LE3 Soft Tissue Tumors Flashcards
- Radiotherapy is most effective in the following circumstances:
A. Administered after surgery
B. Presence of high cellular oxygen
C. Tumors with areas of hypoxia
D. Cells in G1 and late S phase
B. Presence of high cellular oxygen
Rationale: Radiotherapy is most effective in tumors with high cellular oxygen levels, as oxygen enhances the formation of free radicals that damage tumor DNA.
- The imaging commonly used to assess lung metastases in a patient with a 4 cm well-differentiated sarcoma of the lower extremity is:
A. Chest radiographs
B. Chest CT scan
C. Chest MRI
D. Chest ultrasound
B. Chest CT scan
Rationale: Chest CT scan is the preferred imaging modality to assess for lung metastases due to its superior resolution in detecting small metastases compared to chest radiographs.
- The least aggressive histology in patients with sarcoma is:
A. Pleomorphic liposarcoma
B. Angiosarcoma
C. Dermatofibrosarcoma protuberans
D. Leiomyosarcoma
C. Dermatofibrosarcoma protuberans
Rationale: Dermatofibrosarcoma protuberans is considered the least aggressive histology among the listed sarcomas, as it typically has a lower rate of metastasis.
Low- Grade Sarcomas:
- Dermatofibrosarcoma Protuberans
- Fibromyxoid Sarcoma
- Desmoid Tumors (Aggressive Fibromatosis)
- Myxofibrosarcoma
- True statements regarding gastrointestinal sarcoma include:
A. GI bleeding and abdominal mass are common
B. MRI scan is the mainstay of diagnosis
C. Lymphatic dissection is mandatory
D. Less than a 2 cm margin is adequate
A. GI bleeding and abdominal mass are common
Rationale: Gastrointestinal sarcomas (e.g., GIST) commonly present with GI bleeding and an abdominal mass/pain. MRI is not the main diagnostic tool; CT scan is preferred. Lymphatic dissection is not mandatory, and a margin greater than 2 cm is often required.
- True statements regarding the treatment of retroperitoneal sarcoma include:
A. Chemotherapy is beneficial
B. Radiotherapy is always recommended
C. Surgical resection is the most effective treatment
C. Surgical resection is the most effective treatment
Rationale: Surgical resection is the mainstay of treatment for retroperitoneal sarcoma, as complete resection offers the best chance for local control.
- Soft tissue tumors that may be candidates for observation include:
A. A 4 cm subcutaneous mass for more than five years
B. A 2 cm painless mass noted to double in size within a month prior to consult
C. A painless mass 5 cm in size
D. A painful erythematous mass
A. A 4 cm subcutaneous mass for more than five years
Rationale: A stable, small subcutaneous mass without recent changes can be observed, whereas a rapidly enlarging or symptomatic mass warrants further evaluation.
Small Tumors (< 5cm) Less likely for recurrence
- Which of the following is the poorest determinant of clinical behavior of sarcoma?
A. Time of diagnosis
B. Depth of tumor
C. Histologic grading
D. Tumor size
A. Time of diagnosis
Rationale: Time of diagnosis is the poorest determinant of the clinical behavior of sarcomas, whereas tumor size, depth, and histologic grading are more predictive.
- The high incidence of sarcoma in patients with Li-Fraumeni syndrome is due to what?
A. Mutations of the NF-1 tumor suppressor gene
B. Mutations of the Rb tumor suppressor gene
C. Mutations of the p53 tumor suppressor gene
D. Mutations of the BRCA 1 gene
C. Mutations of the p53 tumor suppressor gene
Rationale: Li-Fraumeni syndrome is associated with mutations in the p53 tumor suppressor gene, leading to a predisposition to sarcoma and other cancers.
- True statements regarding Radiotherapy include:
A. Defines the local extent of the tumor and aids in biopsy and diagnosis
B. Preserves the anatomy
C. Neurologic injury is unlikely
D. Fibrosis and contractures are rare
B. Preserves the anatomy
Rationale: Radiotherapy preserves the anatomy as opposed to surgical excision, which may remove or alter anatomical structures. Fibrosis and contractures are common, and neurologic injury can occur.
- What is the imaging of choice for a 7 cm painless mass on the upper thigh?
A. X-ray of the thigh, AP and lateral view
B. CT scan of the thigh
C. MRI of the thigh
D. Whole-body PET scan
C. MRI of the thigh
Rationale: MRI is the imaging of choice for soft tissue masses as it provides excellent contrast resolution to delineate the mass and surrounding structures.
- What is the cost-efficient imaging of choice to determine if a mass invades adjacent vascular structures?
A. CT scan of the mass
B. PET scan
C. Ultrasound with Doppler studies
D. Angiography of the involved vessel
C. Ultrasound with Doppler studies
Rationale: Ultrasound with Doppler is a cost-effective option for assessing vascular invasion by a mass, especially in superficial or accessible locations.
- Advantages of CT scan over MRI in the evaluation of suspected sarcoma include:
A. Preferred imaging for retroperitoneal sarcoma
B. Accurately delineates muscle groups, vascular structures, and tumor
C. Better images for hemorrhagic and necrotic tumor changes
D. Important adjunct to cytologic analysis in distinguishing benign lesions
A. Preferred imaging for retroperitoneal sarcoma
Rationale: CT scan is preferred for retroperitoneal sarcomas due to its ability to provide better detail of the anatomy, including adjacent organs and vascular structures. MRI is better for soft tissue contrast but less practical for retroperitoneal assessment.
- What is the procedure of choice to rule out local recurrence or metastatic focus?
A. Core needle biopsy
B. Fine needle biopsy
C. Incisional biopsy
D. Excision biopsy
B. Fine needle biopsy
- Which of the following has a poor PROPENSITY to metastasize to lymph nodes?
A. Liposarcoma
B. Rhabdomyosarcoma
C. Malignant fibrous histiocytoma
D. Epithelioid sarcoma
A. Liposarcoma
Rationale: Liposarcoma generally has a lower propensity for lymph node metastasis compared to the other sarcomas listed.
- True statement regarding surgical treatment of a 2 cm malignant fibrous histiocytoma, moderately differentiated lower leg extremity soft tissue sarcoma:
A. Amputation is the treatment of choice for patients
B. Wide local excision with inclusion of biopsy scar is the primary treatment
C. Isolated limb perfusion
D. Excision with lymph node dissection
B. Wide local excision with inclusion of biopsy scar is the primary treatment
Rationale: The standard treatment for a moderately differentiated soft tissue sarcoma of the extremity, such as malignant fibrous histiocytoma, is wide local excision, ensuring the biopsy tract is included in the resection.
- The major deterrent to the use of adjuvant chemotherapy is:
A. Risk of adverse toxic effects in patients who do not respond to therapy
B. High cost of chemotherapeutic drugs
C. Response is less than 20%
D. Thrombocytopenia
A. Risk of adverse toxic effects in patients who do not respond to therapy
- These structures are perpendicularly oriented to the long axis of muscles to allow the greatest degree of stretching and contraction without deformity of skin:
A. Collagen
B. Langerhans’ cells
C. Langer lines
D. Corpuscular receptors
C. Langer lines
Rationale: Langer lines, also known as tension lines, are aligned with the orientation of collagen fibers and allow skin to stretch and contract with minimal deformation.
- What is responsible for the barrier to radiation?
A. Keratinocytes
B. Melanocytes
C. Langerhans cells
D. Collagen
B. Melanocytes
- These are tortuous arteriovenous shunts important for the control of body temperature:
A. Eccrine glands
B. Sebaceous glands
C. Glomus bodies
D. Apocrine glands
C. Glomus bodies
- What adnexal structure predisposes the axilla to suppurative hidradenitis?
A. Eccrine glands
B. Apocrine glands
C. Pilosebaceous units
D. Pacini’s corpuscle
B. Apocrine glands
Rationale: Apocrine glands in the axilla can become blocked and inflamed, predisposing the area to suppurative hidradenitis.
- While cleaning their bathroom, the patient was accidentally splashed with the cleaning agent sodium hydroxide on the left hand and forearm. What is the expected type of skin damage?
A. Deep tissue coagulative injury
B. Fat saponification and liquefactive injury
C. Skin abrasion
D. Degloving injury
B. Fat saponification and liquefactive injury
Rationale: Sodium hydroxide is a strong alkali that causes liquefactive necrosis and fat saponification, leading to tissue damage.
Alkaline Solutions:
-Bleach
-Stain Remover (Sodium Hydroxide)
-Cement (Calcium Hydroxide)
- The least likely cause of chemical burn due to extravasation of intravenous fluid in infants is:
A. Calcium infusion
B. Bicarbonate infusion
C. Doxorubicin infusion
D. Dextrose infusion
D. Dextrose infusion
Rationale: Dextrose is the least likely to cause chemical burns due to extravasation, compared to more caustic infusions like calcium, bicarbonate, or doxorubicin.
- Where is the most likely location of pressure injury in a paraplegic patient?
A. Greater trochanter
B. Gastrocnemius area
C. Dorsum of foot
D. All of the above
A. Greater trochanter
Rationale: In paraplegic patients, the greater trochanter is a common site of pressure injury due to prolonged lying in one position, causing pressure on bony prominences.
Bony prominences (tissue destruction):
- Ischial tuberosity (sitting position)
- Greater trochanter (lying on the side)
- Sacrum (lying supine)
- Heel (prolonged lying or sitting)
- A diabetic malnourished patient developed a rapidly enlarging erythematous, tender, swollen soft tissue infection affecting the perineal area. What is the least appropriate management?
A. Aggressive surgical debridement
B. Anti-tetanus vaccination
C. Intensive care unit support
D. Gram-positive antibiotic coverage
B. Anti-tetanus vaccination
Rationale: In a rapidly enlarging soft tissue infection like Fournier’s gangrene, anti-tetanus vaccination is the least urgent intervention compared to aggressive surgical debridement, ICU support, and broad-spectrum antibiotic coverage.
- What is the most common type of cutaneous cyst appearing as a single firm nodule anywhere in the body?
A. Dermoid cyst
B. Epidermal cyst
C. Trichilemmal cyst
D. Pilar cyst
B. Epidermal cyst
Rationale: An epidermal cyst is the most common type of cutaneous cyst and appears as a single, firm nodule that can occur anywhere on the body.
Classification of Cystic Lesions:
- Sebaceous cyst: Upper chest and Back
- Epidermal cyst (hair follicles: Everywhere
- Epidermoid cyst (deeper): Fewer hair (thick skin)
- Trichilemmal cyst: Scalp (Women)
- Dermoid cyst (congenital): bet. forehead & nose tip, eyebrows (lie in SubQ)
- What variant of basal cell carcinoma is relatively aggressive and often appears as a flat, plaque-like lesion and is best treated by excision with a 0.5 to 1 cm margin?
A. Pigmented
B. Micronodular
C. Superficial spreading
D. Morpheaform
D. Morpheaform
Rationale: Morpheaform basal cell carcinoma is a relatively aggressive subtype that often presents as a flat, plaque-like lesion, and it is best treated with excision with a 0.5 to 1 cm margin to ensure complete removal.
- Which of the following statements is NOT a characteristic of squamous cell carcinoma of the skin?
A. Waxy cream-colored skin lesion with rolled pearly borders surrounding a central ulcer
B. Lesions arise in burn scars
C. Common in ears, nose, and lips
D. Associated with UV radiation
A. Waxy cream-colored skin lesion with rolled pearly borders surrounding a central ulcer
Rationale: This description is characteristic of basal cell carcinoma, not squamous cell carcinoma. Squamous cell carcinoma often presents as a scaly, crusted, or ulcerated lesion, commonly found on sun-exposed areas.
- Which of the following suspicious features of a pigmented skin lesion is suggestive of melanoma?
A. Uniform pigmentation
B. Smooth edges
C. Ulceration
D. Flat lesion
C. Ulceration
Rationale: Ulceration is a suspicious feature of melanoma, as it indicates potential aggressive growth. Other concerning signs include asymmetry, irregular borders, and varying pigmentation.
Prognostic Indicators
-Breslow tumor thickness: The most important prognostic indicator for melanoma staging (has replaced Clark’s level).
-Worse prognosis associated with:
–Tumor ulceration.
–Mitotic rate ≥1 per mm².
–Metastasis.
–Elevated LDH (indicative of stage III or greater diseases, high risk of distant metastasis).
A- Asymmetric
B- Irregular Border
C- Color Variation
D- Diameter >6mm
E- Evolution
- What is the most important prognostic indicator in melanoma staging?
A. Breslow tumor thickness
B. Clark’s level
C. Sentinel biopsy result
D. Histologic type
A. Breslow tumor thickness
Rationale: Breslow thickness is the most important prognostic indicator in melanoma, as it measures the depth of tumor invasion, which is crucial for staging and determining the risk of metastasis.
- True statements regarding Merkel cell carcinoma include:
A. Excise with 1-3 cm margins down to fascia
B. Recurrence is common
C. Up to 70% node involvement within 2 years
D. All of the above
E. None of the above
D. All of the above
Rationale: Merkel cell carcinoma is an aggressive skin cancer. Treatment involves excision with wide margins (1-3 cm) down to fascia, recurrence is common, and there is a high rate of lymph node involvement.
- True statement regarding desmoid tumor:
A. Not a low-grade sarcoma
B. Spread aggressively to distant sites
C. Common in the retroperitoneal area
D. All of the above
C. Common in the retroperitoneal area
- All of the following are true about soft tissue sarcoma EXCEPT:
A. Most common site is the trunk and retroperitoneum.
B. There are more than 11,000 new diagnoses of soft tissue sarcoma annually in the United States.
C. Most soft tissue sarcoma-specific deaths are due to uncontrolled pulmonary metastases.
D. The overall 5-year survival rate for all stages of soft tissue sarcoma approximates 50 to 60%.
A. Most common site is the trunk and retroperitoneum.
Rationale: While the trunk and retroperitoneum are common sites, the most common site for soft tissue sarcomas is actually the extremities. The other statements are accurate regarding soft tissue sarcoma incidence, mortality, and survival rates.
- Which of the following is NOT associated with the development of sarcoma?
A. Radiation exposure
B. Herbicide exposure
C. Chronic lymphedema
D. History of trauma
D. History of trauma
Rationale: A history of trauma is not a well-established cause of sarcoma. Although trauma can draw attention to a pre-existing mass, it is not considered a direct cause of sarcoma. The other listed factors, such as radiation exposure, herbicide exposure, and chronic lymphedema, have all been associated with an increased risk of sarcoma.
- Which of the following is a component of the International Contre le Cancer (AJCC/UICC) sarcoma staging system?
A. Tumor size
B. Number of mitoses per high-powered microscopic field
C. Lymph node metastatic status
D. Retroperitoneal sarcoma nomograms
A. Tumor size
- Tumor size is a crucial component of the AJCC/UICC staging system for sarcomas.
- The number of mitoses per high-powered microscopic field (Option B) is not part of this system.
- Lymph node status (Option C) and nomograms (Option D) are not primary components of the
AJCC/UICC sarcoma staging system.
- All of the following are known molecular pathogenic events in sarcoma EXCEPT:
A. Chromosomal translocations
B. Oncogene amplification
C. Complex genomic rearrangements
D. Epigenetic suppression
D. Epigenetic suppression
Rationale: Chromosomal translocations, oncogene amplification, and complex genomic rearrangements are all known pathogenic events in sarcomas. Epigenetic suppression is not typically described as a primary pathogenic mechanism for sarcoma.
- For a T2G3N0M0 sarcoma (stage II), treatment typically consists of:
A. Surgery alone
B. Surgery and radiotherapy
C. Surgery, radiotherapy, pre-surgical chemotherapy
D. Surgery, radiotherapy, pre- and post-surgical chemotherapy
B. Surgery and radiotherapy
Rationale: Stage II sarcoma generally requires a combination of surgery and radiotherapy to ensure local control and to reduce the risk of recurrence. Chemotherapy may be used in higher-stage sarcomas but is not typically standard for stage II.
- Which of the following is true about desmoid tumors?
A. Local recurrence is observed in up to one-third of patients regardless of microscopic margin of resection status.
B. A policy of watchful waiting for desmoids has been validated in prospective clinical trials.
C. Analogous to other nonmetastasizing tumors, chemotherapy has no role in the treatment of desmoid tumors.
D. Due to their propensity for local invasion, radiotherapy, when used, must be given at a dose of 75 Gy.
A. Local recurrence is observed in up to one-third of patients regardless of microscopic margin of resection status.
Explanation of Each Option:
* A. Local recurrence is observed in up to one-third of patients regardless of microscopic margin of resection status.
* This is correct. Desmoid tumors have a high local recurrence rate, with up to one-third of patients experiencing recurrence after surgery, regardless of whether the surgical margins are clear or positive.
* B. A policy of watchful waiting for desmoids has been validated in prospective clinical trials.
* While observation is a common strategy, the option does not specify that it is validated by prospective clinical trials. However, it is used effectively in clinical practice for patients who do not initially require surgery or systemic therapy.
* C. Analogous to other nonmetastasizing tumors, chemotherapy has no role in the treatment of desmoid tumors.
* This is incorrect. Chemotherapy does play a role in the treatment of desmoid tumors, especially for symptomatic cases that do not respond to other treatments.
* D. Due to their propensity for local invasion, radiotherapy, when used, must be given at a dose of 75 Gy.
* This is incorrect. The recommended radiation dose for desmoid tumors is 50-54 Gy, not
75 Gy, as higher doses increase the risk of radiation-induced sarcoma and other side effects.
Following caustic injury to the skin with an alkaline agent, the affected area should initially be:
A. Treated with running water or saline for 30 minutes
B. Treated with running water or saline for 2 hours
C. Treated with a neutralizing agent
D. Treated with topical emollients and oral analgesics
B. Treated with running water or saline for 2 hours
Dilution of the offending agent using distilled water or saline:
- 30 minutes for acidic burns.
- 2 hours for alkaline burns.
The treatment of a hydrofluoric acid skin burn is:
A. Application of calcium carbonate gel
B. Irrigation with sodium bicarbonate
C. Injection of sodium bicarbonate
D. Local wound care only
A. Application of calcium carbonate gel
The area most amenable to salvage by resuscitative and wound management techniques following thermal injury is called the:
A. Zone of hyperemia
B. Zone of coagulation
C. Zone of stasis
D. Zone of scalding
C. Zone of stasis
- The zone of stasis is the area surrounding the central zone of coagulation in a burn injury, where tissue is damaged but potentially salvageable with proper care.
The zone of hyperemia (Option A) is the outermost layer with increased blood flow and is usually not at risk of necrosis. - The zone of coagulation (Option B) is the area of irreversible tissue damage.
- “Zone of scalding” (Option D) is not a recognized term in burn management.
Tissue ischemia resulting in wounds that are characterized as a partial-thickness injury with a blister is considered:
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
B. Stage 2
The presence of sulfur granules in a draining wound should lead to the use of which of the following antibiotics?
A. Rifampin
B. Gentamicin
C. Penicillin
D. Amphotericin
C. Penicillin
Sulfur granules are indicative of actinomycosis, a bacterial infection typically treated with penicillin.
Initial treatment of nonpurulent, complicated cellulitis is:
A. Vancomycin
B. β-lactam
C. Linezolid
D. Clindamycin
B. β-lactam
- Nonpurulent cellulitis, often caused by streptococcal species, is commonly treated with B-lactam antibiotics, which cover gram-positive organisms.
- Vancomycin (Option A) and linezolid (Option C) are generally reserved for MRSA or severe
infections. - Clindamycin (Option D) can be used but is not typically the first-line choice for nonpurulent cellulitis.
In the ABCDE of melanoma, the D stands for diameter greater than:
A. 2 mm
B. 4 mm
C. 6 mm
D. 8 mm
C. 6 mm
The most common site of distant metastasis for melanoma is:
A. Brain
B. Lung
C. Gastrointestinal tract
D. Distant skin
B. Lung
The most common subtype of melanoma is:
A. Lentigo maligna
B. Acral lentiginous
C. Superficial spreading
D. Nodular
C. Superficial spreading
Ocular melanoma:
A. Exclusively metastasizes to the lungs
B. Exclusively metastasizes to the brain
C. Exclusively metastasizes to regional lymph nodes
D. Exclusively metastasizes to the liver
D. Exclusively metastasizes to the liver
The following is NOT true in regard to Merkel cell carcinoma:
A. It is commonly found in white men with a median age of 70 years.
B. It is characterized by a rapidly growing, flesh-colored papule.
C. Treatment should begin with examination of nodal basins.
D. Recurrence is uncommon.
D. Recurrence is uncommon.
What is the most common melanoma in patients with dark skin?
A. Nodular
B. Superficial spreading
C. Acral lentiginous
D. Lentigo maligna
C. Acral lentiginous
Kaposi sarcoma:
A. Excision is the treatment of choice
B. Is predominantly found on the skin
C. Appears as rubbery, blue nodules
D. Is most often seen in patients in their life
B. Is predominantly found on the skin
The following is NOT a prognostic indicator for patients with a sentinel node containing metastatic melanoma:
A. Patient age
B. Site of metastasis
C. Number of positive nodes
D. Thickness, mitotic rate, and ulceration of primary tumor
B. Site of metastasis
Rationale:
* In patients with a sentinel node containing metastatic melanoma, key prognostic indicators
include:
- Patient age (Option A): Older age is generally associated with poorer outcomes.
- Number of positive nodes (Option C): A higher number of positive nodes correlates with a worse prognosis.
- Thickness, mitotic rate, and ulceration of the primary tumor (Option D): These are critical factors that influence the likelihood of metastasis and survival outcomes.
- The site of metastasis (Option B) is not a primary prognostic factor for patients at this stage; it is more relevant in the context of distant metastatic disease rather than sentinel node-positive cases.
A patient with a 5-mm deep melanoma of the thigh and no clinically positive nodes should undergo which procedure?
A. Resection of the primary only
B. Superficial femoral node resection
C. Superficial and deep femoral node resection
D. Resection of femoral and inguinal nodal basins
A. Resection of the primary only
A 5-mm deep melanoma typically requires wide local excision of the primary tumor. Sentinel lymph node biopsy may be performed to assess for microscopic nodal involvement, but without clinically positive nodes, extensive lymph node dissection is not indicated.
A 65-year-old patient who spends winters in Florida presents with a painless, ulcerated lesion on his right cheek. The lesion has been present for 1 year. Physical examination of the patient’s neck reveals no lymph node enlargement. The most likely diagnosis is:
A. Melanoma
B. BCC
C. SCC
D. Sebaceous cyst
B. Basal Cell Carcinoma (BCC)
Rationale: BCC is the most common skin cancer, especially in sun-exposed areas and in older adults with significant sun exposure history, as seen in this patient who winters in Florida. BCC often appears as a painless, slow-growing lesion that may ulcerate, commonly presenting as a pearly or translucent nodule or an ulcer with rolled edges. BCC rarely metastasizes, which explains the lack of lymph node enlargement in this patient. These characteristics make BCC the most likely diagnosis.
The chronic inflammatory disease presenting as painful subcutaneous nodules is:
A. Pyoderma gangrenosum
B. Toxic epidermal necrolysis syndrome
C. Hidradenitis suppurativa
D. Steven-Johnson syndrome
C. Hidradenitis suppurativa
Hidradenitis suppurativa is a chronic inflammatory skin condition characterized by painful subcutaneous nodules, often in areas such as the axillae and groin.
Pyoderma gangrenosum (Option A) involves painful ulcers rather than subcutaneous nodules, toxic epidermal necrolysis syndrome (Option B) and Stevens-Johnson syndrome (Option D) are severe skin reactions but do not present as painful subcutaneous nodules.
Most common primary sarcoma originates from:
a. Retroperitoneum
b. Trunk
c. Extremity
d. Head and neck
c. Extremity
Most common histologic type of soft tissue sarcoma in adults:
a. Malignant fibrous histiocytoma
b. Liposarcoma
c. Leiomyosarcoma
d. Rhabdomyosarcoma
b. Liposarcoma
True statements regarding the survival rate of soft tissue sarcoma, except:
a. Five-year survival rate is only about 50-60%
b. Most patients die due to local invasion of adjacent neurovascular structures
c. Metastasizes in 2-3 years after diagnosis
d. Most common site of metastases is the lungs
b. Most patients die due to local invasion of adjacent neurovascular structures
True statements regarding radiation-induced sarcoma, except:
a. Common histologic types of radiation-induced sarcoma are osteogenic and pleomorphic undifferentiated, with higher radiation doses
b. Prognosis is very poor, and the usual median time between radiotherapy and diagnosis is less than 10 years
c. External radiotherapy causes an 8-50 times increase in the incidence of sarcoma
b. Prognosis is very poor, and the usual median time between radiotherapy and diagnosis is less than 10 years
What cancer therapy is most effective in addressing the destruction of non-multiplying cells in the cell cycle?
a. Surgical resection
b. Chemotherapy
c. Radiotherapy
d. Endocrine therapy
c. Radiotherapy
Radiotherapy can effectively destroy both dividing and non-dividing cells, making it useful for targeting cancer cells that are not actively proliferating.
Delayed primary closure is recommended for:
a. Incised wounds of the forearm
b. Clean lacerations
c. Dirty dog bites
d. Non-penetrating stab wounds
c. Dirty dog bites
Dog bites, particularly those that are contaminated or involve puncture wounds, are prone to infection. Delayed primary closure is recommended to allow time for infection management, such as irrigation and antibiotics, before definitive closure. This approach reduces the risk of trapping bacteria within the wound.
A patient developed redness, warmth, tenderness, and edema of the skin, leading to superficial spreading infection of the patient’s leg. What is your diagnosis?
A. Carbuncle
B. Furuncle
C. Cellulitis
D. Necrotizing soft tissue infection
C. Cellulitis
A. Carbuncle
* Incorrect. A carbuncle is a cluster of furuncles (boils) with multiple openings draining pus, usually involving hair follicles and surrounding tissue. It presents as a deep, localized infection with pus but typically does not spread as a superficial infection like cellulitis.
B. Furuncle
* Incorrect. A furuncle is an infection of a single hair follicle that results in a painful, red, swollen nodule with pus. Like a carbuncle, it is a localized infection and lacks the widespread erythema and edema associated with cellulitis.
C. Cellulitis
* Correct. Cellulitis is a superficial spreading infection characterized by redness, warmth, tenderness, and edema of the skin, which can extend across a large area. It typically involves the deeper layers of the skin and subcutaneous tissues and presents in a diffuse pattern on the affected limb, as described.
D. Necrotizing soft tissue infection
* Incorrect. Necrotizing soft tissue infections are severe, rapidly progressing infections that often present with extreme pain, systemic toxicity, and tissue necrosis. They involve deeper layers of tissue and are often associated with crepitus, bullae, and a rapidly spreading appearance, which is more severe than the description given.
Which of the following statements is NOT a characteristic of squamous cell carcinoma of the skin?
A. Waxy cream-colored skin lesion with rolled pearly borders surrounding a central ulcer
B. Lesions arise from burn scars
C. Common in ears, nose, and lips
D. Associated with UV radiation
A. Waxy cream-colored skin lesion with rolled pearly borders surrounding a central ulcer
