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X-ray examination discovered lungs emphysema in the patient. What is the reason of short breath development in this case? @Decreased lungs elasticity Decreasing of alveoli receptors sensitivity Increased lungs elasticity Inhibition of respiratory center Excitation of respiratory center # 18 At the autopsy: lungs are enlarged in size, pale, of soft consistence, not collapsed, don’t crepitate cutting. Microscopically, the widening of the alveolar paths and the signs of intercapillary sclerosis can be seen. Also the interalveolar membranes are thin. What lung disease are these signs typical for? Pneumonia Pneumosclerosis Pneumothorax Atelectasis @Emphysema # 19 An autopsy of the 47-year-old man revealed within lungs areas of increased pulmonary volume, with some bullas, that bulged out from beneath the pleura. Histological investigation showed thinning and rupture of interalveolar septas resulted in large multiform cavities formation. What is the most likely diagnosis? @Emphysema of lungs Bronchiectatic disease Cavernous tuberculosis Chronic bronchitis Fibrosing alveolitis # 20 A 50-year-old man has died because of chronic pulmonary-cardiac insufficiency. In autopsy the pathologist has found out in the lungs: areas of abnormal enlargement with large subpleural blebs (diameter 0,5-1,5 cm). Microscopic investigation: laceration of the airspace, thinning of alveolar walls with formation of large cavities of the different form. What disease is revealed in lungs? @Emphysema Bronchoectatic disease Cavernous tuberculosis Chronic bronchitis Hamman-Rich-syndrome # 21 A 53-year old male, with a history of the chronic diffusive bronchitis, presented to the hospital symptoms of cardiopulmonary insufficiency, then resulted in the lethal outcome of the disease. An autopsy revealed increased volume and hyperinflation of lungs, which covered a mediastinum with their edges and keep their form when removed from the body and put at autopsy table. Gross investigation showed a pale grey colour of lungs and a crunch sound while making an incision of a pulmonal tissue. A pressing a finger on a lungs tissue creates a fossa. A mucopurulent exudate was determined within bronchi's lumen. What is the most likely diagnosis? @Chronic diffuse obstructive emphysema Chronic focal emphysema Intestinal emphysema Primary idiopathic, emphysema Vicarious compensatory emphysema # 22 An autopsy of the 56-year-old man revealed increased pulmonary volume, pale grey color, soft texture lungs that kept their form when removed from the body and put at autopsy table. Gross investigation disclosed a crunch sound while making an incision of a pulmonal tissue. Histological investigation showed dilated alveolar ducts and alveoli, thinned interalveolar septas and capillary walls sclerosis. For what disease of lungs such morphological picture is characteristic? @Emphysema Pneumosclerosis Pneumothorax Atelectasis Pneumonia # 23 An autopsy of the 69-year-old man with a long history of chronic bronchitis revealed increased pulmonary volume and hyperinflation, pale grey color, soft texture lungs that kept their form when removed from the body and put at autopsy table. Histological investigation showed markedly dilated proximal acini, thinned and somewhere ruptured interalveolar septas. For what disease of lungs such morphological picture is characteristic? @Emphysema of lungs Chronic intestinal pneumonia Atelectasis of lungs Bronchiectatic disease Pleural empyema # 24 A patient, who had chronic obstructive pulmonary emphysema, died of pulmonary-heart insufficiency. What changes can be revealed in the heart? Amyloidosis Left ventricle hypertrophy @Right ventricle hypertrophy Large focal cardiosclerosis Cardiac rupture # 25 A 63-year-old man who is a long-term smoker present with increasing shortness of breath and dyspnea. He has smoked more than 2 packs of cigarettes per day for more than 40 years. He denies havinga productive cough or any recent infection. Physical examination reveals a thin elderly-appearing man in moderate respiratory distress. While sitting him leans forward slightly and breathe quickly through pursed lips. He is afebrile and his blood pressur is within normal limits. Examination of his chest reveals an increased anteroposterior diameter and his lung are hyper-resonant to percussion. His respiratory rate is increased, but no clubbing or cyanosis is present. Chest x-ray reveals his heart to be of normal size, but there is hyperinflation of his lung. Laboratory examination reveals that while breathing room air, his arterial Po2 is decreased but his arterial Pco2 is normal. Which of the following statements is a correct association concerning the pathogenesis of this man’s pulmonary disease? Destruction of entire acinus caused panlobular emphysema Destruction of the cilia on the respiratory epithelial cells resulted in bronchiectasis @ Destruction of proximalacinus caused centrilobular emphysema Hyperplasia of the respiratory smooth-muscle cells resulted in intrinsic asthma Hyperplasia of the respiratory mucus glands caused chronic bronchitis # 26 An autopsy of a patient, who had been working within 20 years the coal worker, revealed grayish- black dense, sclerotic lungs. The vast areas of collagen tissue new growth and multiple macrophages, carrying black pigment within cytoplasm, were recognized under microscope. What is the most likely disease? @Anthracosis Anthracosilicosis Silicoanthracosis Talcosis Siderosis # 27 A 49-year-old patient had been working as a coal miner many years and died of a chronic pulmonary and cardiac insufficiency. A post-mortem revealed hypoinflated, firm, sclerotic, lungs with emphysematous apexes. Pleura had a grayish-black coloring. Gross investigation of the lungs sectional view also showed deep black coloring of the pulmonary tissue. What is the most likely disease resulted in patient's death? @Anthracosis Silicosis Talcosis Asbestosis Aluminosis # 28 A routine chest x-ray performed on an asymptomatic adult man who works at sandblasting reveals a fine nodularity in the upper zones of the lungs and “eggshell” calcification of the hilar lymph nodes. The patient’s serum calcium level is 9.8 mg/dL, while his total protein is 7.2 g/dL. He denies any history of drug use or cigarette smoking. A biopsy from his lung reveals birefringent particles within macrophages. What is this material? Asbestos Beryllium Carbon @Silica Talc # 29 An autopsy of a male, who had been working within 9 years the stone polisher, revealed multiple, roundish, dense, diffuse nodules. Histological investigation of nodules showed concentric whorls of dense collagen fibers. At the periphery there were aggregated of mononuclear cells, mostly lymphocytes, and fibroblasts. What is the most likely disease? @Silicosis Acute pneumonia Bronchiectatic disease Chronic bronchitis Bronchial asthma # 30 An autopsy of the miner, who had worked in coal mine more of 10 years, revealed in a lung whitish fibrous fibers and nodules 0,2-0,3 cm in diameter. Histological investigation of nodules showed bundles of interacting concentric pink collagen with apparent hyalinosis. There was a minimal inflammatory reaction and also noticeable amount of a brownish dust. What is the most likely type of pneumoconiosis in this case? @Silicosis Talcosis Asbestosis Siderosis Berylliosis # 31 Histological investigation of pulmonary segment, removed from a coal worker's lung, revealed multiple roundish, nodules composed of concentric whorls of dense, hyaline fibers of collagen. What is the most likely disease? @Silicosis Tuberculosis Bronchitis Fibrosing alveolitis Cancer of lungs # 32 An autopsy of a patient, who had a long history of exposure to free dioxide of silica in the inhaled air, revealed enlarged, firm lungs with multiple miliary and larger roundish areas of a sclerosis. Gross study showed grey and grey-black colour of his lungs' tissue. What is the most likely diagnose? @Nodular form of silicosis Diffusive - sclerotic form of silicosis Anthracosilicosis Silicoanthracosis Asbestosis # 33 An autopsy of a patient, who had been working within 20 years the coal worker, revealed enlarged, slightly firm and hypoinflated lungs. At the gross investigation of the lungs sectional view multiple, round, grayish-black, diffuse nodules were discovered. Histological study showed nodules composed of concentric whorls of dense collagen fibers, some of them- with hyaline degeneration. What is the most likely disease? @Nodular form of silicosis Miliary tuberculosis of lung Bronchiectatic disease Croupous pneumonia Diffusive - sclerotic form of silicosis # 34 An autopsy of a 54-year-old male, who died of a chronic pulmonary and cardiac insufficiency, revealed enlarged, slightly firm and hypoinflated lungs. At the gross investigation of the lungs sectional view multiple, whitish, 2-3 mm in diameter nodules were discovered. Histological study showed nodules composed of concentric whorls of dense, sparsely cellular collagen. What is the most likely disease? @"Nodular form of silicosis Miliary tuberculosis of lung Fibrosing alveolitis Microfocal pneumonia Metastasis tumor of lungs # 35 After the histological examination of a biopsy material taken from the wall of the bronchus in a patient with chronic bronchitis was detected the overgrowth of the granulation tissue that elevated above the surface and contained a diffuse inflammatory infiltration. What type of bronchitis does the patient have? Chronic deforming Chronic mucopurulent Chronic mucous Chronic purulent @Chronic polypous # 36 Histological investigations of the bronchus wall biopsy material, from the patient with a history of chronic bronchitis, revealed granulation tissue and diffuse inflammatory infiltrate. What kind of a bronchitis was diagnosed? @Chronic polypous bronchitis Chronic mucopurulent bronchitis Chronic mucous bronchitis Chronic purulent bronchitis Chronic deforming bronchitis # 37 A 54-year-old man presents with several roblems involving his face and pain in his shoulder. He states that he has smoked 2 packs of cigarettes a day for almost 40 years. Physical examination reveals ptosis of his left upper eyelid, constriction of his left pupil, and lack of sweating (anhidrosis) on the left side of his face. No other neurologic abnormalities are found. Which of the following tumors is most likely to be present in this individual? A bronchioloalveolar carcinoma involving the left upper lobe A small-cell carcinomainvolving the hilum of his left lung A squamous cellcarcinoma involving the left mainstem bronchus @An adenocarcinoma involving the apex of his left lung An endobronchial carcinoid tumor involving the right mainstem bronchus # 38 Histological investigation of a lung's biopsy revealed atypical cells which formed multiple acinar structures and produced mucus. What is the most likely histological diagnosis? @High differentiated adenocarcinoma Differentiated adenoarcinoma Undifferentiated cancer Differentiated squamous cell carcinoma Glandular - squamous cell carcinoma? # 39 Thereupon the obturation of the middle lobe bronchus by the nodule of soft tissues the atelectasis of the middle lobe of the right lung had formed. At the bronchobiopsy was revealed the overgrowth of the glandular atypical epithelium with pathological mitoses that grew through the underlied tissues and the cartilage. What disease is the most possible due to these signs? Inflammatory polyp Deforming bronchitis @Bronchogenic cancer of the lung Dysplasia of the bronchial epithelium Sarcoma of the bronchus # 40 A patient presents to his physician a middle lobar bronchial obstruction with a node of intraluminal soft masses, resulted in the atelectasis of middle lobe of the right lung. A bronchoscopy revealed in the obturation zone a new growth of glandular type atypical epithelium with pathological mitosises which penetrated the wall of the bronchus and infiltrated along the peribronchial tissue and a cartilage. What is the most likely diagnosis? @Bronchogenic carcinoma of lung Deforming bronchitis Inflammatory polyp Dysplasia of bronchial epithelium Bronchus sarcoma # 41 A 39-year-old woman presents with a cough and increasing shortness of breath. A chest x-ray is interpreted by the radiologist as showing right lower lobe (RLL) pneumonia. No mass lesions are seen. The woman is treated with antibiotics, but her symptoms do not improve. On her return visit, the area consolidation appears to be increased. Bronchoscopy is performed. No bronchial masses are seen, but a transbronchial biopsy is obtained in an area of mucosal erythema in the RLL. After the diagnosis is made, the RLL is removed and section from this specimen reveals well-differentiated mucus-secreting columnar epithelial cells that infiltrate from alveolus to alveolus. Which of the following is the most diagnosis? @Bronchioloalveolar carcinoma Carcinoid Large cell carcinoma Small cell carcinoma Squamous cell carcinoma # 42 Histological investigation of a biopsy of a bronchus revealed a tumor which is constructed from clusters of atypical cells of a laminated (stratified) squamous epithelium, some areas with typical "pearls". What is the most likely diagnosis? @Squamous cell keratinous carcinoma Squamous cell nonkeratinous carcinoma Solid carcinoma Mucinous carcinoma Scirrhous carcinoma # 43 The biopsy is taken from a suspicious site at the mucous the right bronchus of a 58-year old male, with a history of the chronic bronchitis, pneumosclerosis and cardiopulmonary insufficiency. Histological investigation revealed cellular and tissue atypia, presence of a "cancer pearls" structures. What pathological process associated with histological changes listed below? @Squamous cell keratinous carcinoma Chronic polypous bronchitis Bronchiectasis Acute bronchitis Squamous metaplasia of the bronchial epithelium # 44 A 67-year-old man who is a long-term smoker presents with weight loss, a persistent cough, fever, chest pain, and hemoptysis. Physical examination reveals cachectic man with clubbingof his fingers and dullness to percussion over his right lower lobe. A chest x-ray reveals 3.5-cm hilar mass on the right and postobstructive pneumonia of the right lower lobe. Sputum cytology is suspicious for malignant cells. Histologic examination of transbronchial biopsy specimen reveals infiltrating groups of cells with scant cytoplasm. No glandular structures or keratin production are seen. The nuclei of these cells are about twice the size of normal lymphocytes and do not appear to have nucleoli. Which of the following is the most likely diagnosis? Adenocarcinoma Hamartoma Large-cell undifferentiated carcinoma @Small-cell undifferentiated carcinom Squamous cell carcinoma # 45 A 68-year-old man who worked for many years in the asbestos industry presents with weight loss and increasing chest pain. Examination of his sputum finds very rare asbestos bodies, while a CT scan shows a large mass involving the apical surface of his left lung. Surgery is performed and gross examination finds a lesion similar in appearance to that seen in the associated gross photograph of a sagittal section of the lung. Sections from this mass examinated by electron microscopy reveal tumor cells with long microvilli on their surface. Which of the following is the most likely diagnosis? @Malignant mesothelioma Malignant thymoma Metastatic malignant melanoma Poorly differentiated adenocarcinoma Small-cell carcinoma # 46 During a routine physical examination, a 43-year-old man is found to have a 2.5-cm “coin” in the peripheral portion of his right upper lobe (RUL). Several sputum samples sent for cytology are unremarkable, and a bronchoscopic examination is also unremarkable. Surgery is performed and the mass is resected. Histologic examination reveals lobulesof connective tissue that contains mature hyaline cartilage. These lobules are separated by clefts that are lined by respiratory epithelium. Which of the following is the most likely diagnosis? Adenocarcinoma Bronchioloalveolar carcinoma Carcinoid Fibroma @Hamartoma # Konec: #end The pathology of the digestive tract Gastro-intestinal tract diseas # 1 A physical examination of a fauces of a 12-year-old child with tonsillitis revealed the reddening and slight edema of mucosa, with reactive enlargement of tonsils, dotted by pinpoints of exudates emanating from the tonsillar crypts.What clinical-morphological variant of tonsillitis is the most probable in this case? @Lacunar tonsillitis Catarrhal tonsillitis Purulant tonsillitis Fibrinous tonsillitis Necrotic tonsillitis # 2 Physical exam of the patient’s fauces, which has quinsy, reveals hyperemia of the mucous membrane of the palate, and enlarged red tonsils. Small white-yellow focuses can be seen on their surface. What clinico-morphological type of quinsy is the most possible? Fibrinous Catarrhal Suppurative @Lacunar Necrotic # 3 A mother of a newborn complains of her baby's constant belching with undigested milk. Which developmental anomaly is it an evidence of? @Esophageal atresia Anal atresia Labium leporium Faux lupinum Esophageal fistula # 4 All the following statements regarding carcinoma of the esophagus are true EXCEPT most carcinoma arising in the body of the esophagus are squamous squamous carcinoma begin as lesions in situ patients with Barrett's esophagus have approximately a 10 persent risk of carcinoma the most common morphological form is a polypoid fungating mass @distant metastases are frequently present at the time of diagnosis # 5 During the endoscopy the inflammation of a major papilla of the duodenum and the disturbances of bile secretion were found. In which part of duodenum were the problems found? Lower horizontal part Ascendant part Bulb Upper horizontal part @Descendent part # 6 A patient underwent the surgical removal of pathologically disordered distal quarter of small intestine. How will it influense the absorption of nutritional substances in case of patient's ordinary diet? Carbohydrates absorption will be reduced Proteins absorption will be reduced Water absorption will be reduced Lipids absorption will be reduced @Absorption will not be altereded # 7 A 62-year-old man presents after fainting at home approximalety 1h ago. He says that for the past day he has had increasing left-sided abdominal pain, and also he as noted bright red blood in his stool. He denies any history of vomiting or diarrhea. Physical examination finds a low-grade level and gross blood on rectal examination. Further work-up finds abnormalities in his colon that are similar in appearance to the abnormalities seen in the gross picture of his colon below. Which of the following is the most likely cause of his GI bleeding? Angiodisplasia Appendicitis @Diverticulosis Hemorrhoids Instussusception # 8 A 29-year-old woman presents with colicky lower abdominal pain and frequent bloody diarrhea with mucus. Physical examination finds fever and peripheral leukocytosis, while multiple stool examinations fail to reveal any ova or parasites. A colonoscopy reveals the rectum and sigmoid portions of her colon to have superficial mucosal ulcers with hemorrhage, but regions more proximal are within normal limits. Which of the following histologic changes is most likely to be seen in a biopsy specimen taken from her rectum? @Crypt abscesses with crypt distortion Dilated submucosal blood vessels with focal thrombosis Increased thickness of the subepithelial collagen layer Noncaseating granulomas with scattered giant cells Numerous eosinophils within the lamina propria # 9 A 58-year-old man presents with increasing fatigue. His past medical history is unremarcable. Physical examination is also unremarcable exceptfor heme-positive stool. Laboratory examination finds his hematocrit to be slightly decreased and hypochromic microcytic red cells are present in his peripheral smear. An upper GI is unremarcable, but a barium enema study finds a 4-cm mass in the left side of his colon having an "apple core" appearance. Which of the following is the most likely histologic diagnosis for this colon mass? @Adenocarcinoma Leiomyosarcoma Medullary carcinoma Small-cell carcinoma Squamous cell carcinoma # 10 A 45-year-old man presents with feve, chronic diarrhea, and weight loss. He is found to have multiple pain and swelling of his joints (migratory polyartritis)and generalized lymphadenopathy. Physical examination reveals skin hyperpigmentation. A biopsy from his small interstines reveals the presence of macrophagesin the lamina propria that contain PAS-positive cytoplasm. Which of the following is the most likely diagnosis? Abetalipoproteinemia Crohn’s disease Hartnup disease Nontropical sprue @Whipple’s disease # 11 A microscopic investigation of a colon biopsy revealed a superficial defect of a mucosa, decrease of goblet cells number with lack of mucus in them. In addition, considerable lympho- plasmocyte infiltration with presence of segmented leucocytes and eosinocytes was defined. Choose the most probable and exact diagnosis. @Nonspecific ulcerative colitis in exacerbation Crohn's disease Chronic ischemic colitis Dysentery in the third stage Amebiaz of intestine with forming of ulcers # 12 A 39-year-old man present with bloody diarrhea. Multiple stool examinations fail to reveal any ova or parasites. A barium examination of the patient's colon reveals a characteristic "string sign". A colonoscopy reveals the rectum and sigmoid portion of the colon to be unremarceble inflamatory cells within the lamina propria. Worsening of the patient's symptoms results in emergency resection of the distal small intestines. Gross examination of this resected bowel reveals deep, long mucosal fissures extending deep into the muscle wall. Several transmural fistulas are also found. Which of the following is the most likely diagnosis? Ulcerative colitis Lymphocytic colitis Infectious colitis Eosinophilic colitis @Crohn's disease # 13 Two subtotal colectomy spesiments are sent to the laboratory with both showing a hemorrhagic cobblestone appearance of the mucosa. One, however, shows longitudinal grooving of the surface, which suggests ischemic bowel disease multiple polyposis syndrome ulcerative colitis @Crohn's disease intestinal tuberculosis # 14 A distinguishing feature when comparing ulcerative colitis with Crohn's disease is colonic involvement possible malignant transformation artritis @fistula formation absence of granulomas # 15 The colonic wall 30 cm from the anal margin in a man with severe bloody diarrhea. All the statements regarding this condition are true EXCEPT inflammation is usualy limited to the lamina propria multiple crypt abscesses are comonly seen atypical cytologic changes occur in the mucosa @granulomas occur in the mucosa "skip" lesions are not present # 16 A macroscopic investigation of the appendix, 9 cm in length and 0.9 cm in thickness, revealed dull and hyperemic serous membrane. Microscopic study determined edema, stases in capillaries and venules, fine hemorrhages throughout the mucosa. Besides these, the necrotic foci with leukocyte infiltration around them were also verified. What is the most likely diagnose? @Superficial appendicitis. Simple appendicitis. Suppurative appendicitis Flegmonous-ulcerative appendicitis Gangrenous appendicitis. # 17 A vermiform appendix is 9cm long and 0,9cm thick. Serous membrana is dark and sanguineous. Microscopically: the wall is oedematous, capillary and venular stases, small hemorrhages. The focuses of necrosis that are surrounded by leukocytic infiltration are located in the mucous and submucous membranae. What is the most possible diagnosis? Acute phlegmonous-ulcerative appendicitis Acute simple appendicitis Acute phlegmonous appendicitis @Acute superficial appendicitis Acute gangrenous appendicitis # 18 A 16-year-old boy was performed an appendectomy. He has been hospitalized for right lower quadrant abdominal pain within 18 hours. The surgical specimen is edematous and erythematous. Infiltration by what of the following cells is the most typical for the process occuring here? Basophils Eosinophils Monocytes @Neutrophils Limphocytes # 19 An 18-year-old woman presents with abdominal pain localized to the right lower quadrant, nausea and vomiting, mild fever, and an elevation of the peripheral leukocyte count to 17,000/mL. An appendectomy is performed. Which of the following statement best describes the expected microscopic appearance of her appendix? An appendix with a normal appearance @Neutrophils within the muscular wall Lymphoid hyperplasia and multinucleated giant cells within the muscular wall A dilated lumen folled with mucus A yellow tumor nodule at the tip of the appendix # 20 Microscopic study of appendix determined intensive leukocyte infiltration throughout all its layers. What is the most likely type of inflammation? @Suppurative appendicitis Apostematous appendicitis Gangrenous appendicitis. Superficial appendicitis. Flegmonous-ulcerative appendicitis # 21 Microscopic study of appendix determined intensive leukocyte infiltration hyperemia, stases throughout all its layers. What is the most likely type of appendicitis? @Suppurative appendicitis Gangrenous appendicitis Superficial appendicitis Simple appendicitis Chronic appendicitis # 22 A removed appendix delivered to pathology department. Macroscopic investigation revealed its thickening, enlargement, dull and hyperemic serous membrane. A yellowish-green liquid lumen was visible on a cut section within its lumen. What is the most likely type of the appendicitis? @Suppurative appendicitis. Catarrhal appendicitis. Superficial appendicitis. Gangrenous appendicitis. Apostematous appendicitis # 23 Macroscopic investigation of a removed appendix revealed its thickening, enlargement, dull and hyperemic serous membrane with whitish membranaceous incrustation. A whitish-yellow, opaque, viscous liquid detected on a cut section within its lumen. What is the most likely type of the appendicitis? @Suppurative appendicitis. Gangrenous appendicitis Simple appendicitis Superficial appendicitis Chronic appendicitis. # 24 A vermiform appendix, sent to the pathomorphologic department after the operation, is thickened and enlarged in size. Serous membrana is dark and sanguineous. A yellow-green fluid excretes from the lumen, when the vermiform appendix is incised. The wall is diffusely infiltrated with leucocytes. What type of appendicitis do the following changes develop? Superficial catarrhal Simple catarrhal @Phlegmonous Gangrenous Abscessing # 25 At the microscopical exam of the vermiform appendix that was operatively removed were noted the following facts: oedema, diffuse neutrophilic infiltration of the wall with the necrosis and the presence of a mucous membrane defect with the affection of the muscular one. What form of appendicitis has developed? @Phlegmonous-ulcerative Phlegmonous Gangrenous Superficial Abscessing # 26 Microscopic study determined edema, diffusive leukocyte infiltration of appendix wall and also a mucosal lesion with alteration of its muscular layer. What is the most likely diagnose? @Flegmonous-ulcerative appendicitis Suppurative appendicitis Gangrenous appendicitis Superficial appendicitis Apostematous appendicitis # 27 Microscopical examination of a removed appendix revealed an edema, diffuse neutrophilic infiltration of appendix wall along with necrosis and defect of mucous membrane with affection of its muscle plate. What appendicitis form was developed? Phlegmonous @Ulcerophlegmonous Gangrenous Superficial Apostematous # 28 The removed appendix thickened and covered by fibrinopurulent incrustation. A purulent exudates infiltrated all appendix layers; the destruction of mucosa membrane was evident. What is the most likely diagnosis? @Flegmonous-ulcerative appendicitis Simple appendicitis Suppurative appendicitis Gangrenous appendicitis Superficial appendicitis # 29 In the histological specimen an organ is seen. Wall of this organ consists of 4 layers: first is mucous layer forming pits and glands; second is submucous layer of connective tissue; third is muscularis externa containing tree layers of smooth muscles; fourth is serous layer. Which organ can be recognized in the specimen? @Stomach Jejunum Duodenum Esophagus Colon # 30 During histological examination of the stomach it was found out that glands contained very small amount of pariental cells or they were totally absent. Mucose membrane of what part of the stomach was studied? @Pyloric part Cardia - Body of stomach Fundus of stomach # 31 A patient ill with chronic gastritis went for endogastric pH-metry that allowed to reveal decreased acidity of gastric juice. It is indicative of diminished function of the following cells: Chief exocrinocytes @Parietal exocrinocytes Endocrinocytes Cervical cells Accessory cells # 32 Examination of the patient with pernicious anemia revealed antibodies against cell’s proteins of gastric glands cells producing gastric extrinsic factor . What kind of cells in gastric glands was destroyed? @Parietal cells Mucous cells Chief cells DNES-cells Surface- lining cells # 33 A biopsy of the antrurn of the stomach of an adult who presents with epigastric pain reveals numerous lymphocytes and plasms cells within the lamina propria, which is of normal thickness. There are also scattered neutrophil within the glandular epithelial cells. A Steiner silver stain from this specimen is positive for a small, curved organism. These histologic changes are moat consistent with infection by which one of the following organisms? Enteroinvasive Escherichia coli Enterotoxigenic E. coli @Helicobacter pylori Salmonella typhi Shigella species # 34 All the following statements regarding Helicobacter pylori gastritis as illustrated in the photomicrograph below are true EXCEPT it is present in the majority of patients with duodenal ulceration @the inflammatory infiltrate is characteristically rich in eosinophils tissue invasion by microorganisms is inconspicuous organism is absent from arease of intestinal metaplasia urease is an important virulence factor of H. pilory # 35 A 49-year-old woman takin ibuprofen for increasing joint pain in her hands presents with increasing pain in her midsternal area. Gastroscopy reveals multiple, scattered, punctuate hemorrhagic areas in her gastric mucosa. Biopsies from one of these hemorrhagic lesions reveal mucosal erosions with edema and hemorrhage. No mucosal ulceration is seen. Which of the following is the most likely diagnosis? Active chronic gastritis @Acute gastritis Autoimmune gastritis Chronic gastritis Peptic ulcer disease # 36 A gastroscopy of a 55-year old patient revealed a diffusive swelling, hyperemia and solitary small hemorrhage of the stomach mucosa. These were accompanied with considerable quantity of a muddy, viscous grey exudate on a gastric surface. What gastritis has developed at the patient? @ Catarrhal gastritis Hemorrhagic gastritis Flegmonous gastritis Fibrinous gastritis Corrosive gastritis # 37 A gastroscopy of a 44-year old patient, with a history of a pain in epigastrium after meal, revealed a hyperemia of the stomach mucosa with the stomach folds reduction. Histological study showed a thinning of the mucosa, a reduction of the glands quantity accompanied with the- growth of a connecting tissue, lymphocytes and plasmocytes infiltration. Specify, what of the listed diagnoses is the most probable? @Chronic atrophic gastritis. Acute catarrhal gastritis. Acute suppurative gastritis. Chronic superficial gastritis. Giant hypertrophic gastritis. # 38 A histological investigation of a gastric biopsy revealed a thinning of a stomach mucosa with reduction of a glands quantity. This was accompanied with a considerable growth of a connecting tissue, dilation of a glands lumen, lymphocytes and plasmocytes infiltration of the mucosa. What is the most likely diagnosis? @Chronic atrophic gastritis Chronic superficial gastritis Chronic atrophic gastritis with an intestinal metaplasia Phlegmon of stomach - # 39 A histological investigation of a gastric biopsy of a 50-year old woman revealed a thinning of a stomach mucosa with reduction of a glands quantity, foci of an intestinal metaplasia; a plethora, an edema and a stromal sclerosis. These were accompanied with a diffuse leucocytes, lymphocytes and plasmocytes infiltration of the mucosa. What is the most likely diagnosis? @Chronic atrophic gastritis in an active phase • Chronic atrophic gastritis in a nonactive phase Chronic superficial gastritis Acute catarrhal gastritis Acute fibrinouse gastritis # 40 A 37-year-old man has had nausea and vomiting for 5 weeks. He experienced an episode of hematemesis yesterday. On physical examination he has no abnormal findings. Upper Gl endoscopy is performed, and there is a 1.5 cm diameter lesion in the gastric antrum which appears to be an area with loss of the epithelial surface. These findings are most typical for which of the following pathologic processes? Abscess Serositis Granuloma Gangrene @Ulcer # 41 A histological investigation of the removed stomach ulcer revealed in its floor the fibrinopurulent exudate, a zone of the fibrinoid necrosis, a granulation tissue with a fibrous tissue underneath. What is the most likely diagnosis? @Chronic ulcer Acute ulcer Acute erosion Phlegmon of stomach - # 42 A post-mortem of a male with a history of anemia accompanied by vomiting by dark gastric contents reveled in a stomach about 1 liter of liquid blood and bloody clots. A gross investigation showed an on small curvature of a stomach an oval solitary ulcer with the elevated firm edgesand a smooth floor. What is the most likely diagnosis? @Chronic gastric ulcer Chronic atrophic gastritis Acute gastritis Acute gastric ulcer Chronic hypertrophic gastritis # 43 Morphological exam of a stomach reveals a deep defect of a wall with the affection of a muscular membrana; a proximal margin of the last is excavated but a distal one is plain. Microscopically: an area of necrosis is detected at the bottom of the defect. A granulation tissue and a massive area of a cicatricle tissue (at the place of muscular membrana) are located under it. Make a diagnosis. Chronic ulcer at the remission stage Chronic ulcer with the malignancy Acute ulcer @Chronic ulcer at the stage of acute condition Cancer-ulcer # 44 A gross investigation of a stomach revealed a deep defect of a gastric wall with a lesion of a muscular layer. The proximal edge was undermined and distal one was flat. A histological study of the removed stomach showed in its floor the zone of the fibrinoid necrosis, a granulation tissue and massive fibrosis, which replaced the muscular layer. What is the most likely diagnosis? @Chronic ulcer in exacerbation Chronic ulcer in remission Acute ulcer Erosion Cancer-Ulcer # 45 An operation of a male with a medical history of a hematemesis revealed a stomach ulcer penetrated into the muscular layer. Ulcer edges were dense. A bleeding vessel was detected at the ulcer's bottom. What is the type of an ulcer? @Chronic ulcer with hemorrhage Chronic ulcer with penetration Ecute ulcer with bleeding Chronic ulcer with perforation Chronic ulcer with malignisation # 46 A 44-year old patient, with a history of the chronic duodenum peptic ulcer, died of peritonitis. An autopsy revealed multiple steatonecroses of a retroperitoneal tissue and a pancreas. A gross investigation of a duodenum demonstrated an ulcerative defect, which was 5 mm in diameter and 10 mm deep. The edges presented necrotic masses. Diagnose the complication of a duodenal peptic ulcer? @Penetration Hemorrhage Stenosis Perforation - # 47 During the section of a 29-year-old man, that had duodenal ulcer for a long time, were revealed the signs of peritonitis, numerous steatonecroses of extraabdominal fat and pancreas. In the area of the pancreas’ body, an ulcer-like defect was located (diameter - 5 mm, depth - to 10 mm), the margins of which contained necrotic mass. Diagnose the complications of the duodenal ulcer. Malignancy Hemorrhage Stenosis Perforation @Penetration # 48 During the palliative operation of a 46-year-old woman relatively the cancer of the stomach revealed the presence of the Krukenberg’s metastases in the ovaries. What way of metastasis led to the affection of the ovaries? @Lymphogenic retrograde Lymphogenic orthograde Haematogenic Implantation Canalicular # 49 At the section of a 42-year-old woman, who had an operation relatively the tumour of the stomach, the ovary was hardly enlarged in size, of solid consistence and of white color. Histologically: there were revealed atypical epithelial cells, that were located between the strata and shaft brace of connective tissue. What is the most possible disease? Serous cystadenoma @Krukenberg’s carcinoma (metastatic ovarian carcinoma) Pseudomucinous cystcarcinoma Malignant tecoma Malignant granulous-cellular tumour # 50 An autopsy of a 48-year-old woman with a history of the stomach neoplasm revealed the markedly enlarged, firm, white color ovary. Microscopic investigation showed markedly atypical epithelial cells placed among the layers and fibers of a connecting tissue. What is the most likely diagnosis? @Krukenberg tumor of ovary. Serous cystadenocarcinoma Pseudomucinous cystadenocarcinoma. Malignant thecoma. Malignant granulosa cell tumor. # 51 The liver of a 55-year-old man at autopsy contains multiple tumor masses from 2 to 5 cm in size that are mostly firm and tan and that grossly exhibit umbilication with central necrosis. Which of the following statements would best characterize such an appearance: There is multicentric origin of a benign neoplasm. The neoplasm has a high grade. @The primary neoplasm is in the stomach. A carcinogen was the underlying cause for the neoplasm. The neoplasm has an advanced stage. # 52 The subclavicular lymphatic nodules are enlarged in the 45-year-old patient. A metastasis of a signet-ring cell cancer was revealed at the biopsy material from the nodule. Choose the most possible localization of a primary tumour. Pulmonary cancer Esophageal cancer Thyroid cancer @Cancer of the stomach Uterine neck cancer # 53 A 48-year old female presents to her physician enlarged supraclavicular lymph nodes. Microscopic investigation of a biopsy from a lymph node revealed the metastasis of the signet-ring cancer. Choose the most probable localization of a primary tumor. @Cancer of stomach. Cancer of oesophagus. Cancer of thyroid. Cancer of lung. Cancer of cervix uteri. # 54 A 53-year-old man presents with increasing gastric pain and is found to have a 3-cm mass located in the anterior wall of his stomach. This mass is resected and histologic examination reveals a tumor composed of cells having elongated, spindle-shaped nuclei. The tumor does not connect to the overlying gastric epithelium and is instead found only in the wall of the stomach. The tumor cells stain positively with CD117, but negatively with both desmin and S-100. Special studies find that these tumor cells have abnormalities of the KIT gene. Which of the following is the most likely diagnosis? Ectopic islet cell adenoma (VIPoma) @Gastrointerstinal stromal tumor (GIST) Submucosal leiomyoma (“fibroid tumor”) Lymphoma of mucosa-associated lymphoid tissue (MALToma) Nonchromaffin paraganglioma (chemodectoma) # Liver diseases # 1 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 # 2 A 42-year-old previously healthy woman notes that over the past week her eyes have developed a jaundiced appearance. She has had mild nausea and vomiting over the past week. On physical examination she has scleral icterus. She has no other major physical examination findings except for mild right upper quadrant tenderness. Which of the following underlying conditions is most likely to contribute to development of her icterus? Hypercholesterolemia Thrombocytopenia Metastatic carcinoma @Hepatitis Diabetes mellitus # 3 A 4-year-old boy presents with mild fatigue and malaise. Several other children in the day-care center he attends 5 days a week have devel¬oped similar illnesses. Physical examination finds mild liver tenderness, but no lymphadenopathy is noted. Laboratory examination finds mildly elevated serum levels of liver enzymes and bilirubin. The boy recovers from his mild illness without incident. Which of the following organisms is the most likely cause of this child's illness? Cytomegalovirus (CMV) Epstein-Barr virus (EBV) Group A b-hemolytic streptococcus @Hepatitis A virus Hepatitis B virus # 4 |