminar - Inherited metabolic diseases
To know inherited metabolic diseases routinely screened in the first days of life;
To summarize when to suspect inherited metabolic diseases and how to perform diagnosis;
To describe therapeutic approaches (including advanced therapies) in inherited metabolic diseases.
Seminar - Nutritional Evaluation & Metabolic Syndrome
To discriminate among bioindicators of nutritional status
To interpret nutritional status
To discriminate among the various aspects of the so called "metabolic syndrome"
Lecture - Neurologic development and mental delay
To know main stages of neurodevelopment in the first years of life;
To summarize the main causes of mental delay and cerebral palsy;
To describe characteristics of autism, ADHD and main learning disabilities;
Lecture - Pediatric rheumatology
To describe acute rheumatic fever;
To describe idiopathic juvenile arthritis;
To know when to suspect Kawasaki disease, its clinical course and its management.
Lecture - Pediatric endocrinology
To describe risk factors and approach to diabetes mellitus in pediatric age;
To report when to suspect an early or late puberty;
To summarize disorders of sexual development.
Lecture - Common neurologic signs and symptoms
To describe etiopathogenesis of neonatal seizures and to describe the diagnostic and therapeutic approach
To describe characteristics of seizures and epilepsy in the pediatric age;
To know the diagnostic approach to headache in children and adolescents.
Lecture - Lower respiratory tract infections and tuberculosis
To summarize etiopathogenesis and management of bronchiolitis;
To describe signs and symptoms of community-acquired pneumonia in pediatric age;
To know modern diagnostic and therapeutic approach to pediatric community- acquired pneumonia.
Lecture - Genetic diseases
To know when to suspect a genetic disease on the basis of clinical findings;
To describe how to collect clinical history in a child with suspected genetic disease;
To summarize diagnostic assays recommended for genetic disease.
Seminar - Pediatric hepatology
To describe main cause of cholestasis in neonates and infants;
To know clinical and laboratory manifestations as well as outcome of infectious hepatitis according to its etiology in pediatric age.
Lecture - Medical and surgical emergencies
To know clinical signs and symptoms in hypertrophic pyloric stenosis;
To describe how to manage head trauma in pediatric age;
To report how to evaluate burns in pediatric age;
To summarize main reasons for surgery in neonates, children and adolescents.
Lecture - Lymphadenopathy and splenonegaly in children
To know the main differential diagnosis of lymphadenopathy and splenomegaly in children
Common infections causing lymphadenopathy and/or splenomegaly: acute mononucleosis, cytomegalovirus infection, cat scratch fever
Tuberculous and non-tuberculous mycobacterial lymphadenitis
Lecture - Primary and secondary immunodeficiencies
To know when to suspect a primary immunodeficiency;
To describe the main primary immunodeficiencies in pediatric age;
To summarize causes of secondary immunodeficiencies in childhood and their outcome.
Lecture - Central nervous system infections
To know signs and symptoms of meningitis and encephalitis in pediatric age;
To summarize diagnostic approach to central nervous system infections in childhood;
To describe therapeutic management of meningitis and encephalitis in the first years of life.
Lecture - Acute diarrhea
To summarize etiology of acute diarrhea and its management in the first years of life;
To know how to manage dehydration in pediatric age
Seminar - Chronic diarrhea
To summarize etiology of chronic diarrhea;
To describe when to suspect a celiac disease in childhood and the correct diagnostic and therapeutic approach.
To describe when to suspect a Inflammatory Bowel Disease in childhood and the correct diagnostic and therapeutic approach.
Seminar - Vomiting in children
To know the main differential diagnosis of vomiting in pediatric age
To know how to manage vomiting in pediatric age
Seminar - Intestinal parasitoses
To know the main intestinal parasitoses in children
To know how to diagnose and treat intestinal parasitoses in children
Seminar/Lecture - Pediatric hematology and oncology
To know the main causes of anaemia in pediatrics;
To summarize management of idiopatic thrombocytopenic purpura;
To describe when to suspect leukemia and how to confirm the diagnosis in childhood;
To describe clinical presentation and outcome of neuroblastoma;
Metodi didattici
Lectures, Case studies, Clinical examination
Materiale di riferimento
Nelson Textbook of Pediatrics, Elsevier (also available as ebook in the library system of the university)
Moduli o unità didattiche
Obstetrics, gynecology
MED/40 - GINECOLOGIA E OSTETRICIA - CFU: 5
Lezioni: 60 ore

Pediatrics
MED/38 - PEDIATRIA GENERALE E SPECIALISTICA - CFU: 5
Lezioni: 60 ore

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Clinica Pediatrica De Marchi
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Dipartimento di Scienze della Salute San Paolo; ASST Santi Paolo e Carlo, Milano