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NBME 24 Answers

nbme24/Block 2/Question#20

A 52-year-old man is admitted to the hospital for ...

Granulation tissue

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Since you see vascularity that is why it is granulation tissue. Fibrous scar would be 1 month after and you wouldn't see that much blood.

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____?" +  
gubernaculum  i would use pathoma for this. it says 1-3 weeks after an MI you can see granulation tissue +1  

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

+3/- usmlecrasherss(2),

Why is the answer “granulation tissue”? I thought after 14 days you have a fully formed scar.

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. +5  
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. +  
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 +3  
trichotillomaniac  This fits the timeline laid out in Pathoma! 1-3 wks = granulation tissue with plump fibroblasts, collagen, and blood vessels +6