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Cardiovascular Pathology

0All Topics46 questions
1Arteriosclerosis and Atherosclerosis5 questions
2Vasculitis0 questions
3Tumours of the Blood Vessels0 questions
4Congenital Heart Disease1 questions
5Valvular Heart Disease6 questions
6Ischaemic Heart Disease6 questions
7Hypertensive Heart Disease6 questions
8Cardiomyopathy0 questions
9Myocarditis0 questions
10Pericardial Disease0 questions
11Cardiac Tumours0 questions
MCQsSAQsLEQs

Ischaemic Heart Disease ยท0/0 correct0 correct / 0 attempted / 24 total

Back to Cardiovascular Pathology

A 58-year-old man presents with 2 hours of central crushing chest pain radiating to the left arm. Troponin is significantly elevated. Which of the following best describes the earliest microscopic change seen in irreversibly injured myocardium after infarction?

ACoagulative necrosis with preserved cell outlines
BDense scar tissue replacing the myocardium
CNeutrophilic infiltration only, with no cell death
DGranulation tissue with new capillary formation

Which of the following is the single most important modifiable risk factor for the development of ischaemic heart disease?

AFamily history of premature coronary artery disease
BCigarette smoking
CMale sex
DAdvancing age

A patient develops sudden hypotension and distended neck veins 5 days after a transmural anterior myocardial infarction. Echocardiography shows a large pericardial effusion with tamponade physiology. Which complication has most likely occurred?

APapillary muscle rupture
BVentricular free wall rupture
CVentricular septal rupture
DDressler syndrome

Stable angina pectoris is classically produced by fixed coronary artery stenosis of what approximate luminal narrowing?

AGreater than 75%
BGreater than 25%
CGreater than 50%, always symptomatic at rest
DComplete (100%) occlusion

Which cardiac biomarker remains the most sensitive and specific for detecting myocardial injury, and can stay elevated for up to 7-10 days after infarction?

ACreatine kinase-MB (CK-MB)
BCardiac troponin
CMyoglobin
DLactate dehydrogenase (LDH)

Chronic systemic hypertension characteristically produces which pattern of left ventricular hypertrophy?

AConcentric hypertrophy
BEccentric hypertrophy
CDilated, thin-walled ventricle
DNo change in ventricular wall thickness

A long-standing hypertensive patient develops progressive exertional dyspnoea. Echocardiography shows a thickened, stiff left ventricle with preserved ejection fraction. Which type of heart failure does this represent?

AHeart failure with reduced ejection fraction (systolic failure)
BHeart failure with preserved ejection fraction (diastolic failure)
CHigh-output cardiac failure
DRight-sided heart failure only

An atheroma is defined as:

AA fibrofatty plaque formed in the intimal layer of the blood vessel
BA process of forming plaques in the medial layer of the blood vessel
CHardening and thickening of arterial walls with loss of elasticity
DA process of thickening and dystrophic calcification in arterial walls

Circle the odd man out of the following risk factors:

AAlcohol consumption
BHyperlipidemia
CHypertension
DCigarette smoking

Atherosclerotic plaques contain all of the following principal components EXCEPT:

ACells, such as SMCs, hemosiderin laden macrophages, and multinucleated giant cells
BECM, such as including collagen, elastic fibers, and proteoglycans
CIntracellular and extracellular lipid
DFibrous cap

Circle the false aneurysm out of the following:

APost-myocardial infarction rupture
BAtherosclerotic aneurysm
CSyphilitic aneurysm
DLeft ventricular aneurysm following myocardial infarction

Thoracic aortic aneurysms can give rise to all of the following EXCEPT:

AHorner syndrome
BRespiratory distress
CPersistent cough
DValvular insufficiency and heart failure

In cyanotic congenital heart diseases, the heart defects reduce the amount of oxygen delivered to the rest of the body. Circle a cyanotic heart disease out of the following:

ATricuspid atresia
BAtrial septal defect
CMild pulmonary valve stenosis
DPatent ductus arteriosus

Accelerated or malignant hypertension is a clinical syndrome characterized by all of the following, circle the incorrect statement:

ACongestive heart failure
BSevere hypertension (i.e., systolic pressure over 200 mmHg, diastolic pressure over 120 mmHg)
CRenal failure
DRetinal hemorrhages and exudates, with or without papilledema

Which of the following is wrong concerning different forms of hypertension?

AIsolated systolic hypertension is common among adults and it is due to narrowing of the veins caused by aging
BSecondary hypertension is common among young patients and its aetiology is usually known
CEssential hypertension is common among older patients and its aetiology is usually unknown
DPatients with isolated systolic hypertension are candidates for anti-hypertensive drugs

Regarding hypertension (HTN), all the following sentences are not INCORRECT EXCEPT (i.e. choose the one TRUE statement):

AMales are more affected with HTN than females at their premenopausal stage but females in their postmenopausal stage are more affected than males
BEssential HTN is sometimes known as secondary HTN, and it has unknown causes and it accounts for over 90% of HTN cases in developing countries and not globally
CPrimary HTN is sometimes known as essential HTN, and it has unknown causes and it accounts for over 90% of HTN cases in developing countries and not globally
DA diastolic blood pressure above 80 mmHg and systolic blood pressure of 140 mmHg are indicative of stage 1 HTN

Which of the following statements doesn't link well with pregnancy-induced hypertension (pre-eclampsia)?

AThere could be unexplained loss of weight
BIf left untreated, pre-eclampsia can increase blood clotting problems
CPre-eclampsia can increase the risk of a stroke
DPre-eclampsia can increase the risk of fluid in the lungs

Which of the following IS NOT an acute plaque change implicated in the pathogenesis of myocardial infarction?

AFibrosis and aneurysm
BRupture/fissuring
CErosion/ulceration
DHemorrhage

Which of the following statements regarding aortic stenosis is incorrect?

AIt exclusively affects congenitally bicuspid valves
BIs the most common of all valvular abnormalities
CAcquired aortic stenosis is usually age associated "wear and tear"
DCongestive heart failure and angina pectoris are common clinical presentations

A 7-year-old male presents with a sudden onset of knee, hip and elbow joint pain associated with arthralgia, low to moderate grade fever, a skin rash (described by the mother as "ringworms"), and involuntary purposeless movements. Lab investigations show elevated ESR and C-reactive protein; physical examination reveals pericardial friction rubs, tachycardia, and weak first and second heart sounds, with no murmurs. What is the diagnosis?

ARheumatic fever
BSystemic onset juvenile rheumatoid arthritis
CInfective endocarditis
DSeptic arthritis

Which of the following doesn't link well with rheumatic fever?

AMixed inflammatory infiltrates
BPericardial friction rubs
CSydenham Chorea
DPresence of Aschoff body

A 10-year-old boy presents to the hospital with features of heart failure. On further history taking, it is uncovered that he has previously suffered from repetitive sore throats. He is diagnosed with rheumatic valve disease according to the 2023 World Heart Federation criteria. What pathophysiology underlies this condition?

AAntigen mimicry
BCongenital valvular heart disease
CHypertension
DInfective endocarditis

Concerning endocarditis, choose the correct statement:

ANonbacterial thrombotic endocarditis (NBTE) is a rare condition that refers to a spectrum of noninfectious lesions of the heart valves that is most commonly seen in advanced malignancy
BOver 75% of the cases of infective endocarditis are caused by gram-positive bacteria such as Klebsiella pneumoniae
CApproximately 10% of the cases of infective endocarditis are caused by gram-positive bacteria such as Streptococcus mutans
DCurrently, Streptococcus mutans is more implicated in causing infective endocarditis among drug addicts than enterococci

Circle the odd man out of the following regarding diagnostic criteria for infective endocarditis:

APredisposing heart lesion or intravenous drug use
BPositive blood culture(s) indicating a characteristic organism or persistence of an unusual organism
CEchocardiographic findings, including a valve-related or implant-related mass or abscess
DNew valvular regurgitation