OVERVIEW

Pathology is the study (logos) of suffering (pathos). It is a bridge discipline that links basic sciences and clinical practice, focusing on the structural and functional alterations in cells, tissues, and organs that underlie disease. Through molecular, microbiological, immunological, and morphological approaches, General Pathology investigates the causes of disease and the mechanisms by which they lead to pathological conditions, thereby contributing to the development of effective preventive, diagnostic, and therapeutic strategies.

AIMS AND CONTENT

LEARNING OUTCOMES

Upon completion of the course, students will be able to describe and understand the major cellular and tissue responses to injury induced by endogenous and exogenous agents, as well as the underlying pathogenic mechanisms.

AIMS AND LEARNING OUTCOMES

The course aims to provide students with:

• the knowledge required to understand the endogenous and exogenous causes of disease and the pathogenic mechanisms underlying major human disorders;
• a general understanding of the role of the immune system in maintaining health and protecting the body from disease;
• the ability to integrate basic scientific knowledge into the clinical evaluation of patients.

At the end of the course, students will be able to:

• describe the causes and mechanisms of cell and tissue injury;
• recognize the main features and biomarkers of inflammatory processes;
• explain the pathogenesis and progression of common human diseases;
• understand the beneficial and potentially harmful effects of innate and adaptive immune responses;
• apply their knowledge of disease mechanisms to support clinical reasoning and therapeutic decision-making.

PREREQUISITES

Notions of biology, biochemistry and physiology.

TEACHING METHODS

Teaching activities are delivered through lectures supported by multimedia presentations. Course materials are partially made available in PDF format on AulaWeb, enabling students to review and further explore the topics covered in the course and required for the final examination.

No fixed office hours are scheduled. However, students may contact the instructors by email to arrange individual appointments for clarification, discussion, or further guidance on course topics.

Students with Specific Learning Disabilities (SLD), disabilities, or other special educational needs are encouraged to contact both the instructor and the School’s disability coordinator at the beginning of the course. Appropriate arrangements can then be discussed and implemented, in accordance with the course learning objectives and the student’s individual learning needs

SYLLABUS/CONTENT

Introduction 

Scope and objectives of General Pathology.

Mechanisms of cell injury and cellular responses to injury. 

Regressive processes (atrophy, degeneration, and cell death); Progressive processes (hypertrophy, hyperplasia, metaplasia, and neoplasia).

General Etiology

 Definition of intrinsic and extrinsic causes of disease.

Physical Causes of Disease:

Radiation. Definition and classification; Atomic-level effects of radiation; Pathogenic effects of radiation at the molecular, cellular, and tissue levels; whole-body irradiation.

Thermal Injury. Concept of thermal homeostasis; Burns and their systemic consequences; Frostbite; General concepts of sunstroke, heat stroke, and hypothermia.

Mechanical Injury. Basic concepts of trauma affecting bones, joints, and superficial tissues.

Chemical Causes of Disease:

Mechanisms of pathogenic action of chemical agents: pH alterations (local application of acids and bases); buffer systems and the major physiological buffer systems; solvent effects; protein-denaturing effects; toxic effects.

Routes of administration (overview).

Concepts of minimum lethal dose (MLD) and median lethal dose (LD50).

Classification of poisons according to their origin (general principles).

Innate defense mechanisms against toxic agents.

Biotransformation and detoxification of xenobiotics.

Inflammation

Definition, causes, and cardinal signs of inflammation.

Phases of acute inflammation

Classification of acute inflammation: types of exudates​

Chemical mediators of inflammation: cell-derived mediators; plasma-derived mediators.

Acute-phase response: mechanisms and biological significance.

Resolution of acute inflammation and possible outcomes: complete healing (restitutio ad integrum); scar formation; progression to chronic inflammation.

Chronic inflammation: characteristics; cellular components of the chronic inflammatory infiltrate; mechanisms underlying chronicity.

Types of chronic inflammation: diffuse chronic inflammation; granulomatous inflammation.

Granulomas: definition and etiology; granuloma structure.

Granulomatous diseases: tuberculosis and syphilis (overview).

Tissue Repair and Wound Healing: Concepts of regeneration and repair;  Primary and secondary intention healing.

Cutaneous wound healing: clot formation; inflammatory phase; major factors influencing wound healing.

General Oncology

Definition of neoplasia: autonomy; lack of physiological purpose (afinalism); tumor progression.

Morphological atypia; biochemical atypia; behavioral atypia.

Tumor markers.

Stages of carcinogenesis: initiation, promotion, progression.

Oncogenes and their major mechanisms of activation.

Metastasis: definition, routes of dissemination, organ tropism.

Etiology of Cancer: heredity (concepts of general and specific cancer risk); physical carcinogens (radiation); chemical carcinogens (major classes of carcinogenic substances); viral carcinogenesis (overview).

Classification of neoplasms according to biological behavior and histogenesis.​

Tumor grading and staging, TNM classification system.

Histopathology Laboratory Sessions: Light microscopy analysis of inflammatory tissues (e.g., pneumonia, tuberculosis) and neoplastic tissues.

Immunology

Overview of the immune system: Main characteristics; primary and secondary lymphoid organs.

Cells and soluble mediators of the immune system: Cytokines.

Fundamental features of innate (natural) and adaptive (acquired) immunity.

Innate Immunity

Cells and molecules of innate immunity.

Mechanisms of pathogen recognition.

Pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs).

The complement system.

Role of innate immunity in acute and chronic inflammation.

Innate lymphoid cells (ILCs).

Natural Killer (NK) cells; Dendritic cells.

Adaptive Immunity

Antigens.

B and T lymphocytes: mechanisms of antigen recognition.

Major Histocompatibility Complex (MHC): structure and function of MHC class I and class II molecules; antigen processing and presentation to T lymphocytes.

Development and differentiation of B and T lymphocytes: gene rearrangement; generation of antigen receptor diversity.

Activation of B and T lymphocytes and generation of immunological memory.

CD4+ helper T lymphocytes (Th1, Th2, Th17), CD8+ cytotoxic T lymphocytes, and their functions.

Immune Responses

Immune responses to pathogens.

Mucosal immunity.

Vaccines

Immunological basis of vaccination.

Active and passive immunization.

Immunopathology

Hypersensitivity reactions (Types I–IV).

Immunological tolerance and autoimmune diseases: mechanisms of tolerance; pathogenesis and classification of autoimmune disorders.

Immunodeficiencies (overview): primary (inherited) immunodeficiencies; acquired immunodeficiencies (HIV/AIDS).

Antitumor immunity (overview).

RECOMMENDED READING/BIBLIOGRAPHY

Robbins & Cotran Pathologic Basis of Disease, Elsevier

Abbas & Lichtman Cellular and Molecular Immunology, Elsevier

Students with SLD, disability or other special educational needs certification are strongly encouraged to contact the teachers at the beginning of the course to agree on teaching methods which, respecting the teaching objectives, take into account individual learning methods and provide suitable compensatory instruments.

TEACHERS AND EXAM BOARD

Exam Board

CRISTINA BOTTINO (President)

ROBERTA RICCIARELLI (President)

LESSONS

LESSONS START

2nd semester, 2nd year

Class schedule

The timetable for this course is available here: Portale EasyAcademy

EXAMS

EXAM DESCRIPTION

The final examination is designed to assess the achievement of the course learning objectives. Examinations are held on the dates specified in the official examination schedule.

The assessment consists of an in-person oral examination conducted by two instructors. The final grade is calculated as a weighted average of the evaluations provided by the examiners.

Students’ achievement of the learning objectives is assessed through questions covering the topics included in the course syllabus and addressed during the lectures.

Students who do not demonstrate an adequate level of knowledge and understanding of the course content will be required to retake the examination in its entirety.

No fixed office hours are scheduled. However, students may contact the instructors by email to arrange an appointment for further clarification or discussion of course topics.

Examination Committee: Professors Roberta Ricciarelli, Chiara Vitale and Grazia Maria Spaggiari.

ASSESSMENT METHODS

Assessment of learning is based exclusively on the final examination, which is designed to evaluate the extent to which students have achieved the intended learning outcomes. To pass the examination, with a minimum grade of 18/30, students must demonstrate an adequate knowledge of the topics covered during the course and the ability to integrate and relate them critically.

The final grade, expressed on a 30-point scale, is based on the following criteria:

• ability to address the topics under discussion in a comprehensive and critical manner;
• accuracy, clarity, conciseness, and fluency of presentation;
• mastery of the course content;
• appropriate use of scientific terminology.

A grade of 30/30, with possible distinction (cum laude), will be awarded to students who demonstrate an excellent level of knowledge and a thorough mastery of the skills and competencies covered by the course.

Students with Specific Learning Disabilities (SLD) or other duly certified special educational needs may arrange appropriate examination accommodations with the instructors by contacting them at least 10 days before the examination date.