A 29-Year-Old Man Comes to the Physician for a Routine

question 1091

Multiple Choice

A 29-year-old man comes to the physician for a routine preventive examination.  He is currently feeling well but states that he has always had "some dark spots" on his back.  The patient has no family history of heart disease or cancer.  He does not spend much time outdoors and had no prior sunburn.  He does not smoke.  Physical examination shows many pigmented lesions on his back as shown below. The following 8-mm lesion is seen on close skin inspection.
Which of the following is the best next step in the management of this patient's skin lesion?

• A)Assessment of glycemic control and insulin resistance
• B)Excisional biopsy
• C)Incisional biopsy
• D)Photographic documentation and comparison in 6-12 months
• E)Sentinel lymph node biopsy

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Definitions:

Semantics

The study of meaning in language, including the analysis of the meanings of words, phrases, and sentences.

Encoding

The process of converting ideas into a form that can be communicated, such as transforming thoughts into language or gestures.

Impression Management

The process by which individuals attempt to control the impressions others form of them, often in professional or social contexts.

Intimidation

The act of frightening or overawing someone, especially in order to make them do what one wants.