Brainscape's Knowledge GenomeTM

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


See full index

Clin Med1 1 > L1 Derm Cancers > Flashcards

L1 Derm Cancers Flashcards

0
Q

stratum basalis
stratum spinosum
stratum granulosum
stratum corneum

A

4 layers of epidermis (or dermis?)

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

4 layers of epidermis (or dermis? acc’g to objectives)

A

stratum basalis
stratum spinosum
stratum granulosum
stratum corneum

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

which layer of the epidermis is the MAJOR physical barrier

A

stratum corneum

[epidermis (moisture homeostasis and infectious protection)]

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

Dermis contains

A 
support structures (vessels, nerves)
appendages (eccrine (sweat) glands, apocrine, sebaceous glands, hair follicles, nails)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
support structures (vessels, nerves)
appendages (eccrine (sweat) glands, apocrine, sebaceous glands, hair follicles, nails)

are contained in which layer of skin

A

dermis

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

stratum basalis

A

proliferation center of epidermis, cell divide and migrate twds surface

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

stratum spinosum

A

made of early keratinocytes formed in s.basalis

cell begin forming keratin filaments

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

stratum granulosum

A

continue to form keratin and become more flat

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

stratum corneum

A

anuclear keratin-filled layers (15-100 layers)
degradation enzymes destroy organelles and nuclei
MAJOR physical barrier
takes 4 weeks from s.basalis to s.corneum

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

Type 1 immunology

A

Mast cells and basophils, IgE (ER)

Eg: Hives, bronchospasm, laryngeal edema

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

Mast cells and basophils, IgE (ER)

Eg: Hives, bronchospasm, laryngeal edema

A

Type 1 immunology

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

Type II Immunology

A

Cytotoxic
IgG or IgM react with surface antigen and activate complement
Eg.:?

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

Cytotoxic
IgG or IgM react with surface antigen and activate complement
Eg.:?

A

Type II immunity

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

Type III immunity

A
  • Immune complex
  • antigen-antibody complexes are deposited in tissue causing inflammation (IgG or IgM) and also activate complement, chemotaxis of luekocytes, PLATELET DAMAGE and VASCULAR PERMIABILITY.
  • Eg.: VASCULITIS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Type IV immunity

A
  • delayed hypersensitivity
  • cell-mediated immunity, within 24-48 hrs
  • Eg.: poison ivy, candida?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  • delayed hypersensitivity
  • cell-mediated immunity, within 24-48 hrs
  • Eg.: poison ivy
A

Type IV immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  • Immune complex
  • antigen-antibody complexes are deposited in tissue causing inflammation (IgG or IgM) and also activate complement, chemotaxis of luekocytes, PLATELET DAMAGE and VASCULAR PERMIABILITY.
  • Eg.: VASCULITIS
A

Type III immunity

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

what is the basis for many blistering diseases?

A

defects in components of the Basement membrane zone (BMZ) (part of dermal-epidermal junction)

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

defects in components of the Basement membrane zone (BMZ) (part of dermal-epidermal junction)
are the basis for which diseases

A

blistering diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Eccrine gland

A

sweat
coiled GLAND in deep dermis (secretion)
straight DUCT extends to epidermis (transport)
sweat begins isotonic with plasma, but due to electrolyte reabsorption in duct, becomes HYPOTONIC

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

sweat
coiled GLAND in deep dermis (secretion)
straight DUCT extends to epidermis (transport)
sweat begins isotonic with plasma, but due to electrolyte reabsorption in duct, becomes HYPOTONIC

A

Eccrine gland

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

Apocrine gland

A

sweat
fx unknown
in axillary and anogenital regions
duct drains into follicle

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

subcutaneous fat serves to

A
  • passageway for MEDIUM-sized vessels and nerves
  • insulate from cold
  • cushion deep tissues
  • reserve E supply
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

viral infections

A
  • pappiloma (HPV)
  • pox (molluscum)
  • herpes (HSV 1 and 2) (causes lysis and death resulting in vesciles)
  • all caused by DIRECT inoculation but VARICELLA-ZOSTER
  • warts and molluscum only in Upper epidermis and cause Hyperplasia (increased cell production)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

all viral infections are caused by DIRECT inoculation but

A

VARICELLA-ZOSTER

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

most common fungal infections

A

dermatophytes

then Candida

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

which layer of epidermis do dermatophytes penetrate?

A

stratum corneum

Derm’s enzymatically digest KERATIN and penetrate s.corneum

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

candida affects and causes

A

affect mucous membranes
causes pustules
activates complement causing inflammation (then pustules)
risk factors: moisture, steroids, ABs, pregnancy

28
Q

affect mucous membranes
causes pustules
activates complement causing inflammation (then pustules)
risk factors: moisture, steroids, ABs, pregnancy

A

candida

29
Q

Seborrheic Keratosis (SK)

A

Etiology: due to epidermal hyperplasia and benign hyperpigmentation (can resemble melanoma)
Clin present: tan to black papule, warty, “GREASY”, scab or rough, “stuck on”;
irregular but well-circumscribed border; 2mm-3cm or +;
on trunk but can be on face, scalp and extremeties
Tx: reassure, cryotherapy (liquid nitrogen), curettage with electroautery, shave or excisional biopsy

30
Q

Etiology: due to epidermal hyperplasia and benign hyperpigmentation (can resemble melanoma)
Clin present: tan to black papule, warty, “GREASY”, scab or rough, “stuck on”;
irregular but well-circumscribed border; 2mm-3cm or +;
on trunk but can be on face, scalp and extremeties
Tx: reassure, cryotherapy (liquid nitrogen), curettage with electroautery, shave or excisional biopsy

A

Seborrheic Keratosis (SK)

31
Q

Lesler-Trelat sign

A

sudden appearance of multiple SK, with an inflammatory base
can be associated with many skin tags
may be internal malignancy (stomach, colon or breast)

32
Q

Keratoacanthoma ?

A
  • RAPIDLY GROWING (vs. SCC) neoplasm (new and abnormal growth of tissue) of epithilium which is biologically BENIGN but histologically resembles SQUAMOUS cell carcinoma
  • round, flesh colored NODULE that grows rapidly (4-6 wks)
  • resolves on its own within 6 months
33
Q
  • RAPIDLY GROWING neoplasm (a new and abnormal growth of tissue) of epithilium which is biologically BENIGN but histologically resembles SQUAMOUS cell carcinoma
  • round, flesh colored NODULE that grows rapidly (4-6 wks)
  • resolves on its own within 6 months
A

keratoacanthoma ?

34
Q

Actinic Keratosis (AK)

A
  • benign but often precursor to squamous cell carcinoma (SCC)
  • due to SUN EXPOSURE
  • more in males, age related, rare in dark skin
  • 50% resolved by avoiding sun
  • < 1mm - several cm
  • scale or dry/rough patch
  • skin colored, white or light (can be pink or darker)
  • FELT more easily than seen (pts pick the scale but it keep returning)
  • on SUN-EXPOSED areas (bold scalp, face, lips, ears, neck dorsum of hands/forearms)
  • Tx: 5-fluorouracil (5-FU) cream (Efudex); imiquimod (Aldara) imune modulator; cryotherapy; curettage, shave, biopsy; chemical peeps, dermabrasion, lasers; low-fat diet?
35
Q
  • benign but often precursor to squamous cell carcinoma (SCC)
  • due to SUN EXPOSURE
  • more in males, age related, rare in dark skin
  • ## 50% resolved by avoiding sun
A

Actinic Keratosis (AK)

36
Q

Risk factors of skin cancer

A 
>90% are caused by sun (UVB>UVA)
risk doubles if pt has 5 or + serious sunburns
fair skin (bc melanin is protective and fair ppl have less melanin)
male>female
prior skin cancer
radiation
smokers (SCC only)
genetics
37
Q

Basal Cell Carcinoma (BCC) description

A

firm/hard nodule or papule, often with depressed center
“PEARLY” or “WAXY”
pink, red, pale yellow or translucent
can be ulcerated with ROLLED BORDERS
+/- TELEANGIECTASIAS
few mm - 1 cm
bleed with min trauma, oozing or crusting

38
Q

firm/hard nodule or papule, often with depressed center
“PEARLY” or “WAXY”
pink, red, pale yellow or translucent
can be ulcerated with ROLLED BORDERS
+/- TELEANGIECTASIAS
few mm - 1 cm
bleed with min trauma, oozing or crusting

A

Basal Cell Carcinoma (BCC)

39
Q

Basal Cell Carcinoma (BCC)

A

3 out 4 skin cancers
from basal layer
slow growth, rarely metastasizes but can invade local tissue
may recur in same place after tx
35-50% develop new skin cancer within 5 yrs of dx
often mimics other skin conditions

40
Q

3 out 4 skin cancers
from basal layer
slow growth, rarely metastasizes but can invade local tissue
may recur in same place after tx
35-50% develop new skin cancer within 5 yrs of dx
often mimics other skin conditions

A

Basal Cell Carcinoma (BCC)

41
Q

Basal Cell Carcinoma Tx

A 
Nodular subtype is most common
Tx: biopsy if ? about Dx,
refer to Derm for any skin cancer
cure is 85-99%
curettage/electrodessication
excisional biopsy
MOHS microgrphic surgery (highest cure rate for BCC and SCC/ tx for recurrent)
cryotherapy
topical chemo (5-FU, Imiquimod)
42
Q 
Nodular subtype is most common
Tx: biopsy if ? about Dx,
refer to Derm for any skin cancer
cure is 85-99%
curettage/electrodessication
excisional biopsy
MOHS microgrphic surgery (highest cure rate for BCC and SCC/ tx for recurrent)
cryotherapy
topical chemo (5-FU, Imiquimod)
A

Basal Cell Carcinoma Tx

43
Q

Squamous Cell Carcinoma (SCC)

A

2nd most common, more aggressive than BCC but still low risk for met
HEAD and FACE lesions most likely to metastasize, FAST GROWTH??
!!!! AK can often LEAD to SCC !!!!; M>F (legs of Fs)
Same risk factors + exposure to arsenic/hydrocarbons, history of HPV/immune deficiency; PUVA tx for psoriasis (all have higher met risk)
Can be caused by leukoplakia
Can occur where injure: burns, scars, long-term sores

44
Q

AK (Actinic Keratosis) can often lead to what type of skin cancer

A

Squamous Cell Carcinoma (SCC)

45
Q

Squamous Cell Carcinoma (SCC) can often be caused by

A

Actinic Keratosis (AK)

46
Q

SCC clin

A
  • dramatic variation
  • skin-colored, erythematous or yellowish
  • indurated (hard) plaques, papules or nodules (may be ULCERATED)
  • can be flat patches
  • often rough surface with thick hyperkeratotic (thickening of stratum corneum) scales
  • SUN EXPOSED SKIN (face, ears, lips)
47
Q

SCC tx

A

SOC is simple surgical resection, cure >90%
If >2 cm, recurrent or on face/genitals, MOHS
Eletrodessication with curettage
Cryotherapy
If not all tumor removed/difft area/mat’ed, may need radiation/chemo

48
Q

SCC follow-up

A

Always derm referral and close f/u
F/u q 3 mo X 1yr, then q 6 mo X 1 yr, then q 1 yr X 5 yrs
40% new tumor w/i 2 yrs

49
Q

Malignant Melanoma

A

3% but high morbidity (disease state/disability of ind+incidence of dis. in popn)
5th most common in men, 6 in F
Met’s to lung, brain, lymph and anywhere
Starts in MELANOCYTES (produce melanin - most BROWN or BLACK)
M>F; 40 yr is avg age, rare in kids
Darker skin is more protected

50
Q

Malignant Melanoma risk factors

A 
SUN EXPOSURE (-sunburns in childhood; cumulative from outdoors x4; tanning booths)
Fair skin, red/blond hair
Family hx of melanoma (x10)
PERSONAL HX OF MELANOMA
PMH of SCC or BCC
Atypical moles and dysplastic nevi (x10)
Compormised Imm system
51
Q

Dermis

A

Contains vessels and nerves
1 mm - >4 mm
made of collagen, elastic fibers and ground substance (derived from fibroblast)

52
Q

Melanocytes

A

melanin pigment helps protect skin against UV radiation
All same # of melanocytes but color depends on size and distribution of melanosomes
made from tyrosine and packaged in melanosomes

53
Q

Superficial Spreading Melanoma

A

Most common MM 70%
Younger popn
In previously benign mole
RADIAL spread precedes VERTICAL growth
1st appears as flat or slightly raised, discolored patch, with irr.borders
Tan, brown, black, red, blue or white
Trunk in men, legs and upper back in women or upper back in both? but anywhere

54
Q

Lentigo Maligna

A

Long period of horizontal growth followed by rapid vertical invasion
In situ (in its original place) cancer but if turns invasive, is Lentigo MM
Older, due to chronic sun
Face, ears, arms, upper trunk
Many shades of brown
Flat or mildly raised, or may be mottled (with spots/smears of color)
In situ cancer (cancer that has stayed where it began and hasn’t spread)
Subtype of MM

55
Q

Acral Letiginous Melanoma (ALM)

A

Common in AA or dark skin
M>F, higher risk with age
Black/brown discoloration under nails or on soles or palms
Spreads superficially before vertically

56
Q

Common in AA or dark skin
M>F, higher risk with age
Black/brown discoloration under nails or on soles or palms
Spreads superficially before vertically

A

Acral Letiginous Melanoma (ALM)

57
Q

Long period of horizontal growth followed by rapid vertical invasion
In situ (in its original place) cancer but if turns invasive, is Lentigo MM
Older, due to chronic sun
Face, ears, arms, upper trunk
Many shades of brown
Flat or mildly raised, or may be mottled (with spots/smears of color)
In situ cancer (cancer that has stayed where it began and hasn’t spread)
Subtype of MM

A

Lentigo Maligna

58
Q

Nodular Melanoma

A

Rapid vertical growth (wks to mos) but little or no radial growth
MOST AGGRESSIVE TYPE OF MM (10-20% of MM)
Highly invasive at time of Dx
Inflamed or friable (?) nodule
Black or any color
Looks like Superficial Spreading M; previous Hx of M

59
Q

Melanoma Tx

A

Wide surgical excision with .5-3 cm clear margins,
Elective regional lymph node dissection/sentinel node biopsy
Chemotherapy - DTIC Dacarbazine only FDA approved
Immunotherapy: interferon-alpha is only systemic drug (FDA) - improves 5 yr survival of state III pts
Gene therapy
F/u q 3 mo

60
Q

ABCDs of Melanoma

A 
A - assymetry
B- border irregularity
C - color (uneven colors)
D - diameter > 6 mm
Other signs: new nodule, color spreads into surrounding skin, redness or swelling beyond the mole, tenderness, itching, bleeding, oozing
61
Q

depth of penetration of melanoma

A

controls prognosis

62
Q

what controls the prognosis of melanoma?

A

depth of penetration (pathological staging)

63
Q

Ulcerated melanomas

A

worse prognosis

64
Q

Sampling of melanoma

A

!!!! ALWAYS require a full thickness biopsy so as to not lose part of depth (for Breslow depth staging).
!!!! Do NOT cauterize or shave biopsy

65
Q

Prevention of Melanoma

A 
SPF 30+ 1 ounce per app
Moisture with SS
Everywhere and chapstick
Clothing
infants >6 mos: SS and hats or don't take infant in the sun
66
Q

Breslow depth based on thickness of tumor (very thin 4)
ULCERATION at any depth WORSENS prognosis

Clark’s level based on skin layers penetrated:
level V - subcutaneous fat has large vessels
Level of DEPTH = prognosis

A

aha

67
Q

Mycosis Fungoides (AKA Cutaneous T Cell Lymphoma)

A

Localized erythematous PATCHES or plaques on trunk > 5cm
Itchy, may see lymph node swelling
Looks like any other lesion
BIOPSY (may see Sezary cells in blood in late stages)
Diff DX: psoriasis, tinea, drug eruption, eczema
Tx: refer to oncology/derm

68
Q

Localized erythematous PATCHES or plaques on trunk > 5cm
Itchy, may see lymph node swelling
Looks like any other lesion
BIOPSY (may see Sezary cells in blood in late stages)
Diff DX: psoriasis, tinea, drug eruption, eczema
Tx: refer to oncology/derm

A

Mycosis Fundgoides (AKA - Cutaneous T Cell Lymphoma)

Clin Med1 1 (8 decks)

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