An elderly woman is found dead in her home.

[Anonymous]

An elderly woman is found dead in her home. Autopsy demonstrates an
area of pallor on the apex of her heart. On microscopic examination, there
is coagulative necrosis of the muscles accompanied by a modest neutrophilic
infiltrate, which is focally heavy in some areas. No macrophages or
fibroblasts are seen. Approximately how long before her death did this
woman experience a myocardial infarction?
A. 2 hours
B. 18 hours
C. 3 days
D. 10 days
E. 10 weeks












The correct answer is C. The findings suggest a 2-4 day old myocardial infarction (MI). An MI becomes visible grossly after about 12 hours (sometimes earlier) as an area of pallor and eventually, cyanosis. Neutrophils infiltrate the tissue anywhere from 12 to 72 hours after infarction, with increasing evidence of coagulative necrosis.
At 2 hours (choice A), no changes would likely be evident in the infarcted myocardium.
At about 18 hours (choice B), "waviness" of some myocardial fibers may be apparent microscopically, and subtle changes in the appearance of the myofibrils producing alternating densely-colored (contracted) and lightly-colored (expanded) areas can be observed.
At 5 to 10 days (choice D), both macrophages and neutrophils are present and granulation tissue with fibroblasts is growing in from the edges.
After 7 weeks (choice E), the area of infarction is typically completely replaced by scar tissue.

[Roxanita]

this is a good one from q--bank. thanks step1.

[Anonymous]

hi rox. good to see ya. we missed you in the last couple of chats
I hope your course is going well and that you're studying hard.

your right about the qbank question. i'm doing lots of questions from lots of sources, so i try to post some here that i find interesting or relevant to whatever topic we happen to be on. hopefully they will help others in their studies too

hope to see ya soon!