Vascular Pathology Practice Questions

Q: A 35-year-old patient presents with persistent allergic rhinitis, asthmatic episodes, and peripheral hypereosinophilia. Histological findings are shown below. What is your diagnosis?

Churg-Strauss syndrome. ***Churg-Strauss syndrome*** - The **clinical triad** of **allergic rhinitis**, **asthma**, and **peripheral hypereosinophilia** is pathognomonic for Churg-Strauss syndrome (EGPA). - Histological findings typically show **necrotizing vasculitis** with **eosinophilic infiltration** and **extravascular granulomas** affecting small to medium vessels. *Behcet Disease* - Characterized by **recurrent oral and genital ulcers**, **uveitis**, and **skin lesions** (erythema nodosum, papulopustular lesions). - Lacks the **eosinophilic component** and **respiratory symptoms** seen in this case. *Kawasaki disease* - Primarily affects **children under 5 years** with **fever**, **conjunctivitis**, and **coronary artery involvement**. - Does not present with **allergic rhinitis**, **asthma**, or **hypereosinophilia** as seen here. *Buerger disease* - **Thromboangiitis obliterans** affecting **small and medium arteries** in **young male smokers**. - Presents with **digital ischemia** and **claudication**, not respiratory or allergic symptoms.

Question 1

Histopathological examination of an elderly male patient reveals fragmentation of the elastic lamina, lymphocyte infiltration, and multinucleated giant cells. What is the most likely diagnosis?

Accepted Answer

Giant cell arteritis

Answer

Takayasu arteritis

Answer

Polyarteritis nodosa

Answer

Kawasaki disease

Question 2

In atherosclerosis, what leads to increased LDL in monocyte macrophages?

Accepted Answer

Oxidation of lipids within LDL particles

Answer

Presence of LDL receptors on macrophages

Answer

Presence of LDL receptors on the endothelium

Answer

All of the above

Question 3

A 75-year-old woman presents with facial pain, headache, and intermittent visual symptoms. Temporal artery biopsies are performed. If the biopsies show abnormal vessels, which of the following would be the most likely pathological finding?

Accepted Answer

Focal granulomatous inflammation

Answer

Atherosclerotic plaque

Answer

Fibrinoid necrosis

Answer

Fungal hyphae

Question 4

Which of the following are classified as small vessel vasculitis?

Accepted Answer

Classical Polyarteritis Nodosa, HSP, Churg-Strauss syndrome

Answer

Classical Polyarteritis Nodosa, HSP, Wegener's granulomatosis

Answer

Classical Polyarteritis Nodosa, Churg-Strauss syndrome, Giant cell arteritis

Answer

Wegener's granulomatosis, Giant cell arteritis, Churg-Strauss syndrome

Question 5

What type of arteritis may lead to myocardial infarction in children?

Accepted Answer

Kawasaki disease

Answer

Takayasu arteritis

Answer

Polyarteritis nodosa

Answer

Microscopic polyangitis

Question 6

A mycotic aneurysm is an aneurysm infected because of-

Accepted Answer

Both intravascular and extravascular infection

Answer

Fungal infection

Answer

Blood-borne infection (intravascular)

Answer

Infection introduced from outside (extravascular)

Question 7

Which of the following does not cause deep vein thrombosis?

Accepted Answer

Sickle cell anemia

Answer

Estrogen

Answer

Thrombocytosis

Answer

Paroxysmal nocturnal hemoglobinuria

Question 8

A 35-year-old patient presents with persistent allergic rhinitis, asthmatic episodes, and peripheral hypereosinophilia. Histological findings are shown below. What is your diagnosis?

Accepted Answer

Churg-Strauss syndrome

Answer

Behcet Disease

Answer

Kawasaki disease

Answer

Buerger disease

Question 9

The most commonly affected arteries seen by arteriography in Takayasu's arteritis is:

Accepted Answer

Subclavian artery

Answer

Abdominal aorta

Answer

Common carotid artery

Answer

Aortic arch or root

Question 10

A 50-year-old hypertensive man develops very severe, "tearing" chest pain, which migrates from his upper back to mid-back over the period of an hour. Pathologic examination of a specimen removed from the patient during emergency surgery would MOST likely demonstrate which of the following?

Accepted Answer

Cystic medial degeneration

Answer

Infarction

Answer

Plasma cells around the vasa vasorum

Answer

Wrinkling of intima

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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