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THE RESPIRATORY SYSTEM DISEASES
1. An autopsy of the miner, who had worked in coal mine more of 10 years, revealed in a lung whitish fibrous fibers and nodules 0,2-0,3 cm in diameter. Histological investigation of nodules showed bundles of interacting concentric pink collagen with apparent hyalinosis. There was a minimal inflammatory reaction and also noticeable amount of a brownish dust. What is the most likely type of pneumoconiosis in this case?
А. *Silicosis
B. Talcosis
C. Asbestosis
D.Siderosis
E. Berylliosis
2. Histological investigations of the bronchus wall biopsy material, from the patient with a history of chronic bronchitis, revealed granulation tissue and diffuse inflammatory infiltrate. What kind of a bronchitis was diagnosed?
А. *Chronic polypous bronchitis
B. Chronic mucopurulent bronchitis
C. Chronic mucous bronchitis
D. Chronic purulent bronchitis
E. Chronic deforming bronchitis
3. A 72-year old female died of severe grippe. A post-mortem revealed “the big motley lungs”. Histological investigation showed acute hyperemia, hemorrhages, an edema of a pulmonary tissue, erythrocyte-rich exudate that filled the bronchi and alveoli. What is the most likely kind of pneumonia?
А. *Hemorrhagic bronchopneumonia
B. Catarrhal bronchopneumonia
C. Purulent bronchopneumonia
D. Desquamative bronchopneumonia
E. Fibrinous bronchopneumonia
4. A 52-year old female, with a history of the chronic glomerulonephritis and chronic renal failure, presented to the hospital with coughing spells accompanied by thick phlegm and breathlessness. Bronchoscopy revealed congested, edematous, bronchial mucus membrane with small hemorrhages. A bronchial lumen was narrowed by thick mucus. Name the process in bronchi?
А. *Secondary acute catarrhal bronchitis
B. Primary acute catarrhal bronchitis
C. Chronic catarrhal bronchitis
D. Destructive – ulcerous bronchitis
E. Catarrhal - purulent bronchitis
5. A 68-year old patient, with a history of the chronic inflammatory disease of lungs since his childhood, presented to the hospital with coughing accompanied by scanty sputum (expectoration). The complications of pulmonary and a heart failure resulted in his death. What changes in heart have been found at post-mortem?
А. *Right ventricular hypertrophy and dilatation
B. Left ventricular hypertrophy and dilatation
C. Ventricular hypertrophy
D. Ventricular dilatation
E. Heart without gross change
6. A female patient, with 10 years history of cough with a purulent sputum and dyspnea, died from respiratory and heart failure. A post-mortem gross investigation of a dead body revealed her fingers reminded drum sticks. A dissection of lugs showed a bronchial alteration with a saccular deformity and purulent inflammation. What is the most likely diagnosis?
А. *Bronchiectatic disease
B. Tuberculosis
C. Chronic bronchitis
D. Abscess
E. Acute bronchitis
7. A patient died in 3 weeks of the pneumonia onset. Macroscopic investigation of lungs revealed the whole of a left inferior lobe became enlarged, consolidated and airless. Grossly lungs got the appearance of a grayish brown, dry surface with fibrin fibers on the pleura. Histological investigation showed the collapsed and bloodless alveolar capillaries, the exudate within alveoli consisted mainly of neutrophil polymorphs. What is the most likely diagnosis?
А. * Croupous pneumonia
B. Focal bronchopneumonia
C .Influenzal pneumonia
D. Fibrinous pleuritis
E. Intestinal pneumonia
8. The biopsy is taken from a suspicious site at the mucous the right bronchus of a 58-year old male, with a history of the chronic bronchitis, pneumosclerosis and cardiopulmonary insufficiency. Histological investigation revealed cellular and tissue atypia, presence of a "cancer pearls” structures. What pathological process associated with histological changes listed below?
А. *Squamous cell keratinous carcinoma
B. Chronic polypous bronchitis
C. Bronchiectasis
D. Acute bronchitis
E. Squamous metaplasia of the bronchial epithelium
9. Histological investigation of a biopsy of a bronchus revealed a tumor which is constructed from clusters of atypical cells of a laminated (stratified) squamous epithelium, some areas with typical "pearls". What is the most likely diagnosis?
А. *Squamous cell keratinous carcinoma
B. Squamous cell nonkeratinous carcinoma
C. Solid carcinoma
D. Mucinous carcinoma
E. Scirrhous carcinoma
10. A 42-year old male, with a history of the amyloidosis, died of chronic renal failure. A post- mortem revealed in the lower lung lobe multiple dilated bronchi filled with abundant foul sputum. A gross investigation of a cut surface showed a honey-comb pattern of a lungs tissue. A microscopic study demonstrated the chronic inflammation within bronchial wall and also a replacement of elastic and muscular fibers by a connecting tissue. These changes in a lung are regarded as:
А. *Bronchiectasis
B. Bronchopneumonia
C. Chronic bronchitis
D. Chronic pneumonia
E. Abscesses of lungs
11. A 53-year old male, with a history of the chronic diffusive bronchitis, presented to the hospital symptoms of cardiopulmonary insufficiency, then resulted in the lethal outcome of the disease. An autopsy revealed increased volume and hyperinflation of lungs, which covered a mediastinum with their edges and keep their form when removed from the body and put at autopsy table. Gross investigation showed a pale grey colour of lungs and a crunch sound while making an incision of a pulmonal tissue. A pressing a finger on a lungs tissue creates a fossa. A mucopurulent exudate was determined within bronchi’s lumen. What is the most likely diagnosis?
А. *Chronic diffuse obstructive emphysema
B. Chronic focal emphysema
C. Intestinal emphysema
D. Primary idiopathic. emphysema
E. Vicarious compensatory emphysema
12. An autopsy of the 56-year-old man revealed increased pulmonary volume, pale grey color, soft texture lungs that kept their form when removed from the body and put at autopsy table. Gross investigation disclosed a crunch sound while making an incision of a pulmonal tissue. Histological investigation showed dilated alveolar ducts and alveoli, thinned interalveolar septas and capillary walls sclerosis. For what disease of lungs such morphological picture is characteristic?
А. *Emphysema
B Pneumosclerosis
C Pneumothorax
D. Atelectasis
E. Pneumonia
13. A patient presents to his physician a middle lobar bronchial obstruction with a node of intraluminal soft masses, resulted in the atelectasis of middle lobe of the right lung. A bronchoscopy revealed in the obturation zone a new growth of glandular type atypical epithelium with pathological mitosises which penetrated the wall of the bronchus and infiltrated along the peribronchial tissue and a cartilage. What is the most likely diagnosis?
А. *Bronchogenic carcinoma of lung
B. Deforming bronchitis
C. Inflammatory polyp
D. Dysplasia of bronchial epithelium
E. Bronchus sarcoma
14. Histological investigation of a lung’s biopsy revealed atypical cells which formed multiple acinar structures and produced mucus. What is the most likely histological diagnosis?
А.*High differentiated adenocarcinoma
B. Differentiated adenoarcinoma
C. Undifferentiated cancer
D. Differentiated squamous cell carcinoma
E. Glandular - squamous cell carcinoma?
15. A 56-year old male presented to hospital with symptoms of an acute staphylococcal pneumonia of the inferior lobe of the right lung resulted in cardiopulmonary insufficiency and lethal outcome of the disease. A post-mortem revealed within the inferior lobe of the right lung a roundish cavity, 5 cm in diameter containing pus and connected with bronchus. What complication of an acute pneumonia takes place in that case?
А. *Abscesses of lungs
B. Gangrene of lungs
C. Pulmonary thromboembolism
D. Bronchiectatic disease
E. Acute bronchitis
16. A 46-year old female died of croupous pneumonia. A post-mortem revealed turbid pleural effusions and visceral pleura membranous exudate formed by grey strands. What is the most likely kind of inflammation on pleura?
А. *Fibrinous
B. Catarrhal
C. Purulent
D Granulomatous
E. Hemorrhagic
17. A 48-year-old male with a long history of chronic bronchitis presents his physician a cough with a mucopurulent sputum (especially in the morning), dyspnea, and fingers deformity in a shape of the drum sticks. A pulmonal and heart insufficiency was also diagnosed. Make the preliminary diagnosis.
А. *Bronchiectatic disease
B. Bronchial asthma
C. Chronic bronchitis
D. Bronchopneumonia
E. Emphysema of lungs
18. A 48-year old male, with a history of common cold after acute cooling, presented to his physician with symptoms of lung a heart insufficiency. He died soon at the hospital. A post-mortem revealed the right lung enlarged, firm, hypoventilated, with a liver-like consistency and fibrin fibers on the pleura. On a cut section pulmonary tissue had a gray coloring and looked granular. A turbid liquid flowed down the surface. Histological investigation showed an acute inflammation with the exudate within alveoli consisted mainly of neutrophil polymorphs. What is the most likely diagnosis?
А. *Croupous pneumonia
B. Focal pneumonia
C. Intestinal interalveolar pneumonia
D. Staphylococcal pneumonia
E. Idiopathic fibrosing alveolitis
19. A 52-year old male presented to hospital with symptoms of acute pneumonia, complicated on the 6th day by pulmonary edema. The latter one resulted in the patient’s death. A post-mortem revealed the upper part of the right lung enlarged, firm, with fibrin fibers on the pleura. On a cut section pulmonary tissue had a gray coloring and looked granular. A turbid liquid flowed down the surface. Histological investigation showed the exudate within alveoli consisted of fibrin, neutrophil polymorphs, macrophages, and disintegrated red cells. What is the most likely diagnosis?
А. *Croupous pneumonia
B. Staphylococcal bronchopneumonia
C. Virus pneumonia
D. Hypostatic pneumonia
E. Adult respiratory distress syndrome
20. An autopsy of the middle age man with a long history of bronchiectasis revealed markedly enlarged adrenals volume at the expense of a cortical layer. Adrenals were pale, dense, and sebaceous. Microscopic investigation showed the unstructured, amorphous, eosinophilic, Congo red positive deposits by reticular stroma and within vessels walls. These changes indicate a development of:
А. *Amyloidosis
B. Mucoid swelling
C. Fibrinoid swelling
D. Lipidosis
E. Hyalinosis
21. A post-mortem revealed the left lung enlarged, firm, with fibrin fibers on the pleura. On a cut section pulmonary tissue had a gray coloring. A turbid liquid flowed down the surface. What is the most likely diagnosis?
А. *Croupous pneumonia
B. Focal pneumonia
C. Intestinal pneumonia
D. Cancer of lungs
E. Bronchiectatic disease
22. A 42-year old woman, with a history of common cold after acute cooling, presented to his physician with symptoms of cough, chest pain, fever, and difficulty in breathing. She died on the 5th day staying at the hospital.A post-mortem revealed the inferior lobe the right lung enlarged, firm, with membranous fibrin fibers on the pleura. On a cut section pulmonary tissue had a gray coloring and looked granular. What is the most likely diagnosis?
А. *Croupous pneumonia
B. Influenzal pneumonia
C. Bronchopneumonia
D. Caseous pneumonia
E. Measles pneumonia
23. Histological investigation of pulmonary segment, removed from a coal worker’s lung, revealed multiple roundish, nodules composed of concentric whorls of dense, hyaline fibers of collagen. What is the most likely disease?
А. *Silicosis
B. Tuberculosis
C. Bronchitis
D. Fibrosing alveolitis
E. Cancer of lungs
24. A 46-year old male, with a history of the chronic bronchiectasis, died from uremia. An autopsy revealed enlarged, firm kidneys, with sebaceous (waxy) cut surface. To what disease there correspond such changes?
А. *Amyloidosis of kidney
B. Glomerulonephritis
C. Acute tubular necrosis
D. Pyelonephritis
E. Arteriolosclerotic nephrosclerosis
25. A 54-year old male, with a history of destructive purulent bronchitis died of multiple organ failure. An autopsy revealed cardiomegaly, a sebaceous (waxy) kidney and a sago spleen. What process has complicated bronchitis?
А. *Secondary amyloidosis
B.Senile amyloidosis
C. Tumor-like amyloidosis
D. Primary amyloidosis
E. Generalized hyalinosis
26. An autopsy revealed the right lung enlarged, firm, with fibrin fibers on the pleura. On a cut section pulmonary tissue had a gray coloring. A turbid liquid flowed down the surface. What is the most likely diagnosis?
А. *Croupous pneumonia
B. Focal pneumonia
C. Intestinal pneumonia
D. Gangrene of lungs
E. Progressive diffuse interstitial lungs fibrosis
27. A 49-year-old patient had been working as a coal miner many years and died of a chronic pulmonary and cardiac insufficiency. A post-mortem revealed hypoinflated, firm, sclerotic, lungs with emphysematous apexes. Pleura had a grayish-black coloring. Gross investigation of the lungs sectional view also showed deep black coloring of the pulmonary tissue. What is the most likely disease resulted in patient’s death?
А. *Anthracosis
B. Silicosis
C. Talcosis
D. Asbestosis
E. Aluminosis
28. An autopsy of the 47-year-old man revealed within lungs areas of increased pulmonary volume, with some bullas, that bulged out from beneath the pleura. Histological investigation showed thinning and rupture of interalveolar septas resulted in large multiform cavities formation. What is the most likely diagnosis?
А. *Emphysema of lungs
B. Bronchiectatic disease
C. Cavernous tuberculosis
D. Chronic bronchitis
E. Fibrosing alveolitis
29. An autopsy of a 54-year-old male, who died of a chronic pulmonary and cardiac insufficiency, revealed enlarged, slightly firm and hypoinflated lungs. At the gross investigation of the lungs sectional view multiple, whitish, 2-3 mm in diameter nodules were discovered. Histological study showed nodules composed of concentric whorls of dense, sparsely cellular collagen. What is the most likely disease?
А. *Nodular form of silicosis
B. Miliary tuberculosis of lung
C. Fibrosing alveolitis
D. Microfocal pneumonia
E. Metastasis tumor of lungs
30. An autopsy of a patient who died from pneumonia revealed the inferior lobe of the right lung firm, hypoventilated, with the fibrin fibers on the pleura. What is the most likely etiology of the disease?
А. *Pneumococcal
B. Staphylococcal
C. Streptococcal
D. Mycoplasmal
E. Virus
31. An autopsy of a male, who had been working within 9 years the stone polisher, revealed multiple, roundish, dense, diffuse nodules. Histological investigation of nodules showed concentric whorls of dense collagen fibers. At the periphery there were aggregated of mononuclear cells, mostly lymphocytes, and fibroblasts. What is the most likely disease?
А. *Silicosis
B. Acute pneumonia
C. Bronchiectatic disease
D. Chronic bronchitis
E. Bronchial asthma
32. A male patient with a medical history of the malignant neoplasm died from the cancer intoxication. A post-mortem revealed the posterior segments of the inferior pulmonary lobes firm clusters of solid, slightly elevated nodules, poorly delimited at their margins, which had dark red and grey appearance. Histological investigation showed the exudate within alveoli and small bronchi rich with neutrophil polymorphs. What is the most likely diagnosis?
А. *Acute purulent bronchopneumonia
B. Acute bronchitis
C. Croupous pneumonia
D. Intestinal pneumonia
E. Acute serous bronchopneumonia
33. An autopsy of 55-year-old male with a 3 years history of a dry cough, a dyspnea, pulmonary insufficiency and quick weight loss, revealed a pulmonary heart and lungs fibrosis with a honey-comb pattern of the lungs tissue. Histological investigation demonstrated an interstitial fibrosis with the apparent infiltration of a stroma with lymphocytes, histiocytes and some neutrophils. What is the most likely diagnose?
А. *Bronchiectatic disease
B. Postinflammatory pneumosclerosis
C. Chronic bullous emphysema
D. Fibrosing alveolitis
E. Dusty pneumosclerosis
34. An autopsy of a patient, who had a long history of exposure to free dioxide of silica in the inhaled air, revealed enlarged, firm lungs with multiple miliary and larger roundish areas of a sclerosis. Gross study showed grey and grey-black colour of his lungs’ tissue. What is the most likely diagnose?
А. *Nodular form of silicosis
B. Diffusive – sclerotic form of silicosis
C. Anthracosilicosis
D. Silicoanthracosis
E. Asbestosis
35. An autopsy of a patient, who had been working within 20 years the coal worker, revealed grayish-black dense, sclerotic lungs. The vast areas of collagen tissue new growth and multiple macrophages, carrying black pigment within cytoplasm, were recognized under microscope. What is the most likely disease?
А. *Anthracosis
B. Anthracosilicosis
C. Silicoanthracosis
D. Talcosis
E. Siderosis
36. An autopsy of the 60-year-old man with a long history of over consumption of alcohol revealed the right lung enlarged, firm, with fibrin fibers on the pleura. On a cut section pulmonary tissue had a gray coloring. Histological investigation showed the exudate within alveoli consisted of fibrin and disintegrated erythrocytes. What is the most likely diagnosis?
А. *Croupous pneumonia
B. Focal pneumonia
C. Intestinal pneumonia
D. Primary tuberculosis of lung
E. Caseous pneumonia
37. An autopsy of the 47-year-old man revealed the right lung firm with dry hypoinflated granular pulmonary tissue. Visceral pleura presented with membranous gray-brown fibrin fibers on the pleura. What is the most likely diagnosis? What is the most likely diagnosis?
А. *Croupous pneumonia
B. Tuberculosis
C. Bronchopneumonia
D. Intestinal pneumonia
E. Pneumofibrosis
38. A 42-year old man presented to the hospital with symptoms of malaise, complicated with a collapse one hour later. He died soon, not coming to consciousness. A post-mortem revealed the lungs enlarged, congested, cut with a sound of crunch. Whole of a right inferior lobe had a liver-like texture with some fibrin fibers superposed on the pleura. On a cut section pulmonary tissue exhibited a gray-brown coloring. What is the most likely diagnosis?
А. *Croupous pneumonia
В. Bronchopneumonia
С. Acute venous hyperemia in lungs
D. Toxic shock syndrome
E. Acute myocardial infarction
39. An autopsy of the 69-year-old man with a long history of chronic bronchitis revealed increased pulmonary volume and hyperinflation, pale grey color, soft texture lungs that kept their form when removed from the body and put at autopsy table. Histological investigation showed markedly dilated proximal acini, thinned and somewhere ruptured interalveolar septas. For what disease of lungs such morphological picture is characteristic?
A. *Emphysema of lungs
B. Chronic intestinal pneumonia
C. Atelectasis of lungs
D. Bronchiectatic disease
E. Pleural empyema
40. An autopsy of a patient, who had been working within 20 years the coal worker, revealed enlarged, slightly firm and hypoinflated lungs. At the gross investigation of the lungs sectional view multiple, round, grayish-black, diffuse nodules were discovered. Histological study showed nodules composed of concentric whorls of dense collagen fibers, some of them- with hyaline degeneration. What is the most likely disease?
A. *Nodular form of silicosis
B. Miliary tuberculosis of lung
C. Bronchiectatic disease
D. Croupous pneumonia
E. Diffusive – sclerotic form of silicosis
41. Autopsy of a man who had been working as a miner for many years and died from cardiopulmonary decompensation revealed that his lungs were airless, sclerosed, their apexex had emphysematous changes, the lung surface was greyish-black, the incised lung tissue was coal-black. What disease caused death?
A. *Anthracosis
B. Talcosis
C. Silicosis
D. Aluminosis
E. Asbestosis
42. A patient died from cardiopulmonary decompensation. Histological examination revealed diffused pulmonary lesion together with interstitial edema, infiltration of tissue by limphocytes, macrophages, plasmocytes; pulmonary fibrosis, panacinar emphysema. What disease corresponds with the described picture?
A. *Fibrosing alveolitis
B. Bronchial asthma
C. Pulmonary atelectasis
D. Chronic bronchitis
E. Bronchopneumonia
43. The upper lobe of the right lung is enlarged, grey and airless, the inscision surface is dripping with turbid liquid, the pleura has many fibrinogenous films; microscopical examination of alveoles revealed exudate containing neutrophils, desquamated alveolocytes and fibrin fibers. The bronchus wall is intact. What is the most probable diagnosis?
A. *Croupous pneumonia
B. Pulmonary abscess
C. Influenzal pneumonia
D. Focal pneumonia
E. Interstitial pneumonia