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BCR 1 > Pathology - Pathology of arterial circulation > Flashcards

Pathology - Pathology of arterial circulation Flashcards

1
Q

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

a. infarction
b. ischaemia

A

b.ischaemia

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2
Q

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

a. ischaemia
b. infarction

A

b.infarction

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3
Q

which of these has reversible effects?

a. infarction
b. ischaemia

A

b.ischaemia

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4
Q

effects of ischaemia vary based on which factors?

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

A

c.duration and metabolic demands

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5
Q

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

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

A

d.spleen and kidney

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6
Q

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

a.slow progressive reduction in arterial lumen size

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7
Q

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

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

A

b.3-4 mins

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8
Q

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

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

A

a.20- 30 mins

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9
Q

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

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

A

c. 2 hrs

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10
Q

which patient has increased susceptibility to ischaemia?

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

A

a.anaemic

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11
Q

what is the characteristic shape of a renal infarct?

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

A

c.wedge

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12
Q

what type of necrosis causes a cerebral infarction?

a. coagulative
b. liquefactive

A

b.liquefactive

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13
Q

what type of necrosis causes a myocardial infarction?

a. coagulative
b. liquefactive

A

a.coagulative

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14
Q

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

a. splanchnic system
b. watershed
c. coagulative

A

b. watershed

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15
Q

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

A

c.splenic fixture of colon

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16
Q

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

A

b.cerebral hemisphere

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17
Q

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

a.myocardium

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18
Q

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

A

b.transient ischaemic attack

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19
Q

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

A

b.transient ischaemic attack

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20
Q

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

A

b.transient ischaemic attack

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21
Q

infarction of the brain

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

A

a.ischameic stroke

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22
Q

mild ischaemia of the heart

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

A

c.stable angina

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23
Q

moderate ischaemia of the heart

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

A

c.stable angina

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24
Q

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

A

e.acute coronary syndrome -unstable angina

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25
Q

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

A

c.e.acute coronary syndrome -MI

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26
Q

mild ischaemia of the leg

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

A

d. peripheral vascular disease

e. intermittent claudication

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27
Q

moderate ischaemia of the leg

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

A

d. peripheral vascular disease

e. intermittent claudication

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28
Q

severeischaemia of the leg

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

A

c. acute limb ischaemia

d. peripheral vascular disease

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29
Q

infarction of the leg

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

A

c. acute limb ischaemia

d. peripheral vascular disease

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30
Q

which of these causes irreversible neurological symptoms and signs associated with cerebral infarct?

a. transient ischaemic attack
b. stroke

A

b.stroke

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31
Q

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

a. true
b. false

A

a.true

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32
Q

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

A

b.large artery occlusion

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33
Q

an uncomplicated atheroma becoming a significant fixed legion leads to

a. stroke
b. unstable angina
c. stable angina

A

c.stable angina

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34
Q

which of these is not classed as an acute coronary syndrome

a. STEMI
b. NSTEMI
c. unstable angina
b. stable angina

A

b.stable angina

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35
Q

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

a. NSTEMI
b. STEMI

A

b.STEMI

st ELEVATION ON ecg

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36
Q

what type of MI is caused by partial or intermittent blockage of an artery resulting in necrosis

a. STEMI
b. NSTEMI

A

b.NSTEMI

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37
Q

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

a.NSTEMI

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38
Q

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

A

d. prescence of myocardial necrosis

in NSTEMI

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39
Q

What test differentiates between NSTEMI and STEMI?

a. ECG
b. FBC
c. serum troponin blood test
d. blood film

A

c.serum troponin blood test

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40
Q

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

a.24-48 hrs

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41
Q

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

A

b.3-4 days

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42
Q

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

A

c.1-3 weeks

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43
Q

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

A

d.3-6 weeks

44
Q

ECG shows changes in anterior chest leads which artery most likely obstructed?

a. circumflex artery
b. left anterior descending artery
c. right coronary artery

A

b. left anterior descending artery

anterior infarction

45
Q

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

a.circumflex artery

lateral infarct

46
Q

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

A

c. right coronary artery

inferior infarct

47
Q

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

a. true
b. false

A

a.true

48
Q

parasthesia , pallor,pulselessness, paralysis, pery cold in a limb indicates what?

a. intermittent claudication
b. unstable angina
c. acute limb ischaemia
d. myocardial infarct

A

c.acute limb ischaemia

5p

49
Q

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

a.focal accumulation of lipid in the intima of arteries

50
Q

a necrotic centre and fibrous cap are the key components of what pathology?

a. clot
b. embolism
c. atheromatous plaque

A

c.atheromatous plaque

51
Q

which of these is most likely to trigger the formation of an atheroma?

a. smoking
b. obesity
c. old age
d. pregnancy

A

a.smoking

causes injury to endothelium

52
Q

how does an atheroma lead to lumen narrowing?

a. atherosclerotic plaque -> fatty streak
v. tissue response of vessel wall
c. fatty streaks-> atherosclerotic plaque

A

c.fatty streaks-> atherosclerotic plaque

53
Q

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

A

c. fatty streak, fibrolipid plaque and complicated lesion

54
Q

which type of atheromatous lesion is characterised by linear elevations composed of lipid laden macrophages?

a. complicated lesion
b. fibrolipid plaque
c. fatty streak

A

c. fatty streak

55
Q

which type of atheromatous lesion is characterised by bigger lesions with fat, fibrosis and fibroblasts?

a. complicated lesion
b. fibrolipid plaque
c. fatty streak

A

b.fibrolipid plaque

56
Q

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

a.complicated lesion

57
Q

erosion of the media by atheromatous plaque leads to?

a. thrombosis
b. aneurysm
c. emboli
d. acute arterial occlusion

A

b.aneurysm

58
Q

progressive luminal narrowing by atheromatous plaque leads to?

a. thrombosis
b. aneurysm
c. ischaemia
d. acute arterial occlusion

A

c.ischaemia

59
Q

plaque rupture and thrombosis by atheromatous plaque leads to?

a. thrombosis
b. aneurysm
c. ischaemia
d. acute arterial occlusion

A

d.acute arterial occlusion

60
Q

dislodgement of plaque thrombus or plaque core constituents by atheromatous plaque leads to?

a. thrombosis
b. aneurysm
c. embolus
d. acute arterial occlusion

A

c.embolus

61
Q

a localised permanent abnormal dilation of a blood vessel is known as?

a. embolus
b. infarction
c. aneurysm
d. atheroma

A

c.aneurysm

62
Q

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

a.spherical outpouching

63
Q

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

A

b.circumferential dilation of long vascular segment

64
Q

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

A

c. extravasation of blood into perivascular connective tissues

65
Q

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

A

d. extravasation of blood into wall via intimal tear

66
Q

where do saccular aneurysms usually occur ?

a. longer vascular segments
b. intracranial vessels

A

b. intracranial vessels

67
Q

where do fusiform aneurysms usually occur ?

a. longer vascular segments
b. intracranial vessels

A

a.longer vascular segments

68
Q

which type of aneurysm is caused by trauma?

a. saccular
b. fusiform
c. false
d. dissecting

A

b.fusiform

69
Q

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

A

b.AAAA

70
Q

AAAA

A

atherosclerotic aneurysm of the abdominal aorta

71
Q

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

a. male over 50 smokers

72
Q

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

A

b.smoking

73
Q

what is the main risk factor AAAA ?

a. atherosclerosis
b. smoking
c. obesity
d. male

A

a.atherosclerosis

74
Q

which of these is not a complication of AAA?

a. ischaemia
b. embolism
c. impingement of other structures
d. rupture
e. heart failure

A

e. heart failure

75
Q

what type of aneurysm is AAAA?

A.fusiform

b. saccular
c. false
e. dissecting

A

A.fusiform

76
Q

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

A

d.brain

77
Q

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

A

d.feet

78
Q

which structure is most likley to be impinged following AAAA?

a. heart
b. lungs
c. ureter
d. brain
e. spleen

A

c.ureter

79
Q

at what size does risk of rupture become very significant for an AAAA?

a. 10cm
b. 2cm
c. 4cm
d. 5cm

A

d.5cm

80
Q

what makes up the classical triad of AAA rupture ?

A
  1. pain in flank or back
  2. hypotension
  3. pulsatile abdominal mass
81
Q

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

A

c. hypertension

82
Q

what type of aneurysm is a dissecting thoracic aortic aneurysm?

a. saccular
b. fusiform
c. false
d. dissecting

A

d.dissecting

83
Q

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

A

c.media

84
Q

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

A

b.DTAA

85
Q

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

A

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

86
Q

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

a.blood re enters aortic lumen double barreled aorta

87
Q

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

A

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

88
Q

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

a.men over 50 smokers

89
Q

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

A

b.elastin

90
Q

where do berry aneurysms occur?

a. long vascular segment
b. intracranial vessels
c. circle of willis
d. loop of henle

A

c. circle of willis

91
Q

what type of tissue is the normal arterial wall replaced by in berry aneurysms?

a. collagen
b. fibrous tissue
c. muscle tissue

A

b.fibrous tissue

92
Q

what type of aneurysms are berry aneurysms?

a. saccular
b. fusiform
c. false
d. dissecting

A

a.saccular

93
Q

where do berry aneurysms arise on the circel of willis?

a. ends of branches
b. points of branching
c. non branched areas

A

b.points of branching

94
Q

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

A

d.young hypertensive

95
Q

a subarachnoid haemorrhage is produced as a result of a rupture of what type of aneurysm?

a. saccular
b. AAAA
c. DTAA
d. Berry

A

d.Berry

96
Q

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

a.berry

97
Q

which type of aneurysm occurs in the intracerebral capillaries?

a. saccular
b. berry
c. charcot bouchard

A

c.charcot bouchard

micro aneurysms

98
Q

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

A

e.hypertensive and with diabetic vascular disease

99
Q

rupture of a charcot bouchard aneurysm leads to ?

a. massive
b. intracranial
c. intracerebral

A

c.intracerebral

100
Q

what is vasculitis

a. inflammation of veins
b. inflammation of arteries
c. inflammation of blood vessels

A

c. inflammation of blood vessels

101
Q

which of these is not associated with vasculitis?

a. henoch schonlein purpura
b. polyarteritis nodosa
c. rheumatoid arthiritis
d. marfans

A

d.marfans

102
Q

what is polyarteritis nodosa?

a. chronic hep b infection
b. upper resp tract infection with skin rash and renal involvement
c. rheumatoid arthiritis

A

a.chronic hep b infection

103
Q

what is henoch schonlein pupura ?

a. chronic hep b infection
b. upper resp tract infection with skin rash and renal involvement
c. rheumatoid arthiritis

A

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

104
Q

what area is likley to be infarct with polyarteritis nodosa?

a. spleen
b. kidney
c. bowel

A

a.spleen

105
Q

ischaemia due to what causes claudication type pain in the jaw muscles with temporal/giant cell arteritis ?

a. berry aneurysm
b. DTAA
c. vasculitis

A

c.vasculitis

106
Q

damage to the vessel wall in vasculitis leads to?

a. infarct
b. ischaemia
c. thrombosis
d. kidney dysfunction

A

c.thrombosis

BCR 1 (60 decks)

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