ENDOCRINOLOGICAL, KIDNEY AND GASTROINTESTINAL DISEASES
Academic year and teacher
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- Versione italiana
- Academic year
- 2017/2018
- Teacher
- MARIA CHIARA ZATELLI
- Credits
- 9
- Didactic period
- Secondo Semestre
Training objectives
- The integrated course gathers the teaching course in Endocrinology, Nephrology and Gastroenterology, with the aim of providing the physiopathological bases and clinical manifestations of the main endocrine, kidney and gastrointestinal diseases.
ENDOCRINOLOGY
At the end of the course the student should know the main basis of endocrine and metabolic physiopathology. In particular the student should learn:
•molecular and physiopathologic mechanisms of endocrine and metabolic diseases, including endocrine cancers, and their pathologic aspects
•diagnostic approaches (clinical, biochemical and imaging)
•therapeutic aspects and measures of prevention of these diseases
The basic acquired abilities will be:
•to recognize, diagnose and treat the main endocrine and metabolic diseases
•to discriminate normal and pathologic growth as well as to recognize disorders of sexual differentiation.
•to identify gender-related issues in endocrine diseases
NEPHROLOGY
This course will equip the student with a broad view of aetiology and physiopathology of renal and uro-genital tract diseases. Epidemiology will be analysed as well as clinical approach using case reports.
On this background, clinical symptoms of the diseases will be systematically described in order to achieve a good diagnostic (clinical and laboratory) and therapeutic approach. Special emphasis is placed upon early diagnosis and therapy for the systemic life-threatening diseases.
The educational aim is focused on promoting knowledge in: a) the early recognition of the diseases; b) the symptoms that could induce, in the GP, the suspect of a relevant diseases (so-called "red flags") ; c) the ability to identify predictive factors of "outcome" of the diseases; d) the development of a critical appraisal of a diagnostic pathways; e) the basic therapeutic approach. Furthermore, students will acquire notions on the interpretation of the most relevant laboratory and diagnostic procedures. Finally, the student will be able to illustrate to the patient the relevant aspects of the diseases and to suggest the right behaviour in order to prevent or minimize the risk.
GASTROENTEROLOGY
At the end of the course the student should know the main causes and pathophysiological mechanisms of the digestive diseases. The main acquired knowledge will be pathological basis of the digestive diseases
diagnostic approach of digestive diseases
therapeutic outlooks of digestive diseases
The basic acquired abilities will be:
•knowledge of the relevant clinical aspects of the digestive diseases
•ability to take up the clinical practice,
•implement diagnostic and therapeutic procedures of the main digestive diseases.
Furthermore, students will acquire notions on the interpretation of the most relevant laboratory and diagnostic procedures. Finally, the student will be able to illustrate to the patient the relevant aspects of the diseases and to suggest the right behaviour in order to prevent or minimize the risk. Prerequisites
- The student should have adequate prior knowledge on human anatomy of the endocrine, kidney and digestive system, biochemistry and physiology of the endocrine, kidney and digestive system, pathology of the endocrine, kidney and digestive system.
Course programme
- ENDOCRINOLOGY
Pathologic aspects of the endocrine and metabolic diseases.
Diagnostic procedures (clinical, biochemical and imaging) for the endocrine and metabolic diseases. Molecular analysis in the diagnosis of endocrine neoplasia. Role of gender-related differences concerning incidence, physiopathology, diagnosis and therapy in endocrine diseases.
Lectures about the pathophysiological and clinical aspects of the endocrine and metabolic disorders, with specific reference to:
- Thyroid gland: hypothyroidism, hyperthyroidism, thyroiditis, goiter, thyroid nodule and thyroid cancer.
- Physiopathology of calcium and bone metabolism. Osteoporosis. Parathyroid diseases: hyperparathyroidism, hypoparathyroidism, pseudo-hypoparathyroidism.
- Physiopathology of the hypothalamo-pituitary system. Anterior pituitary diseases (pituitary adenomas, excess or deficiency of anterior pituitary hormone production). Neurohypophysis: vasopressin and oxitocin. Diabetes insipidus.
- Male and female hyogonadism. Menstrual disturbances. Male and female infertility.
- Adrenal gland: adrenal insufficiency, Cushing syndrome, congenital adrenal hyperplasia, hyperaldosteronism, pheochromocytoma, adrenal incidentaloma.
- Definition and endocrine aspects of hypertension.
- Multiple endocrine neoplasia type 1 and type 2.
Neuroendocrine tumors and carcinoid syndrome.
- Diabetes mellitus: classification, pathogenesis, clinical manifestations, and complications. Treatment and monitoring of type 1 and 2 diabetes.
- Hypoglycemic syndromes.
- Obesity. Dyslipidemia. Metabolic syndrome.
- Clinical aspects of growth and growth disorders. Disorders of sexual differentiation.
Medical therapy and/or surgical approach to neoplastic and non-neoplastic diseases.
Practical lessons with the patients and discussion on clinical cases.
NEPHROLOGY
General diagnostic of renal diseases: proteinuria, haematuria, creatininemia, clearance of creatinine and glomerular filtration. Primary and secondary glomerular nephropathies; clinical aspects, diagnosis and therapy. Hydratation and electrolytes disorders: potassium and acid-base balance disorders. Acute and chronic, infective and non infective, tubular-interstitial nephropaties. Cystic renal diseases. Acute and chronic vascular nephropaties. Acute kidney failure: etiology, physiology, clinical aspects and therapy. Chronic kidney failure: etiology, physiology, clinical aspects, therapy and complications. Kidney dialysis and kidney transplantation. Protecting the kidney: general aspects.
Clinical management of nephrovascular hypertension, and renal lithiasis.
Moreover, the integration of knowledge of specific sex/gender factors of certain diseases will represent important issue, with particular attention to the differences, in an integrated diagnostic-therapeutic olistic pathway.
GASTROENTEROLOGY
Esophagitis and Gastroesophageal reflux disease
Gastritis, Gastric Ulcer, Duodenal Ulcer, Helicobacter pylori
Inflammatory Bowel diseases
Functional Dyspepsia; Irritable Bowel Syndrome
Maldigestion, Malabsorption, Celiac disease
Diarrhea, Constipation; Diverticulosis and Diverticulitis of the colon
Upper and lower gastro-intestinal bleeding. Gallstone disease; Chronic Pancreatitis, clinical aspects . Liver Cirrhosis
Problem solving on clinical cases Didactic methods
- ENDOCRINOLOGY
The course is organized as follows:
•frontal lectures on all the course’s topics;
•clinical case seminars
•tutorials at the outpatient care (both visits and thyroid ultrasound), Day Hospital, in-patient care and Laboratory of the Section of Endocrinology and Internal Medicine, Dept. of Medical Sciences of the University of Ferrara at the Hospital of Ferrara. Learning assessment procedures
NEPHROLOGY
Lectures and case reports
GASTROENTEROLOGY
Lectures and problem solving on clinical cases. Learning assessment procedures
- ENDOCRINOLOGY
The aim of the exam is to verify at which level the learning objectives previously described have been acquired, by an oral test lasting 20-30 minutes with 4-5 questions, that will evaluate the acquired knowledge. In addition, the test will evaluate the capacity of connecting the acquired notions. To pass this test it is required to get at least 18 points out of 30.
NEPHROLOGY
Multiple choice written test: 30 closed-answer questions, with 4-5 possible responses each (one only right response), with a score definition of 1 point for each correct response, 0 point for each ungiven response, - 0.25 point for each wrong response. Positive test: equal or higher than 18/30. Allowed time: 30 minutes.
GASTROENEROLOGY
Oral exam, with 2-3 questions, 15-20 min. The evaluation is based on the consistence of the answers, as well as on the exposition clearness, on the capacity to identify the diagnostic proceeding and the differential diagnosis.
THE FINAL GRADE IS A ARITHMETIC AVERAGE OF THE MARKS OBTAINED IN EACH OF THE THREE TESTS Reference texts
- ENDOCRINOLOGY
Faglia G., Beck-Peccoz P., Spada A., Malattie del sistema endocrino e del metabolismo, V edizione, McGraw -Hill, Italia 2013
Monaco F., Endocrinologia Clinica, V edizione 2011, Società Editrice Universo- Roma
NEFROLOGY
Chapters treating renal disease included in Internal Medicne Textbook suggested by Professors dealing with this item
www-sin-italy.org (web site of the Italian society of nephrology)
GASTROENEROLOGY
Manuale di Gastroenterologia. Unigastro 2013-2015, Il Pensiero Scientifico Ed.
Sleisenger and Fordtran's Gastrointestinal and Liver Disease- 2 Volume Set, 9th Edition.
