Intestinal infections The relevance of the topic icon

Intestinal infections The relevance of the topic




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Intestinal infections


The relevance of the topic: Intestinal infection is extremely diverse, occur frequently, leading to structural changes in the whole organism, and without treatment lead to serious complications and even death of a patient. Knowledge of pathogenesis, stages of the disease, and morphological changes in these infections is the foundation for the timely and correct diagnosis, the appointment of adequate treatment, prevention of complications, reduce mortality and prevent the development of epidemics. Knowing the topic you need to understand intestinal infections in the clinical departments, in practice the family doctor for a clinical-sectional anatomical analysis of data.


Specific objectives The objectives of entry level


Be competent:

1. To detect macro-and microscopic structure of divisions bowels (Dept. of normal anatomy and histology).


1. To distinguish morphological changes in the intestine at various stages of typhoid, to explain their pathogenesis; identify and extra identify intestinal complications of typhoid fever.


2. To detect macro-and microscopic structure of the stomach (Dept. of normal anatomy and histology).


2. Recognize the morphological changes in the intestine with salmonellas, to explain their pathogenesis; clinical and morphological forms of salmonellas.


3. To detect macro-and microscopic structure of lymphoid apparatus bowels (Dept. of normal anatomy and histology).


3. Recognize the morphological changes in the intestine at various stages of dysentery, explain their pathogenesis; intestinal complications extra identify and dysentery.


4. Ways to recognize the outflow of blood from the bowels (Dept. of normal anatomy).


4. Recognize the morphological changes in the stomach with cholera, to explain the pathogenesis of cholera; identify its complications.





5. Detect and localize the morphological changes in the intestine with amebiasis; amebiasis complications.




In order for you to find out whether you're starting level of knowledge, skills needed, offer to perform certain tasks.


Assignments for self-knowledge, entry-level skills.


Tasks № 1.


Macroscopic represented part of the wall of hollow cylindrical body. Relief mucosa with its low circular folds and short villi. What is this body?

1. Thin intestine
2. Heavy intestine
3. Stomach
4. Urinary bladder
5. Esophagus.


Tasks № 2.

At microscopic relief gut mucosa formed folds, villi and the crypt. Epithelium covering vorsiny, single prismatic, and ophthalmicus define the individual cells. In the mucous layer and submucosus Messier lymphoid follicles (plaque). Which department bowel described?

1. Iliac intestine
2. Duodenum
3. The cross-colon colon
4. Sigmoid colon
5. Direct kishka.


Tasks № 3.

In preparation of hollow wall body with a cylindrical shape on the outer surface defined gaustry, longitudinal strips muscle and glands sprouts, outer surface is covered with peritoneal on three sides. What is this body?

1. Heavy intestine
2. Thin intestine
3. Stomach
4. Urinary bladder
5. Esophagus.


Tasks № .4

At microscopic gut mucosa has numerous deep crypt, villi absent; vistlana single prismatic epithelium, in the crypt contains a large number ophthalmicus cells. Lymphocytes form the focal crowding (solitary follicles) in the mucous and submucosus shell. Which body is described?

1. Thick Intestine
2. Small Intestine
3. Stomach
4. Vermiform
5. Esophagus.

Tasks № 5.


At macroscopic submitted hollow body "hook" forms. Inside its surface with longitudinal and skew folds. The outer surface is smooth, shiny. What is this body?

1. Stomach
2. Thin intestine
3. Heavy intestine
4. Urinary bladder
5. Esophagus.


Tasks № 6.

At microscopic mucosa with folds, fields and cavities, which opened in the bottom of the discharge short Protocols simple unramified tubular glands in some of their major divisions include, parietalis excorinicus, mycocytus and endocrinicus. What is this body?

1. Stomach
2. Thin intestine
3. Heavy intestine
4. Vermiform
5. Esophagus.

Tasks № 7.

When a patient autopsy misbehaving vesnoi drain blood from the bowel. Where ottekaet venous blood from the bowels?

1. In the portal vein
2. In the bottom margin vein
3. In the top of a vein
4. In gastric vein
5. In the vein pancreas.

Tasks № 8.

At macroscopic in the gut mucosa are flat oblong white plaque located on Length gut, as well as white elevation size of a grain of millet. Microscopic this lymph follicles. In what department bowel lymph follicles form a plaque?

1. Iliac intestine
2. Direct intestine
3. Duodenum
4. Sigmoid colon
5. The cross-colon intestine.


Standards of responses to meet the challenges for self and self-knowledge, entry-level skills: 1-1, 2-2, 3-1, 4-1,5-1, 6-1, 7-1, 8-1.

The information needed to replenish the necessary knowledge, skills can be found in the following literary sources:
1. Gain MG, Lysenkov NK, Bushkovich VI Anatomy of Rights / SP "Hippocrates", 2001. - S.234-298
2. Afanasyev YI, Yurina NA Histology, cytology and Embryology / M., meditsina.-1999.-S.514-615.
3. Filimonov VI The normal physiology. -- Kiev. - "Health", 1995. - S.267-275, 243-266.


The major theoretical issues on which possible execution activities:

1. Typhoid fever: aetiology, pathogenesis, morphological manifestations of different stages of the disease, and disease intestinal complications.
2. Salmonellosis: aetiology, pathogenesis, morphological manifestations of disease, clinical and morphological forms, complications.
3. Dysentery: aetiology, pathogenesis, morphological manifestations of different stages of illness, complications.
4. Cholera: aetiology, pathogenesis, morphological manifestations of different stages of illness, complications.
       5. Amebiaz bowel: aetiology, pathogenesis, morphological manifestations, complications.

Literature for learning-skills:
1. Strukov AI, V. Serov Pathological Anatomy. M. Medicine, 1995 - S. 481-492.
2. Lectures chair on "Intestinal Infection"
3. Graf logical structure (annex № 1)
Further reading:

1. V. Serov, Yarygin NE, VS Paukov Pathological Anatomy. Atlas. / Metro: Medicine. - . - S. 1986 347-353.


After examining the material on this subject for self-absorption material is invited to perform the following targets:


Test assignment № 1.

When autopsy men who died of typhoid found that the front abdominal wall muscles and hips dense, brittle, white-yellowish color, reminiscent of stearin. A manifestation of the change process is described in the muscles?

1. Zenkers necrosis
2. Fibrinoidea necrosis
3. Caseosa necrosis
4. Colliquativa necrosis
5. The fat necrosis


Test assignment № 2.

The disease started in a patient acutely profusus accompanied by diarrhea, loss of body temperature. When autopsy the corpse was sharply rigor mortis, skin and mucous membrane dry. The blood in the veins thick, dark. Hinges gut stretched thin, in the Skylight about 5 litres a colourless liquid-type "rice broth", odourless. Serous shell gut with point hemorrhages, matte, covered with sticky mucus. Spleen reduced, wrinkled, in the gall bladder "white bile". What is the diagnosis correct?


1. Cholera (cholera enteritis)
2. Cholera (cholera gastroenteritis)
3. Cholera (algidny period)
4. Dysentery (catarrhalis colitis)
5. Salmonellosis (interstitial form)


Test assignment № 3.

A child 9 years old at the 3 week illness appeared febris hectica, jaundiced skin, sclerite and the child died of liver-kidney failure. When in the rectum autopsy found multiple defects irregularly shaped, with uneven edges, with greenish-white close-brazed to be cloth films, pyo thrombophlebitis vorotnoy veins. In the liver - multiple abscesses, fatty dystrophy hepatocytes, kidney - picture of acute necrotic nefroza. What disease caused the death of a child?

1. Dysentery
2. Salmonellosis
3. Cholera
4. Typhoid fever
5. Amebiaz.


Test assignment № 4.

When microscopic study rectum found large pockets of necrosis mucosa, necrotic masses impregnated fibrin, forming a film. Mucous and submucosus shell on the periphery of the plots full necrosis, dropsical with hemorrhages and leukocyte infiltration. What disease can be offered?

1. Dysentery
2. Cholera
3. Amebiaz
4. Typhoid fever
5. Salmonellosis.


Test assignment № 5.

In patients 30 years with dysentery, which was confirmed by bacteriological study, there were signs paraproktitis. What most likely stage of local changes in question from this patient?

1. Stage ulcerslatio
2. Fibrinozny colitis
3. Colitis follicularis
4. Catarrhalis colitis
5. Stage healing ulcers.


Test assignment № 6.

When a patient 30 years autopsy indicated a sharp dehydration; skin dry, wrinkled, sallow color, the corpse rigor mortis dramatically expressed, and the blood thick. In the stomach and intestines current serous-catarrhalis acute inflammation, and necrosis with desquamatio epithelium. What disease can be thinking?

1. Salmonellosis
2. Dysentery
3. Cholera
4. Typhoid fever
5. Amebiaz


Test assignment № 7.

With the opening of the deceased from typhoid fever in the iliac rectum detected anthrax, located on dlinku gut, their edges smooth, slightly rounded, the bottom of the net, represented by a muscular layer of places, places - serous shell. In the bottom of one of ulcers microperforatio gut wall. To what stage of typhoid fever is characterized described changes?

1. Necrosis
2. Medullaris swelling
3. "Dirty" ulcersatio
4. Healing ulcers
5. "Clean ulcersatio".


Test assignment № 8.

The girl 3 years acutely ill, diagnosed with typhoid fever. Macroscopic group follicles over 1.5 m terminal Division iliac gut increased, fully fledged, dropsical, act above the mucous membrane. On its surface visible and gyrus furrows, resembling the surface of the brain. At the breakdown they are grey-red, juicy. In histological study in the lymphoid apparatus detected typhoid knots, consisting of major mononuclearis cells. To what stage the disease is characterized described changes?

1. Medullaris swelling
2. Necrosis
3. "Dirty ulcers"
4. "Clean ulcers"
5. Scarring.


Test assignment № 9.

A typhoid patient, after 4 weeks from the onset of acute abdominal picture has evolved and with the phenomena intoxicated patient died. At autopsy pathologist found a perforation iliac gut wall and spilt purulent peritonitis. To what stage of typhoid fever is characterized by this complication?

1. Clean ulcers
2. Medullaris swelling
3. Necrosis
4. Healing
5. Dirty ulcers.


Test assignment № 10.

With the opening of typhoid patient in the iliac rectum found several oval ulcers from 4 to 6 cm in diameter, with the rest edges, in walls and bottom of ulcers determined dirty-green mass. What complication of typhoid fever is most frequent in this stage?

1. Intestinal bleeding
2. Peritonitis
3. Perforation ulcers
4. Paraproktit
5. Penetration ulcers.


Test assignment № 11.

When the inspection body, died of typhoid fever, skin on the torso visible roseola-papular rash. When microscopic study in the spleen, lymph nodes, bone marrow, lung, felleus bladder, kidney discovered typhoid granulemy. A manifestation of the process are described changes?

1. Common typical changes with typhoid
2. General netepichnyh changes with typhoid
3. Local changes with typhoid
4. Complications of typhoid
5. Protective hyperplasia with typhoid fever.


Test assignment № 12.

In an infectious office received 2 patients with complaints of abdominal pain, vomiting, frequent greenish chair a foul smell, the temperature of 38-39 C, the death of patients occurred from intoxication. In patients know that they ate smoked chicken. When autopsy the corpse was sharply rigor mortis, dry skin, wrinkled. When microscopic study in the stomach, intestines identified serous acute gastroenteritis. What was the disease in patients?

1. Typhoid fever
2. Salmonellosis
3. Cholera
4. Amebiaz
5. Dysentery


Test assignment № 13.

With the opening of a patient who died of gastrointestinal bleeding, in a blind cecum anthrax found in various sizes with podrytymi, hangs above the bottom edges. When microscopic study determined necrosis mucosa, submucosus and muscular layer with segmentonuclearis leukocyte infiltration. What was the disease in a patient?

1. Dysentery
2. Typhoid fever
3. Amebiaz
4. Cholera
5. Salmonellosis.


Test assignment № 14.

A patient who died from amebiaza, in the liver found multiple cavity size from 0.5 to 6 cm, irregularly shaped, filled with greenish-yellowish troubled contents. What was amebiaza complication in a patient?

1. Chronic abscesses
2. Kazeozny necrosis
3. Acute abscesses
4. Alterativny parenchymal hepatitis
5. Interim hepatitis.


Methodical instructions for students on practical exercises on the theme: "Intestinal infections".
At the start of classes on measurement standards to verify that their answers solutions homework. Then, by controlling the test will verify your preparation for employment. Independently, you should consider macro and microscopic solve situational challenges. Macroscopic changes in bodies in intestinal infections are exploring drugs in the "Typhoid fever, swelling mozgovidnogo stage", "Typhoid fever, stage of necrosis", "Typhoid fever, ulcers stage dirty", "Typhoid fever, ulcers sound stage", "Dizenteriya", using algorithm macroscopic diagnosis. At microfoto "Amebiaz" and mikroscopic "Typhoid fever, ulcers stage of education", "Dizenteriya, stage ulcer colitis" studying the morphology of intestinal infections and describe them using an algorithm microscopic descriptions of drugs.

Venue


Equipment


Teaching materials, teaching aids


Time in the min

Stages




p/p

The training room





Test job


5

Checking and correction of entry level


1.




The microscope, macro and microscopic, mikrofotogrammy


Graf logical structure (annex № 1). Algorithm diagnosing intestinal infections (annex № 2) algorithm and study Macro and microscopic.


30

Self at work. Description macro and microscopic

2.







Target job training

20

Self-correction and absorptive material

3.







Collection of tests


15

The final test control


4.










10

Round-up exercises


5.




Annex 1.

Graf logical structure on the theme: "Intestinal Infection"



Typhoid fever






Pathogenesis


agent

salmonella typhy


Primary reproduction in thin intestines




Primary defeat of lymphoid tissue bowels




Bakteriemia


Reproduction in the gall bladder


Re getting into the intestine with bile


Inflammation in peyerovyh blashkah and solitary follicles


Stage disease


Brain swelling


Stage necrosis


Stage (dirty) ulcers


Stage (net) ulcers


Stage healing


Complication


Gastrointestinal


Bleeding


Perforation









Continuation of Annex 1.



salmonellosis







Agent

Salmonella typhimurium

Salmonella parathphi

Salmonella enteritidis


Pathogenesis





Forms


Enteric

Septic

Bryushnotifoznaya






Complication


Septikopiemiya

Collapse

Dehydration


Dysentery






Healing ulcers




Complication




Bleeding

Perforation, peritonitis, paraproktit

Cicatricial stenosis

Pyelonephritis

Annex 2.

Algorithm morphological diagnosis intestinal infections



Continuation of Annex 2



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