What are the possible mechanisms of the injurious action of the drug on the epithelium?

4. Taking into account the results of the in vitro experiments, which of these mechanisms are the most likely?

5. What processes or cell functions should be studied in the further in vivo experiments to confirm your presumptions about the mechanisms of the pathogenic effect of the tested drug?

Case 2

A technician of the chemical laboratory was not careful working with a toxic volatile chemical. He dropped a flask containing the toxic substance, and smashed it. Before he left the room he had inhaled the noxious vapors of the chemical. Two days later he was admitted to hospital with the following complaints: malaise, somnolence, headache, nausea, back pains, blood in the urine. Blood analysis: erythrocytes 2.7*10¹²/L, Hb 100 g/L, platelets 120*10⁹/L, leucocytes 3.1*10⁹/L; compensated acidosis (metabolic and renal).

The results of the special blood biochemistry analysis: increased concentration of free fatty acid, lipid hydroperoxides, and adenosinephosphate; elevated total creatine phosphate kinase (CPK) activity and potassium content.

Questions:

One of the consequences of the patient's poisoning is a significant decrease of the various blood cell counts. What are the possible mechanisms of this effect?

With regard to the results of the special blood tests what mechanisms of the cell damage can you propose? Which of them caused damage to the membrane of the formal particles? Substantiate your position?

What are the origin and consequences of acidosis in this case?

Why did the signs of intoxication develop in the patient not immediately but 2 days later after the incident?

Case 3

For experimental modeling of hemolytic anemia mice were treated by phenylhydrazine, which stimulated free-radical reactions. After Half an hour decrease in red blood cells count, the presence of free Hb and methemoglobin in blood were revealed

Questions
1.Specify the stage of acute cell damage
2.Specify the sequence of pathological changes during the cell damage
3.Explain the appearance of free hemoglobin in the blood
4. Explain the appearance of methemoglobin in the blood

 

Case 4

Is it possible to set the type of damaged cells on the basis of the following indicators?

Plasma Potassium concentration is - 5.5 mmol / l (normal 3.5-5.0 mmol / l), activity of AST and ALT increased, myoglobin is detected in the urine.
Questions:
1. Specify the mechanisms of cellular membrane damage
2. Specify the consequences of cellular membrane damage
3. Markers of which damaged cells are blood ALT, AST, myoglobin
4. Give examples of markers of erythrocyte, cardiomyocyte cytolysis

 

Case 5

A Laboratory doctor revealed pronounced hemolysis of erythrocytes. Blood smear revealed spherical erythrocytes. When asking for the situation he found that during preparation of a blood sample hypotonic solution of sodium chloride was used:

Questions:
1. Specify the mechanisms of cellular membrane damage
2. Explain the pathogenesis of erythrocyte destruction in the blood sample
3. Why did red blood cells have spherical shape?
4. Describe adaptive mechanisms operating during cell injury

 

Hand-outs: cases, lecture, multimedia presentation

THE LIST OF LITERATURE:

The basic

1. Litvitsky P.F., Pirozhkov S.V., Tezikov E.B. Concise lectures and tests on pathophysiology E-tekstbook. – ГЭОТАР-Медиа, 2007
2. Lectures, handouts.
3. Pathologic basis of disease. Cellular adaptations. Cell injury and cell death. V.Kumar, A.K. Abbas, S.N. Fausto, 8th edition, 2010, P. 3 - 46
4. Basic Pathology. Vinay Kumar, Ramsi S. Cotran, Stanley L. Robbins. 9^th edition, 2013.- P 3 - 24.

Additional

1. Textbook of pathology. Harsh Mohan 4rd edition, Delhi, 12004, P. 14 - 52.

Control – conclusions on cases

5. THE THEME:

«SYSTEMIC ORGANISM’S RESPONSE TO DAMAGE. FEVER»

The purposes of the class:

· Formation of knowledge of the main issues of the theme

· Formation of skills of pathophysiologic schemes construction

· Formation of communicative skills for discussion of the problem

Tasks of study:
• To learn the main issues of the theme
• To develop the skills to use the glossary in three languages for discussion of the theoretical material
• To Learn how to make pathogenetic schemes
• To apply the theoretical knowledge in solving of clinical cases

• To form communicative skills for discussion of the theoretical material
Questions for the theme

1. The systemic reactions to damage, concept, examples.

2. Acute phase reactions, causes, mediators and their effects. Acute phase proteins, their function. The significance of acute phase reactions for an organism. Concept about syndrome of systemic inflammatory response. 

3. Definition of fever. Differences between fever and hyperthermia.

Types of pyrogens.