CLINICAL METHODOLOGY II
Academic year and teacher
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- Versione italiana
- Academic year
- 2022/2023
- Teacher
- CARLO CERVELLATI
- Credits
- 14
- Didactic period
- Secondo Semestre
Training objectives
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Modulo: 005987 - CHIRURGIA GENERALE
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Training objectives
GENERAL SURGERY
The course of Chirurgia III ed emergenze medico-chirurgiche consists of three modules. The general surgery module aims to provide theoretical and practical knowledges to prepare students to recognize emergency surgery pathologies and to define the appropriate pathway for diagnosis and treatment.
ANESTHESIA and INTERNAL MEDICINE
The Anesthesia module aims to provide the knowledge for being able to recognize and deal with emergency, both in the pre-hospital and intra-hospital phase; for being able to evaluate different reactions and behaviors in relation to gender in emergency. At the end of the course the student will know how to apply the differential-diagnostic decision-making process and the treatment of diseases and syndromes that compromise vital functions, even in complex clinical situations. Finally, he / she must know how to illustrate to the patient the objectives of anesthesia, indications and drawbacks of general and loco-regional anesthesia.
Regarding PAIN THERAPY:
The student will know the principles of pain therapy; The pathophysiological mechanisms of pain and the main pain control techniques. Pain rating scales. Pharmacological principles of pain therapy.
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Modulo: 015423/2 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA
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CLINICAL BIOCHEMISTRY aims to give to the student the capacity of using and translating the information and data provided by Laboratory Medicine in clinical practice, i.e. screening, diagnosis, prognosis, and monitoring of therapeutic efficacy.
Knowledge and understanding:
At the end of the course the student will:
- be able to interpret and apply in clinical practice the data generated by clinical biochemistry labs, regarding renal and hepatic functionality, electrolytes, markers of inflammation, markers of lipid and carbohydrate metabolism.
- be able to use the quantitative information present in a laboratory analysis report in a clinically useful ‘tool'
-have knowledge of the gender diffrence of diagnostic profile related to some pathologies
Applying knowledge and understanding:
At the end of the course the student will have developed the ability to:
- understand and correctly employ the main diagnostic exams;
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Modulo: 47775 - ANATOMIA PATOLOGICA
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The PATHOLOGY module aims to provide knowledge on the main methodologies used in pathology diagnostics to be able to understand and correctly use the pathological data for prevention, diagnosis, prognosis and therapy of diseases. Furthermore it provides the systematic treatment of the pathological basis of diseases of the breast, of the gastrointestinal tract, of the skin, of the endocrine glands, of soft tissues and bone.
Knowledge and understanding:
At the end of the course the student will:
- know the principles and purposes of diagnostic procedures used in Pathology and the treatment modalities of various biological samples submitted to pathological exam;
- know the basic concepts about the epidemiological, etiopathogenetic, morphological, clinicopathological and biomolecular characteristics of pathological processes of the breast, of the gastrointestinal tract, of the skin, of the endocrine glands, of soft tissues and bone;
- will be able to understand the clinical pictures related to different pathologies of the aforementioned systems and to understand pathology reports.
- know the biomolecular tests to be performed for target therapies and for immunotherapy in the main types of tumors.
- be aware of gender differences in incidence, diagnosis and treatment of various pathologies of the aforementioned systems.
Applying knowledge and understanding:
At the end of the course the student will have ability:
- to correctly employ the main diagnostic exams, including tissues and cytological samples analyses;
- to use the pathological information provided by morphology, immunohistochemistry and molecular biology, understanding their value in diagnosis, prognosis and therapy. Prerequisites
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Modulo: 005987 - CHIRURGIA GENERALE
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Adequate knowledge of anatomy, physiology and physiopathology of the circulatory and gastroenteric systems.
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Modulo: 015423/2 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA
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Knowledge of chemistry, biochemistry, molecular biology, human physiology and anatomy
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Modulo: 47775 - ANATOMIA PATOLOGICA
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Adequate knowledge of anatomy and histology of breast, of the gastrointestinal tract , of the skin, of the endocrine system, of soft tissues and bone. Knowledge of general pathology, genetics and molecular biology. Course programme
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Modulo: 005987 - CHIRURGIA GENERALE
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For each clinical picture the physiopathology is treated to understand the development of specific signs and symptoms. The physical examination maneuvers, laboratory tests and imaging diagnostics will be presented and discussed under the light of the pathophysiological picture. The student will be trained to a methodological reasoning of the sequence of laboratory and instrumental exams to be requested. Chronic obstructive peripheral arterial disease. Thrombosis and embolisms of the peripheral arteries. Chronic venous insufficiency of the lower limbs. Clinical manifestations and CEAP classification. Deep venous thrombosis and pulmonary embolism. Bladder gallstones and its sequelae. Mechanical jaundice. Acute pancreatitis. Intestinal perforations. Acute peritonitis. Septic shock concept. Digestive hemorrhages. Hypovolemic shock. Intestinal obstructions. Paralytic and mechanical ileus. Esophageal reflux and achalasia. Inguinal hernias and their complications. Pneumothorax.
Particular attention to possible specific sex/gender factors in an integrated diagnostic-therapeutic pathway.
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Modulo: 015423/2 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA
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- Plasma proteins: normal proteinaemia and quantitative/qualitative alterations, role of major plasma proteins, albumin and globulins, antibodies, monoclonal gammopathies, acute phase proteins, malnutrition.
- Water and electrolytes: control of water and electrolyte metabolism, states of dehydration, water intoxication. Sodium hypo- and hypernatremia. Potassium, hypo-and hyperkalemia, Hypo- and hyperchloremia
- Hypo- and hyper-calcemia, markers of bone turnover,
- Copper and iron: physiological role of Cu and Fe, diseases related to overload and deficiency (Wilson's disease, iron deficiency hemochromatosis), biomarkers of iron overload and deficiency .
- Clinical enzymology
- Disorders of lipid metabolism: plasma transport of lipids and lipoproteins; physiopathology of primary and secondary lipid disorders. Diagnosis of dyslipidemia in prevention of atherosclerotic disease.
- Metabolism of carbohydrates: diabetes mellitus, functions of endocrine pancreas and insulin deficiency and periphery resistance in type I and type II DM; alterations of blood glucose, glycosuria. Oral, intravenous and tolbutamide tolerance test. Glycated proteins.
- Markers of liver injury/disease, bilirubin metabolism and jaundice.
- Diseases of the kidney and urinary system. Laboratory test of renal function; Glomerulal and tubular diseases. Acute and chronic renal failure; urine testing, proteinuria and haematuria.
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Modulo: 47775 - ANATOMIA PATOLOGICA
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General Pathology
Role of Pathology. Methods and Techniques in Pathology (cytodiagnostics, macroscopic and histological diagnostics, histochemistry and immunohistochemistry). Molecular methods and application of molecular techniques in main solid tumors.
Endocrine system: Pituitary adenomas. Thyroiditis. Goiter. Benign and malignant tumors of the thyroid. Adrenocortical tumors. Pheochromocytoma. MEN syndromes.
Breast: Benign lesions. Fibroepithelial tumors. In situ and invasive carcinoma. Nipple carcinoma.
Molecular classification of breast carcinoma. Prognostic and predictive factors. Nipple neoplasms. Gynecomastia. Male breast carcinoma.
Digestive system:
Esophagus: Esophagitis. Barrett esophagus. Esophageal tumors.
Stomach: Acute and chronic gastritis. Peptic ulcer disease. Benign and malignant tumors.
Small intestines: Inflammatory pathology. Celiac disese. Primary and secondary tumors.
Colon-rectum: Crohn's disease. Ulcerative colitis. Colitis. Polyps and polyposis
Colorectal carcinoma: Epidemiology, adenoma-carcinoma sequence an different pathways. Grading and staging. Predictive and prognostic factors. Molecular analysis in localized and metastatic colorectal cancer.
Gastrointestinal stromal tumors.
Neuroendocrine tumors of the digestive system.
Skin: Non melanocytic lesions: actinic keratosis, squamous cell carcinoma, basal cell carcinoma.
Merkel cell carcinoma. Melanocytic lesions: nevi and melanomas.
Cutaneous lymphomas.
Classification of soft tissue and bone tumors. Didactic methods
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Modulo: 005987 - CHIRURGIA GENERALE
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The course provides frontal lectures and online assisted teaching. The on-line teaching hours of moodle platform certification service consist in the deepening of some topics presented during the frontal lessons.
The course provides lectures, frequency of the surgical ward and clinics alongside staff, with focus on methodological and diagnostic aspects, and on-line assisted teaching.
The teaching activity is also integrated by practical activity with tutor which consists in physical visit and instrumental diagnosis of chronic venous insufficiency and of arterial diseases. Simulation in a diagnostic lab with phantoms and/or normal subjects. Blood pressure. Measurement of ankle pressure with Doppler and Windsor index. Abdominal areas. Techniques of palpation and percussion of abdomen. Points of interest and surgical maneuvers in the abdomen. Evaluation of acute and chronic wounds.
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Modulo: 015423/2 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA
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The course provides frontal lectures and online assisted teaching. The on-line teaching hours of moodle platform certification service consist in the deepening of some topics presented during the frontal lessons.
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Modulo: 47775 - ANATOMIA PATOLOGICA
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The Pathology I course provides frontal lectures and on-line assisted teaching. The on-line teaching on moodle platform certification service consists in deepening of some topics presented during the frontal lessons providing, in addition to the teaching material presented during lessons, clinical cases, guidelines and recommendations by scientific societies, scientific articles and learning assessment multiple choice test.
The teaching activity is also integrated by practical activity which consists in attendance of Pathology grossing lab with observation of surgical specimens fixed in formalin, and attendance of the histopathology lab to acquire knowledge on diagnostic techniques in particular for intraoperative biopsies and for routine histology. Learning assessment procedures
- THE SCORE (EXPRESSED IN THIRTIETHS) OF EACH COURSE MODULE WILL BE USED FOR THE CALCULATION OF THE FINAL GRADE OF THE INTEGRATED COURSE, BY TAKING INTO ACCOUNT THE WEIGHT IN TERMS OF CFU (WEIGHTED AVERAGE THAT WILL BE ROUNDED UP).
Modulo: 005987 - CHIRURGIA GENERALE
There will be the chance to take the exam of GENERAL SURGERY and CLINICAL BIOCHEMISTRY and CLINICAL MOLECULAR BIOLOGY in the same day (in separate tournaments)
Written multiple choice test: 30 questions, for each question there may be five possible answers, only one correct. Time: 40 minutes. No penalty for wrong or missing answers.
Each correct answer will be evaluated 1.033 points. To pass the exam the student must answer correctly to at least 17 questions. Honors will be awarded to those who pass the rounded score of 30. The duration of the whole test will be increased for students with ‘Specific Learning Disorder'.
Modulo: 005987 -BIOCHIMICA E BIOLOGIA MOLECOLARE CLINICA
There will be the chance to take the exam of GENERAL SURGERY and CLINICAL BIOCHEMISTRY and CLINICAL MOLECULAR BIOLOGY in the same day (in separate tournaments)
Written multiple choice test: 16 questions, for each question there may be five possible answers, only one correct. Time: 20 minutes. No penalty for wrong or missing answers.
Each correct answer will be evaluated 2.0 points. To pass the exam the student must answer correctly to at least 9 questions. Honors will be awarded to those who pass the rounded score of 30. The duration of the whole test will be increased for students with ‘Specific Learning Disorder'.
Modulo: 47775 -ANATOMIA PATOLOGICA
Written multiple choice test: 30-40 questions, for each question there may be five possible answers, only one correct. Time: 25 -30 minutes. No penalty for wrong or missing answers.
Each correct answer will be evaluated 1.0 point. To pass the exam the student must answer correctly to at least 18 question. Honors will be awarded to those who pass the rounded score of 30. The final score (expressed in thirtieths). The duration of the whole test will be increased for students with ‘Specific Learning Disorder'. Reference texts
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Modulo: 005987 - CHIRURGIA GENERALE
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Dionigi, Chirurgia generale e specialistica, Masson
Oxford Textbook in Vascular Surgery, Oxford University Press 2016
Setacci C. Chirurgia Vascolare, Minerva Medica 2015
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Modulo: 015423/2 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA
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CLINICAL BIOCHEMISTRY AND CLINICAL MOLECULAR BIOLOGY
Marshall, Bangert, Clinical Chemistry, Mosby
Antonozzi I, Gulletta E. Medicina di Laboratorio, Logica & Patologia Clinica, Piccin Ed
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Modulo: 47775 - ANATOMIA PATOLOGICA
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Maria Rosaria Cardillo, Nozioni di tecniche diagnostiche di Anatomia Patologica, Antonio Delfino Editore
Rubin, Anatomia patologica e Patologia Generale, Piccin Editore
Robbins e Cotran, Le basi patologiche delle malattie, Elsevier Editore
