Dermatology Flashcards
The most common metastatic tumors to the brain are lung cancer, renal cancer, and _________, which is a malignancy of melanocytes that are embryogically derived from the _______ cells
Melanoma
Neural crest
sebaceous glands responsible for inflammatory acne are a type of ______ exocrine gland, which produce lipid rich secretory product by lysis of the cell membrane and release of cytoplasmic contents
_____ glands release a watery secretory product with no loss of cell membrane
_____ glands release membrane bound vesicles containing the secretory product
Holocrine
Merocrine
Apocrine
young boy with severe photosensitivity, poikiloderma, hyperpigmentation in sun exposed areas and SCC of the skin has _______, which is an AR disorder characterized by defects in __________, causing a deficiency in UV-specific _________
Xeroderma pigmentosum
nucleotide excision repair
endonuclease
________ are dendritic cells found in the skin that act as APCs. These cells are derived from the myeloid cell line and they possess characteristic _______ intracytoplasmic granules known as Birbeck granules
Langerhans cells
racquet shaped
________ are formed in DNA as a result of UV light exposure. A specific endonuclease complex initiates the process of repair by _________ the damaged strand on both sides. The damage segment is then excised and repalcement DNA is synthesized by DNA polymerase
Pyrimidine dimers
nicking
patient presents with bleeding gums, petechia, ecchymoses, poor diet =
caused by a lack of vitamin ______ that acts as cofactor for the hydroxylation of proline and lysine residues in collagen.
process occurs in the _____
Scurvy
C
RER
_______ have nevus cells limited to the dermal/epidermal junction
_______ have both dermal and epidermal involvement
junctional nevi
Compound nevi
The staphylococcal scalded skin syndrome occurs in infants and children due to the production of the ______ exfoliatin, which causes widespread epidermal sloughing especially with gentle pressure (Nikolsky’s)
exotoxin
________ causes hair loss at the anterior scalp and vertex. It shows polygenic inheritance with DHT being the primary pathogenic factor. __________ such as finesteride decrease the conversion of testosterone to DHT and are effective for treating the condition
androgenic alopecia
5a reductase inhibitors
acyclovir, valacyclovir, famciclovir, and ganciclovir are all nucleoside analogues that require herpes viral and cellular kinases for active conversion. Cidofovir, tenofovir, zidovudine, lamivudine require only ______ for activation
cellular kinases
immunosuppressed AML patient with fever and ecthyma gangrenosum, bacteria involved =
type of toxin =
Pseudomonoas aeruginosa
exotoxin
recurrent severe viral fungal or opportunistic (Pneumocystis) infections, failure to thrive, chronic diarrhea =
due to a genetic defect in ________ which leads to dysfunction in B cells
SCID
T cell development
candidal antigen skin test is used to determine the presence of _______ immunity through detection of a delayed type HS reaction (Type ____). The cells involved are CD4+, CD8+, and ______
T cell mediated
IV
macrophages
______ frequently indicate a deep hemorrhage (hematoma) due to bony fracture, ligamentous rupture, or muscular injury
Ecchymoses
_______ contains dihydrouridine, ribothymidine, pseudouridine and has a _____ sequence at its 3’ end that is used as recognition sequence by proteins.
tRNA
CCA
alcoholic with photosensitive dermatitis diarrhea and dementia =
due to vitamin ________ deficiency, which is a cofactor for many dehydrogenase enzymes (isocitrate)
Succinate dehydrogenase uses _____ as a cofactor
pellagra
B3 (niacin)
riboflavin
treatment of psoriasis includes ___________ like calcipotriene, calcitriol, and tacalcitrol to bind to the nuclear receptor and inhibit keratinocyte proliferation and stimulate keratinocyte differentiation
topical Vitamin D analogs
toddler, easy bruising, open wounds, difficult to suture, fragile skin, hyperexnsible skin, umbilical hernia, defect in extracellular processing of collagen =
impaired _____ polypeptide removal
Ehlers Danlos syndrome
N terminal
painful subcutaneous nodule after laceration and sutures 2 weeks ago most likely a reaction to
foreign body (retained suture)
_________ is a deforming infection primarily of the skin and nerves caused by mycobacterium leprae
infection is caused by unhygienic conditions (think 3rd world countries) and be transmitted by ________ is the SW US. Comes in two types:
___________ is the least severe form and is often self limited. Mycobacterial infection is limited by an intact CMI response (Th1). Mild skin plaques, hypopigmentation, hair follicle loss, focally decreased sensation
___________ most severe form occurs in patients with a weak CMI (Th2)
Leprosy
armadillos
Tuberculoid leprosy
Lepromatous leprosy
bilateral skin lesions on elbows, very thin stratum granulosum, prominent parakeratotic stratum corneum with occasional foci of neutrophil accumulation =
Psoriasis
________ is characterized by autoantibodies against hemidesmosomes along the BM of the dermal-epidermal junction. This causes the entire epidermis to separate form the dermis, forming tense subepidermal blisters
in contrast, __________ has autoantibodies (Desmoglein 3 & 1) against desmosomes, intraepidermal cleavage, flaccid bullae, and acantholysis with characteristic tombstone cells on basal layer
Bullous pemphigoid
pemphigus vulgaris
__________ is a major pathogen in burn patients. Only a piperaillin, ticarcillin, ________, and ______ have activity against it. Ciprofloxacin, levofloxacin, and carbapenems are also effective
Pseudomonas aeruginosa
cefazidime, cefepime
________ is used for treatment of dermatophytosis. It inhibits synthesis of fungal membrane ergosterol by suppressing the enzyme _________
Terbinafine
squalene epoxidase
accessory nipples are failed regression of the __________ in utero. They are usually asymptomatic but can become tender along with breast tissue during times of hormone fluctuation
mammary ridge
______ is a protein kinase involved in the activation of signaling pathways for melanocyte proliferation. V600E mutation is seen in 40-60% of patients with melanoma
BRAF
keloids are a result of ________ during the remodeling phase of wound healing. They present as raised, painful, pruritic nodules that grow beyond the wound broders
excessive collagen formation
_________ are small red cutaneous papules common in aging adults. They do not regress spontaneously and increase in number with age. Due to proliferation of capillaries and post capillary venules in the papillary dermis
Cherry hemangiomas
______ is a common condition characterized by the loss of epidermal melanocytes
Vitilligo
_______ disease can occur following transplantation or organs rich in lymphocytes (liver). T lymphocytes found in the donor organ become sensitized against MHC antigens of the recipient and subsequently attack the hosts tissues.
Graft vs host
Pitriasis versicolor, aslo called tinea versicolor, is characterized by hypopigmented, hyperpigmented, or erythematous macules or pathes on the skin. This are visible after extensive _______exposure and are caused by _____ species yeasts. The fungi looks like spaghetti and meatballs on KOH prep
sun
Malassezia
Atopic dermatitis is a common chronic inflammatory skin disorder of childhood. Occurs in response to environmental antigens and is associated with ectopic diseases such as allergic rhinitis and ______
asthma
older AA gentleman with T2DM, several tan brown stuck on round lesions that are well demarcated on ack =
contain ________ cysts
Seborrheic keratosis
keratin containing
acute allergic contact dermatitis is caused by ______ HS reaction. Findings include red, papulovesicular weeping lesions. Histology is characterized by edema in the intercellular spaces of the epidermis called
Type IV
spongiosus
Dermatitis herpetiformis is characterized by red pruritic papules, vesciles, and bullae that appear bilaterally and symmetrically on the extensor surfaces. Strongly associated with _______, which is characterized by increased intraepithelial lymphocytes
celiac disease
______ is critical for fibroblast migration and proliferation. increased activity is responsible for keloids
TGF-B
a unilateral vesicular rash localized on a single dermatome in an elderly patient is most likely ______. Postherpetic _______ is the most common neurologic complication of varicella zoster virus infection
herpes zoster
neuralgia
_________ is a cell mediated inflammatory disorder of the skin characterized by erythematous circular papules that evolve into target lesions. It is most commonly associated with _________
Erythema multiforme
herpes zoster
unilateral vesicular rash in an older patient =
pathology is
varicella zoster
multinucleated cells with intranuclear inclusions
local cutaneous adverse effects of chronic topical corticosteroid use include _______ of the dermis
atrophy/thinning
________ or breslow thickness is the most important prognostic indicator in malignant melanoma
depth of invasion
photoaging of skin is due to __________
decreased collagen fibril
____________ is an autosomal recessive syndrome consisting of immunodeficiency, albinism, and neurologic defects and is diagnosed in childhoold. Nystagmus, peripheral and cranial neuropathies are common. Immunodeficiency results from a defect is neutrophil phagosome lysosome fusion
Chediak Higashi syndrome
poison ivy dermatitis is a form of contact dermatitis caused by ururshiol. This is a _______ HS reaction mediated primarily by ________
Type IV
T cells
unvaccinated immigrant, rash that begins on the face, spreads to the trunk quickly with postauricular and occipital LAD =
type of virus =
if slow spread and darkening/coalesce rash =
Rubella
togavirus
rubeola
common complications of psoriasis include ______ nail pitting, and uveitis
psoriatic arthritis
patient with acute pruritus following administration of morphine most likely has medication induced ______________, which can also be triggered by radiocontrast agents, Abx (vancomycin)
IgE independent mas cell degranulation
2 month history of skin rash that worsens with sun exposure, lately hostile, irritable, disorientation episodes, alcoholic, poor diet and intermittent diarrhea =
can be synthesized endogenously from
pellagra due to niacin deficiency
tryptophan
spliceosomes remove introns containining ____ at the 5’ splice site and ____ at the 3’ splice site.
GU
AG
a bluish tumor lesion under the nail =
normally functions in
benign glomus tumor (glomangioma)
thermoregulation
________ on the Achilles are suggestive of hyperlipidemia
Xanthomas
Urticaria is a transient hypersensitivity reaction characterized by pruritic erythematous plaques that arise suddenly and resolve over hours. Seen in penicillin allergy. Caused by IgE mediated mast cell degranulation, leading to
edema of the dermis
cat scratch disease due to ________ presents with tender regional LAD proximal to the lesion (axillary is common). This bug also causes _________
Bartonella henselae
bacillary angiomatosis and culture negative endocarditis
Axillary lymph node dissection is a risk factor for the development of chronic lymphedema involving the ipsilateral arm. Predisposes the patient to _______, which presents as multiple firm violaceous nodules
angiosarcoma
________ develops on chronically sun exposed areas as a whitish scale that has sandpaper like texture and can form cutaneous horns. This is regarded as premalignant condition to SCC
Actinic keratosis
fever, malaise, and maculopapular rash that includes palms and soles =
serum added to mix of cardiolipin, lecithin, and cholesterol with extensive flocculation seen =
syphilis
RPR test
Lepromin skin test will be positive in patients with _________ as they exhibit strong CD4 Th1 immune response with increased IL2 and IFNy in lesions.
Tuberculin
Vitamin C also called
Ascorbic acid
flaccid bullae =
pemphigus vulgaris
Xanthelasma, a yellowish eyelid plaque with lipid laden macrophages occurs in association with hyperlipidemia. It has association with ______ as well
cholestatic condtaions
acanthosis nigricans presents with thickening and hyperpigmentation of skin in the flexural areas. The lesions have a classic velvety texture, and are commonly associated with ___________ states and GI malignancies
Insulin resistant
