Methodological instruction

to practical lesson of nurse-bachelour students

 

LESSON 1

 

Theme 1. General illness development conformities to natural laws. Etiology and pathogenesis.

Theme 2. Heredity role in human pathology

 

Aim: To be able analyse lawfullness arise, development and diseases consequences. To study in the experiment action of decreased atmospheric pressure upon organism. To get acquainted with study and diagnostic methods of hereditary diseases.

 

Professional orientation of students. In everyday practical activity doctor always takes into account of illness nature and peculiarities of it course. This important for planning of prophylactic arrangements, diagnosis raising, selection of medical drugs. In illness is distinguished two process : ) 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, physiotherapy procedures. By protective reactions one can be governed also by the medium of medical drugs. Aim of such arrangements to raise individual organism resistance to action of harmful agents. During continuous evolution organism has adapted to normal atmospheric pressure. But in conditions of modern life man more often encounters with action of changed atmospheric pressure. This is related to production activity (fliers, cosmonauts, divers), sport (mountaineering). Action of changed atmospheric pressure upon organism is used in medicine for treatment (barotherapy). It is important to know, that durin rapid changing of atmospheric pressure complicated symptomocomplex occurs which is called barotrauma. In modern of contemporary war barotrauma can have wide spread owing to influence of shock wave.

Hereditary factors play an essential role in human pathology. Now is known about 2000 diverse hereditary diseases are known. 4 % of new-born suffer from these or other genetically conditioned defects. This testifies importance of ability to participate in exposure methods of hereditary diseases, study ways of their prophylaxs and cure principles. Heredity pathology plays an important role in development mechanisms of such hereditary conditioned diseases, as atherosclerosis, essential hypertension, rheumatism, diabetes mellitus, gout.

 

Program of independent students preparation

Theme 1 of practical lesson

1. Gist of experimental method

Definition a notion of experiment

Peculiarities, significance and lacks of acute experiment

Peculiarities of chronic experiment

2. General conceptions of illness

 

Definition of illness notion

Looks on illness development

Illness signs

Illnesses classification

Illness periods

Illness ends

Pathological process

Pathological state


 

3. Notion about etiology and pathogenesis

Definition of notion etiology"

Definition of notion pathogenesis"

Main links of pathogenetic chain

Definition of notion compensatory-adaptative reactions

Types of compensatory-adaptative reactions

Role of compensatory-adaptative reactions reactions in convalescence mechanisms

4. Classification of

etiological disease factors

Definition of notion cause and condition

The role of causes and conditions in beginning of desease

External and internal pathogenetic factors

Physical pathogenic factors

 

5. Influence of decreased atmospheric pressure upon organism

Man activity in conditions of decreased atmospheric pressure

Mechanisms of action of decreased atmospheric pressure

Manifestations of hypobaropathy

 

6. Influence of increased atmospheric pressure upon organism

 

 

Man activity in conditions of raised atmospheric pressure

Mechanism of action of increased atmospheric pressure

Manifestations of saturation and desaturation

Use of oxygenation in medicine

7. Possibilities of prophylaxy of disorders, associated changes of barometric pressure

Organism defense during work in conditions of changed barometric pressure

Preventing of the airembolism

Theme 2 of practical lesson

1. Causes of hereditary diseases

Physical mutagenes

Chemical mutagenes

Biological mutagenes

2. Development mechanisms of hereditary diseases

Genome mutations

Chromosome mutations

Genes mutations

3. Inheritance types

Autosomal-dominant inheritance

Autosomal-recessive inheritance

- linked chromosome inheritance

4. Chromosome illnesses

Downs illness

Klinefelters syndrome

Turners syndrome

-trisomy syndrome

Syndrome of catlike cry

5. Molecular hereditary illnesses

Phenylketonuria

Albinism

Alkaptonuria

Galactosemia

6. Diagnostics methods of hereditary illnesses

Cytogenetic method

Genealogical method

Twins method

Populational-statistic method

Immunological method

Dermatoglyphical method

Experimental method


 

7. General principles of hereditary illnesses prevention

Guard of environment

Forbidding of atomic weapon

Increasing of safety of nuclear technologies

Explanatory work among population

Antenatal disclosure of hereditary anomalies

Medical-genetic consultations

8. Cure principles of hereditary illnesses

Genes engineering

Replacement therapy

Removal of metabolite in front of blocked stage

Compensation of metabolite after blocked stage

Elimination of physical deffects

 

Standards of tests task and real-life situations

Theme 1 of practical lesson

Tests tasks (Choose the correct answer).

1. During action of increased atmospheric pressure supplementary amount of gases dissolves in blood and organism tissues. This phenomenon is called - A. Hyperoxia B. Hypoxia C. Hypercapnia D. Saturation . Desaturation

2. Sudden death during dehermetization of cockpit at height 19000 m is rose owing to

A. Carbonic acid deficit B. Organism desaturation C. Gas embolism D. Oxygen deficit . Height meteorism

Real-life situations. Alpinists slowly limb on south side of Everest. It was sixth hours of ascending. General weakness was present. Breath became more difficult. There were palpitation. Pulse rate achieved to 100 beats for a minute. Dizziness, headache lowering of mood and appetite, meteorism were observed.

1.What was the direct cause of these disorders in the alpinists?

2.How this symptomatic complex is called?

3.What height were alpinists on?

4. What significance in this situation had increased breathing and cardiac rhythm?

 

Theme 2 of practical lesson

Tests tasks (Choose the correct answer).

1. While examening a patient doctor turned mind to her low growth, wide shieldlike, insufficient physical and sexual development. External genitalia formed on feminine type, internal underdeveloped. Barr body in cells of mouth mucous membrane was not determined. For what disease is it typical? A. Klinefelters syndrome B. Turners syndrome C. -trisomy syndrome D. Downs illness . Pathaus syndrome

2. What is the inheritance phenylketonuria?

A. Autosomal-recessive B. Autosomal-dominant C. - linked chromosome D. Y- linked chromosome . Type of incomplete dominanting

Real-life situations. Woman is heterozygous on phenylketonuria gene, and her husband is homozygous on normal alleles of this gene. 1. What is probability in this family of giving birth to a child sick with phenylketonuria? 2. Define probability of a phenylketonuria display, if wife is heterozygous on given gene.

 

Answers to tests and to questions of real-life situations

Theme 1 of practical lesson.

Tests tasks: 1 D, 2 C.


Real-life situations: 1. Lowering of partial oxygen pressure. 2. Hypobaropathy of mountain disease. 3. About 5000-6000 m. 4. Compensation significance.

 

Theme 2 of practical lesson.

Tests tasks: 1 , 3 - .

Real-life situations: 1. All of children will be healthy, but 50 % will be phenylketonuria gene carriers. 2. 25 %.

 

Sources of the information

BASIC:

1.      Pathological physiology / Yu.I. Bondarenko, M.R. Khara, V.V. Faifura, N. Ya. Potikha. Ternopil: Ukrmedkniga, 2006. 312 p.

2.      Methodological instructions

ADDITIONAL:

1. Robbins basic pathology, 7/e / Kumar et al. Indian reprint, 2004. 873 p.

 

Method of implementation of practical work

. Theme 1 of practical lesson

Work 1. Experiment: Action of decreased atmospheric pressure upon organism of a rat

Place animal under glass bell. Acquaint with condition of animal before experiment beginning (behavior, skin colour, breathing rate, reaction on sound irritant). By the medium of pump gradually diminish pressure under bell. Observe change of animal condition. Clock each supervision. After beginning of first cramps in animal gradually let air in and observe reneval of organism functions.

Write down the experiment results in the table and protocol of experiment according to scheme:

 

Experience minute scheme:

1.      Protocols number, date

2.      Theme, (topic) of the lesson

3.      Title of experiment (The name of experiment)

4.      Materials and methods

5.      Experiments results and their discussion

6. Conclusion

 

 

Pressure

 

Height

 

General animal condition

breathing rate

behavior

sound irritant

skin

colour

1 atm

0 m

 

 

 

 

0,69 atm

3000 m

 

 

 

 

0,46 atm

6000 m

 

 

 

 

0,30 atm

9000 m

 

 

 

 

0,18 atm

12000 m

 

 

 

 

 

Durind discussion of results we must answer for questions:

1. What stages can be distinguished in this symptomatic complex?

2. Describe each stage.

3. Explain mechanisms of exposed disorders.

 


. Theme 2 of practical lesson

Work 2. To analyse chromosome sets and to make conclusions, for what diseases they are characterized, ground the thought

 

Work 3. To analyse the genealogical tables of pedigree with hereditary diseases (figures 7-17) and to define type of their inheritance ground the thought

 

Work 4. To make conclusions of correlative role heredity and external environment in development of diseases. ground the thought

 

According to results of practical work 2, 3, 4 make up protocol according to analogical scheme

 

Seminar discussion of theoretical questions

1.      Gist of experimental method

2.     General conceptions of illness

3.      Notion about etiology and pathogenesis

4.     Classification of etiological disease factors

5.      Influence of decreased atmospheric pressure upon organism

6.     Influence of increased atmospheric pressure upon organism

7.      Possibilities of prophylaxy of disorders, associated changes of barometric pressure

1.      Causes of hereditary diseases

2.      Development mechanisms of hereditary diseases

3.      Inheritance types

4.      Chromosome illnesses

5.      Molecular hereditary illnesses

6.      Diagnostics methods of hereditary illnesses

7.      General principles of hereditary illnesses prevention

8.      Cure principles of hereditary illnesses

 

 

Students must know:

1. Definition of notions: illness (desease), pathological process, pathological state, etiology, pathogenesis

2. Illnesses classification

3. Illness periods

4. Illness ends

5. Types of compensate-adaptation reactions

6. Classification of etiological factors of illness

7. Pathogenic influence of atmospheric pressure upon organism

8. Pathogenic influence of increased atmospheric pressure upon organism

9. Prophylaxis of disorders, related to change of atmospheric pressure

10. Causes of hereditary disorders in people

11. Beginning mechanisms of hereditary diseases

12. Study methods and diagnostic of hereditary diseases

13. General preventson principles and cure of hereditary diseases


 

Students should be able to :

1. Explain pathogenic influence decreased and increased atmospheric pressure upon organism

2. Distinguish the stages of experimental mountain illness

3. Evaluate change of the breathing, cardiac activity, reflex reactions and behavior due to climb on height and diving

4. Explain pathogenesis of aeroembolism

5. Define reactions of organism, which have compensatory importance at influence of changed atmospheric pressure upon organism

6. Reproduce influence of decreased atmospheric pressure upon organism of rat in experiment and analyse experimental data

7. Diagnose of the chromosome diseases (Downs illness Klinefelters syndrome Turners syndrome ) by cariograms analysis

8. Analyse the genealogical cards, diagnose hereditary diseases and lawfullness of their transmission

9. Evaluate correlative role of heredity and external environment in arising of illnesses on twins sickness rate (analysis of the concordity index)

10. Ground prophylaxis method and cure of hereditary diseases

 

 

 

Methodological instruction made by prof. Yu.I. Bondarenko, as. prof. N.Ya. Potikha.

 

The methodological instruction was discussed

and confirmed at the Department sitting

29 August 2013. Minute 2.