Ateneo - UPO

Pathophysiological bases of cardio-respiratory and systemic diseases

Harrison's Principles of Internal Medicine 21th ed. 2022; Rugarli, Systematic Internal Medicine ed. 2021; Ettore Bartoli, Internal Medicine, ed.2010; McCance, Pathophysiology and Elements of General Pathology ed. 2016; Ernesto Damiani, General Pathophysiology for Medicine and Surgery ed. 2019.

Cognitive objectives: to enable students to understand the pathophysiological mechanisms that lead to the functional alterations characteristic of various groups of diseases that affect each and every organ and apparatus and to promote the understanding of the mechanisms that, starting from pathophysiological changes, cause the appearance of symptoms and characteristic signs of individual diseases; to draft the mechanism of medical competence through which, starting from symptoms and / or groups of symptoms, clinical examination and alterations of biohumoral data, progress is made to the identification and reconstruction of the pathophysiological mechanisms typical of many syndromes and diseases, allowing their recognition and clinical diagnosis; to learn the classification and systematic description of internist diseases, their etiology, progression, symptomatic expression, complications and rational basis of therapy; to begin the process of critical linking of clinical elements common to different pathologies, their recognition, their interrelation, as well as the process of clinical deepening of those differences and diversities that distinguish the different morbid processes and form the basis of the differential diagnosis method.

Have a knowledge of the fundamentals of Human Anatomy and Human Physiology.

Frontal Lesson / distance multimedia teaching

nn

Written exam with multiple choice questions concerning the subjects that make up the integrated course.

Pathophysiology of heart failure: recalls of physiology, heart failure with reduced and preserved ejection fraction. The mechanisms of myocardial damage and hemodynamic compensation. Pulmonary edema: clinical and pathophysiological notes. Shock, definition and classification. Hypovolemic, cardiogenic and distributive shock: pathophysiological mechanisms, clinical correlates, pathophysiological approach to treatment. Clinical scenarios in interactive discussion. The multiorgan syndrome. Gas exchange. Recalls of physiology. Measurements of oxygenation. Alveolar hypoventilation and the calculation of the alveolar-arterial oxygen gradient. Normal gradient (hypoventilation) and increased gradient (V/Q impairment, diffusion impairment, shunt) oxygen exchange disturbances. The transport of CO2 and oxygen. Arterial oxygen content and oxygen delivery. The pathophysiological basis of acid-base balance alterations. The carbonic acid buffer system. Respiratory and renal compensation. The alterations of the acid-base balance. Acute and chronic respiratory acidosis. Respiratory alkalosis. Metabolic acidosis and the anion GAP. Metabolic alkalosis. Methodological approach to arterial blood gas interpretation with practical exercises and interactive discussion. Pathophysiology of essential and secondary arterial hypertension. The organ complications of arterial hypertension. Deep vein thrombosis, epidemiology, risk factors, pathophysiology, clinical and diagnostic elements. Pulmonary thromboembolism, epidemiology, pathophysiology, clinical manifestations and diagnosis. Pathophysiology of electrolyte disturbances. Hyponatremia pathophysiological approach to diagnosis. Pathophysiology of hypernatremia, hypo and hyperkalemia. Methodological approach to the interpretation of the electrocardiogram with practical exercises.

At the end of the course, the student will be able to recognize the main pathophysiological pictures of heart, lung and systemic diseases and will be able to correlate clinical pictures with their pathophysiological bases and to set the laboratory and instrumental diagnostic planning for their solution.