Laurea Magistrale in Medicina e Chirurgia - sede di Torino

Teaching contributes to the realization of the training goal of the course in Medicine and Surgery and is intended to provide appropriate tools for students to acquire and deepen the existing interrelations between the content of basic sciences and those of clinical sciences, including the complexity that is inherent to both the state of health and, above all, the disease state.

The students have to demonstrate that they have learned and understood the main causes and pathogenetic mechanisms underlying human diseases as well as the etiopathogenesis of the fundamental alterations in structures, functions and control mechanisms. The students have to know the basic biological defense mechanisms and their alterations. The didactic path will range from the molecular level to the higher degree of organization (cell, tissue, organ, apparatus, organism). In particular, according to Dublin Descriptors:

1. Knowledge and understanding

At the end of the course, the student: 

• will be able to explain the concepts of health, disease, homeostasis, aetiology, pathogenesis, diseases induced by intrinsic and extrinsic causes;
• will know the main disease classification criteria;
• will know how to describe the elementary pathogenic mechanisms (adaptative responses, cell damage and death) that occur at the level of cells and tissues leading eventually to various diseases;
• will be able to explain the main mechanisms in response to injury, with a focus on inflammatory and healing processes;
• will know the leading causes of tumors and related pathogenic mechanisms;
• will understand the consequences of environmental causes of disease, such as nutrition disorders, exposure to radiation, high and low temperatures and pressures;
• will know and comprehend major aspects related to liver and blood pathophysiology as well as of relevant pathological conditions like diabetes and atherosclerosis.

  2 Applying knowledge and understanding

  At the end of the course, the student: 

  • will be able to apply the acquired knowledge in order to solve problems that will be addressed in the subsequent clinical training.

   

  3. Making judgments

  At the end of this course, the student:

  • will be able to integrate acquired knowledge and to rework the didactic material (slides, personal notes, recommended books) to identify key concepts;
  • will be able to elaborate personal judgements and hypotheses as well as to critically evaluate data to solve analytical and complex problems (problem solving).

   

  4.Communication skills

  At the end of this course, the student:

  • will be able to efficiently communicate, in written and oral form, acquired basic knowledge using a correct specialist terminology.

   

  5. Learning ability

  At the end of this course, the student:

  • will be able to study in a self-managed way and to consult independently healthcare and biomedical bibliographic sources (textbooks, online resources, databases, etc).

Program / frontal lectures

The concept of illness: the disease as an alteration of the normal state; the disease as a modification of the homeostasis of the organism; the disease as a loss of health. Morbid state. Syndrome. Etiology: the concept of "cause" in pathology. Pathogenesis.
General Etiology. Causes of chemical nature (environmental pollutants). Physical causes (high and low temperatures, atmospheric pressure variations). Nutrition as a cause of disease.
Cellular response to damage. Reversibility and irreversibility of cellular lesions. Cellular adaptive  responses to physiological and pathophysiological stimuli (atrophy, hypertrophy, 

hyperplasia, metaplasia, dysplasia) as well as to tissue hypoxia. Autophagy and its role in physiological and pathological conditions. Aging.
Regressive processes.  Diseases based on intra- (steatosis, glycogenosis) and extracellular (amyloidosis) accumulation of biological material. Accumulation of endogenous pigments.
Cell Death. Necrosis, apoptosis, necroptosis and other types of cell death: morphological aspects, molecular mechanisms. Cellular damage assessment with serum-enzymatic techniques.
Inflammation and Repair. Innate immunity and acute inflammatory reaction: tissue, vascular, cellular and molecular aspects, systemic manifestations (leukocytosis, acute response, fever, systemic inflammatory response syndrome, sepsis, septic shock). Chronic inflammation: role of macrophages and lymphocytes, type 1 and 2 polarization responses by macrophages, granulomas. The healing of tissue injuries: tissue, cellular and molecular aspects. Repair processes, fibrogenesis, fibrosis and pathological aspects of tissue injury and repair.
General Oncology. The concept of neoplasia. Clinical and genetic classification of benign and malignant tumors. Nomenclature. Cancer atypia. Tumor markers. Natural tumor history: silent status (cancer dormancy), angiogenesis, infiltrative growth, metastasis, tumor microenvironment. Metastatic pathways, organotropism of metastases. Immune response and tumors. Chemical causes of tumors, experimental carcinogenesis, multiphasic carcinogenesis, concept of tumor progression. Physical causes of tumors: ionizing and exciting radiations, DNA and RNA oncogenic virus. Cell proto-oncogenes, oncosuppressor genes. Regulation of normal and neoplastic proliferation. Genes that control the progression in cell cycle and senescence. Genome instability. Cancer cachexia and paraneoplastic syndromes. Epigenetic mechanisms in tumors. TNM Classification and  tumor specific grading.
Elements of general pathophysiology. Liver pathophysiology: jaundice, fibrosis and cirrhosis. Blood pathophysiology: anemia (post-hemorrhagic, hemolytic, by reduced erythropoiesis), hemostasis and hemorrhagic diathesis, thrombosis, intravascular disseminated coagulation. Diabetes. Atherosclerosis.

The teaching consists of 80 hours of frontal lectures, providing students with materials related to the topics covered, and by 28 hours of supporting activities (internship/tirocinio) for any channel consisting in the microscope observation of histopathological slides; supporting activities are carried out in groups of 30 students. Any student will benefit of a total of 4 hours of internship (2 hours of microscope observation of histopathological slides plus 2 hours of personal learning that will end with an evaluation of eligibility).

The examination consists of two tests, one written and one oral. The first written examination consists of 5 open questions on topics covered in the formal lectures; students have 1 hour to respond. Students who receive a positive assessment (equal to or greater than 18/30) will be admitted to the oral examination, which initially deals with an in-depth discussion related to the topics discussed in the written examination to then analyze other related topics of the program. The final score (in 30ths) attributed to a single student, is a weighted evaluation of the score obtained in the written test and the evaluation of the oral test in terms of critical knowledge and critical thinking skills.

Supporting Activities (Internship/tirocinio - Prof. Manuela Aragno). Supporting activities beyond the expected hours of teaching include observation of histopathological preparations related to the main accumulation pathologies (intra- and extracellular degenerative processes), acute and chronic inflammatory processes as well as peripheral blood slides from patients affected by main forms of anemia. At the end of observation, students have to describe a slide that is chosen between those observed for a positive assessment (eligibility, for this supporting activity / internship).

Supporting Activities (Internship/tirocinio - Prof. Manuela Aragno). Supporting activities beyond the expected hours of teaching include observation of histopathological preparations related to the main accumulation pathologies (intra- and extracellular degenerative processes), acute and chronic inflammatory processes as well as peripheral blood slides from patients affected by main forms of anemia. At the end of observation, students are invited to describe a slide that is chosen between those observed for a positive assessment (eligibility, for this supporting activity / internship).