The histopathology image reveals a pathognomonic cell with a caterpillar-like nucleus, an Anitschkow cell. In which condition is this characteristic finding seen?

1. A

   Viral myocarditis

2. B

   Acute myocardial infarction

3. C

   Old or healed myocardial infarction

4. D

   Pharyngitis 2 weeks ago with Group A beta hemolytic streptococcus infection

Appeared in: NORCET-11 Prelims

Explanation

• Anitschkow cells are large mononuclear cells with a caterpillar-like nucleus, seen in Aschoff bodies.
• Aschoff bodies are pathognomonic for rheumatic carditis, a manifestation of acute rheumatic fever.
• Acute rheumatic fever typically follows a Group A beta-hemolytic streptococcal pharyngitis after a latent period.
• The presence of these cells confirms rheumatic involvement of the heart.

Why Other Options Were Wrong

• Option A: Viral myocarditis does not show Anitschkow cells or Aschoff bodies. It is characterized by lymphocytic infiltration and myocyte necrosis.
• Option B: Acute myocardial infarction is characterized by coagulative necrosis and neutrophilic infiltration, not Anitschkow cells.
• Option C: Old or healed myocardial infarction shows fibrosis and scar tissue, not Anitschkow cells or Aschoff bodies.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification and clinical significance of Anitschkow cells in cardiac histopathology as background academic context rather than a clinical decision trigger.
• Recognizing Anitschkow cells helps confirm rheumatic carditis, guiding appropriate management and secondary prophylaxis.
• Early identification of rheumatic fever can prevent chronic rheumatic heart disease and valvular damage.
• What if? - If the patient had no history of recent pharyngitis or the cells lacked the caterpillar-like nucleus, another diagnosis (e.g., viral myocarditis) would be considered.

How to Approach the Question

• Carefully observe the histopathology image for unique nuclear features (caterpillar-like chromatin).
• Recall which disease process is pathognomonic for Anitschkow cells (rheumatic fever).
• Match the clinical scenario (recent pharyngitis, Group A strep) to the pathological finding.
• Eliminate options that do not fit the histological or clinical context.
• Use the timeline (2 weeks post-pharyngitis) as a key clue for rheumatic fever.

Concept Tested & Keywords

• Concept Tested: Identification and clinical significance of Anitschkow cells in cardiac histopathology
• Stem keywords: histopathology image, Anitschkow cell, caterpillar-like nucleus, pathognomonic cell
• Lead-in keywords: condition, characteristic finding
• Clinical cues: Pharyngitis 2 weeks ago
• Clinical cues: Group A beta hemolytic streptococcus infection

Question ID

QMA-C076t_ThfPFHVqEteU

Copy ID

Reference Book

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 2 (215-514) pp. 13-15, 14-16

E6 PATHOLOGY QUICK REVIEWBased on Harsh Mohan Textbook of PATHOLOGY p. 193-195