Pathology - Pathology of arterial circulation Flashcards
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
the death(necrosis) of tissues as a result of deprivation of oxygen and nutrients?
a. ischaemia
b. infarction
b.infarction
which of these has reversible effects?
a. infarction
b. ischaemia
b.ischaemia
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
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
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
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
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
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
which patient has increased susceptibility to ischaemia?
a. anaemic
b. hypertensive
b. obese
d. elderly
a.anaemic
what is the characteristic shape of a renal infarct?
a. round
b. ovoid
c. wedge
d. berry
c.wedge
what type of necrosis causes a cerebral infarction?
a. coagulative
b. liquefactive
b.liquefactive
what type of necrosis causes a myocardial infarction?
a. coagulative
b. liquefactive
a.coagulative
what is the area where tissues at the interface of two arteries are found?
a. splanchnic system
b. watershed
c. coagulative
b. watershed
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
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
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
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
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
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
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
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
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
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
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 ?
- pain in flank or back
- hypotension
- 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
