Cardiac Pathology Practice Questions

Q: In which of the following conditions are Aschoff bodies observed?

Rheumatic fever. **Explanation:** **Aschoff bodies** are the pathognomonic histological hallmark of **Acute Rheumatic Fever (ARF)** [1]. They represent areas of focal interstitial inflammation found in all three layers of the heart (pancarditis), though they are most common in the myocardium [1]. 1. **Why Rheumatic Fever is correct:** Aschoff bodies are granulomatous structures consisting of a central zone of fibrinoid necrosis surrounded by chronic inflammatory cells (lymphocytes, plasma cells) and characteristic **Anitschkow cells** (caterpillar cells) [1]. These are plump activated macrophages with wavy, ribbon-like chromatin [1]. As these lesions age, they fibrose to form Aschoff scars. 2. **Why other options are incorrect:** * **Acute Myelogenous Leukemia (AML):** Characterized by the presence of **Auer rods** (clumped granular material) in the cytoplasm of myeloblasts, not Aschoff bodies. * **Pheochromocytoma:** A catecholamine-secreting tumor of the adrenal medulla. Histologically, it shows a **Zellballen pattern** (nested clusters of cells). * **Osteopetrosis:** A genetic disorder of defective osteoclast function leading to "marble bone disease." It is characterized by thickened, dense bone with a lack of medullary canals. **High-Yield Clinical Pearls for NEET-PG:** * **Anitschkow Cells:** Large macrophages with "caterpillar-like" nuclei; when seen in cross-section, they are called **Owl-eye cells** [1]. * **Location:** Aschoff bodies are most frequently found in the **subendocardium** and **myocardium** [1]. * **MacCallum Patch:** A map-like area of subendocardial thickening, usually in the left atrium, caused by regurgitant jets in Rheumatic Heart Disease. * **Jones Criteria:** Used for the clinical diagnosis of ARF (Major: Joint, Carditis, Nodules, Erythema marginatum, Sydenham chorea). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, pp. 566-567.

Question 1

A 59-year-old man presents with acute chest pain. Laboratory studies and ECG indicate an acute myocardial infarction. Coronary angiography performed 2 hours later does not show evidence of thrombosis. Intravascular thrombolysis in this patient was mediated by plasminogen activators released by which of the following cells?

Accepted Answer

Endothelial cells

Answer

Cardiac myocytes

Answer

Macrophages

Answer

Vascular smooth muscle cells

Question 2

What is the most common tumor of heart valves?

Accepted Answer

Papillary fibroelastoma

Answer

Malignant fibrous histiocytoma

Answer

Angiosarcoma

Answer

Rhabdomyosarcoma

Question 3

Concentric hypertrophy of the heart is seen in which of the following conditions?

Accepted Answer

Hypertension

Answer

Mitral stenosis

Answer

Mitral regurgitation

Answer

Aortic regurgitation

Question 4

A 30-year-old woman with a history of intravenous drug abuse presents with rapidly progressive malaise, fever, and chills. Physical examination reveals subungual splinter hemorrhages and a systolic murmur. Blood cultures are positive for Staphylococcus aureus. The patient died of myocardial infarction on her third hospital day. What was the underlying condition that led to the patient's demise?

Accepted Answer

Acute infective endocarditis

Answer

Carcinoid heart disease

Answer

Libman-Sacks endocarditis

Answer

Nonbacterial thrombotic endocarditis

Question 5

What is the characteristic pathological finding in carcinoid of the heart?

Accepted Answer

Fibrous endocardial thickening of the right ventricle and tricuspid valve

Answer

Collagen deposition in the wall of the right ventricle and tricuspid valve

Answer

Interstitial fibrous thickening of the right ventricle and pulmonic valve

Answer

Mononuclear inflammatory infiltrate in the wall of the right atrium

Question 6

Restrictive cardiomyopathy is seen in which of the following conditions?

Accepted Answer

Amyloidosis

Answer

Fatty change of the heart

Answer

Viral myocarditis

Answer

Doxorubicin toxicity

Question 7

"Lipidic cells" are seen in which of the following conditions?

Accepted Answer

Myxoma of the heart

Answer

Lepromatous leprosy

Answer

Rhabdomyoma

Answer

Rheumatic heart disease

Question 8

A 56-year-old male patient presented with sudden substernal pain and a sense of impending doom, and died 4 days later. Autopsy revealed a large transmural anterior wall infarction. What would be associated with this finding?

Accepted Answer

Presence of neutrophils

Answer

Presence of collagen and fibroblasts

Answer

Granulomatous inflammation

Answer

Granulation tissue

Question 9

An adult presents to a physician because of repeated episodes of fainting. EKG fails to disclose an arrhythmia. Echocardiogram shows a mass in the left atrium that is acting like a "ball valve" to produce intermittent obstruction of flow. Which of the following would most likely be seen on microscopic examination of the resected mass?

Accepted Answer

Benign myxoid tumor

Answer

Benign tumor with gland formation

Answer

Benign tumor with striated muscle differentiation

Answer

Malignant tumor with gland formation

Question 10

In which of the following conditions are Aschoff bodies observed?

Accepted Answer

Rheumatic fever

Answer

Acute myelogenous leukemia

Answer

Pheochromocytoma

Answer

Osteopetrosis

Cardiac Pathology — MCQs

Cardiac Pathology — MCQs

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