In Buerger’s disease all are affected EXCEPT:
Correct Answer: Lymphatics
Description: ANSWER: (A) LymphaticsREF: Harrison's 16th ed p. 1487Buerger's disease is inflammatory disease of the arteries with involvement of neighbouring viens, and nerves terminating in thrombosis of arteryThromboangiitis obliterans (Buerger's disease) is an inflammatory occlusive vascular disorder involving small and medium-size arteries and veins in the distal upper and lowTer extremities. This disorder develops most frequently in men <40 years of ageThe clinical features of thromboangiitis obliterans often include a triad of claudication of the affected extremity, Raynaud's phenomenon, and migratory superficial vein thrombophlebitis. Claudication usually is confined to the calves and feet or the forearms and hands because this disorder primarily affects distal vessels. In the presence of severe digital ischemia, trophic nail changes, painful ulcerations, and gangrene may develop at the tips of the fingers or toes. The physical examination shows normal brachial and popliteal pulses but reduced or absent radial, ulnar, and/or tibial pulses. Arteriography is helpful in making the diagnosis. Smooth, tapering segmental lesions in the distal vessels are characteristic, as are collateral vessels at sites of vascular occlusion. Proximal atherosclerotic disease is usually absent. The diagnosis can be confirmed by excisional biopsy and pathologic examination of an involved vessel.
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