Ateneo - UPO

Pathophysiological foundations of the major human diseases. Clinical reasoning: from disruption of normal physiology, to symptom, to diagnosis. Overview of the pathogenic processes underlying the principal diseases.

Harrison's Principles of Internal medicine 21th ed. 2022, Rugarli, Medicina Interna Sistematica ed.2021, Ettore Bartoli, Medicina interna, ed. 2010

To guide students in developing a deep understanding of the pathophysiological mechanisms that lead to recognizable clinical features across diseases affecting various organs and systems. Starting from pathophysiological alterations, students will learn to identify deviations from normal physiology and to suspect the presence of specific diseases. The course will foster medical reasoning skills, enabling students to move from symptoms and/or symptom clusters, clinical examination, and alterations in laboratory data toward the identification and reconstruction of the underlying pathophysiological mechanisms typical of many syndromes and diseases, thereby supporting clinical recognition and diagnosis. Students will also learn the classification and systematic description of internal medicine diseases, their etiology, progression, symptom expression, possible complications, and the rational basis of therapeutic approaches.

A solid knowledge of human anatomy and physiology, as well as basic principles of biochemistry and physics relevant to biomedical sciences.

Frontal Lecture / Remote Multimedia Teaching

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Written exam with multiple-choice questions (4 options, only one correct answer) covering the subjects included in the integrated course (in coordination with the Medical Semiology module)

Pathophysiology of heart failure: Review of cardiac physiology; heart failure with reduced and preserved ejection fraction; myocardial damage mechanisms and hemodynamic compensations. Pulmonary edema: clinical and pathophysiological overview. Shock: definition and classification. Hypovolemic, cardiogenic, and distributive shock: pathophysiological mechanisms, clinical correlations, and treatment-oriented approach. Interactive discussion of clinical scenarios. Multiorgan dysfunction syndrome. Gas exchange: Review of respiratory physiology. Assessment of oxygenation. Alveolar hypoventilation and calculation of the alveolar–arterial oxygen gradient. Disorders of oxygen exchange with normal gradient (hypoventilation) and increased gradient (V/Q mismatch, diffusion impairment, shunt). Transport of oxygen and carbon dioxide. Arterial oxygen content and oxygen delivery. Pathophysiology of acid–base balance disorders: Carbonic acid buffer system. Respiratory and renal compensations. Acid–base imbalances: 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: Organ complications of hypertension. Deep vein thrombosis: Epidemiology, risk factors, pathophysiology, clinical features, and diagnostic elements. Pulmonary embolism: epidemiology, pathophysiology, clinical presentation, and diagnosis. Pathophysiology of electrolyte disorders: Hyponatremia: pathophysiological approach to diagnosis. Pathophysiology of hypernatremia, hypo- and hyperkalemia. Methodological approach to electrocardiogram interpretation. Pathophysiology of diabetes mellitus.

The goal is for students to be able to recognize alterations from normal human physiology, formulate hypotheses about the presence of disease based on pathophysiological knowledge, and plan appropriate diagnostic investigations—both laboratory and instrumental—to support clinical decision-making.