What is Burger disease is associated with - and explain in detail?
Ans. is 'b' i.e., SmokingThromboangitis obliterans (Berger disease) o Thrombangitis obliterans is a distinctive disease that is characterized by segmental, thrombosing acute and chronic inflammation of medium sized and small sized aeries, and sometimes secondarily extending to veins and nerves.o Thromboangitis obliterans occurs almost exclusively among heavy-cigarrete-smoking persons.o It is more common in men but incidence is increasing in women because of increasing smoking habit in women. o Buerger disease is associated with HLA B-5 and HLA-A9.o In thrombongitis obliterans there is acute and chronic segmental inflammation of vessels with accompanied thrombosis in the lumen.o Typically, the thrombus contains microabscesses with a central focus of neutrophils surrounded by granulomatous inflammation.o Later, the inflammatory process extends into contiguous veins and nerves and in time all three structures (aeries, veins and nerves) become encased in fibrous tissue, a characterstic that is very rare with other form of vasculitis.Clinical manifestationso Thrombangitis obliterans affects vessels of upper and lower extremities.Symptoms are due to vascular insufficiency, i.e. Ischemia of toes, feet and fingers that can lead to ulcer and frank gangrene.Due to neural involvement, there may be severe pain, even at rest.Buerger disease Vs atherosclerosisBuerger disease is almost exclusively associated with smoking. Atherosclerosis is also associated with smoking,but it has other predisposing conditions also, e.g. diabetes, hypeension, hypercholesterolemia etc. o Burger disease affects smaller aeries. Atherosclerosis involves larger and medium size aeries.o In Atherosclerosis, pain occurs on movement due to vascular insufficiency, while in Buerger disease, pain occursat rest also due to neural involvement.