Acid-Base Balance and Fluid Imbalances PDF

Hyperventilation can cause: a. Metabolic alkalosis b. Metabolic acidosis c. Respiratory alkalosis d. Respiratory acidosis Diarrhoea can cause: a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis Primary changes in case of respirator...

Hyperventilation can cause: a. Metabolic alkalosis b. Metabolic acidosis c. Respiratory alkalosis d. Respiratory acidosis Diarrhoea can cause: a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis Primary changes in case of respiratory acidosis is: a. Decrease of pH b. Decrease of pCO2 c. Increase of pCO2 d. Decrease of SB (standard bicarbonate) e. Increase of SB f. Decrease of BE Normal blood SB (mmol/l) is: a. 22-26 b. 24-30 c. 26-32 d. 28-36 e. 30-38 f. 34-46 Metabolic acidosis develops when patient has: a. Vomiting b. Bronchial asthma c. Hypoxia d. Diabetic ketoacidosis e. A + B f. C + D Metabolic acidosis can be caused by: a. Increased production of endogenous acids, e.g., lactate, ketoacids b. Loss of bicarbonate via diarrhoea c. Accumulation of endogenous acids because of inappropriately low renal excretion in chronic kidney disease d. A + B e. B + C f. A + B + C Respiratory alkalosis can develop in patients with: a. Breathing failure b. Hypoventilation c. Gastric acid loss d. Hypobaric hypoxic hypoxia e. In all these cases Respiratory alkalosis can be caused by: a. Meningitis b. Excessive mechanical ventilation c. Hypoxic hypoxia at high altitude d. A + B e. B + C f. A + C g. A + B + C Respiratory alkalosis can present with a. Light-headedness b. Confusion c. Peripheral and circumoral parasthesia d. Cramps e. Syncope f. B + E g. B + D + E h. A + B + C + D + E i. None of the above Signs and symptoms of acute respiratory acidosis include a. Headache b. Anxiety c. Gait disturbances d. Drowsiness e. Tremor f. A + B + C g. C + E h. A + B + D i. A + B + D + E Respiratory acidosis can develop if the patient has: a. Hyperventilation b. Hypoventilation c. Hyperthermia d. Increased production of organic acids  e. Massive losses of gastric juice Respiratory alkalosis can develop in a. The patient with insufficiency of external ventilation b. During the general anesthesia c. Due to massive loss of gastric juices d. During running e. A + B + C f. B + D About the action of compensatory mechanism in respiratory alkalosis testifies: a. Decrease of pCO2 b. Increase of pCO2 c. Decrease of SB d. Increase of SB About the action of compensatory mechanism to metabolic alkalosis testifies: a. Hyperventilation b. Hypoventilation c. Increased output of the Na+ with urine d. Increased reabsorption of Na+ e. A + D f. B + C Respiratory hypoxia is caused by: a. Bad ventilation of the rooms b. Atmosphere c. Smoke and fog d. Diseases of the respiratory system (obstruction, restriction or regulation) Proximal renal tubular acidosis is characterised by: a. Decreased secretion of H+ b. Increased reabsorption of H+ c. Decreased reabsorption of HCO3- d. Increased urinary elimination of HCO3- e. A + B + C + D f. A + B + C g. A + B h. C + D Distal renal tubular acidosis is characterised by the following except a. Hyperchloremic metabolic acidosis b. Alkaline urine c. Nephrolithiasis  d. Hyperkalemia e. A + B f. C + D Hyperchloremia can be caused by all, except: a. Metabolic acidosis b. Hypnatriemia c. Diuretics d. Steroid medications Which of the following pathological processes can lead to metabolic acidosis? a. Consumption of HCO3- by strong non-volatile acid b. Renal or gastrointestinal wasting of bicarbonate c. Retention of bicarbonate in the internal environment d. Decreased pulmonary ventilation e. A + B f. A + C g. B + C + D h. None of the above listed processes Respiratory alkalosis can develop because of a. Insufficiency of external ventilation b. Hyperventilation c. Hypoventilation d. A + B + C e. B + C f. A + C g. A + B Central limb of the pathogenesis of respiratory acidosis is: a. Hyperventilation b. Insufficiency of external ventilation c. Hyperthermia d. Increased production of organic acids e. Disturbances of excretion of acid products f. Massive loss of gastric juice Primary changes in the respiratory acidosis is a. Decrease of pH b. Decrease of pCO2 c. Increase of pCO2 d. Decrease of SB e. Increase of SB f. Decrease of BE Blood pH is directly regulated by a. Chemical buffer systems b. Lungs c. Kidneys d. Liver e. A + B + C f. B + C + D g. All the listed organs and mechanisms The plasma bicarbonate buffer system consists of: a. Sodium and bicarbonate b. Carbon dioxide and bicarbonate c. Phosphates and bicarbonates d. None of the listed pairs Hypochloremia can be caused by a. Hyponatremia b. Diuretics c. Treatment with glucocorticoids d. A + B e. B + C f. A + C g. A + B + C Hyperchloremia can be caused by all except a. Metabolic acidosis b. Hyponatremia c. Diuretics d. Steroid modification Hyperosmolar hypohydration can develop in all the following situations except: a. Prolonged surgical operations b. Diabetes mellitus c. Bleeding d. Diabetes insipidus e. Hyperventilation Severe diarrhoea usually causes a. Hypoosolar hypohydration b. Metabolic acidosis c. Hyperosmolar hypohydration d. Metabolic alkalosis e. A + B  f. B+C If the patient has severe diarrhea, develops: a. Hypoosmolar hypohydration b. Metabolic acidosis c. > blood pH d. > Na+ elimination with urine Hypoosmolar Hypohydration, the fluid balance is: a. Negative b. Positive c. Hypoosmolar Severe acidosis can cause a. Inhibition of respiratory center b. HCO3- secretion and H+ loss c. Stimulate respiratory center d. HCO3- loss and H + secretion e. A + B f. A + C g. B + C h. C + D To diagnose hyperosmolar hyperhydration, increased osmolarity is measured in the: a. Intracellular space b. Extracellular space c. Interstitial space d. A + B + C e. A + B For the hyperosmolar hyperhydration is typical: a. Development of the symptoms of increased intracranial pressure b. Increasing MCHC and MCH c. Relative decreasing of the total content of proteins in plasma d. The task of treatment-decrease of cellular edema e. A + B + D f. B + C For the hyperosmolar hyperhydration are typical: a. Is developed in patients with diabetes mellitus b. Development of the great thirst c. Increasing of MCHC d. Decreasing of the relative density of urine e. A + D  f. B+C Respiratory alkalosis will develop, if the patient has: a. Insufficiency of external ventilation b. Hypoventilation c. Hyperventilation d. Generalized hypoxia e. A + B + C f. B + D Diorrhoea can cause: a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis Normal carbonic acid bicarbonate buffersystem in blood is a. HCO3//H2CO3 - 1/4 b. HCO3/H2CO3 - 1/20 c. H2CO3/HCO3 - 1/4 d. H2CO3/HCO3 1/20 e. H2CO3/NaHCO3 - 1/4 f. H2CO3/NaHCO3 - 1/20 Anions of the strong acids in the kidneys are excreted in form of: a. Ammonium salts b. Potassium salts c. Sodium salts d. Phosphates During metabolic acidosis, the primary change in internal environment is a. Decrease of bicarbonate concentration b. Increase of bicarbonate concentration c. Decrease of the tension of carbon dioxide d. Increase of the tension of carbon dioxide e. A + C f. B + D g. Non of the listed above Metabolic acidosis can be caused by: a. Hypoxia b. Long-term aspiration of gastric juice c. Starvation d. A + C  e. B + C f. A + B g. A + B + C Cause of metabolic alkalosis can be: a. Long term aspiration of gastric juice b. General arthresia c. Hypoxia d. Fever e. Insufficiency of external ventilation f. Diabetes mellitus The causes of metabolic alkalosis include a. General anaesthesia b. Hypoxia c. Diarrhoea d. Vomiting e. Insufficiency of external ventilation f. Diabetes mellitus The causes of metabolic alkalosis include a. Long-term aspiration of gastric juice b. General anesthesia c. Hypoxia d. Fever e. Insufficiency of external ventilation f. Diabetes mellitus Causes of metabolic acidosis can be: a. Hypoxia b. Fever c. Long term aspiration of gastric juice d. Asthma bronchiole e. A + B f. C + D Last change in metabolic acidosis is: a. Decrease of SB b. Increase of SB c. Decrease of pCO2 d. Increase of pCO2 e. Decrease of pH f. Increase of pH Cells in hypertonic solution undergo: a. Swelling b. Shrinking c. Nothing Vasopressin a. Is synthesized in response to decreased osmolarity of plasma b. Is synthesized in response to severe hypovolemia c. Stimulates water reabsorption in renal collecting tubules d. A + B e. B + C f. A + C g. A + B + C All is typical for vasopressin, except: a. Synthesis in hypothalamus b. Hyperosmolarity blood cause the production of vasopressin c. Increasing of water reabsorption in the proximal part of the renal tubule d. Increasing the facultative reabsorption e. Other name - Antidiuretic hormone Hypo- and hyperhydration is classified into isoosmolar, hyperosmolar and hypoosmolar, based on the osmolarity of: a. Interstitial space b. Intravascular space c. Intracellular space d. Extracellular space The main clinical symptoms of isoosmolar hypohydration develop because of: a. Hypovolemia b. Isovolemia c. Development of “third space” d. Cellular swelling e. A + B f. C + D g. B + C h. A + D The reason of main clinical symptoms of isoosmolar hypohydration is: a. Hypovolemia b. Isovolemia c. Formation of “third space” d. Ions of lymph and digestive fluids e. B + C  f. B+D The causes of isoosmolar hypohydration include a. Decreased water intake b. Excessive sweating c. Loss of blood and/or lymph d. Development of “third space” e. A + B + C f. C + D All are causes of hyperosmolar hypohydration except a. Prolonged surgical operations b. Loss of blood c. Diabetes mellitus d. Diabetes insipidus e. Hyperventilation f. Decrease of thirst sense So-called “water poisoning” causes a. Hyperosmolar hyperhydration b. Hypoosmolar hyperhydration c. Isoosmolar hyperhydration d. Hyperosmolar hypohydration e. Hypoosmolar hypohydration f. Isoosmolar hypohydration For the “water poisoning” is typical: a. It is the isoosmolar hyperhydration b. Increasing MCV and MCHC c. It is the most common type of hyperhydrations d. Development of the symptoms of increased intracranial pressure e. A + B f. C + D Potassium level in plasma is regulated by a. Kidneys b. Liver c. Transcellular ion shift d. A + B e. A + C f. B + C g. A + B + C Hypoosmolar hyperhydration is characterised by  a. Increased volume of intracellular fluid b. Increased volume of the extracellular fluid c. Increased mean corpuscular haemoglobin concentration d. Decreased amount of extracellular fluid e. A+C f. A+B g. C+D h. A+B+C For the hypoosmolar hyperhydration is typical: a. Increased amount of the IC water b. Increased amount of the EC water c. Decreasing of the concentration of Hb in an erythrocyte d. A + B + C e. A + C f. B + C Hyperosmolar hyperhydration is characterised by: a. Clinical symptoms of increased intracranial pressure b. Increased mean corpuscular haemoglobin concentration c. Increased mean corpuscular volume d. Cellular swelling e. B + C Hyperosmolar hyperhydration a. Can develop because of decompensated diabetes mellitus b. Causes thirst c. Increases the mean corpuscular haemoglobin d. A + D e. B + C Hyponatriemia develops in patients with a. Severe diarrhea b. Disturbances of reabsoprtion in kidneys c. Hyperaldosteronism d. Profuse sweating e. A + B + C f. A + B + D Critical consequences of hyperkalemia can be: a. Ventricular fibrillation b. Atrium fibrillation c. Disturbances of the cardiac rhythm d. Pulmonary edema  e. Atonia and meteorism f. D + E Ventricular fibrillations can develop, if patient has a. Hyperchloremia b. Hypernatremia c. Hyperkalemia d. Hyperphosphatemia The fluid moves from intracellular space to extracellular space if the patient has a. Hyperosmolar Hyperhydration b. Hypoosmolar Hyperhydration c. Hypoosmolar Hypohydration d. Hyperosmolar hypohydration e. A + B f. B + C g. C + D h. A + D Osmolarity of extracellular fluids depends mainly on the concentration of a. Sodium b. Chloride c. Potassium d. Glucose e. Urea Hypo-/hyperhydrations are divided into: Isoosmolar, hyperosmolar and hypoosmolar taking into consideration osmolarity of: a. Intracellular space b. Extracellular space c. Interstitial space d. Intravascular space e. A + B + C f. A + B + D Significant increase of plasma osmolarity can be caused by a. Hypernatremia b. Hyperglycemia c. Uraemia d. A + B + C e. A + B f. A + C g. B + C The plasma osmolarity will be increased, if the patient has: a. Increased amount of glucose in the patient plasma b. Increased amount of sodium in the patient plasma c. Increased amount of urea in the patient plasma d. Decreased amount of potassium in the patient plasma e. A + B f. A + C g. A + B + C h. A + B + C + D Plasma osmolarity is determined by plasma concentration of which substances a. Sodium b. Potassium c. Urea d. Glucose e. A + B f. A + B + C + D g. A + C + D h. A + D In clinical medicine, the most common abnormality of electrolyte balance is a. Hyperkaliaemia b. Hypokaliaemia c. Hypernatremia d. Hyponatremia e. None of the listed Which of the following can lead to high anion gap metaboic acidosis a. bicarbonate loss through gastrointestinal tract b. increased lactic acid production c. hypoventilation and carbon dioxide accumulation d. increased ketone production e. use of large volumes of normal saline (sol. NaCl 0.9%) for fluid restoration f. A + B g. B + D h. A + B + D i. B + D + E Common and clinically significant cause/-s of increase anion gap is/are a. Increased level of lactic acid b. Ketoacidosis c. Hypoalbuminemia d. Hyperalbuminemia e. A + B  f. A+C A patient with diarrhoea has developed metabolic acidosis. His blood gas analysis shows pH 7.32, HCO3 22 mmol/L and pCO2 34 mmHg. His plasma Na+ is 132 mmol/L, K+ 4.5 mmol/L, Ca2+ 2 mmol/L, lactate 1.8 mmol/L, Cl- 102 mmol/L. The anion gap is a. 8.2 mEq/L b. 10 mEq/L c. 14.7 mEq/L d. 16.5 mEq/L e. 16.7 mEq/L f. 18.5 mEq/L g. None of the listed values (It’s 8 mEq/L) Anion gap can increase, if in the blood: a. > lactic acid level b. Hypoalvuminemia c. Ketoacidosis d. Hyperalbunemia e. A + B f. A + C Isoosmolar hyperhydration is characterised by all the listed findings EXCEPT a. Pathological accumulation of fluid in the tissues b. Normal mean corpuscular volume and increased mean corpuscular haemoglobin concentration c. Increased hydrostatic pressure in blood vessel All are typical for isoosmolar hyperhydration a. Pathological accumulation of fluid in the tissue b. Membranogenous hypoonkia c. Difficulties in returning of lymph d. Increasing of osmotic pressure in tissue e. Normal MCV and increased MCHC f. Increasing hydrostatic pressure in blood vessels The hypoosmolar hyperhydration - typical changes are a. Increased intracellular volume b. Decreased MCHC c. Increased amount of plasma d. A + C e. C + D f. A + B + C The main intracellular electrolytes are  a. Sodium and chloride b. Sodium, calcium and chloride c. Sodium and phosphates d. Potassium and Chloride e. Potassium and phosphates f. Potassium, calcium and chloride Normal water content in the body of adult male is: a. 80% b. 60% c. 50% d. 45% e. 40% Please characterise the changes of mean volume of red blood cells (MCV) and mean concentration of haemoglobin within a red blood cell (MCHC) in the case of hyperosmolar hyperhydration a. MCV↓ and MCHC↑ b. MCV↑ and MCHC↓ c. MCV↓ and MCHC↓ d. MCV↑ and MCHC↑ Hyperosmolarity of plasma is indicated by the following changes in mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC) a. Increased MCV and increased MCHC b. Decreased MCV and decreased MCHC c. Decreased MCV and increased MCHC d. Increased MCV and decreased MCHC e. None - Osmolarity of plasma does not affect MCV and MCHC Hypoosmolarity of plasma is indicated by the following changes in mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC) a. Increased MCV and increased MCHC b. Decreased MCV and decreased MCHC c. Decreased MCV and increased MCHC d. Increased MCV and decreased MCHC e. None - Osmolarity of plasma does not affect MCV and MCHC A 74-year old man is hospitalized. When looking at the patient objectively the left corner of the lip as dropped down. The patient answers the questions vaguely, pronouncing the words with great effort. What is the most likely diagnosis? a. Alcohol intoxication b. Ischemic infarction in the brain c. Ischemic myocardial infarction  d. All diagnoses are possible The main causes of Oedema are all, except: a. Hydrostatic venous pressure b. Level of plasma proteins c. Plasma osmolarity d. COmpromised lymphatic drainage What can cause metabolic alkalosis? a. Vomiting b. Hypoxia c. Fever d. Breathing failure e. Diabetes mellitus Chronic kidney disease causes the following electrolyte imbalance/-s: a. Hypercalcemia b. Hyperkalaemia c. Hyperphosphatemia d. A + B e. B + C f. A + C Massive proteinuria is a typical finding in: a. Nephritic syndrome b. Nephrotic syndrome c. Pyelonephritis d. Renal tubular pathology Acute tubular necrosis manifests as: a. Chronic renal failure b. Chronic cystic kidney disease c. Acute renal failure d. Acute glomerulonephritis The blood vessel permeability within the inflammatory process a. Increases b. Decreases c. Does not change d. Depend on congestion only Which of the following mechanisms control vascular permeability changes in an inflammation focus: a. Formation intercellular endothelial gaps by retraction of endothelial cells  b. Direct endothelial injury c. Leukocyte-mediated vascular injury d. Transcytosis e. All of the above mentioned Angiogenesis or development of new blood vessels is associated with: a. Normal blood vessel permeability b. Increased blood vessel permeability c. Decreased blood vessel permeability d. The correct answer depends on the type of inflammatory exudate Macrophage activation in an inflammatory focus is associated with: a. Increased concentration of enzymes in lysosomes b. Suppressed metabolism c. Decreased ability to perform phagocytosis and killing d. Synthesis of biologically active substances enhancing fibrosis e. A + B f. B + C g. A + C h. A + D Macrophage activation in inflammation has the following consequences a. Increase macrophagic size b. Increased concentration of enzymes c. Increased ability to perform phagocytosis and killing d. A + B e. B + C f. A + B + C In inflammation, an activated macrophage acquired the following features a. Increased size b. Increased concentration of enzymes in lysosomes c. Increased ability to perform phagocytosis and killing d. A + B e. B + C f. A + B + C g. Activation of macrophages does not occur The systemic manifestation of inflammation include: a. Fever b. Production of acute phase proteins c. Leukocytosis d. A + B e. B + C  f. A + C g. A + B + C The systemic manifestations of inflammation include: a. Redness at the inflamed site b. Phagocytosis of the causative microbe c. Fever d. A + B e. B + C f. A + C g. A + B + C The systemic manifestations of a large subcutaneous abscess include: a. Redness (rubor) and swelling (tumor) of the overlying skin b. Increased levels of C-reactive protein c. Anorexia d. A + B e. B + C f. A + C g. A + B + C Defective (too weak) inflammation results in: Abnormally weak inflammation results in: a. Improved health status b. Increased susceptivility to infections c. Delayed wound healing d. A + B e. B + C f. A + C Inflammation is defined as: a. Complex reactions to injurious agents, e.g. microbes or necrotic cells; b. Disturbances of peripheral blood circulation accompanied by systemic fever c. Subtype of cellular adaptation reactions In the inflammation, the rolling interaction between leukocytes and endothelium is mediated by: a. stenosis b. sirtuions c. selectins d. Necrosis In the inflammation, the leukocytes diapedesis take place in: a. Aorta  b. Muscular arteries c. Postcapillary venules d. Soft tissue Diapedesis is: a. Destruction of mucosal surface by activated inflammatory cells b. Development of new blood vessels in the inflamed site c. Transmigration of leukocytes through the wall of blood vessels d. Conversion of acute ot chronic inflammation The dominating cell type in most acute inflammation is: a. Macrophage b. Eosinophilic leukocytes c. Lymphocyte d. Neutrophilic leukocytes The dominating cell type in most chronic inflammation is: a. Macrophages b. Eosinophilic leukocyte c. Lymphocyte d. Neutrophilic leukocyte Macrophages develop from: a. Neutrophilic leukocytes b. Circulating monocytes in the blood c. Lymphocytes that have undergone activation in lymph nodes d. Circulating lymphocytes in the blood e. Red blood cells Eosinophilic leukocyte is the dominating cell type in: a. All acute inflammations b. Allergic inflammations c. All chronic inflammations d. Tubercolosis Which cells predominate in allergic inflammatory infiltrate? Which cells predominate in allergic inflammatory infiltrate caused by hypersensitivity reaction a. Red blood cells b. Neutrophilic leukocytes c. Eosinophilic leukocytes d. Fibroblasts The “mechanism” of acute inflammation include:  a. Complete resolution b. Progression to chronic inflammation c. Healing by fibrosis d. All of these above mentioned In an acute allergic sinusitis, most of the cells in the inflammatory infiltrate are: a. Eosinophils b. Macrophages c. Fibroblasts d. Neutrophils Which cells have the most important role in acute inflammation? a. Red blood cells b. Neutrophilic leukocytes c. Lymphocytes d. Fibroblasts The following events are characteristic in acute inflammation: a. Fat embolism infiltration of neutrophilic leukocytes or Acute fat embolism b. Infiltration of neutrophilic leukocytes c. Development of granuloma d. Oedema e. A + B f. B + C g. B + D The following changes can be present in chronic inflammation The following event/-s is/are pathogenetically related to chronic inflammation a. Angiogenesis s. proliferation of blood vessels b. Infiltration of neutrophilic leukocytes c. Development of granuloma d. Amniotic fluid embolism e. A + B f. A + C g. A + D h. All of the listed Which cells have the central role in chronic inflammation? a. Macrophages b. Neutrophilic leukocytes c. Lymphocytes d. Fibroblasts The dominant cellular player in chronic inflammation is  a. Neutrophilic leukocyte b. Lymphocyte c. Macrophage d. Necrosis The main morphological patterns of acute inflammation comprise: a. Fibrinous inflammation b. Foreign body granuloma c. Immune granuloma d. Inflammatory ulcer e. A + B f. B + C g. A + D h. C + D i. All of the listed The main morphological patterns of acute inflammation comprise: a. Serous inflammation b. Fibrinous inflammation c. Purulent inflammation d. A + B e. B + C f. A + C g. All of the listed The main morphological patterns of acute inflammation comprise: a. Serous inflammation b. Foreign body granuloma c. Immune granuloma d. Purulent inflammation e. A + B f. B + C g. A + D h. C + D i. All of the listed The morphological components of acute inflammation include: a. Exudation of fluid and plasma proteins b. Development of granulomas c. Migration of neutrophils d. A + B e. B + C f. A + C g. A + B + C The morphological components of chronic inflammation include: a. Infiltration with mononuclear cells: macrophages, lymphocytes, plasmocytes b. Tissue destructions c. Fibrosis and angiogenesis d. A + B e. B + C f. A + C g. A + B + C Acute inflammation is characterized by the following morphology a. Exudation of fluid and plasma proteins b. Oedema c. Reactions of neutrophils d. A + B + C The following outcome/-s is/are possible in a patient having acute inflammation: a. Complete resolution of the inflammation b. Progression to chronic inflammation c. Healing by fibrous tissue scar d. Death e. Anything of the listed In which clinical situations acute inflammation is present or will develop: a. Acute pneumonia b. Myocardial infarction c. Tuberculosis d. A + B e. B + C f. A + C g. A + B + C In which clinical situations acute inflammation is present or will develop a. Acute pneumonia b. Myocardial infarction c. Acute allergic rhinitis d. A + B e. B + C f. A + C g. A + B + C In an acute respiratory viral infection, most of cells in the inflammatory infiltrate are: a. Lymphocytes  b. Neutrophils c. Eosinophils d. Basophils In purulent inflammation, the exudates is rich in: a. Water b. Neutrophils c. Fibrinogen d. Blood Exudate that is rich in neutrophilic leukocytes is described by the term: a. Caseous necorsis b. Pus c. Anasarca d. Ascites Acute inflammation characterized by high content of fibrinogen in the exudate is called: a. Serous b. Fibrous c. Fibrinous d. Granulamatous Cytomegalovirus infections is characterized by a. Purulent inflammation b. Cytopathic cytoproliferative inflammation c. Necrotizing inflammation d. Phlegmonous inflammation Gas gangrene is characterized by a. Purulent inflammation b. Cytopathic cytoproliferative inflammation c. Necrotizing inflammation d. Phlegmonous inflammation In tuberculosis, the typical manifestations in the tissue include: a. Purulent inflammation b. Necrotizing granulamatous inflammation c. Atrophy only d. Thrombosis only To conserve heat, a patient is shivering, and his temperature is increased due to thyroid and adrenal hormones. What type of thermoregulation is described? a. Physical b. Chemical  c. Both Compare two patients with fever: Patient A complains that he has chills. His skin is coolm paly and dry. Patient B is sweating heavily. His skin is hot, red and moist. To which of the patients increase in body temperature is expected? A. Patient A B. Patient B C. Both patients Choose what is typical for the chemical thermoregulation: a. Regulates the production of heat b. Is phylogenetically more new c. Regulates the return of heat d. Is phylogenetically more old e. A + D f. B + C Perspiratio insensibilis is: a. Imperceptible evaporation b. Unimportant sweating c. Evaporation of water steam from lungs d. Evaporation of water steam through skin Perspiratio insensibilis is: a. Sweating b. Evaporation through the skin c. Evaporation from the respiratory tract d. Water loss through the kidneys e. A + D f. B + C g. A + B + D h. A + B + C + D The normal core temperature of the human body is: a. 36.0 C b. 36.6 C c. 37.0 C Which substances act to neurons of thermoregulations for fever development? a. Interferons b. Kallidinum c. Free radicals d. Leukotrienes  e. Prostaglandins For fever, everything is typical except: a. Is protection reaction of the body b. In phylogenesis develops before inflammation c. Arises due to action of the infection d. Is typical pathological process The patient’s skin is hot and dry. Which Stage of fever is characterized by these changes? a. Prodromal stage b. Chill (Stadium incrementi) c. Flush (Stadium fastigii) d. Defervescence (Stadium decrementi) The patient’s skin is hot and damp. Which stage of fever is the patient experiencing? a. Prodromal stage b. Chill c. Flush d. Defervescence During which phase of fever patient is shivering? a. Prodromal phase b. Stadium incrementi c. Stadium fastigii d. Stadium decrementi Thermogenesis in the newborn organism a. Proceeds in the white adipose tissue b. Proceeds in the brown adipose tissue c. Is stimulated by insulin d. Is prevented by catecholamine e. A + D f. B + C All is typical for the stadia increment of fever, except: a. Heat comfort b. Patients feels cold c. Pale skin d. Trembling e. A + C f. B + D Which of the following causes of temperature elevation is characterized by “cytokine storm” and dysfunction of multiple organs?  a. Heat oedema b. Heat exhaustion c. Heat stroke d. Defervescence The reasons of Hyperpyrotic fever are: a. Decrease the heat return mechanism b. Contractional thermogenesis c. Thermoregulation center disorders d. Disconnection of biological oxidation and oxidative phosphorylation e. A + B f. C + D During laparoscopic surgery, a large, red, and swollen appendix vermiformis is found and removed. By histology dense inflammation of mesophilic leukocytes is evident. Your conclusion: a. Hypertrophy b. Metaplasia c. Calcification d. Inflammation Focus on chronic inflammation consisting of microscopic aggregations of lymphocytes, plasmatic cells, epithelioid and giant cells is called: Focus of chronic inflammation consisting of microscopic aggregations of lymphocytes, plasmatic cells, epithelioid and giant cells is called a. Pus b. Granuloma c. Haemorrhage d. Fibrosis The types of granuloma includes: a. Sarcoma b. Foreign-body granuloma c. Immune granuloma d. A + B e. B + C f. A + C The following type/-s of granuloma is/are recognized: a. Purulent granuloma b. Foreign body granuloma c. Immune granuloma d. A + B e. B + C  f. A + C g. A + B + C Poorly degradable pathologic agents that induce cell-mediate immune response case: a. Fibrinous inflammation b. Inflammatory ulcer c. Foreign body granuloma d. Immune granuloma e. A + B f. B + C g. A + D h. C + D i. All answers are correct Inflammation consists of a. Vascular reactions b. Migration and activation of leukocytes c. Systemic reactions d. A + B e. B + C f. A + C Can increased hydrostatic pressure cause oedema: a. Yes, it can b. No, it cannot c. Only in genetically predisposed individuals Can acute inflammation cause oedema: a. Yes, it can b. No, it cannot In an endoscopic gastric biopsy, infiltration of macrophages and lymphocytes is present. Neutrophilic leukocytes are absent. The mucosa also shows loss of gastric glands. What is your diagnosis? a. Hyperplasia of gastric mucosa b. Thromboembolism of gastric mucosa c. Acute gastritis d. Chronic gastritis In an endoscopic gastric biopsy, dense infiltration of neutrophilic leukocytes is present in the swollen lamina propria. The capillaries are markedly dilated. What is your diagnosis: a. Hyperplasia of gastric mucosa b. Acute gastritis c. Chronic gastritis A gastric biopsy has been obtained from a 43-year old lady. Dense infiltration by lymphocytes, plasmatic cells and macrophages is found in the mucose. The gastric glands are mostly replaced by fibrous tissue. What is the most appropriate conclusion, based on these findings: a. Normal gastric histology b. Acute gastritis c. Chronic gastritis d. Granulomatous gastritis e. Gastric ulcer In a gastric biopsy of a 62-year-old male, the dominant morphological feature is intense infiltration of neutrophils. What is the most likely conclusion, based on this finding a. Normal gastric history b. Acute gastritis c. Chronic gastritis d. Granulomatous gastritis e. Gastric ulcer In a core biopsy from the liver, portal fields are widened by fibrous tissue and densely infiltrated with lymphocytes and macrophages. What is the most likely diagnosis: a. acute hepatitis b. hemorrhagic hepatitis c. liver ulcer d. chronic hepatitis Bronchial biopsy has disclosed granulomatous inflammation and presence of caseous necrosis in the granulomas. What is the most appropriate diagnosis: a. acute bronchitis, caused by influenza viral infection b. chronic bronchitis, not further specified c. bronchial tuberculosis d. purulent bronchitis Gastric endoscopy reveals a grossly visible, depression-like, red local defect of the gastric mucosal surface, measuring 1.7 cm in diameter. In a representative biopsy, only necrotic and inflamed tissues are found. What is the most appropriate estimate of this finding: a. Purulent gastritis b. Fibrinous gastritis c. Gastritic oedema d. Gastric ulcer Terminal ileitis (called also Crohn's disease, a type of inflammatory bowel disease) is clinically suspected in a 24-year- old male. Colonoscopy has yielded several biopsies from this area. The mucosa and submucosa are found to be densely populated by lymphocytes. What is the most appropriate conclusion, based on these findings:  a. normal histological picture b. acute terminal iletis c. chronic terminal ileitis d. intestinal ulcer In a bronchial biopsy, infiltration of lymphocytes and macrophages is observed along with fibrosis. Which diagnosis would be most appropriate? a. Infarction b. Acute inflammation c. Chronic inflammation d. Metaplasia During fiberoptic bronchoscopy, acute bronchitis is characteristically seen as: a. Cyanotic bluish areas b. Red and swollen mucosa c. White and hard elevations d. Soft mucosal swelling without colour chage The involvement of lymphatic system in an inflammation can manifest as: a. Increased draining load b. Lymphangitis c. Lymphadenitis d. A + B e. B + C f. A + B + C Toll-like receptors in the inflammation are used for: a. Adhesion to endothelium b. Thrombosis c. Recognition of microbial products Toll-like receptors ensure a. Leukocyte adhesion ot endothelium b. Recognition of microbial products c. Hypercoagulation of thrombosis d. Cellular aging The local components of inflammation, seen in the inflamed focus, include: a. Vascular reactions b. Cellular reactions c. Fever d. A + B e. B + C f. A + C  g. A + B + C Extracellular release of leukocyte products in an inflammatory focus: a. Is not possible b. Can occur via frustrated phagocytosis c. Can occur via cellular regurgitation d. B + C The following mechanism/-s participate/-s in the extracellular release of leukocyte products: a. Regurgitation b. Exocytosis c. Frustrated phagocytosis d. A + B e. B + C f. A + C g. A + B + C The following mechanism/-s participate/-s in the extracellular release of leukocyte products: a. Regurgitation b. Transcytosis c. Frustrated phagocytosis d. A + B e. B + C f. A + C g. A + B + C The extracellular release of lysosomal enzymes occurs via: a. Transcytosis b. Regurgitation c. Frustrated phagocytosis d. B + C The skin overlying subcutaneous abscess is: a. Swollen b. Pale c. Red d. A+B e. B+C f. A+C g. all The local manifestations of a large subcutaneous abscess include:  a. Pain (dolor) b. Increased temperature (calor) of the overlying skin c. Redness (rubor) and swelling (tumor) of the overlying skin d. A+B e. B+C f. A+C g. A+B+C The primary alteration is: a. Caused by etiological factors directly damaging cells b. Not part of inflammation process c. Damaging cells by activation of intracellular enzymes Primary alteration is: a. Cause aethiological factors b. Directly damaging cells c. Damage cells by activation of i/c enzyme systems d. Not part of inflammation process Consequences of alteration are all, except: a. Tissue damage b. Acidosis c. Apoptosis d. Increased osmotic pressure e. Dysonia How does acidosis affect blood flow in brain If patient has acidosis, blood flow in the brain will be: a. Increases b. Decreases c. Does not change Hypercapnia is defined as a. Increased amount of Carbon (CO) in blood b. Decreased amount of carbon (CO) in blood c. Increased amount of carbon dioxide (CO2) in tissues d. Increased amount of carbon dioxide (CO2) in blood e. Decreased amount of oxygen in blood f. Decreased amount of oxygen in tissues g. Increased amount of oxygen in blood Hypoxemia is defined as a. Decreased amount of oxygen in tissue b. Decreased amount of oxygen in blood  c. Increased amount of carbon dioxide (CO2) in tissues d. Increased amount of carbon dioxide (CO2) in blood Patient has developed an acute lung inflammation: Pneumonia. Which changes is/are likely to occur? a. Increased blood level of albumins b. Tachycardia c. Fever d. A + B e. B + C f. A + C g. All A patient has bacterial pneumonia. His blood analysis reveals a. Lymphocytosis b. Neutrophilia c. Eosthophilia d. Monocytosis Which process is MOST LIKELY to directly produce an exudate rather than a transudate? a. Inflammation b. Kidney failure c. Left-sided heart failure d. Liver failure e. Obstruction of lymphatics A patient has bacterial pneumonia. his blood analysis reveals a. lymphocytosis b. neutrophilia c. eosinophilia d. monocytosis Acute phase response includes all, except: a. Elevated white blood cell cunt b. Elevated blood vessel of acute phase proteins c. Fever d. Increased appetite e. Increased heart rate The biological meaning of inflammation is: a. Protection b. Necrosis c. Steatic d. Harmful  e. A+B f. B+C g. B+D h. A+D Acute inflammation can be caused by: a. Bacterium e.coli in the tissues b. Influenza virus in the tissues c. Burns d. A + B e. B + C f. A + C g. A + B + C Acute inflammation can be caused by: a. Bacterial infection b. Viral infection c. Parasitic invasion into tissues d. A + B e. B + C f. A + C g. A + B + C Acute inflammation can be caused by: a. Tissue necrosis in myocardial infarction b. Gunshot wounds c. Groups of apoptotic bodies d. A + B e. B + C f. A + C g. All Acute inflammation can be caused by: Acute inflammation is caused by a. Infection b. Infarction c. Surgical trauma d. A + B e. B + C f. A + C g. A + B + C Acute inflammation can be caused by: a. Heat-induced burn  b. Infected burn c. Allergic reaction d. A+B e. B+C f. A+C g. A+B+C Acute inflammation can be caused by: a. Bacterial or viral infection b. Necrosis c. Cold-induced damage of cells d. A + B e. B + C f. A + C g. A + B + C Acute inflammation can be caused by: a. Infections b. Tissue necrosis c. Microbial toxins d. All of the above During the start of a fever how does the set-point of the hypothalamus change? a. It increases b. It decreases c. Does not change Set-point changes in the hypothalamus thermoregulation center induce: a. Metabolism increase b. Contraction of peripheral blood vessels c. Dilation of the peripheral blood vessels d. Metabolism decrease e. A + B f. A + C g. B + D Which of the following results from a change in hypothalamic set point? a. Heat stroke b. Malignant neuroleptic syndrome c. Malignant hyperthermia d. Fever Resetting of the thermostatic set-point in the hypothalamus to a higher level directly depends on:  a. TNF-a b. Prostaglandins E2 c. IL-1 d. IL-6 e. A+C f. A+D Fibrosis is: a. Type of inflammatory… b. Development of new connective tissue c. Synthesis of fibrinogen by fibroblasts d. A + B e. B + C f. A + C g. All Which morphological features can be helpful in order to distinguish between acute and chronic inflammation: a. Neutrophils and tissue oedema indicate acute inflammation b. Predominance of eosinophils in the inflammatory characteristics for chronic inflammation c. Mesenchyme cell infiltrate and fibrosis replacing specialized tissue are characteristic for chronic inflammation d. A + B e. B + C f. A + C g. All Which cytokines are the most important in causing fever? a. Il-8; Il-10; TGF-b b. Il-1, Il-6 and TNF-a c. Il-17 and platelets The cause of fever include: a. Bacterial infections b. Myocardial infarction c. Viral infections d. A + B e. B + C f. A + C g. A + B + C Which organ is responsible for increasing body temperature in fever? a. Hypothalamus  b. Pinvative gland c. The heart d. The pre-frontal cortex in the brain A 42-year-old male complains to the general practitioner about fatigue, minor headache and cumbersome thirst. On physical examination his bodyweight136 kg, height 179 cm, heartrate 94 beats per minute ad arterial blood pressure 168/102 mmHg. The abdomen is large, the waist circumference 119 cm. The man does not have any significant pas illnesses, but his older brother was diagnosed with type 2 diabetes mellitus a few years ago. Following laboratory analysis is available (parameter value unit (normal upper limit - normal lower limit)). RBC 4.3 x 10*6/ul (4-5), haemoglobin 13 g/dl (12-18), WBC 8.4 x 10*3/ul (4-10), platelets 278 x 10*3/ul (150-450), plasma sodium 143 mmol/l (135-145), plasma glucose 13.4 mmol/l (3.3-5.5), plasma triglycerides 3.4 mmol/l (below 1.7), plasma HDL 0.63 mmol/l (above 1). What is the pathogenesis of thirst in the described patient? a. Hypovolemia due to increased urine output b. Ketoacidosis c. Increased plasma osmolarity due to hyperglycaemia d. High arterial blood pressure e. Peripheral nerve damage f. Ischemia in the hypothalamus due to atherosclerosis g. There is no reason to believe that the thirst is associated with a pathologic state A 36-year-old diabetic patient complains of a sudden onset of cough, shortness of breath, and a sharp rise of temperature in the night before. After chest X-ray the doctors find pneumonia of the upper right lung. Streptococcus pneumonia grows in sputum culture. Three days later, the patient is diagnosed with sepsis caused by streptococcus pneumonia. Another three days later, necorsis develop and abscess (a site of purulent inflammation) in the brain is found on a CT scan. Your diagnosis? a. Pneumonia of the upper right lung b. Sepsis c. Brain abscess Which cells is the pain part of cellular immunity in chronic inflammation? a. Macrophages b. T lymphocytes c. B lymphocytes d. Neutrophil e. Endothelial cell Gross picture shows pigmented lesion of the skin. What changes in the tissues can you observe? a. Asymmetrical form, blood borders  b. Uniform surface, symmetrical form c. Colour variation, alceration d. A+B e. B+C f. A+C g. All Which process appear during diabetic ketoacidosis? a. Hypovolemia b. Metabolic acidosis c. Hyperkalemia d. Hypernatremia e. B + D f. A + C + D g. A + B + C Which disturbance of acid-base balance is the most characteristic for diabetic ketoacidosis a. Metabolic acidosis b. Respiratory acidosis c. Metabolic alcalosis d. Respiratory alcalosis Which disturbance of acid-base balance is the most characteristic for bronchial asthma (bronchial narrowing): a. Metabolic acidosis b. Metabolic alcalosis c. Respiratory acidosis d. Respiratory alcalosis Which disturbance of acid-base balance is the most characteristic for diarrhoea: a. Metabolic acidosis b. Metabolic alcalosis c. Respiratory acidosis d. Respiratory alcalosis Which disturbance of acid-base balance is the most characteristic for vomiting a. Metabolic alcalosis b. Metabolic acidosis c. Respiratory acidosis d. Respiratory alcalosis Metabolic alcalosis can be caused by: a. Vomiting  b. Diarrhoea c. Acute pneumonia d. A+B e. B+C f. A+C g. A+B+C Which disease is indicated by the following symptoms: Excessive thirst, polyuria, nocturia, normal glucose level? a. Diabetes mellitus b. Diabetes insipidus c. Diabetes gynecomasticus d. Hyperglycemic hyperosmolar syndrome The main stages of inflammatory processes are all, except: a. Alteration b. Disorders of central blood circulation c. Exudation d. Phagocytosis e. Proliferation Physico- chemical changes in the focus of inflammation are all, except: a. Acidosis b. Disionia c. Hyperkalia d. Exudation e. Hyperthermia Basic mechanism, which cause exudation are all, except: a. Increased permeability of blood vessels b. Hyperionia in focus of inflammation c. Increased arterial blood pressure d. Changes of filtration in capillary e. Disorders of lymph retention The main types of exudates are all, except: a. Serous b. Catharrhal c. Plasmous d. Fibrinous e. Haemorrhagic f. Purulent Mediators of inflammation - lipids metabolites are:  a. Eicosanoids b. PAF c. Interferons d. Chemokines e. A+B f. A+B+D Inhibition of complement system activation in therapeutic needs can be realised by: a. Cytokines b. Prostaglandins c. Monoclonal antibodies d. PAF e. Bradykinin Interferons major functions are: a. Antiviral b. Antiproliferative c. Activate T-lymphocytes d. A + B + C e. A + B f. B + C COX2 inhibitors blocked synthesis of: a. Prostaglandins b. Lipxynes c. Leukotrienes d. Cytokines e. NO Glucocorticoids directly block activity of: a. COX1 b. COX2 c. Lipooxigenasi d. Phospholipase A2 e. Nothing In case of inflammation induced synthesis of: a. COX1 b. COX2 c. Lipooxigenasi d. Phospholipase A2 e. Nothing Pro-resolution mediators of inflammation are all except:  a. Lipoxynes b. Leukotrienes c. Protectins d. Resolvins In case of SIRS manifestations, CARS activity is: a. Increased b. Decreased c. Not changed d. SIRS development not depends from CARS activity For CRP - all is correct, except: a. Acute phase protein b. Eliminates products of bacteria’s c. Synthesized in kidneys d. Activate alternative way of complement activations All are correct for physical thermoregulation, except: a. Regulates heat production b. Regulates the return of heat c. Phylogenetic - more new d. A + C e. A + B Thyroid hormone level increased can increase heat production after: a. 12 hours b. 1 day c. 9 days d. 14 days e. 30 days Shivering is initiated by impulses from: a. Pituitary gland b. Cortex c. Hypothalamus d. Peripheral NS Activation of alpha-1 adrenergic receptors in vascular smooth muscle causes: a. Vasodilation b. Vasoconstriction c. No effect on blood vessels Sympathetic system (a1-adrenergic) regulates: a. Blood flow in the skin  b. Blood flow in the internal organs c. Secretion of suprarenal gland hormones d. Secretion of thyroid gland hormones e. A+B f. A+B+C g. All answers are right Sympathetic NS alpha 1 adrenoreceptors regulated: a. Sweat glands b. Adrenal glands c. Blood vessel tone d. Brown fat Sympathetic NS regulation of adrenergic receptor type 3 is associated with a. Sweat glands b. Adrenal glands c. Blood vessel tonus d. Brown fat Somatic NS cholinergic receptors induced: a. Sweating b. Increased production of tiroxline c. Shivering d. Blood vessel tonus activity The disturbances of thermoregulation are all except: a. Hyperthermia b. Hypothermia c. Fever d. Shivering The final mediator, which induces set-point changes in hypothalamus is: a. TNF alpha b. Prostaglandin E2 (PGE2) c. IL-1 d. IL-6 Subfebril fever (C°) a. 37-38 °C b. 38-39 °C c. 39-41 °C d. ≥41 °C The body temperature in case of temperate (moderate) fever is:  a. 37-38 °C b. 38-39 °C c. 39-41 °C d. ≥41 °C Active forms of lipoxanes regulates: a. Cytokines activity b. Growth factors release c. Synthesis of prostaglandins d. A + B e. A + B + C IL-6 all are correct except: a. Activates synthesis of acute phase proteins b. Activates synthesis of B lymphocytes growth factors c. Activates effects of TNF excretion d. Induces maturing of plasmatic cells IL-1 all are correct except: a. Exists in alpha and beta isoforms b. Causes fever c. Stimulates proliferation of T lymphocytes d. Causes excretion serotonin in focus of inflammation Pro-inflammation mediators are a. Lipoxines b. Prostaglandins c. Resorbines d. Protectins Inflammation cascade are: a. Cytokines - IL-1, TNF b. COX2 c. Pro inflammation and vasoactive eicosanoids d. A + B e. A + B + C Activation ways of complement system are all except a. Classic b. Traditional c. Alternative d. MB lectin In acute respiratory viral infections, the respiratory mucosa develops:  a. Congestion and oedema b. Mononuclear cell infiltration c. Bleeding d. Hypertrophy e. A+B f. C+D In acute respiratory viral infection uncomplicated by bacterial superinfection, the following changes are observed: a. Purulent inflammation b. Oedema and mononuclear cell inflammation c. Granulomatous inflammation The following changes can be present in acute inflammation: a. Cellular phleomorphism b. Infiltration of neutrophilic leukocytes c. Development of granuloma d. Presence of atypical mitoses e. A + B f. B + C g. A + D The following changes can be present in chronic inflammation: a. Cellular phleomorphism b. Infiltration of neutrophilic leukocytes c. Development of granuloma d. Presence of atypical mitoses e. A + B f. B + C g. A + D Which substances enter the inflamed tissues during exocytosis a. Plasma proteins b. Lysosomal enzymes c. Reactive oxygen intermediates d. A + B e. B + C f. A + B + C Which of the following molecules ensure high-affinity interaction (firm adhesion) between leukocytes and endothelium in inflammations a. Selectins b. Integrins c. Mitoses  d. Mitogens Which of the following molecules ensure low-affinity interaction between leukocytes and endothelium in inflammations a. Selectins b. Mitogens c. Mitoses d. Integrins Which statements is/are true regarding integrins a. Integrins are involved in leukocyte adhesion b. Integrins ensure low-affinity interactions c. Integrins can undergo up-regulation of the affinity d. A + B e. B + C f. A + C g. A + B + C Phlegmonous appendicitis is characterised by: a. Serous inflammation b. Fibrinous inflammation c. Purulent inflammation d. Chronic inflammation Phlegmonous inflammation represents a/an: a. Type of fibrinous inflammation b. Type of purulent inflammation c. Type of systemic inflammation d. Inflammatory ulcer associated with fever e. Inflammation in an immunosuppressed patient Which statements are true regarding fibrinous inflammation: a. The exudate is rich in neutrophils b. The exudate contains red blood cells in a significant amount c. It is characteristic in serous cavities Inflammation of ulcer is: a. Myocardial infarction in patient suffering from lung inflammation b. Tissue destruction of the surface due to inflammation c. Malignant tumour Inflammatory ulcer is a. Local tissue destruction on the surface of an organ due to inflammation b. Myocardial infarction in a patient suffering from lung inflammation  c. Consequence of inflammatory thromboembolism to skin capillaries Hypercapnia is defined as: a. Increased amount of carbon (CO) in blood b. Decreased amount of carbon (CO) in blood c. Increased amount of carbon dioxide (CO2) in tissues d. Increased amount of carbon dioxide (CO2) in blood e. Decreased amount of oxygen in blood f. Decreased amount of oxygen in tissues g. Increased amount of oxygen in blood Hypoxemia is defined as: a. Decreased amount of oxygen in tissue b. Decreased amount of oxygen in blood c. Increased amount of carbon dioxide (CO2) in tissues d. Increased amount of carbon dioxide (CO2) in blood Hypoxemia is: a. Decreased amount of O2 in tissue b. Decreased amount of O2 in blood c. Increased amount of CO2 in tissue d. Decreased amount of CO2 in blood The Figures show a surgically removed appendix: the gross view and the microscopic picture (haematoxylin-eosin stain; original magnification 400x). What is your diagnosis: a. Serous appendicitis  b. Purulent appendicitis c. Chronic appendicitis d. Granulomatous appendicitis The Figure shows a surgically removed appendix: the groos view and the microscopic picture (haematoxylin-eosin stain; original magnification 400x). Please evaluate vascular permeability within this pathological process: a. Decreased b. Unchanged c. Increased d. Necrotic The Figures shows a surgically removed appendix: the groos view and the microscopic picture (haematoxylin-eosin stain; original magnification 400x). Please evaluate the course of this pathological process:  a. Acute b. Chronic The Figure shows pathological changes in the mucosa of gall bladder (haematological stain, original magnification 200x). Which pathological process is evident in the yellow arrow. a. Purulent inflammation b. Epithelial metaplasia c. Inflammatory ulcer d. Amyloidosis  e. Steatosis The Figure shows a pathological process on the mucosal surface (haemotoxylin-eosin stain; original magnification 50x). What is your diagnosis, regarding the pathology at the yellow arrows: a. Serous inflammation b. Fibrinous inflammation c. Granlulomatous inflammation d. Inflammatory ulcer Both figures show morphological findings in the same liver biopsy (haemotoxylin-eosin stain), original magnification 400x and Masson’s thrichrome stain, original magnification 50x). Which pathological process is evident in both figures: a. Red infarction b. Acute hepatitis c. Liver congestion d. Chronic hepatitis Both Figures show the same pathological changes in lung tissues: Grossly and microscopically (haemotoxylin-eosin stain; original magnification 100x). Which term would be appropriate to describe the pathological foci in lung tissue: a. White infarction b. Red infarction c. Lung oedema d. Granuloma The Figure shows pathological changes in the lung (haematoxylin-eosin stain original magnification 100x). What is encircled? a. Pulmonary infarction b. Abscess c. Alceolus  d. Bronchiole e. Haemorrhage f. Granuloma g. Thombus Both Figures show the same pathological changes in lung tissues: Grossly and microscopically (haemotoxylin-eosin stain; original magnification 100x). Please, evaluate the course of this pathological process: a. Acute b. Chronic Figure show pathological changes in visceral pleura (haemotoxylin-eosin stain; original magnification 50x). What is your diagnosis, regarding the pathology at the red arrows:  a. Fibrinous Inflammatioon b. Serous inflammation c. Granulomatous inflammation d. Inflammatory ulcer The Figure shows a pathological process in a heart (haematoxylin-eosin stain; original magnification 50x) What is your diagnosis, regarding the pathology at the yellow arrows a. Fibrinous tissue b. Serous inflammation c. Granulomatous inflammation d. Inflammatory ulcer The Figure shows a pathological process in a nasal mucose (haematoxylin-eosin stain; original magnification 50x) What is your diagnosis, regarding the pathology at the red arrow  a. Haemodynamic oedema caused by blood congestion b. Serous oedema caused by nasal congestion e Figure shows a pathological process in a lung pleura (haematoxylin-eosin stain; original magnification 50x) What is your diagnosis, regarding the pathology at the yellow arrow? a. Purulent peritonitis b. Fibrous peritonitis c. Necrotic foci Other images: A 24-year old female seeks medical help with complaints of weakness, tiredness, recurrent headaches, and shortness of breath during physical activities. On physical examination the woman has no dyspnoea, she is breathing 16 breaths per minute, oxygen saturation (pulse oximetry) is 98%. Her heart rate 98 beats per minute and arterial blood pressure 116/72 mmHg. The skin is warm, dry and pale and the visible mucous membranes are moist but pale. Medical history - during adolescence, she was treated for iron deficiency anaemia with oral iron medication. The dollowing laboratory test results are available: RBC 2.4 x 10*6/ul (4-5) Hg 8.4 g/dl (12-18) WBC 9 x 10*3/ul (4-10= NEUT 4.2 x 10*3 /ul (2-7.5) platelets 380 x 10*3/ul (150-450) pH 7.40 (7.35-7.45) pCO2 40 mmHg (38-42) pO2 100 mmHg (80-100) Bicarbonate 24 mmol/l (22-26) What is the cause of decreased oxygen content in the arterial blood in the described patient? a. Hypoxaemia  b. Decreased haemoglobin concentration in bood c. Decreased amount of dissolved oxygen in arterial blood d. Decreased oxyhaemoglobin to total haemoglobin ratio in the arterial blood e. A+B f. A+B+C g. B+C h. B+C+D i. B+D A 24-year old female seeks medical help with complaints of weakness, tiredness, recurrent headaches, and shortness of breath during physical activities. On physical examination the woman has no dyspnoea, she is breathing 16 breaths per minute, oxygen saturation (pulse oximetry) is 98%. Her heart rate 98 beats per minute and arterial blood pressure 116/72 mmHg. The skin is warm, dry and pale and the visible mucous membranes are moist but pale. Medical history - during adolescence, she was treated for iron deficiency anaemia with oral iron medication. The dollowing laboratory test results are available: RBC 2.4 x 10*6/ul (4-5) Hg 8.4 g/dl (12-18) WBC 9 x 10*3/ul (4-10= NEUT 4.2 x 10*3 /ul (2-7.5) platelets 380 x 10*3/ul (150-450) pH 7.40 (7.35-7.45) pCO2 40 mmHg (38-42) pO2 100 mmHg (80-100) Bicarbonate 24 mmol/l (22-26) What is the cause of decreased oxygen content in the arterial blood in the described patient? a. Decreased oxygen binding capabilities of blood b. Hypoventilation of the lungs c. Decreased blood flow d. Abnormally high haemoglobin affinity to oxygen e. A + B f. A + B + C g. B + C h. B + C + D i. B + D The main osmotically active solutes in the blood are all, EXCEPT: a. K + “Water intoxication” represents: a. Hyperoosmolar hyperhydration A fluid with pH = 5.5 is: a. Acidic Mechanisms regulating blood pH include: a. A + B - Bicarbonate buffering system, Phosphate buffering system The most dangerous form of mixed acid-base balance disorders is: a. Metabolic alkalosis + respiratory alkalosis The causes of lactic acidosis are: - A + B + C - Hypoxia, intense exercise, malignant tumour The main compensatory mechanism/-s of respiratory acidosis is/are a. Bicarbonate reabsorption in the kidney