Pathological physiology
Pathological physiology
Питань: 59
59:00
Питання 1 з 59
Питання 1
Autopsy of the body of a 48-year-old man shows that the bone marrow in the flat bones, as well as in the cylindrical bone diaphyses and epiphyses, is moist, colored gray-red or gray-yellow, and puriform (pyoid bone marrow). The spleen weight is 7 kg; it is dark red on section, with signs of ischemic infarctions. All the lymph nodes are enlarged, soft, and gray-red in color. In the liver there are signs of fatty degeneration and leukemic infiltrates. What is the most likely diagnosis?
Питання 2
An unconscious patient was brought into the hospital. The smell of acetone can be detected from the patient’s mouth. Blood glucose - 25 mmol/L, ketone bodies -0.57 mmol/L. What hormone deficiency can result in the development of this condition?
Питання 3
A patient has developed systemic (megaloblastic) anemia despite eating a balanced diet. The day before he underwent a gastric surgical resection. The anemia in this patient is caused by the deficiency of:
Питання 4
A 52-year-old woman suffering from breast cancer had undergone a course of radiation therapy. As a result the tumor diminished in size. What mechanism of cell damage ensures effectiveness of radiation therapy?
Питання 5
A 34-year-old woman was diagnosed with hereditary spherocytosis (hereditary microspherocytic hemolytic anemia, Minkowski-Chauffard syndrome). What mechanism leads to erythrocyte hemolysis in the patient?
Питання 6
A 54-year-old woman has a total thyroidectomy for papillary thyroid carcinoma. 11 hours after operation she complains of tingling around her mouth. On physical examination, the Trousseau's Sign and Chvostek's sign are present. Her condition rapidly deteriorates with laryngospasm and focal seizures. The surgeon suggests surgical destruction of parathyroid glands. Which of the following is the most likely cause of this patient's neurologic abnormality?
Питання 7
A 68-year-old man comes to his physician with complaints of severe fatigue and altered sensations in his extremities. Past medical history is remarkable for chronic gastritis. He drinks alcohol almost every day. His blood pressure is 130/80 mm Hg, heart rate is 95/min., respiratory rate -14/min. and temperature of 37.1 C. His heart has a regular rate and rhythm, his lungs are clear to auscultation bilaterally. Neurologic examination reveals loss of touch and vibration sense in both upper and lower limbs. Laboratory investigation results include a hemoglobin of 80 g/L, Mean Corpuscular Volume (MCV) of 115 fL (the reference range is 80-100 fL) and White Blood Cells (WBC) of 3.0=109/L. Which of the following is the most likely diagnosis?
Питання 8
An 11-year-old girl is brought to the doctor’s office by her mother who stales her daughter has been weak with swollen face for 5 days. The mother slates her daughter had always been healthy and active until the initiation of symptoms. Upon inquiry, the girl describes a foamy appearance of her urine but denies blood in urine, urinary frequency at night, or pain during urination. Physical examination reveals generalized swelling of the face and pitting edema on the lower limbs. Laboratory study shows proteinuria and microscopic hematuria. Which of the following is the most likely cause of findings in the laboratory study of urine?
Питання 9
A 37-year-old female patient complains of headache, vertigo, troubled sleep, numbness of limbs. For the last 6 years she has been working at the gas-discharge lamp producing factory in the lead processing shop. Blood test findings: low hemoglobin and RBC level, serum iron concentration exceeds the norm by several times. Specify the type of anemia:
Питання 10
The resuscitation unit has admitted a patient in grave condition. It is known that he had mistakenly taken sodium fluoride which blocks cytochrome oxidase. What type of hypoxia developed in the patient?
Питання 11
What condition may develop 15-30 minutes after readministration of the antigen as a result of the increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells, namely tissue basophils (mast cells) and blood basophils?
Питання 12
A 30-year old patient has dyspnea fits, mostly at night. He has been diagnosed with bronchial asthma. What type of aller reaction according to the Gell-Coombs classification is most likely in this case?
Питання 13
A female patient with toxemia of pregnancy has hypersalivation resulting in a daily loss of 3-4 liters of saliva. What disorder of water-salt metabolism occurs in such cases?
Питання 14
A patient has a history of chronic heart failure. Which of the following hemodynamic parameters is a major symptom of cardiac decompensation development?
Питання 15
During auscultation a 26-year-old patient was asked to breathe deep. After 10 breaths the patient lost consciousness, which is associated with the development of the following condition:
Питання 16
A patient was diagnosed with multiple myeloma. Total blood protein is 180 g/L. What proteins, present in the body, are the cause of such total protein value?
Питання 17
After a removal of the pyloric part of the stomach, a person may develop anemia. What is the cause of pathological condition development in this case?
Питання 18
A 6-year-old girl with diphtheria is administered an intravenous injection of diphtheria antitoxin. Ten days after the initial administration of drug, she develops a pruritic rash, fever, and arthralgias. Which of the following is the most likely diagnosis?
Питання 19
A 28-year-old female patient dies of progressive respiratory failure after she was diagnosed with comminuted fracture of the right hip. Prior to her death she developed severe hypoxemia, neurologic abnormalities, and petechial rash. At autopsy, examination of pulmonary microvasculature shows intraluminal orange sudanophilic droplets. Which of the following complications is the most likely cause of this patient's death?
Питання 20
A 30-year-old patient’s blood test revealed the following: erythrocyte count is 6•10^12/L, hemoglobin is 10.55 mmol/l. Vaquez’s disease was diagnosed. Name the leading part of pathogenesis:
Питання 21
This year influenza epidemic is characterised by patients’ body temperature varying from 36.9°C to 37.9°C. Such fever is called:.
Питання 22
After the prolonged vomiting a pregnant 26-year-old woman was found to have the reduced volume of circulating blood. What change in the total blood volume can be present?
Питання 23
A patient was hospitalized in a comatose state. The patient has a 5-year long history of diabetes mellitus type 2. Objectively the patient's respiration is noisy, deep, with acetone breath odor. Blood glucose is 15.2, mmol/L, ketone bodies - 100 μmol/L. These signs are characteristic of the following diabetes complication:
Питання 24
When ascending to the top of Elbrus, a mountain climber experiences oxygen starvation, dyspnea, palpitations, and numbness of the extremities. What kind of hypoxia has developed in the mountain climber?
Питання 25
Autopsy shows clinical presentation of diffuse osteoporosis with foci of bone tissue destruction. In the bone marrow, proliferation of atypical plasma cells can be observed. Bence Jones protein is detected in urine. What diagnosis can be made in this case?
Питання 26
A 3-year-old child has an acute intestinal infection with profuse diarrhea, followed by the development of anhydremic shock. What is the leading link in the development of this complication?
Питання 27
Five hours after eating seafood, a 22-year-old woman developed small itchy papules on the skin of her torso and distal parts of her limbs. The papules were partially merging with each other. 24 hours later, the rash spontaneously disappeared. What mechanism of hypersensitivity underlies these changes?
Питання 28
During a blood transfusion, intravascular hemolysis of erythrocytes started developing in the patient. What type of hypersensitivity has developed in this patient?
Питання 29
A 50-year-old man suddenly developed intense palpitations, pain in the heart, acute weakness, increased blood pressure, and an irregular pulse with pulse deficit. ECG shows f-waves instead of a P wave; RR intervals are irregular. What heart rhythm disorder is observed in the patient?
Питання 30
What will be observed in a 23-year-old man with untreated type 1 diabetes mellitus?
Питання 31
A worker was hospitalized with the bleeding, caused by an injury to the shoulder. Five days later, an increased concentration of certain blood cells will be observed in the patient's blood. Name these cells.
Питання 32
A 55-year-old woman has mitral valve insufficiency and had myocarditis 10 years ago. Currently she has no complaints. Her hemodynamics is within the normal range. What general nosology concept corresponds with this situation?
Питання 33
What changes can be expected in an isolated heart after adrenaline is introduced into the perfusion solution?
Питання 34
What acid-base imbalance can be observed in the patients with accumulation of ketone bodies in blood serum?
Питання 35
Histology of the autopsy material obtained from deceased pregnant woman detected cells of the squamous epithelium of the embryo's skin, downy hair, lubricant, caseous lubricant, and mucins from the embryo’s digestive tract in the microcirculatory system of the lungs. Edema, diffuse alveolar damage, and systemic thrombosis with fibrin thrombi were detected in the lungs. What type of embolism occurred in this woman?
Питання 36
Laboratory testing detected hyperchromia of erythrocytes, as well as megalocytes and megaloblasts, in the blood of a 28-year-old woman. What type of anemia is it?
Питання 37
What complication will develop in a patient diagnosed with hepatic cirrhosis and extremely low levels of albumin and globulin in the blood serum?
Питання 38
A 39-year-old man has been diagnosed with epidemic recurrent typhus. What fever curve is typical of this disease?
Питання 39
In a 49-year-old man, laboratory blood gas test reveals decreased levels of CO2 hypocapnia. What pathological condition has developed in the patient?
Питання 40
A 55-year-old man diagnosed with radiation sickness has been hospitalized into the intensive care unit with signs of hemorrhagic syndrome. What changes in the laboratory findings are the main ones in the pathogenesis of this pathological condition?
Питання 41
During the last 2 days, the patient was experiencing mild shortness of breath that has intensified over the last few hours, with the patient developing cyanosis of the lips and fingertips. Examination results: respiratory rate 30/min, heart rate 105/min, blood pressure 130/80 mm Hg, PaO2 55 mm Hg. arterial blood pH 7.36. What pathogenetic type of hypoxia is most likely in this case?
Питання 42
Two days after the knee surgery, a 56-year-old patient developed dyspnea, acrocyanosis, tachycardia, low blood pressure, and dizziness. His medical history informs that he has been diagnosed with diabetes mellitus two years ago. What is the cause of the detected disorders?
Питання 43
A 26-year-old man has been diagnosed with anemia against the background of chronic gastritis with deficiency of the intrinsic Castle factor. What type of anemia is most likely in this patient?
Питання 44
During an accident on a nuclear submarine, a soldier received a radiation dose of 5 Gy. He complains of headache, nausea, and dizziness. What changes in his leukocyte count can be expected after such a radiation exposure?
Питання 45
The patient's leukogram is as follows: leukocytes – 14 • 10^9/L; myeloblasts – 71%; promyelocytes, myelocytes, and metamyelocytes – 0%; band neutrophils – 6%, segmented neutrophils – 13%; lymphocytes – 7%, monocytes – 3%. What is the patient's blood pathology?
Питання 46
A patient has been hospitalized into the intensive care unit in a severe condition. It is known that he mistakenly took sodium fluoride that blocks cytochrome oxidase. What type of hypoxia has developed in the patient?
Питання 47
After removal of the parathyroid glands, a 43-year-old man developed complaints of lethargy, thirst, and a sharp increase in neuromuscular excitability. These symptoms are caused by disturbed metabolism of a certain substance. Name this substance.
Питання 48
A patient has been hospitalized into the intensive care unit with the diagnosis of ketoacidotic coma. During extination, loud breathing with deep intensified exhalation is observed. What type of pathological breathing is it?
Питання 49
When ascending into the mountains, a group of tourists developed signs of mountain sickness. What factor plays the main role in the development of this pathology?
Питання 50
A 27-year-old woman with diabetes mellitus and signs of increasing acidosis has been hospitalized. What process is the main cause of metabolic acidosis in type 1 diabetes mellitus?
Питання 51
A 48-year-old patient was admitted to the nephrology department of a hospital with complaints of facial edema in the morning, headache, and elevated blood pressure of 155/95 mm Hg. What is the primary pathophysiological mechanism underlying arterial hypertension in chronic kidney diseases?
Питання 52
An unconscious person with signs of carbon monoxide poisoning ning has been evacuated by firefighters from a burning apartment. What type of hypoxia develops in such cases?
Питання 53
What is the pathogenesis of type 1 diabetes mellitus?
Питання 54
What type of respiratory failure can be observed in a patient diagnosed with pneumonia?
Питання 55
A man diagnosed with diabetes mellitus has the following arterial blood values: blood pH - 7.25, pCO2 - 37 mm Hg, standard bicarbonate (SB) - 19.5 mmol/L, buffer base (BB) - 39 mmol/L, base excess (BE) - (-7) mmol/L, blood ketone bodies - 19 mmol/L, titratable acidity of urine - 50 mmol per 24 hours. What acid-base imbalance is observed in this patient?
Питання 56
What pathogenetic factor plays the leading role in the development of edema in patients after prolonged fasting?
Питання 57
A 50-year-old patient in a poor condition was presented to the hospital. Objectively,the skin and visible mucous membranes are cyanotic, arterial blood saturation - 88%, NiBP- 90/60 mm Hg, pulse is 117 per minute, respiratory rate is 22 per minute. From the history it is known that the patient suffers from chronic heart failure. Which of the following types of hypoxia is most likely to
develop in this case?
Питання 58
The patient is presented to the hospital with the phenomena of growing respiratory failure. He has clinical signs of bilateral
subtotal pneumonia. The clinical diagnosis is confirmed by X-ray examination. What type of respiratory failure does this patient most likely have?
Питання 59
A 49-years-old woman who suffers from diabetes for a long time have weakness, paleness, palpitations, anxiety, double vision, numbness of the lips and the tip of the tongue after insulin administration. The blood glucose level is 2.5 mmol/l. Which of the following complications does this patient develop?