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NBME 21 Answers

nbme21/Block 3/Question#25 (reveal difficulty score)
A 32-year-old woman comes to the physician ...
Dysplastic nevi ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +14  upvote downvote
submitted by โˆ—hungrybox(1277)
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Dysplastic nevi are a precursor to melanoma. They have irregular, "dysplastic" borders. Remember the "B" in ABCD stands for irregular Borders. Nevus means mole.

Other answers:

  • acanthosis nigricans - Darkening of skin associated with Type II diabetes mellitus

  • basal cell carcinoma of skin - Rarely, if ever metastasizes. Commonly affects upper lip.

  • blue nevus - Blue-colored type of common mole. Benign.

  • pigmented seborrheic keratosis - "Stuck on" appearance. Mostly benign. Affects older people.

  • (Note - you usually see only one. If multiple seborrheic keratoses are seen, it indicates a GI malignancy - aka "Leser-Trรฉlat sign)
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usmleuser007  correction ~ BCC affects the lower lip more than the upper +2
sympathetikey  Pathoma says upper lip, good sir +29
hungrybox  Yeah basal cell carcinoma actually affects the upper lip. Counterintuitive because it's "basal" which seems to go along with the lower lip. Here's another source (this website is fucking gold btw): https://step1.medbullets.com/oncology/121593/basal-cell-carcinoma-of-the-skin +6
pg32  Can anyone explain how we can rule out C or E purely based on the question stem? If we read into the question that we are looking for something related to melanoma, then I get why we can rule out C and E. However, the question simply asks which lesion appears on both sun-exposed and nonsun-exposed areas of the patient's skin. I would say that C, D and E can all occur in that distribution pattern. +7
paperbackwriter  @pg32 because it specifies "this patient's skin," and the only ones he is more likely to get than the average person because of his family history are dysplastic nevi +2
teepot123  fa 19 pg 473 +
rockodude  just remember BS. basal cell upper, squamous cell lower +



 +7  upvote downvote
submitted by codyluvr95(6)
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Familial dysplastic nevus syndrome is inherited AD and characterized by tons of dysplastic nevi with transformation to malignant melanoma.

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 +3  upvote downvote
submitted by โˆ—soph(84)
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ok but why is blue nevi wrong? i thought q asks lession in both exposed and unexposed areas.

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