Coronary Artery Disease USMLE Step 1 Practice Question
A 59-year-old man with hyperlipidemia and hypertension presents with acute onset crushing substernal chest pain at rest. Vital signs show BP 168/94 mmHg, HR 102 bpm, RR 20, SpO2 98% on room air. Troponin I is elevated at 2.4 ng/mL. Coronary angiography reveals rupture of a previously nonobstructive plaque with superimposed thrombosis occluding the left anterior descending artery. He denies prior anginal episodes. Which plaque feature most strongly predisposed to rupture?
Answer choices
- ALarge lipid core with thin fibrous capCorrect answer
- BDense medial calcification without inflammation
- CSmall lipid core with thick fibrous cap
- DComplete endothelial healing with collagen deposition
- EMarked smooth muscle hyperplasia alone
- FExtensive collagen-rich fibrosis with minimal lipid content
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.