Skin tumours: sentinel lymph node biopsy: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Skin tumours: sentinel lymph node biopsy

Sample item

A 48-year-old has a wide excision of a back melanoma with Breslow thickness 1.8 mm, no ulceration, and no palpable nodes or distant disease. Which staging procedure is recommended?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Sentinel lymph node biopsy

Sentinel lymph node biopsy is offered to patients with clinically node-negative melanoma thicker than 1 mm, or 0.8 to 1 mm with high-risk features, to stage the regional nodes. Nodal status is the most important prognostic factor in localised disease. Completion dissection is no longer routine for a positive node.

Option by option

  • A. Sentinel lymph node biopsy (correct)

    Correct. SLNB is recommended for melanoma thicker than 1 mm.

  • B. No staging is needed

    Staging is required at this thickness.

  • C. Bone marrow biopsy

    Bone marrow biopsy is not used.

  • D. Routine prophylactic radical neck dissection

    Prophylactic radical dissection is not performed.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Sentinel lymph node biopsy. Sentinel lymph node biopsy is offered to patients with clinically node-negative melanoma thicker than 1 mm, or 0.

Why is "No staging is needed" not the answer?

Staging is required at this thickness.

Why is "Bone marrow biopsy" not the answer?

Bone marrow biopsy is not used.

Why is "Routine prophylactic radical neck dissection" not the answer?

Prophylactic radical dissection is not performed.

What concept does this question test?

It tests Skin tumours: sentinel lymph node biopsy in Dermatology. 8 to 1 mm with high-risk features, to stage the regional nodes. Nodal status is the most important prognostic factor in localised disease. Completion dissection is no longer routine for a positive node.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Skin tumours: sentinel lymph node biopsy?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.