Vascular Pathology Practice Questions

Q: Kasabach-Merritt syndrome is associated with which of the following?

Giant hemangioma. **Explanation:** **Kasabach-Merritt Syndrome (KMS)**, also known as Hemangioma-thrombocytopenia syndrome, is a life-threatening condition characterized by the association of a rapidly growing vascular tumor with **consumptive coagulopathy**. **Why Option A is correct:** The underlying pathology involves a **giant hemangioma** (most commonly a *tufted angioma* or *kaposiform hemangioendothelioma*). The complex, irregular architecture of the vascular channels within these large tumors causes blood stasis and platelet activation. This leads to massive **platelet sequestration** and consumption of clotting factors within the lesion, resulting in severe thrombocytopenia, microangiopathic hemolytic anemia, and disseminated intravascular coagulation (DIC). **Why the other options are incorrect:** * **Option B:** Large aortic aneurysms are associated with stasis and mural thrombi, but they do not typically cause the profound consumptive thrombocytopenia seen in KMS. * **Option C:** Giant thrombocytes (platelets) are characteristic of Bernard-Soulier Syndrome, a qualitative platelet disorder, not a vascular entrapment syndrome. * **Option D:** While Arteriovenous malformations (AVMs) involve abnormal vessels, they generally lack the specific proliferative endothelium required to trap and destroy platelets in the manner diagnostic of KMS. **High-Yield Clinical Pearls for NEET-PG:** * **Classic Triad:** Giant vascular tumor + Thrombocytopenia + Consumptive coagulopathy. * **Common Sites:** Skin and soft tissues (most common), but can involve the liver or spleen. * **Laboratory Findings:** Low platelet count, decreased fibrinogen, and elevated D-dimers (indicative of DIC). * **Management:** Often requires systemic corticosteroids, vincristine, or sirolimus; surgery is rarely feasible due to the risk of massive hemorrhage.

Question 1

Cystic medial necrosis responsible for aortic dilatation and rupture is seen in which condition?

Accepted Answer

Marfan syndrome

Answer

Syphilitic aneurysm

Answer

Takayasu arteritis

Answer

Atherosclerosis

Question 2

Which vasculitis affects both the arterial and venous systems?

Accepted Answer

Wegener granulomatosis

Answer

Polyarteritis nodosa

Answer

Behcet's disease

Answer

Kawasaki disease

Question 3

A muscle biopsy in Polyarteritis Nodosa (PAN) shows which of the following findings?

Accepted Answer

Necrotizing arteritis

Answer

Atrophy

Answer

Granulomatous lesions

Answer

Ring lesions

Question 4

An experiment studies early atheroma development. Lipid streaks on arterial walls are examined microscopically and biochemically to determine their cellular and chemical constituents and the factors promoting their formation. Early lesions show increased attachment of monocytes to the endothelium. The monocytes migrate subendothelially and become macrophages; these macrophages transform themselves into foam cells. Which of the following substances is most likely to be responsible for the transformation of macrophages into foam cells?

Accepted Answer

Oxidized LDL

Answer

C-reactive protein

Answer

Homocysteine

Answer

Lp(a)

Question 5

A cleft-like space within an atheromatous plaque typically contains which of the following?

Accepted Answer

Cholesterol crystals

Answer

Smooth muscle cells

Answer

Fibrous tissue

Answer

None of these

Question 6

Which of the following is a predisposing factor for arterial thrombosis?

Accepted Answer

Homocysteinemia

Answer

Antithrombin III deficiency

Answer

Protein S deficiency

Answer

Protein C deficiency

Question 7

Polyarteritis nodosa does not involve which of the following arteries?

Accepted Answer

Pulmonary artery

Answer

Bronchial artery

Answer

Renal artery

Answer

Cerebral artery

Question 8

Kasabach-Merritt syndrome is associated with which of the following?

Accepted Answer

Giant hemangioma

Answer

Large aneurysm of the aorta

Answer

Giant thrombocytes

Answer

Arteriovenous malformation

Question 9

Hyaline arteriolo-sclerosis can be associated with all of the following conditions except:

Accepted Answer

Malignant hypertension

Answer

Diabetes mellitus

Answer

Aging

Answer

Benign hypertension

Question 10

What is true about Epithelioid hemangioendothelioma?

Accepted Answer

It expresses Factor VIII antigen.

Answer

It is a rare vascular tumor of infants.

Answer

It is usually solitary.

Answer

Underlying cirrhosis is common.

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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