Systemic pathology: syphilitic aortitis: 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 · Systemic pathology: syphilitic aortitis

Sample item

A 55-year-old man has aortic regurgitation and a dilated aortic root. The aortic intima has a wrinkled tree-bark appearance, and histology shows obliterative endarteritis of the vasa vasorum with a plasma cell infiltrate. Which part of the aorta is typically involved?

ADescending thoracic aortaBInfrarenal abdominal aortaCAscending aorta and archDPulmonary trunk

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

The answer and the reasoning

C. Ascending aorta and arch

Tertiary syphilis causes aortitis mainly of the ascending aorta and arch, because ischaemia of the media from obliterative endarteritis of the vasa vasorum leads to scarring, aneurysm formation and dilatation of the aortic root with valve incompetence. Atherosclerotic aneurysms are commoner in the infrarenal abdominal aorta.

Option by option

A. Descending thoracic aorta
The descending thoracic aorta is not the typical segment affected in tertiary syphilis.
B. Infrarenal abdominal aorta
The infrarenal abdominal aorta is the usual site of atherosclerotic aneurysm.
C. Ascending aorta and arch (correct)
Correct. Syphilitic aortitis characteristically involves the ascending aorta and arch.
D. Pulmonary trunk
The pulmonary trunk is not affected in syphilitic aortitis.

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.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Ascending aorta and arch. Tertiary syphilis causes aortitis mainly of the ascending aorta and arch, because ischaemia of the media from obliterative endarteritis of the vasa vasorum leads to scarring, aneurysm formation and dilatation of the aortic root with valve incompetence.

Why is "Descending thoracic aorta" not the answer?

The descending thoracic aorta is not the typical segment affected in tertiary syphilis.

Why is "Infrarenal abdominal aorta" not the answer?

The infrarenal abdominal aorta is the usual site of atherosclerotic aneurysm.

Why is "Pulmonary trunk" not the answer?

The pulmonary trunk is not affected in syphilitic aortitis.

What concept does this question test?

It tests Systemic pathology: syphilitic aortitis in Pathology. Atherosclerotic aneurysms are commoner in the infrarenal abdominal aorta.

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 Systemic pathology: syphilitic aortitis?

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.