Nursing

Activity type

Interdisciplinari e cliniche

SSD

MED/06

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

FRANCESCA PRIMI

Activity type

Interdisciplinari e cliniche

SSD

MED/10

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

Elisa Catasca

Activity type

Interdisciplinari e cliniche

SSD

MED/11

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

carlo andrea stazi

Activity type

Interdisciplinari e cliniche

SSD

MED/13

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

ALFONSO PEZZELLA

Activity type

Interdisciplinari e cliniche

SSD

MED/14

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

FRANCESCA TINTI

Activity type

Interdisciplinari e cliniche

SSD

MED/15

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

MARIA ROSARIA RICCIARDI

At the end of the course, the student will have acquired knowledge on the main pathologies of specialist medical/surgical interest by describing the fundamental aspects of the main pathological pictures in the haematological, oncological, nephrological, cardiological, endocrinological and respiratory fields. The teaching allows, in its global contents, the acquisition of basic skills for the management of clinical-assistance problems in the specialist field.

Upon completion of the course, students will be able to describe the fundamental aspects of the main pathological conditions in hematology, oncology, nephrology, cardiology, endocrinology, and respiratory medicine. The clinical, diagnostic, and therapeutic knowledge acquired during the lessons dedicated to the various medical specialties in the individual modules will enable students to identify and describe the appropriate instrumental investigations and laboratory diagnostic tests for different pathological cases. Students will also be able to integrate this knowledge into planning the nursing management of patients with complex conditions in these specialty areas.

The student has an advantage in following the lessons and studying the topics of the integrated course if he has basic knowledge of biology, anatomy and physiology

Module: ONCOLOGY
Course Contents
• Gene mutations and genomic alterations. The process of tumor transformation: multiphase process, monoclonality, tumor heterogeneity. Classes of genes important in tumor transformation: oncogenes, tumor suppressor genes, cyclins, proofreader genes, genes inducing apoptosis and cell survival. Genetic cooperation for tumor transformation. The double- and single-hit theory. Examples of genes involved in tumor transformation: p53 and RB.
Characteristics of the tumor cell: blockade of contact growth inhibition, morphological characteristics, mitotic index, nuclear-cytoplasmic inversion. Benign and malignant tumors: characteristics. Invasiveness and metastasis. Neoangiogenesis. Staging system: TNM.
• Innate and acquired immune response. Antigen-presenting cells: macrophages and dendritic cells. Effectors of the innate response: NK cells and adaptive response: T and B lymphocytes. Overview of antigen recognition mediated by T and B lymphocytes: TCR/HLA-peptide complex and antibody.
The antitumor immune response: the 3E theory or immunoediting. The phases of elimination, equilibrium, escape, or immunosuppression.
• Antitumor therapeutic strategies: Surgery (role, purpose, and types); Radiotherapy (principles and administration methods, combination with surgery or chemotherapy); Medical therapy: chemotherapy (classes of chemotherapy and mechanisms of action, alkylating agents, antimitotics, antimetabolites, platinum analogs, anticancer antibiotics, topoisomerase inhibitors); hormone therapy (mechanisms of action and types of therapy); targeted therapies (outline);
• Immunotherapy: active and passive. Use of monoclonal antibodies in therapy (e.g., trastuzumab and bevacizumab). Adoptive T-cell immunotherapy: TILs, CIKs, and CARs, overview. Vaccination strategy: peptide administration and administration of modified dendritic cells.


Module: RESPIRATORY SYSTEM DISEASES
Anatomy and Physiology of the Respiratory System. Introduction to Respiratory Problems.
Diagnostic Procedures in Respiratory Diseases: Chest Pain; Lung Cancer; Pneumonia; Abdominal Pneumonia; Tuberculosis; COPD; Bronchial Asthma; Bronchodilators; Tracheostomy Management; Air Pollution; Respiratory Failure; Oxygen Therapy.



Module: DISEASES OF CARDIOVASCULAR SYSTEM
Cardiac Anatomy
Coronary Anatomy
(Hemodynamic History)
(Coronary Angiography)
(Angioplasty)

Chronic Ischemic Heart Disease
Electrocardiogram
Arrhythmias: Tachycardias and Bradyarrhythmias

Sinus Rhythm
- AF (Atrial Fibrillation)
- VT (Ventricular Tachycardia)
- AV Block (Atrioventricular Block)
- PSVT (Paroxysmal Supraventricular Tachycardia)

STEMI ANT INF LAT
High-risk NSTEMI (negative precordial ventricular arrhythmias)

Heart Failure
Cardiogenic Shock
Pulmonary Embolism
AGE

DRUGS



Module: ENDOCRINOLOGY
Introduction to the Endocrine System: Mechanisms of Hormone Action
Pathophysiology of the Hypothalamic-Pituitary Axis
Secreting and Non-Secreting Pituitary Adenomas: Clinical Practice, Diagnostics, and Nursing Management of Patients with Pituitary Diseases
Hypopituitarism
Empty Sella Syndrome
Central Diabetes Insipidus
Thyroid Pathophysiology: Hyperthyroidism and Hypothyroidism
Acute, Subacute, and Chronic Thyroiditis
Endemic Goiter
Thyroid Nodule Management
Thyroid Tumors: Histological Classification and Therapeutic Considerations
Calcium/Phosphorus Metabolism
Pathophysiology of the Parathyroid gland: Hypo- and Hyperparathyroidism
Pathophysiology of the Adrenal Glands:.
Dynamic Tests for the Diagnosis of Major Endocrine Disorders
Disorders of the Adrenal Medulla: Pheochromocytoma
Endocrine Hypertension. Primary Hyperaldosteronism
Metabolic Syndrome
Classification of Diabetes: Type I, Type II, and Other Types
Diagnostic Criteria for Diabetes
Laboratory Tests in the Diagnosis and Treatment of Diabetic Patients
Nursing Management of Patients with Diabetes
Glycemic Monitoring
Treatment of Type I and Type II Diabetes (Hints)
Nursing Management of Acute and Chronic Complications of Type I and Type II Diabetes
Gestational Diabetes: Diagnostic Criteria, Nursing Management of Patients with Diabetes During Pregnancy, Treatment.



Module: NEFROLOGIA
Anatomical overview of the kidney and urinary tract; elements of renal physiology.
The nurse–hospitalized patient relationship in the context of renal diseases: assessment of vital signs related to renal function; evaluation of fluid balance.
Basic elements of kidney and urinary tract semeiotics.
Evaluation of renal function: glomerular filtrate and renal clearance.
Urinalysis and its abnormalities Overview of instrumental diagnostics. Renal biopsy.
Main nephrological conditions of nursing interest: urinary tract infections, acute and chronic renal failure, nephritic and nephrotic syndromes, brief overview of glomerulonephritis and polycystic kidney disease.
Indications and management of renal replacement therapy: hemodialysis, peritoneal dialysis, kidney transplantation. Vascular and peritoneal access.



Module: BLOOD DISEASES
Hematopoiesis.
Diagnostic tests in hematology: peripheral blood and bone marrow.
Anemias: classification
Platelet and coagulation disorders.
Onco-hematology
- Definition of neoplasia. General features of the neoplastic cell.
- Integrated diagnostic pathway in onco-hematology:
 Morphological examination
 Flow cytometry
 Cytogenetics and molecular genetics
 Molecular investigations
- Definition and classification:
 Acute myeloid and lymphoid leukemia
 Chronic myeloproliferative neoplasms
 Chronic lymphatic leukemia
 Hodgkin's lymphoma, non-Hodgkin's lymphomas,
 Monoclonal Gammopathies and Multiple Myeloma
Stem cell transplantation: autologous and allogeneic.

The objective of the module is the classification of the main haematologic diseases. The course also aims to provide students with knowledge about the principles of treatment of the onco-haematological patients.

Module: ONCOLOGY
General Pathology, Pontieri, Piccin
General Pathology and Pathophysiology, Pontieri, Piccin
Lecture notes.



Module: RESPIRATORY SYSTEM DISEASES
Lacedonia, Donato; Carpagnano, Giovanna Elisiana; Scioscia, Giulia: Compendium of Respiratory System Diseases. SEU, 2023
Santus - Radovanovic – AAVV: Respiratory System Diseases. Idelson – Gnocchi, 2022.
Teaching materials and other supporting information (slides and handouts) will be provided by the teacher during class.
Reference Books. Harrison: Internal Medicine, McGraw-Hill, 2021



Module: DISEASES OF CARDIOVASCULAR SYSTEM
Lecture Slides
Renato Massini "Internal Medicine" (4th Edition) MC Graw Hill



Module: ENDOCRINOLOGY
F. Monaco Endocrinology (for undergraduate programs in health professions), Società Editrice Universo.




Module: NEFROLOGIA
-Massini Renato – Medicina Interna – Laurea Infermieristica. Mc Graw Hill Education
-Laura Willis: Lippincott Certification Review: Medical-Surgical Nursing. Lippincott Williams & Wilkins



Module: BLOOD DISEASES
Ematologia di Mandelli- Avvisati et al, second edition (2019) ISBN: 978-88-299-2307-6; Piccin.
Compendio di Medicina Interna (Capitolo 7) - Amoroso A, Afeltra A, Rossi Fanelli F - Antonio Delfino Editore.
Any other recently published hematology textbook can be used.

Module: ONCOLOGY
Scientific articles indicated by the instructor


Module: RESPIRATORY SYSTEM DISEASES
N/D
Module: DISEASES OF CARDIOVASCULAR SYSTEM
N/D
Module: ENDOCRINOLOGY
Recent bibliography recommended in class.


Module: NEFROLOGIA
-Review: Imaging and treating chronic kidney disease - February 9, 2015 https://www.nursingtimes.net/clinical-archive/long-term-conditions/managing-and-treating-chronic-kidney-disease/5081921.article#


Module: BLOOD DISEASES
Recent bibliography indicated during the lessons.

The lessons will be held in the classroom with the aid of PowerPoint presentations prepared by the teacher on the various topics of the program.

Mandatory attendance with at least 66% attendance. Attendance will be recorded by the instructor in a specific class register, which will be submitted to the degree program office at the end of the course.

The final exam will be administered by the teachers, either oral or written (consisting of 10 multiple-choice questions) for each module. Students who achieve a passing grade in each module will pass the exam.

- Pulmonary embolism risk factors
- Difference between asthma and chronic bronchitis
- Methodical spirometry

- Endocrine-related hypertension
- Nursing assistance in performing dynamic tests

- Describe the main classification criteria for anemias
- Clinical manifestations of leukemias and lymphomas

_What is STEMI and how is it treated?
_How is atrial fibrillation characterized by an ECG?

- What are the nurse's direct responsibilities in managing patients with chronic renal failure on dialysis?
- What defines creatinine clearance?

- What is the primary purpose of adjuvant chemotherapy?
- What are the risk factors for lung cancer?

Module: ONCOLOGY

•  Gene
  mutations and genomic alterations. The process of tumor transformation:
  multiphase process, monoclonality, tumor heterogeneity. Classes of genes
  important in tumor transformation: oncogenes, tumor suppressor genes, cyclins,
  proofreader genes, genes inducing apoptosis and cell survival. Genetic
  cooperation for tumor transformation. The double- and single-hit theory.
  Examples of genes involved in tumor transformation: p53 and RB.Characteristics
  of the tumor cell: blockade of contact growth inhibition, morphological
  characteristics, mitotic index, nuclear-cytoplasmic inversion. 


• Antitumor
  therapeutic strategies: Surgery (role, purpose, and types); Radiotherapy
  (principles and administration methods, combination with surgery or
  chemotherapy); Medical therapy: chemotherapy (classes of chemotherapy and
  mechanisms of action, alkylating agents, antimitotics, antimetabolites,
  platinum analogs, anticancer antibiotics, topoisomerase inhibitors); hormone
  therapy (mechanisms of action and types of therapy); targeted therapies
  (outline);• Immunotherapy: active and passive. Use of monoclonal antibodies in
  therapy (e.g., trastuzumab and bevacizumab). Adoptive T-cell immunotherapy:
  TILs, CIKs, and CARs, overview. Vaccination strategy: peptide administration
  and administration of modified dendritic cells.


• Antitumor
  therapeutic strategies: Surgery (role, purpose, and types); Radiotherapy
  (principles and administration methods, combination with surgery or
  chemotherapy); Medical therapy: chemotherapy (classes of chemotherapy and
  mechanisms of action, alkylating agents, antimitotics, antimetabolites,
  platinum analogs, anticancer antibiotics, topoisomerase inhibitors); hormone
  therapy (mechanisms of action and types of therapy); targeted therapies
  (outline);• Immunotherapy: active and passive. Use of monoclonal antibodies in
  therapy (e.g., trastuzumab and bevacizumab). Adoptive T-cell immunotherapy:
  TILs, CIKs, and CARs, overview. Vaccination strategy: peptide administration
  and administration of modified dendritic cells.

• Anatomy and
  physiology of the respiratory system. Introduction to respiratory problems.


• Diagnostic
  procedures in respiratory diseases: chest pain; lung cancer; 


• Pneumonia; abdominal
  pneumonia; tuberculosis; COPD; bronchial asthma; bronchodilators; 


• Tracheostomy
  management; air pollution; respiratory failure; oxygen therapy.

• Cardiac anatomy.  Coronary anatomy.  History of hemodynamics.
  Coronary angiography. Angioplasty - PCI: Percutaneous Coronary Intervention. Chronic
  Ischemic Heart Disease (IHD).  Electrocardiogram (ECG). Arrhythmias:
  Tachyarrhythmias and Bradyarrhythmias.


• SR (Sinus Rhythm). AF (Atrial Fibrillation). VT (Ventricular
  Tachycardia). AVB (Atrioventricular Block). PSVT (Paroxysmal
  Supraventricular Tachycardia). STEMI (Anterior / Inferior /
  Lateral)  (= ST-Elevation Myocardial Infarction,
  Anterior/Inferior/Lateral Walls). NSTEMI alto rischio (avr up, precordiali
  negative). High-Risk NSTEMI (positive aVR, negative precordial
  leads)  (NSTEMI = Non-ST Elevation Myocardial Infarction


• Heart failure. Cardiogenic Shock. Pulmonary Embolism (PE). Arterial
  Blood Gas (ABG)

• Introduction
  to the endocrine system: Mechanisms of hormone action Pathophysiology of the hypothalamic-pituitary axisSecreting and non-secreting pituitary adenomas: clinical practice, diagnostics, and nursing management of patients with pituitary diseases hypopituitarism. Empty Sella syndrome Central diabetes insipidus


• Thyroid pathophysiology: hyperthyroidism and hypothyroidism.Acute, subacute, and chronic thyroiditisEndemic goiter.Thyroid nodule management.Thyroid tumors: histological classification and therapeutic considerations.Calcium/phosphorus metabolism. Pathophysiology of the parathyroid gland: hypo- and hyperparathyroidism. Pathophysiology of the Adrenal Glands:.DynamicTests for the
  Diagnosis of Major Endocrine DisordersDisorders of the Adrenal Medulla:
  Pheochromocytoma Endocrine Hypertension. Primary Hyperaldosteronism
  Metabolic Syndrome


• Classification
  of Diabetes: Type I, Type II, and Other TypesDiagnostic Criteria for
  DiabetesLaboratory Tests in the Diagnosis and Treatment of Diabetic
  PatientsNursing Management of Patients with DiabetesGlycemic
  MonitoringTreatment of Type I and Type II Diabetes (Hints)Nursing Management of
  Acute and Chronic Complications of Type I and Type II DiabetesGestational
  Diabetes: Diagnostic Criteria, Nursing Management of Patients with Diabetes
  During Pregnancy, Treatment.

• Anatomical overview of the kidney and urinary
  tract; elements of renal physiology.
  
  The
  nurse–hospitalized patient relationship in the context of renal diseases:
  assessment of vital signs related to renal function; evaluation of fluid
  balance.


• Basic elements of kidney and urinary tract
  semeiotics.
  
  Evaluation
  of renal function: glomerular filtrate and renal clearance.
  
  Urinalysis
  and its abnormalities Overview of instrumental diagnostics. Renal biopsy.


• Main
  nephrological conditions of nursing interest: urinary tract infections, acute
  and chronic renal failure, nephritic and nephrotic syndromes, brief overview of
  glomerulonephritis and polycystic kidney disease.
  
  Indications
  and management of renal replacement therapy: hemodialysis, peritoneal dialysis,
  kidney transplantation. Vascular and peritoneal access.

• Hematopoiesis. Hematopoietic progenitors and stem cells. Diagnostic tests in hematology: peripheral blood and bone marrow.Oncohematology- Definition of neoplasm. General characteristics of the neoplastic cell. Integrated diagnostic workup in oncohematology• Morphological examination• Immunophenotype• Cytogenetics and molecular genetics• Molecular investigations


• Oncohematology- Classification:• Acute myeloid and lymphoid leukemias• Chronic myeloproliferative neoplasms• Chronic lymphocytic leukemia• 


• Hodgkin's lymphoma, non-Hodgkin's lymphomas• Monoclonal gammopathies and multiple myeloma


• Anemias: classification
  
  Platelet and coagulation disorders. Hematopoietic Stem cell transplantation: autologous and allogeneic.