- •Pathophysiology tasks:
- •General doctrine of disease. Basic concepts of general pathology: norm, health. Definition by who. Disease.
- •Disease.
- •Conception of pathological process, pathological state, pathological reaction. Definition of typical pathological processes.
- •Typical pathological processes are the processes which are developed by similar laws, independently on reasons, localization, animals type and organism individual peculiarities.
- •Disease difference from health
- •3 Points of view:
- •Disease, biological and social factors are actual because human being is first of all social creature
- •4 Levels of diseases prescription:
- •5. Diseases classification principles:
- •8. Collapse. Comparative characteristics with shock. Aethiology and pathogenesis. Role of nervous and humoral mechanisms
- •9. Crash-syndrome -
- •10. Coma -
- •11. Informational aspects of cell injury. Pathology of signalization.
- •13. Programmed cell death (pcd)
- •3 Apoptosis phases:
- •14. Outcomes of apoptosis inhibiting and activation.
- •Classification.
- •4 Main types.
- •Classification.
- •16. The concept of primary and secondary alteration. Molecular mechanisms of cell injury. Lipid mechanisms role in alteration pathogenesis.
- •17. Free radicals and their role in pathological processes development.
- •19. Antioxidant mechanisms of cells. Antioxidant insufficiency.
- •19. Apoptosis and necrosis comparative characteristics.
- •20. Reactivity. Types. Dependence on sex.
- •23. Resistance. Passive and active resistance. Resistance and reactivity relationship.
- •25. Constitution, role in pathology, types classification.
- •26. Diatheses.
- •27. Stress, general adaptation syndrome.
- •28. Stress-inducing and stress-limiting systems. Diseases of adaptation.
- •29. Concept of “local microcirculatory disorders”. Some mechanisms.
- •30. Arterial hyperemia
- •2 Subtypes:
- •31. Venous hyperemia
- •32. Ishemia
- •33. Reperfusion syndrome
- •34. Stasis.
- •Variants:
- •35. Thrombosis and embolism. Thrombosis characteristics.
- •3 Main factors encouraging thrombi formation (Wirhow’s triad):
- •36. Embolism.
- •37. Embolism of pulmonary, systemic and portal circulation.
- •38. Microcirculation disorders typical forms:
- •39. Intravascular circulation disorders: rheological changings and changings of blood flow.
- •41. Microvascular tone disorders.
- •42. Extravascular disorders.
- •43. Concept of inflammation. Aethiology.
- •44. Inflammation stages, main signs and types.
- •Inflammation types (continuation).
- •45. Primary and secondary alteration.
- •46. Mediators and antimediators.
- •47. Circulatory changings during inflammation.
- •48. Fever aethiology. Pyrogens classification.
- •49. Fever stages. Fever reactions types.
- •50. Fever comparative characteristics with exogenous overheating and hyperthermia other forms.
- •50. Edemas. Classification. Oncotic and hydrostatic mechanism.
- •58. Anaemias. Erythrocytes regenerative and degenerative forms. Cells of pathological regeneration.
- •54. Anisocytosis, poikylocytosis, price-jonce’ curve movements on the right and on the left.
- •55. Blood loss.
- •56. Acute and chronic posthaemorrhagic anaemias.
- •57. Hereditary hemolytic anaemias.
- •3 Groups:
- •58. Acquired haemolytic anaemias.
- •59. Dyserythropoietic anaemias.
- •60. Aplastic and hypoplastic anaemias. Metaplastic anaemia. Myelophthysis.
- •2 Groups of factors:
- •2 Main pathogenetic mechanisms:
- •61. Cardiac arrhythmias.
- •62. Concept of arterial hypo- and hypertension.
- •63. Primary arterial hypertension.
- •2 Pathogenetical conceptions:
- •64. Secondary arterial hypertension.
- •65. Cardiac insufficiency.
- •2 Overloads types:
- •66.Heart failure myocardial form.
- •67. Coronary cirulation disorders. Reperfusion syndrome. Calcium paradox. Oxygen paradox.
- •68. Respiratory failure.
- •Probes which allow to determine one or another disorders type:
- •69. External respiratory failure. Dyspnea.
- •70. Hypoxies.
- •71. Appetite disturbance.
- •2 Main mechanisms:
- •72. Caries.
- •73. Periodontitis and parodontosis.
- •74. Hypo- and hypertonic gastric dyskinesias.
- •75. Heartburn, eructation, nausea, vomiting.
- •76. Hepatic failure. Classification. Functional hepatic tests.
- •77. Hepatic failure hepatic-vascular form.
- •78. Liver excretory function disorders. Jaundices. Liver functions
- •Proteinic exchange
- •Carbohydrates metabolism
- •Lipid metabolism
- •Pigment metabolism
- •Jaundices differentiated diagnosis
- •79. Haemolytic jaundice.
- •80. Hepato-cellular or parenchymatous jaundice.
- •81. Hepato-portal hypertension. Ascitis.
- •82. Urine amount qualitative and quantitative changings.
- •Urine relative density (weight) (in morning portion)
- •83. Urine pathological components. Protein
- •Leucocytes:
- •Cylinders
- •84. Proteinuria.
- •85. Renal acid-alkaline balance disorders
- •86. Adrenal glands pathology. Cortex acute and chronic insuffieiency.
- •87. Thyroid hypofunction.
- •88. Hypothyroidism.
- •89. General regularities in occurrence and development cns disorders. Pathological processes classification.
- •90. Pathological excitement and inhibiting in nervous centers.
- •I. Of pathological excitement:
- •II. Of pathological inhibiting:
- •91. Ephaptic effects.
- •92. Pain.
66.Heart failure myocardial form.
It is developed as a result of myocardium primary injury.
Reasons:
arhythmic form– heart conductance system injury;
myocardiopathic form– working myocardium fibers injury;
infections;
intoxications;
hypoxy;
avitaminoses;
coronary circulation disorders;
metabolism some hereditary defects;
Failure can be developed even at normal or decreased load to heart. Ca-independent forms of contractility disorders are delt with K-ions, ATP, regulatory proteins, CNS problems.
Cardioplegy – heart artificial stoppage applied during operations on “dry” heart. Approaches for realizing:
ishemic – aorta is pressed before coronary arteries coming; as after 30 min irreversible changings in cardiomyocytes can appear, this approach is benefit only at short-termed operation;
chemical – high levels of K-ions, acetylcholine and some other substances are introduced in coronary arteries – time for operation lasts 40-60 min;
cool cardioplegy –heart is processed with cool (t=+4°--5°C) physiological solution; time for operation is 60 min.
67. Coronary cirulation disorders. Reperfusion syndrome. Calcium paradox. Oxygen paradox.
Calcium paradox – experimental phenomenon which is developed after Ca-ions putting in Ca-free solution with which heart was perfused before this. Myocardium irreversible injury takes place, ATP and creatinephosphate level is decreased, proteins are released from myocardium (particularly enzymes like myoglobine, cratinekinase), sarcoplasmic reticulum is destroyed. Explaining: glycokalyx external layer of cardiomyocytes is coming away from internal one in Ca-free solution as the result of which sarcolemma permeability to Ca-ions is significantly increased. At following Ca putting in heart its level is increased and Ca-dependent injury is triggered.
Reperfusional syndrome – syndrome occurring as a result of blood circulation restoration in myocardium ishemized locus id est as reperfusion result.
Reasons:
coronary angiospasm stoppage;
thrombus lysis;
blood cells aggregates decomposition;
thromb surgical removal;
ligature putting out.
Clinically the syndrome is characterized by significant intensification of myocardial injury right after coronary circulation restoration, patient’s state is getting worse. Minimal ishemia duration after which reperfusion is possible is 40 min. If 20 min – reperfusion syndrome is not developed – such duration is at stenocardia. Essence of reperfusional syndrome is “oxygen paradox” – if heart is perfused with oxygen-free solution (or O2 amount is low in it) and then after 40 min to change this solution to the one with normal oxygen level than heart disorders caused by hypoxy will not be decreased (on the contrary, they will be strongly increased!!!! – paradox). Reason: peroxidative lipid oxidation activation in myocardium.
Heart ishemic disease – is a disease developed as a result of absolute insufficiency of coronary circulation which is expressed in myocardium injury of different degree.
Clinical forms:
stenocardy – ishemy fit is up to 20 min;
pre-infarction state (intermediate coronary syndrome or myocardium acute focal dystrophy) – ishemy lasts 20-40 min;
myocardial infarction – ishemy fit is 40-60 min; coronary circulation irreversible changings;
cardiosclerosis: diffuse (atherosclerotic) and focal (after-infarction).