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Old 05-23-2012
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Neuro What Brain Part Most commonly affected by Septic Emboli?

A 37-year-old, intravenous drug-abusing male presents with fever and chills. Blood cultures are positive for Staphylococcus aureus. He develops central nervous system symptoms, and a cerebral abscess is suspected.
Which part of the brain is most often affected by septic emboli in patients with infective endocarditis?

A. Brainstem
B. Cerebellum
C. Frontal lobe
D. Occipital lobe
E. Parietal lobe
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Old 05-23-2012
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has to be a lobe in mca distribution.
Frontal?
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C) Frontal Lobe
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Default my answer

E. Parietal lobe
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Old 05-24-2012
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Its frontal lobe. I cheated and looked up medscape. Frontal>temporal>parietal>cerebellum>occipital
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parietal lobe ---- source uworld
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E) Parietal Lobe source KPLN
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Quote:
Originally Posted by alfjof View Post
E) Parietal Lobe source KPLN
I new it was E!!! but I forgot why... can you please explain me man?
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why E?

my first thought was global cerebral infarct, in which the most susceptible areas are the hippocampus and cerebellum.
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Quote:
Originally Posted by Dr. Mexito View Post
I new it was E!!! but I forgot why... can you please explain me man?


I have 2 months I did KPLN Qb so the only thing I remember now about this: Embolization from infective endocarditis typically causes multiple, small parietal lobe abscesses. This "factoid" is worth knowing because some patients with infective endocarditis present with what may appear to be multiple, small "strokes" clinically, but their treatable cardiac disease may be completely unsuspected. Parietal lobe infarcts, depending on right or left dominance, would result in a defect in spatial recognition.

Emboli to brainstem may result in cranial nerve defects or respiratory center compromise.
Cerebellum is often affected in alcoholism. It's not a common site for septic emboli.
Frontal lobe is not as common a site for septic emboli as the parietal lobe.
Occipital lobe emboli can result in cortical blindness.
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My last bet would be parietal....

Septic emboli or all sorts of crap that shoots from the heart up lodges in the MCA distribution, cuz thats the most straight vessel on the way from carotids.

Spatial neglect is caused by a lesion in a dominant parietal lobe, but thats truly not the most common presentation of a systemic emboli.

I dont trust Kaplan.
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Quote:
Originally Posted by DocSikorski View Post
My last bet would be parietal....

Septic emboli or all sorts of crap that shoots from the heart up lodges in the MCA distribution, cuz thats the most straight vessel on the way from carotids.

Spatial neglect is caused by a lesion in a dominant parietal lobe, but thats truly not the most common presentation of a systemic emboli.

I dont trust Kaplan.
I'd agree on the not trusting Kaplan part . Look up medical resources online. I didn't find once place which didn't say frontal lobe is the most common.
Does anyone here have access to UptoDate?
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I guess the question was build based on this paper:

http://www.ncbi.nlm.nih.gov/pubmed/17087280
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Quote:
Originally Posted by Dr.NickRiviera View Post
why E?

my first thought was global cerebral infarct, in which the most susceptible areas are the hippocampus and cerebellum.

I thougt exactly as u did , I did never notice this info in U world or kaplan


please need the right answer
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i vote for frontal!
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Quote:
Originally Posted by DocSikorski View Post
I guess the question was build based on this paper:

http://www.ncbi.nlm.nih.gov/pubmed/17087280
Thats a case report. Doesnt really prove anything other than that parietal lobe embolism is possible in IE(which is something we already know). I already looked up pubmed and there's this:
http://www.ncbi.nlm.nih.gov/pubmed/17180609
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Originally Posted by smanthrav View Post
Thats a case report. Doesnt really prove anything other than that parietal lobe embolism is possible in IE(which is something we already know). I already looked up pubmed and there's this:
http://www.ncbi.nlm.nih.gov/pubmed/17180609
M sayin that it was published in 2006, so a great chance that some semi-smart question writer could have used it for Kaplan
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Quote:
Originally Posted by alfjof View Post
I have 2 months I did KPLN Qb so the only thing I remember now about this: Embolization from infective endocarditis typically causes multiple, small parietal lobe abscesses. This "factoid" is worth knowing because some patients with infective endocarditis present with what may appear to be multiple, small "strokes" clinically, but their treatable cardiac disease may be completely unsuspected. Parietal lobe infarcts, depending on right or left dominance, would result in a defect in spatial recognition.

Emboli to brainstem may result in cranial nerve defects or respiratory center compromise.
Cerebellum is often affected in alcoholism. It's not a common site for septic emboli.
Frontal lobe is not as common a site for septic emboli as the parietal lobe.
Occipital lobe emboli can result in cortical blindness.



The answer is parietal lobe
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