Medicine and Surgery

Learning outcomes: For each of the diseases listed below, the students will: a) Learn the macroscopic and microscopic features. b) Understand the relationship between morphologic features and physiopathology c) Understand the correlation between morphology and clinical symptoms d) Understand the role of the Pathologist in the multidisciplinary diagnostic flow-chart and be able to interpret a pathology report. Contents: Gastrointestinal tract: disease of the esophagus (esophagitis and Barrett esophagus; benign and malignant tumors). Disease of the stomach (gastritis; peptic ulcer disease; benign and malignant tumors; tissue determination of prognostic and predictive factors in gastric cancer). Disease of small and large intestines: malabsorption syndromes; inflammatory bowel disease (Crohn disease, ulcerative colitis, overlap colitis); vascular disorders (ischemic bowel disease); benign and malignant tumors; tissue determination of prognostic and predictive factors in colorectal cancer. Disease of liver and biliary tract: infectious disorders (viral hepatitis, bacterial, parasitic and helmintic infections); alcoholic liver disease; metabolic liver disease (non-alcoholic fatty liver disease and steatohepatitis, hemochromatosis, Wilson disease, alpha-1 antitrypsin deficiency); liver cirrhosis; “vanishing bile duct syndrome” (primary biliary cirrhosis, sclerosing cholangitis, chronic liver rejection); nodular hyperplasia, benign and malignant tumours; colelithiasis, colecystitis. Disease of the exocrine pancreas (pancreatitis; benign and malignant tumors). Endocrine system: pituitary gland (adenomas). Thyroid gland: thyroiditis (Hashimoto thyroiditis, subacute thyroiditis, lymphocytic thyroiditis); diffuse and multinodular goiter; benign and malignant tumors. Endocrine pancreas (diabetes mellitus; endocrine pancreatic neoplasms); adrenal glands (pathologic substrates of adrenal cortex insufficiency and hyperfunction; neoplasms of adrenal cortex and medulla); multiple endocrine neoplasia (MEN) syndromes. Head and neck pathology: salivary gland tumors. Larinx: reactive nodules, benign and malignant neoplasms. Diseases of white blood cells, lymph nodes, spleen and thymus: reactive lymphadenitis; lymphoproliferative disorders; myeloid neoplasms; splenomegaly; thimus tumours (benign and malignant). Benign and malignant bone and soft tissue tumors. Diseases of the central nervous system: cerebrovascular disease (ischemia and infarction); intracranial hemorrhages (intracerebral and subarachnoid); infections (meningitis); cerebral and meningeal tumors, primary and metastatic; neurodegenerative diseases (Alzheimer disease; frontotemporal lobar degenerations; Parkinson disease).

Requirements: Basic knowledge of gross and microscopic anatomy, physiology and general pathology

uggested textbooks: Robbins and Cotran: Pathologic Bases of Disease, latest edition

Teaching methods: Lectures and training sessions both in classroom and in small groups. Practical activities include the attendance of autopsies and interactive brain cutting sessions in the autopsy room. _

Roll call. To sit for the exam the Students must attend at least 70% of the activities

Evaluation methods: practical and written examination. The practical examination consists of three exercises, based on the interpretation of images and clinico-pathological cases. The Student is given 30 minutes. Each exercise is awarded the maximum of one point. Those who score 3 points has 2 bonus points for the final grade of the written exam. Those who total 2.5 points has a bonus of 1 point. The practical test is passed with a score between 1.5 and 2 points, with no bonus. The written test consists of 30 questions with multiple-choice answers. The Student is given 40 minutes Oral exam: optional

Teaching methods: Lectures and training sessions both in classroom and in small groups. Practical activities include the attendance of autopsies and interactive brain cutting sessions in the autopsy room. _

Contents: Gastrointestinal tract: disease of the esophagus (esophagitis and Barrett esophagus; benign and malignant tumors). Disease of the stomach (gastritis; peptic ulcer disease; benign and malignant tumors; tissue determination of prognostic and predictive factors in gastric cancer). Disease of small and large intestines: malabsorption syndromes; inflammatory bowel disease (Crohn disease, ulcerative colitis, overlap colitis); vascular disorders (ischemic bowel disease); benign and malignant tumors; tissue determination of prognostic and predictive factors in colorectal cancer. Disease of liver and biliary tract: infectious disorders (viral hepatitis, bacterial, parasitic and helmintic infections); alcoholic liver disease; metabolic liver disease (non-alcoholic fatty liver disease and steatohepatitis, hemochromatosis, Wilson disease, alpha-1 antitrypsin deficiency); liver cirrhosis; “vanishing bile duct syndrome” (primary biliary cirrhosis, sclerosing cholangitis, chronic liver rejection); nodular hyperplasia, benign and malignant tumours; colelithiasis, colecystitis. Disease of the exocrine pancreas (pancreatitis; benign and malignant tumors). Endocrine system: pituitary gland (adenomas). Thyroid gland: thyroiditis (Hashimoto thyroiditis, subacute thyroiditis, lymphocytic thyroiditis); diffuse and multinodular goiter; benign and malignant tumors. Endocrine pancreas (diabetes mellitus; endocrine pancreatic neoplasms); adrenal glands (pathologic substrates of adrenal cortex insufficiency and hyperfunction; neoplasms of adrenal cortex and medulla); multiple endocrine neoplasia (MEN) syndromes. Neuroendocrine tumors of the Gastro-intestinal tract (NET and NEC) Head and neck pathology: Tumors of the oral cavity and naso-pharynx. Salivary gland tumors. Larinx: reactive nodules, benign and malignant neoplasms. Diseases of white blood cells, lymph nodes, spleen and thymus: reactive lymphadenitis; lymphoproliferative disorders; myeloid neoplasms; splenomegaly; thimus tumours (benign and malignant). Benign and malignant bone and soft tissue tumors. Diseases of the central nervous system: cerebrovascular disease (ischemia and infarction); intracranial hemorrhages (intracerebral and subarachnoid); infections (meningitis); cerebral and meningeal tumors, primary and metastatic; neurodegenerative diseases (Alzheimer disease; frontotemporal lobar degenerations; Parkinson disease).

Requirements: Basic knowledge of gross and microscopic anatomy and, physiology and general pathology

Suggested textbooks: Robbins and Cotran: Pathologic Bases of Disease, latest edition

mandatory

1) Practical exam. It precedes the written exam. To give the written exam you MUST pass the practical one. You will be asked to interpret 3 clinico-pathologic cases (gross and/or histologic or cytologic findings). Each correct answer gives you 1 point (maximum: 3 points for 3 correct answers). Answers which are partially correct are scored 0.5. If you do not answer or if your interpretation is completely wrong, the score is 0. If you pass the practical exam with a total score of 3 to 2.5, you will receive a “bonus” of 2 points or 1 point respectively, which will be added to the score of your written exam. The results of your practical exams will be scored as follows: •3 = (with a 2 point bonus) •2,5 = (with a 1 point bonus) •2 to 1,5= you are admitted to the written exam, with NO bonus •<1,5 = You are not admitted to the written exam. If you do not want to give the written exam right after the practical one, you can keep your score until the end of the session (and not more!) 2) Written exam. It consists of 30 multiple-choice quiz. Each correct answer is scored 1. Wrong answers are scored 0. The minimum score required to pass the exam is 18. 3)Oral exam. It is OPTIONAL. You can ask for the oral exam to improve your score if you have a minimum score of 18. Remember that your score may improve, but the opposite is also possible. The exam modalities are the same for Anatomic Pathology I and II. The final score is a mean value of the scores obtained at the ongoing and final exams