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4470 Pathology

A 60-year-old mildly obese woman is admitted to the hospital with a chief complaint of recurrent chest pain on exertion. The patient reports several episodes of chest pain over the past several years and painful leg cramps when walking. Fasting blood glucose (160 mg/dL) and total serum cholesterol (370 mg/dL) are high. The ECG is normal and blood tests for cardiac-specific proteins are negative. Chest pain in this patient is most likely due to which of the following underlying conditions?

AAtherosclerosis of coronary artery
BCongenital anomalous origin of coronary artery
CCoronary arteritis
DIntramural course of the LAD coronary artery
Pathology
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4471 Pathology

A 50-year-old man has a 2-year history of angina pectoris that occurs during exercise. On physical examination, his blood pressure is 135/75 mm Hg, and his heart rate is 79/min and slightly irregular. Coronary angiography shows a fixed 75% narrowing of the anterior descending branch of the left coronary artery. He has several risk factors for atherosclerosis: smoking, hypertension, and hypercholesterolemia. Which of the following is the earliest event resulting from the effects of these factors?

AAlteration in vasomotor tone regulation
BConversion of smooth muscle cells to foam cells
CDysfunction from endothelial injury
DInhibition of LDL oxidation
Pathology
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