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NBME 21 Answers

nbme21/Block 2/Question#24 (67.5 difficulty score)
A 65-year-old man dies in a motor vehicle ...
Squamous cell carcinoma🔍,📺
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 +11 
submitted by tinydoc(244),
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isrntfca luwod eb a ermo lrhraeppie wdege esahp

sbasec udltnwo eb aniesviv to het rusndginuro raae i ti.nkh

smsquuoa llec si rmeo rnleclayt latdceo

'tswan 01%0 erus utb shatt the tsbe esnraw hlusothg udispt ot ievg 0 mstmspyo nad ustj a iretupc, htonngi kile an uatlac lcncilia eansocir

tsl19  Squamous cell is centrally located and has cavitation, which you can see in the pic. Similar to this one: https://webpath.med.utah.edu/LUNGHTML/LUNG068.html +6  
drdoom  ^ linkifying: https://webpath.med.utah.edu/LUNGHTML/LUNG068.html +4  
zevvyt  I also didn't choose infarct cuz i think the lung would have a red infarct. +  



 +6 
submitted by hungrybox(1108),
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M,llaocpiscyroac moussqua cell mranoaicc sdent ot be -fheiwfto in coor,l sniiarg ,mofr nad etgnixned itno a hcrso.ubn

c:eoruS addiRoaeip

privatejoker  Lol am I the only one that picked Malignant Lymphoma? I thought I remembered Sattar mentioning that metastases are the most common form of cancer to be found in the lung? I tend to pick the "most common" presentation when given so little information to work with +2  
blueberrymuffinbabey  but metastases typically present with multiple lesions so I think at least in exams when it's showing you a solitary lesion, think a primary tumor. +4  



 +4 
submitted by lnsetick(97),
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I tn’do hiktn it was ayac;ritv I tnkih taht swa sutj hte orbu.hcsn I ntihk ssessebac dten to eb ,rellams nad du’nwtol afetfc eth rrigunosund paremnahcy ch.mu I swnt’a uspre incodnfte ni pnkgcii mqsousau llec cain,oamcr tbu I did konw atth aumssuoq lcel oarciamnc ndets ot be a loecaendartcyltl- lgnu tru.mo

fallabella4  Squamous cell carcinoma of the esophagus presents itself as an raised plaque with ulcerations +  



 +1 
submitted by bharatpillai(33),
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ma i het ylon neo who ocseh temhsloma?oei ddnit htta olko lkei a epaullr pqeula oieylprrtos to eynno?a

brotherimodu  That's what I thought too. +  



 +1 
submitted by joanmadd(8),

I know that small cell carcinoma wasn't an option in this question, but would there be any possible way to distinguish small cell from squamous cell on this specific gross pathology?




 +1 
submitted by bbr(27),

Abscess: You'd see a hole (remember the air/fluid level on x ray?)

Hamartomas: Benign neoplasm of normal tissue (you'd see more Lung tissue, whatever this white stuff is....it ain't normal red lung tissue). Infarct: No wedge?

Malignant lymphoma: (idk how to rule out)

Mesothelioma: Pleural plaques (this is intra-parenchymal)

Squamous cell Carcinoma: bingo. Centrally located.




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My ociech ofr smaSoquu ellC oanimCcra swa ddugei yb het eanrtlc nioaclto of the .roumt To ,me htat dint’d ookl ilke het yivcat u’doy teg ithw asssecb ubt a eugh mtour.




 +0 
submitted by mdsu(0),
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nugL ssacesb ipc td/miF/meaaico/n3ik)(/8i:puglisocb4._esjsgew.t2r:s06pL7imok3wg_n74.hs

asuoqSmu clel ;mnicaraco trClane - arHil -iasnmtaC avtois




 +0 
submitted by medstudent(15),

FA 2020 p. 684

SCC: Hilar mass arising from bronchus; cavitation, cigarettes, hypercalcemia.




 -2 
submitted by samsam3711(24),
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ahasoeglEp aussqomu lecl cecnsar ear ermo mooncm in mseorsk