Organ System Pathology USMLE Step 1 Practice Question
A 76 year old man presents with several months of exertional chest pain and two episodes of near syncope while climbing stairs. He has a history of hyperlipidemia and smoking. Blood pressure is 132/78 mm Hg. Cardiac examination shows a harsh crescendo decrescendo systolic murmur at the right upper sternal border that radiates to both carotids. The carotid upstroke is delayed and diminished. Which of the following is the most likely underlying cause of this patient's condition?
Answer choices
- AFibroelastic thickening from chronic hypertension alone
- BMyxomatous degeneration of the mitral valve
- CDystrophic calcification of a degenerating tricuspid aortic valveCorrect answer
- DCongenital failure of endocardial cushion fusion
- EImmune mediated destruction of the aortic media
- FRheumatic scarring and commissural fusion of the aortic valve leaflets
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