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  #1  
Old 11-02-2012
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Arrow Billy Step 1 Questions # 70

A 25-year-old man has complained of headaches for the past 5 months. During that time, family members noticed that he was not as mentally sharp as he has been in the past, and that he has become more emotionally labile. Over a 2-week period, he has a generalized seizure, followed by three more seizures. On physical examination, there is no papilledema or movement disorder. CT scan of the head shows a 2-cm mass in the right frontal lobe. A stereotactic biopsy specimen of this lesion shows only gliosis and evidence of recent and remote hemorrhage. The mass is removed, and histologic examination shows a conglomerate of various-sized tortuous vessels surrounded by gliosis. What is the most likely diagnosis?


□ (A) Arteriovenous malformation
□ (B) Organizing abscess
□ (C) Angiosarcoma
□ (D) Prior head trauma
□ (E) Ruptured saccular aneurysm
□ (F) Multiple sclerosis plaque
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  #2  
Old 11-02-2012
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i think it's A or C...not sure

will go with A

thanks
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  #3  
Old 11-02-2012
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(A) Arteriovenous malformation, ....the various-sized tortuous vessels
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  #4  
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I go with AV malformation............thanx.
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Old 11-02-2012
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Quote:
Originally Posted by billy View Post
A 25-year-old man has complained of headaches for the past 5 months. During that time, family members noticed that he was not as mentally sharp as he has been in the past, and that he has become more emotionally labile. Over a 2-week period, he has a generalized seizure, followed by three more seizures. On physical examination, there is no papilledema or movement disorder. CT scan of the head shows a 2-cm mass in the right frontal lobe. A stereotactic biopsy specimen of this lesion shows only gliosis and evidence of recent and remote hemorrhage. The mass is removed, and histologic examination shows a conglomerate of various-sized tortuous vessels surrounded by gliosis. What is the most likely diagnosis?


□ (A) Arteriovenous malformation
□ (B) Organizing abscess
□ (C) Angiosarcoma
□ (D) Prior head trauma
□ (E) Ruptured saccular aneurysm
□ (F) Multiple sclerosis plaque
My answer is A) Arteriovenous malformation
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  #6  
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Answer: A) Arteriovenous malformation
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  #7  
Old 11-02-2012
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i'm going for A...

angiosarcoma is a common lesion of the liver so it's a random pick.
looks more like an AVM.
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Old 11-02-2012
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i choose A. AV malformation
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  #9  
Old 11-03-2012
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Default my answer :)

(A) Arteriovenous malformation?
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  #10  
Old 11-03-2012
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Quote:
Originally Posted by billy View Post
A 25-year-old man has complained of headaches for the past 5 months. During that time, family members noticed that he was not as mentally sharp as he has been in the past, and that he has become more emotionally labile. Over a 2-week period, he has a generalized seizure, followed by three more seizures. On physical examination, there is no papilledema or movement disorder. CT scan of the head shows a 2-cm mass in the right frontal lobe. A stereotactic biopsy specimen of this lesion shows only gliosis and evidence of recent and remote hemorrhage. The mass is removed, and histologic examination shows a conglomerate of various-sized tortuous vessels surrounded by gliosis. What is the most likely diagnosis?


□ (A) Arteriovenous malformation
□ (B) Organizing abscess
□ (C) Angiosarcoma
□ (D) Prior head trauma
□ (E) Ruptured saccular aneurysm
□ (F) Multiple sclerosis plaque
a)A-V malformation..waiting for actual ans though,Billy
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  #11  
Old 11-03-2012
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Pls post the answer Dr billy
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focus
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  #12  
Old 11-03-2012
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Quote:
Originally Posted by billy View Post
A 25-year-old man has complained of headaches for the past 5 months. During that time, family members noticed that he was not as mentally sharp as he has been in the past, and that he has become more emotionally labile. Over a 2-week period, he has a generalized seizure, followed by three more seizures. On physical examination, there is no papilledema or movement disorder. CT scan of the head shows a 2-cm mass in the right frontal lobe. A stereotactic biopsy specimen of this lesion shows only gliosis and evidence of recent and remote hemorrhage. The mass is removed, and histologic examination shows a conglomerate of various-sized tortuous vessels surrounded by gliosis. What is the most likely diagnosis?


□ (A) Arteriovenous malformation
□ (B) Organizing abscess
□ (C) Angiosarcoma
□ (D) Prior head trauma
□ (E) Ruptured saccular aneurysm
□ (F) Multiple sclerosis plaque
□ (A) Arteriovenous malformation
I am not so sure but after ruling out other options. This one seemed more promising.
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  #13  
Old 11-03-2012
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Correct Answer A is correct

Arteriovenous malformations most often occur in the cerebral hemisphere of a young adult and can be removed by a neurosurgeon. There may be slow leakage of blood from the lesion over time, resulting in the clinical symptoms and the gliosis seen on biopsy in this case. An abscess would have an organizing wall with collagen and gliosis, but no prominent larger vessels. An angiosarcoma is not a primary lesion in the brain parenchyma. Head trauma generally produces contusions and hematomas on the surface, but not hemorrhages in the brain parenchyma. A ruptured aneurysm can extend upward into parenchyma in some cases; the outcome is always fatal with this complication. A plaque of demyelination in multiple sclerosis can appear as a mass, but its features include loss of myelin with gliosis and macrophages, not vascular abnormalities.
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