MICROBIOLOGY, GENERAL PATHOLOGY AND CLINICAL PATHOLOGY

Degree course: 
Corso di First cycle degree in Midwifery
Academyc year when starting the degree: 
2018/2019
Year: 
1
Academyc year when helding the course: 
2018/2019
Credits: 
4
Period: 
Second semester
Standard lectures hours: 
70
Requirements: 

Basic knowledge of biology, cytology, histology and genetics is necessary for understanding the topics discussed in the course. There are no constraints on propedeuticity.

Final Examination: 
Orale

The exam will be written and will consist of 3 open questions for each module, to be answered in 40 minutes for each module, in which the student will be asked to demonstrate the knowledge about the course program. The objective of the exam is to check the level of achievement of the objectives of the course.
The exam results will be in thirty points and to pass the exam, the student must score at least 18 (eighteen).
In particular the exam is aimed at assessing the student's skills in relation to:
General Pathology and Immunology:
1) basic knowledge of the innate and adaptive immune system, understanding of the cellular and molecular mechanisms of sensitization and immune activation in response to the recognition of a pathogen and the mechanisms of interaction and cooperation between innate and adaptive immune system in response to pathogens (1/3 of the final vote);
2) understanding and deepening the dynamics of the seven types of hypersensitivity, autoimmunity and HIV infection (1/3 of the final vote);
3) basic knowledge and understanding of mechanisms of cell pathology, cell death, cellular adaptation and tumor pathogenesis (1/3 of the final vote).
Clinical Pathology:
1) knowledge and understanding of pre-analytical variability, sensitivity, specificity and predictive values, as well as major circulating tumor markers, and proteins in diagnostics and indicators of cardiovascular disease (1/3 of the final vote);
2) understanding and deepening diagnostics in hematology, anemia, coagulative and fibrinolytic systems, endocrine disorders: thyroiditis and diabetes mellitus, as well as knowledge of the principles of inflammation, and the two main types of inflammation: acute and chronic and their chemical mediators (1/3 of the final vote);
3) basic knowledge and understanding of mechanisms of clinical enzyme, liver function indices, exocrine pancreas diagnostics, lipoprotein and lipid plasma, bone remodeling markers and renal function diagnostics, and vaccines (1/3 of the final vote).
Microbiology and Clinical Microbiology:
1) to know how to identify the fundamental aspects of a prokaryotic cell, of their physiology, and of the taxonomy with which they are classified (weight of 1/3 in the sum of the final score);
2) knowledge of the infectious mechanisms by which bacteria and viruses interact with the host (weight of 1/3 in the sum of the final score);
3) the mechanisms of action of antibiotics as a cure against infections, and the mechanisms that determine the drug resistance. Particular relevance to the diagnostic and clinical aspects (weight of 1/3 in the sum of the final score).

Assessment: 
Voto Finale

The course provides the general principles and general characteristics of General Pathology and, Immunology, Clinical Pathology and Microbiology and with them the appropriate scientific terminology for communicating these disciplines.
At the end of the course the student will be able:
1) to know and understand the principles of innate and acquired immunity, their dynamics and their functioning in health and illness;
2) to develop understanding and description capabilities of resistance mechanisms to the immune system that the various pathogenic microorganisms implement;
3) to know and understand the characteristics of major hereditary diseases, pathologies that reduce the efficiency of defense mechanisms, and inflammation;
4) to understand the notions of cellular pathology, cell growth and differentiation alterations, amyloidosis, spongiform encephalopathy and cell death (necrosis, apoptosis and autophagy);
5) to understand the etiology and pathogenesis of tumors, differences between benign and malignant tumors, nomenclature and classification criteria for tumors, their gradation and staging, and the study of oncogenes and oncosuppressor genes;
6) to know and understand the units of measurement, the importance of collecting and conserving biological samples, pre-analytical variability, sensitivity, specificity and predictive values;
7) to know and understand the characteristics of the major circulating cancer markers, their classification and clinical use, as well as indications of the use of such markers;
8) to develop understanding and description of hematology diagnostic mechanisms; of coagulative and fibrinolytic system; of liver function; of exocrine pancreas; of proteins; of cardiovascular disease; of diabetes and thyroiditis; of renal function; and associated with bone remodeling;
9) to understand the notions and principles of vaccination; acute and chronic inflammation, their chemical mediators, and systemic manifestations of inflammation;
11) to acquire the knowledge in the disciplines that contribute to the definition of the class of Diagnostic Medicine and Laboratory, and those useful for the characterization of the training path common to the various types of professional training in the Nursing and Obstetric field;
12) to acquire the knowledge about the morphology, physiology, taxonomic and genetic position of bacteria and viruses, and the cellular and molecular bases in the interactions that they establish with each other or with host cell. These interactions will represent simple models for the study and understanding of fundamental biological processes.
The student will also acquire autonomy of judgment and scientific terminology for communication in the field of reference and the correct use of laboratory diagnostics terminology.

GENERAL PATHOLOGY AND IMMUNOLOGY
The lessons will address the following topics:
General characteristics of the immune system. Physical / chemical barriers outside. Internal innate defenses. Molecules and cells of innate immunity. The complement system (4h).
Antigen recognition by T and B lymphocytes. Formation of antigen receptors on lymphocytes. Presentation of the antigen to T lymphocytes. The Major Histocompatibility Complex and various sub-types of T helper lymphocytes (4h).
Lymphocytes B. Various types and functions of antibodies. Dynamics of acquired immunity and primary and secondary lymphoid organs (4h).
Hereditary or genetic diseases and non-hereditary congenital illnesses. Principles of primary immunodeficiency. Acquired Immunodeficiency: HIV infection and AIDS (4h)
Acute and chronic inflammation. Classification of immunopathogenic reactions (4h).
Etiology and pathogenesis of self-immunity. Amyloidosis or beta-fibrillosis: Alzheimer's disease, spongiform encephalomyelitis and prion disease. Transplants (4h).
Cell pathology, cell damage, autophagy and cell death: necrosis and apoptosis. Cell adaptations (2h).
Etiology and tumor pathogenesis. Benign and malignant tumors. Grading and staging. Fundamental principles of carcinogenesis. Oncogenes and oncosuppressor genes (4h).

CLINICAL PATHOLOGY
The lessons will address the following topics:
Introduction to Laboratory Medicine. Collection and conservation of biological samples: pre-analytical variability. Sensitivity and specificity (2h).
Characteristics of the major circulatory markers of cancer, classification and clinical use of tumor markers (4h).
Protein in diagnostics and indicators of cardiovascular disease (4h).
Diagnostics in hematology: anemia. Coagulative and fibrinolytic system diagnostics (6h).
The two main types of inflammation: acute and chronic and their chemical mediators (2h).
Diagnosis of endocrine disorders: thyroiditis and diabetes mellitus (2h).
Clinical enzyme. Indices of liver function. Exocrine pancreas diagnostics. Lipoproteins and plasma lipids (4h).
Bone remodeling markers and renal function diagnostics (4h).
The vaccines. Basic concepts (2h).

MICROBIOLOGY AND CLINICAL MICROBIOLOGY
The lessons will be frontal and will address the following topics:
History of microbiology from how and when the study of this discipline began, focusing on the main findings, characterized by research, and the applicative implications of such discoveries. Study of the comparative elements in the morphological and physiological and biochemical aspects between prokaryotic cells and eukaryotes. Structure of bacteria and viruses and their replication and cultivation mechanisms. Study of the host-parasite interaction that underlies the infectious process with particular attention to the difference between infection and disease, and the consequent immune response. Taxonomy of the main bacteria and viruses responsible for infectious processes in humans. Basic elements concerning sterilization and disinfection, as forms of prevention in the genesis and control of infection. Use of the most important drugs (antibiotics) in the treatment of bacterial infections and their mechanisms of action and their consequent effects. Drug resistance and mechanisms that regulate their effectiveness, and the clinical significance of the antibiogram. Epidemiology and prevention of infections; Vaccines as a tool to prevent major diseases. The new frontiers of Microbiology and the innovative aspects in clinical diagnostics.

GENERAL PATHOLOGY AND IMMUNOLOGY
V. Del Gobbo - Immunology - Piccin Editions (4rd Edition, 2013).
G.M. Pontieri - General Pathology Elements - For Bachelor Degree in Health Professions - Piccin Editions (4rd Edition, 2018).

PATOLOGIA CLINICA
M. Cioffi - Laboratory Diagnostic Manual - Editions Minerva (2010).

MICROBIOLOGY and CLINICAL MICROBIOLOGY
Medical Microbiology II edizione – Guido Antonelli- Massimo Clementi–Gianni Pozzi – Gian mari Rossolini – Casa Editrice Ambrosiana.
Color Atlas and textbook of Diagnostic Microbiology- International Edition seventh edition- Gary W. Procop, Deidre L. Church, Geraldine S. Hall, William M. Janda, Elmer W. Koneman.
All slide lessons: downloadable from the University's E-learning site.

The course of General Pathology and Immunology consists of lectures for a total of 30 hours of frontal lessons (2 CFUs).
The course of Clinical Pathology consists of lectures for a total of 30 hours of frontal lessons (2 CFUs).
The course of Microbiology and Clinical Microbiology consists of lectures for a total of 20 hours of frontal lessons (1 CFU).
All lessons will be supported by power point slides projection.

The lecturer of General Pathology and Immunology, and of Clinical Pathology is available for further information or clarification on topics discussed for individual students or groups of students. He will receive students, after making an appointment by e-mail (lorenzo.mortara@uninsubria.it), at the Immunology and General Pathology Laboratory (1st floor), former Colonia Agricola, via Monte Generoso 71 (# 3), Varese.
The teacher of Microbiology and Clinical Microbiology is available to explore topics of particular interest, to clarify the topics covered where required, both for individual students or for groups of students. The teacher is available to receive students, by appointment, to be agreed via e-mail (francesco.tucci@asst-settelaghi.it), at the laboratory of Microbiology - Hospital of Circolo at Day Center (1st floor), Varese.