Absite- skin and soft tissue

Question 1

Acidic injury

Answer 1

Coagulative necrosis

Question 2

Basic injury

Answer 2

Liquifactive necrosis

Question 3

Hydrofluoride

Answer 3

Calcium gluconate

Question 4

Superficial spreading melanoma

Answer 4

Most common

Arises from pre existing Nevis

Question 5

Nodular melanoma

Answer 5

Blue black or blue red
Most aggressive
Vertical growth
Likely metastasis at time of diagnosis

Question 6

Lentigo maligna

Answer 6

Head and neck
Slow least aggressive
Radial growth
Elevated nodules

Question 7

Acral lentiginous

Answer 7

Soles palms nail beds
Very aggressive
Asians
Blacks

Question 8

Melanoma margin

Answer 8

In situ 0.5cm
<1mm deep 1cm
1-4mm 2cm
>4mm 2cm minimum

Question 9

Basal cell carcinoma appearance

Answer 9

Raised pink pearly papilla

Rolled peripheral edges

Question 10

Squamous cell carcinoma

Answer 10

Flat rough scaly dry
Non healing ulcer
Erythematous papulonodule
Keratotic crust

Question 11

Eccrine carcinoma

Answer 11

Sweat gland tumor

Uv exposure

Question 12

Merkel cell carcinoma

Answer 12

Neuroendocrine carcinoma
Red module that ulcerates
Dome shaped or subcutaneous nodule
Red purple 
Polymovirus infection in immunosuppressed

Question 13

Frost bite

Answer 13

1st degree - superficial firm plaque

2nd degree- milky white blisters- drain

3rd degree- hemorrhagic blister- leave intact

4th degree- extends into bone

Question 14

Dermatofibrosarcoma protuberans

Answer 14

May be mistaken for keloids
Local fascial extension
Finger like projections
High recurrence rate

Question 15

First degree burn

Answer 15

Painful
Red
Blanches

No scarring

Question 16

Second degree superficial partial thickness

Answer 16

Erythematous painful
Blanches, blisters

Spontaneously reepithelializes from retained epithelial structures in 1-2 weeks

Infection can convert to deeper burn

Question 17

Deep second degree burn

Answer 17

More pale, doesn’t blanch

Requires excision and grafting

Question 18

Full thickness third degree

Answer 18

Through epidermis and dermis into subcutaneous fat

Hard leathery, painless
Will not heal, contracts, needs debridement and grafting

Question 19

Fourth degree

Answer 19

Charred

Excision and grafting with flap coverage

Question 20

Parkland formula

Answer 20

For second and third degree burns > 15% in adults, kids <10 with >10% TBSA

4cc/kg x % burns first 24 hrs
Give half in first 8 hrs

LR- UOP 0.5-1cc/kg/hr in adults, 1cc/kg/hr
D5LR - kids <2

Question 21

Wound healing- inflammation (1)

Answer 21

4-6 days

Neutrophil dependent

Question 22

Wound healing- proliferation (2)

Answer 22

Macrophages- peak at day 2-3 
Attract fibroblasts - angiogenesis
Epithelial proliferation
Collagen needs vitamin C for cross linking
Type 3 collagen predominates 
Replaced by type 1
Contraction

Question 23

Wound healing- remodeling (3)

Answer 23

Lymphocytes 
Fibroblasts recede
50% tensile strength by 6 weeks
Collagen replaced by type 1
21 days- 2 years 
Epithelialization 1-2mm/day