Connective tissue’s (mesenchymal) dystrophy

1. A 56 year old female has been ill with chronic fibrocavernous tuberculosis of the lungs for the past 20 years. She entered the nephrology department with an uremia syndrome. A test for the presence of amyloid in kidneys was positive. Which form of amyloid is indicated in this case?

A. *Secondary

B. Primary

C. Localized

D. Familial congenital

E. Senile

2. The dissection of a 49 year old male reveals a deformed mitral valve, which is thickened and does not completely close. Microscopically the foci of the collagen fibers are eosinophilic and give a positive reaction on a fibrin test? The most credible explanation is:

A. *Fibrinoid swelling

B. Fibrinoid inflammation

C. Mucoid swelling

D. Hyalinosis

E. Amyloidosis

3. A 56 year old patient with a six year history of peritonitis has died. During dissection the capsule of the liver and the spleen was markedly thickened in places and was noted as being dense and semi-lucent. The most credible explanation for this is:

A. *Hyalinosis

B. Necrosis

C. Mucoid swelling

D. Fibrinoid swelling

E. Amyloidosis

4. The dissection of a 48 year old patient who suffered with rheumatoid arthritis reveals an enlarged, dense spleen. A spleen’s section demonstrates its brown-reddish color with enlarged follicles which have the appearance of semi-lucent, grayish-white corns. What is the name of these lesions in the spleen?

A. * Sago-like spleen.

B. Glazed spleen.

C. Sebaceous spleen.

D. Hyalinosis of spleen.

E. Porphyry spleen.

5. During the post-mortem performed on a 72 year old man there are noted some diminished areas of the spleen with a pinkish color. Microscopic examination revealed that the follicles are diminished in volume and the walls of the arterioles and trabeculas are thickened as well as containing homogeneous eosinophilic, PAS-positive masses. Staining with picrofuksin dye reveals the masses to be a red color. These changes indicate the presence of:

A. *Hyalinosis

B. Amyloidosis

C. Mucoid swelling

D. Fibrinoid swelling

E. Sclerosis

6. A 52 year old male died from a heart attack. At the time of dissection a symmetric type of severe obesity discovered. The rupture of the right ventriculum wall resulted in hemopericardium. Under epicardium an excessive fat tissue formation discovered. A microscopy of the sample showed the excecive growth of fatty tissue accompanied with atrophy of myocardial fibers. Which pathological process is most likely responsible for the patient’s death?

A. * Simple obesity of the heart.

B. Fatty dystrophy of myocardium.

C. Ischemic heart disease.

D. Hypertension

E. Acute myocardium infarct

7. During dissection of a 65 year old patient, who suffered from a fibrous-cavernous tuberculosis, an enlarged, dense spleen was found. Spleen section grossly had brown-pinkish color, smooth, waxy-like surface. Which pathological process listed below is the most credible?

A. * Sebaceous spleen.

B. Glazed spleen.

C. Porphyry spleen.

D. Sago spleen.

E. Cyanotic induration

8. A post mortem performed on a 50 year old male who died of a heart attack indicated a symmetric type of obesity of the III degree with rupture of the walls of the right ventricle and hemopericardium. Under the epicardium surplus deposits of fat were found. Microscopically, fatty tissue from the epicardium was dispersed in the myocardium with an atrophy of the muscle fibers. Which process listed below is the most reliable?

A. *Obesity the heart.

B. Fatty dystrophy of myocardium.

C. Acute infarct of myocardium.

D. Ischemic heart disease.

E. Hypertension.

9. An autopsy of a 45-year-old female revealed the kidneys were dense, yellow in color and appear to have a greasy brilliance. Which pathological process is most likely?

A. *Amyloidosis

B. Hyalinosis

C. Fatty dystrophy

D. Mucoid swelling

E. Hemochromatosis

10. Macroscopic examination of a stomach delivered from surgery, revealed a round lesion 1.5cm in diameter which extended by the muscle layer at the antral zone of a small curvature. A semilucent dense area on the bottom of the defect was also determined. It resembled hyaline cartilage. Which process developed in the bottom of the stomach lesion?

A. *Localized hyalinosis

B. Amyloidosis

C. Mucoid swelling

D. Fibrinoid changes

E. Generalized hyalinosis

11. A skin biopsy of a patient with allergic vasculitis was submitted for examination. It is discovered that the vessel walls were thickened and homogeneous. Picrofuxin stained a tissues a yellow color. They were Shiff-positive. Which pathological process developed in the walls of the vessels?

A. *Fibrinoid swelling

B. Amyloidosis

C. Mucoid swelling

D. Hyalinosis

E. Lipidosis

12. The post-mortem of a patient revealed feature of chronic kidney insufficiency. Grossly, kidneys were enlarged, dense, wax-like, with foci of irregular depressed scars on their surface. Microscopically, the mesangeal areas were expanded and the glomerular capillaries obstructed by Congo red stain-positive amorphous acellular material. In some sections the deposits took on nodular appearance. Which of the following diagnoses is most reliable?

A. *Amyloidosis of the kidneys (Amyloid nephropathy)

B. Acute glomerulonephritis

C. Chronic glomerulonephritis

D. Subacute glomerulonephritis

E. Lipoid nephrosis

13. At autopsy a 76-year-old male, with a history of peritonitis 10 years ago, is found to have thickened and dense both liver and spleen capsules. They were translucent on a sectional view. What is the most likely pathology of the described organs capsules?

A. *Hyalinosis.

B. Necrosis.

C. Mucoid swelling.

D. Fibrinoid swelling.

E. Amyloidosis.

14. A 55-year-old female, with a long history of rheumatoid arthritis, develops renal failure and dies. An autopsy revealed an enlarged solid spleen. On the sectional view, its tissue had brown-reddish coloring with enlarged follicles that look like translucent grayish-white grains. What is the most likely pathological process?

A. *Sago spleen.

B. Frosted spleen.

C. Lardaceous spleen.

D. Spleen hyalinosis.

E. Porphyry spleen.

15. A 66-year-old female, with a long history of post-traumatic osteomyelitis, is admitted to the hospital for treatment of nephrotic syndrome. On the night pf admission she suddenly dies. Autopsy revealed dense, white kidneys with scars in the cortical layer; they had a sebaceous glow on the cut surface. What is the most likely kidneys pathology?

A. *Secondary amyloidosis.

B. Primary amyloidosis.

С. Idiopathic amyloidosis.

D. Chronic glomerulonephritis.

E. Chronic pyelonephritis.

16. A 55-year-old man, with a long history of a symmetrical type of severe obesity, developed acute heart insufficiency followed with lethal outcome. An autopsy revealed right ventricle wall burst with hemopericardium and excessive amount of fatty tissue under epicardium. Microscopically: adipose tissue from epicardium penetrates myocardium with muscle fibers atrophy. Name the pathological process?

A. *Simple fatty heart.

B. Fatty degeneration of myocardium.

C. Ischemic disease.

D. Essential hypertension.

E. Acute myocardial infarction.

17. An autopsy of a 56-year-old man with cavernous tuberculosis of the lungs revealed enlarged dense spleen. The cut surface of the spleen tissue had brown-red, smooth, and wax-like appearance. Which of the following is the most likely pathology in the spleen?

A. * Lardaceous spleen. .

B. Glaze spleen.

C. Porphyric spleen.

D. Sago spleen.

E. Cyanotic induration.

18. A patient had been suffering from bronchoectases for a long time and died of uremia. Autopsy revealed enlarged, dense kidneys with greasy cut surfaces. Which of the following was the most likely disease?

A. *Renal amyloidosis.

B. Glomerulonephritis.

C. Acute tubular necrosis.

D. Pyelonephritis.

E. Nephosclerosis