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NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 3/Question#34 (reveal difficulty score)
A 67-year-old man comes to the physician 2 ...
Excisional biopsy with narrow margin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: derm inc

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submitted by โˆ—keyseph(99)
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An ulcerated base and a shiny, slightly raised border suggests BCC instead of SCC. Management of BCC is excisional biopsy with narrow margin (3-5 mm). If the lesion were SCC, management would be excisional biopsy with wide margin (5-10 mm).

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groovygrinch  Why not do a punch? +1

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submitted by โˆ—step_prep2(66)
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  • Elderly patient with significant sun exposure (landscaper, farmer, etc.) with an ulcerated, shiny lesion on their chest most consistent with a squamous cell carcinoma or basal cell carcinoma
  • Key idea: Concerning skin lesions should be fully excised with ~3 mm margins unless the lesion is very large or in a location where complete excision may be problematic (ear, face, etc.)

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