RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015
Medical & Surgical Nursing
Easy
Atherosclerotic plaque formation causing narrowing, ischemia lead to thromboembolism, which results in cardio or cerebro vascular disease in patient with?
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015
Explanation
- Hyperlipidemia, characterized by high levels of lipids like cholesterol and triglycerides in the blood, is the foundational cause of atherosclerosis.
- Excess Low-Density Lipoprotein (LDL), often called 'bad cholesterol,' infiltrates the arterial wall, initiating an inflammatory response that leads to plaque formation.
- This process of plaque buildup (atherosclerosis) is the direct precursor to the narrowing, ischemia, and thromboembolism described in the question.
- The other options are either consequences of atherosclerosis (Myocardial Infarction, Cardiogenic Shock) or involve a different pathological process (Infective Endocarditis).
Why Other Options Were Wrong
- Option A: Infective endocarditis involves emboli, but they are septic vegetations (clumps of bacteria/fungi) from infected heart valves, not the cholesterol-laden plaques of atherosclerosis.
- Option B: Cardiogenic shock is a state of severe heart pump failure. It is a potential severe complication or end-stage result of a heart attack, not the initial cause of the plaque formation.
- Option D: Myocardial infarction (heart attack) is an acute event that is a result of atherosclerosis, typically when a plaque ruptures and a clot blocks a coronary artery. It is the clinical outcome, not the underlying chronic condition causing the plaque.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Pathophysiology of Atherosclerosis and Hyperlipidemia to guide bedside assessment, documentation, and the next nursing action.
- Nurses are central to patient education on managing hyperlipidemia through diet, exercise, and medication adherence (e.g., statins) to prevent cardiovascular events.
- Accurate assessment of a patient's risk factors, including family history, smoking, hypertension, and lipid levels, is a key nursing function in primary and secondary prevention of heart disease.
- What if? If the patient presented with sudden, crushing chest pain, the immediate priority would shift from managing the chronic condition (hyperlipidemia) to treating the acute event (myocardial infarction). The priority nursing actions would involve administering oxygen, nitroglycerin, aspirin, and obtaining an ECG, rather than discussing diet.
How to Approach the Question
- First, break down the process described in the question: Plaque formation → Artery narrowing (ischemia) → Clot formation (thromboembolism) → Heart attack or Stroke.
- Recognize that the question is asking for the root cause or the starting point of this entire pathological sequence.
- Evaluate each option in the context of this sequence.
- Ask yourself: Is this option the cause of the plaque, or is it a result of the plaque?
- Hyperlipidemia (high blood fats) is the well-established cause of plaque formation.
- Myocardial infarction and cardiogenic shock are results or complications that occur at the end of the sequence.
Concept Tested & Keywords
- Concept Tested: Pathophysiology of Atherosclerosis and Hyperlipidemia
- Stem keywords: Atherosclerotic plaque, narrowing, ischemia, thromboembolism, cardiovascular disease, cerebrovascular disease
- Lead-in keywords: patient with
- Negative lead-in flag: false
Question ID
QemGI5vjLZqPWfXLh525qi
Reference Book
E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 1 (pp 26-370 of 370) p. 256-258
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 506-508
E6 Medicine Harrison 22e Part 1 p. 2132-2134
Practise the full RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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