Cardiac Pathology Quiz
Questions: 16 · 10 minutes
1. A patient with left-sided heart failure develops shortness of breath and fine crackles. Which pathological change most directly explains these findings?
Systemic venous congestion causing dependent edema
Pericardial fibrosis restricting the heart externally
Coronary vasospasm causing transient myocardial ischemia
Pulmonary capillary congestion causing interstitial and alveolar edema
2. A patient has sharp chest pain that worsens with inspiration and improves when sitting forward. Which pathological process best fits this presentation?
Fibrotic narrowing of the mitral valve
Chronic pressure overload of the left ventricle
Inflammation of the pericardial layers
Stable obstruction of a coronary artery
3. Which molecular abnormality most commonly underlies inherited hypertrophic cardiomyopathy?
A defect in lysosomal glycogen breakdown limited to valve tissue
A mutation affecting type IV collagen in coronary vessels
A pathogenic variant in a sarcomeric protein gene
A mutation affecting cardiac ion channels without structural protein involvement
4. A patient with fever and a new heart murmur has mobile masses attached to a valve on echocardiography. Which lesion is most consistent with infective endocarditis?
Friable vegetations containing fibrin, inflammatory material, and microorganisms
A sterile mural thrombus over an old infarct
Diffuse calcification within the pericardial sac
A smooth fibrous plaque confined to the ventricular wall
5. A heart specimen shows enlarged chambers and relatively thin, poorly contracting ventricular walls. Which condition best matches this appearance?
Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Constrictive pericarditis
Calcific aortic stenosis
6. Long-standing systemic hypertension persistently increases the pressure against which the left ventricle ejects. Which structural adaptation is most expected?
Eccentric right ventricular hypertrophy with chamber dilation
Concentric left ventricular hypertrophy with increased wall thickness
Diffuse fatty replacement of the left ventricular myocardium
Acute thinning of the left ventricular wall without hypertrophy
7. Months after a myocardial infarction, the injured region is no longer composed of viable cardiac muscle. What tissue most commonly replaces the lost myocytes?
Regenerated myocardium with normal contractile structure
Mature cartilage formed by metaplasia
Adipose tissue without collagen deposition
Dense collagenous scar tissue
8. Chronic rheumatic heart disease most characteristically causes which valvular abnormality?
Pulmonic regurgitation from leaflet prolapse
Aortic regurgitation from isolated aortic root dilation
Tricuspid stenosis from carcinoid plaques
Mitral stenosis with commissural fusion
9. Which form of necrosis is most characteristic of an acute myocardial infarction during its early histologic evolution?
Liquefactive necrosis
Coagulative necrosis
Caseous necrosis
Fat necrosis
10. A patient with atrial fibrillation experiences an embolic ischemic stroke. Which cardiac source is most likely?
A thrombus in the right atrial appendage passing through normal lungs
A calcified plaque in the pulmonary valve
A thrombus in the left atrial appendage
A fibrous scar confined to the interventricular septum
11. A myocardial biopsy from a patient with viral myocarditis would most characteristically show which pattern?
Predominantly lymphocytic inflammation with associated myocyte injury
Valve-centered calcification without myocardial inflammation
Caseating granulomas replacing the entire myocardium
Dense amyloid deposits without inflammatory cells or myocyte damage
12. Cardiac amyloid deposition produces stiff ventricular walls and impaired filling. Which functional pattern best fits this process?
Restrictive cardiomyopathy
Dynamic outflow obstruction
High-output heart failure
Isolated right-to-left intracardiac shunting
13. A patient repeatedly develops pressure-like chest discomfort during exertion that resolves with rest. Which underlying coronary lesion most commonly produces this stable pattern?
Inflammatory destruction of all three layers of a coronary artery
Complete coronary occlusion caused by a newly formed thrombus
A fixed atherosclerotic narrowing that limits blood flow during increased demand
An embolus causing abrupt obstruction of a previously normal coronary artery
14. A rapidly accumulating pericardial effusion causes hypotension and distended neck veins. What is the principal mechanism of the resulting cardiac dysfunction?
Excessive ventricular emptying during systole
External compression that impairs diastolic chamber filling
Irreversible obstruction of every coronary artery
Acute destruction of the aortic valve leaflets
15. An older adult has progressive calcification and stiffening of an otherwise three-cusped aortic valve. Which hemodynamic consequence is most likely?
Pressure overload of the left ventricle
Reduced resistance to left ventricular ejection
Volume overload of the right atrium
Direct mixing of systemic and pulmonary venous blood
16. After an inferior myocardial infarction, a patient develops hypotension, elevated jugular venous pressure, and clear lungs. Which complication best explains this combination?
Acute severe left ventricular failure
Chronic mitral stenosis with pulmonary edema
Diffuse pulmonary capillary leakage from left atrial hypertension
Right ventricular infarction with impaired right-sided output