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

A 78-year-old man presents with a 2-month history of fever and intermittent abdominal pain. He develops peritoneal signs and at laparotomy is found to have an area of infarcted bowel. Biopsy shows inflammation of small-to medium-sized muscular arteries. What is the most likely diagnosis?

Accepted Answer

Polyarteritis nodosa

Answer

Churg-Strauss syndrome

Answer

Cryoglobulinemic vasculitis

Answer

Temporal arteritis

Question 2

Which of the following conditions is considered abdominal arteritis?

Accepted Answer

Takayasu arteritis

Answer

Giant cell arteritis

Answer

Kawasaki disease

Answer

Polyarteritis nodosa

Question 3

Microscopic polyangiitis is characterized by the following features EXCEPT?

Accepted Answer

Unlikely to cause pulmonary renal syndrome

Answer

Involves small and medium sized arteries and veins

Answer

75% cases are associated with ANCA positivity

Answer

Palpable purpura, ulcers and vesiculo bullous lesions

Question 4

Which of the following is the characteristic pathologic feature of malignant hypertension?

Accepted Answer

Fibrinoid necrosis

Answer

Hyaline arteriosclerosis

Answer

Medial wall hyperplasia

Answer

Micro-aneurysm

Question 5

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 6

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 7

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 8

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 9

What is the most common site for venous thrombosis?

Accepted Answer

Soleal vein

Answer

Popliteal vein

Answer

Femoral vein

Answer

Internal iliac vein

Question 10

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.

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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