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During the complicated labour the symphysis pubis ruptured. What organ can be damaged the most? Rectum @Urinary blader Uterus Uterine tubes Ovaria # 6 Acute tubular necrosis (ATN) is a fairly common renal lesion and is associated with all the following EXCEPT @red cell casts in the urine proteinuria proximal tubular damage in toxic ATN oliguria acute renal failure # 7 Shock and signs of acute renal failure (ARF) developed in the patient due to severe injury. What is the leading cause of development of ARF in the case? Increased pressure in the renal arteries @Decreased arterial pressure Urine excretion violation Decreased oncotic BP Increased pressure in the nephron capsule # 8 A 50-year-old man had been blocked up for 2 days because of earthquake. After he was rescued, the diagnosis of compression syndrome was made. What further complication is the most likely to develop in this case? Acute vascular failure Acute cardiac failure @Acute renal failure Acute hepatic failure Acute respiratory failure # 9 Violation of safety rules resulted in calomel intoxication. Two days later the daily diuresis was 620 ml. A patient experienced headache, vomiting, convulsions, dyspnea, moist rales in lungs. What pathology is it? Chronic renal insufficiency @Acute renal insufficiency Glomerulonephritis Uraemic coma Pyelonephritis # 10 A patient with the signs of mercuric poisoning had the following processes in kidneys: focal necrotic changes in tubules of the main departments, oedema, leukocytic infiltration and haemorrhages of the interstice and venous congestion. What patient’s condition have developed? Acute glomerulonephritis @Acute necrotic nephrosis Chronic renal insufficiency Acute pyelonephritis Chronic pyelonephritis # 11 An autopsy of a patient, who died from poisoning of ethylene glycol, revealed enlarged edematous kidneys. Their capsule was taken out very easily. Gross investigation showed the wide pale-grey cortical layer and dark red medulla. What disease has developed at the patient? @Necrotic nephrosis Acute pielonephritis Acute glomerulonephritis Acute tubulointerstitial nephritis Lipoid nephrosis # 12 The kidney biopsy is taken from the man who is in clinic with symptoms of a mercury poisoning. Histological investigation revealed focal tubular necrosis, an edema, hyperemia, hemorrhages and leukocytic infiltration in a stroma. What condition has developed at the patient? @Acute necrotic nephrosis Acute glomerulonephritis Chronic renal insufficiency Acute pyelonephritis Chronic pyelonephritis # 13 A 42-year-old man, who had a complicated form of enteric fiver, acute nephral insufficiency developed of which he died. At the autopsy: kidneys are enlarged in size, oedematous, fibrous capsule can be easily removed; on the incision the cortex is pale-gray, pyramids are cherry. Histological exam reveals mostly narrow lumen of the tubules; epithelial cells are enlarged in size without nuclei; glomeruli are collapsed; stroma is oedematous with small leukocytic infiltration and small haemorrhages. What pathology is meant? Pyonephrosis Acute pyelonephritis Acute glomerulonephritis @Necronephrosis Hydronephrosis # 14 At the patient operated concerning a widespread tumour of an abdominal cavity, the considerable bleeding and declining of arterial pressure took place. After operation the acute renal insufficiency, resulted in the patient's death, developed. An autopsy revealed the wide light pink cortical layer, which was clearly delimited from dark red pyramids. Histological investigation showed the absence of nuclei in epithelium of convoluted tubules, tubulorrhexis, venous hyperemia. Nuclei of the cells of vascular glomeruli and straight tubules were unchanged. What pathology of kidneys has developed at the patient? @Necronephrosis Infarct Glomerulonephritis Pyelonephritis Nephrosis # 15 Histologic sections of a kidney reveal patchy necrosis of epithelial cells of both the proximal and distal tubules with flattening of the epithe¬lial cells, rupture of the basement membrane (tubulorrhexis), and marked interstitial edema. Acute inflammatory cells are not seen. Which of the fol¬lowing is the most likely diagnosis? Acute pyelonephritis @Acute tubular necrosis Chronic glomerulonephritis Chronic pyelonephritis Diffuse conical necrosis # 16 A 49-year-old patient died of a massive bleeding from an operating wound. A post-mortem revealed enlarged kidneys with strained fibrous capsule. A gross investigation of a cut surface determined wide, pale grey color cortical layer accurately delimited from cyanotic, dark red pyramids. Histological study showed a necrosis and a marked dystrophy of an epithelium convoluted tubules, tubulorrhexis.What condition has developed in kidneys? @Acute necrotic nephrosis. Postinfectious glomerulonephritis Lipoid nephrosis. Rapidly progressive glomerulonephritis. Secondary amyloidosis of kidneys. # 17 A young man died of a burn disease. A post-mortem revealed the brain edema, liver and kidneys enlargement. Gross investigation showed the thickened pale-grey cortical layer and hyperemic medulla. Histological study demonstrated focal tubular necrosis at different points along the nephron with a disruption of tubular basement membrane interstitial edema with leukocytic infiltration and a hemorrhage. What of the listed diagnoses the most authentic? @Necrotic nephrosis. Tubulointerstitial nephritis. Pyelonephritis. Gouty kidney. Myeloma kidney. # 18 Histological study of a renal biopsy revealed a necrosis and a marked dystrophy of the convoluted tubules epithelium, tubulorrhexis, stromal edema and hyperemic medulla. Name the pathological process? @Necrotic nephrosis Glomerulonephritis Pyelonephritis Cystic disease Kidney stone disease # 19 At the section of a man, who died of burn disease, the brain edema, the enlargement of the liver and kidneys were revealed. The cortex of the last is wide and pale-gray, but the medulla is sanguineous. Microscopically: necrosis of the tubules of main departments with the destruction of basal membranes, oedema of the interstitium with leukocytic infiltration and haemorrhages. What is the most possible diagnosis? Tubulointerstitial nephritis @Necrotic nephrosis Pyelonephritis Podagra kidney Myeloma kidney # 20 On the 6th day of treatment a patient with acute renal insufficiency developed polyuria. Diuresis intensification at the beginning of polyuria stage of acute renal insufficiency is caused by: Growth of natriuretic factor Volume expansion of circulating blood Reduction of vasopressin content in plasma Reduction of aldosteron content in plasma @Renewal of filtration in nephrons # 21 The patient treated for a cold by the big doses of paracetamol, presented symptoms of an oliguria and azotemia. In 5 days he died of an acute renal insufficiency. Histological investigation of kidneys revealed the diffusive edema of an interstitial tissue of a kidneys cortex, its infiltration by lymphocytes, the eosinophils, some neutrophils. Almost intact glomerules were found along with a destruction of a tubular epithelium. Name the most probable type of a kidneys lesion? @Tubulointerstitial nephritis Acute glomerulonephritis Nephrotic syndrome Pyelonephritis Necronephrosis # 22 A 49-years-old- patient with a 10 days history of dysentery presented with raised body temperature, a pain in lumbar area, a fever and a considerable quantity of leucocytes in urine. Histological investigation of a puncture renal biopsy revealed hyperemia, interstitial leukocytic infiltration and numerous inflammatory cells (mainly neutrophiles) with a desquamated epithelium, filling renal tubules. What complication has developed at the patient? @Acute pyelonephritis Chronic pyelonephritis Pyelitis Glomerulonephritis Necrotic nephrosis # 23 A macroscopic investigation of the removed kidney reveled renal swallowing, congestion and a capsule easily taken out. Renal pelvis and calyxes were dilated, filled by turbid urine. Their mucosa was dim, with the areas of hemorrhages. The cut surface of a kidney had a motley pattern; yellow-grey zones were surrounded by plethora and hemorrhages areas. To what disease there corresponds such macroscopic picture of kidneys? @Acute pyelonephritis Acute glomerulonephritis Amyloidosis of kidneys Nephrolitiasis Renal cystic disease # 24 A 60-year-old woman died of a chronic renal failure. An autopsy revealed the irregularly contracted and markedly lobulated kidneys with a fibrous tissue alternated with an intact parenchyma. Renal pelvises were dilated, their walls - thickened. Histological investigation showed sclerosis, lymphocyte - plasmocyte infiltration of the renal pelvis walls, and interstitium. What diagnosis is most probable? @Chronic pyelonephritis Acute pyelonephritis Acute glomerulonephritis Tubulointerstitial nephritis Chronic glomerulonephritis # 25 Histological investigation of a kidney biopsy showed sclerosis, lymphocyte – plasmocyte infiltration of the renal pelvis walls and calyces; tubules dystrophy and atrophy. The intact tubules were dilated, stretched by colloid-like masses. The epithelium was flattened. In whole, the microscopic picture of tissue sample had 'a thyroid kidney' pattern. What diagnosis is most probable? @Chronic pyelonephritis Sharp pyelonephritis Glomerulonephritis Nephrosclerosis Tubulointerstitial nephritis # 26 A post-mortem of a patient with a long history of cystitis and a dyskinesia of ureters revealed morphological signs of uremia. Kidneys were contracted, with irregularly scarred surface. In the renal pelvis fine urate stones and sand were registered. Histological investigation showed 'the thyroid kidney' and areas of an interstitial inflammation. What is the most likely diagnosis? @Chronic pyelonephritis Acute pyelonephritis Atherosclerotic-contracted kidney Primary- contracted kidney Amyloidal- contracted kidney # 27 At the section of a woman, who died of renal insufficiency, the kidneys are unevenly reduced in size and have surface with big tubers; on the incision the areas of cicatricial tissue change with the unchanged parenchyma, renal pelves are widened with thinned walls. Microscopically in the walls of renal pelves, calices and in the interstice are the facts of sclerosis and lymphoplasmocytic infiltration. What is the most possible diagnosis? Acute glomerulonephritis Acute pyelonephritis @Chronic pyelonephritis Tubulointerstitial nephritis Chronic glomerulonephritis # 28 At the biopsy material from a kidney were detected: sclerosis, lymphoplasmocytic infiltration of renal pelves and calices; dystrophy and atrophy of the tubules. Saved tubules were widened, outstretched by colloid-like masses; the epithelium was squashed (disk kidney). What is the most possible diagnosis? Nephrosclerosis Acute pyelonephritis Glomerulonephritis @Chronic pyelonephritis Tubulointerstitial nephritis # 29 A postmortem of a 58-year-old male revealed in kidneys asymmetrical, coarse, corticomedullary scars. Histological investigation of a kidney showed atrophy of cyst-like dilated tubules, filled with colloid eosinophilic masses. Interstitium was characterized by pronounced periglomerular sclerosis. What diagnosis is most probable? @Chronic pyelonephritis with scarring Chronic glomerulonephritis with scarring of kidneys Amyloidosis of kidneys Tuberculosis of kidneys Kidneys at hypertension # 30 An autopsy of a 59- year-old man revealed the coral-like stone filled all renal pelvis of a right kidney. The kidney was enlarged, hyperemic with the capsule, taken out hardly. The pelvis and calyxes cavities were dilated, filled by a turbid, greenish- yellowish viscous liquid. The mucosal layer was dim with some hemorrhages. A cut surface investigation showed motley pattern of the kidney's tissue, with yellow spots in up to 1cm in diameter. What complication to nephrolithiasis has developed? @Chronic pyelonephritis with exacerbation Tumour of kidney Postinfectious glomerulonephritis Primary amyloidosis Rapidly progressive glomerulonephritis. # 31 A 67-year-old woman presents with signs of slowly progressive renal failure. Physical examination reveals mild hypertension, while laboratory tests find increased serum creatinine and BUN with mild proteinuria. A few scattered neutrophils and rare bacteria are seen microscopically in her urine. Grossly both of her kidneys are small and irregular with dilation of the renal pelvis and clubbing of the calyces, these changes being similar in appearance to those seen in the picture below. Histologic sections from her kidneys revealed chronic inflammation of the interstitium. Which one of the following additional microscopic findings should be present in these histologic sections? The renal papillae should have numerous activated macrophages @The tubules should be dilated and filled with colloid casts The afferent and efferent arterioles should demonstrate fibroelastic hyperplasia The glomeruli should have multiple fibrin microthrombi The interstitium should have needle-shaped crystals # 32 The kidneys of a patient, who died of chronic renal failure caused by chronic glomerulonephritis, are reduced in size, of solid consistence, the capsule can be hardly removed, exposing granular surface. On the incision cortex and medulla are thinned; renal tissue is dry, anaemic, of gray color. How can we term such kidney? Atherosclerous-wrinkled Primary wrinkled @Secondary wrinkled Amyloid-wrinkled Pyelonephritic-wrinkled # 33 A 53-year-old patient with a history of a chronic glomerulonephritis died of chronic renal insufficiency. A post-morten revealed smaller that normal, firm kidneys. Their capsule was taken out hardly, baring a granular renal surface. On a cut section a cortical and cerebral layers were thin with dry, anemic, grey color kidneys tissue. How is called such kidneys? @Secondary - scarring kidneys Primary - scarring kidneys Atherosclerotic - scarring kidneys Amyloidal - scarring kidneys Pyelonephrotis - scarring kidneys # 34 An autopsy of the 68-year-old man revealed a sallow-grey colour of his skin with petechial hemorrhages. His face and tongue had a powdery 'uremic frost'. Fibrinous hemorrhagic laryngitis, a tracheitis, a shaggy pericardium and a catarrhal gastroenterocolitis were also diagnosed. For what syndrome the given complex of morphological changes is characteristic? @Chronic renal insufficiency Acute hepatic insufficiency Acute renal insufficiency Chronic heart insufficiency - # 35 For a long time a 49-year-old woman had suffered from glomerulonephritis which caused death. The autopsy revealed that the size of her kidneys was 7х3х2,5 sm, weight 65,0 g, they were dense and small-grained. Microscopically: fibrinogenous inflammation of serous and mucous capsules, dystrophic changes of parenchymatous organs, brain edema. What complication can cause such changes of serous capsules and inner organs? Sepsis DIC-syndrome Anemia @Uraemia Thrombopenia # 36 A post-mortem of a 52- year-old man, with a long history of chronic glomerulonephritis, resulted in his death, revealed markedly reduced, firm, fine-grained kidneys. Microscopical investigation showed fibrinous inflammation of serous and mucosas, dystrophic changes of parenchymatous organs and a brain edema. What complication has led to the serous and mucosas lesions? @Uremia Anaemia Sepsis DIC-syndrome Thrombocytopenia # 37 A 55 year-old man has died after chronic glomerulonephritis, chronic renal insufficiency. In the autopsy the pathologist has found out characteristic changes in kidneys for this disease, also fibrinous pericarditis, pleuritis, bronchitis. Call the cause of the fibrinous inflammation in serosal and mucosal layers. @Uremia Hypolipidemia Hyperlipidemia Arterial hypertension Arterial plethora # 38 A 27-years-old woman has been suffered by diabetes mellitus since she had been a child. During the last years the arterial hypertension and proteinuria have occurred. She has died with signs of uremia. What typical changes were found out in autopsy? @“Cor villosum” “Tiger heart” “Armor heart” Mesenchymal fat dystrophy of the heart Purulent pericarditis # 39 All the following statements are true of urinary calculi EXCEPT they are common in males @they are bilateral in 40 percent of cases they are radiopaque in about 90 percent of cases they may be associated with Pseudomonas infection the incidence is increased in leukemia # 40 A 35-year-old woman presents with the sudden onset of severe, col¬icky pain on the right side other abdomen. She does not relate the pain to food, but says that she cannot find a pain-free position. Physical examina¬tion finds marked tenderness over the right costovenebral angle, but rebound tenderness is not present. A pelvic examination is unremarkablMicroscopic examination of her urine reveals the presence of numerous red blood cells. The urine is negative for esterase and nitrite, and no bacteria are seen. Which of the following is the most likely cause of her signs and symptoms? Choledocholithiasis Cholelithiasis Cystitis @Nephrolithiasis Pyelonephritis # 41 A 65 year old man suffering from gout complains of kidney pain. Ultrasound examination revealed renal calculi. The most probable cause of calculi formation is the strengthened concentration of the following substance: Bilirubin Cystine Cholesterol @Uric acid Urea # 42 A patient with urolithiasis after the examination was administered allopurinol - competitive inhibitor of xanthine oxidase. It was influenced by chemical analysis of the calculuses, which consisted mainly of: Calcium sulphate Calcium oxolate monohydrate Calcium oxolate dihydrate Calcium phosphate @ Sodium urate # 43 During the morphological examination of a removed kidney was detected the presence of a concrement that obturated the lumen of the proximal part of ureter. The kidney is hardly enlarged with the parenchyma atrophy; renal pelves and calyx are hardly widened, too. Microscopically: diffuse sclerosis, atrophy of glomeruli and tubules; saved tubules are cyst widened. What complication of urolithiasis appeared in a patient? @Hydronephrosis Pyonephrosis Pyelonephritis Glomerulonephritis Chronic paranephritis # 44 A macroscopical investigation of a removed kidney revealed in proximal area of an ureter the concrement which obturated its lumen. The kidney was markedly enlarged; a parenchyma was atrophic with considerably dilated pelvis and calyces. Microscopical study of kidney's sample showed the diffusive sclerosis, an atrophy of glomeruli and tubules. Survived tubules were cystically dilated. What complication of a nephrolithiasis developed at the patient? @Hydronephrosis. Pyonephrosis. Pyelonephritis. Glomerulonephritis. Chronic paranephritis. # 45 A postmortem of a 65-year-old patient with a history of the adenoma of a prostate revealed big kidneys with markedly dilated pelvis and calyces filled with a transparent liquid. Name the kidneys pathology. @Hydrohephrosis Glomerulonephritis Amyloidosis Tuberculosis Pyelonephritis # 46 An autopsy revealed substantial enlargement of a right kidney. A gross investigation of a renal cut section showed a stone in it with marked dilation of the pelvis and calyces by urine and thinning of the renal parenchyma. What of diagnoses is the most likely? @Hydronephrosis. Pyelectasia Pyelonephritis. Cyst of kidney - # 47 An autopsy revealed marked enlargement of a kidney. Gross examination of a kidney's section presented with dilation of both renal pelvis and calyces resulted from renal stones. What from diagnoses is most faithful? @Hydronephrosis Simple cysts Pyelonephritis Benign nephrosclerosis Polycystic kidney disease # 48 At autopsy a male is found to have big kidneys with marked dilatation of the renal pelvis and calyces filled with transparent liquid. A thinning of the renal parenchyma accompanied above lesions. Which is the most likely finding? @Hydronephrosis Glomerulonephritis Amyloidosis Tuberculosis Pyelonephritis # 49 An 8-month-old male infant presents with progressive renal and hepatic failure. Despite intensive medical therapy, the infant dies. At the time of autopsy, the external surfaces of his kidneys are found to be smooth, but cut section reveals numerous cysts that are lined up in a row. Which of the following is the mode of inheritance of this renal abnormality? Autosomal dominant @Autosomal recessive X-linked dominant X-linked recessive Mitochondrial # 50 An autopsy of a 44-year-old female revealed a substantial enlargement of a right kidney reminding grape clusters. The cut surface showed cavities varying in size from 0, 5 to 3 cm in diameter, which were filled by serous liquid and colloid masses. Kidney parenchyma between cavities was thinned to 0,1 cm. What is the most likely diagnosis? @Renal cystic disease Chronic pyelonephritis Acute pyelonephritis Nephrolithiasis Dysphasia of kidneys # 51 A post-mortem revealed the enlarged kidneys with a lobulated surface due to plural cavities with the smooth wall, filled with a transparent liquid. What is the most likely disease? @Renal cystic disease Necrotic nephrosis Pyelonephritis Glomerulonephritis Infarct # 52 On autopsy it is revealed that kidneys are enlarged, surface is large-granular because of multiple cavities with smooth wall, which are filled with clear fluid. What kidney disease did the patient have? @Polycystic kidney Infarction Necrotic nephrosis Glomerulonephritis Pyelonephritis # 53 At the section: the kidneys are enlarged in size; their surface is with big tubers on account of the presence of numerous cavities with plain walls and bright fluid. What disease is meant? @Polycystosis Necrotic nephrosis Pyelonephritis Glomerulonephritis Infarction # 54 A middle-aged man comes to you with the single presenting symptom of occasional hematuria of very recent oncet. The most probable cause is acute pyelonephritis nephroblastoma renal cell carcinoma mesoblastic nephroma @renal pelvic urothelial tumor # 55 All the following statements are true regarding transitional cell carcinoma of the bladder EXCEPT that it is more common in men than in woman @it is associated with infection by Schistosoma haematobium it is associated with cigarette smoking it shows increased incidence in aniline dye workers it tends to recur after excision, regardless of grade # 56 A 49-year-old man who is long-term smoker present with frequency and hematuria. Histologic examination of section taken from an exophytic lesion of the urinary bladder reveals group of atypical cells with frequent mitises forming finger-like projections that have thin, fibrovascular cores. These groups of atypical cells do not extend into the lamina propria and muscularis. No glands or keratin production are found. Which of the following is the most likely diagnosis? Adenocarcinoma, noninvasive Inverted papilloma, noninvasive Transitional cell carcinoma in situ Papillary transitional cell carcinoma, noninvasive Squamous cell carcinoma in situ # 57 All the following adnormalities are associated with an increased incidence of Wilms'tumor EXCEPT aniridia male pseudohermaphroditism hemihypertrophy renal medullary cysts @hypoplasia of radii # Reproductive system pathology # 1 A 32-year-old patient has been diagnosed with bartholinitis (inflammation of Bartholin's glands). In what part of the female urogenital system are the Bartholin's glands located? The labia minor @The labia major The uterus The clitoris The vagina # 2 A 75-year-old woman presents with a pruritic vulvar lesion. Physical examination reveals an irregular white, rough area involving her vulv. Which one of the following histologic changes is most consistent with the diagnosis of lichen sclerosis? @Atrophy of the epidermis with dermal fibrosis Atypia of the epidermis with dysplasia Hyperplasia of the epidermis with hyperkeratosis Invasion of the epidermis by individual malignant cells Loss of pigment in the basal layers of the epidermis # 3 Primary malignant neoplasms of the vagina include all the following EXCEPT sarcoma botryoides clear cell carcinoma squamous carcinoma @vaginal adenosis rhabdomyosarcoma # 4 |