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Endocrine, Metabolic and Gastroenteric Diseases

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Endocrine, Metabolic and Gastroenteric Diseases

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Academic year 2023/2024

Course ID
SCB0211
Teachers
Marco De Gobbi (Coordinator)
Alessandro Morotti (Lecturer)
Giuseppe Reimondo (Lecturer)
Alessia Ciancio (Lecturer)
Roberta Giordano (Lecturer)
Alberto Arezzo (Lecturer)
Year
3rd year
Teaching period
First semester
Type
Basic
Credits/Recognition
10 (80 hours of lectures, 40 of exercises)
Course disciplinary sector (SSD)
MED/09 - internal medicine
MED/12 - gastroenterology
MED/13 - endocrinology
MED/18 - general surgery
Delivery
Formal authority
Language
English
Attendance
Mandatory
Type of examination
Written and oral
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Sommario del corso

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Course objectives

The course aims to provide elements of a decision-making process that leads to the diagnosis of the main gastrointestinal, endocrinological and metabolic diseases, as well as to the rational setting of both medical and surgical therapy.

The means proposed for this purpose include:

  • The collection of anamnestic data structured by problems;
  • The patient's physical signs;
  • The knowledge of the biotechnological and instrumental resources that can be used, and of their predictive value according to the different contexts of use;
  • The knowledge of the pathophysiological mechanisms involved in the individual diseases;
  • The critical evaluation and the ability to correlate clinical symptoms, physical signs and functional alterations with pathological lesions, interpreting their production mechanisms and understanding their clinical significance;
  • The concept of etiopathogenetic therapy.
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Results of learning outcomes

After attending the course students will be expected to reach the above-mentioned learning objectives

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Program

ENDOCRINOLOGY

  • ENDOCRINE SYSTEM: definition, general anatomy and physiology, hormone synthesis and secretion, hormonal action and physiological function.
  • HYPOTHALAMUS-PITUITARY AXES: clinical presentation, diagnostic evaluation and treatment of pituitary hormone excess (hyperprolactinemia, acromegaly, Cushing’s disease) and deficiency (hypopituitarism, diabetes insipidus), syndrome of inappropriate antidiuretic hormone secretion (SIADH).
    THYROID GLAND: clinical presentation, diagnostic evaluation and treatment of hypo- and hyper-thyroidism, benign and malignant nodules.
  • PARATHYROID GLANDS: clinical presentation, diagnostic evaluation and treatment of primary and secondary hyper-parathyroidism, hypoparathyroidism; metabolic osteopathies (osteoporosis and osteomalacia).
  • ADRENAL GLANDS: clinical presentation, diagnostic evaluation and treatment of Cushing’s syndrome, hyperaldosteronism, pheochromocytoma, Addison’s disease and congenital adrenal hyperplasia.
  • GONADS: clinical presentation, diagnostic evaluation and treatment of disorders of sexual differentiation, male and female hypogonadism, pathology of the menstrual cycle.
  • GROWTH and PUBERTY DISORDERS: low and high stature, delayed and early puberty.
  • MEN and APS: Multiple endocrine neoplasia and autoimmune-polyendocrine-syndromes.

After attending the course students will be expected to:

  • Know the anatomical and physiological basis of the endocrine system and its modifications across the lifespan;
  • Suspect the presence of the main endocrine disorders;
  • Know the consequences of hormone excess or deficiency;
  • Know advantages and risks of hormonal therapies;
  • Discuss clinical cases focusing on clinical suspicion, diagnostic approach and therapeutic options.


GASTROENTEROLOGY

Gastro-enteric system: definition, anatomy and general physiology, hormonal synthesis and secretion, hormonal action and physiological function. Manage care for patients with gastrointestinal and hepatic diseases

  • ESOPHAGEAL DISEASES AND MOTILITY: Dysphagia, Achalasia, Benign and malignant tumors of the esophagus of the esophagus. Clinical presentation, diagnostic evaluation and treatment
  • GASTRIC DISEASES: Acute and chronic gastritis, peptic ulcer, reflux disease, gastric cancer. Clinical presentation, diagnostic evaluation and treatment
  • INTESTINAL DISEASES: coeliac disease, Crohn’s disease, ulcerative colitis, IBS, colon cancer. Clinical presentation, diagnostic evaluation and treatment
  • LIVER DISEASE: acute and chronic viral hepatitis, steatosis, autoimmune hepatitis, Wilson’s disease and Hemochromatosis. Clinical presentation, diagnostic evaluation and treatment

After attending the course students must:

  • Knowledge of the anatomical and physiological basis of the gastrointestinal and hepatic system;
  • Suspect the presence of major gastrointestinal and liver disorders;
  • Activate decision-making processes based on patient conditions, altered parameter values, laboratory reports and examinations;
  • Manage diagnostic pathways ensuring adequate patient preparation for diagnostic procedure and post-procedure surveillance;
  • Manage the care of patients (pediatric, adult and elderly age) with gastro-intestinal and liver diseases,
  • Managing care in patients with chronic problems
  • Discuss clinical cases focusing on clinical suspicion, diagnostic approach and therapeutic options;
  • Identify educational interventions aimed at people who must continue treatment at home or continue self-management of the disease.


INTERNAL MEDICINE (METABOLISM)

  • DIABETES MELLITUS: Diagnosis, classification, and pathophysiology; Management and therapies; Acute and chronic complications; Discussion of the recent guidelines.
  • DISORDERS OF LIPOPROTEN METABOLISM: Diagnosis, classification, and pathophysiology; Management and therapies; Discussion of the recent guidelines.
  • ARTERIAL HYPERTENSION: Approach to the patients with arterial hypertension (excluded phaeochromocytoma and aldosteron producing adenoma); Resistant and malignant hypertension; Management and therapies; Discussion of the recent guidelines.
  • PURINES and PYRIMIDINES metabolism and disorders.
  • HOMOCYSTEIN metabolism and disorders.
  • INHERITED METABOLIC DISORDERS: inborn error of metabolism and screening.
  • ACQUIRED METABOLIC TOPICS: neoplastic cachexia.
  • IRON and CUPPER metabolism: inherited and acquired disorders (Hemochromatosis, Iron loading anemia, ACD, Wilson disease).
  • ALPHA-1 ANTITRYPSIN DEFICIENCY
  • PORPHIRIAS: metabolic disorders caused by altered activities of enzymes within the heme biosynthetic pathway.
  • HYPERBILIRUBINEMIAS



GENERAL SURGERY

  • ESOPHAGUS:
    • Physiopathology;
    • Gastro-oesophageal reflux disease and its complications;
    • Primary and secondary motility disorders;
    • Traction and drive diverticula;
    • Dysphagia;
    • Achalasia;
    • Pre-neoplastic lesions and carcinomas.
  • STOMACH:
    • Physiopathology;
    • Dyspepsia;
    • Peptic ulcer, Complicated ulcer disease;
    • Acute and chronic gastritis;
    • Helicobacter Pylori infection;
    • Early gastric cancer;
    • Gastric neoplasias;
    • Acute and chronic upper digestive bleedings.
  • GUT:
    • Physiopathology and clinical manifestations of gut malabsorption;
    • Coeliac disease;
    • Chronic diarrhea;
    • Meckel’s diverticulum;
    • Obstruction;
    • Mesenteric Ischemia.
  • COLON and RECTUM:
    • Physiopathology;
    • Complicated diverticular disease, appendicitis;
    • Appendicular mucocele;
    • Obstruction;
    • Constipation;
    • Colon polyps;
    • Inflammatory bowel diseases: Crohn disease and ulcerative colitis;
    • Colon and rectum neoplasias.
  • PANCREAS:
    • Acute and chronic pancreatitis;
    • Pancreatic cancer.
  • LIVER and GALLBLADDER:
    • Diagnostic flow-chart of liver diseases;
    • Differential diagnosis of jaundice;
    • Acute hepatitis and their evolution;
    • Symptomatic gallbladder calculosis;
    • Liver cirrhosis;
    • Chronic liver failure (ascites, porto-systemic encephalopathy, olyguric liver failure, portal hypertension, etc.);
    • Primary and secondary liver tumors.

 

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Course delivery

Course will be delivered as face-to-face lecture

Teaching materials will be uploaded to the Moodle page of the Course

Remember to register for the Course on the Moodle page in order to have access to the teaching materials uploaded on the Moodle page

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Learning assessment methods

As permitted by the University and the MedInTO Degree Course, from March 2022 all teaching activities and exams will take place in person. On-line exams are guaranteed only in case there are health reasons directly linked to the pandemic (certified fragile subjects, subjects in home isolation). Students must sign-up for the exam on Esse3 and indicate their request for remote examination in the "Notes" field.
The self-certification of the reasons for taking online exams may be subject to verification by the University / Degree Course and the result of the exam may be cancelled in the absence of documentation proving the self-certification.

Students have to sign up for both dates by deadlines. No exceptions will be made if someone fails to sign up on Esse3.  As soon as the the final number of Students enrolled to the exam is defined, a detailed calendar and timetable will be provided.

It is not allowed to split the exam. The exam for all the subjects of the course must be taken in the same exam session (i.e. all subjects in January; all subjects in February; all subjects in April and so on).

Unless otherwise specified, timetable will be as it is on Esse3 (not on other Applications, e.g. MyUnito)


There will be a written test with 100 multiple choice questions (1 correct answer out of 4-5 possibilities) divided by discipline:

  • Endocrinology: 30
  • Gastroenterology: 30
  • Internal Medicine: 30 (10 for each module)
  • General Surgery: 10

1 point for correct answer, no penalty for wrong answers.

Score:
0-58: failed
59-74: oral mandatory examination in all subjects
75-100: oral optional examination (if taken, in all subjects)

With a score equal to or greater than 59 (60% overall) the test will be considered passed and the student will have access to the oral exam. Unless otherwise specified, the oral examination will be scheduled in the second date of the session

If a student fails the oral exam or does not complete the oral exam within the ongoing exam session, then the written test must be retaken. In the event a student fails the oral exam only in one discipline, he/she has the opportunity to re-take only the insufficient part during the next exam session. A student with two or more insufficient marks has to take all the subjects in the following exam sessions.

Suggested readings and bibliography



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Book
Title:  
Williams Textbook of Endocrinology
Year of publication:  
2020
Publisher:  
Elsevier
Author:  
Shlomo Melmed, Richard J. Auchus, Allison B. Goldfine, Ronald J. Koenig, Clifford J. Rosen.
ISBN  
Permalink:  
Required:  
Yes


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Book
Title:  
Digestive Disease
Year of publication:  
2022
Publisher:  
EDRA
Author:  
Unigastro
ISBN  
Permalink:  
Required:  
Yes


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Book
Title:  
Sleisenger and Fordtran's Gastrointestinal and Liver Disease
Year of publication:  
2002
Publisher:  
Saunders
Author:  
Mark Feldman, Lawrence S. Friedman, Marvin H. Sleisenger
ISBN  
Permalink:  
Required:  
Yes


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Book
Title:  
Harrison's Principles of Internal Medicine
Year of publication:  
2018
Publisher:  
McGraw-Hill Education
Author:  
J. Larry Jameson, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo, Joseph Loscalzo
ISBN  
Permalink:  
Required:  
Yes


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Book
Title:  
Harrison's Manual of Medicine, 20e
Year of publication:  
2020
Publisher:  
McGraw-Hill Education
Author:  
J. Larry Jameson, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo, Joseph Loscalzo
ISBN  
Permalink:  
Required:  
Yes


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Book
Title:  
Sabiston Textbook of Surgery
Year of publication:  
2021
Publisher:  
Elsevier
Author:  
Courtney Townsend
ISBN  
Permalink:  
Required:  
Yes


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Notes

Students with DSA or disabilities are kindly requested to take note of the reception services and support services offered by the University of Turin, and in particular of the procedures required for exam support.

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Teaching Modules

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Last update: 29/11/2023 14:15
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