melanoma

Question 1

who is highest risk of melanoma

Answer 1

white men >50 yo

Question 2

most common type of ca in what age/

Answer 2

25-29

Question 3

more melanoms from existing nevus or de novo

Answer 3

de novo

Question 4

nevus histo

Answer 4

very organized

Question 5

do melanocytes mature w descent?

Answer 5

in nevi yes, melanoma no

Question 6

of melanocytes are above the basal layer…

Answer 6

BAD SIGN

Question 7

radial growth phase

Answer 7

melanoma in situ

Question 8

vertical growth phase

Answer 8

melanoma that is now invading dermis

Question 9

nevi and melanoma in common

Answer 9

melanocytes
share mut like BRAF
lots of nevi >50 ^ risk
20% melanomas from existing nevi

Question 10

etiology melanoma

Answer 10

multifact
genetic predisp? BRAF?
environment (UV
underlying immune status

Question 11

melanoma risk factors

Answer 11

>50 nevi
giant congenital nevi
atypical nevi
hx of blister sunburns
fam hx melanoma
light complexon
tanning bed
imm dysfn

Question 12

subtypes of melanoma

Answer 12

acral lentiginous
lentigo maligna
nodular
superficial spreading
amelonotic

Question 13

acral lengitinous melanoma

Answer 13

palmar, plantar, subungal skin

most common in pts w darker skin

Question 14

lentigo maligna

Answer 14

older pts w sun-exp skin
melanoma in situ
slow growing, radial growth phase

Question 15

nodular melanoma

Answer 15

sun exp skin
no preceding radial growth is what they say, but no really they start in epid and go into dermis quickly to ecome nodule
2x m>f

Question 16

superficial spreading melanoma

Answer 16

radial growing
janky border
red/white/blue sign

Question 17

other places melanoma can be

Answer 17

inner ear
medulla oblongata
vulva

Question 18

*melanoma mets

Answer 18

lymphatics not exclusively though
SKIN most common 
CNS most common cause of death
node involvement is MOST IMPORTANT Px
most important histo px factor: Breslow thickness, ulcration

Question 19

most important px factor for melanoma met

Answer 19

node inv

Question 20

most miportant histo px factor

Answer 20

brewslow thickness, ulcer

Question 21

what Brewslow’s thickness

Answer 21

dist of inv from granulosum (top) to bottom of lesion

Question 22

tx for melaonoma

Answer 22

catch early, cut it OUT

if met? IFNa, combo chemo, XRT, vax tx

Question 23

mut in melanoma??

Answer 23

1/2 have BRAF mets

Question 24

BRAF involved in waht pway

Answer 24

Ras-Raf-MEK-ERK MapK pway

Question 25

vemurafenib

Answer 25

inhib BRAF for stage IV met melanoma
modest survival benefit (melanoma adapts to it)
combo w Ipilimumab

Question 26

what is Ipilimumab

Answer 26

prevents dact of T cells

stops B7 on APC binding to CTLA-4 of T cell

Question 27

sunlight and skin cancer?

Answer 27

UVB makes thymine dimers which are repaired by endonucleases
squamous cell - cumulative exp
basal cell – UV important but unrel to cumulative
melanoma – role along w genetic, envirnonment, imm

Question 28

xeroderma dermatosum

Answer 28

no endonucleases working so can’t repair thymine dimers

Question 29

sunscreen

Answer 29

SPF 30+, frequent application;