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ЗмістThe specific objectives
Appendix № 2
Instructions for the Study of micropreparations
Inflammatory bowel disease
Diseases of the digestive
(Non-specific general disease small intestine and colon, chronic hepatitis, cirrhosis, penkreatity).
Relevance of the topic. Diseases of the digestive organs, which are now exploring different sharp increase in their frequency, threatening, even fatal complications, which occur acutely or chronically. Prevention is possible through their early morphological diagnosis, treatment and diligent with the morphological control efficiency.
Knowledge of the nature and morphological manifestations of diseases of liver, pancreas, small intestine and colon are needed to study them in the departments of therapy, infectious diseases, surgery, and the work of doctors.
The purpose of (total): able to determine the macro-and microscopic manifestations of diseases of the digestive system, to be able to explain the causes and mechanisms of their development, to assess the credibility and value to the body of possible complications.
In order for you to realize as to whether the initial level of your knowledge, skills required, we propose to perform multiple tasks.
The tasks for self, self-knowledge source-level skills
Objective number 1. Microscopic examination of histological specimens revealed deep crypt, in which goblet cells predominate over cylindrical, no cell Panetta. For some digestive tract characterized by a structure of the mucous membrane?
Objective number 2. Microscopic examination revealed lobular histology drug structure body parenchyma which is presented by epithelial cells, which form a beam between them are sinusoids with blood. The center is located vessel segments of venous type. Between slices in small fields of connective tissue located artery, Vienna and small duct. For a body characterized by a histological structure?
Objective number three. Microscopic examination of histological specimens revealed that the body consists of many densely arranged glands, acini, consisting of epithelial cells with basal nuclei and the location of dark granular cytoplasm, separated by thin layers of connective tissue in the lobules. Among them are pale-colored cells that constitute the strands and irregular clusters. For a body characterized by such a structure?
The correctness of problem solving test, comparing them with the standards of response.
Standards of responses to meet the challenges for self-starting and self-knowledge, skills: 1-5, 2-4; 3-3.
Information necessary to replenish the necessary knowledge, skills can be found in the following literature:
The content of education must ensure the achievement of learning objectives, which assists the logical structure of the Count theme "Diseases of the digestive system" (Appendix № 1).
The basic theoretical issues on which the possible implementation of targeted activities
Literature to develop the necessary knowledge, skills for this topic:
Perform the following targets
Objective number 1. Male 60 years old died from gastrointestinal bleeding. At autopsy: the lower one-third of the esophagus rapidly cyanotic, varicose veins are twisted, enlarged. The liver is a small, dense, uneven surface with the presence of tubercles up to 3 mm, microscopically lobed structure is broken, some segments are not the central vein, there gidropechnaya, fatty degeneration and necrosis of hepatocytes and diffuse fibrosis. What is the most likely diagnosis?
1.Melkouzlovoy cirrhosis of the liver;
2.Krupnouzlovoy cirrhosis of the liver;
3.Smeshanny cirrhosis of the liver;
Objective number two. The immediate cause of death of men 60 years old, who lives with cirrhosis, acute anemia was common. Massive bleeding is a complication of coca localization of liver cirrhosis, which led to the death?
1.Ostrye stomach ulcer;
2.Ostrye ulcers of the esophagus;
3.Varikozno veins of the esophagus
4.Hronicheskaya duodenal ulcer;
5.Hronicheskaya gastric ulcer.
Objective number 3.
During the holidays, the surgical department of hospitalized young man whose home 12:00 to an acute, very intense pain in epigastralnoy area and back. In a patient with a picture of a painful shock from which it could not withdraw. In the context of almost the entire pancreas is enlarged, red, round it to tiny pockets of fat that resemble stearin spot. What is the most likely diagnosis?
1. Chronic pancreatitis with exacerbation
2. Acute pancreatitis is a serous
3. Acute suppurative pancreatitis with hemorrhage.
4. Acute pancreatic necrosis
5. Acute Hemorrhagic pancreatitis sero-
Objective number 4.
In needle biopsy of the colon crypts are isolated goblet cells in which vacuoles of mucus does not RAS-reaction. The surface epithelium is thin, with necrosis of the cells. Dense cellular infiltrate composed of lymphocytes, plasma cells, eosinophils, neutrophils, accumulation occurs in the lumen of the last of the crypts. What is the most likely diagnosis?
1. Crohn's Disease
2. Acute colitis
3. Chronic atrophic colitis
4. Nonspecific ulcerative colitis
5. Ischemic colitis.
Objective number 5.
The young man was hospitalized with symptoms of acute peritonitis. When the operation is found very narrowed segment of the small intestine with the presence of scar tissue around a small ulcer about 1 mm defect. Outside this segment of the small intestine of conventional properties. What is the most likely diagnosis?
1. Crohn's Disease
2. Acute enteritis
3. Chronic atrophic enteritis
4. Nonspecific ulcerative colitis with a lesion of the small intestine
5. Infiltrative carcinoma with perforation.
Methodical instructions to work on a practical lesson, students "Diseases of the digestive system"
In early studies on the standards of answers check home solutions of the problem. Then by the test control will be tested to prepare your lesson.
You have to learn on their own macro-and micropreparations, solve situational problems. Macro-and microscopic manifestations of peptic ulcer disease, cirrhosis of the liver melkouzlovogo studied at the macro and micropreparations: "Cirrhosis of the liver." In this instruction is used to study makropreparatov (application number 2) and micropreparations (Annex № 3).
Classes are completed analysis of the results of independent work of each student by checking the description of the test control micropreparations and learning.
Instructions for the Study of makropreparatov
Appendix № 3^
At low magnification to study medicine, to establish authority. Find the field of view with pathological changes, to determine their nature. special features. Formulate a conclusion about the nature of the pathological process.
Appendix № 4
Morphological changes that are found in the study of macro-and micropreparations
Count the logical structure of the theme, "Diseases of the digestive system"
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