Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Prep > Derm wk 3 > Flashcards

Derm wk 3 Flashcards

1
Q

Red, crusted bump

dry and rough, lotion does not help

sometimes itchy, friable

A

Good description example:

Well circumscribed, 2 cm, erythematous NODULE w central ulceration and crust. The lesion is firm with palpation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Squamous Cell Carcinoma

A

Cell or origin: Keratinocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Squamous cell carcinoma

A

Erythematous nodule, rolled borders, CENTRAL ulceration, crust, growth looking thing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Squamous Cell Carcinoma has all sorts of appearances

A

Papule, plaque, nodule
Pink, scaly, or red
Exophytic- with outward growth
i.e.: Cutaneous horn

Friable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Are Squamous Cell Carcinoma lesions symptomatic?

A

Often not at first, may be ITCHY and TENDER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

“SCC in situ”

A

Bowen’s Dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

“SCC in situ” aka Bowen’s dz

A

Circumscribed pink/red patch or thin plaque w scaly or rough surface

confined to Epidermis, does not invade past dermal-epidermal junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

“SCC in situ” aka Bowen’s dz almost looks like

A

Cellulitis or Erysipelas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Can have SCC of the Nail

A

males 50-70s

Nails appear warty, subunqual hyperkeratosis, oncholysis oozing, destruction of nail plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tx for SCC

A

Surgical excision- make sure borders got all CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does invasive mean?

A

that the carcinoma cells are in the DERMIS

if not, it will be called “in situ”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Surgical tx options for SCC

A

Surgical excision

  • excision w margins
  • Mohs

Curettage and Electrodesiccation or Cryosurgery
-for in situ SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If pt can’t have surgery and has SCC, what are options?

A

Radiation
Photodynamic therapy
5-Fluorouracil
Imiquimod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

5-Flour

A

Antimetabolite, meaning it interferes w DNA synthesis

Approved for AK, Basal Cell, and SCC who can’t have surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Imiquimod

A

Immune response modifier

Induces pro-inflammatory cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Imiquimod

A

for AK of Scalp and FACE

for Superficial Basal cell CA

Non surgical SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What indicates a better response rate when using Imiquimod?

A

a greater inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Higher rates of METs if:

A
  • on Ears, lip without hair, scalp, mask of face
  • in Scars, chronic ulcers, burns, sinus tracts, anogenital region
  • Immunosuppressed
  • Tumor was caused by arsenic ingestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pts w NON-metastatic SCC need f/u how often?

A

every 6-12 mo for 3 years

then yearly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

AK- Actinic Keratosis

A

have the potential of turning into —> SCC Squam Cell CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Do all AK turn into SCC?

A

No, risk within one year is 8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The order of skin progression is:

A

Photo damaged skin –> AK–> SCC in situ (bowens) –> Invasive SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

SANDPAPER lesion

red, flat papule or thin plaque with a rough and gritty scale

A

Actinic Keratosis

AK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Red, scaly patches

A

Actinic Keratosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cutis Rhomboidalis nuchae

A

Reddish neck w rhomboidal furrows (wrinkes)

-example of sun damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Solar Elastosis

A

fine nodularity, pebbly surface

-example of sun damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When you think of “old people arms” w easy bruising

A

Actinic (senile) Purpura

Extravasated erythrocytes and increased perivascular inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Actinic Cheilitis represents

A

AK on the lips, often the lower lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Option to treat Actinic Keratosis

A

Cryotherapy

w liquid nitrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is Cryotherapy?

A

FREEZE it off w liquid nitrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Freeze ball should be

A

1.5x the size of the lesion

32
Q

AK treatment

A

MANY options, helpful to include Dermatologist to guide therapy

  • Liquid nitrogen
  • Curettage and electrocautery
  • 5-FU
  • Imiquimod
  • Ingenol mebutate gel
  • Photodynamic therapy
  • Diclofenac
33
Q

How does Diclofenac work?

A

It’s a POTENT NSAIDs

approved for AK

34
Q

Ingenol Mebutate

A

cause cell death then inflammatory response

approved for AK

35
Q

Pts w AK should have regular skin exams how often?

A

every 6-12 months

36
Q

How often to re-apply sun screen?

A

every 2 hours

37
Q

Extra caution in sun when you are around:

A

Water, Snow, or Sand

All intensify the damage rays of sun

38
Q

Altered tumor suppressor gene in SCC and also AK

A

p53

39
Q

What’s the big difference b/w SCC and AK, because they both can be rough and scaly

A

SCC protrude more, can be crazy looking and stick out

AK are papules or thin plaque

40
Q

Good description of Basal Cell CA

A

Solitary, 5 mm pearly pink papule with telangiectasias, on R zygomatic cheek

41
Q

SubQ injection can be provided prior to intradermal

A

bc subQ is much less painful

42
Q

Results on biopsy indicating Basal Cell CA

A

Rounded nests of basaloid cells, peripheral palasaiding, fibromyxoid stroma and clefts

43
Q

What do you need to do before excising what you think to be a Basal Cell CA?

A

Biopsy the lesion first!

44
Q

What gene mutation is usually involved with Basal Cell CA?

A

PTCH1

45
Q

Although Basal cell CA are often Nodular, they can also present like:

A 
Infiltrative
Sclerotic
Ulcerated
Pigmented
Superficial
46
Q

Difference b/w Basal Cell CA scale and SCC in situ scale

A

Basal: fine scale

SCC in situ: Keratotic scale crust

47
Q

Tool used to help evaluate skin lesions

A

Dermoscope

good for pigmented lesions

48
Q

Benign angiofibroma

A

fibrous papule
Small, homogenous skin colored/pink papule on the nose

No telangiectasias or pearly texture

49
Q

Morpheaform/Infiltrative Basal cell CA requires what treatment?

A

Excision with Mohs micrographic surgery

50
Q

Surgery options for BCC

A

Curette and Desiccation
Cryosurgery
Excisional surgery
Mohs microscopic

51
Q

Is Mohs good?

A

YES

offers complete histologic analysis of 100% tumor margins while permitting max conservation of tissue

Recurrence rates are lower s/p Mohs

52
Q

Indication for Mohs surgery

A

Nose, ears, eyes, lips, scalp, hands

Basically HEAD, or hands

Agressive type

Large tumors or tumors w indistinct borders

Recurrent tumors

53
Q

Non surgical tx for Basal Cell CA is considered when:

A

Superficial
Nodular

Imiquimod
5-FU
Photodynamic
Radiation

54
Q

Basal cell CA prognosis

A

Locally invasive
METs are rare

BUT at greater risk for developing other types of skin CA in the future, should f/u regularly

55
Q

BCC f/u

A

every 6-12 mo for 2 years, then can do self exams

56
Q

Warning signs of BCC

A 
Open sore
Reddish patch or irritated area
Shiny bump or nodule
Pink growth
Scar like area
57
Q

ABCDEs of Melanoma

A 
Asymmetry
Borders
Color
Diameter
Evolving
58
Q

Most common skin CA

A

Basal cell

head or neck

59
Q

Good way to describe Melanoma

A

___(size) dark blue to black plaque w asymmetry, irregularly notched borders and a pink erythematous rim

60
Q

To decrease discomfort with injection

A

what can be added to lidocaine?

Bicarb

61
Q

Where do Melanocytes typically live?

A

Basal layer

62
Q

Where do Melanocytes hang out in cancerous Melanoma??

A

In the upper portions of epidermis

BAD NEWS BEARS

63
Q

When nuclei are large and of different shapes, this is abnormal and known as

A

Cytologic atypia

64
Q

Clinical sx of Melanoma

A

often A-sx

65
Q

Most common type of Melanoma

A

Superficial spreading

on the back, and legs in women. growth is mostly horizontal

66
Q

Other types of Melanoma

A 
Nodular
Lentigo maligna
Acral Lentiginous (gnarly looking)
Subungual (nailbed)
Amelanotic (presenting like something else, the key here is that it is evolving)
67
Q

Breslow depth

A

how to measure depth of Melanoma

68
Q

A good thing to think about before sending someone for biopsy about a lesion concerning for Melanoma

A

Take a picture of the lesion

69
Q

What is the single most important prognostic factor for survival and clinical mgmt of Melanoma?

A

Thickness or depth of the tumor

70
Q

What other things hint at a bad prognosis with Melanoma?

A

Ulceration

Involvement of lymph nodes or distant mets

71
Q

3 prog factors review

A

Breslow
Ulcer
Lymph involvement

72
Q

How often to f/u for Melanoma if pt has stage 1-2?

A

every 6-12 mo for 5 years,

then annually

73
Q

How often to f/u for Melanoma if pt has stage 2b-4?

A

every 3-6 mo for 2 years,

then every 3-12 mo for 3 years,

then annually

74
Q

Who is at the greatest risk for Lethal Melanoma?

A

White males over 50 who live alone

75
Q

How many moles are concerning?

A

> 25 or
5 Atypical moles

or 1st deg relative with biopsy proven Melanoma

Clinical Prep (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions