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Infections of childhood
The relevance of the topic: A childhood infection (diphtheria, scarlet fever, meningococcal infection) is widespread among children, can issue of epidemic outbreaks in children's collectives and give severe complications, which ended in the death of the patient. Knowing the morphological characteristics of these diseases is necessary for the understanding of clinical manifestations, the mechanism of complications and causes of death, that is, to the successful development of the relevant sections of the course of infectious diseases. In practical work of a doctor from this section knowledge required for the conduct of clinical and morphological diagnosis.
The goal (total): to be able to determine the morphological features of infectious diseases, know their etiology, pathogenesis, complications mechanism for the diagnosis and treatment of these diseases
Specific objectives Goals entry level
In order for you to understand whether the initial level of your knowledge, skills necessary, offer to perform certain tasks.
Assignments for self-knowledge entry-level skills.
Assignments № 1. Organ mouth is a few folds mucosa, vistlonitis multilayer flat epithelium. Own plate mucosa builds papillae that deep in the epithelium and submitted loose connective tissue with a lot of lymphoid follicles. To which body is such a structure?
1. Tongue (lingua)
Assignments № 2. At microscopic submitted to a body covered with connective-tissue capsule, has cerebral palsy and layers in the cortex layer defines Glomerular, beam and netted zone. For what characterizes such a body structure?
4. Lymph node
Assignments № 3. In histological study of the inner shell body victlanny muchalignment prismatic, ciliated epithelium. In its own disc contains elastic fibers, lymph follicles and individual bundles of smooth muscle cells. One of the shells formed not confined to the rear of the rings gialin cartilage. What is body?
Assignments № 4. In histological study biopsy body shell membrane victlanny muchalignment ciliated epithelium. Own plate mucosa represented loose fibrous connective tissue with numerous elastic fibers. What is body?
Assignments № 5. Deceased patient from asphyxiation, the autopsy revealed that the clearance larynx obturirovan grayish-white film, which are easily separated from the mucous membrane, the latter moderately tuscolavata and hypermirovana. What form of inflammation occurred in this case?
4. Diphtherialis fibrinous
5. fibrinous fibrinous
Assignments № 6. In myocardial died from diphtheria microscopically detected vesicular and Greasy dystrophy cardiomyocytes, focal lysis muscle fibers. In stroma - Plethora, moderate swelling, focal of lymphocytes infiltration. About myocarditis indicate what form the changes described?
1. Exudative unSuppurative interstitial
2. Exudative Suppurative interstitial
3. Diffuse interstitial
4. altrativnitis parenchymatosus
5. altrativnitis - Diffuse
Assignments № 7. With the opening of the deceased from cerebral meningitis soft shell Swelling sharply fully fledged, dimly, dropsically, impregnated thick greenish-yellow fluid. On what form of inflammation are we talking about?
2. Fibrinous Diphtherialis
3. Fibrinous lobar pneumonia
5. Suppurative (Purulent)
Standards of responses to meet the challenges for self-primary level and self-knowledge:
Responses: 1-3, 2-1, 3-1, 4-2, 5-5,6-4,7-5.
The information needed to replenish your knowledge, skills can be found in the following materials:
1. Anatomy of Rights (edited by MG Privesa). M: Meditsina.-1985. S.255-257; 538-542.
2. Histology (edited by Eliseeva VG). Metro: Meditsina.-1983.-S.265-269; 475-485.
3. AI Strukov, V. Serov Pathological Anatomy. Moscow: Medicine.
4. Basics of pathological anatomy Rights (edited by B. G. Shlopova).- Kyiv.-1999.-S.138-155.
5. V. Serov, Yarygin NE, VS Paukov Pathological Anatomy. Atlas. / M.: Medicine. -- 1986. -- S.340-347).
6. Lectures pathological anatomy department on the theme: "Inflammation".
The theoretical issues on which possible implementation of targeted activities.
1. Etiology, pathogenesis, classification of diphtheria.
2. Pathological Anatomy local and general expressions of diphtheria.
3. Complications diphtheria, the cause of death.
4. Etiology, pathogenesis, classification of scarlet fever.
5. Morphology local and general expressions of scarlet fever.
6. Clinical and morphological characteristics of toxic forms of scarlet fever.
7. Clinical and morphological characteristics and pathogenesis purulent complications in septic scarlet fever.
8. Etiology, pathogenesis, clinical and morphological forms of meningococcal disease.
9. Pathogenesis of complications and causes of death in meningococcal disease.
Literature for learning-skills.
1. AI Strukov, V. Serov "Pathological Anatomy" / M.: Medical .- 1995 - S.593-599.
2. Lectures chair on the theme "Children's infection."
3. Graf logical structure of the topic (Supplement 1).
4. Algorithm morphological diagnosis (appendix 2).
1. VG Shlopov. Basics of pathological anatomy. / Kyiv.-1999. - S. 472-479.
2. VV Serov, NE Yarygin, VS Spiders. Pathological Anatomy. M. Atlas of Medicine .- 1986 .- S. 329-335.
After examining the material on this subject for self-absorption material is invited to perform the following targets:
Test assignment № 1. At the deceased child's autopsy revealed haemorrhagic rash on the skin, moderate swelling and hyperemia nasopharyngeal mucosa, small hemorrhages in the mucous membrane and internal organs, dystrophic abrupt changes in the liver, myocardial acute necrotic nephropathy, massive hemorrhage in the adrenal glands. For a disease characterized by the most changes?
1. Scarlet fever
Test assignment № 2. The child three weeks after the rescheduled scarlet fever appeared oedema under the eyes, skin pallor, and malaise. In the analysis of urine identified protein 1.2 g / l, up to 30 erythrocytes in sight, 5-6 leukocytes. For the complications of scarlet fever is characterized by these changes?
1. Acute pyelonephritis
2. After infection glomerulonephritis
3. Fast increasing glomerulonephritis
4. Chronic glomerulonephritis membrane
5. Interstitial nephritis
Test building № 3. Child Illness began with a high temperature, pain in the throat, swelling under the lower jaw nodes. When inspection throat mucous dropsical, moderately hypermirovana, enlarged tonsils, covered with a whitish-grayish film overlay, densely be brazed with Fabric while trying withdrawal bleeding defects, which are formed. For a disease characterized by detecting changes?
2. Scarlet fever
3. Meningococcal nasopharyngitis
Test assignment № 4. Child Illness began with a high temperature, headache, nausea, vomiting. After three days, despite treatment, died. At autopsy found that mild brain envelope full sharply, dropsical, impregnated thick yellowish-greenish fluid on the basal as well as on convencitalitis surfaces. Brain sharply It is swelled violations in the trunk of great foramen. For any given disease characterized by clinical and morphological data?
1. Septicaemic scarlet fever
4. Meningococcal meningitis
Test assignment № 5. The boy 5 years old fell ill quinsy. When inspection revealed a sharp mouth swab hyperemia, crimson Tongue , sharply increased bright red tonsils with greyish yellow and dimly pockets, which are distributed on peritonssillitis tissue. Under the lower jaw enlarged lymph, melkotochechnaya hemorrhagic skin rashes. For a disease characterized by changes identified?
1. A diphtheria of a pharynx
2. A diphtheria of a throat
3. Менингококковая an infection
4. A toxic scarlet fever
5. A septic scarlet fever.
Test assignment № 6. A child 6 years of illness caused by haemolyticus streptokokkom, started badly, with sharp catarrh in the throat and tonsils, which spread to the mucous membrane of the mouth, the Tongue ( "crimson Tongue"), throat. On the surface tonsils necrosis, covering soft sky, throat, places, as exclusion necrotic masses are formed ulcers. Shane enlarged lymph. On a body a rash of bright red color, no rash of nasolabial triangle. What disease can be thinking?
Test assignment № 7. A child 6 years acutely ill, with nasopharyngeal inspection revealed expressed catarrhatis inflammation and swelling of mucous membranes, especially the rear wall of pharynx, hypertrophy lymph follicles. Suspected meningococcal infection. What is necessary to conduct a study to clarify the diagnosis?
1.Smear of epipharynx
3.Analysis of urine
4.examination cerebrospinal fluid
Test assignment № 8. U girls 12 years old when the autopsy revealed multiple hemorrhages in the skin (mostly buttocks, legs), in serous and mucous membrane in the brain. In adrenal focal necrosis and massive hemorrhage, kidney-necrotic nefroz, pyo arthritis, iridotsiklit, vasculitis. What was the child's illness?
4.systema tupus erythematosus
Test assignment № 9. The disease is a child 7 years old started badly, with inspection of the mouth mucosa soft palate, nasopharyngeal brightly hypermirovan " fauces", enlarged tonsils, juicy, bright red, on Day 2 of illness appeared bright red rash all over the body surface, except nasolabial triangle Under the lower jaw enlarged lymph nodes. Put diagnosed with scarlet fever. What developed inflammation in the tonsils of a child?
Test assignment № 10. A child 9 years old fell ill scarlet fever. At the end of the second week he developed abscessus retropharyngealis , osteomyelitis pyo from and the right temporal bone, pyo-necrotic lymphadenitis neck. What form of scarlet fever in the child?
Test assignment № 11. At 6 years old boy appeared sharp pain when swallowing, pronounced swelling of the neck, body temperature rose to 39 C. At the tonsils white films, which are removed with great difficulty, sharply expressed signs of intoxication. What have diagnosed the child?
Test assignment № 12. The child disease started badly, the temperature rose to 38 C, troubled pain in the throat. The deaths occurred on Day 8 of acute heart failure. When enlarged tonsils autopsy, fully fledged, covered with grayish films. When microscopic study tonsils multilayered flat epithelium necrotisatio, fibrinosus impregnated with fluid leukocyte Impurity segmentonuclearis, in the heart-alterativny parenchymal myocarditis. What was the child's illness?
Methodical instructions on the work of students for practical exercises on the theme "Children's infection".
At the start of classes on measurement standards replies check homework solutions. Then a test of control would be checking you to enter.
Independently, you should consider macro and mikropreparaty solve situational challenges. Macroscopic studied drugs: "Diphtheria throat", "meningitis purulenia". Necessary to study mikropreparaty: "Diphtheria tonsils, larynx Diphtheria," "Diphtherialis myocarditis," "Necroticus quinsy with scarlet fever, meningitis purulenia."
In examining the drug's "Diphtheria tonsils" pareticus need to see the expansion of blood vessels, deep necrosis mucosa with soaking fibrinosus fluid admixture with a small amount of leukocytes.
In examining the drug's "Diphtheria larynx" pay attention to plethora, edema, necrosis superficial mucosa with fibrinoznymi overlaid on the surface with a little touch of leukocytes.
In examining the drug's "Diphtherialis myocarditis" define dystrophic changes in cardiomyocytes (vacuolaris, fatty dystrophy), a hotbed of lysis and the collapse of the muscle fibers, moderate swelling and plethora stroma, the requisite number of small lymphoid infiltratov in the stroma.
In examining the drug's "Necroticus quinsy" pay attention to the sharp plethora tonsils, massive pockets of necrosis with infiltration.
In examining the drug's "meningitis Purulent" needs to see a sharp plethoraand cerebral edema soft shells, their thickening and diffuse infiltration of leukocytes segmentonuclearis with impurity fibrin. When using this algorithm and study Macro mikropreparatov (appendix 2)
Class ends with an analysis of the results of independent work by checking each student's description mikropreparatov test and control assimilation theme.
Graf logical structure on the theme: "Children's infection
Annex 1 (continued).
Graf logical structure on the theme: "Children's infection"
Algorithm morphological diagnosis of childhood infections
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