Perioperative care: Merkel cell carcinoma: practice question

A General Surgery 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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General Surgery · Perioperative care: Merkel cell carcinoma

Sample item

A 78-year-old man has a rapidly growing, painless violaceous nodule on the sun-exposed cheek. Histology shows small round blue cells with paranuclear dot-like staining for cytokeratin 20. Which virus is implicated in the aetiology?

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

The answer and the reasoning

D. Merkel cell polyomavirus

Merkel cell carcinoma is an aggressive neuroendocrine skin cancer of older or immunosuppressed people on sun-exposed skin. Most cases are associated with clonal integration of Merkel cell polyomavirus, and the rest with ultraviolet damage. Wide excision with sentinel node biopsy and radiotherapy is used.

Option by option

  • A. Human papillomavirus 16

    HPV 16 is linked to cervical, anal and oropharyngeal squamous carcinomas.

  • B. Human herpesvirus 8

    HHV-8 is linked to Kaposi sarcoma.

  • C. Epstein-Barr virus

    EBV is associated with nasopharyngeal carcinoma and Burkitt lymphoma.

  • D. Merkel cell polyomavirus (correct)

    Correct. Merkel cell polyomavirus is found in most cases.

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 General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Merkel cell polyomavirus. Merkel cell carcinoma is an aggressive neuroendocrine skin cancer of older or immunosuppressed people on sun-exposed skin.

Why is "Human papillomavirus 16" not the answer?

HPV 16 is linked to cervical, anal and oropharyngeal squamous carcinomas.

Why is "Human herpesvirus 8" not the answer?

HHV-8 is linked to Kaposi sarcoma.

Why is "Epstein-Barr virus" not the answer?

EBV is associated with nasopharyngeal carcinoma and Burkitt lymphoma.

What concept does this question test?

It tests Perioperative care: Merkel cell carcinoma in General Surgery. Most cases are associated with clonal integration of Merkel cell polyomavirus, and the rest with ultraviolet damage. Wide excision with sentinel node biopsy and radiotherapy is used.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Perioperative care: Merkel cell carcinoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.