Cardiac pathology: myocardial infarction: 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.

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Pathology · Cardiac pathology: myocardial infarction

Sample item

On autopsy of a patient who died 5 days after a myocardial infarction, the infarct is soft and yellow, with a hyperaemic border. Which microscopic finding is expected?

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

The answer and the reasoning

D. Disintegrating neutrophils with macrophages beginning to clear necrotic myocytes at the border

Around days 3 to 7 the neutrophils are disintegrating and macrophages begin phagocytosing dead myocytes at the margins. The infarct is softest around days 3 to 10, when rupture is most likely. Granulation tissue is prominent from about 1 to 2 weeks and scar forms after about 2 months.

Option by option

  • A. Dense collagenous scar

    A dense scar is established after about 2 months.

  • B. Wavy fibres and oedema only

    Wavy fibres and oedema are early findings at 4 to 12 hours.

  • C. Granulation tissue with new vessels and collagen

    Granulation tissue is typical of weeks 1 to 2.

  • D. Disintegrating neutrophils with macrophages beginning to clear necrotic myocytes at the border (correct)

    Correct. Day 3 to 7 shows neutrophil breakdown and the start of macrophage clearance.

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.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Disintegrating neutrophils with macrophages beginning to clear necrotic myocytes at the border. Around days 3 to 7 the neutrophils are disintegrating and macrophages begin phagocytosing dead myocytes at the margins.

Why is "Dense collagenous scar" not the answer?

A dense scar is established after about 2 months.

Why is "Wavy fibres and oedema only" not the answer?

Wavy fibres and oedema are early findings at 4 to 12 hours.

Why is "Granulation tissue with new vessels and collagen" not the answer?

Granulation tissue is typical of weeks 1 to 2.

What concept does this question test?

It tests Cardiac pathology: myocardial infarction in Pathology. The infarct is softest around days 3 to 10, when rupture is most likely. Granulation tissue is prominent from about 1 to 2 weeks and scar forms after about 2 months.

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 Cardiac pathology: myocardial infarction?

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.