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  #1  
Old 08-02-2011
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A 32-year-old Asian female presents with a complaint of her left arm being numb, cold and painful. Review of systems identifies low grade fevers, fatigue and myalgias. On physical exam, her left radial pulse is diminished compared to her right. You suspect a vasculitis with granulomatous thickening. Which angiographic finding will confirm your suspicion?
A. Segmental narrowing of distal radial artery
B. Aortic arch narrowing
C. Abdominal aorta dilation
D. Temporal artery occlusion
E. Isolated left carotid stenosis
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Old 08-02-2011
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Quote:
Originally Posted by ricko335 View Post
A 32-year-old Asian female presents with a complaint of her left arm being numb, cold and painful. Review of systems identifies low grade fevers, fatigue and myalgias. On physical exam, her left radial pulse is diminished compared to her right. You suspect a vasculitis with granulomatous thickening. Which angiographic finding will confirm your suspicion?
A. Segmental narrowing of distal radial artery
B. Aortic arch narrowing
C. Abdominal aorta dilation
D. Temporal artery occlusion
E. Isolated left carotid stenosis
well the ans is D..its giant cell arteritis seen in large arteries associated with polymyalgia rheumatica, Reynaud phenomenon n is seen in females there is non atherosclerotic occlusion of large arteries
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Old 08-02-2011
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Quote:
Originally Posted by ricko335 View Post
A 32-year-old Asian female presents with a complaint of her left arm being numb, cold and painful. Review of systems identifies low grade fevers, fatigue and myalgias. On physical exam, her left radial pulse is diminished compared to her right. You suspect a vasculitis with granulomatous thickening. Which angiographic finding will confirm your suspicion?
A. Segmental narrowing of distal radial artery
B. Aortic arch narrowing
C. Abdominal aorta dilation
D. Temporal artery occlusion
E. Isolated left carotid stenosis
I think it is B as it is Takayasu disease which is associated with vasculitis of aortic arch and unequal blood pressure of both sides and upper limbs and lower limbs
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Old 08-02-2011
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b.aortic arch narrowing
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  #5  
Old 08-02-2011
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in Takayasu's arteritis aortic arch and/or proximal great vessels are affected

B)
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Old 08-03-2011
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B ... but syphyllis also attack aortic arch and also make gummas!
but i am not sure if this is the explanation!
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Old 08-03-2011
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yea its def takaysau's. agree with usmleman2020's explanation.
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Old 08-03-2011
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Correct Answer answer

The correct answer is B.
Takayasu arteritis (pulseless disease) is an inflammation with stenosis of medium and large arteries, typically with aortic arch involvement. There is granulomatous thickening which results in an absent/decreased pulse in the distal upper extremity. In addition to a cold, painful arm, patients may have nonspecific fevers and myalgias. Segmental narrowing of distal radial artery is more consistent with thromboangiitis obliterans
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