Acute Myocardial Infarction, Atherosclerosis

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Acute Myocardial Infarction, Atherosclerosis - Quiz

Acute myocardial infarction may sound like a very complex, unheard of condition to the layman, but it is actually the medical term for one of the most commonly known serious medical complications a person can suffer from; the heart attack. What can you tell us about it, as well as atherosclerosis?


Questions and Answers
  • 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?

    • A.

      Cardiac aneurysm

    • B.

      Hemopericardium

    • C.

      Atrial myxoma

    • D.

      Mural thrombus

    • E.

      Nutmeg liver

    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.

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  • 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?

    • A.

      Defects in the cell membrane

    • B.

      Clumping of nuclear chromatin

    • C.

      Swelling of the mitochondria

    • D.

      Autophagy by lysosomes

    • E.

      Detachment of ribososmes

    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.

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  • 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?

    • A.

      Ventricular rupture

    • B.

      Constrictive pericarditis

    • C.

      Increased ejection fraction

    • D.

      Severe mitral regurgitation

    • E.

      Ventricular dyskinesia

    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.

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  • 4. 

    The pathology seen in this heart is most likely associated with:

    • A.

      Viral Infection

    • B.

      Systemic Lupus Erythematosus

    • C.

      Tuberculosis

    • D.

      Acute myocardial infarction

    • E.

      Tumor invasion

    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

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  • 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?

    • A.

      24 – 72 hours

    • B.

      12 – 24 hours

    • C.

      < 12 hours

    • D.

      4 – 7 days

    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?

    • A.

      < 1 day

    • B.

      1 – 3 days

    • C.

      4 – 7 days

    • D.

      7 – 14 days

    • E.

      14 – 28 days

    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.

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  • 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?

    • A.

      Atherosclerosis

    • B.

      Cystic medial necrosis

    • C.

      Fibrinoid necrosis

    • D.

      Medial degeneration

    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.

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  • 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?

    • A.

      Focal coagulative necrosis of myocytes

    • B.

      Abundant cellular debris and neutrophil infiltration

    • C.

      Exuberant macrophage reaction with phagocytosis

    • D.

      Fibrosis and scar tissue

    • E.

      Fibroblast proliferation

    Correct Answer
    E. Fibroblast proliferation
  • 9. 

    The pathology associated with this heart is most likely:  (mark all that apply)

    • A.

      SLE

    • B.

      Acute mycocardial infarction

    • C.

      Rheumatic Fever

    • D.

      Tuberculosis

    • E.

      Tumor invasion

    • F.

      Viral infection

    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

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  • 10. 

    The pathology associated with this heart is most likely due to:

    • A.

      Familial Hyperlipidemia

    • B.

      Infection

    • C.

      Acute Myocardial infarction

    • D.

      Dialted cardiomyopathy

    • E.

      Cheeseburgeremia

    Correct Answer
    B. Infection
    Explanation
    Purulent (Suppurative) Pericarditis

    Thick yellow effusion (pus)
    Inflammatory exudate
    Caused by:
    Infection

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  • 11. 

    The pathology associated with this heart tissue is:

    • A.

      Lyme disease

    • B.

      Acute myocardial infarction

    • C.

      Myomatous tumor

    • D.

      Chagas

    • E.

      Rheumatic fever

    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"

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jul 14, 2012
    Quiz Created by
    Chachelly
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