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DISEASES OF ALIMENTARY SYSTEM
1. An operation of a male with a medical history of a hematemesis revealed a stomach ulcer penetrated into the muscular layer. Ulcer edges were dense. A bleeding vessel was detected at the ulcer’s bottom. What is the type of an ulcer?
A. * Chronic ulcer with hemorrhage
B. Chronic ulcer with penetration
C. Ecute ulcer with bleeding
D. Chronic ulcer with perforation
E. Chronic ulcer with malignisation
2. A removed appendix delivered to pathology department. Macroscopic investigation revealed its thickening, enlargement, dull and hyperemic serous membrane. A yellowish-green liquid lumen was visible on a cut section within its lumen. What is the most likely type of the appendicitis?
A. * Suppurative appendicitis.
B. Catarrhal appendicitis.
C. Superficial appendicitis.
D. Gangrenous appendicitis.
E. Apostematous appendicitis
3. A microscopic investigation of a colon biopsy revealed a superficial defect of a mucosa, decrease of goblet cells number with lack of mucus in them. In addition, considerable lympho- plasmocyte infiltration with presence of segmented leucocytes and eosinocytes was defined. Choose the most probable and exact diagnosis.
A. *Nonspecific ulcerative colitis in exacerbation
B. Crohn’s disease
C. Chronic ischemic colitis
D. Dysentery in the third stage
E. Amebiaz of intestine with forming of ulcers
4. Microscopic study of appendix determined intensive leukocyte infiltration hyperemia, stases throughout all its layers. What is the most likely type of appendicitis?
A. * Suppurative appendicitis
B. Gangrenous appendicitis
C. Superficial appendicitis
D. Simple appendicitis
E. Chronic appendicitis
5. Macroscopic investigation of a removed appendix revealed its thickening, enlargement, dull and hyperemic serous membrane with whitish membranaceous incrustation. A whitish-yellow, opaque, viscous liquid detected on a cut section within its lumen. What is the most likely type of the appendicitis?
А. * Suppurative appendicitis.
B. Gangrenous appendicitis
C. Simple appendicitis
D. Superficial appendicitis
E. Chronic appendicitis.
6. The removed appendix thickened and covered by fibrinopurulent incrustation. A purulent exudate infiltrated all appendix layers; the destruction of mucosa membrane was evident. What is the most likely diagnosis?
A.Flegmonous-ulcerative appendicitis
B. Simple appendicitis
C. Suppurative appendicitis
D. Gangrenous appendicitis
E. Superficial appendicitis
7. An autopsy of a 48-year-old woman with a history of the stomach neoplasm revealed the markedly enlarged, firm, white color ovary. Microscopic investigation showed markedly atypical epithelial cells placed among the layers and fibers of a connecting tissue. What is the most likely diagnosis?
A. *Krukenberg tumor of ovary.
B. Serous cystadenocarcinoma
C. Pseudomucinous cystadenocarcinoma.
D. Malignant thecoma.
E. Malignant granulosa cell tumor.
8. A post-mortem of a male with a history of anemia accompanied by vomiting by dark gastric contents reveled in a stomach about 1 liter of liquid blood and bloody clots. A gross investigation showed an on small curvature of a stomach an oval solitary ulcer with the elevated firm edgesand a smooth floor. What is the most likely diagnosis?
A. *Chronic gastric ulcer
B. Chronic atrophic gastritis
C. Acute gastritis
D. Acute gastric ulcer
E. Chronic hypertrophic gastritis
9. A 48-year old female presents to her physician enlarged supraclavicular lymph nodes. Microscopic investigation of a biopsy from a lymph node revealed the metastasis of the signet-ring cancer. Choose the most probable localization of a primary tumor.
A. *Cancer of stomach.
B. Cancer of oesophagus.
C. Cancer of thyroid.
D. Cancer of lung.
E. Cancer of cervix uteri.
10. A histological investigation of a gastric biopsy revealed a thinning of a stomach mucosa with reduction of a glands quantity. This was accompanied with a considerable growth of a connecting tissue, dilation of a glands lumen, lymphocytes and plasmocytes infiltration of the mucosa. What is the most likely diagnosis?
A. * Chronic atrophic gastritis
B. Chronic superficial gastritis
C. Chronic atrophic gastritis with an intestinal metaplasia
D. Phlegmon of stomach
E.
11. Microscopic study of appendix determined intensive leukocyte infiltration throughout all its layers. What is the most likely type of inflammation?
A. * Suppurative appendicitis
B. Apostematous appendicitis
C. Gangrenous appendicitis.
D. Superficial appendicitis.
E. Flegmonous-ulcerative appendicitis
12. A histological investigation of the removed stomach ulcer revealed in its floor the fibrinopurulent exudate, a zone of the fibrinoid necrosis, a granulation tissue with a fibrous tissue underneath. What is the most likely diagnosis?
A. * Chronic ulcer
B. Acute ulcer
C. Acute erosion
D. Phlegmon of stomach
E.
13. A macroscopic investigation of the appendix, 9 cm in length and 0.9 cm in thickness, revealed dull and hyperemic serous membrane. Microscopic study determined edema, stases in capillaries and venules, fine hemorrhages throughout the mucosa. Besides these, the necrotic foci with leukocyte infiltration around them were also verified. What is the most likely diagnose?
A. * Superficial appendicitis.
B. Simple appendicitis.
C. Suppurative appendicitis
D. Flegmonous-ulcerative appendicitis
E. Gangrenous appendicitis.
14. A gastroscopy of a 44-year old patient, with a history of a pain in epigastrium after meal, revealed a hyperemia of the stomach mucosa with the stomach folds reduction. Histological study showed a thinning of the mucosa, a reduction of the glands quantity accompanied with the growth of a connecting tissue, lymphocytes and plasmocytes infiltration. Specify, what of the listed diagnoses is the most probable?
A. *Chronic atrophic gastritis.
B. Acute catarrhal gastritis.
C. Acute suppurative gastritis.
D. Chronic superficial gastritis.
E. Giant hypertrophic gastritis.
15. A physical examination of a fauces of a 12-year-old child with tonsillitis revealed the reddening and slight edema of mucosa, with reactive enlargement of tonsils, dotted by pinpoints of exudates emanating from the tonsillar crypts.What clinical-morphological variant of tonsillitis is the most probable in this case?
A. *Lacunar tonsillitis
B. Catarrhal tonsillitis
C. Purulant tonsillitis
D. Fibrinous tonsillitis
E. Necrotic tonsillitis
16. A 44-year old patient, with a history of the chronic duodenum peptic ulcer, died of peritonitis. An autopsy revealed multiple steatonecroses of a retroperitoneal tissue and a pancreas. A gross investigation of a duodenum demonstrated an ulcerative defect, which was 5 mm in diameter and 10 mm deep. The edges presented necrotic masses. Diagnose the complication of a duodenal peptic ulcer?
A. *Penetration
B. Hemorrhage
C. Stenosis
D. Perforation
E.
17. A histological investigation of a gastric biopsy of a 50-year old woman revealed a thinning of a stomach mucosa with reduction of a glands quantity, foci of an intestinal metaplasia; a plethora, an edema and a stromal sclerosis. These were accompanied with a diffuse leucocytes, lymphocytes and plasmocytes infiltration of the mucosa. What is the most likely diagnosis?
A. *Chronic atrophic gastritis in an active phase
B. Chronic atrophic gastritis in a nonactive phase
C. Chronic superficial gastritis
D. Acute catarrhal gastritis
E. Acute fibrinouse gastritis
18. A gross investigation of a stomach revealed a deep defect of a gastric wall with a lesion of a muscular layer. The proximal edge was undermined and distal one was flat. A histological study of the removed stomach showed in its floor the zone of the fibrinoid necrosis, a granulation tissue and massive fibrosis, which replaced the muscular layer. What is the most likely diagnosis?
A. *Chronic ulcer in exacerbation
B. Chronic ulcer in remission
C. Acute ulcer
D. Erosion
E. Cancer-Ulcer
19. Microscopic study determined edema, diffusive leukocyte infiltration of appendix wall and also a mucosal lesion with alteration of its muscular layer. What is the most likely diagnose?
A. *Flegmonous-ulcerative appendicitis
B. Suppurative appendicitis
C. Gangrenous appendicitis
D. Superficial appendicitis
E. Apostematous appendicitis
20. A gastroscopy of a 55-year old patient revealed a diffusive swelling, hyperemia and solitary small hemorrhage of the stomach mucosa. These were accompanied with considerable quantity of a muddy, viscous grey exudate on a gastric surface. What gastritis has developed at the patient?
A. *Catarrhal gastritis
B. Hemorrhagic gastritis
C. Flegmonous gastritis
D. Fibrinous gastritis
E. Corrosive gastritis