Англійські тести (Патоморфологія, 2 частина)

A 29 years old patient with a diagnosis of the right thigh fracture with multiple debris: on the 3rd day started complaining about the pain in the chest cavity to the right and the shortness of breath. A day later, due to progressive heart and lung failure, death occurred. Histological examination in the blood vessels of the lungs and brain revealed Sudanophilic droplets of orange color, which completely closed the lumen of the vessels of the microcirculatory bed. What complication is the death of the patient connected with?

A 28-year-old patient had been diagnosed with multifragmental fracture of the right hip. On the third day after the injury he began to complain of pain in the right side of chest, difficult respiration. A day later the patient died of progressive heart and respiratory failure. Histological study of pulmonary and cerebral blood vessels revealed orange sudanophilic droplets that completely obstructed the vessels of microvasculature. What complication caused the death of the patient?

At the autopsy in the right pleural cavity, 0.5 l of yellowish clear fluid with the presence of white loose lumps was found. The parietal and visceral pleura are covered with a white loose bloom. What kind of exudative inflammation is it?

In the autopsy of a deceased patient with chronic renal failure, gray-yellow, tightly joined layers are found colon mucosa, which are separated by the formation of ulcers. Specify the type of inflammation.

A 55-year-old man has chronic glomerulonephritis for a long time. He died of chronic renal failure. At the autopsy urine odor was marked. On the surface of the epicardium and pericardium, grayish-whiteish villous films are found, after removal of which blood overvoluming vessels are clearly visible. What pathological process took place in the pericardium? 

A 65-year-old man was in an ENT unit for purulent, recurrent otitis media. On the 9th day he died of cerebral edema with the involvement of the cerebellar tonsils into a large occipital opening. An autopsy revealed a circular, nonstructured area in the temporal region of the left hemisphere, which is a cavity with uneven, rough edges, filled with a turbid creamy yellowish-green liquid. The cavity walls are lined with brain tissue. What pathological process is evidenced by the described morphological changes in brain tissue? 

A patient of 67 years had a severe form of influenza (a strain of influenza virus A2) with a fatal outcome. At the autopsy, the changes in the lungs were similar to the changes in the "large variegated lungs". Microscopic examination revealed: plethora of blood vessels, hemorrhages, pulmonary edema, bronchial lumen and alveoli exudate, containing mainly erythrocytes. What is the nature of pneumonia in these morphological features? 

A 7-year-old child suffers from acute disease. A pediatrician observed the following during examination: pharynx mucosa is hyperemic, edematous, swollen, cowered with large amount of mucus. Buccal mucosa has whitish discoloured spots. On the next day the child came out in rash with large spots covering the skin of his face, neck and torso. What kind of inflammation causes changes in pharynx mucosa?

Autopsy of a 58-year-old man, who had been suffering from theumatic heart disease and died of cardiopulmonary decompensation, revealed gray diffuse film-andfiber-shaped coatinginhispericardium. What type of inflammation is characteristic of this pericarditis?

The autopsy of the body of a man, who suffered from toxic diphtheria and died on the 9th day from the onset of disease with signs of cardiac decompensation, has revealed the following: dilated cardiac cavities, dull flaccid myocardium, myocardial section is variegated. Microscopy revealed fattydegeneration ofcardiachystiocytes, large foci of myocytolysis, stromal edema with scant lymphocytic and macrophageal infiltration. Specify the type of myocarditis in this case:

Autopsy of a 72-year-old man with recurrent transmural myocardial infarction revealed his epicardium and pericardium membranes to be swollen, thickened, coarce, as if coveredin hair. Name the type of inflammation that occurred in the cardiac membranes: 

In microscopic examination of tissue excised from postoperative infiltrate around the suture, granulomas with giant multinucleated cells were found. What kind of granules do they belong to?

In microscopic examination of biopsy specimen taken from growths in the nasopharynx, granulation and fibrous connective tissue with the phenomena of sclerosis and hyalinosis, as well as clusters of plasmatic, epithelioid, lymphoid cells and macrophages, among which macrophages were found. In the bright cytoplasm of macrophages, Volkovich-Frisch sticks are detected. Name the type of granuloma.

In a microscopic examination, the removed lymph node in a patient with suspected tuberculosis, found granulomas, in the center of which is the focus of easeous necrosis, further shafts of epithelioid and lymphoid cells, between which are found giant cells with giant cells. Name the giant cells by the author.

Woman suffering from chronic gonorrhea has papillary growths of whitish color resembling cauliflower, on the border of the mucous membrane of the vulva with the skin. In microscopic examination: growth of multilayered flat epithelium and underlying stroma with diffuse lympho-plasmacytic infiltration. Specify which of the following pathological processes is most likely observed?

Microscopic examination of the kidney biopsy revealed foci at the center of which are granular eosinophilic masses, surrounded by infiltrate from lymphocytes, epithelioid cells and single cells of Pirogov- Langhans. Select the pathological process that most closely matches the changes described. 

The autopsy of 75 years old patient who suffered from adenoma of prostate and died from renal failure, revealed the expanded bladder with a thickened wall. In the kidneys atrophy of the parenchyma with its transformation into a thin-walled bladder filled with urine, Which of the following processes is the most common?

In microscopic examination of the heart, an extensive focus of cardiosclerosis was found around which cardiomyocytes were enlarged with large hyperchromic nuclei enriched in DNA. Which of the following processes is most common in cardiomyocytes?

A 86-year-old woman, who suffered from atherosclerosis of the cerebral vessels, was found to have brain atrophy at the autopsy. What is the name of this atrophy regarding the cause?

The patient, who was smoking tobacco for a long time, had a cough with the allocation of viscous mucus, weakness after slight physical exertion, pallor of the skin, and lost 12.0 kg of weight in 2 month. In the endoscopic examination of the biopsy, the diagnosis is squamous cell carcinoma. Determine the nature of the pathological process that preceded the onset of the tumor.

As a result of a traffic accident, patient B, 36 years old, received an open fracture of the bones of the shin. In the process of fusion at the site of the fracture, excessive bone marrow was formed. What kind of regeneration should include the formation of excess bone marrow?

After the fall the baby got a fracture of one of the bones of the forearm, after a while there was healing Name the regeneration form and cells that participated in this:

After the fall of the baby a small saddle on the knee was formed, and after a while was completely epithelialized. What form of regeneration took place in this case?

During a surgery of 4 years old girl it was revealed that the right kidney was 1/3 smaller than the left one. The diameter of the right renal artery is 0.3 mm, the left one is 0.4 mm. What pathological process is involved in this case?

The person with anterior pituitary tumor develops hypertrophy of the adrenal cortex, as a result of increased production of corticotropin. What is this type of hypertrophy?

A patient with an amputated lower extremity had painful nodules in the cult. Microscopic examination revealed amputation neuromas. What kind of pathological processes are these entities?

Microscopy of an extracted tooth has revealed the following: odontoblasts and pulpocytes are decreased in size and number; thickened connective fibers of the pulp are stretched between the cells that remain. What general pathological process is likely to be occurring in the tooth pulp?

On autopsy of a 69-year-old woman, who for a long time had been suffering from hypertension, the pathologist determined that both of her kidneys are dense, markedly diminished, with finegrained surface. These changes are indicative of:

A patient has deep lacerated wound with uneven edges. The wound is suppurating; its edges present with moist granulation tissue that does not protrude above the wound level. Name the type of wound healing:

At intraoperative biopsy of a mammary gland the signs of tissue atypism are revealed, which are expressed in disruption of the relation of parenchyma and stroma with the prevalence of stroma, different sizes and forms of glandular structures, laid by a single-layer proliferating epithelium. Your diagnosis:

In histological examination of the uterine mucosa, the growth of glandular structures, consisting of atypical epithelial cells, with hyperchromic nuclei and pathological mitoses that grow into the thickness of the uterine wall, was revealed. Your diagnosis:

A woman, 6 months after delivery, has developed uterine bleeding, Gynecological examination revealed a dark red tissue with multiple cavities resembling a sponge in the uterine cavity. During microscopic examination of the tumor, atypical bright Langhans epithelial cells and giant syncytiotrophoblast cells were detected in blood lacunae. What is a tumor?

A patient with long-term smoking and suffering from chronic bronchitis has a lung tumor detected. During the operation, the tumor was found to be closely related to the bronchial wall and to grow as a polyp. Microscopically, groups of polymorphic epithelial cells have been identified, mitoses, among which scaly oxyphilic non-nuclear structures occur. Name the histological type of tumor.

In a patient with hoarseness, laryngoscopy revealed a laryngeal tumor, gray-white, with a papillary surface Microscopic: the growth of connective tissue covered with multilayered flat epithelium with increased keratinization, without cell atypism. Most likely this is:

In a woman of 37 years objectively: the nipple and the areola of the breast are swollen, pasty, look like a "lemon peel". Breast enlarged in size, compacted. In the bioptate, solid layers, formed from spherical cells with polymorphic nuclei, with a large number of pathological mitoses are detected. The stroma is very scanty, with lymphocytic infiltration. Make a diagnosis.

The tumor consists of ring-shaped cells in which the nucleus is displaced to the periphery, sharply thinned, pyenotic, cytoplasm pushed to the periphery in the form of a narrow rim and surrounds a large mucus vacuole. What is the property of tumor growth thal such cell structure reflect?

A man 63 years old, suffering from esophageal cancer, metastases found in the lymph nodes of the mediastinum, cancer cachexia. What is the pathogenetic stage of the tumor process in a man? 

Female 67 years old suffering from gastric cancer with liver metastases. What property of tumor cells determines their ability to metastasize?

A removed kidney with a node of 5 cm in diameter, quite clearly separated from the surrounding tissues, with hemorrhage. In histological examination of the node site, it consists of cells with a large rim of vacuolated cytoplasm, small, mainly monomorphic nuclei, which form large complexes, strand cells. Choose the right diagnosis.

Examination of the oral mucosa revaled a small nodule with papillary surface. Histological examination revealed conjugate papillary proliferations of stratified squamous epithelium without cellular atypism and underlying stroma represented by thin-walled vessels and loose connective tissue. What formation has developed in a patient?

A dense, movable, clearly separated from the surrounding tissues tumor revealed in the skin. Oncut section it is white in color, represented by fibrous tissue. Microscopically chaotically interwoven collagen fibers, cells are few. Name the tumor.

The young woman had a tumor of the distal end of the femur that was growing rapidly. Microscopically: tumor with a varied appearance from white-gray to brownish-red in color, loose consistency. Microscopically: the main tissue component of the tumor is represented by bone and osteoid structures lined by atypical osteoblasts with pathological mitoses; many thin-walled vessels. What is the most likely diagnosis?

Microscopic examination of the tumor of the upper lip revealed that it is made of numerous slit-like cavities, the wall of which is lined with flattened endothelium, filled with liquid blood and clots. Make a diagnosis.

On the outer surface of the thigh palpable dense node without a clear border, with a diameter of about 10 cm. Microscopically: the tumor consists of immature fibroblast-like cells with pathological mitoses and collagen fibers. Tumor cells sprout between the muscle fibers. Your diagnosis.

A 75-year-old patient has been operated and a tumor measuring 16x8x6 cm was removed from retroperitoneal tissue. Microscopically: anaplastic fat cells with signs of cellular atypism, polymorphism. There are huge distorted cells that have fat droplets in the cytoplasm. The most likely diagnosis should be considered:

A rounded whitish-pink tumor node with diameter of 6 cm has been removed from uterine cavity. Microscopy revealed it to consist of chaotically arranged smooth musclefibers with large amount of stroma threaded with nerves and blood vessels. What diagnosis is most probable?

During the surgery of 40 years old patient, a tumor up to 2 cm in diameter, which was localized in the area of the cerebellar angle of the brain stem and tended to grow into the auditory canal, was removed. What is the most likely type of tumor?

Tumor in capsule, 2 cm in diameter, removed from amputation stump of lower extremity Microscopically consists of spindle-shaped cells of monomorphic appearance, with rod-like nuclei which form "palisade" structures together with the fibers. Specify which of the following types of tumors is most likely to occur.

A 40-year-old patient has a spherical brown formation on his back. Histologically: the accumulation of melanin-containing cells in the form of nests and strands, among which are giant multinucleated cell, in the dermis. Specify the most likely skin pathology.

A piece of tissue, taken from the edge of the ulcer of the left foot, which did not heal for a long time. was sent for histological examination. Microscopic examination of the tissue revealed the growth of polymorphic atypical cells, in the cytoplasm of which there is a yellow-brown pigment, histochemically giving a positive Argentafin reaction. There are numerous figures of mitoses and foci of necrosis. What is your diagnosis?

A 46-year-old man had a dark spot on his skin that protruded from the surface of the skin and did not disturb him. Over time, the spot began to increase, pain appeared, the color became black and brown and the ode began to be palpated. Histological examination of the removed tissue identified spindle-shaped and polymorphic cells, the cytoplasm of which contained a brown pigment. What is the tumor?

Histological examination of the enlarged lymph node revealed the proliferation of lymphocytes, histiocytes, reticular cells, eosinophilic leukocytes, small and large cells of Hodgkin, multinucleated Berezovsky - Sternberg cells. Which of the following diseases corresponds to the morphological data described?

At the autopsy of the deceased patient enlarged, soldered, dense, with white-yellow foci of necrosis oflymph nodes of different localization (cervical and mediastinal) were found. The spleen has a "porphyrial" appearance. Microscopic examination of lymph nodes and spleen revealed the proliferation of polymorphic cells with the presence of atypical cells, among which are noted the multinucleated giant cells of Rhode-Berezovsky-Sternberg. What was the disease in this case?

At the autopsy of a man who suffered from frequent bone fractures and died from uremia, in the bones of the skull, ribs and spine - the phenomena of osteoporosis and multiple smooth-walled, seemingly stamped defects, were revealed. Microscopic examination of the bone marrow revealed diffuse infiltration of its tumor cells by the lymphoplasmacytic row. Which of the following diagnoses is most likely to be?

A 62-year-old woman complains of frequent pain in the chest and spine, rib fractures. The doctor suggested myeloma (plasmacytoma). Which of the following laboratory parameters will have the greatest diagnostic value?

In the study of the corpse of a man who suffered from peptic ulcer of the stomach for many years, complicated by bleeding, pale skin and internal organs were found. In bone marrow of tubular bones, there are phenomena of regeneration with the conversion of fatty bone marrow to red, as well as the phenomena of fatty dystrophy in parenchymal organs.

Histological examination of a lymph node removed from the posterior triangle of neck of an 18-year-old patient revealed some cell agglomerations that included single multinuclear Reed-Sternberg cells, major Hodgkin's cells, minor Hodgkin's cells and many lymphocytes, single plasmatic cells, eosinophils. What is the most likely diagnosis?

A histologic study of a red bone marrow puncture sample had been conducted in the course of examination of a 35-year-old patient, and significant megakaryocyte number depletion was detected. What peripheral blood changes will result from that?