Vascular Disease USMLE Step 1 Practice Question
A 58-year-old man with untreated syphilis presents with substernal chest discomfort and progressive hoarseness. Vital signs show BP 165/92 mmHg, HR 88 bpm, RR 16, temp 37°C, SpO2 98%. Chest radiograph reveals marked dilation of the ascending thoracic aorta with aortic regurgitation on echocardiography. RPR is elevated; FTA-ABS is positive. Coronary angiography shows no significant stenosis. Which pathologic process most likely caused this aortic lesion?
Answer choices
- AMural thrombosis of the abdominal aorta due to smoking
- BImmune complex deposition in postcapillary venules
- CAtherosclerotic plaque rupture in the infrarenal aorta
- DMyxomatous degeneration of the valve annulus
- EObliterative endarteritis of the vasa vasorumCorrect answer
- FCystic medial necrosis of the aortic wall with elastic fiber fragmentation
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