rida
Forum Guru
Topics: 109
Posts: 721
|
A 43-year-old woman is found to have a blood pressure of 200/140 during
a routine examination for a life insurance policy. Further examination
reveals retinal hemorrhages and the electrocardiogram (ECG) shows left
axis deviation. Which of the following is most likely to be decreased in this woman?
A) Arteriolar density
B) Arteriolar wall thickness
C) Arteriolar wall to lumen ratio
D) Capillary wall to lumen ratio
E) Total peripheral Resistance
___________________
"If He takes you to it, He'll take you through it."
|
| mdwannabe
Forum Guru
Topics: 37
Posts: 1,133
|
C... Basis for increased TPR, as axis diviation shows the woman may have LVH, rahter than RV MI, which would show same type diviation, but would also show other changes. This evidence supports long standing HTN.
___________________
"Life not lived for others, is not worth living" Uncle Einstein
"A life is not important, except in the impact it has on other lives" -Jackie Robinson
|
| rida
Forum Guru
Topics: 109
Posts: 721
|
Thats what i thought too, but apparently the answer is A.
___________________
"If He takes you to it, He'll take you through it."
|
| mdwannabe
Forum Guru
Topics: 37
Posts: 1,133
|
makes no sense. Arterolar density where? Or they are just dense on their own? Does it not reffer to the number of arterioles per unit of area?
___________________
"Life not lived for others, is not worth living" Uncle Einstein
"A life is not important, except in the impact it has on other lives" -Jackie Robinson
|
| rida
Forum Guru
Topics: 109
Posts: 721
|
There is no explanation for the answer but i know it can't be B because arteriolar wall thickness increases in a hypertensive patient due to adaptation to high pressures. Can't be E either as TPR is increased in Hypertension. This I believe shows malignant hypertension and D just doesn't make sense to me. If A is the correct answer, that means Arteriolar wall to lumen thickness must increase, however, i am trying to make sense out of that, if anyone knows, please explain.
___________________
"If He takes you to it, He'll take you through it."
|
| rida
Forum Guru
Topics: 109
Posts: 721
|
"rida" wrote:
If A is the correct answer, that means Arteriolar wall to lumen thickness must increase,
Sorry i meant Arteriolar wall to lumen ratio.
___________________
"If He takes you to it, He'll take you through it."
|
| mdwannabe
Forum Guru
Topics: 37
Posts: 1,133
|
Well.. I just reread the question... in askes for what is decreased.. Choice C tells us Wall/Lumen ratio which according to rules of mathematics will be increased, because of increase in numerator (in case of HTN) namely in wall thickness, and decrease in denominator (lumen size) Hence this answer is wrong. Once proving to me that one should not make choices too fast. Hope I did not do it on exam.
However, the refference to Arteriolar Density is new to me, although it makes sense now, I still never heard of this term used in ragards to HTN or any other condition for that matter.
So just by rule of exclusion, the answer is A. Although I gues it easy to imagine that when aetriole contracts it becomes more dense.
___________________
"Life not lived for others, is not worth living" Uncle Einstein
"A life is not important, except in the impact it has on other lives" -Jackie Robinson
|
| Malaysian
Forum Guru
Topics: 28
Posts: 778
|
I agree with u....i have never heard of a terminology 'arteriolar density'.However if the answer is A then I guess its because it implies to increased number arterioles in the body and since arterioles are known as resistance vessels(hence exert the blood pressure),the increased resistance causes LVH as seen in hypertension.
|
| mani
Forum Guru
Topics: 104
Posts: 1,403
|
i guess arteriolar density refers to number of arterioles per unit area of the tissue. this is the thing that actually decreses in HTN due to occlusion of smaller vessels.
___________________
Sincerity and hard work are the keys to success!
|
| kalsam
Forum Elite
Topics: 31
Posts: 361
|
Another consequence of long term HTN is arteriolar Rarefaction..i.e dissolution and loss of arterioles..
Although the mechanism of areteriolar rarefaction is poorly understood..it is believed to result from the long term over perfusion of the tissues..
Organs/tissues in which the vasculature has primarily a nutritive function..like brain,heart,skeletal muscle..they regulate their blood flow in accordance with metabolite needs of the tissues..
Hence these tissues exhibit short term regulation of blood flow such that,the increase in blood flow caused by elevated areterial pr..IS MINIMISED BY ARTERIOLAR CONSTRICTION!!!
THERFORE WHEN INCREASED BP..PERSISTS FOR WEEKS TO MONTHS..MANY OF THE CONSTRICTED ARTERIOLES CLOSE OFF AND ARE RESORBED..
Hence as Mani said..arteriolar density would decrease..
Here the big point is of ..long term auto regulation..
Hope this helps..
___________________
"Read Repeat Recall Remember Recognise & Reproduce"
|
|
| |
| | | | | | | | | | |
