A 9-year-old girl presents with precocious puberty and episodes of uncontrollable laughter. Which of the following mass lesions might explain her symptoms?
b. Choroid plexus papilloma
c. Giant aneurysm
d. Metastatic carcinoma
e. Hypothalamic hamartoma
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is e; Hypothalamic hamartoma.
Hypothalamic hamartomas are nonneoplastic malformations involving neurons and glia in the region of the hypothalamus. They may be discovered incidentally, either on imaging performed for other reasons or at autopsy, or they may cause symptoms referable to the hypothalamus. Most often, the latter involves neuroendocrine functions, causing precocious puberty or acromegaly due to overproduction of growth hormone–releasing hormone. Patients may also experience paroxysms of laughter, known as gelastic seizures. They may be cured surgically. Craniopharyngiomas are epithelial neoplasms arising in the sellar and third ventricular regions. They may cause hypopituitarism and visual field disturbances. Choroid plexus papillomas usually develop intraventricularly and do not extend down into the sella turcica. These tumors affect both children and adults, but they are rare. They are benign if they are surgically accessible and are extirpated early in their evolution. Giant aneurysms occur in many locations, but typically do not cause gelastic seizures or precocious puberty. Metastatic carcinoma generally occurs in older patients and would not be expected to cause these symptoms.