A 56-year-old man comes to the physician because of ...
Fibromuscular hyperplasia of arterioles
Fibromuscular dysplasia is a focal irregular thickening of the walls of medium-sized and large muscular arteries due to a combination of medial and intimal hyperplasia and fibrosis. It can manifest at any age but occurs most frequently in young women. The focal wall thickening results in luminal stenosis or can be associated with abnormal vessel spasm that reduces vascular flow; in the renal arteries, it can lead to renovascular hypertension. Between the focal segments of thickened wall, the artery often also exhibits medial attenuation; vascular outpouchings can develop in these portions of the vessel and sometimes rupture.
I thought this was a weirdly worded answer. I immediately ( stupidly) crossed of fibromuscular dysplasia since it wasnt a younger women =/
I was thinking malignant nephrosclerosis ... but I guess you'd get hyperplastic arteries first -_-
The answer choice is fibromuscular HYPERplasia - I think this is different from fibromuscular DYSplasia (seen in young women);
hello is right. Fibromuscular hyperplasia is thickening of the muscular layer of the arteriole in response to chronic hypertension (as the question stem implies)
Fibromuscular Hyperplasia vs Dysplasia...... are supposedly the SAME thing with multiple names.
Fibromuscular dysplasia, also known as fibromuscular hyperplasia, medial hyperplasia, or arterial dysplasia, is a relatively uncommon multifocal arterial disease of unknown cause, characterized by nonatherosclerotic abnormalities involving the smooth muscle, fibrous and elastic tissue, of small- to medium-sized arterial walls.
*sorry I had to post this because it was confusing!!!*Fibromuscular dysplasia is most common in women between the ages of 40 of and 60, but the condition can also occur in children and the elderly. The majority (more than 90%) of patients with FMD are women. However, men can also have FMD, and those who do have a higher risk of complications such as aneurysms (bulging) or dissections (tears) in the arteries.
These questions are driving me crazy- fibromuscular dysplasia/hyperplasia is the same thing, and it is NOT this presentation and it doesn't refer to arteriolosclerosis seen in malignant HTN!
Is the HTN a cause, or a consequence? I read it as being the cause (uncontrolled HTN for many years)
If it was the consequence, the presentation is still not classical! -_-
Also guys if u take it as Fibromuscular dysplasia resulting in RAS none of the answer choice matches
Not really, Hypotension cause pre renal azotemia. Here long standing HTN resulting in end organ damage so intrinsic renal failure
ugh! i just noticed there's a fairly long h/o of poorly controlled HTN which makes this question simpler now. Thanks!!