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DERM Flashcards

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1
Q

cleared patches on melanoma is due to?

A

cytotoxic T cell recognized tumor ag ( melan A) and induce apoptosis – melanocyte regression due to tx

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2
Q

red area of melanoma is due to?

A

vessel ectasia ( dilation) and local inflammation

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3
Q

brown or black area of melanoma is due to?

A

neoplastic melanocytes

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4
Q

what is pembrolizumab?

A

programmed cell death receptor-1 ( PD-1) inhibitor

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5
Q

how does pembrolizumab work?

A

cancer cell overexpressed PD-L1, this ligand bind to PD-1 recptor on cytotoxic T cell and suppress their ability to apoptosis.

pembrolizumab block PD-1 –> restored CD8 response –> promote tumor cell apoptosis

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6
Q

spongiosis

A

accumulation of edema fluid in the intercellular space of epidermis. found in contact dermatitis

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7
Q

acanthosis

A

thickening of stratum spinosum

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8
Q

hyperkeratosis

A

thickening of stratum corneum

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9
Q

dyskeratosis

A

premature keratinization of individual keratinocyte below stratum granulosum. found in SCC

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10
Q

hypergranulosis

A

thickening of stratum granulosum. found in lichen planus

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11
Q

ecthyma gangrenosum is associated with which microbe?

A

pseudomonase aeruginosa.

it release exotoxins, casuing vascular destruction –> infussificient blood flow to patches of skin –> edematous and necrosis

common in neutropenia, hospitalized, burn indwelling catheter pt

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12
Q

intracellular protozoa with rod-shaped kinetoplasts

A

cutaneous leishmaniasis

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13
Q

MOA of leishmania

A

bite from sandfly –> mature within host MC ( intracellular, round-oval amastigote with rod-shaped kinetoplast

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14
Q

what does terbinafine use for?

A

dermatophytosis such as toe nail infection and tinea corporis

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15
Q

MOA of terbinafine

A

block squalene epoxidase

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16
Q

what can a bluish neoplasm underneath nail bed suggest?

A
  1. glomus tumor - glomangioma

2. subungual melanoma

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17
Q

what is glomangioma?

what is glomus body

A

glomangioma is tumor of modified SM cell of a glomus body

glomus body are several small, encapsulated neurovascular organ forund in dermis of nail bed, pad of finger and toes, ear.

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18
Q

what does glomus body made up of?

A

composed of an afferent arteriole connected to a richly innervated, muscular arteriovenous anastomosis, then connect to an efferent vein . With modified SM cells arranged in layers around these vascular channel.

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19
Q

what is the function of glomus body

A

shunt blood away from skin in cold temperature.

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20
Q

mildly pruritic, polycyclic rash with a raised, scaly border and central clearing; may confluent to form “flower petal” shape. What is the cause?

A

trichophyton rubrum – tinea corporis

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21
Q

where does dermatophyte infect?

A

infect keratinized matter in stratum corneum. Does not invade dermis

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22
Q

what cause photoaging?

Study These Flashcards
A

UVA. penetrate into skin and produce ROS –> activate multiple inflammatory cell-surface receptor and nuclear transcription factos –> decrease collagen fibril production + increase matrix metalloproteinase –>degrade type I and III collagen and elastin

23
Q

what can cause varicose vein?

Study These Flashcards
A
  1. obstruction of venous return – pregnancy, obesity
  2. increased orthostatic pressure – prolonged standing
  3. decreased muscular compression – sedentary lifestyle
  4. damaged venous valves - DVT
24
Q

what is stasis dermatitis

Study These Flashcards
A

red, indurated, fibrotic and deposition of hemosiderin ( from break down of extravasated RBC) –> redddish-brown discoloration

25
what is the complication of chronic venous insufficiency
extravasation of fluid, plasma protein, RBC --> chronic inflammation and stasis dermatitis poor wound healing, weeping, ulceration
26
what is pellagra? and what is the cause?
dermatitis - rough, thick, scaly skin diarrhea - due to atrophy of columnar epithelium of GI, dementia - neuronal degeneration in brain and spinal cord ( similar to pernicious anemia). Caused by niacin deficiency
27
what is niacin?
vit B3. coenzyme for NAD and NADP.
28
where is the source of niacin?
dietary intake endogenously synthesis from tryptophan
29
where can pellagra be seen?
alcoholism, chronic illness, carcinoid syndrome, prolonged isoniazid therapy, Hartnup disease
30
what is anabolic steroid ?
androgen. | ex. methyltestosterone use in athlete
31
what is the role of androgen in acne?
promote follicular epidermal hypreprolifeartion and excessive sebum production
32
what is leprosy
deforming infection primarily of skin and nerve. caused by mycobarterium leprae
33
how dose mycobaterium leprae transmit?
unhygienic condition through respiratory infection or skin-to-skin contact.
34
what are the two types of leprosy?
1. tuberculoid leprosy -- self limited. Th1 mediated | 2. lepromatous leprosy -- severe form. Th2 mediated
35
what is xeroderma pigmentosum?
Autosomal recessive with nucleotide excision repair defect. Cannot fix thymine dimer due to lack of endonuclease
36
what are the sx of xeroderma pigmentosum?
severe photosensitivity, hyperpigmentation in sun-exposed area. risk for skin cancer.
37
what type of inheritance pattern is demonstrated by androgenetic alopecia?
polygenic inheritance. Short arm of chromosome 20, also on X and Y chromosone. Can be X-linked recessive or autosomal dominant
38
what caused nonpurulent cellulitis
beta-hemolytic streptococci. mostly group A. warmth, edema, erythema with no fluctuant nodules
39
what causes purulent cellulitis
S. aureus. painful, fluctuant nodule in dermis/subcutaneous with or without erythema
40
what does pseudomonas aeruginosa causes?
hot tub folliculitis hot tub, pool water. pruritic, papulopustular rash. gram - rod, oxidase +, produce green pigment during culture ( pyocyanin)
41
what is acne vulgaris?
pilosebaceous follicle disorder. hyperkeratinization and obstruction of the follicle with glandular enlargement and increased sebum production --> p. acnes growth. androgen - stimulate sebum production mechanical irritation - promote acne by increasing glandular occlusion and disruption of follicles. sport participation -- tight-fitting clothing
42
what is the effect of oral contraceptive to acne?
reduce acne due to decrease synthesis of androgen
43
why does isocitrate DH activity decreased due to niacin deficiency?
niacin is needed for NAD and NADP. NAD involved in catabolic reaction (citric acid cycle) and cell signaling and DNA repair - NAD is cofactor for isocitrate DH, a-ketoglutarate DH and malate DH NADP needed for anabolic reaction --> FA and cholesterol synthesis
44
how does hookworm infect people?
walking barefoot on a beach. Egg- containing feces deposited into shady, warm, moist sand or soil --> egg hatch into larvae --> direct contact with human skin --> penetrate BM --> dermis --> blood--> rupture into alveoli --> cough up --> swallowed into small intestine --> mature into adult hookworm --> feed on blood from duodenal mucosa --> iron deficiency anemia
45
what are some human hookworms?
necator americanus, A duodenale
46
how does bullous impetigo present?
blistering skin rash with honey-colored crust.
47
what caused bullous impetigo?
s. aureus in young children - exofoliactive toxin A (serine protease) --> target desmoglein 1 nonbullous impetigo -- pustules and crusting, no blistering
48
what is vitiligo?
partial or complete loss of melanocyte.
49
how dose vitiligo present?
flat, well-circumscribed macule and patches
50
what causes vitiligo and what does it associate with?
autoimmune. associated with other autoimmune disease: DM1, pernicious anemia, addison, autoimmune hepatitis, Grave's disease, autoimmune thyroiditis
51
what causes IgE-independent mast cell activation?
medication - opioid, radiocontrast, vancomycin. activation of protein kinase A and PI3 kinase --> release histamine, bradykinin, heparin
52
what is Ehlers-Danlos syndrome
inherited defective collagen synthesis. Deficiency in procollagen peptidase --> cannot cleave terminal propeptide from procollagen --> formation of soluble collagen , cannot crosslink --> joint laxity, fragile tissue with easy bruising and poor wound healing
53
what are the sx of Ehlers-Danlos syndrome
hypermobile joint, over-elastic skin, fragile tissue, easy bruising, wounding, hemarthrosis
54
xanthelasma
cutaneous lesion found on eyelid. Contain lipid-laden MC ( foam cell) Associated with hyperlipidemia -- due to obstructive biliary lesion and primary biliary cirrhosis

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