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What is the most likely diagnosis? @Eclampsia Pre-eclampsia Septicopyemia Septicemia Acute renal insufficiency # 42 A 29-year-old woman presents with severe pain during menstruation (dysmenorrhea). During workup, an endometrial biopsy is obtaineThe pathology report from this specimen makes the diagnosis of chronic endometritis. Based on this pathology report, which of the following was present in the biopsy sample of the endometrium? Neuirophils Lymphocytes Lymphoid follicles @Plasma cells Decidualized stromal cells # 43 A 48-year-old woman with a grease bloody flux from her genital tracts had a diagnostic curettage of her uterus cavity. Microscopical research of the uterus curettage material revealed a thinning of a mucosal layer, reduction of the endometrial glands number, a fibrosis of a stroma and some lymphoid cells infiltration. What is the most likely diagnosis? @Chronic atrophic endometritis Acute purulent endometritis Chronic cystic endometritis Chronic hypertrophic endometritis - # 44 A 32-year-old woman died in post delivery period. At the autopsy were revealed the signs of suppurative endometritis, purulent thrombophlebitis of venae uterinae, numerous abscesses of lungs, abscesses of kidneys and spleen, abscessing myocarditis and purulent meningitis. Diagnose the type of sepsis. @Septicopyemia Septicemia Chroniosepsis Prolonged septic endocarditis Tuberculous sepsis # 45 A 25-year-old woman presents with lower abdominal pain, fever, and a vaginal discharge. Pelvic examination reveals bilateral adnexal (ovar¬ian) tenderness and pain when the cervix is manipulated. Cultures taken from the vaginal discharge grow Neisseria gonorrhoea. Which of the fol¬lowing is the most likely cause of this patient's adnexal pain? Adenomatoid tumor Ectopic pregnancy Endometriosis Luteoma of pregnancy @Pelvic inflammatory disease # 46 A 33-year-old woman gave birth to a dead fetus with gestational age more than 43 weeks. The fetal skin was dry and chap. An autopsy revealed a general hypotrophy and nuclei of ossification (Beclard's nuclei) in a proximal epiphysis of tibial and humeral bones. Amniotic fluid, an umbilical cord and placental membranes were dyed by meconium. Name the period of the described perinatal pathology? @The antenatal period The prenatal period The intranatal period The postnatal period The progenesis period # 47 A female newborn is being worked up clinically for several congeni¬tal abnormalities. During this workup, it is discovered that normal devel¬opment of the vagina and uterus in this female infant has not occurreFailure of the uterus to develop (agenesis) is directly related to the failure of which one of the following embryonic structures to develop? Urogenital ridge Mesonephric duct @Paramesonephric duct Metanephric duct Epoophoron # 48 Microscopical exam of vena umbilicalis of a newborn, who died of intoxication, reveals diffuse inflammatory infiltration of the wall; its lumen is obturated by thrombus with numerous neutrophilic leukocytes, facts of caryorrhexis and with bacterial colonies. What is the most possible after-effect of the thrombus? Transformation into thromboembolus Aseptic autolysis Organization and canalization of thrombus @Septic autolysis Petrifaction of thrombus # 49 A 24-year-old woman, on a 3rd day after childbirth, presented with a diffusive edema and painful palpation of the right breast. Physical examination revealed hyperemia of the breast and a fervescence. Histological research of a gland's tissue showed diffusive leucocytes infiltration of stroma, an interstitial edema and hyperemia of vessels. What is the most likely diagnose? @Acute phlegmonous mastitis Acute apostematous mastitis Acute serous mastitis Chronic purulent mastitis - # 50 A 23-year-old woman presents with a rubbery, freely movable 2-cm mass in the upper outer quadrant of the left brest. Which of the following histologic features is most likely to be seen when examining a biopsy specimen from this mass? Large numbers of neutrophils Large numbers of plasma cells Dust estasia with inspissation of breast secretion Necrotic fat surrounded by lipid-laden macrophages @A mixture of fibrous tissue and ducts # 51 A 39-year-old woman present with the new onset of a bloody discharge from her right nipple. Phsicl exaination reveals a 1-cm freely mavable mass that is located directly beneath the nipple. Sections from this mass reveal multiple fibrovascular cores lined by several layers of epithelial cells. Atypia is minimal. The lesion is completely contained within the duct and no invasion into underlying tissue is seen. Which of the following is the most likely diagnosis? Bening phyllodes tumor @Ductal papilloma Intraductal carcinoma Paget;s disease Papillary carcinoma # 52 A 35-year-old woman present with 2.2-cm mass in her left breast. The mass is excised and histologic section reveal a tumor composed of a mixture of ducts and cells, as seen in the photomicrograph below. The epithelial cells within the duct not atypical in appearance. There is a marked increase in the stromal cellulary, but the stromal ceels are not atypical in appearance and mitoses are not found. Which of the following is the most likely diagnosis? Atypical epithelial hyperplasia @Bening phyllodes tumor Fibroadenoma Malignant phyllodes tumor Medullary carcinoma # 53 A 48-year-old woman presents with a 1.5-cm firm mass in the upper outer quadrant of her left breast. A biopsy from this mass reveals many of the ducts to be filled with atypical cells. In the.center of these ducts there is extensive necrosis. No invasion into the surrounding fibrous tissue is seen. Which of the following is the most likely diagnosis? Colloid carcinoma @Comedocarcinoma Infiltrating ductal carcinoma Infiltrating lobular carcinoma Lobular carcinoma in situ # 54 A 46-year-old woman presents with a 4-month history of a discharge from the nipple. An excisional biopsy of the nipple area reveals infiltration of the nipple by large cells with clear cytoplasm. These cells are found both singly and in small clusters in the epidermis and are PAS-positive and diastase-resistant. Which of the following is the most likely diagnosis? Ductal papilloma Eczematous inflammation Mammary duct ectasia @Paget's disease Phyllodes tumor, malignant # 55 A 65-year-old woman presents with a pruritic red, crusted, sharply demarcated map-like lesion involving a large portion of her labia major. Histologic sections from this lesion reveal individual anaplastic tumor cells infiltrating the epidermis. Distinctive clear spaces are noted between these anaplastic cells and the surrounding normal epithelial cells. These malig¬nant cells stain positively for mucin and negatively with S100. Which of the following is the most likely diagnosis? Clear cell adenocarcinoma Malignant melanoma @Extramammary Paget disease Sarcoma botryoides Squamous cell carcinoma # 56 A 60-year-old woman presents with a slowly enlarging 2.5-cm firm, irregular mass in the upper outer quadrant of her left breast. A biopsy from this mass is interpreted by the pathologist as being an infiltrating lobular carcinoma of the breast. Which of the following histologic features is most characteristic of this tumor? Expansion of lobules by monotonous proliferation of epithelial cells Large cells with clear cytoplasm within the epidermis Large syncytium-like sheets of pleomorphic cells surrounded by aggregates of lymphocytes Small individual malignant cells dispersed within extracellular pools of mucin @Small tumor cells with little cytoplasm infiltrating in a single-file pattern # 57 A 35-year-old woman who underwent a modified radical mastectomy of her right breast for infiltrating ductal carcinoma 2 years ago presents with enlargement of her right breast. The breast has a swollen, red-discolored appearancIt is diffusely indurated and tender on palpation. Multiple axillary lymph nodes are palpable in the lower axille. The working clinical diagnosis is inflammatory carcinoma. Which of the following histologic features is most characteristic of this clinical diagnosis? Duct ectasia with numerous plasma cells @Extensive invasion of dermal lymphatics Infiltrating malignant ducts surrounded by numerous neutrophils Malignant vascular tumor forming slitlike spaces Marked dermal desmoplasia # 58 A 48-year-old woman presents with a painless mass located in her left breast. Physical examination finds a firm, nontender, 3-cm mass in the upper outer quadrant of her left breast. There was retraction of the skin overlying this mass, and several enlarged lymph nodes were found in her left axill. The mass was resected and histologic sections revealed an inva¬sive ducial carcinoma, grade 2 with approximately 50% of the tumor being composed of tubular structures. Biopsies from her axillary lymph nodes revealed the presence of metastatic disease to 4 of 18 examined axillary lymph nodes. Further studies revealed that the tumor cells were positive for estrogen receptors and had high levels of urokinase plasminogen acti-vator. Numerous new blood vessels were proliferating at the edge of the tumor, and the majority of the tumor cells were diploid with low S-phase fraction. Which of the following clinical findings is associated with the worse prognosis for this individual? High levels of urokinase plasminogen activator being present in the tumor cells Histologic grade 2 with approximately 50% of the tumor being composed of tubular structures @Metastatic disease being present in four axillary lymph nodes The majority of the tumor cells being diploid with low S-phase fraction The tumor cells being positive for estrogen receptors # 59 An ovary specimen stained by hematoxylin-eosin presents a follicle, where cells of follicular epithelium are placed in 1-2 layers and have cubic form, there is a bright-red membrane around the ovocyte. What follicle is it? Mature Secondary Primordial Atretic @Primary # 60 Ovarian tumour was diagnozed in a woman. Surgery should be perfomed. What ligament should be extracted by the surgeon to disconnect the ovary and the uterus? Broad ligament of uterus Suspensory ligament of ovary Lateral umbilical ligament Round ligament of uterus @The ovarial ligament # 61 Ovarial cystadenomas or cystadenocarcinoma (serous or mucinous) always produce androgen seldom are bilateral @can be papillary usually occur during pregnancy are extremely rare # 62 The ovarian tumor with the highest degree of bilateral involvement is endometrioid carcinoma serous cystadenoma mucinous cystadenoma mucinous cystadenocarcinoma @serous cystadenocarcinoma # 63 A 23-year-old woman presents with pelvic pain and is found to have an ovarian mass of the left ovary that measures 3 cm in diameter. Grossly, the mass consists of multiple cystic spaces. Histologically, these cysts are lined by tall columnar epithelium, with some of the cells being ciliateWhich of the following is the correct diagnosis for this ovarian tumor, which histologically recapitulates the histology of the fallopian tubes? @Serous tumor Mucinous tumor Endometrioid tumor Clear cell tumor Brenner tumor # 64 The majority of malignant tumors of the ovary take their origin from @surface epithelium urogenital stem cells ovarial germ cells stromal cells hilar cells # 65 A 32-year-old woman presents with the recent onset of oligomenorrhea followed by amenorrhea and then the loss of female secondary characteristics. She has also developed acne, deepening of her voice, and temporal balding. Which of the following types of ovarian tumor is most likely to produce these symptoms? Epithelial tumor @Stromal tumor Germ cell tumor Surface tumor Metastatic tumor # 66 A 51-year-old woman presents with abdominal distention. Surgical exploration finds multiple irregular masses within her abdominal cavity. A biopsy of one of these masses is examined by a pathologist during a frozen section. His diagnosis is "metastatic mucin-secreting neoplasm" and he advises the surgeon to examine the appendix. The surgeon finds the appen¬dix to be grossly normal in appearancIt is resected and examined histo-: logically but no malignancy is founThe next step in searching for this primary tumor should be to look for a tumor in which one of the following sites? Adrenal gland for a conical carcinoma Gallbladder for a papillary cystic tumor Kidney for a clear cell carcinoma @Ovary for a non-germ cell tumor Uterus for a smooth-muscle tumor # 67 An uncircumcised 49-year-old man present with the sudden onset of severe pain in the distal portion of his penis. The emergency room physical examines the patient and finds that the foreskin is retracted but cannot be rolled back over the gland penis. The ER physical calls the urologist, who performs an emergency resection of this patient's foreskin. Which of the following is the most likely diagnosis? Balanoposthitis Epispadias Omphalocele @Paraphimosis Phimosis # 68 Histologic examination of an excision specimen from a lesion on the dorsal surface of the penis reveals a papillary lesion with clear vacuoliza-lion of epithelial cells on the surface and extension of the hyperplastic epithelium into the underlying tissue along a broad front. Which of the fol¬lowing is the most likely diagnosis? Condyloma acuminatum Bowen's disease Erythroplasia of Queyrat @Verrucous carcinoma Squamous cell carcinoma # 69 A patient complains of frequent and difficult urination. Imperfection of what formation can cause it? Bulb-uretic glands @Prostate Testicles Testicle adnexa Sperm bubbles # 70 A 67-year-old man is found on rectal examination to have a single, hard, irregular nodule within his prostate. A biopsy of this lesion reveals the presence of small glands lined by a single layer of cells with enlarged, prominent nucleoli. From what portion of the prostate did this lesion most likely originate? Anterior zone Central zone @Peripheral zone Periurethral glands Transition zone # 71 A 47-year-old man presents with the sudden onset of fever, chills, and dysuriDuring the review of symptoms you discover that he has no history of recurrent urinary tract infections. Rectal examination finds that the prostate gland is very sensitive and examination is painful. .Which of the following is the most likely diagnosis? @Acute prostatitis Chronic bacterial prostatitis Chronic abacterial prostatitis Granulomatous prostatitis Benign prostatic hyperplasia # 72 A 69-year-old man presents with urinary frequency, nocturia, drib¬bling, and difficulty in starting and stopping urination. Rectal examination reveals the prostate to be enlarged, firm, and rubbery. A needle biopsy reveals increased numbers of glandular elements and stromal tissuThe glands are found to have a double layer of epithelial cells. Prominent nuclei or back-lo-back glands are not seen. Which of the following is the most likely diagnosis? Atrophic prostatitis Atypical small acinar proliferation High-grade prostatic intraepithelial neoplasia @Benign prostatic hyperplasia Prostatic adenocarcinoma # 73 A physical examination of a 68-year-old man, with complains to an acute ischuria (retention or suppression of the urine), revealed the nodular enlargement of a prostate. A microscopical investigation showed that the majority of knots were constructed of polymorphic glandular structures, with some retention cysts. The latter ones had thick secreta. What is the most likely diagnose? @Glandular hyperplasia of prostate Fibromuscular hyperplasia of prostate Hyperplasia of prostate mixed form Adenoma of prostate Carcinoma of prostate # 74 An autopsy of an elderly man revealed enlarged, soft, elastic, slightly nodular prostate. A gross investigation of a cut section showed separate nodes parted by layers of a connective tissue. The compressed surrounding prostatic tissue created a plane of cleavage about them. A microscopic study found the increase of glands quantity. There were variable number of prostatic nodes and glands in them. @Glandular nodular hyperplasia Fibromuscular (stromal) hyperplasia Mixed nodular hyperplasia Adenocarcinoma Undifferentiated carcinoma # 75 At the section of a 73-year-old man was revealed an enlarged, soft, elastic, tuberous prostate. On the incision it consisted of separated by strata of connective tissue nodules. Microscopical exam revealed the increment of glandular elements. The size of the lobules and the amount of glandular elements were different. What process is the most possible? @Glandular nodular hyperplasia Muscular-fibrous nodular hyperplasia Mixed nodular hyperplasia Adenocarcinoma Undifferentiated cancer # 76 A 68-year-old man presented with difficulty of a miction. The prostate was operatively removed. A microscopical investigation revealed an increase of glandular and muscular elements numbers. A lobular structure of prostate was also altered. What process in a prostate is the most probable? @Mixed nodular hyperplasia Glandular hyperplasia Fibromuscular hyperplasia Prostatitis Adenocarcinoma # 77 Within prostatic glands, feature consistent with prostatic intraepithelial neoplasma (PIN) incude all the following EXCEPT cellular crowding @absence of a basal cell layer variation in nuclear size nucleoli hyperchromatism # 78 Carcinoma of the prostate tends to do all the following EXCEPT be adenocarcinoma arise in the posterion lobe cause elevation of serum acid phosphatase @be estrogen-depended form osteoblastic metastases # 79 In histological specimen there is an organ, which is covered by tunica vaginalis and tunica albuginea. Stroma of the organ consists of connective tissue with the Leydig’s cells. Parenchyma contains tubules, which are lined by the spermatogeneous epithelium. What organ is there? @Testis Prostate gland Epididymis Mammary gland Ovary # 80 Primary germ cell tumors of the testise occur predominantly in the younger male with the exception of embryonal carcinoma @spermatocytic seminoma polyembryoma choriocarcinoma teratocarcinoma # 81 A 27-year-old man presents with a testicular mass, which is resected and diagnosed as being a yolk sac tumor. Which of the following sub¬stances is most likely to be increased in this patient's serum as a result of being secreted from the cells of this tumor? Acid phosphatase @a-fetoprotein (AFP) Alkaline phosphatase p-human chorionic gonadotropin (p-hCG) Prostate-specific antigen (PSA) # 82 A 44-year-old man presents with painless enlargement of one testi¬clPhysical examination reveals a single testicular mass that does not transilluminatThe mass is resected, examined histologically, and radia¬tion therapy is subsequently given based on the pathologist's diagnosis. Which of the following best describes the expected microscopic appear¬ance of this tumor? A mixture of malignant cytotrophoblasts and syncytiotrophoblasts Abnormal tissue derived from all three germ levels with scattered immature neural elements Large tumor cells with abundant eosinophilic, granular cytoplasm, and rare intracytoplasmic rhomboid crystals @Numerous lymphocytes in the fibrous stroma between groups of tumor cells having distinct cell membranes and clear cytoplasm Sheets of undifferentiated tumor cells having focal glandular differentiation # Endocryne system # 1 An endocrinal gland with parenchyma consisting of epithelium and neural tissue is under morphological examination. Epithelial trabecules have two types of cells: chromophilic and chromophobic. Identify this organ: @Hypophysis Parathyroid gland Hypothalamus Thyroid gland Adrenal glands # 2 A patient has a decreased vasopressin synthesis that causes polyuria and as a result of it evident organism dehydratation. What is the mechanism of polyuria development? Acceleration of glomerular filtration Reduced tubular reabsorption of protein Reduced tubular reabsorption of Na ions Reduced glucose reabsorption @Reduced tubular reabsorption of water # 3 A 23-years-old male presented to his physician with excess of the somatotropic hormone, the enlarged nose, lips, ears, a mandible, hands and feet. What is the most likely diagnosis? @Acromegaly Pituitary nanism Itsenko-Cushing disease Addison's disease Adiposogenital dystrophy # 4 |