Acute Myocardial Infarction, Atherosclerosis
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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?
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Atherosclerosis
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Cystic medial necrosis
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Fibrinoid necrosis
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Medial degeneration
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.JPG "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?
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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?
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Defects in the cell membrane
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Clumping of nuclear chromatin
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Swelling of the mitochondria
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Autophagy by lysosomes
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Detachment of ribososmes
Correct Answer
A. Defects in the cell membraneExplanation
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.Rate this question:
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- 3.
The pathology seen in this heart is most likely associated with:
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Viral Infection
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Systemic Lupus Erythematosus
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Tuberculosis
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Acute myocardial infarction
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Tumor invasion
Correct Answer
A. Acute myocardial infarctionExplanation
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 syndromeRate this question:
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- 4.
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?
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< 1 day
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1 – 3 days
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4 – 7 days
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7 – 14 days
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14 – 28 days
Correct Answer
A. 4 – 7 daysExplanation
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.Rate this question:
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- 5.
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?
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Ventricular rupture
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Constrictive pericarditis
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Increased ejection fraction
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Severe mitral regurgitation
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Ventricular dyskinesia
Correct Answer
A. Ventricular dyskinesiaExplanation
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.Rate this question:
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- 6.
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?
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24 – 72 hours
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12 – 24 hours
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< 12 hours
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4 – 7 days
Correct Answer
A. 24 – 72 hours -
- 7.
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?
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Cardiac aneurysm
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Hemopericardium
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Atrial myxoma
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Mural thrombus
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Nutmeg liver
Correct Answer
A. HemopericardiumExplanation
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.Rate this question:
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- 8.
The pathology associated with this heart is most likely due to:
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Familial Hyperlipidemia
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Infection
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Acute Myocardial infarction
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Dialted cardiomyopathy
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Cheeseburgeremia
Correct Answer
A. InfectionExplanation
Purulent (Suppurative) Pericarditis
Thick yellow effusion (pus)
Inflammatory exudate
Caused by:
InfectionRate this question:
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- 9.
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?
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Focal coagulative necrosis of myocytes
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Abundant cellular debris and neutrophil infiltration
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Exuberant macrophage reaction with phagocytosis
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Fibrosis and scar tissue
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Fibroblast proliferation
Correct Answer
A. Fibroblast proliferation -
- 10.
The pathology associated with this heart tissue is:
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Lyme disease
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Acute myocardial infarction
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Myomatous tumor
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Chagas
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Rheumatic fever
Correct Answer
A. ChagasExplanation
Eosinophilic Myocarditis
Drug reaction (hypersensitivity)
antibiotics, chemotherapeutics
typically have a rash or other immune response
Chagas disease (protozoal infection)
Trypanosoma cruzi
"Kissing bug"Rate this question:
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- 11.
The pathology associated with this heart is most likely: (mark all that apply)
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SLE
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Acute mycocardial infarction
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Rheumatic Fever
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Tuberculosis
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Tumor invasion
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Viral infection
Correct Answer(s)
A. SLE
A. Rheumatic Fever
A. Viral infectionExplanation
Serous Pericarditis:
Straw-colored pericardial effusion
Protein rich exudate
Caused by:
SLE (lupus)
Rheumatic fever
Viral infectionRate this question:
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.JPG "The pathology seen in this heart is most likely associated with:")
.JPG "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?")
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Current Version
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Mar 22, 2023Quiz Edited by
ProProfs Editorial Team -
Jul 14, 2012Quiz Created by
Chachelly
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