Study, describe and draw the slides

N° 26 — glomerulonephritis in lupus erythematosus (stained with hematoxylin and eosin). Pay attention to the thickening of capillary membrane in the glomeruli with «wire loop» formation. Find hematoxylin bodies. Name the outcomes.

N° 27 —periarterial sclerosis in the spleen (stained with hematoxylin and eosin). Pay attention to the growth of connective tissue surrounding the artery, which looks like onion skin.

N° 181 — acute verrucous endocarditis (stained with hematoxylin and eosin). Pay attention to fibrinoid swelling of the cusps, verrucous plaques on them, focal lymphocytic — histiocytic infiltration on the surface of the valve. Possible outcomes of verrucous plaques on the valve.

N° 183 — rheumatic productive nodular myocarditis (stained with hematoxylin and eosin). Name the organ, find Aschoff-Talalayev granuloma. Of what cells does it consist? Where does it appear more often? What types of rheumatic nodules-granulomas are distinguished?

Study the electronograms

Immune complexes in the skin in systemic lupus erythematosus, x 30 000.

Pay attention to focal thickening of basal membranes of the arterioles, accumulation of immune complexes.

Glomerulonephritis in lupus erythematosus, x 40 000.

Pay attention to the accumulation of immune complexes under the endothelium of the glomerular capillaries, podocytes and in mesangium.

Test

1. Definition of lupus erythematosus.

2. Name the types of rheumatic valvular endocarditis: a)..., b)..., c)..., d)....

3. Name the types of rheumatic granulomas: a)..., b)..., c)....

4. What occurs in the cavities of the joints in rheumatoid arthritis: a)..., b)..., c)... .

5. Describe the heart in focal interstitial exudative myocarditis: a) the sizes, b) consistence, c) the cavities of the heart, d) the muscle on incision.

6. The autopsy of the patient with 25-year history of rheumatism has demonstrated that the cusps of the mitral valve are fissed, the atrioventricular orifice is narrowed. There is free fluid in the abdominal and pleural cavities, the veins of the abdomen and esophagus are widened. There is also «nutmeg» liver, brown induration of the lungs, venous plethora of the inner organs. What is the diagnosis and the cause of death?

Answers: 1. Chronic general diseases of the connective tissue and vessels of the skin, internal organs with marked autoimmunization.

2. a) diffuse, b) acute verrucous, c) recurrent verrucous, d) fibroplastic.

3. a) young, b) mature, c) old. 4. a) accumulation of muddy liquid, b) growth of villi and destruction of the cartilage, c) development of fibrous osteal ankylosis. 5. a) enlarged, b) flabby, c) stretched, with thrombotic masses, d) motley. 6. Rheumatic disease. Stenosis of the orifice of the mitral valve. Heart failure.