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NBME 20 Answers

nbme20/Block 2/Question#21

A 25-year-old woman comes to the physician 2 days ...

Granulomas containing stellate microabscesses

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submitted by neonem(227),

Cat scratch disease (Bartonella infection in immunocompetent hosts) causes lymphadenitis (especially in the axillary region) characterized by sarcoid-like non-caseating granulomas filled with neutrophils.

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submitted by sympathetikey(258),

Choice A. would have been correct if this patient was immunocompromised. Per First Aid, "If CD4 <100, Bartonella...Findings: Neutrophilic Inflammation.

However, as this patient has a competent immune system, buzz words are stellate necrotizing granulomas.

yotsubato  Everyones choice A is different. +  
sugaplum  they mean- Diffuse neutrophil infiltration +  

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submitted by sugaplum(35),

B Hensele- Cat Scratch in immuno-compotent - Bartonella henselae in Immuno-compromised- Baciliary angiomatotsis Looks like kaposi sarcoma "Diffuse neutrophilic infiltrate" FA 2019 177