Vascular Disease USMLE Step 1 Practice Question
A 58-year-old diabetic man with end-stage renal disease on hemodialysis presents with a non-healing ulcer on his left foot and progressive toe gangrene. Vital signs show BP 158/92 mmHg, HR 88/min, and normal SpO2. Pedal pulses are diminished but palpable bilaterally. Ankle-brachial index is 1.3 bilaterally. Serum calcium is 9.8 mg/dL with elevated phosphate. Duplex ultrasound reveals no significant stenosis. Which vascular pathology best explains these findings?
Answer choices
- AAtherosclerotic intimal plaque with lipid core
- BThromboangiitis obliterans with inflammation
- CVasculitis from polyarteritis nodosa
- DMönckeberg sclerosis with medial calcificationCorrect answer
- EArterial dissection with intramural hematoma
- FTakayasu arteritis with segmental narrowing of large vessels
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