Methodological instruction
to practical lesson of nurse-bachelour students
Lesson № 1 (practical – 6 hours)
Theme 1. General illness development conformities to natural laws. Etiology and pathogenesis. Action of changed atmospheric pressure upon organism
Theme 2. Role of heredity in human pathology
Aim: To be able to analyze lawfulness 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 motivation
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, and selection of drugs. In illness is distinguished two processes: а) 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, and 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 during rapid changing of atmospheric pressure complicated symptoms 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 prophylaxisіs and cure principles. Heredity pathology plays an important role in development mechanisms of such hereditary conditioned diseases, as atherosclerosis, essential hypertension, rheumatism, diabetes mellitus, and gout.
1. Program of independent students prepare to lesson
Theme 1 practical lesson
1. Gist of experimental method, definition a notion “experiment”, peculiarities, significance and lacks of acute experiment, peculiarities of chronic experiment
2. General conceptions of illness, definition of illness notion, illness development, signs, classification, periods, illness ends
3. Pathological process, pathological state
4. Notion about etiology and pathogenesis, definition of notion “etiology”, “pathogenesis”, main links of pathogenesis
5. Notion “compensatory-adaptative reactions”, types of compensatory-adaptative reactions, role of compensatory-adaptative reactions in convalescence mechanisms
6. Classification of etiological disease factors, definition of notion ” “cause” and “condition”, role of causes and conditions in beginning of disease
7. External and internal pathological factors
8. Influence of low atmosphere pressure upon organism, man activity in condition of low atmosphere pressure, mechanisms of low atmosphere pressure action, manifestations
9. Influence of high atmosphere pressure upon organism, man activity in condition of high atmosphere pressure, mechanism of high atmosphere pressure action , manifestations of saturation and desaturation, hyperbaric oxygenation use in medicine
Theme 2 practical lesson
1. Causes of hereditary diseases. physical mutagenes, chemical mutagenes, biological mutagenes
2. Mechanisms of hereditary diseases development, genome mutations, chromosome mutations, genes mutations
3. Inheritance types: autosomal-dominant, autosomal–recessive, Х– linked
4. Chromosome illnesses: Down’s syndrome, Klinefelter’s syndrome, Turner’s syndrome, Х–trisomy syndrome, Catlike cry syndrome
5. Molecular hereditary illnesses (phenylketonuria, albinism, alkaptonuria, galactosemia)
6. Diagnostics methods of hereditary illnesses (cytogenetic, genealogical, twins, population-statistic, immunological, dermatoglyphical, experimental)
7. General principles of hereditary illnesses prevention (guard of environment, forbidding of atomic weapon, increase of safety of nuclear technologies, explanatory work among population, antenatal disclosure of hereditary anomalies, genetically 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 defects)
2. Examples of the tests and real-life tasks
Choose the correct answer
Test 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
Е. Desaturation
Test 2. Sudden death during dehermetizing of cockpit at height
A. Carbonic acid deficit
B. Organism desaturation
C. Gas embolism
D. Oxygen deficit
Е. Height meteorism
Test 3. At examining of a patient doctor stressed attention to her low growth, wide shieldlike, insufficient physical and sexual development. External genitalia formed on feminine type, internal was underdeveloped. Barr body in cells of mouth mucous membrane was not determined. For what disease is it typical?
A. Klinefelter’s syndrome
B. Turner’s syndrome
C. Х–trisomy syndrome
D. Down’s illness
Е. Pathau’s syndrome
Test 4. What is the type of phenylketonuria inheritance?
A. Autosomal–recessive
B. Autosomal-dominant
C. Х– linked chromosome
D. Y– linked chromosome
Е. Type of incomplete dominant
Real-life tasks.
Task 1. Alpinists slowly climb on south side of Everest. It was sixth hours of ascending. General weakness was present. Breath became more difficult. There was palpitation. Pulse rate achieved to 100 beats for a minute. Dizziness, headache lowering of mood and appetite, and 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?
Task 2. Woman is heterozygous on phenylketonuria gene, and her husband is homozygous oormal alleles of this gene.
1. What is probability in this family of giving birth to a child sick with phenylketonuria?
2. Define probability of phenylketonuria display, if wife is heterozygous on given gene.
3. Answers to the assessments and questions of the real-life tasks
Tests: 1 – D, 2 – C, 3 – В, 4 – А.
Task 1
1. Lowering of partial oxygen pressure.
2. Hypobaropathy of mountain disease.
3. About 5000-
4. Compensation significance.
Task 2
1. All children will be healthy, but 50 % will be phenylketonuria gene carriers.
2. 25 %.
4. References
Basic
1. Bondarenko Yu.I., Khara M.R., Fayfura V.V., Poticha N.Ya. Pathological physiology. – Ternopil TSMU: Ukrmedkniha, 2006.
2. http://intranet.tdmu.edu.ua/data/kafedra/internal/patolog_phis/classes_stud/
Additional:
1. Robbins basic pathology, 7/e / Kumar et al. – Indian reprint, 2004. – 873 p.
5. Students’ practical activities
Theme № 1 practical lesson
Work 1. Action of decreased atmospheric pressure upon organism of a rat (experiment)
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 the first cramp 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
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Pressure |
Height
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General animal condition |
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breathing rate |
behavior |
Reaction of sound irritant |
skin colour |
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1 atm |
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0,69 atm |
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0,46 atm |
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0,30 atm |
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0,18 atm |
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For discussion of results it is necessary to answer the questions:
1. What stages can be distinguished in this symptomatic complex?
2. Describe each stage.
3. Explain mechanisms of exposed disorders.
Theme № 2 practical lesson
Work 2. To analyze chromosome sets and to make conclusions, for what diseases they are characterized, ground the thought
Work 3. To analyze 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
7. Final level of knowledges and abilities (control tasks)
8. Student should 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 prevention principles and cure of hereditary diseases
9. Student should be able to
1. Explain the pathogenic influence of the 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 та analyze experimental data
7. Diagnose of the chromosome diseases (Down’s illness Klinefelter’s syndrome Turner’s syndrome) by cariograms analysis
8. Analyze the genealogical tables; diagnose hereditary diseases and lawfulness of their transmission
9. Evaluate correlative role of heredity and external environmental factors in arising of illnesses on twin’s sickness rate (analysis of the concordant index)
10. Ground prophylaxis method and cure of hereditary diseases
Methodological instruction made by prof. Yu.I. Bondarenko, as. prof. N.Ya. Potikha, as. prof. H.S. Saturska
The methodological instruction was discussed and confirmed at the Department sitting 29.08.2013. Minute № 2.
