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The presence in serum of a mu heavy-chain protein is associated with which of the following disease? @Chronic lymphocytic leukemia Lymphoblastic lymphoma Poorly-differentiated lymphocytic lymphoma Plasma cell myeloma Multiple myeloma # 7 A 64-year-old man is being evaluated for pancytopenia. Clinical examination reveals a marked increase in the size of his spleen. A bone marrow biopsy histologically reveals replacement of the normal marrow cells by a diffuse proliferation of the small mononuclear cells. There is a clear space around each of these abnormal cells (“fried egg” apperance). These cells stained positively for cytoplasmic acid phosphatase and this staining was not inhibited by treatment with tartrate. A bone marrow did not reveal any marrow particles. Although his peripheral leukocyte count was decreased, the majority of the cells were lymphocytes. Which of the following is the expected histologic appearance of these lymphocytes? “Cerebriform” lymphocytes “Chicken-footprint” lymphocytes “Cloverleaf” lymphocytes @”Hiry” lymphocytes “Smudge” lymphocytes # 8 A 54-year-old woman presents with headaches, viral abnormalities, bleeding, and Raynaud’s phenomenon. Work-up reveals normal serum calcium, and no lytic lesions are found within the skeleton by x-ray. Serum electrophoresis reveals a single large M spike in the peripheral blood due to a monoclonal proliferation of IgM. Sections from the patient’s bone marrow reveal numerous plasma cells, lymphocytes, and plasmacytoid lymphocytes. Which of the following is the most likely diagnosis? IgM multiple myeloma Monoclonal gammopathy of undetermined significance Mu heavy-chain disease Plasmacytoid small-cell lymphoma @Waldenstrom’s macroglobulinemia # 9 Clinical investigation of a patient revealed the enlarged lymph nodes, spleen and liver. A microscopical study of the enlarged cervical (neck) lymph node showed the blurring of its structures and absence of lymphatic follicles. All microscopical views were presented by cells with round nuclei and narrow ring of a basophilic cytoplasm. What is the most likely diagnosis? @ Lymphatic leucosis Lymphogranulomatosis Lymphosarcoma Myeloleukemia Multiple myeloma # 10 Microscopical examination of an enlarged cervical lymph node revealed blurring of its structure, absence of lymphoid follicles; all the microscopic fields showed cells with roundish nuclei and thin limbus of basophil cytoplasm. It is known from the clinical data that other groups of lymph nodes are also enlarged as well as spleen and liver. What disease might be suspected? Lymphosarcoma Lymphogranulomatosis Myeloid leukosis Multiple myeloma @Lymphoid leukosis # 11 A 72-year-old man presents with increasing fatigue. Physical examination reveals an elderly man in no apparent distress (NAD). He is found to have multiple enlarged, nontender lymph nodes along with an enlarged liver and spleen. Laboratory examination of his peripheral blood reveals a normocytic normochromic anemia, a slightly decreased platelet count, and a leukocyte count of 72,000 cells/µL. An example of his peripheral blood is seen in the picture below. Which of the following is the most likely diagnosis? Acute lymphoblastice leukemia Atypical lymphocytosis @Chronic lymphocytic leukemia Immunoblastic lymphoma Prolymphocytic leukemia # 12 An autopsy of a 35-year-old woman revealed the enlarged spleen, (weight 800gm), liver (weight 4000 gm) and lymph nodes. A bone marrow of a femur diaphysis was juicy (succulent), crimson-red color. Microscopical study of a liver defined dense infiltrates within portal tracts, consisted of immature blood cells. These cells had a round nuclei and narrow ring of a cytoplasm. What is the most likely diagnosis? @Chronic lymphatic leukemia Chronic myeloid leucosis Generalizated form of lymphogranulomatosis Acute myeloblasts leucosis Acute lymphoblastic leucosis # 13 A liver biopsy was taken from a 66-year-old man, with a history of increased quantity of lymphocytes and pro-lymphocytes in his blood. A histological investigation of a liver sample revealed plural accumulations of the mentioned above cells, mainly between hepatic segments. For what disease above listed changes are characteristic? @Chronic lymphatic leukemia Acute lymphatic leukemia Lymphogranulomatosis Chronic persistence hepatitis Hepatocellular carcinoma of liver # 14 A radiological investigation of a man's head revealed in his maxillary and mandibular bones numerous round defects with smooth walls. A histological study showed osteolysis and osteoporosis accompanied with insufficient bone repair. The laboratory test of the urine detected the Bence Jones protein. What is the most likely diagnosis? @Multiple myeloma Chronic myeloleukemia Chronic erythromyelosis Acute myeloleukemia Acute nondifferentiated leucosis Bone fibrous dysplasia # 15 Patient, 60 years old, is admitted to a hospital with spontaneous fracture of neck of the femur. During the last year motiveless pains in the muscles and bones were observed. Result of biochemical investigation shown that concentration of protein in the blood serum of the patient is 115 g/l, protein of Bence Jones is present. What diagnosis is it possible to think about? @Multiple myeloma Hartnup’s disease Podagra (gout) Myodistrophy Dermatomyositis # 16 A bone marrow aspirate was obtained from a 70-year-old man whose symptoms included weakness, weight loss, and recurrent infection. Laboratory finding included proteinuria, anemia, and an abnormal component in serum proteins. A photomicrograph of the bone marrow aspirate is shown below. The most probable diagnosis is Monomyelocytic leukemia Hitiocytic leukemia @Multiple myeloma Gaucher’s disease Leukemic reticuloendoteliosis # 17 A 70-year-old man presents with increasing weakness and weight loss. Laboratory finding include anemia, hypercalcemia, and increased serum protein. A photomicrograph of the bone marrow aspirate is shown below. Which of the following histologic finding is present in this photomicrograph? Accumulation of glycogen in hystiocytes, as seen with Gaucher’s disease Decreased numbers of myeloid precursors, as seen with aplastic anemia Increased numbers of myeloblasts, as seen acute myelocitic leukemia @Increased numbers of plasma cells, as seen multiple myeloma Numerous inclusions in eritroid precursors, as seen with parvovirus infection # 18 A 34-year-old male is found to have weakness confusion, other neurologic manifestation and polyuria X-ray examination revealed multifocal destructive bone lesions throughout the skeletal system. Electrophoretic analysis revealed increased level of Ig in the blood and Bence Jones protein in the urine. What is the most likely diagnosis? @Myeloma Acute monocytic leukemia Chronic myeloleukemia Lymphogranulomatosis Histiocytosis # 19 A 65-year-old female is noted to be anemic. He serum protein electrophoresis demonstration a large monoclonal Ig G kappa protein. In her bone marrow are increased numbers of atypical plasma cells. Her skull X-ray show multiple lytic areas. What is the most likely diagnosis? @Myeloma Polycytemia vera (erythremia, Osier's disease) Lymphocytic lymphoma Chondrosarcoma # 20 An elderly male is admitted to the hospital for treatment of humeral bone fracture. His fracture's area X-ray showed a new growth and lytic zone within lesion. Histological examination of a biopsy revealed abnormal plasma cells. What is the most likely diagnosis? @Myeloma Chronic osteomyelitis Chondrosarcoma. Bone fibrous dysplasia Metastasis of adenocarcinoma # 21 Chronic myeloid leukemia is LEAST likely to be associated with Splenomegaly Basophilia @Translocation (8; 14) Thrombocytosis Low leukocyte alkaline phosphatase (LAP) # 22 At the roenngenological examination were detected multiple defects that looked like round apertures with plain walls. Histologicaly were revealed the facts of osteolysis and osteoporosis against the background of bad osteogenesis. Bence Jones protein is presented in the urine. Name the disease. Acute undifferentiated leucaemia Chronic myeloleucaemia Chronic erythromyelosis Acute myeloleucaemia @Myeloid disease # 23 Multiple focuses of osteoporosis and osteolysis were visualized in plane bones of the patient during the roenngenological examination. At the biopsy material from bones was revealed an increased amount of tumour plasmatic cells. What is your diagnosis? Histiocytosis Acute monocytic leucaemia Chronic myeloleucaemia Lymphogranulomatosis @Myeloid disease # 24 A 42-year-old female is admitted to the hospital for treatment a blood disorder. A disease complicated with pneumonia led to lethal outcome. An autopsy revealed hyperplasia of a bone marrow with "pus" - like appearance, splenomegaly (5 kg weight), hepatomegaly (6 kg weight), systemic lymph nodes enlargement. What is the most likely diagnosis? @Chronic myeloleukemia Chronic lymphatic leukemia Myeloma Polycytemia vera (erythremia, Osier's disease) Lymphogranulomatosis # 25 Hyperplasia of medulla in plane and tubular bones (pyoid medulla), splenomegaly (6kg), hepatomegaly (5kg), an enlargement of all groups of lymphatic nodules were revealed at the autopsy. What is the most possible disease? Myeloid disease Chronic lympholeucaemia @Chronic myeloleucaemia Real polycythaemia Lymphogranulomatosis # 26 A patient suffering from chronic myeloleukemia has got the following symptoms of anemia: decreased number of erythrocytes and low haemoglobin concentration, oxyphilic and polychromatophilic normocytes, microcytes. What is the leading pathogenetic mechanism of anemia development? @Substitution of haemoblast Intravascular hemolysis of erythrocytes Deficiency of vitamin B12 Reduced synthesis of erythropoietin Chronic haemorrhage # 27 During an autopsy of a man: pyoid marrow with myelocytes, pro-myelocytes and blast cells in it, splenomegalia (7kg) with myelocyte infiltration, hepatomegalia (6kg) with diffuse leukosis infiltration of sinusoids. What is the most probable diagnosis? Acute myeloleukosis @Chronic myeloleukosis Acute undifferentiated leukosis Acute lympholeukosis Chronic lympholeukosis # 28 X-ray showed that a patient has numerous round defects in his jaws. Histologically: osteolysis and osteoporosis in the background of weak osteogenesis. There is Bens-Jones' protein found in the urine. Name the disease. @Myeloid disease Chronic myeloleukosis Chronic erythromyelosis Acute myeloleukosis Acute undifferentiated leukosis # 29 During an autopsy of a man, died of uraemia: there are round, with smooth walls defects in skull bones, ribs and vertebrae. Microscopically: in bones there is lymphoplasmacytic cells infiltration of marrow along with osteolysis and osteoporosis. What is the most probable diagnosis? Heavy chain disease Primary macroglobulinaemia @Myeloid disease Parathyroid osteodystrophy Lymphocytic leukosis # 30 A patient complains about dyspnea provoked by the physical activity. Clinical examination revealed anaemia and presence of the paraprotein in the zone of gamma-globulins. To confirm the myeloma diagnosis it is necessary to determine the following index in the patient’s urine: Antitrypsin Ceruloplasmin Bilirubin Haemoglobin @Bence Jones protein # 31 A patient presented with an infiltrative, plaque-like polymorphic skin rash, which had various contours, sizes and a congested -cyanotic color. The lesions tended to peripheral growth and fusion. A microscopical investigation of a skin biopsy revealed massive lymphocytes' proliferation, which occupied the entire derma and a hypodermic fatty layer. What is the most likely diagnosis? @Limphoma of skin Systemic lupus erythematosus Mycosis fungoi'des Intradermal nevus - # 32 A 20-year-old man presents in the emergency room with respiratory distress resulting from a lymphoma involving his mediastinum. These malignant lymphocytes most likely have cell surface markers characteristic of what type of cell? B lymphocytes @T lymphocytes Macrophages Dendritic reticulum cells Langenhars cells # 33 The non-Hodgkin’s lymphoma pictured in the photomicrograph below may be characterized by which of the following? Increased frequency in adolescents Lymphoblastic lymphoma @B lymphocytes Tingible-body macrophages nodules Well-differentiated lymphocytic lymphoma # 34 A 60-year-old man presents with several enlarged lymph nodes involving his right axilla. A biopsy from one in these enlarged lymph nodes reveals effacement of the normal lymph node architecture by a diffuse proliferation of small, normal-appearing lymphocytes. These same cells are present in the peripheral blood, enough to cause a peripheral lynphocytosis. A bone marrow biopsy reveals a diffuse proliferation of these small lymphocytes. Special stains reveal these cells to be positive for CD5 and CD23. Which of the following is the classification for this type of lymphoma? A high grade non-Hodgkin’s lymphoma (using the Working Formulation) @A low grade non-Hodgkin’s lymphoma (using the Working Formulation) A precursor B cell neoplasm (using the REAL classification) A peripheral T cell neoplasm (using the REAL classification) A poorly differentiated lymphoma (using the Working Formulation) # 35 A 65-year-old presents with several enlarged lymph nodes in his left supraclavicular region. Physical examination reveals painless lymphadenopathy in this region. No other abnormalities are found. A biopsy from one of these enlarged lymph nodes, which is shown in the associated picture, reveals effacement of the normal lymph node architecture by numerous nodules of uniform size that are crowded within the cortex and medulla of the lymph node. Tangible-body macrophages are not seen in these nodules. Which of the following in the most likely diagnosis? @Follicular non-Hodgkin’s lymphoma Lymphocyte predominate Hodgkin’s disease Metastatic adenocarcinoma Reactive follicular hyperplasia Small lymphocytic lymphoma # 36 An 8-year-old African girl develops rapidly enlarging mass that involves a large portion of the right side of her maxilla. A smear made from an incisional biopsy of this mass reveals malignant cells of cytoplasmic vacuolis that stain positively with oil red O. Histologic section from this biopsy reveal a diffuse, monotonous proliferation of small, noncleavedlymphocytes. In the background are numerous tangible-body macrophages that impart a “starry-sky” appearance to the slide. Which of the following viruses is most closely associated with this malignancy? Cytomegalovirus (CMV) @Epstein-Barr virus (EBV) Herpes simplex virus (HSV) Human immunodifeciency virus (HIV) Human pappilomavirus (HPV) # 37 Examination of a tissue sample of enlarged cervical lymph nodes taken from a young woman revealed proliferation of lymphocytes, reticular cells, macrophages, big and small Hodgkin's cells, multinuclear Sternberg-Reed cells. There were also multiple eosinophils, single foci of caseous necrosis of the node tissu E. What is the most probable diagnosis? Tuberculosis Lymphosarcoma Metastasis of lung cancer @Lymphogranulomatosis Acute leukosis # 38 Examination of a 16 year old boy revealed enlarged submandibular and cervical lymph nodes. The boy was subjected to biopsy. Microscopic examination of lymph nodes revealed: typical structure is obliterated, cell population is heterogenous, there are big cells with multilobe nuclei, multiple big mononuclear cells, eosinophilic and neutrophilic leukocytes, lymphocytes, besides that, there are necrotic areas and foci of sclerosis. What is the most probable diagnosis? @Lymphogranulomatosis Granulomatous lymphadenitis Suppurative lymphadenitis Lymph node hyperplasia Non-Hodgkin's lymphoma # 39 A 22 year woman has enlarged lymphatic ganglions. Histological analysis of a ganglion revealed lymphocytes, histiocytes, reticular cells, small and great Hodgkin's cells, multinuclear Reed-Sternberg cells, solitary foci of caseous necrosis. What disease are these changes typical for? Lymphosarcoma Acute leukemia @Lymphogranulematosis Chronic leukemia Cancer metastasis # 40 Autopsy of a 35 y.o. woman revealed not only enlargement of many lymph nodes but also enlarged spleen weighting 600,0. Its incision showed that it was heterogeneous, dark red, dense with greyish-yellow necrotic areas up to 1 cm in diameter (porphyritic spleen). What disease can be assumed? Chronic lymphoid leukosis Chronic myeloid leukosis Cancer metastases @Lymphogranulomatosis Lymphosarcoma # 41 A 25-year-old patient presented with peripheral adenopathy, involving a single cervical lymph node. A biopsy sample investigation revealed an unclear node pattern with mixed cellular infiltration. Histologycal study under higher magnification showed numerous variants of Berezovsky-Reed- Stenberg cells, lymphocytes, necrotic area and mild diffuse fibrosis. What is the most likely diagnosis?. @ Lymphogranulomatosis Nodular lymphoma Burkitt's lymphoma Lymphocytic lymphoma Chronic lymphatic leukemia # 42 The young man presented to his physician with enlarged neck lymph nodes. A microscopical investigation of a lymph node biopsy sample revealed the lymphoid tissue proliferation with presence of a giant Reed—Berezovsky - Sternberg cells, eosinocytes, zones of necrosis and sclerosis. What is the most likely diagnosis? @Lymphogranulomatosis Chronic lymphatic leukemia Multiple myeloma Lymphosarcoma Histiocytosis # 43 A microscopic investigation of the enlarged neck lymph node biopsy revealed the blurring of its structures, plenty of proliferating lymphocytes with adding of solitary giant Reed—Berezovsky-Sternberg cells. What is the most likely diagnosis? @Lymphogranulomatosis, with predominance of lymphatic tissue Lymphogranulomatosis, with exhaustion of lymphatic tissue Mixed cell variant of lymphogranulomatosis Lymphosarcoma Nodular sclerotic variant of lymphogranulomatosis # 44 A biopsy of the enlarged lymph node was taken. A histological investigation revealed a diffuse growth of lymphoid cells with adding of eosinocytes, atypical histiocytes, solitary giant Reed—Berezovsky-Sternberg cells with two and more nuclei, cell's necrosis and sclerosis. What is the most likely diagnosis? @Lymphogranulomatosis Lymphatic leukemia Burkett's lymphoma Sarcoidosis Myeloleukemia # 45 At young men the increased cervical lymph node is removed. Microscopic investigation revealed the altered node's structure, an absence of lymphoid follicles, sites of a sclerosis and necrosis. Thecellular infiltrate is polymorphic with a presence of lymphocytes, eosinocytes, and atypical one- nuclear cells and multinuclear giant cells (Reed—Berezovsky - Sternberg cells). What is the most likely diagnosis? @Lymphogranulomatosis Acute lymphatic leukemia Chronic lymphatic leukemia Burkett's lymphoma Mycosis fungoides # 46 A tomography revealed enlarged lymphatic nodes. A histological investigation of lymph node's biopsy showed a circular growths of a connective tissue, which surrounded a granuloma – like formation, made from lymphocytes, plasmocytes and giant double- nuclear cells. What is the most likely diagnosis? @Lymphogranulomatosis Lymphosarcoma Tuberculosis Sarcoidosis Lymphatic leukemia # 47 A physical examination of a 42-year-old man revealed enlarged lymph nodes. A histological investigation of a lymph node showed lymphocytes, histiocytes, reticular cells, small and big Hodgkin's cells, multinuclear Berezovsky -Reed-Sternberg cells (Sternberg-Reed cells) infiltration with solitary necrotic areas. What disease such changes characteristic for? @Lymphogranulomatosis Lymphosarcoma Chronic leucosis Acute leucosis Metastasis of carcinoma of lungs # 48 A patient has a cluster of matted together dense lymph nodes on his neck. Histological examination of a removed lymph node revealed proliferation of reticular cells, presense of Reed-Sternberg cells. What disease is meant? @Lymphogranulomatosis Myeloblastic leukosis Lymphocytic leukosis Lymphoblastic leukosis Myelocytic leukosis # 49 At autopsy an elderly female is found to have enlarged groups of a neck, axillary and mediastinal lymph nodes matted together. They were firm and rubbery. The cut surface was gray-white, producing a "fish-flesh" appearance. Microscopy revealed heterogeneous cellular infiltrate wich contained lymphocytes, classic and mononuclear Reed-Berezovsky-Sternberg cells. What is the most likely diagnosis? @Lymphogranulomatosis Chronic lymphatic leukemia Lymphosarcoma Retikulosarcoma Mycosis fungoides # 50 An autopsy of a 67-year-old man revealed the systemic enlargement of lymph nodes with formation of tumorous conglomerates. The spleen was also enlarged with a motley pattern of a cut surface. There were plural, tiny, yellowish-white spots on a red background of a spleen's pulp. What is the most likely diagnosis? @Lymphogranulomatosis Sarcoidosis Lymphosarcoma Carcinoma of lung Lymphatic leukemia # 51 A 67-year-old female presented with painless enlargement of lymph nodes. Histological examination of a biopsy sample revealed that the whole lymph node pattern was unclear, with heterogeneous cellular infiltrate. It included abnormal, immature cells admixed with lymphocytes, eosinophils, plasma cells and macrophages. Binucleated Berezovsky-Reed-Sternberg cells, where surrounded by multiple cell types. What is the most likely diagnosis? @Lymphogranulomatosis Acute myeloleukemia Chronic myeloleukemia Mycosis fungoides Tuberculosis # 52 A 14-year-old boy presented to a hospital with enlarged submaxillary and cervical lymph nodes. A biopsy procedure was performed. Microscopical investigation revealed the disorder of a lymph node typical structure, a heterogeneous cellular population with a presence of giant multinuclear cells and plural one-nuclear big cells. There were also eosinocytes, neutrophils and lymphocytes in the cell infiltrate. In addition, sites of necrosis and sclerosis were found. What is the most likely diagnosis? @Lymphogranulomatosis Hyperplasia of lymphatic nodes Granulomatous lymphadenitis Purulent lymphadenitis Non-Hodgkin's lymphoma # 53 At the stomatological examination of a 16-year-old teenager, enlarged submandibular and cervical lymphatic nodules were diagnosed. A biopsy was made. Microscopically the typical structure is wiped and the cellular population is heterogeneous. Giant cells with multi nucleus and multiple mononuclear cells of a big size are presented. There are also eosinophilic and neutrophilic leucocytes, lymphocytes, areas of necrosis and focuses of sclerosis. Diagnose the disease. Hyperplasia of a lymphatic nodule @Lymphogranulomatosis Lymphogranulomatous lymphadenitis Purulent lymphadenitis Non-Hodgkin’s lymphoma # 54 Microscopic examination of the enlarged neck gland of a 14-year-old girl revealed destruction of the tissue structure of the node, absence of the lymph follicles, sclerotic areas and necrosis foci, cell constitution of the node is polymorphous, lymphocites, eosinophiles, big atypical cells with multilobular nuclei (Beresovsky-Sternberg cells) and mononuclear cells of the large size are present. What is the most likely diagnosis? Fungoid mycosis Acute lympholeucosis Chronic lympholeucosis Berkitt's lymphoma @Lymphogranulomatosis # 55 A 22-year-old woman has enlarged lymphatic nodules. Histologically there are lymphocytes, histiocytes, reticular cells, small and big Hodgkin’s cells, multinuclear Beresovski-Sternberg’s cells and single focuses of caseous necrosis. What disease is meant? Chronic leukosis Lymphosarcoma @Lymphogranulomatosis Acute leukosis Metastasis of pulmonary cancer # 56 A thoracotomy of a 58-year-old woman revealed in her anterior mediastinum the enlarged and soldered together lymph nodes. Microscopical investigation revealed atypical cells with predominance of Hodgkin cells and giant Reed—Berezovsky - Sternberg cells. A sclerosis was absent. What is the most likely diagnosis? @Lymphogranulomatosis with low-spirited development of lymphoid tissue Lymphogranulomatosis with predominance of nodularis sclerosis Lymphogranulomatosis with predominance of lymphoid tissue Lymphosarcoma Mixed-cellular variant of lymphogranulomatosis # 57 A post-mortem of a 15-year-old girl revealed enlarged neck, mediastinal and mesenteric lymph nodes, which were integrated in conglomerates. On a cut section, the tissue pattern of the nodes was non-uniform, with foci of necrosis. Microscopical investigation showed the uneven structure of lymph nodes, foci of sclerosis and necrosis. The cell population was also heterogeneous and included uninuclear atypical cells, giant multinuclear atypical cells, a significant amount of eosinocytes and neutrophils, and sparse lymphocytes. What is the most likely form of Hodgkin lymphoma (lymphogranulomatosis)? @Lymphogranulomatosis, mixed cell variant Lymphogranulomatosis, lymphohistiocytic variant Lymphogranulomatosis, nodular sclerosis Lymphogranulomatosis, variant with low-spirited development of lymphoid tissue Hodgkin's sarcoma # 58 A patient is 60 years old. During the thoracotomy enlarged and knitted lymphatic nodules were diagnosed in the mediastinum anterius, where a biopsy material was taken. Microscopically atypical cells were revealed, mostly Hodgkin’s and Beresovski-Sternberg’s giant cells; sclerosis was absent. What is the most possible disease? @Lymphogranulomatosis with a depressed development of lymphoid tissue Lymphogranulomatosis with a domination of nodular sclerosis Lymphogranulomatosis with a domination of lymphoid tissue Lymphosarcoma Mixed-cellular variant of lymphogranulomatosis # 59 A 66-year-old man presents for his annual physical examination. Hi is asymptomatic and physical examination is unremarkable. Examination of his peripheral smear, however, reveal the presence of small mononuclear cells with little cytoplasm and a mature nucleus with a prominent nuclear cleft. No “smudge cells” are seen. The presence of these “buttock cells” in the peripheral blood warrants further clinical work-up to search for which one of the following malignancies? Chronic lymphocytic leukemia Follicular non-Hodgkin’s lymphoma Multiple myeloma @Nodular sclerosis Hodgkin’s disease Small-cell carcinoma of the lung # 60 A 22-year-old woman presents with fever, weing loss, night sweats, and painless enlargement of several supraclaviculars lymph nodes. A biopsy from one of the enlarged lymph nodes is shown in the photomicrograph below. The binucleate giant cell with prominent acidofilic “owl-eye” nucleoli shown stain positively with both CD15 and CD30 immunoperoxidase stains. Also present are atypical mononucleare cells that are surrounded by clear spaces (lacunar cells). Which of the following is the most likely diagnosis? Anaplastic large cell lymphoma Diffuse non-Hodgkin’s lymphoma Lymphocyte predominate Hodgkin’s disease @Nodular sclerosis Hodgkin’s disease Reactive lymph node hyperplasia # CARDIO-VASCULAR SYSTEM Aterosclerosis. Hypertensive disease # 1 A 25-year-old man experiences chest pain on exercise when he attempts to climb three flights of stairs. This pain is relieved by sublingual nitroglycerin. Laboratory studies show a total serum cholesterol of 550 mg/dL with an HDL cholesterol component of 25 mg/dL. He is worried about these findings because his brother died of a myocardial infarction at age 34. Which of the following conditions is this man most likely to have? Diabetes mellitus, type II Malignant hypertension Familial hypercholesterolemia Gushing syndrome Morbid obesity # 2 A 70 year old man is ill with vascular atherosclerosis of lower extremities and coronary heart disease. Examination revealed disturbance of lipidic blood composition. The main factor of atherosclerosis pathogenesis is the excess of the following lipoproteins: @Low-density lipoproteins Intermediate density lipoproteins Cholesterol High-density lipoproteins Chylomicrons # 3 A 56-year-old has not received any medical care nor seen a physician for years. He reports reduced exercise tolerance over the past 5 years. On occasion in the past year he has noted chest pain after ascending a flight of stairs. He smokes 2 packs of cigarettes per day. He is found to have a blood pressure of 155/95 mm Hg. His body mass index is 30. Laboratory findings include a total serum cholesterol of 245 mg/dL with an HDL cholesterol that is 22 mg/dL. Which of the following vascular abnormalities is most likely to be his most serious health risk? Hyperplastic arteriolosclerosis Lymphedema Medial calcific sclerosis @Atherosclerosis Deep venous thrombosis Plexiform arteriopathy # 4 An autopsy study reveals that evidence for atheroma formation can begin even in children. The gross appearances of the aortas are recorded and compared with microscopic findings of atheroma formation. Which of the following is most likely to be the first visible gross evidence for the formation of an atheroma? Thrombus @Fatty streak Calcification Hemorrhage Ulceration # 5 An aorta at autopsy that demonstrated a mild degree of atherosclerosis with only lipid streake and just a few atheromatous plaques would be most consistent with which of the following histories from patients: A 62-year-old man with familial hypercholesterolemia @A 48-year-old man who exercises regularly A 45-year-old woman with nodular glomerulosclerosis A l0-year-old child killer in a motor vehicle accident. A 56-year-old man with angina # 6 A 45-year-old male died in a traffic accident. A histological investigation of his aorta revealed a lipid infiltration of its intima with fats accumulation in myocytes and macrophages of aortal medial layer. Name the stage of atherosclerosis? @Lipoidosis Liposclerosis Atheromatosis Pre-lipoidosis Atherocalcification # 7 A post-mortem of a 65-year-old male revealed yellowish streaks and spots in the abdominal aorta's intima, which did not rise above endothelial surface. These areas were stained by Sudan III in orange color. What stage of atherosclerosis such changes are characteristic for? @Lipidosis Liposclerosis Atheromatosis Ulceration Atherocalcification # 8 At autopsy of 52-year-old male revealed yellowish areas at his aorta's intima, this did not bulge above its surface. Histological investigation showed the accumulation of cells with foamy cytoplasm, stained by Sudan III in yellow color. Name the most likely stage of atherosclerosis in aorta? @Lipidosis Liposclerosis Atheromatosis Pre-lipoidosis Atherocalcification # 9 A 46-year-old male suddenly died after developing a heart failure. An autopsy revealed in abdominal aorta the yellow color areas, which did not rise over its surface. Histological investigation of aorta showed the aggregations of cells with a foamy cytoplasm among smooth mussels and macrophages. These cells had a motley-orange coloring, when stained by a Sudan III. For what stage of an atherosclerosis such picture is characteristic? @Lipoidosis Liposclerosis Atheromatosis Ulceration Atherocalcification # 10 At autopsy of an elderly female an aorta tissue sample collected for histology. Microscopic investigation revealed in aorta's intima the accumulation of xanthoma's cells. At what disease such morphological picture is possible? @Atherosclerosis Hypertension Syphilitic mesaortitis Nonspecific aortoarteritis Nodular periarteritis # 11 The first visible gross evidence for the formation of an atheroma in an artery such as the aorta, even in a young person, is a(an): Thrombus @ Fatty streak Calcification Hemorrhage Inflammatory infiitra.tr; # 12 A 53-year-old female died from acute myocardial infarction. An autopsy revealed multiple whitish dense plaques in her coronal arteries' intimae, which bulged in and narrowed the vessel's lumen. Name the most likely stage of a coronary atherosclerosis? @Liposclerosis Lipoidosis Atheromatosis Atherocalcification Ulceration # 13 During the section of a 69-year-old woman with overweight, who died of acute myocardial infarction, were revealed multiple whitish solid formations in the tunica intima of coronary arteries. They bulge into the lumen and constrict it. What stage of atherosclerosis is described? Stage of a creation of an atheromatous ulcer Lipoidosis Atheromatosis Atherocalcinosis @Liposclerosis # 14 A post-mortem of an elderly male revealed microscopic alteration of his coronary artery. There was narrowing of vessel's lumen due to a fibrous plaque with some admixture of lipids. Name the stage of atherosclerosis: @Liposclerosis Lipoidosis Pre-lipoidosis Atheromatosis Atherocalcification # 15 A 54-year-old male died after developing a heart failure. An autopsy revealed a chronic venous hyperemia of the internal organs, hypertrophy of the left ventricle of a heart and focal cardiosclerosis. Gross investigation of aorta showed yellow-white plaques in the intima with fine-grained masses in their centers, which infiltrated the aortal wall. Give the name of this pathological process. @Atheromatosis Lipoidosis Liposclerosis Arteriolosclerosis Calcinosis. # 16 A 73-year-old woman who exercises regularly falls down the stairs and injures her right hip. A radiograph is taken of the pelvis. There is no fracture but the radiograph reveals calcification of the small muscular arteries in the region of the pelvis. What is the probable vascular lesion which accounts for this calcification? @Ulcerative atherosclerosis Calcific medial sclerosis Metastatic calcification Trauma Dystrophic calcification # 17 If the coronary arteries on dissection at autopsy show severe atherosclerosis in a patient who had clinically acute (60-h) myocardial infarction, you would expect to find Gross evidence of myocardial scarring Coronary thrombosis in 90 percent of cases Coronary thrombosis in 65 percent of cases @A plaque with ulceration, fissure, or hemorrhage Rupture of a papillary muscle # 18 Which of the following complications is LEAST likely to occur in a 49-year-old woman who has developed severe generalized atherosclerosis over the past 20 years: Sudden death Gangrene of the right big toe @Pulmonary artery atherosclerosis Remote (healed) myocardial infarction Retinopathy with blindness # 19 A 63-year-old man has had insulin dependent diabetes mellitus for over two decades. The degree of control of his disease is characterized by the laboratory finding of a hemoglobinAIC of 10.1%. He has noted episodes of abdominal pain following meals, these episodes have worsened over the past year. On physical examination, there are no masses and no organomegaly of the abdomen, and he has no tenderness to palpation. Which of the following pathologic findings is most likely to be present in this man? Ruptured aortic aneurysm Hepatic infarction @Mesenteric artery occlusion Acute pancreatitis Chronic renal failure # 20 A 70-year-old man has noted coldness and numbness of his lower left leg, increasing over the past 4 months. He also experiences pain in this extremity when he tries walking more than the distance of half a city block. On physical examination, his dorsalis pedis, posterior tibial, and popliteal artery pulses are not palpable. Which diagnosis is he most likely to have? General atherosclerosis Trombophlebitis Atheromatosis Atherocalcinosis @Atherosclerosis of a. femoralis # 21 A patient has tissue ischemia lower the knee joint, accompanied with "intermittent claudication". Which artery is occluded in this case? Posterior tibial Proximal part of the femoral Anterior tibial @Popliteal Fibial # 22 The gross appearance an aorta with severe ulcerative atherosclerosis is associated with each of the following additional findings EXCEPT: Mural thrombosis Diabetes mellitus, type I Hypercholester-olemia @Neopiasia Aneurysm formation # 23 A 66-year-old male suddenly died on his way to operation room. An autopsy revealed a hemorrhage into retroperitoneal fat, a saccular dilatation of the abdominal aorta wall with rupture in arterial wall. The aorta's defect had uneven edges and stony hardening of surrounding tissues. Name the disease, resulted in described complication? @Atherosclerosis Hypertension Systemic vasculitis Visceral Syphilis - # 24 A 56-year-old man present with the sudden onset of excruciating pain. He describes the pain as beginning in the anterior chest, radiating to the back, and then moving downward into the abdomen. His blood pressure is found to be 160/115. Your differential diagnosis includes myocardial infarction; however, no changes are seen on ECG, and you consider this to be less of a possibility. You obtain an x-ray of this patient’s abdomen and discover a “double-barrel” aorta. Which of the following is the basic cause of this abnormality? A microbial infection Loss of elastic tissue in the media A congenital defect in the wall of the aorta @Atherosclerosis of the abdominal aorta Abnormal collagen synthesis # 25 Under macroscopic (gross) investigation of aorta yellow patches and stripes, fibrous plaques, ulcers were found out in its intima. What disease is characterized with such changes? @Atherosclerosis Rheumatic fever Tuberculosis Diphtheria Typhoid fever # 26 A 77-year-old woman has experienced abdominal pain for the past month. On physical examination, she has a pulsatile lower abdominal mass. An abdominal CT scan reveals an abdominal aorta dilated to 7 cm in diameter, with calcification of the aortic wall. While awaiting surgery, she has an episode of severe abdominal pain and a repeat CT scan shows marked retroperitoneal hemorrhage. Which of the following diagnosis is she most likely to have? Atherosclerosis of aorta General atherosclerosis True aneurysm False aneurysm Stratified aneurysm # 27 |