Test on Malignant Melanoma: Diagnosis, Staging, and Treatment

Question 1: Most dermatologists primarily rely on the ABCD algorithm for recognizing melanoma.

A. Yes

B. No

Explanation: An investigation of the recognition process of melanoma by dermatologists revealed that most rely more on the lesion’s overall pattern, the "ugly duckling sign," and recent change reported by the patient, rather than the ABCD algorithm.

Question 2: According to Breslow's method, how is the depth of invasion of a melanoma measured?

A. By visually assessing the expansion of the papillary dermis to classify its level of invasion.

B. As a thickness in tenths of millimeters from the surface of the tumor in the epidermis to the deepest tumor cell identified.

C. From the epidermis-dermis junction to the subcutaneous fat, using a qualitative assessment.

D. By determining if it has invaded any subreticular tissues and assigning a corresponding stage.

Explanation: Breslow's method involves a quantitative measurement of the melanoma's depth of invasion. It is measured in tenths of millimeters as a thickness from the surface of the tumor in the epidermis to the deepest tumor cell identified by an ocular micrometer on the microscope. This method is described as simple and readily reproducible, and a powerful prognostic indicator.

Question 3: Elevated serum lactate dehydrogenase (LDH) levels are associated with a significantly higher 1- and 2-year survival rate in patients with disseminated melanoma.

A. Yes

B. No

Explanation: Serum lactate dehydrogenase (LDH) has been identified as an important independent prognostic factor in patients with disseminated melanoma. The 1- and 2-year survival rates were significantly lower in patients with elevated serum LDH (32% versus 65% and 18% versus 40%).

Question 4: What information can the electronic prediction tool developed by the AJCC Melanoma Task Force provide for patients with localized melanoma?

A. The 1-, 2-, 5-, and 10-year survival rates

B. The Breslow depth of the primary tumor

C. The presence of regional lymph node involvement

D. The mitotic rate of the melanoma

Explanation: The study materials state that the electronic prediction tool can be used to predict the 1-, 2-, 5-, and 10-year survival rates from initial diagnosis.

Question 5: During a cervical lymphadenectomy, preservation of the spinal accessory nerve, internal jugular vein, and sternocleidomastoid muscle can be done to improve a patient's appearance and functional neck and shoulder muscles.

A. Yes

B. No

Explanation: The study materials state that a cervical lymphadenectomy can be performed with or without preservation of the spinal accessory nerve, internal jugular vein, and sternocleidomastoid muscle to provide a more acceptable appearance and functional neck and shoulder muscles.