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I-Human Case Week 2 Unusual Mole 72-Year-Old Male
Outpatient Dermatology Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
[History Taking & Skin Cancer Risk Assessment]
Q1: You are evaluating Mr. Henderson, a 72-year-old male presenting for a skin check. He states,
"My wife says this spot on my cheek is changing." Which question regarding the "E" in the
ABCDEs of melanoma is most critical to ask first?
A. Has the mole been painful to the touch?
B. Has the spot changed in size, shape, or color recently?
C. Do you have a family history of thyroid issues?
D. Do you use moisturizer on your face?
Correct Answer: B
Rationale: Evolution refers to change in a lesion; asking about recent changes in size, shape, or
color is the most specific screening question for melanoma in this context, whereas pain is a less
specific later symptom.
Q2: Mr. Henderson mentions the mole on his right cheek has been present for years but "looks
darker" now. Which specific historical detail regarding the onset helps differentiate a benign
lentigo from a concerning melanoma?
A. Whether the lesion appeared before age 20 or after age 50.
B. Whether the lesion is itchy or not.
C. Whether the patient has high blood pressure.
D. Whether the lesion is on the left or right side of the face.
Correct Answer: A
Rationale: While lentigines are common in older adults, a new onset or changing lesion in a 72-
year-old is more suspicious than a lifelong stable spot; however, noting the duration helps
establish a baseline for the "Evolution" criterion.
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Q3: When assessing Mr. Henderson’s risk factors, you note his occupation. Which history is
most relevant to his cumulative UV exposure risk?
A. He worked as an interior painter for 10 years.
B. He worked as a construction foreman for 40 years, primarily outdoors.
C. He worked as a night shift security guard.
D. He worked as a computer programmer in an office.
Correct Answer: B
Rationale: Chronic, occupational sun exposure (like construction) significantly increases the risk
of both melanoma and non-melanoma skin cancers due to cumulative UV radiation damage.
Q4: Mr. Henderson reports a history of "bad sunburns" as a child. How does this history impact
his current skin cancer risk profile?
A. It is irrelevant because sunburns only cause risk in the teenage years.
B. Intermittent, intense sun exposure and blistering sunburns in childhood significantly increase
the risk of melanoma later in life.
C. Sunburns only increase the risk of basal cell carcinoma, not melanoma.
D. It decreases the risk of melanoma because it toughens the skin.
Correct Answer: B
Rationale: Severe, blistering sunburns, especially in early life, are a strong risk factor for the
development of melanoma, independent of cumulative exposure.
Q5: You ask about family history. Mr. Henderson states his older brother was treated for
melanoma at age 65. This family history increases Mr. Henderson's risk by approximately:
A. There is no increased risk for siblings.
B. 2-fold (2x) to 3-fold (3x) increased risk.
C. 10-fold increased risk.
D. 50% chance he already has melanoma.
Correct Answer: B
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Rationale: Having a first-degree relative (parent, sibling, or child) with melanoma roughly
doubles or triples an individual's risk of developing the disease compared to the general
population.
Q6: Mr. Henderson has fair skin that always burns and rarely tans. According to the Fitzpatrick
scale, what skin type is he?
A. Type III
B. Type IV
C. Type I
D. Type II
Correct Answer: D
Rationale: Fitzpatrick Type II describes skin that usually burns and tans minimally; Type I
always burns and never tans. Since he "rarely tans," Type II is the most accurate classification
among the choices.
Q7: During the Review of Systems, Mr. Henderson denies feeling lumps or bumps but mentions
he feels "more tired than usual." While fatigue is non-specific, which associated symptom would
prompt an urgent workup for metastatic disease?
A. Occasional heartburn after spicy meals.
B. Unintentional weight loss and night sweats.
C. Mild stiffness in the knees in the morning.
D. Occasional headache relieved with acetaminophen.
Correct Answer: B
Rationale: Constitutional symptoms like unintentional weight loss, fatigue, and night sweats ("B
symptoms") are concerning for possible systemic metastasis and require further investigation in
the context of a suspicious skin lesion.
Q8: You review Mr. Henderson's medication list. Which medication class is known to potentially
increase the risk of cutaneous squamous cell carcinoma (SCC), though less associated with
melanoma?
A. Statins (e.g., atorvastatin).
I-Human Case Week 2 Unusual Mole 72-Year-Old Male
Outpatient Dermatology Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
[History Taking & Skin Cancer Risk Assessment]
Q1: You are evaluating Mr. Henderson, a 72-year-old male presenting for a skin check. He states,
"My wife says this spot on my cheek is changing." Which question regarding the "E" in the
ABCDEs of melanoma is most critical to ask first?
A. Has the mole been painful to the touch?
B. Has the spot changed in size, shape, or color recently?
C. Do you have a family history of thyroid issues?
D. Do you use moisturizer on your face?
Correct Answer: B
Rationale: Evolution refers to change in a lesion; asking about recent changes in size, shape, or
color is the most specific screening question for melanoma in this context, whereas pain is a less
specific later symptom.
Q2: Mr. Henderson mentions the mole on his right cheek has been present for years but "looks
darker" now. Which specific historical detail regarding the onset helps differentiate a benign
lentigo from a concerning melanoma?
A. Whether the lesion appeared before age 20 or after age 50.
B. Whether the lesion is itchy or not.
C. Whether the patient has high blood pressure.
D. Whether the lesion is on the left or right side of the face.
Correct Answer: A
Rationale: While lentigines are common in older adults, a new onset or changing lesion in a 72-
year-old is more suspicious than a lifelong stable spot; however, noting the duration helps
establish a baseline for the "Evolution" criterion.
,2
Q3: When assessing Mr. Henderson’s risk factors, you note his occupation. Which history is
most relevant to his cumulative UV exposure risk?
A. He worked as an interior painter for 10 years.
B. He worked as a construction foreman for 40 years, primarily outdoors.
C. He worked as a night shift security guard.
D. He worked as a computer programmer in an office.
Correct Answer: B
Rationale: Chronic, occupational sun exposure (like construction) significantly increases the risk
of both melanoma and non-melanoma skin cancers due to cumulative UV radiation damage.
Q4: Mr. Henderson reports a history of "bad sunburns" as a child. How does this history impact
his current skin cancer risk profile?
A. It is irrelevant because sunburns only cause risk in the teenage years.
B. Intermittent, intense sun exposure and blistering sunburns in childhood significantly increase
the risk of melanoma later in life.
C. Sunburns only increase the risk of basal cell carcinoma, not melanoma.
D. It decreases the risk of melanoma because it toughens the skin.
Correct Answer: B
Rationale: Severe, blistering sunburns, especially in early life, are a strong risk factor for the
development of melanoma, independent of cumulative exposure.
Q5: You ask about family history. Mr. Henderson states his older brother was treated for
melanoma at age 65. This family history increases Mr. Henderson's risk by approximately:
A. There is no increased risk for siblings.
B. 2-fold (2x) to 3-fold (3x) increased risk.
C. 10-fold increased risk.
D. 50% chance he already has melanoma.
Correct Answer: B
, 3
Rationale: Having a first-degree relative (parent, sibling, or child) with melanoma roughly
doubles or triples an individual's risk of developing the disease compared to the general
population.
Q6: Mr. Henderson has fair skin that always burns and rarely tans. According to the Fitzpatrick
scale, what skin type is he?
A. Type III
B. Type IV
C. Type I
D. Type II
Correct Answer: D
Rationale: Fitzpatrick Type II describes skin that usually burns and tans minimally; Type I
always burns and never tans. Since he "rarely tans," Type II is the most accurate classification
among the choices.
Q7: During the Review of Systems, Mr. Henderson denies feeling lumps or bumps but mentions
he feels "more tired than usual." While fatigue is non-specific, which associated symptom would
prompt an urgent workup for metastatic disease?
A. Occasional heartburn after spicy meals.
B. Unintentional weight loss and night sweats.
C. Mild stiffness in the knees in the morning.
D. Occasional headache relieved with acetaminophen.
Correct Answer: B
Rationale: Constitutional symptoms like unintentional weight loss, fatigue, and night sweats ("B
symptoms") are concerning for possible systemic metastasis and require further investigation in
the context of a suspicious skin lesion.
Q8: You review Mr. Henderson's medication list. Which medication class is known to potentially
increase the risk of cutaneous squamous cell carcinoma (SCC), though less associated with
melanoma?
A. Statins (e.g., atorvastatin).
