Clinical pathoanatomy MCQs (Q 451-490)

451) “After Y-shaped opening of The pericardium, the pulmonary artery is cut on 2cm after It’s beginning. Tweezers are inserted in the vessel and it’s contents is taken out ,which looks dry and crumble”

452)Indicate the Cause of death according to the described test: After Y-shaped opening,the pericardial sac is filled with water. After puncture of the right heart ventricle with a sharp knife are seen air bubbles.

453)The following microscopic description of the kidney is indicative for: for H-E staining: on low magnification is seen pinkish area with no nuclei or picnotic nuclei and the cytoplasm of the necrotic cells is granular and eosinophilic. Kidney structures looks like shadows. This pinkish area is surrounded by blue rim, of inflammatory cells ( lymphocytes and leukocytes) and thin band of erythrocytes ( the so-called hyperemic- hemorrahagic area ).

454)The following microscopic description of the lung indicate for: On H.E staining : Necropsy material taken 24 hours after death. The alveoli are filled with agglutinate and hemolized erythocytes, the alveolar walls are necrotic. The preserved alveoli are filled with edematous fluid and hemosiderophages. The latest changes are a sign for chronic venous congestion.

455) What is the organ diagnosis if during autopsy are seen the following changes: complicated atherosclerotic plaques of the aorta and renal arteries with ulceration nd thrombosis, small in size right kidney showing depressed area in its middle part, which is 3*4 cm in size, with pale color, firm texture and triangular shape.

456) The following microscopic description Of the heart is indicative for : H-E staining : Among the myocardium are found cavities with purulent exudate. In the center of some of them are seen group of microorganisms, stained in dark blue. The adjacent cardiomyocytes are with dystrophic changes, multitude are seen in the interstitium.

457)What is the described disease in the liver ? H-E staining “ Description of the wall of a cyst. Pink slender membrane is pathognomic for the disease. It reperestns tick, multilayered acellular band which looks like”cigarette smoke”. There is a fibrous capsule between the membrane and the normal liver tissue, composed of collagen connective tissue.Single bile ducts and chronic inflammatory cells are included among the collagen fibers.

458) Indicate the correct answer for the following description: “ Tumor-like process located on the gingiva. Histologically, un dear the stratified squamous gingival epithelium are found fibroblast like cells and giant cells looking like osteoclasts, located in optically empty spaces. Light stripe of connective tissue separates the epithelium and the tumor-lie process.

459) indicate the diagnosis according to the following microscopic description: H-E staining: The thyroid gland is lavishly infiltrated by the lymphocytes and plasma cells. Plenty of lymph follicles are also formed, they are with the wide light centres. The lymphoid infiltration disrupts the lymph follicles; in the preserved ones the colloid is scanty or missing. High cubic eosinophilic cells of Hurtle type can be seen.

460)Suggest the correct answer according to the following microscopic description.H-E staining: The tu our is composed of branches and nests of basal type cells- spindle, with scanty cytoplasm and moderate atypia of nuclei. Mitosis are rarely seen. In the solid nests tumor cells have palisade peripheral arrangement. The stromal reaction is presented by lymphocytes and plasma cells. The tumour nests infiltrates the deep dermal layers.

461) Suggest the correct diagnosis according to the following microscopic description. H-E staining: Unencapsukated intradermal tumor which is poorly distinguished from the adjacent tissue and covered by the atrophic epidermis. The tumor is composed of the capillary vessels with erythrocytes in their lumena.

462)Suggest the diagnosis according to the following microscopic description. H-E staining : Unencapsulated liver tumor which is well distinguished from the adjacent tissues. It is composed of the large vascular spaces resembling similar vascular structures in the penis. Erythrocytes and hemolyzed blood are seen in the lumina of these large vessels. The walls of these structures represent fibrous septi covered with one or two lines of endothelial cells.

463) Suggest the diagnosis according to the following microscopic description: H-E staining: unencapsulated uterine tumor which is composed of the spindle cells arranged in bundles. These bundles cross in different directions. Slight tissue atypia is seen, presented by chaotic bundles of the spindle cells.

464) Suggest the diagnosis according to the microscopic description. H-E staining : The tumor is composed of highly diferentes tissue elements from the three germinal cell layers - - mesodermal layer (connective tissue, cartilage and others), endodermal layer (glands) and ectodermal layer (skin, columnar epithelium, stratified squamous epithelium, brain substance). They create a variety of the morphological picture. There isn’t any sing of cell atypia. Cystic changes are often seen.

465) A resident in surgery is looking for a consultation with regard to a breast nodule in a young woman: can a morphological examination be done prior to surgery ? How the specimen should be taken and in what fixative ? Which are the other options for a routine examination ? What addition morphological methods can be involved ?

466) 52 year old woman with medical history of tonsillitis, developed heart valve defect. She complained of cough, sometimes with rusty expectoration and difficulties in breathing when she lying in bed. Auscultation revealed small, moist noises in both lung bases. What is the cause for all these complains and clinical findings ?

467) Body of a man with total cachexia is sent for an autopsy. The skin is dark-bronze. The Two suprarenal glands are entirely ruined by tuberculosis. Which is the disease ?

468) Nodule measuring 2 cm from the parotid gland of a 32 year old male patient wa sent for the histological examination. Histological result shied jelly-like and at skin areas chondroid substance which surrounds glandular structures and strands of flat cylindrical and spindle cells. Suggest the diagnosis.

469) A tumor from the left forearm in 39 year old woman was resected. Grossly it is well circumscribed, with a diameter of 3 cm. On histology: tumor cells are spindle-shaped, grouped in bundles, nuclei form palisade structures. Set the diagnosis:

470) An autopsy of a 60 years all man revealed a thickened and soft wall of the stomach with indistinct layers. Cut surface showed presents of the dirty grayish-green pus like material. What disease is this :

471) At the autposy in the temporal lobe of the brain a cyst with a diameter of 2 cm, with smooth walks and clear pale yellow liquid was found. What can it be :

472) A man of 68 years is complaining of severe pain in the muscles of the legs occurring when walking fast, which disappears after a short rest. Indicate the correct diagnosis:

473) During an opera performance a singer suddenly lost consciousness and after a few hours died with the signs of hemorrhagic shock without clear source of bleeding. At the autopsy are found 2.5L blood in the abdomen from subcapsular rupture of an unencapsulated tumor formation in the liver, with spongy structre , cherry red color and size-15 x 15cm.Which are the causes of death?

474) The left hemisphere of the brain demonstrates a well circumscribed tumor with a diameter of 3cm, grayish-brown colour and a thick consistency, attached to the dura mater. The underlying brain tissue slows a compression pit. Point the most likely macroscopic diagnosis:

475) On the plantar surface of a 35 year old woman there is bluish-black tumor with lobulated uneven surface covered with bloody crusts.histology shows epitheloid cells with different shapes and sizes with pigment granules in the cytoplasm. Infiltrative growth in respect to dermis and epidermis is present. Give a diagnosis

476) At autopsy in the upper area of the right lung are detected changes including two foci stone hard density. The cut surface is whitish and is grinding like sand. How to explain the presence of these calcium salts?

477) 68 year old man complains of a face ulcer with thick edges and black base covered with brownish crusts. Histologically nests of round cells that form peripheral palisade structures are seen. Which is the correct diagnosis?

478) A man of 62, smoker with obesity treated in a dermatological clinic due to slim problems, dies suddenly after a severe chest pain. Clinicians set as the final diagnosis the skin disease for which he has been admitted to the hospital. At the autopsy a 3.5 cm clay like area with irregular shape in the anterior wall of the left ventricle was seen. The descending left coronary artery was almost entirely occuluded by atherosclerosis. What is the correct diagnosis ?

479) The autopsy of a 43 years old man reveals brain meninges covered by the thick yellowish educate. Meningeal vessels are hyperemic, brain tissue is edematous. What diagnosis?

480) A 35 year old man felt his right carotid gland enlarged, with a nodule 2cm in diameter well demarcated and dense. Histology shows jelly like structures and immature cartilage and between them glandular structures and strands of cubic, cylindrical cells and ducts. Specify the diagnosis:

481) during the autopsy in the temporal lobe of the brain is found a cyst 2cm in diameter, with smooth walls filled with a clear pale yellow liquid. Indicate what it is :

482)At autopsy in the abdominal cavity and on appendices epiploice, many "chalky" white spots are clearly seen. The finding is the same in the pancreas. Point the diagnosis:

483)28 year old woman a year ago felt a knot in the breast 2 cm in diameter well demarcated painless mobile thick. Histology shows concentric connective tissue around the duct of the breast without compressing and distortion of the duct. Specify the exact histologic diagnosis:

484)Bilateral on the skin of the eyelids are seen bulging above the level of the skin nodules yellow colour with he size of rice grains. What is it ?

486) 39 year old female underwent surgery to remove from her left forearm. The tumor is 3cm in diameter, well demarcated and dense. Hsirologiclt shows fusiform(spindle) cells which are grouped in bundles, with nuclei arranged in palisades(fence wall pattern). Set the diagnosis:

487) At autopsy in the frontal lobe of the brain is found well visible and dema4cated area with 3cm in diameter, with Gray green colour, well circumscribed from the surrounding tissue, filled with decaying substance. What illness is described?

488)Autopsy or a patient suffering from elevation of blood pressure comma episodic diarrhoea with abdominal pain, flushing cyanosis pulmonary stenosis with insufficiency shows it thickened nodal end of the appendix the size of 2 centimetres dense with a characteristic yellowish color in the submucosa. Histologically the tumor is composed of rounded to polygonal cells with hyperchromatic nuclei and eosinophilic granular cytoplasm. The granules do not reduce silver salts. Tumor stroma is hyalinized. Give the histological diagnosis of the tumor:

489) the autopsy of 65v year old woman shorts ascending pneumonia chronic bronchitis and bronchiectasis. Indie subarachnoid space and on the surface of the brain is seen an exudates with dense yellowish colour. Histology detect the presence of exudates rich in segmented leukocytes ad fibrin. Diagnosis the process !

490)34 yelled presents with enlarged cervical live notes on the right side of the neck that do not seem to be affected after antibiotic treatment the biopsy of the lymph nodes shows entirely depleted structures with numerous large mononuclear and the binuclear cells, eosinophls, plasma cells, lymphocyets, epitheloid macrophages. Give diagnosis of the pathological process in the lymph nodes !