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A patient with a mitral valvular disease has a cough with a rusty phlegm. What pigment has determined the color? Haemoglobin Melanin @Haemosiderin Haemomelanin Ferum sulphite # 9 A patient with mitral cardiac disease suddenly occurred cough. Sputum has rusty colour. What pigment caused this? @Haemosiderin Melanin Haemoglobin Haemomelanin Iron sulphide # 10 The cells with a brown pigment were determined in patient’s phlegm, who had a mitral valve disease. The Perls’ test is positive. What pigment was mentioned? Bilirubin Haematoidin Melanin Porphyrin @Haemosiderin # 11 While in a home improvement center warehouse buying paint, a 35-year-old man hears "Look out below!" and is then struck on the leg by a falling pallet rack, which strikes him on his left leg in the region of his thigh. The skin is not broken. The yellow-brown color of the 5 x 7-cm bruise to his thigh a couple of weeks after this injury are due to the accumulation of: Lipofuscin Bilirubin Melanin @Hemosiderin Glycogen # 12 A 12-year-old boy with hemophilia A has decreased levels of coagulation factor VIII activity. He has pain about his knees. Over time, there is an increase in size of the knee joints with deformity. Which of the following materials is most likely to be seen within the joint space following episodes of pain: Lipofuscin Russell bodies Neutrophils Cholesterol crystals @Hemosiderin # 13 A 22-year-old woman has a congenital anemia. She has required multiple transfusions of red blood cells for many years. She now has no significant findings on physical examination. Laboratory studies now show a serum AST of 74 U/L and ALT 75 U/L with albumin 3.6 g/dL. Which of the following microscopic findings would most likely appear in a liver biopsy? Steatosis in hepatocytes Bilirubin in canaliculi @Hemosiderin in hepatocytes Glycogen in hepatocytes Amyloid in portal triads # 14 A 36-year-old man presents because his skin has been darkening recently. You notice that his skin has dark, somewhat bronze color. Work-up reveals signs of diabetes mellitus. His serum iron is found to be 1150mg/dL, and his transferring saturation is 98%. A liver biopsy is performed and reveals extensive deposits of hemosiderin in the hepatocytes and Kupffer cells. Which of the following basic abnormalities is the most likely cause of this constellation of clinical findings? Defective excretion of copper into the bile Defective synthesis of α1 antitrypsin Defective synthesis of glycogen Excessive absorption of galactose from the small intestines @Excessive reabsorption of iron from the small intestines # 15 A man with insufficiency of the mitral valve complained of a cough and sputum with a brownish colouring. Which pigment results in this color of the sputum? @Hemosiderin Melanin Hemoglobin Hemomelanin Iron sulfate # 16 The post-mortem of a man who presented in the hospital with a history of snakebite reveals expressed intravessels hemolysis. During dissection it is noted that the spleen, bone marrow and lymphatic nodes had a brown colouring. Microscopic examination showed that the cytoplasm of macrophages got a brown pigment. Which pigment accumulated in the tissues? @Hemosiderin Hematoidin Hematin Lipofuscin Bilirubin. # 17 A 58-year-old male has been ill for many years with leukemia. A post-mortem exposed a brown color in the marrow, spleen, liver, and lymphatic nodes. The Perls' histochemical reaction was conducted. It was determined that the reticular, the endothelial cells and histiocytes of these organs contained granules of a dark blue color. Which pigment is responsible for the colouring? @Hemosiderin Bilirubin Hematoidin Hemomelanin Hematoporphyrin # 18 A 56 year old patient died from chronic cardiac insufficiency as a result of rheumatic heart-disease. A post-mortem revealed that lungs were enlarged, dense with red-brownish coloring. What is the most likely diagnosis? @Brown induration lungs Acute bronchitis Honey-comb lungs Chronic bronchitis Chronic emphysema # 19 A 65-year man died of chronic cardiac failure. Autopsy: brown-coloured due to rheumatic cardiac disease, enlarged and thickened lungs. What's the name for such lung changes? @Brown lung induration Nutmeg lungs Cell lungs Chronic bronchitis Chronic # 20 A patient with mitral valve insufficiency presents in his sputum cells, filled with brown pigment. The Perls' reaction is positive. Name this pigment. @Hemosiderin Hematoidin Melanin Porphyrin Bilirubin # 21 True statement regarding hemachromatosis include all the following EXCEPT It characteristically causes a micronodular pigment cirrhosis It is complicated by carcinoma of the liver in 15 to 30 percent of cases with cirrhosis It causes diabetes with severity unrelated to the degree of pancreatic iron deposition It can be diagnosed by liver biopsy showing raised amounts of hemosiderin @It is associated with skin pigmentation due entirely to deposition of hemosiderin # 22 A patient developed a cyst in the cerebrum following a hemorrhagic stroke. Two years later the patient died from pneumonia due to a complication of influenza. During examination of the brain cyst it is noted that the walls have a rusty tint. Perls' reaction is positive. Name the process occurring in the wall of the cyst? @Localized hemosiderosis General hemosiderosis Local hemomelanosis Infiltration of bilirubin Primary haemochromatosis # 23 A post-mortem of a 44-year-old patient with a history of mitral stenosis reveals dense lungs that are a brown color. Which pathological process is most likely in the lungs? @Hemosiderosis Hemochromatosis Icterus Heme-melanosis Lipofuscinosis # 24 An autopsy of a man, who suffered from mitral stenosis, showed thickened lungs of brown colour. What pathological process is described? @Haemosiderosis Haemochromatosis Jaundice Haemomelanosis Lipofuscinosis # 25 A 45-year-old male, with a long history of rheumatism and mitral valve insufficiency, develops a chronic cough with rusty expectoration. What pigment colored sputum? @Hemosiderin. Melanin. Hemoglobin. Malarial pigment. Iron sulfide. # 26 A 67-year-old man, with a long history of mitral valve's insufficiency, has been experiencing a cough with red-brownish coloring of sputum. Cells with brown pigmentation and positive Perls' test were detected in the sputum. Which pigment responsible for the septum coloring? @Hemosiderin. Hematoidin. Melanin. Porphyrin. Bilirubin. # 27 In newborn on the 5th day of life the hypertermia and seizures are observed. Child flaccid, reflexes are lowering. Skin and mucoses are yellow. Blood level of indirect bilirubin is 65.5 mcmol/l. What is more dangerous in this state? @Kernicterus (nuclear jaundice) Nephrotoxicity of bilirubin Anemia Accumulation of products of hemolysis This is physiologic jaundice (not dangerous) # 28 In newborn on the 3rd day of life skin and mucoses became slightly yellow. Blood level of direct bilirubin is 5.0 mcmol/l, indirect bilirubin is 30.5 mcmol/l. What diagnosis is it possible to think about? @Physiologic (neonatal) jaundice Kernicterus (nuclear jaundice) Toxic hepatitis Parenchymatous jaundice Obstructive jaundice # 29 Blood analysis of a patient’s ill with jaundice revealed increase of total bilirubin by its indirect fraction. Urine and feces are intensively stained. What is the most probable mechanism of these abnormalities? Damage of liver parenchyma Obstructed bile outflow from the liver Disturbed conversion of urobilinogen in liver @Increased erythrocyte hemolysis Disturbed formation of direct bilirubin # 30 In newborn on the 3rd day of life the skin and mucoses are yellow. Blood level of direct bilirubin is 4.5 mcmol/l, indirect bilirubin – 65.5 mcmol/l. This state is the result of what process? @Hemolysis of erythrocytes Obstruction of bile ways Fructose intolerance Parenchymatose jaundice Toxic hepatitis # 31 A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood plasma the total bilirubin is increased, stercobilin is increased in feces, urobilin is increased in urine. What type of jaundice is it? Gilbert's disease Obturational Cholestatic Parenchymatous @Haemolytic # 32 Blood analysis of a patient’s suffering from jaundice revealed increase of total bilirubin by its indirect fraction. Urine and feces have intense colouring. What is the most probable mechanism of these abnormalities? Obstruction of bile outflow from the liver Impaired transformation of urobilinogen in the liver Damage of liver parenchyma Impaired generation of direct bilirubin @Increased haemolysis of erythrocytes # 33 Enzymatic jaundices are characterized by disbalanced activity of UDP-glucuronyl transferase. What compound is accumulated in the blood serum in case of these pathologies? Biliverdin @Indirect bilirubin Verdoglobin Direct bilirubin Mesobilirubin # 34 Young woman after snake’s bite has developed the picture of hemolysis. The jaundice of the skin, scleres and mucous membranes are detected. These symptoms are caused by bilirubin accumulation. What type bilirubin is accumulated in the blood? @Indirect bilirubin Direct bilirubin Indirect and direct bilirubin Ferritine Haemomelanine # 35 A 52-year-old male with a history of sub-acute septic endocarditis is examined by a physician. A doctor revealed marked general pallor with icteric skin, sclera and visible mucous membranes. Blood test showed accumulation of indirect reacting bilirubin (unconjugated bilirubin). The yellow staining of the skin, sclera and mucous membranes indicates which one of the following? @Prehepatic jaundice Fatty dystrophy Hemosiderosis Hepatic jaundice Posthepatic jaundice # 36 All following disorders lead to the haemolytic jaundice EXCEPT one: Sepsis Isoimmune conflict Talassemias Malaria @Arterial hypertension # 37 A full-term normal male infant develops a slight yellow color to his skin on his second day of life. Laboratory examination finds his serum bilirubin levels to be slightly elevated (due to increased indirect bilirubin), but the levels are less than 6mg/dL. Additionally, serum hemoglobin levels are within normal limits. By the fifth day his bilirubin levels have returned to normal levels and abnormal yellow skin color has disappreared. No therapy was given to this infant. Which of the following is the most likely cause of these signs and symptoms? Crigler-Najjar syndrome Hemolytic disease of the newborn Inspissated bile syndrome Intrauterine varicella infection @Physiologic jaundice of the newborn # 38 Pre-hepatic (hemolytic) jaundice takes place in all the following cases besides the only one of them: @Viral hepatitis Sepsis Malaria Hemolytic disease of newborns Relapsing fever # 39 A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will have strengthened concentration in the blood serum? Biliverdin @Unconjugated bilirubin Verdoglobin Mesobilirubin Conjugated bilirubin # 40 A 12-year-old boy with sickle cell anemia presents with recurrent severe right upper quadrant colicky abdominal pain. At the time of surgery, multiple dark black stone are found within the gallbladder. These stones are composed of which one of the following substances? @Bilirubin Carbon Cholesterol Struvite Urate # 41 A 54-year-old man presents with a high fever, jaundice, and colicky abdominal pain in the right upper quadrant. The gallbladder cannot be palpated on physical examination. Work-up reveals hemoglobin level of 15.3g/dL, unconjugated bilirubin level of 0.9mg/dL, conjugated bilirubin level of 1.1 mg/dL, and alkaline phosphatase level of 180 IU/L. which of the following is the most likely diagnosis? Acute cholecystitis Chronic cholecystitis @Bile duct obstruction by a stone Carcinoma of the gallbladder Carcinoma of the head of the pancreas # 42 According to Courvoisier’s law, a pancreatic cancer located in the head of the pancreas should be suspected in an individual with which one of the following clinical signs? Migratory thrombophlebitis @Obstructive jaundice and a dilated gallbladder Obstructive jaundice and a nonpalpable gallbladder Steartorrhea and a nontender gallbladder Steartorrhea and a tender gallbladder # 43 The patient is admitted to a hospital with hyperthermia and complaints of weakness, loss of appetite, and yellow color of skin, lighter than usually color of feces. Blood level of indirect is 28.5 mmol/l, direct bilirubin – 20.5mmol/l. What additional investigation is the most important for diagnosis? @Urobilinogen in urine Tercobilin in feces Hemoglobin in blood Bilirubin in urine Alkaline phosphatase in blood # 44 A patient with apparent icteritiousness of skin, sclera and mucous membranes was admitted to the hospital. The patient's urine was of brown ale colour, analysis revealed presence of direct bilirubin. Feces had low concentration of bile pigments. What type of jaundice is it? Parenchymatous @Obturative Haemolytic Conjugated Absorbtion # 45 A patient ill with jaundice has increased content of conjugated bilirubin and bile acids in blood, no stercobilinogen in urine. What jaundice are these symptomps typical for? Cythemolytic Hepatic Hemolytic Hepatocellular @Obstructive # 46 A 48-year-old patient was admitted to the hospital with complaints about weakness, irritability, sleep disturbance. Objectively: skin and scleras are of yellow colour. In blood: increased concentration of total bilirubin with prevailing direct bilirubin. The feces are acholi c. The urine is dark (contains bile pigments). What type of jaundice is it? Gilbert's syndrome Crigler-Najjar syndrome @Mechanic Parenchymatous Haemolytic # 47 On patient's gastroscopy was detected gastric ulcer of the mucous membrane with stamped edges and brown-black base, and on gastrobiopsy acute ulcer is confirmed with brown-black pigment in its necrotic layer. What is the pigment? @Hydrocloride hematin Hemosiderine Bilirubin Ferritin Porphirin # 48 A fluid of coffee grounds color was endoscopically determined in a patient who had ulcerative disease of the stomach with bleeding. What pigment does determine the color? Haemosiderin @Haematin chloride Bilirubin Ferritin Porphyrin # 49 A 46-year-old man has an acute stomach ulcer complicated by gastric bleeding and vomiting. Gastric masses had a brown color and "coffee-like" appearance. Which pigment created such colouring? @Hematin hydrochloride Hemoglobin Bilirubin Hemomelanin Iron sulfide # 50 A patient with acute peptic ulcer and haemorrhage has vomit of brown, coffee-like colour. What pigment defines the colour? @Haematin chloride Haemoglobin Bilirubin Haemomelanin Iron sulphide # 51 |