A 52 year old woman is evaluated for severe headache and blurry vision. Blood pressure is 248 over 138 mm Hg. Funduscopic examination shows papilledema and flame hemorrhages. Serum creatinine is elevated, and urinalysis shows hematuria with mild proteinuria. Renal biopsy of small arterioles would most likely demonstrate which of the following?
- A)Bright eosinophilic fibrin like material in the vessel wallGABARITO
- B)Metaplastic change from columnar to squamous epithelium
- C)Liquefaction with neutrophil rich abscess formation
- D)Caseation with central acellular debris
- E)Granulomatous inflammation with giant cells
Explicação
Malignant hypertension causes severe vascular injury with plasma protein leakage and fibrin deposition in arteriolar walls, producing fibrinoid necrosis. The marked blood pressure elevation with retinal and renal end organ damage makes this the best match. Ver explicação completa e trilha adaptativa →