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PA ASPECT OF IHD 2021

Total questions: 15

Worksheet time: 8mins

Name
Class
Date
1.

The EXTRINSIC FACTOR below contributes to acute plaque changes, EXCEPT...

a)

Blood pressure

b)

Plaque structure and composition

c)

Platelet reactivity

d)

Vessel spasm

2.

The statement below is the characteristic of STABLE PLAQUE, except...

a)

Large lipid core

b)

Thick fibrous cap

c)

Minimal Inflammation

d)

Densely collagenous fibrous cap

3.

A 60-year-old man experiences episodes of severe substernal chest pain every time he performs a task that requires moderate exercise. The episodes have become more frequent and severe over the past year, but they can be relieved by sublingual nitroglycerin. On physical examination, he is afebrile, his pulse is 78/min and regular, and there are no murmurs

or gallops. Which of the following cardiac lesions is most likely to be present?

a)

Rheumatic mitral stenosis

b)

Serous pericarditis

c)

Restrictive cardiomyopathy

d)

Coronary atherosclerosis

4.

The statement below are constitutional Risk Factor, EXCEPT...

a)

Genetic

b)

Gender

c)

Age

d)

Hyperlipidemia

5.

The cornerstone of the atherogenesis pathway is...

a)

Endothelial dysfunction

b)

Inflammation

c)

Hyperlipidemia

d)

Macrophage activation

6.

The statement below is TRUE about fatty streak, EXCEPT...

a)

It is flat macules that coalesce into elongated lesions, 1 cm or more in length

b)

It composed of lipid-filled foamy macrophages

c)

It can cause a significant flow disturbance.

d)

Not all fatty streaks are destined to progress to atherosclerotic plaques

7.

Atherosclerotic plaques have three principal components: One of them called ECM (Extracellular matrix), It consist of...

a)

Collagen

b)

Proteoglycan

c)

Elastic fibers

d)

All above

8.

PLAQUES TEND TO OCCUR AT OSTIA OF EXITING VESSELS

DUE TO...

a)

Vessel size

b)

Plaque volume

c)

Turbulent blood flow

d)

Vessel location

9.

The ECG usually shows NSTEMI pattern which cause by...

a)

Transmural infarct

b)

Subendocardial infarct

c)

Microinfarct

d)

none above

10.

Microscopic changes above reveal removal of necrotic myocytes by phagocytic macrophages will appear at infarct day...

a)

1-2

b)

3-4

c)

6-7

d)

7-10

11.

The most common causes of Ischemic Heart Disease is....

a)

Myocardial inflammation

b)

Coronary emboli

c)

Coronary atherosclerosis

d)

Hypoxemia

12.

a fixed stenosis that occludes 90% or

more of a vascular lumen can lead to inadequate coronary

blood flow with symptoms even at rest, clinically called...

a)

stable angina

b)

unstable angina

c)

acute coronary syndrome

d)

coronary artery disease

13.

The principal pathophysiologic outcome stemming from atherosclerotic lesions vary depending on the...EXCEPT

a)

Size of the affected vessel

b)

Size and stability of the plaques

c)

Degree to which plaques disrupt the vessel wall.

d)

Rigidity of affected vessel

14.

coagulation necrosis with loss of nuclei and striations of muscle cells with brisk neutrofil infiltrate were microscopic chages due to myocardial infarct day...

a)

1-3

b)

3-7

c)

7-10

d)

10-14

15.

Irreversible injury of ischemic myocytes first occurs in

the subendocardial zone due to...

a)

it

is the last area to receive blood

b)

it is exposed to relatively high

intramural pressures,

c)

Distal occlusion of the

same vessel may affect only the apex

d)

The subendocardial region is most vulnerable to

hypoperfusion and hypoxia