Joaquin Garcia

Making questions for learning

3/11/20
 
I worked with Alica de Leon Dowd and Addi Moya
A 60 year old male presents with a new skin lesion that developed
rapidly. Lesion is a dome shaped nodule located on the R cheek onset 4
weeks ago. Patient worked as a farmer for 40 years. Lesion is biopsied
and reveals a keratin filled center. Based on the presentation what is the
diagnosis?
 
A. Squamous cell carcinoma
B. Basal cell Carcinoma
C. Melanoma
D. Keratoacanthoma
E. Actinic keratosis
F. Seborrheic keratosis
Correct answer : D
The case describes an older man with a keratoacanthoma.
Keratoacanthomas are seen in middle age and elderly patients, are
rapidly growing and biopsy shows a bone shaped nodule with keratin
filled centers. These lesions can resemble squamous cell carcinoma. 

A. Squamous cell carcinoma can look similar to a keratoacanthoma

but biopsy shows keratin pearls.
B. Basal cell carcinoma is described as waxy pink pearly nodules,
with telangiectasias, rolled borders, and central crusting or
ulceration.BCC’s can also appear as nonhealing ulcers with
infiltrative growth or a scaling plaque
C. Melanoma is usually described as dark lesions with ABCDE
diagnostic criteria. Asymetry, Border, Color variation, Diameter,
and evolution.

E. Actinic keratosis is described as a scaly plaque 

         F. Seborrheic keratosis are lesions that are described as flat

greasy pigmented squamous epithelial proliferation of immature
keratinocytes with keratin filled cysts
Chapter 5 Basic Rules for writing one best answer items
Joaquin Garcia

Making questions for learning

3/11/20
The rule that interests me the most is rule 2 in chapter 5. This rule is
each item should assess application of knowledge, not recall of an
isolated fact. I think sometimes a lot of people including me get stuck on
memorizing obscure facts. I know I sometimes get discouraged by how
much minutia I have to memorize. Going forward I will try to find a
balance between memorizing the minutia that is essential and making
sure that I understand the concepts and processes that are important to
the understanding of medicine. There will be multiple triggers that can
clue me into a diagnosis, but the presentation may of may not clue me
into a diagnosis. Knowing minutia can clue me into what condition the
patient may have. If I find a balance in learning how to think thru
questions and memorizing the minutia needed to pass quizzes and
exams I hope that this will result in a good step score.