1.
A 45-year-old man had a myocardial infarction (MI) 4 days ago and is recovering in the cardiac intensive care unit. Which complication is he MOST AT RISK for developing at this time?
Correct Answer
B. Hemopericardium
Explanation
Hemopericardium refers to blood in the pericardial sac of the heart. It is clinically similar to a pericardial effusion, and, depending on the volume and rapidity with which it develops, may cause cardiac tamponade.
The condition can be caused by full-thickness necrosis (death) of the myocardium (heart muscle) after myocardial infarction, as well as trauma, and in patients receiving anticoagulants. Other causes include ruptured aneurysm of sinus of Valsalva and other aneurysms of the aortic arch.
2.
A 58 year old female experienced the onset of severe chest pain. An EKG demonstrated changes consistent with an acute myocardial infarction. There was significant elevation of CK-MB, LDH enzymes and Troponin I, in serum. The increase in serum enzyme levels in the serum results from which of the following changes in the myocardial fibers?
Correct Answer
A. Defects in the cell membrane
Explanation
Irreversible cell injury is associated with loss of membrane integrity. This allows intracellular enzymes to leak into theserum.
All other morphologic changes listed are associated with reversible cell injury, in which the cell membrane remains intact.
3.
A 65-year-old male recovers from an anterior MI with no complications. An echocardiogram is obtained prior to discharge. What problem is the test is most likely to show?
Correct Answer
E. Ventricular dyskinesia
Explanation
An echocardiogram is a test that uses sound waves to create images of the heart. It is commonly used to evaluate the structure and function of the heart. In this case, the 65-year-old male has recovered from an anterior myocardial infarction (MI) with no complications. Ventricular dyskinesia refers to abnormal movement of the ventricular wall during contraction. It can occur after a myocardial infarction and is characterized by areas of the ventricular wall that do not move normally. Therefore, an echocardiogram is most likely to show ventricular dyskinesia in this patient.
4.
The pathology seen in this heart is most likely associated with:
Correct Answer
D. Acute myocardial infarction
Explanation
Notice the fibrinous material sticking to pericardium
Fibrinous Pericarditis:
"Sticky" adherent fibrin strands on surface
Fibrin rich exudate
Caused by:
*Acute myocardial infarction
Uremia (uremic pericarditis) - renal failure
**Post-pericardotomy syndrome -> after coronary artery bypass graft surgery
*Dressler's syndrome
5.
Postmortem examination of a patient who died of a confirmed acute myocardial infarction reveals the cardiac changes shown in the image below. What is the most likely “age” of myocardial infarction in this patient?
Correct Answer
A. 24 – 72 hours
6.
A 67-year-old Hispanic male is found dead in his house. Autopsy reveals hemopericardium due to ventricular wall rupture. How long before his death did the man probably have a myocardial infarction?
Correct Answer
C. 4 – 7 days
Explanation
The presence of hemopericardium due to ventricular wall rupture suggests that the individual likely experienced a myocardial infarction (heart attack) before his death. It takes approximately 4-7 days for a ventricular wall rupture to occur following a myocardial infarction. Therefore, the man probably had a myocardial infarction 4-7 days before his death.
7.
A 55-year-old Hispanic male presents with lower back pain. Physical examination reveals an obese man with BP of 160/110 mm Hg; he has moderately limited range of motion of the back. Arteriography of the patient’s abdominal aorta is shown for your evaluation below. Which of the following is the most likely underlying cause for aortic dilation in the patient?
Correct Answer
A. Atherosclerosis
Explanation
The most likely underlying cause for aortic dilation in this patient is atherosclerosis. Atherosclerosis is a condition characterized by the buildup of plaque in the arteries, leading to narrowing and stiffening of the vessel walls. In this case, the patient's obesity and hypertension are risk factors for the development of atherosclerosis. The arteriography of the patient's abdominal aorta would likely show the presence of plaques or blockages, which could lead to dilation of the aorta. Cystic medial necrosis, fibrinoid necrosis, and medial degeneration are not typically associated with aortic dilation caused by atherosclerosis.
8.
A 56 year old man suffered a myocardial infarction 7 days ago and is recovering in the intensive care unit. If he were to die suddenly at this time, what are the principle microscopic changes you would expect to see in his heart tissue?
Correct Answer
E. Fibroblast proliferation
9.
The pathology associated with this heart is most likely: (mark all that apply)
Correct Answer(s)
A. SLE
C. Rheumatic Fever
F. Viral infection
Explanation
Serous Pericarditis:
Straw-colored pericardial effusion
Protein rich exudate
Caused by:
SLE (lupus)
Rheumatic fever
Viral infection
10.
The pathology associated with this heart is most likely due to:
Correct Answer
B. Infection
Explanation
Purulent (Suppurative) Pericarditis
Thick yellow effusion (pus)
Inflammatory exudate
Caused by:
Infection
11.
The pathology associated with this heart tissue is:
Correct Answer
D. Chagas
Explanation
Eosinophilic Myocarditis
Drug reaction (hypersensitivity)
antibiotics, chemotherapeutics
typically have a rash or other immune response
Chagas disease (protozoal infection)
Trypanosoma cruzi
"Kissing bug"