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 compensatoryadaptation 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.