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Dermatology > Cancer > Flashcards

Cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

What cell does malignant melenoma originate form?

A

Melanocytes

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2
Q

Where are melanocytes found?

A

Basal layer

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3
Q

What is the correct name for moles?

A

Melanocytic naevi

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4
Q

Is melenoma is confined to epidermis what is it called?

A

Melanoma in situ

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5
Q

What is Lenitgo Maligna?

A

Melanoma is situ that occurs around hair follicles on sun damage skin on face or neck

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6
Q

What is an invasive melanoma?

A

Melanoma that grows into the dermis

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7
Q

What are the precursor legions for malignant melanoma?

A

Benign melanocytic naevus (normal mole)
Atypical or dysplastic naevus (funny-looking mole)
Atypical lentiginous junctional naevus (freckle in heavily sun damaged skin)
Congenital melanocytic naevus (brown birthmark)

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8
Q

What is the most common site for melanoma is males?

A

Back

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9
Q

What is the most common site for melanoma in females?

A

Legs

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10
Q

What are the two forms of growth for melanoma?

A

Vertical and horizontal

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11
Q

What is the glasgow 7 point checklist??

A

Major features:
Change in size
Irregular shape
Irregular colour

Minor features: 
Diamterer >7mm 
Inflammation 
Oozing 
Change in sensation
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12
Q

What is the ABCDs of melanoma?

A 
A - asymmetry
B - Border irregularity 
C - colour variation 
D - Diameter over 6 mm 
E - evolving (enlarging, changing)
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13
Q

What are the 4 horizontal melanomas?

A

Superficial spreading melanoma (SSM)
Lentigo maligna melanoma (sun damaged skin of face, scalp and neck)
lentiginous melanoma (on trunk and proximal limbs)
Acral lentiginous melanoma (on soles of feet, palms of hands or under the nails – the subungual melanoma)

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14
Q

What are the 5 vertical melanomas?

A 
Nodular melanoma (presenting as a rapidly enlarging lump)
Spitzoid melanoma (a nodule that resembles a Spitz naevus)
Mucosal melanoma (arising on lips, eyelids, vulva, penis, anus)
Neurotropic and desmoplastic melanoma (fibrous tumour with a tendency to grow down nerves)
Ocular melanoma
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15
Q

What is the Breslow Thickness used for?

A

To measure the thickness of INVASIVE melanomas - from top of granular layer to the bottom of the tumour. The thicker, the more likely there will be mets.

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16
Q

What is the Clark Level of Invasion?

A

Indicated anatomical plane of invasion. Level 1-5, the deeper the level the more likely there will be mets

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17
Q

How are melanomas removed?

A

Surgically with a margin

If lymph nodes in involved they should be removed too

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18
Q

What are benign skin lesions?

A

Ephilides (freckles)
Lentigines
Naevi

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19
Q

How do melanocytic naevi occur?

A

Melanocytes that have failed to mature or migrate in utero

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20
Q

What is the most common subtype of melanoma and who does it affect?

A

Superifical spreading melanoms

Affects young/middle ages adults

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21
Q

What kind of melanoma is more common in elderly patients?

A

Nodular melanoma

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22
Q

What is Hutchinson sign and what does it indicate?

A

Pigmented extension into the nail fold

Acral Lentiginous

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23
Q

Brown/ black greasy lesion

A

Seborhoeic Keratoses

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24
Q

“Stuck on” appearance and regular border

A

Seborhoeic Keratoses

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25
Q

How do you treat Seborhoeic Keratoses ?

A

Reassurance, freezing, curette or shaving it off

may fall off spontaneously on its own

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26
Q

When surgically removed a melanoma, how big should the borders be?

A

1cm lateral margin for every 1mm depth invasion

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27
Q

Definition of Carcinogenesis?

A

The process by which a normal cell becomes a malignant cancer cell

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28
Q

UVA

A

Indirect skin damage
Much more prevalent
Penetrates more deeply into skin

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29
Q

UVB

A

Direct DNA damage
1000 more times damaging than UVA
Only when sun is directly over head

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30
Q

How many types of skin type are there?

A

5

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31
Q

What protects the skin from sunlight?

A

Melanin, absorbs UV

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32
Q

Sunbun and solar lentigo are due to which form of sunlight?

A

UVB

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33
Q

Solar ageing is due to which form of sunlight?

A

UVA

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34
Q

What is solar lentigo a precursor for?

A

Seborhoeic Keratoses

35
Q

What is sunburn?

A

A protective mechanism where badly uv damaged keratinocytes apoptosis or programmed cell death

36
Q

Which type of sunlight doe vitamin come from?

A

UVB

37
Q

What type of sunlight is used to tanning bed?

A

UVA

38
Q

What factors increase your risk of sunburn?

A 
Fair skin 
Genetics
DNA repair syndromes 
Albinism 
Naevoic basal cell carcinoma syndrome 
Immunosuppresion 
Age
Medications
39
Q

Where do tumours in the skin arise from?

A

Any where in the skin

40
Q

What tumours originate form the epidermis?

A

Benign Seborrhoeic Keratosis
Precancerous dyplasias e.g. Bowens disease, actinic keratosis and viral lesions
BCC
SCC

41
Q

What is Seborrhoeic Keratosis ?

A

Benign proliferation of epidermal keratinocytes

42
Q

Where does Seborrhoeic Keratosis occur?

A

Face

Trunk

43
Q

What is Leser trelet sign?

A

Explosive onset of Seborrhoeic Keratosis, can be a sign on internal malignancy as part of a paraneoplastic syndrome

44
Q

What are the three main subtypes of BCC?

A

Nodular
Superficial
Infiltrative

45
Q

Where do BCC’s usually occur?

A

Sun exposed areas e.g. face, back of hands etc.

46
Q

Do BCCs metastasise?

A

V v rarely

47
Q

What are the main precursors for SCC?

A

Bowen’s disease
Actinic Keratosis
Viral Lesions

Showing sqaumous DYSPLASIA

48
Q

What is Bowen’s Disease?

A

Squamous carcinoma in situ. s a neoplastic skin disease; it can be considered as an early stage or intraepidermal form of squamous cell carcinoma.

49
Q

Where does Bowen’s disease usually occur?

A

Legs

50
Q

Appearance of Bowen’s disease?

A

Scaly patchy/plaque, irregular border and no dermal invasion

51
Q

Where do Actinic Keratosis usually occur?

A

Sun exposed areas e.g. scalp, face, hands

52
Q

Who does SCC most commonly affect?

A

Elderly sun exposed individuals

53
Q

Occasionally where can SCC’s come from?

A

Chronic leg ulcer
Burns
Chronic lupus vulagris

ESP SUN DAMAGED SKIN

54
Q

Which 4 specific sites are involved in SCC with poor prognosis?

A

Scalp
Ear
Nose
Lip

55
Q

In embryological terms where do melanocytes come from?

A

Neural crest

56
Q

What is the scientific name for freckles?

A

Ephilides

57
Q

What do defects of the MC1R gene cause?

A

1 defect = freckles

2 defects = freckles and red hair

58
Q

What are the 6 main factors that point you towards and malignant melanoma diagnosis?

A 
Irregular pigmentation 
Change is shape 
New pigmented lesion develops in adulthood 
Ulceration 
Development of satellite nodules 
Bleeding
59
Q

What are the two non-melanoma cancers?

A

BCC

SCC

60
Q

What is the melanoma cancer?

A

Malignancy melanoma

61
Q

What layer does BCC originate from?

A

Basal alyer

62
Q

What layer does SCC originate from?

A

Suprabasal layer

63
Q

What is the commonest human cancer?

A

BCC

64
Q

Which gender is malignant melanoma more common in?

A

Female

65
Q

What is the ugly ducking sign?

A

Mole that looks different from all the other moles, male need be checked out

66
Q

What is a Keratoacanthoma?

A

is a low-grade skin cancer tumor that is similar to squamous cell carcinoma (SCC). It originates in the skin’s pilosebaceous glands, or hair follicles. This skin cancer tumor grows rapidly, in just a few weeks to a few months

67
Q

Why is there an increase risk of cancer in people who have had previous hand transplants?

A

Due to immunosuppression so the body will “accept” the hands

68
Q

Name new treatment for largely superficial BCC?

A

Photodynamic therapy

69
Q

Name new treatment for Nodular BCC?

A

5% imiquimod cream

70
Q

before skin surgery, how long should a patient stop smoking?

A

3 weeks

71
Q

Treatment for melanoma?

A

Initially surgery

Further surgery, radio or chemotherapy may be needed if mets

72
Q

What are the 5 layers of the scalp?

A 
Skin
Connective tissue
Aponeurosis 
Loose connective tissue 
Periosteum

(backwards spells PLACS)

73
Q

4 methods of local anaesthesia?

A

Topical
Local infiltration
Nerve block
Field block

74
Q

Why is adrenaline good to give during anaesthesia?

A

Prolongs anaesthesia and decreases bleeding

75
Q

In what structures should adrenaline not be given in?

A

Fingers and toes

76
Q

In which patients should adrenaline be avoided in ?

A

Cardiac disease

Pychotropic drugs

77
Q

When is Electrosurgery used?

A

Skin lesions e.g. skin tags

78
Q

What is Curettage and Cautery?

A

Abnormality on skin scraped like with a spoon like instrument. After lesion scooped out blood vessels are seared off to prevent bleeding.

79
Q

What patients get Curettage?

A

Old frail patients who had said no to standard surgery

80
Q

Disadvantages of Curettage?

A

Does not provide a good pathology specimen

Does not accurately record the margins of the tumour

81
Q

What is shave excision surgery?

A

simple procedure done to remove growths such as lesions, tumors, and moles on the skin. The growth is removed with a sharp razor and soothed with antibiotic ointment to encourage healing

82
Q

What is a punch biopsy?

A

V sharp round ended instrument used to remove skin abnormalities

83
Q

Advantages of punch biopsy?

A

Quick

Produces good wound edges

84
Q

Disadvantages of punch biopsy?

A

Difficult to judge depth
Round holes do not heal very well
Pathology sample may be too small

Dermatology (10 decks)

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