MINISTRY OF PUBLIC HEALTH OF UKRAINE

Government Institution

‘Lugansk State Medical University’

Department of Pathomorphology,

Forensic Pathology and Medical Legislation

Case studies in Pathomorphology.

Self assessment textbook.

KROK – 1 (STEP – 1)

Part - 2

Lugansk, 2012

Compilers:

O.S. Reshetnikova

O.V.Teleshova

O.V.Kononenko

I.N.Goryanikova

A.P Sysoenko

O.V.Zinchenko

The methodical manual discussed and accepted at session of the academic Council of Lugansk State Medical University 05.10.07, report N 10

Рекомендовано Центральним методичним кабінетом з вищої медичної освіти МОЗ України як навчально-методичний посібник для студентів вищих медичних навчальних закладів IV рівня акредитації (протокол № 2 від 19.03 2010р.)

All rights reserved. No part of this publication may be reproduced, stored in retrieved system, copied or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without written permission from the author.

Contents

ATHEROSCLEROSIS 4

HYPERTENSION 6

ISCHEMIC HEART DISEASE 8

RHEUMATIC DISEASES 12

THE RESPIRATORY SYSTEM DISEASES 18

DISEASES OF ALIMENTARY SYSTEM 28

DISEASES OF THE LIVER 32

DISEASES OF THE URINARY SYSTEM 36

ENDOCRINE SYSTEM DISORDERS 45

PATHOLOGY OF PREGNANCY 51

DISEASES OF THE REPRODUCTIVE SYSTEM 52

PERINATAL PATHOLOGY 56

GAMETOPATHY 56

AVITAMINOSIS 56

INFECTION DISEASES 57

CHILDHOOD INFECTION 61

BACTERIAL INFECTIONS 68

TUBERCULOSIS 78

SYPHILIS 89

SEPSIS 91

Disease of the nervous system 94

DISEASE OF AN OSTEOMUSCULAR SYSTEM 95

MYCOSISES 98

Atherosclerosis

1. A 46-year-old male suddenly died after developing a heart failure. An autopsy revealed in abdominal aorta the yellow color areas, which did not rise over its surface. Histological investigation of aorta showed the aggregations of cells with a foamy cytoplasm among smooth mussels and macrophages. These cells had a motley-orange coloring, when stained by a Sudan Ш. For what stage of an atherosclerosis such picture is characteristic?

А. *Lipoidosis

B. Liposclerosis

C. Atheromatosis

D. Ulceration

E. Atherocalcification

2. A post-mortem of an elderly male revealed microscopic alteration of his coronary artery. There was narrowing of vessel’s lumen due to a fibrous plaque with some admixture of lipids. Name the stage of atherosclerosis:

A. *Liposclerosis

B. Lipoidosis

C. Pre-lipoidosis

D. Atheromatosis

E. Atherocalcification

3. At autopsy of 63-year-old male revealed an atherosclerosis of the brain’s arteries and a thrombosis of the internal carotid artery’s branch. Gross investigation showed a focus of moist softening in his brain’s tissue. Define the pathological process in the brain.

A. * Ischemic infarction

B. Hemorrhagic infiltration

C. Hematoma

D. Encephalitis

E. Tumour of the brain.

4. At autopsy of an elderly female an aorta tissue sample collected for histology. Microscopic investigation revealed in aorta’s intima the accumulation of xanthoma’s cells. At what disease such morphological picture is possible?

A. *Atherosclerosis

B. Hypertension

C. Syphilitic mesaortitis

D. Nonspecific aortoarteritis

E. Nodular periarteritis

5. A 54-year-old male died after developing a heart failure. An autopsy revealed a chronic venous hyperemia of the internal organs, hypertrophy of the left ventricle of a heart and focal cardiosclerosis. Gross investigation of aorta showed yellow-white plaques in the intima with fine-grained masses in their centers, which infiltrated the aortal wall. Give the name of this pathological process.

A. *Atheromatosis

B. Lipoidosis

C. Liposclerosis

D. Arteriolosclerosis

E. Calcinosis.

6. A 66-year-old male suddenly died on his way to operation room. An autopsy revealed a hemorrhage into retroperitoneal fat, a saccular dilatation of the abdominal aorta wall with rupture in arterial wall. The aorta’s defect had uneven edges and stony hardening of surrounding tissues. Name the most likely disease, resulted in described complication?

A. * Atherosclerosis

B. Hypertension

C. Systemic vasculitis

D. Visceral Syphilis

E.

7. At autopsy of 52-year-old male revealed yellowish areas at his aorta’s intima, this did not bulge above its surface. Histological investigation showed the accumulation of cells with foamy cytoplasm, stained by Sudan III in yellow color. Name the most likely stage of atherosclerosis in aorta?

A. *Lipidosis

B. Liposclerosis

C. Atheromatosis

D. Pre-lipoidosis

E. Atherocalcification

8. A post-mortem of a 65-year-old male revealed yellowish streaks and spots in the abdominal aorta’s intima, which did not rise above endothelial surface. These areas were stained by Sudan III in orange color. What stage of atherosclerosis such changes are characteristic for?

A. *Lipidosis

B. Liposclerosis

C. Atheromatosis

D. Ulceration

E. Atherocalcification

9. A 53-year-old female died from acute myocardial infarction. An autopsy revealed multiple whitish dense plaques in her coronal arteries’ intimae, which bulged in and narrowed the vessel’s lumen. Name the most likely stage of a coronary atherosclerosis?

А. * Liposclerosis

B. Lipoidosis

C. Atheromatosis

D. Atherocalcification

E. Ulceration

10. A 45-year-old male died in a traffic accident. A histological investigation of his aorta revealed a lipid infiltration of its intima with fats accumulation in myocytes and macrophages of aortal medial layer. Name the stage of atherosclerosis?

A. *Lipoidosis

B. Liposclerosis

C. Atheromatosis

D. Pre-lipoidosis

E. Atherocalcification