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NBME 24 Answers
A 52-year-old man is admitted to the hospital for ...
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____?"
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.
It's a bit misleading, for me, since you do see fibrosis intermixed with the granulation tissue, but granulation tissue was a better answer.
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.
Thats cause the NBME exam writers read FA, then make questions not fit in with FA
This fits the timeline laid out in Pathoma!
1-3 wks = granulation tissue with plump fibroblasts, collagen, and blood vessels