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Retired NBME 23 Answers

nbme23/Block 2/Question#26 (reveal difficulty score)
A 36-year-old woman comes to the physician ...
Fibromuscular dysplasia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +5  upvote downvote
submitted by โˆ—vshummy(184)
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Page 592 on First Aid 2019 under Renovascular Disease. Main causes of renal artery stenosis: Fibromuscular dysplasia in the distal 2/3rd of renal artery or segmental branches, usually young or middle-aged females.

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submitted by โˆ—mousie(272)
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I chose PAN for this one, saw the renal a. aneurysms and went right for it but PAN would have more systemic findings (fever, weight loss, head ache) and usually effects middle age MEN vs Women in FMD.

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cbreland  Fibromuscular dysplasia = middle aged female with HTN... Maybe it'll stick this time ๐Ÿคฏ +1
weirdmed51  @cbreland Note distal 2/3 of renal artery (questions could be misleading stm) +



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submitted by โˆ—visualninjacontender(18)
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Pathologically characterized by: loss of internal elastic lamina. which can lead to the formation of anuerysms due to weakening of the wall

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submitted by โˆ—drmohandes(193)
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Case = Middle-aged female with severe hypertension (180/120 mmHg), and an aneurysm.

(1) Main cause of renovascular diseae in middle-aged females = fibromuscular dysplasia (FA2019 pg. 592).

(2) Also notice the -classic- 'string-of-beads' appearance of the artery: EXAMPLE

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submitted by โˆ—usmile1(154)
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classic cause of secondary HTN in young or middle aged women. presents with "beads on a sting" appearance and can occur in both the renal and carotid arteries.

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