Vascular Pathology Practice Questions

Q: Physical examination that finds multiple palpable purpuric lesions on the legs of a 7-year-old boy is most suggestive of what condition?

Hemorrhage secondary to hypersensitivity vasculitis. **Explanation:** The clinical presentation of **palpable purpura** in a child, particularly localized to the lower extremities, is the hallmark of **Henoch-Schönlein Purpura (HSP)**, the most common form of **hypersensitivity vasculitis** in children. 1. **Why Option B is Correct:** Palpable purpura occurs when there is inflammation of small blood vessels (vasculitis), leading to vessel wall damage and the leakage of red blood cells into the dermis (**hemorrhage**). Unlike flat petechiae, these lesions are palpable because the inflammatory process causes localized edema and cellular infiltration. In HSP, this is typically an IgA-mediated immune complex deposition in the vessel walls. 2. **Why Incorrect Options are Wrong:** * **Option A:** Excess corticosteroids typically cause skin thinning, easy bruising (ecchymosis), and striae due to collagen breakdown, but not inflammatory palpable purpura. * **Option C:** Erythema from active hyperemia (increased blood flow) blanches under pressure (diascopy). Purpura does not blanch because the blood is extravasated outside the vessels. * **Option D:** Telangiectasias are permanent dilatations of pre-existing small blood vessels. They are blanchable, non-palpable, and do not represent acute hemorrhage. **NEET-PG High-Yield Pearls:** * **HSP Tetrad:** Palpable purpura (without thrombocytopenia), arthritis/arthralgia, abdominal pain (intussusception risk), and renal involvement (IgA nephropathy). * **Diagnosis:** Primarily clinical. If a biopsy is done, it shows **leukocytoclastic vasculitis** with IgA deposition on immunofluorescence. * **Platelet Count:** Crucially, the platelet count in HSP is **normal**; this distinguishes it from Immune Thrombocytopenic Purpura (ITP), where purpura is non-palpable and platelets are low.

Question 1

Physical examination that finds multiple palpable purpuric lesions on the legs of a 7-year-old boy is most suggestive of what condition?

Accepted Answer

Hemorrhage secondary to hypersensitivity vasculitis

Answer

Bleeding secondary to excess corticosteroids

Answer

Erythema secondary to active hyperemia

Answer

Telangiectasia secondary to a congenital malformation

Question 2

Saddle embolus causes sudden death by blocking which arteries?

Accepted Answer

Pulmonary arteries

Answer

Coronary arteries

Answer

Cerebral arteries

Answer

Renal arteries

Question 3

A 45-year-old man presents with a 9-month history of a reddish nodule on his foot. Biopsy of the nodule discloses a poorly demarcated lesion composed of fibroblasts and endothelial-like cells lining vascular spaces. Further work-up identifies similar lesions in the lymph nodes and liver. The tumor cells contain sequences of human herpesvirus-8 (HHV-8). This patient most likely has which of the following conditions?

Accepted Answer

Acquired immunodeficiency syndrome

Answer

Ataxia telangiectasia

Answer

Li-Fraumeni syndrome

Answer

Neurofibromatosis type I

Question 4

What are the most common vessels involved in cutaneous vasculitis?

Accepted Answer

Post-capillary venules

Answer

Arteries

Answer

Arterioles

Answer

Capillaries

Question 5

Which of the following is the least common site of atherosclerotic lesions?

Accepted Answer

Pulmonary arterial trunk

Answer

Aortic bifurcation

Answer

Common carotid artery

Answer

Middle cerebral artery

Question 6

Foam cells are seen in which of the following conditions?

Accepted Answer

Atherosclerosis

Answer

Alport syndrome

Answer

Niemann-Pick disease

Answer

Pneumonia

Question 7

In malignant hypertension, hyperplastic arteriosclerosis is seen in all of the following except?

Accepted Answer

Heart

Answer

Kidney

Answer

Pericardial fat

Answer

Peripancreatic fat

Question 8

Which of the following blood vessels is affected in hypersensitivity vasculitis?

Accepted Answer

Postcapillary venules

Answer

Capillaries

Answer

Arterioles

Answer

Medium sized vessels

Question 9

A patient presents with respiratory symptoms including cough and hemoptysis, along with glomerulonephritis. Serum c-ANCA levels are found to be elevated. What is the most likely diagnosis?

Accepted Answer

Wegener’s granulomatosis

Answer

Goodpasture’s syndrome

Answer

Classic polyarteritis nodosa

Answer

Kawasaki’s syndrome

Question 10

Dissecting hematoma is a clinical complication occurring in which of the following conditions?

Accepted Answer

Marfan syndrome

Answer

Turner's syndrome

Answer

Klinefelter's syndrome

Answer

Down syndrome

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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