NBME 24 Intercostal (NBME Answers)

Retired NBME 24 Answers

nbme24/Block 1/Question#3 (reveal difficulty score)
A 52-year-old woman comes to the physician ...
Intercostal 🔍 / 📺 / 🌳 / 📖
tags: oncology metastasis lymph

+32 upvote downvote
submitted by ∗lsmarshall(465)

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The most direct path, and most likely path, for breast cancer to metastasize to the vertebra are the intercostal veins. This was on an earlier NBME test as well. Breast cancer will cause mixed, lytic and blastic lesions once in bone.

On an unrealated note; I finally came up with a decent way to remember lytic vs. blastic cancers in bone!

kIdneY and thYroId cause lYtIc

prostate > blastate > blastic

Two breasts > two types of lesions > B reast causes B oth

Two lungs > two types of lesions (depending on type of lung cancer)

small-cell lung > "small blasts"

non-small cell > lytic

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artist90 VEINS: 1-Intercostal veins drain into Azygous vein which drains into SVC BUT some blood from this Azygous vein is also draining into BATSONS VERTEBRAL VENOUS PLEXUS how the breast cancer metastasizes to vertebral column. 2-Internal thoracic(mammary) vein drains directly into Brachiocephalic vein. 3-Lateral thoracic vein drains into Axillary vein which drains into Subclavian vein which drains into Brachiocephalic vein. ARTERIES ARE DIFFERENT: Subclavian artery----branches into---Internal thoracic(mammary) artery---Intercostal arteries. Internal thoracic artey is used for CABG if there is 1 vessel block. +22

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submitted by ∗yex(128)

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This was on a previous NBME. How I got it? Intercostal (posterior) is how you get to the vertebral bodies; the other vessels are anterior.

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medguru2295 this was nearly word for word on NBME 22. Slightly different wording maybe? +1

unknown001 dude, intercostal veins are both anterior and posterior +

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submitted by zbird(2)

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@lsmarshall Thanks for sharing BCa met via venous routes spreading through the batson plexus which is a network of veins receiving from azygos vein. The azygos receiving from intercostal veins that drains the breast. Which makes intercostal right

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+0 upvote downvote
submitted by ∗suckitnbme(239)

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Tfw NBME said there's no repeats on 23 and 24 and then you get a repeat.

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j44n The NBME is full of shit... they also say there's "no trick questions" +3

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submitted by hivwizard(3)

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The owners are a bunch of assholes they just took everyones descriptions and are now trying to make money off of it you guys are useless

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