Brainscape's Knowledge GenomeTM

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


See full index

Boards Path > MSI Path > Flashcards

MSI Path Flashcards

1
Q

Stratum Corneum

A
  • Outermost layer comprised mostly of keratin that is attached to each other at desmosomal jct
  • Provides the majority of the barrier function of skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stratum Lucidum

A

-Extra layer that is only found on the palms and soles

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

Stratum Granulosum

A
  • Keratinocytes lose their nuclei in this level

- Secrete lipids

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

Startum Spinosum

A
  • Desmosomal attachments cause spinous appearance as cells dehydrate
  • Still contain nucleus
  • Langerhans cells are here, polar lipids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Stratum Basale

A
  • Basal regenerative layer
  • Connected to BM via basement membrane
  • Contain melanocytes and also merkel cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Sebacous Gland

A
  • Holocrine secretion of waterproofing fluid
  • Most concentrated in hair areas and face
  • Can cause acne
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Eccrine Gland

A
  • Secrete Na/Cl into a duct that is then reabsorbed
  • Found throughout the body and function to cool
  • Sympathetic cholinergic inervation (postganglionic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Apocrine Glands

A
  • Release a sugar, oil, and watery mixture
  • Blebs off membrane
  • Located in axilla and genetalia
  • Are responsible for smell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tight Junctions

A

-Occludins and claudins form a water tight barrier

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

Zonula Adherens

A
  • Connects the cytoskeleton of neighboring cells
  • Functions through cadherins (Ca dependent binding proteins)
  • Loss of cadherins can promote metastasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Macula Adherens (desmosomes)

A
  • Function as spot welds and provide sheer force stabilization
  • Desmogleins/solins in homotypic interactions
  • Ab to desmogleins leads to pemphigous vulgaris
  • Also form connections between myocytes and have been implicated in some congenital arrythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hemidesmosome

A
  • Attach keratin and intracellular to Collagen, laminin etc
  • Integrins bind to lamanin: Cell signaling
  • Ab Attack leads to bullous pemphigoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Epidermolysis Bulosa

A

-Mutation in keratin genes that are important for hemidesmosome function leads to “Skin falling off”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Knee Anatomy

A
  • Names refer to sites of tibial attachment
  • Fibula is on the lateral leg, so use as landmark
  • ACL is anterior lateral tibia and PCL is posterior medial tibia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pudendal Nerve block

A
  • Lateral to Ischial spine
  • S2-4 somatic sensory loss of genital and anal region
  • Childbirth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Supraspinatus

A

-15 degrees of abduction

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

Infraspinatus

A

Lateral rotation and abduction

-Commonly torn in pitchers

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

Teres Minor

A

Lateral rotation

-Adduction

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

Subscapularis

A

Medial rotation

adduction

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

Rotator Cuff Innervation

A

C5-6

-Erb Duschene palsy leads to arm that lies in medial rotation and at side due to paralysis of rotator cuff

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

Scaphoid

A

Makes connection with radius and is the most commonly fractured wrist bone
-Needs attention becase of risk of avascular necrosis

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

Lunate

A

-Dislocation leads to acute carpal tunnel syndrome and paralysis of distal median nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hamate

A
  • Ulnar Nerve goes under

- Fracture leads to loss of sensation to medial palmar hand and medial flexors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Axillary Nerve

A
  • Damage from surgical head fracture (runs with circumflex humeral)
  • Also can be lesioned by dislocation of humerus
  • Leads to paralysis of deltoid and loss of sensation in that area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Radial Nerve

A
  • Runs in the radial groove with the deep brachial artery
  • Fracture of the midshaft of the humerus
  • Dislocation of the radius
  • Saturday night palsy with compression in the axilla
  • Controls Triceps, brachioradialis, supinator, wrist extensors
  • Also sensory to the back of the hand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Median Nerve

A
  • Supracondylar fracture
  • Compression through pronator teres
  • Compression in carpal tunnel
  • Controls muscles flexion of muscles on the lateral aspect of the hand including the thumb
  • Controls sensation on the palmar aspect of the lateral hand
  • Also runs in interosseus nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Recurrent Median Nerve

A
  • Branch post carpal tunnel that controls thumb movements

- Damage by superficial laceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Ulnar Nerve

A
  • Muscles on the medial hand (C8, T1) and sensation on the palmar and dorsal medial hand
  • Damage with hook of hamate
  • Fracture of medial epicondyle
  • Also will get radial deviation on wrist flexion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Erbs Palsy

A

Damage to upper trunk C5-6

  • Childbirth or from rapid pushing of head to other side
  • Causes waiters tip (damage to rotator cuff and some biceps)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Klumpkes Palsy

A
  • Damage to lower trunk
  • From reaching or outstrectched arm
  • Total claw hand with damage to all intrinsic hand muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Obturator

A

-Controls muscles of the medial thigh and causes adduction L2-L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Femoral

A

-L2-4 controls thigh flexion and leg extension (quads)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Common Peroneal

A

Commonly injured because of superficial location on the lateral aspect of the leg (Near the fibula)

  • Causes an inabilty to dorsiflex and evert the foot leading to foot slap and foot drop
  • Loss of sensation from dorsum of foot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tibial Nerve

A
  • Damaged with knee trauma
  • Causes loss of plantar flexion and inversion
  • Loss of sensation over sole of foot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Superior Gluteal

A
  • Controls the gluteus minimus and medius which raise the hip
  • Positive trendelenberg sign, contralateral hip drops when standing on one leg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Inferior Gluteal

A

Gluteus maxiums

-Can’t jump, run, raise from a chair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Endochondral Ossification

A
  • Occurs in appendicular and axial skeleton
  • Cartilagenous frame laid by chondrocytes, replaced by woven bone by clasts and blasts and finally remodeled into lamellar bone
  • Woven bone seen in fractures and Pagets disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Membranous Ossification

A
  • Occurs in facial bones and calvarium

- No cartillage structure, blasts and clasts lay down woven bone directly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Osteoblasts

A
  • Mesenchymal origin
  • Build bone with collagen and ossification
  • Secrete ALKP to keep alkaline environment for ossification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Osteoclasts

A
  • Monocyte lineage, contain RANK-R that respond to RANK-L on blasts
  • Secrete acids and collagenases
  • TARP is a marker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

PTH

A
  • Increases RANKL expression on blasts and increase clast activity to resorb bone.
  • When Ca is present low level PTH will maintain bone remodelling, but when calcium is deficient elevted PTH leads to Ca extraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Estrogen

A
  • Causes apoptosis of clasts and maintains blasts

- Menopause leads to reversal of effect and causes osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Achondroplasia

A
  • AD activating mutation in FGFR3 leading to impaired chondrocyte proliferation. Associated with advanced paternal age
  • Causes impaired endochondral ossification because of improper cartilalge skeleton
  • Epiphysis will be disorganized
  • Shortened limbs and long bones with normal intramembraneous ossification. Normal Head, chest, wrist, etc
  • Normal fertility and other functions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Osteoporosis

A
  • Loss of trabechular bone with porous appearnace on X Ray
  • Does not have unmineralized osteoid like osteomalacia because the fundamental problem is an aging/estrogen induced decrease in blast function and decrease in clast function
  • All labs will be normal
  • Estrogen normally helps to activate blasts and inhibit clasts (IL-1,6, osteoprotegrin) Loss at menopause shifts balance
  • Senile occurs in men and women equally and comes from falling off after peak bone density is reached at the age of 30 or so.
  • Can be aided with exercise, proper diet including vitamin D, and vitamin D Receptor polymorphisms
  • Tx: Raloxifen/HRT, Bisphosphenates which cause apoptosis in clasts, vitamin D, Ca, Diet
  • Symptoms include femoral, hip fracuters and vertebral fractures.
  • Pulsatile PTH can keep blasts functiononing in the face of adequate calcium
  • Gluococorticoids are contraindicated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Glucocorticoids

A

-Contraindicated in osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Osteopetrosis

A
  • Impaired osteoclast function most commonly due to mutation in carbonic anhydrase 2. Leads to inability to acidify the local environment and resorb bone
  • Increased deposition leads to thickened hypermineralized bone that is prone to fracture
  • Extra bone can also compress nerves leading to carpal tunnel or deafness
  • Labs will show a decrease in Ca and increase in ALP
  • Bone marrow would be currative because clasts are from monocyte lineage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

RTA

A

-RTA can be seen with osteopetrosis because of CA mutation leading to impaired acid secreition and bicarb resporption in PCT (type 1)

48
Q

Osteopetrosis complications

A

-Myelpphthesis can cause pancytopenia and EMH

49
Q

Osteomalacia and Rickets

A
  • Low vitamin D levels leads to a reduction in Ca and P in the blood leading to decreased bone mineralization
  • Will stimulate PTH to increase blast activity leading to increase in ALP
  • Prolieration and hypeactivity of blasts leads to the classic unmineralized osteoid proliferation
  • Rickets, kids: Osteoid commonly seen at ribs (rossettes) and forehead. Bowing legs
50
Q

Paget’s Disease

A
  • Etiology unnown, possibly viral. Focal (Not sytemic) increase in clast activity that is opposed by blast activity leads to increase deposition of woven bone and weak mosaic pattern.
  • Clasts will burn out and blasts will continue leading to increasing deposition. Commonly in skull with increased head size or wrist for carpal tunel
  • Labs: Everything is normal except for an isolated increase ALP because of increase osteoid and mineralization.
  • Can lead to osteosarcoma of the adult
  • Can also create AV shunts that leads to high output cardiac failure.
51
Q

Pituitary Dwarfism

A
  • Lack of response to GH

- WIll be shortened in all bones

52
Q

Polyostotic FIbrosa Cystica

A
  • Increase in PTH signalling leads to increased bone resportion
  • WIll be replaced by fibroblasts and will appear as radiolucent portions in bone that is surrounded by normal or sclerotic bone
  • Can also be seen in mccune albright
  • Tx: Bisphosphenates can impede resportion
53
Q

McCune Albright

A
  • Defect in regulation of Gs signalling leading to increase cAMP and overactivity
  • Post zygotic mutation, so patients demonstrate mosacism
  • Causes Shortened digits and PTH hyperresponsiveness
  • Short stature, Polyositis FIbrosa Cystica
  • Also causes precocious puberty and cafe-au-lait spots
54
Q

Osteomyelitis

A
  • Most common in kids and shows up with fever and systemic symptoms and a unifocal inflammatory joint arthtitis
  • Lytic focus with surrounding sclerosis
  • Most often in metaphysis
  • S AUreus most common
  • Pseudomonas in Diabetics and drug users
  • Salmonella in sickle cell
  • Pasturella in bites
  • Nisseria
  • TB
55
Q

Avascular Necrosis

A
  • Loss of blood supply leads to cell death and risk of fracture
  • GLucocorticoids can cause, especially in large joints
  • Sickle cell get vaso-occlusive crisis in hands (dactylitis)
  • Scaphoid fracture that is not properly treted (proximal protion has weak “retrograde” flow from radial artery
  • Can also occur in alcholics
56
Q

Femoral Head Fracture

A

-Avascular necrosis can occur because of disruption of supply from medial circumflex artery

57
Q

Giant Cell Tumor

A
  • Tumor of spindle cell, pleiomorphic giant cells that arises in the epiphysis of long bones (only tumor in epiphysis)
  • Stains CD56+, monocyte lineage
  • Locally aggressiv tumor that has soap bubble appearance on X-Ray, but is not malignant
58
Q

Osteochondroma

A
  • Tumor of bone cells that grow out from growth plate of metaphysis
  • Surrounded by chondrocyte covering that can rarely become malignant
  • Very common and seen in males under 25
59
Q

Osteoid Osteoma

A
  • Osteoblastic tumor leading to dpeosition of osteoid that is not mineralized, appears radiolucent on x-ray
  • Seen in the cortex of long bones
  • Often surrounded by an area of sclerosis
  • Pain improves with aspirin
60
Q

Osteoma

A
  • Extra bone growht, commonly in the head/sinuses
  • May be related to trauma
  • Benign but can cause local mass effect
61
Q

Osteosarcoma

A
  • Tumor of the metaphysis and of osteoblasts. Occurs near the cortex
  • Creates Codman’s angle by pushing the periosteum out of the surface
  • X ray may show “Sunburst sign”
  • Associated with Rb mutations
  • In adults can be secondary to paget’s disease and also radiation
  • Pain does not respond to ASA
  • Resection is definitive cure.
62
Q

Ewings Sarcoma

A
  • Tumor of primitive neuroectoderm cells
  • Occurs most commonly in young males
  • Occur in the diaphysis of long bones
  • May cause onion skinning and proliferation outward
  • Caused by transolatcion (11:22)
  • Aggressive and highly metastatic, but responds well to chemo
63
Q

Chondrosarcoma

A
  • Cartillage tumors arise in the medulla and appear as radiolucent tumors
  • Medulla of diaphysis in long bones (fingers commonly)
  • Seen most commonly in middle aged men
  • Glistening collagen producing tumor
64
Q

Bone Metastasis

A
  • By far more common
  • Most often are lytic metastasis
  • Are osteoblastic sclerotic metastasis in prostate cancer
65
Q

Alkaptonuria

A
  • Defect in tyrosine and phenylalanine metabolism leads to accumulation of homogentisic acid
  • Causes joint pain, dark urine, heart disease
  • Urine will be black
66
Q

Osteoarthritis

A
  • Wear and tear destruciton of cartillage (Col 2 and GAGs/HA from synovium).
  • Age is the biggest predisposing factor, also trauma and obesity
  • Joint space narrowing, eburnation, osteophytes of subcondral bone.
  • Minimal inflammatory debris in joint
  • Involves the PIP and DIP (Heuberdens nodes) and not the MCP
  • Also commonly involves large weight bearing joints
  • Tx is NSAIDs
  • Improves with rest and gets worse with use
67
Q

Rheumatoid Arthritis

A
  • Systemic autoimmune disese most characterizd by joint inflammation
  • RF is IgM to Fc protion of IgG and can correlate with disease severity but not dx. Not all RA have, and many other non RA disease do
  • Use Citrullinated peptide to diagnose
  • Highly associated with HLA-DR4 (MHC2)
  • Inflammation of synovium and increase in lymphocytes and macrophages in joints
  • Eventually panes of granulation tissue and fibroblasts form
  • Pannes cause akylosis of joints and myofibroblast traction and deviation
  • Involves the PIP and MP but not the DIP joints, also stiff in morning gets better with use. Can easily distinguish RA from OA
  • Systemic illness with other manifestations
  • Can cause pulmonary fibrosis and effusions
  • Can cause secondary amyloidosis from (SAA-AA formation (nephrotic syndrome))
  • Anemia of chronic disease
  • Fatigue, LAD
  • Subcutaneous nodes, vasculitis (Fibrnioid necrosis)
  • Bakers cyst
  • Tx: MTX, Infliximab (don’t give if pt has TB)
68
Q

Juvenile RA

A
  • RA symptoms in childhood

- May cause uveitis and blindness as feared complications

69
Q

Sjogrenns

A
  • Caused by autoimmune lympocytic infiltration of exocrine glands. Most commonly the salivary and lacrimal
  • Positive anitbody test to riboneucleoptide proteins (SS-A and B, Ro and La) also very commonly RA positive
  • Symptoms are Xerostomia which predisposes to carries, xerophthalmia which predisposes to infection, and arthritis.
  • Associated with HLA-DR/DQ (MHC2 like RA)
  • Lymphoctic infiltration and germinal center formation predispose to MALT lymphoma in exocrine glands (Hashimotos and H pylori)
  • Ab can cross placenta and cause neonatal heart block
  • Parotid Gland Enlargment
  • Also patients often have cryoglobulins
70
Q

Gout

A
  • Cause by deposition of monosodium urate crystals in joints.
  • MSU crystals cause neutrophilic activiation and episodes of acute gout
  • MSU deposits because of elevated uric acid levels caused by increased production or decreased excretion
  • Production from diet (AMP, GMP in meats) also from leukemia and increased cell turnover
  • More commonly from impaired excretion. Excreted via anion transporter in kidney.
  • Competes with lactate (Von GIerke disease), Alchohol
  • Thiazides and loop diuretics also increase risk of gout attack
  • Produced from purine pathway via xanthine oxidase
  • Tx: Colchicine, NSAIDS
  • Chronic can use allopurinol inhibits xanthine oxidase
  • Probenacid can increase secretion, uricase analogs can break it down
71
Q

Chronic Gout

A
  • Tophi deposit (Ear, elbow, etc)

- Can cause uric acid stone and urate nephropahty leading to acute renal failure

72
Q

Lesch Nyhan

A

XR defect in HGPRT meaning less Purine salvage and more purine loss leading to increased uric acid and gout

73
Q

Tumor Lysis Syndrome

A
  • Seen when treating leukemias etc
  • Spill eveything that was inside into the ECF
  • Increase uric acid and lactic acidosis may cause gout
  • Hyperkalemia, hyperphosphatemia, hypocalcemia
74
Q

Pseudogout

A
  • Deposition of calcium pyrophophate crystals into large joints
  • Most commonly effects the knee (assymetrical)
  • Common in elderly
  • Pyrophosphate comes from ATP breakdown and Ca from elevated Ca levels (hyper PTH, cancer, etc)
  • Positively birefringent rhomboid crystals
  • Tx: NSAIDs
75
Q

Von Gierke Disease

A
  • Dysfunctional glucose 6 phosphatase in muslce prevents glycogen usage leading to lactic acidosis and exercise intolerance in kids
  • Lactate competes with uric acid for excretion and can preciptate and attack of acute gout
76
Q

Infectous Arthritis

A
  • Purulent inflammation of joints, assymetric
  • S Aureus is most commont
  • Classically is Gonorrhea following STD
  • Can also be lyme disease (molecular mimicry)
  • Synovitis, Tenosynovitis, Dermatitis
77
Q

Seronegative Spondyloarthropathies

A
  • RF negative but HLA-B27 positive

- MHC class I and seen more commonly in men

78
Q

Ulcertive Colitis (maybe crohns)

A

-Ankylosing spondyloarthtis and other seronegative arthropathies are commonly seen in inflammatory bowel disease

79
Q

Psoriatic Arthritis

A
  • Occurs in 1/3 of patients with psoriasis
  • DIP is always involved creaing a sausage finger
  • Pencil in cup deformitiy is also often seen
  • Can involve nearly any joint in the body and commonly involves nail changes
80
Q

Ankylosing Spondylitis

A
  • Fusion of sacroiliac joints and lumbar spine
  • Seen as pain, stiffness, and inflexability in young adult men
  • Fusion of joints
  • Can be associated with uveitis
  • Aortitis can also be seen that will lead to aortic anyeurism and aortic regurgitation
  • Can also show a restrictive lung disease pattern because of mechanical obstruction of ventilation
81
Q

Reactive Arthritis

A
  • Arthritis, conjunctivitis, and urethritis following GI or STD infection
  • Can also involve a rash on the palms and soles
  • Chronically may lead to ossification of the achilies tendon
82
Q

Dermatomyositis

A
  • CD4 mediated inflammation and atrophy of perimyseal (apical fascicel)
  • Associated with dermato findings: Heliotrope rash of eyelids, malar rash similiar to lupus, rash on knuckles and knees
  • ANA positive, anti-Jo-1 positive (tRNA synthetase)
  • CK will be increased
  • Often a paraneoplastic syndrome so always look for a GI malignancy when diagnosed
  • Differentiate from lupus because there is overlap in many lab and physical findings
83
Q

Polymyositis

A
  • CD8 mediated inflamation and necrosis of endomysial myocytes
  • Proximal muscle weakness with similiar presentation to dermatomyositis other than the skin findings
  • CK will be elevated, ANA and anti Jo-1.
  • Proximal leads to inabilty to comb hair and rise from chair
84
Q

Inclusion body myositis

A
  • Identical presentation to dermato and polymyositis but there will be no response to steroid treatment
  • T Cell mediated, increases with age,
  • Progressive muscle weakness with dysphagia and foot drop
  • Aspiration pneumonia is a common cause of death
  • May be related to amyloid deposits
85
Q

Myasthenia Gravis

A
  • Most common NMJ disorder
  • Ab to AchR leads to muscle weakness that gets worse with use
  • Patient often complains of diplopia and ptosis that are worse at the end of the day
  • Associated with thymoma and often thymoma removal will lead to resolution
  • Dx with edrophonium and treatment with neostigmine
86
Q

Lambert Eaton

A
  • Ab to presynaptic Ca channels
  • Proximal limb weakness that gets better with use
  • Paraneoplatic syndrome of small cell carcinoma of lung
  • Rare
87
Q

Myositis ossificans

A
  • Trauma can cause fibroblasts in muscle to differentiate into bone
  • May present as odd mass on X-Ray or post injury.
88
Q

Atopic Dermatitis

A
  • IgE mediated type 1 hypersentivity commonly seen with eczema and asthma
  • Most commonly involves flexor surfaces and face
89
Q

Contact Dermatitis

A
  • Contact to specfic iritant
  • Type 4 hypersensitivity
  • Poison Ivy
90
Q

Acne Vulgaris

A
  • Keratin plugs cause backup of sebacous gland leading to accumulation of sebum (holocrine secretions)
  • P acnes can breakdown lipid and cause inflammation
  • Inflammation leads to pimples
  • Tx: DEcrease P Acnes or decrease keratin (vitamin A)
91
Q

Psoriasis

A

-Hyperproliferation of keratinocytes is fundamental problem
-Increased number of basal cell layer
-Nucleated cells in the stratum corneum
-Dermal papillae will come close to epidermis and pinpoint bleeding can occur
-Clinically will appear as salmon colored scaly rashes most commonly at the knee/extensor surfaces and the scalp
-Associated with HLAC (Type 1)
-Can also have reactive arthritis
-Tx: steroids,
UVA and psoralen can also cause death to keratinocytes and prevent their proliferation

92
Q

Lichen Planus

A
  • Polygonal pink, scaly rashes
  • Sawtooth infiltrate at dermal epidermal junction
  • Associated with hep C
  • Commonly see dystrophic nails
93
Q

Pemphigus Vulgaris

A
  • Ab to desmoglein of desmosomes, appears as a reticular pattern on immunoflourescence
  • Causes acantholysis
  • Blisters are weak because lack basal layer and are easily ruptured
  • Rupture can lead to significant skin barrier loss and fluid loss
  • Involvment of oral mucousa and easy breakage are how to clinically differentiate from bullous pemphigoid
94
Q

Bullous Pemphigoid

A
  • Ab to basement membrane (Collagen 4 or lamanin)
  • Lead to linear type 2 hypersensitivity
  • Blisters will be thicker and will be harder to rupture
  • Clinically is more mild than pemphigous vulgaris
  • Does not involve oral mucousa
95
Q

Dermatitis Herpetiformis

A

-Deposition of IgA Ab that cross react with proteins at top of dermal papillae
-Leads to vesicular and pruritic lesios thus herpetiformis
-Caused essentially by celiacs disease, if celiacs is
controlled so will blisters
-HLADQ (MHCII)

96
Q

Eryhtema Multiforme

A
  • Pink variable shaped rash marks with a central area of necrosis
  • Caused by a number of things including drugs and infections
  • Most commonly mycoplasma and HSV
  • Drugs are usually sulfa and beta lactams
  • Necrotic center
97
Q

Stevens Johnsons

A
  • Eryhtema Multiforme that will involve the oral mucousa and one other mucous membrane
  • Can be severe sqequale and is fatal in some cases
  • More commonly drugs than infection
98
Q

Toxic Epidermal Necrolysis

A
  • Extreme form of stevens johnsons with greter than 30% of body desquamated
  • Death is a high possibility
  • Treat patients like burn pateints
  • Commonly associated with drugs
  • Occurs at the Dermal/Epidermal Junction, more devastating than scalded skin syndrome
99
Q

Scalded skin syndrome

A
  • Staph Aureus A and B exfoliative toxin causes dissociation of desmosomes and leads to disintegration of the granulosum
  • Not as serious as TEN
100
Q

Albinism

A
  • Decrease in melanocyte number and quality.
  • Neural Crest origin
  • OFten defect in tyrosinase which converts DOPA to melanin
101
Q

Melasma

A

-Hyperpigmentation of the face associated with elevated progesterone, estrogen levels

102
Q

Vilitigo

A

-Autoimmune destruction of melanocytes leading to localized depigmentation

103
Q

Seborrheic Keratosis

A
  • Stuck on appearing plaques. Contain keratin coils
  • By themselves are benign
  • Leser Trelat sign is massive increase in number due to GI malignancy or lymphoma
104
Q

Icthyosis

A

-Loss of granulosum

105
Q

Pyoderma Gangrenosum

A

-Necrotic lesion of the leg that is associated with hematologic malignancy or autoimmunity

106
Q

Acanthosis Nigricans

A

Hyperplasia of epidermis leading to a velvety skin appearance
-Associated with insulin resistance or GI malignancy

107
Q

Actinic Keratosis

A
  • Premalignant condition that can lead to SCC
  • Often seen on face, hands, neck, related to UVB sunrays (pyrimidine dimers)
  • Scaly plaque
  • Often treated with topical 5-FU
108
Q

Erythema Nodosum

A

-Inflammation of the subutaneous fat in granulomatous diseases (Fungal, TB, sarcoid, etc)

109
Q

Lichen Planus

A
  • Pruriitc, purple, polygonal. Dysplastic nails are also commonly seen
  • Associated with saw tooth infiltration at dermal/epidermal junction
  • Commonly seen with hepatitis C infection
110
Q

Pytariasis Rosea

A
  • Herald patch that looks like ringworm and is often misdiagnosed
  • Shortly after there is massive increase in number of lesions throughout body
  • Self Resolves and often occurs after URI
111
Q

UVA and UVB damage

A
  • UVA causes DNA DS breaks

- UVB causes Pyrimidine Dimer formation

112
Q

Basal Cell Carcinoma

A
  • Tumor of the basal cell layer
  • Associated with sunlight and UVB radiation
  • More common on the upper face than the lower face
  • Ulcerated center with peripheral telangectasia, pearly white nodules
113
Q

Squamous Cell Carcinoma

A
  • Tumor of SC, keratin pearls
  • Can come as a consequence of actinic keratosis
  • Rarely metastasizes
  • Associated with immunosupression, arsenic and chronic inflammation
114
Q

Keratoacanthoma

A

Variety of SCC that appears rapidly and then rapidly disapears
-Has scooped out central portion

115
Q

Melanoma

A
  • S-100 positive neural crest cells
  • Caused by sun exposure
  • Depth of invasion is the primary prognostic factor and metastasis are possible
  • Associated with V600E Brafkinase mutation that can be treated with veruzumab (TKI)
  • Most common location for dark colored individuals is on the hands and feet
116
Q

Dysplastic Nevus syndrome

A
  • Hereditery increased propensity for nevi

- CDNK2A mutation

Boards Path (20 decks)

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