7. 0 Патологічна анатомія
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7.0 Патологічна анатомія 1 Multiple oval ulcers along the intestine were revealed on autopsy of the person, who died from diffuse of peritonitis in the distant part of the small intestine. Bottom parts of the ulcers are clear, smooth, formed with muscular or serous covering, edges of ulcers are flat, rounded. There are perforations up to 0,5 cm in diameter in two ulcers. What diseasis can be diagnosed? A Typhoid fever B Dysentery C Cholera D Tuberculosis E Typhus 2 Patient suffering from trombophlebitis of the deep veins suddenly died. Autopsy has shown freely lying red friable masses with dim crimped surface in the trunk and bifurcation of the pulmonary artery. What pathologic process was revealed by morbid anatomist? A Tromboembolism B Thrombosis C Tissue embolism D Embolism with foreign body E Fat embolism 3 Examination of a patient revealed a dense, movable skin tumour that is standing out distinctly from the surrounding tissues. Its section is found to be white and composed of fibrous tissue. Microscopic examination revealed interlacing collagen fibers and few cells. What tumour is it? A Fibroma B Myoma C Histiocytoma D Dermatofibroma E Desmoid 4 A 50-year-old man has felt vague abdominal discomfort within past 4 months. Physical examination revealed no lymphadenopathy, and no abdominal masses or organomegaly at palpation. Bowel sounds are heard. An abdominal CT scan shows a 20 cm retroperitoneal soft tissue mass obscuring the left psoas muscle. A stool specimen tested for occult blood is negative. Which of the following neoplasms is this man most likely to have? A Lipoma B Melanoma C Hamartoma D Adenocarcinoma E Lymphoma 5 A 40-year-old woman has had a feeling of abdominal discomfort for the past 8 months. On pelvic examination, there is the right adnexal mass. Abdominal CT scan demonstrates a 7 cm cystic mass involving the right ovary with small areas of calcification. The uterus is normal in size. The right fallopian tube and ovary have been removed surgically. Grossly, the mass on sectioning is filled with abundant hair and sebum. Microscopically, the mass has glandular spaces lined by columnar epithelium, squamous epithelium with hair follicles, cartilage, and dense connective tissue. What type of tumour is it? A Teratoma B Squamous cell carcinoma of ovary C Melanoma D Sarcoma of ovary E Metastase of cervical carcinoma 6 A man died 8 days after the beginning of the disease. He was diagnosed with dysentery. At the autopsy it was found out a thickened wall of the sigma and rectum, fibrinous membrane on the surface of mucous membrane. Histologically: there is a deep necrosis of mucous membrane with infiltration of necrotic masses with fibrin. What kind of colitis does correspond to the changes? A Diphtheritic B Catarrhal C Ulcerative D Chronic E Gangrenous 7 A woman suffering from dysfunctional metrorrhagia was made a diagnostic abortion. Histologically in the scrape there were a lot of small stamped glandulars covered with multirowed epithelium. The lumens of some glandulars were cystically extended. Choose the variant of general pathologic process in the endometrium. A Glandular-cystic hyperplasia of endometrium B Atrophy of endometrium C Metaplasia of endometrium D Neoplasm of endometrium E Hypertrophic growth 8 A 46 year-old man complains of difficult nose breathing. Mikulich cells, storage of epithelioid cells, plasmocytes, lymphocytes, hyaline balls are discovered in the biopsy material of the nose thickening. What is the most likely diagnosis? A Scleroma B Virus rhinitis C Allergic rhinitis D Rhinovirus infection E Meningococcal nasopharyngitis 9 Extensive thromboembolic infarction of the left cerebral hemispheres, large septic spleen, immunocomplex glomerulonephritis, ulcers on the edges of the aortic valves, covered with polypous thrombus with colonies of staphylococcus were revealed on autopsy of the young man who died in coma. What disease caused cerebral thromboemboly? A Septic bacterial endocarditis B Septicemia C Acute rheumatic valvulitis D Septicopyemia E Rheumatic thromboendocarditis 10 A patient ill with diabetes mellitus felt acute pain in his right foot. Objectively: foot thumb is black, foot tissues are edematous, there are foci of epidermis desquamation, stinking discharges. What clinicopathological form of necrosis is it? A Moist gangrene B Bedsore C Sequestrum D Dry gangrene E Infarction 11 A denaturation of proteins can be found in some substances. Specify the substance that is used for the incomplete denaturation of hemoglobin: A Urea B Toluene C Sulfuric acid D Nitric acid E Sodium hydroxide 12 During surgery in a 17-year-old patient it was revealed the tumour of 4,5х5,0х3,5 sm in size on the lower surface of the liver with subserose localization, of dark-red color. On the section tumour has cavities with marked amount of blood. What is preliminary diagnosis? A Cavernous hemangioma B Capillar hemangioma C Hemangiopericytoma D Hemangioendothelioma E Lymphangioma 13 A sick man with high temperature and a lot of tiny wounds on the body has been admitted to the hospital. Lice have been found in the folds of his clothing. What disease can be suspected in the patient? A Epidemic typhus B Tularemia C Scabies D Malaria E Plague 14 On autopsy it is revealed that kidneys are enlarged, surface is large-granular because of multiple cavities with smooth wall, which are filled with clear fluid. What kidney disease did the patient have? A Polycystic kidney B Necrotic nephrosis C Pyelonephritis D Glomerulonephritis E Infarction 15 On autopsy it is revealed enlarged dense right lung, fibrin layers on the pleura. Lung tissue is light green color on incision with muddy liqued exudates. What lung disease are these symptoms typical for? A Lung-fever B Bronchopneumonia, C Interstitial pneumonia D Pulmonary gangreneі E Fibrosing alveolitis 16 On autopsy it is revealed: soft arachnoid membrane of the upper parts of cerebral hemisphere is plethoric, it is of yellowish-green color, soaked with purulent and fibrose exudate, it lookes like cap. For what disease is it characteristical picture A Meningococcal meningitis B Tuberculous meningitis C Influenza meningitis D Meningitis at anthrax E Meningitis at typhus 17 On autopsy of the 58-year-old man it is revealed: mitral valve is deformed, thickened, not totally closed. Microscopically: centers of collagen fibers are eosinophilic, have positive fibrin reaction. The most likely it is: A Fibrinoid swelling B Fibrinoid inflammation C Mucoid swelling D Hyalinosis E Amyloidosis 18 Chronic inflammation and transformation of the one-layer ciliated epithelium into multiple-layers flat epithelium was revealed in the thickened mucous membrane of the bronchus bioptate of the patient with smoke abuse. Which of the processes is the most likely? A Metaplasia B Hyperplasia of the epithelium C Squamous cancer D Leucoplacia E Epithelium hypertrophy 19 For a long time a 49-year-old woman was suffering from glomerulonephritis which caused death.On autopsy it was revealed that kidneys size was 7х3х2.5 sm, weight is 65,0 g, they are dence and small-grained. Microscopically: fibrinogenous inflammation of serous and mucous capsules, dystrophic changes of parenchymatous organs, brain edema. What complication can cause such changes of serous capsules and inner organs? A Uraemia B Anemia C Sepsis D DIC-syndrome E Thrombopenia 20 A patient died under conditions of cardiovascular insufficiency. Autopsy results: postinfarction cardiosclerosis, myocardium hypertrophy and dilatation of its cavities, especially of its right ventricle. Liver is enlarged, its surface is smooth, incision revealed that it was plethoric, with dark-red specks against the background of brownish tissue. Histologically: plethora of central parts of lobules; peritheral parts around portal tracts contain hepatocytes in a state of adipose degeneration. How are these liver changes called? A Nutmeg liver B Pseudonutmeg liver C Amyloidosis D Liver cirrhosis E Liver steatosis 21 A 59-year-old man has signs of the parenchymatous jaundice and portal hypertension. On histological examination of the puncture of the liver bioptate, it was revealed: beam-lobule structure is affected, part of hepatocytes has signs of fat dystrophy, port-portal connective tissue septa with formation of pseudo-lobules,with periportal lympho-macrophage infiltrations. What is the most probable diagnosis? A Liver cirrhosis B Alcohol hepatitis C Chronic hepatosis D Viral hepatitis E Toxic dystrophy 22 On microscopic examination of the enlarged neck gland of a 14-year-old girl it was revealed destruction of the tissue structure of the node, absence of the lymph follicles, sclerotic and necrosis parts, cell constitution of the node is polymorphous, lymphocites, eosinophiles, atypical cells of the large size with multiple-lobule nuclei (Beresovsky-Shternberg cells) and onenucleus cells of the large size are present. What is the most likely diagnosis? A Lymphogranulomatous B Acute lympholeucosis C Chronic lympholeucosis D Berkitt's lymphoma E Fungous mycosis 23 A female patient suffering from bronchial asthma had got a viral infection that provoked status asthmaticus with fatal outcome. Histological examination of lungs revealed spasm and edema of bronchioles, apparent infiltration of their walls with lymphocytes, eosinophils and other leukocytes; labrocyte degranulation. What mechanism of hypersensitivity underlies the described alterations? A Reagin reaction B Inflammatory C Autoimmune D Immune complex E Immune cytolysis 24 On autopsy of the 40-year-old woman suffering from rheumatic arthritis, the enlarged solid spleen was revealed. On section its tissue is of the mahogany color with enlarged follicles, which look like semi-transparent grayish-whitish grains. What pathological process is the most likely? A Sago spleen B Glaze spleen C Waxy spleen D Hyaline spleen E Porphyric spleen 25 Local lymphonodules enlarged near the infected wound. Increased amount of macrophages, lymphocytes, lymphatic follicles in the cortical layer and large amount of plasma cells were revealed on histological examination. What process in the lymphatic nodules represent these histological changes? A Antigen stimulation B Acquired insufficiency of the lymphoid tissue C Innate insufficiency of the lymphoid tissue D Tumour transformation E Hypersensibility reaction 26 On autopsy of the man with alcohol abuse for a long time it was revealed: dense, small-knobby, small size liver. Microscopically: small pseudo-lobules, divided with thin layers of connective tissue with lymphomacrophagial infiltrates; hepatocytes in the state of globular fatty dystrophy. What is the most likely diagnosis? A Alcohol cirrhosis B Chronic active alcohol hepatitis C Chronic persistent alcohol hepatitis D Toxic liver dystrophy E Fatty hepatosis 27 An 8-year-old child was admitted to the infectious department with fever (up to $38^oC$) and punctuate bright-red skin rash. The child was diagnosed as having scarlet fever. Objectively: mucous membrane of pharynx is apparently hyperaemic and edematic, the tonsils are enlarged and have dull yellowish-grey foci with some black areas. What inflammation is the reason for the pharynx alterations? A Purulent necrotic B Fibrinous C Haemorrhagic D Serous E Catarrhal 28 A 30-year-old patient with bacteriologically proved dysentery developed the signs of paraproctitis. What is the stage of local changes in this patient? A Ulceration stage B Fibrinous colitis C Follicular colitis D Catarrhal colitis E Healing of the ulcers stage 29 A patient who has been abusing tobacco smoking for a long time has got cough accompanied by excretion of viscous mucus; weakness after minor physical stress, pale skin. The patient has also lost 12,0 kg of body weight. Endoscopic examination of biosy material his illness was diagnosed as squamous cell carcinoma. Name a pathological process that preceded formation of the tumour: A Metaplasia B Hypoplasia C Hyperplasia D Necrosis E Sclerosis 30 Diagnostic scraping was performed to the woman with dysfunctional uterine bleeding. Multiple convoluted glands, ganglially dilated cavities of some glands were revealed histologically in the scrape. Name the type of general pathological process. A Glandulo-gangliac hyperplasia B Atrophy C Metaplasia D Displasia E Hypertrophic excrescence 31 Tuberculine was injected intracutaneously to the child for tuberculin test. Marked hyperemia, tissue infiltration developed on the place of injection in 24 hours. What mechanism caused these modifications? A Cells cytotoxity B Reagin type cytotoxity C Antibody cytotoxity D Granuloma formation E Immunocomplex cytotoxity 32 The intraoperational biopsy of mammal gland has revealed the signs of atypical tissue with disorder of parenchyma stroma proportion with domination of the last, gland structures of the different size and shape, lined with single-layer proliferative epithelium. What is the most appropriate diagnosis? A Fibroadenoma B Papilloma C Noninfiltrative cancer D Infiltrative cancer E Mastitis 33 Arterial hypertension, hyperglycemia, glucosuria were observed clinically for a long time in the patient with upper type of obesity. Death was due to the cerebral haemorrhage. Basophilic hypophysis adenoma, hyperplasia of adrenal gland cortex were revealed on pathomorphological examination. What is the likely diagnosis? A Cushing disease B Diabetes mellitus C Acromegaly D Hypophysis nanism E Adiposogenitalis dystrophy 34 On autopsy it was revealed: large (1-2 cm) brownish-red, easy crumbling formations covering ulcerative defects on the external surface of the aortic valve. What is the most likely diagnosis? A Polypus-ulcerative endocarditis B Recurrent warty endocarditis C Acute warty endocarditis D Fibroplastic endocarditis E Diffusive endocarditis 35 Purulent endometritis with fatal outcome was progressing in the woman after abortion performed not at the hospital. On autopsy multiple lung abscesses, subcapsule ulcers in the kidneys, spleen hyperplasia were revealed. What form of sepsis developed in the patient? A Septopyemia B Septicemia C Chroniosepsis D Lung sepsis E Urosepsis 36 Autopsy of a 73-year-old man who had been suffering from the coronary heart disease along with cardiac insufficiency for a long time revealed: nutmeg liver, brown induration of lungs, cyanotic induration of kidneys and spleen. What kind of circulation disorder was the cause of such effects? A General chronic venous congestion B Arterial hyperaemia C General acute venous congestion D Acute anaemia E Chronic anaemia 37 A 22 year old patient from the West Ukraine complains of laboured nasal breathing. Morphological examination of biopsy material of nasal mucous membrane revealed lymphoid, epithelioid, plasma cells as well as Mikulicz's cells. What is the most probable diagnosis? A Rhinoscleroma B Glanders C Tuberculosis D Leprosy E Syphilis |
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