Modul 1General Pathomorphology Text tests



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Situational tasks

  1. 28 year old woman died at signs of heart failure. During the heart research the following was found: macroscopically - mitral valve is compacted, thickened and moderately deformed; microscopically - bundles of collagen fibrils are homogenised, eosinophilic; metahromasia and components of immune complexes are not detected, they are surrounded by the little macrophage infiltration. Diagnose the type of connective tissue lesion.

    1. *Mucoid swelling

    2. Amyloidosis

    3. Fibrynoid swelling

    4. Hyalinosis

    5. Slerosis

  2. 42 year old patient had been suffering from bronchiectasis for a long time and died of kidney failure. At the autopsy the enlarged pale-yellow kidneys were found. During microscope study clusters of amorphous eosinophilic and kongophilic substance were detected in the vessel walls, basement membranes of tubules, capillary loops, mesangium of glomerulas and connective tissue of renal stroma. Specify which of the following pathologic processes is the most probable?

    1. Hyalinosis

    2. Idiopathic amyloidosis

    3. Ancestral amyloidosis

    4. *Secondary amyloidosis

    5. Senile amyloidosis

  3. 42 years old female, who suffered from rheumatic heart disease, died of cardiac decompensation. At the autopsy there were found: "Muscat liver”, brown induration of lungs, ascites, cyanotic compaction of spleen and kidneys. Microscopically in thickened interalveolar septums and in lumens of alveolas there were identified macrophages with brown grains in the cytoplasm, which are coloured by Perl’s in green and blue. Indicate which of the following pigments is accumulated the most probably?

    1. Hematoidin

    2. Hydrochloric acid-hematin

    3. *Hemosiderin

    4. Bilirubin

    5. Hemomelanin

  4. 68-year old woman has been suffering from fibrous-cavernous pulmonary tuberculosis for 20 years. Signs of chronic renal failure dominate in recent years. Lifetime test for the presence of amyloid in the kidneys - is positive. What form of amyloidosis this is about in this case?

    1. Primary systemic

    2. Secondary systemic

    3. *Bounded (local)

    4. Family innate

    5. Senile (old)

  5. A greyish-white, dense seat, which projects above the mucous membrane, appeared on the mucous membrane of the mouth. Expressed hyperkeratosis is found on this area. What pathological process has developed in mucous membrane?

    1. *Leukoplakia

    2. Hyalinosis

    3. Focal ichthyosis

    4. Local tumourous amyloidosis

    5. Leucoderma

  6. An ulcer of gastric mucosa with dense edges and brown-black bottom was found in patient during gastroscopy. At microscopic study of necrotic layer of ulcer bottom a brownish-black pigment was observed. Which is this pigment?

    1. * Muriatic hematin

    2. Porphyrin

    3. Bilirubin

    4. Ferritin

    5. Hemosiderin

  7. An ulcer of gastric mucosa with the pressed edges and brown-black bottom was found at gastroscopy, and at gastrobiopsy an acute ulcer with brownish-black pigment in its necrotic layer was confirmed. Which is this pigment?

    1. * Muriatic hematin

    2. Hemosiderin

    3. Porphyrin

    4. Ferritin

    5. Bilirubin

  8. At assessment of the newborn its skin is dry, dull with uneven surface and characterised by presence of grey flaps which peel off. Which type of dystrophy is associated with this pathology?

    1. *Corneous

    2. Hydropic

    3. Hyaline-drop

    4. Fibrinoidn swelling

    5. Mucoid swelling

  9. At autopsy of a man who died of typhoid fever, was found that adductor muscle of thigh is whitish in colour, of thick consistency, resembles stearic candle. What pathological process does take place in the muscles?

    1. *Waxy necrosis

    2. Fibrinoid necrosis,

    3. Colliquative necrosis

    4. Cheesy necrosis

    5. Apoptosis

  10. At autopsy of a man who suffered from chronic ischemic heart disease, multiple atherosclerotic plaques in the stage of atherocalcinosis were found in the intima of aorta and coronary arteries. What do underlie such changes of atherosclerotic plaques:

    1. *Dystrophic calcification

    2. Hyalinosis

    3. Sclerosis

    4. Metastatic calcification

    5. Metabolic calcification

  11. At autopsy of patient with leukemia who died from progressive chronic anemia, heart is larger in size, but the myocardium is dull at section, feeble, pale-grey, under endocardium the yellow spots and stripes are seen. What pathological process has developed in heart?

    1. Hyaline-droplet dystrophy

    2. Work hypertrophy

    3. Mesenchymal lipophanerosis

    4. *Parenchymal fatty dystrophy

    5. hydropic [vacuolar] degeneration

  12. At autopsy of the man, who suffered from chronic renal failure, urate calculuses were found. With the disorder of which metabolism this disease is associated?

    1. *Nucleoproteids

    2. Chromoproteids

    3. Hemosiderin

    4. Bilirubin

    5. Lipoproteins

  13. At autopsy of woman signs of rheumatic heart disease were found: thickened, deformed valves, which acquired chondroid consistency with shiny surface. What dystrophic process is observed in heart valves?

    1. Amyloidosis

    2. Obesity

    3. *Hialinosis

    4. Calcinosis

    5. Collagenosis

  14. At autopsy of woman who suffered from rheumatism with combined mitral defect, was found that parts of mitral valve are sharply thickened, conjoined, are of stony density. What pathological process did cause the stony density of the heart valve?

    1. Metastatic calcification

    2. Metabolic calcification.

    3. Hyalinosis.

    4. Amyloidosis.

    5. *Dystrophic calcification

  15. At autopsy of women, who died from chronic alcohol intoxication, sharply increased liver was found, with kneaded consistency, yellowish in color. Optically empty vacuoles of various sizes were detected in the cytoplasm of hepatocytes ast microscope study. What type of dystrophy does take place?

    1. Hydropic

    2. *Parenchymal fatty

    3. Hyaline droplet

    4. Hydrocarbon parenchymal

    5. Mesenchymal fatty

  16. At histological examination of the enlarged lymph node of patient with tuberculosis the randomly scattered small grains of chromatin in caseous necrotic foci were found. Which pathological process these grains are result of?

    1. *Karyorrhexis

    2. Karyolysis

    3. Pyknosis of nuclei

    4. Mitotic activity of nuclei

    5. Apoptosis

  17. At microscopic examination of internal organs a woman who suffered from rheumatism, and died of cardiac decompensation, there was found: bundles of collagenic fibers are impregnated by plasma proteins, homogeneous, eosinophilic, pikrynophilic at colouring by van Hyson, SHIC-positive, pironiphilic at Brasch’s reaction and argyrophilic at impregnation with silver salts. Indicate which of the following pathological processes in connective tissue is the most likely?

    1. Mucoid swelling

    2. *Fibrynoid swelling

    3. Fibrynoid necrosis

    4. Hyalinosis

    5. Amyloidosis

  18. At microscopy study of kidney biopsy material of patient who suffers from diabetes, there was found: epithelium of narrow and distal renal tubular segments is high with light foamy cytoplasm. At coloring by carmine Besta in the cytoplasm of tubular epithelium and lumens of tubules there were found red grains. Indicate which of the following types of parenchymatous dystrophy take place?

    1. Protein

    2. Fatty

    3. Hyaline droplet

    4. Mucous

    5. *Hydrocarbons

  19. At microscopy study of kidneys man died from systemic lupus, sclerosed glomerulas were found; lumens of small arteries and arterioles are narrow, the middle membrane is narrowed with the presence of homogeneous eosinophilic masses in subendothelial space. These masses contain immune complexes and fibrin. What substance is found in subendothelial space?

    1. Fat-protein detritus

    2. Simple hyaline

    3. Lipohyalin

    4. *Complex hyaline

    5. Amyloid

  20. At microscopy study of skin neoplasm of brown colour there was found that the tumor consists of nevus cells that are located in the dermis as conglomerations and chords. Cytoplasm of cells contains brown pigment, which gives a negative Perl’s reaction. Which pigment is the most probably found in the cytoplasm of cells?

    1. Hematoidin

    2. *Melanin

    3. Hemosiderin

    4. Bilirubin

    5. Hemomelanin

  21. At microscopy study of the amputated lower extremity of patient with diabetes there was found that the arterioles and small arteries have narrowed lumen, thinned middle membrane, destroyed internal elastic plate with accumulation of homogeneous eosiniphilic masses in subendothelial space, which give positive reaction to lipids and B-lipoproteins. What substance was found in subendothelial space?

    1. Fatty-protein detritus

    2. Simple hyaline

    3. *Lipohyalin

    4. Complex hyaline

    5. Amiloid

  22. At microscopy study of the brain of a man who suffered from hypertension and died of intracranial hemorrhage, in small arteries and arterioles sharply narrowed lumens of vessels were found, thinned middle membrane, and destroyed internal elastic plate with an accumulation of homogeneous, shiff (PAS)-positive masses in subendothelial space. Indicate which of the following substances is the most probably deposited subendothelial layer?

    1. Fat-protein detritus

    2. *Simple hyaline

    3. Lipohyalin

    4. Advanced hyaline

    5. Amyloid

  23. At study of biopsy material of skin of the patient who suffer from allergic vasculitis there were found the following changes: thickened vessel wall, which is also homogeneous, pyroninophillic in response to Brashe’s reaction, shiff (PAS)-positive, is coloured in yellow by picrofuxin. Name the type of stromal-vascular dystrophy.

    1. *Fibrinoid swelling

    2. Amyloidosis

    3. Mucoid swelling

    4. Hyalinosis

    5. Lipidosis

  24. At study of liver biopsy material of patient with hepatitis, hepatocytes with balloon dystrophy were found; in sinusoidal capillaries – Kounsilmen’s bodies are identified , which appeared to be cell fragments at the electron microscope study; compacted organelles that are surrounded by cell membrane, and also fragments of nuclei were found. Manifestation of what process the Kounsilmen’s bodies are?

    1. * Apoptosis

    2. Necrosis

    3. Nekrobiosis

    4. Paranekrosis

    5. Dystrophy

  25. At the autopsy of 60 year old man who suffered from multiple bronchiectasis and died from kidney failure amiloidosis of kidneys was found at autopsy. Which of the following is the most important diagnostic sign of it?

    1. Greasy appearance of kidneys

    2. *Congo-positive deposits in glomerulas

    3. Renal sclerosis

    4. Compaction of kidneys

    5. An increase of kidneys in size

  26. At the autopsy of 47year old man who had been suffering from chronic purulent osteomyelitis and died from intoxication, enlarged liver and heart with the shiny surface of the section were found. Microscopically – under the endocardium, in the stroma and vascular wall and along the veins the oxyphilic substance is detected which is coloured by Congo-rot in red. Which of the pathological processes in the liver and heart is the most likely?

    1. Pigmentary cardiomyopathy

    2. Brown atrophy of infarction

    3. Obesity of the heart

    4. *Amyloidosis

    5. Lipophanerosis of myocardium

  27. At the autopsy of 56-year old man who suffered from fibrous-cavernous pulmonary tuberculosis, the enlarged dense spleen was found. At section spleen tissue is brown-pink, smooth, with a waxy surface. Diffuse congophilic colouring was found at microscope study. Which of the pathological processes does take place in the spleen?

    1. Frosted (icing) spleen

    2. Purple spleen

    3. Sago spleen

    4. *Greasy spleen

    5. Cyanotic induration of spleen

  28. At the autopsy of 56-year-old man who suffered from fibrous-cavernous pulmonary tuberculosis and died of pulmonary-cardiac insufficiency there was found enlarged dense spleen. On section the tissue of spleen is brown-pink, smooth, with a waxy surface. Specify the figurative name of spleen.

    1. *Glazed

    2. Porphyrinic

    3. Sago

    4. Sebaceous

    5. Cyanotic

  29. At the autopsy of a deceased man who died in the result of intoxication there were found following signs: cachexia, muscle atrophy, wrinkled skin, reduced weight of internal organs, stenotic tumor of antral part of stomach with metastases in the liver and regional lymph nodes. What type of cachexia is the most likely?

    1. Alimentary

    2. * Cancerous

    3. Pituitary

    4. Cerebral

    5. One that accompanies chronic infectious disease

  30. At the autopsy of a man who had been suffering from tuberculosis and died of renal-hepatic failure, there were found dense, increased in size liver and kidneys yellow-gray in colour on the section. Microscopically in the walls of blood vessels and bile ducts of liver there were found congophilic masses. The same substance was found in the basal membranes of tubules, in stroma and vessels of renal glomerules. Which of the pathological processes in the stroma and vessels is the most likely?

    1. Mucoid swelling

    2. Fibrynoid swelling

    3. Hyalinosis

    4. *Amyloidosis

    5. Fibrynoid necrosis

  31. At the autopsy of a woman who had chronic dysentery there were found violet amorphous deposits in the stroma and parenchyma of myocardium, kidneys, mucous membrane of the stomach and connective tissue of lungs. What complications have developed in patients?

    1. *Metastatic calcification

    2. Dystrophic calcification

    3. Metabolic calcification

    4. Amyloidosis

    5. Hyalinosis

  32. At the autopsy of a woman who suffered from rheumatism parts of mitral valve are significantly thickened, joined together, are of stony density. What pathological process has caused the stony density of the heart valve?

    1. Amyloidosis

    2. Hyalinosis

    3. Metabolic calcification

    4. *Dystrophic calcification

    5. Metastatic calcification

  33. At the autopsy of deceased infant, who lived two days, in the cortical layer of the kidneys yellow-orange stripes were found. Microscopically in canaliculuses and lead tubuleses urate natrium and ammonium were found. Indicate substances which metabolic disorders take place in this case?

    1. Ferritin

    2. *Nucleoproteids

    3. Hemosiderin

    4. Bilirubin

    5. Lipofuscin

  34. At the autopsy of deceased man signs of rheumatic heart disease were found: thickened, deformed valves, which have chondroid consistency and shiny surface. What dystrophic process is observed in heart valves?

    1. Amyloidosis

    2. Fibrynoid necrosis

    3. Fibrynoid swelling

    4. *Hyalinosis

    5. Dystrophic calcification

  35. At the autopsy of lungs they appeared to be dense, brown in color due to deposition of endogenous pigment. It is known that the patient had chronic venous stasis in a small circle of blood circulation. What pathological process did cause this picture?

    1. Melanosis

    2. Jaundice

    3. *Hemosyderosis

    4. Porphyria

    5. Calcinosis

  36. At the autopsy of man who died from malaria the enlarged dense lymph nodes, spleen and liver, hyperplastic bone marrow of grey-flaky (slate) color were found. At microscopy study of the cytoplasm of histiocytic and macrophage cells there were found concentrations (clusters) of black pigment granules. The accumulation of which pigment is the most probable?

    1. Hematoidin

    2. Ferritin

    3. Hemosiderin

    4. Bilirubin

    5. *Hemomelanin

  37. At the autopsy of man who died of hemolytic shock after transfusion of incompatible blood there were found: enlarged and dense rusty-brown liver, spleen, kidneys, lungs, lymph nodes. During the microscopy study of the mentioned organs a large number of macrophages with brown amorphous grains in the cytoplasm were found, which give a positive Perl’s reaction. Indicate the pigment which metabolism is disordered in this case?

    1. Hematoidin

    2. Ferritin

    3. *Hemosiderin

    4. Bilirubin

    5. Hemomelanin

  38. At the autopsy of the dead woman, who took iron preparations for a long time, there were found a bronze colour of the skin, dense liver and pancreas of the same color as the skin. Microscopy study of the liver, pancreas and heart revealed increased number of brown pigment, which gives a positive Perl’s reaction. Which of the following diagnoses is the most likely?

    1. Hypermelanosis

    2. Lipofuscinos

    3. Hemochromatosis

    4. Jaundice

    5. *Hemosiderosis

  39. At the autopsy of the deceased from cancer cachexia there were found atrophy of skeletal muscles, reduced in size heart and liver which is yellow-brown in color. At microscopic examination in the cytoplasm of hepatocytes and cardiac hystiocytes the perinuclear grains of brown pigment were found, which give a negative Perl’s reaction. Indicate a pigment which metabolism is disordered the most probably?

    1. Hematoidin

    2. Lipofuscin

    3. *Hemosiderin

    4. Bilirubin

    5. Hemomelanin

  40. At the autopsy of the deceased man 44-year old, who had been suffering from chronic dysentery, chronic ulcerative colitis was found, along with enlarged lungs with thick shiny surface of the section. Microscopically in the vessel walls of lungs and the interalveolar tissue the homogeneous masses were found, coloured in red by congo-rot. Indicate which of the following pathologic processes is the most likely?

    1. Mucoid swelling

    2. Fibrynoidn swelling

    3. *Amyloidosis

    4. Hyalinosis of connective tissue

    5. Pneumosclerosis

  41. At the autopsy of the deceased man who suffered from hypertension and died of hemorrhage in the brain, at microscope study there were found thickened vessel walls due to the accumulation of homogeneous masses in them, that are coloured in pink by eosin and yellow - by picrofuxin; lumens of vessels are sharply narrowed. Indicate which of the following pathological processes in the vessels is the most likely?

    1. Mucoid swelling

    2. Lipoidosis

    3. Amyloidosis

    4. *Hyalinosis

    5. Fibrynoid swelling

  42. At the autopsy of the deceased man, who suffered from tuberculosis for many years, the following was found: liver is 1600 g in weight, dull, of light brown colour ("goose liver"). Microscopically: on the periphery of hepatic particles in the cytoplasm hepatocytes there found sudanphilic inclusions. Which of the following parenchymatous dystrophy is the most likely?

    1. Protein

    2. Hyaline drop

    3. *Fatty

    4. Corneous

    5. Mucous

  43. At the autopsy of the man who died from liver failure there were found greenish-brown ring on the periphery of the eye cornea (Kaiser-Fleisher ring), liver cirrhosis, and dystrophic changes in lenticular nuclei, in paleball and caudate body of the brain. Indicate the mineral which metabolism is disordered at this pathology?

    1. *Cooper

    2. Potassium

    3. Calcium

    4. Iron

    5. Phosphorus

  44. At the autopsy of woman who suffered from rheumatoid arthritis, enlarged dense spleen was found. On the section of spleen the tissue is brownish-pink with large follicles, which look like translucent grayish-white grains. Specify the figurative name of spleen.

    1. Glazed

    2. Porphyrinic

    3. *Sago

    4. Sebaceous

    5. Cyanotic

  45. At the examination of 47 year old patient, who works at aniline factory, there were found chronic anaemia and icteric skin colour. At research of biopsy material of bone marrow the brownish-yellow pigment was detected in the cytoplasm of macrophages (Perl’s reaction on iron was positive). Which of the following pigments this is about?

    1. Lipofuscin

    2. Hematin

    3. Bilirubin

    4. *Hemosiderin

    5. Hematoidin

  46. At typhoid fever the necrotised abdominal plaques of small intestine are coloured in yellow-brown colour. What pigment does impregnate necrotized fabric?

    1. Haemoglobin

    2. Lipofuscin

    3. Melanin

    4. *Bilirubin

    5. Indol

  47. During histological examination of liver biopsy material of patient with viral hepatitis B the violations of beam structure with polymorphism of hepatocytes were found. Many mitotic figures are seen in hepatocytes. Hepatocytes are increased in volume, cytoplasm is filled with vacuoles containing clear liquid. What type of dystrophy is characteristic of this disease?

    1. *Hydropic dystrophy

    2. Granular dystrophy

    3. Hydrocarbons dystrophy

    4. Hyaline droplet dystrophy

    5. Lipophanerosis

  1. 50.Liver biopsy of a woman with viral hepatitis revealed hepatocytes with balloon degeneration Councilmen's bodies in the sinusoid capillaries which, according to electron microscopy, are cell fragments surrounded by a cellular membrane, contained densely positioned organelles as well as nuclei fragments. Which process can be suggested by Councilmen's bodies?

    1. *Apoptosis

    2. Necrosis

    3. Necrobiosis

    4. Paraeccrisis

    5. Degeneration

  2. Microscopy of the amputated lower extremity of the patient with diabetes mellitus showed that the lumens of the arterioles and small arteries were narrowed, the middle membrane is thin, the elastic plate was destroyed with accumulations of homogenic eosinophilic masses in the subendothelial space positive for lipids and beta-lipoproteins. Which substance was revealed in the subendothelial space?

    1. Fat-protein detritus

    2. Simple hyaline

    3. *Lipohyalin

    4. Complex hyaline

    5. Amyloid

  3. Microscopy of the kidneys from a man died of systemic lupus erythematosus revealed sclerosed glomeruli, the lumens of the small arteries and arterioles are narrow, the median membrane is thin, homogeneous, eosinophilic masses are present in the subendothelial space. Immunologically these masses contain immune complexes and fibrin. Which substance is present in the subendothelial space?

    1. *Complex hyalin

    2. Fat-protein detritus

    3. Simple hyaline

    4. Lipohyalin

    5. Amyloid

  4. Autopsy of a man aged 56 who had suffered from fibrous-cavernous pulmonary tuberculosis revealed enlarged dense spleen. On cut section the tissue of the spleen is brown-pink, smooth with wax-like surface. Microscopy revealed diffuse congophilic staining. Which process is observed in the spleen?

    1. Glaze spleen B. Porphyrin spleen

    2. *Sebaceous spleen

    3. Sago spleen

    4. Cyanotic induration of the spleen



  5. A 20-year-old male patient with a posttraumatic variceal dilation and thrombosis of the subcutaneous vein in the middle third part of the shin underwent its surgical removal. Histologically, an obstructive thrombus was found in the lumen of the vein with growing of a connective tissue into the thrombus from the side of the vascular wall. What process did the changes in the thrombus result from?

    1. Organization

    2. Reconstruction

    3. *Canalization

    4. Revascularization

    5. Repair

  6. A 66-year-old male died on the 8-th day after prostatectomy. On autopsy, the veins in the fat of his small pelvis revealed some motley vermiform masses with a dim rough surface that were fastened to the walls of the vessels. The left branch of the pulmonary artery contained some masses of the same kind which freely lied in its lumen. Indicate the most probable kind of embolism of the pulmonary artery.

    1. *Thrombembolia

    2. Tissue embolism

    3. Microbial embolism

    4. Embolism with foreign bodies

    5. Fat embolism

  7. A diver died two hours after rapid decompression. An autopsy revealed crepitation of the skin, anaemia of the internal organs, some foamy liquid blood in the cavities of the heart and major vessels. Microscopically, the capillaries of the brain, spinal cord, liver and kidneys revealed numerous emboli, foci of ischaemia and necrosis; the lungs were characterized by an oedema, haemorrhages and an interstitial emphysema. Which of the kinds of embolism listed below was the most probable?

    1. Air

    2. Tissue

    3. *Gas

    4. Fat

    5. With foreign bodies

  8. A female patient, who suffered from thrombophlebitis of her deep crural veins, suddenly died. An autopsy revealed red free friable masses with a dim goffered surface in the common trunk and bifurcation of the pulmonary artery. What pathological process in the pulmonary artery did a pathologist reveal?

    1. *Thrombembolia

    2. Thrombosis

    3. Tissue embolism

    4. Embolism with foreign bodies

    5. Fat embolism

  9. A male patient with multiple fractures of his long tubular bones suddenly died under the phenomena of acute pulmonary insufficiency. An autopsy did not reveal any pathological changes in the internal organs. Microscopically, there were some diffuse sudanophilous inclusions in the lumens of small branches of the pulmonary artery and capillaries. What kind of embolism was the most probable?

    1. *Fat

    2. Thrombembolia

    3. Air

    4. Tissue

    5. With foreign bodies

  10. A male patient, who suffered from a chronic gastric ulcer, developed a gastric bleeding. Indicate the mechanism of the impairment of the vascular wall which most likely could result in a haemorrhage.

    1. Rupture

    2. Spasm

    3. *Erosion

    4. Diapedesis

    5. Oedema

  11. A microscopic study of the lungs of a male, who died from a brain injury, revealed some parts of the cerebral tissue, small foci of haemorrhages and necrosis in the lumens of the small pulmonary arteries. What kind of embolism was the most probable in this case?

    1. Thrombembolia

    2. Fat

    3. With foreign bodies

    4. *Tissue

    5. Microbial

  12. A microscopic study of the umbilical vein of a newborn, who died from an intoxication, revealed that the vascular wall was characterized by some diffuse inflammatory infiltration, and the lumen had an obstructive thrombus with a large number of heterophilic leukocytes and colonies of bacteria. Indicate the most probable outcome of the thrombosis.

    1. Aseptic autolysis

    2. Organization and canalization of the thrombus

    3. Transformation into thromboembolism

    4. *Septic autolysis

    5. Petrification of the thrombus

  13. A patient with hepatic cirrhosis developed a collapse and hyperaemia of the peritoneum after removal of 10 litres of ascitic fluid from his abdominal cavity. Determine the kind of arterial hyperaemia of the peritoneum.

    1. *Hyperaemia after anaemia

    2. Inflammatory

    3. Vicarious

    4. Collateral

    5. On the ground of an arteriovenous shunt

  14. An autopsy of a 70-year-old male, who suffered from hypertensive disease and died of a disturbance in the cerebral circulation, revealed in his brain stem some cavity which was 2 cm in diameter and filled with blood clots. Name the mechanism of the impairment of the vascular wall which most likely could result in a haemorrhage.

    1. *Rupture

    2. Spasm

    3. Erosion

    4. Oedema

    5. Diapedesis

  15. An autopsy of a 73-year-old male, who suffered from a chronic coronary disease with heart failure for a long period of time, revealed macro- and microscopic signs of the nutmeg liver, brawny induration of the lungs, cyanotic induration of the kidneys and spleen. Indicate the most probable kind of a circulatory disturbance in this case.

    1. Arterial hyperaemia

    2. Acute general venous plethora

    3. *Chronic general venous plethora

    4. Acute anaemia

    5. Chronic anaemia

  16. An autopsy of a female patient, who suffered from a rheumatic heart defect and died of cardiac decompensation, revealed a large number of petechial haemorrhages in the brain. Name the mechanism of the haemorrhages.

    1. Rupture

    2. Spasm

    3. Erosion

    4. Oedema

    5. *Diapedesis

  17. An autopsy of a foetus, who died from intranatal asphyxia owing to an acute disturbance of the uteroplacental circulation, revealed microfocal perivascular petechial haemorrhages in the pia mater, under the epicardium and under the pleura. Name the mechanism of an impairment in the walls of vessels which most probably resulted in the haemorrhages.

    1. Rupture

    2. Spasm

    3. Erosion

    4. Oedema

    5. *Diapedesis

  18. An autopsy of a male, who died from a profuse bleeding after numerous gunshot injuries, revealed large accumulation of coagulated blood in the soft tissues of his left thigh with an impairment of the structure of the muscles. Which of the processes listed below was the most probable?

    1. Haemorrhagic infiltration

    2. Microfocal haemorrhage (petechia)

    3. Bruise

    4. *Haematoma

    5. Ecchymoses

  19. An autopsy revealed a diverse big liver with a picture of a nutmeg on section. In the lumens of the hepatic veins there were parietal thrombi. Name the kind of a circulatory disturbance in the liver.

    1. General venous plethora

    2. *Local venous plethora

    3. Anaemia

    4. Haemorrhage

    5. Bleeding

  20. Following an injury of his cervical veins, a male suddenly died under the phenomena of an acute respiratory insufficiency. An autopsy revealed that his right heart cavities were distended and contained some foamy liquid blood, the major veins contained the blood of the same kind. Microscopically, the lumens of small branches of the pulmonary arteries and capillaries revealed numerous embolic masses. Which of the kinds of embolism listed below was the most probable?

    1. *Air

    2. Tissue

    3. Gaseous

    4. Thrombembolia

    5. Fat

  21. Gross examination revealed an increase in the size of the liver, the cut - a motley, with a pronounced muscat pattern. In the lumina of the hepatic veins identified parietal thrombi. Name the type of circulatory disorders in the liver.

    1. *General venous hyperemia

    2. Local venous hyperemia

    3. Anemia

    4. Hemorrhage

    5. Bleeding

  22. In patients with chronic peptic ulcer bleeding arose. Specify the mechanism of injury vessel wall

    1. laceration

    2. spasm

    3. *Corrosion

    4. Diapedesis

    5. edema

  23. Patients with liver cirrhosis after vydaleniya from the abdominal cavity of 10 liters of ascitic fluid development collapse and congestionperitoneum. Which kind arterial hyperemia of the peritoneum.

    1. *Hyperaemia after anemia

    2. Inflammatory

    3. Vakatnaya

    4. Collateral

    5. Hyperaemia on the basis of arterio-venous fistula

  24. The patient, who has revealed deep vein thrombophlebitis leg, sudden death occurred. In the context of legechnom trunk and the bifurcation of the pulmonary artery revealed unconfined red friable mass with a rough dull surface. What is the pathological process in the pulmonary artery revealed a pathologist?

    1. *Thromboembolism

    2. Thrombosis

    3. Tissue embolism

    4. Embolism alien bodies

    5. Fat embolism

  1. A 46-year-old male patient complains of difficult nasal breathing. A biopsy of his thickened nasal mucosa revealed Mikulicz's cells, clusters of epithelioid cells, plasmacytes, lymphocytes, hyaline balls. What is your diagnosis?:

    1. *Scleroma

    2. Adenovirus rhinitis

    3. Allergic rhinitis

    4. Rhinovirus infection

    5. Meningococcal nasopharyngitis

  2. A 63-year-old male patient, who suffered from cancer of the stomach, developed a sharp pain in the epigastric region, tachycardia, loss of consciousness. Some time later the patient died. On autopsy, about 1000 ml of some yellow-greenish dull fluid in the abdominal cavity, as well as greyish thread-like deposits on the visceral and parietal leaves of the peritoneum, were revealed. What kind of inflammation takes place in the peritoneum?:

    1. *Fibrinous-purulent

    2. Catarrhal

    3. Serous

    4. Haemorrhagic

    5. Productive

  3. A study of the thymus of a 5-year-old child, who died from acute destructive staphylococcal pneumonia, revealed a decrease in the weight of the gland down to 3.0 g. On histological examination, a smaller size of the lobules of the gland with acollapse of the stroma, an inversion of the layers, and cyst-like Hassal's bodies were found out. Which of the diagnoses listed below was the most probable?:

    1. *Accidental reaction

    2. Thymomegaly

    3. Hypoplasia of the thymus

    4. Dysplasia of the thymus

    5. Agenesia of the thymus

  4. An autopsy of a 55-year male, who died from progressing cardiopulmonary insufficiency, revealed petechial haemorrhages under the visceral leaf of the pericardium, the surface of the serous coat was dull and diffusely covered with greyish superpositions in the form of a net, hairs and films, there were 200 ml of some dull fluid in the lumen of the pericardium. What kind of inflammation was there in the pericardium?:

    1. *Croupous

    2. Diphtheritic

    3. Serous

    4. Suppurative

    5. Catarrhal

  5. An autopsy of a 60-year-old male revealed numerous whitish miliary nodules in the lungs and liver. A microscopic examination revealed granulomata with foci of necrosis in their centre and epithelial, lymphoid, plasma cells, as well as macrophages and a large number of Pirogov-Langhans cells on the periphery. Indicate the granuloma which corresponds to the description.:

    1. Macrophagal

    2. Phagocytoma

    3. Epitheliocellular

    4. *Giant cell

    5. Foreign-body

  6. An autopsy of a male, who died from generalized peritonitis, revealed in his liver some cavity, 6 cm in diameter, filled with yellowish semiliquid masses and delimited with the granulation tissue. Name pathological formation.:

    1. *Abscess

    2. Phlegmon

    3. Carbuncle

    4. Empyema

    5. Furuncle

  7. An autopsy of a woman, who died from hepatic insufficiency, revealed that her liver was enlarged, yellow-brown, lobate and tuberous. On section, the liver had several yellow-greyish nodes 3 to 10 cm in diameter with dark-grey foci and fibrinous layers. Microscopically, the liver had foci of necrosis surrounded by a well-developed connective tissue and vessels with the proliferating endothelium, as well as a cellular infiltrate of lymphocytes, plasmacytes and epithelial cells of Pirogov-Langhans. Which of the pathological processes listed below was the most probable?:

    1. Lepromatous form of leprosy

    2. Tuberculoid form of leprosy

    3. Tuberculous granulomata

    4. *Syphilitic gummata

    5. Hepatic cirrhosis

  8. An autopsy revealed 0.5 I of some yellowish transparent fluid with small white crumble clots in the right pleural cavity. The parietal and visceral pleurae were covered with a white crumble coat. What kind of exudative inflammation was it?:

    1. Suppurative

    2. *Croupous

    3. Serous

    4. Putrid

    5. Catarrhal

  9. An examination of a 7-year-old child, who was referred to infectious department with complaints about a sharp pain in his throat, difficult swallowing, an elevated body temperature up to 390C, an edema of his neck, revealed that the tonsils were enlarged, their mucosa was plethoric and covered with a large number of yellow-whitish films which were closely adjacent to the mucosA. An attempt to remove a film results in a deep bleeding defect. What kind of inflammation takes place?:

    1. *Diphtheritic

    2. Suppurative

    3. Serous

    4. Croupous

    5. Haemorrhagic

  10. An examination of a lymph node revealed that it was significantly enlarged and with a thick consistency, on section it was yellow-whitish and crumbleD. Microscopically, in the lymph node tissue there were foci of necrosis surrounded by a bank of epithelial cells and lymphocytes with an admixture of macrophages and plasma cells, Pirogov-Langhans giant multinucleate cells being located among them. Name the kind of granuloma.:

    1. Foreign-body

    2. Scleromatous

    3. Syphilitic

    4. *Tuberculous

    5. Lepromatous

  11. An examination of a renal biopsy revealed some mostly perivascular and periglomerular lymphocytic, plasmacytic and macrophagal infiltration of the interstice against a background of it’s sclerosis. Name the most probable kind of inflammation.:

    1. Productive diffuse

    2. * Productive focal

    3. Granulomatous

    4. Exudative diffuse

    5. Exudative focal

  12. In a 58-year-old male, who died under progressing phenomena of chronic heart failure, a diagnosis of rheumatic granulomatous myocarditis was made. Microscopically, the myocardium revealed granulomata which had a focus of necrosis in the centre and were surrounded by macrophages having hyperchromatic nuclei and a light cytoplasm. What kind of necrosis was in the centre of a granuloma?:

    1. *Fibrinoid

    2. Zenker's

    3. Caseous

    4. Colliquative

    5. Fat

  13. The skin biopsy histological examination revealed granulomata consisting of macrophagal nodules with an admixture of lymphocytes and plasma cells. Besides, there were large macrophages with fat vacuoles containing causative agents of the disease packed in the form of balls (Virchow's cells). The granulation tissue was well vascularizeD. What disease is the described granuloma typical for?:

    1. *Leprosy

    2. Tuberculosis

    3. Syphilis

    4. Respiratory scleroma

    5. Glanders

  14. A histological examination of a skin biopsy revealed granulomata consisting of macrophages, lymphocytes and plasmacells; in the cytoplasm of large macrophages there were fat vacuoles and bacteria packed among themselves in the form of balls or freely located among the cells. Name the disease which the described granuloma corresponds to.:

    1. Scleroma

    2. *Leprosy

    3. Tuberculosis

    4. Glanders

    5. Syphilis

  15. A large aggregate of epithelioid cells is seen in a microscopic section of an ovary removed at surgery. Your diagnosis is:

    1. Granulation tissue

    2. Pyogenic granuloma

    3. Granulosa cell tumor

    4. Granulocytosis

    5. *Granuloma

  16. A male was treated for purulent otitis. On the 9th day of his staying at an inpatient department he died from a brain edema. On autopsy, the temporal region of the left hemisphere revealed a cavity with uneven rough inner edges which was filled with some yellowish-greenish thick dull fluid. The outer wall of the cavity was represented with the cerebral tissue. What pathological process was it?:

    1. *Acute abscess

    2. Colliquative necrosis

    3. Phlegmon

    4. Empyema

    5. Chronic abscess

  17. A microscopic examination of a biopsy taken from vegetations in the nasopharynx revealed some granulation and fibrous tissue with phenomena of sclerosis and hyalinosis, as well as a cluster of plasma, epithelial, lymphoid cells and macrophages, among which there were a lot of "hyaline balls". The light cytoplasm of macrophages revealed Volkovizc-Frisch bacilli. Name the kind of granuloma.:

    1. Foreign-body

    2. Lepromatous

    3. Tuberculous

    4. Syphilitic

    5. *Scleromatous

  18. A microscopic examination of the aorta in a male, who died from a rupture of its aneurysm, revealed in the medial coat of the aorta some foci of destruction of elastic fibres and an inflammatory infiltrate consisting of lymphoid and plasmacells around the "vasa vasorum". Which of the diagnoses listed below was the most probable?:

    1. Tuberculosis

    2. Atherosclerosis

    3. *Syphilis

    4. Leprosy

    5. Rheumatism

  19. A microscopic examination of the myocardium in a male, who died from cardiac decompensation, revealed sclerosis of the perivascular connective tissue and its diffuse infiltration by lymphocytes, macrophages, plasmacytes and solitary neutrophils. Which of the listed kinds of inflammation was the most probable?:

    1. * Interstitial productive

    2. Granulomatous productive

    3. Alterative

    4. Exudative diffuse

    5. Exudative focal

  20. A 6-year-old girl fell ill with diphtheria and three days later died of asphyxia resulting from membranous croup. On autopsy, the mucous membranes of the larynx, trachea and bronchi were thickened, oedematous and covered with greyish films which were easily separated. What kind of inflammation did the morphological changes in the larynx indicate?

    1. Serous

    2. Haemorrhagic

    3. Diphtheritic

    4. *Catarrhal

    5. Croupous

  21. A microscopic examination of the thymus revealed a reduced volume of the lobules, petrification of the thymus corpuscles, a substitutive vegetation of the connective and fat tissues. The production of thymic hormones was significantly decreased. What kind of pathology of the gland was it?:

    1. *Atrophy

    2. Aplasia

    3. Agenesia

    4. Dysplasia

    5. Thymomegaly

  22. A histological examination of the lungs of a male, who suffered for many years from atopic bronchial asthma and died of asphyxia, revealed much mucus with an admixture of eosinophils in the lumens of the bronchioles and small bronchi, sclerosis of interalveolar septa, dilation of alveolar lumens. Which of the mechanisms in the development of a hypersensitivity reaction took place when a fit of asphyxia developed?:

    1. *Reaginic reaction

    2. Cytotoxic reaction

    3. Immunocomplex reaction

    4. Cytolysis owing to lymphocytes

    5. Granulomatosis

  23. A histological examination of a skin graft in a male patient, who underwent dermatoplasty revealed a diffuse lymphohistiocytic infiltration with an admixture of macrophages and neutrophils, an oedema and haemorrhages. Which of the diagnoses listed below was the most probable?:

    1. *Graft rejection reaction

    2. Delayed hypersensitivity reaction

    3. Immediate hypersensitivity reaction

    4. Interstitial inflammation

    5. Arthus phenomenon

  24. In a child, 48 hours after a tuberculin (Mantoux) test, a papule up to 10 cm in diameter formed at the place of an injection of tuberculin. What mechanism of hypersensitivity lay in the basis of the above changes? :

    1. *Cellular cytotoxicity

    2. Anaphylaxis

    3. Antibody-dependent cytotoxicity

    4. Immunocomplex cytotoxicity

    5. Granulomatosis

  25. An experimental animal received a subcutaneous dose of an antigen preceded by sensitization. At the place of the injection, some fibrinous inflammation developed with an alteration of the vascular walls, the main substance and fibrous structures of-the connective tissue in the form of a mucoid and fibrinoid swelling, a fibrinoid necrosis. Which of the diagnoses listed below was the most probable?:

    1. *Immediate hypersensitivity

    2. Delayed hypersensitivity

    3. Transplantation immunoreaction

    4. Normergy

    5. Granulomatosis

  26. In a 10-year-old child, eating of strawberries was followed by appearance of some disseminated monomorphous and severely itching urticaria (red blisters of the round and oval form), elevation of body temperature up to 37.8°C and a gastrointestinal disturbance. A blood analysis revealed eosinophilia. After taking of antihistamine agents the above manifestations were rapidly controlled. Which of the immunological mechanisms lay in the basis of this disease?:

    1. Granulomatosis

    2. *Anaphylactic reaction

    3. Antibody-dependent cytotoxic reaction

    4. Cellular cytotoxicity

    5. Immunocomplex mechanism

  27. An examination of a pregnant woman with a rhesus-negative group of blood revealed a high level of antierythrocyte antibodies; in order to decrease it, a skin flap of her rhesus-positive husband was grafted to her. Two weeks later the flap was rejected; its microscopic examination revealed disturbances of circulation, an edema, a cellular infiltration mostly by lymphocytes, neutrophils and macrophages. Which of the pathological processes listed below was the most probable?:

    1. *Transplantation immunity

    2. Immediate hypersensitivity

    3. Delayed hypersensitivity

    4. Granulomatous inflammation

    5. Interstitial inflammation

  28. An autopsy of a 23-year-old female, who died from puerperal sepsis, revealed an enlarged plethoric spleen whose section gave an abundant scrapE. Microscopically, hyperplasia and a plasmacytic infiltration of both the red pulp and splenic follicles were found out; the red pulp was rich in macrophages. Which of the immunopathological mechanisms most probably lay in the basis of the changes in the spleen?:

    1. *Antigenic stimulation of the organism

    2. Hereditary insufficiency of the peripheral lymphoid tissue

    3. Immediate hypersensitivity reaction

    4. Delayed hypersensitivity reaction

    5. Autoimmunization

  29. An autopsy of a 43-year-old female, who suffered from attacks of expiratory dyspnoea during her life-time and died from asphyxia, revealed some dense glass-like mucus in the lumens of the bronchi, their walls were thick, the lungs had foci of an emphysema and atelectases. A histological examination of the pulmonary tissue revealed some mucus with an admixture of eosinophils in the lumens of small bronchi, sclerosis of the peribronchial connective tissue and interalveolar septa, dilation of the lumens in the alveoli. What mechanism of hypersensitivity formed the basis for the development of asphyxia?:

    1. Immunocomplex reaction

    2. Cytotoxic reaction

    3. * Reaginic reaction

    4. Cytolysis owing to lymphocytes

    5. Granulomatosis

  30. A 16-year-old youth developed edema of his face, oliguria and an increased blood pressure 20 days after he recovered from scarlet fever. A urinalysis revealed an increase of relative density, haematuria, proteinuriA. On microscopic examination of a renal biopsy, a picture of intracapillary proliferative glomerulonephritis was found out, while an electron microscopy revealed deposits on the basal membranes. Which of the mechanisms listed below lay in the basis of this disease?:

    1. Granulomatosis

    2. Anaphylactic reaction

    3. Antibody-dependent cytotoxic reaction

    4. Cell-dependent cytolysis

    5. *Immunocomplex mechanism

  31. A 23-year-old male patient developed the urinary syndrome (haematuria, proteinuria, leukocyturia) after having anginA. A puncture biopsy of the kidneys revealed a picture of intracapillary proliferative glomerulonephritis, while on electron microscopy some large subepithelial deposits were found out. What was the pathogenesis of this disease?:

    1. *Immunocomplex mechanism

    2. Anaphylactic reaction

    3. Antibody-dependent cytotoxic reaction

    4. Cell-dependent cytolysis

    5. Granulomatosis

  32. A 74-year-old male died from chronic heart failure. On autopsy, an old postinfarction scar was found in the heart. A histological examination revealed a focus of fibrosis and hypertrophy of cardiomyocytes. What regeneration do the described changes manifest?

    1. Pathological

    2. Physiological

    3. *Substitution

    4. Restitution

    5. Intracellular

  33. A biopsy of a bronchus of a 50-year-old male patient, who suffered from chronic bronchitis for 20 years, revealed foci of substitution of the stratified squamous epithelium for the columnar one. Which of the pathological processes listed below took place?

    1. Hyperplasia

    2. * Metaplasia

    3. Heterotopia

    4. Heteroplasia

    5. Dysplasia

  34. A histological examination of a scrape from the mucous membrane of the uterus was made in a 50-year-old female patient who complained of a disorder in the ovariomenstrual cycle manifested by irregular significant haemorrhages. A cystoglandular hyperplasia of the endometrium was diagnosed. Name the kind of the pathological process in.the endometrium.

    1. *Neurohumoral hyperplasia

    2. Hypertrophic vegetation

    3. Vicarious hypertrophy

    4. Regenerative hypertrophy

    5. Vicarious hypertrophy

  35. A microscopic examination of a myocardium revealed postinfarction transmural cardiosclerosis surrounded by enlarged cardiomyocytes with large hyperchromatic nuclei rich in DNA. Which of the listed morphological processes in the cardiomyocytes was the most probable?

    1. Physiological regeneration

    2. Complete reparative regeneration

    3. *Regenerative hypertrophy

    4. Pathological regeneration

    5. Work hypertrophy

  36. A youth complains of thinning of the muscles and reduction in the volume of the shin that appeared after a fracture of the femur which did not heal for a long period of time and was not accompanied by any impairment of the nerves. What is the name for such an atrophy of muscles?

    1. Neurotic

    2. Caused by insufficient blood supply

    3. Atrophy owing to pressure

    4. *Dysfunctional

    5. Caused by physical factors

  37. An autopsy of a 23-year-old female, who died from puerperal sepsis, revealed an enlarged plethoric spleen whose section gave an abundant scrape. Microscopically, hyperplasia and a plasmacytic infiltration of both the red pulp and splenic follicles were found out; the red pulp was rich in macrophages. Which of the immunopathological mechanisms most probably lay in the basis of the changes in the spleen?

    1. *Antigenic stimulation of the organism

    2. Hereditary insufficiency of the peripheral lymphoid tissue

    3. Immediate hypersensitivity reaction

    4. Delayed hypersensitivity reaction

    5. Autoimmunization

  38. An autopsy of a 43-year-old female, who suffered from attacks of expiratory dyspnoea during her life-time and died from asphyxia, revealed some dense glass-like mucus in the lumens of the bronchi, their walls were thick, the lungs had foci of an emphysema and atelectases. A histological examination of the pulmonary tissue revealed some mucus with an admixture of eosinophils in the lumens of small bronchi, sclerosis of the peribronchial connective tissue and interalveolar septa, dilation of the lumens in the alveoli. What mechanism of hypersensitivity formed the basis for the development of asphyxia?

    1. Immunocomplex reaction

    2. Cytotoxic reaction

    3. *Reaginic reaction

    4. Cytolysis owing to lymphocytes

    5. Granulomatosis

  39. An autopsy of a 57-year-old male patient, who suffered from hypertensive disease and died of cardiac decompensation, revealed an enlarged heart with dilated cavities. Microscopically, the cardiomyocytes were significantly enlarged and had fatty degeneration with hyperchromatic barrel-like nuclei. Which of the listed morphological processes in the heart was the most probable?

    1. *Excentric hypertrophy

    2. Hypertrophic vegetations

    3. Brown atrophy

    4. Concentric hypertrophy

    5. Vicarious hypertrophy

  40. An X-ray film of a male patient, who underwent an operation of bone fragment repositioning after a fracture of his elbow bone with displacement, one month after the surgical intervention revealed a cartilaginous callus. Name the kind of regeneration of the bone tissue.

    1. * Secondary osseous consolidation

    2. Primary osseous consolidation

    3. Connective-tissue callosity

    4. Preceding callus

    5. Final callus

  41. As a result of falling down, a small abrasion formed of the knee of a child and some time later it epithelialized completely without formation of any scar. What form of regeneration took place in this case?

    1. Physiological

    2. Substitution

    3. * Restitution

    4. Pathological

    5. Intracellular

  42. Substance contained a large amount of plasma cells, the number of lymphocytes was reduced, there was an active proliferation of sinus cells and a significant macrophage response. Name the character of changes in the lymph node.

    1. Acute lymphadenitis

    2. Lymphoma

    3. *Antigenic stimulation of lymphoid tissue

    4. Lymphogranulomatosis

    5. Insufficiency of peripheral lymphoid tissue

  43. Ten years ago a male patient's right lung was removed because of a tumour, since then the capacity of his left lung has increased by 50 %. What process has developed in the left lung?

    1. * Vicarious hypertrophy

    2. Neurohumoral hypertrophy

    3. Vicarious hypertrophy

    4. Work hypertrophy

    5. Hypertrophic vegetations

  44. The deceased, aged 86, who suffered from cerebral arteriosclerosis, with autopsy revealed atrophy of the cerebral cortex. What's that about the cause atrophy?

    1. Neyrotrophic.

    2. From the pressure.

    3. Dysfunctional.

    4. *From the lack of blood supply

    5. From the action of physical and chemical factors.

  45. Name the mechanism lying in the basis of the pathogenesis of organ-specific autoimmune diseases.

    1. *Disturbance of the physiological isolation of organs and tissues to which there is no physiological tolerance

    2. Primary disturbance in the immunocompetent system

    3. Appearance of new nonshared antigens in the organism

    4. Disturbance in the control of immune homeostasis

    5. Atrophy of the lymphoid system

  46. A 65-year-old woman underwent removal of some tumour, 1.0 x 1.0 x 0.8 cm in size, localized under the skin of her thigh. Macroscopically, the tumour had a connective-tissue capsule and was represented on section with a yellowish lobate tissue. Microscopically, there were large cells, which had the sudanophilic cytoplasm and formed lobules separated with connective-tissue layers. Name this tumour.

    1. Hibernoma

    2. *Lipoma

    3. Liposarcoma

    4. Fibroma

    5. Desmoid

  47. An autopsy of a female who died from cachexia, revealed some massive exophytic carcinoma on the lesser curvature of the stomach with metastases to the ovaries. What kind of metastatic spreading took place?

    1. Haematogenous

    2. Lymphogenous orthograde

    3. *Lymphogenous retrograde

    4. Implantation

    5. Perineural

  48. For a histological examination, an eyeball was sent; some black tumour, 1 x 0.4 cm in size, was revealed in its vascular membrane. Microscopically, the tumour consisted of large polymorphous cells grouped in alveolar structures. The cytoplasm of the cells contained some brown pigment. What is your diagnosis?

    1. *Melanoma

    2. Neurilemmoma

    3. Angiosarcoma

    4. Neuroblastoma

    5. Ganglioneuroblastoma

  1. A histological examination of a thyroid gland revealed small cysts, which were lined with atypical epithelium and filled with papillae, the latter originating from the walls of the cysts and growing into their capsules. Name the tumour.

    1. Papillary adenoma

    2. Follicular carcinoma

    3. *Papillary carcinoma

    4. Solid carcinoma

    5. Carcinoma simplex

  2. Covered with a wide layer of the stratified squamous epithelium having proliferation of atypical cells with pathological mitoses, but the basal membrane of the epithelium was not affected. What is your diagnosis?

    1. Nonkeratinizing squamous cell carcinoma

    2. Keratinizing squamous cell carcinoma

    3. *Carcinoma in situ

    4. Leukoplakia

    5. Epithelial dysplasia

  3. A histological examination of the eyeball was made; some black tumour, 1 x 0.4 cm in size, was revealed in its vascular membrane. Microscopically, the tumour consists of large polymorphous cells grouped in alveolar structures. The cytoplasm of the cells contains some brown pigment. What is your diagnosis?

    1. *Melanoma

    2. Neurilemmoma

    3. Angiosarcoma

    4. Neuroblastoma

    5. Ganglioneuroblastoma

  4. A man underwent surgical removal of a black tumour, 2 cm in diamete, from the skin of his thigh. Microscopically, the tumour consisted of polymorphous cells, the cytoplasm of most of them includs some brown pigment (with a positive reaction to DOPA). A large number of pathological mitoses was registered. Which of the tumours listed below was the most probable?

    1. Carcinoma

    2. Sarcoma

    3. Carcinosarcoma

    4. *Melanoma

    5. Nevus

  5. A microscopic examination of a biopsy from a deformed mucous membrane of a lobar bronchus of a 45-year-old man, who smoked for many years, revealed a carcinoma consisting of atypical epithelial cells with hyperchromatic nuclei and numerous pathological mitoses. The growth of the tumour did not spread to the basal membrane of the epithelium. Name the histological form of carcinoma.

    1. Squamous cell carcinoma

    2. Adenocarcinoma

    3. *Carcinoma in situ

    4. Solid carcinoma

    5. Small-cell carcinoma

  6. A microscopic examination of a biopsy from a uterine cervix: it consists of the stratified squamous epithelium, characterized by cellular and nuclear atypism, pathological mitoses, there exist keratin pearls in the depth of the epithelial layers. What is your diagnosis?

    1. Transitional cell carcinoma

    2. Nonkeratinizing squamous cell carcinoma

    3. *Keratinizing squamous cell carcinoma

    4. Adenocarcinoma

    5. Solid carcinoma

  7. An autopsy of a woman, who died from renal insufficiency, revealed in her spinal column, cranial bones and ribs some defects of the osseous tissue with tumour nodes on their margins. The kidneys were enlarged, dense and "greasy" on section. Microscopically, the tumour nodes and bone marrow were characterized by a proliferation of tumour cells of the plasmacytic line. Which of the diseases listed below corresponds to the description?

    1. Metastasis of pulmonary carcinoma into bones

    2. Osteosarcoma

    3. *Multiple myeloma

    4. Osteoporosis

    5. Osteomyelitis

  8. On bronchoscopy in the initial part of the upper lobe bronchus of the right lung some polyp-like formation, 1.0 cm in diameter, with a superficial ulcer was found. A histological examination revealed a tumour consisting of lymphocyte-like cells with hyperchromatic nuclei; the cells grew in layers and bands. Indicate the most probable tumour.

    1. *Undifferentiated small-cell carcinoma

    2. Undifferentiated large-cell carcinoma

    3. Squamous cell carcinoma

    4. Adenocarcinoma

    5. Glandular squamous cell carcinoma

  9. On bronchoscopy an exophytic tumour was found. It was localized in the bronchus and significantly narrowed its lumen. Histologically, the tumour consisted of complexes of polymorphous epithelial cells with hyperchromatic nuclei and pathological mitoses. Among the tumour cells there were eosinophilic concentric structures. Make a diagnosis of the tumour.

    1. Nonkeratinizing squamous cell carcinoma

    2. *Keratinizing squamous cell carcinoma

    3. Large-cell carcinoma

    4. Small-cell carcinoma

    5. Adenoacanthoma

  10. A histological examination of a biopsy from a uterine cervix revealed that its tissue was covered with a wide layer of the stratified squamous epithelium having proliferation of atypical cells with pathological mitoses, but the basal membrane of the epithelium was not affected. What is your diagnosis?

    1. Nonkeratinizing squamous cell carcinoma

    2. Keratinizing squamous cell carcinoma

    3. *Carcinoma in situ

    4. Leukoplakia

    5. Epithelial dysplasia

  11. A histological examination of some spherical neoplasm located under the surface of the skin, revealed papilliform vegetations of the epithelium with phenomena of acanthosis and hyperkeratinization. The tumour stroma consisted of a large amount of the connective tissue and vessels. What tumour took place?

    1. Keratoacanthoma

    2. *Papilloma

    3. Carcinoma in situ

    4. Keratinizing squamous cell carcinoma

    5. Nonkeratinizing squamous cell carcinoma

  12. A microscopic examination of a biopsy from a deformed mucous membrane of a lobar bronchus of a 45-year-old man, who smoked for many years, revealed a carcinoma consisting of atypical epithelial cells with hyperchromatic nuclei and numerous pathological mitoses. The growth of the tumour did not spread to the basal membrane of the epithelium. Name the histological form of carcinoma.

    1. Squamous cell carcinoma

    2. Adenocarcinoma

    3. *Carcinoma in situ

    4. Solid carcinoma

    5. Small-cell carcinoma

  13. A microscopic examination of a biopsy from a large intestine revealed some tumour made of the columnar epithelium which formed atypical glandular structures of various shapes and size. The epithelial cells were polymorphous and with hyperchromatic nuclei, there were pathological mitoses. What is your diagnosis?

    1. Basal cell carcinoma

    2. Solid carcinoma

    3. *Adenocarcinoma

    4. Mucinous carcinoma

    5. Carcinoma simplex

  14. A 65-year-old woman underwent removal of some tumour, 1.0 x 1.0 x 0.8 cm in size, localized under the skin of her thigh. Macroscopically, the tumour had a connective-tissue capsule and was represented on section with a yellowish lobate tissue. Microscopically, there were large cells, which had the sudanophilic cytoplasm and formed lobules separated with connective-tissue layers. Name this tumour.

    1. Hibernoma

    2. *Lipoma

    3. Liposarcoma

    4. Fibroma

    5. Desmoid

  15. A thick encapsulated node, 2.0 cm in diameter, was surgically removed from the mammary gland of a female patient. On section, the tissue of the node was white-pink and fibrous. Microscopically, the tumour consisted of glandular structures, which had no signs of cellular atypism and were compressed with a connective tissue vegetating around. In the tumour, the stroma prevailed over the glandular parenchyma. What is your diagnosis?

    1. Adenoma

    2. *Fibroadenoma

    3. Nonproliferative mastopathy

    4. Proliferative mastopathy

    5. Adenocarcinoma

  16. A male patient, who suffered from chronic bronchitis for a long period of time, revealed a pulmonary tumour, which was closely connected with the bronchial wall and grew in the form of a polyp. Microscopically, the tumour consisted of complexes of polymorphous epithelial cells with a large number of mitoses. Among the tumour cells there were stratified concentric oxyphilic structures. Name the histological type of the tumour.

    1. Mucinous carcinoma

    2. Solid carcinoma

    3. Nonkeratinizing squamous cell carcinoma

    4. Adenocarcinoma

    5. *Keratinizing squamous cell carcinoma

  17. On examination of a 6-year-old child with a tumour on the femoral diaphysis, several metastatic foci of another osseous localization were found. A histological examination of the primary tumour revealed that it consisted of some round cells, which had scanty cytoplasm, were characterized by an insignificant tendency to formation of pseudorosettes, and manifested themselves with solitary mitoses. What is your diagnosis?

    1. Plasmacytoma

    2. Chondroma

    3. *Ewing's sarcoma

    4. Osteosarcoma

    5. Fibrosarcoma

  18. A tumour was found in the locus of a pathological fracture of a rib in a male patient. The case history contained information about persistent proteinuria with presence of abnormal proteins of Bence-Jones type, as well as presence of osteolytic foci in the bones of the spine, skull and pelvis. Histologically, the tumour cells were represented by plasmablasts and plasmacytes. What is your diagnosis?

    1. Primary macroglobulinaemia

    2. Heavy-chain disease

    3. Osteosarcoma

    4. *Multiple myeloma

    5. Fibrosarcoma

  19. A 40-year-old male patient underwent removal of a tumour, 2 cm in diameter, which was localized in the region of the cerebellopontine angle of the brain stem and tended to grow into the auditory meatus. Histologically, the tumour consisted of spindle cells with rod-shaped nuclei; the tumour cells and fibres formed rhythmic structures. Name the kind of the tumour.

    1. Medulloblastoma

    2. Meningioma

    3. *Schwannoma

    4. Oligodendroglioma

    5. Astrocytoma

  20. A 6-year-old boy underwent removal of a tumour localized along the median line of the cerebellum. Histologically, the tumour consisted of the cells which had a poor crown of the cytoplasm, a hyperchromatic nucleus, demonstrated a mitotic activity and tended to form "rosettes". What is your diagnosis?

    1. Astrocytoma

    2. *Medulloblastoma

    3. Oligodendroglioma

    4. Multiform spongioblastoma

    5. Bipolar spongioblastoma

  21. An autopsy of a male, who died from chronic renal insufficiency, revealed numerous nodes with soft elastic consistency in the ribs, bones of the vault of the skull and the breastbone. The osseous substance was decalcified according to the nodes. The kidneys were enlarged, light grey, dense, their section had some greasy lustre. What is your diagnosis?

    1. Primary amyloid nephropathy

    2. Parathyroid osteodystrophy

    3. *Multiple myeloma

    4. Osteoma

    5. Osteosarcoma

  22. Some tumour, which was mobile and clearly delimited from the surrounding tissues, was revealed in the skin. On section, the tumour tissue was white and fibrous. Microscopically, the tumour consisted of chaotically interlaced collagenous fibres and a small number of connective tissue cells. Name the tumour.

    1. Soft fibroma

    2. *Hard fibroma

    3. Histiocytoma

    4. Dermatofibroma

    5. Desmoid

  23. A male underwent surgical removal of a black tumour, 2 cm in diamete, from the skin of his thigh. Microscopically, the tumour consisted of polymorphous cells, the cytoplasm of most of them having some brown pigment (with a positive reaction to DOPA). A large number of pathological mitoses was registered. Which of the tumours listed below was the most probable?

    1. Carcinoma

    2. Sarcoma

    3. Carcinosarcoma

    4. *Melanoma

    5. Nevus

  24. An autopsy of a male, who suffered from frequent fractures of his bones and died from uraemia, revealed phenomena of osteoporosis and multiple smooth-walled defects (as if produced by punching) in the bones of the skull, ribs and spine. A microscopic examination of the bone marrow revealed its diffuse infiltration by tumour cells of the lymphoplasmacytic line. Which of the diagnoses listed below was the most probable?

    1. *Multiple myeloma

    2. Primary macroglobulinaemia

    3. Heavy-chain disease

    4. Paget's disease

    5. Recklinghausen's disease

  25. A 16-year-old boy underwent removal of a nevus, 0.3 cm in diameter, on the skin of his face. Microscopically, a nest-like cluster of cells with some brown pigment in the cytoplasm was found between the epidermis and derma. What kind of nevus took place?

    1. Juvenile

    2. *Intradermal

    3. Junction

    4. Mixed

    5. Blue

  26. An enlarged dense tuberous prostate has been sent for a histological examination. On section, there were tumour nodes, 1-2 cm in diameter, surrounded by connective-tissue layers. Microscopically, against a background of fibrosis there were glandular complexes with atypical epithelial cells, hyperchromatic nuclei and pathological mitoses. Which of the tumours listed below was the most probable?

    1. *Adenocarcinoma

    2. Solid carcinoma

    3. Adenoma

    4. Fibroma

    5. Fibrosarcoma

  27. A thick node without any clear borders, about 10 cm in diameter, is contoured on the outer surface of a thigh. Microscopically, the tumour consists of immature fibroblast-like cells with pathological mitoses and collagenous fibres. The tumour cells grow among the muscular fibres. Indicate the diagnosis which was the most probable one of those listed below.

    1. Malignant histiocytoma

    2. Hard fibroma

    3. Soft fibroma

    4. Dermatofibroma

    5. *Fibrosarcoma

  28. A tumour removed from the white matter of the right hemisphere of the brain is some soft "motley" node, 4 cm in diameter, without any clear borders with the substance of the brain. Microscopically, the tumour consists of polymorphous cells with numerous pathological mitoses, and it also reveals foci of necrosis and haemorrhages which occurred at different time. Name the tumour.

    1. Oligodendroglioma

    2. Oligodendroglioblastoma

    3. Astrocytoma

    4. Astroblastoma

    5. *Glioblastoma

  29. A newborn baby has some red-blue flattened tumor, 5 x 4 x 0.3 cm in size, in a capsule on the skin of its face. Microscopically, the tumour consists of large thin-walled vascular cavities which have an endothelial lining and are filled with blood. Name the tumour.

    1. Venous haemangioma

    2. *Cavernous haemangioma

    3. Capillary haemangioma

    4. Hemangiopericytoma

    5. Lymphangioma

  30. On bronchoscopy in the initial part of the upper lobe bronchus of the right lung some polyp-like formation, 1.0 cm in diameter, with a superficial ulcer was found. A histological examination revealed a tumour consisting of lymphocyte-like cells with hyperchromatic nuclei; the cells grew in layers and bands. Indicate the most probable tumour.

    1. *Undifferentiated small-cell carcinoma

    2. Undifferentiated large-cell carcinoma

    3. Squamous cell carcinoma

    4. Adenocarcinoma

    5. Glandular squamous cell carcinoma

  31. An autopsy of a female who died from cachexia, revealed some massive exophytic carcinoma on the lesser curvature of the stomach with metastases to the ovaries. What kind of metastatic spreading took place?

    1. Haematogenous

    2. Lymphogenous orthograde

    3. *Lymphogenous retrograde

    4. Implantation

    5. Perineural

  32. A histological examination of a thyroid gland revealed small cysts, which were lined with atypical epithelium and filled with papillae, the latter originating from the walls of the cysts and growing into their capsules. Name the tumour.

    1. Papillary adenoma

    2. Follicular carcinoma

    3. *Papillary carcinoma

    4. Solid carcinoma

    5. Carcinoma simplex

  33. A 47-year-old woman underwent radical mastectomy for a neoplasm. A histological examination of the mammary gland revealed an eczematous lesion of the nipple and areola, a cancerous lesion of the ducts of the gland and presence of large light cells in the epidermis of the nipple and areola. Make a diagnosis.

    1. Intralobular carcinoma in situ

    2. Acneiform carcinoma

    3. Papillary carcinoma

    4. Fibrous carcinoma

    5. *Paget's disease

  34. A histological express examination of a tumour node of a mammary gland revealed some encapsulated formation with proliferation of alveoli and intralobular ducts; the interstitial connective tissue grew either around or inside the ducts. Which of the tumours took place?

    1. Foliaceous tumour

    2. *Fibroadenoma

    3. Noninfiltrating intralobular carcinoma

    4. Infiltrating intralobular carcinoma

    5. Paget's disease

  35. During an operation on a woman, her cyst-like changed ovary was removed; it was a thin-walled cavity filled with some yellowish transparent fluid and having a smooth inner surface. Histologically, the cavity wall was lined with the cubical epithelium. Name the kind of the tumour.

    1. *Serous cystadenoma

    2. Mucinous cystadenoma

    3. Serous cystadenocarcinoma

    4. Pseudomucinous cystocarcinoma

    5. Granulosa cell tumour

  36. A histological examination of a biopsy from a uterine cervix revealed that its tissue was covered with a wide layer of the stratified squamous epithelium having foci of proliferation of atypical cells with pathological mitoses, but the basal membrane of the epithelium was not affected. What is your diagnosis?

    1. Nonkeratinizing squamous cell carcinoma

    2. Keratinizing squamous cell carcinoma

    3. *Carcinoma in situ

    4. Leukoplakia

    5. Epithelial dysplasia

  37. A histological examination of some spherical neoplasm located under the surface of the skin, revealed papilliform vegetations of the epithelium with phenomena of acanthosis and hyperkeratinization. The tumour stroma consisted of a large amount of the connective tissue and vessels. What tumour took place?

    1. Keratoacanthoma

    2. *Papilloma

    3. Carcinoma in situ D

    4. Keratinizing squamous cell carcinoma

    5. Nonkeratinizing squamous cell carcinoma

  38. A 26-year-old male patient underwent surgical removal of a tumour, 4 x 5 cm in size, which was surrounded by a capsule and located in the white matter of his brain. Microscopically, the tumour consisted of the stellate and glia cells having various size and located among the glial fibres. Name the tumour.

    1. Oligodendroglioma

    2. Astrocytoma

    3. *Astroblastoma

    4. Glioblastoma

    5. Ependymoma

  39. A 45-year-old male underwent surgical removal of a tumour, 4 x 3 cm in size, from the lateral ventricle of his brain; the tumour surface had small papillae, and it was connected with a vascular plexus. Microscopically, the tumour consisted of villus-like vegetations covered with epithelial cells of the cubical and columnar shape and the monomorphous kind. Which of the tumours listed below was the most probable?

    1. Ependymoma

    2. Ependymoblastoma

    3. *Choriopapilloma

    4. Choriocarcinoma

    5. Glioblastoma

  40. An encapsulated tumour, 2 cm in diameter, surgically removed from an amputation stump of a lower extremity, microscopically consists of spindle cells of the monomorphous kind with rod-shaped nuclei which form "fence-like" structures together with fibres. Which of the tumours listed below is the most probable?

    1. *Benign neurolemmoma

    2. Neurofibroma

    3. Malignant neurilemmoma

    4. Soft fibroma

    5. Fibrosarcoma

  41. On supersonic examination of a 48-year-old male patient, a hepatic neoplasm was diagnosed and a puncture biopsy was made. Microscopically, the tumour consisted of atypical hepatocytes which formed trabeculae, acini or tubules. The tumour stroma was poor and had thin-walled blood vessels. Which of the kinds of tumours listed below was the most probable?

    1. Hepatocellular adenoma

    2. *Hepatocellular carcinoma

    3. Metastasis of adenocarcinoma

    4. Cholangiocellular carcinoma

    5. Solid carcinoma

  42. For a histological examination, a vermiform process (appendix) was sent. Its size is increased, the serous membrane is dim, plethoric and covered with greyish films, the wall is thickened and some pus is discharged from the lumen. Microscopically, a plethora of the vessels, an oedema of all the layers and their diffuse infiltration by leukocytes are observed. Name the kind of inflammation in the vermiform process.:

    1. *Phlegmonous

    2. Catarrhal

    3. Putrid

    4. Mixed

    5. Fibrinous

  1. An operation on 70-year-old female patient with a clinical picture of peritonitis revealed that about 80 cm of her ileum were black, the peritoneum of the intestine was dim and covered with a fibrinous film, the lumen of the superior mesenteric artery was occluded with some brown dry masses which easily crumbled and were fastened to the vascular wall. What process developed in the intestine?

    1. Bedsore

    2. Infarct

    3. Sequester

    4. *Gangrene

    5. Coagulation necrosis

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