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Ministry of public health of ukraine bukovinian state medical university




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MINISTRY OF PUBLIC HEALTH OF UKRAINE

BUKOVINIAN STATE MEDICAL UNIVERSITY


Approval on methodological meeting

of the department of pathophisiology

Protocol №

Chief of department of the pathophysiology,

professor Yu.Ye.Rohovyy

“___” ___________ 2008 year.


Methodological Instruction

to Practical Lesson



Мodule 1 : GENERAL PATHOLOGY.

Contenting module 1. General nosology.


Theme6: Final control - 1


Chernivtsi – 2008

1.Actuality of the theme. In everyday practical activity doctor always takes into account of illness nature and peculiarities of it course. This is important for planning of prophylactic arrangements, diagnosis rising, selection of medical drugs. In illness is distinguished two process: а) damage property illness; b) physiological measure against illness that is complex of protective compensatory-adaptation reactions. The protective reactions perform with nervous, endocrine, immune and other systems. With their help an organism resists to pathogenic factors and restores broken functions. We can train to heighten these reactions, to make them more powerful and firm. For this make use of special loadings, tempering, and physiotherapy procedures. By protective reactions one can be governed also by the medium of medical drugs. Aim of such arrangements is rising of individual organism resistance to effect of harmful agents.

Due to continuous evolution organism has adapted to normal atmosphere pressure. But in conditions of modern life man more often encounters with action of changed atmosphere pressure. This is related to production activity (fliers, spacemen, divers), sport (mountaineering). Action of changed atmosphere pressure on organism is used in medicine for treatment (barotherapy). It is important to know rapid change of atmosphere pressure causes of the symptoms, which is called barotrauma. In modern of contemporary war barotrauma can have wide spread owing to influence of shock wave.

The environment factors constantly affect a man. Inadequate nutrition, bad social conditions, toxins influences and other factors decrease organism resistance. Going in for sport, rational labour and rest routine guard of environment raise unspecific organism resistance. Some factors can be used in medicine for prophylaxy of the diseases. For example, hypothermia (hibernation) increases organism resistance to hypoxia and doctors use that at operation on heart and brain.

Regulating mechanisms of the body temperature.

The control of the body temperature is a function of the centers located in the hypothalamus. Thermoreceptors provide the hypothalamus with the information about peripheral and core temperatures. If the temperature is low the body initiates heat conservation, measured by a series of hormonal mechanisms. Heat production begins with the hypothalamic release of TSH (thyroidstimulating hormone) – RH (releasing hormone), which stimulates the release of TSH from anterior pituitary. The TSH causes release of thyroxin from the thyroid gland. This hormone causes the release of the epinephrine (adrenaline) from the adrenal medulla.

Epinephrine causes vasoconstriction, glycolysis, and increased metabolic rates which increase heat production. Warmer peripheral and core temperatures reverse the process. Decreasing the sympathetic pathway produces vasodilatation, decreased muscle tone, and increased perspiration.

Immune insufficiency is to be considered as an anomalous condition of immune system. The displays of these insufficiencies are quite various: rise of sensitivity to bacterial and viral infections, development of autoimmune diseases. Its clinical displays are determined by defeating of a certain link of immune response. Nowadays there are description and classifications of innate primary immunodeficiency conditions, which are observed in children's age. There also are secondary immunodeficiency syndromes, which are conditions of acquired nature, which arise under influence of environment. Diagnostic of immune insufficiency is complicated, because there are no specific symptoms, or clear parallelism between clinical symptoms and laboratory confirmation. Illness masks and has manifestation similar various clinical symptoms.

The immediate-type allergy is often met in practical activity of physicians of various specialties. That is because of the great environmental pollution by industrial products, chemical matters, and allergens of vegetable animal, bacterial, fungus origin and also due to wide use of various drugs. That type of allergy can develop suddenly. The severity of their proceeding is various – from slight reactions to anaphylactic shock dangerous for one’s life. Preventing and treatment of the allergy reactions is based on knowledge about their development mechanisms.


^ 2.Length of the employment – 2 hours.

Aim:

To khow that are disease, etiology, thermal injury, crush syndrome, immunopathology disease, allergy.

To be able: to analyse the pathogenesis of the thermal injury, crush syndrome, immunopathology disease, allergy.

To perform practical work: Practical examination 1-5.


Control questions of the theme:

  1. Term definition – what is health, norm, disease?

  2. Pathological process and pathological condition".

  3. What is pathogenesis?

  4. How does pathogenesis divide? (four periods of pathogenesis).

  5. What is the connection between the cause and the pathogenesis?

  6. Vicious circle

  7. What is “the main stage” in pathogenesis?

  8. Negative effect of changes of atmospheric pressure.

  9. The effect of ionizing radiation.

  10. Describe the effect of the thermal factors.

  11. Characterize overheating.

  12. Describe the hypothermia.

  13. Explain what is “crush syndrome”.

  14. Characterize the clinical course of crush syndrome.

  15. Pathogenesis of traumatic shock.

  16. Why the decompression phase of crush syndromeis the critical moment?

  17. Characterize immune response.

  18. Describe induction of immune response.

  19. Describe humoral and cell-mediated immune response.

  20. Characterize cellular interaction in immune response.

  21. Describe the forms of changes and disorders of immune system.

  22. Characterize immunodeficiencies; describe examples of congenital or primary diseases.

  23. Cite causes and consequences of acquired or secondary immune deficiencies.

  24. Describe the best known acquired immune deficiency disorder, AIDS.

  25. Define allergy, autoimmunity and alloimmunity.

  26. Characterize the classification of allergens.

  27. Describe the pathogenesis of allergic reaction

  28. Compare the hypersensitivity disorders.

  29. Describe the likely causes of autoimmune disease; cite examples.

  30. Characterize alloimmune graft rejection.


Literature:

1. Gozhenko A.I., Makulkin R.F., Gurcalova I.P. at al. General and clinical pathophysiology/ Workbook for medical students and practitioners.-Odessa, 2001.- P.11-34; 92-115.

2. Gozhenko A.I., Gurcalova I.P. General and clinical pathophysiology/ Study guide for medical students and practitioners.-Odessa, 2003.- P. 5-26; 99-116.

3. Robbins Pathologic basis of disease.-6th ed./Ramzi S.Cotnar, Vinay Kumar, Tucker Collins.-Philadelphia, London, Toronto, Montreal, Sydney, Tokyo.-1999.

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