Atherosclerosis MCQs

1. What is the definition of arteriosclerosis?

A) Chronic inflammation of veins
B) Thickening and hardening of arterial walls with loss of elasticity
C) Dilatation of arteries
D) Blockage of veins

2. What distinguishes atherosclerosis from other types of arteriosclerosis?

A) Deposition of cholesterol and lipids in the arterial intima
B) Deposition of calcium in the media
C) Loss of vascular elasticity
D) Reduction of smooth muscle cells

3. What is Monckeberg’s medial calcific sclerosis?

A) Atherosclerotic plaque rupture
B) Calcific deposits in muscular arteries, common in elderly people
C) Deposition of cholesterol in veins
D) Fibrosis of large arteries

4. Where do atherosclerotic plaques commonly develop?

A) Hyperdynamic areas such as elastic arteries and large-medium arteries
B) Small capillaries
C) Pulmonary veins
D) Venules

5. What is the earliest lesion of atherosclerosis?

A) Fatty streak
B) Fibroatheroma
C) Calcified plaque
D) Thrombosis

6. Which of the following is a non-modifiable risk factor for atherosclerosis?

A) Age (middle to late life)
B) Smoking
C) Diabetes
D) Hypertension

7. Which modifiable factor has the greatest influence on atherosclerosis progression?

A) Hyperlipidemia (HDL/LDL ratio imbalance)
B) Age
C) Gender
D) Genetic predisposition

8. Which of the following is an additional risk factor for atherosclerosis?

A) High levels of C-reactive protein (CRP)
B) Low fibrinogen levels
C) Decreased procoagulant factors
D) Reduced lipoprotein a

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9. How does metabolic syndrome contribute to atherosclerosis?
A) Increases insulin resistance, obesity, and hyperlipidemia
B) Improves lipid metabolism
C) Lowers blood pressure
D) Decreases LDL levels

10. What type of personality has been linked to increased risk of atherosclerosis?
A) Type A personality
B) Type B personality
C) Type D personality
D) Introverted personality

11. What is the primary cause of endothelial injury in atherosclerosis?

A) Increased permeability, leukocyte adhesion, and thrombosis
B) Excess calcium deposition
C) Smooth muscle apoptosis
D) Decreased platelet adhesion
12. What happens to LDL in the vessel wall during atherosclerosis?
A) It undergoes oxidation and promotes plaque formation
B) It is rapidly excreted
C) It is converted to HDL
D) It inhibits macrophage activation

13. Which cell type plays a crucial role in plaque formation by engulfing oxidized LDL?
A) Macrophages (forming foam cells)
B) Neutrophils
C) T-lymphocytes
D) Platelets

14. What effect do foam cells have in atherosclerosis?

A) They accumulate and release inflammatory cytokines
B) They dissolve plaques
C) They decrease lipid retention
D) They inhibit smooth muscle proliferation
15. What role do smooth muscle cells play in atherosclerosis?
A) They proliferate and produce extracellular matrix (collagen, elastic fibers, proteoglycans)
B) They remove cholesterol from plaques
C) They convert LDL to HDL
D) They inhibit macrophage activity

16. At what age can Type I (initial lesion) of atherosclerosis appear?

A) First decade of life
B) Third decade of life
C) Fifth decade of life
D) After 60 years

17. Which type of atherosclerotic lesion is also known as a fatty streak?

A) Type II
B) Type IV
C) Type V
D) Type VI

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18. Which lesion stage is characterized by lipid core formation and clinical symptoms?
A) Type II
B) Type IV (Atheroma)
C) Type I
D) Type III

19. Which type of lesion is characterized by smooth muscle and collagen increase?
A) Type III
B) Type IV
C) Type V (Fibroatheroma)
D) Type I

20. What characterizes a Type VI (complicated) plaque?

A) Thrombosis and hemorrhage
B) Lipid accumulation
C) Foam cell formation
D) Minimal collagen content
21. What is the MOST serious cardiac complication of atherosclerosis?
A) Myocardial infarction
B) Aortic stenosis
C) Pulmonary embolism
D) Mitral valve prolapse

22. Which of the following is a cerebrovascular complication of atherosclerosis?

A) Stroke (Cerebral infarction)
B) Guillain-Barré syndrome
C) Parkinson’s disease
D) Multiple sclerosis

23. What is a common peripheral complication of atherosclerosis?

A) Peripheral vascular disease (gangrene)
B) Chronic venous insufficiency
C) Deep vein thrombosis
D) Raynaud’s disease
24. How does atherosclerosis lead to kidney failure?
A) Kidney infarction due to vascular occlusion
B) Increased urine production
C) Decreased renin secretion
D) Loss of sodium balance

25. What life-threatening vascular condition can result from atherosclerosis?

A) Atrial fibrillation
B) Portal hypertension
C) Varicose veins
D) Aneurysm rupture

26. What is the definition of an aneurysm?

A) Thickening of vessel walls
B) Narrowing of a blood vessel
C) Congenital or acquired dilation of a blood vessel or heart wall
D) Formation of a clot in arteries

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27. Which type of aneurysm involves all layers of the vessel wall?
A) Fusiform aneurysm
B) False aneurysm
C) Dissecting aneurysm
D) True aneurysm

28. What type of aneurysm results from a hematoma forming outside the vessel wall?
A) True aneurysm
B) False aneurysm
C) Saccular aneurysm
D) Mycotic aneurysm

29. What is the MOST serious consequence of an abdominal aortic aneurysm (AAA)?
A) Rupture
B) Varicose veins
C) Venous thromboembolism
D) Aortic stenosis
30. What genetic disorder is associated with thoracic aortic aneurysms?
A) Marfan syndrome
B) Down syndrome
C) Turner syndrome
D) Cystic fibrosis

31. Which type of aneurysm is caused by blood dissecting between the layers of the arterial wall?
A) True aneurysm
B) False aneurysm
C) Dissecting aneurysm
D) Fusiform aneurysm

32. What is the MOST common cause of an abdominal aortic aneurysm (AAA)?
A) Hypertension
B) Atherosclerosis
C) Infection
D) Congenital weakness of the aortic wall
33. Which of the following is a shape-based classification of aneurysms?
A) Saccular, fusiform, cylindrical, serpentine, racemose
B) True and false aneurysms
C) Berry and mycotic aneurysms
D) Abdominal and thoracic aneurysms

34. What is the most common site for a dissecting aneurysm?

A) Pulmonary artery
B) Aorta
C) Renal artery
D) Femoral artery

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35. Which genetic disorder is associated with defective type III collagen and predisposes individuals to
aneurysms?
A) Ehlers-Danlos syndrome
B) Marfan syndrome
C) Down syndrome
D) Cystic fibrosis

36. Which genetic disorder is caused by defective fibrillin synthesis and predisposes to thoracic aortic
aneurysms?
A) Down syndrome
B) Turner syndrome
C) Marfan syndrome
D) Klinefelter syndrome

37. What role do macrophages play in aneurysm formation?

A) They produce matrix metalloproteinases (MMPs) that degrade connective tissue
B) They strengthen the vessel wall
C) They promote endothelial cell proliferation
D) They repair smooth muscle cells

38. Which of the following is NOT a major predisposing factor for aneurysm formation?
A) Atherosclerosis
B) Hypertension
C) Hypercalcemia
D) Connective tissue disorders

39. Which type of aneurysm commonly occurs in the Circle of Willis?

A) Dissecting aneurysm
B) Fusiform aneurysm
C) Berry aneurysm
D) Saccular aneurysm

40. What is a common complication of a brain aneurysm rupture?

A) Subarachnoid hemorrhage
B) Ischemic stroke
C) Pulmonary embolism
D) Deep vein thrombosis

41. What is the most serious and fatal consequence of an aortic aneurysm?
A) Rupture
B) Atherosclerosis
C) Hypertension
D) Aortic valve stenosis
42. What is the primary risk factor for thoracic aortic aneurysms?
A) Hypertension
B) Smoking
C) Hypercholesterolemia
D) Diabetes

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43. Which aneurysm is associated with syphilis?
A) Syphilitic aneurysm
B) Mycotic aneurysm
C) Abdominal aortic aneurysm
D) Berry aneurysm

44. What is the MOST common location of an abdominal aortic aneurysm?

A) Between the renal arteries and the aortic bifurcation
B) Above the renal arteries
C) At the level of the aortic arch
D) Near the pulmonary trunk

45. Which factor increases the likelihood of an abdominal aortic aneurysm?

A) Vegetarian diet
B) Hyperkalemia
C) Smoking
D) Low salt intake
46. What is a possible complication of an aneurysm pressing on surrounding structures?
A) Compression of vertebrae or ureters
B) Stroke
C) Kidney failure
D) Mitral valve regurgitation

47. Which complication of an aortic aneurysm can cause severe ischemia and necrosis?
A) Blood vessel dilation
B) Arterial occlusion leading to thrombosis or embolism
C) Increased blood flow to the kidneys
D) Decreased myocardial workload

48. What is a common clinical symptom of a ruptured aortic aneurysm?

A) Severe abdominal or back pain with hypotension
B) Increased urine output
C) Decreased cardiac output
D) Slow, progressive weight loss
49. What is a serious consequence of a thoracic aortic aneurysm compressing the esophagus?
A) Difficulty swallowing (dysphagia)
B) Increased respiratory rate
C) Hyperthyroidism
D) Chronic diarrhea

50. What is a common symptom of a thoracic aortic aneurysm pressing on the recurrent laryngeal nerve?
A) Persistent cough or hoarseness
B) Hematuria
C) Sudden vision loss
D) Lower limb edema

51. What is the most common risk factor for aortic dissection?
A) Atherosclerosis
B) Hypotension
C) Hypertension
D) Smoking

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52. What is the pathogenesis of aortic dissection?
A) Calcium deposition
B) Blood clot formation in the vessel wall
C) Tear in the intimal layer allows blood to dissect between layers of the vessel wall
D) Hypertrophy of smooth muscle cells

53. Which syndrome increases the risk of aortic dissection due to connective tissue defects?
A) Marfan syndrome
B) Turner syndrome
C) Down syndrome
D) Cystic fibrosis

54. What is the classic symptom of an aortic dissection?

A) Painless abdominal swelling
B) Intermittent fever
C) Dizziness and vertigo
D) Sudden onset of excruciating, tearing chest pain radiating to the back

55. What is the MOST common cause of death in patients with aortic dissection?
A) Rupture into pericardial, pleural, or peritoneal cavity
B) Blood clot formation in the legs
C) Acute renal failure
D) Liver dysfunction

56. What is the primary cause of a ventricular aneurysm?

A) Hypertension
B) Myocardial infarction
C) Stroke
D) Congenital heart disease

57. What happens to the ventricular wall in a cardiac aneurysm?

A) It becomes thinner than the rest of the left ventricle
B) It becomes hypertrophic
C) It accumulates cholesterol
D) It undergoes complete necrosis

58. What is a serious complication of a ventricular aneurysm?

A) Thromboembolism
B) Hyperkalemia
C) Bradycardia
D) Pulmonary hypertension

59. What type of tissue is found in the walls of a ventricular aneurysm?

A) Thickened endothelium
B) Only smooth muscle cells
C) Purely connective tissue
D) Fibrous tissue, necrotic muscle, and viable myocardium
60. Which of the following is NOT a component of an atherosclerotic plaque?
A) Collagen
B) Lipid deposits
C) Foam cells
D) Red blood cells
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61. What type of lipid accumulation is seen in early-stage atherosclerosis?
A) Intracellular and extracellular lipid deposits
B) Only intracellular lipid deposits
C) Only extracellular lipid deposits
D) No lipid accumulation

62. What is the function of smooth muscle cells in advanced atherosclerotic plaques?
A) They produce extracellular matrix (collagen, elastic fibers, proteoglycans)
B) They remove LDL from plaques
C) They undergo apoptosis to stabilize plaques
D) They directly cause plaque rupture

63. What characteristic differentiates a stable plaque from a vulnerable plaque?

A) Stable plaques have a thick fibrous cap, while vulnerable plaques have a thin cap and large lipid core
B) Stable plaques have more inflammatory cells
C) Vulnerable plaques contain only smooth muscle cells
D) Stable plaques contain more thrombi
64. What type of atherosclerotic lesion is most prone to rupture?
A) Fibrotic plaque
B) Fatty streak
C) Calcified plaque
D) Vulnerable plaque with a thin fibrous cap and high lipid content

65. What happens when an atherosclerotic plaque ruptures?

A) The vessel immediately heals
B) The plaque disappears without consequences
C) Thrombosis forms at the site, leading to vascular occlusion
D) Blood pressure decreases

66. Which of the following is a common renal complication of atherosclerosis?

A) Kidney infarction
B) Kidney stones
C) Nephrotic syndrome
D) Polycystic kidney disease
67. How does atherosclerosis contribute to myocardial infarction?
A) Plaque rupture leads to thrombus formation, blocking coronary arteries
B) It causes vasodilation
C) It increases blood flow to the heart
D) It improves cardiac oxygen supply

68. Which vascular complication results from atherosclerosis in the lower limbs?
A) Peripheral artery disease (PAD)
B) Deep vein thrombosis
C) Pulmonary embolism
D) Carotid artery dissection

69. Which neurological complication is MOST commonly associated with atherosclerosis?

A) Epilepsy
B) Stroke (Cerebral infarction)
C) Multiple sclerosis
D) Parkinson’s disease

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70. How does atherosclerosis contribute to sudden cardiac death?
A) It reduces blood clotting
B) It causes immediate heart muscle regeneration
C) It prevents plaque formation
D) Acute coronary artery blockage leads to fatal arrhythmias

71. Which aneurysm is commonly found at the Circle of Willis?

A) Berry aneurysm
B) Fusiform aneurysm
C) Mycotic aneurysm
D) Syphilitic aneurysm

72. What is the MOST serious consequence of an abdominal aortic aneurysm (AAA)?
A) Rupture
B) Chronic pain
C) Increased blood flow
D) Decreased heart rate
73. What structural characteristic is seen in a saccular aneurysm?
A) Bulging on one side of the vessel
B) Complete circumferential dilation
C) Linear narrowing of the vessel
D) Calcified plaques

74. Which of the following is a primary cause of aneurysm formation?

A) Hypercalcemia
B) Excessive clotting factors
C) Weakening of the arterial wall due to atherosclerosis or hypertension
D) Increased albumin levels

75. What happens in a false aneurysm?

A) Blood collects outside the vessel wall in a hematoma
B) The entire vessel wall weakens and bulges
C) The vessel becomes completely occluded
D) Only the adventitia is affected
76. What is the MOST common cause of thoracic aortic aneurysm?
A) Pulmonary embolism
B) Hyperthyroidism
C) Diabetes
D) Hypertension

77. What is the main pathological feature of an aortic dissection?

A) A tear in the intimal layer allowing blood to dissect through vessel layers
B) Fibrosis of the vessel wall
C) Aneurysmal calcification
D) Increased platelet adhesion

78. What clinical symptom is characteristic of an aortic dissection?

A) Sudden onset of severe, tearing chest pain radiating to the back
B) Slow progressive shortness of breath
C) Painless swelling in the abdomen
D) Gradual loss of vision

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79. What is the MOST common cause of death in aortic dissection?
A) Heartburn
B) Rupture into the pericardial, pleural, or peritoneal cavity
C) Pulmonary edema
D) Sudden hypertension

80. Which syndrome is associated with an increased risk of aortic dissection?

A) Marfan syndrome
B) Turner syndrome
C) Down syndrome
D) Klinefelter syndrome

81. Where do MOST abdominal aortic aneurysms occur?

A) Between the renal arteries and the aortic bifurcation
B) Above the renal arteries
C) In the iliac arteries
D) At the pulmonary trunk
82. Which population has the highest risk of AAA?
A) Elderly men who smoke
B) Young women with hypertension
C) Children with congenital heart disease
D) Patients with low cholesterol

83. What is the main symptom of an expanding AAA before rupture?

A) Abdominal and back pain
B) Difficulty swallowing
C) Blurred vision
D) Hypoglycemia

84. What is the MOST fatal complication of AAA?

A) Rupture with massive hemorrhage
B) Increased renal blood flow
C) Vasodilation of the iliac arteries
D) Hypercoagulation
85. What type of aneurysm is AAA classified as?
A) Atherosclerotic aneurysm
B) Mycotic aneurysm
C) Syphilitic aneurysm
D) Dissecting aneurysm

86. What is the MOST common cause of a ventricular aneurysm?

A) Myocardial infarction
B) Hypertension
C) Atrial fibrillation
D) Pulmonary hypertension

87. How does a ventricular aneurysm affect the heart’s function?

A) It reduces the heart’s ability to contract properly, leading to heart failure
B) It strengthens the ventricular wall
C) It increases heart rate
D) It improves cardiac output

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88. What tissue is found in a ventricular aneurysm?
A) Fibrous tissue, necrotic muscle, and viable myocardium
B) Purely smooth muscle cells
C) Only endothelial cells
D) Completely calcified plaque

89. What is the MOST common complication of a ventricular aneurysm?

A) Thromboembolism
B) Increased stroke volume
C) Hyperkalemia
D) Chronic hypertension

90. Which of the following is a risk factor for developing a ventricular aneurysm?
A) Previous myocardial infarction
B) High HDL levels
C) Low blood pressure
D) Chronic anemia
91. What is the best way to prevent aneurysm rupture?
A) Blood pressure control
B) High-fat diet
C) Increased salt intake
D) Chronic anticoagulation

92. What diagnostic test is best for detecting AAA?

A) Ultrasound
B) Chest X-ray
C) ECG
D) MRI

93. What imaging technique is best for diagnosing aortic dissection?

A) CT angiography
B) ECG
C) Blood pressure monitoring
D) Liver ultrasound
93. What is the gold standard imaging technique for diagnosing an aortic dissection?
A) CT angiography
B) ECG
C) Chest X-ray
D) Abdominal ultrasound

94. Which of the following is a first-line diagnostic tool for an abdominal aortic aneurysm (AAA)?
A) Ultrasound
B) MRI
C) Blood pressure monitoring
D) Electrocardiogram (ECG)

95. What is the MOST effective way to prevent atherosclerosis-related aneurysms?

A) Controlling blood pressure and cholesterol levels
B) Taking daily antibiotics
C) Avoiding exercise
D) Increasing salt intake

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96. What is the best initial management for a small, asymptomatic AAA?
A) Regular monitoring with imaging and lifestyle modification
B) Immediate surgical repair
C) High-dose anticoagulants
D) Bed rest and oxygen therapy

97. Which medical therapy is most beneficial for preventing the progression of aortic aneurysms?
A) Beta-blockers to reduce blood pressure and wall stress
B) Antiplatelet therapy
C) High-dose statins alone
D) Diuretics to reduce fluid volume

98. What is the main surgical intervention for a large, symptomatic aortic aneurysm?
A) Endovascular aneurysm repair (EVAR) or open surgical repair
B) Balloon angioplasty
C) Coronary artery bypass graft (CABG)
D) Thrombolytic therapy
99. What is the primary goal of treating aortic dissections?
A) Lowering blood pressure to reduce further dissection and rupture risk
B) Increasing cardiac output
C) Enhancing platelet aggregation
D) Reducing sodium intake only

100. Which lifestyle modification is MOST effective in reducing the risk of aneurysm formation and rupture?
A) Smoking cessation
B) Increasing saturated fat intake
C) Avoiding all physical activity
D) Drinking more carbonated beverages

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