A 6-year-old boy presents to his pediatrician accompanied by his mother for evaluation of a rash. The rash appeared a little over a week ago, and since that time the boy has felt tired. He is less interested in playing outside, preferring to remain indoors because his knees and stomach hurt. His past medical history is significant for an upper respiratory infection that resolved uneventfully without treatment 2 weeks ago. Temperature is 99.5°F (37.5°C), blood pressure is 115/70 mmHg, pulse is 90/min, and respirations are 18/min. Physical exam shows scattered maroon macules and papules on the lower extremities. The abdomen is diffusely tender to palpation. There is no cervical lymphadenopathy or conjunctival injection. Which of the following will most likely be found in this patient?
ACoronary artery aneurysms
BLeukocytoclastic vasculitis
CThrombocytopenia
DMitral regurgitation
EOccult malignancy
A 31-year-old Israeli male with a history of heavy smoking presents to your office with painful ulcerations on his hands and feet. Upon examination, he is found to have hypersensitivity to intradermally injected tobacco extract. Which of the following processes is most likely responsible for his condition?
AEosinophil-rich granulomatous inflammation
BSegmental vasculitis of small and medium-sized arteries
CIncreased endothelial permeability
DNecrotizing inflammation involving renal arteries
EConcentric thickening of the arteriolar wall
A 72-year-old man comes to the physician because of a 6-month history of intermittent dull abdominal pain that radiates to the back. He has smoked one pack of cigarettes daily for 50 years. His blood pressure is 145/80 mm Hg. Abdominal examination shows generalized tenderness and a pulsatile mass in the periumbilical region on deep palpation. Further evaluation of the affected blood vessel is most likely to show which of the following?
AObliterative inflammation of the vasa vasorum
BFormation of giant cells in the tunica media
CNecrotizing inflammation of the entire vessel wall
DFragmentation of elastic tissue in the tunica media
EAccumulation of foam cells in the tunica intima
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