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Hypertension is most closely related to the formation of which one of the following types of aneurysms? Berry aneurysm Atherosclerotic aneurysm Mycotic aneurysm @Charcot-Bouchard aneurysm Saccular aneurysm # 28 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? Hyperparathyroidis @Hypertension Marfan syndrome Thrombophlebitis Vasculitis # 29 A 49-year-old woman has experienced marked pain in her lower extremities on ambulation more than 300 meters for the past 5 months. On physical examination, her lower extremities are cool and pale, without swelling or erythema. No dorsalis pedis or posterior tibial pulses are palpable. Her body mass index is 32. She is a smoker. Which of the following abnormalities of the vasculature is most likely to account for these findings? Lymphatic obstruction @Arteriolosclerosis Atherosclerosis Medial calcific sclerosis Venous thrombosis # 30 An elderly woman, with a long history of bronchial asthma, ischemic heart disease and hypertension, presented with hypertrophy of her heart's left ventricle. Name the cause of the heart alteration? @Arterial hypertension Pulmonary insufficiency Chronic ischemia of cardiac muscle Bronchial asthma Emphysema of lights # 31 A 63-years-old patient, with a history of hypertensive disease, died from cardiac insufficiency. At autopsy, the heart enlargement and dilated ventricular cavities were revealed. Microscopical investigation showed marked hypertrophy of cardiomyocytes, with their fatty dystrophy and hyperchromic barrel-like nucleuses. What pathological process is the most likely in a heart? @Eccentric hypertrophy Myocarditis Concentric hypertrophy Angiogenic cardiosclerosis Cardiomyopathy # 32 An artery demonstrates concentric endothelial cell proliferation which markedly narrows the lumen, resulting in focal ischemia and hemorrhage. This histologic finding is likely to be found: Most frequently in the small vessels of the liver Most commonly in the enderly @In association with progressive hypertension (diastolic >110 mm Hg) Accompanying an acute myocardial infarction As a result of hereditary hypercholesterolemia # 33 The form of vascular disease responsible for malignant hypertension is Medial calcific sclerosis Arteriosclerosis obliterans @Hyperplastic arteriolosclerosis Hyaline arteriolosclerosis Thromboangiitis obliterans # 34 A 41-year-old woman present with recurrent severe headaches and increasing visual problems. Physical examination reveals her blood pressure to be 220/150. Her symptoms are most likely to be associated with which one of the following abnormalities? Medial calcific sclerosis Arteriosclerosis obliterans @Hyperplastic arteriolosclerosis Hyaline arteriolosclerosis Tromboangiitis obliterans # 35 A 64-years-old male died from uremia. At autopsy revealed reduced in sizes kidneys, with 50.0g weight. Their surfaces were regularly granulated; the cortexes were thin. A microscopic study showed considerably thickened walls of glomerular arterioles due to deposition of homogeneous unstructured pink masses. The lumens of these vessels were markedly narrowed; nephrons were diminished with sclerotic changes, tubules were atrophic. For what disease the described changes are characteristic? @Hypertension Chronic glomerulonephritis Amyloidosis of kidneys Pyelonephritis with scarring of kidneys Acute necrotic nephrosis # 36 Malignant hypertension in a 44-year-old African-American man with a blood pressure of 275/150 mm Hg is most closely associated with which of the following pathologic lesions: @Hyperplastic arteriolosclerosis with fibrinoid necrosis Nodular glomerulonecrosis and renal hyaline arteriosclerosis Monckeberg's medial calcific arterial sclerosis Severe occlusive coronary artery atherosclerosis with recent thrombosis Thrombophlebitis with pelvic vein thrombosis # 37 A 52-year-old male had a long history of hypertension. He presented to emergency care physician with complains of an acute, persisted for few hours rise of a blood pressure. What is the most likely alteration of the arterioles' walls due to hypertonic crisis? @Fibrinous necrosis • Hyalinosis Sclerosis Amyloidosis Calcinosis # 38 A patient with hypertensive disease was diagnosed a long hypertensive crisis. Name the pathomorphologic changes in the arterioles walls during the hypertensive crisis. @Fibrinoid necrosis Hyalinosis Sclerosis Amyloidosis Calcinosis # 39 At autopsy, the kidneys are 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 luminal narrowing. These finding are most likely to be present in which of the following patients: A 54-year-old man with chronic renal failure and amyloidosis A 29- year-old woman with proteinuria and lupus nephritis @A 44-year-old woman with marked hypertension and scleroderma A 49-year-old man with acute cellular allograft rejection A 19- year-old woman with graft versus host disease # 40 An elderly male, with 15 years history of essential hypertension, died from renal failure. What would be the most likely gross picture of his kidneys at autopsy? @Small, dense, a surface is fine-grained. Large pied and soft. Large red Large white and smooth Large with the plural thin-walled cysts. # 41 A 67-year-old patient had hypertensive disease for 20 years and died of chronic renal insufficiency. How did the kidneys look at the autopsy? Big, white Big, mottled Big, red @Little, solid with fine-grained surface Big with numerous thin-walled cysts # 42 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 @Hypertensive disease Chronic glomerulonephritis Amyloidosis of kidney Pyelonephritis with shrinkage of kidneys Acute necrotic nephrosis # 43 An autopsy of a 61-year -old female revealed the thickening of her heart's left ventricle up to 2.5 cm. Her kidneys were small, contracted and firm. The surface of the kidneys had a granular appearance. On a cut, there was a thinning of a cortical substance. Microscopical investigation showed arteriolosclerosis, glomerulosclerosis and interstitial sclerosis. What is the most likely disease? @Hypertension Atherosclerosis Ischemic heart disease Rheumatism Amyloidosis of kidneys # 44 A 65-year-old male long time was ill by hypertensive disease and died from chronic kidney insufficiency. The autopsy showed, that both kidneys are considerably decrease in sizes, their surfaces are granulated; histologically - most glomeruluses are containing hyaline, part of them in sclerotic condition, other in hyperplasia; in stroma - the fields of sclerosis, arteriolo- and arteriosclerosis, elastofibrosis of large kidney arteries branches. What is the name of the exposed changes? @Arteriolosclerotic nephrosclerosis Atherosclerotic nephrosclerosis Secondary-restricted kidney Chronic pyelonephritis Amyloidal- scarring kidney. # 45 A 60-year-old man was ill with hypertensive disease for a long time and died of chronic renal insufficiency. At the autopsy was revealed that both kidneys were greatly decreased in size. Their surface was fine-grained. Histologically: the majority of glomeruli were hyalinized, part of them was sclerosed, and some of them were hyperplased. Stroma had the areas of necrosis, arteriolo- and arteriosclerosis, elastofibrosis of large branches of renal arteries. Name these changes. Secondary wrinkled kidney Aterosclerotic nephrosclerosis Chronic glomerulonephritis Chronic pyelonephritis @Arteriolosclerotic nephrosclerosis # 46 A 64-years-old patient died from the brain's hemorrhage. An autopsy revealed markedly decreased kidneys (6x3x2cm in sizes and 60, 0 grams weight). They were dense, anemic with an even, fine- grained surface. On a cut, there was a constant thinning of the kidneys' cortex. Changes in kidneys are the implication of: @Arteriolosclerotic nephrosclerosis Atherosclerotic nephrosclerosis Secondary- scarring kidney Amyloidal- scarring kidney. Gouty kidneys # 47 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 finding with benign nephrosclerosis are most likely to occur with which of the following vascular change: @Hyaline arteriolosclerosis Monckeberg's medial calcific sclerosis Complex calcified atherosclerosis Arterial mural thrombosis Hyperplastic arteriolosclerosis # 48 An autopsy of 48-year-old patient, who died from the complications of hypertensive disease, revealed small, dense kidneys with fine-grained surface. Parenchyma and cortex matter were atrophied. Give the name for such kidneys. @Primary-scarring kidneys Amyloidal-scarring kidneys Secondary-scarring kidneys Pyelonephritic-scarring of kidneys - # 49 A 63-year-old man, with a long history of hypertensive disease, died from a hemorrhage in the brain. An autopsy revealed reduced in sizes, firm kidneys with fine-grained surface and thinned cortex matter. These changes in kidneys are characteristic for: @Primary-scarring kidneys Secondary-scarring kidneys Amyloidal-scarring kidneys Pyelonephritic-scarring of kidneys Infarct of the kidney # 50 An autopsy of an elderly woman, with a long history of hypertensive disease, revealed small size and weight (80 grams), firm kidneys. They had grey color and granular surface. On a cut, there was uniform thinning of a cortex. How it is possible to name the changes in kidneys? @Primary- scarring kidneys Pyelonephritic scarring of kidneys Secondary - scarring kidneys Amyloidal- scarring kidneys Diabetic glomerulosclerosis # 51 At the autopsy of a man who died of hypertensive disease’ complications, small solid kidneys with fine-grained surface were revealed. They had atrophic parenchyma and cortex. Name these kidneys. Amyloid-wrinkled @Primary wrinkled Secondary wrinkled Pyelonephritic-wrinkled Atrophic # 52 An elderly male, with 20 years history of hypertension, died from uremia. An autopsy revealed a heart hypertrophy and diffuses cardiosclerosis. There were also small, dense kidneys with granularity of their surface. Histological investigation of kidneys tissue showed the collapse of glomerular's arterioles and sclerosis. Some glomeruli were replaced with pinkish homogenous masses, negative to the Kongo-red staining. Tubules were atrophic. Name the kidney pathology? @Primary-scarring kidneys Secondary - scarring kidneys Amyloidosis Chronic glomerulonephritis Chronic pyelonephritis # 53 A 53-year-old man presents with severe headaches, nausea, and vomiting. He also relates seeing sport before his eyes and is found to have a diastolic blood pressure of 160 mmHg. Microscopic examination of a renal biopsy demonstrates hyperplastic arteriolitis. Gross examination of his kidneys is most likely to reveal which one of the following changes? A finely granular appearance to the surface @Multiple small petechial hemorrhages on the surface Diffuse, irregular cortical scars overlying dilated calyces Cortical scars overlying dilated calyces in renal poles Depressed cortical areas overlying necrotic papillae of varying stages # 54 Choose correct features of atherosclerosis (3 points): Acute disease @Chronic disease Lesions develop in the small-sized arteries Lesions develop in the both small-sized and large-sized arteries @Aorta have been damaged Aorta and large veins have been damaged Branches of pulmonary artery have been damaged Develops due to lipid disorders @Develops due to both lipid and protein disorders # 55 Choose correct gross-view atherosclerotic changes ofarteria(4 points): @Fatty streaks Liposclerosis Ulceration of intima of small-sized arteries with mural thrombosis @Ulceration of intima of aorta with intramural hemorrhages Increased permeability ofendothelial cells and basement membrane @Fibrous plague Intracellular accumulation of the lipids @Fibrofatty atheroma # 56 Choose correct morphological features characterized fatty streaks changes of atherosclerosis (4 points): @Have been revealed in all ages @More often develop in the zones of branches of aorta For the first time appear in the abdominal part of aorta Are elevated upon the intima @Are not be elevated upon the surface of the intima Lead to stenosis of the lumen of the aorta @Histologically are intimal aggregation of foam cells derived from the macrophages Histologically are intimal aggregation of lipid cells derived from adipose tissue # 57 Choose correct features of the malignant form of hypertension disease (3 points): Hyaline arteriolosclerosis @Hyperplastic arteriolosclerosis @Concentric, laminated thickening of the walls of arterioles Excentric, laminated thickening of the walls of arterioles Necrotizing phlebitis Necrotizing arteritis @Necrotizing arteriolitis # 58 All features of hypertension disease are true EXEPT (3 points): Infarctionofmyocardium @Infarction of spleen @Infarction of brain Hemorrhages of brain Hyaline arteriolosclerosis Hyperplastic arteriolosclerosis @Necrotizing arteritis # Cerebro-vascular disease. Heart diseases. # 1 A 45-year-old man dies suddenly and unexpectedly. The immediate cause of death is found to be a hemorrhage in the right basal ganglia region. On microscopic examination his renal artery branches have concentric endothelial cell proliferation which markedly narrows the lumen, resulting in focal ischemia and hemorrhage of the renal parenchyma. An elevation in which of the following substances in his blood is most likely to be associated with these findings? @Cholesterol Renin Troponin I Triglyceride C-reactive protein # 2 A 66-year-old woman has the sudden loss of movement on part of the left side of her body. She has smoked a pack of cigarettes a day for the past 45 years. She has vital signs including T 37.1 C, P 80/minute, R 16/minute, and BP 160/100 mm Hg. A cerebral angiogram reveals occlusion of a branch of her middle cerebral artery. Laboratory findings include a hemoglobin A1C of 9%. Which of the following components of blood lipids is most important in contributing to her disease? Chylomicron Lipoprotein C lipase VLDL @HDL cholesterol # 3 A 50 year-old patient had hemorrhage of the brain and was taken to the hospital. The place of hemorrhage was revealed on the lateral hemispheres surfaces during the medical examination. What artety was injured? @The middle cerebral artery The posterior cerebral artery The anterior cerebral artery The posterior communicating artery The anterior communicating artery # 4 The majority of cases of subarachnoid hemorrhage result from Transaction of a branch of the middle meningeal artery Bleeding from torn bridging veins @Rupture of a preexisting aneurysm Rupture of an arteriovenous malformation Cortical bleeding occurring opposite the point of a traumatic injury # 5 Subdural hematomas occur most frequently in the Supracerebellar region Infracerebellar region Cerebellopontine angle Pituitary region @Cerebral hemisphere convexities # 6 |