Deck 11: Cardiovascular System

Question 1

A 15 year old girl developed fever,aching joints,and a heart murmur.Her past medical history was negative,except for a "Strep throat" approximately 6 weeks prior,for which she did not seek treatment.An endomyocardial biopsy was performed,via the external jugular vein,a representative section of which is shown in the accompanying photomicrograph.Which one of the following best describes the pathology seen in the biopsy?

A)Acute inflammation
B)Aschoff nodule
C)Chronic inflammation
D)Rheumatoid nodule
E)Rheumatic fever

Answer 1

Aschoff nodule

Question 2

A 67 year old man,with a known history of inoperable pancreatic adenocarcinoma,suddenly developed symptoms of a massive stroke,losing the ability to walk.He subsequently died from cerebral oedema,and the family requested an autopsy.In the accompanying low power photomicrograph of a mitral valve leaflet (L),the thrombus (T)attached to the leaflet was probably caused by which one of the following pathophysiologic conditions?

A)Anaemia
B)Biliary obstruction by tumour
C)Diabetes mellitus
D)Fever
E)Hypercoagulable state A.Shock

Answer 2

Hypercoagulable state A.Shock

Question 3

The low power photomicrograph of the aorta demonstrates a pathologic condition that is usually related to which one of the following disorders?

A)Diabetes
B)Fever
C)Hypertension
D)Shock

Answer 3

Hypertension

Question 4

In this high power photomicrograph of a renal arteriole from a diabetic patient,the area of the image labelled "H" depicts which one of the following pathologic processes?

A)Atrophy
B)Hyaline change
C)Infarction of the vessel wall
D)Thrombosis

Question 5

A 24 year old woman,who was otherwise in excellent health,presented at the Emergency Department complaining of abdominal pain.Her past medical history was notable only for oral contraceptives.A peritoneal tap disclosed gross blood so emergency open laparotomy (abdominal exploration)was performed.A bleeding mass in the liver (L)was found,resected,and good haemostasis was obtained.The patient recovered without further incident.A representative section of the resected mass is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Angiosarcoma
B)Giant cell arteritis
C)Glomus tumour
D)Haemangioma
E)Kaposi's sarcoma
F)Leukocytoclastic vasculitis (microscopic polyarteritis)
G)Polyarteritis nodosa

Question 6

This high power photomicrograph of a medium sized artery in a patient with severe hypertension depicts a serious condition that is known by which one of the following words or phrases?

A)Glomerulosclerosis
B)Hyaline arteriolosclerosis
C)Intimal proliferation
D)Malignant hypertension

Question 7

A 30 year old male homosexual,who was HIV-positive,presented to his primary care physician complaining of a rash on his arm.He had not been taking his anti-retroviral drugs,due to the side effects.Numerous,slightly raised,purple lesions were noted on the patient's forearm by the examining physician.A biopsy of one of the nodules was performed.A representative section of the biopsy is shown in the accompanying photomicrograph.Which one of the following is the most likely diagnosis?

A)Angiosarcoma
B)Giant cell arteritis
C)Glomus tumour
D)Haemangioma
E)Kaposi's sarcoma
F)Leukocytoclastic vasculitis (microscopic polyarteritis)
G)Polyarteritis nodosa

Question 8

A 38 year old female was seen for "fever of unknown origin" (FUO).In addition to fever,she was experiencing abdominal pain.Finally,it was decided that an appendicectomy was required,as her pain seemed to favour the right lower quadrant.The appendix was essentially normal microscopically,but a small artery in the fat surrounding the appendix demonstrated the findings seen in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Acute appendicitis
B)Acute inflammation
C)Chronic inflammation
D)Polyarteritis nodosa

Question 9

In this medium power photomicrograph of a medium artery in a patient with systemic hypertension,the area of the image labelled "In" depicts which one of the following pathologic processes?

A)Intimal necrosis
B)Intimal proliferation
C)Thrombosis
D)Organisation
E)Recanalisation

Question 10

This high power photomicrograph of a renal arteriole in a patient with severe hypertension depicts a serious condition that is known by which one of the following words or phrases?

A)Atrophy
B)Fibrinoid necrosis
C)Hyaline arteriolosclerosis
D)Renal infarction

Question 11

A 54 year old man presented to his primary care physician complaining of headache.A tortuous artery,which was indurated and tender to touch,was noted on his forehead.A representative section of a biopsy of this artery is shown in the accompanying photomicrograph,in low and high power.Which one of the following is the best diagnosis?

A)Atherosclerosis
B)Giant cell arteritis
C)Polyarteritis nodosa
D)Thromboembolism
E)Tuberculosis

Question 12

A 16 year old female was given penicillin for an apparent "Strep throat".She soon developed a reddish-appearing skin rash,which was firm when palpated.A biopsy was performed.A representative section of the biopsy is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Angiosarcoma
B)Giant cell arteritis
C)Glomus tumour
D)Haemangioma
E)Kaposi's sarcoma
F)Leukocytoclastic vasculitis (microscopic polyarteritis)
G)Polyarteritis nodosa