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  #1  
Old 09-06-2012
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Arrow Belindalimm Daily Questions: Pathology #5

A 30-year-old Asian male with exertional calf pain and painful door ulcers demonstrates hypersensitivity to intradermally injected tobacco extract. Which of the following pathological processes is most likely responsible for this patient's condition?

A. Lipid-filled intimal plaque
B. Onion-like concentric thickening of arteriolar walls
C. Granulomatous inflammation of the media
D. Transmural inflammation of the arterial wall with fibrinoid necrosis
F. Segmental vasculitis extending into contiguous veins and nerves
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  #2  
Old 09-06-2012
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Smile :)

i think answer is option F...buerger's disease
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Old 09-06-2012
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B. Onion like concentric thickening of ateriolar walls.

I think I have seen this question somewhere...may be UWolrd.

I m still not sure,what the answer though.
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Old 09-06-2012
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F? Buerger's?
The pathology is a segmental thrombosing vasculitis, thus the name "Thromboangiitins obliterans"
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Old 09-06-2012
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Default my answer :)

F. Segmental vasculitis extending into contiguous veins and nerves
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Old 09-06-2012
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Quote:
Originally Posted by Doc4Step1 View Post
B. Onion like concentric thickening of ateriolar walls.

I think I have seen this question somewhere...may be UWolrd.

I m still not sure,what the answer though.
isn't it a sign of a hyperplastic arteriolosclerosis - hyperplastic arterioles seen in malignant hypertension?
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  #7  
Old 09-06-2012
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Hope this isn't from U World! Haven't done UW yet, and want to not see their questions till I officially do them!
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Old 09-06-2012
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Quote:
Originally Posted by Casandra View Post
isn't it a sign of a hyperplastic arteriolosclerosis - hyperplastic arterioles seen in malignant hypertension?
Oooops...Yes you are right...My bad.

Sorry.
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Old 09-06-2012
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i'll go with F too buerger's
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Old 09-07-2012
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Default Yes, the answer is F, Buerger's disease

Skin lesion demonstrating hypersensitivity to tobacco extract indicates the patient is a smoker. Aside to this, he also presents calf muscle pain worsening while walking and ulcer in foot. All of these give us a clue of Buerger's disease, which is also called thromboangitis obliterans. This disease is seen in heavy smokers, and involves both arteries and veins which present as thrombosing vasculitis. The affected parts are really painful, patients with this disease sometimes auto amputate the digits.
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