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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 When the preparation was withdrawn he developed the symptoms of disease aggravation, decreased blood pressure and weakness.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

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