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Rheumatic diseases

Rheumatic (collagenic) diseases is a group of diseases characterized by primary systemic damage to the connective tissue: rheumatism, rheumatoid arthritis, systemic lupus erythematosus, scleroderma (systemic progressive sclerosis), periarteritis nodosa, dermatomyositis, ankylosing spondylitis, dry Sjogren's syndrome.

Rheumatic diseases have a number of common morphological features: 1) systemic progressive disorganization of the connective tissue, represented by mucoid and fibrinoid swelling, cellular reactions, sclerosis and hyalinosis; 2) vascular inflammation mainly of the microvasculature (systemic vasculitis); 3) deep lesions of immunological homeostasis; 4) damage to the synovial membranes; 5) visceral lesions; 6) chronic, undulating, progressive course. But each of rheumatic diseases is distinguished by its own nosological specificity. Rheumatism is characterized by predominant damage to the heart and blood vessels, for rheumatoid arthritis - joints, for systemic lupus erythematosus - skin, blood vessels, kidneys, for scleroderma - skin, for periarteritis nodosa - vessels, for dermatomyositis - striated muscles.

Rheumatism is a chronic relapsing infectious-allergic disease with a primary lesion of the heart and blood vessels. The following clinical and morphological forms of rheumatism are distinguished: cardiovascular, polyarthritic, cerebral and nodular.

The inflammatory process can capture all the membranes of the heart with the subsequent development of endocarditis, myocarditis and pericarditis. There are several forms of rheumatic endocarditis: 1) diffuse, or Talalayev's vasculitis; 2) acute warty; 3) back-warty; 4) fibroplastic. Rheumatic endocarditis usually ends with heart disease.

Myocarditis with rheumatism can be productive nodular (granulomatous) and interstitial exudative (focal or diffuse). At the end of rheumatic myocarditis, small focal cardiosclerosis occurs.

Rheumatic pericarditis can be serous, serous fibrinous or fibrinous “hairy heart”, resulting in adhesive pericarditis. The combination of endocarditis and pericarditis indicates rheumatic pancreatitis.

Morphological changes in the vessels result in arterio-, arterio- and phlebosclerosis.

Systemic lupus erythematosus - an acute or chronic disease, which is based on a systemic disorganization of connective tissue with predominant lesions of the skin, blood vessels and kidneys.
In this disease, redness in the form of a butterfly occurs on the skin of the face, specific lupus nephritis develops in the kidneys, fibrinoid and inflammatory changes appear in the vessels (small arteries, arterioles and capillaries), diffuse myocarditis, warted Liebman-Sachs endocarditis, serous-fibrinous in the heart pericarditis.

A pathognomonic symptom in systemic lupus erythematosus is the formation of characteristic lupus cells due to nuclear pathology.


1. Rheumatic sclerosis of the valve (okr. Picrofuksinom).

Designations: 1) the center of disorganization of connective tissue in the valve; 2) myocardium; 3) focal cardiosclerosis.

2. Fibrinous pericarditis with the phenomena of the organization (okr. GE).

Designations: 1) myocardium; 2) foci of cardiosclerosis; 3) extensive fibrinous deposits on the surface of the pericardium; 4) connective tissue cords in pericardial tissue.

3. Lupus nephritis (env. GE).

Designations: 1) symptom of “wire loops” in vascular glomeruli; 2) gnalinosis and sclerosis of glomeruli; 3) foci of lymphohistiocytic infiltration of the stroma; 4) parenchymal protein dystrophy of the tubule epithelial cells.

Macro preparations

1. Recurrent-warty endocarditis.

2. Fibrinous pericarditis.

3. The symptom of a “butterfly” on the skin of the face (dummy).

Test questions topics

1. The concept of rheumatic (collagen) diseases. Their classification, etiology, patho- and morphogenesis.

2. Rheumatism. Its clinical and morphological forms, complications, outcomes, causes of death.

3. Systemic lupus erythematosus. Etiology, morphogenesis, morphological characteristics, complications.

4. Rheumatoid arthritis. Morphological characteristics, complications, outcomes.

5. Scleroderma, dermatomyositis. Macro and microscopic characteristics, complications, outcomes.

5. Nodular periarteritis. Etiology, morphogenesis. Primary and secondary periarteritis. Morphological characteristics, complications, outcomes. A man of 50 years old, a disabled person of group II, has been ill with rheumatic mitral heart disease since childhood, was admitted to the clinic with signs of active rheumatism. Against the background of increasing heart failure, left-sided hemiplegia developed, death occurred.

1. What clinical and morphological form of rheumatism are we talking about?

2. What changes in heart valves can be a manifestation of exacerbation of rheumatism?

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Rheumatic diseases

    Rheumatic diseases (systemic diseases of the connective tissue with immune disorders) are a group of diseases characterized by damage to the connective tissue in connection with a violation of immune homeostasis. • The group of rheumatic diseases includes rheumatism, rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, systemic scleroderma, periarteritis nodosa,
  2. Rheumatic heart disease in children
    Questions for repetition. 1. Anatomical and physiological characteristics of the heart. 2. The boundaries of the heart in children of different ages. Test questions. 1. The definition of "rheumatic heart disease." 2. Etiology and pathogenesis of rheumatic heart disease. 3. Classification. 4. Clinic: 4.1. features of rheumatic myo-, endo- and pericarditis. 4.2. features of rheumatoid arthritis. 4.3. defeat
  3. Rheumatic diseases
    1. What disease belongs to the rheumatic group: a) atherosclerosis b) systemic lupus erythematosus c) arthrosis d) anemia e) hypertonic disease Correct answer: b 2. Change in connective tissue with rheumatism: a) amyloidosis, sclerosis b) fibrinoid swelling, hyalinosis c) atherosclerosis, hyalinosis d) atrophy, lipoidosis e) mucoid swelling, mucus Correct answer: b 3. Name
  4. Chronic rheumatic heart disease
    The term "chronic rheumatic heart disease" currently replaces the previously adopted "rheumatism, inactive phase." ICD-10 code: / 05-109 105 Rheumatic diseases of the mitral valve 105.0 Mitral stenosis 105.2 Mitral stenosis with insufficiency 105.8 Other diseases of the mitral valve 105.9 Mitral valve disease, unspecified 106 Rheumatic aortic diseases
    Motivational characteristic of the topic. Knowledge of the topic materials is necessary for the study of rheumatic diseases and heart diseases in clinical departments and in the practice of a doctor for the clinical anatomical analysis of sectional observations. The general purpose of the lesson. Gain knowledge of the morphological manifestations of rheumatic diseases and heart diseases, as well as acquire skills to differentiate and
  6. Diseases of the endocardium, myocardium, pericardium, heart valves. Cardiomyopathy Rheumatism. The concept of rheumatic diseases. Vasculitis Tumors of the heart.
    1. Etiology of cardiomyopathies 1. infection 3. ischemia 2. intoxication 4. not found 2. Components of rheumatic granuloma 1. mast cells 2. Anichkov cells 3. epithelioid cells 4. giant Ashoff cells 5. zone of fibrinoid necrosis 6. giant Pirogov cells 3 With rheumatic heart disease, chronic venous congestion in the pulmonary circulation is accompanied by 1. edema 3.
    This is a group of systemic diseases of the connective tissue, which are based on a violation of immune homeostasis. This group of diseases includes rheumatism, systemic lupus erythematosus, dermatomyositis, periarteritis nodosa, rheumatoid arthritis, scleroderma, ankylosing spondylitis, Sjogren's syndrome. Rheumatism (synonyms: Sokolsky-Buillot disease, true rheumatism, acute rheumatism, rheumatic
  8. Early active detection of rheumatic diseases
    Level 1 screening includes questionnaires that include diagnostic criteria for rheumatoid arthritis, osteoarthritis, reactive arthritis, gout, systemic lupus erythematosus, and systemic scleroderma. Risk group for rheumatoid arthritis: female subpopulation older than 15 years with clear intra-family correlations. Risk group for osteoarthritis: persons over 50 with overweight.
  9. Circulatory system diseases. Rheumatic diseases, functional diagnostics
    Instruction: Indicate one correct answer: 06.01. In the process of adaptation of the body are involved: A) the adrenal gland; B) the hypothalamus; B) the pituitary gland; D) all of the above; D) the cerebral cortex. 02/06. The activity of lymphocytes and plasma cells suppresses: A) suprastin; B) methylprednisolone (urbazone); B) ditoxin; D) trent; D) the prestarium. 03.03. The boy has 5 children fatigue, increased pulsation of the left
  10. Clinical protocol for providing medical care to patients with chronic rheumatic heart disease (heart defects)
    ICD-10 heading: U5-GO9 Conditions under which medical care should be provided All patients with heart defects should be referred for surgical treatment to the appropriate specialized institutions. In cases of impossibility or delay of surgical treatment, such patients are subject to outpatient examination and treatment at the place of residence. The survey may be conducted in district
  11. Acute rheumatic fever
    The term “acute rheumatic fever” currently replaces the previously accepted name for the disease “rheumatism” (Table 1-4). ICD-10 code: 100-102 100 Rheumatic fever without mention of cardiac involvement 101 Rheumatic fever with cardiac involvement 101.0 Acute rheumatic pericarditis 101.1 Acute rheumatic endocarditis 101.2 Acute rheumatic myocarditis 101.8
    The topic of today's lecture is rheumatism. However, you noticed that rheumatic fever was pronounced in the title of the lecture. Why? In order to answer this question, you should first decide on concepts, terms. If you take a few of our textbooks and manuals, even issued in recent years, then in almost all you will still find the term “rheumatism”. The term is “rheumatic
  13. Rheumatic encephalitis
    It is clinically characterized by a progressive course with organic symptoms, indicating a predominantly cortical localization of the pathological process. This term covers a number of clearly defined neurological forms - non-Choreic rheumatic hyperkinesis (rheumatic torsion dystonia), Parkinson's syndrome, hypothalamic syndrome, cerebral rheumatism with epileptiform
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