Cardiovascular: polyarteritis nodosa: 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 · Cardiovascular: polyarteritis nodosa

Sample item

A 40-year-old man with chronic hepatitis B has fever, weight loss, new hypertension, abdominal pain and mononeuritis multiplex. Mesenteric angiography shows multiple microaneurysms. The lungs are clear. What would arterial biopsy most likely show?

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

The answer and the reasoning

C. Segmental transmural fibrinoid necrosis of medium-sized arteries in different stages of healing

Polyarteritis nodosa is a necrotising vasculitis of medium-sized muscular arteries with segmental transmural fibrinoid necrosis. Lesions of different ages coexist, and the arteries form aneurysms, causing renal infarcts, hypertension, gut ischaemia and neuropathy. It spares the pulmonary circulation and is associated with hepatitis B in some patients.

Option by option

  • A. Granulomatous thickening of the aortic arch with giant cells

    Granulomatous aortitis with giant cells describes Takayasu arteritis in young women.

  • B. Necrotising granulomas of the respiratory tract with capillaritis

    Necrotising granulomas of the airways describe granulomatosis with polyangiitis, which involves the lungs.

  • C. Segmental transmural fibrinoid necrosis of medium-sized arteries in different stages of healing (correct)

    Correct. Segmental fibrinoid necrosis with lesions at different stages defines polyarteritis nodosa.

  • D. Leukocytoclastic inflammation of post-capillary venules with nuclear dust

    Leukocytoclastic venulitis describes hypersensitivity or IgA vasculitis of small vessels.

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 C, Segmental transmural fibrinoid necrosis of medium-sized arteries in different stages of healing. Polyarteritis nodosa is a necrotising vasculitis of medium-sized muscular arteries with segmental transmural fibrinoid necrosis.

Why is "Granulomatous thickening of the aortic arch with giant cells" not the answer?

Granulomatous aortitis with giant cells describes Takayasu arteritis in young women.

Why is "Necrotising granulomas of the respiratory tract with capillaritis" not the answer?

Necrotising granulomas of the airways describe granulomatosis with polyangiitis, which involves the lungs.

Why is "Leukocytoclastic inflammation of post-capillary venules with nuclear…" not the answer?

Leukocytoclastic venulitis describes hypersensitivity or IgA vasculitis of small vessels.

What concept does this question test?

It tests Cardiovascular: polyarteritis nodosa in Pathology. Lesions of different ages coexist, and the arteries form aneurysms, causing renal infarcts, hypertension, gut ischaemia and neuropathy. It spares the pulmonary circulation and is associated with hepatitis B in some patients.

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 Cardiovascular: polyarteritis nodosa?

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.