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  1. 1. PATHOMORPHOLOGY GENERAL1. Histological examination of a 40 yo. mans thymus D. IIrevealed decreased share of parenchymatous gland E. Velements, increased share of adipose and loose connectivetissue, its enrichment with thymus bodies. The organs mass 11. A 22 y.o. woman has enlarged lymph nodes.was unchanged. What phenomenon is it? Histologically: a lymph node contains lymphocytes,A. Age involution histiocytes, reticular cells, small and big Hodgkins cells,B. Accidental involution multinucleated Sternberg cells, isolated foci of caseousC. Hypotrophy necrosis. What disease are these changes typical for?D. Atrophy A. LymphosarcomaE. Dystrophy B. Lymphogranulomatosis C. Chronic leukosis4. A 9 m.o. child has delayed dentition, it is also out of D. Acute leukosisorder. Upper jaw configuration is horizontal ("high"palate); E. Lung cancer metastasismicroscopically irregular mineralization of tooth enamel,wrinkled enamel prisms, some of them are vacuolized. 12. A patient died under conditions of cardiovascularPredentin zone is extended; there are solitary denticles. insufficiency. Autopsy results: postinfarction cardiosclerosis,What disease is it? myocardium hypertrophy and dilatation of its cavities,A. Early rickets especially of its right ventricle. Liver is enlarged, its surfaceB. Hypervitaminosis D is smooth, incision revealed that it was plethoric, withC. Late rickets darkred specks against the background of brownish tissue.D. Gout Histologically: plethora of central parts of lobules;E. Osteomalacia peritheral parts around portal tracts contain hepatocytes in a state of adipose degeneration. How are these liver changes6. A patient ill with diabetes mellitus felt acute pain in his called?right foot. Objectively: foot thumb is black, foot tissues are A. Pseudonutmeg liveredematous, there are foci of epidermis desquamation, B. Amyloidosisstinking discharges. What clinicopathological form of C. C. Nutmeg livernecrosis is it? D. Liver cirrhosisA. Infarction E. Liver steatosisB. SequestrumC. Dry gangrene 13. In the surgical department of a hospital there was anD. Bedsore outbreak of hospital infecti on that showed itself in oftenE. Moist gangrene postoperative wound abscesses. Bacteriological examination of pus revealed aurococcus. What examination shall be8. Autopsy of a man who died from influenza revealed that conducted to find out the source of this causative agenthis heart was slightly enlarged, pastous, myocardium was among the department personnel?dull and had specks. Microscopical examination of A. Microscopical examinationmyocardium revealed signs of parenchymatous adipose and B. Phagotypinghydropic dystrophy; stroma was edematic with poor C. Estimation of antibiotic susceptibilitymacrophagal and lymphocytic infiltration, vessels were D. Biochemical identificationplethoric; perivascular analysis revealed petechial E. Serological identificationhemorrhages. What type of myocarditis was developed inthis case? 17. Autopsy of a man who died from chronic cardiovascularA. Purulent collapse revealed "tiger heart". Sidewards of endocardium aB. Granulomatous yellowishwhite banding can be seen; myocardium is dull,C. Interstitial proliferative darkyellow. What process caused this pathology?D. Serous focal A. Fatty vascularstromal degenerationE. Serous diffuse B. Fatty parenchymatous degeneration C. Carbohydrate degeneration9. Colonoscopy of a patient ill with dysentery revealed D. Hyaline degenerationthat mucous membrane of his large intestine is hyperemic, E. Amyloidosisedematic, its surface was covered with greyandgreencoats. Name the morphological form of dysenteric collitis: 18. A 48 y.o. patient was admitted to the hospital withA. Fibrinous complaints about weakness, irritability, sleep disturbance.B. Necrotic Objectively: skin and scleras are yellow. In blood:C. Purulent conjugated bilirubin, cholalemia. Feces are acholic. UrineD. Ulcerous is of dark colour (bilirubin). What jaundice is it?E. Catarrhal A. Gilberts syndrome B. Parenchymatous10. A woman has been applying a new cosmetic C. Mechanicpreparation for a week that resulted in eyelid inflammation D. Hemolyticaccompanyed by hyperemia, infiltration and painfulness. E. CriglerNajjar syndromeWhat type of allergic reaction was developed?A. I 21. A 56 yo. patient has been suffering from thyreotoxicosisB. IV for a long time. What type of hypoxia can be developed?C. С III A. Tissue
  2. 2. B. Mixed B. PancreasC. Circulatory C. ThyroidD. Hemic D. ThymusE. Respiratory E. Liver22. Microscopical examination of a removed appendix 32. Autopsy of a 58 y.o. man revealed that bicuspid valverevealed an edema, diffuse neutrophilic infiltration of was deformed, thickened and unclosed. Microscopically:appendix wall along with necrosis and defect of mucous foci of collagen fibrilla are eosinophilic, react positivelymembrane with affection of its muscle plate. What to fibrin. The most probably it is:appendicitis form was developed? A. Fibrinous inflammationA. Phlegmonous B. HyalinosisB. Apostematous C. AmyloidosisC. Superficial D. Fibrinoid swellingD. Ulcerophlegmonous E. Mucoid swellingE. Gangrenous 34. A patient with clinical presentations of23. A patient is ill with diabetes mellitus that is immunodeficiency went through immunologicalaccompanied by hyperglycemia of over 7,2 millimole/l on examinations. They revealed significant loss of cells thatan empty stomach. The level of what blood plasma protein form rosettes with erythrocytes of a ram. What conclusionallows to estimate the glycemia rate retrospectively (48 can be made according to the analysis data?weeks before examination)? A. Decrease of natural killer cell rateA. Glycated hemoglobin B. Insufficiency of effector cells of humoral immunityB. Ceruloplasmin C. Decrease of T-lymphocytes rateC. Creactive protein D. Decrease of complement system rateD. Fibrinogen E. Decrease of B-lymphocytes rateE. Albumin 35. Autopsy of a patient who suffered from croupous24. A 45 y.o. patient consulted a doctor about pneumonia and died from pneumococcal sepsis revealedplaqueshaped formation on his neck. Histological 900 ml of turbid greenishyellow liquid in the right pleuralexamination of biopsy skin material revealed tumourous cavity. Pleural leaves are dull, plephoric. Name thecells of round and oval form with thin ring of basophilic clinicopathological form of inflammation in the pleuralcytoplasma that resemble of cells of basal epidermal layer. cavityWhat tumour is it? A. PhlegmonA. Basalioma B. Chronic abscessB. Syringoadenoma C. EmpyemaC. Epidermal cancer D. Fibrinous inflammationD. Hydradenoma E. Acute abscessE. Trichoepithelioma 36. Mucous membrane of the right palatine tonsil has a29. An experimental animal was first sensibilized painless ulcer with smooth lacquer fundus and regularwhereupon an antigen dose was introduced subcutaneously. cartilaginous edges. Microscopically: inflammatoryThis injection resulted in the development of a fibrinous infiltration that consists of lymphocytes, plasmocytes, ainflammation with alteration of vessel walls, basal small number of neutrophils and epithelioid cells;substance and fibrous structures of connective tissue in endovasculitis and perivasculitis. What disease is it?form of mucoid and fibrinoid swelling and necrosis. What A. Pharyngeal diphtheriaimmunological reaction took place? B. Ulcerous necrotic Vincents anginaA. Delayed type hypersensitivity C. ActinomycosisB. Immediate hypersensitivity D. SyphilisC. Reaction of transplantation immunity E. TuberculosisD. Normergic reactionE. Granulomatosis 37. A 27yearsold woman has been suffered by diabetes mellitus since she had been a child. During the last years30. Examination of cell culture got from a patient with the arterial hypertension and proteinuria have occurred. Shelysosomal pathology revealed accumulation of great has died with signs of uremia. What typical changes werequantity of lipids in the lysosomes. What of the following found out in autopsy?diseases is this disturbance typical for? A. “Cor villosum”A. Wilson disease B. “Tiger heart”B. Galactosemia C. “Armor heart”C. TaySachs disease D. Mesenchymal fatty dystrophy of the heartD. Phenylketonuria E. Purulent pericarditisE. Gout 38. A 43yearsold patient has a burn of right hand. The31. A teenager was irradiated with high radiation dose that exfoliation of epidermis and formation of bubbles filled byresulted in serious damages of lymphoid system, lysis of semitransparent fluid is manifested in the palm and the backmany lymphocytes. Restoration of normal hemogram is surface of the hand. What kind of inflammation occurs inpossible due to the functioning of the following gland: that case?A. Adrenal A. A.Serous
  3. 3. B. B.Purulent E. After anemiaC. C.FibrinousD. D.Putrefactive 45. A 23yearsold patient got a lesion of the liver because ofE. E.Catarrhal trauma. In time a structure and functions of that organ was restored completely. What kind of regeneration did occur in39. A patient was admitted in the hospital with diagnosis of that case?trichinellosis. What kind of inflammation develops within A. Restitutionthe muscles around the parasites? B. Pathologic regenerationA. Proliferative granulematous C. Physiologic regenerationB. Exudative fibrinous D. MetaplasiaC. Exudative purulent E. SubstitutionD. Exudative serousE. Proliferative interstitial 46. A 4yearsold girl was operated because of an acute appendicitis. During the operation in the retroperitoneal40. A 22yearsold patient was admitted in hospital with space it was found that the right kidney is less by 1/3 incomplaints on heavy nasal breathing. During the comparison with the left one. The diameter of the rightexamination of nasal cavity it was found the thickened renal artery was 0,3 cm, the left one was 0,4 cm. Whatmucous membrane, a lot of mucus and nodular infiltrates pathologic process did occur in that case?without erosions. It was diagnosed as rhinoscleroma of A. Hypoplasianose. It was took the biopsy. What typical morphological B. Pathologic atrophychanges may be found? C. Physiologic atrophyA. Granulomas with Mikulicz’s cells D. AplasiaB. Granulomas with Virchow’s cells E. AgenesiaC. Granulomas with Langhan’s cellsD. Granulomas with foreign body cells 47. A patient has suffered with mitral insufficiency thatE. Interstitial inflammation complicated by chronic cardiac insufficiency with grossly marked edema of the lower extremities. Suddenly cyanosis41. During the histological examination of the fragment of of the face is manifested with attempt standing up and hemucous membrane of urine bladder of the patient suffered has died. What the most probably complication developedwith chronic cystitis it was found out: the transitional in patient?epithelium focally is replaced by stratified nonkeratinized A. Thromboembolism of the pulmonary arteryepithelium. These changes can manifest development of: B. Venousarterial reactionA. Metaplasia C. Infarction of myocardiumB. Dysplasia D. Chronic venous hyperemiaC. Leukoplakia E. Hypertension strokeD. HyperkeratosisE. Hyperplasia 48. A child fell down the tree and got a simple fracture of the one of hand’s bones. In a time healing occurred. Call the42. A 1/3 of the liver with a multicellular echinococcus was kind of regeneration and cells, which taking part inresected during the operation. What typical changes of the restoration.liver tissue surrounding the parasites were found out by the A. Reparative regeneration, osteoclasts and osteoblastspathologist during the histological examination of the B. Physiological regeneration, octeoclastsresected part of the organ? C. Pathological regeneration, osteoclastsA. Formation of nonspecific granulomas D. Intracellular regeneration, osteocytesB. Flabby consistence of the liver E. Cellular regeneration, osteoclasts and osteoclastsC. Formation of specific granulomasD. Exudative tissue reaction 49. A pilot has died because of depressurization of the cabinE. Hydropic dystrophy of the airplane. In autopsy it was found out a gross marked rigor mortis, emphysema of subcutaneous tissue of the body43. During the autopsy it was found the enlarged firm liver and face. There were also edema and perivascularwith rounded margins; the surface of the cut looks hemorrhages within the lungs. There was a foamy and fluidnutmeglike of yellowbrown colour with darkred spots. blood within the veins. The histological examination wasWhat pathologic process do underlie of those changes? showed a lot of bubbles within the vessels of all innerA. Chronic venous hyperemia organs, a fat dystrophy of the liver and a quantity of smallB. Arterial hyperemia gray softening areas in the brain. Call the more probableC. Arterial ischemia cause of those changes.D. Fat embolism A. Gas embolismE. Chronic bleeding B. Air embolism C. Tissue embolism44. There is a redness of skin above the site of obturation, if D. Thromboembolismthe thrombus obstructed the main artery of upper extremity. E. Fat embolismCall the kind of arterial hyperemia appearing as a result ofdisturbance of bloodstream. 50. A man has died in 8th day since beginning of theA. Collateral disease. It was diagnosed dysentery. During the autopsy itB. Angioneurotic was found out a thickened wall of the sigma and rectum,C. Inflammatory fibrinous membrane on the surface of mucous membrane.D. Physiological Histologically: there is a deep necrosis of mucous
  4. 4. membrane with infiltration of necrotic masses with fibrin. C. HyperplasiaWhat kind of colitis does correspond to those changes? D. Neoplasm of kidneyA. Diphtheritic E. PyelonephritisB. CatarrhalC. Ulcerative 57. A woman suffered with dysfunctional metrorrhagia wasD. Chronic made a diagnostic abortion. Histologically in the scrapeE. Gangrenous there were a lot of small stamped glandulas covered by multirowed epithelium. The lumens of some glandulas were51. A patient suffered with rheumatic fever with a mitral cystically extended. Call the variant of general pathologicvalve disease of the heart for a long time. He has died as a process in the endometrium.result of cardiacpulmonary insufficiency. During the A. Glandularcystic hyperplasia of endometriumautopsy it was found out a brown induration of the lungs. B. Atrophy of endometriumCall kind of hemodynamic disorders causing those changes. C. Metaplasia of endometriumA. Chronic left ventricle failure D. Neoplasm of endometriumB. Chronic right ventricle failure E. Hypertrophic growthC. Acute left ventricle failureD. Acute right ventricle failure 58. A 13yearsold child was admitted into the hospital withE. Portal hypertension complaints of fever, weakness, and intense pain in the right thigh. From anamnesis it was defined that he has bitten by52. A patient suffered by stenosis of mitral valve of 4th stage dog 3 days ago. During the visual examination it was foundhas died as a result of cardiacpulmonary insufficiency. out redness, swelling and acute painfulness along rightAutopsy was showed a hemosiderosis of the lungs. Call the thigh. After excision it was made the histologicalkind of hemodynamic disorder in the lungs. examination, which was showed a considerableA. Local venous hyperemia accumulations of polymorphonucleus leukocytes betweenB. General venous hyperemia the mussel fibers partly undergone by purulent fusion.C. Arterial hyperemia Diagnose that condition.D. Inflammatory hyperemia A. PhlegmonE. Hemorrhage B. Abscess C. Gangrene53. A patient has died as a result of cardiac insufficiency. In D. Empyemaanamnesis he had got a pulmonectomy in account of cyst of E. Croupous inflammationthe right lung. During the autopsy enlarged left one wasfound out. Call the pathologic process in the left lung. 59. A patient with severe fracture of both femoral bones hasA. Replacement hypertrophy died in a 4 hours after trauma. What additional staining ofB. Neurohumoral hypertrophy microscopic sections is it necessary to make for exacterC. Dyscirculatory atrophy diagnosis of the cause of death?D. Dysfunctional atrophy A. The lungs and brain by Sudan IIIE. Physiologic hypertrophy B. The lungs and kidney by Congored C. The lungs and liver by Perl’s reaction54. A patient has undergone to amputation of lower D. The brain and kidney by Congoredextremity. In a time a painful nodules appeared in a stump. E. The kidney and heart by toluidinblueAmputatious neuromas were found out during themicroscopical examination. What kind of pathological 61. A 59yearsold woman was admitted into the hospitalprocesses does those formations relate to? with signs of exicosis being in deep shock. After her deathA. Regeneration it was made autopsy showed presence of vibrio cholerae,B. Dystrophy moderate mononuclear infiltrations in the mucosal laminaC. Inflammation propria of intestine. What kind of shock was the cause ofD. Hyperemia death of the patient?E. Metaplasia A. Hypovolemia B. Cardiogenic55. After deep burns of the skin a patient has got a keloid C. Anaphylacticscarring. What kind of pathologic processes does those D. Traumaticformations relate to? E. ToxicA. Incomplete regeneration (substitution)B. Complete regeneration (restitution) 62. A cattle worker has died with signs of severeC. Atrophy intoxication in a 2nd day after beginning of disease. AutopsyD. Hypertrophy was showed the enlarged flabby spleen, on the surface ofE. Metaplasia the cut of darkcherry coloured; the scrape of the pulp is abundant. The leptomeninges are swelling, infiltrating by56. A patient suffered with urolithiasis has died as a result blood of darkred colour (“a red cap”). It was defined auremia. Autopsy is showed an enlargement of right kidney, microorganism – bacillus anthracis – and diagnosedits parenchyma has been thinned; the pelvis and calices anthrax. What kind of inflammation does occur in thathave been extended, filled with fluid. In the orifice of ureter disease?there has been a calculus. Call the pathologic process in the A. Hemorrhagicright kidney. B. PhlegmonousA. Hydronephrosis C. FibrinousB. Replacement hypertrophy D. Purulent
  5. 5. E. Putrefactive D. Tuberculosis. E. Actinomycosis.63. A 65yearsold patient suffered by thrombophlebitis ofthe deep veins of both legs has died suddenly. Autopsy was 69. The patient with severe intoxication has died. Duringshowed free lying dry friable red masses with a dull the autopsy it was found out: the left tonsil was enlarged,crimped surface within the truncus pulmonalis and firm; in section it contained a lot of cavities filled bybifurcation of the lung artery. What process within the yellow–greenish masses. The tissues of the neck, andvessels did pathologist find? mediastinum were undergoing with suppurative fusion.A. Thromboembolism Microscopically: there were a lot of abscesses, in the centerB. Thrombosis of which intensive basophilic formations were defined.C. Tissue embolism Those formations consist of short sticklike elements,D. Postmortem clot surrounded with radiating projections (“ray fungus”). SuchE. Hemangioma changes characterized: A. Actinomycosis.64. A patient was admitted into the hospital with complaints B. Amebiasis.to feel sick, pains in the epigastria after meal. During the C. Brucellosis.gastroscopy it was found out hyperemia, edema of mucous D. Tuberculosis.membrane of the stomach, an excessive amount of viscous E. Scarlet fever.grayish mucus. What kind of inflammation did develop inthe stomach? 70. A 34yearsold woman has got pain, redness and swellingA. Catarrhal of finger on account of careless use of iron. The blisterB. Fibrinous filled by transparent yellowish fluid appears in someC. Serous minutes. What pathologic process do such signsD. Hemorrhagic characterize?E. Purulent A. Exudative inflammation. B. Traumatic edema.65. During the autopsy it was found out: the lungs are firm, C. Hypertrophy.have brown colour because of accumulation of endogenous D. Proliferative inflammation.pigment. It’s known that the patient has suffered with E. Hydropic dystrophy.venous congestion in the pulmonary circulation. Whatprocess did cause such changes? 71. The patient with chronic glomerulonephritis has diedA. Hemosiderosis with accompanied signs of uremia. The cadaver hadB. Calcinosis specific uremic smell. Macroscopically: there were a lot ofC. Jaundice pilelike whitishgrayish puttings on the surface ofD. Melanosis pericardium. The vessels filled with blood became visibleE. Porphiria after removal of such formations. What process did develop in the pericardium?66. During the autopsy it was found out the cavity 2,5x1,5 A. Fibrinous inflammation.sm within the right frontal part of the brain. It was filled B. Organization.with transparent fluid and its walls were smooth and of C. Proliferative inflammation.brownish colour. What process did develop in the brain? D. Hemorrhagic inflammation.A. Cyst as an outcome of hemorrhage. E. Arterial hyperemia.B. Grey softening of brain.C. Abscess of brain. 72. The patient complains of local pain in the back of theD. Birth defect of brain. head, increasing of the temperature in that area.E. Cyst as a outcome of gray softening Macroscopically: there is a conical infiltrate of purpleblue colour with yellowgreenish apex, which protrudes under the67. During the histological examination of the fragment of surface of the skin. Diagnose it:cervix it was found out the area of inflammatory infiltration A. Furuncle.with involvement of walls of small vessels. The infiltrate B. Phlegmona.was composed of plasma cells, lymphocytes, epithelioid C. Abscess.cells and areas of sclerosis and hyalinosis. What disease D. Fistula.does such picture characterize? E. Empyema.A. Syphilis.B. Tuberculosis. 73. During the histological examination of the biopsy theC. Leukoplakia. pathologist has found out granulomas within the livers.D. Erosion of cervix. They contain mainly Tlymphocytes and epithelioid cells,E. Condyloma. and solitary giant Langhan’s cells. In the center of granulomas there was a small area of caseous necrosis.68 During the histological examination of the biopsy it was What pathologic process is characterized by those changes?found out the granulomas composing of lymphocytes, A. Proliferative inflammation.epithelioid cells, plasma cells, macrophages with foamy B. Coagulative necrosis.pale cytoplasm (Mikulicz’s cells), a lot of hyaline balls. C. Liquefactive necrosis.What disease do you think about? D. Neoplasm.A. Rhinoscleroma. E. Exudative inflammation.B. Leprosy.C. Syphilis.
  6. 6. 74. A 5yearsold girl suffered from diphtheria. She has died E. Defect of telomere Хchromosomain three days because of asphyxia caused by diphtheria’scroup. During the autopsy it was found out, that mucous 83. During the autopsy the pathologist has marked: themembranes of larynx, trachea and bronchi were thickening, expressed linear shrinkage and thickening of extremitiesswelling, dull, covering by grayish membranes, which with formation on a skin of large tucks. The head iseasily came off. What process did develop in the larynx? increased, nose is saddle, the oral cavity is semiopen,A. Croupous inflammation. tongue is thick, neck is short, bodies of spondyles areB. Serous inflammation dwarfed, hypoplasia of thorax is combined with hypoplasiaC. Diphteritic inflammation of lungs. Which inherent malformation of a musculoskeletalD. Proliferative inflammation system is it characteristic for?E. Suppurative inflammation A. Lethal micromelia B. Chondroplasia75. As a result of a microscopic examination of the C. Imperfect bone formationfragment of the skin the granulomas were found out; they D. Inherent marble bonescomposed of a lot of macrophages with a few amount of E. Inherent Oppenheim myatonialymphocytes and plasma cells. Besides large macrophageswith fat vacuoles occurred, the microorganisms were 84. In the autopsy of 48yearold man [miner which gotpacked in those vacuoles as “cigars in the box” (Virchow’s hematite] the pathologist has found out increased brownredcells). Granulation tissue had a good vascularization. What dense lungs. Microscopic picture is: a moderatedisease are such granulomas characterized for? pneumosclerosis, submiliary and miliary nodules, whichA. Leprosy consist of dust cells with spots (positive reaction to iron). InB. Tuberculosis. lymph nodes there are a lot of dust and considerable diffuseC. Syphilis. sclerosis. Which professional disease is it?D. Rhinoscleroma. A. Red siderosisE. Actinomycosis. B. Black siderosis C. Aluminosis76. During the microscopic examination of bioptic fragment D. Berilliosisof the skin the granulomas were found out containing E. Anthracosisepithelioid cells, surrounded with Tlymphocytes. Betweenthe epithelioid cells the solitary giant polynuclear 85. In the autopsy of a body of the miner, which gotLanghan’s cells located. There were areas of caseous hematite, the pathologist has found out: black lungs, similarnecrosis in the center of some granulomas. Blood vessels on lungs at an anthracosis. Microscopically: moderatewere absent. What disease do such changes characterize? pneumosclerosis, submiliar and miliar nodules, whichA. Tuberculosis. consist of dust cells with spots [positive reacton to iron]. InB. Syphilis. lymph nodes there are a lot of dust and considerable diffuseC. Leprosy. sclerosis. Your diagnosis?D. Rhinoscleroma. A. Black siderosisE. Hodgkin’s disease. B. Red siderosis C. Aluminosis77. In a biopsy of a сervix uteri of a26yearold women the D. Berilliosisdiagnosis following was established: pseudoerosion. What E. Caplan syndromemicroscopical changes has the pathologist revealed?A. Local changes of a stratified squamous epithelium 90. A 45yearold man has died because of on single-layer prismatic one pulmonarycardiac insufficiency. In autopsy the pathologistB. Cellatypia of an epithelium of an mucosal epithelium has found out croupous pneumonia in lower lobe of leftC. Keratinization of an epithelium of an mucosal lung, 350ml of greenishyellow fluid in the left pleural epithelium cavity. Microscopically it contained many neutrophils. CallD. “Carcinomatous pearls” the complication of pneumoniaE. Local inflammation and necrosis in mucosa A. Empyema of pleura B. Fibrinous pleuritis80. Inheritable predilection to development of lung C. Pneumothoraxemphysema is connected with genetic disturbance, which D. Hydrothoraxone shows in decreasing production of: E. HemothoraxA. Alpha1antitrypsinB. Creactive protein 98. A 60yearold miner has died because of chronicC. Antistreptolysin 0 pulmonarycardiac insufficiency. In autopsy the pathologistD. Hyaluronidasa has found out: areas of dystelectasis, induration,E. Complement pneumosclerosis in the both lungs, local emphysema in the apex. Cut surface was slatyblack. Diagnose this disease.82. Gangliosidlipidosis is characterized by deficiency of A. Anthracosisenzyme alpha –hexoaminidaze and accumulation of B. Silicosisgangliosides in lysosomas of nervous cells.It is connected C. Talcosis.with genetical defect, which is determined as: D. AsbestosisA. Defect of one gene E. Aluminosis.B. Translocation of a geneC. Defects of several genes 108. In 56 year –old patient has suffered fromD. Trisomy of 21 chromosoma bronchoectatic disease and hemoptysis, the edema of face
  7. 7. and waist have appeared. The protein (33 mg/l) was found A. Sequestrumin urine. Pulmonary hemorrhage was the cause of patient’s B. Dry gangrenedeath. In autopsy: enlargement of kidneys was found; the C. Wet gangrenekidneys were densed with lardaceus surface of section. D. InfarctionHistologically: the deposition of homogenous eosinophilic E. Caseous necrosismasses colored with Congo red and given of metachromasiawith methyl violet color in glomeruli and canals were 117. The 46year old woman has suffered from rheumaticfound. What pathological process took place in the patient? fever with combined mitral heart disease. In autopsy the1. Amyloidosis leaflets of mitral valve are thicken, intertwisted and haveB. Grainish degeneration; stony dense. What pathological process has led to theseC. Fatty degeneration; changes?D. Mucoid degeneration; A. Amyloidosis;E. ;Hyalinosis; B. Hyaline changes; C. Dystrophyc calcification;111. In 45year old patient died from sudden cardiac death D. Metabolic calcification;the symmetrical type of adipose heart of third degree; the E. Metastatic calcification;rupture of right ventricle’s wall with hemopericardium andredundant accumulation of fat under epicardium were found 118. Patient is suffered from cholera, which is during within autopsy. Microscopically: the adipose tissue grows from dehydratating, cyanosis and convulsions. In result ofepicardium into myocardium with atrophy of fibers of massive infusion therapy the exicosis is diminished, butmuscle. What process is more probable? anuria is remained. Patient is dead of uremia. ChooseA. Adipose heart; correct position for this case.B. Hypertensive disease; A. Necrotic nephrosis with cortical necrosis takes placeC. Ischemic heart disease; in the kidneys,D. Fatty degeneration of myocardium; B. Choleral typhoid is developed,E. Acute myocardial infarction; C. Development of uremia is connected with acute glomerulonephritis,112. The 48yearold patient, suffered from fibrouscavernous D. Fibrinouse colitis is found in autopsy,tuberculosis, has complained of weakness, reduction of E. Exicosis is due to action of virus exotoxin.daily secretion of urine, edema of the body and extremitiesand increasing of blood pressure to 180/90. The increasing 119. Please, choose incorrect statement.of protein, presence of hyaline and grain cylinders and A. Degeneration is characterized by disorder of tissueerythrocytes were found under analysis of urine. The patient nutrition and in every time lead to distraction ofhas died in a month because of the insufficiency of kidney. nucleus and whole cellIn autopsy, the enlargement of the heart and "lardaceus" B. There are extracellular and intracellular accumulationskidneys with mass of more than 240 g were found. What is C. Pathological calcification may be in two forms:the complication of fibrosecavernouse tuberculosis? dystrophic and metastatic calcificationA. Аmyloidosis; D. Degenerations may be caused by hereditary factorsB. Glomerulonephritis; E. Degenerations can appear in one organ or in the wholeC. Nephrotic syndrome; bodyD. Pyelonephritis;E. Nephrosclerosis; 120. In autopsy: enlargement of kidneys was found; the kidneys were densed with lardaceus surface of section.114. In patient with jaundice the following data were Histologically: the deposition of homogenous eosinophilicestablished: in serum the increasing of bilirubin because of masses colored with Congo red and given of metachromasiathe unconjugated form; in faeces and urine increasing of with methyl violet color in glomeruli and canals werestercobilin; the level of conjugated (direct) bilirubin in found. What pathological process took place in the patient?serum is normal. What type of jaundice takes place? A. AmyloidosisA. Haemolytic jaundice; B. Grainish degeneration;B. Jaundice of newborns; C. Fatty degeneration;C. Parenchymatous (hepatic) jaundice; D. Mucoid degeneration;D. Gilbert’s disease; E. ;Hyalinosis;E. Mechanical (posthepatic) jaundice; 121. Choose one incorrect statement:115. In autopsy of the 83yearold patient’s body, has died A. The mechanism of decomposition is a base ofbecause of stomach cancer, the heart and the liver were genetic storage diseases;diminished in size, condensed, with brown color. What B. Decomposition (phanerosis) – disintegration ofpathological process took place in these organs? membranous structures of cells and intercellularA. Sclerosis; matrix;B. Mesemchymal degeneration; C. Infiltration – redundant accumulation (deposition) ofC. Parenchymal degeneration; metabolites into the cells and intercellular matrix;D. Necrosis; D. Perverted synthesis – synthesis of abnormal substancesE. Brown atrophy in the cells and tissues; E. Transformation – formation of one type of metabolism116. Fragment of dead tissue, which can’t be autolized, products from common initial substances for protein,replaced by connective tissue and which is localized among fats and carbohydrates.alive tissue is named…
  8. 8. 122. Intracellular accumulation of fat in liver is lowerlobar pneumonia with expectoration of mucus withcharacterized by every statements, except one: pus. In autopsy in 910 segments of the right lung the cavityA. Fat is accumulated in extracellular spaces with dense walls filled with purulent masses, was found.B. There are small fat vacuoles in cytoplasm around the The whitish path comes from the cavity toward the radix of nuclei of hepatocytes the lung. Microscopically in was established that the cavityC. Liver enlarged and becomes yellow is divided from saved lung tissue with thin membrane,D. Its consistency is soft and greasy which consists of two layers: internalgranulation tissue, andE. Fat is stained by special stain Sudan 3, and becomes external –connective tissue. What diagnosis is more orangered color probable? A. Chronic abscess;123. A 55 year old man has died after chronic B. Pulmonary gangrene;glomerulonephritis, chronic renal insufficiency. In the C. Acute pulmonary abscess;autopsy the pathologist has found out characteristic changes D. Chronic pneumonia;in kidneys for this disease, also fibrinous pericarditis, E. Bronchoectatic diseasepleuritis, bronchitis. Call the cause of the fibrinousinflammation in serosal and mucosal layers. 150. Cyanosis, enlargement of the liver, edema of the lowA. Uremia. extremities as a result of insufficiency of the right ventricleB. Hypolipidemia of the heart were found in a patient. What is the cause of theC. Hyperlipidemia development of such insufficiency?D. Arterial hypertension A. Hypertension of the small circle of the bloodE. Arterial plethora circulation B. Functional shunts in lungs140. During autopsy of the patient died from chronic C. Increasing of the venous pressurecardiac insufficiency the enlarged dense rusty colored lungs D. Hypercathecholemiawith growth of gray color connective tissue around bronchi E. Cardiogenic cirrhosis of the liverand vessels were found. How can we call this process inlungs? 153. In 53 yearold patient, who has suffered byА Brown induration of the lung bronchoectatic disease and hemoptysis, the edema of faceВ Hemorrhagic pneumonia and waist have appeared. The protein (33 mg/l) was foundС Interstitial emphysema in urine. Pulmonary hemorrhage was the cause of patient’sD Chronic obstructive emphysema death. In autopsy: enlargement of kidneys was found; theE Primary idiopathic emphysema; kidneys were dense with lardaceous surface of section. Histologically: the deposition of homogenous eosinophilic143. In 77yearold patient suffered with atherosclerosis the masses colored with Congo red and given of metachromasiapain has appeared in the right foot. The foot is enlarged in with methylviolet color in glomeruli and canals were found.size, its skin has black color and is macerated; the What pathological process took place in the patient?demarcation line is not clear. What pathological process A. Amyloidosis;takes place in a patient? B. Fatty degeneration;A. Wet gangrene C. Mucoid degeneration;B. Coagulative necrosis D. Grainish degenerationC. Sequestrum E. HyalinosisD. Dry gangreneE. Noma 155. In the case of rheumatic heart disease, pericarditis is characterized by:145. A 65 year old patient, who suffered from A. “Shaggy heart” (“cor villosum”)arteriosclerosis, has been hospitalized in surgical B. “Cor pulmonale”department because he had purulent peritonitis. Thrombosis C. “Tiger heart”of mesenteric arteries was found during operation. What is D. Fatty changethe most probable cause of peritonitis? E. “Bull heart”A. Hemorrhagic infarctionB. Angiospastic ischemia 156. In a 45yearold patient the ulcerativenecrotic damage ofC. Angioneurotic edema the mucosa of the oral cavity takes place; also the spreadD. Stasis lymphadenopathy, slight spleno and hepatomegaly, diffuseE. Chronic congestion hemorrhages in the skin and mucous membranes were found out. In blood analysis the increasing of leukocytes (to148. Under microscopic investigation the postinfarction 100 10 per 1 ml) at the account of lymphoblasts takes place.cardiosclerosis has been found out. Around cardiosclerotic What diagnosis is more probable?area myocardiocytes were enlarged in size and had large A. Acute lymphoblastic leukemiahyperchromic nuclei riched in DNA. What process taking B. Chronic myelocytic leukemiaplace in myocardiocytes is more probable? C. Chronic lymphocytic leukemiaA. Regenerative hypertrophy D. PlasmocytosisB. Physiologic regeneration E. Acute promyelocytic leukemia;C. Complete reparative regenerationD. Pathologic regeneration 159. Chronic venous congestion of organs, hypertrophy ofE. Hypertrophy because of increased workload the left heart ventricle with cardiosclerosis, volumetrical white-yellowish plaques in intima of aorta with149. 56yearold patient has suffered from rightside atheromatous masses in the center, which are deeper in the
  9. 9. wall, are found in the result of autopsy of 70year man, who E. Perineuraldied of heart insufficiency and who suffered from anginapectoris, hypercholesterinemia and obesity. Which 170. At the autopsy of 60 yearold male patient, in thepathological process is more possible in aorta? myocardium of the front wall of the left ventricle of theA. Atheromatosis heart a gray dense focus of 5 х 4 cm, of irregular shape withB. Lipoidosis clear borders, fibrous structure has been found out. WhatC. Arteriolosclerosis pathological process in the myocardium has revealed theD. Liposclerosis pathologist?E. Calcification A. Postinfarctional cardiosclerosis B. Diffuse smallfocal myocardiosclerosis161. All statements are correct in the relations of hyalinosis, C. Myocarditisexcept one: D. Petrification of the myocardiumA. The hemorrhage and hemoliysis play important role E. Infarction in the hyalinosis formationB. Hyaline is accumulated in the connective tissue and 171. In 40yearold patient, the tumor, which grew under skin looks like cartilage of spine was resected. The histologic diagnosis: a lipoma.C. Mainly arterioles and arteries undergo to hyalinosis What principle of the tumors’ classification did theD. Hyalinosis is rare reversible process pathologist use when created his conclusion?E. There are not macroscopical changes of the organs A. Gistogenesis usually, but hyalinosis may lead to deformation and B. Of biochemical features wrinkle of the organs C. Of ultrastructural features D. Of physicochemical features166. In 60yearold patient, during examination the cancer of E. Macrostructure of an organa prostate gland with metastases in the lower parts of thecolumn, pelvic bones and pathological fracture of a femur 172. At histologic research of a biopsy specimen from anwas found out. What pathological process is a basis of the auricle of a heart of a patient with rheumatic disease thedevelopment of metastases? foci of a mucoid swelling, fibrinoid necrosis of a connectiveA. Tissue embolism tissue has been found out. What immune response hasB. Bacterial embolism developed in tissues of the auricle of the heart?C. Airembolism A. Hypersensitivity of an immediate typeD. Embolism by foreign matters B. Hypersensitivity of a delayed typeE. Necrosis of tissue C. Reaction of the transplantative immunity D. Normergic reaction167. In patient with chronic cystitis during the investigation E. Exudative reactionof biopsy of a mucosa of urinary bladder the foci of asquamous nonkeratinized epithelium are found out. It can 178. Call a kind of an infarct according to macroscopicbe a sign of development of: signs, which is characteristic in myocardium.A. Metaplasia A. White with a hemorrhagic haloB. Leukoplakia B. HemorrhagicC. Hyperplasia C. AnemicD. Dysplasia D. MixedE. Hyperkeratosis E. Red168. During the laparotomy in 49 yearold male patient, the 179. What type of exudate appears in pericardium cavity attumor has been found out in the field of a sigma with a rheumatic pericarditis?growth through all its layers and an occlusion of the lumen A. Serous-fibrinousof an intestine. The biopsy has been taken and colonostoma B. Putrefactivehas been overlapped. The clinical diagnosis after operation: C. Hemorrhagica cancer of sigma. What kind of tumor is growth in relation D. Purulentto tissues? E. CatarrhalA. InfiltrativeB. Expansive 180. At autopsy of a patient died because of a cerebralC. Endophytic hemorrhage, strongly enlarged dense and anemic kidneysD. Exophytic ( size :6х3х2см weight 60.0,) with a uniformlyE. Multicentric smallgranulated surface and with uniformly thinned cortex on a cutsurface have been found out. The changes in kidney169. In 36 yearold patient a dark brown color patch on skin are a sign of:of a dextral foot has been resected. The histologic research A. Of arteriosclerotic nephrosclerosishas not been carried out. In 5 months in dextral inguinal B. Of atherosclerotic nephrosclerosisarea a conglomeration of lymph nodes has appeared. At C. Secondary shrinkage of kidneyhistologic research of one of them the metastasis of D. Gouty (podagric) kidneysmelanoma has been found out. What pathway of spreading E. Amiloidshrinkaged kidneys (“lardaceous kidneys”)of tumor takes place?A. Limphogenous spread 183. A 50yearold man had rheumatic mitral disease. He hasB. Hematogenous spread arrived in clinic with sings of active rheumatism. On aC. Anaplastic background of increasing cardiovascular insufficiency hasD. Mixed developed lefthand hemyplegia. The patient has died. What
  10. 10. changes of a brain have caused development lefthand E. The type Vhemyplegia?A. Infarction of a brain 207. The 35yearold female was admitted into the hospitalB. Hematoma. with nephrolithiasis. Anaphylactic shock was appeared afterC. Atherosclerosis of brain’s vessels. intravenous injection of contrast medium. Which cells takeD. Edema of a brain. part in development of this reaction?E. Meningitis. A. Tissue’s basophils B. Fibroblasts187. At histologic examination of tuberculoma resected C. Epitheliocytesfrom right lung a necrosis in center is found out. Call a kind D. Myocytesof the necrosis. E. NeutrophilsA. CaseousB. Fatty 208. Histologic investigation of thyroid gland has showedC. Liquefactive destruction and atrophy of follicles, diffuse lymphoidD. Coagulative infiltration with formation of lymphoid follicles in theE. Gangrene stroma. Call the group of diseases with respect to this thyroiditis.194. A woman, which was in a bed in forced position for a A. Autoimmune specificlong time, has died because of a tumoral dissemination B. Autoimmune nonspecific(multiple metastases and carcinomatosis of a peritoneum) of C. Bacterialmucinous cystadenocarcinoma. During the autopsy the D. Infectiousallergiclarge areas of necrosis of the skin and underlying soft E. Viruses infectioustissues of sacral part were found out. Call a kind of anecrosis. 209. Ultrastructural investigation of tissue’s biopsy hasA. Bedsore showed considerable increase of lyzosomes in theB. Infarct cytoplasm of macrophages within the inflammativeC. Sequester infiltrate. What is connected with appearance of thisD. Caseous necrosis morphologic process?E. Waxylike (Zenker’s) necrosis A. Activation of phagocytosis B. Proliferation of cells198. The examination of the child with measles showed the C. Torpid phagocytosisnonclear border edematous fluctuated areas of redblack D. Activation of apoptosiscolor in the soft tissues of the cheeks and perineum. What E. Torpid apoptosiscomplication did develop in the child?A. Wet gangrene (noma) 210. In biopsy of stomach in patient with autoimmuneB. Dry gangrene gastritis it was found out: infiltration by lymphocytes andC. Gas gangrene macrophages in mucous layer. Which type ofD. Bedsore hypersensitivity is connected with these morphologicE. Trophic ulcer changes? A. The type IV202. The presence of the grains of chromatin in a focus of B. The type IIcaseous necrosis is a manifestation of: C. The type VA. Karyorhexis D. The type IB. Karyolysis E. The type IIIC. KaryopyknosisD. Mitotic activity of nuclei 211. In biopsy of lymph node it was found out a lot ofE. Apoptosis lymphoid follicles with large centers of duplication, increasing of mitoses. Which process is characterized by205. In 77yearold patient suffered with atherosclerosis the these morphologic changes?pain in the right foot has appeared. The foot is enlarged in A. Antigenic stimulation with follicularsize, its skin has black color and is macerated; the hyperplasiademarcation line is not clear. What pathological process B. Atrophy of lymphoid tissuetakes place in the patient? C. LymphosarcomaA. Wet gangrene D. Hodgkin’s diseaseB. Coagulative necrosis E. Metastases of cancerC. SequestrumD. Dry gangrene 212. It was found stopping of breathing and bloodE. Noma circulation in patient after traffic accident. Resuscitation was successful. Call the that condition of patient.206. The 30yearold man has had for two months A. Clinical deathlacrination, pruritic palpebras, rhinitis with mucus. All B. Social deathsymptoms disappeared after treatment by desensebilizators. C. Biological deathWhat type of hypersensitivity occurred in patient? D. Physiologic deathA. The type I E. AgonyB. The type IIC. The type III 213. Call the cells of the immune system that secreteD. The type IV immunoglobulins:
  11. 11. A. Plasma cells Goodpasture’s syndrome. Which pathologic process isB. Macrophages characteristic for this syndrome?C. Tlymphocytes A. Autoantibodies to basement membrane of theD. Dendritic cells lungs and kidneysE. Natural killer cells B. Autoantibodies to mitochondrias of the lungs and kidneys214. Which cells are injured in patient with HIVinfection? C. Autoantibodies to DNAA. Tcells-helpers D. Cytotoxic reaction against epithelium of renalB. Blymphocytes tubulesC. Natural killer cells E. Appearance of immune complexes in glomeruli ofD. Macrophages kidneys and lungsE. Eosinophils 225. The patient was remove the firmly – elastic, fixed,215. The 35yearold man has received prolonged painful tumor, it is localized in femor. At pathomorphologicimmunosupressive therapy after transplantation of kidney. research it was found out: yellow tumor without theHe has died because of generalized cytomegaly. Call the capsule, greyish with the locuses of necrosis andkind of immunodeficiency in patient. hemorrhages; histologically is marked the expressedA. Medicamentous polymorphism of cells. What is your diagnosis?B. Xradiating A. LiposarcomaC. Bacterial B. RhabdomyosarcomaD. Primary C. AngiosarcomaE. Ecological D. Lipoma E. Malignant synovioma216. The 30yearold patient with transplanted kidney hasreceived prolonged immunosupressive therapy and he has 226. Under microscopic examination of the increaseddied because of intoxication. Microscopic examination cervical lymph node it was found out: the absence of itsshowed giant cells with large nuclei encircled by ringslike structure and the lymphoid follicles, infiltration by sphericalbrightening, which looked as “owleye”, located in the cells with narrow cytoplasm. It is known from the clinicalkidneys, liver, pancreas, lungs. Call this disease. dates, that other groups of lymph nodules, and lien and liverA. Cytomegalovirus infection are increased also. What disease it is necessary to thinkB. Tuberculosis about?C. Syphilis A. Lymphoid leukosisD. Leprosy B. LymphogranulomatosisE. Bubonic plaque C. Lymphosarcoma D. Myeloid leucosis217. In biopsy of the lymph node it was found out E. Myelomagranuloma with epithelioid and giant cells. Call the originof epithelioid cell’s development. 227. During autopsy of the body of the 30yearsold man hasA. Monocytes been determined the increased lien (weight 900,0),B. Pericytes increased liver (weight 4000,0), increased lymph nodes.C. Neutrophils Bone marrow of a diaphysis of a femur was red color.D. Lymphocytes Microscopically: infiltration of the portal tract of liver byE. Epithelium cells undifferentiated hemopoietic cells with the spherical shape and narrow cytoplasm. What disease it is possible to think222. In biopsy of transplantanted kidney it was found out: about?diffuse infiltration of stroma by lymphocytes, plasma cells, A. Chronic lymphoid leucosislymphoblasts, plasmablasts, necrotic arteriitis. Which B. Chronic myeloid leucosispathologic process was appeared in organ? C. Generalized form of lymphogranulomatosisA. Immune mutilation D. Acute myeloblastic leucosisB. Acute glomerulonephritis E. Acute lymphoblastic leucosisC. Ischemic infarctionD. Tuberculosis 228. At research of a biopsy of the increased cervical lymphE. Acute pyelonephritis node it were found: the absence of structure of lymph nodes, infiltration by proliferated lymphocytes, single223. Pest’s pneumonia and croupous pneumonia in stage of Shternberg’s cells. What do these changes testify about?red hepatization may be differentiated due to presence of A. Lymphogranulomatosis with predominance offollowing elements in the lungs: lymphoid tissue,A. Fibrin B. Lymphogranulomatosis with suppression of lymphoidB. Carnification tissueC. Macrophages C. Mixed cellular variant of lymphogranulomatosisD. Red blood cells D. Nodularsclerotic variant of lymphogranulomatosisE. Edema E. Lymphosarcoma224. In the 30yearold woman it was found: cough, sputum 229. In biopsy of the increased cervical lymph node of a 14with blood, fever, increased blood pressure, decreased urine yearold girl the pathologist has found out: the absence ofoutput, edema of low extremities. All symptoms have structure of lymph nodes, the absence of lymphoid follicles,developed for 6 weeks. Diagnostic renal biopsy showed foci of necrosis and sclerosis, cellular polymorphism.
  12. 12. There are lymphocytes, eosinocytes, atypical multinuclear distributed irregular. Described morphological features arecells of the large sizes and uninuclear cells of large sizes characteristic for…:also. Call this disease. a. FibromaA. Lymphogranulomatosis B. RabdomyomaB. Acute lymphoid leucosis C. PapillomaC. Chronic lymphoid leucosis D. PolypsD. Berkit’s lymphoma E. LipomaE. Diffuse nonhodgkin’s lymphoma 235. In an autopsy of the 60yearold woman pathologist230. A 14 yearold boy was found out: the increase of lower has found out: tumor of uterine with growth surroundedthird of femur, local hyperemia, strengthening venous tissue, enlarged regional lymph nodule, hemoperitoneum.structure in a zone of pathological process. Ro: injury of Histologically: cellular polymorphism and tissue atypismsupperficial layer of a femoral bone, joint are saved. In in the endomtrium, necrosis and hemorrhages,biopsy was found out the accumulation of atypical metastasises of adenocarcinoma of lymph nodules. Whatosteoblasts with multiple mitosises and foci of the are secondary appearances of tumors?anomalously formed osteal girders with an invasion in 1. Necrosis and hemorrhagesurraunded tissues. Call this disease. B. Lymphogenous metastasises1. Osteogenic a sarcoma C. Hematogenous metastasisesB. Chondrosarcoma D. Cellular polymorphismC. Fibrous dysplasia E. Tissue atypismD. Osteoid osteomaE. Osteoblastoclastoma 236. In young 18yearold woman the sharp pain during swallowing, enlargement of lymph nodes of the neck and231. A 40 yearold man has been suffered by a chronic increasing of temperature to 39 degrees of Centigrade havebronchitis has died because of cachexy. During the autopsy appeared. The whitishyellowish pellicles have appeared onit was found: in a lumen of bronchuses the endophytic the surface of tonsil’s mucosa. After separation of thesegrowth of light grayish soft tissue. Under the microscopic pellicles the ulceration of tissue was formed. The state ofexamination in a wall of a bronchus among growths of an health of the patient has become progressively worse. Sheatypical squamous epithelium were found the keratinous has died in 8 days of the disease with signs of progressivepearls. What is your diagnosis? heart insufficiency. What histological changes in1. Squamous carcinoma with a keratinization cardiomyocytes can be found?B. Squamous carcinoma without a keratinization A. Fatty degeneration;C. Adenocarcinoma B. Mucousal degeneration;D. Undifferentiated carcinoma C. Hydropic degeneration;E. Apudoma D. Balloon degeneration; E. Hyalinedroplets degeneration.232. At intraoperation biopsy of a female brest it wasfound out: the concentric growth intralobular connective 237. A 55yearold woman has had fever and dyspnea fortissue around of smallsized duct covered by a singlelayer over a month along with a 2 kg weight loss. On physicalepithelium Your presumable diagnosis. examination her temperature is 37.8 C. A chest radiographA. Fibroadenoma shows a reticulonodular pattern along with prominent hilarB. Intraductal papilloma lymphadenopathy. A transbronchial lung biopsy isC. Lobular carcinoma in sity performed, and microscopic examination shows no viralD. Noninvasive intraductul carcinoma inclusions, no fungi, no acid fast bacilli, and no atypicalE. Mastitis cells. Which of the following diseases is she most likely to have?233. At gastroscopical research of patient in area of A. Silicosislesser curvature of the stomach it was found out the B. Sarcoidosisexophytic formation (1,5 cm in diameter). In biopsy C. Asbestosisfrom form it is marked : the growth of atypical D. Tuberculosisglandular structures of different shape and size E. Usual interstitial pneumonitis(stretched, round, with irregular outlines, small orlarge) into mucosa and submucosa; the epithelial 238. A 60yearold man has had a cough without productioncells are atypical too: their nuclei are polymorphous of much sputum for the past week. On physical examinationwith various maintenance of chromatin and mitoses. he is afebrile. There are decreased breath sounds at the rightWhat is your diagnose? lung base. A chest radiograph reveals an area ofA. Adenocarcinoma of stomach consolidation in the right lower lobe. He is given antibioticB. Squamous carcinoma of stomach therapy, but a month later the radiographic picture has notC. Polyp of stomach changed, and his cough continues. A bronchoalveolarD. Fibrous carcinoma (Skyrrus) lavage is performed and yields atypical cells along withE. Chronic ulcer scattered alveolar macrophages. Which of the following is the most likely diagnosis?234. In the skin it was found out well –encapsulated firm A. Mycoplasma pneumonianode. On the cut it is showed whitish laminated tissue. B. Bronchioloalveolar carcinomaHistologically: the welldifferentiated connective tissue, the C. Sarcoidosisbands of fibers lay in different directions, vessels are D. Pulmonary infarction E. Silicosis
  13. 13. test is negative. By which of the following immunologic239. Following a vehicular accident with blood loss leading mechanisms is her disease most likely produced?to prolonged, severe hypotension, a 30yearold man is A. Local immune complex formationintubated and placed on a ventilator. He has progressively B. Interleukin release from macrophagesdecreasing oxygen saturations despite increasing PEEP and C. Binding of antireceptor antibodyFI02 of 100%. He remains afebrile. He dies 3 days later. At D. Mast cell degranulationautopsy, the lungs show diffuse hyaline membranes in E. Crossreactivity with tissue antigensalveoli, thickened alveolar walls, and many alveolarmacrophages but few neutrophils. Which of the following 252. A bee sting is suffered by a 28yearold man, and hispulmonary diseases most likely complicated his course? wife searches frantically for the medical kit with theA. Bronchopneumonia injectible epinephrine. Which of the following immunologicB. Chronic bronchitis mechanisms are they trying to prevent?C. Bronchiectasis A. Local immune complex formationD. Viral pneumonia B. Interleukin release from macrophagesE. Diffuse alveolar damage D. Systemic anaphylaxis C. Binding of antireceptor antibody240. A 66yearold man has had increasing malaise for the E. Complement activationpast year. On physical examination auscultation of the chestreveals a friction rub. Laboratory studies show a serum urea 253. A 9yearold boy has a sore throat. A throat culturenitrogen of 100 mg/dl and creatinine of 9.8 mg/dl. Which of grows group A hemolytic streptococcus. 17 days laterthe following forms of pericarditis is he most likely to develops darkcoloured urine. A renal biopsy washave? performed. On immunofluoresence staining the biopsyA. Fibrinous shows granular deposition of IgG and complement aroundB. Hemorrhagic glomerular capillary loops. Which of the following immuneC. Purulent hypersensitivity mechanisms is most likely responsible forD. Serous this pattern of findings?E. Constrictive A. Type I B. Type II244. A 45yearold man was rushed to the hospital following C. Type IIIthe sudden onset of an episode of crushing substernal chest D. Type IVpain. He receives advanced life support measures. His E. Type Vcourse was marked by intractable cardiogenic shock and hedied 4 days later. At autopsy, a large transmural 254. A 48yearold man has had a chronic cough with feveranterolateral area of coagulative necrosis was found in the for 2 months. On physical examination his temperature isanterolateral wall of the left ventricle. Which of the 37.9 C. A chest radiograph reveals a diffuse bilateralfollowing microscopic findings is most likely to be present? reticulonodular pattern. A transbronchial biopsy isA. Fibroblasts and collagen performed. On microscopic examination of the biopsy thereB. Granulation tissue are focal areas of inflammation containing epithelioidC. Necrotic muscle and neutrophils macrophages, Langhans giant cells, and lymphocytes.D. Granulomatous inflammation These findings are most typical for which of the followingE. Diffuse chronic inflammation immunologic responses? A. Type I hypersensitivity250. A 41yearold man has a history of drinking 1 to 2 liters B. Type II hypersensitivityof whisky per day for the past 20 years. He has had C. Graft versus host diseasenumerous episodes of nausea and vomiting in the past 5 D. Polyclonal Bcell activationyears. He experiences a bout of prolonged vomiting, E. Type IV hypersensitivityfollowed by massive hematemesis. On physicalexamination in the emergency room, he has vital signs with 255. Twelve hours after going on a hike through denseT 36.8 C, P 110, RR 22, and BP 80/40 mm Hg. His heart foliage, a 40yearold man notices a slightly raised and tenderhas a regular rate and rhythm with no murmurs and his irregular reddish rash on one forearm that was not coveredlungs are clear to auscultation. There is no abdominal by clothing. This rash gradually increases in intensity for 2tenderness or distension and bowel sounds are present. His days and then fades after two weeks. Which of thestool is negative for occult blood. Which of the following is following forms of hypersensitivity is most likelythe most likely diagnosis? demonstrated in this patient?A. Esophageal stricture A Type I hypersensitivityB. Esophageal laceration (MalloryWeiss syndrome) B Type II hypersensitivityC. Esophageal pulsion diverticulum C Type III hypersensitivityD. Barrett esophagus (metaplasia with gastric mucosa) D Type IV hypersensitivityE. Esophageal squamous cell carcinoma E. Type V hypersensitivity251. A 45yearold woman has experienced progressive, 256. The examination of ovarium tumor was performed. Onincreasing muscular weakness, particularly toward the end gross inspection of the mass, that was surgically excised,of the day, over the past 2 months. She does not have the surface of the mass is smooth, is not adherent toarthralgias or myalgias. On physical examination her motor surrounding pelvic structure, and is cystic and filled withstrength goes from 5/5 to 4/5 with repetitive movement of hair on sectioning. On microscopic examination there isextremities. A chest CT scan reveals an anterior mediastinal squamous epithelium, tall columnar glandular epithelium,mass. Laboratory studies show that her antinuclear antibody
  14. 14. cartilage, and fibrous connective tissue. Which of the D Increased nuclear/cytoplasmic ratiofollowing neoplasms is she most likely to have? E Expansive type of growthA TeratomaB Choristoma 262. A clinical study of patient with pharyngeal infectionsC Hamartoma is performed. Patient experienced fever and chills. OnD Myxoma physical examination, the most common finding is aE Mesothelioma pharyngeal purulent exudate. Which of the following types of inflammation did these patient most likely have?257. A 44yearold woman who has had multiple sexual A. Acute inflammationpartners for the past 30 years has an abnormal Pap smear B. Granulomatous inflammationwith cytologic changes suggesting human papillomavirus C. Abscess formationinfection. Without treatment, she is most likely to develop D. Resolution of inflammationwhich of the following lesions? E. Chronic inflammationA Squamous cell carcinomaB NonHodgkins lymphoma 263. An empyema is a kind of inflammation as:C Kaposis sarcoma A Purulent inflammationD Adenocarcinoma B Serous inflammationE Leiomyoma C Fibrinous inflammation D Chronic inflammation258. A 41yearold woman has an exophytic 3 cm mass E Granulomatous inflammationinvolving the ectocervix. Pap smear testing is performed;she has never had a previous Pap smear. Cytologic changes 264. A 45yearold man has had a fever and dry cough andthat are seen in Pap smears reveals squamous cell his temperature is 38.5 C during last 3 days. A chestcarcinoma. Her serum glucose is 157 mg/dL. She has been radiograph shows a right pleural effusion. A righta commercial sex worker in the past. Which of the thoracentesis is performed. The fluid obtained has a cloudyfollowing is the most likely risk factor for her cervical appearance with a cell count showing 5500 leukocytes percarcinoma? microliter, 98% of which are neutrophils. Which of theA Human papillomavirus infection following terms best describes his pleural process?B Diabetes mellitus, type II A Purulent inflammationC Heavy cigarette smoking B Serous inflammationD Pelvic inflammatory disease C Fibrinous inflammationE Previous cancer chemotherapy D Chronic inflammation E Granulomatous inflammation259. A 27yearold woman in excellent health has a 2 cmfirm, rounded mass is palpable beneath the skin of the left 278. What type of exudates appears in pericardium cavity atforearm. She has no difficulty using the arm and there is no a rheumatic pericarditis?associated pain with the mass, either in movement or on A. Putrefactivepalpation. The overlying skin appears normal. The mass B. Serousfibrinousdoes not change in size over the next year. Which of the C. Hemorrhagicfollowing neoplasms is she most likely to have? D. PurulentA Lipoma E. CatarrhalB Metastatic carcinomaC Melanoma 284. A 90yearold woman has pneumonia. Two weeks laterD Rhabdomyosarcoma a chest radiograph reveals a 3 cm rounded density in theE Leiomyosarcoma right lower lobe whose liquefied contents form a central airfluid level and has a capsule. Which of the following is260. A 35yearold woman had a firm nodule palpable on the the best description for this outcome of her pneumonia?dome of the uterus six years ago recorded on routine A Abscess formationphysical examination. The nodule has slowly increased in B Hypertrophic scarsize and is now appears to be about twice the size it was C Regenerationwhen first discovered. She remains asymptomatic. Which of D Bronchogenic carcinomathe following neoplasms is she most likely to have? E Progression to chronic inflammationA LeiomyomaB Adenocarcinoma 285. A clinical study is peformed of patients withC Leiomyosarcoma pharyngeal infections. The most typical clinical courseD Hematoma averages 3 days from the time of onset until the patient seesE Metastasis the physician. Most of these patients experienced fever and chills. On physical examination, the most common finding261. A study is performed to analyze characteristics of is a pharyngeal purulent exudate. Which of the followingmalignant neoplasms in biopsy specimens. The biopsies types of inflammation did these patients most likely have?were performed on patients who had palpable mass lesions A Acute inflammationon digital rectal examination. Which of the following B Granulomatous inflammationmicroscopic findings are most likely to indicate that the C Abscess formationneoplasm is malignant? D Resolution of inflammationA Invasion E Chronic inflammationB Tissue pleomorphismC Tissue atypia 286. At 38 yearold woman it is observed upperclavicle
  15. 15. multiplied lymphatic nodules. During biopsy research in the gastritis has experienced weight loss and nausea for the pastlymphatic nodules a metastasis of fingerringcellular cancer 8 months. He does not have vomiting or diarrhea. In theis exposed. What organ cancer most probably did develop antrum of stomach endoscopy reveals an ulcerative massat the patient? with elevated margins. Patient undergoes gastrectomy, andA Cancer of stomach the gross appearance shows ulcerated lesion with necrosisB Cancer of thyroid in the center that has extended below the submucosa, intoC Cancer of lungs the muscularis, and has spread more widely extends intoD Cancer of gullet the muscularis propria and beyond. Identify the type ofE Cancer of uterus lesions: A. Early gastric carcinoma289. A 70yearold male with a long history of chronic B. Advanced gastric carcinomaalcoholism has had increasing difficulty with swallowing C. Duodenum carcinomafor the past 2 months. Upper endoscopy reveals an D. Acute gastric ulcerulcerative midesophageal, 3cm mass that partially occludes E. Chronic gastric ulcerthe esophageal lumen. He undergoes esophagectomy, andthe gross appearance shows ulcerated lesion with heaped up 237. An upper gastrointestinal radiographic series revealsmargins and squamous cell atypia of the esophageal advanced gastric carcinoma in a 53yearold female who hasmucosa. Identify the type of lesions: had nausea, vomiting, and midepigastric pain for severalA. Leiomyosarcoma months. Ultrasound investigation reveals an solid tumorousB. Squamous cell carcinoma enlargements of both ovaries 6x5 cm mass. Identify theC. Dense collagenous scar type of lesions in ovaries:D. Adenocarcinoma A. NonHodgkin lymphomaE. Thrombosed vascular channels B. Cystadenoma of ovaries C. Virchows node230. An upper gastrointestinal radiographic series reveals D. Krukenberg tumorsgastric outlet obstruction in a 53yearold female who has had E. Cystadenocarcima of ovariesnausea, vomiting, and midepigastric pain for severalmonths. Upper endoscopy reveals an ulcerated 3x4 cm 238. A 67yearold male with a history of brain hemorrhagemass at the pylorus. The biopsy was performed. Which of has had an episodes of hematemesis at the hospital duringthe following neoplasms is most likely to be seen on biopsy past 2 weeks after hemorrhage. In the mucous shell of theof this mass? stomach body endoscopy reveals an ulcer 2.5cm inA. NonHodgkin lymphoma diameter, round form, with a brown base. Identify the typeB. Neuroendocrine carcinoma of ulcer:C. Squamous cell carcinoma A. CurlingsD. Adenocarcinoma B. VirchowsE. Leiomyosarcoma C. Chronic D. Cushings231. A 67yearold male with a long history of Barrett E. Krukenberg’sesophagus has had increasing difficulty with swallowing forthe past 2 months. In the lower third part of the esophagus 240. During autopsy it was found out croupous pneumoniaupper endoscopy reveals an ulcerative esophageal mass that in lower lobe of the left lung and about 500ml ofpartially occludes the esophageal lumen. Patient undergoes greenishyellow fluid in the pleural cavity. Microscopicallyesophagectomy, and the gross appearance shows ulcerated pleural liquid contained many neutrophils. Identify thelesion with necrosis in the center. Identify the type of complication of pneumonia:lesions: A. HemothoraxA. Leiomyosarcoma B. Fibrinous pleuritisB. Squamous cell carcinoma C. PneumothoraxC. Dense collagenous scar D. HydrothoraxD. Adenocarcinoma E. Empyema of pleuraE. Thrombosed vascular channels 241. 56yearold patient has suffered from rightside235. A barium swallow is performed in a 44yearold female lowerlobar pneumonia with expectoration of mucus withwho has had nausea and vomiting for months. It is known pus. During autopsy in 910 segments of the right lung thethat she had a stomach ulcer for many years. cavity with dense walls filled with purulent masses, wasRadiographically, there is marked dilation of the stomach found. The whitish path comes from the cavity toward thewith "beaking" in the distal portion where marked luminal radix of the lung. Microscopically it was established thatnarrowing exists. A biopsy of the antrum shows ulcer the cavity is separated from notchanged lung tissue withformation with elevated margins and prominent submucosal thin membrane, which consists of two layers:fibrosis without inflammation, epithelium cell atypism. The internalgranulation tissue, and external – connective tissue.most likely cause for these findings is What diagnosis is more probable?A. Chronic duodenum ulcer A. Chronic abscessB. Chronic gastric ulcer B. Pulmonary gangreneC. Acute gastric ulcer C. Acute pulmonary abscessD. Gastric carcinoma D. Chronic pneumoniaE. Duodenum carcinoma E. Bronchoectatic disease236. A 72yearold male with a long history of chronic

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