NURSING ANM AND GNM

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NURSING EXAM QUESTIONS

PATHOLOGY AND GENETICS

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
A 65-year-old man suffered a massive myocardial infarction that was complicated by shock and prolonged hypotension. On arrival in the emergency department he was found to have focal neurological signs in addition to features consistent with low-output cardiac failure. Despite the best efforts of the medical team he died the next day. At autopsy, the most likely change you would expect to see in a brain biopsy would be:
A
Acute haemorrhagic change
B
Coagulative necrosis
C
Granulomatous change
D
Lacunar infarct
E
Liquefactive necrosis
Explanation: 

Detailed explanation-1: -The most commonly encountered mechanical complications are acute mitral regurgitation secondary to papillary muscle rupture, ventricular septal defect, pseudoaneurysm, and free wall rupture; each complication is associated with a significant risk of morbidity, mortality, and hospital resource utilization.

Detailed explanation-2: -Mechanical complications of acute myocardial infarction (AMI) are ventricular septal defect (VSD), papillary muscle rupture or dysfunction, cardiac free wall rupture, ventricular aneurysm, dynamic left ventricular (LV) outflow tract (OT) obstruction, and right ventricular (RV) failure.

Detailed explanation-3: -A heart attack (medically known as a myocardial infarction) is a deadly medical emergency where your heart muscle begins to die because it isn’t getting enough blood flow. A blockage in the arteries that supply blood to your heart usually causes this.

Detailed explanation-4: -The median time from the onset of infarction to shock development was 5.6 hours [4]. In the SHOCK trial registry it was found to be 6.2 hr [16]. Certain characteristics (Table 2) such as, being elderly, diabetic or having anterior infarction predispose patients with myocardial infarction to develop shock [1, 27-29].

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