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An autopsy of a 54-year-old man revealed a fibrinous inflammation at colon. What is your diagnosis? @Dysentery Amebiasis Typhoid fever Cholera Balantidiasis # 67 A 65 -year-old patient addressed to a doctor his complains to frequent urge and painful passage of stool, with mucous and some blood in feces. Proctosigmoidoscopy revealed marked narrowing of a colon's lumen, especially in its distal part. A mucosa was edematous, hyperemic, with areas of necrosis and hemorrhages. A bacteriological study of feces determined the Shigella flexneri. Define the disease? @Dysentery Typhoid Anthrax Crohn's disease Paratyphoid 68 A patient who had come backfrom Asia,died from many abscesses of the liver. On the autopsy of the ascending colon there were ulcers of iirregular forms with overhanging brims the mucous membrane above the gastric fundus collapses when pushing by probe. What is the most possible disease? @ Bacterial disentery Amebiasis Cholera Abdominal typhoid Salmonollosis # 69 Patients with similar complaints applied to the doctor: weakness, pain in the intestines, disorder of GIT. Examination of the faeces revealed that one patient with four nucleus cysts should be hospitalized immidiately. For what protozoa are such cysts typical? Balantidium Intestinal amoeba @Dysenteric amoeba Trichomonas Lamblia # 70 An autopsy of 47- year-old man revealed in sigmoid and rectum plural red ulcers with irregularform. A mucous between ulcers was covered by dirty grey membrane. What is the most likely etiology of the disease? @Shigella Ameba Mycobacterium tuberculosis Salmonella Staphilococcus # 71 Multiple red ulcers of irregular form were revealed in sigmoid colon and rectum at the autopsy. The mucous membrane between them was covered with dirty-gray membrane. Name the etiology of the disease. Mycobacterium tuberculosis Amoeba @Shigella Salmonella Staphylococcus # 72 A patient died on the third day after the operation relatively a perforation of the wall of large intestine with the facts of diffuse purulent peritonitis. At the section: the mucous membrane of large intestine is thickened is covered with fibrinous membrane. Single ulcers penetrate on different depth. Histological exam reveals necrosis of mucosa, fibrin, and leukocytic infiltration with focuses of haemorrhages. The complication of what disease caused the death of the patient? Non-specific ulcerative colitis Abdominal typhoid @Shigellosis Crohn’s disease Amebiasis # 73 Colonoscopy of a patient ill with dysentery revealed that mucous membrane of his large intestine is hyperemic, edematic, its surface was covered with grey-and-green coats. Name the morphological form of dysenteric collitis: Purulent Catarrhal Necrotic @Fibrinous Ulcerous # 74 A 50-year-old man, who acutely fell ill, was diagnosed shigellosis. He died on the seventh day of the disease. The section revealed thickened wall of sigmoid colon and of initial parts of rectum. There was also fibrous membrane on the surface of mucosa. Histologically was detected a deep necrosis of the mucous membrane with fibrin infiltration of necrotic masses. What kind of colitis is meant? @Diphtheritic Catarrhal Ulcerative Gangrenous Follicular # 75 On the autopsy of the patient, who lived in the seaside city in southern parts of the country, with obvious diarrheas and vomiting, dead from dehydration, was foud the picture of acute gastroenteritis with serous-desquamative inflammation in small intestine. Chosoe the most correct diagnosis. @Cholera Bacterial dysentery Abdominal typhus Amebiasis Salmonellosis # 76 A man, with a history of frequent drinking non- boiled water from the river, has developed vomiting and explosive 'rice-water' diarrhea. The abdominal pains were absent; the body temperature did not rise. The intestine biopsy revealed a plethora, a marked swallowing, an edema of enterocytes, and some infiltration of villi by lymphocytes, plasmocytes, and few leucocytes. What is the most likely disease? @Cholera Salmonellosis Typhoid fever Dysentery Lambliasis # 77 A patients, the inhabitant of a seaside city in the south of the country, presented to the hospital with severe diarrheas and vomiting, resulted in his death from dehydration. An autopsy revealed an acute gastroenteritis with serous- desquamative inflammation in a small bowel. Choose the most likely diagnosis. @Cholera Bacterial dysentery Typhoid Amebiasis Salmonellosis # 78 A 45-year-old man presented in the infectious diseases hospital with a profuse diarrhea, exicosis, acute decline of his body temperature. He died soon of an uremia. An autopsy revealed in his small bowel lumen a colorless liquid in the form of rice broth and edematous mucosa. Microscopical investigation of a small bowel showed a hyperemia of vessels, a focal hemorrhage, a desquamation of enterocytes, a hypersecretion of a beaker (goblet) cells and lympho- leucocytes infiltration of a mucosal stroma. What is the most likely diagnosis? @Cholera Salmonellosis Dysentery Typhoid Crohn's disease # 79 An autopsy 54-year-old man revealed markedly dilated lumen of a small bowel filled with a liquid, which reminded "rice broth". The intestine wall was edematous with multiple petechial hemorrhages. For what infectious disease the described enteritis is characteristic? @Cholera Dysentery Salmonellosis Amebiasis Typhoid # 80 An autopsy of a 65-year-old man, who died in week from the beginning of a profuse diarrhea, revealed severe exicosis, dry all tissues and thick, concentrated blood. A bacteriological study of contents of a small bowel, which reminded the rice broth, determined vibrioes. What disease resulted in the patient's death? @Cholera Dysentery Typhoid Salmonellosis Alimentary toxic infection # Tuberculosis. Syphilis. # 1 A child died of a diffuse peritonitis. An autopsy revealed the primary intestinal tubercular complex with primary affect, a lymphangitis and regional caseous lymphadenitis. In addition, an ulcer of an empty intestine with perforation was found within the primary affect focus. What is the most likely way of tuberculosis infection in presented case? @Alimentary (nutritional) Transplacental Aerogenic Mixed Contact # 2 At the section of a died child was revealed primary intestinal tuberculous complex: primary affect-ulcer of jejunum, lymphangeitis and regional caseous lymphadenitis. The death was of the ulcer perforation and development of diffuse peritonitis. Name the way of contamination of the child with tuberculosis. Transplacental @Alimentary Aerogenous Mixed Contagious # 3 An autopsy of a 7-year-old child revealed in the apex of the right lung, under the pleura, a focus of caseous necrosis, 15 mm in diameter. There were also enlarged bifurcational lymph nodes with small necrotic foci. A microscopical investigation of the pulmonal focus and the lymph node's lesion showed necrotic masses surrounded by epithelioid cells, lymphocytes and solitary giant multinuclear Pirogov-Langhans' cells. What is the most likely disease? @Primary tuberculosis Gematogenic tuberculosis with the lesions of lungs Gematogenic generalized tuberculosis Secondary inflammatory tuberculosis Secondary fibro-inflammatory tuberculosis # 4 The girl within last 3 months ate the crude cow milk. She arrived in the hospital with the "acute abdomen" symptoms. An operation revealed in a caecum a circular ulcer with perforation. A histological study of the ulcer edges determined necrotic masses, lymphocytes, epithelioid cells, and few multinucleated giant cells What is your diagnosis? @Primary intestinal affect at tuberculosis Nonspecific ulcerous colitis Amebiasis Carcinoma of blind gut (cecum) Dysentery # 5 A histological investigation of the enlarged supraclavicular lymph nodes, removed from a 40-year- old woman, revealed an alteration of their structure with aggregates of slightly extended cells with a light nucleus. The multinuclear, large, oval-round form cells were also determined. These cells were rich with a cytoplasm and their nuclei were located on periphery in the form of a paling. The lymphoid cells created the next layer. The unstructured pinkish masses were seen within the centers of lesions. What the described changes are characteristic for? @Tuberculous lymphadenitis Metastasis of tumor Lymphogranulomatosis (Hodgkin's disease) Hyperplasic lymphadenitis Sarcoidosis (Boeck's disease) # 6 After introduction of BCG vaccine to babies’ immunity against tuberculosis lasts until in an organism will be alive bacteria of vaccinal strain. How to name such kind of immunity in the most correct way? @Nonsterile Humoral Typospecific Congenital Cross-immunity # 7 At carrying out of medical inspection of pupils Mantoux test was done. Presence of which from the listed below specific factors determines the positive reaction? @Т-lymphocytes B-lymphocytes Antibodies Erythrocytes Leukocytes # 8 At 10 years old child Mantoux test (with tuberculin) was done. In 48 hours in the place of tuberculin injection papule 8 mm in diameter has appeared. Which type of hypersensitivity has developed after tuberculin injection? @IV type of hypersensitivity Phenomenon of Arthus Atopic reaction Serum sickness II type of hypersensitivity # 9 Test Mantoux that appeared negative was done in child at his registration to school for the decision of necessity of revaccination. This result of test testifies about? @About absence of cellular immunity to a tuberculosis About presence of cellular immunity to a tuberculosis About absence of antibodies to tubercular bacteria About absence of antitoxic immunity to a tuberculosis About presence of antibodies to tubercular bacteria # 10 A lung lobe was removed at Surgery Department due to preliminary diagnosed purulent inflammation of a cyst. A gross investigation of the operative material revealed within the 8 segment a dense focus with irregular roundish form, 1,8 cm in diameter. On a cut, it had white-yellow coloring with a dim surface and fine sites of osteal density. The described macroscopical picture characteristic for: @Tuberculous affect with healing Peripheral carcinoma of lung Chondromas Carnification Chronic pneumonia # 11 A post-mortem of a 43-year-old man revealed in the 3 segment of the right lung under the pleura an area of consolidation, 1,5 cm in diameter, with the accurate borders, surrounded with a whitish fibrous tissue. A gross investigation of a cut section showed the white-yellow crumbling foci. Presence of the described focus is characteristic for: @Encapsulation of primary affect Peripheral carcinoma Chondroma Fibroma Infarct of lung with organization # 12 At the section of a 17-year-old girl, who died of lung insufficiency, were revealed confluent areas of caseous necrosis, the facts of caseous necrosis in bronchopulmonary, bronchial and bifurcation lymphatic nodules. What is the most possible diagnosis? Tuberculoma Haematogenous form of progressing of primary tuberculosis Haematogenous tuberculosis with preferable affection of lungs @The growth of the primary affect at primary tuberculosis Caseous pneumonia at secondary tuberculosis # 13 A post-mortem of the 17-year-old girl, who died of a pulmonary insufficiency, revealed confluent zones of a caseous necrosis in the lower lobe of the right lung. The caseous necrosis was also determined in broncho- pulmonal, bronchial and bifurcational lymph nodes. What of the listed diagnoses the most likely? @ Growth primary affect at primary tuberculosis Gematogenic form of progress of primary tuberculosis Gematogenic tuberculosis with lesion of lungs Tuberculoma Caseous pneumonia at the secondary tuberculosis # 14 An 8-year-old child, with no disease in his medical history, presented to the hospital with a dyspnea. An x-ray inspection showed the air and a liquid in a pleural cavity. During operation in the right lung the subpleural cavity, 2,4 cm in diameter was found. It had an irregular form with the residual caseous masses inside. The lesion was connected with the pleural cavity. The similar caseous masses were found at a cut of the enlarged radical lymph nodes. A histological research of a cavity's wall determined lymphocytes, epithelioid cells and multinuclear giant cells. How correctly to name a cavity? @Primary pulmonary cavity (cavern) at tuberculosis Abscess of lungs Empyema of pleura Cavity (cavern) at acute cavernous tuberculosis Cavity at fibrocavernous tuberculosis. # 15 An autopsy of a 44-year-old man revealed tuberculosis. A macroscopical investigation showed in the apex of the right lung the foci of caseous pneumonia. There were caseous lymphadenitis of enlarged lymph nodes of mediastinum and plural milium nodules in many organs. Name the described form of tuberculosis? @Primary with mixed form of progressing Primary with gematogenic spreading Primary with lymphogenic spreading Primary with growth of a primary affect Gematogenic # 16 A medical record of a dead child reveled meningeal symptoms in his medical history. His X-ray showed a dark patch in the III segment of the right lung and enlarged radical lymph nodes. At autopsy, in cerebral arachnoids, the millet grains-like nodules were found. Microscopical study of a nodule determined a focus of a caseous necrosis with wall of epithelioid, lymphoid cells with giant cells between them. These giant cells had big nuclei, situated on periphery in the form of a half moon. What is the most likely kind of meningitis? @Tuberculous Syphilitic Brucellous Influenzal Meningococcal # 17 A 26-year-old patient arrived in a hospital with complaints to a fever and weakness. One of the enlarged cervical lymph nodes was taken for histological study. Microscopical investigation showed in lymphoid tissue the centers of necrosis, surrounded with epithelioid cells, giant multinuclear Pirogov-Langhans cells and lymphocytes. What is the most likely disease? @Tuberculosis Lymphogranulomatosis (Hodgkin's disease) Lymphatic leukemia Sarcoidosis (Boeck's disease) Syphilis # 18 A histological investigation of the cervical lymph node revealed the aggregation of epithelioid cells, lymphocytes and giant Pirogov - Langhans cells. In the centre of a lesion a caseous necrosis was present. Specify the most likely pathology. @Tuberculosis Rhinoscleroma. Sarcoidosis (Boeck's disease) Glanders Syphilis # 19 A histological study of the enlarged cervical lymph nodes revealed nodules with giant, spherical-oval form cells. These cells had a light pink cytoplasm and nuclei located on a periphery. The found out changes are characteristic for: @Tuberculosis Lymphogranulomatosis (Hodgkin's disease) Sarcoidosis (Boeck's disease) Brucellosis. Nonspecific hyperplastic lymphadenitis # 20 A 24-year-old man presented with enlarged cervical lymphatic node. A histological investigation revealed the growth of epithelioid, lymphoid cells and macrophages with nuclei in the form of a horseshoe. In some centers the aggregates of unstructured light pink color masses with nuclei fragments were determined. For what disease the described changes are characteristic? @Tuberculosis Lymphogranulomatosis (Hodgkin's disease) Actinomycosis Metastasis of tumor Syphilis # 21 A histological investigation of the enlarged cervical lymph nodes revealed the nodules consisted mainly of flat, slightly extended cells with pale nucleus. There were also giant cells with spherical-oval form, light pink cytoplasm and with nuclei located on a cell periphery. The centre of some nodules was presented with the unstructured, light pink colored masses. The described changes are characteristic for: @Tuberculosis Lymphogranulomatosis (Hodgkin's disease) Sarcoidosis (Boeck's disease) Brucellosis Nonspecific hyperplasic lymphadenitis # 22 A 7-year-old boy with a history of tonsillitis presented with markedly enlarged paratracheal, bifurcate and cervical lymph nodes. A microscopical investigation of the removed cervical lymph node revealed the centers of a necrosis surrounded with lymphocytes, epithelioid cells and Pirogov-Langhans cells. Specify the most likely pathology. @Tuberculosis Sarcoidosis (Boeck's disease) Rhinoscleroma. Glanders Syphilis # 23 A lungs roentgenogram investigation revealed a dark patch. During a diagnostic express biopsy of a lymph node of a bronchus was removed. A histological study showed a caseous tissue necrosis, round which lied epithelioid and lymphoid layers with few multinuclear large cells (Langhans' cells). Specify the cause of the lymphadenitis. @Tuberculosis Pneumonia Syphilis Metastases of cancer Adenoviral infection # 24 Microscopical exam of the patient’s lungs (52 years) reveals focuses of necrosis that is surrounded by a roller of epithelioid cells and lymphocytes. Giant cells of round shape and with great amount of nuclei on the periphery are located between epithelioid cells and lymphocytes. How can we term such histological changes? Syphilitic granuloma Sarcoid granuloma @Tuberculous granuloma Leprous granuloma Scleromous granuloma # 25 Granulemes were detected during the appendix’s biopsy, which consist of the epitheliod, giant Pirogov-Langxance cells and with necrosis in granulem’s center. These changes give the reason to make a diagnosis: @Tuberculosis Superficial appendicitis Syphilis AIDS Actinomycosis # 26 42-year-old patient complained of a voice timbre change. The larynx biopsy was taken. A histological investigation revealed the aggregates of large, oblong form cells with light nuclei, rich with a cytoplasm. The nuclei were located on periphery in the form of a horseshoe. The described histological changes are characteristic for: @Tuberculosis Leprosy Syphilis Rhinoscleroma Lymphogranulomatosis (Hodgkin's disease) # 27 An autopsy of a child, who died of meningocephalitis revealed under pleura and in pulmonal tissue plural, punctual, yellow-white lesions which reminded millet grains. Histological investigation showed granulomas with a necrosis zone in the centre and a wall of epithelioid cells, lymphocytes, macrophages and some giant Pirogov -Langhans cells. What is the most likely disease? @Primary milliary tuberculosis Secondary tuberculosis Focal pneumonia Croupous pneumonia # 28 At the section of a 44-year-old man, who died of pulmonary-heart insufficiency, were diagnosed pneumosclerosis, emphysema of lungs, and hypertrophy of the right ventricle of the heart. Multiple focuses with the diameter of 1cm were localized in both lungs, mostly subpleural. Histologically: in the center of the focus – the area of necrosis, on the periphery – a roller of epithelioid cells, lymphocytes, few macrophages and plasmatic cells. Giant Pirogov-Langhans cells were determined, too. There was also small amount of blood vessels on the periphery of the focus. What disease did the dead man have? @Haematogenous tuberculosis Actinomycosis of lungs Sarcoidosis Syphilis Silicosis # 29 A 52-year-old man with a long history of a tubercular prostatitis died of a meningocephalitis. An autopsy revealed in arachnoids of the basis and lateral surfaces of a brain, in a spleen, kidneys and liver a considerable quantity of dense grey color nodules 0, 5-1mm in diameter. Histological investigation of nodules showed epithelioid, lymphoid and some giant cells with nuclei located on a cell periphery in the form of a horseshoe. What is the most likely diagnosis? @Acute milliary tuberculosis Acute tuberculous sepsis Chronic milliary tuberculosis Disseminated tuberculosis Septicopyemia # 30 At the section of a 48-year-old man, who died of pulmonary tuberculosis, were revealed: partly devastated symmetric tuberculous cavernae in corticopleural areas with the domination of productive tissue reaction, delicate reticulated pneumosclerosis and emphysema in both lungs, pulmonary heart, tuberculous caseous lymphadenitis in bifurcation nodules. Chon focus was located in the III segment of the right lung. What is the most possible diagnosis? Haematogenous generalization of primary tuberculosis @Haematogenous disseminated tuberculosis Chronic primary tuberculosis Chronic miliary tuberculosis Cirrhotic tuberculosis # 31 An autopsy of a 74- year-old man revealed the enlargement and deformation of the right knee joint. A histological investigation determined the massive foci of a caseous necrosis, surrounded by peripheral mantle of epithelioid, lymphoid cells and some multinucleated giant cells. |