Haemodynamics: infarction: 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 · Haemodynamics: infarction

Sample item

A 16-year-old boy has sudden severe scrotal pain. At orchidectomy the testis is enlarged and dark red-black, with the spermatic cord twisted twice on itself. What explains the haemorrhagic appearance of this infarct?

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

The answer and the reasoning

C. Venous outflow occlusion occurs first while arterial inflow continues, engorging the testis

Red (haemorrhagic) infarcts occur with venous occlusion such as torsion, in loose tissues, in organs with dual circulation like lung and bowel, and after reperfusion. In torsion the thin-walled veins are compressed before the thicker arteries, so blood enters but cannot leave. Pale infarcts occur with arterial occlusion in solid organs with end-artery supply, such as kidney, spleen and heart.

Option by option

  • A. Embolic occlusion by an infected thrombus with abscess formation

    Septic embolism gives a suppurative infarct, which is not a feature of torsion.

  • B. Abrupt arterial occlusion in a tissue supplied by a single end-artery

    End-artery occlusion in solid organs gives a pale, wedge-shaped infarct, as seen in the kidney or spleen.

  • C. Venous outflow occlusion occurs first while arterial inflow continues, engorging the testis (correct)

    Correct. Continued arterial inflow against blocked venous drainage causes haemorrhagic infarction.

  • D. Gradual atherosclerotic narrowing of the testicular artery

    Slow atherosclerotic narrowing produces atrophy or a pale infarct and is rare in a teenager.

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, Venous outflow occlusion occurs first while arterial inflow continues, engorging the testis. Red (haemorrhagic) infarcts occur with venous occlusion such as torsion, in loose tissues, in organs with dual circulation like lung and bowel, and after reperfusion.

Why is "Embolic occlusion by an infected thrombus with abscess formation" not the answer?

Septic embolism gives a suppurative infarct, which is not a feature of torsion.

Why is "Abrupt arterial occlusion in a tissue supplied by a single end-artery" not the answer?

End-artery occlusion in solid organs gives a pale, wedge-shaped infarct, as seen in the kidney or spleen.

Why is "Gradual atherosclerotic narrowing of the testicular artery" not the answer?

Slow atherosclerotic narrowing produces atrophy or a pale infarct and is rare in a teenager.

What concept does this question test?

It tests Haemodynamics: infarction in Pathology. In torsion the thin-walled veins are compressed before the thicker arteries, so blood enters but cannot leave. Pale infarcts occur with arterial occlusion in solid organs with end-artery supply, such as kidney, spleen and heart.

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 Haemodynamics: infarction?

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.