Autopsy examination of the main pulmonary arteries

[Oak]

Autopsy examination of the main pulmonary arteries of a man presumed to have died from a massive cerebrovascular hemorrhage demonstrates a rubbery, congealed mass of blood that is easily detached from the vessel wall. No lines of Zahn are seen. This is an example of which of the following?

A. Canalized thrombus
B. Mural thrombus
C. Occlusive embolus
D. Occlusive thrombus
E. Postmortem clot

[bharat]

I think it is example of occlusive thrombus so i will go for D.
well to tell u franky i am 2nd year student(studing in china at weifang medical collage) & going to third year after 2 month,so my answer may not be correct all the times but i am very impreseed by these types of clinical mcq. which has helped to widen my knowledge in this field. so i am very thak full to Xenomed family and all memeberes.

[Oak]

bharat, we are just discussing the various case scenario to give the another way of understanding clinical medicine.

Clinical MCQs are not to judge who is smart or not, nobody is perfect I also commit mistake. You know there is a great saying in medical literature "It is better to commit then omit"

Those who commit mistake learn medicine quickly because medicine is all about discussion. Its the human nature that we learn by mistake, because more we commit mistake more we learn, I am sure your level of understanding has increased in those MCQs where you made mistake than those you easily figure out.
Therefore I welcome the mistake Nobody is harmed by commiting mistakes in the Clinial Discusion but someone might die if we do the same in our Clinial Practice.

Therefore its good that we commit mistake in the discussion. I hope no words are needed to explain You admit that you commit mistakes that means your great.

[Oak]

The correct answer is E. At autopsy, it is important to be able to distinguish postmortem clots, such as those observed in this subject, 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 (wall) thrombi (choice B), occlusive thrombi (choice D), or emboli (choice C) (from other vessels).

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 (choice A). In practice, this does not 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.