Cell injury: ischaemia-reperfusion: 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.

Try it

Pathology · Cell injury: ischaemia-reperfusion

Sample item

A 58-year-old man with an acute anterior myocardial infarction undergoes primary angioplasty 90 minutes after onset. Hours later a biopsy of the reperfused zone shows contraction band necrosis, and he develops ventricular ectopics. Which statement best explains the additional damage seen after restoring flow?

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

The answer and the reasoning

A. Oxygen radical generation and calcium overload, with neutrophil-mediated inflammation

Reperfusion of reversibly injured tissue can paradoxically worsen injury. Re-oxygenation produces reactive oxygen species from damaged mitochondria and from infiltrating leukocytes, while calcium overload and complement and cytokine-driven inflammation add further damage. Contraction band necrosis, with hypercontracted sarcomeres, is typical of reperfused infarcts.

Option by option

  • A. Oxygen radical generation and calcium overload, with neutrophil-mediated inflammation (correct)

    Correct. Oxygen radicals, calcium overload and inflammation drive reperfusion injury.

  • B. Return of ATP production allows every affected myocyte to recover fully

    Only reversibly injured myocytes recover, and some are made worse by the reperfusion itself.

  • C. Restored flow lowers cytosolic calcium and so halts all further injury

    Calcium influx rises during reperfusion, so injury does not simply stop.

  • D. Reperfusion lessens neutrophil recruitment because the tissue is no longer hypoxic

    Reperfusion actually increases leukocyte and complement-mediated damage, not decreases it.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Oxygen radical generation and calcium overload, with neutrophil-mediated inflammation. Reperfusion of reversibly injured tissue can paradoxically worsen injury.

Why is "Return of ATP production allows every affected myocyte to recover ful…" not the answer?

Only reversibly injured myocytes recover, and some are made worse by the reperfusion itself.

Why is "Restored flow lowers cytosolic calcium and so halts all further injury" not the answer?

Calcium influx rises during reperfusion, so injury does not simply stop.

Why is "Reperfusion lessens neutrophil recruitment because the tissue is no l…" not the answer?

Reperfusion actually increases leukocyte and complement-mediated damage, not decreases it.

What concept does this question test?

It tests Cell injury: ischaemia-reperfusion in Pathology. Re-oxygenation produces reactive oxygen species from damaged mitochondria and from infiltrating leukocytes, while calcium overload and complement and cytokine-driven inflammation add further damage. Contraction band necrosis, with hypercontracted sarcomeres, is typical of reperfused infarcts.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Cell injury: ischaemia-reperfusion?

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.