Situational task No. 2 (Hemorrhagic stroke).

A 78-year-old man was taken to the clinic of nervous diseases from home. According to the
accompanying relatives, it is known that this afternoon the right limbs suddenly weakened,
stopped talking and understanding the speech addressed to him, there was a single vomiting, did
not lose consciousness. In the anamnesis - arterial hypertension for a long time. The blood
pressure measured by the emergency medical service was 200/110 mmHg. On examination: the
condition is severe, blood pressure is 190/100 mm Hg, pulse is 84 per minute, rhythmic. The
level of consciousness is stunning - a shallow sopor. Neck muscle rigidity, Bekhterev's
zygomatic symptom on the left, Kernig's symptom on both sides. Deep right-sided hemiparesis
with plegia in the arm, muscle tone in the right extremities increased by spastic type, Babinsky's
symptom on the right. It is not possible to identify coordination and sensitive disorders due to the
lack of proper contact with the patient. With lumbar puncture, a red turbid liquor was obtained,
uniformly stained with blood in 3 test tubes (color - red, transparency - cloudy, after
centrifugation - color - xanthochromic, transparency - opalescent, cytosis - erythrocytes cover
the entire field of vision, protein - 0.66 mg %.). Neutrophilic leukocytosis in the blood test. CT
scans reveal a high-density area in the frontal region of the left hemisphere.
Questions on pathological anatomy.
1. 1) Describe the macropreparation

2) Describe the micropreparation. Indicate the pathomorphological changes indicated in

the designations.

2. Definition of stroke.
3. Classification of strokes.
4. Morphology of brain hematoma.
5. Complications of hemorrhagic stroke.
6. The outcome of hemorrhagic stroke.
Check-list
criteria for evaluating responses to the description of macropreparations at the midterm
control
№ Evaluation Excellent Good Satisfactory Unsatisfactory
criterion/evaluation
1. Name of the organ 4 3 2 0
2. Organ sizes 2 2 1 0
3. Surface: 1 1 1 0
condition of capsule or
serous membrane,
dullness, gloss, overlay
4. Characteristics of the 8 5 2 0
pathological focus:
Localization, size, shape
(if the ulcer is the
condition of the bottom),
color, consistency
5. Pathoanatomic 5 4 3
diagnosis/conclusion
6. Total 20 15 10 0
The maximum number of points is 20
Check-list
criteria for evaluating responses to the description of micropreparations at the midterm
control
№ Evaluation Excelle Good Satisfactor Unsatisfactor
criterion/evaluation nt y y
1. Name of the organ or 4 3 2 0
tissue
2. Characteristics of 10 7 5 0
pathological changes:
localization, description
3. Coloring (staining) 1 1 1 0
4. Pathoanatomic 5 4 2 0
diagnosis/conclusion
5. Total 20 15 10 0
The maximum number of points is 20
Check-list for evaluating the oral response at the midterm control
№ Evaluation criteria Grades in points

Excellent Good Satisfactor Unsatisfa

y ctory
1. The student answered the 30-27 26,7-21 20,7-15 15 ниже
question: characterized the
pathological process
1. Gave a definition
2. Named the classification
3. Explained morphogenesis
2. The student answered the 30-27 26,7-21 20,7-15 15 ниже
question: characterized the
pathological process
1. Pathoanatomic changes
1) Macroscopic signs
2) Microscopic signs
2. Complications
3. Explained the outcome and/or
causes of death
3. Total 60-54 53,4-42 41,4-30 30<
The maximum number of points is 60 (30 points for each question)