End-Organ Damage Mechanisms · USMLE Step 1

Which end-organ consequence is most likely from long-standing uncontrolled hypertension affecting the cerebral microcirculation?

  1. Formation of large vessel aneurysms only
  2. Arteriolosclerosis with microinfarcts and vascular dementia
  3. Exclusively hemorrhagic cerebral infarcts
  4. Deposition of amyloid plaques in the cortex
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Correct answer: Arteriolosclerosis with microinfarcts and vascular dementia

Hypertensive damage to small cerebral arterioles causes arteriolosclerosis, reduced perfusion, microinfarcts, and white matter damage — contributing to vascular dementia.

Difficulty: Medium Question 19 of 20

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