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Tuberculosis. Syphilis.

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A child died of a diffuse peritonitis. An autopsy revealed the primary intestinal tubercular complex with primary affect, a lymphangitis and regional caseous lymphadenitis. In addition, an ulcer of an empty intestine with perforation was found within the primary affect focus. What is the most likely way of tuberculosis infection in presented case?

@Alimentary (nutritional)

Transplacental

Aerogenic

Mixed

Contact

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At the section of a died child was revealed primary intestinal tuberculous complex: primary affect-ulcer of jejunum, lymphangeitis and regional caseous lymphadenitis. The death was of the ulcer perforation and development of diffuse peritonitis. Name the way of contamination of the child with tuberculosis.

Transplacental

@Alimentary

Aerogenous

Mixed

Contagious

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An autopsy of a 7-year-old child revealed in the apex of the right lung, under the pleura, a focus of caseous necrosis, 15 mm in diameter. There were also enlarged bifurcational lymph nodes with small necrotic foci. A microscopical investigation of the pulmonal focus and the lymph node's lesion showed necrotic masses surrounded by epithelioid cells, lymphocytes and solitary giant multinuclear Pirogov-Langhans' cells. What is the most likely disease?

@Primary tuberculosis

Gematogenic tuberculosis with the lesions of lungs

Gematogenic generalized tuberculosis

Secondary inflammatory tuberculosis

Secondary fibro-inflammatory tuberculosis

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The girl within last 3 months ate the crude cow milk. She arrived in the hospital with the "acute abdomen" symptoms. An operation revealed in a caecum a circular ulcer with perforation. A histological study of the ulcer edges determined necrotic masses, lymphocytes, epithelioid cells, and few multinucleated giant cells

What is your diagnosis?

@Primary intestinal affect at tuberculosis

Nonspecific ulcerous colitis

Amebiasis

Carcinoma of blind gut (cecum)

Dysentery

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A histological investigation of the enlarged supraclavicular lymph nodes, removed from a 40-year- old woman, revealed an alteration of their structure with aggregates of slightly extended cells with a light nucleus. The multinuclear, large, oval-round form cells were also determined. These cells were rich with a cytoplasm and their nuclei were located on periphery in the form of a paling. The lymphoid cells created the next layer. The unstructured pinkish masses were seen within the centers of lesions. What the described changes are characteristic for?

@Tuberculous lymphadenitis

Metastasis of tumor

Lymphogranulomatosis (Hodgkin's disease)

Hyperplasic lymphadenitis

Sarcoidosis (Boeck's disease)

#

After introduction of BCG vaccine to babies’ immunity against tuberculosis lasts until in an organism will be alive bacteria of vaccinal strain. How to name such kind of immunity in the most correct way?

@Nonsterile

Humoral

Typospecific

Congenital

Cross-immunity

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At carrying out of medical inspection of pupils Mantoux test was done. Presence of which from the listed below specific factors determines the positive reaction?



@Ò-lymphocytes

B-lymphocytes

Antibodies

Erythrocytes

Leukocytes

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At 10 years old child Mantoux test (with tuberculin) was done. In 48 hours in the place of tuberculin injection papule 8 mm in diameter has appeared. Which type of hypersensitivity has developed after tuberculin injection?

@IV type of hypersensitivity

Phenomenon of Arthus

Atopic reaction

Serum sickness

II type of hypersensitivity

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Test Mantoux that appeared negative was done in child at his registration to school for the decision of necessity of revaccination. This result of test testifies about?

@About absence of cellular immunity to a tuberculosis

About presence of cellular immunity to a tuberculosis

About absence of antibodies to tubercular bacteria

About absence of antitoxic immunity to a tuberculosis

About presence of antibodies to tubercular bacteria

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A lung lobe was removed at Surgery Department due to preliminary diagnosed purulent inflammation of a cyst. A gross investigation of the operative material revealed within the 8 segment a dense focus with irregular roundish form, 1,8 cm in diameter. On a cut, it had white-yellow coloring with a dim surface and fine sites of osteal density. The described macroscopical picture characteristic for:

@Tuberculous affect with healing

Peripheral carcinoma of lung

Chondromas

Carnification

Chronic pneumonia

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A post-mortem of a 43-year-old man revealed in the 3 segment of the right lung under the pleura an area of consolidation, 1,5 cm in diameter, with the accurate borders, surrounded with a whitish fibrous tissue. A gross investigation of a cut section showed the white-yellow crumbling foci. Presence of the described focus is characteristic for:

@Encapsulation of primary affect

Peripheral carcinoma

Chondroma

Fibroma

Infarct of lung with organization

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At the section of a 17-year-old girl, who died of lung insufficiency, were revealed confluent areas of caseous necrosis, the facts of caseous necrosis in bronchopulmonary, bronchial and bifurcation lymphatic nodules. What is the most possible diagnosis?

Tuberculoma

Haematogenous form of progressing of primary tuberculosis

Haematogenous tuberculosis with preferable affection of lungs

@The growth of the primary affect at primary tuberculosis

Caseous pneumonia at secondary tuberculosis

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A post-mortem of the 17-year-old girl, who died of a pulmonary insufficiency, revealed confluent zones of a caseous necrosis in the lower lobe of the right lung. The caseous necrosis was also determined in broncho- pulmonal, bronchial and bifurcational lymph nodes. What of the listed diagnoses the most likely?

@ Growth primary affect at primary tuberculosis

Gematogenic form of progress of primary tuberculosis

Gematogenic tuberculosis with lesion of lungs

Tuberculoma

Caseous pneumonia at the secondary tuberculosis

#

An 8-year-old child, with no disease in his medical history, presented to the hospital with a dyspnea. An x-ray inspection showed the air and a liquid in a pleural cavity. During operation in the right lung the subpleural cavity, 2,4 cm in diameter was found. It had an irregular form with the residual caseous masses inside. The lesion was connected with the pleural cavity. The similar caseous masses were found at a cut of the enlarged radical lymph nodes. A histological research of a cavity's wall determined lymphocytes, epithelioid cells and multinuclear giant cells. How correctly to name a cavity?

@Primary pulmonary cavity (cavern) at tuberculosis

Abscess of lungs

Empyema of pleura

Cavity (cavern) at acute cavernous tuberculosis

Cavity at fibrocavernous tuberculosis.

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An autopsy of a 44-year-old man revealed tuberculosis. A macroscopical investigation showed in the apex of the right lung the foci of caseous pneumonia. There were caseous lymphadenitis of enlarged lymph nodes of mediastinum and plural milium nodules in many organs. Name the described form of tuberculosis?

@Primary with mixed form of progressing

Primary with gematogenic spreading

Primary with lymphogenic spreading

Primary with growth of a primary affect

Gematogenic

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A medical record of a dead child reveled meningeal symptoms in his medical history. His X-ray showed a dark patch in the III segment of the right lung and enlarged radical lymph nodes. At autopsy, in cerebral arachnoids, the millet grains-like nodules were found. Microscopical study of a nodule determined a focus of a caseous necrosis with wall of epithelioid, lymphoid cells with giant cells between them. These giant cells had big nuclei, situated on periphery in the form of a half moon. What is the most likely kind of meningitis?

@Tuberculous

Syphilitic

Brucellous

Influenzal

Meningococcal

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A 26-year-old patient arrived in a hospital with complaints to a fever and weakness. One of the enlarged cervical lymph nodes was taken for histological study. Microscopical investigation showed in lymphoid tissue the centers of necrosis, surrounded with epithelioid cells, giant multinuclear Pirogov-Langhans cells and lymphocytes. What is the most likely disease?

@Tuberculosis

Lymphogranulomatosis (Hodgkin's disease)

Lymphatic leukemia

Sarcoidosis (Boeck's disease)

Syphilis

#

A histological investigation of the cervical lymph node revealed the aggregation of epithelioid cells, lymphocytes and giant Pirogov - Langhans cells. In the centre of a lesion a caseous necrosis was present. Specify the most likely pathology.

@Tuberculosis

Rhinoscleroma.

Sarcoidosis (Boeck's disease)

Glanders

Syphilis

#

A histological study of the enlarged cervical lymph nodes revealed nodules with giant, spherical-oval form cells. These cells had a light pink cytoplasm and nuclei located on a periphery. The found out changes are characteristic for:

@Tuberculosis

Lymphogranulomatosis (Hodgkin's disease)

Sarcoidosis (Boeck's disease)

Brucellosis.

Nonspecific hyperplastic lymphadenitis

#

A 24-year-old man presented with enlarged cervical lymphatic node. A histological investigation revealed the growth of epithelioid, lymphoid cells and macrophages with nuclei in the form of a horseshoe. In some centers the aggregates of unstructured light pink color masses with nuclei fragments were determined. For what disease the described changes are characteristic?

@Tuberculosis

Lymphogranulomatosis (Hodgkin's disease)

Actinomycosis

Metastasis of tumor

Syphilis

#

A histological investigation of the enlarged cervical lymph nodes revealed the nodules consisted mainly of flat, slightly extended cells with pale nucleus. There were also giant cells with spherical-oval form, light pink cytoplasm and with nuclei located on a cell periphery. The centre of some nodules was presented with the unstructured, light pink colored masses. The described changes are characteristic for:

@Tuberculosis

Lymphogranulomatosis (Hodgkin's disease)

Sarcoidosis (Boeck's disease)

Brucellosis

Nonspecific hyperplasic lymphadenitis

#

A 7-year-old boy with a history of tonsillitis presented with markedly enlarged paratracheal, bifurcate and cervical lymph nodes. A microscopical investigation of the removed cervical lymph node revealed the centers of a necrosis surrounded with lymphocytes, epithelioid cells and Pirogov-Langhans cells. Specify the most likely pathology.

@Tuberculosis

Sarcoidosis (Boeck's disease)

Rhinoscleroma.

Glanders

Syphilis

#

A lungs roentgenogram investigation revealed a dark patch. During a diagnostic express biopsy of a lymph node of a bronchus was removed. A histological study showed a caseous tissue necrosis, round which lied epithelioid and lymphoid layers with few multinuclear large cells (Langhans' cells). Specify the cause of the lymphadenitis.

@Tuberculosis

Pneumonia

Syphilis

Metastases of cancer

Adenoviral infection

#

Microscopical exam of the patient’s lungs (52 years) reveals focuses of necrosis that is surrounded by a roller of epithelioid cells and lymphocytes. Giant cells of round shape and with great amount of nuclei on the periphery are located between epithelioid cells and lymphocytes. How can we term such histological changes?

Syphilitic granuloma

Sarcoid granuloma

@Tuberculous granuloma

Leprous granuloma

Scleromous granuloma

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25

Granulemes were detected during the appendix’s biopsy, which consist of the epitheliod, giant Pirogov-Langxance cells and with necrosis in granulem’s center. These changes give the reason to make a diagnosis:

@Tuberculosis

Superficial appendicitis

Syphilis

AIDS

Actinomycosis

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42-year-old patient complained of a voice timbre change. The larynx biopsy was taken. A histological investigation revealed the aggregates of large, oblong form cells with light nuclei, rich with a cytoplasm. The nuclei were located on periphery in the form of a horseshoe. The described histological changes are characteristic for:

@Tuberculosis

Leprosy

Syphilis

Rhinoscleroma

Lymphogranulomatosis (Hodgkin's disease)

#

An autopsy of a child, who died of meningocephalitis revealed under pleura and in pulmonal tissue plural, punctual, yellow-white lesions which reminded millet grains. Histological investigation showed granulomas with a necrosis zone in the centre and a wall of epithelioid cells, lymphocytes, macrophages and some giant Pirogov -Langhans cells. What is the most likely disease?

@Primary milliary tuberculosis

Secondary tuberculosis

Focal pneumonia

Croupous pneumonia

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At the section of a 44-year-old man, who died of pulmonary-heart insufficiency, were diagnosed pneumosclerosis, emphysema of lungs, and hypertrophy of the right ventricle of the heart. Multiple focuses with the diameter of 1cm were localized in both lungs, mostly subpleural. Histologically: in the center of the focus – the area of necrosis, on the periphery – a roller of epithelioid cells, lymphocytes, few macrophages and plasmatic cells. Giant Pirogov-Langhans cells were determined, too. There was also small amount of blood vessels on the periphery of the focus. What disease did the dead man have?

@Haematogenous tuberculosis

Actinomycosis of lungs

Sarcoidosis

Syphilis

Silicosis

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A 52-year-old man with a long history of a tubercular prostatitis died of a meningocephalitis. An autopsy revealed in arachnoids of the basis and lateral surfaces of a brain, in a spleen, kidneys and liver a considerable quantity of dense grey color nodules 0, 5-1mm in diameter. Histological investigation of nodules showed epithelioid, lymphoid and some giant cells with nuclei located on a cell periphery in the form of a horseshoe. What is the most likely diagnosis?

@Acute milliary tuberculosis

Acute tuberculous sepsis

Chronic milliary tuberculosis

Disseminated tuberculosis

Septicopyemia

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At the section of a 48-year-old man, who died of pulmonary tuberculosis, were revealed: partly devastated symmetric tuberculous cavernae in corticopleural areas with the domination of productive tissue reaction, delicate reticulated pneumosclerosis and emphysema in both lungs, pulmonary heart, tuberculous caseous lymphadenitis in bifurcation nodules. Chon focus was located in the III segment of the right lung. What is the most possible diagnosis?

Haematogenous generalization of primary tuberculosis

@Haematogenous disseminated tuberculosis

Chronic primary tuberculosis

Chronic miliary tuberculosis

Cirrhotic tuberculosis

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An autopsy of a 74- year-old man revealed the enlargement and deformation of the right knee joint. A histological investigation determined the massive foci of a caseous necrosis, surrounded by peripheral mantle of epithelioid, lymphoid cells and some multinucleated giant cells.

What is the most likely disease?

@Tuberculous arthritis

Syphilitic arthritis

Rheumatic arthritis

Gonorrheal arthritis

Deforming osteoarthrosis

#

Tuberculous spondylitis (Pott’s disease) is characterized by all the following EXCEPT

Involvement of thoracic and lumbar vertebrae

Hematogenous spread

@Proliferative synovitis with pannus

Destruction of intervertebral disks

Formation of psoas abscass

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A 10-year-old girl arrived in traumatological unit with symptoms of pathological fracture of the right femur. A histological investigation of an operational material revealed in a bone marrow of a femur fragment, a plural foci of a caseous necrosis with peripheral mantle of epithelioid cells, lymphocytes and solitary Pirogov-Langhans' giant cells. Zones of a caseous necrosis extended on adjoining sites of a bone tissue, resulting in osseous destruction. What is the most likely disease?

@Tuberculous osteomyelitis

Tuberculous spondylitis

Tuberculous koxitis

General(common) macrofocal tuberculosis

Secondary acute focal tuberculosis

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A post-mortem of a 72-year-old vagabond, with marked kypho-scoliosis, revealed the partially destructed thoracal vertebral bodies due to formation of cavities (sequesters), filled with white-yellow brittle masses. A histological investigation determined within altered vertebras big foci of a caseous necrosis, surrounded with solitary giant multinucleated Pirogov-Langhans' cells, epithelioid cells and lymphocytes. Similar changes were diagnosed at mediastinum lymph nodes and disseminated in lungs and kidneys. What is the most likely diagnosis?

@Tuberculous osteomyelitis

Purulent osteomyelitis

Syphilitic osteomyelitis

Osteoporosis

Osteoarthrosis

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An ultrasound investigation of the young 17-year-old man's right kidney revealed pyeloectasis, accompanied with disturbance of outflow of urine by urethra. Microscopical investigation of the renal biopsy showed a diffusive infiltration of the interstitium by lymphocytes and hystiocytes. In the cortical and medullar zones there were the foci of a destruction with formation of the cavities, surrounded by peripheral mantle of epithelioid , lymphoid cells and some multinucleated Pirogov-Langhans' giant cells. What disease is the most probable?

@Tuberculosis of kidney

Suppurative (apostematous) nephritis

Nonspecific tubular-interstitial nephritis

Polycystic kidney

Chronic pyelonephritis

#

A man died of liver cirrhosis. An autopsy revealed in the 1-2 segment of the right lung three grey- yellow, dense foci, 1-1,5cmin diameter with a dim surface. A histological research showed the tubercular endobronchitis, foci of a caseous bronchopneumonia, surrounded with a wall of epithelioid, lymphoid and giant Pirogov-Langhans cells. For what form of a pulmonary tuberculosis the described changes are characteristic?

@Acute focal tuberculosis

Infiltrative tuberculosis

Fibrous-focal tuberculosis

Caseous pneumonia

Primary pulmonary tuberculous complex

#

An autopsy of a 63-year-old man revealed in the second segment of the right lung a tubercular panbronchitis, with the focus of a caseous bronchopneumonia. The focus was surrounded by a wall of epithelioid cells with some lymphocytes and few giant Pirogov -Langhans cells. What form of a pulmonary tuberculosis presented in this case?

@Acute focal pulmonary tuberculosis

Primary tuberculous complex

Growth of primary affect

Acute miliary tuberculosis

Infiltration tuberculosis

#

At histologic examination of tuberculoma resected from right lung a necrosis in center is found out. Call a kind of the necrosis.

@Caseous

Fatty

Liquefactive

Coagulative

Gangrene

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An autopsy of a 48-year-old man revealed in the first segment of the right lung the round formation, 5 cm in diameter, surrounded with a thin connective tissue layer. The centre was presented by write, brittle masses. Diagnose the form of secondary tuberculosis.

@Tuberculoma.

Caseous pneumonia

Acute cavernous tuberculosis

Acute inflammatory tuberculosis

Fibrocavernous tuberculosis

#

A patient, who died of pulmonary tuberculosis, has a white-gray focus that is surrounded by a capsule, diameter 3cm in I segment of the right lung. Microscopical exam reveals a focus of necrosis with a capsule and the absence of perifocal inflammation. Name the form of tuberculosis.

Caseous pneumonia

Acute cavernous tuberculosis

Fibrous-cavernous tuberculosis

Cirrhotic tuberculosis

@Tuberculoma

#

At the section of a 48-year-old man, in the area of I segment of the right lung was revealed a round formation (diameter near 5cm) with well-defined contour that was surrounded by thin stratum of connective tissue and filled with friable masses. Diagnose the secondary form of tuberculosis.

@Tuberculoma

Caseous pneumonia

Acute cavernous tuberculosis

Acute focal tuberculosis

Fibrous-cavernous tuberculosis

#

An autopsy of a man with a history of tuberculosis revealed in the second segment of the right lung the white-grey focus, 3 cm in diameter, surrounded with a capsule. Microscopic study showed a focus of necrosis with a capsule and lack of a perifocal inflammation. Name the tuberculosis form.

@Tuberculoma

Acute cavernous tuberculosis

Fibrocavernous tuberculosis.

Cirrhotic tuberculosis

Caseous pneumonia

#

An autopsy of a 42-year-old man revealed in the second segment of the right lung the focus of consolidation, 5 cm in diameter, surrounded with a thin capsule. The centre was presented by a dense dry crumbling tissue with a dim surface. Morphological changes in a lung are characteristic for:

@Tuberculoma

Carcinoma of lung

Chondromas

The tumorous formof a silicosis

Postinflammation pneumosclerosis

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An autopsy of a 40-year-old man with a history of AIDS revealed both lung lobes enlarged, dense, air free, with fibrinous membranes on pleura. A gross investigation of a cut surface showed the yellow dim pulmonal tissue. A histological investigation determined in alveoli the serofibrinous and fibrinous exudate with large foci of a pulmonal tissue necrosis. For what disease the described changes in lungs are characteristic?

@Caseous pneumonia

Infiltrative tuberculosis

Croupous pneumonia

Lymphogranulomatosis of lungs (Hodgkin's disease)

Carcinoma of lung

#

A 50-year-old man with a history of tuberculosis died of a chronic pulmonary and heart failure. A post-mortem revealed a lobar lesion of the right lung. The upper lobe of the right lung was enlarged, dense, with fibrinous membranes on pleura. A gross investigation of a cut surface showed the yellow brittle tissue. What is the most likely form of secondary tuberculosis described in that case?

@Caseous pneumonia

Fibrous-focal tuberculosis

Infiltrative tuberculosis.

Tuberculoma

Acute focal tuberculosis

#

A 50-year-old man was ill with tuberculosis and died at the background of the facts of pulmonary-heart insufficiency. The section detects the lobar character of pulmonary affection: the upper part of the right lung is enlarged, solid, yellow on the incision, friable with fibrinous strata on pleura. What form of secondary tuberculosis does this pathology belong to?

Tuberculoma

Fibrous-focal tuberculosis

Infiltrative tuberculosis

@Caseous pneumonia

Acute focal tuberculosis

#

A 52- year-old man with a long history of tuberculosis died of a bleeding from lungs. An autopsy revealed in lungs some oval and round cavities. The walls of cavities were presented with necrotic masses and a pulmonal tissue. What is the most likely form of tuberculosis presented in that case?

@Acute cavernous

Fibrocavernous

Tuberculoma

Caseous pneumonia

Acute inflammatory

#

A 40- year-old man died of a pulmonary bleeding. An autopsy revealed in the upper lobe of the right lung a cavity, 4cm in diameter, with dense walls and a rough internal surface, filled with blood clots. A microscopical study of the wall showed the inner layer, presented with fell to pieces leucocytes; the middle layer formed by epithelioid, lymphoid and giant multinuclear cells with nuclei located like a horseshoe. The changes found out in a lung are characteristic for:

@Tuberculous cavern (cavity)

Bronchiectatic cavern (cavity)

Abscess of lungs

Congenital cyst

Infarct of lung with septic disintegration

#

A 47- year-old man died of an acute anemia, resulted from the pulmonary bleeding. An autopsy revealed in the 2 segment of the right lung the cavity, 5-6 cm in the size, which had connection with the bronchus lumen. The cavity had irregular roundish form and filled with blood. The internal surface of a cavity was rough and covered by a flabby unstructured yellowish tissue. A wall was thin, presented by the condensed, inflammatorily changed pulmonary tissue A histological investigation showed that the cavity inside layer consisted of the fused caseous masses with a considerable quantity of segmented leucocytes. What is the most likely pathology presented in that case?

@Acute cavernous tuberculosis

Abscess of lung

Disintegrating carcinoma of lung

Infarction of lung with septic disintegration

Bronchiectatic cavity (cavern)

#

A died woman had a chronic pulmonal abscess in her medical records. An autopsy revealed in 2nd segment of the right lung a roundish cavity, 5cm in the size. The internal surface of a cavity was created by caseous masses; the external one - by a dense pulmonal tissue. A pyogenic membrane was absent. What is the most likely pathology?

@Acute cavernous tuberculosis

Fibrocavernous tuberculosis.

Acute abscess.

Chronic abscess.

Primary pulmonary cavity (cavern).

#

At the section of a woman, who died with a clinical diagnosis chronic pulmonary abscess, was detected a cavity of a round form and 5cm in size in II segment of a right lung. The internal surface of the cavity was formed of caseous masses, the external one – of solid pulmonary tissue. Pyogenic membrane was absent. What process is meant?

Acute abscess

Fibrous-cavernous tuberculosis

@Acute cavernous tuberculosis

Chronic abscess

Primary pulmonary cavern

#

A man died from the progressive pulmo-cardiac insufficiency at the age of 48. On the autopsy pulmonary emphysema, net-like pneumosclerosis, nodules of white-gray colour, in the medium lung lobes symmetrically located cavities 3,5 cm in diameter and hypertrophy of the right ventricle were detected. For which pulmonary

@Fibrous-cavernous tuberculosis

Hematogenically disseminated pulmonary tuberculosis

Chronic abscess of the lungs

Bronchiectatic disease

Acute pulmonary tuberculosis

#

A post-mortem of a 40-year-old patient, with a 10 years history of tuberculosis, revealed a cavity in the 1 and IIsegments of his right lung. It had dense walls. The inner layer was rough, with beams formed by the obliterated bronchi and the thrombosed vessels. The middle and lower lobes were firm, with the yellow foci on a cut surface. What form of tuberculosis is the most likely in that case?

@Fibrocavernous

Acute cavernous

Fibrous inflammatory

Tuberculoma

Cirrhotic

#

A post-mortem of a 58-year-old patient revealed plural pathological cavities in both lungs. Microscopical study showed the inner layer of one cavity presented with necrotic masses and diffuse neutrophil infiltration; the middle one contained an infiltrate of epithelioid cells, lymphocytes and multinuclear giant cells. The external layer consisted of a mature connective tissue. Diagnose the form of secondary tuberculosis.

@Fibrocavernous tuberculosis

Acute inflammatory

Fibro-inflammatory

Acute cavernous

Cirrhotic tuberculosis

#

At the autopsy of patient, which suffered by tuberculosis for a long time, the cavity by the sizes 3õ2 cm connected with a bronchus was found out in the upper lobe of right lung. The wall of the cavity dense has three layers: internal - pyogenic, middle - layer of tubercular granulation tissue, external – layer of connective tissue. What the most probable diagnosis which this formation relative to?

@Fibrous-cavernous tuberculosis

Fibrous-focal tuberculosis

Tuberculoma

Acute focal tuberculosis

Acute cavernous tuberculosis

#

A post-mortem of a 58-year-old patient, with a history of tuberculosis, revealed in the upper lobe of the right lung a cavity, 3x2cm in sizes, which connected with a bronchus. A cavity had dense walls and three layers. The internal layer was pyogenic; the middle one was presented with tubercular granulation tissue and the external coating of connective tissue. What of the listed diagnoses the most likely?

@Fibrocavernous tuberculosis.

Fibrous focal tuberculosis

Tuberculoma.

Acute focal tuberculosis.

Acute cavernous tuberculosis

#

A 40-year-old prisoner died in the house of correction of tuberculosis. The autopsy exam revealed deformation and reduction in size of the both pulmonary apices, numerous cavities with solid walls 2-3mm thick in the upper lobes of both lungs, disseminated focuses of caseous necrosis with the diameter 5mm-2cm in the lower lobes. Diagnose the form of tuberculosis.

Secondary cirrhotic

Secondary fibrous-focal

Haematogenous focal with the affection of the lungs

Primary, primary affect growth

@Secondary fibrous-cavernous

#

A 40-year-old prisoner died in penitentiary of tuberculosis. An autopsy revealed a deformation and reduction of the both lungs apexes, plural cavities with dense, 2-3 mm thick walls in the upper lobes of both lungs. In addition, disseminated foci of a caseous necrosis, 5mm-2 cm in diameter, were found in the lower lobes of lungs. Diagnose the tuberculosis form.

@Secondary fibrocavernous

Secondary fibro-inflammatory

Gematogenic inflammatory with lesion of lungs

Primary, growth of primary affect

Secondary cirrhotic

#

A 56-year-old man died of a progressing heart failure. A post-mortem revealed small, dense lungs; the upper lobes were deformed, penetrated by a cicatrical tissue, with the encapsulated foci of a caseous necrosis, 0, 2-0,5cm in diameter. In the upper and middle lobes there were cavities, 3-4 and 4- 5cm in the size, with dense walls and fiber internal surface, filled with the opaque yellow-green liquid. The surrounding pulmonary tissue was sclerotic. The heart was enlarged at the expense of the hypertrophied right ventricle. Define the form of secondary pulmonary tuberculosis

@Cirrhotic tuberculosis

Fibrous-focal tuberculosis.

Infiltrative tuberculosis

Acute cavernous tuberculosis

Fibrocavernous tuberculosis

#

A 68-year-old woman, with a 20 years history of fibrous - cavernous pulmonary tuberculosis, presented to the Department of Nephrology with symptoms of uremia. Intravital test on amyloid in kidneys appeared positive. What is the most likely form of an amyloidosis presented in this case?

@Secondary systemic

Primary systemic

Limited (local)

Familial congenital

Senile (gerontal)

#

A patient with a history of fibrous - cavernous tuberculosis died of a renal failure. A post-mortem revealed a urine smell, left ventricle hypertrophy, fibrinous pericarditis, and fibrinous – hemorrhagic enterocolitis. Kidneys were small, reduced in sizes, dense, with plural foci of shrinkage. Histological investigation of the slides with Congo-Red staining showed pink masses within glomuleruli and vessels walls. In addition, destruction and an atrophy of the majority of nephrons, accompanied with a nephrosclerosis were determined. What is the most likely pathology of kidneys?

@Amyloid- contracted kidneys

Contracted kidney

Arteriolosclerotic kidney

Atherosclerotic contracted kidneys

Pielonephritic contracted kidneys

#

56-year-old man with a long history of fibrous - cavernous pulmonary tuberculosis died of a chronic pulmonary and heart failure. Within last months the expressed proteinuria was observed. A post-mortem revealed enlarged, firm kidneys, with a waxy surface. What changes developed in kidneys at this form of tuberculosis?

@Amyloidosis of kidney

Tuberculosis of kidney

Glomerulonephritis

Nephrolithiasis

Necrotic nephrosis

#

A 10-year-old boy presented with Hutchinson's triad: parenchymatous keratitis, sensorineural deafness and deformed Hutchinson's teeth (the barrel form), along with saddle-nose deformity. For what illness the presented changes are characteristic?

@Syphilis.

Toxoplasmosis

Leprosy.

Tuberculosis.

Opisthorchiasis.

#

A 14-year old patient was diagnosed a Hutchinson’s triad: screwdriver teeth, parenchymatous keratitis, and deafness. What disease do detected changes point on?

@Syphilis

Toxoplasmosis

Lepra

Tuberculosis

Opisthorchosis

#

A histological study of a biopsy from an oral cavity ulcer revealed the foci of caseous necrosis surrounded with plasmocytes, epithelioid , lymphoid cells and solitary giant multinucleated Pirogov-Langhans' cells. There were also signs of endo - and a perivasculitis in fine vessels. Specify the disease.

@Syphilis

Tuberculosis

Leprosy

Rhinoscleroma

Glanders

 

#

A man's oral cavity investigation revealed an oval, cartilaginous density, slightly elevated ulcer at his buccal mucosa. A meaty, reddened floor was covered with grayish sebaceous deposits. A microscopical investigation showed lymphocyte infiltration, situated mainly round fine vessels. There was also an endothelium proliferation within the vessel's walls. What disease has developed in that case?

@Syphilis

Traumatic ulcer

Erosive-ulcerated leukoplakia

Ulcer-Carcinoma

Ulcero-necrotic Vensan's stomatitis

#

An ulcer of an oval form with little raised edges and cartilaginous infiltrate is presented on the mucous membrane of the patient’s cheek. The bottom of the ulcer is of meaty-red color, covered with grayish greasy scurf. Microscopic exam reveals lymphoplasmocytic infiltrate, mostly around small vessels with the proliferation of endothelium. What disease do these signs indicate on?

Ulcerative-necrotic Vincent’s stomatitis

Traumatic ulcer

Erosive-ulcerative leukoplakia

Ulcer-cancer

@Syphilis

#

A painless ulcer with smooth varnished bottom and margins of cartilaginoid consistence is observed on the mucous membrane of the right palatine tonsil. Microscopically an inflammatory infiltrate, which consists of lymphocytes, plasmocytes, small amount of neutrophiles and epithelioid cells, and the presence of endo- and perivasculitis are revealed. What disease is meant?

Faucial diphtheria

Actinomycosis

Tuberculosis

@Syphilis

Ulcerative-necrotic Vensan’s quinsy

#

The prepuce was removed from a young man. A microscopical investigation revealed the polymorphic infiltrate consisting from randomly located plasmatic, lymphoid and epithelioid cells. There was marked vessels' vasculitis. For what disease the described changes are characteristic?

@Syphilis

Tuberculosis

Actinomycosis

Periarteritis nodosa

Leprosy

#

An 18-year-old patient has enlarged inguinal lymph nodes, painless, solid when palpated. A small ulcer with solid margins and varnished bottom of grayish color exists in the area of genital mucosa. Make a diagnosis.

Lepra

Tuberculosis

@Syphilis

Trophic ulcer

Gonorrhea

#

A 20-year old woman presented with enlarged, not painful, condensed inguinal lymph nodes. In her genital mucosa there was a small ulcer with firm edges and the "varnished" grayish color floor. What is the most likely diagnosis?

@Syphilis

Tuberculosis.

Leprosy.

Trophic ulcer.

Gonorrhea.

#

A biopsy of cervix uteri was taken from the 34-year-old women. Histological investigation revealed the inflammatory infiltration with involving of fine arteries and veins walls. The infiltrate composed of plasmocytes, lymphocytes, and epithelioid cells. There were also zones of sclerosis and a tissue hyalinosis. What is the most likely disease?

@Syphilis

Tuberculosis

Leukoplakia

Cervical erosion

Condyloma

#

An autopsy of a 36-year-old man revealed in his liver s roundish formation, 0,5 cm in diameter. Microscopical investigation showed in the centre of lesion necrotic masses, surrounded by the granulation tissue with some plasmatic and lymphoid cells. There were also signs of the vasculitis in the blood vessels. What is the most likely diagnosis fn that case?

@Solitary gumma of liver

Solitary adenoma of liver.

Solitary leproma of liver.

Chronic abscess of liver.

Carcinoma of liver.

#

At the microscopic examination of a biopsy material, taken from the liver, granulomas were revealed. They consisted of plasmatic, lymphoid, giant multinuclear Pirogov-Langhans’ cells, small vessels with the sings of endo- and perivasculitis. Focuses of caseous necrosis were also detected. What disease are these granulomas typical for?

@Syphilis

Tuberculosis

Lepra

Rhinoscleroma

Glanders (malleus)

#

At the microscopic exam of the biopsy material, taken from the oral cavity, were detected focuses of caseous necrosis, surrounded by plasmocytes, epithelioid and lymphoid cells, and occasionally by giant multinuclear Pirogov-Langhans’ cells. Small vessels with the signs of endo- and perivasculitis could be also seen. Term the disease.

Glanders (malleus)

Tuberculosis

Lepra

Rhinoscleroma

@Syphilis

#

An autopsy of a 54-year-old man reveled above valvular rupture of an aorta with resulted in a cardiac tamponade. Histological investigation of ascending part of an aorta showed in its external and middle layers inflammatory infiltrates. They consisted of lymphoid, plasmatic and epithelioid cells. There were also recognized the necrosis centers and proliferation of a vessels' wall. Changes in an aorta are characteristic for:

@Syphilitic aortitis

Septic aortitis

Rheumatic aortitis

Atherosclerosis

Hypertension diseases

#

A 38-year-old man died trying to elevate the weight. Collapse had developed. The autopsy revealed the rupture of the extensive thoracic aorta aneurysm. During his life the patient had visceral syphilis. What pathological process caused the atrophy of the aortic wall, its dilation and rupture?

Atrophy of the muscular stratum

Dissolution of collagen fibres

@Dissolution of elastic fibres

Changes in intima after the type of shagreen skin

Neoplasm of vessels

#

Tabes dorsalis is characterized by

Hydrophobia

Increased neutrophils in the cerebrospinal fluid (CSF)

Involvement of the motor neurons of the spinal cord

@Degeneration of posterior columns of the spinal cord

Infection of oligodendrocytes

#

A 69-year-old man in an underdeveloped country develops changes in his mental status along with ataxia, deformed knees and ankles, and an abnormal gait during which he slaps his feet as he walks. Physical examination reveals decreased vibration and proprioception in lower extremities along with absent pupillary light reflexes with normal accommodation. Which of the following is the most likely cause of these signs?

Cysticercosis

@Neurosyphilis

Poliomyelitis

Rabies

Progresive multifocal leukoencephalopathy

#



Date: 2016-03-03; view: 2177


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