PATHOLOGY MCQs
BLOOD VESSELS
1) The primary anatomic site of pressure regulation in the vascular system is:
A. aorta
B. arteries
C. arterioles
D. capillaries
E. heart
2) Which of the following characteristics best describes essential hypertension?
A. can be caused by adrenal tumors
B. is commonly seen with aortic coarctation and pheochromocytoma
C. causes arteriolar changes in the kidneys
D. may lead to diabetes
3) Complications of chronic hypertension include each of the following except:
A. left ventricular hypertrophy
B. congestive heart failure
C. renal failure
D. diabetes mellitus
E. brain hemorrhage
4) Causes of secondary hypertension include all of the following except:
A. renal artery stenosis
B. adrenal cortical carcinoma
C. chronic pyelonephritis
D. lipoid nephrosis (“nil” disease)
5) Recognized complications of severe hypertension include all of the following except:
A. renal failure
B. retinal hemorrhages with loss of vision
C. dissecting aortic aneurysm
D. diabetes mellitus
E. acceleration of atherosclerosis
6) Causes of secondary hypertension include all of the following except:
A. chronic renal disease
B. aortic valvular stenosis
C. neoplasms or hyperplasias of the adrenal cortex
D. pheochromocytoma
E. coarctation of the aorta
7) Renal causes of secondary hypertension include which of the following:
A. narrowing of the renal artery
B. acute glomerulonephritis
C. polycystic kidneys
D. chronic glomerulonephritis
E. all of the above
8) Secondary hypertension may be associated with all of the following except:
A. narrowing of the renal artery
B. adrenal adenoma
C. uremia
D. brain stem lesions
E. pheochromocytoma
9) Which is usually associated with thromboangiitis obliterans?
A. high fat diet
B. purines
C. smoking
D. alcohol
E. post menopausal women
10) Patchy destruction of elastic tissue in the aortic media associated with obliterative
endarteritis of vaso vasorum is characteristic of:
A. Marfan’s syndrome
B. giant cell arteritis
C. syphilitic aortitis
D. polyarteritis nodosa
E. Monckeberg’s sclerosis
11) Which is predominantly a disease of vessels of the lower extremities with an
inflammatory component and nerve involvement?
A. dermatomyositis
B. Takayasu’s
C. thromboangiitis obliterans
D. systemic lupus erythematosus
12) Tobacco smoking is important in the pathogenesis of:
A. polyarteritis nodosa
B. Wegener’s granulomatosis
C. Raynaud’s disease
D. Takayasu’s arteritis
E. Buerger’s disease
13) All of the following are true of thromboangiitis obliterans (Buerger’s disease) except:
A. is often associated with severe pain
B. may lead to gangrene of the extremities
C. characteristically and predominantly occurs in females
D. is aggravated by smoking
14) A characteristic of polyarteritis nodosa is:
A. a “butterfly”-shaped rash over the face
B. greatly thickened skin and sloughing of the epidermis
C. severe anemia
D. necrotizing arteritis
E. jaundice
15) Drugs may be a cause of:
A. polyarteritis nodosa
B. systemic lupus erythematosus
C. both
D. neither
16) A 27-year-old woman at a snowy football game developed marked pallor, tingling and
burning of her nose and fingertips. She most likely had:
A. thromboangiitis obliterans
B. Takayasu’s syndrome
C. arteriosclerosis obliterans
D. Raynaud’s disease or syndrome
E. arteriolar sclerosis
17) A 60-year-old male had a 3-month history of severe throbbing pain and tenderness
over the temple. He now presents with blindness. The most likely diagnosis is:
A. Raynaud’s disease
B. syphilitic arteritis
C. thromboangiitis obliterans
D. rheumatoid arteritis
E. giant cell arteritis
18) At autopsy a 23-year-old woman has atypical verrucous endocarditis, hematoxylin
bodies, and fibrinoid deposits in blood vessels, endocardium, serous membranes and
other sites, and glomerulonephritis. She had:
A. eclampsia
B. polyarteritis nodosa
C. progressive systemic sclerosis
D. systemic lupus erythematosus
E. Wegener’s granulomatosis
19) The most common cause of aortic aneurysms is:
A. syphilis
B. congenital weakness of the aortic wall
C. atherosclerosis
D. occlusion of the vasa vasorum
E. bacterial arteritis
20) Syphilitic aortitis is commonly associated with all of the following except:
A. aortic valvular insufficiency
B. difficulty in swallowing
C. endarteritis of vasa vasorum
D. right ventricular hypertrophy
21) Which one of the following is most often the cause of death in cases of dissecting
aneurysms?
A. hemopericardium
B. congestive heart failure
C. myocardial infarction
D. aortic stenosis
22) A 72-year-old male presents with lower abdominal and left flank pain of one week’s
duration. Physical exam reveals a pulsatile mass in the mid-abdomen. An x-ray of the
abdomen reveals obliteration of the left psoas muscle shadow. Each of the following are
likely to be correct except:
A. He has an atherosclerotic aneurysm of the abdominal aorta.
B. He has a luetic aneurysm of the abdominal aorta.
C. The aneurysm is leaking.
D. He needs an immediate operation.
E. His prognosis is poor.
23) The most common cause of abdominal aortic aneurysms is:
A. trauma
B. atherosclerosis
C. syphilis
D. hypertension
E. cystic medial necrosis
24) Aneurysms of the arch of the aorta are most characteristically caused by
A. atherosclerosis
B. tuberculosis
C. syphilis
D. congenital defects
E. fungi
25) Aneurysms associated with generalized atherosclerosis are found most often in the:
A. circle of Willis
B. abdominal aorta
C. arch of the aorta
D. renal arteries
E. ascending aorta
26) Characteristics of berry aneurysms include each of the following except:
A. cause subarchnoid hemorrhage
B. lack a muscular wall
C. more often solitary than multiple
D. occur at bifurcation of internal and external carotid arteries
E. rare in childhood
27) Dissecting aneurysms of the aorta are most characteristically associated with:
A. cystic medial necrosis
B. fibrous dysplasia
C. cystic fibrosis
D. senile elastosis
28) Each of the following diseases is characteristically accompanied by atherosclerosis of
the aorta except:
A. Marfan’s syndrome
B. diabetes mellitus
C. hyperlipidemia
D. tertiary syphilis
E. hypertension
29) Factors operative in the morphogenesis of atherosclerotic plaque include all of the
following except:
A. endothelial injury with platelet aggregation
B. incorporation of mural thrombi into arterial intima
C. vascularization of the atheromatous plaque
D. perivascular inflammation
E. fatty accumulation in intimal cells
30) Which of the following does not appear to be a risk factor in the development and
complications of atherosclerosis?
A. maleness
B. diabetes mellitus
C. hypertension
D. alcoholism
E. cigarette smoking
31) Following injury produced by cutting the toe nail too short, a 70-year-old diabetic
woman developed infection that progressed to gangrene of the left great toe. The most
likely vascular disease process is:
A. infectious arteritis
B. thrombophlebitis
C. arteriosclerosis
D. phlebosclerosis
E. thromboangitis obliterans
32) Thrombophlebitis is associated with:
A. atherosclerosis
B. pulmonary emboli
C. both
D. neither
33) The major cause of pulmonary thromboemboli is:
A. hypertension
B. heart failure
C. atherosclerosis
D. thrombophlebitis
E. varicose veins
34) A benign tumor of vascular smooth muscle origin which usually occurs beneath the nail
bed and which may be painful is the:
A. glomus tumor
B. hemangioblastoma
C. hemangioma
D. hemangiopericytoma
E. lymphangioma
35) A painful neoplasm which most frequently occurs in the fingers is:
A. hemangioma
B. lymphangioma
C. hemangiopericytoma
D. glomangioma
E. hemangioendothelioma
36) A benign vascular tumor arising in the liver is most likely to be a:
A. hemangioma
B. lymphangioma
C. pericytoma
D. glomangioma
E. granuloma pyogenicum
37) A patient has had since birth a single, large red-blue or “port-wine” discoloration of
skin on the face. The lesion is probably
A. a cavernous lymphangioma
B. a hemangioma
C. Kaposi’s sarcoma
D. hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu)
E. an arterio-venous fistula or aneurysm
38) A birthmark on the face characterized by a slightly raised circumscribed deep purple
area is a :
A. hemangioma
B. lymphangioma
C. hemangiopericytoma
D. glomangioma
39) Cystic hygroma is:
A. a malignant blood vessel tumor
B. benign and a variety of lymphangioma
C. a cystic tumor of ovarian epithelium
D. congenital polycystic disease of kidney
40) A cavernous hemangioma is a:
A. neoplasm of vascular elements
B. hamartoma of compact capillaries
C. vascular neoplasm of pericyte origin
D. hamartoma of large vascular channels
41) Pain is usually or often a symptom of each of the following except:
A. thromboangiitis obliterans
B. glomangioma
C. dissecting aneurysm
D. Kaposi’s sarcoma
42) Each of the following statements applies to varicose veins except:
A. are caused by increased venous pressure
B. common source of large pulmonary thromboemboli
C. frequently become thrombosed
D. more common in women than in men
E. occur in association with cirrhosis of the liver
43) Features of Raynaud’s disease include:
A. occurs primarily in men
B. precipitated by exposure to warm temperatures
C. little or no morphologic changes in the affected arterioles early in the course of the
disease
D. nearly always a progressive disease leading to extensive gangrene of the extremities
44) Idiopathic cystic medial necrosis is associated with:
A. tertiary syphilis
B. previous hemolytic streptococcal infection
C. atherosclerotic aneurysm
D. coxsackie infection
E. dissecting aneurysm
45) A 48 year old man suffers the sudden onset of severe tearing pain in his mid-upper
back. His blood pressure is 210/120. Radial pulses are markedly unequal in intensity. The
most LIKELY diagnosis is:
A. thromboangiitis obliterans
B. coarctation of the aorta
C. acute myocardial infarction
D. dissecting aneurysm
46) Thickening and increased permeability of the capillary basement membranes
throughout the body are characteristic of:
A. Raynaud’s disease
B. systemic lupus erythematosus
C. hyperestrogenemia
D. diabetes mellitus
E. bacterial endocarditis
47) Temporal arteritis is associated with each of the following except:
A. granulomatous inflammation
B. gangrene of the scalp
C. older age groups
D. pain
E. visual symptoms
48) Idiopathic cystic medial necrosis is associated with:
A. fusiform aneurysm
B. cardiovascular syphilis
C. dissecting aneurysm
D. atherosclerotic aneurysm
E. saccular aneurysm
49) Migratory thrombophlebitis is most suggestive of:
A. collagen disease
B. cancer
C. contraceptive use
D. pregnancy
E. alcoholism
50) The most significant complication of thrombophlebitis is:
A. stasis ulcers
B. pain
C. edema
D. pulmonary embolism
E. cancer
51) Giant cell arteritis is associated with all of the following except:
A. old age
B. temporal artery
C. pain
D. failure to respond to steroid therapy
52) Migratory thrombophlebitis is often a sign of:
A. varicose veins
B. connective tissue disease
C. neoplasia
D. contraceptive use
53) Aneurysms of the descending aorta are usually caused by:
A. atherosclerosis
B. syphilis
C. trauma
D. polyarteritis nodosa
E. Raynaud’s disease
54) The cleft-shaped empty spaces in histological sections of an atheroma are indicative of:
A. serum
B. collagen
C. fibrin
D. cholesterol
E. calcium
55) Which one of the following complications of superficial varicose veins occurs most
frequently?
A. pulmonary embolus
B. cor pulmonale
C. gangrene
D. thrombophlebitis
E. dependent edema
56) Polyarteritis nodosa is not characterized by:
A. acute inflammation of arteries
B. response to steroid treatment
C. occurrence in young adults
D. sensitivity to tobacco
57) Severe (malignant) hypertension is characterized by:
A. hyperplastic arteriolosclerosis
B. aortic insufficiency
C. Marfan’s syndrome
D. calcific aortic stenosis
E. thromboangiitis obliteran
58) Hypersensitivity angiitis involves:
A. arterioles and venules
B. large veins
C. both
D. neither
59) An aneurysm of the abdominal aorta is:
A. usually the end result of syphilitic aortitis
B. usually the end result of atherosclerosis
C. a frequent complication of polyarteritis nodosa
D. called a berry aneurysm
60) Essential hypertension is associated with all of the following except:
A. arteriolosclerosis
B. amyloidosis
C. left ventricular hypertrophy
D. renal disease
61) Which one of the following diseases is least likely to be associated with thrombosis?
A. Monckeberg’s (medial) sclerosis
B. atherosclerosis
C. temporal arteritis
D. varicose veins
E. polyarteritis nodosa
62) Varicose veins of the legs are associated with which of these:
A. cigarette smoking
B. pregnancy
C. acute pancreatitis
D. excessive walking
63) Petechiae are most suggestive of:
A. acute rheumatic heart disease
B. bacterial endocarditis
C. Libman-Sack’s endocarditis
D. Marfan’s disease
E. carcinoid syndrome
64) Hypertension is associated with:
A. pheochromocytoma
B. adrenal cortical adenoma
C. both
D. neither
65) Hypertensive patients most commonly die of:
A. cerebral hemorrhage
B. renal failure
C. congestive heart failure
D. cerebral infarction
E. pulmonary embolism
66) The most diagnostic histopathologic finding associated with hypertension is:
A. interstitial fibrosis of myocardium
B. arteriosclerosis
C. arteriolosclerosis
D. aortic medial calcification
E. aortic aneurysm
67) Telangiectases are:
A. prone to become malignant
B. caused by polyvinyl chloride
C. composed of dilated lymphatics
D. associated with hyperestrogenemia
68) Capillary hemangiomas are characterized by:
A. frequent malignant transformation to sarcomas
B. infection by retrovirus
C. exposure to polyvinyl chloride
D. frequent regression
69) Which one of the following pathologic conditions is most likely to lead to systemic
hypertension?
A. hypersensitivity to B-hemolytic streptococcus
B. ganglioneuroblastoma
C. pheochromocytoma
D. hypernephroma
E. cystic medial necrosis
70) A 72 year old woman presents to your clinic with a complaint of an acute onset of right
side headache. She also has acute and progressive vision deficit in her right eye. You
promptly admit her to the hospital, requesting a biopsy of her distal right temporal artery.
What histologic features do you suspect will be present in the pathology report?
A. a “lumpy-bumpy” pattern of immunoglobulin deposition in the basement membrane by
immunofluorescent stain
B. a linear pattern of immunoglobulin deposition in the basement membrane by
immunofluorescent stain
C. fibrinoid necrosis and PMN infiltration
D. granulomata and giant cells
71) Hypertension is associated with all of the following except:
A. renal artery stenosis
B. diabetes mellitus
C. coarctation of the aorta
D. minimal change disease
E. anaphylactoid purpura (Henoch-Schönlein syndrome)
72) Amyloidosis is associated with all of the following except:
A. birefringence properties with Congo Red stain
B. multiple myeloma
C. chronic infection, e.g. tuberculosis
D. “butterfly rash” over bridge of nose
73) Polyarteritis nodosa is:
A. caused by hypersensitivity to tobacco
B. does not respond to steroid treatment
C. both
D. neither
74) Raynaud’s disease is associated with:
A. hypertension
B. old age
C. sensitivity to cold
D. arteriosclerosis
E. visual symptoms
75) A neoplasm frequently associated with AIDS is:
A. Kaposi’s sarcoma
B. carcinoma of lung
C. malignant melanoma
D. telangiectasia
E. Follicular carcinoma of thyroid
76) Hyalinized arterioles in the kidney are found in association with:
A. congestive heart failure
B. malignant hypertension
C. hypersensitivity angitis
D. diabetes mellitus
77) A renal biopsy of a patient who has survived a chronic disease for 15 years reveals
massive Congo Red deposits in the mesangium of glomeruli and in subendothelial
locations of small arteries and arterioles. Our diagnosis is:
A. lupus nephritis
B. rapidly progressive glomulonephritis
C. secondary amyloidosis
D. Goodpasture’s disease
E. Kimmelstiel-Wilson kidney