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DISEASES OF THE LIVER
1. A microscopical investigation of a liver biopsy revealed a dystrophy, necroses of hepatocytes, a sclerosis, accompanied with destruction of a hepatic beam and a lobular structure, a formation of false lobes and regenerative nodes. What is the most likely diagnosis?
A. * Cirrhosis of liver
B. Chronic hepatoses
C. Chronic hepatitis
D. Massive diffuse necrosis of liver
E. Acute hepatitis
2. An autopsy of a 53-year old patient, with a history of a chronic alcoholism and repeated attacks of an alcoholic hepatitis, revealed a firm, yellow color liver with pointed edge. A liver surface was coarsely scarred with multiple fine knots on a cut surface. What is the most likely diagnosis?
A. * Cirrhosis of liver.
B. Cancer of liver.
C. Fatty dystrophy of liver.
D. Chronic hepatitis.
E. Acute hepatitis.
3. A 62-year old patient, with a history of a cholelithiasis accompanied with cholangitis and cholangiolitis, presented to the hospital liver cirrhosis. What is the most likely type of cirrhosis presented?
A. *Biliary
B. Infection
C. Toxins
D. Nutritional deficiency
E. Circulatory
4. A patient presented to the hospital an ascites, twice enlarged spleen, a varicose esophagogastric veins and veins around and within the rectum. A histological investigation of liver biopsy revealed micronodular cirrhosis. What process has complicated cirrhosis?
A. * Portal hypertension
B. Cardiac insufficiency
C. Hepatorenal syndrome
D. Hepatic-cellular insufficiency
E.
5. A 62-year old patient, with a history of chronic virus hepatitis, died of an acute posthemorrhagic anaemia resulted from an esophageal varicose veins bleeding. An autopsy revealed the reduced, dense liver with coarsely scarred surface. A microscopical investigation showed regenerative false nodules separated by fibrous tissue, contained the remnants of portal tracts. What morphogenetic type of cirrhosis took place in this case?
A. *Portal cirrhosis.
B. Postnecrotic cirrhosis.
C. Mixed cirrhosis.
D. Viral cirrhosis.
E. Biliary cirrhosis.
6. A 42-year-old male, with a history of rheumatic stenosis of the left atrioventricular orifice resulted in chronic heart insufficiency, presented at the hospital with dyspnea at small physical exercises, tachycardia, a cyanosis of his lips, bubbling rales in the inferior segments of lungs, leg’s edema. What histological changes will be characteristic for a liver?
A. *Necrosis of hepatocytes in the center of lobule, fatty dystrophy on periphery
B. Necrosis of hepatocytes in the center of lobule, hyalin dystrophy on periphery
С. Necrosis of hepatocytes in the center of lobule, hydropic dystrophy on periphery
D. Fatty dystrophy of hepatocytes in the center of lobule, necrosis on periphery
E. Hydropic dystrophy of hepatocytes in the center of lobule, necrosis on periphery
7. A 52-year-old patient presented with fatigue, loss of appetite, muscle and joint aches, an increase in body temperature to 38°С. On the 7th day a patient exhibited a yellow color in the skin, urine and around the whites of the eyes and also an acute pain in right hypochondrium. A histological investigation of his liver biopsy revealed a destruction of the liver’s beam architecture, vacuolar and ballooning dystrophies of hepatocytes, some cells were necrotic. The Councilman’s bodies were also determined. On the periphery of lobes were registered the enlarged quantity of multinuclear hepatocytes. What form of virus hepatitis is most likely?
A. *Icteric hepatitis
B. Malignant hepatitis
C. Chronic hepatitis
D. Cholestatic hepatitis
E. Anicteric hepatitis
8. An autopsy of a male, with a history of a drug abuse, revealed vacuolar dystrophy of hepatocytes, a Councilman’s bodies, periportal inflammation consisted mainly of chronic inflammatory cells, lymphocytes, plasma cells and histiocytes. What is the most likely etiology of the disease?
A. *Viral
B. Bacterial
C. Toxic
D. Parasite
E. Fungus
9. The liver biopsy is taken from the patient with symptoms of a parenchymatous icterus and a portal hypertension. Histological investigation revealed a fatty dystrophy of hepatocytes, a destruction of a hepatic beam and a lobular structure, a formation of false lobes and regenerative nodes. These were accompanied with a porto- portal fibrous septae formation and periportal lympho- macrophageal infiltrates. What is the most likely diagnosis?
A. * Cirrhosis of liver
B. Alcoholic hepatitis
C. Chronic hepatosis
D. Viral hepatitis
E. Toxic dystrophy
10. An autopsy of a male, with a history of a chronic alcohol abuse, revealed a small, firm, micronodular liver. Histological investigation showed a fatty dystrophy of hepatocytes, a formation of small regenerative (false) nodes separated by fibrous septae with lympho- macrophageal infiltration. What is the most likely diagnosis?
A. *Alcoholic cirrhosis.
B. Chronic active alcoholic hepatitis.
C. Chronic persistent alcoholic hepatitis.
D. Toxic dystrophy of liver.
E. Fatty hepatosis.
11. A patient presented with vomiting, loss of appetite and jaundice. A histological investigation of his liver biopsy revealed vacuolar and ballooning dystrophies of hepatocytes and necrosis of some cells. The Councilman’s bodies were also determined. Besides, a destruction of the liver’s beam architecture within lobes and inflammation consisted mainly of chronic inflammatory cells, lymphocytes, plasma cells and histiocytes were registered. What form of virus hepatitis is most likely?
A. Viral hepatitis
B. Purulent hepatitis
C. Cirrhosis of the liver
D. Toxic dystrophy of the liver
E. Malaria
12. A 35-year-old man exhibits clinical symptoms of the virus hepatitis B. A puncture liver biopsy revealed: a destruction of the liver’s beam architecture with polymorphism of hepatocytes and plural mitosis figures. Hepatocytes were enlarged, filled by vacuoles which contained a transparent liquid. What kind of a dystrophy is characteristic for the described case?
A. * Hydropic dystrophy
B. Fatty dystrophy
C. Hyalin dystrophy
D. Carbohydrate dystrophy
E.
13. An autopsy of a female, with a history of a rheumatic disease with a mitral stenosis, resulted in decompensation stage, revealed a general venous plethora, small, firm and micronodular liver. Gross investigation of a cut surface showed a lobular structure and yellowish-brown color of hepatic tissue. Define the most probable pathology diagnosed in a liver.
A. *Portal cirrhosis
B. Fatty dystrophy
C. Billiary cirrhosis
D. Postnecrotic cirrhosis
E. Atrophy
14. A 38 year old patient with full-blown jaundice, small cutaneous hemorrhages, general weakness and loss of appetite underwent puncture biopsy of liver. Hi-stological examination revealed disseminated dystrophy, hepatocyte necrosis, Councilman's bodies. Lobule periphery has signs of significant infiltration by lymphocytes, there are also individual multi-nuclear hepatocytes. What is the most probable diagnosis?
A. *Acute viral hepatitis
B. Toxic degeneration of liver
C. Acute alcoholic hepatitis
D. Chronic hepatitis
E. Miliary hepatic cirrhosis