Derm

Question 1

Pink, Pearly, nodular lesion
Sun exposed areas (upper lip, eyelid, nose)
Superficial telangiectasia
Nonhealing ulcer with a central dimple and rolled, nontender borders (rodent ulcer)
+/- Scaling plaque
Slow growth

Answer 1

Basal cell carcinoma

excellent prognosis

Question 2

Red, Scaly, plaque-like, nodular, papillomatous, and/or verrucous lesion
Sun exposed areas (lower lip, ears, hands)
“Rough” texture
Eventually ulcerates (everted edges, bleeds easily)
Locally invasive but grows slowly

Answer 2

squamous cell carcinoma

Cutaneous

Question 3

Treatment of melanoma or other cancerous skin lesions

Answer 3

Full-thickness excision
(with appropriate safety margins)

0.5–1 cm safety margin: melanoma in situ (T0)

Question 4

Basal cell carcinoma treatment

s/p excisional or wedge biopsy

Answer 4

Standard treatment

• Surgical excision
• Mohs micrographic surgery

Alternatives:

• Radiotherapy
• cryosurgery
• laser ablation
• topical chemotherapy (imiquimod)

Question 5

Cutaneous Squamous cell carcinoma treatment

s/p Punch biopsy

Answer 5

• Surgical excision (with a rim of normal skin) is 1st line
• Mohs micrographic surgery

+ Radiotherapy adjuvant treatment
( if high-risk features)

Question 6

Tumor___ is the most important prognostic factor in Melanoma

Answer 6

thickness

Question 7

an aggressive form of cSCC that typically develops from areas of chronically damaged skin such as ulcers (pressure ulcers, osteomyelitis) and scars (burn scars)

Answer 7

Marjolin ulcer

Question 8

In cSCC regional metastasis to __ is more common than hematogenous spread.

Answer 8

lymph nodes

Question 9

Risk factors to cSCC
Precancerous skin lesions (especially \_\_\_) 
Exposure to \_\_\_
UV exposure
Ionizing radiation

Answer 9

actinic keratosis (sandpaper-like texture)
Marjolin ulcer

Question 10

Which form of skin cancer is more common

Basal Cell Carcinoma or cSCC?

Answer 10

Basal Cell Carcinoma

Question 11

cSC Carcinoma-in-situ: atypical keratinocytes are confined to the ___

Answer 11

epidermis

Question 12

Risk factors for Basal Call Carcinoma:
Sun exposure
Albinism
_____

Answer 12

Xeroderma pigmentosum

Question 13

Nodular basal cell carcinoma →
lesion is pearly, round with central dimple
Most common site face/nose

Superficial basal cell carcinoma →
Lesions look _____ with a pearly border
most commonly on the trunk

Answer 13

flat, eczematous (scaly) plaque

Question 14

Pain and paresthesia in the finger before the development of vesicles

Formation of non-purulent vesicles over the pulp of the finger

Answer 14

Herpetic whitlow

herpes simplex virus (HSV) infection of the distal phalanx

Question 15

Some causes of carpal tunnel include:
Hypothyroidism
Pregnancy
\_\_\_-associated deposition of amyloid
OA
repetitive flexion/extension of the wrist
h/o wrist fracture

Answer 15

dialysis

Question 16

Carpal Tunnel Symptoms develop in the areas innervated by the median nerve: 
Palmar surface of the thumb, index, and middle fingers, and radial half of the ring finger. 
Paresthesia: burning sensation, tingling
Loss of sensation/numbness
Pain
Symptoms worsen at night
Weakened \_\_\_\_
dropping objects
thenar atrophy

Answer 16

pinch and grip

Question 17

confirmatory test for carpal tunnel syndrome

Answer 17

Nerve conduction studies (NCS)

Question 18

Treatment for Carpal Tunnel Syndrome

1. Mild to moderate symptoms:
2. Moderate to severe symptoms (or refractory):

Answer 18

1. Immobilization/splinting
   1a. Steroid injection (triamcinolone)
2. Open or endoscopic release of the transverse carpal ligament

Question 19

The 4th and 5th fingers are most commonly involved
Skin puckering near the proximal flexor crease (earliest sign)
Flexion contracture of affected fingers

Answer 19

Dupuytren contracture

fibroproliferative disorder of the palmar fascia