Question 1

A high power view of an arterial wall is shown in the accompanying photomicrograph.In the portion of the field labelled "C",which one of the following is responsible for the elongated,empty spaces seen?

A)Coagulative necrosis
B)Cholesterol crystals
C)Liquifactive necrosis
D)Technical error
E)Uric acid crystals

Accepted Answer

The foam cells seen are macrophages containing lipid in their cytoplasm.The organic solvents used in tissue processing dissolve lipid,in this instance leaving an empty space in the cytoplasm,making it look foamy.

Question 2

A high power view of an arterial wall is shown in the accompanying photomicrograph.In the portion of the field labelled "C",which one of the following is responsible for the elongated,empty spaces seen?

A)Coagulative necrosis
B)Cholesterol crystals
C)Liquifactive necrosis
D)Technical error
E)Uric acid crystals

Accepted Answer

The area labelled "T" is a thrombus.You can see pink fibres of fibrin,and masses of red and white blood cells,which are caught in the fibrin "net".The thrombus has occurred because of the rupture of the fibrofatty atherosclerotic plaque,which underlies it.The soft material in the core of the plaque contains thrombogenic substances.

Question 3

In the accompanying photomicrograph of a small artery,the abnormality labelled &#34;IP&#34; refers to which one of the following?  &#10;A)Iconographic proliferation&#10;B)Idiopathic protein&#10;C)Initial peninsula&#10;D)Intimal proliferation&#10;E)Ischemic portion

Accepted Answer

By comparison to the location of the internal elastic lamina (IEL),it is easy to judge that the area labelled "IP" is within the portion of the vessel known as the intimAThe intimal proliferation has created an eccentricity within the lumen,which may induce turbulence,and further injury of the endothelium,which may in turn signal further proliferation of intimal smooth muscle via the action of various cytokines.

Question 4

A high power view of an arterial wall is shown in the accompanying photomicrograph.In the portion of the field labelled "C",which one of the following is responsible for the elongated,empty spaces seen?

A)Coagulative necrosis
B)Cholesterol crystals
C)Liquifactive necrosis
D)Technical error
E)Uric acid crystals

Accepted Answer

The plaque largely consists of fibrous scar tissue,and is often called a fibrous plaquEThese plaques rarely rupture and are relatively "safe",in that they do not rupture and cause thrombosis.Large cross sectional areas of the vessels can be involved with fibrous plaques,however.

Question 5

The accompanying photomicrograph shows narrowing of an artery by an atheroma (A).Which one of the following would be the likely clinical symptom(s)if the artery in question were located in the lower extremities?

A)Muscle cramping
B)Claudication
C)Hemiplegia (paralysis of one leg)
D)Spasticity of the muscle
E)Tingling in the skin

Accepted Answer

Cramping and spasticity are essentially the same thing.Paralysis or hemiplegia generally requires injury to the spinal cord or motor cortex.Aching pain in the leg,particularly the calf,due to ischaemia or lack of blood flow is generally called claudication.If untreated,the artery will continue to narrow,and can cause gangrene of the distal extremity,necessitating amputation.

Question 6

A high power view of an arterial wall is shown in the accompanying photomicrograph.In the portion of the field labelled "C",which one of the following is responsible for the elongated,empty spaces seen?

A)Coagulative necrosis
B)Cholesterol crystals
C)Liquifactive necrosis
D)Technical error
E)Uric acid crystals

Accepted Answer

The empty spaces are a technical artifact,but not an error in processing.The organic solvents used in tissue processing dissolve lipid,in this instance cholesterol crystals with pointed ends,leaving an empty spacE

Question 7

The accompanying photomicrograph shows narrowing of an artery by an atheroma (A).Which one of the following would be the likely clinical symptom(s)if the artery in question were located in the lower extremities?

A)Muscle cramping
B)Claudication
C)Hemiplegia (paralysis of one leg)
D)Spasticity of the muscle
E)Tingling in the skin

Accepted Answer

Aching pain in the chest due to ischaemia or lack of blood flow to the myocardium is generally called angina pectoris.If untreated,the artery will continue to narrow,and can cause myocardial infarction,often with resultant ventricular fibrillation.Usually,symptoms do not occur until at least 70% of the vessel is occludeDTreatment is usually angioplasty with stenting.Coronary artery bypass is also commonly used,if angioplasty and stenting fails.

Question 8

A high power view of an arterial wall is shown in the accompanying photomicrograph.In the portion of the field labelled "C",which one of the following is responsible for the elongated,empty spaces seen?

A)Coagulative necrosis
B)Cholesterol crystals
C)Liquifactive necrosis
D)Technical error
E)Uric acid crystals

Accepted Answer

The plaque contains abundant cholesterol and lipid underneath its fibrous cap.These plaques can easily rupture and cause thrombosis via the release of thrombogenic material contained within the soft corE

Deck 8: Atherosclerosis