This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Cerebrovascular Diseases, Subject name: Surgery
[{'content': 'A 40yr old male presented with altered mental status, seizures and vomiting. He has no h/o fever, neck stiffness. On CECT and MRI ring enhancing lesion at gray white interface is seen. General hygiene was poor and he has multiple dental caries. What is the next best step in management of this patient? \nSelect and explain. \nA. Urgent parenteral antibiotics, B. Placement of ICP monitor, C. Lumbar puncture, D. Craniotomy', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Most likely diagnosis is brain abscess as - There is absence of signs of meningeal irritation (fever, vomiting, neck stiffness) Is acquired by either contiguous spread from adjacent structure or hematogenous route Common sites of infection are - ear infections, paranasal sinuses & dental caries. CECT & MRI - reveal ring enhancing lesion at gray white interface. Rx - Appropriate antibiotic therapy To relive mass effect, aspiration/surgery can be done', 'role': 'assistant'}]