CDT Clinical Procedures & Patient Care 3 — Questions and Answers
Question 1: Which of the following is the correct order of layers encountered during a punch biopsy from superficial to deep?
- Dermis → Epidermis → Subcutaneous fat
- Epidermis → Dermis → Subcutaneous fat (Correct answer)
- Subcutaneous fat → Dermis → Epidermis
- Epidermis → Subcutaneous fat → Dermis
Correct answer: Epidermis → Dermis → Subcutaneous fat
The correct anatomical order from superficial to deep is epidermis, dermis, then subcutaneous fat (hypodermis), which guides biopsy depth planning.
Question 2: A patient has a documented allergy to amide local anesthetics. Which alternative should the CDT report to the provider before preparing for a procedure?
- Lidocaine
- Mepivacaine
- Bupivacaine
- Benzocaine (ester-type) (Correct answer)
Correct answer: Benzocaine (ester-type)
Benzocaine is an ester-type local anesthetic and is structurally distinct from amide anesthetics (lidocaine, mepivacaine, bupivacaine), making it a potential alternative for patients with amide allergies.
Question 3: Proper labeling of a skin biopsy specimen container requires all of the following EXCEPT:
- Patient's full name
- Date of collection
- Biopsy site/location
- Pathologist's name (Correct answer)
Correct answer: Pathologist's name
The pathologist's name is not required on the specimen container; required labels include patient name, date, and biopsy site to ensure proper identification and chain of custody.
Question 4: When assisting with Mohs micrographic surgery, the CDT's role in tissue processing includes:
- Interpreting the histologic sections
- Diagnosing residual tumor margins
- Mapping and color-coding tissue specimens per Mohs protocol (Correct answer)
- Selecting excision margins based on tumor size
Correct answer: Mapping and color-coding tissue specimens per Mohs protocol
The CDT assists with mapping and color-coding Mohs tissue stages according to protocol, while diagnosis and margin interpretation are performed by the Mohs surgeon.
Question 5: What is the primary reason for using a chalazion clamp during eyelid procedures in dermatology?
- To anesthetize the eyelid tissue
- To provide hemostasis and stabilize the lesion during removal (Correct answer)
- To widen the visual field during dermoscopy
- To irrigate the lesion site
Correct answer: To provide hemostasis and stabilize the lesion during removal
A chalazion clamp provides hemostasis by compressing blood vessels and stabilizes the eyelid lesion, facilitating safe removal of the cyst.
Question 6: Which antiseptic solution is contraindicated for use near the eyes and ears during pre-procedural skin prep?
- Isopropyl alcohol 70%
- Chlorhexidine gluconate (Correct answer)
- Povidone-iodine (Betadine)
- Hydrogen peroxide 3%
Correct answer: Chlorhexidine gluconate
Chlorhexidine gluconate is ototoxic and can cause corneal damage; it is contraindicated for prepping near the eyes and ears, where povidone-iodine is preferred.
Question 7: A patient presents with severe contact dermatitis on both arms after a patch test. The CDT should first:
- Apply hydrocortisone cream and discharge the patient
- Document the reaction and notify the supervising dermatologist immediately (Correct answer)
- Remove all patches and instruct the patient to apply cool compresses at home
- Administer an oral antihistamine from the office supply
Correct answer: Document the reaction and notify the supervising dermatologist immediately
A severe reaction must be documented and reported to the supervising dermatologist immediately so that appropriate medical management can be initiated.
CDT Clinical Procedures & Patient Care 3
Which of the following is the correct order of layers encountered during a punch biopsy from superficial to deep?