Theme: LOCAL DISORDERS OF CIRCULATION OF BLOOD (To ...
THE MINISTRY OF PUBLIC HEALTH OF UKRAINE
VINNITSIA NATIONAL MEDICAL UNIVERSITY
named after M.I.PIROGOV
EDUCATIONAL-METHODICAL RECOMMENDATION
FROM PATHOPHYSIOLOGY
FOR THE 3RD YEAR
MEDICAL FACULTY STUDENTS
Module N 1 GENERAL PATHOLOGY
Practical training N 2 TYPICAL PATHOLOGICAL
PROCESSES
VINNITSIA - 2012
The manual from Pathophysiology is approved and confirmed for the introduction into the educational process at Pathophysiology department meeting.
Protocol N 1 from 30.08.2011
Сompilers: Head of Department N.A. Rikalo
as. A.S. Grytsenko
as. O.Y. Guminska
as. S.G.Polinkevich
The manual is recommended for the foreign students of medical faculty (3rd course).
Thematic plan
Medical faculty
|Lesson 9. Local disorders of blood circulation (hyperemia, ischemia, stasis, thrombosis, embolism). |
|Lesson 10. Inflammation (vascular reactions). |
|Lesson 11. Inflammation (pus enzymes). |
|Lesson 12. Disorder of heat exchange. |
|Lesson 13. Neoplasia. |
|Lesson 14. Hypoxia. Starvation. |
|Lesson 15. Practical training: “Typical pathological processes.” |
Theme: “LOCAL DISORDERS OF BLOOD CIRCULATION”.
Actuality of theme.
Prevalence of local violations of circulation of blood, such as arterial and venous hyperemia, ischemia and stasis is very important. Their development is predefined violation of the neurohumoral regulation of local blood circulation. Disorders of local blood circulation need the detailed study, as they are the main link of pathogenesis of many pathological processes. Knowledges about general mechanisms of their development are needed for successful treatment and prophylaxis of the proper violations.
It is known that the system of blood circulation takes leading place in support of vital functions of an organism as the whole system.
Providing of necessary blood stream is a difficult process which depends on the adequate functioning of heart, integrity of vascular wall and balance between coagulative and anticoagulative systems of blood.
All known diseases are accompanied with disorders of blood stream.
Local disorders of blood circulation, such as thrombosis and embolism is one of the most frequent reasons of death (thromboembolism of cerebrum vessels, pulmonary artery). That is why knowledge of reasons, mechanisms of development and consequences of thromboembolism has a large significance for a practical doctor.
General purpose of the lesson.
To learn the reasons of arterial and venous hyperemia, ischemia, stasis origin, mechanisms of their development, manifestations, significance for an organism. To learn reasons, mechanisms of development, manifestations, significance of thrombosis and embolism for the organism.
For this it is necessary to know (the concrete purposes):
1. To know the arterial and venous hyperemia, ischemia, stasis definitions.
2. To know the reasons of origin and mechanisms of peripheral blood circulation disorders development.
3. To describe the basic manifestations of different of, explain the mechanisms of their development.
4. To explain the value of local blood circulation disorders for an organism.
5. To be able to make the arterial and venous hyperemia, ischemia at experiment.
6. To give determination of conceptions: "thrombosis", "embolism".
7. To be able to explain principal reasons of origin, mechanisms of thrombosis development.
8. To explain the consequences of thrombosis.
9. To be able to classify embolism by origin and localization.
10. To explain the mechanisms of different kind of embolisms development.
11. To explain the significance of thrombosis and embolism for the organism.
For realization of purposes of lesson it is necessary to have the base knowledges-skills:
1. Dividing of bloodstream into the functional parts (Normal Physiology Department).
2. The conception about the vessels of microcirculation (Normal Physiology Department).
3. Mechanisms of bloodstream regulation (Normal Physiology Department).
4. Structure and functions of endotelial cells, basal membrane (Histology department).
5. Structural and functional organization of the blood circulation system (Normal Physiology and Histology Departments).
6. View about central and peripheral blood circulation (Normal Physiology Department)
7. Conception about the hemostasis system (Normal Physiology Department)
8. Concept about the fibrinolytic system (Normal Physiology Department)
9. Thrombocytes functions (Normal Physiology Department)
The checking of primary level of knowledges.
Give the answers to the following questions:
1. Basic forms of local blood circulation disorders.
2. Arterial hyperemia, definition.
3. What are the reasons of arterial hyperemia development?
4. Types of arterial hyperemia.
5. Venous hyperemia, definition.
6. Reasons of venous hyperemia development.
7. Ischemia, definition.
8. Stasis, definition.
9. Types of ischemia?
10. Types of stasis?
11. Thrombosis, definition.
12. Basic factors which are promote thrombus formation (Virchow’s triad).
13. What are the phases of thrombus formation process?
14. Consequences of thrombosis? From what does it depend?
15. Embolism, definition.
16. Types of embolisms according to origin.
17. Types of embolisms according to localization.
18. Types of exogenous embolisms.
19. Types of endogenous embolisms.
Standards of answers at the theoretical questions of initial level of knowledges:
1. Arterial and venous hyperemia, ischemia, stasis, thrombosis, embolism.
2. Arterial hyperemia – it is increased blood supply through the organ or part of tissue against of increased blood inflow from the arteries.
3. Influence of physical, chemical and biological factors of external environment, multiplying loading on an organ or area of tissue, psychogenic influencing.
4. Types of arterial hyperemia:
1) Physiological (after intensive work of organ, reactive)
2) Pathological (neurogenic, metabolic)
5. Venous hyperemia – it is increased blood supply through the organ or part of tissue against of decreased blood outflow from the veins.
6. Reasons of venous hyperemia:
1) intravascular (obturation of veins by a thrombus or embolus);
2) extravascular (compression of veins by a tumour, scar, tourniquet, by the enlarged organ (for example, by a pregnant uterus) by an edema);
3) constitutional weakness of elastic apparatus of veins, reduced tone of muscle elements of their walls;
4) disorders of general hemodynamics (cardiac failure, diminishing of suction ability of thorax).
7. Ischemia - it is decreased blood supply through the organ or part of tissue against of decreasing or complete stoppage of blood inflow from the arteries.
8. Stasis – it is slowing-down and stoppage of blood flow in the capillaries, small arteries and veins.
9. Basic types of ischemia:
1) Compressive
2) Obturative
3) Angiospastic.
10. Basic variants of stasis:
1) Ischemic
2) Venous
3) True (capillary).
11. Thrombosis - is the vital formation on the internal surface of vessel wall blood clots which consist of its elements. These clots got the name thrombus.
12. 1) Damage of vascular wall; 2) Violation of coagulative and anticoagulative blood system (increase of coagulative system activity or decline of anticoagulative system activity; 3) Deceleration of blood flow.
13. Cellular and plasma.
14. Necrosis (infarcnion), aseptic and septic meltdown, tromboembolism, disseminated intravascular clotting (DIC).
15. Embolism – is transfer of foreign bodies which do not meet there in a norm by the blood or lymph current with the next complete or partial vessel obturation.
16. Exogenous and endogenous.
17. By localization: embolism of greater circulation, embolism of lesser circulation and embolism of portal vein system.
18. Exogenous types of embolisms: air, gas, bacterial, parasite, embolism by foreign bodies.
19. Endogenous types of embolisms: thromboembolism, fatty, tissue, embolism by amniotic fluid.
Test control is for verification of primary level of knowledges:
1. What substance from recital can result arterial hyperemia development?
А. Noradrenaline
B. Thyroxin
C. Aldosterone
D. Somatotropin
E. Acetylcholine
2. What manifestations are not characteristic for arterial hyperemia?
A. Acceleration of blood stream
B. Deceleration of blood stream
C. Increase of local temperature
D. Multiplying the amount of functional capillaries
E. Redness
3. What manifestations are characteristic for venous hyperemia?
А. Increasing of organ blood supply
В. Cyanosis
С. Deceleration of blood stream
D. Hypoxia
Е. All answers are correct
4. Name possible reasons of physiological arterial hyperemia development?
А. Action of angiotensin-ІІ on the vessels of microcirculation
В. Endothelium injuries
С. Increased loading on an organ
D. Compression of the vessels by the enlarged organ or tumour
Е. Obturation of arteries by the atherosclerotic plaque
5. Name possible reasons of venous hyperemia development?
А. Obturation of vein by a thrombus or embolus
В. Obturation of arteries by the atherosclerotic plaque, blood clot, embolus
С. Spasm of arterioles
D. Action of angiotensin-ІІ on the vessels of microcirculation
Е. Increased loading on an organ
6. Hyperproduction of what matters by endothelium can be the reason of arterial hyperemia development?
А. Prostaglandins
В. Nitrogen oxide
С. Endothelins
D. Villebrand factor
Е. All answers are correct
7. What are credible consequences of venous hyperemia?
А. Edema of tissues
В. Hypoxia
С. Enlargement of connecting tissue
D. Liver cirrhosis
Е. All answers are correct
8. What are possible consequences of arterial hyperemia?
А. Hypoxia
В. Hemorrhage in tissues
С. Enlargement of connecting tissue
D. Atrophy of the organ
Е. All answers are correct
9. What biologically active substances which operate on intact vascular wall can be the reason of angiospastic ischemia development?
А. Angiotensin-ІІ
В. Acetylcholine
С. Atrial natriuretic hormone
D. Prostaglandins
Е. Nitrogen oxide
10. The obturative ischemia is the result of -
А. Arteriole spasm
В. Particulate or complete obturation of veins
С. Compression of arteries
D. Partial or complete obturation of arteries
Е. All answers are correct
11. The compressive ischemia is the result of -
А. Particulate or complete obturation of arteries
В. Particulate or complete obturation of veins
С. Compression of arteries
D. Increased loading on an organ
Е. All answers are correct
12. Rubbing by ointment on the basis of snake venom was done to a patient with lumbar radiculitis. Apparent redness arised at the place of rubbing after completion of procedure. What type of local blood circulation disorders took place in this case?
А. Thrombosis
В. Venous hyperemia
С. Stasis
D. Ischemia
Е. Arterial hyperemia
13. Cyanosis of back surface of leg in the middle and overhead third is observed at the patient with thrombophlebitis of lower limb veins. What type of local blood circulation disorders take place in this case?
A. Stasis
В. Arterial hyperemia
C. Ischemia
D. Venous hyperemia
E. Thrombosis
14. Paleness of skin of foot and leg is observed at the patient with endarteritis. The skin is cold by touch. What disorder of local blood circulation took place in this case?
А. Arterial hyperemia
В. Stasis
С. Ischemia
D. Venous hyperemia
E. Embolism.
15. The vessel wall is formed by endothelium, basal membrane and pericytes. This vessel is:
А. Arteriole
В. Venule
С. Hemocapillary
D. Lymphocapillary
Е. Artery with middle caliber
16. Specify factors which promote thrombosis development:
А. Increase of thrombocytes amounts in the unit of blood volume
В. Decrease of red corpuscles amounts in the unit of blood volume
С. Disorders of the acidic - basic state
D. Damage of vascular wall endothelium
Е. Гіпокальціємія
17. What form of embolism from the indicated can develop at transition from the area of the increased barometric pressure to normal?
А. Fatty
В. Thromboembolism
С. Gas
D. Retrograde
Е. Tissue
18. Name the vessels at the damage of which most probable is an origin of air embolism:
А. Femoral vein
В. Jugular vein
С. Ulnar vein
D. Hepatic vein
Е. Portal vein
19. What is the amount of thrombocytes in a norm?
A 60 – 80x109/l
B. 200 – 400x109/l
C. 450 – 500x109/l
D. 30 – 40x109/l
E. 1 – 5x109/l
20. Name the basic factors of thrombosis (Virchow’s triad) (3):
А. Thrombocytes damage
В. Disorders of coagulative and anticoagulative blood systems
С. Deceleration of the blood stream
D. Multiplying speed of blood stream
Е. Damage of vascular wall endothelium
21. What is the main point of physical and chemical content of thrombosis cellular phase?
А. Change of vascular wall electric charge
В. Change of thrombocytes electric charge
С. Stability of vascular wall electric potential
D. Stability of thrombocytes electric potential
Е. All answers are right.
22. Name the basic consequences of thrombosis:
А. Necrosis (infarction)
В. Gangrene (extremities)
С. Aseptic or septic meltdown
D. Ischemia
E. All answers are right
23. The neck is injured at man as a result of accident. What is the most probable type of embolism will develop?
А. Fatty
В. Gas
С. Air
D. Tissue
Е. Thromboembolism
24. A woman got the opened fracture of right femur bone as a result of accident. What is the most probable type of embolism will develop?
А. Bacterial
В. Gas
С. Air
D. Fatty
Е. All answers are right
25. Damage of venous sinus of durae matris was diagnosed at a patient as a result of trauma. What is the most probable type of embolism will develop?
А. Gas
В. Fatty
С. Air
D. Bacterial
Е. Tissue
26. What type of embolism can arise up at a patient as a result of lungs trauma?
А. Gas
В. Air
С. Bacterial
D. Fatty
Е. Parasitogenic
27. What type of embolism can arise up at a diver who was quickly come up from the depth?
А. Gas
В. Air
С. Tissue
D. Fatty
Е. Bacterial
28. What type of embolism can arise up at a pilot as a result of dehermetization of airplane?
А. Parasitogenic
В. Air
С. Fatty
D. Tissue
Е. Gas
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Conclusion:______________________________________________________________
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EXPERIMENT 2. Take the temperature in the floor of the auricle of a rabbit. Put the rabbit in to the thermostat and rise up the temperature to 42°C. Study the changes of the temperature of the rabbit's body and its common reaction at the overheating.
Initial level of temperature - ______°C.
Initial respiratory rate - ______in min.
Temperature of the rabbit after the overheating - ______°C.
Respiratory rate after the overheating - _______in min.
Conclusion:______________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________
EXPERIMENT 3 Brake the frog's spinal cord. Fix the frog on the board, cut the thoracic cavity. Grasp the apex of the heart with a cerfine connected with the myograph. Record with the kymograph the curve of the heart contractions at the effect (under the influence) of Ringer's solution of different t° 25, 30, 40, 50, 60, 70, 80 and so on up to the heart failure.
|Ringer's solution temperature, °C |Heart biting rate, in min. |
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Conclusion:_____________________________________________________________
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EXPERIMENT 4. The students study available records of respiration of different animals: guinea - pigs, rabbits, cats
[pic]
Conclusion:______________________________________________________________
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Theme: «Pathology of tissue growth. Tumours».
Actuality of theme.
By the prognoses of Worldwide health protection organization morbidity and death rate from oncologic diseases in the whole world will grow in 2 times for period from 1999 year for 2020: from 10 to the 20 million new cases and from 6 to the 12 million registered deaths.
Taking into account that in the developed countries there is a tendency to deceleration of growth of morbidity and death rate from malignant tumours (due to the prophylaxis and due to the improvement of early diagnostics and treatment), clearly, that a basic increase will be at developing countries (countries of former USSR). That is why doctors have to expect serious increase of morbidity and death rate from oncopathology.
From data of Committee of cancer prophylaxis 90% tumours are related to influencing of external factors, and 10% - depend on genetic factors.
That is why it is necessary for future specialist to know etiological factors and « risk factors» of tumours origin. Taking into account that tumours appear at the different age, race, sex people understanding of carcinogenesis and metastasis mechanisms and differences of innocent tumours from malignant are necessary for the doctor of any profession.
General purpose of the lesson.
To learn reasons, mechanisms of development, biological features of tumour growth.
For this it is necessary to know (the concrete purposes):
1. To know determination of conceptions " hypertrophy", " hyperplasia ", "regeneration", "atrophy", "dystrophy", "tumour".
2. To know the features of innocent and malignant tumours growth.
3. To describe principal reasons of tumour growth.
4. To be able to explain the mechanisms of transformation of normal cell in a tumour one.
5. To know general principles of patients treatment with malignant tumours.
For realization of purposes of lesson it is necessary to have the base knowledges-skills:
1. To know the structure of cell (Histology Department).
2. To know the mechanisms of cell division (Biology and Hystology Departments).
3. To know principles of metabolism (albumen, carbohydrate, fatty) (Biochemestry Department).
4. To have imagination about DNA- and RNA-contained viruses (Microbiology department).
5. Conception about structure, functions and gene regulation (Biology department).
The checking of primary level of knowledges.
Give answers to the followings questions:
1. Tumour, definition.
2. What carcinogenic substances do you know?
3. What carcinogens refer to the physical (make examples)?
4. What carcinogens refer to the chemical (make examples)?
5. What carcinogens refer to the biological (make examples)?
6. What characteristic of tumours properties do you know (transfer).
7. Stages of tumours development.
8. What is Heyflik’s limit (barrier)?
9. What is immortalisation?
10. What is apoptosis?
11. What the transformation mechanisms do you do know (transfer)?
12. What is proto-oncogene?
13. What is dedifferentiation?
14. What is antigen simplification?
15. What is the Pasteur’s negative effect?
Standards of answers at the theoretical questions of initial level of knowledges:
1. Tumour - is the typical pathological process, which is characterized by unregulated limitless cells and tissues growth which is unconnected with a general structure and function of the damaged organ.
2. Physical, chemical, biological carcinogens, endogenous
3. Physical carcinogens (ionizing radiation, ultraviolet, infra-red radiation, mechanical influence).
4. Chemical carcinogens:
exogenous - organic (multiring hydrocarbon - benzyl, 3,4- benzpyrene, methylholantren), aromatic amine and amide (b-naphtylamine, benzidine, dimethylaminoazobenzene), nitrosamines, which appear in a stomach from nitrites and amines in the presence of HCl (diethylnitrosamine, dimethylnitrosurea, threemethylnitrosurea), aflatoxinы from Aspergillus flavum and sterigmatoсistin from Aspergsllus nidulans, other - uretan, CCl4, epoxideы, plastics, peroxides) and inorganic (chrome, arsenic, cobalt, nickel, beryllium, lead, cadmium);
endogenous (follicle-stimulating hormone, sexl hormones; phenylalanine tryptophan, tyrosine, indole derivatives; free radicals and peroxides, bile acids, cholesterol, vit.В12, nicotine acid).
5. Biological carcinogens: RNA- (viruses of mouse and chickens leukemia, Rous sarcoma, Bittner's virus, and others; for a human - the retrovirus was selected from the leukemia cells - HTLV (Human T- Lymphoma Virus), that causes Т-cellular), DNA - contained viruses (papova - viruses, adenoviruses, viruses (the of Epstein - Barr virus which result of Burkett’s lymphoma development) of herpes, hepadnavirus - is a virus of hepatitis causes the cancer of liver), human papilloma virus (neck of uterus cancer).
6. Anaplasia, metaplasia, displasia, invasive growth, metastasis.
7. Initiation, promotion, progression.
8. Heyflik’s limit - it the maximal amount of cell divisions, which is genetically programmed. It is different for every cells type. For fibroblasts, for example, it is divisions.
9. Immortalisation - is the phenomenon, when cells can be divided long time without signs of senescence.
10. Apoptosis - is programed self-destruction of cells which is characterized by activating of anlyzosomal endogenous endonucleas, which divides nuclear DNA on little fragments.
11. Mechanisms of transformation - mutational, epigenomic.
12. Protoonkogenes - are normal cellular genes which are able at violation of their structure to induce tumour growth.
13. Dediferentiation or anaplasia - is getting by the tumours cells of properties characteristic for the embryo stage of organism development.
14. Antigen simplification is a loss of own antigens (declines of organo-specifity, individualities) and appearance of new tumour-embryos antigens (returning to the embryo state).
15. Pasteur’s negative effect - is disintegration of carbohydrates to pyruvate and transformation of it on lactic acid in aerobic conditions.
Theoretical questions at the base of which the execution of purpose types of activity is possible.
1. Tumour, determination. Morphological, biochemical and physiological features of of tumours cells.
2. Reasons of tumours origin.
3. Basic mechanisms of carcinogenesis.
4. Description of tumour progression.
5. Ways and terms of tumour cells metastasis.
6. Co-operation of tumour and organism. Mechanisms of cancer cachexy.
7. Experimental study of tumours etiology and pathogenesis.
8. Pathophysiological bases of tumours prophylaxis and treatment.
9. Tumours at children.
Literature.
1. Handbook of general and Clinical Pathophysiology/ Edited by prof.A.V.Kubyshkin, CSMU, 2005. – p. 130-138
2. Pathophysiology/ Edited by prof.Zaporozan, OSMU, 2005 – p.105-114
3. General and clinical pathophysiology/ Edited by Anatoliy V/ Kubyshkin – Vinnytsia: Nova Knuha Publishers – 2011. p. 166-183
Testing according system “Krok-I”
Tests of an open database (2010)
1. Lung cancer developed at the patient who smoked tobacco for a long time. What of the carcinogens contained in tobacco smoke and concern to PAH?
A. Benzpiren
B. Dymethylaminoazobenzol
C. β - naphthylamin
D. Diethylnitrozamin
E. Ortoaminoazotoluol
2. There is high stage of interaction between lung cancer and tobacco smoking. What chemical carcinogen is contained in tobacco smog?
A. 3,4-benspyren
B. Orhtoaninotoluol
C. Aphlatoxin
D. Methylcholatren
E. Dyethylnitrosamine
3. Patient, 62 years old, a fireman, complains of general weakness, sudden weight loss, husky voice, shortness of breathing, dry cough. Laryngeal tumor that germinates vocal cords and epiglottis was discovered at laryngoscopy. Name the most likely cause of the tumor in this patient:
A. Polycyclic aromatic hydrocarbons
B. Nitrosamines
C. Aromatic amine and amides
D. Retrovirus
E. Ionizing radiation
(2006-2009)
4. In a patient with metastases of lung carcinoma introduction of cytostatics led to suspension of metastases growth at first but later metastases resumed spread. What is the most possible mechanism of secondary growth of metastases?
A. Absence of contact braking
B. Absence of Heiflik’s limit
C. Rise of genetic heterogeneity of tumor cells
D. Increased glucose consumption by tumour
E. Increased amino acids consumption by tumour
5. A 56-years-old patient, who had contact with diethylnitrozamine at his work place, complains of pain in right subcostal area, weakness, loss of appetite, and decreased workability. At examination of this patient: surface of his liver is rough, splenomegaly and ascites are present in him; his body temperature is 37.2oC; in his blood analysis ESR is 25 mm/hour, besides neutrophilic leukocytosis, and hypochromic anemia were found. What disease developed in the patient’s organism?
A. Cancer of liver
B. Hepatitis
C. Cirrhosis of liver
D. Gallstone disease
E. Dyskinesia of bile ducts
6. Malignant tumor of lung was diagnosed in a patient. What feature of tumour growth testifies its malignancy?
A. Infiltrative growth
B. Unregulated growth
C. Unlimited growth
D. Expansive growth
E. Appearance from one cell
7. The woman complained to the doctor for changing of voice, appearance of hair on the face, and reduction of breast. Where would a tumor develop that could lead to these symptoms?
A. Tumor of zona reticulata of adrenal glands
B. Tumor of ovaries
C. Tumor of anterior lobe of pituitary gland
D. Tumor of zona glomerulata of adrenal glands
E. Tumor of zona fasciculata of adrenal glands
8. Following changes can occur in development of tumor:
A. Pheochromocitoma – hypotension
B. Insulinoma – hypoglycemia
C. Aldosteroma – hypohydratation
D. Tumor of zona reticulata of adrenal glands – inhibition of sexual growth
E. Tumor of thyroid gland – hypothyroidism
9. A male patient, 40, has stenotic (without metastases) esophagus cancer. The following changes were revealed in that patient: muscular and fat tissue atrophy, brownish color of the skin, thin epidermis, and cardiac atrophy. What’s the reason of such symptoms?
A. Alimentary cachexy
B. Myasthenia
C. Addison’s disease
D. Cancer cachexy
E. Brown induration
10. In 1910 Rhauss managed to cause sarcoma in chickens by cell-free infiltrate inserting. What was the method of experimental modeling?
A. Induction
B. Explantation
C. Isotransplantation
D. Homotransplantation
E. Heterotransplantation
11. What biological process augmentation is typical for tumor cells?
A. Anaerobic glycolysis
B. Decarboxilation
C. Tissue respiration
D. Lipolysis
E. Gluconeogenesis
12. Erlich’s tumor was transplanted to animal. What is the evidence of tumor progression?
A. Unlimited growth
B. Resistance to cytostatics
C. Anaplasia
D. Infiltration
E. Tumor weight increasing
13. Unpainted formation under the jaw was appeared in liquidator of Chernobyl’s disaster after 12 years of accident. The size of it has increased till last month. The blood analysis is in norm. What pathological process is most suspicious in this case?
A. Lymphadenitis
B. Syaloadenitis
C. Abscess
D. Malignant tumor
E. Cyst
14. There is a tumor of tongue in patient. What characteristics of tumor may be considered as malignant?
A. Dysplasia
B. Expansion
C. Infiltration
D. Pasteur’s positive effect
E. Mitosis increasing
15. What cell structure is a «target» for chemical cancerogens?
A. Nuclear DNA
B. Lysosomes
C. Mitochondria
D. Cytoplasmic membrane
E. Ribosomes
16. A patient with lung cancer has been smoking 30 cigarettes per day for 20 years. What the group of cancerogens is in tobacco smog?
A. Polycyclic carbohydrates
B. Aminoasosubstances
C. Nitrosamines
D. Amines
E. Heterocyclic carbohydrates
17. A patient with urinary bladder cancer was working in coke factory. What substance was the most probable reason of this pathological condition?
A. Naphtylamine
B. Dichlorethane
C. Vinegar acid
D. Alcohol
E. Pethroleynic aether
18. It is established that tumor tissue receives in 20-25 times less of glucose that intact tissue in equal glucose amount. What metabolic changings lead to such event?
A. Aerobic glycolysis enhancement
B. Oxydation improvement
C. Normal interaction of these processes
D. Tissue respiration improvement
E. Decreasing of anaerobic glycolysis
19. They got nitrogenous nitrite to experimental animals. A tumor was developed in 80% of animals. What was the group of cancerogens?
A. Nitrosamines
B. Aminoasosubstances
C. Polycyclic carbohydrates
D. Simple chemical substances
E. Hormones
20. After Chernobyl disaster morbidity of tumors has been increasing. What action of the radiation has been appearing?
A. Oncogenic
B. Thermal
C. Mutagenic
D. Cytostatics
E. Immunostimulative
|Correct answers |
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1 |A |2 |B |3 |A |4 |D |5 |E |6 |E |7 |A | |8 |A |9 |E |10 |A |11 |A |12 |A |13 |B |14 |D | |
Situate task:
1. Esophagus stenosis, which obstruct food intake developed at a patient after a chemical burn. Acute weight loss developed, mass of body diminished on 16%. At laboratory research of blood the following changes were found out: erythrocytes-3,1x1012/l, haemoglobin-113g/l, glucose-4,7 of mmol/l, protein-57g/l.
1) What is the type of starvation at a patient?
______________________________________________________________________
2) What are the possible consequences of hypoproteinemia?
______________________________________________________________________________________________________________________________________________
3) What are the reasons of this type of starvation?
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2. A man, 45 years, passes in a clinic the course of medical starvation concerning obesity. On 4th day from the beginning of starvation, feeling of hunger is saved, a general weakness, oppressing a psyche, some weight loss are marked. The level of glucose in blood makes 2,8 mmol/l, a selection nitrogen with urine makes 10 g per day. Respiratory coefficient 0,9.
1) What is the type of starvation at a patient?
_____________________________________________________________________
2) What is the period of starvation?
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3) Characteristic of this period of starvation.
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3. The weight loss of a 45% of rats body is marked at the 7th days from the beginning of complete starvation with water. A respiratory coefficient is 0,8. At some animals there are areas of skin necrosis. What is the period of starvation?
1) What is the type of starvation at a patient?
________________________________________________________________________
2) What is the period of starvation?
________________________________________________________________________
3) Characteristic of this period of starvation.
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4. For a patient with stenosis of pyloric part of stomach, the labored reception of meal takes place, there are weight loss, muscular weakness, edema of lower extremities.
1) What is the type of starvation at a patient?
________________________________________________________________________
2) What are the reasons of this type of starvation?
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5. Esophagus stenosis, which obstruct food intake developed at a patient after a chemical burn. Acute weight loss developed, mass of body diminished on 16%. At laboratory research of blood the following changes were found out: erythrocytes-3,1x1012/l, haemoglobin-113g/l, glucose-4,7 of mmol/l, protein-57g/l.
1) What is the type of starvation at a patient?
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2) How to explain the decrease of blood cells and haemoglobin in the blood?
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3) Will resistance of organism to the infectious agents change in this case? Explain the answer.
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6. A child, 2 years old, was delivered to the clinic in grave condition. The family lives in one of the poorest countries in Asia, conditions of life and nutrition are not satisfactory. Breastfeeding is terminated early. Objectively: child is weakened, flaccid, there is a lack of weight and stunting, muscles hypotonia and dystrophy, thinning of hair, generalized edema, hyper-pigmentation and desquamation of a skin in the places of clothes friction.
1) What pathology developed at a child?
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2) What are the causes and mechanisms of this pathology development?
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7. During the earthquake, the scientists, who investigated the mountain caves, were caught under the blockage without supplies of food and water.
1) What kind of a starvation will develop at people?
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2) That is the duration of this type of starvation?
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3) That is the difference of this type of starvation from incomplete?
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