We are excited to see so many of you join our fall FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!

Just a reminder… pay attention to the questions. Here are our general tips one more time:

1. Pay attention to the questions. Look carefully at how many items you are being asked to list. If the question asks for five items, you will not get more marks if you list eight items; the examiner will look at the first five and allocate marks only for the first five answers so be careful. On a SAMP, if it is not clearly stated how many items you should list, look at the amount of points/marks being allocated for the question to get an idea of how many answers the examiner may be anticipating you write down.

2. Do not write lengthy answers. Most questions can be answered in 10 words or less!

3. Be specific when writing down investigations (hemoglobin instead of CBC; CT abdomen instead of CT).

4. Remember that trade names and generic names are both acceptable when writing down medications.

5. For more helpful tips, you can refer to CCFP’s SAMP instructions by clicking here.

SAMP

Skin Lesions. (17 points)

1. What features do you look at when assessing a skin lesion? (5 points)

• • Asymmetry
  • Border – is the border regular or irregular?
  • Colour – is the lesion multi-colour or uneven?
  • Diameter – is the diameter greater than 6 mm?
  • Evolution – has there been a change in size, shape, colour, or presence of crusting or ulceration?

2. What is Dermoscopy? (1 point)

• • A technique that uses a magnifier and polarized light to examine the surface of the skin

3. What are 4 risk factors for melanoma? (4 points)

• • Fair skin, light eyes
  • High latitude environment/living near the equator
  • Tanning bed use
  • People from northern latitudes who take annual short, intensely sunny holidays
  • Blistering sunburns < 18 years old
  • Xeroderma pigmentosum
  • History of retinoblastoma
  • Familial atypical melanocytic mole syndrome
  • Previous melanoma
  • Solid-organ transplant recipients
  • Hematopoietic cell transplant recipients
  • High cumulative dose of PUVA Therapy

4. What are 3 poor prognostic features of melanoma on histopathology? (3 points)

• • Breslow thickness > 2 mm
  • Ulceration
  • Mitotic rate > 1/mm2
  • Lymphovascular invasion
  • Regression

5. What are 4 histologic subtypes of melanoma? (4 points)

• • Superficial spreading
    
  • Nodular
    
  • Lentigo maligna melanoma
    
  • Acral lentiginous

References:

Ashton, R., & Wilkinson, A. N. (2024). Melanoma crash course. Canadian Family Physician, 70(4), 254-257. https://doi.org/10.46747/cfp.7004254

Image by DermNet NZ, https://dermnetnz.org/

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