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Retired NBME 18 Answers

nbme18/Block 3/Question#40 (reveal difficulty score)
47 yo woman with irregular, raised, ...
Subcutaneous tissue ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: derm dermatology

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 +7  upvote downvote
submitted by โˆ—sugaplum(487)
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the deeper the melanoma goes the worse the prognosis

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wishmewell  isn't the basement membrane the deepest? +
wishmewell  nvm! lol +2
lilyo  I also picked basement membrane but unlike you I haven't had a "nvm" moment. Help please. +2
mcdumbass  @lilyo Basement membrane is between the epidermis and dermis; beneath the dermis is the subcutaneous tissue +7
blah  I think some people might have picked basement membrane because we're taught once cancer goes through the BM it turns from in situ to invasive. This is correct, but subcutaneous as the others pointed out are deeper so the prognosis is worse (BM + deeper tissue). +9



 +6  upvote downvote
submitted by cmoralara(6)
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The subcutaneous tissue is highly vascularized and has larger blood vessels than the dermis, leading to a higher risk of metastasis and worse prognosis (TNM staging system)

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spartanmd  this is not the TNM staging, this is the breslow staging of depth. +1



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