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BUKOVINA STATE MEDICAL UNIVERSITY (CHERNIVTSY) Department Pathomorphology and Forensic Medicine APPROVED by: Head of the department

I.S. Davydenko, professor (full name, academic status) (signature) Protocol N ____ 200___.

METHODICAL INSTRUCTIONS FOR STUDENTS OF 3RD COURSE (MEDICAL FACULTY) FOR THE INDEPENDENT WORK DURING THE PREPARATION FOR THE PRACTICAL LESSON:

Viral Diseases: AIDS, influenza. Ricketsiosis. Prion Diseases. Discipline: Pathomorphology Subject Module 2 Systemic Pathology Object Module 9 Pathomorphology of Infectious Diseases. Theme N37

Chernivtsy

1. Topicality of the theme. Acute respiratory viral infectious diseases (influenza, parainfluenza) take one of the first places in human morbility. Multiplicity of viral infectious diseases is determined by their ability to affect different cells of organs and tissues specifically as well as ability to vary. New virus influenza strains appear frequently. Respiratory viruses can produce epidemic and pandemic. Some of viruses (measles, chicken-pox) usually strike children. Now AIDS is a very dangerous disease of mankind with high mortality. It spreads by different ways in adults and children including transplacental invasion of fetus. Typhus is an acute infectious disease called by small organism (rickettsia) affected intracellular structural elements of human tissues. Research of the etiology, mechanisms, morphology, complications of these diseases is important task in the practical medicine because it may help to diagnose and treat these diseases. In clinical practice the knowledge of this topic is necessary for the comparison of the clinical dates with the result of the biopsy research and postoperative materials, and also for the clinic-anatomical analysis of the autopsy. 2. Purpose of training. 3. 3.1. Teaching and educational tasks: Explain the role of immune reactions and viruses in appearance of acute viral respiratory infections. Know the present classification of acute viral respiratory infections. Explain the mechanisms of pathogenesis, morphology and functional manifestations of complications of acute viral respiratory infections (influenza, parainfluenza and others). Learn the frequent complications and causes of death in acute viral respiratory infectious diseases at adults and children. Explain etiology, pathogenesis, morphological signs of measles, its complications. Know etiology, pathogenesis, and morphological signs of different stages of AIDS, causes of death. Explain etiology, pathogenesis, and morphological signs of typhus, its complications and causes of death.

4. Revision of the basic knowledge of the earlier studied themes and disciplines. Discipline: Normal anatomy Student should know Commons information about structure of the respiratory, and other systems Functions of respiratory, digestive system, and other systems. Histological structure of these organs and systems. Student should be able To distinguish in macropreparations different types of tissues, parts of the organs, (and respiratory system) To explain the impairment of almost systems functions. To distinguish in microslides histological structure of the small and large intestine, skin, respiratory system

Normal physiology Histology.

5. The program of independent work. Training tasks 1 Study and description of macropreparations (organs of . dead body, operating material) Concrete definition of tasks 1. Bronchopneumonia. Describe the appearance of the lung: localization of the foci of pneumonia, their sizes, and consistence. Name the causative factors and complications. 2. Bronchiectasis and pneumosclerosis. Describe the kind of a bronchiectasis wall, the color, tissue of the lung on incision, consistence. Give the definition of bronchiectasis. List their causes. 3. Fibrinous-hemorrhagic tracheitis in influenza. Pay attention to the state of the tracheal mucosa: its appearance, color, and presence of a film on its surface. Determine, what form of influenza this preparation demonstrates. 4. Hemorrhagic pneumonia in influenza. Pay attention to dimensions of the lung, its appearance on section. Give the name of the preparation, explain the morphological picture of changes in the lung in influenza; indicate the form of influenza in this case.

2 Study, description and drawing of thematic . microslides

5. Abscess of the lung at child. Pay attention to the appearance of the abscess walls and the content of the cavity. Name the causes of the purulent inflammation and its outcome Slide . Encephalitis in influenza (ought to be drawn) The vessels of brain are dilated. Small hemorrhages can be found here and there. Perivascular cellular infiltrates consist of lymphocytes and macrophages. Slide . Giant cells peribronchial pneumonia in measles (ought to be drawn) The initial inflammation of bronchi passes on the alveolar parenchyma. Bronchial epithelium is necrotic and desquamated. The serous exudate fills in alveolar spaces. The peribronchial and perivascular connective tissue as the alveolar septa as well are infiltrated with lymhpocytes. In the alveolar septa and in the alveolar spaces the giant multinuclear cells typical to pneumonia in measles can be found. Slide. Serous-hemorrhagic pneumonia in influenza (ought to be drawn) In small bronchi and alveoli there is serous-hemorrhagic exudate. The alveolar septa are thickened because of their edema. The vessels are dilated. Necrosis of mucosa and desquamation of epithelium are seen in several bronchi. Slide. Catarrhal tracheitis in influenza The mucosa and partially submucosa of trachea are swollen. Little leukocytic infiltration is visible. The dilated vessels and small hemorrhages can be found in submucosa. Slide . Serous-desquamated pneumonia in measles The alveolar spaces are filled with serous exudate. Alveolar epithelium is partially desquamated. The alveolar septa are thicken because of their hyperemia, edema.

6. Algorithm of practical work of students. First stage Second stage Third stage To estimate base knowledge of students, using the tests. To interrogate students according to the key questions. Algorithm of study of macropreparations ( organs of dead body) ) weight, capacity, size, shape, consistence b) appearance of surface (capsule, serous membrane) c) appearance in cut surface (structure of tissue, local changes) d) shape, color, size and borders of pathological foci Fourth stage To study and description of microslides ) Under low magnification of microscope to note the degree of undamaged tissue b) To understand the character and localization of pathological changes c) To find the structural changes for given pathology, using the high magnification. Fifth stage Analysis and generalization of results of study of macropreparations and microslides: to name the pathological process (disease), characteristic clinical-morphological appearance, etiology, pathogenesis, complications Sixth stage To asses of total knowledge of students, taking into account testcontrol, interrogation, description of macropreporation and microslides 6. Tests on the theme for testing knowledge, problem tasks see section 3.5. Tests for the current control of the level of students knowledge of the given discipline. 7. Place of conducting classes. Class-room and / or section hall of the 6-th municipal hospital or Republic Clinical Hospital named after Semashko. 8. Sources of information. 8.1. Basic literature: City, Publish -ing house Year of edition, vol., issue Num -ber of pages 115129. P. 215, 219231. P. 362-

Author(s)

Name of the source (textbook, manual, monograph, etc)

1 A.K.Zagorulko. Short lectures on . (pathological anatomy). 1 2 Ramzi S. . Kotran, Vinay 2 Kumar, Stanley S. Robbins. 3 Edited by Jonh . M. Kissane

pathology Simfero 2002 pol: 2 ed. CSMU Robbins Pathologic Basis of Disease W.B. 1994 Saunde rs Compa ny, USA Andersons Pathology The 1990 C.V.

Mosby Compa ny. Toronto Philade lphia 4 Thomas C. . Macropathology. B.C. 1990. Decker Inc. Toronto Philade lphia, B.C. 1989 Decker Inc. Toronto Philade lphia

390, 1471 1474 , 1500 . 355 p.

5 Thomas C. .

Histopathology

386 p.

8.2.

Secondary literature: Year of Name of the source (textbook, manual, monograph, etc) . . . . City, Publishing house . . Numbe r of pages C. 319327. 329340.

1 . 1 2 .

Author(s) .., .. .., .., ..

edition, vol., issue. 1998 1986