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Elective_2nd year_Step 1_med

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Having conducted a post-mortem examination of the

58-year-old man, the doctor discovered a deformed and thickened mitral

(bicuspid) valve, preventing complete closure. Under the microscope, the

centers of collagen fibers were eosinophilic with a positive fibrin reaction.

What is the most likely diagnosis? 

    

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At the autopsy of a

40-year-old woman suffering from rheumatic arthritis, the doctor revealed an

enlarged dense spleen. When dissected, its tissue was mahogany-coloured with

enlarged follicles, resembling semi-transparent grayish-whitish grains. What

pathological process is the most likely?

      

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The

lymph nodes were enlarged in the vicinity of the

infected wound. Histological examination revealed an increased amount of

macrophages, lymphocytes, and lymphoid follicles in the cortical layer along

with a large amount of plasma cells. What do these histological changes in the

lymph nodes indicate?

    

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A 30-year-old patient suffering from dysentery developed

the signs of paraproctitis. What disease is characteristic of such local

changes?

       

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An 8-year-old child was admitted to the infectious

department with a fever up to 38

oC

and a bright-red punctuate skin rash. The child was

diagnosed with scarlet fever. The mucous membrane of the pharynx was apparently

hyperemic and edematic. The tonsils were enlarged and had dull yellowish-grey

foci with black areas. What type of inflammation caused such alterations in the

pharynx?  

      

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The autopsy findings revealed a soft arachnoid membrane

located on the upper parts of the cerebral hemisphere. The arachnoid mater was

plethoric, yellowish-green, soaked with purulent and

fibrinous

exudate

, and looked like a cap. Which disease are these

findings typical of?

     

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A patient died due to cardiovascular insufficiency. The

autopsy revealed postinfarction cardiosclerosis accompanied by myocardial

hypertrophy and dilatation of its cavities, especially the right ventricle. The

liver was enlarged with a smooth and plethoric surface. The surface of the

liver had dark

red specks

against the

background of brownish tissue. The central parts of lobes had hemorrhages,

while the peripheral parts around portal tracts contained hepatocytes in a

state of adipose degeneration. What are these liver changes called?  

   

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A patient who has been abusing tobacco smoking for a

long time suffers from cough accompanied by the expectoration of viscous mucus.

He complains of fatigue upon physical exertion accompanied by skin pallor. The

patient has also lost weight (12,0 kg). He is diagnosed with squamous cell

carcinoma. Name a pathological process that preceded the tumour formation:   

          

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During the autopsy

of a man who had been suffering from alcohol abuse for a long time, the doctor

revealed a small, dense, and knobby liver. On the microscopic examination,

there were small pseudolobules, divided by thin layers of connective tissue

with lymphomacrophagial infiltrates. The hepatocytes were in a state of

globular fatty dystrophy. What was the most likely diagnosis?

      

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A female patient suffering from bronchial asthma contracted

a viral infection that triggered status asthmaticus (=acute severe asthma) with

a fatal outcome.

Histological

examination of the lungs revealed spasm and edema of bronchioles. The doctor

diagnosed an apparent infiltration of walls with lymphocytes, eosinophils, and

other leukocytes as well as labrocyte (=mast cell) degranulation. What

mechanism of hypersensitivity underlies the described alterations? 

     

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