(1 point). Listen.
Which of the following events initiates the process of atherosclerosis?

Choice A rationale:

A 76-year-old man with congestive heart failure may experience superior vena cava syndrome (SVCS) due to the increased pressure in the superior vena cava, but SVCS is more commonly associated with malignancies that compress or invade the superior vena cava. While this patient may be at risk for SVCS, the woman with bronchogenic cancer in choice B is at higher risk.

Choice B rationale:

The correct choice. Patients with bronchogenic cancer, particularly lung cancer, are at a higher risk of developing superior vena cava syndrome (SVCS) due to tumor invasion or compression of the superior vena cava. SVCS can cause a range of symptoms, including facial and upper body swelling, dilated neck veins, and difficulty breathing.

Choice C rationale:

A 26-year-old woman who has just delivered her first child is unlikely to develop superior vena cava syndrome (SVCS) as a result of childbirth. SVCS is more commonly associated with malignancies or other factors that cause obstruction or compression of the superior vena cava.

Choice D rationale:

A 6-year-old child with severe asthma is less likely to develop SVCS compared to adults, as SVCS is primarily associated with malignancies and other conditions that lead to obstruction of the superior vena cava. While severe asthma can cause respiratory distress, it is not a typical cause of SVCS in children. .

Choice A rationale:

A systolic pressure between 130-139 mmHg and diastolic pressure between 80-89 mmHg is not considered normal. It falls within the range of prehypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), which classifies normal blood pressure as systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg. The rationale for this choice is that the range provided does not align with the current standards for normal blood pressure.

Choice B rationale:

The correct answer is choice B because a systolic pressure greater than or equal to 140 mmHg and a diastolic pressure greater than or equal to 90 mmHg are indicative of hypertension, as per the JNC 7 guidelines. Normal blood pressure is defined as systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg. Hypertension is a significant risk factor for cardiovascular diseases and requires medical attention and lifestyle modifications to manage. The rationale for this choice is that it correctly identifies the threshold for hypertension, which is crucial for patient assessment and care.

Choice C rationale:

A systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg is indeed considered normal, according to JNC 7 guidelines. However, this choice does not provide an accurate representation of the guidelines as it lacks a systolic pressure range between 120 and 129 mmHg. This gap in the guidelines would lead to confusion when categorizing blood pressure, and the answer is therefore not correct.

Choice D rationale:

A systolic pressure between 120-129 mmHg and diastolic pressure less than 80 mmHg is categorized as elevated blood pressure, not normal. The JNC 7 guidelines clearly specify that normal blood pressure falls below 120 mmHg systolic and below 80 mmHg diastolic. This range is associated with an increased risk of hypertension and should not be considered normal. The rationale for this choice is that it provides an inaccurate representation of normal blood pressure as per the guidelines.