Pretest/Posttest Knowledge Questions and Clinical Vignettes

Question	Question or Clinical History	Answer Choice or Pathologic Diagnosis	Correct Answer
3	Dysplastic (atypical) nevi:	1. Should all be surgically removed	Incorrect
		2. Become melanomas over time	Incorrect
		3. Are significant markers of those prone to melanoma	Correct
		4. Are the results of multiple sunburns during childhood	Incorrect
		5. All of the above	Incorrect
4	The term “SPF” on a sunscreen refers to:	1. The “Skin Persistence Factor” or how long the sunscreen will stay on the skin	Incorrect
		2. The percentage of the sun's ultraviolet rays that are blocked from penetrating the skin	Incorrect
		3. The increase in time one can stay in the sun before burning	Correct
		4. The ultraviolet frequencies absorbed by the sunscreen	Incorrect
5	Which skin malignancy is not related to the sun exposure?	1. Basal cell carcinoma	Incorrect
		2. Squamous cell carcinoma	Incorrect
		3. Malignant melanoma	Incorrect
		4. None of the above	Correct
6	Common acquired nevi:	1. May be brown, black, or blue in color	Correct
		2. Typically begin as elevated nodules in childhood, becoming flatter with age	Incorrect
		3. Are more likely to arise in persons over age 40	Incorrect
		4. Do not exhibit a “halo” (depigmentation of adjacent skin) unless they have undergone malignant degeneration	Incorrect
		5. None of the above	Incorrect
7	What is the appropriate skin cancer risk management strategy for a fair-skinned 20 year-old woman with facial freckles who burns easily and tans poorly, but has no history of skin cancer or nevi?	1. With no other risk factors, no strategy is needed	Incorrect
		2. She should receive education on skin cancer	Incorrect
		3. She should receive education on skin cancer and sun protection techniques	Correct
		4. She should receive education and also been seen by a physician yearly for screening	Incorrect
8	The mortality rate of cutaneous melanoma is most closely related to:	1. The anatomic site of the tumor	Incorrect
		2. The thickness of the tumor	Correct
		3. How dark the tumor is	Incorrect
		4. The gender of the patient	Incorrect
		5. The age of the patient	Incorrect
9	Which component of ultraviolet radiation is most strongly associated with skin cancer?	1. The 100–280 nm range, UVC	Incorrect
		2. The 280–320 nm range, UVB	Correct
		3. The 320–400 nm range, UVA	Incorrect
10	Which of the following is most likely to require biopsy or removal?	1. A 10 × 6mm irregular waxy lesion with a stuck-on appearance that has been slowly growing and changing color in a 60-year old man	Incorrect
		2. A 12-mm flat, irregular, brown-colored lesion in a newborn	Incorrect
		3. A newly arisen 6-mm flat, irregular, blue-brown lesion on the lower lip of a 25-year-old woman	Incorrect
		4. An 8 mm irregular, slightly-raised, brown and black lesion that has been on the back of a 30 year old man for an unknown time but has recently begun to itch	Correct
		5. All of these should be biopsied or removed	Incorrect
11	Which of the following attributes of a garment is most important in protecting against ultraviolet radiation?	1. Tightness of the weave	Correct
		2. Color	Incorrect
		3. Fiber type	Incorrect
		4. Weight	Incorrect
12	Which risk factor is most strongly associated with malignant melanoma?	1. Freckling and 15 dysplastic nevi on the torso	Correct
		2. African American skin type skin type	Incorrect
		3. More than 20 benign appearing small moles on the trunk	Incorrect
		4. Multiple blistering sunburns as a child	Incorrect
20	18 m/o female, unchanged since birth	congenital nevus	Reassure
21	48 y/o male, dark spot appeared 6 months ago in long-standing mole	Superficial spreading melanoma	Biopsy
22	24 y/o woman, persistent spot on side of neck	Compound nevus	Reassure
23	62 y/o male, slowly enlarging lesion on trunk	Seborrheic keratosis	Reassure
24	65 y/o male, asymptomatic, slowly enlarging blemish on left cheek	Lentigo maligna melanoma	Biopsy
25	43 y/o female with lesion on arm, told by friend to get it checked	Superficial spreading melanoma	Biopsy
26	60 y/o male, asymptomatic, worried about cancer	Venous lake	Reassure
27	71 y/o male, dark spot for years, asymptomatic	Lentigo maligna melanoma	Biopsy
28	17 y/o female, asymptomatic, several similar lesions	Dysplastic nevus	Reassure
29	43 y/o woman, lesion present for years without change	Compound nevus	Reassure
30	22 y/o female, dark spot appeared among freckles 3 months ago	Solar lentigo	Biopsy
31	39 y/o male, reports that parts of a mole are getting lighter	Superficial spreading melanoma - regression	Biospy
32	36 y/o male, lesion noted on physical exam, patient unaware that it was there	Superficial spreading melanoma	Biospy
33	58 y/o male, asymptomatic	Seborrheic keratosis	Reassure
34	30 y/o male, asymptomatic, rubs shirtsleeve	Compound nevus — stable	Reassure

Questions used in online pretest/posttests to measure changes in knowledge (questions 3–12) and clinical skills (questions 20–34).

Questions 1 and 2, demographic data were only included on pre-test (results shown in text), questions 13–19, opinions shown in Table 1.