Melanoma

Question 1

most common type of melanoma

Answer 1

superficial spreading

Question 2

nodular melanoma

Answer 2

vertical growth
dark blue/black
raised and asymetrical

Question 3

superficial spreading melanoma

Answer 3

starts flat but becomes irregular and asymetrical

Question 4

lentigo maligna melanoma

Answer 4

old people
brown / black

Question 5

acral lentiginous melanoma

Answer 5

palms, soles, under nail beds
brown stains
most common in non whites

Question 6

uveal melanoma

Answer 6

in the eye

Question 8

when is radiation reccommended

Answer 8

positive lymph nodes
high risk of relapse

Question 9

stage I and II reccommendation

Answer 9

surgery (removing the mass)

Question 10

stage III first line if no BRAF mutation

Answer 10

nivolumab or pembrolizumab
nivolumab / ipilumab but VERY TOXIC

Question 11

first line stage III if braf

Answer 11

dabrafinib / trametinib
vemurafenib / cobimetinib (only v600E)
encorafenib / binimetinib LESS side effects

Question 12

second line Stage III if theyve progressed on an anti PD-1

Answer 12

pembrolizumab + ipilumab

Question 13

who should be tested for BRAF?

Answer 13

everyone with metastatic

Question 14

if we want a BRAF which has fewest side effects

Answer 14

encorafinib + binimetinib

Question 15

which drugs are PD-1 inhibitors

Answer 15

nivolumab
pembrolizumab

Question 16

what moa is ipilumab

Answer 16

CTLA-4 inhib

Question 17

atezolizumab and durvalumab are what moa

Answer 17

PD-L1 inh

Question 18

what is a consideration with ipilimumab and toxicity after initiation

Answer 18

it will look worse before it gets better
need to take all 4 doses and then will see response

Question 19

how many stool per day increase will we hold therapy

Answer 19

4-6

Question 20

how many stool per day increase willl we stop therapy

Answer 20

7+

Question 21

what do we do if theres a severe immune reaction?

Answer 21

discontinue therapy and give high dose steroid