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

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.

Question 2

Thromboangiitis obliterans (Buerger's disease) is associated with which of the following HLA types?

Accepted Answer

HLA - B5

Answer

HLA - DR4

Answer

HLA - DR2

Answer

HLA - B27

Question 3

Which of the following is NOT true about Churg-Strauss syndrome?

Accepted Answer

Intravascular granulomas

Answer

Asthma

Answer

Multisystem involvement of vessels

Answer

Peripheral eosinophilia

Question 4

All of the following are small vessel vasculitis, except?

Accepted Answer

Polyarteritis nodosa

Answer

Wegener's granulomatosis

Answer

Microscopic polyangiitis

Answer

Henoch-Schonlein purpura

Question 5

Which of the following statements is false regarding polyarteritis nodosa?

Accepted Answer

Bronchial arteries are most commonly involved

Answer

Associated with hairy cell leukemia

Answer

ANCA negative

Answer

Granulomas are not seen

Question 6

A 27-year-old man with AIDS develops a reddish, slightly raised rash on his face, neck, and mouth, consistent in appearance with Kaposi's sarcoma. Microscopically, the proliferating cells in this malignancy most closely resemble which of the following?

Accepted Answer

Angiosarcoma

Answer

Carcinosarcoma

Answer

Lymphoma

Answer

Malignant fibrous histiocytoma

Question 7

Which of the following shows a pumping action?

Accepted Answer

Central hemangioma

Answer

Peripheral hemangioma

Answer

Central giant cell granuloma

Answer

All of the above

Question 8

Which vasculitis is not commonly seen in adults?

Accepted Answer

Kawasaki disease

Answer

Henoch-Schonlein purpura

Answer

Temporal arteritis

Answer

Polyarteritis nodosa

Question 9

What is the most important modifiable risk factor for atherosclerosis?

Accepted Answer

Cigarette Smoking

Answer

Hyperlipidemia

Answer

Diabetes mellitus

Answer

Hypertension

Question 10

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

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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