Pathology - Pathology of arterial circulation Flashcards by Jenna Dymond

the result of impaired blood flow / perfusion of tissue causing it to be deprived of vital nutrients eg oxygen

a. infarction
b. ischaemia

b.ischaemia

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the death(necrosis) of tissues as a result of deprivation of oxygen and nutrients?

a. ischaemia
b. infarction

b.infarction

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which of these has reversible effects?

a. infarction
b. ischaemia

b.ischaemia

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effects of ischaemia vary based on which factors?

a. duration
b. metabolic demands
c. duration and metabolic demands
d. tissue structure

c.duration and metabolic demands

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which of these have end arterial circulation rather than dual circulation?

a. lungs
b. lungs and liver
c. spleen
d. spleen and kidney

d.spleen and kidney

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which type of occlusion can promote the development of collaterals?

a. slow progressive reduction in arterial lumen size
b. fast progressive reduction in arterial lumen size
c. fast increase in arterial lumen size
d. slow progressive reduction in blood vessel lumen size

a.slow progressive reduction in arterial lumen size

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how long does it take for irreversable damage to neurones to occur?

a. 20- 30 mins
b. 3-4 mins
c. 2 hrs

b.3-4 mins

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how long does it take for irreversable damage to myocardium to occur?

a. 20- 30 mins
b. 3-4 mins
c. 2 hrs

a.20- 30 mins

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how long does it take for irreversable damage to fibroblasts to occur?

a. 20- 30 mins
b. 3-4 mins
c. 2 hrs

c. 2 hrs

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which patient has increased susceptibility to ischaemia?

a. anaemic
b. hypertensive
b. obese
d. elderly

a.anaemic

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what is the characteristic shape of a renal infarct?

a. round
b. ovoid
c. wedge
d. berry

c.wedge

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what type of necrosis causes a cerebral infarction?

a. coagulative
b. liquefactive

b.liquefactive

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what type of necrosis causes a myocardial infarction?

a. coagulative
b. liquefactive

a.coagulative

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what is the area where tissues at the interface of two arteries are found?

a. splanchnic system
b. watershed
c. coagulative

b. watershed

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what is supplied by the superior and inferior mesentric arteries and is therefore a watershed area?

a. myocardium
b. cerebral hemisphere
c. splenic fixture of colon

c.splenic fixture of colon

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what is supplied by the junction of the anterior and middle cerebral arteries and is therefore a watershed area?

a. myocardium
b. cerebral hemisphere
c. splenic fixture of colon

b.cerebral hemisphere

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what is supplied by the junction of the subendocardial myocardium and outer myocardium and is therefore a watershed area?

a. myocardium
b. cerebral hemisphere
c. splenic fixture of colon

a.myocardium

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mild ischaemia of the brain

a. cerebral infarct/ischameic stroke
b. transient ischaemic attack
c. stable angina
d. peripheral vascular disease
e. acute coronary syndrome

b.transient ischaemic attack

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moderate ischaemia of the brain

a. cerebral infarct/ischameic stroke
b. transient ischaemic attack
c. stable angina
d. peripheral vascular disease
e. acute coronary syndrome

b.transient ischaemic attack

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severe ischaemia of the brain

a. cerebral infarct/ischameic stroke
b. transient ischaemic attack
c. stable angina
d. peripheral vascular disease
e. acute coronary syndrome

b.transient ischaemic attack

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infarction of the brain

a. ischameic stroke
b. transient ischaemic attack
c. stable angina
d. peripheral vascular disease
e. acute coronary syndrome

a.ischameic stroke

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mild ischaemia of the heart

a. ischameic stroke
b. transient ischaemic attack
c. stable angina
d. peripheral vascular disease
e. acute coronary syndrome

c.stable angina

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moderate ischaemia of the heart

a. ischameic stroke
b. transient ischaemic attack
c. stable angina
d. peripheral vascular disease
e. acute coronary syndrome

c.stable angina

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severe ischaemia of the heart

a. ischameic stroke
b. transient ischaemic attack
c. e.acute coronary syndrome -MI
d. peripheral vascular disease
e. acute coronary syndrome -unstable angina

e.acute coronary syndrome -unstable angina

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infarction of the heart a. ischameic stroke b. transient ischaemic attack c. e.acute coronary syndrome -MI d. peripheral vascular disease e. acute coronary syndrome -unstable angina

c.e.acute coronary syndrome -MI

mild ischaemia of the leg a. ischameic stroke b. transient ischaemic attack c. acute limb ischaemia d. peripheral vascular disease e. intermittent claudication

d. peripheral vascular disease | e. intermittent claudication

moderate ischaemia of the leg a. ischameic stroke b. transient ischaemic attack c. acute limb ischaemia d. peripheral vascular disease e. intermittent claudication

d. peripheral vascular disease | e. intermittent claudication

severeischaemia of the leg a. ischameic stroke b. transient ischaemic attack c. acute limb ischaemia d. peripheral vascular disease e. intermittent claudication

c. acute limb ischaemia | d. peripheral vascular disease

infarction of the leg a. ischameic stroke b. transient ischaemic attack c. acute limb ischaemia d. peripheral vascular disease e. intermittent claudication

c. acute limb ischaemia | d. peripheral vascular disease

which of these causes irreversible neurological symptoms and signs associated with cerebral infarct? a. transient ischaemic attack b. stroke

b.stroke

true or false most strokes are caused by arterial thrombosis/ embolism a. true b. false

a.true

occlusion of the terminal part of the internal carotid, proximal middle cerebral artery or basilar artery results in acute ischaemic strokes and is broadly known as? a. small artery occlusion b. large artery occlusion c. infarct d. peripheral vascular disease

b.large artery occlusion

an uncomplicated atheroma becoming a significant fixed legion leads to a. stroke b. unstable angina c. stable angina

c.stable angina

which of these is not classed as an acute coronary syndrome a. STEMI b. NSTEMI c. unstable angina b. stable angina

b.stable angina

what type of MI is caused by a complete and persistent blockage of an artery resulting in necrosis? a. NSTEMI b. STEMI

b.STEMI st ELEVATION ON ecg

what type of MI is caused by partial or intermittent blockage of an artery resulting in necrosis a. STEMI b. NSTEMI

b.NSTEMI

ECG shows T wave inversion, ST depression (may also be normal in this case) which most likley a. NSTEMI b. STEMI c. Unstable angina d. stable angina

a.NSTEMI

what is the difference between unstable angina and NSTEMI? a. type of artery blockage b. duration of artery blockage c. metabolic demand of tissue d. prescence of myocardial necrosis

d. prescence of myocardial necrosis | in NSTEMI

What test differentiates between NSTEMI and STEMI? a. ECG b. FBC c. serum troponin blood test d. blood film

c.serum troponin blood test

At what stage following MI does muscle appear pale and oedematous with acute inflam cell infiltration and necrosis of myocytes appears haemorrhaged if reperfused a. 24-48 hrs b. 3-4 days c. 1-3 weels d. 3-6 weeks

a.24-48 hrs

At what stage following MI does muscle appear yellow and rubbery in the centre with a haemorrhagic border if reperfused, with necrosis , inflammation and early granulation tissue a. 24-48 hrs b. 3-4 days c. 1-3 weeks d. 3-6 weeks

b.3-4 days

At what stage following MI does the infarcted area appear paler and thinner with progressive fibrosis and granulation tissue a. 24-48 hrs b. 3-4 days c. 1-3 weeks d. 3-6 weeks

c.1-3 weeks

At what stage following MI does the infarcted area appear a silvery white, tough scar with dense fibrosis a. 24-48 hrs b. 3-4 days c. 1-3 weeks d. 3-6 weeks

d.3-6 weeks

ECG shows changes in anterior chest leads which artery most likely obstructed? a. circumflex artery b. left anterior descending artery c. right coronary artery

b. left anterior descending artery anterior infarction

ECG shows changes in chest leads I and aVL which artery most likely obstructed? a. circumflex artery b. left anterior descending artery c. right coronary artery

a.circumflex artery lateral infarct

ECG shows changes in chest leads II.III and aVF which artery most likely obstructed? a. circumflex artery b. left anterior descending artery c. right coronary artery

c. right coronary artery | inferior infarct

true or false PCI/CABG are performed alongside drug treatment in acute coronary syndromes a. true b. false

a.true

parasthesia , pallor,pulselessness, paralysis, pery cold in a limb indicates what? a. intermittent claudication b. unstable angina c. acute limb ischaemia d. myocardial infarct

c.acute limb ischaemia | 5p

what is an atheroma? a. focal accumulation of lipid in the intima of arteries b. focal accumulation of lipid in the adventitia of arteries c. dissipated accumulation of lipid in the blood vessels d. focal accumulation of lipid in the media of arteries

a.focal accumulation of lipid in the intima of arteries

a necrotic centre and fibrous cap are the key components of what pathology? a. clot b. embolism c. atheromatous plaque

c.atheromatous plaque

which of these is most likely to trigger the formation of an atheroma? a. smoking b. obesity c. old age d. pregnancy

a.smoking | causes injury to endothelium

how does an atheroma lead to lumen narrowing? a. atherosclerotic plaque -> fatty streak v. tissue response of vessel wall c. fatty streaks-> atherosclerotic plaque

c.fatty streaks-> atherosclerotic plaque

what are the 3 types of atheromatous lesion? a. fatty streak, fibrolipid lesion and complicated lesion b. fatty streak, fibrilipid streak and complicated streak c. fatty streak, fibrolipid plaque and complicated lesion

c. fatty streak, fibrolipid plaque and complicated lesion

which type of atheromatous lesion is characterised by linear elevations composed of lipid laden macrophages? a. complicated lesion b. fibrolipid plaque c. fatty streak

c. fatty streak

which type of atheromatous lesion is characterised by bigger lesions with fat, fibrosis and fibroblasts? a. complicated lesion b. fibrolipid plaque c. fatty streak

b.fibrolipid plaque

which type of atheromatous lesion is characterised by narrowing, endothelial erosion with thrombosis,plaque rupture and fissuring,aneurysm formation. and embolic phenomena? a. complicated lesion b. fibrolipid plaque c. fatty streak

a.complicated lesion

erosion of the media by atheromatous plaque leads to? a. thrombosis b. aneurysm c. emboli d. acute arterial occlusion

b.aneurysm

progressive luminal narrowing by atheromatous plaque leads to? a. thrombosis b. aneurysm c. ischaemia d. acute arterial occlusion

c.ischaemia

plaque rupture and thrombosis by atheromatous plaque leads to? a. thrombosis b. aneurysm c. ischaemia d. acute arterial occlusion

d.acute arterial occlusion

dislodgement of plaque thrombus or plaque core constituents by atheromatous plaque leads to? a. thrombosis b. aneurysm c. embolus d. acute arterial occlusion

c.embolus

a localised permanent abnormal dilation of a blood vessel is known as? a. embolus b. infarction c. aneurysm d. atheroma

c.aneurysm

which of these describes a saccular aneurysm? a. spherical outpouching b. circumferential dilation of long vascular segment c. extravasation of blood into perivascular connective tissues d. extravasation of blood into wall via intimal tear

a.spherical outpouching

which of these describes a fusiform aneurysm? a. spherical outpouching b. circumferential dilation of long vascular segment c. extravasation of blood into perivascular connective tissues d. extravasation of blood into wall via intimal tear

b.circumferential dilation of long vascular segment

which of these describes a false aneurysm? a. spherical outpouching b. circumferential dilation of long vascular segment c. extravasation of blood into perivascular connective tissues d. extravasation of blood into wall via intimal tear

c. extravasation of blood into perivascular connective tissues

which of these describes a dissecting aneurysm? a. spherical outpouching b. circumferential dilation of long vascular segment c. extravasation of blood into perivascular connective tissues d. extravasation of blood into wall via intimal tear

d. extravasation of blood into wall via intimal tear

where do saccular aneurysms usually occur ? a. longer vascular segments b. intracranial vessels

b. intracranial vessels

where do fusiform aneurysms usually occur ? a. longer vascular segments b. intracranial vessels

a.longer vascular segments

which type of aneurysm is caused by trauma? a. saccular b. fusiform c. false d. dissecting

b.fusiform

what type of aneurysm is usually found between the renal arteries and bifurcation of the aorta a. saccular b. AAAA c. fusiform d. false e. dissecting

b.AAAA

AAAA

atherosclerotic aneurysm of the abdominal aorta

who do AAAAs occur most often in? a. male over 50 smokers b. female smokers over 50 c. male over 50 overweight d. female over 50 overweight

a. male over 50 smokers

which of these lifestyle factors is the most significant risk factor for atherosclerotic aneurysm of the abdominal aorta? a. .obesity b. smoking c. poor diet d. alcohol

b.smoking

what is the main risk factor AAAA ? a. atherosclerosis b. smoking c. obesity d. male

a.atherosclerosis

which of these is not a complication of AAA? a. ischaemia b. embolism c. impingement of other structures d. rupture e. heart failure

e. heart failure

what type of aneurysm is AAAA? A.fusiform b. saccular c. false e. dissecting

A.fusiform

which of these structures is unlikely to face ischaemia due to an AAAA? a. kidney b. bowel c. lower limbs d. brain e. vertebral arteries

d.brain

embolism from mural thrombus (wall of cardiac chamber) due to AAAA cause acute arterial ulceration in which area of the body? a. legs b. heart c. lungs d. feet

d.feet

which structure is most likley to be impinged following AAAA? a. heart b. lungs c. ureter d. brain e. spleen

c.ureter

at what size does risk of rupture become very significant for an AAAA? a. 10cm b. 2cm c. 4cm d. 5cm

d.5cm

what makes up the classical triad of AAA rupture ?

1. pain in flank or back 2. hypotension 3. pulsatile abdominal mass

which of these is not part of the classical triad of AAAA rupture? a. pulsatile abdominal mass b. pain in flank or back c. hypertension d. hypotension

c. hypertension

what type of aneurysm is a dissecting thoracic aortic aneurysm? a. saccular b. fusiform c. false d. dissecting

d.dissecting

following blood being forced through a tear in the intima a haemotoma occurs at which location before propagating along the blood vessel wall? a. intima b. adventitia c. media

c.media

a sharp tearing chest pain that radiates to the back is associated with which type of aneurysm? a. AAAA b. DTAA c. saccular d. false

b.DTAA

on a type 1 DTAA what is the outcome? a. blood re enters aortic lumen double barreled aorta b. blood ruptures through adventitia - massive haemorrhage into pleural cavity and pericardium c. blood extends down tributary arteries compressing the lumen - end organ infarction

b.blood ruptures through adventitia - massive haemorrhage into pleural cavity and pericardium

what is the outcome of a type 2 DTAA? a. blood re enters aortic lumen double barreled aorta b. blood ruptures through adventitia - massive haemorrhage into pleural cavity and pericardium c. blood extends down tributary arteries compressing the lumen - end organ infarction

a.blood re enters aortic lumen double barreled aorta

what is the outcome of a type 3 DTAA? a. blood re enters aortic lumen double barreled aorta b. blood ruptures through adventitia - massive haemorrhage into pleural cavity and pericardium c. blood extends down tributary arteries compressing the lumen - end organ infarction

c.blood extends down tributary arteries compressing the lumen - end organ infarction

which of these groups of patients is not part of the 2 common groups for DTAA? a. men over 50 smokers b. men 40-60 antecendent hypertension c. younger patients with syndromes affecting the aorta eg marfans

a.men over 50 smokers

younger patients with marfans are at increased risk of DTAA. This involves a point mutation in the fibrillin gene preventing normal deposition of which substance in the ECM? a. collagen b. elastin c. fibroelastin

b.elastin

where do berry aneurysms occur? a. long vascular segment b. intracranial vessels c. circle of willis d. loop of henle

c. circle of willis

what type of tissue is the normal arterial wall replaced by in berry aneurysms? a. collagen b. fibrous tissue c. muscle tissue

b.fibrous tissue

what type of aneurysms are berry aneurysms? a. saccular b. fusiform c. false d. dissecting

a.saccular

where do berry aneurysms arise on the circel of willis? a. ends of branches b. points of branching c. non branched areas

b.points of branching

what group is most at risk of berry aneurysms ? a. men over 50 smokers b. men 40-60 antecendent hypertension c. younger patients with syndromes affecting the aorta eg marfans d. young hypertensive

d.young hypertensive

a subarachnoid haemorrhage is produced as a result of a rupture of what type of aneurysm? a. saccular b. AAAA c. DTAA d. Berry

d.Berry

thunderclap headache, stiff neck, nausea, vomiting, loss of conciousness and stroke like symptoms are associated with rupture of what type of aneurysm? a. berry b. AAAA c. DTAA

a.berry

which type of aneurysm occurs in the intracerebral capillaries? a. saccular b. berry c. charcot bouchard

c.charcot bouchard micro aneurysms

which group most at risk of charcot bouchard aneurysms? a. men over 50 smokers b. men 40-60 antecendent hypertension c. younger patients with syndromes affecting the aorta eg marfans d. young hypertensive e. hypertensive and with diabetic vascular disease

e.hypertensive and with diabetic vascular disease

rupture of a charcot bouchard aneurysm leads to ? a. massive b. intracranial c. intracerebral

c.intracerebral

what is vasculitis a. inflammation of veins b. inflammation of arteries c. inflammation of blood vessels

c. inflammation of blood vessels

which of these is not associated with vasculitis? a. henoch schonlein purpura b. polyarteritis nodosa c. rheumatoid arthiritis d. marfans

d.marfans

what is polyarteritis nodosa? a. chronic hep b infection b. upper resp tract infection with skin rash and renal involvement c. rheumatoid arthiritis

a.chronic hep b infection

what is henoch schonlein pupura ? a. chronic hep b infection b. upper resp tract infection with skin rash and renal involvement c. rheumatoid arthiritis

b.upper resp tract infection with skin rash and renal involvement

what area is likley to be infarct with polyarteritis nodosa? a. spleen b. kidney c. bowel

a.spleen

ischaemia due to what causes claudication type pain in the jaw muscles with temporal/giant cell arteritis ? a. berry aneurysm b. DTAA c. vasculitis

c.vasculitis

damage to the vessel wall in vasculitis leads to? a. infarct b. ischaemia c. thrombosis d. kidney dysfunction

c.thrombosis