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  #1  
Old 07-19-2011
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I agree Which of the following is a likely finding?

A 35-year-old African-American man is transported to the emergency department because of an unrelenting, severe, excruciating headache. His blood pressure is 245/150 mm Hg.
The ophthalmoscopic examination of the retina:

Which of the following is a likely finding?-screen-shot-2011-07-19-4.25.26-pm.png

Despite all interventions, including administration of nitroprusside, the patient dies. At autopsy, which of the following is a likely finding?


(A) Immune complex vasculitis of the glomeruli
(B) Longitudinal intraluminal tears of the ascending aorta
(C) Multiple punctuate hemorrhages on the surface of both kidneys
(D) "Tree-bark" appearance of the ascending aorta
(E) Unilateral renal artery stenosis
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Old 07-19-2011
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Answer C, Refering to APKD ...
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i guess c

Severe malignant hypertension is a complication of systemic sclerosis (usually observed during a "renal crisis
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Quote:
Originally Posted by rulz View Post
Answer C, Refering to APKD ...
I agree! APKD!-- C
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APKD???? why????
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Quote:
Originally Posted by bebix View Post
APKD???? why????
I am thinking medulloblastoma and retinoblastoma is associated with APKD!
cuz it image for retinal vessels
and there is HTN which is also present in APKD
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I am thinking medulloblastoma and retinoblastoma is associated with APKD!
cuz it image for retinal vessels
and there is HTN which is also present in APKD
Oh....but here we have papilledema
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Oh....but here we have papilledema
i think ur jus playing around :P haha.. but i will stay firm to my ans.. ok papilledema is due to HTN which is in APKD and since this HTN is not getting ok with the Nitroprusside it doesn look like its a normal HTN! :P haha
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Old 07-19-2011
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Oh....but here we have papilledema
So, you want me to think is Aortic Disecction ( option B ) because of the Major Risk of aortic Dissection is HTA.. which is what the patient have here 245/150mmhg leading the pte to Longitudinal intraluminal tear ( Aortic Dissection Patho-Physiology )...

It could be... in that case... Yes, you are right.

But i though it was ADPKD because the complaint of the pte is a "Excruciating Headache which can be due the Subarachnoid Hemorrhage due the rupture of berry aneurysm ( which ADPKD are predispone to.... )

.. That's why i choose C.
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Originally Posted by rulz View Post
So, you want me to think is Aortic Disecction ( option B ) because of the Major Risk of aortic Dissection is HTA.. which is what the patient have here 245/150mmhg leading the pte to Longitudinal intraluminal tear ( Aortic Dissection Patho-Physiology )...

It could be... in that case... Yes, you are right.

But i though it was ADPKD because the complaint of the pte is a "Excruciating Headache which can be due the Subarachnoid Hemorrhage due the rupture of berry aneurysm ( which ADPKD are predispone to.... )

.. That's why i choose C.
The correct answer is C) Multiple punctuate hemorrhages on the surface of both kidneys (no cysts!!!)

This is a typical presentation for a patient with malignant hypertension. The kidneys appear "flea-bitten" because of multiple petechial hemorrhages on the surface (no cysts). Microscopically, the glomeruli display fibrinoid necrosis and hyperplastic arteriolosclerosis.
Immune complex vasculitis of the glomeruli is typical of polyarteritis nodosa. Longitudinal intraluminal tears of the ascending aorta occur with dissecting aneurysm. A "tree-bark" appearance of the ascending aorta results from tertiary syphilis. Unilateral renal artery stenosis can result from fibromuscular dysplasia.
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Thanks for the Option A... was killing my brain trying to get what was that...

PAN!...

Btw, dont Scream at me hahahahaha :P
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