A 73-Year-Old Man Comes to the Emergency Department with Unstable

A 73-year-old man comes to the emergency department with unstable angina.  He undergoes coronary angiography via the femoral approach.  A stent is placed in the right coronary artery, and the patient is discharged.  He returns to the emergency department 2 days later with blue discoloration of his right toe.  He has pain and mild tingling in the affected toe.  Medical history is significant for hyperlipidemia and coronary artery disease.  On physical examination, the right toe appears cyanotic, and there is livedo reticularis affecting the right thigh.  Peripheral pulses in the lower extremities are bilaterally palpable.  Serum creatinine is 2.8 mg/dL (preoperatively it was 1.0 mg/dL) .  Which of the following histopathologic findings would most likely be seen on biopsy of this patient's kidney?

A) Cholesterol clefts in arterial lumen
B) Glomerular crescent formation
C) Hyperplastic arteriolar changes
D) Extensive necrosis of proximal tubular cells
E) Tubular obstruction with urate crystals

Correct Answer:

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