A 30-year-old woman comes to the physician because of severe headaches and lightheadedness for 2 months. She appears anxious. She is 155 cm (5 ft 1 in) tall and weighs 77 kg (170 lb); BMI is 32 kg/m2. Her temperature is 37.0°C (98.6°F), pulse is 96/min, respirations are 14/min, and blood pressure is 168/96 mm Hg. The pupils are equal and reactive. There is a bruit on the left side of the neck. The lungs are clear to auscultation. Cardiac examination shows no murmurs, rubs, or gallops. The abdomen is soft and nontender. Neurologic examination shows no focal findings. Left carotid artery appear tortuous distally with alternating areas of fibrotic webs and aneurysmal dilation. Further evaluation of this patient is most likely to show which of the following?

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Eductional Objective: Fibromuscular dysplasia is characterized by abnormal tissue growth within arterial walls, resulting in stenotic and tortuous arteries that can cause tissue ischemia and are prone to aneurysm formation.  Pathology typically demonstrates alternating fibromuscular webs and aneurysmal dilation with absent internal elastic lamina (string-of-beads appearance).  Renovascular hypertension occurs due to renal artery stenosis and activation of the renin-angiotensin-aldosterone system.

A 30-Year-Old Woman Comes to the Physician Because of Severe