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patho kap q - genius123
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08-21-2007, 04:44 PM
A pt with long term hypertension develops progressive dementia.CT scan of head demonstrates a diffuse loss of deep hemispheric white matter.Which of the following terms best describes the pathological process that is occuring?
A.Anemic infarcs B.Hemmorhagic infarcts C.Hypertensive encephalopathy D.Lacunae E.Subcortical leukoencephalopathy
08-21-2007, 05:08 PM
ANS=E Patient has subcortical leukoencephalopathy(Biswanger Disease),which is one of the neurologic syndrome associated with hyper tension. the histologic findings are diffuse irregular loss of axons and myelin accompanied by widespread gliosis. The pathologic mechanism may be damage caused by severe arteriolosclrosis. None of the other choices would produced diffuse subcortcal white matter involvement. Lacunae are small necrotic foci in deep gray matter ( especially basal ganglia and thalamus) seen in some hypertensive patients.
08-21-2007, 05:16 PM
oppps yes yes true i just skipped the whiite matter thingi..thx genius
08-21-2007, 05:25 PM
u r welcom zkadhem
we i learn more from mistakes not only on usmle,rather in all aspects of life 
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