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Diseases of the liver and biliary system. Hepatitis. Cirrhosis of the liver. Liver cancer. Cholelithiasis.



1. A 40-year-old woman complains of weakness, jaundice. A history of 2 months. before the disease - blood transfusion. An examination revealed an increase in the liver, an increase in the level of hepatic transaminases. Conclusion

1. liver steatosis 3. obstructive jaundice

2. Botkin's disease 4. acute viral hepatitis

2. Viral hepatitis C is characterized

1. high frequency chronization

2. parenteral transmission

3. mild clinical course

4. lack of effective immunity

5. low incidence of cirrhosis

3. Morphological variants of the “response” of the liver to the action of a damaging factor

1. hepatocyte necrosis

2. hepatocyte apoptosis

3. hepatocyte regeneration

4. inflammatory infiltration

5. fatty degeneration of hepatocytes

6. hepatocyte protein dystrophy

7. proliferation of connective tissue

4. Acute viral hepatitis B is characterized

1. hemosiderosis

2. lipofuscinosis

3. fatty degeneration of hepatocytes

4. balloon dystrophy of hepatocytes

5. hydropic dystrophy of hepatocytes

5. In a liver biopsy sample of a 38-year-old man with acute viral hepatitis B can be detected

1. hydropic dystrophy of hepatocytes

2. apoptotic bodies (Councilsilmen's bodies)

3. infiltrate in the parenchyma and portal tracts

4. expansion of portal tracts due to fibrosis

5. merging and / or bridge necrosis of hepatocytes

6. The most important manifestations of liver failure

1. portal hypertension

2. hypercholesterolemia

3. hyperbilirubinemia

4. hyperestrogenemia

5. thrombocytosis

7. Cellular composition of infiltrate in acute viral hepatitis B

1. multinucleated giant cells 4. lymphocytes

2. plasma cells 5. white blood cells

3. fibroblasts 6. macrophages

8. In a liver biopsy of a man of 25 years with chronic viral hepatitis C can be detected

1. merging and / or bridge necrosis of hepatocytes

2. expansion of portal tracts due to fibrosis

3. lymphoid aggregates in the portal tracts

4. hepatocyte macrovesicular steatosis

5. apoptotic bodies

9. The most important manifestations of liver failure

1. anemia

2. jaundice

3. hypocoagulation

4. hyperlipidemia

5. hypoestrogenemia

10. Types of hepatocyte necrosis in acute viral hepatitis B

1. fatty 4. fibrinoid

2. caseous 5. coagulation

3. gangrenous 6. collication

11. Macroscopic characteristics of liver steatosis

1. many rounded foci in the parenchyma

2. increase in organ size

3. soft

4. smooth surface consistency

5. yellow color

12. Set Compliance

SYMPTOM SYNDROME

1. ascites a) liver failure

2. jaundice b) portal hypertension

3. hepatomegaly

4. splenomegaly

5. hypocoagulation

6. “jellyfish head”

7. hyperestrogenemia

13. Types of death of hepatocytes in acute viral hepatitis B

1. apoptosis 4. coagulation necrosis

2. fatty necrosis 5. collicative necrosis

3. caseous necrosis

14. Patient M., 60 years old, has been suffering from chronic alcoholism for 30 years. When examining the liver is dense, the surface is tuberous. On the anterior abdominal wall, the veins are dilated, the spleen is palpated. Liver biopsy can detect

1. wide septa with close triads

2. hepatocyte macrovesicular steatosis

3. monomorphic small nodes - regenerates

4. leukocyte infiltrate in the stroma

5. Mallory bodies in hepatocytes

15. To supplement: The death of small groups of hepatocytes is indicated by the term ______________ necrosis.

16. Outcome of acute viral hepatitis A

1. post-necrotic cirrhosis of the liver 4. chronic hepatitis

2. carrier formation 5. recovery

3. portal cirrhosis

17. Supplement: The most common malignant tumor of the liver in patients infected with Opistorchis sinensis is __________________________________ cancer.

18. Supplement: The focus of hepatocyte necrosis, which spreads from one portal tract to another, is indicated by the term ___________________.

19. A large single lipid vacuole that displaces the hepatocyte core (macrovesicular steatosis) can be observed with

1. obesity 4. viral hepatitis

2. diabetes mellitus 5. alcoholic disease

3. viral hepatitis C

20. Supplement: The primary liver tumor, consisting of polygonal cells resembling hepatocytes, with polymorphic hyperchromic nuclei is called hepatocellular ________________________.

21. Possible causes of liver steatosis

1. fasting

2. alcoholism

3. intoxication

4. severe anemia

5. excess food

22. The appearance of infiltrate in the liver tissue is called

1. regeneration 4. hepatitis

2. dystrophy 5. cirrhosis

3. hepatoma

23. To suggest a viral etiology of liver cirrhosis with a combination of the following histological signs:

1. the multilobular nature of the regenerate nodes

2. hydropic dystrophy of hepatocytes

3. lymphatic macrophage infiltration

4. leukocyte infiltration

5. hepatocyte polymorphism

6. apoptotic bodies

24. In hepatocytes, HBsAg is detected predominantly

1. in the kernels

2. in the cytoplasm

3. both in the nuclei and in the cytoplasm

25. Hepatic cell failure may develop with

1. massive hepatocyte necrosis 4. acute hepatitis

2. macrovesicular steatosis 5. cirrhosis

3. chronic hepatitis

26. Supplement: A liver tumor with the structure of a cyanotic-red spongy node, from which the blood flows from the incision surface, is called cavernous ______________.

27. The bodies of the Councilsilmen formed as a result

1. collication necrosis

2. coagulation necrosis

3. caseous necrosis

4. apoptosis

28. Morphological characteristics of cirrhosis

1. regenerative nodes

2. Ito cell proliferation

3. disturbed organ architecture

4. bridged fibrous septa

5. altered vasculature of an organ

29. Set Compliance

MORPHOLOGICAL SIGN OF DISEASE

In the liver biopsy a) sarcoidosis

1. caseous granulomas b) tuberculosis

2. leukocyte infiltration c) liver steatosis

3. opaque hepatocytes d) viral hepatitis B

e) alcoholic hepatitis

30. The accumulation of HBsAg in the smooth endoplasmic reticulum of hepatocytes gives the cytoplasm the appearance

1. foamy

2. sand

3. frosted glass

4. fine-grained

31. Causes of death of patients with viral cirrhosis

1. increasing hepatic cell failure

2. complications of portal hypertension

3. pulmonary embolism

4. generalized infection

32. Set compliance

LIVER CIRROSIS TYPE MACROSCOPIC CHARACTERISTIC

1. alcoholic a) granular surface

2. biliary b) large-knot surface

3. viral c) greenish color of the parenchyma

33. Cirrhosis of the liver may develop in the outcome of the fulminant form of hepatitis

1. small-knot

2. coarse

3. incomplete septal

34. Portal hypertension may occur

1. ascites

2. congestive splenomegaly

3. bleeding from the veins of the esophagus

4. cerebral hemorrhage

5. the expansion of the veins of the anterior abdominal wall

35. Set compliance

HEPATITIS TYPE INFILTRATE COMPOSITION

1. acute viral a) fibroblasts

2. acute alcohol b) plasma cells

c) lymphocytes and macrophages

g) neutrophilic white blood cells

e) eosinophilic white blood cells

36. Etiological options for chronic hepatitis

1. viral 5. hereditary

2. biliary 6. autoimmune

3. portal 7. cryptogenic

4. medicinal 8. stagnant

37. Often causes a fulminant course of the disease hepatitis virus

1. A 4. D

2. B 5. E

3. C

38. Set Compliance

MACROSCOPIC VIEW MICROSCOPIC VIEW

LIVER CIRROSIS LIVER CIRROSIS

1. small-knot a) multilobular

2. coarse-grained b) polylobular

c) monolobular

d) partial

39. The stage of chronic hepatitis is determined

1. the cellular composition of the infiltrate

2. localization of infiltrate

3. the size of the foci of necrosis

4. degree of fibrosis

40. Viral hepatitis A is characterized

1. low mortality

2. the development of cirrhosis

3. fecal-oral transmission

4. development of lifelong immunity

5. benign cyclic course

41. First of all, with hypoxia, hepatocytes in the acinus zone are affected

1. first

2. second

3. third

42. Options for alcoholic liver damage

1. peliosis

2. cirrhosis

3. steatosis

4. adenomatosis

5. acute hepatitis

43. Viral hepatitis B is characterized

1. prolonged persistence of the virus in the body

2. fecal-oral transmission

3. parenteral transmission

4. vertical transmission

5. the formation of carriage

44. Most often, tumors are found in the liver

1. hepatocellular

2. cholangiocellular

3. secondary metastatic

4. hepatocholangiocellular

45. To suggest an alcoholic etiology of liver cirrhosis with a combination of the following histological signs

1. Mallory's bodies

2. apoptotic bodies

3. leukocyte infiltration

4. fatty degeneration of hepatocytes

5. lymphatic macrophage infiltration

6. the monolobular nature of the regenerate nodes

46. ​​Supplement: Destruction of large groups of hepatocytes is indicated by the term _________________ necrosis.

47. Supplement: The death of individual hepatocytes of the border plate is denoted by the term __________________ necrosis.

48. Supplement: The focus of hepatocyte necrosis, which spreads from one portal tract to the central vein, is designated by the term ___________________.

49. Changes in the color of the skin, sclera and mucous membranes in connection with an increase in the concentration of bilirubin in the blood is called

1. vitiligo

2. cyanosis

3. jaundice

4. melanosis

50. Portal hypertension may occur

1.
ascites

2. congestive splenomegaly

3. bleeding from the veins of the esophagus

4. cerebral hemorrhage

5. vein dilation of the anterior abdominal wall

51. In a liver biopsy, pronounced cholestasis, a foamy type of cytoplasm of epatocytes and lake of bile were found. Conclusion

1. cirrhosis

2. Gilbert's syndrome

3. viral hepatitis B

4. viral hepatitis C

5. obstruction of the biliary tract

52. With hepatorenal syndrome in a patient with viral cirrhosis of the liver, a kidney biopsy can be detected

1. necrotic nephrosis

2. interstitial nephritis

3. focal glomerular necrosis

4. proliferative glomerulonephritis

5. The usual histological picture

53. Viral hepatitis is characterized by C

1. high frequency chronization

2. parenteral transmission

3. mild clinical course

4. lack of effective immunity

5. low incidence of cirrhosis

54. Characterization of viral hepatitis D

1. low chronization rate

2. common in homosexuals

3. often found in hemophilia patients

4. transforms hepatitis B into fulminant form

5. hepatic cell carcinoma often develops

55. In a liver biopsy specimen with chronic viral hepatitis B mild course can be detected

1. preserved lobular and beam structure

2. apoptotic bodies

3. infiltration in portal tracts

4. periportal fibrosis

5. severe cholestasis

56. Supplement: Many rounded gray-white nodes located in both lobes of the liver are characteristic of _________________ organ damage.

57. A malignant tumor that grows into the wall of the gallbladder and spreads to the liver is called ____________________.

58. Between the rows of hepatocytes are

1. portal veins

2. hepatic arteries

3. bile capillaries

59. One side of the hepatocyte faces the lumen of the bile capillary, and the other toward

1. hepatic artery

2. central vein

3. hepatic vein

4. sinusoid

60. The composition of the portal tract includes

1. sinusoid

2. branch of the portal vein

3. branch of the hepatic vein

4. branch of the hepatic artery

5. lymphatic vessel

6. connective tissue

61. In a healthy person, the liver slices are delimited from each other

1. thin connective tissue septa

2. wide fibrous layers

3. bad

62. The basal membrane of the wall of the sinusoid of the liver

1. continuous

2. has small pores

3. absent for a long distance

63. The cells form the wall of the sinusoid of the liver

1. smooth muscle

2. adventitious

3. endothelial

4. kupferovskie

5. Ito

64. The liver receives blood from

1. aorta

2. portal vein

3. inferior vena cava

4. superior vena cava

65. Blood flows from the liver to the veins

1. portal

2. hepatic

3. upper hollow

66. In the formation of bile take part:

1. sinusoid endothelium

2. Kupffer cells

3. Ito cells

4. hepatocytes

67. The direction of blood flow in the liver lobule

1. from the periphery to the center

2. from the center to the periphery

68. Extrahepatic biliary obstruction can lead to

1. hepatitis

2. ascending cholangitis

3. fatty liver

4. primary biliary cirrhosis

5. secondary biliary cirrhosis

69. Components of portal hypertension syndrome

1. ascites 4. kava-caval shunts

2. jaundice 5. port-caval shunts

3. splenomegaly 6. chronic liver failure

70. Supplement: Hypoalbuminemia - a sign of defeat ____________________.

71. Compensatory processes are presented in hepatocytes.

1. necrosis

2. dystrophy

3. hyperplasia

4. hypertrophy

72. Nodular regeneration of hepatocytes occurs with

1. alcoholic hepatitis

2. nodular hyperplasia

3. acute viral hepatitis

4. liver cirrhosis of viral etiology

5. liver cirrhosis of alcoholic etiology

6. chronic heart failure

73. Microscopic types of liver steatosis

1. mixed drip

2. large droplet

3. medium drip

4. drip

74. The most common cause of portal vein obstruction is liver damage with

1. cirrhosis

2. schistosomiasis

3. congenital fibrosis

4. tumors

75. Supplement: Diffuse inflammatory liver disease is indicated by the term _____________________________.

76. Synonym for viral hepatitis A - disease

1. Rustitsky - Kalera

2. Sokolsky - Buyo

3. Wilson

4. Botkina

77. Transmission route for viral hepatitis A

1. pin

2. parenteral

3. fecal-oral

4. airborne

78. Transmission route for viral hepatitis B

1. pin

2. parenteral

3. fecal-oral

4. airborne

79. Transmission route for viral hepatitis C

1. pin

2. parenteral

3. fecal-oral

4. airborne

80. Transmission route for viral hepatitis D

1. pin

2. parenteral

3. fecal-oral

4. airborne

81. Transmission route for viral hepatitis E

1. pin

2. parenteral

3. fecal-oral

4. airborne

82. The most common risk of contracting viral hepatitis B in

1. surgeons

2. gynecologists

3. dentists

4. injecting drug addicts

5. HBsAg-positive women in labor

6. Nursing staff of hemodialysis units

83. Active detection of hepatitis B virus is evidenced by detection in serum

1. HBsAg

2. HBcAg

3. HBsAb

4. HBeAg

5. HBV DNA

6. viral DNA polymerase

84. In hepatocytes, HBcAg is detected predominantly

1. in the kernels

2. in the cytoplasm

3. both in the nuclei and in the cytoplasm

85. Taunus Councilsman can be localized in

1. hepatocytes

2. clearance of sinusoids

3. in kupffer cells

4. in the lumen of the hepatic vein

86. During hydropic degeneration, the cytoplasm of the hepatocyte undergoes

1. swelling

2. wrinkling

3. blocky decay

87. With prolonged cholestasis, the liver becomes color

1. gray

2. yellow

3. green

4. brown

88. Alcoholic hyaline consists of

1. fibrinogen

2. calcium salts

3. plasma albumin

4. intermediate microfilaments

89. The assumption of primary biliary cirrhosis can be made with a combination of the following histological signs

1. multilobular regeneration nodes

2. monolobular regeneration nodes

3. lymphoplasmacytic infiltration

4. epithelioid cell granulomas

5. proliferation of cholangiol

6. Mallory's bodies

7.Cownsilmen's bodies

90. Risk factor for hepatocellular carcinoma

1. viral hepatitis B

2. alcohol abuse

3. use of oral contraceptives

ANSWERS



No. the answers No. the answers No. The answers
4 31. 12 61. 3
1, 2, 3, 4 32. 1a, 2c, 3b 62. 3
1, 2, 3, 4, 5, 6, 7 33. 2 63. 3, 4, 5
4, 5 34. 1, 2, 3, 5 64. 12
1, 2, 3, 5 35. 1c, 2g 65. 2
1, 3, 4 36. 1, 4, 5, 6, 7 66. 4
4, 6 37. 2 67. 1
2, 3, 4, 5 38. 1c, 2a 68. 2, 5
2, 3 39. 4 69. 1, 2, 4, 5
5, 6 40. 1, 3, 4, 5 70. Liver
2, 3, 4, 5 41. 3 71. 3, 4
1b, 2a, 3b, 4b, 5a, 6a, 7a 42. 2, 3, 5 72. 2, 4, 5
1, 4, 5 43. 1, 3, 4, 5 73. 2, 3, 4
2, 3, 4, 5 44. 3 74. 1
Focal 45. 1, 3, 4, 6 75. Hepatitis
5 46. Drain 76. 4
Cholangiocellular 47. Stepped 77. 3
Bridge-shaped 48. Bridge-shaped 78. 2
1, 2, 3, 5 49. 3 79. 2
Carcinoma fifty. 1, 2, 3, 5 80. 2
1, 2, 3, 4, 5 51. 5 81. 3
4 52. fifteen 82. 1, 2, 3, 4, 6
23. 1, 2, 3, 5 53. 1, 2, 3, 4 83. 4, 5, 6
24. 2 54. 1, 2, 3, 4 84. 1
25. 1, 3, 4, 5 55. 1, 2, 3, 4 85. 1, 2, 3
26. Hemangioma 56. Metastatic 86. 1
27. 4 57. Adenocarcinoma 87. 3
28. 1, 3, 4, 5 58. 3 88. 4
29. 1b, 2d, 3g 59. 4 89. 2, 3, 4, 5
thirty. 3 60. 2, 4, 5, 6 90. 1


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Diseases of the liver and biliary system. Hepatitis. Cirrhosis of the liver. Liver cancer. Cholelithiasis.

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  18. Цирроз печени
    Цирроз печени соответствует следующей стадии морфогенеза хронического ГВ прогрессирующего течения. Он характеризуется формированием паренхиматозных узелков, окруженных фиброзными септами. Это приводит к нарушению печеночной архитектоники и сосудистой системы печени с образованием ложных долек и внутрипеченочных анастомозов. Одним из основных неблагоприятных факторов развития цирроза у больных
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