[MCQ] The Pathogenesis, Prevention, and Treatment of Atherosclerosis - Part 1

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The Pathogenesis, Prevention, and Treatment of Atherosclerosis- Part 1

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Question 1

Stenoses due to atherosclerosis occurs focally in which of the following locations ?

A	Proximal left anterior descending coronary artery
B	Proximal portions of the renal arteries
C	Carotid bifurcation
D	All of the above

Question 2

Which of the following represents the initial lesion of atherosclerosis ?

A	Necrotic core
B	Fatty streak
C	Microscopic breaches in endothelial integrity
D	Microthrombi rich in platelets

Question 2 Explanation:

In human atherosclerosis, “fatty streak” represents the initial lesion of atherosclerosis. These arise from focal increases in the content of lipoproteins within regions of the intima. Fatty streak formation begins beneath a morphologically intact endothelium.

Question 3

Which of the following slows the egress of lipid-rich particles from the arterial wall intima ?

A	Glycosaminoglycans
B	Flavonoids
C	Vitamin K
D	All of the above

Question 3 Explanation:

Lipoproteins collect and stay in the arterial wall intima by binding to constituents of extracellular matrix. Lipoproteins when associated with glycosaminoglycans of arterial extracellular matrix lead to their slow from the intima. These lipoprotein particles undergo further oxidative modifications and play a pathogenic role in atherogenesis.

Question 4

Oxidative modification of lipoproteins in the extracellular space of the intima give rise to ?

A	Hydroperoxides
B	Lysophospholipids
C	Oxysterols
D	All of the above

Question 4 Explanation:

Oxidative modification of lipoproteins in the extracellular space of the intima give rise to hydroperoxides, lysophospholipids, oxysterols, and aldehydic breakdown products of fatty acids and phospholipids.

Question 5

Which of the following reactions modifies high-density lipoprotein (HDL) particles to become poor cholesterol acceptors ?

A	Glutathione peroxidase
B	Hypochlorous acid mediated chlorination
C	Carnitine biosynthesis
D	All of the above

Question 5 Explanation:

High-density lipoprotein (HDL) particles modified by Hypochlorous acid (HOCl)-mediated chlorination function poorly as cholesterol acceptors. This links oxidative stress with impaired reverse cholesterol transport as a likely mechanism of the antiatherogenic action of HDL

Question 6

Hypochlorous acid is produced in extracellular space of the intima of arteries by ?

A	Pyruvate -ketoglutarate
B	Succinic acid dehydrogenase
C	Monoamine oxidase
D	Myeloperoxidase

Question 7

Which of the following leads to the formation of proinflammatory lipids ?

A	Ubiquinone
B	Idebenone
C	Lipoprotein-associated phospholipase A2 (LpPL A2)
D	All of the above

Question 7 Explanation:

Member of phospholipase family, lipoprotein-associated phospholipase A2 (LpPL A2) can generate proinflammatory lipids, including lysophosphatidyl choline-bearing oxidized lipid moieties from oxidized phospholipids found in oxidized low-density lipoproteins (LDLs)

Question 8

Which of the following is an endogenous antioxidant ?

A	Thioredoxin
B	Biotin
C	Retinaldehyde
D	All of the above

Question 8 Explanation:

Exposure of endothelial cells to laminar shear stress increases the transcription of Krüppel-like factor 2 (KLF2) and reduces the expression of a thioredoxin-interacting protein (Txnip) that inhibits the activity of the endogenous antioxidant thioredoxin. KLF2 augments the activity of endothelial nitric oxide synthase, and reduced Txnip levels boost the function of thioredoxin

Question 9

Atherosclerotic plaques contain which of the following ?

A	Fibrin
B	Hemosiderin
C	Calcium
D	All of the above

Question 9 Explanation:

All of the above

Question 10

Which of the following proteins found in bone also localize in atherosclerotic lesions ?

A	Osteocalcin
B	Osteopontin
C	Bone morphogenetic proteins
D	Bone morphogenetic proteins

Question 10 Explanation:

Proteins like osteocalcin, osteopontin, and bone morphogenetic proteins that are usually found in bone also localize in atherosclerotic lesions.

Question 11

Which of the following contribute to atheromata lesion formation ?

A	Extracellular matrix production
B	Extracellular matrix production
C	Neovascularization
D	Neovascularization

Question 11 Explanation:

During the evolution of atherosclerotic plaque, a complex balance between entry and egress of lipoproteins and leukocytes, cell proliferation and cell death, extracellular matrix production, and remodeling, as well as calcification and neovascularization, contribute to lesion formation

Question 12

Growing atheroma does not encroach on arterial lumen until the burden of atherosclerotic plaque exceeds ?

A	~ 20 %
B	~ 40 %
C	~ 60 %
D	~ 80 %

Question 12 Explanation:

During initial phases of atheroma development, plaque usually grows outward, in an abluminal direction leading to increase in diameter of the vessel. This type of vascular remodeling is called compensatory enlargement. Growing atheroma does not encroach on arterial lumen until the burden of atherosclerotic plaque exceeds ~40% of the area encompassed by the internal elastic lamina

Question 13

Which of the following is a characteristic feature of the culprit lesion that causes acute MI ?

A	Thin fibrous caps
B	Relatively large lipid cores
C	High content of macrophages
D	All of the above

Question 13 Explanation:

Characteristic features of the culprit lesion that causes acute MI include thin fibrous caps, relatively large lipid cores, and a high content of macrophages. Macrophages & T lymphocytes having markers of inflammatory activation predominate and contain relatively few smooth muscle cells at sites of plaque rupture.

Question 14

Current ATP III guidelines recommend lipid screening in all adults above ?

A	10 years of age
B	20 years of age
C	30 years of age
D	40 years of age

Question 14 Explanation:

Current ATP III guidelines recommend lipid screening in all adults >20 years of age and should include a fasting lipid profile (total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol) repeated every 5 years.

Question 15

Which of the following is a Niemann-Pick C1-like 1 protein (NPC1L1) inhibitor ?

A	Aminophylline
B	Ezetimibe
C	Nicotinic acid
D	Sildenafil

Question 15 Explanation:

Ezetimibe is a LDL-lowering medication that reduces cholesterol absorption from proximal small bowel by inhibiting an enterocyte cholesterol transporter denoted Niemann-Pick C1-like 1 protein (NPC1L1).

Question 16

Blood HDL levels vary inversely with those of ?

A	Cholesterol
B	LDL
C	Triglycerides
D	VLDL

Question 16 Explanation:

Blood HDL levels vary inversely with those of triglycerides.

Question 17

Which of the following can raise HDL levels ?

A	Physical activity
B	Nicotinic acid
C	Weight loss
D	All of the above

Question 17 Explanation:

Weight loss and physical activity can raise HDL. Nicotinic acid, particularly in combination with statins, can robustly raise HDL.

Question 18

Lipoproteins are essential for the transport of ?

A	Cholesterol
B	Triglycerides
C	Fat-soluble vitamins
D	Fat-soluble vitamins

Question 18 Explanation:

Lipoproteins are complexes of lipids & proteins essential for transport of cholesterol, triglycerides, and fat-soluble vitamins.

Question 19

Lipoproteins transport hydrophobic lipids through which of the following ?

A	Plasma
B	Interstitial fluid
C	Lymph
D	All of the above

Question 19 Explanation:

Lipoproteins transport hydrophobic lipids (triglycerides, cholesterol & fat-soluble vitamins) through body fluids (plasma, interstitial fluid & lymph) to & from tissue

Question 20

Lipoproteins are essential in the absorption of ?

A	Dietary cholesterol
B	Long-chain fatty acids
C	Long-chain fatty acids
D	Long-chain fatty acids

Question 20 Explanation:

Long-chain fatty acids

Question 21

Lipoproteins are essential for the transport of which of the following to and from liver to peripheral tissues ?

A	Triglycerides
B	Cholesterol
C	Fat-soluble vitamins
D	All of the above

Question 21 Explanation:

Lipoproteins are essential for transport of triglycerides, cholesterol & fat-soluble vitamins from liver to peripheral tissues and transport of cholesterol from peripheral tissues to liver

Question 22

Which of the following is not a hydrophobic lipid ?

A	Triglycerides
B	Unesterified cholesterol
C	Cholesteryl esters
D	All of the above

Question 22 Explanation:

Lipoproteins contain a core of hydrophobic lipids (triglycerides & cholesteryl esters) surrounded by hydrophilic lipids (phospholipids, unesterified cholesterol) and proteins

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The Pathogenesis, Prevention, and Treatment of Atherosclerosis – Part 1| The Pathogenesis, Prevention, and Treatment of Atherosclerosis – Part 2| The Pathogenesis, Prevention, and Treatment of Atherosclerosis – Part 3

1.Stenoses due to atherosclerosis occurs focally in which of the following locations ?

A. Proximal left anterior descending coronary artery
B. Proximal portions of the renal arteries
C. Carotid bifurcation
D. All of the above
2. Which of the following represents the initial lesion of atherosclerosis ?
A. Necrotic core
B. Fatty streak
C. Microscopic breaches in endothelial integrity
D. Microthrombi rich in platelets

3. Which of the following slows the egress of lipid-rich particles from the arterial wall intima ?
A. Glycosaminoglycans
B. Flavonoids
C. Vitamin K
D. All of the above
.
4. Oxidative modification of lipoproteins in the extracellular space of the intima give rise to ?
A. Hydroperoxides
B. Lysophospholipids
C. Oxysterols
D. All of the above
.
5. Which of the following reactions modifies high-density lipoprotein (HDL) particles to become poor cholesterol
acceptors ?
A. Glutathione peroxidase
B. Hypochlorous acid mediated chlorination
C. Carnitine biosynthesis
D. All of the above

6. Hypochlorous acid is produced in extracellular space of the intima of arteries by ?
A. Pyruvate -ketoglutarate
B. Succinic acid dehydrogenase
C. Monoamine oxidase
D. Myeloperoxidase

7. Which of the following leads to the formation of proinflammatory lipids ?
A. Ubiquinone
B. Idebenone
C. Lipoprotein-associated phospholipase A2 (LpPL A2)
D. All of the above

8. Which of the following is an endogenous antioxidant ?
A. Thioredoxin
B. Biotin
C. Retinaldehyde
D. All of the above

9. Atherosclerotic plaques contain which of the following ?
A. Fibrin
B. Hemosiderin
C. Calcium
D. All of the above

10. Which of the following proteins found in bone also localize in atherosclerotic lesions ?
A. Osteocalcin
B. Osteopontin
C. Bone morphogenetic proteins
D. All of the above

11. Which of the following contribute to atheromata lesion formation ?
A. Extracellular matrix production
B. Calcification
C. Neovascularization
D. All of the above

12. Growing atheroma does not encroach on arterial lumen until the burden of atherosclerotic plaque exceeds ?
A. ~ 20 %

B. ~ 40 %
C. ~ 60 %
D. ~ 80 %

13. Which of the following is a characteristic feature of the culprit lesion that causes acute MI ?
A. Thin fibrous caps
B. Relatively large lipid cores
C. High content of macrophages
D. All of the above

14. Current ATP III guidelines recommend lipid screening in all adults above ?
A. 10 years of age
B. 20 years of age
C. 30 years of age
D. 40 years of age

15. Which of the following is a Niemann-Pick C1-like 1 protein (NPC1L1) inhibitor ?
A. Aminophylline
B. Ezetimibe
C. Nicotinic acid
D. Sildenafil

16. Blood HDL levels vary inversely with those of ?
A. Cholesterol
B. LDL
C. Triglycerides
D. VLDL

17. Which of the following can raise HDL levels ?
A. Physical activity
B. Nicotinic acid
C. Weight loss
D. All of the above
B. ~ 40 %
C. ~ 60 %
D. ~ 80 %

18. Lipoproteins are essential for the transport of ?
Harrison’s 18th Ed. 3145
A. Cholesterol
B. Triglycerides
C. Fat-soluble vitamins
D. All of the above

19. Lipoproteins transport hydrophobic lipids through which of the following ?
A. Plasma
B. Interstitial fluid
C. Lymph
D. All of the above

20. Lipoproteins are essential in the absorption of ?
Harrison’s 18th Ed. 3145
A. Dietary cholesterol
B. Long-chain fatty acids
C. Fat-soluble vitamins
D. All of the above

21. Lipoproteins are essential for the transport of which of the following to and from liver to peripheral tissues ?
A. Triglycerides
B. Cholesterol
C. Fat-soluble vitamins
D. All of the above

22. Which of the following is not a hydrophobic lipid ?
A. Triglycerides
B. Unesterified cholesterol
C. Cholesteryl esters
D. All of the above

[MCQ] The Pathogenesis, Prevention, and Treatment of Atherosclerosis – Part 1

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The Pathogenesis, Prevention, and Treatment of Atherosclerosis- Part 1

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