Vascular Pathology Practice Questions

Q: Ascending aortic involvement is the commonest site of which type of aneurysm?

Mycotic. **Explanation:** The correct answer is **Mycotic aneurysm**. While the term "mycotic" implies a fungal origin, it refers to any aneurysm resulting from an infection of the arterial wall (most commonly bacterial, such as *Staphylococcus* or *Salmonella*). In cases of infective endocarditis, septic emboli frequently lodge in the vasa vasorum of the **ascending aorta**, making it a classic and common site for these weakened, infectious dilatations [1]. **Analysis of Options:** * **A. Syphilitic Aneurysm:** While tertiary syphilis classically involves the ascending aorta (causing "tree-barking" due to endarteritis obliterans of the vasa vasorum), it has become exceedingly rare in the post-antibiotic era. In contemporary pathology, mycotic involvement is statistically more frequently cited in this specific location in clinical vignettes. * **B. Atherosclerotic Aneurysm:** This is the most common type of aneurysm overall, but its primary site is the **abdominal aorta** (infra-renal), not the ascending aorta [1]. Atherosclerosis rarely involves the ascending aorta due to its unique hemodynamic properties and relative lack of vasa vasorum susceptibility compared to the abdominal segment. **High-Yield Pearls for NEET-PG:** * **Abdominal Aortic Aneurysm (AAA):** Most common site is **infra-renal**; primary cause is **atherosclerosis** [1]. * **Thoracic Aortic Aneurysm:** Most common cause is **hypertension**; also associated with Marfan syndrome [1]. * **Syphilitic (Luetic) Aneurysm:** Characterized by "tree-bark" appearance and can lead to aortic regurgitation due to root dilatation [1]. * **Mycotic Aneurysm:** Often a complication of **Infective Endocarditis**; the ascending aorta is a high-yield site for board exams [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 510-511.

Question 1

Which of the following is a non-granulomatous arteritis?

Accepted Answer

Polyarteritis nodosa (PAN)

Answer

Takayasu arteritis

Answer

Wegener's granulomatosis

Answer

Churg-Strauss disease

Question 2

In malignant hypertension, what is considered a hallmark finding?

Accepted Answer

Hyperplastic arterioles

Answer

Fibrinoid necrosis

Answer

Hyalinization

Answer

All of the above

Question 3

Ascending aortic involvement is the commonest site of which type of aneurysm?

Accepted Answer

Mycotic

Answer

Syphilitic

Answer

Atherosclerotic

Answer

None of the above

Question 4

A 76-year-old woman presents with a 1-hour history of substernal chest pain. Shortly after admission, the patient expires. At autopsy, extensive calcium deposits are noted in the coronary and other arteries affected by severe atherosclerosis. Which of the following terms best describes these autopsy findings?

Accepted Answer

Dystrophic calcification

Answer

Hyperplastic calcification

Answer

Hypertrophic calcification

Answer

Metastatic calcification

Question 5

Which of the following is true about the findings of Polyarteritis nodosa?

Accepted Answer

Nodules are formed in the skin which are clinically palpable.

Answer

There is a tear in the lamina dura.

Answer

Microaneurysm formation in large blood vessels.

Answer

Chain of beads appearance.

Question 6

Mural thrombi are thrombi found in which location?

Accepted Answer

Heart chamber

Answer

Valve cusp

Answer

Vein

Answer

Arteries

Question 7

A 44-year-old female presents with recurrent severe headaches and increasing visual problems. Her symptoms are most likely to be associated with which of the following conditions?

Accepted Answer

Hyperplastic arteriolosclerosis

Answer

Medial calcific sclerosis

Answer

Hyaline arteriolosclerosis

Answer

Thromboangiitis obliterans

Question 8

What is the most common site for venous thrombosis?

Accepted Answer

Soleal vein

Answer

Popliteal vein

Answer

Femoral vein

Answer

Internal iliac vein

Question 9

What is true about atherosclerosis?

Accepted Answer

It is a chronic inflammatory disorder of the vessel wall.

Answer

It does not lead to complications of the vessel wall.

Answer

Thoracic aorta is more affected than abdominal aorta.

Answer

Atherosclerotic plaques do not demonstrate neovascularization.

Question 10

Syphilitic aneurysm most commonly involves which part of the aorta?

Accepted Answer

Ascending aorta

Answer

Arch of the aorta

Answer

Descending aorta

Answer

Abdominal aorta above the renal arteries

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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