<prompt> Which of the following changes does not occur in malignant hypeension?Peticheal Haemorrhages on coical surfaceFibrinoid necrosis of aeriolesIntimal concentric thickeningHyaline aeriosclerosis  <response>: Malignant Hypeension:- Some patients with HT have rapidly progressive BP elevations with target organ injury including retinal haemorrhages associated with papilloedema, encephalopathy, and declining kidney function. They have 50 moality rates in 6-12 months, hence the designation malignant. - These patients had vascular lesions called fibrinoid necrosis with the breakdown of the vessel wall, deposition of eosinophilic material including fibrin, and a perivascular cellular infiltrate. Fibrinoid necrosis- obliteration of glomeruli and loss of tubular structures- Progressive kidney failure - without dialysis leads to early moality in untreated malignant-phase hypeension- Endothelial injury can induce microangiopathic hemolysis- A separate lesion may occur in the larger interlobular aeries in some patients with the hyperplastic proliferation of the vascular wall cellular elements, deposition of collagen, and separation of layers designated the onion skin lesion.- Treatment: Antihypeensive therapy is the mainstay of therapyRef: Harrisons 18e p2047 