ABS3 Flashcards
Approximately how long does it take from migration of a keratinocyte from the base layer to the time it is shed from the epidermis
50 days (40 to 56 days)
What is the embryologic origin of melanocytes
Neural crest
Primary type of collagen present in fetal skin
Type III
A pressure of 60 mmHg can result in pressure necrosis of the skin and underlying soft tissue after
1 hour
Radiation wavelengths that is primarily responsible for the development of skin cancer after exposure to the sun
UVB
Best initial treatment of burn with hydrofluoric acid
Copious irrigation with water
Is associated with pyoderma gangrenosum
Monoclonal immunoglobulin agammopathy
A “sebaceous” cyst is removed from the scalp of a 48-year-old woman. What would be expected on histologic exam
The presence of epidermis covered by an external basal layer
Angiosarcoma associated with Stewart-Treves syndrome arises in areas exposed to
Lymphedema
Type of melanoma has the best overall prognosis
Lentigo maligna
A patient presents with a biopsy proven melanoma of the thigh which is 3 mm thick on histologic examination. At the time of excision, how wide should the margins be
2 cm
A chemotherapeutic agent used in the treatment if some patients with dermatofibrosarcoma protuberans (DFSP)
Imatinib
A patient presents with a biopsy proven Merkel cell carcinoma 2 mm in diameter. At the time of excision, how wide should the margin be
3 cm
Nevus sebaceous of Jadassohn is most commonly associated with
Basal cell carcinoma
The relative risk of developing a squamous cell carcinoma of the head and neck for a patient who abuses both cigarettes and alcohol is
35-fold increased risk
*Smoking alone: Male = 1.9-fold increased risk, Female = 3-fold increased risk
*Alcohol alone: 1.7-fold increased risk
The primary lymphatic drainage of the midline of the upper lip is
Preauricular nodes
Features of oral tongue carcinoma
Presentation as ulcerated exophytic mass
May involve submandibular and upper cervical lymph nodes
Can result in ipsilateral paresthesias and deviation of the tongue on protrusion with fasciculations and eventual atrophy
CO2 laser useful or excision o small early tumors
Lymphatic drainage from the supraglottic larynx is primarily to
Superior jugular nodes
Delphian node
Prelaryngeal node
Infection that is correlated with nasopharyngeal cancer
EBV, Epstein Barr virus
Most common salivary gland neoplasm
Pleomorphic adenoma
Level V lymph nodes in the neck are located in the
Posterior triangle
When the tracheostomy is no longer needed, the tube is removed and closure of the opening usually occurs spontaneously
Over a 2-week period
Most common causative organism in otitis externa is
Pseudomonas aeruginosa
Bell’s palsy is most commonly associated with
Infection with Herpes simplex
Most common etiology of facial nerve paralysis
Bell’s palsy or idiopathic facial paralysis
*Treatment = Oral steroids plus antiviral therapy
Ramsay Hunt syndrome is characterized by severe otalgia followed by the vesicles of the external ear and is caused by
Varicella zoster virus
Strawberry tongue is seen in
Scarlet fever
Indication for tonsillectomy in children
After three or more infections per year despite adequate medical therapy
Most common therapy used in the treatment of recurrent respiratory papillomatosis (RRP)
Laryngoscopy with excision and/ or ablation of lesions
*HPV subtypes 6 and 11
Most common site of recurrent respiratory papillomatosis (RRP)
Larynx
Reinke’s edeme is
Edema in the superficial lamina propria of the vocal cord
What temporal bone fracture pattern is most likely to have an associated facial nerve injury
Transverse
Most significant consideration in the management of temporal bone injuries is
The status of the facial nerve
*Delayed of partial paralysis = Almost always resolve with conservative management
*Immediate paralysis = Considered for nerve decompression
The treatment of choice for a small squamous carcinoma of the lip is
Surgical excision alone
Primary repair is possible after excision of what percentage of the lip
<33%
The most common location for Kaposi’s sarcoma of the oropharynx is
Palate
What is the probability that a neck mass measuring 2.5 cm in an adult is malignant
80%
*Neck mass >2cm = Greater than 80% probability of being malignant
What structures is removed in a modified radical neck dissection
Level I-V lymph nodes
Structures removed in a Sistrunk procedure
Portion of the hyoid bone
*THYROGLOSSAL DUCT CYST
Branchial cleft anomalies involving the pyriform sinus arise from the
3rd branchial cleft
Most common malignant epithelial neoplasm of the salivary gland
Mucoepidermoid carcinoma
*Most common benign = Pleomorphic adenoma or benign mixed tumor
Most common malignancies of salivary gland in pediatric population
Mucoepidermoid carcinoma and acinic cell carcinoma
*Adult = Pleomorphic adenoma
Most common site of salivary neoplasm
Parotid gland
The breast receives its principal blood supply from
(1) Perorating branches of the internal mammary artery
(2) Lateral branches of the posterior intercostal arteries; and
(3) Branches from the axillary artery, including the highest thoracic, lateral thoracic, and pectoral branches of the thoracoacromial artery
Initiates ductal development
Estrogen
Responsible or differentiation of epithelium and or lobular development
Progesterone
Primary hormonal stimulus for lactogenesis in late pregnancy and the postpartum period
Prolactin
Regulate the release of estrogen
Gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
Also called recurrent periductal mastitis, is a condition of recurrent retroareolar infections and abscesses
Zuska disease
Chronic inflammatory condition that originates within the accessory areolar glands of Montgomery or within the axillary sebaceous glands
Hidradenitis suppurativa of the nipple-areola complex or axilla
A variant of thrombophlebitis that involves the superficial veins of the anterior chest wall and breast
Mondor disease
Risk actors or the development of breast cancer include
Early menarche
Nulliparity
Late menopause
Longer lactation period
- Increased exposure to estrogen is associated with an increased risk for developing breast cancer, whereas reducing exposure is thought to be protective
- Factors that increase the number of menstrual cycles, such as early menarche, nulliparity, and late menopause, are associated with increased risk
- Moderate levels of exercise and a longer lactation period, actors that decrease the total number of menstrual cycles, are protective
Postmenopausal women at high risk for breast cancer to receive either
Tamoxifen or raloxifene
The gold standard against which breast conservation therapy or DCIS is evaluated is
Mastectomy
* Women with DCIS and evidence o extensive disease (>4 cm o disease or disease in more than one quadrant) usually require mastectomy
* Adjuvant tamoxifen therapy is considered or DCIS patients with estrogen-receptor (ER)-positive disease
Clinical situations where sentinel lymph node (SLN) dissection is not recommended include
Patients with inflammatory breast cancers
Those with palpable axillary lymphadenopathy and biopsy-proven metastasis
DCIS without mastectomy
Prior axillary surgery
How many lactiferous ducts drain into the nipple of the mature female breast
15-20
During pregnancy, alveolar epithelium develops in the breaths which is responsible after delivery for the production of milk. Which part of the alveolar epithelial cell is responsible for the production of the fat present in human milk
Cytoplasm
Protein component of the milk
Endoplasmic reticulum (merocrine secretion)
Lipid component = Cytoplasm (apocrine secretion)
The medial mammary artery is a tributary of the
2nd, 3rd, and 4th intercostal arteries
Absence of the breast (amastia) is associated with
Poland syndrome
Increased risk of breast cancer in men with
Klinefelter’s syndrome
Klinefelter’s syndrome = Gynecomastia
Fleischer’s syndrome = Polymastia
The treatment of choice for Zuska’s disease is
Antibiotics, incision, and drainage
Conditions lead to gynecomastia due to an increased production of estrogen
Nontesticular tumors – Adrenal cortical neoplasms, lung carcinoma, hepatocellular carcinoma
Conditions lead to gynecomastia due to an decreased in testosterone production
Klinefelter’s syndrome
Aging
Renal failure
The treatment of choice for Mondor’s disease is
Observation and nonsteroidal anti-inflammatory drugs (NSAIDs)
The appropriate therapy for Paget’s disease of the nipple is
Resection
Pathognomonic of Paget’s disease of the nipple
Presence of large, pale, vacuolated cells (Paget cells) in the rete pegs of the epithelium
A 35-year-old woman with a BRAC1 gene mutation seeks your advice about her known increased risk of breast cancer. You should recommend
Prophylactic bilateral mastectomy and, if she has completed childbearing, prophylactic bilateral oophorectomy
Present screening recommendations for BRCA mutation carriers who do not undergo prophylactic mastectomy include
Clinical breast examination every 6 months and mammography every 12 months beginning at age 25 years
Appropriate treatment for a 3-cm fibroadenoma
Option for treatment include surgical removal, cryoablation, or observation (especially those larger than 2 cm)
The average lifetime risk for a woman to develop breast cancer is approximately
12%
Aged 50 years = 11% lifetime risk of developing breast cancer
Aged 70 years = 7%
Routine mammography in women over 50 years of age decreases mortality from breast cancer by approximately
33%
Current recommendations are that women undergo baseline mammography at age
35
*Annual mammographic screening beginning at age 40
The most common genetic cause of breast cancer is a mutation in
BRAC2
