Hypertensive Vascular Disease and Atherosclerosis MCQs

Ans. is 'c' i.e., Most commonly involved artery is abdominal aorta It is the most common form of systemic vasculitis in adults, is an acute and chronic, often granulomatous, inflammation of arteries of large to small size. It affects principally the arteries in the head-especially the temporal arteries— but also the vertebral and ophthalmic arteries and the aorta, where it may cause thoracic aortic aneurysm

Pathogenesis of atherosclerosis best explained by the ‘Response to Injury hypothesis to endothelium Reference : Robbins 9th/pg 498-499; 8th/pg 505; Harrison 18th/pg 1503

Nephrosclerosis refers to sclerosis of small renal arteries and arterioles that is strongly associated with hypertension. The characteristic morphologic alterations of the small arterioles are called hyaline arteriolosclerosis, while the arteries show fibrous intimal and medial thickening often resulting in luminal narrowing. The vascular changes cause ischemia, which leads to various combinations of interstitial fibrosis, tubular atrophy, and focal global glomerulosclerosis. Grossly, the kidneys are symmetrically atrophic. Typically the renal surface shows diffuse, fine granularity that resembles grain leather. Others are the features of malignant nephrosclerosis. Reference : Robbins Basic Pathology, 10th edition, Page- 570

In marked enlarge glands, compromise of vascular supply may produce prostatic infarcts. Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition, Chapter - 21 pg 976

(d) Patients long history and classic symptoms of chest tightness, cough with sputum and wheezing along with elevated serum IgE level, peripheral blood eosinophilia and eosinophils in sputum are suggestive of asthma. Characteristic histopathological findings in asthma are: Thickening of airway wall Sub-basement membrane fibrosis (due to deposition of type I and III collagens) Increased vascularity Increase in the size of the submucosal glands and number of airway goblet cells Hypertrophy and/or hyperplasia of the bronchial wall muscle with increased extracellular matrix Reference: Robbins 10th Ed, pg 686

Hyperplastic arteriolosclerosis. This lesion occurs in severe hypertension; vessels exhibit concentric, laminated ("onionskin") thickening of the walls with luminal narrowing The laminations consist of SMCs with thickened, reduplicated basement membrane; in malignant hypertension, they are accompanied by fibrinoid deposits and vessel wall necrosis (necrotizing arteriolitis) , particularly in the kidney Reference : Robbins 10th/pg 493

Answer is C (Giant Cell Arteritis): Jaw Claudication (law Tightness) is a typical manifestation of Temporal arteritis or Giant cell arteritis.

The child had rabies, an infectious disease in which the virus travels from the site of an infected animal bite up nerves to the CNS. Pathognomonic Negri bodies are cytoplasmic inclusions found in the hippocampal pyramidal cells and cerebellar Purkinje cells. Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition, Chapter - 28 pg 1266