2026/2027 Jersey College
Q1. Which pathophysiologic process is the primary underlying cause
of most coronary artery disease?
A) Acute bacterial destruction of coronary arteries
B) Atherosclerotic plaque formation within coronary arteries
C) Excess production of red blood cells
D) Failure of cardiac valves to open
Correct Answer: B) Atherosclerotic plaque formation within coronary arteries
Rationale: Coronary artery disease most commonly develops from
atherosclerosis, in which lipid accumulation, inflammation, and fibrous
plaque progressively narrow coronary arteries.
Q2. Endothelial injury contributes to atherosclerosis primarily by
promoting which process?
A) Lipid entry, inflammation, platelet activity, and smooth-muscle
proliferation within the arterial wall
B) Immediate dissolution of circulating cholesterol
C) Complete prevention of leukocyte adhesion
D) Permanent arterial vasodilation
Correct Answer: A) Lipid entry, inflammation, platelet activity, and smooth-
muscle proliferation within the arterial wall
Rationale: Endothelial dysfunction permits lipid accumulation and
inflammatory-cell recruitment and contributes to progressive plaque
development.
Q3. Which lipoprotein is most strongly associated with delivery of
cholesterol to peripheral tissues and development of atherosclerotic
plaque when elevated?
A) HDL
B) Chylomicron only
C) LDL
D) Albumin
Correct Answer: C) LDL
Rationale: Elevated low-density lipoprotein promotes cholesterol deposition
within arterial walls and contributes to atherogenesis.
, Q4. Which event most commonly triggers an acute myocardial
infarction in a person with coronary atherosclerosis?
A) Increased lymphatic drainage
B) Gradual improvement of coronary perfusion
C) Increased red blood cell flexibility
D) Plaque disruption followed by thrombus formation and abrupt reduction in
coronary blood flow
Correct Answer: D) Plaque disruption followed by thrombus formation and
abrupt reduction in coronary blood flow
Rationale: Rupture or erosion of an atherosclerotic plaque can expose
thrombogenic material and cause acute coronary thrombosis and myocardial
ischemia.
Q5. Why does myocardial ischemia cause chest pain?
A) Inadequate oxygen supply forces myocardial cells toward anaerobic
metabolism and accumulation of metabolites that stimulate pain pathways
B) Excess oxygen directly stimulates cardiac pain receptors
C) Increased lymph flow stretches the myocardium
D) Myocardial cells become hyperglycemic
Correct Answer: A) Inadequate oxygen supply forces myocardial cells toward
anaerobic metabolism and accumulation of metabolites that stimulate pain
pathways
Rationale: Reduced coronary perfusion limits aerobic ATP production and
leads to accumulation of acidic metabolites that contribute to ischemic
discomfort.
Q6. Which statement best distinguishes stable angina from
myocardial infarction?
A) Stable angina always causes irreversible myocardial necrosis
B) Stable angina usually results from transient reversible ischemia, whereas
myocardial infarction involves prolonged ischemia with cell death
C) Myocardial infarction never results from coronary obstruction
D) Stable angina occurs only at rest
Correct Answer: B) Stable angina usually results from transient reversible
ischemia, whereas myocardial infarction involves prolonged ischemia with
cell death