usmlesavvy
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Q. A 70 yr ld man died suddenly and unexpectedly.At autopsy ,multiple tissue sites were sampled for microscopic analysis .Examination of tissues showed noncrystalline amorphous deposits of calcium salts in gastric mucosa,renal interstitium,and alveolar walls of lungs.Which of the following conditions is most likely to explain these findings?
(A) Chronic hepatitis
(B)Chronic Glomerulonephritis
(C)Disseminated TB
(D)Generalized Atherosclerosis
(E)Normal Aging Process
(F)Pulmonary Emphysyma
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| new_n_lost
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E)Normal Aging Process
this one has me stumped.
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| nerve09
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E.
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| Tiff
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D. Generalized Atherosclerosis
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| silver
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E
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| jean robert
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F
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| jerker
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E.
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| pr20
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E.
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| usmlesavvy
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The correct answer isB. Chronic Glomerulonephritis
Question source :Robbins review of pathology, 2nd edition, pg6, q.22
The microscopic findings suggest METASTATIC CALCIFICATION,with deposition of Calcium salts in tissues that have physiologic mechanism for losing acid ,creating an internal alkaline environment that favors Ca precipitation.
Hypercalcemia can have a variety of causes,including hyperparathyroidism,bone destruction due to mets,paraneoplastic syndrome ,and less commonly ,VitD toxicity or sarcoidodis.
Chronic Renal disease reduces phosphate excretion by kidney,resulting in an increase in serum phosphate .Becoz the solubility product of Ca and PO4 must be maintained, the serum Ca is depressed, trigging increased PTH output to increase Ca level which promotes Ca deposition.
Chronic hepatitis leads to hyperbilirubinemia and jaundice
The granulomas of disseminated TB have caseous necrosis and Dystrophic calcification.
Another form of dystrophic calcification occurs when atherosclerotic lesions calcify
Dystrophic calcification is seen more often in the elderly but it is the result of a lifetime of pathological changes ,not aging itself
Pulmonary emphysema can lead to respiratory acidosis that is compensated by metabolic alkalosis,with the result that the serum Ca level remains relatively unchanged.
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| nerve09
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 must read hard
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| silver
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just when you think you've pretty much covered it all.....something new pops up  
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| SmokyWaters
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true
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