Vascular Disease USMLE Step 1 Practice Question
A 26-year-old tall man with long extremities and prior lens dislocation presents with acute severe tearing chest pain radiating to the back after weightlifting. Vital signs: BP 165/95 mmHg, HR 102/min, RR 20/min, SpO2 98% on room air. Chest X-ray shows widened mediastinum. Cardiac exam reveals no murmur. He denies recent cocaine use. Which histologic abnormality of connective tissue most likely predisposed him to this acute aortic dissection?
Answer choices
- ATransmural neutrophilic infiltrates of the intima
- BMedial degeneration with fragmentation of elastic fibersCorrect answer
- CImmune complex deposition in medium sized arteries
- DGranulomatous inflammation with giant cells in the media
- EAtherosclerotic calcification limited to the adventitia
- FExcessive collagen cross-linking with decreased elastin-to-collagen ratio in the media
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