BCC Flashcards
In this station pt was going for temp art biopsy when you noticed this leasion
In this station pt was going for temp art biopsy
when you noticed this leasion.
Q- Why Biopsy? Q- What’s ttt?
TO CONFIRM / EXCLUDE GCA
- prednisolone 60 mg
Q- Why ttt started before biopsy?
to protect vision from Arteritis of Ophth a.
Q-What from items of data you want to see in pathology
summary report regard to skin carcinoma?
1- Varify pf tumor type and it’s Dx
2- Tumor diameter
3-Thickness
4-Clearance to the lateral and deep margins
Q-what features of tumor may give insight of a risk to a metastatic disease?
Presence or absence of lymph vascular invasion
Q-Pt had # NOF 6 months later. What are 3 predisposing fx for that?
Steroids – Female pt – Postmenopausal status (age)
Q-From bioch. Serum Ca / Ph will be in Osteoprotic having acute Osteoprotic #?
Both will be normal
What’s Myloma/Plasmocytoma?
Neoplastic monoclonal proliferation of plasma cells
What this tumor may secreate into serum?
(Myeloma)
Ig or fragmentation of Igs
What’s Bence-Jones Ptn?
Light chain ptn identified in urine
Apart from Osteoprosis why whis pt may susceptible for #?
Because of bone lysis directly form tumor
Wound sepsis – 4 Fx?
DM –
Steroids –
Depressed immunity from plasmocytoma –
Presence of Foreign body prosthesis (DHS)
Pt had sudden death after surgery—Two most likely causes of that?
Fat Embolism – Venous thromboembolism
Q1: What are your physical findings (BCC)?
Pearly papule with central ulceration, and rolled edge, granulation tissue at base surrounded by telangiectasia
Q2: What is your differential diagnosis?
BCC / SCC / Seborrheic keratitis
Examiner gives you histology report.
Q3: What will you look for in the report?
Size / Depth / Invasion
Q4. If unclear margins, what to do?
Re-Excision with Safety margins using frozen sections / Moh’s Procedure
Q5: If there is lymph node involved, what to do?
FNAC
Q6: What is frozen section?
FROZEN SECTION;
–the surgeon takes a small piece of fresh tissue or tumour for Analysis, – the pathologist freezes this sample and sections are immediately cut,
– the sections are stained and
– Results reported immediately by phoned back to theatre
How do malignant cells reach lymph nodes?
Permeation and embolization
Skin graft was done, and the patient had graft failure subsequently.
Q8: What is the possible causes for graft failure?
Q9: Common organisms for wound infection?
Q10: What to do to diagnose it?
- Infection / Hematoma
- Staph Aureus
- Swab – > C&S
Q11. What is MRSA?
Methicillin Resistant Staph Aureus
Q12: What to do if swab for MRSA is positive?
Isolate pt / Contact Infection control team
INpt; IV Vancomycine and Clindamycin/ Rifampicin. if resistant ( Linzolids)
Q13. Who will you involve in management?
My consultant / Plastic Surg / Microbiologist
Patient developed axillary LN enlargement. LN biopsy showed large cells with bilobed nucleus with prominent eosinophilic inclusion like nuclei resembling an owl’s eye appearance.
Q14: What is your diagnosis now?
Hodg. Lymphoma
Q15. Define carcinoma?
Malignant epithelial neoplasm
Q16: Features of malignant cells?
Invasion
Increase in mitotic rate
Anaplasia – > Pleomorphism / Hyperchromatism / Loss of differentiation / Loss of mitotic features / loss of architecture / high Cyt-Nuc ration