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Kaplan Qbank USMLE



Author7 Posts
  #1

Autopsy examination of the main pulmonary arteries of a man presumed to have died from a massive cerebrovascular hemorrhage demonstrates a rubbery, concealed mass of blood that is easily detached from the vessel wall. The clot has a homogenous color without evidence of layering on low power microscopic examination. This is an example of:-
  • A. Canalized thrombus
  • B. Mural thrombus
  • C. Occlusive thrombus
  • D. Occlusive embolus
  • E. Postmortem clot


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  #2

  • Postmortem clot---------------------->E


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  #3

  • E. Postmortem clot


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  •   #4

    e.....postmortem clots....absent lines of zahn....
    present in all other clots...

      #5

    e. postmortem clot


      #6

    shocked

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      #7

    CORRECT ANSWER: POSTMORTEM CLOT

    At autopsy it's important to distinguish postmortem clots from clinically significant premortem thrombi or emboli. The lines of Zahn are red, cell-rich layers in a thrombus that appear dark, grossly. Alternating with these lines are lighter layers rich in platelets and fibrin. No lines of Zahn are seen in postmortem clots, but are present in clots formed premortem including mural thrombi, occlusive thrombi, or emboli. Recent embolus-like postmortem clots may not be attached to the vessel wall, but can be distinguished by the presence of either lines of Zahn or areas of fibrosis (uncommon) within them. With time, thrombi are replaced by fibrous tissue and capillaries will recanalize the thrombus. In practice, this doesn't usually restore adequate blood flow, since the cross-sectional area of the capillary bed is usually much lower than the cross-sectional area of the original vessel.


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