Uveal Melanoma Quiz

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Uveal Melanoma Quiz

Created by Reem Aziz
Edited by Dr. Jessica Chan

_____ is the most vascular structure within the uvea, and represents the most common subtype of uveal melanoma. *

1 point

Iris

Choroid

Ciliary body

Retina

Iris melanoma typically presents _____ in life and which may explain its _____ rate of metastases compared to choroidal and ciliary body melanomas that are _____ commonly present in _____ patients. *

1 point

earlier, higher, less, younger

later, lower, less, older

earlier, lower, more, older

later, higher, less, younger

You’re seeing a 60 year-old male Caucasian patient who presents with increased blurred vision over the past few months. He reports intermittent flashes and floaters but no noticeable visual field defects. He has a past medical history of hypertension, managed by diet and lifestyle changes, and no known allergies. His family history is significant for hypertension, diabetes, oculodermal melanocytosis, and glaucoma. He is a full-time bus driver who lives with his partner in a two-story house. You astutely continue to take a full, thorough history before reviewing with your preceptor. What on history, if anything, raises the biggest concern for possible uveal melanoma? *

1 point

Increasing blurred vision

Intermittent flashes and floaters

Caucasian male in his six decade

Family history of oculodermal melanocytosis

What combination of factors raises the highest risk for transformation of choroidal nevi into melanoma? *

1 point

tumour thickness >2 mm, symptoms, and tumour margin <3mm from the optic disc

serous subretinal fluid, symptomatic presentation, and hollowness on ultrasound

serous subretinal fluid, absences of halos, tumour thickness >2mm

absence of drusen, orange pigmentation, and serous subretinal fluid

Iris melanoma commonly presents with: *

1 point

flashes and floaters

heterochromia and corectopia

photopsia and photophobia

blurred vision and increased intraocular pressure

Fine-needle aspiration is always required for diagnosis of uveal melanoma. *

1 point

True

False

Mrs. Finigan is a 72 year-old Norwegian female being seen in your clinic for query uveal melanoma. She reports progressive loss of vision on the right side with occasional flashes and floaters. She has a history of cataract surgery but is otherwise healthy and active. You perform the required diagnostic workup for uveal melanoma, and find a 12mm tumour in her right eye. What imaging will you recommend for staging purposes?
*

1 point

CT chest

MRI brain

Bone scan

MRI liver

You discuss treatment options with Mrs. Finigan. What would you recommend for her case?
*

1 point

Surgical resection

Plaque brachytherapy

Immunotherapy

Enucleation

You see a 45 year-old patient with a 5mm hyperchromic iris lesion in the inferior left quadrant. They tell you it’s been unchanged for the past 5 years and they are experiencing no symptoms or vision changes. What therapeutic options will you recommend for them?
*

1 point

Observation

Surgical resection

Radiation therapy

Photocoagulation

Despite appropriate treatment and close follow-up, 50% of patients with primary uveal melanoma will eventually die of metastatic disease. What is the most common site for metastasis?
*

1 point

Lung

Skin

Liver

Bone

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