Reproductive system pathology

#

A 32-year-old patient has been diagnosed with bartholinitis (inflammation of Bartholin's glands). In what part of the female urogenital system are the Bartholin's glands located?

The labia minor

@The labia major

The uterus

The clitoris

The vagina

#

A 75-year-old woman presents with a pruritic vulvar lesion. Physical examination reveals an irregular white, rough area involving her vulv. Which one of the following histologic changes is most consistent with the diagnosis of lichen sclerosis?

@Atrophy of the epidermis with dermal fibrosis

Atypia of the epidermis with dysplasia

Hyperplasia of the epidermis with hyperkeratosis

Invasion of the epidermis by individual malignant cells

Loss of pigment in the basal layers of the epidermis

#

Primary malignant neoplasms of the vagina include all the following EXCEPT

sarcoma botryoides

clear cell carcinoma

squamous carcinoma

@vaginal adenosis

rhabdomyosarcoma

#

Vaginal adenosis precedes the development of which of the following?

Condyloma acuminatum

Cervical carcinoma

@Clear cell carcinoma

Carcinoma of the endometrium

Squamous carcinoma of the vagina

#

A 25-year-old woman being evaluated for infertility is found to have an abnormal ridge of red, moist granules located in the upper third of her vagin. Pertinent medical history is that her mother was treated with diethylstilbestrol (DES) during her pregnancy. A biopsy from the abnormal vaginal ridge reveals the presence of benign glands underneath stratified squamous epithelium. Which of the following is the most serious long-term complication of this abnormality?

@Clear cell carcinoma

Condyloma acuminatum

Extramammary Paget's disease

Multiple papillary hidradenomas

Verrucous carcinoma

#

A 30-year-old woman, with a history of a chronic endocervicitis, passed routine inspection at the gynecologist with no complaints. A histological investigation of a biopsy, taken from the pars vaginalis neck of the uteri, revealed the high cylindrical epithelium, secreting mucus and branched out glands underneath. What is the most likely diagnose?

@Endocervicosis

Squamous metaplasia

Glandular metaplasia

Leukoplakia

Erythroplakia

#

A histological investigation of curettage of the cervical canal of the uteri revealed a prismatic epithelium and a significant amount of gland-like structures. They developed from the prismatic epithelium cambial elements, originated from the neck of a uterus. What is the most likely diagnose?

@Proliferative endocervicosis

Simple endocervicosis

Endocervicosis, stage of healing

Cervical adenomatosis

Cervical polyps

#

A gynecologic investigation of the 36-year-old woman revealed bright red brilliant maculae on a uterus neck. They bleed easily at a touch. Biopsy investigation showed that a tissue sample was covered by a cylindrical epithelium with papillary growths. There was also a growth of glands within the thickness of a uterus neck tissue. What pathology of a uterus neck was diagnosed?

@Pseudoerosion

Cervical erosion

Endocervicitis

Glandular hyperplasia

Leukoplakia

#

Which of the following describes multiple small mucinous cysts of the endocervix that result from blockage of the endocervical glands by overlying squamous metaplastic epithelium?

Bartholin's cysts

Chocolate cysts

Follicular cysts

Gartner's duct cysts

@Nabothian cysts

#

The pathologist has found out in histological examination of a remote uterus a lot of glandular formations with syngl cycts in myometrium., endometrium had usual structure. Described changes are characteristic for

@Endometriosis.

Glandular hyperplasia of endometrium.

Adenocarcinoma of uterus

Adenomatosis of a mucosa of a uterus

Leyomyosarcoma of uterus.

#

A 25-year-old woman presents to your office for workup of infertil­ity. In giving a history she describes severe pain during menses, and she also tells you that in the past another doctor told her that she had "choco­late in her cysts." Which of the following abnormalities is most likely to be present in this patient?

Metastalic ovarian cancer

@Endometriosis

Acute pelvic inflammatory disease

Adenomyosis

A posteriorly located subserosal uterine leiomyoma

#

All the following endometrial changes are consistent with secretory endometrium EXCEPT

basal cytoplasmic vacuoles

secretions within glandular lumen

predecidual refction within stroma

neutrophil infiltrate

@plasma cell infiltrate

#

A 24-year-old woman presents with a 2-year history of infertility. An endometrial biopsy is obtained approximately 5 to 6 days after the predicted time ofovulation. This biopsy specimen reveals secretory endometrium, but there is a significant difference (asynchrony) between the estimated chrono­logic menstrual date and the estimated histologic menstrual datNo prolif-erative endometrium is seen. Which of the following is the most likely diagnosis?

Anovulatory cycle (no corpus luteum formed)

@Inadequate luteal phase (decreased functioning of the corpus luteum)

Irregular shedding (prolonged functioning of the corpus luteum)

Normal endometrium during the follicular phase of the cycle (no corpus luteum formed)

Normal endometrium during the luteal phase of the cycle (normal corpus luteum)

#

A 23-year-old woman presents with urinary frequency and abnormal uterine bleeding. A careful medical history finds that her abnormal men­strual bleeding is characterized by excessive bleeding at irregular intervals. A pelvic examination finds a single mass in the anterior wall of the uterus, this being confirmed by ultrasonography. Which one of the following clin­ical terms best describes the abnormal uterine bleeding in this woman?

Amenorrhea

Dysmenorrhea

@Menometrorrhagia

Oligomenorrhea

Polymenorrhea

#

A 50-year-old woman presents with fatigue, insomnia, hot flashes, night sweats, and absence of menses for the last 5 months (secondary amenorrhea). Her urine hCG test is negativLaboratory tests reveal decreased serum estrogen and increased serum FSH and LH levels. Which of the following is the most likely cause of this individual's clinical signs and symptoms?

17-hydroxylase deficiency of the adrenal cortex

Prolaccin-secreting tumor of the anterior pituitary

Gonadotropin-releasing hormone-secreting tumor of the hypothalamus

@Menopause

Menarche

#

Histological exam of the uterine mucosa reveals anfractuous glands (sew- and bottlescrew-like), elongated overgrowths of stroma with proliferation of its cells. What is your diagnosis?

Placental polyp

Acute endometritis

Leiomyoma

Molar pregnancy

@Glandular hyperplasia of endometrium

#

A microscopic investigation of an endometrium revealed coiled extended glands with 'saw' and a 'spin-like' pattern. A stromal proliferation with hyperplasia of its cells was also determined. What is the most likely diagnosis?

@Glandular hyperplasia of endometrium

Acute endometritis

Leiomyoma

Hydatidiform mole

Placental polyp

#

A 45-year-old woman with a medical history of a menstrual cycle disturbance had curettage of the uterine cavity to obtain endometrial tissue for histopathologic analysis. Microscopic investigation revealed the increased quantity of the endometrial glands, their form irregularity. Some of glands were dilated or had a saw-like pattern. What is the most likely diagnosis?

@Cystic glandular hyperplasia of endometrium

Placental polyp

Atypical hyperplasia of endometrium

Glandular polyp of endometrium

Endometrial adenocarcinoma

#

A 42-year-old woman presented with dysfunctional uterine bleeding. A histological investigation of a curettage material revealed increased quantity of coiled glands and their cystic dilation. What is the most likely diagnosis?

@Cystic glandular hyperplasia

Atrophy

Metaplasia

Displasia

Hypertrophic vegetations

#

Cystic hyperplasia of the endometrium is associated with all the following EXCEPT

occurence at or just before menopause

increased estrogen administration or production

excessive uterine bleeding

@secretory cells lining the cystically bilated glands

functioning granulosa-theca cell tumors

#

A 60-year-old postmenopausal woman presents with the new onset of uterine bleeding. An endometrial biopsy is diagnosed as atypical hyper-plasi. Which of the following histologic changes is most characteristic of this abnormality?

@Crowding of endometrial glands with budding and epithelial atypia

Lymphatic invasion by interlacing bundles of atypical spindle-shaped cells

Menstrual-type endometrial glands with focal atypical cystic dilatation

Secretory-type endometrial glands with hyperplasia of atypical polygonal cells clear cytoplasm

Stromal invasion by malignant glands with focal areas of atypical squamous dif­ferentiation

#

A 52-year-old woman, with a medical history of the menstrual cycle disturbances and hemorrhages, had curettage of the uterine cavity. Histological investigation revealed the increased quantity of the endometrial glands. Many glands had a morphological pattern of a proliferation phase, clumped together and had intraglandular papillary protrusions. Some glandular cells exhibited the signs of nuclear and cytoplasm polymorphism. What is the most likely diagnosis?

@Atypical hyperplasia of endometrium

Cystic glandular hyperplasia of endometrium

Glandular hyperplasia of endometrium

Glandular polyp of endometrium

Adenocarcinoma of endometrium

#

A 46-year-old woman undergoes an abdominal hysterectomy for a "fibroid" uterus. The surgeon requests a frozen section on the tumor, which is deferred because of the lesion's degree of cellularity. Which of the fol­lowing criteria will be used by the pathologist in determining behignancy versus malignancy in permanent sections?

@Milotic rate

Cell pleomorphism

Cell necrosis

Nucleus-io-cytoplasm ratio

Tumor size

#

Prolonged unopposed estrogen stimulation in an adult woman increases the risk of development of endometrial hyperplasia and subse­quent carcinomWhich of the following is the most common histologic appearance for this type of cancer?

@Adenocarcinoma

Clear cell carcinoma

Small-cell carcinoma

Squamous cell carcinoma

Transitional cell carcinoma

#

A 23-year-old woman presents to her gynecologist for a routine physical examination that includes a Pap smear. Her sexual history includes many sexual partners beginning at an early age, but she has never been pregnant. Physical examination is unremarkabl. The Pap smear returns as abnormal with the presence of atypical squamous epithelial cells of undetermined significance (ASCUS). She returns for a 6-month follow-up and a repeal pelvic exam is performe. Her cervix is painted with iodine and an area near the cervical os is present that does not stain with iodine. This area is flat and not papillary. Several biopsies are obtained from this pale area, and a representative histologic section shows poilocytosis, which is most character­istic of infection with which one of the following organisms?

Cytomegalovirus

Epstein-Barr virus

Herpes simplex virus

@Human papillomavirus

ParvovirusBlO

#

An 18-year-old woman presents with amenorrhea and is found to, have normal secondary sex characteristics and normal-appearing external genirali. Her first menstrual period was at age 13, and her cycle has been unremarkable until now. She states that her last menstrual period was 8 weeks prior to this visit. A urine test for hCG is positive. Which of the following is the most likely diagnosis?

Ectopic pregnancy

@Intrauterine pregnancy

Stein-Leventhal syndrome

Turner's syndrome

Weight loss syndrome

#

A 24-year-old woman delivers a normal 8-lb baby boy at 40 weeks of gestation. She has no history of drug abuse, and her pregnancy was unre­markablExamination had revealed the placenta to be located normally, but following delivery the woman fails to deliver the placenta and subse­quently develops massive postpartum hemorrhage and shock. Emergency surgery is performed to stop the bleeding. Which of the following is the most likely cause of her postpartum bleeding?

An abruptio placenta

A placenta previa

@A placenta accreta

A hydatidiform mole

A chorioncarcinoma

#

A 29-year-old woman presented to maternity department with termination of pregnancy at 20 weeks of gestation. The fetus and fetal membranes were delivered with some blood clots. Histological investigation revealed fetal membranes, chorion villi and decidual tissue. Name -the described pathology of pregnancy.

@Spontaneous complete abortion

Premature birth

Hydatidiform mole

Invasive hydatidiform mole

Artificial abortion

#

A 26-year-old woman acutely develops lower abdominal pain arid vaginal bleeding. While in the bathroom she passes a cast of tissue com­posed of clot material and then collapses. She is brought to the hospital, where a physical examination reveals a soft, tender mass in right adnexa and pouch of Douglas. Histologic examination of the tissue passed in the bathroom reveals tilood clots and decidualized tissuNo chorionic villi or trophoblastic tissues are present. Which of the following conditions is most likely present in this individual?

Aborted intrauterine pregnancy

Complete hydatidifbrm mole

@Ectopic pregnancy

Endometrial hyperplasia

Partial hydatidiform mole

#

A 23-year-old woman presents with her menstrual cycle disorder went trough a transvaginal puncture of Douglas’ cul-de-sac resulted in aspiration of blood and some other material. A microscopic investigation of the puncture fluid revealed blood, some decidual cells and chorion villi. What is the most likely diagnosis?

@Ectopic tubal pregnancy

Salpingitis

Rupture of Fallopian tube

Hydatidiform mole

Carcinoma uteri

#

A 35-year-old woman had an operation of uterine tube removal at gynecology department. A histological research of a tube's wall reveled chorion villi and decidual cells. What is the most likely diagnosis?

@Tubal pregnancy

Placental polyp

Choriocarcinoma

Paper-doll fetus

Lithopedion

#

A young woman presented to the hospital with an acute pain. Her uterine tube was removed at gynecology department. Macroscopic investigation of a tube revealed its local dilation at the middle third and blood clots accumulations within the lumen. A histological research showed chorion villi, surrounded by areas of erythrocytes with some leucocytes. What is the most likely diagnosis?

@Tubal pregnancy

Acute purulent salpingitis

Hemorrhage in tube of the uteri

Hemorrhagic salpingitis

Tuberculous salpingitis

#

A 39 y.o. woman went through an operation in course of which surgeons removed her uterine tube that was enlarged and a part of an ovary with a big cyst. Histological examination of a tube wall revealed decidual cells, chorion villi. What was the most probable diagnosis made after examination of the uterine tube?

Lithopedion

Choriocarcinoma

Papyraceous fetus

@Tubal pregnancy

Placental polyp

#

At the operation of a 39-year-old woman were removed an enlarged in size uterine tube and a part of ovary with a big cyst. Histological exam of the mucous membrane of the tube wall revealed decidual cells and villi of chorion. What is the most possible diagnosis?

Choriocarcinoma

Placental polyp

@Tubal pregnancy

Papyraceous fetus

Lithopedion

#

A 25-year-old woman with a medical history of recent childbirth presented to gynecology department with metrorrhagia. The histological investigation of a curettage material revealed a pathologic growth, consisted of fibrin clots, chorion villi and decidual tissue, undergoing organization. What is the most likely diagnosis?

@Placental polyp

Glandular hyperplasia of the endometrium

Hydatidiform mole

Choriocarcinoma

Endometritis

#

A woman harboring endometrial adenocarcinoma nearly always has antecedent

obesity

diabetes millitus

@endometrial polyps

endometrial hyperplasia

systemic hypertention

#

A 25-year-old woma in her 15th week of pregnancy presented with uterine bleeding and passage of a small amount of watery fluid and tissue. She is found to have a uterus that is mach larger than estimated by her gestetional dates. Her uterus is found to be filled with cystic, avascular, grapelike structures that do not penetrate the uterine wall. No fetal parts are found. The most likely diagnosis for this adnormality is

partial hydatidiform mole

@complete hydatidiform mole

invasive mole

placental site trophoblastic tumor

chorioncarcinoma

#

A patient had an operation relatively uterine tumour. Macroscopically: a spongy mottled nodule in the myometrium. Histological exam reveals giant bright epithelial cells, among which many dark polymorphous ones are noted. Stroma is absent, vessels look like lumens covered with tumour cells. Multiple haemorrhages are detected, too. How can we term the determined tumour?

@Chorionepithelioma

Destructive (malignant) molar pregnancy

Adenocarcinoma

Cavernous hemangioma

Medullary cancer

#

6 months after labour a woman had uterine hemorrhag E. Gynaecological examination of uterine cavity revealed a dark-red tissue with multiple cavities resembling of a "sponge". Microscopic examination of a tumour revealed in blood lacunas atypic light epithelial Langhans cells and giant cells of syncytiotrophoblast. What tumour is it?

Fibromyoma

Squamous cell nonkeratinous carcinoma

@Chorioepithelioma

Adenocarcinoma

Cystic mole

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A 26-year-old woman in the third trimester of her first pregnancy develops persistent headaches and swelling of her legs and facEarly dur­ing her pregnancy a physical examination was unremarkable; however, now her blood pressure is 170/105 mmHg and urinalysis reveals slight proteinuriWhich of the following is the most likely diagnosis?

Eclampsia

Gestational trophoblastic disease

Nephritic syndrome

Nephrotic syndrome

@Preeclampsia

#

A- post-mortem of a pregnant woman revealed a brain edema, hemorrhagic pneumonia, motley liver with a hemorrhage. Microscopic study showed disseminated blood clotting of vessels, plural fine necroses and hemorrhages in internal organs. In addition, in kidneys there were found cortical necroses and a fibrinoid necrosis of a tubules epithelium within a nephron.

What is the most likely diagnosis?

@Eclampsia

Pre-eclampsia

Septicopyemia

Septicemia

Acute renal insufficiency

#

A 29-year-old woman presents with severe pain during menstruation (dysmenorrhea). During workup, an endometrial biopsy is obtaineThe pathology report from this specimen makes the diagnosis of chronic endometritis. Based on this pathology report, which of the following was present in the biopsy sample of the endometrium?

Neuirophils

Lymphocytes

Lymphoid follicles

@Plasma cells

Decidualized stromal cells

#

A 48-year-old woman with a grease bloody flux from her genital tracts had a diagnostic curettage of her uterus cavity. Microscopical research of the uterus curettage material revealed a thinning of a mucosal layer, reduction of the endometrial glands number, a fibrosis of a stroma and some lymphoid cells infiltration. What is the most likely diagnosis?

@Chronic atrophic endometritis

Acute purulent endometritis

Chronic cystic endometritis

Chronic hypertrophic endometritis

-

#

A 32-year-old woman died in post delivery period. At the autopsy were revealed the signs of suppurative endometritis, purulent thrombophlebitis of venae uterinae, numerous abscesses of lungs, abscesses of kidneys and spleen, abscessing myocarditis and purulent meningitis. Diagnose the type of sepsis.

@Septicopyemia

Septicemia

Chroniosepsis

Prolonged septic endocarditis

Tuberculous sepsis

#

A 25-year-old woman presents with lower abdominal pain, fever, and a vaginal discharge. Pelvic examination reveals bilateral adnexal (ovar­ian) tenderness and pain when the cervix is manipulated. Cultures taken from the vaginal discharge grow Neisseria gonorrhoea. Which of the fol­lowing is the most likely cause of this patient's adnexal pain?

Adenomatoid tumor

Ectopic pregnancy

Endometriosis

Luteoma of pregnancy

@Pelvic inflammatory disease

#

A 33-year-old woman gave birth to a dead fetus with gestational age more than 43 weeks. The fetal skin was dry and chap. An autopsy revealed a general hypotrophy and nuclei of ossification (Beclard's nuclei) in a proximal epiphysis of tibial and humeral bones. Amniotic fluid, an umbilical cord and placental membranes were dyed by meconium. Name the period of the described perinatal pathology?

@The antenatal period

The prenatal period

The intranatal period

The postnatal period

The progenesis period

#

A female newborn is being worked up clinically for several congeni­tal abnormalities. During this workup, it is discovered that normal devel­opment of the vagina and uterus in this female infant has not occurreFailure of the uterus to develop (agenesis) is directly related to the failure of which one of the following embryonic structures to develop?

Urogenital ridge

Mesonephric duct

@Paramesonephric duct

Metanephric duct

Epoophoron

#

Microscopical exam of vena umbilicalis of a newborn, who died of intoxication, reveals diffuse inflammatory infiltration of the wall; its lumen is obturated by thrombus with numerous neutrophilic leukocytes, facts of caryorrhexis and with bacterial colonies. What is the most possible after-effect of the thrombus?

Transformation into thromboembolus

Aseptic autolysis

Organization and canalization of thrombus

@Septic autolysis

Petrifaction of thrombus

#

A 24-year-old woman, on a 3rd day after childbirth, presented with a diffusive edema and painful palpation of the right breast. Physical examination revealed hyperemia of the breast and a fervescence. Histological research of a gland's tissue showed diffusive leucocytes infiltration of stroma, an interstitial edema and hyperemia of vessels. What is the most likely diagnose?

@Acute phlegmonous mastitis

Acute apostematous mastitis

Acute serous mastitis

Chronic purulent mastitis

-

#

A 23-year-old woman presents with a rubbery, freely movable 2-cm mass in the upper outer quadrant of the left brest. Which of the following histologic features is most likely to be seen when examining a biopsy specimen from this mass?

Large numbers of neutrophils

Large numbers of plasma cells

Dust estasia with inspissation of breast secretion

Necrotic fat surrounded by lipid-laden macrophages

@A mixture of fibrous tissue and ducts

#

A 39-year-old woman present with the new onset of a bloody discharge from her right nipple. Phsicl exaination reveals a 1-cm freely mavable mass that is located directly beneath the nipple. Sections from this mass reveal multiple fibrovascular cores lined by several layers of epithelial cells. Atypia is minimal. The lesion is completely contained within the duct and no invasion into underlying tissue is seen. Which of the following is the most likely diagnosis?

Bening phyllodes tumor

@Ductal papilloma

Intraductal carcinoma

Paget;s disease

Papillary carcinoma

#

A 35-year-old woman present with 2.2-cm mass in her left breast. The mass is excised and histologic section reveal a tumor composed of a mixture of ducts and cells, as seen in the photomicrograph below. The epithelial cells within the duct not atypical in appearance. There is a marked increase in the stromal cellulary, but the stromal ceels are not atypical in appearance and mitoses are not found. Which of the following is the most likely diagnosis?

Atypical epithelial hyperplasia

@Bening phyllodes tumor

Fibroadenoma

Malignant phyllodes tumor

Medullary carcinoma

#

A 48-year-old woman presents with a 1.5-cm firm mass in the upper outer quadrant of her left breast. A biopsy from this mass reveals many of the ducts to be filled with atypical cells. In the.center of these ducts there is extensive necrosis. No invasion into the surrounding fibrous tissue is seen. Which of the following is the most likely diagnosis?

Colloid carcinoma

@Comedocarcinoma

Infiltrating ductal carcinoma

Infiltrating lobular carcinoma

Lobular carcinoma in situ

#

A 46-year-old woman presents with a 4-month history of a discharge from the nipple. An excisional biopsy of the nipple area reveals infiltration of the nipple by large cells with clear cytoplasm. These cells are found both singly and in small clusters in the epidermis and are PAS-positive and diastase-resistant. Which of the following is the most likely diagnosis?

Ductal papilloma

Eczematous inflammation

Mammary duct ectasia

@Paget's disease

Phyllodes tumor, malignant

#

A 65-year-old woman presents with a pruritic red, crusted, sharply demarcated map-like lesion involving a large portion of her labia major. Histologic sections from this lesion reveal individual anaplastic tumor cells infiltrating the epidermis. Distinctive clear spaces are noted between these anaplastic cells and the surrounding normal epithelial cells. These malig­nant cells stain positively for mucin and negatively with S100. Which of the following is the most likely diagnosis?

Clear cell adenocarcinoma

Malignant melanoma

@Extramammary Paget disease

Sarcoma botryoides

Squamous cell carcinoma

#

A 60-year-old woman presents with a slowly enlarging 2.5-cm firm, irregular mass in the upper outer quadrant of her left breast. A biopsy from this mass is interpreted by the pathologist as being an infiltrating lobular carcinoma of the breast. Which of the following histologic features is most characteristic of this tumor?

Expansion of lobules by monotonous proliferation of epithelial cells

Large cells with clear cytoplasm within the epidermis

Large syncytium-like sheets of pleomorphic cells surrounded by aggregates of lymphocytes

Small individual malignant cells dispersed within extracellular pools of mucin

@Small tumor cells with little cytoplasm infiltrating in a single-file pattern

#

A 35-year-old woman who underwent a modified radical mastectomy of her right breast for infiltrating ductal carcinoma 2 years ago presents with enlargement of her right breast. The breast has a swollen, red-discolored appearancIt is diffusely indurated and tender on palpation. Multiple axillary lymph nodes are palpable in the lower axille. The working clinical diagnosis is inflammatory carcinoma. Which of the following histologic features is most characteristic of this clinical diagnosis?

Duct ectasia with numerous plasma cells

@Extensive invasion of dermal lymphatics

Infiltrating malignant ducts surrounded by numerous neutrophils

Malignant vascular tumor forming slitlike spaces

Marked dermal desmoplasia

#

A 48-year-old woman presents with a painless mass located in her left breast. Physical examination finds a firm, nontender, 3-cm mass in the upper outer quadrant of her left breast. There was retraction of the skin overlying this mass, and several enlarged lymph nodes were found in her left axill. The mass was resected and histologic sections revealed an inva­sive ducial carcinoma, grade 2 with approximately 50% of the tumor being composed of tubular structures. Biopsies from her axillary lymph nodes revealed the presence of metastatic disease to 4 of 18 examined axillary lymph nodes. Further studies revealed that the tumor cells were positive for estrogen receptors and had high levels of urokinase plasminogen acti-vator. Numerous new blood vessels were proliferating at the edge of the tumor, and the majority of the tumor cells were diploid with low S-phase fraction. Which of the following clinical findings is associated with the worse prognosis for this individual?

High levels of urokinase plasminogen activator being present in the tumor cells

Histologic grade 2 with approximately 50% of the tumor being composed of tubular structures

@Metastatic disease being present in four axillary lymph nodes

The majority of the tumor cells being diploid with low S-phase fraction

The tumor cells being positive for estrogen receptors

#

An ovary specimen stained by hematoxylin-eosin presents a follicle, where cells of follicular epithelium are placed in 1-2 layers and have cubic form, there is a bright-red membrane around the ovocyte. What follicle is it?

Mature

Secondary

Primordial

Atretic

@Primary

#

Ovarian tumour was diagnozed in a woman. Surgery should be perfomed. What ligament should be extracted by the surgeon to disconnect the ovary and the uterus?

Broad ligament of uterus

Suspensory ligament of ovary

Lateral umbilical ligament

Round ligament of uterus

@The ovarial ligament

#

Ovarial cystadenomas or cystadenocarcinoma (serous or mucinous)

always produce androgen

seldom are bilateral

@can be papillary

usually occur during pregnancy

are extremely rare

#

The ovarian tumor with the highest degree of bilateral involvement is

endometrioid carcinoma

serous cystadenoma

mucinous cystadenoma

mucinous cystadenocarcinoma

@serous cystadenocarcinoma

#

A 23-year-old woman presents with pelvic pain and is found to have an ovarian mass of the left ovary that measures 3 cm in diameter. Grossly, the mass consists of multiple cystic spaces. Histologically, these cysts are lined by tall columnar epithelium, with some of the cells being ciliateWhich of the following is the correct diagnosis for this ovarian tumor, which histologically recapitulates the histology of the fallopian tubes?

@Serous tumor

Mucinous tumor

Endometrioid tumor

Clear cell tumor

Brenner tumor

#

The majority of malignant tumors of the ovary take their origin from

@surface epithelium

urogenital stem cells

ovarial germ cells

stromal cells

hilar cells

#

A 32-year-old woman presents with the recent onset of oligomenorrhea followed by amenorrhea and then the loss of female secondary characteristics. She has also developed acne, deepening of her voice, and temporal balding. Which of the following types of ovarian tumor is most likely to produce these symptoms?

Epithelial tumor

@Stromal tumor

Germ cell tumor

Surface tumor

Metastatic tumor

#

A 51-year-old woman presents with abdominal distention. Surgical exploration finds multiple irregular masses within her abdominal cavity. A biopsy of one of these masses is examined by a pathologist during a frozen section. His diagnosis is "metastatic mucin-secreting neoplasm" and he advises the surgeon to examine the appendix. The surgeon finds the appen­dix to be grossly normal in appearancIt is resected and examined histo-: logically but no malignancy is founThe next step in searching for this primary tumor should be to look for a tumor in which one of the following sites?

Adrenal gland for a conical carcinoma

Gallbladder for a papillary cystic tumor

Kidney for a clear cell carcinoma

@Ovary for a non-germ cell tumor

Uterus for a smooth-muscle tumor

#

An uncircumcised 49-year-old man present with the sudden onset of severe pain in the distal portion of his penis. The emergency room physical examines the patient and finds that the foreskin is retracted but cannot be rolled back over the gland penis. The ER physical calls the urologist, who performs an emergency resection of this patient's foreskin. Which of the following is the most likely diagnosis?

Balanoposthitis

Epispadias

Omphalocele

@Paraphimosis

Phimosis

#

Histologic examination of an excision specimen from a lesion on the dorsal surface of the penis reveals a papillary lesion with clear vacuoliza-lion of epithelial cells on the surface and extension of the hyperplastic epithelium into the underlying tissue along a broad front. Which of the fol­lowing is the most likely diagnosis?

Condyloma acuminatum

Bowen's disease

Erythroplasia of Queyrat

@Verrucous carcinoma

Squamous cell carcinoma

#

A patient complains of frequent and difficult urination. Imperfection of what formation can cause it?

Bulb-uretic glands

@Prostate

Testicles

Testicle adnexa

Sperm bubbles

#

A 67-year-old man is found on rectal examination to have a single, hard, irregular nodule within his prostate. A biopsy of this lesion reveals the presence of small glands lined by a single layer of cells with enlarged, prominent nucleoli. From what portion of the prostate did this lesion most likely originate?

Anterior zone

Central zone

@Peripheral zone

Periurethral glands

Transition zone

#

A 47-year-old man presents with the sudden onset of fever, chills, and dysuriDuring the review of symptoms you discover that he has no history of recurrent urinary tract infections. Rectal examination finds that the prostate gland is very sensitive and examination is painful. .Which of the following is the most likely diagnosis?

@Acute prostatitis

Chronic bacterial prostatitis

Chronic abacterial prostatitis

Granulomatous prostatitis

Benign prostatic hyperplasia

#

A 69-year-old man presents with urinary frequency, nocturia, drib­bling, and difficulty in starting and stopping urination. Rectal examination reveals the prostate to be enlarged, firm, and rubbery. A needle biopsy reveals increased numbers of glandular elements and stromal tissuThe glands are found to have a double layer of epithelial cells. Prominent nuclei or back-lo-back glands are not seen. Which of the following is the most likely diagnosis?

Atrophic prostatitis

Atypical small acinar proliferation

High-grade prostatic intraepithelial neoplasia

@Benign prostatic hyperplasia

Prostatic adenocarcinoma

#

A physical examination of a 68-year-old man, with complains to an acute ischuria (retention or suppression of the urine), revealed the nodular enlargement of a prostate. A microscopical investigation showed that the majority of knots were constructed of polymorphic glandular structures, with some retention cysts. The latter ones had thick secreta. What is the most likely diagnose?

@Glandular hyperplasia of prostate

Fibromuscular hyperplasia of prostate

Hyperplasia of prostate mixed form

Adenoma of prostate

Carcinoma of prostate

#

An autopsy of an elderly man revealed enlarged, soft, elastic, slightly nodular prostate. A gross investigation of a cut section showed separate nodes parted by layers of a connective tissue. The compressed surrounding prostatic tissue created a plane of cleavage about them. A microscopic study found the increase of glands quantity. There were variable number of prostatic nodes and glands in them.

@Glandular nodular hyperplasia

Fibromuscular (stromal) hyperplasia

Mixed nodular hyperplasia

Adenocarcinoma

Undifferentiated carcinoma

#

At the section of a 73-year-old man was revealed an enlarged, soft, elastic, tuberous prostate. On the incision it consisted of separated by strata of connective tissue nodules. Microscopical exam revealed the increment of glandular elements. The size of the lobules and the amount of glandular elements were different. What process is the most possible?

@Glandular nodular hyperplasia

Muscular-fibrous nodular hyperplasia

Mixed nodular hyperplasia

Adenocarcinoma

Undifferentiated cancer

#

A 68-year-old man presented with difficulty of a miction. The prostate was operatively removed. A microscopical investigation revealed an increase of glandular and muscular elements numbers. A lobular structure of prostate was also altered. What process in a prostate is the most probable?

@Mixed nodular hyperplasia

Glandular hyperplasia

Fibromuscular hyperplasia

Prostatitis

Adenocarcinoma

#

Within prostatic glands, feature consistent with prostatic intraepithelial neoplasma (PIN) incude all the following EXCEPT

cellular crowding

@absence of a basal cell layer

variation in nuclear size

nucleoli

hyperchromatism

#

Carcinoma of the prostate tends to do all the following EXCEPT

be adenocarcinoma

arise in the posterion lobe

cause elevation of serum acid phosphatase

@be estrogen-depended

form osteoblastic metastases

#

In histological specimen there is an organ, which is covered by tunica vaginalis and tunica albuginea. Stroma of the organ consists of connective tissue with the Leydig’s cells. Parenchyma contains tubules, which are lined by the spermatogeneous epithelium. What organ is there?

@Testis

Prostate gland

Epididymis

Mammary gland

Ovary

#

Primary germ cell tumors of the testise occur predominantly in the younger male with the exception of

embryonal carcinoma

@spermatocytic seminoma

polyembryoma

choriocarcinoma

teratocarcinoma

#

A 27-year-old man presents with a testicular mass, which is resected and diagnosed as being a yolk sac tumor. Which of the following sub­stances is most likely to be increased in this patient's serum as a result of being secreted from the cells of this tumor?

Acid phosphatase

@a-fetoprotein (AFP)

Alkaline phosphatase

p-human chorionic gonadotropin (p-hCG)

Prostate-specific antigen (PSA)

#

A 44-year-old man presents with painless enlargement of one testi­clPhysical examination reveals a single testicular mass that does not transilluminatThe mass is resected, examined histologically, and radia­tion therapy is subsequently given based on the pathologist's diagnosis. Which of the following best describes the expected microscopic appear­ance of this tumor?

A mixture of malignant cytotrophoblasts and syncytiotrophoblasts

Abnormal tissue derived from all three germ levels with scattered immature neural elements

Large tumor cells with abundant eosinophilic, granular cytoplasm, and rare intracytoplasmic rhomboid crystals

@Numerous lymphocytes in the fibrous stroma between groups of tumor cells having distinct cell membranes and clear cytoplasm

Sheets of undifferentiated tumor cells having focal glandular differentiation

#

Endocryne system

#

An endocrinal gland with parenchyma consisting of epithelium and neural tissue is under morphological examination. Epithelial trabecules have two types of cells: chromophilic and chromophobic. Identify this organ:

@Hypophysis

Parathyroid gland

Hypothalamus

Thyroid gland

Adrenal glands

#

A patient has a decreased vasopressin synthesis that causes polyuria and as a result of it evident organism dehydratation. What is the mechanism of polyuria development?

Acceleration of glomerular filtration

Reduced tubular reabsorption of protein

Reduced tubular reabsorption of Na ions

Reduced glucose reabsorption

@Reduced tubular reabsorption of water

#

A 23-years-old male presented to his physician with excess of the somatotropic hormone, the enlarged nose, lips, ears, a mandible, hands and feet. What is the most likely diagnosis?

@Acromegaly

Pituitary nanism

Itsenko-Cushing disease

Addison's disease

Adiposogenital dystrophy

#

A 45-years-old male presented to the hospital with enlarged nose, ears, a mandible and feet. What is the most likely diagnosis?

@Acromegaly

Nanism

Cerebro-hypophyseal cachexia

Adiposogenital dystrophy

-

#

A 42-year-old man presents with increasing fatigue and occasional headaches. He states that recently he has had to change his shoe size from 9 to 10, and he also thinks that his hands and jaw are now slightly larger. Physical examination reveals a prominent forehead and lower jaw, enlarged tongue, and large hands and feet. Initial laboratory examination reveals increased serum glucosWhich of the following is the most likely expla­nation for this constellation of clinical findings?

@Acromegaly

Apoplexy

Cretinism

Diabetes

Giganrism

#

A 45-years-old male presented to the hospital with gradual enlargement of feet, right hand, nose and lips. The adenoma of a pituitary body was diagnosed. What is the most likely disease?

@Acromegaly

Nanism

Basedow's disease.

Addison's disease

Diabetes mellitus

#

A 46 year-old patient has complained of headache, fatigue, thirst, pains in the spine and joints for the last 2 years. Clinically observed disproportional enlargement of hands, feet, nose, superciliary arches. He notes that he needed to buy bigger shoes three times. What is the main reason of such disproportional enlargement of different parts of the body?

Increased sensitivity of the tissues to growth hormone

Joints dystrophy development

Joints chronic inflammation development

Increased sensitivity of the tissues to insulin

@Cartilaginous tissue proliferation under growth hormone influence

#

Gradually, patient’s feet, right hand, a nose and lips began to increase in size rateably. The hypophysial adenoma was revealed. Diagnose the disease.

Addison’s disease

Nanism

Diffuse toxic goiter

@Acromegaly

Diabetes mellitus

#

Arterial hypertension, hyperglycemia, glucosuria were observed clinically for a long time in the patient with upper type of obesity. Death was due to the cerebral haemorrhage. Basophilic hypophysis adenoma, hyperplasia of adrenal gland cortex were revealed on pathomorphological examination. What is the likely diagnosis?

Adiposogenitalis dystrophy

Acromegaly

Diabetes mellitus

Hypophysis nanism

@Cushing disease

#

A 42-year-old woman presented with the obesity, chiefly of the trunk and face, steroid diabetes, an arterial hypertension and secondary dysfunction of ovaries. An autopsy revealed a hypertrichosis, a hirsutism, strias on a skin of hips and a abdomen. In the anterior lobe of the pituitary gland a tumour was found. Histological investigation showed the basophilic adenoma of the pituitary and hyperplasia of a fascicular layer in adrenals. What of the listed diagnoses is the most likely?

@Itsenko-Cushing disease

Itsenko-Cushing syndrome

Simmonds' disease

Adiposogenital dystrophy

Pituitary nanism

#

A male patient presented with obesity of the trunk and face. He also had a long medical history of an arterial hypertension. The death resulted from a hemorrhage in a brain. A morphological investigation revealed a basophilic adenoma of a pituitary body and hyperplasia of adrenals cortex. What is the most likely preliminary diagnosis?

@Itsenko-Cushing disease

Diabetes mellitus

Acromegaly

Pituitary nanism

Adiposogenital dystrophy

#

A 44 year old woman complains of general weakness, heart pain, significant increase of body weight. Objectively: moon face, hirsutism, AP is 165/100 mm Hg, height - 164 cm, weight - 103 kg; the fat is mostly accumulated on her neck, thoracic girdle, belly. What is the main pathogenetic mechanism of obesity?

Reduced production of thyroid hormones

Increased insulin production

Increased mineralocorticoid production

Reduced glucagon production

@Increased production of glucocorticoids

#

An autopsy of a 40-year-old woman revealed the obesity, chiefly of the trunk and face ("moonface" and "buffalo hump"), strias on a skin of hips and abdomen. She had in her medical records an osteoporosis with spontaneous fractures of bones, an amenorrhea, an arterial hypertension, a hyperglycemia. What of the listed diagnoses is the most likely?

@Itsenko-Cushing syndrome

Addison's disease

Friderichsen-Waterhouse syndrome

Conn's syndrome

Sipple's syndrome

#

A patient complaining of weight loss (10 kg during 2 months), pallpitation and exophthalmos came to the endocrinologist. For the hyperfunction of what endocrine gland (glands) are these complaints the most typical?

Pancreas

Ovaria

Parathyroid glands

Adrenal glands

@Thyroid

#

A 19-year-old female suffers from tachycardia in rest condition, weight loss, excessive sweating, exophtalmos and irritability. What hormone would you expect to find elevated in her serum?

ACTH

Mineralocorticoids

Cortisol

Insulin

@Thyroxine

#

A 48-years-old woman presented with insomnia (inability to get enough sleep, a bad dream), a fatigue, irritability, exophthalmos (protuberance of eyes) and tachycardia. The thyroid gland was enlarged. She died soon due to cardiovascular insufficiency. Histological investigation of the thyroid tissue revealed a proliferation of an epithelium with formation of papillas, a colloid colliquation, lymphocyte and plasmocyte infiltration and formation of lymphatic follicles with the germinal centres. What is the most likely diagnosis?

@Diffuse toxic goiter. (Basedow's disease)

Endemic goiter

Sporadic goiter

Hashimoto's thyreoiditis

Benign tumor of thyroid gland

#

A thyroid gland of a 48-year-old male was removed at surgery department. Histological investigation revealed various size follicles which were lined by tall columnar epithelium. The latter one was pilled up at places forming papillary infoldings. Colloid appeared lightly staining, watery and finely vacuolated. The stroma showed increased accumulation of lymphoid cells.

@Basedow's goiter.

B Hashimoto's thyreoiditis

Riedel's thyreoiditis

De Quervain's thyroiditis

Nodular goiter

#

A 40-year-old woman was made a thyroidectomy. Histological exam of the gland reveals big follicles of different size with a foamy colloid. The follicular epithelium is high and forms papillae in some places. The stroma has a focal lymphocytic infiltration. Diagnose the disease of the thyroid gland.

@Diffuse toxic goiter

Hashimoto’s thyroiditis

Riedel’s thyroiditis

de Quervain’s thyroiditis

Nodular goiter

#

A patient suffering from thyrotoxicosis symptoms of vegetoasthenic syndrome was revealed. What of the following would show the histological appearance of a thyroid gland being stimulated by thyroid-stimulating hormone (TSH)?

Increased numbers of parafollicular cells

Decreased numbers of follicular cells

Decreased numbers of parafollicular capillaries

An abundance of colloid in the lumen of the follicle

@Columnar-shaped follicular cells

#

A patient is followed up in an endocrinological dispensary on account of hyperthyreosis. Weight loss, tachycardia, finger tremor are accompanied by hypoxia symptoms - headache, fatigue, eye flicker. What mechanism of thyroid hormones action underlies the development of hypoxia?

Competitive inhibition of respiratory ferments

Specific binding of active centres of respiratory ferments

Intensification of respiratory ferment synthesis

Inhibition of respiratory ferment synthesis

@Disjunction, oxydation and phosphorilation

#

Graves’ disease is associated with all the following EXCEPT

Tachycardia

Anti-TSH receptor antibodies

Localized myxedema

@Toxic nodular goiter

Conversion hysteria

#

A 48-year-old male, with a long history of living in the mountain district of Central Asia, presented with a thyroid gland enlargement, resulted in complicated swallowing. A physical investigation revealed an increasing of a body mass, slowness, drowsiness, and puffy face. A microscopic study of a thyroid gland showed irregular follicles with a hypochromic colloid. What of diagnoses is the most probable?

@Endemic goiter.

Basedow's goiter.

Hashimoto's thyreoiditis.

Sporadic goiter.

Riedel's thyreoiditis.

#

The exam of the patient, who lives in the mountain region of Middle Asia, reveals the enlargement of the thyroid gland, that makes it difficult to swallow, increased weight, retarded thinking, drowsiness and puffy face. Microscopic exam of the gland reveals follicles of different size with hypochromic colloid. What is the most possible diagnosis?

@Endemic goiter

Diffuse toxic goiter

Hashimoto’s thyroiditis

Sporadic goiter

Fibrous goiter

#

A histological investigation of the removed enlarged thyroid gland revealed irregular form and sizes follicles. The follicular epithelium proliferated both into follicles lumen and outside. Layers of the connective tissue separated various sites of the thyroid. What is the most likely diagnosis?

@Macro-microfollicular goiter

Diffuse goiter

Autoimmune thyroiditis

Follicular carcinoma

Riedel's thyreoiditis

#

A 58-year-old woman presents with increased "fullness" in her neck. Physical examination finds nontender diffuse enlargement of her thyroid glanClinically she is found to be euthyroid and her serum TSH level is within normal limits. Sections from her enlarged thyroid gland reveal numerous, mainly enlarged follicles, most of which are filled with abun­dant colloid material. There are areas of fibrosis, hemorrhage, and cystic degeneration. No papillary structures are identified and neither colloid scalloping nor Hurthle cells are present. Which of the following is the most likely diagnosis?

Colloid carcinoma

Diffuse toxic goiter

Graves' disease

Hashimoto's thyroiditis

@Multinodular goiter

#

At operation of excision of a diffusive thyroid gland struma a patient died from acute adrenals insufficiency. An autopsy, besides the atrophy of adrenals, revealed a left ventricle hypertrophy in a heart, a hypertrophy and an intracellular edema of cardiomyocytes, a serous edema and lymphoid infiltration of a myocardial stroma. What is the figurative name of a heart pathology presented at post-mortem?

@Thyrotoxyc heart

Tabby cat heart

Cor bovinum

Cor pulmonary

Brown atrophy of heart

#

A patient presented to surgery with symptoms of hypothyrosis. Macroscopic investigation of the removed thyroid gland revealed its considerable enlargement, dense-elastic texture and lobulated surface. Histological investigation showed the diffuse infiltration of lymphocytes and plasmocytes of gland's parenchyma with formation of lymphoid follicles. The latter ones had hyperplastic germinal centers with atypia and a metaplasia of a follicular epithelium. In addition, the sclerotic alterations of a parenchyma were also determined. What is the most likely diagnose?

@Autoimmune thyroiditis

Diffuse toxic goiter

Colloid goiter

Nodular goiter

De Quervain's thyroiditis

#

A 44-year-old woman presents with anorexia and weight loss. Physical examination reveals a slightly decreased blood pressure along with increased skin pigmentation. Laboratory examination reveals a low cortisol with increased ACTH. After further work-up the diagnosisof adrenal cortical failure is made. One year later this woman is found to have hyperglycemia and after appopriate work-up the diagnosis of type 1 diabetes mellitus is made. Which of the following adnormalities is this individual most likely to develop?

@Autoimmune destruction of the thyroid gland

Bacterial infection of the antrum of the stomach

Fungal infection of the oral cavity

Metabolic hyperfunction of the parathyroid glands

Neoplastic development in the anterior pituitary

#

A perimenopausal woman complains of slight swallowing difficulty, fatigue, and a change in bowel habits. The photomicrograph below is of her thyroid gland. This disorder is

Subacute thyroiditis

Thyrotoxicosis

@Autoimmune thyroiditis

Riedel’s thyroiditis

Conversion hysteria

#

Histological exam of a thyroid gland reveals moderate atrophy of the parenchyma, sclerosis and diffuse infiltration of the stroma by lymphocytes and plasmatic cells with the formation of lymphoid follicles. What is your diagnosis?

@Autoimmune thyroiditis

Parenchymatous goiter

Thyrotoxicosis

Thyroiditis

Fibrous goiter

#

A histological investigation of a thyroid gland, presented to pathology, revealed a mild atrophy of a parenchyma, sclerosis, diffusive infiltration of a stroma by lymphocytes and plasmocytes with formation of lymphoid follicles. What is the most likely diagnose?

@Autoimmune thyroiditis

Parenchymatous goiter

Toxic goiter

Thyroiditis

Riedel's thyreoiditis

#

An 8-month-old infant is being evaluated for growth and mental retardation. Physical examination reveals a small infant with dry, rough skin; a protuberant abdomen; periorbital edema; a flattened, broad nose; and a large, protuberant tonguWhich of the following disorders is the most likely cause of this infant's signs and symptoms?

Graves' disease

@Cretinism

Toxic mulunodular goiter

Toxic adenoma

Struma ovarii

#

A morphological investigation of a thyroid removed due to thyrotoxicosis struma revealed a diffuse infiltration of a gland by lymphocytes with a destruction of parenchyma and an area of connective tissue. What is the most likely diagnose?

@Hashimoto's thyreoiditis

Anaphylactic reaction

Thyrotoxicosis

Cancer of thyroid

Adenoma

#

At the operative biopsy of a thyroid gland, histologically, among the follicles filled with colloid, were revealed lymphoid structures with the growth centers. Define the disease.

Diffuse toxic goiter

Endemic goiter

Sporadic goiter

@Hashimoto’s goiter

Fibrous goiter

#

During the intraoperative biopsy of thyroid gland the histological examination revealed lymphoid structures with growth centers, which were among the folliculi full of colloid. What disease was it?

Endemic goiter

@Hashimoto's thyroiditis (lymphadenoid goiter)

Thyrotoxicosis (Basedow's goiter)

Ridel's goiter

Sporadic goiter

#

A histological investigation of a thyroid gland biopsy, presented to pathology, revealed lymphoid structures with the germinal (growth) centers among the follicles filled with a colloid. What is the most likely disease presented in that case?

@Hashimoto's goiter.

Endemic goiter

Sporadic goiter

Basedow's goiter

Riedel's thyreoiditis

#

A histological investigation of a thyroid revealed a considerable infiltration of a gland by lymphocytes with formation of lymphoid follicles, a destruction of parenchyma, growth of connective tissue fibers. What is the most likely disease presented in that case?

@Hashimoto's goiter

Colloid goiter

Endemic goiter

Diffuse toxic goiter

Parenchymatous goiter

#

The thyroid gland of the patient is twice enlarged. The palpation shows: the gland is solid; its surface is unevenly tuberous. Histological exam reveals diffuse infiltration of the tissue by lymphocytes, plasmatic cells with the formation of follicles and intensive overgrowth of the connective tissue. What disease do these facts indicate?

@Hashimoto’s goiter

Endemic goiter

Sporadic goiter

Diffuse toxic goiter

Fibrous goiter

#

A 42-year-old man presented with a thyroid gland enlargement in two times. A physical investigation revealed firm, irregular lobulated gland. Histological investigation showed a diffusive infiltration of thyroid gland by lymphocytes, plasmocytes with follicles formation and the enhanced growth of a connective tissue. What is the most likely diagnosis?

@Hashimoto's goiter.

Endemic goiter.

Sporadic goiter.

Diffuse toxic goiter.

Riedel's thyreoiditis

#

Follicular carcinoma of the thyroid may show all the following features EXCEPT

Vascular invasion and hematogenous metastasis

@Multiple foci within the gland

A clear cell variant that resembles renal carcinoma

An insular type that is an aggressive form

Absence of ground-glass nuclei

#

A 37-year-old man presents with a single, firm mass within the thy­roid glanThis patient's father developed a tumor of the thyroid gland when he was 32 years of agHistologic examination of the mass in this 37-year-old man reveals organoid nests of tumor cells separated'by broad bands of stroma, as seen in the photomicrograph below. The stroma stains • positively with Congo red stain and demonstrates yellow-green birefrin­gencWhich of the following is the most likely diagnosis?

Follicular carcinoma

Papillary carcinoma

Squamous cell carcinoma

@Medullary carcinoma

Anaplasric carcinoma

#

A 2-year-old child experienced convulsions because of lowering calcium ions concentration in the blood plasma. Function of what structure is decreased?

Thymus

Pineal gland

@Parathyroid glands

Adrenal cortex

Hypophysis

#

Kidneys of a man under examination show increased resorbtion of calcium ions and decreased resorbtion of phosphate ions. What hormone causes this phenomenon?

Thyrocalcitonin

Vasopressin

Hormonal form D₃

Aldosterone

@Parathormone

#

A 52-year-old woman presents with nausea, fatigue, muscle weakness, and intermittent pain in her left flank. Laboratory examination reveals increased serum calcium and decreased serum phosphorus. The patient's plasma parathyroid hormone levels are increased, but parathyroid hormone-related peptide levels are within normal limits. Urinary calcium is increased, and microhematuria is present. Which of the following is the most likely cause of this patient's signs and symptoms?

@Primary hyperparathyroidism

Primary hypoparathyroidism

Pseudohypoparathyroidism

Secondary hyperparathyroidism

Secondary hypoparathyroidism

#

Periodic renal colics attackes are observed in the woman with primery hyperparathyroidizm. Ultrasonic examination revealed small stones in the kidneys. What is the cause of the formation of the stones?

Hypercholesterinemia

Hyperkalemia

@Hypercalcemia

Hyperphosphatemia

Hyperuricemia

#

Osteomalacia may best be characterized as

Failure of bone remodeling

@Failure of bone mineralization

Failure of osteoid formation

Reactive bone formation

Reduction in amount of normally mineralized bone

#

A 56-year-old woman with a long history of parathyroid glands disease, died from increased renal insufficiency. A post-mortem revealed a bones deformation of extremities, a vertebral column, and ribs. Bones were fragile, soft and easily deformed or cat.

Date: 2016-03-03; view: 3211