D1 - Knowledge and understanding
At the end of the course, the student will have to demonstrate knowledge and understanding of the main clinical pictures of the pathologies exposed during the lessons, the diagnostic tools and the principles of medical therapy. He will also have to know the basics of genetics and related pathologies.

D2 - Ability to apply knowledge and understanding
At the end of the course the student must be able to recognize the clinical pictures associated with the pathologies presented during the course and must demonstrate that he is able to apply the correct interventions to correct it.

D3 - Making judgments
At the end of the course, the student must be able to make a differential diagnosis of diseases starting from the symptoms, signs and main laboratory tests, analyzing and proposing where possible different etiological hypotheses regarding clinical pictures that will be presented during the course .

D4 - Communication skills
At the end of the course, the student will have to demonstrate that he is able to expose the notions referred to in point D1

D5 Learning ability
At the end of the course the student must be able to independently find and adopt guidelines and literature on the main pathologies exposed in point D1

To take the final examination of the integrated course the student must have passed the exams of the 3rd year of Pathophysiology and Integrated Pathology and Pharmacology and the exam of the 4th year of Pathology. For a satisfactory learning of the contents of this course it is necessary that the student has acquired the basic knowledge of anatomy, biochemistry, genetics, physiology, molecular biology and medical semiotics.

Assessment of nutritional status and principles of clinical nutrition, refeeding syndrome, malabsorption syndromes, acute and chronic pancreatitis, inflammatory bowel disease, celiac disease and diarrhea (including principles of medical therapy), peptic disease and its complications (signs of medical therapy ) ), metabolic liver diseases, acute and chronic hepatitis (including autoimmune forms), liver cirrhosis and its complications, acute and chronic diseases of the gallbladder and biliary tract, differential diagnosis of jaundice, Mendel's rules, the human chromosomes, karyotype, chromosomal anomalies, structural, chromosomal anomalies, inheritance patterns of monofactorial characters: study of genealogical trees, autosomal dominant and recessive, blood groups, X-linked diseases, mitochondrial inheritance diseases, gene mutations and polymorphisms, assessment of cardiovascular risk, metabolic syndrome, diabetes mellitus and its complications, dyslipidemia, arterial hypertension and its complications (including principles of medical therapy), secondary hypertension, oedematous syndromes, nephrotic syndrome, heart failure heart disease, ischemic heart disease, endocarditis, atrial fibrillation, thromboembolic and arrhythmic risk management, syncope, cor pulmonale, shock, atrioventricular and intraventricular conduction defects, valvulopathy, acute and chronic renal failure, kidney infections and of the urinary tract, kidney stones, dialysis, hyper- and hypo-adrenal syndromes, bone diseases and osteoporosis, calcium-phosphorus metabolism alterations and hyperparathyroidism, hyper- and hypo-thyroid syndromes, thyroid nodules , pituitary adenomas, differential diagnosis and clinical analysis of anemias, purpura, thrombocytopenia, thromboembolic disease, thrombophilias, disseminated intravascular coagulation, leukemia, multiple myeloma, vasculitis, connective tissue disease, arthritis (including bases of steroid therapy and immunomodulatory), amyloidosis, peripheral vascular diseases and microangiopathies, respiratory insufficiency, chronic bronchopathies, pneumonias (including hints of medical therapy), pulmonary embolism, sarcoidosis, tuberculosis, fever of unknown origin , acid-base balance disorders and disturbances, interactions between drugs in the therapeutic prescription of the complex patient and with multiple pathologies, geriatric syndromes (incontinence, delirium, falls, frailty), multidimensional evaluation. Elementary dermatological lesions, infectious dermatology, diseases of immigrants. Venereology. Inflammatory, allergological, immunological and oncological dermatology. Dermatological emergencies. Acute bullous diseases. Severe skin rashes from environmental causes, rapidly progressing reactions after insect/arthropod stings. Acute skin infections. Burns. Rare diseases.

Harrison’s Principi di Medicina Interna 21° Edizione
C. Rugarli: Medicina Interna Sistematica
E. Bartoli: Medicina Interna
Washington Manuale di Terapia - 36° Edizione
Genetica umana e medica di Neri Giovanni; Genuardi Maurizio editore Edra Masson
ESPEN Book - Basics in Clinical Nutrition. 5° Edition Ed. Luboš Sobotka

Dermatology:
Elementary lesions, infectious dermatology, diseases of immigrants. Venereology. Inflammatory, allergological, immunological and oncological dermatology. Dermatological emergencies. Acute bullous diseases. Severe skin rashes from environmental causes, rapidly progressing reactions after insect/arthropod stings. Acute skin infections. Burns. Rare diseases.
Pharmacology:
Treatment of intestinal infections, peptic ulcer, pain, clinical use of steroids, gout therapy
Genetics:
Nucleus, chromosomes and DNA, cell division: mitosis and meiosis, Mendel's laws, human chromosomes, karyotype, chromosomal anomalies, structural anomalies, chromosomal diseases.
• Inheritance models of monofactorial characters: study of genealogical trees,
autosomal dominant and recessive diseases, blood groups, X-linked diseases,
mitochondrial inheritance. •Gene mutations and polymorphisms
Geriatrics
Frailty, falls, restraint, multidimensional assessment, delirium, principles of nutrition in the elderly
Internal Medicine:
Respiratory failure, COPD, asthma, pulmonary embolism, pneumonia, gastroesophageal reflux disease, gastrointestinal bleeding, gastritis and peptic ulcer, ischemic colitis, acute and chronic pancreatitis, diarrhea celiac disease, Crohn's disease, ulcerative colitis, thyroid nodules, hyper- and hypothyroidism, adrenal insufficiency, glucocorticoid excess syndrome, endocrine hypertension, hypo- and hypernatremia, hypo- and hyperkalaemia, hypo- and hypercalcaemia, primary hyperparathyroidism, metabolic and respiratory acidosis and alkalosis, type 1 and 2 diabetes mellitus and its complications, dyslipidaemias , metabolic syndrome, amyloidosis, portal hypertension and ascites, portosystemic encephalopathy, fatty liver, jaundice, cirrhosis, hepatitis, cholestasis, cholelithiasis, cholecystitis, monoarthritis and polyarthritis, rheumatoid arthritis, systemic lupus erythematosus, vasculitis, gout, osteoporosis, anemia, haemostasis and coagulation disorders, disseminated intravascular cogulation (DIC), thrombocytopenia, leukemia, multiple myeloma, tuberculosis, fever of unknown origin, essential or secondary arterial hypertension, renovascular, syncope, ischemic heart disease, heart failure, cor pulmonale, shock, atrial fibrillation, atrioventricular and intraventricular conduction defects, valvulopathies, endocarditis, urinary calculi, acute and chronic renal failure, dialysis, nephrotic syndrome.
Medical therapy:
Treatment of arterial hypertension and community and hospital pneumonia. Anticoagulants: use and news. Treatment of major atrial and ventricular arrhythmias.
Nutritional requirements in the healthy person. Artificial nutrition: indications. Choice and prescription of enteral and parenteral nutrition. Monitoring and complications of artificial nutrition. The refeeding syndrome. Short bowel syndrome

Frontal lectures supported by slides (Power Point) which will be made available to the students
Clinical clerkship rotations in Internal Medicine and Geritric wards

Prof. Rocco Barazzoni
Clinica medica
7 piano Torre Medica
Ospedale di Cattinara
Tel 040-3994416
e-mail: barazzon@units.it

Prof. Gianni Biolo
Clinica medica
6 piano Torre Medica
Ospedale di Cattinara
Tel 040-3994532
e-mail: biolo@units.it

Prof.ssa Giuliana Decorti
Dipartimento di Scienze della Vita - Via Fleming, 22
Tel 040-5588777
e-mail: decorti@units.it

Prof. Paolo Gasparini
Unita' Clinica Operativa di Clinica Pediatrica
Ospedale Burlo Garofolo
Tel: 0403785275
e-mail: pgasparini@units.it

Prof.ssa Iris Zalaudek
Unita' Clinica Operativa di Clinica Dermatologica
Ospedale Maggiore
Tel 040-3992128
e-mail: izalaudek@units.it

Prof.ssa Michela Zanetti
UCO Geriatria
Ospedale Maggiore
Piazza dell'Ospitale 1, TS
Tel 040-3992787
e-mail: zanetti@units.it

The grade of the final exam is based on the evaluation (weighted average) of the tests of the single modules that are included in the integrated course. To pass the final exam it is necessary to have passed (minimum score of 18/30) the written tests foreseen for the single teaching modules. These tests are prepared by the individual teachers of each teaching module in order to verify the progress of knowledge in the specific area covered. They consist of a variable number of open/closed questions established by the teacher; the number and type of questions are communicated to the students in advance at the beginning of the lessons. The mark obtained in the individual tests is considered in the attribution of the final mark, which is calculated according to the weighted average of the tests relating to the modules that make up the course. The final vote is expressed in thirtieths. To pass the exam (18/30) the student must have achieved a minimum score of 18/30 in each test. For defining the average, 1 point is attributed to any honors obtained in the partial tests, i.e. the vote of 30 with honors corresponds numerically to the score of 31. To acquire the maximum score (30/30 with honors) the weighted average obtained from all the tests must be equal or above 30,5/30.

This teaching explores topics closely related to one or more of the goals of the United Nations 2030 Agenda for Sustainable Development