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Examination of a patient revealed hyperkaliemia and hyponatremia. Low secretion of which hormone may cause such changes? @Aldosteron Cortisol Natriuretic Vasopressin Parathormone # 73 A concentrated solution of sodium chloride was intravenously injected to an animal. This caused decreased reabsorption of sodium ions in the renal tubules. It is the result of the following changes of hormonal secretion: Aldosterone increase Vasopressin increase @Aldosterone reduction Vasopressin reduction Reduction of atrial natriuretic factor # 74 A patient had been taking glucocorticoids for a long time. When the preparation was withdrawn he developed the symptoms of disease aggravation, decreased blood pressure and weakness. What is the reason of this condition? Hyperproduction of ACTH @Appearance of adrenal insufficiency Sensibilization Habituation Cumulation # 75 Patient was on glucocorticoids for a long time, discontinuation of usage caused exacerbation of the illness, decreased BP, weakness. How can you explain it? Adaptation to the medicine Cumulation Hyperproduction of ACTH Sensitization @Insufficiency of adrenal glands # 76 A 42-year-old man presents with weakness and dizziness associated with stress. Physical examination reveals a slightly decreased blood pressure along with a diffuse increase in skin pigmentation. Laboratory examination reveals hyponatremia and hyperkalemic acidosis with decreased aldosterone, decreased cortisol, decreased glucose, increased ACTH, de¬creased sex steroids, and increased LH and FSH. Thyroid function tests are found to be within normal limits. Which of the following is the most likely cause of this patient's signs and symptoms? A benign adenoma of the adrenal cortex A malignant tumor of the adrenal medulla @Autoimmune destruction of the adrenal cortex Bilateral hyperplasia of the adrenal cortex Tuberculosis of the adrenal medulla # 77 A 52-year-old man with a history of hematogenic tuberculosis presented to the hospital with hyperpigmentation skins (melanosis) and mucosas, a cachexia, cardiovascular insufficiency. What disease caused such changes? @Addison's disease Pheochromocytoma Simmonds' disease Itsenko-Cushing disease Graves' disease # 78 At the autopsy of a dead man a bronzed color of the skin and mucous membrane of the oral cavity were noted. There were also caseous masses in the adrenal glands. What disease did the patient have? @Addison’s disease Itzenko-Cushing’s syndrome Diffuse toxic goiter Acromegaly Pheochromocytoma # 79 A patient suffers from arterial hypertension strokes, accompanied by tachycardia, excessive sweat, sharp pain in the epigastric region. Which of the mentioned tumorous diseases are these symptoms the most typical for? @Pheochromocytoma Glomerular adrenal adenoma Pituitary basophil adenoma Ovarian tumor Thyroid adenoma # 80 A 40-year-old patient complains of intensive heartbeats, sweating, nausea, visual impairment, arm tremor, hypertension. From his anamnesis: 2 years ago he was diagnosed with pheochromocytoma. Hyperproduction of what hormones causes the given pathology? Aldosterone @Catecholamines Glucocorticoids Thyroidal hormones ACTH # 81 A girl is diagnosed with adrenogenital syndrome (pseudohermaphroditism). This pathology was caused by hypersecretion of the following adrenal hormone: @Androgen Estrogen Aldosterone Adrenalin Cortisol # 82 An 18-year-old man with asthenic body constitution: tall, narrow shoulders, broad pelvis and with poor hair on his face came to the geneticist. There was marked mental retardatoin. The preliminary diagnosis was Klinefelter's syndrome. What method of medical genetics can confirm the diagnosis? Population-statistic Dermatoglyphics @Cytogenic Gemellary Genealogic # 83 Parents of a 10 year old boy consulted a doctor about extension of hair-covering, growth of beard and moustache, low voic E. Intensified secretion of which hormone must be assumed? Of progesterone Of oestrogen Of cortisol Of somatotropin @Of testosterone # 84 Testosterone and it's analogs increase the mass of skeletal muscles that allows to use them for treatment of dystrophy. Due to interaction of the hormon with what cell substance is this action caused? Ribosomes @Nuclear receptors Proteins-activators of transcription Chromatin Membrane receptors # 85 During puberty man's sexual glands produce in a blood man's sexual hormone testosterone which is responsible for development of the secondary sexual features. What cells of spermaries synthesize this hormone? @Leydig cells Sertoli cells Spermatozoons Fibroblasts Spermatids 86 During pubescence the cells of male sexual glands begin to produce male sex hormon testosterone that calls forth secondary sexual characters. What cells of male sexual glands produce this hormone? @Leidig cells Spermatozoa Sertoli's cells Sustentocytes Supporting cells # 87 Intake of oral contraceptives containing sex hormones inhibits secretion of the hypophysiae hormones. Secretion of which of the indicated hormones is inhibited while taking oral contraceptives with sex hormones? Thyrotropic @Follicle-stimulating Somatotropic Oxytocin Vasopressin # Disease of the nervous system (костно-мышечный аппарат) # 1 An elderly man presented to the hospital with progressive dementia (aphrenia), with marked emotional lability; thus the focal neurologic symptoms were absent. After his death, a post-mortem revealed the cortex thinning in frontal, occipital and temporal lobes of the brain. A histological study of a brain's tissue showed the considerable quantity of senile plaques (especially in a cortex), reduction of neurones' sizes with cytoplasm vacuolation. In addition, the little Hirano bodies were determined in dendrites. What is the most likely pathology in the central nervous system? @Alzheimer's disease Lateral amyotrophic sclerosis Disseminated sclerosis Tick-borne encephalitis Viral meningoencephalitis # 2 An autopsy of the 68-year-old man revealed the atrophy of brain's tissue. The cerebral atrophy mainly involved the frontal, temporal, and occipital regions. A hydrocephaly was also found. A microscopical study showed atrophic zones in the cerebral cortex, the senile (neuritic) plaques in hippocampus, neurofibrillary "tangles", damage of neurons and Hirano bodies. What is the most likely main disease? @Alzheimer's disease Lateral amyotrophic sclerosis Disseminated sclerosis Encephalitis Ganglioneuroma # 3 An autopsy of the elderly woman revealed a massive purulent bronchopneumonia. A brain was slightly atrophic, gyri were thinned and sulci were deep. A microscopical study of a brain showed perivascular deposits of amyloid, Hirano bodies and neurofibrillary "tangles". What is the most likely main disease? @Alzheimer's disease Pick's disease Parkinson's disease Disseminated sclerosis Lateral amyotrophic sclerosis # 4 A 75-year-old man, with a history of Alzheimer's disease, died of a bronchopneumonia. A microscopical study of the cerebral cortex revealed the senile (neuritic) plaques, neurofibrillary "tangles" and damaged neurons. What formations characterize cytoskeleton pathology of proximal dendrites at the Alzheimer's disease? @Hirano bodies Councilman's bodies Negri bodies Mallory's bodies Russell bodies # 5 An autopsy of the 78-year-old woman revealed a massive purulent bronchopneumonia. There were numerous grey color plaques, up to 15 mm in diameter, found in the brain and spinal cord. A microscopical study of brain and spinal cord tissue showed plural perivenular sites of a demyelization with limphoplazmocytes infiltration and the plural foci of gliosis. Diagnose a basic disease. @Disseminated sclerosis Pick's disease Parkinson's disease Alzheimer's disease Lateral amyotrophic sclerosis # 6 A 42- year-old forester, a week later after long stay in spring wood, presented to the hospital with a fever, a headache, consciousness disturbance and epileptoid attacks. He died in 4 days. An autopsy revealed a brain edema, plural petechial hemorrhages. A microscopical study showed perivascular and pericellular edema, plural perivascular, mainly lymphocytic, infiltrates. Diagnose the basic disease. @Tick-borne encephalitis Meningococcal infection Poliomyelitis Purulent encephalitis Cerebro-vascula disease # 7 An autopsy of a patient, with a lifetime history of numerous pathological fractures, revealed changes of his long tubular bones. The femurs and tibia bones were curved or spiral with uneven surface and the obliterated bone-marrow channels on a cut. There was also a remodeling of a compact cortical layer into the spongy type. Microscopical investigation showed mosaicity of osteal structures. There were numerous cavities of the resorptions combined with osteoblastic lying down of new bone. These were accompanied with chaotic fme-fibered or lamellar structures of osteal fragments. The arteries were twisted and dilated. What is the most likely diagnosis? @Deforming osteodystrophy Osteopetrosis Parathyroid osteodystrophy Fibrous dysplasia Chronic osteomyelitis # 8 A 20-year-old woman with a history of pathological cross- striated muscular weakness and ptosis died of asphyxia. An autopsy revealed the follicular hyperplasia of a thymus, atrophy and a necrosis of skeletal muscles with focal lymphocytic infiltrates among the cells. Specify the form of a muscles lesion. @Myasthenia Atrophy myositis Progressive myopathy Mussels Leyden's dystrophy Mussels Erb's dystrophy # 9 A 20-year-old woman presented with a several years history of muscular weakness, resulted in the motion, talking, chewing and swallowing problems. A physical examination revealed the ptosis of both eyelids. The thorax roentgenography found a tumorous conglomerate in anterior mediastinum. Histological investigation of the tumor biopsy determined a thymoma. There were also some dystrophic alterations in skeletal muscles. Diagnose the disease. @Myasthenia Progressive mussels dystrophy Mussels Erb's dystrophy Dermatomyositis Poliomyelitis # 10 A 20-year-old woman presented with weakness of the eye, chewing, speech and swallowing groups of muscles. Thus, the normal muscles contraction were completely ceased after the vigorous activity and restored again after the rest. Later, the muscles of extremities and intercostals were also involved in pathological process. Inadequate ventilation of the lungs resulted in secondary focal pneumonia, followed by patient's death. An autopsy showed the atrophy of cross- striated muscles, their dystrophy with focal aggregates of lymphocytes in interstitium. In the enlarged thymic gland the follicular hyperplasia was found out. Specify the most probable diagnosis: @Myasthenia Verdniga-Goffman's spinal amyotrophy Dyushen's mussels dystrophy Lateral amyotrophic sclerosis. Erb's mussels dystrophy # Tooth # 1 Painfulness of tooth and edema of lower part of face at the side of ill tooth are present in a patient with acute pulpitis. What mechanism of edema development is leading one in this case? @Disorders of microcirculation at the focus of injury Increase in production of aldosterone Disturbances of trophic function of nervous system Disorder of neural regulation of water-salt metabolism Hypoproteinemia # INFECTIOUS DISEASES Sepsis. Bacterial infections diseases. # 1 Acute infective endocarditis differs from subacute endocarditis in all the following respects EXCEPT The time required for the lesion to develop The nature of the preponderant organism Embolization and dissemination @The nature of valvular vegetations The causative organism # 2 At the section of a young man, who died being in comatose condition, were revealed: extensive thromboembolic infarction of the left hemisphere, large septic spleen, immune complex glomerulonephritis, and ulcers in the aortic valve hidden by polyp-like thrombi with staphylococcal colonies. What disease led to the cerebral thromboembolism? @Septic bacterial endocarditis Septicemia Acute rheumatic valvulitis Septicopyemia Rheumatic thromboendocarditis # 3 An autopsy of a 48-year-old man revealed the infarct of the left hemisphere of a brain. A macroscopic study also showed a big septic spleen, immunocomplex glomerulonephritis, ulcers in aortal valve leaflets, covered with polypous thrombi. The latter ones had colonies of staphilococcuses, determined by microscopic study. What disease resulted in cerebral thromboembolism? @ Septic bacterial endocarditis Septicemia Acute rheumatic valvulitis Septicopyemia Rheumatic thromboendocarditis # 4 Extensive thromboembolic infarction of the left cerebral hemispheres, large septic spleen, immunocomplex glomerulonephritis, ulcers on the edges of the aortic valves, covered with polypous thrombus with colonies of staphylococcus were revealed on autopsy of the young man who died in coma. What disease caused cerebral thromboemboly? Septicemia Rheumatic thromboendocarditis Acute rheumatic valvulitis Septicopyemia @Septic bacterial endocarditis # 5 A 32-year-old man with a long history of a drug abuse, presented with a fever, the intoxication and a pyuria. An echocardioscopy revealed massive superimpositions (vegetations) on the heart valves. Microbiological blood test showed a presence of a staphylococcus. The patient died of a thromboembolism of a pulmonary artery. Specify the changes of heart, revealed at post-mortem? @Polypous-ulcerative endocarditis Libman-Sacks endocarditis Diffuse valvulitis Acute warty endocarditis Recurrent warty endocarditis # 6 A post-mortem revealed on the external surface of the aortal valve the large, 1-2 cm, brownish-red, easily crumbling superimpositions (vegetations). They covered ulcerative defects in the valves. What is the most likely diagnosis? @Polypous-ulcerative endocarditis Recurrent warty endocarditis Acute warty endocarditis Fibroplastic endocarditis Diffuse endocarditis # 7 On autopsy it was revealed: large (1-2 cm) brownish-red, easy crumbling formations covering ulcerative defects on the external surface of the aortic valve. What is the most likely diagnosis? Fibroplastic endocarditis Recurrent warty endocarditis Diffusive endocarditis @Polypus-ulcerative endocarditis Acute warty endocarditis # 8 A 46-year-old man died of an odontogenic sepsis. An autopsy revealed the marked thickening of semilunar aortic valves. They were whitish, opaque and stiff, with thrombotic masses, 1x1.5 cm in the size on the external surface. What is the most likely form of an endocarditis? @Polypous-ulcerative endocarditis Diffuse endocarditis Acute warty endocarditis Fibroplastic endocarditis Recurrent warty endocarditis # 9 A 48-year-old patient with a history of croupous pneumonia died of the pulmonary and heart failure. A post-mortem revealed a hyperplasia of a spleen, a thickening and defects of the aortal valve leaflet with large, up to 2 cm in diameter, thrombuses attached to tissues underneath. What is the most likely diagnosis? @Polypous-ulcerative endocarditis Acute warty endocarditis Recurrent warty endocarditis Diffuse endocarditis Fibroplastic endocarditis # 10 A patient that had used drugs for a long time had fever, the facts of intoxication, pyuria. Echocardioscopy revealed massive stratification on the cardiac valves. Staphylococcus was cultured in the blood. A patient died of pulmonary artery thromboembolism. Indicate on the changes of the heart that were revealed during the section. @Polypous-ulcerative endocarditis Libman-Sacks endocarditis Diffuse valvulitis Acute verrucous endocarditis Recurrent verrucous endocarditis # 11 A patient fell ill with diphtheria. On the 2 nd week of the disease acute heart failure developed that caused the death. At the section: the ventricles of the heart are dilated, myocardium is of soft consistence, mottled. Histologically were revealed numerous small focuses of myolysis with small perifocal lymphoid infiltration. What caused acute heart failure? Metabolic necroses of myocardium Bacterial myocarditis Septic myocarditis Myocardial infarction @Bacterial exotoxic myocarditis # 12 A 28-year-old woman died in the postnatal period. A post-mortem revealed a purulent endometritis and thrombophlebitis of a uterus veins, plural abscesses of lungs, kidneys and a spleen. In addition, there were an apostematous myocarditis and purulent meningitis. What is the most likely kind of a sepsis? @Septicopyemia Septicemia Chroniosepsis The prolonged septic endocarditis - # 13 A 20 year old patient died from intoxication 8 days after artificial illegal abortion performed in her 14-15th week of pregnancy. Autopsy of the corpse revealed yellowish colour of eye sclera and of skin, necrotic suppurative endometritis, multiple pulmonary abscesses, spleen hyperplasia with a big number of neutrophils in its sinuses. What complication after abortion was developed? Septicemia Chroniosepsis Hemorrhagic shock @Septicopyemia Viral hepatitis type A # 14 A 30-year-old woman with a history of abortion presented with purulent endometritis resulted in a death from sepsis. A post-mortem revealed a purulent lymphadenitis, abscesses in lungs, kidneys, a myocardium, a spleen hyperplasia, and dystrophy of parenchymatous organs. Define the clinico-anatomic form of a sepsis. @Septicopyemia Septicemia Septic endocarditis Granulomatous sepsis Chroniosepsis # 15 Purulent endometritis with fatal outcome was progressing in the woman after abortion performed not at the hospital. On autopsy multiple lung abscesses, subcapsule ulcers in the kidneys, spleen hyperplasia were revealed. What form of sepsis developed in the patient? Chroniosepsis @Septicopyemia Lung sepsis Septicemia Urosepsis # 16 A man with a history of a lower extremity wound, presented with persistent pyesis of a lesion, resulted in death of intoxication. An autopsy revealed a cachexia, dehydration; a brown atrophy of a liver, a myocardium, a spleen and cross-striated muscles. In addition, there was amyloidosis of kidneys. What of the listed diagnoses is most probable? @ Chroniosepsis Septicopyemia Septicemia. Chemogubov's disease. Brucellosis # 17 At the section of a 18-year-old man the spleen is 580g, of dark-red color with big smear of pulp. Histologically were diagnosed a significant proliferation of reticular cells, presence of a big amount of mature neutrophiles in sinusoid capillaries. How can we term such a spleen? Sago @Septic Porphyry Cyanotic Leukosal # 18 All the following have been commonly associated with pyogenic brain abscesses EXCEPT Congenital heart disease Sinusitis Lung abscess @Liver abscess mastoiditis # 19 Autopsy of a man who died from the sepsis in his femoral bone revealed phlegmonous inflammation that affected the marrow, haversian canals and periosteum. Under the periosteum there are multiple abscesses, adjoining soft tissues of thigh also have signs of phlegmonous inflammation. What pathological process was described? Osteopetrosis Chronic hematogenous osteomielitis Osteoporosis @Acute hematogenous osteomyelitis - # 20 A morphological research of a femur reveled the chronic purulent inflammation of compact substance and a bone marrow with sequesters formation. What is the most likely disease? @Osteomyelitis Retikulosarcoma Multiple (plasma cell) myeloma (Kahler's disease) Osteoblastoclastoma Periostitis # 21 A 48- year-old man presented with advanced staphylococcal purulent periodontitis, resulted in a purulent inflammation of alveolar process' bone marrow and then a mandible's body. Microscopical investigation showed thinned osteal beams, the necrosis centers and the osteal sequesters, surrounded with a connective tissue's capsule. What is the most likely disease? @Chronic osteomyelitis Acute osteomyelitis Parodontome Chronic fibrous periostitis Purulent periostitis # 22 A 53- year-old man died of intoxication. An autopsy revealed the enlargement of his hip with some fistulas on a skin. There was yellow - green thick liquid discharge from the fistulas. The gross investigation showed the thickened femur with sequesters formation. A microscopical study determined sequestral cavities, surrounded by granulation and connective tissue with neutrophil infiltration. The bone-marrow channels were obliterated; the compact layer was thickened. What is the most likely diagnosis? @Chronic purulent osteomyelitis Acute gematogenic osteomyelitis Tuberculous osteomyelitis Parathyroid osteodystrophy Osteopetrosis # 23 A 52-year-old man with a 10 years history of chronic osteomyelitis and 3 years a nephritic syndrome, died of uremia. An autopsy revealed dense, white kidneys, with some cicatrices in their cortical layer. They had sebaceous glitter on a cut surface. Specify a pathology of kidneys which has developed. @Secondary amyloidosis Primary amyloidosis Idiopathic amyloidosis Chronic glomerulonephritis Chronic pyelonephritis # 24 A young man died of intoxication on 4th day after eating the crude eggs. An autopsy revealed the stomach and small bowel mucosa inflamed, covered by a mucous exudate. In addition, abscesses were found in lungs, brain and liver. What diagnosis is the most likely? @Salmonellosis (septic form) Dysentery Salmonellosis (typhoid form) Salmonellosis (intestinal form) Typhoid # 25 In the autopsy of a 56 year-old man the pathologist has found out in terminal fragment of a small bowel some ulcers about 1 cm in areas of lymphoid follicles, coated with greyish necrotic masses. Vidal reaction was positive. Diagnose this disease: @Typhoid fever. Paratyphoid Reccurent fever Dysentery Crohn’ disease # 26 Multiple oval ulcers along the intestine were revealed on autopsy of the person, who died from diffuse of peritonitis in the distant part of the small intestine. Bottom parts of the ulcers are clear, smooth, formed with muscular or serous covering, edges of ulcers are flat, rounded. There are perforations up to 0,5 cm in diameter in two ulcers. What diseases’ can be diagnosed? Tuberculosis Typhus @Typhoid fever Dysentery Cholera # 27 Few ulcers from 4 to 5cm in size were revealed in the terminal part of small intestine at the section of a 56-year-old man. The edges of ulcers elevate above the surface of mucous membrane. The walls of ulcers are covered with friable greyish-yellowish masses. The Widal’s reaction is positive. Make a diagnosis. @Abdominal typhoid Paratyphoid Recrudescent typhus Shigellosis Crohn’s disease # 28 Numerous ulcers of an oval form, located along the distal part of small intestine, were revealed at the section of a man, who died of diffuse peritonitis. Bottoms of ulcers were clean, plain, formed of muscular or serous membrane. The edges of ulcers were even and rotund. Two ulcers had perforative holes with the diameter to 0,5cm. What disease can we suspect? @Typhoid (abdominal typhoid) Shigellosis Cholera Tuberculosis Spotted fever # 29 The death of a 16-year-old patient was caused by diffuse fibrinous-purulent peritonitis. At the autopsy an ulcer was revealed in the lower part of small intestine, which repeated the form of Peyer’s plaque and perforated the wall of the intestine. Microscopically: the picture of lymphoid tissue was erased and superseded by proliferative monocytes that form granulomas. The complication of what disease is meant? @Abdominal typhoid Shigellosis Cholera Brucellosis Non-specific ulcerative colitis # 30 A 16-year-old patient died because of diffuse fibrinopurulent peritonitis. The autopsy in the inferior region of small intestine revealed an ulcer with a form of Peyer's plaque, with the perforation of intestine wall. The microscopic examination revealed lymph tissue pattern vagueness, the displacement of this tissue with proliferating monocytes, which were forming granulomata. Complication of what disease caused the death? Brucellosis Nonspecific ulcerative colitis Cholera @Typhoid Dysentry # 31 A patient died of a diffuse peritonitis. An autopsy revealed in the distal part of a small bowel multiple oval ulcers with rounded edges, which were parallel to the longitudinal axis of the intestine. A bottom of ulcers was clean, smooth and glitter. Base of the ulcers presented either by muscular layer of ileum or its serosa. Two ulcers had perforation apertures 0,5cm in diameter each. What disease resulted on a death of a patient? @Typhoid Dysentery Cholera Tuberculosis Epidemic typhus # 32 An autopsy at the Forensic Pathology Department of an unknown man, with a history of alcohol intoxication, revealed in his small bowel the enlarged Peyer's patches, which protruded above the mucosal surface. They were soft, with irregular surface, which reminded brain's gyri and sulci. The cut surface had a gray-red coloring. For what disease the described changes are characteristic? @Typhoid Dysentery Lambliasis Amebiasis Enteritis due to Campylobacter # 33 A patient presented with a sustained fever, enlarged and painful spleen. On the 10th day of a disease a rash of flat, rose-colored spots appeared. On the 21st hospital day he died after developing peritonitis. An autopsy revealed in the ileum deep ulcers within the area of necrotized group of lymphoid follicles (Peyer's patches). One of ulcers was perforated; there was a fibrinopurulent diffuse peritonitis. What is the most likely disease? @Typhoid Dysentery Intestine amebiasis Cholera Salmonellosis # 34 A 38-year-old man died of intoxication. A post-mortem revealed in a small bowel an edema of lymphoid follicles groups. The follicles protruded above the mucosal surface like a soft plaques with irregular surface pattern, which reminded brain's gyri and sulci. What diagnosis is most probable? @Typhoid Dysentery Salmonellosis Acute enteritis Cholera # 35 A 38-year-old man died of diffuse fibrinopurulent peritonitis. A post-mortem revealed an ulcer in a small bowel, which replicated a form of a Peyer's patch and perforated the intestine's wall. Microscopical investigation showed an alteration of lymphoid tissue pattern with replacement of lymphocytes by proliferating monocytes, followed by granulomas formation. The complication of what disease resulted in patient's death? @Typhoid. Dysenteries. Cholera. Brucellosis Nonspecific ulcerative colitis. # 36 A 44-year-old man presented to a surgery department with diffuse fibrinopurulent peritonitis. An operation revealed an ulcer of ileum with a perforation. An ulcer closure, followed by abdomen cavity drainage was performed. Four days later patient died. At post-mortem iliac ulcers of Peyer's patches, parallel to the longitudinal axis of the intestine, were found. A base of the ulcers was presented by serosa. For what disease such changes are characteristic? @Typhoid Intestine tuberculosis Dysentery Intestinal tumours An intestine amebiasis # 37 An autopsy of a 45-year-old man revealed in his small bowel the enlarged, hyperemic groups of lymphoid follicles. The follicles protruded above the mucosal surface; their surface reminded child's brain gyri and sulci. Microscopical investigation showed monocytes, histiocytes and reticular cells proliferation. Macrophages formed aggregates (typhoid granulomas), which replaced lymphocytes. For what disease the described changes are characteristic? @Typhoid Cholera Dysentery Salmonellosis Amebiasis # 38 A 52-year-old woman died in surgery department of a diffuse purulent peritonitis. A post-mortem revealed in a distal part of a small intestine enlarged Peyer's patches, which projected into the intestine's lumen. There surface was covered by brownish-greenish scab. In the centre of some patches were found deep defects, extended to a serous layer. For what disease described intestinal changes are characteristic? @Typhoid Dysentery Intestine tuberculosis Crohn's disease Staphylococcal enteritis # 39 An autopsy of a 53-year-old man revealed few 4-5cm ulcers. The margins were elevated above the mucosa. The walls of ulcers were covered by the yellowish-grayish crumble masses. The Widal test was positive. Diagnose a disease? @Typhoid Paratyphoid Recurrent typhus Dysentery Crohn's disease # 40 At the section of a man, who was ill with abdominal typhoid, the following changes in small intestine were traced: enlarged aggregated lymphoid follicles, elevated above the surface of the mucous membrane, of gray-red color, succulent; their surface had the outlook of convolutions and grooves. The microscopical exam revealed the formation of typhoid granulomas. What stage of abdominal typhoid is this picture typical for? Formation of ulcers Necrosis @Brain-like swelling Clean ulcers Healing # 41 An autopsy revealed groups of enlarged, hyperemic lymphoid follicles in small bowel. The follicles protruded above the mucosal surface; their surface reminded brain's gyri and sulci. The cut surface of follicles was succulent; with gray-red coloring. Microscopical investigation showed monocytes and histiocytes proliferation. Macrophages formed aggregates (typhoid granulomas). Name a morphological stage of typhoid. @Medullar swelling Necrotic Formation of ulcers Pure ulcers Healing # 42 An autopsy of a 45-year-old man, who died on the 5th day of typhoid fever, revealed groups of enlarged, hyperemic lymphoid follicles in small bowel. The follicles protruded above the mucosal surface; their surface reminded brain's gyri and sulci. Microscopical investigation showed hyperemia, edema and granulomas formation. Specify, what period of local changes of typhoid is the most likely? @Stage of medullar swelling Necrotic stage Stage of healing Stage of pure ulcers Stage of ulcers' formation # 43 An autopsy of a 48-year-old man, with a history of typhoid fever, revealed groups of enlarged lymphoid follicles in small bowel. The follicles protruded above the mucosal surface; they had a grey- red coloring, juicy appearance and a surface, which reminded gyri and sulci. Microscopical investigation showed granulomas formation. Specify, what of the listed stages of typhoid is the most likely? @Medullar swelling. Necrotic. Formation of ulcers. Pure ulcers. Healing. # 44 A 42-year-old patient, with a history of dysentery, presented with symptoms of paraproctitis. What is the most probable stage of local changes presented in that case? @Formation of ulcers Fibrinous colitis Follicular colitis Catarrhal colitis Stage of healing # 45 A post-mortem of a patient, who died of diffuse fibropurulent peritonitis, revealed in the wall of a small bowel multiple oval ulcers with rounded edges, which were parallel to the longitudinal axis of the intestine. A base of the ulcers presented either by muscular layer of ileum or its serosa. Two ulcers had perforation apertures 0,3cm in diameter each. Define a typhoid stage. @Stage of pure ulcers Stage of "dirty ulcers" formation Necrotic stage Stage of a medullar swelling Stage of healing # 46 A man, with 4 weeks history of the typhoid, presented with symptoms of 'acute abdomen'. He died soon of intoxication. At post-mortem a pathologist found a perforation of iliac wall and diffuse purulent peritonitis. For what stage of disease the described complication is characteristic? @Stage of pure ulcers Stage of a medullar swelling Necrotic stage Stage of healing of ulcers Bacteriemia # 47 A post-mortem of a 57-year-old male, with a history of typhoid, revealed a dense, fragile whitish-yellowish color of the rectus abdominis and hip muscles. They reminded a stearin candle. The described changes are the result of: @Zenker's necrosis Fibrinoid necrosis Caseous necrosis Colliqative necrosis Apoptosis # 48 A 48-year-old patient with severe typhoid developed an acute renal failure, resulted in a lethal outcome of a disease. An autopsy revealed enlarged and swollen kidneys. On a cut section, the cortex was pale grey, while pyramids were dark red. A histological investigation showed that in the majority of tubules the lumen was narrowed, epithelial cells were enlarged and lost their nuclei; glomeruli were collapsed. A renal stroma was edematous with a small leukocytic infiltration and fine hemorrhage. What pathology of kidneys presented in that case? @Necronephrosis Acute pyelonephritis Acute glomerulonephritis Pyonephrosis Hydronephrosis # 49 A patient with suspicion on epidemic typhus was admitted to the hospital. Some arachnids and insects have been found in his flat. Which of them may be a carrier of the pathogen of epidemic typhus? @Lice Bed-bugs Cockroaches Spiders Houseflies # 50 A sick man with high temperature and a lot of tiny wounds on the body has been admitted to the hospital. Lice have been found in the folds of his clothing. What disease can be suspected? Malaria @Epidemic typhus Tularemia Plague Scabies # 51 A young man presented with rash in the form of roseolas and small hemorrhages (petechias) on a skin of a stomach, thorax and petechial rash on eyes conjunctiva. Lesion of his brain soon resulted in his death. A microscopical investigation revealed in destructive-proliferative endo-trombovasculitis in medullar oblongata and pons of a brain, also in a skin, kidneys and myocardium. What is the most likely disease? @Epidemic typhus Sepsis Periarteritis nodosa Systemic Lupus Erythematosus Brucellosis # 52 A patient died as a result of a heart failure. Macroscopically traces of a pre-existed rash in the form of maculae and spots were recognized. A gross investigation revealed decubituses at the areas of breeches and spinous processes of vertebra. Microscopical study showed a destructive-proliferative endo-trombovasculitis and Popov's granulomas in the central nervous system, in a skin, and adrenals. An interstitial myocarditis was diagnosed in his heart. What is the most likely disease? @Epidemic typhus Q fever Typhoid fever Periarteritis nodosa HIV-infection # 53 A 48-year-old male presented with a sustained high fever, severe headache, a dyspnea, palpitation. A physical investigation revealed a pediculosis, a rash in the form of roseolas and small hemorrhages (petechias) on his thorax skin. In addition, decubituses of legs and foot gangrene were also determined. He died of a heart failure. A histological study showed in the medullar oblongata a hyperemia, stasis, perivascular plasmocytes infiltrates and a proliferation of a microglia (Popov's granuloma). What is the most likely diagnosis? @Epidemic typhus Antrax meningocephalitis Meningococcal meningitis Typhoid fever Rubella # 54 A patient complained of fever, severe headache, dyspnoae, and heartbeating. Physical exam revealed pediculosis, roseola and petechia on the skin of the thorax, bedsores of shanks, and a gangrene of a foot. The patient died with the signs of heart failure. Histologically in the medulla tissue hyperemia, stases, perivascular ferrules of plasmatic cells, and focuses of microglial proliferation (Popov’s granulomas) were detected. What is your diagnosis? Siberian (anthrax) meningoencephalitis @Epidemic typhus Meningococcal meningitis Abdominal typhoid German measles # 55 Skin of a man who died from cardiac insufficiency has an eruption in form of spots and specks. There are also bedsores in the area of sacrum and spinous vertebral processes. Microscopical examination of CNS, skin, adrenal glands revealed in the vessels of microcirculatory bed and in small arteries destructive-proliferative endothrombovasculitis with Popov's granulomas; interstitial myocarditis. What diagnosis corresponds with the described picture? @Spotted fever HIV Enteric fever Q fever Nodular periarteritis # 56 A patient died 3 days after the operation because of perforated colon with the manifestations of diffuse purulent peritonitis. The autopsy demonstrated: colon mucos membrane was thickened and covered with a fibrin film, isolated ulcers penetrated into different depth. Results of histology: mucous membrane necrosis, leukocytes infiltration with hemorrhages focuses. The complication of what disease caused the patient's death? Nonspecific ulcerative colitis Typhoid Crohn's disease Amebiasis @Dysentery # 57 Histological investigation of a rectum revealed large areas of necrosis in mucosa. Necrotic masses were impregnated by fibrin, resulting in membrane formation. Mucous and submucous on periphery of necrotic zones were hyperemic, edematous, with hemorrhages and leukocytic infiltration. What is the most likely diagnosis? @Dysentery Cholera Amebiasis Typhoid Salmonellosis # 58 A male patient, with 5 days history of diarrhea, had a colonoscopy. The investigation revealed a colon mucosa inflammation with grey-green membranes, intimately connected with tissue underneath. What is the most likely diagnosis? @Dysentery Typhoid Nonspecific ulcerative colitis Salmonellosis Crohn's disease # 59 An autopsy of a child, with a history of diarrhea, revealed an exicosis and a widespread fibrinous colitis. A mucosal smear imprint study showed gram-negative rod bacteria. What is your diagnosis? @Dysentery Cholera Staphylococcal intestinal infection Typhoid Salmonellosis # 60 A 7-year-old child, on the 3rd week of disease, presented with hectic fever, skin and sclera icterus. He died soon of the hepatorenal failure. An autopsy reveled in a rectum many irregular form defects with uneven edges. These defects were covered by grey-white membranes, intimately soldered to a tissue underneath. In addition, there was a purulent thrombophlebitis of the intestinal vessels. Plural pylephlebitic abscesses and fatty dystrophy of hepatocytes were diagnosed in a liver. An acute necrotic nephrosis was found in kidneys. What disease caused a lethal outcome? @Dysentery Salmonellosis Cholera Typhoid Amebiasis # 61 An autopsy of an 8-year-old child revealed in his colon multiple irregular form and various depth defects with uneven edges. In addition, there were grey-white membranes intimately connected with tissues underneath. What is the most likely diagnosis? @Dysentery Salmonellosis Cholera Typhoid Amebiasis # 62 A 30-year-old patient with bacteriologically proved dysentery developed the signs of paraproctitis. What is the stage of local changes in this patient? Follicular colitis Fibrinous colitis Catarrhal colitis Healing of the ulcers stage @Ulceration stage # 63 A 39-year-old patient died on the 4th day after operation concerning perforation of a colon wall, resulted in diffuse purulent peritonitis. An autopsy revealed the mucosa of a colon wall thickened, covered by fibrinous membrane. Some single ulcers got on different depth. Histological study of a colon wall showed a necrosis of mucous, a fibrinous inflammation, infiltration by leucocytes with focuses of hemorrhages. What complication of disease became a cause of patient's death? @Dysentery. Typhoid. Nonspecific ulcerative colitis. Crohn's disease Amebiasis. # 64 Autopsy of a 46-year-old man revealed multiple brown-and-green layers and hemmorhages on the mucous membrane of rectum and sigmoid colon; slime and some blood in colon lumen; histologically - fibrinous colitis. In course of bacteriological analysis of colon contents S.Sonne were found. What is the most probable diagnosis? Crohn's disease @Dysentery Salmonellosis Yersiniosis Cholera # 65 An autopsy of a 52- year-old man revealed in sigmoid and rectum plural brown-green membranes, hemorrhages, some blood in the lumen of intestine. Histological study showed a fibrinous colitis. Bacteriological investigation found S. Sonne. What is the most likely diagnosis? @Dysentery Cholera Salmonellosis Yersiniosis Crohn's disease # 66 |