Question

question 4 (mandatory) (10 points)
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diabetes mellitus with an associated benign hypertension causes which change in the microvasculature of the coronary vessels of the heart?
thickening of the basement membrane
nodular glomerulosclerosis
hyperplastic arteriolosclerosis
hyaline arteriolosclerosis
mesangial proliferation

Explanation:

• Thickening of the basement membrane: In diabetes mellitus, non - enzymatic glycosylation of proteins in the basement membrane occurs. This leads to thickening of the basement membrane in various tissues, including the microvasculature of the coronary vessels.
• Nodular glomerulosclerosis: This is a specific lesion seen in the kidneys (glomeruli) in diabetes, not in the coronary microvasculature.
• Hyperplastic arteriolosclerosis: This is more commonly associated with malignant hypertension, where there is concentric thickening of arterioles due to smooth muscle cell proliferation and “onion - skin” appearance.
• Hyaline arteriolosclerosis: This is mainly due to hypertension (benign) where there is deposition of hyaline material (plasma proteins) in the arteriolar walls. But in the context of diabetes - related microvascular changes in the heart, thickening of the basement membrane is more characteristic.
• Mesangial proliferation: This is a feature of glomerular diseases (e.g., in some forms of glomerulonephritis) in the kidneys, not a primary change in the coronary microvasculature in diabetes.

Answer:

Thickening of the basement membrane