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NBME 21 Answers

nbme21/Block 3/Question#25

A 32-year-old woman comes to the physician because ...

Dysplastic nevi

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 +5  upvote downvote
submitted by hungrybox(175),

Dysplastic nevi are a precursor to melanoma. They have irregular, "dysplastic" borders. Remember the "B" in ABCD stands for irregular Borders. Nevus means mole.

Other answers:

  • acanthosis nigricans - Darkening of skin associated with Type II diabetes mellitus

  • basal cell carcinoma of skin - Rarely, if ever metastasizes. Commonly affects upper lip.

  • blue nevus - Blue-colored type of common mole. Benign.

  • pigmented seborrheic keratosis - "Stuck on" appearance. Mostly benign. Affects older people.

  • (Note - you usually see only one. If multiple seborrheic keratoses are seen, it indicates a GI malignancy - aka "Leser-Trélat sign)
usmleuser007  correction ~ BCC affects the lower lip more than the upper +  
sympathetikey  Pathoma says upper lip, good sir +6  
hungrybox  Yeah basal cell carcinoma actually affects the upper lip. Counterintuitive because it's "basal" which seems to go along with the lower lip. Here's another source (this website is fucking gold btw): https://step1.medbullets.com/oncology/121593/basal-cell-carcinoma-of-the-skin +2  

 +2  upvote downvote
submitted by codyluvr95(2),

Familial dysplastic nevus syndrome is inherited AD and characterized by tons of dysplastic nevi with transformation to malignant melanoma.


 +0  upvote downvote
submitted by soph(9),

ok but why is blue nevi wrong? i thought q asks lession in both exposed and unexposed areas.