Derm skin cancer quiz Flashcards
Which of the following is false regarding melanoma?
It can arise in eyes
Red hair is a risk factor
Pre-existing nevi are a risk factor
Causes >75% of skin cancer deaths
answer: Pre-existing nevi are a risk factor
Eyes: It can arise in skin, mucosal surfaces and uveal tract
Red hair: Fair complexion is a risk factor
Last fact is true
Which of the following is true regarding the pathogenesis of melanoma?
Wild type BRAF causes activation of the MAPK (RAS-RAF-MEK-ERK) pathway in MM
CDKN2A mutations cause inactivation of the MAPK pathway
CDKN2A encodes p16, a tumour suppressor
CD8+ T-cell recognise melanoma-specific antigens but cannot kill melanoma cells
true: CDKN2A encodes p16, a tumour suppressor
wild type BRAF: BRAF mutations (not wild-Type) activate the MAPK pathway in MM
CDKN2A mutations: CDKN2A mutations cause activation of the MAPK pathway
CD8+ T cell: CD8+ T-cell are capable of killing melanoma cells by recognizing melanoma specific antigens, if activated appropriately
Which of the following statements is true?
Acral lentiginous melanoma is more common in darker skin types
Melanoma incidence is decreasing
Superficial spreading melanoma is most common variant in pale skin types
Nodular melanoma has a rapid radial growth phase
ANS: Superficial spreading melanoma is most common variant in pale skin types
Acral lentiginous melanoma: Acral lentiginous melanoma affects all skin-types equally
Melanoma incidence is increasing
Nodular melanoma: lacks a radial growth phase
Which of the following is true regarding melanoma detection?
ABCDE rule is helpful for early detection of nodular melanoma
The advent of dermoscopy has rendered history-taking obsolete in MM screening
Melanoma and basal cell carcinoma may appear grossly similar
The ‘black swan’ rule may facilitate detection of melanoma
Melanoma and basal cell carcinoma may appear grossly similar
ABCDE: Asymmetry, border irregularity, colour variation and diameter >5-6mm are products of the radial growth phase, absent in nodular MM
the advent of dermoscopy: Dermoscopy is an adjunctive tool in clinical assessment, and findings must be considered alongside other aspects of clinical assessment
black swan rule: The ugly ducking sign – a mole that does not resemble other nevi - may indicate an MM
Which of the following investigation of melanoma is correct?
Suspected melanoma should undergo punch biopsy
Confirmed melanoma should undergo sentinel lymph node biopsy
BRAF mutation status can inform prognosis and treatment decisions
LDH is relevant in haematological malignancy but not helpful in melanoma
BRAF mutation status can inform prognosis and treatment decisions
suspected melanoma: should undergo complete excision for diagnosis
confirmed melanoma: Suspected melanoma should undergo complete excision for diagnosis
LDH: a major prognostic factor in metastatic melanoma
Which of the following is true regarding keratinocyte carcinoma / dysplasia?
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Actinic keratoses typically evolve into squamous cell carcinoma
Basal cell carcinoma is more likely than squamous cell carcinoma to metastasise
Squamous cell carcinoma is three times more common than basal cell carcinoma
Keratinocyte carcinomas are more common in men than in women
Keratinocyte carcinomas are more common in men than in women
Actinic keratoses may transform to squamous cell carcinoma, but the overall proportional risk is low
Basal cell carcinoma virtually never metastasises
Basal cell carcinoma is more common than SCC 4:1
Which of the following is false about Basal cell carcinoma (BCC)?
Nodular BCC appears as a ‘pearly’ papule
Morpheic BCC resembles a scar
Morpheic, micronodular and infiltrative BCC are aggressive subtypes
BCC never metastasises, and thus treatment is usually desirable rather than essential
BCC never metastasises, and thus treatment is usually desirable rather than essential
Which of the following is true regarding basal cell carcinoma management?
Diagnostic biopsies are always required prior to definitive treatment
Topical treatments should always be offered
Mohs micrographic surgery has replaced traditional excision in surgical management
Vismodegib may be used for unresectable BCC
Vismodegib may be used for unresectable BCC
Diagnostic biopsies are not required if clinical features suffice for diagnosis
Topical treatments are only suitable for superficial basal cell carcinomas on low-risk sites
Mohs micrographic surgery is indicated for aggressive subtypes, critical sites and recurrent BCC
Which of the following is correct regarding cutaneous squamous cell carcinoma (SCC)?
Typical appearance virtually always allows clinical diagnosis
May be difficult to distinguish from keratoacanthoma
Cemiplimab represents an alternative to surgical treatment
Rapid growth is a paradoxically positive prognostic feature
May be difficult to distinguish from keratoacanthoma
Clinical appearances may vary substantially
Cemiplimab is indicated for unresectable or metastatic SCC
Rapid growth is a poor prognostic feature
Which of the following statements is true regarding mycosis fungoides?
Rapid progression is typical
Distinct clinicopathological features allow swift diagnosis
Any pruritus is usually mild
Pathogenesis now clearly defined
Any pruritus is usually mild
Progression may take years or decades
Clinicopathological features may remain non-specific / inconclusive for years prior to diagnosis
Pathogenesis remains poorly understood
Which of the following statements is true regarding Kaposi sarcoma?
It may appear as a pink patch or a polyp
HHV6 plays a role in the aetiology
It signifies a diagnosis of AIDS
It is typically treated with chemotherapy regimens that include doxorubicin
It may appear as a pink patch or a polyp
Cutaneous lesions can vary from pink patches to dark violet plaques, nodules or polyps
HHV8 plays an aetiological role
It may be endemic or related to immunosuppression
Options include radiotherapy, chemotherapy, excision
Which of the following statements is false regarding Merkel cell carcinoma?
It is arises from cancerous Merkel cells
Polyomavirus plays an aetiological role
It demonstrates more aggressive behaviour than melanoma
Surgery, radiation and anti-PD1 checkpoint inhibitors are used in treatment
It is arises from cancerous Merkel cells
Which of the following is not a treatment option for actinic keratoses?
Cryotherapy
Topical 5-Fluorouracil
Imiquimod
Radiation therapy
Radiation therapy
Which of the following represent (relative) low-risk features in squamous cell carcinoma?
Periorificial zones
Acantholysis on histology
Immunosuppression
Absence of perineural invasion
Absence of perineural invasion
Which of the following is statements is false regarding cutaneous T-cell lymphoma?
*****************
In mycosis fungoides, early aggressive treatment is indicated to prevent progression
Active treatment of Sézary syndrome always requires systemic therapy
Radiation therapy may be utilised in mycosis fungoides
Mycosis fungoides is the most common primary cutaneous lymphoma
In mycosis fungoides, early aggressive treatment is indicated to prevent progression
-> Early aggressive therapy does not improve survival
