Haemodynamics: arterial thrombus: 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: arterial thrombus

Sample item

A 62-year-old smoker has an occlusive thrombus overlying a ruptured atheromatous plaque in the left anterior descending artery. Which description best fits this thrombus?

APale and firm, rich in platelets and fibrin, laid down under high shearBGelatinous clot with currant-jelly and chicken-fat layers, free in the lumenCDark red and soft, rich in red cells, formed in slow or stagnant flowDHyaline fibrin microthrombi confined to capillaries and arterioles

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

The answer and the reasoning

A. Pale and firm, rich in platelets and fibrin, laid down under high shear

Arterial thrombi form on a damaged intima under high flow, and are firm, pale and composed of platelets and fibrin with prominent lines of Zahn. Venous thrombi (red thrombi) form in sluggish flow and are rich in red cells. A post-mortem clot is gelatinous and not attached to the vessel wall.

Option by option

A. Pale and firm, rich in platelets and fibrin, laid down under high shear (correct)
Correct. Platelet-fibrin rich pale thrombi form at ruptured plaques under high shear.
B. Gelatinous clot with currant-jelly and chicken-fat layers, free in the lumen
The currant-jelly and chicken-fat clot is a post-mortem clot that is not adherent to the wall.
C. Dark red and soft, rich in red cells, formed in slow or stagnant flow
A red-cell rich soft thrombus forms in stasis, typically in deep veins.
D. Hyaline fibrin microthrombi confined to capillaries and arterioles
Fibrin microthrombi in small vessels describe DIC and are not occlusive thrombi at a plaque.

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 A, Pale and firm, rich in platelets and fibrin, laid down under high shear. Arterial thrombi form on a damaged intima under high flow, and are firm, pale and composed of platelets and fibrin with prominent lines of Zahn.

Why is "Gelatinous clot with currant-jelly and chicken-fat layers, free in th…" not the answer?

The currant-jelly and chicken-fat clot is a post-mortem clot that is not adherent to the wall.

Why is "Dark red and soft, rich in red cells, formed in slow or stagnant flow" not the answer?

A red-cell rich soft thrombus forms in stasis, typically in deep veins.

Why is "Hyaline fibrin microthrombi confined to capillaries and arterioles" not the answer?

Fibrin microthrombi in small vessels describe DIC and are not occlusive thrombi at a plaque.

What concept does this question test?

It tests Haemodynamics: arterial thrombus in Pathology. Venous thrombi (red thrombi) form in sluggish flow and are rich in red cells. A post-mortem clot is gelatinous and not attached to the vessel wall.

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: arterial thrombus?

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.