AssessmentsHypertension: Pathology review
USMLE® Step 1 style questions USMLE
A 60-year-old man comes to the physician office due decreased vision, progressive fatigue and swelling around the ankles for the past 4 weeks. Medical history is significant for myocardial infarction 2 years ago, diabetes mellitus type 2 and hypertension. Current medications include aspirin, captopril, metformin and lovastatin. Temperature is 36.4°C (97.5°F), pulse is 80/min, and blood pressure is 144/90 mmHg. Physical examination shows 2+ edema around the ankles bilaterally. Fundoscopic examination reveals retinal arteriolar narrowing, arteriovenous nicking, and flame-shaped hemorrhages. Laboratories studies are shown:
Which of the following is likely responsible for this patient’s eye examination findings?