A 20-year-old trauma victim dies in a road traffic accident. At autopsy, flat yellow intimal spots and streaks are noted in the aorta, beginning at the posterior wall above the cusps. These lesions contain lipid-laden cells within the intima. What is the earliest lesion of atherosclerosis?

• A Fibrous cap plaque
• B Atheromatous plaque with necrotic core
• C Fatty streak ✓
• D Complicated plaque with surface ulceration

Explanation

The fatty streak, composed of lipid-filled foam cells (macrophages and smooth muscle cells) in the intima, is the earliest visible lesion of atherosclerosis and appears in the aorta within the first decade of life. It may be precursor to plaques or may regress. Fibrous plaques appear later from the second decade onward; necrotic cores and complicated lesions are end-stage changes seen in older adults.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.