Compensatory and adjustment processes. 2 page

B lymphocyte hypertrophy

Follicular dysplasia

@Follicular hyperplasia

Germinal center atrophy

Germinal center metaplasia

#

A patient with a history of frequent hemorrhoid bleeding died of acute myocardial infarction. A post-mortem revealed a red, succulent bone marrow of a hip diaphysis. What pathology developed in a bone marrow?

@ Compensatory hyperplasia

Vicarious hypertrophy

Hypertrophy excrescences

Hormonal hyperplasia

Work hypertrophy

#

A 38-year-old man incurs a traumatic blow to his upper left arm. He continues to have pain and tenderness even after 3 months have passed. A plain film radiograph reveals a 4 cm circumscribed mass in the soft tissue adjacent to the humerus. The mass contains areas of brightness on the x-ray. Over the next year this process gradually resolves. Which of the following terms best describes this process?

Dysplasia

@Hyperplasia

Hypertrophy

Metaplasia

Neoplasia

#

Usually the patients with sepsis have spleen and liver enlargement. What process is underlying this state?

Metaplasia

Neoplasia

@Hyperplasia

Hypertrophy

Pigment accumulation

#

The left lobe of an adult donor liver is used as an orthotopic transplant in a recipient relative with severe liver disease. A year later, the size of each liver is greater than at the time of transplantation. Which of the following mechanisms explains this phenomenon?

Metaplasia

Dysplasia

@Hyperplasia

Anaplasia

Neoplasia

#

In a 40-year-old man, who has a stenosing (without metastases) cancer of the esophagus, the following changes can be observed: the atrophy of the skeleton muscles and of subcutaneous fat. The skin is of ground black colour, epidermis is thinned, and the heart is regressed in size. The myocardium and the liver are of brown colour. Make a diagnosis.

Addison’s disease

Myasthenia

Cachexy caused by cancer

Brown atrophy

@Alimentary cachexy

#

Examination of a 40 y.o. man ill with stenosing (without metastases) esophageal carcinoma revealed the folowing changes: atrophy of skeletal muscles and fatty tissu E. His skin is sallow, epidermis is attenuated, heart has grown smaller. Myocardium and liver are brown. What is the most probable diagnosis?

Brown atrophy

@Alimentary cachexia

Myasthenia

Cancerous cachexia

Addison's disease

#

A man with stenotic oesophageal cancer gained the following: atrophy of skeletal muscle and fat cellulose, skin is brown colour, thin epidermis, heart is diminished in size, myocardium and liver are brown coloured. Name the diagnosis.

@Alimentary cachexia

Myasthenia

Cancer cachexia

Brown atrophy

Addison's disease

#

A patient, who had a cancer of the stomach, died of cancer cachexy. At the autopsy the characteristic changes were detected. How can we call such heart?

Bony heart

Hairy heart

@Brown atrophic heart

Tiger heart

Bovine heart

#

During an autopsy of a man: heart size is diminished, fat cellulose under epicardium is absent, myocardium is thick, brown coloured. Microscopically: cardiomyocytes are diminished, sarcoplasm is full of brown grains of lipofuscin. Name the pathological process.

@Brown atrophy

Amyloidosis

Oil dystrophy

Haemochromatosis

Hypertrophy

#

During an autopsy of a man: heart size is diminished, fat cellulose under epicardium is absent, and myocardium is thick, brown coloured. Microscopically: cardiomyocytes are diminished; sarcoplasm is full of brown grains of lipofuscin. Name the pathological process.

Hypertrophy

Amyloidosis

Oil dystrophy

Haemochromatosis

@Lipofuscinosis

#

A 31-year-old primigravida has a difficult delivery of a term infant. There is loss of 1500 cc of blood. She has hypotension for 6 hours. Over the next month, her ACTH level decreases. Within the next 3 months, her adrenal glands become only about 2 grams each (normal 4 to 6 grams). This alteration of the adrenals is primarily due to which of the following cellular processes?

Metaplasia of the cortex

Lipid depletion of the cortex

Atrophy of the medulla

@Atrophy of the cortex

Adrenal infarction

#

A 7-year-old child presented with a poliomyelitis. His somatic muscles are weak, their volume is reduced, and skin is dry and pale. Choose the most likely pathology, which takes place in the soft tissues?

@ Atrophy

Hypertrophy

Hyperplasia

Metaplasia

Hypoplasia

#

There were adenoma of the prostate and big kidneys with enlarged pelves and calyces, filed with clear fluid on the autopsy. Name the process in the kidneys.

@Atrophy

Inflammation

Hypertrophy

Tumor

Necrosis

#

78 year-old male has complained the retention of urine, intermittent oligouria and incomplete urination. After examination the enlargement of prostate and compression of urethra were revealed. Urography shows the bilateral dilation of ren pelvis and caps, as well as diminishing of kidney parenchyma. What process led to these kidney changes?

Metaplasia

@Atrophy

Hyperplasia

Hypertrophy

Cell injury

#

During a histological research of a removed tooth: sclerosis of conjunctive tissue of the pulp, decreased amount of odontoblasts of reduced size and pulpocytes. Name the diagnosis.

Pulp dystrophy

Pulp necrosis

@Pulp atrophy

Pulp hyalinosis

Acute pulpitis

#

An autopsy of an elderly male revealed the atherosclerosis of the brain arteries accompanied with the thinning of the brains cortex. Name the cause of the atrophy?

@Ischemia

Compression

Chemical and physical factors

Loss of innervations

Decreased workload

#

During an autopsy of a 69 year old woman, who has been suffering from chronic hypertension there was revealed, that both kidneys are of thick consistency, shrunken and with granular surface. How these changes are called?

@Atrophy due to ischemia

Atrophy due to pressure

Elderly atrophy

Dysfunctional atrophy

Hypoplasia

#

A post-mortem of a 64-year-old woman with a long story of hypertensive disease revealed considerably diminished, dense kidneys with a fine-grained surface. What pathology such changes are characteristic for?

@ Blood insufficiency atrophy

Atrophy from pressure

Senile atrophy

Dysfunctional atrophy

Hypoplasia

#

During an autopsy of a 86 year old woman, who suffered from atherosclerosis of cerebral vessels there was cerebral cortex atrophy found. What is the name of such atrophy?

@Atrophy due to insufficient blood supply

Atrophy due to pressure

Atrophy due to chemical and physical factors

Neurotic atrophy

Dysfunctional atrophy

#

Pathohistologic examination of endometrium of 64 year-old menopausal female has revealed: the amount of endometrial glands as well as stroma cells are decreased, stroma replaced by connective tissue, endometrial glands predominantly have small size. What is the name of this condition of endometrium?

Inflammatory metaplasia

Virus-induced neoplasia

Age-related hyperplasia

@Hormonal atrophy

Work hypertrophy

#

A teenager complains of muscular atrophy and negative volume of the shank after a long healing up of the femur fracture without nerve damage. How can we term such atrophy?

Of compression

Neurotic

Of short blood supply

@Dysfunctional

Of physical factors’ influence

#

After long-healing fracture of right thigh bone (nerves weren't damaged), a teenager complains on muscles getting thin and decrease in volume of his right leg. What's the name for such atrophy?

Neurotic

@Dysfunctional

Caused by ischemia

Caused by pressure

Caused by physical factors

#

After removal of tooth patient gained an atrophy of edges of tooth pocket. What kind of atrophy is this?

Ischemic atrophy

@Dysfunctional atrophy

Atrophy due to pressure

Neurotic atrophy

Atrophy due to physical and chemical factors

#

A young male complains of diminishing leg muscles in size and volume as a result of the complicated femoral fracture. The innervations of the muscles was not lost. Name the type of atrophy?

@Disuse atrophy

Degeneration atrophy

Ischemic atrophy

Atrophy due to compression

Atrophy due to chemical and physical influence

#

Histological examination of a 40 y.o. man's thymus revealed decreased share of parenchymatous gland elements, increased share of adipose and loose connective tissue, and its enrichment with thymus bodies. The organ's mass was unchanged. What phenomenon is it?

@Age involution

Hypotrophy

Atrophy

Dystrophy

Accidental involution

#

A 4-years-old girl was operated because of an acute appendicitis. During the operation in the retroperitoneal space it was found that the right kidney is less by 1/3 in comparison with the left one. The diameter of the right renal artery was 0,3 cm, the left one was 0,4 cm. What pathologic process did occur in that case?

@Hypoplasia

Pathologic atrophy

Physiologic atrophy

Aplasia

Agenesia

#

TUMOURS

Epithelial tumour

#

Continuous taking of some drugs foregoing the pregnancy increase the risk of giving birth to a child with genetic defects. What is this effect called?

Embryotoxic effect

Blastomogenic effect

@Mutagenic effect

Fetotoxical effect

Teratogenic effect

#

A 56-year-old man has had a chronic cough for the past year. He is a non smoker. He recently had an episode of hemoptysis. A chest x-ray demonstrates a 6-cm perihilar mass. A sputum sample is collected, and the sputum cytology report reads "Atypical cells present -suggestive of squamous cell carcinoma. Which of the following environmental exposures is most likely to be associated with these findings:

@Asbestos

Radon

Silica

Benzene

Formaldehyde

#

Of the following characteristics of neoplasms, which implies the best prognosis:

Increased expression of laminin receptors

Increased cathepsin expression

Decreased apoptosis

@Decreased doubling time

Decreased nuelear/cytoplasmicratio

#

A biopsy is performed on a patient with a mass lesion that proves to be a neoplasm. Of the following histopathologic findings, the one that best indicates that a neoplasm is malignant is:

Pleomorphism

Atypia

Invasion

@Increased nuclear/cytoplasmic ratio

Necrosis

#

A 65-year-old woman has a firm mass with irregular borders felt in her left breast on a routine physical examination. A fine needle aspiration is performed and microscopic examination shows an infiltrating ductal carcinoma. A left mastectomy with axillary lymph node dissection is performed. A tissue sample of this neoplasm is submitted for analysis by flow cytometry. Which of the following does flow cytometric analysis most likely?

@Determination of aneuploidy

Determination of the karyotype

Diagnosis of benign neoplasms

Distinguishing carcinoma from sarcoma

Quantitation of RNA content

#

An epidemiologic study is performed to determine risk factors for development of malignant neoplasms. A statistical analysis of pre­existing medical conditions is done. Some pre-existing conditions are observed to precede development of malignant neoplasms, while others do not. Which of the following conditions is most likely to be statistically unrelated to subsequent malignancy?

Endometrial atypical hyperplasia

Chronic alcoholism with hepatic cirrhosis

@Cervical squamous dysplasia

Chronic ulcerative colitis

Uterine leiomyomas

#

A 21-year-old woman has a routine Pap smear performed for a health screening examination. The pathology report indicates that some cells are found cytologically to have larger, more irregular nuclei. A follow-up cervical biopsy microscopically demonstrates disordered maturation of the squamaous epithelium, with hyperchromatic and pleomorphic nuclei extending nearly the full thickness of the epithelial surface. No inflammatory ccells are present. Which of the following descriptive terms is best applied to these Pap smear and biopsy findings?

@Dysplasia

Metaplasia

Anaplasia

Hyperplasia

Aplasia

#

At the histological examination of a formation was detected that parenchyma was formed of integumentary epithelium with an increased amount of strata. Stroma together with the epithelial proliferation forms papillae. Term the form of atypism.

Metabolic

Cell

Hystochemical

Functional

@Tissue

#

A teenager male presents with slowly enlarging, painless nodule on his right hand's skin. Microscopic examination of removed lesion revealed an increased number of epithelial layers, with a stroma underneath, with developed a papillomatous pattern. Identify most likely type of atypia?

@ Tissue

Cellular

Metabolic

Functional

Hystochemical

#

A 23-year-old female decided to have a surgeon's removal of a small nodule at her leg's skin. An operation material delivered to pathology department. A histological examination of a new growth has shown that parenchyma has been formed of integumentary epithelium with an increased amount of layers. Stroma together with epithelial proliferation forms papillae. What is the most likely form of atypism?

@Tissue

Cellular

Histochemical

Functional

Metabolic

#

During a histological research of skin neoplasm: parenchyma is made of covering epithelia with increased amount of layers in it. Stroma along with epithelia forms papillae. Name the type of atypism.

@Tissue

Cell

Histochemical

Functional

Metabolic

#

A study is performed to analyze characteristics of malignant neoplasms in biopsy specimens. The biopsies were performed on patients who had palpable mass lesions on digital rectal examination. Of the following microscopic findings, which is most likely to indicate that the neoplasm is malignant?

Pleomorphism

@Atypia

Invasion

Increased nuclear/cytoplasmic ratio

Necrosis

#

A 53-year-old woman feels a lump in her right breast. Her physician palpates an irregular 3 cm mass that is not movable because it appears fixed to the overlying skin, which is retracted. A mastectomy is performed and the pathologist on sectioning the breast finds a 3 x 3.5 cm ovoid mass that does not have discrete borders, but appears to infiltrate into the surrounding fibrofatty breast stroma. The mass is firm, white, and has a fibrous consistency. Which of the following features is most likely demonstrated by the gross appearance of this mass?

@Anaplasia

Aplasia

Desmoplasia

Dysplasia

Metaplasia

#

A 37-year-old woman complained of prolonged cramps, nausea, vomiting, diarrhea, and episodic flushing of the skin. At autopsy, pearly-white, plaquelike deposits were found on the tricuspid valve leaflets. These cardiac lesion most likely were due to

Rheumatic heart disease

Amyloidosis

Iron overload

Hypothyroidism

@Carcinoid heart disease

#

A 59-year-old man has had a worsening cough with chest pain for the past 6 months. On physical examination he has no remarkable findings. A chest x-ray shows a 3 cm left lung mass. A sputum cytology specimen yields cells diagnosed as a squamous cell carcinoma. A mediastinoscopy is performed and reveals metastases in a lymph node. He is given radiation therapy, and the mass diminishes in size. Which of the following classifications best indicates the stage of his disease?

@T₁N₁M₀

T₁N₀M₁

T₂N₁M₀

T₃N₀M₀

T₄N₁M₁

#

A 66-year-old man has a routine physical examination and a stool sample proves positive for the presence of occult blood. He undergoes colonoscopy and a 5 cm sessile mass is present in the sigmoid colon. Biopsy of the mass yields a diagnosis of adenocarcinoma. A chest x-ray shows multiple 1 to 3 cm nodules in both lungs. Presence of which of the following in the neoplastic cells is most likely to explain the presence of lung nodules?

T₁N₁M₀

@T₁N₀M₁

T₂N₁M₀

T₃N₀M₀

T₄N₁M₁

#

A lump in the right breast is discovered on physical examination of a 48-year-old woman. The mass is 4 cm in diameter and appears fixed to the chest wall. Another 2-cm mass is palpable in the left axilla. A chest radiograph reveals multiple 0.5 to 2-cm nodules in both lungs. Which of the following classifications best indicates the stage of her disease:

T1 N1 MO

T1 NO Ml

T2 N1MO

T3 NO MO

@T4 N1 M1

#

A 44-year-old woman notes a lump in her left breast while taking a shower. Her physician notes a 3 cm firm, irregular, non-movable mass located in the upper outer quadrant of her left breast on physical examination. A fine needle aspiration of this mass is performed. Cells obtained from the mass are examined cytologically and are consistent with infiltrating ductal carcinoma. The mass is removed with lumpectomy along with an axillary lymph node dissection. Which of the following findings will best predict a better prognosis for this patient?

The tumor cells are strongly estrogen receptor positive

@No metastases are found in the sampled lymph nodes

Flow cytometric analysis demonstrates aneuploidy and a high S-phase

She has one relative who had a similar type of breast cancer

The tumor has a high grade

#

A 66-year-old woman has developed a chronic cough over the past 2 months. No abnormal physical examination findings are noted. A chest x-ray shows a 3 cm mass in the right upper lobe. After fine needle aspiration biopsy, the mass is resected. Gross and microscopic examination of the mass is performed and it is determined that a neoplasm is present. Which of the following findings regarding this mass is most likely to be irrelevant for determining further therapy and prognosis?

Is the neoplasm invading the margin of resection?

What is the size of the neoplasm?

@What is the degree of atypia and pleomorphism of the neoplastic cells?

How much inflammation is present in the neoplasm?

Is the neoplasm primary or metastatic?

#

A surgical pathology report indicates that a certain neoplasm is graded as grade I on a scale of I to IV. Clinically, this neoplasm is found to be stage I. These findings imply that this neoplasm:

Is unlikely to be malignant

Has probably arisen from epithelium

May spread via lymphatics

Has an in situ component

@Is well-differentiated and localized

#

Preventive examination of a patient revealed an enlarged lymph node of metastatic origin on the medial wall of the left axillary crease. Specify the most likely localization of the primary tumour:

Submandibular salivary gland

Stomach

Lung

Thyroid gland

@Mammary gland

#

A 55-year-old man dies after a year-long illness. At autopsy the liver contains multiple tumor masses from 2 to 5 cm in size that are mostly firm and tan and that grossly exhibit umbilication with central necrosis. Which of the following statements would best characterize the significance of such an appearance?

There is multicentric origin of a benign neoplasm.

The neoplasm has a high grade.

@The primary neoplasm is in the stomach.

A carcinogen was the underlying cause for the neoplasm.

The neoplasm has an advanced stage.

#

A 39-year-old woman presented in oncology with a stomach cancer. Physical investigation revealed metastatic tumors in ovaries (Krukenberg tumors). What is most likely pattern of spread in that case?

@Lymphatic retrograde

Lymphatic orthograde

Gematogenous

Implantation

Along epithelium-lined surfaces

#

A 60-year-old man who has a 90-pack year history of cigarette smoking has had a chronic cough for years. He has recently begun to lose weight. He has a chest radiograph that reveals a right hilar mass. A sputum cytology shows atypical, hyperchromatic squamous cells. What is the most common initial pathway of spread of this lesion:

Bloodstream

Pleural cavity

Contiguous spread to chest wall

@Lymphatics

Bronchi

#

A post-mortem of a 48-year-old woman with a history of an operated stomach tumour in the past revealed markedly enlarged, dense, whitish color ovary. Histological investigation of the ovarian tissue showedutterly atypical epithelial cells, placed among layers and cords of a connective tissue. What if the most likely disease?

@Krukenberg's carcinoma of ovary

Serous cystadenocarcinoma

Pseudomucinous cystcarcinoma

Malignant thecoma

Malignant granular cell tumor

#

A physical examination of a 42-year-old patient revealed enlarged supraclavicular lymph nodes. A histological investigation of a lymph node biopsy showed the metastasis of a signet-ring cancer. Choose the most probable localization of a primary tumour.

@Carcinoma of stomach

Cancer of esophagus

Cancer of thyroid gland

Carcinoma of lungs

Carcinoma of uterine cervix

#

A post-mortem of a 59-year-old man, who died of a lung cancer, revealed plural metastases. What kind from the listed below metastases it is possible to regard as implantation (contact) one according to a mechanism of development?

@Multiple tumorous nodules of pleura

Metastasis in prebronchial, paratracheal lymphatic knots

Metastasis in a brain

Metastases in an adrenal gland

Invasion of tumor from bronchus in an esophagus

#

A 60-year-old man who has a 90 pack year history of cigarette smoking has had a chronic cough for the past 10 years. He has begun to lose weight during the past year. No abnormal findings are noted on physical examination. He has a chest radiograph that reveals a right hilar mass. A sputum cytology shows atypical, hyperchromatic squamous cells. What is the most common initial pathway of spread of this lesion?

Bloodstream

Pleural cavity

@Contiguous spread to chest wall

Lymphatics

Bronchi

#

A mass lesion in the right upper lobe of lung found by chest radiograph is removed by wedge resection and sent to Surgical Pathology, where a neoplasm is diagnosed. Findings that will be important for determining further therapy and prognosis include all of the following EXCEPT:

Is the neoplasm invading the margin of resection?

What is the size of the neoplasm?

What is the degree of atypia and pleornorphism of the neoplastic cells?

@How much inflammation is present in the neoplasm?

Is the neoplasm primary or metastatic?

#

An autopsy of a 50-year-old man, who died of cancer intoxication, revealed the thickening of a stomach's wall to 1, 2 cm. The mucosa was fixed, with ill-defined gastric folds. On a cut view a tissue was homogeneous, whitish with chondroid density. For what macroscopical form of a tumour the described changes are characteristic?

@Infiltrate

Node

Ulcer

Ulcerous-infiltration

Cyst

#

During an autopsy of man, who died of cancer intoxication: gaster wall is thickened (1,2cm), mucous membrane is immovable and has no folds. On incision is homogenous, white coloured, has consistency of cartilage. What morphologic kind of tumour is this?

@Infiltration

Node

Ulcer

Ulcer-infiltrative

Cyst

#

A 45 year old woman has a chest x-ray taken and is found to have a peripheral "coin lesion" that is a rounded, circumscribed 2.5 cm mass in the right mid-lung field. She has no chest pain, cough, or fever. The biologic characteristic that best distinguishes this lesion as a neoplasm, rather than a granuloma is:

Recurrence following excision

Rapid increase in size

Sensitivity to radiation or chemotherapy

@Uncontrolled (autonomous) growth

Necrosis

#

A 45-year old male with a family history of a gastric cancer inquires about screening. A gastroscopic examination of a patient revealed a pedunculated tumor mass 1.5 cm in diameter in the area of the lesser curvature of stomach. What kind of growth does the tumor have?

@Exophytic

Expansive

Infiltrating

Appositional

Endophytic

#

Pre-malignant conditions include all of the following conditions EXCEPT:

Endometrial hyperplasia following prolonged estrogen therapy

Chronic alcoholism leading to micronodular cirrhosis of the liver

Cervical squamous dysplasia

Chronic ulcerative colitis

@Multiple leiomyomas of the uterine myometrium

#

A 40-year-old woman has had a feeling of abdominal discomfort for the past 8 months. On pelvic examination, there is a right adnexal mass. An abdominal CT scan demonstrates a 7 cm cystic mass involving the right ovary with small areas of calcification. The uterus is normal in size. The right fallopian tube and ovary are removed surgically. Grossly, the mass on sectioning is filled with abundant hair and sebum. Microscopically, the mass has glandular spaces lined by columnar epithelium, squamous epithelium with hair follicles, cartilage, and dense connective tissue. Which of the following statements regarding this type of neoplasm is most appropriate?

A sarcomatous element is usually present

A human papillomavirus infection preceded development of this mass

Metastases are unlikely to be present

@Tissues resembling those from an embryo can usually be seen

Such a mass is often seen to arise in the testis

#

A 40-year-old woman has had a feeling of abdominal discomfort for the past 8 months. On pelvic examination, there is the right adnexal mass. Abdominal CT scan demonstrates a 7 cm cystic mass involving the right ovary with small areas of calcification. The uterus is normal in size. The right fallopian tube and ovary have been removed surgically. Grossly, the mass on sectioning is filled with abundant hair and sebum. Microscopically, the mass has glandular spaces lined by columnar epithelium, squamous epithelium with hair follicles, cartilage, and dense connective tissue. What type of tumour is it?

Melanoma

Squamous cell carcinoma of ovary

Metastase of cervical carcinoma

@Teratoma

Sarcoma of ovary

#

A 32-year-old woman has noted dull pelvic pain for the last two months. On physical examination there is a mass palpated in the right lower quadrant. An abdominal ultrasound reveals an 8 cm mass involving the right ovary. The mass is surgically excised. On gross inspection, the surface of the mass is smooth, is not adherent to surrounding pelvic structure, and is cystic and filled with hair on sectioning. On microscopic examination there is squamous epithelium, tall columnar glandular epithelium, cartilage, and fibrous connective tissue. Which of the following neoplasms is she most likely to have?

@Teratoma

Choristoma

Hamartoma

Myxoma

Mesothelioma

#

An epidemiologic study is performed involving patients with long-standing Epstein-Barr virus infection. It is observed that these patients have an increased risk for development of malignant neoplasms in adulthood. Which of the following neoplasms is most likely to be found in these patients?

@Nasopharyngeal carcinoma

Kaposi sarcoma

Small cell anaplastic carcinoma of lung

Date: 2016-03-03; view: 2148