Corso di Laurea in Infermieristica - Azienda Sanitaria Locale "Città di Torino"

By the end of the course each student demonstrates the ability to: 

• Explain the different environmental, chemical, physical and biological causes (bacteria, viruses, fungi, protozoa, parasitic metazoa), which determine the occurrence of the main diseases.
• Describe the elementary pathological phenomena occurring at the level of cells and tissues, which consequently cause the various diseases.

• Explain the consequences of nutritional disorders (with particular regard to fasting, obesity, dysvitaminosis and alcoholism) and the pathophysiological responses of the organism.

• Describe the pathophysiological mechanisms underlying haematological and cardiovascular diseases (anaemia, haemorrhage, shock, ischaemia, atherosclerosis, hypertension, embolism).

• Describe the pathophysiological mechanisms underlying disorders of the liver, pancreas, pulmonary and renal systems.

• Describe the causes and pathogenesis of tumours.

• Describe the inflammatory response.

• Illustrate the cells and molecules involved in the immune response (important for the protection of the host from infection).

• Describe the mechanisms of recognition of a foreign agent by the immune system.

• Describe the consequences of an impaired functioning of the immune system.

• Describe the meaning of the concepts of infection and infectious disease.

• Explain the basic techniques of antisepsis, disinfection and sterilisation as well as measures to prevent the possibility of infection.

• Know the main microscopic and culture techniques in use in the microbiology laboratory.

• Know how to take, transport and store microbiological samples.

• Know the basics of antibiotic therapy.

• Know the main infectious complications related to nursing procedures (injections, catheterisation, medication).

• Know the conditions which may lead to the occurrence of hospital infections and how to prevent them.
• Ensure the correct application of laboratory diagnostic prescriptions for disease prevention, patient care and health 

KNOWLEDGE AND UNDERSTANDING

By the end of the course the student will be able to demonstrate:

• Knowledge and ability to understand the physiological and pathological processes associated with the state of health and disease in people.

APPLYING KNOWLEDGE AND UNDERSTANDING

By the end of the course the student will be able to demonstrate:

• Ability to apply a body of theoretical knowledge derived from the discipline of medical sciences, to individuals of all ages, groups and communities, in order to plan personalised, effective and evidence-based care;
• To facilitate the development of a safe environment for the resident by ensuring constant nursing supervision.

INDEPENDENT JUDGEMENT

By the end of the course the student will be able to demonstrate autonomy of judgement through the following skills:

• Take responsibility and accountability for their actions during professional practice in accordance with the professional profile, code of ethics and ethical and legal standards.

COMMUNICATION SKILLS

By the end of the course the student will be able to:

• Use appropriate communication skills with users of all ages, their families and/or other health professionals within the care process in an appropriate form

LEARNING SKILLS

By the end of the course the student will be able to demonstrate:

• Capacity for self-study and independent study; Ability to cultivate doubts and tolerate uncertainties arising from study and practice, asking appropriate and relevant questions, seeking solutions through secondary and primary sources of research evidence.

Program

Pathophysiology and Pathology

Aetiology (damage - prevention):

• biological causes:  viruses (tumor)
• physical causes: radiation, temperature
• chemical causes: environmental toxins (metals, free radicals, drugs, smoking)
• diet: fasting, obesity, malnutrition, ethyl alcohol
• immigration: imported diseases, immunocompromise

Mode of action of aetiological agents

Concept of homeostasis

• Cellular alterations (pathogenetic mechanisms):
• adaptations (hypertrophy, hyperplasia, atrophy, metaplasia)
• reversible damage
• irreversible damage: death by necrosis (infarction) or apoptosis
• intracellular and extracellular accumulation of substances (lipids, iron, bilirubin, melanin, amyloid)
• ageing

Inflammation:

• acute inflammation
• chronic inflammation
• systemic effects of inflammation
• healing

Immunity:

• the immune system as a whole. Organs and cells of the immune system The major histocompatibility complex. ▪ maturation and activation of T and B lymphocytes
• immune tolerance
• structure and functions of antibodies
• the antigen. Antigen-antibody reaction. Vaccines and sera
• regulation of immune response. Cytokines. The complement system
• hypersensitivity
• autoimmunity and autoimmune diseases
• immunodeficiency (AIDS etc)

Tumors:

• causes (chemical, physical, biological)
• biology of tumours
• classification
• process of carcinogenesis (initiation, promotion, progression)

Organ dysfunction:

• Liver: cirrhosis, jaundice, hepatitis
• Haematopoietic system: anaemias, alteration of the blood cysis
• Cardiocirculatory system: atherosclerosis, hypertension, altered blood volume, thrombosis, embolism
• Pancreas: diabetes
• Pulmonary system (altered gas exchange) and renal system (altered glomerulo-tubular function)
• Central nervous system (degenerative diseases)

Pathology and laboratory medicine

• the pre-analytical phase and biological, environmental and methodological variabilities
• collection of other biological materials; transport and storage of biological samples
• collection of bacteriological samples, cultivation of bacteria, staining techniques and bacteriological diagnosis
• virological diagnosis, serology. guidelines for the prevention of blood-borne diseases
• hints on the variability, accuracy and precision of the intra-analytical phase; post-analytical phase and meaning of the analytical data
• urinalysis; haemochromocytometric examination; examinations for the evaluation of haemostasis
• markers of organ damage
• indices of inflammation
• renal function and electrolytes
• allergy diagnostics
• principles of immunohaematology
• blood groups, haemolytic disease of the newborn, donor blood collection
• hemotransfusion and its complications, legislation

Microbiology

Aetiology (DAMAGE - PREVENTION):

•  biological causes: bacteria, viruses, parasites, mycetes, prions. (morphology, structure, metabolism, function, host-parasite interaction, mechanisms of pathogenicity, replication and growth, classification)

Infection:      

• bacterial infections, viral infections of the respiratory tract, viral infections of the gastrointestinal tract, blood-borne viral infections, protozoan and fungal infections
• prevention (asepsis, disinfection, sterilisation)
• relationship with the environment (transmission routes and hospital infections)
• infections in the immunocompromised host and infections in pregnancy
• treatment (antibiotics, antibiotic resistance)

In order to achieve the educational objectives of the course, the following are used:

• Frontal lessons

The learning assessment method is carried out, on the dates set by the secretary according to the calendar and communicated months in advance to the teachers and students, through a written multiple-choice test.

On the day of the exam, the students receive a single task, divided into sections, containing the questions relating to the three modules.

The written test focuses on the program covered by the teachers of the three modules during the lectures, during the second semester of the first year of the course. The exam is a test of the student's ability to integrate basic knowledge on the pathogenic mechanisms of the onset of the most common diseases, on the causes of these diseases (etiology) and on how to address and frame them, in particular from the perspective of laboratory medicine.

The total number of questions is 66, divided as follows: 33 general physiopathology, immunology and general pathology, 21 microbiology and clinical microbiology and 12 clinical pathology and transfusion medicine. The questions are in the form of multiple choice quizzes. Each question has five possible answers (from the letter A to the letter E).

The correct answer must be indicated with an “X”. If the student gets the answer wrong and wants to correct it, he/she can do so by writing “NO” next to the “X” and adding a new “X” on the answer he/she believes to be correct. The time to complete the task is 60 minutes. If there is more than one correct answer, this will be clearly indicated in the text of the question. At the end of the set time, the assignments are collected by the teachers and corrected immediately.

At the end of the written test, the student can pass the exam if he/she is sufficient (with a grade equal to or higher than 18/30) in all modules. Once the student knows the final grade of the test, he/she has the option to accept or reject the grade.

The grade is calculated based on the number of correct answers in the individual modules. The final grade is expressed in thirtieths. Each incorrect answer corresponds to a score of zero, therefore a negative score is not assigned to the incorrect answer.

If the student reaches a total number of correct answers equal to or greater than 36 but is not seriously insufficient in one or more modules, a reduction of 0.5 points will be applied to the final grade for each missing answer useful for reaching the sufficiency in the single module. If the student does not reach a total number of correct answers equal to or greater than 36 or has one or more serious insufficiencies in the single modules, he/she will be asked to repeat the verification of all 3 modules at the next exam session.

If the student is not sufficient, the insufficient grade will be recorded in the register.