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step 1 > derm > Flashcards

derm Flashcards

1
Q

xanthoma

A

associated with hyperlipidemia or lymphoproliferative malignancies; associated with lipid-laden histiocytes in the dermis

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2
Q

cherry/senile hemangioma

A

small, bright-red papular lesions in 3rd/4th decade; do not regress spontaneously and are always cutaneous

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3
Q

strawberry hemangioma

A

appear in infants; regress spontaneously by 5-8 years of age; bright red near epidermis, more violaceous if deeper

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4
Q

cavernous hemangiomas

A

dilated vascular spaces with thin-walled endothelial cells in the dermis; appear on skin, mucosa, viscera; if on brain/viscera, consider VHL

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5
Q

cystic hygromas

A

lymphatic cysts lined by a thin endothelium; present at birth along neck and lateral chest wall; found in turner/t21 syndrome

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6
Q

xerderma pigmentosum

A

AR mutation that impaires DNA excision repair following UV dmg; pw erythema, scaling, and subsequent hyperpigmentation and lentigo formation in light-exposed areas; skin malignancies develop at 5-6 years of life

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7
Q

fanconi anemia

A

AR, hypersensitivity to DNA cross-linking agents

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8
Q

male patten baldness pw, moa, rx

A

anterior/vertex balding; scalp 5-alpha reducetase activity and the androgenic effects of DHT; finasteride

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9
Q

PKU pw, genetics

A

mental retardation, eczema, mousy body order; AR mutation of phenylalanine hydroxylase

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10
Q

PABA-ester sun screen

A

UVB radiation (290-320) absorbers

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11
Q

acanthosis

A

increase in thickness of stratum spinosum (seen in psoriasis)

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12
Q

dyskeratosis

A

abnormal, premature keratinization of keratinocytes; strongly eosinophilic (seen in SCC)

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13
Q

hyperparakeratosis

A

retention of nuclei in the stratum corneum, incomplete keratinization (normal in mucosa, but abnormal in skin - actinic keratosis)

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14
Q

hyergranulosis

A

excess granulation in the stratum granulosom of the epidermis (seen in lichen planus)

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15
Q

spongiosis

A

intercellular epidermal edema that appears as an increase in the width of spaces between cells; primary histological finding in pt with eczematous dermatitis

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16
Q

RBC extravasation into skin/subQ tissues results in formation of what?

A

petechiae (1 cm); do not blanch as capillaries are not patent

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17
Q

thymidine kinase-deficient VCV means? how to treat?

A

acyclovir-resistent VCV in AIDS pt; rx with foscarnet (pyrophosphate analog viral DNA polymerase inhibitor) or cidofovir (antiviral nucleotide analogue of cytidine monophosphate, does not require viral kinase)

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18
Q

marjolin’s ulcer

A

aggressive, ulcerating SCC on area of previous trauma, chronically inflammed or scarred skin

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19
Q

isotretinoin moa, SE

A

inhibits follicular epidermal keratinzation, loosening keratin plugs of comedones; hypertriglyceridemia and teratogenicity

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20
Q

stewart-treves syndrome

A

chronic lymphedema (2/2 axillar LN dissection) predisposes to angiosarcoma

21
Q

lichen planus pw (5 Ps)

A

polygonal, planar, pruritic, purplish plaques; a.w. hep C

22
Q

xanthelesma pw, histo, a.w.

A

yellow cutaneous lesion on eyelid; lipid-laden macrophages in superficial dermis; cholestatic processes like obstructive biliary lesions or PBC

23
Q

vitiligo histo

A

loss of melanocytes, complete absence of melanin pigment

24
Q

albinism histo

A

melanocytes that do not produce melanin (because of absent/defective tyrosinase)

25
Q

pemphigus vulgaris pw, moa

A

painful, flaccid bullae and erosions ofskin/mucosal membranes; autoantibodies against desmoglein

26
Q

chronic steroid administration to skin results in:

A

atrophy/thinning of dermis, a.w. loss of dermal collagen, dring/cracking/tightening, telangiectasias, ecchymosis

27
Q

atopic eczematous dermatitis: histo

A

intraepidermal vesicles, superficial epidermal hyperkeratosis producing scales, epidermal hyperplasia (acanthosis), chronic inflammatory infiltrate

28
Q

actinic keratosis

A

erythematous papules with central scale/rought “sandpaper-like” texture; premaligmant (SCC)

29
Q

acantholysis

A

loss of intercellular connections

30
Q

pemphigus vulgaris

A

acantholysis forming suprabasal blisters, IgG deposits in reticular pattern around keratinocytes

31
Q

dermatitis herpetiformis: light microscopy

A

accumulation of PMN on the tips of dermal papillae

32
Q

HPV: light microscopy

A

cytoplasmic vacuoles in keratinocytes (koilocytosis) and hyperplasia of the epidermis

33
Q

molluscum contagiosum

A

eosinophilic cytoplasmic inclusions in infected cells

34
Q

androgenetic alopecia inheritance pattern

A

polygenic with variable penetrance; pattern/severity varies b/w males and females depending on circulating androgen levels

35
Q

dermatitis herpetiformis pw, moa, histo

A

herpes-like lesion (erythematous, pruritic papules, vesicles, bullae that appear bilaterally and symmetrically on extensor surfaces); IgA antibodies agianst gliadin (wheat protein) that cross-reacts with reticulin, a protein in the epidermal BM; microabscessess containing fibrin and PMN in dermal papillae tips

36
Q

leprosy: tuberculoid vs lepromatous

A

tuberculoid: positive lepromin skin test, strong TH1 cell-mediate response (IL-2, IFN-gamma, IL-12), macrophages kill organisms and lead to smal number of hypopigmented, well-demarcated plques with decreased sensation; lepromatous: negative lepromin test, Th2 response (IL4, IL-5, IL-10), pw more numerous polry demarcated plaques widespread throughout body)

37
Q

glomus tumor

A

glomus body: small, encapsulated neurovascular organs surrounded by smooth muscle found in the dermis of the nail beed, pad of finger/toes/ears; role is to shunt/direct blood depending on tempreature to maintain temperature

38
Q

psoriasis moa, histo

A

CD4/CD8 T cells activate in epidermis result in production of cytokines (TNF, IL-12, IFN-gamma) and keratinocyte growth factors that stimulate keratinocyte proliferation, inflammation,and angiogenesis; histo: hyperparakeratosis, acanthosis, elogation of the rete ridges, reduced/absent stratum granulosum, thinned epidermal cell layer superior to dermal papilla (pinpoint bleeding= Auspitz sign), PMN form spongiotic clusters in the superficial dermis and parakeratotic stratum corneum

39
Q

hyperkeratosis

A

hyperplasia of the stratum corneum

40
Q

parakeratosis

A

retained nuclei in the stratum corneum

41
Q

Does AK invade the dermis?

A

no; but can evolve into SCC

42
Q

brain metastasis: most common cancers

A

lung cancer, renal cancer, and melanoma

43
Q

apocrine sweat gland causes what lovely finding?

A

malodorous secondary to bacterial decomposition at the skin surface; present in dermis, subQ fat of breast, axillae, genital regions

44
Q

eccrine/merocrine glands

A

present in the skin throughout body, except lips/penis; secrete watery fluid rich in salt

45
Q

psoriasis rx

A

topical vitamin D analogs (calcipotriene) that bind to vita D receptor, a nuclear transcription factor that inhibit keratinocyte proliferaiton and stimulate keratinocyte differentiation

46
Q

melanoma mutation

A

BRAF is a protein kinase involved in activation of signaling pathway for melanocyte proliferation (BRAF V600E mutation is seen in 40-60% percent of melanoma)

47
Q

urticaria moa

A

antigen-induced degranulation of focal mast cells throgh IgE antibody sensitation; OR, IgE-independent urticaria develops after exposure to substances that directly stimulate mast cell degranulation (opiates, antibiotics, contrast)

48
Q

breast cancer: skin retraction moa

A

cancer infiltrates suspensory cooper ligaments

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