Dermatology 3

Question 1

treatment of contact dermatitis

Answer 1

remove source

Question 2

Psoriasis

Answer 2

rare inflammatory skin disease of which the cause is unknown.
dysregulated epidermal proliferation resulting in red scaly patches that may itch
most commonly seen in extensor surfaces of trunk and limbs

Question 3

psoriasis treatment

Answer 3

intially topical treatment - emollients, topical steroids, PUVA (topical drug activated by UV light)
progresses to systemic treatment with drugs that reduce cell turn over e.g methotrexate and cyclosporin

Question 4

name 3 blistering immunological skin conditions

Answer 4

pemphigoid
pemphigus
epidermolysis bullosa

Question 5

how do blistering skin conditions occur

Answer 5

autoantibody attach on skin components causing loss of cell-cell adhesion
a ‘split’ forms in the skin what fills with inflammatory exudate and forms a vesicle/ blister

Question 6

pemphigoid

Answer 6

sub eppithelial antibody attack seeing formation of thick walled blisters
can be oral or skin lesions
managed with immunosuppresants

Question 7

pemphigus

Answer 7

autoimmune condition seeing blisters on oral mucosa and on skin, oral lesions often occur before skin lesions
rarely see intact blisters the surface is easily lost
without treatment can be fatal due to increased infection risk

Question 8

Epidermolysis Bullosa

Answer 8

group of conditions with spectrum of effect from mild to fatal
genetically determined
can see increased infection and fluid loss

Question 9

name 5 hallmarks of cancer

Answer 9

• growth factor independence or self sufficiency
• insensitivity to anti growth signals
• avoidance of programmed cell death (apoptosis)
• ability to recruit a dedicated blood supply
• ability to invade adjacent normal tissue and metastasize to different sites

Question 10

telomere

Answer 10

region of DNA at ends of chromosomes
each time a cells divides, telomeres become slightly shorter , eventually so short they can no longer divide successfully and the cell dies

Question 11

telomerase

Answer 11

enzyme in cells that helps keep them alive by adding DNA to telomeres

Question 12

telomerase and cancer

Answer 12

cancer cells often avoid cell death bu maintaining their telomeres despite repeated cell divisions
they do this by activating telomerase preventing the telomeres shortening to the point of cell death

Question 13

tumour stage

Answer 13

size of tumour , graded from T1 - T4 1 being least severe

Question 14

nodal stage

Answer 14

degree of lymph node involvement
from N0 (none) to N3

Question 15

what might be used for imaging cancer

Answer 15

ultrasound scanning, x ray , CT, MRI

Question 16

name 3 different cancer treatments

Answer 16

surgical , chemotherapy, radiotherapy , palliative

Question 17

surgical cancer treatment

Answer 17

aims to remove tumour completely before it can spread
most effective if small encapsulated tumour

Question 18

side effects of cancer surgery

Answer 18

cosmetic deficit
functional deficit
lymphatic oedema in affected area
general surgical consequences e.g GA risks

Question 19

chemotherapy

Answer 19

aim is to kill tumour cells without harming host cells but this is rarely possible
relies on tumour cells having faster replication that host cells

Question 20

side effects of chemotherapy

Answer 20

rapidly dividing cells are killed - hair loss, oral ulceration , bone marrow suppression
damage to DNA of remaining cells - risk of later cancers, fertility issues
drug specific effects