A 66-year-old man comes to the office for a routine visit. He has a history of hypertension and osteoarthritis. The patient has smoked a pack of cigarettes daily for 40 years and occasionally drinks 1 or 2 glasses of wine but does not use illicit drugs. Blood pressure is 142/82 mm Hg and pulse is 80/min. Cardiopulmonary examination is normal. There is a pulsating, central abdominal mass on physical examination. Which of the following pathologic conditions is the most likely underlying cause of this patient's abnormal findings?

Question

A 66-year-old man comes to the office for a routine visit.  He has a history of hypertension and osteoarthritis.  The patient has smoked a pack of cigarettes daily for 40 years and occasionally drinks 1 or 2 glasses of wine but does not use illicit drugs.  Blood pressure is 142/82 mm Hg and pulse is 80/min.  Cardiopulmonary examination is normal.  There is a pulsating, central abdominal mass on physical examination.  Which of the following pathologic conditions is the most likely underlying cause of this patient's abnormal findings?

Quizplus · Accepted Answer

Eductional Objective: Abdominal aortic aneurysm is associated with risk factors (eg, age >60, smoking, hypertension, male sex, family history) that lead to chronic transmural inflammation and extracellular matrix degradation within the wall of the aorta.  This leads to weakening and progressive expansion of the aortic wall, resulting in aneurysm formation, typically below the renal arteries.

A 66-Year-Old Man Comes to the Office for a Routine