Parenchymal jaundice is characterized by the following laboratory findings
increased indirect bilirubin in the serum, hypercholic stools and increased urobilinogen in the urine
both types of bilirubin are increased in the serum, normal colour of the stocks, both bilirubin and urobilinogen are increased in the urine
increased direct bilirubin in the serum, hypocholic or acholic stools, increased bilirubin in the urine
none of the above
What is the common between fibrosis, sclerosis and cirrhosis?
the common is the increased development of connective tissue in the organ
the common is the lipid accumulation in the interstitium of the organ
the common is the fibrinoid degeneration of the organ
they are different processes and don’t have anything common between them
What is the clinical significance of hyalinosis of the pancreatic arteroles?
it can cause diabetes mellitus
it can cause pancreatic cancer
it can cause acute pancreatitis
hyalinosis in the pancreas is a physiological process related with ageing
Which stain is used to prove rheumatism in acute stage in a heart valve?
Prussian Blue
Toluidin-Blue
Congo-Red
Perls
Mucoid swelling can be seen in
Heart valves in rheumatism
Basedow’s dermopathy
Myxedema
All of the listed above
The necrosis which develops at the base of an acute or chronic active ulcer in the stomach or duodenum is
coagulative
caseous
fibrinoid
liquefactive
Indicate the correct statement(s) for nephrosclerosis arteriolosclerotica
it affects microscopically the afferent and efferent arterioles
it is a result of prolonged benign hypertention
it is a reversible process
the process is hyalinosis
What are the microscopic changes seen in the brain in benign long-term hypertension?
hyalinosis of the vessels’ walls
edema around vessels
accumulation of lymphocytes and plasma cells in the soft brain membranes
developments of specific granulomas in the brain tissue
The gross description: thick, hard, glassy whitish depositions, non-digestable by enzymes, is indicative for
steatonecrosis
liquefactive necrosis
hyalinosis
fibrinoid deposition
The following diseases are examples of amyloid depositions. Find the mistake!
Rheumatoid arthritis - AA amyloid
Multiple myeloma - AL amyloid
Medullary carcinoma of the thyroid gland - AA amyloid
Alzheimer’s disease - A4 amyloid
‘Sago spleen and lardaceous spleen’ are
gross appearance of the localized (sago-spleen)and generalized (lardaceous spleen) amyloidosis of the spleen
sago spleen is amyloidosis of the spleen, while lardaceous spleen is hyalinosis of the spleen
gross appearance of the spleen in Hodgkin’s lymphoma depending on the severity of the process
in lardaceous spleen the amyloid is deposited in the white pulp only, while in sago spleen both white and red pulp have amyloid deposition
Systemic amyloidosis is proven by a biopsy from?
gingiva
heart
fat tissue from abdominal wall
ileum
What type of calcification develops in the complicated atherosclerotic plaques?
metastatic
dystrophic
metabolic
physiological
Which are the causes for hypocalcaemia?
hypoparathyroidism
hyperparathyroidism
intoxication with vit. D
senile osteoporosis
What kind of gout can develop in a patient with leucemia?
gout caused by excessive consumption of meat and meat products
genetic gout caused by error in the metabolism of uric acid
renal injury because kidneys cannot excrete the excessive amount of uric acid
patients with leucosis never develop gout
Which of the following microscopic descriptions most likely suggest kidney amyloidosis? The stain is H-E in all the described specimens
highly enlarged glomeruli, the capillary tufts filled almost all of the capsular space, capillary lumens are obliterated; pink homogeous substance is deposited also in the mesangium, in the basement membranes of the tubules and in the walls of the blood vessels
afferent and efferent arterioles have homogenously thick walls stained in pink, some of the glomeruli look smaller, with totally effaced structure and homogenously pink in color, while others may look normal in size, or even with compensatory hypertrophy
the interstitium shows chronic inflammatory reaction, the main change is seen in the kidney tubules which look dilated and filled with pinkish substance (these tubules look like thyroid follicles)
many glomeruli show crescent proliferations, encompassing 2/3 f the Bowman's space; the process ends with global sclerosis of the gomerulus
Which of the following stain(s) is used to prove amyloidosis?
Van Gieson
Methyl violet
Mark the correct statement(s) for kidney alymoidosis
small, shrunken kidneys with granular surface and difficult decapsulation
enlarged pale kidneys with waxy texture
amyloidosis affects only one of the kidneys and doesn’t lead to chronic renal failure
kidney amyloidosis is reversible after the treatment of the primary disease and has very good prognosis
Granulomatous structures, consisting of uric acid crystals, lymphocytes, macrophages, fibroblasts and giant multinucleated cells type “foreign body” are characteristic for which disease?
tuberculosis
sarcoidosis
gout
brucellosis
Calcification of the aorta characterizes with
hard, rigid wall of the aorta
soft, elastic wall of the aorta
can be complicated with mural thrombosis and aneurysm
is a result of metabolic calcification
Renal complications of gout include
Uric crystals nephrolithiasis
Uric-acid infarction
Urate nephropathy
What type of necrosis develops in the specific granuloma in tuberculosis?
coagulative necrosis
caseous necrosis
Which of the following terms are used to describe liquefactive necrosis of the brain?
ramolicio cerebri
encephalomalacia
infarctus anemicus cerebri
hydrocephalus
What type of necrosis develops in the pancreas?
steatonecrosis/fat necrosis
Indicate the correct statement(s) for dyspasia
it is a process of disordered cellular development
it can develop in soft tissues
it can develop in tissues of epithelial origin
it is an adaptive process
Corpora amylacea can be seen microscopically in?
the glands of uterine mucosa
the glands of prostate
the kidney’s convoluted tubules
the follicles of thyroid gland
How does the hypertrophic myocardium look like grossly?
enlarged in size
smaller in size
papillary muscles are hypertrophic
increased heart weight
Hyperplasia of the endometrium can be
direct and indirect
typical and atypical
with formation of cysts or with formation of pseudo-cysts
diffuse and localized
What are the complications of prostate hyperplasia?
urinary retention, frequent urinary tract infections
sexual dysfunction
transitional cell carcinoma
hydronephrosis
Which is the main complication after squamous metaplasia of the respiratory bronchial epithelium?
squamous carcinoma of the bronchus
chronic bronchitis
small-cell carcinoma
adenocarcinoma of the bronchus
Epistaxis and melena are examples for
edema
exudate
haemorrhages
venous congestion
What is hemascos?
blood in the urine
blood in the peritoneal cavity
blood in the excrement
blood vomiting
What is hematemesis?
blood in the excrements
nose bleeding
bleeding from the lungs
What is hemoptoe
bleeding from the nose
blood in the pleural cavity
Which of the following liver changes is reversible?
liver cirrhosis
liver cyanosis
nutmeg liver
liver amyloidosis
Pin-point hemorrhages in the brain have usually the following pathogenesis
per diapedesin
per rhexin
per diabrosin
all of the above
Can thrombosis develop after death?
yes, this is why we can see blood clots in the vessels after death
no, thrombosis is a pathological process which develops only during lifetime
it can develop both during life and after death
it develops in the agony preceding death
What is characteristic for the post-mortem blood clot?
dry, crumbly, layered structure
moist, homogenous structure
attached to the vessel’s wall
unattached to the vessel’s wall
Indicate types of embolism depending on the content of embolus
gas, air, amniotic
thromboembolism, fat embolism
arterial, venous
orthograde, retrograde, paradoxal
Indicate types of embolism according to the way of blood flow
gas, air, thromboembolism, amniotic, fat, parasite
orthograde, retrograde
paradoxical
Indicate types of embolism according to the character of the obturated blood vessel
thromboembolism, amniotic, fat, gas, air embolism
arterial
venous
orthograde, retrograde, paradoxical
Is it possible to prevent embolism?
no, it is something we cannot control or prevent
yes, by using anticoagulants
yes, by exercise in bed ridden patient and early getting up from bed after operation
yes, by staying in bed without moving after operation
In which organ hemorrhagic infarction can develop?
in organs with nutritive and functional blood circulation
in organs with nutritive circulation only
in organs with many anastomoses
hemorrhagic infarction can develop in any organ
Indicate the organ(s) where hemorrhagic infarction is possible
liver
lung
intestine
How can we prove amniotic embolism?
microscopically, by finding amniotic fluid in the left heart ventricle
grossly, by finding amniotic fluid in the right heart ventricle
microscopically, by finding amniotic particles such as lanugo, meconium etc. in the lungs
grossly, by finding amniotic particles in the lungs
Why does gas embolism develop?
because of the dissolution of blood gases, especially azotic oxide, caused by fast decompression
because of the dissolution of blood gases, especially type caused by fast compression
because the negative pressure of the opened blood vessels on the neck and head can lead to air entry
because the positive pressure of the opened blood vessels on the neck and head can lead to air entry
What is needed for the development of hemorrhagic infarction the lung?
double circulation of the lung
thrombosis of a branch of a. broncialis
thrombosis of a branch of a. pulmonalis
chronic venous stagnation
What is the most common cause for the development of anemic infarction of the brain?
thrombosis or embolism of a. cerebri anterior
thrombosis or embolism of a. cerebri media
thrombosis or embolism of a. cerebri posterior
thrombosis or embolism of a. basillaris
What is the gross appearance of a previous anemic infarction of the brain?
fresh liquefactive necrosis
brain cyst
brain pseudocyst
irregular red-coloured area
Indicate the correct statements
gangrene of the appendix and gangrenous appendicitis are synonyms of one same disease
severe inflammation in gangrenous appendicitis leads to necrosis, while in gangrene of the appendix the necrosis is ischemic
gangrene of the appendix means necrosis of the appendix while gangrenous appendicitis means severe purulent inflammation of the appendix without necrosis
inflammation in gangrenous appendicitis is a primary process, while in gangrene the inflammation is secondary after the necrosis
The gross appearance “Ribbon-like fibrin deposits on the pericardium” describes
chronic pericarditis
fibrinous myocarditis
fibrinous pericarditis
acute pericarditis
Which are the cells that infiltrate the whole thickness of the appendix in phlegmonous appendicitis?
lymphocytes and plasma cells
basophils
neutrophils
giant multinucleated cells
What is typical for purulent lepto-meningitis?
hyperemic vessels, infiltration of the soft brain membranes by lymphocytes
hyperemic vessels, infiltration of the soft brain membranes by neutrophils
yellow-green exudate seen usually on the convex side of the brain
clear cerebro-spinal fluid
Hydatid cysts affect most commonly
the brain
the heart
the spleen
the liver
Which is the second most commonly affected organ by hydatid cysts?
brain
kidney
The following description indicates: Focal aggregates in the form of nodules of cells with phagocytic ability. The diameter of these nodules is no more than 1-2mm, in many cases they are seen only microscopically
granulomas
metastases
polyps
granulation tissue
What type of necrosis develops in the tuberculous granuloma?
fibrinoid necrosis
Which of the following cells are seen in tuberculomas?
Giant cells type Langhans
Epitheloid cells
Tuton giant cells
Lymphocytes
The giant cells type Langhans are derived from
macrophages
epitheloid cells
lymphocytes
monocytes
Which giant cells have specific peripheral arrangement of the nuclei like horse-shoe?
Foreign body giant cells
Langhans giant cells
None of the above
In which stage of syphilis do the specific luetic granulomas develop?
first
second
third
they develop in all stages
What type of necrosis develops in luetic granulomas?
clay-like
caseus
What type of necrosis develops in the cat-scratch disease?
gummous
Mark the correct answer(s) about actinomycosis
has three stages of development
has cervical, abdominal and thoracic forms
grossly, granular substance might be seen in the pus
grossly, rubbery lesions with central necrosis are seen in the affected organs
Mark the correct diagnosis according to the following microscopic description of a granuloma. Lack of necrosis, abundance of epitheloid cell, Langhans cells, collagen fibres, Shaumann bodies
rheumatism
syphilis
Mark the correct diagnosis according to the following microscopic description of a grauloma: Gummous necrosis, surrounded by epitheloid cells, single Langhans cells, abundance of plasma cells, less lymphocytes, fibroblasts
The sulfur granule is characteristic for
felinosis
actinomycosis
leprosy
Mark the correct diagnosis according to the following microscopic description of a granuloma. Fibrinoid necrosis, surrouned by abundant lymphocytes, plasma cells, many cells of Anichkov and pathognomonic cells of Aschoff
rheumatoid arthritis
What histological changes could be seen in thyroid in Hashimoto thyroiditis
unchanged
infiltration of lymphocytes and plasma cells
fibrosis
formation of lymph follicles
The histological changes in Hashimoto thyroiditis affect
entire thyroid gland
markedly focal
The thyroid follicles in Hashimoto thyroiditis are
dilated
polymorphous
smaller
What is hyper-granulation?
mature connective tissue
hypertrophic tumor-like cicatrix/scar
greater amount of granulation tissue
What Is a scar?
hypertrophic granulation tissue
hypertrophic tumor-like cicatrix
What is a keloid?
Which stain can be used to prove of scarring (cicatrix) of the heart?
Congo Red
PAS
Which of the following could not be seen in rheumatoid nodules?
Fibrinoid necrosis
Langhans cells
Indicate the correct statement(s) for the polyarteriitis nodosa
it is an autoimmune disease
it affects mostly the elastic arteries
there is accumulation of glucosaminoglycans in the vessel walls which can be demonstrated with metachromasia with Toluidin Bleu
the branches of the pulmonary arteries are affected
Anaphylactic hypersensitivity reactions are related to
Hemolytic anemia
Hashimoto thyroiditis
Allergic rhinitis
Bronchial asthma
Cytotoxic hypersensitivity reactions are related to
Nodosal poyarteriitis
Immune complexes mediated hypersensitivity reactions are related to
polyartheriitis nodosa
hemolytic anemia
Cell mediated hypersensitivity reactions are related to
Tuberculosis
Polyarteriitis nodosa
Which is the most common way of metastasizing of epithelial tumors?
by lymphatics (lymphogenic metastases)
with blood (hematogenic metastases)
by cerebrospinal fluid
What is papilloma?
malignant tumor of the covering epithelium
benign tumor of glandular epithelium
benign tumor of cover type epithelium
benign soft tissue tumor
Indicate the correct characteristic(s) for papilloma
it has tree-like stroma covered by differentiated stratified squamous epithelium
it has tree-like stroma covered by undifferentiated squamous epithelium with signs of cell atypia
stroma and parenchyma are difficult to distinguish
it doesn’t have a capsule
What is the term used for malignant tumors of cover type epithelium?
adenocarcinoma
papilloma
carcinoma
sarcoma
What is the term used for malignant tumors of glandular type epithelial origin?
adenoma
carcino-adenoma
What is the term used for benign tumors of glandular type epithelial origin?
teratoma
Point the correct statement(s) about basal cell carcinoma
it develops only on the skin
it can develop at any place with squamous epithelium
it characterizes with early lymphogenic and hematogenic metastases
very often it recurs at the same place after surgery
Keratinized squamous cell carcinoma
develops only on the skin
can develop at any place with squamous epithelium
is highly undifferenciated malignant tumor
is a tumor composed of more differenciated cells with keratin production
What kind of structures are the cancer perls?
accumulation of keratin produced by more differentiated malignant cells originating from squamous epithelium
pink-coloured homogenous substance located in the centre of the tumor nests
accumulation of mucus produced by highly undifferentiated malignant cells located in the centre of the tumor nests
pink homogenous substance that accumulates in the stroma of the tumor
The gross appearance of which tumor is called “ulcus rodens”?
squamous cell carcinoma
melanoma
basal cell carcinoma
Squamous cell carcinoma develops in the lung after
acute bronchitis
chronic bronchitis accompanied by metaplasia
bronchial asthma
inhalaton of a foreign body
Papillary carcinoma of the urinary bladder arises from
squamous epithelium
transitional epithelium
glandular epithelium
smooth musculature
What is carcinoma in situ?
malignant tumor limited to the epithelium above the basal membrane
malignant tumor destroying the basal membrane but spreading no more than 5mm below it
benign tumor limited to the basal membrane
benign tumor of a great size compressing the surrounding tissues
Which staining is used for proving mucus production from gelatinous adenocarcinoma?
Congo red
Toluidin bleu, metachromasia is demonstrated
PAS reaction with amylase control
Pericanalicular and intracanalicular are types of
Ductal carcinoma of the breast
Paget’s disease
Renal cell carcinoma
Fibroadenoma
Kruckenberg tumors are
metastases from colon adenocarcinoma in the ovaries
metastases from pancreatic adenocarcinoma in the ovaries
metastases from gastric carcinoma in the ovaries
metastases from hepatocellular carcinoma in the ovaries
Pleomorphic adenoma could be seen mainly
in the parotid gland
in the minor salivary glands
in the stomach
in the thyroid gland
Indicate the correct statements about fibroadenoma of the breast
capsulated and lobulated tumor
non-capsulated malignant tumor with invasive growth
microscopically it has two types - intracanalicular and pericanalicular
seen in older women
