Systemic pathology: mitral valve prolapse: 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 · Systemic pathology: mitral valve prolapse

Sample item

A 28-year-old woman has a mid-systolic click and late systolic murmur. A valve excised years later for regurgitation shows ballooned, floppy leaflets. Which histological change is characteristic?

ASterile fibrin and platelet vegetationsBHeavy calcification of the annulus and cuspsCFibrinoid necrosis surrounded by Aschoff giant cellsDMyxomatous degeneration with expanded spongiosa

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

The answer and the reasoning

D. Myxomatous degeneration with expanded spongiosa

Myxomatous mitral valve disease features thinning of the fibrosa and accumulation of proteoglycan-rich myxoid material in the spongiosa. It is associated with Marfan syndrome, and complications include regurgitation, endocarditis and arrhythmia.

Option by option

A. Sterile fibrin and platelet vegetations
Sterile vegetations occur in Libman-Sacks and marantic endocarditis.
B. Heavy calcification of the annulus and cusps
Annular and cuspal calcification characterises degenerative calcific disease of the aortic valve and the mitral annulus.
C. Fibrinoid necrosis surrounded by Aschoff giant cells
Aschoff bodies are the lesion of rheumatic carditis and produce fibrous leaflet thickening.
D. Myxomatous degeneration with expanded spongiosa (correct)
Correct. Proteoglycan-rich expansion of the spongiosa with thin fibrosa produces floppy leaflets.

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 D, Myxomatous degeneration with expanded spongiosa. Myxomatous mitral valve disease features thinning of the fibrosa and accumulation of proteoglycan-rich myxoid material in the spongiosa.

Why is "Sterile fibrin and platelet vegetations" not the answer?

Sterile vegetations occur in Libman-Sacks and marantic endocarditis.

Why is "Heavy calcification of the annulus and cusps" not the answer?

Annular and cuspal calcification characterises degenerative calcific disease of the aortic valve and the mitral annulus.

Why is "Fibrinoid necrosis surrounded by Aschoff giant cells" not the answer?

Aschoff bodies are the lesion of rheumatic carditis and produce fibrous leaflet thickening.

What concept does this question test?

It tests Systemic pathology: mitral valve prolapse in Pathology. It is associated with Marfan syndrome, and complications include regurgitation, endocarditis and arrhythmia.

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 Systemic pathology: mitral valve prolapse?

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.