Kaplan

Question 1

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.

Answer 1

Basal Cell Carcinoma

Question 2

BCCa are small (malign/B9) basal cells derived from stratum ___ forming dermal nests and strands with peripheral ____ _____.

Answer 2

malignant
stratum basale
peripheral nuclear palisading.

Question 3

Name the seronegative spondyloarthropathies and associated antigen.

Answer 3

HLA-B27
Psoriatic arthritis
Ankylosing spondylitis
Reactive arthritis

Question 4

Anterior uveitis + arthritis + urethritis or cervicitis

Answer 4

Reactive Arthritis

Question 5

dx anterior uveitis with what?

Answer 5

slit lamp

Question 6

Location where each present.

• Peripheral vascular disease ulcers
• Diabetic ulcers
• Venous stasis ulcers (stasis dermatitis)

Answer 6

• Peripheral vascular disease ulcers: tips of digits
• Diabetic ulcers: foot pressure points
• Venous stasis ulcers: above medial malleolus

Question 7

What results from degranulation of mast cells, releasing inflammatory mediators like Histamine. Typically Ig__.

Answer 7

Allergic urticaria

IgE-mediated process

Question 8

In urticaria reactions, ___ cell degranulation results in dilated superficial ___ channels and intradermal edema, leading to development of ____

Answer 8

Mast cell degranulation
superficial lymphatic channels
development of pruritic wheals

Question 9

ABCDE dx of melanoma

Answer 9

Asymmtric
Borders (irregular)
Color (variegated)
Diameter (>5mm)
Enlarging (vertical or horizontal growth)

Question 10

A bicyclist chews tobacco and has actinic chelitis on the lower lip. He is at risk for development of?

Answer 10

Squamous Cell Carcinoma of the lower lip (classic location).

Question 11

What is caused by monosodium urate crystal deposition into joints and soft tissue?

• Common location of presentation early in dz
• Aspiration birefringent test

Answer 11

GOUT

• early: podagra (painful big toe) —> late: tophi
• negative birefrigent yellow needle shape on parallel polarizer; blue when perpendicular

Question 12

Tumor found in long bones of young pts, pain is usually worse at night, concentric laminated periosteal reaction.

Answer 12

Ewing sarcoma

Question 13

translocation of Ewing sarcoma

Answer 13

t(11;22)

Question 14

XR shows narrow joint space, osteophytes, dense sclerotic bone, subchondral bone pseudocytes.

• What is this describing
• Is this inflammatory or non-inflammatory?

Answer 14

Osteoarthritis; non-inflammatory

Question 15

Chronic inflammatory autoimmune disorder characterized by lymphocytes, macrophages, and plasma cells in infiltrate. Morning stiffness.

Answer 15

Rheumatoid Arthritis

Question 16

striated muscle tumor of childhood, most often found in H/N and GU region.

Answer 16

rhabdomyosarcoma

Question 17

Diagnostic test in rhabdomyosarcoma

Answer 17

desmin

t(1;13) or t(2;13)

Question 18

Small cystic spaces caused by myxoid degeneration of connective tissue.

Answer 18

Ganglion cyst

Question 19

Amorphous crystalline masses surrounded by macrophages.

Answer 19

Gout tophi

Question 20

PIP hyperE, DIP Flexed

Answer 20

Swan neck deformity in Rheumatoid arthritis

Question 21

Subcutaneous nodules. Histology reveals fibrinoid necrosis with palisading epithelioid cells.

Answer 21

Rheumatoid arthritis

Question 22

malignancy of epithelial keratinocytes

Answer 22

cutaneous squamous cell carcinoma

Question 23

basophilic rhomboid crystals on polarization

• what is this
• common location

Answer 23

pseudogout

-commonly affects knee

Question 24

What most frequently results form deficiency of enzyme tyrosinase hydroxylase, resulting in in ability to synthesize ___ from tyrosine, an _____ amino acid

Answer 24

Albinism

cannot synthesize melanin from tyrosine, which is an aromatic amino acid.

Question 25

what is pannus?

Answer 25

When synovial membrane becomes markedly thickened in rheumatoid arthritis.

Question 26

What causes joint stiffness in rheumatoid arthritis?

Answer 26

pannus an dedematous villous projections that extend into the joint space

Question 27

- Lung cancer that mets to bones are osteo____. | - Prostate cancer that mets to bones are osteo___.

Answer 27

Lung=osteoLytic (bone resorbing) | Prostate=osteoblastic (bone forming)

Question 28

Expect ___ in a pt who develops erythematous skin lesions with a targetoid appearance. -___ dz infects ____ cells of the skin, causing the targetoid appearance.

Answer 28

Erythema multiforme Herpes Simplex Virus infects keratinocytes. CD4+ peripheral and CD8+ centrally trigger apoptosis.

Question 29

Autoimmune skin condition with IgG antibodies directed against the intercellular attachment sites (___).

Answer 29

Pemphigus vulgaris. | IgG against desmosomes.

Question 30

How does pemphigus vulgaris present?

Answer 30

painful blisters or bullae on skin or oral mucosa with a positive Nikolsky sign.

Question 31

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?

Answer 31

NF1, the macules are cafe-au-lait spots, associated with subcutaaneous neurofibromas

Question 32

What structures are associated with neurofibromas?

Answer 32

Neurofibromas derive from peripheral nerves

Question 33

CAFESPOT mnemonic for NF1 features

Answer 33

``` Cafe-au-lait spots Axillary Freckling "Eye" (lisch) nodules Scoliosis Pheochromocytoma Optic Tumor (Glioma) ```

Question 34

what is this: suprabasal bullous formation with intraepidermal separation of cells dissolution of intercellular bridges that connect squamous epithelial cells. And intraepithelial blisters.

Answer 34

acantholysis associated with pemphigus

Question 35

Suspect ____ with multiple flaccid bullae of skin and mucous membranes.

Answer 35

pemphigus vulgaris * *ORAL * *IgG against Dsg 1 and Dsg 3

Question 36

Suspect ___ with subepidermal blisters and autoab against hemidesmosomes.

Answer 36

bullous pemphigoid **no oral involvement

Question 37

CDKN2A LoF

Answer 37

melanoma

Question 38

significant of acanthosis nigricans lesions

Answer 38

may be a sign of visceral carcinoma (underlying GI adenocarcinoma)

Question 39

Granular deposits of IgA and C3 in dermal papillary tips

Answer 39

dermatitis herpetiformis

Question 40

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?

Answer 40

Seborrheic Keratosis (FGFR3) see keratin filled cysts or pseudo-horn cysts microscopically.

Question 41

normal osteoblast and osteoclast counts. associate Cushing dz with...

Answer 41

osteoporosis

Question 42

Describe muscle weakness progression in DMD.

Answer 42

Begins proximally, affecting hip and lower extremities, later progressively extending to involve the neck, shoulders, arms.

Question 43

Inheritance of DMD.

Answer 43

X-linked recessive.

Question 44

palisading (three things)

Answer 44

Rheumatoid arthritis BCCa Schwannoma