Vascular Pathology Practice Questions

Q: Syphilitic aneurysm most commonly involves which part of the aorta?

None of the above. **Explanation:** The correct answer is **None of the above** because the question asks for the most common site, and while syphilis affects the thoracic aorta, it specifically targets the **arch of the aorta** most frequently, followed by the ascending aorta. **1. Underlying Medical Concept:** Syphilitic (luetic) aneurysm is a complication of tertiary syphilis. The pathophysiology involves **obliterative endarteritis** of the **vasa vasorum** [1]. This leads to ischemic injury of the aortic media (mesoaortitis), resulting in the destruction of elastic tissue and smooth muscle. The weakened wall undergoes aneurysmal dilation. Because the vasa vasorum are most abundant in the thoracic aorta, this is the primary site of involvement [1]. **2. Analysis of Options:** * **Ascending Aorta (A):** While frequently involved and a classic site for syphilitic aortitis leading to aortic regurgitation, the **arch** is statistically the most common site for the actual aneurysm formation. * **Descending Aorta (B):** This is less commonly involved compared to the proximal thoracic segments. * **Abdominal Aorta (C):** This is the most common site for **Atherosclerotic aneurysms**, not syphilitic ones. Syphilis rarely involves the aorta below the diaphragm because the abdominal aorta has fewer vasa vasorum. **3. NEET-PG High-Yield Pearls:** * **Gross Appearance:** "Tree-bark" appearance of the intima due to patchy subintimal fibrosis. * **Key Complication:** Aortic root dilation leading to **Aortic Regurgitation** (proximal involvement). * **Microscopy:** Plasma cell-rich infiltrate around the vasa vasorum [1]. * **Comparison:** Atherosclerotic aneurysms are typically **Abdominal (infra-renal)**; Syphilitic aneurysms are typically **Thoracic (Arch > Ascending)**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 388-389.

Question 1

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 2

Which of the following is NOT true about Berry aneurysms?

Accepted Answer

Most common in the posterior circulation

Answer

Rupture leading to subarachnoid hemorrhage

Answer

A developmental anomaly

Answer

Common in the anterior circulation

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

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 5

Syphilitic aneurysm most commonly involves which part of the aorta?

Accepted Answer

None of the above

Answer

Ascending aorta

Answer

Descending aorta

Answer

Abdominal aorta above the renal arteries

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

Which of the following is classified as a small vessel vasculitis?

Accepted Answer

Granulomatosis with Polyangiitis (Wegener's)

Answer

Classical Polyarteritis Nodosa (PAN)

Answer

Giant Cell Arteritis

Answer

All of the above

Question 9

ANCA is found in all of the following conditions EXCEPT?

Accepted Answer

Takayasu arteritis

Answer

Wegener's granulomatosis

Answer

Churg-Strauss disease

Answer

Microscopic polyangiitis

Question 10

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

Vascular Pathology — MCQs

Vascular Pathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?