Vascular Pathology Practice Questions

Q: Takayasu arteritis most commonly affects which of the following vessels?

Renal artery. **Explanation:** **Takayasu Arteritis (TA)**, also known as "Pulseless Disease," is a chronic granulomatous large-vessel vasculitis that primarily involves the **aorta and its major branches** [1]. 1. **Why Renal Artery is Correct:** While the aortic arch is the most frequent site of involvement, among the specific visceral branches, the **renal artery** is the most commonly affected (involved in approximately 30-75% of cases). This often leads to renovascular hypertension, a classic clinical presentation in young females. In the context of this question, it is the most frequent site among the options provided. 2. **Analysis of Incorrect Options:** * **Coeliac axis:** Although it can be involved as a branch of the abdominal aorta, it is affected significantly less frequently than the renal arteries. * **Coronary arteries:** Involvement of the coronary ostia occurs in about 10-25% of patients due to extension of aortic root inflammation, but it is not the most common site. * **Radial artery:** TA typically affects large elastic arteries. The radial artery is a medium-sized muscular artery and is rarely the primary site of involvement; the "pulseless" nature of the disease is usually due to proximal stenosis in the subclavian or axillary arteries. **High-Yield Clinical Pearls for NEET-PG:** * **Demographics:** Most common in females <40 years of age (Asian descent) [1]. * **Pathology:** Characterized by transmural fibrous thickening of the aortic arch and "tree-barking" of the intima. * **Clinical Sign:** Discrepancy in blood pressure between arms and weak/absent upper limb pulses. * **Diagnosis:** Elevated ESR and angiography (showing "string of pearls" or tapered stenoses). * **Key Association:** Often associated with HLA-B52. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 516-517.

Q: Red infarct is seen in which organ?

Lung. **Explanation:** Infarcts are classified into two types based on their color and the amount of hemorrhage: **Red (Hemorrhagic)** and **White (Anemic)** [1]. **Why Lung is the Correct Answer:** Red infarcts occur in tissues with a **dual blood supply** or loose textures that allow blood to collect in the infarcted area [1]. The lung has a dual blood supply from the **Pulmonary arteries** and **Bronchial arteries** [2]. When a pulmonary artery branch is obstructed, the bronchial arteries continue to pump blood into the necrotic area, but the damaged capillaries cannot contain it, leading to extensive hemorrhage [1]. This results in a firm, red-colored wedge-shaped infarct. **Analysis of Incorrect Options:** * **Kidney (Option B):** This is a classic example of a **White (Anemic) Infarct**. It occurs in solid organs with **end-artery circulation**, where the density of the tissue limits the amount of hemorrhage into the area of ischemic necrosis [1]. * **Liver (Option A):** While the liver has a dual blood supply (Portal vein and Hepatic artery), true infarction is **rare** due to this protective mechanism. When it does occur, it is usually pale or variegated, but it is not the classic textbook example of a red infarct compared to the lung. * **Brain (Option C):** Brain infarcts typically undergo **liquefactive necrosis**. While they can sometimes be hemorrhagic (especially after an embolic stroke with reperfusion), the primary classification for **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Hemodynamic Disorders, Thromboembolic Disease, and Shock, p. 140. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Hemodynamic Disorders, Thromboembolic Disease, and Shock, pp. 137-138.

Question 1

Takayasu arteritis most commonly affects which of the following vessels?

Accepted Answer

Renal artery

Answer

Coeliac axis

Answer

Coronary arteries

Answer

Radial artery

Question 2

Kaposi sarcoma is commonly seen in which anatomical location?

Accepted Answer

Lower limbs

Answer

Upper limbs

Answer

Head and Neck

Answer

Trunk

Question 3

What is the most common cause of pulmonary thromboembolism?

Accepted Answer

Deep vein thrombosis (DVT)

Answer

Disseminated intravascular coagulation (DIC)

Answer

Coagulation disorder

Answer

Venous hypertension

Question 4

Takayasu arteritis involves which of the following?

Accepted Answer

Medium to large sized arteries with a predilection to branches of the aortic arch

Answer

Small arterioles

Answer

Femoral and popliteal arteries

Answer

Abdominal aorta

Question 5

Which of the following are seen in malignant hypertension?

Accepted Answer

Replacement by necrotizing arteriolitis and atherosclerosis

Answer

Atherosclerosis

Answer

Hyalinised arterioles and replacement by necrotizing arteriolitis

Answer

Hyalinised arterioles and atherosclerosis

Question 6

What is the commonest site of lodgement of a pulmonary embolus?

Accepted Answer

Left upper lobe

Answer

Right lower lobe

Answer

Right upper lobe

Answer

Left lower lobe

Question 7

A 77-year-old man has had progressive dementia and gait ataxia for the past 9 years. He succumbs to bronchopneumonia. Autopsy shows that the thoracic aorta has a dilated root and arch, giving the intimal surface a "tree-bark" appearance. The microscopic examination of the aorta shows an obliterative endarteritis of the vasa vasorum. Which of the following laboratory findings is most likely to be recorded in this patient's medical history?

Accepted Answer

Antibodies against Treponema pallidum

Answer

Double-stranded DNA titer positive at 1 :512

Answer

Ketonuria of 4+

Answer

P-ANCA positive at 1 :1024

Question 8

Red infarct is seen in which organ?

Accepted Answer

Lung

Answer

Liver

Answer

Kidney

Answer

Brain

Question 9

In aortic dissection, through which layer does blood initially enter?

Accepted Answer

Media

Answer

Intima

Answer

Adventitia

Answer

Any of the above layers

Question 10

Pericyte formation occurs in which of the following lesions?

Accepted Answer

Hemangiopericytoma

Answer

Kaposi sarcoma

Answer

Glomus tumor

Answer

Myopericytoma

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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