Cardiovascular MCQs for USMLE 2026 | 49+ Questions

Q: A 14-year-old Caucasian female with a family history of familial hypercholesterolemia commits suicide by drug overdose. Her family decides to donate her organs, and her heart is removed for donation. After removing the heart, the cardiothoracic surgeon notices flat yellow spots on the inside of her aorta. Which of the following cell types predominate in these yellow spots?

Macrophages. ***Correct: Macrophages*** - The "flat yellow spots" on the aorta in a familial hypercholesterolemia patient are characteristic of **fatty streaks**, the earliest lesions of atherosclerosis. - These fatty streaks are primarily composed of **lipid-laden macrophages**, also known as **foam cells**, which have ingested oxidized low-density lipoprotein (LDL). - In familial hypercholesterolemia, elevated LDL levels accelerate the formation of these macrophage-rich lesions even in young patients. *Incorrect: Fibroblasts* - While fibroblasts are involved in the later stages of **atherosclerotic plaque formation** by synthesizing collagen and forming a fibrous cap, they are not the predominant cell type in early fatty streaks. - Their presence signifies a more advanced, **fibrotic lesion**, not the initial yellow spots. *Incorrect: T-cells* - T-cells are involved in the inflammatory response in **atherosclerosis** and are found within plaques, but they are not the dominant cell type forming the bulk of the initial lipid accumulation in fatty streaks. - They contribute to the **immune-mediated aspects** of plaque progression. *Incorrect: Neutrophils* - Neutrophils are primarily involved in **acute inflammation** and bacterial infections. - They are generally not a prominent cell type in either early or advanced **atherosclerotic lesions** under normal circumstances. *Incorrect: Endothelium* - Endothelial cells line the lumen of blood vessels and are crucial in the **initiation of atherosclerosis** by becoming dysfunctional and allowing LDL entry. - However, they do not constitute the "yellow spots" themselves, which are subendothelial accumulations of lipids and immune cells.

A 14-year-old Caucasian female with a family history of familial hypercholesterolemia commits suicide by drug overdose. Her family decides to donate her organs, and her heart is removed for donation. After removing the heart, the cardiothoracic surgeon notices flat yellow spots on the inside of her aorta. Which of the following cell types predominate in these yellow spots?

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Cardiovascular — MCQs

Cardiovascular — MCQs

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