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NBME 24 Answers

nbme24/Block 2/Question#20 (reveal difficulty score)
A 52-year-old man is admitted to the hospital ...
Granulation tissue 🔍 / 📺 / 🌳

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submitted by lispectedwumbologist(114),
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W'ree venigiw shti eslic of the ialpsn rcdo form hte botmto ?hirgt The elft ghrti eblasl yaslwa xmi em .pu

submitted by fallenistand(27),
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cenSi oyu ese rauvaitcysl that si hwy it si iuotannglra tsesiu. siobuFr acsr luowd eb 1 nmtoh arfte dna you uown'dlt ese atht hcum obld.o

dentist  The v-fib/death is an attempt to throw you off. The simple way of asking this question would have been: "18 days after an MI, you should see____?" +5  
gubernaculum  i would use pathoma for this. it says 1-3 weeks after an MI you can see granulation tissue +2  

according to UWORLD in Day 10-14 there is granulation tissue , 2 weeks to 2 months there's collagen deposition and scar formation , so good luck to pick up 18 days

+7/- usmlecrasherss(20),

Pic from Robbins for the visual learners:

+1/- hungrybox(1171),

submitted by medstruggle(13),
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Why si eth enwsra nortuinaga“l u?sse”it I othtghu eatrf 41 dysa oyu vaeh a ylluf mfeodr sar.c

colonelred_  If you go back and look at the image you can see that it was highly vascular which is characteristic of granulation tissue. Scar tissue formation will be closer to 1 month, plus you will see lots of fibrosis on histology. +15  
sympathetikey  It's a bit misleading, for me, since you do see fibrosis intermixed with the granulation tissue, but granulation tissue was a better answer. +2  
haliburton  According to FA 2017: 3-14d: Macrophages, then granulation tissue at margins. 2wk to several months: Contracted scar complete. Dressler syndrome, HF, arrhythmias, true ventricular aneurysm (risk of mural thrombus). i'm getting pretty frustrated with NBME contradictions to FA, and FA omissions of content. this stuff is hard enough to get straight as it is. +1  
yotsubato  Thats cause the NBME exam writers read FA, then make questions not fit in with FA +7  
trichotillomaniac  This fits the timeline laid out in Pathoma! 1-3 wks = granulation tissue with plump fibroblasts, collagen, and blood vessels +10  
alimd  never look at the image in the beginning. They dont want you to success. Most of the time images are made to ditract +1  
garble  UWorld also has a handy chart for post-MI that said granulation tissue at 10-14 days, then collagen and scar tissue at 2-weeks to months /shrug +  

Myocardial scar tissue for comparison. Note the intense fibrous deposits.

+3/- peqmd(63),

submitted by impostersyndromel1000(35),

Jokes on me, I pay $60 for NBME to tell me granulation tissue exists 18 days after infarct but UWORLD and AMBOSS say 3-14 days after infarct for granulation tissue and 2 weeks to several months for scar formation.

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