End-Organ Damage Mechanisms · USMLE Step 1

What role do vascular smooth muscle cells (VSMCs) play in the progression of atherosclerotic plaques and subsequent vessel narrowing?

  1. They undergo necrosis and leave behind empty spaces
  2. They migrate to the intima and form the fibrous cap
  3. They transdifferentiate directly into endothelial cells
  4. They secrete anticoagulant and antithrombotic factors
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Correct answer: They migrate to the intima and form the fibrous cap

VSMCs migrate from media to intima, proliferate and secrete extracellular matrix components (collagen/elastic fibers), forming the fibrous cap and contributing to plaque growth and luminal narrowing.

Difficulty: Medium Question 16 of 20

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