Gastro-intestinal tract diseas 4 page

Increased pressure in the renal arteries

@Decreased arterial pressure

Urine excretion violation

Decreased oncotic BP

Increased pressure in the nephron capsule

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A 50-year-old man had been blocked up for 2 days because of earthquake. After he was rescued, the diagnosis of compression syndrome was made. What further complication is the most likely to develop in this case?

Acute vascular failure

Acute cardiac failure

@Acute renal failure

Acute hepatic failure

Acute respiratory failure

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Violation of safety rules resulted in calomel intoxication. Two days later the daily diuresis was 620 ml. A patient experienced headache, vomiting, convulsions, dyspnea, moist rales in lungs. What pathology is it?

Chronic renal insufficiency

@Acute renal insufficiency

Glomerulonephritis

Uraemic coma

Pyelonephritis

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A patient with the signs of mercuric poisoning had the following processes in kidneys: focal necrotic changes in tubules of the main departments, oedema, leukocytic infiltration and haemorrhages of the interstice and venous congestion. What patient’s condition have developed?

Acute glomerulonephritis

@Acute necrotic nephrosis

Chronic renal insufficiency

Acute pyelonephritis

Chronic pyelonephritis

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An autopsy of a patient, who died from poisoning of ethylene glycol, revealed enlarged edematous kidneys. Their capsule was taken out very easily. Gross investigation showed the wide pale-grey cortical layer and dark red medulla. What disease has developed at the patient?

@Necrotic nephrosis

Acute pielonephritis

Acute glomerulonephritis

Acute tubulointerstitial nephritis

Lipoid nephrosis

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The kidney biopsy is taken from the man who is in clinic with symptoms of a mercury poisoning. Histological investigation revealed focal tubular necrosis, an edema, hyperemia, hemorrhages and leukocytic infiltration in a stroma. What condition has developed at the patient?

@Acute necrotic nephrosis

Acute glomerulonephritis

Chronic renal insufficiency

Acute pyelonephritis

Chronic pyelonephritis

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A 42-year-old man, who had a complicated form of enteric fiver, acute nephral insufficiency developed of which he died. At the autopsy: kidneys are enlarged in size, oedematous, fibrous capsule can be easily removed; on the incision the cortex is pale-gray, pyramids are cherry. Histological exam reveals mostly narrow lumen of the tubules; epithelial cells are enlarged in size without nuclei; glomeruli are collapsed; stroma is oedematous with small leukocytic infiltration and small haemorrhages. What pathology is meant?

Pyonephrosis

Acute pyelonephritis

Acute glomerulonephritis

@Necronephrosis

Hydronephrosis

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At the patient operated concerning a widespread tumour of an abdominal cavity, the considerable bleeding and declining of arterial pressure took place. After operation the acute renal insufficiency, resulted in the patient's death, developed. An autopsy revealed the wide light pink cortical layer, which was clearly delimited from dark red pyramids. Histological investigation showed the absence of nuclei in epithelium of convoluted tubules, tubulorrhexis, venous hyperemia. Nuclei of the cells of vascular glomeruli and straight tubules were unchanged. What pathology of kidneys has developed at the patient?

@Necronephrosis

Infarct

Glomerulonephritis

Pyelonephritis

Nephrosis

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Histologic sections of a kidney reveal patchy necrosis of epithelial cells of both the proximal and distal tubules with flattening of the epithe­lial cells, rupture of the basement membrane (tubulorrhexis), and marked interstitial edema. Acute inflammatory cells are not seen. Which of the fol­lowing is the most likely diagnosis?

Acute pyelonephritis

@Acute tubular necrosis

Chronic glomerulonephritis

Chronic pyelonephritis

Diffuse conical necrosis

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A 49-year-old patient died of a massive bleeding from an operating wound. A post-mortem revealed enlarged kidneys with strained fibrous capsule. A gross investigation of a cut surface determined wide, pale grey color cortical layer accurately delimited from cyanotic, dark red pyramids. Histological study showed a necrosis and a marked dystrophy of an epithelium convoluted tubules, tubulorrhexis.What condition has developed in kidneys?

@Acute necrotic nephrosis.

Postinfectious glomerulonephritis

Lipoid nephrosis.

Rapidly progressive glomerulonephritis.

Secondary amyloidosis of kidneys.

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A young man died of a burn disease. A post-mortem revealed the brain edema, liver and kidneys enlargement. Gross investigation showed the thickened pale-grey cortical layer and hyperemic medulla. Histological study demonstrated focal tubular necrosis at different points along the nephron with a disruption of tubular basement membrane interstitial edema with leukocytic infiltration and a hemorrhage. What of the listed diagnoses the most authentic?

@Necrotic nephrosis.

Tubulointerstitial nephritis.

Pyelonephritis.

Gouty kidney.

Myeloma kidney.

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Histological study of a renal biopsy revealed a necrosis and a marked dystrophy of the convoluted tubules epithelium, tubulorrhexis, stromal edema and hyperemic medulla. Name the pathological process?

@Necrotic nephrosis

Glomerulonephritis

Pyelonephritis

Cystic disease

Kidney stone disease

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At the section of a man, who died of burn disease, the brain edema, the enlargement of the liver and kidneys were revealed. The cortex of the last is wide and pale-gray, but the medulla is sanguineous. Microscopically: necrosis of the tubules of main departments with the destruction of basal membranes, oedema of the interstitium with leukocytic infiltration and haemorrhages. What is the most possible diagnosis?

Tubulointerstitial nephritis

@Necrotic nephrosis

Pyelonephritis

Podagra kidney

Myeloma kidney

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On the 6th day of treatment a patient with acute renal insufficiency developed polyuria. Diuresis intensification at the beginning of polyuria stage of acute renal insufficiency is caused by:

Growth of natriuretic factor

Volume expansion of circulating blood

Reduction of vasopressin content in plasma

Reduction of aldosteron content in plasma

@Renewal of filtration in nephrons

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The patient treated for a cold by the big doses of paracetamol, presented symptoms of an oliguria and azotemia. In 5 days he died of an acute renal insufficiency. Histological investigation of kidneys revealed the diffusive edema of an interstitial tissue of a kidneys cortex, its infiltration by lymphocytes, the eosinophils, some neutrophils. Almost intact glomerules were found along with a destruction of a tubular epithelium. Name the most probable type of a kidneys lesion?

@Tubulointerstitial nephritis

Acute glomerulonephritis

Nephrotic syndrome

Pyelonephritis

Necronephrosis

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A 49-years-old- patient with a 10 days history of dysentery presented with raised body temperature, a pain in lumbar area, a fever and a considerable quantity of leucocytes in urine. Histological investigation of a puncture renal biopsy revealed hyperemia, interstitial leukocytic infiltration and numerous inflammatory cells (mainly neutrophiles) with a desquamated epithelium, filling renal tubules. What complication has developed at the patient?

@Acute pyelonephritis

Chronic pyelonephritis

Pyelitis

Glomerulonephritis

Necrotic nephrosis

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A macroscopic investigation of the removed kidney reveled renal swallowing, congestion and a capsule easily taken out. Renal pelvis and calyxes were dilated, filled by turbid urine. Their mucosa was dim, with the areas of hemorrhages. The cut surface of a kidney had a motley pattern; yellow-grey zones were surrounded by plethora and hemorrhages areas. To what disease there corresponds such macroscopic picture of kidneys?

@Acute pyelonephritis

Acute glomerulonephritis

Amyloidosis of kidneys

Nephrolitiasis

Renal cystic disease

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A 60-year-old woman died of a chronic renal failure. An autopsy revealed the irregularly contracted and markedly lobulated kidneys with a fibrous tissue alternated with an intact parenchyma. Renal pelvises were dilated, their walls - thickened. Histological investigation showed sclerosis, lymphocyte - plasmocyte infiltration of the renal pelvis walls, and interstitium. What diagnosis is most probable?

@Chronic pyelonephritis

Acute pyelonephritis

Acute glomerulonephritis

Tubulointerstitial nephritis

Chronic glomerulonephritis

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Histological investigation of a kidney biopsy showed sclerosis, lymphocyte – plasmocyte infiltration of the renal pelvis walls and calyces; tubules dystrophy and atrophy. The intact tubules were dilated, stretched by colloid-like masses. The epithelium was flattened. In whole, the microscopic picture of tissue sample had 'a thyroid kidney' pattern. What diagnosis is most probable?

@Chronic pyelonephritis

Sharp pyelonephritis

Glomerulonephritis

Nephrosclerosis

Tubulointerstitial nephritis

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A post-mortem of a patient with a long history of cystitis and a dyskinesia of ureters revealed morphological signs of uremia. Kidneys were contracted, with irregularly scarred surface. In the renal pelvis fine urate stones and sand were registered. Histological investigation showed 'the thyroid kidney' and areas of an interstitial inflammation. What is the most likely diagnosis?

@Chronic pyelonephritis

Acute pyelonephritis

Atherosclerotic-contracted kidney

Primary- contracted kidney

Amyloidal- contracted kidney

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At the section of a woman, who died of renal insufficiency, the kidneys are unevenly reduced in size and have surface with big tubers; on the incision the areas of cicatricial tissue change with the unchanged parenchyma, renal pelves are widened with thinned walls. Microscopically in the walls of renal pelves, calices and in the interstice are the facts of sclerosis and lymphoplasmocytic infiltration. What is the most possible diagnosis?

Acute glomerulonephritis

Acute pyelonephritis

@Chronic pyelonephritis

Tubulointerstitial nephritis

Chronic glomerulonephritis

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At the biopsy material from a kidney were detected: sclerosis, lymphoplasmocytic infiltration of renal pelves and calices; dystrophy and atrophy of the tubules. Saved tubules were widened, outstretched by colloid-like masses; the epithelium was squashed (disk kidney). What is the most possible diagnosis?

Nephrosclerosis

Acute pyelonephritis

Glomerulonephritis

@Chronic pyelonephritis

Tubulointerstitial nephritis

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A postmortem of a 58-year-old male revealed in kidneys asymmetrical, coarse, corticomedullary scars. Histological investigation of a kidney showed atrophy of cyst-like dilated tubules, filled with colloid eosinophilic masses. Interstitium was characterized by pronounced periglomerular sclerosis. What diagnosis is most probable?

@Chronic pyelonephritis with scarring

Chronic glomerulonephritis with scarring of kidneys

Amyloidosis of kidneys

Tuberculosis of kidneys

Kidneys at hypertension

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An autopsy of a 59- year-old man revealed the coral-like stone filled all renal pelvis of a right kidney. The kidney was enlarged, hyperemic with the capsule, taken out hardly. The pelvis and calyxes cavities were dilated, filled by a turbid, greenish- yellowish viscous liquid. The mucosal layer was dim with some hemorrhages. A cut surface investigation showed motley pattern of the kidney's tissue, with yellow spots in up to 1cm in diameter. What complication to nephrolithiasis has developed?

@Chronic pyelonephritis with exacerbation

Tumour of kidney

Postinfectious glomerulonephritis

Primary amyloidosis

Rapidly progressive glomerulonephritis.

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A 67-year-old woman presents with signs of slowly progressive renal failure. Physical examination reveals mild hypertension, while laboratory tests find increased serum creatinine and BUN with mild proteinuria. A few scattered neutrophils and rare bacteria are seen microscopically in her urine. Grossly both of her kidneys are small and irregular with dilation of the renal pelvis and clubbing of the calyces, these changes being similar in appearance to those seen in the picture below. Histologic sections from her kidneys revealed chronic inflammation of the interstitium. Which one of the following additional microscopic findings should be present in these histologic sections?

The renal papillae should have numerous activated macrophages

@The tubules should be dilated and filled with colloid casts

The afferent and efferent arterioles should demonstrate fibroelastic hyperplasia

The glomeruli should have multiple fibrin microthrombi

The interstitium should have needle-shaped crystals

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The kidneys of a patient, who died of chronic renal failure caused by chronic glomerulonephritis, are reduced in size, of solid consistence, the capsule can be hardly removed, exposing granular surface. On the incision cortex and medulla are thinned; renal tissue is dry, anaemic, of gray color. How can we term such kidney?

Atherosclerous-wrinkled

Primary wrinkled

@Secondary wrinkled

Amyloid-wrinkled

Pyelonephritic-wrinkled

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A 53-year-old patient with a history of a chronic glomerulonephritis died of chronic renal insufficiency. A post-morten revealed smaller that normal, firm kidneys. Their capsule was taken out hardly, baring a granular renal surface. On a cut section a cortical and cerebral layers were thin with dry, anemic, grey color kidneys tissue. How is called such kidneys?

@Secondary - scarring kidneys

Primary - scarring kidneys

Atherosclerotic - scarring kidneys

Amyloidal - scarring kidneys

Pyelonephrotis - scarring kidneys

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An autopsy of the 68-year-old man revealed a sallow-grey colour of his skin with petechial hemorrhages. His face and tongue had a powdery 'uremic frost'. Fibrinous hemorrhagic laryngitis, a tracheitis, a shaggy pericardium and a catarrhal gastroenterocolitis were also diagnosed. For what syndrome the given complex of morphological changes is characteristic?

@Chronic renal insufficiency

Acute hepatic insufficiency

Acute renal insufficiency

Chronic heart insufficiency

-

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For a long time a 49-year-old woman had suffered from glomerulonephritis which caused death. The autopsy revealed that the size of her kidneys was 7х3х2,5 sm, weight 65,0 g, they were dense and small-grained. Microscopically: fibrinogenous inflammation of serous and mucous capsules, dystrophic changes of parenchymatous organs, brain edema. What complication can cause such changes of serous capsules and inner organs?

Sepsis

DIC-syndrome

Anemia

@Uraemia

Thrombopenia

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A post-mortem of a 52- year-old man, with a long history of chronic glomerulonephritis, resulted in his death, revealed markedly reduced, firm, fine-grained kidneys. Microscopical investigation showed fibrinous inflammation of serous and mucosas, dystrophic changes of parenchymatous organs and a brain edema. What complication has led to the serous and mucosas lesions?

@Uremia

Anaemia

Sepsis

DIC-syndrome

Thrombocytopenia

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A 55 year-old man has died after chronic glomerulonephritis, chronic renal insufficiency. In the autopsy the pathologist has found out characteristic changes in kidneys for this disease, also fibrinous pericarditis, pleuritis, bronchitis. Call the cause of the fibrinous inflammation in serosal and mucosal layers.

@Uremia

Hypolipidemia

Hyperlipidemia

Arterial hypertension

Arterial plethora

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A 27-years-old woman has been suffered by diabetes mellitus since she had been a child. During the last years the arterial hypertension and proteinuria have occurred. She has died with signs of uremia. What typical changes were found out in autopsy?

@“Cor villosum”

“Tiger heart”

“Armor heart”

Mesenchymal fat dystrophy of the heart

Purulent pericarditis

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All the following statements are true of urinary calculi EXCEPT

they are common in males

@they are bilateral in 40 percent of cases

they are radiopaque in about 90 percent of cases

they may be associated with Pseudomonas infection

the incidence is increased in leukemia

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A 35-year-old woman presents with the sudden onset of severe, col­icky pain on the right side other abdomen. She does not relate the pain to food, but says that she cannot find a pain-free position. Physical examina­tion finds marked tenderness over the right costovenebral angle, but rebound tenderness is not present. A pelvic examination is unremarkablMicroscopic examination of her urine reveals the presence of numerous red blood cells. The urine is negative for esterase and nitrite, and no bacteria are seen. Which of the following is the most likely cause of her signs and symptoms?

Choledocholithiasis

Cholelithiasis

Cystitis

@Nephrolithiasis

Pyelonephritis

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A 65 year old man suffering from gout complains of kidney pain. Ultrasound examination revealed renal calculi. The most probable cause of calculi formation is the strengthened concentration of the following substance:

Bilirubin

Cystine

Cholesterol

@Uric acid

Urea

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A patient with urolithiasis after the examination was administered allopurinol - competitive inhibitor of xanthine oxidase. It was influenced by chemical analysis of the calculuses, which consisted mainly of:

Calcium sulphate

Calcium oxolate monohydrate

Calcium oxolate dihydrate

Calcium phosphate

@ Sodium urate

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Date: 2016-03-03; view: 1483