Fibromuscular dysplasia preferentially affects which arteries, in which demographic, and by which pathological mechanism?

• A Coronary and mesenteric arteries in elderly men, via atherosclerotic plaques
• B Renal and internal carotid arteries in young women, via non-inflammatory medial fibromuscular hyperplasia causing a 'string of beads' pattern ✓
• C Aorta and pulmonary arteries in children, via immune complex deposition
• D Cerebral small vessels in hypertensive patients, via hyaline arteriolosclerosis

Explanation

Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic vascular disease primarily affecting young to middle-aged women. It most commonly involves the renal arteries (causing renovascular hypertension) and internal carotid/vertebral arteries (causing headache, pulsatile tinnitus, TIA/stroke). The medial dysplasia subtype, most common, shows alternating areas of fibromuscular stenosis and thinning, producing the characteristic 'string of beads' angiographic pattern. The etiology involves genetic susceptibility, hormonal effects on vessel wall, and mechanical stretch. It is distinct from atherosclerosis, vasculitis, or inflammatory aortopathy.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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