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NBME 24 Answers

nbme24/Block 2/Question#25 (39.8 difficulty score)
A 35-year-old African American man comes to ...
Palms🔍
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 +16  upvote downvote
submitted by lsmarshall(345),
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sad interesting fact, this is what Bob Marley died from

+5/- jgraham3(10),




Melanin in darkly pigmented skin can provide an SPF (sun protective factor) of 1.5 - 4. Amount of UV light getting through is 1/SPF, so a SPF of 4 reduces UV radiation by 75%. So the areas without this protective feature are most at risk (palms/soles).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671032/




Acral Lentigious is NOT associated with UV exposure. So there might be another reason

nerdstewiegriffin  Source Pathoma 2017 +  
hungrybox  question doesn't have anything to do with UV exposure +1  
nerdstewiegriffin  I am trying to say palms have less melanin is a wrong concept to apply. Acral Lentigious arises in dark skinned individuals and they are not related to UV exposure. I agree using melanin logic you are able to answer this Q but this logic is incorrect. and you might be aware wrong concepts don't go far. +5  
greentea733  Yeah you just need to know acral lentiginous melanoma most commonly appears in African American/Asian patients. Unfortunately the question leads to to think about UV and kinda melanin, which doesn't have anything to do with what they are actually testing +  



I knew about acral lentigious melanoma in African American's but because I learned that it has nothing to do with UV exposure I didn't pick it and went with forehead.. Why did they talk about how he goes on a boat every weekend and doesn't use sunscreen if they just wanted us to know that African American = Acral Lentigious :( maybe I'm just dumb

mamast16  did the same, maybe we're both dumb :( +  



I just think plams are not protected by the melanin and got this right.

hungrybox  useless +4