Kaplan Flashcards
Pearly or waxy nodule that may have central ulceration. Typically on sun exposed areas of H/N/upper trunk. Rarely mets, can be locally destructive, can recur locally if not excised completely.
Basal Cell Carcinoma
BCCa are small (malign/B9) basal cells derived from stratum ___ forming dermal nests and strands with peripheral ____ _____.
malignant
stratum basale
peripheral nuclear palisading.
Name the seronegative spondyloarthropathies and associated antigen.
HLA-B27
Psoriatic arthritis
Ankylosing spondylitis
Reactive arthritis
Anterior uveitis + arthritis + urethritis or cervicitis
Reactive Arthritis
dx anterior uveitis with what?
slit lamp
Location where each present.
- Peripheral vascular disease ulcers
- Diabetic ulcers
- Venous stasis ulcers (stasis dermatitis)
- Peripheral vascular disease ulcers: tips of digits
- Diabetic ulcers: foot pressure points
- Venous stasis ulcers: above medial malleolus
What results from degranulation of mast cells, releasing inflammatory mediators like Histamine. Typically Ig__.
Allergic urticaria
IgE-mediated process
In urticaria reactions, ___ cell degranulation results in dilated superficial ___ channels and intradermal edema, leading to development of ____
Mast cell degranulation
superficial lymphatic channels
development of pruritic wheals
ABCDE dx of melanoma
Asymmtric Borders (irregular) Color (variegated) Diameter (>5mm) Enlarging (vertical or horizontal growth)
A bicyclist chews tobacco and has actinic chelitis on the lower lip. He is at risk for development of?
Squamous Cell Carcinoma of the lower lip (classic location).
What is caused by monosodium urate crystal deposition into joints and soft tissue?
- Common location of presentation early in dz
- Aspiration birefringent test
GOUT
- early: podagra (painful big toe) —> late: tophi
- negative birefrigent yellow needle shape on parallel polarizer; blue when perpendicular
Tumor found in long bones of young pts, pain is usually worse at night, concentric laminated periosteal reaction.
Ewing sarcoma
translocation of Ewing sarcoma
t(11;22)
XR shows narrow joint space, osteophytes, dense sclerotic bone, subchondral bone pseudocytes.
- What is this describing
- Is this inflammatory or non-inflammatory?
Osteoarthritis; non-inflammatory
Chronic inflammatory autoimmune disorder characterized by lymphocytes, macrophages, and plasma cells in infiltrate. Morning stiffness.
Rheumatoid Arthritis
striated muscle tumor of childhood, most often found in H/N and GU region.
rhabdomyosarcoma
Diagnostic test in rhabdomyosarcoma
desmin
t(1;13) or t(2;13)
Small cystic spaces caused by myxoid degeneration of connective tissue.
Ganglion cyst
Amorphous crystalline masses surrounded by macrophages.
Gout tophi
PIP hyperE, DIP Flexed
Swan neck deformity in Rheumatoid arthritis
Subcutaneous nodules. Histology reveals fibrinoid necrosis with palisading epithelioid cells.
Rheumatoid arthritis
malignancy of epithelial keratinocytes
cutaneous squamous cell carcinoma
basophilic rhomboid crystals on polarization
- what is this
- common location
pseudogout
-commonly affects knee
What most frequently results form deficiency of enzyme tyrosinase hydroxylase, resulting in in ability to synthesize ___ from tyrosine, an _____ amino acid
Albinism
cannot synthesize melanin from tyrosine, which is an aromatic amino acid.
what is pannus?
When synovial membrane becomes markedly thickened in rheumatoid arthritis.
What causes joint stiffness in rheumatoid arthritis?
pannus an dedematous villous projections that extend into the joint space
- Lung cancer that mets to bones are osteo____.
- Prostate cancer that mets to bones are osteo___.
Lung=osteoLytic (bone resorbing)
Prostate=osteoblastic (bone forming)
Expect ___ in a pt who develops erythematous skin lesions with a targetoid appearance.
-___ dz infects ____ cells of the skin, causing the targetoid appearance.
Erythema multiforme
Herpes Simplex Virus infects keratinocytes.
CD4+ peripheral and CD8+ centrally trigger apoptosis.
Autoimmune skin condition with IgG antibodies directed against the intercellular attachment sites (___).
Pemphigus vulgaris.
IgG against desmosomes.
How does pemphigus vulgaris present?
painful blisters or bullae on skin or oral mucosa with a positive Nikolsky sign.
A 14 year old male has 6 light brown skin macules, 3cm in diameter on his torso. Small, firm masses are felt in the subcutaneous tissue below two of the macules.
What does he have?
NF1, the macules are cafe-au-lait spots, associated with subcutaaneous neurofibromas
What structures are associated with neurofibromas?
Neurofibromas derive from peripheral nerves
CAFESPOT mnemonic for NF1 features
Cafe-au-lait spots Axillary Freckling "Eye" (lisch) nodules Scoliosis Pheochromocytoma Optic Tumor (Glioma)
what is this: suprabasal bullous formation with intraepidermal separation of cells
dissolution of intercellular bridges that connect squamous epithelial cells. And intraepithelial blisters.
acantholysis associated with pemphigus
Suspect ____ with multiple flaccid bullae of skin and mucous membranes.
pemphigus vulgaris
- *ORAL
- *IgG against Dsg 1 and Dsg 3
Suspect ___ with subepidermal blisters and autoab against hemidesmosomes.
bullous pemphigoid
**no oral involvement
CDKN2A LoF
melanoma
significant of acanthosis nigricans lesions
may be a sign of visceral carcinoma (underlying GI adenocarcinoma)
Granular deposits of IgA and C3 in dermal papillary tips
dermatitis herpetiformis
B9 epidermal tumors that appear as flat, pigmented, greasy lesions taht seem to be “stuck on” the skin. Can be partially peeled away with a scalpel.
See what microscopically?
What genetic?
Seborrheic Keratosis (FGFR3)
see keratin filled cysts or pseudo-horn cysts microscopically.
normal osteoblast and osteoclast counts. associate Cushing dz with…
osteoporosis
Describe muscle weakness progression in DMD.
Begins proximally, affecting hip and lower extremities, later progressively extending to involve the neck, shoulders, arms.
Inheritance of DMD.
X-linked recessive.
palisading (three things)
Rheumatoid arthritis
BCCa
Schwannoma
