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Which of the following conditions is the most frequent cause of intracerebral hemorrhage? Ruptured aneurysm Trauma Blood dyscrasias Angoimas @Hypertensive vascular disease # 7 A 68-year-old woman can not move her upper and lower right extremities after stroke. Muscle tone of these extremities and reflexes are increased. There are pathological reflexes. What form of the paralysis is it? Monoplegia Paraplegia Dissociation Tetraplegia @Hemiplegia # 8 A patient after hypertension stroke does not have voluntary movements in his right arm and leg with the increased muscle tone in these extremites. What type of disfunction of nervous system is it? Reflex paresis Peripheral paresis Central paresis @Central paralysis Peripheral paralysis # 9 Cerebral embolism occurs frequently in association with all the following conditions EXCEPT Cardiac mural thrombi Left-sided endocarditis @Right-sided endocarditis Cardiac catheterization Prosthetic cardiac valves IBS # 10 The patient has come to the hospital from the smelting workshop in the condition of hyperthermia. What is the direct cause of loss of consciousness at the heat stroke? @Decreased brain blood supply Arterial pressure drop Increased water loss through sweating Dilatation of peripheral vessels Decrease of heart output # 11 A big pallid focus of a softened gray substance of pappy consistence was revealed in the right temporal lobe at the autopsy of a 58-year-old man. Numerous whity-yellow nodes of intima that constricted the lumen were detected in the arteries of the cerebral basis. What is your diagnosis? Abscess of the cerebrum @Ischemic insult Haemorrhage Haemorrhagic infarction Edema of the cerebrum # 12 Autopsy of a 56 y.o. man revealed in the right temporal part of brain a big focus of softened grey matter that was semi-liquid and light grey. Arteries of cerebral tela contain multiple whitish-yellow thickenings of intima that abruptly narrow the lumen. What is your diagnosis? Brain edema Hemorrhagic infarction @Ischemic stroke Brain abscess Hemorrhage # 13 During the section of a dead man, who had atherosclerosis, a thrombosis of a branch of internal carotid was revealed. There was also a gray focus of humid softening of the brain tissue. What pathological process is diagnosed in the cerebrum? Encephalitis Haemorrhagic infiltration Haematoma @Ischemic infarction Braingrowth (the tumour of the brain) # 14 At autopsy of 63-year-old male revealed an atherosclerosis of the brain's arteries and a thrombosis of the internal carotid artery's branch. Gross investigation showed a focus of moist softening in his brain's tissue. Define the pathological process in the.brain. @Ischemic infarction Hemorrhagic infiltration Hematoma Encephalitis Tumour of the brain. # 15 Unexpected sudden cardiac death is a very rare complication of Severe coronary artery disease Myocarditis Cardiac tamponade @Mitral valve prolapsed Dilated or hypertrophic cirdiomyopathy # 16 A 32-year-old man suddenly died during the emotionally strained work. An autopsy revealed uneven myocardium blood supply. Histochemical investigation detected a decrease of the amount of glycogen. Electron-microscopical study showed a destruction of mitochondria, the contractures of myofibrils. What is the most likely disorder of a blood circulation? @Acute ischemia Chronic ischemia Vacating arterial hyperemia Acute vein hyperemia Angioneurotic arterial hyperemia # 17 A 48-year-old patient after severe psychoemotional exertion suddenly began feeling sharp pain in the heart region, irradiating into left arm. Nitroglycerin releaved pain 10 minutes later. What pathogenetic mechanism is responsible for the development of pain in this case? Compression of coronary vessels @ Spasm of coronary vessels Dilation of peripheral vessels Occlusion of coronary vessels Increase of myocardial needs in oxygen # 18 The appearance of coronary artery thrombosis in a 49-year-old man with sudden onset of chest pain is LEAST likely to be associated with: A long history of diabetes mellitus Hypercholesterolemia Acute myocardial infarction @Recurrent pneumonia A history of smoking # 19 A 61-year-old man has the sudden onset of severe chest pain. Vital signs include T 37°C, P 101/minute, R 20/minute, and BP 80/40 mm Hg. An electrocardiogram demonstrates changes that are consistent with myocardial ischemia involving the left lateral ventricular free wall. He is given thrombolytic therapy with tissue plasminogen activator (tPA). However his serum creatinine kinase is found to be 450 U/L 3 hours after this therapy. Which of the following cellular events has most likely occurred? Cellular regeneration Drug-induced necrosis @Reperfusion injury Increased synthesis of creatine kinase Myofiber atrophy # 20 A 52-year-old man has the sudden onset of chest pain. He is found to have a serum troponin I of 5 ng/mL. A year later he has reduced exercise tolerance. An echocardiogram reveals an akinetic segment of left ventricle, and he has reduced cardiac output, with an ejection fraction of 25%. He then experiences a transient ischemic attack (TIA). His serum troponin I is now <0.5 ng/mL. Thrombosis involving which of the following locations is most likely to have put him at greatest risk for the TIA? Saphenous vein Vertebral artery Superior vena cava Left ventricle @Coronary artery # 21 Severe coronary atherosclerosis leads to an acute myocardial infarction in a 55 year old woman. Which of the following factors is LEAST likely to have contributed to this: Endothelial injury occurred in the first 3 cm of the coronary artery frorn turbulent flow Platelets were adherent to a damaged intima following appearance of a lipid streak Disruption of an intimal plaqua led to thrombus formation in the left anterior descending artery Macrophages released growth factors that led to smooth muscle migration and proliferation @A reduced amount of low density lipoproteins with LDL cholesterol were present in the blood # 22 12 hours after an accute attack of retrosternal pain a patient presented a jump of aspartate aminotransferase activity in blood serum. What pathology is this deviation typical for? Collagenosis Viral hepatitis @Myocardium infarction Diabetes mellitus Diabetes insipidus # 23 Marked increase of activity of МВ-forms of CPK (creatinephosphokinase) and LDH-1 were revealed on the examination of the patient's blood. What is the most likely pathology? @Miocardial infarction Pancreatitis Rheumatism Cholecystitis Hepatitis # 24 A patient developed substernal pains in the 7 o'clock in the morning. He presented at the Emergency Department in 8 o'clock in the morning, where electrocardiograph investigation revealed a myocardial infarction. Ten minutes later he died. What most reliable morphological sign of myocardium infarction would be found at histological investigation after the autopsy? @Disappearance of glycogen in myocardial cells Vacuolar dystrophy of myocardial cells Fatty infiltration of myocardial cells Necrosis of myocardial cells Weakening of myofibril of myocardial cells # 25 A 58-year-old male, with a history of hypertensive disease, developed a long attack of substernal pain. The infarction of myocardium was diagnosed. A patient died soon. An autopsy revealed flabby myocardium with uneven blood filling. Histological and histochemical examinations showed disappearance of glycogen granules and decreased activity of oxidizing enzymes. What stage of myocardial infarction presented in that case? @Ischemic stage Necrotic stage. Organization Recurrent myocardial infarction Acute relapsing myocardial infarction # 26 A patient has myocardial infarction in the region ofanterior wall of the left ventricle. What artery basin has the circulatory impairment occured in? Atrioventricular branch of left coronal artery Circumflex branch of left coronal artery Left marginal branch of left coronal artery @ Anterior interventricular branch of left coronal artery Anterior ventricular branches of right coronal artery # 27 The pathology evident in the photomicrograph below usually first appears after which of the following lengths of time following a myocardial infarction? 12 h @3 days 7 days 14 days 28 days # 28 A patient died from acute cardiac insufficiency. The histological examination of his heart revealed in myocardium of the left ventricle the necrotized section, which was separated from undamaged tissue by the zone of hyperimic vessels, small hemorrhages and leukocytic infiltration. What is the most likely diagnosis? @ Myocardial infarction Productive myocarditis Myocardial ischemic dystrophy Focal exudate myocarditis Diffuse exudate myocarditis # 29 An autopsy of a 62-year-old male, with a history of ischemic heart disease, revealed an atherosclerosis of coronal arteries and signs of hypertensive disease. On a cut of the heart, in the area of the apex and left ventricle's frontal and lateral walls, there was a well defined yellowish focus, surrounded by hemorrhages. What is the most likely pathological process in the cardiac muscle? @Myocardium infarction Postinfarction cardiosclerosis Diffuse cardiosclerosis Myocarditis Fatty dystrophy of myocardium # 30 During the section of a man who died of pulmonary edema was revealed a big yellow-gray focus in the myocardium. There was also a fresh clot in the coronary artery. Specify the diagnosis. Myocarditis Cardiosclerosis @Myocardial infarction Amyloidosis Cardiomyopathy # 31 An autopsy of a 49-year-old patient, who died from lungs edema, revealed in myocardium a yellow- grey, large focus and a fresh blood clot in a coronal artery. What is the most likely diagnosis? @Myocardium infarction Cardiosclerosis Myocarditis Amyloidosis Cardiomyopathy # 32 An autopsy of a 56-year-old male, with a history of ischemic heart disease, revealed the edema of lungs. What pathological changes could cause a pulmonary disorder? @Acute insufficiency of left ventricle Acute general anemia Acute insufficiency of right ventricle Ischemia of small circle Blood stasis # 33 A patient aged 59 was hospitalised to cardiological department in a sever state, with diagnosis of acute myocardial infarction of the posterior wall of the left ventricle and septum, and primary pulmonary edema. What is the primary mechanism, which causes the development of pulmonary edema in the patient? * Left ventricular failure Pulmonary arterial hypertension Pulmonary venous hypertension Hypoxemia Decrease of alveolocapillary diffusion of oxygen # 34 Histologic sections (routine H&E stain) of lung reveal the alveoli to be filled with pale, nongranular pink fluid. Neither leukocytes nor erythrocytes are present within this fluid. Which of the following is the most common cause of this abnormality? Bacterial pneumonia @Congestive heart failure Lymphatic obstruction by tumor Pulmonary embolus Viral pneumonia # 35 A 66-year-old patient presented in the hospital with the acute recurrent myocardial infarction of front-lateral wall of the left ventricle. On the 4th day of disease, an acute, marked difficulty in breathing, a cough with considerable quantity of a foamy sputum discharge and facial cyanosis developed. A patient died from progressive cardiac insufficiency. An autopsy revealed enlarged grey- pink color lungs. A foamy liquid flowed down from the cut surface. What pathological process in lungs caused a death? @Edema of the lungs Lungs infarction Hydrothorax Pneumonia Pneumosclerosis # 36 A 55-year-old woman has been treated in the hospital for pancreatitis for the past three weeks. She is examined one morning on rounds and found to have a swollen right leg. It is tender to palpation posteriorly but is not warm. This condition is most likely to be the result of which of the following vascular complications? Venous thrombosis Septic embolization @Congestive heart failure Cellulitis - # 37 Laminar necrosis and watershed infarcts are most suggestive of @Shock Hypertension Fat emboli Vascular thrombosis Verous sinus thrombosis # 38 The mortality from myocardial infarction is most closely related to the occurrence of A pericardial effusion Pulmonary edema Coronary artery thrombosis @An arrhythmia Systemic hypotension # 39 Several days following a myocardial infarction, a 51-year-old man develops the sudden onset of a new pansystolic murmur along with diastolic flow murmur. Work-up reveal increased left atrial pressure that develops late in systole and extends into diastole. Which of the following is the most likely cause of the abnormalities present is this individual? Aneurysmal dilation of the left ventricle Obstruction of the aortic valve Rupture of the left ventricle wall @Rupture of a papillary muscle Thrombosis of the left atrial cavity # 40 A 62-year-old man has experienced substernal chest pain upon exertion with increasing frequency over the past 6 months. An electrocardiogram shows features consistent with ischemic heart disease. He has a total serum cholesterol of 262 mg/dL. By angiography, there is 75% narrowing of the left anterior descending artery. Which of the following vascular complications is most likely to occur in this patient? A systemic artery embolus from thrombosis in a peripheral vein. A systemic artery embolus from a left atrial mural thrombus. Pulmonary embolism from a left ventricular mural thrombus. @A systemic artery embolus from a left ventricular mural thrombus. Pulmonary embolism from thrombosis in a peripheral vein. # 41 A 56-year-old patient presented to the hospital with symptoms of acute myocardial infarction. A diagnosis was confirmed by the EKG and laboratory tests. For 5th days the condition acutely worsened. A progressive cardiac insufficiency resulted in patient's death. A dissection confirmed the diagnosis of myocardial infarction, complicated by the heart's wall rupture and tamponade of pericardium. What process developed in the area of myocardial infarction? @Aseptic autolysis Organization Encapsulation Septic disintegration Petrification # 42 A 48-year-old man, with a history of transmural heart infarction of the left ventricle's myocardium, died from the veritable rupture of heart (the heart tamponade). What process in an infarct zone could promote a heart's wall rupture? @Autolysis with melting of myocardium tissue (myomalacia) Substitution of connective tissue in area of infarction (organization) Rising of blood pressure in the small circulatory circle Scar formation with thinning of wall of the left ventricle # 43 Following development of an acute myocardial infarction (MI), the LEAST likely complication is Cardiac arrhythmia Cardiogenic shock Sudden cardiac death @Cardiac rupture Thromboembolism # 44 A 49-year-old man seven days being admitted to the hospital for an inferior wall, transmural myocardial infarction suddenly becomes short of death. Physical examination reveal hypotension, elevated jugular venous pressure, and muffled heart sounds. His systemic blood pressure drops 13 mmHg with inspiration. Which one of the following pathologic processes produced these clinical findings? Acute inflammation of the pericardium due to an autoimmune reaction Acute mitral regurgitation due to rupture of a papillary muscle Acute suppurative inflammation of the pericardium due to bacterial infection @Blood accumulation in the pericardial cavity due to rupture of the ventricular wall Serous fluid accumulation in the pericardial cavity due to congestive heart failure # 45 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 Ischemic heart disease Fatty degeneration of myocardium Adipose heart Hypertensive disease # 46 Arrange the following numbered statement in the correct order of the expected sequence of events that normally occur during healing of a myocardial infarction. 1 = Collagen is deposited, forming a fibrous scar; 2 = Flocculent densities form within mitochondria; 3 = Granulation tissue begins to form; 4 = Macrophages begin to arrive at the area of coagulative necrosis; 5 = Neutrophils begin to arrive at the area of coagulative necrosis. 2, then 3, then 4, then 5, then 1 2, then 4, then 5, then 3, then 1 @2, then 5, then 4, then 3, then 1 4, then 5, then 3, then 2, then 1 5, then 4, then 3, then 2, then 1 # 47 A 72-year-old man suffered a myocardial infarction involving half the left ventricular free wall 3 months ago. He now has has increasing dyspnea and orthopnea. On examination he has poor capillary filling in hands and feet. A chest x-ray shows pulmonary edema. Which morphological changes most likely to be found in the heart? Cougulative necrosis Colliquative necrosis Diffuse inflammation @Connective tissue scar Hyperplasia of cardiomiocytes # 48 A patient, with a history of myocardial infarction, develops symptoms of blood circulation insufficiency after physical exercises. There is marked cyanosis and edema of subcutaneous tissue of his lower extremities. What changes have developed on a place of a myocardial infarction at the recovered person? @Cardiosclerosis Intracellular regeneration Myocarditis Atrophy of myocardium - # 49 An autopsy of a 58-year-old female revealed in myocardium a large, dense, grey focus, which histologically consisted of the rough connective tissue fibers. It was surrounded by the hypertrophied muscular fibers. What changes arose up in a heart? @Postinfarction cardiosclerosis Ischemic stage of myocardial infarction Necrotic stage of myocardial infarction Diffuse cardiosclerosis Myocarditis # 50 A 52-year-old male, after repeated intramural heart infarction of myocardium, gradually returned to health and further supervision of a district internist. In 2 years he died in a motor-car accident. Define a pathological process in myocardium, which wound be revealed at the autopsy? @Focal cardiosclerosis Diffuse cardiosclerosis. Atrophy. Necrosis. Hyperplasia # 51 A 64-year-old patient, with long history of atherosclerosis and myocardial infarction, developed the attack of substernal pain. A patient was hospitalized in 3 days and died soon from progressive cardiovascular insufficiency. An autopsy revealed in the back wall of the left ventricle and interventricular septum of heart a white color focus, about 3 cm in a diameter. It was fibred, falling back, with a clear boundary. Give the name for these changes: @Focal cardiosclerosis Myocardial ischemia Myocardial infarction Myocarditis Dystrophy of myocardium # 52 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. @Multifocal (postinfarctional) cardiosclerosis Smallfocal (atherosclerotic) cardiosclerosis Acute myocardial infarction Fatty degeneration of myocardium Myocarditis # 53 Examination of coronary arteries revealed atherosclerotic calcific plaques that close vessel lumen by 1/3. The muscle has multiple whitish layers of connective tissue. What process was revealed in myocardium? Myocardium infarction @Diffuse cardiosclerosis Myocarditis Tiger heart Postinfarction cardiosclerosis # 54 A 57-year-old man, with a long history of an alcohol abuse, died at the increasing phenomena of chronic heart failure. An autopsy revealed the weight of a heart 580 grams; a languid, clay color myocardium, with intensive diffuse interstitial fibrosis. Coronal arteries were intact. A microscopical study of myocardium showed a combination of hydropic and fatty dystrophy of cells; atrophy and hypertrophy of cardiomyocites. There were also some foci of a cells lysis, accompanied with sclerosis. What kind of cardiomyopathy described in that case? @Alcoholic Hypertrophic Dilatative Restrictive Metabolic # 55 A 59-year-old patient receiving chemotherapy with the anthracycline Adriamycin develops severe heart failure. Sections from an endocardial biopsy specimen reveal vacuolization of the endoplasmic reticulum of the myocites. Adriamycin therapy most frequently causes what type of cardiomyopathy? @Dilated cardiomiopathy Hyperplastic cardiomyopathy Hyperthrophic cardiomyopathy Obliterative cardiomyopathy Restrictive cardiomyopathy # 56 A 3-month-old girl is being evaluated for feeding difficulty and failure to thrive. Physical examination finds pallor, peripheral cyanosis, tachypnea, and fine expiratory wheezing. Chest x-ray shows cardiac enlargement. She is admitted to the hospital, quickly develops severe cardiac failure, and dies 3 days after admission. At the time of autopsy the endocardium is found to have a “cream cheese” gross appearance. Histologic sections from this area reveal thickening of the endocardium due to a proliferation of fibrous and elastic tissue. Which of the following is the most likely diagnosis? Dilated cardiomyopathy Hypertrophic cardiomyopathy Infective endocarditis Libman-Sachs endocarditis @Restrictive cardiomyopathy # 57 A synonym for nonbacterial thrombotic endocarditis is Atypical verrucous endocarditis @Marantic endocarditis Limban-Sacks ebdocarditis Viridians endocarditis Rheumatic endocarditis # 58 A 23-year-old woman develops the sudden onset of congestive heart failure. Her condition rapidly deteriorates and she dies in heart failure. At autopsy, patchy interstitial infiltrates composed mainly of lymphocytes are found, some of which surround individual myocytes. The most likely cause of this patient’s heart failure is @Viral myocarditis Bacterial myocarditis Giant cell myocarditis Hypersensitivity myocarditis Beriberi # 59 A 23-year-old woman develops the sudden onset of congestive heart failure. Her condition rapidly deteriorates and she dies in heart failure. At autopsy, patchy interstitial infiltrates composed mainly of lymphocytes are found, some of which surround individual myocytes. Which of the following is the most likely cause of this patient’s heart failure? Autoimmune reaction (to group A β-hemolytic streptococci) Bacterial myocarditis (due to S. aureus infection) Hypersensitivity myocarditis (due to an allergic reaction) Nutritional deficiency (due to thiamine deficiency) @Viral myocarditis (due to coxsakievirus infection) # 60 A patient died from progressive cardiac insufficiency. An autopsy revealed a flaccid, dilated in diameter heart. A cut surface investigation showed the irregular blood filling of a myocardium, resulted in the patchy pattern of its tissue. A histological study determined a hyperemia of myocardium and stromal accumulations of small mononuclear cells. The described morphological changes present: @Nonpurulent interstitial myocarditis Vein plethora Fatty dystrophy of myocardium Cardiosclerosis Myocardial infarction # 61 An autopsy of a child, who died of a heart failure, revealed the dilated heart chambers. Microscopic investigations showed the hyperemia of the myocardial stroma, edema, and diffuse interstitial infiltrates consists of hystiocytes, lymphocytes, some scattered neutrophils and eosinophils. What is the most likely diagnosis? @"Diffuse interstitial exudative myocarditis Focal interstitial exudative myocarditis Nodular productive myocarditis Interstitial productive myocarditis Alternative myocarditis # 62 Autopsy of a man who died from influenza revealed that his heart was slightly enlarged, pastous, myocardium was dull and had specks. Microscopical examination of myocardium revealed signs of parenchymatous adipose and hydropic dystrophy; stroma was edematic with poor macrophagal and lymphocytic infiltration, vessels were plethoric; perivascular analysis revealed petechial hemorrhages. What type of myocarditis was developed in this case? Granulomatous Purulent Interstitial proliferative @Serous diffuse Serous focal # 63 Severe mitral stenosis is frequently accompanied by all the following EXCEPT Aortic valve disease Antecedent rheumatic fever Left arterial enlargement with atrial fibrillation @Pulmonary valvular stenosis Chronic passive pulmonary congestion # 64 |