Question 1

Ischaemia is deemed likely to have occurred under which one of the following clinical circumstances?
A)Atrophy of the kidney after longstanding renal artery stenosis
B)Calcification of a tuberculous granuloma
C)Gangrene of the lower extremity
D)Myocardial infarction
E)Pulmonary oedema

Accepted Answer

Damage to or dysfunction of tissue is termed ischaemia,which can be either reversible or irreversiblEIn the present case,longstanding obstruction of the renal artery has led to renal atrophy,which is potentially reversible if the stenosis is correcteD

Question 2

Which one of the following pathophysiologic problems arises from chest pain of cardiac origin arising in a patient with no blockage apparent in their coronary arteries,as documented by cardiac catheterisation (Prinzmetal's angina)?
A)Coronary artery atherosclerosis
B)Coronary artery vasospasm
C)Coronary artery thrombosis
D)Hypertension
E)Prolonged systemic shock or hypotension

Accepted Answer

Prinzmetal's angina is thought to be due to coronary artery vasospasm.

Question 3

A subendocardial infarction would most likely be caused by which one of the following pathophysiologic events?
A)Coronary artery atherosclerosis
B)Coronary artery vasospasm
C)Coronary artery thrombosis
D)Hypertension
E)Prolonged systemic shock or hypotension

Accepted Answer

Subendocardial MI requires profound heart failure or a systemic event such as shock or prolonged hypertension,wherein the subendocardial portion of the heart is not perfused by the blood within the ventriclEThe coronary arteries are not normally responsible for the perfusion of this area of the heart.

Question 4

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct? 
A)1-2 hours
B)4-24 hours
C)2-3 days
D)10 days
E)2 weeks 
F)1 year

Accepted Answer

After about 6 weeks,scars in the myocardium are more or less fully formeDIt is difficult to judge the exact age of a scar,but this is definitely older than 2 weeks.1 year is the best choicE

Question 5

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct? 
A)1-2 hours
B)4-24 hours
C)2-3 days
D)10 days
E)2 weeks 
F)1 year

Accepted Answer

While the photomicrograph shows the eosinophilia of dead myocardium,very few acute inflammatory cells are seen.Inflammatory cells are often not in evidence until between 4 and 24 hours.

Question 6

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following is a likely complication during this stage of myocardial infarction? 
A)Granuloma formation
B)Haemopericardium
C)Hypertrophic scar
D)Neoplastic transformation

Accepted Answer

Macrophages tend to predominate between 7 and 10 days.The heart is maximally soft at this point,and is at risk of rupture into the pericardial space (so-called cardiac tamponade or haemopericardium).

Question 7

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct? 
A)1-2 hours
B)4-24 hours
C)2-3 days
D)10 days
E)2 weeks 
F)1 year

Accepted Answer

Granulation tissue (G)has begun to appear,judging by the presence of fibroblasts,collagen fibres,and numerous small blood vessels.

Question 8

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct? 
A)1-2 hours
B)4-24 hours
C)2-3 days
D)10 days
E)2 weeks 
F)1 year

Accepted Answer

Acute inflammatory cells are now abundant at about 2-3 days.We are about to transition into a stage of macrophage predominance,wherein the dead neutrophils and myocytes will be phagocytoseD

Question 9

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct? 
A)1-2 hours
B)4-24 hours
C)2-3 days
D)10 days
E)2 weeks 
F)1 year

Accepted Answer

Macrophages tend to predominate between 7 and 10 days.The heart is maximally soft at this point,and is at risk of rupture into the pericardial space (cardiac tamponade).

Quiz 10: Infarction

Ischaemia is deemed likely to have occurred under which one of the following clinical circumstances?

Which one of the following pathophysiologic problems arises from chest pain of cardiac origin arising in a patient with no blockage apparent in their coronary arteries,as documented by cardiac catheterisation (Prinzmetal's angina) ?

A subendocardial infarction would most likely be caused by which one of the following pathophysiologic events?

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct?

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct?

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following is a likely complication during this stage of myocardial infarction?

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct?

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct?

In the accompanying high power photomicrograph of infarcted myocardium tissue,which one of the following estimates of the age of the infarct is most likely correct?