Atherosclerosis

Question 1

1. Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the
   vessels?
   Select one or more:
   a. Hyperlipidemia → spasm of vasa vasorum → hypoxia
   b. Hypertension → mechanical compression of vascular wall
   c. Smoking - nicotine → potentiates catecholamine effect → spasm of vasa vasorum → hypoxia
   d. Stress → spasm of vasa vasorum → hypoxia

Answer 1

b/c/d

Question 2

2. Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the
   vessels?
   Select one or more:
   a. Hypertension → mechanical compression of vascular wall
   b. Caffeine → dilation of vasa vasorum → increased collagen synthesis
   c. Hyperlipidemia → spasm of vasa vasorum → hypoxia
   d. Smoking - nicotine → decreased NO production → hypoxia

Answer 2

a

Question 3

3. Which of the following factors contribute to the development of atherosclerosis according to thrombogenic theory?
   Select one or more:
   a. The uptake of modified LDL by macrophages
   b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation
   c. Infiltration of LDL into the arterial wall
   d. Changes of the TXA2/PGI2 ratio

Answer 3

b/d

Question 4

4. The role of ox-LDL in the development of atherosclerosis:
   Select one or more:
   a. it stimulates the migration and the proliferation of smooth muscle cells
   b. it decreases the endothelial PGI2/NO synthesis
   c. it increases the proliferation of macrophages
   d. it has chemotactic effect

Answer 4

a/b/c/d

Question 5

5. Which of the following factors contribute to the development of atherosclerosis according to thrombogenic theory?
   Select one or more:
   a. Changes of the composition of extracellular matrix in vascular intima and media
   b. Changes of the TXA2/PGI2 ratio
   c. Hyaluronic acid content of intracellular matrix decreases
   d. Micro-injuries of the vascular intima promote platelet adhesion and aggregation

Answer 5

b/d

Question 6

6. Modifiable risk factors of atherosclerosis:
   Select one or more:
   105

a. age
b. obesity
c. dyslipidemia
d. hypertension

Answer 6

b/c/d

Question 7

7. Non-modifiable risk factors of atherosclerosis:
Select one or more:
a. obesity
b. age
c. dyslipidemia
d. hypertension

Answer 7

b

Question 8

8. Which of the following factors contribute to the development of atherosclerosis according to the aging theory:
   Select one or more:
   a. The endothelial endothelin production is increased by aging
   b. The uptake of modified LDL by macrophages
   c. The endothelial NO production is decreased by aging
   d. The component of connective tissue of vessels and other tissues change by aging

Answer 8

d

Question 9

9. Components of the atherosclerotic plaque:
Select one or more:
a. foam cells
b. calcium
c. dendritic cells
d. eosinophilic granulocytes

Answer 9

a/b

Question 10

10. Which of the following factors contribute to the development of atherosclerosis according to the response to
    injury hypothesis:
    Select one or more:
    a. Endothelial injury induces platelet activation
    b. Composition of EC matrix is changed due to chronic inflammation
    c. Mediators released from activated platelets induce smooth muscle cell migration from the media into the
    intima
    d. The changed EC matrix causes lipid deposition

Answer 10

b.c.d

Question 11

11. Waist circumference for clinical diagnosis of metabolic syndrome:
Select one or more:
a. in women: 88 cm
b. in men: 105 cm
c. in women: 80 cm
d. in men: 102 cm

Answer 11

a/d

Question 12

12. Which of the following statements are true?
    106
    Pathophysiology 1 MCQs - Team effort
    Select one or more:
    a. Atherosclerosis is a hardening of an artery specifically due to an atheromatosus plaque formation
    b. Arteriosclerosis is a hardening of small arteries
    c. Arteriolosclerosis is a general term describing any hardening of small arteries
    d. Arteriosclerosis is a general term describing any hardening of medium or large arteries

Answer 12

a/c/d

Question 13

13. Modifiable risk factors of atherosclerosis:
Select one or more:
a. dyslipidemia
b. obesity
c. hypertension
d. low income

Answer 13

a/b/c

Question 14

14. Which of the following factors contribute to the development of atherosclerosis according to mesenchymal
    theory?
    Select one or more:
    a. Collagen fiber content is increased, while elastic fiber content is decreased in the intima and in the media
    b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation
    c. The uptake of modified LDL by macrophages
    d. Decrease of the heparin/heparane sulphate content of vessels

Answer 14

a/d

Question 15

15. Which of the following pathogens play an important role in the development of atherosclerosis according to the
inflammation theory?
Select one or more:
a. Cytomegalovirus (CMV)
b. HBV
c. Herpes simplex virus (HSV1, HSV2)
d. Chlamydia pneumoniae

Answer 15

a/c/d

Question 16

16. Which factors increase the risk of developing metabolic syndrome?
Select one or more:
a. polycystic ovarium syndrome
b. hyperthyroidism
c. smoking
d. age

Answer 16

a/d

Question 17

17. Evidence supporting the response to injury hypothesis:
    Select one or more:
    a. Decreased endothelial production of NO/PGI2
    b. Atherosclerotic plaques contain cholesterol crystals
    c. The uptake of modified LDL by macrophages
    d. Distribution of the atherosclerotic plaques
    107

Answer 17

b/c/d

Question 18

18. Non-modifiable risk factors of atherosclerosis:
Select one or more:
a. family history
b. gender
c. Caucasian race
d. age

Answer 18

a/b/d

Question 19

19. Which of the following statements are not true?
    Select one or more:
    a. Arteriosclerosis is a general term describing any hardening of medium or large arteries
    b. Arteriolosclerosis is a hardening of medium arteries
    c. Atherosclerosis is a hardening of an artery specifically due to an atheromatosus plaque formation
    d. Arteriosclerosis is a general term describing any hardening of small arteries

Answer 19

a/b/d

Question 20

20. Which of the following pathogens play an important role in the development of atherosclerosis according to the
inflammation theory?
Select one or more:
a. Helicobacter pylori
b. Chlamydia pneumoniae
c. HCV
d. HBV

Answer 20

a/b

Question 21

21. Which of the following factors contribute to the development of atherosclerosis according to the aging theory?
    Select one or more:
    a. The changed composition of EC matrix potentiates platelets adhesion and aggregation
    b. The uptake of modified LDL by macrophages
    c. Micro-injuries on vascular intima promote platelet adhesion and aggregation
    d. The component of connective tissue of vessels and other tissues change by aging

Answer 21

d

Question 22

22. Which of the following factors contribute to the development of atherosclerosis according to the aging theory:
    Select one or more:
    a. The component of connective tissue of vessels and other tissues change by aging
    b. The endothelial endothelin production is decreased by aging
    c. Micro-injuries on vascular intima promote platelet adhesion and aggregation
    d. The endothelial NO production is decreased by aging

Answer 22

a

Question 23

23. Evidence supporting the response to injury hypothesis:
    Select one or more:
    a. Atherosclerotic plaques contain lymphocytes
    b. Plaques develop in areas with increased shear stress
    c. The risk to develop atherosclerosis is higher in those diseases which cause endothelial dysfunction
    d. Atherosclerotic plaques contain cholesterol crystals

Answer 23

b/c/d

Question 24

24. Modifiable risk factors of atherosclerosis:
Select one or more:
a. Hepatitis B infection
b. CMV infection
c. Chlamydia pneumoniae infection
d. Herpes virus infection

Answer 24

b/c/d

Question 25

25. The possible causes of the endothelial dysfunction based on the response to injury hypothesis: Select one or more: a. Genetic alterations b. Modified LDL (ox-LDL, small-LDL) c. Pathogenic microorganisms (CMV, Chlamydia pneumoniae, etc) d. Increased serum HDL concentration

Answer 25

a/b/c

Question 26

``` 26. Characteristic features of atherogenic dyslipidemia: Select one or more: a. presence of small LDL in the serum b. decreased serum level of HDL c. elevated serum TG level d. dysfibrinogenemia ```

Answer 26

a/b/c

Question 27

``` 27. The clinical manifestation of atherosclerosis: Select one or more: a. myocardial infaction b. acute mesenteric ischemia c. Waterhouse-Friderichsen syndrome d. Addison's disease ```

Answer 27

a/b

Question 28

``` 28. Essential parameters to diagnose metabolic syndrome: Select one or more: a. Se LDL: > 2.4 mM b. visceral obesity c. Se TG: > 1.7 mM d. Se HDL: > 1.4 mM ```

Answer 28

b/c

Question 29

29. Evidence supporting the lipid or infiltration theory: Select one or more: a. intervention studies b. epidemiologic observations c. evidence of animal experiments d. cholesterol is found in the atherosclerotic vessel wall

Answer 29

a/b/c/d

Question 30

``` 30. Modifiable risk factors of atherosclerosis: 109 Pathophysiology 1 MCQs - Team effort Select one or more: a. diabetes mellitus b. heavy alcohol drinking c. sedentary lifestyle d. smoking ```

Answer 30

a/c/d

Question 31

31. The atherogenic effect of homocysteine: Select one or more: a. it damages the endothelium b. it inhibits the proliferation of smooth muscle cells c. it is prothrombotic d. it decreases collagen synthesis in vessels

Answer 31

a/c

Question 32

``` 32. Non-modifiable risk factors of atherosclerosis: Select one or more: a. female gender b. diabetes mellitus c. family history d. hypertension ```

Answer 32

c

Question 33

33. Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the vessels? Select one or more: a. Hyperlipidemia → spasm of vasa vasorum → hypoxia b. Hypertension → mechanical compression of vascular wall c. Catecholamine → spasm of vasa vasorum → hypoxia d. Smoking - nicotine → decreased NO production → hypoxia

Answer 33

b/c

Question 34

34. The atherogenic effect of homocysteine: Select one or more: a. Homocysteine stimulates the proliferation of smooth muscle cells b. Homocysteine inhibits binding of tPA and decreases fibrinolysis c. It inhibits endothelial functions d. Homocysteine increases thrombomodulin expression and activity, therefore increases the activation of protein C

Answer 34

a/c

Question 35

35. Which of the following factors contribute to the development of atherosclerosis according to lipid theory? Select one or more: a. Micro-injuries of the vascular intima promote platelet adhesion and aggregation b. The change of the TXA2/PGI2 ratio c. The uptake of modified LDL by macrophages d. Infiltration of LDL into the arterial wall

Answer 35

c/d

Question 36

``` 36. Modifiable risk factors of atherosclerosis: Select one or more: a. elevated serum glucose b. higher education c. elevated serum homocysteine d. psychosocial stress ```

Answer 36

a/c/d

Question 37

``` 37. The clinical manifestations of atherosclerosis: Select one or more: a. diabetes mellitus b. dissection of the aorta c. arteriosclerosis obliterans d. stroke ```

Answer 37

no answer

Question 38

38. The possible causes of the endothelial dysfunction based on the response to injury hypothesis: Select one or more: a. Increased serum VLDL concentration b. Micro-injuries on vascular intima promote platelet adhesion and aggregation c. Mechanical injuries d. Increased serum homocystein concentration

Answer 38

b/c/d

Question 39

``` 39. Dyslipidemia which promotes atherosclerosis: Select one or more: a. HDL ↓ b. VLDL↑ c. IDL↑ d. LDL↑ ```

Answer 39

a/b/c/d

Question 40

40. True statements about the unifying hypothesis: Select one or more: a. Smooth muscle cells in the plaque have clonal origin b. The hypothesis unifies the lipid and the response to injury theories c. The essence of this hypothesis is: the thrombogenic- and mesenchymal theories have common components d. Modified LDL can also cause endothelial dysfunction

Answer 40

b/d

Question 41

41. True statements about the metabolic syndrome: Select one or more: a. Se LDL concentration is essential to diagnose metabolic syndrome b. It is not a disease, but rather a cluster of disorders of your body’s metabolism c. concomitance of certain risk factors dramatically increases the risk for ischemic heart diseases d. the pear type obesity has higher risk

Answer 41

b/c

Question 42

42. The atherogenic effect of homocysteine: Select one or more: a. it inhibits platelet aggregation b. it increases the amount of ox-LDL by lipid peroxidation c. it inhibits the migration and the proliferation of smooth muscle cells d. it increases collagen synthesis in vessels

Answer 42

b/d

Question 43

``` 43. Components of the atherosclerotic plaque: Select one or more: a. macrophages b. smooth muscle cells c. eosinophilic granulocytes d. lymphocytes ```

Answer 43

a/b

Question 44

44. Which of the following factors contribute to the development of atherosclerosis according to thrombogenic theory? Select one or more: a. Changes of the TXA2 / PGI2 ratio b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation c. Infiltration of LDL into the arterial wall d. The absorption of modified LDL by macrophages

Answer 44

a/b/c

Question 45

45. Based on the mesenchymal theory, what will induce changes in the extracellular matrix component in the vessels? Select one or more: a. Hypertension → mechanical compression of vascular wall b. Hyperlipidemia → spasm of vasal vasodilation → hypoxia c. Catecholamine → spasm of vasal vasodilation → hypoxia d. Smoking - nicotine → decreased NO production → hypoxia

Answer 45

a/c

Question 46

46. Based on the mesenchymal theory, what will induce changes in the extracellular matrix component in the vessels? Select one or more: a. Hypertension → mechanical compression of vascular wall b. Hyperlipidemia → spasm of vasal vasodilation → hypoxia c. Smoking - nicotine → potentiates catecholamine effect → spasm of vasalum → hypoxia d. Stress → spasm of vasal vasodilation → hypoxia

Answer 46

a/c/d

Question 47

47. Which of the following factors contribute to the development of atherosclerosis according to lipid theory? Select one or more: a. The absorption of modified LDL by macrophages b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation c. The change of the TXA2 / PGI2 ratio 112 Pathophysiology 1 MCQs - Team effort d. Infiltration of LDL into the arterial wall

Answer 47

a/d

Question 48

48. Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the vessels? Select one or more: a. Smoking - nicotine → potentiates catecholamine effect → spasm of vasa vasorum → hypoxia b. Catecholamine → spasm of vasa vasorum → hypoxia c. Hypertension → increased elasticity of vascular wall d. Caffeine → dilation of vasa vasorum → increased collagen synthesis

Answer 48

a/b

Question 49

49. Essential diagnostic criteria of metabolic syndrome: Select one or more: a. fasting blood glucose: > 5.6 mM b. Se HDL in men: < 1.0 mM; in woman: < 1.3 mM c. waist circumference in men > 102 cm; in woman: < 88 cm d. Se TG: < 1.7 mM

Answer 49

a/b

Question 50

50. Essential diagnostic criteria of metabolic syndrome: Select one or more: a. RR: > 135/85 mmHg b. Se TG: < 1.7 mM c. waist circumference in men: > 102 cm; in women: > 88 cm d. Se HDL in men: < 1.0 mM; in women: < 1.3 mM

Answer 50

c/d

Question 51

``` 51. Not components of atherosclerotic plaque: Select one or more: a. eosinophilic granulocytes b. foam cells c. dendritic cells d. calcium ```

Answer 51

a/c

Question 52

``` 52. Components of the atherosclerotic plaque: Select one or more: a. macrophages b. smooth muscle cells c. lymphocytes d. cholesterol crystals ```

Answer 52

a/b/c/d

Question 53

53. Which of the following statements are not true? a. Arteriosclerosis is a general term describing any hardening of small arteries b. Arteriosclerosis is a general term describing any hardening of medium or large arteries c. Arteriolosclerosis is a hardening of medium arteries d. Atherosclerosis is a hardening of an artery specifically due to an atheromatosus plaque formation 113

Answer 53

a/c

Question 54

``` 54. Dyslipidernia which promotes atherosclerosis: Select one or more: a. HDLi b.LDL1 c. IDLT D. VLDLT ```

Answer 54

b/c

Question 55

``` 55. which of the following pathogens do not play a role in the development of atherosclerosis according to the inflammation theory? select one or more: a. Helicobacter pylori b. Chlamydia pneumoniae c. HBV d. HCV ```

Answer 55

c/d

Question 56

``` 56. which of the following pathogens do NOT play a role in the development of atherosclerosis according to the inflammation theory? a. Cytomegalovirus (CMV) b. herpes simplex virus (HSV1, HSV2) c. Chlamydia pneumoniae d. HBV ```

Answer 56

d

Question 57

57. which of the following factors contribute to the development of atherosclerosis according to mesenchymal theory? a. hyaluronic acid of intracellular matrix decrease b. changes of the TXA2/PGI2 ratio c. changes of the composition of extracellular matrix in vascular intimate and media d. micro-injuries of the vascular intimate promote platelet adhesion and aggregation

Answer 57

a/c

Question 58

58. characteristic features of atherogenic dyslipidemia: a. elevated serum TG level b. presence of small LDL in the serum c. decrease serum level of HDL d. disfibrinogenemia

Answer 58

a/b/c