robin082006
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Autopsy of a 72-year-old man demonstrates the presence of deep venous thrombosis of the legs and multiple acute brain infarcts due to thromboembolic occlusion of penetrating arteries. Which of the following pathologic conditions would most likely account for these findings?
A.  Atherosclerosis of penetrating cerebral arteries
B. .gif) Endocarditis of the tricuspid valve
C. Patent foramen ovale
D. Pulmonary thromboembolism
E. Trousseau syndrome
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| msyamp
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e
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| robin082006
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why did u choose E? explain pls!
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| Doc2378
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E
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| msyamp
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atheroscleroiss causes thrromcbosis mostly. and not related to deep vein thrombosis
endocarditis of TV is not realated to DVT or cerebral embolism
patent foramen ovale in a such old man is difficutl to produce theses complicaiton
pulm thromboebolis not related to cerebral embolism
trousseus syndrome is where you have DVT and superficial thrombosis. every where. in the body hypercoaguable state msostly due to internal malignancy
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| Geroo
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C. Patent foramen ovale .embolus crossed to systemic circulation through it.
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| msyamp
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foramen ovale with out symptoms till that age?without CHF?
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| robin082006
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sorry msyamp E is not the ans
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| Geroo
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yep patent foramen oval can be silent.actually 30% of patent foramen oval are silent with no symptoms
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| Geroo
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Trousseau syndrome is migratory venous thrombosis doesn't explain the cerebral arty embolism in this case
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| robin082006
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you got it Geroo, ans is C
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| msyamp
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oh thats again tricky
see i am giving quick wrong anwers
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| msyamp
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Anyway . great questions today. robin thank yuo very much.
did you increase toughness today? i found them tough. may be in a hurry to answer i found them that way or else my eyes are not seeing what my brain doesnt know
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| robin082006
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for this q we should think that there is an anastomosis between venous and arterial systems
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| Natasa
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C-patent foramen ovale.It is called PARADOXICAL EMBOLISM,due to an incompetent valve of the fossa ovalis(between LA and RA). Shunting can occur through dilation of the valve orifice secondary to either right atrial or left atrial enlargement. Venous thrombus migrates from deep veins and enters the systemic circulation through a patent foramen ovale(paradox is in direct passage of embolus from venous to arterial circulation).It can be undiagnosed until late age(or never,if uncomplicated and small),and in this case thats what happened,because he DID not have deep venous thrombosis earlier in his life.
Trousseau syndrome (thrombophlebitis migrans) is venous thrombosis of the upper and lower extremities associated with visceral cancer. It is classically associated with pancreatic cancer, but other tumours, particularly adenocarcinomas, can cause it.THERE IS NO EMBOLISM.
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| msyamp
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ya i know what you said. but i overthought the question. see that gives us a lesson too
when you get a few difficult Qs and then a direct one. don t think over hard on how to mark it wrong.
anyway paradoxical embolus has pulled my leg today
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