nbme 1 - fatimabk

[ArchivalUser]

An asymptomatic 57-year-old man comes to the physician for a routine health maintenance examination. He has smoked one pack of cigarettes daily for 37 years. His blood pressure is 180/112 mm Hg, and pulse is 82/min. Abdominal examination shows a bruit in the right upper quadrant and no masses. His hematocrit is 42%, serum urea nitrogen (BUN) level is 23 mg/dL, and serum creatinine level is 1.4 mg/dL. Which of the following is the most likely cause of this patient's bruit?

A
) Accumulation of lipids in the arterial wall

B
) Hypertrophy of the arterial wall media

C
) Infiltration of arterial wall by giant cells

D
) Infiltration of round cells in the arterial wall

E
) Reflex vasodilation

[ArchivalUser]

A

[ArchivalUser]

Isn't this Hyaline, or Hyperplastic (in malignant hypertension; systolic 180) arteriolosclerosis?
I do not think it is A. Why not B?

[ArchivalUser]

arteriolosclerosis start from lipid deposit...BP is always 2dary product in arteriolosclerosis

thats what i remember from step 1 now

[ArchivalUser]

reh; arteriolosclerosis is a hypertension-induced process, with 'hyaline' representative of 'protein', and NOT lipid. Lipid accumulates secondary to endothelial-injury INDUCED by hypertension.