32. Violation of the metabolism of nucleoproteins - gout: definition of the concept, types. Macro- and microscopic changes in organs, clinical significance, complications, outcomes.

Nucleoproteins are a complex of proteins and nucleic acids.

Types of nucleoproteins:

1. DNA-containing

2. RNA-containing.

Methods for detecting DNA-containing nucleoproteins are the Felgen method, and RNA-containing nucleoproteins are the Brachet method.

Gout (podos leg, agra trap) is a disease in which sodium uric acid salts periodically fall out in the joints, which is accompanied by a painful attack.

Causes of gout:

1. congenital disorders of purine metabolism (primary gout)

2. nutrition features (consumption of a large amount of dry wines, champagne, beer), a stationary lifestyle

3. complication of tumors of hematopoietic cells (with their increased decay), endocrine diseases, kidney diseases with the outcome of nephrocyrrosis (secondary gout)

Morphology of gout: sodium uric acid salts in the synovium and cartilage of small joints, in tendons and joint bags, in the cartilage of the auricles; necrosis of tissues around salt deposits, perifocal inflammatory granulomatous reaction with accumulation of giant cells; gouty cones - an increase in salt deposits and the proliferation of connective tissue around them; joint deformation.

Complications and possible causes of death in various types of nucleoprotein metabolism disorders:

1. joint deformity

2. CRF, secondary shrunken kidney, death from uremia.

33. Necrosis : definition of the concept, etiology and pathogenesis, classification by etiology and pathogenesis.

Necrosis is necrosis, death of cells and tissues in a living organism, complete cessation of their vital activity.

Necrotic processes occur constantly both in pathology and in normal conditions. In conditions of pathology, necrosis can have an independent significance or enter as one of the most important elements in almost all known pathological processes or complete these processes (dystrophy, inflammation, circulatory disorders, tumor growth, etc.). Necrotic processes are natural manifestations of the normal vital activity of the body, since the administration of any physiological function requires the expenditure of a material substrate (cell death), which are constantly replenished by physiological regeneration.

Stages of necrosis development:

1. Paranecrosis - necrotic-like, but reversible changes.

2. necrobiosis - irreversible dystrophic changes with the predominance of catabolism over anabolism.

3. Cell death.

4. Autolysis is the decomposition of a dead substrate under the action of enzymes of dead cells and macrophages.

Classification of necrosis:

1. depending on the cause:

1. traumatic (burn, frostbite, electrical injury)

2. toxic (poisoning, infection)

3. trophoneurotic (bedsores in patients with central nervous system damage)

4. allergic - usually fibrinoid (Arthus phenomenon)

5. vascular (heart attack)

2. according to the mechanism of development:

direct - direct effect of the damaging factor (1+2)

indirect - indirect effect of the damaging factor through the vascular and neuro-endocrine system (3+4+5 )

c) clinical and morphological:

1. coagulation (dry) necrosis - dehydration of tissues and coagulation of protein in tissues with a small amount of fluids and large amounts of protein (waxy necrosis of abdominal muscles in typhoid fever)

2. colliquation (wet) necrosis - melting of soft tissue, formation of cysts in tissues with a large amount of fluids and a small amount of protein (brain)

3. gangrene - necrosis of tissues in contact with the external environment (limbs, lungs)

4. Sequestration is a section of dead tissue that does not dissolve and is freely located among living tissues.

5. infarction - necrosis of tissue with impaired blood supply to the organ.