“UKRAINIAN MEDICAL STOMATOLOGICAL ACADEMY” Approve

216 Pages·2017·19.2 MB·English

MINISTRY OF PUBLIC HEALTH OF UKRAINE
HIGHER STATE EDUCATIONAL OF UKRAINE
“UKRAINIAN MEDICAL STOMATOLOGICAL ACADEMY”

Approved
on the Chair of Pathophysiology meeting
“____”_______________2016
transactions № ____
Head of the Department of Pathophysiology
Sc.D., Prof. V.A.Kostenko

METHODICAL INSTRUCTIONS
for academic staff

Learning subject Pathophysiology
Module № 1

Significance of experimental method in pathophysiology. Kinetosis.
Theme General etiology and pathogenesis. The role of causes and conditions in occurrence
of altitude sickness.

Course III
Faculty Medical

Poltava
2016
1. Specific objectives:
To know:
• The object and purpose of pathophysiology;
• Pathophysiology methods and modern methods and techniques of experiments;
• the basic stages and rules of realization of an experiment, to prove the statement that pathophysiology is the
basis of clinical thinking, to apply statistical data methods in processing of experimental material
• basic concepts of general nosology.
• Basic concepts of etiology, pathogenesis, sanogenesis;
• Basic ways and mechanisms of influence on the body of pathogenic factors;
Skills:
• Planning and setting up experiments on laboratory animals, anesthesia, immobilization, of subcutaneous,
intravenous, reproduce to kinetosis model.
• Playback hypoxic hypoxia in the Komovsky’s apparatus;
• Appliances subcutaneous and intradermal injections.
Competence:
• reproduce the experiment kinetosis of white mice;
• Identify the pathological kinetosis manifestations;
• analyze the mechanisms of pathological processes and their manifestations in kinetosis;
• Identify role in terms of acceleration mechanism of pathogenic effect on the body;
• justify prevention and pathogenetic therapy of kinetosis;
• estimate value obtained experimental data for clinic;
• execute protocol experiment (in the form of: section, topic, purpose, course of study (briefly) the results
obtained; discussion of experimental data, conclusions (according to the number of experiments) opinion, the
value for theoretical and practical medicine.
• highlight key of pathogenesis, vicious circle;
• In animal experiments to find out the causes and conditions of pathological processes and mechanisms of
functional impairment that while there;
• reproduce the experiment altitude sickness, to determine its pathological manifestations, interpret
pathophysiological phenomenon in hypoxic hypoxia;
• evaluate the clinical significance of the experiment;
2. Basic knowledge

The names of previous Received skills
subjects received skills

Department of normal To know the basic laws and categories of dialectics
physiology
Department of normal To know the definition of the terms "the norm", "health". To be able to evaluate
physiology the functional state of organs and systems in the norm (respiratory rate, heart
rate, blood pressure)
Department of Biophysics To understand the basic concepts of probability theory
3. The organization of the content of educational material. Structural and logical scheme of themes
(attached).
4. Planning and structure of a class on discipline

№ The main stages of employment, Learnin Control methods and Materials of Distributi
their features and content g training methodical on of
p/p objectiv maintenance time
es in (control, visibility, (Minutes)
the guidance)
levels
assimil
ation
1-3 min..
1. Preparatory stage Express survey using Learning objectives,

interactive relevance of the topic
Arrangements
technologies Complex tests in the
10-25%
individual survey pathophysiology
Setting learning goals and
(tasks for
motivation
Tests II lv.
I independent work).
Control of entry-level training Part 1. General
Objectives II lv.
nosology. Typical
1. Pathophysiology as a science pathological
and academic discipline, its processes "Tables,
component parts. The object and overheads, structural
purpose pathophysiology. logic.
2. Methods of pathophysiology.
Experiment as basic method
pathophysiology, its importance
for solving the fundamental
problems of medicine. The
modeling of pathological
processes in animals:
opportunities and limitations. The
value of comparative evolutionary
methods for the development of
pathophysiology.
3. The moral and ethical issues of
using animals as objects of the
experiment. Bioethics
requirements for working with
laboratory animals. Types
experiment.
4. Modern methods and
techniques of experiments.
General principles of planning
experimental studies, accounting,
statistical processing and analysis
of results. The experimental
therapy.
5. Methods of clinical
pathophysiology. Methods of
physical and mathematical
modeling of pathological
processes.
6. General theory of disease. Basic
concepts of general nosology.
Norm. Health WHO definition.
Disease.
7. The concept of the pathological
process, pathological condition,
pathological reactions. Definition
typical pathological process.
8. illness as a biological, medical
and social problem. Abstract and
concrete in the concept of
"disease". Unity destructive and
protective of the disease.
9. Principles Classification of
Diseases, WHO classification.
Basic laws of disease. Periods of
illness. Remission, relapse,
complications.
2. The main stage The method of Algorithms for the 10-20%
formation of skills: formation of
Master the skills (technique)
practical training professional
planning and setting up
during the pilot abilitiesText atypical

experiments on laboratory
phaseThe method of situational
animals, anesthesia,
II formation of skills: problemInstructions
immobilization, of subcutaneous,
professional training lablaboratory
intravenous, reproduce
in dealing with equipmentlaboratory
experimental models of
unusual clinical animals
exogenous hypoxia.
situationsLaboratory
To research laboratory,
(experimental) study
experimental pathogenic effect on
(work)
the rats rarefied atmosphere
against the backdrop of the
introduction of caffeine.
Play kinetosis experiment white
mice;
To determine the pathological
manifestations kinetosis;
To analyze the mechanisms of
pathological processes and their
manifestations in kinetosis;
To determine the role of
conditions in the mechanism of
acceleration of pathogenic effect
on the body;
Justify prevention and
pathogenetic therapy kinetosis;
assess the value obtained
experimental data for clinic;
draw up a protocol of the
experiment (in the form of:
section, topic, purpose, course of
study (briefly) the results
obtained; discussion of
experimental data, conclusions
(according to the number of
experiments) opinion, the value
for theoretical and practical
medicine.
3. The final stage Methods of control Tasks III lv.
skills: individual
The final level of training Tests III lv.
control skills or their
monitoring.
results skills testing
The results of
methods: analysis and
Overall student learning activities. laboratory research.
evaluation of the
Informing students about the topic III results of laboratory
of the next session. research and
recorded; atypical
solutions of problems;
test control III lv.

5.Methodical guidelines for practical training at a class:
5.1. Preparatory stage. To underline the significance of this topic for further professional training and
professional activity in order to create incentives for targeted learning activities. To acquaint students with
specific goals and plan of classes. To conduct standardized control entry-level training of students.

5.2. The main stage

Task 1. Students will study instructional material. Questions for discussion:
1. Pathophysiology as a science and educational discipline, its structural parts: general pathology, pathophysiology of the
organs and system of the organs. Subject and tasks of pathophysiology.
2. Methods of pathological physiology. An experiment as the main method of pathophysiology, its significance for the decision
of fundamental
problems of medicine. Modelling of pathological processes and diseases at animals: possibilities and limitations. Significance
of comparatively-
evolutional method for development of pathophysiology.
3. The rules of work with laboratorial animals. Kinds of experiment.
4. Moral and ethic problems on using animals as subjects of experiments. Bioethic requirements concerning to manipulations with laboratory
animals. General principles of experimental investigation planning, counting, statistic processing and analysis of results.
Experimental therapy.
5. Methods of clinical pathophysiology. Methods of physical and mathematical modelling of pathological processes.
6. General doctrine about disease. The basic concepts of general nosology. Norm, health, definition of WHO. Disease.
7. Conception of pathological process, pathological condition, pathological reaction. Definition of typical pathological
processes. Disease as biological, medical and social problem. Abstract and concrete in definition "disease". Unity of
destructive and protective at disease.
8. Principles of classification of diseases, classification of WHO. The main regularities of progress of disease.
9. Periods of development of diseases. Remission, relapse, complication. Variants of outcome of disease: absolute and non-
absolute recovery.
10. Kinetoses. Action of space flight on the organism. Speed-up, zero- gravitation.
Task 2. Analyze of the denotative card).

EXPERIMENT 1. Pathogenic effect of rarefied atmosphere on mice under caffeine administration.
10 mice are used for this experiment. 5 of them are injected intraperitoneally with 10% caffeine solution (1 ml/100 g body
wt.), the next 5 mice of control group are administered with 0.9% NaCl (1 ml/100 g body wt.) In 10 min after administering the
animals are placed into the Komovsky apparatus bell-glass. Atmosphere should be rarefied to 0.7 of manometer figure. It is
necessary to register the moment when convulsions begin in the animals.
Statistical processing of experimental results.
1. To construct variational series of indices for control and test groups.
2. To estimate arithmetic mean (М).
3. To calculate root-mean-square deviation (σ) by the following formula:
2
n 1
∑α2 – sum of each variant square deviations from arithmetic mean (M),
n – number of animals in a group.
4. To calculate mean error of arithmetic mean (m) by the formula:
m
n

5. To calculate Student’s confidence coefficient (t) by the formula:
M M
t 1 2
m2 m2
1 2

6. To estimate degree of freedom (n '):
n' n n 2
1 2
7. To calculate error plausibility by the Student’s table.
Р < 0,05 points the differences of results obtained are significant.
RESULTS:
The control The test
n Time of convulsion α α2 n Time of convulsion α α2
development (min) development (min)
1 1
2 2
3 3
4 4
5 5
n =5 ∑α2 = n =5 ∑α2 =
1 2
M = M =
1 2
σ = σ =
1 2
m = m =
1 2
t=
n'=
P>0,05 P<0,05 P<0,02 P<0,01 P<0,001
(to underline the necessary points)
EXPERIMENT 2. Modelling of kinetosis and studying mechanisms of its development.
3 mice of identical weight are used for the experiment. The first mouse is introduced with 0.25 % aminazine solution (1
ml/100g body wt.), the second one is introduced with 10% caffeine solution (1 ml/100g body wt.), the third mouse is the control. In
10-15 min after injection mice are placed into the cabin of the hand centrifuge and subjected to radial acceleration for 40 c. Then
mice are quickly taken away. It is necessary to observe their condition, comparing it with input data (behaviour, respiration, eyeball
condition, motor coordination) and to analyze results of the experiment. Radial acceleration rate is calculated by the formula: а = R
( n)2, where R – rotation radius in metres, = 3,14, n – number of turns.
TESTS:
1. What of the following definitions is the most precise for the concept of pathophysiology as a science?
a) it’s physiology of pathological processes
b) it studies the specific patterns of occurrence, development and outcome of diseases
c) it studies the general patterns of occurrence, development and outcome of diseases *
d) it’s a science about vital activity of an ill organism
2. What is the subject of pathophysiology?
a) the changes of physiological functions
b) body response to environmental factors
c) disease, unhealthy organism*
d) structural, functional, biochemical changes in an organism under different conditions
3. The main objective of pathophysiology is to determine:
a) functional body changes that occur with disease
b) main distinctions of the health as state and a disease
c) the common mechanisms of the underlying diseases, their development and outcome*
d) main distinctions in the disease development in a human and an animal
e) the background for preventive as well as therapeutic health care measures and practices
4. What of the following definitions of “The health” concept were introduced in WHO Charter preamble?
a) the health is normal condition
b) the health is state having no restrictions in performing genetically stipulated self-correcting, self-renewal, and self-reproducing
processes
c) the health is the state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity *
d) the health is harmony
e) the health is an ability to maintain the human body functions without any considerable changes under changeable environmental
conditions
5. Pathological reaction
a) may occur in reply to usual, habitual irritation
b) may occur in reply to extraordinary irritation
c) is biologically inexpedient body response
d) is a peculiar form of body adaptation to the environmental conditions
e) a and c *
f) b and d
6. Choose the most exact definition of pathological process
a) it is a process developing as organism response under the continual pathogenic factor effect
b) it’s a complex of pathological and protective-adaptative reactions as response to pathological factor injury *
c) it is a complex of protective-adaptive reactions which intensity is supernormal
7. Choose the correct term for stable nearly unchangeable disorder of tissular (organ) structure and function
a) pathological reaction
b) pathological condition (status pathological)*
c) chronic process
d) pathologic process
e) disease
f) structural trace
8. Relapse is
a) worsening of patient’s health condition after temporal alleviation *
b) disease complication
c) turning of a disease into a chronic form
d) temporal alleviation of patient’s health condition
e) an obligatory symptom of a disease
9. Disease complication may be defined as
a) worsening of patient’s health condition after temporal alleviation
b) aggravating of disease course *
c) turning of a disease into a chronic form temporal alleviation of patient’s health condition

5.3. Final stage.
To estimate the current activities of each student during the class, to apply standardized control, to analyze students’
achievement, to announce evaluation of each student and put marks into the students’ register. Monitor should copy
the marks into the attandence list and the lecturer certifies it with his / her signature.
The lecturer should inform students about the topic of the next classes and instructional techniques to get prepared.
6. Appendix. Means testing (tests, situational tasks, test questions, practical tasks

References

Basic references
Handbook of General and Clinical Pathophysiology / A.V.Kubyshkin, ed. – Simferopol, 2005.
General and Clinical Pathophysiology. Workbook / A.I.Gozhenko, R.F.Makulkin, I.P.Gurkalova et al. – Odessa, 2001.
Alpern D.E. Pathological Physiology. – M.: Mir Publ., 1967.

Additional references:
Anderson's Pathology / Kisaane J.M., ed. ( 9th ed.). - St. Louis: C.V. Mosby, 1990.
Handbook of Pathophysiology / Gary J.Arnold et al. – Springhouse, 2000.
Pathophysiology: Concepts of Altered Health States (6 edition) / Carol Mattson Porth et al. – Lippincott, 2002.
Pathophysiology: the biologic basis for desease in adults and childrens / Kathryn L. McCance, Sue E. Huether.- The C.V.Mosby
Company, 1990.
Rоbbins Pathologic Basis of Disease / Cotran R.S, Kumar V., Robbins S.L. (6th ed.). – Philadelphia etc.: WB Saunders Cо, 1999
Textbook of Medical Physiology / Artur C. Guyton, John E.Hall.-W.B.Saunders, 1996.
Walter J.B., Israel M.S. General Pathology. – Churchill: Living-stone.
MINISTRY OF PUBLIC HEALTH OF UKRAINE
HIGHER STATE EDUCATIONAL OF UKRAINE
“UKRAINIAN MEDICAL STOMATOLOGICAL ACADEMY”

Approved
on the chair of Pathophysiology meeting
“____”_______________2016
transactions № ____
Head of the Department of Pathophysiology
Sc.D., Prof. V.A.Kostenko

METHODICAL INSTRUCTIONS
for academic staff

Learning subject Pathophysiology
Module № 1

Theme Pathophysiology of extremal and terminal states. Hereditary and congenital diseases. Injuries of cell
membranes. Pathogenic effect of ionizing radiation.
Course III
Faculty Medical

Poltava
2016
1. Specific objectives:
To know:
• the concept of extreme environmental factors and extreme conditions organism;
• concept of terminal conditions;
• classification of extreme factors of environment;
• etiology, pathogenesis, manifestations of extremal and terminal conditions and general arrangements
for submitting emergency care for them;
• pathogenesis of electric current therapy
• mechanisms of membrane damage;
• pathogenesis of radiation sickness

Skills:

• electrical simulations in laboratory animals
• Playback experimental models of acute radiation sickness, blood sampling, determine the number of
leukocytes in the blood of white rats.

Competences:
• Identify key physiological indicators of the body (heart rate, respiratory rate, nature, characteristics);
• differentiate different extreme and terminal conditions;
• evaluate the role of each of the main parameters of electric current, which determine the extent of its
pathogenic effect;
• explain the disruption of the heart and nervous system Peel the passage of electric current through
them;
• analyze the development of various pathological processes influenced by electrocution;
• analyze the basic mechanisms of electric current;
• justify the application of electric current in medicine;
• assess safety at work with electric shock.
• apply knowledge about the mechanisms of free radical damage in the membrane pathology;
• analyze the etiology and mechanisms of pathological mechanisms leading radiation damage.
• explain the features of the pathogenesis of various forms of radiation damage, bone marrow, intestinal,
cerebral.
• justify the prevention and treatment of radiation injury.

2. Basic knowledge

The names of previous Received skills
subjects

Department of Normal Be able to determine the normal state of the cardiovascular and respiratory
Physiology systems
Department of Propedeutics Be able to determine the pulse of the main and peripheral vessels, to
of internal diseases and measure blood pressure, listen to heart sounds and breathing in adults and
children children

Biophysics course To know the physical characteristics of the electric current course

Department of Biophysics; No know the safety rules while working with electrical current
Normal physiology

3. The organization of the content of educational material. Structural and logical scheme of themes
(attached).