LEARNING OUTCOMES

EDUCATIONAL GOALS

The course aims to enable the student to know the etiological basis and the pathogenic mechanisms of the diseases in humans, as well as the basic pathophysiological mechanisms of the major organ and systems. It also seeks to understand the morphological aspects which are intimately connected with the functional-biochemical aspects. The study of general pathology is divided into several chapters: Concept of health and disease; Causes of disease; Cellular pathology; Oncology; Physiopathology. The course pays special attention to the teaching of medical terminology.

AIMS AND LEARNING OUTCOMES

The main purpose of the course is to provide students with basic knowledge on the etiology and pathogenetic mechanisms of diseases in humans, as well as the fundamental pathophysiological mechanisms of the main organs and systems. Attendance at lectures and the individual study will allow the students a) to know the etiology of human diseases, b) to recognize the different responses of cell adaptation to injury, c) to describe the neoplastic atypia and to classify epithelial and connective tumors and d) to acquire an adequate medical terminology.

PREREQUISITES

To effectively address the teaching content, the following basic knowledge is needed: elements of cell and genetic biology; notions of anatomy, histology, physiology and immunology.

TEACHING METHODS

Teaching is organized in frontal classroom lectures for a total of 80 hours. The lectures are given by the teacher through the use of presentations that are made available to students on the web classroom. In periods of health emergency, lessons are held remotely using the TEAMS platform.

SYLLABUS/CONTENT

INTRODUCTION. Field of study of General Pathology. Homeostasis concept. Differences between disease, state, process and morbid phenomenon.

CELL DAMAGE. Reversible and irreversible cell damage. Biochemistry of cell damage. Hypoxia and ischemia. Necrosis: coagulative, colliquative, caseous, gangrenous, steatonecrosis. Markers of necrosis. Apoptosis.

CELLULAR PATHOLOGY. Regressive processes: Atrophy. Vacuolar degeneration. Mitochondrial swelling. Fatty degeneration. Protein accumulations. Progressive processes: Hypertrophy and hyperplasia. Notes on the alterations of differentiation: metaplasia, dysplasia and anaplasia.

GENERAL ETIOLOGY. INTRINSIC CAUSES Genetic and chromosomal pathologies. Notes on congenital malformations. Aplasia, agenesis and hypoplasia. Embriopathies and fetopathies and causes.

EXTRINSIC CAUSES OF PHYSICAL NATURE. Radiation. Definition; classification (corpuscular and electromagnetic). Main types of corpuscular radiation. Electromagnetic radiation. Distinction of ionizing and exciting radiation. Ionizing radiation: effects on the atom. Direct and indirect effects. Effects on the cell. Effects on the fabric. Effects of total body irradiation. Carcinogenesis, mutagenesis, teratogenesis from ionizing radiation. Exciting radiation: nature. Effect on the atom. Direct (e.g. thymine dimers) and indirect (photodynamic substances) effects. Effects on the skin: acute and chronic.

Mechanical causes. Trauma of superficial tissues. Trauma of internal organs. Osteoarticular trauma. Regeneration and repair concepts. Healing by first or second intention. Healing of the skin wound and its phases: clot formation, inflammatory phase, granulation tissue formation, re-epithelialization, remodeling. Consequences of scarring.

Thermal causes. Thermal equilibrium concept. Burns (and their general consequences) and freezing. General concepts of heat stroke and frostbite.

EXTRINSIC CAUSES OF CHEMICAL NATURE. Pathogenic mode of action of chemicals. PH alteration: local application of acid or base. Solvent action. Denaturating action. Toxic action. Definition and concepts of concentration at the active site, dose, volume of distribution, time, route of administration. Classification of poisons by origin (general). Defenses against poisons. Congenital and acquired defenses. Generic defenses. Enzyme defenses: phase I and II biotransformation mechanisms.

FOOD CAUSES. Causes of protido-energetic malnutrition: marasm and kwashiorkor. Anorexia and bulimia. Fat-soluble vitamins (A, D, E, K) and relative deficiencies. Water-soluble vitamins and relative deficiencies: beriberi, pellagra, vitamin B6 and B12 deficiencies, folic acid, scurvy. Mineral deficiencies. Obesity. Relationships of diet with atherogenesis and cancer.

THE FEVER. Heat production and heat dispersion. Fever hyperthermia. Types of fever.

TUMORS. Definition of neoplasia: concepts of autonomy, afinalism, progression.

Morphological atypia: tissue atypia; cellular atypia; subcellular atypia (atypia of the intermitotic nucleus and mitosis, atypia of the plasma membrane, mitochondria, ribosomes).

Biochemical atypia. Atypes of glucose metabolism (anaerobic glycolysis). Atypics of lipid metabolism. Atypes of nitrogen metabolism (qualitative and quantitative alterations of protein synthesis).

Behavioral atypia: loss of adhesiveness, loss of contact inhibition, acquisition of motor and invasive capacity. Metastases: definition, metastatic pathways, concept of organotropism.

Molecular basis of tumors: oncogenes and their activation. Alterations of tumor suppressors. Retinoblastoma.

Etiology of tumors. Initiation and promotion concept. Heredity and tumors: predisposition. Carcinogenic physical factors. Carcinogenic chemical factors: the classes of carcinogenic substances. Viral carcinogenesis. Oncogenic retroviruses (rapid and slow); examples for humans (HTLV). DNA tumorigenic viruses and the concept of transforming protein; examples for humans (EBV, HPV, HBV). Diet-tumor ratio. Hormone-tumor relationship.

Classification of neoplasms: classification by behavior (benign and malignant); classification by histogenesis (epithelial and connective tissue tumors); classification by staging and gradation (TNM system).

ALTERATIONS OF THE HEMODYNAMIC BALANCE

Edema. Triad of Virchow. Thrombosis. Arterial and venous thrombi. Solid, liquid and gaseous embolism.

PATHOPHYSIOLOGY OF BLOOD VESSELS

Atherosclerosis: risk factors. Endothelial damage. Pathogenesis of plaque formation.

BLOOD PATHOPHYSIOLOGY: Anemias. Leukemia. Lymphomas.

PATHOPHYSIOLOGY OF THE HEART AND CIRCLE: Ischemic heart disease. Hypertensive heart disease. Valve diseases. Changes in rhythm. Shock. Hypoxia. Ischemia.

PATHOPHYSIOLOGY OF THE RESPIRATORY SYSTEM: Respiratory failure. Pneumonia. Chronic obstructive lung disease (bronchial asthma - acute and chronic bronchitis - emphysema). Pleurisy. Pneumothorax.

PATHOPHYSIOLOGY OF THE FOOD SYSTEM: Oral mucosa lesions. Dental pathologies. Salivary gland pathologies. Esophageal pathologies. Gastric pathologies. Intestinal pathologies (colitis - diverticulosis - appendicitis - peritonitis - hernia). Liver, biliary tract, pancreas: Jaundice. Viral hepatitis. Toxic hepatitis. Chronic hepatitis. Liver failure. Cirrhosis. Cholelithiasis. Pancreatitis. Diabetes.

PHYSIOPATHOLOGY OF THE RENAL-URINARY SYSTEM: Classification of kidney diseases. Glomerular (inflammatory and degenerative), tubular (toxic and ischemic), interstitial and urinary tract (occlusive and compressive) diseases. Acute renal failure: failure on a pre-renal basis (with pathogenesis of the decrease in systemic blood pressure), renal and post-renal. Chronic renal failure: definition, etiology and mechanism.

PATHOPHYSIOLOGY OF THE ACID/BASE BALANCE. The pH of the blood and its maintenance: buffer systems, roles of the lung and kidney. Concepts of acidemia and alkalemia. Concepts of acidosis and alkalosis. Simple respiratory and metabolic disorders of the acid-base balance. Concept of expected compensation. Mixed disorders of the acid-base balance.

PATHOPHYSIOLOGY OF THE TEGUMENTARY APPARATUS: Pigmentation and melanocyte disorders. Inflammatory skin and chronic dermatoses. Bullous diseases. Disorders of epidermal appendages. Skin infections and infestations.

PATHOPHYSIOLOGY OF SENSE ORGANS: Eye diseases: hordeolus - chalazion - conjunctivitis - cataract - glaucoma - retinopathies. Ear diseases: otitis - labyrinthitis - otosclerosis - deafness - Menière's disease.

PATHOPHYSIOLOGY OF THE CENTRAL NERVOUS SYSTEM: Cerebrovascular diseases. Infectious diseases (meningitis - encephalitis). Degenerative diseases (Parkinson's disease - Alzheimer's disease) - Spongiform encephalopathy. Demyelinating diseases (multiple sclerosis).

RECOMMENDED READING/BIBLIOGRAPHY

PONTIERI G.M.: PATOLOGIA E FISIOPATOLOGIA GENERALE-EDIZ. PICCIN-TERZA EDIZIONE

KUMAR V., ABBAS A.K., ASTER J.C.: ROBBINS-FONDAMENTI DI PATOLOGIA E FISIOPATOLOGIA-EDIZIONE 2013

CELOTTI F. :PATOLOGIA GENERALE E FISIOPATOLOGIA-EDISES-EDIZIONE 2013

Lecture notes will be available and shared on Aulaweb.