Cardiovascular system Circulation
52 years old officer had a progressing total heart failure, and a heart transplantation was performed to him. Pathology examination of transplanted (removed) heart was performed: weight of left cardiac ventricle was 210g, weight of interventricular septum was 130g, left cardiac chamber was dilated. There were no changes in coronary arteries. Histological examination revealed hypertrophic cardiomyocytes, some atrophic cardiomyocytes, interstitial and substitute myocardial fibrosis. What is a most likely cause of these changes? Select one: 1 Dilated cardiomyopathy. 2 Chronic ischemic heart disease: scar after myocardial infarction. 3 Systemic arterial hypertension. 4 Restrictive cardiomyopathy. 5 Hypertrophic cardiomayopathy.
1
75 year old man suffers from weakness, irregular heartbeat, dyspnea. He noticed his pulse became irregular. During cardiac auscultation the heart activity is arrhythmical. The heart rate is 130 bpm. On ECG no P wave, R-R interval are different, wavelets are seen. What pathology are diagnosed? Select one: 1 Arrhythmia syndrome, atrial fibrillation. 2 Chronic left ventricle failure. 3 Arterial hypertension syndrome. 4 Sinus tachycardia
1
Carotid sinus massage sometimes stops supraventricular tachycardia, because: Select one: 1 It increases vagal discharge to the conducting tissue between the atria and the ventricles. 2 It decreases sympathetic discharge to the sinoatrial node. 3 It decreases sympathetic discharge to the conducting tissue between the atria and the ventricles. 4 It increases vagal discharge to the sinoatrial node.
1
During exercise or stress, the sympathetic nervous system causes vasodilation in the skeletal muscle but vasoconstriction in the skin. It is able to achieve these opposite effects because: Select one: 1. The muscles have cholinergic sympathetic fibers and the skin has adrenergic fibers. 2. Bradykinin stimulates constriction of arterioles in the dermis. 3. Sympathetic fibers secrete epinephrine in the muscle and acetylcholine in the skin. 4. The muscles have (alpha) a-adrenergic receptors and the skin has (beta) b-adrenergic receptors.
1
High and sharp T wave is typical for: Select one: 1 Hyperkalemia. 2 Post- infarction aneurysm. 3 Hypokalemia. 4 Myocardial ischemia.
1
Patient with a bleeding was admitted to the hospital. For blood volume urgent restoration he need the plasma-containing solution. What type of solution you think is more reasonable to use? Select one: 1 0.9% NaCl solution. 2 Glucose 40% solution. 3 0.65% NaCl solution. 5 Glucose 5.0%. 6 1.2% KCl solution
1
Physical findings in aortic regurgitation are: Select one: 1 The diastolic regurgitant murmur over the aortic area radiating down to the Erb's zone, the systolic arterial blood pressure is higher than normal, the diastolic b2 lood pressure is low. The systolic murmur over the aortic area, the systolic blood pressure and pulse pressure are low; the diastolic blood pressure usually remains normal. 3 The systolic murmur over tricuspid area, normal arterial blood pressure. 4 The systolic murmur over the aortic area, the systolic arterial blood pressure is low.
1
The pringle manevuver (a surgical intervention when faced with exsanguinating hemorrhage from the liver) involves clamping the: Select one: 1 Portal pedicle. 2 Aorta above the coeliac axis. 3 Hapatic artery only. 4 Splenic artery only. 5 Hepatic vein only.
1
To which type of hyperlipoprotienemia is characteristic deficiency of low density lipoproteins (LDL) receptors Select one: 1. Familial hypercholesterolemia. 2. Familial hyperchylomicronemia. 3. Familial hypertrigliceridemia. 4. Disbetalipoproteinemia.
1
Which of the following compounds cardiomyocytes begin to use more, when skeletal muscles work intensely in aerobic conditions? Select one: 1 Lactate. 2 Glucose. 3 Ketone bodies. 4 Fatty acids.
1
Which should be part of your care for a severe bleeding open wound? Select one: 1 Apply direct pressure and elevate the injured area (if no broken bones). 2 Use a tourniquet to stop all blood flow. 3 Allow the wound to bleed in order to minimize infection.
1
Cells of atrioventricular bundle are very important in the conducting system of the heart. During a conference you are asked to compare the differences (in histological structure) between these cells and usual working cardiomyocytes. You say that cells of atrioventricular bundle: Select one or more: 1. Are larger than usual working cardiomyocytes, but contain less myofibrils. 2. Contain more glycogen and mitochondria. 3. Are larger than usual working cardiomyocytes, and contain more myofibrils. 4. Possess a lot of nuclei and because of this they contain less myofibrils. 5. Are smaller than usual working cardiomyocytes and contain less myofibrills. 6. Are connected by desmosomes to each other and because of this they contain more myofibrils. 7. Are fusiform and their cytoplasmic projections branch in various directions forming a network.
1, 2
ECG changes in the left ventricular hypertrophy are: Select one or more: 1. ST segment depression and a negative T wave in the left leads. 2. An abnormally high R wave in leads V5, V6 and often an abnormally deep S wave in leads V1, V2. 3. Prolonged PQ interval. 4. Right axis deviation.
1, 2
Myocardial blood flow (coronary) to the left ventricle increases during: Select one or more: 1 Myocardial hypoxia. 2 Increased work load. 3 Sympathetic stimulation. 4 Infusions of Physiological Salt Solutions. 5 Early systole.
1, 2
The characteristic ECG features of the right bundle branch block are: Select one or more: 1 An rR pattern or a wide slurred R wave in leads V1 and/or V2. 2 A wide QRS complex of 0.12 s or wider. 3 QRS complex duration is 0.06 s. 4 An rR pattern or a wide slurred R wave in leads V5, V6 and/or lead I.
1, 2
Myocardial infarction can lead to which of the following complications?Select one or more: 1 Acute mitral valve insufficiency. 2 Cardiac tamponade. 3 Left-to-right shunt. 4 Acute aortic valve insufficiency.
1, 2, 3
Physical findings in acute pulmonary oedema are: Select one or more: 1 The respiratory rate is elevated. Cardiac auscultation may be difficult because of the respiratory sounds. 2 Respirations are grunting and labored with inspiration with loud inspiratory and expiratory gurgling sounds that are often easily audible across the room. 3 Hypoxemia is present, cyanosis is deep. 4 Normal breath sounds during auscultation of the lungs. 5 Arterial PaO2 is normal 6 Heart sounds are clear heard.
1, 2, 3
Erythrocytes content in patient decresaed till 2X10¹²/l. It is accompanied by dyspnea, a faint and noise in ears. The most probable reason for such condition is the following: Select on or more: 1 Blood respiratory function failure. 2 Hemoglobin content decreasing. 3 Hypoxia. 4 Insufficient oxygen capacity.
1, 2, 3, 4
Increased plasma level of which of the following is among the risk factors of atherosclerosis? Select one or more: 1 Total plasma cholesterol. 2 LDL cholesterol. 3 HDL cholesterol. 4 Lipoprotein Lp(a).
1, 2, 4
Release on nitric oxide (NO) from endothelium depends on: Select one or more: 1 Membrane potential of the endothelial cell. 2 Activity of calcium-activated potassium channels. 3 Myogenic autoregulation. 4 Increase in endothelial calcium concentration. 5 Release of adrenaline.
1, 2, 4
Arterioles: Select one or more: 1 Play a major role in regulating local blood flow. 2 Play a major role in regulating arterial blood pressure. 3 Have a smaller wall lumen ratio than have arteries. 4 Have a larger total cross-sectional area than do the capillaries. 5 Offer more resistance to flow than capillaries.
1, 2, 5
Dilation of the coronary arteries will be caused by: Select one or more: 1 Increased in blood K+ concentration. 2 Decrease in blood O2 partial pressure. 3 Pressure rise in right ventricle. 4 Increase in serum Mg+2 concentration. 5 Increase in blood CO2 partial pressure
1, 2, 5
Indicate three most important effects of the cardiac glycosides: Select one or more: 1 Decrease of conduction velocity in atrioventricular node. 2 Decrease of heart rate. 3 Increase of conduction velocity in atrioventricular node. 4 Decrease of force of contraction of heart. 5 Increase of force of contraction of heart.
1, 2, 5
71 years old man who had myocardial infarction 2 years ago suddenly died after complaining about intensive pain in chest behind sternum. Present these changes detected during autopsy in chronological order (numbers of correct order are marked in the left): 1 Atherosclerosis aa. coronarium 2 Stenosis aa. coronarium 3 Thrombus organisatus recanalisatus a.coronariae dex. 4 Cicatrix post infarctum myocardi posterioris ventriculi sinistri cordis. 5 Thrombus obturatorius recens r.interventricularis anterioris a.coronariae sin. 6 Infarctus myocardii transmuralis anterolateralis ventriculi sinistri cordis 7 Insufficientia ventriculi sinistri cordis acuta: oedema pulmonum.
1, 2, 5, 3, 6, 4, 7
The symptoms and signs of chronic left ventricular failure are: Select one or more: 1. Exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea. 2. Functional systolic murmur over mitral area. 3. percussion: the right border of the heart is displaced to the right. 4. Percussion of the heart is normal. 5. Cardiac beat. 6. percussion: the left border of the heart is displaced to the left.
1, 2, 6
Which one of the following belong to necrosis? Select one or more: 1 Cellular swelling. 2 DNA fragmentation is random. 3 Cellular condensation. 4 It is active process. 5 Ladder-like DNA fragmentation. 6 It is passive process.
1, 2, 6
Re-entry phenomena is a common cause of: Select one or more: 1 Paroxysmal atrial tachycardia. 2 Sinus arrhythmia. 3 Atrial fibrillation. 4 Respiratory arrhythmia.
1, 3
The characteristic ECH findings for the left bundle branch block are: Select one or more: 1 An rR pattern a wide slurred R wave in leads V5, V6, aVL, I. 2 A normal QRS complex. 3 A normal QRS complex of 0.12 s or wider. 4 A mean QRS axis deviation to the right.
1, 3
Physical findings of aortic stenosis are: Select one or more: 1 Palpable systolic thrill at the second right intercostal space at the right sternal border. 2 The diastolic murmur over aortic area. 3 The harsh systolic ejection murmur over the aortic area, it transmitted to the neck, to the carotid arteries. 4 The diastolic murmur over tricuspid area. 5 The diastolic murmur over mitral area. 6 A diminished S2 in aortic area.
1, 3, 6
The symptoms and signs of chronic right ventricular failure are: Select one or more: 1 tachycardia, gallop rhythm, accentuated S2 over pulmonic area, functional murmur over tricuspid area. 2 Accentuated S2 heart sound over mitral area. 3 Accentuated S2 heart sound over aortic area. 4 Dyspnea, cardiac beat, hepatomegaly, edemas, ascites.
1, 4
76 years old woman had a left femoral head fracture, due to this fracture she was hospitalized and surgery was performed. Two weeks after femoral surgery the calf of left leg became swollen and painful when moving the left leg. What complications most likely can occur? Select one: 1 Disseminated intravasal coagulation. 2 Pulmonary thrombic embolism. 3 Pulmonary fat embolism. 4 Thigh haematoma. 5 Foot gangrene.
2
A 25 year old man came to the emergency department and his angiogram exhibited that he was bleeding from vein, that accompanied by the posterior interventricular artery. Which of the following veins is most likely to be ruptured? Select one: 1 Small cardiac vein. 2 Middle cardiac vein. 3 Anterior cardiac vein. 4 Great cardiac vein. 5 Oblique vein of the left atrium.
2
A 52 year old man with a known arterial fibrillation returns to see his cardiologists for follow up his cardiac health. The right atrium is important in this case because it: Select one: 1. Receives right pulmonary veins. 2. Contains sinoatrial node. 3. Is associated with the apex of the heart. 4. Receives blood from the oblique cardiac vein.
2
Baroreceptors are specialized pressure receptors found in the: Select one: 1 Medulla oblongata 2 Aortic arch 3 Descending aorta 4 Vena cava
2
Chronic myocardial ischemia is caused by: 1 Myocardial infarction. 2 Atherosclerotic stenosis of coronary arteries. 3 Thrombic embolism of coronary arteries. 4 Thrombosis of coronary arteries. 5 Scar after myocardial infarction.
2
During a seminar you are asked to discuss structural peculiarities of the blood capillaries. You are asked to indicate which of the following characteristics distinguishes somatic capillaries from visceral (fenestrated) capillaries: Select one: 1 Thickness of the blood capillary wall. 2 Presence or absence of fenestrae in the endothelium. 3 Presence or absence of fenestrae in the basal lamina. 4 Presence or absence of smooth myocytes. 5 Size of the blood capillary lumen. 6 Presence or absence of pericytes.
2
The phases of the ventricular muscle action potential are represented by the numbered points below. At which point on the ventricular action potential is associated with cardiac electromechanical coupling? Select one: 1.Point 4 2. Point 2 3. Point 1 4. Point 3 5. Point 0
2
The pulse of dorsalis pedis artery can be palpated on dorsal surface of the foot: Select one: 1 Between the tendons of the tibialis anterior and the abductor hallucis muscles. 2 Between the tendons of the extensor hallucis longus and the extensor digitorum longus. 3 Between the tendons of the extensor digitorum longus and tibialis anterior. 4 Medial to the tendon of the tibialis anterior muscle. 5 In midway between medial and lateral malleolus.
2
Which of the following drugs is used in severe hypertensive emergencies, is very short acting and must be given by intravenous infusion? Select one: 1 Prazosin. 2 Nitroprusside sodium. 3 Metoprolol. 4 Captopril.
2
58 years old had a chronic rheumatic disease and died due to progressing heart failure. Autopsy was performed, and bicuspidal (mitral) valve stenosis of rheumatic origin was detected. Most likely that due to this there will be: Select one or more: 1 Aneurysm of left atrium. 2 Hypertrophy of left cardiac atrium. 3 Dilation of left cardiac atrium. 4 Dilation of left cardiac ventricle. 5 Hypertrophy of left cardiac ventricle
2, 3
A section of the human heart is examined in the Histology laboratory. You are asked to explain and describe the histological structure of adult human myocardium. You say that: Select one or more: 1 Cardiomyocytes lack myofibrils. 2 Myocardium has a rich blood capillary network. 3 Cardiomyocytes contain numerous mitochondria. 4 Reticular connective tissue predominates in the interstitium of myocardium. 5 Cardiomyocytes are connected to each other by Z shape sarcomeres. 6 Interstitium of myocardium consists of mesenchyme.
2, 3
Ventricular filling: Select one or more: 1 Can occur only when atrial pressure is greater than atmospheric pressure. 2 Gives rise to third heart sound in some healthy people. 3 Is most rapid in the first half of diastole. 4 Depends mainly on atrial contraction. 5 Begins during isometric ventricular relaxtion.
2, 3
Which of the following apoproteins are accepted by very low density lipoproteins (LDL) from circulating high density lipoproteins (HDL)? Select one or more: 1 ApoB. 2 ApoE. 3 ApoC. 4 ApoA.
2, 3
Heparin: Select on or more: 1 Has higher bioavailability than low molecular weight heparins. 2 Enhances antithrombin III activity about 1000 folds. 3 Is anticoagulant of choice in pregnant women. 4 Normally is found in mast cells. 5 Has been used to restore blood perfusion following obstruction of coronary blood vessels. 6 May cause thrombocytopenia.
2, 3, 4, 6
Which three of the following drug mechanisms of action pairs are properly matched? Select one or more: 1 dopamine- inhibits beta 1 adrenoreceptors and decreases intracellular concentration of Ca+2. 2 dopamine- stimulates beta 1 adrenoreceptors and increases intracellular concentration of Ca+2. 3 Digoxin inhibits Na+/K+ ATPase and increases intracellular concentration of Ca+2. 4 Digoxin- causes structural change of actin molecule. 5 Amrinone- inhibits phosphodiesterase and increases intracellular concentration of Ca+2.
2, 3, 5
ECG changes in AV junctional escape rhythm are: Select one or more: 1 Heart rate is 20 bpm, arrhythmical. 2 Negative P in II, III, aVF, V4- V6 leads before QRS. 3 Heart rate is 70-80 bpm, arrhythmical. 4 Heart rate - 40-60 bpm, rhythmical. 5 Normal P before QRS.
2, 4
The transfusion of fresh frozen plasma (FFP) is indicated for which od the following reasons? Select one or more: 1 Volume replacement. 2 Specific coagulation factor deficiency with an abnormal prothrombin rime (PT) and/or an abnormal activated partial thromboplastin time (APTT). 3 As a nutritional supplement. 4 For the correction of abnormal PT secondary to warfarin therapy, vitamin K deficiency, or liver disease.
2, 4
Indicate two antiarrhythmic drugs from class IV Select one or more: 1 Metoprolol 2 Diltiazem 3 Lidocaine 4 Propranolol 5 Verapamil
2, 5
Systemic blood pressure elevation may be caused by: Select one or more: 1 Hypoxia due to chronic respiratory failure. 2 Excessive secretion of aldosterone. 3 Myocardial hypertrophy of the left ventricle. 4 The rapid cardiac action of ventricular tachycardia. 5 Excessive secretion of adenocorticotrophic hormone.
2, 5
60 year old man, bus driver, came to the intensive care unit of cardiology with severe chest pain - pressing - in substernal area. The pain persist 40 minutes. It began after conflict with his neighbor. So strong pain is the first time. The patient smokes 12 cigarettes per day 20 years. ECG was recorded, ST elevation from V1 to V6 is seen. Troponin 1 is increased. What pathology was diagnosed? Select one: 1 Chronic left ventricle failure. 2 Stable angina pectoris. 3 Acute anterior myocardial infarction. 4 Heart arrhythmia. 5 Arterial hypertension syndrome.
3
70 year old man came to the hospital due to repetitive headache in the occipital region in the morning. Arterial blood pressure 190/95 mmHg. Pulse is rhythmical 90 bpm. Apex beat is displaced to the left and down. Select one: 1 Chronic right ventricular failure. 2 Chronic left ventricular failure. 3 Arterial hypertension syndrome. 4 Mitral regurgitation. 5 Heart arrhythmia.
3
A 80 year old man with a typical coronary circulation has been suffering from an embolism of the circumflex branch of the left coronary artery. This condition would result in ischemia of which of the following areas of the heart? Select one: 1.Right auricle. 2. Pectinate muscles of the right atrium. 3. Most of the left ventricle. 4. Posteroinferior one-third part of the interventricular septum. 5. Antrior papillary muscle in the right ventricle.
3
ECG was recorded to 61 year old man: sinus rhythm, QRS complex duration 0.09 s. QS in leads II, III, aVF, ST segment is on the baseline, T wave is positive, normal in the same leads. Patient's ECG shows Select one: 1 Acute inferior myocardial infarction. 2 Left bundle branch block. 3 Old myocardial infarction in inferior wall of the left ventricle. 4 Left ventricle hypertrophy.
3
Ecg was recorded to 75 years old man. QRS complexes of ventricle type, P wave is not seen, heart rate is regular 25 bpm. ECG changes show: Select one: 1 Sinus bradycardia. 2 Sinus tachycardia. 3 Ventricular escape rhythm 4 Left ventrical hypertrophy 5 AV functional escape rhythm
3
Local blood pressure regulation is controlled by: Select one: 1 Venal blood flow. 2 Vascular length. 3 Vascular diameter. 4 Blood viscosity. 5 Heart rate.
3
Stroke volume is regulated by all of the following except: Select one: 1 Contractility. 2 Peripheral resistance. 3 Cardiac output. 4 End-diastolic volume.
3
The amount of blood pumped by one ventricle in one minute, is called the: Select one: 1 Ejection fraction. 2 End-diastolic volume. 3 Cardiac output. 4 Stroke volume. 5 Afterload.
3
The diagnostic criteria of ventricular tachycardia are: Select one: 1 QRS complexes of supraventricular type at a rate of 100-250 bpm, negative P waves before each QRS complex. 2 Normal QRS complexes at a rate above 150 bpm, no P before QRS, regular rhythm. 3 Three or more consecutive QRST complexes of ventricular type at a rate 110-250 bpm, absence of the anterograde P waves before the ventricular complexes, usually regular rhythm.
3
Which medicine is orally effective antiarrhythmic drug with actions similar to lidocaine? Select one: 1 Adenosine. 2 Verapamil. 3 Mexiletine. 4 Metoprolol.
3
Which of the following medicines reduces myocardial oxygen demand by decreasing contractility and heart rate? Select one: 1 Isosorbide mononitrate. 2 Prazosin. 3 Metoprolol. 4 Nitroprusside soduim.
3
What are advantages of alteplase over streptokinase? Select one or more: 1 Alteplase may be used for the prevention of thrombosis in high-risk patients. 2 Alteplase does not increase risk of bleeding. 3 Recent streptococcal infections do not reduce efficacy of alteplase. 4 Alteplase is less likely to cause hypersensitivity. 5 Alteplase may be administrated orally.
3, 4
28 year old woman came to the emergency room due to palpitation, ECG was recorded: regular heart rhythm 170 bpm. The duration of QRS complex is 0.08 sec. P wave is not seen. ECG changes show: Select one: 1 Sinus tachycardia. 2 Atrial fibrillation. 3 Left ventricle hypertrophy. 4 Supraventricular tachycardia. 5 Ventricular tachycardia.
4
55 year old woman came to the hospital due to dyspnea occurring after physical activity. Rheumatic fever was diagnosed in her childhood and after some time mitral valvular disease was found. During heart auscultation the heart sounds are rhythmical, heart rate is 85 bpm. The first heart sound is diminished over the apex, the second heart sound is accentuated over the pulmonic area. Holosystolic murmur is auscultated over the apex, it radiates to the left armpit. Arterial blood pressure is 120/80 mmHg. What valvular heart disease was diagnosed? Select one: 1 Tricuspidal regurgitation. 2 Mitral stenosis. 3 Aortic stenosis. 4 Mitral regurgitation. 5 Aortic regurgitation.
4
71 year old man came to the hospital due to cardiac arrhythmia. ECG was recorded: the premature QRS complexes of ventricular type are written. Absence of the anterograde P wave before the premature complexes. Following compensatory postextrasystolic pause is seen. ECG shows: Select one: 1 Sinus bradycardia. 2 Acute myocardial infarction. 3 Left ventricular hypertrophy. 4 Ventricular premature beats. 5 Sinus tachycardia
4
Catecholamines released during stress: Select one: 1 Increases synthesis of growth hormone. 2 Decreases heart rate. 3 Decreases metabolism reactions. 4 Induces vascular dilation in muscles. 5 Decreases blood circulation in kidney.
4
Decreased tissue perfusion results in hypoxia. Relative to normoxia, in hypoxia the: Select one: 1 Pyruvate dehydrogenase complex will be active. 2 Ratio to the oxidized form of NAD+ to the reduced form (NAD) will increase. 3 Electron transport will be upregulated to provide protons for ATP synthesis. 4 Process of substrate-level phosphorylation will be increased in the cytosol.
4
Ejection fraction of 65% is suggestive of: Select one: 1 Hyperkinetic circulation. 2 Heavy systolic dysfunction. 3 Combines systolic and diastolic dysfunction. 4 Normal systolic function.
4
Physical findings of cardiac percussion in mitral stenosis are Select one: 1 Left border of the heart to the left. 2 Right border of the heart to the right and left border of the heart to the left. 3 Upper border of the heart to up and left border of the heart to the left. 4 Right border od the heart to the right and upper border of the heart to up.
4
The classic of aortic stenosis symptoms are: Select one: 1 palpitation, oedemas. 2 Dyspnea, angina pectoris, oedemas. 3 Dyspnea, palpitation, oedemas. 4 Angina pectoris, dyspnea, syncope. 5 Oliguria, palpitation, oedemas.
4
The surgeon ligates the posterior tibial artery at its origin. Which of the following arteries has no blood flow immediately after the ligation? Select one: 1 Dorsalis pedis. 2 Superior medial genicular. 3 Anterior tibial. 4 Peroneal. 5 Descending genicular artery.
4
12 years old boy died due to complications of acute viral infection. These changes were detected in aorta during autopsy. Most likely, that histological examination will reveal: Select one: 1 Lipidic core, granulation tissue and heamorrhage. 2 Lipidic core covered with fibrous cap. 3 Foamy macrophages, necrosis areaa and calcification foci. 4 Cholesterol crystals surrounded by smooth muscle cells and foamy macrophages. 5 Foamy macrophages and infiltration of lymphocytes.
5
59 year old man had increased arterial blood pressure. He died suddenly. Hematoma in the right cerebral hemisphere was detected during autopsy. Histological slides were prepared and doctor pathologist observed these changes when performing a microscopic examination of kidneys. Most likely that the cause of increased blood pressure in systemic circulation is: Select one: 1 Primary (essential) systemic arterial hypertension. 2 Minimal change disease of kidney. 3 Chronic glomerulonephritis. 4 Diffuse extracapillary proliferative glomerulonephritis. 5 Chronic pyelonephritis.
5
68 years old woman had a gastric ulcer disease. She was diagnosed with anemia. Most likely, that this anemia developed: Select one: 1 Due to thrombocytopenia. 2 Due to diathesis haemorrhagica. 3 As a result of haemorrhagia per diapedesin. 4 Due to overdose of antocoagulants. 5 As a result of haemorrhagia per rhexin.
5
72 years old woman had a 6 cm pulsating mass in abdominal cavity detected for her by palpating. Angiography was performed, and significant dilation of aortic segment distal to renal arteries was identified. Most likely these changes in aorta developed due to: Select one: 1 Marfan syndrome. 2 Primary (essential) systemic arterial hypertension. 3 Rheumatic disease. 4 Secondary (symptomic) arterial hypertension. 5 Atherosclerosis.
5
During a seminar you asked to discuss structural peculiarities of the heart, blood vessels and lymphatic vascular system. You are asked to indicate which statement of the following features is most characteristic for lymphatic vessels: Select one: 1 They contain mesothelial cells in their tunica intima. 2 They resemble arteries more than veins. 3 They contain pericytes in their wall. 4 They have sharp (distinct) borders between their tunics. 5 Typically they lack valves. 6 They have smooth muscle cells in their tunica media.
6
Which process is represented by this morphologic manifestation? ................... These changes occurred due to .........................
Acute left- sided heart failure, myocardial infarction
89 years old man died in car accident, and these changes observed in histologic slide. These changes are best described as .................................. Characterize the processes occuring in this tissue. This is: A. ..................... B. ..........................
Cicatrix post infarctum myocardii et hypertrophia cardiomyocytorum, reparative regenaration, compensatory hypertrophy
Classification of antiplatelet agents: PDE3 inhibitor - GP IIb/ IIIa inhibitor- Irreversible COX inhibitor- ADP receptor antagonist-
Cilostazol Abciximab Acetylsalicylic acid Clopidogrel
ACE inhibitor captopril is drug of choice in treatment of hypertension in late pregnancy: Select one: True False
False
59 year old man had a wide anterolateral transmural (with ST elevation) myocardial infarction of left cardiac ventricle. 3 years later he died due to progressing heart failure. Autopsy was performed, and wide transmural scar after myocardial infarction in left cardiac ventricle and interventricular septum was detected. Histologic slides were prepared, and doctor pathologist observes these changes when examining one of the histologic slides. This is........................... of liver. Changed identified during macroscopic and histological examination indicates that there is .........................
chronic venous hyperemia, chronic total heart failure
73 year old man with intensive smoking history from 21 years old had a diagnosis of chronic bronchitis. These changes developed in heart for him. This is .........................................., developed due to ........................................
compensatory hypertrophy of right cardiac ventricle, overload by blood pressure.
59 years old man had a dilatative cardiomyopathy and total heart failure. He died suddenly. This was detected during autopsy. This is thrombic embolism from ........................ Most likely thrombus developed due to .................................................
deep veins of legs, decreased speed of bloodstream
58 years old woman died after bleeding into cerebral hemispheres (after rupture of cerebral artery due to increased blood pressure). Autopsy was performed, and both kidneys were decreased (each of then weight 70g) with structural changes observed on their surface. Few fragments of kidney tissue were cut out for microscopic examination, histological slides were prepared. And most likely these changes are................................ . Most likely patient diagnosis is .......................................
diffuse glomerular sclerosis and arteriole hyalinosis, Glomerulonephritis chronica
67 year old man had a wide transmural anterolateral myocardial infarction of left cardiac ventricle and died 23 days after initial clinical symptoms. Autopsy was detected, and these changes were detected in kidneys. This is..............................., most likely developed due to ..............................
focus of coagulative necrosis thrombic embolus in renal arteries from left cardiac chambers.
51 year old man died suddenly. Autopsy was performed and histologic slides were prepared. Pathologists observes these changes of anterior interventricular branch of left coronary artery through microscope. Observed pathology most likely caused ............................. in myocardium and patient died due to ....................................
formation of local coagulative necrosis focus, acute left- sided heart failure
56 years old expressed complaints about sharp pain in chest behind sternum. When emergency unit arrived, patient was found unconscious, resuscitation procedures were performed, but patient died. Pathology autopsy was performed and histologic slides were prepared, doctor pathologist observed these changes. This is ................................ Most likely patient died due to ......................
infarctus myocardi recens, acute left- sided heart failure
Blood vessels are examined in the Histology laboratory. You are asked to identify the major cell type found in the artery wall (in the layer indicated by the blue asterisk) and shortly to describe them. You say that ................................. are most abundant cell type in the layer indicated by the asterisk and most characteristic for those cells is that........................................................................ they secrete extracellular matrix componentsin the middle layer of the blood vessel.
smooth muscle cells, they secrete extracellular matrix componentsin the middle layer of the blood vessel
59 years old man died in car accident. Forensic autopsy was performed, and this was detected during autopsy. Most likely that changes observed in macroscopic specimen developed due to .................................. This is ..................................., developed due to .......................................
systemic arterial hypertension, compensatory hypertrophy, overload by blood pressure
57 years old man died in car accident. These macroscopic changes were detected during forensic autopsy. Histologic examination revealed chronic venous pulmonary hyperemia. Most likely, that changes in macroscopic specimen developed due to............................ This is ................................, its pathogenesis mechanism is ..................................
ystemic arterial hypertension, compensatory hypertension, overload