System diseases 3
A.A. 2023/2024
Obiettivi formativi
The course is designed to address, with systematic and multidisciplinary approach the diseased of endocrine and gastrointestinal systems. The endocrinology module is designed to teach the students the appropriate skills to diagnose patients with endocrine disorders, to interpret endocrine tests and manage acute and chronic conditions. The gastroenterology module addresses disorders and diseases of the Gastrointestinal Tract, including the Liver and the Pancreas with a systematic approach and is designed to make students familiar with clinical presentation and differential diagnosis of GI diseases. Aside to Endocrine and Gastrointestinal module, there are (similarly to SD1 and SD2) the moduls of radiology and nuclear medicine modules, clinical biochemistry, microbiology and pathology modules. The imaging issues related to the clinical topics of endocrinology and gastroenterology, the clinical biochemistry module introduce the laboratory tests used to diagnose and monitor endocrine and gastrointestinal disorders, the role, the pathogenic mechanism and the laboratory methods available for rapid diagnosis of the gastrointestinal and endocrine diseases (including the liver) related etiology agents and the pathological features of neoplastic and non-neoplastic lesions of endocrine and gastrointestinal diseases will be addressed. The pathological changes of the liver and of the pancreas in the course of neoplastic, infectious and inflammatory diseases are addressed.
Risultati apprendimento attesi
Students are expected to: - identify the typical and atypical features of endocrine disorders, their presentation, clinical course and expected outcome. - interpret endocrine tests and manage acute and chronic conditions. - describe aetiologies, pathogenetic mechanisms, morphological changes of neoplastic proliferations of the pituitary gland, thyroid gland, parathyroid glands and adrenal gland - describe pathological classification and prognostic markers of the neuroendocrine tumors. -describe aetiologies, pathogenetic mechanisms and morphological changes of non-neoplastic diseases of the endocrine system. - interpret endocrine tests and manage acute and chronic conditions. -identify the typical and atypical features of gastrointestinal disorders, their presentation, differential diagnosis, clinical course and expected outcome. -describe aetiologies, pathogenetic mechanisms and morphological changes of non-neoplastic diseases of the gastrointestinal tract -describe the aetiologies, pathogenetic mechanisms, morphological changes, prognostic and predictive factors of esophageal, gastric and intestinal tumors. - describe the pathological changes of the liver in hepatitis and cirrhosis and tumors and tumor-like lesions. -describe the pathological changes of the inflammatory and neoplastic conditions of the pancreas - interpret the laboratory tests used to diagnose and monitor endocrine and gastrointestinal disorders. -interpret the imaging issues related to the clinical topics of endocrinology and gastroenterology. - describe the pathogenic mechanism and the laboratory methods for rapid diagnosis of the gastrointestinal and endocrine diseases related etiology agents.
Periodo: Primo semestre
Modalità di valutazione: Esame
Giudizio di valutazione: voto verbalizzato in trentesimi
Corso singolo
Questo insegnamento non può essere seguito come corso singolo. Puoi trovare gli insegnamenti disponibili consultando il catalogo corsi singoli.
Programma e organizzazione didattica
Edizione unica
Responsabile
Prerequisiti
To take the System Diseases 3 exam, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Modalità di verifica dell’apprendimento e criteri di valutazione
Student assessment is based on a combination of written and oral examinations. The written exam is a multiple-choice test with 30 questions focused on the topics of the modules: Clinical Biochemistry, Microbiology, Pathology (10 questions each). Only students who successfully pass the written tests of all subjects (threshold 7/10) are allowed to take the oral examination, focused on the following modules: Diagnostic Imaging, Endocrinology and Gastroenterology. The result of the written exam is communicated immediately after the end of the test.
The oral examination must be passed in the same session as the written examination. The students must undergo both written and oral examination on the same day. Examinations on two consecutive days are seldom possible depending upon the availability of teachers or rooms. If the student does not successfully pass the oral examination, the positive result at the written test is valid only within the same session.
The final mark is the weighted average of the marks obtained during the oral examinations.
Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.
Registration to the exam through SIFA is mandatory.
The oral examination must be passed in the same session as the written examination. The students must undergo both written and oral examination on the same day. Examinations on two consecutive days are seldom possible depending upon the availability of teachers or rooms. If the student does not successfully pass the oral examination, the positive result at the written test is valid only within the same session.
The final mark is the weighted average of the marks obtained during the oral examinations.
Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.
Registration to the exam through SIFA is mandatory.
Gastroenterology
Programma
PROGRAM:
MODULE: ENDOCRINOLOGY AND METABOLISM (INTEGRATED)
Topic 1 - ENDOCRINOLOGY: Impact of endocrinology on general health
Overview of hormonal axes involved in homeostasis and their regulation
Feedback mechanisms
Stress response
General mechanisms of endocrine diseases
Epidemiology of the main endocrine diseases
Topic 2 - ENDOCRINOLOGY, RADIOLOGY: Hypothalamus and Pituitary
Hypothalamus and pituitary
Pituitary/hypothalamic lesions (Non-functioning adenomas, Prolactinomas and Somatotropinomas/acromegaly/ craniopharyngioma) and correlated syndromes (pathogenesis, diagnosis, clinical manifestations, and management)
Radiology of pituitary tumors craniopharyngioma, autoimmune and other hypophysistis, genetic hypopituitarism
Topic 3 - ENDOCRINOLOGY: Hypothalamus and pituitary: hypopituitarism
Causes of (pan)hypopituitarism
Diagnosis, clinical manifestations, and management of (pan)hypopituitarism
Water balance disorders
Topic 4 - ENDOCRINOLOGY: Thyroid function and hypothyroidism
Thyroid gland follicles: origin and function
Thyroid hormone action and regulation
Testing of thyroid function
Causes of hypothyroidism, autoimmune thyroiditis
Thyroid and conception/pregnancy
Clinical manifestations
Diagnosis and management
Topic 5 - ENDOCRINOLOGY: Thyroid dysfunction: hyperthyroidism
Causes of hyperthyroidism/thyrotoxicosis
Clinical manifestations, including orbitopathy
Diagnosis and management
Subacute and post-partum thyroiditis
Topic 6 - ENDOCRINOLOGY: Diagnostic problems of thyroid conditions and rare thyroid diseases
Diagnostic problems in hypo- and hyperthyroidism
Resistance to thyroid hormones
TSH-secreting adenomas
Topic 7 - ENDOCRINOLOGY, RADIOLOGY, CLINICAL BIOCHEMISTRY: Thyroid goiter, nodules and cancers
Iodide deficiency and goiter
Clinical manifestations of nodular goiter and cancers
Diagnosis and management of nodular goiter and cancers
Diagnostic and interventional radiology of the thyroid gland
Nuclear medicine of the thyroid gland: diagnosis and treatment
Laboratory diagnostics of thyroid diseases
Topic 8 - ENDOCRINOLOGY: Obesity, disorders of lipid metabolism and nutrition disorders
Epidemiology
Classification
Metabolic and cardiovascular consequences
Bariatric surgery
Topic 9 - ENDOCRINOLOGY, CLINICAL BIOCHEMISTRY: Diabetes Mellitus type 1 and 2
Epidemiology
Classification
Diagnosis and management
Complications (comas, nephropathy, etc)
Gestational diabetes
Laboratory diagnostics of diabetes
Topic 10 - ENDOCRINOLOGY: Hypoglycemia and differential diagnosis
Epidemiology
Classification
Diagnosis and management
Topic 11 - ENDOCRINOLOGY: Diabesity and gouts
Topic 12 - ENDOCRINOLOGY: Urbanization, lifestyle changes and metabolic diseases
Topic 13 - ENDOCRINOLOGY: Male reproductive endocrinology
Puberty: mechanisms and sex differences
Delayed puberty in males
Klinefelter syndrome and hypogonadotropic hypogonadism: diagnosis, clinical manifestations, and management
Late onset hypogonadism: diagnosis, clinical manifestations, and management
Topic 14 - ENDOCRINOLOGY: Female reproductive endocrinology
Delayed puberty in females
Amenorrhea, Turner syndrome and Primary Ovarian Insufficiency: diagnosis, clinical manifestations, and management
Hirsutism and Polycystic Ovary Syndrome (PCOS): diagnosis, clinical manifestations, and management
Topic 15 - ENDOCRINOLOGY, CLINICAL BIOCHEMISTRY: Adrenal function and diseases
Adrenal function: physiology
Hypercorticolism
Cushing disease vs syndrome and pseudocushing: diagnosis, clinical manifestations, and management
Endocrine hypertension (pheochromocytoma, primary hyperaldosteronism)
Addison disease and 21-hydroxylase deficiency
Determination of steroid hormones
Topic 16 - ENDOCRINOLOGY, RADIOLOGY: Discussion of clinical cases and adrenal imaging and Pathology
Management of patients with adrenal diseases
Radiology of adrenal glands
Nuclear medicine of adrenal glands
Topic 17 - ENDOCRINOLOGY, CLINICAL BIOCHEMISTRY: Disorders of calcium homeostatsis
Parathyroid gland and vitamin D
Hypercalcemia and Hyperparathyroidism: clinical manifestations, diagnosis and management
Hypocalcemia and Hypoparathyroidism: clinical manifestations, diagnosis and management
How to test vitamin D, PTH, and calcemia
Topic 18 - ENDOCRINOLOGY, RADIOLOGY: Multiple Endocrine Neoplasia and neuroendocrine tumors
MEN1: pathogenesis, clinical manifestations, diagnosis and management
MEN2: pathogenesis, clinical manifestations, diagnosis and management
Radiology of parathyroid
Nuclear medicine of parathyroid
Topic 19: ENDOCRINOLOGY, RADIOLOGY: Metabolic Bone disorders
Primary and secondary osteoporosis: pathogenesis, clinical manifestations, diagnosis and management
Imaging diagnosis of osteosarcopenia.
Topic 20 - PATHOLOGY: Pathology of the Thyroid
Topic 21 - PATHOLOGY: Pathology of the pituitary gland and adrenal gland
Topic 22 - PATHOLOGY: Neuroendocrine tumors
Topic 23, 24, 25 - Clinical cases: critical analysis of the pathology report
Topic 26 - MICROBIOLOGY: Pathogenic role of microbes in endocrine diseases - part 1
Define the relationship between infectious agents and endocrine system
Discuss the relevance of infectious agents and antigen mimicry in the pathogenesis of autoimmune endocrine diseases
Steroid treatment from triggering factor to therapeutic tool in infections
Define the role of microbes in Diabetes pathogenesis and complications
Topic 27 - MICROBIOLOGY: Pathogenic role of microbes in endocrine diseases - part 2
Describe the possible involvement of infectious agents in thyroiditis and hypophisitis.
Describe the relations between infectious agents and Adrenal and Gonadal infections (with a focus on hypogonadism and infertility)
Define the relationship between Microbiota and endocrine diseases: facts and perspectives.
Describe the laboratory test and the markers to be used for diagnosis of microbial infection relevant for the endocrinological diseases.
ENDOCRINOLOGY: Interactive clinical case discussion
Problem solving (group study and preparation)
Role playing
Interactive discussions
MODULE: GASTROENTEROLOGY (INTEGRATED)
Session 1. GASTROENTEROLOGY: Course Presentation & Frontier Lecture
Introduction to the Course
Physical examination of the abdomen
Frontier Lecture: The GALT and the microbiome: from "physiological" inflammation to disease and therapy
Session 2. GASTROENTEROLOGY, RADIOLOGY: System Diseases: Esophagus
Esophageal function
Motor disorders of the esophagus
Gastroesophageal reflux disease
Esophageal structure, Barrett's esophagus and esophageal tumors
Eosinophilic Esophagitis
Imaging of the esophagus
Session 3. GASTROENTEROLOGY: Approach to the patient with dysphagia and gastric symptoms
Dysphagia: the diagnostic flow-chart
Dyspepsia, Nausea and Vomiting
Case discussion
Session 4. PATHOLOGY: Pathology of the esophagus
Esophagitis, gastroesophageal reflux disease and Barrett esophagus.
Epidemiology and pathogenic mechanisms of esophageal tumors.
Classification and prognostic parameters.
Session 5. GASTROENTEROLOGY, RADIOLOGY: System Diseases: Stomach and Duodenum
Gastric function
Helicobacter Pylori Infection & its clinical relates
Peptic Ulcer Disease and its complications
Gastric Adenocarcinoma and Other Tumors of the Stomach
Imaging of the stomach and duodenum
Session 6. GASTROENTEROLOGY: Approach to Patients with GI bleeding
Hematemesis, melena, hematochezia, occult bleeding
Diagnostic work-up and Case Discussion
Session 7. PATHOLOGY: Pathology of the stomach
Acute and chronic gastritis: etiologies, pathogenic mechanisms and morphological changes
Pathogenic mechanisms and pathological changes of peptic ulcer disease
Epidemiology, risks factors and pathogenic mechanisms of gastric cancer
Classification, morphologic changes, prognostic and predictive parameters of gastric adenocarcinoma
Gastrointestinal stromal tumors
Lymphoid neoplasms of the stomach
Session 8. GASTROENTEROLOGY, RADIOLOGY, CLINICAL BIOCHEMISTRY: System Diseases: Pancreas
Pancreatic function
Acute pancreatitis - clinical and imaging
Chronic pancreatitis and pancreatic insufficiency
Pancreatic adenocarcinoma, cystic and neuroendocrine neoplasms of the pancreas - clinical, laboratory and Imaging
Case discussion
Session 9. PATHOLOGY: Pathology of the pancreas
Acute and Chronic Pancreatitis: morphological changes.
Pancreatic neoplasms: histological classification, morphological changes, prognostic factors.
Session 10. GASTROENTEROLOGY, RADIOLOGY, CLINICAL BIOCHEMISTRY: Approach to the patient with Liver disease
Laboratory tests and imaging interpretation in clinical practice
Bilirubin secretion and its disorders
Diagnostic flow chart in jaundice
Imaging of liver failure
Case discussion
Session 11. GASTROENTEROLOGY: Liver diseases due to infectious Agents
Hepatitis Virus from A to D and beyond: clinical features and outcomes
Case discussion
Session 12. GASTROENTEROLOGY: Clinical consequences of Liver diseases
Cirrhosis and its complications, portal hypertension and Hepatocellular Carcinoma
Case discussion
Session 13. GASTROENTEROLOGY, RADIOLOGY: System Diseases: Immune mediated Liver diseases
Autoimmune Hepatitis
Primary Biliary Cholangitis
Primary Sclerosing Cholangitis
Differential diagnosis, imaging
Case discussion
Session 14. GASTROENTEROLOGY: System Diseases: Inherited liver diseases
Hemochromatosis
Wilson disease
Case discussion
Session 15. GASTROENTEROLOGY: Metabolic and toxic liver diseases
Drug-induced hepatotoxicity
Alcoholic hepatitis
NASH, NAFLD
Case discussion
Session 16. GASTROENTEROLOGY, RADIOLOGY: Diseases of the biliary tract
Gallstones: diagnosis, natural history and complications
The propaedeutic use of imaging methods
Session 17 - PATHOLOGY, RADIOLOGY: Pathology of the liver and gallbladder
Patterns of hepatic injury
Morphologic changes of acute and chronic hepatitis. Grading and staging of chronic hepatitis
Morphological changes in liver cirrhosis
Tumors of the liver: histological classification, morphologic changes and prognostic factors
Imaging of liver tumors
Session 18 GASTROENTEROLOGY, CLINICAL BIOCHEMISTRY: System Diseases: Small and Large Intestine - Part 1
Celiac Disease and Other Malabsorption Syndromes
Infectious causes of diarrhea and malabsorption - clinical
Irritable Bowel Syndrome
Case discussion
Laboratory tests
Session 19. GASTROENTEROLOGY: Frontier Lecture/Seminar: Intestinal epithelium: a multifunctional machinery
Session 20. GASTROENTEROLOGY: Approach to the patients with chronic diarrhea
Diagnostic flow-chart of chronic diarrhea
Case discussion
Session 21. CLINICAL BIOCHEMISTRY: Uses and abuses of laboratory tests, with special reference to neoplastic markers
Session 22. GASTROENTEROLOGY, RADIOLOGY: System Diseases: Small and Large Intestine Part 2
The use of radiologic imaging to evaluate the small bowel and as an alternative to colonoscopy
Inflammatory Bowel Diseases
Diverticular disease of the colon
Colorectal cancer
Case discussion
Session 23. PATHOLOGY: Non-neoplastic diseases of the small intestine and large bowel
Celiac disease: morphological diagnosis
Inflammatory bowel disease: Morphological changes in Crohn disease and Ulcerative colitis and their complications
Session 24. PATHOLOGY: Tumors of the small and Large intestine
Tumors of the small intestine: Adenocarcinoma; Carcinoids; Gastrointestinal Stromal Tumors
Intestinal polyps: non-neoplastic and adenomas. Histological classification and dysplasia
Colorectal carcinogenesis: adenoma-carcinoma sequence
Epidemiology, risks factors and pathogenic mechanisms of colorectal carcinoma
Classification, morphologic changes, prognostic and predictive parameters
Session 25. MICROBIOLOGY: Etiology, pathogenesis and laboratory diagnosis of viral diseases of gastrointestinal tract including the liver
Describe the various types of viruses involved in the diseases of the gastrointestinal tract
Define the pathogenesis of viral diseases of the gastrointestinal tract
Describe the putative involvement of viruses in colorectal cancer
Describe the laboratory test and the markers to be used for diagnosis and prognosis of viral diseases of the gastrointestinal tract
Principles of antiviral therapy and of vaccination
Session 26. MICROBIOLOGY: Etiology, pathogenesis and laboratory diagnosis of parasitic, fungine and bacterial diseases of gastrointestinal tract including the liver
Define the parasites, fungi and bacteria involved in the diseases of the gastrointestinal tract.
Define the pathogenesis of bacterial diseases of the gastrointestinal tract.
Describe the laboratory test and the markers to be used for diagnosis and prognosis of bacterial diseases of the gastrointestinal tract.
Principles of antimicrobial therapy and of vaccination
Parasitic and fungine infections will be included in the slide sets but remain as Self Study Program
Session 27 - PATHOLOGY, RADIOLOGY: Appendix and the anal canal
Acute and chronic appendicitis
Tumors of the appendix: adenocarcinoma and neuroendocrine neoplasms
Tumors of the anal canal: adenocarcinoma, melanoma and Paget disease
Radiological imaging of the appendix and rectum
Session 28 - PATHOLOGY: Molecular pathology of tumors of the gastrointestinal tract
Molecular features and prognostic biomarkers in esophageal squamous cell carcinoma.
Molecular pathology of stomach cancer and cancer of the gastroesophageal junction. HER2 testing: who gets trastuzumab? Historical perspectives, the TOGA trial, diagnostic guidelines.
Syndromic and sporadic colorectal cancer. Molecular classification. Mismatch repair testing: when and how? Morphological features suggestive of mismatch repair deficiency; clinical importance of MMr testing by immunohistochemistry and microsatellite instability. Clinical importance of tumor mutational burden assessment. Immunotherapy.
Session 29. PATHOLOGY: The pathology report in gastrointestinal pathology
Digital pathology, examples of pathologic reports and review of the main topics discussed in the previous lectures
MODULE: ENDOCRINOLOGY AND METABOLISM (INTEGRATED)
Topic 1 - ENDOCRINOLOGY: Impact of endocrinology on general health
Overview of hormonal axes involved in homeostasis and their regulation
Feedback mechanisms
Stress response
General mechanisms of endocrine diseases
Epidemiology of the main endocrine diseases
Topic 2 - ENDOCRINOLOGY, RADIOLOGY: Hypothalamus and Pituitary
Hypothalamus and pituitary
Pituitary/hypothalamic lesions (Non-functioning adenomas, Prolactinomas and Somatotropinomas/acromegaly/ craniopharyngioma) and correlated syndromes (pathogenesis, diagnosis, clinical manifestations, and management)
Radiology of pituitary tumors craniopharyngioma, autoimmune and other hypophysistis, genetic hypopituitarism
Topic 3 - ENDOCRINOLOGY: Hypothalamus and pituitary: hypopituitarism
Causes of (pan)hypopituitarism
Diagnosis, clinical manifestations, and management of (pan)hypopituitarism
Water balance disorders
Topic 4 - ENDOCRINOLOGY: Thyroid function and hypothyroidism
Thyroid gland follicles: origin and function
Thyroid hormone action and regulation
Testing of thyroid function
Causes of hypothyroidism, autoimmune thyroiditis
Thyroid and conception/pregnancy
Clinical manifestations
Diagnosis and management
Topic 5 - ENDOCRINOLOGY: Thyroid dysfunction: hyperthyroidism
Causes of hyperthyroidism/thyrotoxicosis
Clinical manifestations, including orbitopathy
Diagnosis and management
Subacute and post-partum thyroiditis
Topic 6 - ENDOCRINOLOGY: Diagnostic problems of thyroid conditions and rare thyroid diseases
Diagnostic problems in hypo- and hyperthyroidism
Resistance to thyroid hormones
TSH-secreting adenomas
Topic 7 - ENDOCRINOLOGY, RADIOLOGY, CLINICAL BIOCHEMISTRY: Thyroid goiter, nodules and cancers
Iodide deficiency and goiter
Clinical manifestations of nodular goiter and cancers
Diagnosis and management of nodular goiter and cancers
Diagnostic and interventional radiology of the thyroid gland
Nuclear medicine of the thyroid gland: diagnosis and treatment
Laboratory diagnostics of thyroid diseases
Topic 8 - ENDOCRINOLOGY: Obesity, disorders of lipid metabolism and nutrition disorders
Epidemiology
Classification
Metabolic and cardiovascular consequences
Bariatric surgery
Topic 9 - ENDOCRINOLOGY, CLINICAL BIOCHEMISTRY: Diabetes Mellitus type 1 and 2
Epidemiology
Classification
Diagnosis and management
Complications (comas, nephropathy, etc)
Gestational diabetes
Laboratory diagnostics of diabetes
Topic 10 - ENDOCRINOLOGY: Hypoglycemia and differential diagnosis
Epidemiology
Classification
Diagnosis and management
Topic 11 - ENDOCRINOLOGY: Diabesity and gouts
Topic 12 - ENDOCRINOLOGY: Urbanization, lifestyle changes and metabolic diseases
Topic 13 - ENDOCRINOLOGY: Male reproductive endocrinology
Puberty: mechanisms and sex differences
Delayed puberty in males
Klinefelter syndrome and hypogonadotropic hypogonadism: diagnosis, clinical manifestations, and management
Late onset hypogonadism: diagnosis, clinical manifestations, and management
Topic 14 - ENDOCRINOLOGY: Female reproductive endocrinology
Delayed puberty in females
Amenorrhea, Turner syndrome and Primary Ovarian Insufficiency: diagnosis, clinical manifestations, and management
Hirsutism and Polycystic Ovary Syndrome (PCOS): diagnosis, clinical manifestations, and management
Topic 15 - ENDOCRINOLOGY, CLINICAL BIOCHEMISTRY: Adrenal function and diseases
Adrenal function: physiology
Hypercorticolism
Cushing disease vs syndrome and pseudocushing: diagnosis, clinical manifestations, and management
Endocrine hypertension (pheochromocytoma, primary hyperaldosteronism)
Addison disease and 21-hydroxylase deficiency
Determination of steroid hormones
Topic 16 - ENDOCRINOLOGY, RADIOLOGY: Discussion of clinical cases and adrenal imaging and Pathology
Management of patients with adrenal diseases
Radiology of adrenal glands
Nuclear medicine of adrenal glands
Topic 17 - ENDOCRINOLOGY, CLINICAL BIOCHEMISTRY: Disorders of calcium homeostatsis
Parathyroid gland and vitamin D
Hypercalcemia and Hyperparathyroidism: clinical manifestations, diagnosis and management
Hypocalcemia and Hypoparathyroidism: clinical manifestations, diagnosis and management
How to test vitamin D, PTH, and calcemia
Topic 18 - ENDOCRINOLOGY, RADIOLOGY: Multiple Endocrine Neoplasia and neuroendocrine tumors
MEN1: pathogenesis, clinical manifestations, diagnosis and management
MEN2: pathogenesis, clinical manifestations, diagnosis and management
Radiology of parathyroid
Nuclear medicine of parathyroid
Topic 19: ENDOCRINOLOGY, RADIOLOGY: Metabolic Bone disorders
Primary and secondary osteoporosis: pathogenesis, clinical manifestations, diagnosis and management
Imaging diagnosis of osteosarcopenia.
Topic 20 - PATHOLOGY: Pathology of the Thyroid
Topic 21 - PATHOLOGY: Pathology of the pituitary gland and adrenal gland
Topic 22 - PATHOLOGY: Neuroendocrine tumors
Topic 23, 24, 25 - Clinical cases: critical analysis of the pathology report
Topic 26 - MICROBIOLOGY: Pathogenic role of microbes in endocrine diseases - part 1
Define the relationship between infectious agents and endocrine system
Discuss the relevance of infectious agents and antigen mimicry in the pathogenesis of autoimmune endocrine diseases
Steroid treatment from triggering factor to therapeutic tool in infections
Define the role of microbes in Diabetes pathogenesis and complications
Topic 27 - MICROBIOLOGY: Pathogenic role of microbes in endocrine diseases - part 2
Describe the possible involvement of infectious agents in thyroiditis and hypophisitis.
Describe the relations between infectious agents and Adrenal and Gonadal infections (with a focus on hypogonadism and infertility)
Define the relationship between Microbiota and endocrine diseases: facts and perspectives.
Describe the laboratory test and the markers to be used for diagnosis of microbial infection relevant for the endocrinological diseases.
ENDOCRINOLOGY: Interactive clinical case discussion
Problem solving (group study and preparation)
Role playing
Interactive discussions
MODULE: GASTROENTEROLOGY (INTEGRATED)
Session 1. GASTROENTEROLOGY: Course Presentation & Frontier Lecture
Introduction to the Course
Physical examination of the abdomen
Frontier Lecture: The GALT and the microbiome: from "physiological" inflammation to disease and therapy
Session 2. GASTROENTEROLOGY, RADIOLOGY: System Diseases: Esophagus
Esophageal function
Motor disorders of the esophagus
Gastroesophageal reflux disease
Esophageal structure, Barrett's esophagus and esophageal tumors
Eosinophilic Esophagitis
Imaging of the esophagus
Session 3. GASTROENTEROLOGY: Approach to the patient with dysphagia and gastric symptoms
Dysphagia: the diagnostic flow-chart
Dyspepsia, Nausea and Vomiting
Case discussion
Session 4. PATHOLOGY: Pathology of the esophagus
Esophagitis, gastroesophageal reflux disease and Barrett esophagus.
Epidemiology and pathogenic mechanisms of esophageal tumors.
Classification and prognostic parameters.
Session 5. GASTROENTEROLOGY, RADIOLOGY: System Diseases: Stomach and Duodenum
Gastric function
Helicobacter Pylori Infection & its clinical relates
Peptic Ulcer Disease and its complications
Gastric Adenocarcinoma and Other Tumors of the Stomach
Imaging of the stomach and duodenum
Session 6. GASTROENTEROLOGY: Approach to Patients with GI bleeding
Hematemesis, melena, hematochezia, occult bleeding
Diagnostic work-up and Case Discussion
Session 7. PATHOLOGY: Pathology of the stomach
Acute and chronic gastritis: etiologies, pathogenic mechanisms and morphological changes
Pathogenic mechanisms and pathological changes of peptic ulcer disease
Epidemiology, risks factors and pathogenic mechanisms of gastric cancer
Classification, morphologic changes, prognostic and predictive parameters of gastric adenocarcinoma
Gastrointestinal stromal tumors
Lymphoid neoplasms of the stomach
Session 8. GASTROENTEROLOGY, RADIOLOGY, CLINICAL BIOCHEMISTRY: System Diseases: Pancreas
Pancreatic function
Acute pancreatitis - clinical and imaging
Chronic pancreatitis and pancreatic insufficiency
Pancreatic adenocarcinoma, cystic and neuroendocrine neoplasms of the pancreas - clinical, laboratory and Imaging
Case discussion
Session 9. PATHOLOGY: Pathology of the pancreas
Acute and Chronic Pancreatitis: morphological changes.
Pancreatic neoplasms: histological classification, morphological changes, prognostic factors.
Session 10. GASTROENTEROLOGY, RADIOLOGY, CLINICAL BIOCHEMISTRY: Approach to the patient with Liver disease
Laboratory tests and imaging interpretation in clinical practice
Bilirubin secretion and its disorders
Diagnostic flow chart in jaundice
Imaging of liver failure
Case discussion
Session 11. GASTROENTEROLOGY: Liver diseases due to infectious Agents
Hepatitis Virus from A to D and beyond: clinical features and outcomes
Case discussion
Session 12. GASTROENTEROLOGY: Clinical consequences of Liver diseases
Cirrhosis and its complications, portal hypertension and Hepatocellular Carcinoma
Case discussion
Session 13. GASTROENTEROLOGY, RADIOLOGY: System Diseases: Immune mediated Liver diseases
Autoimmune Hepatitis
Primary Biliary Cholangitis
Primary Sclerosing Cholangitis
Differential diagnosis, imaging
Case discussion
Session 14. GASTROENTEROLOGY: System Diseases: Inherited liver diseases
Hemochromatosis
Wilson disease
Case discussion
Session 15. GASTROENTEROLOGY: Metabolic and toxic liver diseases
Drug-induced hepatotoxicity
Alcoholic hepatitis
NASH, NAFLD
Case discussion
Session 16. GASTROENTEROLOGY, RADIOLOGY: Diseases of the biliary tract
Gallstones: diagnosis, natural history and complications
The propaedeutic use of imaging methods
Session 17 - PATHOLOGY, RADIOLOGY: Pathology of the liver and gallbladder
Patterns of hepatic injury
Morphologic changes of acute and chronic hepatitis. Grading and staging of chronic hepatitis
Morphological changes in liver cirrhosis
Tumors of the liver: histological classification, morphologic changes and prognostic factors
Imaging of liver tumors
Session 18 GASTROENTEROLOGY, CLINICAL BIOCHEMISTRY: System Diseases: Small and Large Intestine - Part 1
Celiac Disease and Other Malabsorption Syndromes
Infectious causes of diarrhea and malabsorption - clinical
Irritable Bowel Syndrome
Case discussion
Laboratory tests
Session 19. GASTROENTEROLOGY: Frontier Lecture/Seminar: Intestinal epithelium: a multifunctional machinery
Session 20. GASTROENTEROLOGY: Approach to the patients with chronic diarrhea
Diagnostic flow-chart of chronic diarrhea
Case discussion
Session 21. CLINICAL BIOCHEMISTRY: Uses and abuses of laboratory tests, with special reference to neoplastic markers
Session 22. GASTROENTEROLOGY, RADIOLOGY: System Diseases: Small and Large Intestine Part 2
The use of radiologic imaging to evaluate the small bowel and as an alternative to colonoscopy
Inflammatory Bowel Diseases
Diverticular disease of the colon
Colorectal cancer
Case discussion
Session 23. PATHOLOGY: Non-neoplastic diseases of the small intestine and large bowel
Celiac disease: morphological diagnosis
Inflammatory bowel disease: Morphological changes in Crohn disease and Ulcerative colitis and their complications
Session 24. PATHOLOGY: Tumors of the small and Large intestine
Tumors of the small intestine: Adenocarcinoma; Carcinoids; Gastrointestinal Stromal Tumors
Intestinal polyps: non-neoplastic and adenomas. Histological classification and dysplasia
Colorectal carcinogenesis: adenoma-carcinoma sequence
Epidemiology, risks factors and pathogenic mechanisms of colorectal carcinoma
Classification, morphologic changes, prognostic and predictive parameters
Session 25. MICROBIOLOGY: Etiology, pathogenesis and laboratory diagnosis of viral diseases of gastrointestinal tract including the liver
Describe the various types of viruses involved in the diseases of the gastrointestinal tract
Define the pathogenesis of viral diseases of the gastrointestinal tract
Describe the putative involvement of viruses in colorectal cancer
Describe the laboratory test and the markers to be used for diagnosis and prognosis of viral diseases of the gastrointestinal tract
Principles of antiviral therapy and of vaccination
Session 26. MICROBIOLOGY: Etiology, pathogenesis and laboratory diagnosis of parasitic, fungine and bacterial diseases of gastrointestinal tract including the liver
Define the parasites, fungi and bacteria involved in the diseases of the gastrointestinal tract.
Define the pathogenesis of bacterial diseases of the gastrointestinal tract.
Describe the laboratory test and the markers to be used for diagnosis and prognosis of bacterial diseases of the gastrointestinal tract.
Principles of antimicrobial therapy and of vaccination
Parasitic and fungine infections will be included in the slide sets but remain as Self Study Program
Session 27 - PATHOLOGY, RADIOLOGY: Appendix and the anal canal
Acute and chronic appendicitis
Tumors of the appendix: adenocarcinoma and neuroendocrine neoplasms
Tumors of the anal canal: adenocarcinoma, melanoma and Paget disease
Radiological imaging of the appendix and rectum
Session 28 - PATHOLOGY: Molecular pathology of tumors of the gastrointestinal tract
Molecular features and prognostic biomarkers in esophageal squamous cell carcinoma.
Molecular pathology of stomach cancer and cancer of the gastroesophageal junction. HER2 testing: who gets trastuzumab? Historical perspectives, the TOGA trial, diagnostic guidelines.
Syndromic and sporadic colorectal cancer. Molecular classification. Mismatch repair testing: when and how? Morphological features suggestive of mismatch repair deficiency; clinical importance of MMr testing by immunohistochemistry and microsatellite instability. Clinical importance of tumor mutational burden assessment. Immunotherapy.
Session 29. PATHOLOGY: The pathology report in gastrointestinal pathology
Digital pathology, examples of pathologic reports and review of the main topics discussed in the previous lectures
Metodi didattici
Synchronous learning: lectures, Clinical cases, Seminars, Grand Rounds, Case studies and Laboratory skills.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Materiale di riferimento
Sleisenger And Fordtran's Gastrointestinal And Liver Disease, 10th edition
Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
Endocrinology
Programma
The course is based on a strong integration of different disciplines, thus the program of the single disciplines must be considered embedded in the program of the whole course which is reported in module Gastroenterology.
Metodi didattici
Synchronous learning: lectures, Clinical cases, Seminars, Grand Rounds, Case studies and Laboratory skills.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Materiale di riferimento
Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
Endotext: The best Clinical Endocrinology source in the world, and FREE. (www.endotext.org)
Endocrinology, Adult and Pediatric 7th edition. JL Jameson & LJ De Groot eds; Elsevier Saunders
Endotext: The best Clinical Endocrinology source in the world, and FREE. (www.endotext.org)
Endocrinology, Adult and Pediatric 7th edition. JL Jameson & LJ De Groot eds; Elsevier Saunders
Pathology
Programma
The course is based on a strong integration of different disciplines, thus the program of the single disciplines must be considered embedded in the program of the whole course which is reported in module Gastroenterology.
Metodi didattici
Synchronous learning: lectures, Clinical cases, Seminars, Grand Rounds, Case studies and Laboratory skills.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Materiale di riferimento
Robbins and Cotran. Pathologic basis of Disease (9th Edition)
Radiology
Programma
The course is based on a strong integration of different disciplines, thus the program of the single disciplines must be considered embedded in the program of the whole course which is reported in module Gastroenterology.
Metodi didattici
Synchronous learning: lectures, Clinical cases, Seminars, Grand Rounds, Case studies and Laboratory skills.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Materiale di riferimento
Essential of Radiology. F. A. Mettler. 3rd Edition. Elsevier Saunders (ebook)
Microbiology
Programma
The course is based on a strong integration of different disciplines, thus the program of the single disciplines must be considered embedded in the program of the whole course which is reported in module Gastroenterology.
Metodi didattici
Synchronous learning: lectures, Clinical cases, Seminars, Grand Rounds, Case studies and Laboratory skills.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Materiale di riferimento
Medical Microbiology, 8th edition. P. Murray, K Rosenthal, A. Pfaller Elsevier
Clinical Biochemistry
Programma
The course is based on a strong integration of different disciplines, thus the program of the single disciplines must be considered embedded in the program of the whole course which is reported in module Gastroenterology.
Metodi didattici
Synchronous learning: lectures, Clinical cases, Seminars, Grand Rounds, Case studies and Laboratory skills.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
All teaching materials (files of the teaching presentations and/or recorded lectures) will be made available on a specific Ariel platform.
Materiale di riferimento
Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Burtis & Bruns, 7th Edition, Elsevier
Moduli o unità didattiche
Clinical Biochemistry
BIO/12 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA - CFU: 1
Lezioni: 8 ore
: 4 ore
: 4 ore
Docente:
Tringali Cristina Alessandra
Endocrinology
MED/13 - ENDOCRINOLOGIA - CFU: 4
Lezioni: 36 ore
: 12 ore
: 12 ore
Gastroenterology
MED/12 - GASTROENTEROLOGIA - CFU: 4
Lezioni: 36 ore
: 12 ore
: 12 ore
Docenti:
Caprioli Flavio Andrea, Dell'Era Alessandra, Lampertico Pietro, Maconi Giovanni, Pastorelli Luca
Microbiology
MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA - CFU: 1
Lezioni: 8 ore
: 4 ore
: 4 ore
Docente:
Alteri Claudia
Pathology
MED/08 - ANATOMIA PATOLOGICA - CFU: 2
Lezioni: 16 ore
: 8 ore
: 8 ore
Docenti:
Fusco Nicola, Kuhn Elisabetta
Radiology
MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA - CFU: 2
Lezioni: 16 ore
: 8 ore
: 8 ore
Docente/i
Ricevimento:
Disponibile su Teams ed in presenza; giorno ed ora sono da concordare con il docente via email.
Teams or in presence
Ricevimento:
Venerdì 14-15 (su appuntamento)
IRCCS Istituto Auxologico Italiano - Ospedale San Luca (5°piano) - Piazzale Brescia 20 - 20149 Milano
Ricevimento:
Lunedi e Venerdì ore 9-10
Ospedale Niguarda Cà Granda, Piazza Ospedale Maggiore 3, 20162, Milano. Blocco Nord, III piano, Stanza 14
Ricevimento:
su appuntamento
Piazzale Brescia, 20 - Istituto Auxologico - Ospedale San Luca 20149 MILANO (MI)
Ricevimento:
Da concordare telefonicamente o tramite posta elettronica
Centro Diagnostico Italiano, Via Saint Bon 20, Milano
Ricevimento:
previo appuntamento da concordare via e-mail
Ricevimento:
previo appuntamento da concordare via e-mail
Ricevimento:
Previo appuntamento
Ospedale San Giuseppe, Via San Vittore 12, Milano
Ricevimento:
previo appuntamento da concordare via e-mail
Ricevimento:
Riceve su appuntamento da concordare via e-mail
Ospedale San Paolo - III piano blocco A, stanza 38 - Via Di Rudinì 8, Milano
Ricevimento:
previo appuntamento
Ist Auxologico Italiano, Via Magnasco 2, Endo 3° p, 20149 Milano
Ricevimento:
Da concordare via email
IRCCS Ospedale Galeazzi-Sant'Ambrogio, piano 0
Ricevimento:
su appuntamento tramite telefono/e-mail
via F.lli Cervi 93- LITA Segrate
Ricevimento:
Martedì e Giovedì ore 12 previo appuntamento