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Young: Wheater's Basic Pathology, 5th Edition
Chapter 09: Thrombosis and embolism

Test Bank

Multiple Choice

1. The three major factors, often referred to as “Virchow’s triad” that predispose patients to
thrombosis consists of which one of the following groups?

A. Altered blood flow, endothelial damage, and hypercoagulability

B. Female gender, birth control pills, and smoking
C. Fever, obesity, and smoking
D. Male gender, obesity, and smoking

ANSWER: A. Virchow’s triad refers to altered blood flow (turbulence or stagnation),

endothelial damage, and hypercoagulability (from whatever cause).

2. The accompanying photomicrograph shows alternating layers of a thrombus. This

layering effect is known by which one of the following terms?

A. Alternating current
B. Bilayer cementing
C. Lines of Zahn
D. Zebra stripes

ANSWER: C. The layering is known as the Lines of Zahn. See also Fig. 9.2b and related
text.

Copyright © 2010 by Churchill Livingstone, an Imprint of Elsevier Ltd.

Test Bank 9-2

3. The accompanying low power photomicrograph of the left ventricle shows a thrombus
(T) in the heart of a 66 year old man who died of a heart attack. Which one of the
following factors most likely explains the underlying pathophysiologic reason for a
thrombus to occur in this area?

A. Endocardial (endothelial) damage

B. Hypercoagulability
C. Hypertension
D. Inflammation
E. Vasospasm

ANSWER: A. It is likely that the myocardial infarction injured the endocardial surface,
which promoted thrombus formation. See also Fig. 9.3 and related text.

4. This low power photomicrograph of the lung shows a thromboembolism within a

pulmonary artery. What is the most likely source for this thrombus?

A. Deep leg veins

B. Left atrium
C. Left ventricle
D. Likely formed in situ on top of an atherosclerotic plaque
E. Right atrium
F. Right ventricle
G. Vena cava

Copyright © 2010 by Churchill Livingstone, an Imprint of Elsevier Ltd.

Test Bank 9-3

ANSWER: A. Complicated atherosclerotic plaques with overlying thrombosis are rare in the
pulmonary circulation. However, the deep veins of the pelvis and leg are often involved by
venous thrombi, which commonly dislodge, are pumped through the right side of the heart,
and end up wedged in one or more branches of the pulmonary arteries. Large thrombi can
occlude the main pulmonary artery, causing instant right heart failure, and/or ventricular
fibrillation. See also Fig. 9.4 and related text.

5. This medium power photomicrograph of a small artery likely depicts the result of which
one of the following pathophysiologic events?

A. Atherosclerosis
B. Fracture of a long bone
C. Organisation
D. Recanalisation
E. Therapeutic embolisation
F. Thromboembolism

ANSWER: B. Fracture of a long bone may lead to embolisation of the bone marrow (as in
this case) and also fat. Both can lodge within arteries and cause hypoxia and ischaemia. See
also Fig. 9.5 and surrounding text.

6. This medium power photomicrograph of a small artery depicts the result of which one of
the following pathophysiologic events?

Copyright © 2010 by Churchill Livingstone, an Imprint of Elsevier Ltd.

Test Bank 9-4

A. Atherosclerosis
B. Fracture of a long bone
C. Organisation
D. Recanalisation
E. Therapeutic embolisation
F. Thromboembolism

ANSWER: C. Organisation of a thrombus, in the form of granulation tissue (G) is seen in

this photomicrograph. There is a portion of thrombus (T) that has not yet been organised. See
also Fig. 9.7a and related text.

7. This medium power photomicrograph of a small artery depicts the results of which one of
the following pathophysiologic events?

A. Atherosclerosis
B. Fracture of a long bone
C. Organisation
D. Recanalisation
E. Therapeutic embolisation
F. Thromboembolism

ANSWER: D. This artery shows the continuum endpoint of the organisation of a thrombus,
with new vessel formation (V). We call this event “recanalisation”. See also Fig. 9.7b and
related text.

Copyright © 2010 by Churchill Livingstone, an Imprint of Elsevier Ltd.