Mixed dystrophy. Disturbances of the mineral exchange Importance of the theme icon

Mixed dystrophy. Disturbances of the mineral exchange Importance of the theme




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Mixed dystrophy. Disturbances of the mineral exchange

Importance of the theme: mixed dystrophies - These are the morphological manifestations of the disrupted metabolism, which are located in both parenchyma,stroma and walls of vessels. In the paranchymal cells and stroma, products of the exchange of minerals appear. Minerals play very important role in the life of organism, carrying out many different functions eg Calcium is connected with the processes of the permeability of cellular membranes, the excitability of neuromuscular apparatus, coagulation of the blood, regulation of acid-base state, formation of skeleton and teeth; Potassium - participates in the construction of cellular cytoplasm, ensures normal protein -[lipid] exchange, neuron- endocrine regulation , etc). The disturbance of such exchanges of these substances are the basis of many illnesses and they are studied in the different clinical departments. The formation of stones is the basis of the appearance of the [slyunnokamennoy], gallstone and urolithic diseases, which are the special pathology of Donbass. In the professional activity for doctors of many specialties (eg surgeons, urologists, stomatologists, epidemiologists , etc) it is necessary to know the pathogenesis of the formation of stones in order to successfully prevent this pathology and to treat its complications.

Purpose (general): to know how to reveal and recognize the special morphological features of the different types of the mixed dystrophies, which are mostly caused by disturbances in mineral exchange.Also to determine their reasons, pathogenesis, outcomes of each process and its value for the organism.

^ The specific goals to know how:                                            Purposes of the initial of [urovn]:

To know how:

to 1.characterize the manifestation of lime dystrophy, varieties of calcinosis: petrifaction, lime metastases and metabolic calcification, their value

1. To explain the ways of the metabolism of calcium, the general and local factors, which regulate the metabolism of calcium (department of medical biochemistry).

to 2.[explain] the chemical composition of concrements, the mechanism of their formation and role in the development of the urolithic and gallstone diseases

2. To determine the anatomy of bile and urinary tracts and the chemical composition of bile, urine and other secrets ( department of general anatomy and medical biochemistry).

3. To explain the chemical composition of concrements, the mechanism of their formation and role in the development of the [slyunnokamennoy] disease (for the stomatological department)




4. To explain reasons, pathogenesis and morphological manifestations of rachitis (for the pediatric department)




, So that you could explain, the initial level of your knowledge- skills does answer necessary, we propose to carry out number of problems.

^ TASK FOR THE SELF-VERIFICATION OF THE SELF-CONTROL OF THE INITIAL LEVEL OF KNOWLEDGE- SKILLS.

Task of № 1. Select the cause of increased content of calcium in the blood (hypercalcemia):

1. the hyperfunction of parathyroid glands;

2. the hypofunction of parathyroid glands;

3. the overproduction of Calcitonin;

4. the hypo-production of Calcitonin.

Task of +№2. What mechanisms forms the basis of the development of hypercalcemia?

1. the intensive yield of calcium from the depot;

2. the decreased removal of calcium from the organism;

3. the increased entering of calcium into the organism with the food;

4. hypovitaminosis d.

Standards the answers [k] to the solution the tasks for the self-verification and the self-control initial the level the knowledge- skills: 1-1, 4; 2-1, 2.

Information necessary for completing the necessary knowledge- skills can be found in the following literary sources.

1. Increase in weight [M].[G]., Lysenko [N].[K]., [Bushkovich] [V].[I]. // the anatomy of man. - “Hippocrates”,  2001, [s].282-285, 322-334.

2. [Afanasev] [YU].[M]., [Yurina] [I].[A]. // histology, cytology and [embryologyya]. - G., medicine, 1999, [s].597-607, 671-672.

3. Is birch [T].[T]., [Korovkin] [B].[F]. // biological chemistry. - G. - Medicine, 1990. - [s].65-89, 369-399.

The theoretical questions, on basis of which is possible the fulfillment of the purposeful forms of activity.

1. Mineral dystrophies, the physiological role of minerals, the histochemical methods of their development in the cloths (methods of the detection of calcium).

2. Lime dystrophy. Forms of calcinosis, their pathogenesis, morphological changes and the value of each form of calcinosis.

3. Formation of stones, location of stones, morphology, chemical composition, the mechanism of formation.

4. Urolithic disease, its outcomes, location of stones, their chemical composition.

5. Gallstone disease, the chemical composition of stones, location and outcomes.

Lecture for acquiring the necessary knowledge- skills to this theme “the mixed dystrophies. Disturbances of the mineral exchange".

1. [Strukov] [A].[I]., Serov explosives. // pathologic anatomy. - Kharkov, “fact”, -1999. - [s].90-108.

2. Lectures of department for the theme “ the mixing of dystrophy the formation of stones “.

3. Graph of the logical structure of theme “mixed dystrophy” (application of № 1).

4. Graph of the logical structure of the formation of stones ( application of № 2).

5. Algorithm of morphological diagnostics of the disturbance of the exchange of [khromoprote]ї[d]і[v] (application of № 3).

Additional literature:

1. Serov explosives, [Yarygin] A.D., spiders [V].[S]. // pathologic anatomy. Atlas. - G. Medicine. - 1986. - [s].43-59.

2. [Shlopov] [V].[G]. // the bases of the pathologic anatomy of man. - Kiev, 1999. - [s].62-77.

3. [Shlopov] [V].[G]. Pathologic anatomy: Textbook. - Vinnitsa: NEW BOOK, 2004. - 768 s.

You will accomplish the following purposeful tasks.

Test task of № 1

During dissection of a 75 years old man the revealed multiple white colour stony density, atherosclerotic platelets in the intima of aorta, coronary arteries of heart, arteries of bowels and lower extremities. Whats the cause of the stony density of platelets in the vessels?

1. mucoid swelling;

2. metabolic calcification;

3. metastatical calcification;

4. hyalinosis;

5. dystrophic calcification.

Test task of № 2

In the woman, who suffered myeloma disease, during her dissection were revealed the centers of [osteomalyatsii] (softening the bones). Microscopically in the mucous membrane of stomach, in the myocardium of left ventricle and in the kidneys were the presence of the intensively violet coloured deposits. The reaction Of [kossa] is positive. Estimate the described changes?

1. metabolic calcification;

2. dystrophic calcification;

3. metastatical calcification;

4. hyalinosis;

5.[fibrinoidnoe] swelling.

Test task of № 3

During preventive inspection of a child of 1,5 years, focal thickenings in the region of edges , wrists , bend of legs were revealed. Stomatologist suggested the late eruption of teeth, disturbance of the order of the eruption of teeth, configuration of the upper jaw of in the form “high sky”. Which illness did develop in child?

1. metabolic calcification;

2. dystrophic calcification;

3. metastatical calcification;

4. rachitis;rr

5. [osteomalyatsiya].

Test task of № 4

After dissection of the corpse of the man of 57yrs,the right kidney was sharply increased, deformed, capsule is removed with the great difficulty, in the kidney was revealed coralliform form the dense formation, which fills it practically completely. The cavities of wash-tub and cups are extended, are filled with the turbid greenish-yellow binding liquid, mucosa them dim, full-blooded, with the centers of hemorrhages. What process in the kidneys did lead to the described changes?

1. urolithic disease;

2. metabolic calcification;

3. the amyloidosis of kidney;

4. dystrophic calcification;

5. metastatical calcification.

Test task of № 5

Man suffered chronic fibrous- cavernous pulmonary tuberculosis for 17 years. He died suddenly as a result profuse pulmonary hemorrhage from the tubercular cavity. At the autopsy in the region of the root of right lung, white stony densities were found in the peribronchial lymph nodes. Which pathologic process did cause the stony density of lymph nodes?

1. metastatical calcification;

2.[podagricheskie] lumps;

3. metabolic calcification;

4. dystrophic calcification;

5. amyloidosis.

Test task of № 6

During the microscopic study of lungs, mucous membrane of stomach, myocardium of the left ventricle and kidneys of man, which perished as due to sublimate poisoning with the defect of kidneys and thickening of gut, the anatomical pathologist found the presence of the intensively violet color of amorphous deposits on the channel of small vessels (reaction Of [kossa] positive). Estimate the changes indicated?

1. metabolic calcification;

2. dystrophic calcification;

3. metastatical calcification;

4. hyalinosis;

5.[fibrinoidnoe] swelling.

Test task of № 7

During preventive inspection of a 1 year old child[vvyavili] in an orphanage,the expansion and aplasia of fontanelle, the presence of tower skull (caput of quadratum), thickening the joints of bones and cartilages of separate edges and thickening the epiphyses of long tubular bones (rosary and bracelets) were found. Is [diagnostovan] rachitis. Estimate the metabolic disturbance which caused these abnormalities?

1.[belkovogo];

2.[zhirovogo];

3.[uglevodnogo];

4.[mineralnogo].

5.-

Test task of № 8

In the patient, who suffered chronic adenomatous hyperplasia of prostate gland, during dissection, the anatomical pathologist found in the urinary bladder stones.These stones were smooth surfaced and disk-shaped with diameter to 3,0 cm. What most ideal local condition for the development of urolithic disease in this dead person?

1. the disturbance of the draining of urine;

2. [hypokalamia];

3. hypercalcemia;

4. the presence in water of a large quantity of salts;

5. the disturbance of the exchange of carbohydrates.

Test task of № 9

In a man who had multiple comminuted fractures of the bones of hip and thighs, during dissection, microscopically in the mucous membrane of stomach, in the myocardium of left ventricle and in the kidneys the revealed the presence of the intensively violet deposits. The reaction Of [kossa] is positive. Estimate these changes?

1. metabolic calcification;

2. dystrophic calcification;

3. metastatical calcification;

4. hyalinosis;

5.[fibrinoidnoe] swelling.

Test task of № 10

In a patient, [keotoryy] who suffered chronic adenomatous hyperplasia of prostate gland, hematuria developed. With a Knots- study of the urinary bladder, stones with diameter of 3,0 cm. What complication of urolithic disease did develop in patient?

1. purulent inflammation;

2. colic;

3. the necrosis of the wall of the bladder;

4. the obturation of duct;

5. hemorrhage.

The operating instructions to the work of students in the practical instruction “mixed dystrophias”.

At the beginning of the class, use the answers to verify the solution of domestic task, then via test control check your preparation for the class.

Independently (and with the aid of the instructor) give the description of the macro- and of micro-preparations. Give answers to the situation tasks. Being guided by algorithm, make macro-preparations (see Systematic recommendations of № 1). It is necessary to study the following macro-preparations “calculous cholecystitis ", “the stones of urinary system ", “[calculus] pyelonephritis”.

Study micro-preparations of lime metastases of lungs. In the tables are microscopic manifestations of lime metastases of kidneys, myocardium, lungs, stomach.

The class concludes with the analysis of independent work, which ends by checking the description of micro-preparations and test control of the acquired knowledge.

Application of №1

Graph of the logical structure of theme “lithogenesis”

Камнеобразование



Фактори, которые способ-ствуют образованию камней

Локализация

Осложнения





Общие

Местные





Еапушения всех видов обмена


Мочекаменная болезнь



Химический состав камней

Локализация

Осложнения






Ураты

Оксалаты

Фосфаты


Желчекаменная болезнь



Химический состав камней

Локализация

Осложнения








Холестеринове

Пиментные

Известковые

Комбинированные



Application of №2

^ Graph of the logical structure of the disturbance of the exchange of calcium


































                       














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