Haemodynamics: paradoxical embolism: 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: paradoxical embolism

Sample item

A 30-year-old with calf swelling suddenly develops hemiparesis. Echocardiography with bubble study shows a patent foramen ovale. Through which mechanism did the stroke occur?

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

The answer and the reasoning

B. Paradoxical embolus from the venous system

Venous thrombi from the leg can cross a right-to-left shunt such as a patent foramen ovale into the arterial circulation. This causes systemic or cerebral emboli despite a venous source.

Option by option

  • A. Cholesterol embolus from the aortic arch

    Cholesterol emboli arise from ulcerated atheroma in older patients and cause livedo and renal failure.

  • B. Paradoxical embolus from the venous system (correct)

    Correct. A deep vein thrombus crossing a septal defect becomes an arterial embolus.

  • C. Fat embolus from long bone fracture

    Fat emboli follow fractures and cause lung, brain and skin signs, and no calf swelling.

  • D. Embolus from a left ventricular mural thrombus

    A left ventricular thrombus arises after myocardial infarction and does not relate to calf swelling.

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 B, Paradoxical embolus from the venous system. Venous thrombi from the leg can cross a right-to-left shunt such as a patent foramen ovale into the arterial circulation.

Why is "Cholesterol embolus from the aortic arch" not the answer?

Cholesterol emboli arise from ulcerated atheroma in older patients and cause livedo and renal failure.

Why is "Fat embolus from long bone fracture" not the answer?

Fat emboli follow fractures and cause lung, brain and skin signs, and no calf swelling.

Why is "Embolus from a left ventricular mural thrombus" not the answer?

A left ventricular thrombus arises after myocardial infarction and does not relate to calf swelling.

What concept does this question test?

It tests Haemodynamics: paradoxical embolism in Pathology. This causes systemic or cerebral emboli despite a venous source.

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 Haemodynamics: paradoxical embolism?

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.