Vasculitis: thromboangiitis obliterans: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pathology · Vasculitis: thromboangiitis obliterans

Sample item

A 32-year-old man who smokes beedis heavily has calf claudication, painful ulcers on the fingertips and recurrent superficial thrombophlebitis. Angiography shows segmental occlusion of distal limb vessels with corkscrew collaterals. Which histological feature fits his disease?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cellular occlusive thrombus with neutrophilic microabscesses and a preserved internal elastic lamina

Thromboangiitis obliterans is a segmental thrombosing vasculitis of small and medium arteries and adjacent veins in young smokers. The thrombus contains neutrophilic microabscesses, and the vessel wall architecture including the internal elastic lamina is preserved, unlike in other vasculitides. Stopping tobacco is the only effective treatment.

Option by option

  • A. Segmental fibrinoid necrosis of medium arteries at branch points with skip lesions

    Fibrinoid necrosis with skip lesions at branch points describes polyarteritis nodosa.

  • B. Granulomatous inflammation with giant cells fragmenting the internal elastic lamina

    Giant cell granulomas fragmenting the elastic lamina describe giant cell arteritis.

  • C. Concentric intimal fibrosis with cholesterol clefts and medial calcification

    Atheromatous intimal plaques with calcification describe atherosclerosis in older patients.

  • D. Cellular occlusive thrombus with neutrophilic microabscesses and a preserved internal elastic lamina (correct)

    Correct. Microabscesses within a thrombus with intact vessel architecture characterise this disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Cellular occlusive thrombus with neutrophilic microabscesses and a preserved internal elastic lamina. Thromboangiitis obliterans is a segmental thrombosing vasculitis of small and medium arteries and adjacent veins in young smokers.

Why is "Segmental fibrinoid necrosis of medium arteries at branch points with…" not the answer?

Fibrinoid necrosis with skip lesions at branch points describes polyarteritis nodosa.

Why is "Granulomatous inflammation with giant cells fragmenting the internal…" not the answer?

Giant cell granulomas fragmenting the elastic lamina describe giant cell arteritis.

Why is "Concentric intimal fibrosis with cholesterol clefts and medial calcif…" not the answer?

Atheromatous intimal plaques with calcification describe atherosclerosis in older patients.

What concept does this question test?

It tests Vasculitis: thromboangiitis obliterans in Pathology. The thrombus contains neutrophilic microabscesses, and the vessel wall architecture including the internal elastic lamina is preserved, unlike in other vasculitides. Stopping tobacco is the only effective treatment.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vasculitis: thromboangiitis obliterans?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.