MLT GlobeBasic Pathology: Hemodynamic disorders – page 2
153 Basic Pathology MCQs on Hemodynamic disorders with answers and explanations.
A patient with cirrhosis has abdominal distension with shifting dullness. The fluid is located in the:
Ascites is accumulation of fluid in the peritoneal cavity.
After losing two litres of blood in a road accident, a man is hypotensive with a weak rapid pulse, fast breathing and cool, clammy skin. His shock is:
Loss of blood volume causes hypovolemic shock with compensatory vasoconstriction, producing cool clammy skin. Early septic and neurogenic shock show warm, vasodilated skin.
Edema is favoured by which combination of changes?
Higher hydrostatic pressure pushes fluid out, and lower plasma protein reduces oncotic pressure that draws it back, both favouring edema.
Minutes after a bee sting, a patient develops hypotension and airway swelling from IgE-mediated systemic vasodilation and vascular leakage. This is:
Anaphylactic shock follows a type I (IgE) hypersensitivity reaction, with widespread vasodilation and increased permeability.
Endotoxic (septic) shock is most classically caused by lipopolysaccharide from:
Lipopolysaccharide (endotoxin) in the outer membrane of Gram-negative bacilli triggers massive cytokine release, vasodilation and shock.
Which outcome follows directly from endothelial injury in Virchow's triad?
Endothelial injury exposes subendothelial collagen and tissue factor, promoting platelet adhesion and coagulation, i.e. thrombosis.
Which event is NOT part of normal hemostasis at a site of vessel injury?
Hemostasis involves vasoconstriction, platelet plug formation, fibrin generation and later clot removal. Collagen deposition belongs to wound repair.
Low plasma oncotic pressure, as in hypoalbuminemia, leads to accumulation of which type of fluid?
Reduced oncotic pressure with intact vessels causes a protein-poor transudate. Exudates result from increased vascular permeability in inflammation.
Minute pinpoint (1 to 2 mm) haemorrhages in the skin or mucosa are called:
Petechiae are 1 to 2 mm, purpura about 3 mm or more, and ecchymoses 1 to 2 cm bruises. A haematoma is a mass-forming collection of blood.
A thrombus attached to the endocardium over a recent left ventricular infarct is called a:
Mural thrombi adhere to the wall of heart chambers or the aorta. Vegetations sit on valves; phlebothrombosis refers to venous thrombi.
Massive lymphoedema of the legs and scrotum after chronic Wuchereria bancrofti infection is called:
Filarial worms obstruct and scar lymphatics and nodes, producing chronic lymphoedema with thickened skin (elephantiasis).
Microscopically, oedematous tissue shows pale spaces caused by fluid separating the:
Interstitial fluid expands the extracellular space, so collagen fibres and matrix appear pale and widely separated.
A mass of fat globules travelling in blood after a femoral fracture and lodging in lung capillaries is classified as an:
An embolus is any detached solid, liquid or gaseous mass carried by blood to a distant site. A thrombus forms in situ.
A child with nephrotic syndrome first shows swelling in the loose connective tissue around the eyes. This is called:
Renal oedema tends to appear first in loose tissue such as the eyelids. Cardiac oedema is typically dependent, e.g., at the ankles.
The membrane glycoprotein on subendothelial fibroblasts and smooth muscle cells that initiates coagulation upon exposure is:
Tissue factor (factor III) binds factor VIIa to start the extrinsic pathway. Thrombomodulin and prostacyclin are anticoagulant or antiplatelet.
A transudate forms when capillary hydrostatic pressure and plasma colloid osmotic pressure change in which directions?
Raised hydrostatic pressure (e.g., heart failure) or reduced oncotic pressure (e.g., hypoalbuminaemia) drives protein-poor fluid out of vessels.
Which cells are the central regulators of haemostasis, switching between anticoagulant and procoagulant roles?
Intact endothelium provides prostacyclin, NO, thrombomodulin and heparan sulfate; when activated it expresses tissue factor and vWF.
Alternating pale platelet-fibrin layers and dark red-cell layers in a thrombus, showing it formed in flowing blood, are called:
Lines of Zahn indicate antemortem thrombosis in flowing blood; postmortem clots lack them.
A newborn not given prophylaxis bleeds on day 3 with prolonged PT and APTT. Deficiency of which vitamin is likely?
Vitamin K is needed for gamma-carboxylation of factors II, VII, IX and X; neonates have low stores, hence routine prophylaxis.
Bleeding into a joint cavity, typical of severe haemophilia, is termed:
Haemarthrosis is blood in a joint space, a hallmark of coagulation factor deficiency. The others describe blood in the pleura, pericardium and peritoneum.