PATHANATOMY EXAM 3RD COURSE 2016-17

Patient has complains on increasing of sizes of thyroid gland, shortness of breath & swallowing, torpidity, sleepiness. In physical examination: increasing of thyroid gland, brachycardia, hyperkeratosis, decreasing of basal metabolism. Operation thyroidectomy was done. In histological examination: replacement of tissue of thyroid gland by lymphoid elements. What kind of goiter was revealed?

Lungs in emphysema have following appearance

Following changes in lungs were revealed in autopsy of girl of 2 y.o.: mononuclear infiltration of alveolar septi, hyperplasia of alveolar epithelium, large cells with intranuclear inclusions, serous liquid in lumens of alveoli. What is etiology of this disease?

In autopsy of the man of 53 y.o., lungs are with focal consolidation in low lobe of right lung, of the dark red color on the cut, there are granular grayish-red confluent foci up to 4 cm in diameter in low lobe of right lung. In pressing on lungs the mucous-purulent plugs are discharged from bronchi. Reddish foam liquid flows from the surface of the cut, lungs are congested. What complication has developed?

Patient 54 y.o. was admitted in cardiac intensive care unit with complains on breathlessness, edema of low extremities, havieness in right hypochondrium. In anamnesis: transmural myocardium infarction. In examination: boundaries of heart are dilated; there is pulsating bulging formation in area of heart apex. Suddenly the right hemiplegia developed, patient lost conciseness & died. What changes is it possible to find in autopsy?

Patient 63 y.o., suffering from diabetes mellitus was admitted in hospital with complains on arrhythmia, dyspnoe. Suddenly the condition of patient became worse, reanimation measures are without effect. He died in reception ward. In autopsy: stenosed coronary arteries, yellowish color areas, surrounded by focal hemorrhages at apex & anterior wall of left ventricle. What is possible cause of myocardial lesion?

Male, 51 y.o., was admitted in hospital with complains on breathlessness, cough with abundant sputum. At first time such symptoms appeared 30 years ago, all this time he continued to smoke. On X-ray examination: emphysema of lungs, saccular & cylindrical dilations of bronchi, cardiac borders are dilated by means of right ventricle. There are clubbed fingers. Symptoms of developing renal insufficiency have appeared. Patient has died from hyperazotemic uremia. What is pulmonary disease of this patient?

Patient, 64 y.o. has diabetes mellitus during long period. Pains in abdomen, clinical picture of intestinal obstipation & surgical abdomen has suddenly appeared. All following is correct for this clinical situation, except of

Patient, 68 y.o., was admitted in neurological intensive care unit with acute developed paralysis. Blood wasn’t revealed in liquor. There is infarction of left hemisphere of brain in anamnesis. What are the morphological changes in brain?

Morphological changes of the knee joint of the patient P., 43 y.o. are presented by hypertrophy & hyperplasia of synovial cells with overgrowth of villi & formation of granulation tissue as a layer covered hyaline cartilage & subchondral bone. What extraarticular changes are possible to find at this patient?

Big white kidney was revealed at autopsy of woman of 47 y.o.There is deposition of amyloid in glomeruli, tubular basal membranes, wall of vessels & stroma in histological investigation. From anamnesis: woman had pathology of joints for a long period. This morphological picture is complication of following disease

Patient has complains on bad sleeping, general weakness, soreness, protrusion of the eye-balls, heartbeats, tachycardia. There is diffuse increased thyroid gland in palpation. What are the typical microscopical changes

Male, 51 y.o., was admitted in hospital with complains on breathlessness, cough with abundant sputum. At first time such symptoms appeared 30 years ago, all this time he continued to smoke. On X-ray examination: emphysema of lungs, saccular & cylindrical dilations of bronchi, cardiac borders are dilated by means of right ventricle. There are clubbed fingers. Symptoms of developing renal insufficiency have appeared. Patient has died from hyperazotemic uremia. What is the cause of renal insufficiency?

Woman of 63 y.o. suffers from pain in knee joints, their stiffness & puffiness. There is crepitation in joints in physical examination. The reconstructive surgical operation was executed. There is destruction of articular cartilage & subchondral osteosclerosis with expressed thickening of cortical layer in dissected bone. What does better describe the etiology of this disease ?

Histological investigation of knee joint of patient of 22 y.o. revealed thinning of articular cartilage. What from predisposing conditions has place in appearance of these morphological changes in joint

Woman, suffering from atherosclerosis, was on treatment in neurological department with diagnosis: disorder of cerebral blood circulation in region of right hemisphere & brainstem. Clinically: paralysis of left extremities (hemiplegia), disorder of swallowing, often chocking. After regular meal the cough appeared, increasing of dyspnoe, body temperature increased up to 39?C., moist rale in right lung. What process in lungs may these symptoms be related with?

In chronic bronchitis like in bronchial asthma, there is direct dependence between expression of inflammation & reactivity of

Male person, 60 y.o. suffered from hypertensive disease during 15 years, last time he has complains on weakness, fast fatigability, polyuria. In examination: proteinuria, significant increasing of creatinin in blood. He died from increasing renal insufficiency. What is the pathological process in kidney

Patient was admitted in hospital with complains on acute pains in abdomen, weakness. After several minutes after admission he lost the conciseness, thready pulse, patient was operated. About 1500 ml of blood was revealed in abdominal cavity. There is sacciform bulging of aorta in abdominal part, it’s wall is thin. Complication of what disease is described?

Patient has suffered from rheumatic defect of mitral valve. Patient has died from chronic cardio-vascular insufficiency. In autopsy: leaflets of mitral valve are thickened, adherent, opaque, dense, of milky-white color. What pathological process is in the base of changes of mitral valve?

Patient, 67 y.o., left revisional meniscectomia was done. What morphological changes in organs are appearance of complications at this patient?

Patient has complains on bad sleeping, general weakness, soreness, protrusion of the eye-balls, heartbeats, tachycardia. There is diffuse increased thyroid gland in palpation. What is disease at this patient?

Patient has complains on increasing of sizes of thyroid gland, shortness of breath & swallowing, torpidity, sleepiness. In physical examination: increasing of thyroid gland, brachycardia, hyperkeratosis, decreasing of basal metabolism. Operation thyroidectomy was done. In histological examination: replacement of tissue of thyroid gland by lymphoid elements. What kind of goiter was revealed ?

Patient has complains on breathlessness in physical activity, heartbeat, pains & tightness in heart region. There is stable increasing of blood pressure during last 2 years. In examination: protein in urine, significant increasing of creatinin in blood. Patient has died in increasing autotoxication from chronic renal insufficiency. What clinic-morphological variant of hypertensive disease has place?

Following changes were revealed in histological investigation of autopsic material: in lungs – edematic liquid, fibrin, massive accumulation of leucocytes are in alveoli; leuco-lymphocytic infiltration of interalveolar septi, in some areas septi are necrotized with formation of microabscesses. Capillaries are congested, some of them contain leucocytic thrombi. Walls of bronchi are thickened, sclerous. Masses of leucocytes, mucus, desquamated epithelium in limen of bronchi. What complication has developed?

Bronchial asthma is accompanied by predominant eosinophilic infiltration of bronchial wall, but chronic bronchitis is characterized by predominance of neutrophils in infiltrate and presence of

Pathological process, which is characterized by fibrosis, destruction, rebuilding & deformation of lungs

Patient, 32 y.o. was admitted in clinics with complains on dyspnoae, pains in left part of chest, temperature up to 39?C. He became sick suddenly after overcooling. In examination: dulling of sound above low lobe, pleural rub. In spite of conducted treatment after 4 weeks the cough was kept, dullness and absence of conducting of breathing sounds in projection of low lobe of left lung. What complication does develop at this patient?

Patient, 35 y.o., has suffered from hypertensive disease during 2 years. Level of diastolic pressure is constantly more than 120 mm Hg. What morphological changes of vessels is it possible to find at this patient?

A 19-year-old female presents with urticaria that developed after she took aspirin for a headache. She has a history of chronic rhinitis, and physical examination reveals the presence of nasal polyps. This patient is at an increased risk of developing which one of the following pulmonary diseases following the ingestion of aspirin?

Long time patient has suffered by chronic bronchitis & bronchiolitis, which later complicated by emphysema of lungs. Emphysema became to dominate in clinical picture. Patient has died. What kind of emphysema had place in this case?

What diseases may lead to the development of acquired heart defects

Large depositions of urate crystals, surrounded by accumulation of macrophages, lymphocytes & giant cells of foreign bodies were revealed in articular cartilage, periarticular ligaments, tendons & soft tissues in histological investigation. What complications are possible in kidneys?

The yellow color foci with violet-reddish collar were revealed in autopsy. What changes is it possible to find at histological investigation?

What are most common heart defects

Following changes are present in bronchial wall in acute period of bronchial asthma

Big white kidney was revealed at autopsy of woman of 47 y.o.There is deposition of amyloid in glomeruli, tubular basal membranes, wall of vessels & stroma in histological investigation. From anamnesis: woman had pathology of joints for a long period. This morphological picture is complication of following disease

Patient has suffered from rheumatic defect of mitral valve. Patient has died from chronic cardio-vascular insufficiency. In autopsy: leaflets of mitral valve are thickened, adherit, opaque, dense, of milky-white color. What pathological process is in the base of changes of mitral valve?

Patient has complains on increasing of sizes of thyroid gland, shortness of breath & swallowing, torpidity, sleepiness. In physical examination: increasing of thyroid gland, brachycardia, hyperkeratosis, decreasing of basal metabolism. Operation thyroidectomy was done. In histological examination: replacement of tissue of thyroid gland by lymphoid elements. What is pathogenesis of this disease?

Patient has complains on bad sleeping, general weakness, soreness, protruded eye-balls, heartbeats, tachycardia. There is diffuse increased thyroid gland in palpation. What are the typical microscopical changes

Patient, 64 y.o., has used antibiotics during 2 weeks due to acute respiratory disease. Death from progressing respiratory insufficiency. Polymorph picture were revealed in lungs: walls of alveoli with irregular lymphohistiocytic infiltration, giant mononuclear cells in alveolar epithelium, squamous metaplasia of bronchiolar epithelium are in some areas, destructive purulent bronchiolitis is present in many areas, surrounded alveoli are filled by serous-leucocytic exudates, there are foci of abscesses. What is etiology of this disease?

Following changes are present at the surface of the cut of the lungs of the patients, died due to the attack of bronchial asthma

Woman, 62 y.o., on 7th day after cholecystectomia due to calculous cholecystitis following symptoms appeared: body temperature 38,5°C, cough & dyspnoea. After 4 weeks of massive antibiotic therapy temperature decreased, but X-ray examination revealed one round-shaped cloud. What histological changes is it possible to find in lung?

Acute destructive processes in lungs

Long time patient has suffered by chronic bronchitis & bronchiolitis, which later complicated by emphysema of lungs. Emphysema became to dominate in clinical picture. Patient has died. What is the cause of death?

Patient, 57 y.o., was admitted in hospital with attack of heart angina. In anamnesis: hypertensive disease during 20 years. On ECG: no changes, which are typical for myocardial infarction. After 15 minutes patient died from ventricular fibrillation. What changes were revealed in autopsy?

Patient has complains on breathlessness in physical activity, heartbeat, pains & tightness in heart region. There is periodic increasing of blood pressure during last several years. In examination diseases, which maybe connected with arterial hypertension were not revealed. Diagnose of hypertensive disease was established. What clinic-morphological variant of hypertensive disease is described?

Histological investigation of knee joint of patient of 22 y.o. revealed thinning of articular cartilage. What from predisposing conditions has place in appearance of these morphological changes in joint

What are the main microscopic changes in valve in case of acquired heart defects

Patient C., 50 y.o., died in the ambulance car, which was called because of appearance of severe retrosternal pain & fear of death. In autopsy: very liquid blood, features of increased angiostaxis, edema of lungs. Patient has died from

Patient, 68 y.o., was admitted in neurological intensive care unit with acute developed paralysis. Blood wasn’t revealed in liquor. There is infarction of left hemisphere of brain in anamnesis. What are the morphological changes in brain?

Male, 49 y.o., was admitted in hospital with complains on breathlessness, cough with abundant sputum. At first time such symptoms appeared 30 years ago, all this time he continued to smoke. On X-ray examination: emphysema of lungs, saccular & cylindrical dilations of bronchi, cardiac borders are dilated by means of right ventricle. There are clubbed fingers. Symptoms of developing renal insufficiency have appeared. Patient has died from hyperazotemic uremia. What is pulmonary disease of this patient?