Teachings

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Professor
STEFANO ANGIONI (Tit.)
VALERIO MAIS
Period
First Semester 
Teaching style
Convenzionale 
Lingua Insegnamento
 



Informazioni aggiuntive

Course Curriculum CFU Length(h)
[40/39]  MEDICINE AND SURGERY [39/00 - Ord. 2015]  PERCORSO COMUNE 7 115

Objectives

KNOWLEDGE AND UNDERSTANDING
Students will achieve general knowledge related to the organization, the structure and normal functioning of the female reproductive system. The main purpose is to understand the standard healthy patients care and any pathological changes. Knowledge from a preventive to diagnostic and rehabilitative point of view will be required. In particular, the objectives are:
- understanding the state of health and disease.
- recognize the most frequent forms of gynecological pathology.
- achieve knowledge of the pathophysiological, psychological and clinical problems concerning female fertility and sexuality and its dysfunctions from a medical sexual point of view
- understand natural and assisted reproductive techniques from an endocrine-gynecological point of view;
- pregnancy and prenatal morbidity and childbirth.
APPLICATION CAPABILITIES
Students will have to address any preventive, diagnostic, prognostic and therapeutic issues related to the female reproductive system. Throughout a physiopathological interpretation, they will have to detect clinical and laboratory findings to make a final diagnosis and evaluate the prognosis.
Cost / benefit ratio evaluations in the choice of diagnostic procedure will be required, paying attention to the correct clinical principles of evidence-based medicine.
Changes in the maternal organism during pregnancy will be learned together with the theoretical knowledge of physiological full-term birth and the clinical presentation of obstetric emergencies.
Students will have to know the theoretical basis of contraception and the pathophysiology of menopause, the theoretical tools for the clinical classification of abnormal uterine bleeding, endopelvic masses and pelvic floor pathology.
Moreover, they will have to know the screening programs and the early diagnosis of the main gynecological neoplasms, and how to set up a basic counseling for contraception, infertility and menopause.
AUTONOMY OF JUDGMENT
Students will have to detect from a clinical and socio-cultural point of view all information relating to the state of health and disease of patients. Problem solving skills will be necessarily developed to make appropriate considerations in terms of physiopathology and priority health problems.
COMMUNICATION SKILLS
Students will learn clear communication skills with colleagues and patients (including their family members). Professionality and sympathy should be both exercised.
LEARNING ABILITY
Students will learn the critical-analytical reading of scientific articles and how to carry out bibliographic research and updating. In addition, the management of independent study and of their own lifelong organization will be crucial for their individual growth.

Prerequisites

Attendance to Integrated Courses of the years preceding the VI

Contents

GYNECOLOGY
1. Anatomy of the female genital system, elements of embryology
2. Biological basis of reproductive function (steroid hormones, pituitary hormones, prolactin, hypothalamic hormones, oxytocin, inhibin)
3. Ovarian and menstrual cycle
4. Gynecological, clinical and instrumental diagnostics (gynecological physical examination, oncological cytodiagnostics, colposcopy, gynecological ultrasound, radiological examinations in gynecology, hysteroscopy, gynecological laparoscopy)
5. Menstrual changes; anovulation; dysmenorrhea
6. Puberty
7. Menopause
8. Amenorrhea, hirsutism and polycystic ovary syndrome
9. Contraception (hormonal; intrauterine devices; sterilization)
10. Inflammation of the female genital system (vaginitis, pelvic inflammatory disease)
11. Pelvic floor pathology (urinary incontinence, utero-vaginal prolapse)
12. Sexually transmitted diseases
13. Endometriosis
14. Fibroids
15. Diagnosis and infertility treatments. Assisted reproductive techniques
16. Law 19/02/2004, No. 40 "medically assisted reproduction"
17. Cervicocarcinoma screening; HPV, Pap smear, dysplastic lesions
18. Cervical cancer: diagnosis, staging and therapy
19. Metrorrhagia
20. Benign pathology of the endometrium (polyps, hyperplasia)
21. Endometrial cancer and uterine sarcoma
22. Ovarian cysts
23. Ovarian tumors (benign, borderline and malignant)
24. Vulvar dystrophic lesions and vulva carcinoma
25. Trophoblastic neoplasms (hydatiform mola, choriocarcinoma)
26. Main gynecological interventions (myomectomy, hysterectomy, adnexal surgery, laparoscopy)

OBSTETRICS
1. Fertilization and implantation
2. Placental anatomy and physiology
3. Physiological modifications of the main systems in pregnancy
4. Surveillance protocol of physiological pregnancy
5. Ultrasound in pregnancy: principles and fundamental notions in obstetric ultrasound diagnostics
6. Evaluation of fetal well-being: cardiotocography; fetal biophysical profile; Doppler velocimetry
7. Labor and delivery
8. Physiology of the puerperium
9. Evaluation of the newborn (Apgar score, pH on cord blood)
10. Prenatal diagnosis: diagnostic techniques (amniocentesis, CVS, cordocentesis) and screening.
11. Puerperium
12. Maternal diseases in pregnancy
13. Infections in pregnancy: viral infections (cytomegalovirus, rubella, parvovirus, HIV), toxoplasmosis, syphilis
14. Diabetes in pregnancy
15. Hypertension in pregnancy
16. Multiple pregnancy
17. Preterm birth
18. Extrauterine pregnancy
19. Abortion
20. Law 194
21. Placenta previa and placental abruption
22. Amniotic fluid disorders (oligohydramnios, polyhydramnios)
23. Rh alloimmunization, ABO isoimmunization
24. Intrauterine growth retardation
25. Pathologies of delivery: dystocia, fetal-pelvic disproportion, abnormal presentations
26. Secondment disorders (placenta retention, postpartum haemorrhage)
27. Pathology of the puerperium (traumatic, infectious, metrorrhagia, thromboembolic)
28. Obstetric operations
29. Indications for the Caesarean section
30. Obstetric emergencies
31. IVG and Law 194

Teaching Methods

The course will take place with lectures that involve the use of PowerPoint presentations and practical activities that will be held in the ward and clinics. Lectures can be alternated with innovative teaching methods, which aim to actively involve students in the learning process (activelearning) through the analysis and interpretation of clinical cases. In accordance with what is indicated in the Manifesto of Studies for the AY 2020-2021 (page 12): "Teaching will be delivered simultaneously both face to face and online, thus outlining a mixed teaching that can be enjoyed in university classrooms but at the same time also at a distance. At the beginning of the semester, the student will opt for face-to-face or remote teaching. The choice will be binding for the entire semester. If the number of students exceeds the capacity of the classrooms, determined on the basis of government provisions on health matters for the purpose of combating the Covid-19 pandemic, access to the educational facilities will be regulated through a shift system that will be communicated in due time to the interested students

Verification of learning

The final exam consists in a written or oral test.
Written test: the student will have to answer multiple choice questions on different blocks of the program.
Oral exam: the student will have to answer open-ended questions on the different topics of the program also presented in the form of a clinical case.
In both cases the final grade is expressed out of thirty. The test is passed if at least the mark of 18/30 is achieved.
Knowledge of the course topics, rational diagnostic hypotheses and the set-up of appropriate diagnostic program will be assessed. The non-specialist knowledge of therapies relating to the various pathologies examined will also be assessed. Finally, the use of appropriate terminology and synthesize abilities will be assessed.
The final grade takes into account:
Quality of knowledge, skills, competences possessed and / or manifested:
a) appropriateness, correctness and congruence of knowledge
b) appropriateness, correctness and congruence of skills
c) appropriateness, correctness and congruence of skills
Exhibition mode:
a) Expressive capacity;
b) Appropriate use of the specific language of the discipline;
c) Logical skills and consequentiality in the connection of contents;
e) Ability to connect different topics by finding common points and establishing a coherent general design, that is, taking care of the structure, organization and logical connections of the expository discourse;
f) Ability to synthesize.
The judgment can be:
a) Sufficient (from 18 to 20/30)
The candidate demonstrates few acquired notions, superficial level, many gaps, modest expressive skills, but sufficient to support a coherent dialogue; logical skills and consequentiality in connecting elementary level arguments; poor synthesis and graphic expression skills; poor interaction with the teacher during the interview.
b) Fair (21 to 23)
The candidate demonstrates a fair acquisition of notions, but little in-depth, few gaps; expressive skills more than sufficient to support a coherent dialogue; acceptable command of scientific language; logical skills and consequentiality in the connection of topics of moderate complexity; more than sufficient capacity for synthesis and graphic expression.
c) Good (from 24 to 26)
The candidate demonstrates a rather broad knowledge base, moderate in-depth study, with small gaps; satisfactory expressive skills and significant command of scientific language; dialogic ability and critical spirit well noticeable; good synthesis skills and more than acceptable graphic expression skills.
d) Excellent (from 27 to 29)
The candidate demonstrates a very extensive, well-studied knowledge base, with marginal gaps; remarkable expressive skills and high command of scientific language; remarkable dialogic ability, good competence and relevant aptitude for logical synthesis; high capacity for synthesis and graphic expression.
e) Excellent (30)
The candidate demonstrates a very extensive and in-depth knowledge base, any irrelevant gaps; high expressive skills and high command of scientific language; excellent dialogue skills, strong aptitude for making connections between different topics; excellent ability to synthesize and great familiarity with graphic expression.
Honors are attributed to candidates clearly above the average, and whose possible notional, expressive, conceptual or logical limits are, on the whole, completely irrelevant.

Texts

Trattato di Ginecologia e Ostetricia
GC Di Renzo
Verducci Editore

Ostetricia e Ginecologia
C Nappi
Idelson Gnocchi

Questionnaire and social

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