 |
|
ENDOCRINE SYSTEM DISORDERS
1. A 23-years-old male presented to his physician with excess of the somatotropic hormone, the enlarged nose, lips, ears, a mandible, hands and feet. What is the most likely diagnosis?
A. *Acromegaly
B. Pituitary nanism
C. Itsenko-Cushing disease
D. Addison’s disease
E. Adiposogenital dystrophy
2. A histological investigation of the removed enlarged thyroid gland revealed irregular form and sizes follicles. The follicular epithelium proliferated both into follicles lumen and outside. Layers of the connective tissue separated various sites of the thyroid. What is the most likely diagnosis?
A. *Macro-microfollicular goiter
B. Diffuse goiter
C. Autoimmune thyroiditis
D. Follicular carcinoma
E. Riedel’s thyreoiditis
3. A 42-year-old man presented with a thyroid gland enlargement in two times. A physical investigation revealed firm, irregular lobulated gland. Histological investigation showed a diffusive infiltration of thyroid gland by lymphocytes, plasmocytes with follicles formation and the enhanced growth of a connective tissue. What is the most likely diagnosis?
A. *Hashimoto’s goiter.
B. Endemic goiter.
C. Sporadic goiter.
D. Diffuse toxic goiter.
E. Riedel’s thyreoiditis
4. A 52-year-old man with a history of hematogenic tuberculosis presented to the hospital with hyperpigmentation skins (melanosis) and mucosas, a cachexia, cardiovascular insufficiency. What disease caused such changes?
A. *Addison’s disease
B. Pheochromocytoma
C. Simmonds’ disease
D. Itsenko-Cushing disease
E. Graves’ disease
5. A 48-years-old woman presented with insomnia (inability to get enough sleep, a bad dream), a fatigue, irritability, exophthalmos (protuberance of eyes) and tachycardia. The thyroid gland was enlarged. She died soon due to cardiovascular insufficiency. Histological investigation of the thyroid tissue revealed a proliferation of an epithelium with formation of papillas, a colloid colliquation, lymphocyte and plasmocyte infiltration and formation of lymphatic follicles with the germinal centres. What is the most likely diagnosis?
A. * Diffuse toxic goiter. (Basedow’s disease)
B. Endemic goiter
C. Sporadic goiter
D. Hashimoto’s thyreoiditis
E. Benign tumor of thyroid gland
6. A 48-year-old male, with a long history of living in the mountain district of Central Asia, presented with a thyroid gland enlargement, resulted in complicated swallowing. A physical investigation revealed an increasing of a body mass, slowness, drowsiness, and puffy face. A microscopic study of a thyroid gland showed irregular follicles with a hypochromic colloid. What of diagnoses is the most probable?
A. * Endemic goiter.
B. Basedow’s goiter.
C. Hashimoto’s thyreoiditis.
D. Sporadic goiter.
E. Riedel’s thyreoiditis.
6. A 56-year-old woman with a long history of parathyroid glands disease, died from increased renal insufficiency. A post-mortem revealed a bones deformation of extremities, a vertebral column, and ribs. Bones were fragile, soft and easily deformed or cat. They had some motley tumorous formations. Kidneys were contracted. Histological investigation revealed lacunar bone resorption. In addition, a microscopic study demonstrated giant cell granulomas within the centres of tumorous formations, accumulations of erythrocytes and a hemosiderin. Name the described disease.
A. *Parathyroid osteodystrophy.
B. Metastases of cancer in a bone
C. Chronic renal insufficiency
D. Paget’s disease
E. Myeloma
7. A 42-year-old woman presented with the obesity, chiefly of the trunk and face, steroid diabetes, an arterial hypertension and secondary dysfunction of ovaries. An autopsy revealed a hypertrichosis, a hirsutism, strias on a skin of hips and a abdomen. In the anterior lobe of the pituitary gland a tumour was found. Histological investigation showed the basophilic adenoma of the pituitary and hyperplasia of a fascicular layer in adrenals. What of the listed diagnoses is the most likely?
A. * Itsenko-Cushing disease
B. Itsenko-Cushing syndrome
C. Simmonds’ disease
D. Adiposogenital dystrophy
E. Pituitary nanism
8. A histological investigation of a thyroid gland, presented to pathology, revealed a mild atrophy of a parenchyma, sclerosis, diffusive infiltration of a stroma by lymphocytes and plasmocytes with formation of lymphoid follicles. What is the most likely diagnose?
A. *Autoimmune thyroiditis
B. Parenchymatous goiter
C. Toxic goiter
D. Thyroiditis
E. Riedel’s thyreoiditis
9. A 55-year-old woman died from uraemia. A post-mortem revealed a parathyroid gland adenoma, bones deformation of extremities, a vertebral column, and ribs. Bones were soft, with slight porousness. On a cut they had a motley pattern with multiple cysts. Histological investigation revealed marked bone remodelling and lacunar resorption of osteoid and fibrous tissues. What is the most likely diagnosis?
A. *Parathyroid osteodystrophy.
B. Chronic osteomyelitis
C. Osteoporosis
D. Fibrous dysplasia
E. Paget’s disease
10. A 62-year-old man with a 14 years medical history of a diabetes mellitus presented with significantly worsened eye vision for the last two years. What characteristic processes resulted in worsening of the eye vision?
A. *Microangiopathy
B. Macroangiopathy
C. Calcinosis of hyaloid body
D. Dimness of cornea
E.
11. A 45-years-old male presented to the hospital with enlarged nose, ears, a mandible and feet. What is the most likely diagnosis?
A. *Acromegaly
B. Nanism
C. Cerebro-hypophyseal cachexia
D. Adiposogenital dystrophy
E.
12. A male patient presented with obesity of the trunk and face. He also had a long medical history of an arterial hypertension. The death resulted from a hemorrhage in a brain. A morphological investigation revealed a basophilic adenoma of a pituitary body and hyperplasia of adrenals cortex. What is the most likely preliminary diagnosis?
A. * Itsenko-Cushing disease
B. Diabetes mellitus
A. Acromegaly
D. Pituitary nanism
E. Adiposogenital dystrophy
13. A thyroid gland of a 48-year-old male was removed at surgery department. Histological investigation revealed various size follicles which were lined by tall columnar epithelium. The latter one was pilled up at places forming papillary infoldings. Colloid appeared lightly staining, watery and finely vacuolated. The stroma showed increased accumulation of lymphoid cells.
A. *.Basedow’s goiter.
B Hashimoto’s thyreoiditis
C. Riedel’s thyreoiditis
D. De Quervain’s thyroiditis
E. Nodular goiter
14. A 45-years-old male presented to the hospital with gradual enlargement of feet, right hand, nose and lips. The adenoma of a pituitary body was diagnosed. What is the most likely disease?
A. * Acromegaly
B. Nanism
C. Basedow’s disease.
D. Addison’s disease
E. Diabetes mellitus
15. A histological investigation of a thyroid revealed a considerable infiltration of a gland by lymphocytes with formation of lymphoid follicles, a destruction of parenchyma, growth of connective tissue fibers. What is the most likely disease presented in that case?
A. * Hashimoto’s goiter
B. Colloid goiter
C. Endemic goiter
D. Diffuse toxic goiter
E. Parenchymatous goiter
16. A 64-year-old patient died of a cachexia. A post-mortem revealed an adenoma of parathyroid glands, bones deformation of extremities, a vertebral column, and ribs. Bones were soft, with slight porousness and easily deformed or cat. What of the listed diagnoses is the most likely?
A. *Parathyroid osteodystrophy.
B. Osteopetrosis
C. Chondrodysplasia
D. Osteomyelitis
E. Fibrous dysplasia
17. A histological investigation of a thyroid gland biopsy, presented to pathology, revealed lymphoid structures with the germinal (growth) centers among the follicles filled with a colloid. What is the most likely disease presented in that case?
A. * Hashimoto’s goiter.
B. Endemic goiter
C. Sporadic goiter
D. Basedow’s goiter
E. Riedel’s thyreoiditis
18. An autopsy of the man revealed a bronze coloring of a skin and mucosa of an oral cavity. In addition, caseous masses were defined in adrenals. What is the most likely disease in that case?
A. * Addison’s disease
B. Itsenko-Cushing syndrome
C. Basedow’s disease.
D. Acromegaly
E. Pheochromocytoma
19. A 64-year-old man died with symptoms of a hypoglycemic coma. A post-mortem revealed reduced, dense pancreas. Histological investigation of pancreas showed the growth of a connecting tissue, an atrophy of Langerhans islets. What disease caused such changes in a pancreas?
A. *Diabetes mellitus.
B. Mucoviscidosis.
C. Acute pancreatitis.
D. Cancer of pancreas.
E. Hypoplasia of pancreas.
20. A 64-year-old man, with a medical history of a diabetes mellitus, presented augmented symptoms of renal failure. What disease caused such changes in a pancreas?
A. *Glomerulosclerosis.
B. Necrosis of renal tubular epithelium.
C. Amyloidosis.
D. Proliferative glomerulonephritis
E. Membranous nephropathy.
21. A morphological investigation of a thyroid removed due to thyrotoxicosis struma revealed a diffuse infiltration of a gland by lymphocytes with a destruction of parenchyma and an area of connective tissue. What is the most likely diagnose?
A. * Hashimoto’s thyreoiditis
B. Anaphylactic reaction
C. Thyrotoxicosis
D. Cancer of thyroid
E. Adenoma
22. A patient presented to surgery with symptoms of hypothyrosis. Macroscopic investigation of the removed thyroid gland revealed its considerable enlargement, dense-elastic texture and lobulated surface. Histological investigation showed the diffuse infiltration of lymphocytes and plasmocytes of gland’s parenchyma with formation of lymphoid follicles. The latter ones had hyperplastic germinal centers with atypia and a metaplasia of a follicular epithelium. In addition, the sclerotic alterations of a parenchyma were also determined. What is the most likely diagnose?
A. *Autoimmune thyroiditis
B. Diffuse toxic goiter
C. Colloid goiter
D. Nodular goiter
E. De Quervain’s thyroiditis
23. At operation of excision of a diffusive thyroid gland struma a patient died from acute adrenals insufficiency. An autopsy, besides the atrophy of adrenals, revealed a left ventricle hypertrophy in a heart, a hypertrophy and an intracellular edema of cardiomyocytes, a serous edema and lymphoid infiltration of a myocardial stroma. What is the figurative name of a heart pathology presented at post-mortem?
A. *Thyrotoxyc heart
B. Tabby cat heart
C. Cor bovinum
D. Cor pulmonary
E. Brown atrophy of heart
24. An autopsy of a 40-year-old woman revealed the obesity, chiefly of the trunk and face ("moonface" and "buffalo hump"), strias on a skin of hips and abdomen. She had in her medical records an osteoporosis with spontaneous fractures of bones, an amenorrhea, an arterial hypertension, a hyperglycemia. What of the listed diagnoses is the most likely?
A. * Itsenko-Cushing syndrome
B. Addison’s disease
C. Friderichsen-Waterhouse syndrome
D. Conn’s syndrome
E. Sipple’s syndrome
25. A renal puncture biopsy was taken from a patient with elevated blood sugar levels and high amounts of glucose in his urine. Histological investigation revealed extension of mesangium with focal accumulation of membranous substances and periglomerular sclerosis of some glomerules. In addition, there were found a hyalinosis and plasmatic infiltration of arterioles; lymphocytes, histiocytes and some leucocytes infiltration of a stroma; glycogen deposits within nephrocytes of narrow segment. What is the most likely diagnosis?
A. *Diabetic glomerulonephritis
B. Arteriolosclerotic nephrocirrosis
C. Pyelonephritis
D. Acute glomerulonephritis
E. Subacute glomerulonephritis
PATHOLOGY OF PREGNANCY
1. A 29-year-old woman presented to maternity department with termination of pregnancy at 20 weeks of gestation. The fetus and fetal membranes were delivered with some blood clots. Histological investigation revealed fetal membranes, chorion villi and decidual tissue. Name the described pathology of pregnancy.
A. *Spontaneous complete abortion
B. Premature birth
C. Hydatidiform mole
D. Invasive hydatidiform mole
E. Artificial abortion
2. A young woman presented to the hospital with an acute pain. Her uterine tube was removed at gynecology department. Macroscopic investigation of a tube revealed its local dilation at the middle third and blood clots accumulations within the lumen. A histological research showed chorion villi, surrounded by areas of erythrocytes with some leucocytes. What is the most likely diagnosis?
A. *Tubal pregnancy
B. Acute purulent salpingitis
C. Hemorrhage in tube of the uteri
D. Hemorrhagic salpingitis
E. Tuberculous salpingitis
3. A 35-year-old woman had an operation of uterine tube removal at gynecology department. A histological research of a tube’s wall reveled chorion villi and decidual cells. What is the most likely diagnosis?
A. *Tubal pregnancy
B. Placental polyp
C. Choriocarcinoma
D. Paper-doll fetus
E. Lithopedion
4. A- post-mortem of a pregnant woman revealed a brain edema, hemorrhagic pneumonia, motley liver with a hemorrhage. Microscopic study showed disseminated blood clotting of vessels, plural fine necroses and hemorrhages in internal organs. In addition, in kidneys there were found cortical necroses and a fibrinoid necrosis of a tubules epithelium within a nephron.
What is the most likely diagnosis?
A. *Eclampsia
B. Pre-eclampsia
C. Septicopyemia
D. Septicemia
E. Acute renal insufficiency
5. A 25-year-old woman with a medical history of recent childbirth presented to gynecology department with metrorrhagia. The histological investigation of a curettage material revealed a pathologic growth, consisted of fibrin clots, chorion villi and decidual tissue, undergoing organization. What is the most likely diagnosis?
A. * Placental polyp
B. Glandular hyperplasia of the endometrium
C. Hydatidiform mole
D. Choriocarcinoma
E. Endometritis