Melanoma

Question 1

Melanocytes: derived from? produce melanin in___ using ___ as precursor

Answer 1

neural crest. melanosomes. tyrosine

Question 2

skin tone depends on___

Answer 2

activity of melanocytes (# of melanosomes) rather than number

Question 3

dysplastic nevus syndrome, genes associated with it

Answer 3

tons of nevi, predisposes to melanoma. CDKN2A, CDK4

Question 4

how do you biopsy an atypical nevus

Answer 4

excisional specimen. Not shave or point biopsy due to heterogenous nature of mole

Question 5

Majority of melanomas develop denovo or w/in existing dysplastic nevus?

Answer 5

denovo

Question 6

CDKN2A

Answer 6

increases S-phase entry and accelerates p53 breakdown (decreased apoptosis)

Question 7

Most common environmentally caused mutation causing melanoma

Answer 7

BRAF. results in V600E dimer

Question 8

Most important predictor of prognosis in melanoma

Answer 8

Breslow level (not including node status)>ulceration>mitotic rate

Question 9

Four types of melanoma

Answer 9

superficial spreading, lentigo maligna, acral lentiginous, nodular

Question 10

Superficial spreading melanoma

Answer 10

intermittent sun exposure, good prognosis

Question 11

Lentigo maligna

Answer 11

chronic sun exposure, good prognosis

Question 12

Acral lentiginous

Answer 12

palms and soles (often in AAs), unrelated to UV light

Question 13

Nodular

Answer 13

early vertical growth, poor prognosis

Question 14

Lymph node mets: better to worse prognostic indicators

Answer 14

rim better than central better than solid tumor

Question 15

Name some biologics used to tx metastatic melanoma

Answer 15

vemurafenib, IL-2, ipilimumab