A 56-year-old man with risk factors is most likely to have which vascular abnormality?

A 56-year-old man with risk factors is most likely to have which vascular abnormality?

• A. Hyperplastic arteriolosclerosis
• B. Medial calcific sclerosis
• C. Atherosclerosis
• D. Plexiform arteriopathy

Answer: (C)

The vascular abnormality being tested is atherosclerosis, which is most likely in a 56-year-old man with risk factors. Atherosclerosis occurs in medium to large arteries and starts with endothelial dysfunction from risk factors like smoking, high cholesterol, hypertension, and diabetes. This leads to accumulation of lipids in the intima and recruitment of macrophages that ingest lipids to become foam cells, forming fatty streaks. Over time, these evolve into fibrofatty plaques with a lipid core and a fibrous cap. As plaques grow, they narrow the vessel lumen, reducing blood flow, and plaques can rupture, triggering thrombosis and acute ischemic events. Other vascular changes mentioned occur in different contexts: hyperplastic arteriolosclerosis is related to severe hypertension and affects small arteries; medial calcific sclerosis involves calcification of the media with little to no luminal narrowing; plexiform arteriopathy is characteristic of pulmonary arterial hypertension.

The vascular abnormality being tested is atherosclerosis, which is most likely in a 56-year-old man with risk factors. Atherosclerosis occurs in medium to large arteries and starts with endothelial dysfunction from risk factors like smoking, high cholesterol, hypertension, and diabetes. This leads to accumulation of lipids in the intima and recruitment of macrophages that ingest lipids to become foam cells, forming fatty streaks. Over time, these evolve into fibrofatty plaques with a lipid core and a fibrous cap. As plaques grow, they narrow the vessel lumen, reducing blood flow, and plaques can rupture, triggering thrombosis and acute ischemic events. Other vascular changes mentioned occur in different contexts: hyperplastic arteriolosclerosis is related to severe hypertension and affects small arteries; medial calcific sclerosis involves calcification of the media with little to no luminal narrowing; plexiform arteriopathy is characteristic of pulmonary arterial hypertension.