02359 - General Pathology and Physiopathology (A)

Learning outcomes

The students will learn the etiology of the disease processes, the pathogenetic mechanism of their development, the basic reactions to abnormal stimuli and the morphological changes they induce in cells and tissues, together with the systemic and functional consequences for the organism. By the elaboration of molecular, morphologic, microbiologic and immunologic knowledges, the students will understand the wherefores of the signs and symptoms manifested by patients and will be provided with a sound foundation for evidence based medicine.

Course contents

Cellular and extracellular pathology. Cell adaptations: hypertrophy, hyperplasia, atrophy, metaplasia. Cell death: morphological and molecular aspects of necrosis and apoptosis. Anoikis, autophagy, entosis. Vacuolar degeneration. Dystrophic and metastatic pathological calcifications. Amyloidosis, molecular basis of Alzheimer's disease and prion diseases. Lipid trafficking: steatosis and familial hypercholesterolaemia.

Free radicals and reactive oxygen species. Formation mechanisms and effects on fabrics; enzymatic and non-enzymatic protection systems.

Environmental pathology. Damage from: exciting and ionizing radiation; passage of electric current; high and low temperatures; cigarette smoke; ethanol abuse.

Inflammation, regeneration and repair. Acute inflammation: cells and chemical mediators, vascular phenomena, types of exudate, cellular phenomena, adhesion molecules, receptor-ligand interactions and activation, chemotaxis, phagocytosis and bacteriocidia, NETs and netosis. Neutrophils and bacterial biofilm. Chronic nonspecific and granulomatous inflammation, pathogenesis of tuberculosis. Pneumoconiosis. Regeneration and repair of tissues, wound healing. Pathological outcomes of inflammation and repair. Sclerosis and cirrhosis.

General physiopathology: Thermoregulation, non-febrile hyperthermia, malignant hyperthermia, fever. Thrombosis and embolism. Pathogenesis of shock and heart attack. Atherosclerosis: risk factors, formation of atheromatous plaque, consequences. Other arteriosclerosis: Mönckeberg medial calcific sclerosis and arteriolosclerosis. Ethiopathogenesis of diabetes mellitus and its complications. Diabesity and metabolic syndrome. Edema.

The biological basis of aging: role of telomeres and oxidative metabolism; progeroid syndromes; relationships between aging and inflammation: inflammaging.

The microbiota in health and disease. Relationship with the immune system and metabolism.

The low-grade systemic inflammation in relation to neoplastic and metabolic diseases: obesity, diabetes, atherosclerosis, cancer. Role of stress and relationships with the central nervous system.

Readings/Bibliography

Robbins-Cotran, The pathological basis of disease, 9th edition, Elsevier

Teaching methods

A total of 64 hour of lectures. It is strongly recommended to print the slides, and to use the prints as a track to make notes. The histopathology laboratories will be made with small groups of students. Each drill lesson will be preceded by a preparatory lecture.

Assessment methods

The exam is oral and aims to evaluate the knowledge acquired by the student on teaching topics in order to achieve the educational objectives. The exam assesses the student's ability to frame the topic of general pathology or general pathophysiology on which he/she is questioned and to expose it by making the necessary logical-deductive connections, also in relation to specific morphological alterations. The coherence of the conceptual succession and the appropriateness of the scientific language are further elements of evaluation. The examination of the General Pathology and Physiopathology Course includes the observation and oral description of a microscopic preparation up to the recognition of the specific histopathological picture.

Graduation of the final grade

Insufficient: lack of preparation. Serious and repeated conceptual errors.

18-19: knowledge of the basic concepts without serious gaps. Exposition of concepts and language as a whole acceptable.

20-24: knowledge of the basic concepts without gaps. Ability to analyze and link in partial autonomy. Exposure of discrete concepts and language.

25-29: preparation of good or very good level or even excellent preparation but with inaccuracies in the presentation that compromise the achievement of full marks. Ability to analyze and link independently. Exposure of concepts in the right succession and mastery of the language.

30-30L: full preparation, consolidated and without inaccuracies on the topics covered in the course. Ability to promptly frame the topic. Ability to analyze and connect independently. Concepts in the right succession and full command of the specific language.

The exam will focus on the topics covered in class and will be supported with the Professor who taught. Each student will therefore take two tests in Pathology and General Physiopathology which will contribute 50% to the final grade. The General Pathology and Physiopathology exam will take place together with the General Pathology Laboratory test. The final grade will derive from the mathematical average of the marks reported in the two individual tests, approximated by excess (-,5). Honors will be awarded to the Student who has been proposed for honors by at least one of the two Professors and only if the full grade (30/30) has been achieved in the other part.

Teaching tools

Slides are available from the "Virtuale" website

Office hours

See the website of Massimiliano Bonafè