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  #1  
Old 07-28-2011
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Default Reason for the pathological finding in Pulmonary Artery

A 54-year-old man has had increasing dyspnea for the past 6 years, but no cough. On physical examination there is increased jugular venous distension. He is afebrile. A chest radiograph shows increased lucency in upper lung fields and increased lung volumes, with flattening of the diaphragmatic leaves. There are no infiltrates. The pulmonary arteries are enlarged and prominent bilaterally, and his right heart border is enlarged. Which of the following pathologic findings is most likely to be present in his main pulmonary arteries?

A Granulomatous vasculitis

B Organizing thromboemboli

C Medial dissection

D Atherosclerosis

E Aneurysm formation
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Old 07-28-2011
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Quote:
Originally Posted by usmle2011 View Post
A 54-year-old man has had increasing dyspnea for the past 6 years, but no cough. On physical examination there is increased jugular venous distension. He is afebrile. A chest radiograph shows increased lucency in upper lung fields and increased lung volumes, with flattening of the diaphragmatic leaves. There are no infiltrates. The pulmonary arteries are enlarged and prominent bilaterally, and his right heart border is enlarged. Which of the following pathologic findings is most likely to be present in his main pulmonary arteries?

A Granulomatous vasculitis

B Organizing thromboemboli

C Medial dissection

D Atherosclerosis

E Aneurysm formation
b or e... but i think its E
and still confused in option b saddle embolus can b possible?
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Old 07-28-2011
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Quote:
Originally Posted by usmle2011 View Post
A 54-year-old man has had increasing dyspnea for the past 6 years, but no cough. On physical examination there is increased jugular venous distension. He is afebrile. A chest radiograph shows increased lucency in upper lung fields and increased lung volumes, with flattening of the diaphragmatic leaves. There are no infiltrates. The pulmonary arteries are enlarged and prominent bilaterally, and his right heart border is enlarged. Which of the following pathologic findings is most likely to be present in his main pulmonary arteries?

A Granulomatous vasculitis

B Organizing thromboemboli

C Medial dissection

D Atherosclerosis

E Aneurysm formation
He has features s/o Cor pulmonale, Pulmonary Hypertension with Right ventricular hypertrohpy. So i will go with A. Atherosclerosis of main pulmonary arteries ?
i mean D ??
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Old 07-28-2011
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Pulmonary Hypertension => Cor pulmonale

D) Atherosclerosis
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Old 07-28-2011
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Pulmonary Hypertension

D Atherosclerosis
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Old 07-28-2011
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Originally Posted by usmle2011 View Post
A 54-year-old man has had increasing dyspnea for the past 6 years, but no cough. On physical examination there is increased jugular venous distension. He is afebrile. A chest radiograph shows increased lucency in upper lung fields and increased lung volumes, with flattening of the diaphragmatic leaves. There are no infiltrates. The pulmonary arteries are enlarged and prominent bilaterally, and his right heart border is enlarged. Which of the following pathologic findings is most likely to be present in his main pulmonary arteries?

A Granulomatous vasculitis

B Organizing thromboemboli

C Medial dissection

D Atherosclerosis

E Aneurysm formation
the ans is B
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Old 07-28-2011
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D) It is "Pink Puffer" - no couph COPD - increase of pulmonary arterial pressure leads to sclerosis and RV hypertrophy.
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Quote:
Originally Posted by usmle2011 View Post
A 54-year-old man has had increasing dyspnea for the past 6 years, but no cough. On physical examination there is increased jugular venous distension. He is afebrile. A chest radiograph shows increased lucency in upper lung fields and increased lung volumes, with flattening of the diaphragmatic leaves. There are no infiltrates. The pulmonary arteries are enlarged and prominent bilaterally, and his right heart border is enlarged. Which of the following pathologic findings is most likely to be present in his main pulmonary arteries?

A Granulomatous vasculitis

B Organizing thromboemboli

C Medial dissection

D Atherosclerosis

E Aneurysm formation
Atherosclerosis
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  #9  
Old 07-28-2011
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atherosclerosis
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Old 07-28-2011
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Quote:
Originally Posted by usmle2011 View Post
A 54-year-old man has had increasing dyspnea for the past 6 years, but no cough. On physical examination there is increased jugular venous distension. He is afebrile. A chest radiograph shows increased lucency in upper lung fields and increased lung volumes, with flattening of the diaphragmatic leaves. There are no infiltrates. The pulmonary arteries are enlarged and prominent bilaterally, and his right heart border is enlarged. Which of the following pathologic findings is most likely to be present in his main pulmonary arteries?

A Granulomatous vasculitis

B Organizing thromboemboli

C Medial dissection

D Atherosclerosis

E Aneurysm formation
my ans is BBBBBBBBBBB......
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  #11  
Old 07-29-2011
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Default Explanation

(A) Incorrect. Wegener granulomatosus is a process that can lead to pulmonary vasculitis, though the peripheral arteries are typically involved, and more of a restrictive lung disease develops.

(B) Incorrect. Pulmonary thromboembolism is an acute process. It is not related to emphysema.

(C) Incorrect. A dissection does not occur in pulmonary arteries, as in the aorta, because the pressures are not as high, even with pulmonary hypertension.

(D) CORRECT. Cor pulmonale is the result of pulmonary hypertension, which is the major cause for pulmonary atherosclerosis. His emphysema has reduced the pulmonary vascular bed, promoting the hypertension. Note that the forces driving systemic atherosclerosis are not operative on the pulmonary arterial system.

(E) Incorrect. Aneurysms may complicate atherosclerosis, but the degree of atherosclerosis and the arterial pressures in the pulmonary system are not as marked as in the aorta.
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