Medicine and Surgery

The Integrated Pathology II course deals with renal and genitourinary tract pathology. Lessons will be administered during the first semester of the 4th year. The Pharmacology Teaching Unit of the integrated renal and genitourinary tract pathology will address the following topics • Diuretics • Therapy of urinary tract infections (UTIs) • Therapy of benign prostatic hyperplasia • Therapy of bladder cancer Diuretics. The renal anatomy and physiology will be described focusing on the general mechanisms of glomerular filtration, renal epithelial transport, renin secretion and regulation, and feedback between macula densa cells and iuxtaglomerular cells. This will represent the basis for the understanding of diuretic action. The following classes of diuretics will be described in terms of clinical indications, mechanism of action, adverse effects, drug-drug interactions and contraindications: inhibitors of carbonic anidrase, osmotic diuretics, loop diuretics, thiazide and thiazide-like diuretics, K+-sparing diuretics. UTI therapy. Students will be will be introduced to the pathology of the UTIs and to the main pathogens responsible of the disease. The European guidelines for the therapy of UTI will be discussed and the antibiotics for both uncomplicated and complicated UTI will be described in terms of clinical indications, mechanism of action, adverse effects, drug-drug interactions and contraindications. Benign prostatic hyperplasia. Students will be introduced to the pathophysiology of the disease. The European guidelines for the therapy of the disease will be discussed and drugs will be described in terms of clinical indications, mechanism of action, adverse effects, drug-drug interactions and contraindications. Bladder cancer. The European guidelines for the therapy of bladder cancer will be described. Students will be introduced to the TNM staging of the disease and to the prognostic factors for disease recurrence. Instillation therapy (immunotherapy and chemotherapy) for superficial disease will be described as well as first line and second line chemotherapy for metastatic disease. All drugs will be discussed in in terms of mechanism of action, adverse effects, drug-drug interactions and contraindications

Knowledge of the anatomy and physiology of the kidney and urinary tract (important)

PowerPoint presentations of the Course lessons Goodman and Gilman's The Pharmacological Basis of Therapeutics, McGraw-Hill Education, XIV edition, 2023

Class attendance is mandatory, according to the Faculty rules

i. active partecipation during lessons (25%) ii. results from written examination (75%). Multiple choice-quizzes will be the standard test. Duration of the written examination will be 10 minutes for each unit. At least 4 correct answers are required to pass the test. In case the student will fail the written exam, he/she will be offered oral examination. For the oral examination, some of the elements that will be taken into consideration are: the logic applied to the resolution of the question; the adequacy of the response in relation to the knowledge the student should have acquired at the end of the course; the use of appropriate scientific language. In-coming international students who will request it, have the possibility to pass the exam in English. In this case, only oral examination will be offered.

Frontal lections and clinical case discussions with students. These will allow to obtain points 1 and 2 of learning objectives (see section on learning objectives awaited). Tutorials on how to navigate through the EMA, AIFA, and main scientific societies' websites, to find international therapy guidelines, will allow to obtain point 5 of learning objectives. Multiple-choice quizzes and/or short scientific reports will teach students how to integrate the knowledge derived from attending the course to formulate judgements based on the available data. (point 3 of learning objectives). Students will also be requested to discuss some scientific articles and translate their content into patient and relative-friendly information, in order to accomplish point 4 of learning objectives.