USMLE forum
 
Archives
Step 1
Step 2 CK
Step 2 CS
Matching & Residency
Step 3
 
Forum
 
 
  <<   < *  Step 1  *  2006 Archives  *   >   >>  

* CNS Biopsy
 #134420  
  yelito61 - 10/31/06 23:09
 
  A 7-year-old girl develops a fever, conjunctivitis, photophobia, and a cough. Her pediatrician notes white spots on a bright red background on the girl's buccal mucosa. Within days, a rash begins around the hairline, then spreads to the trunk and extremities. One week later, the child suddenly begins to convulse, and loses consciousness. She is taken to the emergency room, where involuntary movements and pupillary abnormalities are noted. Which of the following would most likely be seen on CNS biopsy?

A. Demyelination of white matter of cerebral hemispheres with abnormal giant oligodendrocytes
B. Perivenous microglial encephalitis with demyelination
C. Phagocytosis of motor neurons in the spinal cord
D. Severe hemorrhagic and necrotizing encephalitis of the temporal lobe with eosinophilic Cowdry type A inclusion in neurons and glia
E. Small granulomas with central caseation in the meninges

 
Report Abuse

* Re:CNS Biopsy
#538555
  bep111 - 10/31/06 23:12
 
  bbbbbb  
Report Abuse

* Re:CNS Biopsy
#538557
  cd45 - 10/31/06 23:14
 
  a???  
Report Abuse

* Re:CNS Biopsy
#538559
  yelito61 - 10/31/06 23:15
 
  Yes bep 111, you're completely right.

The correct answer is B. The initial history given is classic for measles, with the appearance of Koplik's spots (white spots on the buccal mucosa) followed by a rash beginning along the neck and hairline and spreading to the trunk and extremities. The sequela this child is experiencing is post-infectious encephalomyelitis, which can follow either infection with measles, varicella, rubella, mumps, or influenza, or vaccination with vaccinia vaccine or rabies vaccine derived from nervous tissue. Treatment is supportive, with a mortality of 15 to 40%; survivors frequently have significant permanent neurologic deficits. The pathologic finding is perivenous microglial involvement with demyelination.

Choice A describes the findings of progressive multifocal leukoencephalopathy, a demyelinating disease caused by infection with JC virus, especially in immunocompromised individuals.

Choice C describes the findings of poliomyelitis, a paralytic disease affecting the ventral horn of the spinal cord and motor cortex, caused by an enterovirus (poliovirus).

Choice D describes the findings in herpes encephalitis, which typically affects the inferomedial temporal lobes and orbitofrontal gyri.

Choice E describes the findings in tuberculous meningitis, caused by M. tuberculosis.

 
Report Abuse

* Re:CNS Biopsy
#538562
  sage2006 - 10/31/06 23:17
 
  hmm, CD45, how dare you picked a wrong one... it is qbank q...  
Report Abuse

* Re:CNS Biopsy
#538586
  cd45 - 10/31/06 23:32
 
  hmm i think cause i still have some 40 qs in path to go thats why. heheheee

anyways i have been totally abusing qbank... i just review my wrong answers.. maybe when i did this one i got it right and now i dont remem :(((
jejjejeejeee
 
Report Abuse

          Page 1 of 1          

[<<First]   [<Prev]  ... Message ...  [Next >]   [Last >>]
 

 

 

Google
  Web USMLEforum.com
 

Step 1 Step 2 CK Step 2 CS Matching & Residency Step 3
USMLE Forum ArchivesUSMLE LinksUSMLE Forum Home