THE UKRAINIAN MINISTRY OF PUBLIC HEALTH
Vinnitsa National Pirogov Memorial Medical University
МETHODICAL RECOMMENDATIONS
FOR INDIVIDUAL WORK OF STUDENTS
WHILE PREPARING PRACTICAL CLASS
Discipline
Theme of lesson
Basis of clinical medicine
Аnomalies of constitution: diathesis
Course
3
Faculty
Pharmaceutical
1. Background.
About 90% of chronic disease occurs against a background of a predisposition.
Diathesis defined as polygenic (multifactorial) inherited tendency to disease, objectively
recognizable deviations from normal.
2. Aims:
1. Acquire knowledge certain anomalies of the constitution.
2. Determine the diagnostic criteria of allergic, lymph, urine acid diathesis.
3. Differential diagnosis of clinical and pathogenetic types of diathesis.
4. Be able to make the test program to detect allergic, lymph, urine acid diathesis.
5. Acquire knowledge of the principles of treatment and rehabilitation for allergic, lymph, urine
acid diathesis.
3. Base knowledge, abilities, skills necessary for the study of theme (interdisciplanary
integration)
Names of previous
Got skills
disciplines
1. Normal anatomy
Structure of the skin, subcutaneous tissue, organs of the
neuroendocrine and immune systems
2. Normal physiology
The regulation of normal physiology and functioning of
the immune system in young children
3. Histology
Histological features of the structure of the immune system
in young children
Features biochemistry of purine metabolism in young
children
4. Biochemistry
4. Task for independent work during preparation to employment
4.1. List of basic terms, parameters, descriptions which a student must master at
preparation to employment
Term
1. Allergic diathesis
Determination
the understand constitutional-conditioned, congenital or
acquired immunological features, autonomic or metabolic
functions that determine readiness for the development of
sensitization, allergic reactions and diseases.
2. Lymphatic diathesis
characterized by constitutional-caused congenital or acquired
morphological and functional features of the neuroendocrine
and lymphatic systems of the body and its immune
responsiveness, which lead to a decrease in adaptive capacity
to the adverse effects, predispose to severe or chronic
inflammatory diseases and immunopathological reactions.
3. Urine acid (neuro-arthritic) is polygenic, inherited metabolic abnormality, are in
diathesis
contravention of purine metabolism with excessive
production of uric acid and its predecessors, the instability of
other exchanges (primarily glucose and lipid) with a
tendency to ketosis due to a defect of regulatory enzyme
systems that predispose children to the development of
chronic diseases of the musculoskeletal system, kidneys, gall
bladder and hypertensive reactions.
4.2. Theoretical questions to employment:
1. The concept of constitutional anomalies, clinical and pathogenetic classification.
2. Allergic diathesis: diagnostic criteria.
3. Lymphatic diathesis: diagnostic criteria.
4. Urine acid diathesis: diagnostic criteria.
5. Differential diagnostic signs of allergic, lymph, urine acid diathesis.
6. Algorithms for treatment and rehabilitation measures for allergic, lymph, urine acid diathesis.
4.3. Practical tasks which are executed on employment:
1. Work with the tests tasks.
2. Students work in the wards: clinical examination of young children with anomalies of the
constitution.
3. The decision of situational problems.
tutorial chair, textbooks information, in the network of Internet.
Materials for self-control:
Tests:
1. By pathogenic markers of lymphatic diathesis include all except:
A. Absolute and relative lymphocytosis.
B. Signs of sympathetic-adrenal imbalance.
C. Signs of activation of T-helper lymphocytes.
D. Disproteinemia.
E. Partial ungraded immunodeficiency.
2. Lymphatic diathesis refers to a group of hereditary predisposition: I
A. Immunotopic.
B. Dysmetabolic.
C. Organotopic.
D. Neurotopic.
3. Lymphatic diathesis most often manifests:
A. Lymphoproliferative syndrome.
B. Intermittent symptoms of adrenal insufficiency soledefiсit.
C. Allergic symptoms.
D. Disproportion physique.
E. All of the above.
4. Of these drugs adaptogens are all, except:
A. Tincture of ginseng.
B. Altey decoction of the root.
C. Pantocrinum.
D. Golden Root.
E. Leuzea.
5. Thymus, adrenal insufficiency may show all except:
A. Sudden development of cardiovascular disorders.
B. Rise of suffocation.
C. Acute liver failure.*
D. Symptoms similar to the form of adrenal insufficiency soledefiсit.
6. Specify a particular diet of children with lymphatic diathesis:
A. Restriction of foods rich in purines.
B. Limitation of meat.
C. Carbohydrate restriction.
D. All listed.
E. A special diet is not provided.
7. At the heart of urine acid diathesis is genetically determined violation of enzyme activity
involved in the metabolism:
A. Uric acid.
B. Pyruvic acid.
C. Citric acid.
D. Succinic acid.
E. Polyunsaturated fatty acids.
8. Urine acid diathesis may be manifest to all, except:
A. Aсeton vomiting.
B. Pain in the extensor muscles.
C. Limfopoliadenit.
D. Chorey hyperkinesia.
E. Accelerated development of the mind and speech.
9. Genealogical history of children with high uric acid diathesis propagation wounded:
A. Gout.
B. Urolithiasis.
C. Functional disorders of the nervous system.
D. Diabetes.
E. All of the above.
10. Secondary hyperuricemia may develop any pathology, except:
A. Resorption of pneumonic infiltrates.
B. Encephalopathies.
C. Hyperparathyroidism.
D. Leukemia.
E. Dystrophies.
Situational tasks
№1. My child is 3 years old, girl. Active, agile, lean. Talks a lot, rich vocabulary, knows poetry,
emotional lability. Pale, traumatic brain nerves without pathology. Facial expressions mobile.
Decreased appetite, frequent vomiting. Condition of internal organs were normal. The blood uric
acid, 0.5 mmol/l. If vomiting appears in urine acetone. Blood sugar - 3.85 mmol/L, urine diastase
- 32 units. Set a preliminary diagnosis
№2. Mother three years went to the doctor complaining of irritability of the child, violation of
appetite, sleep, intermittent vomiting, pain in the joints. Objectively: the child emotionally labile,
capricious, subcutaneous fat layer is reduced, urticaria on the back. Internal organs without signs
of pathology. Neurologist diagnosed neurasthenic syndrome. The urine revealed an increased
amount of urate. What is the most likely diagnosis?
№ 3. A child of 3 months, artificially fed, after the introduction of egg yolk on congested cheek
skin vesicles appeared that quickly come to light with the release of serous fluid, formed a crust.
Rash accompanied by itching and anxiety the child loose stool. What kind of disease should be
considered?
№ 4. A child six years, had hyperuricemia, giperurikuriya. Pathogenetic features of which
diathesis can it be?
№ 5. Mother of a girl of 7 years old complained of recurrent abdominal pain and skin rash,
increased sweating, reduced amount of urine and its rich character. Noted nіcturia. BP 90/60 mm
Hg. Art. Society. An. incontinence: the relative density of urine - 1028 Protein - 0.04 g / L, white
blood cells - 9-10 p / sp, erythrocytes - 6-8 in the modified p / sp., cylinders - not expos., salt - a
lot of oxalates . Set a preliminary diagnosis.
Literature
Main:
1. Lectures on propaedeutics of children’s diseases.
2. Kapitan T. Propaedeutics of children’s diseases and nursing of the child. – Vinnitsa, 2006. –
Pg. 347-404.
3. Kapitan T. Propaedeutics of children’s diseases and nursing of the child. – Vinnitsa, 2011. –
Pg. 385-453.
4. Kapitan T. Training manual «Fact issues of pediatrics». – Vinnitsa, 2009. – Pg. 27-54.
Additional:
1. Pediatric clinical methods. – New Delhi, 2004. – Pg. 49-65.