new_n_lost
Politically InCorrect
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Examination of an autopsy specimen from a Mexican immigrant demonstrates a heart with massive dilation of the aortic root and adjacent aortic arch. Opening the aorta reveals a smooth interior wall without obvious lesions.
If a histological section through the aortic wall is made, which of the following would most likely be seen?
A. A heavy eosinophilic infiltrate
B. Fibrinoid necrosis with a neutrophilic infiltration
C. Focal fragmentation of elastic elements
D. Obliterative endarteritis of the vasa vasorum
E. Ring-like calcification of the vessel media
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| mytime
Kick my butt!
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B?
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| mms
Forum Junior
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D) ?
Syphilis?
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| doc179
Forum Guru
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D ?
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| treblechar
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D. Obliterative endarteritis of the vasa vasorum
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| mytime
Kick my butt!
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YA looks like D it sud be........ if Syphylis is what we got here. 
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| new_n_lost
Politically InCorrect
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___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
Politically InCorrect
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The correct answer is D.
Massive dilation of the aortic root with an absence of atherosclerotic vessel lesions strongly suggests a syphilitic aneurysm. These aneurysms are a manifestation of tertiary syphilis and have become very uncommon now, probably due to a combination of deliberate therapy and therapy of undiagnosed disease when antibiotics are given for some other condition. The histologic hallmark of the syphilitic aneurysm is a plasma cell lesion of the small blood vessels (the vasa vasorum) that supply the aorta, and eventually obliterate the small vessel lumina.
Choice A is a feature of Churg-Strauss syndrome, which is a variant of polyarteritis nodosa that involves vessels smaller than the aorta.
Choice B is a feature of polyarteritis nodosa, which involves vessels smaller than the aorta.
Choice C is a feature of cystic medial necrosis, which can cause aortic dissection.
Choice E is a feature of Mِnckeberg's arteriosclerosis, which involves vessels smaller than the aorta.
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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