CLINICAL INTRODUCTION III

Integrated educational activity

Course Sheet

Course code:

CRD22B6

Academic Year of enrolment:

2019

Year of supply:

2020/2021

Degree:

Course of 1st Cycle Degree in CARDIOCIRCULATORY AND CARDIOVASCULAR PERFUSION TECHNIQUES

Moduls:

PHARMACOLOGY I - 1 credits
PHARMACOLOGY II - 1 credits
NEPHROLOGY - 2 credits
NEUROLOGY - 1 credits

Location:

CHIETI

Credits:

Programme Year:

Cycle:

Second semester

Hours of classroom activity:

Prerequisites:

As expected from academic regulations.
For the nephrology course, knowledge of:
- anatomy and histology of the genitourinary system;
- general concepts of physiology of the genitourinary system;
- general diagnostic concepts for images of the genitourinary system;
- general notions concerning inflammatory, infectious and immunological processes.

Objectives

The course of pharmacology I is part of the specific objectives of the study program aimed at training a professional figure able to: know and understand the concepts of general pharmacology and non-steroidal anti-inflammatory drugs In particular, the Pharmacology course aims to allow the Student to i) develop: - - the principles of pharmacokinetics (the path of the drug within the human organism, assessed in its qualitative / quantitative aspects) and of pharmacodynamics (drug / target interactions and analysis of the dose-response relationship); - adequate knowledge on the pharmacological basis of therapy, with particular attention to anti-inflammatory therapy ii) acquire: - the tools for a reasoned understanding of what the drug produces once it has been introduced into the human organism (pharmacodynamics) taking into account how it is distributed and modified in the organism itself (pharmacokinetics), integrating the knowledge on the mechanism of action, efficacy and safety of drugs with knowledge on the physiology of pharmacological targets and on the pathophysiology of processes modified by pharmacological intervention.
EXPECTED LEARNING RESULTS At the end of the course the student, as far as his / her competence is concerned, will be able to know the pharmacological basis of the therapy. The course will help to provide the student with tools that will enable him to enhance his skills in relating to the team ( doctors, psychologists, health assistants, etc.) who, in an increasingly multidisciplinary approach, will be called to take care of the patient.

The course of pharmacology II is part of the specific objectives of the study program aimed at training a professional figure able to: Know and understand the concepts of general pharmacology and the main classes of drugs (action mechanisms, therapeutic indications, effects) side). In particular, the Pharmacology course aims to allow the student to develop: i) adequate knowledge on the pharmacological basis of therapy, with particular attention to anticoagulant, antiplatelet, antihypertensive and anti-inflammatory therapy; ii) tools for a reasoned understanding of the principles of pharmacogenomics.
EXPECTED LEARNING RESULTS At the end of the course the student, as far as he is competent, will be able to: i) know the pharmacological basis of the therapy; ii) to know the collateral and toxic effects of drugs and the potential interactions between them. The course will help to provide the student with tools that will enable him to enhance his skills in interacting with multidisciplinary teams with other professional figures (doctors, nurses, etc.) who, in an increasingly multidisciplinary approach, will be called to take care of the patient.

The course of nephrology contributes to the realization of the educational objective of the Course in Cardiocirculatory and Cardiovascular Pathophysiology Techniques providing students with knowledge about signs and symptoms, diagnostic procedures and therapeutic indications in the pathologies of the nephropathic patient, consistently with the professional profile of Technician Perfusion.
Expected learning outcomes
At the end of the course the students will be able:
a) With reference to the signs-symptoms proteinuria, haematuria, oliguria, polyuria, perife¬rico edema:
- to illustrate the individual pathophysiological mechanisms;
- to list the clinical significance and the main causes;
- to plan a correct diagnostic procedure.
b) Interpret in a physiopathological and diagnostic key the possible results of the urine test.
c) Specify indications and contraindications, complications, costs, reliability of the main specialized diagnostic procedures:
- renal function test
- urine culture
- renal biopsy
- diagnostic imaging
- laboratory diagnostics.
d) With reference to the systematic nosography:
- To know, on the basis of epidemiological information, which are the most frequent pathologies affecting the urinary system.
- Differentiate and interpret the pathophysiological elements of clinical semeiology for the purpose of a correct classification of pathologies.
- Specify the pathogenic role of the main risk factors.
- Being able to analyze clinical and instrumental data to make a correct diagnosis and set up a therapeutic scheme.

The course of neurology contributes to the realization of the educational objective of the Course in Cardiocirculatory and Cardiovascular Pathophysiology Techniques providing students with knowledge to identify the diagnostic suspicion of cerebrovascular accident and to identify the brain areas involved. The student should know the causes on ischemic and hemorragic stroke and the general principles of stroke management.
Finally, the student should identify and classify different degrees of alterations of consciousness state.

Contents

The integrated Course of clinical propaedeutics III consists of : pharmacology I and II, nephrology and neurology
The course of pharmacology I includes two sections:
1) General pharmacology: this section describes the principles that underlie the human-drug interactions and that in turn are divided into two chapters, the one related to Pharmacokinetics (the effects that the body has on drugs) and the one on Pharmacodynamics (the cellular and molecular mechanisms that underlie the therapeutic, unwanted and toxic effects of drugs).
2) Special Pharmacology: this section describes the characteristics of the single classes of drugs (in particular non steroidal antiinflammatory drugs)

The course of pharmacology II includes the special Pharmacology consisting of two sections: one in which the characteristics of the individual classes of drugs are described (steroidal anti-inflammatory drugs, anti-platelet drugs, anti-coagulant drugs, antihypertensive drugs, principles of antimicrobial therapy) and one dedicated to the principles of pharmacogenomics

The course of nephrology aims to provide students with adequate knowledge concerning:
1) Diagnostic use of nefro-urological signs and symptoms interpreted in relation to their physiopathogenesis.
2) Physiopathological, laboratory and instrumental diagnostic procedures and their indications in nephrology disorders.
3) Systematic nosology of the main nephrological diseases.
4) Basic concepts concerning the criteria and indications of renal replacement therapy.
5) Main techniques of renal replacement therapy in intensive care units.

The course of neurology aims to provide students with adequate knowledge concerning clinical pathophysiology of stroke, ischemic stroke and choma.

Extended Syllabus

Pharmacology I
General pharmacology:
- Pharmacokinetic aspects: absorption, plasma protein binding, distribution, metabolization and elimination of drugs. Half-life of a drug and administration interval.
- Aspects of pharmacodynamics: receptor, mechanisms of receptor signal transduction, concept of agonist and antagonist, potency and efficacy of a drug, therapeutic index.
Non-steroidal anti-inflammatory drugs (NSAIDs)

Pharmacology II
Steoidal anti-inflammatory drugs;
Pharmacological bases of anticoagulant and antiplatelet therapy;
Levels of pharmacological intervention in hypertensive patients;
Principles of antimicrobial therapy, beta-lactam antibiotics, aminoglycosides, macrolides;
Principles of pharmacogenomics

Nephrology
PHYSIOPATHOLOGICAL AND DIAGNOSTIC ELEMENTS OF NEPHROPATHIES
Evaluation of the urine test; evaluation of renal function; signs and symptoms of kidney disease; instrumental investigations in nephrology; renal biopsy.
GLOMERULAR NEPHROPATHIES
Classification; clinical glomerular syndromes; synthetic references on the etiopathogenesis and on the main anatomical-clinical pictures; diabetic nephropathy; general criteria of therapy.
VASCULAR NEPHROPATHIES
Classification; hypertensive nephropathy; nephrovascular hypertension; ischemic nephropathy.
INTERSTITIAL NEPHROPATHIES
Classification; pyelonephritis; kidney cystic diseases.
RENAL ACUTE INSUFFICIENCE
Classification; etiology, pathogenesis, pathophysiology, symptomatology, clinical and instrumental diagnosis of the various forms of acute renal failure; general criteria of medical therapy.
CHRONIC RENAL FAILURE
Classification in 5 stages; etiology, epidemiology, pathophysiology, symptomatology, diagnostics, medical therapy to antagonize the progression of the disease and to treat the complications associated with it.
REPLACEMENT THERAPY OF THE CHRONIC UREMIA
Start and choice of chronic artificial replacement therapy; main features of hemodialysis and peritoneal dialysis; suitability for renal transplantation and main characteristics of the transplanted patient.
REPLACEMENT THERAPY OF ACUTE RENAL INSULATION
Timing and choice of renal replacement therapy in the Intensive Care Unit.

Neurology
1. Description of extracranial and intracranial brain blood perfusion. Anteriore and poterior ciruculation, Willis polygon.
Description of the causes and pathogenesis of stroke with specific attention to compensation mechanisms as related to changes in arterial diameter and perfusional pressure.
2. and 3. Description of the causes and pathogenesis of ishemic and hemorragic stroke.
4. Description of organization of stroke units and of optimal management of acute stroke.
5. Description and classification of consciousness alterations and choma and identification of underlying causes.

Recommended Bibliography

Pharmacology
-Farmacologia generale e molecolare". F. Clementi e G. Fumagalli. Editore:UTET
-Panus PC, Katzung B, Jobst EE, Tinsley SL, Masters SB, Trevor AJ. Farmacologia in riabilitazione. Edi-ermes
-Rossi F, Cuomo V, Riccardi C. Farmacologia-Principi di base e applicazioni terapeutiche. Edizioni Minerva Medica

Nephrology
- Albertazzi Porena, Malattie del Rene, delle Vie Urinarie e dell’Apparato Genitale Maschile, Piccin Editore, 2017
- V. Bonomini, Nefrologia Clinica, Esculapio Editore, 1990

Neurology
- Cambier, Masson. Neurologia. Edizioni Masson

Teaching Methods

The courses of pharmacology I e II include lectures and interactive lessons. The courses aim to provide the theoretical basis necessary for a reasoned understanding of what the drug produces once it has been introduced into the human organism (pharmacodynamics) taking into account how it is distributed and modified in the organism itself (pharmacokinetics). At the same time, special care will be taken in linking theoretical knowledge with the evidence emerging from the use of drugs as tools of therapeutic armamentarium. In itinere will be proposed exercises (multiple choice tests) to verify the level of personal learning.

The nephrology course includes frontal lectures for all students, small group exercises during the frequency of the Nephrology Clinic.

The neurology course includes frontal lectures.

Evaluation methods

Verification of learning:

For the courses of Pharamcology I e II, the learning will be evaluated through a final assessment, which includes a written test [multiple choice questions (each question has 4 answers, only the correct one)]and an oral one aimed at providing a balanced assessment of the achievement of the objectives of the Core Curriculum. The written exam must be completed within 30 minutes of the start. The examination procedure and its evaluation are indicated by the teacher at the beginning of the lessons.

For the course of nephrology the learning will be evaluated through a final assessment, which will consist of an oral exam.

For the course of neurology the learning will be evaluated through a final assessment, which will consist of a multiple choice questionnaire

Contacts/More Information

Each teacher indicated the information deemed appropriate

Università degli Studi
"G. d'Annunzio"

Chieti - Pescara

Aree