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479904 The autopsy of the patient with 25-year history of disease has demonstrated that the cusps of the mitral valve are fissed, the atrioventricular orifice is narrowed. There is free fluid in the abdominal and pleural cavities; the veins of the abdomen and esophagus are widened. There is also «nutmeg» liver, brown induration of the lungs, venous plethora of the inner organs. Which diagnosis is more possible
**Rheumatic disease
Systemic lupus erythematosus
Rheumatic disease
Septic endocarditis
Glomerulonephritis
Atherosclerosis
479905 In 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 semitransparent grayish-whitish grains. What pathological process is the most likely?
**Sago spleen
Glaze spleen
Hyaline spleen
Sago spleen
Porphyric spleen
Waxy spleen
479906 Histology study of biopsy material from the heart auricle of the patient with rheumatism revealed foci of mucoid swelling, fibrinoid necrosis of connective tissue. What immune reaction developed in the tissue of heart auricle?
**Immediate hypersensitivity reaction
Immediate hypersensitivity reaction
Delayed hypersensitivity reaction
Rejection reaction
Sclerosis
Exudative reaction
479907 The 7-year-old child died from progressing rheumatism with the expressed allergic reactions. In autopsy edemic mitral valve, hystologically is fibrinous swelling. Hyperemia of myocardium, diffuse infiltration by lymphocytes takes place. Pericardium is thickened, grayish color. The described changes in heart it is possible estimate as:
**Pancarditis
Endocarditis
Myocarditis
Pancarditis
Pericarditis
Cardiosclerosis
479908 In the 30-year-old woman it was found: cough, sputum with blood, fever, increased blood pressure, decreased urine output, edema of low extremities. All symptoms have developed for 6 weeks. Diagnostic renal biopsy showed Goodpasture’s syndrome. Which pathologic process is characteristic for this syndrome?
**Autoantibodies to basement membrane of the lungs and kidneys
Autoantibodies to mitochondrias of the lungs and kidneys
Autoantibodies to DNA
Cytotoxic reaction against epithelium of renal tubules
Autoantibodies to basement membrane of the lungs and kidneys
Appearance of immune complexes in glomeruli of kidneys and lungs
479909 A 40-year-old woman suffered from rheumatic heart disease. Last years manifestations of chronic cardiac insufficiency were observed. She has complaints: a breathlessness, increase in an abdomen, edema of legs, the increased liver is palpated. It is diagnosed mitral stenosis. The patient has died because of the chronic cardiac insufficiency. What histologic changes of the mitral valve can be found out?
**Sclerosis, hyalinosis, petrification, union of the valve leaflets
Purulent inflammation
Fibrinous inflammation
Sclerosis, hyalinosis, petrification, union of the valve leaflets
Necrosis
Edema
479910 A 45-year-old patient has died because of uremia in a systemic lupus erythematosus. Formation of what antigens is most probable in the mechanism of development of this disease?
**To native DNA
To myocytes
To a myosin
To endothelial cells
To native DNA
Of the rheumatoid factor
479911 Systemic lupus erythematosus is characterized by all features, except one:
**Antigen of hepatitis B virus is found very often
Artralgia and arthrosis
Antigen of hepatitis B virus is found very often
Skin injury – erythema (butterfly)
Endocarditis so-called Libman-Sacks
Glomerulonephritis
479912 Which disease is not the systemic disease of connective tissue?
**Sarcoidosis
Sarcoidosis
Rheumatoid arthritis
Scleroderma
Rheumatic fever
Systemic lupus erythrematosus
479913 Red-brownish stains are found on the symmetrical parts of both cheeks in the result of autopsy of 45 year dead woman. Heart is increased, leaflets of aortic valve are condensed and thickened, have thrombotic masses on its surface. Kidneys are increased. Medulla is duck red, cortex is gray-brownish with red half-transparent points. Histologically: “hemathoxilin bodies” are found in the nucleus of ductal epithelium; thickening of basal membranes of glomerular capillaries, which look like “wire-loops”, several places in capillaries have hyaline thrombus and focuses of fibrinoid necrosis. Which diagnosis is more possible?
**Systemic lupus erythematosus
Rheumatic heart disease
Septic endocarditis
Systemic lupus erythematosus
Glomerulonephritis
Atherosclerosis
479914 Death of the patients in early stages of rheumatic fever because of acute cardiac insufficiency is connected with one of the following manifestations of the rheumatic fever:
**Myocarditis
Pericarditis
Endocarditis
Septic endocarditis
Myocarditis
Cardiosclerosis
479915 Please, choose the rare localization of heart infarction.
**Right atrium
Intraventrical septum
Cor apex
Front wall of left ventricle
Lateral wall of left ventricle
Right atrium
479916 A 45-year-old man was rushed to the hospital following the sudden onset of an episode of crushing substernal chest pain. He receives advanced life support measures. His course was marked by intractable cardiogenic shock and he died 4 days later. At autopsy, a large transmural anterolateral area of coagulative necrosis was found in the anterolateral wall of the left ventricle. Which of the following microscopic findings is most likely to be present?
**Necrotic muscle and neutrophils
Fibroblasts and collagen
Granulation tissue
Necrotic muscle and neutrophils
Granulomatous inflammation
Diffuse chronic inflammation
479917 A 63-year-old man has had increasing exercise intolerance for the past 5 years. Laboratory studies have shown fasting blood glucose measurements from 145 to 210 mg/dL for the past 25 years, but he has not sought medical treatment. Which of the following is most likely to be the immediate cause of death in this man?
**Myocardial infarction
Myocardial infarction
Nodular glomerulosclerosis
Cerebral hemorrhage
Hyperosmolar coma
Right lower leg gangrene
479918 A 53-year-old man has experienced severe chest pain for the past 6 hours. On physical examination he is afebrile, but has tachycardia. Laboratory studies show a serum troponin I of 10 ng/mL. A coronary angiogram is performed emergently and reveals >90% occlusion of the left anterior descending artery. In this setting, an irreversible injury to myocardial fibers will have occurred when which of the following cellular changes occurs?
**Nuclei undergo karyorrhexis
Glycogen stores are depleted
Cytoplasmic sodium increases
Intracellular pH diminishes
Nuclei undergo karyorrhexis
Blebs form on cell membranes
479919 The 67-year-old patient had repeated myocardial infarction and died because of developed cardio-vascular insufficiency. What macroscopical changes can be found in the liver?
**“Nutmeg” liver
“Goose” liver
“Nutmeg” liver
Large, red and soft liver
Diminished dense liver with macronodular surface
Large dense, cyanotic liver
479920 The patient, aged 74, with the history of hypertensive syndrome, lost consciousness suddenly and died of increasing disturbance of respiration and heart activity. The autopsy has demonstrated a dark-red focus in the trunk of the brain measuring 2x1x5 cm. The weight of the heart is 550 g. the thickness of left ventricle wall is 2,5 cm. The vessels of the brain base are considerably thickened, whitish-yellow, the lumen is narrowed. What is the diagnosis?
**Hypertensive disease
Hypertensive disease
Ischemic heart disease
Glomerulonephritis
Atherosclerosis
Chronic bronchitis
479921 A woman who was sick with rubella during the pregnancy gave birth to a dead child with hare lip and cleft palate. This congenital defect is an example of:
**Patau's syndrome
Down's syndrome
Edward's syndrome
Genocopy
Patau's syndrome
Phenocopy
479922 A 40-year-old pregnant woman underwent amniocentesis. The examination of fetus karyotype revealed 47XY+21. What pathology of the fetus was found out?
**Schereschevsky-Terner's disease
Phenylketonuria
Patau's disease
Klinefelter's syndrome
Down's syndrome
Schereschevsky-Terner's disease
479923 The Respiratory Distress Syndrome often takes place in immature newborns. What is the most probable cause of this syndrome?
**Immaturity of alveolar-parenchyma connected with deficiency of surfactant
Immaturity of alveolar-parenchyma connected with deficiency of surfactant
Aspiration of amniotic fluid
Intrauterine asphyxia
Imperfection of nervous regulation of respiration
Intrauterine hypercapnia
479924 Autopsy of the newborn showed jaundice of the skin, signs of the bilirubin encephalopathy in the brain substance, bilirubin infarctions in the kidneys, enlarged liver and spleen. His mother is Rh-negative. The child died on the third day after birth. What is your diagnosis?
**Hemolytic disease of newborn
Birth injury
Hemolytic disease of newborn
Pneumonia in newborn
Respiratory distress syndrome of newborn
Edematous hemorrhagic syndrome
479925 In microscopic examination of a 2-day-old pre-term-newborn it was found out: diffuse edema and numerous hemorrhages in the lungs, pulmonary capillaries overfull by blood. What is the probable diagnosis?
**Edematous-hemorrhagic syndrome
Edematous-hemorrhagic syndrome
Hemolytic disease of newborn
Birth injury
Pneumonia in newborn
Respiratory distress syndrome of newborn
479926 The 30-year-old patient with transplanted kidney has received prolonged immunosupressive therapy and he has died because of intoxication. Microscopic examination showed giant cells with large nuclei encircled by rings-like brightening, which looked as “owl-eye”, located in the kidneys, liver, pancreas, lungs. Call this disease.
**Cytomegalovirus infection
Tuberculosis
Syphilis
Leprosy
Bubonic plaque
Cytomegalovirus infection
479927 The farmer acutely was ill and died because of severe intoxication. In the autopsy it was established: meninges had dark red colour, edema (“cardinal’s cap”), increased spleen of dark-cherry colour, scraping of a pulp copious. Microscopic investigation: serous- hemorrhagic inflammation in meninges, tissue of brain with edema, multiple hemorrhages. Described morphological changes are characteristic for:
**Anthrax
Tularemia
Anthrax
Brucellosis
Pest
Cholera
479928 A 36-year-old farmer had been suffering from unknown disease for 3,5 months. Microscopical investigation: there were granulomas in internal organs consisting of epithelioid, Langhans giant- cells, plasma cells, eosinophils. In granulomas there are a lot of vessels with features of productive-destructive vasculitis. Diagnose this disease
**Brucellosis
Malignant anthrax
Tuberculosis
Brucellosis
Classical typhus
Leprosy
479929 The examination of the child with measles showed the non-clear border edematous fluctuated areas of red-black color in the soft tissues of the cheeks and perineum. What complication did develop in the child?
**Wet gangrene (noma)
Dry gangrene
Gas gangrene
Bedsore
Wet gangrene (noma)
Trophic ulcer
479930 The 3-year-old boy has had pain in the throat. During the examination it was found: red pharynx and edematous inflammated tonsils, “raspberry” tongue, increased submandibular lymph nodes, small-spots erythematous rash on the skin. Diagnose this disease.
**Scarlet fever
Scarlet fever
Measles
Influenza
Pertussis
Diphtheria
479931 A.C. is a four-year-old girl who is referred to hospital by her family doctor. She has presented with catarrhal inflammation in the mucous membrane of the mouth, trachea, bronchi, and conjunctiva. The mucous membrane is swollen, plethoric; the mucous secretion is increased, which is accompanied by rhinitis, cough, lacrimation. Enanthema is noted on the mucous membrane of the cheeks against the lesser lower molars. It looks like whitish spots called Belsky-Filatov-Koplik’s spots, which develop before the eruption on the skin. What diagnosis is most probable?
**Measles
Mumps
Infectious mononucleosis
Diphtheria
Scarlet fever
Measles
479932 A 10-years-old girl has died after acute disease with the following clinical symptoms: high temperature, headache, meningococcus has been found out in blood and liquor. In autopsy the pathologist has found out yellowish- white “cap” on the hemispheres of the brain with hyperemia. Microscopically: exudate in meninges contains fibrin, neutrophils. Call this disease.
**Meningococcal meningitis
Measles
Infectious mononucleosis
Diphtheria
Meningococcal meningitis
Scarlet fever
479933 In autopsy of the man, which has died on 5th day after beginning of the typhoid fever, the following changes were detected: the Payer’s patches of the ileum were enlarged, hyperemic and formed plateau-like elevations with a numerous sulci and furrows above the surface of the mucous membrane. Histologically: hyperemia and edema of the tissue, presence of the large cells with a pale cytoplasm, which contain the microorganisms. What stage of typhoid fever do such local changes characterize?
**Stage of cerebriform swelling
Stage of a necrosis
Stage of formation of ulcers
Stage of cerebriform swelling
Stage of clean ulcers
Stage of healing
479934 During the autopsy in the sigmoid and rectum the multiple red ulcers of different shapes were found out. The mucous membrane coated by dirty-grayish film between them. Call the most probable etiology of this disease:
**Shigella
Shigella
Ameba
Micobacterium of tuberculosis
Salmonella
Staphylococcus
479935 A 30-year-old patient with bacteriologically proved dysentery developed the signs of paraproctitis. What is the stage of local changes of this patient?
**Fibrinous colitis
Healing of the ulcers stage
Fibrinous colitis
Catarrhal colitis
Ulceration stage
Follicular colitis
479936 A patient died 3 days after the operation because of perforated colon with the manifestations of diffuse purulent peritonitis. The autopsy demonstrated: colon mucous membrane was thickened and covered with a fibrin film, isolated ulcers penetrated into different depth. Results of histology: mucous membrane necrosis, leukocytic infiltration with hemorrhages foci. The complication of what disease caused the patient’s death?
**Dysentery
Dysentery
Nonspecific ulcerative colitis
Amebiasis
Crohn’s disease
Typhoid
479937 Patient has suffered from cholera. Clinical dates are dehydratating, cyanosis and convulsions. In the result of massive infusion therapy the exicosis has been diminished, but anuria has been remained. Patient has dead because of uremia. What morphological features in kidney have been found out?
**Necrotic nephrosis with cortical necrosis takes place in the kidneys
Necrotic nephrosis with cortical necrosis takes place in the kidneys
Choleric typhoid is developed
Development of uremia is connected with acute glomerulonephritis
Fibrinous colitis is found in autopsy
Exicosis is due to action of virus exotoxin
479938 The 48-year-old patient, suffered from fibrous-cavernous tuberculosis, has complained of weakness, reduction of daily secretion of urine, edema of the body and extremities and increasing of blood pressure to 180/90. The increasing of protein, presence of hyaline and grain cylinders and erythrocytes were found in urine. The patient has died in a month because of the insufficiency of kidney. In autopsy the enlargement of the heart and "lardaceous" kidneys with weight more than 240 g were found. What is the complication of fibrous-cavernous tuberculosis?
**Amyloidosis
Nephrotic syndrome
Amyloidosis
Glomerulonephritis
Pyelonephritis
Nephrosclerosis
479939 In autopsy of the 72 year-old man, which has died because of a myocardial infarction, increasing and deformation of a right knee joint were detected. Histologic examination of tissues of the joint and adjoining areas showed the massive foci of caseous necrosis and multiple epithelioid-cell granulomas; in the tissues around of the joint there were signs of exudative inflammation. Diagnose described process.
**Tuberculous arthritis
Syphilitic arthritis
Tuberculous arthritis
Rheumatic arthritis
Gonorrheal arthritis
Deforming osteoarthrosis
479940 In autopsy of the 63-year-old man multiple pathological cavities in both lungs were found out. Microscopically: there were the necrotic masses diffusely infiltrated by neutrophils in the internal layer of the cavity’s wall; in the middle layer – the infiltrates containing epithelioid cells, lymphocytes and multinuclear giant cells; the external layer consists of a mature connective tissue. Diagnose the form of secondary tuberculosis.
**Fibrous-cavernous
Acute focal
Fibrous-focal
Fibrous-cavernous
Acute cavernous
Cirrhotic tuberculosis
479941 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 thromboembolism?
**Septic bacterial endocarditis
Rheumatic thromboendocarditis
Septic bacterial endocarditis
Septicemia
Septicopyemia
Acute rheumatic valvulitis
479942 During the microscopic examination of bioptic fragment of the skin the granulomas containing epithelioid cells, surrounded with T-lymphocytes were found out. Between the epithelioid cells the solitary giant polynuclear Langhan’s cells located. There were areas of caseous necrosis in the center of some granulomas. Blood vessels were absent. What disease do such changes characterize?
**Tuberculosis
Tuberculosis
Syphilis
Leprosy
Rhinoscleroma
Hodgkin’s disease
479943 In 2 days after a criminal abortion the female patient’s temperature elevated up to 40 °C, she was semiconscious, and there were numerous hemorrhages in her skin. She died three days later. What type of sepsis according to its entrance gate was there?
**Urosepsis
Septicopyemia
Lung sepsis
Chroniosepsis
Urosepsis
Septicemia
479944 In the autopsy of 48-year-old man [miner which got hematite] the pathologist has found out increased brown-red dense lungs. Microscopic picture is: a moderate pneumosclerosis, submiliary and miliary nodules, which consist of dust cells with spots (positive reaction to iron). In lymph nodes there are a lot of dust and considerable diffuse sclerosis. Which professional disease is it?
**Red siderosis
Black siderosis
Aluminosis
Berilliosis
Red siderosis
Anthracosis
479945 In 53 year-old patient, who has suffered by bronchoectatic disease and hemoptysis, the edema of face and waist have appeared. The protein (33 mg/l) was found in urine. Pulmonary hemorrhage was the cause of patient’s death. In autopsy: enlargement of kidneys was found; the kidneys were dense with lardaceous surface of section. Histologically: the deposition of homogenous eosinophilic masses colored with Congo red and given of metachromasia with methyl-violet color in glomeruli and canals were found. What pathological process took place in the patient?
**Amyloidosis
Amyloidosis
Fatty degeneration
Mucoid degeneration
Grainish degeneration
Hyalinosis
479946 The autopsy of the man's body, that was working for a long time as a miner and died beacuse of chronic pulmonary-cardiac insufficiency, revealed that lungs were not in their fulvolume, significantly thickened, sclerotic, the apexis were emphysematously changed, the surface was gray-black in colour, on section the lung tissue was aspid-black in colour. What disease caused the death?
**Anthracosis
Silicosis
Asbestosis
Aluminosis
Talcosis
Anthracosis
479947 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 probable?
**Metaplasia
Metaplasia
Necrosis of the epithelium
Squamous cancer
Hyperplasia of the epithelium
Leucoplacia
479948 Choose a kind of chronic gastritis, characterized by transformation of epithelium
**Gastritis with intestinal metaplasia
Antral gastritis
Superficial gastritis
Gastritis with intestinal metaplasia
Fundal gastritis
Profound gastritis
479949 The patient, who suffered from ulcer of the stomach, had gastric bleeding. Which is the most probable mechanism of the vascular wall damage?
**Erosion
Edema
Rupture
Spasm
Erosion
Increased permeability
479950 In biopsy of the liver of a 40-year-old man, who received injections of narcotics the pathologist has found out acidophilic Councilmen’s bodies, lymphocytes and macrophages surrounding portal tracts, "ground-glass” hepatocytes (an etiology of disease is virus B). Name this disease
**Virus hepatitis B
Virus hepatitis B
Tuberculosis
Virus chirrosis
Parasitogenic hepatitis
Steatosis
479951 The 41-year-old woman was admitted into the hospital with complaints of a pain in the epigastrium during 2-2,5 hours after meal. From anamnesis it’s known about alimentary intolerance to fish and eggs. At the FGDS with histologic examination the chronic ulcer of a bulbus of a duodenum was detected. There were positive reaction to ureasa. What the main mechanism of development of this disease is most probable?
**Helicobacterium infection
Production of autoantibodies
Helicobacterium infection
Intestinal infection
Decrease of synthesis of prostaglandins
Alimentary allergy
479952 A patient of infection department complained on weakness, absence of appetite, increased temperature (38 °C). On the day, he developed acute pain in the right hypochondrium and yellow skin. Microscopy of the biopsy material has demonstrated disturbances in the beam structure, hydropic and balloon dystrophy in the hepatocytes, necrosis, Councilmen’s bodies in some of them, increased amount of polynuclear hepatocytes on the periphery of the lobules. What form of viral hepatitis is the most probable?
**Acute hepatitis
Carrier state
Acute hepatitis
Chronic hepatitis
Fulminant hepatitis
Incubation period
479953 Liver’s biopsy of a man aged 31 who had chronic hepatitis demonstrated dilated bile ducts and capillaries, they were overfilled with bile with necrosis of adjacent hepatocytes, marked periportal sclerosis with periductal lymphocytic infiltration. The liver beams were discomplected. The structure of the liver was reformed with considerable development of connective tissue. What diagnosis is the most probable?
**Biliary cirrhoses
Postnecrotic cirrhoses
Persistent chronic hepatitis
Biliary cirrhoses
Toxic degeneration of the liver
Steatosis
479954 A 22year-old patient was ill with a virus hepatitis B 2 years ago is hospitalized in clinic with the complaints to pain in the right hypochondrium, dyspepsia, loss of weight. In a biopsy of the liver tissue the pathologist found out: irreversible intracellular changes, which were characterized the transferred virus hepatitis B. Call this changes
**Councilmen bodies
Hydropic dystrophy of hepatocytes
Mucoid swelling
Intracellular obesity
Councilmen bodies
Intracellular glycogen accumulation in hepatocytes
479955 A 12-year-old child has developed nephritic syndrome (proteinuria, hematuria, cylindruria) after angina of 2 weeks ago. In a biopsy of kidney it was established: diffuse proliferation of endothelial and mesangial, epithelial cells in glomeruli, infiltration with leukocytes, both neutrophils and monocytes, interstitial edema. Described changes are characteristic for…
**Acute poststreptococcal glomerulonephritis
Acute poststreptococcal glomerulonephritis
Crescentic glomerulonephritis
Membranous glomerulonephritis
Chronic glomerulonephritis
Acute necrotic nephrosis
479956 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?
**Polycystic kidney
Necrotic nephrosis
Infarction
Polycystic kidney
Glomerulonephritis
Pyelonephritis
479957 A.B. is a 13-year-old girl who is brought by her parents because she had become lethargic and her face appeared swollen, particularly around her eyes. On enquiry, she had recently recovered from a flu-like illness. As part of routine examination, her urine is tested with a dipstick and is found that to contain both protein and blood. She is also noted to have a mildly raised blood pressure. The patient is referred to hospital where she is found to have raised urea and creatinine together with a reduced urine output. Renal biopsy is performed. The histology report reveals hypercellularity of glomeruli with neutrophils in capillary lumens. Granular deposition of IgG, Clq and C3 are seen in the glomerular basement membrane and mesangium. Electron microscopy confirms the presence of electron dense deposits in the basement membrane, predominantly in a subepithelial location. Which diagnose is most probable?
**Acute diffuse proliferative glomerulonephritis
Acute diffuse proliferative glomerulonephritis
Focal segmental proliferative glomerulonephritis
Chronic glomerulonephritis
Acute pyelonephritis
Chronic pyelonephritis
479958 A woman suffered with dysfunctional metrorrhagia was made a diagnostic abortion. Histologically in the scrape there were a lot of small stamped glandulas covered by multirowed epithelium. The lumens of some glandulas were cystically extended. Call the variant of general pathologic process in the endometrium.
**Glandular-cystic hyperplasia of endometrium
Metaplasia of endometrium
Atrophy of endometrium
Glandular-cystic hyperplasia of endometrium
Neoplasm of endometrium
Hypertrophic growth
479959 The pathologist has found out in histological examination of a remote uterus a lot of glandular formations with single cysts in myometrium, endometrium had usual structure. Described changes are characteristic for …
**Endometriosis
Endometriosis
Glandular hyperplasia of endometrium
Adenocarcinoma of uterus
Adenomatosis of a mucosa of a uterus
Leyomyosarcoma of uterus
479960 A 25-year-old woman palpates a left breast "lump" on self-examination. Her physician palpates an ill-defined mass. There is no pain or tenderness. No axillary lymphadenopathy is noted. Fine needle aspiration is performed and cytologic examination shows cells that appear benign. The lesion persists, and 6 months later another biopsy is taken and shows ductal epithelial proliferation with ductal apocrine metaplasia, stromal fibrosis, and sclerosing adenosis. Which of the following is the most likely diagnosis?
**Fibrocystic changes
Lobular carcinoma in situ
Fat necrosis
Ductal carcinoma in situ
Fibrocystic changes
Intraductal papilloma
479961 A 20-year-old woman gives birth to a term girl infant following an uncomplicated pregnancy. She breast feeds the infant. Six weeks later, her left breast becomes painful and slightly swollen. On physical examination there is a tender 3-cm mass in the left breast beneath a nipple that shows several painful fissures. Which of the following pathologic findings is most likely to be present in this breast?
**Staphylococcus aureus infection
Fat necrosis
Infiltrating ductal carcinoma
Numerous plasma cells
Sclerosing adenosis
Staphylococcus aureus infection
479962 During the intraoperative biopsy of thyroid gland the histological examination revealed lymphoid structures with growth centers, which were among the folliculi full of colloid. What disease was it?
**Hashimoto's thyroiditis (lymphadenoid goiter)
Sporadic goiter
Endemic goiter
Ridel's goiter
Thyrotoxicosis (Basedow's goiter)
Hashimoto's thyroiditis (lymphadenoid goiter)
479963 Complaints of the patient: the increasing of appetite, thirst, polyuria, dryness and itch of the skin, often purulent diseases. The data of objective examination: hyperglycemia, glucosuria. Call the main disease.
**Diabetes mellitus
Diabetes mellitus
Hashimoto’s thyroiditis
Thyrotoxicosis
Viral hepatitis
Cerebro-vascular disease
479964 At early prenatal diagnostic of chromosomal anomalies of a fetus optimum tissues for research are:
**Cells of amniotic fluid
Lymphocytes of the mother
Lymphocytes of the father
Cells of decidual tissue
Cells of amniotic fluid
All indicated
479965 The patient aged 58, smoker for many years with 5-year history of angina pectoris died during the attack. The autopsy has demonstrated atherosclerosis of the coronary arteries, uneven color of anterior wall of the left ventricle, flabbiness of the myocardium. What is the diagnosis?
**Acute IHD, myocardial infarction
Acute IHD, sudden cardiac death
Chronic IHD, cardiosclerosis
Acute IHD, myocardial infarction
Chronic IHD, cardiac aneurisma
Hypertensive disease
479966 A 53-year-old man has experienced severe chest pain for the past 6 hours. On physical examination he is afebrile, but has tachycardia. Laboratory studies show a serum troponin I of 10 ng/mL. A coronary angiogram is performed emergently and reveals >90% occlusion of the left anterior descending artery. In this setting, an irreversible injury to myocardial fibers will have occurred when which of the following cellular changes occurs?
**Nuclei undergo karyorrhexis
Glycogen stores are depleted
Nuclei undergo karyorrhexis
Cytoplasmic sodium increases
Intracellular pH diminishes
Blebs form on cell membranes
479967 A study is performed involving persons who have a history of diabetes mellitus type 1 or type 2. These patients are found to have cellular injury that results from glycosylation end products and from sorbitol accumulation within cells. The same patients are also shown to have ischemic tissue damage from accelerated and advanced atherosclerosis. Which of the following complications is most likely to result from atherosclerosis in these patients?
**Stroke
Stroke
Chronic renal failure
Impotence
Cataracts
Retinopathy
479968 A 45-year-old man was rushed to the hospital following the sudden onset of an episode of crushing substernal chest pain. He receives advanced life support measures. His course was marked by intractable cardiogenic shock and he died 4 days later. At autopsy, a large transmural anterolateral area of coagulative necrosis was found in the anterolateral wall of the left ventricle. Which of the following microscopic findings is most likely to be present?
**Necrotic muscle and neutrophils
Necrotic muscle and neutrophils
Fibroblasts and collagen
Granulation tissue
Granulomatous inflammation
Diffuse chronic inflammation
479969 In 46-year-old patient with rheumatic heart disease (mitral stenosis) the short-wind in low physical loading, tachycardia, cyanosis of lips, wet crepitation in the lower parts of lung and edema of legs have appeared. What histological changes are characteristic in the liver?
**Necrosis of hepatocytes in the center of lobule fatty degeneration in outlying districts
Necrosis of hepatocytes in the center of lobule hyaline degeneration in the outlying districts
Fatty degeneration of hepatocytes in the center of lobule necrosis in the outlying districts
Hydropic degeneration of hepatocytes in the center of lobule necrosis in the outlying districts
Necrosis of hepatocytes in the center of lobule fatty degeneration in outlying districts
Necrosis of hepatocytes in the center of lobule hydropic degeneration in the outlying districts
479970 Which disease is not the systemic disease of connective tissue?
**Sarcoidosis
Rheumatoid arthritis
Sarcoidosis
Scleroderma
Rheumatic fever
Systemic lupus erythrematosus
479971 In the case of rheumatic heart disease, pericarditis is characterized by:
**“Shaggy heart” (“cor villosum”)
“Shaggy heart” (“cor villosum”)
“Cor pulmonale”
“Tiger heart”
Fatty change
“Bull heart”
479972 What type of exudate appears in pericardium cavity at a rheumatic pericarditis?
**Serous-fibrinous
Putrefactive
Hemorrhagic
Purulent
Serous-fibrinous
Catarrhal
479973 The 7-year-old child died from progressing rheumatism with the expressed allergic reactions. In autopsy edemic mitral valve, hystologically is fibrinous swelling. Hyperemia of myocardium, diffuse infiltration by lymphocytes takes place. Pericardium is thickened, grayish color. The described changes in heart it is possible estimate as:
**Pancarditis
Endocarditis
Myocarditis
Pancarditis
Pericarditis
Cardiosclerosis
479974 In 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 semitransparent grayish-whitish grains. What pathological process is the most likely?
**Sago spleen
Glaze spleen
Hyaline spleen
Porphyric spleen
Sago spleen
Waxy spleen
479975 A patient has suffered with mitral insufficiency that complicated by chronic cardiac insufficiency with grossly marked edema of the lower extremities. Suddenly cyanosis of the face is manifested with attempt standing up and he has died. What the most probably complication developed in-patient?
**Thromboembolism of the pulmonary artery
Venous-arterial reaction
Infarction of myocardium
Thromboembolism of the pulmonary artery
Chronic venous hyperemia
Hypertension stroke
479976 A 42-year-old woman has noted increasing dyspnea for the past 6 years. On examination rales are auscultated in both lungs. She is afebrile. A chest radiograph shows an enlarged cardiac silhouette and bilateral pulmonary edema. Past history reveals that, as a child she suffered recurrent bouts of pharyngitis with group A beta hemolytic streptococcal infections. Which of the following cardiac valves are most likely to be abnormal in this woman?
**Mitral and aortic
Aortic and tricuspid
Mitral and aortic
Mitral and pulmonic
Aortic and pulmonic
Tricuspid and pulmonic
479977 A 22-year-old woman is bothered by an erythematous rash involving her cheeks and nose every time she spends more than a few minutes outdoors on a sunny day. On physical examination between these episodes, there are no abnormal findings. A biopsy of the skin involved with the rash shows deposition of IgG along the basement membrane by immunofluorescence microscopy, but uninvolved skin does not demonstrate this IgG deposition. Her antinuclear antibody test is negative. She has no other complaints. Her renal function tests are normal. Which of the following is the most likely diagnosis?
**Discoid lupus erythematosus
Dermatomyositis
Progressive systemic sclerosis
Contact dermatitis
Systemic lupus erythematosus
Discoid lupus erythematosus
479978 At autopsy, the kidneys of a 44-year-old woman who died suddenly are found to be of normal size. Their surfaces appear finely granular. There are small hemorrhages noted. The cortices appear pale. Microscopically, many small renal arteries and arterioles demonstrate concentric intimal thickening with marked lumenal narrowing. These findings are most likely to be present as a result of which of the following underlying diseases?
**Scleroderma
Rheumatoid arthritis
Amyloidosis
Systemic lupus erythematosus
Scleroderma
Viral hepatitis
479979 A 10-year-old girl has complained of joint pain for the past 2 years. The pain is localized to her knees and ankles; it occurs either with and without movement. The arthralgias are accompanied by a fever. On physical examination she has a temperature of 38.1 C. There is no deformity of her knees. She has generalized lymphadenopathy. Which of the following is the most likely diagnosis?
**Juvenile rheumatoid arthritis
Gonococcal arthritis
Juvenile rheumatoid arthritis
Ankylosing spondylitis
Tuberculous arthritis
Gout
479980 In autopsy the whole lower lobe of left lung had dirty-grey colour and liver-like consistence. There was yellow-gray fibrin on a pleura. An etiology of disease is pneumococcus type 1Y. Call this disease:
**Croupous pneumonia
Clottage of pulmonary arteries
Clottage of a bronchial arteries
Tuberculosis
Syphilis
Croupous pneumonia
479981 What complication is not a result of croupous pneumonia?
**Secondary amyloidosis
Secondary amyloidosis
Abscess of the lung
Carnification
Gangrene of the lung
Empyema of pleura
479982 During autopsy of 42-years-old patient who suffered with chronic diffuse bronchitis and died because of pulmonary-cardiac insufficiency the following changes were found out: enlarged lungs with increased airiness, the margins of lungs cover mediastinum; lungs have pale-gray color; the crunch takes place when the lungs are cuted; the pitish appears after finger’s pressure; the mucous-purulent fluid exudes from the bronchial lumen. What diagnosis is more probable?
**Croupous pneumonia
Chronic focal emphysema
Compensative emphysema
Croupous pneumonia
Focal pneumonia
Interstitial pneumonia
479983 Pest’s pneumonia and croupous pneumonia in stage of red hepatization may be differentiated due to presence of following elements in the lungs:
**Fibrin
Fibrin
Carnification
Macrophages
Red blood cells
Edema
479984 In 30-year-old patient after heavy cooling the weakness, short-wind, pain in the left side of thorax and increasing of temperature to 39°C has appeared. Under objective examination the following features were found: the absence of breathing in the area of low lobe of the left lung, blunted sound under percussion and the murmurs of pleura’s friction. The patient died in 7 days after the beginning of the disease. During autopsy: the low lobe of the left lung had dense consistence, airless, grey colored on section, the pleura was thicken, dimmed, with multiple fibrinous films. Call the main disease and its stage.
**Grey hepatization, croupous pneumonia
Grey hepatization, croupous pneumonia
Red hepatization, croupous pneumonia
Interstitial pneumonia initial stage
Gangrene, initial stage
Bronchoectatic disease, last stage
479985 In a 45-year-old patient the ulcerative-necrotic damage of the mucosa of the oral cavity takes place; also the spread lymphadenopathy, slight spleno- and hepatomegaly, diffuse hemorrhages in the skin and mucous membranes were found out. In blood analysis the increasing of leukocytes (to 100 10 per 1 ml) at the account of lymphoblasts takes place. What diagnosis is more probable?
**Acute lymphoblastic leukemia
Chronic myelocytic leukemia
Chronic lymphocytic leukemia
Acute lymphoblastic leukemia
Plasmocytosis
Acute promyelocytic leukemia
479986 During autopsy of the body of the 30-years-old man has been determined the increased lien (weight 900,0), increased liver (weight 4000,0), increased lymph nodes. Bone marrow of a diaphysis of a femur was red color. Microscopically: infiltration of the portal tract of liver by undifferentiated hemopoietic cells with the spherical shape and narrow cytoplasm. What disease it is possible to think about?
**Chronic lymphoid leukemia
Acute lymphoblastic leukemia
Hodgkin’s disease
Lymphoma
Chronic lymphoid leukemia
Lymphogranulomatosis
479987 A 17-year-old adolescent receives whole body radiation as part of a preparatory regimen for bone marrow transplantation to treat acute lymphocytic leukemia. Which of the following cells and tissues in the body is most likely to remain unaltered by the effects of this therapeutic radiation?
**Neurons of cerebral cortex
Neurons of cerebral cortex
Ovarian follicles
Small intestinal epithelium
Erythropoietic cells of bone marrow
Spermatogonia of testicular tubules
479988 A 45-year-old man has a traumatic injury to his forearm and incurs extensive blood loss. On physical examination in the emergency department his blood pressure is 70/30 mm Hg. Which of the following cellular changes is most likely to represent irreversible cellular injury as a result of this injury?
**Nuclear pyknosis
Epithelial dysplasia
Cytoplasmic fatty metamorphosis
Atrophy
Nuclear pyknosis
Anaerobic glycolysis
479989 In 45-year-old patient died from sudden cardiac death the symmetrical type of adipose heart of third degree; the rupture of right ventricle’s wall with hemopericardium and redundant accumulation of fat under epicardium were found out in autopsy. Microscopically: the adipose tissue grows from epicardium into myocardium with atrophy of fibers of muscle. What process is more probable?
**Acute myocardial infarction
Adipose heart
Ischemic heart disease
Fatty degeneration of myocardium
Acute myocardial infarction
Hypertensive disease
479990 Choose the most authentic early [1-2 hours] sign of a myocardial infarction:
**Petering of a glycogen in the cardiomyocytes
Petering of a glycogen in the cardiomyocytes
A vacuolar dystrophy of the cardiomyocytes of a subendocardial zone
Fatty infiltration of the cardiomyocytes
Decreased activity of dehydrogenases
A release phenomenon of myofibrils
479991 At autopsy of a patient died because of a cerebral hemorrhage, strongly enlarged dense and anemic kidneys (size :6х3х2см weight 60.0,) with a uniformly small-granulated surface and with uniformly thinned cortex on a cut-surface have been found out. The changes in kidney are a sign of:
**Аrteriosclerotic nephrosclerosis
Gouty (podagric) kidneys
Аtherosclerotic nephrosclerosis
Secondary shrinkage of kidney
Аrteriosclerotic nephrosclerosis
Amiloid-shrinkaged kidneys (“lardaceous kidneys”)
479992 A 65-year-old patient, who suffered from arteriosclerosis, has been hospitalized in surgical department because he had purulent peritonitis. Thrombosis of mesenteric arteries was found during operation. What is the form of atherosclerosis takes place?
**Atherosclerosis of mesenteric arteries
Atherosclerosis of mesenteric arteries
Atherosclerosis of brain
Atherosclerosis of kidney’s arteries
Atherosclerosis of coronary arteries
Atherosclerosis of extremities
479993 66-year-old man took medical aid because of the sharp pain in the heart with irradiation to the left upper extremity and short-wind. The arterial tension – 100/50 mm of Hg, pulse – 90 per 1 min; electrocardiographically: the hypoxia of myocardium of the front wall of the left ventricle was found. He has died in 2 hours after taking medical aid. In autopsy, the congestion (venous hyperemia) of the internal organs was found. There was also dilatation of the heart’s ventricle. In the fore wall of left ventricle the myocardium was parti-colored with yellowish dim areas of 3,5 to 4 sm. Coronary arteries had atherosclerotic plaques and narrow lumen. In aortic intima, many yellowish-whitish plaques were found out also. The lungs had pasty consistence. What pathological process is characterized with such clinical and morphological marks?
**Multifocal (postinfarctional) cardiosclerosis
Multifocal (postinfarctional) cardiosclerosis
Smallfocal (atherosclerotic) cardiosclerosis
Acute myocardial infarction
Fatty degeneration of myocardium
Myocarditis
479994 At the autopsy of 60 year-old male patient, in the myocardium of the front wall of the left ventricle of the heart a gray dense focus of 5 х 4 cm, of irregular shape with clear borders, fibrous structure has been found out. What pathological process in the myocardium has revealed the pathologist?
**Myocarditis
Myocarditis
Diffuse small focal myocardiosclerosis
Postinfarctional cardiosclerosis
Petrification of the myocardium
Infarction
479995 Under gross investigation of the brain’s vessels of the patient who has died because of brain’s infarction the following changes were found: intima of the brain’s vessels was rough with a great number of yellow and yellowish-whitish patches, which narrow vessel’s lumen. What diagnosis is more probable?
**Arteriosclerosis
Hypertensive disease
Periarteriitis nodosa
Rheumatic fever
Arteriosclerosis
Diabetes mellitus
479996 A microscopic examination of the enlarged neck gland of a 14-year-old girlrevealed 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 large size cells are observed. What is the most likely diagnosis?
**Lymphogranulomatosis
Lymphogranulomatosis
Fungous mycosis
Chronic lympholeucosis
Berkitt's lymphoma
Acute lympholeucosis
479997 A child aged 8 developed weaknesses, increase of body temperature, nasal bleeding and odontorrhagia. The hemogram has demonstrated 20,000 leukocytes (mainly lymphoblasts) per mm2. What type of leukemia is it judging by the level of differentiation of leukemia cell and cytogenesis?
**Acute lymphoblastic leukemia
Acute myelogenous leukemia
Hodgkin’s disease
Lymphoma
Acute lymphoblastic leukemia
Infections mononucleosis
479998 In a 45-year-old patient the ulcerative-necrotic damage of the mucosa of the oral cavity takes place; also the spread lymphadenopathy, slight spleno- and hepatomegaly, diffuse hemorrhages in the skin and mucous membranes were found out. In blood analysis the increasing of leukocytes (to 100 10 per 1 ml) at the account of lymphoblasts takes place. What diagnosis is more probable?
**Acute lymphoblastic leukemia
Acute promyelocytic leukemia
Chronic lymphocytic leukemia
Plasmocytosis
Chronic myelocytic leukemia
Acute lymphoblastic leukemia
479999 A patient has suffered with mitral insufficiency that complicated by chronic cardiac insufficiency with grossly marked edema of the lower extremities. Suddenly cyanosis of the face is manifested with attempt standing up and he has died. What the most probably complication developed in-patient?
**Thromboembolism of the pulmonary artery
Thromboembolism of the pulmonary artery
Venous-arterial reaction
Infarction of myocardium
Chronic venous hyperemia
Hypertension stroke
480000 A 23-year-old woman has had worsening malaise along with a malar skin rash persisting for 3 weeks. On physical examination, she has an audible friction rub on auscultation of the chest, along with a faint systolic murmur. An echocardiogram reveals small vegetations on the mitral valve and adjacent ventricular endocardium. Laboratory studies show a positive antinuclear antibody test, with a titer of 1:2048. Which of the following is the most likely diagnosis?
**Systemic lupus erythematosus
Systemic lupus erythematosus
Polyarteritis nodosa
Progressive systemic sclerosis
Wegener's granulomatosis
Adenocarcinoma of the pancreas
480001 A 42-year-old woman has noted increasing dyspnea for the past 6 years. On examination rales are auscultated in both lungs. She is afebrile. A chest radiograph shows an enlarged cardiac silhouette and bilateral pulmonary edema. Past history reveals that, as a child she suffered recurrent bouts of pharyngitis with group A beta hemolytic streptococcal infections. Which of the following cardiac valves are most likely to be abnormal in this woman?
**Mitral and aortic
Aortic and tricuspid
Mitral and aortic
Mitral and pulmonic
Aortic and pulmonic
Tricuspid and pulmonic
480002 As he continues to age, a 50-year-old man is bothered by slowly progressive loss of mobility of his spine at the hips since the age of 25. He has a brother who is similarly affected. On physical examination there is loss of lumbar lordosis with decreased range of motion at his hips. Which of the following pathologic abnormalities involving his sacroiliac joints is most likely to be present?
**Ankylosis
Mosaic growth pattern
Gummatous necrosis
Ankylosis
Osteonecrosis
Pannus formation
480003 At autopsy, the kidneys of a 44-year-old woman who died suddenly are found to be of normal size. Their surfaces appear finely granular. There are small hemorrhages noted. The cortices appear pale. Microscopically, many small renal arteries and arterioles demonstrate concentric intimal thickening with marked lumenal narrowing. These findings are most likely to be present as a result of which of the following underlying diseases?
**Scleroderma
Scleroderma
Amyloidosis
Systemic lupus erythematosus
Rheumatoid arthritis
Viral hepatitis
480004 A 35-year-old previously healthy woman dies suddenly and unexpectedly. At autopsy, one of her cardiac valves demonstrates attenuation of the chordae tendineae, with rupture of one of the chordae. On microscopic examination, one of the mitral leaflets show myxomatous change. Which of the following is the most likely cause for her death?
**Mitral valve prolapse
Mitral valve prolapse
Carcinoid heart syndrome
Rheumatic heart disease
Infective endocarditis
Acute myocardial infarction
480005 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?
**Rheumatic thromboendocarditis
Acute rheumatic valvulitis
Septic bacterial endocarditis
Septicopyemia
Septicemia
Rheumatic thromboendocarditis
480006 At histological research of a biopsy specimen from an auricle of a heart of a patient with rheumatic disease the foci of a mucoid swelling, fibrinoid necrosis of a connective tissue has been found out. What immune response has developed in tissues of the auricle of the heart?
**Hypersensitivity of an immediate type
Hypersensitivity of a delayed type
Reaction of the transplantative immunity
Normergic reaction
Hypersensitivity of an immediate type
Exudative reaction
480007 The 7-year-old child died from progressing rheumatism with the expressed allergic reactions. In autopsy edemic mitral valve, hystologically is fibrinous swelling. Hyperemia of myocardium, diffuse infiltration by lymphocytes takes place. Pericardium is thickened, grayish color. The described changes in heart it is possible estimate as:
**Pancarditis
Cardiosclerosis
Endocarditis
Myocarditis
Pericarditis
Pancarditis
480008 In the 30-year-old woman systemic lupus erythematosus was diagnosed. Which tissues do the autoantibodies react against?
**Against nuclear constituents of virtually every cell within the organism
Against nuclear constituents of virtually every cell within the organism
Only against thyroid constituents
Only against thyroid and cardiac constituents
Only against components of bone marrow
Only against basement membrane of kidneys and lungs
480009 One of the following positions is not typical for polyarthritic form of the rheumatic fever?
**Serous or serous-fibrinous inflammation develops in the joints’ cavities
Serous or serous-fibrinous inflammation develops in the joints’ cavities
The large joints are involved
The mucoid degeneration appears in the synovium
The joint’s cartilage is not involved
The deformation and ankylosis are typical
480010 Systemic lupus erythematosus is characterized by all features, except one:
**Antigen of hepatitis B virus is found very often
Glomerulonephritis
Artralgia and arthrosis
Skin injury – erythema (butterfly)
Endocarditis so-called Libman-Sacks
Antigen of hepatitis B virus is found very often
480011 In 46-year-old patient with rheumatic heart disease (mitral stenosis) the short-wind in low physical loading, tachycardia, cyanosis of lips, wet crepitation in the lower parts of lung and edema of legs have appeared. What histological changes are characteristic in the liver?
**Necrosis of hepatocytes in the center of lobule fatty degeneration in outlying districts
Necrosis of hepatocytes in the center of lobule fatty degeneration in outlying districts
Necrosis of hepatocytes in the center of lobule hyaline degeneration in the outlying districts
Fatty degeneration of hepatocytes in the center of lobule necrosis in the outlying districts
Hydropic degeneration of hepatocytes in the center of lobule necrosis in the outlying districts
Necrosis of hepatocytes in the center of lobule hydropic degeneration in the outlying districts
480012 Red-brownish stains are found on the symmetrical parts of both cheeks in the result of autopsy of 45 year dead woman. Heart is increased, leaflets of aortic valve are condensed and thickened, have thrombotic masses on its surface. Kidneys are increased. Medulla is duck red, cortex is gray-brownish with red half-transparent points. Histologically: “hemathoxilin bodies” are found in the nucleus of ductal epithelium; thickening of basal membranes of glomerular capillaries, which look like “wire-loops”, several places in capillaries have hyaline thrombus and focuses of fibrinoid necrosis. Which diagnosis is more possible?
**Systemic lupus erythematosus
Glomerulonephritis
Rheumatic heart disease
Septic endocarditis
Systemic lupus erythematosus
Atherosclerosis
480013 A 50-year-old man had rheumatic mitral disease. He has arrived in clinic with sings of active rheumatism. On a background of increasing cardiovascular insufficiency has developed left-hand hemyplegia. The patient has died. What changes of a brain have caused development left-hand hemyplegia?
**Infarction of a brain
Hematoma
Atherosclerosis of brain’s vessels
Infarction of a brain
Edema of a brain
Meningitis
480014 A 44-year-old woman dies as a consequence of a "stroke". At autopsy, she is found to have a large right basal ganglia hemorrhage. She has an enlarged 550 gm heart with predominantly left ventricular hypertrophy. Her kidneys are small, about 80 gm each, with cortical scarring, and microscopically they demonstrate small renal arterioles that have lumenal narrowing from concentric intimal thickening. Which of the following is the most likely diagnosis?
**Malignant hypertension
Malignant hypertension
Dominant polycystic kidney disease
Arterial changes with diabetes mellitus
Vascular disease with hyperlipidemia
Monckeberg's sclerosis
480015 A 57-year-old man has had blood pressure measurements in the range of 160/95 to 180/110 mm Hg for many years. He has taken no medications. A renal scan reveals kidneys of normal size for age. These findings with benign nephrosclerosis are most likely to occur with which of the following vascular changes:
**Hyaline arteriolosclerosis
Monckeberg's medial calcific sclerosis
Complex calcified atherosclerosis
Hyaline arteriolosclerosis
Arterial mural thrombosis
Hyperplastic arteriolosclerosis
480016 An autopsy study is conducted involving the gross appearance of the aorta of adults ranging in age from 60 to 90. In some of these patients, the aorta demonstrates atheromatous plaques covering from 70 to 95% of the intimal surface area, mainly in the abdominal portion, with ulceration and calcification. Which of the following contributing causes of death are these patients most likely to have?
**Hypertension
Thrombophlebitis
Hyperparathyroidism
Marfan syndrome
Hypertension
Vasculitis
480017 A 53-year-old man has experienced severe chest pain for the past 6 hours. On physical examination he is afebrile, but has tachycardia. Laboratory studies show a serum troponin I of 10 ng/mL. A coronary angiogram is performed emergently and reveals >90% occlusion of the left anterior descending artery. In this setting, an irreversible injury to myocardial fibers will have occurred when which of the following cellular changes occurs?
**Nuclei undergo karyorrhexis
Nuclei undergo karyorrhexis
Glycogen stores are depleted
Cytoplasmic sodium increases
Intracellular pH diminishes
Blebs form on cell membranes
480018 The 67-year-old patient had repeated myocardial infarction and died because of developed cardio-vascular insufficiency. What changes can be found in the lung as a result of chronic venous hyperemia (congestion) in the lung?
**Brown induration of the lung
Interstitial emphysema
Hemorrhagic pneumonia
Brown induration of the lung
Hemosiderosis of the lung
Primary idiopathic emphysema
480019 The patient has suffered with hypertensive disease for a long period and died with signs of cardiac and vascular insufficiency. What macroscopical changes and in which parts of the heart can be found during autopsy?
**Hypertrophy of left ventricle
Hypertrophy of left ventricle
Hypertrophy of right ventricle
Brown atrophy of myocardium
Sclerosis of mitral valve
Fibrinous pericarditis
480020 A 65-year-old patient, who suffered from arteriosclerosis, has been hospitalized in surgical department because he had purulent peritonitis. Thrombosis of mesenteric arteries was found during operation. What is the form of atherosclerosis takes place?
**Atherosclerosis of mesenteric arteries
Atherosclerosis of brain
Atherosclerosis of kidney’s arteries
Atherosclerosis of mesenteric arteries
Atherosclerosis of coronary arteries
Atherosclerosis of extremities
480021 At autopsy of a patient died because of a cerebral hemorrhage, strongly enlarged dense and anemic kidneys (size :6х3х2см weight 60.0,) with a uniformly small-granulated surface and with uniformly thinned cortex on a cut-surface have been found out. The changes in kidney are a sign of:
**Аrteriosclerotic nephrosclerosis
Amiloid-shrinkaged kidneys (“lardaceous kidneys”)
Аtherosclerotic nephrosclerosis
Secondary shrinkage of kidney
Gouty (podagric) kidneys
Аrteriosclerotic nephrosclerosis
480022 At autopsy the diminished kidneys with weight of 50.0 have been found out, the surface has been closed-grained, cortex has been uniformly thinned. At microscopic examination a wall of arterioles has been considerably thickened because of deposition of homogeneous unstructured pink colored masses, the lumen has sharply narrowed down, the glomeruli have been reduced, with sclerosis and atrophy of tubules. What disease the described changes are typical for?
**Hypertensive disease
Hypertensive disease
Chronic glomerulonephritis
Amyloidosis of kidney
Pyelonephritis with shrinkage of kidneys
Acute necrotic nephrosis
480023 At the autopsy of 60 year-old male patient, in the myocardium of the front wall of the left ventricle of the heart a gray dense focus of 5 х 4 cm, of irregular shape with clear borders, fibrous structure has been found out. What pathological process in the myocardium has revealed the pathologist?
**Postinfarctional cardiosclerosis
Diffuse small focal myocardiosclerosis
Myocarditis
Postinfarctional cardiosclerosis
Petrification of the myocardium
Infarction
480024 In 45-year-old patient died from sudden cardiac death the symmetrical type of adipose heart of third degree; the rupture of right ventricle’s wall with hemopericardium and redundant accumulation of fat under epicardium were found out in autopsy. Microscopically: the adipose tissue grows from epicardium into myocardium with atrophy of fibers of muscle. What process is more probable?
**Acute myocardial infarction
Acute myocardial infarction
Ischemic heart disease
Fatty degeneration of myocardium
Adipose heart
Hypertensive disease
480025 Great quantity of foam cells is found in the result of histologic research of the aortic wall. They are situated in intima. What disease has got this pathological picture?
**Atherosclerosis
Polyartereitis nodosa
Syphilitic aortitis
Nonspecific aortitis
Hypertensive heart disease
Atherosclerosis
480026 In 53 year-old patient, who has suffered by bronchoectatic disease and hemoptysis, the edema of face and waist have appeared. The protein (33 mg/l) was found in urine. Pulmonary hemorrhage was the cause of patient’s death. In autopsy: enlargement of kidneys was found; the kidneys were dense with lardaceous surface of section. Histologically: the deposition of homogenous eosinophilic masses colored with Congo red and given of metachromasia with methyl-violet color in glomeruli and canals were found. What pathological process took place in the patient?
**Amyloidosis
Amyloidosis
Fatty degeneration
Mucoid degeneration
Grainish degeneration
Hyalinosis
480027 During autopsy of the body of patient suffered with chronic glomerulonephritis the following changes have been found: the kidneys have been diminished in size, densed with small grained section surface; the fibrinous inflammation of serosal and mucosal membranes has taken place as edema of the brain as well. Call macroscopical changes in kidneys.
**Nephrosclerosis
Polycystic kidney
Infarction of the kidney
Necrotic nephrosis
Nephrosclerosis
Pyelonephritis
480028 A patient died with uremia. The autopsy demonstrated kidneys to be enlarged, of flabby consistence, cortex was broad, edematous, with red spots; medulla was dark red in colour. Microscopic examination in the glomeruli capsule cavity revealed "semilunar formations", squeezing capillaries, nephrocytes dystrophy, edema and infiltration of stroma. What disease caused the death of the patient?
**Glomerulonephritis
Glomerulonephritis
Nephrotic syndrome
Renal amyloidosis
Pyelonephrosis
Nephrolithiasis
480029 A patient suffered with urolithiasis has died as a result uremia. Autopsy has showed an enlargement of right kidney, its parenchyma has been thinned; the pelvis and calices have been extended, filled with fluid. In the orifice of ureter there has been a calculus. Call the pathologic process in the right kidney.
**Hydronephrosis
Replacement hypertrophy
Hyperplasia
Hydronephrosis
Neoplasm of kidney
Pyelonephritis
480030 A 22year-old patient was ill with a virus hepatitis B 2 years ago is hospitalized in clinic with the complaints to pain in the right hypochondrium, dyspepsia, loss of weight. In a biopsy of the liver tissue the pathologist found out: irreversible intracellular changes, which were characterized the transferred virus hepatitis B. Call this changes
**Councilmen bodies
Councilmen bodies
Hydropic dystrophy of hepatocytes
Mucoid swelling
Intracellular obesity
Intracellular glycogen accumulation in hepatocytes
480031 Liver’s biopsy of a man aged 31 who had chronic hepatitis demonstrated dilated bile ducts and capillaries, they were overfilled with bile with necrosis of adjacent hepatocytes, marked periportal sclerosis with periductal lymphocytic infiltration. The liver beams were discomplected. The structure of the liver was reformed with considerable development of connective tissue. What diagnosis is the most probable?
**Biliary cirrhoses
Biliary cirrhoses
Persistent chronic hepatitis
Postnecrotic cirrhoses
Toxic degeneration of the liver
Steatosis
480032 A patient of infection department complained on weakness, absence of appetite, increased temperature (38 °C). On the day, he developed acute pain in the right hypochondrium and yellow skin. Microscopy of the biopsy material has demonstrated disturbances in the beam structure, hydropic and balloon dystrophy in the hepatocytes, necrosis, Councilmen’s bodies in some of them, increased amount of polynuclear hepatocytes on the periphery of the lobules. What form of viral hepatitis is the most probable?
**Acute hepatitis
Incubation period
Carrier state
Chronic hepatitis
Fulminant hepatitis
Acute hepatitis
480033 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?
**Liver cirrhosis
Toxic dystrophy
Alcohol hepatitis
Chronic hepatosis
Viral hepatitis
Liver cirrhosis
480034 A patient was admitted into the hospital with complaints to feel sick, pains in the epigastria after meal. During the gastroscopy it was found out hyperemia, edema of mucous membrane of the stomach, an excessive amount of viscous grayish mucus. What kind of inflammation did develop in the stomach?
**Catarrhal
Catarrhal
Fibrinous
Serous
Hemorrhagic
Purulent
480035 Radiography demonstrated partial shortening and deformity of the large intestine with stenosed lumen in a patient aged 28. Histological study of the mucous membrane revealed granulation and scarring of the ulcers with incomplete epithelization, and formation of granulematous and adenomatous pseudopolyps. What diagnosis is most probable?
**Non-specific ulcerative colitis
Non-specific ulcerative colitis
Amebic colitis
Dysentery colitis
Diphtheritic colitis
Croupous colitis
480036 In 30-year-old patient the sharp pains in right hypogastrric area and vomiting appeared one day ago. Some hours ago the increasing of the body’s temperature to 39o C has appeared. The patient has been hospitalized. During surgical operation the thicken appendix with hyperemic mucosa with fibrous-purulent films was found. What type of acute appendicitis was found in this patient?
**Acute phlegmonous ulcerative appendicitis
Acute simple appendicitis
Acute phlegmonous appendicitis
Acute phlegmonous ulcerative appendicitis
Acute gangrenous appendicitis
Apostematous appendicitis
480037 A 56-year-old woman has smoked 2 packs of cigarettes per day for the past 35 years. She has had a chronic cough for the past 8 years, but recently has noted increased sputum production. On physical examination she has a few crackles ausculated best over the lung bases. Bronchoscopy with biopsy is performed. The biopsy reveals bronchial epithelium with squamous metaplasia. Which of the following statements represents the best interpretation of these findings?
**She has an increased risk for pulmonary infection
She has an increased risk for pulmonary infection
This is a physiologic process of aging
This process is irreversible, even if she stops smoking
She has metastases to lung from a primary somwhere else
A pulmonary thromboembolus caused pulmonary infarction
480038 Autopsy of a man aged 56 who had right lower lobar pneumonia and for a long time coughed out muco-purulent discharge has revealed a cavity with dense edges with purulent masses in the 9-10th segments of the right lung. White line stretched from cavity to the root of lung. Microscopy has revealed that the cavity is limited with a membrane, connective tissue outside and granular inside. Which of the diagnoses is most probable?
**Chronic abscess
Bronchiectatic disease
Gangrene of lungs
Chronic abscess
Abscess of lungs
Chronic bronchitis
480039 Autopsy of a man aged 69, who had chronic bronchitis and frequently suffered from acute pneumonia, has revealed dense lungs with small amount of air, with honeycombing cut surface. The walls of the bronchi are dense, thickened with sack- like protrusions containing purulent masses. The heart weighs 520 g. The walls of the right ventricle are 2 cm thick, thei cavity is dilated. The wall of the left ventricle is 1.2 cm thick. Which of the listed diagnoses is most probable?
**Bronchiectatic disease
Bronchiectatic disease
Obstructive emphysema
Pneumosclerosis
Chronic bronchitis
Chronic abscess of lungs
480040 At macroscopic examination of the lung’s tissue was noted the areas of increase of airiness with numerous blebs 0,5-1,5 cm in diameter. Histologic examination showed thinning and rupture of interalveolar walls with formation of large cavities of the different shapes. What disease was revealed in the lungs?
**Emphysema of the lungs
Chronic bronchitis
Bronchoectatic disease
Acute cavernous tuberculosis
Emphysema of the lungs
Fibrosing alveolitis
480041 In an autopsy of the 59-year-old man, who has died because of chronic pulmonary-cardiac insufficiency the pathologist has found out: increased, densish lungs, cut surface with diffuse whitish nodules {2-3 mm in diameter}. Microscopic investigation: nodules contained concentric collagen fibers. Diagnose this disease:
**Nodal form of a silicosis
Miliary pulmonary tuberculosis
Hamman-Rich syndrome
Nodal form of a silicosis
Nodular pneumonia
Metastases of carcinoma of stomach in the lung
480042 A 60-year-old miner has died because of chronic pulmonary-cardiac insufficiency. In autopsy the pathologist has found out: areas of dystelectasis, induration, pneumosclerosis in the both lungs, local emphysema in the apex. Cut surface was slaty-black. Diagnose this disease.
**Anthracosis
Anthracosis
Silicosis
Talcosis
Asbestosis
Aluminosis
480043 The 43-year-old patient was hospitalized 22 days ago in pulmonological department because of two-sided bronchopneumonia. The patient has died. During autopsy the round-formed cavity in diameter of 3,5 cm with clear borders filled with greenish-yellowish color fluid was found in the left lung. About what type of inflammation can we talk in this case?
**Exudative purulent inflammation
Exudative hemorrhagic inflammation
Proliferative inflammation
Exudative serous inflammation
Exudative fibrinous inflammation
Exudative purulent inflammation
480044 Autopsy of a man aged 42 has revealed that the right lung is enlarged, of liver density, heavy with marked fibrinous layers on the pleura. On cut surface, the lung is grey, grainy, eosin turbid fluid. Histology study revealed the signs of acute inflammation with fibrinous exudate in the alveoli. Which of the listed diagnoses is most probable?
**Croupose pneumonia
Chronic bronchitis
Bronchopneumonia
Croupose pneumonia
Lung carcinoma
Idiopathic fibrotic alveolitis
480045 Pest’s pneumonia and croupous pneumonia in stage of red hepatization may be differentiated due to presence of following elements in the lungs:
**Fibrin
Red blood cells
Carnification
Macrophages
Fibrin
Edema
480046 During autopsy of 42-years-old patient suffered with chronic diffuse bronchitis and died because of pulmonary-cardiac insufficiency the following changes were found out: enlarged lungs with increased airiness, the margins of lungs cover mediastinum; lungs have pale-gray color; the crunch takes place when the lungs are cuted; the pitish appears after finger’s pressure; the mucous-purulent fluid exudes from the bronchial lumen. What diagnosis is more probable?
**Croupous pneumonia
Croupous pneumonia
Chronic focal emphysema
Compensative emphysema
Focal pneumonia
Interstitial pneumonia
480047 What complication is not a result of croupous pneumonia?
**Secondary amyloidosis
Gangrene of the lung
Abscess of the lung
Carnification
Secondary amyloidosis
Empyema of pleura
480048 A 42-year-old woman has noted increasing dyspnea for the past 6 years. On examination rales are auscultated in both lungs. She is afebrile. A chest radiograph shows an enlarged cardiac silhouette and bilateral pulmonary edema. Past history reveals that, as a child she suffered recurrent bouts of pharyngitis with group A beta hemolytic streptococcal infections. Which of the following cardiac valves are most likely to be abnormal in this woman?
**Mitral and aortic
Mitral and aortic
Aortic and tricuspid
Mitral and pulmonic
Aortic and pulmonic
Tricuspid and pulmonic
480049 Multiple oval ulcers along the intesti¬ne were revealed in autopsy of the person, who died from diffuse purulent 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 disease can be diagnosed?
**Typhoid fever
Dysentery
Typhus
Tuberculosis
Typhoid fever
Cholera
480050 A 30-year-old patient with bacteriologically proved dysentery developed the signs of paraproctitis. What is the stage of local changes of this patient?
**Fibrinous colitis
Follicular colitis
Healing of the ulcers stage
Catarrhal colitis
Ulceration stage
Fibrinous colitis
480051 A 36-year-old farmer had been suffering from unknown disease for 3,5 months. Microscopical investigation: there were granulomas in internal organs consisting of epithelioid, Langhans giant- cells, plasma cells, eosinophils. In granulomas there are a lot of vessels with features of productive-destructive vasculitis. Diagnose this disease
**Brucellosis
Brucellosis
Malignant anthrax
Tuberculosis
Classical typhus
Leprosy
480052 What microorganism is the cause of bacterial dysentery?
**Schigella
Ameba
Staphylococcus
Vibrion
Schigella
Mycobacterium
480053 A.C. is a four-year-old girl who is referred to hospital by her family doctor. She has presented with catarrhal inflammation in the mucous membrane of the mouth, trachea, bronchi, and conjunctiva. The mucous membrane is swollen, plethoric; the mucous secretion is increased, which is accompanied by rhinitis, cough, lacrimation. Enanthema is noted on the mucous membrane of the cheeks against the lesser lower molars. It looks like whitish spots called Belsky-Filatov-Koplik’s spots, which develop before the eruption on the skin. What diagnosis is most probable?
**Measles
Diphtheria
Mumps
Infectious mononucleosis
Measles
Scarlet fever
480054 The 3-year-old boy has had pain in the throat. During the examination it was found: red pharynx and edematous inflammated tonsils, “raspberry” tongue, increased submandibular lymph nodes, small-spots erythematous rash on the skin. Diagnose this disease.
**Scarlet fever
Scarlet fever
Measles
Influenza
Pertussis
Diphtheria
480055 A 8 year-old child was ill acutely with clinical signs of vomiting, headache and severe intoxication. After two days of the disease he has died. In autopsy the pathologist has found out: meninges thickened, yellowish color on basal surface, edema and hyperemia. Meningococcus was detected from liquor fluid. Diagnose this disease.
**Meningococcal infection
Scarlet fever
Pertussis
Diphtheria
Meningococcal infection
Measles
480056 In a patient with severe total pleuropneumonia the Yersinia pestis was detected from sputum. What contagious infection was advanced?
**Pneumonic plaque
Pneumonic plaque
Malignant anthrax
Brucellosis
Tuberculosis
Leprosy
480057 In autopsy of still-born it was found out: teratoma in ovary, nevus on skin, rupture of tentorium cerebelli, hypoplasia of thymus, polydactilia. What is the variant of perinatal pathology?
**Birth injury
Hemolytic disease of newborn
Pneumonia in newborn
Birth injury
Respiratory distress syndrome of newborn
Edimatous hemorrhagic syndrome
480058 Microscopic examination of the lungs of a dead 2-day-old newborn showed: pinkish masses that line the respiratory bronchioles, alveoli. These masses are largely made up of fibrinogen and fibrin, admixed with cell debris chiefly from necrotic alveolar lining pneumocytes. Areas of dys- and atelectasis are found out too. What is your diagnosis?
**Hyaline membranes
Hyaline membranes
Hemolytic disease of newborn
Birth injury
Pneumonia in newborn
Edematous hemorrhagic syndrome
480059 A lung of a premature infant is presented on electronic photomicrography of biopsy material. Collapse of the alveolar wall caused by the deficiency of surfactant was revealed. Disfunction of what cells of the alveolar wall caused it?
**Alveocytes type II
Alveolar macrophages
Secretory cells
Alveocytes type II
Alveocytes type I
Fibroblasts
480060 A 5-year-old boy has a height that is less than the 5th percentile for age. On physical examinaation most of his decreased height is due to very short legs. However, his trunk and head appear normally proportioned for age. He is of above average intelligence and becomes an orthopedic surgeon. His parents and relatives are not affected by this disorder. Which of the following is the most likely diagnosis?
**Achondroplasia
Achondroplasia
Fibrous dysplasia
Osteogenesis imperfecta
Ollier disease
Alport syndrome
480061 There is considerable defect of anterior abdominal wall, hypoplasia of abdominal cavity, protruded outside intestine and liver in newborn. What is the probable diagnosis?
**Eventration of the organs of abdominal cavity
Spina bifida occulta
Eventration of the organs of abdominal cavity
Microgyria
Amelia
Chondroplasia
480062 During the operation of the 2-year-old girl in the retroperitoneal area it was found out: hypoplasia of right kidney. Call the most probable period of development of this change:
**Embryogenesis
Embryogenesis
Blastogenesis
Progenesis
Early fetogenesis
Late fetogenesis
480063 Mrs G.H. is a 30-year-old housewife who is seen by her doctor because her sister had told her that she was looking a bit thin. She tells you that she has indeed lost weight in spite of a good appetite. When you question her you notice that she has exophthalmos. On examination, her thyroid gland is diffusely enlarged and her pulse is 100 with atrial fibrillation. Microscopy: prismatic epithelium turns into cylindrical, epithelium proliferation with formation of papillae, colloid vacuolization, lymphoid plasmocyte stroma infiltration, formation of lymphoid follicles with germ centers are observed. Which of the listed diagnoses is most probable?
**Basedowian disease (Graves disease)
Follicular carcinoma
Sporadic goiter
Endemic goiter
Autoimmune thyroiditis
Basedowian disease (Graves disease)
480064 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 hemorrhage. Basophilic hypophysis adenoma, hyperplasia of adrenal gland cortex was revealed on pathomorphological examination. What is the likely diagnosis?
**Cushing disease
Cushing disease
Acromegaly
Diabetes mellitus
Hypophysis nanism
Adiposogenitalis dystrophy
480065 A 20-year-old woman gives birth to a term girl infant following an uncomplicated pregnancy. She breast feeds the infant. Six weeks later, her left breast becomes painful and slightly swollen. On physical examination there is a tender 3-cm mass in the left breast beneath a nipple that shows several painful fissures. Which of the following pathologic findings is most likely to be present in this breast?
**Staphylococcus aureus infection
Numerous plasma cells
Infiltrating ductal carcinoma
Staphylococcus aureus infection
Sclerosing adenosis
Fat necrosis
480066 A 29-year-old woman has been taking oral contraceptives for the past 12 years. She now has a palpable "lump" in the left breast that has persisted for the past 3 months. Which of the following breast lesions is most likely to be associated with her oral contraceptive use?
**Galactocele
Galactocele
Acute mastitis
Fat necrosis
Hypertrophy
Cyst formation
480067 A clinical study is peformed involving subjects who women are ranging in age from 15 to 45 years who palpated breast "lumps" on self-examination. The presence of breast mass lesions in these subjects was subsequently confirmed by physical examination and by mammography. All subjects had a biopsy or excision of their lesion performed, with a definitive pathologic diagnosis made. Which of the following diagnoses is likely to be the most frequent in these subjects?
**Fibrocystic changes
Fibrocystic changes
Absces
Fibroadenoma
Lobular carcinoma in situ
Infiltrating ductal carcinoma
480068 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.
**Glandular- cystic hyperplasia
Hypertrophic excrescence
Glandular- cystic hyperplasia
Metaplasia
Displasia
Atrophy
480069 During histological investigation of prostate gland, that has been resected in 72-year-old patient with symptoms of difficult urination the following signs were found: enlargement of glandular and muscle’s elements with disturbance of glandular structure. What process is more probable?
**Glandular hyperplasia
Adenocarcinoma
Muscle-fibrotic hyperplasia
Glandular hyperplasia
Mixed variant of prostatopathy
Prostatitis
480070 The pathologist has found out in histological examination of a remote uterus a lot of glandular formations with single cysts in myometrium, endometrium had usual structure. Described changes are characteristic for.
**Endometriosis
Adenocarcinoma of uterus
Glandular hyperplasia of endometrium
Endometriosis
Adenomatosis of a mucosa of a uterus
Leyomyosarcoma of uterus
480071 In a biopsy of сervix of a 26-year-old woman the diagnosis following was established: pseudo-erosion. What microscopical changes has the pathologist revealed?
**Local changes of a stratified squamous epithelium on single-layer prismatic one
Local changes of a stratified squamous epithelium on single-layer prismatic one
Cell-atypia of an epithelium of an mucosal epithelium
Keratinization of an epithelium
“Carcinomatous pearls”
Local inflammation and necrosis in mucosa
480072 Purulent endometritis with fatal outcome was progressing in the woman after abortion performed outside of the hospital. On autopsy multiple pulmonary abscesses, subcapsule ulcers in the kidneys, spleen hyperplasia were revealed. What form of sepsis developed in the patient?
**Septicopyemia
Septicemia
Chroniosepsis
Lung sepsis
Septicopyemia
Urosepsis
480073 Autopsy of man aged 60 demonstrated numerous whitish millet-grain-sized nodes in the lungs and liver. Microscopy demonstrated granulomas with foci of necrosis in the center and epithelioid, lymphoid, plasmatic cells on the periphery as well as macrophages and numerous Pirogov-Langhans cells in the infiltrations. Which of the listed granulomas is most probable?
**Giant-cell
Giant-cell
Phagocytic
Epithelioidcellular
Macrophage
Foreign-body granuloma
480074 During the histological examination of the biopsy the pathologist has found out granulomas within the livers. They contain mainly T-lymphocytes and epithelioid cells, and solitary giant Langhan’s cells. In the center of granulomas there was a small area of caseous necrosis. What pathologic process is characterized by those changes?
**Proliferative inflammation
Exudative inflammation
Coagulative necrosis
Liquefactive necrosis
Neoplasm
Proliferative inflammation
480075 During the autopsy of the 9-year-old girl the following changes were found out: the focus of the caseous necrosis 1,5 mm in diameter in the right lung; increased bifurcation lymph nodes, contained the small-sized foci of coagulative necrosis. Microscopic findings – in the pulmonary focus and in lymph nodes around necrotic masses the epithelial cells, lymphocytes and single multinuclear giant cells were detected. Diagnose this disease.
**Primary tuberculosis
Hematogenous tuberculosis with primary involvement of the lungs
Primary tuberculosis
Hematogenous generalized tuberculosis
Secondary focal tuberculosis
Secondary fibrous-focal tuberculosis
480076 The X-ray examination was showed a fibrous-focal tuberculosis in the both lungs, in apexes – there was bullous emphysema. Suddenly after physical exercise the strong pain in a right half of thorax and dyspnea had appeared in patient. During the clinic examination it was found out: cyanosis, thympanitis on the right side of the thorax, loosened breathing. What complication of tuberculosis has arisen?
**Spontaneous pneumothorax
Spontaneous pneumothorax
Arrosive bleeding
Atelectasis
Acute “cor pulmonale”
Amyloidosis
480077 In autopsy of patient, which suffered by tuberculosis for a long time, the cavity by the sizes 3х2 cm connected with a bronchus was found out in the upper lobe of right lung. The wall of the cavity dense has three layers: internal - pyogenic, middle - layer of tubercular granulation tissue, external – layer of connective tissue. What is the most probable diagnosis which this formation relative to?
**Fibrous-cavernous tuberculosis
Fibrous-cavernous tuberculosis
Fibrous-focal tuberculosis
Tuberculoma
Acute focal tuberculosis
Acute cavernous tuberculosis
480078 A man died in 8 days after the beginning of the disease. He was diagnosed with dysentery. In 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?
**Diphtheritic
Catarrhal
Chronic
Diphtheritic
Gangrenous
Ulcerative
480079 A 30-yer-old patient with bacteriologically proved dysentery developed the signs of paraproctitis. What is the stage of local changes of this patient?
**Ulceration stage
Healing of the ulcers stage
Catarrhal colitis
Fibrinous colitis
Ulceration stage
Follicular colitis
480080 During the past year a 22-year-old man begins to note persistent lower back pain and stiffness that diminishes with activity. Within the next 10 years he develops hip and shoulder pain with decreased range of motion. On physical examination at age 42 he has diminished lumbar lordosis with decreased lumbar spine mobility. He has no other major medical problems. Which of the following is the most likely diagnosis?
**Ankylosing spondylitis
Ankylosing spondylitis
Rheumatoid arthritis
Osteoarthritis
Lyme disease
Calcium pyrophosphate dihydrate deposition disease
480081 A 10-year-old girl has complained of joint pain for the past 2 years. The pain is localized to her knees and ankles; it occurs either with and without movement. The arthralgias are accompanied by a fever. On physical examination she has a temperature of 38.1 C. There is no deformity of her knees. She has generalized lymphadenopathy. Which of the following is the most likely diagnosis?
**Juvenile rheumatoid arthritis
Gonococcal arthritis
Juvenile rheumatoid arthritis
Ankylosing spondylitis
Tuberculous arthritis
Gout
480082 In autopsy the whole lower lobe of left lung had dirty-grey colour and liver-like consistence. There was yellow-gray fibrin on a pleura. An etiology of disease is pneumococcus type 1Y. Call this disease:
**Croupous pneumonia
Croupous pneumonia
Clottage of a bronchial arteries
Tuberculosis
Syphilis
Clottage of pulmonary arteries
480083 What complication is not a result of croupous pneumonia?
**Secondary amyloidosis
Abscess of the lung
Carnification
Gangrene of the lung
Secondary amyloidosis
Empyema of pleura
480084 A 45-year-old man has died because of pulmonary-cardiac insufficiency. In autopsy the pathologist has found out croupous pneumonia in lower lobe of left lung, 350ml of greenish-yellow fluid in the left pleural cavity. Microscopically it contained many neutrophils. Call the complication of pneumonia
**Empyema of pleura
Fibrinous pleuritis
Pneumothorax
Empyema of pleura
Hydrothorax
Hemothorax
480085 The patient has high temperature, dyspnoe, pain in the right part of the chest. 700 ml of creamy green-yellowish fluid was moved off in the result of pleural puncture. Which diagnosis is more possible?
**Empiema of pleura
Empiema of pleura
Hemorragic pleuritis
Serous pleuritis
Carcinomatosis of pleura
Fibrinous pleuritis
480086 In 30-year-old patient after heavy cooling the weakness, short-wind, pain in the left side of thorax and increasing of temperature to 39°C has appeared. Under objective examination the following features were found: the absence of breathing in the area of low lobe of the left lung, blunted sound under percussion and the murmurs of pleura’s friction. The patient died in 7 days after the beginning of the disease. During autopsy: the low lobe of the left lung had dense consistence, airless, grey colored on section, the pleura was thicken, dimmed, with multiple fibrinous films. Call the main disease and its stage.
**Grey hepatization, croupous pneumonia
Red hepatization, croupous pneumonia
Interstitial pneumonia initial stage
Gangrene, initial stage
Bronchoectatic disease, last stage
Grey hepatization, croupous pneumonia
480087 On autopsy it is revealed enlarged dense right lung, fibrin layers on the pleura. Lung tissue is light green color on incision with muddy liquid exudates. What lung disease are these symptoms typical for?
**Pulmonary gangrene
Interstitial pneumonia
Bronchopneumonia
Lung-fever
Pulmonary gangrene
Fibrosing alveolitis
480088 In the autopsy of a body of the miner, which got hematite, the pathologist has found out: black lungs, similar on lungs at an anthracosis. Microscopically: moderate pneumosclerosis, submiliar and miliar nodules, which consist of dust cells with spots [positive reacton to iron]. In lymph nodes there are a lot of dust and considerable diffuse sclerosis. Your diagnosis?
**Black siderosis
Black siderosis
Red siderosis
Aluminosis
Berilliosis
Caplan syndrome
480089 A 60-year-old miner has died because of chronic pulmonary-cardiac insufficiency. In autopsy the pathologist has found out: areas of dystelectasis, induration, pneumosclerosis in the both lungs, local emphysema in the apex. Cut surface was slaty-black. Diagnose this disease.
**Anthracosis
Talcosis
Anthracosis
Asbestosis
Silicosis
Aluminosis
480090 In an autopsy of the 59-year-old man, who has died because of chronic pulmonary-cardiac insufficiency the pathologist has found out: increased, densish lungs, cut surface with diffuse whitish nodules {2-3 mm in diameter}. Microscopic investigation: nodules contained concentric collagen fibers. Diagnose this disease:
**Nodal form of a silicosis
Miliary pulmonary tuberculosis
Hamman-Rich syndrome
Nodular pneumonia
Nodal form of a silicosis
Metastases of carcinoma of stomach in the lung
480091 The autopsy of the man's body, that was working for a long time as a miner and died beacuse of chronic pulmonary-cardiac insufficiency, revealed that lungs were not in their fulvolume, significantly thickened, sclerotic, the apexis were emphysematously changed, the surface was gray-black in colour, on section the lung tissue was aspid-black in colour. What disease caused the death?
**Anthracosis
Anthracosis
Silicosis
Asbestosis
Aluminosis
Talcosis
480092 Microscopy of bronchial biopsy of a man aged 50 with 20 years history of chronic bronchitis has revealed that the mucous membrane is thicken, mucous glands look like cysts; columnar epithelium has partially turned into multiplayer squamous one. Which of the listed diagnoses is most probable?
**Metaplasia
Hypertrophy
Hyperplasia
Dysplasia
Atrophy
Metaplasia
480093 Autopsy of a man aged 56 who had right lower lobar pneumonia and for a long time coughed out muco-purulent discharge has revealed a cavity with dense edges with purulent masses in the 9-10th segments of the right lung. White line stretched from cavity to the root of lung. Microscopy has revealed that the cavity is limited with a membrane, connective tissue outside and granular inside. Which of the diagnoses is most probable?
**Chronic abscess
Chronic bronchitis
Bronchiectatic disease
Gangrene of lungs
Abscess of lungs
Chronic abscess
480094 A 56-year-old woman has smoked 2 packs of cigarettes per day for the past 35 years. She has had a chronic cough for the past 8 years, but recently has noted increased sputum production. On physical examination she has a few crackles ausculated best over the lung bases. Bronchoscopy with biopsy is performed. The biopsy reveals bronchial epithelium with squamous metaplasia. Which of the following statements represents the best interpretation of these findings?
**She has an increased risk for pulmonary infection
She has an increased risk for pulmonary infection
This is a physiologic process of aging
This process is irreversible, even if she stops smoking
She has metastases to lung from a primary somwhere else
A pulmonary thromboembolus caused pulmonary infarction
480095 During autopsy of the 29 year-old man, which suffered by a peptic ulcer of a duodenum for a long time, the signs of a peritonitis, multiple steatonecroses of pancreas and retroperitoneal fatty tissue were found out, and in the duodenum - the ulcer-like defect with diameter 5 mm and depth to 10 mm with margins contained necrotic masses. Diagnose complication of the peptic ulcer of the duodenum.
**Penetration
Perforation
Bleeding
Stenosis
Penetration
Malignization
480096 The patient, who suffered from ulcer of the stomach, had gastric bleeding. Which is the most probable mechanism of the vascular wall damage?
**Erosion (arrosion of vessels)
Rupture
Erosion (arrosion of vessels)
Spasm
Edema
Increased permeability
480097 An individual is characterized by rounded face, broad forehead, a mongolian type of eyelid fold, flattened nasal bridge, permanently open mouth, projecting lower lip, protruding tongue, short neck, flat x hands, and stubby fingers. What diagnosis can be put to the patient?
**Down's syndrome
Turner's syndrome
Alkaptonuria
Supermales
Down's syndrome
Klinefelter's syndrome
480098 In autopsy of stillborn it was found out: complete defect of posterior wall of spine, meninges, soft tissues, skin. Spinal cord is visible on anterior wall of spine clearly. What is the most probable diagnosis?
**Rhachischisis
Rhachischisis
Anencephaly
Hydrocephalus
Amelia
Cyclopia
480099 During the autopsy the pathologist has marked: the expressed linear shrinkage and thickening of extremities with formation on a skin of large tucks. The head is increased, nose is saddle, the oral cavity is semi-opened, tongue is thick, neck is short, bodies of spondyles are dwarfed, hypoplasia of thorax is combined with hypoplasia of lungs. Which inherent malformation of a musculoskeletal system is it characteristic for?
**Lethal micromelia
Chondroplasia
Imperfect bone formation
Lethal micromelia
Inherent marble bones
Inherent Oppenheim myatonia
480100 Mrs G.H. is a 30-year-old housewife who is seen by her doctor because her sister had told her that she was looking a bit thin. She tells you that she has indeed lost weight in spite of a good appetite. When you question her you notice that she has exophthalmos. On examination, her thyroid gland is diffusely enlarged and her pulse is 100 with atrial fibrillation. Microscopy: prismatic epithelium turns into cylindrical, epithelium proliferation with formation of papillae, colloid vacuolization, lymphoid plasmocyte stroma infiltration, formation of lymphoid follicles with germ centers are observed. Which of the listed diagnoses is most probable?
**Basedowian disease (Graves disease)
Basedowian disease (Graves disease)
Sporadic goiter
Endemic goiter
Autoimmune thyroiditis
Follicular carcinoma
480101 During the intraoperative biopsy of thyroid gland the histological examination revealed lymphoid structures with growth centers, which were among the folliculi full of colloid. What disease was it?
**Hashimoto's thyroiditis (lymphadenoid goiter)
Ridel's goiter
Sporadic goiter
Endemic goiter
Hashimoto's thyroiditis (lymphadenoid goiter)
Thyrotoxicosis (Basedow's goiter)
480102 A clinical study is peformed involving subjects who women are ranging in age from 15 to 45 years who palpated breast "lumps" on self-examination. The presence of breast mass lesions in these subjects was subsequently confirmed by physical examination and by mammography. All subjects had a biopsy or excision of their lesion performed, with a definitive pathologic diagnosis made. Which of the following diagnoses is likely to be the most frequent in these subjects?
**Fibrocystic changes
Abscess
Fibrocystic changes
Fibroadenoma
Lobular carcinoma in situ
Infiltrating ductal carcinoma
480103 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.
**Glandular- cystic hyperplasia
Glandular- cystic hyperplasia
Hypertrophic excrescence
Metaplasia
Displasia
Atrophy
480104 During histological investigation of prostate gland, that has been resected in 72-year-old patient with symptoms of difficult urination the following signs were found: enlargement of glandular and muscle’s elements with disturbance of glandular structure. What process is more probable?
**Glandular hyperplasia
Adenocarcinoma
Muscle-fibrotic hyperplasia
Glandular hyperplasia
Mixed variant of prostatopathy
Prostatitis
480105 The pathologist has found out in histological examination of a remote uterus a lot of glandular formations with single cysts in myometrium, endometrium had usual structure. Described changes are characteristic for …
**Endometriosis
Glandular hyperplasia of endometrium
Endometriosis
Adenocarcinoma of uterus
Adenomatosis of a mucosa of a uterus
Leyomyosarcoma of uterus
480106 A woman suffered with dysfunctional metrorrhagia was made a diagnostic abortion. Histologically in the scrape there were a lot of small stamped glandulas covered by multirowed epithelium. The lumens of some glandulas were cystically extended. Call the variant of general pathologic process in the endometrium.
**Glandular-cystic hyperplasia of endometrium
Atrophy of endometrium
Glandular-cystic hyperplasia of endometrium
Metaplasia of endometrium
Neoplasm of endometrium
Hypertrophic growth
480107 An autopsy has revealed that kidneys are enlarged, surface is large-granulary because of multiple cavities with smooth wall, which are filled with clear fluid. What kidney disease did the patient have?
**Polycystic kidney
Polycystic kidney
Infarction
Glomerulonephritis
Pyelonephritis
Necrotic nephrosis
480108 A.B. is a 13-year-old girl who is brought by her parents because she had become lethargic and her face appeared swollen, particularly around her eyes. On enquiry, she had recently recovered from a flu-like illness. As part of routine examination, her urine is tested with a dipstick and is found that to contain both protein and blood. She is also noted to have a mildly raised blood pressure. The patient is referred to hospital where she is found to have raised urea and creatinine together with a reduced urine output. Renal biopsy is performed. The histology report reveals hypercellularity of glomeruli with neutrophils in capillary lumens. Granular deposition of IgG, Clq and C3 are seen in the glomerular basement membrane and mesangium. Electron microscopy confirms the presence of electron dense deposits in the basement membrane, predominantly in a subepithelial location. Which diagnose is most probable?
**Acute diffuse proliferative glomerulonephritis
Focal segmental proliferative glomerulonephritis
Chronic glomerulonephritis
Acute diffuse proliferative glomerulonephritis
Acute pyelonephritis
Chronic pyelonephritis
480109 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 7x3x2.5 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?
**Uremia
Thrombopenia
Uremia
Anemia
Sepsis
DIC-syndrome
480110 A patient died with uremia. The autopsy demonstrated kidneys to be enlarged, of flabby consistence, cortex was broad, edematous, with red spots; medulla was dark red in colour. Microscopic examination in the glomeruli capsule cavity revealed "semilunar formations", squeezing capillaries, nephrocytes dystrophy, edema and infiltration of stroma. What disease caused the death of the patient?
**Glomerulonephritis
Glomerulonephritis
Nephrotic syndrome