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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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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: +6  
drdoom  ^ linkifying: +4  
zevvyt  I also didn't choose infarct cuz i think the lung would have a red infarct. +  

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  

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 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

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

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. +  

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?

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 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.

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

submitted by medstudent(15),

FA 2020 p. 684

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

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