General Pathology USMLE Step 1 Practice Question
A 12-year-old boy of African descent presents with a 3-week history of progressive swelling of the right earlobe following ear piercing at a local mall 6 weeks ago. The earring was removed 3 weeks ago when swelling began, but the lesion has continued to enlarge. His mother reports developing a thick, firm scar on her abdomen after cesarean delivery 12 years ago that never regressed. On examination, the patient is afebrile with stable vital signs. The right earlobe shows a 2-cm, firm, flesh-colored nodule that extends beyond the original piercing site. The overlying skin is intact and nontender. There is no associated warmth, fluctuance, or cervical lymphadenopathy. Which of the following pathologic processes best explains this clinical presentation?
Answer choices
- AAbnormal wound healing characterized by excessive collagen deposition extending beyond original wound marginsCorrect answer
- BLocalized bacterial infection with abscess formation responsive to antibiotic therapy
- CType IV hypersensitivity reaction to nickel or other metal in jewelry
- DBenign lipomatous tumor arising from subcutaneous fat with no scar tissue involvement
- EForeign body granuloma from retained jewelry material or piercing debris
- FHypertrophic scar with collagen deposition limited to original wound boundaries
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