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

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;
in drafting the mechanism of medical competence through which,
starting from symptoms and / or groups of symptoms, from clinical
examination and alterations of bio-temporal data, progress is made to the
identification and reconstruction of the pathophysiological mechanisms
typical of many syndromes and diseases , allowing its recognition and
clinical diagnosis; learn the classification and systematic description of
internist diseases, their etiology, progression, symptomatic expression,
complications and rational basis of therapy; begin the process of critical
linking of clinical elements common to different pathologies, their
recognition, their interrelation, as well as the clinical deepening of those
differences and differences that distinguish the different morbid
processes and form the basis of the differential diagnosis method.

Having passed the examination of Immunology and Pathology fundaments and methodology and Medical Semeiotics

Frontal Lesson / distance multimedia teaching

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Written exam with multiple choice questions concerning the subjects that
make up the integrated course.
Oral exam with discussion of clinical scenarios.

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 and interactive discussion.

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 set the laboratory and instrumental diagnostic planning for their solution.