High-Yield Skin Cancer MCQs for PLAB 2 / UKMLA

1. A 68-year-old man presents with a slow-growing lesion on the nose. It is pearly with visible blood vessels. Most likely diagnosis?

• A. Malignant melanoma
• B. Squamous cell carcinoma
• C. Basal cell carcinoma
• D. Actinic keratosis

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✅ Answer: C – Basal Cell Carcinoma (BCC)

• Classic: pearly + rolled edges + telangiectasia

• Slow growing, rarely metastasizes

2. A chronic ulcer on the lower lip that is indurated and bleeds easily.

• A. BCC
• B. SCC
• C. Melanoma
• D. Psoriasis

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✅ Answer: B – Squamous Cell Carcinoma (SCC)

• SCC = non-healing ulcer + induration + bleeding

• Common on sun-exposed areas (lip, ear)

3. Which skin cancer has the highest metastatic potential?

• A. BCC
• B. SCC
• C. Melanoma
• D. Actinic keratosis

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✅ Answer: C – Melanoma

• Melanoma = most aggressive

4. Which is a precursor to SCC?

• A. Melanocytic nevus
• B. Actinic keratosis
• C. Lipoma
• D. Hemangioma

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✅ Answer: B – Actinic keratosis

• Rough, scaly lesion → can progress to SCC

5. “Rodent ulcer” refers to:

• A. Melanoma
• B. SCC
• C. BCC
• D. Fungal infection

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✅ Answer: C – BCC

• BCC = rodent ulcer (central ulcer + rolled edges)

6. A dome-shaped lesion with central keratin plug growing rapidly.

• A. SCC
• B. BCC
• C. Keratoacanthoma
• D. Melanoma

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✅ Answer: C – Keratoacanthoma

• Mimics SCC → treat as SCC

7. Which suggests SCC over BCC?

• A. Pearly edge
• B. Slow growth
• C. Pain + lymphadenopathy
• D. Telangiectasia

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✅ Answer: C

• SCC → more aggressive → lymph node spread

8. Which is most common?

• A. Melanoma
• B. SCC
• C. BCC
• D. Merkel cell carcinoma

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✅ Answer: C – BCC

9. Which is most specific for melanoma?

• A. Smooth border
• B. Uniform colour
• C. Evolution
• D. Crusting

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✅ Answer: C

Evolution = CHANGE over time

This includes:

• Increase in size

• Change in shape

• Change in colour

• New symptoms:

  • Bleeding

  • Itching

  • Crusting

A mole that hasn’t changed for years → usually benign

A mole that recently changed → RED FLAG = melanoma until proven otherwise

10. Which UV pattern is most associated with melanoma?

• A. Chronic daily exposure
• B. Occupational exposure
• C. Intermittent intense exposure
• D. Indoor lighting

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✅ Answer: C

Melanoma is most associated with intermittent intense UV exposure (e.g., holidays, sunbathing, sunburns).

• This causes sudden high-dose DNA damage → increases melanoma risk

• Especially important if it leads to sunburn (childhood = very high risk)

❗ In contrast:

• Chronic daily exposure → more linked to SCC and BCC