Cardiovascular & Respiratory Pathology

Topics in this chapter

• Ischemic Heart Disease
• Valvular and Infective Heart Disease
• Cardiomyopathies and Complications
• Pulmonary Vascular Disorders
• COPD and Cor Pulmonale
• Interstitial Lung Disease
• Lung Cancer and Histology

Practice questions

1. Question 1Q-8804F7

   A 55-year-old male with a history of anterior wall myocardial infarction 3 days ago develops sudden, severe chest pain, profound hypotension, and a disappearance of carotid pulses despite continuing electrical activity on the cardiac monitor. Which of the following is the most likely underlying structural complication?

   1. A.Ventricular septal rupture
   2. B.Free wall myocardial rupture with cardiac tamponade
   3. C.Papillary muscle rupture with acute mitral regurgitation
   4. D.Left ventricular pseudoaneurysm formation
   See the answer and solution
2. Question 2Q-99B6EE

   A 65-year-old smoker presents with chronic cough, dyspnea, and barrel-shaped chest. Histological examination of his lung parenchyma reveals diffuse enlargement of airspaces distal to the terminal bronchioles accompanied by destruction of alveolar walls without significant fibrosis. Which protease-antiprotease imbalance mechanism is primarily responsible for this pattern of emphysema?

   1. A.Excess elastase activity due to macrophage and neutrophil recruitment
   2. B.Deficiency of tissue inhibitor of metalloproteinases
   3. C.Excess angiotensin-converting enzyme activity
   4. D.Hyperactivation of bronchial mucosal goblet cell secretion
   See the answer and solution
3. Question 3Q-491D55

   A 28-year-old pregnant woman in her third trimester presents with acute onset shortness of breath and pleuritic chest pain. She undergoes a ventilation-perfusion scan and CT pulmonary angiography, which confirms a massive pulmonary embolism. Which of the following hemodynamic and structural consequences is most characteristic of acute massive pulmonary embolism?

   1. A.Left ventricular pressure overload and eccentric hypertrophy
   2. B.Right ventricular pressure overload and acute cor pulmonale
   3. C.Left atrial volume overload and concentric hypertrophy
   4. D.Decreased pulmonary vascular resistance with increased cardiac output
   See the answer and solution
4. Question 4Q-67A5DB

   A 45-year-old male with a history of untreated streptococcal pharyngitis several weeks ago presents with migratory polyarthritis, subcutaneous nodules, and a new-summit systolic murmur. Endocardial biopsy demonstrates characteristic focal inflammatory lesions consisting of a zone of fibrinoid necrosis surrounded by lymphocytes, plasma cells, and plump macrophages with abundant basophilic cytoplasm. What is the classic name for these macrophages?

   1. A.Langhans giant cells
   2. B.Aschoff cells
   3. C.Schaumann bodies
   4. D.Anitschkow cells
   See the answer and solution
5. Question 5Q-EFDF0D

   A 60-year-old chronic smoker presents with a centrally located right lung mass. Biopsy reveals nests of malignant epithelial cells showing intercellular bridges and keratinization, along with areas of keratin pearls. Which of the following is the most likely diagnosis?

   1. A.Small cell carcinoma
   2. B.Adenocarcinoma
   3. C.Squamous cell carcinoma
   4. D.Large cell carcinoma
   See the answer and solution