Study, draw and describe the slides

N° 230 — cerebriform swelling ofPeyer 'spatch in typhoid (stained with hematoxylin and eosin). Describe the degree of blood filling and cell composition in the patch, give a quantitative assessment of the lymphocytes and reticular cells. Describe the reticular cells (size, colour of their nuclei, state of cytoplasm). Name the structures which are formed by the reticular cells.

N° 231 — hyperplasia of lymph node in typhoid (stained with hematoxylin and eosin). Point out whether the lymph node structure is intact and describe the cell composition of the typhoid granulomas. What may be revealed in the cytoplasm of the reticular cells? In what organs are similar changes possible?

N° 232 — diphtheritic-ulcerative colitis in dysentery (stained with hematoxylin and eosin). Describe composition of films on the mucous coat of the large intestine; point out how deep they penetrate into the wall (layers) of the intestine. Describe the mucous coat, the degree of its intactness, the depth of ulcerative defects, the state of the vascular system. Name possible outcomes of this pathology and possible intestinal complications.

Test

1. List stages of changes of Peyer's patches in typhoid: a) ...,b)...,c)..., d)..., e)....

2. What forms of salmonelloses are distinguished: a)..., b)..., c)... ?

3. Name the main intestinal complications in dysentery: a)...,b)...,c)...,d)...,e)...,f)....

4. List the main morphological changes in the small intestine that are revealed in persons who died within the active period of cholera: a) blood filling, b) state of the epithelium, c) state of the serous coats, d) contents of the intestine.

5. Name the main causes of death in cholera: a)..., b)..., c)..., d)....

6. Autopsy has revealed fibrinopurulent peritonitis. In the ileum, in the centre of necrotized Peyer's patches there are ulcers with uneven edges. One of them is perforated in the bottom. Microscopically, the edges of partially necrotized patches reveal proliferation of the reticular cells. What diagnosis should be made on the basis of the above findings? (The disease, the stage of its development, the name of microscopical structures in Peyer's patches).

Answers: 1. a) cerebriform swelling, b) necrosis of Peyer's patches, c) formation of ulcers, d) stage of clear ulcers, e) healing of ulcers. 2. a) intestinal (toxic), b) septic, c) typhoid. 3. a) perforation, b) paraproctitis, c) peritonitis, d) intestinal phlegmon, e) intestinal hemorrhage, f) cicatrical stenoses of intestine. 4. a) acute plethora, b) necrosis and desquamation of epithelium, c) colourless fluid without any smell («rice water»), d) dry with hemorrhages, dim, covered with mucus. 5. a) dehydration, b) coma, c) uremia, d) intoxication. 6. Typhoid, stage of formation of ulcers, typhoid granulomas.