These symptoms developed shortly after nd always sharply intensified after a sligh e. At inspection: there are tachycardia, y mucous membranes. ily diuresis - 11 000 ml, specific gravity sis are absent.
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- TASK No 2 A patient of 37 years old suffers from polyuria, polydipsia, fast fatigability, headache. These symptoms developed shortly after traumatic brain injury and always sharply intensified after a slight restriction of fluid intake. At inspection: there are tachycardia, arterial hypotension, dry mucous membranes. Analysis of urine: daily diuresis - 11 000 ml, specific gravity - 1.001, protein and glcosis are absent. Blood test: glucose - 4.8 mmol, residual nitrogen - 16 mmol/ 1 (norm 14-28 mmol/l) Questions: 4. What is the cause of this disease? 5. What kind of disturbance of water metabolism does the patient have? 6. Name the characteristic clinical manifestations of this disturbance of water metabolism. 7. What type of typical pathological processes should be developed in the patient?TASK No 2 A patient of 37 years old suffers from polyuria, polydipsia, fast fatigability, headache. These symptoms developed shortly after traumatic brain injury and always sharply intensified after a slight restriction of fluid intake. At inspection: there are tachycardia, arterial hypotension, dry mucous membranes. Analysis of urine: daily diuresis - 11 000 ml, specific gravity - 1.001, protein and glcosis are absent. Blood test: glucose - 4.8 mmol, residual nitrogen - 16 mmol/ 1 (norm 14-28 mmol / 1) Questions: 1. Lack of which hormone led to the development of this clinical picture in the patient? 2. Name the main biological effects of this hormone. 3. What endocrine disease is arosed in the patient? 4. What is the cause of this disease? 5. What kind of disturbance of water metabolism does the patient have? 6. Name the characteristic clinical manifestations of this disturbance of water metabolism. 7. What type of typical pathological processes should be developed in the patient?TASK No 2 A 44-year-old patient, suffering from varicose veins for a long time, complains of calf muscle cramps and leg swelling, which increase with physical activity. On examination: skin is thin, cyanotic, edematous, cold to the touch. In the area of the inner ankle of the right leg, a painless ulcer is found. Questions 5. Describe the osmotic factor of edema development. 6. Is it possible to its inclusion in this case? Justify your answer. 7. Describe the mechanism of cyanosis development in the patient?
- TASK No 2 A 44-year-old patient, suffering from varicose veins for a long time, complains of calf muscle cramps and leg swelling, which increase with physical activity. On examination: skin is thin, cyanotic, edematous, cold to the touch. In the area of the inner ankle of the right leg, a painless ulcer is found. Questions: 1. Name the disorder of regional circulation that has led to the development of edema on the legs. 2. Give the definition of edema. 3. Name the initial pathogenetic factor of edema development in this case. 4. What other reasons can lead to the inclusion of this factor of edema development?TASK N 2 A 45-year-old patient suffers from arterial hypertension. There are complaints about progressive obesity, weakness, fatigue, headaches. On examination: height - 170 cm, body weight - 96 kg. There are dyspnea at rest, edema of feet and calves. Arterial blood pressure is 190/95 mm Hg. A blood test for iodine-containing thyroid hormones and glucocorticoids is normal. General blood and urine tests are normal. Questions: 1. What types of typical pathological processes should the patient have? 2. List the patient's heart failure symptoms. 3. Describe heart failure by its origin, the mechanism of development, mainly affected part of the heart, the severity of the clinical course. 4. Explain the pathogenesis of edema in this patient. 5. Indicate the most likely morphological changes in the myocardium and coronary vessels of the patient. 6. Why hypertension is a risk factor for heart failure? 7. Why is obesity a risk factor for heart failure?TASK №o 1 A patient of 19 years old felt weak, dizzy, pain in the neck, nausea after four hours spending in a hot bath. On examination: the skin is moist, strongly hyperemic. Body temperature is 39° C. Questions: 1. What pathological process has been developing in the patient? Give its definition. 2. Indicate the cause of this pathological process. 3. List the stages of development of this pathological condition. 4. Indicate its possible complications 5. Indicate changes in metabolism, typical for the pathological condition that has developed in the patient. 6. What type of typical pathological process (TPP) is needed to be differentiated in the patient? Give its definition. 7. Conduct a comparative analysis of this TPP and pathological process in the patient.
- TASK No 4 A 43-year-old patient complains of pain in the right hypochondrium, periodic body temperature rises of up to 38°C, periodic icteric skin color changes, heartburn, nausea. Ultrasound examination revealed an increase in the size of the liver and gall bladder. Multiple small stones were found in the lumen of the gall bladder and bile ducts, Questions: 1. What disease has the patient? 2. List risk factors for this disease. 3. Specify a type of jaundice that periodically arises in the patient due to this disease. 4. Describe the disorders of pigment exchane. 5. Can skin itching be typical for this kind of jaundice? 6. Explain the most likely mechanism of possible dyspeptic disorders in the patient. 7. What changes in the cardiovascular system are typical for this type of jaundice.TASK N 4 A 39-year-old man, who previously considered himself to be practically healthy, felt severe pain in the epigastric region and strong weakness while performing heavy physical work. After 20 minutes the pains weakened but there were complaints of nausea and vomiting. On examination: the state of moderate severity, arterial pressure is 70/45 mm Hg, sinus bradycardia. Careful palpation revealed no signs of a gastrointestinal pathology. After ECG registration, the patient was hospitalized with the diagnosis "Acute left ventricular infarction". Questions: 1. Indicate the form of infarction with such unusual localization of the pain syndrome and the presence of dyspeptic disorders. 2. Describe the most typical localization of pain during myocardial infarction. 3. What changes on the ECG are typical for myocardial infarction? 4. Which plasma enzymes can be measured in order to confirm the diagnosis? 5. List possible causes of heart attack in the absence of pre-infarct symptomatology…TASK No 4 At a patient of 40 years old after a trauma of the right arm there was a pain, delicacy and difficulties of any movements. On examination: the skin is dry and thinned; there is atrophy and a decrease in the tone of skeletal muscles, weakening of tendon reflexes. Questions: 1. Indicate the cause of hypokinesia in the patient. 2. Describe the level of damage that initiates the patient's hypokinesia. Justify the answer. 3. Describe the patient's hypokinesia by severity of lesions. Give the definition of this type of hypokinesia.
- TASK N 1 A patient, 15 years old, after the epidemic parotitis transferred to the doctor with complaints of weakness, fatigue, constant thirst, an increase in appetite. On examination: the skin is dry, height - 165 cm, body weight - 48 kg. The arterial pressure is 110/70 mm Hg, the heart rate is 80 beats / min. The level of glucose in the blood is 9 mmol /1, ketone bodies are found in urine. Questions: 1. What disease does the patient suffer? 2. What was the immediate cause of this disease? 3. What other reasons can lead to the development of this disease? 4. Describe the mechanism of development of this disease. 5. What does the occurrence in the urine of ketone bodies evoke? 6. What changes in the water balance are characteristic for this disease? 7. List the late complications of this disease.TASK No 4 A patient 65 years old after a subtotal resection of the thyroid gland complained of weight gain, muscle weakness, fatigue, memory impairment, swelling of the face and extremities. At inspection: the face is pale and edematic, the skin is dry. Patient's speech is indistinct. Body temperature - 35.4° C, the pulse is very slow, arterial pressure is 95/60 mm Hg. Questions: 1. List the hormones that are synthesized in the thyroid gland. 2. What endocrine pathology does the patient have? 3. What is the cause of this endocrine pathology? 4. What are the other possible causes that lead to this form of pathology? 5. How must be changed the level of thyroid-stimulating hormone (TSH) in the patient's blood? 6. Descrive typical changes of lipid, protein and carbohydrates metabolism with this endocrine pathology? 7. Explain the mechanism of the onset of edema in the patient.TASK No 4 A patient, 50 years old, suffering from chronic glomerulonephritis, developed massive proteinuria (excretion of protein in the urine). On examination: swelling on the legs and lower back was found. Questions: 1. What does the term edema mean? Give its definition. 2. Indicate the cause of the development of edema in this patient. 3. Indicate the initial pathogenetic factor of edema in this case. Justify the answer. 4. Name other reasons that can initiate this pathogenetic factor. 5. Make a scheme for the pathogenesis of this edema. 6. Which group of microcirculation disorders include edema? 7. Describe the lymphogenous factor of edema development.
