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Retired NBME 22 Answers

nbme22/Block 2/Question#25 (reveal difficulty score)
A 37-year-old woman undergoes excision of a ...
Angiogenesis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +7  upvote downvote
submitted by โˆ—armymed88(49)
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Wound healing inflammatory for up til 3 days (clots, PMNs, macros) Proliferative 3days til weeks- granulation tissue, new vessels, new epithelium, contraction (repair and regeneration) Remodel 1wk til 6m- replace collagen III with I, increase strength (up to 60-70% original strength possible)

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john055  it looks like the patient has new onset erythema which points to infection and I think neutrophils make sense. I myself have marked angiogenesis but I did it offline. Is angiogenesis the right answer ? +1
almondbreeze  yup +
almondbreeze  according to FA 2019 pg217, neutrophil is present during inflammatory phase- i.e. only up to 3d after the wound. After that we have the proliferative phase with granulation tiss. and angiogenesis, epithelial cell proliferation, dissolution of clot, and wound contraction (involved cells: fibroblasts, myofibroblasts, endothelial cells, keratinocytes, mf) +1
mitchell_to_lakers  why not fibrosis? +
waterloo  mitchell_to_lakers They are asking why is the incision erythematous and slightly warm. When someone is red, Dr. Sattar says that's because blood is going there. Fibrosis isn't a mechanism where someone's tissue will appear red and warm, it's collagen deposition. +7
juanca10  Very good! +
srmtn  is not infected, is healing. normally when healing is a little warm and erythematous because of angiogenesis. +3



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submitted by โˆ—btl_nyc(72)
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Proliferative phase of wound healing. FA 2019 pg 217

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 +2  upvote downvote
submitted by โˆ—asharm10(37)
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It,s not an infection, it's basically a healing process, angiogenesis leads to warmth and erythema,

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pfebo  It says no pain or drainage on the stem, this is how I eliminated the answer choices of infiltratiom (neutrophil, lymphocyte) +1



 +0  upvote downvote
submitted by โˆ—usmleuser007(464)
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https://www.google.com/search?q=wound+healing+steps&tbm=isch#imgrc=WGrdA71sE1oqXM:

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