USMLE Step 1 Questions: Cardiovascular System Pathology

USMLE Step 1 Sample Question

 

The 72-year-old patient had prior elective aortic aneurysm resection but returned to a surgeon with the unusual complaint that both lower legs fell asleep when he had been kneeling on a church bench. Physical examination reveals tense pulsatile masses in the flexor space behind both knees

 

The MOST likely diagnosis is:
  1. Baker cysts
  2. Popliteal aneurysms
  3. Bursitis
  4. Osteoarthritis
  5. Lesser saphenous thrombophlebitis

 

USMLE Step 1 Question Answer

 

The answer is: B. Vascular atherosclerosis is a generalized disease and reconstructive surgery is palliative. Following resection of an aneurysm in one area, the same propensity exists in others, and popliteal aneurysms are common in patients with vascular artherosclerosis. If this patient’s cardiac status would allow him to safely tolerate more surgery, elective repair of these new aneurysms should be considered, keeping in mind that his cardiac status may be quite poor.




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