Pathanatomy Colloq 3 - (Unit 14 - 18)

8/8/2019 Pathanatomy Colloq 3 - (Unit 14 - 18)

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UNIT (14) : Disease Of Genital Tract & Breast

452. Name types of ectopic pregnancy? (p=3) tubal ovarian abdominal

453. Name types of tubal pregnancy according to sites of fetusimplantation. (p=3)

ampular interstitial frimbrial

454. What is placenta polyps? (p=3) tissue masses of variable size with polypous structure surrounded by hyperplastic trophoblast may have necrosis projects into myometrium

455. What is hiditidiform mole? How does it affec t pregnancy? (p=3) gestational trophoblastic disease appear as mass of hydrophic swelling [swollen] cystically dilated chorionic vili covered by proliferating

cytotrophoblast andsyncytial trophoblast.

fetus is absent is called complete hitidiform mole: or dying notlater than 4 th month of gestation called partial hyditidiformmole.

456. Describe microscopic composition of the choriocarcinoma. (p=5) choriocarcinoma is malignanization tumour develop from

completehyditidiform mole. from artificial abortion or after normalpregnancy.

only epithelial cells with anaplastic cuboidal syncytiotrophoblastandcytotrophoblast with tissue atypism.

stroma vessel and vili are absent invading surrounding structure with hemorrhage and necrosis.

*457. Specify most typical complications of uterus carcinoma. (p=6) cachexia hemorrhage thrombosis of pelvic vein peritonitis appearance of uterus fistula

*458. Peritoneal pregnancy was found. Identify possible variants of itsorigin. (p=2)

459. During vagina examination there is found a broad bright redcrown near

External orifice of cervix .the crown does not give hemorrhagesby

Instrumental spatula touch. During microscopic examinationthere are

columnar epithelial cells covering vaginal surface with numerousglands in its

thickness. Give your diagnosis. (p=2) Diagnose:endocervicosis of neck of uterus

ADDITIONAL QUESTIONS:1. In post-mortem examination of elderly man there are found

the enlargement of the prostate to marked degree and itscompression of urethra lumen. Mucous membrane of thebladder is dull.hyperemic with hemorrhages. The ureter isenlarged.pelvis are filled with pus.on cut surface of thekidney small abseccess are observed.what is the disease of urinary tract described here.what is the p athogenesis?(p=3)

disease: ascending pyelonephrits pathogenesis: stagnation of urine and nodular hyperplasia of

prostate.

2. Specify preinvasive form of exocervical carcinoma in theuterus. (p=1) Cancer in situ

3. The ovary has been supplied as a biopsy samples. It ispresented by gross cyst about 20 cm in diameter with fluid& heavy pappilary projection with white cauliflower tissueremainder. Microscopically papillaries of the tumor arecovered by columnar epithelium with nuclear hyperchromia

& mitosis. On separate sections adenous complex growsthrough cystic wall. Specify the tumor. (p=3) papillary cystoadenocarcinoma

Unit (15) : Diseases of Endocrine

381. Which are typical microscopic changes in thyroid gland inBasedovs

disease [Graves disease]? (p = 4) star shaped follicles (hypertrophy & hyperplasia of follicular

epithelium) papilla of epithelium projecting into follicular lumen pale colloid lymphoid infiltration of stroma

382. Name histology types of colloid goiter. (p = 3) microfollicular macroflollicular mixed

383. Name causes of death with patients of Basedovs disease. (p = 4) heart insufficiency liver failure during toxic hepatitis acute adrenal insufficiency during thyroectomy cacchexia

384. Name common symptoms of diabetes mellitus. (p = 6) hyperglycemia

polyuria glucosuria polydypsia ketonuria, ketoacidosis hyperlipidemia polyphagia

385. Name changes of Langerhans islets found in diabetes me llitus. (p= 2)

decrease number of beta-cells atrophy

386. Name causes of death in patients with diabetes mellitus. (p = 4) diabetic coma sepsis heart failure uremia

387. Name clinical morphologic changes of Icenko- Cushings disease.(p = 6)

coentaneous striae arterial hypertension glucosuria hyperglysemia hirsutism polydipsia weight gain (buffalo hump) arrested sexual development

388. Give the definition of parathyroid osteodystrophy concept. (p =4)

parathyroid osteodystrophy is a disease associated with increaseparathyroid hormone production.

disturbance in calcium and phosphate exchangelead tohypercalcemia & hypophosphataemia.

marked destruction of bony tissue and defect of bone structure(osteodystrophy).

*389. Specify basic changes in bone tissue in hyperparathyreosis. (p =6)

390. 55 yrs old male of 112cm height is proportionally built and his

mental progress isadequate to his age. Give your diagnosis. Specify the character

and the localizationof pathologic process. (p = 6)

diagnosis: pituitary dwarfism characteristic: decrease production of growth hormone by

somatotrophic producing cells


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localization: anterior pituitary gland causes: -pituitary tumour in childhood

-necrosis in pituitary in childhood-hemorrhage into pituitary in childhood

-retarded sexual development, but normal intelligence

UNIT (16) : Rheumatic fever & Congenital heart disease

332. Give definition of rheumatism.(p=3) rheumatism is an immunologically mediated inflammation with

systemic disorganization of connective tissue. as acute and chronic disease with damage of many organs but

prefers cardiovascular system.

333. Specify clinical anatomic forms of rheumatism.(p=4) cardiovascular form cerebral form arthritic form nodosal form

334. What is the main organ involved in rheumatic pathology.(p=1) heart

335. Designate forms of rheumatic endocarditis according to theprocess localization and to the character of morphologic changes.(p=7)

According to localization: Valve

Chordal Visceral According to morphologic changes:

Valvulitis Fibroplastic endocarditis Acute verruceous endocarditis Recurrent verruceous endocarditis

336. Name thromboendocarditis types.(p=2) polypous-ulcerate verruceous

337. What is valvulitis?Give its morphologic signs.(p=6) valvulitis is diffuse endocarditis characterized by dystrophic

changes in valvular CT without affecting endothelium , nothrombus formation.

morphologic sign: inflammation sclerosis mucoid & fibrinoid swelling (in vessel) fibrinoid necrosis

338. Show most typical localization of rheumatic granulomas in themyocardium.(p=1)

At perivascular connective tissue(in the auricle of left atrium)OR left ventricular auricle,posterior wall of left ventricle andventricle septa.

339. Give forms of rheumatic myocarditis.(p=2) Nodular proliferative inflammation (granulomatous) Local and diffuse exudative interstitial

*340. Name formation stages of rheumatic valve disease.(p=4)

341. Specify clinical anatomic forms of rheumatic mitral valvedisease.(p=2)

Stenosis mitral valve Mitral insufficiency

342. Specify forms of rheumatic aortic valve disease leading to thehypertrophy of left ventricular of the heart.(p=2)

Stenosis of aortic valve Insufficiency of the valve

*343. Specify forms of valve insufficiency according to thepathogenesis.(p=2)

344. Specify results of connective tissue disorganization within the skindue to scleroderma.(p=2)

Sclerosis Hyalinosis Petrification of heart

345. What are LE-cells?(p=2) Lupus cells are leukocytes with autoimmune antinuclear

antibodies. Take up calls with destroyed DNA.Usually found within vesicle

of phagocytic macrophages.

346. Specify diseases leading to the formation of valvular heartdisease.(p=6)

Rheumatism Athesclerosis Brucellosis Trauma Mitral valve prolapse Systemic lupus erythromatosus with Libmans Sacks lupus

endocarditis Arterial endocarditis

347. Name most frequent forms of congenital heart disease.(p=4) Stenosis of pulmonary artery Tetralogy of fallots

Pathologic patent ductus arteriosus (channel between pulmonaryartery and aorta)

Atrial and ventricle septal defect

348. Name anatomic changes of the heart with te tralogy of fallot.(p=4) Dextra position of aorta Stenosis of pulmonary artery Ventricular-septal defect Hypertrophy of right ventricle myocardium

349. During postmortem examination,sclerosis and growth into one of cusps are found in mitral valve.The obliteration of pericardial cavitywith calcified deposits in the lesion are found.Name changes found anddisease to developed them.(p=3)

Changes: Obliteration of pericardial cavity with connective tissue. Petrification of Calcium in pericardium(shell heart) Endocarditis lead to stenosis

Disease: rheumatism

350. During postmortem examination of the child there are foundstenosis of pulmonary artery,hypertrophy of the right ventricularmyocardium,ventricular septal defect and dextraposition of aorta.What is your diagnosis?

Tetralogy of fallot

Unit (17) : Arterial Hypertension.Hypertensiondisease.Cerebrovascular disease.324. Give the definition of the hypertonic crisis. (P=4)

Exacerbation of hypertension

Characterized by rapid elevation of in arterial hypertension dueto generalized spasm of arterioles which leads to morphologicalchanges in wall of arterioles.

Characterized by rapid elevation in arterial blood pressure withlesion of the organ, especially within brain.

325. Name stages of hypertensive disease (primary arterialhypertension). (P=3)

Functional changes of arteries and small arterioles Changes in walls of small arteries and arteriole Changes within organs

326. What morphological changes in small vessels of the brain due tohypertensive disease (primary arterial hypertension). (P=4)

Increase vascular permeability with plasmorrhagia Fibrinoid necrosis of wall Microaneurysm Hemorrhage Vasospasm


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327. Name outcome of arterial changes of hypertensive disease(primary arterial hypertension). (P=2)

Hyalinosis Sclerosis (atherosclerosis) Lipidosis and narrowing of lumen

328. Name signs that are typical for malignant hypertension having inmind; the frequency of crisis; the nature of morphological changes insmall vessels; cause of death. (P=3)

Frequency: Often crisis Nature of morphological changes in small vessels:-

- Fibrinoid necrosis- Microaneurysm- Increase permeability with plasmarrhagia

Cause of death : Uremia, Ischemic infarct of brain.

329. Give the definition of hypertensive disease (primary arterialhypertension). (P=4)

Chronic disease with elevation of arterial pressure When relationship btw blood volume and total peripheral

resistance is altered Without connection with lesion of organs Due to disturbances of nerve regulation, due to constriction of

artery and alteration of vessels, insufficiency mechanism of vascular dilatation

330. What are the most frequent causes of death due to hypertensivedisease (Primary arterial hypertension)? (P=3)

Cardiac insufficiency/ cardiac fa ilure(acute,chronic) Uremia Stroke (Cerebral vascular accident)

331. In anamnesis, the patient had firm elevation of blood pressureduring of long duration with repeated crisis of the brain has right sidedhemiplegic. Death is of heart decompensation. What is the diseasedescribed here? What possible macroscopic (gross) changes are foundin the heart, the brain? What is the localization of changes in brain?(P=6)

Disease: Hypertension (primary arterial hypertension) Macroscopic changes:-

-Heart: hypertrophy of left ventricle and myogenic dilatation,fatty dystrophy-Brain: hemorrhagic infiltration and hematoma with cystformation

Localization of changes in brain: Left Hemisphere due to rightsided hemiplegia.

UNIT (17) : Atherosclerosis & Ischemic heart disease

314. Give the definition of atherosclerosis. (p=6) Atherosclerosis is a chronic disease with abnormal

lipid and protein metabolism and destruction of large artery & aorta(elastic &

myoelastic type)

with formation of atherosclerotic plaque called fibro-fatty plaque in the intima of muscular elastic artery(large artery : aorta)

315. Give successive names of progress stages of atherosclerosisaccording to the view of scientists supporting infiltrate(combinative) theory of atherosclerosis. (p=6)

Prelipidosis Lipidosis Liposclerosis Artheromatosis Ulceration Artherocalcinosis

316. Give pathological anatomic characteristics of theatherosclerotic plaque and specify its localization. (p=5) Cells components (smooth muscle cells,

macrophages, leukocytes) Extracellular matrix (collagen, elastic fibres,

proteoglycans) Intracellular & extracellular lipids

Localization: aorta & large arteries (elastic & myoelastictype)

317. Specify histological findings in atherosclerotic (primarywrinkled) kidney. (p=4)

Atherosclerotic plaque in large arteries Sclerosis of stroma Narrowing of lumen Hyalinosis & sclerosis of small arteries

318. What are complications connected with the ulceration of

atherosclerotic plaques on the aorta? (p=4) Aneurysm of aorta Rupture of aorta with hemorrhage Thrombosis & thromboembolism Cholesterol embolism

319. What is the ischemic heart disease? (p=3) Ischemic heart disease is group of closely related

disease with abnormality of cardiac blood circulation Caused by imbalance between myocardium oxygen

demand & blood supply (absolute relativeinsufficiency)

320. What coronary arteries changes lead most frequently to theprogress of myocardial infarction? (p=4)

Stenotic atherosclerosis Thrombosis Spasm of vessel for long time Embolism

321. Specify results of myocardial infarction. (p=4) Acute aneurysm (necrotic tissue undergoes rupture at

any case) Rupture of heart with hemorrhage into pericardial

cavity Chronic aneurysm (connective tissue) Post infarction cardiosclerosis

322. What are typical changes of the brain due to atherosclerosisof the cerebral arteries? (p=2)

Ischemic white infarction of brain Atrophy of brain (with encephalopathy & memory)

323. During postmortem examination fluid blood and clots of theblood are found in pericardial cavity. Heart weights 650g.The thickness of the wall of left ventricle is 2.5cm. vastsection of the wall is near the top of the heart and is gray-yellow color, soft consistency, blood-layered.What is the disease described here according to moderninternational classifica tion of diseases? What is itsmanifestation of this case?What is the direct cause of death?Name background disease. (p=6)

Disease: ischemic heart disease Manifestation: transmural myocardial infarction with

rupture of heart Direct cause of death: f rom hemotamponade of heart Background disease: hypertension

Additional Question

1. Name forms of valvular heart deficiency according to thepathogenesis. (p=2)

Functional Organic

Unit (18) : Renal Disease

351. Name two basic groups of diffuse nephropathies. (p=2) Tubulopathy Glomerulopathy

352. Name general mechanisms of glomerulonephritis development.(p=3)

Deposit of immunocomplex (circulation/ cell-mediated) orantibodies

Glomerulosclerosis


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Leukocytes infiltration

353. Specify typical renal symptoms of the glomerulonephritis. (p=4) Nephrotic syndrome Proteinuria Hematuria Casturia

354. Specify typical extra renal symptoms of the glomerulonephritis.(p=6)

Hypoalbuminemia

Hypertension Azotemia & Uremia Generalized edema Hyperlipidemia edema

355. Specify forms of the glomerular nephritis according to the processlocalization. (p=2)

Intracapillary Extracapillary

356. Name morphologic phases of development of acuteglomerulonephritis. (p=3)

Changes to chronic glomerulonephritis Sclerosis of kidney Recovery

357. Name basic morphologic types of chronic glomerulonephritis.(p=6)

Membranous proliferative glomerulonephritis Mesengial proliferative glomerulonephritis Rapidly progressive glomerulonephritis Mesengial capillary glomerulonephritis Focal segmental glomerulonephritis Glomerulonephritis associated with nephrotic syndrome

358. Name glomerulopathies of non inflammation character frequentlyfound in clinic

and accompanied by nephrotic syndrome. (p=3) Nephropathy during pregnancy Diabetic nephropathy Amyloidosis

359. Define morphologic substrate of primary nephrotic syndrome(lipoid nephrosis) .(p=3)

Characterized by minimal changes of glomerular filtration Expressed by loss of podocytes and small branches

360. Give the characreristics of basic electronic microscopic sign of membranous

glomerulopathy. (p=4) Membranous transformation associated with deposition of

immunocomplex in the epithelial cells of the basal membrane

361. What is the renal amyloidosis? What are renal structures withamyloid deposition?

What are groups of symptoms to give clinical manifestations of

this process? (p=7) Renal amyloidosis is a disease with deposition of amyloid intothe renal structure.

Structure: - glomerular- vessels- stroma (interstitial peritubular tissue)

Symptoms: - chronic renal failure- nephrotic syndrome- hypoalbunemia- hyperlipidemia- edema-uremia

362. Name most frequent renal diseases that leading to secondarycontracted kidneys.

( p=3)

Chronic glomerulonephritis Chronic pyelonephritis Amyloid nephrosis Chronic renal failure

363. Specify most frequent causes of development of acute renalfailure. (p=5)

Hemolytic & Massive loss of blood Trauma Burn Sepsis poisoning

364. Name stages of development of acute renal failure. (p=4) Initial Oliguria (maintainence) Polyuria

Recovery365. Specify causes of death patients with necrotic nephrosis. (p=2) Uremia Acute heart insufficiency

366. Designate microscopical renal changes typical for acute renalfailure of toxic nature:

a) bleeding filling in the cortex, b) the condition of interstitialtissue, c) the condition

of epithelial cells in the convoluted tubules, d) the condition of thetubular lumen.

( p=4) a) ischemia of cortex b) edematous of interstitial tissues c) epithelial cells of proximal tubular are necrosis d) granular casts are seen in the enlarged tubular lumen

*367. Name most frequent types of chronic hereditary tubulopathies.(p=3)

cystiuria phosphatic diabetes oxcalaturia syndrome of Debra de Toni Fancon

368. Give the definition of the pyelonephritis. (p=4) Pyelonephritis is renal disorder with purulent inflammation

affecting stroma, calyx,tubules, interstitial and renal pelvis. Cause by bacteria infection

369. Name diseases frequently leading to ascending pyelonephritis.(p=4)

Stones of ureter Constriction of ureter Sclerosis of ureter & urethra Hypertrophy of prostate Tumor in urethra, ureter or prostate

370. Name most severe manifestations of acute purulent pyelonephritis.(p=3)

Pyonephrosis Urogenic sepsis Papillonecrosis Suppurative paranephritis Aponematous nephritis

*371. Give the definition of urolithias disease. (p=5)

372. Specify stones structures most frequently found in the kidneyaccording to their

composition.( p=3) Calcium oxalate and phosphate stone Magnesium ammonium phosphate stones Uric acid stone Cystine stone

373. Name variants of macroscopic (gross) types of kidney with the

urolitiasis. (p=5)

Hydronephrosis Atrophy Purulent nephritis Pyonephrosis Replacement of kidney with fatty tissue


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374. Name most frequent renal diseases that leading to nephrosclerosis.(p=7)

Chronic glomerular nephritis Interstitial nephritis Pyelonephritis Atherosclerosis Amyloid nephrosis Hypertension Diabetes mellitus

375. Give the definition of the uremia. (p=4)

Uremia is a pathologic condition associated with azotemia and aconstellation of clinical signs and symptoms of organs andbiochemical alteration (including uremic gastroenterocolitis,neuropathy, uremic fibrinous pericarditis).

376. Due to teminal stage of the glomerular nephritis, patient hadoliguria and azotemia.

He died. During postmortem examination, there were found verysmall contracted

kidneys, fibrinous tracheal bronchitis, pericarditis andenteroclolitis with effects of

hemorrhage diathesis. What is the designation of renal complication?

What is the origin of mechanisms? What is the term for renal changes? (p=3)

Designation: Chronic renal failure Origin of mechanism: Kidneys cant regulate volume and

soluble composition of urine Glomerular filtration rate is less than 20% Renal changes: secondary wrinkled kidney

377. After taking the solution of sublimate by mistake patient hasanuria , very high urea

and creatinine. What disease is it? What are microscopic changes of renal structures? Where are they involved? (p=4)

Disease: necrotic nephrosis Microscopic changes :- dystrophy of tubular- necrosis of the epithelial cells- cylinder /cast in glomerular and tubular- edema of stroma

378. For histology essay, extracted kidney was delivered. There is superenlarged kidney.On cut it is expressed by multichamber formation. Chambers are filledwith slightly turbid fluid. Parenchyme of kidneyis thinned replaced byfibrous tissue. In the enlarged pelvis and cups, partially the stone goesinto ureter mouth. Pelvis membrane has hyperemia, it is rough anddull.

Give your diagnosis. What is process most frequently associated by that disease?

What is microorganism most frequently induces it? Name renal changes according to the process. What is common diseas with the source as this associated

process? (p=6)

Diagnose: Hydronephrosis Microbes: E.coli Kidney changes: pyelonephritis, pyonephrosis Common disease: -calculi

- tumor- congenital atresia of urethra- spinal cord damage with paralysis of

bladder General disease: Urosepsis

*379. During postmortem examination of elderly man, there are found

the enlargementof prostate to marked degree and its compression of urethralumen. Mucous

membrane of the bladder is dull, hyperemic with hemorrhages.The ureter is

enlarged. Pelvis is filled with pus. On cut surface of the kidneysmall abscesses are

observed. What is the disease of urinary tract described here? What is the pathogenesis? (p=3)

*380. Give the definition of Addisons disease. (p=3)

Additional Questions:

1. What are typical morphologic manifestations of acuteexudative and proliferative

intracapillary glomerulonephritis? (p=3)

Development of pathological process in the vessels of glomerular

Proliferation of cells in glomerular Leukocytic infiltration

2. What exudative glomerular nephritis types do u know?(p=3)

Serous Fibrinous Hemorrhagic

3. Give the definition of nephrolithias disease. (p=5)

Nephrolithias disease is chronic disease Formation of stones in kidney calyces, pelvis, ureter Stones is of different sizes, structure and chemical composition

4. Name of 2 general theories of stone formation in urinarytract. (p=2)

Matrix Colloid crystal

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Pathanatomy Colloq 3 - (Unit 14 - 18)