Degree course: 
Corso di Long single cycle degree (6 years) in MEDICINE AND SURGERY
Academic year when starting the degree: 
Academic year in which the course will be held: 
Second semester
Standard lectures hours: 

In addition to the compulsory prerequisites, it is advisable for the student to have in mind the fundamental concepts of Biochemistry, Physiology and general pathology. The course starts from the knowledge previously acquired by the student in the course of Medical Microbiology.

The verification of the expected knowledge and skills is carried out with an oral exam. It will be evaluated:
1) knowledge and understanding of the proposed concepts and methods (30%);
2) the ability to apply this knowledge autonomously and knowingly (30%);
3) logical-argumentative abilities, or the relevance of answers with respect to questions; the ability to construct one's own critical, relevant, clear, effective and personal discourse (40%).

Voto Finale

It is the general objective of the course to provide the student with the basis for a rational use of Laboratory Diagnostics in order to optimize the diagnostic-therapeutic pathway. This is achieved by treating and placing laboratory investigations with respect to biological and physiopathological processes concerning organs, systems and metabolic systems. In particular, aspects relating to a correct clinical methodological approach are highlighted, including the appropriateness of the request for diagnostic investigations, the evaluation of their clinical efficiency and the estimation of the impact on the efficacy of treatment. Acquire the diagnostic test methodologies for infectious diseases, the criteria that guide the choice of these tests and the interpretation of the results. At the end of the course the student must be able to recognize the potential and limits of the main clinical biochemistry, cellular and molecular biology techniques; the student must also be able to evaluate the diagnostic-clinical aspects of microbiological and virological analysis.

A. General Part
1. Interpretation and appropriateness in laboratory medicine. Reasons for requesting laboratory tests

2. Biological variability and interpretation of laboratory tests
1. definitions
1. Controllable biological variability
2. inter-individual biological variability
3. intra-individual biological variability
4. analytical and interpretative relevance of biological variables
5. field of application
2. Definition of analytical goals according to biological variability
1. metrological premises
2. imprecision goals
3. goals of inaccuracy
4. analytical goals for different quality levels
3. relevance of biological variability for the interpretation of results
1. critical difference
2. reference values
4. medical relevance of biological variability
1. index of individuality

3. Interpretative criteria for the optimal use of laboratory tests
1. Reference intervals
1. factors that influence and characterize the reference population
2. internal laboratory factors that influence and characterize the reference values
3. recommendations for the production of reference values
4. definition of the terminology
5. operational strategies for determining "reference values" and "reference limits"
6. statistical treatment of reference values to obtain the reference interval
2. comparison of the results with the previous results of the same patient
3. decision-making levels
4. the interpretation of the results in probabilistic terms
1. clinical sensitivity
2. clinical specificity
3. "ROC" curves
4. likelihood ratio or likelihood ratio
5. multivariate reference regions
6. differential diagnosis (discriminant analysis)
7. the interpretation of the results by deterministic rules
8. the criterion of the outcome of the disease (outcome)

4. Pre-analysis phase
1. patient-related variables
1. biological variability
2. pre-analytical variability, related to the preparation and the state of the patient
2. sample-related variables
1. request for inappropriate examination or necessary examination not required (appropriateness of the request)
2. insufficient sample
3. coagulated sample
4. hemolyzed sample
5. lipemic sample
6. jaundice sample
7. sampling order
8. recommendations for venipuncture
9. pre-analytical treatment problems in the laboratory

B. Special part
1. Diagnosis of diabetes mellitus
1. physiopathological and clinical bases
1. carbohydrate metabolism and its regulation
a. the phases of energy homeostasis
2. metabolic alteration in different conditions
a. hyperglycemia
b. hypoglycemia
c. diabetic ketoacidosis
d. coma osmolar
e. dyslipidemia
3. epidemiology, etiopathogenesis and classification of diabetes mellitus
a. epidemiology
b. etiology
c. classification
2. laboratory evaluations
1. methodological aspects
a. glycemia
b. glycated hemoglobin
c. glycated plasma proteins
d. chetonic bodies
e. microalbuminuria
2. choice and interpretation of laboratory examinations
a. criteria for the diagnosis of diabetes mellitus
b. interpretative criteria of laboratory tests

2. The laboratory in the evaluation of cardiovascular risk
1. physiopathological and clinical bases
1. lipoproteins and their metabolism