A physician has been treating a 60 year old patient with renal failure due to polycystic kidney disease. The physician should be specifically concerned about the possible coexistence of which of the following conditions?
High-Yield Explanation
There is a specific association between the adult form of polycystic kidney disease and congenital berry aneurysms of the circle of Willis. These aneurysms can rupture, producing a subarachnoid hemorrhage, and possibly causing death. Aneurysms of the aoic root are associated with syphilis. Atherosclerosis causes abdominal aoic aneurysms, many of which are seen in diabetics. Cystic medial necrosis can cause dissecting aneurysms (e.g., in Marfan's syndrome). Ref: Hemphill, III J.C., Smith W.S., Gress D.R. (2012). Chapter 275. Neurologic Critical Care, Including Hypoxic-Ischemic Encephalopathy, and Subarachnoid Hemorrhage. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.