Vascular Pathology Practice Questions

Q: In polyarteritis nodosa, lesions are seen in all except?

Lung. **Explanation:** **Polyarteritis Nodosa (PAN)** is a systemic necrotizing vasculitis that typically affects small- to medium-sized muscular arteries [1]. The hallmark of PAN is that it involves multiple organs but **characteristically spares the pulmonary circulation.** 1. **Why Lung is the correct answer:** PAN involves the systemic circulation but does not affect the pulmonary arteries. Therefore, pulmonary involvement and bronchial artery lesions are absent. If a patient presents with systemic vasculitis and lung involvement (like granulomas or hemorrhage), clinicians should look toward other diagnoses like Granulomatosis with Polyangiitis (GPA) or Eosinophilic Granulomatosis with Polyangiitis (EGPA) [1]. 2. **Why other options are incorrect:** * **Liver & Pancreas:** PAN frequently involves the mesenteric and visceral arteries. The gastrointestinal tract and liver are involved in approximately 70% of cases, often leading to abdominal pain or infarcts. * **Heart:** Coronary artery involvement is common in PAN and can lead to myocardial ischemia or heart failure. * **Kidney (Most Common):** Though not an option here, the renal artery is the most frequently involved vessel, typically causing hypertension rather than glomerulonephritis (as PAN spares the capillaries). **High-Yield Clinical Pearls for NEET-PG:** * **Association:** Strongly associated with **Hepatitis B surface antigen (HBsAg)** in about 30% of cases. * **Morphology:** Characterized by **"segmental"** transmural inflammation with **fibrinoid necrosis** [1]. * **Angiography:** Shows a **"string of pearls"** appearance due to coexisting aneurysms and fibrosis [1]. * **Key Exclusion:** PAN is **ANCA-negative** and does not affect capillaries or venules (distinguishing it from Microscopic Polyangiitis). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 517-518.

Q: What is true about glomangioma?

More common in hands and feet. **Explanation:** **Glomus tumors** are benign, highly vascularized tumors arising from the modified smooth muscle cells of the **glomus body**, a specialized arteriovenous anastomosis involved in thermoregulation. **Why Option B is correct:** While the classic "glomus tumor" is famously subungual, the specific variant known as **Glomangioma** (which has a prominent vascular component resembling a cavernous hemangioma) is more frequently found in the **distal extremities (hands and feet)** but is less strictly localized to the subungual region compared to the solid glomus tumor. **Analysis of Incorrect Options:** * **Option A:** The **solid glomus tumor** is the classic subungual lesion (under the fingernail). Glomangiomas are more likely to be found in the deep dermis or subcutaneous tissue of the extremities. * **Option C:** While glomangiomas contain large vascular channels, **thrombosis** is not a characteristic or defining pathological feature of this tumor (unlike cavernous hemangiomas where it is common). * **Option D:** The **solid glomus tumor** is the most common histological variant (75%), followed by glomangioma (20%) and glomangiomyoma (5%). **High-Yield Clinical Pearls for NEET-PG:** * **Classic Triad:** Paroxysmal pain, localized tenderness, and sensitivity to cold (especially in subungual types). * **Histology:** Nests of uniform, round "glomus cells" with "punched-out" nuclei surrounding thin-walled vascular spaces. * **IHC Marker:** They are positive for **Alpha-Smooth Muscle Actin (α-SMA)** because they originate from modified smooth muscle cells. * **Hildreth’s Sign:** Disappearance of pain upon inflation of a blood pressure cuff (positive in glomus tumors).

Question 1

All of the following are true about aortic aneurysms except?

Accepted Answer

Saccular aneurysms involve the entire circumference

Answer

True aneurysms involve all 3 layers

Answer

Atherosclerosis is the commonest cause

Answer

False aneurysms are not covered by all 3 layers

Question 2

In polyarteritis nodosa, lesions are seen in all except?

Accepted Answer

Lung

Answer

Pancreas

Answer

Liver

Answer

Heart

Question 3

Which of the following is NOT included in Virchow's triad?

Accepted Answer

Hypercoagulability

Answer

Risk of intravascular thrombus

Answer

Endothelial injury

Answer

Venous stasis

Question 4

Which of the following is NOT a characteristic of granulomatosis with polyangiitis (Wegener's granulomatosis)?

Accepted Answer

Involvement of large vessels

Answer

Granuloma in the vessel wall

Answer

Focal necrotizing glomerulonephritis

Answer

Positive for c-ANCA

Question 5

Hyperplastic arteriolitis with necrotizing arteriolitis is seen in which condition?

Accepted Answer

Malignant hypertension

Answer

Buerger's disease

Answer

Benign hypertension

Answer

Diabetes

Question 6

Aortic arch syndrome is due to which condition?

Accepted Answer

Takayasu arteritis

Answer

Polyarteritis nodosa

Answer

Temporal arteritis

Answer

Buerger disease

Question 7

What is true about glomangioma?

Accepted Answer

More common in hands and feet

Answer

Usually subungual

Answer

Thrombosis can occur

Answer

Most common type of glomus tumor

Question 8

Foam cells in atherosclerosis contain lipid in the form of?

Accepted Answer

Oxidized LDL

Answer

Reduced LDL

Answer

Oxidized VLDL

Answer

Reduced VLDL

Question 9

What is the most common source of pulmonary embolism?

Accepted Answer

Large veins of the leg

Answer

Amniotic fluid embolism

Answer

Renal artery embolism

Answer

Cardiothoracic surgery

Question 10

What is the most common cause of aortic aneurysm?

Accepted Answer

Atherosclerosis

Answer

Syphilis

Answer

Trauma

Answer

Congenital

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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