In Episode 8 of Med School Question of the Week for USMLE, Luke Maxfield, MedSchoolCoach expert tutor, answers this medical school question: An 81-year-old farmer presents to his primary care physician with a non-healing sore on his cheek. The patient has a past medical history of hypertension that is controlled hydrochlorothiazide. The patient reports he first noticed the spot as a scaly bump but that over the past six months it has progressively gotten larger and occasionally bleeds. The patient’s temperature is 36.6 celsius (94F), blood pressure IS 130/94 mmHg, heart rate is 76/min and regular, respirations are 12/min. Physical examination is notable for a hyperkeratotic papule over the left superior lateral cheek with a hemorrhagic crust. The lesion is shown in the image provided.
Luke obtained his B.S. from the University of Colorado while working at the University of Colorado Anschutz Medical Campus department of pathology as a student researcher. He completed studies at the University of Tennessee at Chattanooga and is a current dermatology resident. Luke scored in the 99th percentile on his COMLEX exams.