Management of Dysplastic Naevi not in 3rd Ed

Question 1

The total number of melanocytic naevi and the presence of atypical moles are independent risk factors for the development of melanoma.

Answer 1

T

Question 2

Most melanomas arise within dysplastic naevi.

Answer 2

F De novo.

Question 3

Dysplastic naevi rarely occur on the chronic sun-exposed skin of the face or hands.

Answer 3

T

Question 4

7% of Caucasians have clinically atypical (dysplastic) naevi.

Answer 4

T

Question 5

Patients with >100 uniform small naevi are not at increased risk of melanoma.

Answer 5

F “Cheetah phenotype” – increased risk

Question 6

Dysplastic naevus / atypical mole syndrome can occur sporadically or be inherited.

Answer 6

T

Question 7

Unlike persons with common naevi, it is not unusual for persons with atypical naevi to continue to develop new lesions throughout life.

Answer 7

T

Question 8

‘Classical’ atypical mole syndrome is characterised by having: >100 melanocytic naevi, 1/more naevi with atypical features, and 1/more naevi >8mm diameter.

Answer 8

T

Question 9

Individuals with dysplastic naevi who have at least one blood relative with melanoma have a lifetime risk of developing melanoma of greater than 80%.

Answer 9

F At least two blood relatives.

Question 10

Removal of all dysplastic naevi in a patient eliminates the risk of developing melanoma.

Answer 10

F Most arise de novo.

Question 11

A wood’s lamp can help visualise areas of naevus regression by highlighting depigmented areas.

Answer 11

T

Question 12

Proposed surgical margin for in situ melanoma is 10mm.

Answer 12

F 5mm

Question 13

Proposed surgical margin for less than or equal to 1.0mm thick melanoma is 10mm.

Answer 13

T

Question 14

Proposed surgical margin for 1.0-2.0mm thick melanoma is 10mm.

Answer 14

F 10-20mm.

Question 15

Proposed surgical margin for 2.01-4.0 mm thick melanoma is 20mm.

Answer 15

T

Question 16

Proposed surgical margin for >4mm thick melanoma is 20mm.

Answer 16

T

Question 17

Sentinel lymph node biopsies provide a survival advantage.

Answer 17

F Only provides prognostic information.

Question 18

The incidence of a second primary melanoma is 25% in patients with a history of melanoma.

Answer 18

F 0.2-8.6%.

Question 19

Risk factors that increase the chance of developing new primary melanoma(s) include male sex, older age, having atypical moles, family history of melanoma, and family history of atypical moles.

Answer 19

T

Question 20

A focused review of systems aimed at pts with melanoma should include queries about weight loss, fatigue, headache, numbness, dizziness, SOB, cough, abdo pain and bone pain.

Answer 20

T

Question 21

The first site of metastasis is most commonly the skin and subcutaneous tissue, followed by lymph nodes, lung, liver, brain and bone.

Answer 21

T

Question 22

The greatest risk of recurrence of melanoma is in the first 10 years following the diagnosis.

Answer 22

F First 1-5 years.

Question 23

The time to recurrence for patients with node-negative disease varies inversely with the thickness of the primary tumour.

Answer 23

T Thin melanomas can potentially recur many years after the initial diagnosis.

Question 24

Regarding melanoma, men and older pts have a worse Px than women and younger pts.

Answer 24

T

Question 25

Predictive factors for regional node metastasis include increasing tumour thickness, presence of ulceration, high mitotic index, lymphovascular invasion and Clark level greater than III.

Answer 25

T

Question 26

Dysplastic naevi have increased recurrence rates

Answer 26

F 2014 questions – Dan added – this is how the question was remembered. I think false

Question 27

Ophthalmology review is necessary in dysplastic naevus syndrome

Answer 27

F 2014 questions – Dan added

Question 28

Dysplastic naevus syndrome patients have increased risk of melanoma

Answer 28

T 2014 questions – Dan added