A 61-year-old woman with long-standing type 2 diabetes mellitus and hypertension on lisinopril presents with progressive dyspnea and chest discomfort with exertion. Vital signs show BP 158/92 mmHg, HR 88/min, RR 18/min, SpO2 98% on room air. Serum creatinine is 1.8 mg/dL (previously 0.9). Urinalysis reveals mild proteinuria. Renal biopsy demonstrates homogeneous eosinophilic thickening of arteriolar walls with luminal narrowing. Cardiac enzymes are normal. Which of the following is the most likely diagnosis?
- A)Monckeberg medial calcific sclerosis
- B)Polyarteritis nodosa
- C)Fibromuscular dysplasia
- D)Hyperplastic arteriolosclerosis
- E)Hyaline arteriolosclerosisGABARITO
Explicação
Hyaline arteriolosclerosis is correct. Chronic hypertension and diabetes cause plasma protein leakage and smooth muscle matrix deposition in arterioles, producing a pink hyaline thickening with luminal narrowing. This contributes to chronic ischemic injury in ... Ver explicação completa e trilha adaptativa →